HomeMy WebLinkAboutEAGLE RIVER VALLEY RANCHETTES LT 20DEagle River
Valley
Ranchettes
Lot 201)
#050-223-02
GREATER ANCHORAGE AREA BORWJGH
-• Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DIS PO AL SYSTEM
NAME 4- - 1AILING ADDRESS GV G -3 PHONE J SS
LOCATION V-'91 A&,u _ez AA, • LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE NUMBER OF
FROM WELL,6! d'_17ANUFACTURER XR1y) MATERIAL COMPARTMENTS
X
I
INSIDE LENGTHy INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY GALLONS.
SEEPAGE RItTC�_tce,/L. J
NUMBER OF PITS / DIAMETER —OR WIDTH, LENGTHJ DEPTH /
LINING MATERIAL A-CPtL CRIB SIZE: DIAMETER _DEPTH v/l DISTANCE FROM: WELL
.0 TOTAL EFFECTIVE
BUILDING FOUNDATION_, NEAREST LOT LINE.L=. ABSORPTION AREA (WALL AREA).
ADDITIONAL ABSORPTION
TYPE ly—CONSTRUCTION DEPTH DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION LOT LINE , SEWER LINE , TANK , SYSTEM
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED REMA
DISTANCES:
INSTALLED BY: / t
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
DATE
Form No. ED -031
DIAGRAM OF SYSTEM
f
4 , y �l
�12 <�n�
&//t;
APPROVED
a000
• r �+IL_ItJ I O I PRL I TY , OF F1F'JCHOF'FaGE
DEPARTMENT OFAHEALTH AND ENVIRONMENTAL PROTECTION
2510 E. TUDOR RD.. ANCHORAGE, At:. 99507
276-2221
OtJ='� I T� 'SEWER PERf•7I T" ' -
PERMIT NO. C 76360 )
APPLICANT CALKINS ENTERPRISF_S BOX 683 694-2555
LOCATION, WHIRLAWRY ROAD
LEGAL L20D EAGLE RIVER VALLEY RANCHE' LOT SIZE 1782 SQUARE FEET
TYPE OF SOIL ABSORBTION SYSTEM IS:. TRENCH ,
MAXIMUM NUMBER. OF BEDROOMS = 3 SOIL RATING CSO FTrBR)=' 115
t•
THE REQUIRED S17THE SOIL ABSORP ON SYSTEM IS:
L�Er•TH= 10 EtJGTH= 2S,) GF_F=l k -'EL DEPTH- - F
r ! . •:AIh�D.
THE LENGTH DIMENSION IS THE LENGTH CIFJ FEET) OF THE TF.'EhJ�H CF. DF
THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IFJ FEET).
THERE IS NO SET WIDTH FOP. TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IFJ FEET).
2EG?lJ I RELY SEPT I C TR�JfC S I c.E= 3..00C=+ GRLLOtJ�
. 1
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 200 FEET FOP. A PUBLIC WELL.
SPECIFICRTIOFJS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER,
INSTALLATION.
PERF•7I T %- RL I E> FOR OF'JE YEFiF FROM I'SSLiE
I CERTIFY THAT
1: I AM FAMILIAR WITH THE REQUIREMENTS FOR OFJ-SITE SEWERS AND WELLS AS SET
FORTH BY THE PIUFJICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS.
SIGhIED:! Sr__. _ --------
APPLICANT CALKINS ENTERPRISES.
i 1
ISSUED BY/S--- DATE_ �__ / I " /
Ale,
D. v
Average for all Test Pits 1"/10 Min.
Lot 20, Block D, Eagle
River
Valley Ranchettes
ELAPSED TIME
IN MINUTES
DEPTH TO WATER
NET DROP
DATE
READING NO.
TIME OF
RD. BET14EEN RD.
IN INCHES
IN INCHES
June 4
Pit 1
Start 1
8:55
11"
2
9:05
10
18
7
3
9:15
21.75
3.75
4
9:25
24
2.25
5
9:35
26
2
6
9:45
27.5
1.5
7
9:55
28.5
1
8
10:05
29.5
1
Pit 2
Start 1
8:55
10
2
9:05
10
17
7
3
9:15
1120.5
3.5
4
9:25
of23.5
3
5
9:35
25
1.5
6
9:45
26.5
1.5
7
9:55
27.5
1
8
10:05
28.5
1
Pit 3
Start 1
8:55
8
2
9:05
10
15.5
7.5
3
9:15
18.5
3
4
9:25
21.5
3
5
9:35
23.5
2
6
9:45
25.5
2
7
9:55
27.5
2
8
10:05
28.5
1
Average for all Test Pits 1"/10 Min.
MOENING-GREY & ASSOCIATES, INC.
GEOLOGISTS AND ENGINEERS
715 L STREET, SUITE 5 ANCHORAGE. ALASKA 99701
MUNICIPALITY OF ANCHORAGE TELEPHONE 274.2214
DEPT. OF N`_ALTN &
ENVIRONMENTAL PROTECTION, June 30, 1976
JUL 201976
RECEIVED
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
Attention: Bob Neal
Re: Lot 20, Block D, Eagle River Ranchettes, Eagle River, Ak.
Gentlemen:
This is in regard to our discussion on whether or not
water table will be within 16 feet of the surface of the
subject lot. Our experience and knowledge of the area
indicate that the water table is generally very deep
in this area. Accordingly, we feel it is a safe assump-
tion that the water table is not within the aforementioned
16 feet. Accordingly, Pir. Caulkins present installation
should be satisfactory.
Please advise if you have any further questions concerning
this matter.
Yours truly,
MOENING-GREY & TES, INC.
Woar_MJ*.y*�
HJG/pf
MOENING-GREY & ASSOCIATES, INC.
GEOLOGISTS ANC ENGINEERS
719 L STREET. SUITE S ANCHORAGE. ALASXA 99901
MUNICIPALITY OF ANCHORAGE
TELEPHONE 274.2214 CEPT. Of MW.AM. &
EPN;AONWNIAI PROTECTION
June 7, 1976
JUN 15
RECEIVED
Anchorage Municipality
Dept. of Environmental Quality
3330 "C" Street
Anchorage, Alaska 99501
Re: Results of Soils & Percolation Tests Lot 20, Block
D, Eagle River Ranchettes.
Attention: Rolf Strickland
Gentlemen:
The soils examination conducted on the subject property
indicated a percolation valve that was less than accept-
able under the Municipality's present standards. Accord-
ingly, a percolation test was run. Results of the per-
colation test indicate net drop of one inch in 10 minutes.
Please advise if your department has any questions regarding
these requests.
HJG/pf
Enclosure
S, INC.
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. 050-223-02 COSA # Qjp 0331c
Expiration Date: R — — O -7
1. GENERAL INFORMATION
Complete legal descripti
Location (site address)
8/1 j1J1;,
Current Property owner(s) Marion Carlisle Day phone 317-4830
Mailing address
Lending agency
Mailing address
19049 Whirlawav Eanle River, AK 95577
Day phone
Real Estate Aggnt. Greatland Realty Day phone
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3
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 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 Onsite 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 engineers 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 riles 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 KND ENGINEERING, INC Phone 696-6111
Address _20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date 7/27/2006
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. Therefore,
KND can not give any estimate of how long a � OF At. %to
system will function satisfactory for current or future �Q.,� 9^`1
occupants or can KND guarantee that no unseen �, of f •,.•»•••..••,V'!
encroachments, deficiencies or discrepancies exist * ?aoTu V.& �.
5. DSD S�NATURE
Approved for 3 bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By:_ _ _�� ' /,t/. / 4 Original Certificate Date: R
(Rev. 1 VMS)
PROGRAM
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196850
Anchorage, AK 99519.8650
www.muni.org/onsfe
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Eagle River,Rancheftes Lot 20 D Parcel ID: 050-223-02
A. WELL DATA Val -e)
Well type Public
Date completed
Total depth ft.
Date of lest
Static water level
Well production
If A. B, or C provide PWSID #
Sanitary seal (YIN)
Cased to _ft.
FROM WELL LOG
ft.
g.p.m.
WATER SAMPLE RESULTS:
Well Log (Y/N)
Wires properly protected (Y/N)
Casing height (above ground) _in.
AT INSPECTION
Coliform _colonies/100mL Nitrate _ mg/L Other bacteria _ oolonies/100 mL
Arsenic: _ mgll Date of sample:—Collected by:
B. SEPTICIHOLDING TANK DATA
ft.
g.p.m.
Tank Type/Material Septic/Steel Date installed 7119176 Tank size 1000 gal.
Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) N Depression over tank (Y/N) N
High water alarm (Y/N) NA Date of pumping 7/24106 Pumper JR Pumping
C. ABSORPTION FIELD DATA
Date installed 71l 9178 Soil rating (g.p.d.e or ft2/bdrm) 115 ftlbr System type Trench
Length 30 ft. Width 2 ft. Gravel below pipe 6 ft. Total depth Lft.
Eff. absorption area 360 112 Monitoring tube Y Depression over field N
Date of adequacy test 7124106 Results (Pass/Fail) Pass For 3 bedrooms
Fluid depth in absorption field before test 0 in. Water added450gal. New depth 21 in.
Elapsed Time: 720 min. Final fluid depth 0 in. Absorption rate >= 450 g.p.d.
Any rejuvenation treatment (past 12 mo.) (YM & type) N If yes, give date
D. LIFT STATION — ADVANTEX
Date installed— Size in gallons _Manhole/Access (Y/N)
'Pump on" level at _in. `Pump off" level at in.
DatumCycles tested
E. SEPARATION DISTANCES LO'
SEPARATION DISTANCES FROM WELL ON LO' TO:
Septic tank/lift station on
Absorption field on lot
High water alarm level at in.
Meets alarm & circuit requirements?
On adjacent lots
On adjacent lots
Public sewer main 251+ k b 1 I C-� Public sewer
Sewer/septic servi ine tNA
Ll% &TE R - Holding tank
Animal conta' ant areas Manure/animaliexcrete
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
areas 1001+
100'+
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main 101+ Water service line 101+ Surface water. W.V�/OD r i fl, a_,
Wells on adjacent lots OCA ( t,,E—
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 101+ Water main 01+
Water Service line 101+ Surface water 1001+ Driveway, parking/vehide storage 104
Curtain drain 50'+ Wells on adjacent Iotg 60 + /V A cL o-2.
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I 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 KENNETH M. DUFFUS
Date712712006
COSA Fee $430.00
Date of Payment / —7 �2 7144
Receipt Number
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
., ...,. V ♦ r. uo yu ra44yu21 JRS SEPTIC PAGE 01
JRs Pumping
PO Box 77]415
Eagie River, AIC 99577
(90'77 694.6454
[Billina lnformadon�
KND Engineering
20441 Ptarmigan
Eagle River, AK 99577
(907) 696.6111
iJob $Ito Information
Victor
19049 Whirlaway Road
Eagle River, AK 95577
(907) 868-5032
884-3398
Job Descnpson:
10008
P.O. Number.
Order Date:
Twma:
Net 30
Sal":
Karlia
Map Book:
clew. 50-49:
Crest View Lane
Job comments:
Unknown
Service Agreement
Number.
020545
Order Date:
19 -Jul -2006
Service Date:
24 -Jul -2006 12:00
Technician:
Tony
Access Tank
Sludge - BF- X 2's
Additional Location Comments Diagram: amkgmm2'n`4u=
MORE DESCRIPTION NEED DRAWING
Septic @ Front of Home?
Service Type
Septic Service 15K
city Price Each Tax?
1 $135.00 No
Tax Y.: 0
Job Type: Repeat
Map Grid: 99 - .
Gallons Planned: 1000
Gal. Actual:
Hose Length:
Double Tank: O —
Pump System:
Baffles Inlet: O
Baffles Outlet: O
Extension Actual
$135.00
NonTexeblw Toth Taxable Total Twe Total Grand Total
Estimated Chargex $136.00 $0.00 $0.00 $135.00
Actual Charges:
Custom" agrees to the terms and conditions shown. THIS 13 A BINDING AGREEMENT.
Signalme and Tlds or Customer Repreesetadw Data
Accepted by JRs Pumping
Data Accepted
For your added convenience we accept: American Express, Dices . View and Master Card payments over the phone.
After 30 Days accounts will be turned mw to collections. $25.00 For NSF Checks Returned.
J
wKiQ
19
i •(
�5
R di
AS -BUILT � -
I hereby ,certify, that I .have surveyed the Iolloviing
d, ribed property:�4-[. ! �p;.�9'_ ,'•
Anchorage Recording Precinct,Alaska, and,that.the
Improvements situated thereon are within the, property,
lines and do not overlap or.encroach on the property
lying adjacent thereto, that no improvements on, prop,
erty lying adjacent thereto encroach on tho premises in
question and that there are no roadways,'transmissionn
lines or other visible casements on said property except
as indicated hereon.
Dated at Eagle River, Alaska
thjday of
ROBERT C.'JOIINSON
SCALE: Registered Land Surveyor No. 680 -LS
V= 2!,i Box '458,Eagle River, Alaska., -
Phone 694-2543
MUNICIPALITY OF ANCHORAGE
• DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services ism
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. # 050-223-02
1. GENERAL INFORMATION
HAA# 11\12kILIA-L)
Complete legal description Lot 20-1), Eagle River Valley Ranchettes
Location (site address or directions) 19049 Whirlaway Road, Eagle Rivre, AK 99577
Property owner .
