HomeMy WebLinkAboutEKLUTNA HGTS STEWART ADDN LT 16 Eklutna Heights
(Stuart Addition)
Lot 16
#051-063-33
Rug 24 89 lO:OOa JERRY LERCH
To: DHHS Date: 24 Aug 1999
We hereby notify DH/IS as required by permit of the intent to terralfft the
following property.
Lot: 16
Block:
Subdivision: Eklutna Heights Subdivison
Address: Peters Creek
RECEIVED
AUG 2.4 1999
Murdmpality ot Anchorage
Oept. Health & Human Services
Engineer Consulted:
IGND
Yes X
No
Jerry Leach
Alaska Drainficld Restoration
President
GRL.,FR ANCHORAGE AREA BOR,,. IGM
Department of Environmental Quality
3330 ¢ Street
Anchorage, Alaska gg503
II~SPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME
'LOCATION
MAILING
LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE q~ i ~ ~1~
FROM WeLl MANUFACTURER
INSIDE LENGTH "~'~ INSIDE WIDTH '"'-"-'
NUMBER Of
MATERIAL p_~_/w~-~ ~ COMPARTMENTS /
LIQUID DEPTH ~ LIQUID CAPACITY/~. GALLONS.
t:L.'- DRAIN FIELD:
DISTANCE FROM WELL ~,1~ / FOUNDATION
! TOTAL LENGTH ~>,~5 '
NEAREST LOT LINE .J~'-' OF LINES
NUMBER OF LINES / DISTANCE BETWEEN LINES
ABSORPTION AREA '4~)~) SQ. FT. LENGTH OF EACH LINE c~;~-/
. ~ DEPTH OF FILTER
DEPTH: TOP OF TILE TO FINISH GRADE ~---~'~ ~ MATERIAL BENEATH TILE__O~
TRENCH WIDTH ::~ IN. TOTAL EFFECTIVE
.'d"l~. ABOVE TILE IN.
WELL:
TYPE
BUILDING NEAREST
FOUNDATION__ LOT LINE__,
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED
' 4
{~l.C.IJJ '~1 ~ bi I/CONST RUCTION
NEAREST
SEWER LINE__
DEPTH
SEPTIC SEEPAGE
TANK.__, SYSTEM
REMARKS
DISTANCE FROM:
DISTANCES:
INSTALLED BY:
SEWER LINE DEPTH:
pipe
LOT SLOPE:
REMARKS:
Form EQ-032
DIAGRAM Of SYSTEM
(~/ G~-A.A.B. ' ' -
CFIL. V I N
L.:I.E; IEI<I_.LITtqR I."iE I Gl-ITS SUE:C,
:;t..8E'~2 CL. EVELF:Ii'.,ID ,l~;;;i'. I:tNCHOF;i:I:;IGEE 99
t_CrT' SI2~.E 84E~EJ ':'i;I]:il...ll:tl:;.':Ei: F:EE:T
'T'"r'F:'E Eft:' SO :1: L. Rt!.:.'v.:iiORErT' I ON S"r'STEM I S: 'T'REtqC:H
i'"IFI;,':;:[MI_IM I",II...IME3ER OF' E3E[:,I:;::OOM2:.; = ].']:
SOIL RR'T'ING ,::S(;! F'T',..'BR) .... ::I..]~:E[
TtqlE I:;¥E(;:!U I RED S I ZE O1:: THE SO I L FIE:SOI:~'.I:'T I ON S"r"-=.;TEEM I S:
'THli:.'] LENGTH [:, I ME:N:~:; I CpI",I I S THE LENGTH ,:.' I N FEET ::, OF THE TRENCH OR [:,l:r.':R I NF' I EL.[:,.
THE [::,EF"']"I'"I OF I:::1 TRENCi4 OR F'IT I':.'; ]"HE D ISTRI'.,ICE Ei:ETWEEN THE: '.:~;IJI~:I::'F:ICE (.')F' THE
GROLti'.,I[:, FII'.,ID 'T'HE BOTTOM OF THE Ei:.-';CRVRTIOI",I (:IN FEET).
THERE: :['.!ii; NO SE-F FII[)'T'H FOR ]"REI'.dE:HES.
THE GRF:t',,,'EL. E:,E'F'TH tS TPIE MII'.,IIMUM DEPTH OF' GRFIVEL BETklEEN THE OUTI:::'RLL.. F;:'tPE
FIN[:, THE E:OTTOI"I OF THE EXCR',,,'RTi'ON (IN FEET).
E:I:::tC:I<F' :i: LL ]: NG OF Rl",l"r' S"r'STEM W I THCILIT F I I",IRL INSPECT I ON Ffl",ID RI:::'F'RO'v'I:::IL BY 'TH I :ii;
[:,IEF'F:IF?.TMEIq]" ,WIL. L BE SIJI.:.3J'ECT ]'O PROSEC:IJ]"TON.
MINIMUM [:,I'.:;i;"FRt",IE:E E::ETklEEI",I I::1 I.,.IELL RN[.':' RN"r' ON-?T, ITE '_=.;E!.4F:IGE D ISPOSRL :E;"r'S'T'E:M :[:5
:i.I;i!u;:!~ FIEIET FOR FI F':'RIVRTE 14EI_L. OR 2CIO FEET F'OR FI PUBLIC kiEl J_.
'.:!i;I:::'IEC I F' I oR"ri ON:E; RN[:, COI'.,I:E;TRUCTI ON [:, I RGRI::tMS RRE R',,,'R I [..F:IE~L..E TO I NSI..IRI!~: F:'REd::'E'I:;~:
I i'.,I:STF!L..L RTI ON.
I CE:RTIF'.¢ 't"HRT
::1..: I I:::1i"I F:Ri'"tlL. IFIR klI"FH THE REQUIREi"IEEN]"S FOR OI'.,I-SITE SEt.,.IERS RI'.,I[;, I.,.IE:I_.I._S Fl:f::; :.7.'i;E'1"
I:::'C[F.':TH B'¢ THE MLIi'.,I I C I F'RL Z 'T¥ OF F:Ii'.,ICHORRI]iE.
2: :[ I.,.IIL.I.. INSTFILL THE S"r".:".;]"EM IN RCCOF.'.[:'I:INE:E WITH THE' CODES.
::ii:: I IjI",iDER'.STI::tI"4I} THRT THE ON-SITE SEt.,.1ER S"r'STEM MI::I'?' RE6:!LIIRE ENI_FIRC'~EMENT ZF'" THE:
RIE:::'i; I [:,ENCE I :::.:; RIEI"IODE.'LED '['O Z NCLUDE MORE THFIN ]: BE'DROOMS.
t:;IF'PI.... I C:FII'.,IT I]:RL'v'I N DtR',,,'EL
....................
~-IIJ[~l I C: I P.I~L I '-r".' ~':.~F' RNCH(~,~'3E
DEPRRTMENT 0~ HERLTH RND ENVIRONMENI"RL F X!TECTION
:L~ 0 SQFT
LOT S I ~E ..... r'-
MINIMUM DISTRN.,E FROM WELL TO ~NM SEPTIC T~NK,.-'P~CK~QE PLRNT OR ~OIL ~B~O~PTION
SYSTEM IS 200 FT FGR A PRIVRTEWELL AND 200 FT FOR R PUBLIC WELL.
WELL LOGS MUST BE RETURNED TO THE DEPARTMENT WITHIN 3~ D8¥S OF THE WELL
COMPLET I ON.
SPECIFICATIONS AND CONSTRLICTION [:,IRGRRMS RRE AVAILABLE TO INSURE PROPER
I NSTRLLRT I ON.
I CERTIFY THAT I AM F'RMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEI4ERS RND WELLS
8S SETFORTH BY THE MUNICIPALITY OF RNCHORRGE RND WILL INSTRLL IN 8CCORDRNCE
~,~ MUNICIPALITY OF ANCHORAGE
Departm~ of Health and Environmental ~cection
SOILS LOG
PERCOLATION TEST
Performed for Calvin Dauel Date Performed 7/21/76
Legal Description Lot 16, Eklutna Heights Subdivision
10
14
16
18
2O
(See back for test hole location)
Red-brown, sandy silt w/Qrganics (ML) perC rate.= 275 ft~Z/barm.
