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Home My WebLink AboutHUFFMAN #1 BLK 1 LT 3L5 GAAB-HD-I GR~ ~TER ANCHORAGE AREA BOROL H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM 3~? 9'9/7 ADDRESS SEPTIC TANK: D~STANCE FROM WELL LIQUID CAPACITY /~ GALLONS. INSIDE LENGTH 6' '7 ' NUMBER OF / COMPARTMENTS /~/ LIQUID INSIDE WIDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF FITS / OUTSIDE DIAMETER LINING MATERIAL / NEAREST LOT LINE OR WIDTH. /O LENGTH //¢ , DEFTH DISTANCE FROM WELL BUILDING FOUNDATION TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) /¢¢ SQ. FT. TILE DRAIN FIELD: DISTANCE FRO/WELL ~ , NEA~ TOTAL LENGTH , OF LINES. .,,,~. TOTAL EFFECTIVE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF :ILTER MATERIAL BENEATH fILE' IN, ABOVE TILE. WELL: LOT LINE TYPE. DEPTH NEAREST SEWER LINE SEPTIC · TANK DISTANCE FROM · BUILDING FOUNDATION, SEEPAGE · SYSTEM WATER SAMPLE · CESSPOOl. NEAREST OTHER , SOURCES DISTANCES: DATE DIAGRAM OF SYSTEM GAAB-HD-2 GREATER' ~NCHORAGE AREA ! ~ROUGH HEALTH DEPARTMENT . 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT No. /'>~ OTHER APPLICATION TO INSTALL: SEPTIC TANK ., SE~EPAGE PIT ., DRAIN FIELD , 'ro PERCOLATION TEST RESULTS ANTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS , PERMIT TO INSTALL A AS DESCFIIBED BELOW. SIZE OF UNIT TO BE SERVED · SEPTIC TANK SIZE .TYPE SEEPAGE AREA DISTANCES: Health Authority TYPE DIAGRAM OF SYSTEM I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. ..... v BOROUGH, ~ ~[]REATE~ ANCHORi ...... AREA HEALTH DEPARTMENT CASE 327 EAGL~ STREET ,, ~ ANCHORAGE~ ALASKA 99501 ~.hls ~orm .eDorts a g ~ Dep ~. a ~' ~- Soil Chara~-te~'istics Location Sketch Was GPound Wa~e~ Encounte~ed~ ~o ~ What Depth~ _ ~ Reading Date Gross Time Net Time Depth To H20 Net D~op F~oposed nstallat~on: Seepage Pit ~' D~ain Field Test Pemfo~med B3. Development Services Department 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 018-161.04 GENERAL INFORMATION Complete legal description LOt 3 Block 1 Huffman Pr~-~! Location (site address or directions) HAA#. Expiration Date:. ~:~- iL{-' -0 L/_ 13836 Lake Otis Parkway~ Anchora.qe, AK 99516 Current Property owner(s) Mike Anderson Mailing .address Lending agency Mailing address Day phone 345-1488 13836 Lake Otis Parkway~ Anchoraqe, AK 99516 Day phone o Real Estate Agent Nancy Ber.qh-PollocldJack White Day phone 762.5813 ' Mailing Address 3201 C Street, Ste. #200, Anchoraqe, AK 99503-3994 Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: NUMBER OF BEDROOMS: .. 2 TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class. Public Water System Well TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank r--I Community On-site I-"l Public Sewer The Municipality of Anchorage Development Services Depadment (DSD) Issues Certificates' of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 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) on properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to home owners. 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 sample results less than 30 days old. 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. (Rev. t 1/99) 5. 'STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date showr{ below, I verify that my investigation based on procedures outlined in the Health Authority Approval Guidelines for 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone En.q. Svc. Phone 272-8218 Address P.O. Box 102954, Anch, AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious n ineerin anal sis of the s temin accordance with MOA DSD Guidelines & Regulations. The e g g y ys .......... reported results describe the performance of the system ...... under the conditions encountered at the time of the test, and separation distances measured to readily ~dent]fiable features. The operational life of all wellsandse tics tems depend on the loeal soil condition, ground water'levels that may fluctuate ~ p ys · · " re " during the year, and the water usage of the family being served by the system. These cond~tions a ~ ..... outside the control of the evaluator ofthis system. 'All systems eventually fail and satisfactory test results ~ ' do not guarantee future performance of the system, nor do they g~arantee that there are no hidden defects or encroachments. PES can therefore not provide any warranty for future Performance nor give any ~ Ponnone/~, ~ estimate ofhow long the system will continue to meet the operational requirements ofthe ADEC or MOA DSD. The content of this report is for the sole benefit ofthe owner listed above. Any reliance upon r use ofth~s re ort b an other erson or party is not authorized nor will it confer any legal right ~hatsoever P Y y P 6. DSD SIGNATURE ~ Approved for ~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Expiration Date: X ', · ,~,,,-;qv, .-' --. · ~:~--..' , '..~?~_ ,c--~: ',--, ..... ~-- - ~. WATERAND . rn... g '.. PROGRAM ..-'. ~ ~ <'& ". · °' · ~. -~,~, ..... . ,.~.co -, ·v Maintenance Agreements Supplemental Engineer's Report Other , Original Certificate Date: Reissue Date: 6" / '3 oq (Rev. 11/99) ' , Municipality 'of Anchorage r DeveloPment' services Department ~ : Building Safety Division . : On-SiteWater and WaStewater Program, : 4700 South' Bragiaw Street P.O. Box 196650 AnChorage, AK 99519-6650 ~ ~www.ci.anchorage.ak.us . (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. WELL DATA Well type P · ~ Date completed 5/1111970 Total depth 150 ft Lot 3 Block,1 Huffman Subdivision '. i!f A, B,~ or C Provide PWSID # Saniiary seal. .cased to -40+ ft "· FROM WELL LOG '; 5/1111970 . Da{e of test Static water level 105 Well production 2.5 WATER SAMPLE RESULTS: Coliform., 0 colonies/100'ml Date of sample: ~ 5110i2004 B. SEPTIC/HOLDING TANK DATA Tank Type/Material ' Concrete Date installed 7/811970 , .: Tank size Cleanouts _Y. Foundation cleanout Y,..~* Date of pumping $/312004 :' Pumper C,ABSORPTION FIELD DATA. Date installed ,71811970 ,! Length 14 ft Total depth 7.._~3 ft : ~ ft 'g.p.m ~Nitrate co;:lleCted by: 0.123 ~ mg/I Laura Pannone 1000 'gal: · ,; Depression over tank Iq Isaac's Pumpinfl ' Soil rating Width ,,10 ' ft ' '~ .: Effective abs0'rption area ~84 ft2 · Date of adequacy test 5/1012004 Results (Pass/Fail) Fluid depth in absorption field before test 8 in (g.p.d./R2 or.ff2/bd/m) 8..~5 :, Parcel i.D.: 0i8.161-04 Well. Log _Y : Wires properly prOtected _Y Casing height (above ground) . 