HomeMy WebLinkAboutTHUNDERBIRD HEIGHTS #1 BLK 6 LT 16Thund rbird
H
ights
Block 6
Lot 16
#051 - 582-13
~ MUNICIPALITY OF ANCHORAG[
OEPARTMENT OF HEALTH & ENVIRONMENTAL ~RO~EC~ION '
I~ ~NVIRONMENTAL ENGINEERING DIVISION
ON.~ITE SEWAGE DI~AL SY~EM AND/OR WELL IN~ECTION RE~RT "~ ' ~ ~ ' ' '
~~~' . ..~* '..'.~,
DISTANCETO: W" ~,.. .EnM,TNO. .: . '
OTHER
: I'iUNZCIPALIT¥ OF' RNCHORROE l~'5. n. t4
' D('Pf~TI'IENT,~, HEALTH FIND ENVIR'ONN~NTF[. t'"'n'OTECTION
~ OF DOIL N~PTION ~V~TE. i~: T~E~H
SOIL RATING ¢$G FT,,'BR),,, ~
~ REGUI/I~D $1Z~ OF THE SOIL IREI$O~PTION 5VC~TEH
, DEPTH-- 9 LENGTH-- 34 GRAVEL DEPTH--
~ ~ DI~I~ IS T~ LEITH (IN ~) ~ T~ TR~
~ ~ ~ ~ ~ ~ EXCflV~T%~ KIN ~).
~ %5 ~ ~ W%D~ ~ ~.
~ ~ ~ IS ~ HIN%~ DEPTH ~ ~ ~T~H
' ~ ~ ~T~ ~ ~ ~TI~ (iN
------ THO .(2) ZNSPECTIOND ~RE' REQUIRE
~ NILL ~ ~CT TO ~EC~I~
¥4. 8
HINI~U~I DI~Tflli~E ILrPsLq~l R ELL ~ ~ OI~-$ITE
TO fl ~l~ ~ LI~ IS ~ FEET.
O~ ~Z~S ~ ~. SPECIFICRTI~ ~
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2: I ~ I~ ~ ~ IN ~~ WITH
./
I~D'JZ~ .ENGIN£Ef~iNG .
8011.8 LOG -.PERC.*TEgT "'
.' " .'., {:]percolation t~
performed for: · *
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Oround .water
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Municipality of AnchOrage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99507
www. muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 051-582-13
COSA # ~)~"~
Expiration Date:
GENERAL INFORMATION
Complete legal description Lot 16, Block 6, Thunderbird Heights Subdivision No~ 1
Location (site address) 24515Thunderbird Drive Chugiak, AK 99567
Current Property owner(s) EIIsworth and Nancy Hoffman
Mailing address 24515 Thunderbird Ddve Chugiak, AK 99567
Day phone 688-4777
Lending agency ·
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup.
NUMBER OF BEDROOMS: Four (4)
TYPE OF WATER SUPPLY:
Individual Well []
Individual Water Storage []
Community Class ~ 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' On-Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered 'in the State of Alaska. Certificates of On-Site Systems 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 COSAs upon request to homeowners. Certificates of On-Site SYstems 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. (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
o
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 Certificate of On-Site Systems 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 Engineering
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E.
DSD ~NATURE
,/
i,,/' Approved for T
Disapproved.
Conditional approval for
bedrooms.
Phone 522-7773
Date 4/1~2,J~1~,~,%~ · .'
bedrooms, with the following stipulations:
By:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental EngineeCs Report
Other
Original Certificate Date:
(Rev 11/05)
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99507
www. muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description:
A. WELL DATA
Well type
Date completed
Total depth
Lot 16, BlOck 6, Thunderbird Heights Subdivision No. 1
If A, B, or C provide PWSID #
Sanitary seal (Y/N)
Cased to f.
FROM WELL LOG
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform colonies/100 mL
Arsenic: ug/I
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel
Tank size 1,250 gal.
Foundation cleanout (Y/N) Y**
Date of pumping 8/5/2010
C. ABSORPTION FIELD DATA
Parcel ID: 051-582-13
Date installed 2/23180
Length 34
Total depth 9.
g.p.m.
Well Log (Y/N)
Wires properly protected (Y/N)
Casing height (above ground)
AT INSPECTION
Nitrate ~., mglL
Date of sample:
g.p.m:
Number of Compartments .Two
Depression over tank (Y/N) N
Pumper Sanitary Pumpers
Other bacteda
Collected by:
Soil rating (g.p.d./~ .or ft2/bdrm) 85 SF/BDRM
ft. Width 3 ft.
ft. Eft. absorption area 340 ft2 Monitoring tube
Date of adequacy test 3/21/11 Results' (Pass/Fail) Pass
Fluid depth in absorption field before test s3
Elapsed Time: 1,067 min. Final fluid depth 53
Any rejuvenation treatment (past 12 mo.) (YIN & type)
Date installed 2/23/1980
Cleanouts (Y/N). Y'
High water alarm (Y/N)
in.
colonies/100.mL
System type Di~ep Trench
Gravel below pipe 5 ft.
Y DepressiOnover field N
For 4 bedrooms
in. Water added. 612 gal New depth .58.4 in.
'in. Absorption rate >= 600 g.p.d.
N . If yes, give .date
LIFT STATION
Date installed
"Pump on" level at~
Datum
in.
E. SEPARATION DISTANCES
Size in gallons
"Pump off' level at~
Cycles tested
in.
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot N/A
Absorption field on lot N/A
Public sewer main N/A
Sewer/septic service line N/A
Animal containment areas >50'
Manhole/Access (Y/N)
High water alarm level at
Meets alarm & drcuit requirements?
in.
On adjacent lots N/A
On adjacent lots N/A
Public sewer manhole/cleanout
Holding tank N/A
Manure/animal excrete storage areas
N/A
>100'
Building foundation >5'
Water main >10'
Wells on adjacent lots >2oo'
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Property line >5' Absorption field >5'
Water service line >10' Surface water >100'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line >1o' Building foundation >1o'
Water Service line >1o' Surface water >1o0'
Curtain drain None Noted Wells on adjacent lots >200'
COMMENTS: **Foundation Cleanout is Located in the Crawl Space.
Water main >1o'
Driveway, parking/vehicle storage
Absorption Trench is 88% saturated.
>25'
..... n n
I ce~/~ that I have dete~/n~ though f/eld/nspectio s a d
~view of Municipal m~s that the above systems am in
~n~ance w~h MOA COSA guidelines in e~ct on this date.
Engineers Printed Name Michael E. Andemon, P.E.
Date 1/4/2011
COSA Fee $
Date of Payment
Receipt Number
(Rev. 11105)
01 o 1
Waiver Fee $
Date of Payment
Receipt Number
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
Septic System Advisory
Certificate of On-Site Systems Approval # 111107
During a recent adequacy test on the septic system for Block 6, Lot 16 of
Thunderbird Heights No.1 subdivision, 53 inches of standing water was
observed in the absorption field. This indicates that approximately 88% of
the absorption area is inundated. Although this system passed the adequacy
test, the remaining life expectancy may be limited.
This advisory must be attached to all copies of the subject Certificate of On-
Site Systems Approval
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
Parcel I.D.
1.
051-582-13
GENERAL INFORMATION
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Expiration Date: ~'"
Completelegaldescripfion THUNDERBIRD HEIGHTS SUBDIVISION i~1; LOT 16~ BLOCK 6
Location (site address or directions) 24515 THUNDERBIRD DRIVE * CHUGIAK, AK
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
STEVE WALKER
24515 THUNDERBIRD
Day phone 688-0154
DRIVE * CHUGIAK, AK 99567
Day phone
REGAN RUSSEY w/ REAL'P( EXECUTIVES Day phone 261-7388
341W. TUDOR ROAD * ANCHORAGE~ AK 99503
Unless otherwise requested, HAA will be held by DSD for pickup.
NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class 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 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.
IIVote: Alaska Water and Wastewater Consultants, Inc. shall be paid $
to closing for the engineering services provided.
aC or pdor
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I vedfy 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 vedfy 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 &: WASTE'WATER CONSULTANTS, INC. Phone
Address 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK 99504
Engineer's Printed Name JEFFREY A. CARNESS, 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 desc. dbed 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 ail we/Is and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate dudng the year, and the water usage of the family being served by the system.
These conditions are outside the control of the e valuator 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 #ght whatsoever,
DSD SIGNATURE
~ Approved for J-~ bedrooms.
Disapproved.
Conditional approval for
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
bedrooms, with the fllowing stipulations: ~.~
· ....
~'~
Manitenance Agreements
Supplemental Enginee(s Reo~
O~er
(Rev. 12/01)
Original Certificate Date: .~° / (~ ~) 3
Municipality of Anchorage
Development Services Department
Building Safe~ Division
On-Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage. AK 99519-6650
www.d.snchorage.ak.us
......... (soz) 343.79o4
Legal Description:
WELL DATA
HEALTH AUTHORITY APPROVAL CHECKLIST
THUNDERBIRD HEIGHTS S/D i~li LOT 16 BLOCK 6 Parcel ID: 015-582-1,3
Well type ~ If A, B, or C provide PWSlD# 211156 ~
Oats completed _ ~ Sanitary seal Wires properly protected (Y/N)
Casing height (above ground)
ff.
in.
FROM WELL LOG
Date of test
Statlo water level ~ fl.
Well production
WATER SAMPLE RESULTS:
Coliform colonies/100 mi.
SEPTIC/HOLDING TANK DATA
ATINSPECTION
/~ g.p.m.
Tank Type/Material STEEL
Tank size, !250 gal. Number of Compartments 2
Foundation deanout (Y/N) *YES Oepression over tank (Y/N) NO
Date of pumping 4/30/2003
ABSORPTION FIELD DATA
Date installed 2/23/lg80
Length 34 fL
Pumper
PBELOW EXISTING GRAD~'I
Soil rating (g,p.dJft~or(~ 85
Width _ ~ 3 fl.
Total depth *'/.13 fi, Eft. absorption area 340 ff~ Monitoring tube YES
Date of adequacy test 4/30/2003 Results (Pass/Fall) PASS
Fluid depth in absorption field before test 24.5 in. Water added 800 gal.
Elapsed Time: 12 min. Final fluid depth 6 in. Absorption rate >= 600+
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date
**WATI~ .5' ADOVE INVERT
Date installed 2/23/1980
Cleanouts (Y/N) YES
High water alarm (Y/N) N/A ,
CHUGACH PUMPING
System type TRENCH
Gravel below pipe 5 fl.
Depression over field NO
For 4 , bedrooms
New depthe*50.51n.
g.p.d.
Date of sample: Collected by:
1'4' CI.F. ANOUT INSIDE: HOU~F.. SNAKED I~Y BILL McDONALD ON 5/8/2003.1
,. g.p.m.
N ~~~~~~ ~ colonies/100 mi.
D. LIFT STATION
Date installed Size in gallons M~
"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 On adjacent lots
Absorption field on lot ~
Public sewer main ~ Public sewer manhole/deanout
S~ Holding tank
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
PUBLIC WATER
Building foundation '5' Property line. 5'+ Absorption field. 5'+
Water main 10'+ Water service line 10'+ Surface water. 100'+
Wells on adjacent lots 200'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+
Water service line 10'+
Building foundation. 10'+ .,,~(Vater main 10'+
Surface water ~ ~riveway. parkingNeh cie storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots. 200'+
F. COMMENTS
*PER 1980 INSPECTION REPORT
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 effecf on this date.
Engineer's Pdnted ~ia~e
JEFFREY A. GARNESS
HAA Fee $ ~,~'
Date of Payment
Receipt Number
(Rev. 12~ol)
Waiver Fee $
Date of Payment
Receipt Number
~.'
~ '% . - ~ -/~-
*"
. . ~ ~
NOT=- ~
I~O'~N ON ~tE ~CORD~ ~T, ~RE NO~ ~
strtcttons wht~ %0 not a~ear on t~e~recorded sub-~
~iviston ~lat. Under fl~ ciK~stmnce~should any. . ~ ~ .... .~:~_
data hereon be used for const~ctton or for es~b-
lish(n9 bounda~ or fence lines. ~e su~eyar take: ~
r.sponsJ~J11,~y_f~c.~e tnttial ..transaction onl~.
~, ,,~ I1~1 CAP ~O~.INT
LOT 16 : . BLOCK-_ 5 . ,.
ANCHORAGE REBORDIN6 DISTRICT
Q IIIQN PiP!
· ITI~L~L' PIX
C~ suJtvrt/(ul · TACK
aY. DOVA. ING & A~$OC~AT~S.~. 1 Residence c~: . ·
804 ECASI: 15Ih Ave~ auA~ ¢ i: .. · '
June .t~O. ~L¢
(site add~ ord{re~{ons~. ' ~ 7~~
' D~ phone ;'
... Day phone.
;:Agent" V~q~ Koh~/ R~ GF EAGLE RZVER. Dayphone. ~g~-~o~ "'
~UMB~ OF BEDROOMS: 4 ....... "
~- ~blic water ...........
., . . ,. ..., r :' .,m' , ..
to th~ leg81~ and ~tus of ~em.. .....
Date
~rooms, with ~e foll~ng ~pu~lons:_
............ .,*..~,~,,..,.~, ,. ,...,,L,I . ~il ..
~d Human
mp~e~m~x~ ~ven in
a~
'RO~'~HECKLI
~on~
RESULTS: ' '
'-'~'," ¢'' ' '~'"'"" " ' ' ,. : '~ :"!?q,'::'~!l~.J"'
gsltons Manhole/Access ~
n DATA
f'~ ~ ~ ' .Gruel ~s
~ .. ~'i
,,. ~ ~ ~ f~ ~fom te~ /~' ~er t~
· '~; ~ ~i~ ~ 12 ~) ~ ~aJ~ /~ ~/ ff yes, g~e ~e
?, '-' ~P~ D~CE ~ ~OR~ FIELD TO:
", Were ~ ~ ~ ~ ~e~ ~s
d' ~ ~ ~s ~ ' ~ ~ M~ W~er ~Wsew~
; ~ ~ O~ay. ~e~ ~om~ ~ea /o
~~ ~CA~ON
..... ' ~
... ! ,.,. Y ~...,.,~
'.,-'-- /I /
-- ~
~ __~ _~/~ ~ ~..
" ,~/~ ~l ~ ~ ~4~:':"? .~
· '~' / I -'" .... '
.....
· ~ -~$,, ' Wa~rF~$
~"" ~ ~ ~ ~ ' ~ ~ Dato ~ Pa~
;,,..', .~-
CALrtlON
r
ABSORPTION fiELD DATA
So~ I~.tlng in Abeorptm~ 81r~ll
"Pump ~ L~,M It
/ ";. '..~.:'.'~r~:: .;.',:;'~; ?.'.; '.':,:'
Vent (Y N) 11. ...... ' ..... ; ~ ';. ~ ~
~ge2M2
INSPECTION AFPOINTMENr$
]TtME
DATE
~ATE flECEIVED
MUNICIPAL.ITY OF ANCHORAGE ". '
DEPARTMENT OF HIALIH · e. NVl RONMIMTAL ~OTE~i~iPA[~,Y i~e
ENVIRONMENTAL SANITATION DIVISION ENYII~)NM~NI',~.
Tdel~oM 2M-4720 00"~2 1 1~0"!~
REOUEST FOR APPROVAL OF INDIVIDUAL WATER AND SF:~/;R FACILITIES r
PROPERTY RESIDENT (Jr d~ffe~t I~m Maow)
I
,~,~~ ~., o; ' , -- ~, ,. ~ ~ .. ~...
i~IcoNOIVIDUAL' ' A1"$ACH WE LL LOG. A
MMUNI~ ~ ~ 1975. For ~IIs drill~ ~r to ~ ~,~ ~1 :' . ' '
N41TE,e YEAR O~.SITE SY~EM ~ I~ALL~,
~TE: ~E I~ F2E ~ A~Y EACH REQUEST BEFORE PR~E~INQ
'" ~' ? T~S S;~,~ I'OR O~'.'"IC~AL USE O~C¥ ,r ,1 , . . ' "...*.... *' '
' ~ MUL'~PLEFAMILY : ~'~'~" ~ F~fl ', · ~; SIX
. , .. . . ','. , ?.. , · . ...,.? ~_~/..:~.,
~:NDIVI~A~N ~ITE. r, ~:. ,, DATE I~TAL~D ...................
] . ~ ,~ ~_.
: ~ ~ ' %--I I~ALL~ ............ . .....
~T~~T~ .' . ,'. ,., .,~
~: "' ' IfT~b~ ~A~ -. . .... ,~.,~.~.,..~,~
. · :~' ;'~LLTO:- '*. ,; ' ~ ; ' . [;, , ',. ~1' ~.' -~ ,.'
~'~ '."V:~'*" ' * :..~,.." ' · ' '
· :..: .~ . *,. ,: ...~ .... . . ..', ..~.,,.~:
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