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Home My WebLink AboutBIRCH HILLS TERRACE BLK 2 LT 5 GR'"'i'ER ANCHORAGE AREA BOROI:;'--H DEPARTMENT OF ENVIRONMENTAL OUALfl ~ ;3500 TUDOR ROAD ANCHORAGE, ALASKA ggS07 27~-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION ~',~' ,~"~"~',~' SEPTIC TANK: MAILING ADDRESS LEGAL DESCRIPTION DISTANCE FROM WELL ,.~'~'/"~' MATERIAL 'b~'/'.~-.~'-~ ,...~7-£.~--,~. ~-"~,.,~ LIQUID CAPACITY ,/~'~' GALLONS. INSIDE LENGTH SEEPAGE SYSTEM: SEEPAGE Pll'~ NUMBER OF PITS / OUTSIDE DIAMETER LINING MATERIAL / NEAREST LOT LINE T'"'"~"'g~ I N FIELD: DISTANCE FROM WELL NUMBER OF LINES NUMBER OF ,..,. COMPARTMENTS LIQUID INSIDE WIDTH DEPTH OR WIDTH ,/~'~ /~ / o LE NG TH /,5~/*?--~-'/, DE PTH ~_../ · DISTANCE FROM WELL /~0 / '~ / , BUILDING FOUNDATION. · TOTAL EFFECTIVE ABSORPTION AREA [WALL AREA) '"~.2~ SQ. FT. , FOUNDATION ABSORPTION AREA SQ. FT. DEPTH: TOP OF TILE TO FINtSH GRADE WELL: ~," d.,~/4x~' Ty p F.~,,C////gT~" DEPTH LOT LINE ~'~/' NEAREST · SEWER LINE ,~,'~/t/~" , NEAREST LOT LINE DISTANC.ES: e''/~,,e.s"r/.~.~x,/.. ~/ TOTAL LENGTH OF LINES TRENCH WIDTH IN. TOTAL EFFECTIVE LENGTH OF EACH LIN-~~- DEPTH OF FILTER MATERIAL BENEATH IN. ABO'~E~I~F,,.TILE _ /,~.-~, / DISTANCE FROM --~'7 /WATER ° BUILDING FOUNDATION..,.~/ SAMPLE ..4/~,4./.C" . ·NEAREST SEPTIC SEEPAGE OTHER , TANK ~/~ . SYSTEM /~ / , CESSPOOL ~ , SOURCES DIAGRAM OF SYST~ O .A.A.B. GREATER ANCHORAGE AREa BORuUGH SEWAGE DISPOSAL SYSTEM ~. APPLICATION AND PERMIT INSTAL~T,ON LOCATION ~'~ /'~'~' "GALDESCR,~,ON t'~''' ~ ~" INSTALLATION OF: SEPTIC TANK 7 TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH "A'L'NG ADDRESS NO~; THIS PERMIT IS NOT VALID WITHOUT FINAL INSPECTION, 24 HOUR NOTICE: RE:QUIRIrD. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE: . HEALTH BEPARTMENT AUTHORITY WILL BE BUSJECT TO PROSECUTION. SEPTIC TANK SIZE MINIMUM DISTANCES. REQUIREMENT~ FOUNDATION TO SgPTIC TANK FOUNDATION TO SEEPAGE PIT ~O SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK DRAIN FIELD ALSO CONSIDER AREA WELLS. DIAGRAM OF SYSTE:M WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD DRAIN FIELD C,~AET IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF GRAVEL BACKFILL CONFORM TO BORO EGULATIONS REGARDING INSTALLATION. OR I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS DF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. =S-S8 AND THAT THE ABOVE A..L,CANT'..,G.ATURE · r~: .ATE~ ~q£i-~r~.Ar-.[ Apr". :.'IO?~Pl,. DEPARTI'!EIIT OF Ei'lViROIIH£lii,.L 3500 TUDOR RP,,AD ANCHORAGE, ALASKA 99502 CASE Performed For Narrt ~.,~e Date Perf?rmed Legal Descrintion:~ Lot ~¥Block._~__.Subdivision~[~l! This ~orm Re~orts Soils Log ~ Percolation Test_ Qeoth Feet 2 5-- Soil Characteristics lO__..} Was Ground Water Encountered?_~ Yes, At what Depth? A/ Readin~ Date Gross Time Percolation Rate Ninute ProeoseU Inst~'l--~'~ion: Seer, a¢~e Pit Den. th of Inlet /-? Denth To cn~'."~ENTS: ~(, t',7/I' ~S~.~-~: ...... Net Time Denth to H20 ~ .... Prain Field Bott¢:m Of Pit I Net DronI I i Test Performed 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 Parcel I.D. CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Lot 5; Block 2; Birch Hills Terrace Location (site .a.d. dress or directions) ,Prop rty owner · 'Mailing] address' ...18117 N. Eagle River Loop Rd. .~ Le'nding agency " Mailing address · ' Agent Virginia KOhfield/ Remax of Eagle River Address 18117 North Eagle River Locp Rd. Eagle River, AK Day phone Eagle River, Day phone Day phone 696-2842 AK 99577 694-4200 Unless otherwise requested, HAA will be held for pickup. 3 NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water RECEIVED MAY 15 Munimpah~y gl Anchorage DepL Hea th & Human 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. STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal affixed hereto and as ofth~ 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. $ & $ ENGINEERING Name of Firm 176~l Eeg~e River Loop I¢oad No, 2~4 Eagle Rlver, Alaska 99577, Address ~ / Engineer's signature e~//. [.~"7 ,-'~/ Phone (~'q 'Y- ~'q 7~ Date ,~'//!~//¢ 7 DHHS SIGNATURE Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By:. ~~'~ / /~/l~/~'-~ Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authorit~ Approval Certificates based only upon the representations given in paragraph S above by an independent professional engineer registe red in the State of Alaska. The D HHS does this as a courtesy to purchasers of ho roes and their lending institutions in order to satisfy certain federal and state requirements. E~ployees 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. IV~JNICIPALITY OF AIqC. HORA~ ENVIRONMM~AL Sf. RVICF. S DIVI~ON Municipality of Anchorage MAY 15 1991 DEPARTMENT OF HEALTH & HUMAN SERVICES _ 825"L" Street, Room 502 · Anchorage, Alaska 89S01· (907) 343..47:~t~~'~' · Health Authority Approval Checklist :: ''.. ,, ~-. Legal Descrlptfoa: Lo-r ~ ~,l,~clr 'V ~ ~,,eC.~ H~,,< Parcel I.D.: A. WELL DATA Log presem (Y,~I) Tolal depth FROM WELL LOG AT INSPECTION Date of test S~a~i¢ wa~- level Well production J g.p.m. ~ g.p.m. WATER SAMPLE RESULTS: Coliform Dat~ of sample: SEFrlC/IlOLOING TANK DATA Nitrale '" - O~er.4~aClcria Collected by: Dat¢inslailed "I-II'T~ Tanksize tOo~ Number of Companmems ~ Cleanouts~N).~E$ Fouada~oa~O~o~(~)~0 Yes t~-p~io.(Y~ ~o,ighw~..~(V~. No Date of Pumping A~oRI~ION l;l~l.rl DATA , Dat~instalJed '7-ll-'7~L Soiiratin$ ($.pdJfi-ot(~ ~..~" Systemtypc [,e,,~ ~t~, Leo~b IS', 2'ZI' Width I,', t'/I Gravel thickness beio., pipe 6' Totaldeptb e.S' Effecliveabsml~tionaxen /~'2(~~ MoniloringTubepresent(~N)~re~ionoverfield(Y~) No Date of a. deq~a.-~ te~ ~/q/q'~ Results (~Fail)P~,.s ~ For ~, bedrooms Fluiddepthinabsorpdonficldbeforetesl(in.):~ ~.~ lmm~diat~lyatter,l'~Osal, waleradded (in.): =7~si Fluid ?' (ins.) Minutes latin. ~ff',,~t~ Absorption rat~ ~ t~O I~.p.d. Peroxid~u~stn~nt(pa~ 12monUts)(y~ ~1~ Y.d~J Ifyes, s/vcda~ LIFr STATION Dale installed Manhole/^cce~ (YfN) High wat~ ~ {~~l~''~'''~'~- *Datum SEPARATION DLSTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding lank on Iol Absoq~tion field on lei Public sewer main ~ RECEIVED : On adjacent lots Municipality o! Dept. Health & HumBn Public sever manhole/cleanaul Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Building foundation "L9* ~ Property line lOI t- Absorption field ~ 1-4' Water mam/se~,ice line let¥ Surfacewater/drainage 10ol.4· Welis on adjacent lots IOOIp SEPARATION DISTANCE FROM AILSORPTION FIELD ON LOT TO: · Wate~ mnin/sen4ce line Building foundation :[~ I..~ Surface water too 1,4. D riv~-wa.v, parking/vehicle storage aren Wells on adjacent lots IOoA-~- PmperD.' line F. ENGINEER'S CERTi~ICAT1ON I certi~, that I have determined thru field inspections and review o in conjbrmance with MOA It,4A guidelines in effect on this date. HAA Fee $ ~0'2> , ~ Date °£ Puymen' '~' R~'. ~95 OSS: ~.wk,~ Date,Of Paymem Receipl Number Arctt¢ ~um~ & Well P.O. Box Eagle River, Alaska Offffoe Fax 688--2543 RECEIVED JU~,l § 199'/' Municipality of Anchoragl~ Dept. Health & Human Services MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. tf CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING L'-')-~('") - ~L-~. ~,- \[,~ HAA# 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot. block, subdivision, section, township, range) Lot 5: St. ock Location (address or directions) Ig117 ~o~,~h E~g~.¢ R~v~_~ Loop (b) Property owner Mailing Address (c) Lending Institution P. O. 8ox 1504 F~gte R~u~a,'Ab..:99~77 - ' -" 'i Telephone ' (d) Mailing Address Real Estate Company and Agent 1;[E/,W~X OF EAGLE Address 16600 Ccn.tC~{~¢~.d Telephone 694-4500 (e) Mail the HAA to the following address: (or check here~, if hold for pick up.) List contact person and day phone ndmber below: 17034 Eagle R~er Loop Road 2. TYPE OF RESIDENCE Single-Family ~ Number of bedrooms L '~'W 3. WATER SUPPLY Individbal Well [] Community [] Public I~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site I~K Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. Page 1 of 2 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION AS certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe. functional and 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. Telephone ~ ¢ ~'~"~ '7 ~ Name of Firm Address $ & S ENGINEE. 17034 Ea~- *~'- Date Eagle Rivet, ~ ......... .,27 6. DHHS APPROVAL Approved for'77JP- -~)~edrooms by "';~-'~ ~_t~,~.t,~..~C Date Approved ,/~ Disapproved Conditional /~..~..~ .,-,'/,z.~ ' . , __ D/ The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph $ 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 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. .... 72~s (,~,. 7/.) e,~k Page 2 of 2 . ~ & ~ ~.ttgitteeri,g SRB xg6x, EAGLE RIVER, AI~ASKAg9577 ROBERT A. SHAFER, P.E. 694-2979 FOLD To: 'DATEOFMESSAGE REPLY From: DATE OF REPLY StGNATUflE OF REPLIER TITLE OF REPLIER RETAINED BY ADDRESSEE MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) ~ ' CHECKLIST - FEBRUARY 1984 ~ ~)~-'0--[ ~//_ (/o 343-4744 '. Legal Description: L.-,~T ~ ;T=~..c~y 'Z. Date Completed Depth of Grouting If A, B, C, D.E.C. Approved (Y/N) Yield Pump Set At . Sanitary Seal on Casing (Y/N) Depression Around Wellhead (WN) ; On Adjoining Lots ~~,*o ~'' ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole ; Date A. WELL DATA Well Cla~sificati(~n Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL:' To Septic/Holding Tank on Lot ~.,~c>~ To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot WaterSample Collected by WaterSample Test Results B. SEPTIC/HOLDING TANK DATA Date Installed '/-l'/o'37~ Size ~t'~.~o No. of Compartments Standpipes (~1) '~ Air-tight Caps {~1) Depression over Tank (Y~ P.umping/Mainte.nance Contact on File (WN) Holding Tank High-Water Alarm (Y/N) ~/R*.* SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply We'll ~ ~, ~ ~ To Property Line [ ~ To Water Main/Service Line lc:J4' To Stream, Pond. Lake or Major Drainage Course Comments *~Or,'lP~-~'~ ~ '~.~ Foundation Cleano/ut~ (Y~) Date Last Pumped ~-I I -q ;fo Temporary Holding Tank Permit (Y/N) To Building Foundation ~ ~ To Disposal Field ~.-t 4-- Page I of 2 C. ABSORPTION FIELD DATA Soils Rating in AbsorPtion Strata Date Installed -'/-- % '1 - "'/'Z.. Width of Field t4~ ~ t'l ! Square Feet of Absortion Area Depression over Field (Y~ Results of Last Adequacy Test Date .of Last Adequa.cY,.~e,st T. yPe of System Design Length of Field I ~P'~ '~ "Z..'Z Depth of Field ~ ~:,,~' Gravel Bed Thickness I,J Statndpipes Present ~N) ¥ SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well To Building Foundation Lot ~/'~*' To Water Main/Service Line ' t r> ~'~'" To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ;~ ~,~...=,~')t.~..~ To Property Line I.~ To Existing or Abandoned System on ; On Adjoining Lots To Cutback (if present) D. LIFT STATION Date Installed Dimensions Siz~ln Gallons Manhole/Access (Y/N) ,,r).,~,,...,,,~. On" Level at .... ' .. · ' - ~ "P-mn_.~ ~. Off" Level at " THigh dW~t~r Alarm Level at ~ 'l/ertt"~C/N) ,n ' I durra" este o .... ~~'~~in~ Cy~ ' g Adequacy Test. M~ets MOA EI;ctrical C~ · Comments '*Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.". Signed Company Date MOA No. S & S £NGINEERINr,.. 17034 Etgl,~ giver L~p Road Eagle River, Al.,ka 995~ Receipt No. ~[ Date of Payment Amount: $ /~-0'~ (Rev. 7~88) Back -' Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 MUNICIPALITY OF ANCHORAGE MU/q~CIPALITY OF ANCHOI~,GE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF HEALTH 82~ L Street - Am=t~d'a~, Aladm ~1 ~IRO~ENTA~ F~OTE~I~ ENVIRONMENTAL ENGINEERING DIVISIONTeie~e ~7~ , JULS REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND 2. BUYER ~, LENDING INSTITUTION MAILIN DRESS 4. REALTOR/AGENT MAILING ADDRESS PHONE PRO 5. LEGAL DESCRIPTION STREET LOCATION 8. TYPE OF RESIDENCE SINGLE FAMILY [-I MULTIPLE FAMILY 7, WATER SUPPLY ~1~ INDIVIDUAL· I--I COMMUNITY [] PUBLIC UTI LITY INDIVIDUAL/ON-SITE'* [] PUBLIC UTILITY NuMBeR OF BEDROOMS [] One [] Four {~ Two [] Five [] Three I'-I Six [] Other.__ · ATTACH WELL LOG. A well log is required for ell wells drilled since June 1975. For wells drilted prior to that date, give well depth (attach log if available.) * *1 f individual/on-slte, give installation date ~ If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. TIME DATE INSPECTOR DIRECTIONS: ,~. THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME DATE DATE INSPECTOR INSPECTOR 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS' [] ' ONE' °'~ '~I~'~I~HREE~ FIVE I'--I TWO I--I FOUR [] SIX 2. WATERSOPFLY r-I INDIVIDUAL [] PUBLIC UTI LITY Connection Verified '3. SE / ;E 5;SmSAL SYSTEM r"IINDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified []Septic Tank or [] Holding Tank Size: If Tank is homemade give dimensions: TYPE OF TANK LOG RECEIVED INSTALLER TOTAL ABSORPTION AREA 4. DISTANCES WELLTO: Absorption Area to nearest Lot Line MATERIAL ~.,. t j+' 5. COMMENTS LEGAL DESCRIPTION 0~;~'PPROV E D FOR ~ BEDROOMS CONDITIONAL APPROVAL (letter must accompeny certificate) [::~DISAPPROVED 724310 (Rev. 3/78) DAVID A. SLENKAMP MECHANICAL ENGINEE~ 694-9055 lu~t 4, 1980 ROBERT A. SHAFER CIVIL ENGINEER 694.2979 MUNICIPALITY OF ANCHORAGE DEPT. GF H;;ALTH & ENVIRONMENTAL I ;:-:T[CTION Robert Btu .~man P.O. Dox 1253 ~-.~.le River, Alaska 99577 AU6 5 1980 RECEIVED Dear ~r. Bru~man, Rof,,rence: Lot 5; ~lock 2; Birch lllll Terrnce Subdivision At your request~ a-sewer system adequacy test was p.,rformed on the system locnted on the referenced property. ~m septic tank was pu~ped and verified to have a capactty.'of 1000 gallons. The seepage pit was charged with approximately 1OO0 callons Df '~ter end after a period of 24 hours all the wnter which had been added h~d p~rcol~ted out of the crib. It cnn be concluded from the a',:ove test thnt the se~?e system is currently adequate for a two bedroom home. If we may be of further assistance, plen:;e do not he.~itate to call. SJ ncer~ly~ v Robert~'t ~. Shafer~ P.E. cc. I..~nicipality of Anchorape De.~rtment of H~nlth and Enviorm~cnt~.l Protection Alnska 1.~,tual SavinEs Bank Tenmsters .Branch AT~'F2.~I"N: ,Laurie Cate SRB 196X EAGLE RIVER, ALASKA