HomeMy WebLinkAboutEAGLE RIVER VALLEY RANCHETTES LT 2CI¢X
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MUNICIPALITY OF ANCHORAGE
· DMSION OF ~qVIRONMF2YrAL HEALTH
DEPAKrME~£ OF HEALTH AND ~%riRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUI'HORITY APPRQVAL CERTIFICATE
1. General Info~'n~tion Application Date June
(a) Legal Description (include lot, blcck, subdivisic~l, section, township, range)
Lot 20, Ea~le River Valley Ranchettes
Locati6h (addressordirections)
146 Citation Road, .Eagle River, AK 99577,
(b)
(c)
Applicants. Nam~ Start Sorenson Telephone 694-2882
Applicants Address 146 Citation Road, Eagle River, AK 99577
Applicant is (check ors) Lending Institution
Buyer ~; Other ~ (explain);
(d) Lending' instituticn ]~/A . T~ lephone
Address
(e) Real Estate Co. & Agent ~q/A ..
Address
Telephone
2..Type of Residence.
Single-Family ~
Number cf Bedrccms
3. Wate-" Supply
e
~,lti-Family ~
Other (describe)
Individual Well ~-~ C~.~,~nit!; ~ Public ~
Ncte: If community ~11 system, must ha%~ written ccnfirmaticn fron the State
Dep~t~ent of Envirc~'~rmntal Conservation attesting to the legality and status.
Es .the ~11 adequate for the number of bedrooms specified in this Hk~ (Y/N) N/A
Se wa.~e Disposal
Onsite ~-~ Public ~-~ Cc~Nrunity I.. i Holding Tank ~-~
Is tb~wasteWater disposal system adequate fcr *_he rnmber of ~dro~ns (Y/N) y~
[Pa~e 1 of 2]
2-15-84
5. Engineerinq Firm Providin~ ,Inspections, Tests, Data and Information
I ~rtify that I have checked, verified, cr confounded to all M3A HAA Guidelir~s in
effect on the ~ate of this
6~
1984
Name of Firm:nE tech Engineers, Inc. 694-3574
Telephcme
Address 13 LeDoux, Eagle River, AK 99577
Signed by Vernon L. Roelfs, PE
Date.._ June 6. 1984
(ENGiNEER SEAL)
6 .,DHEP Approval
Appro~d for ~ bedrcQ~
Approved ~ Disapp~o~d ~
Terms of Conditional Approval
The Municipality of Anchorage Department of Health and' Envirc~Tental Protection dces
not guarantee the continued satisfactory perfQrmanee of the water supply and/cr t~he
wastewater disposal system. This approval indicates that, as of the validation date
shown above, based ex1 tt~ data and information furnished by an er~3ineer registered in
the State of Alaska, the water supply and wastewater disposal system is safe and func
ticr. al for the rzumber of bedrooms and type of structure indicated.
7.'Mail the HAA to the following address:
146 Citation Road
River, AK 99577
KB2/d5/s
[Page 2 of 2)
2-15-84
A®
/,,,~UNIClPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTIOI',J
MUNICIPALITY OF ANCHORAGE (MOA)
HFALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
Legal Description:
JUII 2 2 1984
.RECEi.VEI
Sorenson
Lot 2Ct Eagle River Valley Ranchettes
Well Classification Community
Well Lo~ P~esent (Y/N) N/A ·
Total Dspth N/A
Static Weter I~l N/A
Casing Hsight Abo~ Ground
Cased to
N/A
If A, B, ce C, D.E.C. ApprOVed(Y/N) Yes
Date Ca~pleted N/A Yield N/A
N/A Depth of G~outirg N/A
Pump Set At N/A
Sanitary 'Seal on Casing (Y/N)w/~,
Electrical Wirin~ in Conduit (Y/N)
Separation Distan~ss f~cm Well:
To Septic/HoldinG Tank cn Lot 200' +
To Nearest EdGe of Absorption Field c~ Lot
TO Nearest Public Sewer Line N/A
C leancut/Manhole
Wate~ Sample Collected By N/A
Water Sample Test l~sults N/A
Da~-ession Around Wellhead (Y/N)N/A
; On Adjoining Lots 200' +
200' + ; On AdjoininG Lots 200' +
To Neeeest Public Sewer
To Nearest Sewer Service Line on Lot 200' +
~ Date N/A
SEPTIC/HOLDING TANK II%TA
Dste Installed lJnknnwn Size 1/~/7{7 ~ml No. of C(~a~t2r~n~s ~
Standpipss (Y/N) Yes Air-tight Caps '(Y/N) ¥.s Foundation Cleanout (Y/N) Nn ~
DsUression o~sr Tank (Y/N) No Date Last Pumped 4-21-84
lam~pirg/Maintenance Contzact on File (Y/N)~ N/A ~ fac N/A
HoldinG Tank High-Water Alam~ (Y/N) N/A Tempceaey Holding Tank Permit (Y/N) N/A
Sepa~ation Distano~s f~cm Septic/Holdir~3 Tank:
To Wete~-Supply W~ll 200' +
To l~operty Line 35'
To Water Main/service Line 30'
Course N/A
To BuildinG Foundation 5'
To Disposal Field 20'
To Stream, Pond, Lake, ce Major' D~ainage
Comnsnts
[Page 1 of 2]
2-15-84
C. ABSORPTION FIELD [I%TA
Soils Rating in Absorption Strata
Date Installed Unknown
Width of Field Unknown
Squa=e Feet of Absorption Area Unknown
Dap=essic~. over Field .(Y/N) No Date of Last Adequacy Test
Results cf Last ~4equacy ~est 540 ~pd ~
Separation Distance frcm Absc~ption Field:
To Water-Supply Wall 200' + To P~operty Line 15'
Unknown Type of System Design Crib
Length of Field Unknow~
Depth of Field _.. 7,?'
Gravel Bed Thickness Unknown
Standpipes Present (Y/N) Yes
5-22-84
To Building Foundation ?B' To Existing or Abandoned System cn
Lot 29' ~ ; On Adjoining Lots 10Q' +
To Water MaiP/Service Line ~0' ~ To Cutbank(if present)
To Stream/Pond/Lake/~'Majo~ Drair~ge Ccurse N/A
To D~iveway, Parkirg Area, or Vehicle Stcrage A~ea 4~'
C~,,~=nts There appears to be an abandoned system on the lot. No
~ - - '..."--- I ~ I - /. ," - '
LIFT STATION - ~ ~.
Siz~ in Gallons
"Pump On" isvel at
High Water Alarm Level at
Tested for
Electrical Codes(Y/N)
Manhole/A~ss (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles du~ing Adequacy Test.
M~ets ~DA
**
** Check Permitted Bedrocm Rating Against HAA Request
I' certify that I have checked, verified, c~ conformed to all MOA HAA Guidelines in effect
on t.he date of this inspection.
Ccmpany Entech Engineer'S, Inc.
2-15-84
TECH ENGINEERS, INC.
CIVIL · SANITARY
June 5, 1984
Municipality of Anchorage
Department of Health & Environmental
Protection
825 "L" Street
Anchorage, AK 99501
Re: Sorenson Health Authority Approval Application;
Lot 2C, Eagle River Valley Ranchettes
Dear Sir,
During the period from May 26 to May 29, 1984, we
performed research, investigations and testing persuant to
Health Authority Approval on the above referenced lot. The
property is served by an approved public.yater system (see
attached letter from DEC). We performed an adequacy test on
the septic absorption system and found that it absorbed at
the rate of 540 gallons per day (gpd). This is more than
the 450 gpd required, and the system is adequate. The
septic tank was pumped as part of the test and the tank
volume was verified to be 1000 gallons.
To our knowledge, we have assembled all available
information on the HAA Checklist and Application Form. We
were unable to locate an Inspection Report for the sewage
disposal system. We found the system to be a 1000 gallon
septic tank with a crib for effluent disposal.
We offer this information for your review.
call if you have any questions.
Please
· -..~ oF 4, -%',
cc Stan Sorenson
Attachments
x ioa ion
~ Checklist
33 LE DOUX LANE · EAGLE RIVER, ALASKA 99577 · TELEPHONE~OT) 694-3574