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Home My WebLink AboutEAGLE CREST #1 TR B LT 22 bevelopment Services Department Building Safety Division On -Site Water & Wastewater Program t 4700 Elmore Road P.O. Box 196650 Mark Begich Anchorage, AK 99507 S A F E: T Y Mayor www.muni.org/onsite (907) 343-7904 Pump Installation Log Parcel Identification Number: 65 0 - � 't 2 - 0 3 Legal Description Ec� 6-e s I :t4- I Ty- 43 L .2.2 - Pump Installation Date: 'Flell &' Pump Intake Depth Below Top of Well Casing: -74 4/feet Pump Manufacturer's Name: e-.1-7 K E D Pump Model: C-ri 4? S 2 / Pump Size I hp Pitless Adapter Burial Depth: / 2, feet Date of Issue: ego �Saza, Proverty Owner Npme & Address: '3yZF-T #IQA.> -5 0 6*1 _?_ ^-,,o 5 5:? . L -_A (� Lc A, . Pitless Adapter Manufacturer's Name: A41qVt.1rj0.Sj^r Pitless Adapter Installer: A)r� Well Disinfected Upon Completion?yF-1 Ido o Method of Disinfection: K Comments: Pump Installer Name:ANCHORAGE WELL & PUMP SERV. 330 EAST 76T" AVENUE *14 ANCHORAGE, AK 99518 PHONE: 907-243-0740 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. GRE.~ '~ANCHORAGE AREA BOR Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH MANUFACTURERS~ lurer INSIDE WIDTH t/~J' r,~ ~ .UMBER OF *¢(> MATERIAL ~ u~.~ COMPARTMENTS J LIQUID DEPTH IIQUID CAPACITY t0~ GALLONS. SEEPAGE -fu~.: NUMBER OF PITS LINING MATERIAl (~OCK BUILDING FOUNDATION , ADDITIONAL ABSORPTION DIAMETER (,~;; OR WIDTH CRIB SIZE: DIAMETER NEAREST LOT LINE__ LENGTH__, DEPTH DEPTH---/I DISTANCE FROM: WELL I~ A~SORPT,ON AREA (WALL AREA)'rl~ ' SQ. WELL: · YPE '%,~-,~ CONSTRUCT,ON ~1~ BUILDING NEAREST NEAREST FOUNDATION LOT LINE SEWER LINE CESSPOOL APPROVED OTHER SOURCES DISAPPROVED REMARKS DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK I COI SYSTEM I lO I DISTANCES: DIAGRAM OF SYSTEM INSTALLED PIPE MATERIAL: LOT SLOPE: REMARKS: Form NO. EQ-031 LOG OF DRILLING by A DRILLING COMPANY STATIC LEVEL OF WAT£R DRAW DOWN FT. .~j~ ' ' FROM ~.' FT. TO _~ -- ~'-' ' ' ^ ................................. rr ............ ::.~.~t,~ U,-"' ~o~....~..~. ........ FROM ~ ~ ..........~. TO.....iil ............. ~..~T~.~I ..T...( ~'//,' ,:'( FROM .... - ........ -, .......... ,,. TO.~:i~Y. ............. ~....~.~.~.~Z ............. r~o~.......l.~: ........... ~. TO.....~...)~ ........... ~..C~.~r~.~;~, ~ r.O. )~':t ~. TO )~ --' ,~ ~" .......................................... ~.N~. r~o~ ....... ~:,.~. ........ ~. TO ~ ).~ ~,., /,~,~. = ~ ,~,. .... ,~' ......................... .. raoM ~ r~o~.....~..:~._~ ......... ~.ro I ~ L ~. ~ ~,~ ~ j -- ......................... [. .............. ~.~l F~OM ........................ ~. TO ...................... ~ .............................. r,o, /l~. ....... ~. ro.....!.2.~} ~'.-~'l~J..t(-4'ff' ':" ~ao, ....................... ....................... ' .............................. ' FROM .......................~. TO ...................... ~ ........................... FROM ) ~. TO ~ I ~' ~ (~J.~. / ~ '. ~ ' .................. ~ ................. · i-~...~...t..n ~ ~.~.t ': ~ ~OM ........................~. TO .......................~ ............... MISCL. INFORMATION~ ~ " " L,.