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Home My WebLink AboutRINNER RANCH ESTATES LT 6Oql fi7 Well Owner Well Location Water Well D[illing Phone 340-31109 ^nchorage, Bale Phone Size Casing ~':' Deptl~ of Hole_ / 7 ". i: .... Cased to .,, * ' feet Static Water Level '"": feet Well Test - ~--' Gal per Minute for ' Hours Bate of Completion WELL LOG · , , ~ ) , ~ ,~ ../ % ' ,. u I ..~-:/;/ :, ' , /) ? ? " ..!., '' ..', · ~, '~v' ~ ~ - ,.' / ~ ( : . :" ' ~' ?'2 ' / ," V /;"~' . .>~' ' . " ...... _.'- ~. '" : ~ ,~ "' - .'-/~ ¢', ' _,:/ ":-.~--4.~-.~ "- ' ' ~- AUTHORIZATION TO DRILL I hereby anthorize W.W.D Drilling Io proceed with the above work. Payment shall be made in the lollowing manner: Rig up Mininrmr~ (50% of anticipated depth) ____feet. @_ per foot Balance due upon completion. In the event it is necessary to drstitute legal proceedings to collect any amounts due on this contract, I agree to pay an additional sum of ]en pmcent (10%) of the o~iginal contract price as attoraey's fees, plus costs, for legal proceedings. Date __ Address MUN.C.PAUTY OF ANC.ORA~Er~ / OEPARTMENT OF HE^LT. & .UMAN SERV, CES "- DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date ' ~'~'/~' i ./ /4 ;~ ~' GENERAL INFORMATION fMUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Property Owner I~A/'/Y)~ Telephone: Home Mailing Address (c) Lending Institution Telephone Mailing Address Business (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the followina address: or: Check here/~ if hold for pick up. List contact person and day phone number below. TYPE OF RESIDENCE Single-Family [] Number of Bedrooms WATER SUPPLY Individual Well"~ Community [] Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite [] Public'~, Community [] Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 IRev ,~/80 Front ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed ~ereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein, I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address '~.'~¢/E2 Date ~"~ / Telephone , ' oA4d 7 DHHS APPROVAL Approved for ~.~.~'~)__ bedrooms by Approved ~ Disapproved Terms of Conditional Approval · Conditional CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHSdoesthis as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 ,Rev 8/861 Back _.~.~ MUNICIPALITY OF ANCHORAGE (MOA) ~\.\T~ O'~/'' -.o m~[5~OHHEALTH AUTHORITY APPROVAL (HAA) ~O~C~,~5~~ CHECKLIST ~ FEBRUARY 1984 ~0~~' 264-4744 Legal Description: / Well Classification ~P--J ~]/~,~E' If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) ~Y' Date Completed ~¢-/'2.~tP / ~! Yield Total Depth ~¢~ ~'¢1' Cased to ~¢1/.&¢1 Depth of Grouting Static Water Level [,VF..bL LO~ 4~~ / 'T'Hi~T~T ~t Pump Set At Casing Height Above Ground Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole -',~' lOC / Water Sample Collected by Water Sample Test Results Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots / + 100 ~A To Nearest Public Sewer To Nearest Sewer Service Line on Lot Afqo~ ; Date l'/'~L'~]t/~¢ Comments SEPTIC/HOLDING TANK DATA Date Installed Size Standpipes (Y/N) Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service Line Course No. of Compartments Foundation Cleanout (Y/N) Date Last Pumped ; for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72 026 trey 886~ Fronl ABSORPTION FIELD DATA ~[~C/~, Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I/~ave checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~(~.~/~A, Date 2../' / ~ 8 Receipt No. / ~ / O O O ¢ Date of Payment ~//¢ ¢~ Amount: $ / ~~ ~]¢ Page 2 of 2 ~ 72-076 fRev 8/861 Back Client's Name: ~F-~SE~ EPPS & P~S EAST 88 AVENUE kNC~GE, AK 99507 (907) ,34~1 WATER WELL TEST Date: Address: TESTER: .~ 5nP//~ ~ £ Initial Reading on Meter: , DRAW GALLONS GArgDNS FIELD METER DOWN TIME GPM VOLUME TOTAL MONITOR LEVEL READING ~ ' ' 't'/ ~ver / 7t, ~,< , ' d,= Production Rate: <~ ~ GP>I 24-Hour Ca[)acit'f Gallons 907-277 8378 Besse, Epps, & Potts 2220 E. 88th Avenue Anchorage, Alaska 99507 Attn: Andy Potts Date Arrived: Time Arrived: Date Sampled: Time Sampled: Date Completed: 01/29/88 1350 Various Various 2/10/88 Source: See Below Sample ID#: A012988-5 ================================================================================= Parameter Unit A012988-5 ADEC-MCC* L6, Rinner Ranch Nitrate-N mg/L <0.10 10.0 ~ , Date 2 ~11 Carol 3. Garrison, Vice-?resident * HCC = Haximum Contaminant Concentration Quality Control Report Client: BEP ID#: A012988-5 Listed below are quality control assurance reference samples with a known concentration prior to analysis. The acceptable limits represent a 95~ confidence interval established by the Environmental Protection Agency or by our laboratory through repetitive analyses of the reference sample. The reference samples indicated below were analyzed at the same time as your sample, ensuring the accuracy of your results. Sample # Parameter Unit Result Acceptable Limit EPA 578-1 Nitrate-N mg/L 0.33 0.28 - 0.34 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPAtYf~'~NT OF HEAL'i}1 AND 5/gVIRONMENTAL PROTEC~iON APPLICATION FOR HEALTH ~3THORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Dssoriptiqn (incl~u(~ lot, block, subdivision, section, township, ra~3e) Locat iqn (add~ess..o~ diregtion~) __ , ~ (~) Applicants N~um__~._~JP~ ........ (c) Appliqant is (check one) Lending I. nstitution ~ B~!;sr ~; Othe= [2] (explain), · (d) Lendin9 Institution~.j~._[$~i g~ j~f.~Z~.._~, 'Sslephone 2. ~.~_~.f t~sidene~ Single-Family Number of Dedroc~rs Multi-Family O~e~ (~s~i~) 3. Wa te~, Note~ If ~lnity well system, must have written c~nfirrf~xtion from th~ State Depa~U-~nt of Envirorm~ntal Conservation attesting to tl~ legality and status. Is the ~11 adequate fo~ tho. number of l~droc~s specified in this HAA 4 Sewage Dis~al Onsite [--~_,_ Public ~ Community ~ Holding Tank Is the wastewateF, disposal system adequate for the r~R)er of bedrccz, xs (Y/N) [Page 1 of 21 2-15-84 5. E_g~qineering Firm P2ovi~din~.I__ns~ctions~__%%sts ~ Data and Information I certify that I have checked, verified, or confomn~d to all MOA HAA Guidelines~ effeet on the date of this inspection. Te 1~63 (ENGINEER SEAL) App oved b c ocers Terms Conditional Approval The Municipality of Anchorage Department of [~alth and Enviro~-~ntal P~otection does not guarantee the. continued satisfactory perfor:mar:ce of the wate~ supply and/or the. wastewater disposal system° This approval indicates that, as of tba wd. idation date shc~z~ above, based on the data and inforr~ntion furnished by an engir~er registered in the State of Alaska, the v~ter supply and wastewater disposal system is safe and func- tional fo~, the number of bedrocks ~%d type of structure indicated. ( [IHEP SEAL) 7. Mail the 751A to the following adck. ess: KB2/dS/s [Page. 2 of 2] 2-3.5-84 SJ MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Well Classification ?~/'d~J~_, Well Log P~esent IdAY 1 6 1984 RECEIVED Total D~pth ,, Static Water Level Legal Description: /~O7-~ ~.!N~_~ If A, B, C~ C, D.E.C. App=oved(Y/N) ~te ~leted ,,~/~ / Yield Card to ~g / 3 ~ ~pth of G~outin~ ~-~ Casing Height Above G~cund Electrical Wi~ing in Conduit/?,/N) Separation Distances f~om Well: To Septic/Holding Tank on Lot · -) / Sanitary Seal on Casing Depression A~ound Wellhead ; On Adjoining Lots ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot To Nearest Public Sewe~ Line ,'>~.~ / TO Nearest Public Se~r Cleancut/Manhole ~/oOz To Nearest Sewer Service Line on LOt '~' Wate~ Sample Collected By ~/¢/~./,.'-~/,/..~/~--~ ; Date Water Sample Test Results / SEPTIC/HOLDING TANK DATA Date Installed A3//~ Size A3//~ No. of Cc~pa~tr~nts Standpi~s (Y~) /3~+ Ai~-tight Caps (Y~) ~/~rFoundation Cleanout (Y~) Holding Tank High-W~ A~ (y~) ~-~~a~y Holdl~ Tank ~r=t (Y~)~/~ ~p~ation Distan~s~/~~old~ng Tank: To Water-Supply ~,1~/. ~C,~ To ~ilding F~ndation Comments [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of AbsorptionA~ea Depression over Field (Y/N) Results of Last Adequacy Test A2/~_ Type of System Design Length of Field Depth of Field ~'/~ Gravel ~d Thick.ss ~ Stan~i~s ~esent (Y~) ~te of ~st A~a~ Te~t Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/o~ Major D~aina~e Course To D~iveway, Parking A~ea, or Vehicle Sto~age A~ea ; On Adjoining To P~o~erty Line ~//~ To Existing or Abandoned System an Lots ~//~ To Cutbank(if present) Co.rents D. LIFT STATION Date Installed Size in Gallons ~Q/~ "Pump On" Level at ~/.~- High Water Alarm Lavel at Tested for Electrical Codes(Y/N) Cou,~nts Dimensions Manhole/access (Y/N) "Pump Off" Level at ~//~ Vent ,!.Y,/N ) Pumping Cycles du~ing Adequacy Test. Meets MOA ** Check Permitted Bed~oc~ Rating A~ainst HAA Request ** certify that I have checked, verified, or conformed to all MOA HAA Guid~ines in effect on the date of this inspection. KBl/d5/s [Pa~ 2 of 2] 2-15-84 ALASKA eF1UII ODmeDTAL CODTI OL S I UICeS, IriC. (~nqineerin§ $ ~nuironmenl~l $ludies May 7, 1984 Department of Health and Environmental Protection 825 L Street Anchorage, Alaska Subject: Lot 6 Rinner Ranch Estates This office performed a well flow test on the private well on the property. The sta~.c water level was measured at 51.18 feet. The maximum drawdown was 53.8 feet. The well sustained a flow rate of 4.0 gpm throughout the 4 hour test period. The well 'recovered' within .28 feet of statJ, c water level. The estimated time for full recovery was 6 minutes. During the test period, the well produced a minimum of 720 gallons of water, which exceeds the MOA requirement of 450 gpd for the 3 bedroom residence. On the basis of this test, the well can be considered adequate for the residence. If this office can be of further assistance, please contact us at 561-5040. Sincerely, L. D. Montgomery 1200 I.Uesl 33rcl Aoenue, Suile ~ · Anchoroqe, Aloska 99503 '~ [907) 276-1361 ALASKA ENVIRONMENTAL CONTROL SERVICE INC. ].200 West 33rd Avenue Suite. B ANCHORAGE, ALASKA 99503 Phone 276.1361 JOB ~' SHEET NO CALCULATED BY CHECKED BY SOA~E /4~' DATE S h,~.,4 Pl~c£ ~ --''- DA:i:~ R ECL'IV ED r iNSPEcTiON APPOINTMENTS · ~1~ .1 DATE DATE ' - MUNI(IPALI~Y OF MUNICIPALITY OF ANCHORAGE DEP3. OF 14~/'tL$'i{ & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIO~NvIRONMENTAL pgOTECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION (JOT i 5 Telephone 264-4720 REOUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTiONs: CompLete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing, MAILING ADDR~S '~ P~O¢~RTY R~IDER¢ (If different from above) ..... ¢ ' PHONE ~~ ESS f 3. ~ENDI~G IN~(T~T~N ~~ ~' PHONE MA~ING~DDR E88 ADDREss ~', L~EGAL DESCRIPTI_(~ ~ STREET LOCATtDN 6. TYPE OF RESIDENCE NUMBER OFxBEDROOMS ~ One ~ Four ~ SINGLE FAMILY ~ Two ~ Five ~ MULTIPLE FAMILY ~ Three ~ Six Other 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY PUBLIC UTILITY * ATTACH WELL LoG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give Well depth (attach log if available.) 8, SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ~ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE NITIATED. 72-010 (Rev, 6/79) THIS SIDE FOR OFFICIAL USE. ONLY 1, TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SIX [] OTHER 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM E~ INDIVIDUAL/ON -SITE [~] PUBLIC UTILITY Connection Verified []Septic Tank or [~]Holding Tank Size: If Tank is homemade give dimensions: PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCES WELL TO: Absorption Area to nearest Lot Line Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line 5. COMMENTS DATE ¢~;]~'~PPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED ///'~ 72-010 (Rev. 6/79)