HomeMy WebLinkAboutEAGLE CREST #1 TR B LT 34
Municipality of Anchorage Page J 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: ~\ x']clL~ t"xS<l:~ PID Number:
Name: ~/Uo~E~,~ ~O J~,~ ~.., ~,~, WastewaterSystem: D New ~ Upgrade
~,~ ABSORPTION FIELD
Phone: ~--~O ~ Deep Trench ~ShallowTrench DBed ~Mound DOther
Lot: ~ ~: ~K~c~ ~ Su~iv~ion:~bE ~T ~p~pi~f~odginalgmde:~.
Township: I Range: I ~tion: Fill Idd~ a~ve o~ginal g~de: Grovel length:
WELL: ~t~T~ New ~ Upg Gmvelwldtm
SEPARATION DISTANCES ~ Septic ~ Holding a S.T.E.P.
From Tink F~ld ;tltl~ Tank ~tU~ A~ ~
Sudace
Water IOO'~ loc'+ -- -- - LIFTSTATION
Foundation ~' ~' -- -- -- 'Pump °n' ~e' '~~'eve"t: I Hig~ water"a~ at:
Cu~ain
Drain
Remarks: . BENCH MARK
ENGI~L
Inspections pedormed bt7034 Earle m"r [°°P "~' He'~ates: 1st "' =°' ~ ~
Department of Health and Human Se~ices ap~
Pea'mit No.' SW960053
2 2
Page .of
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
Legal Description:LOT 54, TRACT B, EAGLE CREST S/D PIDNo.:05029116
/
STI ST2 COl Cl~3
NE~
SEP
TAN (
88.9 86.9~-'"- I
A82,9'
;0 GROUND WA'I Ell 16~5, l
4-18-98
SI1 31' I ~l ·
~ m~ CO: 71' I 90'
~ ~ C01 43.2' I 71'
Ja ~ [~ . MI1 70.~ { 88.5'
~ ~ ~. MT2 68.5' 78'
~,~.. ~ ~..~
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)
PAGE 1 OF 1
PERMIT
PERMIT NUMBER:SW960053
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:WYNN DAVID C & ROBYN
OWNER ADDRESS:19057 FIRST ST
EAGLE RIVER, ALASKA 99577
DATE ISSUED: 4/19/96
EXPIRATION DATE: 4/19/97
PARCEL ID:05029116
LEGAL DESCRIPTION:
EAGLE CREST TR BLT 34
LOT SIZE: 17820 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /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 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT)
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:
Mmxicipali ' of Anchoragc
Department of Health and Human Services
825 "L" Street
Rick Mystrom.P.O. Box 196650 Anchorage. Alaska 99519-6650
Mayor
April 24, 1996
Robert C. Cowart, P.E.
$ & S Engineering
17034 Eagle River Loop Road
Suite 204
Eagle River, Alaska 99577
Subject;
Waiver Request for Lot 34 Tract B Eagle Crest Subdivision
Waiver Request #WR960015, PID #050-291-16, SW960053
Dear Mr. Cowan:
Your request for waiver of the required 10 foot separation between an on-site wastewater
disposal field and the west property line has been approved. The waived distance is 1
foot.
This approval applies to the existing on-site wastewater disposal field and lot line
separation only. Any future upgrade to the on-site wastewater disposal system will
require all separations be met or another approval from this department.
If there are any questions, please call this office at 343-4744.
Sincerely,
Civil Engineer
On-site Services
DJR/ljm:Wynn Waiver
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
HA#
WR# WR960015 PID# 050-291-16
Date Received: April 19, 1996
Legal Description: Lot 34 Tract B Eagle Crest
Engineer: Robert C. Cowan, P.E., S & S Engineering
Permit #SW960053
17034 Eagle River Loop Road, Suite 204, Eagle River 99577
Applicant: David C. Wynn
Waiver Requested: Lot waiver from absorption trenches to property line
of 1 foot
Criteria: 1. Geology: Points:
A. Water Table ~
B. Soil Sorption ~ ~ ~.~
C. Permeability ('% ro ~
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
Special Conditions:
3. Other:
Waiver is Granted: ~ Waiver is NOT Granted:
List Conditions or Reasons for above: ~p~o/w~m& lop ~
Date: ~- 2~-~/_
Re c #: //~t/~?/'~ ~/'~/7/)Am°unt:
Name of Reviewer
$ //~?6-g) Date Paid:
ROBERTC. COWAN, RE.
ROBERTA. SHAFER, RE.
April 19, 1996
CIVIL ENGINEERS
(907) 694-2979
FAX (907) 694-1211
~LTEST
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
P.O. Box 196650
Anchorage, AK. 99519
REFERENCE: Lot 34, Tract B, Eagle Crest S/D
Request you issue a permit to upgrade the septic system
serving the existing three bedroom house on the referenced
property. Also, request you issue a one foot property line
waiver due to lack of area.
A test hole was excavated and percolation test performed.
The approximate location of the test hole is located on the
attached site plan.
At the time of excavation water no was encountered. The
monitoring tube has been checked and found to be dry.
Attached is the proposed upgrade design.
We do not anticipate any adverse effects on neighboring
wells, septic systems or drainage patterns by the
installation of the proposed septic system.
The proposed 1000 gallon septic tank is to be placed
outside the well protective radius. Attached is a site
plan which depicts the location of the proposed tank.
If you require additional information, please contact us.
Robert C. Cowan, P.E.
RCC/gk
Enclosure
17034 NORTH EAGLE RNER LOOP · SUITE 204 ', EAGLE RIVER, ALASKA 99577
DRAWN J.L.M.
iNEW ~000 GAL
SEPTIC
NEW
FAGI F (':RFC:;T ~URRIVIRION
R.C.C. DATE4_18_96 ]SET. 2 OF 2
I
STRUCTURES, EASEMENTS, OR ENCROACHMENTS
SHOWN ON THIS SITE PLAN ARE AS SHOWN ON
AN AS-BUILT SURVEY DRAWN BY:
DUANE MARK SEWARD
IT IS THE RESPONSIBILITY OF THE CONTRACTOR
TO VERIFY EASEMENTS, REQUIRED SEPARATION
DISTANCES, AND PROPERTY LINES PRIOR TO
CONSTRUCTION.
1 O' UTiL.
ESMT.
CONTRACTOR IS REQUIRED TO
OBTAIN UTILITY LOCATES
PRIOR TO ANY EXCAVATION
WORK.
EXISTING CRIB
AND SEPTIC TANK
DESIGN CRITERIA:
$ BDRM = 450 GPD
SOILS= 0.8 GPD/SQ.FT..
450/0.8 SO, FT. REO'D.
TRENCH CRITERIA:
'7,5' DEEP
4' EFFECTIVE
5' WIDE
60' LONG
2 @ 50' LONG EACH
ALL PORTIONS OF SYSTE,M
WITH LESS THAN 3.5' OF
COVER REQUIRE INSULATION.
FIRST
STREET
CLIENT ME
E3C~T DIMENSIONS AND DESIGN
pARAMETERS IN THE fl~O, IF
NECES~. TO ME~
CONDITIOn.
LEGAL LOT 34, TRACT B,
DRAWN J.L.M. I CKD.
I
LOT 28
EAGLE CREST SUBDIVISION
R.C.C. iDATE 4-18-96 IS"T. Or 2
STRUCTURES, EASEMENTS, OR ENCROACHMENTS
SHOWN ON THIS SITE PLAN ARt' AS SHOWN ON
AN AS-BUILT SURVEY DRAWN BY:
DUANE MARK SEWARD
IT IS THE RESPONSIBILITY OF THE CONTRACTOR
TO VERIFY EASEMENTS, REQUIRED SEPARATION
DISTANCES, AND PROPERTY LINES PRIOR TO
CONSTRUCTION.
LOT 27
LOT 26
CONTRACTOR IS REQUIRED TO
OBTAIN UTILITY LOCATES
PRIOR TO ANY EXCAVATION
WORK.
N
LOT 33
LOT 34
LOT 55
I\
A:..L PORTIONS OF SYSTEM
:fITH LESS THAN 3.5' OF
C.3VER REQUIRE INSULATION.
--- (~ FIRST
LOT 40
LOT 39
LOT 38
CLIENT
PERFORMED FOR:.
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 'L" Street, Anchorage, Alaska 99502-0650
SOILS LOG ~ PERCOLATION TEST
LEGAL
9-
10-
'Township, Range. Section:
SLOPE SITE PLAN
13-
14-
15-
16-
17-
18-
19-
WAS GROUND WATER
ENCOUNTERED?
IF YES. AT WHAT
DEPTH?
~el~h t~ Waer~r/~,d ' ~1
Itlonitori~g? ~ L"'"~7
Gross Net DePth to Net
Reading Date Time Time Weter Drop
20 -
PERCOLATION RATE __ Immures/tach) PERC HOLE DIAMETER
TEST RUN BETWEEN ~' ' ~"' FTAND '7.a' FT
,_,'/ /_,~
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE.
72-008 (Rev.
CERTIFY THAT THIS TEST WAS PERFORMED IN
~,~ SOtLS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT Of' HEALTH AND ENVIRONMENTAL I'ROTECTION
SOILS LOG - PERCOLATION TEST
r-t Pi eCOLA"hON
1-
3 ~,~¥
4
S
13-
14-
IF YES. AT WHAT
DEPTH'
·
E
PERCOL&11ON RAT[.
'TEST RUN GETWE[N ,, FT AND . - IrT
· ' ' ' '~"~ ~ "/ '~71 Kr~,v.,/E( ~ I~q~ ~,Il*r ~l~r~J~t- .
,[.,o.,,,o,.~ ,c~,~/_-_,' ,c(.,,,,,o,.:._/.~ ,.A..' 7~,/~
ROBERT C. COWAN, RE.
ROBERTA. SHAFER, P.E.
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
MATERIAL SPECIFICATIONS
CIVIL ENGINEERS
(907) 694-2979
FAX (907) 694-'1211
REFERENCE: Lot 34, Tract B, Eagle Crest S/D
April 19, 1996
GENERAL:
1.
0
e
e
The scope of this project includes the installation of
a 1000 gallon septic tank and a five foot wide
drainfield to serve the three bedroom residence
located on the referenced property. The existing crib
and 1000 gal septic tank is to be excavated, pumped,
crushed, and removed.
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 Wast.water 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 wast,water disposal systems
must be certified by the Municipal Health Department
for system installations. Owners installing their own
systems must also receive prior approval from the
Municipal Health Department.
~EPTIC TANK INST~?.?,RTION=
A septic tank is to be constructed by a certified
septic tank manufacturer. Construction shall include
two 4" cleanouts for pumping access.
me
The septic tank shall be sufficiently bedded to
prevent settling or shifting of the tank.
3. Ail standpipes on the septic tank shall extend a
minimum of 12 inches above final grade.
17034 NORTH EAGLE RNER LOOP · SUITE 204 · EAGLE RIVER. ALASKA 99577
Page Two
Lot 34, Tract B, Eagle Crest S/D
April 19, 1996
e
e
Septic tanks installed with less than 4 ft. of cover shall
be insulated.
A foundation clean.ut 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 clean.uts
(unless an effluent pumping system exists within the septic
tank). These clean.uts shall be located on undisturbed
soil not more than 10 ft. from the tank. The first
clean.ut, in line, shall be to clean toward the leachfleld.
The second clean.ut 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.
ABSORPTION TRENCH/DRAINFIELD INST~?.~,RTION:
Excavate the proposed trench to the dimensions shown on the
design. The bottom of the excavation shall be within 2
inches of level. If the sidewalls of the excavation become
smeared, they must be raked or scratched (ruffed-up) before
gravel (sewer rock) placement.
Once the gravel is installed, the distribution pipe is to
be installed level with the perforations faced downward.
Gravel is then to be placed over the distribution pipe to
provide a minimum of 2 inches of cover over the pipe.
A silt barrier must be installed between the final gravel
layer and the native soil backfill. Ensure the silt
barrier covers the entire gravel surface before placing
backfill.
Monitor tubes shall be of four '(4) inch diameter,
installed approximately in the locations shown on the
design, and extend a minimum of 12 inches above final
grade. The portion of the monitoring tube extending
through the gravel shall be perforated from the bottom of
the trench to the invert of the distribution pipe. This is
equivalent to the effective depth of the gravel as noted on
the design.
Page Three
Lot 34, Tract B, Eagle Crest S/D
April 19, 1996
Backfill over the final gravel layer must not be less than
twenty-four (24) inches. Insulation must be installed when
the backfill depth is less than thirty-six (36) inches.
The finish grade over the trench must be mounded to prevent
the formation of a depression after settling.
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 (~DPE) 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, Fernco, or equal).
A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N,
or equal) must be install6d between the final leachfield
gravel layer and the native soil backfill.
All leachfield gravel-(sewer rock) shall be 0.5"-2.5"
screened gravel with less than 3% passing the #200 sieve.
When sand is being used as a filter material, its gradation
specifications must conform to current M.O.A. or D.E.C.
requirements.
Page Four
Lot 34, Tract B, Eagle Crest S/D
April 19, 1996
XNSPECTIONS=
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
excavation of ditches, pits, trenches, or beds and
before the installation of any gravel. A septic tank
may be set in place, but may not be backfilled before
this inspection.
me
The second inspection must be conducted after the
placement of the silt barrier, gravel, distribution
lines, standpipes, cleanouts, and insulation, but
before the placement of any other backfill.
The final inspection is to occur upon final grading of
the property.
Often there will be more than these 3 inspections required.
Especially with the installation of multiple trenches, sand
filters, pressurized distribution systems, etc. Thus, 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.
Page Five
Lot 34, Tract B, Eagle Crest S/D
April 19 1996
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.
CONTRACTOR/INSTA?,LER
MUNICIPALITY OF ANCHORAGE ..
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
82S L. $,eet. Anchm'~. Ala~.ke B9501 264-4720
SOILS LOG - PERCOLATION TEST
/~ SOILS LOG
J'-I PE RCOLATIDN
PERFORMED FOR:
LEGAL DESCRIPTION:
8
9
5~'~-.- '~- ~' DATE PERFO.MEO: ?/~'/'~'~
10-
11
12
13-
14-
15-
16-
17'
18-
SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
IF YES. AT WHAT
DEPTH?
Reading Dale Time T,me Water Df OD
pr-RCOLATION RATE
· TEST RUN BETWEEN . FT AND , FT
SE?-20-B4 TUE 10:35
S, O, R, DIV, OF I,I~TER FRX NO. ~075§~1384 P. 07
USGS
· ~','ATER t~ELL DRILLERS LOG
co.
Loc~tion (address of: To',~ship.~.......r, Range,. ~ Section (If kno~); dlstence ~om ro~d:
-_ . .,,
idle of Casing~ Depth of Hole et, Cased to~ ' , feet,
' '
Static water level~feet (above) (bel~.) land s~iace. Finish of well
(check one) Of:ch end ( ~: Screen ( ): Perforated ( ),
Describe screen or p~rf~ions: _
lle!l pulp!nE ~}t at~allons per (hr) (m~n) tot ., h~urs with
~' ~eet of dra~vdoivn from ststtc level.
R~s~arks
..... ._~ept~. in !ac': from Gi~ye letails cf :ormzti~ns penetrated, siz~]o/ ~,ate:lal.
tO
tO
~0
· ~ 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
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
ParcelI.D. tt ~5"'O ~// /&, HAA# ~/~cl(-C':~.~,~''
1. GENERAL INFORMATION
Complete legal description Eot 34: Tract "B" Eac~le Crest Subdivision
Location (site address or directions)
Property owner
Mai!lng address
Lending agency
Mailing address
19057 First Street
Eaqle River, AK 99577
PHH/Hcmequity (Wynn) Day phone
c/o Jack [%~ite Co. 11823 Old Glenn H~y. Eaqle River,
AK
99577
Day phone
Agent Barbara Crittenden/ Jack White Co.
Address
Day phone 694-5500
e
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: .~ '~
TYPE OF WATER SUPPLY:
Individual well Xxx
Community well
Public water
RECEIVED
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. 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 fuhher 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.
Phone
$ & S ENGINEERING
Name of Firm ~7~4 ~-~:,. ....... ,- ............
Eagle River, Alaska ~9577
Engineer's signature
Date
DHHS SIGNATURE
~ Approved for -~
Disapproved.
Conditional approval for
bedrooms.
bedrooms, 'with the following stipulations:
Additional Comments
Date
The Mu~cil~lity of A~bhorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Ce~ificates 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
Environmental Services Division
825"L" Street, Room 502 · Anchorage, Alaska 99501· (907) 343-4744
Health Authority Approval Checklist
Legal Description: ~o~''St~ '"~'ff.-.~e.~'~' ~,~..~ ~t-~m:elLD.:
A. WELL DATA
Wellt.~pe ~¢t-'~t~e.rL- lfA. B. orC. attach.~DECletter. ADECwatersystemmtmber
Log present ~) q Date completed "/.- Z~ -- '7'7..-
To~ depth 24-~( Ca,~d to z47 '
FROM WELL LOG
Date of le~l '7
Static water level
Well production
WATER SAMPLE RESULTS:
Casing height (above ground)
proper .ly protected t~N) ~
Wires
~..,
AT INSPECTION '~
~,o '~ _
Coliform 0
SEPTIC/HOLDING TANK DATA
Nitrate
/. $ S- Other bacteria
Collected by:
s & s ~NGll~ntNO
17034 Eagle River Loop Roicl NO. 2G4
Eagle River, Alaska 99.~77
AI~ORFFION l,-[~ct.l~ DATA
~ ~0 ' Wi~ ~ ~ G~I ~ ~low pi~ ~ t To~ ~ ~, ~
Eff~ve ~Uon ~ ~ ~ ~ang TU~ p~ ~ ~ion ~r field (V~ ~
D~ of ~ I~ J/~ ~ ~ (~) For ~
Fluid depth in absorption field before tesl (in.);
Fluid d~th. '""'--- .(ins.) Minute~ later: -'
Peroxide tte~tmem (past 12 months) (Y,~
lrttmedia!ei.x' a~r"-"'--gaJ, water ~dd~ (in.):
Absorption rate = g.p.d.
If yes. give dote
D. LIFF STATION
Date it~alled
Siz~ in gallons
Manhole/Access (Y/N) "Pump on" level al*
High water alarm level al* ~ *Datum
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on Iol
Absorption field on lot
Public ses~r main
Sewer/septic service line
: On adjacem lots
: On adjacent lots
Public sewer manhole/cleanoul
tion
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation
Water muin/se~ice line
Properly. line /O t Absorption field
Surface water/drninnse ~ Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation "~ ~ ' Water main/service line
Surface water ~'~ g:~ ~ ¥ Driveway, parking/vehicle s~orage area
Curtain drain ~'~J~ Wells on a~jacent lois I~-~t'~ Property. line
F. ENGINEER'S CERTIFICATION
I certeS, that I ha~t d*t*rrnmed thru field inspections and re~e~ ofMuniC~l~l r*cordx
"-.
Date
HAA Fee $ .~OZ9,0 o
Date of Payment f-/b~ ~,
Rev. 8/95 O$S: haa.wkdoc
Waiver Fee $
Date of Payment
Receipt Number
0~/10x96 11H~9 CT&E ESI AN(~AGE ~ 9~76941211 N0.9~9 ~
CT&E Environmental Services Inc.
Laboratory Division ~
Laboratory Analysis Report
CT&£ Eer.# 961202.9517
Client Sample [D L34 TRACT I~ £AG CREST[ 120~-Ot
Matrix Ddnklng Water
Collected Date 04104196
TechniCal Directo~
Sample Kema~k$:
Nitrete-N 1.~,~ -- 0.100 mg/L EPA ~,~3.Z 0~/O9/9~ 0~.109/96 eau
200 W. Po~ter Drive, Anchorage. AK 99518.1606 -- Tel: (907) 562.2343 Fax: (907) $61-5301
3180 Peger Road. Fairbanks, AK 99709-5471 -- Tel: (907) 4?4-8656 Fax; (907) 474-9695
ENVIRONMENTAL FACILITIES IN ALASKA. CALIFORNIA, FLORIDA. ILLINOIS. MARYLAND. MICHIGAN, MISSOURI. NEW JERSEY. OHIO. WEST VIRGINIA
Parcel I.D. # ,
(~ MUNICIPALITY 0F ANCHORAGE .
DEPARTMENT OF HEALTH & HUMAN SERVICES.
"- ~' Division of Environmental Services . .
: -.~ ,* '. · * . .:.On-Site Serv ces Section
P.O. Box 196650. Anchorage.'Alaska 99519-6650
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
05'0 '~1 I ~,, HAA# J-lA
GENERAL INFORMA ....... ' ' '
TION -,
Complete legal description Lo:~ $4; T~z~
Location (site address or directions) ' !9057 F~t~:~
Property owner .7o/~ Fu~0~ Day phone
Mail[r~g address ~ ~057 F~t~:t $:t~[~ E~ ~
Lending agency _ --
Mailing address
Agent
Address ~ :'-
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: ~ ....
3. TYPE OF WATER SUPPL~: '
Day phone_
Day phone
Individual YJ(X .....
NOTE: If co~lm~-nl~/'~v~l/'~s~em,~p~vide written confirmation from State ADEC__attest*
'"{ lng to the legality and status of system.
4. ~ 'TYPE OF WASTEWATER DISPOSAL:
Individual on-site XYJ(
oldlng tank ;;;; ~.'-' ,'::. ':*...- ' · :;: ,.' ·
Community'~n;site'.,' ,.'- ' ". ' - ;' - ·
'"' '" ' .* -~* '.'.:. ' ,' ..... ,..~ .... L-.~-..2. ~. . '' '"' ,:,:~:i.~:.'-' ;"; *. '' .
=. . ~ ' ., *~., ~,/ ..... ;,.~;_.,~_! ...~,,~ .... ,. '~ ...... ..~. . ~.!,_ ~'~,.~ ...~'.' .... .
NOTE. If communi~ wastewater system, provide walden confi~ation from ~ta~; ~EC ~.'%'; ..:,....
' a~ting to the legal~ a~sta{us of s~tem.~ ....... : . .,..... ?. ,:, .- -; -. - .,;;- ' .,,.
' .., ~./~.~,?~c~.., .... ·
-. . . .
STATEMENT OF INSPECTION BY ENGINEER
As certified by mY seai 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 vedfy 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 s & S ENGINEERING Phone
7034 Ea~le River Loop Road
Address ~ Date ~
Engineer's signature
I~rooms, with the following stipulations:
~ ::~: "Additional comments'
The MUnicipality of Anbho'rage Department of Health and Human Services' (DHHS) Issues Health Authority ..
Approval .Certificates based only upon the mpre~entations given in pa.r:agral~h 5 above by an Independent
professi~na~eng~neerregistered~ntheState~fA~aska~TheDHHsd~esthIsasac~udes~/t~purchaears~fh~mes.. __ __ · ';
andth~r~.ndina~nstit~t~ns~n~rdert~atisfv~ertainfedera~andstatem~u~rements-Em~vess~fDHHSd~n~t - .-
· . ' ~3~d~Jct'ln~oections or. analyze data before a c~rtificate is Issued. ~rhe Municl .l~.)lty of Anchorage is not . ~,
". ' . resp~nsi~ef~rerr~rs~-~mIss~ns~ntheprofessi~a~eng~neer~s~rk::;-:i:~;~``i~i~:~::~;~. : ':.. ': ' ": '"~i.
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: ~ Z~ -.~ {~ ~,,~. Parcel I.D. O 5'"0 ~- 9 !
A. Wall Data
Well type '~-~I~ If A, B, or C, attach ADEC letter. ADEC water system number
~-I1~
FROM WELL LOG
/5"
7-,~-77-- Driller ~-~.c.~ Z~,~-,-.J'~.
2.17 ' Casing height
Wires properly protected {~)N)
Log present(~N)
Total depth
Sanitary seal
Date of test
Static water level
Well flow
Pump level1
SEPARATION DISTANCES FROM WELL TO:
Seplic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer service line
Date completed
Cased to
.g.p.m.
WATER SAMPLE RESULTS:
Coliform ~:) Nitrate
Date of sample: ~-.'~ / '=/- 13
1.13
Collected by:
Other bacteda ~)
B. SEPTIC/HOLDING TANK DATA
Date installed ~"/'?.~-
Cleanouts ~,1)
High water alarm
Date of pumping
Tank size '~. ~ ~ Compartments
Foundation cleanout ~N) ~" Depression (Y/~)
,J Alarm tested (Y/N) ,"
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot \o<> t~
To property line ~. ~,
Surface water/drainage
On adjacent lots ~ c, ~ Foundation
Absorption field ~-- J '~' .Water main/service line
Io0
~2-02~ (3,~)' Ffo.t
CONTINUED ON BACK PAGE
C. UFT STATION
Date installed
Manufacturer
Size in gallons Manhole/Access (Y/N)
' ~ 'Pump on" level at _ 'Pu~j33poff"'L~elat~
Vent
High water alarm level ,,.C/c~s tested . . .
Meets MOA electrical codes (Y/N) ~ ~ .
SEP~ATION TO:
We-l~on lot On adjacent lots .Surface w~ter.
D. ABSORPTION FIELD DATA
Date installed I ~
.. Length. ' UI/ W'dh
· :. Total ~rpt~n area
"Date of adequacy test
Water'level Ih absorplion field before lest
· Peroxide treatment (past 12 months) (Y~
Soil rating (GPD/FF) -~ ·~ o '~//~'~-System type /~ -r-
~j/Z_. Gravel thickness {J~- Total depth N ~, 5'
Cleanout present (~'N) ~' Depression over field (Y~) ~/'
Results~il) ~ /',,,~ for /~ ~ Bedrooms
D '~ Nter~est 2-~. '
/Jo,~/~-/~-,J~ ~J ,~' ff yes, give date /'~/~
SEPARATION DISTANCE FROM ABSO.RPTION FIELDTO: ~" ~,J~-y ~-~-~,'~-~'~ ,~
Well on lot /oo
To building foundation
On adjacent lots ' ,,~c,
Suflace water / o o
Curtain drain r ~
F-- ENGINEER'S CERTIFICATION
On adjacent lots /~>o /''' Property line
~ 5- ~ '/'' To existing or abandoned system on lot
"- Cu~ank 'J//,~ Water main/service line
Driveway, parking/vehicle storage area
I cerb'fy that I have checked, vedfled, or conformed to all MOA and HAA
Date '0 /
HAA Fee $ ~)
Date of Payment
Waiver Fee $
Date of Payment
Receip{ Number.
CT&E Ref.#
Client Sample ID
l~latrix
Commercial Testing & Engineering Co.
Environmental Laboratory Services
LABORATORY ANALYSIS REPORT
94.4~3-3
LOT 34 ~ 'B" ~GLE C~ST S~
WAlK
ClientName S & S ENGINEERING WORK Order 82232
Ordered By PJS Printed Date 09.r20/94 ~ 09:41 hrs.
Project Name Collected Date 09/13/94 ~11:15 hrs.
Project# Received Date 09114/94 ~16:55 tu'~.
PWSID UA
Technical Director
STEPtlEN C. EDE
Sample Remarks: ROUTINE SAMPLE COLLECTED BY: RAY.
QC Allowable Ext. Anal
Parameter Results Qual Units Method Limits Date Date Init
Nitrate-N 1.13 mg/L EPA 353.2/300.0 10 09/16/94 CMR
* See Special Instructions Above UA=Unavailable
** See Sample Remarks Above NA = Not Analyzed
U = Undetected, RepoSed value is the practical quantification limit. LT= L~ss 'lhnn
~ D = Secondary dilution. GT= Cseater Than
7.
,' 5633 B Street, Anchorage, AK 99518-1600 -- Tel: {907) 562-2343 Fax: (907) 561-5301
ENVIRONMENTAL FACILITIES IN ALASKA. COLORADO, FLORIDA, ILLINOIS, MARYLAND. NEW JERSEY, OHIO. UTAH, WEST VIRGINIA
MUNICIPALITY OF A~CRORA~E
DIVISION OF ENVIRO~MZNTAL HEALTH
DEPARTMEN~f OF HEALTR AND ENVIROnMeNTAL PROTECTION
APPLICATION F0K HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information
Application Date
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or direc~io~)
(c) Applicant is (check one) LeMi~ Institution ~; ~er/b~lder ~ ;
Buyer ~ ; Other [ [ (explain);
(d) LendlnE Institution .... /. tt /~ {?/
(e) Real EsEa~e Co, & Aien: ~/~
Telephone /~,ff-f ~2_~!
Address
(f)
Telephone
Hail the HAA to the following address:
?/v
Type of Residence
Single-Family~
Number of Bedrooms
Hulti-FamtlyF--~
Other (describe)
3. Water Supply'
Individual Well~-~ Comauni~y~---~
Public~-~
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
de
Sewage Disposal .' '" ..,.
· :j.,? · .
Onsit, ~--~ Public ~ Comdu.n. ity ~-l.:' :: ~olding Tank ~
No~e: If community ~ll system,' must .have.~l~te~.co~i~a~ion from the S~ace
Department of Enviro~en~al Con~e~ation'at~dsting to the legality aM s:atus.
[Page 1 of 2]
5. En~ineerin~ Firm Providin~ lnspectio~s~ Testa~ File Search~ Data and Information
As certified by my seal affixed hereto and as of the validation date sho~n below, I
verify that my investigation of this Health Authority Approval shows that the on-site
water supply and/or ~rastewater 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 I~uni¢ipality 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 regula-
tions in effect on the date of this inspection.
Date 9' ~ 0~ :-.~. ~ .,,; ..,. ,
DHEP Approval
Approved for_~__
Approved ~,
bedrooms
Disapproved
Conditional
Terms of Conditional Approval
CAUTION
THE HL~ICIPALITY OF ~NCHORAGE DEPARTMENT OF f~.,~LTH AND Eh~IROh%~}~AL PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON TRE REPRESE,N~-
ATIONS GIVEN IN PARAG~H 5 ABOVE BY ~N INDEPENDENT PROFESSIONAL ENGIh~ER REGISTERED
IN THE STATE OF ALASKA. TH~ DflEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES ~ND
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE-
HENTS. ~tPLOYEES OF L~/EP DO NOT CONDUCT INSPECTIONS OR ~NALYZE DATA BEFORE A
CERTIFICATE IS ISSUED. THE HUNIOIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR EPHORS
OR OMISSIONS I~ THE PROFESSIONAL ENGINEER'S ~ORK.
P,.Ri/el/Di8
[Page 2 of 2]
(DIIEP SEAL)
7-19-84
A. ~ELL ~TA
MUNICIPALITY O~ ~NCHOR~GE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CMEC~IST- FEBI~ARY 1984
Legal Description:
Static ~4ater
Casing Hsight Above Ground /.~-
Electrical Wiring in Conduit .(Y/N)
Separation Dista~s f~cm Wsll:
To Septic/Holding Tank.
To Nea~st Edge of ;~tion Field
To Nearest public Ss~= Line
; ~n Adjoining Lots /~ ' ~
; On Adjoining Lots ./~/'~
~-/~' To Nsa~est Publi. c_~Sew~r'
Cleanout/Manhole .~'~3~'~ .~N_q~ To N~a=est Sews~ Se~vi~e Lihs on LOt c-~- ' ~-
Wa~ S~ ~st ~sul~
B. S, EPTIC/I'iOLDING TANK [1%TA
D~ts Installed I~7~ Size ~. CQ.~ NO. of C~a~tmsnts 1
S~i~s (Y~) ~F3 Ai~ti~t ~ (Y~)~ F~n~ti~ C~a~t (Y~)
~e~i~ ~r Ta~ (Y~)~ ~ ~a~t ~d
~i~in~ ~a~ ~ Fi~ (Y~)/]~ ; f~
~ati~ Dist~s ~ ~pttc~di~ Ta~:
To ~~ly ~11 /~ / ~ To ~.ildi~ F~n~ti~ /~ ' ~
TO ~rty ~ /~' ~ TO ~al Field ~--~ ~
To ~ter ~i~i~ Li~ lb-' ~ ~'S~m, ~, ~, ~ ~j~ ~ai~
C~
Ce
ABSORP~ON F~ELD I~A
Date Installed /~?~- Length of Field
Width of Field /////f)/,~?)/3 ~p~ of Fi. Id
Gra%~l Bed Thickness ///~//r'/V.~ Id/r)
Square Feet of Abso~tion A=ea [)N~/Vdu3~/ StanclpiL~es P=esent (Y/N) ~/~__~
Delm, ession ove~ Field (Y/N) ~/~ Date Of last ~squao/ ~est
Rasults Of r*~t ~cy ~st
~Da~ation Dism f]rm At~<~tim Field:
Zo Wate~l~ply all .<S~ ~ l~<~rty Line /S-~
· o ~iidir~ Foundatio~ ~.,f ~ ~ To L~istir~ c~ ~ar~cned System cn
Lot /,/,~'/C ~'/C,9 ; On Adjoining Lots ~O ' ~-
To ~ate~ Main/Service Line ~,~/~/ ~ To Cutbank(if ~-esent)
7o s~/~/~/~ ~ ~.ins~ e=~ ?/.//7~
TO D=iveway, Pa~king A~ea, (x Vehicle Stc=ags A~a ~--/
De
LIF~ STATION
Date Installed
Size in Gallons
"Pump On' Leal at
High Water Alarm Leal at
Tested fo=
Elect=ical Cocbs (Y/N)
Cements
Dimensions
Manhole/a~ess (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles du=ing Adsqua~Z ~st.
** C~eck Permitted Bed~oc~ Rating Against HAA Bequest
on t...~i. ~V~~
KB1/dS/s
[Page 2 of 2]
BAA Guidelines in effect
4,?~ OF. AC~ I
· e~'.... .... ~e; ~
2-15-84
7 8 91 2 3 4 5 6 7 8 9]. 2 3 4 5 6 7 8 91
............... :..~...~...~:.~x'...~ ..~.c .: . ..:::::~ :::: :::::::::::::::~:: ~:::~ :~::, .:::::':::: :::: :::~ :: , .... ~'-
..................... ~ ..... / .......................................... ~ .............................. ~.~., ~...,,,/~ ...l ~¢ ........
.......... .,~. .... ...... .... .......... .............. .... , ......... ; ...... ..... .!~¢, .... .............
' X .... .... ' .... ' ' ~ ~ -i · ~ t~ ~"7,7¢Z ~ ~
DIRECTIONS: Complet~ =il ~,rts on ~ 1. I.~.l;Im r~lu.l~ wiU r~t b~ pr;i~il(~W~~l~)
PROPERTY OWNER
4Al LING ADDRE~
BUYER
LAI LING ~,~RF.~
PHONE
PHONE
PHONE
I ~rREET L~CATION *
TYPE OF RESIDENCE NUMBER OF BEDROOMS
[~ SINGLE FAMILY
· [] MULTIPLE FAMILY
7. WATER EUI~'LY
INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTILITY
8. EEWAGE DIS _PO~_~L BYSTEM
[~ INDIVIDUAL/ON*SITE**
I-1 PUBLIC UTI LITY
[] One [] Four
~ Two [] Five
[] Three [] Six
[] Other
* ATTACH WE LL LOG. A w~ll log is requireS for all walls drilleS ~
since June 1975. For walls drilled prior to that date, give wall
depth (attach log if available.) I I 'J I f//!/~.
**If individual/on-site, give installation data /C~ -7.0, .
bylf systemthis Department.is over two (2) years old an adequacy t~st is required/
NOTE: THE INSPECTION FEE MUST ACCOMPANY EAcH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72..010(3178)
· ~' ~ ~' THIS SIDE FOR OFFICIAL USE ONLY ~
DATE RECEIVEO ,
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
'L TYPE OF RESIDENCE NUMBER OF BEDROOMS
I'-1 SINGLE FAMILY [] ONE [] THREE i-'l FiVE I-'1 OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[-'] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified INSTALLER
[] Septic Tank or [] Holding Tank
Size: If Tank is homemade SOILS RATING
give dimamions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
8. COMMENTS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
72~)10 (Rev. 3/78)
October 24, 1970
Carolyn ~chr. u~rlo
Anchorage, Alask~ 9950)
~ubJect~ Tract ~ Lot 34 =agl~ Crest Subdivision
Approval for your ln~lvidual sawer and water facilities will not bo gran~e~
()
()
Aw ell log is submittua to ~hia d~partm~n~.
Th~ top of ~hQ w~ll ca,lng is sealed with a ~anitary seal so that
()
T~o deprcssion or pit around ~hu w~ll casing should be filled
~lth i~nervloue t}~ soil so t~h it slopes a~ay £rom tho
()
%,, (x)
Th~ well camin~ i-- er. tended twelve(12) inches above ground level.
~partm~nt.
A four(~) inch oa=t iron cleanout he inBtalled to the septic tan);
or leachin~ area.
A ~rcolation test bo pcr£orm, ed on th~ existin? leaching area.
~.,xis will determine if the system ia adequate accor~in~ to ]~ational
~andards. A list of ~rlvats fir~s w~ ~erfozmthe test la avail-
able at ~his office.
()
th~ sewer system ~as orginally approved for. Thmrefor~ an
u~rade will be required.
2;otify ~is departm~nt for a re-inspection when ~e~repancies have been
office at 264-4720.
Sincerely,
r4~rt c. ~rattl R.~.
Associate Specialist
MECHAH I CAL ENGINEER
DAVID SLE~IP
694-9055
S&S ENGIIIEERIIIG
'SRB 196X
EAGLE RIVER, ALASKA 99577
7 November 1978
CIVIL ENGINEER
ROBERT A. SIIAFER
694-2979
Star Realty
ATTN: Mr. ~ax Bevins
640 West 36th Street
Anchorage, AK 99503
Property located on Tract B,
Lot 3~, Eagle Crest Subdivision
Dear Hr. Bevins:
A sewer system adequacy test was conducted per your request on
4 and 5 November 1978. The septic tank was pumped and.1500 gallons
were removed. This did not completely empty the tank and though the
tank is verified to have a capacity in excess of 1500 gallons, it is
estimated the tank has 2,000 gallons. Excavation took place to locate
the seepage pit and cleanout. The water level in the seepage pit was
recorded and the pit charged with 750 gallons of water. Percolation
over a 24 hour period as recorded on $ November 1978, resulted in the
removal of 700 gallons or 350 gallons per bedroom. It can be con-
cluded that the percolation through this seepage pit is adequate for
the two bedroom residence.
On the basis of the above survey and test, it ts determined that the
system (septic tank and seepage pit) is adequate.
1 Incl
CF:
Dept of Health and
Environmental Protection
Ve.ry...r~uly yours,.) ,
< !