HomeMy WebLinkAboutT13N R1E SEC 10 SE4SW4NW4-' ~ ',,, . MUNICIPALITY OF ANCHORAGE
· 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
NAME PHONE E]~EW
MAILING AD RESS
LEGAL DE IPTION
LOCATION ~~~ Well ¢~[ PERMIT~'~O
DISTANCE TO: I
Manufacturer Material No, o~ compartments
Uq' ~ap~lt~"~8gO"S [F HOM~mDE: Inside length Width L]qu:d depth
, Z Well Dwelling PERMIT NO.
~Z DISTANCE TO:
O Z ~ Manufacturer Material Liquid capacity in gallons
~= DISTANCE TO: Well /OO / Foundatlon~¢, Neares~ogi~e, PERM~
= -- ~ Total len~h ~li~s Trench width ,,
~ ~ No. of lines Length of each line.~ / Distance between lines
-- / ~ ~ Y Material ~en~th/tile ~ ~ inches
~ ~ ~ Top of tile to finish rade ~ y~
~ ~ ~ inches Total effec i~ absorption area
Length Width Depth PERMIT
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
~ DISTANCE TO:
~ 3lass~ ~-. ~ Depth Driller Distance to lot line PERMIT NO.
~ Building foundation Sewer line Septic tank Absorption area(si
~ DISTANCE TO:
OTHER
PIPE MATERIALS
~Bo3~
SOl L TEST ~ATING
) tO~ ~.~
INSTALLER ~ ~ ~v
REMARKS / ~
APPROVED DATE L[GAL
72-013 (Rev. 3/78)
TYPE OF' SOIL RBSORBTION SYSTEM IS~ TRENCH
' MR,':'(IMUM NIjMBER OF BEDROOMS = 4 SOIL RRTING (SL.] FT,/BR)=
!THE REL.]UIRED SIZE OF THE '-:',OIL RB..-'5ORPTION SYSTEM IS:
t:1.,0
THE LENGTH [.',IHENSION ~S '['PIE LENGTH (~N FEE'["..', OF THE TRENCH OR [:,RR~NFIELD.
THE DEPTH OF R TRENCH OR P~'F IS THE DISTFINCE BETHEEN TNE SLIRFFIE:E OF THE
GROUND RND THE BOTTOM OF THE E',:.::CFIVFITION (IN FEET.'.".
THERE ~S NLI SET WIDTH FOR TRENCHES.
THE GRRVEL DEPTH IS THE MIN~MUH DEPTH OF GRFIVEL BETI.4EEN THE OUTFRL.L. PIPE
FIND THE BOTTOM OF' THE EXCRVRTION (~N FEET).
PERMIT RF'PLICRNT HRS THE RESPONSIBIt-IT'¢ 'FO INFORM THIS [.',EPRRTMENT DURING THE
!NSTFIL. LRTION INSPECTIONS OF RN'T' HELLS RDJFtCENT TO THIS PROPERT"¢ RN[:, THE
NUMBER OF RESIDENCES THRT THE HELL WILL SERVE.
BRE:KF]~L. LZNG OF RN'¢ S~r'STEM WITHOUT FINRL ~NSPECTZON RND FIPPRO"/flL
DEPRRTMENT WILL BE SUBJECT TO PROSECUTION.
f'IINIMUM DISTANCE BETWEEN fl P.IEL. L AND RNY ON-SITE SEklRGE: DISPOSAL S'¢STEM IS
t00 FEET FOR R PRI',/RTE HE[_.L; OR
150 TO 200 FEET FROM R PUBLIC HELL [:,EPENDING UF'ON THE T'¢PE OF PUBL. IC HELL
OTHER REQUIRENENTS MR'¥' RPPL'¢. SPECIFICRTIONS RN[:' CONS]"FdJCTION DIRGRRMS FIRE
RVRILRE:LE TO INSURE PROPER INSTRLLRTION.
CER. T I F"r' THRT
I RM FRMILIRR NITH THE REQUIREMENTS FOR ON-SITE SEHERS RN[:' HE:LLS RS SET
I
±:
FORTH B"r' THE MLINICIPRLIT'¢ OF RNCHORSGE.
2; I HILL INSTFILL THE S"r'$TEM IN FtE:E:ORD£~NCE HITH THE CODE'.{=;.
2: I UNDERSTFIND THRT THE ON-SITE SEHER S"r'STEM MR"r' REQUIRE ENLRRGEMENT IF THE
RESI[:,ENCE 1:5 REMO[:'.ECE[:' ]"0 INCLIJ[:,E MORE THRN 4 BEDROOMS.
//
F~C:F~NT ~i/~.'~.~IEL E G_I,'~r,
...................
,~"O '.~ E GEO'~'ECHNICAL Er DEVELOPMENT CO.
Box 90, Davis St,, Eagle River, Alaska 99577
694-2774 or 688-2280
Russell Oyster
694-2774 SOIL LOG
So[is Et Foundations
Perfomed for:
Legal Description:
Depth (feet)
Name: /W]~ /'/G/~
Mailing Address:
Ear/Ellis
Land Developmerit
Tel, No,
Sotl Characterlsttca
2
3
4
5
7
8
9
I0
12
~3
~5
~6
Ground Water Encountered: Yes__ No
Proposed Installation: Seepage Pit
Comments:
If yes, what depth
Orain Field
Performed by: ~_~ ~/~-~_ Date: .~)?~L/ ~ ~P?~
MUNICIPALITY OX!ANCHORAGE
,POUCH 6-650 ANCHORAGE, ALASKA 99502
PLEASE REPLY IN AREA BELOW ~I~''~'*~
REPLY DATE
FORM 91-008(3/76)
FROM
POIJ~H 6 650
ANGHORAGE. A[A~,k,t !)9502-0650
(907) ~64 4111
<Permit #: 820912
~January 31, 1983
TO: Permit Applicant
Subject: T13N R1E Section 10 SE¼ SW¼ NW¼
A permit issued by this department for an individual well
and/or on-site sewer system has expired as of December 31,
1982.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal Ordinance.
If you have drilled the'well, a well log needs to be sent
to this department for documentation of the installation
date and to close the permit.
If a private engineer inspected the installation of the
on-site sewer system, please have them send us the as-builts
for our files and documentation.
If there are any further questions, please call this office
at 264-4720.
Sincerel~
Robert C. Prattt R.S.
Acting Program Manager
Sewer and Water Program
RCP/ljw
enc: Copy of Permit
SWP/057
PERMIT NO.
~dLl~4Ii] If'~L I TY CmF R~CH ~:AGE
DEPARTMENT O~ HEALTH AND ENVIRONMENTAL PKOTECTION
825 'L' STREET, ANCHORAGE, AK. 99501
264-4720
~4ibb PERMIT
8209i2 )
APPLICANT
LOCATION
LEGAL
MICHAEL E GUINN
T±~NRiE S &O SE4 SW4 NW4
PO BOX 4-~18 99509
LOT SIZE
264-6567
999999 SQUARE FEET
MINIMUM DISTANCE BETWEEN A WELL RND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
i00 FEET FOR A PRIVATE WELL OR 150 TO 208 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM R PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND
TO R COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS
OF THE WELt_ COMPLETION.
OTHER REQUIREMENTS MAY APPLY, SPECIFICRTIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILRBLE TO INSURE PROPER INSTALLATION.
PEP. i'"I T T E,'"~;P I F~:E_'~;--. E:-,ECEFIBEF.' -~::L..
I
i:
..F, ORTH BY THE MUNICIPALITY OF RNCHOR'RGE.
2: I WILL INSTALL T~ SYSTEM IN RCCORDANCE WITH THE CODES,
S I GNED: ........
RPPLECRNT ['~:HREL E 6UINN
,-
CERTIFY THRT
I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
V4. 0
'* ,DEF'I::IRTf"IEt",IT OF . dEi::ILTH FIi",I[) EN', :[ REff',II"IENTF:IL P, I'ECT ]: OI ~
825 '" L.. '" :5"f'I'~'.EET., I::INE:HOF~:FIGE., FIR. :~-~9~;C~:L
2'79-25J..±
~..qi iE2; ~__ it .... f~ E~E F,?.: I.t'*-fl :E -if'"
F'EF.'.H:I:TNO. ( 778':~7 ;'
~ _,, ~ _:.j.,.., H?',ICH
I::IPF:'L I E:!:~NT I'"1 ]: C:l-"ll:::l[':J._ IFjI.J :[ I",IN PO ...... - '::" ':'
t.._O(::l:ITZ[l:Zlf',i [~:I",~[::' I:iI:::~'-~ [:l-II:il...[:~ F?..~'/[~'.
