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Home My WebLink AboutSUETAWN ESTATE LT 3 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 N-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE 'NEW MA'L'NG ADORES 5, x LEGAL DESCRIPTION NO. OF BEDROOMS LOCAT'ON DISTANCE TO: ] ~W~ ' IAbs°rpti°n area Dwei'ing PERMIT NO' 7~ad.~ 5 / ~ I- Liq. ~n gallons iF HOMEMADE: Inside length Width Liquid depth : ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O ~ ~ Manufacturer Material Liquid capacity in gallons ~i~,,, DISTANCE TO:~ ~,1~)~ ~ I/.-~ Foundationoo Nearest lot line PERMIT NO, I--- , ~v~; inches Total ef fe~e~o~J/--area No, of lines ~ Len f each I ne Total len t.~.~of~ines Tren i th Distance between l ines~ //~ ~ ~- , Top of tile to finish grade Material beneath tile ~ ~r~ ~-~g inches Length Widt~ Depth PERMIT NO, ,~ I- Type of crib Crib diameter Crib depth e Total effective absorption area ~u Well Building foundation Nearest lot line ~ DISTANCE TO: .~ ~lass Depth Driller Distance to lot line PERMIT NO. LU Building foundation Sewer line Septic tank Absorption area{s) DISTANCE TO: APPR~ D ' DATE LEGAL PERMIT NG. !APPLICANT LOCATION LEGAL · DEF'ARTMENT OF MEALTH FIN[:, ENVIRONblENTFIL PROTECTION 82-5 'L' STREET., ANCHORAGE., AK. 99501 224-4?20 ( ~9~51 ) PAUL D. GRADY SUE TAWN EST. L} SUE TAWN ESTATES 80X 955 CHUGIBK LOT SIZE 47000 SQIJSRE FEET TYPE OF SOIL FIBSORBTIQN SYSTEM IS: TRENCH MRXIMUM NUMBER OF BEDROOMS SOIL RATING (SQ FT/BR)= 125 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM 'IS: : [)EPTH= 8 LEr-.IGTH= 4~ Ii l~, FP,/E L DE P:t:H==- 4 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVFITION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRBVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFBLL PIPE AND THE BOTTOM OF THE EXCAV8TION (IN FEET). RECaLl I RED SEPT I C TRf~k'. S I ZE= iL'~£'u--] ~RLL_C,f-~S PERMIT APPLICANT HRS THE RESPONSIBILITY TO INFOR~ THIS DEPARTMENT DURING INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT T~ THIS PROPERTY AND THE ~NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. TI-10 ( 2 ) INSPECT I OFJS F:iRE REf2LI I RE[:, BHL;KFILLIN~ OF FINY SYSTEM WITHOIJT FINAL INSPECTION FIND APPRO~AL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELU OR ±50 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST 8E RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS ~OF THE WELL COMPLETION. ~OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS 8RE AVAILABLE TO INSURE PROPER INSTALLATION. F'E~:I~I I T ENF" I RES [;,ECE~'IBEP. __~.-_!1_.. THE I CERTIFY THAT i1: IRM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND HELLS RS SET iFORTH BY THE MUNICIPALITY OF ANCHORAGE, ~: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ,}: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM M89 REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS· .... ..... APPLIuBNT'~' PAUL D. GRBDY / / / ISSUED BY_ -L-~-~ _DATE ...... %,-~, I~-~ ,~.:' ,.~ !i .".:':~.,,.' I!::;:)1' "~.~.~1 ''lir',l:'l!'l~li!: ii;l'!'il i'' !"i .I ~ 'i '"".' ',1 ~ ~,'~;i ::ii'~"~,li~iti,! ,~L~ !t~k::l,'"t'i~.l;' ,:iP'.ii ,:fl."!L~ ! I I.It,;.~.~1,:' .~':'.'l"]~l ','ik'~ ~,'1:~'~ i,.,I.l,l.,~,:k,,i ?,1:r · '~ .L ,. ~:~'~g;::: % ,1: .. ', . ~: ,~"! ~,~.:.:~.. I .,:: ,l!.'.,~ ~ '~1::-~;. '~ ~ ~1 :'~ :,~ ,~ '~L~, ' "" ' i ' ~' "" ' iiiii '/,l ii~::K.": ~. ,:! .I..t~. I, "~C ~' ~ ' - "~:. ;.'.':~(li'.l:~l :'!',-~T i']'i (ii ~..~:ll,.il',?:y.:;ll.~;::l~.li:t L'r! ~ t"',] I1'~('¥',.~ :lid I I. ;!'~ I':; ~) : ~ ~ !, ,. ' ' ~A~ ~ .... ~, .;::l"lO0?h;]:~k:! ::: !4,1ii '. ?;'bl;t'l :~(111 I ;!4]' ;'~1' ';t:i. L:l';I;;~i'l;:; ;l ,:t '~ .'i'::?~ i '. ,., / 5.; ' 08"E Russell Oyster 694-2774 Soils ~r Foundations Performed for: Legal Description: GEOTL~HNICAL 8' DEVELO,,,~dENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 SOIL LOG Name: /Z:~,.'gU/- ~' ~/ Tel. No,. ~_. Mailing Address: ~¢'~X Earl Ellis 688-2280 Land Development 15 16 Ground Water Encountered: Yes No c.~ If yes, what depth_.=~_ Proposed Install.ation: Seepage Pit__~ Drain Field____._ Comments: DEPRRTNENT~L / HERLTH RND EN'¢IRONMENTR~t~. 2:0TECTION F:°.~_,=._" L'¢" STREET., RNCHORRGE, RK. ~2~92 264-4720 I-.IELL- PERf"1 Z T F'EF.:MIT NO. ( ,=,2. E~l~:1. ', Pill Jr_ GRflD'.r' ..TH:MINE =:,T F..E ET ]PPL I CRNT ,_.OCFtT I ON LEGRI_ LOT 3: SUETRHN ESTFITE ._,F..R E,O,.-, 'aS~ OLD GLENN HH'¢. "'-'"' '-"~'-'= LOT _,I~.E 4~.J~_,~d SI.-,!UFtRE FEET MINIMUM [:,ISTRNCE BETHEEN R HELL RND RN¥ ON-SITE SEHRGE DISPOSRL SYSTEM IS] 100 FEET FOR R PRIVRTE HELL OR 158 TO 288 FEET FROM Fi PUBLIC HELL DEPENDING UPON THE TN'PE OF PUBLIC HELL NINIMI_IId [:,ISTRNCE FREM R PRIVFITE HELL TO Fi F'RIVFITE SEHER LINE IS 25 FEET FiND TO R COMMUNIT'¢ SEHER LINE IS 75 FEET. HELL LOGS FIRE REQUIRED FIND MUST BE RETURNE[:' TO THE DEPFiRTNENT HITHIN 3:F..l DR'CS OF THE HELL COMPLETION. OTHER REQUIREMENTS MFi'T' FiPPL.~'. SPECIFICRTIONS FIND CONSTRUCTION DIRGRRMS RRE RVFIILFIBLE TO INSURE PROPER INSTRLLFITION. F'ERi-"I I T E:,';F" I RE-- [:,ECEf'IE:E~: _%Z~1.. 1981 ! CERT I F'-r' THRT 1: I Rf'l FFIMILIRR HITH THE RE.F. LIREMEftT- FOR ON-_-,ITE '~EHERS FIND HELLS FI=:"], SET FORTH E:'-¢ THE MLINI]IF'FtLIT¥ OF FINCHORRGE. ":" I 1.4ILL IN_THLL THE _~.:TEfl IN I-IL.L. URDflN_.E HITH THE CFIDE'-'; y a .~ 000000000000 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMII-Y DWELLING Parcel I.D.# ~--"%~\ - ~C~\ -\"-~ HAA # 1. GENERAL INFORMATION Complete legal description Lot 3~ $u6 Tawn Estates Location (site address or directions) 18935 Jasmine Road Property owner Mailing address Lending agency Mailing address Pa~ Grady K~nn~bunk~ ~ain~ Day phone Day phone Agent Dave P~_ck TARGET~ INC. Address P. 0.Box 774627 Ea,ql6 Riv~r~ Ak. 99577 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: individual well X× Community well Public water Day phone 694-2388 NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: XX Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72~)25(Rev. l/91) Front MOA#21 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Phone ~Q~ ~'~ ~.~'79 Name of Firm ~t & S ENGINEERING Add ress 11034 Eofjle RiYer Loop Road No. 204 i~,,,4e River, Alaska 9~577 Engineer's signature DHHS SIGNATURE /~/ Approved for ~'~ Disapproved. Conditional approval for bedrooms. Date /\- c-{-~ ) bedrooms, with the following stipulations: Additional Comments Date ,///- 7 - ~'/ The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements, Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work, 72~)25 (Rev. 1/91) Back MOA ( Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: [~-':'~ ~--------~"~-Jl, J Parcel I.D. A. WELL DATA Well type /(~'\~/~'~ If A, B, or C, attach ADEC letter. Log present4~i~N) Total depth Sanitary sea~) ADEC water system number '-----' Date completed '~.~-- ~1 Driller ',./,~.l ' Casedto ~, ~ . Casing height Wires properly protectedz~Tt4) \/ FROM WELL LOG Date Of test "~.- '" ~"'~:~ Static water level Well flow PumP level g.p.m. AT INSPECTION [ {~,~- '~-~r'~Ji~UNJCIPALITY OF ANCHORAGE .,~'1 ENVIRONMENTAL SERVICES DIVISION I'10V 0 4 1991 ~"' ~-~' ' g.p.m, RECEIVED SEPARATION DISTANC,ES FROM WELL TO: . Septic/ho d ng tank on lot \'~'~ Absorption field on lot Public sewer main I'~c2 r-~ Sewer service line WATER SAMPLE RESULTS: Colifo~;m ~.,___./~_..~> t -.//~-,_~. ,,.j~ Nitra, te Date of sample: ~ ~" ~'~f ~'~ I ; On adjacent lots L ~ I Jr' ; On adjacent lots ~ ~ I ,.~ Public sewer manhole/cleanout Petroleum tank Other bacteria Collected by: ~//' ~c:::::~1~, . B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts4¢¢:~) High water alarm (Y/N) Date of pumping Tank size t ~ Compartments Foundation cleanout~) V Depression (Y/,_~ ~ Alarm tested (Y/N) ~'~.,) 1"~ ¢ ) i"~, Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot \~'~' On adjacent lots To property line { ~'~ I ~ Absorption field Surface water/drainage ~ ~c:>~ ''~ Ip¢ Foundation ~ ~:~' t~'~ Water main/service line ~ ~ I''jr 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATIO% Date installed ~ Manufacturer Size in gallons ~ Manhole/Access (Y/N) __ Vent (Y/N) Pump~ "Pump off" level at High water alarm level ~ C.4~les tested Meets MOA electrical codes (Y/N) ~ SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Length ~""-C;:~ ~ Width Total absorption area Depression over field (Y~ Results (pass/fail) Peroxide treatment (past 12 months) (Y~ Soil rating /~/¢~ System type Gravel thickness dC Cleanouts present~[~N) Date of adequacy test for ~o~'~ ~'t,~r-~ If yes, give date Total depth bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellon lot To building foundation On adjacent lots Surface water Curtain drain E. ENGINEER'S CERTIFICATION On adjacent I°ts 1 "-~t~ t A" Property line ~"~6:::?~ To existing or abandoned system on lot Cutbank '~' ~-~" Water main/service line Driveway, parking/vehicle storage area I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection, S & S ENGINEERING Signature 17034 Eaqle River Loop I~ond Eagle River, Alaska 99577 Engineer's Name Date t/'- ~'-~ ~ HAA Fee $ / 7~ Date of Payment //- ~/- ¢/ Receipt Number ¢~-~/¢~'¢f ~'~¢ ¢-~ Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 ANALYSIS REPORT BY SAMPLE for WORKorder$ 39640 Date Report Printed: OCT 28 91 6 14:13 FAX: (907) 561-5301 Client Sample ID:L3 SUE TAWN PW$ID :UA Collected OCT 24 91 ~ 20:30 l~s. Received OCT 25 91 ~ ~3:35 h~e. Preserved with :AS REQUIRED Client Na~e :S ~ S ENOINEERINO Client Acct :SNSEROP BPO t PO t NONE RECEIVED Ordered By :R. SDAFER Analysis Completed :OCT 28 91 Send Repo~te to: Laboratory Superviapr ;STEPHEN C.E}E I)S & S ENOINEERING Released By: ~~ Chemlab Ref t: 915753 Lab Smpl ID: 5 Matnix: WATER Allowable Parameter Tested Result Unite Method Lim~.te NITRATE-N i.5 ~r/1 EPA 353.2 10 Sample ROHYI~ $A~iPLE COLLECTED BY: Renarke: I Tests Pe[£ormed ' See Special In~txuctiona Above DA=Unavailable ND- None Detected '* See Sample Re~arke Above NA= Not Analyzed [T-Less Than, OT-Oreatex Than ~S~ Member of the SGS Group (Soc[dt6 GOndrale de Surveillance) CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. TEL~:PRONE (907) 592-2343 5633 B Street Anchorage, Alaska 99518 Drinking Water Analysis Report for Total Colif?rm Bacteria TO BE COMPLETED BY WATER SUPPLIER F1 PUBLIC WATER sYsTEM I.D. # "1 t I I I I I j~i~'PRIVATE WATER SYSTEM 17034 Eagle Ri,,,er Loop Road [~aale River~ Alaska 95)577 Mailing Address Ph~o No. Mo. Day Year SAMPLE TYPE: 4~outine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose [] Treated Water [] Untreated Water SAMPLE Ho. LOC~TI~', Time Collected Collected By II fO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: ~Satisfactory [] ~nsatisfactory : [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail Date Received /~/.~'~//~[ Tima Roceivsd Analytical Method: Membrane Filter No. of colonies/100 mi. Lab Ref. No. Result* Analyst BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Reported By TNTC = Too Numerous To Count OB = Other Bacteria Membrane Filter: Direct Count Verification: LSB BGB Fecal Coliform Confirmation Final Membrane Filter Results PART ONE OF T~VO: REHAINDER TO FOLLO~ Coliform/100 mi