HomeMy WebLinkAboutEAGLE PARK BLK 2 LT 7
825 "L" Street
I~ick Mystrorn.
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
ht tp://www.ci.a nchorage.a k.us
Suly 8, 1999
Lan'y & Wendy Lescanec
9627 WREN LANE
Eagle River, AK 995778762
Subject'
EAGLE PARK BLK 2 LT 7
Permit # SW980178 PID # 050-782-29
The subject permit, issued 6/16/98 by this office for a single family well and/or on-site
wastewater system, has expired as of 6/16/99.
If you have drilled the well, a well log must be sent to this office for documentation of the
installation and to close the permit.
Ifa licensed Professional Engineer has inspected the installation ofthe on-site wastewater
system, the original as-built inspection report must be sent to this office for review,
approval and documentation. Ail inspection reports must be submitted within 30 days of
construction completion.
A new permit must be obtained from this office for a well and/or on-site wastewater
system NOT installed by the expiration date.
When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit
and $120.00 for a well permit.
Ifyou have any questions, please call this office at 343-4744.
Program Manager
On-site Services
enc: Copy of Permit
PPY
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF ~EALTH AND KGMAN SERVICES
P.O. BOX 196650, 825 #L" STREET, ROOM 502
/~CHORAGE, ALASKA 99519-6650
PAGE I OF I
ON-SITE WASTEWATER DISPOSAL SYSTEM {UPGRADE) PERMIT
PERMIT ~UMBER: SW980178
DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES
OWNER NAME:LES~C LARRY E & WENDY H
OWNER ADDRESS:9627 WREN LN
F~%GLE RIVER, A3~ASKA 99577
DATE ISSUED: 6/16/98
EXPIRATION DATE: 6/16/99
PARCEL ID:05078229
LEGAL DESCRIPTION:
EAGLE PARK BLK 2 LT 7 ...-
LOT SIZE: 45694 (SQ. PT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PEP. MIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHEDAPPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED INA NCHORAGE MUNICIPAL CODE C}5~/~TERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGulATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. TRE ENGINEER MUST NOTIFY D~S AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 34~-4744 ( 24 HOURS ) (NOT REQUIRED FOR NELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WF_.ATHERMUST BE EITHER:
A. OPENED AND CLOSED ON THE SA~ DAY
B. COVERED, SEALED A~ ~EATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIA~ PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED BY: {~ f..4 % (~J% ~-'f-~' ~
ISSUED BY:~
'" Eagle River Engineering Services
Louis Butera, P.E.
P.O. Box 773294 (907) 694-5195 tel
Eagle River, AK 99577-3294 (907) 694-3297 fax
June 3, 1998
Jim Cross, P.E.
Manager, On-Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re: Eagle Park Lot 7 Blk 2
Narrative & Permit Application
Dear Mr. Cross:
The proposed septic upgrade will have very limited impact on iadjacent properties for the
following reasons:
1. The surrounding lots are large, allowing sufficient room for septic sites.
2. Immediate neighboring septic systems are all +30' distance.
3. Reserve space is adequate, due to absorption capacity.
4. Drainage will not be affected and is not a major consideration in our design.
If you have any questions please call our office at 694-5195.
Sincerely,
Louis Butera, P.E.
\ 1997~98-034-1~AR. DOC
EAGLE RIVER
ENGINEERING SERVICES
P.O. Box 773294
Eagle River, Alaska 99577
(907) 694-5195
ERES Project No.: 98-034
Calculated By: LB
Date: 5/29/98
Legal: Eagle ParkL7 blk2
Single Family 4 Bedroom Dwelling
TEST HOLE 1
Deep Trench Subsurface Wastewater Disposal Field
Water use at 150 gallons per bedroom = 600 gallons
Percolation rate = 3.33 minutes per inch
Wastewater application rate = 1.2 gallons per day per square foot
Required absorption area = 500 square feet
Trench width (W) = 3 feet
Gravel depth(D)= 7 feet
Required length = Required absorption area / 2 / D
Required length = 500 / 2
Required length = 36 feet
Total Excavation Depth = 10.0 feet
I 7
98-034-cal.xls 3:20 PM5/29198
' WEST ~,'u.
I ~ LOT 7 ~/oo.
~isti~ Deck ~ ~ ~ ~ -~;sJln~ Septic Tank
~ ~ ~ ~ be removed and ~ / ~'
~ ~ replaced as ~ / ~ ~
~ -
~:LL 152' ~ ¢~oa: ~Tt
~ 14g.45
O O~RSION VAL~
~ S89'40'12"E ~ - TEST
· - MONITOR ~BE
o - S~R CL~0UT
/
NO SURFACE WATER ~ PTARHI~N
WILL
~MENT
NO KNOWN CURTAIN D~INS PROPOSED L~CHFIELD
House IocaJion from 1986 RC Johnson Su~ey,' Not Verified ~- EXISTING L~CHRELD
SEPTIC UPGRADE SITE- PL
LEGAL: Eaq~e Park Lot 7 BIk 2 ~LN~........~
CONTRACTOR: N/A ~* ~~
JOB~ 98-034 J DATE: 6/3/98 J SCALE 1" = 50'
I EAGLE RIVER ENGINEERING SERVICES ~ ~ou,s~
~ EAGLE RIVER. AK. 99577 w~~° ~'"
(907) 694-5195 FAX: (907) 694-329? ~u~~
Eagle River Engineering Services
Louis Butera, P.E.
