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Home My WebLink AboutEAGLE RIVER HEIGHTS BLK 2 LT 43 PEF'r,ITT NFl APF'L.I CFIN T IJ]CAT ! Oi'.J I _El]Al_ l.ll_ll'-J ]: I.-:_: ],.,--'""~1_ ] 1-"r' i-_iF' r)KPmF,.Tr,tEt.,ll"~,EAI.TH AN£) EN',? ] R - Nt'tENTI~ . 'rECT =:~?-'5 -'1_./ STFrFET, R~'.JCHORflFJE., 279-25i'! L,JE-]I_I_ F't-_--_F~I-1 ]r T 775.1.9 ) CI flPFNC. E LAI'IA'Y P.O. BX. 9-~5 E. R. 694 HTS I.OT SIZE 1fl742 SQUARE FEET [,1TNIMIIM DIS]'hNCE RETLJEFH fl WFI I. RtJl') Ri'.J¥ NN-SITF SEWAGE DISPASRI.. SYSTEM IS '1AA EFFT FAF' R PPIVRTF T, IEI.I. NE' ?AA FEET FlIP FI PI_IRI_IC L,.IEI.I.. WFI_I_ Ir, A':, APF RF~)IIIRFI:, ANt) I',lil:,T F:F RETIIF'NFI') TA ]'HE r)EPRPTHEI'-,~T HTTHIH ];A i]F THE L,.IFi_I. £:AblPI.FT]NN i]THFR t~'FKUlIF:'EI'dFi'.JTS l,lA'7' FIPPI.¥ sPFr:TFTf]FITII-ff.J'~, AND cr~N'STFHICT]CiN DIRGRFII,1S ARE AVA TI..RP, LF Ti-i I bL-]l IRF F'k:NPEP T rJ':,TRI .I.FIT ] Ahl I RFRTTF¥ TI,IRT :1: I RI,1 FFIFIII_.IRR HITH THE Frill'TH F;"r' THF [dlli',,ITI3TPAI.TTY I-IF Ri'.~ll-;Hl~lF'FIF'iE. P: T WIll.. IN'-qTSI.I. THF S"r'STEH IN FICCOF:DFIr.~ICE WITH THE COI')ES. RFK~IJIRFHFNTS FAP AN-ql]E SEWERS FIN[) [,JELLS AS SET V.~. 0 This well is producing g~l{o~s of water per hovr. ~et Dump IN¥01C'E L'~OON D~iLLING BOX 668~ I~OGARD RD. PALA~P,. ALASKA 99645 T£~PHON£ 745-4071 WELL LOG CA$1,~ FORMATION 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 4~, Block 2~ Ea~le River Hei~htst T14N R2W Sec.12 Location (address or directions) 168 Chandalar St. (b) Applicant Name Stan So~,h Telephone:Home 60~I-/4108 Business N/A Applicant Address 168 Chandalar St Eagle River AK 90577 (c) Applicant is (check one): Lending Institution []; Owner/builder ~]; Buyer []; Other [] (explain); (d) Lending Institution Alaska Mutual Bank Address Eag~{' Rtv~'~' AK (e) Real Estate Company and Agent .Address Telephone 6cy~-cy571 Telephone (f) MailtheHAAtothefollowingaddress: p~ckup by Ap?]~cAnt TYPE OF RESIDENCE Single-Family ICq Multi-Family [] Number of Bedrooms /l Other WATER SUPPLY Individual Well[] Community[] Public[] Note; If community well system, must have written'confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite[] Public'J~l 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 I of 2 72,.0~5 (11/84) · . 5.* ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION I verify that my investigation of this Health As cc~rtified by my seal affixed hereto and as of the validation date shown below, ~" 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 Ihe 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 ~LE i~ivF, l~ FN~iNI::FI~iN~ SF~Vi(,ES Telephone Address F/~RI /'~ ,'//~,,/,F~' P. 0. BOX 773294 Date ,or ~;; rn.;V;~co r~di ti~o al Approva~iSappro~Ted Conditional 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 es 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 72~025 ( I t/84) MUNICIPALITY OF ANCHORAGE (MO~t HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 MUNICIPAUTY O~ AN~IOI;AGE DEPI'. O~ HEALTH & ENVIIIOhI~NTAL P~OTECTION MAR Legal Description: WELL DATA Well Classification /¢~.v~ //./A T'~ Il A, B, C. D.E.C. Approved (Y/N) Well Log Present (Y/N) ~ Date Completed /~,P,2 Yield /-~ Total Depth ,ejf;. /o~,! Casedto Static Water Level ."~"~ ' /f'~ ~'- Casing Height Above Ground ~/~ Electrical Wiring in Conduit (Y/N) ~paration Distances from Well: To Septic/Holding Tank on Lot ~ To Nearest Edge of Absorption Field To Nearest Public Sewer Line ~ Cleanou~Manhole ~ ~ ~ Water Sample Collected by ~/~ Water Sample Test Results ~ ~ Comments ~// /~ ~ Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots W.,'-,-~ ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot '~.,~3,3" ! B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) Depression over Tank (Y/N) 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 Main/Service Line Course Size No. of Compartments Air-tight Caps (Y/N) Foundation Cleanout (WN) 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{11/84} ABSORPTION FIELD DATA ,~/~ Soils Rating in Absorption Strata Date Installed 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 ,/u,,,//~ Date Installed Size in GalIons "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 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. Signed .~-~~-----~ Date Company ~'.~' 4,.~-.~" MOA No. Receipt No. ~'~ '"7 ,~"7 ~ ~ Date of Payment ~ - I -~ '~ ..,.-c.c, ~ ~ ,:-~-~,, t t,--_~ · . .. £ng~neer s Seal Amount: $ {43 "~ Page 2 of 2 ""N?~UNICIPALITY OF ANCHORAG~~''~ ~_mah ~,,-~En ~-~r~._) DEPARTMENT OF HEALTH AHD £NVIRONMENTAU' PROTECTIOH 825 L Street, Anchorar~,-. Alaska 99501 264-,1720 Date Received: ~1: Time ~;~/~PD( ~2: Time ~3: Time Date ;I-IU-Uq~/?,~5 Date Date Insp ~ Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Mailing Address: ~',LAC~ 'q-~-] d~Ol~%~6) Phone: Property Owner: ~1 r~a~.~o_ ~ ~N~ . Phone: Single Family Residence: ~) Number of Bedrooms: F'A~_~ Multiple Family Residence: ( ) Number of Bedrooms: well System: Permit # Construction Individual well ~) Com.munity/Public System ( ) Depth of well Well Log on File Bacterial Analysis ( ) Sewage Disposal System: Permit ~ Septic Tank Size Absorption Area On-site System ~) Public utility Installed Installer Manufacturer Soils Rate Material ( ) Distances: Well to to Sewer Line to Nearest Lot Line Septic Tank Nearest Lot line to Absorption Area Absorption Area ~fge Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities ComMents: Affadavit Attached: ( ) Letter Attached: ( ) Approved: , ~'~~ Da te: Disappro%U: Date: Department Worksheet: ! ! MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L Street, Anchorage, Alaska 99501 279-2511, ext. 224, 225 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: 2. Property Owner: CLARENCE LE MAY Mailing Address: 3. Name of Buyer: LARRY E. & BARBARA EBERLY VA FHA__ .CONV XXX Day Phone: Mailing Address: Name of Lending Institution: Mailing Address: POUCH 7007 NONE Name of Realtor or Agent: Mailing Address: NHN CHANDALAR PEOPLES BAK & TRUST Day Phone:. 337-3233-EXT. :~34 · Phone:_ Legal Descr[ption:~K. Location: Phone: 279-7511 EXT 242 NHN CHANDALAR Type o! Facility to be Inspected: SFR Water Supply WELL & SEPTIC APPROVAL Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: If Individual, date of installation No. I~drms. 2 Individual Public Utility Individual (on-site) DEPt. J,F H~AL.TH &, ENVmON~,,rN. J~:~I'ECTIOJ",[ NOV 81977 _RECEIVFD DATE ALASKA 'DEPARTMENT OF HEALTH AND SOCIAL SER~'~CES DIVISION OF PUBUC HEALTH INDIVIDUAL AND SEMI.PUBLiC BACTERIOLOGICAL WATER AHALYSIS Lab Ne. OFFICE INDIVIDUAL NAME ADDRESS SEMI.PUBLIC [] . CHLORINE RESIDUAL PPM REPORT RESULTS TO CITY ZIP CODE [] Sample too long in transit; sample &hould not be ove~!48 SANITARIAN'S REMARKS COMPLETE THIS SECTION ONLY IF WATER IS AN INDIVIDUAL ~UPPLY // SAMPLE COLLECTED BY ~o.,- O w~ o c~,c,.,. O LOCATION: [] Ye, [] Ha PURPOSE OF EXAMINATION; Illness Suspected? [] Yes New Source of Supply? rl Yet READ INSTRUCTIONS ON REVERSE SIDE BEFORE cOLLECTING SAMPLE [] No BACTERIOLOGICAL WATER ANALYSIS RECORD l'~ /////'~/'/'~ "- T~.. R~.;v,d ~ / om ~' ' "= AGAR .~ovember 10, 1977 Peoples Bank and Trust }~rtgage Loan Section Pouc~ 7-007 Anchorage, Alaska 99510 Subject: Lot 43 Block 2 Eagls R~ver Heights l~orth Subdivision Clarence La May Property Before this department can approve the request for sewer and water facilities, this wffice will require two(2) items. (1) Supply th&s department with a copy of the well log. (2) Seal the sanitary well seal so that it is air tight. If ther~'~are any further questions,p~lease contact this office at 264-4720. Sincerely, Robert C. Pratt, Sanitarian