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Home My WebLink AboutPROSPECT HEIGHTS #2 BLK 8 LT 3Pro pect Height Block 8 Lot #015-134-74 Jur: 02 2 3 I :5-,a /•Anc'7o-age ,?Jell & Punip 5e, 072430742 p.1 Well Drilling Permit Number: Parcel Identirwation NTuniber:_Q/f5" /V " 7 Legal Description PrOs eo C .f )qec , 2 8 t., Pump Installation Date: f j` Pump Intake (Depth Below Top of Weli Casij,g;'feet Pump Manu.#iacturer's Name. Punip Model: Date of Issue: Property Owner Name & Address: )Ball Size d lip Pitless Adapter Burial. Depth, � wn vt Pit#ess :�tiapter A7:tna#'acruret•'s "�:anie: ��t W2 ►%�"'�-'S r Pitless Adapter Installer: Well Disinfected Upom Completion? L : yei LII .N(, Method of (Disinfection - Comments: SZa e Pump Installer Nalale: t 1, Attention- The Pump islsta'ler Small prwvide a j.%mi a installeltion log to the DSD wihin 30 days of pump Installation. y.,�u04, Y:» a'•..=", til"-('G'C;-z. i gr!cr�r x4c; 2lFFP. �� '+�:7 f:1:.�}w: r`:'� �,:��'• L.''S�.;}w l��i �� _ A. _ �, t 0 imc.r Read ° _ F - .�'}c•3,'r`4 sB�1Ch. !�Cf�1TG?L`, AK 9 50''` A�1ayc� c:v,^, muni arcr�am,it2 ✓" Well Drilling Permit Number: Parcel Identirwation NTuniber:_Q/f5" /V " 7 Legal Description PrOs eo C .f )qec , 2 8 t., Pump Installation Date: f j` Pump Intake (Depth Below Top of Weli Casij,g;'feet Pump Manu.#iacturer's Name. Punip Model: Date of Issue: Property Owner Name & Address: )Ball Size d lip Pitless Adapter Burial. Depth, � wn vt Pit#ess :�tiapter A7:tna#'acruret•'s "�:anie: ��t W2 ►%�"'�-'S r Pitless Adapter Installer: Well Disinfected Upom Completion? L : yei LII .N(, Method of (Disinfection - Comments: SZa e Pump Installer Nalale: t 1, Attention- The Pump islsta'ler Small prwvide a j.%mi a installeltion log to the DSD wihin 30 days of pump Installation. Municipality of Anchorage Page., 1 of ~-* DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~'L,~~ PID Number: ~ Na...: ~C~C (~,~£y Wastewater System: D New ~Upgrade Io~ ~d~ D~ A~c~,.~ I~ ABSORPTION FIFLn .~o.*~ G - I E~l o.o,~,: ~D.pTrench ~ShaUowTrench ~Bed ~Mound ~Other LEGAL DESCRIPTION so. Rating: To=I Depth from o,gi.I ~ Bl~k: ~ Su~iv~ion: ~ ~ to pi~ ~om ~m O~i~l grade: G~I depth ~neath pi~ Grail wi~h: Numar of li~: WELE EXt~Ti~ew D Upgrade / ~ I ~ SEPARATION DISTANCES ~Se.~c U.o~,~., ~ S.~.~.. Sudace wate~ I°°~+ ~o~* -- -- -- LI~ STATION Cumin Remarks: BENCH UARK Inspections pedo~ed b~ ~sm~ d~..r~¢. I~. Dates: 1st ~ L & ', yv x .x ...... ¢..:...2 ~ C~-; 953 Depadment of Health and Human Sewices approval % . .'4, ~ ..."~; Reviewed and approved by: Date: 11-~.~6 'EBM~.NUMB~; AS BUILT DR. AW~G SW980415 - PARCEL ID NUMBER 015-154-74 F~_C0 _A. 19"5 NEW 1500 GALLON ~ I ST1 46.0 19.0 SEPTIC TANK'-k ~ST2 55.0 26.0 DBL1 58.0 29.3 ~L2 59.0 ,t0.4 NEW DRAINFIELD-~ / \ co, ,6.2 s~.s / \ I 11111 ~S~ WAI'~ ~ W~'x'~wA'x~ CONS~T~S, ~C. ~~.. PROSPECT HEIGHTS SUBDIVISION ~2, LOT 5, BLOCK 8, AS-BUILT OF SEPTIC SYSTEM UPGRADE CHUCK ~AILEY 346-1831 C~ -795~.. Box 1369, S?AR IIOUTE A ANCHORAGE, ALASKA 344-7714 SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF DRILLED AT THE RATE OF $.9.2. 0,0 PER FOOT. PROPERTY OWNER ~,'~. C. hac£ &~u,e,.i, 376-3~,10 LOCATION OF WELL SITF f--t, ~./c, Su~t DRILLER B~ ~m~ O~ ~ ~ ~0~. WELL LOG: 0 .... ~4' ~ ~ 3~ ~ ~ 17 ~ ~4 ~. 49---56' ~ ~o~ ~. 56--~60' Bed~oct. R ~~; ~oc3c. 260 7e~t. ilo wa, te~ 1/2 ~ 3/4 fJ~E ~,~o,~ co~p,l,e.,f~r~ aZ :260 1.5 C,.j,R ~ ~,;,tl~ u,o¢. ,q po.o,~.Z, bJ~ 2000 ~ p.e,z d.~ · 'ce.oee. z,¢. ,~,oo oue,~ ~00 ~ .o~t.a,uf~ ~ c~. 1.6 9a,L~ 3/4 Ilo,'~¢ 3ubm. e,.~.~L,J.~. ~'u.~p..ohou, l.~ .be .;.n,o~ 70 .to 15 ~ O~r~ hO't,tOm.. CO'~Z O~ ,D.'t,LL, LA~: $99.00 p.e,Z .;.oa.t X 260 ,;.ze,t,: $5720.00 RECEIVED OCT 29 1998 Municipality o! Anchorage Dept. Health & Human Services COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLE'I'ION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF $~,~10.00 THANK YOU VERY MUCH. DATF BERNIE CLAUS OF RAMPART ~DRILLING WORKS SERVICE CHARGEOF lY~% PER MOtH ~]LL BE ASSESSED ON~T ~NTS. ~ .~kI~*CFI O/~A~E, ~kLA~KA ~1'7714 SIX INCH WATER WELL DRILLED .......... OUT TO THE DEPTH OF 507 DRILLED AT THE RATE OF ~20.00 PER FOOT. Co,c~t ~,t.om.. -965-500 ~. 0~. PROPERTY OWNER C~J~ ~ ~J~ ~,~j~q 10q01 ~ t46-7811 LOCATION OF' WELL SITF f_A. B J Jo. Sub. DRILLER_ WELL LOG: ~¢/~,4t o4 ~ ~ tae2.c, .k~,~ ~65 ~. ~ 507 .~.. 265--316' 3ed~mn2~.~ ~ed~ack. ~ ~ c~r~e h~ack. 316'~398' ~ ~ed~-m~cam~c~c ~ock. floa-uak~c beu~ln~ ~ 398-.-420' $~ ~cock. ~ed~b~ I~a~. 420-.-4547' .4 g,tmu/J.=~ '~.1,1~ ,,~oclc. .~ o.,~ou, o -- .ohoa~W. ua,tea ~ o,~ 7/54 4:27--485' $edm, z~zut, a,',..~ e. oc.[ u. CtA ~ (zae~ o.~ ~ & p.o.,~u,o ua.t.e,z 458--507' ,~ ~ ~ .oed. Z-~.t.m~oa~ ~ ~o~ ~ ~. ~e o~ ~ $20.00 p~ ~. ~ 265-500 ~. ($1,000.00 ~ o~ ~.) COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE ~ OF $3,700o00 THANK YOU VERY MUCH. '~ ' BERNIE CLAUS OF RAM~RT DATE ~/~- 14~t, -~ERVICI:' CHARG~'OI~ ~Y,~4 PER I~ONTH WILL BE A~SE$SED ON PAST DUE ACCOUNTS. MUNICIPALITY OF ANCHORAGE Department of Health end Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Oct 21, 1998 Expiration Date: Oct 21, 1999 Pem~it Number: SW980415 Legal Description: PROSPECT HEIGHTS #2 BLK 8 LT 3 Design Engineer:. 0041 AK Water & Wastewater Consulta Owner Name: CHUCK BAILEY OwnerAddmss: 10501 SCHUSS DR ANCHORAGE, AK 99516-1139 ParcellD; 015-134-74 Site Address: 010501 SCHUSS RD Lot Size: 100791 SQ. FT. Total Bedrooms: 5 Permit Bedrooms: 5 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be In accordance with: 1. The attached approved design. 2. All mqairaments 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 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. Issued By: ~ ? ~ Date:/~) -2 ! - 78 Alaska Water & Wastewater Consultants, Inc. 7320 East Chester Heights Circle ~ Anchorage ~ Alaska 99504 Phone (907) 337-6179 - Fax (907) 338-3246 Consulting Engineers October 15, 1998 Municipality of Anchorage Department of Health & Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Ret~ Septic System Upgrade for Lot 3, Block 8, Prospect Heights Subdivision//2. To whom it may concern: 1. GENERAL: The existing 5 bedroom home is served by a private septic system and well. The existing trench is surcharged and must be upgraded prior to the sale of the house. One test hole was excavated to the north ofthe existing septic system. The soils are summarized as follows. 2. SOIL CONDITIONS: The test hole was excavated to a depth of 19 feet. There were virtually no organics at the site where the test hole was excavated. The soil was primarily a dense SM/ML material to a depth of 5.0 feet, where the soils changed to a SW/SM material. No groundwater was encountered. One percolation test was performed at a depth orS.0 to 8.5 ft. which perked at a rate of 2.96 minutes per inch. Based upon a visual assessment of the soils, a 0.8 application rate was used in the design. The intent is to place the bottom of the drainfteld at the deepest level allowable for the depth of the test hole, thus staying beneath the tight soils above the 5 ft. depth. 3. DRAINFIELD: We are proposing to install one 60 ft. long trench that is 2.5 ft. wide. It will be 13 ft. deep with an effective dej~th of 8 ft. This cotxesponds to un absorption area of 960 ft2, or an applicat!on rate of 0.78 gpd/ft~ (assuming 750 gpd total flow). This gives a very conservative application rate since the allowable absorption rate is 1.2 gpd/ft2. 4. SURFACE WATER: There are no surface waters within I00 feet of the proposed upgrade. 5. TOPOGRAPHY: The ground where the proposed trench is to go is virtually flat. There are no concerns regarding the slope of the terrain. Ifyou have any questions, please call me a 337-6179 or 244-9612. Sincerely, mess, P.E., M.S. LOT 7. BLOCK 7 PROSPECT HEIGHTS PROPOSED S£P~C SY~TEU (SEE DESIGN PACE 2 OF 2) LOT 2. BLOCK 8 PROSPECT HEIGHTS #2 5 BDRU HOUSE / o~o / / LOT .3. BLOCK 2 PROSPECT HEIGHTS .~2 LOT 6, BLOCK 7 PROSPECT HEIGHTS ~2 LOT 4, BLOCK PROSPECT HEIGHTS II II I I I I I LOT 2, BLOCK 2 PROSPECT HEIGHTS #2 ~ ~-,M~KA WA'i've, AND WAs'I'i~wATEK CONSULTANTS, INC. PROSPECT HEIGHTS SUBDIVISION t~2, LOT 3, BLOCK 8 SITE PLAN CHUCK BAILEY 346-185'1 10/14/98 A.C.G. 1 = I00' '1 OF 2 (Z.'~Lr Z-200) PROPOSED TRENCH LONG BY 2.5' WTDE 1.3' DEEP W/ 8' OF CLEAN, WASHED SE'W.ER THt~ PRIOR TO CONSTRUC'nCN. t 2)R£PLAC/ CLEAN-OUT AT THE WEST END OF j J EXISTINC TRENCH AND INS'TALL NEW CL[AN-OUT AT EAST END. INSTALL NEW MONrTOR,NG TUBE AT WEST END OF TRENCH. VER,FY SEPARATION FROM D(I~"TING TRENCH TO WELL BEFORE ADDING NEW ' / ~,T.&S]~ ~A't't~ ~ ~,~'i'~-wA't'~ CO~NSTJJ,'i',~tTS, ]:NC. PHONE (907) .-~7-6170/FAX:(907) 3~8-.3246 '~'*~'~'.:/17/ /~':': PROSPECT HEIGHTS SUBDIVISION ~2. LOT 3. BLOCK SITE PLAN " f CHUCK BAILEY 346-1851 '(/0~$.',~... J7:-795'~ ...' .~, ~J~,,. '..... ....,,~'.~ '~[~,:.e.._ ' ........... ~..--- 10/14/98 A.C.G. 1 = 60' 2 OF 2 LEGAL DF.SCRIPTION: PERFORMED FOR:_ DATE PERFORMFD:, .'ALASKA WATER & WASTEWATER CONSULTANTS~ 7~o..~._aj,_[_s_,~_U~ ~c~E · ~c,o~,~, ~. rr~JN~. [~U/J 337-6179 * FAX (907) ,338-5246 FSOIL LOG - PERCOLATION TESTI PROSPECT HEICHTS SUBDN]SION f2. LOT 3, BLOCK CHUCK BNLEY ~o/2/98 I TEST HOLE I NO, 9608 SM/ML 3leNT SW/SM GP o~°~o~ SW ~H~t SC DEPTH TO 3ROUNDWATEI; DATE DRY 10/2/98 DRY ~0/9/9a I \ COHHENTS: B.O.H. DATE READING 1 4 5 6 7 8 10 11 12 I~RCOLATION RATE TEST RUN BETWEEN CLOCK NET TINE WATER LEVEL NET DROP TINE (HINUTES) READING (INCHES) 4:40 6' ~ 4:50 10 2 3/8' 3 5/8# 4:50 5:00 10 2 5/8" ,,3 3/8' 5:00 5:10 10 2 5/8' ,3 3/8' 5:10 5:20 10 2 5/8" ,3 3/8" 5:20 ~ 6' 5:30 10 2 5/8' 3 3/8' 5:50 -- 5:40 10 2 5/8' 3 ,3/8' 2.96 .(HIN./INCH) PERC. HOLE DIA.., 6 (INCHES) 8.0 FT. AND. 8.5 Fr. BASED UPON VISUAL ASSESSMENT OF SOILS. USE A 0.8 APPUCATION RATE. PF'RFOMED BY ALASKA WATER & WASTEWATER I. , CERTIFY THAT THiS WAS PERFORMF.D IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEUNES IN EFFECT ON THiS DATE. DATE: ? MUNICIPALITY OF ANCHORAGE i DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street o Anchorage, Alaska 99501 Telephone 264-4720 ~ ON-SITE SEWAGE DISPOSAL SYSTEM AND/~ff WELL INSPECTION REPORT NAME NO. OF BEDROOMS OTHER PiPE M~TERIALS ~ ~ ~' )~ SO~L TES~ ~AT~NG ~ ~ . tlLIt,l -r C I f""~L ! T"r' OF · ° RF~GE ,,.a DEPARTMENT Or HEALTH AND EHVIRONHEHTAL PROTECTION ., 825 'L' STREET, ANCHORAGE, ~64-47~ PERMIT NO. ( 810~OD ) 8PPLICONT CHHRLES A. BAILY 402 TAYLOR LOCATION SCHUSS DRIVE LEGAL LZ B8 PROSPECT HT$ TYPE OF SOIL 8BSORPTION SYSTEM IS: TRENCH MA,'{IMUfl NUfIBER OF BEDROOMS = 5 SOIL RATING (SQ FT?BR)= THE REQUIRED SI~E OF THE SOIL HBSORPTION SYSTEM IS: DEPTH= ::1.2 LEf-/GTH= -"'6 BR~%~EL DEPTH= THE LENGTH DIMEHSION IS THE LENGTH (IH FEET) OF THE TRENCH OR DRRIHFIELD. THE DEPTH OF 8 TRENCH OR PIT I~ THE DI~TRNC~ BETNEEN THE SURFACE OF THE GROUND RND THE BOTTO¢t OF THE EXCRVRTIOH (IN FEET). THERE I~ NO SET I'IIDTH FOR TRENCHES. THE GROVEL DEPTH I~ THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE E~CRVRTION (IN FEET). PERMIT APPLICANT HAS THE RESPONSIBILITV TO INFORM THIS DEPRRTMEHT DURING THE INSTRLL~TIOH INSPECTIOHS OF ~NV NELLS RDJRCEHT TO THIS PROPERTV RHD THE fIUfIBER OF RESIDENCES THAT THE NELL NILL SERVE. ------ TIWO (2) I [~SPECT I O[WS ARE REQu I RED BACKFILLING OF ANY SYSTEM NITHOUT FINAL INSPECTION RHD 8PPROVRL BY THIS DEPARTMENT NILL BE SUBJECT TO PROSECUTION. MINIMUH DISTANCE BETWEEH ~ NELL AND RN~ ON-~ITE SENRGE DISPOSAL S~STEN IS 1~0 FEET FOR ~ PRIVATE HELL OR 150 TO 200 FEET FROM ~ PUBLIC NELL DEPENDIHG UPON THE TYPE OF PUBLIC WELL. MINIMUr.1 DISTANCE FROM R PRIVATE WELL TO R PRIVOTE SEWER LINE IS 25 FEET AND TO 8 COMMUHITY ~ENER LINE IS F5 FEET. NELL LOGS RRE REQUIRED RND MUST BE RETURNED TO THE DEPRRTPIEHT NITHIN ~ DRYS OF THE NELL COMPLETION. OTHER REQUIREMEHTS HAY 8PPL~. DPECIFICRTIOH5 AND COHSTRUCTION DIAGRAMS ARE RVRILRBLE TO INSURE PROPER IHSTRLLRTIOH. I CERTIF~ THAT l: I Rtl FRNILIRR MITH THE REQUIREF~EHTS FOR ON-SITE SEHERS 8ND NELLS RS SET FORTH BM THE MUHICIPRLIT~ OF ANCHORAGE. 2: I NILL IHSTRLL THE S~TEN IN RCCORDRNCE MITH THE CODES. -.: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLRRGEMEHT IF THE RESIDEHCE IS REMODELED TO INCLUDE MORE THAN 5 BEDROOMS. S I GNED: 8PPLICSHT CHSRLES 8. BSILY ]~SUED B~ .... DOTE___ ~ k. - LOT SIZE 100000 SOU~R~ FEET LO/ · .~ SOILS LOG f~,UN1CIPALITY OF ANCHORAGE DEPARTMENT DF HEALTH AND ENVIRONMENTAL PROTECTION I-I . PERCOLATION Pouch ~-650, Anchorc~e, AJa~ka S~502 276.22:21 TEST SOILS.LOG -- PERCOLATION TEST PERFORMED FOR: ' ' ~ ~ [~'~'~ DA'I~E PERFORMED: '. SLOPE SITE PLAN Reading Date Gro~t Net . De~th~to, ~ '- Net Time -: Time · . ,JWater · ' I T" DrO~ .: ~ 17, ~ 18- .... SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF_ DRILLED AT THE RATE OF. ~33o00 PER FOOT. PROPERTY OWNER [,,t'~. LOCATION OF WELL SIT DRILLER ~' B~U~.~ ~a~f~ WELL LOG: 2¢0 ~.__.~c.,'u,,¢. dd~o ouo~. 300 7a.~ ~b:,nd. Ln? ~_.._cc,~'.n.¢. 1,6 7~ .3/4 I~o,'~, Su, bae,~,bb,~, 2U.~l~ ahou, L~ .~¢ ,b~ 10 /co 15 ~ o~. Co~-t, o~ .~,t,/J,d~7.: $2.2.00 pe, z £004, X 2,~0 /c¢6: tZo Cha.~¢ ~o.t ~.'ed.L Sc~L: .:5720.0~ IdUNIC~P,M.I'~ OF ANCHORAGE ["FTr C'~ ! ...... ~ * C,.,, z, 1982 RECEIVED COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF . ,~4~-')0°00 THANK YOU VERY MUCH, DATE BERNIE CLAUS OF RAMPART ~R 1 LLIj~ ~.W.f~O RKS APPLIC " IT FILLS OUT UPPER HAL'-:ONLY Buyer Address Zip Code Realty Co. & Agent Address Legal Description Street Locati<~ Type of Residence ~7 Single Family [:] Multiple Family [:::] Other ' ~ Individual Zip Code No. of Bedrooms Phone ATt'ACH WELL LOG. A wall log Is required for all wells drtled e nce June 1975. For wells drilled pr or ID that date, give weft depth (attach log If available). Year Individual Installed: / When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector ( PROVED BEDR~MS 'CONDITIONS OF APPROVAL ( ) DISAP~OVED ( ) CONDIT~NAL APPROVAL' Soils Rating Date ~wer Install~ Well To ~SOtptlon Area I ~ ~ Well Log Recelv~ ~ ~ ~ I Well lO Tank t ~ Septic T~k Size t Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D: 0157134-74 GENERAL INFORMATION Complete legal description Location (site address) Expiration Date: PROSPECT HEIGHTS #2 BLOCK 8 LOT 3 10501 SCHUSS DR. ANCHORAGE, AK 99516 Current Property oWner(s) Mailing address Day phone Lending agency Mailing address Real Estate Agent Day phone BOB BROCK Day phone 261-7603 Mailing Address , Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBEROF BEDROOMS: 5 TYPE OF WATER SUPPLY: Individual Well [] Individual Water Storage [] Community Class ~ Well [] Public Water System [] TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems Approval (COSA) based onl.y upon the rep.resentations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date. shown below, I verify that my investigation, based on procedures outlined in the Certificate of On'Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater dispOsal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Spurkland Enginneering Address 203 W. 15th Ave., Ste 202, Anchorage, AK 99501 Engineer's Printed Name Lam Spurkland bedrooms. DSD SIGNATURE ~ Approved for Disapproved. Conditional approval for Phone 279-3916 Date 8/11/2011 ,?" $ 49 ^ ''. '/ bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well FlOw' Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other ~~"~ Original Certificate Date: //- (Rev. 11/05) Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (g0?) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: A. WELL DATA Well type PmJ'. Date completed (,/~/ Total depth 5o-Jr ft. Date pf test Static water level Well production ~, 5 - 7..0 WATER SAMPLE RESULTS: Coliform N'¢~ colonies/100 mL J If A, B, or C provide PWSID # __ Sanitary seal (Y/N) y ff. g.p.m. Nitrate /VD mg/L Cased to FROM WELL LOG H5 Arsenic:' /VD ug/L date of sample: SEPTIC/HOLDING TANK DATA Tank Type/Material Tank size ~500 gal. FoundatiOn deanout ~/N) Date of pumping ~v; ~SORPTION FIELD DATA Date ins~ ~n~h Total depth J~ ff. Date of adeq~cy ~t Fluid depth in abso~tion field before test %~ in. Elapsed Time: J~ min. Final fluid depth ~y rejuvenation tr~tment (past 12 mo.) ~ & ~pe) Number of Compartments Depression over tank (Y/N) A/ pUmper /~+ ~oe% ~ro~ceo Well Log (Y/N) Wires propedy protected (Y/N) Casing height (above ground) AT INSPECTION IO/(,[ Il '31 ft. 1,5 g.p.m. Collected by: Logo ~'~mkl~-~ Date installed ~0 l",.zj ~,/,~,~ Cleanouts (Y/N) ~/ High water alarm (Y/N) /V' Iol:zz~/~ Soil rating (~orft2/bdrm)O.~ ft. Width ,3 ft. Eft. absorption area ~J(,O fi2 Monitoring tube .'~ {0/~11 Results(Pass/Fail) 13~,, Water added ~) gal. System type Gravel below pipe '~ ft. Depression over field For ~3 bedrooms New depth ~ in. in. Absorption rate >= ~50 g.p.d. /~o.¢ ~o~ If yes, give date D. LIFT STATION "Pump on" level at~. Datum / E. SEPARATION DISTANCES Size in gallons "Pump off' level at /in. Cycles tested / Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit~ents? in. SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer/septic service line Animal containment areas On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank /V/A, Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5' + Property line ~' ~ Absorption field ! Water main A/ ~[ Water service line 10 -I- Surface water Wells on adjacent lots [00 t+ Property line Water Service line , Curtain drain ~0 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: [0 + Building foundation Jo + (0 'f Surfacewater lO0 -F iV. O Wells on adjacent lots J 00 ~'f F. COMMENTS lor. CorJ. Water main Driveway, parking/vehicle storage O. g' e s 'ted ame .5 ? :~R~,[SPURK ' .~,~. ~, Date t°l-zSltl ~17~., lol2blll.'~ Date of Payment ~ k - ~ ~ ~ Date of Payment Re~ipt Number O~ ~ O~ ~ Re~ipt Number (Rev. 4/10) Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907) 343-7904 CERTIFICATE OF 0N-SITE SYSTEMS ~,PPROVAL FOR .b, SINGLE FAHILY DWELLING Parcel I.D. 1. GENERAL INFORMATION COSA~ 0~0~::~0 Expiration Date: Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent M~iling address 'PROSPECT fi~iC~f§- 10501 SCHUSS DRIVE * ANCHORAGE~ AK 99507 GERAL & KATHLEEN COX Day phone 727-4579 10501 SCHUSS DRIVE * ANCHORAGEI AK 99507 Day phone Day phone Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: Individual Well ~] Individual Water Storage Community Class Well [--~ Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Cedificates of On-Site Systems Approval (COSA) based only upon the representations given in paragreph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a pdvate or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for propedies served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequale for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewaler disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Nameof Firm GARNESS ENGINEERING GROUP. Ltd. Address 3701 E. TUDOR ROAD. SUITE 105 * ANCHORAGE. AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Phone 337-6179 Date ~,/7/oG Engineer's Comments: In conducting this evaluation, GEG, LtD. affarnpted to provfde a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results desc~bed the performance of tho system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of ali wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate dudng the year, and the water usage of the family being served by the system. These conditions are eufside the control of the eva/uator of the system. Satisfactoq/ test results do not guarantee future performance of the system, nor do they guaranlne that there are no hidden defects or encrcochments. GEG, LTD. can therefore not provfde any warranty er future estimate of how long the system will continue to meet the operational requirements of the ADEC er MOA DSD. The content of this repo~ Is for the scle benefit of tho owner listed above. Any reliance upon or use of this repe~ by any other person er party Is not euthedzed, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the fllowing stipulations: Attachments; COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other Municipality of Anchorage Development Services Department BrJldlng Safety DNilton On-Site Wste~ & Wastewster Program 4700 Bragaw Street P.O. Box 196650 ~ge, AK 99519-6850 wlA~wmunLo~/ofllite (907) 343-7g04 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Dasatption: A. WELL DATA *DEEPENED ON 6/1/1988 Well type PRIVAI[ If A, B, or C provide PWSlD~ N/A Date c~rnpleted 7/1/1981 Saniterysaal (Y/N) YES Total deplh "507 ft, Cased to 260 ff. FROM WELL LOG 6/1/196s 4.5-55 ft. 1.5-2,0 g.p.m.. Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform C) colonies/100 mi. Arsenic: _~._ ug./L. SEPTIC/HOLDING TANK DATA PROSPECT HEIGHTS S/D tll2; LOT ], BLOCK 8, Parcel ID: {~t/~"""/~ ~-'7 y Well Lng (Y/N) Wires properly protectecl (Y/N) Casing height (above ground) AT INSPECTION 5/1/2006 206 .ft. 0,57 .g.p.m. Tank Type/Material Tank ~ 1500 gal, FoundstJon cluanout (Y/N) YES Date of pumping 5/2/2006 C. ABSORPTION FIELD DATA Date installed 1o/33/tgg8 Lengm 60 fi. YES YES 12+ in. Nllmte ~ mg,/I.. Other bacteria ~:) colonies/100 mi. Date of sample: 5/1/2006 Collected by: GEG Ltd, SEm C/ST E Number of Compartments 2 Depmssinn over tank (Y/N) NO Pumper Soil rafJng (~:Jor ftYodrm) 0.8 Width 3 .ft. Date installed lO/23/1998 Cleanoute (Y/N) YES High water alarm (Y/N) N/A MCDONALDS PUMPING Totaldepth '1'~ fl. Eff. absoq~flonama 960 ft= Monltodngtebe YES Date of adequacy test 5/1/2006 Results (Pass/Fall) PASS Ruid depth in absoq3Uon field before test 75 in. Water added 584 gal. F,.tapsed Time: 11 min. Final fluid depth 73 in. Absorption rate >= Any r~juvenatlofl treatmeht (pest 12 mo.) (y/N & type) NONE KNOWN System type TRENCH Gravel below pipe 8 fl. Dapmssicn over field NO For 5 bedrooms New depth 76 in. 750+ g.p.d. If yes, give date - D. UFT STATION Date installed Size in gallons ~ 'Pump o~ H~h ~ter_alaml ~evell a.t ._ in. ~ Cycles tested Meets alarm & circuit requirements? E, SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absoq~on field on lot 100'+ Public sewer main Sewer/septic senace line 25'+ Animal containment areas * 18' I00'+ On adjacent lots 100'+ On adjacent lots 100'+ Public cewer manhole/cieanout N//A Holding lank N/A Manum~animal excrete storage areas SEPARATION DISTANCES FROM SEPTICJHOLDING TANK ON LOT TO: Building foundation 5'+ Water main N/A Wells on adjacent lots 100'+ Property line Water service line 5'+ 10'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Propert~ line 10'+ Water service line 10'+ Curtain drain . 50'+ F. COMMENTS Absorption field 5'+ Surface water 100'+ Building foundatJon 10'+ Surface water 100'+ Wells on adjacent lots 100'+ Water main N/A Driveway, parking/vehicle storage I0'+ *TO HORSE CORRAL CONTNNING 2 HORSES. O. ENGINEER'S CERTIFICATION I certify tlmt I have determined through field inspec~or~ end review of Municipal mcorcl$ that the elJove systems em in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS COSA Fee S ~2 0 0 Date of Pe e.t "7 / 3 ]OG Receipt Number C ~C~C'~ 6 (e~v. t ~o~) Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Water Well Advisory Health Authority Approval # 060330 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block 8, Lot 3 of Prospect Heights #2 subdivision, the well's productivity was determined to be 0.57 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 5-bedroom residence is 0.52 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. 01/25/06 10:17 FAX 90?335165! 0~/28/05 10:17 FAT 9073381681 PROCL'RB-I~%~ AEF~ ~003 Oo 8 GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CON ! ~[ACTORS ~ July 28, 2006 Municipality of Anchorage Development Service Department On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907) 343-7904 Ref: Waiver from well to horse corral for Prospect Heights Subdivision #2; Lot 8, Block 3, To whom it may concern: The existing 5 bedroom house is served by a private well and septic system. The well and septic system were tested on 5/1/2006 for the purpose of obtaining a COSA. During this site visit it was noted that the well was approximately 18 feet from the horse corral. We request a 18 foot waiver from the well to the horse corral. The following items are justification for the waivers: · As can been seen on the attached drawing the area around the well is sloping slightly towards the well; however there is also a slight ditch line that runs between the horse corral and the well. If there was any surface run offit appears the it would run down the ditchline and away from the well. · Water samples were pulled on 5/1/2006 and show levels of nitrates to be non-detected and colifrom bacteria samples to be not-detected. Based on these results the horse corral has not effected water quality. We are unaxvare of any adverse impacts with the granting of this waiver would have on the well. If you have any questions, please contact us at 337-6179. Thank you for your assistance. ~ ;, P.E., M.S. 3701 E. Tudor Road, Suite 101 * Anchorage. AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com ~B IIIIno Inf~rmatfon Krtstal Ma~n 18949 Elnora Lane Eagle River, AK 99577 (907) 250-3282 Gob Site Information Krtstel 18949 Elnora Lane Eagle River, AK 99577 (907) 250-3282 Service Agreement Numba': 020543 Order Date: 20-JUL2006 Service Date: 24-Jul-200~ 12;00 Technician: Tony & Gene 0 J~ T~: Repeat Map O~: 128- o Last Serv Unknown New Customer Additional Location Comments I~gr.m: - ~ 4- Bdrm - Hillside Ranch Style 2ql~£D DRAI~q, rJ~G Home - #'s @ start of DW Dead End Sign + For Sale Sign + Open House Sign 1~ start of DW Septic @ Ba~ of Home Gallons Planned: 1250 Gal. Actual; . Hose Length: ~o Double Tank: r-I Pump System: [] Baffles Inlet: [], Baffles Outlet: [~ ~ Service Type Septic Service 15K Qty Price Each T~x? Extension Actual I $135.00 No $135.00 /;~' No. Tax.de TaM T~x.ldl Total T~;~ To~ Grand Total E~ma~d Cha~ - S135.00 '. $0.00 $0.00 .... ~. Actual Ch~ge~: ~ THIS Ie: A BINDING AGREEMENT, 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. muni.org/onsite (907) 343-7904 ON-SITE SEWEPJVVELL SUBMITTAL COMMENT SHEET To: O'eff ~arness Legal description: Prospect Heiqhts ~2 Block 8 Lot 3 The attached paperwork has been reviewed and is being returned for the following reasons: Original signature or stamp missing on Calculation error in design. Additional soils information needed. Water monitoring results inadequate. Discrepancy in information submitted. Topographic information missing or inadequate. Incomplete; missing Incomplete; missing Additional adequacy test information needed. Water sample unacceptable. Measured/proposed distances/dimensions missing. Locations of all soils, percolation and water monitoring tests not shown. Proposed system too deep for soils information submitted. Well log required. Omission in narrative. Insufficient fill over tank or field. Other. Anirpol containment area must be 50 feet from well, Name of reviewer: Poet Date: 7-27-06 P/ease supply the necessary information and re-submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P,O. Box 196650 Anchorage, Alaska 99519-6650 343-4744' Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING n1~-1~4-74 NAA# 1, GENERAL INFORMATION Complete'legal description Lot 3; Block 8; Prospect Heights #2 Location (site address or directions) Property owner Mailing address Lending agency. Mailin. g address Chu~ BaSle? 10501Schull Drive 10501 ~ehu~ Dr~ve .Anchoraqe, AK Oayp~one 346-1831 Anchoraqe, AK 99516 Day Phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: XX If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OFWASTEWATER DISPOSAL: NOTE: Individual on-site Xx Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances and regulations in effect on the date of this insDectio~ NameofFirm ~.,. ~.l+ .~ ~/1'.~. ,~ / Phone Engineer'sslgnature L.. .JA.//',,~ /L/ I' J Date //'t ' ALASKA WATER & WASTEWATER CONSULTANTSv IS TO BE PAID $2470.00 AT CLOSING-FOR ENGINEERING SERVICES PERFORMED. DHH8 SIGNATURE A.p. proved for bedrooms. INC Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date I1' z . The Municipality of Anchorage Department of Health and Human Services (DHHS) tssues Health Authority Approval Certificates based only upon the representations given In paragraph 5 above by an independent professi(~nal engineer registered in the State of Alaska. The DHHS does this as a co u rtesy to purchasers of ho roes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality of Anchorage 0Cl ~: ~J DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Sewices Division 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist begaiDescdpfion: ~se=c~- ~'~&t~': #Z ~ L~/' .~1[~4¢ 8~ ParoelI.D.:. A. WELL DATA Well type Log present~rlY) Total depth Saniten/ssal~/N) If A, B, or C, attach ADEC letter. ADEC water system number ~/~ Cased to :Z~,O Casing height (above ground) /e" .i- Wires property protacted~lN) Yes Date of test Stettc water level Well production FROM WELL LOG AT INSPECTION "Tq g.p.m. O. ~'q . g.p.m. WATER SAMPLE RESULTS: Coliform Date Of ssmple: I0 / B ~)4~RN~qrlkN~ DATA Date installed le/"?.~./,I, 8 Tank size Foundation cleanout ~1) Date of Pumping /~ -~ Pumper Nitrate 15;oo Depression (Y~ AJ~ Number of Compertments High water aimm (Y~ /Jp C. ABSORPTION REED DATA Date instellad I o/Z~/96 Soil rating ~)or~) 0_~ Syetem type /:=~3~ ~ Total depth IH Length Width ~, Gravel thiclmess below pipe ~ I Effective absorption ama ~ Monitoring Tube present (~0N) V~s~- Depression over field (Y/l~i). Date of adequacy test ~,~e.~ Results (Pass/Fail) -'-' For --~ Ruid depth in absaq~on field before test (in.); Fluid depth ~ (ins) Minutes later:. Peroxide treatment (past 12 months) (Y/N) ~ Immddlately after '--- gal. water added (in.):. - Absorption rate = g.p.d. ""-- If yes, give date 72-026 (Rev, 3/96)* D. UFT STATION Dat~.~__~ . Size in gallons . . Manhole/Access (Y/N) ~~--~ump off' level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main ~ Sewer/septic sen~ce line ~ ~lf. On adjacent lote lop I.~. On adjacent lots I Public sewer m~nhole/oleanoot ~/~- Lift ~on ~/."~- SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation j~ I.._~ Property line ..-~0I~ Absorption field. Water main/sewloe line 1 or+ Surface weter/draJnage I oo ~+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line SGrfane water Curtain drain I Building foundation Wells on adjacent lots Iool'f Ioo~+ Water main/service line I Driveway, pafldng/vehicle storage ama I ~ ~-+' Wells on adjacent lots loc* I, Date of Payn'mnt/~/~*-~/~ ..c.,,,,.un.,per 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number AI.ASKA WATEI( & WASTEWATER CONSULTANTS, INC. 7320 EAST ~HESTER HEIGHTS (~RO..E * ANCHORA~,' ALASKA 99504 · PHONE: -'437-6179 FAX: 538-,.9246 _WELL FLOW TEST DATA STREET ADDRESS: Io~;~t -.~_~uc$ CLIENT: ~'HUc.~. {~a,6el/.-e"t' PHONE NUMBER: ~qf.-I~_~J NUMBER OF BEDROOMS ~ F.H.A. - FOUR HOUR FLOW' TEST: YEASURL"~£NTS IN 'rES / ~ TEST DATE START I°/zz/tS TEST DATE END Io/'~-/ WELL DEPTH (PER WELL LOG): -~c~7m CASING DEPTH (PER WELL LOG): ~C.o~ r'. _ CASING HEIGHT (ABOVE GROUND): DEPRESSION AROUND WELl.= YES / NO SA.~TAR~ SEA'-' ~ES / .0 W~RES ~N CO.DU~T: 'rES / .0 WATER SAMPLES TAKEN.* (~)/ NO IF' YES, DATE-* TIME METER READING FLOWRATE WATER LEVEL (~.P.M.) (BELOW TOP Or CASING~ DRAWDOWN WELL PRODUCTION MEASURED 0 0,5'q + COMMENTS: