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