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HomeMy WebLinkAboutMACHENFELD LT 1 Frorn: RLPLNE DR!LL 90? 345 0202 Rpr, 18.1994 1l:~3 PH PO1 STATE OI= ALASKA DEPARTMENT OF NATURAL RESOUR01;~8 DIVISION OF WATER : : :J~UOH SUaDrVJ~4ON LOT BLOCK 8EOTION QTR$ IBTION TO~IP flRNQE / ~. .~ .. ~t~ ~'M~$UREO FROM:~eastng top Ooround sudaco WELL D~TH: . . DATE OF COM~tO~., ........... Depth of h01e:~ft "'"' :.:.:~,. ................... , , . * ,:. :fi . .(~A':) CJ') J, ~, ........ {t below ' :~':" :'~"; / M~HOD OF DRILLING: ~ air rotaw ~ .Gable tobl t~::~*',': , ' ,?: :' .,~.,;, ,:. '.':' :.~:~LJ~.'~.. .~ . .: .~ ... , . Volume used:.. Depth to top: ' ' · {' · "i: ~: "~ ~ 3 ~ GROUT TYPE: Volume: : :' "'" DeC Healt~ ~" D~ELOPMENT M~HOD: ' ' '' PUMPING L~EL AND YIELDI i.~ , ," z '" / . hrs pumplng~ ~ ' PUmP ,.TAK. Dietfl: ft HorEepower;,,~',. INFORMATION: REMARKS: ! .".: , /) . ' b~ ' ~' / / , .~ ~ ,< , 4 :. :,,~L~,~,,,~'.~ ~,...:~ ~' ~' ~, ~ ;;~ ;., ::~:~ ~,:of AuthOrized RosP~sentative Date PLEASE MAIL WHITE COPY OF LO!2[~TO: DNRIDIVI~ION OF WATER PO BOX 772116 :~'"" 0 ./' PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM PERMIT PERMIT NUMBER:SW930295 DESIGN ENGINEER:ANDERSON ENGINEERING OWNER NAME:HALCRO ROBERTA JAYNE OWNER ADDRESS:4701 W 80TH AVE ANCHORAGE, ALASKA 99502 PARCEL ID:~lllll~i ~\-\\\~ LEGAL DESCRIPTION: T12N R4W SEC 10 LT 4 E240' LOT SIZE: 159838 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 8/13/93 EXPIRATION DATE: 8/13/94 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: PUBLIC SEWER IS BEING EXTENTED TO SERVE THIS LOT. AWWU FILE NUMBER S93-028 RECEIVED BY DATE: DATE: ./ BLM MEANDI]R LINE 86 SAND LAKE ~',.-CURRENT SHORE LINE~ LO3' WD ~8.1 FND REBAR PROPOSED HOUSE F.F. ELEV 91.§' 86,0' (TOP OF WATER 7/28/92) 4'02;[-'M REC 88.4 e,~ FND BLM BO ~',"' ~ 2o.oo', N 89'58'00" E WELL o Z 0 0 4'- WELL 0 f- r- Zo ~ 89.5 S 8g'56' 1,6 FND REBAR UNSUBDIVIDED I/ II W ,0.00' TRACTI I A 3.2 FNO CN 1/~ TRAC1 I B A~ichoel Anderson 4381 - E Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 (907) 343-4744 CERTIFICATE Of HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING 011-111-23 GENERAL INFORMATION Completelegaldescdption M^CHENFELD SOUTH SUBDIVISION: LOT 1 Location (site address or directions) 4640 WEST 80th AVENUE. ANCHORAGE. AK 99507 Property owner ROBERT AND BARBARA HALCRO Mailing address 2525 "c" STREET. ANCHORAGE. AK 9950,3. Lending agency. Mailing address Agent BRIAN BURNETr w./ FORTUNE PROPERTIES Address 2525 "c" STREET. ANCHORAGE. AK 9950,3 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well xxx Community well Public water Dayphone (907~ 000-0000 A'Iq'N: BRIAN BURNETT NOTE: Day phone Day phone (907) 265-9116 If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WABTEWATER DISPOSAL: Individual on-site Holding Tank Community on-site Public sewer NOTE: xxx If community wastewater system, provide written confirmation from State ADEC lng to the legality and status of system. 72-025 (Rev. 1/91) Front MOA ~21 Computer Vemlon Note; Alaska Water and Wastewater Consu. ltants, Inc.. shall be paid $800.00 at, or prior to, clostng for the engineering setwces prot4dec~. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation data shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewatar 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 i sD, fiction, the on-site water supply and/or wastawatar disposal system is in compliance with all Munici ~'{Ind State codes, ordinances, and regulations in effec't on the date of this inspection.~ J//' _~,/~,'~ / ..~_~._'/ . Name of Firm ALASKA VyATE~ E/V~A,~/T~ ~Tt~R CONSULTANTS. INC. Phone (907)337-6'179 Address 6901 DEBARR I~,OAD/~/LJ~2~A C~ORAGE, ALASKA 99504 Engineer's Signature ~-../'/~/~/~'/ ~ ~ Date ~,/7- In conducting this evaluation, AWWC, I~b. ~tte~ipted to provide a thorough, conscientious engineering'analysis of the system in accordance with ADEC and MOA D/-~IS Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and eeparat/on distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local sells condition, ground water 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 net guarantee future performance of the system, nor do they guarantee that.there are no hidden defects or encroachments. AW1/VC, /nc. can therefore not provide any warranty for future estimate of how long the system wi//continue to meet the operational requirements of the ADEC or MOA DHHS. 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 pady is not authorized, nor will it confer any legal right whatsoever. 6. DHHS SIGNATURE ~ Approved for ~ Disapproved Conditional approval for bedrooms bedrooms, with the following stipulations: Additional .Comments 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. 72-025 (Rev. 1191 ) Back MOA #21 Computer Version ei 'CEIVED Municipality of Anchorage dUN DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division MUNICIPALiTy 825 "L" Street, Rm 502 Anchorage, Alaska 99501 (907) 343-4744"~'IMEN]'^[. Health Authority Approval Checklist Legal Description: MACHENFELD SOUTH S/D; LOT 1 Parcel I.D.: 011-111-23 A. WELL DATA Well Type PRIVATE If A, B, or C, attach ADEC letter. ADEC water system number N/A Log present (Y/N) NO Date completed Total depth 49'+ Cased to 40'+ Sanitary seal (Y/N) YES UNKNOWN Casing height (above ground) Wires properly protected (Y/N). 2~ YES FROM WELL LOG AT INSPECTION Date of test ~' 6/6/2000 Static water level .....~ .~ 47' Well production g.p.m. 6.5 g.p.m. WATER SAMPLE RESULTS: Coliform 0 Date of sample: 6/6/2000 Nitrate 0.5 rng/L Other bacteria 0 Collected by: A.W.W.C., INC. B. SEPTIC/HOLDING TANK DATA Date installed Tank size ~ Foundation cleanout (Y/N) De r~s~3~~- High water alarm (Y/N) ~ Pumper C. ABSORPTION FIELD DATA CITY SEWER Date installed Length Width Effective absorption area Date of adequacy test Fluid depth in absorption ~st (in.); [ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3~96)" Computer Version R~Fail) Number of Compartments Soil rating (g.p.d./ff2 or ft2/bdrm) System type / Gravel thickness below pipe ~ota~p. th~ Monitoring Tube ~ Depression over field (Y/N) For Bedrooms Immediately after Absorption rate = If yes, give date gal. water added (in.): __ D, LIFT STATION / Date installed ~ Manhole/Access (Y/N), ~evel at* "Pump off" level at* High wa~ *Datum ~Cyeles-t~sted E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main. Sewer/septic service line N/A N/A 100'+ 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout 100'4- Lift station __ N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation Property line _ Water main/se ' ' Surface water/drainage SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property line Surface water Curtain drain I certify that I h,~ve of Municipal r¢corc~ Signature ~ Engineer',, Name~_~ J/_~J~ Date ~.-~-.Q.~ ~ Wells on adjacent lots_. Building foundation ~~"-'-'--~ ~ _--------Dri~~g/vehic~e storage area. ~eld inspections and review , systems are in conformance )n this date. JEFFREY A. GARNESS Wells on adjacent lots [/CE-7 53 ..." HAA Fee $ ~ ~'~ ' ~ Date of Payment d/P- / / Receipt Number ~ ~'~k-- 72-026 (Rev. 3/96)* Computer Version Waiver Fee $ Date of Payment Receipt Number ALASIO WATER & WASTEWATER June 9, 2000 Robert and Barbara Halcro C/O Brian Burnett Fortune Properties 2525 "C" Street Anchorage, AK 99503 Subject: Lot 1, Machenfeld South Subdivision Dear Mr. & Mrs. Halcro, Per your request, a flow test was performed on 6/6/2000 for the well on the subject property. Prior to starting the test, the static water level was 47 feet below the top of the casing (BTC). Water was pumped fi~om the well at an average rate of 6.3 gallons per minute (gpm) over a 2 hour and 50 minute period with 2 feet of draw down. Based upon this data it can be concluded that the well will continuously produce at least 6.3 gpm. Water samples were taken and tested for coliform bacteria and nitrates. The results were satisfactory. We have submitted your paperwork to the Municipality of Anchorage (MOA) for Health Authority Approval (HAA). If you have any questions please contact our office at 337-6179. business. We appreciate your 6901 Debarr Road, Suite 2~B * Anchorage, Alaska 99504 Ph: (907) 337-6179 Fax: {907) 338-3246 email: akwwc.com ' DEPARTMENT OF'H~ALTH & HUMAN SERVICES- i '~ DiviSion:of Environmental Services ;r,,, .~.{~. On-Ste servicesSecti0n '?' .~, .,, ~;:',,,, ;.. ,. P.O. Box 196650 Anchorage, Alaska 99519-6650 '~i:,i' ' ..... 343-4744 : ., '.,; ' ~ CERTIFICATE OF HEALTH AUTHORITY'- APPROVAL FORA.SINGLE FAMILY DWELLING . . "NERAL.' INFORMATION 3omplete legal description l~0~ation (site address or directions) perry owner-~'~:~u'~' ./4~'' VO · ' "Day phone 'cendi'ng:agency Mailing address Agent .:'., Address .:'Day'phone · ' 'Dayphone ,'~·'..~ .2J, NUMBER OF BEDROOMS: : ' ',3.;:: 'TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for piCkup. Individual Well × ~(X >t " ....'" itywell ". ' ~: Commun Public water NOTE: if Community'well system, 'provide written mg to the legality and. status of system.. TYPE OF WASTEWATER DISPOSAL: Individua on-site Holding tank Commenity On-site Public sewer . ~. :"---:.' NOTE: 7-,'~'/"~:.. .~.'-,:~': -~' ':~ '. . If community wastewater system, provide ~vritten. confirmation, from; State ADEC ' ? attesting to the legality and status of system. : 72-025 [Rev. 1/91) Front MOA #21 ~, ~,. 5:. STATEMENT OF INSPECTION'B~ ENGINEER: '~':~,"J::', ' ~ :'.~ ' AS certified~bY ~ny seal'affixed;hereto'and a~ ~)f,;~h~ivalridation..d~te shown below, I verify investigation of this Health AU{horitYlAppro'va :application' shows that the on-site water su and/or wastewater disposal system is' saf(~; functional and adequate for the number of bedrooms and type of structure indicated herein. I farther Verify that based on the information obtained fro rn. the Municipality of Anchorage files andfrom 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. Name of Firm . '~r'''q~''-ftSOrJ '~-'~ ¢_, /,d ~'t.,/ M/-- Phone Address Engineer's signature DHHS SIGNATURE ='==' ''' I ='r'l= I I=' '?'~' ApprOved for' ~' bedrooms. .: ...: . Disapproved. · Conditiolnal approval for bedrooms, with .the following stipulations; . ':,' A,,:d~itional Ca rnments Date' 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 eng neet registered inthe State 0f AlaSka; The DHHS does this as a courtesy to purchasers of homes ~nd their lending inStituti0ns in 0rder*i6 sati~f~.~erta n federa and state re.qb'i~ements, EmploYees of DHHS do' noti :.'i conduct: nsPect onmor analyze datA';'bef°re'a Certificate is issued..The MUniciPality of'AnCh0mge is'n°t' r%PO~S ble for errors o~omiSSiOns i?the p~OfessiOnal engineers wgrk:!:,: : :' .. :!.. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: /..¢,'T' /, A/'~AO~.I~,J ~--L,b 5uJ~. Parcel I.D. A, Well Data Well type Log present (Y/N) Total depth Sanitary seal (Y/N) '(7'~i~_t,J A'F' :~- If A, B, or C, attach ADEC letter. ADEC water system number "1/ Date completed 6/'/¢/¢/~ Driller ~-Jr'%/-2-' Cased to !iL~(z. / Casing height Y Wires properly protected (Y/N) Y' FROM WELL LOG ~--C~ g.p.m. Date of test Static water level Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot C¢,~ Public sewer main ,;~ Sewer service line AT INSPECTION ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank I11 © WATER SAMPLE RESULTS: Coliform O Date of sample: L///~ SEPTIC/HOLDING TANK DATA D8 Cleanouts (Y/N) High water alarm (Y/N) Date of pumping Nitrate Tank size Foundation cleanout (Y/N) / oiO ~v~9/L Other bacteria Collected by: Compartments Depression Alarm tested (Y/N. SEPARATION DISTANCES FROM SEPTIC/HOt Well(s) on lot To property line Sur 72-026 (3/93)* Front acent lots Absorption field Water ma CONTINUED ON BACK D~ ~ Manufacturer Size in gallons ~ ~___ Vent (Y/N) "Pump on" lev6l-at~ "Pump off" Level at High water alarm level ~ -'U-~te.~!ed SE__Pc~,~CFfON DISTANCE FROM LIFT STATION TO: ;~ Well on lot On adjacent lots Surface water ~-"'"'~'"~ .so.PT O. PAT^ Date Soil rating (GPD/FF) System type Length Width Gravel thickness Total ~ Total absorption area __ Date of adequacy test Water level in absorption field before test __ __Cleanout present (Y/N) (pass/fail) Peroxide treatment (past 12 months) (Y/N) for After test If yes, give date eld (Y/N) Bedrooms SEPARATION DISTANCE FROM ABSORPTIi Well on lot To building foundation On adjacent lots Surface E. ENGINEER'S CERTIFICATION acent lots line To existing or abandoned system Cutbank. __ __Water main/service line~'~. Driveway, parking/vehicle storage area I certify that I have checked, verified, or conformed to ali MOA and HAA gu/defines in effect on;tti~':~Y'¢,;o~ ~Ois inspection ,- -: .~ -~¥. ', : ".4~ '~, ;. Signature ~// C<:./.v~ J~, ~ ~, '~ ° "'" © Engineer's Name Date HAA Fee $ Date of Payment Receipt Number 72-026 (3/93)* Waiver Fee $ Date of Payment Receipt Number