Loading...
HomeMy WebLinkAboutVALLI VUE ESTATES #2 BLK 5 LT 17Onsite File r Municipality of Anchorage Development Services Department Building Safety DMston On-Sita Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Ancflorage, AK 99519-6650 www.d.anchorage.ak, us (907) 343-79O4 CERTIFICATE OF HEALTH ,UTHORITY .APPROVAL FOR ,b, SINGLE FAHILY DWELLING Parcel I.D. 051 - 125 -40 1. GENERAL INFORMATION HAA Expiration Date: Complete legal description Location (site address or directions) Current Property owner(s) Mailing address ' Lending agency Mailing address Real Estate Agent Mailing address ~/ALLI VUE SUBDIVISIONS #2; LOT 17, BLOCK 5 6901 CROOKED TREE DR~E BILL AND MARY MARTIN Dayphone PRUDENTIAL JACK WHITE Day phone 563-5500 3201 'C' STREET SUITE 200, ANCHORAGE, AK 99503 BONNIE MEHNER Day phone 242-1188 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBEROF BEDROOMS= 3 3. TYPE OF WATER SUPPLY= Individual Well Individual Water Storage Community Class Well Public Water System 'PfPE OF WASTEWATER DISPOSAL: r~ Individual On-site [~] Individual Holding tank B Community On-stte ~1~ Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Cerl/ficates 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'he 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. CertJficetes of Health Authority Approval ara valid for 90 days from the date of issue for properlJes served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work. Note: Alaska Water and Wastswater Consultants, Inc. shell be paid $1110.00 et, or prior to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As ce~'fied by my seal affixed hereto and as of the validation date shown be/ow, I vedfy that my investigation, based on procedures outlined in the Health Authodty Approval Guidelines for this applica#on, shows that the on-site water supp~ and/or wastawater 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 Insl:~CtJon, 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 effecf 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. (;ARNESS. P.E. Date 337-6179 i / Engineer's Comments: In conducting ~his evalua#on, AWWC, Inc. attempted to provide a thoreugh, consden#ous engineering analysis of the s~fem In accordance with ADEC and MOA DSD Guidelines & R~gula#ons. The reported results desodbed the performance of the system under the cond~ons encountered at the Eme of the test, and separation distances measured to readily identifiable features. The opera#onal life of all wells and sep#c systems depend on the Iocal soils condition, groundwater levels that may fluctuate dudng the year, and the water usage of the family being se~ed by the system. These conditioc~s are outside the contrel of the evaluator of the system. ~a#sfactory test results do not guarantee futura performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWC, Inc. can therefore not provfde any warranty or fuluro es#mate of how long the system will continue to meet the opera#ona] requirements of the ADEC or MOA DSD. The content of this repot is for the sole benefit of the owner listed abo~e. Any re/lance upon or use of this report by any other person or petty is not authorized, nor will it confer any I~jal right whatsoever. DSD SIGNATURE [-" Approved for '~ Disapproved. Conditional approval for __ ~-~. · 0~,~ bedrooms. ~.. '. ~: ON-SITE ~ WATER AND bedrooms, wi~ ~e ~l~lng s~pula~ons:~ . WASTENATER , _ ~ ~ PROG~M .: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Manit~nance Agreements Supplemental Engineer's Reort Other Original Certificate Date: ~j' - / ~ - O I Municipality of Anchorage Development Services Department Bu~d~g Sa;e~, o~on On.Site warm & W~tewmr Program 4700 8oulh 9ragaw ~ P.O. Box 196850 Anchorage, AK g951g-~850 HEALTH AUTHORITY APPROVAL CHECKLIST LegalDes~lpflonYALU rUE ESTATES 1~2 SUBDM$10Ni LOT 17, BLOCK 5PorcellD: 015-123-40 A, W~LL DATA Wellqtpe ~ IfA, B, orCprovklePWSID~ ~ ~ Date completed ~ Wlre~ propedy protected (Y/N) ~ ~ to It. Casing height (above ground) In. FROM WELL LOG AT INSPECTION Stalic water level ~ J ~ g.p.m. /- g.p.m. WATER ~auMPLE RESULTS: Coliform colonies/100 mL Nltmte B. 8EPTIC/NOLDING TANK DATA Tank Type/Matehel STEEL Tankalze 1000 gal. NumherofComperlments 2 Founda~oncleanout(Y/N) YES Oepresslonovertard((Y/N) NO Date of pumping 7/16/2001 Pumper C. AB$OEPllON FIELD DATA Date Instelled 7/7/1975 Length 45 It. __ co;or..'