HomeMy WebLinkAboutEAGLE RIVER HEIGHTS BLK 2 LT 46B f, ~ MUNICIPALITY OF ANCHORAGE t"-'~
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 2644720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
MAILIN~ ADDR E~ .
LEGAL DESCRIPTION
LOCATION ' '
~ ~ DISTANCE TO: Wall Dwelling PERMIT NO.
~ DISTANCE TO: Well Building foundation Nearer lot line
~ DISTANCE TO: Building foundation Sawer line Septic tank Absorption area(s)
OTHER
{gerlifieh rilling
by
A & L DRILLING COMPANY
BOX 97, EAGLE RIVER, ALASKA 99577 · TELEPHONE 694-2588
OWNER OF LAND O'~''J
ADDRESS /~of
/...
LEGAL DESCRIPTION
DATE-Started I~,/~
PEILMIT NUMBER
Ended
DEPTH OF WELL I 0 I I o
STATIC LEVEL_DF WATER FT.
DRAW DOWN ~.
t ~/~ ,/7~ GA~. PER HR ~00
KIND OF CASING
KIND OF FORMATION:
From ~'~ Ft. to / Ft.
From I Ft. to ~ -~' Ft.
From ~'~' Ft. to ~5"' Ft.
From ('~" Ft. to '9'7 Ft.
From 77 Fi. to ~'~ Ft..
From ~[ ~ Ft. to { ~ )' Ft..
From Ft. to Ft._
Fromm. Ft. to Ft.
From Ft. to Ft,
From __ Ft. to Ft.
From Ft. to Ft
From Ft. to Ft._
From Ft. to Ft._
From Ft. to Ft._
From Ft. to Ft.
From__.Ft to Ft.
From Ft. to Ft._
From
From
From
From
From
From
From
From
From
From
From
From
From
From
Ft. to Ft.
Ft. to Ft._
Ft. to Ft.
Ft. to Ft.
Ft. to Ft.
Ft. to Ft.
Fi. to Ft.
Ft. to___Ft.
Ft. to Ft.
,Ft. to Ft.
Ft. to Ft.
Ft. to Ft._
Ft. to Ft,
Ft. to Ft
Ft. to Ft.__
Ft. to Ft..
Ft. to Ft,
MISCL INFORMATION:
DRILLER'S NAME
COMPAtN ,<
L DRILEING
KIND OF FORMATION:. :: . .,' ] ' ' ,. :., ' ............ ,-r ': ';' -:
Fro ri;to:) :~Ft. "°d'='dd;~'° From Ft. to ' rt.
From I ri.'t~' ~'~' Fi'. ~4~'~ '""--'; ~. From ....... Ft]'to .... rt.~ "" '~
From '~-.Fi. th' ,Ft. ~' ~ From' Ft. tO' Ft._
r,om 6~.rt.,o~7~7' n."~O'"'t/6~v~=~--rro~ ' ' r,.to .....
From Fi] to Ft. From - Fi. to ' Ft..
From -. 'Ft. to '" Ft..~
From Ft. to Ftc.
From Ft. to' . Ft._
From' ·Ft~ t~ Fi.
From Ft;to" ' ' ' Ft.
From ' Ft. to · ' "Ft,'
From ' Fi. to 'Fi
From ' Ft. to Ft.
From Fi. to - Ft.-
rr?._z_~./rt, io.'-ri.- -
From
From
Fro~
From
From
Fi. to Ft..
Fi. to ' Ft.
Ft. to Ft.
Ft. to Ft..
' ''Ft. to ~" ' Ft. '
Fr~m ' FL to Ft.
Fr~m' Ft~to Ft..
From Fi. to 'Ft..
From "'' Ft.~o ' Ft.
From - . ~Ft. to Ft~
"MISC~ INFORMATION:
; HU~ I C I P~L- 1 1'¥ OP-- ANCHORt~E
,.~.- ~,' DEPAP. TMENT OF~'"'EALTH AND ENVIRONMENTAL P~EOTION ~ ~
. I ~' NELL ~ND Ot~--SZTE 5EI4ER PER~[T I~~
LOCRT1UN WILDWOOD 51' ' W~ '15:17
L~HL L 46B B 2 EAGLE RIVER HTS. LOT SIZE 11475 SQURRE/FE~
]YPE OF SOIL 8BSORBTION SYSTEM IS: DRAINFIELD
MHXIMUM NUMBER OF BEDROOMS = ~ SOIL RATING (SQ FT/BR>=
I'HE REQUIRED SIZE OF THE SOIL ~BSORPTION SYSTEM IS:
DEP]'H= ~:3. ~5 LENL~-rH= 72 L~RI-]~/EL DEP]-H= 2
THE LENGIH DIMENSION IS THE LEIOTH (IN FEET) OF THE TRENCH OR DRAI~IFIELD.
1HE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET>.
3'HE ]-RENCH HID]'H I5 5. 000 FEET
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET>.
RE~!. IJ I lC. ED SEPT I
i PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIO~I$ OF ANY I,I~LLS ADJACENT TO THIS PROPERTY AND 3HE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
Ti-lO < 2 > I Nc;pECT I 01'~15 ARE REt.-!. U I RED
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BET~IEEN A WELL RI'~D ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL: OR
150 TO 200 FEET FROM 8 PUBLIC ~IELL DEPENDIN(3 UPON THE TYPE OF PUBLIC WELL
~ELL LOUS 8RE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 20 DAYS
OF THE WELL COMPLETION.
UTHE~ REQUIREMENTS I'IRY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
PERM I T EXP I IRES DECEMBER :~-1 . 155~7~.
I CERTIFY THAT
l: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET
FORTH BY THE MUNICIPALITY OF RNCHORROE.
2: I I,IILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
~: I UNDERSTAND THAT THE ON-SITE 5E~IER SYSTEM MRY REQUIRE ENLARGEMENt IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~BEDROOMS. ~e../~. ~ ., ·
..............................
'] Soils Log
· · ~ Percolation Test
4
6
8
12
14
16
Steven A. Johnson ~'
'-~x 76
~hugiak, Alaska 99567
Phome: 688-3085
Performed for
Legal Description
Test Pit Location
Dan Snoot Date
Lot ~6B, Block ~, Ea~lr River Heights Sub.
10'E and 10'N of the SW property corner
SW
GW-
GM
O'to 1' red brown silty gravel w/organics (GM) 225
1'to 2.5' red brown clean well graded sand
125ftE/bdrm
2.5'to 5.5' gray brown well graded gravel (GW)
w/ cobbles to six in. grading to
dense (GN) at 5.5' 125ftZ/bdrm
16' well graded ~½1~y gravel (GN) w/
boulders to ~o ~n. material contains
lenses of.dense silty fine sand ~
170ftZ/bdrm
perc tested from 6.5'to 8.5'
Total depth this test ~6 feet
AVERAGE ABSORPTION AREA REQUIRED FROM SOILS LOG ~
ft.2/bdrm.
DaTE NET TIME CMin.) NET DROP (In.) [PERC RATECMin/in)
9/29/78 ~0 6.2~ ~, ~
60
Percolation rate
minutes/inch A
· ~ MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D.#
1. GENERAL INFORMATION
Complete'legal description /-o~' C'~,~
Location (site address or directions) /~"~' z~")~'°~"~z:~ '~"'"~'~"~'~
Property owner
Mailing address
Lending agency
Day phone
Mailin. g address
Agent
Address
Day phone.
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: ~"
TYPE OF WATER SUPPLY:
Individual well /
Community well
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF wASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE:
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
.6.
