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HomeMy WebLinkAboutKNIK HEIGHTS BLK F LT 3Knik H ights Block F Lot 3 #017-$71-03 Municipality of Anchorage Development Services Department ~'~ Building Safety Division - On-Site Water and Wastewater Program. 4700 Elmore St. P.O. Box 196650 Anchorage. AK 99519-6650 Page of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: .~O~10 i¥~ PID Number: O[~-~ - O~ Name: F~o ~r~ ~ Wastewater System: ~ New ~ Upgrade Address: l~ 5~EL ~q~E ~0~O ABSORPTION FIELD Phone: , Number of Bedrooms: ~ ~ Deep Trench ~ Shallow Trench ~ Bed ~ Mound ~ Other: LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: ~.O GPDIFt~ ~.5 Ft. BIock:~ Lot:~ K~[~ Subdivision:~l ~T~ Depth to pipe bottom from original, grade: Ft. Gravel depth beneath pipe:~ Ft. Township: Range: Section: Fill added above odginal grade: Grave~ Length: 1-~ ~,. ~ ~,. ~:~2~abo~{~~, ~New ~ Upgrade Gravel width: ¢ Ft. Number oflines:[ Distance bekaert lines:__ Ft. ' ' (P ' to, A,~, C): Total Depth: Cased to: Total absorption area: Pipe Material: Driller: Date Ddlled: Static Water Level: Installer: Yield: GPM Pump Set at: Ft. Casing Height Above Ground: ~,. TANK SEPARATION DISTANCES D Septic ~ Holding D S.T.E.P. ~ Other: T~ Septic Absorption Lift H°lding 3ublic/Private Manufacturen~ ~ At ~ Capacity: Tank Field Station Tank SewerLine Mateda~[O ~ ~ ~ Gal.~ ~ Number of Compadments: t ~]~ Size: Manufacturer: ~/A "Pump 9n'' level~at: in. "Pump off' ~level at: in, High water~l/~ala~ at: in. Foundation / Make & Model Electrical CudainDrain ~' O. ~. O, ~. O. / ~ PumA~y~ ,,8pectionspedormedby: Remarks: ~,r,{;., %-~ ~ PF~ F;~3 BENCH MARK / Location and Description: Assumed Elevation: "H" IOO Inspections performedby: b~c5 ~,C~n~ Dates: 1st */Z~/O' Engine~'.~p ~ .--~ ~,, Development So.ices Depa~ment Approval ~ e;..' ~'~ '"':7 ~ ,.z ..... ~ ....... ~... Conditional Approval Date: N A B ¢ O 27.0'5.0' E 33.$'15,0' F SZO' 98.4' 0 74.0'90.6' INSTALLED 4-BEDRO01~ SEPTIC SYSTEI*t BIOCYCLE TANK P// SHALLOP/ TRENCH LENGTH ¥0 FEET P/IOTH 5 FEET TOTAL DEPTH 4.5 FEET ROCK DEPTH 2.5 FEET INSULATION 2 INCHES COVER +/- 3 FEET SLgPE ¢ lOX · .*.. . ..*"*** . '.'* : · MOA CODE REOUIREMENTS LOT 4 NOTE: THIS IS NOT A SURVEYED PI. AT. WELL & SEPTIC LOCATIONS TAKEN FROtl ON-SITE WATER AND WASTE WATER OEPARTI~ENT OOCUIIENTATION. ALL LOCATIONS SHOWN ARE APPROX#IA TE. 2~ 0 2~ ~0 75 100 125 1~0 SCALE; 1' = 50 Fll .£T 8 · 49th No, CE-11500 SPURKLAND ENGINEERING 205 P/ 15TH. AVENUE ANCH. AK. 99501 (9OX) 2Z9-$91~ IIKNIK HEIGHTS BLOCK F LOT 3 FRED GRIFFITH 12900 SHELBURNE ROAD SEPTIC SYSTEM ASBUILT DATE: OCT, 9, 2009 SHEET: 2/$ GRID: 2856 PERMIT # SV090179 PID # 017-371-03 KnikHei~?h$sYBFL3D2.dwg £OUIVg~AT]LIV CLEAN OUT ~ 4' #tlNITll~ T.H. F z'- F_..R4i~ TO llP. AIIV I SLI~PE FINISt,,E'B GR411E AllAY / ~L~-I/~ I~ULATIIJN - ~ 6' MIN .... ~:'a ~ T/iV/3/ALL .D/,CZ"CT/O/V$ ' 93.4' a' .a nl$CttA/i~E ,~~ d '. ..... --- ........................ ;,-t' l'£/_m.= ~t.$'l ^ - -- I ~-0 ~%.~' SA/O/GiZAVEL I SHALLOV T~ENCH I '~[ ......................... ~?'"'"'"'"'"' ........ [~ ~ ~2 LEVEL~ ~T~ ' E.O.~. 7~.~' IN2 TALL A TION 1, EXCAVATE A iff' x ]fl' x ~fl' flEEP HOLE FOR ~IOCYCLE 2YSTE~ ~, PLACE 4 MINIMUM OF ~' SAND OR GRAVEL FOR LEVELING COURSE IN THE ~OTTOM OF THE EXCAVATION COMPACT AS REQUIREfl, 2 PLACE 4 SHEETS OF ~' x ~' x ~' DIRECT EURIAL RIGID INSULATION ON TOP OF ~OMPACTEfl LEVELING COURSE TO PROTECT EOTTOM OF FIEERGLAS2 TAN~ TAKE EXTRA CARE TO ASSURE THAT INSULATION COURSE I2 LEVEL IN ALL flIRECTION~ ~. EACKFILL AROUN~ TANK UP TO INVERT OF 4' INFLUENT AND ~-~/4' EFFLUENT LINES ~ITH FREE-FLO~ING NSF MATERIAL FREE OF LARGE STONES OR EOULflER2,  2ANB/G~A VEL BACKFILL / / .'.:.'' . .... ~ / .; :~. ".'...:.,.'~:.: "":~ 'Z 4~ ~ h~ "'...'....: ~....~..:?: ..... ~.~ ........ t:r ..... ~., ..... .... .. ...., SPURK~D ENGINEERING ~IK HEIGHTS BLOCK F LOT 3 sePTIC SYSTEU ASBUILT 20~ · t5TH. AVENUE ANCH. AK. 9950f FRED GRIFFITH DATE: OCT. 9, 2009 ('907) 279-~9~6 f2900 SHELBURNE ROAD SHEET: I/3 GRID: 2~8 PERMIT ~ ~090179 PID ~ 017-371-03 gnlkHelghts~FL39gd~g Inspection, Report Municipality of Anchorage, Building Safety DiVision 4700 Elmore Road INFO & HELP (907) 343-8211 INSPECTION: VOICE (907) 343-8300 · FAX (907)249-7777 · www.muni.org Name same Company solid ground elec Address 12900 SHELBURNE RD Grid SW2836 Subdivision KNIK HEIGHTS Work Description INSTALL FOR SEPTIC SYSTEM Insp. performed/prepaid Permit Technician Comments or Directions Permit # 09-9749 Inspection Date 30-Sep-2009 AM Phone 727-8008 LOT 3 BKF TR n/a 1/1 BROOKS, TINA J. call 30 minutes out Inspection Type Electricai::Final Electrical Comments (for inspector use only) MUNICIPALITY OF ANCHORAGE Development Services Deparlment On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Sep 16, 2009 Expiration Date: Sep 16, 2010 Permit Number: SW090179 Legal Description: KNIK HEIGHTS BLK F LT 3 Design Engineer: 0007 SPURKLAND ENGINEERING Owner Name: FRED GRIFFITH Owner Address: 12900 SHELBURNE ROAD ANCHORAGE, AK 99516-2923 Parcel ID: 017-371-03 Site Address: 012900 SHELBURNE RD Lot Size: 43500 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] DisposalField [] SepticTank [] Holding Tank [] Privy [] Private Well [] Water Storage Ail 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Date: Municipality of Anchorage Development Services Department ' Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road ~-'l' ~ P.O. Box 196650 Anchorage, Alaska 99507 www. muni.org/onsite (907) 343-7904 ON-SITE SEWER/VVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Property owner(s). FRED GRIFFITH Mailing address 12900 SHELBURNE RD., ANCHORAGE, AK Site address SAME Legal description (Sub'd, Block & Lot) KNIK HEIGHTS BLK F LOT 3 Legal description (Township, Range & Section) Lot Size .Day phone 345-1282 Zip Code 99516 .Zip Code /"1 ~.. ~'00 Sq, Ft. Number of Bedrooms 4 THIS APPLICATION IS FOR (~3 all that apply): Absorption Field [] Septic Tank [] Holding Tank [-~ Pdvy [] Pdvate Well [] Water Storage [] THIS APPLICATION IS AN: Initial [] Upgrade [] Renewal [] 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. (Sign~ure of property owner or authorized agent) Permit/Rush Fees: Date cf Payment: Receipt Number: (Rev. 11/05) Waiver Fees: Date of Payment: Receipt Number. Environmental Consulting and Deslgn I SEPTIC SYSTEM DESIGN KNIK llEIGIITS BLOCK F LOT 3 Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 Elmore Road Anchorage, Alaska 99519 September 11, 2009 Subject: Septic System Installation Permit 12900 Shelbume Road Ladies and Gentlemen: I am writing to request a permit to upgrade thc septic system for thc above referenced property. The proposed system will serve a 4-bedroom single-family residence. The existing system was installed in 1982 and is in a state of failure. Soil logs, design calculations, a site plan, design drawings and construction specifications are enclosed for your review. Design Calcs: No Groundwater observed to a depth of 17 feet Soil Rating. From Test hole (8/26/09) 11.4 rain/in = 3.0 gal per sq.fl./day No. of Bedrooms 4 Required Area per Bedroom: 150/3 =50 sq.fl. Total area required: 50 x 4 = 200 sq.fl. System: We are proposing a BioCycle Advanced Treatment System, and a shallow trench absorption field. The absorption field will be 40 feet long, 5 feet wide and contain 2.5 feet (312 sq.fl, effective) of sewer rock. Soils: A test hole was excavated on August 26, 2009. See the attached soil logs. Ground water was monitored for through September 2 , 2009. Ground water was not observed. Surface Water: No surface waters were observed within one hundred feet of the proposed septic system upgrade. Topography: The lot slopes west at a slope of S-10 %. 203 West 15'h Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland~gci. net Environmental Consulting and Design I Waivers: None Required The installation o fthis septic system will not prevent wells and septic systems from being installed on thc adjacent lots. The proposed septic system will not change the general slope ofthe area. Ponding and/or concentration ofsurface runoffwill not result from this installation. i fyou have any questions or concerns, please contact me at 279-3916. Sincerely, Civil Engineer 203 West 15t~ Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland~gei.net ¸17 LOT ~6 r- LOT 15 I- LDT ~ LDT I THIS I$ NOT ,4 SURVL'I'Efl PLAT, I~LL & $~PI7~ I LOC4170NS TAK~tl ~ ON-S~'~ WA1~R AND N~4ST~ ~41~R APPR~XI~L4 ~ SCALD 1' = lflfl FT, SPURKLAND ENGINEERING 203 IV 15Ttl. AVENUE ANCN. AK. 99501 279-3916 II I6YlK HEIGHTS BLOCK 1~ LOT 3 FRED GRIF£1TN 12gO0 SHELEURNE ROAD SEPTIC SYSTEId DESIGN DATE: SEPT. II, 200~ SHEET: I/$ GRID: 2836 PID # I I I N F 3 LOT 4 NO~' ~i~ B NOT ,4 SURV~D 1~AL WELL & .~PTIC ~EP/i~L'NT ~t~,UML'NTATION. AII LOCATIOXS ~OWN ARE APPROXIIIA SCALE, 1' = 50 FT. 7T 8 i~ 49~h SPURKL4ND ENGINEERING 203 I~ 15TN. AVENUE ANCX. AK. 99501 (~07) 27~-3~ PERMIT # IIKNIK HEIGHTS BLOCK F LOT 3 FRED GRIFiTTH 12900 SNELEURNE ROAD Piti # II SEPTIC SYSTEM DESIGN BATE: SEPT. 11, 2009 SHEET: 2/3 GRID: 2838 KnlkHeightsBFL3£~.dwg I SHALLOV TRENCH INSTAL L A TI£N 1. £XCAVAT£ A ID' x ID' x ID' ~EEP tgTI. E ~ ~IOCYCLE SYSTEK ~ FY. ACE A HINIY~4 ~F' 4' SAND ~1~ Ed~,4VEL I:~ LEVELING COL~$E 1N THE ,~7TT~4 Dr THE EXCAVATI~L ,2 PLA~ 4 SHEETS Dr 70 PEOTE£T ~TTTOH Dr FIB£R~I. AS~ TANK T,A,~E £XTRA CAd~E TO ASSU~E THAT [A~..ATJ27N COURS£ ]$ LEVEl. IN ALt ~IR~CTI~tq$, 4, ~4Clfiril. t AR'[7UIVD TANK LP T~ INVE,~T Dr 4' INFLUENT AND 1-1/4' EFFLUENT LINES VITH F[?EE.4'I. OVINC. NSF MATERIAL FREE Dr L~ ST~VE$ SAND/6RA V~L ~4CXTILL :' ',,7,.":.' ~'::~*[~ 40~h ~ · .. - .. ..: ~.....~......~.....r~tl.......,.....~ · · ·~..l.~_~.~ ............. SPURKLANO ENGINEERING I I 20J W I5TN. AVENUE ANCN. AK. 99501 (907) 279-:7916 KNIK HEIGHTS BLOCK £ LOT 3 FRED GRIFFITN 12900 $HELBURNE ROAD IISEPTIC SYSTE~ DESIGN DATE: SEPT. II, 2009 SHEET: I/:7 GRID: 2878 PERMIT # SVO9OXX PID # KnlkHeloht$~cLS~dvo Performed For: Legal Description: 1., 5- 6- 7- 8- 9- 10- 11- 12- Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Soulh Bragaw St. P.O. Box 190650 Anchorage. AK 99519-6650 www.muni.org/onsite (907) 343-7904 Soils Log - Percolation Test Fr:'-~, 6,,'(Fi t~ Lo~- .,.~ Township. Range, Section: Slope LE Site Plan WAS GROUND WATER ENCOUNTERED? IF YE S. AT WHAT DEPTH? ~ L O 15- 16- 17- ~8- B,o.~, 19- COMME.TS P~ So.~.~ Reading Date Gross Time Net Time Depth to Water Net Drop r~ "~/~ ,, mos PERCOLATION RATE ( ~, ~ (.~.x~ ~'~) PERC HOLE DIAMETER TEST RUN EETWEEN ~t/% FT AND ~1/~. FT PERFORMEDS¥: /.',,, ' /.-.', 5',"J'1'4 CERT,.T.AT'"',,STESTWAS PERFORMED IN ACCORDANCE Wh'H ALL STATE AND MUNICIPAI. ~'I~DELINE~S IN EFFECT ON THIS DATE. DATE: */,/O~* AI)VANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND IH;PAIR AGREEMENT blEMORANI)UM (IF UNDERSTANI)IN(; BETWEEN blUNICII'AIATY OF ANCIIORA(;E AND F,--,¢ C~,-;(f', tk, 'H IlS MF. MORANI)UM OF {INI)I!RSTANDING made and entered into as oFthis herein thc "OWNER." anti rite Municipality of Anchorage. herein thc "MUNICIPAI.ITY." In consideration of thc mutual covenants contained herein. parties to this Memorandum of Understanding agree as follows: I. AI)VANCED WASTEWATER TREATMENT SYSTEMS. Munici~lity grants ~rmission to Owner to utilize and o~rate an Advanced Wastcwater Treatment System (AWW'rS). described as $,c ~_~g ....... located 2. I)efinitions. · Anchorage. Alaska. A. Alteration. Any change lo the design or fimction ol'an AWWTS Ihat Includes the installation nr removal of any parts, components or pieces not incladed in the original construction ~it and design. I'rior to ~rfbmling any alterations to an AWW'I S the ox~ner must obtain a Wastewater l)isB*sal System Construction Pcmfit thnn thc Manicipality pursuant to Anchorage Municipal Code (hereinafter. "AMC"} 15.65. B. Certificate of On-Site Systems Approval An approval by thc Municipality of existing water and wastexvater disposal systems given at the lime of pro~rty sale and tille transtkr in accordance ~xith AMC 15.65. These approvals ccrtil~' that the systems are adequate lbr thc homes that they supIx~rt and meet thc codes that were in place at the time of system construction. C. Damage. Any man-made or naluml change in a system fl~at ~ould inhibit fl~c system flora ~rl~rming as designed. D. Maintenance and Repair. 'lhc scheduled and as needed replacement of cxisting parts, core,merits and pieces of an AWW'I-S that were included in thc original design ~hich would allow thc AWWTS to continue ~rfo~ as &signed. E. Permit (Conslruction) An On-Site Wastcx~alcr DisD~sal S)stem Construction I'crmit as defined by AMC 15.65. F. Permit (Operating} An Advanced Wastcaater Treatment System Operating Permit. An annual ~rmit, issued by the Municipality, that allows the Owner to o~ratc an AWWTS. u~m meeting all the rcquircmen[s of this ag~cmcnt, fl~c conditions of O~rafing Permit, thc requirements of the On-Site Wastcwatcr System Construction Permit and all relevant provisions of AMC 15.65 3. Fee. O~ncr shall pay In Municipality an annual fcc o1'~ ($ .~._.00). pasablc on or I~fi~rc thc issuance o[Ihe o~rating permit and mmualb' thcrcallcr. Thc annual fcc is duc on or ~fl~re the annivcrsao' date of the approval by Ibc Municipality of installed system. 4. Term. The tcmt ot'this Memorandum of Understanding shall ~ for thc lil~ ortho AWWTS. The term begins on tile date of approval by Ihe Municipalit) of the installed system and shall continue while thc AWWTS system is in usc or o~rational or until the pro~rty is sold or title is transferred by owner and a new certificate of On-Site approval is issued to thc new o~ ncr or transl~rec of thc pro,ny. 5. Al/erati~n~ Installation and Removal of Additional F;qulpment. O~ncr agrees not (o make any alterations, removal of paris or additions 1o thc AWWTS ~ithout a ('onstmclion Permit from thc Municipality. 6. ~lainlenance and Repairs. A. Throughout thc term of this Memonmdum of Understanding. the Owner shall maintain AWWTS in go~ repair. In addition, it shall be thc responsibility of the Owner during thc tc~ of this Memon~ndum of Unde~tanding, and any extensions or renewals ~crcof. at the o~ncr's sole ex,nsc, to pay for any and all: (I) repair(s), (2~ maintenance. (3) a4justment(s~. (4} replacement costs, and (5) ins~ction costs. Further. Owner ag~cs lo comply x~'ill all applicable o~inancc, lax~ s. regulations. rules and orders for the AWWTS. B. ()x~ncr agrces lu provide the Municipality a wriltcn schedule of routine maintenance and rcpain which ha~c ~cn ~rfimncd on the system pursuant to thc terms and conditions contained in thc Owner's AWWTS O~rating I'cnnit. This schedule shall ~- submitted lo thc Municipality annuall3 upon thc rencx~al ol'thc ~rmil. The schedule ofmaintcnancc and rc~air contained in the Oxxncr's AWWTS C. Owner acknuxvlcdgcs lhat Iht linc schedule liar failing to maintain and repair an AWWTS arc codified in AMC 14.60. D. Owner agrees Ihal only maintenance, repair personnel ccrtificd by the Municilxdity will inspect and make an)' necessa~' maintenance, repairs or permitted alterations to the system. I!. ().`.`'ncr agrees lo grant thc Municipality reasonable access to test and inspect the AWWTS upon 24 he, uts written notice. F. ().`.`'ncr agrees that any sale or transfer of ti tlc of the property ','.ill not occur x.` ithout a new Certificate of On-Site Systems Approval. (;. O~.`ncr agrees thztt the relev;mt provisions ofthc standard specilication guidebook for AWWTS is thc governing professional gnid¢lincs for the construction. maintcn:mcc and repair of Ihe O.`vner's AWWTS. 7. Nonwaiver. The Ihilurc ofcithcr party at any time to enforce a provision ofthis Memorandum of Understanding shall in no way constitute a waiver of thc provisions, nor in any way cfli:ct thc validity of the Mcmorandam of Understanding or any part hercol: or the right of such party thereafter to cnf~arce each and c% cry provision hcreot: 8. Amendment. A. *l'his Memorandum of tlnderstanding shall only bt amended, modified or changed by a writing, executed by authorized representatives of thc parlies, v, ith the same lbrmality of lifts Memomndtun of t Inderslanding was execulcd ami such v, riling shall be attached lo Ibis Memorandum of Underslanding as an amendment. B. For the purlx'~scs ofany amendment modification or change to thc terms and conditions of this contract, thc only authorizs:d representatives of thc parties arc: ^nehorage: Purchasing, ¢)fficcr C. Any attempt to amend, modi[~', or chan~c this contruct by either an unauthorized representative or unauthorized means shall bc void. 9..luri~diclion: Choice ~r I,a,,. Any civil action arisin~ lh)m Ibis Memorandum oF Undcrst~ndin~ shall bc brought in the Su~rior Court G~r thc Third Judicial District oFthc State oFAlaska at Anchor~c. Thc laws o~thc St;dc o~Alaska shall ~nvcm thc rights and obligalions oF Ibc parties under Ihis Memorandum of Understanding. 10. Severahilily. Any provisions oflhis Memorandum of Unde~tanding decreed invalid by a court of core,tent jurisdiction shall not invalidate thc remaining provisions of thc Memorandum o1' I Indcrstanding. OWNER: MIINICIPAI,ITY: Da~ _ _ Date: STATE OF AI.ASKA ) ) TI IIRD JUDICIAl. DIS'H~ICT ) Thc fi~rcgoing instrument was ackno~lcdgcd ~fi~re mc this ~day of ~~ N()T~Kh I'IIBI.IC I.