P.O. Box 773294 (907) 694-5195 tel
Eagle Riwr, AK 99577-3294 {907) 694-3297 fax
LEGAL:
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
Eagle Park Lot 7 BIk 2
6/3/98
A. GENERAL
· 1. The well and septic plan are for a single family residence only. 2. The drawing and or site plan shall be a part of thls specification.
3. All materials and workmanship shall meet the Anchorage Department of Health and State
Department of Environmental Conservation requirements.
4. All soil tests are advisory to the design and are to be verified or modified in the field by the englneer.
5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet
Municipality of Anchorage, Department of Environmental Conservation requirements.
6. It is the responsibility ~f the owner to obtain all necessary permits or easements and to locate any
adjacent multi-family wells.
7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer
approval.
8. It is always recommended that a surveyor locate the nearest lot line position and the location of any
easements.
9. Any remaining open test hole excavations shall be filled.
B. SEPTIC TANK
I. Septic tank shall have a minimum capacity of 1250 gallons and be of MOA approved design.
C. TRENCH
!. The trench is to follow the natural land contour to maintain uniform total depth of the trench bottom.
2. The bottom ofthe trench shall be level, plus or minus 1.5".
3. The total depth ofthe trench excavatlon is not tn exceed 10' at any point.
4. A diversion valve shall be placed after the tank and shall divert flow to the proposed trench. The
effluent line within the trench shall be lald level within 0.03'.
5. The trench gravel is to be covered with typar fabric material.
6. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed
over the leachfield.
7. The area over the trench is to be finlsh graded to prevent ponding of surface water runoff.
8. The septic tank and leachfield must not be closer than 100' tn any existing private well, 150' to any
Class "C" well, or 200 feet to any community well.
RECOMMENDED LEACHFIELD DIMENSIONS:
TOTAL DEPTH = 10' GRAVEL DEPTH = 7' under pipe, 2" over pipe
TRENCH LENGTH = 36' a TRENCH WIDTH = 3'
SOIL RATING = 1.2 GPD/ft~ BEDROOM CAPACITY = 4
SEPT1CTANK = 1250
Twenty-four (24) hours notice required for all inspections.
\1997~98-034-spec.doc
PERFORMED FOR:,
LEGAL DESCfl~PTION:
4
?-
8-
10
13
16.
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 #L" Street. Anchorage. Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
DATE PERFORMED:
~/~ / '7 ~',,~ Township, Range. Section:
SLOPE
WAS GROUND WATER
ENCOUNTERED?
SITE PLAN
Groll Net De!3th to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN
(mmutes/~nch) PERC HOLE DIAMETER
~- FTAND ~ FT
COMMENTS
PERFORMED BY: ~--~' I ~~' -'~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE, DATE ~'4"" *''~- ~Oc~
72'008 {Re~. 4/~,~)
r '~ MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage. Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
PHONE
LEGAL DESCRIPTION
LOCATION ~ Iq W X~ ¢[[~ NO. OFBEDROOMS ~
~ Z Manuf~turer Material No, of compartments
/~ IF HOME.DE: ....
~ ~ ~ DISTANCE TO: Wetl Dwelling ~ PERMIT NO.
O ( Manufacturer Material Liquid capacity in ~llons
~ Well Foundation Nearest lot line PERMIT NO.
~ ~ DISTANCE TO:
~ DISTANCE TO:
m Building foundation Se~r line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER
PIPE MATERIALS
2-Qt3 (Rev. 3178) ........ ~/
MUNICIF'AL ITY OF ANCI-]ORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L STR. EET, ANCHORASE~ AK 99501
264.-47~0
-'RMIT NO:
~TE ISSUED:
850151 UPGRADE
04/30/85
~PLICANT:
]DRESS:
ROBERT MCWILLIAM
P.O. BOX 771811
' EAGLE RIVER~ AK
99577
--GAL DESCRIP: SUBDIVISION: EAGLE PARI{ LOT: 7
SECTION: S17 TOWNSHIP: 14N RANGE: 1W
IT SIZE: (SQ.FT. OR ACRES)~.
BLOCK:
certi£y that:
1. I am £amiliar
5.
with the requirements for on-site s~wers and w~lls as set
forth by the Municipality o£ Apchorage (MOA) and the State of Alaska.
I will ,install the system in accordance with all MOA codes and rogulations,
and in compliance with the design criteria or this permit.
I will adhere to all MOA and State of'Alaska requirement~ for tho set back
distances ~rom any existing well~ wastewater disposal system or public
sewerage system on this or any adjacent or ~earby lot.
-' A LIFT STATION'IS INSTALLED I~ AN AREA COVERED BY MOA BUILDING CODES,
~EN (1) AN ELECTRICAL PERM'IT AND INSPECTION MUST BE OBTAINED; (2> AS-BUILTS
ILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE
WORK MUST BE DONE BY.A LICENSED. ELECTRICIAN.
~PLICANT: ~;;ER;~:¢AM ~ ....................
