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BASE HILL LT 1
MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMEN'rAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME IP-I-ION E / [] NEW MAILING ADDRESS ,,~/~_ ~c~ ~ ~ ~5'77 LOCATION BEDROOMS ~ ~ DISTANCE TO: I ~/~ ~ [ AbsorPtion~area D~elling~ ~ O ~ PERMIT NO. ~h Z M~nufacturer ~ Ma~~ N~f compartments Liq. ca~c~ i~ns IF HOMEMADE: Inside lengt~ Width ~ Liquid dept~ ~ DISTAN~ Nell D~elling PERMIT NO. Q Well Foundation~ Nearest lot line PERMIT NO~/~ ~ Z DISTANCE TO: ~/ ~ /¢~ /O -- ~O ~ ¢~ w~Z~ in~h.s ;~ mop of tile to finish grade ~ Material beneath tile ~ Total effedti~~narea Length Width " Depth PERMIT NO, ~ ~ ~ Cribdiameter/~ribdepth~/ ~/~otale~tiveabsorp~/~ ~ ~ / B~oundation Nearest lot line DISTANCE TO: ~ ~ C~ Depth Driller Distance to lot line PERMIT NO, ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIALS SOtL TEST RATING' v ~~ , t~ REMARKS 72-013 (I] v. 3/78) PERMIT NO. RPPLICRNT LOCRTION LEGRL f41_lf-J IC:I F'RLIT'T' ~]F- Rr-JI]HC~RR,3E DEPRRTMENT HERLTH RND ENVIRONMENTRL '~OTECTION 825 _ STREET, RNCHORRGE, BK. 264-4720 ON--SITE SEttlER F'EF~£4 IT ( 810183 ) WITMBN EXCBVBTING CHUGIBK 8RE8 TRBCT 8 STRBTFORD HEIGHTS S.R. BOX 24? LOT SIZE · -; _'-'.':;.r,',?. 1000F~0 SQURRE FEET TYPE OF SOIL. RBSORPTION SYSTEM IS: TRENCH MRXIMUM NUMBER OF BEDROOMS = 4 SOIL RBTING (SQ FT?BR)= 125 THE REQUIRED SIZE OF THE SOIL RBSORPTION SYSTEM IS: DEF'TIH= 1~ LE~I]TH= '4~._~ ,3~:R~"EL E~EP-FH= ~; THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF ~ TRENCH OR PIT IS THE DISTBNCE BETWEEN THE SURFBCE OF THE GROUND 8ND THE 80TTOM OF THE E~C8VBTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRBVEL DEPTH IS THE MINIMUM DEPTH OF GRBVEL BETWEEN THE OUTFBLL PIPE 8ND THE BOTTOM OF THE E×CBVBTION (IN FEET). RE,2~I_I I RE[) SEPT I C: PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTBLLBTION INSPECTIONS OF RNY WELLS 8DJBGENT TO THIS PROPERTY 8ND THE NUMBER OF RESIDENCES THST THE WELL WILL SERVE. BRCKFILLING OF RNY SYSTEM WITHOUT F'INRL INSPECTION RND RPPROVRL BY THIS DEPRRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETWEEN R WELL RND RNY ON-SITE SEWRGE DISPOSBL SYSTEM IS -' -' 1~0 TO , t00 FEET FUR 8 PRIVBTE WELL DE'=- 200 FEET FROM 8 ~LIBLI_. WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTBNCE FROM 8 PRIVBTE WELL TO 8 PRIVBTE SEWER LINE IS 25 FEET 8ND TO 8 COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MBY 8PPLY. SPECIFICBTIONS 8ND CONSTRUCTION DIBGRBMS 8RE 8VBILBBLE TO INSURE PROPER INSTBLLBTION. PERt.11 ]- E.'--":F' I F..'ES D, EC:Er'IBER _~-':t.. I CERTIFY THRT t: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH BY THE MUNICIPBLITY OF' RNCHORRGE. 