HomeMy WebLinkAboutBEVERLY HEIGHTS LT 3
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TANKS
SEPTIC .- ' · [] HOLDING
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Envtronmefltal Health Division
825 "L' Street. Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
DISTANCES
LOT LINE
TYPE OF SYSTEM
TRENCH f-I BED [] W. DRAIN [] OTHER
o,',g,.~ O,~oe ~ FT /&2 FT
FT 6 FT
~ FT ~-~FT
~ ~ SQ ET ~ ET
WELLS
~ PRIVATE ~ OTHER
Pr~a~ ~ 7~ I FT f~o FT
I
FOUNDATION
SEPTIC ABSORPTION
TANK FIELD WELL
N
REMARKS:
INs I~i0a wis pedm'med Icom'dino Io III
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
825 L Street, Anchorage, Alaska ~501 545-4720
Permit Number:
Date Issued:
O.N- S I T E
890002 Up g rade
01/10/89 Engineer
SEWER PERMIT
Designed
Owner Name:
Owner Address:
SECRETARY OF H.U.D.
701 'G' STREET BOX 64
ANCHORAGE, AK 99515
Day Phone:
271-4665
Parcel Id: 051-252-50
Lot LeGal: Subdivision: BEVERLY HEIGHTS SUB. ~ot:
Section: 18 Township: 15N Range: 1W
Lot Size 29500 (sq. ft. or acres)
Max Bedrooms: This Permit: 2 Total Capacity: 5
Block: -
SEPTIC TANK: Minimum total septic tank capacity: 1,500 gallons. Each septic
tank must have at least 2 compartments. Depth to top of septic tank(s) < 4.0
feet requires insulation over tank(s).
INFORM D.H.H.So PRIOR TO 1ST & 2ND INSPECTIONS BY ENGINEER, IF
AFTER OFFICE HOURS, CALL 545-4681 AND LEAVE A MESSAGE.
CONSTRUCT PER ENGINEERS ATTACHED APPROVED DESIGN.
THIS PERMIT EXPIRES 12/51/89 AND VALID FOR A SINGLE FAMILY HOME.
I CERTIFY THAT:
1. I am ~amiliar with the requirements ~or on-site sewers and wells as set
forth by the Municipality of Anchorage (MOA) and the State o~ Alaska.
2. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria of this permit. ..
5. I will adhere to all MOA and State o( Alaska requirements for the set' back
distances from any existing well~ wastewater disposal system
sewerage system on this or any adjacent op nearby l~t. · . ,.:
4. I undeestand that this permit is valid foe a maximum of
also understand that the capacity of the total system is 5 bedeooms',,ahd
any enlargement will require an ~dditional permit. .
Signed:
(Owner
Issued By:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 2644720
SOILS LOG - PERCOLATION TEST
SOILS LOG
D PERCOLATION
TEST
PERFORMED FOR: ,/'7/ .l,.~ ,~) ·
LEGAL DESCRIPTION:
4 - .::,.'...'"
6-
11-
12-..
13 - :- ,
14~
I E*~.~,'.
7-/5"/~,''
SLOPE
WAS GROUND WATER
ENCOUNTERED?
IF YES. AT WHAT
DEPTH:'
Readm9 Dale
DATE PERFORMED:
.Sec l~
SITE PLAN
S
L
O
P
E
TEST RUN BETWEEI~ FT AND FT
Net
DrOD
PERFORMED BY
Eagle Rwer. AK .~9577
CERTIFIED BY:
DATE
LOT 4
LOT 2
100' R
BEVERLY DRIVE
WELL AN]] SEPTIC SITE
LEGAL~ LOT 3, BEVERLY HEIGHTS
OWNER, H.U.D.
CONTRACTOR, N/A
EAGLE RIVER ENGINEERING SERVICES
PD BX 773294
EAGLE RIVER, AK. 99577
694-5195
PLAN
EXIf:TING LEACH FIr'ID
NE~,/ LEACH FIELD :t
Ct. EANgUT - ·
~.~ ~ touh A. eut,ra
~T AN ASBUILT SURVEY
RELATIVE SEPTIC LOC. ONLY
LEGAL:
LOT ~,
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
BEVERLY HIEGHTS
GENERAL
l. The well.and septic plan are for a single family residence only.
2. The drawing and or site plan shall be a part of this specification.
5. All materials and workmanship shall meet the Anchorage Department ,
Health and State Department Of Environmental Conservation requir,
merits.
4. All soil tests are advisory to the design and are to be verified ,
modified in the field by the engineer.
5. All excavations and depths are advisory and are to be verified ,
modified in the field by the contractor to meet Municipality ,
Anchorage, Department of Environmental Conservation requirements.
6. It is the responsibility of the owner to obtain all necessary permi
or easements and to locate any adjacent multi-family wells.
7. The excavation is to be exactly in the area shown on the site pla
any deviation requires engineer approval.
8. It is always recommended that a surveyor locate the nearest lot
position and the location of any easements.
TRENCH 1. The trench is to follow the natural land contour to maintain unifo
total depth of the trench bottom.
2. The bottom of the trench shall be level, plus or minus 1.5".
5. The total depth of the trench excavation is not to exceed 10' at a
point.
4. The sewer line is to be connected into the existing leach lin,
between tank and pit, to allow effluent overflow to the upgrad.
leachfield.
5. The trench gravel is to be covered with typar fabric material.
6. Soil or combination of soil and extruded board insulation to a dep
of 4' or equivalent is to be placed over the leachfield.
?. The area over the trench is to be finish graded to prevent ponding .
surface water runoff.
8. The septic tank and leachfield must not be closer than 100' to a
existing private well, 1SO' to any Class "C" well, or 200 feet to a
community well.
RECOMMENDED LEACHFIELD DIMENSIONS
TOTAL DEPTH = lO
GRAVEL DEPTH
Soil Rating = 150
Bedroom Capacity : 2 additional = 5
Septic Tank Size = Existing
TRENCH LENGTH = 25 TRENCH WIDTH
total~
100
70
~ 5O
~0
R~I~4 SIZE 3ISTRI~UTIOH TEST REPORT
C
C r',r'
10
.' : : : : : : ·
: : : : : : :
208 100 10.0
.'
.'
..
GR~IN SIZE - mm
E:6.3
Teat .%+75m,~, Z GRAVEL
1 0.0 12.6
0.01
SILT
1.1
I LL PI
~ N/A tiP 3.76 0.74
{
M~I~RIAL B~SCRIPTION
,O .:.Hrq.U. POORLY GRaf!Eli HiT~
D50 I50
0.57 O. ~::-; 1
LOT ~
B15 1310
t,:.Co
SF'
I
ItIo HATEP.
O.O01
{ Z CLAY I
~ ·-'~Cu
0.85 3.1
A.qSHTO
~-l-b
I t.l:I.J ! CATED
zJ:~te:, i 1-19-8E;
L:,RAItl SiZE BISTRIBLITION TEST REPORT
-. GRAIN SIZE DISTRIBUTION TEST DATA Test No.: 1
Date: 11-19-88
Project No.: 88-053
Project: BEVERLY HEIGHTS, LOT 3
===============================================================================
Sample Data
Location of Sample: TEST HOLE 1
Sample Description: SAND, POORLY GRADED WITH GRAVEL
USOS Class: SP Liquid limit: N/A
AASHTO Class: A-I-B Plasticity index: NP
Notes
Remarks: NO WATER INDICATED
Fig. No.: I
Mechanical Analysis Data
Initial
Dry sample and tare= 1711.90
Tare : 271.60
Dry sample weight = 1440.50
Tare for cumulative weight retained= 271.6
Sieve Cumul. Wt. Percent
retained finer
I inches 271.60 100.0
0.75 inches 28~.70 99.0
0.~75 inches ~55.40 94.5
~ 4 455.20 87.4
~ 10 584.20 78.5
~ 20 786.~0 64.~
~ 40 1208.50 55.0
~ 60 1548.40 11.4
~ 100 1658.60 5.7
~ 200 1695.80 1.1
Fraotional Components
+ 3 in. = 0.0 ~ GRAVEL = 12.6 · SAND = 86.5
FINES = 1.1
D85= 5.76 D60= 0.7~7 DSO= 0.572
DSO= 0.~811 D15= 0.27606 DIO= 0.25768
Cc = 0.8289 CU = 5.1010
Tom Fink.
Mayor
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
January 10, 1989
Lou Butera, P.E.
PO Box 773294
Eagle River, Alaska
99577
Subject: Waiver Request for Lot 3 Beyerly Heights Subdivision
Waiver Request %WR88-89-001, PID%051-232-50
Dear Mr. Butera:
Your request for waiver of the required 100 foot separation of
a septic system to a private well has been approved. The
approved separation distance is 90 feet.for Lot 3; and,
95 feet from septic tank to well on Lot 4 Beverly Heights
Subdivision.
This waiver approval applies to the existing septic system to
well separation only. Any future upgrade to either will
require all separation distances be met or another approval
from this department.
Sincerely,
Daniel J. Roth
Civil Engineer
On-site Services
DJR/ljw#6
cc.'
Judy Kleven
HC 78 Box 2315
~hugiak, Alaska
99567
EAGLE RIVER ENGINEERING SERVICES
December 7, 1988
Lou Rutera, P~.
~ P.O. Box ~73294
Eagle River, Alaska 99577
Telephone (907) 694-5195
ENYL':,ONM~NTAL S[2, VICr$ ~:VI$1CN
Mr. Daniel J. Roth
Civil Engineer
On-Site Services
Municipality of Anchorage
P.O. Box 196660
Anchorage, AK 99619-6650
q 1938
RECEIVED
REF: Lot 3, Beverly Heights
Dear Mr. Roth:
On behalf of my client, H.U.D., I am submitting the information
necessary for your determination of a waiver of separation distance,
well to on lot septic tank, and neighbors septic tank to 90'and 95'
respectively, for the above referenced lot. The separation is to a
neighbors well to the west on Lot 4 as shown on the attached site.
plan.
The existing tank was installed in 1982 by Hamman Construction
and was inspected and approved by the Municipality at that time, as
per the Inspection Report enclosed. The request for final approval
makes no reference to the neighbor well. Distance to the on lot well
is shown as 95'. The original septic system was installed in 1973. Our
field measurements confirm the tank inlet to be at 90' from the well
on Lot 4. The owner of Lot 4 has granted us a letter of non-objection
to the separation distance which is attached.
The owner's Lot 4 well log (attached) shows that the well draws
from a sandstone confined aquifer at a depth of 233'. The casing is
continuous to 233' where it encountered water. The drill log shows
several clay/gravel, hard pan and shale layers at depths of
62' - 143'. The sandstone was penetrated 88' to water entry level. The
well on lot 3 does not have a well log but was tested with a static
water level of 60', and water entry indicated at 75'-79' level during
flow testing. The surface topography is such that any surface seepage
would be directed away from both well locations toward a 20% slope to
the North. The subsurface soil is a sand and gravel type with a perc.
rating of 100. The area in question has a iow population density. The
tank is a recent installation done to Municipal code.
If there are any questions or concerns, or if additional
information is needed, please feel free to call me at 694-5196.
Sincerely,
Lou Butera, P.E.
I00' R
LDT 3
__(~T.H.
LOT 2
LOT 4
XISTZNG
100' R
~/ELL
H.$.E
/
DR~Vr" ZLL
]~EVERL¥ ]]RIVE
V/ELL AND SEPTIC SITE
LEGAL, L~]T 3, BEVERLY HEIGHTS
n~NER~ H.U.D.
CDNTRACTDR~ N/A
EAGLE RIVER ENGINEERING
PD BX 773294
EAGLE RIVER, AK. 99577
694-5195
SERVICES
PLAN
61' ..... Send and ,~.,mve~
629" ..... ' ~-~,~d
to ..'35 ..... S~r,c
/,,'o. ~.,~. at 231 * '" '
c~.aff. Ao,. c.te_.anout_ and no
June 20, 1988
Municipality of Anchorage
Department of tlealth & Human Svcs.
825 "L" Street
Anchorage, AK 99502
RE: Wavier Request
Lot 3, Beverly Heights
I have no ~bjection to the location of the septic tank serving
lot 3 Beverly Heights, being 90' distance from a well that is
temporarily abandoned on my lot 4 of Beverly Heights. While I am not
presently utilizing this well, it is being kept as a backup should my
primary well fail.
Sin~Terely,
Judy Kleven
HO 78 Box 2315
Chugiak, Alaska 99567
Owner: Lot/~, Beverly lleights
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
ON-SITE WASTEWATER DISPOSAL SYSTEM INSPECTION
ENGINEER FIELD AUDIT
LEGAL DESCRIPTION:
ENGINEER:
EXCAVATOR:
AUDITOR:
COMMENTS:
AUDITOR: ..........
NAME
MA'L'NGADDRL= : g
0 Z ~ Manufacturer
¢ MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
[ H~O N E J I~NEW
Inside length
Dwelling
Foundation
Total length of lines
Material beneath tile
Depth
Crib depth
Building foundation
Driller
Sewer line
Well
DISTANCE TO:
NO. of lines Length of each line
Top of tile to finish grade
DISTANCE TO:
Building foundation
DISTANCE TO:
NO. OF BEDROOMS
Mat;~ ~, ~ No. of compartments
Width Liqu~th
PERMIT NO.
Material Liquid capacity in gallons
Nearest lot line PERMIT NO.
Trench width
inches
inches
PERMIT NO.
Nearest lot line
Distance to lot line
Septic tank
OTHER
PIPE MATERIALS
APPROVED DATE
LEGAL
PERMIT f,40.
· APPLICANT
LOCATIO~i
LEGAL
IRA KRUGER
BEVERLY DRIVE
LOT 2 BEVERLV HEIGHTS
SR i BOX 2207 99567
LOT SIZE
688-2988
42080 SQUARE FEET
TYPE Of SOIL ABSORPTION SYSTEM IS: TRENCH
MAXIMUM NUb'lEER OF BEDROOMS = 5
SOIL RATING (SO FT?BR)= ~
THE REOUIRE[~ SIZE OF THE SOIL ABSORPTION SYSTB'I IS:
DEPTH= ~. LEf41]TH= 5 6RR'-.-'EL
DEPTH=
THE LENGTH DI~IENSION IS THE LENGTH (IN FEET> Of THE TRENCH OR DRRINFIELE
THE DEPTH OF R TRENCH OR PIT IS THE DISTA~'~CE BETI,~EEN THE SURFACE OF THE
GROUP,II> AND THE BOTTOM OF THE EXCAVATION (IN FEET>.
THERE IS NO ~ET HIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE f4INI~IUM DEPTH OF GRAVEL BETI.EEN THE OUTFRLL PIPE
AND THE BOTTOM OF THE EXCAVATION <IN FEET>.__--~¢ ~~
REQIJIRED SEPTIC tRr4~( SIZE= 150e GR~Or4S
PERMIT ApFILICA~.~T HAS THE RESPONSIBILITV TO INFORM THIS DEPART~IENT DURING THE
INSTALLATIO~'~ INSPECTIONS OF A~'4'~' WELLS ADJACENT TO THIS PROPERTV AND THE
~Uf'IBER Of RESIDENCES THAT THE I,IELL HILL SERVE.
------ TI,lO (. 2,--, I I'-,ISPECT I Of,IS PRE REQLI I REP,
BRCKFILLING OF Rf-lY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTIO[{
MINIMUM DISTANCE BETI,EEN A I4ELL AND Rt.4Y O[-;-SITE SEI4RGE DISPOSAL SYSTEM IS
100 FEET FOR R PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC !,ELL DEPENDING
UPO~I THE TYPE OF PUBLIC WELL
~IINI~!UM DISTANCE FROM A PRIVATE I,IELL TO R PRIVATE SEI,ER LINE~ IS 25 FEET AND
TO R COMMU~.FFTV SB4ER LINE IS 75 FEET.
OTHER REQUIREMENTS MAY APPLY. SPECIFICRTIOf.~S RI.ID CONSTRUCTIO[.~ DIAGRAPlS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
PERPl I T E>'-': P I RES DEOEf4E:ER __?::.I .. '1982
I CERTIFY THAT
l: I 8M FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEI,IERS AND t4ELLS AS SET
FORTH BY THE ~!UNICIPRLITY Of ANCHORAGE.
2: I I,IILL INSTALL THE SYSTEM IN RCCORDA,~ICE 44ITH THE CODES.
2: I UN[~ERSTAND THAT THE ON-SITE SEI'~ER SVSTEM £'IAY REOUIRE ENLARGEMENT IF THE
RESIDENCE IS RE~IODELED TO INCLUDE MORE THRf'4 5 E:EDROOMS.
SIGNED: ........................... ~ ............ RPF'LICANT IRA ~(RUGER
V4. 0
MUNItIPALITY OF ANCHORAGE_ (:~O ~-(~-~,.
'. Department'--f Health and Environmenta'~?rotection
825 ~ ~ Street, ~chorage,
264-4~20
Pe~it ~q~ WELL AND/OR ON-SITE SEWER PERMIT
T~e of Soil ~so~tion System Is: ~[ot~e: ~
Trench: ~ Drainfield: ~ Seepage Bed~
Max~ N~er of Bedrooms: ~ Soil Rating(sq.ft/br)
The Required Size of the Soil Absorption System Is:'
DEPTH d~) .LENGTH ~ . GRAVEL DEPTH ~ WIDTH ~)
The length dimension is the length(in feet) of the trench or drainfield. 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.outfa~ll_pipe and
the bottom of the excavation(in feet). ~,/~pS~/~_~/d4J d9~ 7~/U~
* * REQUIRED SEPTIC(IIO~.~,~) TANK-~IZE-j /~-~90 GALLONS * * --
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection and approval by this departmen
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 fee
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
.. * * * PERMIT EXPIRES DECEMBER 31, 1 9 3 2 * * *
I certify that:
(1) I am familiar with the requ'irements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
I will install the system in accordance with codes.
(2)
(3)
Signer:
I understand that the on-site
t~iden~e is remodeled to
Applicant~'~~--
SWP/024(1/81)
ASunicipalit3r,
Anchorage
POUCH 6-650
ANCHORAGE, ALASKA 99502-0650
(907) 26,1-4111
D[PA~TMfiNT OF HEALTH ANO £NVIIIONMENTAt PIIOTECTION
January 4, 1982
Ira Kruger
Star Route 1 Box 2307
Chugiak, Alaska 99567
Subject: Permit for Property on Beverly Drive
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
/-"UNICIPALITY OF ANCHORAGE~ .
Department ~Health and Environmenta. rotectzon
825 L Street, Anchorage, AK. 99501
264-4720
* * * HANDWRITTEN PERMIT * * *
WELL AND/OR ON-SITE SEWER PERMIT
~ ~ ~ ~_ Mailing Address:
Applicant:
Location: "~,0~[ ~" Phone Number: ~.~'~' ~e~
Type of Soil Absorption System Is:
Trench: ~ Drainfield: &---_Seepage Bed: ~ Holding Tank:
Maximum Number of Bedrooms: .~' Soil Rating(sq.ft/br) ;
The Required Size of the Soil Absorption System Is:
DEPTH J LENGTH J J . GRAVEL DEPTH t. WIDTH
The length dimension is the length(in feet) of the trench or drainfield. 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 outfall Pipe and
the bottom of the excavation(in feet). J~O~,~A~
* * REQUIRED SEPTIC(HOLDING) TANK SIZE =-~-~'~''-zS'i~ GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number,
of residences that the well will serve.
~ * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is i00 fee~
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * # PERMIT EXPIRES DECEMBER 31, i 9 8 1 * * *
i certify that:
(1) 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 in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the residence is remodeled to include more that 3 bedrooms.
Signe~ :~~CApplicant ~~c~'~ ~ Issued by: .~Q~/~
Date: /
swp/024(i/81)
GREA]" ANCHORAGE· AREA BOR,r' -H
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99S03
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME Ray En~ons MAILING ADORESS P.O. Box 88, Chugtak PHONE 688 2333
LOCATION Beveerly Drive LEGAL DESCRIPTION Lot 3, Beverly Heights Sub.
SEPTIC TANK: . U.L.# 184927
DISTANCE
FROMWELL 62' MANUFACTURER Stack Steel MATERIAL Steel
NUMBER OF
COMPARTMENTS
INSIDE LENGTH
INSIDE WIDTH
LIQUID DEPTH
I,IQUID CAPACITY 1000
SEEPAGE PiT;
NUMBER OF P1TS 1
LINING MATERIAL Log
BUILDING FOUNDATION__
DIAMETER 48 OR WIDTH 12', LENGTH12m, DEPTH 6m
CRIB SIZE: DIAMETER DEPTH DISTANCE FROM: WELL
TOTAL EFFECTIVE
NEAREST LOT LINE ABSORPTION AREA (WALL AREA) 288
ADDITIONAL ABSORPTION
2
GALLONS.
WELL:
TYPE Dr'~11ed CONSTRUCTION
BUILDING 101 NEAREST 34'
FOUNDATION LOT LINE
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED
DISTANCES:
standard 216'
DEPTH DISTANCE FROM:
NEAREST 10'+ SEPTIC 62~ SEEPAGE 95'
SEWER LINE TANK SYSTEM
REMARKS
DIAGRAM OF SYSTEM
INSTALLED BY: Ray Emmons
Cast Iron
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Tm No, EQ-O31
[~IZA-A-B-
I'1 LIl'-.I T C I PAL I T'-r' i)F Rt-ICHORRGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTIOH
825 L STREET, ANCHORAGE, RK 99501
264-4720
PERMIT NO:
DATE ISSUED:
8400~7
0~/09784
RPPLICRHT:
ADDRESS:
CONTACT PHONE:
LEGAL ~ESCRIP:
LOT SIZE:
LOT LOCATION:
IRA L. KRUGER .
SRi, BOX 2~07
CHUGIAK, AK '99567
688-2988
~LIBDIVISION: E:EVERLY HEIGHTS
SECTION: iS TOHtISHIP:
43000 (SQ. FT. OR ACRES>
BEVERLY STREET
LOT: 3 BLOCK: 'NA
RANGE:.IH
SIGNE[.,
APPLICANT:
ISSUED BY
I CERTIFY THAT:
· l. I RM FRHILIRR HITH THE REOUIRENENTS FOR ON-SITE SEHERS AND HELLS RS SET
FORTH BY THE MUNICIPRLIT? Of ANCHORAGE (MOA> AND-THE STATE OF ALASKA.
2. I HILL INSTALL THE SYSTEN IN ACCORDANCE HITH ALL NOR CODES AND REGULATIONS,
AND IN COMPLIANCE HITH THE DESIGN CRITERIA OF THIS PERMIT.
I HILL ADHERE TO ALL NOR AND STATE OF RLRSKR REQUIREMENTS FOR THE SET BACK
DI~TRNCE~ FROM ANY EXISTING HELL, WRSTEHRTER DISPOSAL SYSTEM OR PUBLIC
SEHERRBE SYSTEH OH THIS OR ANY ADJACENT OR NEARBY LOT.
,~NICIPALITY OF 6NCHORAGE,...__. .
Department .:Health and Envlronmenta ~otect~on
825 L Street, Anchorage, AK. 9~501
264-4720
"" # * HANDWRITTEN PERMIT * * *
WELL"~/tm uN'fit IL Sff.~ PERMIT
[-- kXW(~fi eF'- Mailing Address:
Phone Number:
Applicant: ~6k
Location:
Legal Description: ~3~f~ J~ ~/T5
Type of Soil Absorption System Is
f
Lot Size:
Trench: ~ Dr~/~~--~'~ge Bed: Hol~ing~
Maximum Number of Bedrooms: ~ ~Q Soil Rating(sq.ft/br)
The Required Size of the Soil Absorption System Is:'
DEPTH
LENGTH "---- . GRAVEL DEPTH "---- WIDTH'
The length dimension is the length(in feet) of the trench or drainfield. 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 outfall Pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the nLunber
of residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection and approval by this departme~
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 fe~
for a private 'well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
"* * PERMIT EXPIRES DECEMBER 31, 1 9 8 3 * * *
I certify that:
(1) 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 in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the~residence/is remodeled to include more that-3-bedrooms.
Slgne~:~-~. ~'~_.~.~-~ / Issued by: ~ ~C/XL~~-~
Applicant / ~ ~
Date: ~- D -
SWP/024(1/81)
CHUGIAK, ALASKA
688-3199
'"° co. 4,
WE SERVE ALI. ALASKA
POST OFFICE BOX 42- CHUGIAK, At. ASKA 99567
KODIAK, ALASKA
. 486-4826
O ........... ' Ira Kruger
WDiI:.K Ut' I.d%l~LI ......................................................................................
ADDers'. .........
w~r[ :- srrE ....~....a...~Z~..r.~L~..i.~,.h.!S.......,'. ................. i ..........
3-g-84 - · -
DATE - STARTED ,.-~ ................................................... ~ ............ ~.:.' ........
3-9-84 ·
DATE - ENDED ......................................... ; ...................... ~ ......................... ' '
DEPTH OF WELL ........8...1..'. ........................................................ ~. .......... ~..
STATIC LEVEL OF WATER FT. ........3.O.:.....iD...,holR.~'e'S.t.. ............
DRAW DO~N FT.....8...Q..S.....e...9...~..:. ......................................... i ................ ~..
cats. ~'E~ .R..~.?....~?..~..'. ................................. .L...: ........... :.....
KIND OF CAS~N~ ........ .6...-......s...c.h~.4...0...-..6..8.. ................................. : ......... '
KIND OF FORMATION:
FROM ...i....0.....: ........ leT. TO ........... .5. ........ leT...O~'...e...fb..u...r.d...e.~ ......
FROM ..:.....5.7.. ......... leT. TO .......... 9..8.]..... FT. ]~.a.,.~...e. ,r.....s.a.~ ......
FROM ....... GS......i... FT. TO ........... 81 ...... Fr..C/a.y. .......................
FROM ..................... leT. TO ................. FI' ........ : .....................
'FROM ..................... IT. TO .................... leT. ~;....: ....................... ;... '
FROM ...................... leT. TO ' FI' ........ L....;.:;. ..................
FROM ................. ;~;.. Fr. TO .................... FI' ..................................
FROM; ..................... leT. To ..................... FT .................................
FROM ....................... FT. TO ....~ .................. FT ........... ~ ...................
FROM ...~ ................... FT. TO ........................ let ................. ; ............ ~.. ,./,,' · ' '
FROM ....................... FT. TO ........................ FI' ................................
FROM ....~ ............ ~.... FT. TO ...--~ ......... ~..... FT .......... L.....~...? .........
FROM ....................... leT. TO .................. .:-. FT ....................... :.._.L
FRO.',! ...................... FT. TO ...................... ~ ............................... ~.
FRO,',! ...................... leT. TO .... .................... FT ................................
FROM .....................leT. TO ...................... FT ........... ; ....................
FROM ....................... FT. TO ........................ FI' ........... ~ ..................
FRO.',! ................. ......'leT. TO ........................ let ....... ~ ......... ~ ..............
· FRO.',{ ..................... ;. leT. TO .................... L. FT .......... '.......~....2 ........ ~.
· FROM ...;...;....~.....h.. FI:. TO ........... ~ .......... 'FT ................................
MISCL. INFORMATION:
lO'-of slot screen and
should be set at 76'.
14" of 5" steel pipe in hole.' Pump..:
No varranties Or no warranty '~mplied.
o~27
~?' - 2?½'
50'0" - 65'
65' - 71 '6"
71'6" - 126'1"
126'1" - 20~5'
207'5" -
210 '10"
216'0"
...........................
.......................... .--$and,
- ......................... - S~d aad ~.
Sw~d uneoni, no Ll. a$&,
S~oJ~d o~.
S~d
One ~
He,d el~y, boU:o~ oI~
Slopped d.,,_;!lgny, ct~ 216'0". D,U.L&d ~.~ ~ ¢l,.,y mai. wd.~. tge. l.Z
dcveJ..oped I)etavee. n 210'10" ' ~ "
~af,
Locw~on ...................
szs~ o~ Cow-,~v .............
St_ai~c ~ &~ei ..........
~ ....................
o~27
27' - ~1'
~1 - 5~'0"
50'0' - 65'
65' - ?t '6'
71 t~. - 12~tl"
I~'l" - 20f5'
207'5' -
2tO 90':
£16'6'
........................... 4~4
........................... CZ,~,
........................... S~nd and wole~.
off.
Slopped dri. Z].i. ny. ag
devduped bet. ween P/Il'lO" and Pl6'bY, o.~ taw 'ga]J, on,x a rniamte.
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
Lot 3; Beverly Heights Subdivision
Location (site address or directions)
Property owner
Mailing address
Lending agency
Mailing address
Scott Olsen
RR1 Box 171
18923' BeverlF Drive
Chugiak, AK
Day phone
Beres Ford, South Dakota
Day phone
Agent Cindy Lindblcm/ Greatland Realty
Address
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: 5
TYPE OF WATER SUPPLY:
Individual well xxx
Community well
Public water
Day phone
NOTE:
694-9125
MuNiCIPAUT~Of ANCHO,~GE
ENVIRONIv~5b,II'ALSSRVICE$ DIVISION
OCT 1 1 199
RECEIVED
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.
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 furtherverify 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.
$ & S ENGINEERING
Name of Firm 17034 £.,,I. R;.., Lov~, R,~.d N~. 204
Address Eagle River, Alaska 99577
Engineer's signature
Phone
DHHS SIGNATURE
· /,^ roved
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additiona! Comments
Date
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 registe red in the State of Alaska. The DH HS does this as a courtesy to p u rchasere of homes
and their lending InstitutioNs in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct Inspections or analy~e data before a certificate Is issued. The Municipality of Anchorage is not
rasponslble for eh'ors 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 · (90
Health Authority Approval Checklist
LegalDescflption: Lc~' :~.~ I~Vf.;,~.'~ 1~'4;ic~l'S ~JO PamalI.D.:
A. WELL DATA
wal~ type
Log present
Total depth
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed 3 - q - 8 q
Cased to ~:)l"l' Casing height (above ground)
Wires properly protected
FROM WELL LOG
AT INSPECTION
Date of test
Static water level
Well production
g.p.m.
WATER SAMPLE RESULTS:
Nitrate
Other bacteria
Date of sample:
B. SEPTIC/HOLDINGTANK DATA
Date installed ~- ! q - ~Z Tank size
Foundation cleanout ~ ~' /~/~
Date of Pumping tll/' 5-/o) (~
C. ABSORPTION fiELD DATA
Date installed ' ' I ' H- 8'~
Effective absomtlon area ~'q~'l~
I~o Number of Compartments 7- Cleanoute ~1)
Depression (Y~) ~ High water alarm (Y,~)
Pumper ,~"/'/,u,?~.y ' ~.',','/P~,C 5
So~lmfing (g.p.d./fFor~adrm) " S~tem~e
Date of adequacy test lo -' q -q G
Fluid bepth in absorption field betem test (in.);
Fluid depth ~1 (ins) Minutes later:
Peraxide tmalment (past 12 months) (Y/N) ~d~
Grmml thickness below pipe
Monitoring Tube present ~N)
Results (~1)
Immediately affer2~ c gal. water added (in.):
Absorption rate = "':7:~o'e · g.p.d.
/~l~u~ If yes, give date ~
Total depth lo
Depression owrflald (Y~ No
For ~ bedrooms
72~26 (Rev. 3me)-
D. LIFT ~TATION
Date installed Size in gallons
Manhole/Access (Y/N)
'Pump on' levee
'Pump off' level at*
High water alarm level at'
*Datum
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
~olding tank on lot "~
~so~flon field on Im I
Pu,tc s.er .in
S~r/~pfic se~ line
SEPA~ON DIST~CES FRO~O~ING T~K ON L~:
~undafion ~ ~ ~ Pmpe~ line I o i + ~rpaon field
Wa~r m~se~ llne
On adjacent lots
Public sewer manhole/cleanout
Lift station
Sur~cewater/dralnage loot+ Walls on adjacent lots ~0i ~. tlmlsq ~'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
I
Property line Je Building foundation ~Jrtt + Water maln/sewice line lei 4,
Surface water I Oo t + Drk. eway. parking/vehicle storage area Ioe ~ +
Curtain drain I'~/~ Wells on adjacent lots IO0~'J'
Date of Payment
Receipt Number ~ ~ ~/' ~'/~J'
Waiver Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*
~;~x96 17:d8 C?SE ESI P~CH~ ~ 9~T6941211 N0. a°~ 1~13
CT&E Environmental Services Inc.
Laboratory Divieion ~,__ _a,~4ae ..........
Laboratory Analysis Report
CT&E Rd',//
Client Name
Project Name/#
Client Sample I1)
~tatrlx
Ord~ed By
PWSID
,~ampl: Remarks:
Collected By: ~y
964973001
Lot 3 Beverly X-Its
Lot 3 Bcvedy
Dtitddag Water
Client PO//
[~in~ed Date.~Time 09130196 15:27
Collected Date/Time 09/26196 14:20
Received Date/Time 09/26196 15:30
Technical Director: ~tephe~ C. 1Ede
Parameter Reaultn PQL Units Method Limits Date Date Init
toter cotito~ 0 0 ¢ol/lOOmL Sala 9~ZZ~ 097~6796
200 W. Potter Drive. Anchorage. AK 99518-1605 -- Tel: (907) 562-2343 Fax: (907) 561-5301
3180 Peoer Road, Fei,benkl, AK 99709-6471 -- Tel: {907) 474-8656 Fax: (907) 474-9685
ENVIRONMF. N]AL FACILITIES IN ALASKA- CAUFORNIA. FLORIDA, ILUNOI$, MARYLAND. MICHIOAN, MISSOURI, NEW JERSEY. OHI0. W~$? V~RGJNIA
Pa~'cel I.D. #
1. GENERAL INFORMATION (Must be completed prior to submittal)
· (a) Legal Description (include lot, block, subdivision, section, township, range)
Beverly Hts. Lot 3 T15N, RlW. Sec.18
Location (address or directions)
Beverly Street .....
(b) Property owner H.U.D. Telephone: (home)
MaiLing Address 605 W. 4th Ave. Suite 081 Anchorage. AK
(c) Lending Institution Telephone
Mailing Address
(d) Real Estate Company and Agent
Address R040 C~I .~,~,~f' Anr'hc~*ac~,
Telephone
(e) Mail the HAA to the following address: (or check here r-I, if hold for pick up.)
List contact person and day phone number below:
MUNICIPALITY OF ANCHORAGE ~
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
99501
Business 271-4665
2. TYPE OF RESIDENCE
Single-Family 15t Number of bedrooms
3.
5
WATER SUPPLY
Individual Well ~] Community I-I Public r~
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
SEWAGE DISPOSAL/'
On-site CI Public r'l Community I-I Holding Tank I'1
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legailty and status.
Page I of 2
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation dateshown 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 end 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 FirmEagle River Engineering Services Telephone 694-5195
Address P.O.B. 773294 Eaqle River, AK 99577
Date ~/~-~/~
6. DHHS APPROVAL
Approved for ~ bedrooms by
Approved ~ Disapproved
Terms of Conditional Approval
Conditional
Date
The Municipalityof Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
cerificated based only upon the representations given in paragraph 5 above byan independent professional engineer
registered in the State of Alaska. The DHHS does this as a courtesy 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.
Page 2 of 2
A. WELL '.': ~
Well Classification ,~'"'~*"~" ~
MUNICIPALITY OF ANCHORAGE (MOA)
Health Aulhorlty Approval (H. AA)
CHECKLIST - FEBRUARY 1984 '
343-4744
Legal Description:
Well Log Present (Y/N) /'') Date Completed ~., ~',"
Total Depth ~'77 / Cased to "'~/~ · Depth of Grouting
Static Water Level ,4'~ / ,,'~./,,..,,,
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
To Nearest Sewer Service Line on Lot
Water Sample Collected by
Water Sample Test Results
If A, B, C, D.E.C. Approved (Y/N)
Yield
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
; On Adjoining Lots ~-/,~o
; On Adjoining Lots
To Nearest Public Sewer Cleanout~Manhole
/..3j,.-~
; Date ,7-,/',/4/~' ?
B. SEPTIC/HOLDING TANK DATA
Date Installed /~'g-.3.. Size
Standpipes (Y/N) /~ Air-tight Caps (WN)
Depression over Tank (Y/N)
Pumping/Maintenance Contact on File (Y/N) ~/,/,'f
Holding Tank High-Water Alarm (Y/N)
No. of Compartments -.~
Foundation Cleanout (Y/N)
Date Last Pumped· ,-~/~'¢'f ~'~r~.
