HomeMy WebLinkAboutEAGLE RIVER VALLEY RANCHETTES LT 6B
Munic!palityof Anchorage Page I of"-~-.
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
Na~ ~ ~ ~' Wastewater System: ~ New ~pgrade
~ I~(~ ~1~ ABSORPTION FIELD
Phone: I NO. Of B~ms: ~DeepTrench D Shallow Trench ~ Bed ~ Mound ~ Other
LEGAL DESCRIPTION S°'lRating: ~PD/Sq Fl. T°talDepthfr°m°Hgin~Tde:
Lot: ~ Block:~ ~~Su~visi°n: ~ /)e~th to pi~ ~om from. odginat~.~gr~de:lFl. Gravel depth beneath pi~ ~Ft.
Township: I Range: ~~~. Fill addedaboveoriginal~rade:,~ -- I Ft. Gravel length: ~'t.
Number of lines: ~ Distance ~nli~s:
WELL: D New D Upgrade Grav~:~ ~/ rt I ~ I ~-
~Classificati°n~(Private'~ ~A'B'C)'/i~ Total Depth: Ft. Cased To= FL Total absorption area:~Q Ft.~~PiPe materia~~
Drillen Date Drilled: Static Water Level: ,n~alle~
Yield: GPM~ Pump Set a~ Ft. [~ ~sing Height Above Gmund:Ft, TAN K
SEPARATION DISTANCES ~eptic B Holding ~ S.T.E.P.
From Tank F~ld $ation Tank Sewer Lines . J ~
Sudace
Water f~ l~'~ ~ ~ ~ LIFT STATION
Lot ~acturer:
CudainDrain --¢~'~ ~0~1¢ Pump Make&.~,l ] Electrical, Inspections pedorm.
b~
Remarks: BENCH MARK
Location and Description:
ENGI~AL
Department of Hea d H~~ ices approval 't~?.,' ..~'~
Reviewed and approved Date:
72-013 (1/91) MOA 25
Permit No.'~ k"~q'~-~:::::~FI Page _'~' of ~
Municipality of Anchorage
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
Legal Description: _' L.-~,'I'" ~
PID No.:
N
72-013 A {2/91) MOA 25
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
PAGE 1 OF
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW920071
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:ALASKA HOUSING FINANCE CORP
OWNER ADDRESS:PO BOX 101020
ANCHORAGE, AK 99510
DATE ISSUED: 5/01/92
EXPIRATION DATE: 5/01/93
PARCEL ID:05022125
LEGAL DESCRIPTION: EAGLE RIVER VALLEY RANCHETTES
LT 6B
LOT SIZE: 17955 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
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 (ISAACS0).
3. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
ISSUED BY:
DATE:
April 27, 1992
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
CIVIL ENGINEERS
(907) 694-2979
FAX 694.1211
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOIL TEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DEStGN
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
Anchorage, Alaska 99501
REFERENCE: Eagle River Valley Ranchettes, Lot 6B
Request you issue a permit to upgrade the septic system
serving the referenced property.
The existing septic system which was serving a mobile home is
to be abandoned. The upgrade will serve a three bedroom home
therefore an alternate site has been depicted on the attached
site plan.
A test hole was excavated and a percolation test was performed
in the area of the proposed upgrade. Attached is the proposed
upgrade design.
This property is served by a Community water system. There
are no protective well radii which encroach upon the property.
As can be seen from the site plan this lot is large enough for
another future upgrade. We do not anticipate any adverse
effects on neighboring properties by the installation of the
proposed septic upgrade.
If you have any questions or require additional information
for your review, please contact us.
Sincerely,
ROGER J. SHAF~R~ P~'
RJS/lsu
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
I"-- $0'
SCALE
SEPTIC UPGRADE
la,.
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage. Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PER ORUEO POR;
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16-
17-
18-
19-
20-
DATE
Township, Range, Section: '~-t ~,t~ L "1~1 ~, ~--~'~--' ~1'
SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
S
L
IF YES, AT WHAT O
DEPTH? p
E
Depth lo Water Alter_ / Date: .,i ~.,.., ~/~.~_.,,..
Gross Net Depth to Net
Reading Date Time Time Water Drop
m
PERCOLATION RATE '~ (m,nutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN I~ FT AND ~ FT
£ & £ ENC::;=EP. INC ...--- -
PERFORMED BY: 17034 Eagle River Loop Road No. L20,I'~ / [...~ CERTIFY ;~HAT THIS TEBT WAS PERFORMED IN
ACCORDANCE WITH A I IDELINES IN HIS DATE. DATE:
72-008 (Rev. 4/85)
PERr. IIT N0.
r-lUN 'r CZ: 'r r 3L 'r T~-' OF R I'-.I CH~' ';!'. R G E
DEPARTMENT ~F HEALTH Ar. ID Er-IVZRONT{NTRL F,-,'OTECTION
825 'L'~ STREET, ANCHORAGE, AK. 99501
264-4720
01"4--S I TE SENER LIPGRADE PERI"1 I T
( 790461 )
AF'PLICArIT
LOCATION
LEGAL
WILLIAM HENTROBLE SRB 196X E. R.
MRr'I OF HAR
L6B EAGLE RVR VALLEY RRHCHETTE
LOT SIZE
694 9226
i7955 SQLIRRE FEET
TYPE OF SOIL ABSORBTIOH SYSTEM IS: TRENCH
I'IRXlI'IUI~ tIU/'IBER OF BEDRO0;'IS = ~
SOIL RATING <SQ FT?BR)= 228
THE REQUIRED SIZE OF THE SOIL ABSORPTIOr'I SYSTEr'I IS:
DEPTH= ir3 LEI'-.I G Tt-! =..~-- "'8 '-- ISRR%'EI DEPTH= 6
THE LENGTH DII'IENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETHEEN THE SURFACE OF THE
GROUt.iD Ar.iD THE BOTTOr'I OF THE EXCAVATION (Itl FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETHEEN THE OUTFRLL PIPE
AND THE BOTTOrl OF THE EXCAVATION (IN FEET).
RFI~LI I RFD SEPT I C TRt4I( S I ZE= 1[-'~£-'~r3 GRLLOt-~S
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORI'I THIS DEPRRTI'IENT DURING THE
It-ISTALLRTION IrISPECTIONS OF ANY HELLS ADJACENT TO THIS PROPERTY RND THE
NU['IBER OF RESIDENCES THAT THE I,IELL WILL SERVE.
TI,IQ ( 2 ) I I'-,ISPECT I LnI'-.IS ARE REI_n~LI I RED
E:RCI(FILLING OF RHY SYSTEI~ WITHOUT FINAL IHSPECTION Ar. ID APPROVAL BY THIS
DEPARTMENT HILL BE SUBJECT TO PROSECUTIOr.I.
MINI~'IUr,1 DISTRt. ICE BETWEEN A HELL At. ID ANY ON-SITE SEWAGE DISPOSAL SYSTEr,1 IS
100 FEET FOR A PRIVATE WELb OR
i50 TO 20(9 FEET FROI,1 R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC HELL.
OTHER REQUIRE~IENTS MAY APPLY. SPECIFICATIONS A~lD COr. ISTRUCTION DIAGRRr~S ARE
AVAILABLE TO INSURE PROPER INSTALLRTIOH.
PERF.1 I T E:---': P I RES DECEI"IBER 3...-1.. -1 97'--n~ _.
I CERTIFY THAT
l: I RM FAMILIAR HITH THE REQUIREI~ENTS FOR ON-SITE SEWERS AND HELLS RS SET
FORTH BY THE MUrIICIPRLITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
~: I UNDERSTAteD THAT THE ON-SITE SEHER SYSTEI~ MAY REQUIRE ENLRRGEMErtT IF THE
RESIDENCE IS REMODELED TO ItICLUDE MORE THRr{ ~ BEDRO01~S.
SIGHED:
APPLICANT WILLIRr'I WENTROBLE
ISSUED BY
V1 2
PERrqIT NO. (
8PPLICFINT /.4.)!
LOCFIT I ON ,~ ~ ~1 ~Z..JC)..~- '
LEGAL ~'~ ,,
TYPE OF SOIL RB$ORBTION SYSTEH IS:
MAXIMUM NUMBER OF BEDROOMS =
LOT'SIZE
SOIL RFITING
SQUFIRE fEE~
THE REQUIRED SIZE OF THE, SOIl FIBSORPT'ION SYSTEM IS:
E>F'PTH= /0 L.Er-IOTH= ~' i-~F.'Fi'...'EL, DEP-J-H=
THE LENGTH DIMENSION IS THE LENGTH (~N FEET) OF .THE TRENCH OR DRFIINFIEi'D.
THE DEPTH OF FI TRENCH, OR PIT IS THE DISTFINCE L::ETWEEN THE SURFFI~E OF THE
GROUND FIND THE BOTTOM~ OF THE E:Z, CFIVFITION (II'J FEET). ,'
THERE IS NO"SET WIDTH, FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETHEEN THE IOUTFFILL PIPE
AND THE BOTTOM OF THE, EXCFFIVFITION (IN FEET). ,
' c> ,
PERMIT FIPPLICFINT HFIS THE. RESPONSIBILITY TO INFORI`I THIS DEPFIR]ZHENT DURING THE
IHSTFILLFITION IN$PECTIONS~OF FINY WELLS ADJACENT TO THIS PROPERTY FIND THE
HUrIBER OF RESIDENCES THFIT THE WELL WILL SERVE.
TI..-IO .C :~' ::, .I I'-.ISpEI_-:T.. 'r ,-,r-Is I-'il~-E ~-:E~.,U T
BFICKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION FIND APPROVFIL BY THIS
DEPFIRTItENT WILIJ. BE SUBJECT TO PROSECUTION.
MINIMUM DISTFINCE BETWEEN'FI WELL AND FINY ON-SITE SEWAGE DISPOSAL. SYSTEM IS
:lO0 FEET FOR FI PRIVATE WELL~ OR
150 TO 200 FEET FROM F1 PUBLIC HELL DEPENDING UPON THE TYPE OF' PUBLIC WELL.
: HELL LOGS ARE REQUIRED FIND t'IUST BE RETURNED TO THE DEPFIRTHENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER REGUIREMENTS MiRY APPLY. SPECIFICFITIONS AND CONSTRUCTION DIFIGRFIMS FIRE
FIVFIILABLE TO INSURE PROPER INSTFILLFITION.
PfRr~l I T EXP I F:ES DEC:ErlBFR ~:--. ::1_ ..
I CERTIFY THFIT ,
:1.: I FIM FFIMILIFIR WITH .THE REQUIREMENTS FOR ON-SITE SEWERS FIr-ID HELLS AS SET
FORTH BY THE MUNICIPFILITY OF ANCHORFIGE.
2: I WILL INSTFILL THE S','STEM IH FIOCORDFIrJCE WITH THE CODES., ,
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6-650, Anchorage, Alad(a 99602 276-222!
SOILS LOG - PERCOLATION TEST
r-i SOILS LOG
PERCOLATION
TEST
LEGAL DESCRIPTION:
1
2
3-
4
5-
6
7
8
9
10
11
12
13
15-
16-
17-
18-
19-
-of
275 300
SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED? '
IF YES, AT WHAT
.DEPTH?
Reading Date Gross Net Depth to Net
Time Time Water Drop
/ //~(.. /:~o? ---,~z " ----
20 ' ch~
-- PERCOLATION RATE & ~F (minutes/in
72-008 (7/76)
GREATER ANCHORAGE AREA BOROtI~H
HEALTH DEJ~ARTMJ~NT f ~'
327 EAGLE ST. ANCHORAGE, ALASKA 99501 2)'9-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
MAILING ~ .
ADDRESS~'~.~J~_~/'~/-*~' _/~,'~-- ~/~/'-~-~J~ PHONE
LEGAL DESCRIPTION ,/~/-'-'
DISTANCE FROM WELL
LIQUID CAPACITY //'~:~ ~ ~ GALLONS.
MATERIAL .~,, ~_,r._.~._' NUMBER OF
,COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH, DEPTH,__
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAL
NEAREST LOT LINE
SEEPAGE PIT:
OUTSIDE DIAMETER
- OR WIDTH /'.,,"~ /
LENG;H
, , DEPTH
· DISTANCE FROM WELL ~"~"~,/~"..,'/~--~ ~ BUILDING FOUNDATION
· TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~' ~' ~ SQ. FT.
