HomeMy WebLinkAboutBIG DIPPER LT 1Big Dipper
Lot 1
#050-201-56
inspection Report i -Tr z.00c
Municipality of Anchorage
Community Development Department Page 1 of 2
On -Site Water and Wastewater Program
4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http:/Iwww.muni.org/onsite • (907) 343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP121017
PID Number: 050-201-56 ❑ New ❑✓ Upgrade
Name:
Michael Smith
ABSORPTION FIELD
❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound
Address
21613 Eagle River Road
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
2
GPDlSF
Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
Ft.
Gravel depth beneath pipe
Ft.
Subdivision
Block Lot
Big Dipper
1
Fill added above original grade
Ft.
Gravel length
Ft.
Township Range Section
Gravel width
Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
Fe
Ft.
well
111.5
TANK D Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Anchorage Tank
Capacity
1 1000Ga1.
Surface water
100+
Material
Number of compartments
Lot Line
32.5
Steel
2
NA
Foundation
41.5
LIFT STATION
Manufacturer
Capacity
Curtain Drain
N/A
I
Gal.
RemarksTank replace only.
Pump on level at
in.
Pump off level at
In.
High water alarm at
in.
Pump make and model
Electrical Inspections performed by
Installer
PIPE MATERIAL Housetotank 3034 Tankto
drainfield PVC
Flintstone Enterprises
_
Drainfield N/A CO/MT PVC
Inspector Pannone Engineering Services
BENCH MARK (Assumed elevation) 100ft
Inspection M 2/17/2012
dates:
a
2^ 2/18/2012
Location and description
3b
41n
House FF.
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Engineer's Stamp
el29'L
O� A�,titi
Conditional Approval:
Date
:,
seven ,�. �annome K
CE 8149
Approved
^�
inspection Report i -Tr z.00c
�z
mz
o!�
HOUSE
(E)
1 12-
/ 32.5
WELL (E)
W \y\
EXISTING COLLAPSED
1000g SEPTIC TANK
ABANDONED PER CODE
INSTALLED NEW 100Dg SEPTIC TANK
WITH DCO
10' GAS EASEMENT
—W
EAGLE RIVER ROAD
NOTES: PANNONE ENG SVC, LLC'oF a���l D 3 e2
RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 r � .......•. is 712
PHONE (907) 272-8218 FAX (907) 272-8211 drg�P �y p� Scale
j*:49TH 1"=50'
P.I.D. NO
BIG DIPPER, LOT 1!- \` ^- ! 050-201-56
MICHAEL SMITH
/ Steven `R. onnonef PERMIT NO
/
/ p.P kJy7 v5.i 9t;',�"� SheetD21017
21613 EAGLE RIVER ROAD /p
PLAN EAGLE RIVER, AK 99577 llog70�P`
2 of 2
A B
Cl
32.3
33.9
T7
45.3
43.3
T2
50.0
48.8
DCO
53.0
52.3
NOTES: PANNONE ENG SVC, LLC'oF a���l D 3 e2
RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 r � .......•. is 712
PHONE (907) 272-8218 FAX (907) 272-8211 drg�P �y p� Scale
j*:49TH 1"=50'
P.I.D. NO
BIG DIPPER, LOT 1!- \` ^- ! 050-201-56
MICHAEL SMITH
/ Steven `R. onnonef PERMIT NO
/
/ p.P kJy7 v5.i 9t;',�"� SheetD21017
21613 EAGLE RIVER ROAD /p
PLAN EAGLE RIVER, AK 99577 llog70�P`
2 of 2
On -Site Wastewater Disposal System Permit
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
Permit Number: OSP121017
Tax Code Number: 05020156000
Work Type: Septic Upgrade
Permit Effective Dates: February 17, 2012 to February 16, 2013
Z17 �p"1
Design Engineer: PANNONE ENGINEERING SERVICE
Subdivision: BIG DIPPER
Site Legal Address: BIG DIPPER LT 1 G:0058
Owner/Address: SMITH MICHAEL EUGENE
PO BOX 770036 EAGLE RIVER AK 995770036
Site Mailing Address: 21613 EAGLE RIVER RD, Eagle River Lot Size in Sq Ft: 46732
Total Bedrooms: 2
This permit is for the construction of:
N Disposal Field Y Septic Tank 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.
Received
'' // II
Issued By: v_(102 4Z� Date: 7 Z
MUNICIPALITY OF
Community Development Department
Development Services Division
On -Site Water & Wastewater Program
Mayor Dan Sullivan
Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 095-&J- 5_6
Property owner(s) My Day phone
Mailing address F.Dom. , at 77d236 ,6hGIF RhIOK, 04K 44&72
Site address Z 4[:5 _ A-Al—L� 21Vb92 904.0
Legal description (Sub'd., Block & Lot) _ $I/. PtPPo"R i4pZ 1
Legal description (Township, Range & Section)
Lot Size 416, 73Z Sq. Ft. Number of Bedrooms Z
THIS APPLICATION IS FOR:
THIS APPLICATION IS AN:
(® all that apply)
Initial ❑
Absorption Field
❑
Septic Tank
Upgrade
Holding Tank
❑
Renewal ❑
Privy
❑
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
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 or authorized agent)
Permit/Rush Fees: 4 A 6 0 — Waiver Fees:
Date of Payment: a 1(P'( Imo_
Receipt Number: G 852.3 CJ
Permit No. d 8 PIa LO IT
Date of Payment:
Receipt Number:
Waiver No.
G:\Building\On Site\Forms\Client FormsTermit App_01041 i.doc (Rev. 1/11)
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steveftrianenaak.com
February 16, 2012
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
4700 S. Bragaw Street
Anchorage, Alaska 99519
Subject: Big Dipper, Lot 1
Emergency Septic Tank Replacement Permit Request
Ladies and Gentlemen:
I am writing to request that a permit to install a new 1000 gallon septic tank be issued for this lot.
The proposed systems will serve an existing two-bedroom house. Currently the lot is developed.
The existing septic system was designed and installed for a three-bedroom house and will be
verified to determine that it is operating adequately for three bedrooms during installation. The
existing 1000 gallon septic tank is collapsed and is exposing raw sewage to the environment.
The existing tank will be filled with clean gravel or concrete and abandoned per code. The
surrounding lots are served by private wells, and there are no wells within 100 feet of the
proposed septic tank. This lot is served by a private well that is over 100 feet from the existing
drain field and proposed tank. PES will verify all required separation distances at time of
installation.
1. Upgrade Tank Design.
a. See Sheet 1 of 1 of the plan set
2. Surface Water: There is no surface water within 100 feet of the proposed system. The
proposed systems will maintain at least 100 feet from all surface water and drainage ditches.
3. Topography: Lot 1 slopes from north to south at approximately 10% in the area of the
tank replacement. The proposed installation will be located in the central portion of the lot next
to the existing septic tank and absorption system.
Mailing: P.O, Box 1.0021.7, Anchorage, Alf 99510-0217
Physical: 332 1j2 East Manor Ave, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
Page 2 of 2
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,
Steven R. Pannone, P.E.
Owner/Civil Engineer
Attachments:
Mailing: P.O. Box 1.00217, Anchorage, AK 99510-0217
Physical: 332 1/2 East Manor Ave, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
2
I
WELL (E)
pw�m__M '\
w \�
Cn Py�
w (
(n M 1 G�� • \
M I
• WELL (E)
\ O
2BR /
o• HOUSE 3 INSTALL 1000g SEPTIC TANK (P)
(E) WITH DCO
4Y—
EMERGENCY TANK REPLACE
PLAN
/ EXISTING COLLAPSED
3g 1000g SEPTIC TANK
ABANDON PER CODE
• j 10' GAS EASEMENT
W�
EAGLE RIVER ROAD
PANNONE ENG SVC, LLC
P.O. BOX 100217 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
BIG DIPPER, LOT 1
MICHAEL SMITH
21613 EAGLE RIVER ROAD
EAGLE RIVER, AK 99577
Scale -_
... . . .. ......... P.I.D. NO
050-201-56
"tteven * ..� nnone j PERMIT NO.
I� s: CE 8149..���/ XXXXXXXXX
Sheet
1 OF 1
NAME
Anchorage, Alaska 99503
INSPECTION REPORT Ofd -SITE SEWAGE DISPOSAL SYSTEM
MAILING ADDRES
PHONE��2��
LOCATION LEGAL DESCRIPTION /ill `/ 4-`
SZPT I C "i A N K:
DISTANCE / NUMBER OF
FROM WELL MANUFACTURER � YLZZ MATERI `�«jUL'y/fi�>c`J/� COMPART:MIENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH--- LIQUID CAPACITY J -__GALLONS.
SEEPAGE PIT:
NUMBER OF PITS
DIAMETER OR WIDTH L!� LENGTH 2� DEPTH --
LINING MATERIALCRIB SIZE: DIAMETE -ZSDEPTI-l—, L. DISTANCE FROM:
✓✓ TOTAL EFFECTIVE
BUILDING FOUNDATION--2-,'� NEAREST LOT LINE CZ . ABSORPTION AREA (WALL AREA)
ADDITIONAL ABSORPTION
VJ�7?
WELL Z,2 �
SQ. FT.
TYPE -// �,=� CONSTRUCTION -/'2 f't/ DEPTH DISTANCE FROM:
BUILDING NEAREST NEAREST _ SEPTIC SEEPAGE
FOUNDATION LOT LINE -- SEWER LINE TANK ��=� SYSTEM
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED REMARKS
INSTALLED BY:
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
DIAGRAM OF SYSTEM
\,
--'\ c7
w
t
DAT??'4 : /li APPROVED
.A.A.B.
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
UII�Jj I } s 3330 "C" STREET ANCHORAGE, ALASKA 99503
�0
p TELEPHONE 274-4561
p` nulls..
,,.n �..ee�
SEWAGE' DISPOSAL SYSTEM ERA - APPLICATION AND PER,,MT
NAME OF APPLICANT
INSTALLATION LOCATION
LEGAL DESCRIPTION _ '
PERMIT NO.
/� >l
PHONE
b'i / CC/ /�./
';�r'i',;•_/ Z,. 'fir:. C_-•'? MAILING ADDRESS - '��/'� �-�
INSTALLATION OF: SEPTIC TANK 4 SEEPAGE PIT DRAIN FIELD OTHER
TYPE AND SIZE OF FACILITY TO BE SERVED
i
FINANCED THROUGH TO BE INSTALLED BY
SOIL TEST RESULTS GIa� V - NOTE: THIS PERMIT 15 NOT VALID VYITHOUT 5,01L TLS
COMPLETION DATE ANTICIPATED
TFINAL INSP2-CT ION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPEC`f ION BY THE
IEPARTM r:T OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE / �G TYPE -S/_ L 1 SEEPAGE AREA SIZE TYPE
.V INIMUIV. REQUIREMENTS
FOUNDATION TO .SEPTIC TANK
FOUNDATION TO SEEPAGE PIT ' -"l DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK SEEPAGE PIT ., DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
i
DRAIN FIELD -
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
—. SEEPAGE PIT ",/ r
SEPTIC TANK, SEEPAGE PIT DRAIN FIELD
TO RIVER, LAKE, STREAM.
-,CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIS 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 SAC'KFiLL
CONFORM TO BOROUGH -REGULATIONS REGARDING INSTALLATION.
G.A.A.B.
OR
LICENSED DESIGNER
DIAGRAM OF SYS""1",Mai
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
bATt ` APPLICANT'S SIGNATURE !� ` ' --,.--------
1 � I.•la i,) Nom),'Q-p'16
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY Case #
3330 "C" Street
ANCHORAGE, ALASKA 99503
Performed For u.5 jl;.Iles Dated Performed u7 73
Legal Description . Lot B1 o c k Subdivision �o�
This Form Reports Soils Log � Percolation Test
- Soil Test Must Be Logged To 4' Below Proposed Seepage System -
Depth
Feet Soil Characteristics
1--
2-
3-
4-
5-
6-
7-
8-
9-
10-
11-
12-
13-
14—
Was Ground Water Encountered? t'Jc;,
If Yes, At What Depth?
Reading Date Gross Time Net Time Depth to H2O Net Drop
vercolation Kate Minute
Proposed Installation: Seepage Pit Drain Field
Depth of Inlet Depth to Bottom of Pit or TrencF
COMMENTS: F"5- ff
Test Performed BY.,�.e_ S"J?G�J�u..c1 Date Certified BY:
Date
825 'L' STREET, ANCHORAGE, HK. 99501
264-4720
PERMIT NO ( 790448 )
APPLICANT LESTER/YHLERIE GRELL STAR RT BOX 191-C 694 9501
LOCATION EAGLE RIVER RD
LEGAL SWI/4 S9 T14N R1W TR H DOUGLAS LOT SIZE 29688 SQUARE FEET
MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR H PRIVATE WELL/ OR
150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
���M I -V F -E X F:" I ����Irl ED EE_ F:;:," ��� ���1-C-4
I CERTIFY THAT
1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
SIGNED:
APPLICANT LESTER/YHLERIE GRELL
ISSUED BY�J� _DHTE__���-;Q1
__�_�_ V] 2
(y -----~--��----------i-~��--- ' «- �
OWNER OF LAND
ADDRESS
LEGAL DESCRIPTI
DATE - Started .—
PERMIT NUMBER
KIND OF FORMATION:
s
tr b : r
�tt*u NICIPALITY OF ANCHORAGE
G
DEPT. = _ `17 I &
b} NVIRONMENTAL r^- OTECTION
DOC Co. dba
SULLIVAN WATER WELLS
P.O. BOX 272, CHUG IAK, ALASKA 99567 • TELEPHONE 688-2759
Ended
SEP 12 1979
RECEIVED
DEPTH OF WELL
STATIC LEVEL OF WATER FT.
DRAW DOWN FT.
GALS. PER HR
KIND OF CASING
From
Ft. to Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
From
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Ft.
From
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Ft.
From
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From
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From
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Ft
From
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From
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Ft
From
Ft. to—Ft.
From
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From_
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From
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From
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MISCL. INFORMATION:
DRILLER'S NAME
A� 18111-91
f
MUNICIPALITY OF ANCHORAGE
• -� 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. # n�Sn —='_C�1 -CLQ HAA # �1'�1';�9 r)l-'-_
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Le al Description (include lot, block, subdivision, section, township, range)
�, L✓ t o o�� LOT l
Location (address or directions)
(b) Property owner �lls Telephone: (home) Business
Mailing Address
(c) Lending Institution
Mailing Address
(d) Real Estate Company and Agent
Telephone
Address
Telephone �Ar — �p
(e) Mail the HAA to the following address: (or check here"I67if hold for pick up.)
List contact person and day phone number below:
S & S ENGINEERING
17034 Eagle River Loop Road No 204
Eagle River, Alaska 9'9577
2. TYPE OF RESIDENCE
Single -Family Number of bedrooms
3. WATER SUPPLY
Individual Well' Community ❑ Public ❑
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_ 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
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this
Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe,
functional .and adequate for the number of bedrooms and type of structure indicated herein. I further verify that
based on the information obtained from the Municipality of Anchorage files and from my investigation and
inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and
State codes, ordinances, and regulations in effect on the date of this inspection.
Name of Firm
Address
Date —
Telephone e5 f �e 2 7 -7
S & 5 ENGINEERING
341 =gala River Loop Road No 204
Eagle River, Alaska 99577
6. DHHS APPROVAL
Approved forbedroomsby Date
Approved —— Disapproved Conditional
Terms of Conditional Approval
CAUTION
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
cerificated 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 order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections
or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions
in the professional engineer's work.
72-025 (Rev. 7/88) Beck Page 2 of 2
MUNICIPALITY OF ANCHORAGE (MOA)
• ' thority Approval (HAA)
( Y OF ANC :°`h.AuIST - FEBRUARY 1984
NV)l. 7Al_�ER.viC.� 343-4744
Av — Legal Description: �` l NE741)) L- o %~
A. WELL DATA R E C E IV E a' ,
Well Classification 1tc\q I If A, B, C, D.E.C. Approved (Y/N)
Well Log Present ON) t Date Completed Yield--�-
Total Depth �Zt Cased to �2� Depth of Grouting
t-,
Static Water Level Pump Set At
Casing Height Above Ground �'1- Sanitary Seal on Casing(40N)y
Electrical Wiring in Conduit(l`ya'N) Depression Around Wellhead (Ytp
SEPARATION DISTANCES FROM WELL:
t
To Septic/Holding Tank on Lot I �� k ; On Adjoining Lots \ �� 1 A -
To Nearest Edge of Absorption Field o Lot l. �_�� ; On Adjoining Lots — �a t
To Nearest Public Sewer Line P To Nearest Public Sewer Cleanout/Manhole A
To Nearest Sewer Service Line on Lot 2r 4 -
Water Sample Collected by ':S'4rS� t r�1?� r�G ; Date
Water Sample Test Results �+����`j' 1 N
Comments I r- - WCC-- 122::A
��-i�rt�PU. V��Lt_,. i-l� ����--► �i�'l�c�-��� /y-(���u. 1rZ—
t�i'r1�'yi►s�,� w%ii'%.�� ��: D• �9 \�J�. t r-�:���� �1 �a ��.b� �s 'i�� v.�i�
B. SEPTIC/HOLDING TANK DATA1T�`
Date Installed 6--�7'I3 Size 1 =N5;,o No. of Compartments
Standpipest7N) `/ —Air-tight
`l Caps (WN) V Foundation Cleanout (Y,9I
Depression over Tank (Y/6) fes' ate Last Pumped —2-E39
Pumping/Maintenance Contact on File (Y N �r R' ; for
N
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 ) I
To Property �� -;-
p y Line To Disposal Field
To Water Main/Service Line
% -k-
To Stream, Pond, Lake•or Major Drainage Course �o �-
Comments '��-S ��5ec =A__ i;�)
72-026 (Rev. 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata Type of System Design U� cam, (5
Date Installed S' -''l3 Length of Field "Z
Width of Field �Z\ Depth of Field 2,
Gravel Bed Thickness 8
Square Feet of Absortion Area t Statndpipes PresentdVN) V
Depression over Field (YN) r Date of Last Adequacy Test S i 8q
Results of Last Adequacy TesttS�-
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water -Supply Well 14- To Property Line k >1 _�_
t
To Building Foundation �- To Existing or Abandoned System on
Lot N P ; On Adjoining Lots �5c:> 14 -
To Water Main/Service Line `� ,� To Cutback (if present) h
To Stream, Pond, Lake, or Major Drainage Course \ w
i+_
J,-
To Driveway, Parking Area, or Vehicle Storage Area
�d
Comments
D. LIFT STATION
Date Installed
Size in Gallon
"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)
Pump ycles during Adequacy Test.
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this
inspection.
Signed S & S ENGINEERING ++w -'"w1
17034 Eagle River Loop Road No. 204 '(� NM••�
Company�,,`� may. '•.,,s,�. j
/�,
Date I_ �� AV #�;&aL
MOA No.�.....«s...-
�`
Receipt No. n s
Date of Payment -lam /
Amount: $ / 7e- 60
r�'• sb*d A. Sh�tw
;p ••. Na 1457-E
Receipt No. ��\�`V ••i.,s....•' �,�.` •�r
Waiver Fee: $
Date of Payment
72-026 (Rev. 7/88) Back Page 2 of 2
°o CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343
FEDERAL TAX ID # 92-0040440
LABORATORIES
Client Sample ID:TRACT "A" DOUGLAS
PWSID :UA
Collected MAY 1 89 @ 10:30 hrs.
Received MAY 1 89 @ 16:00 his.
Preserved with :AS REQUIRED
ANALYSIS REPORT BY SAMPLE for Work Order # 13011
Date Report Printed: MAY 4 89 @ 07:56
Client Name S & S ENGR
Client Acct SNSENGP
P.O.# NONE REC"D
Req #
Ordered By : RJS
Analysis Completed :MAY 1 89 Send Reports to:
Laboratory Supervisor :STEPHEN C. EDE 1)S & S ENGR
Released By �� G Vk'-- 2)
Special
Instruct:
Chemlab Ref #: 5084 Lab Smpl ID: 1 Matrix: WATER
Allowable
Parameter Tested Result/Units Method Limits
---------------------------------------------------------------------------------------------------------------
NITRATE-N 1.6 mg/l EPA 353.2 10
Sample ROUTINE SAMPLE.
Remarks: SAMPLE COLLECTED BY RJS.
I Tests Performed " See Special Instructions Above UA=Unavailable
ND= None Detected "" See Sample Remarks Above
NA= Not Analyzed LT=Less Than, GT=Greater Than
APPLIC NT -FILLS -OUT UPPER HAI ONLY
Prop0ty Owner Ps z� Uff / j P
Phone
Mailing�A^ddrelss
Code f
Zip Code
/0
Buyer
c
►
Address r
Zip Code
Lending Institution 4 S -, G
Date
Phone
Address
Zip Code
Realty Co. & Agent
Address (
Zip Code CJ
2 7V—
Legal Description 7- G7141-
Street Location
Type of Residence
Ingle Family
❑ Multiple Family No. of Bedrooms
Field Notes:
❑ Other
OF ANCHORAGE
Watepply
ndividual
ATTACH WELL LOG. A well log is required for all wells drilled since June 1975.
