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HomeMy WebLinkAboutT12N R3W SEC 32 SW4NE4 PTN E OF RR P.C,. SOX 6650 ANCHORAGE, ALASI<A 99502-C850 (907) 264-4111 DEPARTMENT OF HEALYH & HUMAN SERVICES January 10, 1986 TO: Permit Applicant Subject: Permit # 850010 T12N R3W Section 32 SE¼NE¼ A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1985. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system the original as-built inspection report(three part form) must be sent to this office for review and approval,and for documentation. If there are any further questions, please call this office at 264-~720. Sincerely, Susan E. Oswalt Program Manager On-site Services SEO/ljw eric: Copy of Permit DI!!!F:'ARTHEIxlT 01: I tE(~I...Ttt AND 1::: '. u" ~:'- x ~'":::'. i z,~ tl ,. 1, d. tll I,Jl, ,..... P',:~:C) !"EC'T t ON c~': ,:~ ,~, I .~.,..L I :, ,,'fl f(,I I()1 ,AE,I AK 95'L'~!.11 DATI!: ...... I.I... ,.," ';!'~ ]"Al',llc: ,h,k.,I ,h.~ .... AT lEAST' ]'l.,,tO ) I1~ ~1 III1.Iit :1: c:er"(' :i. f'y 'Nla'L ~: fc>P'Lh ]::i':.,' '[:.l'ie~ Phu=l:ic:ipa].:Lt¥ o{' Aru::l"ic:>r.:~.~:;ic~ (MOA) aqd '~:.I~,:~ St'a'[:.,::~ c)f ~:/:'.,, :[ ~:o:[]l :i~;'~?x!l t. he:~ ~:~y~:d:.c. ml :Jm ac::ccu"danc~::~ v~:i.'Ll"~ a].]. MOA amd :in (:::c:~mp:~:L/.u~cc:~ t,~J'l:h l:t'l~) c:h~,s:igr~ ,::l':i. kc>r'Ja c:~f' [~f'i:i.~; pc~'m:i'L,, :5. ]: t,~:i, ll c:tc:ll'~:.u'e to a].] MC](:I al'Jcl ~Jkl:.':v[:.~.::~ c)~' A],asl::~:~ P,:.:~[jL.~Jp~/i¢~tit~ }'o!'~ 'ILIi~ :~(::~'('. l::p':~(::h: sc0~,~c:u'.age) ~iystx,'un c:u'~ L,l~:i.s c:)l' any ::,tc:ljaccu-vL ar' nea~'by x!,, ]: ul'idcq'~;lt:.tllc:l I:i~a'('. 'Lhis pel~m:i.l:, :i.t~; raj:id f'c;n' ct maximum ..... ~ . .11:,t,j :I:NS"I'AI..I..E~) ]:N AN AI..Iz.A COVEI:;~I~i:D BY MOA ~:)UII_ZOING CL)D!::: ::~ 'I"IIIZN (:1) AN l.l.~.(,l~ .L .,Al_ F:'I~:F:RM:I:T AND ]:NSPtZCT':[(]N ,I.J,,,~l , ~:: t,h.,,~.f.l,ll,.~ (2) Wilt. NO'I" )2, E ~l.l.,~,..::b W!TI-IOLF'I- AN ]]xlSI::'EC'TION I::~IZF:'OI:RT; AND I...lt.,Il.1. ,~ _, NE)RI::: HUST [::~1~]: DONF: BY A I ,kl ,::,1::, L..LL 1 ].....L SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG-- PERCOLATION TEST PERCOLATION TEST d PERFORMED FOR: LEGAL DESCRIPTION: ,~ ~ I/~l ) I'~ ~- ~/'~ ) 1 2 3 4 5 6 7 8 9 10 11 13- 14- 15- 16 17 18 19 2O COMMENTS PERFORMED BY: DATE PERFORMED: ,,( SLOPE ) SiTE PLAN 'Ttt WAS GROUND WATER ENCOUNTER ED? IF YES, ATWHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE /1 ~' /,~ (minute,~"~) TEST RUN BETWEEN ~ FT AND 72-008 (6/79) Well Owner Location M-W DRILLING, DRILLING LOG INC. Use of Well ,~,:i, (address of: Township, Range, Section, if lmown; or distance main road Size of casing u' Depth of Hole J!;i'/ 10Y 5'; feet Cased to__ '- feet Static water level ft, (~69~) (below) land surface. Finish of well (check one) Screen ( ); Perforated ( ). open end ( Describe screen or perforation Well pumping test at i.. gallons per of drawdown from static level, ; / .: / / / Date of completion~ (minute) for ], .hours with ft. WI:LB LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness TO_ _ b;~ .~k, x{i~, cluing) TO .TO .TO TO / TO. ' TO TO TO TO TO ,i, TO__ _TO _ TO. i -) ~'~ .TO ) o. !.t;? ?,:t:':t'¥~ ] , uubJy (,14 y 2 -- STATE