HomeMy WebLinkAboutSAND LAKE #2 BLK 4 LT 38,Sand Lake
Block 4
Lot 38
#011-135-15
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and 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. 011-135.15
GENERAL INFORMATION
Complete legal description
Location (sit~ address or directions)
Expiration Date:
Lot 38. Block 4. Sand Lake Subdivision No. 2
8212 Seacliff Street
Current Property owner(s) Bob and Bonnie Day
Mailing address 8212 Seacliff Street Anchoraqe, AK 99502
L~nding agency
Mailing address
Real Estate Agent
Mailing Address
Un/ess otherwise requested, HAA will be held by DSD for pickup.
NUMBER OF BEDROOMS: Three (3)
Day phone 243,7300
Day phbne
Day phone
o
TYPE OF WATER SUPPLY:
Individual Well
Indk,idua: Water Storage
Community Class _.C Well
Public Water System
[]
[]
[]
[]
TYPE OF WASTEWATER DISPOSAL:
Individual On-site []
Individual Holding tank []
Community On-site []
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 5 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 dispcsal and/or water
supply system. DSD also issues HAAs upon request to homeowners. Certificates o1' 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 sample results less than 30 days old. (Cedificates may be reissued for a period of up Io one year with
valid water samples.) Cedificates are valid for one year for propedies 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 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 inspection, 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 effect at the time of installation.
Name of Firm Anderson Enaineerinq
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E.
DSD SIGNATURE
ox' Approved for .~
Disapproved.
Conditional approval for
Phone 522-7773
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
~''
Maintenance Agreements
Supplemental Engineer's Repod
Other
Original Cedificate Date:
Municipality .of Anchorage
Development Servmes Department
Budding Safety Division
On-Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.cianchorage, ak.us
(957) a4a-7~04
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:
A. WELL DATA
Well type private
Date completed 6/111982
Total depth _Unknown ff.
Bo
Lot 38, Block 4. Sand LakeSubd'wlslon No. 2
If A, B, or C provide PWSID # 8321-FA087
Sanitary seal (Y/N)Y_
Cased to >40 ff.
FROM WELl. LOG
Parcel ID: 01t,135-15
Date of test
Static water level
Welt production
WATER SAMPLE RESULTS:
Coliform p colonies/100 nd.
Date of sample: 10/10/2002
SEPTIC/HOLDING TANK DATA
Tank Type/Mate~rJa, I,
Tank size 1,000 gal.
Foundation cleanout (Y/N) Y_
Date of pumping t0/$/2002
ABSORPTION FIELD DATA
Date installed 6/28/1982
Length 40
Total depth _6 ff.
fro
g.p.m.
Well Log (Y/N)N
Wires properly protected (Y/N) Y
Casing height (above ground) >24
AT INSPECTION
10/13/2002
159
8.7 g.p.m.
Nib'ate .~ mg./I.
Collected by: MEA
Other bacteria .0 colonies/lOO mi.
Number of Compartments _2
Depression over tank (Y/N) N_
Pumper A Plus Home Services
Date installed 6/2811982
Cleanouts (Y/N) Y
High water alarm (Y/N) N
Soil rating (g.p.d./ft~ or ~/Ixlrm) 85 SF/Bedmom System lype 5' Wide Shallow Trench
ff. Width 5 ff. Gravel below pipe 1.5 ff.
Eft. absorption area ~25~.._~ Monitoring tube Y Depression over field N
Date of adequacy test 10113/2002 Results (Pass/Fall) Pass For Three (3) bedrooms
Fluid depth in absorption field before test 0_. in.
Elapsed Time: 0_ min. Final fluid depth 0_ in.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N
Water added688 gal. New depth_0 in.
Absorption rate >= 450 g.p.d.
If yes, give date
D. UFT STATION
Date installed
"Pump on" level at in.
Datum
E. SEPARATION DISTANCES
Fo
Size in gallons
"Pump off' level at ~
Cycles tested
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot >100'
Absorption field on lot >100'
Public sewer main NIA
Sewer/septic service line >25'
Manhole/Access (Y/N)
in. High water alarm level at in.
Meets alarm & circuit requirements?
On adjacent lots >100'
On adjacent lots >100'
Public sewer manhole/cleanout N/A
Holding tank N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >5'
Water main NIA
Wells on adjacent lots >100'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line >10'
Water Service line >10'
Curtain drain None Noted
COMMENTS
Property line. >5'
Water service line >10,
Building foundation >10,
Surface water >100'
Wells on adjacent lots >100'
Class C Separation Distance Waiver Issued to 100' on 9113/1982.
ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name Michael E. Anderson, P.E.
Date 11118/2002
HAA Fee $
Date of Payment
Receipt Number
(Rev. 12/00)
Absorption field >5'
Surface water >100'
Water main >10'
Driveway, pa~Jng/vehicle storage >25'
Waiver Fee $
Date of Payment
Receipt Number
MEMORANDUM
DATE:
February 2, 2003
TO: Joe Goodall
FROM:
Mike Anderson, P.E.
SUBJECT:
Lot 38, Block 4, Sand Lake Subdivision No. 2
Certificate of Health Authority Approval
Attached is a copy of the waiver from ADEC allowing the septic tank to be within 97.5'
from the well on the lot. All information requested has now been submitted for the
Certificate of Health Authority Approval for this lot. Please issue the certificate at your
earliest convenience.
DEPT. OF ENVIRONMENTAL CONSERVATION
DIVISION OF ENVIRONMENTAL tIEALTH
DRINKING WATER and WASTEWATER PROGRAM
555 CORDOVA STREET
ANCHORAGE, AK 99501
hlt. p.'//,.v ww,sm',c .ak .u~dcc./homc/h~m
FRANK H. MURKOWSKI, GOVERNOR
Telephone: (907) 269-7519
Fax: (907) 269-7650
Michael E. Anderson, P.E.
Anderson Engineering
P.O. ,Box ~240773
Anchorage, Alaska 99524
January3,2003
Re: Lot 38, Block 4, Sand Lake Subdivision No. 2, Class C Public Water System,
ADEC Project # 2932
Dear Mr. Anderson:
This is in response to the waiver request for an existing Class C public water system located on lot
38, Block 4, Sand Lake Subdivision No. 2 received in this office on November 22, 2002. I have
reviewed the engineering drawings, the waiver granted in 1982 from 150 feet to 100 feet, resent
sample results and the documentation provided on the pub!ic water system.
Waiver
Your request for a waiver between the Class C public water system source well and the on-lot
wastewater system has been reviewed. The well logs, current water sample 'results, and thc plan ....
drawings have been reviewed. It appears the waiver request is reasonable.'" Therefore, in
accordance with the State Drinking Water Regulations (18 AAC 80.020), the following waiver is
granted.
The separation distance between the Class C public water system source well located on I,(~t
38, Block 4, Sand Lake Subdivision No.2 and the two compartment wastewater septic tank
serving the home on this same lot has been waived from 150 feet to 97.5 feet.
The distance noted in the waiver is from your submittal. It appears that the distance is from the
nearest edge of the wastewater disposal system's existing septic tank to the nearest edge of the
existing Class C public water system source well. If any part of the wastewater disposal system
fails or contamination can be traced back to the system, this waiver will be invalid.
This approval does not imply the granting of additional authorization nor obligate any state, federal
or local regulato~ body to grant required authorizations.
Mike Anderson Page 2 01/03/03
Public Water System
It appears that the Class C public water system was installed and a final operational approval
granted in 1982. At that time a public water system identification number [PWSID~] was not
assigned for this public water system. In order to correct and update the records on this system, I
have attached the Class C public water system registration form.
Since final operational approval has been issued for this public water system, and current sample
results are on file. The only information the department needs concerns the number of individuals
using the system and an update of owner. Once the owner of the existing Class C public water
system completes sections A1 and B4 and returns the registration form, I will be able to issue a new
operational approval and a Public Water System Identification (PWSID) number.
Thank you for your cooperation. If you have any question please do not hesitate to contact me at
269-7519.
WRR
Enclosures: As Stated
· Re~s~pectfully, , iq
William R. Rieth, P.E.
Environmental Engineer
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 (FAX)
MEMORANDUM
DATE:
November 15, 2002
TO: Jeff Poet
FROM:
Mike Anderson, P.E.
SUBJECT:
Lot 38, Block 4, Sand Lake Subdivision No. 2
Certificate of Health Authority Approval
Attached is a copy of the Encroachment Agreement from Chugach Electric for the well
on the subject lot. A waiver was requested from ADEC over six weeks ago and will be
forwarded to you once it becomes available. Please let me know if you have further
questions.
ENCROACHMENT PERMIT
1204-10B
EN02046
011-135-15
This pe,mit is between Chugach Electric Association, Inc., an Alaska non-profit electric
· cooperative, (herein "Chugach"), whose address is P. O. Box 196300, Anchorage, Alaska 99519-
6300 and Robert A. Day (herein "Permittee"), whose address is 8212 Seacliff Street, Anchorage,
Alaska 99502.
1. Easement. Chugach is the grantee or user of an easement for the construction and
maintenance of electrical facilities, as follows:
Described in that certain written instrument recorded on the 11th day of March 1952 at
Volume 69, Page 105 of the records of the Anchorage Recording District, Seward
Meridian, Alaska,
Described in that certain written instrument recorded on the 14th day of April 1952 at
Volume 70, Page 325 of the records of the Anchorage Recording District, Seward
Meridian, Alaska,
Described in that certain written instrument recorded on the 13th day of October 1978 at
Book 344, Page 733 of the records of the Anchorage Recording District, Seward Meridian,
Alaska,
(herein "Easement") which pertains to the following described real property:
The North Ten Feet (lq 10') of Lot 38, Block 4, Sand Lake Subdivision No. 2, according to
Plat Number P-176, recorded on the 26th day &April 1950, on file in the office ofthe
District Recorder, Anchorage Recording District, Seward Meridian, Alaska.
Permittee ac'knowledges the validity ofthe Easement. Permittee warrants and represents that
Permittee is thc owner of the fee simple interest in the land subject to the 'Easement and the
following described real property to which the Easement is adjacent:
Lot 38, Block 4, Sand Lake Subdivision No. 2, according to Plat Number P-176, recorded
on the 26th day of April 1950, on file in the office of the District Recorder, Anchorage
Recording District, Seward Meridian, Alaska,
(herein "Parcel"). Encroachment Permit - Page 1 of 4
2. Encroachment. Permittee proposes to continue the existence of the following
improvement(s) on or within the real property subject to said Easement:
A well within said Easement in the northeast comer of said Parcel; and, a 12 foot ~ide
deck across the full width of said Easement, the east side of deck located approximately
44 feet west of the east side of said Parcel. Ifthe deck must be removed for Chugach's
use of said Easement, the Permittee will not reconstru'ct the deck within said Easement,
(herein "Encroachment").
3. Permit. Chugach hereby authorizes Permittee to continue the existence of the
Encroachment in its proposed location subject to the covenants set forth in this permit.
4. Indemnification. Permittee shall indemnify and hold Chugach harmless from any
claims for personal injury, property damage or other loss arising in any ~vay from the continuation of
the Encroachment.
5. No Expansion or Increase. Pennittee shall not in any ~vay expand or increase the
extent to which the Encroachment occupies any of the real property encumbered by the -Easement
without the prior ~vritten consent of Chugach. Chugach has no obligati0n, to provide such consent.
6. No Interest in Real Estate Actluired. Permittee hereby acknowledges that the
Encroachment and any additions thereto, even if in violation ofthis permit, has not and shall not in
the future give rise to any interest or estate in the real property subject to the Easement or any other
real property. Without in any way limiting the foregoing, Permittec acknowledges, that the
Encroachment is not adverse to any interest of Chugach and its continuation is entirely with the
permission of Chugach for purposes of the common law doctrine ofadverse possession. This permit
creates no interest in the real property subject to the easement.
7. Modification of Utility Facilities. lfthe electric utility facilitie~ located within the .
~Eascment are upgraded, added to, replaced or reconstructed, Permittee shall pay that portion of
Chugach's total costs for such modification which is reasonably attributable to accommodating or
preserving the Encroachment. If. such payment is not made within thirty (30) days of~xitten demand
for same, Chugach may terminate this permit in accordance with paragraph 9, below.
8. Covenants Runnine xvith the Land. The obligations of the Pcrmittee arising from this
permit shall be covenants running with the land which shall burden the Parcel and the Permittee's
interest in the land subject to the Easement and shall b~nefit the Easement.
9. Termination. Chugach may terminate this permit after the giving ofthirty (30) days
written notice of such termination if:
a. The Encroachment is enlarged, increased or ektcnded ~vithin the real property affected
by the Easement.
Encroachment Permit - Page 2 of 4
b. The Encroachment is damaged by any means to an extent of more than thirty percent
(30%) of its replacement cost at the time of destruction.
c. Permittee fails to make the payment described in paragraph 7, above.
10. Term. This permit shall, ifnot sooner terminated by Chugach, expire forty (40) years
from the date hereof.
l 1. Entire Aereement. This written pemfit constitutes the entire agreement betxveen the
parties with respect to the subject matter hereof and supersedes all other prior or contemporaneous
agreements, oral or written, between the parties. No modifications, amendments, deletions, additions
or alterations of the permit shall be effective unless in writing and signed by all of the parties hereto.
CIIUGACII ELECTRIC
ASSOCIATION, INC.
By:
Michael Massin, Director
Engineering Services Division
By:
PERMITTEE
Date:
Date: /,~/~:~ ~/
Encroachment Permit - Page 3 of 4
STATE OF ALASKA )
) SS:
THIRD JUDICIAL DISTRICT )
2002, by /~.~t~-t-- ,~- /~A/(
day of
My commission e..xpires: ~)74~/3//7-~SK:)C~.
STATE OF ALASKA )
) SS;
THIRD JUDICIAL DISTRICT )
OFFICIAL :SEAL
.STATE OF ALASKA
NOTARY PUBLIC
j AI. AI'4A C. WOOTEN
. My Comm. expJre$:
Thc foregoing instrument ,,vas acknowledged before me this day of
· 2002, by Michael E. Massin, Director, Engineering Services
Division of Chugach Electric Association, Inc., an Alaska corporation, on.,behalfofthe corporation.
Notary Public in and for the State of Alaska
My commission expires:
AFl'ER RECORDING RETURN TO:
Chugach Electric Association, Inc.
P.O. Box 196300
Anchorage, Alaska 99519-6300
Encroaclunent Permit - Page 4 of 4