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Home My WebLink AboutUS SURVEY 3044 LT 38A T10N R2E SEC 17/18 M-W DRILLING, Inc. P. O. Box 4-1728 e 2811 Dawson ~ c 907- -~ ' ANCHORAGE, ALASKA 99509 DRILLING LOG Well Owner_ Use of WeB D Location (address of: Township, Range, Section, if known; or distance main road Size of casing. · Static water level Depth of Hole ); Perforated ( Describe screen or perforation Well pumping test at '. gallons per (~) of drawdown from static level. h7 feet Cased to_ ;:' feet (below) land surface. Finish of well (check one) open end ( ). (minute) for ' hours with Date of completion WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness ); .TO.__ TO. .TO__ _TO _TO_ _TO _ TO_ TO TO- .TO_ TO. TO TO. 3 -- Contractor CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. FEDERAL TAX ID # 92-0040440 ANALYSIS REPORT BY SAMPLE for Nork Order $ 18107 Date Report Printed: NOV 9 89 @ 12:39 Client Sample ID:LOT 38A USS 3044 PW$ID :gA Collected NOV 6 89 ~ 15:00 hrs. Received NOV ? 89 @ 10:00 hrs. Preserved with :AS REQUIRED Client Name : S & S ENGR Client Acer : SNSENGP ?.0.$ NODE RECEIVED Req $ Ordered By : S N S ENGINEERING Analysis Completed :NOV 8 89 Send Reports to: Laboratory Supe_~vi~ori:~STEPHEN I)S & S ENOR Released By : .~F~_,~_~ 2) Special Instruct: Chemlab Ref $: 8423 Lab Smpl ID: 1 Matrix: WATER Allowable Paramete~ Tested Result Units Method Limits NITRATE-N 0.20 mg/1 EPA 353.2 lO Sample ROUTINE SAMPLE. Remarks: SAMPLE COLLECTED BY 1 Tests Performed * See Special Instructions Above UA=Unavailable ND= None Detected '* See Sample Remarks Above DA= Not Analyzed L~=Less Than, GT=Greater Than INC. CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, TELEPHONE (907) 562-2343 5633 B Street ~ Drinking Wate. r Analysis. Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER :~ PRIVATE WATER SYSTEM Name Phone No. S & S ENGINEERING 17034 I;agte River L.,,o~i~a~ No. 204 Eagle River, Alaska 99577 City State Mo, Day Year Zip Code SAMPLE TYPE: ¢ Routine ~ Check Sample (for routine sample with lab ref. no. 55 Special Purpose [] Treated Water [] Untreated Water SAMPI. E NO. LOCATION 4 I e i Time Collected Collected ~ TO BE COMPLETED BY LABORATORY satis shows this Water SAMPLE to be: is factory [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received I[~ '7'~ c/ Time Received _ /0¢ Analytical Method: Membrane Filter · No. of colonies/100 mi. Lab Ref. No. Result* §425 I Analyst BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Membrane Filter: Direct Count _/~ Verification: LTD BGB_ Final Membrane Filter Results ~ Time: TNTC = Too Numberous To Count OB = Other Bacteria Col[[orm/lOOml ' PART ONE OF TWO REMAINDER TO FOLLOW MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) LOT 38A; U S S 3044 Location (address or directions) M.I. 7 A. layeSka Highway ' (b) Property owner Michael R. Finnigan Mailing Address gnx' ~;3g (c) Lending institution .~/,P_~_x/*a H_q~,' Mailing Address ~" ~ Telepl'~ne: (home) l- 78 ~- ¢~; ~; Business (d) Real Estate-Company and Agent Address '' Telephone : ' ' (e) Mail the HAA to the following address: (or check hereX~ if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING Eagle River, Alaska 99527 2. TYPE OF RESIDENCE Single-Family E~× Number of bedrooms 1 3. WATER SUPPLY Individual Well ~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL O~-site,~ Public []~ Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72~o25 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION , As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of thil Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, fpnctional and 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 Address Date 17034 Eagle River Loop Roa~{ No. 204 Eagle RIY,~J Telephone 6. DHRS APPROVAL Approve]d for / bedrooms by Approved ,.,~ - Disapproved Terms of Conditional Approval The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this 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. 72-025 (Rev. 7/88)Back Page 2 of 2 Static Water Level. 2:~ z/ / , dr: '~ MUNICIPALITY OF ANCHORAGE (MOA) \x'ix ', ~'J(?'-~.~ Health Authority Approval (HAA) .:,~< i~~¢' ~/' cHECKLIST - FEBRUARY 1984 *;~ ~'¢ Legal Description: Ao% ~¢ A. WELL DATA Well Classification ~ i ~ ~ I~. ~. :. ;__,I.~ If A, B, C, Approved (Y/N) Well Log Present (Y/N) ~ Date Completed ~ ~ ~ ~/ Yield Total Depth ~ Cased to ~O / Depth of Grouting Pump Set At Casing Height Above Ground Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line / TO Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments ; On Adjoining Lots /J/ct ; on Adjoining Lots ( Co ~- To Nearest Public Sewer Cleanout/Manhole ,/(LO0 '~ B. SEPTIC/HOLDING TANK DATA Date Installed Size Standpipes (Y/N) '%. No. of Compartments Air-t~aps (Y/N) Foundation Cleanout (Y/N) Depression over Tank (Y/N) Date Last Pumped Pumping/Maintenance Contact on File (Y/N)~ ' ~ ; for Holding Tank High-Water Alarm (Y/N)~k ) N ~l(~nporar, Holding Tank Permit SEPARATION DIsTANcES FROM SEPTI~/HOLDING~K: To Water-Supply Well To Bi~ng Foundation To Property Line To Disp%Field To Water Main/Service Line (Y/N) To Stream, Pond, Lake or Major Drainage Course 72-026 (Rev, 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Type of System Design Soils Rating in Absorption..~trata Date Installed % Length of Field Width of Field ~ Depth of Field Gravel Bed Thickness Square Feet of Absortion Area % Statndpipes Present (Y/N) Depression over Field (Y/N) hJ "~. ~,,~ Date of Last Adequacy Test Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FI~D: To Water-Supply Well "'% To Property Line To Building Foundation "% To Existing or Abandoned System on Lot ; On Adjoining Lots To Water Main/Service Line To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage A, rea Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed S & S ENGINEERING 17034 .~agle klYer Luup Ruad No. ;,;,~5 Company ~=o.,~, f~ivar. Alaska 99577 Date --"'- -~///~ ' ¢= ~1 Date of Payment //-/ ~ "~ Amount: $ / ~. '~ 72 026 (Rev 7/88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2