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Home My WebLink AboutEAGLE RIVER HEIGHTS BLK 6 LT 29 WELL SITE AS-BUILT I hereby certify that I have su:'xeyed the fo]lowing Anchorage ~eeording Precinct, Alaska, aixd lhat the improvements siluated thereon are within the propcrl lines and do not overlap or encroach on the property lying adjacenl thereto, that no improvement~ <m prop- erty lying adjacent thereto encroach on the pre: :ises m questinn mid that thcwe are no roadways. lines or other visible easements on said property e,:cepl as indicated hereon. Dated at Ea~le Eiver, Alaska t~s re, , · day of ..... ~.t z.~ ~ !9 ROBERT C. JOtlNSON ,', · SCALE: , Registered Land Stlrveyo~' ~; ~3O-LS 1" :: ~,f Box 456, Ea~le River, Alaska Phone ~94-2543 t-ll_l[.t [ r: ! F'AL ! T'~ i-~F FI[~C:HC~E'RGE DEPARTMENT OF HEALTH AND EN'v'IRONMENTAL F'ROTECTION 25i0 E. F'EF.:M I T NO. (: 7'6_~4_~ .'., RF'PLICANT EAGLE RIVER HATS UTILIT. BOX 5'17 LOCATION COLVILLE & BRRRNOFF LEGAL L29 86 EAGLE RIVER HGTS _-,LIB[. LOT SIZE 160000 SO. LIARE FEEl" MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC: HELL. HELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F"EF~:t.1 I T ~..'I--IL I D, F'-,E: s--st4E 'T'ERR FE:C~FI I S_C.l_lE I CERTIFY' THAT i' I At'l FAMILIAR WITH THE REQ_IREMENTS FOR ON-SITE SEWERS AN[:, WELLS RS SET FORTH E:'¢ THE MUNICIPALITY' OF' ANCHORAGE. 2: I HILL INSTRLL THE S'¢STEM IN AC:CORE',RNCE WITH THE CODES. S I GNE[:,: ......... RFFLIL-:RNT EAGLE RIVER HGT~ UTILITIES ( erlifie Drilli g DRILLING COMPanY BOX 97, EAGLE RIVER, ALASKA 99577 · TELEPHONE694-2588 OWNER OF LAND , .,~ ,-. ~O ADDRESS ::~.?;~. /,,:,d:~/~ /-~6~7-,~ UTI<IT-1~ LEGAL DESCRIPTION z.~.~c/ ,/~L/,d (o ~g~ ~d~5~ /¥~7",~ $o~5~. DRAW DOWN FT. DATE-Started ~;/~5//>~ Ended GALS. PER HR PERMIT NUMBER -7'(0 5' ~'~?) KIND OF CASING ! DEPTH OF WELL STATIC LEVEL OF WATER FT. KIND OF FORMATION: From ': Ft. From ! ' Ft. From :; 2 Ft. From ·: Ft. From ~-',~ Ft. From ~' Ft. From 'P Ft. From .( Ft. From ~.,"? Ft. From ~ Ft. From' '( ~ Ft. From :~?i~Y: Ft. to . From Ft. to From : 7 Ft. to From :; ~' Ft. to From Ft. to From '~)~t~' Ft. to From /qi Ft. to [~7 Ft. ,~4.,~O¢ 6~',,~' ..... From____Ft. t9 Ft.,~"~'A,;z ,9~"no~' 7'~; : F~om /~7 Ft. to /,ff~ Ft. dCrS'~ to ~71 Ft..~/~,4ad ~' 6,4d~L g-oo~-~ From / to ~/~ Ft. ~ ~ V ~/~ ~h From Ft.~d ~ ~ W ~ ~ From~ /~$'~ Ft. f~ ~/~ ~ ~ From Ft. ~%~ ~ ~Orfgo~ From~ /(~/ Ft. ~/4~v~ C~aW~ From Ft. to O~d) Ft. __Ft. to__Ft Ft. to__Ft Ft. to Ft Ft. to Ft. Ft. to Ft Ft. to Ft Ft. to Ft. Ft. to Ft DRILLER'S NAME ADH-HSE-6-F1 (f) -- ~ ~ ~o-~5. ~ ~ Lab. No. ~ INDIVIDUAL ..WATER SUPPLY ~1, ,../ / (°/ '~'~ .~ Smlthasat,l~ I ALASKA DEPARTIWKNT OF HEALTH omccc Section of Sanitation and Engineering ACTION ON REQUEST FOR BACTERIOLOGICAL WATER ANALYSIS Your recent request for cm analysis of a sample o~,the Illlttvidu~l Private Water Supply serving ~? ~ was received, and examination has been completed. Records in this office indicate this Individual Private Water Supply to be of /~S~siactory Questlonable__.Unsatisfactory sanitary status. Analysis shows this SAMPLE to be Satisfactory. Questionable .Unsatlslactory. If an "Unsatisfactory" or "Questionable" status is indicated above, you should take immediate action as recommended below. 1. Boil or chemically treat your water supply to protect your fmnlly from water-borne diseases as outlined in en- closed leaflet, "Drink It Pure." 2. Improve your spring -- See bulletin HSE-$-2 3. Improve your cistern -- See bulletin HSE-$--~ 4, Improve your dug well- See bulletin HSE-6-4 5. Improve your driven well -- See bulletin HSE-6-5 6. Improve your drilled well- See bulletin HSE-6-6 7. Relocate your well to a safe location in relationship to your sewage disposal system -- See bulletin HSE-15 8. Bottle broken in transit, please send new sample. 9. Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample, 10. Contact your nearest [] Local Health Department or [] Alaska Health Department, Sanitation office for bulletins, consultation, and assistance. II. This is a surface water source and subiect to pollution by man and an~.mals. An approved water supply source should be developed, SANITARIAN'S REMARKS ADH--HSE~-Ft le) ' ,~i Thh Form Must Be Filled[ Out Completely, FA! WAqER SAMPLE TO: 1 ~1~,,....~, .~ ~ esaay, Wednesday Lab~:m~,, 945 Sixth Ave. ~~U~ ~tlon of ~flon ~d ~ee~g Request for Bacteriological Analysis / .__ · /) La,b. No ........:L2::...~.,Z:::.2 .............. Water sample collected by.....~..4~:{~.~...~..~....~..~.../..q-q.----~-'...-: ......................... ~..'-...-/J..~..../. ..... .-.~.-.~....~..'~7~ (Name of person collectln~ sample) U (Date) (Time) Water sample collected from [] Kitchen tap; [] Bathroom tap; [] Basement tap; .............. ......... ........ : ..... O~er Address premise where source is loca~ed.~&~..J3....'..~../_...;.~.../~.~-....~....~./.C...:.~/..t:.~f.f...//.~L.~..C.:(~...~f/C#L~.i~.{~'~ ~-~'~'- - -- ............................. ........ ................ (Name) (Nox No. or s reet dress) (Clty~ Please place an "X" in the box before items which best describe your water supply: SOURCE: Well -- [] Dug, [] Driven, ~[~ Drilled, [] Bored # [] Spring, [] Cistgrn, [] Other (list) ............................................................................................................... [] Creek, [] River, [] Lake, [] Pond ................................................................................................................. DUG WELL OR CISTERN CONSTRUCTION: Walis- [] Wood, [] Concrete, [] Metal, [] Tile, [] Brick or Concrete Block Top -- [] Wood, [] Concrete, [] Metal, [] Open Top LOCATION: [] In ba~'t)ent, [] BaSement offset, [] Under house, [] In yard Other ...~..~(,.?~ ~.......f~...(?...b(..~..~. ..................................................................................................................................~ -- ~...~.,.. DISTANCE TO: Building sewer or other drainage pipe...~,~...c.:..feet, Septic tank .,~..~:..o......feet, Tile field feet, Seepage pit ~.O..-c?......feet, Cesspool ~..~....O.... feet, Privy..o~....~.. feet. Other possible sources of contamination (list) ....... ~d~-Jl.£ ...................................................................................................................... MAT~IAL: Building sewer -- [] Cast iron, [] Wood, [] Tile, [] F~bre pipe,. [] Asbestos cement Joint material -- Type......'~.~..~.....~..~.....~..-..e...2~.......~.~...../~...~...C./...q.../..~:~..g ........................................................ GENERAL INFORMATION: Does water become muddy or discolored? [] yes, [~no When? ...................................................................................................................................................... ~lameter of well ............. ~--.'"~"' .................................. . dep~ ..... '/..?./-, ......................................... feet e~n~ mateml,5~.~.~:.L.~.,..~.....~-. .... mameter.....~-. ........... depm .................................. Well Length of drop pipe ................................................... ~,. ....................................................................... Water depth from bottom ............................ ~.~..' ..................................................................... feet Pump location: ~ In well, [] Offset in basement, [] In basement · [] In utility room, [] On top of well [] Other (listI ........................................................................................................ PURPOSE OF EXAMINATION: Illness suspected? [] yes, [] no New source of supply? ~yes, [] no , Repairs to .existing systam.~, [~ yes ~ no ~ · ' . ' '~ - .. e, !;. ' Remarks. ~.~-.~....~.~.~=.~-.~..~g".~.*~`~... .~...~.....~...~..~.-~.&..~"ez...~e...~.~.gs ............. PLEASE DRAW A SKETCH IN THE SPICE BELOW. THIS SKETCH SHOULII[ SHOW LOCATION OF I'1~,;' ~'A:&'r.~ - SUPPLY SOURCE, SEPTIC TANK, SEWER, DRAIN LINES OR OTI-~ .k'!R SOURCES OF POLLUTION AND DISTANCES BETWEEN WATER SUPPLY SOURCE AND ANY OF ABOVE FACTrwi'i.~So SAMPLES MUST BE SUBMITTED IN CONT~~ ~YIDED BI/'~'~1~ ALASKA DEpARTMENT OF HEAL'i'M