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 of this Health Authority Approval application 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 0~-~' ~. ~J~'~ Phone('~.~) ?'~. _/~?.,f
'
Engineefssignature. ~ Date.I~' ~'~ ~
DHHS SIGNATURE
~ A.p. proved for
bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Note: The well for this property meets existing State and Municipal Codes,
performed to insure the wells continued suitability. Current nitrate
More information on nitrates is available from the On-site Services Program,
Additional Comments
Date
The Municipality of Anchorage Department of Health and Human Sen/ices (DHHS) issues Health Authority
Approval Certificates based only upon the representations given In paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DH HS does this as a co urtesy 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.
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division
825 L Street, Room 502 · Anchorage, Alaska 99501 ° (907) 343-4744
Health Authority Approval Checklist ...............
Legal Description: ~,~,,-4/~,~; ~'~'.~/~'~/-~ .~ac'~. y,,-~. Parcel I.D.:
WELL DATA
Well type ,~="~' 4/.,; 2"'~'
Log present (Y/N)
Total depth /~' / "/~' · /
sanity ssal (Y/N) '/
Date of test
Static water level
Well production
If A, B, or C, att~lch ADEC letter. ADEC water system number
Date completed ~e~. ~'/
Cased to ,4~'z~ "/~-,~' Casing height (above ground)
Wires properly protected (Y/N)
AT INSPECTION
FROM WELL LOG
WATER SAMPLE RESULTS:
Coliform ~ Nitrate
Date of sample: -~'~'~',~_~ /'2 P~
~,. a~. Other bacteria
Collected by: ,~'~.~'~ /-*/--~/.
SEPTIC/HOLDING TANK DATA
Date installed /,//S,~J~./, Tanksize /~,oo,~NumberofCompartmente ,E.. Cleanouts(Y/N) .
Foundation cleanout (Y/N) )/ Depression (Y/N) ,Al High w~ter alarm (Y/N)
Date of Pumping 9~ ,//~,~, Pumper '~'~'/"~"~'~"
Ce
ABSORPTION FIELD DATA
Data installed
Length /~,:~','~'/.
Soil rating (g.p.d./fff or ?bdn~. )
-~' / Gravel thickness below pipe
/¢/ System type
~''/ Total depth
Effectlveabsomtionarea ~'/'~"~-'~ MonitoringTubeprssent(Y/N) ~ Depmssionoverfleld(Y/N) ,4/
Date of adm~,mm/test .~'~' "~//~/~'~ Rasulte(Peg~/F.. all). ,'" For ~ bedrooms
- -'~, / .(/-
Fluid depth in et)soorP, flon field before test (in.~. ~'"'/~ ' Immedlataly after/a~*/oal, water added (in.}: a; 7' ~'
FJuid depth & Z. ' (ins) Minutes Jater: ~ ~ g.p.d.
Peroxide treatmem (past 12 months) (Y/N)
72-026 (Rev. 3/96)*
Absorption m.t~ = ;,-",.v',~,~
If yes, give date
D. UFT STATION
Date installed
Manhole/Acceso (Y/N)
High water alarm level at*
Size in gallons
"Pump on",level at*
~Da'~t~m~ /
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot ~'~ /
Absorption field on lot
Public sower main
Sewer/septic service line
On adjacent lots
On adjacent lots /~ ~ "*,~"/*
Public sewer manhole/cleanout
Eft station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation ~ / Property line ~' ~ / Absorption field
Watermain/sowicellne 'z'~'~/z'JSu~facewatsr/dralnage /~ '*'~","(Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO'
Property line
Surface water
Curtain drain
Building foundation ~'-~'~' Water rnaln/sorvice line
Driveway, parking/vehicle storage ama ~"~'~"~'--~ 7'
Wells on adjacent lots /z?~*",*~','z
F. ENGINEER'S CERTIFICATION
Receipt Number (:::~ z~'/o~ ~,~
(Rev.
Waiver Fee $
Date of Payment
Receipt Number
.~tK CT&E £nvlronmamal Se~lce~ Inc.
. CT&E Ret'.//
Client Name
Pro~ect Names
Client Sample ID
Mntrix
Ordered By
PWSID
sa=p] '
Douglas Kenley P.E.
Lt 46B Bk 2 Eagle River Hts
L145B Bk 2 gagle River His
Drinking Walct
Client pO//
Printed Date/Time 10102198 I
Collected Date/Time 09/28/95
Received Date/Time 09/'28/98
Teclmtcal Director: Stephen C. I~
Rele.~ed By ~
Tozat CoLiform O cot/lO0~ ~,H8 9222B
Municipality of Anchorage
RickMystrom, P.O. Box 196650 Anchorage, Alaska 99519-6650
Mayor htr p://www.cl.anchorage.ak.us
343-4744
October 21, 1998
Douglas Kenley, P.E.
9960 East Pdffin Drive
Palmer, Alaska 99645
Subject: Waiver Request for Lot 46B Block 2 Eagle River Heights
Waiver Request ~WR980079, PID ~050-281-21, HA980379
Dear Mr. Kenley:
Your request for waiver(s) of the required 100 foot horizontal
separation of an on-site wastewater disposal system to a private
well has been approved. The approved separation distance(s) are
86 feet from the private well to the on-site septic tank on property.
This waiver approval applies to the existing on-site wastewater
disposal system to well separation only. Any future upgrade to either
will require all separation distances be met or another approval
from this department.
If there are any further concerns or questions regarding this waiver,
please call our office at 343-4744.
Sincerely,
Daniel J. Roth
Civil Engineer
On-site Services Program
lJm:~6
Dou£1a~ ~. Kenley, PE 9960E. Puffin Drive. palmer, Alaska 99645 (907) 74~-1076
October 7, 1998
Mr. Dan Roth
Municipality of Anchorage
Health & Human Services
On-site Services
825 L Street, Room 502
Anchorage, Alaska 99501
Re:
Septic system and well adequacy test on, Lot 46B, Block 2, Eagle River Heights
Subdivision, 10107 Wildwood Street, Eagle River, Alaska 99577
Owner:
Mrs. Beverly J. Smoot.
Mr. Roth:
Our office was contacted in early September to perform an adequacy test of the on-site well and
septic system for the above referenced property. Prior to the test being performed, a copy ofthe
original installation inspection report was obtained from your office. A site visit was then
conducted to visually inspect the installed septic system and well.
Documentation obtained from your office indicates the installed system consists of a foundation
clean-out, a 1,000 gallon septic tank with one clean-out, a 45-foot-long trench with a single clean
out and a single 4-inch diameter sump at the far end of the trench. The trench is shown in the
original installation report as being 45 ft. long by 3 ft. wide by 2 ft. effective depth. A
discrepancy was noted in that the stated dimensions of the trench result in a total effective
absorption area of 180 sq. ft. while the inspection report listed 513 sq. ft. as the absorption area.
Our inspection of the septic system revealed that the single trench clean-out was partially full of
dirt. The clean-out was further discovered to be disconnected at the tee fitting on the drain line.
The clean-out and fitting were excavated, cleaned, and reconnected. It was also discovered that
the sump was buried beneath asphalt pavement in the driveway. Approximately 18 ft. of the
trench falls beneath the driveway.
After repairs were made on the clean-out, a 2-inch diameter monitor tube was driven into the
absorption trench, approximately 24-inches from the clean out nearest the tank, to a depth of 93-
inches.
An absorption test was performed on September 28, 1998, with initial water level readings of
0.5-inches in the sump and 41-inches in the tank. (the tank had been recently pumped and was
only partially full). After pumping 500 gallons into the clean-out, the water level was 24-1/4-
inches. Water flow was then transferred to the tank, to fill the tank and confirm that water was
reaching the leach field. During the course of filling the tank, the water level in the newly
installed steel monitor tube dropped to 23-inches. After 750 gallons ofwater had been delivered
(500 gallons directly to the leach field clean out and 250 gallons to the tank), the water level in
the monitor tube had risen to 24-1/4-inches, indicating that the tank had filled and water was
running into the leach field from the tank.
Mr. Dan Roth
Lot 46B, Block 2, Eagle River tleights Subdivision
10/08/98
A reading made on the monitor tube, 24-hours later, indicated 1 l-inches of water. This would
have indicated a marginal passing ofthe system. At this time, Fred Kenley came into your office
to discuss options as the system is installed on a very small lot with very little room for an
alternate system. During the visit and review of documentation it was realized that the inspection
report had errors regarding the absorption area.
Because ofthe discrepancies noted on the original as-built documentation, you requested that the
actual dimensions ofthe leach field trench be determined. The steel monitor tube was driven an
additional 31-inches into the ground with blow counts consistent with that of septic rock,
indicating the trench depth was at least 68-inches. A snake was extended into the leach field
drain pipe to confirm the total length of trench was consistent with the 45-foot dimension
provided in the as-built documentation. We therefore determined that the dimensions of the
trench were 45-feet in length by 68-inches of effective depth.
A second absorption test was then performed on the septic system October 3, 1998. The initial
reading in the monitor tube was 42-inches. After 1,051 gallons was introduced into the system,
water flow was stopped and water level measured 67-3/4-inches. Sixty minutes after the flow
was stopped the water level measured 63-inches, which indicated an absorption of 450 gallons.
The reading taken 24-hours after completion of the test revealed 43-inches of water in the
monitor tube. This indicated a total absorption of 900 gallons over the 24-hour period, which is
double the 450 gallons required by the Municipality. A float was inserted at the tank clean out to
ensure that at no time during the test did that water level rise above the elevation of the leach
field drain line.
The test indicates that the majority of absorption is taking place in the top 30% of the trench,
which is reasonable for a system constructed in 1979. All water level readings for both the initial
and latter test have been provided on the Municipality of Anchorage Health Approval Checklist.
Please note that the water level readings for the initial test were adjusted, to correspond to the
elevations of the latter test.
The well to septic tank distance was measured to be 86-feet. Please note that this separation
distance was approved on the Municipality of Anchorage construction permit dated October 2,
1978. The well flow was also found to be adequate.
If there should be any questions regarding the test procedures or results, please call us at 746-
1076.
Sincerely,
Dou
CE #8176 L/
Page 2
nt By: RE/MAX OF EAGLE RIVER, INC.; o 9076960214; Oct-6-g8 9:46; Page 111
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· ~.,.~. ,~ . , v~ ~.
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{mprov~mn~ it~d thc~on are wi~n
lines and do nol over~p or tn~oach on the prop~y
~ sdiacenl ~he~eto, ~t ao imvrovImen~
~ "t,~ r viable e~m~'on ~d pro~
Douglas T. KenI*9,,PE 9960E. Puffin Drive. Palmer,,41asla 99645 (907) 746-1076
October 12, 1998
Mr, Dan Roth
Municipality of Anchorage
Health & Human Services
On-site Services
P.O. Box 196650
Anchorage, Alaska 99519-6650
Re: Well/septic tank separation waiver research on Lot 46B, Block 2, Eagle River Heights
Subdivision.
10107 Wildwood Street, Eagle River, Alaska 99577
Owner:Mrs. Beverly J. Smoot
Dear Mr. Roth:
This cover letter represents acknowledgment by the engineer of existing well and septic
documentation compiled on two lots adjacent to the above referenced property located Block 2
of Eagle River Heights Subdivision and one lot across Wildwood Street in Block 8 of Eagle
River Heights Subdivision.
The packet contains a map of each subject lot and the following information information when it
was available:
1. Well logs with static water levels, total depth of the wells and overbearing strata of
tight soils that might be protecting the source of water from contamination.
