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PRATOR BLK 1 LT 3
Municipality of Anchorage Community Development Department On-Site Water and Wastewater Program 4700 Elmore St. •P.O. Box 196650 Anchorage,AK 99519-6650•http_Nwww.muni.orglonsite•(907)343-7904 Well Decommissioning Log Legal Address: , -z Subdivision ?te"c&or Block Lot w T R Section Lot On-site Water&Wastewater Program certified contractor performing the well decommissioning Name: Hefty Dimming, grit. Signature: , P.O. Bo, 1"1ZO 11 Company: .f orage,.f Well decommissioning date S-)A- 1 t Method of decommissioning: AMC 15.55.Q60L1 a. n b. n 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 comers_ 9e CP Wei °#144." I ot,t, ct G r-7 Cjc i-k5 . G:\Community Development\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms1Well Decommisioning form.doc He~./h and Environmental Prote~ .zon Fourth Floor West 825 L Street 3~nchorage, Alaska 99501 264-4720 INSPECTION REPORT ONLSITE SEWAGE DISPOSAL SYSTEM NAME~,_~--.O'-f-A '~ '~:~ ~,%Ok~ MAILING ADDRESS ~,O,~::)oy,, (o'~-A, ~.~%_%..Ll'~ PHONE ,','~""((o'~~,-'~o%,~ · OCAT,ON ' 9,,:, LEGALDESCR,PTION %', SEPTIC TANK: DISTANCE FROM WELL. INSIDE LENGTH NUMBER OF MANUFACTURER %L%IOS~-T__ __ MATERIAL ~\NgeJN/'C~L~rS COMPARTMENTS INSIDE WIDTH ~]l~ LIQUID DEPTH ~1~' LI,,QUIDCAPACITY \'oOOGALLON5 TILE DRAIN FIELD: ~ - TOTAL LENGTH DISTANCE FROM WELL ~, r~"-[ FOUNDATION L~fL~O NEAREST LOT LINE ~'~'O ,OF LINE # of Lines (~O/gE DISTANCE BETWEEN LINES ~ I~ TRENCH WIDTH;~:)O IN. TOT ALEFFECTIVE ABSORPTION AREA (O("]~ SQ, FT. LENGTH OF EACH LINE O~,~ (~ ¢ DEPTH OF FILTER DEPTIt: TOP OF TILE TO FINISH GRADE L~¢~-) MATERIAL BENEATH TILE \~-~) ,IN. ABOVE TILE ~ IN. SEEPAGE PIT: Log Crib Rings BUILDING FOUNDATION__ DIAMETER __ OR WIDTH LENGTH DEPTI4 Crib Size: DIAMETER_ NEAREST LOT LINE__ DEPTH_ DISTANCE FROM: TOTAL EFFECTIVE / SQ. FT. Well Class: Depth: Well Distance To: Lot Line~ Bldg: Pipe Materials: ~ of Bedrooms: Installer: Remarks: PERHIT NO. DEF'FIF:TMENT 01::' HEFILTH FIND ENVIRONMENTRL PRO'TEC"f'ION 825 '"L" STREET., RNCHCIRFIGE, Rt<. 995~i 264-4728 780047 > FIF'F'L i C:FINT L 0 F:Ft T I 0 I'.,I LEGFIL LEOTIR J' DENN I SF'IN H I '-' ~. C-'~ RRE:E:I]- CRK RD L2: B± F'F..P F..t.. SLIE; T'T'F'E I']F SAIL RE:SORBTION E;'T'?FEM IS: TRENC:H HFI::.::IMUi"I 1'.4L.Ii"IBEI'<.: OF E:EDF<OOHS := SOIL RRTING ,.'.'SI_::! F'T,.-"Eq:;.:::,= 't::5 THE REQI..I]:F.:ED SIZE OF THE SOIL FIE:SORF"FIL-IN S"r'STEM THE LENGTH DIMENSION IS THE LENGTH '.'.'IN FEET.'.', OF ]"HE TRENCH OR DRFIlN. F'IELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BE:TNEEN THE SURFRCE OF THE GROUND RND 'T'HE 80TTOM OF THE E',:'::CR","R]'ION (IN FEET). ]"HEF.'.E IS NO SE]" [4IDTH FOR TRENCHES. THE GRI:Y',"EL [:'EPTH IS THE MINIMUM DEPTH OF GRFIVEL BETNEEN ]"FIE OUTFFIL. L PiF'E RND 'THE BI]~TTOM OF THE EXCI::IVRTIEIN '::IN FEE:'/). ...................... F" ~ CE: ~::.: R "'5~ EE F' ~__ F~ ~",~ ~'" b--, F" -F ! E:~ ~"~ FI PRCKRGE PLRN'F MR'T' BE INSTR[_LED RT THE PERMITTEE"S OPTIOIq SUBJECT 'TO THE FOLLOI,.I t NG COND I T I ON'.:.:;: ±. EITHER R CLRSS I OR II NSF RF'F'ROVED PL. RNT MR"r' BE INE;TFILL.ED. 2. R CONTINUOUS MFIINTENFINCE RGREEMENT IS REL'-:!UIRED. IF f~ HRINTENFINCE RGREEMENT IS NOT lEE:PT CURRENT 'T'OU MR"r' BE F-'.EQUIRED TO ENLRRGF THE SOIL RBSORPTION S'¢S'I'EM RND,.'"OR 'T'OU I"1R'¢ BE '~;L.IB..TEC]" TO PROSECUTION. "- ' ":" ' = '- F' ' - "' '" "' '* B 'T' BRI-:I<FILLING OF RN"r' --,T_,IEFI t,.IITHEd_II" FII",IFIL .T.N.':,PE_.~IAN RND HI-~ ~_ ,HI_ 'THt:5 E:'EF'RR]7'IENT I.'JILL BE ':~UBJEI::T 1~0 F'RFISECUTI':~N MINIMUM D'ISTRNCE BETI.'.IEEIN R NELL RND RN"r' ON-SITE SEI,.IRGE D'ISF'OSRL S'T'STEM IS '100 FEET FOR R PRI',,"I:TT'E NE/.L OR 200 FEET FOR R F'UBLZC NELL OTHER REQUIREMENTS MFI'T' RPF'L'T'. SPECIFICRTIONS RN£:' CONSTRUCTION E:'IRGF.'.RMS FIRE RVRILRBL. E TO TNSURE I--'ROF'ER INSTRLLRTION. I CERTIF'¢ THRT ±: I FIM FRMILIRF.'. NIT'H T'HE REQUIREMENTS FOR ON-SITE SEI.'.IERS FIND NEI..LS InS SET 'FORTH B'T' THE MUNICIPRLIT'¢ OF RNCHORRGE. !: I NIL. L INS:';'I"RLL TFIE '_:.:;"r"_'E;TEM IN RCCORDRHCE !.'.IITH THE CODES. :: I UNDERSTRND TI-IRT THE CIN-SITE SENER S'¢STEM MR'T' REQUIRE: ENLlaRGEMENT IF' THE ESIE:'ENF:E IS REMFIDELED TO INCLI_IDE MOF::E THI=IN :2: E:EDF.:00f'l~ .~, ,%F'¢£i',_-.',:,NT //__EOT,'-] J'. DENNISON XmaS__ / ;.2 / AREA OF REMAIN N LOT 3 BLOCK 1, PRATOR SUB. IN THE Wl/2NjEI/4, Section 35 T. 12N.,R.3W.,S.M. No Well \ \ \ 3'X 2?'Alternate Trench 3"'X 2~,' Primary Signature Date Attached To Page Of-- Dated. STAT:E OF ALASKA DEPARTMENT OF HIGHWAYS PLAT SHOWING TRENCH LOCATIONS FOR REMAIN PORTION OF PARCEL 38-A. CENTRAL DISTRICT Area. ~;cale. , I" = 30~ .Project# QRS'OSOZ~(5) Dwn. JH Date 5-76 Parcel# 38-A. CONSULTANTS~ INC. 2.49 £A.~T 515T AVENUe' P,O. BOX 6087 ANCHORAGE, ALASKA 99~05 * TE:L£PPIONE 907-279-04~EI3 * . ANCHORAGE FAIRBANKS JUNEAU May 17, 1976 'Mr. Timothy Tittle Department of Highways '5700 Tudor Road Anchorage, Alaska RE: Test Hole and Soil Log Report for Sanitary System Lot 3 Block 1 Prator Subdivision Dear Mr. Tittle: We are submitting herewith 'the boring logs, percolation results and our comments regarding soil conditions encountered at th~ subject ~ite. This investigation was performed in accordance with your request of ~y 14, 1976 and those procedures outlined in a letter dated July 15, 1976, by Mr. Rolf Strickland of the Municipality of Anchorage, Department of Environmental Quality. A single test hole was put down within the Lot 3 area for the purpose of defining general subsurface soil conditions and conducting percolation tests for the proposed sanitary system° Excavation was accomplished with a truck-mounted auger type drilling rig and the test.hole was extended to a total depth of 19.0 feet below ground surface. The final log prepared for the test hole has been included in Drawing A-01. Ground water was not encountered in the test hole. we appreciate being given this opportunity to be of service to you. Should you have a~y questions with regard to the above, please do not hesitate to contact us. Very truly yours, R & M CONSULTANTS, INC. James W. Rooney Vice President JWR/WED/pe xc: Municipality of Anchorage TH i SILTY sAND W/ SOME GRAVEL (SM) Tan SANDY GRAVEL W/ SOME-TRACE SILT (GM-GW) 205 GP.~J. rELLY S~D W/ TRACE SILT (SP) 0.0f 1.5I 4.51 SANDY GRAVEL ALTEP~MATING WITH LAYERS OF GRAVELLY SAND WITH SOME SILT (SM SP). 185 No Scale 14.5' SANDY GRAVEL W/SOM~ SILT (GM) No Water Table 19.0' T.D. DWN; CKD: DATE: SCALE: 1"=3' Log Represents Location of Test Hole Lot 3 Block 1 ~ Prator Subdivision 5-18-76 m ~ ~' M R & M CQNBUI.TANTg, INC. Log of Test Hole Alaska Highway Department ~ PRO&NO. 656~$8 Anchorage, Alaska DWG. NO. A-01 PERCOLATION TEST HIGHWAY DEPARTMENT R & M NO. 656238 TIME 10:30 10:31 10:32 10:33 10:34 10:35 10:40 10:45 10:50 10:55 11:00 11:05 11:10 11:15 11:20 11:25 11:30 ELAPSED TIME 0 1 1 1 1 1 5 5 5 5 5 5 5 5 5 5 5 60 minutes DROP INCHES 0 3 3 2 1/2 2 1/2 2 1/4 9 6 1/4 4 3 1/2 3 1/4 3 3 2 3/4 2 i/2 2 2 53 1/2 Total Drop #1: Time 1:3'~ Date 1-1' Insp Pr~ ,DEPARTM~ j. OF HEALTH AND ENVIRONSEIx~ PROTECTION 825 L Street, Anchorage. Alaska 99501 264-4720 Date Received: January 9, 1979 ~p.m. #2: Time I :,,~ ~h \ #3: Time .78 Thursday Date j_//,~fl/ ]~>~ Date Insp [~. Insp REOUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIE~ Lending Institution Request: Coast Mortgage Company Mailing Address: 4797 Business Park Boulevard Phone: 279-0665 2. Property Owner: L.J. Dennison e Phone: 376-'2328 Mailing Address: Box 634 Wasilla 99687 Legal Description: Lot 3 Block 1 Prater Subdivision 4: Single Family Residence: (x) Number of Bedrooms: Two Multiple Family Residence: ( ) Number of Bedrooms: Well System: Permit # Construction Individual well (x) Community/Public System ( ) Depth of Well 225' Well Log on File ( ) Bacterial Analysis 0 Sewage Disposal System: Permit # Septic Tank Size Absorption Area On-site System (x) Public Utility ( ) Installed Installe~ Manufacturer Soils Rate Material 7. Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line AbsorPtion Area to Nearest Lot Line o ~UNICIPALITY OF ANCHORAG~.~ ~,::,, ,~, Department of Health and Environmental Protection' 825 L Street, Anchorage, Alaska '99501 :'~ .... 264-4720 equest for Approval of Individual Sewer and Water Facilities Property Owner: Mailing Address: Name of Buyer: Mailing Address: Phone: Mailing Address: Phone: Realtor/Agent: Mailing Address: Legal Description: Street Location: Single Family Residence: (~) Number of Bedrooms: Multiple. Family Residence: ( ) Number of Bedrooms: Water Supply: *Individual Well (~) Public/Community System If Individual Well, well depth ~,~ If Community System, name of system ( ) Sewage Disposal System: *~n-site System (W) Public System ( ) If On-site System, date of installation: *NOTE: A well log is required on ALL wells drilled since 6/75. ** If on-site sewer system is over two(2) years old, an adequacy test is required by this department. A fee of $25.00 must accompany each request before processing can be initiated. 3/77 P~ge Two ," Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 3 Block 1Prator Subdivision Comments: Affadavit Attached: Appr~ed: Disapproved: Letter Attached: ( ) Date: f~-~ ~7 ~ Date: Department Workshe (ep!s ,~e~o eeS) --QIQIAO~Id ~19¥1~qA03 :I3NYBI1SNI ON 0085 u~o4 Sd 3iVO ~0 ~58 ............flUO aassaJpp~ o~ XJa^!lap qJ!M ~ ~G£ "paJaHlap aJaqm pu~ amp 'moq~ el s~oqs '~ ~§9 ............~lUO aassaJppe oT ~Ja^llap q~lM q 1dl]33~ ~! ........... paJaAIlap 81ep pue moq~ ol s~oqs '[ S3]J 1VNOlllaav ao~ S]OlA~3S ~o00 dlZ ON¥ 31¥~S "O'd (a;Be~,sod snld) ~O£--'IlVIN 031.-IIJ.8:13 ~10-1 [~.,. January 17, 1978 L.Jo Dennison Box 634 wasilla, Alaska 99687 Subject: Lot 3 Block 1 Prator Subdivision This department cannot approve your request for sewer and water for the following reasons: (1) Both well casings need to be sealed so that they are air tight. (2) The ex~sting sewer system has been condemned due to the relocation of Rabbit Creek Road° If monies are escrowed to cover the cost of the above mentioned items~ then a temporary appronl may be granted. Prior to the upgrade, a permit must be obtained from this department. A soils test has been perfommed, which we have on file. If there are any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Sanitarian Connie Hood P~lar Realty Coast Mortgage Company 4797 Business Park Boulevard 99503 March 3, 1978 L.J. I;ennison Box 634 Wasilla~ Alaska 99687 Subjeet: Lot 3 Bloak t Prator Subdivision An inspection of the above property revealed that both the wells have not been sealed properly. F~en though one of the wells is disconneeted~ it will need to be soaled as to prevent any contamination o~ the acquifer. The seal m%~st bs air tight. The well serving the property will also need a seal that is air ti~ht. If there are any further questions~ please ~onta~t this office at 264-4720. Sincerely, Robert C. Pratt~ Sanitarian KCP/ljh cc: Coast Mortgage Company ' 4797 Business Park Boulovard 99503 I ~abbit C~k R~ad 57C~ T~der ~,~at the pro~ed loc~tio~ of ~ ~tilttie~ ~m this pa~l Y gol~ Strl~klan~, I/4 ro © E ,ck ~ "p. / I/£ lock~ ~ NC )ck -/5 / N O0° 04' July 8, 1974 State of Alaska Department of Highways 5700 Tudor Road Anchorage, Alaska 9950? SUBJECT; Project Q~-0504 (4), Rabbit'Creek Road '.~ :, 7'---..f-~...i-..- Dear Mr, This letter is to reiterate our recent conversatio~in regar8s tothe relocation of an individual ~ater and sewer system on the sub~ect project.'!]:..''' ' -:- One of your f~eld personnel discussed this problem with me on July 2, 197~ '-' .... regarding t~is possible relocation prior to the highw~ department'S -'-'-'_:'. 'i ' reconstruction of the Rabbit Creek Road ~rojecto - · - .... ~--.."-.."-].:'-. ~'. A~ this time we wish to advise you that ~ the maps and the projectplans presen'~ed to Us and from ~ field inspection made approximately, three weeks _-.' i"/ . ago, it appears tl~at there should be no difficul~ in the proposed location - of both utilities on this parcel of land. ' ''.. .. ' ]".,"i~ .... Should you need 'Further information or additional assistance in'this ma~ter, please contact the undersigned. Rolr~- o~rickland, R.S. Chief Sanitarian lw