HomeMy WebLinkAboutBELLA VISTA #1 LT 26A
Well Owner
M-W DRILLING, Inc.
P. O. Box 4-1224 · 1310C International Airport Road
(907) 274-4611
ANCHORAGE, ALASKA 99509
DRILLING LOG ~:r~ ~
GORDON UNWIN
Use of Well
DOM
Location (address of: Township, Range, Section, if known;or distance main road
845 E. 79th Ave.
E75' of S100' of L26, Belie Vista Subdivision
Size of casing. 6" .Depth of Hole 111 feet Cased to 110 feet
Static water level 40 ft. (abo~) (below) land surface. Finish of well (check one)
Screen ( ); Perforated ( ).
Describe screen or perforation. NONE
Well pumping test at 3 gallons per (hog'a)~
of drawdown from static level.
Date of completion 24 Sept ,73
Depth in feet from
ground surface
0 .TO. 35
35 .TO 105
105TO' 111
~O
.TO
TO.
~O.
TO.
TO.
TQ
.TO
~O
__TO
~O
.TO
open end (
xx );
(minute) for 1 hours with 100%
ft.
WELL LOG
Give details of formations penetrated, size of material, color and hardness
Gravel: small, silty/sandy,
Gravelly Clay
Sandy Gravel: waterbearing
loose
1 -- CUSTOMER
APPLI( NT FILLS OUT UPPER HA[ ONLY
'~ .... ~y Owner W ~,) E~/ ~ / ~3A/:z~ Phone
Buyer ~ t~ Y ~-~/~ ~"~-~)~ ~
Lendinglnstitution ~' ~ ~,~, .-- / Phone
Address ~9 ~'.) ~ ~g~ Zip Code
lngle Family
: Other
Water Supply
divldual : A~ACH WELL LOG. A w~l 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 Ulillty
Sewer Disposal
~ Individual Year Individual Installed:
Public Utility 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 Date Date
Inspector Inspector Inspector Inspector
Field Notes: NICIPAUTY OF
(/ ) APPROVED BEDROOMS *CONDITION8 OF APPROVAL
( ) DISAPPROVED
( I COND,T,ONAL APPRO_*AL'
Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received
Well to Tank Septic Tank Size
72.023 (3182)
...... = ' - - _ - .. - , NIUNI¢IPALrrY OF ANCHORAGE
_ _ ~"'_ ~ - _:'.j MUN'ICtPAL~TyOF-ANC~HORAGE - - DEPT O-- ' "
~I~E~)tONS: Complete-all parts on-page 1,1n¢OmpJet~reques~Will not be Proce~ed, Pleaseallow ten (10) days fo~ processing, -
~-PROPER~Y OWNER
MAI~ING ADDR~S _ - - ~
.~orpERTY R~IDE~T (lfdi~erent-~roma~_ove) - --' - ' - i PHONE
BUYER
THIS SIDE FOR OFFICIAL USE ONLY
INSPECTION APPOINTMENTS
TIME
DATE
TIME
DATE
DATE RECEIVED
TIME
DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
TYPE RE 'i D .CE
[] SINGLE FAMILY
[] MU_LTIPLE FAMILY
2. WATER SoPP[¥
[] INDIVIDUAL
[] COMMUNITY
[] PUBLIC UTILITY
Cohriection V~'rified-
NUMBER OF BEDR~OOMS .....
[] ONE F-l' THREE - {~ FIVE
[] TWO - [] FOUR [] SIX
LOG RECEIVED
INSTALLER
SOILS RATING
3. SEWAGE DISPOSAL SYSTEM
[] INDIVIDUAL/ON -SITE
[]PUBLIC UTILITY
Connection Verified
[]Septic Tank or [] Holding Tank
Size: If Tank is homemade
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL ~
Septic/Holding Tank
4. DISTANCES
WELL TO:
Absorption Area to nearest Lot Line
5. CO MMENTS
DATE
[~-~APPROV ED FOR I BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
II
LEGAL DESCRIPTION
72-010 (Rev. 3]78)
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received
Time of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
requested by:
Date of Inspection ~-
Mailing Address: - Phone:
2. Property Owner: ~'q-~'~m~r~ [~'~, ~ ~~ .. ' .... ~N~ne: ~-~ ~
Mailing Address: ~ ~_._ r~<~ (~,~,~o,~~ ..
Legal
Description:
Location: ~)l~ J~,.,~ N~ ~,~tL,)r~,.,~,,.--~-~~j . .
Type of facility to be inspected ~ ,,k~b ~m~r~,~ ,-No. of bedrooms (~,,~
6, Well Data:
D. Bacterial Analysis
B. Installer
C. Constructionf~~~),
Sewage Disposal System: ~)~_~_~_
A. Installed
C. Septic Tank: 1. Size
2. Manufacturer
D. Seepage Pit: 1. Absorption Area
2. Material
E. Disposal Field: Total length of lines
8. Distances:
A. Well to: Septic tank
, Absorption area
, Sewer Lines ,
Nearest lot line
, Other contamination
B. Foundation to septic tank
, Absorption area
C. Absorption area to nearest lot line
EQ-034 (1/74)
Page 1 of two pages
Page 2 of two pages -Rec,
Legal Description & I'~' t_.~ '~¥~_
Comments
;t for Approval of Individual S
~r & Water Facilities
~ ~ Disapproved Date
Approved~,,. ~-~ /~A~I ~' 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)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF ENVIRONIVlENTAL QUALITY
3330 "C" Street, Anchorage, Alaska 99503 - 274-4561
1. Type of Inspection:
2. Property Owner:
Mailing Address:
3. Name of Buyer:
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
CMRO VA FHA
;~'~,~' ~ -J'~l 'C'I~ ~ Day Phone
Mailing Address:
4. Name of Lending Institution:
Mailing Address:
5. Name of Realtor or Agent:
CONV '~'
Day Phone
Phone
Mailing Address:
Legal Description'
Location:
, Phone
Type of Facility to be inspected:
Type of Supply: Public Utility Individual
Water Supply
No. Bdrms.
If Individual, number of dwellings presently served
If Individual, depth of well J ~i~)
Sewage Disposal System
Type of System:
Public Utility
Individual (on-site)
If Individual, date of installation
EQ-037 (1/74)