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HomeMy WebLinkAboutSPRING BROOK VISTA #1 BLK 1 LT 9-A1GREA,ER ANCHORAGE AREA BOR .JGH Department of Environmental Quality 3330 C Street Anci]orage, Alaska 99503 NAME INSPECTION REPORT ON-SITE SEWAGE DISPOSAl. SYSTEM LOCATION .,--c~.. (.~L(c.&¢~ '~ ' LEGAL DESCRIPTION SEPTIC TANK: DISTANCE FROM WELL_ INSIDE LENGTH MANUFACTURER r,.~_A..,e_ .,t/~ MATERIAL __ INSIDE WIDTH LIQUID DEPTH NUMBER OF COMPARTMENTS LIQUID CAPACITY /)a"~GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA DEPTH: __NEAREST LOT LINE FOUNDATION J DISTANCE BETWEEN LINES _ TRENCH WIDTH ~_ IN. Yg) 2¢ SQ. FT. LENGTH OF EACH LINE ¢ / DEPTH OF FILTER ~/~ / TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE TOTAL LENGTH /, OF L,NES TOTAL EFFECTIVE __ IN. ABOVE TILE ~ IN. WELL: TYPE __ CONSTRUCTION BUILDING NEAREST FOUNDATION__ LOT LINE ...... CESSPOOL OTHER SOURCES APPROVED DISAPPROVED NEAREST SEWER LINE__ DEPTH SEPTIC SEEPAGE TANK__, SYSTEM REMARKS DISTANCE FROM: DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE: '~ '~:"'~"/~ REMARKS: DATE ~/~/~APPROVED Form LQ-032 'l"hll. i; I..[i::l'.~G'f'H t::, ]: t"ili:t',!:iii; a: ON ]:~:!; THE I..J;ii:N(}i'l"H 4 ;[ i'.,l I-'EE:T ::, 0t::: THE: 'I'I:;::EI',IC:H 01:;~'. I:)F:FI:[ NF:':[ EI....D. 'r'H[}~: DIEF"I"I.t OF' I':l TI:;;'.IENC:I.I OF: I::']:T ]::~; THE D:[!~I'HNC:E ~:E'ri'l,.IE{J-~b.! THE :{:;Lit;~:F.'f:~(Z;tE OF THE I::~l:;~:l:;ll..lP',~j;:, I:::lhlt::' TI"Il:; ~',l:?l"i'l::liq 01:: '11'1[~: "I-HF:I;;:E :['.~; !"40 ~:;ET F!:[[;'TH F'OF:: '!'HI~:: Cq:;;:FI'¢I~:I.... D~:;F'/'I'I ;~::~:; THE: FIH[::' THE: [¢[::)'1 'icir'/ 01;: 'i'1..~1~: IE;qC:FI',,,'FIT GEO, ~CFINi CAL a. F)i~vl:!ii,,. ~M~NT' Box 90, Davis St., [:.agle Rivor, Alaska 99577 094-2774 or 688-2280 Russe# Oyster 694-27?4 Soils ~ Foundations Performed for: Neme: ~,?~:,~Z~/~ C©. Earl Ellis 688-2280 Land Development Grotmd ~,tai:er Encountered: Ye~; ...... N~) ~ If y~S]~ Ubs!i; depth Con~ents' Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 w,.vw.ci.anchorage.ak.us (907) 343-7904 Parcel I.D. 050-091-41 1. GENERAL INFORMATION CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Expiration Date: C.,f2 ';~'/e~' Complete legal description SPRING BROOK V1STA S,/D; LOT 9A, BLOCK 1 Location (site address or directions) 12311 WEST PRINCE OF' PEACE DR. * EAGLE RIVER~ AK 99577 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address JIMMY &: DIANNE HARKINS Day phone Day phone CYNDIE PARTCH w/ JACK WHITE Day phone 4;t0-7775 3201 'C' STREET SUITE 200 * ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OFWATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private er Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Note: Alaska Water and Wastewater Consultants, thc. shall be paid $ at, or prior to dosing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my ~e~l affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I fur~her 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the §me of installation. Name of Firm ALASKA WATER &: WASTE'WATER CONSULTANTS, INC. Address 6901 DEBARR ROAD, S01TE 2B * ANCHORAGE. AK 99504 Phone Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 337-6179 Engineer's Comments: In conduc§ng this evaluation, AWWC, thc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being sen/ed by the system. These conditions are outside the control of the evaluator of the system. Satisfacto~7 test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content cf this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or pariy ia not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE ~ Approved for '~ bedrooms. Disapproved. Conditional approval for Attachments: HAA Checklist Septic System Advisory Well Flow Advisory bedrooms, with the fllowing stipulations: .~L',~.~,\'~.~ · ' ON-ail ['- WATER AND ; .. ..... Manitenance Agreements Supplemental Engineeds Reo~ Other {Rev, 17J01) Original Certificate Date: Municipality of Anchorage Development Sentices Department Building Safety Division OmSlte Water & Wsstewater Program 4700 ~ Bragaw St, P.O. Box 196650 Anchorage, AK 99519-6650 (S0?) a43-?g04 Legal Descflpflon: A. WELL DATA HEALTH .AUTHORITY APPROVAL CHECKLIST SPRING BROOK VISTA $/Di LOT 9A-1~ BLOCK 1 Parcel ID:, 050-091-41 Well ~ ~ Data completed T .Cased to IfA, B, or C provide PWSID# __ Well Log (Y/N) Sanltar/seal (Y/N) __ ~ ~ (Y/N) FROM WELL LOG Date of test Static water level Casing height (above ground) AT INSPECTION g.p.m. ~ g.p.m. Total depth to .ft. Eft. absorption area 408 ft= Monitoring tube YES Date of adequacy test 5/30/2002 Results (Pass/Fall) PASS Fluid depth in absorption field before test 55 ~n. Water edded 554 gal. Elapsed Time: 350 min. Final fluid depth 19 in. Abeorptlon rote >= Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN *DID NOT BACK-UP INTO SEPTIC TANK Depmsston over field NO For 3 bedrooms Now depth *74 in. 450+ g,p.d. If yes, give date - I$E~11C b-~ltJd WAS PRE-SON(ED ON 5/29/2002I WITH 1000 GAt. LONS OF WAle.~ l Soil rating (g.p.dJff~o~ 125 System type TRENCH Width 3 .ft. Gmvst below pipe 6 B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL Tanksize 1000 gal. Number of Compartments 2 Foundation c~eanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping 5/30/2002 Pumper. C, ABSORPTION FIELD DATA Date installed e/1 ;'ts Length. 34 .lt. Date installed 6/1976 Cleanouts (Y/N) YES High water alarm (Y/N) N/A dR'S PUMPING WATER SAMPLE RESULTS: Colifo~. ~ie~100 mi. N~te .._.~mg./L. Other becte ' . · Date of sample: Collected by: D. LIFT sTATIoN Date installed Size in gallons , "Pump on" level at" in. "Pump of~ n. High water alarm level at in. Da.~m Cydes tested Meets alarm & circuit requimmente? E. SEPARATION DISTANCES P U B L I C WATER SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main On adjacent lots Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Prober~ line 5'+ Water main 10'+ Water service line 10'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Absorption field Surface water Pmpen'y line 10'+ Water service line 10'+ 5'4- Curtain drain NONE KNOWN F. COMMENTS G. ENGINEER'S CERTIFICATION Building foundation 10"+ Surface water 100'+ Wells on adjacent lots 200'+ Water main 10'+ Driveway, parking/vehicle storage 10'+ I certify that I have determined through field inspections end ret4ew of Municipal reconts that the above systems ere in conformance with MOA HAA guidelines in effecf on this date. Engineer's Prln}ed N?ne J~'I-'REY A. GARNESS NAA Fee S __~"~'~ Date of Payment ~:~ '- ~-/"{ -- ~) ~-- - R~ipt Number 0 ~ ~,"~ T"~ ~ I (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number 69T£ gO" /.06 T MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROI"ECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL. OF ON-SITE SEWER AND WATER FAC. ILtTY 264-4720 Application Date August 11, GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 9A, block 1 ~p_ringbrook Vista T14N R2W Sec. Location (address or directions) 1986 (b) Applicant Name _. Jin]my HarR:_iJ:t~Telephone: Home _69~4-32B,4 -- Business Applicant Address 12'~11 Prince of Peace ~,a.gle Rive~ A'l~,qka 995~ (c) Applicant is (check one): Lending Institution I-1; Owner/builder []; Buyer []; Other [] (explain); (d) Lending Institution ~C_&~_Z__~ortgage r'O~w~/, Telephone Address 405 W. 36th, Suite 1OO Aneho~age~ A~ 995~L3 (e) Real Estate Company and Agent . N/A Address Telephone (f) Mail the HAA to the following address: Pickup by engineer TYPE OF RESIDENCE Single-Family ~ Multi-Family [] Number of Bedrooms _ ,~ Other WATER SUPPLY individual Well [] Community [] Public [] ~4 ~,~ 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 72-025 {11,84) ENGINEERING FIRM PROVIDING .~SPEC'rlONS, TESTS, FILE SEARCH, DAlh AND INFORMATIOI~I As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of t, his Health Aathority 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. * EAfi[.E I~IVER ENGINEERING SERVICES Name of Firm EA~EE'RiVE~?'7 Telephone Address ~: t3. R~3× 77~2,q4 Date _~'~' / -¢' ~' 694-519~ DHEP APPROVAL Approved for ,/~/~.~'~'~ bedrooms by Approved ~59~.~_ Disapproved Terms of Conditional Approval Conditional 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 DI-IEP 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 72-025 (11/84) Well Glassification ~P~/, / ,' c MUNICIPALITY OF ANCHORAGE (MO,~j HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: Well Log Present (Y/N) 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/Man hole Water Sample Collected by · g~"¢¢( If A, 13, C, D.E.C. Approved (Y/N) Date Completed Yield 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 13. SEPTIC/HOLDING TANK DATA Size /¢*~,~ (~ t Date Installed Standpipes (Y/N) .,t/ Air-tight Caps (Y/N) Depression over Tank (Y/N) / Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ¢'~-¢"¢ / To Property Line ~l'~" To Water Main/Service Line '~ / Course "~/"~ No. of Compartments ~ Foundation Cleanout (Y/N) ~ Date Last Pumped ,Z~3'~ 1'~"4 ~'~ ; for ,'"'",/~ Temporary Holding Tank Permit (Y/N) ~ To 13uilding Foundation ,¢P / To Disposal Field ,5-/~-,~ ~-~.,~.~ To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ?~' ? ~' Width of Field L~ / Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation 42~ · Lot .'~',,~ Z/o~ ¢ Type of System Design Length of Field '~' / Depth of Field /o" Gravel Bed Thickness ~,,' / ~ Standpipes Present (Y/N) Date of Last Adequacy Test To Properly Line ~ 2 ' To Existing or Abandoned System on ; On Adjoining Lots ~'-?~ / To Water Main/Service Line H/~ / To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Cutbank (if present) LIFT STATION ~ Date Installed Size 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 during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all M CA and HAA guidelines in effect on the date of this inspection. Signed ~.. ~~ Date Company ~-'~/'~/'~$ ' MOA No. Receipt No. 4('"~0 / _1~/~_~ Date of Payment ~/,,2..~/ Amount: $ _(~,¢~ Page 2 of 2 72-026 (H/84) October 10, 1983 To Whom it May Concern: I certify that as of today there are 18 homes existing in Spring Brook Vista Subd., Prince of Peace Drive, Eagle River. (There are a total o:f 27 lots in the Su.hd.i. vision. Ten of these lots have not been buiJt on and remain vacant. Tho~;e lots ronlaininl:~ vacant are Lots 2,3,4,5,7,9 !;~ocl: 3, Lot:~ 3,5,6 and 7, B].ock 1.) If 1 can bc' of £urther assistance, pl. ease call ~le :~t: 694-9008. Sincerely~ Beverly g. Johns ] , n :unl.)er Board P.O. P, ox 357 Eagle R.ive'r, Alask~ 99577 OC ~)] roctoT5 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 ection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Date Received _July 16. 1976 1;$0 p.m. 7-19-76 Conv. 1. Approval requested by:~ 'Alaska Bank of Commerce Mailing Address: 2. Property Owner: Mailing Address: 3. Legal Description: Post Office Box 7012 Robert C. Johnson Phone: Phone: Post Office Box 456, Eagle River Lot 9A Block i Springbrook Vista Eagle River 694-2543 4. Location: Se Type of facility to be inspected Single Family Well Data: A. Type C. Construction Sewage DispoSal Syste~} A.' Installed 1976 C. Septic Tank: 1. D. Seepage Pit: E. Disposal Field: Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank Public Utility No. of bedrooms 2 B. Depth D. Bacterial Analysis On-site system B. Installer Size 2. Manufacturer 1. Absorption Area 2. Material Total length of lines , Absorption area , Other contamination , Absorption area .., Sewer Lines C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Re< st for Approval of Individual ,~ ~r & Water Facilities Legal Description Lot 9A Block 1 Springbrook Vista ~1 Comments Approval~Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and .ccurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. Date .... SIGNED EQ-034 (1/74) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTIO~I 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA FHA CONV 2. Property Owner:--~',~--¢--~-'-~-/L~ ~/ Mailing Address:~, ~"% ~ ~/~- ~ uay Phone: Mailing Address: ~ ~X ~ ~/~ ~ . Day Phone:_ 4, Nameof Lending Institution: .~ ~-~ ~ ~. ~2~/~ Mailing Address: Name of Realtor or Agent:_ Mailing Address: ~'r~ '~ Phone:. Phone: Legal Description:. /~'~- Location: No. Bdrms.. ~ Water Supply Type of Supply: Public Utility ~ Individual If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility If Individual, date of installation ,/"¢~-,Y;,~J t/i,~.~_ Individual (on-site). 72-O03(3/76)