Gray sandy well-graded ~ravel with some silt (GW)
' Perc rate = 85 ft.~/bdrm.
Gray, sandy well-graded gravel with fairly high
silt content (GW-GM)
Perc rate estimated = 130 ft.2/bdrm-
Gray, sandy well-graded gravel (GW) with
trace silt
Per~ rate = 85 ft.2/bdrm.
Total Depth = 18 feet.
No water table encountered.
AVERAGE PERC RATE FROM SOILS LOG = 118 ft.2/bdrm.
Date Net Time Depth Net Drop
7/21/76 -0- 5.0 in. -D-
7/21/76 2 min 7.5 in. .2.5 in.
7/21/76 13 min. 12.5 in. 7.5 in.
7/21/76 27 min. 13.5 in. 8.5 in
Percolation Rate 3 minutes/inch = 70 ft.2/bdrm.
Performed By ~--~6~~ ~ NORTHWEST EXPLORATION SERVICES, INC..
'o
~ 0 ~ ,,jo
MUNICIPALITY Of ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
i. ~ i~':i~ ',:i APPROVAL FOR A SINGLE FAMILY DWEL~-IN(~ .' 'i:i;.::,:'~. ~,ii :~.i:,~:i~i.i:.: :.
1. ~ GENERAL INFORMATION '
Complete legal 'description
Location (site address or directions) ct'~l ~--'~ ~r~l~(~'O~'~
Pr,operty owner
Mai'ling address
Day phone
Lending agency
Mailing address
Day phone.
Address
'~..Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.... ·
\
TYPE OF wASTEwATER DISPOSAL: ~/~
NOTE:
Individual on-site .
Holding tank
Community on-site
Public sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-O25(Rev. 1/91) F~ont MOA#21
o
STATEMENT OF INSPECTION BY ENGINEER
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 application shows that the On-site Water supply
and/or wastewater disposal system s safe, funct onal and adequate ~or th~ numbe_r 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 ~y investigation and inspection, the on-site water
ordnances and regulat OhS n effect on the date of :this inspection..,- .... h "-' ~:~ ....... ¢ "' ;'
Name of Firm .......... Pfione - . ....
' . 20441 Ptarmi)gan Blvd, Eagle R~'er, AK 995~.7..~ . ~--. c: .~-:- 7:" '
Address ............ t ' --
DHHS,SIGNATURE ,:..'. -'" ' ' -i: - ~" ~'
X Approved for 3 bedrooms. :'? **' ' ' '
-'- _..-_;~: . :
Disap. proved.' .......
Cond tonal approval for bedrooms, with the ~ollo_wir'~_g. st!_p..u_!ati0ns:
Additional Comments
By:
The Munic pa .:ty of~ Anchorage Department of Heath and .Humpn:Services (DHHS) ssqes Hea!:t~h..~,Nth0fitY
Approval Certificates'based only uPon the r~presentations given in paragraPh 5 above bY an indepefident
professiona eng neet registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their Fending institutions in order to satisfy c~rtain federal and state requirements. Employees of DHHS 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 engineeffs work.
MUnicipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SER~'~.~.~,%~
Environmental Services Division
825 L Street, Room 502 · Anchorage, Alaska 99501 · (907)
Health Authority Approval Checklist
Legal Description:
Parcel I.D.:
A. WELL DATA
We, pe
Log present (Y/N)
Total depth //(~,,'~ /
Sanitary seal (Y/N)
IfA, B, or C, attach ADEC letter. ADEC water system number
Date completed ~b//~'~
Cased to /Z./~ / Casing height (above ground)
Wires properly protected (Y/N)
Date of test
Static water level
Well production
FROM WELL LOG
~,O ' g.p.m.