L..EGF-~L "[':j..:~:NR&E::.~';EC:J.E~SE::I~,,"q-:.:JP.k:I..,,"'4.1",It.4:L,.",::I- LOT S:[ZE ¥SEIEh~J::2 SI::!IJRRE FEET
i"i]:NZPILIH i):[:STFINCE E:ETI.,.IEEN FI I-4EI...I_ FIN[::, Fli'.4¥ ui'.,l-:,Z I E :,E.I.IHaE I)]:~;F'O'.:_;FIL
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· i.~3C~ FEE:T F'"'F' R FR.I. h E [4E[...L -'d-;' 2R¢~ F'_F.:E'T' F-'F;' FI 'Z:
t.,.IE:LL L-a.., RI~:E F~:E[.:.!U.'[F?.EE:' FINE:' I'iU-,I E,I- F;:ETUF?.N[i::D 'f'EI THE i)!EF'RF~¥THEN-f' I.,.I]:TH:[N
Cfi:' 'THE b.lELL '" "I'"IF'I .E:T.T.
CFI"f-[EF?. F.~:EI;¢J]:F!Ef'IEN"['2; I'"IR"~' RF'F'L¥. '_'~F'EE:ZI::';[CFIT]:Ed'¢-:, FINE:' Z'Oiq'E;TF-'_"ZI"ZZi"4 [::, ]: FIEiF~:F/H~.; F:IF?.E
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II, l'q].L.,qEL[.: TE) Fl:... FEF.
:[ C:ER T ;[ F'*¢ THFIT
::L: ]: FIH F'I:::IHZI:LF[F:IF:: !-,.I:[TH THE ,~:Ei:~;:!I..I:[[;,'E:I',IEt'.4"I"'.E; FLF.
FOI:RTH E?'r' THE I"llJl"~ :[ E::[ F'FIL .T. T"r' OF
2: ]: 1.4];LL :[NS'I"FILL. THE.:.~'.~"r"-:?fEH :IN FIE:E:Ch~".".IZ::'Ri",IC:IE I-,.IZTH 'TIqE C:ODE~;.
,
FIF'I::'L/J~L~ CI'-IF]E:L GLI
by
A & L DRILLING COMPANy,-,
BOX 97, EAGLE RIVER. ALASKA 99577 · TELEPHONE 694'2588
OWNER OF LAND ~q/C /-//~zr~d (~OI ~3~x]
LEGAL DESCRIPTION~ ~ I F 3~c ~O
DATE-Started I0/~ /. ~ Ended
PE~IT NUMBER . 77 ~ Y
DEPTH OF WELL
STATIC LEVEL OF WATER FT.
DRAW DOWN FT. _ ;~)O !
KIND OF CASING C ¢ O O
KIND OF FORMATION:
From ~2 Ft. to [ ~ Ft. /7/ to '~ A30/d~o~-~'~ From
From J~;" Ft. to~l~ Ft. (~L~f ~o~. ~/~oo~a~mXFrom__
From~~.~-, Et. to [~ Ft. t/~ ~' ~0o~O~C~ff From__
From[~ Et. to /G~ Ft. ~ ~o~c ~'~ From
From~Ft. to Ft. ~7-~ ~ From__
From Ft. to Et, From
From Ft. to Ft._ From__
From .Ft. to Et_ From
Fro~ Ft. to Ft. From__
From-- Ft. to Et, From
Fromm. Ft. to Et, From
From Ft. to.~ Ft. From_
From .Ft. to Ft. From
From~ Ft. tO~ Et, From
From Ft. to .Ft. From
From Et, to Ft. From
Ft. to Ft.
Ft. to _ Ft.
Ft. to Ft.
Ft. to Ft.
Ft. to Et,
Ft. to Ft.
Ft. to Ft._
.Ft. to Ft.
Ft. to Ft,
.Ft. to. Ft.
Ft. to Ft,
Ft. to. Ft.
.Ft. to Ft.
.Ft. to__Ft.
Ft. to Ft,
Ft. to Ft.
Ft. to Ft
MISCL. INFORMATION:
DRILLER'S NAME