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Home My WebLink AboutEDEN PARK #3 LT 3Eden Pa k #3 Lot 3 008-042-69 Do Not Approve HAA for this property. Well is <<50' from sewer line Public water is available. 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 008-04~-69" HAA# t~-\'~ '~ (-} ~ GENERAL INFORMATION Complete legal description Lot 3, Eden Park subdivision No. 3 Location (site address or directions) 2811 East 46th Avenue Property owner Mailing address M?nn AC~ Day phone 14524 Riverside Drive Fort Meyers, FL 33905 Lending agency Mailing address Day phone Agent '"-'Jason Wooten @ Prudential Vista Address · Unless otherwise requested, HAA will be held for pickup. One (1) NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well ~ Community well Public water Day phone 273.--7219 NOTE: If community well system, provide written confirmation from State ADEC attest- ing 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 S~rATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I var!fy 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 Ancho?age 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 Anderson Engineering Phone 522-7773 P.O. Box 240773 Anchorage, AK 99524 Address Engineer's signature"'~ * '~~¢'~ ~ ~ Date 4/23/99 DHHS SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments Date 2 '~'7' c79 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 DH HS 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/~1) Back MOA~21 Legal Description: A. WELL DATA Well type Private Log present (Y/N) 107' Total depth Sanitary seal (Y/N) Municipality of Anchorage r~ ~- ~- r- DEPARTMENT OF HEALTH & HUMAN SERVI~E~t~ ~ I V ~ D Environmental Services Division 825 L Street, Room 502 · Anchorage, A}aska 99501 · (90~84~-~7181~9 Municipality ot Anchorage Health Authority Approval Checl41~tL Hea th & -lumen Serv].ces Lot 3, Eden Park No. 3 Parcel I.D.: 008-042-69 If A, B, or C, attach ADEC letter. ADEC water system number N Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform 0 Date of sample: 4/15/99 B. SEPTIC/HOLDING TANK DATA - Date ins{ailed Foundation cleanout (Y/N) Date of Pumping C. ABSORPTION FIELD DATA - Date installed Length Width Effective absorption area Date of adequacy test Date completed 107 ' Cased to Y FROM WELL LOG g.p.m. Prior to 1971 Casing height (above ground) 2 ' Wires properly protected (y/N) Y AT INSPECTION 4/15/99 30' 5.8 g.p,m. ~DT 0 'Nitrate Other bacteria Collected by: Property is on City Sewer Tank size Fluid depth in absorption field before test (in.); Fluid depth (ins) Minutes later: Peroxide treatment (past 12 months) (y/N) 72-026 (Rev. 3/96)* T. Kimbrough Number of Compartments __ Cleanouts (Y/N).__ Depression (Y/N) High water alarm (Y/N) Pumper Property is on City Sewer Soil rating (g.p.d./ft2 or ft2/bdrm) ~ Gravel thickness below pipe Monitoring Tube present (Y/N)__ Results (Pass/Fail) Immediately after Absorption rate = System type Total depth Depression over field (Y/N) __ For gal. water added (in.): g.p.d. bedrooms If yes, give date D. LIFT STATION Date installed Manhole/Access (Y/N). High water.alarm level at* Cycles tested E. SFPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot N/A Absorption field on lot Sewer Placed After Well Public sewer main Sewer/septic service line GT 25 ' Property is on City Sewer Size in gallons "Pump on" level at* *Datum "Pump off" level at* On adjacent lots On adjacent lots GT 100 ' GT 100 ' Public sewer manhole/cleanout Sewer Placed After Well Lift station N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: None on Lot Foundation Property line Absorption field Water main/service line Surface wateddrainage SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Building foundation Property line Surface water Curtain drain Wells on adjacent lots None on Lot Water main/service line Driveway, parking/vehicle storage area Wells on adjacent lots F. ENGINEER'S CERTIFICATION I certify that I have determined 1 in confon~ance with MOA HAA guidelines in effect on this date; Signature "~/~.a~c& ~ ~ Michael E. Anderson, P.E. Engineer's Name Date 4/23/99 HAA Fee $_ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number RECEIVED DATE: April 23, 1999 MEMORANDUM APR. 2. 6 1999 Mu~lioipalJty ot Anci~orag~ Oept. Health & HL~rrmn Services TO: Onsite Services Engineer FROM: Mike Anderson, P.E. SUBJECT: Lot 3, Eden Park Subdivision No. 3 Well Construction Date The well located on Lot 3, Eden Park Subdivision No. 3 is currently closer than 75' from the sewer lateral traversing East 46"' Avenue. It appears, however, the sewer lateral was placed long after the well was in place. As-Builts for the sewerline at AWWU are dated July 6, 1971, indicating the line was placed near that date. There is no documentation concerning the construction or completion date of the well. We do know, however, that the house on the lot was constructed in 1957. It is logical the well was constructed that year to serve the house. Based on this information we conclude the well was placed before the sewerline and did not have to meet minimum separation distance requirements. APR-21'99 15:17 FRO~-CTE ENVIRON~NTAL S$15301 T'I?6 ~.0~/0~ F'~O '~t~. CT&E Env;ronmental Services Inc. CT&E Ref.; Client Name Project Name/// Client Sample ID Matrix Ordered By PwSID ~Ple Remarks: 991597001 Andezson Engineering L3 Eden Park #1 Outside Spigot Driv.king WaTer Client PO~ Printed Date/Time 04/20/99 16:38 Collated Date/Time 0~/15/99 15:30 Received Date/Time 04/16/99 11:15 Technical Director: Stephen C. Ede Released Total CoLiform ResuLts 0.500 u units cot/lOOmL 0.500 mS/L EPA ~OO.O Limits Oate _Date , Ini~t o~/16199 RMV 10 mar 04/16/99 0411bl99 SCE Received Time Ap ,21, 2:ISPM APR-gl'99 15:lT FRO~-CTE ENVIRONMENTAL 55J5301 T'l~6 P.05/05 P-970 zTF. CT&E Environmental Services Inc. haborator~ Division ~Jxxl~f~'~'l~r~'~ar~'w~ 200 W. Po'aer Drive Drinking Water Analysis Report for Total Coliform Bacteria*e,^"e"°rag"'~907~ SEAD INSTRUCTIONS ON ~VE~E SIDE,BEFO~ COLLECTING S~PLE Fax: (907) S6~-sso~ MUST BE COMPLETED BY WATER SUPPLIER TO BE COMPLET~D BY LABO~TORY Cl PbBL[C WAT£RSYSTEM I.D.# __.PRIVATE wATER SYSTEM Month Day Year SAMPLE TYPE. ~ Routine fi, Treated Water [] Repeat Sample (,for routine sample r~ Untreated Wa~er with Jab ref. no.. ) rn Special Purpose Time Coll~ted SAMPLE LOCATION Collected By Analysis SHOWS ibis Waler SAMPLE to Sansf~clory Sample over 30 hourS old, results may be unrehable Sample too long in ~ans~t, ~ample should m mdica~ rehablcresull~. Please send new s~ple via agar,al ~el~e~ mud. Date R~eived Tim, R,ceived Analysis Began Anal~lgal Mclhod: ~ Membrane Piker ~ MMO-MUG · Number of colonieSq 00 mi. ~...& a.t ~ ..... Result" ,~.nalyst Fbk~ Jun Client notified of un,atisfactury results: Phoned ~,poke wah Dare. BACTERIOLOGICAL WATER ANALYSIS RECORD MMO-MUG R~uI*: Total Califort$ E. Coil Membrane Filter; Dlr~c~ Coant Verification; LTB BCB Colonies/tOO mi COLIFIRM. Fecal Coliform Confirmation Final Membrane ~'ilter Rrsah$ Reported By ~.-.----~/"-'~' -"~----~Date Colifermt I O0 mi [] Faxea hr~ I~~ Member of mn SG$ Group (Socmte Gonoralo ao S.rvn~llance) ENVIRONMENTAL ~ e c e i v e d 'r i m er.A p r. ~ 1. i~ 2: 18 PM)A. ,LUNO~S. MA,~N". MICHIGAN. MISSObRI. NEW JERSEY. O~lO. WEST VIRGINIA i 0 0 l-- APPLI HT FILLS OUT UPPER HA' ONLY ~ Phone Mailing Addre~ ;'~- ~ t ~ 'G? Z~ ~..~ ~%-~.~ '/~,, ~ ~ r'~ r.: ,~ ~:~,,; 'C. Zip Code Phone Lending Institution Zip Code Address Phone Realty Co. & Agent ~ ~/. 5~. ~: ~ ~ ,%,..3 Street Locati~ ~. ~,.J, ~ ~ ~.. Type of Residence ~ingle Family ~ Multiple Family No. of Bedrooms ~ Other Water ~upply ,~dividual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ~ Community For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility Sewer Disposal ~ Individual Year individual Installed:_ ,Public When Connected to Public Utility: Utility Holding Tank NOTE: THE iNSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Dat~ Date Inspector Inspector Inspector Inspector ( ii' ) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Well to Tank Septic T~k Size 72 O23 (3182) GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALIlY 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 DATE RECEIVED: INSPECT:_.~/~ ,, TIME: REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES FOR APPROVAL REQUESTED BY: ADDRESS: ~' ; ' / PHONE: PROPERTY OWNER: LEGAL DESCRIPTI6N' TYPE FACILITY TO BE INSPECTED: PHONE: / STREET: NUMBER OF BEDROOMS: WELL DATA: A. TYPE B. DEPTH C. SIZE D. E. CONSTRUCTION ~ ": "~ BACTERIAL ANALYSIS SEWAGE DISPOSAL SYSTEM: A. SEPTIC TANK (IF HOMEMADE, SHOW DIAGRAM ON BACK) 1. SIZE :~ 2. AGE 3. MANUFACTURER 4. INSTALLER APPROVAL REQUEST FOR SEWER & WATER FACILITIES PAGE TWO B. SEEPAGE PIT 1. SIZE 2, LINING C. DISPOSAL FIELD 1. NUMBER OF LINES 2. TOTAL LENGTH REQUIRED MEASUREMENTS A B C D E F G H COMMENTS: WELL TO SEPTIC TANK WELL TO SEEPAGE PIT WELL TO SEWER LINE WELL TO PROPERTY LINE WELL TO OTHER POSSIBLE CONTAMINATION FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEEPAGE PIT TO PROPERTY LINE APPROVED: DISAPPROVED" ' ' DATE: DATE:~__ APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY