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Home My WebLink AboutWONDER PARK #1 BLK 3 LT 11Wond r Pork Block 11 #006-292-32 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. 006-292-32 1. GENERAL INFORMATION Complete legal description WONDER Location (site address or directions) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address PARK SUBDIVISION; LOT 11, BLOCK 3 302 STEWART STREET * ANCHORAGE, AK RHODA TURINSKY Dayphone .335-4663 P.O. BOX 116 * KENAI, AK 99611-0116 Day phone JANICE MITHCELL w/ PRUDENTIAL VISTA Day phone 4241 "B" STREET * ANCHORAGE, AK 99505 273-7726 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well [] Individual On-site [] Individual Water Storage [] Individual Holding tank [] Community Class Well [] Community On-site [] PuSlic Water System [] Public Sewer I 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 rei.ssued 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. Note:Alaska Water and Wastewater Consultants, Inc. shall be paid $ at, or prior I to closing for the engineering services provided. I 4. STATEMENT OF INSPECTION BY ENGINEER 5o As certified by my s~al afiTxed 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 ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone Address 6901 DEBARR ROAD, SUITE 29 * ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 537-6179 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 performance 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 wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. 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 person or party is not authorized, nor will it confer any legal right whatsoever. DSD SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. (((((((III','. · ~.'.-. ,..V, .. ..... bedrooms, with the fllowing stipulations.,,~,~o.' '-. .,~'~-~ : ON-SII: ~ ;. WASTEWATER ; :- Attachments: HAA Checklist Septic System Advisory Well Flow Advisory By: (Rev. Manitenance Agreements Supplemental Engineer's Reort Other Original Certificate Date: Municipality of Anchorage Development Sentices Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 09519-6650 www.ci.snchorage.sk,us HEALTH AUTHORITY AppRovAL CHECKLIST Legal Description: . WONDER PARK S/D; LOT 11t BLOCK 5 Parcel ID: A. WELL DATA *WELL DRILLED PRIOR TO 1969. REGULATION O THAT TIME WAS CASING WAS TO BE 50'+ Well type P,~IVA'II~ If A, B, or C provide PVVSID~ N/A Well tog (Y/N) NO Date completed N~PROX· 1954. Sanitary seal (Y/N) YES Wires propedy protected (Y/N) YES · ~ Total depth 50+ It. Cased to *50+ ff. Casing height (above ground) 12+ in. 006-292-52 FROM WELL LOG AT INSPECTION Date of test 11./'18/~,2002 Static water level .A ,~..~ ~"~ ft 24. , ff. · Well production ~ __ g'p.m. 4.:1~. g.p.m. WATER SAMPLE RESULTS:*RE-SAMPLES FOR COUFOEM AND BACTERIA WERE PU~!FT~ 12/12/2002 Coliform , 0 ~ colonies/100 mL Arsenic: N,/A mg./L. SEPTIC/HOLDING TANK DATA Nitrate ,,,0.2 mg./L. Other bacteda _ 3 colonies/100 mi. Date of sample.~11/18/2002 Collected by: AKWWC~ INC. PUBLIC SEWER Tank Type/Material ....... Date installed Tank size , gal. Number of Compartments Foundation cteanout (Y/N) ~&r~'g~g~~i High water alarm (Y/N) ~, , Pumper C. ABSORPTION FIELD DATA Date installed _ Soil rating (g.p.d./ft~or fl~odrm) System t~pe Length ~_ fl. Width ~ fl. Gravel bel~ ' .~~'"~ fl. Total depth , It. Eft. absorption area ~ ~ fl~ Monitoring tube~_-..-."'"'~epression over field Date of adequacy test ,, Resul~ P~.ss~~''~ For, bedrooms Fluid depth in absorption fiel~ ~fo~ t~--"'~ in. Water added .~ gal. New depth in. D. LIFT STATION Date installed. Size in gallons Man~ "Pump on" level at .in. ~ High water alarm level at in. ~ ~ Cycles tested Meets alarm & circuit requirements?. E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot N/A On adjacent lots 100'+ Absorption field on lot N/A On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: N/A PUBLIC SEWER Building foundation Water main Property line Water service line~ Absorption field ace water SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Building foundation Water service line Surface water ~dr~i~-.--------~ Wells on adjacent lots F. COMMENTS G. 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. Water main ~ide storage Engineer's Pried. N~me Date ' [/,,~'"//0.~ JEFFREY A. GARNESS HAA Fee $ ~ Date of Payment Receipt Number (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number 11/26/02 13:36 FAX 907 273 8440 PRUDENTIAL VISTA'REAL ES ~002 EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON. I'hereby certify Ihet I nave aurveye(~ the following described p~opertT, Lot [/ BIo~ ~.. ~O~E~ ~ ~D. Anchorage recording district Alas~a, and that the ~pmvements situateO tmereon are wl~ln ~e ptope~ Sines end eD not overlap or encroa(h on · e p~openy lying adjacent theretO, that no ~provamentt on prope~y lying adjacent encroach on the premises In question and that the}e are no roadwayS, transmission lines or ~sible easements on said prope~y except as indicated hereon. ·.,: ..... ,, ~ ..... I . i ' .~:',t~.~= / "= ~o' ""' ~...~.; .... .. % .I.o,,. * THE INF{,RMATION HEREON IS FOR THE USE OF LENDING iNaCTiONS SPECIFICALLY TO SHOW A~ COrrECT8 B~EEN EXISTING STRUCTURES AND P~ED LOT LINES OR EASEMENTS AND NOT TO BE USED FOR POSITIONING ADDITIONAL STRUC% RES OR FENCELINES. "ASBUILT" ' ' No corners set ~ook .? *'kll CT&E .Environ'mental Services lnc: Laboratory Division · · :'.'* · - ' -* * 200 W. Pott~r Drive Drinking Water Analysis Repo~t for Total Coliform Bacteda A,,ho,aoo.AK 99518-1605 Tel: (9071562-2343 RE~ID I~VSTRUCTION$ ON REVERSE SIDE BEFORE COLLECTIN~ SAMPLE Fax: (907) 561-5301 ' ' I~ST BE COMPLETED BY WATER SUPPLIER, TO BE COMPLETED BY LABORATORY O PUBLIC WATE~ S¥STEB~( I.D. ~. Analysis shows this Water SAMPLE to be:. . Un~'.tisfactory Sample over 30 hours old, rc$~j~ may bc ~nr~liablc v o Sample too 10ag in transit; sample should not be ovcr~]~aotrrs old at examination to indicate reliable results. Please scad new sample via special dclivcB, mail. ' -"" Date Recelved ,, ti Time Received ) t~l O AnalyshBegan [ INp"t~[.) . Analytical Method: "J~Mcmbranc Filter /1~ MMO-IviUG ~,~ I'RIVATE WATER SYSTEM .. ~ WATER & WA~WATER wo.;...,~ CON~ULT~, ~C. i' aoNst.:raJvm, mn. 0901' DgBARR RD.. SU1Tg 2B c~y ~,, z~p c~, * O0 mi. SAMPLE DATE: '* ~-['~ ~'~. ~ 1 02~S29 Result* Analyst SAMPLE ~PE: ' ' ~ Repent Sample (for routine simple ~ Unlreited~ater Faxed with lab tel ~o. .) Date: Time: 5 Special Purpoic Client noiifled of unsatisfactory resul{s:. l~honed Spoke with Date: Time: Time Collected SAMPLE LOCATION Collected By BACTERIOLOGICAL WATER ANALYSIS RECORD &~MNiO-MUG Result: Total C6liforM Comments: E. Colt Fecal Coliform Confirmation FinalMembr=~e~d[~ ~ ~ ~~~ CoUfor~lOOm, Faxed ~~ Member of the SOS Group (Soci~te G~n&ale de Surveillance) r Ol:C~ r 9~; z. OS '~ .... , *.,- .... ,~, e, mn,r~a it ! IMtglg. NUkRYLAND. I~ICHIGAN. MISSOURI. NEW JERSEY. OHIO· WEST VIRGINIA ~t~__ CT&E Environmental ~wlces Inc. CT&E, Ref.# Client Name Project Name/# Client Sample ID Matrix All Dates/Times are Alaska Standard Time Printed Date~lme 11/22/2002 9:37 Collected Daterfime 11/18/2002 17:25 1027929001 AK Water & Wastcwater Consultants Inc. Wonder Park LI 1 B3 Outside Bib Wonder Park LI I B3 Drinking Water RecelvedDate/Time · 11/19/2~),2,~ 14:10 Technical Dir~ Step.he~C.l~de PWSID 0 Released By .~'~~ Sample Remarks: Allowable Prep Anal~is Parameter Resvlts PQL Units Method Limits Date Date Init Waters Department Nitrate-N 0.200 U 0.200 mg/L EPA 300.0 (<-10') 11/20/02 M£crob£olog¥ Laboratory' Total Coliform Unknown quantity of O col/100mL SMI8 9222B 11119102 KAP 12-23-0Z 14:ZZ FRO~-CT&E EHVIROfl~XTAL SRV 90?5616301 T-254 P.O1/01 F-O?4 CT&E Environmental Services Inc. Laboratory Divisi~:n r~,*a~,ar~a¥~'.~'a~a~.~'~cc~-a,~o~,~r.~,.a~eav~,;~~~~~ 200 W. Pother Drive Drinking Water Analysis Report for Total Coliform Bacteria ^,cho,,o,. aK 9es~e.~eos Tel: (FOil 562-2343 READ INSTRUCTIONS ON R. EFg. RSE SIDE BEFORE COLLECTING gAMP£E -, Fax: laO'/) 581-5301 MbST BE CO-MP~.ET£D I:l~ WATER. SUPPI~iER . P..LIC W^~. sYsTE~ ,.D. # i']11 12 PRIVATE WATER SYSTEM i'1 ,~end Results D Send invoice . SAMPLE DATE: Month SAMPLE TYPE: ~ Routine I:1 Repeat Sample (for routine sample with lab ref. no. ) D Special Purpose Day Year 12 Treated Water ~ Untreated Watcr TO BE COMPLETED BY LABORATORY Oalysis shows thcs.Water SAMPLE to be: ~alisfactory ' 12 Unsati.sfactory 12 Sample ovgr 30 hours old, results may · be un. liable Sample too long in transit; sample should not be ovcr~Ohours old at examination to indicate reliable results. ]~lease send new sample via special delivery ma.iL Date Received Time Received _ Analytical Mrthod: ~.% Membrane Filter Time Collected Collected By Dat~:. , ~ Time: Client notified of unsatisfactory results: Phoned Spoke with Date: Time: Comments: BACTERIOLOGICAL WATER ANALYSIS RECORD MMO-MUG Rtnult: Total C61tform ,, Membrane l~lter: Direct Count ,.~ Verification: LTB BGB Fecal Coliform Confirmation E. Cola 0~), ~.\'l ,. ColonterJlOO mi COLIFIRM. Final Membrane Filter Results ~.. _~~(_..~a~.6~A4 Coliform/100 mi [] Foxed OB - Otker ............ ,,, *, amy& t~Ain:fgRNIA. FLORIDA. ILLINOIS. MARYLAND, MICHIGAN. MISSCRIRI. NEW JERSEY. OHIO. WEST VlRGIN~