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HomeMy WebLinkAboutZODIAK MANOR ALASKA BLK 6 LT 15Zo HEFIL. I't-I FIN[;, E]'-,!',,,'IROI'.,tHEI'.,ITI'::IL 3TECTi[ON STI~'.EET., FIi",!CI-IOI=;!FIGIE., FII.:::. ~.,~ IIZE L_ L_. F" ii.:.E ~:;,3': ~--'11 ][ HI ILI_. LEJE:FIT 101'-,I I_IZEiFtL I,.I:.I,IliE II.-I '=.:.;IMI='501'-,I I-'1"..1._.61.... 6 2:1.][:~]]:;:11( III II'li...iF4. .... ,=~.l TIJ[:,[)I:;?. f;.D. FlI f"lt..ll"l [:, I STFti",ICE E~ETI4EEN iR I.'.IELL. RNE:' I':11",1"? ON'-51 l"E SEI.qRGE [:,i SF'O'=-;PIL '='.!;'¢STEM Z S I=EIET F:OF?. Iq PP~Ik,'FITE PJI. E[...L Olq: 20L'R FEE;T FCIF:: I'"'1 F:'UE:LIC !.4ELL. ,~4ELL LOGS RI;rE: I;i:E];!UII:;rlEC, FII",IC, MUST BE I~'.ETUI:;d",IE[:, TO THE E)EPFIF.'.TMIENT !.4ZTFIZN THE I.'.IIEIJ.~ CEIMF'LETZON. OTI'IEF:'. RIE6K]ZI:;~%I'"IEI",FI'S hlFl"¢ RF'PL"r'. SF'ECIFZCR"f'IOIq% RNI.;" CONSTRUC"FTON DZF:IGI~:RMS FI","FtZL. RE:LIT. TO f.I",ISS.,LJRE PROPEl;;: ZNS-I'FILLF:ITION. II=" EE ~:;:-'.'t II""1t ZE T' I CER'T'IF:'," THFI"r ::L: I F:lh'l FI:Ii"I]:LII:::II~: !.,.lIl"H I"I-I,[E f;,'EI;JUiF,'EMENTS F'OI;;: I:II",I-'~ITE SEI.,IEF?.'_'ii; I::11'.I[:, b. IELL'.'E; I::lt~; SET FORTH I:~:"," THE F1UNICIPFiI._IT'¢ 2: I 1.4ZLL Ii'.,ISTRLI_ THE '-..:;'.r'SI'E]',I Zi'.,! FICCOFd)FtNC:E I, IITH THE CODES. k'?, 0 I~-W DRILLING, Inc. P.O. llox4-].224 · ]3].0C InJernationaiAirport Road (907) 274-461] ANCHORAG£, Al_AStrA99509 DRILLING LOG Well Owner_ _ _ Stev~ B.r__ov_m ........ Use of Wd] _Do~ Location (address of: Township, Range, Section, if known; or distance main roacL .... L19~ 'B6~ Zodiak Manor Size of casing O Depth of Itole 74. feet Cased to 74 feet Static water level 55 ~t. Screen ( ); Perforated ( ). None Describe screen or perforation ::~ ............ Well pumping test at _~5 gallons per ~6'dl9 (minute) for_ 1 .hours with J~0©~ of drawdown from static level ('I436*~L9 (below) land surface. Finish of well (check one) open end ( x ); Date of completion m 22._Apri]..19~75 WrLL LOG Depth in feet from qround surface Give details of formations penetrated, size of material, color and hardness O_ _[L'O~ ~ _ Organics .. 2 _TO. 46 · ~ TO 56_ 5~ __To 158 _ _ 5~ TO 60_ 60 _TO_ . 72 TO 75_ TO_ __ TO~ __ ._ TO _TO TO TO · Silty Gravel S_an dy Gravel Black Silt Sand Silty Gravel: s_m al 1 .... _Gravel.: slightlx sar~Pv', waterbe_aTing _ 1--CUSYOMER TIME DATE INSPECTOR NSPECTION APPOINTMENTS TIME DATE INSPECTOR DA E RECEIVED MUNICIPALITY OF ANCHORAGEpRoTECTi(~ViROi,~Mi~N~.,d DEPARTMENT OF HEALTH & ENVIRONMENTAL 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATIC)N DIVISION Telephone 264-4720 R E C E I V ~ D I NSPECTOF, t-~ M¥1-d,~ll~,,,,t~/f ~h ANCHORAGE REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1, Incomptete requests will not be processed. Please allow ten (10) oays for 13recessing. pHONE 1. PROPERTY OWNEFI MAILING ADDRESS PROPERTY RESIDENT (If different from above( PftONE PHO E PHONE -- S, L E I~J.. D E S C..R I~PT I O N ' STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS ~SINGLE FAMILY ~ One ~ Four ~l Two ~ Five ~ MULTIPLE FAMILY ~Tbree E~ Six [] Other WATER SUPPLY ~ INDIVIDUAL* [] COMMUNITY ~ PUBLIC UTI LITY ATTACH WELL LOG. A wel m§ is reauired for all wells drilled s~nce June 1975, For wells drilled prior to that date, give wel depth (attach log if available.) YEAR ON-SITE SYSTFM WAS INSTALLED. 