HomeMy WebLinkAboutTIMBERLANE PARK #1 LT 1B
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(907) 243-2282
KEN JOHNSON
KEN'S COMPANY
WATER WELL DRILLING
PUMP SALES & SERVICE
30 YEARS ALASKA DRILLING
3163 LINDEN DRIVE
ANCHORAGE, ALASKA 99502
NAY 29, 1985
MOVING ON CONSTRUCTI0~ INC.
Don Hannah
P.0o BOX 112028
ANCHORAGE, .~LASKA 99511
RE~ LOT iB Blk 2 Timberlane Subd.
- WATER WELL LOG
( 349-1124 344-2014 )
( Klatt Rd. & Humble )
Bent casing off
Hole NCo two
0 ft to 3 ft
3 ft to 9 ft
9 ft to 18 ft
18 ft to 21 £t
21 £t to 31 ft
31 ft to 36 ft
36 ft to 37 ft
37 ft to ~9 ft
~9 ft to 50 ct
50 ft to 56 gt
56 ft to 64 ft
64 ft ~o 77 ft
77 ft To 77-6
77-6 ft
twice at 19
ft. on large boulder., move Rig
Fill & clay ENrico ~ .... ~ &
NM~L P~OTE~iO~
Sandy clay OCT2 1985
Course ¢rav ray silt IVO C'"-ED'
Med. gray & gray silt
Course gr~v & gray silt
~ed grav& gray silt
Boulder
Course gray & gray silt
( tight )
Overniteo.6 ft H20..bail dry
~ed. grav& gray silt ( weeps )
Same ( dry )
Same with silty clay
Fine ~rav & sand H20 £2 't he~,d
Clean med 8ravel and sand. owa~er bearing
Sta~,ic wa~e~ -~v~i 39 ft. ( b0' Head ,
Test balled one hour at i0 gp~
23 ft. drawdown
Recovers at 5 GPM
Bottom Stable
~otal Casing 79~ft-0 in,
I
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
Application Date
GENERAL INFORMATION
(a) Legal Description (i qciude lot, block, subdivision, section, township, range)
Lo~' I tg j Bile E
Location (address or directions)
(b) ApplicantName~ ~ .~ Telephone. Home ~.-.~/~T//'~O? Business
(c) Applicant is (check one): Lending Institution [] i Owner/builder ~; Buyer []; Other [] (explain};
(d) Lending nstitution Telephone
Address
(e) Real Estate Company and Agent
Address
Telephone
(f)
MacJ~h~ HAA to the following address:
TYPE OF RESIDENCE
Single-Family[~ Multi-Family[]
Number of Bedrooms ~
Other
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.
4. 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 I of 2 72-025 (11/84)
I
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 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 i.nspection.
NameofFirm ~'[/c~j~ ~'~Jl,~t~'c~( 5,~ru'~:.~' Telephone '~-t~
Address c4o
Approved for ~ 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 Alasks. 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
WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4726
Legal Description:
'7'7~ bert~ne
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
:_i 2 4 1985'
Well Classification
Well Log Present (Y/N)
Total Depth 7'7, 5" ~
Static Water Level 3~ '
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Ta0k on Lot
If A, B, C, D.E.C. Approved (Y/N)
~¢' Date Completed ,5-/~-~/~;5- Yield
Cased to ~ '7 ' Depth of Grouting hh 4L ,
Pump Set At ~'~/¢'
~ Y" Sanitary Seal on Casing (Y/N)
Y
Depression Around Wellhead (Y/N)
/~o,~ ~ ; On Adjoining Lots '~ too i
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
Cleanout/Manhole I
Water Sample Collected by
No[l~~ ; On Adjoining Lots ~ (oO
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
Water Sample Test Results '~'~'sr"~C ~"',Y -- ¢
Comments ~ '-~r~ er' ~ S~
N
; Date ~/t~/ 04'
B. SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes (Y/N) Air-tight Caps (Y/N)
Depression over Tank (Y/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
To Property Line
To Water Main/Service Line
Size No. of Compartments
Foundation Cleanout (Y/N)
Date Last Pumped
; for
Temporary HoJding Tank Permit (Y/N)
To Building Foundation
To Disp. osal Field
To Stream, Pond, Lake, or Major Drainage
Course
Comments
Page 1 of 2
72-026(11/84)
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
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation
Lot
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments (Or~r~ ~o(._/~o,'~ ;~2 /"f-¢2, ~
/
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes Present (Y/N)
Date of Last Adequacy Test
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots
To Cutbank (if present)
D. LIFT STATION NefiJ-,
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 ~F~'''~'~4- ~- ~'//-¢"~ Date
Company }~"_ (¢',~:/~'~ ~-,¢c~,~t6¢( ~ MOA No.
Date of Payment 9-¢~¢-~¢
Engineer's Seal
Page 2 of 2