HomeMy WebLinkAboutSUNSET HILLS BLK B LT 27) ,~IUNIClPALITY 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
MAIUNGADDRESS
~GAL DESCRIPTION
Liq. c[~pacity in gallons Inside length
Width ~ ~ Liquid d.pth
~z~ ~ DISTANCE TO: Well ....¢~ Dwelling PERMIT NO.
O ~ ~ Manufacturer Material Liquid capacity in gallons
O Well Foundation Nearest lot line PERMIT NO.
-- No. of lines Length of each line~ ~. Total length of lines Trench width
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption mea(s)
OTHER
PiPE MATERIALS
~OI L TEST RATING ---- --
_ , .
REMARKS
72-013 (Rev. 3/78)
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Z F THE:
Performed For
leoal Oescri~tion: lot.~ Block
This Form Re~orts Soils Loc M~
2204 Cleveland Anchorage, A]aska 99503
Percolation Test
r~eoth
Feet Soil Characteristics
16 -
20 --
Was Ground Water Encountered?
IF Yes, At what genth?
Readinq Date Grnss Time bet Time Depth to H2(~ bet gron
Fercolation Rate !Nnute
?rnnosed Installation: Seenaoe Pit Drain Field
Deeth of Inlet Denth To Bottom Of Pit Or Trer, ch
2204 Cleveland Anchorage, Alaska 99503
Performed For Jim Bensler Date Performed
Le.al
This
Oescrtntton: Lot 27 Block.B
;orm Re,errs Sotls Lan ,Yes
4-3-78
Subdivision Su. ns,e,t Hil%.$ Subaiv~Jmn
Percolation Te.it ....
~eeth
Feet Soil Characteristics
" ~eda~_sd" ~1±~ --
Clean Sandy Gravel
4----
10-- Brown Gravelly
Silty Sand
14--
Bottom of Test Hole
20--
Was 8round Water [ncountered?_No
I~ Yes, At what Depth?..
Readtn~ Date Grnss Time Net Time Depth to H20 Net Drop
i i
Percolation Rate Htnute
Prnposed Insta-Yl~'o{~'6: Seenaae Ptt Drain Field
Deoth of Inlet De~t-F"l~6-q)'5~iom Of Pit OF Trenc~
CmM~£NTS:_,,85 s~. F~.~Fatna~e area required per,bedroom fr, o,m. minus 1.5' to 7.5'
Test Performed By,.. y/~).~....~/~'~-.t.~.V._ _ Data Certified
Date: 4-5-78
DRILLING LOG
Well Owner ~ i.~;: ! :~ Use o£ Well
Location (address of: Township, Range, Section, if known; or distance main road_
Size of easing
Static water level ii ,[Ji)~
Screen ( ); Perforated ( ).
Describe screen or perforation
Well pumping test at ? gallons per -(hrbhr)
of drawdown from static level.
Date of completion ~ / )()/
r' ?e~+~ ~. of Hole ', ~/
feet
ft. (abo-de) (below) land surface.
Cased to i'~/ ')~ feet
Finish of well (check one) open end (
(minute) for i hours with
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
);
_TO
_TO
_TO
_TO.
_TO
_TO
TO
TO
TO
TO
TO
TO
TO__
3 -- CONTRACTOR
DATE SIGNED
4S 469 SEND PARTS I AND 3 WlTtl CARBON INTACT,
. PolyPal~i5O el 14P469 PART 3 WILL BE REIURNED WITH REPI.Y.
~ D A~:'~ RECEIVED
--TIME I NSPECTI ON APPOITiMENTM EI~ ¥~-~ TIME(~'~L~'~)~/'~'~(~' ' ~'~/~
~ATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
DEPT. OF HEALTH &
MUNICIPALITY OF ANCtlORAGE ENVIRONMENTAL PROTECTION
825 L Street - Anchorage, Alaska 99B01 MAR
ENVIRONMENTAL SANITATION DIVISION
Telephone 264-4720 RECEIVED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts ol~ page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
~BUYER _ ~ PHONE
LENDING INSTITUTION ~[ ...... - I PHONE
4. R~AL'r~.NI' ~ ~ ~ PHONE
5. LEGALDESCRIPTIONz,,,~ ~'~ ~ ..~.,~/~ .
6, TYPE OF RESIDENCE NUMBER OF~BEDROOMS
[] One [] Four
~ SINGLE FAMILY
[] Two [] Five
[] MULTIPLE FAMILY '(~ Three [] Six
E3 Other
7. WATER SUPPLY
~. INDIVI DUAL* * ATTACH WELL LOG. A well log ~s reauired for all wells dr(lied
[] COMMUNITY since June 1975. For wells drilled prior to that date, give we-fl
[] PUBLIC UTI LITY oepm (attach log if available,
8. SEWAGE DISPOSAL SYSTEM
'(~ INDIVIDUAL/ON-SITE** Iq 7 t~' YEAR ON-SITE SYSTEM WAS INSTALLED.
[] PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72 010 (Ray. 6/79) /' ~,',¢'~ [.~'~ /[,~ji~
. THIS SIDE FOR OFFICIAL USE ONLY
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
Connection Verified INSTALLER
[~]Septic Tank or []Holding Tank
Size: '~.)L~ If Tank is homemade SOILS RATING
give dimensions:
TOTAL ABSORPTION AREA MATERIAL
4, DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line
WELLTO:
Absorption Area to nearest Lot Line¥1.,
5, COMMENTS
[]~]~'APPROVED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL {letter mjb~t accompany certificate)
[]~'~'-DI SAPP R OV E D If Y
72-010 (Rev. 6/79)
ANCI!OISAGE, AI/'\SKa, 99501
(907) 2'6,4 4i '11
tda:ci.'h 11 , 198].
Ga._y Morri s
Star Rouhe A Box 4033-C
Anchorage, A]aska 99502
Sfl~ject: f,o{: 27 Block B Sunse{: Ilills" ' "' "
7~ppx'oval for.your individual .~ew.x' and water facil£L.ie.s
call,loll be gralllJed i1N[tJ]. 1..he following i. hems have been
compleeed:
d(..~. ~ vered ko
(]) The water analysis ~epor[ needs 1'.o be ,' '
of{lice from the (!h(!R/ ]3ab, 5633 B S[lrooJ2, J~or out-
iii!' hhere are any further guestions, please call[ th:is
offf:ice at 264-4Y20.
RoberL C. Pra{3~:, R.S.
As sociaff, e Spec ] all.:i.s {:
RCP/ljw
Alaska Firs{~ P!o~rhgage Corporahion
20'1 Eash Northern hJ. ghhs ]3etllevard
99503
Alene Palmer
Cenhury 21[ ~-. Sle(:ipe}:
8050 O].d Seward HJ.ghway 99502
ENV RONMENTAL ENGINEERING DIVISION
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SI-"WER FACILII'IES
MUNICIPALITY OF ANCHORAGE
DEPARTMENT 13F HEALTH & ENVIRONMENTAL PROTECTION
825 L Street - Anchorage, Alaska 99501
DIRECTIONS= Com~)lete ell parts on page 1. Incomplete requests will not be processed. Please allow ten (10} davs for processing.
1. PROPERTY OWNER PHONE
MAI'LING ADDRESS
.~' /..~ ~G
PROPERTY RESIDENT [if different from above]
IPHONE
PHONE
LENDING INSTITUTION
· PHONE
MAILING ADDRESS
~7 o 7 ~./~. / ~,<~s _
4, REALTOR/AGENT PHONE
MAI LING ADDRESS -
5.' LE~AL.'DESCRIPTION
STREET LOCATION
6, TYPE (;IF RESIDENCE
L~ SINGLE FAMILY
I-q MULTIPLE FAMILY
7, 'WATER SUPPLY
INDIVI;)UAL'
[] COMMUNITY
PUBLIC UTILITY
[] One [] Four [] Other
Two [] Five - '
Three [] Six
ATTACH WELL LOG, A well log is reauired fop all wells drilled
smce June 1975, For wel s drilled prior to ti~at date, give
oeoth (attach log if available,)
**If individual/on-site, give installation date 7 - ~-~o ~ ? ~'
If system is over two [2) years old ap adequacy test is required
Dy this DepartmenL
8, SEWAGE DISPOSAL SYSTEM
INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
NOTE: THE INSPI-'CTIGN FEE MUST ACCOMPANY EACH REQU EST 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 BEDROOM8
~ SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
1~ INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTI LITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
~ INDIVI DUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified [O{ '~ ~ :-~
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 WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
~PPROVED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED ,/~,-/
LEGAL DESCRIPTION
72-010 (Rev. 3/78)