HomeMy WebLinkAboutNORTH LAKE VISTA LT 1Onsite File
North Lake
ami4713
a. "� � "'��„� �' �, Y � ;,,._,fit:, �,^
MOA has on
a , survey for this lot.
Legal Address:T 15N RlW See 30
Subdivision: Block: Lot:103,
T: R Section Lot:
On-site Water & Wastewater Program certified contractor performing the well decommissioning:
Name: Signature:
Jim Sullivan
Company:
Arctic Pump & Well, Inc
Well Decommissioning Date 12-21-17 Method of Decommissioning: AMC 15.55.06OLI a.E1 b.E1 c.Fx_1
Z:�
Location: Use the space below to provide a drawing of the property showing the following items:
• North Arrow
• Decommissioned well
• Other water wells on the property
• Two separate swing tie distances for each well shown on the drawing
Note: the swing tie distances shall be measured from either permanent structures or the property comers.
Arctic Pump & Well, Inc.
Page I of 1
101 DRILLING
WATER WELLS
R P GReeke
.Wrl$9elby
Star nt.Js Box 1111 Sos
at irx, AK 99si7 I! SGS SITE ID61�11214"a°4/61
'"�£ wit LOCAL NO . seor5oor 3o et Cc/ 030
Name. 1I„ , /7. 7(:.s�� I.c',i! '4. 011.0yy AL 071 i A
Address. O L b 0 --/CA/ L 9kc 4s;of/o deer. SIM .E M. a 73ox 3 it- 0.4Lie ik, Ak
--ALL premtt z# 774,
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{"a mut 745.8281
ClannalMa 882-341p
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AUTHORIZATION TO DRILL
I hereby authorize 101 Drilling Co. to proceed with the above described work. Payment shall be made
in the following manner: y f 1
�Aati -sir_ uII. 4Jrfe/1 WA/c* dl)e/f is C`'anrp/e•%
l
In the event it is necessary to institute legal proceedings to collect any amounts due on this contract, I
agree to pay an additional sum of not to exceed ten percent (10%) of the contrac rice as attorne
fees, plus costs, for legal proceedings.
Date
a l s'PZ 77
a
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
'> INSPECTION REPORT ON-SITE SEWAGE DISPOSAL�SYSTEMS/�
NAME �KA`Iry n10-2-7 l AD MAILING ADDRESS S k" &DX C31 E1' Cts 1?.,PHO'N�EE
LOCATION (J la CI e -.NN I JCU LEGAL DESCRIPTION t 103 S'e C, So 7" v IJ 4
SEPTIC TANK:
DISTANCE �Q NUMBER OF
FROM WELL l_U_C.(.e MANUFACTURER �Ij/L/SAT MATERIAL I�'�r�� COMPARTMENTS 4,9'q�
Ila'
INSIDE LENGTH INSIDE WIDTH
LIQUID DEPTH LIQUID CAPACITY/deOGALLONS.
TILE DRAIN FIELD:
r TOTAL
DISTANCE FROM WELL / I oFOUNDATION / ( NEAREEST LOT LINE �D / 7 OF LENGTH/
GT H'�/
NES
NUMBER OF LINES DISTANCE BETWEEN LINES '/�" TRENCH WIDTH.) N TOTAL EFFECTIVE
ABSORPTION AREA
DEPTH: TOP OF TILE TO FINISH GRADE
SQ FT LENGTH OF EACH LINE _7G ( S/ / 32 S “5:2
DEPTH OF FILTER
MATERIAL BENEATH TILE ' S IN ABOVE TILE / IN
WELL:
TYPE CONSTRUCTION DEPTH DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION LOT LINE SEWER LINE TANK SYSTEM
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED
REMARKS
DISTANCES 4 1
4C_
INSTALLED BY -
SEWER LINE DEPTH•
PIPE MATERIAL
LOT SLOPE:
REMARKS:
Form EQ -032
DIAGRAM OF SYSTEM
DATE7L/X-77APPROVE
^
HERMIT NO
R . � o�Fr.
r+'PART 0P;--IFHLTF HND ENVIROuMFNTR|.. 'ECTION
�TR[ET, HNCMORGGE/
---
( 77470 ) cV
APPLICANT RAY MARTIN
|0C1TION OLD GLENN HWY
.LEGAL 110] SEC 7:0 11514 RIG
`�'`��/
K �^
]
/B��
S[� AUX 784 E. R.OLD GLE��''�
/=`-)
�
LOT SIZE 420000 SQUARE FEET
°'`
TYPE OF SOIL HBS0RRT70N SYSTNM IS: DRHINFIELV
MAXIMUM NUMPER OF BEDROOMS = ] SOIL RATING
TAN REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
!_# - V.E FP' 11-11-1= ,�
(SQ FT/BR)- 190
THE LENGTH DIMENSION IS THE LENGTM (IN FEET) OF THE |RFNCH OR DRHINFIELD.
