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HomeMy WebLinkAboutEKLUTNA HGTS STEWART ADDN LT 12Add,:- MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONIVIENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL iNSPECTION REPORT PHONE MAILING ADDRESS LEGAL DESCRIPTION NO. OF BEDROOMS LOCATIO~ ~ ~~ I DISTANCE TO: Well _v I- Z Manufacturer ~ ~ Liq, capacity in gallons I /~O<~ ,t- .u,v,~,w/~u=: DISTANCE TO=IWe" ~0 __~ ~ Manufacturer ~Z J DISTANCE TO: J _u.~ J No. ofhnes J Length of each hne J I ~ ~ J Top of tile to finish grade ~ Length Width <~ I- I Type of crib Crib diameter ~x' DISTANCE TO: Well ~ Class Depth "~ I DISTANCE TO Building foundation Abs or pti o~,~a r/ea i Dwelling,/,~. 1 Material Width PERMIT NO. No. of comp~tments Inside length Liquid depth Dwelling PERMIT NO. F ou ndation,~) ~ Total length of lines Material beneath tile Depth Crib depth Building foundation Driller Sewer line OTHER PIPE MATERIALS ~ ~,(~, ~~ /;~ SOIL TEST RATING INSTALLER REMARKS Material JNearest lot line i Trench wid(~,~ inches Liquid capacity in gallons A PPRy/ DATE LEGAL inches :~) /~'T7 PERMIT NO; PERMIT NO. Total effective~absorption area Total effective absorption area Nearest lot line Distance to lot line PERMIT NO. Sept c tank Absorpt on area(s) 72-013 (R~{~v. 3~78) DRILLING, INC. ' ~'qN CIPALITY C? ~-hrCHORA©E FNVIR©N i'. CJ ON Well Owner Walt Kurka DRILLING LOG RECEIVED _Use of Well,D°m' Location (address of: Township, Range, Section, if known; or distance mare road_ Lot 12 Eklutna Heights, Anchorage Size of casing_ 6" Static water level Screen ( .Depth of Hole 205 feet Casedto 133.2 feet 105 ft. :l~:~:e) (below) land surface. Finish of well (check one) open end ( xx ); Perforated ( xx )' Describe ~perforation ~ 10 shot perfs 129'-131' Well pumping test at 3 gallons per ~c) (minute) for__ 1 hours with of drawdown from static level. ); Dat6 of completion 10/19/78 100% f~.x WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 0 TO 2 2 TO 3 __3 TO 42 42 ~TO 54 54 .TO 73 73 .TO. 85 85 .TO. 100 200 TO 104 104 TO 120 128 131 TO 205 TO TO TO TO Casing stickup Organics Silty gravel & cobbles Silty gravel Gravelly hard pan Wet gravel Silty gravel Damp silty gravel Gravelly hard pan W~ar gr~vo] - 1 gpm Bedrock, greenstone: water seaps in sporadic fractures throughout PERMIT NO. DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 "L' STREET, ANCHORAGE, AK. 9950t 264-4720 L-I~-]--S I I"E S';E[.~ER PERr"I I 'T APPLICANT LOCATION LEGAL KURK8 ALASKAN BUILDERS PETERS CRK Ll2 EKLUTNA HTS PO BOX 2~4 LOT SIZE 694 ~493 8400 SQUARE F'EET TYPE OF SOIL RBSORBTION SYSTEM IS: TRENCH MAXIMUM NUIdBER OF BEDROOMS SOIL RATING (SQ FT?BR)= THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: [::. [--Z F' T H = :_1_ Fi-'-'4 L E I'-,I G T F-t = 5:-~---. GRR%.'EL [:,EP'FH: e] "rHE LENGTH DIMENSION IS THE LENGTH <IN FEET) OF THE TRENCH OR DRR!NFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL. PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). F-:E~-~LI I RE[:, SEF'I' I C: PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY FIND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS i00 FEET FOR R PRIVATE WELL~ OR i50 TO 200 FEET FROM 8 PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELl .... WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DRYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERr.1 I T E.~-=.'P I F.:ES [:,ECEt-lBEF~' ~11... I CERTIFV THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNIC:IPALITY OF ANCHORAGE. 2: I WILL INSTALl_ THE SYSTEM IN ACCORDANCE WITH THE CODES. 2:: I UNDERSTAND THAT THE~-SITE SEWER S'T'STEM MAY RE.F..!UIF.;E ENLARGEMENT IF THE RESIDENCE IS'~~2HRN ~ BE~~ DROC, MS. S I GNED: ..... .... -~~~-~~-----~- RP~~{LIR. K~RSKRN~ ~ E:UILDERS INC '~~/~ ~_~4 5 8 ~_~10 11 ,, 12 ~5 16 O ~' E GEO. ~:CHNICAL ~ DEVEL~,PMENT Russell Oyster 694-2774 Soils ~ Foundations Performed for: Legal Description: ~/~ iX, Name: ~/~ Hat 11ng Address: Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 SOIL LOG //r'r~.,4-.-¢t~/'//~ /'~/Z/.~'/'ZJ /~, Tel. No. Earl Ellis 688-2280 Land Development Depth (feet) So11 Characteristics Ground Water Encountered: Yes~ Proposed Installation: Seepage Pit Comments: No ~ If yes, what depth Drain Field Performed by: Date: ~ Telephone 264-4720 A...OVA --"~NICIPALITY O~: ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT · C: DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECT r~' , ' ' 825 L Street - Anchorage, Alaska 99501 ENV,RO.MENTAL ENG,NEER,NG D,V,S,ON 'O C 2 DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10} days for processing. 1. PROPERTY OWNER J PHONE Walter J. Kurka J 694-3493 MAILING ADDRESS Post Office Box 214 99577 PROPERTY RESIDENT (if different from above) PHONE 2. BUYER PHONE Dale/Cindy Knipfer MAI LING ADDRESS 3, LENDING INSTITUTION I PHONE State of Alaska Veteran's Administration J 275-7555 99503 JPHONE 694-9555 MAILINGADDRESS 907 West Northern Lights Boulevard 4. REALTOR/AGENT Virginia Kohfield % Area Realtors MAILING ADDRESS Post Office Box 249 99577 I I ; h~ ,c)n't 5. LEGAL DESCRIPTION Lot 12 Eklutna Heights Steward Addition Subdivision STREET LOCATI ON Meet Virginia at the property. 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [] Four [] Other~ ~: SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ~ Three [] Six 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTI LITY * 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.) 8. SEWAGE DISPOSAL SYSTEM ~X INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY **If individual/on-site, give installation date 1 9 7 8 ,. If system is over two (2) years old an adequacy test is required by this Department, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) Need engineer report - Virginia will get O & E to get it in here. THIS SIDE FOR OFFICIAL USE ONLY ' DATE RE(~EIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE ' INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE I-1 OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [] Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL ' 4, DISTANOESwELL TO: Septic/Holding Tank IAbsorption Area JSewer Line [ Ne~irest Lot Line Absorption Area to neeFest Lot Line ; · COMMENTS · ''APPROVEDFOR "3 BEDROOMS [] CONDITIONAL APPROVAL {letter must accompany certificate} [] DISAPPROVED BY ITi~, LEGAL ~E~CRiP~Ti~ON~ 72-010 (Rev, 3/78) REALTORS® o REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES Type of Inspection: CMRO Property Owner: Mailing Address: J~ zZ~y ..~/~/ ~/~ /~,~,~, Name of Buyer: VA FHA Mailing Address: '4. Name of Lending Institution: Mailing Address: . ~ 5. Name of Realtor or Agent: Mailing Address: ~.~ CONV A/ Day Phone ~V- ~ ~'?~. Day Phone e Legal Description: _~-,,'¢"~/~ ~z///~ Location: /~ ~m~Y ¢¢"~', 7. Type of Facility to be inspected: 8. Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility ~ If Individual, date of installation: Individual (on-site) ~N' ,.. REALTOR® AREA, INC. REALTORS [~ Anchorage "C" St. Office 3300 C Street I9Q7) East Anchorage [] Eagle River Eastgate Office Parkgate Office 5437 E. Northern Lights P.O. Box 249 (907) 278-2525 (907) 094-9555