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Home My WebLink AboutEAGLE RIVER HEIGHTS BLK 2 LT 18 --,~ DATE RECEIVED INSPECTION APPOINTMENTS ~-'~ TIME TIME TIME . )ATE DATE DATE ,~SPECTOR ,NSPECTOR ,NSPECTOR ~)~ '~' ~UNICIPALITY OF ANCHOI~,AGE MUN,C,PAUTY OF ANCHORAGE ~P~'. O~ ~L'r~, .'-' ENVIRONMENTAL SANITATION DIVISION OCT 6 1980 Telephone 264-4720 1. PROPERTY OWNER I PHONE MAILING ADDRESS PROPERTY RESIDENT Iii different' from abo~e) PHONE 2, I~UY .E R PHONE MAILING ADDRESS ~. LENDING INSTITUTION J PHONE MAILING ADDRESS MAILING ADDRESS 5. LEGAL DESCRIPTION ~a /,r: STREET LOCATION 6. TYPE OF RESIDENCE f-'l SINGLE FAMILY ~ MULTIPLE FAMILY NUMBER OF~BEDROO~ [] One ~ --~o~' [] Other~ Five ~,~j [] Two Six .J~/ [] Three 7, WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY · ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** [~ PUBLIC UTI LITY ,YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72.010 (Rev. 6,'79) '--' THIS SIDE FOR OFFICIAL USE ONLY . .: ., ' 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTI',~R [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] 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 Connection Verified iNSTALLER r-'lSept[c Tank or F"lHolding Tank Size: If Tank is homemade SO~LS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL Absorption Area to nearest Lot Line 5. COMMENTS [~;3"~'APPROV~D FOR ' L~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) I'-I DISAPPROVED DATE BY 72.010 (Rev. 6/79) · ~. CHEMICAL & GLvLOGICAL LABORATORIES b.'~ ALASKA, INC. ~ Drinking Water AnalySiS.Report for Total ColifOrm Bacter,a TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: I.D. NO. " Meiling Address · , City ~ State Mo. Day Y~ SAMPLE TYPE: [3 Routine I-I Check Sample (for routine ~ample with lab ref. no. [3 Special Purpose Treated Water Untreated Water SAMPLE NO. LOCATION I Time Collected Collected By TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: ~. ~'Sa'tisfactory [-I Unsatisfactory [] Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample. Date Received Time Received Analytical Method: [3 Fermentation Tube ,~'0 Membrane Filter Lab Ref. No. Result* Analyst READ INSTRUCTIONS BEFORE COLLECTING SAMPLE BACTERIOLOGICAL WATER ANALYSIS RECORD GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received 2/19/74 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: ~nnv~nt~nnal Clarence Lamay 3. Legal Description: 4. Location: Caribou Street 5. Type of facility to be inspected 6. Well Data: A. Type C. Construction 7. Sewage Disposal System: Phone: 6q4-?114 Phone: Lot 18~ Block 2~ Eagle River Heights Dupl ex A. Installed C. Septic Tank: 1. Size D. Seepage Pit: 1. Absorption Area E. Disposal Field: Total length of lines No. of bedrooms 6 B. Depth D. Bacterial Analysis Public Se~er B. Installer 2. Manufacturer 2. Material ., Absorption area Other contamination , Absorption area Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank C. Absorption area to nearest lot line , Sewer Lines , EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Re~.st for Approval of Individual er & Water Facilities Legal Description Con~ents Approve~ ~, Disapproved. Date Approval Valid for one year from date signed Greater Anchorage Ar&a Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) Mr. Alva LaXhy Box 935 Eagle River, Alaska 99577 SLrgEcr: Lots 17 [ 18, Block 2 Eagle River Heights Subdivision Dcar t,[r. Le~hy: It is not the normal practice of this department to require engineered plans for duplex mits such as the ones you propose. This is normally handled by the Greater Anchorage Area Borough. As the t~ units will be on a Public Sewer System and based on our kn~dedge of the general ground water situation in the Eagle River area, we feelthat the proposed well and approximately 150 gallon storage tank which will you propose will be adequate to meet the denmnd of the t~,~units. This is of course assuming that a well is developedwith a proper yield. In smD' it is our feeling that the systems which you propose should be adequate for the projects assuming that a properly developed well is established at each site. Yours truly, Regional Environmental ~gineer cc: GAAB-DEQ RECEIVED [.tAY ~. 'i 1973 A~ . Municipality of Anchorage • e , On-Site Water and Wastewater Program -_.t !