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Home My WebLink AboutUS SURVEY 3043 LT 70B015-Oq \- \% IV[-W DRILLING, Inc. P.O. Box 10-378 · 10300 Old Seward Highway (907) 349-8535 ANCHORAGE, ALASKA 99511 DRILLING LOG Well Owner BROCK~AY~ DANA Use of Well Domastic Location (address Of: Township, Range, Section, if known; or distance main road Lot 70B, U S Survey tJ3043 Size of casing. 6" Depth of Hole Static water level 41 ft. ~ Screen ( ); Perforated ( 82 feet Cased to_ 80.7 feet (below) land surface. Finish of well (check one) open end ~ ); ). Describe screen or perforation Well pumping test at 5 gallons per of drawdown from static level. Date of completiov-- May ql. 1 (minute) for ]. hours with 100% ~x WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 0 Casing stickup 2 5 20 70 75 TO- 2 TO_ 5 TO_ 20 TO_ 70 TO 75 TO g2 TO_ TO. TO_ TO. TO. TO. TO. TO. TO Gray clay and gravel (damp) Gray silty, gravel Gray clay MUNICiPALiTY OF ANCHORAGE i:NviRON'M2NIAL pROiEC¥[ON NWWA Certifisd ~'orfifi,.-t~: No'~- ,q].~ ~' h/,-. 1 -- CUSTOMER P~srmit ~ Applicant: Lbcation: Legal Description3 ~Y~ ~,7~> TYpe of Soil Absorption System Is: Trench: Drainfield: ~UNItIPALITY OF ANCHORAGE , Department i ~ Health and Environmental?~X~rotection 825 ~ Street, Anchorage, AK. >J501 264-4720 * * * HANDWRITTEN PERMIT * * * ~30~)'~TE LL MOD7L PERMIT k~{ ~o'-~t~.~-kc~ Mailing Address_-' ~,~,6'~' t1(5.%- ~ none Number: 3 ~g % ~0~{~ Lot Si~93 Seepage Bedz __ Holding Tank: Maximum Number of Bedrooms: ~ ~ Soil Rating(sq.ft~br) The Required Size of the Soil Absorption System Is:' DEPTH ~'~ LENGTH GRAVEL DEPTH ~-: WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There ~is no set width for trenches. The gravel depth is the minimum~depth Of gravel between the outfall pipe and the bottom of the excavation(in feet). * '* REQUIRED SEPTI~C(HOLDING) TANK SIZE = ~ GALLONS * * Permit applicant has the responsibility to inform this department during the i~mtallation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS .ARE REQUIRED Backfilling of any system without final inspection and approval by this department w.ill be subject to prosecution. Minimum i~istance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a priuate well to a private sewer line is' 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are a~ailable'to insure proper.installation. * * * PERMIT EXPIRES DECEMBER 3L 1 9 8 3 * * * I. certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if th~t~bedrooms. the residence is remodeled to include more Signe~: issued by: Applicant SWP/024 (1/81) lJUNtC[PAL[TY OF A, NCHORAGE Depa~t~.aent ce H~alth and Env~-O~me~tal PrOteCtiOn 264-4~0 ' ~ ~ ~ HANDNR~TTEN PER~IT ~ ~ ~ ' ., p.e~mi~ f ........ W~LL ~. ~ ;. _ · <: - -~. - PERMIT ~e Of So~i ~so~tion ~y~t~ Zs~ Trench~ D~a~fte[4~ Seepage B~ Ho%ding T~: . dfiueufl~oR is ~e length(i~ fae~) of the t~enoh ct dra~nfteid. depth of a t~nch or pit is the distance between the surface of ~he ': The gravel depth i~ ~e m~ depth of grave[ betwe~ the outfa~ ~[p~ ~: ' . the bottom of the excavation(in feet), ' * * R QUIR D SEPTIC(HO ING) TANK SiZE : GALLONS" o~ re~er, ce~ that the well will S.~v~. ?'~ ~ ~ ~ ~ ~0(2) ~NSPECTIONS A~ RSQUIRED ~ ' ' ~. B~qk~illf~g Of any ~ys~ without f~al ~sp~ation ~d approval by ~4in~ d~stance between a wall ~d any one,itc sewag~ die~a~ ey~t~ 'i~ :; f~r a. p~iva~e we~l or,150 to 200 fe~t from a publi~ well depending ~ certify that: z ~ ~illar with the re~ir~m~s fo~ on-si~e mewerm ~4 we~l~ set fio~h by the M~icipaZity of ~cho~ag~. ~ will ~stati th~ myst~ ~ accord~e with that the on-site sawer system may re~uir~ e~&rge~e~t ~- MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) L 07- 70 ~ ~ 58 .3. t)q,_~ .% i,~ ?-/o ~.~ ~ ~- ~ Location (address or directions) ~.4~,_"r o~'F O,~'muc/ c/~'. ,~r~, ¢--. /Z~' ...r~i. YE, m~ (b) Applicant Name Z).4~/,4 ~.,'~'~c,¢' z.~/.¢.¢ Telephone: Home 7~¢5'- ~-7~'~, Business Applicant Address (c) Applicant is (check one): Lending Institution []; Owner/builder ~![,; Buyer []; Other [] (explain); ~, , (d) Lending Institution Address Telephone (ei Real Estate Company and Agent Address Telephone (f) Mail me HAA to the following adc 'ess: F2/~'A SC- ~,¢,¢ &- ¢ 2. TYPE OF RESIDENCE ' Single-Family ~ Multi-Family[] Number of Bedrooms ~, Other WATER SUPPLY ndividual Well ~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status, 4. SEWAGE DISPOSAL Onsite [] Public/[~' Community [] Holding Tank [] Note: If corn munity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page I of 2 72-025 {11/84) ENGINEERING FIRM PROVIDINC INSPECTIONS, TESTS, FILE SEARCH, D,~-~ AND INFORMATION As certified by my seal affixed here~,., and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. [ 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 ~)I~ACI'Z~ ~-""~ ~l~J~'7'~'l'~b Telephone Z.?~ -- ..?270 Address Date Engineer's Seal DHEP APPROVAL Approved for .' ./~'./),.~.2~_ bedrooms by Approved_ ~-~ Disapproved Terms of Conditional Approval Conditional CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy oertain federal and state requirements. Employees of DHEP 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 (11/84) ~WJNIGJPAJJTY OF ANCHORAGE f~I~@NMENTAL SERVICES DIVISION 2 3 1987 A. g E;: tAV E D MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Legal Description: .4~r 7~ Well Classification Well Log Present (Y/N) Total Depth 8~ Cased Static Water Level '~'O' 5/" Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot If A, B, C, D.E.C. Approved (Y/N) Date Completed ..¢'-.~/- 8~, Yield Depth of Grouting Pump Set At 7 Sanitary Seal On Casing (Y/N) r Depression Around Wellhead (Y/N) ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot .4//,¢ ; On Adjoining Lots To Nearest Public Sewer Line 75" / To Nearest Public Sewer Cleanout/Manhole //~' To Nearest Sewer Service Line on Lot Water Sample Collected by bO. /'7)c,~-A~,Z~AJ ; Date I~-Zo Water Sample Test Results 5ATISFACT~,I~-y] OCO4.¢FO.'~I~) .~.~1t;0~,/~ Comments i~/C'LL. 15 .4c~'~,UAI'~ ,~'o,~-- SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) 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 To Property Line To Water Main/Service Line Course Size No. of Compartments Foundation Cleanout (Y/N) Date Last Pumped ; for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72 026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: 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 Type of System Design Length of Field Depth of Field Gravel Bed Thickness 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) LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions 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, or conformed to all M O,A and HAA guidelines in effect on the date of this inspection. Signed ~ ~--~ ~ Date Company ~U,'~t/~l ~,~6~t,~, MOA No. Receipt No. //~)~;) / ~ ¢ ¢ ~ Date of Payment ./~__/~.¢o/ Amount: $ ./, ¢~ ~ Engineer's Seal Page 2 of 2 72-028 (11/841 /~'?~ 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FEOERA' TAX # 92-0040440 C! ient Smpl ID: }tP,,OC~AY/GIR~IOOD WI~LL WhTER S~qple Rec'd : DEC 2i 8? Ordered By : Reports ?o~ AI~ALYSIS R~ORT DY SA~IPLE Work Order No. : 4432 Client Account :HCFAWC Date Report Printed: DEC 22 87 $13:28 Released By : 3~g.- Reports Address 92 M1CHORAGE, special COLLECTED 12-20-87 ~Y W. ~,ICFADD~{ Instruct: ~: ~hemlao Ref 8666 Lab 5%!p1 ID: 1 Hart1×: Water Allowable Parameter Tested Result/Units Nethod Limits iIi,~ATR~ 0.29 mg/! i0 Sample ROUTINE A~LYSlS CO~PL~D: 12-2.-8. Remarks: I 7 ~BORATORY ~JPERVISOR: ~EPH~I C. EDE ~ ~' ! Tests Performed * See Special Instructions Above N~ Hone Detected ~ See Sample Remarks Above g: Hot A~alyzed LT:Le~ Tha~, ~=Grea~er Than APPLI("NT FILLS OUT UPPER HAl" ~ONLY Buyer Address ~X[ ~,~1 - ~ - ~ ' ~ %F~'~ Zip Code / Phone Address /'~ //q Zip Code Legal Description 2.0'T Type of esJ~nce Single Family ~tiple Family NO. of Bedroo~ Water Supply ~l~ldividual ~ A~ACH WELL LOG. A w~l log is required for all wells drilled since June 1975. ommunity For wells drilled prior to that date, give well depth (attach log if avaqable). Sewer Disposal ~', [~ ~b~b~m O- ' Year IndivJduaJ Installed: ~ Individual ublic Utility NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. I Time Time Time Time Date Date Date Date~ Inspector Inspector Inspector Inspector ~ ~ MUNICIPALITY OF ANCHORAGE Field Notes: ~ 1,'~DEPT. OF f!E/.LTil C,,3 RECEIVED ( ~,~AFFROVED BEDROOMS *OONDITIONSOF APPROVAL ( ) DISAPPROVED ( ) CONDmONALAPPROVAL' DATE f,'~ ~ ~ "~'"--'~ Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Well to Tank Septic Tank Size 72.023(3/82}