HomeMy WebLinkAboutELJAY LT 4Onsite File
OWNER OF LAPID. _P=°t. r�
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ADDRESS ---------L
eo
... WELL SITE.-
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DATE—START
DATE—ENDED ------J0__b----- 4�'-`----'q----..41.... 70 --------•-----
KIND OF FORMATION:
DEPTH OF' WELL __ --- --=_d-- ----- IC
FROM--------0--•-------FT.
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STATIC LEVEL OF
107ATER FT.
.,9J__Q----------------------- -
DRAW DOWN FT.
------•;30- ----------------------•-----------•-------------
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FT. tX C3
GALS. PER HR. ------
-•----a----------------------•-----------
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FTSfi'r .. ......•......
FROMI
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FROM FT. TO..
FT.
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KIND OF CASING
-- -----®-°-10f
...............................
FROM--------0--•-------FT.
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TO-------411-----••-•----FT.-
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FT. TO-- z_1 ----
rs/yr
FT._ZS
FROM ----------
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FT. tX C3
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-FT� kid ----tom-�---4&OM------------------------
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FT .f'�C. 4 L€ FROM ........................
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MISCL. INFORMATION:
1
DRILLER'S NAME -s_J�.__. _{ L _i_yfc't t �i---------------------------
os,
R
P�l��c'�
E I J��� I r A (C �rrent)
l
To House
ELJAY SUBDIVISION
LOT 4
Outfall
Cover
Pressure
Tank
1'T
High Level
Alarm
Control
Panel
Concrete
Slab
Sump
Pump
2 49th;
LOT 4 WELL HOUSE
.........................................ttSS--...
's •Michael E. Andaman. i (NO SCALE)
d,�; No. CE4381 r;
1.5'
11'
MUNICIPALITY OF ANCHORAGE
DEP^RT,,ENT OF HE^LTH AND HUMAN SERV,CES O FO -- ? I -- 03
Environmental Health Division
825 "L' Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name DISTANCES
L-. ~--L--~or-~ ~ ~X~ ~ ~~ ~ SEPTIC ABSORPTION WELL
~u~ TANK FIELD
Phone(s) Permit NO. No. of ~oo~ WELL ~ ~ ~
LEGAL DE6CRIPTION
~. A FOUNDATION ~/ t~'
T~wnship, Range, Section AS-BUILT DIAGRAM (Show location of well, septic system, propeAy lines, foundation,
~ ) ~ ~ ~. ~ driveway, water bodies, etc.)
m .KS / - N
SEPTIC ~ HOLDING / - XCr
Manufacturer Capacity in oa,lo~s .. * ~ ~ ~, ~ I
Material ; No. of Compa~ments
TYPE OF SYSTEM ~' .~ '~
I
~RENCH ~ BED ~ W. DRAIN ~ OTHER ~ ~ { ~
Depth to pipe bottom from Total depth from original grade ./ ' ~
original grade ~ FT ~ ~ FT ~ t J~
Fill added above original oracle ~ravel depth beneath pipe ~
~ FT ~ FT
Gravel length Bravel width ~
~ FT ~ ET' ~~
t
~ ~ ~~ //
Total absorption area ~g ET Distance between lines ~,-,/~ F] ~ ~ ~ ~ ~ ~ '~ ....... ~' '~
~umber of lines Soil rating Pipe material
installer ~ ~ ~: ~(~ Date Installed
WELLS ~ ~ '.
~IVATE ~ OTHER {Identifv) ~ ~ ~ ~ ~ ~ -
Classification (A,B,C) Total Depth ~ ~1 ~ ~ [ ~ ~ ~ ~
Cased to ~
Installer Date Installed: ~ ~ ~ ~
Scale: ~ ~. '~ ENGINEER'S SEAL
~n~p~tio.~ .e,or~U by:
5 & S ENGINEERING '
I ..... CO 'l, thal,h' ,nspe.ion was ( ~~~: ~.:
17034 Eagle .,..r ~ -vaa .0. Z~ ~.~ ~ ~ pe,ormed according to all '~ ~'~~"r
Health Depailr,~e~t Approval:~' Date: ~ ~0~[~~
72-013 (3/85)
I~,'":":::; L Street ~ Anchorac e, Alaska 9950 1 343....472()
Date Issued: "z~,.:;'"~:~,',;~,..,:, Eng:i. neer Desic~tr]ed.
[]wr'~er Name: I ..... VERNON/BILL. IE J. MOORE
'~ ') ...... I~.I. VtER ROAD
Owr'ler'Ach:tlr'ess: ,: .Eh,dj IEAGI,..,E .....
EAGLE I:R:[MER, Al< 99577
D a y P h on e =
F::'a r ct:,?: 1 I d: 05(),,.,.97 :t....,.():]!;
Lot L,,e:gal~ Subc:liv:i, sic~r'~, ELJ~¥ I.,.ot: TR A E.)~ock= N/A
Section~ 17 Township~ 14N Range= 1W
Lot Size 15.22A (sq. F'L,, or acres)
Max Bedl"oc~ms~ 'l'h:i.s Per'mit: ;3 Total Cal:)ac::bt.y= 3
...d...,i: t ,1. C TANK ~ M i n ti. mum it, o't..a 1 s6'~i::rL i c t an I< (::: apac:: i ty: 1 ~ C ()C) (:ti a 11 on s. Each sept i ct:
t,~d"ll.:: ~llu. st l")ave ~:~'[. ].east
PERM I T IE X P ]: RES DEE',Iii!:MBIEF~'. 31, :1. 989 ,,
ENGII\IEEI::i MUST F:~E]::'Cff:~I' ]ST AND 2ND INSPECTIC)NS BY CAL. LING 343"'"4744
OR 343-4~8:1..
I:::'RC)F::'ERI..Y ABANDON GI::d.:,YMAf'IER SYS'T'EM AND []I.,..D CRIB.
t CERT.[F::'Y THA'I":
:1.,, I am {am:i. liar' ~i'Lh the rectu:i.r'emen'Ls Fo)r, On-s;:i. te sewer's and wells as set
I:'c::,r"Lh by the Mur'~:[c::i. pal:i, ty c:,[' AnchoPage (MI]A) and the State o[' Ala~q.::a.
2.. Z 44. 1 ]. :i.r'istal 1 the sysi:.em in accordanc:e"~itl'~ al. 1 M1]A c:ode~s and '~;¢~Lt~:i~'~'l:.:i. or'ls~
and in comp ]. ianc:e wJ.i:,h 'f.J'al~e de:,sigr~ cr J. teP ia (::)[' tt, h :J.s l:)6erm:L'E ,,
3,, I wil3. 8dl'~ere 'Lo all MOb and State oF ¢.~l,~a[il.::a requ:Lcemer'rLs {of the set. back
d J.s'LaFic:es F r'om any ex ist:i, ng wel ]. :, was'LeWa'LeP d :Ls;i:)osa]. system of pul:) ]. ti.c:
~s6?wer"a{:)je sy!c4i'..eFti on this
]: I...tf"ideF.!ii'l:.arld that tl"~is [:er'mit is va].J.d /f'oP a ma>(:i, mt..ull c:)F :3 []edr'c)oms. I
aJ. so unch.?rsi'..arid that the capac:i, ty oF the total sysi:.ern is :::,~; I:)edrc)c]ms and
any enlar'gemer'it ~i].Z requ:i, re art add:i.'Lic~rlal per'tfl:Lt,,
,," ..... .... 6x :, ............................. ............
S :i, g n ecl: ~,:
(Owner' ~ t~EI:~,IOt',t/[.~_L~:E J ,, MOORE
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L' Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
3
4
5
6
9
DATE PERFORI
Township, Range, Section; ///_./Z/L/)/° //./t.)./' / '7
SLOPE SITKE PLAN ~
10
11
12
13
14
15
16
17
18
19
2O
ENCOUNTERED?
S
L
IF YES, AT WHAT O
DEPTH? p
Depth to Water After/J~/,~
Monitoring? ~ ~ ,7 Date:
'"G ro~ Net Depth to Net
Reading Date Time Time Water Drop
TEST RUN BETWEEN ~ FT AND ~-~ FT
PERFORMED BY: L~~ECT ON THIS DATE CERTIFY THAT ~HIS TEST)/VAS/~ PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDE . DATE: //~' '~/~ ~
72-008 (Rev. 4/85)
tntA
wear cap. (w)
April 1%6
U. S. DEPT, Or THE INTERIOR
MASTER CARD
Bate _
LatItude:
c -ion
Local
MIT number•
Rel l Be. _! 1 •>/- / -� 7 — _
WELL SCHEDULE
GEOLOGICAL SURVEY WATER RESOURCES DIVISION
,Ceeaded on 4zo-r-.�/ fhedo ,yRr�l 7-5/
�t.s ae mu r:
o�naie•A/�R�pt,4-- -_
Owner or name: �iiFi:d�1eT iT''r[T1�/%r �'rd n °1 c' Z r
) (ORl n 11
Address:
Ownership: Cc (C
red" Cf['y, Cerp (or Cc, P (p te, Scsea A{ney, Natir)DLt % r�
(A7 (S) -(C) . (D) CE) YP) (n (I) (lo (N) (P) (R) P
Vs* of Air cand, Eoetiing, Ca.s, Devater, Paver, Pire, �, Irr, lad, Ind, P R, EAC,
vacar; (S) (T) (U) ..
Stock, IM tit, .Unused, Rapsunra, 7,charS4, DOae1-P R, DesalTrther. Other
ee�
Use of (A) (D)
Anode, Drain, Ssi mi ,Beat Ras, Obs. 011-;u, sachets" Test, Doused, Nit(Rraw, waste, pato`oyed
DATA AVAILASLS: Well ( data(_." Pres. VA ts..; -
�6'- weField souLFar char. °c❑
Hvd. lab. data: - - - 't❑
qual. rater data;•cvpe:
,.�
Pref. damollne; -1 1 Yes
I�ra_J PwParw imentorv• M, Period: ,ya
Aperture cards:_ yet 'tQ
Wes data:
WEL C -DESCRIPTION CARD
BAMS AS ON MASTER CARD Depth Mil: //10 Maas..:
p N Ft rept
(flits ca d• C s accuracy
ft s 1 - a int--•�-�
(( (!)) )is )) eves: tom' i,,: Dim.
Finish: potous Sradel v. stavii pp hods. (D) (P) CS) T) (y) (E) _ �PP"'�p"•
cotacnu, (Perf.) , (screen} Sallary, dn2n Perf., screen, eo, p,., shored, Rgti, ($)
method ( ' ) P�� test
Drilled: air berdd, c763a, duj, pyd jetted, air reverse trenching, dt�dn, drive
rot, /mss! rot., _ Percussion, rotary, rash, 6JpJ
Date / % J� �---
� rs PIaPD intake settl..e; ft '
Driller: . -
Lift (A) (S) (C)n (7 , (L) (M) a reds
C • air, bucket, ewltiPle, nu101y1a, (w) (P) (R) (S) (T), (R) Dnp
(cent.) (curb.) nope, Piston, rot, subwa s, cur6b other E:�,I
Pyr oat LP Shallow 40
(type): diesel, Ie SM, Saeeline, hand, Sea, rled; 1U, _ V TFR6e. er
�__ or m.
DascrlP. NP-�'
above
ft, bsIwLSD . Alt. NP
Alt. LSD: /-3D - r , ,Q Accuru
mater. n/
L.iiJ�
source `� 'f' +`n .r{ L
• s L;
��e above above
ft below !4i 9t balew 16D Accuracy: all i
*to ° L, LJ
=_n: - 19S r d '3' . ss yield:: 7 .� r : a Method
dlCexmlMd
q�
➢rndav°' ft '. � Accuracry; "' in a
DALITY oP O!' '� s,hra sy,�,�rt
NA76R DATA: Iron 1 / isulfats �`j •'b Ab
TPM-
---7T' Chloride 1 i std F
-7t�
Conduct QD R x . L�1. Taw, O Dtipff— r
yQ/. QD� One > ink
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