HomeMy WebLinkAboutWALTER G PIPPEL #2 BLK 12 LT 19lock
~ ' MUNICIPALITY OF ANCHORAGE
.,, DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME PHONE ~EW
LOCATION NO. OF BEDROOMS
Well . w / Absorption area ~Dwelling PERMITNO.
I
~ ~ Manufacturer Material No. of compartments
~ ~ Liq. capacity in gallons Inside length Width Liquid depth
IF HOME,DE:
9~ DISTANCE TO: IWoll /~ /
O ~ ~ Manufacturer Material Liquid~gallons
~ DISTANCE TO: Weft ~ / /. Foundation Nearest lot llne PERMIT
~ ~ No. of lines Length o TotaJ length of lines Trench width Distance between lines
~ inches
~ Top of ti~e to finish grade ~ /~ Material beneath tile Total effective absorption area
~ ~ Type of crib Crib dJam Crib depth Total effective absorption area
m B~il~ing ~oundation Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER
PIPE MATERIALS
SOIL TEST RATING / ~
INSTALLER ~ ~ ~_. ~( [
REMARKS ~
eVE DATE LEGAL ~ ~ ~
Rev. 3/78)
Permit
Applicant: ~/0
Location: ~~
Legal Description:~/~ ~ /~ ~,~ *f~'~/ ~''
Type of Soil Absorption S~stem Is:
Trench: Drainfield:
Maximum Number of Bedrooms:
MUNICIPALITY OF ANCHORAGE
Department( f Health and Environmenta' protection
825 ~ Street, Anchorage, AK. k~9501
264-4720
* * * HANDWRITTEN PERMIT * * *
,~---,Z~I~/OR ON-SITE SEWER PERMIT
J~/-~"l~./~ ~/ Phone Number:
Lot Size:~-~ /~?0~0
Seepage Bed: Holding Tank:
Soil Rating(sq.ft/br)
The Required Size of the Soil Absorption System Is:'
DEPTH LENGTH GRAVEL DEPTH WIDTH
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).
* * REQUIRED _,.,~[C(HOLDING) TANK SIZE =~0~)0 GALLONS * *
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(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection.and approval by this departmen~
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 fee~
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days Of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 3L 1 9 8 3 * * *
I certify that:
(!) I am familiar with the requirements for on-site sewers
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3)
Signe~'.
and wells as
I understand that the on-site sewer
the residence is remodeled to include more t~ 3 bedroo~
Issued by~,~
Date: ~/~/~.~
Applicant
system may ~require enlargement if
SWP/024 (1/81)
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litu~t~ ~n nre with~ ~e ~y ~ ~ do
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~WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geoiogicol& Geophysicol Surveys
Drilling Permit No.
LOCATION OF WELL (Please complete either [a~ lb or lc.) A,D.L. NO.
~lBorough, Subdivision Lot Block ~ I/4qtrs. Section No. TownshiPNE] Range E~] Meridian
~DISTANCE AN~DI~ECTION FROM ROAD INTERSECTIONS 3. OWNER OF WELL;~3~'
Address:
Sfree~ Address end Area of Well Location
2. WELL LOG Feet Below 4. WELL DEPTH: (final) 5. DATE OF COMPLETION
bo~.~.~_' ~ "~ ..... g~'ave;L~ ~.:;m'[: 0 ~'.~ e. ~co~,. too, x~Ro~ory
* C;~ ~ A~ger ~Uetted ~ Bored ~ O~her:
(',~.:t. :::C~):~ ~'~ ?~ 7. USE: ~ Domestic ~ Public Supply,~JJ~ industry
I0. STATIC WATER LEVEL: ft.
n
LOCATION OF WELL (Please Complete either la. Its or lo.)
rtWATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geological 9 Geophysical Surveys
Drilling Permit No.
A.D.L. No.
la. Borough Suearlaon Lot Black Ip.
I/�qV..
Section No. Township N Range E❑ Meridian
.it —Gu )9 /„Z—of—a'-of
60 w❑
Ice DISTANCE AN IRECTION FROM ROAD INTERSECTIONS
S. OWNER OF WELL: Eruro
Hr.
Address:
Street Address and Area of Well Location
)
2. WELL LOG
Fsef Bao
Surfacer
0. WELL DEPTH: if not)
S. DATE COMPLETION
4=26—=';
21-7 fl.
