HomeMy WebLinkAboutDEBORA #2 BLK E LT 10# 050 Dol 21
° MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
j 825 L Street - Anchorage, Alaska 99501 Telephone 264A720
ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION
REPORT
NAME
�
PHONE
O
Y/
UPGRADE
MAILING ADDRESS 1
%57.4
LEGAL DESCRIPTION L tJ i /D StirL iT
LOCATION
NO. OF BEDROOMS 3
Uy
DISTANCE TO:
Well �/ / f'
Absorpuor� eye
Owell�ng ZZ /�
PERMIT NO. /
EZ
Manufacturer /•� E�
Materia
No. of compartmen
C
n~G�
Lid. capacity in allons
a ot3
IF HOMEMADE:
Inside length
Width
Liquid depth
dvz
DISTANCE TO:
Well
Dwelling
PERMIT NO.
Oz
F
Manufacturer
Material
Liquid capacity in gallons
0
Wel /
Foundation /
Nearest lot line Za /
PERMIT NO. /
W LL zNo.
F-?�
o/ liner /
Length of each line
Total length of lines {.
Tren ILO
O inches
Distance between li
/V
c t-
Top of rile to finish grade /
Material beneath the / /, ♦
/
Total effective a sorption area
o
.S
S�YJF/L /?OG%� Inches
Z 16 a
ength
Width
Depth
PERMIT NO.
d
Type of Crib
Crib diameter
Crib depth
Total effective absorption area
W
w
DISTANCE TO:
Well
Building foundation
Nearest lot line
Class
Depth
Driller
Distance to lot line
PERMIT NO.
W
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
W
IL
PIPE MATERIALS
C -T/G'
SOIL TEST RATING .97 / f
INSTALLER f
�/
.•{
REMARKS
k
N
p
,r : //
_ _ . .... .' •c��
No. 7157-E %�?'+..
dG
CIO
APPROV
D j DATE LEGAL
72ux tyrev. ants) / 01
/
PERMIT NO.
ML.1r.F I C I F=`nL_ I TY OF= nr4CHORt=I(3E
DEPARTMENT C`00"�T_ALTH A14D ENVIRONMENTAL ►-SECTION
825 'L -STREET, ANCHORAGE, AK. 99501
264-4720
OhF-'S I TE SEWEFZ F'EFZM I T
< 790019 )
APPLICANT JOE SENTER SR BOX 147-A EAGLE RIVER 594 9982
LOCATION ELENORA ST (EAGLE RIVER.)
,LEGAL L10 BLK E DEBORA #2 LOT SIZE 9990 SQUARE FEET
TYPE OF SOIL ABSORSTION SYSTEM IS: TRENCH
MAXIMUM NUMBER. OF BEDROOMS 3 SOIL RATING <SO FT%ER)= 85
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
DEPTH= 12 LEr+7C3TH= 1SP C3FRnVF-=L F>EP'TH= e
THE LENGTH DIMENSION IS THE LENGTH <IN FEET) OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF 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).
FZEQIJ I FZEF> SEF}T I C -rnNK 'SIZE= :l.iC-+@CD GRL_LCr4S3
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.
--- TWO K 2> I "n3F'ECT I OMS f=l FZE FZa(G'L.1 I FZEF> ---
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL; OR
150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
PEFZM I T EXP I FZES E>ECEM0aR :3-1r 1.'? r'101
I CERTIFY THAT
1: I AM 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.
3: I UNDERSTAND THAT THE ON-SITE SEWER. SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS.
SIGNED
ISSUED
APPLICAIIT JOE SENTER
V3. 2
• 0,& E-GEO. CHNI CAL & DEVEL%.01JMENT CO.
• Box 90, Davis St., Eagle River, Alaska 99577
/ 694-2774 or 688-2280
Russell Oyster Earl Ellis
- 6942774 SOIL LOG 688.2280
Soils B Foundations Land Development
Performed for: Name: 49 C . ;7�zf- �� A,"' O Tel. No. lo9c1- 99f1z
Mailing Address: � : ��cl`� 02o-� /4/7-/l
Legal Description: 6: ��,�-/�ol�lsA4 !S�'c,/30,
Depth (feet) $oil Characteristics
0
2
3
4
5
6
7
8
9
10
11
10/
L/cam, cL��,✓ J.
12
13
14
16
-`i
Ground Water
Encountered: Yes
No '�
If yess
what depth
Proposed
Installation: Seepage Pit
-. Drain
Field
Comments:
e- esu
Pr, rf
4,.22--",;;-�
3
r rJ C t -' 4d 4 -:71A -
Performed by: �. % «. �T��/�.�ir�C' Date:
Carr ifird riilin�g ��u ICIPALITY AL ANCHORAGE
DEPT. C7 I:'-'-.LT}I &
71RON!l.=NTAI F�.OTCCTION
by , tAY 3 119-19
A & L DRILLING COMPANY
BOX 97, EAGLE RIVER, ALASKA 99577 • TELEPHONE 6942586 RECEIVED
OWNER OF LAND J5 C
ADDRESS
LEGAL DESCRIPTION L /O oeG✓ f Of'3�_5�44
DATE • Started ! Ended 7�
PERMIT NUMBER 710v
KIND OF FORMATION:
From
Ft. to t
DEPTH OVWELL
..1
STATIC LEVEL OF WATER FT. O? 7
Ft. to
Ft.
DRAM' DOWN FT.
From
Ft. to I I
S�
GALS. PER HR
From
KINU OF G\SING
6 fi D
From
Ft. to t
FL�Pd.QA�
..1
From
Ft. to
Ft.
From
Ft. to I I
Ft.
f!/4�0 %F' `�
From
Ft. to
Ft.
From !
Ft. to—:1-0179.
AN'd Q Q v - L
From
Ft. to
Ft.
From O
�
Ft. to-JI—Ft.
Cel
From
Ft. to
Ft
From i_Ff,
to_.L_Ft.
r
,,00rt:
Ft. to
Ft
r
From
Ft. to
Ft.
Froin—Ft.
to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Fl. to
Ft.
From
Ft. to
Ft
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Fl. to
—'Ft.
From
Ft. to
Ft.
From
Fl. to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
From—Vt.
to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Ft. to
FI.
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft
NIISCL. INFORMATION:
DRILLERS NAME 11. !� f -"f"•'"
MUP�1 I G I Pf tL I TY OF FaP 0"l'-lFZRGE
DEPARTMENT ir),iEALTH AND ENVIRONMENTAL �''TECTION
825 'L STREET, ANCHORAGE, AK. 99Sul
264-4720
WE=LL F}EF2M I T
PERMIT NO. C 790011 )
APPLICANT SULLIVAN LEE BOX 197 EAGLE RIVER 688 2543
LOCATION ELENNOR ST
LEGAL L 10 B E DEBRA SUB LOT SIZE 8901 SQUARE FEET
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM I5
100 FEET FOR A PRIVATE WELL: OR
150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL.
WELL LOGS ARE.REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER, REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER. INSTALLATION.
F'F=FZPl I T EXF" I FZF=S FJF=CT=MF3EFZ 31. ZS3 r "=j
I CERTIFY THAT
1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL 7I TALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
- A m
SIGNED
ICANT SULLIVAN LEE
ISSUED
J�.�� V3. 2
r-
Lme'
Time
e
Date
Date
Date
=inL�-Z' ) -a
Inspector
Inspector
Inspector
Comments
J
Conditional Approval
Date Sewer Installed
Permit No.
Septic Tank Size /p 0 O
S_ "')
Holding Tank Size
Solis Rating
Well To Absorption Area
Well Log Received
Well to Tank /01
Yom_
APPLICANT FILLS OUT LOWER HALF ONLY
Property Owner JUNIOR RAY THOMPSON
Phone
Mailing Address Eleanora Drive, Eagle River, AK 99577
694-9157
Buyer Sam Stadler
Address 409 D 7th Street, Ft. Richardson, AK 99505
Lending Institution Home Federal Savings
Phone
Address
272-1451
Realty Co. 6 Agent Totem Realty, Inc, - - Barbara Wagnitz
Phone
Address - P.O. Box 911, Eagle River, Ak 99577
694-9494
Legal Description L10 B "E" Deborah Sub
Street Location Eleanora Drive - NHN, EAGLE River, AK
Type of Residence
XI Single Family $
O Multiple Family No. of Bedrooms
0 Other
Water Supply
XI Individual 1 ATTACH WELL LOG. A well log Is required for all wells drilled since June
0 Community 1975. For wells drilled prior to that date, give well depth (attach log If
0 Public Utility available.
Sewage Disposal
C Individual Year Individual Installed:
0 Public Utility When Connected to Public Utility
0 Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
r4N
• CHEMICAL & GL/LOGICAL LABORATORIES vF ALASKA, INC.
TELEPHONE (907).2784014 ANCHORAGE INDUSTRIAL CENTER
_ 274-3364 6633 B Street
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
WATER SYSTEM:
I.D. NO. L
1'•,./'.1'T,TI�i+Y"�-
Water System Name /I c -y�- I Phos No. I
Mailing Address
LOCATION
I
Collected
By
city - _-
_
State .. j '"" ... Zip Code
=
'
Z
SAMPLE DATE:
Mo.
Day
year ..
SAMPLE TYPE:
❑ Routine
❑ Check Sample (for routine sample
with lab ref. no. ) ❑ Treated Water
❑ Special Purpose ❑ Untreated Water
SAMPLE
NO.
LOCATION
Time
Collected
Collected
By
Z
r
�n
3I
4
READ INSTRUCTIONS
BEFORE
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
pSatisfactory
❑ Unsatisfactory
❑ Sample too long in transit: sample should
not be over 48 hours old at examination
to indicate reliable results. Please send
new sample.
Date Received l
Time Received
Analytical Method:
❑ Fermentation Tube
❑ Membrane Filter
Lab Ref. No. Result' Analyst
m
I I m
.No ol<o nos/lo0ml. WNo 01 Pout.00n.am,
06.1220(b) BACTER IOLOGfCAL WATER ANALYSIS RECORD
Rae. 1276
Date collactso sow"
A.M.
EMB Brom 24 howa, Bran 49 noun,
COLLECTING SAMPLE Mult ole Tube Raooru 20ml Tubas P"tt"rretal 10tnl Po"10011
Membrane Peter, Dlraot Count Collbrm/100ml
Vbltkatlon, LTB Ban
Final Membrane Filter Rasulta Colltorm/loeml
Repealed M 04ta
Tine a.m.
_ P.m.
