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Home My WebLink AboutEAGLE RIVER HEIGHTS BLK 2 LT 9 t ~ MUNICIPALITY OF ANCHORAGE ~ ! ~.~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ° ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION RI~PORT r~l UPGRADE LEGAL DESCRIPTION DISTANCE TO: IWell q(~ ' IAb$°rptl°nllre~" I O'tling ~I PERMIT NO, ~ Well Foundation ~ ~ Nearest lot hne[ O ' PE"MIT NO~ ~ DISTANOETO: + tO O Trench ~ ~ I ~nches Total eff~ti ~th PERMIT NO. DISTA~E TO: Building fou Nearest lot line ~ ~ CIos~ Depth Driller Distance to lot line PERMIT NO. OTHER SOIL TEST RATING; REMARKS .... L. 72-013 (Rev. 3~78) F'ERH IT NO. r-lU t-.I I C I PAL I T"T" OF Rr-iCHORRGE DEPARTHENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 'L' STREET, ANCHORAGE, Ri'.'. 995E~1 264-472~ 0t4--5 I TE SEI4ER PERt4 I T APPLICANT LOCATION LEGAL CLARENCE LAHRY C?O C. BA HILDHOOD ST L9 82 EAGLE RIVER HTS PO BOX LOT SI~E 694 2767 1~742 SQUARE FEET TYPE OF SOIL RBSORBTIOH S'¢STEI'I IS: TRENCH r. IRXIHUM HUMBER OF BEDROOMS SOIL RATIHG (SD FTZBR)= 190 THE REOUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEF'TH= 1 ~---'~ LE~-4GTH= 4E: GRR%~EL DEPTH= THE LENGTH DIMENSION IS THE LEHGTH (IH FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETHEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE E×CRVRTION <IN FEET). THERE IS IlO SET HIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MItlIHUM'DEPTH OF GRAVEL BETHEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE E×CRVRTIOrl (IN FEET). ~.'EQl_l I RED "---;EPT I C TRI'-~K S I ZE= ::LO£~O ~iRLLEH'*.I--c; PERMIT APPLICAHT HAS THE RESPOHSIBILITY TO INFORM THIS DEPRRTHEHT DURIHG THE INSTALLATION ItlSPECTIONS OF ANY HELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDEHCES THAT THE HELL HILL SERVE. THO ( 2 .', I ~.iSPECT I 0~4S ARE F-: E ~-~U I RE[:-. BRCKFILLIHG OF ANY SYSTEH HITHOUT FIHRL INSPECTION RHD RF'PROVAL E:Y THIS DEPARTMENT HILL BE SUBJECT TO PROSECUTION. MINIHUH DISTANCE BETHEEN A HELL AND ANY ON-SITE SEHAGE DISPOSAL SYSTEH IS lO0 FEET FOR R PRIVATE HELL~ OR 150 TO 200 FEET FROM R PUBLIC HELL DEPENDING UPON THE TYPE OF PUBLIC HELL OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTIOH DIAGRAHS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PEAr'11 T E.':-'.P I RES DECEt'IBER ~:L, '1979 I CERTIFY THAT 1: I RM FAPIILIAR HITH THE REQUIREMENTS FOR ON-SITE SEHERS AND HELLS AS SET FORTH BY THE HUNICIPALITY OF ANCHORAGE. 2: I HILL INSTALL THE SYSTEM IN ACCORDANCE HITH THE CODES. '::: I UNDERSTAND THAT THE ON-SITE SEHER SYSTEM HAY REQUIRE ENLRRGEHEHT RESIDENCE IS REI,IODELED TO INCLUDE r,IORE THAN ~ BEDROOMS. APPLICANT CLARENCE LRMRY C/O C. BRRR IF THE V-~. 2 PERI'lIT I~0. PIL:~I I C I PAL I T%-' OF i~ICHOF-:AGE DEPARTMENT OF HEALTH AND EHVIROrIMEHTAL PROTECTIOI.I 825 'L' STREET, R~CHORBGE, 2~4-472E~ [WELL PER,,1 I T ( 79~16~ ) APPLICAIIT LAI48Y COrtST. CO. BOX 9~5 E. R. LOCBTIOII WILDWOOD LEGAL L9 B2 E.R. HTS. S?D LOT SI~E 1~887 SQUARE FEET MI~-IIMUI'I DISTANCE BETHEEH 8 HELL 8~.1~ ANY O~.I-SITE SEWAGE 18E~ FEET FOR ~ PRIVATE HELL; OR 15E~ TO 2~ FEET FROM 8 PUBLIC WELL DEPE~I~IIIG UPO~.I THE TYPE OF PUBLIC HELL. WELL LOGS ARE REQUIREP 8~1~ MUST BE RETURIIE~ TO THE OEPRRTME~IT WITHIll OF THE HELL COMPLETIO~I. OTHER RE~UIREME~TS MAY APPLY. SPECIFICATIONS 8N~ CONSTRUCTIO~'~ ~IBGRAMS ARE AYAILABLE TO INSURE PROPER I~ISTALLATIO~'& PERI4IT EXPIRES DECEI~BER I CERTIFY THAT l: I AM FBr'IILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AP.iD HELLS RS SET FORTH E:Y THE I'IUIIICIPALITY OF ANCHORAGE. 2: I HILL IHSTALL THE SYSTEH IIJ ACCORDRIICE WITH THE CODES. ............... - 8PPLICA~LAMRY CO~IST. CO. .... V-~. 2 SULLIVAN WATER WELL P. O. BOX 272. CHUGIAK, ALASKA 99567 · TELEPHONE 688-2769 OWNEROF LAND ,' ,"~,';,x;F' C :,,.~ c. ,, DEPTH OFWELL ~' ADDRESS '. ;:' c,' ,,~ ,' ~ /~ STATIC LEVEL OF WATER FT. LEGAL DESCRIPTION /- ~';' / "/¥' 3 ~..~. ,, .~ ,~,',,-.~ ,~o ,~ DRAW DOWN FT. - ' DATE · Started ........ Ended ~' / ~' / 7 GALS. PER HR ~ ~'~ r~ tC ,, KIND OF CASING ~%=:'- 0 /] PERMIT NUMBER KIND OF FORMATION: From '; Ft. to -! Ft. /'~ ""'~ ~' From Ft. to Ft. From -' FI. to ?o '-' ~"'/,*;'~ ,~ " '-' Ft. -" ...."~ ;.,~,,:-c From Ft. to Ft.__ ! From .? d~ Ft. to '.7- f Ft. ~"':' '*~ '~' /'/'"'*'~ ~/ From Ft. to Ft. ~rom '~' t> Pr. to ~'-~ Ft. ,L .~,/:~ , /-,,\' ~ ~-: ~ From Ft. to FI. F~m ~;"~ Pr. to /c;' / Ft. ~//~ f.~ ~"~?~- From__.Ft. to Ft. F~m / ~ / Ft. to /~/' Ft. -~ *'~ ~ ~/~'~- ~ From Ft. to Ft.. F~ __ Ft. to Ft._ ~ ~ ~ ~ ~ From ~t. E~m __ Ft. ~ Ft, F~m Ft. to Ft. From Fi. to Ft. From .__Ft. to Ft.__ F~m -- Ft. to Ft._ F~m.__Ft. to Ft F~ Pt. to Ft. F~m Ft. to Pt. F~m Ft. to Ft. F~m Ft. to Ft. F~m Ft. to Ft. From Ft. to From Ft. to Ft.. From __Ft. to Ft. Frm Ft. to Ft.. F~m Ft. ~ Ft.__ F~m Ft. to Ft._ F~m Ft. to MISCL. INFORMATION: · n SOILS LOG Steven A. ,Johnson P.O. Box 76 ~ PERCOLATION ChugJak, AK g9567 ZEST Phone: 907-688°3085 SOILS LOG - PERCOLATION TEST SITE PLAN 1 3 4- 5- 6- 7- 8 9 10 11 12 13 14- 15. 16- 17- 16- 19- 20- COMMENTS PERFORMED BY: WAS GROUND WATER ENCOe,TERED~ /',l 0 IF YES, AT WHAT DEPTH? O E T~M t~,~.k iq' Gros~ Net O~oth to Net Read~g Dete Time Time Water Drop i 5/~-l~ I~ ~'-- ~,~ ~ ~o~ ~1o~ 8,0 ~,~ PERCOLATION RATE TEST RUN BE~EEN t~ FT AND ~ FT. ~-' - a, ;)ATE RECEIVED INSPECTION APPOINTMENTS )ATE DATE DATE \~-\L~- <~O MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PR~i 825 LStr~t-An~or~,Al~e~l DEPT. OF E~I~ON~/[NTAL ;, CESSION ~.W.O.~.TAL SAN~TA~O. D~WS~ON REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND ~¢~ES DIRECTIONS: Complete ail parts o~l page 1. Incomplete r~u~ will ~ot ~ Dr~d. Please allow ten (10} days for pr~slng. I. PROPERTYOWNER { PHONE MAILING ADDRESS PROPERTY RESIDENT (If different from ahoy) PHONE ~ BUYER PHONE MAILING ADDRESS / & LENDING INSTITUTION J PHONE MAILING ADDRESS ' 4. REALTOR/AGENT PHONE MAILING ADDRESS / 5. LEGAL DESCRIIrrlON 6. TYPEOF RESIDENCE NUMBER OF,BEDROOMS [] One [] Four I--I SINGLE FAMILY ~], Two [] Five [] MULTIPLE FAMILY ~ Three [] Six 7. WATER SUPPLY [] INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY [] Other · ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE'* [] PUBLIC UTILITY .YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79)J~J/~,.,~ · · THIS