~ IIX) mL 8/2/1990 For 3 bedrooms New depth 2.751n. 450+ g.p.d. ff yes, give date - Date of adequacy test 7/20/2001 Results(Pass/Fall) PASS Fluid depl~ In absorpllon flald pefom test DRY In. Water added **5239gat. Elapsed Time: 0 min. Final fluid depl~ 2.75 In. Absorpt~ mte >~ Any rejuvenation treatment (pest t2 mo.) (Y/N & q~Pe) NONE KNOWN ISTABALIZED O 2.75- OVER 450 GALLONS'II .10.5 lt. Eff. absorplJonama 450 ft' Mon~tube *YES Oepmsalonoverflekt NO *kO' I~ A 6- SUMP THAT ONLY ~XIF.,ND~ 25- BELOW THE IHVE,.RT.I ~PRE-SON~ ~ 4545 0N.,LONS ON 7/17/2001. ~oil rating (~ f~/bdml) 150 b-'~m type DEEP TRENCH Width 2.5 It. Gravel below pipe 5 Total depth C~eanoute (Y/N) YES High w~ter A+ HOME SERVICES D. UFT STATION Date Installed, Size In gallons ~ 'Pump on' level et In. 'Pump . High water alarm level at In. ~ Cycles tested. Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: PUBUC WATER 8epU¢ tank/lift eaUon on lot Absorption field on lot Publlo ~ewar main On adjacent lots Hokling tank SEPARATION DISTANCES FROM SEFrlC/HOLOING TANK ON L°T TO: Building ~oundaUon 5'+ Property line 5'+ Abeorpfion field 5'+ Water main lO'+ Water cen~:e line lO'+ Surface wate£ 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line. ' '"10'+ Building foundatlon lO'+ · Water service ilne , uNKNOWN Surface water 100% · ! i Curtain dl'aln NONE KNOWN Wells on adjacent lots, 2oo'+ 'F.: COMMENTS . Water main, 1 o'+ Driveway, paddng/vehlcle morage 25'+ G. ENGINEER'S CERTIFICATION I cerEfy that I have determined through field InspecSon~ end review of Munldpal recc~s that the above aysfems ere In ~onformance wfth MOA HAA guldeflnes In effect on this date. Engineer's Pd~ts~ N~ame Oeta JEFFREY A. GARNESS HAA Fee $ ~ Data of Payment Recalpt Number Waiver Fee $ Data of Payment, Receipt Number MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division . 825 "L' Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES ^ddre~ j~, //"/~/~a ¢'~ ~ ~'¢, ,~ ~ SEPTIC ABSORPTION Phone(s) P,rmi, NO.~'~ ~'~ NO. ~edrooms WELL Township, Range, Section AS-BUILT DtAGRAM (Show location of w~U, septic system, properly lines, foundation, ~/~ ~ /~ ~/ ¢ driveway, water bodies, etc.) TANKS 'i No, ol Compa~mems TYPE OF SYSTEM ~TRENCH ~ BED ~ W. DRAIN ~OTHER Depth to pipe bottom from Total depth from original grade FT FT ~ * - Gravel length ~th ~ FT To(al absorption area~ Distance betwee~ lines SQ FT FT ~' / Pipe material Num/berolh~ Soilratiflg S~ FT WELLS ~ PRIVATE ~ OTHER Jldentilvl InstaUer ~staned: I ] ~ ~ C, ~ J, J Z codify that Ihis inspe.ion was pedormed according to ag o Municipal and State guidelines in ellect on this dale.. / · 72-013 (3/85) D~epav'(.m~-~!YL o~' Health 1!~,~i!5 L.. St..r'e~&~ Ar!ci'ic, r. age, Alaska 99501 T A N K I::' E R M I T BILL & MARY MARTIN 690:i. CROOKED TREE DR]]VE ],? BiLock: 5 iiii:Z!;:;'TLlZC 'l ANK:: M:L n :i. mum tel'La ]. sept ic tan k c;apac i ty :i 1 ~, ()00 gal l~::i~'t~ ~ Eac;h ~i~:~ ~. i(;:: .I CI}:I::;:'I]:i:::Y '[HAT.'.' [c:,v'~h by tl-i(~ l~!Lu-i:i.c:i, pa],;i'l:.y ol Anc:l"lcir. agez, (MOA) al-id '~.,l-l(~ St. ate of A],a~T~ka,~ ;.,?,,[ ~,,~:i.:ll :ins'!,a:l,l ti'ii,,.: sys'L[.:im icj ac:cc, r'clai'ic:e ~n;i.'Lh ai'p::l :ii'i cl:)mp],iaric:e ~,~,~:i,'(.l-i ti]G) design ci"i?.ep:i.a of this per'mi'L~ :.::;,, ii; L,~:i.]l.:l, acilti~-~r'~,~ t,c~ all MCiA and State c~!' A]i.a~d:;a i'ecluil~ements (cir. t.t'l(~ set back 4. [ und,:,};,r'!~Lat'!d that this pei"-mit is valid ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 SHEET NO. / OF CHECKED BY DATE SCALE GRE/i'% R ANCHORAGE AREA Department of Environmental Ouality 3330 C Street Anchorage, Alaska ggS03 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION MAILING ADDRESS ~'?()' [~£)X ~.~,~.~'J ~/*~'/~/~/(" PHONE LEGALDESCR,PT,ON X/'; /7 fi// 5- F,'d, SEPTIC TANK: DISTANCE FROM WELL /(',~,, I ,.,.~_ INSIDE LENGTH NUMBER OF COMPARTMENTS INSIDE WIDTH LIQUID DEPTH LIQUID CAPAdlTV TILE DRAIN FIELD: DISTANCE FROM WELL_~'~ I FOUNDATION /g) I NEAREST LOT ~LINE /~-~ / oFTOTALLINEsLENGTH/'/~- NUMBER OF LINES / DISTANCE BETWEEN LINES /t~/I/~' TRENCH WIDTH,-'~IN. TOTAL EFFECTIVE ABSORPTION AREA &Y'5'0 SQ. FT. LENGTH OF EACH LINE ¢/'5' ) .~ DEPTH OF FILTER DEPTH: TOP OFTILE TO FINISH GRADE ~ ) MATERIAL BENEATH TILE ~ IN. ABOVE TILE // IN. WELL: TYPE ~t~]~ ~'Jq CONSTRUCTION ,DEPTH BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE SEWER LINE TANK , SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCE FROM: DISTANCES: SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE: REMARKS: Form LQ-032 DIAGRAM OF SYSTEM DATE 7',7°/~,.~"~PPROVED G,A.A.B. ~ . GRE/. -"R ANCHORAGE AREA BOF ,dGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3350 "C" STREET ANCHORAGE, ALASKA 99905 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO. SOIL TEST RESULTS /~(O [~ Z J~6~4v ~' NOTE, THIS PERMIT IS NOT VALID WITHOUT ~OIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY TH, E DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION, MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK ~ / FOUNDATION TO SEEPAGE~F ~ DRAIN FIELD SEPTIC TANK TO SEEPAGE ~-WALL TO WELL TO SEPTIC TANK ~ SEEPAGE pet CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL ] CERTIFY THAT ] AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORD[NANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. I also certify that this home will contain a maximum of three () bedrooms. I understand an~l~pgrade would be necessary should more bedrooms be added. DATE DEPTH in, FEET ' .... SOiL ~SCtl~PT~©~ .. FROM TO B~TTOM 'rEST HOLE : ~FT REMARKS: FROST LINE: ~*e FT ~' 5VATERLEVEL: - S.A. m ~ ~ ~ DRY GROUP OTHER APPLIC-NT FILLS OUT UPPER HAI'-'~ ONLY Phone Mailing Addre~ ~ Zip Code Buyer [x~] ~ Phone ' ~ ~ ~ ~ Zip Code : RealtyCo.&A~nt CC.~a~Of ~ T',.' ~ ,, Time Time Time Time Date Date Date Date ~- Inspector Inspeclor Inspector Inspector (~) APPROVEDBEDROOM?~- ~~ ~' .COND~2V-~ ~ ) ~,~..~ov~o ~ ) co.~,~,ON~ ~...ov*~' BY: Soils Rating Date ~wer Installed Well To ~sorption Area Well Log Received Well to Tank Septic T~k Size 72-023 (3182) August 15, 1983 Merrill Lynch Relocation (Van Dusen) Subject: Lot 17 Block 5 Valli Vue Sub. ~2 Approval for the individual se~er and water facilities cannot be granted until the follo%~ing items have been completed: o The septic tank pumped with a receipt submitted to this department. The total number of gallons pumped needs to be ~< on the receipt and verified by a registered engineer as to ~he actual number of gallons pumped. This is to verify the ~-~'~size of the septic tank. An adequacy test needs to be performed on the existing leaching area. This test %~ill determine if the system is adequate according to National Standards. A listing of r ~ the test is enclosed. This report private firms performing needs to be submitted to this office for our review° Please notify tbis Department for a reins~ection when the noted discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. Sincerely, RP32/p/E Enclosure Robert C. Pratt Associat~ Environmental Specialist APPLIcaNT FILLS OUT UPPER HA~-~'~ONLY Ma~ing Addre~ ~/, ~/ Zip Code Lending Institution ~;~ /~ ~ x e "- ~ ~: ~ ~.//~ ~ Phone /x ~ ~ ~'~ Phone Street Locati~ ~ ~ Single Family ew~,r Disposal Time Time Time Time 72.023 (3182) ALASKA e JlROnmenTAL CONTROL InC. ~' ~n§in~¢rin§ $ ~nuironm~nlal $1udi~s R.B. VIC KERY SRA BOX 33-A ANCHORAGE AK 99507 01/28/83 SELLER - R.B. ¥ICKERY BUYER~PETER VANDUSEN SUBDIVISION-VALLI VUE ESTATES#2 BLOCK-5 LOT-17 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A ABSORPTION SYSTEM WITH AN UNKNOWN AREA. THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 900 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 4 BEDROOM HOME. SEPTIC TANK ADEQUACY Clean out leading to septic tank is crushed. or verify the size of the septic tank. I could not pump January 14, 1983 Peter A. and Mary L. Van Dusen 6901 Crooked Tree SRA 33-A Anchorages AK 99507 Subject: Lot 17 Block 5 Valli Vue Estates Subdivision No. ii Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: o The septic tank pumped with a receipt submitted to this department° An adequacy test needs to be performed on the existing leaching area° This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this office for our review. Please notify this Department for a reinspection when the noted discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. Sincerely,/~ ~m Roberts Associate Environmental Specialist JR28/p/EH Enclosure January 14; 1983 Robert B. and Margaret L. Vickery SRA Box 1612 Anchorage, AK 99507 Subject: Lot 17 Approval for the be granted until Block 5 Valli Vue Estates Subdivision No. individual sewer and water facilities cannot tile following items have been completed: rChe septic tank pumped ~;ith a receipt submitted to this department. An adequacy test needs to be performed on the existing /~ leaching area. This test will determine if the system ls adequate according to National Standards. A listing Of private firms performing the test is enclosed. ~'his report needs to be submitted to this office for our review. Please notify this Department for a reinspection when the noted discrepancies have been corrected. If ~here are any further questions, please call this office at 264-4720. Sincere~ ~Jim Roberts Associate Environmental Specialist JR27/p/EH Enclosure GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received March 30, 1976 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Conv. 1. Approval Mailing Address: 2. Property Owner: Mailing Address: requested by: First National Bank of Anchorage Post Office Boxy720, 99510 Timber Enterprises Phone: Phone: Post Office Box 3351, Anchorage 99510 279-4481 x 223 349-1922 Legal Description: Lot 17 Block 5 Valli Vue Estates Location: 6901 Crooked Tree~i' Type of facility to be inspected Single Family Well Data: No. of bedrooms A. Type Community System B. Depth C. Construction ~ D. Bacterial Analysis Sewage Disposal System: On-site system. A. Installed B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank , Absorption area , Sewer Lines , Nearest lot line , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages Page 2 of two] pages - Re~ .st for Approval of Individual . er & Water Facilities Legal Description Lot 17 Block 5 Valli Vue Estates Comments Approved ApplDisapproved Date ~-~'/~ Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ,034 (1/74) 1. Type of Inspection: 2. Property Owner: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 -- 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES CMRO Timber Enterprises VA FHA CONV xx Mailing Address: P. O. Box 3351, Anchorage, Ak Day Phone 3. Name of Buyer: Robert Bruce Vickery and wife, Margaret L. 349 1922 Mailing Address: 4873 Weselyn Drive, Anchorage, AkDay Phone 337 2990 / 278-2611 4. Name of Lending Institution: The First National 'Bank of Anchorage Mailing Address: P, O. Box 720, Anchorage, Alaska 995]Ophone 279-4481 x 223 5. Name of Realtor or Agent: Area Realtors (Ann Marie Bentley) Mailing Address: 3300 "C" Street- Anchorage, Ak Phone 278-2525 Legal Description: Location: Lot 17, Block 5~ Valli Vue Estates 6901 Crooked Tree~.Anchorage, Alaska 99504 7. Type of Facility to be inspected: 8. Water Supply Type of Supply: Public Utility c0mmunity If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation Individual Individual (on-site) mep~m mystem single family residence No. Bdrms. 3 EQ-037 (1/74) 3/24/76 do