HomeMy WebLinkAboutMADDUX PARK LT 2Maddox Park
Lot 2
#018-251-02
GRE,.,,ER ANCHORAGE AREA BOk, UGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INS~PECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH
MANUFACTURER
INSIDE WIDTH
MATE RIAL
NUMBER OF
COMPARTMENTS
LIQUID DEPTH
LI QU ID CAPAC I TV/. ~,,("~)_ GALLONS.
TILE DRAIN FIELD:
DISTANCE FROM WELL FOUNDATION _NEAREST LOT LINE
NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH[(~r%IN.
ABSORPTION AREA ~¢ ~ SQ. FT. LENGTH OF EACH LINE
DEPTH:
TOTAL LENGTH
OF LINES ~
TOTAL EFFECTIVE
TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER
MATERIAL BENEATH TILE_ ~¢' IN. ABOVE TILE ~'( IN.
WELL:
TYPE
BUILDING
FOUNDATION
CESSPOOL
APPROVED___ --
CONSTRUCTION
NEAREST NEAREST
LOT LINE ____ SEWER LINE__
OTHER SOURCES
DISAPPROVED
DEPTH _
SEPTIC SEEPAGE
TANK__ SYSTEM
REMARKS
DISTANCE FROM:
DISTANCES:
INSTALLED BY:
SEWER LINE DEPTH:
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
DIAGRAM OF SYSTEM
G.A.A.B.
Form EQ-032
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:'t..lli!ui!:J [:::'Eilili:'l" i:::'ON I::1 I:::'[;iI:I~',,,'I::T'I'E P.ililiZi...L. O1:;i'. ;~i'.(.:.lli~l [:::]i!i~]iiii'i" 1:::'O1:~ I::1 I:::'l..Ji!i?,L.. :[ I::'.: [.4[!i!:[...[ ....
'.i~;t:::'lii!iC]i[:::'illC:l::lTiliOH!~; I:::lt',ll'.i:~ 12Ol",l~;T~;i'.l...ll:i:T:liOl",l Iii:':lli:::lliiii]:;ill:::ll'"l'.iii; I::ll:;iil!i!i I:::l',,,'l::lZtlL..l::lli!i',l..~!i: 'i'O ]:N:i!;!..ll:;i'.liill
ill 1"4 ili','T I:::1 L. L.. I:::1"1" i[ IZ)['.].?
CONSULTING GEOLOGIST
BOX 476-M, STAR ROUTE A · ANCHORAGE, ALAf$I(A 99507 ' PHOI"IE 344-7071
Date
SOILS LOG
-'10-
-'14--
-'16,
-18-
-20-
Total DepthS- £eet in -~ ~'~
Was groundwater encoun'bered ~0~' ? What dep'~h ~
Depth to bedrock '2 '2-0i
Respec-b£ulty submitted
Gary F. Player
Consulting Geologist
[:,EPFIR'I"MENT ..... · HEFIL..TH FIN[:, EI'..IV ]: F;'.C)NHEI'.JTF:II ..... OTI:EC'T' I OIq
825 '" I....'" STI:?.E[~]'*,, F:INC:I..4[)F~'.F:I[~iE'.., F:II<.
]L,..II IL-.~... L,. Il. ...... II':::' [EZ ~;-'~: If'"'ll ]t:: '"lF"
PERf"tIT NO. ,:: 7"7E~86 )
RF'I::'L ]: CFIN]" 1.41LL I Ir:lt"l F.". SIZ:I-IF.'.IECT
t..EEiFII .... L. OT ;2'. MFIE:,DLI~-,', F'FIRK
M 1 t'41 I'"II. JM [:, I .'E:;TI::INCE 13ETI.'JEEf-,I R NELL I'qND RN'¢ Ol"J-::?.; :[ "f'E :5EIqI:::IGIE [:, i :SF:'OE;FII~.. S"r'STEM :[ :ili;
::I..E~EI FEET FOF.'. R PRI',,,'RTE WEL..I._ (]iR ;:.'i:E~O F:'EE]' FOR la F'L.IBL]:C WE]...I ....
I.,.IEL. L. LOG?.; RF.'.E I:;.'.E6!IJIF.'.I~.:.]:) FIND MI...I:i~;T I!ii:lE I:;;:ETL.IFE'.NE[)TO THE [:,IEF'I::II~'."FMEI".I'T I,.II'I"HIN ii:El [:, l:::l"r' :.:.!;
ElF THE I.,.IELL C'OMI::'L.ET I ON.
L:!;F'EC ]; F I E:fl'[' IONS i:lN[:, C(:)N:iSTRUCT I ON [:' I I::IGRI::Ifr,IS~; RRE: R',,,~F:I I I....FIE:I..E TO ].' NSLIRE I::'REIF:'I!ZF':'.
I NSTFILLI':CF I ON.
]: C:ER'T'iF"r' "I"IqRT
::L: I I::11'"1 F'F~FIILIlaR I.,.II]"H THE REL]UIREMEI'.,I'T'E; FOR ON-:E;]:'T'E '.ZI.::I.,.IE:I~::E; FIN[:, I,.IEL.L.S F:l:~i; SET
F:'OR'I"I..~ B"r' ]"HE MUN I C ]: PR[... I '¥'¢ OF I::INE:HOF-:FIGE.
;2:: I !.,.IIL..I.... IN".:!!;TFfl-L. 'T'HE S'~"S'I~E:I'"I IN f:ICC:OF..'[:'FINCE 14ITFt THE
FIF;'F'L. I CRNT I.,.I I I...L I ~~:.' F...'. Ii:: ~"~,.
-'
1
Driller
DELTA DRILLING COMPANY
5R'A I~0}{ 39,4 El
ANCHORAGE, ALASKA ~9~O'7
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650
Anchorage, AK 99519-6650
www. muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. Oi%~ ?.51- O 2_
GENERAL INFORMATI'ON
Complete legal description ~
Location(site address)
Current Prope~y owner(~.:~'~ac~ Mailing address ~
Lo~ Z
COSA# O-~(2/\1i ko%-
Expiration Date:
Day phone
Lending agency
Day phone
Mailing address
.Real Estate Ag, ent, ~J(~, ~-~r~'~'
Mai[~, Add(eSS' ? ~,;-..
Unle~ ofhe~i&e..:re~sted, '~OSA will be held by DSD for pickup.
NUM BE~OF~B,~RO, O~S:
Day phone
TYPE 615'WATER SUPI~Y: TYPE OF WASTEWATER DISPOSAL:
Indivi(~'dal.~)611 "'" "'' '; '::'~ [] Individual On-site J~]
Individual Water' Storage [] Individual Holding Tank []
Community Class ~ Well [] Community On-site []
Public Water System [] Public Sewer []
II
The Municipality of Anchorage Development Services Department (D. SD) issues Certificates of On-Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On-Site System's Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my.investigation,
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) 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(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm
Address ,203
Engineers Printed Name ~&~ ~p~j~,~' '
DSD SIGNATURE
~-.,~/'"' Approved for LJL
bedrooms.
Disapproved..
Date 5/~..~ ~i
Conditional approval for
bedrooms, with the following stipulations:
ON-SITE
~: ~ATERAND · m:
~ "WARTFW~T~ : :
~ ~.. PR~M ...] ~
~3~'-. .
Attachments: COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
By:
X
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
,~)~ Original certificate Date:
(Rev. 11105)
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99519-6650
www. muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal'Description: ~1~)~ ~).Ck L/)'~ '~. ParcellD: O1~3-Z-51-O~-
A. WELL DATA
Well type ~'i
Date completed
Total depth' ~5 ft.
Date of test
Static water level
Well production
IfA, B, or C provide PWSID # --- WelrL(~"(Y/N)
Sanitary seal (Y/N) ~' Wires propedy protected (Y/N)
Cased to 8.~ ft. Casing height (above ground)
FROM WELL LOG AT INSPECTION
55 ft. $~ ft.
[~, g.p.m. ,.~,~ g.p.m.
'7'
WATER SAMPLE RES, ULTS:
Coliform /,/'~t~ colonies/100 mL' Nitrate. ~, 1'7, mg/L
Arsenic:
'B'~ SEPTIC/HOLDING TANK DATA
Tan k Type/Mat~rial ~'~e_
Tank size.
FoUndation cleanout (Y/N)
C. ABsORpTION, RELD: DATA
Date: nsta,ed
I
Length '2.~ . ~ ff~ Width z/ ff.
Total depth
o a e, uac e , .e u.s
Fluid depth in absorption field before test/'/0 in.
Elapsed Time:
Depression over tank (Y/N)
Pumper /4 + ~o~(= .~er'u,i'~'.'~
Any rejuvenation treatment (past 12 mo.) (Y/N & type)
Collected by: LA~
I
Date installed ~°h/~':~
Cleanouts (Y/N) ~
High water alarm (Y/N) ~
Water added(0~=~) gal.
. in. Absorption rate >=
System type P4_=~=p '7'~.,~._k
Gravel below pipe '~ ft.
Depression over field /V'
For ~-.... bedrooms
New depth ~' in.
~50 g.p.d.
If yes, give date ~
D. LIFT STATION
!E.
Date installed ,,,/
"Pump on" le~.
Datum
SEPARATION DISTANCES
Size in gallons ,,,,'/
"Pump off" level at __~.
Cycles tested //
ManhOle/Access(Y/N) j/
High water alarm level at ..
Meets alarm & circuit r.,~ements?
in.
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on lot
Public sewer main /V'/~,
Sewer/septic service line
Animal containment areas .~O
SEPARATION DISTANCES 'FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5 I+ Property line 5 if. Absorption field
Water main ./V'//a, Water service line JO~ Surface water
Wells on adjacent lots J00
On adjacent lots J~:~ '+
On adjacent lots ICO~-I-
Public sewer manhole/cleanout
Holding tank JV/~Z~.
Manure/animal excrete storage areas
.F.
SEPARATION 'DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line ~0' + Building foundation 10 ~ Water main ...
Water Service line {0 i~
Surface water 100 ~-f (/V~0)Driveway;'pa~ng/vehicle storage
Curtain drain ~Dt+ (N, 0,~ Wells on adjacent lots [0~) I.{.
COMMENTS
COSA Fee $..
Date of Payment
Receipt Number
(Rev, 4/10)
-t-
7~ 7
S RECORD, OTHER THAN
THOSE SHOWN ON THE ~EOO~DED
PLAT A~E NOT SHOWN HEffiEON.
AS-BUILT NO CORNERS SET THIS DATE
I hereby certify th~,.t I have performed a Mortgagee's
spection ot' the foIlov4ng described property:,
L, or' ~.., " ,4"I,4'~/P ux
Anchorage Recording Precinct, Alaska, and that the improve-
ments situated thereon are within the property lines and do
not' overlap or enCroach on the property lying ai~jacen~th~
to, that n6 improvements on property lying adjacent thereto
encroach on the premises in question and that there are no
roadways, transmission lines or other visible easements on
said property except as indicated hereon.
Dated at Anchorage, Alaska
this ,/.%7~!day o~ ?XdF-D?.:~'~.~ , ~9 '77
FRED WALATKA & ASSOCIATES
Engineers and Surveyors
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
GENERAL INFORMATION
(a)
(b)
(c)
Application Date
Legal Description (include lot, block, subdivision, section, township, range)
/_07'
Location (address or directions)
· Z620 I
Applicant Name ~.~_, .S ¢-. Ii/~',FC. ~ Telephone: Home _~ (/.J~" ~J~:L~ (2 Business
Applicant is (check one): Lending Institution []; Owner/builder [~; Buyer []; Other [] (explain);
(d) Lending Institution ~/~'¢,..,~¢{/t.J¢~.
Address ~ ~' '~ ¢*
(e) Real Estate Company and Agent
(f) Mail the HAA to the following adCress:
TYPE OF RESIDENCE
Single-Family ~ Mulli-Family
Number of Bedrooms
Other
WATER SUPPLY
Individual Well ~ Community [] Public []
Note: If community well system, must have written confirmation from the State Department ol Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite J~ Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Envirom'nental Conservation
attesting to the legality and status,
Page 1 of 2 72-025 nlz84)
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto 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 hereJm I further verify that based on the information obtained
from the Municipality of Anchorage flies 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.
NameofFirm ~ EE,S INC_,, Telephone
Date
DHEP APP.OVAL CC~-3
Approved for /,'~'-¢'.,4~. bedroo
Approved ,~-~' Disapproved Conditional
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984
264-4720
Legal Description: /---07' 2.
'TI2-N R~uJ
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH
ENVIRONMENTAL PROTECTION
APR 1
SE~ .53
WELL DATA
Well Classification PI~ 1
Well Log Present ~__~N)
Total Depth ~:¢~-~ / Cased to
Static Water Level ,~',.~, -~ /
Casing Height Above Ground 2.
