HomeMy WebLinkAboutTHUNDERBIRD HEIGHTS BLK 3 LT 12Thund rbird
Height
Block 3
Lot 12
#0§! -721-23
Permit
Applicant:
_MUNICIPALITY OF ANCHORAGE_.. .
Department/-~, Health and Bnvironmenta? ~rotectzon
825 ~ Street, Anchorage, AK. ~9501
264-4720
~'~ * * ' HANDWRITTEN PERMIT ~ ~ #
~ WEI.L AND/O~ ON-SITE SEWER PERMIT
Phone Number:
The Required Size of the Soi~ ~bsorption System. Is: '/ _ !_
LENGTH . GRAVEL DEPTH · WIDTH
Location:
Legal Description: ~/~/~~~~, Lot Size:
Type of Soil Absorption System Is:
Trench: Drainfield: _ Seepage Bed~ __ Holding Tank:
Maximum Number of Bedrooms: _~ Soil Rating(sq.ft/br)
DEPTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in 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(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = '/~' GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
~ ~ ~ TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection .and approval by this departmen
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 fee
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. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. SpecificatiOns and construction diagrams are
available to insure proper installation.
e . . PERMIT EXPIRES DECEMBER 31, 1 9 8 3 ' *
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the M~nicipality of Anchorage.
(2) I wil~/~nstall ~ system ~n accordance with codes..
(3) I uDde~s~nd ~t the on-site ~ewer system may require enlargement if
o ~~/~/~modeled to include more t~ ~edroo~y~
S igned///~ ~/.~f//~ Is sued by: ~_~ ~/~-~
~lican ~ Date: ~--/~---~-~
PERFORMED FOR:
LEGAL DESCRIPTION:
DEPTH
2- O
4
5-
6-
10-
11-
12-
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street. Anchorage, Alaska 99501 264-4720
SOILS LOG -- PERCOLATION TEST
/'/ ,,,..,
13-
17 ~ ~/.~ .......... : ~
20-
r-i PERCOLATION
TEST
~--'7)~ C- DATE PERFORMED: ~?'
SLOPE ~TE PLAN
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Reading Date
GROSS
Time
S
L
O
P
E
Net
Time
Depth to Net
Water Drop
PERCOLATION RATE
{minutes/inch)
TEST RUN BETWEEN FT AND FT
72~08 {6/79}
""MOUNTAIN ENGINEERING
10251 Crestview East · Eagle River. Alaska 99577
Anchorage 907-696-1700
Outside Anchorage 800-478-0101
ADEQUACY TEST RESULTS
July 16, 1990
LEGAL : Thunderbird Heights,
ADDRESS : 104 Goshawk, Eklutna
TYPE : Single Family
WATER SYSTEM : Residential
DATE OF TEST : July 16, 1990
Lot 12, Block 3
SEPTIC SYSTEM TESTING PROCEDURE:
During the saturation on July 15, 1990, 450 gallons of water
were added to the monitoring tube using the community water
system as a source. On July 16, 1990 the system adequacy
test was conducted with 500 gallons of water being added
into the monitoring tube of the absorption field. There was
a rise in the fluid level in the drainfield standpipe of 11
inches. In the period of 20 minutes the fluid level dropped
a total of 6 inches. Water was added at an average rate of
4.5 gallons per minute.
SEPTIC SYSTEM RESULTS:
THIS SYSTEM MEETS OR EXCEEDS Tile REQUIREMENTS OF TIlE
MUNICIPALITY OF ANCHORAGE TO SERVE A 3 BEDROOM RESIDENCE.
This analysis was conducted to quantitatively measure the
performance of the referenced absorption system. While the
system performed more than adequately, prediction of the
overall operational wastewater
absorption field is not Operational life
expectancy is affected by n.~any variable as homeowner
maintenance, soils fluctuation of
groundwater levels.
a
life expectancy of the
,t herein implied. ~per
[ by :;.many variable such
conditions, ~_. _?~% fluc
Address
City
STATEMENT
DEPT. OF £N%'IRONMENTAi~ CONSI~R%'ATiON
ANCHORAGE DISTRICT OFFICE
3601 C STREET, SUITE 322
ANCHORAGE, ALASKA 99503
August 29, 1991
WALTER J. HICKEL, GOVERNOR
563-6775
FOR: Bates Technical Services
Mr. Harry R.J. Bates
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 80.200, State of Alaska Drinking Water Regulations.
Sincerely,
Keven K. Kleweno
Lead Engineer
Property Owner
Mailing Addre~
Buyer
APPLIC' NT FILLS OUT UPPER HAI" ONLY
):yers Construction, Inc.
Zip Code
Address
Lending Institution
Zip Code
Phone
Address
Realty Co. & Agen!
Address
Legat Descript~n
Street Location
Type of Residence
~3 Single Family
El Multiple Family
i-I Other
Water Supply
r-1 Individual
~ Community
[~ Public Utility
Sewer Disposal
~ Individual
r-t Public Utility
C) Holding Tank
Zip Code
RE/;[AX of eagle river, [nc., (Jin ].[ont~uo)
PO Box 8~8, EaKle River. AK zmco~e 99577
Lot 12, Block 3, Thunderbird Heights Subdivision
Goshawk Court
6q4-.4 nn
No. of Bedrooms 3
ATTACH WELL LOG. A well log Is required for ell wells drilled eince June 1975.
For welle d~llled prior to that date. give well depth (attach log If available).
Year Individual Installed: '1 9R3
When Connected to Public Utility:
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time Time Time Time
Inspector Inspector Inspector Inspector
MU~qlC P~4.1TY OF
DEPT. OF HfALTH
ENVlRO;'C'Vt,~NTAL PROT~CI'ION
OCT 1 21 2
RECEIVED
APPROVED BEDROOMS
DISAPPROVED
'CONDITIONS OF APPROVAL
Soils Rating
Well ,o Tank ~ /'~ Septic Ta~lk Size
Parcel I.D. #
1.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Servlces Section
P.O. Box196650 Anc, horage, Alaska 99519-6650
343-4744 · "' ·
C~=RTIFICATE OF HEALTH'AuTHORITY .
APPROVAL FOR A SINGLE FAMILY DWELLING
HAA #
GENERAL INFORMATION
Complete legal description
3
Location (site address or directions)
Property owner z3',,e~'t~' -~'.
Mailing address
Lendi~ agency
Mailing address
Agent
Address ,,'~ ¢,-'~- ~',~'
Day phone
~,~. 7~m.~/~.~ ~.~G/~'~/(. ~?.~<'~V
Day'phone
Day phone~'~~-~'z-~
Unless otherwise requested, HAA will be held for pickuP.' r ~¢A ~-~ cA c/..-
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of s)J~tem
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
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.
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verity 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·
,;
6; ~'> DHHS SIGNATURE
Approved for '~
__ . Disapproved.
__ Conditional approval for
bedrooms.
/]
cs ~'. ~ · ~. ,, ~.'- ~
t~Z ..... ~ ..~.- ~
bedrooms, wi~ the following stipulations:
Additional Comments
Date .
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 order to satisfy certain federal and state requirements. Em ployees 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.
Municipality of Anchorage ~
Department of Health & Human Services :.
HEALTH AUTHORITY APPROVAL CHECKLIST
A. WELL DATA
Well type ~'
Log present (Y/N)
If A, B, or C, attach ADEC letter. ADEC water system number ' 2.//
Date completed · , Driller · '
Total depth
Cased to Casing height
Sanitary seal (Y/N)
Wires properly protected (Y/N)
Date of test
Stati(~ v,;ater level
Well flow
Pump level
FROM WELL LOG
g.p.m.
AT INSPECTION
J~¥NICIPAL~TY OF ANCHOEAGE
F-.N~R~,.,~NMENTAL SERVICES DIVISION
R[P EIVED
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
; On adjacent lots
Absorption field on lot
; On adjacent lots
Public sewer main
Public sewer'service line
Public sewer manhole/cleanout
Petroleum tank
WATER SAMPLE RESULTS:
Coliform
Nitrate
Other bacteria
Date of sample:
Collected by:
B. SEPTIC/H~L;;;;C, TANK DATA
Date installed ,5-'/'~'-~' Tank size
Cleanou~Y/,N.)'~
High ~al~}m (Y/N~
Date pumping
SEPA'R~ION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on.lot
TO property line
Surface water/drainage
Foundation cleanout (Y/N) Y
On adjacent lots
Absorption fiel(~ ' ,.-3-/~
Compartments ~-
Depression (Y/N)
Alarm tested (Y/N)
Foundation
Water main/service line
CONTINUED ON BACK PAGE
C. I. IFT STATION
Date installed
Size in gallons
Vent (WN)
"Pump on" level at
Manufacturer
Manhole/Access (Y/N)
"Pump off" level at
High water alarm level
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Cycles tested
Well on lot
On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date Installed'
Length ~ ~''/ Width
Total absorption area ~'~g' g
Depress!on 'over field (Y/N)
Results (pass/fail)
Peroxide treatment (past 12 months) (Y/N)
Soil rating /~-.5"'~-,~-/~/~ System type
Gravel thickness
Cleanouts present (Y/N)
Date of adequacy test
for
.,4../ If yes, give date
Total depth
bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot
To building foundation
On adjacent lots
Surface water
Curtain drain
Onadjacentlots .~ ..7,~C~ ' Propertyline
To existing or abandoned system on lot
Cutbank .'¢"/~ Watermain/service line
Driveway, parking/vehicle storage area ~
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signature
Engineer's Name
Date
HAA Fee $
Date of Payment
Receipt Number
Waiver Fee: $
Date of Payment
Receipt Number