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Home My WebLink AboutEAGLE CREST #1 TR A LT 77 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. # ~:~_Z..~-~ ,. ,~,~'~1.~. ~::)t.,~ HAA # GENERAL INFORMATION Complete legal description Loca,on (s.e address or direc.ons) Prope~ owner ~D~ ~ Day phone Mailing addre~ Lending agency Day phone Mailing addm~ ' Agent Addre~ 3. e 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. 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 ~he vaiidation date shown'i~elow, I verifythat 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 ~ompliance with all Municipal and State codes, .... b~dinsnces~ and regulations in effect on the date of this i~lJ~:~dti~n~ '*"1_7 ...... ;' .............. KND Engineering .... -'16~6-611 I Name Of Firm - ..... *' Phone' '20441 Ptarmigan Blvd:i Eagle..Riv6r, AK 995.77.-', ,-":':',- ': .' Address · ' Date :The MuniciPality of ArTchorage Department of I-leal~ and Hum, an Sewicss (DHHS) issues Health Authority Approval CertificateS~based only upon the representations given in paragraph 5 above by an independent professional engim~,r registered i~ the Si~ of Alaska. The DHHS does this as a courtesy to purchasem of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze date 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 dUN 3 0 F)99~ DEPARTMENT OF HEALTH & HUMAN SERVICF-~op~ Environmental Services Division ~NV~K~ia~ 825 L Street, Room 502 · Anchorage, Alaska ggs01 * (907) 343-4~i~1' Health Authority Approval Checklist If A, B, or C, attach ADEC letter. ADEC water system number y FROM WELL LOG g.p.m. Casing height (above ground) "/ Wb p obe,Vp,ot ed (Y/N) Y AT INSPECTION Nm-ate A. WELl DATA Log pmseht (Y/N) Total depth Date of test Static water level Well pn~ucfion WATER SAMPLE RESULTS: B. SEPTIC/HOlDING TANK DATA g.p.m. Date installed~ ~ank size /,~'"~ Number of Compartments ~ Cieanouts (Y/N) . Foundation cteanout (Y/N) y Depres4don (y/N) /~/ High water aJann (y/N) ~,~ Date of Pumping ~,..~. c/p Pumber ~..~ C. ABSORPTION FIElD DATA Date installed ~ Soil rating (g.p.dJfff or fl~odrm) Effective absorption area Fluid depth in absc~Won field before test (In.); Flutd depth / 7~/~-' (ins) Minutes le~c Perax~ tTeatment (past 12 montl~) (y/N) /~'/~ Gravel thick~ below pipe Monlteting Tube present (Y/N) '~ Results (Pass/Fall) ~$ ~ For ~ Irnme~ately afler~, water ack:led (In.): TOteJ depth UFT STATION Date installed / Size in gallons //' CycJes tesmd E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot /C)C:) ~ Absorption field on lot /~)C> ~ 4- Public sewer main /~) / Sewer/septic sewice line ~-~) "~ On adjacent lots On adjacent lots Public sewer manhole/cleanout ~ station SEPARATION DISTANCES FROM SEPTIC2HOLDING TANK ON LOTTO: Foundation /C~ ' ~' Pro~en'y line /(~ L+ Abserptionfleld Watermain/sewicellne -/~ + Su~lacewater/dminage /~)~) + Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION RELD ON LOT TO: PmpertTilne /~) '+ Building foundation /C) ~+ Watermain/sewicellne Su~ace water 1~)~) ~ -t- I~flveway, paxtdngNehicle storage area Curtain drain IDD ['~ Wells on adJacem lots /~) ~,,.' ~+ /O Lp R ENGINEER'S CERTIFICATION in cortfo~ w/th MOA HAA gutdellne~ in effect on Ibis date. Date of Paymem ~ ~.~~ Waiver Fee $ Date of Payment Receipt Number. 72.o26 (Rev. ASBUILT I HEREBY CER~FY .THAT I HAVE SURVEYED THE SC~E, ~~.~~FOLLOWING DES~IB~ PROPERS, , ~AT NO ~HME~S EXIST ~CE~ AS INDICAI~D. IT IS THE R~SIBILITY OF THE - ~ ~ D~ERMINE T~ ~ISTEN~ OF ANY ~ID, ~ ' '" ' ~1~ DO N~ ~R ON ~E RE~ ~DI- VISION ~T. UND~ NO CIRCUMSTANCES S~ 'FB: 't~}.. ~-691~ .."