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Home My WebLink AboutWYNTER PARK #1 BLK 1 LT 4 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEAL'I-14 & ENVIRONMENTAL PROTECTION ENVIRONIVlENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ~x:~/6 ~1: UPG.ADE [Absorption LEGAL DESCRIPTION DISTANCE TO: Manufacturer DISTANCE TO: IF HOMEMADE: I nslde, le_n nth _L Dwelling DISTANCE TO: I of each Foundati~ 'Potallength oflines ~ No, of lines Material beneath tile Top of tile to finish grade Length Width Depth Type of cril Crib diameter Well Trench w~d t I~- -- J inches NO. OF BEDRO~ PERM: ~o.,7 go ~..3 No. of cogipartments PERMIT NO, Liquid capacity in gallons PERMIT NO. ~ ~ Di,t.nee b~t~7~s EERMIT NO. Crib depth effective absorp~n area Depth Driller Distance to lot line DISTANCE TO: Building foundation Sewer llne Septic tank PIPE MATERIALS OTHER SOIL TEST RATING INSTALLE~ ~ REMARKS~/~-~ PPR ' Df 72-013 (Rev, 3~78) DATE LEGAL r["r'I:'li" I::)[:; :i~;IJ) I I Ffl:?,E;OF~'EFI'r I ON fl;"r"Ji;TI. El"l ]:::~: I"ll=l::':Xl:l'"ll..ll"l I'.,IIJI'"IE':EF~.~ IEIF:' I.!:EE)I;i:[)C$1!}i; :: Tl'llii [;i:EX;!LIi[F?.I'i:I::, :E: :[ ;:'i:E OF 'FILE: I:::'E:l:;i:l'l:([ FII::'F'I..IC:I:::INT J'lFl'.b '[FIE t,::E:::};F'l:)i'-rl::!!;:[[-~]:l...]Z'l"r' TCI ]:NF'OI;~:r'I ll.D.;E; I)I-;:F:'F:I~,i:Ti"II'JF:I',!,T I)l.jl(::[['.,!ljZi II'IE ]iN:;i:'FI::IL..I.F'IT]iON ]iNE:I::'ECIICH",IfE: OF:' FII",IY HELLE!: f=ID,]F:ICEI',FF TO THI"=i: F:'I:i:OF'EiF~T'.d FIND I',!I..IPIE:E:EiF?. (ilft= Fi:E::~:]iI)I:~:I",ICE'J;i: rFIF:FT' 'rl.lE HHL.I.. H]IiL. L I!iIF:IC:I':::F:' I I.L 1[1",1[3 OF I:::II",I'T' ::!i;"r'E;'I-E'iH I,I l TI'lOUT F I I',IFIL_ ]: i'.4:i:~F'EC:T ]: O1",1 I::ll'qJ::, F:II':'F'I:;:O',/FII. F::"*' t'I'1:1:'..i; E:,Ii!iF'I::tI:;i:I'I"II!]'iNT I.I:[LL. E:E': :iil. Jl;~I.:t'EZCT TI:Zl F'F;:CIJ];ECLITICII't. Steven A. Johnson P.O. Box 76 Chugiak, AK 99567 Phone: 907-688-3085 SOILS LOG - PERCOLATION TEST ~ SOILS LOG [] PERCOLATION TEST P.RPOR,~.O PO.:__ ~-o ~ G o't-'f i ~s ~',' ~r.'~ LEGAL DESCRIPTION: 1 5 6 7 8 9 10 SLOPE SITE PLAN 11 13 14 15 16 17 18 19 2O WAS GROUND WATER ENCOU.TE.EO~ _ bio ~ IF YES, AT WHAT DEPTH? o Gross Net Depth to Date Time 'rime Water '"-L..,. PERCOLATION RATE (minutes/inch) COMMENT$__~ ~ r- I'). I~ ~,~ l_~ PERFORMED BY: ~4~ ~ ~P ~'""t% 72.00~ (7/76) TEST RUN BETWEEN FT AND ~-- FT MUNICIPALITY OF ANCHORAGE DFPARTMENT 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 DWFLLING Parcel I.D. # _(-'~/-~\ ~ ~-/°~ ~- L~LC~ .,, ,, HAA #.--. ~F~'~ \ ~(~')~-A.(,O 1. GENERAL INFORMATION Complete legal description Lot 4; Block I~ Wynter Park Location (site address or directions) AHFC lt99189 Prope'~ty owner Mailing address Lending agency Mailing address Agent J~.~_.~on,,¢,c,i~__GI?FAT! AN'f) ]?EAI TV Address 11411 Old Glenn Highway, 520 East 34th Avenue, Day phone AnChorage. Alaska 99503 Day phone___ Day phone~_ 694-9125 Eagle River, Alaska 99577 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3, TYPE OF WATER SUPPLY: NOTE: Individual well Community well Public water XX _ If community well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL.: Individual on-site Holding tank Commur~ity on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. X× 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, arid regulations in effect on the date of this inspection. Name of Firm s & ~ ENG!NEER!.HG Phone 17034 Eagle River Leop Read J~O., Address ............ , EngineeCs signature Date "Thc cond~ons of thc H~h A~ho~y Approv~ issued February 13, 1991 hav~ b~n m~. Thos~ por~o~ of th~ s6¢pag~ trench und~ th~ d~v~ay ~.~:.~,~,~ ~v~ b~n r~d." DHHS SIGNATURE ("~'~ Approved for Disapproved, Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: .... Date 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 OHHS 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. 72K)25 (Rev. 1/91) Back MOA ~v21 MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPEC'FION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WA'FER FACILITY FOR SINGLE FAMILY DWELLING ~),~:~ / ~ LI~/-L~-c'~ NAA# 1. GENERAL INFORMATION (Must be completed prior to submittal) Ca) Legal Description (include lot, block, subdivision, section, township, range) Lot 4; Block I; Wynter Park #I Location (address or directions) 24033 Park Circle (b) Property owner AHFC# 99~89 W.A.#13356 Mailing Address 520 EaSt 34th Avenue Telephone: (home) Anchoraqe¢ Alaska 99503 Business Cc) Lending Institution 'Telephone Mailing Address Cd) Real Estate Company and Agent GREATLAND REALTY ATTN.'L&6 Seantlin Address 11411 Old Glenn Highway, Eaql6 River, Ak. 99577 Telephone 694-9125 Ce) Mail the HAA to the following address: (or check here B~if I~old for pick up.) List contact person and clay phone number below: S & S ENGINEERING 17J334.~C. aUh~R~¥er-L-eop R~,~,cJ Nv, 294 Eagle River, Alaska ~577 2. TYPE OF RESIDENCE Single-Family)~( Number of bedrooms 3. WATER SUPPLY Individual Well [] Community []x Public [] NotE:: If community well system, must have written confirmation from the State Department of Environmental Conser(,ation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site E~x- 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. 72-025 (Rev. 7/S8) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of tills 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 wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. '-'ame of Firm Telephone Address Date S & S · '~ ~-,~, '~' Loop Road 170,~4 ~-=u,- ~,,wer No, 204 ~-,..,r,.~ ~!iv,,r. Alaska 99577 6. DHHS APPROVAL Approved for ,~ Terms of Conditional The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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. Page 2 of 2 A. WELL DATA Well Classificatidn Well Log Present (Y/N) Total Depth Cased to Static Water' Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) SFPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot 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 ~"v,~_ \~> "~ MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) ~N~'~i~ o~, ;,,CHi-'.4~K~I. ST - FEBRUARY 1984 343-4744 ~'e t t t~l~[ Legal Description: __~ REEi IV D Date Completed Depth of Grouting If A, B, C, D.E.C. Approved(~) ~ Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On A'djoining Lots To Nearest Public Sewer Cleanout/Manhole ; Date B. SEPTIC/HOLDING_TAN~( DATA Date Installed ~'d-~-¢~/'~ Size Stand pipes ~::YN) ',,J Air-tight Caps (~'N) Depression over Tank (Y~) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) SE:PARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well ~.o,=, To Property Line ~o~ ~' To Water Main/Service Line \ To Stream, Pond, Lake or Major Drainage Course Comments .~,~t-4P~--~ ~ '"'~'_~2_..~ Temporary Holding Tank Permit (Y/N) No. of Compartments ~., Foundation Cleanout I~N) _ Date Last Pumped 'Z..- ; for To Building Foundation To Disposal Field 72-026 (Rev. 7/88) Fronl Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~-'q '~1 ,.~/¢~/?~ Width of Field ~ Square Feet of Absortion Area Depression over Field (Y~ Results of Last Adequacy Test Type of System Design SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line lo,' '~' Length of Field "~"~ Depth of Field ~' Gravel Bed Thick, ness Lc~ Statndpipes Present~;N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutback (if present) IA, To Stream, Pond, Lake, or Major Drainage Course To Driveway, .Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines ~n effec inspection. Signed Company -+~,, ~ .. ::~:?, fDivei' LOOp l,~o~d Date : ~qio ~ivot', Ala~:a 99577 MOA No. O ¢ ¢o ~ Receipt No. Date of Payment Amount: Receipt No, Waiver Fee: $ Date of Payment of this, ~.~ 72-026 (Rev 7/88) Back Page 2 of 2 DEPT. OF ENIVIRONMENTAL CONSERVATION A,~ORA~,~ WESTERN DISTRICT O.~I(.~ 3603. C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 WALTER J. HICKEL, GOVERNOR 563-6775 January 31, 1991 FOR: S & S Engineering Attn: Ray PWSI~ ~!211431 Dawn Water Company. My revieu of the records on file in this office Dawn Wat@r Company Class A Public Water System with the provisions of 18 AAC 80.0§0, State of Water Regulations. reveals that the is in compliance Alaska Drinking Sincerely, !~:arnowsk i Environmental Engineer TK:ect APPLk ,NT FILLS OUT uPPER HA. ONLY Really Co. & Agent Phone Address Zip Code Type of Resi~nce Water Supply ~ Individual A~ACH WELL LOG. A w~l log Is required for all wells drilled since June 1975. ~ Community For wells ddlled prior to lhal date, give well depth (attach log If available). ~ Public Utility Sewer Disposal NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. 'rime Time Time Time Inspector Inspector inspector Inspector Field Notes: ~UNICIPAUTY OF ANCHORAGE ( ) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL* Soils Rating Date ~wer Installed Well TO Absorption Area Well Log Received February 4, 198.3 Alaska U.:;.A. Fe(teral Credit Union 2600 DeBarr Anchorage, AK 99504 Subject: Lot 4 }~lock 1 Wynte~.~ Park ~h]bdivision Approval for the individual sewer and %;attar facJ. litJ. os cannot be granted until tho. following items haw~ been c¢)mpleted: The wat(~r analysis report needs to be submitted to this office from the Chem Lab, 5633 I.~ Street, for our review. The septic tank pumpn, d with a receipt subn]itted to this (lepartment0 'J.'he total number of gallons pun~ped needs to be on the rc~ceipt and verified by a registered engineer as to the actual number of gallons pumped. This J.s to verify the flizo of tile septic tank. A four (4) inch cleanout needs 'to be installed to the sep- tic tank. An adequacy test needs to be performed on the existing leaching area. This test will determine if the system ig adequate according to l~ational Stand{ards. A listing of private firms performing the te,~;t i.(~ enclose~]o This report needs to be ~ubmitted to this off lee for our re. view. Please notify thi.~ Department for a reinspection when the noted di.~Icrepancies have been corro, ctod. If there a):e any further questions, please call this office at 264-4720. Sincerely, Enc ].o~ Ll12C~ Jim .Roberts Associate Environmental ~pecialist P(!bruary 4 ~ BOX CI'NIg 1,d., Al< 99%67 Lot 4 Block... 1 Wyn t CiT. Park ~lubd 'J. v .~"-'o ion Approval for ,.h,. individual ,,.w~r and w~.tcr ¢' ' ] '"' ,,' be granted until the following Jiem.~ have! been completed: water am'll, ysis report needs to ~.e ~ l}).mitted to this o lrice {rom the Chem Dab, 5633 '!'he septic tank pumped with a r,~coJ, pt submitted to this department, The total number of qallom; pu,~ped needs to be on thc* receipt: and verified by a reqistered cmglneer as to thc actual nuraber o~ gallons pul,pod, t,'.'his is to verify the size of the septic tank. o A four (4) Inch chmnout nec_t,, to I)o J.l],.;'kalled uo tho ,~3e}?- tic tank. An adequacy %;est needs to he performed on the oxisl;ing leaching area. This test will determine if the system is adequate accordinq to National Standards. A listinq of 9rivat:e firms performiBg tho test :i.s enclose(1, 'fhis report needs to be submitted to this office for our review, Plea.qc notify this I.)o. partmenk for a reinspoction when 'thc~ noted " f~rkher questions, please ci~ll t:his office al: 264-4720. c'i cely J P, 6 1/p/l'~:[I Jim ASSociate ~nvJronme~ltal Specialist ~ EXCAVATION ROBER ¥ A. SI IAI:Ell WORK CIVIL [iNGINEEI4 February 15, 1983 Tholna s Gui. tierney P.C,. Gox 552A ,~'.hu(] [ a k, A].aska 99567 Dea:ll Fir. Gult'J. orney, i(eference: [,ot 4,: Block 1: Wynterpark Subdivision A sewer sysbem adequacy test was performed on the sysEc, m locahed on the referenced property, as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The absorption trench was tested by a continuous flow of water over a period of 48 hours without any adverse effect on the system. It can be concluded from this test that the waste water disposal system serving the 'three bedroom trailer located on this property is currently functioning adequately. However, the system cannot be guaranteed against subsequent failures. If we may be of contact us. further service, please do not hesitate to cc: ,,unmcipality of Anchorage, Department of Health and ~ vlronmental Protection MUNICIPALIiY OF ANCI!ORAGE SRB 196X EAGLE RIVER, ALASKA