HomeMy WebLinkAboutEKLUTNA HGTS STEWART ADDN LT 3 Eklutna
Heights
Stewart
Addition
Lot 3
#051-063-20
' ', , .Municipality ofAnchorage.
((,~,~ ' r. ~ 11 ~:.
Department of Health and Hum. an serVices
~,~.~.~/] : ~' '.' '; Division of Environment.al Serv,ces"."
~ i: ,~ , ' On-Site Services Section 825'L Street Room 502
'-: 2: Re. Box 196650 Anchorage, AK 99519-6650
'.. ' www.ci.anchorage.ak.us .'
:' ' ': (907) 343-4744
, CERTIFICATE OF HEALTH AUTHORITY:APPROVAL ....
_. FOR A' ' -..'
ossa"co3"':"
Parcel I.D.- NAA#
· :"" ..... .'::., Expiration Date:
1.' ~ GENERAL INFORMATION
,,. :. . '. ~.
'...'/.:Complete.!egalde~cdption Lot 3, Eklutna Heights Subdivision
' '"'' 'ite"'~d~ie~"" '~_ ) 21631 Bear View Place
',' Location (s . rdirections ' · :.-
'..CtJrrentPropertvo~Nher~s) Warren Olrich ' ' '- D~ypt~or{e 688-5144., .
"-M~ili'ri~'~dd~.~ss PO Box 672175, Chugtak,A~ 99567
Lending agency Day phone
Mailing address
Real Estate Agent Prudential/Lynn Swanson Dayphone689-6464
Mailing Address 16635 Centerfield Dr., Eagle River,AK 99577
Unless otherwise requested. HAA will be held by DHHS for pickup. HAA picked up
NUMBER OF BEDROOMS: 3/ '
TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class
Public Water System
Well
TYPE OF WASTEWATER DISPOSAL:
[]
[]
Individual On-site []
Individual Holding Tank []
Community On-site []
Public Sewer []
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues ~ertificates of
Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent
professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are
required for the transfer of title (except between spouses) on properties served by a single family on-site
wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners.
Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by
a private or Class C well and may be reissued with new water sample results less than 30 days old. 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.
72.025 (Rev. 01/00)'
5. STATEMENT OF INSPECTION BY ENGINEER
As Certified by my seal affixed hereto and as of the vahdabon Bate shown below, I verify that my investig~ation
' ~, based on procedures outlined in the Health Authority Approval Guidelines for the Health Authority Approval
~'~p'pl[cati~n show that the on-site water supply and /or wastewate~' disposal'
.;system is safe, functional and adequate for the number of I~edmoms 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation.
Address 17034 Eagle River Loop Road No. 204
.Engineer'sPr!ntedName Robert C. Cowan Date 1;). /,.~'/~0
DHHS SIGNATURE !: ' '
6.
X · .. · Approved for .~- bedrooms.
Disapproved. .,
Conditional approval for ":':- ~ ' ' ' .....
........ ' bedrooms,'w~ih'the following st~
'Additional Comments
Attachment~:
HAA Checklist'.
Septic System Advisory,
Well Flow Advisory
Expiration Date:
Maintenance Agreements
Supplemental Engineer's Report
Other P~/~./E,~
Original Certificate Date: / - ~- ~)/
Reissue Date:
72-025 (Rev. 01.,00)'
RECEIVED
Municipality of Anchorage ~
Department of Health and Human ServlcesDFC 0 6 2D00
Division of Environmental Services
On-Site Services Section 825 'L" Street Room 502
P.O. Box 196650 Anchorage, AK 99519-665~,INIC~PALITY OF ANcHORAGE
www.ci.anchorage.ak.us
(907) 343-4744
HEALTH AUTHORITY APPROVAL CHECKLIST
~T[k,r'1~T /~I~]91T~
A. WELL DATA
Well type ~'~! t/,~J~-, If A, B, or C provide PWSID #
Totaldepth /-~/'~- 'it Casadto '~-~ It
Date of test
Static water level
Well production -~
WATER SAMPLE RESULTS:
FROM WELL LOG
Coliform .~ colonies/100 mi
Date of sample: ?/Z.~/~7~' /
B. SEPTIC/HOLDING TANK DATA
It
g.p.m
Nitrate /o'~(' mg/I
Collected by:
Tank Type/Material, ~
Date installed / ~-~ Tank size
Parcel I.D.:
Ce
Well Log y~-'~'
Wires properly protected
Casing height (above ground) ( -~- in.
AT INSPECTION
'/fO It
/, ~ g.p.m
Other bacteria '~)~-colonies/100 mi
S & S ENGINEERING
17034 E~gle Riff LOQp Road No. 204
Eagle River, Alaska 99577
/~_.) gal Number of Compartments
Foundation c~eanout//VS/~;~ Depression over tank /l~O High water alarm ..
Pumper ,...//~
Cleanouts c///"5,
'
Date of pumping
ABSORPTION RELD DATA
Date installed /'~:~ Soil rating (g.p.d,/It2 ocli) .~-~--O System type
Le.l~gth, :~_.it, Width ~ ~ It ~Gravel below pipe /0 It
/~ / /
Total~.e~h.~'/.,.,_,/.,'~,,~,,~,~ff,Effect, iveabsorptionareaY~P'~ It Monitoring tube ~J~-5 Depression over field /~O
o, ed. uac test Resu,, For.
· /...'.. / , ~- ,.
Flu d depth m abeorption field before test ~ in Water added~_ gal. New depth .~ in.
Elapsed Time: ~O min Final fluid depth ~-~'" in Absorption rate >='/~'7~ g.p.d.
Any rejuvenation treatment (past12 mo.) (y/N & type)'--/~/A/L/E.- Z~,4//Z4/~/ Ifyes, givedate "'"'-
72-02E (l:~v. 01/oo)'
D. LIFT STATION
gallons
"Pump on" levelat//~ in "Pump
off" level at __
Datum .,//.,,,/ Cycles tested
E. SEPARATION DISTANCES
in
Manhole/Access
High water alarm level at in
Meets alarm & circuit requirements
SEPARATION DISTANCES FROM WELL ON LOT TO:
~so~tton field on lot ~ =. adjacent I~ ·
Public s~er m~n ~/~ Public sewer manhole/cleano~
Sewer/septic se~i~ line ~ ~+ Holding ~nk
SEPARATION DISTANCES FROM SE~IC~K ON LOT TO:
Building foundaion ~/~ Pro~ line ~
/
Water
main ~/A Water sewice line
Drainage ~ ' ~ Wells on adja~m Io~ ~.
SEPA~TION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line
Water Service line
Curtain drain ~
F. COMMENTS
Building foundation /~::) -~- Water main .,/V//,zl-
Surface water /z~ /-~ Driveway, perking/vehicle, storage
Wellson adjacent lots ~o~,' t~ .-~r ~. (:k,/t q~.~ ~-)
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems am in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name ~0~7- ~'. Ce~a,,J
Date I ~-/
CE · 880 i
HAA Fee $ ~'/-""~ · ~
Date of Payment /,:~[//_x /,~'~
Receipt Number
72-0~ (Rev. 0t/00)*
Waiver Fee $
/1.. /,.-,)
Date of Payment
Receipt Number ~)' '-
Oe-_
Itl 117 iiCI 15:O4 TRUkl CIE t-flVIROfikqHIAL 5615311t 1.853 P.O)/fl] I 541
CT&E Environmental Services Inc.