~SU~D BY~ .......... DATE: ___
GRr *,R ANCHORAGE AREA BOROL"'~
DL.~dTMENT OF ENVIRONMENTAL QUALI"I, i
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE FROM WELl
LIQUID CAPACITY
NUMBER OF
MATERIAL ~- ~£'~?''~'L/'~- COMPARTMENTS
INSIDE LENGTH INSIDE WIDIH
GALLONS.
LIQUID
DEPIHo~
SEEPAGE SYSTEM: SEEPAGE P~t:
NUMBER OF PITS
LINING MATERIAL ~1~
NEAREST LOT LINE
,,
OUTSIDE DIAMETER ~ OR WIDTH , LENGTH ~'~- / . DEPTH
~'.~"z~,~'5' . InStaNCE PROM WELl /~9 . BU,m,NG FOUNDatZO~
, TOTAL EFPECTIVE ABSORPTION AREA ~ALt AREA) ~ .SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL~ T~'-~)~ANCE BETWEEN LIN~ , NEAREST LOT LINE
NUMBER OF LINES / DIS TRENCH WIDTH
ABSOrPtiON2 A~ SQ. FT. LENGTH OF EACH LINE ~''- ~
DEPTH: TOP OF TILE TO FINISH GRADE
TOTAL LENGTH
, OF LINES
FECTIVE
DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE
WELL: tYPE ~ ~, II.L) DEPTH //'~ ! DISTANCE FROM ,¢~O'' wAtEr
· . , BUILDING FOUNDATION. SAMPLE IU~U.,e-~ , NEAREST
NEAREST SEPTIC ~;~, ~ SEEPAGE /~, ~, OTHER
~ , SYSTEM , CESSPOOl , SOURCES
LOt LINE ~'/ ~'"/C' /~) . SEWER LINE TANK
DISTANCES:
DIAGRAM OF SYSTEM
DAte
Well Owner
DRILLING, INC.
Bob McWilliams
DRILLING LOG
~UN ,-,, A.h f C.' ,'~ ~C."
D£PT. (,: : 'Li ',I
..... ,9,1
,Use of ',,Veil Dom.
Location (address of: Township, Range, Section, if known; or distance main road.
Lot 7 Block 2 Eagle Park Subdivision, _E_agle River
Size of casing 6" .Depth of Itole
Static water level 52 ' ft. (,'~:,.~)
Screen ( ); Perforated (
8-0~feet Cased tO---8.0 '---~ feet
(below) land surface. Finish of well (check one)
).
open end (
xx);
Describe ~t~ or perforation ~.'_~__6~_e_r_forations from 54-57'
Well pumping test at 1-0---gallons per (h~'f,~ (minute) for__1 hours with_ 100~
of drawdown from static level.
Date of completion 6/13/79
WElL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
0
2
3
51
56
.TO. 2
,TO. 51
vo
TO 80
TO.
TO
TO
TO
TO
TO
.TO
--.TO
.TO
.TO
Cas iq~_s_tj.~.ku, p
__Sil~y,gEp~el
Water
S_i.l_~y_gr ayel_
1 -- CUSTOMER
'4 ' - ' 1~. GENERAL INFORMATION
'=~:: -.:~: ' Complete legal description -
,.. . Propert7 owner
,~-.~ ....: .,., . M,a, iling adctress
MUNICIPALIT~ O~= ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Se~'ices Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343..4744 .. :
cERTiFICATE OF HEAL'TH AUTHOI~ITY
,' APPROVAL FOR A SINGLE FAMILY DWELLING
Lot 7; Biock 2:. Eag£e ~ar~ ~uDolvzs~o.
Location (site address or directions)
9627 Wren Lan6
Eagle River-
J~rlath Mayes Day phone
[ 9627.Wren Lane, Eagle.River, Alaska' 99577
(w) 562-2281
(h) 696-0340
'~ . .- Lending agency
.~ ; ,: ,. ~ . ;, Mailing address
; .'~j.'"':."' Agen .
"' '*: .... : ..Address
:~' · · - ' .. Unless otherwise requested,'HAA will be held ~or pickup.
-:' :2. ',NUMBER OF BEDROOMS: .
~- L:'3. ' T~PE OF WATER SUPPLY: - -
Day phone
:-'"' ':. Day phone .......
Individual well
Community.well.
Public water : , ....... .,. ~, , . ..., .... ' ......
If communi~ Well gyste, m, p~v,{d~,'w, ri, tte~ conf.,irmation from state ADEC, attest- ' ,..
lng to the legaiityra~'d'stat~s bf s~'~tem. ' ~'~ ''
· . , '-- -.::-:.:...- ...
NOTE:
.: ,. , DispOsAL:
.... *'' ~ '~YPE
~-. 4.. OF WASTEWATER -.
.... Individual o6-site '
"- ": Holding tank,-,:.?- ,.. ......... :
:. ' ': ' ' ..... ity"on-si--t~ ...... ' .... ' '"'
,,.,,... . , Commun : ... .,.. : . ,,,
.Public sewer " ' · ':'.
NOTE:* .If community wastewater system,.provide written confirmation from State ADEC :~
attesting to the legality ~'n'd status of System.. '
TAI' cTiON 'IN E ' ' ....
'*"~ "' .'S MENT.OF.INSPE ENG E R':.'~" ....
· - .5.' ,BY:
: ...' As certified by'my Seal affixed hereto'and as *'f ' - . · .- . ..... . .
.~.. . . o the validation date shown below. I ver fy that mv · '*. ' '~' -~ '
' t.,gabon of th~ e, Auth.o.r ' va, * .p 0 .w?.. ,ha ...... y~ '
- · .... ' " ....... at r'
.i s SH al~h ~tyAppro lap licationsh t tthe'on-sitew I
'.:...: ';' ': and/or wastewater dispoSal sYStem Is ~fe, ~un~t~0~l ~hd a~lequ~'iefor the number of bedr00r~s
- : and,type of'structure In~icate~.. h, ere~n. !,furtJ~,,v~ri~/th?t ~ ~r{,the nformation obtained fl:o~" ,:~
'~': · ;r":4.' 'the ab'r~icipality of Anch0ra~ f, iies ~r{d ~'~;.~Y' n'~ti~ti~)n an~'i~ On the on-o io ,~,;*,;-' ' :'.' :"' '"
~,.., - ~ , supply and/or wastewater dmposal sYStem s in comp ahc~'w th a Mun c n~ and ~*;~;,
~. :::,. ..... (~rdmances, and regulations Jn effect on the date of this inspection....- , ..... '..~ , -. :. ~ ;~: :', ~ ~ ': .~: .: .~..,:~
Disapproved. ·
Conditional approval for
bedrooms, 'with the following st'pulaflons:
Additional Comments
,~,. :.. The Municipality of Anchorage Department of Health and H~Jman Servlc~s (DHHsi i~ues Health Authority ;.
: .:'" ii' "Approval Certificates based only upon the representations given In paragraph 5 above by an Independent~
? gl regi theSt ~HHSdoesthsa ~c~ rtesytop rsofho
..': ..:; . professionalen, neet stered n ate ora aska. The s u urchase mes' '
e'rtai fed~i~l~ldst eq relAxantS Empl fDHHSd(~ 0t "
gl tOs~ti fy '* .: '"
.... ' andthelrlendin nstitutionslnorder s c n ater u . oyeeso n
?::'i~:: ~ "conduct inspections or analyze data' befor~.a' ~ertiflc~te ]slssued. Thee Municipali~ of Anchorage Is not .., .... ,~.
' ~': '-' responsible for errors or omissions In th~ prOf~sSioii~l engineer's work.. '
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: L..c~ "] ~t..~--~ ~'<~r~,~-- P~ 5~° Parcel I.D.
A. Well Data
Well type ~,,.~l
Log present ~N) "~
Total depth
Sanitary seal ~/N)
FROM WELL LOG
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed L. - t"5 -'] =1 Driller
.Cased to ~),~' t:'(-~.~ ~'4--5"7 Casing height
Wires properly protected (~TN)
g.p.m.
Date of test
Static water level
Well flow
Pump lev.ell
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot ~ o ~ ~ '~
Absorption field on lot ~ C:'~' ~
Public sewer,main ~/~
Sewer service line 'z..5' ~''
AT INSPECTION,
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
.Petroleum tank
WATER SAMPLE RESULTS:
Coliform ~ .Nitrate
Date of sample: "~" ~[ -'~ ~'
B. SEPTIC/HOLDING TANK DATA
Collected by:
Other bacteria D
$ & $ ENGINEERING
t~u~4 I:agle River Loop Road No. 204
Eagle River, Alaska ~577
Date installed
Cleanouts~N)
High water alarm (Y/~
Date of pumping
Tank size / 2.~" o Compartments ~"
Foundation cleanout ~N) y Depression ~/~
Alarm tested ~/N) /~t.4. .
c¥'~ Pumper -..~-~'.
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot
To property line
Sudace water/drainage
On adjacent lots
Absorption field ~" ~J~" . ~
Foundation
Water main/service line
~-me (3~3)- Front CONTINUED ON BACK PAGE
C. UFT STATION
Date Installed .Manufacturer
Size in gallons Manhole/Access (Y/N)
Vent (Y/N) 'Pump on' level at 'Pun3p.ofP'L"6~ at"~
High water alarm level
Meets MOA electrical codes (Y/N)
On adjaeont lots .Surface water
D. ABSORPTION FIELD DATA
:Total absorPfion area '"'J ~-
Date Oi adequacy test' '5 .- c~ _ ct ~
Water level In absorption field before test
Peroxide treatment (past 12 months) ('~
'ct~ .Gravel thickness' L~~ Total depth
.Cleanout present (~1) ~/ Depression over field (Y.~
Results .~d~ail) ~0~.<~ ~ for ~ Bedrooms
~'=~" Aftertest "Z~ ~=.
F-[ = ~{~- ~'~/~ ~-~'~ If yes, give date ~0.
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
On adjacent lots
Surface water
Curtain drain
Well on lot I o ~
To building foundafion
ENGINEER'S CER~RCA~ON c0~
On adjacent lots / ~ c, Property line
~ ! To e/xisting or abandoned system on lot
Cutbank 'J[~ Water main/sewice line
Driveway, paridng/vehicle storage area
I certify that/have checked, verified, or coofon/~e~o all MOA and HAA guide/ines in e~ec.t.;~ ~e~te of,!~is inspecb'on.