Electrical Wiring in Conduit
Separation Distances from Well:
If A, B, C, D.E.C. Approved (Y/N) /V'/~
Cate Completed ~,~'/J .'~/ 7 7 Yield
Depth of Grouting
Pump Set At {) Al_
Sanitary Seal on Casing ~I~N)
Depression Around Wellhead (Y~
To Septic/Holding Tank on Lot ~J '"')1~ (~) ; On Adjoining Lots "~ I00
To Nearest Edge of Absorption Field on Lot 4~ 7 "~' (~ ; On Adjoining Lots ~"
To Nearest Public Sewer Line /~/'//~ To Nearest Public Sewer
Cleanout/Manhole ,/~'//~ To Nearest Sewer Service Line on Lot
Water Sam pie 'Collected by/~"~,,~ //~, J,~ jc~ j j~ ;Date
Water Sample Test Results ,~7'/..~
Comments '~ MER.SU~FA4EA/'F-.S FRO~v't ~7'ANDRP~$ : I~F-S'F' Of:
B. SEPTIC/HOLDING TANK DATA
Date Installed g'/~,/77 Size /2..,~2~O No. of Compartments
Standpipes (ON) Air-tight Caps (~)'N) Foundation Cleanout ON)
Depression over Tank (Y~) Date Last Pumped (7//~(~/~',~
Pumping/Maintenance Contract on File (Y/N) ,/~///~- ;for ,/V/~
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 "'lL JO0/'~
Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Comments ~/V~ ~ ~.SUA -¢~E/Ct'-$
I tV~?EC'FlOtV FORM.
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed ~/-~/77
Width of Field ¢ /
Square Feet of Absorption Area .~ 6
Depression over Field (Y/~
Results of Last Adequacy Test P~?~,~E_ ~)
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
Type of System Design
Length of Field 2,..~ /
Depth of Field / ~ /
Gravel Bed Thickness o¢ /
Standpipes Present (~N)
Date of Last Adequacy Test
gDP 8£bfCOO/v
'TRENct4
To Property Line ~/0 /
To Existing or Abandoned System on
; On Adjoining Lots ~f' ..~O /
To Cutbank (if present)
·
Comments
D. LIFT STATION
Date Installed Dimensions
Size in Gallons I r~~-,~uuuss iY/**~'--'-/~N)
"Pump On" Level at kl I ~'~" ~--~'~''' "Pump Off" Level at
High Water Alarm Level at~I [.~-~*~ Vent (Y/N)
Tested for ~ Pumping Cycles during Adequacy Test. Meets MOA
Electrical Codes (Y
** Check Permitted Bedroom Rating Against HAA Request **
I certifythat I h ~ c .~;hec v rjr[ed, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.,~
Signed Date_
MOA No.
Company
Receipt No.
Date of Payment
Amount: $
Page 2 of 2
72-026 (11/84)
Time
Date
Insp
DEPARTMEF
825
9;30 a.m.
3-9-78 Thursday
Pratt
MUNICI, PALITY OF ANCHORAGE
OF HEALTH AND ENVIRONMENT.
L Street, Anchor@o~. Alaska
264-4720
PROTECTION
99501
Date Received: March 6, 1978
#2: Time ~3: Time
Date Date
Insp Insp
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
Lending Institution Request: First National Bank of Anchorage
Mailing Address: Post Office Box 720 99510 Phone: 276-6300
Property Owner: William R/Patricia A. Schreck Phone: 344-7745
Mailing Address: Star Route A Box 4029-Z 99507
3. Legal Description:
4:
Lot 2 Maddux Park Subdivision
Single Family Residence: (x)
Multiple Family Residence: ( )
Well System:
Permit ~
Number of Bedrooms: Four
Number of Bedrooms:
5. Individual well (x)
Depth of Well
Cons= c o
6. Sewage Disposal System: On-site System (x)
Installed
S-'o
Community/Public System ( )
85' Well Log on File (x$
Bacterial Analysis
Public Utility ( )
1977 Installer
Manufacturer ~
Soils Rate Material
Permit #
Septic Tank Size
Absorption Area
Distances: Well to Septic Tank ~]
to Sewer Line Nearest Lot line
to Absorption Area ~ '
Absorption Area
to Nearest Lot Line
Page Two
Department of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal Description: Lot 2 Maddox Park Subdivision
Comments:
Affadavit Attached: /~)
/ !
Approved: ,_C~
Disapproved:
Letter Attached: ( )
Date:
Department Worksheet:
31V(] BO
~.IU V FLI.$ 0 d
]dOD dlZ (]NV ."-I,I.VIS "O'd
'ON (]NV J.33UJ.$
01 IN3S
(aBelsod s.ld) ~Og--~IlVtN 031.41111319 HOJ &dlDO3U
ANCHOI~A~F./WESTERN DISTRICT OFFICE
437 'E" STREET, SUITE 303
A~CHOR,~E, ALASKA 99501
274-Z533
May 13, 1985
~s. raven Tureer
Alaska [nvtron~ental
Control ~rvtce
1ZOO ~est 33rd Aven~
~tte B
Anch~age, Alaska 99503
SU~ECT: ~alver ~r~zon~t Separation be[~n ~el~ and ~ptlc
Lot Z, ~ddox P~ S~dtvtston - ~cho~age,
8521-WA-[52
Dear t~s. Turner:
The Department has reviewed the subject waiver request and hereby waives
the rmrtzontal separation between the ~ell and septic tank to 81 feet
and well to absorption trench to 97 feet on the subject property for a
single f~mtly residence only.
This waiver ts contingent upon information st~owlng tl~e septic tank is
equipped with calder couplings or the equivalent.
Si ncere ly,
Dtstrict Englneer
SE/da
^ C
ALASKA e,,JIROn eFITAL COFITIgOL S61R, , E , IBC.
~fl§l~e6rirl§ ~ ~nuiro~menlol $1uchcs
BILL SCHRECK
2525 BLUEBERRY ROAD #203
ANCHORAGE ALASKA
99503
SELLER-S~4-E
MAY 24 1985
WILL PICK UP FROM OUR OFFICE
50158
LEGAL:MADDUX PARK SUBD/LOT 2
ADEQUACY TEST FOR SEWER SYSTEM
ADEQUACY TEST DATE-APRIL 29 1985
THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 368 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 619 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
4 BEDROOM HOME.
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR
THIS 4 BEDROOM HOUSE.
THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON APRIL 20 1985 .
FLOW TEST ON WELL
WELL FLOW DATE-APRIL 29 1985
A FLOW TEST WAS PERFORMED ON THE WELL. 619 GALLONS OF WATER WAS
PUMPED AT A RATE OF 7 GPM OVER A DURATION OF 1.5 HOURS.
THE DRAWDOWN WAS 2.9 ' WITH A RECOVERY TIME OF 30 MINUTES
AND THE STATIC WATER LEVEL WAS 55.3 FEET.
THE WELL IS ADEQUATE FOR THIS 4 BEDROOM HOME.
ADDITIONAL COMMENTS : ....
1200 ~esl 33rd ~¢nue. Suile B, Anchoroqt AIos~c .o9503
ALASKA ENVIRONMENTAL
CONTROL SERVICES, INC.
1200 West 33rd Avenue Suite B
ANCHORAGE, ALASKA 99503
Phone 561-5040
SHEET NO
CALCULATED BY, ~-.~7. ~'y~'~
CHECKED BY .
/'~=
SCALE
OF
OATE
DATE
/
/
MUNICIPALITY OF ANCHORAGE
/~-~, i Department of Health and Environmental Protection i
//~'~-,~\~/ 825 L Street, Anchorage, Alaska 99501
t[~! i~I 264-4720
"~'"~ffff'~equest for Approval of Individual Sewer and Water Facilities
Mailing Address
Name of Buyer:
Mailing Address:
Phone
Phone:
Mailing Address: Phone
4 Realtor/Agent:
Mailing Address:
Phone:
Legal Description:
Street Location:
Single Family Residence: Q~'~ Number of Bedrooms: ~
Multiple Family Residence: ( ) Number of Bedrooms:
Water Supply:,. *Individual Well ~ Public/Community System
If Individual Well, well depth ~
If Co]mnunity System, name of system
8. Sewage Disposal System: *~n-site System
If On-site System, date of installation:
Public System
( )
*NOTE: A well log is required on ALL wells drilled since 6/75.
** If on-site sewer system is over two(2) years old, an adequacy
test is required by this department.
A fee of $25.00 must accompany each request before processing
can be initiated.
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