a Lc%r i�Li as - /o e5 -7 %
J o P�41
5. LEGAL DESCRIPTIO
MUNICIPALITY OF ANCHORAGE MUNICIPALITY:: CHOP.AGE
.,�,L h
&
DEPARTMENT OF HEALTH B ENVIRONMENTAL PROTEC'F4pN �T,.��T� ` i ,-` r,CTION
•
825 L Street • Andhorapa. Alaska 99601
STREET LOCATION
ENVIRONMENTAL ENGINEERING DIVISION MAY 3 0 1979
Telephone 2644720 R [ I �/ F j�
REQUEST FOR APPROVAL OF INDIVIDUAL
e h C,<
WATER AND SEWERT�ACILA4
DIRECTIONS: Complete all parte on page 1. Imomplela rekPwla will not be processed. Plain allow, ten (10) do" for preowsnp, -
1. PROPERTY NER
PH NE
SINGLE FAMILY
❑ One ❑ Four ❑ Other
MAILING AOURESS
PROPERTSY RESIDENT (If different from above)
H NE
Three ❑ Six
7. WATER SUPPLY
2. BUYER
INDIVIDUAL'
O i✓
❑ COMMUNITY
MAILING ADDRESS
If
3. LENDING INSTITUTION
PHONE
S. SEWAGE DISPOSAL SYSTEM
MAILING ADDR SS
Z,°es
4. REALTOR/AGENT
P ONE
1,161Z eg
❑ PUBLIC UTILITY
/
MAILING ADDRESS
le
I
5. LEGAL DESCRIPTIO
.,�,L h
e�
� C�ils69h"i� Jr'�`
STREET LOCATION
�+
c
Zi7 /e-
e h C,<
cJ
/i 1 ✓e -/,r
S. TYPE OF RESIDENCE
'NUMBER OM
SINGLE FAMILY
❑ One ❑ Four ❑ Other
❑ Two ❑ Five
❑ MULTIPLE FAMILY
Three ❑ Six
7. WATER SUPPLY
INDIVIDUAL'
' ATTACH WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
S. SEWAGE DISPOSAL SYSTEM
—_1 INDIVIDUAL/ONSITE"
half individual/on-site, give installation date
If system is over two (2) years old an adequacy test is required
❑ PUBLIC UTILITY
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
71[4110g1/1/�/tll i� I /'� `7�`/c'3Q.[.IiLJ / L G..[L�
Q. S :.l
LMILL-Nuy IU.. .✓ur-d— 10t46ul)`
asuzel UL]rl n r S., 0 0")c
THIS SIDE FOR OFFICIAL USE ONLY
INSPECTION APPOINTMENTS
DATE RECEIVED
TIME
TIME
TIME
DATE
DATE
DATE
INSPECTOR
INSPECTOR
INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE ❑ THREE ❑ FIVE ❑ OTHER
❑ TWO ❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED -
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON-SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATEINSTALLED
INSTALLER
❑SepticTankor ❑Holding Tank
Size: If Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK
MANUFACTURER _
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELLTO:
Septic/Holding Tank
AbsorptionArea
Sewer Line
Nosiest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
Cl�—APPROVEDFOR— BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE
�3-
BY Title
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
CHEMICAL 9 GEOLOGICAL LABORATORES OF ALASKA.INC. (907) 27W014
P.O. BOX 4-1276 ANCHORAGE, ALASKA 99509 4649 BUSINESS PARK BLVD.
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
PUBLIC WATER SYSTEM:
,•+
SAMPLE DATE:, EFY0 I / 12
Mo. Day Year
TO BE COMPLETED BY LABORATORY
LABORATORY:
effem L,46
NAME
sG33 °13`' S�
AO KESS
4A)V /i
CITY
Date Received
Time Received 3a0
SAMPLE TYPE:
Analytical Method:
❑ Routine
❑ Check Sample (for routine sample
❑Fermentation Tube
with lab ref. no.
1 ❑ Treated Water
Membrane Filter
❑ Special Purpose
❑ Untreated Water
SAMPLE
NO. LOCATION
Time Collected
Collected By
Lab Ref. No. Result' Analyst
I i s K
I
cPS�g — 7 1 C�
1
I �s' P
I I m
2 ��,- _p
3
I I m
4
I
I I m
eNn N aMaJee/100 nL a Na M �OeIIM parllaea
06.1220(b) BACTERIOLOGICAL WATER ANALYSIS RECORD
Rev. 1978
Wte Collected
Source
READ INSTRUCTIONS
a.m.
BEFORE
COLLECTING SAMPLE
Form No. 18-310 (3.78)
EMB Bram 24 Fours: Broth 48 hours:
Multiple Tube Report: lOml Tubes PONtIN/TOUI 20MOPOrtiOne
Membrane Flitw, Direct Count L•OII/0mi/1Bbrnt
Verltkatlr
Final Man
Reportep
p.m.