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MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 995~9-6650
(907) 343-4744
ON-SITE WATER SUPPLY PERMIT
Initial
Date Issued: Nov 18, 1998
Expiration Date: Nov 18, 1999
Permit Number: SW980450
Legal Description: SUNSET HILLS BLK ALT 8
Design Engineer: 0014 Anderson Engineering
Owner Name: Spinell Homes
OwnerAddmss: 9210 Vanguard Drive
Anchorage, AK 99507-
Parcel ID: 018-202-01
Site Address: 014100 SUNVIEW DR
Lot Size: 19700 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
[] Disposal Field [] SepticTank [] Holding Tank [] Privy
[] Private Well [] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
November 16, 1998
Municipality of Anchorage
Department of Heath & Human Services
825 "L" Street
Anchorage, AK 99502-0650
Subject:
Lot 8, Block A, Sunset Hills Subdivision
Well Construction Permit
Dear Onsite Services Engineer:
We hereby apply for a well permit for Lot 8, Block A, Sunset Hills
Subdivision. The location of the proposed well is shown on the attached
Site Plan. Locations of wells in the surrounding area are also shown. The
lot will be served by Municipal sewer from the south of the lot.
No conflicts were noted between the location of the new well and any
septic systems in the area. The lot to the east and to the south are vacant
'and do not impact the location of the well. In addition the placement of
this well will not impact future wells because all undeveloped lots will
probably be served by the community sewer system.
Sincerely,
Michael E. Anderson, P.E.
Attachments
THIS PROJECT
VACANT
VACANT
Well
Well
Well
v ,~CAJT ;
AREA MAP
SCALE 1" = 100'
SITE ~_1.._ N
SCALE 1 = 2uA~
ANDERSON/13OUTET
, .l
9075226779 11/18 '98 15:35 N0.719 02/02
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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. # (]1R-2(12-01
1, GENERAL INFORMATION
Completelegaldescription Lo~- R: '~]ook A: SunSet: H±lls SuSd±v±s±on
Location (site address or directions) Sunv±ew Dr±ye
Property owner
Mailing address
Lending agency
Mailin. g address
Agent.
Address
Spinell Homes
q?lh 1/'.~ n ~c/11 .=l T' r'l
Day phone 344-5678
Anchorage: AK 99507
Day ~hone
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: Four (4)
TYPE OF WATER SUPPLY:
Individual well XXX
Community well
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
Holding tank
Community on-site
Public sewer
NOTE:
XXX
If community wastewater system, provide written confirmation from State ADEC
attesting tO the legality and status of system. :
72~)25(Rev, 1/91) Front MOA~21
o
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.
Name of Firm Anderson Engi n~_~rinq Phone 522-7773
Address P.O. Box 240773 Anchoraqe~ AK 99524
Enginee(ssignature f~-~'~J~" ~--~ ~/'~'~ Date 6/24/99
DHHS SIGNATURE
~ A.p.proved for
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 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.
Municipality of Anchorage R L~ C J~ I V E D ~
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division JUN 2,5 ]999
825 L Street, Room 502 · Anchorage, Alaska 99501 · ~'~ 343-4744
· , ~pal~y ol A~,cno~age
~ept, Health & Human Services
Health Authority Approval Checklist
LegalDescription: T,n~- R: R]n,~ A~
A. WELL DATA
Well type ~__
Log present (Y/N) ¥
Total depth 8.9 '
Sanitary seal (Y/N)
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed
Cased to 8 9 '
Y
FROM WELL LOG
12/8/98
75'
10
12!8!98
Casing height (above ground)
Wires properly protected (Y/N)
AT INSPECTION
g,p.m, g.p.m.
Nitrate 2_54 rng/T, Other bacteria 0
Collected by: MEA
Property Connected to Municipal Sewer
Tank size Number of Compartments __ Cleanouts (Y/N)__
High water alarm (Y/N)
to Municipal Sewer
Depression (Y/N)
Pumper
- Property Connecte~
System type
Total depth
Depression over field (Y/N) __
For
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform
Date of sample: 6/23/99
B. SEPTIC/HOLDING TANK DATA
Date installed
Foundation cleanout (Y/N).
Date of Pumping
C, ABSORPTION FIELD DATA
Date installed
Length Width
Effective absorption area
Date of adequacy test
Soil rating (g,p,d,/ft2 or ft2/bdrm)
Gravel thickness below pipe
Monitoring Tube present (WN)
Results (Pass/Fail)
Immediately after
gal. water added (in.):
cl.p.d.
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)*
Absorption rate =
If yes, give date
bedrooms
LIFT STATION - None on Lot
Date installed
Manhole/Access (Y/N)
Size in gallons
"Pump on" level at*
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
High water alarm level at* *Datum
Cycles tested
E, SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
N/A
N/A
>75'
~25'
Property line
Surface water
Curtain drain
"Pump off" level at*
On adjacent lots > 1 0 0 '
On adjacent lots > 1 0 0 '
Public sewer manhole/cleanout
Lift station N / A
>100'
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: - N/A
Foundation Property line
Water main/service line Surlace water/drainage
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
Building foundation
Driveway, parking/vehicle storage area
F. ENGINEER'S CERTIFICATION
I certify that
in conformance with MOA HAA g~ideljpes in effect on
Signature
Engineer's Name Mi
Date 6/24/99
Absorption field
Wells on adjacent lots
-
Water main/service line
Wefts on adjacent lots
?
this date. ~ ,
es~temsam
HAA Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*
Waiver Fee '$
Date of Payment
Receipt Number
P-~28
SUNSET HILLS SUBDIVISION
LOT 8, BLOCK A
9,720 S.F,
· ~ 1 "--20'
20'
LOT 8
N 56"48'2~."E 145.58'
· ~: ?~..~......::.*..*...
Received Time Jun,23,
._A_S- B U I LT
4726 ~ ~ AYENUE
JUN'24'99 16:52 FROM'CTE ENVIEONMENTAL 561530t T'158 P.O1/02 F'578
CT&E Environmental Services Inc.
Laboratory Division
200 W. Potter Drive
Anci~orage, AK 99518
Tel: (907) 562-2343
Fax: (907) 561-5301
CT&E Ref. ~: 99.2977 Client PO~. n/a
Client Name: A~derson E~lg~neer~r~9 Pr~ntea Date/Time: 06/24/99 18:45
Project Name: nla Colle~ed Date/T~me: 06/23/99 16:30
Client Sample ID: LS BlockA Sunset Receive,~ Da:e/T~me: 06/23/99 16:45
Matnx' Drinking Water Tec~mcal Director: Stephen Eda
PWSID Released
Sample Remarks
Allowable Prep Analysis
Parameter Results PQL Units Methoa Limits Date Date In~t
Total Coliform (MF) 0 col/100 mi SM9222i3 G6/23/99 KAP
Nitrate 2.54 0,5 mg/l. EPA 300 10.0 06/23/99 SCL
Received Time Jun,24, 3:54PM