Laboratory Division r,.s~,,~:~-,~,,~'~",~'.~~
200 W. Potter Drivn
Drinking Water Analysis Report ['or Total Coliform BacteriaTel:Ahab°rage'is07) 662-2343AK s.qlilS.160G
READ IN$I'RUCTION$ ON REF'EI~£ SIDE BEFORE CO£[ECTIN.GS~AfPLE Fa x.- {907 _ ? I._- .67_0.I ........
El PUBt.IC WATER SYSTEM l.l). #
'~ I'RIVATE WATER SYS'F£M
Send gel#et! El Send Ira*nice
Eagle River, Alaska 9~577
sAMPLE DATE:
Month
SAMPLE TYPE:
~ Routine
O Rtpeai SatTIple (for routine ~nmple
with lob cci.
sAMI'LE LOCATION
Zt,i -Irs
ysiS shows thin Watts SAMPLI~. lo be:
Satisfactory
tJn~atisfaclofy
Sample ov~ 30 houra old, results may
be unreliable
Sample too long in ~nslt sample slmntd
not be ovet~m~s old st exnminnfion
Io Indlc~te scllnble ~esuttn. Please ~cn(I
new sample via
..,....,...
/
7',
n.~b"~' ~"" .,I
Analytical Method: ~mbt~ne Filter
~ MMO-MU(]
Untrealrd Wirer
Client notified of unsatisfactory results:
l'honea Spoke with
Date: Time~
Time Collected
Collecled By
[]
BACFEI~IOLOGICAL WATER ANALYSIS RECORD
MMO-MU(~ Itesall: Total Coliform
Membrane Filter'. Plreel Counl
Verification: LTB.
E. Cell
Colonial/tOO mi
, COLIFIRM.
Collfarm/t0~l mi
TI,ne .w/~'~l. hr,
ENV~I1ONM~NTAt. FACILITIE~ IN ALASKA. CALIFORNIA, FLORIDA. ILLINOIS. MARYLAND. MICHIGAN, MtStlOUfll, NEW JEI~tlEY. 01110. WE~JT Vt~OINIA
Ill Il/ fill 15:114 I~1!).1 cie tII¥1ROIIH fllAI
,~T~- CT&E Environmental Services Inc.
C-I'& F i~d.# 10057(;4001
Cltrnl Name ,q & S F. nRineerinp,
~roJtcl Nnmrl~ 1,3 Eklutnn lite.
Cllenl Sample ID L3 Ektulna
Malriz ~l[nk[ng Water
O~dered By
(:Ileal
Printed Dale/'llme 09129/2000 13:53
Cotterted Dale/Time 09/25/2000 10:30
Rrrelvetl Date/Time 09/25/2000 16:30
Technical t)lre~f~ Stephen C. Ede
Rample Remmks:
Allegeable flep &nntysi~
P~,~lm~l~ Re~tstt~ PQl. Units Method Lhnits Date Dele I,it
Nil~nte N 1.40 0.$00 mlIIL F_PA 3(XI.O Il) max 09125/00 SCI.
-torn1 colirotm
colll00mL SMI8 9222B
09/25/00
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
On-Site Services
Waiver Review Worksheet
WRY: WR000107 PID~: 0514)63-20 HA#: HA000615
Date Received: December 6~ 2000
Legal Description: Eklutna Helghta~ Lot 3
Permit:
Engineer. S & $ Engineering
17034 Eagle River Loop Road~ #204~ Eagle River~ AK 99577
Applicant: Warren Ulrich
Waiver Requested: Request following eeparatlon distance waivers: 85 feet from well to
absorption field; 67 feet from well to eeptlc tank; 75 feet from well on lot 4 to eepflc tank on
subject property; 92 feet from well on lot 4 to absorption field on eubJect property.
Cdtaria: 1. Geology Points: A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizeetal Separation
Total:
2. Special Conditions:
3. Other:.
Waiver is Granted:
Waiver is not Granted:
List Conditions or Reasons for above: ~'~£
Date:
Rec~: 06480
By: P~/~/
Name of Reviewer
Amount: .~920.00 Received: '12/6/00
Mtmicipalit3. .of Anchoragc
Geor, qe I: 11 uerch. Mayor
Public Works
Robert C. Cowan, PE
S & S Engineering
17034 Eagle River Loop Road, #204
Eagle River, Alaska 99577
Subject: Waiver Request for Eklutna Heights Stuart Addition Lot 3
WaiVer Request Number WR000107, Parcel ID # 051-063-20
Health Authority Number HA000615
Dear Mr. Cowan:
Your request for a waiver of the required 100 feet horizontal separation from the on-site
wastewater disposal system to water wells on the subject lot and the neighboring Lot 4
have been approved. The approved separation distances are as follows:
On-lot septic tank to water well
On-lot absorption field to water well
· On-lot septic tank to Lot 4's water well
On-lot absorption field to Lot 4's water well
67 feet
85 feet
75 feet
92 feet
This waiver approval applies to the existing septic system to water wells only. Any
future upgrade to the on-site wastewater disposal system will require all separation
distances be met or another approval from this department.
Sincerely,
Daniel J. Roth
Civil Engineer
On-site Water & Wastewater Program
.@
I
I
= Lg
r
Z.?
ff. 7
ROBERT C. COWAN, P.E.
December 4, 2000
CN1L ENGINEERS
(9O7) 694-29?0
FAX (907) 694-1211
MUNICIPALITY OF ANCHORAGE
Department of Human and Health Services
PO Box 196650
Anchorage, AK 99519 ,~. ~a~?~'''''
~T Z~''''~ '
Reference Lot 3 (Principal) and 4; Eklutna Heights'Subdivision
We request you grant the following waivers for the referenced properly:
1. The horizontal separation distance between the private
well on Lot 3 and the absorption field on Lot 3 to 85 feet
2. The horizontal separation distance between the private
well on Lot 4 and the septic tank on Lot 3 lo 75 feet.
3. The horizontal separation distance between the private
well on Lot 4 and the absorption field on Lot 3 to 92 feet.
A risk analysis was performed using the State of Alaska, Department of
Environmental Conservation's Separation Distance Waiver Guidelines.
Our results are as follows:
a. WATER TABLE:
The Lot 3 well log shows silty sand to --6 feet, with gravel sand silt
mixes to 18 feet. The static water level was measured at 110 feet on
9/25/00. The total depth of the well is 175 feet.
Wells in the area appear to be drilled relatively deep and to
comparable depths, approximately 200 feet.
From the well logs of the surrounding properties we can see that the
static water levels of wells completed in the same aquifer indicate the
water table slopes to the east. This slope is in excess of 3%, away
from the referenced onsite wells, towards the onsite septic tank and
leachfield on Lot 3.
17034 NORTH EAGLE RNER LOOP · SUITE 204 * EAGLE RNER. ALASKA 99577
Page 2
Lot 3 (Principal) and 4, Ekluma tlcights Subdivision
b. SOIL ABSORPTION:
From the soils log used in the design of the Lot 3 existing septic
system, we find the receiving soils for the septic system have
silt/sand/gravel (SP/SM soils) to 5.5 feet, with gravel/sand/silt (GP
soils) to 18 feet, rated as 0.6 gpd/sqft which should provide good
septic effluent treatment. The onsite wells should be protected from
contamination from any surfacing effluent by soil absorption,
topography which slopes away from the wells and vegetation.
Surfacing effluent should receive some additional treatment through
the vegetated lawn.
c. PERMEABILITY:
The ML soils to 1.5 feet, and SP/SM soils to 5.5 feet should provide a
reasonable absorptive layer, slowing effluent travel to subsoils and
hence into the aquifer. The soils to 18 feet are rated at 0.6 gpd/sq.ft,
(20 min/inch), allowing for acceptable retention/treatment times in the
leachfield, providing good effluent treatment.
d. HORIZONTAL SEPARATION:
The horizontal separation distances between the:
Lot 3 well and Lot 3 leachfield is 85 feet.
Lot 4 well and Lot 3 Septic tank is 75 feet.
Lot 4 well and Lot 3 leachfield is 92 feet.
e. ADDITIONAL CONSIDERATIONS:
1. The existing system has been in service for twenty-two years with
little to no apparent adverse effects to the onsite well or surrounding
properties. There appears to be a slow rise in Lot 3 Nitrate levels, but
these levels continue to remain in the acceptable range.
2. Per our inspection of the onsite septic system, the system
appears to be functioning adequately for a three bedroom residence.
Page 3 S '~ w'g ~.T
Lot 3 (Principal) and 4, Eklutna Hcights~ubdivision
3. Past water samples indicate satisfactory results. The current water
samples from the referenced lots' wells are:
Nitrate mg/L Fecal Coliform Other Bacteria
Lot 3 1.40 0 0
Lot4 6.13 0 0
4. As shown on the attached as-built and site plan, the topography is
such that surfacing effluent from onsite waiver contamination sources
would flow away from the Lot 3 and 4 onsite wells.
We request these waivers with some trepidation. We also realize that
mitigating our concerns is the fact that most, if not all of the properties in the
area have similar separation problems. We see no purpose in penalizing the
current or future property owner for a long standing problem, and feel that
while the situation is not ideal, water quality continues to remain in the
acceptable range. We do not anticipate any extraordinary adverse effects on
neighboring wells, septic systems or reserve areas by the granting of the
requested waivers.
If we may be of further service please contact us.
Sincerely,
Robert C. Cowan, P.E.
RCC/mjc
LOT 3 & 4, EKLUTNA
B.J.J. [ R.C.C.
HEIGHTS
[~; 12-5-00
LOT
LOT
9
10
LOT 4
WAIVER REQUEST
FLAT+
FLAT±
LOT
11
LOT 2
ALL PORTIONS OF' SYSTEM
WITH LESS THAN 5.5' OF
COVER REQUIRE INSULATION.
CONTRACTOR IS REQUIRED TO
OBTAIN UTILITY LOCATES
PRIOR TO ANY £XCAVAT[ON
tJ~ "~:?'~'~; ' .:. ~,~M.W DRILLING, INC~,-~
I ~f&.- .......... , .
I~.-.~ ~ ~. ~~ ~. , ~,..,..-~
J:,~,W~ ~J ~t at J ~lllo~ ~r (H~ (minute) lot i
,' .:.', ~ ~ ~ . ~. .
~:,;~r ,. .. ;
t,~'~--~ ......... : :
~' ;(: ~ ~l~ ' ; ~l~ de. lb ol Jo~ltlo~l ~netrat~, size
- ~ 8 Silt'/ n~avel: m sandy :' ' ;,'"'"'-"
' ' lo se ~ravet ',,...'
}"' 101 Snn~Iv ~ravel
Clen. sand~ ~rnvel
~,; ,lo9-_ z2~
[~., _~, tTe~ sandy gravel
~.: }~:=~ ~~ ~,,.,. .... .,,,,..,:,...,:,.,,,.....~
~ :,~',~. ,,
,~.'}~ ,..
Well Owner
.'.T .'.'~ 5 Location
DRILLING, INC.
Walt Kurka
DRILLING LOG
Use of Well Dom.
(address of: Township, Range, Section, if known; or distance main road
Lot 4 Eklutna tleights Steward Addition,
6":' Hole357 feet Casedto 16~,8 feet
Depth of
(below) land.surface. Finish of .well (che~:k one) open end (xx );
).
ll/a
(minute) for '~ hours with !gg']i .ft'c
Size of casing
'Static'water level 1GO ft. ·
"i~"~;a Screen ( ); Perforated (
"Describe screen or perforation
Well pumping test at · 5 gallons per;:(h~tYr)
"~"-: of drawdown from static level.
Date of completion 5/25/78
'"" ? ~ WELL LOG
~)epth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
"' 0 TO 2
' 2 ~0 7
)'"" lO TO. 40
t~, 40 TO 55
55 TO 8O
80 TO 110
· 110 TO 115
j~l15 ' TO' 142
i' 142 TO__1~9
.TO
TO
'" "~: TO
?~...
TO.
.TO
Casing stickup"
Silty gravel
Loose gravel
Silty cobbles
Loose Gravel
Silty cobbln~
LOOse ~r~,veq:
Sand
Silty gravel
Bedrock, water sca.,p-': in sporadic fractures throu?ho,.l~ ..
3--CONTRACTOR
10-24-00
08:48 FROM-CTE ENVIRONI/~NTAL 5615301 T-833 P.03/03 F-911
CT&E Environmental Services Inc.
Laboratory Division ~,
PUBLIC WATER SYSTEM I.D,
PRWATE WATER sYSTEM
200 W. Prater Drive
rinking Water Analysis Report for Total Coliform Bacteria ^.~"'"-*, ^K
Tel: (~7} 582.2~
. ~E ~E ~EFO~ COLLE~ING S~P~ Fa~ ~7 661 -S~l
~u~ON$ ON .............
~ TO BE CO~L~D
yfia ~o~ ~il
S~6~f~
SAMPLE DATE:
~,~dR?LE TYP£:
ouUne
Month
r~ Repeat Sample (for murine sMnple
wlltt lab ret'. no. )
fl Special Purpose
Day
Tine
CoI~M
Sample over 30 hom~ old, ~sults rosy
be unreliable
Simple too Io~s in tr~s~t; sample should
not ~'ov~ old at ex~
~ ~c~ mli~le ~. P~ ~d
ll .l
SAMPLE LOCATION
vl~ MML~.MULt
~c~' ', Nvmbe.~r colo~ies/100 mL
--- ~.~ Result* Analyst
Trelt~ ~ ~ Anc~ Fb~ Jun
~ Fixed
,,. Ti~:
Olent no,fid ef u~a~fam~
Colke~
S~ O D
BACTERIOLOGICAL ?/AT~R ANALYSIS RECORD
CoJoeks/100 mi
,, BCB COLIFIRM
Feeal Coliform Coofltu~tlen
F'm.l Membrane Flltat Rfnlu D ·, Collform/10g mi
MMO-MUG Jbsull: Tet~ Coliform
Membttue ~ Detect Cmllt
YeflflcaUou: LTD
I~~ Meml~ef of ~tj IG I OrOulHSocii~ Glflimle de 5u~llenceJ ------
ENVIRONMENTAL FACILITIES iN ALASKA. CALIFORNUL FLORIDA, ILLINOIS. MAAY1.M40. MICHIGAH. MISSOURI. NEW JERSEY. GHCI. W~ST VlRGINIA
10-24-00 08:48 FRO~CTE E~VIRONhENTAL
,~tK CT&E Envlronment. I Se~ice, Inc.
