HomeMy WebLinkAboutT12N R3W SEC 15 LT 37A/JIT I.VSPEcT/ot/
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Permit Number: SWO10351
'Legal Description: T1 2N R3W SEC 15 LT 37
a4�NK•
Date Issued: Aug 29, 2001
Expiration Date: Aug 29, 2002
Parcel ID: 015-052-05
Design Engineer: 0832 F. Robert Bell and Associates Site Address: 004338 ABBOTT RD
Owner Name: TINA & BERNARD KOPER Lot Size: 32228 SQ. FT.
Owner Address: 4338 ABBOTT RD Total Bedrooms: 2 Permit Bedrooms: 2
ANCHORAGE , AK 99507-4308
This permit is for the construction of:
❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well El Water Storage
All construction must be In accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Date: _9_ 1� O
Date: 8 —2 9-0/
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
ON-SITE SEWERMELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 0151- OSZ- OS Permit Number SW O103F
Propertyowner(s) Bernard & Tina Koper Day phone
Mailing address (1) 4338 Abbott Road; Anchorage, AK
Mailing address (2) Zip Code
274-1072
99507
Legal description (Lot, Block & Sub'd.) Lot 37, NN 1/4, Sec. 15, T12N, R3N, S.M.
Legal description (Section, Township & Range)
Same as above
Lot Size 1.59/ 69,333 Acres q.F Number of Bedrooms
32,
THIS APPLICATION IS FOR:
2
Sewer Only ❑ Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade x❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit Fees:a�
320 —00 Waiver Fees: _le,.QE.
/
Date of Payment: j? —16,01 Date of Payment:
Receipt Number: 8776 Receipt Number: blb2�l
(Rev. 12'00)
1. Robert
holit;
'Eassnc,
801 West Fireweed Lane • Anchorage, Alaska 99503-1801
(907) 274-5257 • FAX (907) 272-7531
August 15, 2001
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, Alaska 99519-6650
Re: Design and Site Impact Narrative
Septic System Upgrade, Lot 37, NW % of Section 15, T1 2N, R3W, Seward Meridian
To Whom It May Concern:
The existing two bedroom home on the above referenced property is currently served by two 6'x 6'x 6' deep
wooden cribs, plumbed in series. The above referenced property is being replatted, and the existing system is
required to be upgraded as a condition of this replat process.
The proposed improvements to this system includes:
1. Pumping both cribs to remove accumulated liquid, sludge and solids.
2. Removal of the first crib. Includes excavation and removal of top section, and backfill of crib space with
Type -II NFS material compacted to 95% of maximum density.
3. Installation of a new, 1,000 gallon, two-compartment septic tank and associated piping upstream of the
remaining crib.
4. Installation of a ground water monitoring tube in the vicinity of the remaining crib, extending to a depth
of 4 feet below the bottom elevation of the crib. This will verify that the existing facilities have a
minimum separation of 4 feet from the ground water table.
Please note these improvements have been detailed on the attached drawing.
The subject property is relatively flat with a gentle slope from north to south. There is no surface water within
100 feet of exiting system or the proposed improvements.
Also attached is a copy of the original well log for the well on Lot 37.
The materials used and the construction practices will comply with standards outlined in Chapter 15.65
Wastewater Disposal of the Anchorage Standards of Specifications.
We are open to any suggestions from your department, which would improve the submitted design. We are
unaware of any adverse impacts this construction will have on adjacent property, wells, or septic systems. If
you have any questions regarding this submittal, please contact me at 274-5257. Thank you for your
assistance.
Regards,
Bob Bell, P.E., RLS,
F. Robert Bell and Associates
50'
165.04'(e
ABBOTT ROAD
�1
;1 S89,59'000"W
1 I
IS TALL 1,000 CAL I COMP. SEPTIC SCAU I SO'
i TANK. REMOVE EXISTING
!I 6'x8' CRIB. SEE NO S Z g 7.
E%IS TING SEWER
.>.� L.-tl''.•'::'`' MSTALL FNON.
CLEANOUT STANDP.PE. TYP.
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INSTALL
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WELL \IDD WLLx. I
WELL I 1 LOT 37 ON
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`RPR 19 '91 04:51PM ST -AK DNR WATER 967 269 8947 P.1
o+a UNITED STATES
DEPARTMENT OF THE INTERIOR y ,
090=ICAL SURVEY
• WATER RESOURCES DIVISION
WELL toG °rte" Nos.
State county Subarea
Ownff
Drilled by �e /�+'L� Address
Date /20-eALaa-1 19 •J-4' C&gng dialn. •• Land -surf. alk -
Source of data
(Eater hive of W4 Derf oralim, ytrld, end drawdown at and of lop)
Rtow air DATE Baal — of
F �. �.M•MN ww.M YF4 1►-�1 W
Received: 4/19/01 16:05; 907 289 8947 -- F ROBERT BELL AND ASSOCIATES; Page 2
- RPR 19 '01 04:51PM ST -AK DNR WATER 907 269 8947 P.2
WELL DESCRIPTION AND
l3.Zly
WELTS CSes-/CdsFO)
ADL/LAS
— NO W61L LOG
CONSTRUCTION
OWNER: 1st as of mo yrI6
LOCATION: Community/area F•( t 1( %.A it _ _ _ _ _ _ N E _
} } } } Sec T S R W B&M
Subdivision: Lot T7 Block ALT/LSD
DATE OF VISIT: 9-lLl -RBY: i.II •Ye+••wk L.1...•. Wia— ,o
DRILLER/COMPANY: DATE COMPLETED:
WELL FINISH:
WELL DEPTH 1(, O ? ft TOTAL CASING ft DIAMETER in. PUMP DEPTH SET ft
WATER USE INFORMATION:
WELL YIELD gPm for hours with ft drawdown. Method of
determining discharge:
WATER LEVEL: describe MP -r o .c which is S. O above—ft LSD
Measuring Instrument used: elow
Time Hold -cut WL below MP WL below LSD ` LtA.&
1. a�ee /.!O- t aP - ( 1 3 3. ( /Js•J9
2.
3.
4.
PHOTOGRAPH OR SKETCH / V
4
i.OT- ;1
LFT
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COMMENTSt (include well yield and quality, use of well,
n
presence of rower problems, and neighbors' water
problems) lJ�-kcv wn -cr i,1\0, c
L. ve ... Tar n dn_, Of .Z lii•.....? o
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A•• �t� r►...K K.,„c•r heel �ekI�
L « i IVO t ri Cwtn t
Received: 4/19/01 16:06; 007 269 8947 -> F ROBERT BELL AND ASSOCIATES; Papa 3
r RPR 19 '01 04:52PM ST -RK DNR WATER 907 269 6947 NnKmC- 1/JS P,31el-ab
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WATER RESOURCES DIVISION
GROUND WATER S1IEINVENTORY
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O / I WELL \ WEll aloNs I
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I i I I
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I
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165.15'(EZIsnNc _ ,j_ � 15.09'(EXISTING)
N89'59'30"E
Off,
A I LOT 42
NOTES
1. THE PROPOSED PROPERTY LINE SHOWN ON THIS
SITE PLAN DEPICTS THE PROPOSED LOT CONFIGURATION
REQUESTED THROUGH DCPD REPLAT CASE #S-10655,
WHICH SHIFTS THE COMMON LOT LINE 37.46' TO THE WEST.
2. CONTRACTOR SHALL PUMP BOTH CRIBS OF ALL LIQUID AND
SOLID MATTER PRIOR TO START OF CONSTRUCTION.
3. EXCAVATE AND REMOVE WESTERLY CRIB, APPROX. 11 FEET BELOW
GRADE TO BOTTOM OF WOOD CRIB. BACKFILL WITH TYPE -II
NFS MATERIAL COMPACTED TO 957. OF MAX. DENSITY.
4. IF ELEVATIONS OR SLOPES DIFFER GREATLY FROM THOSE DEPICTED
ON THE DRAWINGS, THE CONTRACTOR SHALL CONTACT PROJECT
ENGINEER FOR DIRECTIONS.
5. EXISTING CRIB LOCATIONS ARE APPROXIMATE AND DESIGN
MAY NEED TO BE ALTERED AFTER GROUND IS EXCAVATED
AND THE PRECISE CRIB LOCATIONS ARE REVEALED.
6. EXISTING WELL LOT 37 HAS A 6"0 CASING THAT EXTENDS
180' BELOW GRADE.
7. THE SUBJECT AREA IS RELATIVELY FLAT WITH A GENTLE SLOPE FROM
FROM NORTH TO SOUTH.
8. ALL CONSTRUCTION MATERIALS SHALL COMPLY WITH ANCHORAGE
ORDINANCES DETAILED IN CHAPTER 15.65 WASTEWATER DISPOSALS.
LOT 37, NW 1/4, SEC. 15
T. 12N., R. 3W., S.M., ALASKA
B.L.M. PLAT 1978-1813
1
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Municipality of Anchorage
Development Services Department
Building Safety Division
On•Site Water and Wayteweter Program s
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.sk.us
(907)343-7904
Waiver Review Worksheet
u71 PID#: 016-062-05 t1A#: Permit#: gW010S¢�-
WR#: WR0102'Sf
Date Received: 08/16101
Legal Description:
1.1t. n+vu 6191!on 16 Lot 37
Engineer. F Ro`"' oo s AWoclates
Applicant: Tlna Uerard Kooe 1% L 59b
L021
Cksk
Waiver Requested: 90 feet fromAW to tank
Geology Criteria:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
................................",'masseuse...................................
Waiver is not Granted: �—
Waiver Is Granted:
List Conditions or Reasons for above:
By:
Date: Name of Reviewer
...............................................................................
Red: 10246 Amount: 5626.00
LjCN 3�) U -")kA *\r
Date Paid: 1 t 1
P``\
- — —� - - - ABBOTT ROAD
so' n
S89'59a'00"
165_04'(EXISnNW (rill
sc-4- 14-59 EXISSPNCSElNfl
ST10pPE/
t3x
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CL
100
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00 _ I L.J
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EXISTING I ��
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00 b V
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COT lv X35% LOT 38
�� I wE
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NOTES
TALL 1,000 CAL,
:OMP. SEPTIC
IK. REMOVE EXISTING
6.6 CRIB. SEE NO ES 2 & J.
ALL FNDN. EXISTING SEVER
WOUT STANDPIPE. TYP.
\ _ EXISTING C'.5' CRIB
SEWER CLEANOUTS
E'a5
(n
+G HOUSE �32X
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LB'%12' GREENH
SHED
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a: <
317. LOT 37
SE
10'x30'
_v
SHED
0.10 EXISTING DRAINAGE
no �� (TYP.)
�2z a I Z I t1
0
165.15'(EXISnNG)115.09'(EXISTING)
N89'59'30"E
LOT 42
1. THE PROPOSED PROPERTY LINE SHOWN ON THIS
SITE PLAN DEPICTS THE PROPOSED LOT CONFIGURATION
REQUESTED THROUGH DCPD REPLA.T CASE #S-10655,
WHICH SHIFTS THE COMMON LOT LINE 37.46' TO THE WEST.
2. CONTRACTOR SHALL PUMP BOTH CRIBS OF ALL LIOUID AND
SOLID MATTER PRIOR TO START OF CONSTRUCTION.
3. EXCAVATE AND REMOVE WESTERLY CRIB, APPROX. 11 FEET BELOW
GRADE TO BOTTOM. OF WOOD CRIB. BACKFILL WITH TYPE -II
NFS MATERIAL COMPACTED TO 951 OF MAX. DENSITY.
4. IF ELEVATIONS OR SLOPES DIFFER GREATLY FROM THOSE DEPICTED
ON THE DRAWINGS, THE CONTRACTOR SHALL CONTACT PROJECT
ENGINEER FOR DIRECTIONS.
5. EXISTING CRIB LOCATIONS ARE APPROXIMATE AND DESIGN
MAY NEED TO BE ALTERED AFTER GROUND IS EXCAVATED
AND THE PRECISE CRIB LOCATIONS ARE REVEALED.
6. EXISTING WELL LOT 37 HAS A 6"0 CASING THAT EXTENDS
180' BELOW GRADE.
7. THE SUBJECT AREA IS RELATIVELY FLAT WITH A GENTLE SLOPE FROM
FROM NORTH TO SOUTH.
8. ALL CONSTRUCTION MATERIALS SHALL COMPLY WITH ANCHORAGE
ORDINANCES DETAILED IN CHAPTER 15.65 WASTEWATER DISPOSALS.
LOT 37, NW 1/4, SEC. 15
T. 12N., R. 3W., S.M., ALASKA
B.L.M. PLAT 1978-1813
—}� — 50'
II
on
on
�.........................
9�•'. FRANK R. BELL .:
NO. 2162 -CE
ANCHORAGE AREA 10,,01GH
@G11AT11
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM t�6aL
G2l TJC— _ MAILING ADDRESS _SAA PHONE y�—
NAME Raw' Sec. rS_ rL07-----5�--
�edo.�- Q�l LEGAL DESCRIPTION Y(�•N:
LOCATION
SEPTIC TANK: NUMBER OF
DISTANCE �.,s� MATERIALCOMPARTMENTS�
FROM WELL q� MANUFACTURER.
GALLONS.
INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY
INSIDE LENGTH
SEEPAGE PIT: THJ�, LENGTHL/ DEPTH
'
NUMBER OF PITS _1--. DIAMETER AOR WDEPTH
DISTANCE FROM: WELL��•
LINING MATERIALIE2CRIB SIZE: DIAMETER_.DEPTHr
TOTAL EFFECTIVE `•(�37-- SQ FT
NEAREST LOT LINE ABSORPTION AREA (WALL AREA) '�—
BUILDING FOUNDATION__.
ADDITIONAL ABSORPTION f
WELL:
TYPE CONSTRUCTION
Q C� DEPTHDISTANCE FROM:
NEAREST TANKC C�. TEM /'•L�"(
BUILDING NEAREST SEWER LINE f
FOUNDATION LOT LINE
CESSPOOL . OTHER SOURCES
APPROVED
DISAPPROVED — REMARKS
DIAGRAM OF SYSTEM
DISTANCES:
%�`
INSTALLED BY: W 1
PIPE MATERIAL:
SLOPE:
r.a. l0
4 b'
APPROVED
G.A.A.B.
.S3oAM
SjjjbLV-
�iiar*\ 23w
tr, 416Y-4� s
kA 3 ,
E, o i5- (:)Sa -(D Ll
1.
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
TEST HOLE # 1 SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTION: Lot 36, Section 15. TON. 113W, S.M.
DATE PERFORMED: Aueust23,I996
PERFORMED FOR: Skin and Cassic Williams
DEPTHS PI SLOPE
SM Reddish sandy loam
Shl Cray, silty sand
Dry, noncohesive
SP/SM Fine, slightly silty sand
Soft, no cobbles, lenses of SM
ShVML Very silty anal
Dense, cohesive
SPISM hlcdiuin, somewhat
silty sand, damp
lenses of ML, SP
Depth to Groundwater Date
o roumtwater r
onttor w e
w
o.
0
N
SITE PLAN
pa
BDM
HOUSE
o
0DRIVE
®$
o
T.H. T.H. o
b2 f)1
Date Roading
Clock Not Time
Time (minutes)
Percometer Net Drop
Reading (inches)
6/23 --121Piresonk
(minutesAnch)
7)
Add wmcr start
t 1:15'40
' 23 3/R
/l
11:16:40_21
1 d 2 4
dd ate23
3/11
I
11:18 1
11; 114
Add water
11:18:1
#3
217/16
Adt
1 : 0
1
23 6
F4
1:2 :3 I
213/8
PERFORMED BY FLATTOP TECHNICAL SERVICES. I �� 7:1p. r L CERTIFY THAT THIS TEST WAS PERFORMED 114
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 9 /r/ / 9,6-
JPERCOLATION
RATE
<1
(minutesAnch)
PERC HOLE DIAMETER 5 112
TEST RUN BETWEEN
7.5
FTAND go
FT
COMMENTS: No sand filter should be neccvsnry ns the material Pcrc'ed is
fine sand.
_
PERFORMED BY FLATTOP TECHNICAL SERVICES. I �� 7:1p. r L CERTIFY THAT THIS TEST WAS PERFORMED 114
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 9 /r/ / 9,6-
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE. ALASKA 99516
TEST HOLE k 2 SOILS LOG •• PERCOLATION TEST
LEGAL DESCRIPTION: Lot 36, Section IS T12N R31V S.M.
DATE PERFORMED: Au¢nst 23, 1996
PERFORMED FOR: Skin and Cassie Williams
ncoTu
COMMENTS:
Pt
Ski Reddish sandylomn
SM Gmygmvellysilty sand
Lenses of SP
SP7SM Gmy gravelly. somewhat silly sand
Densef, less SP than T.H. Ni
SM Cray sillysmul
Lenses of SP
Lcnscs of b4
D.H.
SLOPE
Depth to Groundwater
Date
o room'--
71319
onttor to c r
7.75
FT AND S.25
FT
dd w le nA ala3:Q:1Udd
water
_42
SITE PLAN
L'
q BDRM
E
o HOUSE a n
a
z
O
r a,�
I„DRIV � � o ,
31 0
T.H. T.H. o
N2 N1
Data Reading
Clock
Time
hot Time Percometer
(minutes) Reading
Net Drop
(Inches)
B 3 rcver
7.75
FT AND S.25
FT
dd w le nA ala3:Q:1Udd
water
_42
M1/22j
water
3
:53:10All
4dd
4: 3•
1 114
Acid water
:p
U44,13,20
10 77 114
PERCOLATION RATE
g
(minutes/Inch)
PER HOLE DIAMETER 6.6” _
TEST RUN 13ETWEEN
7.75
FT AND S.25
FT
PERFORMED BY FLATTOP TECHNICAL SERVICES. I or CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 9
h' MUNICIPALITY OF ANCHORAGE
II D. .4RTMENT OF HEALTH AND HUMAN SEF. „ES
Environmental Health Division 1
zoil-
1325 •'L" Street, Anchorage,
1/•ON-SITE
Alaska 90502, Telephone 264-4720 0j, -1
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION
REPORT
Namc
E2/ 2 y 215 DISTANCES
._.
AacleSs TO SEPTIC ADSORPTION
Q3�3 FROM TANKFIELD
WELL
2 L_SSJ�
PIwnJISr
PPmm No. no bl becrobmf WELL
271-8831-t g D2�1 3 rota' to�c'
facnl oefcmar,oN LOT LINE ; $ ' a
Sa3 tliork SJoalvlswn L 2
a" i
gn
6
FOUNDATION
1 ownslop, nniy,o. Socbon 'e)_
AS•DUILT DIAGRAM 15rww Iccabun o1 wr.l. Wpbr syswm. F1uPP•ly anew. Iamulabon,
alrawa , wa:n bua,cs. KC 1
TANKS
SEPTIC
t I HOLDING BQO t
A•NgJTGllnl•I Qpaceym e�NLli,,�6�{�/ ! S
S
btaimy`1 Au. of Conq,t•!n•rnts
Z—
__ TYPE OF SYSTEM —
TRENCH ❑ BED [] W. DRAIN ❑ OTHER
r
—
DoMh to pw boaun1110,1• IOW avpal Mum p.q bn� ar,aW
Dogma. pmab
FT FT
hu wccc AYOH1 w•p11 VV a�dCt Gwa1 Uey,rl Mnbam pp.• —
/
0 F1 6 FT
--
�rar..i �crgio GIaw1 w•6b ' --
3 �_
_ FT ^� FT
_ _
aoiN abaw NOn arca Ihs1.mG tC'wtun urta 4o T
L_i L SOFT N�nc FT ` L
N,.mber OI lnuy o•11a11ry1 Yil:t n.a,"na1 •r 0
SOFT 03 0SL1
_DPL
_H
nf'NIP1 DAIr MKlal•ta "
OWNra-2
WELLS
Be
PRIVATE
IiC1LVl(J11t%�L
rs1m1.1
REMARKS:
'SHE
r
hlunic,pat and State pwuellnes in ellecl
Health Departmont Approval: _
1 -DIY rA,NS,
❑ OTHER (Identify)
v Dcpm (.n>ra u,
(g
F71 UR
t 1,•fInML'a
Pae lq�s
0 SA'1_R"��"�t
Inspections
PPerf0f'mec by
a1l"
Unity that INS mepeclion waS Pedarmall aceerdmp to all
Dale
�.o n5�,ypenb seAt•,q
r.; > A
Ck •�
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION r PERCOLATION
625 L. Straet, Anchorage, Alaska 09501 264-4720 TEST
SOILS LOG — PERCOLATION TEST
PERFORMED FOR'TL- n o PA O IC C DATE PERFORMED. 2- 11- �e%
LEGAL DESCRIPTION: i In1/i 1� 1 1`,
CPTH Gw
IF ..
1 a.•• wEu. G/Lnocc Cn.Ave.t_
C-L.cn,r
.
3 e.
4-
5-
7 5 7 o V
8
. .r
9 �
17
18
19
20
G vi- G M
GQhDEO G2hVC(-,
^' S%o S I LST
�Q• .1 w1ED. L-0trsr_
QQ•h.
SLOPE
WAS GROUND WATER 5
ENCOUNTERED? L
O
P
IF YES, AT WHAT E
DEPTH?
MEMO-
Dais
Gross
Time
Not
Time
Depth to
Water
Rwssi>ra�i`►i�ss�a���
�Nr1.o
�i'■, �I�■
NIMENNN.N■IN
Rteding
Dais
Gross
Time
Not
Time
Depth to
Water
Net
Drop
A PERCOLATION RATE
StPTtCSa�f, To ate A4>r 0*4V91. RUN BETWEEN
rr. n M n.1 tre O r_s r_ 'a-13 ) R,')n-C-
it C r O m %A �_ .h I t4 Q C 4
PERFORMEDBY: to. .ArA T 14k4rt Gy CERTIFIED
72.008 (6/79)
G � V •�e••e��• Q
'•FdjrAp
r �' .7 • 1
i Vllllf m 1 e D)
tit • CE - 724 c A
I;}tb64(OvJA( ..:.I�JFO ,I !1 "l "l -x r.
' � ; . �. w t� c2 . a3 R.t2.'t � ��c ft �c s . • i , I
i
J.
P(- t r .N 0.: ; . I _.....
h.l Tttt? Time Cr- PCE'Qll)tIT.' tSS i'AJC,e , OVL
T•O... . TK t= SO.t LS Fn.CtVn1 ti L"CL tr0 DOZ("(r
OUR•-13- @i $Ott_S InIVESTtGhTro,v,
gbR SOtL- Itr2hTA P20PoatE�O: Fort ^CsOiLPTt0,J
LA) E fLU VL-% )hl-..1.`I o' l Ai3 t�f l_`/> AS Gw"(rN/I/
X:; A-^ D C I V C iJ .,A Q C_ C.D S 0 I L j
QATIr- G OF Lt(O fr{Z/QL--�O0OC>vnA C)u(7- To
Tttl t_twtlTcp
7
r�2A,.1G� QCtw cc .� t2S�F
acct 11CC)Qaw—( QA rn YtLxvS<Z 2etaz) I SD �-kn662_/+n
` ; CPt2c Ti=srwC, (L�o'n%, DKHs 2cCZt_Jcm- STLp
�r@ GITIAk- A SIL\/l: A,\lA0(SlS 02 A PCCLt_•
t -TEST . .TO - DET��"tr4e.. .-�\CTVA`.-AC902PTto^.
C A PA C_t T '( .
T WAS aLe-c-rTO'�
P t12 p 0'CL. IN1 .A
PL2C. TLSt� DOS TO �-A..) E.XPeL"rt:-O 2An1GG
CCt/nt_t)C-'S COOLCZ) DC- ' Ji TTQIQUTCO
i -co -rke 01 L'S. rD C PE"�)A'+l UPo'j
IN L'lrV 17ENSt(Y� A-jfl WWC,n t,JoVLD Iv0T-
e hPPTC2w n StE.ve ^^X'it-•`tslS,
Ori R- ll - g71 "% Pt2C.-17t'rs'1 w ^ S
P(�21:�at vo eo I�') Ttq (z VL C- I JL < `1 PF TVI E
P(ZOPO s t.--O /<IISo2P Z tong sK g?(!----'n h T
pEPTvt V• 7' a6t-0-J OCLtC,(. ryk.- G 2AID t.
TVI1s PLAC_L4-- TK G PS(?-C T S7 I^J 7H
Sot t_ Sza o T-7 WKIctq
..�IISo2PT(Of',.._ ..
ETC-v-?-.. tJiL.l-:.P . . l-(vLE.... 71 I Tilic- '
• .IQo Ot=� :.h IJ_ Ex vit.t�-,rJ..,. {�lT:.. o :.
1 .. OF•: �. TVl.6 ;. I-toL.�.. I W hs;_ ,QE2PCi2tNtl'O� :..Pt2lUY2J . TD .
' ..'... 12vnrnn'�It, tilt c 't e�Z' Tct2
:I l
�O
� '.s•.h4.
t
, 6f so. ,t� + , t ,(` f .1 i Lt1.�
a
- (.000 C.:LLo.J ScPTCC-. \C,
I�
A Ad
INS
.
q�.` _.
:........ _.. OF-AlAw
so
F
s coo
%i 49,L* 4
_;.
P -2c,
Nzt..:.oF'...'I
.,:.
.:. .....
.. SoI�S....
o e
d``►aa�'►�ma ,
• X02
✓� � a Ego 2ovw� ��cSZ c^f^ :
.
-L49cL .�4.2-
.AIISoaP'Cloti
.Af (--A 2E.ob
PtaF. tom, Pte......
W' CAP
G 2 A V L
Q t_ cVJ P I
P s w✓ r CL'C r. .
a
- (.000 C.:LLo.J ScPTCC-. \C,
i
.
q�.` _.
:........ _.. OF-AlAw
so
s coo
%i 49,L* 4
�a,••. CE -72 oo
o e
d``►aa�'►�ma ,
:..
i
tt I
4
' , '��_ � i i � 1l 1 >, � •--F �.. 1 C. ' ( I '.., iyl�.l 1. ,.'a i
,. �, , _� 1 1- ., ,- I' r , ; .�,J. � .f tl I , � i 'i �Y. -1. 11 rl.� � r r.���: >�•.
_. a
f
IF 1- I I
.1 1 I.
�� I �'
O15Jo�Z-o�
PERFORMED
LEGAL 0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG - PERCOLATION TEST
COMMENTS
UL.
6ti01'0
am
V�L
(F
0,
Range, Section:
SLOPE
PERFORMED BY: NIG. 11'I avr—\.
ACCORDANCE WITH ALL STATE AND MUNICIPAL
72.0031Rov. 4,e l
WAS GROUND WATER � Ip
ENCOUNTERED? /�f
S
IF YES, AT WHAT L
DEPTH? O
P
E
Depth to Wafer Aller
KonitofinD7 Dale:
PERCOLATION RAI EL&ImmueesnncnlpERC MOLE DIAMETER
TEST RUN OETWEEP —7,_ FT AND /� FT /`
t �' CERTIFY THAT HIISS TESSTT WAS PERFORMED IN
EFFE THISDATE. DATE: -w( w4
-��
iF --
li.�
wel
PERCOLATION RAI EL&ImmueesnncnlpERC MOLE DIAMETER
TEST RUN OETWEEP —7,_ FT AND /� FT /`
t �' CERTIFY THAT HIISS TESSTT WAS PERFORMED IN
EFFE THISDATE. DATE: -w( w4
• }} Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVIC
825 ••L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: M 1,( F' Mri4-,e 0,1 l I vo
Dnq
Lor 3q
LEGAL DESCRIPTION: T17_ N Pz, J 47/s c ,f Township Range Section-
4
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
COMMENTS
OL
6M
54411 SO„dy Grc,ve
SAN W/$e Alr v'PN Je'1.
S
:.)7 GINEERS SEAL)
B J CorvAn v �/
C �-t203
ITE
C M �! ►_1J l I I I I I I I I I�
S<e,.r l G rr,w l WAS GROUNDWATER
ENCOUNTERED? No
S t
IF YES, AT WitAT L _
DEPTH? 0 -- —
P
E
Depth to water A ler ?
fEonlloring? r
ML
S.1+
61,4
NO GROJAIO (✓A-v.n•
ENCO✓NYe -1 U
Reading
Date
Gross
Time
Net Depth to
Time Wator
Not
Drop
/0:ot
s
6
r
/0 /r
G
/
,06 r
PERCOLATION RATE'?-i--61—(mrnutes?mcn) PERC HOLE DIAMETER6"
TEST RUN BETWEEN -V FT AND /6" FT
PERFORMED BY: JEee11 Kcr. r47 1 �-CERTIFY T_HATTJJJHIS TE T WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELIN S IN EFF C ON THIS DATE DATE:��
72-008 (Rev. 4105)
o•
Municipality of Anchorage
fir DEPARTMENT OF HEALTH & HUMAN SERVICES
825'L7 Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: DX1.L' /)JA.(�. C'o i1 n7- DATE PER
LEGAL DESCRIPTION: I C+T $% Township, Flange. Seetion: r
DEPTH SLOPE
tFEFT1
1
2
3 a/l/
Oete
::ar
4-
Depth to
Water
5:13
16-
6
x
6
7
< 3s
8
.o•.
I_
9 -1
�•:r..
10
11
12
13
14
15
Oete
::ar
Net
Time
Depth to
Water
5:13
16-
6
17
17
< 3s
8
.o•.
I_
18
�•:r..
19
WAS GROUND WATER
ENCOUNTERED? NO
S
IF YES. AT WHAT L
DEPTH? 0
P
E
Wilt to Wa:tr mir
Mcnitanng? r/o tvAirr. Gilt "110A,
PLAN
/%
e
Reading
Oete
G'O11
Time
Net
Time
Depth to
Water
Net
Drop
/
A
8
.o•.
I_
A
.q P
I f 7 ••
r ,.
//
i. z
/y•r
•.
20 -{
11_ JI PERCOLATION RATE '
-- • 5 lmmutevinenl PERC MOLE DIAMETER
TEST RUN BETWEEN rr' FT AND f'3 FT
COMMENTS /'L'� il(i( iS'' %A /71'.Z ( -/ , rRA' •- G - 70- Cir' / � / +�f!) '•L
J F � rG i/ i'c F� /rY0 L?
PERFORMED DY: L!1A'I,,Ir.. 111 a f- A W>?; A/ I M% myL C- Ao G Eutj TIFY THAI THIS TCESpT WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS GATE. DATE:CO /OCJ
72-000 lRev. 4/857
1)cpr 'mint or lic;11t), :u,d Erivironmcnla' otection
251.6 17. '1•uclur Road
Anchorage, Alaska 99507
276-2221
" -Still's I.0c; ITANll.e\TP)l'.
Performed for. C//ir! ��Ej�.�F�l� _._�Q!� Prrforw-..J Z 7
I.1,jal Ucscripliun:_
laf.32..se�...!5,._T..l.tti(
This form rcpurts: Solis Ing rl'en:olatiml Inst'_
J _...._. --- --- -- -
epth ,/e y//
F
Feet
2
S,
3-
4-
�/Q
6-
7-
�i -
9 _
10
11 -
12 -
13 -
�. CV,7 �rraue�ry iopSoi/
Ton .ti//y Jnr1d- Syndysi/i/
ran -Je ray sandy J;// aii/n
rouoded s/o onyu/ar
9rrrnve/ reachi.,y eo%6/e
s/te•. Len3es o�
si//y Sandy �inyu/ar �/o
6abnn�e a/pr 3nw� /,
Crude/y ur�ss -bedded
2/idv%o/ doi/ 40rdevg�':/ vrtt't,
Ad.
- /i/�!/T OT GrCG4UOJ`/Cir!
/
Nate : //b/e 0`Z
c d th s�
.S/ o wed
A
14 -
----
Vias I round water encountered? /(/Q If yus, at ,-,;IJt
No% : owner re/dor�s 7/1iq�
dopth?
"�ti�
'
an o%� hgngL dug arre// o,;
vecen>�/y /r%/ec✓. L/ was oboe ZS{f deFjo and min/// dr
;oi-ap'��y was
Reading
Date Cruss_lime
_
lict Timc
No drop
)epth t.--VVtr 1
-
—
Q
/O1.13
..G..ZS.....
-
----------
Pe__rcolation.,ratti _/¢_tit,!74,,,l"r+4
-----"
__..._—_
`"
-Proposed 1115tdllaClUn: Scupatle Pit 11rain
A
14 -
----
Vias I round water encountered? /(/Q If yus, at ,-,;IJt
No% : owner re/dor�s 7/1iq�
dopth?