Mailing address .
Lending agency _
Mailing address 3201 "C" Street, Suite 200, Anchorage, AK 99503
Tom & Ann Rothe
--Jack White Real Estate
Day phone
Day phone
276-4244
563-5500
Agent John Blaine Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3 v
3. TYPE OF WATER SUPPLY:
Individual well
Community well XXX
Public water
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 XXX
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-M(14".1/91) Front MOA,21
5.
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I furtherverify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm 5 b S ENGINEERING 17034 fiovk River I sop Read No, 204 — Phone G 91 — 3-j 7%
Address Eagle River, Alaska 99577
Engineer's signature
6. DHHS SIGNATURE
_ff Approved for TNR FE bedrooms.
Disapproved.
Conditional approval for
Additional Comments
M
Date S 12, A7 B
6 OF
�,-RCIERT C. co WAN
lig: CE -8801
s
Is. �Cii:S.. _
bedrooms, with the following stipulations:
Date fl— S. `) s
•
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 courtesy to purchasers of homes
and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-M (FW. 1191) 6� M0A m
:_IVLIJ
~ Municipality of Anchorage S 0 1 1998
DEPARTMENT OF HEALTH & HUMAN SERVICES
ANJi
Environmental Services Division MUIV LIFAIIT., CERVICESY OF WCESIU AGE
-•^nNAcnn DIVI"'
825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744
of sample:
B. SEPTIC HOLDING TANK DATA
Collected by:
Data Instailed1-1 °I '1 L Tank size 1000 Number of Compartments 7-- Cleanouts)
Foundation cleanout (Y(111) Depression (Y4% e- High water alarm (YM) ')
Dais of Pumpirr>D " Pumper S3 . I JMfi Jt,
C. ABSORPTION MELD DATA
Date insltalled 19'► V ..:.. Soil rating (g.p.d]W or ft'/bdrm)/•'t system"
Length 3 0 Width �'3, Gravel thickness below pipe L Total depth 1 Z
Effective absorption area 3L 0 ` Monitoring Tube present t%) -Y— Depression over field (YA P)
Date of adequacy test Result P8S/Feil) _P") For 3 bedrooms
Fluid depth in absorption field before test (in.); 6N Immediately atter'S0gal. water added (in.):
w -
Fluid depth 3 (ins) Minutes later: r►" • 1) Absorption rate = a.p.d.
Peroodde treatment (past 12 months) (Y& KA�6441' If yes, give date
72-026 (Rev. 3196)'
Health Authority Approval Checklist
Legal Description: Z 0 D
M_LL f -W Lt 4au�
Parcel I.D.: o Sb 22 3 - a 'L—
A. WELL DATA
Well type MO tk
If A. B, or C, attach ADEC letter.
ADEC water system number
Log present (Y/N)
Date completed
Total depth
Cased to
Casing hei ground)
Sanitary seal (YM)
Wi roperly protected (YM)
FROM WELL LOG
AT INSPECTION
Date of test
Static water level
Weil production
g.p.m.
WATER SAMPLE SULTS:
Coliform
Nitrate
Other bacteria
of sample:
B. SEPTIC HOLDING TANK DATA
Collected by:
Data Instailed1-1 °I '1 L Tank size 1000 Number of Compartments 7-- Cleanouts)
Foundation cleanout (Y(111) Depression (Y4% e- High water alarm (YM) ')
Dais of Pumpirr>D " Pumper S3 . I JMfi Jt,
C. ABSORPTION MELD DATA
Date insltalled 19'► V ..:.. Soil rating (g.p.d]W or ft'/bdrm)/•'t system"
Length 3 0 Width �'3, Gravel thickness below pipe L Total depth 1 Z
Effective absorption area 3L 0 ` Monitoring Tube present t%) -Y— Depression over field (YA P)
Date of adequacy test Result P8S/Feil) _P") For 3 bedrooms
Fluid depth in absorption field before test (in.); 6N Immediately atter'S0gal. water added (in.):
w -
Fluid depth 3 (ins) Minutes later: r►" • 1) Absorption rate = a.p.d.
