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Home My WebLink AboutTHUNDERBIRD HEIGHTS #1 BLK 7 LT 20"A E I Dc..*O�(L ft�l COSI- S41 -o9 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 PHONE / EW 0 UPGRADE MAILING A RES LEGAL DESCRLPYOI`�_ LOCATION t� NO.OF�DROOMS D Wel DISTANCE TO: Absorption area / Dwelling PER -, Y EQ LU Manufac erg �� Mater i No. of compartment to Liq. cit • Ions Inside length rIF HQMEMADE: Width Liquid depth 6 Y JaZ DISTAN ell Dwelling PERM SF M acturer Material Liquid capacity in gallons C1We W = DISTANCE TO: Fou �ti Nearest 1 t line + �� 0 PER J LL Z Z W No. of lines Length of eacn / Total length of lines Trench widt ches Distance bet yen lines •�' fes.. O Top of tile to finish grade „ r Material beneath tile inches Total effe t a bso 'on area W Length Width pth PER aH W Type of crib Crib diameter Crib depth Total effective absorpt"0 rea W H ISTANCE TO: Well Building foundation Nearest lot Zine JClass J Depth Driller Distance to lot line PERMIT NO. W 3: TO: Building foundation Sewer line Septic tank Absorption areas) OTHER PIPE MATERIALS 0 3 Ll e Pap SOIL TEST RATING LJ INSTALLEROn �� 70c'n 7 E 1 5 REMARKS 3 AP/PPROyE /n DATE LEGAL Yd !, I r 72-013 (Rev. 3/78) rl Lj r_4 I c I r^=:, L_ I T 1T' o F= A r -i C H i"� F=1 G E 0 DEPARTMENT 0. - HEALTH AND ENVIRONMENTAL F ..JTECTI ON 825 'L' STREET, ANCHORAGE, AK. 99501 264-4720 $ltd–'S I TE EF: WEFc' r=`ERr-1 I T PERMIT NO. C 790469 ) APPLICANT JAK CONST/JOHN KINSELLA LOCATION THUNDERBIRD HTS LEGAL L20 B7 THUNDERBIRD HTS CHILKAT CT BOX 2511 ►. v Mmm 7-�9 �v A lrnt -7 9 694 3181 LOT SIZE 21780 SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER. OF BEDROOMS = 3 SOIL RATING {SQ FT/BP,)= 135 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: E►EF-TH= .L FLErJGTH= :E---4 C3FZntif EL- GoEF-TH= E• THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DP•.AINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE 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__* E: iD. 1_I I F:,: EE: s -EF -T I G TF1r-4K 'c I =E= 1L1740 0 CGRLLLf-Ir-d L=. PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY I -JELLS ADJACENT TO THIS PROPERTY AND THE NUMBER. OF RESIDENCES THAT THE WELL WILL SERVE. --- -rWO C - ? I rJ_OE;F'ECT 10 r4 E; F91FR, E F E0 _I I FZEE> --- BACKFILLING OF A14Y SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL; OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F-EFZM I T aXF=> I FZ E�3 E>ar= eaFZ =::L.- 3_SN71 so 1 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 IPJ ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED:---- -------- —-------- APPLICANT J - CONSTrJOHN I:INIELLA / DATE--- ` V3. 2 ISSUED QED BY- --- --------------'c'--- -� --�- A O & E ENG JEERING &-DEVELOP .JIENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694-2774 SOIL LOG 688-2280 Performed for: Name: `T A. Cowsr/ZUCT4o Af Tel. No. 6951-3/8/ Mailing Address: C1111411021 r' eT Box •i G!�6�E oe,✓ER, 4k 99r 77 Legal Description: Lor .2d Be.oc 4c ?, 117-s. S'aa. Depth (feel) Soil Characteristics 0 ML �'/47--7v� Sit. .2 7J- 2 1 2 3 GP Cogtsr Sq,vo y p�r��,Q. ` 4 5 6 7 8 �,eAd.Ec �v/.Sa.yE 9 5 PLOT PLAN 10 _... 70 17E.vI�/ /y9�Y 11 116fos 12 13 7— PERC.TEST 14 15 16 Ground Water Encountered: Yes No L--� If yes, what depth Proposed Installation: Seepage Pit- Drain Field Comments: NNT FILLS OUT UPPER HA'`' ONLY Time i / r rL- 1 ,.• -- Phone4A Time Date Date Date Date Zip Cod:ea , Inspector 4 1✓i2ovCNCE 1 PfIAIEClf Inspector Field Notes: Zip Code cress JUN 2 91983 vurticipality of "Dept. of Health & le ()APPROVED BEOROOMS3 Phone Lending Institution ' �v� P oNn L 31)uk VP IgIAs/.lo Zip Code r Address SoilslRating _ Date Sewer Installed Co. & Agent Realtytiar o'l�.t� �y lNe ... �7�,e,ey uJr�, �� Phone D!/ �P�AL Zip Code �r%�7+9N-9y9y Address Legal Description ��cCk % 1 %i.� nrc�l/! b1,Pd �4y �s Street Location Type of Residence SingleFamily Multiple Family No. of Bedrooms ❑ Other Water Supply ATTACH WELL LOG. A well log Is required for all wells drilled since June 1975. ❑ Individual §Z, Community - For wells drilled prior to that date, give well depth (attach log If available). ❑ Public Utility Sewer Disposal Individual Year Individual Installed: -/: Q 1 JQ ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank" NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: cc JUN 2 91983 vurticipality of "Dept. of Health & le ()APPROVED BEOROOMS3 -CONDITIONS OF APPROV (IVIfCII ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE BY: SoilslRating _ Date Sewer Installed Well To Absorption Area WELogceivedS SeSlze (� D!/ Well to Tank ?2023 (M .. d<>111 . MUNICIPALITY OF ANCHORAGE • -- DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # n!,A - /A\ — Crk HAA # UMQ 11,11 1 1. GENERAL INFORMATION Complete legal description Lot 20; Bloch 7; Thundenbtind Heights Subdiv.ie.ion Location (site address or directions) 24411 Magpie Dnfve Property owner Kevin Cote Day phone Mailing address' 24411 Magpie Dn. Chug.i,ak, AP.a6ka 99567 Lending agency Nati.onae Bank o6 Ataska Day phone Debbie Eh6t4and Mon.tgage Depaktment Mailing address C 4thoot Anehohago Afab a 99503 Agent Don Mc Kenzie DUN bicKENZIE REAL ESTATE Day phone 694-9035 Address P U Bax 772922 Eagte Rivek, Ak. 99577 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 'v 3. TYPE OF WATER SUPPLY: Individual well XX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest - Ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site xx Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. i 72-025 (SOV. 1/91) front MOA 821 5. STATEMENT. OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. I 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 FirmPhone S 8 5 ENGINEERING Address 17034 Eagle River Loop Road No 204 C3nla River, Alaska 99577 �2 Engineer's signature 6. DHHS SIGNATURE Approved for Disapproved. By: Date as '',��'••. J:a r.� t'i t��h toe•• y j • 4 j 'Y .� r.•7 _ i '. p t 1 i.. P E. t t bedrooms. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date////i1A1'/- The Municipality of Anchorage Department of Health and Human Services (DHHS) Issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct Inspections or analyze data before a certificate Is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. /21) Back MOA 121 R MUNICIPALITY OF ANCHORAGE • Department o1 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. # � �g� 9 HAA # 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) -P-0 % %"�riyL�rll�.iLt %lam Location (address or directions) (b) Property owner Mailing Address `S6s �� v Telephone: (home) Business (c) Lending Institution —�—�J i Telephone Mailing Address (d) Real Esta Address Telephone (e) Mail the HAA to the following address: (or check here O, if hold for pick up.) List contact person and day phone number below: 17034 Eagle River Loop.Road No. 204 C y y 79 2. TYPE OF RESIDENCE O Single -Family Number of bedrooms 3 3. WATER SUPPLY Individual Well ❑ Community O Public J 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 O Community O Holding Tank O 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 Telephone e5F"'— 2 97S Addreeo 17034 Eagle River Loop Road No, 204 Date 6. DHHS APPROVAL / Approved for bedrooms by Date 1� �S —b7g 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) sack Page 2 of 2 F P''%IPALITY OF ANCHORAGE (MOA) r. I Health Authority Approval (HAA) �OCHECKLIST - FEBRUARY 1984 343-4744 Legal Description: A. WELL DATA Well Classification If A, B, C, D.E.C. Approvedl(�J J) Well Log Present (Y/N) Date Completed Total Depth Cased to Depth of Grouting Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: Yield Pump Set At Sanitary Seal on Casing (Y/N) — Depression Around Wellhead (Y/N) To Septic/Holding Tank on Lot ?moo ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot 'L+od�� On Adjoining Lots To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by To Nearest Public Sewer Cleanout/Manhole Water Sample Test Results Comments QZ_--% 1S? ?tet 1 S B. SEPTIC/HOLDING TANK DATA ; Date Date Installed Size 17,45�12 No. of Compartments Z Standpipes (IN) —Air -tight Caps (VN) `f Foundation Cleanout (Y,(ffp�— Depression over Tank (YO Pi Dto Last Pumped Pumping/Maintenance Contact on File (Y/N�2. ; for �— r Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: ( To Water -Supply Well Zo o h To Building Foundation To'Property Line t �-t To Disposal Field 8 r To Water Main/Service Line t '� To Stream, Pond, Lake or Major Drainage Course 14' Comments �� ►�lr-t P I 72-028 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Type of System Design Date Installed In— I"i- j9 Length of Field Width of Field • - �✓� Depth of Field ) Gravel Bed Thickness to Square Feet of Absortion Area 4z<;,'m Statndpipes Present GAN) v Depression over Field MUM Date of Last Adequacy Test Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well ��01 i' To Property Line l o -k- To Building Foundation ?moo 4- To Existinfq or Abandoned System on Lot 0 On Adjoining Lots To Water Main/Service Line 1 4- To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course on (-�- To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION 0 4,Date Installed Size in "Pump On" Levela� High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) — "Pump Off" Level at ` Vent(Y/N) Pump)n "Check Permitted Bedroom Rating Against HAA Request" I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in inspection. Signed Company S & 5 ENGINE ERINU 1,fo W Eagle River Loop Road a_qnA Date Eagle River, Alaska 99577 4 fo Apt MOA No. _Rf�yco ? Receipt No. `� 0^7 ` rs9ellla. Date of Payment Amount: Receipt No. Waiver Fee: $ Date of Payment 72-028 (Rev. 7/88) Back Page 2 of 2 Adequacy Test. this Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST �I Legal Description: Uc<Zo t?!K-1 %oa ro ass• Parcel I.D. A. WELL DATA Well type A If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed Driller Total depth Cased to Casing height Sanitary seal (Y/N) Wires properly protected (Y/N) m FROM WELL LOG AT INSPECTION 7z oz Date of test m 2> Static water level n c rn mo Well flow g•P•m. g•P:Z� �n z rn N H4 Pump levet 0 0 0 SEPARATION DISTANCES FROM WELL TO: z "' Septic/holding tank on lot Zoo On adjacent lots 1 {- Absorption field on lot 2 e' o ; On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer service tine Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate Other bacteria Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed `(�' ��-�� ' Tank size 12�� r Compartments Z' Cleanouts ®/N)— Foundation cleanout (YQ Depression (Ya High water alarm (YAM Alarm tested (Y/N) �'- Date of pumping b �3 -�,t•" Pumper S Q- (SSS?oo SEPARATION DISTANCES. FROM SEPTIC/HOLDING TANK TO: Zo o t On ad scent lots 4/4 Foundation �'� t Well(s) on lot j To property line 10 -Absorption field g Water main/service line 10 Surface water/drainage 72.026 (Rev. 7/91) Front I CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level Meets MOA electrical c on lot Manufacturer _ _ Manhole/Access fY ":Pump on" level at 'ANCE FROM LIFT STATION TO: D. ABSORPTION FIELD DATA On adjacent lots "Pump off" level at ` Cycles tested Surface water Date installed 1Soil rating System type �-14L,-F Length*? X75. Width _ 3� Gravel thickness LO1 Total depth 9 I Total absorption,area 420Cleanouts present &N) V J Depression over field (Y0 Date of adequacy test /-7-�I1 Result as ail) PAss i for -_ T�� 3) v bedrooms Peroxide treatment (past 12 months) (Yo /Jo �� F�TJo ay If yes, give date ` /a - SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot s -�r— On adjacent lots At, -Propertyline l o To building foundation -2,z71 To existing or abandoned system on lot la, �k On adjacent lots 2;,oCutbank �� Water main/service line 1014 Surface water 1oc:-> t-�- Driveway, parking/vehicle storage area L%O t Curtain drain E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in aa((Atf to of this Inspection. o ite S & S ENGINEERING _ Signature - 77034 Eagle River r Eagle River, Alaska 99577 Engineer's Name Date \ r 1� — `� ,) r *:4gTw , #e21s k x1 ROF SO�-I HAA Fee $ - AZO Waiver Fee: $ Date of Payment /-y`L Date of Payment Receipt Number N2 5 3 Receipt Number 72-026 (Rev. 3/91) Back MOA 21 WALTER J. HICKEL, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 563-6775 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 FOR: S & S Engineering Ray June 25, 1991 PWSID #211156 My review of the records on file In this office reveals that the Eklutna Thunderbird Heights Subdivision Class A Public Water System, is in compliance with the provisions of 18 AAC 80.060, State of Alaska Drinking Water Regulations. Sincerely, Keven K. Kleweno Lead Engineer YrY pointed on ictyclyd p?•u, to y C. C_ STEVE COWPER, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION 563-6775 ANCHORAGE/WESTERN DISTRICT OFFICE 3601 C STREET, SUITE 1334 ANCHORAGE. ALASKA 99503 DATE: November 9. 1988 PWSID: 211156 To Whom It May Concern: According to the records on file in this office. the THUNDERBIRD HEIGHTS SUBDIVISION Water System is in compliance with the State of Alaska Drinking Water Regulations. Sincerely, zzj '�' d4 E. Craig Vera E 9 Environmental Field Officer VEC:pkk