2. Available nitrate readings.
3. An approximation of elevations referenced with the well area as a 100' benchmark.
4. Well to septic tank encroachments denoted by distance in feet.
5. Location of public sewer and water.
6. As-built drawings when available.
It should be noted that Caribou Street has public sewer and water and all lots in Block 2 are
presently hooked up to public sewer. Wildwood Street has public sewer within 77' of the
referenced property.
If you should have any further questions, please contact Doug or Fred Kenley at (907) 746-
1073 and (907) 243-5372 respectively.
Sincerely,
CE #8176
LEE :
WILDWOOD
-''~ · , - DATE-RECEIVED
'~' "~- INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR ,NSPECTOR
~UNICIPALITY OF ANCHORAGE gEPT. OF I:~ALTH &
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEJRO~ENT,~L ~;CT~ION
~ ENVIRONMENTAL SANITATION DIVISION
Tele~on. ~47~ RECEIVED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete 811 parts Del page 1. I~omplltl I~U~ will not ~ pr~. Please allow ten (10) days for pr~sing.
PHONE
1. PROPERTY OWNER
PROPERTY R ESI DENT Jif different from ebon)
~ BUYER
MAILING ADDRESS
PHONE
MAILING ADDRESS
5. LEGAL DESCRIPTION
,TREET LOCATION
TYPE OF RESIDENCE NUMBER OF~BEDROOMS
[] One [] Four .
J~ SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY [~ Three [] Six
r-i Other
7. WATER SUPPLY
{~ INDIVIDUAL*
[] COMMUNITY
I--1 PUBLIC UTI LITY
ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, ~l~ve~vell
depth (attach log if available.)
SEWAGE DISI~)~AL SYSTEM . ~ INDIVIDUAL/ON'SITE"
~ PUBLIC UTILITY
YEAR ON-SITE SYSTEM WAS INSTALLED.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
TYPE OF RESIDENCE
I-'1 SINGLE FAMILY
r-I MULTIPLE FAMILY
2. WATER SUPPLY
i--I INDIVIDUAL
[] COMMUNITY
[] PUBLIC UTILITY
Connection Verified
3. SEWAGE DISPOSAL SYSTEM
[]INDIVIDUAL/ON -SITE
[]PUBLIC UTILITY
Connection Verified
[]SepticTank or []HoldingTank
Size: If Tank is homemade
live dimensions:
TYPE OF TANK
TOTAL ABSORPTION AREA '
4. DISTANCES
WELL TO:
Absorption Area to nearest Lot Line
_,' THIS SIDE FOR OFFICIAL USE ONLY
NUMBER OF BEDROOMS
[] ONE [] THREE [] FIVE [] OTHER
[] TWO [] FOUR ~ [] SIX
PERMIT NUMBER
DEPTH OF WELL .
DATE DRILLED
LOG RECEIVED
PERMIT NUMBER
DATEINSTALLED
INSTALLER
SOILS RATING
MANUFACTURER
MATERIAL
Sept~c/Holcl~ng Tank IAb$orption Area
5. COMMENTS
ISewer Line
DATE
[~ APPROVED FOR _'~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
72-010 IRev. 6/79)
' / unicipality
Anchorage
825 "L°' STREET ,~
ANCHORAGE, ALASKA 99501
(907) 264-4111.
OEOROE M. SULLIVAN,
~.fAYOR
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
March 12, 1980
Daniel E./Beverly J. Smoot
Box 10 Caribou Street
Eagle River, Alaska 99577
Subject: Lot 46B Block 2 Eagle River Heights Subdivision
Approval for your individual sewer and water facilities
can not be granted until the following items have been
completed:
(1) A well log submitted to this department for our
review.
\ ~'~The water analysis report be delivered to this office
~k~/ from Chem Lab, 5633 B Street, for our review.
If there are any further questions, please contact this
.. office at 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist
'RCP/ljw