HomeMy WebLinkAboutTHUNDERBIRD HEIGHTS #1 BLK 4 LT 3Thunderbird
'D
Heights #1
Block 4
Lot 3
#051-721-29
Municipality of Anchorage Page 1
of 3
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SW040078 PID Number: 051-721-29
Name:
Randy Evans Wastewater System: Tank Only
Address:
24817 Thunderbird Drive Chu iak AK
ABSORPTION FIELD
Phone: Number of Bedrooms:
688-2363
Existing Trench
LEGAL DESCRIPTION
Soil Rating:
Total Depth from original grade:
Block: Lot: Subdivision:
4
GPD/Fl=
Depth to pipe bottom from onginal grade:
Ft.
Gravel depth beneath pipe:
3 Thunderbird Hts . No. 1
Fl.
Township: Range: Section:
Fill added above onginai grade:
Ft.
Gravel Length:
Fl.
Ft.
Well: Municipal Water
Gravel width: Number
of lines: Distance between lines:
Classification (Private, A, B. C): Total Depth: Cased lo:
Ft.
otal absorption area:
Ft.
Pipe Material:
Ft. Ft.
FP
Driller. Date Drilled: Static Water Level:
Installer.
Date Installed:
Fl_
MM&M Contracting
4/27/2004
Yield: Pump Set at: Casing f eight Above Ground:
TANK
GPM Ft. FI.
SEPARATION DISTANCES
® Septic ❑ Holding ❑ S.T.E.P. ❑ other:
To
Septic
Absorption
Lift.
Holding
DublictPrIvate
•
From
Tank
Feld
Station
Tank
Sewer Line
Anchorage Tank
1,000
Well
N/A
N/A
N/A
N/A
>25'
Material:
Steel
Number o ompanmen s:
Two (2)
Surface Water
>100
>100'
N/A
N/A
LIFT STATION — NONE ON LOT
Lot tine
.>51
>10,
N/A
N/A
Planufaclulen
Gat.
Foundation
>51
> 10 �
N/A
N/A
'Pump on eve it:
ump o eve at:
g wa era arm a :
in
In.
in.
Curtain Drain
None
Noted
Pump Make Mode
lectnpl Inspections performed by:
Remarks:
Tank Only Replaced Under This
BENCH MARK
Locauon and wescripLion:
Permit.
Top of Footing.
Assumed Elevation:
100.0 Ft.
Engineer's Stamp
OF 111
�••`'
W
Inspections performed by: TLX Dates: 1 st 4/27/04
`49th `''� �0
0;1g 0
2nd 4/27/04
MICHAEL E. ANDERSDN•
Department
Department of alth an Human Services approval
�'1W
AF
'0 s�..• No. CE -4381
Reviewed and approved b . Date: 28 �v. tt>)
PP Y' - --
��� t•..................�•�••�'��
/+
--
4;;:::S:a`'••�
THUNDERBIRD HEIGHTS NO. 1
LOT 3, BLOCK 4
21,000 S.F.
Permit No. SW040078
EAST
PID No.: 051-721-29 136.40
N
N
N �
w W
d• �O
v co N
co
3 co
a C
hCO
Existing Absorption Trench
Exact Location Unknown
A A B
T e Bedroom S1 24.8' 15.0'
ome S2 26.5' 16.9'
C2 29.0 22.7'
C3 29.6' 23.4'
Garage
NOTE:
Tank Only Replaced Under This Permit..
1
0• ur�C�ty Easement ' • `'
BIRD 1+
THUNDER OF
.. .....,,...•..�j4 .
AV
' 49thff
�....
.....f
,f
... ....... f .................
:MICHAEL E.ANDERSONrPLANAS BUILT NoCeasat s
ir
SCALE 1" = 40' •• ���.FESSI�P:�`�`
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit No. : SW040078
TBM = 100
NOTE:
103.45
Tank Only Replaced Under This Permit.
E
NOTE: Informational Only.
Page 3 of 3
PID No.: 051-721-29
4.4
'• _ 49th
PROFILE AS-BUILT•"Ai
MICHAEL E.ANOERSON
Scale: NONE
�1�%•' NO. CE4381
1.J'�'•_
p�bFESS1�Pi
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
3�m
Date Issued: Apr 26, 2004
Expiration Date: Apr 26, 2005
Permit Number: SW040078 Parcel ID: 051-721-29
Legal Description: MHUNDERBIRD HEIGHTS #1 BLK -4 LT'S 3
Design Engineer: 0014 Anderson Engineering Site Address: 024817 THUNDERBIRD DR
Owner Name: RANDY EVANS Lot Size: 29712 SQ. FT.
Owner Address: 24817 THUNDERBIRD DRIVE Total Bedrooms: 3 Permit Bedrooms: 3
CHUGIAK , AK 99567-5131
This permit is for the construction of:
❑ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By: Date: 4—z, "'DY
Issued By:
Date: 1'2 0 4L
Municipality of Anchorage
G� B
• Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St. S" `'"
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 051.721.29 Permit Number SW 04 0078
Property owner(s)_Randy Evans Day phone 688.2363
Mailing address (1) 24817 Thunderbird Drive Chugiak, AK 99567
Mailing address (2) Zip Code
Legal description (Lot, Block & Sub'd.) _Lot 3, Block 4, Thunderbird Heights Subdivision No 1
Legal description (Section, Township & Range)
Lot Size-20,4e63f Acret Cq.Ft.
7.9`7/2
THIS APPLICATION IS FOR:
Number of Bedrooms Three (3)
Sewer Only ® Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
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 Fees:
Date of Payment: 4- Z Z- O v
Receipt Number- 0 9Z_ C,
(Rev. 12/00)
Waiver Fees:
Date of Payment:
Receipt Number:
ANDERSON ;ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 : 522-6779 (FAX)
April 22, 2004
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 3, Block 4, Thunderbird Heights Subdivision No. 1
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The septic tank on Lot 3, Block 4, Thunderbird Heights Subdivision No. 1 is located too
close to the foundation and must be moved or replaced. We are concerned the age of
the tank will not allow movement and replacement is the only option. There is currently
a 1,250 gallon septic tank on the lot that was placed 1980. We are proposing to
replace the tank with a new 1,000 gallon tank to serve the three-bedroom home on the
lot. We are therefore requesting a permit be issued for the construction of a new
septic tank to serve the home. The attached Site Plan and backup documentation
identify the location and configuration of the existing septic system and the location of
the new tank. Also identified on the plans is the estimated location of the existing water
on the lot. The new tank will be placed in the same location as the existing tank with the
exception that it will be more than 5' from the foundation. The existing tank will be
properly disposed on the property or removed from site. The drainage patterns will be
maintained after construction.
The ground surface on the lot slopes at varying grades. The new septic tank will be
constructed near the location of the existing tank and as parallel with the slope of the
land as possible in conformance with Municipal requirements. The new septic tank will
be constructed a minimum of 10' from the existing water service on the lot and those on
the adjacent lots and will not conflict with other facilities in the area.
If the system is constructed in accordance with our design the following statements
apply:
1. The system, if constructed as designed, will have no adverse impact on the wells
Lot 3, Block 4, Thunderbird Hts. No.
April 22, 2004
Page Two
in the area or those to be constructed in the future.
2. The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
3. The system, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
4. The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,
M-C-4� EA'-4�
Michael E. Anderson, P.E.
Attachments
THUNDERBIRD HEIGHTS NO. 1
LOT 3, BLOCK 4
21,000 S.F.
EAST
136.40
N
CID <o
(p S1
N �
O
a co
co
ry.
3
C-2
Existing Absorption Trench
Exact Location Unknown
1%-5%-
Thffa�edroom
Remove and Properly Dispose
1,250 Gallon Septic Tank
Existing
Place New 1,000 Gallon Septic Tank
Garage
9
with Two Post Tank Cleanouts
10 uCdtty Easement
THUNDERBIRD
��•►����t>A�
W,�E F, ,4
;��♦♦
DRIVE
�� �P.•••••........
�. °•
�
A �'' �♦♦
49th
�.... `.................... ::.... 00
SITE PLAN
.....:`..-cr. ��rN
MICHAEL E. ANDERSON
♦i ��: N0. CE4 81 •� � :
♦♦♦'*+4�FESSt��� i•
—
SCALE 1 - 40
�•.....••
I MUNICIPALITY OF ANCHORAGE I
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
I
PHONE � �
❑
A/
rrZl�OG - e.
UP RADE
MAILING AD RES
LEGAL DESCRIPTIOGN_
3 �/Q Y//• 1
LOCATION O/
4?
NO. OF BEDROOMS
Uy
DISTANCE TO:
Absorption are/ ,�-
Dwelling t.74
PERM N O.
F2
Manufacturer /�
Mater' Q
No. of co partment5
a Q
wH
(�
to
Liq.c p,7city,in,�allons
L (J
IF HOMEMADE:
Inside length
Width
Liquid depth
OO�Z
DISTANCE TO:
Well
Dwelling
PERMIT NO.
_ F
Manufacturer
Material
Liquid capacity in gallons
W
DISTANCE TO:
t!
!btUL/U(c
FoundatioZo �,
Nearest Igt� r}r.
PERM N
=
U U. Z
No. of lines
Length f ea ne
Total le th � lint
Trench idth ��
�
Distance et een 1i
/'V
Z W
_
Inc es
/
~ cc
Top of the to fi�rish gr de
AI' Terial bj each tile �y ((
Total effective absorption area
p
?
--lJ t.�(�GIetJ�.��
/L inches
Length
Width
Depth
PERMIT NO.
w
a
n I—
Type of crib
Crib an mer
Crib depth
Total effective absorption area
Wd
WWell
V)
,
Building foundation
Nearest lot line
DISTANCE TO:
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
LU
Buil n fo id t n
Sewer line
Septic tank
Absorption area(s)
DISTANCE TO:
OTHER
PIPE MATERIALS
Z
SOILTESTRATING IjL
INSTALLER
LG�O AJS
I
REMARKS
T
f—
as
d
w
6
f
drM1 : cert i:ofar L•; rA
1.1
e• t
.✓-
`Fin
APPROVED DATE LEGAL
S Engineering
72-013 (Rev/3/781
r+iat�1 I o- I r" ----uL I To -r OF Hr-40H"'T7'--F=lf3E
DEPARTMENT Q ,HEALTH AND ENVIRONMENTAL p!eOTECTION
825 't 'STREET.- ANCHORAGE, AK. 95 1
264-4720 xz)o
t=11r-4-�7, I TELJEFZ F=`EFSrl I T
PERMIT NO. t 800504 )
APPLICANT GARY S. KOCKLER SRR 6105 A-3 PALMER,AK. 745-2553
LOCATION THUNDER BIRD DR..,,., ..... .... _........ ....... :....... , , .
LEGAL I.LOT 3 BLK....4�THUNDERBIRD HTS.. LOT SIZE 21000 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING {SQ FT/BR)= 125
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
[EP'TH= 3 L-Er-4C3TH= --2 AGF ~IRtir'EL_ F?EF='TH= E
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTA14CE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION CIN FEET).
f- EoU I Fz�Ei> n3EF---pT I C TtRr-4U'. w -:-,12:E:== GFaILL.Cr+FS}
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION I14SPECTIO14S OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. '
--- TL4L-Di C 2> I N -F -"ECT I O"!S RF= E FRaGGU I FSEF> ---
BACKFILLING OF ANY SYSTEM 14ITHOUT 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 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER. LINE IS 75 FEET.
OTHER. REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F~EF-Rrrl I T aXr—' I FSE F>EIGEMOC- M = 11 Z. 5=4:0
I CERTIFY THAT
1: I AM 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.
3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS.
SIGNED:
ISSUED
ALTRI TrAPIT f.ppv q. vnrlGL_FR
a
V4. 0
PERFORMED FOR:.
LEGAL DESCRIPTH
1.
2-
3-
4.-
5-
6-
7 -
-3•4:5•6•7•
8.
91
—r�l0.
11
12
13
14:
15
16
17
18
19
20
1 SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
TEST
825 L. Street, Anchorage, Alaska 99501 2644720 7z;
SOILS LOG -PERCOLATION TEST 7
GC�(1 f I L le -1 DATE PERFORMED: vr%t
7v� sd c.
Ltoo,..,t7
f3o i V.) 1!'4, v
Com• . V °♦i r�'7
Robert A, afar
Reading
Date
WAS GROUND WATER
L
ENCOUNTERED?
Net
Drop
O
P
E
IF YES, AT WHAT
DEPTH?
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
i
PERCOLATION RATE (minutes/inch)
TEST RUN BETWEEN FT AND FT
PERFORMED BY: :S & S Engiie;jj rr CERTIFIED
72.008 (6/79)
Municipality of Anchorage
Development Services Department -
Building Safety Division ..
\_ On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
vrv+w.muni.orglonsile
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. oV— 7—� �1 1—o?yt COSA# 14140Q1611q
1. GENERAL INFORMATION Expiration Date: _6�— / "( "/ C)
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
THUNDERBIRD HEIGHTS #1, BLOCK 4, LOT 3
24817 THUNDERBIRD DRIVE • CHUGIAK, AK 99567
TAREK WETZEL Day phone 688-8867
24817 THUNDERBIRD DRIVE • CHUGIAK, AK 99567
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual Well
❑
Individual Water Storage
❑
Community Class A Well
❑
Public Water System
❑
Day phone
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
N
Individual Holding tank
❑
Community On-site
❑
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 ppouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the
information obtained from the Municipality of Anchorage 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 GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179
Address 3701 E. TUDOR ROAD. SURE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date ao o
Engineer's Comments:
In conducting this evaluation, GEG, VD. attempted to provide a thorough,
conscientious engineering analysis of the system In accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the ownerlisted above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for 3 bedrooms.
Disapproved.
Conditional approval for bedrooms, with the fllowing
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
L/ Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Nitrate Advisory Other
By. Zv.
0
(Rev 11/05(
Vy, A.,.Ca;4ess
CE -795 :i
Y,OF
•ON-SITE .•'�"
WATER AND m"
WASTEWATER
o: PROGRAM
Original Certificate Date: — / '-/ ` D q
Municipality of Anchorage ,
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program `
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: THUNDERBIRD HEIGHTS N1, BLOCK 4, LOT 3 ParcelID:Cis%"%;.l'29
A. WELL DATA
Well type 'A'
Date completed
If A, B, or C provide PWSID# 211156 Well
Cased to ft.
FROM WELL LOG
Date of test
Static water level ft. ;
Well production -9 -P.M.
WATER SAMPLE RESULTS:
Wires properly protected (YIN)
Casing height (above ground) in.
AT INSPECTION
ft.
g.p.m.
Coliform colonies/100 mL Nitrate mg./L, co ornesl100 ml.
Ars Date of sample: Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank TypeNatedal SEPTIC/STEEL Date installed 4/27/2004
Tank size 1000 gal Number of Compartments? Cleanouts (YIN) YES
Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) N/A
Date of pumping 4/29/2009 Pumper JRS PUMPING
C. ABSORPTION FIELD DATA BELOW EXISTING GRADE
Date installed 10/28/1980 Soil rating (g.p.d./ft'o lbdr 125 System type TRENCH
Length 42 ft. Width 5 ft. Gravel below pipe 6 ft.
Total depth • 11.34 ft. Eff. absorption area 500+ fe Monitoring tube YES Depression over field NO
Date of adequacy test 4/29/2009 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test"SO In. Water added 500 gal New depth ***62 in.
Elapsed Time: 250 min. Final fluid depth •'50 in. Absorption rate >= 450+ g.p,d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date
»•14 INCHES :BELOW THE INVERT OF DISTRIBUTION LINE
►'•2 INCHES BELOW THE'INV ERT OF DISTRIBUTION LINE
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N
'Pump on' level at in. 'Pump oft" level High water alarm level at in.
Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES COMMUNITY WATER SYSTEM
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAift station on lot
Absorption field on
Public sewer main
Sewer /septic
On adjacent
Public sewer manhole/cleanout
Holding tank
AJtr'mal-C6ntainment areas Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent tots 200'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main 10'+
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 200'+
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 JEFFREY A. GARNESS
Date
COSA Fee'—I.Waiver Fee $
Date of PaymenDate of Payment
Receipt NumberReceipt Number
(Rev. 11105)
fill IN 05/06/2009 13:24 9073449821
■ ■
■
i■
■� JRs Pumping
PO Box 773413
EagleRiver, AK 99577
(907) 694-6454
Blilin Information
Tarek Wetzel
24817 Thunderbird Drive
JRS SEPTIC
Job Desorption: 12509
P.O. Number:
Chugiek, AK 99587 Tom, Net 30
(907) 688.8867 salssrep: Dawn -Dawn
Map Book:
rJOb site Information cross streets: Old Glenn Hwy
Kyle Q Gamess Job Comments:
24817 Thunderbird Drive
Chuglak, AK 99567
(907) 688-8867
Additional Location Comments
O's are on the house 8, mailbox
Cedar home w/red trim
lank on the side of home
Service Type
Septic Sery 1250K
PAGE 01
Service Agreement
Number. 028461
Order Date: 28 -Apr -2009
Service Date: 2B -Apr -2009 12:00
Technician: Mike
Tax %: 0
Job Type: Repeat
Map Grid: 7 - -
125og
camped & checked tank
1250g's
2EC: repump in 30-60 Days - due to solids
Diagram: S'1Dlagramsl2aeel.bmo
"NEED DRAWING"
Qty Price Each Tax?
1 5180.00 No
Gallons Planned: 1250
Gal. Actual:
Hose Length:
Double Tank: ❑
Pump System: E
Baffles Inlet: ❑
Baffles Outlet: ❑
Extension Actual
$180.00
Nontaxable Total Taxable Total Tax Total Grand Total
Estimated Charges' $180.00 $0.00 $0.00 $180.00
Actual Charges:
Customer agrees to the terms and condition" shown. THIS IS A BINDING AGREEMENT.
Signature and TM* of Customer Representative Data
Accepted by JR5 Pumping Data Accepted
For your added convenience we accept; American Express. Dicover, Viae and Master Card payments over the phone.
After 30 Days account will be turned over to COLLECTIONS. $30.00 For NSP Checks Resumed.
7A rJ
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
rg
CERTIFICATE
Co rL
-
-
S• [T♦
r
OF HEALTH AUTHORITY APPROVAL '�41
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 051-721-29 HAA#_f j O � 1
1. GENERAL INFORMATION Expiration Date: 4 — � 9 " 0 5
Complete legal description THUNDERBIRD HEIGHTS SUBDIVISION #1; LOT 3, BLOCK 4,
Location (site address or directions) 24817 THUNDERBIRD DRIVE * CHUGIAK, AK. 99567
Current Property owner(s) ' ' 'RANDY EVANS Day phone 688-2363
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
24817 THUNDERBIRD DRIVE * CHUGIAK, AK. 99567
Day phone
LISA CONNER w/ ' DYNAMIC PROPERTIES Day phone 569-2013
3111 ."C" STREET * ANCHORAGE, AK. 99503
Unless otherwise requested, HAA 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 A Well
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 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) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues HAAs upon request to homeowners. 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 samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the
information obtained from the Municipality of Anchorage files and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd.
Address 3701 E: TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, Ltd. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identit<able features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for 3 bedrooms.
Disapproved.
Phone
337-6179
Date
V,AYJAW
FEt7953
.• ~cG
pro f esslo�°000
Conditional approval for bedrooms, with the filowing stipulations:
ik i --CV OF A�
ON-SITE
:^:ATERANn
WASTEWATER
• PROGRAM-
Attachments:
ROG AMAttachments: �'-�,�0� • • . . • • •' ��`\�
HAA Checklist Manitenance Agreements
Septic System Advisory Supplemental Engineer's Reort
Well Flow Advisory
Other
By: �• Original Certificate Date: L+ —al -04
(Rev. 12101)
I.Municipality of An
chorage ,
° e
;Development Services Department
_-
Building Safety Division "
On -Site Water & Wastewater Program g";
4700 South Bragaw St. t.
'P.O. Box 196650 Anchorage, All 99519-6650 ;
www.ci.anchorage.ak.us
(907)343-7904
' HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Descn tion: THUNDERBIRD HEIGHTS S / D 1 SLOT 3 BLOCK 4 Par cel ID: 051-721-29
A. WELL DATA
COMMUNLTY WATER SYSTEM
Well type „A.. j
I, If Al -B, or C provide PWSID# 211156 Well L� g (Y/N)
Date completed Sanitary seal (Y/N) t res properly, protected (Y/N)
I I , I
Total depth' ased to ft. n Casing height (above ground) in.
i . FROM WELL LOG AT INSPECTION
Date of test �I
it { : I . ,
Static water level ft. ft.
Well production g.p.m. g.p.m.
i
p WATER SAMPLE RESULTS: I'
i
�} Coliform colonies/100 ml.'Nitrate — mg./L. Other bacteria — colonies/100 mi.
Arsenic. — mg./L. Date of sample G Collected tiy:' —
I I
I:
B.. SEPTIC/HOLDING TANK DATA
I
Tank Type/Material STEEL' Date installed 4/27/2004
Tank size [(1000 -gal. Number of Compartmenits 2 Cleanouts /N) YES
Foundation cleanout (Y/N) YES Depression over tank (YIN) NO High water -alarm (Y/N) N/A
Date ofllpumping NEW Pumper
C. ABSORPTION FIELD DATA r ! *BELOW ExisTiNc cRAOE
�
Date installied 10/28/1980 Soil rating (g.p.d./12o lbdrm 125 System type TRENCH
Length 142 ft. Width 5 ft. Gravel below pipe 6 ft.
Total depth *11.5 ft. Eff. absorption area 500+ ft2 Monitoring tube YES Depression over field NO
Date of adequacy test 4/1 /2004 I j Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 46 in. Water added 582 gal. New depth **50in.
i ,
Elapsed Time: 15 min. Final fluid depth X45 in. 1 Absorption gate >= 450+ g p d
�,
Any reluvenaUon treatment (past 12 mo) (Y/N 8� type) NONE KNOWN If yes, give date —
** 13 INCHES BELOW INVERT OF DISTRIBUTION LINE.
' rl�
D.; LIFT STATION
DatelAnstalled Size in gallons e Access (Y/N)
3"PujmlP 'on" level at in. evel at in. High water alarm level at in.
—
1l
1!D t Cycles tested Meets alarm & circuit requirements?
E.SEPARATION DISTANCES
:COMMUNITY WATER, SYSTEM
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot On adjacent lots
Absotion field on lot On ad* a`c*1I:1t1IC11
I
a
Public main Pu
bl Public sewer manhole/cleanout
service c e �lrin line Holding tank
Sew
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Property line 5'+ 5'+
5'+ Absorption field, -
Building foundation
10'4�
Water main 10,+; Water service line 10'+ -'Surface water— 10 r
i Wells on adjacent lots 200'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property Ii
I'll 1 '10. + Building foundation - 10'+ Water main 10'+'
: e: 10'+
Waterservice line 10,+ Surface water 100'+ —Driveway, parking/vehiclebtorag
.
Curtain drain NONE KNOWN Wells on adjacent lots 200'+
IF... COMMENTS
�G. ENGINEER'S CERTIFICATION
C/)
that I have determined through field inspections and
y ...... ........
I certify
f I 1i I � VA
review 0 Municipal that the above systems are in
conformance with MOA HAA guidelines in effect on this date. J...
ff e rn s.—I! PA
Eng neerls� Printed Name JEFFREY A. GARNESS 7953
< C,
Am- QProfesSI
ALO,
Date
Waiver Fee $ rega is
:HAA Fee 76'
:
'Ijoc�rjLoy Date of PaymentIIF
Date of Pa ment
ly
!Rec ipt Number Receipt Number
(Rev. I i/0 11)
IT,
i
q
i
N
tJG7-�
AS -BUILT
I hereby certify that I bave surveyed the following
described property: 4-ar 3. e o
t
Anchorage Recording Precinct, Alaska, and that
.thee.
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 the premises in
question and that there are no roadways, transmission-,..
lines or other visible easements on said property except
as indicated hereon. I
'
Dated at Eagle River, Alaska
this!" '—"—day of
ROBERT C. JOHNSONCy - "
SCALE: Registered Land Surveyor h' $$D -LS
1 = 3o Box 456, Eagle River, Alaska
Phone 694-2543
''
I
r, , lCWA I I Y or 01.2110RAGE
-- _—�
fc-T,,ELf LOCATIO C r --- --- ---
i>[PF .- 1J, Or IIZAt ,t' ° :•'JJL1Ofv E"JTAL Plf OT1E f 1rJ
R y )JOCIPAUTY OF ANCHORAGE
---
.�� .,, ii �5 1 Str4r t • knell r - Alasl.d UP501
DEPT. OF HEALTH &
[G7—T YP E OF HESiDENCE _.._ I
; ,t J ,
ENVIRONMENTAL PSOTECTION
I r I I / +
3 i F.N\ InotimErJ1AL ENGlrJEFRIr.!G DIVISION
�-
One [73Fvur E3 Other
UX SINGLE FANHLY
a
TL l etal:0!lc ZJi•$IZO
PfT 6 1D((�t
A .tt 1 c
APR81
MULTIPLE I'r;L%ttLY
I REQUEST FOR 14PFROVAL 01- INIDIVIDUAL WATER AND,SE -' •RACI`LIITIESS
CE -`'EID
Three El Six
_
D&i CT16NS: Complexe eG parrs an pe^e 1. Incomplete rcquesL will not 6n promml. Pleare aticw tan (10; days to. o, acessina.
-
—
T-1, C,..FRTY D4UiJf.:R
UN
COMMUNITY
CaS Kockler
l_I PUBLIC UTILITY
tl-pth,(attach Inn it' avdi!able.)
s. s[tvAGL DISPOW. SvSTEP4
�y
"If inst,11136on i
fX ItJDIVIDUAL(Uiv1•S(TE". �
Yi'*JFR , HEs: E Jr (11 rLtf-Trent from rbo..0 --- ------
PHONE
-
NNN ;Thunderbird'Drive
'! _
PHONE
Evans; Randall,N. & Linda L.
.11-.41LIIXiA0Di9�.
(;i. LENUI �U 1l'.wTl1'U7ICN I '� -
PHOiJf
-
1 Mutual Bank
274_2551
!
_Alaska
ADDHE3S
P. 0' Box 1120, Anchorage, Alaska 99510
a ,.t"�:r.�r.:,tncE�:1
�
rlwl•�e:
r Totem Realty/Bill Schelgel
j
LEGAL DES3CWVTION
I Lot_ 3 Block 4Thunderbird Heights Subd.
-- _—�
fc-T,,ELf LOCATIO C r --- --- ---
--
---
NHN Thunderbird Drive
[G7—T YP E OF HESiDENCE _.._ I
I NU�'(s_R
OF t3LGHOOMS
❑
�-
One [73Fvur E3 Other
UX SINGLE FANHLY
C_I
I Two ❑ Fite
MULTIPLE I'r;L%ttLY
C-�cI
Three El Six
7. JLOTCH SUPP LY— !
I
INDIVIDUAL*'
ATI ACH WELL LOG. A well log is required for all wells drilled
COMMUNITY
since J.tne 1975. Fcr wells r -Ir ,I:d prier to Owt date, give west
l_I PUBLIC UTILITY
tl-pth,(attach Inn it' avdi!able.)
s. s[tvAGL DISPOW. SvSTEP4
�y
"If inst,11136on i
fX ItJDIVIDUAL(Uiv1•S(TE". �
individuali0n-site, 9N*! 0,i!'C .• .
'
If system is over, two (7) y^ars old an adequacy test IS M-1.1ired
0 Fi1R1.IC UTII.ITY
by thiS JCpa1t[T•cn4.
1 NOTc. THI; INSPECTION FEL' MUST ACCOMPANY EACH REQUEST BFFO!;E PrL LCF: SING CAN BE INITIATED.
POP. OFFICIAL USE ONLY
i
INSPECTIC)iqPPOINI %".ENTS
MAIZI�L LIVLD
DA F-
1. TYPE OF RESIDENCE
NUMEB OF BEDROOMS
SINGLE FAMILY
0 ONE ❑ THREE
❑ FIVE ❑ OTHER
❑ MULTIPLE FAN-11LY
El TWO C3 FOUR
D six
2. WATER SUPPLY
PERMIT NUMBER
❑ INDIVIDUAL
DEPTH OF WELL
-CO,%',Nl.UNITY
DATE DRILLED
PUBLIC UTILITY
ConnectionVerifiedLOG
RECEIVED
.1. SE1.4JACE DISPOSAL SYSTEM
PERMIT NUMBER
1-INDIVIDUAL/ON -SITE
L
OPLIBI IC UTILITY
Connection Verified
1.4 TALLI-li
0':)ePti-. Tank, or 0Holding l"ank
Size: If Tank is homernarle
SOILS RATING
give dimensions:
TYPE OF TANK
MANUFACTURER
TOI AL.ABSORPTION AREA
MATERIAL
TBISTANCES
-:optjr/Hol,!mq-unk Absorption AreaSewerLine Neatest Lot —unc..
WELL TO:
Ahsorp000n Arra to Lct —Line
CCMMENTS
li"APPROVED FOR
_�BEDROOMS
0 CONDITIONAL APPROVAL
(Iet I(" must accompany certificate)
0 DISAPPROVED
DAT[
LEGAL
DII�Lllulj ION
72 n 1 n m., n i 7n i