~)R ~A~A I OI'I'I('I;Xl. SI:Al, I - -- I USA A. VANDESGRIFF I I NOTARY I'UBI.I~ I 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 V~AI LING ADDRESS LEGAL DESCRIPTION LOCATION Well DISTANCE TO: Liq, capacity in gallons Inside length IF HOMEMADE: H Absorption area I Dwelling 15 .. 5' II, Mate~  Width NO. OF BEDROOM..g Foundation PERMIT NO. No, of compartments Liquid depth Well Dwelling PERMIT NO. DISTANCE TO: Manufacturer I Material Liquid capacity in gallons DISTANCE TO: Total length of.~n.e~ ~. Material beneatl~-tile Nearest lot line '~ i No. of lines Top of tile to finish grade We,, /20' P E PdYl I T NO. Distance ~ ToOtSie n area Length Width Depth PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area Well Builciing foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO, DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS ~2~13 (Rev. 3/78) DATE LEGAL ! i'iif!-:i::I-i" I' 'THE L.!iii;!",!(!i I'!'1 £;:, ;Ii !"lt!i;?:!'i~; '!"HE DEI::'TF! O!:::' I:;:1 ~.~i!:,iX}I..IND I::Ii",!!) "I"H!:{ "i'Hli~;i:;;:!ii: ];;:~i; i",!O :~i;E!:T HIDTH 'i"I"iii~:: (]~Fi:l:::t',,,'!ii~l... D!i~:}::'"I-H FIND "i"!'1i!:~: !30"1'-1'O?! O!::: U!:::'EII'-! 'T!'IE "i"~.'!:::'li~: OF' !:::'I..J.~3L.]:C t,.!lii!L.! ..... I"I;i;H)ii'"IL!!"! D]:ST!:':fi":!CIF_:. FI:;iiOI"! !::! I:::'l:;?.:i:',?Fl"!'[i: HELL '1"O F:! Pl:;il];'v'l:::l"Fl!i: :ii!;li!:HEi;;: I_..]:l",!lii: ;(!i!; ;?.!.!!i !;::'!Eili~T FIND I:::! E:OI"!I"ll..II",!:!]T"/ :i~.;!i!:HEl:;i~ !... iii i'qE !'S 7"!!il !:::'!~EE:'T. HF[I...I.. t...(~'lG S THE I,IEI...I... O"F H i~i;!:;i: F:i~D~:!tJ I:::! V !:::I ;I; L. l::!!i:). L !i!!; !.: ;( i:::I1"I F'I:::II"! ;!; L. :!: F!!:;?. !.,.!;~"!"H THE I:::'(')!:;~'.TH !~i',"~" "I'H.E !'"I!.JI",!iti(]:;!;!;:'FII....:ilT'./ ;~::: ;!; H ;!; L.L. ]1: I',!!!iiTFIL. L. T!-'IL( S"/i:]~;"i"!ii:i'"l ]: i":! FICE:O?.DFi!",!(.':!;ii; 14 i~ 't"1"1 't"t'"1!i:~i (.":ODE'E;. ;~:: ;1; LIHI;)EI::?.!i!!;TI:::II",!i:) Tt"IFI']" THE ON'""':'.:;~TE S!!i!:I.,-IL::i:;~I S"/?F!!~::!"I !"!F!"?' !:;?.IE~;!IJi!iI:;?.~: E,~.,!L.!:::!i:;;:(?~!i:t"i~_::iH"I'' ]:!:::' "FHii~ RE!::; i!; D.~Ji;!",lC:!i:{ ]: ':::; F?.!~i!;f"'!OD~ii:i....F~D "i'O PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 5 6 7 8 9 -~"--1 o 11 12 13 14 15 16 17 18 19 2o COMMENTS PERFORMED BY: SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTFCTION 825 L, Street, Anchorage, Alaska 99§01 264-4720 SOILS LOG -- PERCOLATION TEST [] PERCOLATION TEST DATE PERFORMED: SLOPE SITE PLAN I I I THOMAS R, SMITI-I 2248..E WAS GROUND WATER~ ~(~ S ENCOUNTERED? L O P E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND//~-- FT 72-O08 (6/79) WATER WELL RECORD STATE: OF ALASKA DEPARTMENT OF NATURAL RESOURES MUNICIPALITY OF ANCHORAG~ivision of Geological a GeophysicelSurveys ~FPT (~r: I-'~,',i.T'~ :% LOCATION OF WELL e~.IBOrOugh Subdivision ' ' I~0t Block c~.~OISTANCE AND DIRECTION FROM ROAD INTERSECTIONS (Please complele either la~ lb or lc.) Streel Address and Area of Well Locotlon Material Type WELL LOG o,_ o,_o, --r .... r- - , [] Top Feet Below Surfoce Bottom E[-~ Meridian wE] 16. WATER WELL CONTRACTOR'S CERTIFICATION: 4. WELL DEPTH: (final) '~ ;'F:, ft. 5. DATE OF COMPLETION G, []Ceb~e too, []Rotary []B,i.en []D.g E] Auger E;] dotted [3Bored © Othe,, 7. USE: [] Domestic [] Public Supply ~ Induslry [] Irrigelloe [] Recharge [] Comma,leal [] Test Well [] Olher: B. CASING, [] Threaded E~ Welded dian~. ..' .in. to i,J~) ft. Depth Woighl ¢'~' ,lbs./ft. diem, in. Io.__ ff. Depth Stickup__. fl. This well woe drilled peder my jurisdlclion cad this report is true Io the besl of my knowledge and belief; :,:~:, i ~';i ! 1:;.'_,,; ' h/~. 14. REMARKS: ~5. Water Tomperuture ...... o ~[-'~ F [] C I2,GROUTING Well Grouted: [] Yes [] NO Molerlel: E~Noaf Cement []Other: )!:16HE','~i. 13, PUMP: (if available) HP Length of Drop Pipe fl. copocily g.p.m. E) Subm. [3 Jet [] Cenlrifice[ [] Other Registered Business Noms ¢ Contract License Number ..(/ ¢ ' / / ' -" - ~ aa,o: ~--';'.,,./l"v~';".' ,., %¢ ~ t' ~ ........ Aul~orlz~ ' Rep~ese~o~i've , , Il. PUMPING LEVEL below land surface cad YIELD ff. afler hfs, pumping '0. STATIC WATER t. EVEL: 'i :' ' ft. ~" /i~. Date [] Above or [] Delow land surface API: LIC FILLS OUT UPPER HAL ONLY Phone Address Zip Code Lending Institution Phone Address Zip Code Address Zip Code Street Locati~ Type of Residence ~'" Single Family [] Multiple Family No. of Bedrooms n Other Water Supply ~'"'lndividual A-[TACH WELL LOG. A well Icg is required for all wells drilled since June 1975. [] Community For wells drilled prior to that date, give well depth (attach Icg if available). [] Public Utility Sewer Disposal /~ Individual [] Public Ulilily [] Holding Tank Year Individual Installed: When Connected 1o Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: ANCHORAGE ,MUNICIPALITY OF ~-~7) APPROVED BEDROOMS 'CONDITIONS OF APPF{OVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL* Sofls Rating Date 8ewer Installed Well To Abeorplion Area Well l_o~ ~eceived Well to Tank Septic Tank Size 72-023 (3182) Oct. 22, ~9S2 & ENGINEERS, INC. $ .... .,MUNICIPALITY OF ANCHORAGE 7125 OLI0 SEWARD HIGHWAY, ANCHORAGE, ALASKA ~uz ~,~:, ~ ...... ,~, ~ , ,.. 'L [iON ENVii~ i' ~ Municipality of Anchorage Dep't. of Health and Enviromental Services 825 L. Street Anchorage, Alaska Gentlemen: The undersigned has inspected the well/septic system located an Lot 3A Block F Knik Heights Subdivision. The following are my findings: The well casing is 6-inch O.D. 1/4" steel extending approximately 36~ inches above grade and is capped with a water tight seal. The The electrical wires are extended below grade within conduit. The well is located 145 + feet from the nearest point of the septic system . If you have any questions,please give me a call at 349-6561. EAGLE RIVER ANCHORAGE HOMER (907) 694-9846 (907} 349.6561 (907) 235-8179