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Home My WebLink AboutCAMPBELL HEIGHTS BLK 4 LT 1Bmo 4 0oo DAILY DRILLING LOG PENN JERSEY DRILLING CO. Anchorage. AI. tkl 99~07 3M-~$12 O ........ All-Bur Const. ..,. 8404 Hartzell Road, Anch. Ak. 99507 ADDRE~ ................................................................... Lot 1 B Blk. 4 Gamble HeiF, hts WELL--SITK ................................................................................... Juno 12 - 82 DATE~?ARTED ........................................................................................... June 12 - 82 DATF~--ENDL~) .................................................................................................... KIND OF FORlVIATION: 0 ...... 6 __ Topsoil FR~,, 6 ,.~ ,~ 14 ,,~ Grey Gravel & Sand i~u Itt ~,~ .~n 15 ~-~ Boulder i~OM....1..~ ................. Ir. ?o......2. B. .............. Ir..S..p.pd.x...c.~.ax..~...qr ave 1 r~oM....?.~ ................. FT. TO....~.~ ................ Ir..R~...C.~X.e.~ .......... i~_~_ 32 ~ -- 62 ~ Clay & Gravel O 62 66 Da:~ Cla & ve FR M ......................... FT. TO ......................... Ir ........ P. ......... ~........G.r.a 1 66 - 68 ~ Boulder I~OM ....................... Ir. T~ ..................... ~r ................................... _. ~8 ---- 82 --Clay & Gravel ~_',. B2 ~ __ 84 ~ Gravel & {~ater FROM ...................... Ir. TO ........................ Ir ..................................... FROM ...................FT. ~O ................... Ir ................................ MISCL. INFORMATION: DEI'FH oP WELL. .................... 8!~.'. ................................................. STATIC LEVEL OF WATER FT ........................................................... DRAW DOWN Ir ................................... filLS. I'£R JlR ............. ..5...~.~. ................... KIND 6" Steel h'elded OF CAfiINi] ....... FRO.mi .......................... FT. TO .......................... Ir ......................................... FROM ......................... FT. TO ......................... Ir ......................................... FROM .......................... FT. TO ......................... FT ......................................... FROM ......................... Fr. TO .......................... I~T ......................................... FROM .......................... FT. TO ......................... FT ......................................... FRO,~! ......................... Ir. TO ......................... Ir ........................................ FROM .......................... FT. TO ......................... Ir ......................................... ['ROM ......................... Ir. TO .......................... let ........................................ FROM ......................... Ir. TO .......................... F~ ................ .t..,...~ ........... ~ O FRo,, .......................... Ir. ,o ......................... Ir .................. ,OM ......................... Ir. ,o .......................... Ir ................ DRILLER'S NAM ~....~ .c..h..~ ~..h..1. ~ S., ... La ~J~...,I.F., _ Tom ,... 1~ b ,...& _ 1~ o no.. ~"ILI~4 I C I~'",l=t L I TY OF I=I~-IC-.I~'~RI DEPARTMENT,',..°/ HEALTH AND EMVIRONMENTAL P, OTECTION 825 ~L~ STREET, ANCHORAGE, AK. 264-4?20 IWELL PERfd I T PERMIT NO. < 820458 ) RPF'LICANT ALI BUR CONST LOCRT I ON HRRTZELL LEGAL LiB B4 CAMPBELL HTS 8404 HRRTZELL LOT SIZE 349-4E:4& 8?00 SQUARE FEET MINIMUM DISTANCE BETHEEN R HELL AND ANY ON-SITE SEHRGE DISPOSAL SYSTEM IS 100 FEET FOR R PRIVATE HELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM R PRIVATE HELL TO A PRIVATE SEI,IER LIME IS 25 FEET AND TO A COMMUNITY SEHER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT HITHIN ~0 DAYS OF THE HELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO IN-~URE PROPER INSTALLATION. PE~:M I T E~P I RES DECEME:ER I CERTIFY THAT l: I AM FAMILIAR HITH THE REQUIREMENTS FOR ON-SITE SENERS AND HELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I HILL INSTALL THE S.Y-c,/7~EM IN ACCORDANCE HITH THE CODES. SIONED: _--~ ~ ~ ~_~~ .............. .... ........... ................. -,,. V4. 0 MUNICIPALITY OF ANCHORAGE DMSION OF ~-A~IRONMENTAL HEALTH DEPARTMENT OF HEALTH ;%ND ~iNVI~ONMENTAL PRO~-~-£&ON APPLICATION FOR HEAL%7{ AUTHORITY APPROVAL ~Ki'IFICATE 1. Cer~.ral Infc~,aticn Application Date (a) Legal Description (include lot, block, subdivision, section, t~mhip, range) Lccaticn (add~ess o= directior~) (b) Applicants ~ Applicants Address (c) Applicant is (check one) Lendirg Instituticn Buyer ~--~; Other ~ (explain); (d) Lendi~ Institution /~/u~ o~ (e) Bual Estate Co. &AGent (~k/J "'~=~%~ Ad. ss 2. Type of ~sideno~. SinGle-Family ~ Number of Bedrc~:s' 3. Water Supply Individual Well Multi-Family ~--~ Note: If ~u,,,unity ~11 system, must have w~itten confirmation fzcm the State Departwent of Envirc~rental Co~-servation attestinG to the legality and status. Is the ~11 adequate for th~ number of bedrccms s~ecified in this FAA ~N) 4. Sewage Disposal Or_site ~--~ Public~. Cr.z~unity ~-~ Holdir~3 TarR ~ Is the wastmwate= dispGsal system adequate fcr the rnmbe~ of bedrooms (Y/N) [Page 1 of 2] 2-15-84 5. £ngineerir~ Firm Providir~. Inspectionsr Tests~ Data and Infcvmaticn I ce=tify that I ha~ ~hecked, verified, c~ oO~fOrn=d tO all ~DA ~%A ~i~li~s in effe~ ~ ~ ~te ~ ~is i~cti~. ' ' m~ OF 4 -~0~'"",'~,,.~~. -- 6. ~ ~proval Tee'of ~¢itio~al A~al The Municipality of Anchorage Dapartaunt of H~alth nct guarantee the co, timed satisfactory ~e=fcz~nance of th~ ware= supply and/ct the wastewate= disposal system. This apUroval i~.dicates that, as of th~ validation date shown abo%~, based on th~ data and infc~,,~tion furnished by an ergineer registered in the State of Alaska, the water supply and wastewater disposal system is safe ar~ func- tio~ml fc~ the number of badrcc~s and type of structure indicated. (DHEP SEAL) 7. Mail the HAA to th~ following address: KB2/dS/s [Pa~e 2 of 21 2-15-84 MUNICIPALITY OF A~'4C~.AO~ MUNICIPALITY OF ;%NCFDRAGE (MOA) D.~ OF HEALTH & ENVIRON,~2NTAL PROTE~I'IO~ ,~... HFALa~ ALr~D~TY AFl, OVAL (~) '~ ~Z~ - F~Y Z984 JUL 2 ~84 A. ~ELL DaTA RECEIVED Be 'Well Classification ~.//~./',~/7/~ If A, B, cr C, D.E.C. A~,~'=c~sd(Y/N) Well L~g P=esent (Y/N) '~/ Date C~leted , ~-~ /2-~Z Yie. ld .~/~/~ Total Depth /~ ~/ Cased to Static Water fe~l .~// Pump Set At Casing Height Abo~ Ground 2 Elect=ical Wiring in Conduit (Y/N) Sepa=ation Distances f~cm Well: TO Septic/Holding Tank on Lot Depth of Grouting ~-~ Sanitary Seal on Casing (Y/N) / Depression A~ound Wellhead (Y/N) /~ ; On Adjoining Lots To Neaz~st Edge of Absc=ption Field on Lot ~.,~ ; On Adjoining Lots ~leanOut~?o~ /' ~est Se,r Service Line on LOt Pate Installed Sfzs No. of C~.,%~a~tments Star~lpipes (Y/N) Ai~-tight Caps (Y/N) Foundation Cleanout (Y/N) Dep=ession ove~ Tank (Y/N) Date r~-t Pumped Pumping/Mainte~mnce Contract on File (Y/N) ~ fc~ Holding Tank High-Wate= Alarm ~Y/~ '~, , Temporaz-y Holding Tank Permit (Y/N) TO Wate=-$upply Well ~/tw~ L ,~~ Building Foundatim To Water Main/Service Line' ~/,/ To Stream, Por~, [ake, ~ Major D~air,~ge Co~se Cc~nts 2-15-84 Co ABSORFrlON FI~.r~ E~TA Soils Rating in Absc=pti(m Strata Date Installed Width of Field Square F~mt Of Abs(xgtion A~ea Ty~e of System DesiGn I~nGth of Field Depth of Field Gravel Bed Thickness StandpiPes P~esent To Water-Supply Well ~ To P=o~ty Line To Building Foundation TO Exil~%lng c~ Abangk~ed System Lot ~ Lo ._ . To Wate= Main/Service Line ~____~_~__ To Cu%~n~( if sent) To D=iveway, Pa~kirg A=ea, (r Vehicl~ ~a~ ~ ~ D. LIFT STATION Date Installed Size in Gallcm. s Manhol./ x ss (Y/N) Feets MOA ** Check Pe~aitted Bedrocm Rating AGainst HAA Bequsst ** 2-15-84 ..-.. -..~ APPLi"~,NT FILLS OUT UPPER HA'"'~,, ONLY Lending Institutlo~ -/ ~ // v . Phone Address ~ Zip Code Type of Residence VLJ- Multiple Family No. of Bedrooms I-I Other Water Supply ~lndivldual ATTACH WELL LOG. A well log IS requbed for all wells drlled since June 1975. ~'~mmuntty For wells ~rilled prior ID that date. give well depth (attach log II available). Sewer Disposal i-I Individual Year Individual Installed: ~,Publlc Utility When Connected to Public Utility: ] ,~ .? Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Inspector Inspector Inspector Inspector Field Notes: j ( ) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ~ DISAPPROVED:.'.~ ( ~ CO.D,T~.AL APRROVA'' BY: ~C ~ Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Well ID Tank Septic Tank Size /A N '10' L)'rl I~IT¥ S~,S ENG ZNEERS, TNC 7t25 OLD SEWARD HWY. ANCHORAGE. ALASKA 99504 DEPT. OF ENVIRONMENTAL CONSERVATION BILL SHEFFIEI. D, ~OVERNOR SOUTHCENTRAL REGIONAL OFFICE 437 "E" STREET, SUITE 200 ANCHORAGE, ALASKA 99501 August 29, 1984 274-2533 Morris J. Turner, P. E. Polarconsult 2735 East Tudor Road Suite 201 Anchorage, Alaska 99507 SUBJECT: Waiver Horizontal Separation between Private Well and Public Sewer Cleanout Lot l-B, Block 4, Ca. ell Heights S/D 8521-WA-023 Dear Mr. Turner: The Department has reviewed the subject waiver request and hereby waives the horizontal separation between the well and public sewer cleanout on the subject property. BEE/dd Sincerely, ' olsrconsult Cm ARCHITECTS · ECONOMISTS · PLANNING CONSULTANTS duly 26, 198~ Bruce tterlckson State o¢ Alaska Department of E~vlronmental Conservation 437 E Street, 4th Floor Anchorage, Alaska 9950! Reference: Waiver of Protective Radius For a Prlvate l.later l~ell to a Sewer Llne. Dear Hr. Herickson: Enclosed is an as-built drawing of Lot lB, Block h/ Campbell Heights Subdlvlslon. It shows an exlstlng well approximately 85' From the sewer 11ne which stubs Into the property on Winchester Street. The 85t Is to the sewer cleanout. ]n ]982, wheh thls well was drilled, the mlnlmum distance of 75' to the communlty sewer was all that was required. Currently, this has been changed to 100'. %.le ask For a waiver of protective radius based on: 1. Grandfather rights, i.e. the well Is greater than the mlnlmum required by the 1982 building permlt copy enclosed. 2. Both the well and the sewer lln~ are relatlvely new, plus the reasonable health safety should be Insured. In accord .wlth the Alaska statues, we request a waiver of the water well. to sewer line dlstance. Should you have any questions, please Feel Free to contact the undersigned. Sincerely, POLARCONSULT ALASKA, INC. Horrls d. Turner, P.E. Professional Engineer /Jkb 2735 EASTTUDOR ROAD · SUITE201 · ANCHORAGE, ALASKA99507 · PHONE (907) 561-1933 · TELEX:26708 PCAAHG U dcipality of Anchor ¢ DATE: TO: FROM: SUBJECT: MEMORANDUM August 19, 1982 'Laura Crow Environmental Health Division Request for Refunds - Account %2460 Please make arrangements for the following refunds, a public water line was put in and owner/builder did not need to drill the private wells: C & E Enterprises, Inc. Post Office Box 10-991 Anchorage, Alaska 99511 Lot 3A Block 4 Campbell }{eights Subdivision Permit #820142 Lot 3B Block 4 Campbell }[eights Subdivision Permit ~820143 Lot 4A Block 4 Campbell Heights Subdivision Permit #820144 Lot 4B Block 4 Campbell }[eights Subdivision Permit %820145 Lot 5A Block 4 Campbell Heights Subdivision Permit ~820146 Lot 5B Block 4 Campbell }{eights Subdivision Permit Each permit for Well only is: $15.00 each Total: Paid for the permits at the One-Stop Permit Office, Road on April 6, 1982. Thank you. #820147 $60.00 Refund 3500 Tudor Laura J. Ward Senior Office Assistant LJW attachements 91.010 (5/78}