HomeMy WebLinkAboutGREENLAND BLK 5 LT 9MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
Pump Installation Log
Well Drilling Permit Number: _______________ Date of Issue: ____-____-____
Parcel Identification Number: ____-____-____
Legal Description Block Lot Property Owner Name & Address:
Pump Installation Date: _____-_____-_____
Pump Intake Depth Below Top of Well Casing: __________ feet
Pump Manufacturer’s Name: ___________________________ Pump
Model: _____________________________________
Pump Size: ____________hp
Pitless Adapter Burial Depth: _________ feet
Pitless Adapter Manufacturer’s Name: _________________________
Pitless Adapter Installer: ____________________________
Well Disinfected Upon Completion? XX Yes No
Method of Disinfection: _____________________________
Comments:
Pump Installer Name: __________________________________
Company: ___________________________________________
Mailing Address: ______________________________________
City: ___________________ State: __________Zip: _________
Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation.
NlunicipalitYof
Anchorage
P.O. BOX 6650
ANCHORAGE, ALASKA 99502-0650
(907) 264-~flfl× 4744
TONY KNOWLES,
MA YO,q
DEPARTMENT OF HEALTH & HUMAN SERVICES
February 9, 1987
James E. Schefers
4700 East 1471h Avenue
Anchorage, Alaska 99516
Subject:Lot 9 Block 5 Greenland Subdivision
On-site Sewer and Well Permit #860026
A permit issued by this Department for an individual well and/or on-site sewer
system has expired as of January 30, 1987.
Your permit expired on the date of issue basis by authority of Municipal ordinance
existing at that time. A new permit must be obtained from this Department for
any well and/or on-site sewer system not installed by the expiration date. The
new permit will come under the calendar expiration date as per the new Waste-
water Ordinance (effective May 20, 1986).
If you have drilled the well, a well log needs to be sent to this Department
for documentation of the installation and to close the permit.
If a private engineer inspected the installation of the on-site sewer system the
original as-built inspection report (three part form) must be sent to this office
for review and approval, and for documentation.
If there are any further questions, plesae call this office at 264-4744.
/R.W. Rdbinson
Program Manager
On-site Services
RWR/lj w
enc: copy of permit
4/00 liii:~ 147TH AVE
ANL~FIUI'~.AGI::., AK 99516
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PERFORMED FOR:
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG B PERCOLATION 'rEST
(ENGINEER'S SEAL)
LEGAL DESCRIPTION: ('~"'~- ~'~'/~"~'/")~'/}/~-~) Township, Range, Section: -% '~-~, ';/"L/J/ /~-.;¢(-() 5//-~
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COMMENTS
SLOPE SITE PLAN
WASGROUNDWATER
ENCOUNTERED? /~
IF YES, AT WHAT
DEPTH?
Deplh to Waler After
~onitoring/ Date:
. P
E
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE _____ tmmutes/inch) PERC HOLE DIAMETER __
TEST RUN BETWEEN_ FTAND
PERFORMED BY: 0 '1,3,/, E./'/~_?~.,t.~ ..~k'/C..~ .... /-..-~-"
· ..~]-- oc'"~, .? ~ :Z-'~ I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON TFIIS DATE. DATE:
72-008 (Rev. 4~85)
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PLOT PI_Akl
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MunicipahtYo¥
Anchorage
P.O. Bt_,,, 196650
ANCHORAGE, ALASKA 99519-6650
(907) 264-4111
TONY KNOWLES.
MA YO R
DEPARTMENT OF HEALTH & HUMAN SERVICES
June 23, 1986
James E. Schefers
4700 East 1471h Avenue
Anchorage, Alaska 99516
Subject: Lot 9 BLock 5 Greenland Subdivision
On-site Sewer & Well Permit #860026 - Issued January 30, 1986
On May 20, 1986, The Anchorage Assembly approved a new ordinance
regulating on-site wastewater disposal systems (septic systSms).
All septic systems constructed after the effective date of this
ordinance are subject to the provisions of this ordinance.
Our records show that you currently hold a permit for the installation
of a septic system. We strongly urge that you contact this office
prior to constructing your system. Any changes in the code that could
impact the constructiou requirements of your septic system will be
identified and brought to your attention. Please contact the
Environmental Services Divislon at 264-4720.
Thank you for your cooperation.
Sincerely,
Susan E. Oswalt
Program Manager
On-site Services
SEO/SSM/ljw
