HomeMy WebLinkAboutEAGLE CREST #1 TR A LT 58
-' Municipality of Anchorage Page ! of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: $~df'~,~/¢~ PID Number: ~',~o
Name;
~.~=,,.~, ~,. ~ Wastewater System: D New ~ Upgra~
Address: ABSORPTION FIELD
~o~ i ~ ~/~ ~Deep%ench DShal~owTrench ~Bed nd ~Other
LEGAL
WELL: g New D Upgrade G,ave, wid,h: / Numar o, ,iDes:
ClassJhcatJon (Private. A.8.C): ~ Total Depth: Cased TO: Total absorplio~ea: Pi~ material:
Dr,lief: ~ Date Drilled: Static Waler L~l: Installer: Date installS:
SEPARATION DISTANCES ~Septic ~ Holding ~ S.T.E.P.
Well Z~Z ~ /~ ~ ~ ~ ~ t+ Material: Numar olCompa~ments:
Surface
Cu~ain
Drain
Remarks: ~~ ~ ~ ~ BENCH MARK
L~ation and Description:
j Assumed Elevalion:
~dO.d
Department of H u ces ap ~
Reviewed and approved Date: -,.
Permit ~Jo. SW940010 Page 2 of. 2
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
EAGLE CREST SUBDIVISION,
Descriptio_TRACT.. A, LOT 58 PID No.: 0,5030415
Legal
~ ~ i COt 39.5 67~'0 ........................................ ] .......................................
i i ~ C02 43.0 72.0
i i [ co4 ~o.o at.o
, { i co~ 54.0 ~z,o
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L# STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PAGE 1 OF
PERMIT NUMBER:SW940010
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:OCHOA GREGORY B &
OWNER ADDRESS:3741 RABBIT CREEK RD.
ANCHORAGE AK 99516
DATE ISSUED: 1/14/94
EXPIRATION DATE: 1/14/95
PARCEL ID:05030413
LEGAL DESCRIPTION: EAGLE CREST TR ALT 58
LOT SIZE: 17820 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONTRUCTION OF:
SEPTIC TANK SYSTEM
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 ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED BY: ~%-0 .
ISSUED BY: -~oE~J~,%~rM
DATE:
DATE:
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
January 11, 1994
CIVIL ENGINEERS
(9O7) 694-2979
FAX 694-1211
Municipality of Anchorage
DEPARTMENT OF HEAL TH AND HUMAN SERVICES
825 L Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
REFERENCE: Eagle Crest Subdivision Addn. #I, Tract A, Lot 58
Request you issue a permit IMMEDIATELY to replace the septic tank
serving the four bedroom home on the above referenced property.
The existing septic tank has collapsed. We would appreciate you
expediting a permit to replace the existing septic tank and locate it outside
the 100' well radius.
If you have any questions or require additional information for your review, please
contact us.
RAS/LSU/Isu
ON Srr E
DES~N
17034 NORTH EAGLE RIVER LOOP ' SUITE 204" EAGLE RIVER, ALASKA 99577
EAGLE CREST SURD. ~1. TRACT A_
I,C) T
STRUCTURES, EASEMENTS, OR ENCROACHMENTS
SHOWN ON THIS SITE PLAN ARE AS SHOWN ON
AN AS-BUILT SURVEY DRAWN BY:
SHANE A. HOLT
IT IS THE RESPONSIBILTIY OF THE CONTRACTOR
TO VERIFY EASEMENTS, REOUIRED SEPARATION
DISTANCES, AND PROPERTY LINES PRIOR TO
CONSTRUCTION.
1250 GAl,.
TANK
GAP~G P-
CO
["ICI ST. 1250
TO B~ A~ANDOgED
4 BDRM
HOUSS
FIRST STREET
OF 1
N
CONTRACTOR IS REQUIRED TO
OBTAIN UTILITY LOCATES
PRIOR TO ANY EXCAVATION
WORK.
THE ENGINEER MAY VARY THE
EXACT DIMENSIONS AND DESIGN
pARAMETFRS IN THE FID. D, IF'
NECESSARY, TO MEET
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
MATERIAL SPEClFICATIONS
REFERENCE: Eagle Crest Subdivision Addition # 1, Tract A, Lot 58
GENERAL:
1.
The scope of this project includes the intallation of a 1250 gallon septic tank
outside the 100' well protective radius to serve the four bedroom residence
located on the referenced property. The existing 1250 gallon septic tank is
to be excavated, pumped, crushed, and abandoned in place.
Construction shall be in accordance with the approved site plan and design
drawings; Municipal permit with any special provisions or conditions; and all
applicable State and Municipal Wastewater Disposal Regulations.
The contractor shall be responsible for obtaining any necessary
underground utility locates.
Unless specifically agreed otherwise, the property owner shall be
responsible for final grading areas subsequently depressed from soil
settling.
Contractors installing wastewater disposal systems must be certified by the
Municipal Health Department for system installations. Owners installing
their own systems must also receive pdor approval from the Municipal
Health Department.
SEPTIC TANK INSTALLATION:
A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4' cleanouts for pumping access.
The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
All standpipes on the septic tank shall extend a minimum of 12 inches
above final grade.
4. Septic tanks installed with less than 4 ft. of cover shall be insulated.
Page Two
Eagle Crest Subdivision Addition #1, Tract A, Lot 58
January 11, 1994
A foundation cleanout shall be installed one to four feet from the building
foundation. In the line between the tank and the leachfield there shall be
two adjacent cleanouts (unless an effluent pumping system exists within the
septic tank). These cleanouts shall be located on undisturbed soil not more
than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward
the leachfield. The second cleanout shall be to clean toward the septic
tank.
Final grading over the septic tank shall be such that a positive slope exists
away from the septic tank.
MINIMUM MATERIAL SPECIFICATIONS:
Any septic tank proposed for installation must be constructed by a
Municipally approved septic tank manufacturer.
The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Type of Pipe Perforated .Solid
Cast Iron Yes Yes
ASTM D3034 (PVC) Yes Yes
ASTM F810 (HDPE) Yes No
ASTM D2662 (ABS) Yes Yes
Use of a type of pipe other than listed above must be approved by the
inspecting engineer.
Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow
Chemical Company Styrofoam HI or equal).
Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Femco, or equal).
Page Three
Eagle Crest Subdivision Addition #1, Tract A, Lot 58
January 11, 1994
INSPECTIONS:
Typically there will be a minimum of three (3) inspections required during the
installation of the wastewater disposal system. These inspections will occur as
follows:
The first inspection must be conducted after the tank has been set;
lines, cleanouts, standpipes, and insulation are in place; and prior
to backfilling.
2. The final inspection is to occur upon final grading of the property.
The inspecting engineer is to be contacted at least 24 hours prior to the start of
construction. If necessary, a pre-construction meeting will take place on-site. The
inspecting engineer will not coordinate, direct or control in any way the contractors
activities.
The owner shall contract with the contractor to perform the work outlined in these
specifications and plans and in accordance with the attached M.O.A. permit.
There will be no contractual arrangement existing between the contractor and
S & S Engineering. S & S Engineering shall be the owner's representative and will
inspect the work as stated above to document the contractors activities. Final
acceptance of the contractors work rests with the owner and the M.O.A.
S & S Engineering shall have no liability to the owner or to others for acts or
omissions of the contractor or any other persons performing work on this project
or the failure of the contractor to carry out the work in accordance with these
construction documents. S & S Engineering's inspecting engineer will not be
responsible for the construction means, methods, techniques, sequence,
procedures or the safety precautions incident to this project.
o...-.~, GR"'~ER ANCHORAGE AREA BOROU'~.t
· ~ ..... DEPARTMENT OF ENVIRONMENTAL OUALIi,
3500 TUDOR ROAD ANDHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE FROM WELL ~Y~""~"/~ /' NUMBER OF
MATERIAl -R'7-c9/~J~ -~'~/-~' ~ COMPARTMENTS ~
LIQUID CAPACITY /~ GALLONS. INSID~ LENGTH ~ INSIDE WIDTH ~ DEPIH~
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS / OUTSIDE DIAMETER OR WIDTH / ~7 ~
--- LENGTH /? '
, DEPIH
L,N,NG MATER'AL / /~ ~14, h D,STA.CE FBOM WEL' /e/' . BU,,D,NG FOUNDAT,ON (.'/ /
NEAREST LOT LINE
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELl
NUMBER OF LINES
ABSORPTION AREA
DEPTH: TOP OF~Tit~RADE
. FOUNDATION~
~~TF~H cEFLcH UNE TRENCH WIDTH
TOTAL L[t;GTH
, OF LINES
IN. IOTAL EFFECTIVE
DEPTH OF FILTER /~IATERIAL BENEATH TILE
IN. ABOVE TILE
WELL: Type 7~£,/~ ii'
LOT LINE ~'43
7')~,i/~/j~)DEPTH ,~s~, i DISTANCE FROM WATER
BUILDING FOUNDATION ~ I
· SAMPLE. . NEAREST
NEAREST /,~ ~,. SEPTIC ~ SEEPAGE I OTHER ~
SEWER LINE 1AN~ ~ , SYSTEM /~/ , CESSPOOJ , SOURCES
DISTANCES:
/1~-C]~ ST I~Ol~
.S, mL ~T by
4'x~716q
DIAGRAM OF SYSTEM
, . z~l 4~ ~_,~ ~ ........
' . .... ~ ~, Ir'/.o ........... i .......... :. ·
,' '.!':",,!~ :'/':"J:" .' ": .........
.~: :.' ~,~ ' '. ~ F ' :"~,~ :~ :' ::"; t :; ~.:-: :-'
_.' 'J. ,,,,,, ,..111 .:...~'~..~ ..... '-'.-I ....
............. :-q ...... ~y/l~ ~-~ ......... ~--~=- .....
~ . . ,,'. -'Ylli ,%4 ::! :': "~:-. ::.::I '.;':':'-::.-
· , ~' ~ i .'X"' .... ~ ....:'] ...... :'
...... , ~N.,'~s-~ - ~ ~ .... . t ' ' : ' ' ' t :' ": ....
........ : .......... ~ .' ~ ~.,~ TTt~T-=-[- ~::r, . :: '"
· . : - · ':~1 :,-¢~ .' .I ....... :,.,t ........
, . ~:~ ~ ........................
, . . ¢~¢ ....
DATE /T/q? So, /972- APPROVED
G.A.A,B,
GREATER ANCHORAGE AREA BOR~JUGH
NO. po /
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
INSTALLATION OF: SEPTIC TANK
TY. ..~ ... o~ .*~,.T. *o.
OTHER
-~'~'~[~/~ _/~/ NOT~; THIS PERMIT IS NOT VALID WITHOUT SOIL
COMPLETION DATE ANTICIPATED
FINAL INSPECTION~ '~4 HOUR NOTICE REQUIRED, BACKFILLING OF AN'( SYSI'~M WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
SEPTIC TANK TO SEEPAGE PIT WALt.
WELl. TO SEPTIC TANK
DRAIN FIELD
SEEPAGE PiT 100
ALSO CONSIDER AREA
DRAIN FIELD
DIAGRAM OF SYSTEM
GRAVEL BACKFILL
/ /' .~..
ABOVE
GREA_T_ER ANCHORAGE AREA BOROUGH
DEPAR'~NT OF ENVIRONMENTAL QUALI
3500 TUDOR ROAD
ANCHORAGE; ALASKA 99502
CASE f
Performed For ~ e~ /-r/~.,.~/
Legal Description: Lot~rBlock
This Form Reports Sotls-L-~g,~o
Date Performed ~/~'/~z_
Subdivision '-~r~'/ ~ ~/~ ~,~rr J~/~f.
Percolation T~st
Depth
Feet Soil
1-- 'To
Characteristics
17-5-
13- Ground Water Encountered?
