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HomeMy WebLinkAboutCAMPBELL HEIGHTS BLK 2 LT 7BI-iTS DALLY DRILLING LOG PENN JERSEY DRILLING CO. 2833 E~st 7end Avenue Anchorage, Ahska 99S0~ Mike Whedbec OWNER OF LAND ........ 3~46 E. 67th. Ave. Anch. Al. 99507 ADDRESS .......................................................... w£tJ~-srrF- ............ ~.~,~,l~].L_$.ub ..................................... DATE--STARTED ............... . .3. ~..1...6..U. -7...7- .................................. 3-16-77 DATE---END£O ............................................................................................... DEPTH OF W~LL ................ ,?.3.:. ....................................... STATIC LEVEL OF WATER FT ............. ~..~.:. ................................. DRAW DOWN FT ....................................................................... 20 GFH OALS. PER HR. ................................................................................... 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TO ....................... FT ....................................... FROM ......................... FT. TO ........................ FT ....................................... FROM .......................... FT. TO ......................... FT ..................................... FROM .......................... !~. TO ......................... FT ......................................... FROM .......................... FT. TO .......................... FT .................................... ',-.. FROM ........................ FT, TO ......................... FT .................................. .~... FROM ......................... FT. TO .......................... FT ................................ ~ ...... DRILLEWS NAM E.....I,?,r.r~: _i...'f J~...~.~_ka~:h.1 a ............................................  ' /"~JNICIPALITY OF ANCHORAGE DEPARTMENT ~ HEALTH AND ENVIRONMENTAL .'ROTECTION · 825 L Street, Anchorage. Alaska 99501 " I 264-4720 ~_.- Date Received: September 30, 1977 ~1: Time 9:30 am ~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: State of Alaska Veteran's Administration Mailing Address: 907 West Northern Lights'Blvd. Phone: e Property Owner: Mailing Address: 3. Legal Description: Kenneth Whedbee 3445 East 67th Avenue 99502 Phone: 349-2167 Lot ~ Block 2 Camplbell Heights Subdivision 4: Se Single Family Residencef (x) Multiple'Family Residence: ( ) Number of Bedrooms: Two Number of Bedrooms: Well System: Permit # Construction Individual Well (x) Community/Public System ( ) Depth of Well Well Log on File Bacterial Analysis ( ) Se Sewage Disposal System: Permit % Septic Tank Size Absorption Area On-site System ( ) Public Utility Installed Installer Manufacturer Soils Rate Material (x) e Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest ~ot line Absorption Area to Nearest Lot Line ® qUNICIPALITY OF ANCHORAGE ° ......... Department of Health and Environmental Proteqt~on.".~.~ ~,' '' 825 L Street, Anchorage, Alaska 99501 ..... 264-4720 · - ..... uest for Approval of Individual Sewer and Water Facilities Property Owner: /~/(~0 iq Q ~q ]9] Mailing Address: ~q~ ~_ ~, Name of Buyer: /~,.~,v ~, S_~r~ ~ Mailing Address: Phone: Phone: Lending Institution: Mailing Address: Phone: ® Realtor/Agent: Mailing Address: Legal Description: Street Location: Phone: Single Family Residence: Multiple Family Residence: Number of Bedrooms: Number of Bedrooms: Water Supply: *Individual Well If Individual Well, well depth If Community System, name of system Sewage Disposal System: On-site System If On-site System, date of installation: Public/Community System ( ) ( ) Public System *NOTE: A well log is required on ALL wells drilled since 6/75. '3/77 Page Two ~ - Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 7B Block 2 Campbell Heights Subdivision Comments: Affadavit Attached: ( ) Approved: ' Disapproved: Letter Attached: ( ) Date: Date: Department Worksheet: