HomeMy WebLinkAboutGIRDWOOD ENTRY LT 1 TLS 2003-1SAM
Well permit closed W/O water samples
Girdwood Entry
Lot 1
TSL 2003-1
#075-132-91
E y DiMing, qn.c.
1Vater 1t'ell 'DI-iiiit%q and `Frrtrrl1 Set-in
Illi {ii7'dCii. IIffIN1,.. (oo'
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURCES
DIVISION OF MINING, LAND & WATER
WATER WELL LOG
Drilling Started: Q7/_2-5 120 4 completed: 07� 25X2014
City/Borough: Subdivision: BLOCK LOT Property Owner Name & Address: Darren Mattingley
irdwood &^i%r�4 191 Old West
Girdwood, AK
Meridian Township Range Section r/a of r/4 of %4 of V4
BOREHOLE DATA(frorn top of casing)Depth
Drilling method: (X) Air rotary, ( ) Cable tool, Other
Material: Type, Color & wetness I From I To
Well use: ( ) Public supply, (X) Domestic, Other
stickup
0
2-
Depth of hole: 80 ft, Casing stickup: 2 ft
Casing type: steel Thickness: .250 inches
Casing diameter: 6 inches Casing depth: 80 ft
gravel pad
2
5
Liner type: Diameter: inches Depth: ft
Static water (from top of casing): 5 ft on 07� 25 - 014
peet
5
8
pumping level & yield: feet after hours at gpm
Recovery rate: 50gpm, Method of testing: airlift
clay
8
18
Development method: airlift Duration: 1 hour
silt &gravel
18
24
Well intake opening type: (X ) Open end, ( ) Open hole, Other
Screened- Start: ft, Stopped ft
Screen type: Slotirncsh size:
wet clay w/ gravel
24
42
Perforated: Start: ft. Stopped-. ft
Start: ft. Stopped: it
gravel w/ H2O
42
68
Note: ................................................ ...................................................
gravel w/ 1-120 w/ clay layer
68
72.
Grout type: bentonite volume -
Depth; from ground surface , to 20 f
coarse gravel w/ H2O
72
80
Pump intake depth: ft
Pump size: hp, Brand name:
Was well disinfected upon completion? (X) Yes, ( ) No
Method of disinfection:.Calciuti-Hypochlorlte..(G.hlorine)...
Driller coritmemsi disclaimers: .............................................................
.................................................."""........................................................
........... ..................................................................................................
................................................. a".........................................................
Well driller name: ... ).9h9t1y Kay , ........................
Company name:... Hefty. Drilling, "Inc. .
..............................................
Mailing address:...3540 Akula Dr.
city: Anchorage : AK Zip 99516
Phone number: ( 907 ) 4 _ 93 fax:345-4700
i
Drillers signature:
Alaska state law requires that a copy of this well log be sent to the
Department of Natural Resources within 45 days: faxes are
acceptable. (AK statutes 38.05.020, 38.05.035.41.08.020.
46.15.020 and AK regulations 1 I AAC 93.140).
DNR/ Division of Mining, Land and Water.
550 W 7th Avenue, Suite 1020
Anchorage, AK 99501-3562
Phone (907)269-8639 and fax (907)269-5947
Within the City of Anchorage, it is required that a copy ol' the well log be
sent to the appropriate city office within 60 days and that another copy of
the well log be sent to the well/property owner within 30 days.
Permit Number: OSP141092
Date of Issue: Ap011 -29 %2014
Parcel Identification Number: - -
Is well located at approved permit location? ( X) Yes or ( ) No
01!31� FR*Ciil:
�T
0
Puree! Identification Number.—
Legal Deveription Propnerty Owner Nime,,.Address:
PA
Parsap.taxsta3tt4aan ate: -p t
Purnp Intake Depth Hefow'fop of Well Ca�Untr. L) feet
Punt r-Manufgcturer'sNaaw
Pump Madcl:
Pump sine hp
Pifiw Adapwrgurial Depth: feet
I'Mess Adapter Installer: C,
Well
, I
Disinfected Upo"? n CosenpictioYe,. F 1 No
n: JN
Mettind ar oisinrectio
Comments:
Pump hxOaller Name:
A F 9
Attention: The pump i wMal ter q N11 provid Lz a piamp itt�,ul lation foe, to the DSD whhin 30 days of pum-p itw,,Alation.
Permit Number: OSP141092
Tax Code Number: 07513291000
Work Type: Well
Permit Effective Dates: April 29, 2014
Design Engineer:
Subdivision:
On-Site Water System Permit
GIRDWOOD ENTRY
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Initial
to April 29, 2015
Site Legal Address: GIRDWOOD ENTRY LT 1 TLS 2003-1 G:5012
Owner/Address: ALASKA MENTAL HEALTH
TRUST AUTHORITY/TRUSTEE % TRUST LAND OFF 718 L ST STE 202 ANCHORAGE AK 995013336
Site Mailing Address: Lot Size in Sq Ft: 32670
Total Bedrooms: 2
This permit is for the construction of:
N Disposal Field N Septic Tank N Holding Tank N Privy Y Private Well N Water Storage
All construction must be in accordance with: 1. The attached approved design.
2. All requirements 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services
Depadment at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
I UNICIPALITY OF ANCHORAGE
Community Development Department
Development Services Division
On-Site Water & Wastewater Program
Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 0 '7 1
Property owner(s) ~v~' [,~J/ Day phone
Mailing address
Site address J~/65--/L ..cF (~'/'r¢,/~c¢oq/'
Legal description (Sub'd., Block & Lot) -.<&¢ /~' -/L¢~',?.~/,~o /0
Legal description (Township, Range & Section) -.., c~-~-¢,'-~ ./~. ;';*:'c,¢~-,d'.
Lot Size ~5'. OOO ~c. Sq. Ft. Number of Bedrooms
APPLICATION IS AN: TYPE OF DWELLING:
Initial [] Single Family (SF)
(w/wo ADU)
- [] Upgrade []
Duplex (D)
'1--] Renewal [] IV?u;;.;' - .
(SF and/or D)
APPLICATION IS FOR:
([~ all that apply)
Absorption Field []
Septic Tank
Holding Tank
Privy
Private Well
Water Storage
[] APR 2014
THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(SignatureC%rty own~agent)
Permif/Rush Fees:
Date of Payment:
Receipt Number:
Permit No.
2-1~5- 1~¢_,,//~..4~,~' Waiver Fees:
~/:2. ~/~ ~'/ ¢_~_ Bate'of Payment:
~::~'~' J ~' Receipt Number:
OS JOf q ! C~4 ~ Waiver No.
Permit App_9-1-12,doc
8