2: I WILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES. ~: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN 4 BEDROOMS. SIGNED: RPPLICRNT ISSUED BY_ WITMRN ERCRVRTING MUNICIPALITY OF ANCHORAGF · Health and Environmenta Street, Anchorage, AK. Department 825 264-4720 * * * HANDWRITTEN PERMIT * * * ~D/OR ON-SITE SEWER PERMIT Applicant: ILL}' ~/~2/~ ~' Mailing Address: Location: ~/'t. Plt~'J Legal Description: ~"-~~ Type of Soil Absorption System Is': Trench: ~--~ Drainfield: 'rotection 99501 Phone Number: ~.~?~;,~'--"~ 3'~Z ~/pt~/~ ~Ot Size: f)C~7/,~,'~ Maximum Number of Bedrooms: ~ Soil Rating(sq.ft/br) . / The Required S~ze of the Soil Absorption System Is: DEPTH !~"~~ LENGTH C:~I~ GRAVEL DEPTH ~/e~ WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a 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). * * REaUIRED SEPTIC(HOLDING) TANK SIZE : , /_2~--d GALLONS * * 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. ' * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection.and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31~ 1 9 8 1 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site the r~~ce is remod~le~ to Signed: ~x~ _ sewer system may require enlargement if include more (~~ bedrooms. SWP/024 (1/81) SOILS LOG PERFORMED FOR: LEGAL DESCRIPTION: 1 .~'~ 2 3 4 5 7 12 14 1§ 17 20 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SLOPE [] PERCOLATION TEST WAS GROUND WATER ~/~ ~_ ENCOUNTERED? O P E IF YES, AT WHAT DEPTH? SITE PLAN Ne, 1457.C Gross Net ' Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) COMMENTS TEST RUN BETWEEN FT AND FT PERFORMED BY: 72-008 (6/79) CONSTRUCTION AND OPERATION CERTIFICATE ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION. PUBLIC WATER SYSTEM APPROVAL TO CONSTRUCT Plansfortheconstructionof ~c~e ti;Il D in bY [.,6Ts i ~ '2 public water system located ~, approved. Alaska, submitted in accordance with 18 AAC 80.100 have been reviewed and are [] conditionally approved. (see attached conditions). BY 'TITLE - ~ DATE If construction has not started within two years of the approval date, this certificate is void and new plans and specifications must be submitted for review and approval before construction. APPROVED CHANGE ORDERS Change (contract order no. or descriptive reference) Approved by Date The "APPROVAL TO OPERATE" section must be completed before any water is made available to the public. APPROVAL TO OPERATE water sys:tbm was completed on (date). The, ~ystem is hereby granted interim approval to operate for 90 days following the cpmpletion date· BY TITLE DATE As-built plans submitted during the interim appr~)val period, or an inspection by the Department has confirmed the system was constructed according to the approved plans. The system is hereby granted finaJ approval to operate. ¥1i'£~ -- ~ DATE PAGE 1 OF 2 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940020 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:G£)ODNIGHT GREGORY N & OWNER ADDRESS:P.O. BOX 671307 CHUGIAK AK. 99567 DATE ISSUED: 2/03/94 EXPIRATION DATE: 2/03/95 PARCEL ID:05144108 LEGAL DESCRIPTION: BASE HILL LT 1 LOT SIZE: 58520 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: EXISTING WELL MUST BE ABANDONED BY FILLING THE CASING WITH CONCRETE OR GROUT TO A LEVEL 4 FT. BELOW EXISTING GRADE AND CUTTING THE CASING OFF AT 4 FT. BELOW GRADE. A COPY OF THE WELL LOG MUST BE SUBMITTED TO DHHS WITHIN 30 DAYS OF WELL CO PAGE 2 OF 2 MPLETION. RECEIVED BY: ISSUED BY: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519- 6650 DATE: DATE: ~o°r'Y & Engei '<~'o'odn'i'~ht .....1 :hucjlak, AK Location Or Well ~nchor~ge ~asfHill"' J. lJ , Well Log Alaska NoW-Well/Vern's Drllillng 1224 I. Avlon Anchorage, klmt)ku 996 !6 (907) ~45-44,7 IAA~a27 ii MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL ~E~RVICE$ DIVISioN / AUG 11 1994~ RECEIVED ~ p~ T · SW~40020 . 'lS'e'cuo"nNol~ow'n~p 1~t" [ .... ~ng~ '1~1 I~d~ ~~ .... i~11, ' IWll '~ '~/ell Log FL, Below Surface I'leLerlel Type Top Bet. ton :~roWn loamy '0 ' 10 ~Cay cla~,/, Sill .................... 10 15 :ed rusty, gravel. 15 16 !ray claysto,~e/~reen rock ......... 16 22 Jray/biack bedr0ck,,wtth seep, 0,n top,of',,roc, k ,, ,2,2 ........ 55 lray rock 55' 110 tt__ay rock. wtlh white streaks 110 130 lr~ay/black rock 130 210 jra¥/b!,ack, r;~k,wtth,whYt'e sir,e,,~ks, %epaoel' :" ~'i"o ' ' 2i5 'ractured ,white, rockjn ,gray be,,drock/H20 .... 21,5, 220 :He~w_weli, an~",ch,ec, k, ed w',aLe'.r,'f'i'ow~,.~;'~25g'Pm .... ','], ,, ', .'' .. Veil should prqd,~c,e,9oo 9Pd ...... Welt Depth (fit) Dale off Completion r°t'ry ' _J J~'Omesu,c 3 CIsing ,Type I~'elded I Diameter (in,) 6 Lo J4" liner Lo Finish af Well Type Diameter J open hole J J Stltlc Wlter Level Level (fl,) Date i ~81 [ 7/21/g.] ,D,pth (fl,) , W,elght (lbs/rtl)7 I~°' ~'' '~ol~vc'" J 61 Pumping Level Below T of C (fl,) After (hfs) 6rouLIng Yesl~ Material Pump H,P, Capacity Settincj (ri) Remarks Pump!rig (g.!p,m) I Type Jsubmersible 'his well was_drilled under my ,jurtsdlct on and this report Is true to the best of my knowledge and belief. ,.uthorlzed Representer. lye ,ernorV[ N~eli _ ! F Z NOO'OO'O9'W 194,93' F~lX 0© --4 SO0'O0'09'E 194,93' DIVISION STREET mg Z OO Z > ~o ~ ~ ~o 0~0 , > ~1~ ~ m~> - , ' ', ~6'¥6I- ' ' ' .-- .. - . :. ~ ~ ~ ~ · .. ~ t ' . B ~., '~ ,60 ,.oo~ o ~ ~OISI~ L ,' .~ Time, Time Date Date Inspector Inspector · Insl~ec't~r Comments Condl{Ional Approval ' ' Perm t No. Septlo Tank Sl~e Dete Sewer Installed ~~ ~ Holding Tank Size Soils Rating Well To Absorption Area ' Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Realty Co. & Agent . bhone Type~ Residence . ~lngle. F~ll~, - ~ Multiple ~a~Hy No. of Bedrooms ~. " · C Other Wate~upply - ~ ~ndlvldual · A~ACH WELL LOG. A well 10g Is required for all wells drlll~ since June D Communl~ ."-.. 1975. For wells drtlled prior to that date, give well depth (attach log If ~ Public Utlllt~ available.) ~dlvidual . ' Year Individual Install d' ., ~ Public Utility ,, When Connected to Public Utility: .... : ' D Holding T~k , , NOTE: THEiNSPECTION~EE MUST ACCOMPANY EAcH REQUEST BEFORE PROCESSING CAN BE INITIATED.