The URL can be used to link to this page

Home My WebLink AboutTHUNDERBIRD HEIGHTS BLK 1 LT 5 .. p--,, MUNICIPALITY OF ANCHORAGE '* ~' DE .ITMENT OF HEALTH AND HUMAN SER~S Environmental Health Division 825 "L' Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT """'" Cc,/4/,./,~: '~,M;'~-...~ DISTANCES ~ SEPTIC ABSORPTION ^ao,e~ TANK FIELO WELL ~,~. ~=,~' ,./-/~, ,z::-'.rz. Au. ~.,o,.e~,) L//)t-~..* b ~ WELL ~' } //.t~,~vz,;_~.F%~z2, ~/~. FOUNDATION ~ TANKS Jo~ ~ N ~EPTIC ~0~)-o~ D HOLDING ~%v TYPE OF SYSTEM ' ~RENCH ~ BED ~ W. DRAIN ~ OTHER ~.~[ .~x ~/~ so FT FT ~ ~ ~ / / WELLS ~ ~ PRIVATE ~THER (Identify1 FI ca~ to ~ ' ~ A~ ~ ~Z ~Z~~ ,.. I ~ ~ ~ E~ ~ c~ly that Ihis inspe~n w~ pe~rmed a~rdiflg to all .' 7 " ' Eagle Rtver~ Alaska ~S~ Health Depa.men, Approval: Date g--/' ~7 72-013 (3'r85) M UNICIF'ALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, AK 99501 264-4720 OI~4--S I TIE SEWER PERM I T PERMIT NO: DATE ISSUED: 870079 UPORADE 05/12/87 AF'PLICANT: ADDRESS: CONTAC] F'HONE: CONNIE BATES C/O S&S ENGINEERING 17054 EAGLE RIVER LOOP ROAD NO. 204 EAGLE RIVER, AK 99577 694-2979 LEGAL DESCRIP: LOF SIZE: SUBDIVISION: THUNDERBIRD HEIGHTS LOT: 5 SECTION: 25 IOWNSHIP: 16N. RANGE: 1W 22000 (SQ.FT. OR ACRES) BLOC),.. 1 I certify that: 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State oF Alaska. I'will install the system in accordance with all MOA codes and ~egulations, and in compliance with the design criteria oF this permit. I will adhere to all MOA and State oF Alaska r~qui~ements For the set back distances from any existing well~ wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES/ THEN (1) AN EL~CTP~CAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL !~OT BE APF'IfigO~D WIT~OU~ AN EL~CT~CAL INSF'ECTION REPORT; AND (5) THE ELEC~KICAL WO~ $~JST ~D~/ BY~~LECTRICIAN, APPLICANI:~.O~ IF_ BATES C/O S&S ENGINEERING , ISSUED BY _~ ~;~_ _.___,__.~__~_= .......... DATE: ~:-/fl-:~Z--- .? S ~,. S ENGINEERING 17054 E. PHONE CONNIE L~A'I ES 17054 E.R. LP ~204 E.R. AK 99577 I:tlr~ I AL.: I I~11UNE: 694-2c?'7 c/ l.[J] 5 IJLI': I 'IHGI,IDERL~IRI~ Hrs. LICGAI. I)[-;.'51jlRIP I' SEC 25 ~TI~fJ~F<lPJ LI]] SIZE: 22000 <SO F'T OR ACRES) flAX. I]IJI'IDEF( OF DEDROOPlS: 1 SOIL RAI'IFII3: 150 SO F'T/BR 5~llt_ IES'I DEW'IH: 14 F'I ~10 ~AIE[< F'I{[[SEH[ IN ]'ESI' HOLE. IlIIS IS AN UPGRADE 0~ I ~EDROGtl ]0 'IHE liXISIII&t4 5Ek"l 1S SYSIEFI '1 t(ENGH t-:ED W. Di(AINF IELD ~f'f/UJ[~l_ I~I~NDII1OHS 0[( 1NSI[(UC'ILGMS: A 1(~ F~.. PI]I~I'IOPl []t: '[~t~ EXIS'III'IC~ ][~El'i~:lt WILL I1.1 HAVE SLIFFII~IENr [~OOPI FOt~ ]HE 50Q GAL. ADD-Cffl A~ICH. '£ANFC '10 I:~£ USED [~,~ U~I'I,IIlNCII£h,I WITH THE EXIS[[I, IO 1000 CJAL. SE[~I 1[; lANK. I SHT. ,/ ' ' ~ ~ -~'~"~'~[I~N~INEER'S SEAL) - Mun~l~lily of Anchorage ~ 825 'L" Street, Anchorage, Alaska 99502~650 ~ ~"~' PERFORMED FOR: / W~. ~. DATE PER~ LEGAL DESCRIPTION: ///~''* SLOPE SI~E PLAN 1 2 3 4 5 6 7 8 g ~ ~10 11 12 13 14 15 16 17 18 19 20 ENCOUNTERED? . C~ IF YES, AT WHAT SL DEPTH? pO E Menitm'ing? ~ Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE (m~nutes/,nch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND --FT COMMENTS L~.~ ~ r ~'~" -~ ~ ~1~: Z~ ~'~//~ PERFORMED BY; 17~ ~ ~['~ [~ "O"" "O. 2~/~CERTIF, ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELIN~ I~EFFECT ON THIS DATE. DATE: ~2~ (R~, 4/~) ~.--~IUNICIPAL~TY OF ANCHORAG~-~ a and Environmental Prot~ .ion Fourth Floor West 825 L Street Anchorage, Alaska 99501 264-4720 ~L~Tr~D INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE ~ NUMBER OF FROM WELL MANUFACTURER MATERIAL '~"'t~D~'C_~%-~.-~ COMPARTMENTS ~-~ TILE DRAIN FIELD: DISTANCE FROM WELL # o¢ Lines ABSORPTION AREA DEPTIh TOP OF TILE TO FINISH GRADE TOTAL LENGTH F FOU;IDATION ~'?'% NEAREST LOT LINE "~ ~ OF LINE D.STANCE BETWEEN """ TOT^LB.ECT, E SQ. FT. LENGTH OF EACH LINE f'~%.~ DEPTtl OF' FILTER MATERIAL BENEATH TILE "~ '~ IN. ABOVE TILE W-~ IN. SEEPAGE PIT: Log Crib Rings BUILDING FOUNDATIO?,I DIA~VIET ER OR WIDTH Crib Size: DIAMETER NEAREST LOT LINE LENGTH DEPTH DEPTH DISTANCE FROM: WELL TOTAL EFFECTIVE · ABSORPTION AREA(WALL AREA) SQ. FT. Well Class: Depth: Well ~istance To: Lot Line Bldg: __ Sewer Line: Pipe Mater-~ls: # of Bedr?oms: ~ Remarks: %f%~T-~ u ~{~ ¢O~ ~ ~ i I January 3, 1978 Harve11 Harrison Dev. 3201 C Street Calais Building Anchorage, Alaska 99502 Subject= Lot 5 Block i Thunderbird Heights Subdivision Permit %?71026 A permit issued by this department for well and/or sewer system has expired. Permits are isgued on a calendar year basis, as stated on the permit, by authority of Municipal ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If there are any further questions, please contact this office at 264-4720. Sincerely, tIealth and Environmental Protection Sewer and Water Section PERI'I'I T NO. ,t'lUt,lICI~ 'ILITY OF RNC~-~' ?