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Home My WebLink AboutEAGLE CREST #1 TR A LT 21NAME 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 I~ UPGRADE LEGAL DESCRIPTION ' LOCATION O,STANCETO: I I^bs°rpt'°' Manufacturer DISTANCE TO: Type of crib Crib d~ameter DISTANCE TO: Total le~.h..~ f th nes Mater~al beneath tde Depth lb depth Build)ng foundation IMaterial Nearest Ito~n ef Trench w~ inches inches NO. OF BEDROOMS PERMIT NO. No. of compartment~_. Liquid depth PERMIT NO. Liquid capacity in gallons PER T Total ef.f~t~..~o~l~on area PERMIT NO. Total ef lecture absorption area Nearest lot line Driller D~stance to lot hne PERMIT NO. DISTANCE TO: foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS "~OIL TEST RATING~i INSTALLER REMARKS DATE 72~13 {Rev. 3178) LEGAL ON--SITE PERMI'T NO: DATE ISSUED: MUNil3IPALITY 01--- ANCHORAGE DEPARTMENT C~--HEALTH AND ENVIRONMENTAL ~gTECTION 825 L STREE~264-4720 ANCHORAGE, AK SEWER' & WELL PERMIT 850520 0&/18/85 APPLICANT: ADDRESS: CONTACT PHONE: % S&S ENGINEERING CURTHESS CONST SRB 19&-X EAGLE RIVER, AK 99577 694-2979 LEGAL DESCRIP: LOT SIZE: MAX BEDROOMS: 'SUBDIVISION: EAGLE CREST SECTION: 7 TOWNSHIP: 11070 (SQ.FT. OR ACRES) LOT: 21 14N RANGE: 1W BLOCK: A Listed.below are the options available to you system. Choose'the option in designing your that best fits your site. septic TRENCI-I BED I~. DRAIN DEPTH TO PIPE BOTTOM (FT.)' 4.0 4.0 4.0 GRAVEL DEPTH (FT.) &.O 0.5 5.5 TOTAL DEPTH (FT.) 10.0 ~ 4.5' 7.5 GRAVEL WIDTH (FT.) 2.5 17.0 5.0 GRAVEL LENGTH (FT.> 52.0 54.0 41.0 GRAVEL VOLUME (CU. YDS.) 19.5 21.5 ~0.4 TANK SIZE (GALS) 1,000.0 ** 1~000.0 ** 1,000.0 ** SOIL RATING (SQ. FT./BR) 125 125 125 ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS I certify that: 1. I am familiar with the requirements for on-site sewers and wells as set ~forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 5. I will adhere to all MOA and State of Alaska requirements ~or the s~t back distances from any existing well~ wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maximum of .5 bedrgoms and any enlargement will require an additional permit. IF A LIFT STATION IS INSTALLED THEN (1) AN ELECTRIO~.-~PERMIT AND INSPECTION MUST BE OBTAINED; (2) WILL NOT BE APPRO~I~ W~HOUT AN ELECTRICAL INSPECTION REPORT; AND ELECTRICAL W~US~~ BY~ICENSED ELECTRICIAN. SIGNED .~i~ DATE: APPLICANT. 7~S~-~GINEERING CURTHESS CONST · ,sS,E' BY' ~~ ...... DATE, IN AN AREA COVERED BY MOA BUILDING CODES, AS-BUILTS (5) .THE SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION SOILS LOG - PERCOLATION TEST PERCOLATIO.~ TEST LEGAL DESCmPT~ON= ~ ?--~ 1 4- 5 6 7 8 9 DATE PERFORMED: ~::~- SLOPE SITE PLAN I / 10 11 12 13- 14 15- 16- 17- 18- 19- 20- COMMENTS PERFORMED BY: ENCOUNTERED? IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop R PERCOLATION RATE L~ {minutes/inch) TEST RUN BETWEEN FT AND FT 72-008 (6/79) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services · On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 3434744 ', CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # O &'"O -- ~o ~ -30 'V HAA#. 1, GENERAL INFORMATION -.. ' Complete legal description 1998 } Lot 21; Tract At Eagle Crest Subdivision 19546 Third Street Location (site addFess or directions) Eagle Rivert AK F. ag 1 e River, ,"Property owner '" ' Theresa M. Gray ?...'.Mailing address 1954~ Th~_rd Street .Lending agency - ,M~iling'address Day phone 694.-.6664 AK 99577 Day phone Agent Address Day phone 257-0129 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 ~' 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system.. / ' 's 4. TYPE OFWA TEWATER DISPOSAL: : NOTE: Individual on-site xxx Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 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 wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further {/erify 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 regulatio~3s in effect on the date of this inspection. · 5& S ENGINEERING . Address Engineer's signature Name of Firm 17034 Eagle River Loon Road I~. _e_t~. Phone C ct ff - ~. q -~ ~ · ~agle River, Alaska 995~ ' DHHS SIGNATURE __ Approved for -~ Disapproved. Conditional approval for bedrooms. 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 orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct Inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) Legal Description: A. WELL DATA Health Authority Approval Checklist ~ ~: [~&L/: C..d~51' Parcel I.D.:. Well type Log present(~l) Total depth If A, B, or C, attach ADEC letter. ADEC water.system number L~r::~ Date completed ."~""o ~ ~- 2~: Cased to 5011 Casing height (above ground) Wires properly protected (~VN) c~ G ~ Date of test Static water level Well production FROM WELL LOG AT INSPECTION Z(,, 7,- / Z'.~,~ / g.p.m. WATER SAMPLE RESULTS: Coliform C~ Nitrate ,I Collected by: B. SEPTIC/HOLDING TANK DATA Date installed 4-~7~' Tanksize /~D~) Foundation cleanoul(~). ~'.~ Depression (Y~) ~ ¢. ABSORPTION FIELD DATA · 7034 Eagle Rhmr' Loop Road No. 204 r. agle Klver, JUaska 99577 Number of Compartments High water alarm (Y~) Datelnst~lled gJ~l~,~ Soilrafing (g.p.dJfff~ ~.~::~ ~/stemtype Length ,,~,~ I Width "51'~''~ G ravel thicknass below pipe Total depth JO! Effective abSOrption ama "~-i'Z' Monitoring Tub. pmsent~N) ~) Depression over field (~ Date of adequacy test "5/4r ~c~ Rasults ~l/Fai,)~A~% For "T'..(~:. bedrooms Pluiddepthlnabsorpfionlleldbefomtest(in.); ~:~,~.~ Immedlatelyafter~fC~gal. wateradded (in.): Fluid depth 17~ (ins) Minutes later:. ~I~- Abeorpfion rate = g.p.d. PeroxJdetmatment(past12months)(~ /~Ol~e ~.,~ov,t~ Ifyas, givedate 72-026 (Rev. ~6)* D. UFT S~ Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested E. SEPARATION DISTANCES Size in gallons 'Pump ~ 'Pump off' level at* *Datum ~ SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic sewice line ~-~ On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~ I -~ Property line ~ ! .t. Absorption field ~' Water maln/sewice llne ID ' 4' Surface weter/dralnage 100 I+ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line ~) I Building foundation I~t ~ Water main/service line Surface water I(;~ l ~- Driveway, parking/vehicle storage a?a 0 Curtain drain (~O/~'. ~,/ Wells on adjacent lots ' ' ~"" ' R ENGINEER'S CERTIFICATION I ceriffy that I have determined thru field inspections and revfew of Munic/pal -' ' ~'ystems are in conformance with MOA HAA guidelines in effect on this date. Date Waiver Fee $ ~_0. O0 Date of Payment 3 - 2 '*~"'"c~ ~''''' HAA Fee $ "~<::)C:~ .0 0 Date of Payment ~ - 2 ~'"- (::~*~::~ Receipt Number ~) :~- c/~ [~.~_.~ Receipt Number 02~'"~[ (~0~~-) 72-028 (Rev, 3/9S)* Rick Mystrom, Mayor Municipali.W of Anchorage Department of Health and Human Services 825 "L" Street P,O, Box 196650 Anchorage, Alaska 99519-6650 http://www.ci.anchorage.ak.us 907-343-4744 April 6, 1998 Robert C. Cowan, P.E. S&S Engineering 17034 Eagle River Loop Rd. Suite 204 Eagle River, AK 99577 · Subject: Waiver Request for Eagle Crest Subdivision Lot 21, Tract A Waiver Request #WR980011, PID #050 303 30 #HA980065 Dear Mr. Cowan: Your request for a waiver of the required 100 foot horizontal separation from the absorption field to a private well has been approved. The approved separation distance is 85.0 feet. The waiver is for the subject lot absorption field to the well on lot 22. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-4744. Sincerely, Daniel J. Roth Civil Engineer On-Site Water Quality Program MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR#[~_~i~_ PID# 050-303-30 Date Received: March 25, 1998 HA # ~C%C~9 (-~r~l Permit # Legal Description: Lot 21 Tract A EaKle Crest Subdivision Engineer: Robert C. Cowan~ P.E~,S & S EnKineerinK Applicant: 17034 Ea~le River Loop Roadr Suite 204, EaAle River, Alaska Theresa M. Gray 99577 Waiver Requested: leachfield on Lbt 21 Tract A EaKle Crest to the private well on Lot 22 Tract A Eagle Crest Criteria: 1. Geology: Points: A. Water Table WJ~IVER RE~L4EST i~J~ ~8.,c~RPTIfl~ FIELD O~/$#.~.FG()' /mT' To ~'z.I. o4/ /.or ~Z OF UELC HISreRY- I P~/~, r $ '. ', "T MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) (b) Legal Description (include lot, block, subdivision, section, townshi_p~ range) Location (address or directions) Appl,cant Name.. _~.'~' ~'~'~-'~'~'~,,'~ Telephone: Home Applicant Address (c) Applicant is (check one): Lending Institution I-I; Owner/builde~,,; Buyer []; Other [] (explain); (d) Lending Institution . ~_/Z~AJ ~"~'- Telephone (e) Real Estate Companyand Agent ~ _ ~~ Address Telephone (f) ~e HAA to the following address: TYPE OF RESIDENCE Single-Family~ Multi-Family Number of Bedrooms Other WATER SUPPLY Individual Well~. Communityrl Public[] Note: If comm unity well system, must have written confirmation from the State Department of Environmental Consen~ation attesting to the legality and status. SEWAGE DISPOSAL OnsiteJ~: Public[] Community[] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental attesting to the legality and status. ~onservation" .~ Page 1 of 2 1~.ms(~) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigatior~ of this Health Authority Approval 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 ~ & ~£-*....~ ....... - ----t,,~,,.., Telephone Address -...~L~ Date DHEP APPR~ Approved lot Approved Disapprovm Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based aotely upon the representations given in paragraph 5 above by an independent professional' engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 !:' ,72-~s i'l'us4) WELL DATA Well Classification Well Log Present.N) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 ~UNI¢IPALITY Of: ANCHO~AG3 DEPT. DF HEALTH ENVI£C, NMENTAL P~CTECTIOi'I Legal Description: Total Depth '~ f Cased to Static Water Level "~'~"'~.-s Casing Height Above Ground Electrical Wiring in Conduit (t~N) Separation Distances from Well: To Septic/~'_-'!~_!~g Tank on Lot If A, B, C, D.E.C. Approved (Y/N) /'~/~"~/~' Date Completed . ~,~-~-- ~"~"'"' Yield ~ t ! Depth of Grouting -"'-' Pump Set At L) ~ '~-"~' ~ Sanitary Seal on Casing~N) Depression Around Wellhead (Y~ ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot ~ ~c:,~-~ I j~. ; On Adjoining Lots To Nearest Public Sewer Line ~ /~' To Nearest Public Sewer ~.,~ CleanoutJManhole ~.3/A To Nearest Sewer Service Line on Lot Water Sample Collected by ~'_~;-4> .~,1~,~....~C.~_~,-..3~, ;Date ~ -'Z.--~-'2-[::~. Water Sample Test Results ~'""~/>'~"t~"/~-.c--.,rz.-, ~ ,.-- I Comments B. SEPTIC/~ TANK DATA Date Installed Standpipes (~N) Air-tight Caps Depression over Tank Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) ' Separation Distances from Septic/Holdin~g Tank: To Water-Supply Well ~ ~" ~ '"" To Property Line To Water Main/Service Line ~ c:> I..~. Course ~ Size .~ No. of Compartments ~ Foundation Cleanoutd~N) Date Last Pumped ~ '-' r'~ ;for ~'~/'~' Temporary Holding Tank Permit {Y/N) ~ To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Instafled ~ -' ~"~' Width of Field '~f'C>~ Square Feet of Absorption Area Depression over Field (Y/~). Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot v.~//~ To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments '~ "Z.,~ -'¢' t,~-,~-''' Length of Field Depth of Field Gravel Bed Thickness ~ ~ ,~..4p ...,,,. Standpipes Presentil[~llN) Date of Last Adequacy Test Type of System Design To Property Line To Existing or Abandoned System on ; On Adjoining Lots ~ "~ ~ ~ ~,'c='l ~ To Cutbank (if present) {~3/.~, -,/,, D, LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level ai Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA '* Check Permitted Bedroom Rating Against HAA Request I certify that I have checked, verified, or conformed to all MOA and _.HAA guidelines in effect on the date of this inspection. Signed S g~ .*" E~!~3I~ESRI;',~ Date Company'C,,.~,LE RIVER, AL,C,~,;',A .~'377MOA No. ~(<~"-'~T-~) ..~ Receipt No. Date OI Payment ~' ,'~- ~"~'- Amount: $ z),.~'~0~ ' Page 2 of 2