HomeMy WebLinkAboutLot 16
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
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property owner
Mailing address ~/J (-~' /~:~
Lending agency .?:;/;/;[{,.'~,'~'~-~¢.
Mailing address ~i zy, :),( ~'
Agent ,.-¢' g /~ ~nl-~::c:,~f~;_ >/~..:.,... ..... ,; ..... ..~,.;.
Address /i:qG~/7 ~. : ~.~ .,... ~..
Unless otherwise requested, HAA will be held lor pickup.
NUMBER OF BEDROOMS:
- , :'-:'~- Day phone
Day phone
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
lng to the legality and status of system.
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.
72-025 (Rev. 1/91) Front MOA #21
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affi.~ed hereto and as of the validation date shown below, I verify that m.y
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 Firm
Address
Engineer's signature
S & S ENGINEERING
Eagle River, Alaska ~577
Phone
DHHS SIGNATURE
Approved for 2
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with 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. 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. 1/91) Back MOA h~21
RECEIVED
Municipality of Anchorage JUN 2:2 1998
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division NtUNIC.;IPALITY OI~ AN(;HOP, AGE
825 L Street, Room 502 · Anchorage, Alaska 9950~I'V~?~T~-S~/~:'~s [~VlS~O
Health Authority Approval Checklist
LegalDescdption:Lap /(~ ~/~oc~ 5 /-/?,,-sg~ /P"/~4$"~'~arcelI.D.: O0 R- ;Lq ~. '~
A. WELL DATA ·
Well type f)/~ / ~''~ 7' ~
Log present (Y/~ /v 0
Total depth ~ (~
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed
Cased to q o -/-- Casing height (above ground)
Wires properly protected (Y/N)
Sanitary seal ~N) ¥ ~ 5;
FROM WELL LOG AT INSPECTION
Date of test ,~ ?/t, L 1 ~ '~'-f- '(o / ~/
Static water level ] &'" / " tz ]
Well production ~ / '~ g.p.m. ~-
g.p.m.
WATER SAMPLE RESULTS:
Coliform O
Date of sample: (~ / ~ ]
B. SEPTIC/HOLDING TANK DATA
Nitrate
Collected by:
Other bacteria 0
S & S ENGINEERING
17034 Eagle River Loop Road No. 20a
Eagle River, Alaska ~577
Date installed Tank size NumblY/N)__
Foundationclean0u!..(~/N).~,,~ ~' :.. ~. · High water alarm (Y/N)
Date of'Putn i ' ,~ i~', Pumper
C, ABSORPTION FIELD DATA
Date!nstalled -- Soil rating (g.p.d./fF or fF/bdrm) System type
Length .width ~ ____ Gravel thickness below pipe
Effecti~,e absorption area Monitoring Tube pre~~sion over field (Y/N) _
Fluid depth in absorption ~.); Immediately. affe~ gal. water added (in.):_
;~t (past 12 months)(Y/N) If yes, give dar~~~r: ~n ~e =: .g.p.d.
72-026 (Rev. 3/96)*
D. LIFT STATION
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Size in gallons ~
"Pump on" level at~ t~
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot /'/ / 4
Absorption field on tot ~ lA
On adjacent lots
On adjacent lots
Public sewer main ,.¢ 0 '¢" Public sewer manhole/cleanout
/v
Sewer/septic service line /o -/-- Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation Property line Absorption field
Water main/service line Surface water/drainage ~lots __
DISTANCE FROM A~TO:
SEPARATION
Property line ~uilding foundation Water main/service line
ENGINEER'S CERTIFICATION
I certify that I have determined thru field inspections and review of Municipal record~,~,~,_.,¢~,~ s are
in conformance_ / ~ ~/ ,~wit¢ MO~ H~ guidelines in effect on this date.