Signature ~ ~ ~NGIN££RIN~'"'~ ~'/ ~-~'Z ~ ~'
WaiverFee$
Date of Payment
Receipt Number
HAA Fee S
Date of Payment
Receipt Number ~
72-026 (3/93)° Back
Commercial Testing & Engineering Co.
Environmental Laboratory Servlce~
LABORATORY ANALYSIS REPORT
CI'~ {-1Ref.~t 9.l.101%1
Clicm~. $~I¢ ID I,?H2 .EAOLE [?d~,l S 'D
M~tfix WATER
Clicr. t N:une S & $ ~;O~'~ERL'qO WORK ~
Print~D~tc 03/14~
~oject Hame Reteiv~
~ject~
I'W~ID UA T~hui~[ ~re~or S~ C. EDE
S3mple Item~tkst ROUTI2~ [~MI'LE COLLECTED BY: P,-~,Y.
L}C Allowable Ext. An.q[
I'r. rmmet~r T, emults Qu:fl Units Mefl~od Limits D~i~ ]')ate Init
Nitr='te-N '/.64 m,~.q. F.PA .~:{].2/3t~0.0 10 03/11194 CMR
* .~ee 9peclat ln~trtztiou~ Above UA ~'UnaYellabl¢
** ~ Sample Re~m~a Above ~A- Not ~yz¢4
U' Un&t~t~ Rq~o~edva1~ la the pra~;~l ~)mti~dbm ~t. L% ~ I~qs 'lhan .
5633 B Street, Anchorage, AK 9961B-1600 -- Tel; (907) ~62.2343 Fax: 19071561-5301
ENWRONMEt~AL FAClLITIF$ IN Al AS~A. COLO~DO. FLORIDA. ILLINOIS. MARY~ND, NEW JERSEY, OHIO. UTAH, WES1 V~IGINIA
MUNICIPAUTY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date
GENERAL INFORMATION
(a) Legal D~.scription (include lot. block, subdivision, section, ~nship, range)
Location (address or directions)
(b) Applicant Name."~dO'"P'..~," Telephone: Home Bu.~s
(c) Applicant is (check one): Lending Institution t-I: Owner/builder,~; Buyer []; Other [] (explain);
eal Company and Agent
Address
(f) Me~'the HAA to the followi.ng address:
2. TYPE OF RESIDENCE
Single-Family ~ Multi-Family[]
Number of Bedrooms
Other
WATER SUPPLY '
Wellv~~' Community [] Public [] ~
Individual
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4.. SEWAGE DISPOSAL
Onsite~' Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environ mental Conservation
attesting to the legality and status.
Page 1 of 2
'5.
ENGINEERING FIRM PROVIDIN~ INSPECTIONS, TESTS, FILE SEARCH, DA*t A AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this
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 ~ ~ ~
Address ~D R 1
Date FAg[I;: DIV;R; AK
Telephone
DHEP APPROVAL
Approved for "~t'/~t%~'~'~bedroomsby~ "~° ~'a.~ Date
Approved ~ Disapproved Conditional
· Terms of Conditional Approval
CAUTION
The Muncipality of Ancl~o~'age 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 purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Description: ~
A. WELL DATA
Well Classification "~' ~,,
Well Log Present ~N)
Total Depth ~_~:)r Cased to
Static Water Level ~.~, i
Casing Height Above Ground
Electrical Wiring in Conduit {~N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
If A, B, C, D.E.C. Approved (Y/N)
Date Completed /~ - / ~ -'~-~' Yield
Depth of Grouting ~-
Pump Set At ~-.) ~--
Sanitary Seal on Casing {~N)
Depression Around WeIIheed (Y~
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line /'"l//~3i
Cleanout/Manhole *'-'---'"'
~ ; On Adjoining Lots /.,-"x~
/ ,,~,-~/4 ; On Adjoining Lots ./~
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot ~-~"
Water Sample Collected by --~*~"~::> ~'~.-Jr-,,.~",--.-~-~,,-,~- ;Date /?
Water Sample Test Results ~ ~/~
B. SEPTIC/HOLDINGTANK DATA
Date Installed ~-Z.Z,- 05'
Standpipes (~).
Depression over Tank (Y,~
Pumping/Maintenance Contract on File {Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
Size /~' "'~ No. of Compartments
Air-tight Caps (~)N) Foundation Cleanout
Date Last Pumped /2_.-/,~ - _~t'~
I'~/I/~--- ; for
Temporary Holding Tank Permit (Y/N)
To Water-Supply Well
To Property Line /~,~.4
To Water Main/Service Line /~,
CourSe /~,l d / lC
To Building Foundation I o t ~'
TO Disposal Field 5' ''~
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72-026{11~84)
jGuNICtPALITY OF ANCHO2AG~
DEPT. 0{: HEALTH &
Fr. NViIIOI~NTAL pi~OTECTION
RECEIVED
ABSORPTION FIELD DATA
Soils Rating in Absorption Strata ~'~'~'
Date Installed /~P -~---/-
Width of Field ~
Square Feet of Absorption Area ? /.,.,~
Depression over Field (Y~
Results of Lest Adequacy Test ~ /3"7'~ % ~-'~'~"'~'-~'r
Separation Distance from Absorption Field:
Type of System Design __
Length of Field -. ~: ~
Depth of Field ~o t
Gravel Bed Thickness t',
Standpipes Present (~)
Date of Last Adequacy Test
To Water-Supply Well /tX) t.--f
To Building Foundation I ~ f
Lot y~.~
To Water Main/Service Line /~ /-F
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area. or Vehicle Storage Area
Comments
To Property Line (~b
To Existing or Abandoned System on
; On Adjoining Lots
To Cutbank (if present)
/od/'-P
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
"Check Permitted I~droom Rating Against HAA Request
I certify tl~tJ h~v~ C h_eq. k. _e_d~ ve ri f led, or conformed to all MOA and HAA guidelines in effect on the dale of this inspection.
5& SENGINE~ING
Signed ~B lY6X Date
Compan~ ................. MOA No~ ~ ~ ..... ~.~.,~.
Date of Payment /~~
Page 2 of 2
~t '~,,",. .-'-~
*' MUNICIPALITY OF ANCH0~AGE I DIVISION OF E~O~
~CATION FO~ ~TH ~HO~$~ ~PKOV~ ~T~CA~
Le~ DescrSp~n~ ~ (include~lo~ ~bl°c~ ~subdSv$s$°u~secti°u~ to~sh~p~ ra~e)
Location (add~ess or dSrec~$o~)
Ho~e
Business
(c) Applican~ is (check one) LeMi~ Ins=t=u=ion
Buyer [ ] i O=her ~ (~plain)i
(e) ~eal Estate Co. & A~eu~
Address
2, T~pe of Residence
Single-Family~
Number of Bedrooms
Multi-Family
¢
Other (describe)
3. Water Supply'
Individual Well ~ Co=unity ~ Public ~
Note: If community well system, must have ~rrittea confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
4. Sewage Disposal
Ousite~ Publlc~ · Communtty~ Holding Tank~
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
[Page 1 of 2]
Ensineerin~ Firm Providin~ Inspections~ Tests~ File Search~ Data and Information
As certifi~d by my seal affixed hereto and 'as of the validation date sho~n below,
verify that my investigation of this Health A~thority Approval shows that the om-site
water supply aM/or wastewater disposal system is safe, functional aM adequate for
the number of bedrooms amd type of structure indicated herein. I fu=ther 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 regula-
tions in effect on the date of this inspection.
Name of Firm Telephone
Address - "= =!~.!-'~ ~'~,<~.
Date .........
..,,,., _ .~'._ L_ J /-- ~.--~ ~./. ~?.-.~- ~,~-'-, /,~
Approved for ~/~ bedrooms By
Approved ~ Disapproved . Conditional
Terms of Conditional Appr~'
~uTio~.
TR~ HUNICIPALIT¥ OF ANCHOKAG~ DEPARTMENT OF HF. ALTH AND ENVIROI',~fENTAL PROTECTION
(DEF. P) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON TH~ REPRESENT-
ATIONS GIVEN IN PAEA~ $ ABOVE BY ~I INDEPENDENT PROFESSIONAL ENGINEER REGISTERED
IN TEE STATE OF ALASKA. TE~ ~ItEP DOSS Ttlis AS A COURTESY TO PURCEASERS OF HOMES AND
· ~IR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE-
HENTS. ~MPLOYEES OF DEEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A
CERTIFICATE IS ISSUED. TJE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS
OK OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK.
(DEEP SEAL)
KK4/e~/D18.
[Page 2 of 21
7-19-84
'~ - · BUNI¢IPALITY OF
' (~) ~1 ~cr~Cion (~nclude lot, b~ck, subd~ston, s~Ctton, to.ship, ~a~e)
(c) A~c~n~ ~s (check one) Le~ng l~s=X~Xon ~; ~er/b~l~er ~;
Buyer ~; Other ~
(e) ~e~ Estate Co. &
Address
(f)
Telephone
,~a~he RAA tO the followi~ ~dress:
Type of Residence
Single-Family~
Number of' Bedrooms
Other {describe)
Water Supply
.{ndividual Well ~ Community ~--~ Public ~--~
Note: If c~unity ~11 system, must ~ve ~ttten co~i~tiou fr~ the State
Department of Enviro~ental Co~e~ation attestin~ to the legality a~ status.
Sewa~:e Disposal
Onsite ~ Public ~--~ Community ~-~ Holding Tank ~--~
Note: H community ~ell system, must have vritten co~imation from the State
Department of Environmental Conservation attesting to the legality and status.
[Page 1 of 2]
~o. E~ineerin~ Firm Providing Inspections~ Tests~ File Search~ Data and Information
As certified by my seal a~fixed hereto n~ as of the validation date shown below, I
verify that ~y investigation of this Eealth Authori~y Approval sho~ that the on-site
rater supply and/or vastesrater disposal system is safe, functional and adequate for
the number of bedrooms and ~ype of structure indicated herein.. I further verify that,
based on the lv~ormatiou obtained from the Fauicipall~y of A~chorage files and iro~ my
investigation and inspection, the o~-site starer supply and/or was:evater disposal
system is in co~pliance sr~th all Hunicipal n~a State cndes, ordinances, and regula-
tions in e~fecC on ~he date of C~is inspection.
r.,Ag~TON
TEE IiUNI¢IPALITY OF ANCIt0RAGE I~FAR~'~IEI~T 0~ ~TE ~ E~Ok~
: (D~P) ZSS~S ~TH ~H~I~ ~OV~ ~ET~ICA~S B~ SO~LY U~N T~ ~SE~-
ATIO~ ~N ~ P~ 5 ~0~ BY ~ ~PE~ ~OFESSIO~L ENGI~ER
i~ ~ING ~TI~10~ ~ O~EE TO SATISFY ~K~IN ~DE~ ~ S~ ~QU~-
~S. ~O~ES OF ~EP ~ NOT ~UCT ~SPECTIO~ 0~ ~YZE ~ BEFO~ A
~ETIFICA~ ~ ~S~D. ~ ~ICIP~I~ OF ~CH0~ ~ NOT ~SPONSIB~
OK ~ISSIO~ LN ~ ~OFESSIO~ ~NGI~ER'S WO~.
RR4/eJ/D18
[Page 2 of 2]
(DEEP SEAL)
7-19-8~
1984
[ ........ ~.,x~.,L i'. Z
RECEIVED ,
~7 ,~z
To ~ea~est Public Sewe=
To Neazest Sewe= Service Line c~ Cot
; Date
TO Nearest Public Se~= Line
C lea~cu~A~o~e
Wa~e= Sample Collected By
Wa~e= S~le Test l~esults
[Page 1 c~ 2] 2-15-84
Dat~ lnsr. alled ~ Length c~ Field ,J-O- e ' v - ,
Width of Field ~ / Depth of Field
.~avel Bed ~m~
~i~ ~ Field ~ ~ ~ ~t ~
~ate Installed Din~nsiccs
Electrical
2-15-84
APR ! g
,
MUNICIPAL TY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECT~,i~N4,.~NTAL
~ LSd. ~. A~I
ENVIRONMENTAL ENGINEERING DIVISION
Talephm~e 264-4720
I~l[t~ ~DDR ES~
'RO]~ERT'~ R ES1 DENT (I I disaffect fr°m~ab°ve) -/ / IPHONE
I
PHONE
~ert MoWflli~ 277 [107
MAILING ADDRESS
353]. E. h2nd Anchorage. Alask& A~t, #207
~. LENDING INSTITUTION
MAILING ADDRESS
& RF~LTORI&OBNT
MAILING ADDRESS , ·
523 N.. At~ ATe, Ancbo;sge.'Ala~k~ aq;03
PHONE
PHONE
27h 1631
LE(LA L DE~CRmFT~ON ·
Lot 7, Block 2 Eagle Park Subdivision, Ea~le River, Anchorage Recording DiRt
~TREET LOCATION .
TYFt OF R~IDENCE NUMBER OF BEDROOMS
~ IN LE AMILY ~ One ~ Four ~ O~er
~ S G F ~ Two
~ MULTIPLE FAMILY ' ~ In '
~ATER ~LY
INDIV~0UA[' A~ACH WELL LOG. A ~H I~ ~ r~u~ for aH ~ll~ dnH~
~ PUBLIC UTiliTY dep~ (a~ I~ ~f avaH~leJ~ /~
H system is over two {2) years o~d an ~u~ t~ is r~ut~
~ PU8k{C UTI LITY by th~s De~r~nt
NOTE: 7HE IN~PECTION~H REQUEST BEFORE PReEnING ~N BE INITIATE~
72~10(3/78) / n · ,
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;
[] SINGLE FAMILY I--I ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
2. WATER SUPPLY PERMIT NUMBER
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
J-'l PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVI DUAL/ON -SITE
- DATE INBTALCED
[]PUBLIC UTILITY
Connection Verified
INSTALLER
[]Septic Tank or []HoldingTank
Size: If Tank is homemade SOIL8 RATING
gi~e dlmemions:
TYPE OF TANK MANUFACTURER
TOTAL AB~ORP¥iON AREA MATERIAL
5. COMMENTS
APPROVED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL (leklar must accompany certificate)
[] DISAPPROVED
DATE By {Title) ~' /
694-9055
E N Gl NEE R ING "'
· HECIU%NICAL ENGINEERS
CIVIL ENGINEERS
SRB 196X Eagle River, Alaska
99577
~ ENGIMEER
ROBERT A. SEAFER
694-2979
April 17, 1979
REF: Fowler property, Lot 7,
Block 2, Eagle Park Subdivision
Century 21
Metropolitan Realty
523 W. 8th Avenue
Anchorage, AK 99501
A sewer'system adequacy test was conducted on the referenced property
'on April 13 and 14, 1979 per. your request.
The septic tank was pumped and verified to have a capacity of approxi-
mately 1,250 gall. ons-r The water level in the seepage pit was recorded.
The pit wa's charged with approximately 1,000'gallons of water. Perco-
lation over a 24 hour period, as recorded on April 14, resulted in the
removal of approximately 850 Eallons. It can be concluded that thc
septic tank and seepage pit are adequate for a four bedroom home.
CF:
Mr. Fowler
National Bank of Alaska
Hain Branch
Municipality of Anchorage
Dept of Health & Environmental ~rot
Addr~
City
e
Gk.~TER ANCHORAGE AREA BOROUGh'"
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99507
279-8686
DATE RECEIVED:
INSPECT:
TIME:
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER AND WATER FACILITIES
FOR
APPROVAL REQUESTED BY:
ADDRESS:
2. PROPERTY OWNER:J~ .PHONE :~
3. LEGAL DESCRIPTION. * .
4. TYPE FACILITY TO BE INSPECTED. STREET:~
NUMBER OF BEDROOMS:_m.~W~:~~
SEHAGE DISPOSAL SYSTEH:
Ae
SEPTIC TANK (IF HOMEMADE, SHOW DIAGRAM ON BACK)
3..A.U/iCTu. ER / w~* ?~u~ ~ ~
¢. INSTALLER J~4/'~//':~ C ~
' '' ' ,; API~ROVAL REQUESI FOR SEWER & WATER FACILITIES · PAGE TWO
SEEPAGE
SlZE
LINING
DISPOSAL FIELD
1. NUMBER O~S
2. TOTAL LENGTH~*''''*
REQUIRED MEASUREMENTS
A. WELL TO.SEPTIC TANK
B. WELL TO SEEPAGE PIT
C. WELL TO SEWER LINE
D. WELL TO PROPERTY LINE
E. HELL TO OTHER POSSIBLE CONTAMINATION
F. FOUNDATION TO SEPTIC TANK
G. FOUNDATION TO SEEPAGE PIT
H. SEEPAGE PIT TO PROPERTY LINE
8. COMMENTS:
DATE: ~./~Y~ ~ DATE:
APPROVAL VALID FOR ONE YEAR FROM OATE SIGNED.
GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY
,/
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
PART L--TO BE COMPLETED BY FHA
~SUSlNG OFFICE
Anchorage
Lee Fowler St. Rt. Box 1GG Eagle River
su~'~i~ ye r Park
TOTAL NUMNR~
[~] Public system
S4WAGi DISI~OSAL IYs
Public system
~ASEA~q' "I [] New installation
[]Yes [].No
~1 Community system
]Community system
PART Il.inTO BE COMPLETED BY HEALTH DEPARTMENT
It is the opinion of the [] State [] County [] Local Department of Health that this individual water.supply system
r4~is [] is not satisfactory as a domestic water supply for the subject property.
It is the opinion of the [] State [] County [] Local Department of Health that this individual sewage-disposal sys-
tem with proper maintenance:
~'J Can be expected to function satisfactorily, and [] Cannot be expected to function satisfactorily
is not likely to create an insanitary condition
~arch
TITLE
NOTI: The heel~h euthorJt¥ should complete the appropriate Ol~nlon statement above and olfix date, signature and title in the
spaces provided.
Use of the above grid fo# Health Department Iflspecto,'s sbetch as well os use of the beck of this form is at the option of the
health authority,
PART Ill.--FOR USE OF FHA OFFICE
TO THE CHIEF UND(RWRITERi
I have revi~ed the f,otegoing and the pertinent FHA Coml~li~ce Inspection Report. and recommend that the
Individual water-supply system be considered [] Acceptable [] Not Acceptable
5eqP.'~ge disposal be considered [] Accep~ble [] Not Acceptable.
ISIGNATURE
HIALTM AUTHORITY APPROVAL
INDIVIDUAL WATIR SUPPLY AND SEWAGE DISPOSAL SYSTEM
J~op~rtles in nelgh~h~x)d ["1 are I-I are nc~ being developed with both indlvidual water-supply and sewage.disposal systems.
size! fe~t wide, feet deep. Dwelling set I~¢k flora fn)nt property llne,, feet.
Individual water supply f~om: I'-I L)rdled well. I'-1 Driven well. I-1 Dug well. 1-1 Bored well.
04statue of w~# frorm
Building fimndation,
seepage pit. feet: cesspool
Diameter inches. Total depth,
Appruximite depth m pumping level of wi(et in well.
~e~led watemght to depth of fc~t.
nearest lo( line if 1-1 horn, VI side. 1-1 rear
feet; s~ptic tank.. .fec~; disposal field,
feet; ocher so. roes o~ possible pollution. ~'eet.
feet. Typ~ ¢~' casing,
feet. Approximate yield.
Depth of casing,
.gallons per minute.
Exterlo¢ space around casing ~taled with: 1-1 Cemen! grout. 1-1 Puddled clay. 1-1 OrdinarY' backfill.
%V/ell cover: 1-1 Concr~e. 1-1 Wood. 1-1 Me~al. Openings in well cove~ watertight: 1-1 Yes. 1-1 No.
PvmFa 1-1 Shallow ~11. I"1 Deep well. Length of drop pipe feet. Pump capacity,
L~atecl in: I"1 Basen~tnt. 1-1 Pumproom off basement. VI Pumphouse above ground. 1-1 Pump pit.
Pump~oom p~operly drained: I-1 Ye~. I-I No. Pump mounting watertight: [] Yes. [] No.
Typ~ u( stcxage: [] Pressure. [] GravitT. Capacity, gallons.
Has bactetiologlcal examination o( water been made? [] Yes. 1-1 No. If answer is "yes," give c~te
QualKy o( water 1-1 is 1-1 is not sacisfacxo~y for human consumption.
Ins~aUa(~°~ 1-1 does VI docs no~ comply wi[h approved exhibits, il' any.
Insp¢a:~ion made by: 1-1 S~ate. 1-1 County. 1-1 Local Heahh Aud~o~ity.
Inspected by
Date of inspection ~ 19
gallons per minute.
19
l'eet;