The URL can be used to link to this page

Home My WebLink AboutDEBORA #2 BLK F LT 34 0 i \ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 26413720 \ ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE EW ❑ UPGRADE MAILING ADDRESS �a LEGAL DESCRIPTION ^� L.-3 vE00R s 'y # LOCATION M6RC� %)rvve-y C)vv QxvjiJ wA NO. OF BEDROOMS 3 DISTANCE TO: Well �Q� Absorption area Dwelling S'1 PERMIT NO. '1 so QOManufacturer ® U JLiq. Material No. of compartments kxh capacity in gallonsInside IF HOMEMADE: lengthWidth Liquid tlepth DISTANCE TO: Well Dwelling PERMIT NO. Manufacturer /� 1"1 Material Liquid capacity in gallons O W = DISTANCE TO: Well \ \ S Foundation Nearest lot lines PERMIT NO. —iW Z F 2 W No. of lines Length of each line Total length of lin �}3 Trench Trench widt inches Distance between lings� ty H p Top of lila to finish grade 1 li 0 Material beneath lila \ tt Inches Total effective absor�or�er� �s''Lt W Length Width Depth PERMIT NO. o. /- o. Wd Type of crib Critic! Crib depth Total effective absorption area h DISTANCE TO: Well Building foundation Nearest lo[ line r ss t'L N Depth Driller Distance to lot line PERMIT NO. W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPEf,�1ATERIALS (F\� '3034 SOIL TEST RATING gs 3 6 INSTALLER S VZ LF' REMARKS Hu �• 4t Cc 0 0 P VIED DATE LEGAL (Rev. 3/78) MLJr4 I Cl I ("9L_ I TY OF Fl r4 C! V1 '_!Z FY C3 EE: DEPARTMENT L. HEALTH AND ENVIRONMENTAL t-OTECTION 825 'L' STREET. ANCHORAGE, AK. 99501 264-4720 CD r4 I TE n3EWER F='ERr'F I T PERMIT NO. C 780996 ) APPLICANT RONALD SCHWIGEL LOCATION MERCY DP. LEGAL L3 DEBO SID #2 bl,L iq BOX 194 MERCY DR 9: L aa. 694 9837 oolu'S' LOT SIZE 9750 SQUARE FEET TYPE OF SOIL ABSORB T ON SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS 3 SOIL RATING CSQ FT/BR>= 8f THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: OEF"TH= 10 L_EtJGTH= CaRR',�EL_ [7EF�TF-1= THE LENGTH DIMENSION IS THE LENGTH CIN 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 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). FRE: GlU I REL7 '�EF=*T I XD, TF=l r-aK E5 I ZE= 1000 13FILL04r-FS} 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. --- TWQ C 2 ] I r4SF�ECT I KDNE3 FIRE REGtU I RELY --- 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. F"EwRM I T EXP I RES FJECEMF3ER 01_r I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR OW -SITE SEWERS 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 RESIDENCE IS REMODELED TO InCLUDE MORE THAN 3 BEDROOMS. SIGNED CANT IGEL ALED70S AND WELLS AS SET ENLARGEMENT IF THE ISSUED ------- DATE- 1,12I!b! j1L___ V3.2 0 & E GEQ''`-CHNICAL & DEVEL'O`PMENT CO. Box 90. Davis St.. Eagle River, Alaska 99577 6942774 or 6882280 i'sac:l Oyster EaA Ella C91 2774 SOIL LOG 6M-2280 Snnc h ioundanons �_-. Land Development J Performed for: Name: /I c J c Tel . No. Nailing Address:'c.t. Legal Description: Depth (feet) /�,�\. Soil Characteristics i 5 u 15 16 Ground Water Encountered: Yes No / If yes, what depth Proposed Installation: Seepage Pit Drain Field ✓�� Cc=ents: Performed by: ` / <-" -. - -•_� Date: — L 0101 C�c.en� l .s K V owN (L L=A - lA-C&� ��4;, tW r6 At, J/ 4,— s�aa . Pcgsn ANCHORAG upra firb Drilling U47,1,'IEPROTECTIONE by A & L DRILLING COMPANY JAN 41979 BOX 97, EAGLE RIVER, ALASKA 99577 • TELEPHONE 694-2598 E C E I V E D OWNEROFLAND FK S77,ce! ADDRESS DEPTH OF WELL I U O STATIC LEVEL OF WATER FT. 2 LEGAL DESCRIPTION 4d(3 BC -l- O%401 kN pi's T.fedbRAW DOWN FT DATE • Started Ended 3 ` GALS. PER HR . T v PERMIT NUMBER e- O S: KIND OF CASING y- C Q KIND OF FORMATION: From Ft. to °) Ft. 0 tl"� /3d40E-✓ From Ft. to - � Ft. From 1 FL toL- Ft. C<.+� ��c 1130�'v`�Frotn Ft. to Ft. From Ft. to jz- Ft. L'4 i �' � � ` = �— From Ft. to Ft. From - Ft. to � Ft. SN ^ From Ft. to Ft FromL' Ft. to Ft. /yn� - From Ft. to Ft From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From t Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft MISCL. INFORMATION: � lr DRILLER'S NAME L� -Pl LJ r4 I C! I F�'iL_ I TY CDF= F1t4CH SFiGE \d DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 'L' STREET, ANCHORAGE, AK. 99501 264-4720 WELL F}EFZPlIT PERMIT NO. ( 780055 ) APPLICANT NORA EKSTEDT BOX 923 EAGLE RIVER 694 2354 LOCATION MERCY DR LEGAL L3 BF DEBORAH SUB #2 LOT SIZE 10165 SQUARE FEET MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 200 FEET FOR 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=•ERM I T E>4F} I FZES} OECEMFIEFZ "IALw 1E=+?L 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. SIGNED:_ 006v 22K 40/ 0TV/1--------------- APPLICANT NORRA` EKSTEDT p ISSUED BYE. yi� ___-____DRTE_��Jla_____ V3. 0 I rob 'I NiCIPAUTV C, y 8. LEGAL DESCRIPTION D r . Ll i. -AL F, —�3 — MUNICIPALITY OF ANCHORAGE ENVIRCNW.. NTAL F,—"i:CTIdN STREET LOCATION DEPARTMENT OF HEALTH i ENVIRONMENTAL PROTECTION • 926 L Stove l • Andwnga, AWaa 99601 MAR 19 079 0. TYPE OP RESID NCE ENVIRONMENTAL ENGINEERING DIVISION RECEIVED Telephone 2646720 1:1 One 1:1 Four ❑ Other REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on Pool. Ineompbb reeueb will not be pawwd. 1110 G119* tea 1701 daYe for flQg irlg. 1. OPERTY OWNER -- O E o S l urr 9 -ia'3 MAILING ADDRESS since June 1975. For wells drilled prior to that date, give well rX / - c i C.o�[r 9 7 PROPERTY RESIDENT I dif trent 1r aeowlP 014E .0 At c s. BUYER If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY MAILING ADDRESS NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 3. LENDING INSTITUTION PHONE MAILING ADDRESS ♦ REALTOWAGENT PHONE e " MAILINGADDRESS 8. LEGAL DESCRIPTION T £ J A s,.2 STREET LOCATION 0. TYPE OP RESID NCE NUMBER 1:1 One 1:1 Four ❑ Other d SINGLE FAMILY I� Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY M 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 "If individual/on-site, give installation date �"c r /9 %Op J>rl INDIVIDUAL/ON-SITE** 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. 724)10(3/78) �yJv�C F Ow - 1000oJ� THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED - TIME TIME TIME DATE DATE DAT 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 OATEINSTALLED INSTALLER SOILS RATING ' ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL T0: Septic Holding Tank Absorption Arm Simeir Line 71wrest of Line Absorption Arm to merest Lot Line 5. COMMENTS 03i APPROVED FOR L BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE Y— /I--) BVTitle c LEGAL DESCRIPTION 72-010 (Rev. 3178) CHMAL 6 GEOLOGICAL LABORATORIES OF ALASKA+ INC. i o7i iiwol4 P.O. BOX 4-12764849 BUSINESS PARK BLVD. ANCHORAGE, ALASKA 99F309 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER PUBLIC WATER SYSTEM: I.D. NO. AA /G • yLA city O 3 Jlare SAMPLE DATE: � m Mo. Day Year SAMPLE TYPE: ❑ Routine ❑ Check Sample (for routine sample ❑Treated Water ❑ Special Purposee with lab ref. I ❑ Untreated Water SAMPLE Time Collected NO. LOCATION Collected By 3 4 5 I` ,i I _ •t ' Fx READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Form No. 18-310(3.78) - TO BE COMPLETED BY LABORATORY P • LABORATORY: NAME i ADDRESS CITY Date Received Time Received A Analytical Method: � ❑ Fermentation Tube �Ip Membrane Filter Lab Ref. No. Result' Analyst i m i � m M; •iia el eeleeMa I IN InL M Ma M ►ea11M ierll^^a- • 0e-1220 lot BACTERIOLOGICAL WATER ANALYSIS RECORD Rev. 1976 Date source a.m. EMB erem c. ......... MulliPle Tube Report: IOmI Tube$ P"U"i Totai 10m1 Pwtlw$ Membrane Filler: Direct Count Coillorm/100ml Verification: LTB BGS Final Membrane FNler i $ _ Colllorm/lOMnl Renorled BY Date i M p.m.