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HomeMy WebLinkAboutTURNAGAIN BLK 4 LT 3/2 'Z-0.3 ,O2o MUNICIPALITY OF ANCHORAGE He~'.h and Environmental Prote ~ion Fourth Floor West k~ 825 L Street Anchorage, Alaska 99501 279-2511, x 224, 225 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH_ MATERIAL --J~ ---/~-~:¢~-- ~____ COM PA R TM ENTS 2- __ .__ INSIDE WIDTH _ __ LIQUID DEPTH LIQUID CAPACITV/'~ GALLONS. TILE DRAIN FIELD: TOTAL LENGTH · DISTANCE FROM WELL ....... FOUNDATION NEAREST LOT LINE ............ OF LINE __ DISTANCE BETWEEN LINES ........ TRENCI4 WIDTH~_~I'~. TOTAL EFFECTIVE: ABSORPTION AREA .... SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE_ MATERIAL BENEATH TILE__9 ~ ABOVE TILE ~' _IN, SEEPAGE PIT: Log Crib BUILDING FODNDATION __ DIAMETER __OR WIDTH__, LENGTH. DEPTH Rings/CRIB SIZE: DIAMETER___DEPTH_ DISTANCE FROM: WELL TOTAL EFFECTIVE NEAREST LOT LINE___ ABSORPTION AREA (WALL AREA) FT. Class:~.~3~g Depth. Well Distance To: Lot Line Bldg: Sewer Line: Pipe Materials: # of Bedrooms: Installer: ~-- Remarks: DATE_~_ APPROVED , I ~ SOILS LOG ~"~ *.r.~Y MUNICIPALITY OF ANCHORAGE [] PERCOLATION DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST Pouch 6-650, Anchorage, Alaska 99502 276-222~ SOILS LOG -- PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11- 12- 13- 14- 15- 16-~ 17- 18- 19- 20- ~SLOPE ~ SITE PLAN WASGROUNDWATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) ,51o 000 SIX INCH WATEr WELL DRILLED AND CASED OUT TO THE DEPTH OF ~ ~co%. DRILLED AT THE RATE OF PROPERTY OWNER ~: LOCATION OF WELL SITE _ DRILLER RA~ni~ ~1 ~}.~ ~/ELL LOG: 0----26' Sa~y ~ravel. ~ silty ~dy cl~v. ~7--121~ Ha~, 12~-~26' silty water bea~ing sa_ndy~_g~a~vel. After two hours of pumpinH showed ve~y little signs of clearing. i26--X35' Sandy silty water bearing ~aterial. Very p~or qualitywater. 135--178' Sil%ywe% olay. 178--179' Water bearing g~avel producing 3 GPM. Drill~i out %o 200 feet. Blue olay from ~79 to 200 feet. D~illere decision %0 perforate water at ~21 to ~26 feet. a late~ time if needed. After pumping several hours well is ready for permanent pump. ~mmp should be installed at ll~feet. Well should produce ~% OPM at ll~ fe~t. This well may pUmp sand if submersible pump is installed much lower than ll~ feet. P~ater stand in casing ~mes to~O fee%efs~face. A screen can be ins%ailed at WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF THANK YOU VERY MUCH. COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. $~.00 DATE_ BERNIE Cl, A~l~ OF RAMPART DRILLING WORKS Nov. ?th, 77 SERVICE CHARGE O F C, HEMICAL 8~ GEOLOGIOAL LABORATORIF.~ OF AL.ASKA, INC. :- P.O~ BOXY4-1276 ANCHORAGE, ALASKA 99509 4649 BUSiNESSPARK BLVD. TELEPHONE (007) 279-4014 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER ' sample )? [] Treated Water ~_ [] ~ntreated Water Zip Code Tir~ . Collected Collecte=d By PUBUOW^TEnSYST" '.'M: t1' I '1 I I I sAMPLE DATE: SAMPLE TYPE: ~ Routine ~Check:S~mple (f~.routine with lab rdL no.~ ~ Special Pu~ose ~ SAMPLE L~' CATIONO - - 2 TO BE COMPLETED BY LABORATORY LABORATORY: ADDRESS ' CITY Date Received f ~'-' Analytical Method: [] Fermentation Tube ~xry~:mbrane Fi ter' Lab Ref. No, Result* Analy~st~ I! BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS BEFORE Form No. 18-310 (3-78) Date Collected r Source · · Date Received Time Received I~,m, Lab. NO. EMB ~3roth 24 hours= COLLECTING SAMPLE Multlpre Tul?e. Report: Membrane Filter: Direct Count Firl~ ~embrane Filter J~l~-? ~'~.'[ .-' MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. ©,: :-/LT;] & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECT E~VjRO /~ , 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION OEO ~ ~ lC78 Telephone 264-4720 DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed. Please allow ten (10) days for processing. ~AILINO ADDRESS ql~ r~- PROPERTYj~o~ RESIDENT__ ~ ) \(If different from~ /~'~ ~L~ab°ve) ~l~,j~ lj PHONE R.YER J ,,.ONE MAILING ADDRESS 4. REALTOR/AGENT M--~FE?~.--D DR ES S 5. LEGA DES~:~ 6, TYPE OF RESIDENCE NUMBER OF BEDROOMS ~ One ~ Four ffi Other ~ SINGLE FAMILY ~ Two ~ Five aU TI. aFAM LY a a 7. WATER SUPPLY ~ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all we/Is drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [~ PUBLIC UTILITY ~ dept~,(attach log if available.)' J]g~ INDIVIDUAL/ON SITE**)i~(,~JV/~//~I~ '~l~iC¢~/¢YEh'site' give installation date//~/,// _. - 0~ ~/~/'~'~_ ~t~s¥Ci~n~i~Jover two (2) years old an adequacy test is required [3 PUBLIC UTILITY u ~.v'/_.~ i~ [, D e pa r t ment. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72~10(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS -IME TIME TIME DATE DATE DATE INSPECTOR I NSPEC'I-OR INSPECTOR DIRECTIONS: NUMBER OF BEDROOMS 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY ~2. WATER SUPPLY INDIVIDUAL COMMUNITY PUBLIC UTI LITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM ~INDIVIDUAL/ON -SITE ~J PUBLIC UTILITY Connection Verified ~']Soptic Tank or [_~]Holding Tank Size: If Tank is homemade give dimensions: TYPE OF TANK TDTAL ABSORPTION AREA 4. DISTANCES WELL TO: [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SIX [] OTHER PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOILS RATING MANUFACTURER MATERIAL Septic/Holding Tank .LAbsorptlon Area Sewer Line .[Nearest LoTLine 5. COMMENTS /APPROVEDFOR___/_ __.E ROOMS · DISAPPROVED DATE IBY (Title) LEGAl_ DESCRIPTION 72-010 (Rev. 317~