—1 —
Material Type
Top
Bolcom
EoulGCru, gravel, dirt
0
5
6. ❑Cable tool ,0 Rotary ❑Driven ❑Dug
❑Auger ❑ueffed 01110,6d ❑other•
Eeorock> �
Coal r..con
e5
95
?.USE: ❑ Dome.11c ❑ Public Supply Xa Industry
❑ Irrigation ❑ Recharge ❑ commerical
Test Well ❑other:
Pedroek 95 l03
Coal sear 163 170
T pr)rock
170
2�7
S, CAS NO, ❑ Th,61ded X)o Welded
diem. In. tdle> n. Depth Weigh117 lbs./o.
diam. In. to fl. Depth Sllckup 11.
9. FINISH OF WELL:
n
Trpi'-en Hole Dlnm.rer•
Slot/Mesh SIse: Length:
Ser bNo.n fl. and ft.
Backfilling Gravel pack
10. STATIC WATER LEVEL: ft.
❑ Above or ❑ B.law land surface Date
Equipment used:
11. PUMPING LEVEL below land surface and YIELD
ft. alter—hrs. pumping_g.p.m.
fu offs, _life. pumping—g.p.m.
12.GROUTING Wall Grouted: ❑ Yee ❑ No
Material: ❑ Neal Cemerd ❑ Other:
IS. PUMP: (if available) HP
Length of Drop Pips fl. capacity 9. P.M.
❑ Swear. ❑ dst ❑ Centrifical ❑ Other
I41.11EMARKS:
Fail tected at 1 Gcli
'tater mootly froc: coal ream
16. WATER WELL CONTRACTORS CERTIFICATION:
IS. Water Temperature ❑ F ❑ C
—e
This well was drilled under my Jurisdiction and this
report is
true to the best
of my knowledge and belief;
oor. I:Tillir.,
AA 5365
Registered Business Nome
Contract
License Number
Address: P.C.Pox le itcrq
A.
9577
Signed: A.�-l-( /c.,-. «. /l
LA
� /CCsI. --�D %+sY �e ;c,
el •:
Authorized Representative
Form 02•WWR (II/BI) Copy Distribution: WHITE
-Stage DOGS,
PINK -Driller. CANARY-Customor
n r,
Z c
PLAN REVIEW
CLASS "C" SYSTEMS
1. Information required for plan review for Certificate to Construct
the system.
A lot diagram with 150 ft radius from well showing water lines,
valves or keyboxes for service connections, and sewage disposal
systems including sewer lines, manholes, septic tanks and
leach fields.
2. Information required for plan review for Certificate to Operate
the system.
`e. Well Log
Water Sample (Coliform)
sbullt plans detailing water system (include s.tora
tank if needed)
`d. Flap yield
e. Calculations showing adequate yie d.
(L)—inssaataaaous-e-mand:
8 gallons_per._minute-for-20-minutes per residence
(2h-daily—demand
150 gallgpva—peLday—per—bedroom
f. If well is not capable of meeting demands then storage will
b u re . Ca cu a storage are as follows (example).
9 pk.-td crb we 1( Cary ..S
s4CL tNA c t /C-) ac)
�6-ie1Z� � f07 es
Well Yield - 10 gal/min
!!Residence - 5
Instantaneous demand (id) - 8 gal/min/20 min/residence
Calculate (id)
(id) - 8x20x5 - 800 gal
Calculate pump yield for 20 min
py - 10x20 - 200 gal
Calculate storage required
800- 200 - 600 gal
Pressure tanks supply storage but vary from 25-30% available storage.
Obtain available storage data from the manufacturer.
Assume 40% available storage in example above.
Calculate storage assuming pressure tanks will be used to provide
that storage.
600 - (0.40) x
x - 1500 gal pressure tank.
21
i
13-d
Zv
CONSTRUCTION AND OPERATION CERTIFICATE
ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION .
PUBLIC WATER SYSTEM
APPROVAL TO CONSTRUCT
83�)(- f -A -311
Plans for the construction of
public water system located
in �1 i F Y Alaska, submitted in accordance with 18 AAC 80.100
by `t 1 t- have been reviewed and are
F];, approved.
❑ conditionally approved (see attached conditions).
BvU 1 6AT>
If construction has not started within two years of the approval date, this certificate is void and new
plans and specifications must be submitted for review and approval before construction.
APPROVED CHANGE ORDERS
Change (contract order no.
or detcrlpliw referenu)
Approved by
Date
The "APPROVAL TO OPERATE" section must be completed before any water is made available to
the public.
APPROVAL TO OPERATE
The construction of the public
water system was completed on (date). The system is hereby
granted interim approval to operate for 90 days following the cpmpletion date.
By TITLE DATE
As -built plans submitted during the interim approval period, or an inspection by the Department has
confirmed the system was constructed according to the approved plans. The system is hereby granted
final approval to operate.
TITLE DATE
E118W. w