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Home My WebLink AboutNORTH WOODS PHASE 2 BLK 4 LT 1Northwoods Block 4 Lot I #051-741-36 · ' ;~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ~NEW MAILING ADDRESS LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS Dwelling ~ PERMITN~ ~ ~ Manufacturer Material / No. of ~mpartments Liquid depth Liq. cap~ity in gallons Inside length Width ~ /~¢O IF HOME'DE: Well Dwelling PERMIT NO. DISTANCE TO: Manufacturer Matorial Liquid capaciW in ~ DISTANCE TO: Foun¢i; Nearest lot lin, PER~T NO. Trench wi~ ~ ~ ~ Too of tile to finish ~raOe Material beneath tile Total offafitive absorption ~rea Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: ~lass Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: ~ Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOILiNsTAELERTEST RATI ~¢/O~ ~2-~ X ~em REMARKS t ~ APPROVED DATE LEGAL 72:013 Rev. 3/78 PERMIT NO. ] [)EPRRTMENT Or HERLTH AND ENVIRONMENTRL H,..OTECTION ,32...ff "L"' STREET., RNCHORRGE., RK. 99501 264-4'720 ( 83:063:6 ) APPLICANT LOCATION LEGAL HRMRNN CONST NORTHWO0[:, Li B4 NORTHWOODS PHRSE II PO BOX 6i7 99577 LOT SIZE 6942776 555555 SQUARE FEET 'TYPE OF SOIL RBSORPTION SYSTEM IS: DRRINFIELD MRXIMUM NUMBER OF BEDROOMS = -?. SOIL RATING (SQ FT?BR)= ±00 THE REQUIRED SIZE OF THE SOIL RBSORPTION SYSTEM IS: THE LENGTH DIMENSION IS THE LENGTH ':.'IN FEET) OF THE TRENCH OR DRFIINFIELD, THE DEPTH OF R TR. ENCH OR PIT IS THE DtSTRNCE BETWEEN THE SURFRCE OF THE GROUN[:, RND THE BOTTOM OF THE EXCRVRTION ,:lIN FEET). THE GRAVEL DEPTH iS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET). 5 RED, ~';. EZF" T ][ C: TIFIi~-.~I-c] ~--:; t ZEE= PERMIT RPF'LICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTRLLRTiON INSPECTIONS OF RNY WELLS RDJRCENT TO THIS PROPERTY RND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. ........... T ].-J~C, ( 2 ) I I'--I51F:'EE:T ][ ,--"NS Ri~:E F-: E ~%,tLJt :I. 8RCKFiLLING OF RNY SYSTEM WITHOUT FINAL INSPECTION RN[:, RPPROVRL BY THIS DEPRF-':TMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETWEEN A NELL RND RNY ON-SITE SEWRGE DISPOSRL. SYSTEM IS i00 FEET FOR R PRIVRTE WELL OR i50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM A F'RIVATE WELL TO A PRIVATE SEWER LINE IS~._,~ FEET AN[:, 'TO A COMNUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAIdS ARE AVAILABLE TO INSURE PROPER INSTALLATION. I CERTIFY THRT ±: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH BY THE MUNICIPALITY OF RNCHORRGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE COPES. ]:: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE .[,HTE ....... Z ........... . V4. 0 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street. Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST ~ SOILS LOG [] PERCOLATION TEST PERFORMED FOR .,~'"~'./'e.,. ,,~ i~:~dj C,, LEGAL DESCRIPTION: 1 2 3- 4- 5- 6 DATE PERFORMED: SLOPE SITE PLAN 10 11 12 14 15 16 17 19 20 COMMENTS WAS GROUND WATER ~ SL. ENCOUNTERED? O P IF YES, AT WHAT / E DEPTH? JO Gross Net Depth to Net ~Reading,. Date Time Time Water Drop PERCOLATION RATE (minutes/inch} FT AND ~ FT TEST RUN BETWEEN PERFORMED BY: '--'"~.r-,-- ~) CERTIFIED BY: 72-008 (6/79) APPLIC:"- T FILLS OUT UPPER HAL '"DNLY Buyer ~ /'~//~ ~4 ~:~ Lend ng nst tut on Address ~.