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Home My WebLink AboutVANS BLK 3 LT 7ALoC- MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTN AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH ANTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicants Name Telephone - Nome Business Applicants Address_~ (c) Applicant is (check one) Lending Institution Buyer ~; Other~__~ (explain); (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: 2. ~ype of Residence · Single-Family[~ Number of Bedrooms 3. Water Supply~ Individual Well'~ Multi-Family ~ Community ~<~ Public Other (describe) 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 community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] e 5. Engineering Firm Providing Inspections, Tests, File Search, Data and Information As certified by my seal affixed hereto and as of the validation date sho~m below, I verify that my investigation of this Health 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/or w~stewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection° Name of Firm Address ,~ ~_2.0 DHEP Approval Approved for~) bedrooms (ENGINEER SEAL) Approved __ Disapproved -- Conditional X' _ Telephone CAUTION THE Mb~;ICIPALITY OF ANCHORAGE DEPARTME~f OF HEALTH ~ND ENVIRONb~NTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONA~ 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 REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR z~ALYZE DATA BEFORE A CERTIFICATE IS ISSUED° THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK° (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 May 14, 1985 Department of Health and Environmental Protection 825 "L" Street Anchorage, AK 99501 Attn: Susan Oswalt Re: Lot 7A, Block 3, Vans Subdivision ~ter Well Approval Dear Susan, In reference to the water well locate~ on Lot 7A, Block 3, Vans subdivision and our field inspections, analysis and review, and with respect to the Alaska Department of Environmental Conservation criteria (letter attached), we m~ke the following comments and recormmendations: 1. The well casing is presently approximately 2' above the well house floor; ~e flowed the well at approximately 5 gpm for about 450 gallons (150 gal/bdrm x 3 bdrm, report attached). '±~he States' criteria for "peak instantaneous demand" for this particular case (duplex a~d trailer unit on water well) is 8 gpm/unit or 8 gpm x 3 = 24 gpm for 20 minutes: therefore, 24 gpm - 5 gpm (test well flow) = 19 gpm; 19 gpm x 20 minutes = 380 gallons equivalent water on de[~nd. 3. We recommend a 400 gallon surface n~uKt~d tank be installed to nmet th~ States' criteria. Since ~e seller, John Kovacs, bas indicated to us a need to close on this property as soon as possible, we suggest escrowing $1,800 to m~ke the required improvements and issuing a conditional approval at this time. We anticipate ADEC unconditional approval after the improvements are made request the improvements be complete by July 1, 1985. Please call if you have ar~ cerements or questions. Sincerely, Dale R. Merrell, P.E. Rooert Engineer RPW/lbs ENGINEERING, PLANNING, SURVEYING 2220 E, 88th Ave,/Anchorage, Alaska 99507/Telephone 907~349-6451/ 344-1352 "Providing a quality personalized service to those building Alaska's future" DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/~ESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 BILL SHEFFIELD, GOVERNOR 274-2533 May 10, 1985 Mr. Robert P. ~essels Besse, Epps & Potts 2220 E. 88th Avenue Anchorage, Alaska 99507 SUBJECT: Lot 7A, Block 3, Vans Subdivision, Anchorage, AK (8521 -FA-189) Dear Mr. Wessels: The Department has reviewed the subject property and we find the following necessary before approval can be granted: 1. Extend the well casing up to 12" above the well house floor. Add water storage to achieve an instantaneous flow rate of 8 gpm/residence. If all three residences are hooked to the well, this would require a flow rate of 24 gpm for 20 minutes. Please call me for additional information. Sincerely, Steven W. Eng, P.E. District Engineer SNE/msm (907) 349-645z Initial Readin~ om Meter: 78qo Production Rate: ~ ,~. GPM 24-Hour Capacity -- Gallco. s Address Zip Code Address Zip Cede Type of Resi~nce ~ Single Family ~ultiple Family No. of Bedroo~s Water Supply June ~ndividual A~ACH WELL LOG. A w~l log is required for drilled 1975. ~ Community For wells drilled prior to that date, give well depth (attach Icg if available). Public Utirlty ~Publ~c Utility When Connected to Public ~itity: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time ~ ~,~,/ Time Time ~O/ O~---Y Da~,,~ , <~..~ Date Date Insp~tor [nsp~tor Insp~tor Insp~tor Field Notes: ~__ ~~ ~ d~ ~ ~ ) ( ~PPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAP~OVEO ( ) CONDITIONAL APPROVAL' Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received Well to Tank Septic T~k Size 72 023 CHEMICAL & G~LOGICAL LABORATORIES F ALASKA, INC. Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: I.D. NO. Water System Name Mailing Address Phone No. City State Mo. Day Year SAMPLE TYPE: [] Routine [] Check Sample (for routine.sample with lab ref. no. [] Special Purpose [] Treated Water [] Untreated Water Zip Code SAMPLE NO LOCATION Time Collected Collected By TO BE COMPLETED BY LABORATORY Ana vms shows this Water SAMPLE to be: I~]CSptisfactory [] Unsatisfactory [] Samole too long ntranslt; samDleshould no1 be over 48 hours old at examma[~on [o indicate rehable results. Please send new sample, Date Received Time Received Analytical Method: [] Fermentation Tube ~ Membrane Filter Lab Ref. No. Result* Analyst I J I READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06-1220 (~) Rev. 1978 BACTERIOLOGICAL WATER ANALYSIS RECORD Date Collect ecl Source Presumptive .: /Omi 10mi 10mi /0mi /0mi 1,0mi 0.1mi 24 Hours 48 Hours Confirmatory Broth 24 hours= Membrane Filter= Direct Count Veriflcat Ion= LTB BGB. Date A. ~ELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALed AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Legal Description: MUNICIPALITY' OF ANCHORAGE DEPL OF HEALTH & I~NVIRONMENTAL PROTECTION AP 2 6 RECEIVED f A, B, o~ C, D.E.C. Approved(Y/N) Date Completed ~ Yield ~ ~ ~ ~ ~pth of ~outing -- ~ ~t At ~ Sanit~y ~al on Casing (Y~)/ ~ession ~nd ~l~ead (Y~)~ Well Classification Well Log P~esent (Y/N) ~/ Total Depth --- Cased to Static Water Level ~ Casing Height Above Ground ~ / Electrical Wiring in Conduit (Y/N) ~/ Separation Distances Scm Well: To Septic/Holding Tank on Lot /V//% To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line /~O-h ; On Adjoining Lots /~/~¥ ; On Adjoining Lots To ~est ~blic Cle anout/MaDlTole Water Sample Collected By Water Sample Test R~sults C~%~'ents Date Installed Size No. of Compartments Standpipes (Y/N) Air-tight Caps (Y/N) Foundation Cleanout (Y/N) Depression over Tank (Y/N) Da~e Last Pumped Pumping/Maintenance Contract on File (Y/N) ; for Holding TapJ~ High-Water Alarm (Y/N) Temporary Holding. Tank Permit (Y/N) Separation Distances f~cm Septic/Holding Tank: To Water-Supply Well To Building Foundation To P~ogerty Line To Disgosal Field To Water Main/Service Line To Stream, Pond, Lake, c~ Major D~ainage Comn~nts [Page 1 of 2] 2-15-84 Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption A~ea Depression ove~ Field (Y/N) Results of Last Adequacy Test Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes P~esent (Y/N) Date of Last Adequacy Test Separation Distance f~cm Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Ihtoperty Line To Existing or Abandoned System cn ; On Adjoining Lots To Cutbark(if present) To Stream/Pond/Lake/c~ Major D~ainage Course To D~iveway, Pa~king A~ea, o~ Vehicle Sto~age A~ea C~t~t~nts Date Installed SiR in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. M~ets MOA Cc~nts ** Check Permitted Bedroom Rating A~ainst HAA l%~=quest ** I certify that I have checked, verified, c~ confc~red to all MOA HAA Guidelines in effect on the date of this inspection. KB1/d5/s [Page 2 of 2] Date MOA No. 2-15-84