HomeMy WebLinkAboutEAGLE PARK BLK 2 LT 4Eagl
Pork
Block
Lo, 4
#050-782-32
coo 1 1 is 10 15a Anchorage VVEH 8, Pu +, Ot 072430742 .
AtUendon: 'rhe purip KnOr 561 pmvida pLu7:,,T, jrKINAn A 110 the DSD WIN 30 days of pump insmuakn.
bevelopment Services Department
Building Safety ivision
q
U -K. SWater Wastewater Program
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'114att s5g."ch
Anrhcraqe, AK 9955C7
4,layor
not) 343490",
Purnp Installation Log
MV %Hbg Knot Numb"n
SAI Date of lssm,:
Parcel
AtUendon: 'rhe purip KnOr 561 pmvida pLu7:,,T, jrKINAn A 110 the DSD WIN 30 days of pump insmuakn.
Municipality of Anchorage Page I of 3
Department of Health and Human Services
Division of Environmental Services
On -Site Services Section 825 "L" Street Room 502
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: S 01027 PID Number: 050-782-32
Name:
Robert Soptei
Wastewater System: New Z Upgrade
Address:
20510 Raven Drive Eagle River, AK 99577
ABSORPTION FIELD
Phone: Number of Bedrooms:
Three 3)
(
Shallow 5' Wide Trench
LEGAL DESCRIPTION
Soil Rating:
Total Depth from original grade:
8
.7 GPD/F t2
Ft.
Block: Lot: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe:
2 4 Eagle Park
5 Ft.
3 Ft.
Township: Range: Section:
Fill added above original grade:
Gravel Length:
0 Ft.
80 Ft.
Well: Existing
Gravel width:
Number of lines: TY
Distance ' an between lines:
5 Ft.
I N/A FL
Classification (Private, A, B, C):
Total Depth:
Cased to:
Total absorption area:
Pipe Material:
Ft.
Ft.
690 W
ASTM D3034 PVC
Driller:
Date Drilled:
Static Water Level:
Installer:
Date Installed:
Ft.
Charles Barr Cont.
8/19-21/01
Yield:
Pump Set at:
=t.
Casing F eight Above Ground:
TANK
GPM
F
Ft.
SEPARATION DISTANCES
Z Septic [:] Holding E] S.T.E.P. M Other:
To
Septic
Absorption
Lift
Holding
:lublic/FTnivaite
Manufacturer:
'apace ty in Gallons:
From'---,,
Tank
Field
Station
Tank
Sewer Line
Anchorage Tank
1,000
Well
>1001
>1001
N/A
N/A
>251
Material:
Steel
Number of Compartments:
Two (2)
Surface Water
>100'
>100'
N/A
N/A
LIFT STATION — NONE ON LOT
Lot Line
>5'
49
N/A
N/A
V
"'o.
Manufacturer:
Gal.
Foundation
>5'
>10'
N/A
N/A
'Pump on' level at: -
"Pump off' level at:
High water alarm at:
in.
in
in.
None
Noted
Pump Make & Model
Electrical Inspections performed by:
Curtain Drain
Remarks:
BENCH MARK
Existing Septic Tank Pumped and Removed From
Location and Description:
Site. Existing Absorption System Connected to New
Back Deck Southeast Corner.
System with Bull Run Flow Diverter Valve.
Assumed Elevation:
100.0 Ft.
See Lot Line Waiver for New Absorption Trench.
En 91 _eeesp. Stamp
OF
A, IQ
Z-1
Inspections performed by: Stuart Gilbert Dates: 15t 8/19/01 p,
V�
2nd8/21/01
s ��MCHAEL E. L,N0ERS-0N
Department of Health and Human Services approval
C_
-%2`-:..� 17
jefl, Poe E12TIDI
au,
Reviewed and approved by: Date:
ESS
(Rev. 10/99)
. . Municipality of Anchorage
· ." DEVELOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK 99519-6650 - 343.7904
On-Site Wastewater Disposal System or Well Inspection Report
..
Permit Number SW010273 PID No. 050-782-32
Page 2 of 3
RAVEN DRIVE
~xisting :
Well C7
./
Bedroom
~xistin,
Well
System ~Exact.
Location and Configuaration
Unknown )
1 0'. Utility Easement -----
PLAN AS-BUItT
SCALE 1" --40'
../
A B
S1 21.3 45.2
S2 26.7 50.0
C5 42.0 58.8
M1 39.5 56.4
C6 ,49.0 44.5
C7 33.0 14.3
M2 32.4 19.1
LEGEND:
C - Cleanout
~RV~ Septic Vent
Bull Run
Diverter Valve
· · Page 3 of 3
Municipality of Anchorage
DEVELOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK 99519-6650 - 343.7904
On-Site Wastewater Disposal System or Well Inspection Report
Permit Number SW010273
PID No. 050-782-32
To
House
91,9
\ 91.4
88.4
26'
Ceotextile Fabric
~ ql r,
Draln£ield Rock
Total Trench Length - 80'
PROFILE AS-BUILT
1" = 10' -
79.0~
ill'
Municipality .of Anchorage
]3uil d ~rtg Safety Dix:ision
P.O. Box 1OCfoS0 · 4700 S. Bmgaw Strcct
Anchoragc, Alaska 90519-C_fo50 * (907) $33-8001
ht tp://www.ci.anchoragc .ak.us
Public Wo rko;
Anderson Engineering
ATTN: Michael E. Anderson, PE
PO Box 240773
Anchorage, AK 99524-
August 29, 2001
Subject: Waiver Request forEAGLE PARK BLK 2 LT 4
Waiver # WR010072 Lot Line Request for Parcel ID 050-782-32
Dear Engineer:
Your request for a waiver of the required 10 feet horizontal separation of the on-site wastewater
disposal system to the lot line has been approved. The approved separation distance is 4 feet.
This waiver approval applies to the current on-site wastewater disposal system and lot line
separation only. Any future upgrade to the on-site wastewater disposal system and lot line will
require all separation distances to be met or another waiver approval from this depa~hnent.
If there are any further concerns or questions regarding this waiver, please call our office at
3434744.
Sincerely,
JeffPoet
Engineering Technician III
On-Site Water Quality Program
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
On-Site Services
Waiver Review Workahe~
WR#: 01007~ PIO~: 050-7~2-,~;1 HA#: 010460 PermiUt: 010273
Date Received: 8-28-01
Legal Description: Eeale Park Subdivision Block 2, Lot 4
Engineer:* Anderaeon Enatrleerlng
P.O. Box 240773 Anchoraae Ak,99524
Applicant: Robert $o~1[eI
Waiver Requested: Absomtlon Field to Lot Line of 4 f~
Criteria: 1. Geology Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
2. Special Conditions:
3. Other:,
Total:
Waiver Is Granted:
LEst Conditions or Reasons for above:
Waiver is not Granted:
Date: ~ "~,~'~.-'O I
Rec~: 8-28-01 Amount: 115.00
Date Paid: 8-2{1~1
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 (FAX)
August28,2001
Municipality of Anchorage
Department of Heath & Human Services
825 "L" Street
Anchorage, AK 99502-0650
Subject:
Lot 4, Block 2, Eagle Park Subdivision
Separation Distance Waiver
Absorption Trench to Lot Line
Dear On Site Services Engineer.
The absorption trench on Lot 4, Block 2, Eagle Park Subdivision was inadvertently
constructed within 4' of the west lot line to provide sufficient area for the length required
to serve the three-bedroom home on the lot. Lot lines were not well defined during the
construction process and accurate measurements were not available until the final as-
built for the house was surveyed. It was also necessary to adjust the alignment of the
trench to avoid landscaping and trees on the lot. Soils on this lot were found to be very
effective for the absorption of septic effluent and placement of the trench at this location
will not pose a problem to neighboring lots. We therefore recommend the waiver be
issued allowing the trench to be within 4' of the property line.
Sincerely,
Michael E. Anderson, P.E.
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Jul 30, 2001
Expiration Date: Jul 30, 2002
Permit Number: SW010273
Legal Description: EAGLE PARK BLK 2 LT 4
Design Engineer: 0014 Anderson Engineering
Owner Name: Robert Soptei
Owner Address: 20510 RAVEN DR
EAGLE RIVER, AK 99577-8740
Total Bedrooms: 3
Parcel ID: 050-782-32
Site Address: 020510 RAVEN DR
Lot Size: 47835 SQ. FT.
Permit Bedrooms: 3
This permit ls for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Privy
[] Private Well
[] Water Storage
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 DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Date:
Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 995196650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWERJVVELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 050.782-32
Permit Number
Property owner(s) Robert Soptel
Mailing address (1) 20510 Raven Drive Eagle River~ AK 99577
Mailing address (2).
Legal description (Lot, Block & Sub'd.)
Day phone 696.1104
.Zip Code
Lot 4~ Block 2~ Eagle Park Subdivision
Legal description (Section, Township & Range)
Lot Size 47~835 SF Acres/Sq. Ft.
Number of Bedrooms Three
[-'] Well Only r-]
[] Water Storage
THIS APPLICATION IS FOR:
Sewer Only
Sewer and Well
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub
Swimming Pool
Therapy Pool
[] Jacuzzi []
[] Water Softening Unit []
I certify that the above information is correct. I fudher certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit Fees:
Date of Payment:
Receipt Number:
(Rev. 12/00)
Waiver Fees:
Date of Payment:
Receipt Number:
MEMORANDUM
DATE:
TO:
FROM:
SUBJECT:
July 27, 2001
Jim Cross, P.E.
Mike Anderson, P.E.'~
Lot 4, Block 2, Eagle Park Subdivision
Septic System Design and Permit Application
I have reviewed your comments and revised the septic system design for the subject lot
accordingly. The application rate used::to 'design the new absorption trench is now
shown uniformly as .7 GPD/SF~ water.:monitodng results have been added, the
application has been chan. ged to'¢SeWe'~ uisgrade", lengths of each leg of the trench
are shown, and the house Is .sho,w.n.cor)sistently as three-bedrooms..
The sbmp for the existing ab{mrption trench is shown on the plan. It is currently in
place above ground. It is more than 10' from the proposed trench upgrade and proper
separation from the trenches will be maintained
Please let me know if additional information is required before the construction permit
can be issued.
July 18, 2001
Municipality of Anchorage
Development Services Department
On-Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject:
Lot 4, Block 2, Eagle Park Hills Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:.
The existing septic system on Lot 4, Block 2, Eagle Park Subdivision has failed and
must be replaced as soon as possible. We are therefore applying for a permit to
construct a new septic system on the lot to serve the three-bedroom home. The
attached Site Plan and backup documentation identify the location and configuration of
the new septic system and the parameters used in the design. Also identified on the
plans is the location of the existing well and septic system along with the test holes.
The existing septic tank falls within the 100' protective radius of the well on the lot and
will be pumped, crushed and removed from the lot. Existing drainage patterns are
shown and will not be altered by the development of the lot. The existing absorption
trench will be tied into the system for future use with a Bull Run Flow Diverter Valve.
Test holes were placed near the location of the new absorption trench. These holes
indicated a light gray to gray gravel material with silt. Percolation test in the material
resulted in a rates between 12 and 17 minutes per inch. For purposes of the trench
design we are using a blended application rate of .7 gallons per day per square foot.
No groundwater was found during placement of the test hole and none developed
during the monitoring period. We are therefore proposing to place a 5' wide absorption
trench with 3' of gravel beneath the distribution pipe. The total depth of the trench will
be approximately 8'. The distribution pipe will be placed at 5' below the ground surface.
The ground surface on the lot slopes as shown on the attached Site Plan with shallow
grades in all direction, The new absorption trench will be constructed on a fairly flat
surface in conformance with Municipal requirements and parallel to ground contours
where possible.
If the system is constructed in accordance with our design the following statements
apply:
1. The system, if constructed as designed, will have no adverse impact on the wells
in the area or those to be constructed in the future.
Lot 4, Block 2, Eagle Park
July 18, 2001
Page Two
2. The system, if c. onstructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
o
The system, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,
Michael E. Anderson, P.E.
Attachments
RAVEN DRIVE
'0
~xisting
Well
?S e Lonc
· Wide X
l~p~h Abs
?
Well
~ed=oom ,~,
'~-xisting Septic Tank
Gallon
Tank
ing
Sump
~xisting
System (Exact
Location and Configuaration
Unknown}
SCOPE OF WORK: -----.
1. Verify Foundation Cleanout
2. Pump, Crush and Remove E~ isting Septic Tank.
3. Place New 1,000 Gallon Septi: Tank.
4. Place 2 post Tank Cleanouts
5. Construct New 75' Long X 5~ .~.;_do Y '~' Fffective
Depth Absorption Trench.
6. ~ie in Existing Absorption System With
Bull Run Flow Diverter Valve.
7. Regrade All Disturbed Areas.
8. Revegetate Area As Required.
10' Utility Easement
NOTE:
SITE PLAN
SCALE 1" -- 40'
i14' to
Neighboring
Septic System
No Conflicts With Neighboring
Wells or Septic Systems.
LOT 4, BLOCK 2, EAGLE PARK SUBDIVISION
DESIGN FACTORS:
SYSTEM REQUIREMENTS:
Three Bedroom Home
Perc. Rate: 12-17 MinJInch
Application Rate: .7 GPD/SF
5' Wide Trench System
1,000 Gallon Septic Tank
3' Drainfield Rock
3 Bedrooms X 150 GPD 1.7 GPDISF = 642.9 SF of Absorption Area
642.9 SFI5 LF (Width)'.58 (Red. Factor) = 74.6 LF Trench Length
Therefore: Construct a 75' Long X 5' Wide X 3' Effective Depth Absorption Trench.
Flowline Elevation in Trench to be 5' Below Original Ground Surface. Total Depth to be 8'
Below Existing Ground. All Components of Septic System to be Outside the 100' Well
Radius.
2" Insulation & 2'
o~
Geotextile Fabric & 3'
3t
4" ?VC ASTM D3034
Drainfield Rock
.5e'
NOTE:
TYPICAL WIDE TRENCH SECTION
(NO SCALE) .~.~.~.~. ~.
G fade Area Over Trench to Drain Away.
Minimum 6' Sepa~tion From B~rock.
Minimum 10' Sepa~tion From Lot Line.
Minimum 4' Sepa.tion From Groundwater.
Minimum 100' Sepa~tion From Wells In the Area. .
Municipality of Anchorage
Development Services Department
4700 South Bragaw Street Anchorage, AK 99519-6650
SOILS LOG - PERCOLATION TEST
Performed For:. ~
Legal Description: Lot 4. Block 2. Eagle Park Subdivision
10
11
12
13
14
15
16
17
18
21
OGIOL
GM
Light Gray
Sandier
SLOPE
North
Was Groundwater
Encountered?
GM If Yes, What Depth?'
Depth to Water
After Monitoring
Gray Date:
South
No S
L
O
Dr~ P
7-26-01 E
Bottom of
Hole
Date Performed:
SITE PLAN
See Site Plan
Reading Date Gross Net Depth To Net
~Time Time Water Drop
I 7/14/01 2:34 10"
2 3:04 30 12.5" 2.5"
3 3:05 10"
4 3:35 30 12.5' 2.5"
5 3:36 10"
6 4:06 30 12.5' 2.5"
Perc. Rate: 12 Min./inch Perc. Hole Diameter: 8'
Test Run Between 5 Ft. and 6 Ft.
Comments: Testhole Presoaked Prior to Percolation Test.
Performed By: ~ I, ~ Certify That This Test Was Performed
In Accordance W~th All State and Municipal Guidelines In Effect On This Date: 7/16/01
Municipality of Anchorage
Development Services Department
4700 South Brogaw Street Anchorage, AK 99519-6650
SOILS LOG - PERCOLATION TEST
Performed For: Robert Sogtie
Legal Description: Lot 4. Block 2. Eagle Park Subdivision
OGIOL
GM
Light Groy
SLOPE
North
South
Sandier
SITE PLAN
See Site Plan
Was Groundwater
Encountered? No
GM If Yes, What Depth?
1 Depth to Water
After Monitoring Dry
11 Gray Date: 7/26/01
12
13
14
15
16
17
1E
Bottom of
Hole
Reading Date Gross Net Depth To Net
Time Time Water Drop
I 7114/01 2:40 3.75"
2 3:10 30 5.5" 1.75"
3 3:11 3.75"
4 3:41 30 5.5" 1.75"
5 3:42 3.75"
6 4:12 30 5.5" 1.75'
21
Pert, Rate: 17 Min./Inch Perc, Hole Diameter: 8"
Test Run Between 5 Ft. and 6 Ft,
Comments: Testhole Presoaked Prior to Percolation Test.
Performed By: ,~ad,_GJJb..ed. I, ~ Certify That This Test Was Performed
In Accordance With PJI State and Municipal Guidelines In Effect On This Date: 7/16/01
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 4, BLOCK 2, EAGLE PARK SUBDIVISION
GENERAL:
The scope of this project includes the pumping, crushing and removal
of the existing septic tank on the lot and the procurement and
placement of a new 1,000-gallon septic tank at the location shown on
the site plan. Work also includes the construction of a new 75' long X
5' wide X 3' effective depth absorption trench at the location shown.
The distribution line in the trench will be placed at 5' below the existing
ground surface. Total depth of the trench will be 8' below the existing
ground surface. A Bull Run Diverter Valve will be required and the
existing absorption trench and cdb tied in to the new system for
possible future use. The new septic tank and all components of the
new system will be constructed outside the 100' protective radius of
the existing well on the lot.
Construction shall be in accordance with the approved site plan,
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 all underground utility
locates and for the layout of the septic system and verification of the
location of all lot lines.
Unless specifically agreed otherwise, the contractor shall be
responsible for final grading areas subsequently depressed from soil
settling. Property owner shall be responsible for revegetation of
affected areas unless specifically agreed otherwise.
Contractors installing wastewater disposal systems must be certified
by the Municipal Department of Health and Human Services for
system installations. Owners installing their own systems must receive
pdor approval from D.H.H.S. before beginning system installation.
SEPTIC TANK INSTALLATION
1. A new 1,000-gallon septic tank must be procured from an approved
source and installed at the location shown.
A septic tank is to be constructed by a certified septic tank
manufacturer. Construction shall include two 4" cleanouts for pumping
access.
3. The septic tank shall be sufficiently bedded to prevent settling or
shifting of the tank.
4. All standpipes on the septic tank shall extend a minimum of 12 inches
above final grade.
5. Tanks installed without 4' of cover shall have a minimum of 2" of direct
burial insulation.
'Lot 4, Block 2, Eagle Park Subdivision
July 18, 2001
Page 2 of 3
6. A foundation cleanout shall be installed one to four feet from the
building foundation. Two cleanouts are required between the tank and
the drainfield.
7. Final grading over the tank shall be such that a positive slope exists
away from the septic tank.
DRAINFIELD CONSTRUCTION:
1. The drainfield shall be constructed to the dimensions shown on the
design. The bottom of the trench shall be within 2" of level.
Distribution piping must be placed level with perforations down atop a
level bed of drainfield rock. Rock should then be placed over the pipe
to provide a minimum of 2" of cover.
3. A silt barrier or geotextile fabdc must be placed between the drainfield
rock and the natural soil backfill.
4. Monitor tubes must be 4' in diameter and installed at the locations
shown on the design. The portion below ground must be perforated.
Contractor shall vedfy the septic tank and drainfield are a minimum
100' away from any pdvate water wells in the area, 150' from a Class
'C" Well or 200' from any community well.
Direct bury insulation must be placed over the distribution system if
less than 3' of backfill depth is available. Finish grade over the trench
must be mounded to prevent settlement or depressions.
7. Grade area surrounding the absorption trenches to drain away.
A minimum 2' of accepting soil is required below the drainfield rock for
a 5' wide trench. Contractor shall verify this condition prior to
placement of the rock. All pockets of unacceptable materials must be
removed and replaced.
MATERIAL SPECIFICATIONS:
1. Septic tanks must be constructed by a municipally approved septic
tank manufacturer.
2. The following pipe materials ara approved for use in septic system
installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated
and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and
ASTM D2662 or A.B.S. (perforated and solid).
3. Insulation shall be at least 2" thick extruded direct burial polystyrene
(Dow Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Femco, or equal).
· ; '. ; 'Lot 4, Block 2, Eagle Park Subdivision
July 18, 2001
Page 3 of 3
5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed
between the final drain rock layer and the native soil layer.
6. All drain rock shall be .5" to 2.5' in diameter with less than 3% passing
the #200 sieve.
INSPECTIONS:
Municipal Ordinance requires a minimum of two inspections. These
inspections must be conducted under the supervision of a professional
engineer registered in the State of Alaska. The first inspection must be
conducted after the excavation of trenches, beds or pits and before the
installation of any gravel. A septic tank may be set in place, but may not
be backfllled.
The second inspection must be conducted after the placement of the
geotextile fabdc, gravel, distribution piping, standpipes, cleanouts and
insulation. No backfill should be in place at the time of inspection.
Contractor shall provide a copy of all field survey layout and construction
notes for use in preparing the certified as-built of the completed system.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 LStreet-Anchorage, Alaska 99501 Telephone264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL DESCRIPTION
LOCATION
DISTANCE TO:
PHONE I'-INEW
7/27t PG"ADE
DISTANCE TO:
Manufacturer
IF HOMEMADE:
Well
DISTANCE TO: / 't~
No. ofli~es /n h r Lengthofe
Width
NO, OFBEDROOM~...~
PERMIT NO,
Length W~dth
Type of crib
Well
DISTANCE TO:
No, of compartments
Inside length Liquid depth
Dwelling
PERMIT NO,
Material
Foundation Nearest Iq~ ~
Depth
Liquid capacity in gallons
Building foundation Nearest lot line
Class
DISTANCE TO:
Building foundation Sewer line Septic tank
OTHER
PIPE MATERIALS
SOIL TEST RATING
REMARKS
'./
APPR E
[r~,l~ (Rev. 31~81
PERFORMED FOR:
LEGAL DESCRIPTION:
4-
5
6
7
8
10-
11
13-
14~
15
16
17
18
19-
20-
COMMENTS
PERFORMED BY:
~"'~ ~ [] so,us ,oo -~'"
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch, 6-6S0, Anchorage, Al~ka gg602 27~-2221
SOILS LOG -- PERCOLATION TEST
SLOPE
DATE PERFORMED:
SI
PERCOLATION
TEST
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
. ,o
PERCOLATION RATE (minutes/inch)
1 RUN BETWEEN --~-~'""' FT AN FT
72-008 (7/76)
PERMIT NO.
MUlti I ¢ I PAL I TY OF A[-I¢I-IORAGE
DEPARTMENT r"? HEALTH AND ENVIRONMENTAL ~'~OTECTION
825 ~L ~TREET~ ANCHORAGE, AK. ~1
264-472~
0[~--5 I TE SEWER UPGRADE PERM I T
APPLICANT ED UHEKOOLANI S. R. BOX l~6-X E. R.
LOCATION RRVEH ST.
LEGAL ~'4 B 2 EAGLE PARK ; LOT SIZE
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
20000 SQUARE FEET
MRXIMUM NUMBER OF BEDROOMS
SOIL RATING (SQ FT?BR)= 2~4
THE REQUIRED SIZE OF THE SOIL ABSORPTIOH SYSTEM IS:
DEPTH= 18 LENGTH= 40 GRAVEL DEPTH
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD,
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AHD THE BOTTOM OF THE EXCAVATIOH (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 EXCAVATION (IN FEET).
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
t~UMBER OF RESIDENCES THAT THE WELL WILL SERVE.
TI.,.IO < 2 > I I'-,ISPEOT I 01"~$ ARE REI3U I RED
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR R PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM A PRIVATE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER LINE IS 75 FEET,
OTHER REQUIREMENTS MAY APPLY, SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION,
PERMIT EXPIRES DECEMBER ~l~ ~L~80
I CERTIFY THAT
l: I AM FAMILIAR WITtl THE REQUIREMENTS FOR ON-SITE SEWERS ArID WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE,
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE BODES.
~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS,
GRr'-'T, ER ANCHORAGE AREA BOROU~":!
DE. aRTMENT OF ENVIRONMENTAL QUALI~. -
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
~.,"/~'"',"~",.,""~-'/~"" ADDRESS ~"~'-'~' ~',,'~-~"-; .-,.~'~'~--,'~,
LOCATION .,,,~Z..~-e:~·~' X f ,,'~"·"~"~'..~'.·'~/ LEGAL DESCRIPTION ~
SEPTIC TANK:
~' NUMBER OF
DISTANCE FROM WELL--MATERIAl. ..,.¢'o,7'-'~ COMPARTMENTS - -
LIOUID
LIQUID CAPACITY /,~ O ~' GALLONS. INSIDE LENGTH / INSIDE WIDTH, ~ ~DEPIH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS // OUTSIDE DIAMETER~OR WIDTH
LINING MATERIAl ,~ ~ ~' ~.~'~"/,,~' . DISTANCE FROM WELL //~'
NEAREST LOT LINF s:~ ~ . TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
LENGTH '*'-'" DEPTH ~
· BUILDING FOUNDATION /~ /,
SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL ., FOUNDATION.
NUMBER OF LINES ~N LINES
ABSORP~A SO. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE
TOTAL LENGTH
, NEAREST LOT LINE , OF LINES
DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE
WELL:.,~,.~:,,·,,,,..,w~-//.~.~.,,e .~,.,,,,-,-.;~'. ~,..,
TYPE ~,'"~-/~""~-~'" DEPTH ~"~ / DISTANCE FROM
. BUILDING FOUNDATION
NEAREST SEPTIC ,d~.-.m · SEEPAGE
LOT LINE /~ /~'~'' .o SEWER LINE ~'~ ~'' TANK , SYSTEM
~..~/ · WATER
.SAMPLE ~'/,"~"'-~ NEAREST
~ CESSPOOl ~, SOURCE~
DISTANCES:
,7'A~ --",.,~.~ ·
DIAGRAM OF SYSTEM
""~'~I'E APPROVED ~-'~.
· ' G.~,.A(.B.
GRea,ER ANCHORAGE AREA BOR~:JGH
SEWAGE DISPOSAL SYSTEM N APPLICATION AND PERMIT
INSTALLATION LOCATION
FINANCED THROUGH
S OIL T ES T RES U LTS ,/~/,,'~
SEEPAGE PIT DRAIN FIELD OTHER
TO BE INSTALLED BY
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
Ilia'ALT. DEPARTMENT AUTHORITY WILL Br SUBJ£CT TO PROSECUTION.
FOUNDATION TO SEEPAGE PIT
SEPTIC TANK TO SEEPAGE PIT WALL
WELL TO SEPT,C TANK '~"
SEPTIC TANK*~'~/~ SEEPAGE PIT
DRAIN FIELD
· DRAIN FIELD
· SEEPAGE PIT
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL·
4 INCH DIAMETER CAST IRON EIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FIT'TED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILl.
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
LICENSED DESIGNER
DIAGRAM OF SYSTEM
I CERTIFY THAT ! AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE I%10. 28-68 AND THAT THE ABOVE
OEEC.,BED S*STE. 'S '" ACCOROA.CE W'T' SA'O COOE. ~J/.~---h' ~ ~
Development Services Department -
Building Safety Division ...... ' /
On-Site Water and Wastewater Program
4700 South Bragaw SL ' 'Z""
. · - - P.O. BOX 196650 Anchorage, AK. 99519-6650' . '.' .~ / .; .' .~ [/ ,~'
· ' , '.'..~www.ci-anchorage-ak.us ,., :*". *'/'/*--~, ','
· . . . -.--
CERTIFICATE'OF HEALTH AUTHORITY APPI~ogAL',,' ' .· . .. - '
.... ' FOR A SINGLE FAMILY DWELLING '"*':": -: ' v*. ~ ."
......... 7 :':' :'-: ....
...... ;'. ' '-"- ': .-: '" : .. - '""'; "::/ a"/: ....... .'
'.1. GENERAE'INFORMATION. .,* . .:. ': ;-' · ' :.. ; .... :.-
· ., ..~; .Complelelega descnobon. :Lo[,~.'moc~z. caomt'ar~ueow~son---_ -- . ..: .... .,,,.,~. ..*- ',.-.,. ?.* ......
.,, - --, ,, Locabon (s te address or d rectionsl r 20510 Raven Dnve .............. - .......... - ...............
~... , ,.,-. 2 -*,,,,*,~!.,..~.,.t %~...~,,*.. ;.t.,' .., , .. ,.,...?.., ....... ~......~., ..... .,.....:,,.,.,o,,,~.. > .,,.:.,,,.,: ~.,..-
. .v-,,, '.:, rrrope[ty ownerts)., Robert oo[~el-- .,. ·., ~ : ·: ?., ,~ ...... ; L~ay phone ~ 696;1104 '. .....,,~,: .: ,.', :,
, ..: '. ':. ,:, * -., Ma ng address 20510 Raven Drive Fag e River/AK 99577 . '...;'..,. ~ r ..., * ,*,. z ,; .: :: ~..4 ,;,.-., ' .:,.
,;.- ' .Lendnaaaencv,',,: .......... · ..... , ~ · '..--'-'-': ; ,,."~Davunone~.,*.~'~e~:,-~'"q.,.---- .... .'-
,"--,-"-' Ma ngaddress-.:.-" ·.-.;.:,; ..... '.;.'.*·..:~;_.·;,..'.:'~:.:, -, .~.
~.'~..,, .~ . :~...... t ...., ~, .~.: "~- '~',3",.'?*'.'*'.'~.*,:~ ~','-~'~ .'.'~'"~? ~ ~, '~; '~,';~,'~ 5'" '*'.:' '-:t'-'-:~'*~. !~-r'c~';'.~*~.'t'
,.,.- · .~ .., .*. Real Estate Agent.....- ~ ...... r .................... ~ ......... - ,, ',Day phone ..--,,~.-,-,'~ ..... ~-~..
~,- . "~ ,' ,,., -. · ~ Ma rl~ Aooress' , ' -',;~-"~;'- ,:'-':* ,;,L,.:,~-'~ ;;; '..",':~'.'.~; i' '~ ;;',, T~: ~...-'." '.-tG;: .~ w...~,. · .~...1~,~? .~..~.; .
-' ,.-: -':,.Unlessotherw~serequested?HAAwillbeheldbyDSDforp~ckup...-., ..... '., .... ,.'?*~,,,'-:-,~;',,, ~-..,~,. ,.,, .;-,. ....
~ .......22 NUMBER OF BEDROOMS. ,-, :.-.' ,. ,Three(3) ~ ; .- .. ,~ , -.: :. ~ ,.;, ,~.:- :,.., ...... ,,
· ;.,.,,, ~ .. -~,- ,-.,, ~,, ,~ :.~,, -.: t-~; ;:,.,,, ..... ~ ..,~,~-.~...,~ .... ¢,,..,.:~ ~-..., -...~. ....
~:.,,"*'.',: ,';.,3.,; ,TYPE OF,WATER SUPPLY: r_..,... ;,;~.. j.-~b~: ,,:: .~, -:,TYPE OF:WASTEWATER DISPOSAl':'/*, .'
~-..-.,Ind~wdualWeli'-..' ...... ,...- ,': ? y .[~;~]'..,,, , -.-,, · ndwdua On*ste, *.~' -..'.w~., ~(~,,,,,,~ ..... .,...
,,,,:: . ~ ,. :'..'. Individual,Water. Storage *~- ,~... --:,'?,; *,'E].t ,',;'~ *, ' ,':*..,Individual Holding tank .:*
. .., . ,_Community Class ....... Well. .. ,[-~.,. , Commun ty On-s te ...... , [~ t.., .
. ,.* ? · ',*, Pub cWalerSystem.- ~ ,.... ~lJ~ , .,,..: ....'*Pub cSewer: '* ,' ;, .., .....ITl ,. ~ .... *
;; .,- ...~Th~Mumc~lmhty; of ~ora~ [~y~opmenJ Ser~c~s,O~partme,n~t,~(DSD).lss,u,~ ~ca!,.~ of
'"'r !i ^pproval {HP~) besod only upon the repro~ntat~ons fl~'en m paragraph $ by an independent profess~onal~¢~l c~. ....
· ~:,'. '~ ·eng no~r r~:j stered m the State of ~aska.,Certifica~es of Health Authon~ ^pprova are requir~:l
:~ · ~..~ ...~ title (e×¢ept between ~$pous~q) for~ pmperbo~ s~'~-ved .by ~ ~m§l,o. fam~l~.on-s~te,wast?~,att~ d~sposal ,and/or, water
; , .': .: '. '.valid for 90 days from the date of is~;u~ f0r'lDr(:~-:.dJes ~'v~d b~' ~ ~riv~t~ ~ Cla~s C~&ll*and 'r:nay I:~'r$is~0'~l ~ith ,;. ", '.
...... ; . [, new water sample results less than 30 days old: (Ced~cates may be reissued for a period of up to one year w~th .. '~ '
;~--. ;... ,.. vahd water samples.), Certificates are vatid for.one year for properties served by Class A or, B wells or a public -.-
~,'. "i" 'water. system. The Mumc~pal~ o¥.Anchora~: ~s not. responsible for errora, or'omissions, in,the pr~fo~onal .' '
.4.
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal afl"~xed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures ouUined in the He:~Ith'AL~thodty Approval Guidelines for this application, shows that the
on-site water supply and/or wastewater dispos~,l s~,stem is(are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I fu~'ther verify that based ~n the information obtained from the
MunlciDality of Anchorage files'and from my investigatic~n and inspection, the on-site water supply and/or
wastewater disposal system is(are) in compliance with all applicable Municipal and State code., ordinances,
and regulations in eff~:t at ~e. t~me o'~ !r~s~allation;
Name of Firm Anderson En.qineerin.cl .' , · ~ * . *Phone · 522-'///3
Address P.O. Box 240773 An~:hora.qe, AK 99524 , ·
Engineer's Printed Name Michael E.'Anderson. P.F_,'. : . ' Date 8/28/2001
~.. ', '.'- ;" '- ..... '~: ' ............ ?"°''. ...... ~ ". ''
· ~ '. · ,,, . , .... ' . .... .,.
"' ............. ' .................. ' ~'" ..... ""'~'~"~" "~"~' """~"'~"~''"' ......... ""';'~ " ~M.~IT~.- ,~."'
:, .... ,,, ~",' · Add~bonal'" Comments ;'"~ ......
' :HAACheckhst.'," .~, ,':.~ '-,:X'. :: ::L:'. ,::'..~.Mamte,nanceAgre. e,ments".,',: /,. ......
,' ' "- ' ' Se,~ficS,,stem'Advson/', ..;~? ,~ ~ .. ',. - , Supplemental Engineer's Report,.,. ..... ·
", :~We FowAdvsory ,..., . ,:: . : Other ...........
"""~ ' ' ' ...,.. , : "L-'. ,"; -'r "" '.,' ?-' '::~" ~', ,; ~ . - .',"- '
.? ,- Ongmal Certificate ,Date.,. ~' - .,~,·
.:,.- .- .. ,
.~,.; '~'. , .... :. '. :,:
Municipality of Anchorage
Development Services Department
BuiJding Safety D~sion
On-Site Water & Wastewater Program
4700 South Bmgaw St.
P.O. Box 196650 Anchorage. AK 99519-6650
www.cLanchorage.ak.us
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal DescripUon: Lot 4, Block 2~ Eagle park SubdivisionParcel ID: 050-782-32
..........X:-~n~LE~XfX .................................................................................
Wee type Private
Date completed
Total depth __ f.
Date of test
Static water level
we~ r~duct~n
Ce
If A, B, or C pn:wide PWSID #
Sanitary seal Or/N) Y_
We~ Log 0rA,I) N
W'.'es propedy protected Or/N) Y
Cased to >40 ft. Casing height (above ground) >24
FROM WELL LOG AT INSPECTION
. 7./2001
fi. 73 ft.
g.p.m. 4.8 g.p.m.
WATER SAMPLE RESULTS:
CaJ'dorm 0 colonieS100 mi.
SEPTIC/HOLDING TANK DATA
Tank Type/Material ~pt~lSteel
Tank size t,000 gal.
Foundation cleanout Or/N) Y_
Date of pumping
ABSORPTION FIELD OATA
Date installed 8121/200t
Length 80
Total depth 8_ fL
Nitrate 3.51 mgJt.
Ca,lected by: StuartOlroert
Other bacteda I caloniesJ100 mi.
Number of Campmtments _2
Depression over tank (Y/N) N
Puml::mr N/A
Date instead ~/19/200t
Cl~anouts Or/N) Y
High ~ elann Or/N) N
Soil ratJng (g.p.dJt~or~rodrm).TOPD/SF System type 5' Wide Tmnch
ft. Width 8 ft. Gravel below pipe 3
Eft. absorption area 690 ~ Monitoring tube Y Depression over field N_
Results (Pass/Fall)
.fi.
Fluid depth in absorption field before test in. Water added gal
Elapsed 'rime: min. Final fluid depth in. Ab-~=rpflcm rote >=
Any rejuvenation b'eatment (past 12 mo.) Or/N & type) N
For. bedrooms
Now depth in.
g.p.d.
ff yes, give data
D. LIFT STATION
Date installed
"Pump on" level at __ in.
Datum
E. SEPARATION DISTANCES
Size in gallons
'Pump off' level at in.
Cycles tested
Manhole/Access (Y/N)
High water alarm I6~el at
Meets alarm & circuit mquimmeets?
in.
Proparty line 4
Water Sewtce line >10'
Curtain drain None Noted
COMMENTS
Go
Sewer/septic sen~ce line =25' Holding tank N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >5' Property line >5.
Water main N/A Water service line >lo'
Wells on adjacent lots >100'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation >t0'
Surface water >100'
Wells on adjacent lots >200-
~, See Lot I. Jne Wal~ef allowtnq eflcroadm~nt to wilhin 4' of m3~eflv line.
ENGINEER'S CERTIFICATION
I certify that I have detetmk',ed through field inspecf~ns and
review of Municipal records that the above systems are in
conformance wfth MOA HAA guidelines in effect on this date.
Engineer's Printed Name Michael E. Anderson, P,F_
Date 8/28J01
Date of Payment
Receipt Number
(~q~v.
Absorption field >5'
Surface water >100'
Water main >10-
Ddveway. parldng/vahldes~ >25'
Waiver Fee $
Date of Payment
Receipt Number
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot >100- On adjacent lots >100'
........... A~p--uo-~ i~-(i' ~ -~i- ->-i ii0'- ........................... O~-&~ji~i'~5-t~-s~o~ ..............................................
Public sewer main N/A Public sewer manhole/cleanout N/A
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
Parcel I.D. # ~,~O 78~. ~- HAA # .~_. C.~O~ _ I~, ?3 C~ ~
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (inc. lude lot, block, subdivision, section, township, range)
Lot 4~ Bt. ock2;
Location (address or directions)
~05t0 I~v¢~ O~t~.ue E~tqt.¢ RZvt./[ A~ 99577
(b) Prope~y owner ~.~
Mailing Add~ess S~ A~ A~u~
(c) Lending Institution [~ ~A~ [o~Z Ho~z
Mailing Address . 101' ~e~ Be~6~, B~ud. A~e~o~9~ A~6~ 99504
(d) Real Estate Company and Agent
Telephone: (home)694-59~g Business 565-1661
Telephone ~;64- 0557
(e)
Telephone
Mail the HAA to the following address: (or check here~, if hold for pick up.)
List contact person and day phone number below:
~G
$7~34 Eagle River Li4p Rea*/Ne.
2. TYPE OF RESIDENCE
Single-Family r~ Number of bedrooms =~
3. WATER SUPPLY
· Individual Well I:~ Community r-I Public I-I
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 legality and status.
?2-o25 (,,..?/~) Page 1 of 2
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
A's certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of th'is
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
$ & S ENGINEERING
Address 17n_'~a m,~la Rlve~. Loop
Date
6. DHH$ APPROVAL
Approved for
Approved
Terms of Conditional Approval
Disapproved Conditional
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 Anchorage is not responsible for errors or omissions
in the professional engineer's work,
Page 2 of 2
~,~. MUNICIPALITY OF ANCHORAGE (MOA)
. , Health Authority Approval (HAA)
:¥ ~:~ ~,.N~LIST- FEBRUARY 1984 L'
[h~ .., .,i ,~./, i 1: ~,~. st.~.VlCES DIVISION ' 343-4744 ' ' -
,-' s,. ~, ]. 5 ].988 : Legal Description: ~ ~
A. WELl. DATA I~ ~ I~' [:: ] V J~ I") ' '
Well Classification~' ~ ' If'A, B, C, D.E.C. Approved
Well Log Present (Y.~) ~ Date Completed' ' ~ ~ ~ Z-.' Yield
Total Depth ~"~ Cased to '~;'~' Depth of Grouting '"-"-'
Static Water Level "~c,' Pump Set At [ ~
Casing Height Above Ground I'~,~ ,4- Sanitary Seal on Casing:~N)
Electrical Wiring ir~ Conduit~'N) ' '"/ Depression Around Wellhead (Y~[[~ I
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot ~ '~,'7.-, ~ ; On Adjoining Lots t
To Nearest Edge of Al~sorption Field on~Loi ' ~. ~'.'.'.'.'.'.'.'.'.~>t~e'~ ' '; On Adjoining Lots .
To Nearest Public Sewer Line ~//~ To Nearest Public Sewer Cle~nout/Ma~l'{ol~
To Nearest Sewer SerVice Line on Lot ~ I''l--
Water Sample Coll'ected by '~,/----~ _ ."~-._~(,~,',',',',',',',','~w ;Date c:~
Water Sample Test Results
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed (z~- ~,-'~. ?~. Size ~. C3C~) No. of Compartments
StandpipeS/N) "/ Air-tight Caps~N) '7'
Depression Over Tank (Y~
· ' Pumping/Mainter~ance Contact on File (Y/N) j
;'."'~"! .~i' ,Holding Tank High-Water Alarm (Y/N) I'/-~'
..... "~; '~ DISTANCES FROM SEPTIC/HOLDING TANK: .... .
· ~. ,,,:SEPARATION ·
;"? ,To Water-Supply Well" ~'~' / ,I .
To Building Foundation
. To Property, Line "' ~. c::) I..~. To Disposal Field : '~1"! '
~1'o Wate,r Main/Service Line: \ ~
,To Stream, Pond,,Lake or Major Drainage Course ~ ~ I.~
C~lr~ents i.~-~-.~ ~c:::~::~.~- "J~::~..3~---t~::~l ~.-~-'t.,
Foundation Cleanou~)
Y
Temporary Holding Tank Permit (Y/N)
Page I of 2
C. ABSORPTION FIELD DATA , ' ' · '
Soils Rating In Absorption Strata '~'~'~¥'~'.~.--' Type of System Design. ~-----~..~
Date Installed I~,/~ 2.....- ~,/~o 'Length of Field
Width of Field *' ~' '~ .... Depth of Field
· . ' Gravel BedThickne~s
Square Feet of Absortion Area A" ~--~1~ StatndPiPes
Depression over Field (Y~ ~ Date of LaS! Adequ~,cy Test
Result~ of Last Adequacy Test ~~F~/.~...T.-~z~ ~ .~: -{z~,~
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water-Supply Well [ ~:~c:, ~
T° Building F°undati°~ t~Lot ,..~ I
To Water Main/service Line
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments C:~/.....D ~.~---I/~
.
TO Property line' '
' 'To Existing or Abandoned System on
; On Adjoinir~g Lots ~ ~'
To Cutback (if present) r'~
Date Installed
Size tn~ ~ _ '
"Pump On" Level at ~
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
Dimensions
' ' Manhoie/Access (~'/N) '
"Pump Off" Level at '
Vent '(WN) : '.' ~
ring Adequacy Test.
**Check Permitted Bedroo~n Rating Against HAA R, equest°*
I certify that I have checked, Verified, or conformed to all MOA an,d HAA guidelines in effect on the date of this
inspection. . ' .
$ & $ ENGINEERING
Signed
Company
Date
MOA No.
I~agle Rivert Alaska 99577
Receipt No. ~["7 ~ O5 -- 20~ ~:~'
Date of Payment (~ I .% I ~ ['
Amount: $ J"'7 ~ .OC:)
'Receipt No.
Waiver Fee: $
Date of Payment
Page 2 of 2
CHEMICAL & GEOLOGICAL LABORATORIES OF .4I~4SKA, INC.
~',~ 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343
~,-~.~o.~ FEOER^L TAX ,O. 92~040.0
Client S~ple ID:J4. ~2 EAGLE
P~ID :UA
Collected $[? 8 88 ~ 15:45 h~s.
~ece~ved $~P 9 88 B 15:00 lus.
P[elezved with :4 ~BG. C
Client Neme : S & $ ENGI~B~ING
Client Acct: SNSENGP
O~de~ed ~y :
Analysts Coapleted :$£P 12 88 Send Repo{ts to:
Special
lr~tzuct:
Cha-~ab her I: 2546 Lab $apl ID: I ~t{lx: WATEE
Allowable
NITRAYB-N 1.8 ~/l EPA 351.2 tO
Sample ROU~I~ S~N~LE
[ema~ko: SABLE COLLB~BD BY RJ$
I Tests texfo:med · See Special In~txuctton~ Above gA-On~vatlable
ND- None Detected "See Sample Remarks Above
WA- Not Analyzed LT-Lott !hen. GT-Gzeato[ Than
CHEMIC,4L & GEOLOGIC~IL LzlBOR/ITORIES OF ~4L/ISK.4; INC.
TELEPHONE (907) 562.2343 5633 B Street
Anchorage, Alaska 99518
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
PUBLIC WATER SYSTEM I.D.ff
~ PRIVATE WATER SYSTEM
Names & S ENGINEERING
17034 Eagle R~e~ Leep Road No. 2S4
Malll~a~r~E~yer, Alaska 9~577
Phone NO.
City State
Mo. Day Yeer
Zip Code
SAMPLE TYPE:
~ Routine
[] Check Sample (for routine sample
with lab ref. no.
[] Special Purpose
) [] Treated Water
[] Untreated Water
SAMPLE
NO. LOCATION
1
31
41
s l
Time Collected
Collected By
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
,~Satisfactory o
I
[] U.nsatlsfactory
[] S~mple too long In transit; sample should
not be over 30 hours old at examination
to indicate reliable results. Please send
new sample via special delivery mall.
Date Received
Time Received
Analytical Method: Membrane Filter
* No. of colonlesll00 mi.
Lab Ref. No. Result*
BACTERIOLOGICAL WATER ANALYSIS RECORD
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
Membrane FIItec Direct Count
Co[Iformll0Oml
Verification: LTB 8GB
TNTC = Too Numberous To Col
OB = Other Bacteria
MUNICIPALITY 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
264~1720
Application Date
GENERAL INFORMATION
(a)
Legal J3escription (include lot, block, subdivis]D.n, section, t~ip, range)
'"1- . ' ·
Location (address or directions)
(b)
(c)
(d) ' Lending Institution
Address
Applicant Name ~ Telephone: Home ,_~.5; o~ -~,5",5"'o~._ 'Business
Applicant Address --~~
Applicant is (check one): Lending Instituti~)n rl; Owner/builder D; Buyer ri; Other,J~ (explain);
, ~ Telephone
(e) Real Estate Cbmpany and Agent
· ' Address ' '
~.~hone '. J
(1~ .Me~lhe HAA to Ihe Iollowin,g address:
TYPE OF RESIDENCE
Single-Family~ Multi-Fam~FI Other
Number of Bedrooms ~
WATER SUPPLY
Individual Well~[~ Community r-~ Public []
Note: If com reunify well system, must have written confirmation from the State Department of Environ mental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite,~ Public[] Communityr't Holding Tank []
Note: It corn munity well system, must have written confirmat on Irom the State Department of Environ mental Conservation
attesting to the legality and status.
Page 1 of 2 t2.o2s u ~,s~l
· ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of Ihe 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 liles 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 ~, 8, S'E~qlne,~'l~ll
SRB I76x
Address F.,-,~;u --,~v~, -' lask~ ~"'~. ST'J'
Date
Telephone
Approved for ._/.~'?/_~5~E..Z_ bedrooms by~.~)
Approved ~%. Disapproved Conditional ·
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Department of 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 purchaseCs 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
72-02.5 (I t~4)
WELL DATA
Well Classification
MUNICIPALITY OF ANCHORAGE (MOA/
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
2644720
Legal Description'
JV~q~IClPALITY O~ ANCHORAGE
DEPT. O~c HEALTH &
ENVII~NTN. P~OTECTION
APR '!
Well Log Present ~
Total Depth ~ '7 ~' Cased to
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit
Separation Distances from Well;
To Septic/Holding Tank on Lot
If A, B. C, D.E.C. Approved (Y/N)
Date Completed ~ c'~ ~'7--- ~ Yield
z-./O; ~ Depth of Grouting
Pump Set At
/Z.; I ~' Sanitary Seal on Casing (~)
Depression Around Wellhead,('Y'/~
; On Adjoining Lots
To Nearest Edge of Absorption Field on L~t
To Nearest Public Sewer Line /4'/'4'
CleanouVManhole '-'
Water Sample Collected by -~ ~ ~'l'q {0 t,.""4 ~t~G
Water ~ample T~t R~sults
Comments ~ ~ ~~
IO~ ~ ; On Adjoining Lots '~ 430
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot ~
; Date ~ "~
SEPTIC/HOLDING TANK DATA
Date lnstalled _~-'~//~./~'.~' Size ~(3~..~,~::~ ko. of Compartments
Standpipes~.N)*'-- Air-tight Caps~/~ Foundation Cleanout ~
Depression over Tank,,(.Y~ Date Last Pumped ,,~'" ~' ~'-,.'~C,
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding'Tank:
To Water-Supply Well ~ ¢~ ~
To Property Line ~ ~ ~
To Water.Mei~'Service Line ~o ~ ~"
~/,.4.- ; for ~
Temporary Holding Tank Permit (Y/N) ~'(//~
Course
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Page I of 2
72-026( $1/84)
ABSORPTION FIELD DATA
Soils Rating in Absorption Strata Z ~> ~ ]~/~-'-
Date Installed '7- /~' ~,O
Width of Field .~ ~'
Type of System Design
Length of Field
Square Feet of Absorption Area
Depression over Field,(,,Y~
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well //Oc.~ I ~-
To Building Foundation ,~'~ /
Lot ~'/~'-
To Water I~afn/Service Line ~c> ~ e-
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
· Comments ,,'3,.' ~ ~'~,~/~' ,~ ~'-/'z-t /x..; ~'
Depth of Field
Gravel Bed Thickness
Z./~) / Standpipes Present~,N)
Date of Last Adequacy Test
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots .~'~' / ~
TO Cutbank (if present) *J~'
D: LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (WN)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all M?A/~nd .H~_A guidelines in effect on the date of this inspection.
Signed S & S El~m'h~ · C' Date ~4~'/,~/~:~ ~
Company E,..;:~ -'.:, ~., ",',,~'-.. ~ ' MOA No.
Receipt No.
Date of Payment
Amount: $
Page 2 of 2
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
DEPT. OF IL'ALTH &
825 L Street - A~hor~ge, Al~ka 99501 ~I~ENT~ P~OT:~ ~
ENVIRONMENTAL ENGINEERING DIVISION
Td,~,~7~ JUL 2
I
I
E. LEGAL DESCRIPTION
STREET LOCATION
6, TYPE OF RESIDENCE
,~ SINGLE FAMILY
[] MULTIPLE FAMILY
NUMBER OF BEDROOMS
I--1 One [] Four [] Other
[] Two [] Five
~ Three r'l Six
7. WATER SU~LY
J~ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled
[] COMMUNITY s[nce June 1975. For wells drilled prior to that date, give well
[] PUBLIC UTI LITY depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
J~' INDIVIDUAL/ON-SITE*' **If indivldual/on-slte, give installation data
If system is over two (2} years old an edequacy test is required
[] PUBLIC UTILITY by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78) , ~, ~.[~
f
._:~ THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER Of= BEDROOMS
r-I SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
2. WATER SUPPLY PERMIT NUMBER
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTI LITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[]INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY [ q ~'"~_
Connection Verified
INSTALLER
[]Septi~Ta~k or []Hold[ngTank
Size: (~"'~ If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES I Septic/Holding Tan Sewer Line Nearest Lot Line
WELL TO:
Absorption Area to nearest Lot Line
5. COMMENTS
~VED FOR ~---'~ BEDROOMS
APPROVAL (letter must ac,~pany certificate)
CONDITIONAL
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
July 9, 1980
~lward & Rhoda Uwckoolani
Box 15
Eagle River, Alaska 99577
Subject: Lot 4, Block 2, Eagle Park Subdivision
Approval for your individual sewer and water facilities can
not be granted until the following items ahve been completed:
(1) The septic tank pumped with a receipt submitted to this
office.
(2)
An adequacy test be performed on the existing leaching
area. ~nis test will determine if ~he system is adequate
according to llational Standards. A listing of private
~ir~s perform/ng the test is enclosed. This rep~ot needs
to be submitted to thi~ department for our review.
(3)
The top of the well casing sealed with a sanitary
seal so that it is air tight.
(4~S .The water analysis report be delivered to this office
~/~0~from the Chcm Lab~ 5633 B Street, foroour review.
Please notify this department for a re-inspection when the noted
dezcrepancies have been corrected. If there are any further
questions, please contact this ~fice at 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Z~socia~ Speciali~t
cc: R~nior ~rt~ge Co.
P. O. Box 1200 99510
Great Land P~alty
P. O. Pox 633,
Eagle River 99577
DAVID A. SLENKAMP
ROBERT A. SHAFER
MECHANICAL ENGINEER
694-9055
July 13, 1980
CIVIL ENGINEER
694-2979
Mr. Ed~rd U~ekoolani
c/o Greatland Realty
ATT~rION:. Lola
P jO. Box 633
Eagle River, Alaska 99577
De~r Mr. Uwekoolani,
Reference.' I~t 4;' Block 2;' Eagle Park Subdivision
At the request of Great Land Realty,. a se~e system sdequacy test
~as performed on the system located on the referenced property.
The test tins performed during the period of July 11 through 13, 1980.
The septic tank uas ptLmped and verified to have a~ capacity of 1000
gallons. The seepage pit was charged with approxim;tely 1000 gallons
of fresh uater. The ~ater level ~as measured after a period of
24 hours and 48 hours. Approximately 335 gsllons percolated out
of the crib during this period. This equates to appromim~tely 167 '~
gallons over a 24 hour period.
It can be concluded from the above test that the septic tank is
adequate. However, i regret to inform you that the seepage pit
percolation is only currently adequate for one bedroom. In order
for the system to be acceptable for a three bedroom house, the ·
absorption area Mill require upgrading. You m~y obtain a permit
for this upgrading from the ~m~cipality of Anchorage, Bopartmont
of Health and Environmental Protection, 825 L. Street, Anchorage,
Ale ska.
If we m~y be of further assistance, please do not hesitate to call.
Since~reSy,
~c" °/~'~nicipality
Department of Heat
Anchora ga
and Enviorn~ental Protection
SRB 196X EAGLE RIVER. ALASKA
GI~ATER A~HORAG~ ARP. A BO~UGH
3500 Tudor Road, Anchm'~ge, Alaalm g9507 27~-868~
Time of inspection
Date of
R~QURST FO~. APPROVAL OF
II~IV~3]UAL .~W~R & WATER FACILITIES
FO~
5.
Requested By:
Phone=
Wall Data~
Sewage Dtavossl S~tem:
A. Inltalled ~ R. Installer.,
C. Septic Tank:
D. Seepage Pit: 1. Size
E. Disposal F{eld: Total ~th of Lines ~ ~/~ ...
A.
C.
") A~sorption Area /~. /
~atton to ~pttc Tank ~/ ,,,
A~ti~ A~a to Mea~st Lot Line ~ , ~_
, Absorption Area ///~ / , Sewer Lines
Other Contamination
.Request for Approval of
Page
App, rove! Valid for One Year Fr~m Date Stqned
Greater Anchorage A~ee Borough, Department of Env~ror~enta] ~ueltty
D~AGRAU OF SYST~.
cert~f7 that the information contained in th~e request for approval to be · true
and accurate repraee~.tet4oa of the sub.iect sower and water facilities located at:
$iqnad Date
Gk. AT[R ANCHORAGE' AREA 80ROUG,,.*~ *
DEPARTHEHT OF ENVIRONHEflTAL QUALITY
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99507
2Z9-8686
DATE RECEIVED:
INSPECT:
TIHE:
~EQUEST FOR APPROVAL OF
INDIVIDUAL SE~ER AND HATER FACILITIES
FOR
APPROVAL REQUESTED 6Y:
ADDREss:
PHONE:
PROPERTY OHNER:
LEGAL OESCRIPTION:'
TYPE FACILITY TO 6E
NUMBER OF BEDROOMS:
HELL OATA:
A. TYPE
6. DEPTH ~ ~'
¢. SIZE ~ ~
O. CONSTRUCTION
E.
BACTERIAL ANALYSIS ~"~,~-,~
SEWAGE DISPOSAL SYSTEM:
SEPTIC TA~K (I~ HOMEMADE, SNOH DIASRAM ON BACK)
1. SIZE
2. ' AGE
3. MANUFACTURER
4. INSTALLER
- .' ', : ~ APPROVAL
PAGE THO
REOUI-... ~ FOR SEi4ER & HATER FACILI, ~-'*S
B. SEEPAGE PIT
~. SIZE ..
2, LI~ING
C. OZSPOSAL FIELD
I. NUMBER*OF*LINES
2. TOTAL LENGTH
REQUIRED ~EASUREMENTS
A.
8.
C.
O.
E.
F.
G.
H.
HELL TO SEPTIC TAN~
HELL TO SEEPAGE
HELL TO SEHER LINE
HELL TO PROPERTY LINE
HELL TO OTHER POSSIBLE CONTAMINATION
FOUNDATION TO SEPTIC TANK'
FOUNDATION TO SEEPAGE PIT
SEEPAGE PIT TO PROPERTY LINE
APPROVAL VALID FOR ONE YEAR
GREATER ANCHORAGE
DISAPPROVED:
DATE:
FROM DATE SIGNED.
AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALI'