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Home My WebLink AboutT12N R3W SEC 33 LT 222TI2N C · Loi- 232 018- $22 -12 Alpine Drilling & Enterprises Well Log Permit Number: #SW 111287 Date of Issue: 10-11-11 Date Started: 10-17-11 Date Completed: 1018-11 Is well locaarcel d at Identification Number: 01832212000 Legal Description: T12N R3W Sec 33 Lot 232 Pp permit location`. x Yes No Property Owner Name & Address: Wolfe Virginia W. 15302 Old Seward Hiahwev ' Borehole Data: Soil Type, Thickness & Water Strata Depth ($) From To - _ - . - Method of Drilling x air rotary 0cable tool Stick-up Casing type: steel 0 2 Wall Thicknem .025 inches silt 2 5 Diameter: 6 inches Depth: 92 feet silty gravel 5 75 Liner Type: _ gravelly silt 75 90 Diameter _ inches Depth: _ feet silty water sand & gravel Casing stickup above ground: 2 feet - silt 90 96 Staticwater level (from ground level): 70 feet 96 97 Pumping level: 95 feet after 2 hours pumping 10 gpm Recovery Rate: 10 gpm Method of Testing: air li Well Intake Opening Type: ❑ Open End ❑ Open Hole x Screened Start 91 feet Stopped 97 feet ❑ Perforations Star— feet Stopped _ feet Grout Type: Bentonite Volume: 1 bg T.._A. Pump: Intake Depth_ feet Pump size _ hp grand Name Well Disinfected Upon Completion? x Yes ❑ No Method of Disinfection: chlorine tablets Comments: The existing well located on the above property was decommissioned per AFDC and MOA requirements. Well Driller: Alpine Drilling & Enterprises PO Box 110496 Anchorage AK 99511 Mark Begich Mayor Development Services bepartment Building Safety bivision On-Site Water & Wastewater Program 4700 Elmore Rood P.O. 8ox 196650 Anchorage, AK 99507 www.muni.org/onsit¢ (907) :343-7904 Well Drilling Permit Number: SW,,, Number: ~,..~V Parcel Identification F Pump Installation Log Date of Issue: Legal Description Property Owner Name & Address: Pump Installation Date: /~/~' .~,~',,-¢ Pump Intake Depth Below Top of Well Casing: ~ feet Pump Manufacturer's Name: ~..~ ,?~ Pump Model: '7~.~.'cc., ,~7 c?.. ~;'. ~'. · ~ Pump Size¢~,/'~...~ hp Pitless Adapter Burial Depth: ?~' feet Pifless Adapter Manufacturer's Name: ,f? ~'¢~: ,. ,.- Pifless Adapter Installer: ,c~ /.~7> ::. ¢~ Well Disinfected Upon Completion? ~¥es [] No Method of Disinfection: .~ ~_ .<~¢; ~. ,..~/- Comments: Pump Installer Name: Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. On-Site Water System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP111287 Tax Code Number: 01832212000 Work Type: Well Upgrade Permit Effective Dates: October 11, 2011 to Design Engineer: Subdivision: T12N R3W SEC 33 October 10, 2012 Site Legal Address: T12N R3W SEC 33 LT 232 G:3134 Owner/Address: WOLFE VIRGINIA W 15302 OLD SEWARD HIGHWAY ANCHORAGE AK 995163954 Site Mailing Address: 15302 OLD SEWARD HWY, Anchorage Lot Size in Sq Ft: 108900 Total Bedrooms: 3 This permit is for the construction of: N Disposal Field N SepticTank N Holding Tank N Privy Y Private Well N Water Storage 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date: Issued By:./~_ ~'//'~ ~/~~ Date: /(~/,~////~/, MUNICIPALITY OF ANCHORAGE Community Development Department ~~ '""" Development Services Division On-Site Water & Wastewater Program Parcel I.D. ¢ ./¢ Property owner(s). Mailing address Site address Mayor Dan Sullivan ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Day phone Phone:907-343-7904 Fax:907-343-7997 Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) 'T" ~,~/V' . 11[ Lot Size / O ~ 0 cc oOSq. Ft. Number of Bedrooms THIS APPLICATION IS FOR: ((~ all that apply) Absorption Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage [] THIS APPLICATION IS AN: Initial [] Upgrade [] Renewal [] THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: ..~L%'-' i~')'O- fZ',~,~,'¥-i Waiver Fees: Date of Payment: [~' \'~'-~ -\ \ Date of Payment: Receipt Number: ~,~(,,_,~U~ ~L..L ,-~..- '~ ~_ Receipt Number: Permit No. '"'¢ ~'~ 'Y '\ \\ ~_~ ~'"-'~ Waiver No. G:\Building\On Site\Forms\Client Forms\Permit App_010411.doc (Rev. 1/11) OnSite Mon Oct 10, 09:28:35, 201~1 Map: OnSite N Scale 1:1200 Legend: SEV~E P._MANHi ]'xt STF{EET._NAMEI PARCELS (~ CityViewTM Municipal Software Corporation '-HEALTH AU]'_HORITY APPROVA-L INDIVIDUA[WATER SUPPLY ANDSEWAOE DISPOSAL SYSTEM PART I.~TO BE COMPLETED BY FHA iNSURING OFFICE First National Bank of Anchorage[ 10135 Anchorage, A]aska PROPERTY ADDRESS Seward Highway & Rabbit Creek Road, A~c~ra~e-~Alaska ..... ....... J~LOCK~.- ~toT ~.32 ~ Individual MOI~TOAGOR OR SPONSOR Wayne A. Mahurin Public system ~ ~mmuni~ system [~New installation [] Public system [] Community system PART II,--TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT INSPECTOR'S SKETCH It is the opinion of the [] State [] County [] Local Department of Health that this individual water-supply system [~]'is [] is not satisfactory as a domestic water supply for the subject property. It is the opinion of the [] State [] Counts, [] Local Department of Health that this individual sewage-disposal tern with proper maintenance: [] Can be expected to function satisfactorily, and ~ Onnot be exacted to function satisfactorily 'ts not likely to create an insanitaD, condition July ~% 1970 j . . t .,' ................. ' ' J EnvironmenTal Health Supemvisom TO THE CHIEF UNDERWRITER: DATE PART Ill.--FOR USE OF FHA OFFICE I have reviewed the foregoing and the pertinent FHA Complim~ce Inspection Report, and recommend that the Individual water-supply system be considered [] Acceptable [] Not Acceptable Sewage disposal be considered [] Acceptable [] Not Acceptable. SIGNATURE HEALTH AUTHORITY APPROVAL I~IDI¥1DUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM ] CHIEF ARCHff~CT ] DEPUTY FORCHIEF ARCHITECT FHA form 2573 ~ ~ ~[0~ ~ I} ~ / . REQUEST~ APPrOVaL OF [ ~ ~ / (Fill out in T~iplzcate) ~ . ~Nama of ~e~son ~equestxn~ approval d. Distance fPom well to closest existing oP p~oPosed: ~at ez~.J~ysis: a. Ba ct~i~Ll b. DetemEent data: /Id c. Casing Size 1, SeweP line 2, Septic tank ~l · 3, Seepage ^~ea, / ,~ / 4. Cesspool' . 5, P~opePty Llne~. 6. Other sources of possible contamination, i.e., creeks, lakes, houses~ barn~ dmalna~e ditch, etc. · Sewage disposal system. a. ;%ge of system b. Septic tank capacity in gallons c. Name of septic tank manufactu~e.~'~ ~ ~ d.' is S fl o s e a · ' · e n t e ' D' po al 'e~ ~ e p ~e p't s'z a d ~ ~ ,., - 1, D~stance to p~'y-.~ne ~ ~ to house lo.darvon '-M ~ . Percolat£o~ Te~t ~nesulIS f. Percolation Test performed by Use the reverse .side of this form to show dla£ram. Diaf~am should include ~he foilowing information: p~operty li~es;.well location, house location, ~ic tank location, disposal a~ea location, location of percolation test, a~ directlon of ground slope. The ~f-ommation on this form is true and correct To the best of my knowledge, S.ignature of Applicant' TO BE FILLED OUT BY HEALTH DEPART~.JENT PERSONNEL Date Signed ~he above described sanitary facilities are he'reby approved, subject ,to.~e Conditions: The above descmibed sanitaPy facilities are disapproved for the following reasoRs: Date .Approval is valid for one year following the date of approval, CPJ:cw AOHW- LAg - 2W DATE STATE, ~ ALASKA Dr~'~RTMENT OF hEALTH AND WEU-"~E . DIVISION'OF,PUBLIC HEALTH BACTERIOLOGICAL WATER ANALYSIS Lab. No. '' - OFFICE PUBLIC [] SEMI-PUBLIC [] 'NDIVIDUAL ~ OTHER REPORT RESULTS TO' SAMPLE COLLECTED BY _. r DATE COLLECTED ' -'' ' "~ TIME COLLECTED Sample Collected From 3 Kitchen Tap E Bolhroorn Tap Well- gJ Dug [~ Driven E] Drilled [] Bored SOURCE: [] Spring ~ Cistern [] Olher Dug Well or Cistern Conslruclion: Brick or ro~- [] Wo°d [] C ...... 3 MelaI [] Open Too When? Diameter of Well. Death Feel. Well Casing Records tn this office indicate Ihls WATER SUPPLY .to be Satislaclory [] Questionable [] Unsatisfactory Sanitary Sfalus. ,"Analysis shows Ihis Water SAMPLE lo ae: SaEsfactory [] Queslionable ~ Unsallslaclory. If an "Unsatisfactory" or "Questionable" status is indicated above you Should take immedibte action as recommended below. - _ , 1. Notify consumers waler is polluted. Boil or chemlcaily ;~'/.' ~ treat tbts water as oullined n the enclosed leaflet "Drink g Pure." 2. Increase cblorinollon sufficiebtly to meet recommended residual standards. Determine source of contamination and take aclion necessary 1o mainlaln a sale water supply al all times 3. Check chlorinolion and other btechanical equipmenl Make cerlain U is funcllonbtg properly. 4. If afld~i~ckbtg equip~ebtra-dJsinJecfin9~ r~sidual is~r~ot obtained., please wire Ibt~'~/~ice for emerg~aer ossislance o~"ed~isory services~ ~ 5. This is a surface waler source and sublecf 1o aollullon by man aaa abtmalsl An approved waler supply source should be developed. 6. Improve your J~ spring [] dug well [] driven well [] drilled well [] cistern. Z. Relocate your well to a sate Ioca~Jon in relationship to your sewage disposal system. [] see enclosure B. Sample Ioo long m translt: sample should not De over 48 hours old al examination to indicate reliable results, olease send new sample. [] Botlle Broken in fransJb please send new samole. · 9. Contact your nearest [] Local Health Deparlmem or [~ Alaska Division al Public Health. sanitation office for bulletins, consultation and assislance. SANITARIAN'S REMARKS Signalure READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE BACTERIOLOGICAL WATER ANALYSIS RECORD -- , / '71 ~ '-C;? () - //(:'").Time Received ]( ~rn"Lab. No Date Received · ' 48 hours Brilliant Green 24 hours 48 hours EMB AGAR Lactose Brolh, 24 hfs 48 hrs.. Groin's stain Coliform Density [Mosl probable No. per IOOcc.) MF resulls '