HomeMy WebLinkAboutTHUNDERBIRD HEIGHTS #3 BLK 4 LT 17
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
LOCATION NO. OF BEDROOMS
DISTANCE TO: ' Dwelli
ul~ ~ Manufactur ~ partmonts
~ ~ DISTANCE TO: Well Dwelling PERMIT NO.
O ~ ~ Manufacturer Material Liquid capacity in gallons
~ = DISTANCE TO: Well ~ Foundation/~ ( , NearestL~]ot line
Trent 'dt
~ O Top of tile ,o finish grade~/ 3 3~' inches inches Total~¢~orption
~ Mated~beneath tile ~ area
Length Width' Depth PER~T NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
~ DISTANCE TO:
~ Class Depth Driller Distance to lot line PERMIT NO.
~ Building foundation Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER
REMARKS ~/~ '
72-013 (F~/~ 3/78)
F'r:~r:ti
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LOT rE; Z 2:E
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..~..__, ]. .............. ..,.[ .... ,E.r .....
BF!CKF!LLiNG OF FINY'
........ F ..... t,~. n.~E~ ..... -'-" ::USO ~FI ;2E~C~ FEET F'F:OM FI PL.!E:L. IC NEL..L DEPENDING
_IF'ON THE ]"¥F'EE
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~.: I !4!L.L. !NS-!'IaLL. THE .:,~=,TE.~, ii'4 RCCOF:DFINCE .~Z'~"H THE CFd)LES.
:~" i UNE:,EZRS'I"RND THFIT THE -'H-'~T-E :SEHE:F:
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MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVl RONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
[] PERCOLATION
TEST
PEREORMEDEOR: ,_ te e ,Fr 5'
OL- OFcj~B~qiC'~ Lc~'~
7
DATE PERFORMED: ~'0I~' 4~'
SLOPE SITE PLAN
WAS GROUND WATER /~) i~
ENCOUNTERED?
O
P
E
R ~ i~' U (~J ~'(~ ~l~c~ IF Y ES, AT WH AT
~]~/~ -- ~-' ; ' DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
15-
16-
17-
18-
19-
20-
COMMENTS
PERFORMED BY:~ ~
PERCOLATION RATE (minutes/inch)
72-008 (6/79)
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
Lot 17; Block 4; Thunderbird Heights Subdlvision~
Location (site address or directions) 24709 Tea]
Property owner
Mailing address
Ellis and Ora-Zella Mercer Day phone_
HC 70 Box 129 Raven View Loop, Chugiak, Alaska
Lending agency
Mailing address_
Day phone
Agent Lynda Banner - RE/MAX OF EAGLE RIVER Day phone
Address.16600 Centerfield Drive, Suite 201, Eaqle River, Alaska
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
NOTE:
694-4200
99577
4 v
Individual well
Community well _ _xxx
Public water
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:
_ ×x×
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~f21
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.
~, ~;, ~:, ~, .iC-i ;..~';';~Id N (~ Phone __~ ¢ ¢"~2~¢
Name of Firm
Address
i Ff~3.~ l?.~gle River Loop Road
Engineer's signature
Date ~_~/¢ /
DHHS SIGNATURE
Approved for ,~'~.r_:.p._('/../'/.
Disapproved·
..... Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
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 th is 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.
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:
A. WELL DATA
Parcel I.D.
Well type A
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
If A, B, or C, attach ADEC letter.
Date completed
Cased to
ADEC water system number
Driller
Casing height
Wires properly protected (Y/N)
FROM WELL LOG
Date oftes~ '
Static water level
Well flow
Pump level
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Public sewer servme line
g.p.m.
AT INSPECTION
; On adjacent lots
g.p.ml, m,
m
; On adjacent lots
Public sewer manhole/cleanobt
Petroleum tank
WATER SAMPLE RESULTS:
Coliform Nitrate
Other bacteria
Date of sample:
Collected by:
B. SEPTIC/HOLDING TANK DATA
Date installed ~ ' ~'
Cleanouts (~N) y
High water alarm (YA~
Date of pumping L
Tank size I '/,.'¢5 C:) Compartments
Foundation cleanout (Y~) /'J Depression (Y~)
Alarm tested (Y/N) '"//~'
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
~" ~J'~' Foundation ~,~ L.,
Well(s) on lot '/.--c~ C;) On adjacent lots
To property line t'7.- Absorption field Water main/service line ~'~C)~
Surface water/drainage ~ c, c~~-
72-076 (Rev. 3/91) Front MOA21 CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Manufacturer
Size in gallons
Vent (Y/N) "Pump on" level at
High water alarm level ~
Meets MOA electrical .c.~;~Ie~/N)
;PII~DISTANCE FROM LIFT STATION TO:
ct On adjacent lots
Manhole/Access (Y/N) ~
~el at
Cycles tested
Surface water
D. ABSORPTION FIELD DATA
Date installed
Length_ '~ Width
Total absorption area '~7'~'
Depression ove~' field (Y~j)
Peroxide treatment (past 12 months) (Y~
Soil rating ¢5' ~'/~.¢...- System type
Gravel thickness ~ ' Total depth
Cleanouts present i:~/N)
Date of adequacy test '7 - Z
for F~--
If yes, give date
bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Wellon lot -~, ¢,c-
To building foundation
On adjacent lots "Z~c' ~'~
Surface water
Curtain drain
On adjacent lots ~J/~' Property line
b," To existing or abandoned system on lot
Cutbank ~'J'/~' Water main/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.
S·' .~" ENGI~JEERING
Signature ~/03,.~ ~gle Ri~,-, L6op ~,~ ~o, ~g4
.,Ea~¢e River, Alaska 9957Z
Engineer'sDate .ame¢~/~/ -
/ /
HAA Fee $ ~.70
Date of Payment
Receipt Number
72-026 (Rev. 3/91) Back MOA 21
Waiver Fee: $
Date of Payment
Receipt Number
MUNICIPALITY OF ANCHORAGE (MO~l
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH 8,
ENVIRONMENTAL PROTECTION
MAR 2 198
LegalDescription: Lot 17, ~oo~r~!VED
Thunderbird Heights #'3'
WELL DATA
~(,Vwell Classification None If ,A,, B, C, D.E.C. Approved (Y/N) . ~ .
ell is Eklutna Utility System. Certizicate of Compliance attacnee.]
Well Log Present (Y/N) Date Completed Yield
Total Depth Cased to
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:.
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
Depth of Grouting
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
; Date
Water Sample Test Results
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed 8/82 Size 1250 gals No. of Compartments 2
Standpipes (Y/N) */es Air-tight Caps (Y/N) ,/es Foundation Cleanout (Y/N) no
Depression over Tank (Y/N) no Date Last Pumped
Pumping/Maintenance Contract on File (Y/N) nde ; for
Holding Tank High-Water Alarm (Y/N) n/a Temporary Holding Tank Permit (Y/N) n/a
Separation Distances from Septic/Holding Tank:
To Water-Supply Well over 200'
To Property Line 12 '
To Building Foundation 13' - 6"
To Disposal Field 6'
To Water Main/Service Line 50' to service line To Stream, Pond, Lake, or Major Drainage
Course No major drainage courses only s£te
Comments Drainage and roadway drainage passed to downstream lot.
Page I of 2 ,~,/?..~//~ ~,
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata 85
Date Installed 8/82
Width of Field 3'
Square Feet of Absorption Area~¢'~ j ~/sf'fV~"
Depression over Field (Y/N) no
Results of Last Adequacy Test Passed,
Separation Distance from Absorption Field:
To Water-Supply Well over 200~
'To Building Foundation 13~ - 6"
Lot none
To Water Main/Service Line 50'
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
Trench
Type of System Design
Length of Field 33'
Depth of Field 42"
Gravel Bed Thickness 6 ~
Standpipes Present (Y/N) yes
Date of Last Adequacy Test 3/16/86
system never filled after 675 gallons
To Property Line 12' to east, 24' to south
To Existing or Abandoned System on
; On Adjoining Lots 50' _+ east, 125' _+ west
To Cutbank (if present) none downstream
No ma.jor drainage. Just site drainage.
5'
No snow removal or parking on top of drainfield was observed.
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
none
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I _h.a,a,a~e checked, verified, or conformed to all MOA and HAA guidelines in
Signed ~//¢0 1~'.'¢-.' 27~' ("~t~.'..'-'O Date
Company MOA No.
Receipt No.
Date of Payment
Amount: $
effect on the date of this inspection.
Engineer's Seal
Page 2 of 2
72-026 (11/84)
Thomas M, Kearns /
No. CE-6289
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE DISTRICT OFFICE '
3601 C STREET, SUITE 322
ANCHORAGE, ALASKA 99503
June 25, 1991
WALTER J. HICKEL, ,GOVERNOR
563-6775
FOR: S & S Engineering
Ray
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
,~ printed on recycled psl}er b y O, ~
MUNICIPALITY OF ANCHORAGE ~
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date_ March 21, 1986
GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 17, Block 4, Thunderbird Heights #3
Location (address or directions)
129 Teal Loop Drive
Applicant Name Ellis Mercer Telephone: Home B[dsiness 265-8869
Applicant Address 129 Teal Loop Drive, Chugiak, Alaska 99567
(b)
(c)
Applicant is (check one): Lending Institution []; Owner/builder []; Buyer ~; Other [] (explain);
(d) Lending Institution Telephone
Address
(e) Real Estate Company end Agent
Address
Telephone
(f)
Mail the HAA to the following address:
TYPE OF RESIDENCE
Single-Family [] Multi-Family []
Number of Bedrooms .,3
Other
WATER SUPPLY
Individual Well [] Community][][ Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite [] Public [] Community [] Holding Tank []
Note: If com munity well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 (11184)
ENGINEERING FIRM PROV [ ~ INSPECTIONS, TESTS FILE SEARCH,!~'= '~A AND INFORMATION
As certified by my seal affixed hereto and as of the validation data shown below, I verify that my investigation of [his Hea!th
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/ar
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 Kramer, Chin & Mayo, Inc. Telephone (907) 563-0666
Address 3701 East Tudor Road~ Suite 205~ Anchorag% Alaska 99507-1217
Date March 17~ 1986
Engineer's Seal
DHEP APPROVAL ~ ~.,..~ ~ .
,~,
Approved for "~'~l~ bedrooms by ~/¢/~'¢'~-"
Approved Disapproved Conditional
Date
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct irrspections 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.
Page 2 of 2
72-025 0
ION /
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA 99501
BILL SHEFFIELD, GOVERNOR
7'elephone: (907)
Address:
274-2533
To Whom it May Concern: ~c~~
According to records on file in this office the ~~m
~]2~' Water System is in compliance with the State Drinking
Water Regulations
Sincerely,
Michael P. Lewis
Environmental Engineer
__ 0~ ~t~~0~-
March 21, 1986
Mr. Ellis Mercer
129 Teal Loop Drive
Chugiak, Alaska 99567
Subject: Septic Tank Field Test
Dear Mr. Mercer:
MUNICIPALITy OF ANCHORA
DEPT. OF H GE
ENViRONxx= ..... EALTH &
,v,~,~. PROTECTION
RECEIVED
This letter is a report of the drain field absorption test conducted at your
property on March 16, 1986. The legal description is:
Lot 17, Block 4
Thunderbird Heights, No. 3
The attached sketch shows the configuration of your system. The drain field
from the standpipe of the septic tank outlet to the standpipei at the
absorption field terminal point measured 33 ft. The standpipe at the end of
the absorption field was ll' ll" from top of pipe to bottom. No groundwater
was encountered in the standpipe. The ~ter source was calibrated by running
a hose ~into a bucket and then weighing on a scale. It provided 7 1/2 gallons
per minute. The hose was then inserted down into the stand pipe and water
surface elevations were made periodically as shown in the table attached.
