HomeMy WebLinkAboutSUNSET HILLS WEST BLK 4 LT 16' \oclc
MIUNICIPALITY OF ANCHORAGE
DEPARTMENT OF REALTH & ENVIRONIVlENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 'telephone 264-4720
ON-SITE SEWAGE DISPOSAl. SYSTEM AND/OR WELL. iNSPECTION REPORT
NAME [7~)
MAILING ~DDI SS
LOCATIO~ ~ NO, OFBEDROOMS
L q capac ty n ga ohs Inside length Width Liquid deptl~
~ ~ , IF HOME.DE:
, ~ Well Dwelling PERMIT NO,
~ ~ ~ Manufacturer Material
~ Well Foundation Neorest lot line~
W~ Top of tile to fiMsh grade ~ ~ateria, beneath tile
LU Length Width Depth PERMIT ~,
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~u Well Building foundation Nearest lot line
~ DISTANCE TO:
~ Class Depth Driller Distance to lot line PERMIT NO,
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
INSTALLER /
-
72-0 (Rev, 3/78)
F:IF'F'L I CFINT
L.E)C~T 2( Oiq
LEGFIL
I--IFIRL FIN i"10 0 RE
J I::lf~'.'v' I
L.:1..6 B,4 5;IJNSET I~IL...L. 2: 14E'.ST
I:"t'F:'E OF SOIL RE:SORE:T]:Oi'.,I
i"ti:~',:-:',ll'"tUi'"i NIJHE~:ER OF' DEC, R00H::2;
RED ':S I ZE Of:' 'T'F'IEE SO I L FIE:'..SOF.:PT I ON '.S'.,.'2;TEH :[ 5;:
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TFIE LI£NGTH E:, I i'tEi',l¢~; t Oi"..I I S; TFIE: LENGTFI ( I N I:EE[.-':T ) OF THE TRENC:H i~1[~ [i:,[:::R :[ NI':;' :[ El ..[).
THE E:,IEF'TII OF FI TRENCH OF..' PZT :[~5 TFIE D:['.:.:.;TFINCE BETI-,.IEEN THE E;LIF;'.F'flCE~ OF' THE
E!iROUf.,Ib RND THE BOTTOH OF TFIE
TI".IEf;;:E ]:S NO SET 14IDTH FOR Tr4'.Ei".,ICFIES.
THE.: QI';.:F:I'v'EL DEPTH :[~; THE i','IZNZHEJi',I E)EP'fTI OF GRFI'v'EE.. BETP.IEIEI'.4 TFIE: OUTFRL. I..
Ri'.,IE:, TI-IE BOTTOM OF THE E',,..',C:R',/FFr:[oi'4 ,::ZN F[EE'f'::,.
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]:N~STFIL. LF:FFION IF,ISPECTIONS OF IRN"? I'.IEL. L.S FID.3FIE:ENT TO THIS f:'F.:OF'EF4'.T"/ FIND "I"FIE
NIJfIBER OF' R[:i:'%:[I::'ENCE'.i~; THFtT TF'I[~: ['.IELL P.I:[LL '9.;ER',,,'IS:.
L:~I::IC:I'.'..'F I IJ. ~ f',lG OF' FIN"/ S~¢S"['EM PI]: TTIOUT F Z NFtI... ~ NSF'EC:T :[ ON FINE:' FIF'PROVFIL. B'¢ TH Z S
[::,EF'F~t~'.TH[~:NT I.'.1Z LL B[£ SLIB..TECT TO F'[~OSEC:LIT I ON.
MIt'.,I):MUH I):I::STFINCE E:ETP.IEEN fa !dELL. F'liqE:, RI".,I'¢ Oi".,I-.-SI'l"l!i: '.:.:;E:P.IFIEiE: [:,Iti~;F'OSl::lL. S;'¢:-Sl'li!i:H I2;
:t. OO FEET FOF:': F'I f::'R:[',,,'RTE I.,.IELL.; OF..'
±50 TO 200 FEET F:'ROi"I R F"'I.J[~:L.~C I.,.IEIJ.. DEPENE:,ZNEi UPO~',I THE T'T'F'E OF' F'UE:L:[C I.,.IEL.L..
O'fHEP:: I~:[.'-.'I]:dJ[REHEN'r% I'dFl'¢ RF'F'L'¢. SF'EC.'IF'IC:FIT.]:ON5 FINE:, CCli'.,ISTF;:I..ICTIO~'.,I
R',/FIILfr'iBLIE TO :[iqSLIRE PROF'E~'..T.i",ISTRLLRTZC'fN.
I CE:f.i:'FZF"¢ TI-IRT
::L: .'[ F:IM F'I.-qHIL):RR 1.4~'FFI TI.lIE REt~!L.IJ:F;'.EH[i:i"dT'.2~; F'Of4: I.')N-..':?.;:[TE SE],IERS FIND HE;-'L...L.S RS S;ET
F:'OF.:.'TH E~'~.' THE f'tUN;[C:):PRI...:[T"r' OF RNCHOF'.RGE.
2: ]: I,.I];L.L INS'T'FILL THE S~,".'STEM :(iq FICE:Oi'~:[3'f:INE:E .q:[TH THE CODES.
:J:: :[ LINDIZF..'S'FRND TI'fi:IT THE or.,F-SZTE 5EI.,.IEF;'. S.;'¢2;TEM I',IR'¢ R[.~6!U:[F:E ENLFIRE~[~:r'I[_::I'.,1T :[F THE
I~!ESIE:,[:-'NCF: I~E; REi'dC~DELED "Fi:) IN£::I...UDE i'40RE TNFIN 4
I~F'F l., :[ C:F~.~T HFIRLFII"] MOOf~,E
...... ,,:,:. .
Flu.sell Oyster
694-2774
Performed for:
O & E ENgiNEERING & DEVELC,,~IVl[--N'T CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
SOIL LOG
Name:. /-7/A/~/-/~/'/ .~', //~Oo~.E __ Tel. No
Mailing Address:
LegalDescription: /,~T' /~,,
Earl Ellis
688-2280
Depth (feet)
Soil Characteristics
/'f~
,,~-. 4
5 __.~p
6
7
14__
Ground Water Encountered: Yes
Proposed Installation: Seepage Pit
Comments:
PLOT PLAN
PERC. TEST
~--~ 1~-,~ '
Drain Field ~ %. ~¢ ~/~,.
:( E:EI:':~TJ;I:='r' THf:'IT
:;t.: ;I; FIH Fl=lf'l ;I; t_ ]; l:qtR 14 :!; TH TI'II!; R'.F;6!I..I ;[ I;;'.I~;I"IE;I",ITS
l='OI;;',ll'l E',"¢ TI'Ii; I'II..II",I];C];F'I=iL.I: f'"r~ OI':: I:::Ii",ICI-I()[;::I:;'IGE
;;;:; ;i; 14;!i1,1
E/W
~_~Oomestlc [~Publlc Supply L~]lndus%ry
C~lrrIga~lon [~Recharge [~Co~rcl~l
L~Test ~ell ~]Other:
6. USE:
?, CASING: [] Thceaded [~We~ded
[]Above [_~Oelow Land surface
ft,
inches abo?e grade
13. PUMP: (If available) UP
WATER WELL LOG
LOCATION_ L ~ ~ /.~'~.
FOSS DRILLING
1336 Ingra Street
~nchorage, Alaska 99501
SIZE OF CASING~_~DE~TH OF HO~.E./_~Pr. CASED TO /..~- / ~ FT.
PEr,WP OF DRAWDOWN.
REMARKS
DATE COMPLETED
C~,t O__ ~F
~.t O ....
~.t O~ ~--
C~H~IICAL I~ eF. OLOelC,~I. LABORATORIF~ OF AI.A~K~
P.O~ BOX 4-1276 4649 BUSINE~.~ PARK BLVD.
ANCHORAGE, ALASKA 99509
· ": ~:" 'D~nkin§ W~ter ^nalysis Report for Total Coliform Bacteria
TELEPHONE
{gO7) 278~1014
TO BE COMPLETED BY WATER SUPPLIER
PUBL,C WATER SYSTEM:
Publlo v~.er system Namer
City State Zip Code
Mo. Day Year
SAMPLE TYPE:
[] Routine
[] Check Sample (for routine sample
wtth lab ref. no.
