HomeMy WebLinkAboutTURNAGAIN PARK Block 2 Lot 6 Hwy Runs Thru Here'Lox'
· ~'J," MUNICIPALITY OF ANCHORAGE
~ Z~-,.~ ~'~ 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
MAILING ADDRESS
NO. OF BEDROOMS
Well
m~ ~ ~ Manufacturer ~ ~aterlal J~ ~o. of compartments
~ ~ ~ DISTANCE TO: Well Dwelling PERMIT NO.
O z ( Manufacturer Material Liquid capacity in gallons
~ Well Foundation Nearest lot line PERMIT NO,
~ No.DISTANCE TO:of lines / Length of eacb line//~ Total length of ,ines/lh~ Trencb width. ~ inches Distance between ,~/~
~ ~ Type of chh Crib diameter Crib depth Total effective absorption area
m 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)
OTHER
Pi P~ MATERIALS ~ ~ ~
SOl L TEST RATING
REMARKS
/ /
APPROVED. __. __~ DATE
(Rev. 3/7B)
.... DEPFtRTHEI'..!T k,:...../ HEFILTH FI,ND ENV ! ROi'.~HEi',!TFIL b~:"nTP'F:T T r'!N
,..,,: .... "'L'" .z, I REE.., i:I!.,IE:HELF-.'.FI(]E., FI,k]
;2 E. 4 - ~ 472
PERHIT NO. ( ',;.?:.1_;:LE~;24 )
EIPPL I C Fff.,Fr
LOCFtT ]~ ON
LEGRL.
JFIHES E. J'FICKSO!'..!
L6 B;2 TUI::~'.NRGFIIN PAR/.(
F'O E:OX :t0-422
LOT SiZE
21.75E~E~ SQI.JRRE FEET
TYPE OF' SOiL RBSORF'TiON SYSTEi"1 IS: DRR!NFIELD
MFI',,.::iF'!i._Ii',I b!LiME~ER OF BEDROOMS
SOIl_ RR'T]:NG (S(;! F:I.',,'E~R)= ;~:3(.~
THE REI:!L.IIRED SIZE Of,:- THE SOIL RBSORP'TZON SYSTEPi IS;
THE LENGTH [:,II',IEI'.J'rqIFt',I ........ IS THE LENGTH ,::IN. Fr':'ET'''.- OF 'I'HI::._ l'...:;'r~i',.,~"L "F' [:,F'A! '.Ii-':'iE _'}.
:-FIE C, EF'TH OF' R 'I"RENCH C~F~ F'!T IS 'THE C,):STFtNCE 8ETP.~EEN THE SURFFICE OF THE
GROUND Ri',!D THE BOTTOH OF 'THI,E EXCR',,,'FiTION ,.'.'ii'4 FEE"[').
THE GI,~:F:P,,'EL PEP'TN IS TNE HINiHUM DEPTH OF' GRRVEL E~E"Fk!EEN THE OL.Fi"FRLL PIPE
RN[:, THE E:O'I.'TCff,I Of,:' TI,-IE EXCFIYFITION ,(IN FEET).
P'E~",'!'r"l" RFCL..I.]:FN] HFtS THE RE.::";h'ONSIBIL. ITY TO !NFFRi',I" "::
..... _ . It-II.._, DEPFIRTNENT DLIRZNG
!!'4S"i-RLLRTION INSF'ECTIONS OF FINY klELLS RC, JFICEi'.,FI,' l.'C! TFI!S F'ROPERTY RND THE
NUi',IBER OF' R~:":;:[DE!'.,tCES TNRT THE 14EL.L I4.iLL SER',,,-'E.
BRCKF'ILL. ING OF' RI",!Y SYSTEM W!TI,-IOLtT FINRL iNSPEC]"ION FIND RPF'ROYFE. BY TNiS
DEF'RRTHEN]' F!ILL E:E SUBJECT 'FO PROSECUTION.
MINH'!LIM DISTI,:INCE 8E:TP.IEEN R piEt....L, ltl, NC, FINY ON-SITE SEI,.IRGE DISPOSRL SYSTEi'! IS
:t.~)E) FEET FOR R F'RZVFITE HEL. L. OR 15El TO 2C~C~ FEET FROH F:I PUBLIC klELL DEPENDING
UPON THE TYF'E OF PLIDL.!C iqEL.L.
FI.INZMUM DISTRNCE FROM R PRIYRTE WELL. 'TO R PRIVRTE SEHER LINE iS 25 FEET F:iND
TO ~ COHMUNITY SEHER LINE: IS 75 FEET.
OTNER REQUIREMENTS MRY RPPL9. SF'ECIF':[CI:TTIC~NS RND CONSTRUCTION DIRGRF~HS RRE
R',,,'RiLRSLE TO INSURE PROPER !NS'FRL.t_RTION.
i CERTIFY THRT
'_t: i RM FFIHZLIFIR 14ZTH THE REQUIREMENTS; FOR ON-SZ'TE SENERS RND HELL. S FIS SET
FORTH BY TNE MUNZC:[PRL..ZTY OF RNCHORFIGE.
2: Z 14ZL. L ZNSTF!LL THE SYSTEM ZN RCC:ORDRNCE NZTH THE CODES,
2:: ! UNDEF~STRNE:, ]"HFFT THE ON-'S!'I'E SE!.,. IF THE
RESIDENCE IS REHODE:LED TO :[NCLLtDE MC
S i GNED
EIPPL ]
iSSUED RY ..........
R SYSTEM hlraY RE6]UZRE ENLRRGEi"iENT
E TNF~N 3 BEDRC~OMS;.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
SOILS LOG - PERCOLATION TEST
SO~LS LOG
PERCOLAT[ON
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
2
3
4
5
6
7
8
9
10
11
12
14-
I,
18
19
20
SLOPE ; SITE PLAN
ENCOUNTERED?
0
P
IF YES, AT WHAT
DEPTH? ~,~1 E
Gross Net , Depth to I Net
Reading Date Time Tinge ~, Waler Drop
,o..o, o ,,",o
?" ,,_ ,o:,o zo ,~N'l ~"
7~" ,, _ ,o :~ _~o ;, ~"~ ~"
7 ~" ,~ ~: ~1 ~1 II ~"~/~,,
~' ,/ II:ol ~o II" /"_
PERCOLATION RATE
TEST RUN ETWE N
al~ FT AND FT
?2-0O8 (6/79)
~ WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Dirts on of Geological ~ Geochysicol Surveys
Drilling Permit No
LOCATION OF WELL (please complete either ID. lb or Jc.) A.D.L Ne.
I~l. IBorough Subdi¥{~io, Lot Brock ~ '/4qtrs. Section ,o, TownshiPN["'] Range
~JO~STnNC= A,O DIRECTION FROM ROAD INTERSECTIONS ~. OWNER OF WELL:
Address: ~eOe ~0~ ~L,~.~
Ancho:cagc~ ~
/'Z~L%!VtUI~: ~O~'!~ &~d ~O~ 0 ~ 6. ?~Cable too~ ~Rotory ~Driven ~Dug
9. FINISH OF WELh: 0~)011 bo'ttom
~ ')~ ft. after 2 hrs. pumpin~ I :) g.p,m.
Fos~ Dri!].i~f: AA 0758
APPLIC_.NT FILLS OUT UPPER HAI ..::ONLY
,,~'roperty'Owner U~'V~.~ ~-'" ~~ Phone
Address Zip Code
~t ~ ~ Phone
Address C2/~ ~ C ~ ~ ~ n~r~_. Zip Code
RealtyCo.&A~nt ~ /~ .-- ~
~:> 0 ~ ~ ~ ~ ~ Phone
Type o Resi~nce
~i~gle Family
~ Multiple Family NO. of Bedrooms
~ Olher
Water Supply
~ndividual ATTACH WELL LOG. A wall Icg is required for all wells drilled since June 1975.
~ Community For wells drilled prior lo that date, give well depth (attach Icg if available).
~ Public Utility
Sewer Disposal
~ndividual Year Individual Installed: /
~ Public Utility When Connected lo Public Utility:
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
Time Time
Date Date
Inspector Inspecto
Field Notes:
( ~ APPROVED BEDROOMS
( ) DISAPPROVED
( ) CONDITIONAL APPROVAL*
DATE
'CONDITIONS OF APPROVAL
Soils Rating
Date Sewer Installed
/0 U "'
Well To Absorption Area
Well to Tank
Well Log Received
Septic Tank Size
CHEMICAL & GE~_~OGICAL LABORATORIES £~.~ ALASKA, INC. i~
TELEPHONE (907)-279-4014 ANCHORAGE INDUSTRIAL CENTER
274-3364 5633 S Street
Drinking Water Analysis Report for Total Coliform Bacteria
TO SE COMPLETED BY WATER SUPPLIER
WATERSYSTEM:
I.D. NO.
Water System Name Phone No
Mailing Address
MO. Day
SAMPLE TYPE:
n~Routlne
[] Check Sample (for routine sample
with lab ref. no.
[] Special Purpose
State
Year
[] Treated Water
[] Untreated Water
Zip Code
SAMPLE
NO LOCATION
I
, I
I
Time Collected
Collected By
TO BE COMPLETED BY LABORATORY
Analysis snows this Water SAMPLE to De:
[]i Satisfactory
[] Unsatisfactory
r- Samme too long in transit, samole should
not be over 48 hours old at examination
[o indicate re ~ble results. Please send
new sample. ~.
Date Received
Time Received
Analytical Method:
[] Fermentation Tube
ID,~ Membrane Filter
Lab Ref. No, Result* Analyst
I~' /~>1 I--[~~_ "-'~'
I m
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
06-1220 (D)
Rev. 1978
BACTERIOLOGICAL WATER ANALYSIS RECORD
24 Hours
Confirmatory
Final Membrane F tar ~'~u ~r ' ~'~
_BGB