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HomeMy WebLinkAboutEAGLE CREST #1 TR B LT 33 b) A & L DRILLING COMPANY ,. BOX 97, EAGLE RIVER, ALASKA 99577 · TELEPHONE 694-2588 ; DEPTIIOFWELL' ~6~ '"'-, ',, /~ ~g~OR~' .' ; ' 'STATICLEVELOFWATER~. OWNER OF LAND ADDRESS ~ t~ LEGAL DESCRIPTION Z~7' 32 T~'A¢? :4~ ': ~ ~rCF/, DATE - Sla.ed .XI~I/7~ Ended ?/,/Ts ~ - / PERMIT NUMBER 7~ O0 ~.~ KIND OF FORMATION: From From From From Frmn From ~) Ft. to c:~ Ft. From ~ Fi. to ~ Ft.- From From ' Ft. I~ Fl From FI. to Ft. .Ft. Io Ft. 'Ft. to }' ' F ' Ft. ~o.~FL Ft. lo Ft. to___ Ft. to Ft. to Ft. to Ft. to Ft. to Ft. to Ft. to Fl Ft. Ft. -Ft. FI. Ft. Ft. Ft. Ft. From Ft. to Ft. l. From Ft. to__FL From __ Ft. to Ft. From Ft. to Ft. From__Ft. to Ft. From__.Ft. t0 Ft. From__FL to Ft From__.Ft. to Ft, MISCL. INFORMATION: ' DRILLER'S NAME ~ ~ ~ 'L' S REET, nNCHORAGE, WELL ~D O~--S I TE SEWER ~ PE~JE-T PERMIT NO. < 78~025 > RPPLICRr'IT C~. PO BX. 87 CHUGIRK LOCATION F~ST. LEGAL LT. ~ TRACT B EAGLE CREST S/D LOT SI~E ~82~ SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ FT/BR>= 258 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= :10 LEbIGTH= ?E: GRRYEL DEPTH= 5 THE LENGTH DIMENSION IS THE LENGTH (IN FEET> OF THE TREe, CH OR DRRINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCRVATIOr'I (IN FEET>. THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATIOM (IN FEET>. REQUIRED SEPTIC Ti:INK SIZE= 'I 000 GI~LLOI'-IS PRCKRGE PLRI'-IT OPT 1' 0[,i A PACKAGE PLRNT WRY BE INSTALLED AT THE PERMITTEE'S OPTION SUBJECT TO THE FOLLOWING CONDITIONS: · 1. EITHER R CLRSS I OR II NSF RPPROVED PLAt. IT WRY BE INSTRLLED. 2. R CONTINUOUS MRINTE~RNCE RGREEMEMT IS REQUIRED. IF R MAINTENRNCE RGREEMENT IS NOT KEPT CURRENT YOU WRY BE REQUIRED TO B'~LRRGE THE SOIL . ABSORPTION SYSTEM R~D?OR YOU WRY BE SUBJECT TO PROSECUTION. Thio ~ 2 > I I'-ISPECT I 01'-I$ ARE REQU I RED BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 200 FEET FOR 8 PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AMD CONSTRUCTION DIRGRRrIS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERr'I I T EXP, I RES DECEMBER CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS FOR O[.I-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAr. ID THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE ISSUED B ........ DATE ....... V1 0 0'~ E (~_'~HNICAL ~ DE.'~'EL~'"'~MENT CO. Russell Oyster 694-2774 Soils ~. Foundations Perfomed for: N&me: Hatltng Address: Legal Description: Oepth (feet) Box 9(3, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 SOIL LOG £att El~ia Lend Development # $otl Characteristics 1 2 7 8 lo 11 12 Ground Water Encountered: Yes Proposed Installation: Seepage Pit Co~ents: ~-~ ~ ~ ~ NO ~/' If yes, what depth Drain Fteld/ Performed oy ~. ~* - [O0o ,, ,,,,, · ~ 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 05029117 GENERAL INFORMATION Complete legal description Location (site address or directions) Lot 33,(~'~=~==~.~-¥' 3, Eagle Crest First Addition 19039 1st Street Eagle River, AK Property owner Mailing address Lending agency Mailing address Agent Address. Mike and Kathy Black Dayphone 19039 1st Street Eagle River. AK Day phone 696-6022 Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: NOTE: Three (3)~ Individual well X Community well Public water If community well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: X 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 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 ,~,nde~:son ~..ngineez::l~9 Phone. 563-'/155 Address P.O. Bo× 240773 ~,~cho]:a~ret ,M( 99524 Engineer's signature ~-~ Date 9/12/97 DHHS SIGNATURE "'/ Approved for '~ Disapproved, __ Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: '7~~ ~/~ 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. Employees of DHHS do not conduct inspections or analyze data before a certificate Is issued. The Municipality of Anchorage is not . responsible for errors o~; omissions in the professional engineer's work. Legal Dessdpfion: A. WEII DATA Well ~se Private LoG pmsem Total depth 2 6 8 ' Municipality of Anchorage ~ DEPARTMENT OF HEALTH & HUMAN SERVICE~ Environmental Services Division E C E IV E D 825 L Street, Room 502. Anchorage, Alaska 99501 · (907) 3~)4~4~ 3997 Health Authority Approval Checklist Municipality of Anchorage ~ Dept. Health & Human Services Lot 33~ Bt ]~acjle Crest ParcelI.D.: 05029117 Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform 0 Date of semple: 8/4/97 B. SEPTIC/HOlDING TANK DATA - Date installed Foundation claanout (Y/N) Date of Pumping C. ABSORPTION FIElD DATA Date installed Length Width Effective absorption ama Date of adequacy test If A, B, or C, attach ADEC letter. ADEC water system number ¥ Date completed 4 / 1 / 78 Cased to 268 t Casing height (above ground) ¥ Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION 4/1/78 ~/4/97 :~30' 240' 25 g.p.m. 3.5 Y Nitrate .1 mcj/L 0 Collected by: MOA Sewer System Tank size Number of Compartments __ Cleanouts (Y/N)__ Depression (Y/N) High water alarm (Y/N) Pumper g.p.m. Fluid depth in absorption field before test (in.); Fluid depth (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) 724)26 (Rev. 3/96)' Other bacteria J. Niqodemu$ Soil rating (g.p.dJfF or fff/bdrm) Gravel thickness below pipe Monitoring Tube present (Y/N) Results (Pass/Fall) Immediately after Absorption rate = If yes, give date System type ToteJ depth Depression over field (y/N) __ For gal. water added (in.): g.p.d. .bedrooms D. UFT STATION - Date installed Manhole/Access (Y/N) High water alarm level at' Cycles tested E. SEPARATION DISTANCES MOA Sewer System Size in gallons "Pump on' level at* 'Datum On adjacem lots On adjacent lots line placed after we~! was "Pump off" level at' I certify that l have determlned fflru fleld inspectlons and review of Municipe/ ~~tel are in conformance with MOA HAA guidelines in effect on ~hls date. Englneer'eName Hichael E. Anderson HAA Fee $ Waiver Fee $ Date of Payment C~. t--~ -~-~ Receipt Number C'~ ~\ °k~ Date of Payment Receipt Number 724)26 (Rev. 3/96)* Water main/sewice line Surface water/drainage SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line Building foundation Surface water Curtain drain F. ENGINEER'S CERTIFICATION Water main/service line Driveway, pm'king/vehicle storage area Wells on adjacent lots Wells on adjacent lots SEPARATION DISTANCES FROM SEPTIC/HOLDINGTANK ON LOTTO: MOA Sewer System Foundation Property line Absorpt]on field. SEPARATION DISTANCES FROM WELL ON LOT TO: Sept]c/holding tank on lot N/A Absorption field on lot N/A Public sewer main Sewer/sspt]c service line ** MOA sewer >100' Public sewer manhole/cleanout 86 ' Lift station N/A .i.n serv.i, ce. #StrltB-i 9'74361001 Resutts ~ 0.100 U 0.100 0 l~mfed 13~Kefl~an~ 08/02/97 17:46 Co~__~e.alhte~F'u~e 08/04/97 14:00 R_,,.pi~d l)ate/Tbne 08/04/97 15:30 Tectmk2l Dire~r: Steld~ C. Ede Atloid~te Prep Afln%¥sJ$ Method Ltelta 0ate Dute Ifll.~ SM18 4500-1~3F 10 ms~ 08/05/97 JUL ANDERSON ENGINEERING P,O. BOX 240773 ANCHORAGE, AK 99524 56377155 563~5389 (FAX) MEMORANDUM DATE: October 3, 1997 TO: FROM: Anthony Klm, MOA- DHHS Mike Anderson, P.E.''~-~ SUBJECT: Lot 33, Block B, Eagle Crest Subdivision, First Addition Certificate of Health Authority Approval Attached is the as built for the sewerline fronting Lot 33, Block B, Eagle Crest Subdivision, Addition No. 1. The lateral was placed in September of 1977. The well on the lot was subsequently placed on April 1, 1978. At that time the mandated distance between a well and manhole was 50'. The separation distance requirement did not change to 100' until 1982. The well was therefore in compliance with regulations at the time it was installed. MUNICIPALITY OFANCHORAGE 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. # 1. GENERAL INFORMATION Complete legal description CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA# e e Location '(site address or directions) Property owner Mailing address Lending agency Mailing address 19059 LoeJ.$ot~on 19039 F~6( St. Day phone AK Day phone 696-$$05 Agent .; C,b~d~L_L_,~q.b~.om/GREATLAND REALTV Address I 141 t 0~d G~,enn Hwq. E~zq~e /~uert AK Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: "~ 'v TYPE OF WATER SUPPLY: Individual well X~ Community well Public water NOTE: Day phone 694-9155 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. 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 Phone 17034 Eagle R.,lyer'. ~L~p R~d No. 204  Date .~-"~'5;'- ~' ~ DHHS SIGNATURE ~'X~. Approved for __ Disapproved. ~ bedrooms. Conditional approval for bedrooms, with the following stipulations: Additional Comments 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. 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 Parcel I.D. A. WELL DATA Well type Log present ~TN) Total depth Sanitary seal~/N) If A0 Bo or C, attach ADEC letter. ADEC water system number ~/~ Date completed ~ '\~'~ ~'Driller ~1~ ~...~..~..~,~bt Cased to ~'L~ E~ Casing height tg'-~t' " Wires properly protected {~N) ~ / FROM WELL LOG AT INSPECTION ~_'~ Static water level ~'~o ~ ..~ ~ ~ ~ Well flow ~.~'~0 o g,p.m. ~'~- '~' ~ SEPAR~.A~ON'DISTANCES FROM WELL TO: Septic/holding tank on lot ~\~' ; On adjacent lots ~~=~Sr '~' Absorption field on lot I'~\ J~ ; On adjacent lots ~ O~ ~ ''~ Public sewer main ~-~' ~ Public sewer manhole/cleanout ~ ~5' ~ -"~' e~..~wer service line ~. ~. Vt-' Petroleum tank '7--%" t ¥' WATER SAMPLE RESULTS: f r ~) Nitrate ~C).~ Co i o m Other bacteria ~ S & S ENGINEERING Date of sample: '~P - ~.."5 .c~ Collected by: ................ Eagle River, Alaska B. SEPTIC/HOLDING TANK DATA ~ ~ ~ Date installed Tank size Compartments _ ..Depre~slo,n (Y/N) . Cleanouts (Y/N) Foundation cleanout (Y/~N) "' ' ' High water alarm (Y/N) Alarm te~t~'er(Y/N) ! "'~ ' ~ : Date of pumping S:~;~s~ll~tN D ISTAN C E~S ~G TANK TO: Foundation_  Absorption field Water main/service line 72-026 (Rev. 7~1) Frcm CONTINUED ON BACK PAGE C. LIFT STATION Date installed ' , Size in gallons Vent (Y/N) "Pump on" level at Manufacturer -', Manhole/Access (Y/N) Cycles tested Soil rating Gravel thickness High water alarm level Meets MO/~/ele, ctr~ Well on lot ' ~ ' On adjacent lots ~ Date installed ~ ~ [~; .', . .'. . "'[~ gth n ~, Width ~' ~otal ~bsorpti~n area ¥ Depression'bver field (Y/N) i.' Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) ' ' ~ On adjacent lots To buildin~ ¢ound;tion_~ ~u~ain drain Surface water System type ; ·. To.., ,.,~.... Cleanouts present (Y/N) for ~ J If yes, give date. Property line To existing or abandoned system on lot Cutbank Water main/service line Driveway, parking/vehicle storage area bedrooms $ & $ ENGINEERING Engineers Name HAA Fee $ /7~ ~ ~ Waiver Fee: Date of Payment ~ -~- ~ ~ Date of Payment Receipt Number ~~ (~77 > Receipt Number E. ENGINEER'S CERTIFICAT!ON', '.' I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. ROBERTSHAFER. PE ROGERSHA£ER.P.E [I~LL, FLOW TEST DATA CIVIL ENGINEERS [g07) 694 2979 FAX694 12! I 17034 EAGLE RIVER LOOP, SUITE 204. EAGLE RIVER ALASKA 9957? · , -03/25/93 11:18 CT~E ANCHOPASE ~.056 Q09 CHE,~HCAL &~EOLOGICAL L4BORATORY ~epoEt Cool,tot ~Illll[-~ ~.10 U m~i [PA 3!).l/:C~.C 10 03/2i/g3 LLB MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAl SERVICES 343..4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 53; Tra~t B; E~zg~.¢ Cr~t Location (address or directions) 19059 FZ. r6t S.~¢~, Ectgl~ River, Ala6ka (b) Property owner Mailing Address 1525 (c) Lending Institution Telephone: (home). Business Su.,i~. 600 O)~6~n~ton, D.C. 20005 Telephone Mailing Address (d) R~al Estate Company and Agent 2001 REALTY ATTN.' P~I~:~. Address 1345 ~6t 9th Aue~ S~ 201, Anchoraq~, Ak. 99501 Telephone ~76-~00~ (e) Mail the HAA to the following address: (or check here~, if hold for pick up.) List contact person and day phone number below: $ & S ENGINEERING 17034 Ea~jle Rive~' L~p Road No. 204 Eagle River, Alaska ~9577 2. TYPE OF RESIDENCE Single-Family,~[ Number of bedrooms 3. WATER SUPPLY Individual Well IX Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site [] Public/~' Community [] Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. Page 1 of 2 5. 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 investigation 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 Telephone ' ~ ~'z.~...-~.~ ~' ~ $ & S ~GINE~RING Address ~ 7~4 ~aqle Ri~e~ L~p Road No. 2~ ~ag~o River~ A[~.~ ~577 6. DHHS APPROVAL Approved for ,~:~- .~ledrooms by Approved ~ Disapproved Terms of Conditional Approval Conditional Date ' The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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 An chorage is not responsible for errors or omissions in the professional engineer's work. · 72-4325 (Rev. 7/88) ~©k Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) ~. I~ON~E~~RUARY 1984 343-4744 FEB 2 ]920 ,' Legal Description: ~¢ -~-~ "~" ~ EECEIVED ' A. WELL DATA Well Log Present (Y/N) ._~ . Date Completed ,t~ _ ! .-- '~ ~ Total Depth.~..-(z~.--Cased to ~0 "t- ~ Depth of Grouting If A, B, C, D.E.C. Approved (Y/N) Yield 2.,. ~-- ~,oaA Static Water Level ~. 5 "~ Casing Height Above Ground I,~ ~' '~ Electrical Wiring in Conduit (Y/N) ~ SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot AJ//~ Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot ; On Adjoining Lots ! To Nearest Public Sewer Line ~'=J ~ To Nearest Public Sewer CleanouVManhole. To Nearest Sewer Service Line on Lot Z Water Sample Collected by ~ ~. ~ ~'~o~'~J~ ;Date ..-_~P,~Jd~'w Water Sample Test Results .~-~/~r~$~"~---~w~..- ~ ~ Comments '~ I/~'J /~::~"~P/~-"~ V'Jl"7"~'~ ~-~::~cJ/..-,~o/--}$ ~ '"'/~"/~. B. SEPTIC/HOLDING TANK DATA /V/~ Date Installed Size No. of Compartments Standpipes (WN) Air-tight Caps (WN) Depression over Tank (WN) Pumping/Maintenance Contact on File (WN) Holding Tank High-Water Alarm (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well * · - To Building Foundation To Disposal Field To Property Line ' -' To Water Main/Service Line To Stream. Pond, Lake or Major Drainage Course Comments ~"~t''3~ ~ ~'-e"t~ ~ Foundation Cleanout (Y/N) Date Last Pumped ; for Temporary Holding Tank Permit (Y/N) 7~-o28(..., ~/~) ~,o.~ Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field '-'; Square Feet of Absortion Area ~Depression over Field (Y/N) Results of Last'Adequacy Test ,,. ,.;-,. ~_ .,. - . ; , - \-, SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well To Building Foundation Lot TO Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments~ k)~.3\ ~ ~,~..~ Type of System Design Length of Field Depth of Field Gravel Bed Thickness Statndpipes Present (WN) Date of Last Adequacy Test To Property Lin~ - ' To 'Existing or Abandoned System on ; On Adjoining Lots ,h ' To Cutback (if present) D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimehsion~ * ' Ma'n'hol(~/Access (Y/N) '"Pump Off" Levelat ' ~ · ' ' "" ' Vent (Y/N) " Pumping Cycles during Adequacy Test. **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 Company Date MOA No. Receipt No. Date of Payment Amount: $ 72-02~ (Rev. 7~8) Back Receipt No.*- ' - Waiver Fee: $ Date of Payment Page 2 of 2 CHEMICAL & GEOLOGICAL LABORA2~RIES OF ~4IASKA, INC. ~",~ 5633 n STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 ~ FEDERAL TAX ID # 92-0040440 tNALY$I3 NEPOP, T E! SAY2LE ~oz Mozk O/dez I 19478 Date Nepott PlAnted: JAN 29 90 ~! 15:31 Client ~anpla lD:L33TI~ACT B KA~LE CREST P~ID :UA Collected JIH 23 90 H ll:15 I~s. Neceived JIN 24 90 I 16:40 bzs. Client Naae Client Acct P.O.I NONE Analytte Completed :JAN 26 90 Sene ~epo~ts to: Labozetory Supe~vis~z :~H C. EDE 1)3 G $ EH~ ~,l,,,,d ~y: .~~. 'F./Z.----~. 2) Special lnatzuct: Chenlab SeE I: 9306 Lab Snpl ID: S ~t~ix: lite,able Pazametet Tested ~esult Urges Method Limes RITRATE-~ ~O(O.lO) ~/l EPA 353.2 Sanple ~OUTIIIg $AtfPLE Remarks: SABLE COLLECTED BY t Tests PezfoEmed See Special lt~ttuctio~ Above UA-Unavailable MD- None Oetectea ** ~ea Sample ~ena~ks Above -- APPLIC ¢T FILLS OUT;UPPER HAL " DNLY. Property Owner ~.OBL~ ~' 3.~1~ ~ Malllng'Addrm BOX 26, CresCviev Lane, EaRle l~,iver z~pcode 99577 694-3740 euyer". [enneth Calhoon, C-21 lletttage 1~omes & Zmrestments, Znc. Address 207 I~.. Northern Lights zip Code 99503 Lending Institution Asstmptton through ~ Spokane l~tS. Phone Address :3201 C, Anchorage, Alaska Zlpcode 99503 277-0543 Realty Co. & Agent Ce~tu:'~r 21 l~egttag& EDges & Znvestd~ents, Znc/He~':L1.Tn Fgtce Phone Address 207 E. I¢ortheim L/ghts ~lvcl.;': ) zip Code 99.503 276-1333 Street Locatlm First Street, three .lots /n fr°m corner DE ~irch & First,--'[ .one blockl N. of ,Eagle [~ Single Family n Multiple Family No. of Bedrooms n Other r-I Public Utility ~ Indivldua~ Year Individual Installed: ~ Public Utiflty When Connected to Public Utility: I'-I Holdiog Tenk NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH BEOUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Field Notes: ~ . ~ p?T C'~ RECEIVED ~--~ ~ Well to Tank Septic T~k Size October 12, 1982 Robert and Janet Earl BOK 26, Crestview Lane Eagle River, AK 99577 Subjects Lot 33 Tract B Eagle Crest Approval for the individual sewer and water facilities cannot be granted until the following items have been completed~ Exposed electrical wires to the well head are in violation of the }~unicipality of Anchorage codes and must be encased in conduit. The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. The septic tank pumped with a receipt submitted to this department. A four (4) inch cast iron cleanout needs to be installed to the septic tank and/or leaching area. An adequacy test needs to ~e performed on the existing leaching area. This test will determine if the system is adequate according to }:ational Standards. A listing of private fir~s performing the test is enclosed. This repor't needs to be submitted to this office for our review. Please notify this Department for a reinspection when the noted discrepancies have been corrected. If there are any further questions, please call thi~ office at 264-4720. ~ Z' ~ [ ~cerely' RPlDS/p/gl{ -.. ~nclo~ure Robert C. Pratt /} Associate Environmental Special{st ALASKA I]UIROI*II E nTAL COFITROL $ RUIC6S, IRC. ~fl~jinm'ifl~j [, ~nuironmcnf~l STudies RECEIVED lO/15/82 TRANSAMERICA TITLE/SALLY GREEN 207 E NORTHERN LIGHTS ANCHORAGE AK 99503 SELLER - ROBERT & JANET EARL BUYER- SUBDIVISION-EAGLE CREST BLOCK-TRACT B LOT-33 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 860 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYST~ IS 294 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF THIS 3 BEDROOM HOUSE. ~[~.."' ...~ (~" ~ ~".;~' , ~ ~'.. ,o. ~,,.~ ..<~ 1000 IS ADEQUATE FOR 1220 LUc$! 251~ Auenue · Ancl~onxje, Alaska ~9503 · (907) 276-1361 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 82~ L Stoat. A~ Almt~ ~9501 ENVIRONMENTAL ENGINEERING DIVISION Telephone 2~~. 6720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES ,,,,.,,.....,O,,R.. "',~'f---- S' " PROPEF~TY REEI~)ENT (1! different from abo~) BUYER MAILING AOOR E~S ~. LENDING INSTITUTION PHONE PHONE PHONE .,,EALTO,,,A,,EN',' /'Px ' ;¢,..¢,,,.,s b'P'7¢"-- MA,,.,,,,~AOORE" ¢~/---)-' /Z/.'"~/ '--'¢¢"'----~ - · LEGAL DESCRIPTION · ~z'- ~ T,~'~¢T e. TW~ OF R~ID~CE ~SINGLE FAMILY ~ MULTIPLE FAMILY 7. WATER ~LY ~ INDIVIDUAL' ~ COMMUNITY ~ P~BLIC ~TILITY ~ ~AGE DIS~L ~EM ~ INOIVI DUAL/ON-SITE *' ~ PUBLIC UTILITY NUMBER OF BEDROOMS E~] One I--I Four 1-'1 . .Other -- I"-1 ~.Two F-I Five ~. ,' ~ Three I-'1 Six A'I'I'ACH WELL LOG. A well log is required for ell wells drilled since June 1975. For wells drilled prior to that d~te0 give well depth (a~tach log if available.) ' 'if individual/on-site, gl. insta,,,,io, date If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST REFORE PROCESSING CAN BE INITIATErt 724) 1013/78) INSPECTION APPOINTMENTS TIME TIME ~ TIME DATE DATE ~ DATE INSPECTOR J4~ECTOR INSPECTOR 1. TYPE OF RESIDENCE ' NUMBER OI~ BEDROOMS ~ MULTIPLE FAMILY ~ TWO ~ FOU" ~ SIX 2. WATER SUPPLY PERM,T NUM6ER ~ COMMUNITY DATE DRILLED m m ,AG DIS~AL SYSTE~ PERMIT NUMBER ' VIDUAL/ON-SITE ~ - DATE IN~ALLED Conn~tion Verified S[ze:~ If Tank is homemade BOILS RATING TYPE OF TANK 5~I MANUFACTURER TOTAL A"OR~EA MATERIAL 4. DISTANCESwELL T0: ~tlc/Hol~[~jTank J/~[A~°rpti~ Ar~ J~r/~Line F ~mt/~/L~ Li~ /O ' 5. ~MMEN~ ~ CONDITIONAL APPROVAL (letter must a~m~ny ~rtifi~te) ~ DISAPPROVED DATE BY (T, tie, LEGAL DESCRIPTION Z~r~S ~F 72-010 (Rev. 3/78) Russell Oyster 694 -2774 Soils ~ Foundations O'~-'E~E~CHNICAL 8 D-qL_ .PMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 6,94-2774 or 688-2280 Earl Ellis 688-2280 Land Development W/A? /% /??~