Peroodde treatment (past 12 months) (Y& KA�6441' If yes, give date
72-026 (Rev. 3196)'
D. LIFT STATION
Date installed
Manhole/Access (Y/N)
High water alarm level at'
E. SEPARATION DISTANCES
Size in gallons
"Pump on" level at'
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
line
On adjacent lots
On adjacent lots
u io sewer manhola/deanout
Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
off" level at'
Foundation to Property line 10 1t Absorption field '16 ti'
Water main/service line to 1* Surface wateddrainage l o0 1r Wells on adjacent lots 1�� ti
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line to ► x Building foundation 10 t r Water main/service line l o
Surface water \C7 0 It -Driveway, parkinghrshicle storage area to 1 t
Curtain drain t) Ik Wells on adjacent lots ate' o kir-
F.
ir-F. ENGINEER'S CERTIFICATION
I cerfdy that 1 have detey/
rrnminSeepdthru Held inspections and review o/
in conformance- with
Al0in�i Imes in eRect on this date.
Signature Q /�
Engineers Name / M h 4 i ` d wAr•�
Data 9 �,%
HAA Fee 3 '300,00
Date of Payment C?/z /9 F
Receipt Number O Y03 9- (!Yc? /O
72-026 (Rev. 3/913)'
Waiver Fee $
Date of Payment
Receipt Number
*006Rr C. COWAN'"
CE -8801
ate
r�-
,r
-1
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME
TIME
TIME
DATE
DATE
DAT
�%u.c2�.
INSPECTOR
INSPECTOR
INSPECTOR .
((�UDEPT.
MUNICIPALITY OF ANCHORAGE OF F:7AUH &
OF HEALTH & ENVIRONMENTAL PROTECIWI� ONMENTAL P"�31'CTION
DEPARTMENT
825 L Street • Anchorage, Alaska 98601
• JUL 11980
1
ENVIRONMENTAL SANITATION DIVISION
Telephone 264-4720 RECEIVED.
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTY OWNS
PHONE/
f ?
T
MAILINGADDRESS-
JO -So `/Z ;tom„FS O 7.
PROPERTY RESIDENT Of different from aboVel,
PHONE
2. BUYER
PHONE
o a
MAILING ADDRESS
3. LENDING INSTITUTIONS
PHONE
MAILING ADDRESS
0. REALTOR/AG/ENT �7
PHONE
,e—
MAILING ADDRESS
r
5. LEGAL DESCRIPTION/
/T
r
STREET LOCATION
���� ff//
Wffi /
6. TYPE OF RESIDENCE
NUMBER OFsBEDHOOMS
❑ One ❑ Four ❑ Other
VSINGLE FAMILY
❑ Two ❑ Five
❑ MULTIPLE FAMILY
Three ❑ Six
7. WATER SUPPLY
❑r�-INDIVIDUAL'
*ATTACH WELL LOG. A well log is required for all wells drilled
W COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
S. SEWAGE DISPOSAL SYSTEM
d INDIVIDUAL/ON-SITE”
177 Z YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLICUTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72010 (Rev. 6/79)
n n-
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE ❑ THREE ❑ FIVE ❑ OTHER
❑ TWO ❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLICUTILITY
Connection Verified
PERMITNUM8ER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON-SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATEINSTALLED
(P
INSTALLER
J
❑Septic Tank or ❑Holding Tank
Size:OLIO
� If Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA -
MATERIAL
4. DISTANCES
WELL T0:
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line - -
S. COMMENTS
tYAPPROVEDFOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany ce ' 'cate)
❑ DISAPPROVED
DATE
BY
72010 (Rev. 6/79)
Mr. Carl Hoffenkamp
Box 165 4Fhirlaway
Eagle River, Alaska
Dear Mr. Hoffenkamp,
DAVID A.SLENKAMP
MECHANICAL ENGINEER
694-9055
99577
July 8, 1980
Reference: .Lot 20D;.Eagle River Valley Ranchettes
ROBERT A. SHAFER
CIVIL ENGINEER
694-2979
A sewer system adequacy test was performed on the system located
on the referenced property on July 5 and 6, 1980. The septic
tank was pumped and in accordance with Municipality records has
a capacity of 1000 gallons. The seepage pit was tested by con-
tinuous flow of approximately 632 gallons of water over -a period
of 24 hours. The water level in the sump at the end of the trench
was monitored with no measurable rise in the water level during
the test period.
It can be concluded from this test that the sewage system is
currently operating adequately for the three bedroom residence
located on this property.
If we may be of further assistance, please do not hesitate to
call.
SZn2yR. SFI11F P.E.
cc: Municipakity of Anchorage
Department of health and Enviornmental Protection
Sourdough Realty
ATTENTION: Natalie Huff
Security Pacific Bank
SRB 196X EAGLE RIVER, ALASKA