HomeMy WebLinkAboutSTUCKAGAIN HEIGHTS #2 BLK 1 LT 6, WK
DevelopmentServices Depar t rnent
Building Safety Division
,j Gr -Site Water & Wastewater Program, _
Ft � 4 70 Bragow Street
' =•. Box 19.6650 CIC LOU
Mark Begich Anchc•r.^_ce, .4K 99519-6650
Mayor ;v.wv.muni.orgi onsit€
(907}343-7904
Pump Installation Log
Well Drilling Permit Number: SW_ Date of Issue: _
Parcel Identification Number:
Legal Description
S,-rU C, min e fi a
% LI S
Property Owner Name & Address:
Fie%K Ltd
g6yo /jvRnlogl3vsl, D4.
Pump Installation Date:
Pump Intake Depth Below Top of Well Casing: PJaLfeet
Pump Manufacturer's Name: Go�Laf
Pump Model: /056/0 / /60C311 MOTOR,
Pump Size ( hp
Pitless Adapter Burial Depth: /a feet
Pitless Adapter Manufacturer's Name: �---
Pitless; Adapter Installer:
Well Disinfected Upon Completion?Yes ❑ No
Method of Disinfection: CLOT rlh< PLOOd1fTel
Comments: A
Anchorage PUMP & sAfeil Service
Pump Installer Name: 330 Fast 76th Avenue
Anchorage, Alaska 99518-
9518Phone:
Phone:907-243-0740
Fax: 907-243-0742
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pLunp installation.
MUNICIPALITY OF ANCHORAGP
DEPT. OF. H=a r.., .
IRONMENTAL Pi;11,7ECii G,+J
L„ MUNICIPALITY OF ANCHORAGE
® :;OC� — 8 1984
DEPARTMENTENVI
ONM NTArL ENG NIEEERINGN IVISIONTECTION
F
325 L Street - Anchorage, Alaska 99501 Telephone 264-4720
T' I VS__
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION R EIC
NAME
PHONE
6�'NEW
l -I )-I
❑UPGRADE
MAILING ADDRESS
LEGAL DESCRIPTION
LC>'i &=lr " S i UC 1 6 �I,iJ )' Y - I' ' LtiJ Sr_='C.
LOCATIONNO.
OF BEDROOMS
I 7U c- iwsiA
.3
Well_
Absorption area
Dwelling I
PERMIT NO.
U
DISTANCE TO:
1G <.�r
S
Its
,r'l=�l) _v a�j
Y
F z
Manufacture r',
Material
No. of co artments
NF
_
LP
Liq. capacity in gallons
IF HOMEMADE:
Inside length
Width
Liquid depth
) 'Z,St'
6 c7 z
DISTANCE TO:
Well
Dwelling
PERMIT NO.
= z F
Manufacturer
Material
Liquid capacity in gallons
o
DISTANCE TO:
Well
1 Cil f
Foundation
Nearest lot -line,
Z)
PE IT NO.
o 6�f�
m=
,'-f
a z
No. of lines
Length of aGh line
�%
Total length of lines
Trenclh width
Distance W/a lines
Z w
~
1
-, �i
, -mahes
f
W-
Q F
Top of tile to finish grade /
Material beneath tile
6
sorb lort are
Total effective ab�
=
4
; s
4 ,
Length
Width
Depth
PERMIT NO. / �t
W
YU/ .T
Q f°
Type of crib
Crib diameter
Crib depth
Total effective absorption area
as
Lu
W -
w
Well
Building foundation
Nearest lot line
DISTANCE T0:
r
Class,.
i r IVIAAI;c
Depth
Driller
Distance to lot line
PERMIT NO.
IVA-
w
�
Building foundation
Sewer line
Septic tank
Absorption areas)
DISTANCE TO:
OTHER
PIPE MATERIALS
f -%A )Am) --A-
SOIL TEST RATING 7
,
INSTALLER
AjcL --urs
REMARKS
\11/`�•
gcG ilo C-'
1NSP'E':I ris 's4ri
4
tf
00ILI
APPROVED DATE LEGALgel
{�';-. `�/Iy ��,;♦: L Cf 1 t U C. I'f/I6n i•1,J di i"C 'i -l' -/U %.t'��
l.i
72-013 (Rev. 3/78)
`
,. U-1 IU ffM 11 C� I F-irA L_ I _F N' ILI, ������IF<, ir-N C3 1EE: �
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION N �
825 [ STREET, ANCHORAGE, AK 99501
264-4720 ` {^
\`
X 7'!E� �[E-.-.VJE=_FR ���M I _T '
PERMIT NO: 840680
DATE ISSUED: 08/08/84 `
APPLICANT: JOHN HAYNARD
ADDRESS: PO BOX 4~599 /'^
ANCHORAGE, AK 99509' \
CONTACT PHONE: 562-0047
. y `
LEGAL DESCRIP: SUBDIVISION: STUCKAGAIN HTS" #2 LOT: 6 BLOCK: 1 \
SECTION: 6 TOWNSHIP: 12N RANGE: 2W
LOT SIZE: 48805 iSQ^FT. OR ACRES)
MAX BEDROOMS: 3
Listed below are the options available to you in designing your septic
system. Choose the option that best fits your site.
** TANK MUST HAVE AT LEAST TWO COMPARTMENTS
_ _ ~_ _ _ _ _ . _ _ _ _ _ _ _ _ _ _ _ ` . - _ - _ _ _ _ ^ . - ^ _ _ _ _ _ _ --
I
I certify that: I _
1. I am familiar with the ryquirements for on-site sewers and wells asset
forth by the Municipality of Anchorage (MOA) and the State of Alaska"
2" I will install the system in accordance with all MDA codes and regulations,
' and in compliance with the design criteria of this permit"
3" I will adhere to all MOA and State of Alaska requirements for the set back
distances from any existing well, wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot" '
4" I understand that this permit is valid for a maximum of 3 bedrooms and
any enlargement will require an additional permit"
`
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES,
THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS~BUILTS
WILL NOT BE APPROVED WITHOUT AN ELECTRICAL JNSPECTION REPORT; AND (3) THE
ELECTRICAL WORK MUGT9:SED ELECTRICIAN..
SIGNED DATE:
_____-~_'� W /
T�44
APPLICANTt JOHN HQYWAR�
`
ISSUED BY DATE: �
---------------- ------------------ .....
'
�'
0- FT? E07 T40 C! 1-1
ED: F'F_ T-)
L"i~�FRI, r_1 :1 11�41
DEPTH TO PIPE BOTTOM (FT")
4"0
4"5
4,0
GRAVEL DEPTH (FT")
6^5
0"5
3"5
TOTAL DEPTH (FTA
10"5
5.0
7"5
GRAVEL WIDTH (FT")
� 2"5
17"0
5"0
GRAVEL LENGTH (FT")
29"0
34.0
41"0
GRAVEL VOLUME (CU. YDS.
x8miLl-
=909M
_E�c��
TANK SIZE (GALS)
1,000,8 **
1,000"0 *5
1,000.0 **
SOIL RATING (SQ"FT,/BR)
125
125
125
** TANK MUST HAVE AT LEAST TWO COMPARTMENTS
_ _ ~_ _ _ _ _ . _ _ _ _ _ _ _ _ _ _ _ ` . - _ - _ _ _ _ ^ . - ^ _ _ _ _ _ _ --
I
I certify that: I _
1. I am familiar with the ryquirements for on-site sewers and wells asset
forth by the Municipality of Anchorage (MOA) and the State of Alaska"
2" I will install the system in accordance with all MDA codes and regulations,
' and in compliance with the design criteria of this permit"
3" I will adhere to all MOA and State of Alaska requirements for the set back
distances from any existing well, wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot" '
4" I understand that this permit is valid for a maximum of 3 bedrooms and
any enlargement will require an additional permit"
`
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES,
THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS~BUILTS
WILL NOT BE APPROVED WITHOUT AN ELECTRICAL JNSPECTION REPORT; AND (3) THE
ELECTRICAL WORK MUGT9:SED ELECTRICIAN..
SIGNED DATE:
_____-~_'� W /
T�44
APPLICANTt JOHN HQYWAR�
`
ISSUED BY DATE: �
---------------- ------------------ .....
'
�'
PERFORMED
i W
.�s
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
LEGAL DESCRIPTION
1
2
3
4
5
6
7
s
9
10
11
12
13
14
15
16
17
18
19
20
COMME
PERFORMED BY:
72-008 (6/79)
bRG
iop.sod
xSOILS LOG
❑ PERCOLATION
TEST
DATE PERFORMED: lq'j' 19eq
any D. Barter r
o�iP�GO y CE 5130 -jvy
ttq a °oo°o ��4�er
� FSP c
O,��y.�`� WAS GROUND WATERS
ENCOUNTERED? _/%o L
E
IF YES, AT WHAT
DEPTH?
/TAP'D PRN CIAy
W i t V LAN
r C
Reading
Date
Gross
Time
t e !
Depth to
Water
Net
Drop
xSOILS LOG
❑ PERCOLATION
TEST
DATE PERFORMED: lq'j' 19eq
any D. Barter r
o�iP�GO y CE 5130 -jvy
ttq a °oo°o ��4�er
� FSP c
O,��y.�`� WAS GROUND WATERS
ENCOUNTERED? _/%o L
E
IF YES, AT WHAT
DEPTH?
/TAP'D PRN CIAy
W i t V LAN
r C
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
PERCOLATION RATE LIJAVA"L 0- /,I5f'—�yuteshnch)
TEST RUN BETWEEN FT AND FT _
CERTIFIED BY:
DATE: R -,S -JV
MUNICIPALITY OF AHCHnRAGE
DEPARTMENT F__,HEALTH AND Et•1VIRONMENTAL I,—/JTECTION
225 L STREET: ANCHORAGE, AK 99501
264-4i'20
PERMIT NO:
DATE ISSUED
I APPLICANT
(ADDRESS:
CONTACT PHONE
LEGAL DESCFIP
(LOT SIZE:
840485
06/19/84
JOHN HAYWARD
P.O. BOX 4-599
ANCHORAGE: AK 99509
2€2-0047
SUBDIVI_ION: STUr_:f;AGAIH HTS. #2 LOT: S
SECTION E. TOWNSHIP: 12N RANGE: 2W
48805 (SQ. FT. Cid: ACRES)
BLOCK: 1
GI CERTIFY THAT:
1: I AM FAMILIAR 14ITH THE REQUIREMENTS FOR OH—SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE (MOA) AND THE STATE OF ALASKA.
2. I WILL INSTALL THE SYSTEM IH ACCORDANCE. WITH ALL MOA CODES FIND REGULATIONS:
AND IN COMPLIANCE WITH THE DESIGN CRITERIA OF THIS PERMIT.
{. I WILL ADHERE TO ALL MOA AND STATE OF ALASKA REQUIREMENTS FOR THE SET BACK
DISTANCES -FROM ANY EXISTING WELL: WASTEWATER DISPOSAL SYSTEM OR PUBLIC
SEWERAGE SYSTEM ON THIS PR ANY ADiA#.'ENT OR NEARBY LOT.
_,IGNED
APPLICANT: •IOHt
ISSUED BY —
DATE:
DATE:
: _��%_/f/`("may_
SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF 305
DRILLED AT THE RATE OF 41OW PER FOOT. ChaAge P/G 250 A an4..
PROPERTY OWNER ft'hn Ka,raAd 562-0047 562-3972
ML
OF
Lt. 6 B%k. 1 Suit. Stucker ain He g tfN pTL Ij g AN�HOROAnE
LOCATION OF WELL SITE g t lKUN NlAL FRUILUIUN
DRILLER Bea.
re Cta" o-� Raapa2t hAtit aq Oo&k4.
AUG 1YH4
WELL LOG: RECEIVED
0----221 StJ4 4aiW# Vmve t w.ith 35% clay btnd &.
22---68' Coa&ie aAauet SeveAat 4mait b
68 99' Haidadpan A cemented p w" About 1/2 gPRI o4 444t4 water at &ed&oc-k
99--305' Bed&ock. A 4ed aentau_!&ock. good watu YA,&Ld Aoa 271 .to 278 A.
A po wu4 hype &ock 4howing. about 3 9PIR. A 4a 3/4 CPIR Pwa 234 to 237 A.
Add.i ti onat watea yield o� 3/4 g'& jbwn 294 to 298 A.
Thio we.0 .ice 4hour4n.g a good 4 1/2 ,to 5 aPIR. good cteac high guai 4 wat".
Caztaq -i4 4eated dnto the beduck &.the 4-i.Q4 water at bed,,wa .ice compdetei, .phut
o". One ko&4e SuueLJA.b.%e Pump 4hou& be 4nzta tied 15 .deet og bottom..
WateA ccawA back up to with in. 55 . "t o. 4u&�ace. 1.6 ga cn4 oj� watet in. h,me&ve.
400 gat) -am to &eoewe.
A very. good hzgh gua. 4b.� hy"
Ro Cha&ge fa& .t4an4po&tatioa at 4et up coat. Ro ChaAge A& b.iamoad DAta bit co4-t.
Totat cost a� D&ZWna: JIM pec A X 250 A aniV
IRaAk' .1'm. gdad to get you .ouch a good Glel t & ateo give btou a good beak an p�iice!!
COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING.
WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF
THANK YOU VERY MUCH.
BERNIE CLAUS OF RAMPARTRILLING WORKS
DATE P -d4 15-th.. 84
SERVICE CHARGE OF 1V2% PER MONTH WILL BE ASSESSED ON PA T DUE ACCOUNTS. -"
MUNICIPALITY OF ANCHORAGE O4/ 02/ 3.,~''-
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF ENVIRONMENTAL SERVICES
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4744
Application Date
GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lo'T l¢ 1 .C;Tdc42A A-//4
Location (address or directions)
PropedyOwner Ch-i,'-c~ ~l~.~'¢'r*~'-- telephone:Home
(b)
Mailing Address ~. T./t~eleph~O 'n~Le'
(c) Lending Institution ~*;i; ~ /'//~:~ (,[L~ ~, ~/~
Mailing Address -' ' d ~ -
{d)AddressReal Estate C°mpanya~d Agent ~V~ ~-' '1~I- '
Telephone ¢ ~'~ ~ ¢'~'¢ [
(e) Mail the HAA to the followin~ address: or: Check here~ if hold for pick up.
List contact person and day phone number below.
V ~.~f.~,~ '~ Business
TYPE OF RESIDENCE
Single-Famil 'y~
Number of Bedrooms
WATER SUPPLY
Well~ Community [] Public []
Individual
Note: If community weJl system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
::siWt:~ DIpSuPblOi:~E~ Community D Holding Tankr-I
Note:~ community well system, must have written confirmation from the State Department of Er~vironmental Conservation
attesting to the legality and status.
Page 1 of 2
72-025 (Rev 81861 fronl
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation da!e shown below, J verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional end adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Name of Firm ~, ~'~¢~"~' Telephone
Address
Date
Seal
Approved for "Z"~.¢~) bedrooms by _ . . .
Approved ~/.~_ Disapproved Conditional
Terms of Conditional Approval
CAUTION
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
certificates based only upon the representations given in paragraph 5 above by an independent professional engineer
registered in the State of Alaska. The DHHS does th is as a courtesy to purchasers of homes and their lending institutions in
order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data
before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional
engineer's work.
Page 2 of 2 72 025 fRev 8/86) Back
.ct~O?.b,G~'MUNICIPALITY OF ANCHORAGE (MOA)
7 \9%%
Well Classification ~ ~,~ '~
Well Log Present (Y/N) Y
Total Depth ~ ~ Cased to
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot J
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
Le"al Descri'~tion'~ LO 7 ~. ~ il, ~"~'12C~.~4~/N
ifA, B,C~ D.E.C. Approved (Y/N)
Date Completed ~//~,,3-~, ~/ Yield
Depth of Grouting r~ o ~ ~
Pump set At ~,~0 7' 7'0 &'~
Sanitary Seal on Casing (Y/N) ~
Depression Around Wellhead (Y/N) ~
; on Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewer Service Line on
:Date
Water Sample Test Results
Comments
B, SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes (Y/N)
Size J ~'',,~O No. of Compartments
Air-tight Caps (Y/N)
Depression over Tank (Y/N)
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well ~t
TO Property Line -~
To Water Main/Service Line ~ ! 0
Course
Comments .~ L).~
~/ Foundation Cleanou, (Y/N)~,.,~/
Date Last Pumped 1~,~
;for
Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Page 1 of 2
72-026(11/84}
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed ~,~.~ ~
Width of Field
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
Standpipes Present (Y/N)
Date of Last Adequacy Test
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots
To Cutbank (if present)
To Water-Supply Well
To Building Foundation
Lot
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments ~L.~¢~ ~ .¢ ~
NON
Ioo £
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimension8
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified,.e¢ conformed to all MOA and HAA guidelines in effect on
Signed '"~ ~~ Date ~.~,,[ ~",'~'~
Company
Receipt No. O ,~ ...~
Date of Payment
Amount: $
Page 2 of 2
72-026 (11/84)
MOA No.
/TD oo
the date of this inspection.
Engineer's Seal
~ ~ 203 W. 15th AVE "C" SUITE 203
CONSULTING ENGINEER TELEPHONE: (907) 279-3916
RESIDENTIAL WELL INSPECTION
LEGAL:
Lot 6, Block 1, Stuckagain Heights #2
LOCATION:
OWNER:
TYPE OF WELL:
On Burning'Bush
Michael McGuire
Single Family
WELL LOG AVAILABLE:
INSTALLATION REQUIREMENTS
WELL YIELD FROM WELL LOG:
~...
MET:Yes
~ ..: ....... -. .;,.,
~%~ ' L ',. -.~"
5 Gallons per Min6te', ""
PUMP YIELD FROM TEST:
6.5 Gallons per Minute
DATE OF INSPECTION:
April 4, 1988
TEST PROCEDURE: Well was pumped at a constant rate while the
drawdown was monitered with an acoustic probe. At the beginning
of the test water level was found at 9~6 feet below top of c~siqg.
At a pumping rate of 6.5 gallons per minute the water level dropped
to 100 feet after 20 minutes of pumping and remained at that
level for the remainder of the test, 50 minutes. A total of 600
gallons were pumped. The well recovered instantaneously.
TEST FOR E.COLI AND TOTAL NITROGEN: Water was tested for E.Coli
and total nitrates on ~_.
E.Coli 1. Total Nitrates
<4.1 mg/l~.
Max. allowable Total Nitrates 10mg/1.
TEST RESULTS: This well meets-the requirements of the
Municipality of Anchorage.
THIS WELL WILL PRODUCE MORE THAN 3 GALLONS PER MINUTE FOR MORE
THAN FOUR HOURS
The Municipal requirement for well flow is 150 gallons of water
per bedroom per day. This well exceed this -requiremept. The
assessment of the condition of the well applies only to the
conditions as of the day tested. The flow rate may change due to
subsurface conditions that may not be observed from the surface,
and changes in the land use and other factors that may impact the
aquifer feeding the well.