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE*' ~ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, THIS SIDE FOR OFFICIAL USE ONLY 1, TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SIX [] OTHER 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTI LITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified []Septic Tank or [~]Holding Tank Size: _ If Tank is homemade give dimensions: TYPE OF TANK TOTAL ABSORPTION AREA 4, DISTANCES WELL TO: Absorption Area to nearest Lot Line PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER ' DATEINSTALLED Area Sewer Line Nearest Lot Line INSTALLER SOILS RATING MANUFACTURER MATERIAL Septic/Holding Tank Absorption 5. COMMENTS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE 72-010 (Rev. 6/79) CHE?,tlCAL & GL LOGICAL LABORATOI~IES . / ALASKA, INC. TELEPHONE (907)-279.4014 ANCHORAGE INDUSTRIAL CENTER 274-3364 5633 B Street Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER I.D. NO. Mailing Address State Zip Code City Mo. Day Year SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab reft no, [] Special Purpose [] Treated Water [] Untreated Water SAMPLE NO, 2 I 4 I LOCATION Time Collected Collected By TO BE COMPLETI-'D BY LABORATORY Analysis shows this Water SAMPLE to be: [] Satisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample. Date Received Time Received Analytical Method: [] Fermentation Tube :[] Membrane Filter Lab Ref, No. Result* Analyst L J L J L J READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06-1220 (b) Rev. 1978 BACTERIOLOGICAL WATER ANALYSIS RECORD ;o~nflr rn&tow Reported By. Collforrn/lOOml , ,; p.m. January 4, 1978 Kenneth Simpson 6531 Tudor Roacl Anchoraget Alaska 99507 Subject: Lot ].5 Block 6 Zodiak Manor Subdivi~ion Permit 0770988 permit issued by this department for well and/or sewer s~tem has expired, Permits are issued on a calendar year basist as stated on the permit~ by authority of Municipal ordinance. %f you have drilled the well, a well loq sheuld be sent 'bo this department to document the installation date° If there are any further questions, please contact this office at 264-4720° Sincerely~ Health ~u~d Environmental Pretection Sewer and Water Section GREATER ANCHORAGE AREA BOROUGH ,<;., , .... DATE ANSWER TO: DEPARTMENT: ~.~)d',/J~:¢:~-'...~.~.~...~' ~.~.~ .~?=~?] REQUESTED: RECEIVER: REQUESTED ACTION SCHEDULE %,~.-'F~R INFORMATION ONLY ~ PREPARE BACK-UP iNFC~M.~loi~ ~-. FOR IMMEDIATE ACiION ~.2 CALL ME BEFORE YOU ANSWER FOR YOUR CONSIDERATION .: NEED YOUR RECOMMENDAHON O?HER FORM pU 007