-AGE DEPRRTMEHT b, HEALTH AND ENVIRON~IENTRL ~-,~OTECTION 825 '~L~ STREET, Rt.JCHORRGE, AK. 99501 264-4720 Ot-4--S I TE SEI~Ei-'~ PEEt'I I T APPLICANT 'LOCATION ,LEGAL HRRVEI.LE HRRR)RON D~V. ~20i C ST FALCON DR & THUNDERBIRD DR L5 Bi THUNDERBIRD HTS SUB (CALAIS OFFICE CENTE 276 5551 LOT SIZE ~2008 SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MRXIMUII NUHBER OF BEDROOPlS = 3 SOIL RATING THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= '1_0 LEN(~TH= ..T~ (3F~RVEI_ DEPTH= THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION <IN FEET). THERE IS NO SET WIDTH FOR TREHCHES. THE GRAVEL DEPTH IS THE MINIMUm1 DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE AND THE BOTTO~I OF THE EXCAVATION (IW FEET). REm"J)U I RED SEPT I ¢ TRNt-~ $ I ,7_E= I 000 r~RLLOt~5 PACI<AGE PLAt-IT OPT I Or4 'A PACKAGE PLANT MAY BE INSTALLED RT THE PERHITTEE"S OPTION SUBJECT TO THE >OLLOWING CONDITIONS: ~. EITHER A CLASS I OR II HSP APPROVED PLAHT ~AV BE INSTALLED. 2. A CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF R MRINTEHRNCE AGREEMENT IS HOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SOIL ;. RBSORPTION-~YSTEM AND/OR YOU MAY BE SUBJECT T0 PROSECUTION. TI-lO ( 2_ ) I t-ISPECT I OtIS RF;~E REO. LI I RED qCKFILLING OF ANY SYSTE~ WITHOUT FINAL INSPECTION AND RPPROVRL BY THIS EPRRTMENT WILL BE SUBJECT TO PROSECUTION. IINIMUH DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTE~I IS 100 FEET FOR R PRIVATE WELL OR 200 FEET FOR R PUBLIC WELL. OTHER REQUIREI4ENTS MAY APPLY. SPECIFICATIONS AND COHSTRUCTION DIAGRAMS ARE AVAILABLE TO IWSURE PROPER INSTALLATION, ~ PEI';:I'I I T EXP I RE':;- _ DECEt'IBEi-~ ...~-I., :1.977 I CERTIFY THAT :~ I RH FRHILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET ; ~RTH BY THE MUNICIPALITY OF ANCHORAGE. ;~ I WILL IHSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. i I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEHENT IF THE ;, ~,SIDENCE IS REMODELED TO INCLUD~E MORE THAN ~ BEDRO0~IS. :. ~t-iE~~_~__~~ ........ APPLICANT H~ELLE HARRISON DEV '; ~UED BY ............. DRTEYZ~_ V~. a · '""'" · O ~ E GEC' :CHNICAL 8 DEVEL~'~?MENT CO, Russell Ovater 694.2774 Soils ~ Foundations Perfomed for: Legal Description: Depth (feet) Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 68~-2280 Earl El~is 688-228O Lend Development SOIL LOG flame: ~'~ ~_-,~.'~ ~-~.. Tel. !~o.~ Hatltng Address: ~~<~ ~ ~ ~ ~ ~ Soil Chlractertsttcs 2 5 6 8 9 10 11 15 16 Ground Water Encountered: Yes I~o v/ %f yes, whit dmpth Proposed Installation: Seepage Pit Drain Field Comments: ~ ~r~.~ -z.~' ~ k~' h~ Performed by:~Date: ~,~-s¢ xo~. x~'"77/ 30' DATUM PLOT 5 SCALE I"; 5C~ OR OWNER TO VERIFY THAT BUILDING LOCATION. . ~.. ~ ~J~ .~ t, ,/~'~ ..... LOT ~ , BLOCK · f V '~,~'.. ..'t~ ParcelI.D.# 1. 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 051-721-03 HAA # '~%Ct°lbC)~''~''~ GENERAL INFORMATION Complete legal description Thunderbird IIeiqhts Lot 5, Block 1 Location (site address or directions) 27231 Falcon, Chugiak, AK Property owner Mailing address Lending agency Mailing address Agent Address Michael & Catherine Jotmson 11421 Old Glenn H'~., Eaqle River, AK 9~?? Craw£orcl R.E.! ¢1if£ ,Johnson Day phone 16511 Canterfield Drive, Eagle River, ~ 99577 Day phone 688-0834 Day phone 694-4994 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: x 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: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 5. STATEMENT OF INSPECTION BY ENGINEER AS certified by my seal affixed hereto and as of the validation date shown below. I verify that m.,, 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 Ihat 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 Eagle River Engineering Services Phone 694-5195 Address P.O- I~ny 77~2g4: ~gle River. AK 99577 Enginee(s signature _~~ .~"~'~-- Date-~--- /.F-~( DHHS SIGNATURE X Approved for __ Disapproved. __ Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments Date J'"-,/~ ' ~' The Municipality of Anchorage Department of Health and Human Services IDHHS) Issues Health Authority Approval Certificates based only upon Ihe 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 . DEPARTNIENT OF HEALTH & HUMAN SERVICF~ Envimnmenta! Services Division RTCE I V E D 025"L" Street, Room 502 · Anchorage, Alaska 99501e (907) ~43-4744 MAY 1 S 1996 Municipaliq~ of Anct~orage Health Authority/~oproval Checklist Dept. Hearth & Human Sen~tcm Pa~cl I.D.: Well production ,/" g.p.m. &p.m. B. SEPTIC./~3~G TAN~DATA Dat~installcd Tanksiz~ ,/~:~/ ___._-mh*n'OfCompa~ O~-m~(Y/N) }/~5 ' .... ..................... Fluid ~ in absorption field before ~cst (in.); Flm,t~pm ~ (m)M=m m~. / ~ ~ (l~St 12 month~) (Y/I~) ~ lmnv.di*t*,ly 8P. ff 7-J~J.; ~ (in.): Absorption rate = D. LIFT STATION /~//~ Da~ inmllcd Size in ?nqns "Pump off' I~d at" E. SEPARATION DISTANCF.,S SEPARATION DISTANCES FROM W~]-ON LOT TO: /'//~ ScptiOholdins r..~ on lot Al~orption ~ on lot PUbUc scw~r fl~tln ; On adjacent lots Public ;ewer m~nhnle/cle~mat Lift station S~PARATION DISTANCF. S FROM SEFIIC~.ICL~:~ TANK ON LOT TO: Building fo-nde*ion ~ ~ Property lln~ ~' ~ AbSOll2fion field Watetm~i~/se~iceUne rio' Suffacowatcr/diminn~o. r'loG; WeUsonadjacemlots SEPARATION DI~'rANCE FROM ABSORPTION l~,~, r{ ON LOT TO: Buildin~ foundation Surface wat~ ~'/0/~ / Driveway, parkinF/vehicle storage area r-/~," Wells on adjaccat Iols /~ ~'~) ' Fe P,~ceipt Number ~ l.°~'~ ! ~/~7 ~'/ Da~ or~aym~t R~zipt N.m_hcr Rev. 8,/95 OSS: haa.wk.doc MUNICIPALITYOFANCHORAGE --.-' :. /;~,:._-- DEPARTMENT OF HEALTH & HUMAN SERVICES. .' Division of Environmental Services . .. On-Site Services Section P.O. Box 196650 Anchorage,'Alaska 99519-6650 34,3-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ~ZI o~ HAA#. 1~ 9L°~9~c GENERAL INFORMATION Complete legal description . t~5 i~i Location (site address or directions) '7_-~ Z~J ~ ;'=1 ¢o,~ ~- Property owner Mailing address Lending agency "Mailing address Agent Address Day phone Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~ 3. TYPE OF WATER SUPPLY: Individual well Community well Public water e NOTE: · ~ lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: NOTE: If community well system, provide written confirmation from State ADEC attest- Individual on-site -~, ~ -~'" ,: '.,, .,, Holding tank ; ;<; '-'i ..' Community on-site . . .;., .. Public sewer .J;,/ ,,;...,.. If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. STATEMENT OF INSPECTION BY ENGINEER ' As certified by my seal affixed hereto and as of ~he ~alidation 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 furtherverify 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 cedes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Engineer's signature bedrooms. 6. '- DHH~GNATURE '. ' ;" Approved for ~ __ Disapproved. __ Conditional approval for bedrooms, with the following stipulations: Additional Comments ' B~'~'"'""~ '~"i~'~- J~//~"~'~' Date ' '/'~/~ ' *': ".The M~lc~ffili? of.~hbmge ~ent of H~I~ and Human ~1~ (DHHS) ~u~ ~1~ A~ofl? App~o~l ~fi~ ~ on~ u~n ~e mp~n~tions gi~ In ~mgmph 5 a~ve by an Ind~dent prof~lonal engJ~r ~iste~ tn ~e S~te of Al~k~ ~e DHHS d~ ~is ~ a cou~ to pum~m of ho~ and ~elr lending in~i~ons in order to ~fi~ ~in f~eml and ~te ~ulm~, ~pl~ of DHHS do not condum Ins~ons or ana~e ~a ~fom a ~fl~te is ~. ~ Municl~ of ~chomge b not ~nsible for e~m or omi~lons In ~e pm~ional engin~fs wo~ Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~ 5 ~}oc.~c [ "t'~,,,,,~,~'~ [3r~ Parcel I.D. O5'1 A. Well Data Well type C~,rnuw r~ Log present (Y/N) Total depth Sanitary seat (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number. .Date completed Driller .Cased Io Casing height Date oftest Static water level Well flow J Pump level1 J SEPARAT~ FROM WELL TO: Septic/holding tank on lot 'f Z.~o' Absorption field on lot .Wires propedy protected (Y/N) J FROM WELL LOG AT IN~N g.p.m, g.p.m. Public sewer main Sewer service line ..~Z~o ; On adjacent lots ; On adjacent lots ,'v ,e, .Public sewer manhole/cleanout .Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: .Nitrate. rx/ ~-- ~_------------~Collected by: B. SEPTIC/HOLDING TANK DATA Date installed s~o ~, - sl~,~. Cleanouts (Y/N) "/ High water alarm (Y/N) Date of pumping .Tank size ~ ~ ~ (.-~o'rw-) Compartments Foundation cleanout (y/N) ~' .Depression (Y/N) ,~J P~ Alarm tested (Y/N) , -- I o- ~'-gz. Pumper ,,T'E~3. R"~'~ J~'~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ~u P On adjacent lots ~'7_,:=o' Foundation To property line .-+ Sc>' Absorption field 5'' .Water main/service line Surface water/drainage ..~ o4Y CONTINUED ON BACK PAGE C. LIFT STATION Manufacturer On adjacent lots D, ABSORPTION FIELD DAT.~ Date inslalled/'~'~" ~]8=t Soil rating (GPD/FF) Date Installed Size In gallons Manhole/Access Cf/N) Vent Cf/N) 'Pump on" level at "Pu~el at High water alarm level ~ ~ted Meets MOA electrical codes (Y/N) ~'J · S= n=O Length r~', .~,'r~..Width $' Total absorption area. 6 ~A- ~" Date of adequacy test I Water level in absorption field before test Peroxide treatment (past 12 months) Cf/N) .Cleanout present Cf/N) Results (pass/fail) Sudace water ~ <~o (~'~ System type <;'.~, .Gravelthickness ~;.o' ¢~,,~) Totaldepth ~-~'~ '~ ~ Depression over field Cf/N) t5 P'"~ ~ for ~' Bedrooms After test - If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation .4-Z.o' On adjacent lots -I- Sudace water Curtain drain 4-~0' .On adjacent lots +'7-oo' Property line .To existing or abandoned system on lot .Cutbank. ~- 5o' .Water main/service line Driveway, parldng/vehicle storage area E. ENGINEER'S CERTIFICATION ~.~':"'~' '...~'~,~,T~z~, . . ' I ~ ~t I ~ c~k~, ~dfl~, ~ ~ to afl MOA and ~ guideli~s i~t ~e~s~on. Date [,.. H~ F~ $ I~~ WaNer F~ $ Date of Pa~ent t~-3~ Date of Pa~ent Re~ipt Number ~ t ~ ¢ (4~ Re~ipt Numar 72-026 (3/93)* Back Rick Mystrorn, Mayor January 17, 1995 Municipality of Anchorage · Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska99519-6650 Michael L. and Catherine M. Johnson 27231 Falcon Drive Chugiak, AK 99567-5123 Dear Mr. and Mrs. Johnson: During the fall of 1994, the On-Site Services Section of the Department of Health and Human Services conducted a review of on-site septic systems involved in the legal proceedings concerning Chuck Landers. Your property, Lot 5, Block 1, Thunderbird Heights Subdivision was involved in this review process. Following site visits and submittal of additional required information by the engineer on this project, Mr. Henry Wilson, P.E., your system was determined to be in compliance with applicable municipal codes. One of the additional submittals required for your system was a Certificate of Health Authority Approval for a Single F2mily Dwelling. I have included the original of this certificate and an additional copy for your files. The original blue copy of the certificate should be delivered to the lending institution which processes the mortgage on this property, for the existing original in their possession includes an invalid signature. All remaining paperwork (permit designs and/or as-built inspection reports) concerning your on-site septic system has been updated and is on file at the Department of Health and Human Services. Should you desire, you may obtain a copy of this paperwork for your files. If you have any further questions regarding this matter, please contact me at 343-4744. SiTerely, J'ames Cross, P.E. Program Manager On-Site Water Quality cc: Robert O. Baker, Ph.D., Acting Manager, Environmental Services Division HENRY WILSON 9601 RUDDY WERNER DR.: ANCHORAGE, AR 99516 (907) 346-2000 Constrdt'ting Engineers Engir gers, Surveyors CHARLES A. I~NDERS HC83 BOX 192-A, MYRTLE DR. EAGLE RIVER, AK 99577 {907) 694-9098 July ~, 1994 Muncipality of Anchorage DHHS, On-Site Services Po Box 196650 Anchorage, AK, 99519 re: Lot 5 Block i Thunderbird Heights Sub Health authority approval checklist and certificate Gentlemen: Please substitute the attached original signed reports for the reports originally submitted and processed, and remove the file copies and send to me at the above address. Henry H. Wilson, P.E. 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. # CpS I 1. GENERAL INFORMATION Complete legal description Location (site address or directions) 'Z.~-7..7~ Property owner "~-~--/ ~,0~-~l ~'~h~, Mailing address Day phone Lending agency Mailing address Agent Address Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site ~. Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 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. Engineer's signature bedrooms. DHHS SIGNATURE Approved for ~c~. ~,) Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: ,~ ~ Date /c~--.t./_,~ ~_. / 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 DH HS 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. Legal Description: A. WELL DATA Well type (e'~,~v,~T'f If A, B, or C, attach ADEC letter. , Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST ADEC water sYStem number Log present(Y/N) Date completed . Driller Total depth Sanitary seal (Y/N) Date of test Static water level Well flow ' / / ': . SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Cased to Casing height Wires'properly pr~N]-.._.~p~~UNI~ :' " : ' ' ~-AT INSPECTIOI~ o ALIT'/OF ANCHORAGE FROM WELL LOG t-) ~ ' ENVII~ONMENTAL SERVICes DIVISION R[C. EIVED Sewer service line g.p.m. ; On adjacent lots ~- ~Oo t ; On adjacent lots ~rZ~ ' Public sewer manhole/cleanout I~ ~q Petroleum tank ~'Z~o' WATER SAMPLE RESULTS: Coliform Date of sample: .--.-~- · .----- Collected by: B. SEPTIC/HOLDING TANK DATA ~ooo ~- ~/'~15 ' " ' " Datelnstalled ~:o~- ~;/B:/ Tanksize I~;"~o~;~{ Cleanouts (Y/N) High water alarm (Y/N) Date of pumping Foundation cleanout (Y/N) "/ ' Alarm tested (Y/N) I~- I%-- '~ 'z" Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well (s) on lot ~J P' Topropertyline ' +*~C" Surface water/drainage 72-026 (Rev. 7/91) Froat Compartments ~' (~'~¥~ 0 Depression (Y/N) ~ On adjacent lots +Z~:~' Foundation 'Absorption field ' '~' ..... wate~'main/serviCeline · . CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (WN) High water alarm level "Pump on" level at ' ' ' ; ' ,J'P~ie,~el at ~',~.~l~~s tested. Meets MOA electrical codes (Y/N) ,~'" .... ~ ~ / . , · '. · S E PARATI O_~L~.~.N C TATION TO: ........ ~. Well orjJot~- ' On adjacent lots ~ ' Surface Water Manufacturer Manhole/Access (Y/N) D. ABSORPTION FIELD DATA ,Daie installed ,~'~ ~o,~ .- Length -. (o~/~Width ~' Total absorption area ~' ~ ~ '~ Clean(~uis'presen~ (Y/N) Depressioh bver field ~/Ni 1,3 ' Date of adequacy test Results (pass/fail) "F P~ ~ 5 ' for Soil rating ' I~'~ (tgi/) System type Gravelthickness ~;.o ('}~-~} Totaldepth Y bedrooms Peroxide treatment (past 12 months) (Y/N) SEPARATION DISTANCE FRoM ABsoRpTION FIELD TO: Well o~ lot 't'~O ' To b~ilding foundatior~. ' On adjacent lots '~t Surface water '+ too Curtain drain If Yes, give date ~ On adjacent lots .4- ~o' Property line ~-~ ' To existing or abandoned system on lot .Cutbank +*~o' Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that l hay? checked, verified, or conformed to all MOA and HAA guidelines in..~.~..t~.on~.~. inspection. HAAFee$- /?~ o Date of Payment /~' /~' Receipt Number o~,,~"/~ ~ -. 72-O2~ (Re~, 3/91) ~ack MOA 21 Waiver Fee: $ ~/~/z//4//,~1 '- Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1, GENERAL INFORMATION (Must be completed prior to submittal) .. (a) Legal Description (include lot, block, subdivision, section, township, range) Lo.~ 5; 8t. oc~- 1; Tiv:J~.~bZ~td HcZglt.t6 Location (address or d!.rections) 27£$I Fa.~con *P,'~Zv~ * ' (b) Property owner H.[/./7.# Mailing Address ' 605 ~.,~:~ 4~,. (c) Lending Institution Telephone:(home) .99501 Telephon~ _ Business Mailing Address (d) Real Estate Compan~ and Agent ASSOCIATED ~OKERS ATT~: Sand~ Telephone' · 5(;_~-=T=;=?~ '~: ...... (e) Mail the HAA'~o the following address: (o~' check here,l~ if hold for pic~ up.) List contact person and day phone number below: $ & $ ENGINEERING 17G34 p~.l,. D;vm- I e~.~ D~A ~_~. ~__a~. Eagle River, Alaska 99577 2, TYPE OF RESIDENCE Single-Family ,[~ Number of bedrooms 3. WATER SUPPLY Community l~x. Public · Note: If com~nunlty well system, must have written confirmation from the State Department of Environmental ' Conservation attesting to th legality and status.' ....................... sEwAGE bisPosAL' :' ~, On-siteEX :. Publicrl ',. Communityrl HoldingTankD. · ..... . - ".' Note: If community well system, must have written confirmation from the State Department .o.f En~ironmen.tal "Conservation attesting to the legality and statu{. ' ' "":' ..... ' Page 1 of 2 .- 5. ENGINEERING FIRM PROVIDING. INSPECTIONS,... ..... TESTS, FILE SEARCH, DATA,.AND;. '.*- .*.INFORMATION' , ' ,.-**. - ,~S ce~ified by my seal affixed hereto and as of the validation date shown below, I veri. fy that my investigation of th is *,, ·--"'~.., He-alth 'Aothonty Appi'o~,~l 'shows'~ that:the o'n~mti~' water' supply and/or Wastewate?, disposal system is safe,. ' "/functi~rJal,and adequate f0i;'the number of bedrooms~and type of structuie indicated'l~'ein further-v~ f'j'that :' '. :..-; ba~d on the Information obtained from the Munimpality of Anchorage' files and from my Investigation ~nd'-C.:-; ; In~pectloh, the on:site watel; Supply End/or wastewater disposal System is in'Co'mpliafic~-with all Municipal and '. ~' Statecodes ordinances~ and regulations ir/ effect ofi the date of this inslsectioh; :" ?;';~-,? /J .ii.i . ~'. : ' :'~.~ N':~e ~f F.rm .Telephone ~ ~:;~z/~,,~_,,,~ . ......... " ........ ~ .................. S & S ENGINEERING ........................... ' ............ ,... :_.,. ',~,~,:;. ........ ..~;_. ,..~-,~_'.L,.;~ ::..'.,..;*, - Address ¥~n'la F~,aleRlver Lo~p RoadNa '~na ..' :'· · ~ '*,,'.'· :-- ~- ,~' '*- ~ .... :":'. :', ':' Eagle PJver~ Ala~,ka 0~$~7 Date 6. D~HS APPROVAL . , Approved for ~;~ ' bedrooms by Conditional The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations give'n 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 inst'tut'ons in order to sat'sfy certa'n federal and state requ rements. Employees of DHHS do not conduct mspecbons 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 MUNICIPALITY OF ANCHORAGE (MOA) Health AuthorltyApproval (HAA) ; CHECKLIST - FEBRUARY 1984 343-4744 , ' Legal Description:. A. WELL DATA Well Classificati~)n '/~" 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 T~ank on Lot ' '"'~.-~C:~:>~"~' To Nearest Edge of AbsOrption'Field on Lot To Nearest Public Sewer Line Date Completed Depth of Grouting . If A, B, C, D.E.C. Approved<l~) y Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ·; On Adjoining Lots ' To Nearest Public Sewer Cleanout~Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results ; Date B. SEPTIC/HOLDING,TANK DATA - * '" Date Installed ~'//~57 Size I~"c:~:D'l'""~'~o. of Compartments ~ .~T-'~- Standpipes~'/N) ~ Air-tight Caps (~/N) y Depression over Tank (Y/~!~, r4 [~ate Lest I~*/~::> ; for Pumping/Maintenance Contact on File (Y/.N~ / Holding Tank High-Water Alarm (Y/N)'s'"/,c~ Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: TO Water-Supply Well '. '~-..'~::C)"-(-" To Building Foundation ~.~;~1 To Property I'lne ' ~ ,~=.t ~ To Disposal Field To Water Main/Service Lt'ne ~ ~ Foundation Cleanout~t.-?~N) ~' Pumped ''~ ~' ~ ~ ~ "' ~2~9 To Stream, p,~q?d, Lake or Major Drainage Course . Comments"-\c::,,oo ~'=~:,..L...,..'l~..-- !~.~---~'1"~ %r~ 1~', ~~. .. , Page I of 2 ".4 C. ABSORPTION FIELD DATA * Soils Rating in Absorption Strata ~'~ '" * ~z~ c) /f'Sn.. Type of System Design '""~"~--,,~--t---~-'k[ Date Installed ~,/~ s~ d~ ~"/657 Length of Field '"~"~' ~ ~ ~' Width of Field ' "~ Square Feet of Absortion Area Depression over Field (YS:~ Results o'f Last Adequa~:y T~si SEPARATION DISTANCE FROM ABSORPTION FIELD: TO Building Foundation {.,~r ~6','1"-~-t.. Statndpipes Present Depth of Field Gravel Bed Thickness Date of Last Adequacy Test To Property Line ~r.-~I To Existing or Abandoned System on ; On Adjoining Lots "=~c>t ~ To Cutback (if present) · Lot To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area -' Comments D. LIFT STATION D~ed Dimensions __ Size in Gal'F0~3s~. Manhole/Access (Y/N) "Pump On" Level at~'"""~ ' ' ' ""pump off" Lea/el at High Water Alarm Level at -"'"'""'".