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HomeMy WebLinkAboutSEIDLER LT 1Seidler Lot 1 #050-131-10 Municipality of Anchorage tA��,t. � ,Y , a © Development Services Department n "' Building Safety Division' W, On -Site Water and Wastewater Program, 4700 S. Bragaw St, P.O. Box 196650 Anchorage, AK 99519-6650 Page/ of 3 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SLAJ(jj402.2a PIDNumber: 056—/3/—/0 Name: Cff�t2L/� 'F4SJ-E1_L/ Wastewater System: ;KNew ❑Upgrade Address' q.25 Lt/60445- ���� ABSORPTION FIELD Phone', Number of Bedrooms: D Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound S W7D� Other. LEGAL DESCRIPTION Soil Rating / GPD/Ft' Total Depth from original grade Block'. Lot Subdivision S�rDGE 2 Depth to pipe bottom from original grade', Ft. Gravel depth beneath pipe: 3_5 Township: Range: Sectictz - 3 Ft. Fill added above original grade: Ft. Gravel Length �/ Ft. eC � ( Ft. Well: Ex(ST G El U rade /N ❑ pg Gravelwitln: •, Number of lines: Distancebaen lines: Ft. 2— S Ft, Classification (Pr te, A, B, Cr tal Depth'. Cased to: Ft. Total absorption area'. /� �QQ Pipe Material: Ft. Driller, ,% Date Drilled Stati afar Level; Ft' Installer: � pp 9 NC' d6J X / Y C....�. 40 Date Installs, / Ft. DE�d Exe.4�i.4rfoN / c ViP p Set at '� Casing hl Above Ground: > GPM Ft. Ft. : TANK SEPARATION DISTANCES ❑ Septic ❑ Holding S.T.E.P. ❑ Other: To From Septic Tank Absorption Field Lift Station Holding Tank ublWPrivate Sewer LineAtff'c)tied Manufacturer: Capacity: Gal. Well 0�,f, VV /�/r/f (/V /�o �� �� Material: 5 Number of Compartments: a Surface Water /0044 /00 — LIFT STATION Lot Line z,r r.(— / Q rf- Z C rf' V .. ize' /� l5106 Gal. Manu acturer /�^ /�/T//� 1C lr`- /�1Vi K.. Foundation .5r ( f _ 'Pump on' level aC Pump off' level at: High water alarm at ( in. 3`1 in. Curtain Drain •- ^- — ^ Pump Make 8 Model Electnw edormetl by: i�u(c uB EtEG7jZrc ,ii,Jc. Remarks' aPG r L/N V 7' oxff,GC P B N ARK ST�4 KE9 .S�Ku� o� Fo c2 Location and Descnplion: Q G F f3L Q CC, w ALL cy �F% �—C W � Jc z,`_, V !-�rt��� Assumetl Elevation: V JOCI Ft. wit Q A4 i•tQ�•4"•........,SOS �1 �• performed by. Or k7(M Dates: 1a I 49TInspections • x•.• �*;...�4 2n7 . ..1 Cz Development Services Department Approval �� st•.an W. En Reviewed and approved by: Date: ,� �/� ,_/� �--� f (Rev. 12/00) �fut% PE 6256 'V�r 1�9F�a........•.••�E+� A40FESSIONP,,,�r 1� zz Z� Mz Z mma a � d O M -P Dn U H n V J I U) bd F -I 0 H r- I I ---1 � -i 3 r � p iTl MnD H M v <mz� Z r V g o r Q M o H d N Irl M � o a t m m V) � CD w 0 d F-1 N O o X a � z ti N 0 w +�� N r c CD 0 CD 0 m M b m m r r or O O O I O �r10=1v, Z a O + 'O W -P N �r -' U) o��,rtn S v <mz� r m o N o M 3 3 0 to 3 CD a 0 Z X a S o 3 X +�� N o CD D D O v !n 0 h c n n. G -0 SC/) _� 0 0 O '+ N 5 ff �, CD fA O oLA Ul 3 I> <+- 0_ r- N m o C) N N ca O N O c v . p C1 0 O p O CD rt � O O (D O 0 (JI 0 CD m 3S � O O 3 cn �. (2 D O C 3 0) CCD 0 0 C 0 0 0 ONCD a < .O -t o O O O CD _0 Z CD O Cl 10' 10' Utility Easement Q 0 p � 7 n�7C��(nZ�CnZ O 0--I O O N szr -:r :Y M M M M Q d 0-0- 01 C)' Cn -P- 4'. (A (A (A Q UtC)'Cn-P-.p(A(A(i 'D O) �N�ppCnVj cn � O�(Acn O PCnpNjl D7 �r10=1v, + 'O W -P N -' p o��,rtn m <mz� r m o N 3 3 0 to 3 CD a 0 Z 3 3-0h N S 3 z +�� N o O !n h c n n. G -0 SC/) _� 0 CD '+ N 5 ff �, CD fA O oLA �< 3 I> <+- 0_ r- c 3 N N N . 3 Lot p 0 (D O +0 3 3S 3 cn �. o O C o Y 0) CCD 3 3 r 0 ONCD o CD _0 Z O Cf) rt O c rt S m O rn Q- 10' 10' Utility Easement Q 0 p � 7 n�7C��(nZ�CnZ O 0--I O O N szr -:r :Y M M M M Q d 0-0- 01 C)' Cn -P- 4'. (A (A (A Q UtC)'Cn-P-.p(A(A(i 'D O) �N�ppCnVj cn � O�(Acn O PCnpNjl D7 # W � tz F- F- --- m F- m J 5 w ? 7 0 w \ Nb,L9jLmr-' oq aq F- m 3 m \ { } \ M R \ \ g n j \ \ 99ƒ2112 rD®a`ro /# 4� �»_ (D -t) \)!e §a~7�G ±;/,9*2 g //� n& E _-CC5- $U®®-0« a® __ .:3 0 ®_3ac �lC0 %@tn �_� \\\\ some nn Q-0 (D &2 7\ro-5 >a9n3 RJn;r o=, on<,- / n m _q g- \fo P 7[\ \ §2\ /�0 /\ \ [ ; REDI ELECTRIC, INC. DAILY FIELD REPORT Job Nok: Page: of Job Name: r 9y So So Date: 7-7/6-6y Location: Le e Weather: Foreman: L r%N' r' Temp. a.m. p.m. No and Type5 of Nfen Working: (lours SPeci�at Tm i - ' uip ne t oil Si No. ST I OT DT General Foreman Foreman Journc man Apprenticcs Total Men 8 Sub -Total Hours Grand Total Hours I For the Record - Problems/Comments: \ Signature USE SUPPLF.AIGNT #1 FOR ADDITIONAL COMINIE.NTS '7-1616q At ODAJ MUNICIPALITY OF ANCHORAGE #/36 Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SWO40222 Legal Description:§; IDLED'L 1 Design Engineer: 0838 North Rim Engineering Owner Name: CHARLIE TASSELLI Owner Address: 11925 LUGENE LN EAGLE RIVER , AK 99577-7902 Date Issued: Jun 25, 2004 Expiration Date: Jun 25, 2005 Parcel ID: 050-131-10 Site Address: 011925 LUGENE LN Lot Size: 37220 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date: Issued By: I 1 11 Date: G o Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci,anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-131-10 Permit Number SW Property owner(s)C azKL/ F TAS (F! C ( Day phone Mailing address (1 Mailing address (2y Gu, ^$SAFETY Code �.F %'7 Legal description (Lot, Block & Sub'd.) G- a7— (F .5-EIpGE5 yA Legal description (Section, Township & Range) Lot Size 0.O' -S Acres/Sem. Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner oyVhoriz6d agent) Permit Fees: /LO Waiver Fees: Date of Payment: !o//8/c" � Date of Payment: Receipt Number: SPF Z `{ ,tel_ Receipt Number: (Rev. 12/00) FROM :NORTHRIM FRX NO. :9076947026 Sun. 25 2004 07:51RM P1 Date: 6125/04 To: Joe, MOA FAX NorthRim Engineering Steve Eng, PE, PH (907)694-7028 830-4186 (cell) NorthRimEng@aol.Com Subject: Seidler S/D, Lot 1, Eagle River Joe, Number of Pages: 3 Fax: 249-7847 We had a design change on this one. I increased the trench length & tank size. I can bring in originals on next office visit. W G_ p„ T FAqkl-% 3 6toi2 coati J' 70 Thanks -Steve EN BRIM , FEEERIN6 NorthRim Engineedng 17237 Bear Paw Circle Eagle River, AK 99577 907-694-7028 907-830-4186 June 17, 2004 Joe Goodall MOA On -Site Water & Wastewater Program 4700 Bragaw St Anchorage, AK 99519 RE: Seidler SID, Lot 1, Eagle River Dear Joe, The existing septic system on the referenced property failed an adequacy test. A replacement system is necessary. A S.T.E.P. tank will be required to pump to two up- slope absorption trenches. Please review the replacement septic system design for the existing 3 bedroom single family home. I have included design plans & specs, design guidelines, & soil tests. If there is need for additional information or clarification please give me a call. Sincerely, Steve Eng, PE, Design Enclosures m CD CD 0CD m I- d fn 3 O O N U hm TI v N 'o �zy.� ""I T a N �y'rtlWg`§ M C "' Q � < - oCb v v o 3 F— cn r O d r m 0 D � m Z � 3 ZJ m d m z ci ? z O F-v� o r� R) CD 0 3 0 o 4 o m m '^ V! 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The existing septic system failed an adequacy test. The best placement for an absorption trench is upslope, which will require a S.T.E.P. tank (lift station). This requires a 1500 gallon S.T.E.P, tank, manufactured by Anchorage Tank & Welding per Orenco Systems specifications. This lot is about 0.85 acres in size and no adverse impacts are expected from development. The neighboring lots range similarly in size. The closest property to the septic system is to the south and is undeveloped. No conflicts to the other lots will take place by this septic system replacement. There is a 10' utility easement that has not been encroached upon. Soil tests found typical soil for this area; sandy gravel w/silt. The system utilized a 5' wide trench with allowable reduction factor. An application rate of 1.2 GPD/FT2 with 0.54 reduction factor for utilizing a 5' wide trench. Bedrock was encountered after 12'. Water was also present at 12'. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. a Two compartment, 1500 gallon S.T.E.P. tank, conforming to Anchorage Tank & Welding/Orenco Systems Specifications. a Watertight couplings on inlet & outlet a 5 foot minimum between the tank and bed. 10 foot to property lines. a 2 feet of cover and i" insulation is required for trench. a Tank & solid pipe must be set on well compacted, stable soil a 4 inch diameter cleanouts with airtight caps are required 1 to 4 feet from foundation wall, prior to any 90 degree bend in 4 inch line. a All cleanouts must extend to at least ground level a In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron a Trench to be placed level, minimum of 4 feet to groundwater, 6 feet to bedrock from drain -rock a Drain rock to be %: inch to 2 %: inch screened. Drain rock to be distributed uniformly throughout the trench. a Distribution pipe shall be 1.25" Schedule 40 PVC w/ 1/8" orifices @ 27" on center w/ Flushing Valve Box at end of pipe on both ends. a Force main shall be 1.25" Schedule 40 PVC, conforming to Anchorage Tank & Welding/Orenco Systems specifications. Force main burial to be 4' minimum. a Silt barrier (filter fabric) to be installed above the drain rock a Smeared trench sides must be raked or scarified before drain rock placement a Backfill over drain rock must not be less than 24" & 1" insulation. The finish grade must be mounded to promote drainage over the bed a Insulation must be placed over any pipe installed under driveways or parking areas a Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, PVC Schedule 40. a Sewer Service Line is minimum 2% slope a Septic Tank to be pumped every two years or when required a Insulation board shall be extruded direct burial polystyrene (Dow Styrofoam HI or equal a The existing septic system will be abandoned; the septic tank will be pumped, crushed, and filled with sand/gravel or removed and properly disposed of. t TER WELL W . ar O / n `# NG WATR WEA th$ PR L SEPTIC SYSTEM ot) t lv 0.85 ❑T . �.. ". Sy `rx ' e2ih � 3"z�'.rs ✓�+4 i fIV � :. ,;' N" d�} eye yt��•Y `f,�� >u�^,v^ �c� 4 lr�4 L❑PE @15% `� i M L�CS�'�x{' (� (�4 d L+ 4 fF i A'+3 .. ���••' ir`. � T+9 N°Yrh Y r47 �'•+SF� `+k a a,.Xa z a�'�S-`'tit -' . GENERAL D"G 'k STEY on, `l f\TD ELOPED- .. v�a. al�r�✓3 e�s5�' r` iG '' :Y ,,.. y D �P a x`�ti:,' w49a•J f Y.'.Y }. 'i ms77 tyty: 't F 1,+ AY2bW. ;kawd}„xc �x-'Nv.�'^• mmv s 1 �s ft NORTHRIM @��p .....•... s*:4s' ,�`� SEIDLER S/D AREA PLAN ENGINEERING , s 17237 Bear Pow Circle Eagle River, Alaska 99577 ce- ,. r 1• = F � LOT 1 Dotm HEFT: 6/15/04 2/4 0 S❑ILS LOG PERC❑LATI❑N TEST � ���INTFE ERING I Date Performed: 6/15/04 Performed For: Charlie Tasselli Legal Description: L1, Seidler S/D DEPTH (FEET) Organic T,H, Location: See Attached Design Slope @ 15% As Indicated Broken Rock Bedrock Groundwater? Yes Depth 12' Water Depth After Manitorinn. Nnnp no+P: AIPP/nd # Date lGross Time Net Time Depth Net Drop 1 6/15 0 -- 9.25' -- 2 6/15 2 2 min 7.75' 1.5' 3 6/15 15 -- 9.25' -- 4 6/15 17 2 min. 7.75' 1.5° 5 6/15 30 -- 8,5' -- 6 6/15 32 2 min 7.0' 1.5' Percolation Rate 1,33 min./inchPerc Hole Diameter 6' Test Run Between 3' and 4' Comments: Performed By NorthRim Eng, CERTIFY THAT THIS TEST WAS Performed in Accordance with All Sta /Municipal Guidelines in Effect ON THIS DATE, DATE 6/22/04 ��, ,.......,- ,� NORTHRIM p* * TESTH❑LE LOG T, H. 1 ENGINEERING , ; 17237 Bear Paw CJrale afire Edoo River, Alaska 99577 �i -exss a } GE❑TECHNICAL %t -o- 6/22/04 MUNICIPALITY OF ANCHORAGE p DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/Oil WELL INSPECTION REPORT NAME PHONE [] N % uPGR�IUE�— MAILING ADDRESS 7�X- ---- LEGAL DESCRIPTION 107__ LOCATION`/� NO. OF BEDROOMS 7� 0 0;.O Well Absorption area Dwelling PERMIT NO. U Y DISTANCE TO: Z Manufacturer-�� Material —_ No. of compartments LH _ Liq. rapacity in gallons IF HOMEMADE: Inside length Width Liquid depth 0 �' DISTANCE TO: Well Dwelling PERMIT NO. 02< zH Manufacturer Material Liquid capacity in gallons O 2 DISTANCE TO: Well / G (3 i Foundation Q r Nearest lot lin �f PERMIT NO. t / U 5, s—( J LL Z No, of lines r Length of each line Total lengthofVines / Trench width ,-�— G� inches Distance between lines FTop of the to finish grade Material beneath tile0 Total effective ab/gor do area Length Width Depth PERMIT NO. LU f9 F- Type of crib Crib diameter Crib depth Total effective absorption area a w° y DISTANCE TO: Well Building foundation Nearest lot line J Class��a .* Depth Driller Distance to lot line PERMIT NO. J V W DISTANCE TO: Building foundation Sewer line Septic tank Absorption areas) OTHER PIPE MATEF31ALS% SOIL TEST RATING INSTALLER G 1 1313.5 rc,Xc REMARKS pn _ w r5 -A)6-1 . -- e / o LEGAL is c ��- APPROVED /DATE 721013 (Rev. 3/78) <_�r THE RET(AUIRED SIZE OF THE SOIL HBSORPTION SYSTEM IS� �31 �EY: too ����= J E-.',.: R__ PEED[`::�l����� � THE 1 -140TH 10����Q 1 �U Il�� ��� ���U�������� THE TfaENCH (mR DRHINFIELD, THE DEPFIR TMEll T HEALTH HND TION THE SURFHCE OF THE ' 825 'L' STREET/ HNCHORHGE, HK 99501 OF THE EXCHYHTION (IN FEET). THERE 264�4720 SET WIDTH /�*� WS! -­!_E,.��, 37 -Y KEE Q EEE h j IRE too U 1"" U> IEEE 9 E'-1 �P:�l� � � ��h8� PERMIT NO ( 811099 ) BETWEEN THE OUTFHLL PIPE HND HPPLICHNT JOHN HUBERT EXCHYHTION (lN FEET). SR BOX 694��979 L HPPLICHNT HHS THE RESPONSIBILITY T0 INFORM THIS LEGHL LOT A. SIEDLER SUB INSPECTIONS LOT SIZE ]0000 SQUHRE FEET TYPE OF ' SOI NUMBER TRENCH THHT THE NELL WILL SERVE. MHXIMUM NUMBER OF BEDROOMS SOIL RHTING 150 Q A > THE RET(AUIRED SIZE OF THE SOIL HBSORPTION SYSTEM IS� MINIMUM DHNCE BE1WEEN H WELL HND HNY OP&SITE SENHGE DIS�OSHL SYSTEM IS 100 FEET FOR H PRIVRTE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DI�T�NCE FROM H PRIVATE WELL TO R PRIVHTE SEWER LINE IS 25 FEET HND TO H SEWER LINE IS 75 FEET. OTHER REQUIREMEF MHY PECIFICHTIONS HND CONSTRUCTION DIAGRAM ARE HVHILRBLE TO INSURE PROPER INSTHLLHTION F!" FEE IT: B-1 �1 '11^ ���1: nos IV, FIE 1:1 Q M KEY�� I THAT 1 I HM FHMILJHR WITH THE REQUIREMENTS FOR ON~SITE WELLS HS SET FORTH BY THE VII NICIPHLITY OF HNCHORHGE 2: I WILL INSTALL THIE SYSTEM IN HCCORDHNCFE WITH THE: CODES. ]� I UNDE�STHND THRT THE ON—SITE SEWER SYSTEM MHY REQUIRE ENLHRGEMEHT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN ] BEDROOMS SIGNED���z���� — RPPLIC�NT JO�N HUBERT ISSUED BY ' DHTE f~f�����~���~�~~—'~----�--��'~� �31 �EY: too ����= J E-.',.: R__ PEED[`::�l����� � THE 1 -140TH DIMENSION IS THE LENGTH (IN MET) OF THE TfaENCH (mR DRHINFIELD, THE DEPTH OF It TRENCH OR PIT THE' BETWEEN THE SURFHCE OF THE GR�U�D RND THE': BOTTOM OF THE EXCHYHTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRHVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFHLL PIPE HND THE BOTTOM OF THE EXCHYHTION (lN FEET). PERMIT HPPLICHNT HHS THE RESPONSIBILITY T0 INFORM THIS DEPHRTMENT DURING THE INSTHLLHTION INSPECTIONS OF RNY WELLS HDJRCENT TO THIS PROPERTY HND THE NUMBER OF RESIDENCES THHT THE NELL WILL SERVE. �. I CIO Q A > �'01", 1 F`!"l E"_:� ��11__9 T���� ~ IE: HCKFILLING OF HNY SYSTEM WITHOUT FINAL INSPECTION AND HPPROVHL BY THIS DEPHRTMENT WILL BE SUBJECT TO P�Oi".; ECUTION MINIMUM DHNCE BE1WEEN H WELL HND HNY OP&SITE SENHGE DIS�OSHL SYSTEM IS 100 FEET FOR H PRIVRTE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DI�T�NCE FROM H PRIVATE WELL TO R PRIVHTE SEWER LINE IS 25 FEET HND TO H SEWER LINE IS 75 FEET. OTHER REQUIREMEF MHY PECIFICHTIONS HND CONSTRUCTION DIAGRAM ARE HVHILRBLE TO INSURE PROPER INSTHLLHTION F!" FEE IT: B-1 �1 '11^ ���1: nos IV, FIE 1:1 Q M KEY�� I THAT 1 I HM FHMILJHR WITH THE REQUIREMENTS FOR ON~SITE WELLS HS SET FORTH BY THE VII NICIPHLITY OF HNCHORHGE 2: I WILL INSTALL THIE SYSTEM IN HCCORDHNCFE WITH THE: CODES. ]� I UNDE�STHND THRT THE ON—SITE SEWER SYSTEM MHY REQUIRE ENLHRGEMEHT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN ] BEDROOMS SIGNED���z���� — RPPLIC�NT JO�N HUBERT ISSUED BY ' DHTE f~f�����~���~�~~—'~----�--��'~� /JET SOILS LOG �, +.e\ \ I MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264.4720 ❑ PERCOLATION Net Time 15 Net Drop SOILS LOG — PERCOLATION TEST PERFORMED FOR: +✓ ,/ / #a Xet,- •✓ , DATE PERFORMED: O LE=GAL DESCRIPTION: �.. / �5Ill'd- ley DEPTH (FEE 1 � / �r�`« 2 � 3 C9, � U 4 y 5- 0� 6 o f 9 - ob 10- ; I 11 WAS GROUND WATER ENCOUNTERED? 12 IF YES, AT WHAT DEPTH? 13- 14- Date Gross Time Net Time 15 Net Drop 16 , r t � Yl i n•Y� t 17- ;so RObort A. 19 6�K PE0. 1a a:y t lY ey fin s SITE PLAN L O P _ / E l� ( / Reading Date Gross Time Net Time Depth to Water Net Drop t 20-1 PERCOLATION RATE (TESST RUN BETWEEN COMMENTS //j�L'J 7—��L�' Le PERFORMED BY: „7 '(S ��✓G-l�E%%/���✓� CERTIFIED B 72-008 (6/79) �(minutteesss//inch) FT AN G7 Li�liU C� � ro-O)o/c DATE: f(! ✓�'� 0 t GAA8-HD' GPFATER ANCHORAGE AREA BOROI'f�-y HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 _ INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING NAME ADDRESS A'DX %`'�i �- G PHONE, -?&',y LOCATION CFDTI(' TANIV. N r I __e� c(("r s S OP NUMBER OF DISTANCE FROM WELL �G � � �. MATERIAL s �G"�`"� COMPARTMENTS dam" LIQUID LIQUID CAPACITY G� _GALLONS. INSIDE LENGTH INSIDE WIDTH "" DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: � '� s NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH LENGTH / , DEPTH , LINING MATERIAL �pS DISTANCE FROM WELL BUILDING FOUNDATION_Zd�" , NEAREST LOT LINE �o / TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) lA SQ. FT. TILE DRAIN FIELD: DISTANCE FROM W NUMBER OF�CINES AREA FOUNDAT ANCE BETWEEN LINES SQ. FT DEPTH: TOP OF TILE TO FINISH GRADE WELL: TYPE `� , DE NEAREST LOT LINE SEWER LINE_ DISTANCES: �±}oe2-, NEAREST LOT LINE- TREN'H WIDTH EACH LINE DEPTH OF FILTER MATERIAL BENEATH TOTAL LENGTH IN. TOTAL EFFECTIVE IN. ABOVE TILE 4 DISTANCE FROM ,.WATER Z, BUILDING FOUNDATION. SAMPLE , NEAREST SEPTIC �-,&EEPAGE ��. --OTHER f �- TANK , SYSTEM CESSPOOL , SOURCES_ DIAGRAM OF SYSTEM C Id, air v f G5 '. \ 8� 4s 14 DATE f a_:5`c.rr2-[. //" fC A �- GAAP -2ID-2 GREATE ANCHORAGE AREA. TROUGH Case Na. HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM e APPLICATION & PERMIT L-1 S? e / ee MAILING ADDRESS �43 — PHONE N0. NAME OF APPLICANT `�Sf' / t'/-_ RESIDENCE ADDRESS L 0,k)A-)(- LOCATION OF INSTALLATION / aI 12C - LEGAL DESCRIPTION -- APPLICATION TO INSTALL: SEPTIC TANK_ � °�,,SEEEEPAAGE PIT_ DRAIN FIELD OTHER TO SERVE THE FOLLOWING FACILITY__ .� IrrZ{V_l (y) FINANCED THROUGH TO BE INSTALLED BY -- PERCOLATION TEST RESULTS__ ANTICIPATED DATE OF COMPLETION-2- BELOW OMPLETION, — THIS IS TO SERVE AS BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT ,PERMIT TO INSTALL A AS DESCRIBED BELOW. SIZE OF�UjVITWO BE SERVED � E is �F,�_ a•lz__ SEPTIC TANK SIZE _100 TYPE.Q�•k -nl- SEEPAGE AREA ---TYPE go DIAGRAM OF SYSTEM "pe e) zvC e__"'4 - DISTANCES: Goth M10 Pj ITO TH AUTHORITY OR SED DESIGNER I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinaj)ce No. 28-68 and that the above described system is in accordance with said code. � `I��- u )Om BJ � U �� DATE o _ APPLICANTS SIGNATURE-- I Milo I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinaj)ce No. 28-68 and that the above described system is in accordance with said code. � `I��- u )Om BJ � U �� DATE o _ APPLICANTS SIGNATURE-- ,REATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT CASE # 327 EAGLE STREET ANCHORAGE, ALASKA 99501 Performed For Date Performedgs�.v Legal. Description: Lot ���B7.ackSubdive� ision�/ R I?;'�^.,�71�%�L.. �•� This Form Reports a: 5oi]s Lo ri ercolatl�'on Test Depth Feet Soil Characteristics Location Sketch aur...,..:,Lm�suM+VMen._+f.-.CrMmT✓�.M�..n..m�n.� n^�M= T ht -e is c, hic-1A e7o llie,^c cere soi-))e vYv,c, � - pe 411 lev„es 6('0 s� Was Ground Water Encountered? O If Yes, At What Depth Reading Date Gross Time Net Time DepthToH20 Net D p� .tea ..ate P I Ell�pl erco a ion a e"r7 inu a rroposed Installation -Seepage Pit I,�- Drain Field Depth Of Inlet y `- Depth To Bottom Of Pit Or Trench'"" Test Performed By:��.!`� Data Certified By,7.� . Date• Municipality of Anchorage • Development Services Department 4,0, - Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street 4, P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 050-131-10 COSA# osclalUS? Expiration Date: G —9 -/1 1. GENERAL INFORMATION Complete legal description Seidler Subdivision .Lot 1 Location (site address) 11925 Lugene Lane, Eagle River AK 99577 Current Property owner(S)AK USA Federal Credit onion Day phone 257-0169 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 400 National Wav, Simi Valley CA 93065 Day phone Rebecca Day phone 257-0169 householdsold-names. corn Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 T3_TYyP_E_O _WATER.SUPPLY: _ - TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems 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 sample results. (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. 4. 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 NorthRim Engineering Phone 694-7028 Address PO Box 770724 Eagle River Engineer's. Printed Name Steve Eng Date 3/2/2012 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. �aQ . 40� ll a vfi %V, 5. DSD SIGNATURE ..... 9 ` Approved for f' bedrooms. n C Sseven^1 PE 52y5 Disapproved. t , s�2 (L 'mow"�P Conditional approval for bedrooms, with the following stipulatidhsF�� Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory z Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: (Ree 11705) Municipality of Anchorage • ''° Development Services Department e Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Seidler Subdivision, Lot 1 Parcel ID: 050-131-10 A. WELL DATA - Public Water Well type P If A, B, or C provide PWSID # _ Well Log (Y/N) N Date completed 2jj97 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 150+ ft. Cased to 40+ ft. FROM WELL LOG Date of test na Static water level na ft. Well production na 9 -10 -m - WATER SAMPLE RESULTS: Coliform Pass colonies/100mL Nitrate ND mg/L Casing height (above ground) 20 in. AT INSPECTION 3/1112 110 ft. 0.9 g.p.m. Arsenic: ND ug/I Date of sample: M2 Collected by: nr B. SEPTIC/HOLDING TANK DATA Tank Type/Material Seutic/Step Date installed 7 3 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) )L -Date of pumping J. %z • S Pumper -?/7//?-. C. ABSORPTION FIELD DATA Date installed 7/13/04 Soil rating (g.p.d./ft2 or ft2/bdrm)1_2 System type Trench Length 2@27 ft. Width 5 ft. Gravel below pipe Jft. Total depth 7 ft. Eff. absorption area 500 ft2 Monitoring tube Y Depression over field N Date of adequacy test 3/1/12 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 600 + gal. New depth 5 in. Elapsed Time: 60 min. Final fluid depth 0 in. Absorption rate > 600 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) unknown If yes, give date = D. LIFT STATION Date installed 7113/04 Size in gallons 1500 Manhole/Access (Y/N) Y "Pump on" level at 41 in. "Pump oft" level at 30 in. High water alarm level at 45 in. Datum Tank Bottom Cycles tested 3 Meets alarm & circuit requirements? Yes E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 1001+ Absorption field on lot 100' + Public sewer main NA Sewer /septic service line 251+ Animal containment areas 501+ On adjacent lots 1001+ On adjacent lots 100'+ Public sewer manhole/cleanout NA Holding tank na Manure/animal excrete storage areas 1001+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 25'+ Absorption field 5'+ Water main na Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main na Water Service line 10'+ Surface water 1001+ Driveway, parking/vehicle storage 20'+ Curtain drain n/a Wells on adjacent lots 1001+ F. COMMENTS G. ENGINEER'S CERTIFICATION l certify that 1 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. Engineer's Printed Name Steve Eng Date 3/2/2012 COSA Fee $490.00 Date of Payment 315112. Receipt Number 056--ra W (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number 0 :e',y3 Steven W. End PE 2, Municipality of Anchorage \� Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage. AK 99507 www.muni.org/onsite (907)343-7904 -� 0-0-30.5 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D.nri(1- I31 _j(1 COSAa_ n 0: Expiration Date: _ l I g /6q1. GENERAL INFORMATION Complete legal description Lot 1; Seidler Subdivision Location (site address) 17925 Lugene Ln. Eagle River. AK 9957 Current Property owner(s) Deb Small Day phone 227-M6 Mailing address same Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site ❑r Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems 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 sample results. (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. 4. 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 s a s engineering Address 15861 S. Sin:hwood Loop CI giak gg Engineer's Printed Name 5. DSD SIGNATURE __ Approved for L_ bedrooms. Disapproved. Phone 694-2979 Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory �— Supplemental Engineer's Report 1.1e Advisory Other By:i'/ 1Z! Original Certificate Date: (Rev IIM) Municipality of Anchorage ' Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SY STEMS APPROVAL CHECKLIST Legal Description: L oT �� &/Dhm s/fj Parcel ID: 05V-1 31-/ 40 A. WELL DATA Well type �IV'ITL" Date completed Total depth J-0—+ft. Date of test Static water level Well production If A, B, or C provide PWSID # Sanitary seal a) -As I Cased to �ft. FROM WELL LOG WATER SAMPLE RESULTS: 1011- bul Well Log (Y& /UO Wires properly protected) u Casing height (above ground) / f in. AT INSPEC ION 3r o ft. I - ft. 9 Pm. �k �117Y �tcvF�r �.p.m. 300 fit) ! anTTre- STae'W -rwk- l v CRPAfiL`` Coliform D colonies/100 mL Nitrate P_J3_7ng1L Other bacteria 0 colonies/100 mL Arsenic: t7 ug/L date of sample: Collected by:'� EA;61 LTEif,#C B. SEPTIC/HOLDING TANK DATA Tank Type/Material �J. / . Date installed, f 3 D Tank size 15to gal. Number of Compartments 02 Cleanout04) 4) Yrs Foundation cleanout 51) v5' Depression over tank (Y®_ALb High water alarn(Cg�N) Date of pumping Pumper �IS �Uh1Prx9Cc C. ABSORPTION FI LD DATA Date installed `l 05 b� Soil rating p.d./ft2 r ft2/bdrm) �� System type Fill DlO Length 5�/ a )ft. Width $• U r fl. Gravel below pipe 3 • $ r ft. r Total depth ft. Eff. absorption area 600 ft' . Monitoring tube CS Depression ove field A)O Date of adequacy test '�/ �� Result Pas aiq For T bedrooms �' rnTI=r9M mra=15" Fluid depth in absorption field before test in. Water addedL al. New depth_ in. mTt'01 nriz; p'l (�GY7+ Elapsed Time: min. Final fluid depth _ in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Nn type) 0o If yes, give date '— D. LIFT STATION Date installed 7 I Size in gallons /—COO n "Pump on' level at In. *Pump off" level at3D in. Datum 'FoTiom of IA/<1k- Cycles tested 3 E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot I00 '4— I Absorption field on lot /00 'I Public sewer main Sewer /septic service line -) Animal containment areas 60 -t Manhole/Access®N) High water alarm level at in. Meets alarm 8 circuit requirements? Yrn_ I On adjacent lots 1004- I On adjacent lots /009 4- Public sewer manhole/cleanout A Holding tank N�q Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation [✓ Property line Absorption field S , r Water main Water service line /O Surface water /GYM t Wells on adjacent lots /40 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /D r'/" Building foundation Water main r Water Service line /D 1 f Surface water 100 '� Driveway, parking/vehicle storage /D Curtain drain AXAZ /(,tbOA) Wells on adjacent lots /tom F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determine review of Municipal records,11h. conformance with MOACOS gt Engineer's Printed Name Date COSA Fee Date of Payment Receipt Number (Rev. 11105) rhyIVC3)—..,�,,,, — > *ay -rvmt o-PZ17rr'IT31NCry WGAoo . ..of...��?��ti�r h field inspections and i .'•%J r above sfflothi re i y % 4 is date. Y �` � "�'.'.• %••• 6 »o Waiver Fee $ Date of Payment Receipt Number e. 9 Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Nater Well Advisory Health Authority Approval # 080351 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Lot 1 of Seidler subdivision, the well's productivity was determined to be 0.94 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 4 -bedroom residence is 0.42 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. .,ll ' tip• - ,' I • ` J�Af J ' r „ D.rhr r,a N Rifles,.Rr .. to t ' / Staff'! S1Sat1^ fz f4 f�l,t� t 7 1 !}^8 3 " ; 1 hereby - certify that d have surveyed the following defcrlbed property L92 1�sriclEs.•r6'I�pis. � ) r_� �� �•t:SY�a�.it;� Tra��-,�$:ytC, -tIA P� •..w.. �+e'a w& ...LrL fess- '� 1 w . i" ;,. ncho2age 'Recordiig Precinct,'. Alaska, an'd > that 'the C' •t.T iu , Improvements situated thereon are within the"property nes and.do overlap or encroach on the property lying adjacent thereto, that no improvementx on prop , fr` �e• any -lying adjacent thereto encroach on 4he premixs in - _, question and that there are no roadways, transmission Ines or otber Visible easements on said property except r ° t , as. indicated hereon.. , o �f �a� r ,CIS ` d e Q-tA Dated at Eagle River, Alntka ' thls_dav oLt4Y. [ r zocae��sfs 15GAt ; r ROBERT-C.'JOHNSOYi_�Cf> Ir ' i Registered Land Surveyor No 889-LS ' ' �,. .3p Box 456, Eagle River, Alaska •2543 Phone 09x Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www:ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel LD. QSQ - (3(—/0 ,q HAA # Expiration Date: 1. GENERAL-`INI=ORMAPIUN Complete legal descriptlori:'. SLS/DI-e5c - b LOT Location (site addresssor dirgctions) 1I F-25 L1/6a(,r G4ff,5 Current Property owners) C -1y -49/-t'= 7;fJJ6441 Marling address aa. Lending agency Mailing address Day phone Day phone -------Real Estate Ageni - - - 1«/ lJC�1tTQ --- --Day pfione ----- - Mailing Address QF 44C Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site] Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ 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 sample results. (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. 4. 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 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 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 /fOl�'rffR/�n Er<l6,-WE��/W6 _ Phone Address 17.23% SES r3g0'j C'19446, 6G� RtJ L Engineer's Printed Name STGdE 45W Date AC �cp` ` Ste(ve`n�. ..e...4 5. DSD SIGNATURE t s'•.• PE 6256 n ✓ Approved for bedrooms. e�4F�pR0r ESs1� `=.� Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other LL By: o Original Certificate Date: 7 — ! Q (Rev. 01102) "If A, B, or C'providePW815#_ -47 11,41- r v. Wires, properly protect ed (Y/N) _ unieipa rty of Anchorage Developmenti Services Department .... P ° fig,,- Building SafetyDivision ti _ a� l g p.m. On Site lNater `& Wasfe%yerrogram s ^ E T colonies/100 ml Nitrate 1 mg./I Cd) . ...,.. M 4," mg /I Date of 9amp)e S"/! Collected by �or �rw P O B0 196' Anchorage AK 99 19- e1"� lrC ff4R<�(i� TigN����STEr'� Date installed ' wwa ci.anchorage�:ak us ' Cleanouts (Y/N) iut (YyNj Depression over tank (Y/N) High water alarm (Y/N) r ; HEALTH ISG Pumper AUTHOF2ITY APPRf3Vr1L CHECKLIST �nntinn•` S�/�:�./e-�S�/1", ,-� dT / '�..�"----..` n ra_ iii_ .,. "If A, B, or C'providePW815#_ We -11 -to" g (Y/N)``'Y c Sanitary seal (Y/N) Wires, properly protect ed (Y/N) _ '—ft. Cased to 4Q t ft. Casing height (above ground) in. ti g:p m a� l g p.m. colonies/100 ml Nitrate 1 mg./I Cd) Other bacteria d colonies/100 ml. M 4," mg /I Date of 9amp)e S"/! Collected by �or �rw 7: e1"� lrC ff4R<�(i� TigN����STEr'� Date installed gal Number of Compartments Cleanouts (Y/N) iut (YyNj Depression over tank (Y/N) High water alarm (Y/N) ISG Pumper D. LIFT STATION _ Date installed (3 104 Size in gallons 560_. Manhole/Access (Y/N) "Pump on" level at/ in. "Pump off' level at 30 in. High water alarm level at in. Datum Wit -54T7'0g^ Cycles tested Meets alarm & circuit requirements? u E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WEI L ON LOT TO. Sep tic 'tank/lift station on lot /00IT On adjacent lots Absorption field on lot _" G Q `r On adjacent lots Public sewer main Public sewer manholeicleanout_Nl� , Sewer /septic service line SG * Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO Building foundation .S r� Property line Z? _ Absorption field Jr P Water main Water service line t Surface water Wells on adjacent lots Q a r� SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO. , _, ;,,.m�,s�,: : pmxsn�;,w�,Msx„•a»m ^`��rvax:,��. ,,.s, e e �n:..�e� ., ,-,.,,, Property line �O r t Building foundation /O f Water main yr 9 Water Service line Orf Surface waterrr Driveway, parking/vehicle sto age Curtain drain tiP1.4 _ Wells on adjacent lots r F. COMMENTS o`A G. ENGINEER'S CERTIFICATION iyNPA,r'�- �,I�-- 1 certify that I have determined through field inspections and % * 49 /"... ...... review of Municipal records that the above systems are in �•':'••'! e conformance with MOA HAA guidelines in effect on this. dates •'• STI; F-lti�a Steven �'•�: awl Engineer's Printed Name �,Ji••. PE 6256 �y o F9F P80F SS Date�`ROF _ t,F y�ESS HAA Fee $ Waiver Fee $ Date of Payment _ Date of Payment Receipt Number Receipt Number (Rev. 12/01) - , . Municipality of Anchorage Development Services Department 4-r Building Safety DivisionaOn-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Water Well Advisory Health Authority Approval # 040334 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block , Lot 1 of Seidler subdivision, the well's productivity was determined to be 0.9 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 4 -bedroom residence is 0.42 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. MUNICIPALITY OF ANCHORAGE Ji • DEPARTMENT OF HEALTH & HUMAN SERVICES j 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. # �'� ! 3 ( / 0 v HAA # 0) 1 a(r) � 1. GENERAL INFORMATION Complete legal description Ll ;.7nein jar/ Location (site address or directions) ZZDL- ` ae,5',13'" Property owner Day phone haw - IWI Mailing address � 'Z5-Z,4'6L�u1>' Z'"V& 4 l; 1 /61'�re �� � S7� Lending agency Day phone Mailing address Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. 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. 72-025 (Rev. 1/91) Front MOA H21 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 safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verifythat 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. David R. Dayton P.E. Name of Firm _ 2.0210 Donalar St. Phone (19 C;lugiak, Alaska 99567 Address Engineer's signature 6. D,--�— SIGNATURE Approved for Disapproved. Conditional approval for Additional Comments bedrooms. Date Z-/9-3 bedrooms, with the following stipulations: Date //-- 10 -9 j 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 courtesyto purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employeesof 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. 72-025 (Rev. 1/91) Back MOA f121 __ _. _.-__--A Legal Description: A. Well Data Municipality of Anchorage .� Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Parcel I.D. 05-0 0 Well type 1'i2i �� If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) AJ Date completed u v cr I'?7/ Driller GJK 7 fez Total depth aK Cased to , 4 Casing height 2 _ Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y _ FROM WELL LOG Ale ill;; - Date of test Static water level Well flow Pump levell SEPARATION DISTANCES FROM WELL TO: �k.. Septic/holding tank on lot Absorption field on lot __Z� AT INSPECTION C 4., 0 ; On adjacent lots I o0 1 - On adjacent lots ) OCs Public sewer main A)//,' Public sewer manhole/cleanout Sewer service line /04- Petroleum tank /-Ajr4IuZ/c.. inl IfY9 WATER SAMPLE RESULTS: Coliform Nitrate Other bacteria Date of sample: /��/ e Collected by: U � B. SEPTIC/HOLDING TANK DATA Date installed /,9/10 Tank size /000 Compartments Cleanouts (Y/N) Y Foundation cleanout (Y/N) Depression (Y/N) w' High water alarm (Y/N) i`-/0//' Alarm tested (Y/N) Date of pumping iU 4Z--5 -5 ; Pumper J° 'a SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 7 O On adjacent lots To property line ,20 Absorption field_ / ee") '` Foundation / �L Ul Water main/service line /c� f Surface water/drainagef- -� t�iPt�#-it.'t�r'rr_'i iAJS/Os+�ctle/ai�J% 72-026 (3/93)' Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons - Vent (Y/N) allonsVent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested Surface water Date installed 1971 `l Ft Soil rating (GPD/Ft) % 5 System type ,,6 y-` 72,�,✓cxw- 4%)r-'i 14- C/+-1 0 J(f CCA—) a W r [ Lengthraeucp 19 Width `3 ` Gravel thickness Total depth ". e Total absorption area ) s -jCleanout present (Y/N) f Depression over field (Y/N) Date of adequacy test 1 C7 / c 77 Results (pass/fail) A?'i=f 5 for i Bedrooms Z2"suc r 2erTdZit,/ Water level in absorption field before test 4s,' f! r After test z, ,, vrr `"rpoi& 2 4 "a Peroxide treatment (past 12 months) (Y/N) it1 If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot / 0 ':5 On adjacent lots To building foundation I `!' ( OC.) .t - Property line 10+ To existing or abandoned system on lot On adjacent lots i Dc)t Cutbank f Z. Water main/service line /vr Surface water ✓ 00 Driveway, parking/vehicle storage area %U i Curtain drain I L/' d -a i��..�owA'i (_' kk r - TL _ ,'Y a 5 1'i7 r^irG)C;- tic::.., As 77 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 inspection. �r .`0 `t✓n°usvoo novo 'ri+ David R. Dayton P.E. y 0� z ° 20210 Donalar St. , g��� a°= ° a`cp Signature Chugiak, Alask 99567, 4 » Engineer's Name' paviu It, bnytonag 2205-r— Date Pp ..l s �G HAA Fee $ C 6 Waiver Fee $ Date of Payment 'C ` Date of Payment Receipt Number b Receipt Number 72-026 (3/93)' Back D. R. DAYTON, P.E., R.L.S. _ kni MI I awgiak, Alaska 99567 (907) NMUM 20210 Donalar 696-2417 October 22, 1993 WELL FLOW TEST !Legal Description: Lot 1, Seidler Subdivision Date of Test: October 19, 1993 (Well Depth: Unknown, Greater than 149' Static Water Level: 66 ' :Requirements: 3 BR - 450 gallons per day Test: The well was tested with the existing pump through an outside hose bib. The water level was pumped to the point where the drawdown was stabilized with the pumping rate. Pumping was continued for an additional 2 ]lrs. Results: The well produced 0.85 gallons per minute with a stabilized drawdowm at 82' (149' well depth). The well recovered 33' (to 116' well depth) in 60 minutes. At the 0.85 gpm rate, the well should produce 1224 gallons per day. The well is currently producing adequately for a 3 BR home. F ,Quo.acs. {p •• ••O f1. � � O T H Av•a �f,r soa c. aefAsEca•n..v•- �lle.ea kio��Ye'om".y v L P 4 'cj' a Darid ft. DaySon _u ' I_Qe s'•• No. z2-o•r: 1:'' }�C p•a.•.°•a.pe 6 s`O?Ror�ssw�'w; D. R. DAYTON, P.E., R.L.S. kHMMMIM Chugiak, Alaska 99567 (907) MUNN 20210 Donalar 696-2417 October 22, 1993 ADEQUACY TEST.' Legal Description: Lot 1, Seidler Subdivision Date of Test: October 19,1 93 Septic Tank: 1000 gallon steel tank Absorption System: 14' x 14' x 6' seepage pit & 19' x 3' x 4' trench Soils Rating: 110 sq ft per bedroom I Requirements: 3 BR - 450 gallons per day Test: Water was pumped into the seepage system while measuring volume, and water level rise. After pumping was stopped, the water level drop was measured at timed intervals. The results were graphed and extrapolated to 24 hrs. Results: The absorption system is currently functioning adequately for a 3 BR home. OF 44 Q� �' 3µ`9 °n • /`u aoc eon n cx ° 'e w.a'l✓. '�' : Ll°'J OO• Lu..a p04p 9..11° Dmid k• Dayton w t� i; •_ a.a• NO. 2205•E • 1 �� Y1<C °p•°e a•aaa a+�� � � �� MUNICIPALITY OF ANCHORAGE I�A • 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 Parcel I. D. # -_ I.31 % HAA #"� 1, GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Seidten Subdivision Location (address or directions) 11925 Luqene Lane, Eagte Rive, Ata.5ka (b) Property owner Fattenman Telephone : (home) 694-6029 Business Mailing Address 11925 Luqene Lane, Eaqte Riven, Ata/,ka 99577 (c) Lending Institution AK. U.S.A. FED. CR. UN. Telephone Mailing Address Anehonage Ata3(za (d) Real Estate Company and Agent HERITAGE REAL ESTATE/Suzanne Coot Address 18550 Eagte Riven Road Eagte Riven Ata6ka 99577 _ Telephone (e) Mail the HAA to the following address: (or check here if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single -Family lKX 3. WATER SUPPLY Number of bedrooms — 3 Individual Well ❑ Community ❑ Public ❑ ondened by Suzanne Coot 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 M 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. 