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HomeMy WebLinkAboutPROSPECT HEIGHTS BLK 2 LT 130.-15 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: _______________ Date of Issue: ____-____-____ Parcel Identification Number: ____-____-____ Legal Description Block Lot Property Owner Name & Address: Pump Installation Date: _____-_____-_____ Pump Intake Depth Below Top of Well Casing: __________ feet Pump Manufacturer’s Name: ___________________________ Pump Model: _____________________________________ Pump Size: ____________hp Pitless Adapter Burial Depth: _________ feet Pitless Adapter Manufacturer’s Name: _________________________ Pitless Adapter Installer: ____________________________ Well Disinfected Upon Completion? XX Yes No Method of Disinfection: _____________________________ Comments: Pump Installer Name: __________________________________ Company: ___________________________________________ Mailing Address: ______________________________________ City: ___________________ State: __________Zip: _________ Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation.  MUNICIPALITY OF ANCHORAGE i · 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 NAME rUP RADE LO°AT,ON Absorotion area D~ellin~ ~IT ~0. ISTANCE TO' ] ~ ~ Manufacturer ~ ~ No. compartments Liq. capac~t~n ~allons Inside length Width Liquid~epth / ~ 0 ' IF HOMEMADE: ~ , ~ ~ ~ DISTANCE T~/ /~ ~ PERMIT NO. O~ Man ~ ~ ~ ~ -- ~ ~ / Liquid capacity in gallons ~ Well Foundation Nearest lot line PERMIT NO. ~ ~ DISTANCE TO: ~_ No. of ]ineso~ ~ Length of eac~ , Total leng~f~e,, Trench width~,~ Distance between~ ~lines ~ ~ ~ Top of tile to finish grade / Material beneath tile~b~°~t ~ Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ DISTANCE TO: Well Building foundation Nearest lot line ~ ~ ~~ Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER SOl L TEST RATING ~ ~ ~ ~[ ~ , APPROVED /~ DATE LEGAL PE~.M I T NO. APPLICANT C A SMITH 68±0 HYATT DR. LOCATION PROSPECT DR. LEGAL LT l~ BLK. 2 PROSPECT HTS. S/D LOT SIZE TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (SQ FT/'BR)= THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: /_/... ¢.rJb _-2.:44_64._~. 6 90440 S..]L ARE FEET 170 [:,EF' T~-~= 12 L E~-.~ ~_3T H = 4 ":-~- t3 F-: R'-.." E L [:,EPTH= ;-" THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTFtNCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE E',:'CCB'./ATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRBVEL 8ETWEEN THE OUTFBLL PIPE BND THE BOTTOM OF THE EXC8VBTION (IN FEET). PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTRLLRTION INSPECTIONS OF' RN'¢ WELLS RDJRCENT TO THIS PROPERTS' ~ND THE NUMBER OF RESIDENCES THRT THE WELL WILL SERVE. BBCKFILLING OF BNM SMSTEM WITHOUT FINBL INSPECTION BND BPPROVRL BM THIS [:,EPRRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETWEEN R WELL RND RN'T' ON-SITE SEWRGE [:,I$PO$RL SYSTEM IS !88 FEET F JRt ' R F'RIVRTE WELL ]R 158 TO - ~:8 FEET FROM R PUBLIC WELL DEPEN[:,ING IIPC~N_ - THE TYPE OF FLBLIg.' I ' "WELL. MINIMUM DISTRNCE F~_ff'l" R F'RIVRTE WELL TO R F'RIVRTE SEWER LINE IS~'>~._, FEET RNC, TO R COMMUNITY SEWER LINE I$ 75 FEET. OTHER REQLIIREMENTS MRY RPPLY. SPECIFII]:RTIONS RND CONSTRLICTION [:,IRGRRM$ RRE A ~' J - " ': ' ' '1'1 ' ,~tILHBLE TO IN_URE FR_PER INSTRLLRTION. F"E~.] Z T E::-::P ~ RES g"E~E:E~-]BE~: I CERTIF'¢ TFIAT t: I BM FFIMILIBR WITH THE REQUIREMENTS FOR ON-SITE SEWERS BND WELLS BS SET FORTH BY THE MUNICIF'BLIT'¢ OFH~gL. HUR~UE.-'~ -'-~ 2: I FJILL INSTBLL THE SMSTEM IN HCCORDBNCE WITH THE CODED. g: I UNDERST8ND THBT THE ON-SITE SE~4ER Sb%TEM M~Y REQUIRE ENLARGEMENT IF THE RESI[:'ENC~EMO[:,ELED TO INCLUE~E MORE THBN 4 BEDROOMS. -- ' --- PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13- 14- 15 16 17 18 ~9 *."49! 2O COMMENTS g SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 99502 276-222~ SOILS LOG- PERCOLATION TEST [] PERCOLATION TEST )ATE"ERFORMED: 8/Z3 LoT 13. 1'SLocw.. OL. WAS GROUND WATER ~'"~ J'~ ~?'~ I'~ N C O U NT E R E D 7 DEPTH? IF YES, AT WHAT SLOPE SITE PLAN 2225-E 25. 1971 Gross Net Depth to Net Reading Date Time Time Water Drop N RATE (minutes/inch) TEST RUN BETWEEN FT AND ~ FT PERFORMED BY: T~, S r~L,,tit~l/C.~..J~J'~j ~ I CERTIFIED BY: 72-008 (7/76) · " INSPECTION APPOINTMENTS D~'~E RE0kEIVED MUNICIPALITY OF ANCHORAGE ) DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION JUL ~ 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 - " REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete aH parts on page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing. 1.~PERTYOWNER ~ PHONE MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 3, LE~DING I~STITUTIOB , 4, REALTOR/AGEnT PHONE 5. LEGAL DESCRIPTION STREET LOCATION ~ /' ' , 6. TYPE OF RESIliENCE ~" NUMBER OF,,BEDROOMS ~ SINGLE FAMILY ~ One ~ Four ~ Two ~ Five ~ MULTIPLE FAMILY ~ Three ~ Six 7. WATER SUPPLY [] Other INDIVIDUAL* COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM *ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) ,~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY ,YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUSTACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS /~ SINGLE FAMILY [] ONE (~J THREE (~] FIVE [~] OTHER MULTIPLE FAMILY [] TWO ~ FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY  INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTI LI'TY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED [--1PUBLIC UTILITY Connection Verified INSTALLER I~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 ~APPROV ED FOR ~(~ BEDROOMS ~'ONDITIONAL APPROVAL {letter must acc~y ~ DISAPPROVED 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 ~ ~¢-~ GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION July 17, 1980 Estate of Allen/Connie Thompson % Larry Eaton Polar Realty 1101 East 76th Avenue #B Anchorage, Alaska 99502 Subject: Lot 13 Block 2 Prospect Heights Subdivision Approval for your individual sewer and water facilities can not be granted until the following items have been completed: (2) (3) (4) The water facilities were not turned on for this department to obtain a water sample for analysis Please re-schedule an appointment with this department for us to take the sample. Expose the well for our inspection to determine proper construction, also to insure the minimum distance requirements are met between your well and sewer system. Locate and expose the standpipes to the seepage pit and septic tank for our inspection. A four(4) inch cast iron cleanout needs to be installed in the septic tank and seepage pit area. The distance requirements between the well and the seepage pit area is 10.0 feet and 50 feet between the well and septic tank. Larry Eaton July 17, 1980 Page Two If the distance requirement can not be met, the sewer system will need to be upgraded. Prior to any upgrade a soils test will need to be performed so that a permit may be issued. If the sewer system can meet the distance requirements, the following will be needed: (1) The sepbic tank pumped with a receipt submitted to this department. The total ~umber of gallons pumped need to be on the receipt to verify the size of the tank. This will need to be verified by a registered engineer. (2) An adequacy test be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this department for our review. If there are any further questions, please call this department at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: First National Bank of Anchorage % Una Mo Bennett Southcenter Branch Post Office Box 4-2090 99509 · , ~/' Department of Environmental Quality '-' " ~ 3500 Tudor ~oad, Anchorage· Alaska 99507 279-8686 ] R~QU~ST FOR APPROVAL OF ~ I~IVIDUAL SidER & WAIiR FACILITIES FOR 2. Pro~erty ~ner: 5. Type of Facility ~o be Inspected: ~u~e~ o~ ~oo~,, .... : :~ Well Data: qfc A. Type B. c. construcUon ~./~' D. Depth, Bacterial Analysis 7. Sewage Disoosal System: A. Installed C. Septic Tank: 1, Size D. Seepage Pit: 1. Size Disposal Field: 8. Installer ~. ~aterial...'_~/~ Total Length of Lines Distances: Septic rank~/~ A. Well To: , Absorption Area/~ ! , Nearest Lot Line /~ , Other Contamination Bo Foundation to Septic. Tank c>Q ~ "~, Ab§°rption Area C. Absorption Area to Mearest Lot Line ~ · Sewer Lines ' R--est.fore~u Aporoval of ;~" ~' · ' ividual Sewer & Water Factlitie Page Two 9.'i Comr.~ents: Ap~roved~~'~Disapproved Date Approval Valid for One Year From Date Signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities located at: -59© 25 ' 50' 10" E .... Z 280,00 0[- --~ S 59© 25' 10" E