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HomeMy WebLinkAboutKASILOF HILLS BLK 2 LT 3 /~.¥~~ M UNICIPA I_ITY OF ANCHORAGE DEPARTMENT OF REALTH & ENVIRONMENTAL PROTECTION -'/O ENVIRONMENTAL ENGINEERING DIVISION I/ 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 N-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME i ],PH.O ~ E fc/¢ MAILING /M~4;)~ES~ ~ ,-, . L. OCATIOF DISTANCE TO: Manu factureJ Liq. cap DISTANCE TO: Wi(It Inside length IF HOMEMADE: ND. OF,BEDROOMS Liquid depth Well Dwelling PERMIT NO. Manufacturer Liquid capacity in gallons DISTANCE TO: No. of line~ __ Top of the to finish grade Width Foundation Total I e n~t~_~, i~ s Material beneath tile Depth Length Type of crib Crib diametel Crib depth Well Building foundation DISTANCE TO: Material Nearest I o ( ?~,~ l_ T'encb ~ Class Depth Driller DISTANCE TO: Building foundation Sewer line OTHER INSTAL LER (~~~ R EMAR KS Distance b ~t~.~e2l~l e s Total ~cti~)absorption,~,~ area PERMIT NO.  Total effe c~t i ve a bs o r p ti o n~a.r~e a line -~ ~'~ 7~-~ ~ERMIT NO. Septic ta~-~ I Absorption area(s) ~'~,T~ ~ DATE LEGAL . ALASKA ENVIRONMENTAL CONTROL SERVIr '~, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 SHEET NO OF CHECKED BY SC^LE / ,'JO DATE (:iF;:(]l .!h![:, '!'T.! E Fi'.~'.:: FIND SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PERCOLATION TEST [] PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 .~A.;.,./. 7 8 9 '10 11 12 16 17 ~8 19 2O '7-/t COM'V, ENT,S .ERFORMED DATE PERFORMED: SLOPE SITE PLAN WAS GROUND WATER S PI IF YES. AT WHAT E ~,~ ,/j~,/~ .DEPTH? . Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN (minutes/inch) FT AND FT DATE: 72-008 (6/79) ]]Ox J~3~Bg. STAR ROUTE A AI'~CI~ORAGE. ALASKA 9950~ 344-77~14 SlX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF 79~· ~ n-/e.e.~.o DRILLED AT THE RATE OF _,,' .... ,, PROPERT'Y OWNER LOCATION OF WELL, SI"I"E DRILLER WELL LOG: PER FOOT. 3tq,.,7c0o MUNICIPALITY OF ANCHORAGE D?T C': !27 .~z'~ ~. .3 ~ ...... //_5 ' //~:t.(71~ruz. ,q ce#!.en.L(..d. .,:, 2:.o O0 ,, .... /:e..:.: :/,'.050~ O© Co.¢.:L o.,?. ,!)a.?.l?.,,'n.rx.: '~ ~ "09'7 "e' WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF COST INCLUDES ALL. LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. ;7/,,-,o 5'0 ~ OO THANK YOU VERY MUCH. BERNIE CLAUS OF RAMPART DRILLING WORKS DATE /,:i'd.~!. 30.f:l?.~ 1,0~2 , -~ SERVICE CHARGEOF 1~% PER MONTH WILL BE ASSESSED ON PAST DUEAO(.OUNTS. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL ~ ~ - ~) / (~"~ / OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Property Owner'T'/'~-v~(/¢r:,' Mailing Address (c) Lending Institution Mailing Address. Telephone: Home y l'~ 770 Telephone Business -- (d) Real Estate Company and Agent ~-~f/-,y ~ntef -- ~-ec~,oe,/-/~ ~'~-~/~'~.f Address ~00 ~w tt ~.~ ~chor~ ~'~7 Telephone ~ ~ - 0~ f (e) Mail the HAA to the followina address: or: Cheok here'S, if hold for pick up. List contact person and day phone number below. "~ 5'5'-- /35-5- TYPE OF RESIDENCE Single-Family [] Number of Bedrooms WATER SUPPLY Individual Well [] Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite [] Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-075 trey 8/861 Front ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA 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 verity that based on the information obtained from the ~unicipality of Anchorage files a~d from my ~nvestigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations the date of this inspection. Name of Firm F(~ ~cA~;c~/ ~r~ Telephone Address I Y~ ~ ~c4~ ~. ~ ~om~ ~ ~ ~1~ Date ~ ~, DHHS APPROVAL Approved for ~"~//.,,~ (~) bedrooms by Approved ~ Disapproved Terms of Conditional Approval Conditional Date CAUTION The Municipality of Anchorage Department of Health and Human Services (DF{NS) 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. Page 2 of 2 72-025 fRev 8/86) Back WELL DATA MUNICIPALII~IL(I~II~"I~O~I~EOF ANCHORAGE (MOA) ENVIRONMENT~-~.q'iEEAI;JW~E;~RITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 i¢~V 9 ]988 264-4744 Legal Description: RECEIVED J Well Classification Well Log Present (Y/N) If A, B, C, D.E.C. Approved (Y/N) _ Date Completed ,5-/ Sd /~ 8 Yield IE~t Depth of Grouting Pump Set At /I,¢" ~e(o~, Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) Total Depth ~ 8,.¢ ?¢r Cased to Static Water Level ¥3' o,~ Casing Height Above Ground [6"" Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot I/¢~' To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments /~?~or~ ; Gn Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on ; Date '7'/ B. SEPTIC/HOLDING TANK DATA Date Installed ~//'8/',CE Size Standpipes (Y/N) Depression over Tank (Y/N) N Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well I (O ' To Property Line ~ (o ' To Water Main/Service Line Air-tight Caps (Y/N) No. of Compartments ~. Foundation Cleanout (Y/N) Date Last Pumped 5"/?/~,9 ; for Temporary Holding Tank Permit (Y/N) Y b,? .Z'.coo c_c ^f, Z, To Building Foundation 7' ..¢~m ~,c,. To Disposal Field 1 2 ~ To Stream1 Pond, Lake, or Major Drainage ,j Page 1 of 2 72-026tRey 886~ Fronl C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ,¢//'e- ,/' Width of Field ~'o'" ~ Square Feet of Absorption Area Depression over Field (Y/N) N Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation I?' Lot /6 dr',,~ Type of System Design Length of Field Depth of Field Gravel Bed Thickness 0'" ' Standpipes Present (Y/N) Date of Last Adequacy Test ,.5'-/.~/,¢'~' To Water Main/Service Line ~, '~. To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Properly Line IO' ,,~er- _¢e/c.A'¢ o.~-¢~;ft To Existing or Abandoned System on ; On Adjoining Lots .> ~o ~ To Cutbank (if present) rS"' ,~ .¢2¢1! )~ ~. D. 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 date of th is inspection. Signed .¢']'-~ ~,2'~ Date Company t'~(¢~/-/~/~ ;7~c,4 .g'~'cd MOA No. _ Receipt No. ~ ~~ Date of Payment Amount: $ / ~ ~ ¢ 0 Page 2 of 2 72 026fRev 8861 Back ~?**~" ° ° /~, ' ' ~)~A Engineer's Seal CHEMI L & GEOLOGICAL LABORATORIES OF ALASKA, INC. FEDERAL TAX ID # 92-0040440 MUNICIPALITY OF ANCHORAGE (M HEALTH AUTHORITY APPROVAL (HA~) CHECKLIST - FEBRUARY 1984 264-472O Legal Description: 4'~2'2~.~ A, ~/ELL DATA 'Wel; C,assification. ~'~,~/I/'/~' . If A, B, C, .D.E.C. Approved (Y/N) Well Log Present) 0ate Corn ?ted .~""-..~0- ~',~-~-' . Yield Total Depth ~-~_/ Cased30 ~ Depth of Grouting Static Water Level _t~ ~-.-¢/, ~ Pump Set At / 7 &-AN · Casing Height Above Ground Electrical Wiring in Condui (t~N) '-Separation Distances from Well: Sanitary Seal on Casin[;[~) Depression Around Wellhead (Y~) :E.~t 3-o Septic/Holding Tank on Lot //O ; On AdJoining Lots To Nearest Edge of Absorption Field on Lot f~ /~"~ / ; On Adjoining Lots To Nearest Public Sewer Line _/Z'//~ TO Nearest Public Sewer " CleanouVManhole "'~/~ To'Nearest ~wer Se~ice Line on Lot :'~B, ]EPTIO/HOLDIN6 TANK DATA .: .." .~tandPi~s~) ' 'Air-tight Caps') _ Depression over Tank ( -Pumping/Maintenance Contract on File (Y/N) ,Holding Tank High-Water Alarm (Y/N) /J/~, .Se paration Distances from Septic/Holding Tank:' -To Water-Supply Well .'..'fo Property Line · ",To Water Main/Service Line Course L ' ~ - Comments 'Page I of 2 "Foundation Cleanout~) · Date Last Pumped ;for Tern porary Holding Tank Permit (Y/N) · : _To Building Foundation ,' "' To Disposal Field To Stream, Pond, Lake, or Major Drainage . ~lJNIcIPA~,r~ ~~, .._.~ .. "-- ~Or~iON' ABSORPTION FIELD DATA Soils Rating in Absorption Strata r Date Instal[ed .,'~ Width of Field "~"~ ~ Square Feet of Absorption Area Depression over Field ResL~lts of Last Adequacy Test ~ Separation Distance from Absorption Field: · To Water-Supply Well .~,A~ To Building Foundation *~-"~/' ! Lot ," ~4//~' To Water Main/Service Line _ To Stream/Pond)Lake/or Major Drainage Course To Driveway,'Parking Area, or Vehicle Storage Area Type of System Design ,.Length of FJeld . · ~ · Depth of Field , Gravel Bed Thickness Stanapipes Present Date of Last Adequacy Test To Property Line To [Lxisting or Abandoned System on ; On Adjoining Lots ~ To Cutbank (if present) 'Comments ** ~heck Pe~i~ed Bedrdom Rating Against HAA Requmt .i ~ . ~ I Ce~i~ {hat ~ ~c~ verified, or conformed to all MOA and "AA guidelines in effect on the date o' this ins~ct'on, Receipt No. ' ' '~ .' ~ '~; ~ '-: '~ '" ~'~ Date of Payment Amount: $ Page 2 of 2 P.O. boX 196650 ANCHORAGE, ALASKA 99519-6650 (907) 264-4111 TONY KNOWL~S MA YOt? DEPARTMENT OF HEALTH & HUMAN SERVICES November 13, 1986 Alan Wien Alaska Environmental Control Services 1200 West 33rd Avenue Anchorage, Alaska 99503 Subject: Lot 3 Block 2 Kasilof Hills Subdivision Waiver Request WR86-156 Dear Mr. Wien: Your request for a waiver of the 100 foot separation required between the well on the subject lot and the septic system on the adjacent lot (Lot 4) has been granted, The separation required between the septic tank on Lot 4 and the well on the subject lot has been waived to 83 feet and the separation required between the absorption field on Lot 4 and the well has been waived to 87 feet. This waiver is valid for the existing three bedroom single family dwelling only. Sincerely, · Morris Civil Engineer On-site Services ALASKA Bi UIRODmE DTAL CODTROL SE I dlCE $, IIqC. ~nqJnecrinq 6 ~nuironmcnla[ SlucJJes October 30, 1986 Municipality of Anchorage 825 L Street Anchorage, Alaska 99501 Re: Lot 3, Ble(;k 2, Kasilof Hills The above refereuced lot consists of a 3 bedroom single family residence served with a private well and on-site sewage disposal system. 0n October ].7, 1.986, I performed a Health Authority Inspection aloag with a well flow and adequacy test. Adequacy and well flow results are attached. From the Health Authority inspection, we find tlmt the separation distance from the subject well and the neighbors (lot 4) septic tank and absorption area is 83 feet and 87 feet, respectively. The neighbors septic system was installed on September 8, 1981 and consists of a 1250 gallon septic tank and a trench measuring 41 feet long, 9 feet total depth wi. th 5 feet grave] depth. Approximately 68 percent of this trench is within the ]00 feet pad]us of the subject well. The subject well was drilled on May 20, 1982 to a total depth of 225 feet. The well log shows thal:.bedrock was encountered at 45 feet. also indicates that the well was ~ased to the bottom. The ueighbors septic system is downhill from the subje~:k well with appz'ox]mately a 10~ slope and a water sample taken October 17, 1986, shows the well to be free of coliform bacteria. ~., ,J,'/~, Using the "Separation DJstauce Waiver- Guidelines" issued by Alaska Department of Environmental Conservation, the point valaes are as follows: Water 'rabies l)istance from the bottom of the system 'to the highest water table Jn feet. Bottom of system is at 9 feet and well log shows water production at 172 feet. Seperation distance 163 feet. Point Value: = 7.4 Soil Sorp[ion 0:18 feet silty gravel, 18 :feet - 36 feet coarse gravel with 202 clay, 36 feet to 45 feet hardpan and cemented gravel, 45 feet to 1.72 feet bedrock. Point Value: 18x2.5/163 -~ 18x2.5/163 4 9xl/163 ~ 127xl/163 - 1.37 3. Permeability Point Valae: 18xl/163 + 18x0/163 + 9x.9/163 + 127x.9/163 .23 Water Table Gradient Maximam drawdown is to 99 feet. Point Value Water productioa begins at 172 feet. = 7.0 5. Horizontal Seperation 1200 UJesl 33rd Aucnu¢, 5uile B · Anch0raq¢, Alaska 99503.(907) 561-50q0 83 :feet. Point Value 2.5 TOTAL POINT VALUE: 1.8,5 This kota] shows that this well is almost, sure to he free from any form of contamination. We do no'/ feel that the separation diskaaee poses a threat of contamination. We therefo~-e request a waiver be granted for- the distances ]isted above. If you have any quesLions, please feel free to call. Sincel'ely, Alan Wien Engineer, lng Technician Approved: Leroy C. Reid, .Jr., PhD, P.E. President APPLI( NT FILLS OUT UPPER HA[ ONLY Buyer Address Zip Code Lending Institution Phone Address Zip Code Address Zip Code Type of Re¢~nce ~ Multiple Family No. of Bedrooms ~ Other Water~,~1~ualSUpply /-~:;/ f ~ ex/ ATTACH WELL LOG. A well Io9 is required for all wells drilled since .June 1975. ~ Community For wells drilled prior to that date, give well depth (attach Io9 if available). ~ Public Utility Sewer Dispel.al ~,al Year Individual Installed: ~ ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~QCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Da t e/ - ¢'-~L"~ ~ ~ .'" ("~'~'~ ~L-, ~.)~'~ .~'\L Inspector inspector Inspeclor Inspector,.--,, MUi*.~4~p ~,LIT'¥' O~- ANrJHORAGE Field Notes:--'~,O DEPT. OF t-!r~?.LTH & FNVIRONMENTAL PROTECTION MAY 2 0 .RECEIVED (3) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL/APPROVAL' Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received  Well to Tank Tank Size Septic APPLI(' NT FILLS OuT'UpPER HA[ ONLY ..... , , //~ -~ ,..-.. -- ]~I~/~ (.\..: / :.:~S/ Phone Property Ow~mr Mailing Address ~f '~/-,.~,~ 0 ~--~ / Buyer ~_~) (](/t~% ~ Address Zip Code Le[]din.q Institution ¢¢ ~- Phone Realty Co. & Agent Phone Address /t ¢ )/t, ~ Zip Code Legal Description //% 0:/ "* ~/¢ C ~/~ ~' '-//, ,L ,', ; .~ Street Location ~ /~ (X./ ¢ Type of Residence c~/ t~}~'in g I e Family [] Multiple Family No. of Bedrooms ',. E] Other Water Supply I~,'~ndividual ATTACH WELL LOG. A web Icg is required for all wells drilled since June 1975. [] Community For wells drilled prior to that date, give well depth (attach Icg if available). ~ Public Ulility Sewer D,j. sposal I~}~ndtvldual Year Individual Installed: / U~ Public Utility When Connected to Public Utility: [] Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Da/t~ ~-'~ . Date Date Date ¢-- / / Inspector Inspector Inspector Inspector ( ~ ) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAP~OVED ( ) CONDIT:ONAL APPROVAL' DATE ~ '- { ~- ~ ~- Soils Rating Bale ~wer Installed Well }o Absorption Area / 0 0 Well Log Reoeived ~--' ~ ( ¢- ~--C Well to Tank ( O O Septic Tm:k Size 72-023 (3182)