~ ~ DATA H~N BE US~ ~R ~N~U~ION ~'~ A~OF ~LiNES.LIN~, OR me E~LISHING ~ND- zt__.CT&E Environmental Services Inc. CT&E Ref.# 992478001 Client Name KND Engineering Project Name/# N/A Client Sample 1D Eagle Crest Blk A Lot 77 Matrix Drinking Water Ordered By PWSID 0 Sample Remarks: Client POI Printed Date/Time 06/10/99 12:20 Collected Date/Time 06/03/99 I I:00 Received Date/Time 06104199 14:05 Technleal Director: Stephen C. Ede Parameter ResuLts PQL ' Units Atltmabte Prep Analysis Method Limits Oate Oate Init Total CoLiform NItrate-N 9 08/100 ~Lw NO COLI 0.500 U 0.500 eg/L SN18 9222B 0610(,199 rAP EPA $00,0 10 max 06/0~/99 06104199 SCL RECEIVED JUN ,30 19 9 Municlpahty ot Anchorage Oept. Health & Human Services MUD RECORD FORMATION D,~ILY DRILLIN8 REPORT ~°"'"-"°" ' , ~ DAILY DRILLING REPORT HRS, DE~ARTI,~NT OF HEN.TH & ~RONMENTAL PROI'ECT~N CERTIFICAT~ OF INSPECTION ON~ITE SEWER AND WATER FACILITY Lot 77 TraCt A Eagle Crest Sub. I', UI · APPLIC"NT FILLS OUT:UPPER HA~'' ONLY Buyer Type of Resl~nce Single Family ~ Public Utility ~wer Disposal ~ Holding Tank ~OTE: T~PE~ION ~E MUST ACCOMPANY EACH RE~EST BEFORE ~ESSING CAN BE INITIATED. Time line ) Time Time D.,. r ,~ D.,. / V~ o.. ~ ~/. o.,. , / -- ( ~ ) APPROVED ~DR~MS u 'CONDITIONS OF APPROVAL ( ) DISAP~OVED DATE INSPECTOR INSPECTION_ APPOINTMENTS D, _Z RECEIVED TIME TIME MUNICIPALITY OF ANCHORAGE E~IRONMENTAL p20~ECTtO~ DEPAR~E~ OF "~L~ & E~IRONME~AL PROTECTION ~s~-*~,~, AUG ~ 2 1981 E~IRONMENTAL S~ITATION DIVISION RECEIVED REQU~ FOR ~PROVAL OF INDIVIDUAL WATER ~D SEWER FACILITIE~ )IRECTIONS: Complete ell parts on page 1. In(~m~detJ req~e~t~ w~ll not be i~mte~Jl. Pie~e ~llow ten I10) days for proc~iflg. ~A ILI N~ A~]IDR ESS ~,~ .,.. ..O.E_ 44 7. WATER SUPPLY r--1 INDIVIDUAL' q I-'] COMMUNITY r'l PUBLIC UTILITY 8. SEWAGE DISPO~A~ SYSTEM ·[] INDIVIDUAL/ON-SITE" [] PUBLIC UTILITY [] O~e [:::] Four [] Other [] Two [] Five Three r-I Six · ATTACH WELL LOG. A well tog is required for all wells drilled since June 1975. For wells drilled prior to that date, 91ye well depth (attach log if available.) .YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY, , 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE r-I OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED [] PUBLIC UTI LITY Connection Verif~l ' - INSTALLER i'-ISept;c Tank or I'"lHolding Tank Size: If Tank is homemade SOILS RATING 9;ve dimensions: TYPE OF TANK ~ ~ MANUFACTURER TOTAL A~SORPTION AREA MATERIAL Se~tlc/Holdlng T,a nk [Absorption Ar ee ' IS~*r Li~e I Na~r~t Lot Line 4. DISTANCES / ~ · Absorption Area to n~ l*J~t ~ '~ "APPROVEDFOR 3 BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED 72.010 (Rev. 6/'/9) EXCAVATION ROBERT A. SHAFER WORK CIVIL ENGINEER 694-2979 September 17, 1981 Century 21, Heritage Homes ATTENTION: Dottie Harness 207 East Northern Lights Boulevard Anchorage, Alaska 99503 Dear Mrs. Harness, Reference: Lot 77: Eagle Crest subdivision A sewer system adequacy test was performed on the system located on the referenced property, as you requested. The septic tank was pumped and verified to have a capacity in excess of 1000 gallons. The seepage pit was charged with approximately 700 gallons of fresh water and after a period of 24 hours approximately 606 gallons had percolated out of the crib. It can be concluded from this test.that the waste water disposal system serving the three bedroom residence located on this property is currently functioning adequately. However, the system cannot be guaranteed against subsequent failures. If we may be of further assistance, please do not hesitate to call. Sincerely, cc: clint Conover Home Federal Savings and Loan Municipality of Anchorage Department of Health and Enviornmental Protection SRB 196X EAGLE RIVER. ALASKA ' '/v un icipali Anchorage 825 "L' STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GIJO¢IGE M. SULLIVAN, MAYOR OEPA~qT,%IENT OF HEALTFI AND £NVIRONMENT~XL PItOTECTION August 14, 1981 (2) (3) Mary Lea/Clint Conover % Dotti Harness . Century 21 - lleritage Homes 207 East Northern Lights Boulevard Anchorage, Alaska 99503 Subject: Lot 77 Tract A Eagle Crest Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. Expose the septic tank manhole to verify the tanks existance. The septic tank pumped with a receipt submitted to this office. The total number of gallons pumped need to be on the receipt and verified by a registered engineer as to the 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 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. If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw ~-,,~4UNICIPALITY OF AN£HORAGE,'"'~ DEPARTMEN', JF HEALTH AND ENVIRONMENTA_]PROTECTION 825 L Street, Anchorao~. Alaska 99501 \"~'c,~,~.' ~64-4720 .Date Received: April 20, 1978 ~1: Time 2:3%~.m. #2: Time ~ll',l-~ ~n% ~3: Time 1/ Date 4-25~78 Tuesday Date ~l-~l~-~? ! ,DFC/ Date Insp Pratt ~ Insp ~ .~,mC Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: 'Mailing Address: Phone: 2. Property Owner: Leroy Alward Phone: 694-3139 J Mailing Address: Box 1002 Eagle River 99577 Legal Descriptibn: Lot 77 Eagle Crest let Additionj})?~ 4:. Single Family Residence: Number of Bedrooms: Three Multiple Family Residence: ( ) Number of Bedrooms: Well System:' Permit # Construction Individual Well W~ Community/Public System ( ) Depth of Well 352' Well Log on File Bacterial Analysis (x) Sewage Disposal Permit # Septic Tank Size Absorption Area System: Installed 1974 Installer %~k~'~ Manufacturer ~u~$~ Soils Rate Material On-site System ~) Public Utility ( ) Distances: Well to Septic Tank ~OO to Sewer Line Nearest Lot line to Nearest Lot Line to Absorption Area \~ Absorption Area .% ?oo ,v~-- P "' i ~ ~INICIPALITY OF ANCHORAGE ' t ,,,,v · ~O~ !. Department of Health and Environmental Protection ~ ~./o~-~.~/' ' 825 L Street, ~chorage, Alaska 99501 ~-~ 264-4720 ~ ~quest for Approval of Individual Sewer and Water Facilities' ' ' me Property Owner: Mailing Address: Name of Buyer: Mailing Address: Phone: Phone: ® ® Se Lending Institution: Mailing Address: " Phone: Realtor/Agent: ~f~ Mailing Address: Legal Description: 1.)~ Street Location: 6. Single Family Residence: (~'~Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: e Water Supply: * Individual Well (b~' Public/Community System If Individual Well, well depth _~___~ If Community System, name of system ( ) 8. Sewage Disposal System: *~n-site System (~''Public System ( ) If On-site System, date of installation: Z~_]~ *NOTE: A well log is required on ALL wells drilled since 6/75. ** If on-site sewer system is over two(2) years old, an adequacy .test is required by this department. A fee of $25.00 must accompany each request before processing can be initiated. 3/77 Department of Health'and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 77 Eagle Crest, 1st Addition Comments Affadavit Attached7 ) Letter Attache._d: ( ) k'pproved: .~" ..,///~ ' Da'te: .~ - ~)" Disapproved: Date: bepartment Worksheet: