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Home My WebLink AboutCHANDELLE ACRES LT 8i~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION ~ 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LE~L~SCRIPTtON t LOCATION NO. OF ~OOMS ~ DISTA~CETO: I~ LO0 ' IAbsOrptiOn~rea ~ ~ ManufactureG ~~ MaterB~ C No. of com~m:nts Liq. c~p~ gallons IF HOMEMADE: Inside length Width Liquid depth ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O Z < Manufacturer Material Liquid capacity in gallons ~ Well ~ ~ Foundation~, ~eares[ Iot~ ~ DISTANCE TO: Length of~e Total ,e~p~lines Trench ~g Distance b~f~et 7 ~ ~ ~ Top of tile to finish grade Materiai beneath tile area ken,th ~idth Depth P~MIT ~O. ~ ~ Tgpe of crib Crib Oiameter Crib dopth Total effective absorption area m Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS so, AP~ DATE LEGAL 72-013 (RI ~/78) RETURN TO: Division of Geological and G --',yslcal Surveys (DGGS) "- 3001 Porcupine Dr)ye ~Telt e: 277-6615} Anchorage, AJaska ~95Oi WATER WELL RECORD Drilling Company Name ~w~&gnuBon Dri~in~ U.S.G.S. Local )lo. Drllllng Permtt No. STATE OF ALASILA DEPARTHENT OF NATURAL RESOURCES LOCATION OF WELL 1 Please complete either la, lb, or lc. M.~.~. Range Met id la. Borough Subdivision Lot Block lb. Fraction Section No. Township Anc~ C~a~delle ~ ~ / y N/S E~ 1~ Distance and DireA~ef~Om Road ,nter~ectlons ~. 0~ 0~ ~. Jerry Bl~omfiel~ ~ ~803 Whi~e Birch Dr. Street Address and Area of Welt ~ocatlon Anchorage, Z. WELL LOG Feet BeJ~ 4. WELL DEPTH: (completed) Surface Elevation Date of Materlal Type Top BOttom O~eea~toae, some wate~ 2[O ~8 6. USE: ~Do~stiC ~Public Supply ~ Industry ) ~ 7. CASING: ~ Threaded ~Welded ~ ),.~ ; ..... in. tO ft. Depth _(. ,,, 8. FINISH OF WELL: ,.?, ~" Type: O~e~ HO~ Blaster: . ~ r ~ ~ i ~ ~ 5lot/Mesh Size: Length: ~ Fittings: ~. STATIC ~ATER LEVEL: ft. ~A~ve ~8elow land surface Type of Heasur~nt: [ I0. PUHPING LEVEL below land surface ft. after hrs. pumping g.p.m. ~ ft. after ~ hrs. pumping ~ g.p.m. I I. ~ELL H~D COMPLETION: ~ In Approved Pit ~Pltiess Adapter ~ inches a~ve grade 12. GROUTING: ~el) Grouted: ~ Yes Material: ~Neat Ce~nt ~ Other: 13. PUHP: (If available) HP Length of Drop Pipe 336 ft. Type: ~ ~ub~rslbte ~ Eec~proca~ lng ~ Jet ~ Other: Water Temperature: ~5. WATER WELL ~ONTRACTOR'5 CERTIFICATION: Th~s we~] wa5 dri~ed under my jur;sd~c~on a~d th~s re~rt is ~rue to the best oF my knowledge and belieF: ~ 5~85 -- jeg~st~r~BU~ N~ ~ Contract License Number Add res s: - A~tg~r ized--Representat lv~ Form 02-~R Copy Distribution: WHITE - S~ate DGGS, PiNK - Driller, CANARY - Customer PERMIT NO. r~LINIC:I~='RLITY OF R[-4CF ~RRGE DEPARTMENT HEALTH AND ENVIRONMENTAL p~OTECTION 825 'L' STREET, ANCHORAGE, AK. 99501 264-4720 ON--SITE SEFJER PER[4IT APPLICANT LOCATION LEGAL A&B EXC. INC. L8 CHRNDELL ACRES 2702 GAMBELL ST 9950~ LOT SIZE 2?9-0574 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS SOIL RATING <SQ FT?BR>= 295 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: [:,EPTH= ii LEI'-,IGTH= 76 GRRVEL [~EPTH= THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. 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 OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). REC-~U I RED SEPT I r_'_: TRNK _'5 I ZE= :1.000 GRLL'_-~NS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. TL~O (2) I [~SPECTI~][~S RRE RE~2UIRED 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 DISPOSRL SYSTEM IS 100 FEET FOR R PRIVATE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTRNCE FROM R PRIVRTE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND TO R COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MRY RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE RVRILRBLE TO INSURE PROPER INSTRLLRTION. PERM I T E;-,'P I RES DEC:EI'IBER 31.. :.1_982 I CERTIFY THAT i: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF RNCHORRGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 5 6 7 8 9 SLOPE It' SITE PLAN 10 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? 14 15 16 17 18 19 0 P E Gross Net Depth to Net Reading Date Time Time Water Drop 20 f ~ (minutes/inch) PERCOLATION RATE TEST RUN BE WEEN t~. FT AND Z FT COMMENTS /~-/'~.~ ~ ze~ ~'/?~~ ' ~_ ~ ~/ PERFORMED'Y: ¢,'~ .~ 4~e~n CERTIFIED~Y:~IJ "*TE: 72-008 (6/79) MUNICLPALITY OF ANCHORAGE DMSION OF ENVIRONMENTAL ~r~ALTH DEPARIHENT OF HEALTH A~D ENVIRONMENTAL PROTECTION A~PLICATION FOR ~F.~J~TH A~THORII"f APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Descriptio~ (incl~d%~ot, b,%ock, subdivision, section, township, range) Location (address or directions) Applicants Addresg~/Z AO ~{! ~ Telephone - Home Bus ines s (c) Applicant _is (check one) Lending Institution ~-~ ; O~er/builder ~7~ ; uyer Other Address (e) Real Estate Co. & Agent Address (f) Telephone the RAA to the follour~ ~g address: 2. Type of Residence Single-Family~ Number of Bedrooms Multi-Family ~--~ Other (describe) 3. Water Supply Individual Well~ Communlty~--~ Publl¢~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite .? Public ~--~ Community I I Holding Tank ~-~ / Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] 5. En~ineerin~ Firm Providin~. Inspections~ Tests~ File Search~ Data ar~ Informa~iom As certified by my seal affixed hereto ad as of the validation date shown below, ! verify that my investigation of this Health Authority Approval shows that :he on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms a~d type of structure indicated herein.- I further verify that, based on the information obtained from the M~nicipality of Anchorage files and from my investigation and inspection, the om-site water supply amd/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm Telephone Date Approved for .-~ bedrooms ~~/ ~/./~ te Approved Disapproved Co~ttion~~ Te~s of ion~ Approv~ CAUTION T~E MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORIT~f APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESEMT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE D~EP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS · OR OMISSIONS LN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/e~/D18 [Page 2 of 2] 7-19-84 A® Well Classif icatiojt Well Log P~esen~N~ Total Depth ~~ Cased to Static Water Level _~ ~ ~_ Casing Height Above Ground ~--~" Electrical Wiring in Condui~/~ Separation Distanaes from Well: To Septic/Holding Tank on Lot /d~D ~ To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line /~ /~ MUNICIPALITY OF ANCHORAGE HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Legal Description MUNICIPALITY OF ANCHORAGE (MOA) DEPT. OF HEALTH & ENVIRON/'/,ENTAL PROTECTION JAN 6 I985 If A, B, ar C, D.E.C. Approved(Y/N) Date Completed ~d'~ ~ ~-- Yield ~/O ' Depth of Grouting. ~ Pump Set At Sanitary Seal on CasingS) Depression Around Wellhead (¥~ ; On Adjoining Lots /~ ~- ; On Adjoining Lots /~gO To Nearest Public Sewer Cleancut/Manhole ~J j ~,~ TO Nearest Sewer Service Line on LOt ~- ~ Water Sample Collected By ~.¢~ ~.~//~F~'/~/~; Date /////~ Water Sample Test Results ..'(~--I I J' ,,~ .~c '~'~..--,; Comments B. SEPTIC/~TANK DATA Date Installed 7/~A t._ Size /~ dC) Standpipes ~) Air-tight Caps (Y~) Depression over Tank ~f~ Date Last Pumped Pumping/Maintenanoe Contract on File (y~/16~-- Holding Tank High-Wate~ Alarm (Y~/~ No. of C~%~artments 2 Foundation Cleanout (~/~ ; for ----- Temporary Holding Tank Permit (Y/~//~ Separation Distances frcm Septic/~-~ank: To Water-Supply Well //6 To Property Line ~ ~ To Water _Main/Service Line Course To Building Foundation To Disposal Field To Stream, Pond, Lake, ar ~ajor Drainage Conl~ents Receipt # Date Paid: xmou t: [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~/~ Width of Field Square Feet of AbsorptionArea/~)~ Depression over Field (Y~y Date of Last Adequacy Test Results of Last Adequacy Test Separation Distance frcm Absorption Field: To Water-Supply %~11 /O~ ~ Type of System Design //~i~'/ Length of Field ~ / Gravel ~d ~ickness ~ ~ /' Stan~i~s ~esent ~) To Building Foundation ~ Lot /~ ~.~ ~ ; On Adjoining Lots To Water Main/Service nine / ~ ~ To Cutbank(if present) To Stream/Pond/Lake/or Majo~ Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Existing or Abandoned System cn Comnents ~ ~-~ D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Din~nsions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. ~ee ts 5~DA Con~Nents ** Check Permitted Bedroc~ Rating ~z3ainst HAA Request I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect _ on the date ~ Signed ~.- ~t" Ri~P. AlP, SKIt. '~57F Date ' ~ .... -."~.. '"'"-"""'"* "'"'" - - Company MOA No. ~ '~,q ~R~-,.~J?,.o - '.'~.. KB1 ldn/s '~:]-. Ho. 1,~7-~ ..' ~.~.~ .. .. [Page 2 of 2] 2-15-84 APPLI(-NT FILLS OUT UPPER HAt 'ONLY Phone Property O'~ner Address Zip Code Lending Institution ~(.~ ~ ~_~ Phone Address F~~/~,~ ~ ~Z~U~O~ Zip Code Realty Co. & A~nt Phone Address Zip Code Legal Descript~n ~ ~ ~~-~ ~~ Street Locati~ Type of Resi~nce ~ Single Family ~ Multiple Family No. of Bedroo~ ~ Other Water Supply Individual ~ ~ c ~ ~ - A~ACH WELL LOG. A wall log is required for all wells drilled since June 1975. Community~[ ~ ~ For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility ~ ~ Sewer Disposal ~ndividual ~ ~ ~o~ ~ Year IndivMual Installed: / ~ ~ ~ Public ~ility LL,~%~ Ot-~-~ When Connected to Public Utility: ~ ~- ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date D,~.e Date Inspector Inspector Inspector Inspector Field Notes: LJ, J~0 '--~-----'~ '~- ~ MUNICIPALITY OF ANCHORAGE "¢~' "'~ · 2 1982 ,' .z, RECEIVED, ( ) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAPPROVED Soils Rating Date Sewer Installed Well To Absorption Area / ~ ('-~ Well Log Received /~ ~ ~ C'~ _. (~) '~.-- Well to Tank Septic Tank Size 72-023 (3182) January 6, 19~3 Jerry Bloomfield P.O. Box 4-1138 Anchorage, AK 99509 Subject: Lot 8 Chan~elle Acres Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: The top of the well casing should be sealed so that it is water tight. Exposed electrical wires to the ~;ell head are in violation of the Municipality of Anchorage codes and must be encased in conduit. The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. The depression over tile sewer system will need to be filled so that surface water drains away from the sewer system. The standpipe to the se~;er system need caps on them. Please notify this Department for a reinspection %.~hen the noted discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. Sincerely, Jim S Roberts ~.~ssociate ~nvironmental 5pecialist~.~