HomeMy WebLinkAboutEAGLES NEST BLK 1 LT 2
MUNICIPALITY OF ANCHORAGE
/ · DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
I
ENVIRONMENTAL ENGINEERING DIVISION
/ 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME IPHONE .~'~'EW
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION // NO. OF BEDROOMS
DISTANCE TO:
No, of compartments
Well Dwelling PERMIT NO.
TO:
~ Well Foundation
~ N°' of 'i~s__ Length ofe~h lin~ Total length of line~ Trench width Distance between lines
Length Wid Depth PERMIT NO.
Type of crib Crib diameter Crib depth Total effective absorption area
~ DISTANCE TO:
Class Depth Driller Distance to lot line PERMIT NO,
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
PIPE MATERIALS OTHER
REMARKS
72q313 (Rev. 3/78)
PERFORMEF,, F~
LEGAl
1
2
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15
FEET)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
r-] PERCOLATION
TEST , I I ~_~
DATE PERFORME_'/ ~,'_ V~ - C, ._/7 ,, i~'
,,
SiTE PLAN
WAS GROUND WATER /, I S
ENCOUNTERED? /L -' L
O
P
E
IF YES, AT WHAT
DEPTH?
[
Reading Cate Gross Net Depth to Net
Time Time W~ler Crop
PERCOLATION RATE / "~ ~' Iminutes/inch)
TEST RUN BETWEEN FT AND --. FT
PERFORMED BY: c,~-I 1),~'7~' ,.,
CERTIFIED BY:
i -1 iD i'-,l I "-: I Ft L I T ",r" "--,~ F- F-I !'-,,I "]: i- .,~ F-: Fi '"-~ E
DEPARTHENT : HEALTH AND ENVIRONHENTAL ROTECTION
:5:--'5 "L"' STREET., ANCHORAGE, AK. 99501
264-4720
i.4Ebb F'EF-:i"i i f
PERMtT NO. ( 8].0557 )
JOSEPH L. KUNES BOX 177 HIGHLAND DRIVE.., E.R. 694-D6D0
LOT 2 BLK & EAGLENEST SUB LOT SIZE DDgDD¢ SOUARE FEET
APPLICANT
LOCATION
LEGAL
i'iINIHUM DISTANCE BET~4EEN 8 WELL AND AN'¢ ON-SITE SEWAGE DISPOSAL S'¢STEM IS
i00 FEET FOR A PR I ',,,'ATE WELL OR i50 TO 200 FEET FROM 8 PUBLIC ~4ELL DEPENDING
UPON THE T'¢PE OF PUBLIC: WELL.
MINIHUI'! [.,iST8NCE FROId A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNIT'¢ SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE [:,EPRRTMENT WITHIN ]:0
OF THE WELL COMPLETION.
OTHER F.:EQUIREMENTS MA'¢ APPL'¢. SPECIFICATIONS AN[:' CONSTRUCTION [:,IAGRAMS ARE
AVRILAE:LE TO INSURE PROF'ER INSTALLATION.
F'EF-:I'-I I T E:=-=:F' I E:ES [:,FE:EI"'IBEF-: ---=: :_t. .. :.1..'_-}- :--:--'<
i CERTIFY THAT
±: i AM FAMiLiAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS 8ND WELLS AS SET
FORTH B9 THE blLINICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE S~STEH IN ACCORDANCE WITH THE CODES.
SIGNED:
APPLICANT JOSEPH L. KUNES
V4. 0
SULLIVAN WATER WELLS
P. O. BOX 272, CHUGIAK, ALASKA 09567 · TELEPHONE 688-2759
OWNER OF LAN. '~/E /.<'u~/~.~"
ADDRESS EO~ ' / 7 7 ~/~ ~'t,V,,*O ,9~ Z; ~'
LEGALDF~RIPTION ~ ]' /oT" ~ '~',,~9~4J' /z,/~'~'~'~''
DATE-Started ~ 7//~' Ended
PERMIT NUMBER
l
DEPTH OF WELL O~ 0 0
STATIC LEVEL OF WATER FT.
DRAW DOWN FT.
GALS. PER HR /6~ 4)
KIND OF CASING
/'7
KIND OF FORMATION:
From ~ Ft. to
From ,~ Ft. to ~P' ,
from ~P
From ''~ 0
FromtrC'Y' Ft. to ~J~-_~ Ft.
From ~ 3 Ft. to / ~,~Ft.
From] ~' Ft. to
Fromm. Ft. to
From /~f~ Ft. to.
From Ft. to Ft.
From__ Ft. to Ft
From Ft. to Ft._
From Ft. to~Ft
From Ft. to~Ft
From Ft. to____Ft.
From Ft. to Ft._
From Ft. to Ft._
· Ft. 00CC'~. 4~O~'~'~,~ From__
, Ft. ~ ~~ From~
_ Ft, to ~0, Ft. ~ ~~ From~
Ft. to ~ ~ Ft. ~ [c From ~
~~ I~~ From ~
~ ~ ~ ~rom
From__
From ~
From
From
From
From
From__
From
From
.Ft. to__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.
.Ft. to Ft
Ft. to___Ft
Ft. to Ft
Ft. to Ft.
Ft. to Ft.
.Ft. to Ft.
, Ft. to Ft.
Ft. to Ft.
MISCL. INFORMATION:
DRILLER'S NAME ~'~ ~
APPLI( NT FILLS OUT UPPER HA! ONLY
Property Owner -- ", - '~
Mailing Addre~ ~' ~ . ~,~ _~ ._~ ~( ~ ~ ~ -~ ~ . ~.,. ~ ~ Zip Code -;'~i ~; ", ~
Buyer
Address 7~ .'- ~ ~ ~ ~ c -_ . ~-~ ~-~ ~ ~ Zip Code
Lending Institution [~ :¢ .~ ~ ~ ~ ~ ~ %~ ~_ ~_. ~ (. ,_~_ ~ ~ ... ~_~ Phone
Address '~'~ t~ ~: ~ ~' ~ ~ ~% ~ ~ .~._~:~ , r ~ Zip Code
Realty Co. & A~nt Phone
Address ~ ~ Zip Code
Type of Resi~nce
~le Family ~
~ Multiple Family No. of Bedroo~ ~
~ Other
Water
Supply
~ -- A~ACH WELL LOG. A wall Icg is required for all wells drilled since June 1975.
~ividual ~
~ Public Utility
Sewer Disposal
~vidual Year Indiv~ual Installed: ~ ~ ~ ~
~ Public ~ility When Connected to Public Utility: ~
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED.
Time Time Time Time
Date Date Date
Inspector Inspector Inspector Inspector
Field Notes: ~.~ ~ ~
~ ~ ~..O,,,~$,lj~ MLJNIC;!PAL~TY OF ANCHO~GE
['EPT. r~F Hz/.LTH
~ ~ ~ ENViRO~M:N]AL P~OTECTION
RECEIVED.
( ~ APPROVED BEDROOMS 'CONDITIONS OF APPROVAL
( ) DISAPPROVED
( ) CONDITIONAL APPROVAL*
Soils Rating Date ~wer Installed Well To Absorption Area / O ~ V~ ~ Well Log Received ~
/~ ~ - /~ . ~ ~ We, toTank /~'~ Septic T~k Size
72-023 (3182) ~ ~1~ J ~
CHEMIC/iL &
/ TELEPHONE (907) 562-2343 ANCHORAGE INDUSTRIAL CENTER '
5633 B Street
~ Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
WATER SYSTEM:
Water System Name
I.D. NO.
Phmle No.
Mailing Address
City State
Zip Code
SAMPLE 'I~'PE:
[] Routine
[] Check Sample (for routine sample
with lab ref. no.
E] Special Purpose
[] Treated Water
[3 Untreated Water
SAMPLE
NO.
4
Time
LOCATION CoIl~
, I
* I
TO BE COMPLETED BY LABORATORY
Analysis sh0~ this Water SAMPLE to be:
,[~-atisfactory
[] Unsatisfactory
[] SamDle too long in tranmt: sample should
not be over 48 hours old at examination
to ~nd~cate rehable results. Please send
new sample.
Date Received
Time Received
A~alytlcal Method:
[] Fermentation Tube
.~lembrane Filter
Lab Ref, No. Result* Analyst
I I-J-J
I J-T-J
I J-F"I
I I-I-i
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
h'mmptlve ZOml lOml lOml 1Omi lOmt 1,0mi O.lrnl
:onflrmatory
Membrane Filter: OIm~t Count Collform/lOOml
Final Membrane Filter R~ults I (~'~-~ " Collfotm/lOOml
Time. / p.m,
~Jecember 12, 19~
Ooseph L. and Kathleen D. Kune$
P. o. Box 772403
Eagle River, AK 99577
Subject: Lot 2, Block 1, Eagles Nest Subdivision
Approval for the individual sewer anG water facilities cannot
be ~ranted until the following items have been completeG:
o A well log suOmitted to this office for our files anG
review.
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,
CW71/ej/EI
Cory willis, R.S.
Acting Sewer & Water
Program Manager