HomeMy WebLinkAboutT13N R3W SEC 33 LT 69BLoq'"' 6,
Mark Beg
Mayor
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Ellnare Road
P.O. Box 196650
Anchorage, AK 99507
Ww .muni.ore/onsite
(907) 343-7904
Pump Installation Log
Well Drilling Permit Number: SW_ Date of Issue:
Parcel Identification Number:
Legal Description
Property Owner Name & ddress:
L fZ�ma`
T/_3 R3 iN 5��. 93
� ori
p
to 47 s
o,tAgz rl K g45°i
Pump Installation Date: ^ '3 1
Pump Intake Depth Below Top of Well Casing: feet
Pump Manufacturer's Name: Q A Cwt f
Pump Model: '75"3"
Pump Size �� t/ hp
Pitless Adapter Burial Depth: O feet
Pitless Adapter Manufacturer's Name: /
Pitless Adapter Installer: I
Well Disinfected Upon Completion." ,L\y x es J No
Method of Disinfection: C IqL D
Comments:
Pump Installer Name: Ai1Cl401eWjf- W£I'' Pvrn�%�2�V1�i
Attention: Tlie pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
FA
?' '"' MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
' ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
PH~'4-- 1650 []UPGRADE
NAME ~mil Remus [~NEW
MAILINGA~I~Po~S VI ~, AnchoTace Alaska
LEGAL DE~I~TIS~, S~ TI~N, RDW Grid 183~
L A ON NO. OF BEDROOMS
DISTANCETO: ]Well 110 ~ IAbs°~ti~rea Dwelli~s ~ PERMITN~8066~
~Z Manufacturer S~se~ ~S~C Material~e~~ No, ofco~partments
~ ~ Liq. ca acity in gallons Inside length Width Liquid depth
1~O ~1 IF HOMEMADE:
~ ~ DISTANCE TO: Well Dwelling PERMIT NO.
O ~ ~ Manufacturer Materia] Liquid capacity in gallons
D Well Foun~ Nearest lot li~ ~t PERMIT NO,
~ DISTANCE TO: 130 ~---
~= ~ ~ NO. of li~es Lengt~ ea~ine Total len~f ~s Trash ~h Distance between lines
~ Top oltil~to~ni~r.de Material ~ne~tilo inches ITot. I
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundatio~ Nearest lot llne
~ DISTANCE TO:
~ Class Depth Driller Distance to lot [Jne PERMIT NO,
~ Building foundation Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER
PIPE MATERIALS
Cast Iron & Perf Plastic Pipe
SOl L TEST RATING
150 sq ft/bedEoom
DATE LEGAL
72-013/Rev. 3/78)
F'ERM~T NO.
[:'EF'RR'FMENT OF?'FtEFILTH FIND EN',/IRONMENTFIL P~?FECTION
· ' 825 '"L S'FREET., FINCHORI~GE, FiE.
26,4-472E~
780664 >
3:4.4
'gF..,I It~RE FEE'F
T'~'F'E 13F =,LIIL. HE.:,uF. ETkI[4 _,LJEfl IE;: FFEN_.H
f'tR::'::If'ILIf'I ['4LfiE. EF. OF E:EE:,F.:OOM:5 :=.:.?
9]IL fi:FITING :'5;. Fl. E,F. .....
THE REI;!LIIRED 'qlZE OF THE ~,,FIIL I-IE,::,uF..FI I.N ..,'~_, E. fl I_
[:"~EF"TH= "-'-) L. Ehl,3]"I"-I= 4-C5 EJ~?~'-/EL- E- ELF ]
THE LENGTH [)IMENSION IS TNE LENCFH ,'IN FEET~ )F THE TRENCH )F' DRFIINF!ELi:,.
THE DEPTH OF Fl TRENCH OR PIT !S THE DI'STFINE:E E, E F[4EBI THE SURFFlCE OF THE
GRCtI_IN[:, 8ND TNE BOTTGM OF THE E}::I]Ft',/R-[IGN (IN FEEl'::'.
THERE=' IS NO SET ~,.II[:,TN FF¢_ . TRENd{z,.¢ ' -' '-
THE GRfl',,,'EL [:,EPTH IS THE HINIMUM [:,EF'TH OF GRR',,,'EL E, ETHEEN THE OIJ1TRLL F_FE
RND THE E:OTTOM OF THE E..-~Hcd]ILN (IN FEET).
F'ERi','I I l" HI- F L I JtN f ~ 1 _ THE RE: F ult:: I ~ ~ L I 1 ~- TO I NFOI-tl',l TH I ~:; r:,EPFF. J'FIENI' DUR I ilL"~ l'}iE
INSTFILLFITIGN ~it_FE_.rlJl_, OF tiNY ~.ELL_ FtDJ'FE:ENT TO THL{:, ~; F:_FEN'~ FIN[) TFlE
' :'= : ' - ': -,EF., E,
NUME:E[4: OF RE-,I[-UL.E-, TH~T THE ['.tELL I'4ILL '": '""
.......... 'T f,4C~ (-..="':" .":" Z tN.=-F E-L- F :[ C~ F-k:7 R F.' E: F:"F:. .... l::,l ~ I F-': E: [:'
E:RCKFILLING GF RN"r' S"/STEM [,IITliOUT FINFlL INE, PECTION fiND HFFF.. HL E,'r TIII~,
" ' ':-' ' FR_:EE. UTI-N.
DEF'Ia[;t. TMENT [4ILL BE :,IJE, JE_.I TIZI ''-'- ' -
I"tINIHLJM DtSTRNCE BE'I}EEN FI [4ELL FINE) RN'¢ ON-SITE SEI,.IRGE DISF:'O:SRL SYSTEM IS
:I.E~8 FEEl" FOR R PRIVRTE [,ELL~ OR
15~} TO 2e,~, FEET FROH R PUBLIC 1.4ELL DEPENDING UPON THE 'F'¢PE OF PUBLIC I,ELL
O-FHER REI;!UIREf'IENTS f'lFfT' RPPL"L SPECIFICRTICINS fiND CONSTRUCTION DIFIGRt:~I"IS RRE
FIVRILGBLE TO I[GURE PROPER iNSTRL. LRTION.
F::'EK:P1 I "F EE...-,,F Z K.E._. [)~C:Ef-IBEtE: 2c::L.,, il_.,
I _.ERIFz THflT
i: I Rf't FFtMILIRR kllTH THE RE~?UIREMEf'ffS FOR ON-SITE SEHE[~'.S RN[> HELLS FlS
FORTH Bk" THE HUNZCIPflLIT'¢ OF RNCHORRGE
2: Z I.,~ILL INSTFILL I'HE E;YSTEM IN RCCOR[:,RNCE klITH THE CODES.
3: Z UN[:,EFSTRND 'THRT THE ON-'SITE SEt.4ER P¢STEM HRY REI~!UIRE ENL. FIRGEMENT IF THE
RESI[)ENCE IS REHODELED TO INCLUDE MORE THRN 3 BEDROOMS.
S 113NED: .....................................................................
BRUSS
1940 POST
PHONE
& ASSOCIAT£$
ROAD ANCHORAGE ALASKA 99501
¢907.~ 279- 5033 BERNARD BRUSS P.E. CONSULTING CIVIL
ENGINEER
28 June 1978
Invoice 7810628
Mr. Emil Remus
Laurel St
Anchorage Alaska
Dear Mr. Remus:
Attached are three copies of a 1978 Sewer Improvement Drawing
as requested by you at a cost of $150. This drawing should be
submitted ~o the Municipality for approval before work is started.
Sincerely yours,
(/'N, :~'~) ~ SOILS LOG
MUNICIPALITY OF ANCHORAGE
[] PERCOLATION
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST
Pouch 6,650, Anchorage, Alaska 99502 276-222~
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR: Emil Remus, Laurel St Anchorage AlaskaoatE PERFORMED: 22 July 1978
LEGAL DESOR,PT'ON: Michelle Subdivision Lot 69B (SW~,NW~,sec33.,T13NR31~ SM)
1
2-
6-
7-
8-
®-
11-
12
14
15
16
17
18
19
2O
Spi__l Description
~rown s~d with wood
eor~s vege~atzon
Clean Brown sand, some
tan s~nd~ dry, SP
SLOPE
SITE PLAN
WAS GROUND WATEF~res at
ENCOUNTERED? i~ '~'
r§h? ilty silt
IF YES, AT WHAT
DEPTH?
Table at 13 Ft
om of pit 13 ft
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
(minutes/inch)
TEST RUN BETWEEN FT AND FT
COMMENTS 14 ft long trench excavated down to depth of 13 Ft. Water found
at 13 Ft. Clean brown-tan s~d found do~n to 1Oft at soil rating
n~' 15~ ~n ~t p~ b~_ ~ ,,~ ~ ~tw~n h-9 ft for !each_
72-008 (7/76)
L~URE ST.
............... r2r-
-I N 0 o 06;30" V'/ - 131.93
NO°O6'30"W - 263.83
VI ST.
PEFd"1I T
FFLI _.l-WI
t_L' 7 FIT I ON
LEGFtL
Ir.1 IUt ~-& % iCZ: .~ ,-'~'~-~ L_ ~ T' "m"
[:,EF'FhRTMENT L
:'~:2P; '" L'
Et'lI L ~i Ei'l_ _
V I _, FF. EEi'
"HEFILTH Ffiq[:, EN!,,,'IRONf'IENTRL/- '[~!TEI_-:TIL'd'.,I
C, TREET FII'.~ '2. F EIF~ FIGE., =t -::
L_,SgE: %3:3: T:L~N R2~N GRID
5'108 ',/I _-,TF~.E.E"I
L. El'f' '51 Z EZ
MINIfdUH .C, ISTRNCE BE'T!-,.IEEN R P~ELI.. RND FINY ON-E;ITE EiEHIRGE [:,ISF'OSRL S'.r"STEf'I tS
iE'"Z~ FEET FOR R PRIVRTE NELL.~ OR
:1_5C'~ TO 200 FEET FF:'.Offl Fi PUBLIC HELL DEPEN[:'ING UPON THE T'T'F'E OF' PUE:I..IC I-,.tELL.
NELL LOGS RRE REQUIRED FIND i"tUST BE RETURNE[:' TO THE DEPFIRTMENT !.,.IITI-IlN ]~0 DR"r'E;
OF ]'NE NELL COf'IF'LETION.
OTHER RE(-]UIREMENTS i'lFl"," FtPPL."r'. SPECIFICBI"IONS RND CONSTF.'.UC]'ION [."IRGRRi'"I~.;; RF:E
flVfllLFIBLE TO INSURE PROF'ER INSTRLI~FI~ION.
I L-:ERTIF"r' TI-IFIT
1: ]' Fli"l FRi"tILIFtR NITI-I THE f4:EQUIREi"IENT~; FOR JN-:.,I FE $E!.,.IERS FINE:' I-JEt_LE;
FITJRTH B"r' THE i"IUNI_.IPBLIT~ OF Hi',IE. HI..IRH.~E
2:: I NILL. II'4.:TFILL THE _,¢_,TEi'I IN FI_-C-F.'DFINF:E I.,.tITN THE L-:OE. EE;.
RF'F'L I C:RNT Et,II L F.:EMU S
i .m,:.',UE[ EfT' ............ [:'~TE
//
SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF
~15o00
DRILLED AT tHE RATE OF PER FOOT.
Ilk. ~ lt. ?,~ PawJ~¢¢, /lAzzoL~ 99507 944-1650
PROPERTY OWNER
LOCATION OF WELL SITE.
DRILLER /~e2n, J~ ~
WELL LOG:
0 .... 27 ' Sa. ad.
780651
WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF
COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING.
,¢21.q6. O0
THANK YOU VERY MUCH.
DATE'
BERNIE CLAUS OF RAMPART DRILLING WORKS
SERVICE CHARGEOF lY2% PER MONTH WILL T DUE ACCOUNTS.
MUNICIPALITY OF ANCHORAGE MUNICIPALITY' OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT OF U~,LT'''{., 8
825 L Street- Anchorage A aska. 99501 EFtVJRONi;~N1-AL'.. >£ Li'.~r rCTION~ ~
ENVIRONMENTAL ENGINEERING DIVISION ADP ~ ~l,~ ~/
Telephone 264-4720 m/~ ~ ..... ~
SEW
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND .~(~
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing·
1. PROPERTY OWNER PHONE
MAILING ADDRESS
PROPERTY RESIDENT (If different from above) ~
PHONE
PHONE
PHONE
2. BUYER
PHONE
MAILING ADDRESS
3. LENDING INSTITUTION
MAILING ADDRESS
MAI LING ADD~ESS
·
S. LEGAL DESCRIPTION
6. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] One [] Four [] Other__
~' SINGLE FAMILY ~E]. Two [] Five
[] MULTIPLE FAMILY [~ Three [] Six
7. WATER SUPPLY
~r' INDIVIDUAL~ * ATTACH WELL LOG. A well log is required for all wells drilled
[] COMMUNITY since June 1975. For wells drilJed prior to that date, give well
[] PUBLIC UTI LITY depth (attach log if availablm)
8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE~
[] PUBLIC UTILITY
**If individual/on-site, give installation date
L,,~tl.:.,B ~,__. t..._..t,
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
I NSPECTI ON APPel NTM ENTS .
TIME TIME TIME
DATE CATE DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTI LITY
Connection Verified_ LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified INSTALLER
[~Septic~nk or [] Holding Tan~
Size: ) ~ If Tank is homemade SOILS RATING
give dimensions: [ ~ (~
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCESwELL TD: Septic/Holding//O Tank Absorption[ ~ '-~ Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
~PPROVEDFQR ~_~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED ~~
DATE BY (T~ C
LEGAL DESCRIPTION J
72-010 (Rev. 3/78)