HomeMy WebLinkAboutKWIK LOG BLK 4 LT 5
M-W DRILLING, INC.
DRILLING LOG
Well Owner_
Use of Well
Location (address of: Township, Range, Section, if known; or distance main road
Size of casing ~: ' Depth of Hole
Static water level i~ ft. (aboVe)
Screen ( ); Perforated (
Describe screen or perforation
Well pumping test at ; ': gallons per (hSfir)'
of drawdown from static level.
Date of completion !) .~/ 'r'~ 'I ~' ~ ~
':(', (' feet Casedto ~ feet
(below) land surface. Finish of well (check one)
).
(minute) for '! hours with
WELL LOG
Depth in feet from ~
ground surface Give details of f0~m~tions penetrated, size of material, color and hardness
open end ( . );
ft.
_TO
TO
TO
_TO
_TO
TO
.TO
.TO
TO
TO
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TO
TO
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3 -- CONTRACTOR
January 29, 1979
1135 Hi!loro~t ~rive
Subja~'~t Lot 5 ~look 4 ~x,/~ik Lo~ Subdivision
AI~Droval for your individual se-~.,~e~: ~n,, water facilities
that it i~3 ~rat~r tiqht.
(x)
b,~ fitl~d with impervious ty~.~e ~oi! 80 that i% slop~a~
a~ay fro~.~.~ th~ w~3~l casinc30
i:totify this de-partmen-t for a re-inspection wigeon d~s~urepancios
l~v~ }'>o(~n ~orr~ot~d. If th~'~re are ~%y furth~r~ que~tions~
please ~ont~ct this of fica at 264-4720. -
Sincer~ly,
I{ob~r~ C. Pratt, Ro:i~
Associato ~3po,(:ial i~t
Alaska Bank of Committee
Pouch 7,~012 9951{)
MUNICIPALITY OF ANCHORAGE --- MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF I!EALTH &
825 L Street - Anchorage, Alaska 99501 I:NVIRONMENTAL F~,orECTION
ENVIRONMENTAL ENGINEERING DIVISION JAN 2 5 1979
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SE~
DIRECTIONS: Complete aH parts on page 1. Incomplete reques~ will not be processed. Please allow ten (10) days for processing.
PHONE
MAILING ADDRESS
PROPERTY RESIDENT (If different from above) PHONE
2, BUYER PHONE
MAI LING ADDRESS
3. LENDING INSTITUTION ~
MAtL~N~
4, REALTOR/AGENT ] PHONE
J
MAILING ADDRESS
6. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] One [~ Four
[] SINGLE FAMILY
[~] Two [] Five
~ MULTIPLE FAMILY [] Three [] Six
7. WATER SUPPLY
Other
INDIV DUAL*
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**
~ PUBLIC UTILITY
**If individual/on-site, give installation date
If system is over two (2) years old an adequacy test is requ red
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72.010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2, WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified iNSTALLER
[]Septic Tank or []Holding Tank
Size: If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4, DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line
1
WELL TO:
Absorption Area to nearest Lot Line
5. COMMENTS
{]~'APPROV ED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL (Petter must accompany certificate)
[] DISAPPROVED
DATE BY (Title)
LEGAL DESCRIPTION
72-010 (Rev, 3/78)
CHEmiCAL & ~EOLO~ICAL LABORA*Ir'ORIE8 OF ALAS~ INC.
P.O. 8OX 4-1276 4649 BUSINESS PARK BLVD.
ANCHORAGE, ALASKA 99509
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
PUBLIC WATER SYSTEM:
-(~ I .~ I.D. NO.
Public Waler Syalem'-k'lame ' ' ' '~//
Mailing Addreaa ,~
Clty Stale
SAMPLE°ATE:
Mo. Day Year
Zip Cede
SAMPLE TYPE:
[] Routine
[] Check Sample (for routine sample
with lab ref, no.
[] Special Purpose
[] Treated Water
E} Untreated Water
SAMPLE
NO. LOCATION
I
Time Collected
Collected By
TELEPHONE
(807) 279-4014
TO BE COMPLETED BY LABORA'rORY
LABORATORY:
NAME
-ADDRESS "
CiTY
Date Received /--~'~-'~' C-
Time Received / yO
Analytical Method:
I~ Fermentation Tube
~3~ Membrane Filter
Lab Ref. No.
I
J
Result* /&l'~a I,y s t
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
Form No. 18-310(3-78)
06-1220 (b)
Rev. 1978
BACTERIOLOGICAL WATER ANALYSIS RECORD
Date Collected Source
Date Received__ Time Received _p.m, Lab, NO
Presumptive 10mi 10mi ].Omi 10mi ]Omi 1.0mi 0,1mi
24 Hours
48 Hours
Confirmatory
24 Hours
48 Hours
BGB
Date
A £~1£1t0,q,~ ~E 99501
August 10, 1978
Kurt Stenehjem
1135 Hillcrest Drive
Anchorage, AK
Subject: LS, B4 Kwik Log Subdivision
Dear Mr. Stenehjem:
We have received and reviewed the plot plan of the subject
lot and proposed apartment house (4-plex). The well pro-
posed to serve the project is approved for the features with
which this department is concerned providing:
1. The well is located 100 feet from the sewer line in East
73rd Avenue.
The sewer service line for the 4-plex must enter the
ground at least 75 feet from the well. It may be nec-
essary to set the proposed building back from the road
a few more feet in order to meet this requirement.
If you have any questions regarding the content of this let-
ter, please feel free to contact me.
cc: ~DHEP
Sincerely,
James O. Starr
Environmental Engineer