~ Vent (Y/N) _ Tested for ~ Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) ~ Comments ~'* ' ", ~ **Check Permitted Bedroom Rating Against HAA Request'" I certify that I have checked, verified, or conf0rm~d to all MOA and H'AA guidelines in effect o inspection. ..,,' ..... ,, Company ....,. Signed S & ~; ENGINEERING 17034 Eagle River Loop Road No. 204 ., Date MOA No. · Receipt No.'' .~//~'? '' ' ~ ' '' Date of Payment ~'~'"" r~ ~' ,'~) '' : Amount: $ ' .//;;;:~'~- ' (Rev. 1/88) Back ~ ~Recei~t No.' waiWr Fe~: $ ' Date of Payment Page 2 of 2 ParcelI.D.# MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 5, Block 1, Thunderbird Heights ,, Location (addre~s.o~directions) 101 Falcon D~. (b) Property ownerg~'nm ~1 Mailing Address Telephone: (home) ~O~i W.' 4th, ;~nc'hn~';~, l%l~. 99501 Business (c) Lending Ins!itution Telephone Mailing Address (d) Real Estate Company and Agent ,]~ ~a~l ~-y m-nt->- n~n m,r-~a~-,~y (e) Address 8nzm ~c~l ~",.- : An~hm~'=g=,. Ale. qcF[c~9 Telephone Mail the HAA to the following address: (or check here~, if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING 17034 Eagle River Loop Road No. 2~4 Eagle River, Alaska 2. TYPE OF. RESIDENCE SingleLFamily E~ Number of bedrooms 4 3. WATER SUPPLY Individual Well I-I Community ~ Public I-I Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site [~ Public E] Community [3 Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. Page I of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION · As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investiga'.ion of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is s~,fe, 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 Address Date 17034 Eagle Rive~ Loop Road No. 204 Telephone 6. DHHS APPROVAL Approved for '~ Approved -~ _ Disapproved Conditional Terms of Conditional Approval The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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. 72-025 (Rev. 7/'8~)Back Pa g e 2 of 2 ~uNiC~UNICI ,PAI;J.'CY/OF ANCHORAGE (MOA) ~.' (~l~'~o~Jealti'cAut ~pp roval (HAA) ' '~ CHECKLIST FEBRUARY 1984 · "iAY ]. :. ]988 343-4744 ' ' . " Legal Description: RECEIVED A. WELL DATA Well Classification Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Date Completed Depth of Grouting If A, B, C, D.E.C. Approved (~) ~ Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot ~/'~F To Nearest Public Sewer Line ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments ; Date B. SEPTIC/HO_.~.~ANK DATA Date ,nstalle~-~/~ Size I ~"oo/~"~:~,t-N o. of Standpipes (~1) '7' Air-tight Caps~N) Depression over Tank (Y.~ ~ , P??pir~g/Maintenance Contact On. File Holding Tank High-Water Alarm (Y/N) (Y/NI?~/- Compartments "/' Foundation Cleanout(~N) Date Last Pumped ~'"'11 ~/~ : ;for Temporary Holding Tank Permit (Y/N) ""t~A/ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Suppl~'~Well '7..-~,~, IA..- To Building Foundation To Property Line ' \ '==' To Disposal Field To Water Main/Service Line \ To St~'eam<.Po_.~Lake or Major Drainage Course Comments'~"'-- ~:~c:;,~ ~.~,~"t.... ~2-o~ (,,. ~) ~,o~, Page I of 2 C. ABSORPTION FIELD DATA ' Soils Rating in Absorptiop Strata \'~ -- ~ ~"c=,'"~ Type of System Design "'~""~ ? ' Date Installed '~ A~5 .i~ /~-~ , Length of Field ~ ~ "~' Width of Field "~: ~ Square Feet of Absortion Area Depression over Field (Y~ Results of Last AdequaCy Test Depth of Field ~ c:;> ' ~Gravel Bed Thickness '~' ~'' ' ~ '~'~'"=P'q-'c="T3'1~ Statndpipes Present (~N) Date of Lest Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well "'Z.-~c:, t~ To Property Line t '~"¢:'~ '~ To Existing or Abandoned System on ' ; On Adjoining Lots '~ [ c> t~ TO Cutback (if present) TOLotBUilding Foundatio~/h To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date .Iz~e d Size in "Pump On" Level High Water Alarm Level at · Tested for Meets MOA Electrical Codes (Y/N) Comments _ Dimensions Manhole/Access (Y/N) · "Pu'~"p/Oif" Le'vel a{ ' ~ Vent (Y/N) ing Adequacy Test, **Check Permitted Bed~'~>om Rating Against HAA Request" I certify that I have checked, Verified, or conformed to all MOA and HAA guidelines inspection. $ & S ENGINEER'.NG ~','. Signed 17034 ~9t~ Rlvw Loop k(.~ No. 204 Company .. MOA NO. ~'/*~=' / O~P-~03 ~ Receipt No. ,~-~-.-~ ./,/~'"'~ ' ~ ,~"/~--, Re(~eipt No. I ' Date of Payment ~'/~- ~l ' ' I Waiver Fee: $ Amount: $ / ~' ~ Date of Payment ~ ~.~. 7~> e.~ Page 2 of 2 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAL INFORMATION I'MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision., section, township, range) Location (address or directions) (b) PropertyOwner./Z~/'~/'t ~c~';"'~'7 Telephone:Home Business Mailing Address (c) Lending Institution Telephone Mailing Address (d) Real Estate Companyand Agent (,/'~;~" Address o. < Telephone/ ~ ~ (e) Mail the HAA to the followino address: or: Check here/~ if hold for pick up. List contact person and day phone number below. 17034 Eagle River Loop Road No. 204 Eagle River, Alaska W;)/,' TYPE OF RESIDENCE Single-Famil~' Number of Bedrooms WATER SUPPLY Individual Well [] Community [] Public~ 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 1-1 Holding Tank [] Note: I! community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page I of 2 ?~-m5 ~s~, 8,8~ F,or. 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION AS certified by my seal affixed hereto and as ot the validation date shown below, I verify thai my investigation of this Health Authority 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 flies 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 Address '17034 Eagle Rlve~ L~ Read No. 204 Date Eagla Rf~er, Alaska ~577 DHHS APPROVAL Approved for ~ Approved ~ Disapproved Conditional Terms of Conditional Approval CAUTION 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. Page 2 of 2 '.,2..o?$ i~ev 8,'86) Sack A. ,ELLDATARECEIVED MUNICIPALITY OF ANCHORAGE (MOA) MUNtCIPALI1'~ Of= ANO'IO~'GEHEALTH AUTHORITY APPROVAL (HAA) ENVIRON~,ENTAL SERVICES DtVIStON CHECKLIST- FEBRUARY 1984 2~1-4720 APR 2 7 1987 Le a, Descr~n: Well Classification /Z~ 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/Manhole Water Sample Collected by Water Sample Test Results Comments /~ W5 4"'). ~ 'If A, B, C, D.F-C. Approved ~VN)' Date Completed Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (WN) ; On Adjoining Lots ~ tv.)tW' ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date B. SEPTIC/HOLDING TANK DATA Date Installed Z.//.~/ q~3 Size ,/c:~c~) No. of Compartments Standpipes ~N) Air-tight Caps ~1) Foundation Cleanout ~;~1) Depression over Tank (Y~ Date Last Pumped Pumping/Maintenance Contract on File (Y/N),~ /'~'/~v~ :for Holding Tank High-Water Alarm (Y/N) ~' Temporary Holding Tank Permit (Y/N) Separation Distances Irom septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service Line Course /~//~ To Building Foundation ~ To Disposal Field ~/ To Stream. Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026I11/84} ABSORPTION FIELD DATA ' Soils Rating in Absorplion Strata Date Installed ?~//o / ~,~5 Width of Field ,~,o" Square Feet of Absorption Area Depression over Field (Y~ Results of Last Adequacy Tesl Separation Distance from Absorplion Field: To Water-Supply Well ~-. To Building Foundation 2.. ~ / Lot Type of System Design Length of Field ~ t3/ Depth of Field /G' Gravel Bed Thickness ~ Standpipes Present {~N) Date of Last Adequacy Test To Water Main/Service Line ~'D/-'/ To Stream/Pond/Lake/or Major Drainage Course To Driveway. Parking Area, or Vehicle Storage Area Comments To Property Line /O To Existing or Abandoned System on ; On Adjoining Lols ~Z~ ~'-.~ To Cutbank (if present) D. LIFT STATION Dale 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/~lOA and,,HAA guidelines in effect on the date of this inspection. S~_n_$ & $ ENGINEERING '~ ~,~ ..... Receipt No. Date of Payment Amount: $ Page 2 of 2 DEPT. OF ENVIRONMENTAL CONSERVATION ,~. / .:~. ST~V~ COW,m, COW~~O~ / ANCHORAGE WESTERN DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 May 3, 1990 563-6775 S & S Engineering 17034 Eagle River Loop, Suite 204 Eagle River, Alaska 99577 PWSID~ ~11156 Accordtn9 to the records on file tn thls office, the Thunderbird Het~ht~ Subdivision Lot 5 Block 1 Water System is in compliance with the State of Alaska Drinking Water Regulations. Sincerely, VERA E. CRAIG Environmental ricer VEt:bas STEVE COWPER, GOVERNOR 3601 C ST~ET, SUITE 32a ANCHO~GE, ~ 99503 563-6775 DATE~ May 11,.1989 PWSID~' 211156 To Whom It May Concerns According to the records on file in this office, the Eklutna Thunderbird. Heights S/D Water System is in compliance with the State of Alaska Drinking Water Regulations. Sincerely, Vera E. Craig Environmental Field Officer VEC:kk ROBERTA. SHAFER CIVIL ENGINEER 694-2979 SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING S't~DIES AND REFORTS SITE ROAD DESIGN SOILTEST ~ITRUCTUR&L & MECHANICAL INSPECTIONS DE$1GH 825 L Anchorage, A,f~6~x~ 99501 DEPT. OF HEALTH & F'J~/IRONMENTAL PROTEC~o MAY 2 8 1987 RECEIVED ATTENTION: Laura REFERENCE: Lot 5; 8lock 1; Ti~nde,'rbirE ffe,~g~ On Ap~ 29, 1987, Vow /66~ed a He~h Au~ho~L~V Approua~ {or a t~ee bedroom r~/dence locked on the referenced prop~v. When th~ ~ four bedroom6 and ba6ed upon Vour guidance.Letter of Feb~u. arV 17, 1987 we requited a pe~u~d.t ~o upgrade the exZ6tZng 6eptZc 6V~tem to fou~ bedroom6. Vo~ permit 870079 ~a6 Z66~ed for t/~t upgrade. SRB 19~X EAGLE RIVER, ALASKA99577 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Dl S,O. OF EN RO.ME.TAL SERVICES CERT, F,CATE OF,.SPECT,ON FOR HEALTH AUTHOR,W ^PPROVAL Z2 .3-7 OF ON-SITE SEWER AND WATER FACILI~ 264~7~ Application Date Ap,'t~ 22t 1987 GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 51 /~t. ock Location (address or directions) I01 F~co~ (b) Property Owner Hom~_qu~t~ Mailing Address (c) Lending Institution Mailing Address Telephone: Home Business Telephone (d) Real Estate Company and Agent .TA~K ~HITE COMPANV/CoRt!.~.e Bat~ Address P.O. Box. 711699t Ectq~ RJ.u~t., A~.6b.~ 99577 Telephone 694-5500 (e) Mail the HAA to the followina address: or: Check here [~. if hold for pick up. List contact person and day phone number below. $ t $ ENGINEERING 17054 Eaa_~e RZve~c Loo~ Road, Suite ~04 TYPE OF RESIDENCE Single-Family ~ Number of Bedrooms WATER SUPPLY Individual Well I"1 Community I-I Public [~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite 1~1 Public F'l Community I-I Holding Tank.l'1 Note: If corn munity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status, Page 1 of 2 z~-o;5 trey 8/861 Front ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation ¢3ate shown below, I verify that my investigation of this Health Authority 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. Name of Firm Telephone $ & $ ENGINEERING Address ;7G;-4 ~g;- R;,~ L~p R~a~ ~. ~ Date ,.~. River, Alask. "5~ DHHS APPROVAL Approved for ~J~"~'C'~) bedrooms by ~ ~;:) ' ~"~/a'''''~'~ Date Approved g""'""' Disapproved Conditional Terms of Conditional Approval CAUTION The Municipality of Anchorage Department of Health and Human Services CDHHS) 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. DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA qg50! 274-~533 DATE: 23 April 1987 PWS I.D.# 211156 To Whom it May Concern: According to records on file in thl~ office the E~ llUND~RBIP, D [~IGt~$Water System is in compliance with the State Drinking Water Regulations Sincerely, t'~' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date Ma), ? ~ 1986 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot ~, Block 1, Thunderbird llei~hts T16N R1W Sec.25 Location (address or directions) Falcon Drive (b) Applicant Name Fz',ank Heffez"nan Telephone: Home 688-3363 Business N/A Applicant Address SR-2 101~ ChuKiak~ Al{ (,:,)~).567 (c) Applicant is (check one): Lending Institution r3; Owner/builder ~; Buyer []; Other [] (explain); (d) Lendinglnstitution Alaska Pacific MortKaKe Telephone Address 101 E. Benson, AnchoraKe, AK (e) Real Estate Company and Agent N/A Address Telephone (1) MailtheHAAtothelollowingaddress: pickup by applicant TYPE OF RESIDENCE Single-Family[] Multi-Family[] Number of Bedrooms 3 Other WATER SUPPLY Individual Well I-I Community r'.'.3 Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. ~ ¢~.. ~-,'~ ~,--~- Z ~- ;' · *f4' 4. SEWAGE DISPOSAL Onsite[] Public[] Community[] Holding Tank[] Note: If community well system, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status. Page 1 of 2 72025 (tl,84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION ~' AS certified by my seal affixed hereto and as of Ihe validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply end/or wastewater disposal system is.safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify Ihat 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 EAGLE RIVER ENGINEERING SERVICES Telephone EAGLE RIVER, AK 99577 Address P.-()~OX--7732g ~ DHEP APPROVAL Approved for ~ bedrooms Approved Y 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 DHEP 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 (1 t/84) WELL DATA A E MOA~- MUNICIPALITY OFANCHOR G ( Al- HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 MUNICIPAl. IT? OF ANCHORAGE DEPT. OF HF.,ed. TH & ENVJRONNENTAL PROTECTION 264-4720 Legal Description: Well Classification ~'~'"""~"'~'*"~,~ ~"/"~"~'~ "' I1 A, B, C, D,E.C. Approved (Y/N) ~ Well Log Present (Y/N) Dale Completed Yield 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/Manhole Water Sample Collected by Water Sample Test Results Comments 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 B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) ,Y Air-tight Caps (WN) 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 '~,~P / To Property Line -~"'~'" To Water Main/service Line Y'/~ Course Size /~ ~--I No. of Compartments Foundation Cleanout (Y/N) Date Last Pumped ; for .,'"'//.4 Temporary Holding Tank Permit (Y/N) To Building Foundation ,~ / To Disposal Field ( ~' To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(I 1/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ,/~' 2 ~' Width of Field 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 Lot /[/~/"f To Water Main/Se~ice Line /,/,~ Type of System Design 7'''r'~'~''~c~ Length of Field ~ ~ Depth of Field /~' Gravel Bed Thickness g' / Standpipes Present (Y/N) Date of Last Adequacy Test --~-.-/.~//~' To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Property Line ~'d To Existing or Abandoned System on ; On Adjoining Lots '/',.~<~ ~ To Cutbank (if present) D. 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 MOA and HAA guidelines in effect on the date of this inspection. Date MOA No. Signed ~-,~-~ Company ~"/P~.~', -~, Receipt No. Date of Payment Amount: $ ~ ~'Cx~. Page 2 of 2 72-026 ( 1 I, 84)