If Yes, At What Depth?
if;
Reading Date Gross Time Net Time Depth to H20 Net Drop
nute
Proposed Installation: Seepage Pit Drain Field
Oepth Of Inlet Oepth To Bottom Of Pit Or Trench
COMMENTS: ~'~
Test Performed ByI //~ ~..~T/~,i' Da[a Certified By:.
Date:
(~ MUNICIPALITY 0F ANCHORAGE :', ~':~'.
DEPARTMENT OF HEALTH & HUMAN SERVICES
"' Division of Environmental serVices ·:
'" On-Site SerVices Section ~
· P.O. 'Box 196650 Anchorage. Alaska 99519-6650 .'
· 343-4744
Parcel I.D. # c~..~-=~ -
1. GENERAL INFORMATION
· Complete legal descrlptlo, n
E/,?: '.
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
tl ^
Location (site address or directions) /?-~"~.5"' /Z--""
Property owner
Mailing address
Lending agency
Mailing address
Agent
Address
~cx~o,~ . ~-~-~,~Y .~' ~'~/~',"' Day phone
Day phone
Day phone ~_.,.f,~,,,z~:) ,~.~.,y-z.~,,,'
e
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;~tt~t~ " '~;"
lng 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
a ttestin~ tO the legality and status of system.
STATEMENT OF INSPECTION BY ENGINEER
As certified y. my. seal affixed hereto.and es 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 westewater dtsposa; system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
20210 Donalar St.
Address ..
· 1/ Approved for +
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulat ons:.,
j._- .:?.' .:
-~-, ,. ~' Additi(~nal 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 pu mhasem 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 Munlclpafity of Anchorage Is not
responsible for errors o~:omisslons In the professional engineer's work.,
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:,
A. Well Data
Well type
Parcel I.D.
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Date of test
Static water level
Well flow
Pump level1
If A, B, or C, attach ADEC letter. ADEC water system number
~ Date completed ~/d_.. Driller
Cased to Casing height
Wires properly protected (y/N) "//
FROM WELL LOG
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot ,/m( /
Absorption field on lot /'~' '"
Public sewer main ,,,"o c~ 7"-
Sewer service line ~Q '"
g.p.m.
AT INSPECTION
; On adjacent lots /oo
; On adjacent lots
Public sewer manholelcleanout ~'o ~, .f--
Petroleum tank
WATER SAMPLE RESULTS:
Coliform ~)
Date of sample:
Nitrate ~, ~'7 Other bacteria
/~/~/,~,//P'~/ Collected by:
B. SEPTIC/HOLDING TANK DATA
Date installed
Cleanouts (y/N)
High water alanm (y/N)
Date of pumping
Tank size /~>~::> Compartments
· Foundation cleanout (y/N) y Depression (Y/N)
· ~,~- Alarm tested (Y/Ni ''
~',,~vC. /,'~J ,~',t,~ ~'~ Pumper .....
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot /~/
To property line ~
Surface water/drainage
72~26 (3~93)' Front
On adjacent lots /~c> x- Foundation
Absorption field /~",~- .Water main/service line .~"~'
· CONTINUEDON BACK PAGE
C. UFT STATION
Date installed
Size in gallons
Vent (Y/N).
High water alarm level
'Pump on' level at
Manufacturer
.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 lots
Surface water
D. ABSORPTION FIELD DATA
Date installed
Length / 7
'Total absorption area fl~z.~.~-"' Cleanout present (Y/N)
Date of adequacy test ~?~,5.~ ~/~/'~ Results (paSS/fail)
Water level In absorption field before test
Peroxide treatment (past 12 months) (Y/N)
,/~' /?~Z. Soil rating (GPD/FF)
W~dth ! ? .Gravel thickness
Y
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Total depth
Depression over field (Y/N) ~/
for .-~ Bedrooms
After test :~.~ ~,~,~,/
If yes, give date
Property line
.To building foundation
On adjacent lots
Surface water
Curtain drain
On adjacent lots / D O 7'- ~,)'"'"'
~/~'/-" .To existing or abandoned system on lot
.Cutbank ~/,'~- Water main/sauce line ~-'/--
/~, c> ./--- Driveway, parking/vehicle storage area ~' ~'"~
ED ENGINEER'S CERTIFICATION
I cerb'[y that I have checked, verified, or confc~ned to all MOA and HAA guidelines in effect on the date of this inspect/on.
David R. Dayton P.E.
~ngin~fs Name ~ ._ ~
H~ Fe ~' ~ ~ · ~ ' Waiver Fe
Date of Pa~ent /~ ~ ~ ~ ~ Date of Pa~t
~ocaipt ~um~er
72.026 (W93)* Back
10/17/94 (38:4G CT~E Eh~JIRON~NTAL LAB SERUICES
Oommemial Testing & £ngineeHn
· Envizonmental Laboratory Services ~
5633
CT&E Ref.$ :94o5200-1
Client r~ample ED :L 58 TRDEAGLE CREST
Anchorage, AK 99518-1600
Tel: (907) 562.2343
Fax: (907) 561-5301
Client 14a~e tOAVIO DAYTON, P.E. WORK Order :829?6
Printed Date :10/14/94 ~ 15130 hrs.
O~dercd By : Collected Date :10/10/94 @ 11:00 hrs.
p~oJect t~ae : Received D~te :10/t1/94 @ t2:45 hrs.
Pro~ect! :
PWSID ~UA Tect~,icol
Director :ST~PH~ C. Z[~
~le Re~arks: ROUTINE /~ CO~I~cr~u BY: D.R.D.
QC Allowable Ext. Anal
Results ~p.~al Units Met~cd Limits Date Date Init
pareme, ter ... _ .........................
N ttrate-N 0.67 ~ ~A 353.2/300.0 10 t0/t2
UA = U~va~ab~e
* See S~cia[ lnst~i~s A~ve HA = Not ~1~
** S~ ~ple R~rks ~ve
~= U~etect~, Re~rt~ value ts the practi~l ~nttft~tt~ limit. LT = ~ss ~n
= Seco~ry dilution. ~ = Greater
ENVIRONMENTal FAC[L~T ES N A~$KA. COLORADO. FLORIDA. ILtlNOIS. MARY~ND. NEW JERSEY, OHIO, UTAM. WEST VIRGIN[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
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
Complete legal description Lo:~ 58~ Tr,,c~ A~ E~zg~¢ Cr~t S~§dJ.v~.4io~t~
Location (site add.ress or directions) 19515 F~t S~e~;~
Property owner
Mailing address
Lending agency
Mailing address ·
Agent~n~'~j. ~ F~
G~.g ~ Evelyn Ochoa
Day phone
Day phone
Address ?~_~_n_n ~,¢._t~_~]~_~,~
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
Day phone""~q4-~0 '",
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.
J
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 ofsystern.
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the valic~ation date shown below, I vet;fy tha~' 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
17034 Eagle River Loop Road
Engineer's signature
DHHS SIGNATURE
Appro:,~d for
DisapR~(~ved'
Conditional approval for
Phone
b'edrooms.
bedrooms, with the following stipulations:
Additional Comments
By: .... Date . .
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. Em ployees 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: ~..-c~ ~ "["~/~.~' ~ ~.~t',~,..~z.-- . Parcel I.D.
A. WELL DATA ' -
Well type'[;:~'t V N'~'~-.'' If A, B, or C, attach ADEC letter. ADEC water system number
Log present (~) ~
Total depth ,.'z~¢::, O ~
Sanitary seal (~N) ~
Date completed '~' tc~'~3''' Driller
Cased to ~1'~[~' Casing height
Wires properly protected (~TN)
FROM WELL LOG
Date o.f test ",, ,,
Static water level
Well flow
Pump level ,,"
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot .~
Absorption.field on lot
Public sewer main
Sewer service line
WATER SAMPLE RESULTS:
Coliform 'O ¢'"~ll~j2_ Nitrate
Date of sample: [\ "~
g.p.m.
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank
Collected by:
B. SEPTIC/HOLDING TANK DATA
Date installed '~','"~ -'"J"/." Tank size
Cleanoutst~N) y Foundation cleanout (Y~)
Other bacteria ~=~-
S & S ENGINEERING
17034 Eagle Rl~er Leep Road No. 2[~1
Eagle River, Alaska ~577
Compartments 'Z...
Depression (Y,~' /J
Alarm tested (Y/N)
Pumper
High water alarm (Y(~) ~J
Dale of p~mplng · ~ t -"~'~" '
SEPARATION DISTANCES I~ROM SEPTIC/HOLDING TANK TO:
Well(s) on lot ~'"7'l
To property line ~r2 ~
Surface water/drainage
Onedjacentlots I C)C) i.e- Foundation
Absorption field ..~,~ t - . Wat~rmain~service~i~
72-026 (Rev. 7/91) F~t CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons '
Vent (Y/N)
High water alarm level
Meets .M.O.A .elect~'~
SEP~TANCE FROM LIFT ~TATIoN TO:
Wel~on~lot'.''''. ~ · ' On adjacent I~ts";
' "' Manufacturer '.
Manhole/Access (Y/N) ~------'"---
"Pump on" level at ' el at :
~ycles tested ,
Surface water
DJABSORPTION FIELD DATA
Date installed .... ~' -'~PO
..... % , ,-
Length ["] '*'" ' 'Width
Total absorption area
Depression over iield (Y~
Results ~ail) ~ for
Peroxide treatment (past
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Soil rating % {.~'~ *Jr/~*~' SYstem type
Gravelthickness ~ ' ' Totaldepth |"~
Cleanouts present ~YN)
Date Of adequa(~y test \ \ ° ~' ~ I
)~ If ye~, give date "J/~-
bedrooms
On adjace'nt lots '
~ c)c3 ~ 4' Property line
.~
To existing or abandoned system on lot
Cutbank ~ ~' -' '~ -~ Watermaln/serviceline, Driveway. parking/vehicle storage area' -
I certify that I have checked, verified, 'or conformed to all MOA and HAA guidelines in effect oq~tl~.~ate ~f this Inspection.
Date ....
, ,, , . ~.. · ..~-~
/?b · .,
H~ F~e $ Waiver F~: $
Date of Payment //-/~ ~ / Date of Payment ' ' ' '
Receipt Number .3 ~ ~ ~ ~ ~ ~1 ~ ~ Receipt Number
7'2-026 (Rev. 3/91) ~,aCk MOA 21
CHEMICAL & GEOLOGICAL LABORATORY
56333 STREET ANCHORAGE, ALASKA99518 TELEPHONE ~0~ 562-2343 FAX:(907) 561-5301
Date Report Frinte~: NOV 7 91 I 03:12
~W310
Colleotea NOV 4 91
Recetvea ¥OV $ 91 I 14:10 hzs.
Client Mane :$ & R
Client Acct
3FO I tO ! MO)~ RECEIVED
Send Reports to:
2)
Chemlab Ref l: 915958 Lab Smgl ID: S hertz: WATER
Allovable
PareMter Teste~ ResuJ. t Untie ~thod Liners
MITRATE-M 0.68 B~/1 EPA 353.2 10
MOnO Detected °' See $e~le ie~Mrke lbove
~SGS Member of Ihe SGS Group (Socl~t§ G~n6rale de Survei,ance)
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received March 25, 1976
Approval 'requested by: ~lamka
Mailing Address:
2. Property Owner:
Mailing Address:
3. Legal Description:
4. Location:
601 West 5th Avenue
Phone:
Lee Howard Phone:
383 Nowe11 Avenue, Juneau, Alaska
Type of facility to be inspected
Well Data: Individual
A. Type D/q,7/=/3
C. Construction ~ ir'~l) ~
Single Family
274-3561 x 235
Lot 58 Tract A Eagle Crest Subdivision
NHN 1st Street, Eagle River .. ~2..- '",
300'
Sewage Disposal System:
A. Installed
C. Septic Tank:
O. Seepage Pit:
E. Disposal Field:
B. Depth
O. Bacterial Analysis
On-site system
May ,1972 B. Installer
1. Size
1. Absorption Area
Total length of lines
2. Manufacturer
2.