-~. =., ,-,_ ~t ~,~ ~',~ J MUNICIPAUTY 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 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section. Locationze addre o °r direc, ions Applicant Name ~ ~ ~o ~ ~,elephone: Home Applicant Address (b) · (c) Applicant is (check one): Lending Institution r-I; Owner/builde Buyer 1'3; Other I-I (explain); (d) Lending Institution Address (e) Real Estate Company and Agent __ Address Telephone (f) ~e~e~n?ne~Tele hone 2. TYPE OF RESIDENCE Single-Family~ Multi-Fam~/I-I Other Number of Bedrooms ~ WATER S U PPis' Individual Well,,[~ Community r'l Public r3 Note: If commbnity well s~,stem, must have written confirmation from Ihe State Department of Environmental Conservation attesting to the legality and status. S EW~,~ DISPbSAL ' Onsit~/t::~ Public [] Community [] Holding Tank [] .; Noto.J" ~--'lf community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 I ~* 5, G /ERING 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 investigation of this Health Authority Approval shows that the on-site wafer 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 c Z. ~' ~--;,~"~,{~;~*~;~ Telephone Approved for"'"~[-~.~ bedrooms b ~--~t/ /./ I ~ Disapproved Conditi~ Approved ,~ ,Y ' l / '--' Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department el Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely 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 A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HA.&) " CHECKLIST-FEBRUARY,,. 2644720 , Legal Description: L~-'C' Well Classification "~>~ ~ Well Log Present (~N) Total Depth "2"-"-"-"-"-'~-'""C3 ~ . Cased Static Water Level ,~--~ ' Casing Height Above Ground Electrical Wiring in Conduit 4'"ii'N) Separation Distances from Well: To Septic/I,4~ Tank on Lot If A, B, C, D.E.C. Approved (Y/N) Date Completed S -"1 - '1 .~' Yield Depth'of Grouting Pump Set At Sanitary Seal on Casing ~N) . Depression Around Wellhead (Y/~ ; On Adjoining Lots t ~ f '~- To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhote Water Sample Collected by Water Sample Test Results Comments r ~"' ~ ~- ; On Adjoining Lots I ~-"..'r'~ 14- To Nearest Public Sewer To Nearest Sewer Service Line on Lot I c,.~ ; Date B. SEPTIC/N~E=I~,ff~I~ TANK DATA Date Installed Standpipes~l) Depression over Tank (Y~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic'~k'lel~Tank: Size [ ~?~"~ No. of Compartments L) Air-tight Capsd~N) Foundation Cleanout (Y~'~ Date Last Pumped ; for Temporary Holding Tank Permit (Y/N) To Water-Supply Well To Property Line To Water l,,4.~aCService Line Course 14/A 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 Installed Width of Field Square Feet of Absorption Area Depression over Field Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well I (~'~"~ ( '~* To Building Foundation {-~ ~ Lot /~/~. To Water Mew'r/Service Line ~ o ~ '~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field L'I ~ ~- Depth of Field ~.1, [~. Gravel Bed Thickness ~ ~, Standpipes Present (Y/N) Date of Last Adequacy Test I To Property Line LC:> To Existing or Abandoned System on ; On Adjoining Lots ~ at To Cutbank (if present) Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump orr' Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all M2A and/~_AA guidelines in effect on the da. re of this inspection. S~gned . ~ ~ ...... - - c&~ ~]w~, ACAS~ =~ ~OA No. ~ ~ -- ~ ' ~ "~"~w ~ ~ Date of Payment ~-~ '~ ~mount:$ ~ ~ - ~' Page 2 of 2 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. TELEPHONE (907) 562.2343 ANCHORAGE INDUSTRIAL CFNT~ ~(~'" IL,, - --- _ Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPUER TO BE COMPLETED BY LABORATORY WATER SYSTEM: LD. NO. (') See h on back .po z3o~ /? ? SAMPLE TYPE: E;~lqoutlne I-I Check Sample (for routine lample with lab ref. no. ) 0 Special f:~Jrpoee Treated Water ill-Untreated Water Analysis shows this Water SAMPLE to be: I~Satisfactory [-] Unsatisfactory J'-I Sample too long In transit; sample should not be over 30 hours old at examination to Indicate reliable results. Please send new 1--sample via special delivery mall. Time Received Analytical Method: I-I Fermentation Tube l~embrane Filter ~AMP[E NO. 1. IL ~.z. f , f 5 Time Collected .C,~, ~cted ~ Lab Ref. No. Reeult° I I I ['Z'l I [-~ Analyst BACTERIOLOGICAL WATER ANALYSIS RECORD _READ INSTRUCTIONS _BEFORE ,.COLLECTING SAMP! F Membrane FIItac Direct Count Verification: LTB BGB Final Mambrane FIIILt.,'-~reiu~s/' / Time: TNTC= Too Numerous To Count Collform/lOOml Collfon~l100mi DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA q950! BILL ,~IEFFIELD, ~,OVERNOR T#lei~hon~: Addre~: 274-~533 To Whom it May Concern: According~to records on file in this office the ~------~y~~-- Water System is in compliance with the State Drinking Water Regulations sincerely, ... . APPLIP'~,NT FILLS OUT UPPER HAr"~ONLY Address Zip ~e Address Zip ~e ~ Other NOTE: THE INSPE~ION ~E MUST ACCOMPANY EACH RE~EST BEFORE ~ESSING CAN BE INITIATED, Dale Date Date Date Field Notes: ~ SEP ? 1982 RECEIVED (~PROVED ~DR~MS *CONDITIONS OF APPROVAL ( ) DISAP~OVED ( ) CONDIT~NAL APPROVAL* -- 3E COMPLETED BY LABORATORY,, :~- ~ BE E." . ,..~ .... ~ ~ *.~ S~ ~.E: ,~-.~ ',' .-. Lr .*..~1 ~, ;~ .....~ · ..... .~, . ,~*~.. ~r*SAMPLE to be: · L' sample too long . .. no! be over.~48 hoUrs'~ld'at e~'mination ',, nd cate ~ehable r~ults.~ ~se-send. Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: I.D. NO. Water System Name Phone No. City Stets Mo. D~y Ye~' SAMPLE TYPE: .D"Routlne f-1 Check Sample (for routine sample with lab ref. no. ·" [] Special Purpose [] Treated Water [] Untreated Water SAMPLE NO. 4 N ' Time Collected LOCATIO CollecteC By I I TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: [::~-'Satisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable results Please send new sample, Date Received Analytical Method: [] Fermentation Tube ~ Membrane Filter Lab Ref. No. Result* Analyst I I-T-I I l-i-I I I-1-1 I ~ READ INSTRUCTIONS BEFORE COLLECTING SAMPLE BACTERIOLOGICAL WATER ANALYSIS RECORD MUNICIPALITY OF ANCHORAGE ~-~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEI~I[~/~ipA[~-~ OF ANCHOEAGE ENVIRONMENTAL ENGINEERING DIVISION Te ,phoo, 2644720 2 1980 M,~I LI NfO ADDRESS PHONE $. LEG DES IP ' N ~ SINGLE FAMILY I-'1 One [] Four [] Other ~ Two [] Five [] MULTIPLE FAMILY [~] Three [] Six 7. WATER SUPPLY ~ INDIVIDUAL' ' ATTACH WELL LOG. A well log is required for ell wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach log if available.) S. SEWAGE DISPOSALSYSTEM INDIVIDUAL/ON-SITE" [] PUBLIC UTILITY If mdlvldual/on-s~te, g~ve installation date If ~ystem is over two {2 years old an sdequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. '~2~10(3/78} INSPECTION APPOINTMENTS DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR 1..TYPE'OF RESIDENCE NUMeER OF BEDROOMS . ~ SlNGCEFAMILY · .. ~ ONE ~ THREE , ~ FIVE ~ OTHER ~ MULTIPLE FAMILY ~ TWO ~ FOUR ~ SIX 2. WATER SUPPLY PERMIT NUMBER ~ INDIVIDUAL DEPTH OF WELL ~ COMMUNITY DATE DRILLED ~ PUBLIC UTILITY Connection Verifi~. LOG RECEIVED 3.-SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ~INDIVIDUAL/ON .SITE DATE INSTALLED ~PUBLIC UTILITY Connection Verified ~Seplic Tank or ~Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: ~ . TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL WELL TO: I 5. COMMENTS ~ CONDITIONAL APPROVAL (letter must a~mpany 72 010 IRev, 3/781 LABORATORIES ,. ~' ALASKA, INC. TELEPHONE (907)-279-4014 ANCHORAGE INDUSTRIAL CENTER 274-3364 5633 n Street Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: Mailing Addreu SAMPLE DATE: I.D. NO. Phone No. SAMPLE TYPE: D Routine I-I Check Sample (for routine sample with lab ref. no. cI Special Purpoae r'l Treated Water [3 Unt;eated Water SAMPLE NO, I = I I 1 I LOCATION L Time Collected Collected By TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: .[~'Satisfactory I-1 Unsatisfactory [] Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample. Date Received Time Received / z_/'~ ,0 Analytical Method: Fermentation Tube Membrane Filter Lab Ref. No. Result* Analyst t~,~ o- ~'9 I I'-I"q /7'/" 1 I I-I-1 I I-VI READ INSTRUCTIONS BEFORE COLLECTING SAMPLE o,s-z22o iz~) BACTERIOLOGICAl. WATER ANALYSIS RECORD Rev. 1978 David Drinkhouse Box 82 Crestvieu Lane Eagle River, Alaska Dear Hr. Drinkhouse, DAVID A. SLENKAMP ROBERT A. SHAFER MECHANICAL ENGINEER 694-9055 June 9, 1980 CIVIL ENGINEER MUNICIPALITY OF ANCHORAGE 694-2979 DEPT. OF Ik-ALTH & ENVIRON[AENTAL H'.OTECTION -. j-UN 980 RECEIVED 99 5'7'7 Reference, Lot 22; Tract B; Eagle Crest S~bdivision A seMer system adequacy test ~as performed on the system located on the referenced property per your request. It ~ss noted that you hsd installed the standpipe at the end of the trench ss requested by the Nunicipality. The absorption trench ms tested by adding ~ater through a continuous floM for'a period of 48.hours. The trench accepted sn average of 580 gallons over ~' 24 hour period Mithout any mensurable rise in the standpipe at the end of the trench. The septic tank ms also pumped and verified to have a cap, city of approximately 1000 ~llons. It can be concluded from the above test that the se~mge system loc,ted on the referenced property is adequate. If Me ray be of further assistance, please do not hesitate to call. Sl~/,/y, // ~OSE~r A. S~, ~.E. cc, Ar. _ ATT~IONI ].mureen Clay%on ).%ulicipality of AnchoraEe Department of Health and Enviornmental Protection SR8 196X EAGLE RIVER, ALASKA ~y 22~ 1900 David Drin~,ouse Pox 82 Crostvtew Lane Eagle P~ver, Alaska 99577 Subject: Lot 22 Tract D Eagle Crest Subdivision Approval for your individual sewer and water facilities can not be granted ~ntil the following items have been completed: The water analysis report be delivered to this department for our review from Chem Lab, 1633 Street. The septic tank p~ped with a receipt submitted to this department. The total n~r~er of gallons needs to be on'the receipt to verify the size of the tknk. A four(4) inch cast iron cleanout neeas to be installed in the leaching area. An adequacy test be performc~ on the existing leaching area. This test will determine if the system is adeTaate according to National Stands~ds. A listing of private firms performing the test is enclosed. This report needs to bo submitted to this department for our review. If there are any further questions, please call thi~ office at 264-4720. Sincerely, R~b~tt C. Pratt, Associate Specialist RCP/lJw cc: Coast }~rtgage Company 4797 Business Park Boulevard 99503