HomeMy WebLinkAboutT15N R2W SEC 25 LT 38 Municipality of Anchorage Page / of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: ~q$~o77 PIDNumber:
Name: Wastewater System: ~ New ~ Upgrade
Address:
Pc. ¢~0. ~7/~ ~¢¢¢ ~,~¢~¢ ~ Ce¢7F ABSORPTION FIELD
Phone: ~ NO of ~drooms: ~Deep Trench B Shallow Trench ~ Bed ~ Mou~d ~ Other
LEGAL DESCRIPTION S°ilRatJng: /, Z GPD/Sq. Ft. T°talDepthfr°m°rigin8lgrade~
Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe
WELL: ~ New ~ Upgrade ,Gravelwidth: Numberoflines: lDistCncebetweenlines:
~ Ft. / Ft.
Classification (Priwte, A,B,C): Total De~th: . Cased TO: Total absorption area: Pipe material: ~
Driller: Date Drilled: Static Water Leveh Installer: Date installed:
Yield: ' Casing Height Above Ground:
SEPARATION DISTANCES ~ Septic ~ Holding U S.T.E.P.
Well /Z/ / /~ ~ ~ ~l~ ~aterial: ~ Number°fC°mpartments:
Surface ,~ LIFT STATION
Water /~O /dO / ~ ~
Foundation ~/ ~TJ ~ ~ ~ 'Pump °n" level at: ~ I High water alarm at:
CurtainDrain ~ ~ ~ ~¢ ~. 'umpMake&Mode, ]Electricallnspectionsperfo~
Remarks: ~C ~%~ ~¢~ ~¢~¢ BENCH MARK
"~ ENG N~S SEAL
Inspections performed by: ~70~E~leR~ver Lo~ Ro~d, NB~: 1st ¢ -z-e~ ¢ ~~
Department of Heal~um~n Services approval , , -~, .,. ~ '
72-013 (Rev 9/91) MOA 25
Permit No. ~W930077
Page 2 of 2
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: T15N R2W
N.T.S.
CO1 CO
~
looo OAL I'~
SEPTIC [ 92.7'
TANK J
DBL CO
MT1
SEC 25, LOT 38
TRENCH
NEW 1000 GA
SEPTIC TANK
No 05128137
PID .:_
MT:
86.3~
80,3' NO WATEE FOUND ·
CO3
100' WELL RADIUS WELL#1
3 BDRM
HOUSE
A B
FCO 22 19
C01 47 44
C02 72 69.5[
CO3 99 112.5
MT1 86.5 94-,5
SCALE
WELL#2
72-013 A (2/91) MOA 25
ENGINEER'S SEAL
(gerlifie Drilling
by
DOC Co. dba
OWNER OF LAND
ADDRESS f ~
LEGAL DESCRIPTION
DATE - Started
PERMIT NUMBER
SULLIVAN WATER WELLS
P.O. BOX 670272, CHUGIAK. ALASKA 99567 · TELEPHONE 688-2759
~"'~_ C~'~-''~ DR.~.W DOWN FT.
Ended _ ~ GALS. PER HR _
KINI) OF CASING 6
KIND OF FORMATION:
From ~) Ft. to~. Ft.
From i~ Ft. to ~ ..... Ft.
Fro q' Ft. togS Ft.
Fromo2 ~' Ft. to CIO
From Ft. to Ft.
From ~0 Ft. to.~_ Ft.
From 4 ~ Ft. to.-~e'~ Ft.
,From~O Ft. toT$" Ft.
From '7.$- Ft. to ~-~ Ft,
From Vt. to Ft.
From __
From __
Ft. to Ft.
Ft. to Ft.
.Ft. to Ft.
From__.Ft. to Ft.
From Ft. to.__Ft.
From__Ft. to.___Ft.
From Ft. to Ft.
From Ft. to~ Ft
From Ft. to Ft.
Ft. to Ft
From Ft re__FI
From~ Ft. to Ft.
From Ft. t(, Ft.
From Ft. to Ft._
KtL~IV~U
From Ft to Ft.
From Ft. to_ Vt, NOV 4
~unJcipaHty o~ AnCho~
From~Ft. to DepL Heaiih & Human
From FL to__Ft.
From Ft. to Ft.
From FI to~_Ft.
_ MISCL. INFORMATION:
by
DOC Co, dba
SULLIVAN WATER WELLS
P.O. BOX 670272. CHUGIAK, ALASKA 99567 * TELEPHONE 688-2759
OWNER OF LAND / /CH ~2'g~L '~'
ADDRESS )~ / OX 77/¢q
LEGAL DESCRIPTION ~
DATE - Started Ended
PERMIT NUMBER
DEPTH OF WELL 4 ~i. i .T~. C....'
STATIC LEVEL OF W&TER FF
DRAW DOWN FT
GALS PER HR
KIND OF CASING
KIND OF FORMATION:
From ~ Ft. to-~:~ Ft.
From ~ Ft. to ~ Ft.
From ~ Ft. to ?.~'" Ft.
From-~-~ Ft. to ~'{3 Ft.
Fromm-- 0 Ft. to
From~"" Ft. to__Ft.
From __ Ft. to Ft.
From __ Ft. to Ft.
From __ Ft. to Ft.
From Ft. to Ft.
From Ft. to Ft.
From -- Ft. to Ft.
From __ Ft. to__Ft.
From. Ft. to Ft
From Ft. to Ft.
From Ft. to Ft.
From Ft. to Ft
From ~ Ft. to
From~ Ft. to
From __ Ft. to
From Ft. to
From__ Ft to.
From Ft. to
From Ft. to
From Ft. to.~
From_ Ft. to~
From Ft. to~
From _ Ft. to _
From F& to
From Ft. to
From Ft. to
MISCL. INFORMATION:
Ft.
.Ft.
Fl.
Ft.
Ft
Ft.
Ft.
FI.
Ft.
Ft
Ft
Ft
Ft.
Ft.
_ Ft
DRiLLER,S NAME /~ ~'''-~
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
PERMIT NUMBER:SW930077
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:BOSELA RICHARD A
OWNER ADDRESS:P.O.BOX 771443
EAGLE RIVER, AK 99577
PAGE 1 OF
ON-SITE WELL AND WASTEWATE~ DISPOSAL SYSTEM ~ERMIT
DATE ISSUED: 4/28/93
EXPIRATION DATE: 4/28/94
PARCEL ID:05128137
LEGAL DESCRIPTION: T15N R2W SEC 25 LT 38
LOT SIZE: 108900 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / 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 343-4329 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:
· /
issuED
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER&WATER
INSPECTION
ENGINEERING STUDIES
ANDREPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOIL TEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
iNSPECTIONS
ON SITE
WASTEWATER
OlSPOSALSYSTEM
DESIGN
April 27, 1993
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825'L Street
Anchorage, AK 99519-6650
REFERENCE: Lot 38, Sec 25, T15N, R2W, S.M.
We request you issue a permit to drill a well and install a
septic system to serve the proposed 3 bedroom house on the
ireferenced property.
A test hole was excavated and a percolation test performed.
The approximate location of the test hole is located on the
attached site plan.
This property has enough area for a septic upgrade which can
be seen on the attached site plan. We do not anticipate any
adverse effects on neighboring properties by the installation
of the proposed septic system.
If you have any questions, or require additional information
for your review, please contact us.
Sincerely,
Roger J. Shafer, P.E.
RJS/RLS/LSU/lsu
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
ROBERT SHAFER1 P E
ROGER SHAFER. P E
CIVIL ENGINEERS
{907)694-2979
N~9~ 3lis
,Og = ,,~
Municipality o! Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
DE ~"'~
(FI ET
2 ., ~
3
6-
7-
8
9
~2
15
16-
17-
18-
20-
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Oep(h to W~ter\Alter ~ _
MoniLorino? ~ Oale: z~-.~_.J ~
DATE PERFORMED:
Township, Range, Section: .~ ~"~.~ ,
SLOPE SITE PLAN
i ,
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE '~ (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN '~' FTAND ~' FT
COMMENTS
$ & S ENGINEERING
PERFORMED BY: ;7634 Ea~;~ F,;~,=~ L~.~p
ACCORDANCE WI~J~[~L ~,~ ~J~:~L GUIDELINES IN EFFECT ON' THIS DATE,
72-008 (Rev. 4/85)
CERTIFY THAT THIS TEST WAS PERFORMED tN