HomeMy WebLinkAboutSLEEPY HOLLOW #2 BLK 1 LT 20L. OF
2__.0
GREA,,.,t ANCHORAGE AREA BORL
Department of Environmental Quality
3330 g Street
Anohorage, Alaska ggs03
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM,
SEPTIC TANK:
DISTANCE
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY/~-)(-~(-~)GALLONB,
TILE DP, AIN FIELD:
/~-~N ' 'j TOTAL LENGTH ~?
DISTANCE FROM WELL, J~.) 7'/~/_FOUNDATION ..- _ EAREST LOT LINE:~L) OF LINES /'~1 __
ABSORPTION AREA_ ~ 3~Fd S~. ~T. U~T, O~ ~ACH U~
DEPTH: TOP OF TILE TO FINISH GRADE ~ ~ DEPTH OF FILTER ~1, ,
WELL:
TYPE
BUILDING
FOUNDATION
CESSPOOl
APPROVED. _
_._CONSTRUCTION
NEAREST
LOT LINE
OTHER SOURCES
DISAPPROVED
NEAREST
SEWER LINE
DEPTH
SEPTIC SEEPAGE
TANK .... SYSTEM_
REMARKS
DISTANCE FROM:
DISTANCES:
SEWER LINE DEPTH: ~4 I
LOT SLOPE:
REMARKS:
DIAGRAM OF SYSTEM
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MUNICIPALITY OF ANCHORAGE
Department of lIealth and Environmental Protection
SOILS LOG
}~E~ICOLA%'IO~~. m~
Performed for Tom Yelverton Date Performed 7/2/76
Legal Description Lot 20, Bloc~ 1, Su~tivision #2
4
~0
16-
3.o.
0- 1.5' - Red-br6wn, sandy silt (ML)
Perc rate = 225 ft.2/bdrm.
1.5-14' - Red-brown, sandy gravel (GW)
Cobbles to 8 inches (Frost line at 1.5')
6 -- ]4' - No Frost
Perc Rate = 85 ft~2/bdrm.
Total Depth = 14 feet
No water table encountered.
AVERAGE PERC RATE = 100 ft.2/bdrm.
Da te
PePee 1 a, t ~ee~-~
Ne t Time
Depth
Net Drop
DRILLING, INC.
Well Owner_
Tom Yelverton
DRILLING LOG
.Use of Well
Location (address of: Township, Range, Section, if known; or distance main road
Block 1 Lot 20 Sleepy Hollow Subd.
Dom,
Size of casing 6" Depth of Hole
Static water level 406' ft.
Screen ( ); Perforated (
430' feet Cased to 4].5' feet
(below) land surface. Finish of well (check one)
).
open end ( XX );
Describe screen or perforation
Well pumping test at, 7-8 gallons per (~) (minute) fo]' i _hours with ]00% f~.
of drawdown from static level. Slotted liner, 20' of 4" ABS plastic with 3~'
9/31/76 of 3~" OD steel pipe attached by set screws
Date of completion
/ /
to bottom.
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
0 TO_ 2 Casinq Stickup
2 .TO_ 4
4 TO 12
TO_ 60
TO 82
TO. 200
TO 220
TO_ 274
TO_ 280
TO_ 287
TO 295 _
~o 23_7__
TO 3~L2
TO. 321
TO_ 411
12
6O
82
20O
220
274
280
287
297
312
321
Orqanics
Loose Gravel
Silty Gravel
Silty Sand and Gravel
Gravely Hard Pan
Gravely Hard Pan & large cobbles
Gravely Hard pan
Sand - Very Fine - Wet: 1/2
C1 av
Grave%y Hard Pan _-_ Water 1 gpm
Hard Pan
kk~rUiicate l'3o's. 8!,t ~ 9~3~
Gravely Hard P~JI
Cemented Gravel
Cel~ented Gravel - Occ. Cobbles
1 -- CUSTOMER
DRILLING, INC.
Well Owner_
DRILLING LOG
Tom Yelverton - Page 2
.Use of Well
Location (address of: Township, Range, Section, if known; or distance main road_
Size of casing. __Depth of Hole_
Static water level ft. (above)
Screen ( ); Perforated (
feet Cased to feet
(below) land surface. Finish of well (check one)
).
Describe screen or perforation
Well pumping test at gallons per (hour)
of drawdown from static level,
Date of completion
open end ( );
(minute) for hours with ft.
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
411 "fO_ 414 Boulder
414 TOt 430
TO_
TO_
TO
TO_
TO
TO
TO_
TO_
TO_
TO
TO
TO
TO
Cemented Gravel
NWWA Certifkd Cot~a'ac,tor
.......... N ~, 0..,~ C'< 573
1 -- CUSTOMER
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
1. GENERAL INFORMATION
Application Date May
27~1986
(a) LegalDescription(includelot, block, subdivision, section, township, range)
Lot 20, Block 1, Sleepy Hollow #2T15N~ R1W Sec.15
Location(addressordirections) Peters, Creek
(b) Applicant NameT~homas Yelverton Telephone: Home 688-3193 Business N/A
Applicant Address I'OB 670235, Chu~iak, Al( 99567
(c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer [~; Other [] (explain);
(d) Lenaing Institution
Address
Telephone
(e) Real Estate Company and Agent RE/Max Ba,Ele River -
Address POB 2849, Eagle River, AK 9~577
Telephone 694-4200
(f) Mail tile HAA to tile following address:
__ ~ir~up b ~e~n g~r
Lee Walker
TYPE OF RESIDENCE
Single-Family [] Multi-Family []
Number of Bedrooms 3
Other
WATER SUPPLY
Individual Well E~ Community [-] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to tile legality and status.
4. SEWAGE DISPOSAL
Onsite ~] Public [] Community [] Holding Tank []
Note: If community well system, must bare written confirmation from the State Department of Eevironmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 (11¢84)
ENGINEERING FIRM PROVIDI! INSPECTIONS, TESTS, FILl" SEARCH, D '. AND INFORMATION
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 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. '~I~OCJU'i]?oB w~t¥:J_o~' 'w'o~_l 1;o 'ca.r~1~ d~_sl;a.~co-~)l ~ .
Name of Firm Telephone
Address FJ~I-ERJVER-EN G IN EERINP_.'~S ER¥tGE~
Date EAGLE RIVER, AK 99577
P. 0. BOX 773294
§94-5195
DHEP APPROVAL
Approved for '/"~ '~¢-'e~(~/~bedrooms by-~'-"~"'''''''/"~' '~'~'~'~'~"~
Approved ~ Disapproved Conditional
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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.
Page 2 of 2
z2-o~s ¢ u~,)
WELL
MUNIciPALiTY OF ANCNoP, AS~ MUNICIPALITY OF ANCHORAGE (MO~l
DEpt. OF H~.ALT HEALTH AUTHORITY APPROVAL [HAA)
[:NVIRONMEN~.~. H &
,.~L PROTECTION CHECKLIST- FEBRUARY 1984
264-4720
MAY 2 ? 1986 Legal Description: ,A
./-/,~//,., ~
oA ECEIV_E :
Well Classification ?~,~/~',~TZ-F If A. B. C, D.E,C. Approved (Y/N)
Well Log Present (Y/hi) Y DaTe Comaleted ~.'/,.~/// 76 Yield
Total Depth Z/~C' / _ Cased to '~//3'-" Depttlof Grouting
Static Water Level _ ~' ,,2,d,"
Casing Height Above Ground ~'~° ~' /
v
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lol
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer L~ne _ ,4,///4
Cleanout/Manhole_
Water Sample Collected Dy /:~.~4,
Water Sample Test Results
Comments
./D~ /
To Nearest Public Sewer
Tc Nearest Sewer Serwce Line on LOt
,~¢ ~".~ ~'"'~'~' '"' ~'~ Date ~-.,-~ ~../¢¢¢
Sanitary Seal on Casin9 (Y/N) ,'
Deoression Around Wellhead [Y/N)
: On Ac.oining Lots
: On Adjoining Lots
B. SEPTIC/HOLDING TANK DATA
Date Installed ¢c~/
Standpipes (Y/N) ~ Air-tight Caps (Y/N)
Depression over Tank (Y/N)
Pumping/Maintenance ConTracT on File (Y/N) /'~'//4
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank
To Water-Supply Well ~/ /
To Property Line %'" '
To Water Main/Service Line ")o Course
Size /4,~¢~ ~'~/: No. of Compartments
,.v Foundation Cleanoul (Y/N) _
Date Last Pumeeo
; for
_ Temporary Holding Tank Permit (Y/N) _
To Building :oundation
To Disnosal Field
To Stream, Pond, Lake. or Major Drainage
Comments
Page 1 of 2
72-026(11184)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed /~'
Width of Field ,.~' /
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Type of System Design
Length of Field ~//
Depth of Field /4> ~'
Gravel Bed Thickness ~ /
Standpipes Present (Y/N)
Date of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation '2'3 /
Lot
To Water Main/Service Line '~/o"
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
To Property Line ~¢'
To Existing or Abandoned System on
; On Adjoining Lots ¢'-J' ¢¢ /
To Cutbank (if present) ~'
Comments
LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the d~te of this i n.spection.
Date
MOA No.
Signed ~~
Company
Receipt No. '-~
Date of Payment ,.~ -
Amount: $ /~ ~"',
Page 2 of 2
72-026 (11/84)
MunicipalitYo
Anchorage
P.O. BOX 196650
ANCHORAGE, ALASKA 99519-6650
(907) 264-4111
TONY KNOWLES,
MA YO~
DEPARTMENT OF HEALTH & HUMAN SERVICES
June 9, 1986
Lou Butera, P.E.
Eagle River Engineering Services
P.O. Box 773294
Eagle River, Alaska 99577
Subject: Lot 20 Block 1 Sleepy llollow Subdivision #2
Waiver Request, WR86-066
Dear Mr. Butera:
Your request for a waiver of the 100 foot separation distance required
between the well and septic tank on the subject property has b~en granted.
The required distance has been waived to 91 feet.
This waiver is valid for the existing three bedroom single family dwelling
only.
Sincerely,
Stephen S. Morris
Civil Engineer
On-site Services
SSM/ljw
ENGINEERING SERVICES
EAGLE RIVER
Leu Butera P.E.
Eagle River, Alaska 99577
Telephone (907) 694..5195
May 27, 1986
Mr. Stove Morris
Civil Engineer, On-site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
REF: Lot 20, Block 1, Sleepy Hollow #2
Dear Mr. Morris:
On behalf of ]ny client, Mr. Thomas Yelverton, I anl submitting the
information necessary for a determination of a wave. er of separatzon
distance, well to septic tank, to 91' for the above referenced ]_ct.
The septic system absorbtion rate has been tested and found
adequate for a 3 bedroom use. The leaehfield was installed in 1976 by
Hamilton Construction and was inspected and approved by the Municipality
at that time, with the well not installed, as per the inspection report
enclosed. A later request for final approval[ shows the well to septic
tank distance as 100' Our field measurements show the tank inlet to be
at 91~ from 'the ~4e].l. The enelesed well log shows 'that the well draws
from an unconfined aquifer at a depth of 415' The casing is continuous
to 415' and passes thru several hardpan and one clay layer. The surface
topography is such that any seepage would be directed away from the well
location toward a +25% slope to the southeast. The subsurface soil is a
loose gravel with an 85 pete. r~rting. A water sample for coliform
bacteria was satisfactory. Due to the depth of the well it is unlikely
that the septic tank at 91' distance would pose a health hazard,
If there are any questions or if additional ~niormatzo is required
please feel free to contact me at 694-.6195.
Sincerely,
Leu Butera, P.E,
Encl:
HAA application
soil log
inspection report
well log
MUNICIPAl ITY OF ANCHORAGE
HEALTH AND ENVIRONMEN1 ~RO~ECTION
DaLe Received. ~ril !~ 1~7
#1: Time ICiL~I~PA #2: Time
Date _~J~_;7 7 Date
REQUEST FOR APPROVAL OF
I~3: Time
Date
Insp
INDIVIDUAL SEWER AND WATER FACILITIES
1. Lending Institution Request: Alaska Bank of Commerce
MailJ_ng Address: Pouch 7-012 99510 Phene:
279-5641
688-.3193
2. Property Owner: Thomas W. Yelverton
Mailing Address: Post office Box 235 99567
Phone
3. Legal Description: Lot 20 Block 1 Sleepy Hollow Subdivision ~2
' i
4: Single Pam__ly Residence: (x) 3
Multiple Family Residence:
Number of Bedrooms:
Nmnber of Bedrooms:
Well System:
Permit #
Construction
Public/Conununity System: ( )
Depth of Well 430'
Bacterial
Individual Well: (x)
We]_]. Log on File
Analysis
( )
Sewage Disposal System: On--site System ~ Public Utility ( )
Distances: Well to Septic Tank .._~.~__2 _ . to Absorptien Area
to Sewer Line
Nearesu Lon line Absorption Area
to Nearest Lot Line
',JN[C][PAL.[TY OF ANCHORAGE D~m'l', o~: i~ ,,~,,~ .'~
~[7~J)Jl'x~:~l/ 27~--25~, ~. 22~, 22~ A.P~ 1
~=~Request for Approval of Individual Sewer and Water
Mailing Address: ~,~, 2 ~ Phone:
2. Name of Buyer:
Mailing Address:
,, ,, Phone:
Mailing Address:
Phone:
Realtor/Agent:
Mailing Address:
Legal Description:
Street Location:
Phone:
Single Family Residence: (,VO Number of Bedrooms:
Multiple Family Residence: ( ) Number of Bedrooms:
7. Water Supply: *Individual Well (~ Public/Co~nunity System (
If Individual Well, well depth
If Community System, name of system
8. Sewage Disposal System: On-site System (X) Public System ( )
If On-site System, date of installation:
*NOTE: A well log is required on ALL wells drilled since 6/75.
~/77
~acj'e
Department of Heal~:h and Env±ronmenta[~. Protect:i_on
Request ~or Approval of Individual Sewer and Water Facilities
Legal Descrip'tion:
Lot 20 Block 1 Slegpy._Hollow _Su__bdivision _~2
Corm~e~t s.
Affadavit Attached: ( ) Letter Attached: ( )
Disapproved: Date:
Department Workshee%: