HomeMy WebLinkAboutMCMAHON BLK 1 LT 7
Development Services Department
Building Safety Division
A
Q-
71
0 -Site Water cWastewater Program
n
4700 Elmore Road
P.O. Box 196650
Mark Begich Anchorage, AK 99507 s A F E T Y
Mayor www.muni.org/onsite
(907) 343-7904
Pump Installation Log
Well Drilling Permit Number: SW Date of Issue:
Parcel Identification Number: 0
Legal Description
McMahon L`7
Property Owner Name & Address:
Pump Installation Date:
Pump Intake Depth Below Top of Well Casing: :5? 3feet
Purnp Manufacturer's Name: A%1
Pump Model: -,,—z 3 0 5-0 ! j
Pump Size k— hp
Pitless Adapter Burial Depth: 0 afeet
Pitless Adapter Manufacturer's Name:
Pitless Adapter Installer: tj
Well Disinfected Upon Completion? Kyes F-1 No
Method of Disinfection:
Comments:
Pump Installer Name: O*q LAJ ANCHORAGE WELL & PUMP SERV.
330 EAST 76T AVENUE
ANCHORAGE, AK 99518
PHONE: 907-243-0740
nen/s» rnai;
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
~--", MUNICIPALITY OF ANCHORAGE
. · DE, ~ITMENT OF HEALTH AND HUMAN SERI,.~ES
~ · Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Nam~ DISTANCES
Address TANK FIELD WELL
~i~ .o. ~o. ¢ ~roo~ WELL
LEGAL DESCRIPTION
Subdiws~on
Lo, ~ Bmo~ I ¢~M~ ~)~ FOUNDATION
Township, Range, Section
~ ~ ~ ~ ~ ~ dnveway,AS'BUILTwaterDIAGRAMbodies, etc.)(Sh°w Iocat
TANKS
~anulactu[er Capacmty m gallo~s m
TYPE OF SYSTEM
~RENCH ~ BED ~ W. DRAIN ~ OTHER
Depth to pmpe bottom from Total depth/rom ormgmal grade
on~m,~me ~ ~ FT (k'~ FT ~
FmC added above original grade Gravel depth beneath pmpe
Gravel length Gravel w~dlh
T°talabs°rpb°narea ~ ~0 FT~DistancebetweeRJlnes ~/~ ~T '~' '. ~'~ ~
Number ol hnes Soil rating P~pe material %..
WELLS
~ PRIVATE ~ OTHER (Identify) ¢~ '~
Classdlcahon~ [~[ ~(A'8'C) 7olal Depth ET Cased to FTJ ~
~p ~ scm:.~ ~eo
96X
I ~ ~ cenif~ thai thisJnspection was ped0rmed according l0 all
Municipal and State guidelines in effect on this da[~: / / ~ / ~/ ~
72-013 (3/85)
,.:1 :l:N iqEI..!E!:tR
% S~M~; EN(S t N!EIEI::;'. I
E:/~,['~LE R :1: VE~:I:R ~, hie
SLJ~i'.~D i V ! S I Ohl~ HCMAHON
SL;!.C '[ t L:;F! ~ ;2(3 T'[]t~tNSH ! F:' ~
:3:::,!;?,i.?.~; (S£;!. 1:::' i' ,, (::fi:;: ,qE:RES )
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t'or't.h by -Lhie Mun:i.c:il:lal:i..Ly c:,f' ¢:!rid'~c,r-ag~ (11E)¢:~) arid 'Lhs~ S'!'.at.~e of'
2~ i (.¢;i.i]. :Ln~d:.a].:l '!:.1"~,:~:(, ~i.y~i;.'l:.(ellt :i. ri ;~ic:c:or'dai'~r'lc:E~ l,,~J.t. Jq a:l.]. I"1[:)~t c:oc:l(~.~s arid
::i~;,, :[ ~.~J.:l.:!. aii::!l'i~;~r.i.:~:, to:, a~] i MO::.~ and S't'..afi'.i.z(, c;;,i' ~'.:~:l.a!~ii.ca~ i',:;...;,q!..~ir-i.~:.:m6..:,rlt.~B loll" 'Lh(~.;.~
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,:;d'iy (.~¢i"i].aPgamei"fi'. (,,¢j.]J. i'6::q::lL!iPe an add:i.'LJ.i:)ri,;;~].
'I"HIEN ( :l. ) ~::ffq IFi...EC"i R I C;f~d.. F'[EI-:i:M :[ T Pdq~:¢ I FISF'IEL; T i E)lq FiUS'I i::G~: Ok:q Pi I NE:C, ~ ( 2 ) P~%....i::iL} I
i4:[L.I.. !;ll::)'l' ieeE:: Pff:i:;'Fd::iVED t41 i'HO!Ji' ~-:¢!'~I I~:[.i:EC'I'!.~.i:!:;¢~L. II~IBPI~:.CTIE)N l;:/!El:;'EiFi'l'~i i:WqD CJi;) '[HIE
¢.,il:' P i.. ;i: "" '" '
Municipality ot Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
3
"~~~EAL)
PERFORMED:
DATE
Township, Range, Section: / ~ /'J. ~
SLOPE Sl~ PLAN
10
11
12
13-
14-
15
16-
17-
18-
19-
20-
WAS GROUND WATER
ENCOUNTERED7
S
L
IF YES, AT WHAT Q
DEPTH7 P
E
Oeplh to Water After
Monitoring? Dale:
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER __
TEST RUN BETWEEN .--. FT AND __ FT
COMMENTS ~
s.. . CERT, THA_ T TES ASPERFORMED.N
72-008 (Rev. 4/85)
GAAB,HD-I
Gl" .TER ANCHORAGE ~REA
D,-r'ARTMENT OF ENV R01~ENTAL QUALI, ,"
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
SEPTIC TANK:
MAILING ~-:
ADDRESS
LEGAL DESCRIPTION
DISTANCE FROM WELL//~')~///-,~ '-" ' / c-~ .. - NUMBER OF
,) cz; ,.¢~h:½h MATERIAL ~',~"~-2:-+~.. COMPARTMENTS
LIQUID CAPACITY /~_,/;/~/~'/'("7 GALLONS. INSIDE LENGTH iNSIDE WIDTH
LIQUID
DEPTH __
SEEPAGE SYSTEM: SEEPAGE PiT:
NUMBER OF PiTS ' /' OUTSIDE DIAMETER
NEAREST LOT LINE. ~'~2~'~) / ~ ,'//,/~) /'-/'-- I-OTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
OR WIDTH ,,,~/ , LENGTH /t , DEPTH
DISTANCE FROM WELL /~?~2'Z",~./,~;.' /'~.¢'~(.~ ~_.:z.~½. , BUILDING FOUNDATION.
SQ.
TILE DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES
ABSORPTION AREA
DEPTH: TOP OF TILE TO FINISH GRADE
SQ. FT. LENGTH OF EACH LINE
NEAREST LOT LINE
~E~CH WIDTH
DEPTH OF FILTER MATERIAL BENEATH TILE
TOTAL LENGTH
OF LINES
iN. TOTAL E/FFECTIVE
.IN. ABOVE TILE
WELL:
LOT LINE
DISTANCES:
-. NEAREST
., SEWER LINE
DISTANCE FROM --~ WATER
, BUILDING FOUNDATION.____SAMPLE
NEAREST
OTHER
SOURCES
SEPTIC _ ,! SEEPAGE .~ ,/ ,, '-,,'
-~J '~/'~¢~ , SYSTEM ~2 ):,'&'-',~. , CESSPOOL
, TANK -
DIAGRAM OF SYSTEM
DEPTH.
L
GRE^r'ER ANCHORAGE'AREA BONOUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY*
3800 TUDOR ROAD POUCH 6-650
ANCHORAGE, ALASKA 99502
TELEPHONE 279-8686
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PERMIT NO.
NAME OF APPLICANT
'EGAL DESORIPT,ON
MAILING ADDRESS J 7 ~-~ ~ ,~,"~,~'-~' PHONE
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SOil TEST RESULTS
COMPLETION DATE ANTICIPATED
SEEPAGE Pit ., DRAIN FIELD , OTHER
TO BE INSTALLed BY /~--~7~ /~',~¢~¢ ,~
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY Will. BE SUBJECT TO PROSECUTION.
TYPE
SEEPAGE AREA SIZE . .
MINIMUM DISTANCES, REQUIREMENTS
SEPTIC TANK TO SEEPAGE PIT WALL
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN FIELD
WATER MAiN TO SEPTIC TANK
Drain FIELD /~¢~
DRAIN FIELD
ALSO CONSIDER AREA WELLS.
· SEEPAGE P~T
SEPTIC TANK. r':r~~/, SEEPAGE Pit ,/"~./.~ '/ DRAIN FIELD TO RIVER, LAKE STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION S 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 BOROUGH REGULATIONS REGARDING INSTALLATION.
OR
LICENSED DESIGNER
DIAGRAM OF SYSTEM
I
CERTIFY THAT [ AM FAMILIar WITH THE REQUIREMENTS OF GREATER A/NCHORAGE AREA B~GH ORDINANCE NO, 28.68 AND THAT THE ABOVE
~aEA:z,~ ANCH~,~,~,z~ AREA
HEALTH DEPAEi?~E~ T
327 EAGLE STREET
AMCHORAGF, ALASKA ~
Was Ground Water Encountered?_~,~
If Yes, At What Depth
Reading
Date
G~osS TJ me
Depth To H20
Net Drop
Performed For~i , ~ ~' /t . , ',.
This
.
DeB+ h
Feet SoL1 ChapaCte~'istics
i .~ ~ Location Sketch
GREATER ANCHORA~GE_. AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD'
ANCHORAGE, ALASKA 99507
279-8686
DATE RECEIVED:
"'" ' TIME :___
'~-~-~ ~L'~'/K r~"}~q'~< ' REQUEST FOR APPROVAL OF
~ INDIVI'DUAL SEWER AND WATER
=ACILITIES
FOR
. ~ '
1. APPROVAL REQUESTED BY:
PHONE:
2. PROPERTY OWNER: S/]?~:~...'~ PHONE:
// / F ' ~ '? ~/ '/
NUMBER OF BEDROOMS:
5. WELL DATA:
B. DEPTH
D. CONSTRUCTION
' ,)J'~.
E. BACTERIA, ANALYSI
SEWAGE DISPOSAL SYSTEM:
Ao
SEPTIC TANK (IF HOMEMADE. SHOW DIAGRAM ON BACK)
MANUFACTURER ~~/,
INSTALLER
APPROVAL REQUEST FOR SEWER & WATER FACILITIES
PAGE TWO
SEEPAGE PIT
1. SIZE
2. LINING
DISPOSAL FIELD
1. NUMBER OF LINES
2. TOTAL LENGTH
REQUIRED MEASUREMENTS
A. WELL TO SEPTIC TANK
B. WELL TO SEEPAGE PIT
,, (
C. WELL TO SEWER LINE
D. WELL TO PROPERTY LINE
FOUNDATION TO SEEPAGE PIT
SEEPAGE PIT TO PROPERTY LINE
E. WELL TO OTHER POSSIBLE CONTAMINATION
F. FOUNDATION TO SEPTIC TANK
G. '~ .~
8. COMMENTS:,
DATE: .II l' -.,,, DATE:
APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED.
GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY
GREATER ANCHORAGE AREA BOROUGH~
Department of Environmental Quality
"C" Street, Anchorage, Alaska 99503 274-4561
Date Received <~--~k.--"~
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
~4. Location: ~i ~
.5. Type of facility to be inspected
'6. Well Data: Q-~'
Mailing Address: ~'~.(~, ~:::~.
Property Owner: ~ k.~ Phone:
Mailing Address:
Legal Description:
No. of bedrooms ____~___
B. Depth /0~ /
D. Bacterial Analysis
C. Construction
Sewage Disposal System:
A. Installed
C. Septic Tank: 1. Size
B. Installer ~ ~ %
\,. ~ ~ ~ 2. Manufacturer
D. Seepage Pit: 1. Absorption Area
2. Material
E. Disposal Field: Total length of lines
8. Distances:
A. Well to: Septic tank ~ ~ Absorption area /~'~ /-/- Sewer Lines
Nearest lot line
, Other contamination
B. Foundation to septic tank'
., Absorption area
C. Absorption area to nearest lot line
EQ-034 (1/74)
Page 1 of two pages
· P_~ge 2' of two pages - ReK"~J for Approval of, Individual ?"~'" & Water Facilities
Comments
Approve~~~--~-~Disapproved Date
Approval Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I certify that the information contained in this request for approval to be a 'true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED Date
EQ-034 (1/74)
GREATER ANCHORAGE AREA BOROUGH·
Departmen% of Environmental Quality
3330 "C" St., Anchorage, A1 aska 99503 -.274-456~t~'zm~_~-
' 'REQUES, APPROVAL
INDIVIDUAL SEWER & WATER FACrLITIES
Type of. Inspection; .C~IRO VA FHA CONV XX
P~'ope'rty Owner: . ..A. la~n Gierke
Mailing Address: St. Rt. A Box 15626 .Day Phone 344-9806 .i.
Anchorage, A1 aska " ....
Name of Buyer: Kenneth.M. Ridder :.
Anchorage, Alaska
t,~ailing Address: 2620 Porter Place Day Phone 27972030
,Name of Lending InstitUtion: National Bank of Alaska'
Mailing Address: P.O. Box 3-3859
Anchorage, Alaska
Name of Realtor or Agent:
Mailing Address:
Phone 279-2506 ext. 19
n/a
Phone
6.. Legal Description:· Lot 7, Block 1, McMahon Subdivision
Location: Mile 1.5 Huffman Road
.Type of Facility to be inspect·ed:
Water Supply '
Type.of Supply: .Public Utility
SFR No. Bdrms. 3
Individual X
If Individual, number of dwellings presently .served 1
if Individual, depth of well 100'
Sewage Disposal'SYstem
· Type ,of S~stem: Public Utility __ Individual (on-site)...X
If'individual, date of installation dur~ing constroction period between -0~lY~9~1 and. Janua~ 1972