HomeMy WebLinkAboutLA FORET LT 8La Forct
Lot 8
#017-342-08
'Municipality of Anchorage
Development Services Department
... ' ' Building Safety Division ' . . ,'
· ':?',: CERTIFICATE OF ' : : :
", 'Current Property owner(s) ~Angela Eberhardt'" - -' ' ."': · ,*, Day phone 760-219-1217 :'". :, '.:' '
Mailing Addres§ 3380 C Street~ Anchora.qe~ AK 99503 -
Unless ofl~envfse requested, HAA will be held b~ DHHS for pickup. HAA picked up by:
2. NUMBEROF 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 are required for the transfer of
title (except between spouses) on properties sewed 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 are
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 wells 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 certified by my seal affbxed hereto and as of the validation date shovm 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 wastewater disposal system is safe. functional and
adequate for the number of bedrooms'and typo of structui'e 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 Fim~ '" '~' ' ' "'A ~-'; .. ,.· . ....,
Pannone EnR. s~C.: ~',' i': "'~* ' '!- Phone ~72-8218
Address P.O. B0x 102954, Anch~ AK 99510: *: ..... '
- - * .-.iEngineer'..s Pdnt~d Name Steven R~' Pa'nn0n~, P.E., Date ~ '~/~.~'/'o{ '
· I .... '* '" *: ..... ' " ' " ' ' ' ...........
Eng'neersComments. L~co~duclmganadcquacytcst, latI~a tloprot, xlcat~orou coz~sci~fious - . ·
va:lls and scpUc sTstcms dcix~d on thc Ioc~l soil condition, ~ou~d watcr Icvc~ ~t ~y fl~t¢ ".'-
. durLngthcycar, andlhewatcr-~¢oftl~fium'lybcingservcdbythcsystcm. Th~condibo~ : '
rem~ll~ do eot guaramce futm: ix:fforma~ce of t~¢'s~ ant d6 they guarantee tJ~t ~ ~ no /
~,'1,~,'~ dc£cct.s or e~croactm~e~ts. PES can'thcre fore sot provide ~my ~'ra~F for ~ ~o~ ~ f~__~Steven
. ....
rel~an~ upan ~ .u:se~O f tl~ rclx~rt by any ot~' lX~Sr~On or Fu'ty ~s eot anthorLzed eot wdl ~t conf~ any ..
· ~i~t,i=~.,-..'. ' · '-. :- .-:'. -'. ~': ".- . - ' : . :%._,i-~:p~\~,"
"6.': DSO SIGNATURE ,'" : ..... ' ' -
- · .. l>""_". Approved for "-'~ bedr~0mS.. ....
· -- Disapproved.
. Conditional approval for - bedrooms, with the following stipulations:
Additional Comments
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
X
Maintenance Agreements
Supplemental Engineer's Report
Other
~./~'/ d/ '
Expiration Date: / l- /- C) /
Odginal Certificate Date: ~ - /- 0 /
Reissue Date:
Legal Description:
A. WELL DATA
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Westewater Program
4700 8outh Bragaw Street
' P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
I.<)~ $ La Fore..~S~% Parcel I.D.: 017-342-08
Well type_P
If A, B, or C provide PWSID # ~
Date completed 61111976
Total depth Unknow ft
Sanitary seal Yes
Cased to 40'+ fl
FROM WELL LOG
Dale of test
Static water level / It
Well production l' g.p.m
WATER SAMPLE RESULTS:
Well Lng _N.
Wires properly protected Yes
Casing heigM (above ground) :~4
AT INSPECTION
61812~01
zos
4,0+ g.p.m
Coliform 0 colonies/100 mi Nitrate .1~ mg/I r
Date of sample: II~fIPI~/~/O/ Collected by: Laura Pan.gne
B. :sEpTIC/HOLDING TANK DATA
Other bacteria
{) colonies/100 mi
Tank Type/Mateflal · Or~er Sleep
Date installed 5/24/1978 Tank size t000 gal Number of Compmlments 2_
Cleanouts Y Foundation cleanout 1~ Depression over tank N High water alarm N__
Date of pumping $15/~01)1 Pumper A+Home Sen~ices
Ce
ABSORPTION FIELD DATA
Date installed 5/24/1978 Soil rating (g.p.d./lt2 or ff2/bdrm) 225sfrod
System type- ~p Trench
Length 45 fl Width ~,6 ft Gravel below pipe 8 fl
Total depth ~2 ft Effective abeo~ption area 7;~0 ft~ Monitoring tube Y Depression over field N
Date of adequacy test 6/81:~001 Results (Pass/Fail) Pass ~ For_3 bedrooms
Fluid depth in abcorption field befo~;e test DW in Water added4__,_~ gal. New depth0 in.
Elapsed Time: _0 min
Final fluid depth PrY in
Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N9 ,~
(Rev. 11~))
Ifyes, givedate
D. UFT STATION *
Date' installed Size In gallons
'Pump on' level at in'Pump ofT' level at
Datum Cycies tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT 'TO:
JR
Manhole/Access
,High water alarm level at ~
Meets alarm & circuit requirements?
Septic tanldlift atation on lot t00,+ On adjacent lots 100'+ ''
Jn
Absorption field on lot 100,+
Public sewer main NIA
On adjacent lots t1~0'+
Public sewer manhol~cleanout NIA
Sewer/septic service line
Holding tank 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line t0,+ Absoq~lon field
Water main 10,+
' Water service line II)'+ * Surface water t00,+
Drainage 100,+
Wells on adjacent lots 100,+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: .
Property line 10,+
Water Service line 10,+
Curtain drain
Building foundation 10,+
Surface water 100'+
Wells on adjacent lots 100'+
Water main 10,+
Driveway, ~ng/vehicie storage
F. COMMENTS
G. ENGINEER'S CERTIFICATION
' i cerlffy that l have date~nined through fleld inspectkms and
revfew of Municipal records that the above sy~ems are in,
confonwance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name Steven R. Pannone, P.I~,
Date" ~;~/~_.~ [c~ ~,
HAA Fee $
R ,pt .umbe,
(Rev. 11~)
Waiver Fee $
Date of Payment
Receipt Number
AUG-Or-O! 10:05 F~E £NVIROI~HTAL SRV 907§$~5301 T-g04 P.OI/OZ F-4~Z
CT&E Environmental Services Inc.
Laboratory Division
20~ W. Pctter Drive
,N~,chomcje, AK 9~518
Tet: (907) 862-2343
Fax: (907) 5~1-5301
CT&E Ref. ~: 1014772n01 Clie~ PO~; rJa
Cllaf~! Name: Pannone Engineering Prlnte'~ Da~me: ~8~1~1 10:~
P~oject Na~; ~a . ~ C~e~ ~a~ime: C7~0~1 11:~
Cliff Sam~e ID. Lot B ~For~t~ R~iv~ DaYtime: C7~'0~1 11:10
Ma~: D~nk ng Waif Te~ic~ Dim~o~ S~phe~ E~e
PWSID n/a
Sampte Rema'ks.
Release~ By~
Parameter Results PQL Units Method
Total Cci form (MF) D c~r/100 r~ sMg222B
Nitrate 0.8 U 0.5 mg[ EPA 3C0
~Jt~va=re Prep Analysis
LIm;~ Date Date In~t
10.0
n7/3C/D1 KAP
n7/3G'31 SCL
kU~-01-01 19:eT FR~-.CTZ~ EN¥1F~II~N?AL S~ 9075615301 T-904
CT&E Environmental Services Inc.
Laboratory DivWion
200 W. Pot~ar Dove
Ddnking Water Analysis Report for Total Coliform Bacteria *~o,.... ^~ gu~.-~.o~
Tel: (~?} ~2-2343
READ INSTRDCTIO,¥$ ON ~E ~E 3EFORE COLLE~IN~ S~p~ Fa~ ~7) 661-5~I
MUST BE COMPLETED BY WATER SU['PLIEE
PUBLICWAT;RSYST;~ I~." I' i I t' I i 1
PRIVATE WATER SY~EM
V
Mo~h Day
SAMPL~ ~'PE:
Routl~ D T~ted Water
with lab rd, no. )
~peclal
SAMPLE LOCATION
Tlma Collected
Coil.ted
II'.Ob-
TO 81:- COMPLETED BY LABORATORY
mdysie shows this Wat~ SAMPL£ ~o be:.
Sa~faemry
Un,aris factory
D Sample over .10 hou~ old, results may
be unreliable
Saw,pie too Ic~g m transit: sample should
11o! be over~l~ours old at exanthTat~on
to indicate reliable results. Please need
ney. s~mple via ~ecial delivery r~ml.
Time RKeJved
A~ttlytJc&l Method: ~L"/LJ~,temb,"ane Fillet' · 0 MMO*MUG
* Nm?betofcoloflies/100 mi.
analyst
101477
Client notified of unsatisfactory results:
D
D
Fawd
BACTERIOLOGICAL WATER ANALYSIS RECORD .
Caloale~/lOO mi
~ ~?~.C'~~''''' Dsm
BGB COLIFIRM
~ '~ Collhrm/t O0 mi'
iNVIRONMENTAL FAI:ILmES IN ALASKA. CALIFORNIA, FLORIDA. ILLINOIS. MAHI'LA~D. MICHIGAN. M~,~SCIURL NEW ,JERSEY. OHIO. WE~I' V1RGINIA
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska '99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAt. SYSTEM AND/OR WELL INSPECTION REPORT
NAME ]PFIONE
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION NO. OF BEDROOMS
~IST~CE TO:
IAbsorption area
Manufacturer
Liq. capacity in gallons Inside length
IF HOMEMADE:
DISTANCE TO:
Well
Manufacturer
DISTANCE TO: Length of each line
NO, of lines I Well
Top of tile to finish grade
Width
Length
[~NEW
[~UPGRADE
Dwelling
Wid~,
Dwelling
Material
Nearest lot line
Foundation
Total h;ngth of lines I Trench width
/-4~ ~r' I _ __~D ~nehes
Material beneath tile
Depth
PERMIT NO.
No. of compartment~:~
Liquid deptl~
PERMIT NO.
Liquid capacity in gallons
PERMIT NO.
Distance~/e~,~n ,nes
Total effectiva absorption area
PERMIT NO.
Type of crib Crib diameter Crib depth Total effective absorption area
Well Building foundation Nearest lot line
DISTANCE TO:
Class Depth Driller Distance to lot line PERMIT NO,
DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTALLER
RFMARKS
~-?,v;. ' A - ';;C-~
APPROVED
72-013 (Rev. 3/78)
LEGAL
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MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6-650, Anchorage, Alaska 99502 276-222'[
SOILS LOG - PERCOLATION TEST
ySOILS LOG
[] PERCOLATION
TEST
SLOPE SITE PLAN
(
10
11
12
13
14
15
I6
17
18
19
20-
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
(minutes/inch)
~__.? ~/ ~ TEST RUN BETWEEN FT AND -- FT . ,, --
72-008 (7/76)
'-'--.~-.... /
' .
103 East 26th Avenue t '~~
Anchorage, AK 99503
Re: Subsurface InvesLigat[on'for Dryer Subdivision
Located within SE 1/4t Sec. 2?, T.12N., R3W., S.H., AK
Dear Mr. Korynta:
As instructed, we conducted a subsurface investigation for
tile above referenced property on Hatch 26, 29 and April
~976. The results of that investigation are included in
this report. Following the text are:
Vicinity Map
Test Hole I,ocation Sketch
Idea/Lized Soil Profiles
Test Hole Logs
Grain Size Distribution Curves.
Standard E>:planatory Information
Figure 1
Figure 2
Figure 3-6
':['able 1"
Sheets 1-6
Sheets 7-9
Drilling was accomplished utilizing a Hobile Drill B-50
drill rig mounted on a F]extrac-Nodwell.tracked vehicle.
owned and operated by Denali Drilling, Inc. The test holes
were logged, the. drilling supervised and the percolation
tests run by Mr. O.H. Hatch, staff geologist with A].aska'
Testlab.
Samples were taken off the flights of the solid flight auger
· as it was brought to the surface. The samples were sealed
in plastic bags and transported to the laboratory where
their natural moisture content and dry strength was determined.
Each samFle was then visually classified and grouped accord-
lng to the soil's color, texture, and grain size distribution.
Laboratory analysis was then done on the group .as a whole
rather than on individual samples.
Unwin Schcben & Ko: ynta
April '5~ 1976
Page 3
For the percolation tests, the test tiles were filled with
water and ].eft ~,vernight to sedum;ate. On retu~.ning, the
holes were refiiied and the drop in t]~e water level carefully
monitored over the next 60 p. dnutes.
This procedure 5s not a stantardized percolation test,
· however, we unc]ur::~tand that the Anchorauc Department of
Environ,mental. Quality prefers test performed in this manner
to evaluate a site for a proposed On-site sewerage system.
Using the'above test, tho observed minim~nn percolation rate
was 5.5 rain/inch fo~. test hole 1, and ~.7 min./inch for test
hole 5. --~
Additionally, we qSzLZ~-t-e that the pereolation'rntes for the
.other holes (using vi~:ua], a~id laboratory data) to be:
Test Hole 2 -
Test ]ble 3 --
Test Hole 4 -
Test llo!e 6 -
Test llole '7
'Pest ltele 8 -
l,ess than 8 min./inch
l,nss than 30 min./inch
],ess than 30 min./J, nci~
Less than 10 min./inch
I,ess than 5 min./J nch
Less than 5 min./inch
Depending o.u the re.~{ult£; of the final percolation tests to
be performed after access is provided te the site, package
treatment plants Rlay be required in tile area e~: test holes
3 and 4. Even this area should percolate fairly well
particularly below ten feet.
No water table was ~'ncountered dur]ng o:.:p] oration. It
should be neued, however, that the water level will fluctuate
with seasonal and climatic changes.
To help visualize the .~oil strata at the site, we have drawn
~;ome idea].i:<ed soil profiles.for the site. It should be
remembered when using these though, that wide var'lances may,
and prebably de, exist between test holes.
Vt?. hope'this is sufficient for your present needs. If we
can offere clarification please, do not hesitate te centact
II S . ..
Very truly yours,
Halrin R. Nichols, CE
H.RN: nun
,/
DEF THENT OF ENVIRONMENTAL QU/ .TY
PLATTING OR PLANNII,IG. ~, ZOHING CASE REVIEW
CASE liO..
'/, / ,_i"',~/, ,
TITLE:
Date Case Received
By
Suspense Date Comments to Planning Department
For Planning & Zoning Commission Meeting Date
ROUT I NG
Environmental Engineering
Air Pollution
Noise
Environmental Sanitation