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HomeMy WebLinkAboutLAKEWOOD HILLS #2 LT 21D MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 8;25 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE [~NEW '~"~"~'~'~ t [~]UPGRADE NAME MAILING ADDRESS LEGAL DESCRIPTION LOCATION . · ~ ~) , · · We - Absorption area · I DISTANCE TO' I ~.~3T N/ I I O ~_v ' ~ -.~__ I.. , ~..~ DISTANCE TO' JWelI~ Dwelling ~ I Manufacturer ' , ~ ~ J Well Foundation ~1DISTANCE TO: I No~ IM ~ ~ ~ No. of lines . Length of each line Total length of lines ~ Top of tile to fln~ ~ Material beneath tile ~ Length q~dth Depth ~ ~ I Type of crib ICrib diameter Crib depth ~m JWell Building foundation DISTANCE TO: ~ IClass I Depth Driller ~ DISTANCE TO J ~ilding foundation Sewer line W dth Material Nearest lot line Trench inches NO. OF BEDROOMS ¥ PERMIT NO, No. of comErtments Liquid depth PERMIT NO. Liquid capacity in gallons Distance between lines inches PERMIT NO. Total effective absorption area Nearest lot line Distance to lot line PERMIT NO. Sept c tank Absorpt on area(s) Total effective absorption area OTHER PIPE MATERIALS SOIL TEST RATING REMARKS LEGAL Dotten Drilling Co. BOX 10056 SOUTH STATION 12061 JOHN'S ROAD ANCHORAGE, ALASKA 99511 PHONE 344-1952 WATE~ WELL LOG Location: Lakewood Hills sub-division~ i,'~2. Date competed: October~ 1951. J)c:~.i?"-' of well: 209'. Static water level: ~-~2' off bottom. i~ro,duction: 6 GPM 20' off bottom. Brown till & rocks Silty sand Till Brov~n s~l~ tight & dry Dry sand & gravel Silty sand Til!~ soft & wet Runny mutt Brown till with gravel streaks, wet 'd'ater sand & gravel 0 88 89 182 20 ~ 20~ 209 ~2 ?~ 88 182 20~ 209 Drilled by: PERMIT NO. RF'PL I CFINT L 0 C FI T II] N LEGRL DEPRRTMENT C. HERLTH RND ENVZRONMENTRL ~ .OTECTZON 825 "L" 264-4728 810566 ) :;,TE,,, E.hl SM t TH F:F~F1 WEST 86TH fl',,,'ENLIE 9'~.?-]¢12 3:49-2484 Fi ILLS I DE,-."WH I ST L ::~±D LRKEHFu]D HILLS S/D ~2' LOT SIZE 46200 SQURRE FEET '-- I .... '"" "-- TRENCH T'¢F'E OF =,l.li_ RE'-]FIF'PTTFIN =,~r_TEfl IS: MFINIMUM NIJMBER OF BEE:,ROOMS = 4 SOIL. R~TING ,'q.3 FT,. E,F...- Z._,L" THE REQUIRE[:, SIZE OF THE SOIL RBSIDRF'TION =,~r.:,T_fl I=,. [:. E F" -ir" H =.'= :9_ ._~:: L E ~"~~ ,3 "'F H = ~_'"; El .... - %m E [_ [:. i=_' F" l-" H == THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIEL. D. THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFFICE OF THE GROUND RND THE BOTTOM OF THE E,s:',CR"/RTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRR',,,'EL DEPTH IS ]'HE MINIMUM DEPTH OF GRFI',,,'EL. BETWEEN THE OUTFRLL PIPE FIND THE BOTTOM OF THE E',:..',CRVRTION (IN FEET). PERMIT RPF'LICRNT HRS THE F.'E'EF'DNSIE:ILIT'-? TO INFORM THIS DEF'RRTMENT [:,URING THE INSTFILLRTION IN.-_]FECI"ION5 OF RN"r' WELLS R[:,JRCENT TO THIS FF._FEF..F'r RN[:' THE REz, I[.ENCE.:, THFIT THE WELL WILL SERVE. N,_HEER OF -'- ' "- T[.~C, ,:: 2 ::, I ~-~5;F'E,Z:-f" :[ C~'-~'----" F~F.'E F'E~..]"I ~ lr E;FtCKFtLLING OF RN'¢ SYSTEM WITHOUT FINRL INSPECTION RN[:, RPF'RO',,,'RL B'¢ THIS '- ' P F'R ]'SE ]:UT I fiN. [:,EPRRTMENT WILL BE .:-,LIE,..TE_.T MINIMUM DISTRNCE BETWEEN R WELL .FIND RN'¢ ON-SITE SEWRGE DISPOSRL S'¢STEM IS ±OR FEET FOR R PRIVRTE WELL OR t50 TO 200 FEET FROM R PUBLIC NELL DEPENDING UPON THE T'¢PE OF PUBLIC WELL MINIMUM DISTRNCE FROM R PRI',,,'FITE WELL TO R PRIVRTE SEWER LINE IS 25 FEET RND TO R COMMUNIT'¢ SEWER LINE IS 75 FEET. WELL. LOGS FIF:'E REQUIRED RND MUST BE RETURNED TO 7'PIE DEPRRTMENT WITHIN 3:0 DR'.dS OF THE WELL COMPLETION. OTHER REQUIREMENTS MFt'.r' FIPPL¥. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE R",,'RIL. RBLE TO INSURE PROPER INSTRLLRTION. F" E:_' F: ~"I .~. T E.---.F ][ F:ES [:.E~Z:Et'-IBEF--" 3:t.. I CERTIF'¢ THRT ±: I RM FRMILIRR WITH TFIE REL]UIREMENTS FOR ON-SITE SEWERS FIND I.,.tELLS FIS SET FORTH B'¢ THE MUNICIPRLIT¥ OF RNCHORRGE. 2: I WILL INSTFILL. THE SYSTEM IN FICCORDRNCE HITH THE CODES. 3:: I UNDERSTFIND THF!T THE ON-SITE SEWER S'¢STEM MR'¢ REQUIRE ENLFIRGEMENT IF ]"HE RESIDENCE IS REMODELED TO INCLUDE MORE THFIN 4 BEDROOMS. .:, I UNE[ ................................................ FIPPL I CFINT STEVEN SMITH t SSUED B'¢_ ..................................... DRTE--L~----~-OL---~- ....... V4. 0 ~"~T' ~ TANK SI ZE ~ GALLON~ ~ ~ ~ ~0(2) iNSP~C~lONg A~ R~OUIRED ~ ' ~ available to t~ls~e pro~ ~Bsta~kation. ~ * * PaR~T EXP~R~S D~C~ER 5[, i 9 8 1 * ~ * (~) ~ ~ ~e~ia~ wi~h ~he r~]utr~n~s for on-~[t~ sewer~ add ~L~ so~ forth by th~ M~i~ipaL~t~ of ~chora9~ ~NICIPALITY OF ANCHORAGE " ,Department os Health and Environmental ~.rctection S25 L Street, Anchorage, AK. 99501 264-4720 * * * * * * HANDWRITTEN PERMIT - - WELL ~AND/OR"ON~SITE SEWER P:ERMIT L~cation: ~il I~,.~ a~ ~) ~i~ Phone Number~: ~ Legal Description: L ~/~ L~oo~ ~/I.~~2 Lot Size: ~,~©~ Type of Soil Absorption System Is: Trench-: %/~ Drainfield: Seepage Bed: Hold'ing Tank: Maximum .Number of Bedrooms: q Soil Rating(sq.ft/br)_ ICC~'-~ The Required Size of the Soil Absorption System.Is: DEPTH /~/ LENGIH ~,/,~.. GRAVEL DEPTH' ~..--W-i-DTH : The length d~mension is~t e th(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the .excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(~ TANK SIZE = /2,%--C) GALLONS * Permit applicant has the responsibility to inform this department during the installation ~nspections of any wells 'adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED Backfilling of any system without final inspection and approval by this department will be subject 5o prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a. private well to a private sewer line is 25']fee5 and to a 'community sewer-line ss 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other r~quirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMITEXPIRES DECEMBER 1 9 8 1 * * * I certify that:- (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. · - ." (2) I will install the.system in accordance with codes.- (3) I.understand that the on-si~e sewer system may require enlargement if .- '.the residence is _remodeled -to. include more that 3 .bedrooms. 'Signe~: Issued by: .Applicant . Date: SWP/024(1/81) PER¢ORMED--FOR, LEGAL:DESCRIPTION: THiS FORM REPORTS: . JCl,ON lEST I AB Steye Smith Lol ' 21D ~Visual Soils Examination Block 18C'~'', W. 481'H AViL SI E- 't;' ANC,tORAGE, ALASKA 99505 248-1:555 ' DATE PERFORMED: Subdivision L'akewoofl; l.lilts 0 Percolation: 9~29/79 DEPTH SOIL ZEET .: . DESCRIPTION NOTES : ';P~:atll Reddish Silt Brown Sandy Silt Gravelly Sand Occasional Boulders BOTTOM OF HOLE ,'AS GROUND WATER ENCOUNTERED : YES, WHAT DEPTH EGEND Parc zone ' S'-- Sample loken ' -- Frozen zone " Woler loble EAD1NG DATE GROSS TIME -~-~ ~ ~ ; i I-Tq-~7' -7~-~-~ 327"-~ .... d .... NET TIME ~ DEPTH TO H20 NE~ DRAINAGE t ERCOLATION RATE: ROPOSED INSTALLATION OY, MENTS '. min/inch DRAINAGE REQUIREMENTS: 15_O_s_ f/_b__r _ SEEPAGE PIT ~ DRAIN FIELD O OTHER £ST PERFORMED BY:___D~Z.:i:_~d_y_a_U_]-._ ................. DATA CERTIFIED BY: ..... ~n.~Y._.~r .Baxter. DATE: .... _5/!/81 ......... T~me~. Time '~e Date Date Date ~'~ Inspector Inspector Inspector Comments Conditional Approval Date Sewer Installed ~:~ ~ ~?~,~ ~ Permit No. Septic Tank Size .~ .~ ~'/ Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Address Phone Realty Ca. & Agent '., Address ~/~ Type ~esidenoe ~ Single Family ~ Multiple Family No. of Bedrooms g Other Water~pply ~ Individual A~ACH WELL LOG. A well log is required for all wells drilled since June g Community 1975. For wells drilled prior to that date, give well depth (attach log ~ Public Utilit~ available.) Sew~ Disposal ~ Individual Year Individual Installed: j g Public Utility When Connected to Public Utility: g Holding Tank NOTE: THE INSPECTION FEE ~UST ACCOmpANy EACH REQUEST BEFORE PROCESSING CAN BE INITIATED,