TILE DRAIN FIELD:
TOTAL LENGTH
DISTANCE FROM WELL FOUNDATION ,. NEAREST LOT LINE ~ ~ OF L~.~;~$ --
NUMBER OF LINES .~TANCE BETWEEN ~ ~ IN. TOTAL EFFECTIVE
ABSORPTION AREA / ~__~~ OF EACH LINE~'''~ '
DEPTH: TOP F/TILE TO FINISH GRADE .DEPTH OF FILLER MATERIAL BENEATH TILE IN. ABOVE TILE
WELL:
DISTANCE FROM . WATER
TYPE ~'~ ~' ~~"~/-~'~:~/~--'~ DEPTH ,BUILDING FOUNDATION.~SAMPLE , NEAREST
NEAREST SEPTIC SEEPAGE OTHER
LOT LINE , SEWER LINE , TANK , SYSTEM , CESSPOOL , SOURCES
DIAGRAM OF SYSTEM
DISTANCES:
APPROVED
OAAB-HD-2
GREATEI'"~,NCHORAGE AREA '"-')ROUGH
IIEALTil DEPARTMENT ~ ,~ 279-2511
327 Eagle St. Anchorage, Alaska 99501
Case N0.°2'~
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
NAME OF APPLICANT ! ~,~ .¢ ~r .,
RESIDENCE ADDRESS
LEGAL DESCRIPTION
APPLICATION TO INSTALL: SEPTIC TANK
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH
PERCOLATION TEST RESULTS
MAILING ADDRESS ~/, ¢~?.~'7 PHONE NO.
LOCATION OF INSTALLATION
SEEPAGE PIT ~ , DRAIN FIELD U , OTHER
ANTICIPATE" BATE OF COMPLETION, ~ff '~, -~,-
THIS IS TO SERVE AS /.,/.~'-~-~,,,~,.,, _/,~., , PERMIT TO INSTALL A ,~.~-"'~ ~. ~.~
s,,v,,
DIAGRAM OF SYSTEM
DI~ANCES: ~
~. ~/
H~alth ~uthorit~
I certify that I am hmi~ar with the requkements of Greater Anchorage Area Borough Ordnance No. 28~~ .
above des~ibed system is in accordance with ~id code. '" ~
Parcel I.D. #
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
1, GENERAL INFORMATION
Complete legal description
Lot 6B; Eagl~ River Vat~y Ranch~tt~s
Location (site address or directions)
Property owner
Mailin~ address
Lending agency
Mailing address
Agent
Address
18730 Man O' War
¢~rr:o,.,~o~o Day phone
Day phone
Day phone
$76-1900
e
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
X×
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 {Rev. 1/91) F~'ont MOA#21
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 of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is s~fe, 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
Address
Engineer's signature
6. DHHS SIGNATURE
Approved for --~
Disapproved.
Conditional approval for
.~ & .~ ]::N~tNE~.IN~ Phone
17034 Eagle River Loop Road No. 204
~-agle i<iver, Alast(a ~*'/5'//
Date
bedrooms.
bedrooms, with the folloWing stipulations:
Additional Comments
Date .~'7---
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragrapl~ 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 in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
MuniciPality of Anchorage
Department of,Health & Human Services ......
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: L~'JT",~; ~ IA '~--~.~P~cel I.D.
Well type
A. WELL DATA ,
If A, B, or C, attach ADEC letter. ADEC water sys;;em'number'''~~ '~--~ ~ ~
Log present (Y/N) Date completed Driller
Total depth Cased to
Sanitary seal (Y/N)
casing heigh~
Wires properly protected (WN!
Date of test
Static water level
Well flow '
Pump level
SEPARATION DISTANCES FROM WELL TO:
FROM WELL LOG
g.p.m.
AT INSPECTION
Septic/holding tank on lot
Absorption field on lot ~ ~''~-
Public sewer main '
Sewer service line
WATER SAMPLE RESULTS:
Coliform Nitrate
; On adjacent lots
; On adjacent I°ts
Public sewer manhole/cleanout
POtroleum tank
Date of sample: Collected by:
Other bacteria
B. SEPTIC/HOLDING TANK DATA
' ~-~/~",~'/q ~"'' Tank stze I~ Compartments
Dateinstalled-~· y ,..,j.,,:i.,,.,Foundationcleanou~,N) ~ Depression(Y~) J'~
Cleanouts~l~l') ?:
d/4
High water alarm ( · 'Alarm tested (Y/N)
Date of Pumper ~ -
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
,~/.A.,_,, ":'~'" I~'
: ·: Onadjacentlots~:~:~~Foundation
Well(s) on lot
/
Topropertyline tl~2~'Ll~' ' ' 'Absorption field ' '~--~"~ ........... Wat&rr~ain/s~rgicelin~
Surface water/drainage I~::)~ ~'['-- ' '
72-026 (Rev. 7/91) Front
CONTINUED ON BACK PAGE
LIFT STATION
Date installed '
Size in gallons
Vent (y/N)
: ' : Mandf~cturer 4 * ' : r ~ ~ '
'' ';Pump on"l
evel at ':" ~ '" "Pump off" level at ~
Cycles tested
High water alarm level
Mee~ts MOA'electrical codes (Y/N)
SEPARATION DISTANC~M LIFT STATION TO:
- -Well on lot / ' ~ ' '
Surface water
Soil ratingr ~'~ystem type "'J~'~ ~
Gravel thickness ~:~.z~ / Total dep.th ~ /
On adjacent lots
D. ABSORPTIOi~* FIELD'DATA
Date installed
?', I; ? . /.
Lengt.h_; ~ :" Width
Total.absorPtion ar~ea' Cleanouts resen N)
Depression Over Date of adequacy test
Results (pass/fail)i I~J..~.l~.J' .~---~?~"T".~'~ for
Peroxide treatment (past 12 months) ( ~ ' ~ If yes, gK'e date
'SEPARATION DISTANCE FROM ABSORPTION FIELD TO: .: .
-Welionlot- * ]'~/'~. " : ':' :: ....
On adjacent lots"~-~:D~/'''r' ' Propertyline
To building foundation i ~,1 To existing or abandoned system on lot
On adjacent lots ~ "'~ Cutbank t,..tC>l~J..~__.. Water main/service line
Surface water [ C:)(~:) ~ '{'- Driveway, parking/vehicle storage ar~a'
'Curtain drain /..~t~)'r,~ '[~.d~C:~i,c.~l~ ....
bedrooms
E. ENGINEER'S CERTIFICATION
........ :i.~ , .
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspe~ion.
,. . , ~ . ,,.,.,..~_'~'~._ ~: ~
' ,',',. :.: , :': ... ·
S & S £N~iNEERiNO '" ~"~.~... ~ %~..~j,~. .
~nglneers Name ..... s-1--.~, ~aJ~J~eee ~
Date ~ ~ ~ O--~ '~ R~E~ J. flHAFER: ~
HAA Fee $
Date of Payment ~Z
Receipt .umber
72-026 (Rev. 3/91) B~ck MOA 21
Waiver Fee:$ ; - '- '
Date of Payment
Receipt Number
DEPT. OF ENVIRONMENTAl, CONSERVATION
ANCHORAGE DISTRICT OFFICE
800 E. DIMOND BLVD., SUITE 3-470
ANCHORAGE, ALASKA 99503
WALTER J. HICKEL, GOVERNOR
(907) 349-7755
April 24, 1992
FOR: S & S Engineering
PWSID # 210875
My review of the records on file in this office reveals that the Norfolk Utilities (Eagle River
Valley Ranchettes), Class "A" Public Water System, is in compliance with the routine
coliform bacteria sampling requirements listed in Table C, and with the inorganic sampling
requirements listed in Table B of 18 AAC 80.200.
Sincerely,
Byron Roys
Project Engineer
BR/cf
1 MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date
GENERAL INFORMATION
Legal Description (include lot, block, subdivision, section, township, range)
I
Location [address or directions)
(b) ."Applicant Name L.c>~z.,~.~,-~.> J~ I ~,.~a~_.- Telephone: Home Business .~- ~ .
Applicant Address ~[; ~~ ~ ~~ ~~; ~.~
(c) ' Applicant is (check one): Lending Institution ~; Owner/builder ~; Buyer ~; Other ~ (explain);
(d~~ Lending Institution ~ ~ ~~ ~ Telephone
Address ~~ ~ "'
(e) Real ~tate Company and Agent ~ ~ -- ~ ~. ~ i ~ ~ ·
: Address ~~ ~
Telephone J ~ ~ ~ ~
(f) ~ th~ HAA to the followin~ address:
TYPE OF RESIDENCE
Single-Family ~ .Multi-Family
NumbEr of Bedrooms
Other
WATER SUPPLY
Individual Well !-I Community I-t Public,~
Note: If community well system, must have writte.n confirmation from the State Department. of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
OnsiteJ~- Public [] Community[] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 ors4)
ENGINEERING FIRM PROVIDING ,NSPECTIONS, TESTS, FILE SEARCH, DA'I,~ AND INFORMATION *-' ~..
As certified by my seal affixed hereto and as of t.he validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-s!te 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
Address
Date
Telephone
Approved fo~,'~--c--''~' bedrooms by
Approved ~.~ Disspprove~' Conditional '~,"
Terms of Conditionnl Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval c~rtificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
72-025 ($1/84)
A. WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264**4720
MUNICIPALITY OF ANQ-IORAGE
DEPT. OF HEALTH &
ENVIRON~ENTAL PROTECTION
0 Blg85'
Well Classification.
Well Log Present (Y/N)
Total Depth
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/J=lol4;lim3 Tank on Lot . ~t'Jt-
To Nearest Edge of Absorption Field on Lot '~ ~
I! A, B, C, D.E.C. Approved~;Z~l)
Date Coml~leted Yield
Cased to ~/~ Depth of Grouting
Pump Set .At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer Line To Nearest Public Sewer
Cleanout/Manhole To Nearest Sewer Service Line on Lot
Water Sample Collected by ; Date
Water Sample Test Results
Comments . L,- ~
B. SEPTIC~G TANK DATA
Date Installed /'o-;Z,- ~'~
Standpipes~N) Air-tight Caps ~/N)
Depression over Tank (Y~)
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/i,4e~dh,~J-Tank:
To Water-Supply Well ~ I.~
To Property Line ~ O ~ '-}" '
To Water Main/Service Lin~ ~ ~ t,.~ :'
Course ~
Size ?~ No. of Compartments
Foundation Cleanout (Y/~
Date Last Pumped
; for --
Temporary Holding Tank Permit (Y/N)
To Building Foundation ~
To Disposal Field ~.~ t
To Stream, Pond. Lake, or Major Drainage
Comments
Page I of 2
72-026(11/84~
C. ABSORPTION FIELD DATA
Soils Rating in Abs.orption Strata
Date lnstalled (~/r-'/~ ..-. :~/,'-'/~ Length of Field
' - i $ -- .
Width of Field I~.. / "~'" Depth of Field
/ Gravel Bed Thickness
Square Feet of Absorption Area "P'~'~ / ~-'3t'~C)'~ Standpipes Presenti~l)
Depression over Field (Y~. -,' / Date of Last Adequacy Test , /~ -/- ~'
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well .?~.~....~
To Building Foundation I,~:~ ~'~
Lot
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots '~'~:) ~''~
Tp Cutbank (if present)
Comments
LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Dimensions
Manhole/Access (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Electrical Codes (Y/N)
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 ~ '~
Compag~ ;~ ~
Receipt No, '
Date of Payment
Amount: $ ~
Page 2 of 2
72-026 (11/84)
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA 99501
BILL S~IEFFIELD, GOVERNOR
Telephone:
Addre~:
274-2533
According to records 9p.~ile in this office the
ter System is in compliance with the St~e Drinking
Water Regulations
Sincerely,
,. ' ' MUNICIPALITY OF ANCHORAGE. ENVIRONMENTAl., P~,OTECTION
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
' 825 LStrlet-Ancho~'lge. Alask. 99501 'JUL, P. 6 1979
ENVIRONMENTALENOINEERINGDIVISION RECEIVED
Telephone
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: C~nplete all parts on page t. Incomplete reques~ will not be proeell~ed. R~ "11o~ ten (~tO) ~ for I~r~ing.
1. PROPERTY OWNER ~.~/~ PHONE
MAI LING ADDRESS ~._~
PROPERTY RESIDENT (if different from abo~,~) PHONE
2. BUYER PHONE
MAILING ADDRESS
3. LENDING INSTITUTION ~ PHONE
I
MAILING ADDRESS
4. REALTOR/AGENT I PHONE
I
MAILING ADDRESS
r STREET LOCATION 0
I E. TYPE OF RESIDENCE .. NUMBER OF BEDROOMS
[] One [] Four
~ SINGLE FAMILY [~ Two [] Five
[] MULTIPLE FAMILY [] Three [] Six
[] Other
7. WATER SUPPLY [] INDIVIDUAL·
COMMUNITY
[] PUBLIC UTILITY
· ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
SEWAGE DISK)SAL SYSTEM
INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
· *If individual/on-site, 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.
72-010(3/78)
THIS SIDE 'FOR OFFICIAL USE ONLY ~ .
DATE RECEIVED
I NSPECTI ON APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOIV~
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY ~ --~-'~ ~,~
Connection Verified INSTALLER
[]Septic Tank ~_r [] Holding Tank
Size: f~-~) If Tank is homemade SOILS RATING
give dimensions:
TYPEOFTANK MANUFACTURER ~
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCESwELL TO: Septic/Holding Tank IAbsorption Area JSewor Line I Neerest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
I~'APPROVED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE BY (Title)
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
DAVID A. SLENKAMP
ROBERT A. SHAFER
MECHANICAL ENGINEER CIVIL ENGINEER
694-9055 JVIUNICIPALITY OF ANCHOI~AG[ 694-2979
DEPT. OF H~ALTH &
AtJgLtst 15, 1979 £NVIRONMENTAL F~OTECTION
William Wentroble
100 Man of War
Eagle River, Alaska
99577
AUG 1 6 979
RECEIVFD
Dear Mr. and Mrs. Wentroble,
Reference: Lot 6B; Eagle River Valley Ranchettes
In our letter dated August 6, 1979 we informed you that your
seepage System was inadequate and an upgrading of the system
would be required. In order for the system to be upgraded,
you requested that a soil test be preformed. This test was
completed on August 11, 1979, and a permit to upgrade the
system was obtained from the Municipality. (Copies enclosed.)
Your excavator completed the upgrading in accordance with your
permit and all work was inspected by us. A copy of the in-
speeti°n report forwarded to the Municipality is also enclosed.
We sincerely hope you are satisfied with the service provided
and if we may be of further assistance please do not hesitate
to call.
Sincerely ,.~
'A. ER, . ..
encs: 4 ~
CF:
Area Realty w/o encs
ATTN: 'Sue' Gallion
Department of Health and
Enviornmental Protection w/o encs
SRB 196X EAGLE RIVER, ALASKA
DAVID A. SLENKAMP
ROBERT A. SHAFER
MECHANICAL ENGINEER
694-9055
AUgust 6, 1979
CIVIL ENGINEER
694-2979
William Wentroble
100 ~n of War
Eagle River, Alaska
99577
Dear ~. Wentroble,
Reference: Lot'6B; F~gle Rtv~ Ran~hettes"
A~ sewer system adequacy test ms performed on August 2 and 3, 1979
per your request. The test ~us to verify the sdequacy of the sewer
system (septic tank and seepage pit) serving a 2 bedroom mobile home
on the referenced property.
The septic tank was humped and verified to have a capacity es sho~n by
municipal record bf I000 gallons. The seepage pit was full of water and
approximately 800 gallons hsd to be removed. The system was recharged
with approximately 850 gallons of fresh water. Measurements taken
at the end of a 24 hour period showed ~hat the system had lost approxi-
mately 114 gallons through percolationl This quantity is satisfactory
for approximately 0.74 bedrooms.
I regret to inform you that as a result of the above test it can be
concluded ~hat the system is not adequate and will reouire upgrading
with an absorption trench tied into the seepage pit that Mill be sufficient
to carry approximately 1.25 bedrooms.
If we can be of further assistance, please do not hesitate to call us.
CF:
Area Realty
ATTN: Sue Galian
Department of Health and
Enviornmental Protection
aRB 196X EAGLE RIVER, ALASKA