7',fen'- I;
Material ,/~- e~/Iql
Distances:
R. Well to: Septic tank ~'?~ , Absorption area
Nearest lot line '~O-Jf , Other contamination
/
B. Foundation to septic tank (~7 , Absorption area
C. Absorption area to nearest lot line
Sewer Lines ,
EQ-034 (1/74) Page 1 of two pages
333O
J~UN~CIPALITY OF AHCHOP. AOF
'GREATER ANCHORAGE ARt/, BOROUGH D~Plr. OF H_=;Z. TH &
Department of Environmental Quali
"C" St., Anchorage, Alaska 99503 - 274-45G1
UAR 2 5 1976
INDIVIDUAL SEWER & WATER FAC[LiT[ES ......
· 1. Type of Ips'pectio. q:. iCt,lRO' . VA
2. Property O,tner: [--~'~ I-[o~J~.~c~ '
Nailing Address:9~ ~o~e~J'Aue ~,~
.4.
FHA
CONV ~"' .
~ay Phone _ -
flame of Buyer:
~,ame of Lending institution: A L J~/I ~ . , ~._~ .1
Type of Facility.to be 'inspect:ed:. '~o-~J~
Water Supply.. ,..'
Type of Sopply: · Public Utility'i__ Individual
" If' Indtvidu~l,'number of dwellt'ng~ presehtly'se6~ed
If Individual, depth'of well
9~ Sewage Disposal..'System
Type.of S~st~m: Public Utility .__
.............. I.f..Individual~ dat~ of installation
Bd~s.
'indiviaoal (on-site)
Page 2 of tWo pages - Req...st for Approval of Individual ~"~r & Water Facilities
Le~aq.Descr~ption Lot 58 T:act A I~agle C:emt Subclivision
Coo~nents
Approved
__~Oisapproved Oate~//~
Approval kValid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAm4 OF SYSTEM
certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operattna satisfactorily.
SIGNED k~/.~LY)JL.~ ~/
EQ-034 (1/74) ~
HAMILTON EXCAVATING
Box 155 Phone 688-2618
Chugla~, Alas?a 99567
CUSIO~S ~EC'D
~ Red;f . KEEP ~IS SLIP FOR REFERENC~
VA Administration
Loan Guaranty Office
42? "D" Street Suite 214
Anchorage, Alaska
Subject: Lot ~8, Tract A,
Eagle Crest
Subdivision
Dear Sir:
The sewer syste~ for the subject property was approved by this
~epart~;ent on )lay 30, 1972 for ~ four bedroom: house. The yell
is now approved and the water sample taken at the subject
property proved to be satisfactory.
If you have any questions regardtnQ this t~atter, please contact
the undersigned.
Sincerely,
Lynn S. Coad
Envtront~ental Specialist
bb
cc: Lester I{ottard
Star Route Box 144-B
Eagle River, Alaska
99577
July 5, 1972
Lynn Coad
Department of Environmental Quality
Greater Anchorage Area Borough
3500 Tudor Road Pouch 6-650
Anchorage, Alaska 99502
RECEIVED
Dear Mr. Coad,
This letter is per your request from our telephone conversation
of July 5, 1972, regarding operability of a now abandoned
cesspool. I've attempted to include all applicable dates and
occurances so that a statement verifying inoperability of that
cesspool is warranted. I truly appreciate your cooperation in
this matter and have. given both my home and business phones
at the close of letter.should you have any questions.
Legal Description of Property
Lot 58, Tract A, Eagle Crest Subdivision
Home first occupied by me on April 5, 1972.
House drains started to malfunction approximately April 25,
1972, became inoperable on April 27, 1972. The cesspool was'
pumped out on April 28, 1972. Drains did not function immediate-
ly, but a liquid drain cleaner cleared the line.
Within 10 days the drains were again inoperable, the cesspool
again full (water level less th~n one foot above the bottom
of the vent pipe.gr, about three feet belo~ ground level).
Effluent during was nearly all water.
Within another 10 days drains again were not functioning.
Close inspection of drain lines determined water was s~eping
out through a loose drain joint beneath the house. Pumping
and liquid drain cleaner were again employed, to no avail%
A 100-foot snake was run through the line several times. I
noted an obstruction in the same area during every run of the
snake. Although I managed to break through the obstruction
each time, drainage di~ not occur, even with the snake in the
line.
~ge 2.
Believing most of the problem may have been due to substantial
ground water as a result of the rather sudden thaw at that time,
I lowered water usage (or rather drainage) to an absoulute
minimum, for a period of one week or so. This had no effect.
The water level in %he cesspool remained the same and any
apparent drainage (sinks, toilet) was merely through the pre-
viously mentioned drain joint beneath the house.
A complete sewer system was installed the weekend of May 28,
1972 (Memorial Day). During the work (Permit ~2031, Hamilton
Hxcavating) I observed the following:
1. Water level in the former cesspool had not lowered
(lowered slightly when old line was tapped and drained).
2. The existing drain line was water filled.
3. There was no evidence the area was saturated with
ground water. Of course the new site was in an area
removed from the old site.
Finally, as of July 4, 1972, the old cesspool was still filled,
indicating to me at least, all drainage features were. gone.
The new System has been functioning without problem.
Yours ,/~ J
Lester J. Howard
Home Phone: 694-9313
Business Phone: 277-6652 Ext. 120
~ ~ R~d, Ancho~ge, kles~ ~7 27g~6 , '
Da~e
3. Legal ~sc~p~ton: ,, ./, . .~ .I~ , '
D. seepage
E. Disposal E~eld: Total ~th o~ Lines
A. Well To=
Sap~ic Te~k
Foundation to Septic Tank I7 "> A~Sorption Area ,
A~sor~tio~ ~ee t~ ~eereet Lot ~ine ~-~
Request .~o.~ Approval of It.o~vtdual Sawer & Water Pectlttie. !i
,.'. ~"'~' ~ ~ J~ l l '
D)AGRAU OF SYS'TE~
! certify that the tnform~tion contained in this request for approval to be a true
end accurate repreae~tatton of the aub.iact aewer a~ w~ter facilities located et:
Date
GR,.,~TER ANCHORAGE AREA BOROUGh.
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99507
DATE RECEIVED:.
INSPECT:
dde'REOUEST FOR APPROVAL OF
INDIVIDUAL SEWER ANDFoR WATER FACILITIES
APPROVAL REQUESTED BY:
A~DRESS: ~
NUMBER OF BEDROOMS:
NELL DATA:
A. TYPE ~/~
C. SIZE ~ (~ ~
O. CONSTRUCTION
E. BACTERIAL ANALYSIS
6. SEWAGE DISPOSAL SYSTEM:
Ae
SEPTIC TANK (IF HOMEMADE,
1.
2.
3. MANUFACTURER
SHOW DIAGRAM ON BACK)
SIZE
4. INSTALLER
'*-.. '~- APPROVAL REQUEST"FOR SEWER & WATER FACILITIE~~
;. PAGE TWO
SEEPAGE PIT
1. SIZE
2. LINING
C. DISPOSAL FIELD
1. NUMBER OF LINES
2. TOTAL LENGTH
REQUIRED MEASUREMENTS
A.
B
C
D
E
F
G
H
WELL TO SEPTIC TANK
WELL TO SEEPAGE PIT ~
WELL TO SENER LINE
WELL TO PROPERTY LINE 30~+
NELL TO OTHER POSSIBLE CONTAMINATION
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
SEEPAGE PIT TO PROPERTY LINE
8. COMMENTS:
APPROVED:
DATE:
APPROVAL VALID FOR ONE YEAR
GREATER ANCHORAGE AREA
DISAPPROVED:
DATE:
FROM DATE SIGNED.
BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY