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Home My WebLink AboutEAGLE CREST #1 TR A LT 33A (' \ MUNICIPALITY OF ANCHORAGE ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street o Anchorage, Alaska 99501 Telephone 264~t720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME MAI LING ADDR~ LEGAL DESCRIPTION LOCATION DISTANCE TO: Manufacturer Well --~ ~ I Absorption 8rea DwelLing ~:~.~ r-I UPGRADE IND. OF BEDIMS PERMIT DISTANCE TO: IF HOMEMADE: Dwe I n~ dth Manufacturer Material WeN Nearest lot hne DISTANCE TO: I O No. of bnes ~e~ I Trench wi~ ( Top of tile to finish grade Material beneath "'] ~" inches Length Depth Type of crib Crib depth Total effective absorption area Sewer line Well Building foundation Nearest lot line DISTANCE TO: Depth Driller DISTANCE TO: OTHER Liquid depth PERMIT NO. Liquid capacity in gallons PIPE MATERIALS SOIL TEST RATING REMARKS O~stance to lot line~ ~_~ PERMIT NO. Septic tank ~ ~ Absorption area(si/ DATE LEGAL ~ "; MUNICIPALITY OF ANCHORAGE ~ '~ DEPARTI~ENT 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 NAME PHONE [] UPGRADE MAILING ADDRESS LEGAL DESCRIPTION LOCATION NO, OF BEDROOMS D,STA.CETO= IWe'' 'TSIAb,o,p,,o..re~ D.,,ing PERM,,NO..O;~O.7a.. Manufacturer -~---- -~ No. of comp~ments DISTANCE TO: IF HOMEMADE: Dwell ng PERMIT NO. Manufacturer Material Liquid capacity in gallons Well Foundation Nearest lot line- Pt. MiT NO. DISTANCE TO: I O Distance between ines No, of line~ Leng! Total I1 ) ! Top of tile to finish grade Material beneath tile Total effectiv.~e ab.$o.rl~,tion area inches Length Wmclth Depth Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: Depth~ )riller Dmstance to lot line~/~ PERMIT NO:... Sewer line Septic tank Ab$orptio~ DISTANCE TO: -- ~ .~ I C OTHER PIPE MATERIALS SOl L TEST RATING INSTALLER '"q~ Leoc~ REMARKS APPROVED · DATE LEGAL /~-.-..;~ ?.~.. . . -v -, ,..~.W UKILLII~/ I1~.' , .... - ' ,~'... . . .......... . . ... · .. . . '~ ~.....~,-,~',,... ~ ...' .,~ :. . .. .. ~" ' I ~RILLING ...... .. ~eH Owner '~m~- .M~T.~nd . · .... Use o~ Well ~atton {addr~ off Iowmhtp, ~ e , If ~own; or distance main road ~t 33 Tract A Eagle Crest Subd., Eagle ~ver Size of casing Depth of Hole feet 'Cased to -'-' feet Static waterlevel 73 ',ft.' (~i~ ribelow) land surface. Finish of well (checkone) openend ( xx ); Screen ( ); Perforated .('.~! · . , .~"~i~; Describe screen or perforai~bn iN)A ~ Well pumping test at 4 gallons/pe~ ~h~) (minute) for 1 hou~ with 100'/. r~t.' of drawdown from static l~el. ,~ .: ..... ::' completion 8/28/78 ~: ~, ~-., Date of ,' '- ' - WELL L~G Depth in ~eet trom~ .~ i~z ;~,~ ~.9~ ~: ,'," .... · '"' ~round surface ' Give details o~ io~mations penetrated, size of material, color ~d hardness ..... . ~ .. .Medium ,~ravel ~ ,.~ ~, ;'Sandy~gravel/ · ,.~and .i.:. ~t...':. ~Sandy .6ravel: cobblF. ~:Sand7,: gravel :..~, d~p Sandy, ~ater gravel' · , ' 0 TO__ 2 . 2 TO 10 10 TO 15 15 TO 40 40 TO 60 60 TO_ 62 62 TO_ 84 84 TO__92 TO. TO. ____TO ____TO ' TO _TO "', 3-- CONT'RACToR / DEPFIRTIIEfIT O~,-,~EALTH At. ID Ef.f.,,¢Z F:Of'~IIEf!TAL FT"""'~TECT I Of'~ · 825 'L--~TI~:EET, Flt'ICHOE:FIGE, RL ./ " 264-4720 . .RPPLICRf. IT R. SEVERSOt.I/D. MCLEOD SR BO.'.< 165B EAGLE RIVER 6_'94 ~l.'~..: · LOCRTIOt'I 2HD ST LEGAL L~-~ TAR EAGLE CI~:'EST S?D. LOT SIZE '1T"556 SO JAPE' FEET '" TYPE OF SOIL FIBSORE:TION SYSTEI'I IS: TREtICH °. MRXIIIUII HUM~:'..ER OF E:EDROOMS = ~ SOIL' RI'~TII/G '(SO FT/BR)= 1'10 ' THE REQUIRED SIZE OF THE SOIL RBSORPTIOt. I SYSTEM DEPTH= it--'1 LEI'IGTt'-I= 28 · 6F-:R'-.-'EL [:'EPTH= '6 THE LEt. IGTH DIMEt~SIOtl IS THE LEHGTH (Itl FEET> OF THE TREHCH OR DRRIHFIELD. THE DEPTH OF Ft TRBICH OR F'IT IS THE DISTANCE BETI,IEEM THE SURFACE OF, THE GROUflD At'ID THE E:OTTOId OF-THE EXCAVRTIOt'I (IH FEET>. : THERE IS rio SET ~IIDTH FOR TRBICHES.. , _ THE ORR'eEL' DEPTH'IS THE ~IIt'IIMUM DEPTH OF GRAVEL BETI'IEE~i THE OUTF~LL PIPE RtlD THE BOTTOtl OF THE EXCAVRTIOH '(IH FEET.>:: PERfIIT APPLICRfIT HAS THE RESPOf'I~IBIL. ITY TO ItIFORMCTHIS DEPARTI'IEf'IT DURIHG THE I~ISTRLLATIOfl It~$PECTIOt5 OF At'IY I;IELLS ADJACB~T.,'TO THIS PROPERTY RHD THE NUItE;ER OF RESIDEtICES ,THAT THE fELL ~IILL SERVE? TI-lO -,::- 2 > I I'-,ISPEOT I 01'4S ARE E:FICKFILLIt~G OF Aff¢ SYSTEM'I,~ITHOUT FltlRL IHSPECTIOH At. ID APF~C./AL' ' ' E:.Y THIS DEPARTMBIT I.IILL BE SUBJECT TO PROSECUTIOt. I.¢ tlINIMUM DISTFltIOE BETI, EEH FI fELL i~ FEET FOR Fl PRIVATE I'IELb OR ' \ TO 200 FEET FROr'I A PUE:LIC fELL DEPEII[:'ItIG UPOf'I THE TYF'E OF PUBLIC I,IELL. 'I,IELL LOGS FIRE I~:EQUIRED FIND MUST E:E RETURHE[> TO THE DEPFIRTt'1Ef'IT $,~ITHI, H ~0 DHr_, ,OF THE I.IELL COMPLETIOH. ' ,OTHER REQUIREfIEt'ITS flAY FlP. E'LY. SPECIFICATIOt'IS FltlD COf'IST~UCTIOtI~'[:,IAGRRMS ARE FIYFIILABLE TO ~ I HSURE F'ROPEI~: II/STFILLRTIOH. ' F'ERI'"I I T E.XP I RES DECEflE:ER __~--::L.. I CERTIFY THAT : i:-I A['l FFIMILIRR I'IITH THE REOUIRE~IEt'ITS FOR Ot'kSITE SEI'IERS Rf'ID 14ELLS FlS SET FORTH B'¢ THE f'IUflICIPFILITY OF AtICHORRGE. 2: I ~IILL IHSTFlLL THE SYSTEM It~ RCCORDRf.~CE ~IITH THE CODES. ~: I Uf.~DERSTRfID THAT THE Of.I-SITE SEI, IER SYSTEM f'IRY REOUIRE Ef. ILRRGEMEHT IF THE RESIDEHCE IS REMODELED TO' I[~CLUDE ~IORE THRf. I 2 BEDROOfIS. ~G~IE ...... ~ ~PP~C~IT R. SEVERSO~I/D. ~lCLEOD 0 2 4 6 Steven'A. Johnson Box 76 . Ch~g~ak, Alaska 99567 Phone: 688-3085 Performed for Legal Description Test Pi~Location Roger Severson Soils Log Percolation Test Date 8/8/?8 Lot 33, Tract A, Eagle Crest Subdivision 20' W. 60' N of SE corner 16 GW- SW 0'- 2' red brown silty sandy gravel w/organics (GM) 225 ft2/bdrm 2'- 3.5' gray brown sandy gravel w/some silt 200 ft2/bdrm 3.5' - 10.5' gray brown sandy gravel w/trace silt and cobbles-to eight inches (GW-GM) 110 ft2/bdrm'~ 10.5' to 14' gravel (SW) gray brown clean medium sand w/some 125 ft2/bdrm No water table encountered Total depth this test feet AVERAGE ABSORPTION AREA REQUIRED FRDM SOILS LOG = 140 'ft. /bdrm. DATE NET TIME (M~n.) NE, T DROP (In.) pERC RATE(Min/in) Percolation rate Signed ~ minutes/.ir~ch A ' 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 HAA# 1. GENERAL INFORMATION Complete legal description Location (site address or directions) /'~' ~-~'=~ ~'¢~-'~{ ~ . ~'~ ~' Property owner~[/+~'~-'A- ~'/~ Mailing address /~'-~ ~/ge~.' St' Day phone Lending agency Day phone Mailing address Agent ~--~.~;~//f'~ ~,J~Z~-,,~'.g~ ~'~,'~,~.~.~'~/_,~/~-~*J/ Day phone '~'-~'~2~:~::~ Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 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. 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. STATEMENT OF INSPECTION BY ENGINEER AS certified by my seal affixed hereto and as*of the vaiidation 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 informati(~n 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 David R. Dayton P.E. 20210 Donalar St. Address Chuglak, ~t~tka 995&? /"1 DHHS SIGNATURE ~)~ App;oved for' bedrooms. Disapproved. Conditional approval f6r bedrooms, with the following stipulations: AdditionalComments Note: m ~ _he--w___ f~h~s--p~y me~t-s--ex~ng State and Municipal Codes. There are nitrates present. It is suggested that a periodic testing be performed to insure the wells continued suitability. Nitrate concentration is (9.3 mg/1. Date EPA The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality Of Anchorage ~, Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description; ~:,"r'~ ~''T-~--'r' ~' A. WELL DATA Well type Log present (Y/N) Total depth Parcel I.D. Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number '~Y '~/~Datecompleted ~//'~J~~ Driller ~-'* ~ased to '~ ''/- Casing height Y wires properly protected (Y/N) ·. FROM WELL LOG Date of test Static water level Well flow 4- ? Pump level g.p.m. AT INSPECTION ---- R IVED SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank ,~J~ WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate ~, '~ Collected by: Other bacteria Bo SEPTIC/HOLDING TANK DATA Date installed ~'/? Cleanouts (Y/N) High water alarm (Y/N) Date of pumping Tank size ) 0~:::) Compartments ~' Foundation cleanout (Y/N) ~f Depression (Y/N) ~ Alarm tested (Y/N) ~'///'~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK .TO: Well(s) on lot ~5'" On adjacent lots J oc~ '1- Foundation To property line ~ ~' ' Absorption field ~- Water main/service line Surface water/drainage io-o3- 72.026 (Rev. 7/91~ Fron! CONTINUED ON BACK PAGE C, LIFT STATION Date Installed Manufacturer Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manhole/Access (Y/N) "Pump off" level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent I°ts Surface water D. ABSORPTION FIELD DATA Date installe~t ': ' ~'/~ Length -~ ! Width -~ Total absorption area Depr~s~i0n overlfield' (Y/N) ' ~' Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) Soil rating ~'~'" ' ' System type Gravel thickness ~' Total depth Cleanouts present (Y/N) ~/' Date of adequacy test for __ ~ If yes, give date bedrooms Curtain drain SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot //O / On adjacent lots [o0 ,+-' Pr,ope ,rty line I To building foundation ~ To existing or abandoned SYstem on lot On adjacent lots Ioo + Cutbank J 0 ~ Water main/service line /'-"//~ Surface water /00.,,- . Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name Date Chu~lak, Alaska HAAFee$ /?'~ Date of Payment . Receipt Number Waiver Fee: $ Date of Payment Receipt Number Department of Health and Human Serv,ces Tom Fink. 825 "L" Street Mayor P.O. BOX 196650 Anchorage, Alaska 99519-6650 343-4744 April 13, 1993 David R. Dayton, P.E. 20210 Donalar Street Chugiak, Alaska 99567 Subject: Waiver Request for Lot 33 Tract A Eagle Crest Subd. Waiver Request %WR930015, P.I.D. 050-303-38 Dear Mr. Dayton: Your request for waiver(s) of the required 100 foot horizontal separation of a septic system to a private well has been approved. The approved separation distance(s) are 85 feet from the well to septic tank on the subject lot. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Daniel J. Roth Civil Engineer On-site Services Concur: ~r ogr am Manager On-site Services ljm:%6 MUNICIPALITY OF ANCHORAG~i' Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# WR930015 PID# 050-303-38 HA# HA930105 Permit Date Received: March 23, 1993 Legal Description: Lot 33 Tract A Eagle Crest Subdivision Engineer: David R. DAyton, P. E. 20210 Donalar, Chu~iak, Alaska 99567 Applicant: Cheryl Payne Waiver Requested: Well to septic tank - 85' Criteria: e 1. Geology: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: Special Conditions: Points: 3. Other: \/ Waiver is Granted: 3~ List C6~ditions or Reasons Waiver is NOT Granted: for above: Date: ~'/2 -~3 Rec #: 24547/7037 B~ewer Amount: $ 410.00 Date Paid: 3-23-93 o+ ~ -2.? 2.? D. Ri DAYTON, P.E., R.L.S. Chugiak. Alaska 99567 20210 Donalar 696-2417 March 22, 1993 Municipality if Anchorage Dept of Health and }{uman Services On-Site Services 825 L Street Anchorage, Alaska 99519-6650 Re: Lot 33 Tract A, Eagle Crest Subd. Add Well to Septic Tank distance waiver Please review the attached site plan, well logs and risk analysis for a distance waiver from 100 ft. to 85 ft. for the subject lot. The septic system was installed in 1978 with a waiver granted at time of construction. Subsequently the waiver was rescinded by the State . A risk analysis has been performed and it'appears that the well is "almost sure to be free from any form of contamination from household sewage". Only the septic tank is within the 100 ft. radius of the well constituting a lesser hazard than a leach field. Lot 33, Tract A is the only property affected by the proposed waiver. Coliform and Nitrate tests are submitted with the }{ealth Authority Approval. The owner of the property is: Cheryl Payne 18306 Birchtree Chugiak, Alaska 99567 Tele. 688-4040 home, 694-4040 work. If there are any qiestions, please call. S~erely, /'~ David R. Dayton MU~"IC'%~'JTv "~F ~.I~*'"I"O'~.AGE ENVIkGN~.%[,".TI.I. :.ER' I~. :.S ;JIVI$1ON RECEIVED q\o,OO N59'56'00'W 1,32.00' SECOND STREET N Scale: 1' = 50' I hereby certify t~at a rnortG'~ge inspection of the LOT :33. TRACT A 1ST ADD. TO EAGLE CREST SUBDIVISION was moos on F'eoruory E~, 1995, improvements I~y Alaska Development Consultants. The addi-- tio~ to the previous osbu;It locations. This is RODNEY P. KINNEY ASSOCIATES, INC. CONSULTING ENGINE[RS 16600 C~N~R~[',.~ DRrV£, ":UIT~ 202 P~[:(907) 694-2~2 F~:(Q07) ~g4-1807 f~~.~et~,t set tn;s survey. At the time of this inspection there was '~' cf snow. it is pass[Die that other surface improvements were hi<=c~en from view. ~/j~/ .~[/~//%~ Easements of record, other thom those shown -~$~ j uu~ P'~I NW55 IM %a E NP, SECOND STREET El rM M hereby oertl'ythat a mCrt9OQ* inspection of the Improvements on the folio'wlng described propertr, LOT as, MOT A 18T ADD. TO EAGLE Cag$T SLODWUWM was mode on February 8, 199,3, ir4rovementz shown are based upon On asbuilt Survey performed. 'by Alosko DevelOPMent Consultants.' The c'ddl— tionol Irnprovemetnts have been sh.Own In rela— tion to the previous Gsbuilt lodction'�s. This 'is 0 recertification c4byilt, No corners found or :3et this survey. At the time' Of thIS Inspection there was a' of snow. It I$ possible that other $urfccO Improvements were hidden frorn view. Easements of record. other than those shown T n the recorcled plot, ore not shown hereon, Datod at Anchorago, Ala,%ka this 8th day of* February. 199&