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Home My WebLink AboutTHUNDERBIRD HEIGHTS #3A BLK 4 LT 14 MUNICIPALITY OF ANCHORAGE ,, DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAl_ ENGINEERING DIVISION · 825 L Street- Anchorage, Alaska 99501 Telephone 2..64-4720 ON-SITE SEWAGE DISPOSAl_ SYSTEM AND/OR WELL INSPECTION REPORT PHONE [] NEW MAI LING ADD R ESS I ]0 / ~1o~ ~ ~ Manufacturer ~ No, of compartments ~ ~ Liq. capacity in gallons Inside length Width Liquid depth /~ IF HOMEMADE: ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O ~ ~ Manufacturer Material Liquid cspaciw in gallons ~~ ~~~ Foundation Nearest-lot line PERMIT NO. ~ DISTANCE TO: 3~' /,~[ ~'0~' No. of li~es Length of each li~ Total len~ ~nes Trench width Distance between lines ~--~-- Topoft~letofinishgrade ~z~ .~ inches ~ / Material beneath tile ~ / inches Total effective~absorption area Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area m Well Building foundation Nearest lot llne ~ DISTANCE TO: ~ Cla~4~~ ~ Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: ~ Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS ['~ SOl L TEST RATING INSTALLER 3 APPROVED DATE LEGAL 72-013 (Rev. 3/78) NAME MAILING ADDRESS ! / LEGAL DESCRIPTION / Lo.C-/,/ /~ g 7t~.~dr_,.zJci,-z ~ ~'f'~. LOCATION MUNICIPALITY OF ANCHORAGE - , ~ ,, ~ ,,:~ DE.ARTMENT OF .EA'T. ENV, RONMENT^L PROTECt,ON ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ~ ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE ~EW We]] Absorption area Dwelling t Inside length Widt NO, OFBEDROOMS DISTANCE TO: . Liq. capac ty n PERMIT NO. No, of co~.artments Liquid depth IF HOMEMADE: Well PERMIT NO. Manufacturer Liquid capacity in gallons LenDth of each line Top of tile to finish grade ~ ~, Fo nd ion Total length of lines Material beneath tile Width Crib diameter Well DISTANCE TO: Depth Building foundation DISTANCE TO: "~ ~00 OTHER Length Depth Type of crib Crib depth Building foundation PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS / Material Nearestl~ Trench width ~ ,,~ ~/ inches 7 / inches APPROVED ~2-f2~-3~Rev. 3/78) Driller DATE LEGAL PERMIT NO. 8~ozo¢ Distance bet wee~l~j~ Total effect~a~sostion area PERMIT NO, Total effective absorption area Nearest lot llne Septic tank Absorption area(s) Distance to lot line ' PERMIT NO, DEPFIR-FMENT OF HEFIL. TH RND [ENV!RONI"iENT~L. F'RC~TEEi:I"!ON 825 "L'" STREET., i~NCHORFIEiE, ;~:~,4..-.4 }?.E~ FqPPL.. ! E:FI!'q'F LOCFIT I ON LEGBL, STEVEf.,! L. SKRGGE; Lt4 84 THUNDERBIRD HT~ P0 BOX D CHUGIF:iK 'i"'¢PE OF %OiL FIE:LE.,ORPTION %'¢STEM iS: TRENCH NUMBER OF' BEDROOMS = :~: SOIL RFITiNG (SE:! FT:..-'E:R)= 85 THE REQUIRED SIZE OF "['~--IE SOLE.. RBE;ORP'r'IoN S'.r'STEM I:2: 'THE L.[EhIGTH D!i',iENfi;ION IS 'THE L.ENGTFi (IN FEET) OF IFHE TRENCH OR DRRINFIELD. THE DEPTH OF R ]'RENCH OR PIT Z% THE DZE;'TRNCE BE'T[4EEN THE SURFRCE OF THE; GROUND Fff4D THE BOTTOM OF' THE EXE:RVRTZON '::~N FEET). THERE !S NO SET WIDTH FOR TRENCHES. THE GRF~VEL. DEPTH IS THE M!NZ[MLIM DEPTH OF GRRVEL E:EIF['IEEN THE OUTFFILL PIPE RN[) THE BOTTOM OF THE EXCF¢,/F~TZON (iN F'EET). PERM i T Fff:'F'L :1: E:FINT H,F!S THE: RESPONE; i 81 L !'T'¢ TO Z NFORi',i TH I:E-; DEPF:IR-FP'tENT f}UR l FIG ZN%'TF&J_.J::FTZON !N:E;PEgZ:TiONf~:; OF' F-IN"r' !4EL. LE; RD..)'FICENT TO TIqIS F'ROF'ERT'~' FINE) THE NE.JI'I!ErER OF RE.~E;IDE["4CES THFIT THE I.,!ELL I,.[!LL :SER"/E. THE E:F~CKFiLI. LiNG OF' RN"? F_4?'::;TEM I.'.iIT]*'IOUT FIZNRL IN:F;PECTION FiND P,F'F'RO',/FIL B'T' THIS DEPARTMENT !4ILL. BE SUBJECT TO PROSE:CLFFIOI",E l',!i'NIHUM DISTF!NCE BE:T!,.E.EE]'.~ Fl HELL RN[;, RN'¥' ON-SITE E;EI4FIGE I}ISF'OE;FIL '_:!;'¢S,-FEN IS :[.E~) FEET FOR R PRI',,,'FITE .tIEL. L OR :!.SE~ "FO ;;2e~',.'~l FEET FROM F! PUBL. IC HELL DEF'END!NCJ UPON THE T'?'PE OF PUE~L.!C !4EEL. ['!IP'4I[I!U[q Di::STFI["i!C:E FROM R PF-'.I',,"RTE HELL 'FO R F'RI',,,'F!TE E;EE.IER L. INE iE; ;25 FEET FINE.'-' TO R COMMUN;fT'¢ SENE:R L]:F,IE !S I;:'5 FEET. OTHER RE(Z.!:EREMENT':2' MFI'¢ RPF'L'?. E;PECIFZCRT:EON5 FIND E:ONSTRE.!CT.f'ON E:'ZRGI:RFhN"5 RRE RVFtILRB!...E TO INSURE PROPER IN::7.'TFILLRTION. I CERTIF? 'T'HRT ±: I FIM FFIMILZRR P.!ITH THE RE(;!U!REMENTfE; FOR OI'.,!-.'E;ZTE :?_';EWERS F4iq[:, I.,.[ELLS fl..E; SET FCIRTH E?¢ THE ["ILINZC:fPFiL!T'T' OF F.!NC:HOF.:RGE. 2:: I i,.iZLL. ~;"¢~;TFIL.L THE 'S"r':E;TEM IN P]CC:ORE:,RNCE t,.!ITH 'FF!E CO[:,E~. ]:: I U,k!ii~EEF,~%Tt~f.:!E:, TH¢~' "FHE ON-L;.:ITE: :i~;,EEZ[,~E:~'. S'T':E;TEM i'"]f:!'T' RE~;¢.J!RE E?.:ILFiR!3E!I'IEi'J,T l? THE{ [E'EF-';IlE:,F'F]['.E~IS/F,?F!"IF'"i.~:]~ Et", ] ..... IN-:I IE:4::: i',liCIE:E THFI~'~ :~-: BEE:,ROE]?']S. Russell Oyster 694-2774 O :& E ENG.NEERING & DEVELO ENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 SOIL LOG Earl Ellis 688-2280 Name: Performed for: Mailing Address: /~, Legal Description: Lc'/~ /'/~'/ ~£~i<: Depth (feet) Soil Characteristics 0 1__ 2 3__ 5__ 6__ 8__ 9__ 10__ r n PLOT PLAN 12__ 13__ 14__ 15 16__ PERC. TEST Ground Water Encountered: Yes Proposed Installation: Seepage Pit__ Comments: No v~ If yes, what depth Drain Field Performed by: Date: .2.,/ 7/~ ~- 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # ~--~\ ---~ .~\- ;a3~ 1, GENERAL INFORMATION Complete legal description Lot 14; Block 4; Thunderbird H~ights Location (site address or directions) 24743 Teal Loop Chugiak, AK Property owner Mailing address Lending agency Mailing address Agent Address Cathy Alcorn 24743 T~al Loop Chugiak, Day phone 688-6174 AK 99567 Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual well Community well XXX Public water 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 Y, XX 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. 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. $ & S ENGINEERING Name of Firm 'JTO3~e~c. Address Eagle River, Alaska 99577 Engineer's signature Phone ~ c4U-~'cl'7~ Date_. ~//)- ¥ /R/~ DHHS SIGNATURE Approved for 4 Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: ~ ~',';. ~-~. 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. Legal Description: A. WELL DATA Municipality of Anchorage ~ ~ DEPARTMENT OF HEALTH & HUMAN SERVICES%'~'¥%~^ Q Environmental Services Division ~'.~. 825"L" street, Room 502 · Anchorage, Alaska 99501. (907) 343-4744 Health Authority Approval Checklist Lon- Iq ? ~e..~; q 1 ~otlo~e.&~mo Parcel I.D.: ~ Well type If A. B, or C, attach ADEC letter. ADEC water system number Log preseut (Y/N) Total depth Sanitary seal (Y/N) Date cotnpleted Cased to FROM WELL LOG Date of test Static water level ~ Well production ~ g.p,m, WATER SAMP~ Coliform ~ Nitrate ate~of sample: Collected by: Casing height (ab~ AT INSPECTION g.p.m. Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed '7- I~- ~7_. Tank size Foundation.cleanout (YI~ Date of Pumping '2 o ZE,-- C. ABsoRPTIoN FIELD DATA Date installed '7 - 15- 0 Length ~'-/~ Width Effective absorption area Date of adequacy test 12 50 Number of Compartments '2 Cleanouts (~q) Depression (Y~ Iq High water alarm (Y/N) 14 Pumper Y Soil rating (g.p.d./ft2 or ft2podrm) ~51dA~, System type ~ ~ Gravel thickness below pipe Monitoring Tube present{~YI'4) x{ Results (Pass/Fail) 10~55. Total depth I Ot Depression over field (Y~ bi For /4 bedrooms %% Fluid depth in absorption field before test (iu.); O ~' hmnediately after qq o gal. water added (iu.): Fluid depth ~ J.~' (ins.) Minutes later: lO Absorption rate = '~;: ' .p,d. eeroxidetreatmeut (past 12 months) (Y~}) v[o~¢--- ¢-~o~ Ifyes, givedate t2~lA. LIFT STATION Date iustalled Size iu gallo~l~ Manhole/Access (YfN) ~~el at* "Pmnp ofF' level at* High water ahmn lc.v,.eka+*'~ *Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: [Sepl~k)holdmg tank oil lot 2Oc)~ + : On adjacent lots Absorption field oil lot V,o~o ~ . Public sewer main / Public sewer manholc/cleanout / ~)tic service line Lift station SEPARATION DISTANCES FROM SE~-'~C~HOLDING TANK ON LOT TO: Building foundation lo t +.~ Property lille /o t 4- Absorption field Water maitffsel;,ice line 10 t./_ Surface water/drainage ]oo~d- . Wells on adjacent lots ]o 14' '2.00 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation ~O' Water main/service line Surface water Curtain drain Driveway. parking/vehicle storage area ~5 Wells on adjacent lots 7)..oo~ 4- Property line F. ENGINEER'S CERTIFICATION I certi[j; that I have determined thrufield itw)ections and review of Municipal records in con/brnlance n ith ~[0~ ~[~1 ~uidelines i~ffect on this date ~.~ ' HAA Fee $~ ~ ' ~ Waiver Fee $ Da te of Paylnm,t_ ~ff~Z~ Date of Pay nleut Receipt Number_ /~0~ _ . Receipt Number Rev. 8/95 OSS: haa.wk.doc MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t. block, subdivision, section, township, range) Lot 14; Block 4; Thunderbird Hei.qhts #3A CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SiTE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Location (address or directions) 24743 Tzal Loop Property owner K6n ~ Ros& Jon~ Mailing Address HO 79 (b) Telepnone: (home) 688-3159 Business Box 121 Teal Loop. Chuglak. Alaska 99567 (c) Lending institution Telephone Mailing Address (d) Real Estate Com 2any and Agent RE/MAX nf Eag£¢. RiuCJ~ ATTN: V,frgdnda Knhf~'¢J~d (e) Address 1~00 Ce,te~de~d D~dut Ru2te 201 Eag£e Rdu¢% Ab.99577 Telephone 694-4200 Mail the HAA to the following address: (o ' check here [~j(if hold for oick up.) List contact person and day phone number below: S & $ ENGINEERING Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single-Family,~ Number of bedrooms 4 3. WATER SUPPLY '~' Individual Well [] Community Ek Public [] Note: If community well sysmm, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site ~ PuNic [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 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WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) Health A~uti]~r~Y Approval (HAA) cIPALI j tJ N 2 ? 1990 RE/ £1VED Well Classification Well Log Present (Y/N) Date Completed Totar Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/l~'c~qm,g, Tank on Lot ~ "Jr-- To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments Depth of Grouting Legal Description: ~-~ [J~c' "~,/ ~"' If A~ B, C, D.E.C. Approved(l~N) --~-- Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole ; Date B. SEPTIC~ TANK DATA Date Installedq~' I~'- ~ ~--Size Standpipes~/N) '-/ Air-tight Caps ~N) Depression Over Tank (Y/~[~) Pumping/Maintenance Contact on File (Y/N)/~,,~ Holding Tank High-Water Alarm (y/N) ~A"- SEPARATION DISTANCES FROM SEPTIC/HOE'DINC=~TANK: To Water-Supply Well To Property Line To Water Main/Service Line No, of Compartments y Foundation Cleanout ("~Y_~ r../ Date Last Pumped ~/,~ ; for Temporary Holding Tank Permit (Y/N) /~/~ To Building Foundation To Disposal Field /o r./. To Stream, Pond, Lake or Major Drainage Course Comments ! 72-026 (Rev. 7/88)Fror~t ' Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata ~;;~.- .~4.//~¢.._ Date Installed '7-~ I ~'--- ~"~--- Width of Field Square Feet of Absortion Area Depression over Field (Y/~ Results of Last Adequacy Test Type of System Design Length of Field ¢-'7 I Depth of Field /o ~ Cravel Bed Thickness '¢ /"~'~ ~ Statndpipes Present ClaN) Date of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well TOLotBUilding Foundatiop~//~ To Water Main/Service Line '¢--'¢f'2/'~ To Property Line / -~:)r To Existing or Abandoned System on ; On Adjoining Lots ~2° ,// To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT S't"A~ Date Installed ~ Dimensions ,,S, ize in ~al, l,o, ns'. % Manhole/Access(Y/N) Pump On' Level at ~_ "Pump Off" Level at High Water Alarm Level at ~ Vent (Y/N) _ Tested for ~ Pumping Cycles during Adequacy Test. ~l:emtSmeMnOtsA Electrical Codes (Y/N) **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect onthe date of-'~l~is inspection, Signed S & $ E. NGINEERING 17034 Eagle Rlvm' Loop Roa~t No. 204 Company ~,~I~ ,~l;'c r, ~ = -'.k."- Date MOA No. ,/'~ ~,,,~~/ "~/-- '~0' ~.~ Receipt No Date of Payment Amount: $ 72-026 (Rev. 7/88) Back Receipt Waiver Fee: $ Date of Payment Page 2 of 2 ANCHORAGE, ALASKA 99503 STEVE COWPER, GOVERNOR 563-6775 DATE: June 26, 1990 PWSID: 211156 To Whom It May Concern: According to the records on file in this office, the EKLUTNA THUNDERBIRD HEIGHTS S/D water system is in compliance with the State of Alaska Drinking Water Regulations. Sincerely, VERA E. CRAIG Environmental Field Officer Address ~~ ~/~ Zip Code Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: ( ~PPROVED BEDROOMS ~I~ *CONDITIONS OF APPROVAL ( ) DISAPPROVED 7(~;~' '~ Well to Tank '-' Septic Tank Size ' !:1';: .[:', EASEMENTS OF RECORD, OTHER THAN - THOSE SHOWN OM THE RECORDED PLAT, ARE NOT SHOWN HEREON. i-, "LOT ~URVEY aE~TIFIOATION, LOT ~¢ BLOOK THUNDERBIRD HE~RHTS ~DDN. No. 3R ANCHORAGE HJ~OO~DIN~ DISTRiOT · .-~ .. ANCHORAGE, ALASKA BBSOI L£GEN. D: ~~giSlONS JResidence of: ne - Time Date Date Date Inspector Inspector Inspector ~)rn~ments ~,4~,~'~-~'~'~- ~ --.. -~ · Date Sewer Installed Permit No. Septic Tank Size ~. ~ ~ Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY . Property Owner Phone Mailing Address ~oz 2524, ~alae~, A[ 99645 2~5-2731 Buyer Aoge~ G. & Cynthia ~. ~evesque Address [665 W~cge~sh~m, Aac~o~a~e, A[ Phone Lending Institution A[asAa ~uEua[ Address ~503 W. 3[s~ A~e~ue~ A~cho~ege~ A[ 99503 274-255[ Realty Co. & Agent ~o~ea [ea[~ [~c./W~[[~am ~. Schlage[ Phone Address 724 S. 15th A?eaue~ Aac~o~age~ A[ 9950[ 272e057~ Legal Description Street Location ~ea[ ~oo~ Aoad Type of Residence ~ Single Family ~ Multiple Family No. of Bedrooms ~ Other Water Supply ~ Individual A~ACH WELL LOG. A well log is required for all wells drilled since June ~ Community 1975. For wells drilled prior to that date, give well depth (attach ~og if ~ Public Utility available.) Sewage Disposal .. ~ Individual Year Individual Installed: · ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.