HomeMy WebLinkAboutSAND LAKE #2 BLK 7 LT 11I.', f;
MUNICIPALITY OF ANCHORAGE
®� DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME/
�
iJ✓V �[�,� �
I PHONE
❑ UPGRADE
MAILING ADQ�!SS
y
LEGAL DESCRIPTION
LOCATION L ADX
NO. OF BEDROOMS
Qx
DISTANCE TO:
Well •/
0
Absorption area
3 s
Dwelling
/
PERMI
/
w2
Manufacturer ����
Material q L
d
No. of compartments
y~
Liq. capaci y in gallons
IF HOMEMADE:
Inside length
Width
Liquid depth
0 Y
DISTANCE TO:
ell
Dwelling
PERMIT NO.
J Z
= z H
Manufacturer
Material
Liquid capacity in gallons
w=
DISTANCE TO:
WellFoundation
�p % —�_V
Nearest lot line
PERMIT NO.
J LL z
No. of lines
Length oeach line
Total long t of lines
Trench width
Distance between lines
F Z w
t
'1/
y
inches
F
Top tile to finish
Material beneath
of grade
tile
A
Total effective absorption area
D
inches
Length
Width
Depth
PERMIT NO.
LU
(7
Q F
Lu a
w
Type of criba
Crib depth
Total effective absorption area
well
DISTANCE TO:
Building foundation
Nearest lot line
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
.V,97_
LU
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
O
PIPE MATERIALS
SOIL TEST RATING
)
/L
INSTALLER
bw,NgR
REMARKS
7�
L
O
A O 'D DATE LEGAL -
L�
L -V I3 Inev. 01/a)
HOWARD TEAL
saa-oass
WATER WELLS
665 W. 87th Avenue
Anchorage, Alaska 99502
WELL CONSTRUCTION LOG
Drilling Co. y `/!f ;� y?� j% �- (% USGS no.
Driller c��L Type of rig �tZr�—Date well completed f_09. /9r�f
Y .o
Well owners �H� (�jyyQ l� ( J�u� Rur-iesearest community Cz,,X
67
Well location: (address & legal description) nn Location sketch or remarks
L_v7`//. ice•'' .SL"�� __ ye�r0 �; t � —
Depth of well -1,•3 1 ft. Casing: depthAS I ft. diam.in.
Static water Ievel6 ft. (above, below) land surface. Date
Finish of well: (open-end, screen, perforated, open -hole, other)
Describe intervals and size:
Well yield tested by (pumping, hailing, air) at 15— gal/min,
for—hours with 0 O ft. of drawdown from static level.-
DRILLER'S MATERIAL LOG
Depth below land
surface in feet
Give description of
(size of material, color, hardness
strata penetrated
of drilling, and water content)
e/
to
O
6Y6:—to
t
!
_0 o
1_12 U t o
',4. 11
elo.tc Zlo
210 ta
j
to
.
t0
e
i
_
t0
I O
iC)(a`l I
to
t o
MUNICIPALITY OF ANCHORAGE
t0
VI
to
-
to
1982
to
otototo-
to-
to
to
~ �U g' -J 1 0:::: 1, ��I _T_ g-0 �� ��F' jF'"�� Lo'X_�/
DEPARTMENT G.-' HEALTH AND ENV IR8NMENTHL`\''8TECTION
825 /L/ STREET/ ANCHORAGE/ HK. 99501
264-4720 �
�EA L.. FiV-4EN
PERMIT NO. ( 810158 )
APPLICANT JON RUNESTHD 2810 RUNESTHD CIRCLE
LOCATION WILCOX
LEGAL L11 B7 SAND LAKE #2 LOT SIZE
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
24]-509] k
�
6750 SQUARE
|
|
--
MAXIMUM NUMBER OF BEDROOMS = ] SOIL RATING (SQ FT/BR)=: 125
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
������A== -I ::L 13����1FER - E7.
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIEL[!
THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE 8F^THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
�I—E 0 kJ I F-" E C- SE. EE F='T 10 �F-i r -J �I :E EF_ � ����ff-Tfo ����CH 1�4�
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
1- L-1 RD ;2 > Pnl!E; F� 1= ::--T- I C, V-4 _S7. �F-n EE FZEE 17A U I���
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN fY WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL
MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ]0 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS FIRE
AVAILABLE TO INSURE PROPER INSTALLATION.
F="F= F."PI I -F E: X F� I Ff E--"—=. ���E ir-I F_. E.= -'F-:-' ::-:--:AL J_ j
I CERTIFY THAT
1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
]� I UNDERSTAND THAT THE ON-SITE SEWER S\/STEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS.
SIGNED:~
APPLICANT JON RUNESTHD \
ISSUED BY 4" ~-
---- DATE _--��V4. 0
u // [ �
�
SOILS LOG
� i 4
MUNICIPALITY OF ANCHORAGE
• ti.e\ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
I Pouch 6650, Anchorage, Alaska 99502 276-2221 TEST
SOILS LOG — PERCOLATION TEST
r -7 Q
PERFORMED FOR: '. 0 ') - 1R \ -Y) �, �j�� �' ) DATE PERFORMED: G.- 7CJ
LEGAL DESCRIPTION:_(�j"{"— 1 1 (+Jf.1�,�C � ✓�SfSU -
DEPTH QJF [� (SLOPE SITE PLAN
�y j
bey I J
4 - i __1— -
5
s a �-L2a�Gt r U -10/
o
8
9
10
i3
12
13
Z)&*,vQ �'� +mow
- j1
Re,N Tept
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
14-
416
COMMENTS
Date
Gross
Time
16-
Depth to
Water
Net
Drop
17-
18-
19
19-
20-
20
COMMENTS
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
PERCOLATION RATE
TEST RUN BETWEEN
,/ ["7 _
(minutes/inch)
FT AND FT
72-008 (7/76)
Time
Time
,,e
Date =
Date
Date
Inspector
Inspector
Inspector
Comments
Conditional Approval��� L 1�
Date Sewer Installed —r„��
Permit No.
Septic Tank Size
V
d
V
Holding Tank Size
Soils Rating
Well To Absorption Area
Well Log Received
Well to Tank
APPLICANT FILLS OUT LOWER HALF ONLY
Property Owner C7) - , f ; Lj OC -s T A -b
Phone
Mailing Address - I�c� (n a a ��-r)C A O rarer � k 6-2 t�.S
Buyer
Address
ending Institution -(c r c l',�t le C v- r(Z1 I c'e zt-0.
Phone
ddress L/D 0kTt-1 C.-rC!lfS 1 11C/1ofciCg�
-f,210
v
ealty Co. & Agent
Phone
Address
Legal Description -0 I OCC '% h e FI c Z
Street Location c5 L1 x
Type pf,Residence
Single Family
❑ Multiple Family No. of Bedrooms
❑ Other
Water� Syypply
C7 Individual ATTACH WELL LOG. A well log is required for all wells drilled since June
❑ Community 1975. For wells drilled prior to that date, give well depth (attach log if
❑ Public Utility available.
Sewag�Disposal
I
Individual Year Individual Installed:
❑ Public Utility When Connected to Public Utility:
❑ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN DE INITIATED.
,Ir. ion
91)502
March 2r" l9d2
7
La, 1,2 Sand
�yn;3 y7nt--,r c� nnot
proval for tbr-� ind! 7irlual (2 c� 1 e
qrant�(l iintil, iterip 1)avf-- been
o N-10 ton o' the CiIrjjjg -1 -1 1-
scal So
that ii-- U3 watew ti -IT -It.
t---:!.Tivir -, . in n
-x-i-Dose"I electrical wir,,-is to the, i-O'll ll.ead a.L , e ) 3. c, t
of-.* thc "itunidial ity or-,' rinclioracie cr)dies an� !,llmt lb-envcasn(�
in conduil-.
re to dS
zl-�Ill ci �,,,!ater an-alysis -rn!:t I)e sub., -t�z to t�i
of �Iccl� ��rem tlie Chem Lain. 5633 31 Stre-ot, fo-r our revieli.
AnIvartuient for a rfainspection w4vin O's
licvv'z:? Crrectod. !�: there are, -iny
furilier quef--tions, -plerri-.e 00113, tyin!, o'- `1C€' at 2i/,-4720.
C. Pratt
Associato 711viroilr-,,ent a l