HomeMy WebLinkAboutEAGLE RIVER VALLEY RANCHETTES LT 9A Municipality of Anchorage Page
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P,O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Nam~ ~ ~. ~ ~V~l~ ~ ~astewaler System: D New ~Upgrade
Total ~pth from originalgr e:
LEGAL DESCRIPTION s°"""""~:O. ~.D~s~ ~, I~.~
I
Lot: ~ ~~ L~x~ ~ ~ ~Bl~k: Su~ivision: ~p ~ to pi~ ~ffom Item ~ginM~grade- Fl Gravel depth ~neat~ pi~Ft
Class*hcation (Private, A.B.C): ~L~L~ ~ Total~pth: Ft. Cas~ ~o; Ft. Total absOrptionarea:l ~ ) SQ~ FI. ~ial~[~~
SEPARATION DISTANCES optic a Holding a S.T.E.P.
SuVaco
LInoL°t ~ I0'+ __ ~ ~ $izelngatl°ns: IManufacturec~
Remarks: BENCH MARK
Reviewed and approved by: ~ Date: /-~- ~
Municipality of Anchornge
DEPAHTIAENT OF HEALTH AND HUMAN SEFIVIOE$
ENVIRONIAENTAL SEHVIOE$ DIVISION
P.O. Box lOSB$0 · Anchornge, Alaska 09519-~850 · Telephone: 34:34744
On-Site Wastewater Disposal System and/or Well Inspection Fleport
Legal Description:~:~l
A
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 #L' STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW910378
DESIGN ENGINEER:S & S ENGINEERS
OWNER NAME:MEYERS THOMAS E & CYNTHIA L
OWNER ADDRESS:lB606 LITTLE CAPE CIR.
EAGLE RIVER, AK 99577
DATE ISSUED:12/20/91
EXPIRATION DATE:12/20/92
PARCEL ID:05022118
LEGAL DESCRIPTION: EAGLE RIVER VALLEY RANCHETTES
LOT 9A, SECT, T14N, R1W, SM
LOT SIZE: 17955 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE FOLLOWING SPECIAL PROVISIONS.
RECEIVED BY:
ISSUED BY:
SPECIAL PROVISIONS:
DATE:
DATE:
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
SEWER & WATER
MAiN EXTENSIONS
WELL INSPECTtON
S FLOW TEST
SITE IPt.ANS
ROAD DESIGN
SOIL TEST
PERCOLATION
TEST
December 12, 1991
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
Anchorage, Alaska 99501
REFERENCE: Eagle River Valley Ranchettes Subd.; Lot 9A
Request you issue a permit to upgrade the septic system
serving the referenced property.
An adequacy test was performed on the existing system and the
absorption capacity of the system was found to be inadequate.
Two test holes were excavated and percolation tests performed
in the area of the proposed upgrade and alternate site. The
monitoring tubes within the holes have been checked and found
to be dry. Attached is the proposed upgrade design with an
alternate site depicted.
We do not anticipate any adverse effects on neighboring
properties by the installation of the proposed septic upgrade.
This property is serviced by Municipal Water. The water
service line enters the home from Man-O-War Road. There are
no wells within 200' of the proposed upgrade or the proposed
alternate site.
If you have any questions or require additional information
for your review, please contact us.
Sincerely,
S~H(FER, P.E.
RJS/lsu
DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
PERFORMED FOR.'~'~-/~
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street. Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
LEGAL OESCRIPTION~-~'~f~d"L-~'"_~"I"~ ~wnship. Range. Section~ I/~, ~.~
~ ~ ' SLOPE ~ITE pLAN
1
WAS GROUND WATER
ENCOUNTERED?
3
6-
7-
8-
9-
I0-
11
IF YES. AT WHAT
13-
14-
15-
1'6-
Reading Date Gross Net Depth to Net
Time Time Water Drop
~ ~ ~:~o ~ ,.~ ~'1~" ~/~"
PERCOLATION RATE '"~"~ (minutes/inch} PERC HOLE DIAMETER
C O M M E N T S.~..~_.~T~ ~ ~{~ .~_..~ 'rEST RUN BETWEEN ~ FTAND ~ FT
~;='r:''--------__________:I:T~=~O'd "'' ~ ,~ERT,FY THAT THIS TEST WAS PERFORMED IN
PERFORMED
72~ (R~.
M.fl~c,psfil~ Of Anchorage ~.,?.~.*:,';,'G I
DEPARTMENT OF H~LTH & HUMAN SERVICES '~'t~/~/ ~ I
825 "L" Street, Anchorage, Alaska 99502~50 9~~.~ I
SOILS LOG -- PERCO~TION TEST
.
2
3
4
5
6
7
8
9
10
11
12
13
14
15-
16
17,
18-
19-
20-
WAS GROUND WATER
ENCOUNTERED? ,
IF YES, AT WHAT
DEPTH? pO
E
De~h ~o Wit~ ~ .I
Reading Date Gross Net Depth to Net
Time Time Water Drop
I tT--l~-~l '~:/-~-~-~ ~ ~,'/A-"
-~_ ,.., -~;(~' I~m,~ ~1~. ~/~,'
~ / ~2~ ~ ~'~ ~/~,,
~ ~ ~-~ / ~1~ ~1~."
~ ) ~ ..~ ~. ~ ~,' ~ / ~:
PERCOLATION RATE ~ (m,nutes/, PERC HOLE DIAMETER ~,~ ri
TEST RUN BETWEEN '~'~' FT AND n~ FT
$ & S ENGINEERING ~'~L...~ ,"'~ /""~ A
PERFORMED BY: , I / ' CERTIFY THAT THIS TEST WAS PERFORMED IN
I/U.s4 t. agio K~Y~ L~p Road NO. ~ ~ [ ~ I ~ I ~
ACCORDANCE WIT~g~~ GUIDELINES IN EFFECT ON ~IS DATE. DAT~ 1~ ~ ~ ~
72~ (R~.
PERMIT NO.
I'ILIt'.I T C Z~_F_'RL -r T'-r' ¢~F RI'~CHOI;;:RGE
DEF.'ARTMENT} ~ ~ HEALTH AND EN'¢IRONMENTRL ~'OTECTION
~x-:. 825 ~ STREET, RNCHORAGE~ AK. 99~
264-472~
Ot-~--5 I TE 5E~4ER PER~ I T
RPPLICRNT. 5. ~: K. FOSTER 40 BOX 770~9£ E.R. 99577 ~94-~871
LOCATION ADD 500 GAL. TANK TO OUTFRLL OF i000 G~L ~
LEGAL LgR'~'R~"~E R. VALLEY RANCHETTES LOT SIZE 999999 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
MRXIMUH NLIHE:ER OF BEDROOMS = 5
SOIL RATING (SO FT?BR)= 225
THE REO. UIRED SIZE OF THE SOIL ABSORPTION SYSTEH IS:
E, EPTH= :LE-~ LEt~GTH= _'~-4 GRR%,'EL DEPTH=
THE LENGTH DIMENSION IS YHE LENGTH (IN FEET)OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AHD THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS. NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
REC-.'U I ~'ED SEPT I C TRt~K S I ZE= -15r--j£'~ !]RLLOI'-IS
PERMIT RF'F'LICRNT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS RDJRCEHT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. .
TI~O ( 2 > I t~SPECT I ON5 ARE RE~U I RED
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION. AND APPROVAL BY THIS
DEPARTMENT HILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETHEEN A HELL AND ANY ON-SITE SEHAGE DISPOSAL SYSTEM IS
t00 FEET FOR A PRIVATE WELL OR 15~ TO 2~ FEET FROM R PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC HELL
HINIMUM DISTANCE FROM A PRIVATE WELL TO.R PRIVATE'SEHER LINE IS 25 ~EET AND
TO 8 COMMUNITY SEWER LINE I5 75 FEET,
OTHER REQUIREMENTS MAY APPLY. SF'ECIFICRTIONS AND CONSTRUCTION DIRGRAHS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F'ER[1 I T EXP I RES DECEIIBER
I CERTIFY THAT
l: I AH FAItILIRR HITH THE REQUIREMENTS FOR'ON-SITE SEHERS AND WELLS RS SET
FORTH BY THE ItUHICIPALITY OF ANCHORAGE.
2: I HILL INSTALL THE SYSTEM IN ACCORDANCE HITH THE CODES.
· 3: I UNDERSTAND THAT THE ON-SITE SEHER SYSTEM MAY REQUIRE ENLRRGEMEHT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 5 BEDROOMS.
APPLICANT S.. ~: K. FOSTER
V4. ~
825 "L_" STREET
ANCI-iORAGE, ALASKA 99501
(907) 264 4111
January 4, 1982
Stephen Foster
Box 691
Eagle River, AK
99577
Permit ~ 811103
Subject: Lot 9 A E.R. Valley Ranchettes
A permit issued by this department for a well and/or sewer
system has expired as of December 31, 1981.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal Ordinance.
If you have drilled the well, a well log should be sent to
this department to document the installation date.
If an engineer inspected the installation of the on-site
sewer system, please have them send us the as-builts for our
files.
If there are any further questions, please call this office
at 264-4720.
Sincerely,
Sewer and Water Program
Enclosure: Copy of Permit
PERMIT NO.
APPLICANT
LOCATION
LEGAL
STEPHEN FOSTER BOX ~-~l -~577 E, R.
MAN-OF-WAR RD.
LOT 98 E.R. VALLEY .E~r~"t~ ~ ur~J ~i. LOT
~94-~871
21750 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
MRXIblUM NUMBER OF BEDROOMS
SOIL RATING
THE REQUIRED SIZE OF THE SOIL RBSORPTION SYSTEM
DEPTH= 10 LEf~GTH= 5~ GRR%~EL
DEPTH=
THE LENGTH DIMENSION IS THE LE~I~TH,.(,IN F, EET~..OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE'EXCAVATION <IN FEET>.
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN PEET>.
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY HELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL HILL SERVE.
TI.~O ( 2 > I ~SPECT I 0~$ RRE REQU I RED
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTIOM.
MINIMUM DISTANCE BETWEEN R WELL AMD ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR R PRIVATE WELL OR 150 TO 200 FEET FROM R PUBLIC HELL DEPENDING
UPON THE TYPE OF PUBLIC HELL.
MINIMUM DISTANCE FROM R PRIVATE HELL TO A PRIVATE SEWER LINE IS 25 FEET AND
TO R COMMUNITY SEHER LINE IS 75 FEET.
OTHER REQUIREMENTS MAY RPF'LY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
R',/AILABLE TO INSURE PROPER INSTALLATION.
PEAr-11 T EXP I RES DECEr'~BER 3:L~ :1_98:1_
I CERTIFY THAT ~ I ~
l: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND HELLS RS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
~: I UNDERSTRMD THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS.
....... w .... .... w.
MunicipalitYof
Anchorage
825 'L" STREET
ANCHORAGE, ALASKA 99501
(9.07) 264-4111
(~EORGE M. SULLIVAN,
&fA YOR
DEPAR]'MENT OF HEALTH AND ENVIRONMENTAl. PROTECTION
December 31~ 1980
Yates Construction
Box 243
Chugiak, Alaska 99567
Permit ~ 800640
Subject: Lot 9A Eagle River Valley Ranchettes Subdivision
A permit issued by this department for well and/or sewer
system has expired as of this date.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal Ordinance.
If you have drilled the well, a well log should be sent
to this department to document the installation date.
If an engineer inspected the installation of the on-site
sewer system, please have them send us the as-builts for
our files.
If there are any further questions, please call this
office at 264-4720.
Sincerely, // --
Senior Environmental ~F~cialist
LNB/ljw
enc: Copy of Permit
SWP/057
: MUI'~ I C I?IRL I TY OF RhlCP~"~RAGE
' ', DEPARTMENT~,. ~HEALTH AND ENVIRONMENTAL . .OTECTION
', 825 ~L' STREET, ANCHORAGE, AK. 99501
264-4720
ON~ [ TE ~EtdE~ UP~E PE~ · T
PERMIT NO. ( 800640 )
RPPLICBNT ~ C 2 ~ ' BOX
LOCATION MAN-O-WAR .ROAD
LEGAL ["SR ~E RIVE~'~'~'~;~ LOT SIZE 21750 SQUARE FEET
TYPE OF SOI~ RB5ORPTIOt~ SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS
SOIL RATING (SQ FT?BR)= 212
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM
DEPTH= ~-0 ler~Gth= 52 GRRVEL DEPTH=
THE LENGTH DIMENSION IS THE LEtIGTH (IN FEET) Of THE TRENCH OR DRRINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE
AND THE BOTTOM Of THE EXCAVATION (Itl FEET).
REQU 1- RED SEPT 1' C TRNK S 1' ze= :1_000 GRLLOr4S
PERMIT APPLICANT HAS THE RESP~BILITY TO IN~I THIS DEPRRTM~,NT DURING THE
INSTALLATION INSPECTI~.~S OF ~ELLS RDJRCE~ TD~THIS ~ROP~T~' AND THE
------ T~dO 5~g ~Ir~SPEOT~ON~ RR~EQUZRED ------
BRCKFILLIHG OF RNe~STEH HITHOUT FI~iRExIK~PECTIO~t,~t)D APPROVAL BY THIS
DEPRRTMENT WILL BE SUBJECT TO PRo~Ec~TIOf~.
~ZNZMU, D~STRNCE ~ETWEZN~r~ZL~
lee FEET FOrt ~ PnZWTZ ~ ~{de TO ~ee Fi~ FR~/~ ~'~LZC .ELL ~EPEN~Z.~
UPON THE TYPE OF PU~UC ~ZK~--
M.~MUM ~ZSTRNCE FnOM R ~RTE
TO R COMMUNITY SEIqER LI~E ~I~ 75 F~.
OTHER REQUIREMENTS MAY RPPLY. S~CIFICRT~ONS RND CONSTRUCTION DIAGRAMS RRE
AVAILABLE TO INSURE PROPER ItISTALLRTION.
PERM I T EXP I RES DECEMBER 3:L~ :L-q80
I CERTIFY THAT
l: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM Itl ACCORDANCE WITH THE CODES.
3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO ItICLUDE MORE THAN 3 BEDROOMS.
SIGNED:
APPLICANT YRTES CONSTRUCTION
ISSUED BY .............................. DRTE_ZA=,-$.Jzfir~___ V4. 0
r.llJ[-I I '~- I PRE T T'T' . I_--'1~- I=~[~CHIi'I~;:RI~I~'~
DEPARTME"T
.. ~ . ' 264-4720 /~'// /-
~IELL Rf4D E~[-~--S I TE SE[4ER PER~I~ m
NO.
LEGAL ~. --. // . / ~ ~ LOT FEET
TYPE 0F
MAXIMUM NUMBER OF
THE REQUIRED SIZE OF THE SOIL ~BSORPTION SYSTEM IS:
DEPTH= /~). LEI~JGTH= S~ GRR'.~'EL DEPTH== ~
THE LENGTH DIMEN~I0,, I~ THE LENGTH (IN FEET> 0F THE TREt,CH OR DRRINFIELD.
THE DEPTH OF R TRENCH O~ PIT I~ THE DISTANCE BETWEEN THE ~URFRCE OF THE
GROUND AND THE BOTTOM OF THE' EXCAVATION (IN FEET).
THERE I~ NO ~ET WIDTH FOR TRENCHE~.
THE GRAVEL DEPTH I~ THE MINIM,JM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE
AND THE BOTTO, OF THE EXCRVRTION (IN FEET>.
TI40 (2) I 1'4¢PECT- _ I Of 4q_ I-~RE RE~_-~LI I RED
BACKFILLING OF ANY SYSTEM HITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPRRTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN R HELL AND ANY 0N-SITE E. EHRGE DISP0$RL SYSTEM IS
400 FEET FOR A PRIVATE WELL OR 3.58 TO 200 FEET FROM R PUBLIC HELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM R PRIVATE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND
TO R COMMUNITY E. EWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST 8E RETURNED TO THE DEPRRTMEHT WITHIN ~0 DRYS
OF THE I~ELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIRGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
PERMIT EXPIRES DECEMBER
I CERTIFY THAT
l: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL'THE SYSTEM IH RCCORDANCE WITH THE CODES.
~: I UHDERSTAND THAT THE ON-SITE SEHER SYSTEM MAY PEQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS.
..............
APPL I CRNT/~
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3-
6-
7-
8
9
.,10
11
12
13
14
15
16
17'
18-
19-
20-
COMMENTS
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, AIl[kl 99501 2644720
SOILS LOG - PERCOLATION TEST
SOILS LOG
PERCOLATION
TEST
.'~"'! /"1 ", /?l//'/.I, //r '
SLOPE SITE PLAN
/
..... ,/ /..-i
~.,/'/! t.',~: /
/~ '"? }-- '/':" ,/~ /~VASGROUNDWATER
~,~ ~ /~ ~-:',/~E NCOUNTER ED
-~ -~~I~ES, AT WHAT
DEPTH?
Reading Date Time Time Water Drop
f Il:. r . .~ _
,:.11.:,~ /
,_ // I 't.':;:', ,, i: "~' --
,~,z.,.-.~ ,,,,,. ,,. ~: "~,/- ?z.'
T
PE.COLAT,O..ATE -~' ) .~m,nu,..,,..h, ~ t.':/ ~'
TEST RUN BETWEEN , FTAND FT
PERFORMED BY'.'
72-008 (6~79)
/
.'DATE: t.>' £~ -'"--
GrI~TER ANCHORAGE AREA BORO~IG.,~H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE. ALa, SKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION .,,~/J~.'~,/' ~'~ / ./~"~'~"~ .'~'.I '~ '~'
SEPTIC TANK:
MAILINGADDRESS '~--')/~'./~""'~. '~--~' ~f"',_ PHONE ~._~__
LEGAL DESCRIPTION
DISTANCE FROM WELl
LIQUID CAPACITY .~/ ~ ~ 4:) GALLONS.
NUMBER OF
MATERIAL .~,~'~-'"' COMPARTMENTS /'
LIQUID
INSIDE LENGTH INSIDE WIDTH· /'~ DEPTH
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAl
NEAREST LOT LINE
SEEPAGE PIT:
OUTSIDE DIAMETER
'""""""~ OR WIDTH
DISTANCE FROM WELL
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
, LENGTH /~' / DEPTH
, BUILDING FOUNDATION _'~"'~
so. FT.
TILE DRAIN FIELD:
TOTAL LENGTH
DISTANCE FROM WELL / . FdUNDATION .~.~lql~T LOT LINE ..~'~"'""~F LINES .
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
WELL:
DISTANCE FROM WATER
IYPE._,,~..~ DEPTH ,BUILDING FOUNDATION. SAMPLE__, NEAREST
NEAREST SEPTIC SEEPAGE OTHER
LOT LINE , SEWER LINE , TANK , SYSTEM , CESSPOOL , SOURCES
DISTANCES:
DIAGRAM OF SYST/M
· GREATEK' .,NCHORAGE AREA I -' ROUGH
IIEALTll DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
Case
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
RESIDENCE ADDRESS LOCATIQN OF INSTAL~TION ~.
LEGAL eESCRIPTIO"
APPLICATION TO INSTALL: SE~ICTANK ~ ,SEEPAGE PIT ~ ,DRAIN FI , OTHER
TO SERVE THE FOLLOWIN6 FACILITY
FINANCED THROUGH TO BE INSTALLED BY ~.~..~ _
PERCO~TION TEST RESULTS ANTICIPATED DATE OF COUPLETION
BELOWTO BE FILLED OUT BY HEALTH DEPARTMENT ~ ~ '
THIS IS TO SERVE AS _"~-~'~_) ""~z~-~h ] , PERMIT TO INSTALL A -~'~"~', "k~"r~ ~'~-~'~.~ / AS DESCRIBED BELOW. SIZE OF UNITTO BESERVED ~ ~ '~
..SE~IC TANK SIZE /~ O~ ~I~yPE ~ . SEEPAGE AREA TYPE ~ ~/~
~ DIAGRAM OF SYSTEM C/ ~
DISTANCES:
H~alth Authority
I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No.~¥6~a~na~t the
above described system is in accordance with said code. am~t~ x~c~aog aagx
DATE APPLICANTS SIGNATURE , '~. t~_~? {7.~ / .....
MUNICIPALITY OF ANCHORAGE
o,
Development Services DepartmentPhone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 050 221 18
1. GENERAL INFORMATION
Expiration Date: S— IL 26 Z Lj
Complete legal description EAGLE RIVER VALLEY RANCHETTES LOT 9A
Location (site address) 18412 MAN O WAR
Current property owner(s) Milette Day phone
Mailing address
Real estate agent Day phone
2. TYPE OF DWELLING:
0 Single Family (w/ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Private Well ❑ Private Septic 0
Water Storage ❑ Holding Tank ❑
Community Well ❑ Community ❑
Public Water System 3 Public Sewer ❑
Waiver request for: N O N E
Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $
Date of Payment
Receipt Number 0 j a a 3 D
COSA # 0JC, 2212 1
Waiver Fee $
Date of Payment
Receipt Number
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 C&M ENGINEERING Phone 8545558
Address 20182 TULWAR
Engineer's Printed Name CHARLES BALZARINI Date 5/6/22
6. DSD SIGNATURE
System #1 Approved for _�_ bedrooms
System #2 Approved for _ bedrooms
Disapproved
Conditional approval for
OF A�gsll
law
1
rJ CHARLES G BALZARINI
FFG, • CE -13854 ••c�`�/�
�il`F�PROFESSI�NP�'
bedrooms, with the following stipulations:
BY: Original Certificate Date:
The Municipality of Anchorage Development 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 Checklist blue sheet
Legal Description: EAGLE RIVER VALLEY RANCHETTES LOT 9A
If more than 1 septic system on lot: COSA Checklist # 1 of 1
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled
Total depth ft
Cased to ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Comments PROPERTY ON PUBLIC WATER
B. TANK DATA
Age of tank(s) 7 years
Tank type/material STEEL SEPTIC
Measured operating fluid level in septic tank 50
❑ Standpipes/foundation cleanout per record drawing
Date of pumping 5/6/22
D. ABSORPTION FIELD DATA TRENCH
Which system tested (date installed) 2007
❑ ALL standpipes present per record drawing
Total measured depth from grade 13.3 ft (max)
Measured depth to pipe invert from grade 8.3 ft (min)
❑ N/A — pressurized field
❑ Monitor tubes go to bottom of effective. If not, state
depth into effective
Parcel ID: 050 221 18
Structure served by this system 1
Well production at time of test gpm
Water storage tank volume gallons
Well disinfected for coliform test? ❑ Yes ❑ N
❑ Coliform bacteria is Negative
Nitrate mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ❑ Arsenic less than MRL (ND)
Collected by
Date of Sample
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
Adequacy test date 5/13/22
Results ❑✓ Pass For 4
Fluid depth prior to test 122
Water added 18 gal
New depth 12 in
Elapsed time 1440 min
bedrooms
in
Al Code -required soil cover over field Final fluid depth 12 in
❑ System presoaked Absorption rate 600 gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NO
date of test) If yes, enter date y NA
Gallons introduced 2000 gallons
Comments/Deficiencies: NONE
COSA Checklist yellow sheet
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'
Yes
if No
Community Sewer Manhole/Cleanout > 100'
Yes
if No
ft
❑ Yes
if No ft
Neighboring Tank > 100' ❑ Yes
if No
ft
Private Sewer/Septic Line > 25' ❑ Yes
if No ft
Absorption Field on Lot > 100' ❑ Yes
if No
ft
Holding Tank > 100' ❑ Yes
if No ft
Neighboring Absorption Fields > 100'
Yes
if No
Animal Containment > 50' ❑ Yes
if No ft
❑ Yes
if No
ft
if No
ft
F. ENGINEER'S COMMENTS
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ❑Yes
if No
ft
❑ Yes
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10' 0 Yes if No ft Surface Water > 100' Yes if No ft
Property Line > 5'
Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
Yes
if No
ft
Private Wells > 100' 0✓ Yes if No ft
Water Main > 10'
Q Yes
if No
ft
Community Wells > 200' ✓/ Yes if No ft
Water Service Line > 10'
Q Yes
if No
ft
If septic tank is under driveway comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10'
El
Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
R
Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'
0
Yes
if No
ft
Private Wells > 100' El Yes if No
Water Service Line > 10'
M
Yes
if No
ft
Community Wells > 200' Yes if No
Surface Water > 100'
0
Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
1 certify that I have determined through field inspections and review
of Municipal records that the above systems are in conformance with
MOA COSA guidelines in effect on this date. 5/10/22
COSA Checklist yellow sheet
. 49 TH '
HARLES G BALZARINI
���sT • , • CE -13854 • • _ .��� AW
ROFESS,ON -®-
ft
If,
Municipality of Anchorage
Development Services Department
Building Safety D~vision
On-Site Water & Wastewater Program
4700 South Bragaw SL
P.O. Box
www,ci.anchorage,ak,us
~USH 196650 Anchorage. AK 99519-6650
(. ERTIFICATE OF HEALTH ,UTHORITY APPROVAL
FOR A SINGLE FAHILY DWELLING
Parcel I.D. 050-221-18
1. GENERAL INFORMATION
Expiration Date: J O - /~/o - cO ~
Complete legal description EAGLE R~VER VALLEY RANCHETS SUBDIVISION; LOT 9A
Location (site address or directions) 18412 MAN O WAR ', EAGLE RIVER, AK 99577
Current Preperty owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
DEERA STEPHENS Day phone 696-7586
18412 MAN O WAR * EAGLE R~ER, AK 99577
Day phone
DAN FEERELL w/ PRUDENTIAL VISTA Dayphone 689-1808
16635 CENTERF1ELD DRNE * EAGLE RIVER. AK 99577
Unless otherwise requested, HAA will be held by DSD for pickup,
2. NUMBER OF BEDROOMS: 3
3. TYPE OFWATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
community On-site
Public Sewer
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer '
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid
water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water
system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's
work.
Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $
to closing for the engineering services provided.
4. STATEMENT OF INSPECTION BY ENGINEER
at, or pdor
As certified by my seal affixed hereto and as of the validation date shown below, I vedfy that my
investigation, based on procedures outlined in the Health Authority 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 bedreoms and type of strocture indicated herein. I further vedfy 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 ALASKA WATER &: WASTEWATER CONSULTANTS, INC. Phone
Address 6901 DEBAER ROAD. SUITE 2E3 * ANCHORAGE, AK 99504
Engineer's Printed Name JEFFREY A. GAENESS, P.E. Data
337-6179
Engineer's Comments:
In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reporled results described the performance of the
system under the conditions encountered at the lime of the test. and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year. and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there ara no hidden defects or encroachments. AKWWC, Inc. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approvod tot
bedrooms.
Disapproved.
Conditional approval for
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
bedrooms, with the fllowing stipulations:
Manitenance Agreements
Supplemental Engineer's Reort
Other
12)01)
Original Certificate Date: /0 - /' ~.~ -' 0 .~
Development Services Department
Bu~tng Safety Olvtakxt
On-SM Water & Wastewater Program
4700 Soulh Bragew SL
P.O. Box 196650 Anchorage, AK 99519-6650
w~av.cLanchomge.ak.us
(9O7) 343-79O4
Legal Oe$cdption:
A. WELL DATA
Co
Well type
Date completed
Total depth
HEALTH AUTHORITY APPROVAL CHECKLIST
EAGLE RIVER VAI IF'y RANChLI~ S/D; LOT gA Parcel ID:
Cased to __
FROM WELL LOG
If A, B, or C provide PWSID#
Sanitary seal (Y/N),
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform __ colonies/100 mi.
Ar~a4rli~::
SEPTIC/HOLDING TANK DATA
Tank Typa/Mata~l
Nitrate mg.a..
Date of trample:
Tank size 1250 gal.
Foundation cleanout (Y/N) YES
Date of pumping 7/19/2002
ABSORPTION FIELD DATA
Date installed ' '1/.!/1091
Length 6,1 ft.
STEEL
Number of Compartments 2
Depression over tank (Y/N) NO
Pumper
pI~ELOW EXISTING GRN)EI
Soil rating ~or ft~clrm) 0.6
Width 3 ft.
050-221-18
PUBLIC WATER
Well Log (Y/N)
Wi.aa prSparly protected (y/N)
Casing height (above ground)
AT INSPECTION
g.p,m.
Other bact~.~i~
Collected by:
in.
oek:,, a~aJ I O0 n~.
1/3/1091
Elapsed Time: 307 min. Final fluid depth 91 in. Absorption rate >=
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE: KNOWN
=*SYSTF..M SIZED FOR 4. BEDROOMS
System type DEEP TRENCH
Gravel below pipa 8.5 fl.
Depression over field NO
For **,1 bedrooms
New depth 102 in.
600-1- g.p.d.
If yes. give date -
Totaldepth .13.75 ft. Eff. absorption area 1071 fi= Monltoring~be YES
Date of adequacy test 9/24/2002 Results (Pass/Fail) PASS
Fluid depth in absorption field before test 76 in. Water added 706 gal.. ,
Date installed
Cleanoute (Y/N) YES
High water alamt (Y/N) N/A
JR'S PUMPING
D. UFT STATION
Ee
Date installed
Size ;n gallons
Manhole/Ac~',-; (Y/N)
"Pump on" level at in. "Pump off" lev,N st in.
High water alarm level at
in.
Datum - Cycles tested
SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Meets alarm & clmuit requirements?.
PUBLIC WATER
Septic tanWIIft station on lot
Absorption field on lot
On adjacent lots
On adjacent lots
Public sewer main
Public sewer manhole/cleanout
.Sew,,,/s~vUu sewice line Holding tank
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field
Water main 10'+ Water service line 10'+ Sudace water
,5'+
100'+
Wells on adjacent lots 200'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+
Water sewice line 10'+ Sudace water 100'+
Curtain drain NONE KNOWN Wells on adjacent lots. 200'+
Water main 10'+
Driveway, paddng/vehicte storage
10'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspecifons and
mt4ew of Municipal records that the aVove systems em in
conformance with MOA HAA guidelines in effect on this dale.
Engineer*s Printed Na~ne
Date I~lld/D~
JEFFREY A. OARNESS
Date of Payment ~ D / ! ~'I 0..~ Date of Payment
Receipt Number O~) (~ R~I~ Numar
(~. ~1)
10/14/02 t~0N 12:04 FAZ 6896499 VISTA ~U~:AL £STAT~ ER
t~: ..'. · , .... ----.. ~ .~*. s~, . ~' · . ·
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· ..~, ~ . ~ ~ ,~ ~ ove~p or en~ on the pm~ lying ad~ce~.t the~tO, that
~? : ~9~ ~' ~ ..~ ~ ' ~ ~p~n~ on. pm~ I~g adjacent t~to
~ ~e pm~ ~'~bon ah~ t~at ~em am ~ roadways,
. ~ ~;-s-~t~"J ~ ~ ~~'or other v~W~ e~ments onlaid
' t~.~. .~------/~ . -- ~ ~Jn~ated he, on. ' .' ' · ·
: "~ r,o.a~ :~'"~ ~ n~.l~ ~vo~ ~. · '
.. , ';"" * '.'.. ... .: ~o~6~3 "' "" '
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
· HAA # ~ ~tc~
Parcel I.D. # 05022118
1. GENERAL INFORMATION
Complete legal description Ea_ale Rive~' Yel].e_v Ranchettes.' Lot 9A
Locati6n (site address Or directions)
P~operty owner Thomas E. and Cynthia L. Meyers Day phone
Mailin~ address .[8606 Little Ca_De Cir., Eagle River, AK 99577
LendJ6gagency " Day phone
Mailing address'
Agent Robert Wambolt REMAX Day phone 694-4200
Address 16600 Centerfield Drive, ~201, Eagle River, AK 99577
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water X
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OFWASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE:
x
If commUnity wastewater system, prov!de written confirmation from State ADEC
attesting to the legality and status of system.
**
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 S & $ ENGINEERING Phone __
I/U;J4 Eagle KJYer Loop Road No.
Address Eagle River, Alaska 99577
Engineer's signature
Se
DHHS SIGNATURE
A'pproved for ~ ~-~'~ bedrooms.
Disapproved,
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
By: /,,~L.~...~ (~z.c~,-.,~:~-
The Municipality of Anchorage Department of Health and Human Services (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 DHHS does this as a courtesy to purchasers of homes
and their lending institutions tn 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
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: ~ ~.~- Parcel I.D.
A. WELL DATA
Well type~T"~L~ ~f A, B, or C, attach ADEC letter.
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
ADEC water system number
Date completed · Driller
Cased to Casing height
Wires properly protected (Y/N)
FROM WELL LOG
AT INSPECTION
Date of test
Static water 'level
Well flow
g.p.m.
Pump level
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot
Pubiic sewer m~ln
Sewer service line
/o,~_.-.~,,/~/.,,.~/.d..._ ;On adjacent lots
~:~/ ';On adjacentlots
Public sewer manhole/cleanout
Petroleum tank
MUNICIPALITY OF ANCHORAGE
ENVIRONMENTAL SERVICES DIVISIOI,,
R EI EI 99z
'Municipality of Anchorage
Dept. Health & Human Services
WATER SAMPLE RESULTS:
Coliform
Nitrate Other bacteria
Date of sample:
Collected by:
B. SEPTIC/HOLDING TANK DATA
Date Installed I:~' ~ -~"" Tank size I'~'~-'~ ~t~I~'' Compartments
Cleanout~)N) Y F°undation cleanouON) "'~ ;:. ,"; '-: De~.e~sl0n (y~P)~
High water alarm (Y~ I~/.~'~ Alarm tested (Y/N)'
Date of I~[~mping' "I,.-[~..1~ '~f,,~ ~ pumper ------'
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot :"' I'~f~5~ Onadjacentlots
To propertyline [ ~) ~-4-" ~ AbsorptiOn field
Surface water/drainage I/~/~ ~ ~ ' .... ':' "''~
Foundation I ~ t..~_
Water ~ai'n/~ervlce line "~
72-026 (Rev. 7/91) From . CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
M_eets MOA electrical co~es~f~ .
SEPARATION DISTA/NCE FROM LIFT STATION TO:
Well on lot ,." On adjacent lots
"Pump on~t~ "Pump off,, level at '
Cycles tested -- ·
Surface water
D. ABSORPTION FIELD DATA
Soil rating
Gravel thickness ~,~! Total depth
C:l.eanouts present (~N) "~
~ ' Date of adequacy test ('..I/~: '
for ~
Date installed
Length , ~_...~1 Width
Tgtal absorption area
Depression oger field (Y.~
Peroxide treatm,e, nt Cpast
SEPARATION DISTANCE FROM ABSORPTION FIEI~D TO:
' ' If yes, give date
bedrooms
' ~ OnadjacenHots ~..L~'-.-F' '- 10%t.-
Well on lot Property line
T6 building foundation I~"~~ ''~'- To existing or abandon;d -~ystem on lot
On adjacent lots ¢~ ~ Cutbank t.-~ O f',..t.~ Water main/service line
Surface water [~"~ %{- Driveway, parking/vehicle storage ar~a ' ~
Curtain drain ~,J 4"2 ~"~ ~-- ' L'/'~ ~',.-~ ~1,'~ I t-- ~
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in'effect .On the dat~of this i~Spection.'*
......
$ & S ENGINEERING ' ' .
m,,',,ot;.,~, - 17034 Eagle R var Loea Road Ne
Eng neees Name .......... '
Date / .----~o lc..-
: . '.., . . . ~j.".~..*.. ' .,, ..'.<C-~~' .
HAA Fee $
Date of Payment ~ -- Lo-ct ~)
Receipt N mber
I
Waiver Fee: $
Date of Payment
Receipt Number
· . DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPEClOR INSPECTOR I
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
825 L Street - Anchorage, Alike 99501
~ Tele~e
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all pa~s o, page 1. I~omplete ~u~ will not ~ pr~. Please allow ten (10) days for pr~sing.
I. PROPERTY OWNER I PHONE
MAILING ADDRESS '
, PROPERTY RESIDENT (If ~ifferent from a~) PHONE
2.BUYER t / PHONE
MAILING ADDRESS /
3. LENOING INSTITUT~ ] PHONE
MAILING ADDRESS
5. LEGAL DESCRIFTION
6. TYPE OF RESIDENCE ' BER OF~BEDROOMS
~NGLE FAMILY One ~ Four
- ~ MULTIPLE FAMILY ~ Three ~ Six
[] Other
7. WATER SUPPLY
{~,,,JcNDIVI DUAL* * ATTACH WELL LOG. A well log is required for all wells drilled
OMMUNITY since June 1975. For wells drilled prior to that date, give well
[] PUBLIC UTILITY depth (attach log if available.)
:?/YEAR ON-S,TE SYSTEM WAS',NSTALLED.
[] PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
THIS SIDE FOR OFFICIAL USE ONLY .
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY I-'l ONE I--) THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO I'-1 FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
r-I PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
I']INDIVIDUAL/ON -SITE DATE INSTALLED
I--1PUBLIC UTILITY & -' ~'~ 6
Connection Verified INSTALLER
[--ISeptic, T~nk or 1"3Holding Tank
Size:' ~;)O If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
Absorption Area to nearest Lot Line
5. COMMENTS
r"l APPROVED FOR BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[]~"" DISAPPROVED
DATE BY
72-010 (Rev. 6/79)
EXCAVATION
ROBERT A.$HAFER
WORK
March 2, 1982
CIVIL ENGINEER
694-2979
Pat Welch
Totem Realty
P.O. Box 911
Eagle River, Alaska
99577
Dear Ms. Welch,
Reference: Lot 9A: Eagle River Ranchettes Subdivision
A sewer system adequacy test was performed on the system
located on the referenced property as you requested.
The septic tank was pumped and verified to have a capacity
of ~000 gallons. The seepage pit was charged with approximately
600 gallons of water and after a period of 24 hours approximately
155 gallons of water had percolated out of the crib.
It can be concluded from the above test that the septic
tank is adequate for a three bedroom residence. However,
I regret to inform you that the seepage pit ~ only adequate
for approximately one bedroom and will have to be upgraded
before it can be considered adequate for three bedrooms.
If we may be of further assistance, please do not hesitate
to call.
Sin~,
cc: Alaska Ban~
of Commerce
Municipality of Anchorage
Department of Health and Engironmental Protection
SRB IgGx EAGLE RIVER. ALASKA
Patricia J. ~olch
Totem Realty
P.O. Box 911
Eagle River, AK 99577
SubJeetz Lot 9A Eagle River Eetates
Approval for the individual sewer and water facilities cannot
be granted until ~e following items have been completed~
The adequacy te~t performed on your sewer system shows the
system ie not functioning properly for a 3 bedroom single
family dwelling.
Therefore, before approval may be granted, an upgrade will be
required. Prior to the upgrade, a soil test will be needed so
that a permit pu%y be issued with specifications.
Please notify this department for a reinspection when the
noted discrepancies have been corrected. If there are any
further questions, please call this office at 264-4720.
Robert C. Pratt
Associate Environmental Specialist
RP47/p/E!l
February 25, 1982
Steven and Karen Fomter
P.O. Box 691
Eagle River, AK 99577
Subject: Lot 9A Eagle River Ranchetts
Approval for the individual sewer and water facilities cannot
be granted until the following itemm have been completedl
· The septic tank pumped with a receipt submitted to this
department.
· A four (4) inch cast iron cleanout needs to be installed to
the septic tank and/or leaching area.
An adequacy test needs to be performed on the existing
leaching area. This test will determine if the system is
adequate according to National Standsrds. A listing of
private firms performing the test is enclosed. This report
needs to be submitted to this office for our review.
· The depression over the sewer system will need to be filled
so that surface water drains away from the sewer system.
Please notify this department for a reinspection ~en the
noted discrepancies have been corrected. If there are any
further questione, please call this office at 264-4720.
Sincerely,
'~ ~ /
Robert C. Pratt
Associate Environmental Speciali~t
Enclosure
r p3nlplm{