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Home My WebLink AboutMILLPLACE ESTATES LT 3(NON MOM3 FO O OW w Z-wWOZ�oZ 0 t—Z $=mO to w t= �o w=m=o=z v_ UJLL.0 1� � W OW0WWOO C9 -OW ZU_O UU Z ONG t— 0 W O m U OW O w zuiIrm w o O w0wo m zz w m oWW0�v�c�Lu z U = 0 W p O m tn Z g qwz Z = Zee wWUJ z =awL=ov!� z=w t� 0 (—'n o ozo: in 0)- ® J i M Z Yn W 1 4 O ^ Z O Im �a-j Z N r$ w w o >dL LO N o ®o N a+- W = �' (n N N z 0 V) m D ti LO V) N V) t^ N Z LL JJ < �— �_ uj V co V! J � O LA U 0- (NON MOM3 FO O OW w Z-wWOZ�oZ 0 t—Z $=mO to w t= �o w=m=o=z v_ UJLL.0 1� � W OW0WWOO C9 -OW ZU_O UU Z ONG t— 0 W O m U OW O w zuiIrm w o O w0wo m zz w m oWW0�v�c�Lu z U = 0 W p O m tn Z g qwz Z = Zee wWUJ z =awL=ov!� z=w t� 0 (—'n o ozo: in 0)- ® J i M Z Yn W 1 4 O ^ Z O Im �a-j Z N r$ w w o >dL LO N o ®o N a+- W = �' (n N N Municipality of Anchorage Development Services Department Building Safety Division ~...~.y on-Site water & Wastewater Program 4700 South Bragaw St. i~ P.O. Box 196650 Anchorage, AK 99519.-6650 www.cLanchorage .ak .us (907) 343-7904 . RTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-112-40 1. GENERAL INFORMATION Expiration Date: Complete legaldescription T12N, R3W, SECTION 15; LOT 16B Location (site address or directions) 10501 ABOTr LOOP ROAD * ANCHORAGE, AK 99516 Current Property owner(s) Mailing address IRENE DeFRANG Day phone 258-2284 Lending agency Mailing address Real Estate Agent Mailing address Day phone CONNIE FIEIIINGA w/ COLDWELL BANKER Dayphone 2525 'C' STREET * ANCHORAGE, AK 99503 229-4783 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 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 Ctass 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. Note: Alaska Water and Wastewater Consultants, lnc. shall be paid $ at, or pdor I to dosing for the engineering services provided. 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 Authodty 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 inspe~'on, 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 tir~e of installation. NameofFirm ALASKA WATER &: WASTEWATER CONSULTANTS, INC. Phone 337-6179 Address 6901 DEBARR ROAD. SUFrE 2B * ANCHORAGE. AK 99504 Engineer's Printed Name JEFFREY A. CARNESS, P.E. Date Engineer's Comments: In conducting this evaluation, AKVVWC, Inc. attempted to provfde a thorough. conscientious engineetthg analysis of the system in accordance with ADEC and MOA DSO 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 o fall wells and septic systems depend on the local soils condition, greundwater levels that may fluctuate during the year, and the water usage of the family being sen/ed by the system. These conditions are outside the central of the evaluator of the system. SatisfactoQ/ test results do not guarantee future performance of the system, nor do they guarantee that there ere no hidden defects or encroachments. AKWWC, Inc. can therefore not pro~dde any warranty or future estimate of how long the system will continue to meet the operational requiraments 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. 5. DSD SIGNATURE Note: ~ere are nitrates present. ~"-" ON SITE Approved for ~ bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulafio~O~ ..... ' Thw well for this properFy meets existing state It is suggested that periodic testing be performed to insure the wells continued suitability, The current nitrate concentration is~8.48mg/1. EPA maximum concentration is 10.0 m~/1. More information on n. itrates is available from the On-site services program, at 343-7904. Att~:fiments: HAA Checklist I.,,,/ Manitenance Agreements Septic System Advisory Supplemental Engineer's Reort Well Flow Advisory Other Original Certificate Date: Municipality of Anchorage Development Services Department Building ~afety Division On. Site Water & Wastewater Program 4?00 Soufft Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www,d.anchorage.ak.us (sm,) ~43-?;04 Legal Des=lpUon: A. WELL DATA HEALTH AUTHORITY APPROVAL CHECKLIST T12N, RSW, SEC. 15, L16B PamallD: 015-112-40 Well type PRIVAI~ IfA, B, or C provide PWSID~ N/A. Date completed PRE 1990 Sanltaryseal(Y/N) YES Totaldepth 133'+ ft. Date of test Static water level Well predudion ~ WATER SAMPLE RESULTS: Coliform 0 colonies/100 mi. Amenio: N/A mgJL. SEPTIC/HOLDING TANK DATA Cased to 40+ ft. FROM WELL LOG 8/8/84 UNKNOWN ft. 2.5 g.p.m. Nllmte 8.48 mgJL Date of sample: 7/19/2002 Tank Typa/Mata~tal STEEL Tank size 1000. gal. Number of Compartments Foundation deanout (Y/N) YES 2 Depression over tank (Y/N) N,O. Well LJ:,g (Y/N) Wires propedy protected (Y/N) Casing height (above ground) AT INSPECTION 7/19/02 129 It. 5+ g.p.m. YES YES 124- OUler bacteria 0 colonlesJ100 mi. Collected by: AKWWC, INC. Date installed 9/24/1gg0 Cleanouta (Y/N) YES High water alarm (Y/N) N/A Date of pumping 8/12/2002' Pumper DENAU SEWER AND DRAIN pBELOW EXIEI1NG GR,'U)EI Soil rating ~ lt~/Ixlrm) 268 ABSORPTION FIELD DATA Date in,steWed e/2~/1~90 Length 51 fl. Width 3 lt. Totaldeplh ,12 ft. Eff. abso;ptlonarea 816 fl= Monitodngtube YES Date of adequacy test 7/19/2002 Results (Pass/Fall) PASS Fluid deplh in absorption field before test 0 in. Water added 1180gal. Elapsed Time: 1188 min. Flrml fluid deplh 19 in. Absorption rote >= Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN System type TRENCH Gravel below pipe 8 lt. Depression over field NO For 3 beqmoms New deplh 51 in. 4504- g,p.d. If yes, give date - D. UFT STATION Date installed 'Pump on' level at in. Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Fe Size in gallons 'Pump off' le~ at Cycles tested SepUc tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer IsepUc service line 25'+ Manhole/Acee<- ("(/14) High water alarm level at Meets alarm & drcult requirements? On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/oleanout Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Water main N/A Water service line 10'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Water service line 10'+ Curtain drain NONE KNOWN COMMENTS Building foundation 10'+ SurPace water 100'+ Wells on adjacent lots 100'+ G. ENGINEER'S CERTIFICATION I cattily that I have determined through field inspections and review of Municipal recortls that the above systems are/n conformance v/~th MOA HAA guidelines in effect on this date. Engineer's Printed N~me Date JP.J'F~EY A. GARNESS Absorption field 5'+ Bur[ace water 100'4- Date o, P, nt 15- (~. ~) Water main Driveway. partdng/vehlcte storage Waiver Fee $ Date of Payment Receipt Number in. 10'4-