HomeMy WebLinkAboutALYESKA BASIN #6 BLK 22 LT 16
Da'Lc I ssu(.~'.,;d ~ t2. / i 1/'89
Owner' Name: JAHES V
Own E,r' Acldr'ess:
D a y I:::' h (::1 r'l e ~
L,:::~'L S i z e '1.";'~,.,.': ........ 17 ( s q ,, f t' .... o r' a c r' e s .;
Hax Bed r, ooms ~ Th .i. s F:'er' m :L 'L: :7,!; "f'o'La 'J. Capar,,: :i.'L y: 3
I:::'E]::i'.Mt 't EXP I I:";,'IES '.Oi!i!Ji)E]'"IBIER 3 :t. , :t. 9Ei9 ,,
I/,JlEI....I .... i....OG )]L..IE: WI'I"HtN 'l"HIl::i f'Y (30~ DAYS F::'(]tL..L..I]W ING WEL..I .... COMF:'L.E:T ION,,
PUBL I E; SEWtii!]::~: CONIxEiiZ)T t l]l".l VER I t:::' ! tED BY iOl'"lH!ii~ :I. 2- 1:1.'""89 ~
f'c,r't..!"t by 'Lt"'~(~.~:, I"h..u"l:i.c:i. pal:i, ty c)f Anchcir'age (MOA) and 'l:..h,.~,.,: State of Alaska,,
2,, :[ L,.,~:i.].:l. :i. nsta'.l. 1 the sy'jliF(:.eilt :J.r] ac:coif'dance w:i.'t'..l"'~ .:.~:l.'.l. M!'.',)r::t ccx::lE:,s and
(~"~,:::i :i,n,.':::cm",p :L :i. ar",c::.:~.:, ,,,~i'l:.h the des:i, gn ct' :i. ter' :i.a of th is per'm:i.t,
3, ;1: w:i.!J. ,;,',',.dh,'.~:..~r'e 'E.o all MOA and S't:.a't'..(.:.t; c~f Alaska r'6:C:lU:i.~-~-~:mer~'l:..s for' the
d :i, !E.t,E'd']r.:]E:,S ~' r' om any ex :i. s'L :i. ng we ]. 1 :, was't'..ew,:,'.~,'t'..er' d :i. Sl;::,c:,sa]: !~iyfiFI. L(i.:~,fl'l or' pul::) .t. :L C
4, ;[ u.r",.d6?r'E,'iLar'ld tl"l,'~ 'l~.t"i:i. si!. pet"r~:J.'f.. :J.s val:i.d f'(:::,r' a rrh',i'¢-(:i.¢¥'~u,m c:~,f' :]; bedr'.cq::;,rrn'B,,
-:?:'~ ], %C) LtI"iC:IE:'I* .~.7t-,ar"~c~that the capac :i. t¥ o f' 'Lhe .t:.(:.~.I:..a ]. systerr~ :i. s ::'.!; I:)ed r' (:::,cm'~s and
,,'::', r", v e n :1. a r' ~::l '..::.:' m,:.:.:~, ¢,,., ~...:i: :1. 11. r' ,~.:.., ,.::l~i. r. ~..'.:, a n a cld :i. !:. :i. ~::) n ...',~',. 1 p e r' rr, :i. t ,,
..........
WATER WELL. RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geologicot ~ Geophysicol Surveys
Drilling Permit No.
LOCATION OF WELL (Please complete either la, lb or lc.) A.D.L. No.
!alilB?rough Subdivision. # z~' Cot Block Ib"'~.I I/4qtrs. Section No. TownshiPN0 Ronge El"-} Meridian
_0,_ o,__o, -- s 0 wO
i~. DISTANCE AND DIRECTION FROM ROAD INTERSECTIONO $. OWNER OF WELL:
Street Address and Area of Well Location
Feet Below 4. WELL DEPTH~ (final) 5. DATE OF COMPLETION
2. WELL LOG Surface
.. // - -
Material Type To~ Bottom ....
/, ~.~ .~:~ ~ ~ ~ ,,~,~,.~.,., .~,,, ~.~ ~ 7. USE: ~Domeltic ~ Public Supply ~ Indu,try
K~ //~ / ~/~ ~ ~, ~ ~ ~ Irri~otlo, ~ Recharge ~ Commerlcal
~ ' '/~ ~ 8. CASINO: ~ Threaded ~'Welded
diam. in. to ff. Depth Slfckup ~ ft.
SIot/Mesh~ Size: Length:
,,~" X Set between :'~' ft. end ff.
.,..:,.~ ., ~ Backfilling Gravel pack
,, ~ ,/ Date /
tl. PUMPING LEVEL below lend surface and YIELO
M~ICIPk[I~ O~ AN~ ~ft. after ~hrs. pumping g,p.m.
Dt~'t, O~ ~EALTH G I~,GROUTING Well Grouted: ~ Yes .~No
c~n/~t~M~NTAL PROTEOIC ~
.... Material: g Neat Cement ~ Other:
---- Length of Drop Pipe ft, capacity ~g.p.m.
14. REMARKS:
16. WATER WELL CONTRACTOR'S CERTIFICATION: 15. Water Temperature .o 0 F ~ C
This well was drille~under my~urJsdfcllon and this report Is true to the.,~est of my knowledge and belief;
......... ~'~'FsTere~ "BU~i~eS'~ ~'me~ ' Contract License
Form 02-WWR (11/81) Copy Distribution: WHITE-State DOGS. PINK-Driller, CANARY-Customer
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
Parcel I.D. #
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lOt, block, subdivision, section, township, range)
L 16, B22 Alyeska Basin Subd Unit VT (Sec 17, T10N, R2E, SH, Alaska)
(c) Lending Institution
Mailing Address
(d) Real Estate Company and Agent
Address
Location (address or directions)
Alpine Avenue, A'lyeska
(b) Property owner James V. Wa] 1 er Telephone: (home)344-4863
Mailing Address 7021 Joseph, Anchorage Alaska 99518
Cit,y Mortgage Telephone 563-0700
405 Nest 36~ Suite 100~ Anchoraqe, Alaska 99503
Buyer's Real tv
Business
Telephone
277-2897
(e) Mail the HAA to the following address: (or check here [~, if hold for pick up.)
List contact person and day phone number below:
2. TYPE OF RESIDENCE
Single-Family;[~ Number of bedrooms 3
3. WATER SUPPLY
Individual Well ~
Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site [] Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legality and status.
72-025 (Rev. 7/88) Page 1 of 2
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s!q]. to uo!].eB!l. Sa^U! Aw leq]. X].IJaA I ',V, olaq u,',,Ao qs alep uo!].eP!le^ aq]. ].o s'~ pue o].aJaq pax!,t:!.e leas Aw Xq Pa!].!:].Jao sv
NOI.L¥1NI:IO:INI aNY ¥.LVa 'HOEt¥=IS ~'11.-! 'SJ. SE]£ 'SNOIJ. O=.dSNI ~NlalAO~d IAI~II-I DFUI:I]-'qNIgN~ .cj
MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)
^dr( oF A,~IE~I[IST - FEBRUARY 1984
Fr. NVtP, ONMENTAL SEP, VtCES D~VtSiOh~43-4744
RECEIVED
Individual
A. WELL DATA
Well Classification
Well Log Present (Y/N) Y
Total Depth 42 Cased to __
Static Water Level 23
Casing Height Above Ground 2
Electrical Wiring in Conduit (Y/N) Y
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot N/A
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line 120 '
To Nearest Sewer Service Line on Lot
Water Sample Collected by
Water Sample Test Results
Comments
Date Completed
4O
Legal Description:
Lot 16, Block 22
Alyeska Basin Unit VI
11/25/89
Depth of Grouting None
38
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
If A, B, C, D.E.C. Approved (Y/N)
Yield 30 GPM+
Y
N
N/A
N/A
250'
; On Adjoining Lots
N/A ; On Adjoining Lots
To Nearest Public Sewer Cleanout/Manhole
53'
Jim Walker(Directed by Engr.);Date February 21,
Nitrate-N (ND(0.10)) Coliform (0) 23 Feb 90
1990
This residence was disconnected from Cherrier-King
Community water system (see ltr dtd 12/6/89).
B. SEPTIC/HOLDING TANK DATA
Date Installed Size
Standpipes (Y/N)
Depression over Tank (Y/N)
Pumping/Maintenance Contact on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
(N/A)
No. of Compartments
Air-tight Caps (Y/N)
Foundation Cleanout (Y/N)
Date Last Pumped
; for
Temporary Holding Tank Permit (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water-Supply Well
To Property Line
To Water Main/Service Line
To Stream, Pond, Lake or Major Drainage Course
Comments
To Building Foundation
To Disposal Field
72-026 (Rev. 7/88) Front Page :1 of 2
C. ABSORPTION FIELD DATA ~
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absortion Area
Depression over Field (Y/N)
Results of Last Adequacy Test
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water-Supply Well
To Building Foundation
Lot
To Water Main/Service Line
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Statndpipes Present (Y/N)
Date of Last Adequacy Test
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots
To Cutback (if present)
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test.
**Check Permitted Bedroom Rating Against HAA Request**
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this
inspection.~ ,.,~ ~ ~. ~
Signed _"~..¢-¢z~..~ 'Y'-~ ~ ~~ ,
Compan~ ~J ~, /~ ~ ~~
~?"~ ~al
Date ~-- ~ ~ ~
MOA No. ,d/~
Receipt No.
Date of Payment
Amount: $
72-026 (Rev. 7/88) Back
Receipt No.
Waiver Fee: $
Date of Payment
Page 2 of 2
/ ' N, .~'/ . ' . '~ , ~.
'. , - ." '
. '. .
. · . .- ,
- ,
I~ ~ th~ r~pon~lblllt$ of the ~n~r to determfne, t---~ ~~&_~
the existence of any ea'~ements, covenaflts,'or re U . ~:'.,.
st~Icttons ~htch do' not appear on the recorded sub-
dtv~ston plat. Under no cfrc~stances should any NOTE
data hereon be used. for construction or for estab-
lishing boundary or fence 11nes. The surveyor take~ saowN ~ THE RECORDED
re~po~s!b~ltt~ fo~ the tntttal transaction only. s~owN amZON...
LEGEND
LOT /& · ~OCK'_ ~Z
. ..ANCHORAGE RECORDING DISTRICT . . , ~,, ~,e, .
14~6 HYDER STREET
ANCHORAGE~ ALASKA 9 9501
Alpine DHIling & Enterprises
P.O. Box 110496
Anchorage, AK 99511-0496
FIELD PUHPING TEST
DATA SHEET
PROJECT: DATE OF TEST=y//'"'.,,,C2
~,IELL DEPTH: .,~/~2-, FT. CASID~G: ,~,,/"C~2,.- FT SCRFE:~: -----..--
~ ,~r'~" ~1 .
STATIC '.,lATER LEVEL (Top of Casing): 4~~.~ ET ·
CIock
Time
ElaPseo lime Since
Pumping Start.=d/
Stopped, Hin,
0
!
5
10
15
20
25
30
35
40
45
50
55
60 (! hour),
9O
120 (2 hours
150
180 (3 hours
210
240 (4 hours
RECOVERY
o
5
~o
15
20
25
35
Depth to
Water, ft.
Drawdown/
Recovery
Pumping
Rate, GPM
Start
'7
Renarks
I I t
December 6, 1989
To Whom tt may comeern:
The well located on Aleyeska Basin # 6 subdivision Lot 16 Block 22 mee~s
a!]. state and local requirements as to depth, dtsiance to sewer and water
quality, also quanity is well above FHA s$~ndard, s,
The residence located on the above named lot is disconected from the
~herrler-Ring community water system and is rum~ing on. the well system
soley.
David L. Harper
p. n Drill ~g & ~t~-rp.~.Ises
P,O, Box 110496
Anchorage, Ak 99511
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
ANALYSIS REPORT BY SAMPLE £or Work Order # 19942 Date Report Printed: FEB 23 90 @ 17:03
Client Sample ID:L22, B16 ALESKA BASIN #6
PWSID :UA
Collected FEB 20 90 @ 15:00
Received FEB 21 90 @ 10:00
Preserved with :AS REQUIRED
Client Name : WALKER, JIM
Client Acct: WALKJC
P.O.8 NONE RECEIVED
Req ~
Ordered By : JIM WALKER
Analysis Completed :FEB 21 90 Send Reports to:
Laboratory Sup~r~v~so~:STEPHEN 1)WALKER, JIM
Releaeed By :.~~j_ ~
Special HOLD FOR PICK-UP AND PAYMENT.
Instruct:
Chemlab Kef #: 900160 Lab Smpl ID: 1 Matrix: WATER
Allowable
Parameter Tested Result Units Method Limits
NITRATE-N ND(O.iO) mg/1 EPA 353.2 10
Sample ROUTINE SAMPLE
Remarks: SAMPLE COLLECTED BY JIM WALKER.
1 Tests Performed ' See Speclal Instructions Above UA-Unavailable
ND- None Detected "See Sample Remarks Above
NAr Not Analyzed LT=Less Than, GT-Greater Than
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
TELEPHONE (907) 562-2343
5633 B Street
Anchorage, Alaska 99518
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
[] PUBLIC WATER SYSTEM I.D.#
[] PRIVATE WATER SYSTEM
Name
Mailing Address
City
State
I I
Phone No.
Mo. Day Year
9_5",, 2; ......
Zip Code
SAMPLE TYPE:
[~ Routine
[] Check Sample (for routine sample
with lab ref, no.
[] Special Purpose
[] Treated Water
[] Untreated Water
SAMPLE
NO. LOCATION
4 I I
Time Collected
Collected By
/
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
TO BE COMPLETED BY LABORATORY
Date Received
Time Received
Analytical Method:
Analysis shows this Water SAMPLE to be:
~Satisfactory
[] Unsatisfactory
[] Sample too long in transit; sample should
not be over 30 hours old at examination
to indicate reliable results. Please send
new sample via special delivery mail.
too0
Membrane Filter
* No. of colonies/100 mi.
90.0160
I
I
Result*
BACTERIOLOGICAL WATER ANALYSIS RECORD
Analyst
Membrane Filter: Direct Count
Verification: LTB
Final Membrane~~esults
Reported
TNTC = Too Numberous To Count
OB = Other Bacteria
Collform/100ml
BGB
----Date
Time;
Collform/100ml
eom,
PART ONE OF TWO
REMAINDER TO FOLLOW