HomeMy WebLinkAboutO'BRIEN BLK 5 LT 10 01¥
May 20 22 10:43p Anchorage Well & Pump Ser
9072430742 p.1
MUNICIPALITY OF ANCHORAGE
Development Services DepartmentPhone: 907-343-7904
®
On -Site Water & Wastewater Section Fax: 907-343-7997
Pump Installation Log
Well Drilling Permit Number:
Parcel Identification Number: 014 1311 so
Date of Issue:
Legal Description
O'BRIEN
Block
5
Lot][2004
10
roperty Owner Name &Address:
UEVEDO CHAVARRIA OSMAN J & ANA N
W46TH AVE #13
NCHORAGE, AK 99517
Pump Installation Date: os - 13 - 2022
Pump Intake Depth Below Top of Well Casing: 120 feet
Pump Manufacturer's Name: XYLEM
Pump Model. 8S 1 2
Pump Size: 50 hp
Pitless Adapter Burial Depth: 10 feet
Pitless Adapter Manufacturer's Name: MARTINSON
Pitless Adapter Installer:
Well Disinfected Upon Completion? t Yes ❑ No
Method of Disinfection: PELLETS
Comments:
Pump Installer Name: ANCHORAGE WELL & PUMP SERVICE
7640 KING STREET
Company:
ANCHORAGE, AK 99518
907-243-0740
Mailing Address:
City: State: Zip:
Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation.
G~ TER ANCHORAGE AREA BOROI '-I
D£r~ARTMENT OF ENVIRONiVlENTAL QUALI'~
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME_ f;/,,7~/2 ) ~ -
LOCATION
MAILING f- . '~' .., .. -,
__ADDRESS /'A2/.~(, /4z_4;'/,' .s% Pt.lO~E;~. t/t 2043
SEPTIC TANK:
DISTANCE FROM WEU
LIQUID CAPACITY__/~_-~z~' Cb
GALLONS.
MATERIAL
NtJMBER OF
COMPARTMENTS
LIQUID
INSIDE LENGTH_ '~ INSIDE WIDTH 'r~ DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PiTs_ / OUISIDE DIAMETER
LINING MATERIALC-~?-/~;E,/('W/,c~ /~//}'¢" .~.
OR WIDTH ~2'<, C;' , LENGTH , DEPTH__
DISTANCE FROM WELL J"'3~! , BUILDING FOUNDATION d,'/
NEAREST LOT LINE ,'7-~ b- TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)_ SQ. FT.
TILE DRAIN FIELD: / C ~'~/6.¢-", 4z4"c,' ,.;.~._¢0,~:~¢' - c¢ ¢¢4. ,~
/ ~/ ~Z /~ TOTAL LENGTH
DISTANCE FROM WELL f// _~~ATION . NEAREST LOT lINE. OF LINES
NUMBER OF LINES~ DISTANCE BETWEB~ TRENCH WIDTH
ABSORPTION AREA SQ. FT.
LENGTH OF EACH LINE
IN, TOTAL EFFECTIVE
DEPTH: TOF OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE____
WELL: TYPE ~'/~1 //£ ~ ~]///"-0 DEPTH '/ DISTANCE FROM _ , WATER
! ,BUILDING FOUNDATION .... SAMPLE__ , NEAREST
NEAREST ¢_.-- SEPTIC ~--- SEEPAGE OTHER
LOT LINE , SEWER LINE ., TANK , SYSTEM__ ", CESSPOOL '~SOURCES__
DIAGRAM OF SYSTEM
DISTANCES:
IbATF
GREAl'ER ANCHORAGE AREA BOR,_.,UGH
DEPARTMENT OF ENVIRONMENTAb QUALITY
3500 TUDOR ROAD POUCH
ANCHORAGE, ALASKA 99502
TELEPHONE 279-8686
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PERMIT NO.
22O7
NAME OF APPLICANT 7~¢~{/~'4"/
INSTALLATION LOCATION
'EGAL DESCR,PTION &'4 ,' O
INSTALLATION OF; SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
SOIL TEST RESULTS
COMPLETION DATE ANTICIPATED
SEEPAGE PIT /~ , DRAIN FIELD OTHER
NOTE: THIB PERMIT IS NOT VALID WITHOUT BOIL 'FEET
FINAL INBPECTION: 24. HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INBPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE / 75~O TYPE 5~'~-~ SEEPAGE AREA SIZE __ ~ TYPE 0
MINIMUM DISTANCES, REQUIREMENTB
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PiT. ., DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL ///.5
SEPT[C TANK '~.--~0 f' 20 /
SEEPAGE PIT
TO NEAREST LOT LINE.
!
DRAIN FIELD /'~)
, DRAIN FIELD
SEPTIC TANK, ~r~ SEEPAGE PIT , DRAIN FIELD
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROU,~r~EGULAT[ONS REGARDING INSTALLATION,
~1A~M FAMIL HEALTH AUTHORITY
OR
LICENSED DESIGNER
I CERTIFY THA IAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DES BED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
lATER ANCHORAGE AREA BORO[
DEP/~RTNENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99502
CASE #
Lemal Descrintion: Lot [0 Block__
This Form Reoorts Soils Lo9 ~
!late Per f,ormed
Subdivision
Percolation Test
F)enth
Feet
Soil Characteristics
Ground Water Encountered?
Yes, At what Denth?
Readinq
Date
Gross Time
Percolation Rate Minute
Proposed Installation: SeeDaqe Pit
Pemth of Inlet
CnMmENTS:
Net Time
Depth to H20
-I
Net DroDi
Drain Field
Depth To Bottom Of Pit Or Trench
Test Performed
Data Certified By:.O~'~I~-~
Date:
Hrs. Glenn F. Thomp.~on
7216 Lake Otis Parkway
Anchorages, Alaska
Lot 10, Block 5, OJBrien Subdivision
L)'~ar !irs. l'hOl,~psoJl:
Following the receipt upgrade of the s~.mi~,public well
serving the subject lot, tilts departmenl; ts able to ()r~nt f~lll
approval for the sewer and ~.l~ter system. This approval is
granted for the <Iwellinq which consists of a thr~ (F~) bedroom
residence and a F. ublic recreation hall in
If you have any qu(~stions coi'icerni~g ~he
· Free g() contacl; ':;hi s .ie?ar~m('>nt ai;
Sanitarian
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3500 Tudor Road, Anchorage, Alaska 9950'7 279-8686
Date Received
Time of Inspection
Data of Inspection
REQUBS'¥ FOR APPROVAL OF
INDIVIDUAl, SEWER & WATER FACILITIES
FOR
Type of Facility to be Inspected:
Number of Bedrooms:
'Re]l Data:
A. Type 3~-m~./~b ,
C. Constructi
Sewage Disoosal.System:
A. Installed
C. Septic Tank: 1. Siza/~
D. Seepage Pit: 1. Size
Disposal Field:
B. Depth__~
D. Bacterial Analysis
Distances:
2. Material
Total Length of Lines
A. ~el! To: Septic Tank />~L
, Nearest Lot Line
U, Foundation to Septic Tank "~ Absorption Area
C, Absorption Area to Nearest Lot Line
, AbsorPtion Area__~_~_~, Sewer Lines
, Other Contamination
Req-~ast for Approval of ~,~fvidual Sewer & Water l~aO~lt~ler
Page Two
Aooroved D~sapproved Date
Approva] Valid for One Year FrOm Date $~gned
G~eater Anchorage Area Borough, Department of ~nvironmenta] Quality
DIAGRAM OF SYST5~
I cert~fw that the information contained in this request for appreval to be a true
and accurate represen~at~.on of the sub,iect sewer and water facilities located at:
Signed Date
Gb',E^TE!~ ANC!-IC. RAG~' AO. EA 90ROUGH
D,~.r,a~tment of Environmental
~5~0 T'sdo~ '2oad, Ancho~a;~e, Alaska 90507 279-~686
Date Received /- .~ ~- 7.~
Time of Inspection
Date of Insnectton~
INDIVIDUAL FEhFk' & "'
,~ATE,-, FfiCILITIES
Address~ /~ / 8 ~/~'~ ~.~,' Phone. q~/-
Type of FacllJ. tv to be ~nsr,eC~ed: .' 4¢%/z~./ .~ (.~-.~¢c_-
Number of Bedrooms:
Wel] Data:
C. Construoti on
7. Sewage Disoosal
A. Installed
Septic Tank
D, Seepage Pit
Disposal ,~.e,o:
8, Dtstance~:
A. Well
Seotic Tank ~eO/4- , Absorption Area
"~; '~' , Other, (,onta,,:inatton
, .._~r.,t, Lot !ir:o ./-m i~ .
Foundation to ~¢?ti.c Tgnk
' ;, AbSorotton Area
Aosorotton Area to Nearest I. ot LiDe
/2~' ¢'' , Sewer Line~
GREATER 4NCHCRAGE AREA BOROUGH
Daoartment of Env~rm2men~a] O,~ltf, y
3500 Tudor ..oad. Anchorages, Alaska 99507 279.8686
INDIVIDUAL~.. E~:..~.' S ?TATER FACILITIES
5. Type of Fac]ii. tv to be
Number of Bedrooms:
6. Well Data:
A. Installed f-/- / ~ ;].
C. Septic Tank~ ]. Size /~f3"&)
D. o~epage Pit. ], ~iza 20~3L;I 2,
~.: Disoosal, Field:
Distances:
A. Well T:):
Seotic Tar, k_._?ffff~ .... , Absorption ,Area
..... . Other Cor:tamination
, ne,.,r~,t Lo+, ltr:,~, Zc:~'~v'-
Foundation +o ~tic Tonk '~ Absorption Arqa
Aosormtton Araa to Hearesl Lot
Sewer Lines
Request for Approval of I~,,.;ividual Sewer & Water Facilitte
Page Two
9. Comments: '(L~fcL.~.~_. ~-~'l. uc.~_/~.cz. ~ f : ~' ~ ~' ' ~'~
~~:/ ,-'~.--.' ' - -~ - 7 ..... ,' ~ ',
~O~rove~,-~..~ ~ ~c Z: z,~ ,, O, is~poroved Date 2-/-~/'~:'~.
........ .. . .,/ , /. -
Approval Valid for One Year Yro:~ Date S~gned
Greater Anchorage Area ~orouqh, Department of ~nviron~ental Quality
DIAGRAt/, OF SYSTEY.
/
Z ce~&fy ~hat ~he ~nforma~on con~atned Zn ~h~ recfues~ ¢o~ approva~ ~o be a
and accurate representation of the m]b4ecfi sewer and weber facilities located
?