HomeMy WebLinkAboutKASILOF HILLS BLK 4 LT 8 MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVlRONMENI'AL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAl. SYSTEM AND/OR WELL INSPECTION REPORT
NAME PHONE [] NEW
Matt B. Haynes 338-3108 [~UPGRADE
MAILING ADDRESS
1013 East Dimond Blvd.f No. 511, Anchorage, Alaska 99515
LEGAL DESCRIPTION
Kasilof Hills Subdivision, Lot 8, Block 4
LOCATION
Section: 24 Township: 12N
[ Well
DISTANCE TO: ! 100~+
~= 2~ I Manufacturer
~%< I Greer Tank
iuq. capacity ir] gallons
__/. 1000
~ DISTANCE TO' tW~II
,,-i, = /DISTANCE TO:
Length of each ]ine
Range: 3W
[Absorption area Dwelling
55' 14'
Material
Steel
NO. OF BEDROOMS
3
PERMIT NO.
8502?2
No. of compartments
2
Inside length Width Liquid depth
Dwelling PERMIT NO.
Foundation
Material
Nearest lot line
No. of lines 'Total length of lines Trench width
inches
Top of tile to finish grade Material beneath tile
inches
Length Width Depth
35' 18' 1' - 2' Below Grade
Type of crib
:Bed
DISTANCE TO:
Class ,
Individual
DISTANCE TO:
Crib diameter
Well
145'
Depth
300'
Building foundation
48'
OTHER
PIPE MATERIALS
PVC ASTM 3034
Crib depth
Building foundation
65~
Driller
Jay Williams
Sewer line
00'+
1 BR.
SOIL TEST RATING
125 S~._ Ft.
INSTALLER
Self
Liquid capacity in gallons
PERMIT NO.
Distance between lines
Total effective absolption area
PERMIT NO.
850272
REMARKS
Entire system is insulated with
2" high density styrofoam. Two
feet of ground cover over the
drain field.
· :_--' ~-,.~ ¢,,','T ¢~ ~
A ~PRO~ED ' '~'Q~'k~ [ ~:',[';~7[;'¢" DATE
Total effective absorption area
630 S.F.
Nearest lot line
Distance to lot lin(!
15~
Septic tank
100~
25'
PERMIT NO,
Absorpt on area(s) ] 4 %'
LEGAL
JOB Z~T ~
SHEET NO.
OF
CALCULATED BY
DATE
CHECKED BY
SCALE ~ ~¢~:;:
DATE
$5/ '/_
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
[] BOILS LOG
PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
Matt Haynes DATE PERFORMED: June 6, 1985
Block 4, Lot 8, Kasilof Hills Subdivision
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
Peat, topsoil
Silty sanay
fracture rock
Sandy fracture with
some silt (6P)'i;I~';~.
Bottom test hole
frost or frozen ground
~.~ SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
YES, AT WHAT
.:PTH?
Reading Date
6/6
6/6
6/6
6/6
NO s
L
O
Net
Time
Depth to
Water
Net
Drop
4:36 PM 00 5" 00
4:41 PM 5 min 14" 9"
4:46 PM 10 min 16 3/4" 11 3/4"
5:06 PM 50 min 18 3/4" 13 3/4"
20
PERCOLATION RATE 2 · 18 min/inoh (minutes/inch)
TEST RUN BETWEEN ~3=. 0 FT AND '"~'2' FT
COMMENTS The percolation rate indicates a rating of 125 ft- per bedroom. The
frozen ground limits the 'hype of system for use on this lot. It appears a
_shalfhew bed .~y.~em w~]'l worW ~n~~Ine high permeability, of the
surrounding soil.
PEFIFORMEDBY: Mic:W~el E. Andersun, p.~CERTIFIEDBY:. DATE: June 7, 1985
72-008 (6179)
<
Z
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 FACIt. ITY
264-4720
Application Date
GENERAl. INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 8, Block 4, Kasilof Hills Subdivision
Location (address or directions)
Applicant Name Ha'ct Haynes Telephone: Home Business 338-3108
1013 East Dimond~ No. 511, Anchoraqer AK
Applicant Address
(b)
(c) Applicant is (check ()ne): Lending Institution []; Owner/builder [] · Buyer []; Other [] (explain);
(d) [_ending Institution Telephone
Address
(e) Real Estate Company and Agent
Address
Telephone
(f) Mail tile NAA to the following address:
TYPE OF RESIDENCE
Single-Family~ Multi-Family []
3
Number of Bedrooms
Other
WATER SUPPLY
Individual Well [~ Community [] Public []
Note: If community well system, must have written confirmation from tile State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite ~] Public El 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 72K)25 (11,84)
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 verify that based on the information obtained
from the Mueicipality 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.
Name of Firm QUADRA Engineering, Inc. Telephone 276-3770
401 E. Fireweed Lane, Anchorage, AK 99503
Address
Date
December 2, 1985
Engineer's Seal
DHEP APPROVAL/'
Approved for L~_/~¢-'~L.~ ....
Approved ..... ...~,.,
\
bedrooms by,/~7)~'"'~*--"-'~-/~'-~'> :'"'¢--;~ .... ~:~- -jD'ate
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 certificato is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Description: Lot
Kasilof
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAl PROTECTION
OEO05 tgEEi
,,.oc R£¢EIVED
Hills Subdivision
WELL DATA
Private
Well Classification
Well Log Present (Y/N) Y
300' 40'
Total Depth Cased to
Static Water Level 50 '
Casing Height Above Ground 24"
Electrical Wiring in Conduit (Y/N) Y
Separation Distances from Well:
To Septic/Holding Tank on Lot 100 '
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line N/A
Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
If A, B, C, D.E,C. Approved (Y/N)
Date Completed 8/5/85 Yield 3.0 GPM
Depth of Grouting
Pump Set At 290 '
Sanitary Seal on Casing (Y/N) Y
Depression Around Wellhead (Y/N) N
; On Adjoining Lots 500 ' +
145 ' ; On Adjoining Lots 500 ' +
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot 75 '
M.E. Anderson ;Date ]December 4, 1985
Acceptable
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed 7/85 Size 1000 GAL No. of Compartments 2
Standpipes (Y/N) _ ¥ Air-tight Caps (Y/N) ¥ Foundation Cleanout (Y/N) ¥
Depression over Tank (Y/N) N Date Last Pumped New System
Pumping/Maintenance Contract on File (Y/N) 'N ; for
Holding Tank High-Water Alarm (Y/N) I'4 Temporary Holding Tank Permit (Y/N) N
Separation Distances from Septic/Holding Tank:
100'
90'
75'
To Water-Supply Well
To Property Line
To Water Main/Service Line
Course N/A
To Building Foundation 14 '
To Disposal Field 55 '
To Stream, Pond, Lake, or Major Drainage
Comments System is recently installed.
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field 18 '
125 Ft2
Square Feet of Absorption Area 630 Ft2
Depression over Field (Y/N) i'4
Results of Last Adequacy Test New System
Separation Distance from Absorption Field:
To Water-Supply Well 145 '
To Building Foundation 90 '
Lot N/A
To Water Main/Service Line 1 2 0 '
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments System is newly
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes Present (Y/N)
Date of Last Adequacy Test
Bed
35'
3'
1'
Y
New System
To Property Line 110 '
To Existing or Abandoned System on
; On Adjoining Lots N/A
To Cutbank (if present) N/A
N/A
200'
isntalled.
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 this inspection.
Signed ~'~/'~'¢;~(._~-~ ~"~-¢1.('41~ ~te December 2, 1985
Company <)UADRA Enqineerin~oA No. ST 85;~,,.'t-~9.- ~- ___
Receipt No. 3 (.¢/.¢L) ~ ~
Date of Payment
Amount: $
Page 2 of 2
72-026 (1 i/84)
ACHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
TELEPHONE (907) 562-2343 5633 B Street
Anchorage, Alaska 99518
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
[] PUBLIC WATER SYSTEM I.D.#
,~PRIVATE WATER SYSTEM
Name
27b..~ 770
Phone No.
Mailing Address
City State
Mo. Day Year
Zip Code
SAMPLE TYPE:
Routine
Check Sample (for routine
with lab ref. no.
[] Special Purpose
sample
_) [] Treated Water
[] Untreated Water
SAMPLE
NO.
2 I
5 I
Time Collected
LOCATION Collected By
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
.~Satisfactory
[] Unsatisfactory
[] 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
Time Received
Analytical Method:
Membrane Filter
* No. of colonies/100 mi.
Lab Fief, No. Result*
J
J Eq-q
Analyst
BACTERIOLOGICAL WATER ANALYSIS RECORD
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
Membrane Filter:. Direct Count
Verification: LTB BGB
Final Membrane Filter Result~ ~
Reported By ~ ~ .
Time: _
TNTC = Too Numberous To Count
Coilformll00ml
Coilformll00ml
/~ - 5~Z~~
p.m.
OB = Other Bacteria