Signature ~~,~
Engineer's Name ~ ~ &'~)- (' G ~d'J :::
HAAFee $. ~.~(:~)(:~,(~) 0
Date of Payment
Receipt Number
Waiver Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*
CT&E Ref.#
Client Name
Project Name/#
Client Sample ID
Matrix
Ordered 9y
PW$ID
Sample
982797001
$ & S Engineering
Lt 16 Blk 3 Hanson Acres No.1
Lt 16 Blk 3 Hanson Acres No.l
Drinking Water
0
Client FO//
Printed Date/T/mc 06/12/98 t5:53
Collected Date/Time 06/09/98 11:30
Received Date/Time 06/09/98 12:20
Technical Director: Stephen C. Ede
Released By~~q~
Results
P~L
Totat Coliform
gitrate-M
0.100 u
eot/lOOmL
0.100 m~j/L
$H18 922Z~ 06109198 lMg
EPA ~00.0 10 max 06/09/98 06/0919~ 6CP
JUN-18-1998 12:36 CT~E ESI ANCHORAGE 9075615301 P.03×03
'zt
CT&E Environmental Services Inc.
Laboratory Division ~~,,,~',~-,~ar, ar, e,~,;~-.ar~,-f~e-~,,~:ar.~-~-~,jff~jtjffjfjj~j~
Drinking Water Analysis Report for Total Coliform Bacteria 2oo w. Pot:,,,,,~e
Anchorage, AK 99518-1605
REWD hY..TTRUCTIO/~T O;V R£1/'ER.~E SIDE ;~EFORE CO/.,£ECTI?;G,YAMPL£ Tel: {$07) 582-2343
MUST BI[ COMPL~:I'ED BY WATER' SUPPLI~R
PUBLIC WATER SYSTE~I I,D.#
PRIVATff 'WATER. SYSTEM
5.%MPL£ DATE:
SAMPLE TYPE:
~ Routine
C1 Repe~ Sample ([or roadne sample
w}th lab ret. ~o,
O Speciol Purpose
S~MPLE LOCATION
Month ~ Year
Treated Water ....
Untreat~l Water
Time
Collected
Collected
By
~ax: f907) 561-5301
yalysis shows this Wa~er SAMPLE to be:
Saris fac~o~
Unsatis~actoU
S~plc over ~0 hours old, r~sul~ may
b~ unr~liabl~
8ampi* ~oo long [~ ~m~sit; samDle should
no~ b. over 48 hours old a~ examination
m indicate reliable resulu. Pl.~e send
new s~mple via spec~ ~ivcw mail.
AnalyticaiD[~hod: ~ Membrane Fil~er
' Number ofcolonigs/100 mi.
Result·
Commen[$:
~ch 1Fbks Jun ~
..................... Fa~ed
Date: .... Time:
/ C';tltnotifi~dofunsati$faetOevre$u]ls: ~
BACTERIOLOGICAL WATER ANALYSIS RECOR~D
· M.MO-.MUC Result: Total Coliform E. CeE
Membrane Filter: Direct Count ~ Colonicdl00 mi
Verification: LTB ........ BGB ........... COLIFIRM
Fecal Coliform Conllrmat;on
Final ,Membrane Filter Re~ulL~
Coliroem/l O0 mi
Ti~e ~ hrs
TOTIqL P. 133
lle 19, 1998
ROBERT C, COWAN, P.E.
CIVIL ENGIN EEP-.S
(907) 694-2979
FAX (907) 694-1211
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER&WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD OESIGN
SOILTEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ONSITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN
Municipality of Anchorage
Department of Health & Human Sen,ices
P.O. Box 196650
Anchorage, AK 99519-6650
Reference: Lot 16, Block 13, Hanson Acres # 1
RECEIVED
JUN 2 2 1998
k'/unicipality of AnchOrage
Dept, Health & Human Services
This is to request Health Authority Approval for the referenced property and approval for an
exception to the requirement that the well extend one foot above grade. We believe exteuding the
well above grade is an unnecessary and excessive financial hardship which would produce no
environmental benefit or additional protection of the occupants. This well is equipped with a jet
pump in the house and no wiring extends into the well.
As indicated on the attached letter from the owners, the well was drilled in April 1955 to a depth
of approximately ninety six feet, The well met the requirements at that time. Six inch casing was
used and as shown on the attached receipt, a six inch well seal was installed. The well would
have had to be cased in excess of forty feet in order to avoid sloughing. As indicated the desired
water bearing aquifer was found at fifty to sixty feet with a static water level at approximately
fifteen feet below grade. Refer to the attached surrounding well logs for more i~fformation about
the soils at various depths.
Due to tile unusual circumstances, please allow this exception. Connection to public water has
been estimated to be in excess of $40,000. Excavation of the existing well may jeopardize the
house foundation as well as create potential for freeze ups. Attached is the Health Authority
Approval certificate and checklist for your approval.
Pleas contact us if you need any additional infornmtion.
Siucerely,
RCC/SH
Attachments
17034 NORTH EAGLE RIVER LOOP · SUITE 204 ° EAGLE RIVER, ALASKA 99577
06:23PM FROM MAILBOXES ETC. 1109
17034 Eagle River LOOp
Eagle River, Alaska 99577
June 17, lgg8
9060 Los Puentes Rd.
Nevoas%le., Ca 95658-9706
Phone 916-663-4606
Dear
We were Just informed that more information is wanted rex our
Property at ~57 E Dowling Rd in Anchorage Ak mo~e specifically that
you need more information about the well.
The well was drilled on Lt 16 B1K 3 Hanson Acres Subd in 1955
by Curtis "Stub" Chapman who lived on East Potter nea~ where C st
is now. He hit water at a depth of less than 1~ ft. we ~alked
over with Mr Chapman and although ~e were short on money we decided
~o 9~ deeper. He hit very good water with a fair flow a~ 90 to 60,
bu~ a well only about ~0' %o 50' east oD the next lot Just finished
hitting artesian wa~sr which flowed up ~o the roof of their house.
We ~alked i% over with Mr. Chapman (the driller) and it was decided
to go on down to about 100' if neceesar~ as the very good possibility
o£ hitting artesian appealed to us as we were short of money and
artesian would save us from buying a pump ~nd pipe, not to mestion
the savings of electricity to pump it the rest of our lives.
Mr Chapman drilled on down to about 10~' -- 9~' to the beet of
our recollection but no artesimn~the wa%er d~d come up inside %he
casing ~o about 15 to 20 belo~ ground level I believe. We said we
can,t Put any more money gambling on artesian.
He pU~ in 55' of pipe so we would have 40'of water above ~he
bottom of %he plastic pipe. I dug out a 6' by 6' pit around the
steel casin~ and du~ from the casing underground a~d under ~hs
basement wall cement footin~ to run pipe at a right angle from the
well to the pump. The pipe Com~e up through the cement flOOr in ~h~
basement to the pump, pressure tank and water heater a~d f~ruace.
After Mr Chapman connected it all up and had ~he sanitary seal
in place, I covered up %he pit, and filled i5 in later so no one
could fall in i~ if the timbers rotted out. In th~ las~ 43 years
i~ has never run dry or ~ailed a wa~er sampling ~est. Besides there
is no monthly water bill ~o pay -- only the electricity to pump it.
Enclosed is a rec~p~ fo~ the pipe we had p~t in the well in
1955. At this time %he cancelled ohec~ to Chapman Drilling Co or
CUrtis Chapman, s not available. Hopu this reoeip~ for the pipe
Will be suffieien~ proof of the date and depth of the well.
My vi£e June an~ I eon see no logical reason to make any changes.
Digglng down into the ground and removing the sanitary seal
to weld on 8'to lO' of casing to bring it above ground th~n digging
another pit $o get the waterline i~$o the house below the frostline
is not nearly as good as it is now. Why do such a foolish thing
when it is nob necessary and would be very costly and with all the
contractors working bigge~ projects ~t might be weeks or months
before it could be done. This could conceivably cost us the closure
on the sale of this p~operby, not to mention the cost ~o Our buyer
and to others involved in the transfer of this property.
I hope the information in this letter and the rec'eipts for pipe
in 1955 will satisfy any doubts ms to the quality and depth of the
well.
FROM ~AILBOXES ~TC, II09
?O3