AT INSPECTION
/
WATER SAMPLE RESULTS:
Coliform
Date of. sample: ~//'~/9~
SEPTIC/HOLDING TANK DATA
Date installed ~Tb~/~'~ Tanksize
Foundation cleanout (Y/N)
Nitrate ~_~, ~'
Collected by:
Date of pumping
/OO~ZZ) Number of Compartments __
Depression (Y/N) cA/
~//~/~ Pumper
Other bacteria
J Cleanouts (Y/N) .
High water alarm (Y/N) ,/~/,/~
ABSORPTION FIELD DATA
Dateinstal!ed. 7~3-~//~ Soil rating (g.p.d./fFo~
Length ~,~-' / Width ~ ~ /' Gravel thickness below pipe
EffectiVe absorption area Y~ Monitoring Tube present (Y/N) Y
Date of adequacy test ~///'~,/~.~.~ Results (Pass/Fail) Y
Fluid depth in absorption field before test (in.); /r~//
Fluid depth ~' (ins) Minutes later:
~ treatment (past 12 months) (Y/N)
/:~0 System type ~ 7 ~j~n C~
~ / Total depth /~) /
· Depression over field (Y/N) /(//
For ,-~ bedrooms
Immediately after z//5'~ gal. water added (in.):
Absorption rate = z~/~~) -~ g.p.d.
If yes, give date
/ '/
72-026 (Rev. 3/96)*
D. LIFT STATION
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Cycles tested ~
SEPARATION DISTANCES
Size in gallons ~
"Pump on" level at* ,_~'~'""~"Pump off" level at*
SEPARATION DISTANCES FROM WELLON LOT TO: ~ ~~,'vr'~'' /~Z~/E/
Septic/holding tank on lot _~ ~ I ~y- On adjacent lots
~,~ ~ '~ On adjacent lots
Public sewer main ~)~) ~ -h Public sewer manhole/cleanout
Sewer/septic service line ~ /~ Lift station /~)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation /(~) ~ ~' Property line /~ /'~' Absorption field
Absorption field on lot
Water main/service line
I
/ D -+
~'~ Surface water/drainage //')/~ '''~ Wells on adjacent lots /0~ '~'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: .
Property line ~ Building foundation /~) t...~ Water main/service line r~,~/-~
Surface water / ~) ~ / ''/ Driveway, parking/vehicle storage area
Curtain drain /~) I./ Wells on adjacent lots /~2 ~)
F. ENGINEER'S CERTIFICATION
I certify that I have determined thru field inspections
in conformance with MOA HAA guidelines in effect on this date.
Signatur~~
Engineers Name
Date
HAA Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
,SEP-15-99 11:$$ ~ROM-CTE ENVIRONMENTAL 5515301 T-9T1 P.02/05 F-344
. CT&E
Environmental Semites Inc,
CT&E
Client Name
Ordered B~
PWSID
S~mpl¢ Remarks:
994221001
liND Ealiu~riug
L16 Ell. HT.
L16 ~. HT.
Client ~
l~nted ]~.te/Time 08120/~ 12:03
Col]~ed ~a{ePfime 08/16/~ 19:00
Reee{ved ~teYTJme ' 08/17/99 16;35
Technical l~'e~or: Stephen C, Ede
PqL
Un{ts
N{trate-N
0 Got/1OO.~ ~18 ¢ge2B 08/17/~ JOT
6.~8 0.500 ~l/L EPA SOO.0 10 max 08/17/99 08/17/99scc
Rick Mystrom.
Mayor
Municipality of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
http://www.ci.anchorage.ak.us
December 27, 1999
Kenneth Duffus
KND Engineering
20441 Ptarmigan Blvd.
Eagle River, AK 99577
Subject:
Waiver Request for Eklutna Heights, Stewart Addition, Lot 16
Waiver Request #WR990100
Parcel ID #051-063-33
HA990465
Dear Mr. Duffus:
Your request for a waiver of the required 100 feet horizontal separation from the
on-site wastewater disposal system to private well has been approved. The approved
separation distances from the private well to the septic tank and absorption field are 78
feet and 86 feet respectively.
This waiver approval applies to the existing on-site wastewater disposal system to
private well separation only. Any future upgrade to the on-site wastewater disposal
system will require all separation distances be met or another approval from this
department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-4744.
