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Home My WebLink AboutHOPP LT 4 opp ol4- o 11 "/.I ooo, PERMIT NO. APPL I CANT LOCRT I ON L. EGAL DEPI=IRTMENT 0F HEFILTH AND ENVIRONMENTAL Pt.::CiTECTION 825 "L" STREET, RNCHORRGE., 264...-47:.~8 [--~ EE L_ L F' ( 788629 ) BERNARD HOPP TONDI LN L. 4 HOPP 6858 'FONDI L. RNE LOT SIZE 3:44 5:!.:12 12593: :E. QURRE FEE]" MINIMUM DISTFINCE BETWEEN 8 WELL AND ANY ON-SITE SEWAGE DISPOSAL. SYS'T'EM IS t£10 FEET FOR R PRI',,,'FITE WELL.~ OR 15E~ TO 20El FEET FROM 8 PIJBLIC WELL DEPENDING UPON THE T'¢PE OF PUBLIC WELL. HELL LOGS ARE REQUIRED AND MUST BE RETURNED TO TNE DEPFIRTMENT WITHIN 3:0 DA"r'S OF THE WELL COMPLETION. OTHER REQLIIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIFIGRRMS FIRE AVRI. LRBLE TO INSURE PROPER INSTALLATION. F' E F'~ J"'l Z T' E ::-:: F' I F;-: E2 S [:, E C: E i'-1 E: E FE: ]:-]: :~_ .. :~_ Sa 7' I CERTIFY THAT i: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH Ok' THE MUNiCIPRLIT'¢ OF ANCHORAGE. 2: I WILL INSTF4LL TNE S'¢ST~M IN ACCORDANCE WITH THE CODES. .. ...... Y]:. 2 December 29, 1978 ~780629 Bernard Hopp 6850 Tondi Lane Anchorage, Alaska 99507 Subject~ Lot 4 Hopp Subdivision 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, Les N. Buchholz, R.S. Senior Environmental Specialist LNB/ljw eno: copy of permit : ,~ W A T E R W E L L LOCATION OF ~JELL I Subu [,~ [ ~iol~ Lo~"-'l~ Iock Frac~ ion STAPLE OR i, RECORD Drilling Permit Number OWNER Section No, Town N/S R'nge E/~ OWNER OF WELL: STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES Street Address and Area of Well Location Z WELL LOG ' Material Ty~e Bottom Address: WELL DEPTH: (completed} Surface Elevation Date of Completion E~ Rotary E~ Driven 13 SANITARY: Nearest Source of Well disinfected upon completion ~es ~'lNo F"~Jet 16WATER WELL CONTRACTOR'S CERTIFICATION: Length of Drop Pipe ?~ft. capacity Type: ~rslble E~Other: EReclprocatn9 This well was drilled under my jurl)dj, ctlon and this report Is true to the best of my knowledge and belief: Registet~d Business Nam"~'' U--e ~ ' Contract LI s u . Autho~'ized P..presentati~ 7 CASING: E~Threaded ~ded Height: E~Above E~Below ln. to ft. Depth weight /~ .lbs/ft. FINISH OF WELL: Slot/Mesh Size Set between ft. and Fi:tings: STATIC WATER LEVEL: Type df Measure~nt lO PUMPING LEVEL below land surface ft. after hrs. pumping g.p.m. [~in Approved PIt~L~Pitiess A~apter F~12" At~¥e Grade 12 GROUTING: Well Grouted: F--lYes Nateriat: E~fleat Cement E]Other: PUMP: (If available) 7Z- ~ g.p.m. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1. GENERAL INFORMATION (a) (b) (c) (d) (e) Location (address or directions) Applicant Name A~,;~'~ Telephope: Home Business Applicant Address x-',-?~,4'~ ¢.~ Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other ¢~' (explain); .. [_ending Institution ~._~/- ?'~,,/Z,44.,-~ Telephone Address ~~ z ~ _ Real Estate Company and Agent ~/~.g~' Telephone ' ~ ~ ~-- ~ ~ (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-F~mily,j~ Multi-Family [] Number of Bedrooms ,-~ Other WATER SUPPLY Individual Well,¢~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite [] Pubtic~' Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & $ ENGINEERING Telephone SRB 196X Address Date EAGLE RIVER, AK 99577 IAY 21 1986 DHEP APPROVAL Approved for~''~,e~ ~ bedrooms by Approved X~ Disapproved lerms of Conditional Approval Conditional CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. WELL DATA Well Classification Well Log Present~YN) Total Depth Static Water Level MUNICIPALITY OF ANCHORAGE (MOA) MUNICIPALITY OF _A.b/,[:HDJ~,(~E, ........ DEPT. OF HL~,','~-~I'&~R-'~u'nunHT APPROVAL (HAA) ENVIRONMENTAL PROT~KLIST- FEBRUARY 1984 264-4720 MAY 2 2 1986 Legal Description: ~ R ECEIVED /-'~'~¢' If A, B, C, D.E.C. Approved (Y/N) Date Completed ///~ /~:) ' r7 Cased to 't~ ' Depth of Grouting ~r Pump Set At ~'~,T::~ Casing Height Above Ground Electrical Wiring in Conduit ~N) Separation Distances from Well: To ~ank on Lot To Nearest Edge of Absorption Field on Lot Sanitary Seal on Casing~D~/N) Depression Around Wellhead (Y~ ; On Adjoining Lots ~1/~ ; On Adjoining Lots To Nearest Public Sewer Line cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments ~"/'/~/-~ ¢" '¢ SEPTIC/HOLDINO TANK To Nearest Public Sewer To Nearest Sewer Service Line on Lot ~/,4' Date Installed Standpipes (Y/N) Air-tight Caps (Y/N) Depression over Tank (Y/N) , / Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service Line Course Size No. of Compartments Foundation Cleanout (Y/N) Date Last Pumped ; for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Page 1 of 2 C. ABSORPTION FIELD DATA r Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design Length of Field Depth of Field Gravel Bed Thickness /, Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions /)n hole/Access (Y/N) "Pump Off" Level at Vent (Y/N) . Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed S & S ENGINEERING Date SR B 196X ,o^,o. Receipt No. ,,-4 Date of Payment Amount: Page 2 of 2 72-026 (11/84) : ' APPLIC IT FILLS ouT UppER H 4L ONLY Phone RealJy Co. & Agen~ '"~. Phone Address Zip Code Type o~ ~es~nce Single Family Multiple Family No. of Bedrooms ~_D ~ Other Water Supply ~ tndividual:~ A~ACH WELL LOG, A well log is required for all wells drilled since June 1975, Co~munit~ For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility ~ ~<:.~ ~ 74 Sewer Disposa~ ~ Individual Year Individual Installed: ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Date Date Dates Inspector Inspector Field Notes: Inspe~or Time Inspector ( ' ) APPROVED BEDROOMS :,2} DISAPPROVED ) CONDITIONAL APPJ~J3~/~L* *CONDITIONS OF APPROVAL Soils Rating Date Sewer Installed Well To Absorption Area Well to Tank Well Log Received Septic Tank Size August 15~ 1983 Bernard P. and Mabel E. ~lopp 6850 Tondi Lane Anchorage, AK 99507 Subject: Lot 4 Hopp Subdivision Approval for the individual sewer and water facilities cannot be granted until the following item, s have been completed: ~ Exposed electrical ~ires to the well head are in violation of the Municipality of Anchorage codes and must be encased in conduit. Please notify this Department for a reinspection when the noted discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. Sincerely~ ~(obert C. Pratt Associate ~nvlronmental Specialist RP29/p/E