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Home My WebLink AboutBROADWATER HEIGHTS BLK 2 LT 5Broaclwater H ights Block 2 Lot 5 #050-081 -32 0 0 0 0 0 0 0 0 0 0 0 1-1 F07 ^ , DEPHRTME �.-& HEALTH AND ENYIRO` 1EN-HP.{OTECT �g- 825 'L' STREET, ANCHORAGE, HK 99501 " 264-4720 9-9 E -E L -L_ EF'RE IC PERMIT NO. ( 811169 - w:` HPPI ICHNT ROGER NETTLOW SR2-72~ [/ D 69-- 4 ��006��' LOCATION 229 SKYLINE DR � LEGAL L2\85 BROADWATER HTS / / LOT SIZE 43500 SQUARE FEET 100 FEET FOR A EET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF RPBLIC WELL. --,TAt,!CE FROM A PRIVATE /!WE- L TO ARIVATP WELL OR TO A COMMUNITY SEWER LINE IS 75 FE T. WELL LOGS ARE REQUIREB AND MI -IST RETURNED TO THE DEPARTMENT WITHIM 39 DAYS OF THE WELL COMPLETION OTHER REQUIREMENTS MAY SIPECIF*�ATIONS AND CONSTRUCTJ -IGRRM% FRE AVAILABLE TO !NSURE PROPER ALLAT :4. Fo' E07 I CERTIFY THAT 1 m` rm,ILInn WITH / D WELLS AS SET FORTH BY 2: I WILL INSSYQTEM IN RE tRDANC WITH TIF X)ES. SIGNED:___ _---- ---_ APP C RO R W GRE/ .R .ANCHORAGE AREA BOR 3H Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM tic TANK: ,DISTANCE FROM WELL INSIDE LENGTH COMPARTMENTS INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY/'~O(~GALLONS. TILE DRAIN FIELD: DISTANCE' fROM WELl FOUNDATION TOTAL LENGTH NEAREST LOT LINE OF LINES NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH IN. TOTAL EFFECTIVE ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE IN. TYPE _ BUILDING FOUNDATION CESSPOOL 'APPROVED ,.CONSTRUCTION NEAREST NEAREST SEPTIC LOT LINE__, SEWER LINE__, TANK__ OTHER SOURCES DEPTH DISAPPROVED REMARKS SEEPAGE , SYSTEM DISTANCE FROM: DISTANCES: INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL' LOT SLOPE: REMARKS: Form EQ-032 DIAGRAM OF SYSTEM DCFTH =- // L ~,/vC~ T l'-I - / G.A.A.B. WATE~ WELL LOG FOSS DRILLING 1336 Ingra Street Anchorage, Alaska 99501 ~orrt-q use o~ WELL~ ~Z)~'~a~ SIZE OF CA~ING ~' DEPTH OF HOLE/~) STATIC WATER LEVEL ~ ~ PT. YIELD~§7~) GAL.PER.:~: WITH PEET OP DRAWDOWN. REMARKS ~PUMP TO BE SET AT, 0 ,tO to..... tO_.._ , .to to tO__ to , to .__.tO ~'-'l~lUi'-,q ): C: %. F"FIE .... 3[. 'T"-r" i::lF' i:~I"qIC-:HI:.~IF~-.'.AC.~E DEPFIRI"r'IEI',H" OF' HEFILTH PII'41) EI'4V:[R. OI"d"IENTRL~ PR. OTECI":[OI'-~ ]%.::3:0 C ST~'.EET., RNC'HORRGE, RI...R~;KR '.~:~5~]!: R7"4-456~.. PERM]iT NO. E,' ]] L. L PlO R R I S LOC:RT':[ ON L. EGRL N...II 1E, I:::.R OF E,E[.. RO.,.ll 1=, := ) :,1.200 W D]:MOND BI_VD SK'¢I,., I NE F..', F;:'. I..5 B2 E:FROFIL":,NRTER FIT."5 :1,E:50:;~: '.:,-'; 6!F T T'T'PE OF SO I.L. FIBSORPT :[ ON :5'CE;TEl',1... :E;OIL. RRT:[NG., S~2FT' :1.5E~ TRErNCH 'THE!: F.':IE~:.:.!IJ :[, REE:' F; ]: ;;if'.E OF 'THE St',) ]:1 .... REI~ORPT I ON t~'¢STEM .'[ S :,DEPT, H= .5 I_ENGTH=~ 45 'T'HI~RE .T.::-.'; NO '..:.'!;ET N]:I:;,TH FOR ~rF.'~NCFIE:.::;. FOR r':,RR:[NF:[EL.D~-;., THE H]:DTH ]:::5 _~ FT. THE DEPTH ]:'.F.; ']"HE E:,EP'TH OF' TRENCH OR P.T.T BETNF..EN 'THE OUTFFIEI... P:CPE FIND THE BO"I"TOM OF 'T'HE E;:,O:.':RVF:IT ]: (::iN. THE I...ENGTH D:[HF'.'i:NSION :IS THE L. ENGTH OF ERCH SIDE FOR R ~EEPRGE PIT OF,' THE I...ENGTH OF:: ]"HE".' TRENCH, OR [.'.',RR ]: NF :[ ELD. PI :[ N ]; HLIM D.f.S'TANC,'E: FROH NELL TO RN'¢ SE:P'f'~C TANK,.."PRCKRGE PLFINT OR SO]:L ABSORP'T'I.C~N S'¢:STEP1 .f.~; :1. OO FT FOR FI PR:f. VFITE NELl .... FIND 200 FT FOR RPUBI_:[C NEL. L.. NELL. LOG'.:::'; f,ll...l:~;"t" BE RETI...IRNtE[.':, TO THE DEPARTHENT 1.4ZTH:[N '.'!¢0 DR'CS OF THE NELl .... COHPL. ET T ON. SF,~EC,T.F.T, Cf':.~T.T, ON.'r::; RND I.'.";ONL=.,'T'RUCT.T, ON D:[AGRAP1S ARE RVR.'[L. RBLE TO .T. NSURE PROPER ]: N:~;TRLLRT Z ON. ..EF:."I .I TFIFIT :[ RI'4 FRI',I];I.....IRR L,I:[TH '¥H.FL REt...!UIREflENT.~, FUF.. UN-=,IIE .=,EHER_ RNI) [4ELI SET F'OF::T'H R'.r' "I"HE HI...IN.T. C :[ PRE ;1: T'T' OF RNCI.4C~RRGE RND N.T. LE Z NSTRLL :[ N RCCORDRNL-:E ...... ,.._ ................. ! O 8' E GEO', .CHNICAL E~ DEVEL~. MENT CO. ih~.~se, fl Oyster 094 2774 !~oils It Foundations Performed for: Legal Description: p~e. Et_h_h (feet) Box 90, Davis St,, Eagle River, Alaska 99577 694-2774 or 688-2280 SOIL LOG Mailing Address: \~_~("'~ Earl Ellis 688-2280 Land Deveiopment Tel. No. ~,4 - -Y~_~ S~l! Characteristic) ' i:~ater Encountered: Yes No ¢ If yes, what depth Installation: Seepage Pit v/ Drain Fte~d_ ~ MunicipalitY of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.alLus (907) 343-7g04 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D., 050-081-32 HAA# .~--~..~:? . Expiration Date: · 1. GENERAL INFORMATION . :.... .,.'." '... ' . Complete legal description ':' Lot $, Block 2 Broadwater Hei.qh~-- (sEe " "' ' .... . Location{ address or directions) ' 18339 Ja~ie Driv~~ Current Property owner(s) Steve & Kathy Franklin Day phone .229-7970 - Mailing address ¶ 8339 Jamie Drive, EaRle River~'AK Lending agency. · Mailing address Real Estate Agent - - . Mailing A. ddress Unless oth~'se requested, HAA wfll be held by DHHS for pickup. HAA picked up by:. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well 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 5 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval am required for the transfer of title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to home owners. Certificates of Health Authority Approval am valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. Certificates are valid for one year for properties served by Class A or B walls or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. . 5. STATEMENT OF INSPECTION BY ENGINEER ' · · As cedJfied by my seal 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 Health Authority Approval application shows that the on-site water supply and/or wastowater disposal system ls 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm. pannone Eng. sVC. ': Phone ~ 272-8218 Address .P.O. Box 102954, Anch~ AK 99510 Engineer's pdn, ted Name Steven R. Pannone, P.E. Date e~gJneedng analysis of th~ ~ in accord~mce with MOA D~D GtdcEIJn~ & P~fions. The reportcd rc~ul~ ,4*'~'q'bc the ixat'ormance of ~c system undar fl~ conditions ~nco~ at ~ ~ o£. ~et~andSeparationd~n~tormdilyid~ati~ablefcatu~. Thcop~tioa~llifeofall · a, wcllsaads~l~tics~stemsd~pcad°nthcl°cals°ilc°nditi°n'gr°uadwat~'levc~t~fl~ · ~, dur/ng Ihe year, and Ihe water n~L,e of the fam/ly behg served by Ihe sy~m. Thc~c cond/fi~ ~ · outride thc conirol of Ihe evaluat~ of ~ ~ All slr~cms ~catually fa/l and sa~ factory ~ resutts do not guarantee fuaire pa'formance of the s-ysic~ nor do they guarantee Ihat thexe are no ' ~ddca dcfc~ts or ~croadun~ PES can therefore not provide amy warranty for future I~al'ormanc~ n°r gwc a~Y ~t~m~fc °ftmw I°ng t~c s3~tcm will c°nt~uc t~ mcct thc ol:cmfi~ ~ of ~ ADEC or MOA DSD. The conttmt of thi~ report is for Ihe sole benefit of Ihe owner listed abov~ ~y rclkmc~ upon ~r usc of this rclx~rt by any oth~' IX~Oa ~- patty is not autho~ nor.wiH it ~ ~y legal ~Sht ~aL~wc~. ,. ,, 6..DSD SIGNATURE . "~'""' ~' APp'.r0ved for 3' bedrooms. . DiSap,.~ved. - ' Conditional approval for ..... bedrooms,' with the following stipulations: Additional Comments Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory ~' Other By~ Original Certificate Date: Expiration Date: Reissue Date: Maintenance Agreements Supplemental Engineer's Report /o- /-ol Municipality of Anchorage Development Services Department Buildiog Safety Division On-Site Water and Wastewater Program 4700 South Bregaw Street P.O. Box 196650 Anchorage, AK 99519-6650- www.ci.anchorage.ak.us (9O7) 34379O4 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Desc~ption: A. WELL DATA Well type Private Date compleled 10/10/1581 Tntat~epth 706/150 It Be Date of test Lot 5. Block 2 Broadwater His Parcel I.D.: 050-081-32 Static water level Well production WATER SAMPLE RESULTS: Coliform ~ colonies/100 mi Date of sample: 91501200t SEPTIC/HOLDING TANK DATA Tank Type/Materiat pLaSTIC Date installed 11/7/1975 Tank size Clean0uts Y Foundation cleanout Y If A, B, or C provide PWSID #__ Sanitary seal Y/Y Cased to 20132 ft FROM WELL LOG 10/10/1e 1 891492 It 0.33/0.33 g.p.m Nitrate /~'~ Colle~ed by: Well Log Wires Foparly prolected Y/Y Casing heigM (above ground) 361:)6 in. AT INSPECTION 6/912001 T/rR' ft 0,4/0.3 g.p.m mg/I Other bacteria S.R.Ppqr~one 1000 gal Delxession over tank N . colonies/100 mi Number of Compartments l_ High water alarm N/A Date of pumping 6/9/2001 Pumper JR'a P#l~pil?g C. ABSORPTION FIELD DATA Date installed 11/7/1975 Soil rating (g.p.d.lfl2 or It=/bdrm) 160 System type TRENCH Length ~,0 It W'idth ~ It Gravel below pipe 5 fl Toeal depth 1J. ff Effective absorption area 500 ft= Monitoring tube Y Depression over field N Date of adequacy lest $/912001 Results (Pa,~/Fail) PASS For 3 bedrooms Fluid depth in absorption field before te~st DRY in Water addedb'70 ga ..... Ne~ depth0 in. Elapsed Time: 0 min Final fluid depth DI~Y in Absorption rate >= 450* g.p.d. Any rejuvenation tmatme .pl.. ~(pas{ 12 mo.) (Y/N ~, type) .... If yes, give date (Rev. ItM) D. UFT STATION · Date installed 'Pump on' level at Datum Size in gallons in'P~mp off" level at Cycles tested SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: in Manhole/Access High water alan~ level at In Meets alarm & circuit requirements? Septic tankJlifl station on lot Absoq~tion field on lot t06' Public sewer main Sewer/septic sewice line · On adjaceht lots 100+ On adjacent lots t00+ Public sewer manhole/cleanout NIA Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LoT TO: Building foundation 25 Water main N/A Drainage, 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 35 -" 'o' Absorption field 20 Water service line 50+ * Surface water Wells on adjacent lots 100+ Pmpe;ly line Water Service line 75 Curlain drain F. COMMENTS Building foundation, 45 Surface water 11~0+ Wells on adjacent lots t00+ Water main NIA Driveway, parking/vehicle storage, * - Well to seotic tank waiver aranted 6-1-76 and is on G. ENGINEER'S CERTIRCATION review of Municipal records that the above systems are in confom~ance with MOA HAA guidelines in effecf on this date. Engineer's P;inted Name Date Steven R. ppnnone, P,E, 10-1-Ol Date o; Payment Receipt Number (R~. 11~) Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewatcr Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Water Well Adviso~~ Health Authority Approval # 010534 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block 2, Lot 5 of Broadwater subdivision, the well's productivity was determined to be 0.7 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3-bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. APPLI ,NT FILLS OUT UPPER HA, ONLY Property Owder Buyer Address Zip Code Address Zip Code Type of Resi~nce ~ Single Family : Multiple Family No. of Bedrooms ~ Other Water Supply : Individual A~ACH WELL LOG. A w¢l Icg is required for all wells drilled since June 1975. : Community For wells drilled prior to that date, give well depth (attach Icg if available). Sewer Disposal ~ Individual Year Individual Installed: ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED. Time Time Time Time ~1~.//~,,/3, Date Date Date Date ¢///~., Inspector Inspector Inspector Inspector Field Notes: / '~ ~ "Municipality of Anct~0ra~e" ( ) APPROVED BEDROOMS *CONDITIONS OF APPROV~vir0nmelT[al Protection" ( ) DISAP~OVED ( ) CONDITIONAL APPROVAL* DATE BY: Well To Absorption Area Well Log Received so,,s..,,n, , Well to Tank Septic T~k Size 72-023 (3182) INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME— , `- DATE DATE \ DATE i INSPECTOR `` INSPECTORn \ INSPECTORS ❑ MULTIPLE FAMILY MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIOpEPT. OF HEALTH & 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL PROTECTION ENVIRONMENTAL SANITATION DIVISION NOV 9 1981 Telephone 264-4720 gg REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SER_ FE dll�'IC DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER 1 /PHONE M XI LING ADDRESS '5/Z 7 6fZ-,L/.,1C ZN2 . �� t c 12. /z- S -7 PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION PHONE 4 -&A -5e14 MAILING ADDRESS Ib/c/ .5 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION STREET LOCATION , `- 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS SINGLE FAMILY ❑ One ❑ Four ❑ Other / ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ` INDIVI DUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) ( THIS SIDE FOR OFFICIAL USE ONLY ( 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC_ UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: /000 If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must company certificate) Cts-'DISAPPROVED L DATE �� - BY 72-010 (Rev. 6/79) ' '- DATE RECEIVED ~'~ME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR I NSPECTI3R DEPT. OF H~ALTH & MUNICIPALITY OF ANCHORAGE ENVIEON~EHTAL DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street- Anchor,~, Alaska 99501 J U N 5 1980 ENVIRONMENTAL SANITATION DIVISION · .,.,,o.. ,,.,,,0 R E C E 1 V E D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete reques~ will not he proceed. Please allow ten (10) days for processing. PROPERTY R~SIDENT (If different from a~ove) ; M~ILI~G ~DD~ MAILING ~DRESS / 4, REALTOR/AGENT PHONE' MAI LING ADDR ESS STREET LOCATI I 6. TYPE OF RESIDEN~:E /~ SINGLE FAMILY [] MULTIPLE FAMILY WATER{ S~UPPLY /~ INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY NUMBER OF~BEDROOMS [] One [] Four /~ Two [] Five Three [] Six [] Other * ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available.) B. SEWAGE DISPOSAL SYSTEM ~/~ - ~/~ INDIVIDUAL/ON-SITE** / YE^R N SITE SYSTEM .WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified []Septic Tank or [] Holding Tank Size: !~) ~1 ~) If Tank is homemade give dimensions: TYPE OF TANK TOTAL ABSORPTI ON AR EA 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line NUMBER OF BEDROOMS [] ONE [] THREE [] TWO [] FOUR [] FIVE [] SlX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOILS RATING MATERIAL Septic/Holding Tank IAbsorption Area ISewer Line [] OTHER INearest Lot Line 5. COMMENTS DATE [~-~APPROVED FOR ._.._~ ~' BEDROOMS " [] CONDITIONAL APPROVAL (letter must accompa~ertificate) ! 72-010 (Rev. 6/79)