16: in. · AT INSPECTION 5110/2004 g.p.m. Final fluid dePth 8 in N Other bacteria ,,, 0 colonies/lOO mi Elapsed Time: 1440 min Any mjuvena~tion treatment (past 12 mo.) (WN & type) (Rev. 11/99) ~. Number of Compartments 1 High water alarm N/A i System type Crib Gravel below pipe 3 ft Monitoring tube Y Depression over ~eld N._. Pass: :' For 2 bedrooms Water'added304 gal. -' ' N~w d(~pthl._~9 in. Absorption rate >= 300+ g.p.d. If yes,' give date Eo "P~mp on" levei at/.~P~mp ofr,~ at ! '!.! iq ,, High watel:; alarm le'veJ at :in Datum / Cycles tested: " .' Meets alarm & circuit requirements? SEPARATION DISTANCES SEPARATION DISTA S FROM WELL ON LOT TO: Septic tank/lift station on lot 100+ Absorption field on lot ,.'100+ ' Public sewer main 100+. ~ . On adjacent lots 100+ On adjacent lots 100+ · Public sewer manhole/cleanout 100+ Sewer/septic service line' 25'+ ' Holding tank 100+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK .ON LOT TO: Building foundation 40' '.." Propertyline 15 Absorption field 25' Water main 100+ ... ~: . Water service line 50'+ Drainage 100+ ;. Wells on adjacentlots 100+ Surface water 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Propertyline -1 Building foundation 58 Water main 100+, Fe Water Service line 75'+~ Surface water ' 100+,. .. Driveway. parking/vehicle storage 20+ Cudaindrain None Observed Wells on adjacent lots 100+ ~ . . . ~ ~' ' * _ _/,,.,,-,] ..... COMMENTS -' ! '-J-I~/'Jd.~ ~ ~,,.,, .l')l~l"~) , .... ' ~ ~ ..*.~'c.....'. ..... ; L~e~, ' ' CERTIFICATION' · ' ' ENGINEERS ' .. L '- I certify that I have determined through field inspections and ' review of Municipal records that the above systems are k~ ~""'~~ ........... '" ..... conformance with MOA HAA guidelines in 'effect on this date. , ~.?.-~..~,.~.._ ......... ;r.....~.~ · , Engineer's Printed Name Steven R. Pannone, P.E. . . .. · ~,~ ' . .. Date . [q~/~q- , . HAAFee $ R,eceiP, Number (Rev.' 11/99) _Waiver Fee $ Date of Payment Receipt Number SURVEY CERTIFICATION PLOT PLAN FOUNDATION AS-BUILT FINAL STRUCTURE A~-BUILT LOT SUI~v~y SURVEY. TYPE ; ..... , ........ · . . SYMBOLS · SET rEBAR ~ ~ DR~JNACE ~ ASPHALT -o FOUND REBAr = c o WOOD FENCE ~ CONCRETE __~_~AS~UED ELEV. '-X4¢----~ . ONLY ~O'$E IMP~O~MEN~ ABO~ FROUND ~D ~SIBLE ~LL BE SHQ~... F~CES, ~, S~C ~AN~, SlDEWALKS. DRI~WA~. .'..~.,;~E SHO~ 'IN.~R .APPRO~MA~ LQCA~QN, ONLY. SNOW .. MAY. P~E~T SQME.IMP~O~EN~'~OM B~N¢ SE~ AND LOCATED. A~ pitTANCES ARE RECORD UNLESS O~ERWISE NOTED_ UNDER NO'~R~MSTANC~ ~OU~ ~ 'A~bT BE ~B FOR C~S~ON- OR TOE EST~U~INC BOUND~y OR ~ LINES. ~E SUR~YOR T~ES R~BIM~ [~ ;~E INI~'~SAC~ON ~LY ~D ~M~ ~N~AL MABIM~ ~LY F~ ~E COST OF ~E SURLY. US~ Ol~S 'PR~L O~ SC~N~. ~ R~O~ON MAY CAUSE ~RO~ IN :: ",~-~-~"' : ...... ;i;.'~ ' . Prepared by · :;-?~ ,-,r-..---,,-. ....... Assoc. ~-' ..... '" ~;::.:'.'J '/~:7-~!'P'~fes~l~nal Land Surveyors . M / ~Y' ~ '"l "L'~ .......... 8¢2 ~ 12 a~ ~ '' - ~ : .~ ~.lD~te ~d' Dro~ b . , . .............. ~.~ ..... ~" ': .... J ~ I~,~,~ ~ _. ../.~ ~J .t~Y' 12,2004. · [ 29'33 [~'°'24090 ~¢..~'"' ..... '.. ...... ' ~*'~. 'lm.,~co~-uuo,: . - '"'¢- ' ......... ~,~. ' ~1 ........ :'-," - · · FOUNDA'TIO~ AS-BUILT PLOT PLANS & LOT SUR~YS IT IS ~E RESPONSIBIM~ OF ~E BUlmER OR O~ER, PRIOR'TO CONSTRUC~ON, TO ~Rl~ PROPOS~ BUI~ING ~ADE TO FINISHED GRADE ~D U~U~ CQNNEC~ONS AND ;TO DE, MINE THE EXIS~NCE OF ANY EA~M~ CO~TS OR RES~IC~ONS ~ICH DO NOT APPEAR ON ~E RECORDED SUBDI~SION P~T. GS Ret'.V .'llent Name ~teject Name/# :llent Sample ID fatrix WSID 0 1042405001 Pannone Eng. Sty. Lot 3. Block I. Hufrman S/D Lot 3, Blo:k 1, Hufflnan S/D Drink/ng Wa!er All Dates/Times are Alaska Standard Time Printed DnteFrime 05/13/2004 16:30 Collected Date/time 05/10/2004 12:15 Received Daterrim~,,..- 05/10/2004 13:23 Technical Direeto~,./7 Stephen C. Ede ample Remanks: AlIowablc Prop Amflysis ~,'amcter R:sul~ PQL la'n/~s Method Container ID I,[mlt~ l:~te Date Init l'¢itrzte.N :i. cz:ob:Lology T. abo:,at:o:y Total Coliform 0.123 0.I00 nag% EPA 300.0 B (<-10) 05/10/04 IMP co[/lOOrr, I., SMi8 9222B A (<-I) 05/10/04 DKC REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 ~7~5~1 Date ~c~v~ ..d~/~uary\ ~"'/~ 24, 1977 Time ~,~ion Date of~nspection Cony. l. Approval requested by: Alaska Pacific Bank Mailing Address: Post Office Box 420 Phone: 276-3110 2. Property Owner: Howard & Dorothy Vines Phone: 344-0416 Mailing Address: Star Route A Box 224B 99507 3. Legal Description: Lot 3 Block 1 Huffman Subdivision #1 4. Location: 5. Type of facility to be inspected Single Family No. of bedrooms 2 Well Data: ~ / A. Type Individua B. Dept C. Construction L~ . D. Bacter~ia'~na]ysis Sewage Disposal System: %~ On-sit stem ~ A. Installed B. I~ta]]e< /~ C. Septic Tank: l. Size 2. Ma~u~Fac~urer ~ D. Seepage Pit: l. Absorption Area 2'~ Material 150' E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank , Absorption area , Sewer Lines , Nearest lot line , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line E0-034 (1/74) P~n~ 1 n~ fwn nmn~c "~ MUNICIPALITY OF ANCHORA(~I: ~ MUNICIPALITY OF ANCHORAGE ~ ~ ~c,,t .,.~c u~:~.fT, a. DEPT. OF HEALTH & //~~IRoNMENTAL PROTECrld~UNICIPALITY OF ANCHORAGE ENVIRONMENTAL PROTECTI N Jj ~,~J~'~mll DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION JAN 2 42~1~est Tudor Road, Anchorage, Alaska 99504 276-2221 JAN 2 ! 1977 h r' ~' I-, tl~% REQUEST FOR APPROVAL OF P ~: F ~: I V F D J~ ~J~ l.VJl~[l~J~/~ IDUAL SEWER and WATER FACILITIES ,x ~,,~ ,-,-- ,-- 1. Type of Inspection: CMRO VA FHA CONV ×× 2. Property Owner:. Howard and Dorothy Vines Mailing Address: SRA Box 224B, Anch. 99507 DayPhone: 344-0416 Name of Buyer: n/a refinance Mailing Address: 4. Name of Lending Institution: Mailing Address:. P' 5. Name of Realtor or Agent: Mailing Address: 6. Legal Description: Location: 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: Day Phone: Alaska Pacific BAnk O. Box 420 Phone: 276.3110 none Phone:~ Lot 3, Block 1 Huffman SD #1 Lake Otis Road -Off DeArmoun Rd. and Mew Seward Hwy. near Rabbit Creek Elementary School single family No. Bdrms., 2 Public Utility .Individual one If Individual, number of dwellings presently served If Individual, depth of well 150 ' Sewage Disposal System Type of System: Public Utility If Individual, date of installation, unknown xx 150' Individual (on-site) xx 72-OO3(3/76) If at all possible, could you call me a verbal approval when available? Would appreciate it.~ ~~~/ Pa~e 2 6f ~wo p~ges - Re,. t for Approval of Individual r & Water Facilities Legal Description Lot 3 Block 1 Huffman Subdivision #1 Comments Approved Disapproved Date Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) February 8, 1977 Anchorage, Alaska 99510 Subj~=t~ Lot 3 Block I Hu£~man ~ ~e ~y ~est~ns, pl~se ~at~t, ~i~ office 279-2511, Sang,arian