❑ Community
For wells drilled prior to that date, give well depth (attach log if available).
❑ Public Utility
PROTECTION
Sewer D' osal
ndividual
Year Individual Installed:
❑ Public Utility
When Connected to Public Utility:
❑ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
r0
.y
PRO
Time
Time
Time
Time
Date
Date
Date
Date
Inspector
Inspector
Inspector
Inspector
Field Notes:
OF ANCHORAGE
J
MUNICIPALITY
DEPT. PT. OF HEALTH Pt
1
PROTECTION
ENVIRONMENTAL
MAR 15 198'%D
A�
RECEIVED
( L;,} PPROVED BEDROOMS -3 'CONDITIONS OF APPROVAL
( ) DISAPPROVED
( ) CONDITIONAL APPROVAL'
i
DATE
BY:
Soils Rating
Date Sewer Installed
Well To Absorption Area /vJ
Well Log Received
�.
Well to Tank
Septic Tank Size
72023 (3/82)
}March 18, 1983
t,es and Val "'rell
S ta r Rt 1910
Eagle River 99577
Subject: Tract A, Douglas Subdivision
Approval for the individual sewer and water facilities cannot
be granted until the following iteitis have been corapleted:
The top of the well casing should be sealeci ;so that it is
water tight.
Exposed electrical wires to the well he a{. are in violation
of the MlunicipaliLy of Anchorage codes and must: be encaseo
in conduit.
0 The water analysis resort needs to be submitted to this
otfice from the Che i -,t Lab, 5633 B Street, for our review.
The septic tank pul-tiped with a receipt submitted to tilis
departtent:. The total number of gallons pumped needs to be
on the receipt anti verified by a registered �ngineer as to
the actual number of gallons pumped. This is to verify the
size of the septic tank.
Locate and expose the cleanout to the seepage pit and/or
leaching area for our inspection. This is to insure the
minimum distance require,,ments are Tiiet between the well and
.�Cwer system.
An adequacy test needs to be performed on the existing
leaching area. 'Mis test will determine it the systen. is
adequate according to "National Standards. A listing of
private firms jx1rforming the test is dncloscd. This re -port
needs to be submitted to this ottice I -or Our review.
Please notify this Departnent for a reinspection when the
noted discrepancies have been corrected. IL thure are any
iurther questions, please call this office at 264-4720.
Sincerely,
JR174/ej/El Jim Roberts
Enclosure Associate Environi3ental Specialist
March 18, 1933
Buchanan & Associates
Sharron Stapleton
2044 Rastridge Drive
Anchorage, Ak 99504
Subject: Tract A, Douglas Subdivision
Approval for the individual sewer and water facilities cannot
be granted until the following items have been completed:
The top of the well casing should be sealed so that it is
water tight.
0 Exposed electrical wires to the well head are in violation
of the Municipality of Anchorage codes and must be encase6
in conduit.
The water analysis report needs to be sub,,.iitted to this
office from the Chem Lab, 5633 b Street, for our review.
0 The septic tank pumped with a receipt submitted to this
department. The total number of gallons pumped needs to be
on the receipt and verified by a registered engineer as to
the actual number of gallons pumped. I.-L"his is to verify Uie
size of the septic tank.
0 Locate and expose the cleanout to the seepage pit and/or
I
leaching area for our inspection. This is to insure the
minimum distance requirements are met between the well and
sewer system.
An adequacy test needs to be performed on the existing
leaching area. This test will determine if the system is
adequate according to National Standards. A listing of
private firms performing the test is enclosed. This report
needs to be submitted to this office for our review.
Please notify this Department for a reinspection when the
noted discrepancies have been corrected. If there are any
further questions, please call this office at 264-4720.
Sincerely,
JR176/ej/El Jim Roberts
Enclosure Associate Environmental Specialist
March 18, 1983
Alaska State Bank
Nortflern Lights & Denaii
Anchorage, Ak 99503
Subject; Tract A, Douglas Subdivision
Approval for the individual sewer and water facilities cannot
be granted until the following items have been cor'.tpleted:
* The top ot" the well casing should be sealed so that it is
water tight.
* Exposed electrical wires to the well he -ad are in violation
of the Municipality of Anchorage codes and r,.iust be encased
in conduit.
* The water analysis report needs to be submitted to this
office from the Chem Lab, 5633 B street, for our review.
The septic tank Pumped with a receipt submitted to this
department. The total number of gallons pumped needs to be
on the receipt and verified by a registerea engineer as to
the actual nui;,iber of gallons 1,;umped. This is to verity the
size of the septic tank.
Locate and expose the cleanout to
leaching area for our inspection.
minimum distance requirements are
sewer systert.
the seopacie pit and/or
This is to insure the
met between tkie well and
0 An adequacy test needs to be performed on the existing
leaching area. Thics test will determine ii the systeat is
adequate according to I'lational Standards. A listing of
private firms performing the test is enclosed. This report
needs to be submitted to this office for our review.
Please notify this Department for a reinspection when the
noted discrepancies have been corrected. If there are aay
turther questions, please call this office at 264-4720.
Sincerely,
Jim Robert8
Ei-tclosure Associate Envirorii:'Iental 111;-pecialist
$P_�
EXCAVATION
Mr., Les Grell
Star Route Box 191C
Eagle River, Alaska 99577
Dear Mr. Grell,
WORK
March 2G7 1983
Reference: Tract A; .Douglas Subdivision; SA of Section 9;
T14N; Rlw; Seward Meridian
ROBERT A. SHAFER
CIVIL ENGINEER
694-2979
AA sewer system adequacy test was performed on the system located
on the referenced property, as you requested. The septic tank
was pumped and verified to have a capacity of 1000 gallons.
The seepage pit clean out had to be located with a metal detector.
After locating the pipe, 1000 gallons of fresh water was injected
into the system and after a period of 24 hours all the water which
had been added had percolated out.
It can be concluded from this test that the waste water disposal
system serving the three bedroom residence located on thin,property
is currently functioning:adequately. However, the system cannot
be guaranteed against subsequent failures.
It should also be noted that the well wires had been placed into
conduit as required by :the Municipality.
If we may be of further service,,please do not hesitate to contact
us.
cc: Municipality of Anchorage
Department of Health and Environmental Protection
SRB 196X EAGLE RIVER, ALASKA
r
5. LEGAL DESCRIPTION
MUNICIPALITY OF ANCHORAGE r
;J! or!', l `.:- . TION
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
825 L Street - Anchorage, Alaska 99501
Mile 3, Eagle River Rd.
ENVIRONMENTAL ENGINEERING DIVISION
NUMBER OF BEDROOMS
Telephone 264-4720
E C E I E D
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. PROPERTYOWNER
7. WATER SUPPLY
PHONE
James Jansen
*ATTACH WELL LOG. A well log is required for all wells drilled
694-9748
MAILING ADDRESS
❑ PUBLIC UTILITY
St. Rt. Box 191C, Eagle River, AK 99577
8. SEWAGE DISPOSAL SYSTEM
PROPERTY RESIDENT (If different from above)
kR INDIVIDUAL/ON-SITE**
PHONE
2. BUYER
If system is over two (2) years old an adequacy test is required
PHONE
Lester & Valerie Grell
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
349-3360
MAILING ADDRESS
13470 Seawind, Anchorage AK
3. LENDING INSTITUTION
PHONE
Spokane Mtg. Corp.
1277-0543
MAILING ADDRESS
4. REALTOR/AGENT
PHONE
AREA Inc. Realtors/Carrole Sherrod
1694-9555
MAILING ADDRESS
P. O. Box 249, Eagle River, AK 99577
5. LEGAL DESCRIPTION
Tract A, Douglas SUb.
STREET LOCATION
Mile 3, Eagle River Rd.
6. TYPE OF RESIDENCE
NUMBER OF BEDROOMS
❑ One ❑ Four ❑ Other
:0 SINGLE FAMILY
❑ Two ❑ Five
❑ MULTIPLE FAMILY
® Three ❑ Six
7. WATER SUPPLY
;0 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.) 120 feet
8. SEWAGE DISPOSAL SYSTEM
kR INDIVIDUAL/ON-SITE**
**If individual/on-site, give installation date 1973
If system is over two (2) years old an adequacy test is required
F-1 PUBLIC UTILITY
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
INSPECTION APPOINTMENTS
DATE RECEIVED
TIME
TIME
TIME
DATE
DATE
DATE
INSPECTOR
INSPECTOR
INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE ❑ THREE ❑ FIVE ❑ OTHER
❑ TWO ❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON -SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED
INSTALLER
❑Septic Tank or ❑ Holding Tank
Size: 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
5. COMMENTS
❑r APPROVED FOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE
BY (Title) i
i
jr
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
SSS Cf,1GIi;f�EfIflr
MECHANICAL. (_NGINEE'R SRB 1.96X CIVIL ENGINIEF'R
DAVID SJ, 1?NKA11P DAGL) RIVER, ALASI;A 99577 ROPI?R'.I' A. S11A1';?1:
MUNICIPALITY $�U j
694-9055
DEPT. OF I ALTH &
ENVIRONMENTAL PROtECTION
July 16, 1979 .
JUL 18 1979
James Jansen
S};ll'-y1-r1l;RECEIVED
E?,gle Ivor, Alaska 99577
Dear Mr. Jansen
Reference: Tract A, Douel-as Sobd-i.vision, rile 3, lgle River Road
At tho requo„t o:i Are<:, Realty a sewer system adeciva cy tri st dor per.—
form: --d on referenced property 12 & 13 Jul�7,1979. `.P.he oept_ic t9,111
was pumped and found -to h,-,ve a capacit,, of 3ppy,o,- i, , tel_y 1000 ga1__lons
and is ,adequate 'to ;orve a 3 bedroom residence.
The seepage pit was jhrq.€;c;d 'With 1000 pallons of ,;r i,ex . Piea:>t�re m:gin is
taken "at the emd of a 2/hou..r. pefdod _i.nd:icl,�ted thh t : ipproxim^toly
1.411 p,,illons hnd been lost from the systo,n or 7.70 € ,Mons per bedroom.
As a res?ilt of the above >urvey and test it can be concluded thr,,t the
system is adeou?3to.
Sincerely,
A.
Area Realty: Atll-n: Carol Shorrod
Spoi'.i ani? Yort€19,-c- Company
Dep"rtaaaent of 13eallth and Env:i.ronm an'tiil
Protoctl.on pie�Cy.
an -LID OR -Ln -
GREATER ANCHORAGE AREA BOROUGH
DepartrDent of Environmental Quality
3330 "C" Stre Anchorage, Alaska 99503 274-4561
-Date Received May 19, 1976
Time of Inspection
h0c� Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR ��LO �e�� �!P 7Jr9YYtQ
Conv.
1. Approval requested by. Peoples Bank and Trust Company % Lynn Manley
Mailing Address: Pouch 7-007, 99510 Phone: 279-7511
2. Property Owner: James J. & Neoma A. Jansen Phone: 279-1441
Mailing Address • Star Route Box 19111"TC Eagle River
3. Legal Description: Block A Douglas Subdivision
ear '_: c%
4. Location: Mile 3 2 Eagle Road - j�� -Aa,-,c� 41U 6/0- (211 0 61L-a"l
5. Type of facility to be inspected Single FAmily No. of bedrooms 3
6. Well Data: Individual
A. Type B. Depth
C. Construction D. Bacterial Analysis
7. Sewage Disposal System: On—site system
A. Installed B. Installer p�
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
EQ -034 (1/74) Page 1 of two pages
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" Street, Anchorage, Alaska 99503 — 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PRO i ECTION
MAY 19 19,'6
RECEIVED
1. Type of Inspection, CMRO VA FHA CONV
2. Property Owner• .-
EOMA A.sV-1l'
Mailing Address` fxLA:m x IgI`C Day Phone 219-- 1441
3. Name of Buyer:
� its-
Mailing Address: Day Phone
4. Name of Lending Institution: ��I�I.�.►5 a�tiL EVIS �.
Mailing Address: TOlALA 003 U04. Aa'510 Phone VIR IS1
5. Name of Realtor or Agent: NAxnj: Lq,s I"1K&j1i
Mailing Address: Phone
`+j��
6. Legal Description: K. 't�Lbo� S�14-0, s
Location: M11..E -S'/21L 12\��2 ��1�
7. Type of Facility to be inspected: ' a" epl-4 S No. Bdrms.
8. Water Supply
Type of Supply: Public Utility Individual x
Page 2 of two pages - Re, st for Approval of Individual S "rer & Water Facilities
Legal Description Block A Douglas Subdivision
Hpprovai;vaiid for one year from nate signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
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 and these facilities
are operating satisfactorily.
SIGNED Date
EQ -034 (1/74)
V