_ (907) 343-7904 ti 1. f , 1' CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-281-43 Expiration Date: _)— 2 1i 1. GENERAL INFORMATION Complete legal description Eagle River Hts Block 2 Lot 18 Location (site address) 10142 Caribou Street Current Property owner(s) Blatchford Day phone 696-0357 Mailing address Same Real Estate Agent Laura Hamilton Day phone 696-0357 2. TYPE OF DWELLING: k`' S 7 8 n ❑ Single Family (w/wo ADU) �� . A ® Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) r SEP 2 2017 A 3. NUMBER OF BEDROOMS: 4 ,` 4' ��<` �3_L9 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class C Well ❑ Community ❑ Public Water System ❑ Public Sewer Received by: t,----------j-5e-- Date: /.a:C 77 COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 4 5-o Date: Date of Payment 4/94€ /19- Date of Payment Receipt Number !16-1WJ Receipt Number COSA# 56C/2114 jp Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm NorthRim Engineering Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 9/25/2017 .}'� Fir 6. DSD SIGNATURE `!" ' °3. '• '' +w' System #1 Approved for ^ bedrooms. ;'r • ,d System #2 Approved for bedrooms. • f" ci p Disapproved. /�S�r�4s S Conditional approval for bedrooms, with the following stipulatio'rts: . olottlfirir ON-SITE WATeR At tD WASTEWATER o PROGRAM o 2i�cM SERVO-c° .4/1011111111111111111P B6Y 1 t.�.---�� Original Certificate Date: 0 ( -17 The Municipality of Anchorage Devlopment Services Division(DSD)Issues Certificates of On-Site Systems Approval(COSA)based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska.The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 9.1-12.doc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Cerrt facate of Ort-Site Systems Approval Checkaast Legal Description:`AaE Pl/ 2 f7S 82 4/D Parcel 56' '8( A. WELL DATA Well type P If A, B, or C provide PWSID# Well Log (YIN) N Date completed (1M< Sanitary seal (Y/N) ! Wires properly protected (YIN) Total depth VA/ -ft. Cased to LIOt ft. Casing height (above ground) ZL( in. FROM WELL LOG AT INSPECTION Date of test `7/20 7 // 1 Static water level r ft. ‘ r. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform (/ colonies/100 mL Nitrate -5, 7/ mg/L Arsenic /v l) ug/L Date of sample: /22// 7 Collected by: 'Vee '^^� B. SEPTIC/HOLDING TANK DATA °OBLI - 5'E Tank Type/Material Date installed Tank size gal. Number of Compartments Cleanouts (Y/N) Foundation cleanout (Y/N) Depression over tank (Y/N) High water alarm (Y/N) Date of pumping Pumper C. ABSORPTION FIELD DATA /'U,CjG/G ,SFt,JE�2 Date installed Soil rating (g.p.d./ft2 or ft2lbdrm) • System type Length ft. Width ft. Gravel below pipe ft. Total depth ft. Eff. absorption area ft2 Monitoring tube Depression over field Date of adequacy test Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION AJ4 Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot NA On adjacent lots /OO �.1— Absorption Absorption field on lot A f A On adjacent lots /00 - Public sewer main ( 7O �t Public sewer manhole/cleanout /40 'f Sewer/septic service line Z 5 /4- Holding tank /CO '4- Animal containment areas 5 D �' Manure/animal excrete storage areas /O Q '# SEPTIC/HOLDING TANK ON LOT TO: Pu$/.(U S el..)e---(e- Building Building foundation Property line Absorption field Water main Water service line Surface water Wells on adjacent lots ABSORPTION FIELD ON LOT TO: pc,$t./ . SF_A- Z Property line Building foundation Water main Water Service line Surface water Driveway, parking/vehicle storage Curtain drain Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION -stay J certify that 1 have determined through field inspections and A0 � � review of Municipal records that the above systems are in ,'•, ,., conformance with MOA COSA guidelines in effect on this date. . •:� Engineer's Prin d NaTe %(/ /F l� cam `2 5 Date 77 �'''"" • COSA yellow sheet 2-6-15.doc — r I .--. --_. ".�_ 13(.1--. i►: :, • j tx iil^Irmax, f ,.41 i• Ft r— t;,.... ,, ,... -% 4, L .i.1 Fi , 1 .• ., ... ! . ..,.. , i . 4 i �-t !r � \ Coo4 4. F I�fii d i 1 i H • :if I •i v. ..ti iw. i H AS-BUILT I hereby certify that I have eurvcyed the fuil.>wi:w described property:l__-Lis, .e.I.K." 14__ 2.._,.:....._ '. - .._ice- T L ..'- S,Lf -t - - ; Anchorage Recording Precinct, Alaska, and that the '-:,k4,1 1 -' improvements situated thereon are within the pi•op.rty -a r,, • Yr" . ' lines arid do riot overlap or encroach on the property ie lying artiarent thereto, that no improvements on or(s.- ert7 lying adjacent thereto encroach on the prrmisc- =* question end that there are no roadways. trz*,. r.:iai , Irne_ rr othe- visible easements on said property exi:out ae indicated hereon. Dated at Eagle River, Alaska this"?_*- '-_____day of__ .e44.__ • _-- _ ROBERT C. JOHNSON F"', r:, L"6�= fb 5•1 4-t- SCALE: Registered Land Surveyor No. 33o-i.:. j` Zf Box 45E, Elele River. Alask+• Phone 804-7543