[] Special Purpose ,
) [] Treated Water
[] Untreated Water
SAMPLE
NO.
I
I
L
LOCATION
Time Collected
Collected By
TO BE COMPLETED BY LABORATORY
LABORATORY:
NAME
ADDRESS
CITY
Date Received ~ ~ ~ I/~ ~ff
Time Received __. /%'(f~"
Analytical Method:
[] Fermentation Tube
~'~'Membrane Filter
I_ab Ref. No.
J
J
J
Result* Analyst
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
Form No, 10.310 (3-78)
06-1220 (b)
Rev. 1978
BACTERIOLOGICAL WATER ANALYSIS RECORD
Date Co acted.
Presumptive
2,t Hours
46 Hours
confirmatory
24 Hours
4B Hours
EMB
MuHIple TUbe Report:_
Membrano Filter= Direct Count
Verification= LTB
,,' ~ ,: , I, ,./\I/\SK&99501
September 24, 1979
· Harlan E. Moore
Post Office Box 10-882
Anchorage, Alaska 995].1
Subject: Lot 16 Block 4 Sunset Hills West Subdivision
Approval for your individual sewer and water facilities
can not be granted until the following items have been
completed:
(1) A well log is submitted %o this office.
(2)
The water analysis report be delivered to this office
from Chem Lab, 5633 B Street, for our review.
If %here are any further questions, please contact this
office at 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist
RCP/ljw
cc: First Federal Savings and Loan
Post Office Box 4-2200 99509
ENVIRONMENTAL ENGINEERING DIVISION SEP '~ ,,,. 19'/;
Te.epho.e 2..7.0, R E'' VpC E 1
REQUEST FOR APPROVAL OF INDIVIDUAL WATRR AND SEWE~ FACILITIES
MUNICIPALITY OF ANCHORAGE --DEPT. O; ~ & ]
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIONIRONM[:NI'A~ P~(Q/[-C~ ION I
825 L Street - Anchorage, Alaska 99501
DIRECTIONS: Complete all carts on page 1. Incomplete requ(~sts will not be processed, Please allow ten 0 days for process nq,
PHONE
1, PROPI-'RTY OWNER
M^,L,N~ADD.ESS FO ~v IQ~¢~ z
ill different from above) ' / PHONE
OPERTY RESIDENT ' PHONE
~ LENDING INSTITUTION
~"AI LING ADDRESS
4. REALTOR/AGENT
M-AILING ADDRESS
LPHONE
5. LEGAL DESCRIPTION , --
:REETLOO^T,O '
6. TYPE OF RESIDENCE
~ SINGLE FAMILY
[] .MULTIPLE-' FAMILY
7, WATER SUPPLY
~ INDIVIDUAL*
[] COMMUNITY
I [] PUBLIC UTILITY
--~, SEWAGE DISPOSAL SYSTEM
~ N DI VI DUAL/ON-SI'I"E
[] PUBLIC UI'I LITY
~UMBER OF BE'DROOMS
[] One ~ Four
[] Two [] Five
[] Three [] Six
E] Other
ATTACH WELL LOG Awel Icg is required for all we sdrilled
since June 1975, For wells drilled prior to that date, gwe well
aeoth (attach Ioc~ if available,)
'*If individual/on-ske, give installation date ~ f,~
If system is over two (2) years old an aaequacy/test is required
by this Department,
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BI:FORE PROCESSING CAN BE INITIA'rED,
~-010(3/78) ~...~
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
ITIME TIME TIME
DATE DATE DATE
NSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
E] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] I NDIVI DUAL/ON -SITE DATE INSTALLED
[] PUBLIC UTI LITY ~q' ~"~ ¢7
Connection Verified INSTALLER(-~
[]Septic Tank or [] Holding Tank ~,--~-~.--~'~-
Size: I,~.~O If Tank is homemade SOILS RATING
give dimensions: ~,~'~ O
TYPE OF TANK MANUFACTURER¢ j~10 .,~. ~
TOTAL ABSORPTION AR EA MATERIAL
4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
~"APPROV ED FOR '~, BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE BY {~
LEGAL DESCRIPTION
72-010 (Rev. 3/78)