The URL can be used to link to this page

Home My WebLink AboutABBOTT LOOP MANOR BLK 1 LT 9 3h9-5552 (0~fice) AREA Engineering 1207 E. 74th Ave. Ste. 203 Anchorage, AK 99518 562-2161 Ext. 583 (Message) August 12, 1986 TO WHOM IT MAY CONCERN: Re: Well pump test, Lot 9, Block 1, Abbott Loop Manor A well pump test vas performed by the undersigned this date with the following results: Pumping rate: 0.5 gpm Casing size: 6" 0 Hr. Static water level: 22' 0.5" " " 31.5' 1.0" " " 32' 1.5" " " 32 ' 2.0" " " 32' 2.5" " " '" 3.0" " " " 3.5" " " " h·O t, . . n The present occupant stated that the well has been in existence since at least 1965; no well log is available. The above information indicates that the well is more than adequate to serve a 3-BR dwelling. Please call me at your convenience if there are any questions. Sincerely, Robert D. Schilling, P.E. . CE.R~,I.F~ICATE OI ...... I~~sc~tion (include IoL b Location (address or directions) .~ .'~MUN!ClPALITY OF ANCHORAGE ~ .~0F. HEALTH AND ENVIRONMENTAL PhUTECTION ~DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL :OF ON-SITE SEWER AND WATER FACILITY Application Date Legal Description (include lot, block, subdivision, section, township, range) (b) Applicant Name/~r~'/_~ J~y. ~.¢ .,~ Telephone: Home ' Business Applicant Address (c) Applicant is (check one): Lending Institution r"l; Owner/builder D; Buyer/J~ Other D (explain); (d) Lending Institution Address _~'~'~, Cc-'), "~,/~ '/--~' -~'~- /~ (e) Real ~tate Companyand Agent ~z/~.~ ~.~ / ~. Address ~ ~0~ ~.~/~ ~,/~ ~ ~ Telephone ~ ~ ~ ~ ~/ (l) Mail the HAA to the following address: Page i of 2 TYPE OF RESIDENCE $ingle-Family~ Multi-Family FI Number of Bedrooms WATER SUPPLY Individual Well ~ Community I"1 Other I I ~, Public Note: If community well system, must have written co'nfirmation lrom the State Department of Environmental Conservation attesting to the legality and status· :, SEWAGE DISPOSAL '. t ~ . . Onsite Note: If community well system, must have written confirmation from the State Department o! Env ronmental Conservation attesting to the legality and status. *" · '~ ," ~ ' '*-~";.* "' ' ~. , 5.' ENGINEERING FIRM PROVIDI~"'~INSPECTIONS, TESTS, FILE SEARCHi F.,~"~'X AND INFORMATION ,As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system !s safe functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection?the on-site water supply and/or wastewatcr disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Address - ~, ~ . · ~ ~?"-'-'-'-'-'-'-'-'-~, Date Engineer's Seal DHEP APPROVAL Approved for ~"~--"~'~') bedrooms by ~ Approved ~'""'"' Disapproved ,~C/. *'"~,~.,~..~, Date Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP} issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. · ~ , ' ~ ' ' ' '~' · ' Page2of2" ..... ' ....... ~" MUNICIPALITY OF ANCHORAGE (MO~,t HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-472O Legal Description: .~ WELL DATA Well Classification ~/'7~J ~.~'_ If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) ~ Date Completed ~.../~,,--~x' /~:~(~"' Yield Total Depth ~ Cased to ~ ........ Depth of Grouting Static Water Level ·- Casing Height Above Ground / ' Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot ' To Nearest Edge of Absorption Field Pump Set At ../-~..~-- J ,,, ,.5'"c.,~" Sanitary Seal on Casing (Y/N) 1// Depression Around Wellhead (Y/N) ,Aw/ ; On Adjoining Lots ~ · ,; On Adjoining Lots ------- To Nearest Public Sewer Line /~ · '/~ '" To Nearest Public Sewer CleanouVManhole /~,' ~' To Nearest Sewer Service Line on Lot . Water Sample Collected by _,~' ,/~'~'~-~."~; ; Date B'-'~/~- Water Sample Test Results Comments SEPTIC/HOLDING TANK DATA ,~/~'~ ,.,"Z//O~.~,~,~ .~**~,g~----.~ /'~ ,~'"*'~ ~e_4~,- Date Installed Standpipes (Y/N) Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service Line Course Size No. of Compartments Foundation Cleanout (Y/N) Date Last Pumped ; for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 72-026( I 1/84) ABSORPTION FIELD DATA /.. Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Fietd: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) D. LIFT STATION Date Installed Size in Gallons 'Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (WN) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA *' Check Permitted Bedroom Rating Against HAA Request *° I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed~ Date ~'--/2--~:::~ Receipt No. Date of Payment ~-~-~ Amount: $ Page 2of 2 ~*-. Engineer's Seal