HomeMy WebLinkAboutCAMPBELL HEIGHTS BLK 2 LT 7A
.)
DALLY DRILLING LOG
PENN JERSEY DRILLING CO.
~833 E~st 72nd Avenue
Anehor~'e, Alaska
344-2612
~I~.l',e !.'he,bee
OWNER OF LAND
WELL--SITE. ....... ~ .a_w.. b_ ?_1..1_, S_u_b _, ........................................
DATE--STARTED ......... .:%..L5..-..7.1 ..............................
DATE--ENDED .................. .-~.-T~ .~.T. 7....7. ......................................................
DEPTH OF WELL. ................ _Z_9..~_ ...............................................
STATIO LEVEL OF WATER FT .............. ~..7..*. ............................
D~W ~OWN FT ...........................................................................
OA~. ~ER ss_ ................ .~.o.....?..,'.L ....................................................
6-~nch welded
KIND OF CASING ....................................................................................
KINO OF FORMATION: ~;ELL ~ 3.
FRO~._..0.. .................FT. TO ........ ..1.:?~ ......... FT,.~..r...,_..%%n..~...§....C..r..~ve! FROM .......................... FT. TO ...................... rT .....................................
FKOM...L~ ................ FT. TO ....... ~ ........... FT,2=~...~,%n~i~,.r.~v~l & l~'a ,FROM ........................ FT. TO ........................ PT ....................................
FROM....3...5.. ................. FT. TO ........ ,.5.2. ............ FT~.r..o.l:_$.?,p~,4...L.Gr. avel FROM .......................... FT. TO ........................ FT ........................................
FROM....5...2. ................. Fr. xo..._....7~;_ .......... Fr.~..r..;.....S.~..n..~....&....~.r..~..v.e ~ FROM .......................... FT. TO ....................... FT .......................................
FROM...7./~ ................. FT. TO......../:?_ .......... FT-,~-zmp...~r.,..-%n,.~-..& (;'rave FROM ......................... FT, TO ......................... FT ......................................
F~OM....7...7_ ................. Fr. TO.._.._7..P.. .......... FT~.~.,....~.~r~d~...fin~.~l &
FaOM....7..9.. ................ FT. TO ....................... rr ......... }..;.a...t...e..r.. ..............
FROM .......................... FT. TO ....................... FT ....................................
FROM .......................... FT, TO ....................... Fl' .....................................
FROM ......................... FT. TO ......................... PT ................................. ~ ....
FROM ......................... FT. TO ......................... FT ...................................
FROM ......................... FT, TO .......................... FT .....................................
MISCL INFORMATIONc
FROM .......................... FT. TO ........................ FT .......................................
FROM .............. ~ .......... FT. TO ......................... FT ......................................
FROM .......................... FT. TO ........................ FT .....................................
FROM ......................... FT. TO ......................... FT ........................................
FROM .......................... FT. TO .......................... FT .........................................
FROM .......................... FT. TO ......................... FT .........................................
FROM ......................... FT. TO ......................... FT .......................................
Larry, Tim & ,':nnny $chachle
DRILLER'S NAME ....................................................................................................
;~NICIPALITY OF ANCHORAGE ~
' DEPARTMEN~ .F HEALTH AND ENVIRONMENTAL./ROTECTION
825 L Street, Anchorao~. Alaska 99501
I 264-4720
.' Date Received: September 30, 1977
Time 9:30 a.m ~2: Time ~3: Time
Date 10-5~77 Wednesday Date Date
Insp Pratt Insp Insp
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
Lending Institution Request: Lomas and Nettleton Company
Mailing Address: 4449 Business Park Boulevard Phone: 274-7661
Re
Property Owner: Kenneth Whedbee
Mailing Address: 3446 East 67th Avenue 99502
Phone:349-2167
3. Legal Description: Lot 7A Block 2 Campbell Heights Subdivision
4: Single Family Residence: (x) Number of Bedrooms: Two
Multiple Family Residence: ( ) Number of Bedrooms:
Well System:
Permit #
Construction
Individual well (x) Community/Public System ( )
Depth of Well Well Log on File
Bacterial Analysis
( )
6. Sewage Disposal System: On-site system ( ) Public Utility (x)
Permit # Installed Installer
Septic Tank Size Manufacturer
Absorption Area Soils Rate Material
7. Distances: Well to Septic Tank to Absorption Area
to Sewer Line Nearest Lot line Absorption Area
to Nearest Lot Line
"' / ' ,'IUNICIPALITY OF ANCHORAGE ' , r~ ,,-,,,.,, ','
,~J Department of tIealth and Environmental Protec~ioh"
'ff~;~.'9,,~\\l 825 L Street, Anchorage, Alaska 99501~c,. ,
.-. o
'""~'~.-tt~quest for Approval of Individual' Sewer and Water
Property Owner:
Mailing Address:
2. Name of Buyer:
Mailing Address:
Phone:
Phone:
3. Lending Institution:
Mailing Address:
Phone:
4. Realtor/Agent:
Mailing Address
Phone:
'5..Legal Description:
Street Location: 3 ~"~
6. Single Family Residence:
Multiple Family Residence: ( ) Number of Bedrooms:
7. Water Supply: *Individual Well ~ Public/Community System ( )
If Individual Well, well depth~ ~O~
If Community System, name of system
Sewage Disposal System: On-site System ( ) Public System
If On-site System, date of installation:
*NOTE: A well log is required on ALL wells drilled since 6/75.
3/77
~age Two
Department of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal Description: Lot 7A Block 2 Campbell Heights Subdivision
Comments:
Affadavit Attached:
Approved:
Disapproved:
Letter Attached:
Date:
( )
Date:
Department Worksheet: