HomeMy WebLinkAboutANGELA HEIGHTS LT 8
r~LINI~ I PRLIT~" OF R~4~HORRGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
25t0 E. TUDOR RD., RNCHORAGE, RK. 99567
276-222i
~libb PER£1IT
PERMIT NO. ( 76297
APPLICANT ~
LOCATION CHICKALOON ST
LEGAL L8 ANGEL8 HGTS
BO~ 80 E.R. 69,~-9387
LOT SIZE ti4J .... E..¢JRF..E FEET
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
i00 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DRYS
OF' THE WELL COMPLETION.
SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER
INSTALLATION.
PERMIT %~RLI [~ FCtR tDNE "T'ERF~ FRIZtM I SSLIE
I CERTIFY THAT
l' I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RN[:, WELLS RS _ET
FORTH BY THE MUNICIPALITY OF ANCHORAGE
2' I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH 'THE CODES.
SIGNED:
ISSUED
APPLICANT DAVE DEANS
by
A & L DRILLING COMPANY
BOX 97, EAGLE RIVER, ALASKA 99577 · TELEPHONE 694-2588
OWNER OF LAND
ADDRESS
LEGAL DESCRIPTION Zdd~' ~; /d/}~-d C ~&,~/r
DATE-Started ~//~ ,'~/J '~ Ended
PERMIT NUMBER ff~ ,~ ~ 7
DRAW DOWN FT.
GALS. PER HR
KIND OF CASING
DEPTH OF WELL / ~if. ~
STATIC LEVEL OF WATER FT.
/?
/
/o/
KIND OF FORMATION:
From (~ Ft. to c.~. Ft. ~)cY~Z,~/~/,4~w~ From__
From c~ Ft. to / 7 Ft. 5,d~q-~dr ~/q'r/~C_ From~
From /7 Ft. to3g Ft. ~ From~
From ~ Ft. to '~ Ft. C&~ ~ ~~ From~
From ~ Ft. to ~/ Ft. ~/~ ~~ From~
From ~/ Ft. to. ~'~Ft. ~C~ ~~ From~
From. ~ Ft. to 7'3-- Ft. ~ Fro,n~
From 7~Ft. to ~0 Ft. 5~n .~ ~~ From~
From ~ Et. to ~ Ft. ~~ From~
From ~ Ft. to fl/~--Ft. ~O /~ ~~ From
From //-~Ft. to/~ Ft. ~Z~ g~'~~ From
From/~ Et. to ~ OFt..~~ ~'~< ~' ~~m~
From ~ Ft. to Ft. From ~
From.~Ft. to Ft. From
From Ft. to Ft. From~
From Ft. to Ft. From~
From Ft. to Ft From
Ft. to__Ft.
Ft. to_____Ft
Ft. to__Et
Ft. to__Et
Ft. to Ft.
Ft. to Ft
Ft. to Ft.
Et, to Ft.
Ft. to__Ft.
Ft. to Ft.
Ft. to__Ft.
Et. to Ft.
Ft. to__Ft.
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MISCL. INFORMATION:
DRILLER'S NAME
CONTACT:
EA( ~ RIVER AREA
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Myrna Johnston, Area
694-9555
1. Approval requested by:
Mailing Address:
2. Property Owner:
Mailing Address:
Legal Description:
4.
5.
6.
e
Date Received Septemberl, 1976
Be
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Conv.
United Bank of Alaska
645 G Street
% Debbie Border
Phone: 278-9526
Phone:
Dave Deans Construction
% Box 249, Eagle River 99577
Lot 8 Angela Heights Subdivision
Location: 5th house on right on Chickaloon Street off of Eagle River Road
Type of facility to be inspected Single Family No. of bedrooms 3
B. Depth 140'
D. Bacterial Analysis
Well Data:
A. Type Individual
C. Construction
Sewage Disposal System:
i. Size
1. Absorption Area
Total length of lines
Public Utility
B. Installer
· 2. Manufacturer
A. Installed
C. Septic Tank:
D. Seepage.Pit:
E. Disposal Field:
Distances:
, Absorption area
, Other contamination
2. Material
, Sewer Lines
, Absorption area
A. Well to: Septic tank
Nearest lot line
B. Foundation to septic tank
C. Absorption area to nearest lot line
EQ-034 (1/74) Page 1 of two pages
Municipality of Anchorage
Environmental Protec~tion
2516 Tudor Road
Anchorage, AK 99507
REQUEST FOR APPROVAL' OF
INDIVIDUAL SEWER & WATER FACILITIES
MUNICIPALIi'Y OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
SEP 1 1976
RECEIVED
1,
'3.
TYpe of Inspectio. n'
Prope'rty Owner:
Mailing Address:
. CF!RO VA
Dave Deans Construction.
% Box 2'49. ~
F H ,q
CO~IV xx
Eagle River, AK 99577 D.9_y. Phone None
Name of Buyer: David and Fonda Deans % Box 249
Hailing Address: Eagle River, AK 99577
Day Phone
None.
Debbie
Border
~a~e of Lending 'Ins~ituti0n: United Bank Alaska. ATTN:
645 G Street
Mailing Address: -.~a~Xa Anchorage,.AK 99501Phone 278-952'6
Name of 'Realtor 'o,r Agent:
Myrna Johnston, AREA, Inc'., Realtors·
Nailing' Address:
Legal
Description:'
Location:
~ver, 9AK .~9577
Phone 694-955.5
Angela Heights SubdiviSion, Lot 8
5th H0use on Right' on Chickaloon Street off Eagle
Rive~ Road· .(Ho~se is occupied.- Agent can'-accompany)
Type of Facility to be 'inspected:
~later Supply'..
Type Of S~pply: Pu~li'c Utility
If Individual, 'number of dwell]ng.s, pre'sehtly .seFved
If Individual, depth of well 140'
Sewage Disposal'System
Ind%¥idual 'xx
Type .of S~st'em: Public Utility xx
"individual (on-site)
................. If. Individual, date of installation
Page.2 of two pages - Re( st for Approval of Individual F ~r & Water Facilities
Legal Description Lot 8 Angela Heights Subdivision
Comments
Approved
,~/~ 3/? ~ , Disapproved Date
Approval Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
Date
EQ-034 (1/74)
06-12201a Rev. 1973
/ / DATE
AL, A DEPARTMENT OF HEALTH AND SOCIAL SEI, ,:S
OIVISION OF ~BLIC HEALTH
INDIVIOUAL AN_ SEMI-PUBLIC
BACTERIOLOGICAL'! WATER ANALYSIS,_
NDIVIDUAL [] SEMI-PUBLIC [] CHLORINE RESIDUALPPM
REPORT RESULTS TO
ZIP CODE
[] No t ,~,
[] Yes E] No Signalure
ADDRESS /~
oPSO RCE c_ w' o
COMPLETE THIS SECTION
ONLY IF WATER IS AN INDIVIDUAL SUPPLY
SAMPLE COLLECTED BY ~' ~
DATE ~OLL~TED ~ TI~ ~OLL~TED
S~mple {olle~fed From ~en Top ~ B~hroom T~p ~ Bose~$n~p
~ Other (List)
We --~ Dug ~ Driven ~ Drilled ~ Bored
SOURCE: ~ SBring ~ Cistern ~ Other
Dug Wel or C stern Construction:
Walls-- ~ Wood ~ Concreie ~ Metal ~ Tde Brick
Top ~ Wood ~ Concrete ~ Metal ~ Open Top ~ Concrefe
LOCATION
~ In Bosemenl ~ Basement Offset ~ Under House'
~ InYard ~ Other
Building Sewer Septic
DISTANCE TO: or Other Drainage Pi~e Feet. lank Feet
Tile Seepage Cass-
Field Feel Pit Feet. PGa] ~ Feet. Privy ~ ~Feet.
Orner Poss~D~e
Sources of Confamlnahon
MATERIAL: Building Sewer - ~ Cast~lron ~ Wood ~ Tile ~ Fibre ~ Asbestos
~ Plostic Jo nt Material T~'pe Cement
GENERAL Does Water Become Muddy or Discolored? ~ Yes ~ No
When?
Diameter of We~ (~ ' Depth ' / ¢~0 ' Feet
Well Casing
Mflterla .Piameler , Deom
Length at W~ter Depth
Drop Pi Ge From Bottom Feet.
Offset m m Utility
P~MP LOCATION ~ n Well ~ Basement ~ n Basement ~ Room
On Too
~OfWel ~ Other '
PURPOSE OF EXAMINATION nessSuspected? ~ Ye~ /
New Source of Supply? ~ Yes ~ No Repairs to System?
Lab No.
EMB . ~. AGAR
BEFORE ~ocrose Broth 24 hrs. 48 hrs. gram's sram
Coliform Density Mosf arobable No, oar lO0cc
MF Resulls
COLLECTING SAMPLE //~
Reported by i/(~ ..... ~/'
This analv ............ Coliform Org(] n-i'~m~ t o be:
Presenl
Lactose Broth /' '
;, ~ . 10cc 10cc 10cc t 0cc 10cc 1.0cc 1.0cc
24 Hours ..
48 Hours "''''~' <
Brilliant Green' ~t
24 Hours ' '"
48 Hours ~'
ON
I;~EV E RSE SIDE
- /
[ 06-1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD ,
- READ INStRUCTJ.,ONS OateReceived Time Received ~ .~b No.
,~' ~ _ '/ 'I/ ~-, _
OFFICE
Ano ysls shows this Water SAMPLE ro ge:
~ Satisfactory
[] Unsatisfactory
[] Questionable T
E] Sample too long '~ transm sarrole should nor oe over 48
nours old or examination to indicate reliable results. Please
sena new sample
[] Bottle brbken in transit olease sena new sam~e
SANITARIAN'S REMARKS