"�ti�
'
an o%� hgngL dug arre// o,;
vecen>�/y /r%/ec✓. L/ was oboe ZS{f deFjo and min/// dr
;oi-ap'��y was
Reading
Date Cruss_lime
_
lict Timc
No drop
)epth t.--VVtr 1
ro% /nin.�,n
Net Drop
/O1.13
..G..ZS.....
-
----------
Pe__rcolation.,ratti _/¢_tit,!74,,,l"r+4
-----"
__..._—_
`"
-Proposed 1115tdllaClUn: Scupatle Pit 11rain
I*ielJ 1/
Depth of Inlet Depth to hotloni ul' pit ur
COhItIL'tiT5:
trcncl.
..../�0:,���rA�1n�,/_.Gedru��n...------•---...-.._..-----•--
- .... -- ..........
PerfonncJ ,ytlfiod U'y' -—�._.._ ----'ate:
I -M-040 (G/74)--
M -W DRILLING, INC.-...
DRILLING LOG
Well Owner ° "
_Use of Well
Location (address of: Township, Range, Section, if known: or distance main roars
Size of casing Depth of Hole feet Cased to 1�feet
Static water levet ' ft.above
( ) (below) land surface. finish of well (check one) open end
Screen ( ); Perforated ( ).
Describe screen or perforation ;.W.
Well pumping test at ''' gallons per ()ioui) (minute) for_ i, hours with
of drawdown from static level.
Date of completion '' / 7. i. /'/
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
TO
TO
TO
TO
TO
, .)bb l:1t:
TO_,
TO
TO
— TO
TO
TO
fI.;C. „t..,.,,I1
N%%V,'t Ci,itiiir(l GmtiSMnt
Ceti Ica U; n.) 4. .+
2 —STATE
F'1.:(t-v
, .)bb l:1t:
fI.;C. „t..,.,,I1
N%%V,'t Ci,itiiir(l GmtiSMnt
Ceti Ica U; n.) 4. .+
2 —STATE
MUNICIPALITY OF ANCHOFfA9
Qt NIOtPT. O TALE FROSEGTIOAMUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1904
JUL 91 tqA
264-4744
r r C e r D
Legal Description: "
j� :�n 7
,trZ
-JJ, R-3 t,t_3
t nn
A. WELL DATA
Well Classification���� If A. B, C. D.E.C. Approved (Y/N) N/�
Well Log Present (Y/N) to — Date Completed9/ 2,1 -7 : f Id ~
Total Depth -Z_ Cased to V Depth of Grouting Iv
Static Water Level I J (v Pump Set Al
r
Casing Height Above Ground g tr Sanitary Seal on Casing (Y/N)
r
Electrical Wiring in Conduit (YIN) Depression Around Wellhead (Y/N)
Separation Distances from Well: )
To Septic/Holding Tank on Lot � ���'��r ; On Adjoining Lots ,
_ _1I 1: t On Adjoining Lots 1J��
7o Nearest Edge of Absorption Field on Lot 9
To Nearest Public Sewer Line ` - To Nearest Public Sewer
CleanouVManhole ( To Nearest Sewer Service Line on Lot -
Water Sample Collected by 1-47 44P ; Date �Q
Water Sample Test Results
Comments � + ' f
B. SEPTIC/HOLDING TANK DATA
Date Installed 6 � Size 1 �-5 U No. of Compartments �-
r
Standpipes (Y/N) Air -tight Caps (Y/N) Foundation Cleanout (Y/N)
Depression over Tank (Y/N) NJ Date Last Pumped 11,) '
Pumping/Maintenance Contract on File (YIN) f� � - ; for U`r�
Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N)
Separation Distances Irom Septic/Holding Tank: �.
�f�r)( To Building Foundation j
To Water -Supply Well Z � I
To Property Line —t To Disposal Field
To Water Main/Service Line 7�S( - To Stream. Pond, Lake, or Major Drainage
Course t
Comments
Page 1 of 2
77.e9P !Rry P R61 r"I
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata — / S Type of System Design
Date Installed 1. f T
,.— Length of Field%�}
Width of Field % S ( Depth of Field _ f
Gravel Bed Thickness �� I
Square Feet of Absorption Area l % 1� Standpipes Present(Y/N) _ 1r
Depression over Field (Y/N) J Date of Last Adequacy Test
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water -Supply Well . I (t; f To Property Line " t
To Building Foundation ) 5 1 TO`E� ling or Abandoned System on
Lot ZIP ( ; On Adjoining Lots
To Water Main/Service Line To Cutbank (if present)
To Stream/Pond/Lake/or Major Drainage Course
To Driveway. Parking Area. or Vehicle Storage Area - f) t
Comments
D. LIFT STATION
Date Installed Dimensions
Size in Gallons fvlarhole/Access
"Pump On" Level at Off' Level at
High Water Alarm Level at Vent (Y/N)
Tested for Pumping Cycles during Adequacy Test. Meets MOA
Electrical Codes (YIN
Comments
Check Petted Bedroo Rating Against HAA Request "
I certify It
Signed .
Receipt No.
it Cd. or conformed to all MO ai
OA No.
Date of Payment
Amount: $ / i�/� • U J
5,?o q
ENVIRONMENTAL MUNICIPALITY
SERVICES DIVISION
Page 2 of 2
72 076I Ro lt41 B•vt
JUL 11 1988
RECEIVED
HAA guidelines in effect on the date of this inspection.
1n.
Engineer's Seal
T12N. R3W.
Section 15
Lot 42
#015-052-10
O -
PERFORMED
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG - PERCOLATION TEST
e c'y r r
LEGAL DESCRIPTION:_ 1JT �...rCi✓' �7
DEPTH
(FEET)
1
2-
3-
4 3 4
5
6-
7-
9-
112
7912 a
13-
14-
16-
17-)
31416 17
18
19
20
COMMENTS
5r�1 C�M
15T-1 ►-r.
e'A k"
DATE PERFORMED: -
Range, Section: %/ L /`/
SLOPE
WAS GROUND WATER
ENCOUNTERED?
S
IF YES, AT WHAT L
DEPTH? O
P
E
Depth to Waver Aller
Monittring? Dale: S=G=
ROGFRI C. COWAN
CE -8001
I
r
Reading Date Gross
Time
Net
Time
Depth to Net
Water Drop
r!S C '' 2 —
O
n •—
PERCOLATION RATE L-• (minutevinch( PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND —7 FT
PERFORMED e .& S ENGINEERING
CERTIFY THAT THIS TEST WAS PERFORMED IN
1k03Eagle River Loop Road No. 204
'3/t7 �O o
ACCORDANCrLWITeW"r,TAt&kbIZ9*MCIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
Municipality of Anchorage t
U&
DEPARTMENT OF HEALTH 8, HUMAN SERVICES !
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG - PERCOLATION TEST'
t T ; ROBERT C. COWAN
141"0,'• CE -8801
PERF0A&IE0 FOR: SO^ DATE PERFORMED: y •rcLar ,
LEGAL DESCRIPTION: -/OT ` z'A :5-6.z`? ,' Township, Range, Section: ZAf PL t. -J
E-7- ESLOPE SITE P AN
1
2-
3-
4-
6-
7 34 6 `
8-
10-
11 1011
12-
13-
14-
15-
16-
17-)
21314 15 1617
18
19
20
COMMENTS
d 'C�/G t-'wc-tn —
51-4 CrH
150 t -r -
WAS GROUND WATER
ENCOUNTERED? A/0
IF YES, AT WHAT
DEPTH?
DeDtll to Water A"er
MonllorinD? Date
1i
PERCOLATION RATE Iminulcannch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND 47- FT
& S ENGINEERING
PEAFORMED B ; I 'tom CERTIFY THAT THIS TEST WAS PERFORMED IN
I Y0 4 Eagle River Loop Road No. wu4 %
ACCORDANCELWITMRUeBTA1$kbt9" 1TCIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: �0 O
72-008 (Rev. 4185)
��■«�•�mrammy,
rramImam
JfA-
ymmwff
PERCOLATION RATE Iminulcannch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND 47- FT
& S ENGINEERING
PEAFORMED B ; I 'tom CERTIFY THAT THIS TEST WAS PERFORMED IN
I Y0 4 Eagle River Loop Road No. wu4 %
ACCORDANCELWITMRUeBTA1$kbt9" 1TCIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: �0 O
72-008 (Rev. 4185)
' YL LY YY IY•o
JAL
1 11.111 .11 61, 1. bwllrin..
ME Environmental Services Inc.
Laboratory Division
2100 W. Pone, Drove
DrinkingWater Analysis Report for Total Coliform Bacteria Anchorage. AK 99618.1 SOS
Y p Tel. (9071562.2343
READ I.'vSTRVCTlO,NS ON REVERS£SIDE BEFORE COLLECTING SAAIP4E Fax (907) 561-5301
ML•,�P SE COMPLETED BY WATER SUPPLILR I TO SE CONIPLETED DY LABORATOky
c PUBLIC WATER SYSIVil I.D.9
.t+r!PRIVATE WATER SYSTEM
0 Send `e`suln ^ ' 0 Send favalre /
S S V
ro �
Cl ScodResYtrr 0 Srodrnwree
My.I./ FL.[ VY[I L.mt
Yr y 614
Z.,
SAMPLE DATE
Month
SAJvIPLE TYPE:
Routlne
Cl Repeat Sample (for routine vairiple
with Iib ref. no. )
O Special Purpose
SAMPLE LOCATION
E0 ED
Day Year
Lff r4Z _Q 31) Ci,$L&SQu 91D
Comments:
O Treated Water
eUntreated Water
Time Collected
Collected By
1:40 —y
Hex..lra.
Analyses shows this Water SAMPLE to b t
Satisfactory
0 Unsatisfactory
0 Sampleover 30hours otd. res ultsmay
be unreliable
0 Sample too long in rransit, sample should
not be over 48 bourn old at examination
to indicate reliable results. Please send
new simple via special delivery nail.
Date Received ca/�- -0
Time Received 6,GV
Analysis Began Ii I5o
Analylleal lffeth0d: Membrane Filter
0 MMO-MUG
• Numberofcolontes/100m1.
-- — - -- ' :exult• Analyst
Data Tome -
a'._
Falx Jun ❑
Faaea
Client notified of uasatixfaetory results:
❑ - ❑
PhanL•d SpeUewiih Fazed
Data Tonic.
BACTERIOLOGICAL WATER ANALYSIS RECORD
MMU MUG Rtsult: TOral Coliform
E. Cat;
Membraoefilter: Direct Count 0 Coloalesil00ml
Verification: LTB BGB COLIFIRM
Fecal Coliform Confirmation os
Final Membrane Filter Results l J Colifornu100 mi
Reported By Date cso Time ik�D!?fl bra
_ IVEne MemaaroltneSGSGrouplSocoAteGanaratodaSurveillaneal _
ENVIRONMENTAL FACILITIES IN ALASKA. CALIFORNIA. FLORIDA, ILLINOIS. MARYLAND. MICMIGAN, MISSOURI. NEW JERSEY. OHIO. WEST VIRMNI
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURCES
DIVISION OF MINING 6 WATER MGMT
LOCATION OF WELL WATER WELL RECORD
BOROUCH
SUBOM310N
�Wxn; t'nt
BLOCK SECTION OTRS
SECTION TOANSHI►
RANOE
µERIDIAN
GROUT TYPE: \ Volume: '
Depth: from "�—ftrto It
%LLi`OTT
1
k,
❑N
❑E
1
❑S
❑W
LOCATIONISKETCH:
WELL OWNER:
DEPTHS MEASURED FROM:❑Casing
top []ground surface
WELL DEPTH: DATE OF COMPLETION
of hole: % 9 It
Depth of casino: ft
BOREHOLE DATA:Depth
M
Depth
Type end Color
From To
_L
�+at�elot
DEPTH TO STATIC WATER LEVEL:
of-i�11r
O ?� _/P & ft below 19 top of casino ❑ oround surface
Date: —1—I S 19.5
METHOD OF DRILLING: P<eir rotary ❑ cable toot
t—'Ia�t
❑ other
USE OF WELL: Kdomesttc ❑ irrigatfon ❑ monitor
❑ publlo supply ❑ otheCASING•STICK• P: ft. Diam: o In. to 4q1
v Casino type:rt, to 1 �7 f
WELL INTAKE OPENING TYPE: .9 open end ❑ screened
perforated ❑ open hole
! f 19 Depths of openings: to It
SCREEN TYPE:
SIotlMesh Size:
Oiam: In.
Length: It
GRAVEL PACK TYPE:
Volume used:
Depth to too:
GROUT TYPE: \ Volume: '
Depth: from "�—ftrto It
DEVELOPMENT METttOD:
nurarinn• / _.,LA
PUMPING LEVEL AND YIELD:
It after _� hrs pumping =LO opm
PUMP INTAKE DEPTH: ft Horsepower:
WELL DISINFECTED UPON COMPLETION? ❑ YES ❑ NO
CONTRACTOR LNFORMATI N: REMARKS:
egista usiness Name/
AY!�— —f%�t�f� PLEASE MAIL WHITE COPY OF LOG TO:
gnature of Autlonzed Respres stiveat♦�—' ONRIDIVISIONOF MINING R WATER MOMT
7005
ANCHORAGE AK 99510.7005
ny0
F
0
PEP
LEG
I
1
1f
11
17
13
14
15
16
17
18
19
20
MunlcIP811ty of Anchorage
DEPARTMENT OF HEALTH Q HUMAN SERVICES
825 •L" Street. Anchorage. Alaska 995D2.0650
SOILS LOG - PERCOLATION TEST
x t! '•�'v':c
.............. M.F.
bort A. Mafe. d
No. I"?.& P i,i
COMMENTS
PERFORMED BY:
77-008 (Aft. 4185)
'ESZ RAN BET WEEN/-- T FT AND �.L�f7
CERTIFY THAT THIS TEST WAS PERFORMED IN
204
ELINE F ECT ON THIS DATE. DATE:
PERFORMED
Municipality of Anchorage
DEPARTMENT OF HEALTH d HUMAN SERVICES
825'L* Street, Anchorage, Alaska 99502.0650
SOILS LOG — PERCOLATION TEST
DATE PER
LEGAL DESCRIPTION:�,Lg Y{'e%.. IS_TI��i K<W;6MInship, Range, Section:
COMMENTS
SM — Tm-rT r CA. o
'�hzy
Ibbeol A. Shefr• t
WAS GROUND WATER
ENCOUNTERED?
•s G
IF YES, AT WHAT L
DEPTH? O
P
A-
a
Br,Nh b Weer elf 'j�(? �/ �,�q���
Moniterinpi - �-V Batt �-f
®=®m®
PERCOLATION RATE (minutevmch) PERC HOLE DIAMETER H
PERFORMED B)6JLS ENGINEERINIi No (
ACCORDANCE :gr % j AA&tG#I IPAL Ggla River Loop UIBECIN
734)08 (Rev. 4+85)
L CERTIFY THAT THIS TEST WAS PERFORMED IN
ON THIS DATE. DATE:
C,
PERCOLATION RATE (minutevmch) PERC HOLE DIAMETER H
PERFORMED B)6JLS ENGINEERINIi No (
ACCORDANCE :gr % j AA&tG#I IPAL Ggla River Loop UIBECIN
734)08 (Rev. 4+85)
L CERTIFY THAT THIS TEST WAS PERFORMED IN
ON THIS DATE. DATE:
C,
i, Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES wig t
Environmental Services Division ,r/•.
825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744A�
Health Authority Approval Checklist %nqn
Legal Description:71Z�,' 93w;_ 6�/-67T 4Z Parcel l.D.: 40/15"05Z-/0
A. WELL DATA
Well type If A. B, or C, attach ADEC letter. ADEC water system number
Log present ON) (16'5- Date completed /
Total depth IJCased to Casing height (above ground)
Sanitary sea(Y N) �r''i Wires properly protected&) !`C$
FROM WELL LOG
Date of test
Static water level I In l0
Well production —
g -p.m -WATER SAMPLE RESULTS:
AT INSPECTION
Coliform Nitrate 0.95-1 Other bacteria 4191
Date of sample: Collected by: S S ��cll//(/(��//1/G--
B. SEPTIC/HOLDING TANK DATA
Date installed W5 Tank size / Z5-71 Number of Compartments 42, CleanoutSON)Y6f)
Foundation cleanouytY N) Cs Depression ( /N High water alarm (Y/N
Date of Pumping�- Pumper
C. ABSORPTION FIELD DATA
Date installed !� (.p.
Soil rating dJft2 r ftz/bdrm) System type
Length'//1. Width_ Gravel thickness below pipe Total depth / Z ,
Effective absorption area Monitoring Tube prese Y ) Depression over field (YO No
Date of adequacy test Results (Pass/Fall) SS For _bedrooms
Fluid depth in absorption field before test (in.); Z � A Immediately after S/O gal. water added (in.): "'
Fluid depth 'a,/ (ins) Minutes later: Absorption rate �a t g.p.d.
Peroxide treatment (past 12 months) (YIN)�O/Y��/�/i/II yes, give date
72-026 (Rev. 3/96)'
D. LIFT STATION
Date installed
Manhole/Access (Y/N)
High water alarm level at' _
Cycles tested
E. SEPARATION DISTANCES
Size in gallons
"Pump on" level at' "Pump off" level al'
'Datum
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septictholding tank on lot /00 'O• On adjacent lots 100 /f
Absorption field on lot /pp //— On adjacent lots
Public sewer main /y A Public sewer manhole/cleanout N 4
Sewer /septic service line %s Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
i
Foundation S f Property line _ Jt f Absorotion field
Water main/service line %Q Surface water/drainage /U?i Wells on adjacent lots /&V
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
/
Property lino �� Building foundation l� r Watermain/service line /O / 7`
I /
Surface water ,, // �t7a �/-
/ . Driveway, parking/yehicle storage area / 0
Curtain drain /Vl%/l�E , -WaaOdAl Wells on adjacent lots /od 9"
F. ENGINEER'S CERTIFICATION
I certify that I have determined thru field Inspections and review of Municipal
In conformance with A A gu, lines In effect on this date.
Signaturo n
Engineer's Name !C�%���?' C• �Ow�l.. S
Date
HAA Fee $ �` +
Date of Payment
Receipt Number I
72-026 (Rev. 3!96)'
Waiver Fee $
Date of Payment
Receipt Number
ROBERT C. COWAN - i'
CE -8801
°0�nOrcSS\"`
are
Joe
• BATES ENGINEERING -:7BHEET NO.
0 Design 0 Construction 0 Resource Development OF
441OCEANVIEW DRIVE CALCULATED BY- DATE—"�z���f/
ANCHORAGE, ALASKA 99515
Telephone (9D7) 345-0807 CHECKED BY DATE
SCALE
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--� �_/jFQOOr'✓� -44
' ! PE's G I ATE '- - / ✓ �
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• :.. �iSE.. _EfE.���.<" z Z— � Z Lai✓ s
{ vl .<GL'_T/Lfit/CN A40Ao1174PrG 7(/t3G�:lP�ir�
1
_— —I __ !A.� F�/L!'f?/f?C /.Vd�EL.._fJO:.S!• _i _.._..__. i i,. '• 1 '
_! _.-If- � -- �-t-•-i--'-..:.:-;...: i.�.r.TA.<�-_.PE.�i!i�AB�E..si�r�t���iE'2" -
r •
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-- - - - _ - -
_77 ;
-I - ,--- _-- tSiS%4. /,3E�ir/ GGo�.DA/!/CGJ /,vi•T
G.gjioi✓sem S7,,4
! _ I - i �. /G M/ �--:/19.�ii1_i_CE'/2T%rT'i�C-d /•NSTALG��.._
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1:• - I I i I! I f I i I I f i i I ,-; -- -; >>�ZACfFSS1�'�� + i