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Home My WebLink AboutEAGLE RIVER HEIGHTS BLK 2 LT 38 G~"~'ER ANCHORAGE AREA BORO~It~I:~ HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION SEPTIC TANK: MAILING ADDRESS PHONE. DISTANCE FROM WELL '~"Z... LIQUID CAPACITY /,~O'~ MATERIAl ~ · GALLONS. INSIDE LENGTH NUMBER OF COMPARTMENTS / INSIDE WIDTH ~' //~)t~ LIQUID DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS LINING MATERIAl NEAREST LOT LINE OUTSIDE DIAMETER OR WIDTH ~ /--"~("-<; D,STANCE FROM WELL ~'O ~ TOTAL EFFECTIVE ABSORPTION AREA ~WALL AREAJ ,LENGTH ~' ,DEPTH ,BUILDING FOUNDATION~ so. FT. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA ,, FOUNDATION. DISTANCE BETWEEN LINES SQ. FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE NEAREST LOT LINE TOTAL LENGTH · OF LINES TRENCH WIDTH IN. TOTAL EFFECTIVE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILF . WATER WELL: TYPE DEPTH DISTANCEBuiLDiNG FOUNDATFROM ON, I~" I · SAMPLE , NEAREST NEAREST SEPTIC SEEPAGE OTHER LOT LINE . SEWER LINE TANK , SYSTEM CESSPOOL , SOURCES DISTANCES: DIAGRAM OF SYSTEM GAAB-~iD.2 GREATEL NCHORAGE AREA- - ROUGH HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT / APPLICATION TO INSTALL: SEPTIC TANK ~/ , SEEPAGE PIT. '/ , DRAIN FIELD. TO SERVE THE FOLLOWING FACILITY / /~O. goo~ ~/o~' FINANCED THROUGH PERCOLATION TEST RESULTS TO BE INSTALLED BY ANTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS, ~g' ~'~"q/~r"'( ( ~' (" . PERMIT TO I"STALL A AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED · SEPTIC TANK SIZE /~0 ~ TYPE d,D~, SEEPAGE AREA DISTANCES: 5'0' Health Authority TYPE DIAGRAM OF SYSTEM Cd(r- o_~ifj I certify that I am familhr with the requkcments of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. Fabruat*y ~ o 1~76 File No.: 4-1 r,.lr. JOseph P.O. Box ~a~le River, Alaska 905?? Deer ~r. Kapolla: It h~ be~n broqaght to om* ottsntion that put)Be sewer is available t~ Lot ia, BM 2, Eagle River Heights fJubdtvtaton. Aeem~ing to lbo Aneho~t Code'of Ordinanc~ 'Sewage DIopo~l Praeileo.*, . Cluptsr II, Aflteb ll.4S, SJ0tinn lJ.4$.t$0: ,wil~lo within ,verity (?0) fe, t or the ne~ast lot line sam premlm...". '. The ~un~ty or An~ ~_~_ _ of Publle Worhe has ~h~kod their rd~ds and they Indice~ that 3mu~ struetn~ (s) Is If we do not b~r h~m 3mu within ooven CT) Mo, we will somme that our ro~orda are c~rreet. ~*e, thet*eb~, requ~t 7au ~eat ~ny and nil atru~tu~s too~od on the oubJtet property to publl~ sewer b~ You mu~t mppty rot. a eonne~hm p~mlt from th, permit orfl~er fbF the Muulelp~lity or Anchorage, 3S00 East Tudor* Ro&d. If you have any queJtlon8 rowsr~J~ th~ above, pleass do not hesitate to eonte~t the permit of Tl~e~ at 2t~.-llfS, ezf. oneion M0 or the Department or Health and l~nvirmm, ntei RECEIPT FOR CERTIFIED MAIL--30~' (plus postage) STREET AND NO, P.O. STATE AND ZIP CODE OPTIONAL S[RV-IC[S FOR-ADDITIONAL FEES ._S_E~V!_CES. S~ With Clel~very to Id~ressel Only ............ SSt OELIV[R TO-X~Iq ~ E ~0 N['Y~~o~ POSTMARN OR DATE PS Fo~ Apr. ID?I 3800 I(0 INSURANCE COVERA[:[ PROVIO£U-- HOT fOR INTERNATIONAL MAIL 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 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) · Lot ~8. Blk 2. Ea~le R~ve~ ~e~ght8 Location (address or directions) Chandalar Steer 12/15/86 (b) Applicant Name.Audrey' Mason TelePhone: Home 69/4-/4200 Business Applicant Address _POB 7728/49, Ea;le R:[ver. Alaska q9577 "'(c) Applicant is (check one): Lending Institution I-I; Owner/builder I-I; Buyer 1"1; Other I~1 (explain); RP:~I (d) Lending Institution Northland MoPt~a~¢ Telephone Address /400 W. Tudor. Anchorage. Alaska gg~O~ (e) Real Estate Companyand Agent s;~'lle as above, Address Telephone (f) Mail the HM to the following address: · 2. TYPE OF RESIDENCE Single-Family r;1 Multi-Family r-I Numberof Bedrooms, ~ Other WATER SUPPLY Individual Well I"1 Community ~l Public D Note: If corem unity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsitel'l 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. Page 1 of 2 72-025(11,84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, D~, I 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 Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequat~ 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 ~.~[.F. i-d~,'F.~ ~-~,~;[;~-~,~:],~ ,~-;tVICr~ Telephone Address FA~I F RIVER. AK 93577 Date 1~!17/£" P. 0. B0X 773294 ~pproved for I ff'~!, ' bedrooms by Apl~roved (~,,, t~,,, Disapproved ' -'/ C(~nditional · Terms of Conditional Approval i ' , -~ ,, 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 S 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 A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST o FEBRUARY 1984 264-4720 Legal Description: Well Classification Well Log Present (WN) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line ,'~. -, I! A, B, C, D.E.C. Approved (Y/N) Date Completed Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer CleanouVManhole Water Sample Collected by Water Sample Test Results Comments To Nearest Sewer Service Line on Lot ; Date SEPTIC/HOLDING TANK DATA Date Installed Size __ Standpipes (Y/N) Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Dislances from Septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service Line Course No. of Compartments Foundation Cleanout (Y/N) Date Last Pumped ; for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026( 11 ABSORPTION FIELD DATA ,~ Soils Rating in Absorption Strata Date InstalIed Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway. Parking Area, or Vehicle Storage Area Comments Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) LIFT STATION ~ Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (WN) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments Signed ~ ~ Date Company ~7-,~ ~-,,..r7 MOA No. Receipt NO~ *" Check Permitted Bedroom Rating Against HAA Request *" I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Date of Payment Amount: $ Page 2 of 2 DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA g9501 SHEFFIELD, GOVERNOR Telephone: (907) Adding: 274-2533 DATE: PWS To Whom it May Concern: According to records on file in this office the /_o7L4 ~ 7f~ ~¢¢~ /~L~Water System is in compliance with the State Drinking Water Regulations Sincerely, MUNICIPALn~ OF Ah/CHORA~ E:~PT. C'F H~ALTH & EN~VIRO,~ E NTAL FRO/ECTIOI~ OEC 1 91980 RECEIVED DATE RECEIVED INSPECTION APPOINTMENTS DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR · UAY 2 9 1981 ENVIRONMENTAL SANITATION DIVISION Telephone 2644720 R E C E i V E D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES MAILING ADDRESS -- , /' ~ * !3. LENDING I~ITUTIOKI /-'~ -/ t/ -'"]--- PRON.~ · ~EALTOR/A~ ~ ~' ' / I PHONE 5. LEGAl ,~CRIPTION [~-~'SING LE FAMILY ~ One ~ Four Two ~ Five ~ MULTIPLE FAMILY ~ Three ~ Six 7. WATER SU~LY I-3 Other ~ INDIVIDUAL· [] COMMUNITY [], PUBLIC UTILITY SEWAGE DISPOSAL SYSTEM · 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.) INDIVIDUAL/ON-SITE" ' .YEAR ON-SITE SYSTEM WAS INSTALLED. PUBLIC UTI LITY 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 [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ,ERMIT NUMBER I'-IINDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified iNSTALLER []SepticTank or ~--IHoldingTank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 5. COMMENTS PP.OVEDFOR BEDROOMS [] CONDITIONALAPP"OVAL {letter must~c¢ompan¥ certificate} 72-010 (Rev. 6/79} TEL~EPHONE (907)-27g-4014 ANCHORAGE INDUSTRIAL CENTER · 2,74-3364 5633 S Street ~ Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: Water System Name I.D. NO. I~one No. Mo. Dey yem' SAMPLE TYPE: D Routine [] Check Sample (for routine sample with lab ref. no. [:3 Special Purpose I'-I Treated Water [:3 Untreated Water SAMPLE NO. LOCATION Time Collected Collected By TO'BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: I ~ Satisfactory [] 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: [:33 Fermentation Tube i' ~E] Membrane Filter Lab Ref. No. Result* Analyst 06-1220 ID) Rev. 3978 BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS BEFORE COLLECTING SAMPLE ~1: Ti~ Dat~ Insp ..._MUNICIPALITY OF ANCH.O, RAGF~ Z~L~L~ /2toaA ~'OF HEALTH AND ENVIRONMEN. ~ PROTECTION Street, Anchorage, Alaska' 99501 279-2511, ext. 224 or 225 Date Received: Ma~ 4., 1977 2: Time · ~ 3: T~me Date Date Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Alaska Mutual Savings Bank Post Office Box 1120 99510 Mailing Address: 2. Property Owner: M.K, Jacobs Phone: 694-9940 Mailing Address: Phone: 274-3561 3. Legal Description: Lot 38 Block 2 Eagle River Heights Subdivision 4: Single Family Residence: (x) Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: 3 5. Well System: Indi~idu. al we.ll ( ) Community/Public System~ ~ / Semi-public, service to Lot 37 & 38 ' _.~. ~ /~_. Construction ' /~--'~/~ Bacterial Analysis 6. Sewage Disposal System: On-site System ( ) \ Public Utility (x) Permit ~ / ~ ~alled .~y Insta~ Septic Tank Size ~ / / I / /~nufq4~ture~ Absorption Area ~ ~'Soil s~,Ra te I Mater~al Distances: Well to to Sewer Line to Nearest Lot Line .[c~ank ' ~ ~. ~to Absorption Area. ~~ Absorption Area MUNICIPALITY OF ANCHORAGE D:PT. DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ,VI~ON,',;FNT^L 2510 East Tudor Read, Anc~m'~g.. )U~kJ 99504 276-2221 [',t ,'~Y 4 1977. REOUEST FOR APPROVAL OF INDIVIDUAL SEWER mxJ WATER FACIUTIES 1. Typeof Inspection: CMRO. .VA FHA 2. Property Owner: JACOBS, 14. K. (Eagle River Home Builders) CONV xxx Mailing Address: 3. Nameof Buyer: WISDOM, Jim L. & Sandra V. Day Phone: 694-9940 MailingAddresa: 629 Bra~a~} ~4 Anchm AK Day Phm~:.. 265-8326 (wife work) 4. Nameof Lending Institution: Alaska Mutual Savtn~;s Bank MaillngAddress: P.O. Box 1120 Phone: 274-3561 ex: 217 5. Name of Realtor or Agent: none Mailing Address: n/a Phone: n/a 6. Legal Description: Lot 38~ Blk 2~ Ea~le River Heights Subd. Location: Ea~le Rivert AK 7. Type of Facility to be Inspected: well · 8. Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well ? 9. Sewage Disposal System Type of System: Public Utility ]O(X If Individual, date of installation No. Bdnm. ~ Individual xxx 2=serves Lot 38 & Lot 37 Individual (mt-site) 72-003(3/76) "P. age Two Department of Health and Environmental Protection Request for Approval 'of Individual Sewer and Water Facilities Legal Description: Lot 38 Block 2 Ea~le River.Heights Subdivision Comments: 'Affadavit Attached:. .. ;(') //~ Letter Attached: ( ) Approved: ~~~ Date: ~--//~/~ ~! . Disapproved: Date: Department Worksheet: 06:.122~,~a) eRev. 1973 ALA, ~DEPARTM£NT OF HEALTH AND SOCIAL Si TES DIVISION OF PUBLIC HEALTH iNDIVIDUAL AND SEMI-PUBLIC BACTERIOLOGICAL WATER ANALYSIS INDIVIDUAL -SEMI-PUbLIC [] .... CHLORINE RESIDUAL PPM- REPORT RESULTS TO NAME ZiP CODE OF 5OURCE Lab No. OFFICE [] QuestionobI~ - . ~ANITARIAN' REMARKS COMPLETE THIS SECTION ONLY IF WATER IS AN INDIVIDUAL SUPPLY SAMPLE COLLECTED BY DATE COLLECTED TIME COLLECTED [] Olher []Easement Tap [:] LOCATION: []In Yard [] OIher Top[] [] Under House F~t. Privy []Tile []Fibre ?TA*bedos [] Yes ~-I NO PUMP LOCATION: [] In WIU n Balement Depth Felt. [] In Ba~menl [] Room [] Yes [] No , READ INSTRUCTIONS ON REVERSE SIDE BEFORE ' COLLECTING SAMPLE o~42~o(b) BACTERIOLOGICAL WATER ANALYSIS RECORD Rev. 1973 Loceose Broth IOcc IOcc 1Otc IO~c 1Gcc 1.0cc 1.Icc GREATER ANCHORAGE A.~% BOROUGH Tax Code: I Date: Owner~ Maih~g Address~ User/Tenant: Property Address;c./~, , Subdivision: DYF TFST: [] Positive Administered By.', ' Builtinq Dol~art~ent lte&&th &n~l llnvlron~ental ~zot~ctlon is agProve~ by this department. L~a Il. lluahholz ~anitarian