HomeMy WebLinkAboutNORTH SLOPE #2 BLK 5 LT 13GREA-i'E R ANCHORAGE AREA BOR IGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
SEPTIC TANK:
DISTANCE _~ .... ~
FROM WELL ~ ~IANUFACTURER ~:;~'~"~J/~'~' MATERIAL
INSIDE LENGTH '~ INSIDE WIDTH LIQUID DEPTH __
NUMBER OF
COMPARTMENTS ~
.LIQUlD CAPACITY /~'A~ GALLONS.
SEEPAGE ~,~t,: '//z~J~'
NUMBER OF PITS ~ DIAMETER
LINING MATERIAL ~ CRIB SIZE:
BUILDING FOUNDATION
OR WIDTH
DIAMETER
/
NEAREST LOT L,NE
ADDITIONAL ABSORPTION
DEPTH ~ t/
DISTANCE FROM: WELL
TOTAL EFFECTIVE /~ '7,~
ABSORPTION AREA (WALL AREA) ,:, ,, ~ . FT.
WELL:
TYPE
BUILDING
FOUNDATION __
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST
LOT LINE
OTHER SOURCES.
DISAPPROVED
NEAREST
SEWER LINE
REMARKS
DEPTH DISTANCE FROM:
SEPTIC SEEPAGE
TANK SYSTEM
DISTANCES:
PIPe MATERIAL ·
REMARKS:
DATE 7/~?"~v//']~ APPROVED G.A.A.B.
.... q,lM-W DRILLING, INC.
DRILLING LOG
Well Owner Jeff Pollard Use of Well goa'/
Location (address of: To~vnship, Range, Section, if known; or distance main road
L13, Blk 5, North Slope Subdivision, Ea River
Size of casing. 6
Static water level
Screen (
.Depth of Hole
125 ft. (~}~'~)
)~ Perforated (
Describe screen or perforation
Well pumping test at_ 4 _gallons per (~)
of drawdown from static level.
Date of completion 24 JUlY 1976
200 feet Cased to 150.5 feet
(below) land surface. Finish of well (check one) open end ( X );
).
~[~3~ Mills Knife perfs: 8 ea., 140 to 135'.
(minute) for 1 hours with 100%
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
0 TO 2
2 TO 125
125 TO 139 .
139 TO 145
_145 TO 150 .
_l_SD___TO_200
~TO
~.TO
__,TO.
TO.
TO
TO
.TO
.TO
Casinq STickup
Till: qravellv hardpan
Silty Gravel; ~mall, occasional boulders
' · wet
__~rodk: dark blue siltstone: fractured
A,/A~ making v~ry l~tt]~ water
surface
i~i%V\VA Ccr~fict! Contractor
I -- CUSTOMER
THE: I....ENGTH [::,tME:I'.,IE;:I:~:.'.Ii",I :1:~; THE L.ENGTH ,:::[i"4 F'EE'I"::, OF: THE ]"RIEI",ICH (:)iR
"i"HE PEF']'H E~F' R TREI",IE:H OIE: P.'[T :[E; ,'1'HIE I'_':,).':E;TFINCE BETNEEN THE %I...IRFRCE OF THE
EiF.'%)LIN..F..', RN[::, THE I~iiu3]"]"E~l'4 OF' THE EXCRVI::IT:[ON '-':.~N
THE TRENCH I.,.t ]: D"I'H FOR [::,[;;:1::1Z NF ~ E[...[::"-':.; :["-'~1 2.": FEi:ET.
THE GI~;;'.t::IVEI... [::,E:F'TH .'[ f2; THE: i'"1 :[ i",1 :t: [¢ILIi'"I [.'.',EF']"H OF' GRFI',,,'EL. E~ETF.tEE:N THE
RI",IE:, 'i'HE E~OTTEJFI OF THE: EXCR',,,'RT:]:ON ':.']:N FEET.':'.
E',RE:~:::F' ]: I....I... :!: i",iG Elf::' F:lf",t"r' ::E;'T'2:;TEt"'I t.,.t
t;::,E:F'RFiiTI'"tEI",IT 1.4 ]: L.L. BE ~;UE',..:I'ECT TO F'REE:.:,ECIJT
I"'I Z N Z I"'11...1t'"1 [::, ~ :~;TFII'4CE E:ETI.,.tEEN t::1 1.4ELL. [:II"4D Fll",l"r' ON-':'~; :[ 'i"E '.:.:;E[,.II:IGIE E:' Z 2~i;F'I.3!5RI.... ':'~;"r%]'Et"l :[ ~]:;
ZE;(i:.F FEET F'J::)f4: F::l F'F;;'.]:',,,'F:ITE I.,JE:L.L OR ;-?'.'E~EI FLEE]' FOP:: ~::1 F:'UE:L]:C t.'.IELL
HELl_ LOEi:i~; R~;;:lli:.' ~'.IE(;;!U];I;::Et::."
OI::~ 'f'HE [4EL. L
SPEC Z F'Z CRT:t: ONE; Ri"4D
:t: N:~.;TRL. L. RT :[ Ed'4.
i E:[EI;Z'.T l F"r' THI::tT
i: ): t::1i"'1 t:::RI'"I]:L:[F:I[~: £,.I.t.'TH THE F~:EQUIRE:I"'IIENT2: FOR ON-~;I"FE :F2;EWERS
FORTH B'¢ THE I'"IUN :[ E: ]: F'RL Z ']"'¢Ot::' RNCHORRGIE.
2: Z ['.tZt...I._ :I:t",I¢~;]"RL.I.. THE S"~"E;"t"Ef"I :IN F:tE:COtr4'.DRNCE PJZ'I"FI THE
::~:: :!: I...INDEF;~:~;"I"RN[::' THt::IT 'THE ON-E;ZT[E E;E['.tE[~: E;"r%TEf"I P'IFI"¢ [~:E(;!t.J]:RE
~[~'t...:1: ::RNT -..'EF:'F F:'Z
OErE
Russell OySter
694~2774
Soils E~ Foundations
Perfomed for.' Name~
GEG ..... ECHNICAL ~ DEVELJ'PMENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Hailing Address:
SOIL LOG
Earl EII/s
688-2280
Land Development
Tel. No.
Legal Description:,,
Depth (feet)
0
2
'3
6
9,
~LO~
Soll Characteristic~
Ground Water Encountered: Yes
Proposed Installation: Seepage Pi~
Co~ents:
No If yes, what depth~
Drain Field
Perfomed by: Date:
DEPT. O:
MUNICIPALITY OF ANCHORAGE ENVIRONMEN %L
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
825 L Street- Anchorage, Alaska 99501 J U
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed, Please allow ten (10) days for processing,
1. PROPERTY OWNER [ PHONE
Jeffrey ?olZaraI 694-3093
MAI LING ADDRESS
?. O. Box 662, Eagle River, AK 9957?
PROPERTY RESIDENT (If different from above) PHONE
2, BUYER PHONE
Kenneth A. Klindera 753-8262
MAILING ADDRESS
21435 Citrus Ave, Elmendorf, AK 99506
3, LENDING INSTITUTION I PHONE
Coast Mortgage, Attn: Judy VossI 279-0665
MAILING ADDRESS
4797 Business Park Blvd, Anchorage, AK 99503
4. REALTOR/AGENT I PHONE
Myrna Johnston, AREA, Inc. RealtorsI 694-9555
MAILING ADDRESS
P. O. BOX 249: Eagle. River, ~?.r 99577
5. LEGAL DESCRIPTION
North Slope Subd ~2, Block 5, Lot 13
STREE~ LOCATION
Sagwon Avenue (off mile 9.5, Eagle River Road)
6. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[-~ One [] Four [] Other
[] SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY [] Three [] Six
7. WATER SUPPLY
[] INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTI LITY
* ATTACH WELL LOG. Awell Icg is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attaCh Icg if available.)
! 8. SEWAGE DISPOSAL SYSTEM
[] INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
**If individual/on-site, give installation date July 19 76.
If system is over two (2) years old an adequacy test is required
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (3/78) ~. ~
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
I NSP ECTOR INSPECTOR INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified_ LOG RECEIVED
3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[~ INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified INSTALLER
[]Septic Tank or []Holding Tank
Size: If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line
WELL TO:
Absorption Area to nearest Lot Line
5. COMMENTS
*/APPROVED FOR ~.~/ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED ? ~
DATE BY (Title)
LEGAL DESCRIPTION
72-010 (Rev, 3/78)
Address
City