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HomeMy WebLinkAboutJOHN WELLS 1952 ADDITION BLK 2 LT 1/D Lo'l- HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 2/9-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: ~'t 1 /%?'f 7 __ADDRESS %~ 7~ / LEGAL DESCRIPTION DISTANCE FROM WELL_ LIQUID CAPACITY i GALLONS. NUMBER OF .MATERIAL ":-~TC~TZ~ COMPARTMENTS '~ INSIDE LENaTH INSIDE WIDTH ' DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF: PITS __ / LINING MATERIAL__ ~ ~: ~<~' NEAREST LOT LINE '~Z':; ~' OUTSIDE DIAMETER OR WIDTH DISTANCE FROM WELL /~ ~' ? TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) , LENGTH , DEPTH BUILDING FOUNDATION ':]- ~"'~ -/ SQ. FT. TILE DRAIN FIELD: TOTAL LENGTH DISTANCE. FROM WELL_ F,gUNDATION_ , NEAREST LOT LINE ~ OF LINES IN. TOTAL EFFECTIVE NUMBER ~F LINES__ DISTANCE BETWEEN LINES_ TRENCH WIDTH ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO ~ NISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: TYl~E..!./-//v'/g'~.~..:'f-,~ , DEPTH / ~'~'/' ' LOT LINE ' ~E~ ~ NEAREST -" SEPTIC · SEWER LINE ~d ",' TANK DISTANCE --ROM WATER ~: , ~ BL _DING FOUNDATION. '~(.' t t SAMPLE "t ~' ~ . NEAREST ~ ~_ ~ SEEPAGE /~:~. OTSER . · . SOURCES SYSTEM CESSPOOL DIAGRAM OF SYSTEM DISTANCES: 7/: _. ,>'~ · -'? ('~' ./~ ( - x¥f:>?'6' / ,'f " /2 DATE ",' ~ APPROVED AAB-HD"2 Case No., ? -~' '~ HEALTH DEPARTMENT Anchorage, Alaska 9950~ 279-2511 SEWAGE D~;P©SAL bt¥~¥E~'~ ~ APPMCA?[ON & P~:RM~T RESIDENCE ADDRESS ";_..~~ LOCATION OF INSTALLATION ~/(;,/-~";/=£-- '-/ u~ APPLICATION TO INSTALL: SEPTIC TANK ~' , SEEPAGE PIT. ,DRAIfi FIELD~ ,OTHER TO SERVE THE FOLLOWIN6 FACII_I'rY.~}~:'~ }~).~'-~~~ FI~ANCED'rHROUGH~d'2 ' TO BEI~STALLED BY PERCOLATION TEST RESULTS ..... ~~ .................. ANTICIPATED DATE OF COMPLETION ~ ~' BELOW! TO BE IqLLED OUT i~y HEALTH DEPARTMENT THIS IS TO SERVE AS / _/--" '/~;Y-;"~ '~ , PERMIT 'Fo INSTALL A ,-) L-- ~ _ _~ASDESCRIBED BELOW. SIZE OF UNITTO BESERVED~ '? '~ . ~z; Z~_ SEEPAGE AREA ~~TYPE SEPTIC TAN K SIZE ~:Zc: ~TYPE DIAGRAM OF SYSTEM L~ I certify that I am familiar with the rcqufl'cments of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. APPI.ICfk~TS SlGNATURE~~~ REQUEST FOR APPROVAL OF II~uiVIDUAL SEWAGE AND WATER FACILITateS (FiM out in Triplicate) l,~.ame of person requesting approval lb~mt,~r~. ,,~ b~d~'ooms in house Wat:~ Anal'~sis: b. Deter~ent r . 2. Septic tank 3. Seepage Ar e a__~¥;~ 5. Property Line Z ¢: ¢ 6. Other sources of possible contamination, i.e., creeks, lakes, houses, barn, drainage ditch, etc. Sewe~ge d~ sposa], system. Septic tank capacity in galiOT, S /. ~=%-, [. Z~ "home ~de" $how d~ o~ ~everse ~ide d.' Disposal field o~ seepage Z size and type 1, Distance to property 2in~ '~(' '-~ to house fotmdation f. Percolation Test performed by _~ Use the reverse ~slde of this form to show diagram. Diagram should include lhe foJl~ow.]n~ information: property lines ~ -well location, house loca'tion~ ~[~,~'lc tank l~ocation, disposal area location, location of percolation tes{ a~,d d~.ection of ground slope. 9. Tke ~.~,.,-t~,,-~t %<,r~ on this form ,is true and correct to the best of my knowledge, S!4nature of Applicant Date Signed The above described sanitary :facilities are disapproved for the following Approval is valid for one year following:,, the date of ~pproval. CPJ: cw (907) 243-2282 KEN JOHNSON WATER WELL DRILLING PUMP SALES & SERVICE 30 YEARS ALASKA DRILLING LESTER BROWN 8490 HARTZELL RO~ ANCHORAGE, ALASKA 9950? ( 344-2306 Res Lot 3 Blk. 1 John Wells Subd. WATER WELL LOG 3163 LINDEN DRIVE ANCHORAGE, ALASKA 99502 I~4ay 21, 198~ 0 ft to 4 ft 4 ft to ? ft ? ft to 9 ft 9 ft to 12 ft 12 ft to 14 ft 14 ft ~o 19 ft 19 ft to 35 ft 35 ft to 40 ft 40 £t to 56 ft 56 ft to 60 ft 60 ft to 6? ft 67 ft to 88 ft 88 ft to 99 ft 88 ft to I00 ft 100 ft to 102 ft 102 ft to 104 ft Brown silt..compact Loose sandy silt : Medium gravel & brown silt Course gravel & brown sil~ Boulder in M2o formation~ Ned gray & s&lty gray clay Course gray & gray silt Same., Weeps..8° ft head Same..dry.. Fine gray & dark gray silt Fine gray & Blk silty clay Sandy clay..weeps H2o Ned gray & dark gray silt..dry.. Fine dirty sand..H2o..20 ft head Same with some courser material Clean ~edo sand & gray .. Water bearing Static 45 ft. ..( 59 ft head ) TOg ) Total depth 104 ft ( TOg ) Total casing 104-1 Test bailed at 14 GPM with 30 ft. DRAWDOWN Good recovery & bottom stable bD° DF:PT. OF HL~LTH & 6k MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTI{  825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION 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) davs for processing. 1. PROPERTYOWNEI],~, ! ~ ,_, PHONE P~OPE~TY ~ESIDENT (If different from above~ PHONE PRONE ~G ADDRESS 3. LENDING INSTITUTION S J PHONE MAILING ADDRESS PHONE 4. REALTOR/AGENT MAILING ADDRESS 5. LEGAL DESCRIPTION 3 .'7''"'-' ' b 6. TYP~ OF ~ESIDENCE NUMBE~ OF BEDROOMS ~ One ~ Four ~ Other ~: SINGLE FAMILY ~ Two ~ Five ~ MULTIPLE FAMILY ~ Three ~ Six 7. WATER SUPPLY ' INDIVIDUAL* COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8, SEWAGE DISPOSAL SYSTEM **If individual/on-site, give installation date L~J IND)VlDUAL/ON-SITE*'×' If system is over two (2) years old an adequacy test is required I~ PUBLIC UTILITY by ~his Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, 72-010(3/78) Tills SlUE FOR OFFICIAL USE ONEY DArE RECEIVED INSPI~C rlQN APPOINTMEN'I S DATE [)ATE i N,';PI%; I 0N ' i~$P~OH -- -- ~1NSPECTOP~- I)llli (:'lIONS: 1. 'I'¥i)E O1:: hE,~II)i,I~CL. J I SINt;I.L! FAMII Y i i MtJl 'ilPi.i FAMILY 2. WA'Il'it{ gtlPPI Y [~1 INDIVII)UAI I I COMMUNI I'Y ] I PULqJC UTII I1Y Comxx:d.r~ Verified 3. SEWAGE I)ISPOSAL SYS1 EM [ IINI)IVII)UA[/()Iq SI IE [ IPtJBLIC UIII II'Y Connec[ion VrH'if~ud ~ ~Sepl:icTankm' [ ]HohlinflTank Size:. _ I f Tank is homemade flive dimm~si.ns: 4. DISTANCES WFll TQ' NUMBER OF BEDROOMS ONE ~q THREE [~J FIVE E~] OTHER TWO · I FOLJR F:] SiX PERMIT NUMBER I)EPrH OF WELL -DA-i:E D~R II_LED I.OG RECEIVED PEF~MIT NUMBER ~'A T~E D ~A LEE R SOILS RATING MANUFACTURER ' MA~RiA~ S,,I,tic/lloldin.qTmk [AbsorpdenAroa 5. COIVilVIE NTS 4~ ! APPHOVtiD FOH ' ~,~ BEDROOMS I I ¢;ONDITIONAL APPROVAL (letter must acuompany certificate) II I)ISAI'PROVI~I) -'---,--- d Z-fi-. S 72(}10 (I-lev. 3/'/i{)