In summary, the ~ter surface rose to a maximum depth below the ground of lO'
l", however, neve¥ at any time did it rise to the level of the absorption
drain field. After continuing the test for 90 minutes With ~esulting flows of
675 gallons or more~ the test was stopped because the system could not be
filled. At the conclus~ion of the test, a second calibration of the water
source Was conducted and confirmed that the water was still running at 7.5
gallons per minute, ~
Base~ upon the d~ta provided by the as-built records ~f your septic tank
installation' and review of the Health Authority Approyal guidelines dated
February 1984 for the Municipality of Anchorage,- your Septic tank ~d
absorption field are, adequate ~or a three bedroom residence. It should be
noted for the ~ecord the two dimensions were in disagmeement with. the
Publ,ished document, the first being distance of the~"~septic t~nk to the
foundation of the building your closest distance presently measUre~'13' 6".
Upon inquiry of Mr. Steve Morris of the Anchorage HeaYth Authority,. I was
informed that the guidelines were in error and that dimension is lO'.
Secondly, the parking area for your RV was within the lO' limit as identified
on Item 5i. Again, Mr. Steve Morris confirmed on March 19, 1986 tha~ the set
back for vehicle parking was not of concern as long as there was no snow
removal or parking actually over the trench which could result in freezing of
Mr. Ellis Mercer
March 20, 1986
Page Two
the drain field. I have observed for the past'several years how you have used
this area and can personally verify that no such activities have occurred.
Based upon as-built data of your septic tank and field absorption test and the
atached letter of compliance for the Eklutna Thunderbird Heights Water System,
your septic tank, and drain field meet all requirements of the Municipality.
If I can be of further assistance, please don't hesitate %o call.
Si ncerety,
Thomas M. Kearns, P.E.
TMK:dag
Attachment
DRAIN FIELD ABSORPTION TEST RESULTS
TIME DEPTH TO WATER SURFACE
1 minute 10'5"
2.5 minutes 10'5"
4 minutes 10'7"
6 minutes 10'8"
'10 minutes 10'5"
'15 minutes 10'5"
19 minutes 10'3"
25 minutes lO'l"
20 minutes 10'5"
40 mi nutes lO' 5"
50 mi nutes 1 O' 5"
60 mi nutes 1 O' 5"
70 minutes 10'5.5"
80 minutes 10'4.5"
90 minutes 10'5"
Stopped test.
Drain field can not be filled.
FROM TOP OF STAND PIPE
Test date: 3/16/86
Legal description: Lot 17, Block 4, Thunderbird Heights no. 3
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA g9501
BILL SH£FFIELD, GOVERNOR
Telephone: (907)
Address:
274-2533
KRAMEri, CHIN, & MAYO, INC.
ANCHORAGE
To Whom it May Concern:
According to records on file in this office the~-c~ L/7~~
~//--
cm ~f~Water System is in compl lance with the State Drinking
Wa~er Regulations
Sincerely,
Michael P. Lewis
Environmental Engineer
,~,~ O~ .7%0~
APPLI IT FILLS OUT UPPER HA!'-- 'ONLY
Property Owner Phone
~ G.S.K. ConsTruction
Ma~2ng Address SPA Box 6105-A3, Palmer, Ak. 99645 ZipCode 99645 745-2553
Buyer
Ellis W. Mercer & Ora-Zella Mercer
Address 4708 Mills Dr. Anch. Ak. zip Code 99504
Phone
Lending Institution
Alaska Pacific Bank
Address P.O. BOX 420 Anch. Ak. zipcode 99510 276-3110
Phone
Realty Co. & Agent Totem Realty, Inc./William J. Schlegel
Address 734 E. 15th Avenue, Anchorage~ Ak 99501 ZipCode 99501 272-0571
LegalDescriptlon Lot 17, Block 4, Thunder'bird Heights O~l./
Street Locatio~ Raven Loop Rd. ' /. ~/~.
Type of Residence
~ Single Family
[] Multiple Family No. of Bedroon~ ~
Water Supply
[] Individual 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: 1982
~ 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: MUNICIPALITY O~ ANCHORAG~
RECEIVED
( ) CONDITIONAL APPROVAL*
DATE
~ ~D ~ / ~/-' ~ '~'~' Well to Tank Septic Tank Size