|HF DE.PTH OF H TRENCH OR FII IS THE DISTANCE BETWEEN THE SURFACE OF THE
AROUND HHD THF RPTTOM ON THE EXCAVATION (IN FEET)
THE TRENCH WIDTH FOR DR9INFIELDS IS ] FEEL�
TME GRAVEL. DEPTH IS THE MINIMUM DEPTH OF GRAVEL. BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF !HE EXCAVATION (IN FEET)
���
, ..4. : _II__ CA
--------- V11111!:Ii<IHICIFT. 11E.:1X_EW,111 ''''
A PLANT MAY AN INST8LLED AT |HE PERMITTFE'S OPTION SUBJECT TO THE
FOLLOWl@8 CONDITIONS:
1. EITHER H CLASS 7 OR if NSF AM -WAVED PLANT MAY RE INSTALLED.•
H CONTINUOUS MAINTENANCE HGREEMEN| 'IS REQUIRED. IF H MAINTENANCE
AGREEMENT' 7S NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SOIL
ABSORPTION SYSTEM AND/OR YOU MAY BE SUBJECT TO PROSECUTION.
1-11,.11CI I �H191".7E.14r-GEH (1,,- I EDG:!).o'6���ID!
BRCKFILLlNG OF ANY SYSTEM WI|HOUT FINAL INSPECTION AND APPROVAL BY THIS
DEFRR|MFNT WILL 8E SUBJECT |O PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 EEET FOR H PRIVH|E WB'L OR 20m FEET FOR H PUBLIC WELL
OTHER REQUIREMENTS MAY APPLY. SPNCINICH/IONS AND CONSTRUCTION DIAGRAMS ARE
AVGILHGLL TO INSURE PROPER INSTALLATION.
��). 0-((. �N "���
I CERTIFY THAT
1: I HM FAMILIAR WITH THE REgUJREMENTS FOR ON-SITE SEWERS AND WELLS H� SET
FORTH By THE MUNICIPALITY OF ANCHORAGE. //l
2: I WILL INSTALL THE SYSTNM IN HCCORDRNCE WITH THE CODES.
]:HI UNDERSTAND TyEG '' THE ON-SITE: SEWER S;6|EM MAY REQUIRE ENLARGEMENT IF )HE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS.
HPPi^{CHNT ROT HHRTIN
Q £;E GEOT_ONNICAL Et DEVELC MENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Russell Oyster
694-2774 SOIL LOG
Soils 8 Foundations -
Performed for: Name:.' ou �� ��P1 ,!_' Tel. No.
Mailing Address: Z 'Sc 3`0 -\ c. `./Z- 0P 77
Legal Description: 'a‘.,AS\ \- a -e \v 'S h • C\ • �� � �� ' S�
Depth (feet) Soil Characteristics
Ear/ El/is
689-2280
Land Development
0
1
3-1i-_ N -NI \wawts
—2 CCC\-. �, ./ y f??SC., j >y sem: iv W..tNa%
3 ceea 1Z- \,Jc,.>. t_->
4 _ c.77Lre_c_91,A<, c 3'oma Af�c__
5
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7
8
9
10
11
12
13 fir.
14
15
16
Ntlit
\ _ Ci'1kb-nitt/A*1e%
Ground Water Encountered: Yes '� No If yes, what depth Z
Proposed Installation: Seepage Pit Drain Field
Comments:
Performed by:
Date: 1p.` 2.3 7`)
W1QAAA -1 ( '11 I 77
101 DRILLING
WATER WELLS
ROTARY
W. H. Selby
Star Rt. C, Box 88 >'/., 4
Palmer, AK vis t
u i
0 s , .
e i . ,) 1 ;11
7_\.
Anchorage 279-1938
k , : P.almert, 745-3351
Glemiallen 882-3413
; 1 .. ./.1 . 1/
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Name: i z : l. t;' A /
I.,— cl___ Date//,
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Results
Amount
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AUTHORIZATION11'0 DRILL
I hereby authorize 101 Drilling Co. to proceed with the above &scribed work. Payment shall be made
in the following manner:
/ , , 1/
In the event it is necessary to institute legal proceedings to collect any amounts due on this contract, I
agree to pay an additional sum of not to exceed ten percent (10%) of the contract price as attorney's
fees, plus costs, for legal proceedings.
Date