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HomeMy WebLinkAboutWOODRIDGE BLK 2 LT 16Jun 13 22 07:29p Anchorage Well & Pump Ser 9072430742 p.1 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section t Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: Date of Issue: Parcel Identification Number: 020_09324 Legal Description Block Lot Property Owner Name & Address: ERICKSON LARRY D & KAREN D WOODRIDGE 2 16 16400 VIRGO AVENUE 11 ANCHORAGE, AK 99516 Pump Installation Date: 06 - 06 - 2022 Pump Intake Depth Below Top of Well Casing: 140 feet Pump Manufacturer's Name: A.Y. MCDONALD Pumn Model: 23075V3LB Pump Size: .75 Pitless Adapter Burial Depth: 12 feet Pitless Adapter Manufacturer's Name: MARTINSON Pitless Adapter Installer: Well Disinfected Upon Completion? Yes Method of Disinfection: PELLETS II Comments: Pump Installer Name: Company: Mailing Address: ❑ No ANCHORAGE WELL & PUMP SERVICE 7640 KING STREET ANCHORAGE, AK 99518 907-243-0740 State: Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. NAME MAILING ADDRESS LEGAL DESCRIPTION LOCATION 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 PHONE ........... 1[~] UPGRADE 1 Abs°rpti°n~.~eta Inside length Dwelling Dwelling Material Manufacturer.. ~ Manulacturer NoTo~ .~ I Length el eacb line PIPE MATERIALS I Tot ' length Material beneath tile tMaterial N-~.a ~o t lin ~p/~ ? ~ inches Depth Crib depth Total effective absoq)tion Building foundation Nearest lot tine Driller Distance to lot line Sewerline Septic tank OTHER NO. OF BEDROOMS PERMIT NO. No. of c.~_par tments Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT NO. rpao~Ls'-' Distance between lines Total ef fecti~.~..~P~,~ area PERMIT NO. APPROVED DATE LEGAL 72-013 (Rev. 3/78) ,~,' ~) '!"HE LENFilH D:[FIEN:i:;;[EIF! ];E; 'I'FIIE !...EF,I[~'FH ,:: :l: i-..I I:::EET> OF' THE 'TI:~:ENC:,U 'TI. El: [:,!i:!:F:"t"H C!F: t':l "I"F~:E:NC:H i.::!l:;~ F:'ZT ZS; TH!E [:,T:E;TFINCE: !FE:T!"I,E~;Ehl fl-II.E: E:;!J[;i~F?:'u]:[i: OF T'I.IIE GFi:OI.J?,!I_:) FINE) 'T'HI.!: E~OT'FCd',i Cfi:' '/'tl!?: E-:;:.,:C:i:::fVI:::IT:[OI'..! ,:;i[f.,! FF.1EI;?.E ;IS; t'-.!O :~;Ei' !.,.! :I: E:,"f'N FOI4: TF~ENCHE:E;. 'THE: G[~:Ft'.,,'E].. [:,EF"[!.4 ]:::i; TI:II-: H ]: F! :[ FIUI'"t [:,EF'TH O1:::' (!ff;..:Ft',,,'EX. [3E:T'bU. ii:;!i]'.,I t!..IE F:ff. ID T!.IE I.~',OT"FCd'I C!F: 'f'HE E]4[::F¢,/F:F'F]:OI'.,! ,::11'.,! I','i:[l'-,!]:i',ilJt','l [):[E;T'FIh!CE [3ET!4E:E:N F! NE]J._ FIN[:, F~t",!"r' ON-..E!;z'r'!z ::l..!i!nlg F'E!i:'F I::'O1:,?. 13 F'F;'.Z',/FITE: I,.!EL.L [)R ::t.!X~EI 'FO UF'()H THE T'-r'F'E: (:IF' F'LtE~!...]:C t,.!EI..! H]:I"t:[I'"!IJ!"I I..)]:"L?f'FII",E:E: FFi:OP1 FI F'F~:[VFFi'E: FI[ELI... 'FO FI FI:;?.?,,,'F:I'I'E 'E;rEH!Z[;[: L.]:i',IIC ];E; ;i.'_':i; F'!iii:E:'F FIH[:, TO F! COMI"II..IN:[T'¢ :!ii;[!;klE:F: !.!NE; ZE; ;:"[.i I::'E;ET. HEL.L.. 1...O[ii:"il; 1:::It:41E [;;:E)]!I..IZ[f;?.E;[:, I::IF,!t:} i'"llJ:i¢'i- I[~[,k.': [~:r}71'l._l!;i:l'.,!EI3, fiE[ '['HIE DE:F'RFi:F!,I!ENI' HI"FH:[N 2::C! [:,F!"r% OF '!'hie HELl... CEIP1PL.E:T']:Cd",I. Oi HE:R t:,~:!;EI;)I...I :[ l~E:i¢!E:.i'.,!'i'% r'!!'::l"¢' FIF:'PL.."/. '.i~r:'EE: :[ F I::I'v'I::I:[LFIEd..E[ 'Tr3 ];N'_.'i;Ut';?[!. F'F.:OPE:F~: :[h!E;TFtL.L.FIT:[CIN. :iL: FOFi:i'H [3¥ THE: I"II.JF,IICIF"FI!_:[T'¢ OF:' F:ff.,!(:::HCtI:;!i:::II::iiE. :ii:: ]: I.,t'[!..L :[N:~;'f'FII_L THE :~?¢E;l"Ef"! :[t".I FIE:E:OR[:,Fff',E::E; 14ZTH '!"F'll~; C'O[:'I~;;:~:. I;[:E:~;]:DE~I",IC:E ]:E; [;:[;!*IO[>E;LE[::' '1h'3 ]:NC:i.I..I[:,E t'qOF?.E 'il. Il:aN 4 Fn:: h~::,~,,'..,'F t.Y~,~:r;t.,. ~:: H,::~R~.~:t,~ E:~;~: :[ ::::~-::::~ :::~.. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEAt. TH AND ENVIRONMENTAl. PROTECTION 825 L Street, Anchor,~go, Alaska 09S01 2~4-4720 SOILS LOG -- PERCOLATION -rEsT SOILS LOG PERCOLATION TEST LEGAL DESCRIPTION' L~ - ~' C'~( ~(.- . ~ 3 4 6 7 8 9 1 2 G/v\, S-, / fi? .... ~L, SITE PLAN 10 11 12 13 / ~ ' /IV[ L, WAS GRODND WAFER ENCODN'I ERED? IF YES, AT WIIAT DEPTH? 14 15 16 . I7 ~8 19 1 2O Leroy No. 2251.E [ /.~: ~¢f' ~'F /, ?-9 / : 0 0 PERCOLA1 ION RA'I E ..... ~ .(minutes/inch) '1'Esr RUN BETWEEN ~ FF AND .~- .... FT 72-008 (6/79) 0 APPLI(, N'r FILLS OUT UPPER HAL ONLY('- / Address Zip Code Phone Realty Os. & Agent Phone Address Zip Code Street Locati~ j {¢ ' ~ 0 (' ~ ~ ( '-,O )"~ Type of Resl~nce Multiple Family No. of Bedrool~ Water Supply ~ Individual A~ACH WELL LOG. A wall Icg is required for all wefts drilled since June 1975. ~ Community For wells drilled prior lo that dale, give well depth (attach Icg If available). ~ Public Ulillty ~ Individual Year IndivMual Installed;_ Public Utility When Connected to Public Utility: ~ Holding Tank Time Time Time Date Date Date Dale Inspector Insp6ctor Inspector Inspector Field Notes: g. ~F' ~ ,> Well ,o Tank Septic T~k Size