Sincerely,
Daniel J. Roth
Civil Engineer
On-Site Water Quality Program
~J J~ l V ~ R R E t~ U £ $1" Y O R O I~ - / o T W ~ L L TO S ff P T' / c 7'R /v,~ R /V O h ~$ O /~ /V'/~
FIELD OF 7~ ~BNO ~ /~£~r R£$PffCTIv£1. Y .
THE
~o
7.1
1.8
, ~ X
78 .. .---_~
2,0
2./
I~,~-
~D ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907)696-6111/FAX (907)696-8111
October 10, 1999
Municipality of Anchorage
Dept. of Health & Human Services
On-Site Services Section
P. O. Box 196650
Anchorage, Alaska 99519-6650
REF: Lot 16, Eklutna Heights, Stewart Addition Well to Septic Tank/Field Waiver
Request
Dear Mr. Jeff Poet:
On August 16, 1999, we performed a well flow and adequacy test on systems serving
the subject lot. Both systems were found entirely adequate and paper work was
submitted for a Health Authority Certificate. An existing waiver was granted in 1976
for the separation distances. Based on your review of the submitted information it is
our understanding that the Department is requesting the owners to provide
supporting documentation for the previously granted waiver in 1976. In addition to
our field check the property was surveyed on August 14, 1999, a copy of which is
included for your reference. Based on this investigation the surveyor has measured
the separation distance between the well and tire tank as 79.5 feet. Therefore, the
septic tank was less than 100 feet from the well.
From records in your files, it was determined that the original was well drilled and
documented on late 1975 early 1976 and that the septic tank was installed in July
1976 to serve this residence. Subsequently a permit and inspection report was
completed by the MOA dated 7/28/76 for this lot; the MOA provided information
indicating that proper separation did not exist and that a waiver was granted.
Based on the field check and the subsequent survey we did find that the tank
appeared to be approximately 79.5' from the well. Assuming that the end of the tank
is approximately 1.5' closer to the well, the septic tank is 78' from the well. We are
therefore requesting a waiver of 86' for the field and 78' for the tank.
The well log indicates the presence of silty gravel in the first 20 feet, then clay for the
next 16 feet and clay, silt and gravel for the rest of the way till it hits bed rock at 149'.
The well depth is at 188 feet. Our nitrate sample yielded a reading of 6.38 mg/liter.
REF:
Lot 16, Eklutna Heights, Stewart Addition Well to Septic Tank/Field Waiver Request
November 10, 1999
Page 2 of 2
The sewer system lies on the northwestern portion of the lot and is separated from
the well by the house foundation. From the septic tank the lot begins to slope gently
to the east, away from the well and dwelling. Bedrock was encountered at 149' and
static water was encountered at 132' from TOC.
In compIiance with 18 AAC 80.020 and 18 AAC 72.021(a), I have addressed geological
conditions for this request and have assigned the following number values:
Distance from sewage system bottom to groundwater
Soil sorbtion below the sewage system
Soil permeability below the system
Water table gradient
Horizontal separation
7.12
3.50
2.00
0.00
2.12
TOTAL: 14.74
Based on these values we believe that they provide supporting documentation for
issuance of the previously granted waiver. Additional mitigating factors that
support issuance of the permit is the house is situated between the well and septic
system and the use of the well is for the individual house. Although there are above
normal readings of nitrates there was no bacteria or coliform in the samples taken,
therefore the potential for bacteriological pollution is not likely per the ADEC's
separation distance waiver guidelines.
Your prompt attention to this request is appreciated and if you have any questions,
please contact me at 696-6111.
Respectfully submitted,
~' Duffus, PE
Enclosures: Certificate of Health Authority Approval
Health Authority Approval Checklist
As-Built Survey
Water Test Results
MND ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907) 696-6111/FAX (907) 696-8111
December 6, 1999
Municipality of Anchorage
Dept. of Health & Human Services
On-Site Services Section
P. O. Box 196650
Anchorage, Alaska 99519-6650
RE: LOT 16, EKLUTNA HEIGHTS STEWART ADDN.
Dear Mr. Dan Roth:
Per your request of November 23, 1999; we are submitting the available data of past
nitrates, well logs and a site plan with well locations for the above referenced
property.
If you have any questions, please contact me at 696-6111/FAX 696-8111.
Respectfully submitted,
~ Ix~1]~ Engineering
Brent M. Western
Attachments:
Well Locations Site Plan
Well Logs
Water Analysis Nitrates
A.~BUILT
I. HEREBY CERT!~.~.,TH~'[. l 'HAVE SURVEYED .~HE l.t GALE,
?OLLOW~N~ D~S~:~.~D~'"pROpERT~.~-' .:. y y.-:- [..
~.~ T NO ~CH~N;S: ZX~ST ~CE~ As....'m..~
INDIOA~D.. T -t8::THE~ES~NSIBILITY'OF;T~E
OWN~:~ D~ER~INE ~HE:'EXISTENCEjOF-:ANY. RJD~
~EMENTS, COVENANTS, OR 'RESTRICTIONS-.'.:
WHICH DO NOT ~PEAR ~N THE RE~D~
VISION PLAT. UNDERNO CIRCUMSTANCES S~
~Y DATA H~EON'BE'USED, FOR CONSTRUCTION
OF FENCE LINES, OR FOE EST~LiSHIN~'~ND;'
ARY LINES.
.... SE"WARD & ASSOCIATES l~l~,,? SURVEYING 694-0~}29~.
~e// Waiver ~i~;e P/c~n
Eklu~cn,a Heights S~ew~r~ ~dd,, Lo~ 16
~ 2
~ OF ~¢~ PREPARE~ FOR,
~*~'" ~ '"'~ J' 21639 MATTSaN ScaLe: 1"= 100'
CHUGIAK,
~567
~ ........ ~ ........... ~ ................'~ (206)706-7059
PAGE 1
~ouxo~r: SEWARD ~: B~W
........ "~ ~ ~SBU,LT: SEWARD
~~ NW ~ 4~0
ACAOr'LE:ggos&DWg dOBNo.: gg056 (gO~)Sgs--8111/~ (go?)sgs--8111
z'~zI
· - Mai
1 ' ' t ~ ~,I ~.,~?.-..,,,._~,.,,,,,,~..~? /_..
,, .... z .-':'1
,- · ::.>
. ,,/;~,.. ~ ' '., t IZ5~ ]-'""~' /
~;""-s~'~'~'~ {"'" I" .' .. -"
0 .TO. 2
I 3 .TO 7
· ?_TO 32L
37 TO 50
50 TO 80
8q TO
~][ .TO 118
33~_To .
120 TO 140
140 TO_ 143
143 TO_ ~4~
~t _'[4~.~ ~l 'I WELL LO<) '
Give details of formations penetrated, size of material, color
Uater ~rave!
'~-W DRILLING, INC.
DRILLING LOG
Well Owner Walt Kurka UseofWell Do~I.
Location (address of: Township, Range, Section, if kmown; or distanc~ main road
Lot I1 Eklutna Heights Subdivision 5~£~,1~ /~Carl~
Size of casing 6" Depth of Hole
Static water level 100 ft. (g~vv~)
Screen ( ); Perforated (
Describe screen or perforation
Well pumping test at 1-~ gallons per ('F~-~: (minute) for
of drawdown from s~atic level
Date o! completion 6/26/7~
204 feet Casedto--136-5 teet
(below) land surface. Finish of well (cheek one) open end ( XX );
).
~/^
1 hour~ with
WELL tOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
0 TO 2 Casing stickup
2 .TO 4 Organics
4 .TO. 25
25 .TO. 40
40 TO. 57
__.TO. 75
__.TO 85
TO 95
__.TO 100
___TO 128
TO 192
TO 136
,TO 204
__.TO
__.TO
57
75
85
95
100
128
136
Silty loose ~ravel
S~Hdy gravel
Sandy gravel~ rnhbly
Gravelly hard pan
Sandy Kravel
Silty cobbles
Loose gravel
Silty hard p~n
Hard pan
CUSTOMER