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HomeMy WebLinkAboutTERLACHER LT 1Terlacher Lot 1 #008-051-56 Municipality of Anchorage Community Development Department On-Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 Well Decommissioning Log Legal Address: Subdivision 7--c r J& C r r Block Lot T R Section Lot On-site Water & Wastewater Program certified contractor performing the well decommissioning: Name: Signature: / Company: Well decommissioning date 5 �1 2 0l S Method of decommissioning: AMC 15.55.06OL1 a. ❑ b. ❑ c. Location: Use the space below to provide a drawing of the property showing the following items; • North arrow • Decommissioned well, • Other water wells on the property. Two separate swing-tie distances for each well shown on the drawing, Note: The swing-tie distances shall be measured from either permanent structures or the property corners. N q,7g5 VI ri�wr Si. t O wtl� G1Community Development\Development Services\Building Satety\On Site Water and Wastewatenrormsa,uent runnsrvell Dewnmiuiviwiy wIJI t4pril 4, 1920 077122 Nrnest 1lubam Post office Box 1014 Anchorage, Alaska 99510 subject: Permit Expiration A permit issued by this department for well acid/or on --site sewer installation on Trot 1 Terla.chor Subdivision has expired since the :Issue date exceeds ono(1) year. In the event you still plan to install the well and/or on -- lite sewer system, a. new permit is required. The original soil test may be usect to obtain a. current permit, JX the well has been drilled, a well log should be sent to this department to document the installation date. I: you have any questions regarding the above matter, ploaso contact this office izainediatel.y at 264-477.0. Sincerely, Les N. Buchholz, R.S. Senior Lnvironmontal Specialist LIM/1 j h 1-1 u._u 1'-•1 ;F i 1; F-" F -_u IL_...1.. _I- 'v" fl. ;A der u"u 1`'8 P 1-H yc.0 ry_:i E ' DEPARTMENT -fir HEALTH AND ENVIRONMENTAL PROTECTION 25 STREET, ANCHORAGE, AK. 9 i1. 279-2511. PERMIT NO. ( 77:122 :.'- APPLICANT APPL..ICANT UENEi'a f_ AIJBMH P i t BOX 10111 279-4746 6 I...IcGAL L.:l. TERLACHER 15UBD SIZE: °'r;:? SQUARE FEET MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-' ITE'SEbTAGE I....I:-;POSAI_. SYSTEM 0--1 100 FEEFOR A PRIVATE WELL. OR 200 FEET FOR A RI_`BL...IC: WE .J. WELL.. LOGS ARE REQUIRED I:RED AND MUST BE RETURNSTOIE DEPA OTMENT WITHIN 30 EJE-1Y_' OF THE WELL COMPLETION. SPECIFICATIONS AI'+Ili CONSTRUCTION DI :AMS AF:tE A AI .HEL..E TO INSURE PROPEF! INSTALLATION. I " IFii; F:' 1-^ 1 J: -II °^.r° u F......f.. F:-. 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