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HomeMy WebLinkAboutEAGLE RIVER HEIGHTS BLK 2 LT 46EPAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM PERMIT PERMIT NUMBER:SW960020 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:K & K INC OWNER ADDRESS:10021 WILDWOOD ST EAGLE RIVER, ALASKA 99577 DATE ISSUED: 2/15/96 EXPIRATION DATE: PARCEL ID:05028157 LEGAL DESCRIPTION: ~AGLE RIVER HEIGHTS.BLK 2 LT 46E.~ LOT SIZE: 11442 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS pERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) - (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. i OF 2/15/97 1 SPECIAL PROVISIONS: DATE: PATE: PLOTPLAN Y- ASBUILT SCALE ~,'~o' GRID NvJ ~ Project No. 1731 George Bell Circle ~,.~1]~.'[!~1{~ G~, ~~ ~'~' Anchorage, Alaska 99515 (907)345-6476 Dated this thc ~Day of_ ~U~ , 19 ~U, at Anchorage, Alaska · , ...... ' . It is the responsibility of the owner to determine thc cxlstcnce of any easements. ~; "'. -.' "..:,~.~ covenants, or restrictions which do not appear on the recorded subdivision plat. '~,.['" · OWNER O~LAND P.3 . .., ;. ADDRESS . · , ,..., '.' · · ~'r£.sm~,~ . . ~ . .. .." '. ..... .~',,.~ · ~'., - ' ; ~ ' ~ ' ".'~ ' : ~'.KiNDOFCASIN~.~ · . .. .. . . lffHUMBER = ~ ' I~ · .:'" ' .'..'~. · · i:: ., ~..: PE~ - ... . ,'. · .. .~ .... ,..... '.' · '. .. - ..' ' :...~.. ' -'," '~ ~" ,'. I'.... · ;.~::~'~"~-,:~.' '~~~'"'~ ..... . u~o.o~ ~o~ON: ,~.' ~ · · ...~. _. :-' .. ·" '.. .... '~.' ' ~ " ~ '' ~d~ ~1~ ~ · From_ .FLto, --~t._ c.~ 7) Ft. I~ ~t.~ ' ~ · ~;~ · · ' ' ' · · ;.~. ~ / ' ': '.~--~ ~O~ ~ · ' ' From ~ft. to~ .... ~som ~ ' .F~.to ~ .-~t. '~"~ ...... .'..~ ' .. · . ~ ' Fro ~t. to I.~' - · ' : ' · : · a . - -- '- '. a.' · ', .: ~ - ,. Ft. to .Ft~ ' ~ 'q - '/~LA~ , ~.~ ... ~to?~ . . - ..... . ' Ftom~ ~ Ft. to ~ Et._ ~/ . -- ....;,,~_. ~/:~, .,.,_~.., . . . ... ., " ,'.' ., . I~ .e.,L~O"~t ~1~ / o~ , ' ~. ~ ..... ~::., . :~ .~. - . , .... '~m~ v~** ~"'~ · · ', ~ .~.: e'*'~."' - ~'~ ~.-'' ;'3".' ' . - . -", ' "' . .~ ~..~ ~/. ~t. t I~l' ~' . · ..... ., ..... . .... .~.,~. .. .' ' ~ ,'.". ~.~ ~ ..._~ ~,.. ~ ~.~.., .~ .;~e~,.m, . . · ~ .~ · ~- e~ ~ ~t' · ~ ~t s -s · . ' ' ;' . ' " '. ' .... ...... ~ ~0 &ga~ ·... F,o,~... ... ~l~ .r~ ~ ~ , _ . .... · . . ... - ; · .. e, " ,." ' · . . .. ./~~ ftom_ Ft. to Fi, '~ - - '" ' ' · .' ·" · . · · ' · a.. F~om · Fl. te~ .=r From. _~t. le 'F~ ' ' . -~ ' '-. ' ' . .. · '; : '"' ' - -' ' From " :fi. lo , FI. , ' " from_ .~t. to~ FL_ · ' .. t- ~-~ '~ .&~Z-.~...-*~rFt~ ~'"'F~,lto3'T'-:~t'~ "' · · ,. '. .... Fgom~' .~t.'to '~' ~ Ft,:r .... ~ "'~' '' .~ r - . : .' · Ftom~ FL lo -Ft.__ ' , . .. . · . Flom: -~t.. la_ .~ ~ . , " ' ' F~om ', .Ft. from_ Fi. I~ -TI. . : · '.' '. ~m_' F~om~ --Ft. to .Ft. From .Ft. ~o , .Fi · ' ' ' U~' ~ 1~7"' " ";~' " " 0 ' ~ " : ' D~pt. H~al~h & Human ~o~ice~ .. Parcel I.D. 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 . CERT F CATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING H~ # GENERAL INFORMATION Complete legal description Location (site address or directions) .x ,~ a .~ ,* ,:,..,; c~.,~,...,~.z*, ~-.,,,.-'~, Property owner Mailing-address Lending agency Mailing address Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: '-~ TYPE OF WATER SUPPLY: Individual well NOTE: community well Public water If commUnity well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. ' .,e" ' '/' ' 4. TYPE OFWASTEWATER DISPOSAL: Individual on-site Holding tank ' Community on-site NOTE: Public sewer if community waste~water 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 Invesfiga!ion pf this Health Authority Al~proval application shows that the on-site water supply and/or wast'e,~,~ter diSl~OSal system is safe, functional and adequate for the number of bedrooms and type of structure Indic,~ted herein. I further verify that based on the Informat on obtained from the Municipality of Anchorage files and from my investigation and Inspection, the on-site water supply and/or wastewater disposal systemis in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this Inspection. Name of Firm Enginesr's signature .'~ .~._~ DHHS SIGNATURE ,' ~' Approved for -~ Disapproved. Conditional approval for bedrooms. Date 5' ~ '~'~'~ bedrooms, with the following stipulations: Additional Commer~te-' The ~ell for thf. s propert7 meets existtn~ State and Nunicipal Codes. '-~here a~e n~t~ates p~esen~. [~ ~s continued suitability. Nitrate concentration is 6.69 mg/l~ EPA .B~'/ /~~- ~~ ...... Date ~ -/~-~ - The Mumclpahty of Anchorage Department of Hea th and Human Services DHHS Issues ;.., ~-: .... - ,,, . ( ) Health Authority Appro. val .Cer~mcates;based only upon the representations given in paragraph 5 above by an independent prof .eSSio~?, engin~r~g stered ntheStateofAlaska. The DHHSdOeSthisasacourtesytopurchasemofhomes and thei[ lending In{titutions i~ order~to satisfy certain federal and state req uirements. 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 pmfe~sion~l 6n~gineer's ~or~. ...... ENVLII~eI~AL SERVICES DIVISION Municipality of Anchorage MAR 19 1997 DEPARTMENT OF HEALTH & HUMAN, SERVICES '" Environmental Services Divis,on ~ ~-~4D 825 L Street, Room 502 · Anchorage, Alaska 99501 o~ Health Authority Approval Checklist Legal Description: ~- ~'*'~ -'~',~ ~. ~"..,.~-~,<..~,~,a-~ ,~,/"~".~. Parcel I.D.:. A. WELL DATA Well type '~:~"~'~"~' Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number -- Date completed ,~/'~'~/v' / ~ Cased to /~ ~ ~'/ Casing height (above ground) -~ ~' ' ~/- Wires properly protected (Y/N) )/ AT INSPECTION Date of test Static water level Well production FROM WELL LOG ~-~ g.p.m. ',~-.-'"'~ g.p.m. WATER SAMPLE RESULTS: Coliform . Nitrate Date of sample: -~"~'.~' ~'~-~, "~'~' SEPTIC/HOLDING TANK DATA Date installed Tank size Other bacteria Collected by: ,~"".<~"z:~ ~?--~. . Number of Compartments .~ Cleanouts Foundation deanout (Y/N) Data of Pumping ABSORPTION RELD DATA Date installed Effective absoq~lon ama Date of adequa~ Depression (Y/N) Pumper Soil rating (in.); (ins) Minutes later: P~roxide treatment (past 12 months) (Y/N) Hlgh wateralarm below pipe present (Y/N) Immedlatoly atter Absorption mm = If yes, give date 72-026 (Rev. a/ge)* Ce System type Total depth Depression over field (Y/N) __ For_ gel. water added (in.): g.p.d. D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at' Size in gallons 'Pump on" level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ,~"/~ Absotpfion field on lot Public sewer main /~ Sewer/septic service line On adjacent lots On adjacent lots Public sewer manhole/cJeanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: R Foundation Property line Absorption field Property line Surface water Water main/service line Surface water/drainage Wells on adjac~ SEPARATION DISTANCE FROM ABSORPTION FIELD O1~1 LOTTO~ nveway, Water main/service line parking/vehicle storage area Wells on adjacent lots ENGINEER'S CE~'I IFICATION ~..,~.~.~.\\% I cerfify that I have determined thru field ins ons and review of Municioal · ..L..I,:. Data Receipt Number o,~-J,~.~--~ ('/~'-~"~,O~'' ) Receipt Number 72-026 (Rev. 3/96)* CT&E Environmental Services Inc. Laboratory Analysis Report March04, 1997 Douglas .K. enley Douglas Kenley P.£. 7920 Houeysuckle Dr. Anchorage, AK 99645 Cl~em N~ne Printed Douglas K.e~ley P.E. Lft 46E BK2 Eagle Heights [971003] March 04. 1997 Enclosed ale the analytical results associated with the above project. · b the state of Alaska and thc USE'PA. a fotaxtal Quality Assurance/Quality Control Program .As requa.ed y , ,.,.~ n.~ 'tv Control Manual that outlines this program is available ~s maintamcd by CT&E. A copy of ,,,~ ,,~,.ah.~ al your request. Except as specifically noted_, all. statements aa_d, data in dds report are in conformance ~o the proe.sions set forth in our Qua, ty t~ssmrance rrogram Plan. If you have any questions regarding this report or if we can be of any other assistance, please call your CT&E Project Manager al (907) 562-2343. The following descriptors may be found on your report which will serve to further qualify the dam. U - Indicates the compound was .a,~1...F~-d. f?r bu_t ~n.ot d??c. ted.-ter J - Indicates an estimated value lRat tails OelOW FtfL, I)Ul 15 g~ca than the MDL. B - ladicate~ the m~alyte is found in.t.he .b, lagk associated with the $al~ple. ~' - The analyte ha.n exceeded al]owa~le irrupts. GT - Oreater Than D - Secondary Dilution LT - Less Than ,<,'. 200 W. Pot~er Drive. Anchorage, AK 99518-1605 --Tel: {907} 562-2343 Fax: (907) 561-5301 " 3180 Pager Road. Fairbanks, AK 99709-5471 ~ Tel; (907) ~,74-$656 Fax: {907) 474-g655 ENVIRONMENTAL FACILITIES IN ALASKA, CALIFORNIA. FLORIDA. ILLINOIS. MARYLANO. MICHIGAN. MISSOURI. NEW JERSEY. OHIO, W~ST V~RGINI O~,~O.~,9T 15:~9 CT~C ESI ~SHORAGE  Fnvlro,mental Serv~ci4 Inc. CT&E CT&E Ret.# C~ Name Project Namel# Client Sample ID Ordered By I'WSID ~71003001 Douglas K~-uley P.E. LoI 46£ BK2 ~r~:le Hdghm Lot 46E BK2 ,~agIc Dtiukiug Water Clle~l PO# P~l.ted Date/Time 0110419'1 08:40 Collectedl)~eYllme O~.t.Vll~rl 11:1,5 R~v~ Date/~ ~7/97 13:30 T~h~l ~t~or: Sigher C. E~ #ftrate-N Total Colifor~ 6.69 0 I~L Unit~ #ethod 0.500 eg/L rdqlB &500-NOSF cot/1O0~L SWI8 9227.8 At tos, able Prep 10 max 02/27/~7 E'~B 02/27197 ~ CT&E Environmental Services Inc. Drinking Water Analysis Repog for Total Coliform Bacteria :oo w. ~o..r o,i,, Anchorage. AK S9S18.1605 R.~4D LViT, RUCTION$ O.v ~..EV£J~C£ $ID£.BEFORE. COLL£CTL','G iAMPLE Tel: t909} S62-laa3 Fax: (90~) 561-5301 ~ST BE COMPLET[D ~Y W.~TEK S~PLIE~ TO BE COMPLE~D ~Y L~O~TOKY PUBLIC WATER SYST£1H I.D. PP, IVAT£ WAT£R iYSTK.~! Day Year SAMPLE DATE: Month SAMPLE TYPE: o Repc:~! Sample (for roulin~ $ample with lab roe ~o. O Special Purpose Time Collecled Collected By S.-xMJ'LE LOCATION Analyais shows this Water SAMPLE t£ be: iatliracto,-,v. Unia:iafacto~' Samp[e over 30 hou~ oM. relults may b¢ unrcli~bl~ O Sample too Ion~ in transit: sample should not be over 45 houri old at examination to indicate reliable results, please scad new ~ample via $p<ial dcli~c~ mail. Date Rcctlvcd ~/~ Time Received ~ '~ A~alytlcal ~lgLhod~ Mcmb~n¢ Fihcr ' Humber of~oloai~dl00 mi. Re~ul~* Analyst _1 [97.1003] ~ ~t,~ BACTEI~IOLOGIC.~-L WATER ANALYSIS RECOP,.D bh%lO*bll, lG Result: Total Coli(orm . . , ' Ver[~c2don: LTB gGg £. Ctdi Colonies/tOO mt CO LI FIR,',I ¢olifol'm:100 mi 3-~-¢q ~,m, /0~-~/ ,,,, PART ONE OF' 'l",b'o ' F~B ~G ~97 09:i9 R~X OF DAGL~ RIVR PLOTPLAN ASBUILT ~ SCALE J'"f°~ GRID H~ 6=5 Pro[oct No. ~ 1'/31 George Bell Circle j.~kf,.i:!~q~' P. ecordln$ District, Alaska. Sad ~a~ ~ ~provcmests tltuat~d ~ ~... .~ *~ ~ thcrcOn are within th~ ~ropcrty lln~s and do not ~ncro~Ch o~to the ~ropcrty Idj~¢e~tthereto, th~tsoimprovementsont~e~ro~crtyl~inGsdjacantth~rcto ~v~. ~..~ .~ -- *t ~>.........'i~ DATE SCHEDULED I I . TIME SUBDPaS~O~ EAGLE R~VER HEIGHTS · ~ISPECTOR BL,V~I-T/TRACT BLK 2 LT 46E INDICATE NORTH Ig 17E MAIN: ITYPE MAIN; I DEPT AT t,,tAIN: 'PROP. UNE: CONNECT LOCATION: COMMENTS INSPECTED BY: INDICATE NORTH I ~-. EAGLE RIV£R BO+O0 END CONSTRUCTION , r..'.~..~, 1170,5