72-025 (Rev. 7/88) Page 1 of 2 Z;o Z abed PPE] (eetc Aea) M -U ->IjoM s,Aeouibue leuolsseloid ay; ui suoissiwoao sioaaa ao; alglsuodsaa lou si abeaogouV;o Al! IvdlolunW ay1-panssi sl oleol;llaao a aao;aq elep azAleue ao suolloadsui lonpuoo lou op SHHQ bo s99Aoldw3 'sluawaalnbaa alels pue leaapa; ulelaao Alslles olaapao ui suoilnlllsul bulpual aiagl pus sawoq ;o saasegoand of Aselinoo a se slgl saop SHHQ a41 T>IselV ;o alelS ayl ul paaalsl69a aaauibue leuolssa;oid luepuadepui ue Aq anoge g 4dea6eaed ul uan16 suoileluesaidw a43 uodn Aluo paseq paleoilpeo lenoaddV Allaouln`d ulleaH sonssi (SHHd) saoinaaS uewnH pue 4l1eaH;o luawliedap abeaogouV;oAllledlolunW oql all eW.n• J 6 '^ -. e . ,eve •y w� io�a i i it N011nvo IengaddV leuoll!puoO;o swial leuoll!PUOO panoaddeslp panoaddV alep � Aq suaooapaq ao; panoaddy -IVAOHddV SHHd LLS66 e3lseltl'jeAl2i v dovi .1eAIN elfie3 4£OLL EJNI2I33NIE)N3 58 . d� 2� auoydala 1 aleQ ssaappV wall ;o aweN •uolloodsui slid ;o alep ayl uo loolle ul suollelnbei pue 'saoueulpio 'sopoo alelS pue ledlolunw Ile q;lm aouelidwoo ui sl walsAs lesodslp aalemalsem ao/pue Alddns aalem olls-uo ayl 'uolloedsul PUB uolleBllsanul AW woa; pue Sall; a6eaoyouV ;o AllledlolunNl a43 woa; paulelgo uollewao;ul a43 uo paseq leyl A;laan aagljn; l •ulaaay paleolpul ainlonils;o ads l pue swooapeq;o aagwnu aul ao; alenbape pue leuolloun; 'ales si walsAs lesodslp aalemo;sem )o/pue Alddns aalem alls-uo aq; leyl smogs lenoiddV Allaoglnd U3Ie9H slid;o uo1.le61.ls9nul Aw leyl AJ!JOA I 'molaq unnoys alep uollepllen a43;o se pue olaaay pail;;e leas Aw !q pal;lliao SV E NOI1VWbIOdNl aNV VIVO `HOMS 3lld 'S1S31 `SNOIlO3dSNl ONIWOHd Wdld ONId33NION3 '9 nnuNaPAU Y OF A.Nci ORAel ENn„ONMENIAL Si-WICFS DIVISION MUNICIPALITY OF ANCHORAGE (MOA) • '� Health Authority Approval (HAA) 1 lqn CHECKLIST - FEBRUARY 1984 t 343-4744C' i_ V 3'1 �. Legal Description: U 1 G1G117L, A. WELL DATA Well Classification _ ��1\�� _ If A. B, C, D.E.C. Approved (Y/N) Well Log Present (Yt!P__ Date Completed k�. lail Total Depth�Cased to B '—Depth of Grouting Static Water Level �� Pump Set At _ Yield 27_�'D 61?_0 Casing Height Above Ground 1 4- -J^ Sanitary Seal on Casing67N) Electrical Wiring in Conduit¢ /N) Depression Around Wellhead (Y/&p SEPARATION DISTANCES FROM WELL t To Septic/Holding Tank on Lot o ; On Adjoining Lots c� Ifi To Nearest Edge of Absorption Field on of i bfa I+ ; On Adjoining Lots To Nearest Public Sewer Line p To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by S 1 Date C>- SQ' Water Sample Test Resultsol��is�. �L_ a 51 j`1t�� z d, Comments \1Ae\ L B. SEPTIC/HOLDING TANK DATA Date Installed V9 0"� Size 1 Qom No. of Compartments Standpipeso7N) — _Air -tight Caps ON) Foundation Cleanout (Y44 r --�- Depression over Tank (YA4�) t" Date Last Pumped a- 1 o -,as Pumping/Maintenance Contact on File (Y/N) ; for _ Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: ) To Water -Supply Well To Building Foundation To Property Line I c-�' 1+ "Fo Disposal Field — 1 To Water Main/Service Line a To Stream, Pond, Lake or Major Drainage Course Comments 72-026 (Rev. 7/88) Front Page 1 of 2 r- ABSORPTION FIELD DATA Soils Rating in Absorption Strata IZ5 Type of System Design ) Date Installed ��� 1 `� �/ I Length of Field l Width of Field Depth of Field Square Feet of Absortion Area Gravel Bed Thickness G f'5 (7-O� / ,4 Statndpipes Present(Y/N) Depression over Field (Y/® rJ Date of Last Adequacy Test Icy ` CD `8e Results of Last Adequacy TestISGz/S�-�52 SEPARATION DISTANCE FROM ABSORPTION FIELD: 1 I To Water -Supply Well + To Property Line b "F ( To Building Foundation To Existing or Abandoned System on Lot �)A ; On Adjoining Lots 3o I+ To Water Main/Service Line To Cutback (if present) r) To Stream, Pond, Lake, or Major Drainage Course tib t l� To Driveway, Parking Area, or Vehicle Storage Area ZC Comments -X- 17'7 '� Ji�6,P��p to L- ':>K r -s , D. LIFT STATION/L Date Installed "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Check Permitted Bedroom Rating Against HAA Request" "Pump Off" Level at /N) Pumpin --y s during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on tV&,�ate of this inspection. S & S ENGINEERING -" �' 17034 Eagle River Loops Kcaa oie, A,,Signed c• Eagle River, Company gam'• ,�'� •... Date /O MOA No. • � �, 1447A dir d< Av Receipt No. U ��J p Receipt No. c�ILJ� �� Date of Payment �� ` 14` Waiver Fee: $ IDIUD LQ3LU Amount: $ Date of Payment ) U I Ll 45 �{ 4n 4a &D L 72-026 (Rev. 7/88) BA re` Page 2 of 2 L��Q 0 Municipality of Anchorage } .r rl�� Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 October 25, 1988 Robert A. Shafer S & S Engineering 17034 Eagle River Loop Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 1 Seidler Subdivision Waiver Request #WR88-065, #H88-0448 Dear Mr. Shafer: 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. 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. S' ce.�reelyy,, C� / )- s&V Daniel J. Roth Civil Engineer On-site Services DJR/ljw#6 h Uctoben 13, 1988 ROBERT A. SHAFER CIVIL ENGINEER 694-2979 HEALTH AUTHORITY APPROVALS Munic.cpatity og Anchonage DEPARTMENT UP HEALTH AND HUMAN SERVICES 825 L S-tneet Anchonage, Ata.6ka 99501 SEWER a WATER MAIN EXTENSIONS REFERENCE: Lot 1; Seideen Subdivision Request you izsue the attached Heatth Authon.ity App&ovat (HAA) and gnant a wa,iven bok ,the hon.izontat sepanati.on distance between the SEWER&WATER pn.ivate wet and .the septic ,tank tocated on ,the Le6ekenced pn.open.ty INSPECTION at a dietanee o6 90 beet. The onig.inot septic sy.6tem was .instatted .in appnoximatety 1971 without pe, m.its on inspection.6. The teaehb.ietd was upgraded .in October, ENGINEERING STUDIES 1981. A Heat-th Cen.t,1..4,iea.te was then is.6ued in Octobers, 1981. In AND REPORTS May ob 1983 .the on.ig.inat septic -lank wa.5 neptaced with a new 1000 ga ton, ,two compartment s-teee septic -tank. A kis k analysis has been penbonmed and .it appea7.6 that no bacte7.iatog-icat WELL INSPECTION &FLOW TEST .{. pottution iz poaatibte bn.om this bounce. Attached bm yours nev,iew ah.e .the bottowing documents: A. Cot.iboxm and ni.tnate anaty.6is ob wa.ten ,taken bnom the wett SITE PLANS tocated on ,the n.egenenced p1topen.ty. B. A blow -test neponti bon the %ebenenced vett. C. R.iek anatys.is wa,ive)L nev.iew worksheet. ROAD DESIGN D. A ptot plan showing hetative distances between on -,site wastewater disposat systems and wets. SOIL TEST E. A wett tog bnom a weft tocated on a tot tocated neap the hebeneneed pnopen.ty. It .is ouh, opinion that the honi.zonia/__itsepanafiion distance pnesen�.bed PERCOLATION by 18AAC72.021 is not nequ.ined in this case. TEST Ib you nequi.ne additionat in6mmation, ptease contact us. STRUCTURAL & MECHANICAL INSPECTIONS Sinc ety, 'W&E_A. SHAFER, P.E. bh ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 -\ , c:-,) P -C,5, CIL %S4 I (I-30' I him > i m Cl) as \-X I I ' S I. TERMS ;Net 10th of month following this sole. SEE BELOW, y iW " vO CHARGE ❑ CASH ek CK y.SALESMAN Ol1AN. +- DESCRIPTION - - h TOTAL WEIGHT 70TAG rtrt . I CHECK HERE IF TAX DEDUCTIBLE ITEM'— ❑ r � c BAL. FORD AMOUNT / r WRITTBN t- i .BALANCE DEPOSIT i BAL. FORD - i NOT NEGOTIABLE- I- CHECK HERE IF TAX DEDUCTIBLE ITEM — ❑ 9T �(. C BAL FO R'D X� i WRITTEN (Z 1 I( i/ 1 BALANCE DEPOSIT BAL. FORD OWNS= j NOT NEGOTIABLE - DAteRECEIVED INSPECTION APPOINTMENTS TIME TIME TIME: 6. TYPE OF RESIDENCE ff -- DATE DATE DATE ❑ Two ❑ Five ❑ MULTIPLE FAMILY q- _'��-�l \w� INSPECTOR INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE: MUNICIPALITY OF ANCHORAGE DEPT. OF I '� \Ll l I c°< DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONN4ZNTAP',:U I ECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION t�1 _ 0*2 Telephone 264-4720 ((' n REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWA V)' kJTYE� °" DI RECTI ONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER PHONE John i Katherine Hubert 694-2454 MAILING ADDRESS P. 0. Box 906 PROPERTY RESIDENT (If different from above) PHONE Sante - Eagle River, AK 99577 2. BUYER - PHONE MAILING ADDRESS 3. LENDING INSTITUTION PHONE MAILING ADDRESS �PHONE 4. REALTOR/AGENT Maureen L. Clayton - AREA, Inc. Realtors 1694-9555 MAI LING ADDRESS P. 0. Box 249, Eagle River, AK 99577 5. LEGAL DESCRIPTION Seidler Sub. Lot 1 STREET LOCATION Lugene Lane 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS ❑ One ❑ Four ❑ Other__ ® SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY K1 Three ❑ Six 7. WATER SUPPLY ® INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) _ 8. SEWAGE DISPOSAL SYSTEM - IM INDIVIDUAUON-SITE** 1971 YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) 72-010 (Rev. 6/79) ■ THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY PERMIT NUMBER ❑ 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 or ❑ Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5. COMMENTS t- t tl L�J/APPROVED FOR BEDROOMS75 �� ❑ CONDITIONAL APPROVAL (letter must accompany cer` tj ❑ DISAPPROVED DATE 72-010 (Rev. 6/79) ■ 9 All [4.; 825 "1_' f 1-1, F;[_ " AN(:I10RAG , AI_i: l'.F; 9950' 1907) 2Wl /) I "I 1 DEPARTMENT Of HFAL-I H AND f G!VHMI� Aif fi I AI_ Pki(i! 1 C"fION September 30, 1981 John/Katherine Hubert Post Office Box 906 Eagle River, Alaska 99577 Subject: Lot 1 Seidler Subdivision An adequacy test performed on the existing sewer system revealed the system is not working properly. Therefore, before we may grante approval to the lending agency, an upgrade will be necessary. Prior to the upgrade, a soils test will need to be obtained so that a permit can be issued from this office. If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: Maureen L. Clayton % Area, Inc., Realtors Post Office Box 249 99577 k EXCAVATION WORK Area ]Zealtti ATTR?PdTIOi': Maui.een C.l-ayton ox 2 ;9 ;agle River, Alaska 99577 September 27, 1981 ROBERT A. SHAFER CIVIL ENGINEER 694-2979 0 _ __ i:_ V Dear i.rs. .-lay Lon, deference: l,ot l.; S:iedler- Subdivision; John Ilubert property A sewer s;rstem adequacN/ test was performed on the system located on the referenced property as you requested. The septic tank was pumped. an0 versified to have a capacity of 1000 gallons. The seepage pit was chFrged with 850 gallons of water and after a period of 24 hours 324 (jallons had percolated out of the crib, ]:t can be concluded from this test that the septic! tank is adequate for the three bedroom residence; however, I regret to inform you that the seepage p.i.t is only adequate for approximately two bedrooms. It will be necessary to have the system upgraded Cor one additional bedroom for it to be consideted adequate for the three bedroom .residence. If we may he of further assistance, please do not hesitate to call. Sincerely, 7 1 \.`1TT S/ss . cc: Peoples Lank and Trust Nuni.cipal.i.ty of Anchorage Department of Ilealth and Psnvironmental Protection SRB 196X EAGLE RIVER, ALASKA MUNICIPALITY OF ANCHORAGE= DERARTME: OF HEALTH AND E:NVIRONMEN' PROTECTION r. I 3215 L Street, Anchurac e Alaska 99501 r 279-2511, ext. 224 or 225 Date Rece:ivect: August 15, 1977 {f 1: I":'lme1 2.: Time � ;# 3 e T:hTie . 2..�2.C�� _.�So_ Date mate >._�l _lf-AA, Date _ 17 . - In p IC¢ 111 Sp 7 REQUEST FOR APPROVAL OF TNDTVIDUAL SEWER AND WATER r'ACII,I'I'_TE ].. Lrndi.n�i Tnst.it.uti.on Rocuest: Alaska Mutual Savings Bank % Sheryl Smith Mailing Adil:rc!ss: Post Office Box 1120 99510 Phone 274=3561 __ ......... - 2. Propert:.y 0w-ner- -Tert%Lethe Zuberg PFIc�I�c,. 694-9420/h Mailing Address: Box 99577 344-1564/w 3. Legal Descr.ipti.on: Lot 1 Seidler Subdivision 4: Single Family Residence: (x) Number of Bedrooms Three Multiple l zani.l-y Residence: ( ) Number_ of Bec`.t-Looms: 5.wel.]., System: Tnd:iv.i.dual well Kermit 4 Depth of Constrl_ici--ion 6. Sewage Disposal System Permit: n . optic 'a'ank Sire Absorption Area it-y/Publi_c System ( ) Well Log on File ( ) ct:erial Analysis Vtac- (x) Public UtilityIn Vast 1..1.1- S .0 7. Distances: Well to Septic Tank ^^ --_— r - to Absorption Area to Sewer Line Nearest- Lot line Absorption Area to Nearest Lot Line 1"I i1 . 1 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality /1,J•;;. 3330 "C" St., Anchorage, Alaska 99503 - 274-.44561 ,- r REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: CMRO VA FHA _ CONV xxx 2. Property Owner: Albert & Letha. Zuberg ^_ Mailing Address: Box 326 Eagle River AK. Da Phone L ___ e Hm.694-9120 iim.694-942E---- 3. Name of Buyer: p -0- 0-Mai1ing MailingAddress: D,a�Phone 4. Name of Lending Institution: Alaska Mutual savings Bnak Mailing Address: - P. o. Box 1120 Phone 274-3561Ext. 246 5. Name of Realtor or Agent: -0- Mailing Address: Phone Lot 1 Seidler Subd. 6. Legal Description: Location: _�tiintene — 7. Type of Facility to be inspected: a:jxae rAmiU_No. Bdrms. 8. Water Supply Type of Supply: Public Utility _ Individual _ x If Individua15 number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility _ Individual (on-site) x If Individual, date of installation EQ -037 (1/74) It 1.: Time Date V- I ns p MUNICIPALITY OF ANCHORAGF 6�-4 A , DE PARTME OF HEALTH AND ENVIRONMEN PROTECTIONd 4,Le; �2� 82-r 3 1, Street, Anchorage, Alaska 9950'1 , 2.79- 2:;1:1., ext. 224 or 225 Date. August 15, 1977 1;2: 'j., i q e -A,,, ;Is: T h"le Da te Date TTjSp REQUEST FOR Aj.TROVAL OF INDIVIDUAL SIEWER AND WATER J,i'ACI1,1'11l1BS 1,c.nding Tnstituti.on i1equest: Alaska Mutual Savings Bank % Sheryl Smith KL-Iilinq Post Office Box 1120 99510 Phone: 274=3561 0 2..Fj--1'7()p(,:r �ty Owner - -ATUe -/Lethd Zuberg 694-9420/h Mailing Address: Box �- 99577 344-1564/w 3. Description; Lot 1 Seidler Subdivision 4: Single Pamily Residence: (x) Mi.iltiple Family Re s-i(Ilance: ( ) S. W011. SyStc'-ffi- Tn(J-ividual Well ( Permit Cons true 1 --ion Depth of 6. Sewage Dispof-:;al System: Septic '!.lank Size, Absorption Area So 7. Distances: Well -to Sept..ic Tank to Sewer E,j.n.e to Nearest Lot -Line Number of Bedrooms: Three NuMIDC-r Of BedIOOMS: ity/plibli-C system ( ) Well Log an File, Pnalys:i-s e Ill ( X) public Utility R,_i t e Nearest Lot line, Material to Absorption Area Absorption Area Depart:.ment: fleal.th and E"nvir.onment'.al Prc?l.ection 'I Re(JL e ;,t for Approval of Indiv:i-flual Sexier and W-,',_er 1 'c, �',�c��al" r Pesa.pition s Lot 1 Seidler Subdivision f la i