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HomeMy WebLinkAboutDEBORA #2 BLK F LT 2()Ioow600 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTALPROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street. Anchorage, Alaska 99501 Telephone 264-4720 r:tconcel CVSTFM AND/OR WELL INSPECTION REPORT 7 - PHONE ANEW NAME _ X94-7 ❑UPGRADE MAILINGADDRESS A 5. Box /11- LEGAL DESCRIPTION a / ,7- Z , UlK �i OC i30 2A � NO. OF BEDROOMS LOCATION I' D���t r .5 /'/AE'�C Well / Absorption area 'S Dwelling PERMIT NO. IJc 2 P DISTANCE TO: 4" D y Manufacturer Mater I 1-19si No, of compartments 2 62Q LfjST/G5 i le Liquid depth W F" Inside length h Liq. capacity in gallons IF HOMEMADE: Width Well Dwelling PERMIT NO. d Y DISTANCE TO: J O Z Material Liquid capacity in gallons 024 Manufacturer Well Foundati�rL 7 Nearest Ipttl line PER fy0� ( �= DISTANCE TO: �� W Length of a I fe Total I h 9f lines Trench width Distance f Ines 1Y Z No. of lines C inches ~ Q x Top of the to finish grade Material beneath lila inches Total effective absorption area 304 S�. FT. I- O Depth PERMIT NO. Length Width W Q H Type of crib a—y Crib diameter Crib depth Total effective absorption area w Well Building foundation Nearest lot line r� DISTANCE TO: Depth Driller Distance to lo[ line PERMIT NO. J Class JAbsorOtion WBuilding foundation Sewer line Septic tank area(s) �+ DISTANCE TO: OTHER PIPE MATERIAl..PVC �7Ev,/ErL K- Orr PVC 'if Q.AIN I F— C. 3 SOILTEST RATING /00 SCf. FT�i3. rj �• INSTALLER C NAQcE 1 REMARKS 6� re ie J'•' NO. 17 5.IES—VSA \1 OFES51���r APPH vED DATE LEGAL 01. o/ . /Al2-11 Z07.0 13 (Rev. 31761 r•1LJt4 I Co I F'"IL_ I T•T EDF Ffr4cHf"q?FlC;E WEPARTMENlT 0. HEALTH AND ENVIRONlMENTAL F.. iTECTION! 825 'L' STREET, ANCHORAGE, AY., 99501 264-4720 T t-�tJ—'= ITE-E4•JEF✓ PEF=:t•1 I PERMIT FMO. f 780821 ) -' APPLICANT JOE SENlTEP. �R BOX 147A EAGLE RIVET: 694 9982 LOCATION MERCY/IRIS ST, LOT SIZE 9768 SQUARE FEET LEGAL L2 ELF; F DEBORA 82 TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL EATING CSG! FTZ041= 100 THE REQUIRED SIZE OF THE SOIL ABSORPTION! SYSTEM IS: E•EF'Tfi== 3-C3 LEt4 3TH= �^ GF A'•. EL G•EPTH= �=. THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH DRAOFFTHEC THE DEPTH OF A TRENCH OR, PIT IS THE DISTANCE BETWEEN! THE SURFACE GROUND AND THE BOTTOM OF THE EXCAVATION CIN 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 CIN FEET). F:Ei3U I F:EC1 QEF T I C JFFjrtft = I =E= ALCDCDC, GFiLLC�t 15 PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONlS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. _ IFt4ED C z" "I I M5= FEE=T I oro = 0'& E GE67ECHNICAL & DEVE -.,'PMENT CO. Box 90, Davis St.,Eagle River, Alaska 99577 694-2774 or 688-2280 Earl Ellis 688-2280 Russell oyster SOIL LOG 694.2774 Land Development Soils & Foundations Tel. No. Performed for: Mailing Address: Legal Description:" De Soil Characteristics If Lell 0 1 2 3 4 5 6 A 8 9 10 11� 12 13 14�r ;7- 7� 15� 16� If yeso what depth Ground Water Encountered: Yes No Proposed Installation: Seepage pit. Grein I , Field� Comments :—'�"- �17 I Date: Performed W ------- Ter fifi rb . Prilling I.E u g by A & L DRILLING COMPANY BOX 97, EAGLE RIVER, ALASKA 99577 • TELEPHONE 694-2586 S J OWNER OF LAND `��"�1< I Ed DEPTH OF WELL STATIC LEVEL OF WATER FT. ADDRESS DRAW DOWN FT. 4 LEGAL DESCRIPTIO. Ended --3— Cf0 ' �n �" � `� GALS. PER HR DATE • Started S KIND OF CASING PERMIT NUMBER KIND OF FORMATION MISCL. INFORMATION: MILLER'S NAME ' ` .__ Ed ao s .J From Ft. to Ft.— From Ft. to Ft. O r'i4' �> S Ft. C� vF i (.Cr+v= From Ft. to Ft._ From Ft. to / C i A f Ft. Ft._ Ft. Cn �4 t 6,C.Fv:=[ From to From Ft. to_LI— � �Ft. Sr% V �, �,Pfvc � From Fl. to Ft`_ From Ft. to 25� < < r zz From Ft. to Ft— From Ft. to Ft. FL_ 7V�t 7 . Ft. tot=F�t. From Ft. to From 7 o i �!� Sf%o r From Ft. to FL_. From Ft. to • FL_ ) ) Ft. to�? FL From Ft to From � Io -) (•^ sem^ U- From Ft. to Ft. _ From F ' Ft rF �CFm Ft. to Ft. .% i, -/ to -)( G.Ft. Ft . if — o S i _ ^J C S `9 Tv�'f' m _ From . Sry J S Tu ✓f From Ft. to Ft.— From Ft. to �' v FL From Ft. to Ft.— From Ft. to Ft. From Ft. to Ft.—. From Ft. to—Ft - From Ft. to—Ft.— o Ft.—From From Ft. to Ft. Ft._ From Ft. to From—Ft. Ft. to Ft. From Ft. to—Ft-- o Ft._From From Ft. to Ft Ft— From Ft. to From—Ft. Fl. to Ft. MISCL. INFORMATION: MILLER'S NAME ' ` .__ MLar4I C IrvqFL I -f'Y 4F FFNCF-'�'FZFFGE DEPARTMENT Ot HEALTH AND ENVIRONMENTAL PROTECTION 025 'L' STREET, ANCHOP.AGE, AK. 99501 264-4720 WELL F='EFZM I T PERMIT NO. C 700054 ) APPLICANT NORA EKSTEDL BOX 923 EAGLE RIVER. 694 2354 LOCATION MERCY DR LOT SIZE 10165 SQUARE FEET LEGAL L2 BF DEBORAH SUB #2 MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 200 FEET FOP. A 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'EFSM I T EXF=' I FZES L]ECEMBEFZ ?1 s 1S=j I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR OFJ-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IM ACCORDANCE WITH THE CODES. SIGNED �N " e Z&----------------- APPLICANT NORA EKSTEDT ISSUED BVxed.=�1-2-X--- ------DATE-114.1-Z�L----- - V3. 0 1 ��ticti? S MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH ENVIRONMENTAL PROTECtW©RIOIPALITY OF ANCHORA 825 L Street • Anchorage, Alaska 99501 DEPT. OF HEALTH & ENVIRONMENTAL PM107:CTIO ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 Nov 81978 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW `� . D 01RECTIONS: complete all parts on page 1. Incomplete rcquesu will not ha processed. P�•`�• allow ten (101 days for processing.— I P ONE 1. PROPERTY VJNER - I �� ; . �,1nILItiG ,ALY,(N ESS H NE `E a �� �— F cliT Y Fi ESIDENT Ilf tldfefent from above) PHONElueLl %hQu. u':u DURESS PHONE IN, _��_�L I: AILING AU DR ESS PHONE '0AI�4. REA' T R/AGENT •D{DRESS l/ /� - THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS onTE HLA- 1'vs'ECTOR -IT ECiiGNS: , 1. TYPE OF RESIDENCE SINGLE FAMILY `.1ULTIPLE FAMILY :. WATER SUPPLY INDIVIDUAL COMMUNITY PUBLIC UTILITY Connection Verified _:_ 3. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON -SITE -'PUBLIC UTILITY ::w1nection Verified —Septic Tank or E3 Holding Tank _'0-92-8 If Tank is homemade dimensions: WFOF TANK TOT;'L ABSORPTION AREA 4. DISTANCES _ WELLTO: .-r.. �ruonr• Arra to nearest Lot Line 5. COM%IENTS L NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ TWO ❑ FOUR ❑ SIX PERMIT NUMBER DEPTH OF WELL DATE DRILLED CEIVED TUN IaER_ Rc&�L STALLEU SUI LS RATING MANUFACTURER MATERIAL V APPROVED FOR _3_ BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED BY (TWO ,,". J, 7cl ❑ OTHER 0 CHEMICAL a GEOLOGICAL LABORATORM OF TELEPHONE �`►r (907) 279.4014 4649 BUSINESS PARK BLVD. zw�,P.O. BOX 4.1276 ANCHORAGE, ALASKA 99509 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER PUBLIC WATER SYSTEM: I,p,No. SAMPLE DATE: ' Ifs—'-� ff � Mo.- SAMPLE TYPE: ❑ Routine ❑ Check Sample (for routine sample with tab ref. no._ —I ❑ Special Purpose ❑ Treated Water ❑ Untreated Water SAMPLE NO. LOCATION �l 2 IQ�$a Qt S/° 3 II 4 Time Collected Collected By TO BE COMPLETED BY LABORATORY LABORATORY: NAME y —7---T—AD—DR—ESS ' CITY Date Received " Time Received 0 -P ryl Analytical Method: ❑ Fermentation Tube X$l Membrane Filter Lab Rett. No� Result' Analyst m 'Ro. •1 CO1onMf 1100 •:l M Me. M Fe•IIM pMMn•. 06.1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD Rev. 1976 sour" oat. Collected 11-14 78 , ,n_ READ INSTRUCTIONS Time R• 01 '. Lab. No. 5ConfifmatorV veA loml 10MI loml lOml Ioml I.0ml 0.1ml e rs r% BEFORE rsrsBroth 46 hburf:- EMB Broin 24 boort: IOmI Th 45 Posllly/Tolal lOml Portions COLLECTING SAMPLE M.,101'Tub•R•Port: coliform/loom, Membra" Ftit•n Direct Count BGS Verification: LTB coliform/loomi Final Membrane Filter Res is / • Oat Form No. 18310 (3.78) a•Pwt.a ev rk-+ Tlme a m. p.m.