; for .,'~'~,,~
Temporary Holding Tank Permit (Y/N) ~'
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water-Supply Well ~' '"
To Property Line ~','~'"
To Water Main/Service Line /'/~'"
To Stream, Pond, Lake or Major Drainage Course
Comments · ·
To Building Foundation "~ ~ /
To Disposal Field
72-~26 (Rev. ?/88) F~onl Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata //////////~--,~
Square Feet of Absortion Area
Depression over Field (Y/N)
Length of Field ,/~./.A, ~
Depth of Field
, ",,Gravel Bed Thickness
.2.J~'/$ ~,p Statndpipes Present (Y/N)
/~ Date of Last Adequacy Test
Type of System Design J"~c,,~.,r~,~;/- //-,'-,,--,~,C
Results of Last Adequacy Test
'SEPARATION DIST~,NCE FROM ABSORPTION FIELD:
To Water-Supply Well
To Building Foundation' ~'-,~'- /
Lot /4, / ;~ 7,-.-<.~ ~ f'~,,
To Water Main/Service Line ,'-x~ /
To Stream. Pond, Lake, or Major Drainage Course
To Driveway. Parking Area, or Vehicle Storage Area
Comments
To Property Li~e /~/'
To Existing or Abandoned System on
; On Adjoining Lot~' *".~" /
To Cutback (if present)
D. LIFT STATION
Date Installed
Size in Gallons ' ' *' '
"Pump On" Level at
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (WN)
"Pump off" Level at * '
Vent (Y/N)
Pumping Cycles during Adequacy Test.
**;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
Ea~le Rivet Engfnecring Servlco$
Company P 0 Box
Date ~/'Tta/'r'f Eaoto River. AK 99577
MOA No. ,~ ;-~ ¢
Receipt No.
Date of Payment
Amount: $
72-026 (Re~. 7/~8) Beck
~ ~,,~,,~, ....... ·. A ~ngmeer s ~ea~
Receipt No.
Waiver Fee: $
Date of Payment
Page 2 of 2
MUNICIPALITY OF ANCHORAGE
DMSION OF 5NVI~ H~_ALTH
DEPARTMENT OF HEALTH AND ENVIRC~MENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL '~':i{TIFICATE
(a) /~ggl Des~ipticn,(i~ldd~.'~fot, block, subdi~i, sicn~, segtion, tc~rmhip, range)
,'1 11 .S'l/ z _C i ;'-/..s-,c.,
Lcca~cn (addFess or directions)
Applicants Adc~ess
Ad.ess
(e) ~al Estate Co.& Agent
Applicant is (check o_q.~ Lendirg Ir~tikution ~-~; Owr~r/builder ~-~;
Buyer ~; Other,~-(explain); -3~/'/~-~'
Te le phone
Ty~e cf Besidence
Single-Famil~
Number of Bedrcc~
Multi-Family
Other (cbscribe)
3. Water Supply
0
Individual Well ~;~ Cc~unity ~-~ . ~ublic
Note: If ~,,,~nity ~i1 system, ~st ~ ~it~n ~f[~ti~ .~ ~ State
~nt cf ~rcr~ntal Cc~tion attesting to ~ ~Gality ~d s~tus.
O~.it'~ 'blic ~
IS ~ ~s~wate~ dis~al sys~m ~ f~ ~ ~ of )
[Page 1 of 2]
2-15-84
5. Enqineering Firm Providirg Inspecticns, Tests, Dsta and Infc~mation
Signed by
( ENGINEEK SEAL)
The Municipalit9 of Anchorage Department of H~alth ar~] Envirc~rental Protection does
not ~uarantee ~.~ cc~ti~,,ed satisfactory ~erfcrmance of the water supply and/ct the
wastewater disposal system. This apu~oval indicates that, as of the validation date
shown abo%~, based on the data and infc~-mation furnisl~d by an engirmer registered in
the State ~f Alaska, the water supply and wastewater disposal system is safe and func-
tional f~ th~ rnmber of bedrooms and type of structure indicated.
(D~EP SEAL)
7. Mail the HAA to the follcwing address.'
KB2/dS/s
[Pa~e 2 of 2]
2-15-84
SEPTIC/HOLDING TA~ ~%TA
Depression ~r Ta~/N)
Size
Ai~-tight Cairn (Y/N)
Det~ Last Pumped
No. cf C~tmsnts
[Pa~e 1 of 2] 2-15-84
Soils Sting in Abso~pti~ St~ate ~ of System ~si~
Wid~ of F~91d ~p~ Of Field
~sul~ of ~t ~ ~st ,/
~ati~ Dist~ ~ ~ti~ F~ld: /
To ~te~ly ~11 % To ~ty Li~
To ~ildi~ F~ti~ ~ ~ ~ti~ .~ ~d S~m
To ~= ~i~=vi~ Li~ ~ ~ ~t~(if ~t) ''
[Page 2 of 2] .,..~.~..~,,.,~...,~
2-15-84
Ae
BJ
MUNICIPALITY OF ANCHOP~GE (MOA)
HEALTH 0THORITY A PROVAL (HAA)
CHECKLIST - FEBRUARY 1984
MUNIClPAUTY O~ N,~HORAOE
DEPT. Of HEALTH &
ENVIRONMENTAL PROTEC110~
Static ~ater Leal ~ ! Pump Set At
Casing F~igh.t ~/X~,~ G=.nd /~"
Separation Distan~ss f~cm Wsll:
To Septi¢/Holdin~ Tank c~ Lot gZ /
Sanitary Seal on Ca_-ing~
Dsp~ession A~ound Wsllhsad
; On Adjoini~ Lots /OO -/-
TO Nsaz~$t lkk3s of Absc=ption Field on L~t~-- ' ; On Adjoining Lots -//O ~ 4
TO Nsaxest Public Sew~= Line /~///~ TO Nearest Public Se~r .
S~C~ ~ ~A
Sta~i..~)' Ai~ti~t ~. ~) F.n.ti. C~a~.t (Y~
~e~i~ ~= Ta~ (Y~ ~te ~a~t ~d ~--~ --~ ~
~i~in~ ~a~ ~ Fi~ (Y~) ~ f~
Moldi~ Ta~ Hi~te= ~a~ (Y~) ~ra~ ~ldi~ Ta~ ~t (Y~)(
~ati. Dist--. %~tic~ldi~ Ta~:
To ~te~u~ly ~11 To ~ildi~ F~n~ti~ ~ /
To ~=ty ~ ~O ~ To Dis~al Field ~ ~
To ~ter ~i~i~ Li~ ~/~ To S~e~, ~, ~e, ~ ~j~ ~ai~
/tQ . ' '
C. ABSOR1DTION FIELD DATA
Soils Rating in Absorption Stxata
Width of Field / 2
Ty~e of System
Length of Field
~p~ of Field
Gravel Bed Thickness
StandpiDes ~esent
Square Feet of absorption Area ~ ~/
~ati~ Dist~ ~ ~ti~ F~ld:
To ~ildi~ F~n~ti~ ~ ~ ~
To ~isti~ ~ ~d S~ ~
~t ~ / 1~ ; ~ ~oini~
To
To ~i~y, ~kf~ ~ea, ~ Vehic~ St~ ~a /~ ~'~
D. LIFt STATION
** Check Permitted Bed~ocm Fating AGainst HAA l~squsst
I ~s~tify ~~ve'~hecked, ~=ified, o~ ~onfcz~sd to all MOA HAA Guidelines in effect
2-15-84
AOEOUACY TEST
WATER AND SEWER iNSPECTION
WELL INSPECTIONS AND
FLOW TEST
SITE pLANS
ROAD OESIGN
~arch 2l~ 198~
ROBERTA. SHAFER
ClVlLENGINEER
694-2979
The Municipality of Anchorage
Department of Health and Environmental Protection
825 L Street
Anchorage, Alaska 99501
REFERENCEI, Lot 3; Beverly Subdivision; S%; Section 18; T15N; R1W
Request a Health Authority Approval Certificate be provided for the residence
located on the referenced property. Provided for your information are the
following documents~
A. Application for Health Authority Approval Certificate
B. Health Authority Approval Checklist dated February 1984 and supplement
checklist
C. A well log for the exisiting well located on the referenced property and
a new well which was drilled March 9, 1984
D. ~ coliform bacteria analysis of the water for both the existing well
and the new well
A visual inspection made of the sewer system on this property and all the cleanouts
are visible and equipped with adequate air tight seals. The existing well ~as tested
for yield and after a period of two hours and twenty minutes of a flow of approximately
O.10a gallons per bedroom per minute the well went dry. An adequacy test was
performed on the sewer system on the property and found to be adequate at this time.
A new well was drilled by Jay Williams Drilling and a temporary hook up was made
between the house and the new well. It ~ill be necessary for the water line to be
buried and a pitless ddapter installed and at this time the electrical wires need to
be placed in conduit. This work should be able to be completed within the nex~
sixty to ninety days. The yield test from the new well was satisfactory.
If we may be of further service, please do not hesitate to call.
HEMIC,4L & GE LOGIC,IL L,4BOR,4TORIES OF AL,4$K,4, INC.
TELEPHONE (907) 562-2343 ANCHORAGE INDUSTRIAL CENTER
I '~ ; . 5633 B Street : f
,-
Drinking Water Analysis'Report for Total Coliform Bacteria
EAGLE RIVER ENGINEERING SER%,'S
P.O. Box 773294
EAGLE RIVER, ALASKA 99577
· ' Phone 694-5195
To Susa~ Oswalt
Municipality of Anchorage, Department of H%~an Services
~ LETTER
Date 3une 20, 1988
Subject~:-:-- , Beve~:ly Heights
825 L Street . _- , - ~ -, --....
Anchnrage, Ala~km 99502
Regarding Bev6rl~ Heights Est."'Lot 3.
,In going over. the paper work, it_seems that t~ ~epti6 ' ' " '
system was up. ~raded in r1982,
-'by adding a 1500 gallon septi6 tank. ~A health approval was granted in 1984, for 5
.... bedroom capacity utilizing existing seepage pit. The ,pit is adequate for. absorbtion ::
despite-design size of 288 square feet. - : "/ [, {.,: · , i > '-,
Question: Can I obtain 5 bedrocm capacity without modifying existing leachfield
BEFORE
COLLECTING SAMPLE
Yerltlcellon: LTB BOB
Final Membrane Filter Resulte
Time:
~..
CollformllO0ml
Property O~ner /.~--'/~,~
Mailing Addres~
Buyer
Address
Address
Realty CO. & A~ent
Address
Legal Description
Type of Residence
{:] Multlpte Family
r-I Other
r-I Community
r-I Public Utllily
Sewer Disposal
{::] Holding Tank
APPLIC'"NT FILLS OUT UPPER HAI"~,ONLY
Zip Code
Phone
Zip Code
/~ Y~'/r ~,
NO. of Bedrooms
ATrACH WELL LOG. A wail log is required for ell wells drilled since June 1975.
For wells drilled prior to fl~at date, give well depth (attach log If avallabte).
When Connected 1o Public Utility:
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN SE INITIATED.
Time
Date
Inspector
Field Notes:
Time Time Tlmq ~. '
Inspector Inspector Ins ector .
APPROVED BEDROOMS
DISAPPROVED
CONDITIONAL APPROVAL'
*CONDITIONS OF APPROVAL
Well Log Received
Septic Tank Size
February 10, 1984
Ira Kruger
SRI, Box 2307
Chugiak, AK 99567
Subject: Lot 3, Beverly Heights
Approval for the individual sewer and water facilities cannot
be granted until the followinG items have been completed:
°,C~]xpose the well for our inspection to determine proper
~construction, also to insure minimum distance requirements
~./. are__ met between the well and sewer system.
o The septic tank pumped with a receipt submitted to this
department.
An adequacy test needs to be performed on the existing
leaching area. This test will determine it the system is
adequate according to National Standards. A listing o~
private fi~ms performing the test is enclosed. This report
needs to be submitted to this office for our review.
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 264-472U.
Sincerely,
CW.12/eJ/E1
Enclosure
Cory Willis, R.S.
Associate Environmental Specialist