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i~ L._~ 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
LEGAL D ESCRT~?.~.'
DISTANCE TO:
a.~- <~Z Manufacturer G ~." J~_
Liq. capacity in gallons Inside length Width Liquid depth
/ 2 ~.~ IF HOMEMADE:
~ ~; DISTANCE TO: Well ~-----.~_ ~ PERMIT NO.
O Z <~ Manufacturer ~ Liquid capacity in gallons
o Wa,, , Eoundat,o Naar.st,ot bPERM,T,O.
__.:~uJ ,~- Nc. of lines %..~ Leng~h;o, eac}} line ~. ~ Total 7~,~h_~ Jines Trench widthS. ~)inches Distance betweT~n
F-~ Topoftiletofinishgrad,-b~-' ' MaterJal beneath tile motaleffective~o~.~
u~ Length Width Depth PERMIT NO.
__. Type of crib Crib diameter Crib Total effective absorption area
u~ Well Building foundation Neares~'~.~
~ DISTANCE TO:
Building. f, undation Sewer~o j Septic)~.~ , Absorp~r~a(s)
~ DISTANCE TO:
OTHER
PIPE MA}r ER I.~A LS
........
INSTALLER
' ' ' ' ' ' ' ' ;" j4
.
APPROVED / / /; DATE LEGAL
Permit %_~
Location:
Legal Description:
Department. .~-H~alth and Environment~jProtection
825 "% Street, Anchorage, AK. 99501
* * * HANDWRITTEN PERMIT * * *
~ON-SITE SEWER PERMIT
Mailing Address: ~ ~/~ ~,,
Phone Number: 6
, ~/~~~' ~ LOt Size:
Type of Soil Absorption System Is:
Trench: ~ Drainfield: Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: ~ Soil Rating (sq. ft/br) IT ~--
The Required Size of the Soil Absorption System Is: '
DEPTH [[~'~' ! LENGTH /52' '
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 SEPTIC(HO-L-B-t"r~G') TANK SIZE = ~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 departmeni
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 witkin 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31, i 9 8 3 * * *
I certify that:
(!) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the~~res.~denceo i):deled to i~cludeissuedmore t.~~~.by:
S igne~: ~,
Applica~nt' ' '~ -~' /~-~ 6'
~ Date:
SWP/024 (i/si)
unicip i yof
Anchorage
POUCH 6-650
ANCHORAGE, ALASKA 99502
(907) 279-2511
GEORG£ M, SULLIVAN,
MAYOR
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
(825 "L" Street)
January 5, 1978
Art Skoog
3305 Eide Street ~1
Anchorage, Alaska 99503
Subject: Lot 1 Block 5 North Slope Subdivision 92
A permit issued by this department for well and/or sewer
system has expired.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal ordinance.
If you have drilled the well, a well log should be sent
to this department to document the installation date.
If there are any further questions, please contact this
office at 264-4720.
Sincerely,
Health and Environmental prOtection
Sewer and Water Section
F'E RF'I Z "['
F:II::'I::'[... :!: C l::li'.,l'T'
I r"lC F:IT I ON
THE LENGTH [:, :[ I"IEI',tL:!; I ON I2!; THE: LEI",IGTH ,:;.IN FEET> OF' THE TRENCH OR
]"HE [.',EF'TH QI::" R TF:'.'ENC'.'H OR F'.f.T I':.E; THE!: [.',ISTF:Iiq(::E BE]"I.,IEEN THIE !E;URFFIE:E EtF'
EiROUI'.4[::, 'FII'.,I[:, THE BO1"1"O1'4 OF THE EXCf:t',,,'Ft]"IOIq ,:: :i:i'.,I F'E:ET::,.
THE:RE I2i; i'.,IO SET 14]:.[2]"H F'OR 'TRENC'HIES.
THE E'iRFI',,,'EI... [:,IEF'TH ]:2; THE I"'Ii'N;[P'ILII"I E:,EF:'TH Of':" GRFt',,,'E':L. E:ET.t,.IEE;I'-,I THE OUTI::'F:IL.L
FIN[:, THE': BO]"TOt'"t Ot:::' THIE E;:.::E:FI',,,'R"I":I;Oi'.,! ,::I iq FEET).
li3FI[?KF:']:LI....:[NG "IF:' 1::ll"4"r' ::,~.':,IE.II FILTH'-: rT FINF:IL INSF'IECTIIDI'.,t FIN[) ptl: FI;.., t1_ 'T'H .
[:,E'F:'t::tI:;~'.TI'"IENT 1.4 ]: L.L Ei~E' :E;IJIEL.'rEE:T TO F:'F'F '~.;E Z _ T.'[ O1'.,t.
I',I:I.'NIr,'IUI'4 D IS"I"FIi'.,IE:E E,'ETNEEN f:l .~4EL. L FtN[::, Rt",l"r' Ed'4-.-SITE ':_:;EI.,.IFIGE [:,IE;F'O2.;I::II... !Sh.':i~;"FE.:.r,'l
FEE]" FOR F:I F'I:;Z'.Z',,,'FrrE 1.4E[..L. OR 2E~C~ FEi:ET F:'OR FI F'UBLIC I.,-IEL.L.
1.4ELL LOG:E; RRE RE6!UIRE[::, RN[:, I','IUST BE RETURNED TO '1"HE DEPRI:~".]"fdEi'.,IT I.,.ll"l"H:[l',l ::ii:6 17::, i:::1'.¢ '.5
THE 1.4EL. I._ COt','iF'L.E'T".r. ON.
:E;F'EC :1: t::' ]: CI:::tT :[ QN:5 F:II'.,ID CCdq:?T'RUCT ]: ON E:, Z F:iGF..'Fli"'iLE; FIRE R',,,'R .~: L. RBLE TCI I iqS.:;I...IRE I::'ROF:'F.~:R
N~;'T'FtL b F~T ]: Oi",1.
I CERT:I:F'¢ TFIFIT
::t.: :[ Fti'"l I:::'RN:[L.:[I::IR .~,.I]:TH THE REQUtREi'"IENT% FOR ON-?;ITE SEI,.1ERS RN[:, WEI...[...S FI:/:; 5;ET
F'ORTH E','.r' THEi: i',IUN I C: ]: F:'I::IL I 'T'¢ I.'.'tF.' FINCFIOF;'.RGE.
2:: :!: I-,.t:[LL ]:N:E;TFI[.I~.. 1"HE S'.¢2;TEM It'.,l RCE:OF~:[':,FIIqCE NITH THE
2i:: I UN[:,EF.%TRND THFIT THE ON.-.!.T.,.T. TE 2;EktE:R :i::?¢."~TEi'"l MFI'.~.' I:~:IE~:.]LIIRE E:NLFtRGEF'IENT It::.' THE
RE::S]:E:,ENC'E I'L;.: REP10[:,ELE[:, TO I t'.,ICLU[:,IE I'"iORE ]"HFaN Z;
::: ,::,,. n:' 72_%
' 'O.,"8' E GE(;-~ECHNICAL 8' DEVEL~JPMENT CO.
Box 90, Davis St,, Eagle River, Alaska 99577
694-2774 or 688-2280
Russell Oyster
694-2774
Soils 8' Foundations
SOIL LOG
Mailing Address:
Legal Description:
Earl Ellis
688-2280
Land Development
Depth (feet),
Soll Characteristic)
0
2
5
6
7
8
10~
11~
12~
16
Ground Water Encountered: Yes No__
Proposed Installation: Seepage Pit
Comments:
If yes, what depth
Drain Field_._~
A & L DRILLING COMPANY
BOX 97, EAGLE RIVER ALASKA 99577 · TELEPHONE 694-2588
OWNER OF LAND ~://.~' /
ADDRESS . _,, ,4,, I'
LEGAL DESCRIPTION '
DATE - Started :~/,/'1,' ';' ~' Ended
PERMIT NUMBER ]'¢'
~,//', ,/%!-
DEPTH OF WELL .' -'
STATIC LEVEL OF WATER FT. I' / '
DRAW DOWN FT. '; ,'
GALS. PER HR ' }'O
KIND OF CASING {'" ,; ~ ' ~
KIND OF FORMATION:
From ; Ft. to / Ft.
From / Ft. to Iff 'J Ft.
From ) '; Ft. to ' II- '~ Ft. . ' ·
From A-)-', Ft. to ? ''a Ft. ,:'~,:,
~-."-om__ Ft. to Ft. /
l'rom ..... Ft. to ~v.[~: Ft. , :, ,':','~ ..
From ~ Ft. to Ft.
From Ft. to Ft.
From.~Ft. to Ft,
From Ft. to Ft.
From.~Ft. to Ft.
From ~ Ft. to Ft.
From.~Ft. to Ft.
From Ft. to Ft.
From Ft. to_~Ft.
From. Ft. to Ft.
From Ft. to Ft
lFrom
From__
From__
From__
From
From__
From
From
From
From
From
From
From
FFOm
From
Ft. to--Ft.
Ft. to Ft.
Ft. to__Ft.
Ft. to__Ft,
Ft. to--Ft,
Ft. to__Ft.
Ft. to__Ft.
__Ft. to Ft.
Ft. to Ft.
Ft. to__Ft
Ft. to Ft.
Ft. to.__Ft
Ft. to Ft.
Ft. to Ft
Ft. to Ft.
__ Ft. to.__Ft.
Ft. to.__Ft
MISCL. INFORMATION: