HomeMy WebLinkAboutEAGLE RIVER VALLEY RANCHETTES LT 32BEagl
River Valley
Ranchettes
Lot 32
050- 224
-19
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program, 4700 Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 of 4
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: OSPl11303 PID Number: 050-224-19
Kenneth Kvitek Wastewater System: [] New [] Upgrade
Address:
18728 War Admiral Road ABSORPTION FIELD
Phone: Number of Bedrooms:
[] Deep Trench [] Shallow Trench [] Bed [] Mound [] Other:
LEGAL DESCRIPTION So, Rating: Total Depth from original grade:
0.8 GPD~Ft~ 8.4 Ft.
Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe:
32B Eagle River Valley Ranchettes 4.4 Ft. 4 Ft.
Township: Range: Section: Fill added above originar grade: Gravel Length:
0 Ft. 25 pt.
Well: [] New [] Upgrade Gravelwidth: Number of lines: I gistance between lines:
5 Ft. 1 - Ft.
I
Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Matedat:
AWWU pt. Ft. 250 Ft2 3034 PVC
Driller: Date Drilled: Static Water Level: installer: Date installed:
Ft. Flintstone Enterprises 11/2/2011
Yield: Pump Set at: I Casing Height Above Ground:
GPM Ft.I Pt. TANK
SEPARATION DISTANCES [] Septic [] Holding [] S.T,E.P. [] Other:
T~_To Septic Absorption Lift Holding ~ublic/Private Manufacturer: Capacity:
From ~
Tank Field Station Tank Sewer Line Anchorage Tank 1250 Gal.
Material: Number of Compartments:
Well N/A N/A NIA Steel 2
Surface Water 100+ 100+ ~ / LIFT STATION
Lot,ina 26.2 40.5,~ Size: Manufecturer~
Gal,
Foundation 9.2 31.0 "Pump on' level at: "Pump oft" level at: High water alarm at:
in. in. in.
Curtain Drain N/A N/A Pump Make & Model Electrical Inspections performed by:
Upgraded existing field by expanding to accommodate a four BENCH MARK
Location and Description:
bedroom house. Garage FF
Assumed Elevation:
100.0 Ft.
Engineer's Stamp
Inspections performed by: PANNONE ENG. SVC, LLC Dates: 1st 11/2/2011
2nd 1113/2011
Development Services Department Approval
ar
Conditional Approval Date:
~:fl~*.Steven R. Pannone~,~
;~ ~ ///'J/.~/~Z--~,/~//.//" / 'L"~b~ ' "'r~'" N°' CE ~'~+v " .~' , ... %'.
Reviewed and approved by: ~,::Y--'/, /~ ate: / / - 7- /
A B C
FC 17.6 2.0
T1 15.6 15.5
T2 20.9 21.2
.~ DC 23.2 23.1
i ECl 53.4 54.7
~ C1 63.6 57.8
~ ,~ F1 49.9 44.6
_~ ~ M1 50.2 42.8
~ g F2 63.6 33.5
/"-~ ~- M2 61.0 33.8
WAR ADMIRAL ROAD ~ 1000gABANDoNESEPTICpERTANKooDE(E)
~ ~ 32A ~ ~ /,L~o~ SE~T,C
4BR RESERVE FIELD ~ ~ D/W , /! / TANK (P)
. 25LFxS'Wx4'ED, 7'TD-
NEWFIELD EXPANSION ~0%'~~;::~'~
~~ ~F1 /'/ J ~ ~I"CU WATER
SEm~C (g) ~ ~0.01 ¢~ ~¢~0~
F1 e~ ~ / / SERVICE
~%~r/// ~ SEPTIC (E)
570 SF) EXPANDED FOR 4 BR. ~ 31A~ ~ _
- - w W ~ ~ w~ ~, N~ w~
3~c 3~D .... ~ / 31c~"
8"~C. ~ ~ CONN 'CTED TO MID-
....... ~'~ ~ ~ ~6~'+ r~F FIELD
EXlST'G
SEPTIC ~ CONNECT TC EXlST'G
EXIST'G SEPTIC ~ EXIST'G SEPTIC
NOTES: P~O~ ~G ~C, L~
~co~ ~AW,~O ~.0. ,0X ~00~ ~,C,0~O~, ~X ~0 ~"
PHONE (907) 272-8218 FAX (907) 272-8211 ~... ~..~ fa sc=~e
~..-~~ '...~ ~"=~o'
P.I.D. NO
EAGLE RIVER VALLEY RANCHETTES, LOT 32B_. onno~e
KENNETH KVITEK ',~~C~ PERMIT NO.
18728 WAR ADMIRAL ROAD IE'*~:.. ..%¢~ OSPl~}o5
PLAN EAGLE RIVER, AK 99577 ~II?~¥~ Sheet
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE
STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE
WASTEWATER DISPOSAL SYSTEMS.
2. ALL WORK WAS IN ACCORDANCE WITH THE All'ACHED SPECIFICATIONS.
5. SCOPE OF WORK: INSTALLED 4- BEDROOM ADDITION TO SOIL ABSORPTION SYSTEM AND NEW 1250g SEPTIC TANK.
4-. NO APPARENT WATER TABLE WAS OBSERVED TO A DEPTH OF 14- FEET AS EVIDENCED BY THE SOIL TEST HOLE. AN
APPARENT WATER TABLE WAS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 14- FEET BELOW EXISTING GRADE.
4 BR ADDITION ~ 15~' 104.1--
985~ ~N t '~ 1986
94.5-- ~NNXN~-GRAVEL BEDDING .~--DRAIN FIELD (E)
GM/ i ~-4" 0 PERF PiPE I,~-93'6
SM 6.8 ~DRA N ROCK
-140 J -87.7
NOTE: F~SeFVe dFainfield
identical to addition.
