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Home My WebLink AboutTRAILS END BLK 8 LT 7Trails End Block 8 Lot 7 #015-191-49 Municipality of Anchorage Development Services Department Building SafebJ E;vislcn OmSite Water & Wastewater Prcgram 4700 South Bragaw SL P.O, Eex 196650 Anchorage. AK 99519-6650 www.d,anchorage.ak, us (§07) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-191-49 1. GENERAL INFORMATION Expiration Date: Completelegaldescfiption TRAILS END SUgDIVISION; LOT 7~ BLOCK 8 Location (site address or directions) 11500 BROWDER AVENUE~ ANCHORAGE, AK Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address 99516 MIKE McDANIEL Day phone CONTACT AGENT 11500 BROWDER AVENUE, ANCHORAGE, AK 99516 Day phone. GEORGE McCOY w/ PRUD. JACK WHITE Dayphone 3201 "C" STREET, ANCHORAGE, AK 99505 783-2937 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well [] Individual Water Storage [] Community Class Well [] Public Water System [] TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding tank ~___ Communi~ On-site II 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) 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 cf 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. (Ce~ficates may be reissued for a peded of up to one year with valid water samples.) Certificates are valid for one year fcr properties served by Class A or B wells or a public water system. The Municipality cf Anchcr-=~e is ncr responsible for e."rcrs or emissions in the professional engineer's work. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $800.00 at, or prior I to closing for the engineering services provided. 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, 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 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER &: WASTEWATER CONSULTANTS. INC. Phone Address 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE. AK 99504- Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 337-6179 Engineer's Comments: In conducting this evaluation, AWWC, Inc. attempted to provfde a thorough, cons~ientious engineeting 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 et the t/me of the test, and separation distances measured to readily Identifiable features. The operational life of a# wells and septic systems depend on the local soils condition, graundwater levels that may fluctuate durfng the year, and the water usage of the family being sen/ed by the system. These conditions ara outside 'the control of the evafuator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. A WWC, Inc. can therefore not provide any warranty or futura estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of 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 party Is not authorized, nor will it confer any legal tight whatsoever. 5. DSD SIGNATURE Approved for ~ Disapproved. Conditional approval for Attachments: HAA Checklist Septic System Advisory Well Flow Advisory bedrooms. bedrooms, with the t~lowing stipulations: Manitenance Agreements Supplemental Engineer's Reort Other Original Certificate Date: I I - I ~J - ~ ( , Legal Descd~on: A. WELL DATA Well type ~v^; Date completed Total depth 12o Municipality of Anchorage Development Services Department BuMlng 6a;e~ Oivtskm On-~te W~ter & W~mtswster Program P.O. Box 196650 Anchorage, AK ~9519-6650 HEALTH AUTHORITY APPROVAL CHECKLIST TRAILS END SUBDIVISION; LOT 7, BLOCK 8 Parcel ID: 015-191-49 IfA, B. orC provide PWSID# N/A 5/29/84 Sanitary seal fi/N) YES It. Casedto 116 ft. FROM WELL LOG Date of test 5/29/84 Static water level 52 .lt. Wall production 5 g.p.m. WATER SAMPLE RESULTS: Date of sample: 11/7/2001 B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL We, Log (Y/N) Wires property protected fi/N) Casing height (above ground) AT INSPECTION 11/7/2001 33 .ft. 3.0+ g.p.m. YES YES 12"+ in. Nitrate 0.5 mgJL. Other bacteria 0 colonies/100 mi. Coll~ by: AWWC~ INC. Date installed 10/27/97 Tank size 4000 gal. Number of Compartments 1 Cleanoute (Y/N) YES Foundation deanaut (Y/N) YES Depression over tank (Y/N) NO High water ala~n (Y/N) ~ C. ABSORPTION FIELD DATA Date Installed ~ Soil rating (g.p.d./lt~r ~/bdrm) System type__~ Length ~lt. Width ft, G~v/,qJ,balO~ pipe ft. Total deplh fl. Eft. ebco~on area ft~ ,~,~__,Dg, tul~~ Depression over nation treatment (past 12 mo.) (Y/N & type) If yes, give date D. UFT STATION Data installed Size in gallons ~__ _ "Pump on" level at in. "Pump off' n. High watar alarm level at __ .in. Da.~m Cycles tested. Meets alarm & drcult requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tsnk/litt station on lotN/A Ab~orpfion field on lot N/A Public sewer main N/A Sewer/septic sendce line 25'+ On adJacent lots. 100'+ On adjacent lots. 100'+ Public sewer manhole/desnout Holding tank 75'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Absorption field N/A Surface wats;: 100'+ Property line 5'+ Water service line 10'+ Building foundation 5'+ Water main N/A Wells on adjacent lots 75'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Bulidlng fou dn aflon.~t~--.--------'-'--'-/ Water service line ~______._~e.~e~ Driveway, parklng/vehlole storage C~~ Wells on adjacent lots. F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field Inapec~ons and review of Municipal records that the above systems ere In conformance with MOA I-IAA guidelines In effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date HAA Fee $ Date of Payment Receipt Number (eev. 12/m) Waiver Fee $ Date of Payment Recelpt Number NOV-13-01 05:4~PM FiK)M-CT&E ENVIRONWNTAL SRV ~1~K ~&E Environmental Servlco~ Inc. 9075615~01 T-155 P.O2/O] Fo86Z CT&E Ref,# Client Name Fro]eel Name~ Client Sample ID Mntrlx Ordered By FW$1D 1017762001 A~ Water & W,tstewater Con~ultanls Inc. Trails ~nd S/D LT: BS Outside Hose b,b Drinking Watc~ Sample Rc"mnf ~: Results PQL Client PO# Printed Dar r./Ttme !!/13/2001 12:29 Colletted Datefflme !1/07/2001 16:00 Received Dntt4Time 11108/2001 14:00 Me~h~d AJIowible P~ep Analysis LimiB Date Date Init WaC-era Depar~men: Nitrate-N 0.500 U 0.500 mg/L EPA 300.0 (<10) II~WOI SCL Microbiology Laloora~ory To~lColi~nn ¢olll00mL SMIS 9222B (<D I I/O~dOI SBH