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beve1c,prnen-Ir 5ervices bapartmerit
Building Safety bivisiorl
(,*-Site Water & Wcstewcter 10nogram
4700 E-Flmorle 'Rlorvi
P.O. Rex 196�50
;dark, B69I& k--iorcqe, AK 99507
Mayor
(�+, 7) 343 -79 �4
Pump Installation Log
WeR Drilling Pct-yrdt SNAT__ Date of Issue:
Pared Ideiitification Nlijvviher; 050 5
Legal D"cription IFFPr��Z perty 0�,-vmer Na -me Address:
j
ee j e
E, L I
Pump InstalkiTiwi -)w
7o
Pump Inta'tl-.F-, Depth 130o -vv iop of '1-1ell Casing: fect
Pu ,Tp Manufacturer's N";nw.,
Putup Modei:
Pump Size V -e qi1p
Pitless Adapter -%lanufacturs.CsNurne:
PiCeSS Adapter I wqt' afler:
Well Disinfected Upor Ccimp3etioa.1 alves;_'No
ASethod M'Disirfectiu-q,
Commelits:
Pump Installer Name:
Atteriden: The shnll,,x:ovt'da pvrnp U-suallation lfj,,-- To C -e LSD --,vith�n 30 Liays of pwrnp install ar.-ion.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME : PHONE ~NEW
MAILING ADDRESS
LEGAL DESCRIPTION '
~,STANC~ TO: W.,,/~O I~'°r~4~ P~,'b,, ~O /t P~RM,T N~/O ,:[ '7
~N Liq. apacity~ gallons '
~'O ~ --~ IF H~E~DE: Inside lehgth Width Liquid depth
~ D,STANCE TO: We,I ~/~ .Dwelling PERMIT NO.
O ~ Manufacturer Material Liquid capacity in gallons
~ Well
-- No. of I,,es
~ Topoftiletof,nish grad~ [ ~ Mat~l ~eneath tile?z [/ .~/ Tota[effect' eaDsorpd hare
~ength Width Deptb PERMIT
~ ~ Type of crib Crib d[am Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
m DISTANCE TO:
~' DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
QTHER r~,/
PIPE MATERIALS
SOl L TEST RATING
REMARKS
...................
, , RFCE'%ED
APPROVED x DATE LEGAL
72-013 (ReZ 3/78)
PERMII" NO.
DEP~RTMENT L ~HE~LTH ~N[:, ENVIRONMENTFIL , ,<OTECTION
825 "L" STREET., ANCHORAGE., AK. 9SJ50:L
264-4728
( 8d.05~7 )
FIPPL I C:FINT
LOCFIT 1 ON
LEORL
DRNIEL L. BEHNKE
4. 5 MI ER RI:,
LZE,_-. =,rEWRRT ~t. (ER:)
2±6;0 WFiSI LLR
LOT _-', I ~E
2:64.0EI SQt_IFIRE FEE]'
I_,. TREN_.H
T'T'F'E OF '.SOIL ME,=,_[~P'ftON =,Y-~TEM
MHz, IMLM IqUME, ER OF EEDRuuM_, = ]; SOIL RRTINO (S6! FT,-E,R.*.- Z4E~
]'FIE REQUIRED _,I,-E OF THE SO!L ME, z, uRPII_N =YzTEi'I IS:
[:,[5F'T~--~:= 1:1- I_E[~-4-.~ Tl'-~= 5:~-3 _..~F~:~-~ . El_ [)EF"Tf4= 7
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF' THE TRENCH OR DRFIINFIELD.
THE DEPTH OF FI TRENCH OR PiT IS THE DISTFINCE BETWEEN THE SURFACE OF THE
GROUND FIND THE BOTTOM OF THE E',:~:CFI',/FITtON (IN FEET).
THERE IS NO SET WIDTFI FOR TRENCHES.
THE GRR'¢EL [:'EPTH IS THE MINIMUM DEPTH OF GRFI'¢EL BETI4EEN THE OUTFFILL PIPE
RN[:' THE BOTTOM OF THE EXCRVFITION (IN FEET),
PERMIT FIPPLICFINT HAS THE RESPONSIBILIT'¢ TO INFORM THIS DEPRRTMENT DURING THE
INSTFILLFITION INSPECTIONS OF FIN9 WELt.'---; FIDJBCENT TO THIS PROPERT'¢ FIND THE
NUMBER OF RESIDENCES THFIT THE WELL WILL SERVE.
Z ][ ~'-.~-__';PEC:T ]E C,l'-,IS RRE REEqL! Z E~E[:"
- ,:~ ',- '-
BRRKFILLING OF RN'T' _~TEfl NI'FHOUT FINAL INz, FEL. TIJN AND HFFR_,RL THIS
4-..=,UBJEL. T TO PRCSECUTION.
DEPFIRTMENT WILL EE
MINIMUM DIS'FFINCE BETWEEN R WELL FIND RN'.r' ON-SITE SEWFIGE DISPOSFIL S'¢STEM IS
J. OC~ FEET FOR FI PRIVATE WELL OR ~_5C~ TO 2C~0 FEET FROM FI PUBLIC WELL DEPENDING
UPON THE TYPE OF' PUBLIC WELL
MINIMUM DISTRNCE FROM FI PRI',/FITE WELL TO FI PRI',/FITE SEWER LINE IS '-25 FEET FIN[:,
TO FI COMMUNITY SEWER LINE IS 75 FEET.
OTHER REQUIREMENTS MR*r' RPPL"r'. SPECIFICFITIONS RND CONSTRUCTION DIFIGRRMS FIRE
R'.,,'FIILFtBLE TO INSURE PROPER INSTFILLFITION.
F'E F.:' f'l Z -~ E:=-~F" ]: ~4. E.._-..-) [:,EICEI"IE:ER ]::1 .... ±Z-'c-=-±
I CERTIFY THRT
1: I RM FFIMILIFIR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WEL. LS RS SET
FORTH BW THE MUNICIPRLITW OF RNCHORFIGE.
2: I WILL INSTFILL THE SYSTEM IN FICCORDRNCE WITH THE CODES.
~: I UNDERSTAND THFIT THE ON-SITE SEWER SYSTEM MFI¥ REQUIRE ENLFIRGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN S BEDROOMS.
O & E ENG,NEERING & DEVELOPMENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Russell Oyster Earl Ellis
694-2774 SOIL LOG 688-2280
Performed for: Name: /~/~'~' ~ ~j ~'~-~J"~-~ Tel. No.c?
Mailing Address: ~'~//~ '~E'~ ~,, ;~?~-.~o ~/V~'z/ ~-~ ~.t,.r~OI
Legal Description: L-~'-r' / ~,~ ~ .~"/-~-,/~-~- A. /~
Depth (feet)
Soil Characteristics
PLOT PLAN
PERC. TEST
Ground Water Encountered: Yes
Proposed Installation: Seepage Pit.__
No j If yes, what depth
Drain Field c'~"
Comments:
Performed by: ~~'~ Date'
825 "L" STREET
ANC~'tQRAGE, ALASKA 99501
(907) 264 4111
January 4, 1982
Daniel L. Behnke
SR Box 2160
Wasilla, AK 99687
Permit ~ 810349
Subject: L 1 B 3 Stewart ~1
A permit issued by this department for a well and/or sewer
system has expired as of December 31, 1981.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal Ordinance.
If you have drilled the well, a well log should be sent to
this department to document the installation date.
If an engineer inspected the installation of the on-site
sewer system, please have them send us the as-builts for our
files.
If there are any further questions, please call this office
at 264-4720.
Sincerely,
Sewer and Water Program
Enclosure: Copy of Permit
F'ERH I T
RPF'L I CRNT
LOCRT I ON
LEGRL
DEF'FIRTMENT I~HERLTH AND ENVIRONMENTAL, ,P~;~]TECTION
.... ,:.._, '"L _,TF..EET., RNCHORAGE., Fit::;. S'S
l--iEEE F'EF:~r4 ][ T
< 8t02:49 >
EBGLE R I ",,'ER
L± B2: STEWART ~± LOT SIZE
MINIMUM DISTRNCE BETWEEN R WELL RND RNY ON-SITE SEWRGE DISPOSAL SYSTEM IS
±00 FEET FOR R PRIVSTE WELL OR ±50 TO 200 FEET FROM R PUBLIC WELL DEPENDING
UPON THE TgPE OF PUBLIC WELL
MINIMUM DISTANCE FROM A PRIVRTE WELL TO A PRIVRTE SEWER LINE IS 25 FEET AND
TO A COMMUNIT9 SEWER LINE IS '75 FEET.
WELL LOGS ARE REQUIRED RND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DRgS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPL9. SPECIFICRTIONS RND CONSTRUCTION DIAGRAMS ARE
AVAILRBLE TO INSURE PROPER INSTALLRTION.
F'ERF! Z T E::-::F' 11 ~;:ES [:-.E~Z:EJ"-IBEF-: 2~1..
I CERTIF9 THRT
t: I AM FAMILtFIR WITH 'THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET
FORTH 89 THE MUNICIPRLITY OF ANCHORRGE.
2: I WILL INSTRLL THE SYSTEM IN ACCORDANCE WITH THE CODES.
FIPPLICRNT [:,RNIEL L. ,.D[~I~';E ~'~-/qr,./~-~
I SSLIE[:, B9_ .... DRTE_
',74. 0
RETURN TO: Div]sron of Oeo]ogrcal and Geophysical Surveys (DGGS)
3001 Porcup ne Drive (Te?~one: Z77-6615)
0rilllng Company Name
STATE OF ALASKA
OEPARTHENT OF NATURAL RESOURCES
OCATION OF WELL ] PZease complete eiLher la, lb, or lc. ~'~ .......
Mile 6 Eagle River Rd. Address:
2. WELL LOG s.~f~ce 165 ft.
.;:C~'v'e.L ~ 1].? 5, ~Cable t~ ~otary ~Oriven ~Oug
oecroclc ll:;s l~,~ ~ Auger ~ Jetted ~red ~ Other:
6. USE: ~sC c ~PubH~ Supply ~ I.dustry
~ Irrigation ~ Rec~rge ~ Co~rc)a)
~Tes: Veil ~ Other:
7. CAS NG: . .~ Thr~ded ~elded
~ ln. to ~7 ft. 0epth Ve)ght ~ lbs/ft.
Type: O~e~ ~O1~ Oia~ter:
....... ulraLl~ OF ANCHO~
.... ~.~itless Adapter ~.
Cot~:en-[,~agnuson ])ri!lin~7 Contract License Number "'
Address:, '/ .. ' ,/ Date:J~z~ ~ t ~J~ '
Form 02-WWR