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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.