No groundwmteF SECTION
monitoFed
o
o o o
~o o o ~
o ~.~/ EXIST'GFIELD ~3034PVC
4.0
SEPTIC 97.7~ ~ : : ~--97.7
93.7-- ' ' --93.7
5-WIDE TRENCH
DESIGN PARAMETERS LEGEND
4 BEDROOM UPGRADE SEPTIC SYSTEM
NO. BEDROOM: ¢ (600 gpd) ~W- WATER LINE/ ABBREVIATION$
TANK SIZE: 1250g SEPTIC WELL RADIUS CU COPPER
PERC RATE = 6-15 MPI A.C. ASBESTOS CONCRETE
SOIL RATING: 0.8 GPD/SF ~ 88 ~ NEW SEPTIC TH TEST HOLE
AREA RQD: 750 SF FC FOUNDATION CLEAN OUT
EXISTING FIELD = 570 SF T¢ TANK CLEAN OUT NO.
NEED TO ADD = 180 SF C~ CLEAN OUT NO.
SYS. ~PE: 5-WIDE TRENCH 4' E.D. M~ MONITOR TUBE NO.
MIN LENGTH: 18LF
USED: R.I. RIGID INSU~TION
25 LF X 5' WIDE, 4' E.D., 8' TD DCO DOUBLE CLEAN OUT
ADDING 250 SF DV DIVERTER VALVE
TOTAL AREA: 820 SF FS FLOW SPLICER
RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510
EAGLE RIVER VALLEY RANCHETTES, LOT 32B~ ~~~h~6&& ~ 050-224-19
KENNETH KVITEK ~¢~ CE 8149 .~ PERMIT NO.
18728 WAR ADMIRAL ROAD f~i~... ...~
DETAILS EAGLE RIVER, AK 99577 ,li~¢ta~M/Sf~W~,~.,,ur~o.~2~ Sheet
Permit Number:
Tax Code Number:
Work Type:
On-Site Wastewater Disposal System Permit
OSPl11303
05022419000
Septic
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Upgrade
Permit Effective Dates: October 26, 2011 to October 25, 2012
Design Engineer: PANNONE ENGINEERING SERVICE
Subdivision: EAGLE RIVER VALLEY RANCHETTES
Site Legal Address: EAGLE RIVER VALLEY RANCHETTES LT 32B G:0054
Owner/Address: tO/ITEK KENNETH L
18728 WAR ADMIRAL RD EAGLE RIVER AK 995778328
Site Mailing Address:
18728 WAR ADMIRAL RD, Eagle River
Lot Size in Sq Ft: 17955
Total Bedrooms: 4
This permit is for the construction of:
Y Disposal Field Y SepticTank N Holding Tank N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Special Provisions: Notice: Spill-over trenches are not allowed.
Received By:
Issued By:
Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
www. muni.org/onsite
(907) 343-7904
ON-SITE SEWER/VVELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 050-224-19
Property owner(s) Ken Kvitek
Mailing address18728 War Admiral Road, Eagle River
Site address 18728 War Admiral
Day phone
Zip Code 99577
.Zip Code 99577
Legal description (Sub'd., Block & Lot) Eagle River Valley Rachettes, Lot 32B
Legal description (Township, Range & Section)
Lot Size 17,955 Sq. Ft. Number of Bedrooms 4
THIS APPLICATION IS FOR ([~] all that apply):
Absorption Field []
Septic Tank []
Holding Tank []
Privy []
Private Well []
Water Storage []
THIS APPLICATION IS AN:
Initial []
Upgrade []
Renewal []
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.
Pannone Engineering Services~ k[~,~~i~~~
(Signature of property owner or authorized agent)
ush Fees:
Date of Payment:
Receipt Number:
(Rev. 11/05)
Waiver Fees:
Date of Payment:
Receipt Number:
Pannone En§ineerin§ Services LLC
Steven R. Pannone, Principal
Registered Professional En§ineer
E-mail: steve@panen~ak.com
October 18, 2011
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
4700 S. Bragaw Street
P. O. Box 196650
Anchorage, Alaska 99519
Subject:
Eagle River Valley Ranchettes, Lot 32
Septic System Permit Upgrade Request
Ladies and Gentlemen:
I am writing to request a permit to construct an upgraded septic system be issued for this property. The
proposed systems will serve an existing four-bedroom house. Currently the lot is developed with a three
bedroom system. This permit will upgrade the field to accommodate a four bedroom house. The lot is
served by AWWU Public Water. The existing septic system is operating adequately for a three bedroom
home (see COSA OSCl11131). The reserve field will be based on a Category III Advantex system. The
surrounding lots are served by AWWU Community water.
1. Soils. A single test hole was excavated by Pannone Engineering Service in October of 2011. See the
soil log attached. Ground water was monitored for seven days. No ground water was monitored to a
depth of 14 feet below ground level after the monitoring period. Bedrock was not encountered in the test
hole. It is my opinion, based on the results of the percolation tests and overall soils appearance; an
application rate of 0.8 gallons/day/square feet should be used for a conventional system and 5.0 gps/sf
for a category III reserve field.
Soil Absorption System Design.
a. See Sheet 2 of the design package
3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and the
existing drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water
and drainage ditches.
4. Topography: The topography in the area generally slopes to the north at 10 to 15%.
Mailing: P.O. Box 100217, Anchorage, AK 99510...0217
Physical: 615 East 82~ Ave, Cuite B6, Ancho~'age, AK 99503
Telephone: (907) 272-8218 FAX: (907) 272-8211
Page 2 of 2
5. Drawing Markings: The Drawings are marked "For IVloA Review Only". When written notification
that the review is complete and that there are no further comments is received from IVloA On-Site
Department, the note will be removed and "Issued for Construction" drawings will be issued.