-'~/n, Realty Co. &Agent Type of Residence · Phone Phone Phone I~Single Family [] Multiple Family [] Other No. of Bedrooms Water Supply J~;t~ivid ual II~"Comm unity [] Public Utility Sew~er~'osal Ll~qndividual [] Public Utility [] Holding Tank ATTACH WELL LOG. A w~l log is required for all wel~s drilled since June 1975. For wells drilled prior to that date, give well depth (attach leg if available). Year individual Installed: When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: ~-~' ~-" ~ ' MuNiCIPALiTY OF ANCHORAGE ENVIRONMENrAL pROTECTiON RECEIVED _~ APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL* DATE /~.,,. 'il" ~ -,~ Soils Rating Dat~,~Sewer Installed Well To Absorption Area Well Log Received / ~ I~/~ / '""~t-~(~ Well to Tank Septic Tank Size ~ 72-023 (31~2) Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P,O. Box 196650 Anchorage. AK 99519-6650 www.ci.anchorage,ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 05 t-741-36 '1. GENERAL INFORMATION Expiration Date: / / - ~--" ~) '~ Complete legaldescription NORTHWOODS #2; LOT 1. BLOCK Location (site address or directions) 23012 NORTHWOODS 0RIVE Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address GREG & JO HOBBS Dayphone 688-4622 23012 NORTHWOOOS DRIVE. EAGLE RIVER, ALASKA 99577 Day phone FRANK STEVENS C/O PRUDENTIAL VISTA Day phone 689-6480 16635 CENTERFIELD OR. EAGLE RIVER, AK. 99577 Unless otherwise requested, HAA will be held by DSD fcr pickup. 2. NUMBER OF BEDROOMS: ,:3 3. TYPE OFWATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well [] Individual On-site [] Individual Water Storage [] Individual Holding tank Community Class A Well [] Community On-site [] Public Water System [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the 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. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (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. 4. 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, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system ia(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 end inspection, the on-site water supply and/or wastewater disposal system ia(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER &: WAST-------'------~ATER CONSULTANTS. INC. Phone Address 6901 DEBARR ROAD, SUITE 2B * ANCHORACE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS. P.E. Date ,337 - 6179 Engineer's Comments: In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the perfon'nance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all we/ts and septic aystems depend on the local soils condition, groundwater levels that may fluctuate durfng the year, and the water usage of the family being served by the aystem. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AKWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other peraon or pady is not authorized, nor will it confer any legal right whatsoever. $. DSD SIGNATURE /'/"' Approved for -.~ bedrooms. Disapproved. Conditional approval for Attachments: HAA Checklist Septic System Advisory Well Flow Advisory bedrooms, with the fllowing stipulations: ..-,-- ~ WASTEWATER .' = Manitenance Agreements Supplemental Engineer's Reort Other (Rev. 12,'01) Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division On-S~ Water & Wastewater Program '~ 4700 ~ Br~ ~L P.O. Box 196650 Anchorage, AK 99519.6650 www.cLenchmege.ak,us (eo ) Legal Description: WELL DATA Well typeCOuuu~m' Date completed Total depth HEALTH AUTHORITY APPROVAL CHECKLIST NORTHWOODS #2; LOT 1, BLOCK 4 Parcel ID: 051-741-56 If A, B, or C provide PWSID# A Well Log COMI UNITY Sanitap/seal (Y/Nt Wires pmpedy protected (Y/N) Cased to ft. Casing height (above ground) in. FROM WELL LOG Date of test Static water level .. Well p,cdu,,Uun g.p.m. AT INSPECTION WATER SAMPLE RESULTS: Coliform colonies/100 mi. Nitrate mg./L A~,~nin' ,,,u.~. Date of ~lmple: B. SEPTIC/HOLDING TANK DATA Tank Tybe/Material STEEL Tank size 1000 gal. Number of Comparlments 2 Foundation deanout (y/N) YES Depression over tank (y/N) NQ Date of pumping 9/14/2002 Pumper C. ABSORPTION FIELD DATA Date installed 7/~ ~/83 Length 40 ft. Oth&r t,~erla __ Collected by: COMMUNITY colonies/lO0 nfl. Date installed Cleanoute (Y/N) High water alarm (Y/N) JR'S PUMPING I'MT EXTENDS ,%5.25" BELOW INVERT.I Soil rating (g.p.d./ff~) 100. System type Width 5 ft. Grovel below pipe 7/11/1983 Absorption rote >= Total del:~t 5.9 ft. Eft. absorption ama 312 fl2 Monitoring tube *YES Date of adequacy test 10/10/2002 Results (Pass/Fall) PASS Fluid depth in absoq3tion field before test 28 in. Water added 505 gal. Elapsed Time: 1051 min. Final fluid depth 29 in. Any mjuvenaUon treatment (past 12 mo.) (y/N & type) NONE KNOWN YES N/A TRENCH 2.5 It. Depression over field NO For 3 bedrooms New depth36.2~n. 450 + g.p.d. If yes, give date - D. UFT STATION Data installed Size in gallons 'Pump on' level at in. "Pump o~ I~,~_1 at Datum Cycles tasted E. SEPARATION DISTANCES ManholelAcc~'~; (Y/N) in. High water alarm level at in. Meets alarm & circuit requirements? Septic tank/llft station on lot Absorption field on lot Public sewer main Sewer Ite~,ho~wtce line SEPARATION DISTANCES FROM WELL ON LOT TO: On adjacent lots Public sewer manhole/cieanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Pmberty line 5'+ Absoq~flon field $'+ Water main 10'+ Water service line * 10'+ Surface water 100' + Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Pmpen'y line 10'+ Building foundation 10'+ Water sewice line * 10'+ Surface water 100'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ Water main 1 O' + Driveway, parking/vehicle storage 10'+ F. COMMENTS *SEE A.W.W.U KEYBOX LOCATION ON CONNECT CARD G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspec~ons and re~4ew of Municipal records that the above systems em in conformance wfih MOA HAA guidelines in effect on this date. Engineer's Printed NaT Dete fO/~ JEFFREY A. GARNESS Date of Payment 10-- ~ Receipt Number (Rev. 12~ol ) Waiver Fee $ Date of Payment Receipt Number · s ~- "-~<(~'>:~ s'~ ~'~' <. -:-.-:... <. ~:- <--:~-:':-:':',;-:~-'---'-:~--'---~- ~,'-:- ~, MUNICI~ALI~ OF ANCHORAGE ::-~:~?-~-:-:--;--'.'-::.~;:~-:~:~.~:::-~-:-'<--:~-~ ;~:~:.~::~:~:- ~.<--:.~ ,~, WATER CONNECT ON -- L~ Re,rd :"" ":'" ' ""' :'"': ":' LOT ! BLOCK ~ SIZE CONN, DATE MADE LOCATION: ALLEY [] STREET I~ CORP STOP CUR8 STOP C TO C CURB STOP C TO I CORP CONNECTOR COUPLING C TO I X BRASS BUSHING GALVANIZED BUSHING 2 PART UNION 3 PART UNION SERVICE CLAMP X LOCATION *~/ ~ ~ '~ ,~ p/_ CONNECTION MADE BY 3[-058 ADDITION NEW CONN. REPLACEMENT CONN. )SHOW SKETCH ON REVERSE THAW PLATE KEARNY WIRE CONNECTOR OTHER: COMMENTS: BROKEN MAIN, EXT. CONNECTION, CASING, DELAYS, ETC. DISCONNECTS EXCAVATOR APPOINTMENT TIME: TIME READY.' TYPE OF MAIN SIDE PERMIT NO. CONN. PERMIT TOTAL EXTRA PIPE FT. [] PAID PREY. [] PAID CASH [] IMP. [] EXT. AGREEMENT 10/25/02 FI/I 13:39 FAX 6896499 VISTA REAL ESTATI~ £R I~001 ASBUILT I HEREBY CERTIFY .THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY~ AND THAT NO ENCROACHMENTS EXIST E:X,.EPT AS ..,-~//~'.z.~.~ INDICATED. IT I$ THE RE.~PON$1BILITY OF THE: OWNE]R TO DETERMINE THE EXISTENCE: OF ANY GRID: EASEMENTS, COVENAN'rS, OR RESTRICTIONS . .,,~/-~,'~'...s-g"~ WHICH DO NOT APPEAR ON THE RECORDE]) SUbDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOM..D ANY DATA HEREON 8E USED FOR CONSTRUCTION · OF FENCE LINE,.~ OR FOR E:STABLISHIN~} BOUND- DRAWN: ARY LINES.