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Home My WebLink AboutSUETAWN ESTATE LT 5 Tawn Estates Lot § #051 - 501 - 15 Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak, us (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051 -50_1~/,~' 1. GENERAL INFORMATION Complete legal descriptior~4~~_ -~' j Location (site address or directions) Expiration Date: 18821 Jasmine Road Current Properly owner(s) Elaine Oldham Day phone 688-3416 Mailing address P.O. Box 670393 Chugiak; Alaska 99567 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unlesb oth'brw~se requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] [] Individual Holding tank [] [] Community On-site [] [] Public Sewer [] The Municipality of Anchorage Department of Health and Human Services (DHHS) 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) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. Cedificates 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 sample results less than 30 days old. 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. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation dc'e shown below, I verify that my investigation based on procedures outlined in the Health Authority Approval Guidelines for this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe1 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm KND Engineering Phone 696-6111 Address Engineer's Printed Name Kenneth Duffus 20441 Ptarmigan Blvd. Eagle River= Alaska 99577 .=. Date 6)29~00 bedrooms. 6. DHHS SIGNATURE ~ Approved for ,.~ Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Expiration Date: / ~ ' ~- /1/ - c~ ,o Maintenance Agreements Supplemental Engineer's Report Other Odginal Certificate Date: Reissue Date:_ Date of test Legal Description: A. WELL DATA Well type private IfA, B, or C provide PWSID # __ Date completed 10/8/1982 Sanitary seal yes Total depth 120 ft Cased to. 120 ft FROM WELL LOG I 0/6/1 982 Municipality of Anchorage [ V E Department of Health and Human Services Division of Environmental Services ~ ~ C E On-Site Services Section 825 "L" Street Room 502 · P.O. Box 196650 Anchorage, AK 99519-6650 ~JUL 1 ~ 2000 www.ci.anchorage.ak.us (907) 343-4744 ~UN~CIPAI, II¥ O~ .,/?r~NMENTA'~ SERVICES HEALTH AUTHORITY APPROVAL CHECKLIST Sue Tawn Lot 5. Parcel I.D.: OSJ-~'0t Static water level unknown ft Well production 2 0 g.p.m WATER SAMPLE RESULTS: Coliform 0 colonies/100 mi Nitrate 2.12 Date of sample: 6/22/2000 Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Steel Date installed ~, Tank size 1000 Well Log yes Wires properly protected yes Casing height (above ground) 24 in. AT INSPECTION 6/22/2000 90.5 ft 6 g.p.m _mg/I Other bacteria 0 .colonies/100 mi KND Engineering gal Cleanouts yes Foundation cleanout yes Depression over tank n_go Date of pumpinq 6/21/2000 . Pumper JRs Pumping C. ABSORPTION FIELD DATA Date installed JC~R~ Soil rating (g.p.d./ff2 or ft2/bdrm~ 120ft2 Number of Compartments_2 High water alarm yes System type Deep Trench Length 27 ft Width 36 ft Gravel below pipe 7 ft Total depth 10.5 ft Effective absorption area 378 fl2 Monitoring tube y~e$ Depression over field no Date of adequacy test (~/~/00 Results (Pass/Fail) pass For3 bedrooms Fluid depth in absorption field before test 38.5 in Water added455 gal. New depth43 in. Elapsed Time: 20 min Final fluid depth 40 in Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (WN & type) no If yes, give date D. LIFT STATION Date installed "Pump on" level at __. in Datum E, SEPARATION DISTANCES Size in gallons. "Pump off" level at __ in Cycles tested Manhole/Access High water alarm level at __ Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots I 0 0 ' + Absorption field on lot 100% On adjacent lots I 0 0 ' + Public sewer main 100'+ Public sewer manhole/cleanout Sewer/septic service line 100'+ Holding tank I 0 0' + SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK QN LOT TO: Property line I 0 ' + Water service line I 0 ' + Wells on adjacent lots I 0 0 ' + Building foundation 10'+ Water main 10'+ Drainage 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 1 0' + Water Service line 10'+ Surface water I 0 0 ' + Curtain drain 100'+ Wells on adjacent lots I 0 0 ' + F. COMMENTS ENGINEER'S CERTIFICATION I certify that I have determined through fie/d inspections and review of Municipal records that the above systems are in conformance with MOA HAA guide/ines in effect on this date. Engineer's Printed Name KND Engineering Date 7/11/00 Jn 100'+ Absorption field I 0 ' + Surface water 100'+ Water main 10'+ Driveway, parking/vehicle storage I 0 ' + HAA Fee $ Date of Payment Receipt Number (Rev. 11/gg) Waiver Fee $ Date of Payment Receipt Number 08-2~-00 08:38 FRO~-CTE ENVIRON~NTAL ZIK CT&£ Enviro~lmental Services Inc. 5615301 T-754 P 02/03 F-OIl CT&£ ReL~ 1003254001 Client Name KND Engineering Project NameP~ Sue Tawa #1 B1 L5 Client Sample ID Sue Tawn al B1 L5 Matrix Dnnkmg Water Ordered By PWSID 0 Client POB Printed Date/Time 06/28/2000 15:22 Collected DateJTime 06/22/2000 11:00 Received Date/Time 06/22/2000 13:12 Techaical Director Stephen C. Ede Sample l~mark$: POi- un,Is 2.12 0.500 mgic EPA ~00.0 (~10) 06/22/00 08-29-00 08:38 FROg-CTE ENVIRONgENTAL 5815301 T-754 P.03/02 F-011 CT&E Environmental Services Inc. Laboratmy Division ~ 200 W Potter Drive 99518-1605 Fei (907l 562-2343 3rinkmg Water Analysis R~port for Total Coliform Bacteria ^.cho,,~o, A~< READ INSTRUCTIONS ON REVERSE $IDE 8£FORE COLI. E£TING SAMPLE FaxAO07} 561-5301 ~LET~D BY WATER SUPPLIER TO BE COMPLETED BY LABOR?-TORY : Analysis ShOw'S this Water SAMPLE to be n PUBLIC wATER sYSTEM I.D.t~ X pRIVATE WATER SYSTEM Mmnh Day Year ~-/' Sat~sfaclory n Unsaus facto'o/ Sample over 30 hou~ old, res~l~ may b~ unrehable Sample mo long m ~sl[; sample should not be over 48 hours old at [o ind::ale ~ehable resulm. Please new sam~te vm spiral 4ehve~ marl. Analys~ 1003 54 Sent to A.D,F=-C. Anch Finks "00 mi. Result' .analyst Client nol~fied of unsatisfactory result's: Phgn*(l Spoke ~lth Faxca SAMPLE TYPE:. X R°uti"e ~"~1~ ~1~ ~ Treated Water o Repeat Sample (for reu~ne sample UnTrea~ Waif with Inb rd. no. -- ) a Sp~ial Purpose Time Cellec~ SAMPLE LOCATION Coll~t~ By BACTERIOLOGICAL WATER ANALYSIS RECORD BGB ~~ Mem~,or of ~l~a SGS Group (Soc,e~e Gene'ale a" Survmnan¢°l ~ 00o - DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT MAILING ADDR SS - LEGAL DESCRIPT[O , ~ Well ~,j_ Dwelling PERMIT NO. ~ ~ DISTA.NCE TO: Well Foundation No. of lines / Length of each I]~ ~_ To~a] length~of~l~es~ Trench~wldth inches Distance i~/flbe en line~ ~--~ Top of ti,e to finish grade j Materialbeneathtile Totaleffectfvea~s~tionarea ~ ~ Type of ~rib grib dism~er~j~ grJb depth To~l effe~live 8bsorpdon Bre~ ~ DISTANOE TO: ~ DISTANOE TO: · OTHEB INSTAELER / / 72-013 (Ri v. 3~78) .... - l'-'iLIll,,t 'r C: 1' F-FiL'i" T'-r" OF I':Ir-'IcH'-~P..F::IGE ~//-~ DEPARTMENT (t ,HEALTH AND EMy'rRONMEr...ITAL '~.~C. ITEC:TION 825 "L~ STREET., ANCHORAGE, Al<. 9~.q~'._.01- :' 264-4?20 'I-~ELL R[-4[) k--,r-l--S I TE SEUEF.' PERi'-11 T PERMIT NO. ( 82091~ ) RPPLICRNT LOCRTION LEGRL MYERS CONST L5 SUETRWN PO BOX ~51 9956? LOT SIZE 694-4414 999999 SQU~RE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MBXIMUM NUMBER OF BEDROOMS SOIL RBTING (SQ FT?BR)= 120 THE REQUIRED SIZE OF THE SOIL 8BSORPTION SYSTEM IS: [:.EPTH= iC_-~ LE~'~GTH= 2r:_-; G F-: R'~.' E L [)EF'TH= 7 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRBINFIELD. THE DEPTH OF 8 TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFBCE OF THE GROUND BND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GR~VEL DEPTH IS THE MINIMUM DEPTH OF GROVEL BETWEEN THE OUTFALL PIPE BND THE BOTTOM OF THE EXCBVRTION (IN FEET). ~:E~.~L! I RED SEPT I C TA~tK S I ZE= iOOO GALLC~P-~S PERMIT 8PPLICBNT HBS THE RESPONSIBILITY TO INFORM THIS DEPORTMENT DURING THE INSTBLLBTION INSPECTIONS OF 8NY WELLS 8DJACENT TO THIS PROPERTY 8ND THE NUMBER OF RESIDENCES TMBT THE WELL WILL SERVE. T~4CR (2) I ~JSPECTIONS 8F~E REQL~IREC, BBCKFILLING OF 8NY SYSTEM WITHOUT FINBL INSPECTION 8ND 8PPROVBL BY THIS DEP~RTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTBNCE BETWEEN 8 WELL 8ND 8NY ON-SITE SEW8GE DISPOSAL SYSTEM IS 100 FEET FOR 8 PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIMATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS 8RE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DBYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MBY ~PPLY. SPECIFICBTtONS 8ND CONSTRUCTION DIBGRBMS ARE 8VAILBBLE TO INSURE PROPER INSTBLLBTION~ PERM I T E,~-~: F' I RES DEC:EtdBEE: --~:1.. 1982 I CERTIFY THAT 1: I BM FBMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF 8NCNORRGE. 2: I WILL INSTRLL THE SYSTEM IN ACCORDRNCE WITH THE CODES. }: I UNDERSTBND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THBN ~ BEDROOMS. SOILS LOG PERFORMED FOR: LEGAL DESCRIPTION: 1 2 ~3 7 8 ~2 ~3 14 17 ~8 20 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVl RONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264°4720 SOILS LOG - PERCOLATION TEST [] PERCOLATION TEST W^SGRO' NOWATER / ~- S- E.COUNTERED? IF YES, AT WHAT DEPTH? Reading Date SLOPE SITE Time Time Depth to Water Net Crop PERCOLATION RATE [minutes/inch) COMMENTS TEST RUN BETWEEN 72-008 (6/79) CERTIFIED I FT A __ FT or~?~.~ co~pa.¥ Ra~e Ma~nusQn Dr~,~g Anch uetawn ___/ / / /Io. Top soil Dr~.~ravel and boulders Wet ~L~_qvel water inc. Brown clay Wet ~ravel water incl. 0 ._5_ lO~ lO1 IlO llO 120 STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES Drilling Permit NO. 3. OWNER OF WELL: - ~. Paul Myers ^ddr*~$: P.O. Box 351 Chugiak ~ Ak. 99567 4. WELL DEPTH: (completed) ! Surface Elevation Oateof 120 f ~____l_~-- [~Test Well E]Other: 7. CASING: ~] Threaded X~Walded 6 i.. to 120 Pt. Depth Weight 17lbs/ft. Type: O~ez~ Hole Oia~ter: I ft. lh WELL HErO COMPLETION: 12. GROUTING: Well Grouted: [~]Yes ~r~ Material: [~Nea: Cement L~]Other: Type: [~Submerslble [~Reciprocatlng El Jet [~]Other: Bail tested at 20 GM4 Water Temperature: Drillin~ AA 5385 · Ma~nuson ~ APPLIC,~,r~IT FILLS OUT UPPER HAL~.j, ONLY Property O~er ~Myers Construction, Inco Phone MaJJing Address Zip Code 9 9 5 7 7 6 9 4 -- 9 6 3 3 Buyer Ronald & Elaine Newcomer Address 7100 Lake Otis #9 Zip Code Lending Institution First Federal Savings & Loan Phone Address 813 Wes[ ~or~herR Lights Blvd. Zip Code 2?4--6565 RealtyCo.&A~nt Totem Realty, InC~ ,~ ~agle River Branch Phone - Lega~ DescrYing. ~ 5, Sue ~ Estates s~ree~ Loca~ N}~ Jasimine Street, ~ Single Family ~ Multiple Family No. of 8edroo~ 3 Water Supply ~ Individual A~AGH WELl LOG. A w~l Icg is required for aB wells drgled since June 1975. ~ Community For wells drilled prior to that date, give well depth (a~tach Icg if available). Sewer Disposal ~lndividual Year Indiv~u81 Installed: 1982 ~ Public Utility Whe~ Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUSI ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector In spector~)¥~(~.._~ Field Notes: Ob, 2 '~ 1982 RECEIVED (__~) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL* DATE .,/~'~ BY: ftc'- ~--~? Soils Rating Date Sewer Installed Well TO Absorption Area Well Log Received ~'/.i3A .~' ~'-'8 "L_- w~,, to T~.k Sept,~ T~k S,~e /~O 72.023 CHEMICAL & Glo,LOGICAL LABORATORIES \.,.~; ALASKA, INC. TELEPHONE (907)-279-4014 ANCHORAGE INDUSTRIAL CENTER 274-3364 5633 B Street Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: Water System Name . I,~D. NO. Phone Mailing Address City SAMPLE DATE: ~ MO. Day SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no. ) [] Special Purpose State Zip Code Year [] Treated Water [] Untreated Water SAMPLE NO. t I 4 LOCATION Time Collected Collected By TO BE COMPLETED BY LABORATORY A. na~ys~s shows mis Water SAMPLE to be: /~ Satisfactory [] Unsatisfactory [] Sample too long in transit: samole should not be over 48 hours old at examination ~o ~dicate reliable results. Please send new sample. Date Received Time Received Analytical Method: [] Fermentation Tube ~/Membrane Filter Lab Ref. No. Result* Analyst *NO of colonies/100 mi. or NO. of Posture 3orllons READ INSTRUCTIONS BEFORE COLLECTING SAMPLE-:' 06-1220 (b) Rev. 1978 BACTERIOLOGICAL WATER ANALYSIS RECORD Date Collecte~l Source Date Received Time Recelve~ D,mo Lab. No. Presumptive 10mi 10mi 10mi /0mi 10mi 1.0mi 0.1mi 24 Hours 48 Hours Confirmatory 24 Hours I 48 Hours BGB December 13, 1982 Myers Constructionf Inco Eagle River, AK 99577 Subject: Lot 5 .Sue Ta%~n Estates Approval for the individual sewer and water facilities cannot be granted until the following items have been completed. The water facilities scheduled inspection. appoint~ent. %~ere not turned on at the time of the Please call this office for another A four (4) inch cleanout needs to be installed tie tank. to the sap- o A four (4) inch cleanout needs to be installed to the leaching area. Please notify this Department for a reinspection when the noted discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. Sincerely, RP2~9/p/EH Robert C. Pratt Associate Environmental ~pecl. allst