The proposed installation will not affect the future development of the surrounding or existing lots. There
are no wells or septic systems within 100 feet of the proposed septic location.
If you have any questions or concerns, please contact me at 272-8218.
Sincerely,
~' 49TM ~
e.....&.,,.~~.
m ........ ~.~.~,,,,~,,,.~
Steven R. Pannone,
Owner/Civil [ngineer
~ttachments
Maitif~g: P,O~ Box 1002t7, Anchorage, AK 995t0~0217
Physical: 62,5 East 82®. Ave, Suite B6, Anchorage, At( 9..,,.>05°~'
Telephone: (907) 272-8218 FAX: (907) 272-S211
W 11.9
N86
18 1
/ ,
WAR ADMIRAL ROAD /-- 1000g SEPTIC TANK (E)
/ABANDONE PER CODE
/ /4BP RESERVE F~ 32B / ///-~25Og SEPTIC
/ / 'BASED ON CATIII SYSTM
/ , , , , ~ D/W I /, / TANK (P)
- 25LFxSWx4ED, TTD-~ ~ / ,~ _~15,~
FIELD EXPANSION(P) ~ '~~~l /~I"CU WATER
25LFXS'WX4'ED, 8'TD ~ / TH I~ ~EC~I k/ SERVICE
~~~ 15.'&~ ~/~ABANDON CRIP PER CODE
SEPTIC (E)~ ~[ ='~',~~ CAP LINE TO FIELD
DRAINFIELD (E) 10.0~~-1~% SEPTIC (E)~
8"A.C. WATER ~-CONNECT TC~ MID-
MAIN- / POINT OF FI ~LD
EXIST'G SEPTIC~ EXIST'G SEPTIC
NOTES: P~O~ ~G ~C, L~
~ OM A&~'I~ ~ o/25/~
FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 ~.- .... ';~
g*.'~~ k*g ~"=~o'
050-224-1~
EAGLE RIVER VALLEY RANCHETTES, LOT 32~ · · ~ PERMIT NO.
KENNETH KVITEK '~, ~e ve ~ Em~ l~n n ~
18728 WAR ADMIRAL ROAD ,~.. .~ xxxxxxxxx
PLAN EAGLE RIVER, AK 99577 ~ ...... ~ Sheet
-~~ 1 OF 4
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST cURRENT EDITION OF THE MUNICIPALITY OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
ON-SITE WASTEWATER DISPOSAL SYSTEMS.
2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS.
3. SCOPE OF WORK: INSTALL 4 BEDROOM ADDITION TO SOIL ABSORPTION SYSTEM AND NEW 1250g SEPTIC TANK.
4. NO APPARENT WATER TABLE WAS OBSERVED TO A DEPTH OF 14 FEET AS EVIDENCED BY THE SOIL TEST HOLE. IF AN
APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 14 FEET BELOW EXISTING GRADE NOTIFY
THE ENGINEER IMMEDIATELY.
4 BR ADDITION ------------- 15%
TH- 1
4.0
GM/ I ~i~ ~GRAVEL BEODING .
SM ~:~! DRAIN FIELD (Z)
IP .o
S.O ~OIE: reserve droinfield
o identicol to oddiUon.
~roundwoter
SECTION
; monitored
-14.0
o
~ o o ~ ~
z oo
~ ~ ~CONNECTTO ~4
o ~/ EXIST'GFIELD /3034PVC
/
/
~ ' ~250 ~
SEPTIC
5-WIDE TRENCH
DESIGN PARAMETERS LEGEND
4 BEDROOM UPGRADE SEPTIC SYSTEM
NO. BEDROOM: ~ (600 gpd) W WATE~ UN~/ ABBREVIATIONS
TANK SIZE: 1250g SEPTIC WELL RADIUS CU COPPER
PERC RATE = 6-15 MPI A.C. ASBESTOS CONCRETE
SOIL RATING: 0.8 GPD/SF -- SS -- NEW SEPTIC TH TEST HOLE
AREA RQD: 750 SF FO FOUNDATION CLEAN OUT
EXISTING FIELD = 570 SF T¢ TANK CLaN OUT NO.
NEED TO ADD = 180 SF C¢ CLEAN OUT NO.
SYS. ~PE: 5-WIDE TRENCH 4' E.D. M~ MONITOR TUBE NO.
MIN LENGTH: 18LF
USE: R.I. RIGID INSU~TION
25 LF X 5' WIDE, 4' E.D., 8' TD DCO DOUBLE CLaN OUT
ADDING 250 SF DV DIVERTER VALVE
TOTAL AREA: 820 SF FS FLOW SPLICER
~~. D a t e
NOTES:
FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211 ~..,~ ·
NTS
P.I.D. NO
KENNETH KVITEK -.,~.,,~:~onno~e ~ PERMIT NO.
18728 WAR ADMIRAL ROAD~ ':~,i,,.~.. .~ xxxxxxxxx
DETAILS EAGLE RIVER, AK 99577 ~SgOg~~r~ '. ...... '~ Sheet
-~~ 2
SOILS LOG - PERCOLATION TEST
TEST HOLE 1
OR ORGANICS SLOPE SITE PLAN
1 -- WAR ADMIRAL ROAD
3-- GM GRAY SILTY 32A 32B
~ GRAVEL D/W
HOUSE (E) . -- 1
7--
8 -- BROVVN SILTY ~[
SAND AND H %
9 -- GM/SM GRAVEL -- 1 0% -- -- ....
STIFF/HARD
10 -- DIGGING 15% : 31A
~V W W-- W-- W W-- -- W-- ~' UTIL',TWEASF
11 10' UTILITY EASE
12- 32C 32D 31C
13 --
WAS GROUND WATER SLOPE
14 ENCOUNTERED? N
BOH · --
15
IF YES, AT WHAT
16 -- DEPTH? -0-' TH
X
17 -- DEPTH TO WATER AFTER
MONITORING? -DRY~
18 -- DATE: 10/18/11
19 i
READING DATE CLOCK WATER
TIME NET TIME LEVEL NET DROP
READING
DATE PERFORMED: 10/11/11 1 10/11/11 1:17 --- 5.72 ---
2 1:27 10 MIN 7.24 1.52
3 1:27 --- 5.72 ---
4 1:37 10 MIN 7.27 1.55
5 1:37 --- 5.72 ---
6 1:47 10 MIN 7.42 1.70
PEROLATION RATE 5.9 (rain/inch) PERC HOLE DIAMETER 6 inches
TEST RUN BETWEEN 7 FTAND 8 FT
COMMENTS: Test hole excavated by FLINTSTONE ENTERPRISES. Prec hole was presoaked.
Test run for one hour. Last 3 readings reported
PERFORMED 13Y: Steven R. Pannone~ P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
NOTES: PANNONE ENG SVC, LLC
~.. oF AL .,'~, 10/25/11
FoR CONSTRUCT, ON P.O. "OX 100217 *NOHO"ACE. 99 10
......
PHONE (907) 272-8218 FAX (907) 272-8211
Sco[e
EAGLE RIVER VALLEY RANCHETTES, LOT 32B~~~ '"'--''""-~-~ -~--: ...... '?''~.~ P.I.D.050_224_19NTSNo
KEN N ETH K VI TEK '¢&":S.~e~v'e'n_'_]i~'._'~n'n'6.~ & ,,~'
'¢¢~.~..... CE 8149 -~.~".,~"~'~ PERMITNO.
18728 WAR ADMIRAL ROAD ,~,.~.. .:,~..~?~ xxxxxxxxx
SOILS LOG EAGLE RIVER, AK 99577 ~ "' -" Sheet
READING DATE CLOCK WATER
TIME NET TIME LEVEL NET DROP
READING
~ 10/11/11 1:17 -- 5.72 ---
2 1:27 10 MIN 7.24 1.52
3 1:27 --- 5.72 ---
4 1:37 10 MIN 7.27 1.55
5 1:37 --- 5.72 ---
6 1:47 10 MIN 7.42 1.70
AUXILIARY BASIN PUMP
(N~C)
1 EA.
ADVANTEX 24-" AUXILIARY
4" JIM CAP_ AX20 POD'-~ INSULATED PUMP PASSIVE
'"*' ~ I RISER- BASI~(NiC AIR
SLIDE SECTION
OF 6" PIPE
OVER THIS CONNECTION " 14'.
TO PROVIDE
SHEER PROTECTION-
EXTEND TO
BRIDGE EXCAVATION
DESIGN PARAMETERS LEGEND
4 BEDROOM RESERVE SEPTIC SYSTEM
NO. BEDROOM: 4 (600 gpd) --W- WATER LINE/ ABBREVIATIONS
TANK SIZE: 1250g SEPTIC WELL RADIUS CU COPPER
PERC RATE = 6-15 MPI A.C. ASBESTOS CONCRETE
SOIL RATING: 5 GPD/SF (CATIll) ~ SS NEW SEPTIC TH TEST HOLE
AREA RQD: 120 SF FC FOUNDATION CLEAN OUT
SYS. TYPE: 5-WIDE TRENCH 4' E.D. T# TANK CLEAN OUT NO.
MIN LENGTH: 12LF C# CLEAN OUT NO.
USE: M# MONITOR TUBE NO.
25 LF X 5' WIDE, 4' E.D., 8' TD R.I. RIGID INSULATION
TOTAL AREA: 250 SF DCO DOUBLE CLEAN OUT
DV DIVERTER VALVE
FS FLOW SPLITTER
NOTES: PANNONE ENO SVC, LLC
~ _ .,~ Date
., ~?... 0I- A
FOR
CONSTRUCTION
P.O.
BOX
100217 ANCHORAGE, AK 99510 ,~.. ·
PHONE (907) 272-8218 FAX (907) 272-8211 ~,~*~."~,9 TH NTS
EAGLE RIVER VALLEY RANCHETTES, LOT 321~.- ~ ............ ~ P.kD. NO
050-224-19
KENNETH KVITEK PERMIT NO.
18728 WAR ADMIRAL ROAD *~. .:/.~ xxxxxxxxx
DETAILS EAGLE RIVER, AK 99577 !~.?p/~OFESS\O~A~L_.v~?'43 ....... ~ Sheet
-~~ 4 OF 4
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
, ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME /) IPHONE
UPGRADE ,
7
~ Well ~ Absorption area Dwelling PERMIT NO.
DISTANCE
TO:
I
~ Manufacturer ~/:~/~ a Material No. of compartments
Liq. capacity in gallons IF HOME,DE: Inside length Width Liquid depth
Well. /~.~ Dwelling PERMITNO.
.
~ -- ~ Manufacturer // ' Material Liquid capacity in gallons
~ -~/J/~/~/~l Foundation ~ / ~ Nearest lot lin[/ PERMIt, NO.
;¢~ ~' b~w~ lines
_~ ~ ~ No. of lines ~ Length Total li~es Trencht~width~ inches Dista~'
~ ~ ~ Top of tile~ finish grade Material.beneath tile ' Total elective absorption ar~
inches
Length Width ~epth / PERMIT NO.
~ Type of cri~F ~, ~ib~~diameter __ Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
m DISTANCE TO:
Class -- -- Depth Driller Distance to lot line PERMIT NO.
~ -
~ DIST~ 10: ~uildin~ foundation Sewer line Septic tank ~b~orption area{,}
OTHER
PIPE MATERIALS , ~ ~. ,~ ~
SOl L TEST RATI NG~
/
REMARKS /
AP~ROV~ - ~ DATE LEGAL .....
'72-013 (Rev. 3/78) V
PERMIT I'-,10.
RPPLICBNT KENNETH NOOD SRR ~.VE,,X EBGLE RIVER
LOCRTION ;4RR ~.RDMIRBL
LEGRL LOT i32~EBGLE RIVER VBLLEY' RRNC LOT SIZE
TYPE OF SOIL RBSOR'p~ION SYSTEM IS: TRENCH
DEPRRTMENT OF HERLTH RND ENVIF:ONMENTRL PROTECTION ~"~~~
825 '"L"' STREET, RNCHORRGE, RI{. 9~501
264-4?20 ~
~][4--'~--% I Ti 5EI..~EF-: LIP~-'~RR[:,E PERI4 I T
(820626)
694-2974
±6000 SQURRE FEET
MR)'(IMUM NUMBER OF BEDROOMS
SOIL RATING (SQ FT?BR)= lDO
THE REQUIRED SIZE OF THE SOIL RBSORPTION SYSTEM IS:
[:-, E F' T I--i: -11 L E I'-J'_.~ T H = 57 6RR'..-'EL [:-,EPTH= 5
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETNEEN THE SURFRCE OF THE
GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET).
THERE IS NO SET NIDTH FOR TRENCHES.
THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETNEEN THE OUTFRLL PIPE
RND THE BOTTOM OF THE EXCRVRTION (IN FEET).
PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE
INSTRLLRTION INSPECTIONS OF RNY WELLS RDJRCENT TO THIS PROPERTY RND THE
NUMBER OF RESIDENCES THRT THE NELL NILL SERVE.
TI-4~] ( 2 ], I f-~$PECT I ~] f-4'---"; RRE REL-'2. !_11 F-:ED
E:RCKFILLING ElF RNY SYSTEM NITHOLIT FINRL INSPECTION RND RPPRO',..'RL BY THIS--.
DEPRRTMENT N ILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTRNCE BETI4EEN R NELL FIND ANY ON-SITE SENRGE DISPOSRL SYSTEM IS
400 FEET FOR R PR IVRTE NELL OR 150 TO 200 FEET FROM R PUBLIC NELL DEPENDING
UPON THE TYPE OF PUBLIC NELL.
MINIMUM DISTRNCE FROM R PR I '.,.'RTE NELL TO R PRIVRTE SENER LINE IS 25 FEET RND
TO R COMMUNITY SENER LINE IS 75 FEET.
OTHER REQUIREMENTS MRY RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE
RVRILRBLE TO INSURE PROPER INSTRLLRTION.
PEF-:r-1 I T E::-~P I F-:E$ DEC:-Et-IBER _..~=::2., :I.L-~- :~:2_
I CERTIFY THRT
l: I RM FRMILIRR NITH THE REQUIREMENTS FOR ON-SITE SENERS RND NELLS RS SET
FORTH BY THE MUNICIPRLITY OF RNCHORRGE.
2: I NILL INSTRLL THE SYSTEM IN RCCORDRNCE NITH THE CODES.
3: I UNDERSTRND THRT THE ON-SITE SENER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THRN ~ BEDROOMS.
SIGNED:
ISSUED
V4. 0
[] SOl LS LOG
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
14
16
17
COMMENTS
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SLOPE
PERCOLATION
TEST
Robert A. She
PERFORMED BY:
72-008 (6~79)
WAS GROUND WATER //~D ~_
ENCOUNTERED?
O
P
E
IF YES, AT WHAT
DEPTH?
Reading Date Gross Net Depth to Net
Time Time Water Drop
........ 77
PERCOLATION RATE 7b'"'" (minutes/inch)
~'~ FT AND f~ FT
TEST RUN BETWEEN t
~ ~..lY ,~ 7'" ~ ' '
DATE:Z~dU'"y /
ANCHORAGE AREA BOF '"' H
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH
MANUFACTURER
NUMBER OF
COMPARTMENTS
INSIDE WIDTH
LIQUID DEPTH
.LIQUID CAPACITY. /(~00 GALLONS.
SEEPAGE PiT:
NUMBER OFPITS / DIAMETER bV'OR WIDTH/&, LENGTH/b~ DEPTH
LINING MATERIAL C~/~'1~'~' CRIB SIZE: DIAMETER.__~DEPTH DISTANCE FROM:
BUILDING FOUNDATION ~/._._~t, NEAREST LOT LINE ~ TOTAL EFFECTIVE
WELL
ABSORPTION AREA (WALL AREA)
ADDITIONAL ABSORPTION
TYPE
BUILDING
FOUNDATION __
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST
, LOT LINE
, OTHER 5OURCE5
DISAPPROVED
DEPTH
NEAREST SEPTIC
, SEWER LINE. , TANK __,
REMARKS
DISTANCE FROM:
SEEPAGE
SYSTEM
DISTANCES:
DIAGRAM OF SYSTEM
INSTALLED BY:
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Form No. LQ-031
DATE ~f' ~./q7~-~ APP R OV ED~
/ / ~//G,A,A,B.
GREaTEr ANChOraGE ArEa BOrOUgh
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
PERMIT NO.,
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
INSTALLATION DF= SEPTIC TANK ~" SEEPAGE PIT . /~'"- . DRAIN FIELD OTHER
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTI'CE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT ~O · DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL /
SEPTIC TANK . SEEPAGE PIT
TO NEAREST~___~. ~'~'1'~ '~"~ ('4'~ '" t ~'LOT LINE. ~,[~/7~''~
WELL TO SEPTIC TANK
DRAIN FIELD
I
DRAIN FIELD
, SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
DIAGRAM OF SYSTEM
WATER MAIN TO SEPTIC TANK
DRAIN FIELD.
SEEPAGE PIT
SEPTIC TANK, , SEEPAGE PIT. ,. DRAIN FIELD
TO RIVER, LAKE. STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
OR
LICENSED DESIGNER
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHO~E AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
FORM N~Q-Ot 6
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.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. o5o-224.-~.9
GENERAL INFORMATION
Complete legal description
Location (site address)
COSA# O..~C ti 11 ~ l
Expiration Date: ,5"/~q /I ;~
, Eagle River Valley Ranchettes S/D, Lot 32B
x8728 War Admiral Road
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Kenneth Kvitek Day phone 69/+-9287
18728 War Admiral Road, Eagle River, AK 99577
Day phone
Real Estate Agent
Mailing Address
Craig Nagunst
Day phone 694-9x25
2. ,..NU, MBF~R OF` Bi~.DROOMS:
3:?' TYPEOF WATER'~:OPPLy:
,, IndividUa~ W,bl'l
' Indigi'd~al Water storage
. :GOmmunity'Ciass
Pul~'lic wat~- System
Unle~s,oLherwise requested, COSA will be held by DSD for pickup.
Well
TYPE OF WASTEWATER DISPOSAL:
[] Individual On-site
[] Individual Holding Tank [--1
[] Community On-site I-'1
[] 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 Pannone Engineering Services, LLC Phone 272-8218
Address P.O. Box 1_oo227, Anchorage, AK 9952o
Engineer's Printed Name Steven R. Pannone, P.E. Date 22/7/2o22
Engineers Comments: In conducting an adeguacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in
accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions
encountered at the time of the test, and separation distances measured to readily identifiable features.
The operational life of all wells and septic systems depend on the local soil condition, ground water
levels that may fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of this system. Alt systems eventually fail and
satisfactory test results do not guarantee future performance of the system, nor do they guarantee that ~
there are no hidden defects or encroachments. PES can therefore not provide any warranty for future
performance nor give any estimate of how long the system will continue to meet the operational
requirements of the MOA DSD. The content of this report is for_the sole benefit of the owner listed .Steven R. Po ~ ~
above. Any reliance upon or use of this report by any other person or party is not authorized nor will it No. CE 8149
confer any legal right whatsoever.
5. DSD SI,.GNATURE
Lj Approved for LTL
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
X
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date:
Municipality of Anchorage
Development Services Department
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: Eagle River Valley Ranchettes SlD~ Lot
A. WELL DATA
Parcel ID:
Well type Public If A, B, or C provide PWSID # ~
Date completed ~ Sanitary seal (Y/N)_
Total depth ~.ft. Cased to ft.
FROM WELL LOG
Static water level ~ ft.
Well Log (Y/N)
Wires properly protected (Y/N)
Casing height (above ground)
AT INSPECTION
in.
Well production ~_ g.p.m, g.p.m.
WATER SAMPLE RESULTS: e~mg/L ~
Coliform colonies/100 mL Nitrat
Arsenic: ~ ug/I Date of sample: Collected by:~'"'~~
SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic I Steel
Date installed
Tank size ==5o gal. Number of Compartments_~ Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N
Date of pumping New
Pumper
ABSORPTION FIELD DATA
Date installed 7/=,;/=.9'8= Soil rating (g.p.d./ft2 or ft2/bdrm) zgo SF/BR
Length ~f~ ft. Width 1.~/ ft.
Total depth-~5_ ft. Eft. absorption area 570 ft~,~l':f3~ Monitoring tube Y
Date of adequacy test ~.12Al~,oS.z Results (Pass/Fail) Pass
System type Deep Trench
Gravel below pipe ~ ft.
Depression over field N
For~'bedrooms
Fluid depth in absorption field before test ~-5 in.
Water added~5o gal.
New depths_9 in.
Elapsed Time: 6_~o min.
Final fluid depth ~_5 in.
Absorption rate >=.4~,~ ~,O0-/- g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date
D. LIFT STATION
"Pump on" level at ~ in.
Datum
E. SEPARATION DISTANCES
Size in gallons Manhole/Access (Y/N)
"Pum~ } in.
Cycles tested Meets alarm & circuit requlrem
SEPARATION DISTANCES FROM WELL ON LOT TO:
on lot
Absorption field on I~
Public sewer main
Sewer/septic service line
Animal containment areas
On adjacent lots
On adjacent lots
~~ sewer manhole/cleanout Holding tan k-~"'~'--..~
Manure/animal excrete storage areas'"'""'"
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 9.2
Property line 26.*,
Absorption field 2,i.6
Water main 56.4
Water service line 10
Surface water ~oo+
Wells on adjacent lots ~oo+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 25.8
Water Service line
Curtain drain 50+
COMMENTS
12.7
Building foundation =o+
Surface water zoo+
Wells on adjacent lots zoo+
Water main 20.7
Driveway, parking/vehicle storage zo+
Engineer's Printed Name Steven R. Pannone, P.E.
Date
New upgrade to existing field be expanding to accommodate a four bedroom house.
ENGINEER'S CERTIFICATION
I ce~ify that I have determined through field inspections and
review of Municipal mco~s that the above systems are in ~.....[
conformance with MOA COSA guidelines in effect on this date.
...........
COSA Fee $.
Date of Payment
Receipt Number
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
LOT ~2-A c~
LOT 52-C
WAR ADMIRAL ROAD
.~ WOODEN FENCE
. 62.4/
-Ill
N 89'57'15"E 153.00'
.-.
// ·
/---CHNN-UNK FENCE
LOT $2-B
18,101 S.F.
NOTE:
1) LOT IS SERVED BY
PUBUC WATER SYSTEM
POWER UNE
PORCH
//
BI-LEVEL RESIDENCE
36/
19.1'
o
x 18.5' CANT
LOT 51-A
x x x
S 89'57'15-"W 133'~00'
-/
LOT 52-D
,--.-SEPTIC CLEANOUTS
~10' UT1UTY EASEMENT
LOT 3I-C
PLOT PLAN
AS BUILT X SCALE 1" = ;50' GRID NW 054 Project No. 11-068
La n g (907) 522-6476
Registered Land Surveyors (907) 522-4625
kenOlangsurvey, com/ JonafhanOlangsurvey.com
&: Associofes, inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-,5049
Phone
Fax
I hereby certify fhaf I have surveyed the following described properly:
LOT $2B, EAGLE RIVER VALLEY RANCHETTES, (Plat 6`5-129A)
Anchorage Recording District, Alaska, and that the improvements situated thereon are
wlfhln the properly lines and do not encroach onto the properly adjacent thereto, fhaf
no Improvements on the properly lying adjacent thereto encroach on the surveyed
premises and fhaf there are no roadways, fransmisslon lines or other visible
easements on said properly' except as indicated hereon.
Dated this the "/--%~-? Day of F~ , ~.~3~\ , at Anchorage, Alaska
If is the responslbillly of the owner fo determine the existence of any easements,
covenants, or resfrlcflons whlch do not appear on the recorded subdivision plat.
""" 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
(a) Legal Description (include lot, block, subdivision, section, township,,range)
Location (address or directions)
(b) Applicant Name ~,,~/,-~.3~--~ ~--~::,_r~- Telephone: Home
Applicant Address ~/"~. ~ 'r"','~ ~'-,r'_-_' //[')/~,~--~' "'
(c) Applicant is (check one): Lending Institution r-I; Owner/builder []; Buyer []; Other,~' (explain);
(d) Lending Institution ~~/Lt.- ~,~_//~J~7./.-/ Telephone
/
Address
Business
,,,7__, ~
(e) Real Estate Company and Agent
Address
Telephone
(f)
the HAA to the following address:
TYPE OF RESIDENCE
Single-Family,S' Multi-Family []
Number of Bedrooms
Other
WATER SUPPLY
Individual Well [] Community [] Public~
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite~[~--. 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 {11/84)
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
Telephone
the date of this inspection.
Name of Firm ~ ~, ~.
Addr~ ' ~, -
Date .PH,
DHEP APPRO..~._VAL ~. _,
Approved fo~'//'-/"~-~i! bedrooms by
Approved , ' · Disapproved
Terms of Condi'tional Apl~roval
Conditional
Date
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates 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
WELL DATA
Well Classification
Well Log Present (Y/N)
MUNICIPALITY OF ANCHORAGE(MOA)'" · P£O1£C7/o~
Total Depth Cased to
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
HEALTH AUTHORITY APPROVAL (HAA)
CHECKL'ISm i FEBRUARY 1984
: Legal Description: ~;T
ifA, B, Cl D.E.C. Approve~:~N)
Date Completed' Yield
Depth/ef Grouting
:~, / Pump Set At
/~k'~ /~nitary Seal on Casing (
//~ression Around Wellhead (y/N)
To Septic/He!d!r~g Tank on Lot ~--,~-'-?~'~
To Near'est Edge of Absorption Field on Lot
To Nearest PublJc Sewer Line Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer '" ~"
To NeareSt Sewer Service Line on Lot '
; Date
Comments
SEPTIC/HeL-B+N~ TANK DATA
'7 - 7:g
Date Installed ~ Size
No. of'(~ompartments
Standpipes~N) Air-tight Cap~N)
Depression over Tank (Y/~
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Ho!al!rig Tank:
To Water-Supply Well ~'"'~z:>
To Property Line ~ C'
To Water ,Mai,q/Service Line
Course
Comments
Foundation CleanoUt([~)
Date Last Pumped
; for ' ,:
Temporary Holding Tank Permit (~iN)
To Building Foundation
To Disposal Field
To Stream, Pond, LakeJ or Major Drainage
Pagelof2"
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed '~ '" ~ -~:--
Width of Field .~t"~
Square Feet of Absorption Area'
Depression over Field (Y~t~
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation
Lot t ~
Type ,of System Design
Length of Field ~:~ ~ ~
Depth of Field J ~
Gravel Bed Thickness (~o~::)
~':~, "'t ~:~ c~ .~ Standpipes Present('E~l)
Date of Last Adequacy Test
I
To Water Ma!n/Service Line ~ ~ -'~ :
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
To Property Line I ._~ ~
To Existing or Abandoned System on
; On Adjoining Lots ~ .4-
To Cutba'nk (if present) ~/A.
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments
Dimensions
Manh ole/AcceSs (Y/N)
"Pump Off" Level at
Ven! (Y/N)
Pumpi,ng Cycles during Adequacy Test. Meets MOA
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all ~OA ar)d HAA gu de ines in effect on the date of this inspection.
!MOA No.
Receipt No.
Date of Payment %-;X~ -~
Amount: $
Page 2 of 2
72-026 (11/84)
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
~s~jta- '-'~ A Date Received September 16, 1976
C].~ ~/~._~ ~.,l~-'~,/~x~'~a~,~;~;O~ Time of Inspection
q-D ' ~~ _1. '~~~ ~__1,~ ~~ Date of Inspection]
- ~,-, ~t~.~~ REQUEST FOR APPROVAL OF
]. Approval requested by: Home Federal Savings & Loan
Mailing Address: 535 D Street Phone: 272-1451
2. Property Owner: E~in & Jan~t'Miller _ Phone:
Mailing Address: % Smiley's Realty, Gary 694'2114
3. Legal Description: Lot 32B Eagle River Valley Ranchettes
4~ Location: See directions on white copy
5. Type of facility to be'inspected Single Family''. No. of bedrooms 3
6. Well Data:
Bell Utilities
A. Type B. Depth
C. Construction
D. Bacterial Analysis
7. Sewage Disposal System: On-site system
A. Installed 1973
B. Installer
C. Septic Tank: 1. Size
2. Manufacturer
D. Seepage Pit: 1. Absorption Area
2. Material
E. Disposal Field: Total length of lines
8. Distances:
A. Well to: Septic tank
, Absorption area
, Sewer Lines .,
Nearest lot line
, Other contamination
B. Foundation to septic tank
, Absorption area'
C. Absorption area to nearest lot line
LQ-034 (1/74) Page 1 of two pages
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
2510 East Tudor Road, Anchorage, Alaska 99504 276-2221
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
Type of Inspection:
CMRO VA ,~' FHA_ CONV
4. Name of Lending Institution:
Mailing Aadress:~ ~'X
6. Legal Description: ~¢ T~ Location: ~ ~
7. Type of Facility to be Inspected:
Water Supply
Type of Supply:
Public Utility ~/"l~'/E'-~lndividual
If Individual, number of dwellings presently served
If Individual, depth of well
9. Sewage Disposal System
Type of System: Public Utility Individual (on-site)
If Individual, date of installation
72-003(3176)
page ~ of two pages - Rei"~'st for Approval of Individual S'~r & Water Facilities
Legal Description
Lokt 32B Eaqle River Valley Ranchettes
Comments
Approved
]/4~x.?~.X"/~/~Djsapproved Date
/ i '
Approval\Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
certify that the information contained in this request ifor approVal to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are ~operat~ng satisfactorily.
SIGNED Date
EQ-034 (1/74) I-.
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3500 Tudor Road· Anchorage, Alaska 99507 279-8686
Date Received November 26, ·1973"
Time of Inspection ]] :'30 am
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
1. Aoproval Requested By:
Address:
2. Prooerty O~ner:
3. Legal Description:
4. Location:
FOR
Smiley's Realty for Erwin Miller
Eagle River AK
Phone
Phone:
Lot 32B Eagle River Valley Ranchettes
November 26 1973
694-2115
5. Type of Facility to be Inspected: Single Family ~;ellinq
Number of Bedrooms: 2
6. Well Data:
A. Type Conmunity Well B. Depth
C. Construction
7..Sewage Dts~osal System:
A. Installed ' 1973
C. --Septic Tank:
D. 'Bacterial Analysis'
1. Size 1000 qals2.
Insta!.ler Hamilton Excavatino
Manufacturer Hamilton .
D. Seepage Pit: '1. Size 16~16
2. MatertalConcrste Rinn~
E. Disposal Field: Total.%ength of Lines
Distances:
A. Well To:
Septic Tank
, Nearest Lot I. ine
Foundation to Septic Tank
, Absorption Area
Absorption Area to Nearest Lot Line
· Other Con'tamination
"~ Abgorption Area
, Sewer Lines
· "' -~eq,Je~.t for Approval of : ~.vtdual Sewer & Water Factlitte/~,
Pa.qe Two
9. Comments:
// Approval Valid for One Year From Date Signed
~reater Anchorage Area Borough, DeF. artment of Environmental Quality
DIAGRA~ OF SYST~.~
'I certify that the information contained in this request for approval to be a true
and accurate representation of the subject sewer and water facilities located at:
Signed Date
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3500 Tudor Road· Anchorage, Alaska 99507 279-8686
Date Received
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SFWER & WATER FACILITIES
FOR
1. Aoproval Requested By:
Address: 902 South Lane Anchora.qe AK 99504
2. Prooertv O~ner: Same
Phone .'
Phone:
3. Legal Description: Lot 32 B.., Eagle Riwr Valley ~e~¢~ette~
Location:
5. Type of Facility to be Inspecte, d:_ $ingl. Family nwe!!ing
Number of Bedrooms: 2-3 (two
6. Well Data: Conmunity Water
A. Type
C. Construction
7. -Sewege Dts6osal S.vs{em:
A. Installed 1973
C. -.Septic Tank: 1.
D. Seepage Pit: 1.
B. Depth
D. 'Bacterial Analysis'
Installer Hamilton Excavatinn
Size ilO00 9als'2. Manufacturer- ,~amiltnn
Size 16xl6x6' 2. Material Concret~
E. Dtsposal Field: Total.~ength of Lines
Distances:
A, Well To:
Septic Tank
· Nearest Lot Line
, Absorption Area
· Sewer Lines
, Other Contamination
B. Foundation to Septic Tank "~ Absorption Area
C. Absorption Area to Nearest Lot Line
r(eq~e~t for Approval of Inoividual Sewer & Water Facilities
Page Two
9. Comments:
Aporova] Valid for One Year 'From Dat.e. Signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYST~.~
I certify that the information contained in this request for approval to be a true
and accurate representation of the subject sewer and water facilities located at:
Signed Date