5615~01
T-833 P.02/O) F-gl1
CT&£ Re[.# 1006473001
Client l~ame S & S Engineering
Pro]e~! Name/~ IA Elduirm Ills
CUent Sample ID L4 Ekluln~ Hts
Matrix D~nl~ng Water
Ordettd By
PWSID 0
Sample
Client PO~
printed Date/Time 10/20/2000 14:21
Colle~ed Date/Ttme 10/16/2000 13:30
Received Date/Time 10/17/2000 10:15
T~hnlcnl Dire~or Stephen C. £de
Releued ~ ~
R~ul~
PQL
Units
Allowable P~ep Anal~
Limits Date Date Init
Nitrate-N
6.13 0.§00 mg/L £PA 300.0 10max 10/17/00
SCL
~c~obiology~abor~tory
T~d Col~mm 0
col/100mL SM18 9222B
10/17/00 KAP
P.O, Sox 196650
Human Services
825 "L" Street
Anchorage. Alaska 99519-6650
343-4744
March 3, 1993
Roger Shafer, P. E.
S & S Engineering
17034 Eagle River Loop Road
Suite 204
Eagle River, Alaska 99577
Subject: Waiver Request for Lot 2 Eklutna Heights Stewart Addition
Waiver Request tWR930002, PID 1015-063-19, HA930015
Dear Mr. Shafer:
Your request for waiver(s) of the required 100 foot horizontal
separation of a septic system to a private well has been approved.
The approved separation distance(s) are a septic tank and private
well on property of 80 feet~ the septic tank to private well on
Lot 1 of 94 feet; the septic tank to private well on Lot 3 of
92 feet and well on property to septic tank of 87 feet and
leachfield of 98 feet on Lot 3.
This waiver is conditional based on the water quality from the well
meeting federal and state primary drinking water standards. Should
the water quality fail to meet these standards, this waiver will
become void. As a further condition to this waiver DHHS may
periodically collect and analyze water samples to confirm water
quality.
This waiver approval applies to the existing septic system to
well separation only. Any future upgrade to either will
require all separation distances be met or another approval
from this department.
Sincerely,
Cf
Daniel J. Roth
Civil Engineer
On-site Services
Concur: __ ~
Program anager
On-site Services
ljm~t6
~: .,'~ :':~ DEP'I'.OFEN¥11IONIIERITALCONSEIWATION
~ ', :~ ' ". Nr~Gt/k~, ALAsr, A 99S01
~?* NI;H09J~=~[/~ DISTRZCT 0FFZCE
*": ~ 437 "E" STREE'ro SUITE 200
[:.~ ,..~, ', 203 W. 1Sth Avenue
~ .. .... - ..AAchor~ge, Alask~ 99501
Deal, ~. Spurkland:
Septe. ber 21, 1984
274-2533 '- ~"
:.. ,.,,. SubJect:. Matver Horizontal Separation between ~ell and Septtc Tank,
,' .; ~'. ..., . .?, Lot. 3, Eklutna Heights Sulxllvtslon, Eagle Rtver, Alaska
:i~'.i~ :.' ,'. * .., (8621-1dA-037) .
:!.::.:ii!; ... !,,., .Tim ~l~rt.ent:has reviewed the subject .a~ver request and ~reby .alves
· i'il..~*~'~.:.. ..', .'the horJzonta] separ&tton between the ~eH and septic tank to 75 ft
~:..;~..... !..; 'on .t.~ ~:t I~'o~ert.~ for & 3
~ ~, :"..' . ' B-~uce E, Erickson
'!' ~ "' EnvJror~ental Engineer
Anchorage
Deoe~ber 23, ~gaG
S&~ ~ngineerLng
subJectl Lot 4 Eklutna Rolghts su~divi-ion
~aiver Requeot !~66-173
Dear Mr. Shafer~
Your request for waivers of the separation distances required
between the septic system on the subject lot and the Wells
serving the subject lot and the adjacent Lot ~ have been
~ranted. The well on the subject lot Is located 77 feet from
tho septic tank end 9? feet to the leach trench on that same
lot. The well on Lot ~ As located approximately 96 feet from
the ~oa~h tre~ch.on the subject lot. This depar2men~ has
recexvea a notarized letter of non-objection from ~he owner, og
Lot 3. The 100 £oo~ ee~&ration requirements have be~,m waived
to tho eM~etin~ sop&rations referred to above.
The~e waiverfl are baaed on your eesesomenk that ~ho~o ie lit.~le
rl~k of contamination of ~heee wells from household oova~e.
Any upqredos or enlar~emenk of the septic system on the subject
lot. will void these waivers.
Sincerely,
stephen s. ~orrls
civil Engineer
on-site ~ervicoa
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
MAILING ADDRESS ~.~
LEGAL DESCRIPTION
LOCATION
Yff77
PHONE ~NEW
~ DISTANCE TO: I Well 7~' ,
I- Z Manufacturer
Liq capac ty ngallonsl ~
~,~,~ ~ Ir HOMEMADE:
DISTANCE TO: We
IAbsorption area Dwelling
/4 I Material
~Tz~E z_
W dth
NO. OF BEDROOMS
PERMIT NO.
No. of comDartme.~ts
Liquid depth
Inside length
Dwelling PERMIT NO.
Manufacturer Liauid capacity in gallons
Materia]
Foundation ! Nearest lot line
z,~ io '
Total length of lines I Trench width
~ ~' I 4~ inches
Material beneath tile
Well
DISTANCE TO:
No. of tines Length of each line
Top of tile to finish grade
PERMIT NO.
Distance between lines~_ :,
I ' I
Total effective absorption area
Length Width Depth
Type of crib Crib diameter Crib depth Total effective absorption area
Well Building foundation Nearest lot line
DISTANCE TO:
Class Depth Driller Distance to lot line
Building foundation Sewer kine
DISTANCE TO:
OTHER
PIPE MATERIALS ,~ /t C~_.. ; 4"/~(.:
SOIL TEST RATING
INSTALLER
PERMIT NO.
PERMIT NO.
Absorption area(s)
Septic tank
REMARKS
APPROVED
DATE
LEGAL
72-013 (~ev. 3/78)
PERMIT NO.
IIF'F'LI[:AN[ P..,._~.,.,, ,~.~_,,'.., ti BULL[-' .,-~,,-. P.O. ,-.,0,", 214 E.
LOCal I ON
LEGAL L ~ EKLUTNA HTS STEWART ,qDD
T','PE FJF SOIL 8E,'SORBTION S4'STEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = 3
DEPARTMENT OF HEALTH Arid ENV~ROJ, c,,TFIL , ,~,TFC. ~J4 ,
025 'L' STREET., Ar-~HORAGE, AK.
264-472~
WELL 8~4D O~4--SITE SEWER F'ERMI T
R. 99577 G94-~493
LOT SIZE 8400 SQLIRRE FEET
SOIL RATING (SQ FT,/DR)
,,IE REQLIIF~.~_[. SIZE OF TII~ COIL ,,,..,JO,'-, ,IO,,I ._,,_~Tr', .....
[::EPTH= 14 LEN(]TH= 42 G R I::1"," E L I)EPTI-t=---- '""
T~tE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIFLD.
THE DEPTH OF R TRENCH OR PIT,.~'' TIlE DISTANCE ~ETWEEN THE SURFACE OF ~",1~.- ~'
~ROu,,~. AND THE BOTTOM OF THE EXC,~VRTION (IN FEET).
TIIERE IS NO SET WIDTH FOR TRENCHES.
TIIE GRAVEL DI"PTII 15 Till,, ,,I,,,.MUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
R,,..-. TIlE BOTTOM OF' THE EXCAVATION (,r. FEET).
RE~_IJ I RED SEPT I C TANK S I ~'E= i000 Gl:ILl
PERMIT I~PPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
D~UMBER OF RESIDENCE5 THRT TI:E WELL WILL SERVE.
TWO ( 2 ) I NSPEC--T ION$ F:IRF REQU I RFD
...,_~.,4L; OF FIN'¢ 54STEM W,T,/O~T Flral INSPECTION AND APPRO'v'f'L B'~ Tills
DEF',~RT,~NT WILL BE SLID JEST TO PROSECUTION.
Mi,,,M,JM DIST,~NCE ~°ETWEEN FI WELL AND ,qN'~' ON-SITE SEWAGE DISPOSAL S'~'STEM 1-5
~.C0 FEET FOR 8 PRI'~TE WELb OR
PUB~ ~. WELL
~=~ TO 2~ FEET FROM R PU~IC WELL ~PENDING UPON THE TYPE OF ' '~
~ LOGS ARE REQUIRED ~'~D MUST ~ RETURNED TO T~ DEPARTMENT WITHIN
OF THE WELL COMPLETI~.
OTHER RETIREMENTS MRS' 8PPL?. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
RV~ILRDLE TO INSURE PROPER INST~LRTION.
PERM I T E~CP I RES DECEMBER -~--~- ) i970__ ·
i: I,,,,~ FAMILIAR WITH THC REQUIREMENTS FOR ON-SITE SEWERS AND WELLS,°c,-, SET
FORTH BY THE MUNICIPalITY OF RNCH~RGE.
2: I WILL INSTALL THE 5?STEM IN ACCORDanCE WITH THE CODES.
3: I UD~ERST~ID THAT THE ON-SITE SE~ ?,'STEM MAY REQUIRE ENLARGEMENT
RESIDENCE IS RE~~ TO tN~~ORE THAN ~ ~EDROOmS.
_. :.,.':.,' .: >.- ..
-- . /7-
· ,-,-' '~ By__ ' '~: ~~L~~*~ DATE.
IF TIlE
VI 2
O Er E GEC ECHNICAL Er DEVEL ~PMENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Russell Oyster
694 2774
Soils ~ Foundations
Performed for:
Legal Description: ~cT ~ _x~,'<'Z ~YT, I,/~ ~/(~m~
SOIL LOG
Land Development
o
Name: '~/'/~Z ~" ~:/-~.J~A Tel. ,o.
Mailing Address: ~L:, ~r,~ 2/¢, ~ZE ~,~.
Depth (feet)
Soil Characteristic)
!o
11
12
'~,¢f£
Ground Water Encountered: Yes~
Proposed Installation: Seepage Pit~
No ~ If yes, what depth ~ ~2(, ~.~
Drain Field
Comments:
Performed by:
Date:
A1 Romaszewski
Box 770848
Eagle River, AK 99577
August 28, 1984
Tobben Spurkland, P.E.
203 W. 15th Avenue "C" Suite 203
Anchorage, AK 99501
SEPTIC SYSTEM ADEQUACY TEST
LEGAL: Lot 3, Eklutna Heights, Steward Addition
LOCATION: Eagle River
OWNER: Johannesom
RESIDENCE: 3 bedroom home, single family
WATER SYSTEM: On site well
SEPTIC SYSTEM: From municipal records. A 1,O00 gallon septic tank
and trench type leachfield septic system~ will require a separation
distance waiver from the State DEC.
DATE OF TEST: August 25, 1984
TEST PROCEDURE: The septic tank was previously pumped and verified
to have a capacity of 1,000 gallons. The trench was charged with 450
gallons of fresh water and after a period of 24 hours all the water
which had been added to the crib had percolated out.
TEST RESULT: The septic system is adequate for the described property
on this date, August 28, 1984.
DRILLING, INC.
Well Owner
Location
DRILLING LOG
Use of Well
(address of: Township, Range, Section, if known; or distance main road
Size of casing Depth of Hole feet Cased to feet
Static water level ft. (above) (below) land surface. Finish of well (check one)
Screen ( ); Perforated ( ).
Describe screen or perforation
Well pumping test at gallons per (hour)
of drawdown from static level.
Date of completion
open end (
(minute) for
hours with
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
);
ft.
.TO.
_TO.
_TO
.TO.
.TO.
.TO.
.TO.
.TO.
.TO.
.TO.
.TO.
.TO.
.TO.
.TO
.TO.
2 -- STATE
A1 Romaszewski
Box 770848
Eagle River, AK 99577
August 28, 1984
Tobben Spurkland, P.E.
203 W. 15th Avenue "C" Suite 203
Anchorage, AK 99501
WELL INSPECTION
LEGAL: Lot 3, Eklutna Heights
TYPE OF WELL: Private
CASING ABOVE GROUND: 20"
WIRES IN CONDUIT: Yes
SEPARATION DISTANCES: 75' to septic tank, 100' to leachfield
SURFACE GRADING: Satisfactory
LAB TEST: Satisfactory
WELL STATIC LEVEL: 100' below casing
WELL YIELD: 1.8 GPM for 4 hours
DEPTH OF WELL: 175'
The sustained 4 hour yield of this well is adequate for the residence
described on this date.
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
Parcel I.D. #
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
f'~"~--~ \ - [~.~.5- ;-'~"3~ HAA # 'b-~ ~'1°1f-'~F~'-([~'\
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 3, EKLUTNA WEIGHTS STEWART ADDITION
Location (address or directions)
NHN La Paqe
(b) Property owner AHFC#79776
Mailing Address 520 E~t 34th Avenue
(c) Lending Institution
Telephone'(home)
Anchoraqe, Ak. 99503
Telephone
Business 561-1900
Mailing Address
(d) Real Estate Company and Agent RE,/.'!AK OF EAGLE RIVER ATTN: Ev~'. Lc, ken
Address 16600 Centerficl~ Drive ¢201 Eagle River, A~. 99577
Telephone 694-4~0~
(e) Mail the HAA to the following address: (or check here~ if hold for pick up.)
List contact person and day phone number below:
$ & S ENGINEERING
17034 Eaqle River Lc~p Rand
Eagle River, Atasl(a 99577
2. TYPE OF RESIDENCE
Single-Family ZX Number of bedrooms ..
3. WATER SUPPLY
Individual Welh,~ Community Z 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'S' 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.
025 ~, 7 ~8, Page 1 of 2
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DA~A 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. ] 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
5 & S ENGIbiEERIt4G
· -,,,-~.~ ~nnle River Loop ~oacl No. 20,4
Eagle River, Al~s~:-~ 9~577
Telephone
Approved for -~-' bedrooms by~"~2~/~ Date ·
Approved '¢'" ~'" Disapproved Conditional
Terms of Conditional Approval
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 DHHSdo 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) Bac× Page 2 of 2
A. WELL DATA
Well Classification
MUNICIPALITY OF ANCHORAGE (MOA)
c ~ H~e~!th.AuthoAt]/Approval (HAA)
,~ ~: ............. ~43-4744
Legal Description: ~
RECEIVED
If A, B, C, D.E.C. Approved (Y/N)
Well Log Present~/N) ~ Date Completed '~'-~ ~, -- '"'/~ Yield
Total Depth I'~" ~ased to !Z¥,,¢~' ~epth of Grouting (
Static Water Level ~, ~::~"~ Pump Set At t'"~"~
Casing Height Above Ground \,.~_)I,.~ Sanitary Seal on Casing CD'N)
Electrical Wiring in Conduit(~'N) "f Depression Around Wellhead (Y~;~
· On Adjoining Lots
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field o/n Lot \ ~ · On Adjoining Lots
To Nearest Public Sewer Line t J/"/& To Nearest Public Sewer Cleanout/Manhole
To Nearest Sewer Service Line on Lot '~"~ l'Ob-
Water Sample Collected by '~'¢~ ~¢'3~':::~l~:~¢~%'Date
Water Sample Test Results _~---~. ~(¢-Z~~ ~ ~ ~ ~.-~t~
Comments ~ ~'-~ ~'~ V~ \ ~'~ ~:~) !~ i ~) ~.... ~ _,~ ~ ~
B. SEPTIC/HOLDING TANK DATA
Date Installed I~--~/~'t~ Size
Standpipesg N)
Depression over Tank (Y/~
Pumping/Maintenance Contact on File (Y/N) /
Holding Tank High-Water Alarm (Y/N)
Air-tight Ca p s(~.:;:~ N)
No. of Compartments 7----
y Foundation Cleanout
/,4 ?~,_e Last Pumped '7 -- I
; for
Temporary Holding Tank Permit
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water-Supply Well
To Property Line
To Water Main/Service Line
To Stream, Pond, ~_ake or Major Drainage Course
Comments '~--~
To Building Foundation
To Disposal Field
72-026 (Rev 7 88~ Fron: Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absortion Area
Depression over Field (Y/~
Results of Last Adequacy Test
Type of System Des
Length of Field ~
Depth of Field ~zt¢~
Gravel Bed Thickness ~ ~
Statndpipes Preser~N)
Date of Last Adequacy Test
,/
SEPARATION DISTANCE FROM ABSORPTION FIELD:
I ~ To Property Line 1 ~
To Existing or Abandoned System on
To Water-Supply Well
TOLotBUilding Fou n d~.~/~::~
To Water Main/Service Line
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Veh..[.C,J.e Storage Area
Comments ~,,~
; On Adjoining Lots '-'~c=.
~ ~;, To Cutback (if present)
D. LIFT. STATION
Date Ins~4~. Dimensions
,,S, ize i ~ G~a_l,l,o?_s _ , _ .-'""--~- Man~ole/Access (Y/N)
Pump On Level at ~__ ' Pump Off" Level at
High Water Alarm Level at ~"'"'~__ Vent (Y/N)
Tested for ~mping Cycles during Adequacy Test.
Meets MOA Electrical Codes (Y/N) ~
Comments ~
**Check Permitted Bedroom Rating Against HAA Request**
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this
inspection.
Signed S & S ENGINEERING
17034 Eagl~ River L~up ~,~a~ ~io. ~.
Company ~.a~;= ~.,t.e% Alaska 99577
/
Receipt No. f.~ / ~////7Y ~
Date of Payment ~"...~L"') '- ¢O
Amount: $ ~ / 7~"?~' ('~
72 026 (Rev 7/88) Back
Waiver Fee: $
Date of Payment
Page 2 of 2
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
5633B STREET · ANCHORAGE, ALASKA99518 · TELEPHONE (907)562-2343
FEDERAL TAX I.D. #92-0040440
ANALYSIS REPORT BY SAMPLE for Work Order t 21945 Date Report Printed: MAY 26 90 @ 12:47
Client Sample ID:L3 EKLUTNA HTS
PWSID :UA
Collected MAY 22 90 ~ 20:50 hrs.
Received MAY 23 90
Preserved with :AS REQUIRED
Chent Name : S & S ZNGR
Clxent Acct : SNSENO?
P.O.) NONE RECEIVED
Req )
Ordered By : R. SHAEER
Analysis Completed :MAY 25 90 Send Reports to:
Laboratory Supe!wsgr j~HEN C. EDE i)S & S ENGR
Re eaeed 2)
Special
Instruct:
Chemlab Ref ): 901507 Lab Smpl ID: 3 ~atrix: WATER
Allowable
Parametez Tested Result Ur~ts Method Lzmts
NtTRATE-N 0.48 mR/1 EPA 353.2 i0
Sample SAMPLE COLLECTED BY R.J.S. ROUTINE SAMPLE.
Remarks:
1 Tests Performed ' See Special Instructions Above UA=Unavailable
ND- None Detected "" See Sample Remarks Above
NA- Not Analyzed LT-tees Than, GT-Gzeater Than
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
TELEPHONE (907) 562-2343 5633 B Street
Anchorage, Alaska 99518
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
Z PUBLIC WATER SYSTEM I.D.#
-~IVATE WATER SYSTEM
Name Phone No.
/ State Zip Code
City
Mo. Day Year
SAMPLE TYPE:
._,~Curine
heck Sample (for routine sample
with lab ref. no.
~ Special Purpose
-- Treated Water
~_ Untreated Water
SAMPLE
NO.
1
LOCATION
Time Collected
TO BE COMPLETED BY LABORATORY
,~sis shows this Water SAMPLE to be:
,~ Satisfactory
~, Unsatisfactory
--] Sample too long in transit; sample should
not be over 30 hours old at examination
to indicate reliable results. Please send
new samp!e via special delivery mail.
Date Received
Time Received
Analytical Method:
Membrane Filter
* No. of colonies/100 mi.
Lab Ref. No.
?0,t507 (.~
l
I
Result*
Analyst
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
BACTERIOLOGICAL WATER ANALYSIS RECORD
Membrane Filter:. Direct Count
Verification: LTB
Final Membrane Filter Results
Reported By (~ ~---~'"'~-- ~_r~r.~.--'-''~
BGB
Date
Time:
Collform/100ml
Coliform/100ml
TNTC
OB =
= Too Numberous To Count
Other Bacteria
PART ONE OF TWO
REMAINDER TO FOLLOW
..~NICIP.4~LITY OF >2;CHCR~%GE
DIVISION OF ENVIRO:C.~h-TAL H=-EALTH
DEP.~ OF ~TH J~D E~fVIROIQ~NTAL PROTECTION
~PLICATION FOR ~TH AL~HORiTY ~PROV~ CERTIFICATE
1. ~neral Info.etlon Application Date ~ ~Z~-~/
(a) Legsl Description (include lot, block, subdivision, section, to.ship, ra~e)
Z ~ ~ ~/F/~.~., i/~,.~ ~'~'~ ..... ' ~Z~. ~,. ..... .. ..~1~. ~'-'~
Location (address or directions)
(b) Applicants Name
d*~ q - ~'-~ 7
,,~ / ,4°. ~'~a z~' --~ ~,', Zelephone - Home Business
Applicants Address
(c) .~pplic.ant is (check one) Lending Institution
(d) Lending Institution ~ j ' z,', ~ ,.' ~ .....
Address /~,', ~,,~. . A, ~ "~'l'
(e) Real Estate Co. & Agent'~ ~,., ~l~, ~ .~.~
Address (, ~ '~ 7 2.~ / -,' ~.' ~ % // /'
Telephone ( ~-,_,,_ z/ .? ,,
, ,1 · O~ner,,'bc/lderl j ;
Telephone ~-72~ (T [ ,
the F~.A to the following address:
2. Type of Residence
N,am~er ~f Bedrooms
~Li.Cf , d~l_iDe
3. Water Sup?l7
individual Well [---~ Community i t Public [ ~;
Note: If community well system, must have ~-ritten confi~atzon from the State
Department of Environmental Conservation attesting to the !egolltl; ~nd status.
4. Sewage Disoosal
Onsite L-~ Public ,_~ Community _[
Note: If community well system, must have written ~on£irmation from the State
Department of Enviror~ental Consep;ation attesting to the legality and status.
[Page I of 2]
5. En~ineerin~ Firm Providin~ 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 systen 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 ~L~nicipality of Anchorage files and from my
investigation and inspection, the on-site water supply and/or .~astewater disposal
system is in compliance with all Municipal and State codes, ordinances, and regula-
tions in effect on the date of this inspection.
Address
DHEP Approval
Approved fo.: ,/~,.e'~ b~drocms
Approved ~ B± sapprove~
(E NG!Nq~ER SEAL}
/
Te!e~hone .~ ?f'- 3 v/¢
Te:-:s of Conditional Approval
CAL~ION
T~ ,'FC.,~CI.A~ITY 0F ~NC,,O~ D~PAR~..~,,~ b:
(DHEP) ISSUES ~ILWH AL~HORITY AFPROV.~ CERTiFiCAIE3 3A3a~ SO~LY UPON T~= ~
~ ~.' ..... ,=~R ~SISTERE2
AT!ONS ~ ..... u~C~ESS~0"A~ ....
=I~=_~ I?; PArAGraPH ~ ABOVE BY ~4 INDEPE>;DENY ..... . .= ~
IN Ti~ STATE OF ~AS~%- TF~ DHEP ~ES THIS AS A CO~%ESY TO FL~CiLkSE2S OF HCMEZ
T~IR ~NDING INSTITUTIONS IN CRDER TO SATISFY ~:R~A!., FEDE~ ~D STATE
MEh~S. ~'ir~u~:.~o OF LHEP DO .~T CONDUCT ~.,ar_CI.o.,S "~ .~,.~.Za DATA
~oPO.,o.3~ FOR ERKOE5
CERTIFICATE !S ISS~D. TF~ ..[~iCI, A~lil OF .U~CHO~&GE iS NOT -"~
OR OMISSIONS IN ~ PROFESSIOii~L ENGINEER'S "~R.x.
(DHEP SEAL)
RR4/ej/D18
[Page 2 of 2]
7-19-~4
MUNICIPALITY OF ""'~' ~': "~'-
iVtF, Oix~MENTA,. F ~ . ~ C ~:C74
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH ~UITDRITY APP~DVAL (HAA)
CHECKLIS~ - FEBRUARY 1984
S£P 2 1
RECEIVED
A. ~ELL ~TA
Legal Description: ~-7~ 3
f,ff/~/~- ~//=. ~-~-~ .~,~,~.,
Well Classification p~:
Well Log P~esent (Y/N)
Total Depth / ? ~- ' Cased to
Static Water [~1 /~m
Casing Height Abo~ G~ound /~
Electrical Wiring in Conduit (Y/N)
Separation Distanaes f~cm Well:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Se~ Line
; On ~djoining Lots /mo ~-
; On Adjoining Lots /~ ~-
To Nearest Public Se~
Cleancut/Manhole /~ To Nearest Se~r Se~vioe Line c~n LOt
Wate~ Sample Collected By ~.~,~ ; Date
Wate~ Sample Test Results ~
B. SEPTIC/HOLDING TANK [~kTA
Date Installed /~ ~ Size /~o ~/ No. cf Ccmpa~tments
Standpipes (Y/N) ~ Ai~-tight Caps (Y/N) )/ Foundation Cleanout (Y/N)
Deg~ession o~ Tank (Y/N) ~/ Date Last P~,~ed /~
P~,ping/Maintenanae Co~t_~act cn File (Y/N) ~/~ ; fc~
Holding Tank High-Wate~ Alarm (Y/N) //~ Temporary Holding Tank Permit (Y/N) ~/~
Separation Distances f~c~ Septic/Holding Tank:
To Water-Supply Well ~ /
To P~agerty Line /o ~
To Water Main/Service Line
COU~ se /~ (
To Building Fc~ndaticn
To Disposal Field 1 9 z
To Stream, Pond, r~ke, c~ Major D~ainage
[Page 1 of 2] 2-15-84
ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed /5 ~ &-
Width of Field ~ //
Square Feet of Absorption A~ea
~ ~ Type of System Design
Length of Field ~-/S- /
Depth of Field /4, x
Gravel Bed Thickness /~ /
7~ ~6 Standpipes P~esent (Y/N)
Depression over Field (Y/N) /V' Date of Last Adequacy Test /Y~
Results of Last Adequacy Test
Separation Distance f~cm Absu~ption Field:
To ~ater-Supply Well /~ ~ To P~operty Line
To BuildinQ Foundation ~ F / To Existing or Abandoned System cn
Lot /~- ; On Adjoining Lots
To Water Main/Service Line /~ To Cutbank(if p~esent)
To Stream/Pond/Lake/or Major D~ainage Course '~/~'~-
To D~iveway, Parking A~ea, or Vehicle Storage A~ea
C~m~nts
D. LIFT STATION
Date Installed
Si~e in Gallons
"1~ O~" Level at
High Water Alarm Level at
Tested for
Electrical Codes(Y/N)
Dimsneions
Manhole/ ccess (Y/N)
"PUmp Off" Level at
Vent (Y/N)
Pumping Cycles d,,~ing Adequacy Test.
M~ets ~DA
Cc~nts
** Che~k Permitted Bedroom Rating Against HAA Request
I certify that I have checked, verified, c~ o~nfc~ed to all MOA HAA Guidelines in effect
on t~. date of this inspection.
KB1/d5/s
[Page 2 of 2]
2-15-84
MUNICIPALITY OF ANCHORAGE ~JNICIPALITY OF ANCHOI~GE
DEPT. OF HEALTH &
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROT~T~,~i~qMENTAL PROTECTION 0u~/%
825 L Street - Anchorage, Alaska 99501
(~) ENVIRONMENTAL ENGINEERING DIVlSlONTelephone 2e~ ~.720nrc r, ~ ,rnSEP27 19Z8
Di RECTIONS: Complete all parts on page 1. Incomplete requas~s will not be processed. Please allow ten I1OI days for processing.
1. PROPERTY OWNER I PHONE
Walter J. KurkaI 694-3493
MAILING ADDRESS
Post Office Box 214 99577
PROPERTY RESIDENT (If different from above) PHONE
Gary Johannes
2. BUYER PHONE
Gary Johannes
MAILING ADDRESS
3. LENDING INSTITUTION I PHONE
Alaska Bank of CommerceI 276-7200
MAILING ADDRESS
3230 C Street 99503
4. REALTOR/AGENT I PHONE
Virgina Kohfield, Area RealtorsI 694-9555
MAILING ADDRESS
Post Office Box 249 99577
5. LEGAL DESCRIPTION
Lot 3 Eklutna Heights Subdivision
STREET LOCATION
6. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] One [] Four [] Other
~X SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY ~ Three [] Six
7. WATER SUPPLY
X~;~ I NDIVI DUAL* * ATTACH WELL LOG. A well log is required for all wells drilled
[] COMMUNITY since June 1975. For wells drilled prior to that date, give well
[] PUBLIC UTILITY depth (attach log if available.)
8. SLqNAGE DISPOSAL SYSTEM
~X iNDiViDUAL/ON.SiTE.* '*If individual/on-site, give installation date 197 8
If system is over two (2) years old an adequacy test is required
[] PUBLIC UTI LITY by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010{3/78)
~ATE RECEIVED
~ ~ U~LITY
T~ ~K ~UFA~
REA LTORS
!. Type of Inspection: C!,iR0
2. ?roper;y Owner: Walter J. Kurka
Lc; ,, X
... . -sa P. O. BOX 214, Eagle River,~_;
,.,~]l;na nu.~.'ress: 7~,, ?h0;.e 694-3493
o. ,4alt;e 07 Euyer: Gary Johannes
:tailing A. dJress:
~iame of Lending Institution: Alaska Bank of Commerce 3230 C Street
Mailing Address: _Anchorage, Ak 99503 ?hone ~.76-77flfl
~iame of Realtor or Agent: Vir_~inia Kohf~_]d: ARRA;
P. O. Box 249
99577
Mailing ,Address: Eagl_~ River, AK __
Tnm_ ~altor$
fiq~-9555
Legal ~escription: Eklutna Hts. Stewart Add. Lot 3
Location: Peters Creek
7. Type of FaciiiCy to be inspected: Residential
8. Water Supply
Type of Supply: Public L'tility __ individual
if Individual, number of c,.,'~ngs presently served
If individual, depti~ of wall 175'
9, Sewage Disposal Syste;x
Type of System: Public Utility __
If individual, date of ir, stal!ation:
x
individual (on-site)
Approx. July 1978
X
AREA, INC. REALTORS
Anchorage
"C" St. Office
3300 C Street
East Anchorage -~,c-,'de River
5437 E. Horthern L;(jnts P.O. Boq 249
ItEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
TELEPHONE (907) 562-2343 ANCHORAGE INDUSTRIAL CENTER
5633 [~ Street
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
wATER SYSTEM: LD. NO.
Phone No.
(') See h on back
Zip
SAMPLE TYPE:
~ Routine
~] Check Sample (for routine sample [] Treated Water
with lab ref. no. ') .~'Untreated Water
~ Specl'l Purpose /..
Time Collected
Collected
TO BE COMPLETED BY LABORATORY
Satlysls shows this Water SAMP~.E lC ~
~sfactory
[] Unsatisfactory
[] $ampie too long in transit; samp!e shou'd
not be over 30 hours old at examination' to
indicate reliable results. Please sene new
sample via special delivery mail.
Date Received
Time, Received
Analytical Method:
[] Fermentation Tube
.~..~em brahe Filter
Lab Ref. No. Result' Ana¥~t
.::,_\._
0~ (~)
BACTERIOLOGICAl. WATER ANALYSTS RECORD
READ INSTRUCTIONS
BEFORE
Membrane Filter. Direct Count
Verification: LTB
Final Membrane Filter Resultl ~'~
DGB.
COLLECTING SAMPLE TNTC = Too Numerous To Count
(C37) 27r2J 914
COMPLETED gY \,
LD. NO.
Mo. Day Year
S,*J':PLE TYPE:
(3 Rcvtine
L3 Check S=m~.,e (for routine s-2mple
with lab raft no,
~Special Purpose (--~7A.4,~
Treated Water
Untreated Water
SAMPLE
NO.
1
2
3
4
5
LOCATION
I
Time Collected
CoHo;ted By
TO ~,E CO[,:PLF_q%D :-.Y
L/.-2ORATORY:
CHLM & GEO LABS~OF A~K.~ i:JC.
4649 BUSir~ESS P/2K BLVD.
ADDRESS
A%HORAGE, ALASKA
Date Received
CiTY
Time Received
Analytical Metl~od:
Ferment&tion Tube
Membrane Filter
Lab Ref. No. Result' Analyst
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
Form No. 18-310 (3-78)
O6-1220
BACTERIOLOGICAL WATER ANALYSIS RECORD
10-3-78 s
1 0-4-78 _Timer .....: ' 0---9'45, ~,~. . . ,,o. 8837-12
Broth 24 hours: __ Broth 48 hours:
]0mi Tubes Positive/Total ]0mi Portions
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE/~ESTERI~ DISTRICT OFFICE
437 "E" STREET, SUITE 200
ANCHORAGE, ALASKA 99501
BILL SHEFFIELD, GOVERNOR
Telephone: (907)
Address:
274-2533
September 21, 1984
Mr. TobOen Spurkland
203 W. 15th Avenue
Anci~orage, Alaska 99501
Dear i,ir. Spurkland:
Subject:
Waiver Horizontal Separation between Well and Septic Tank,
Lot 3, Eklutna Heights Subdivision, Eagle River, Alaska
(8521-WA-037)
The Uepart~nent has reviewed the subject waiver request and hereby waives
the horizontal separation between the well and septic tank to 75 ft
on the subject property for a 3 bedroofl single family residence only.
Si ,~erely, .
Bruce E. Erickson
Envi ron~ental Engineer
BEE/msFa