SIDE FOR OFFICIAL USE ONLY 1o TYPE OF RESIDENCE I'--I SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM []INDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified [--]SepticTank or f-'lHoldingTank Size:. tO(~O If Tank is homemade ive dimensions: TYPE OF TANK TOTAL ABSORPTION AREA 4. DISTANCES WELL TO: NUMBER OF BEDROOMS [] ONE [] THREE I-'] FIVE [] OTHER r--I TWO [] FOUR [] SiX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATEINSTALLED INSTALLER BOILS RATING MANUFACTURER~' ~ MATERIAL Septic/Holding Tank Absorption Area ISewer Line 5. COMMENTS [] APPROVED FOR BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) DATE (~.~'DISAPPR OV ED 72-010 (Rev. 6/79) · CHEMICAL & GI~,.~LOGICAL LABORATORIES [,£ ALASKA, INC. TELEPHONE (907)-279-4014 ANCHORAGE INDUSTRIAL CENTER 274-3364 5633 B Street Drinking V~ater Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: Water System Name I.D. NO. Phon~ No. Mailing Address Zip C~de MO. Day Yw SAMPLE TYPE: ,., 0 Routine I-I Check Sample (for routine sample with lab ref. no. ' n Special Purpose " [3 Treated Water [] Untreated Water SAMPLE NO. LOCATION Time Collected . Collected By TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: ~E]/Satisfactory [] I:lnsatisfactory []"Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample, Date Received / '~ / ~' '~' Time Received / [ "~J"Y') Analytical Method: 0 Fermentation Tube · -/El _Membrane Filter Lab Ref. No. Result* Analyst I~F.~°''/¢lI-~ ~-" I IITl I II-I-I I II-FI I II-n READ INSTRUCTIONS .... BEFORE COLLECTING SAMPI'E BACTERIOLOGICALWATER ANALYSIS RECORD _ / / . DEPARTMENT O, HEALTH & ENVIRONMENTAL PROTECTION ) ENVIRONMENTAL ENGINEERING DIVISION · RECEIVED REQU~T ~PROVAL OF INDIVIDUAL WATER ~D S~ER FACILITIES ~IR[C~O~: ~.e ~1 ~; ~ ~ 1. I~ ~ ~11 ~ ~ ~=, ~= all~ t~n (10) ~ f~ ~~~ PHONE ~ LEND~STIT~IO~~~~ ~ ~ ~d 1 * ~ 2 I PHONE ~ R~L~GENT . / . ~ / PHONE ~MAILI~ ~bRE~ [:~ One SINGLE FAMILY Two MULTIPLE FAMILY ~ Three ST EE~T LOCATITC)N 6. TYPEOI": R~IDEN'CE NUMBER OF $EDRO0~ I--1 Four f--I Five Six 7. WATER SUPPLY ~' INDIVIDUAL' [] COMMUNITY [] PUBLIC UTI LITY 6. SEWAGE DISPOSAL SYSTEM J~ INDIVIDUAL/ON-SITE'" [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for ell wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available,) '*If individuel/o~-sita, give inltallation data._./~?' If syttem is over two (2} years old an edequ~y test it required by th;s Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. _~ THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPEC~v~ INSPECTOR D~flECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOI~ [] SINGLE FAMILY F-I ONE r-I THREE [] FIVE [] OTHER · [] MULTIPLE FAMILY I-'1 'rwo [] FOUR [] SIX 2. WATER SUPPLY PERMIT NUMEER [] INDIVIDUAL DEPTH OF WELL C'1 COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED ~O'~) / ~*"~)~_ 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMEER / [ t / [] INDIVIOUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER ~-'~Septic Tank or []HoldingTank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: 'S~°fic/H°ldi~lg'~enklAb~°¢pti°nArea ISmamr Line INaa~t LO~ Line 5. COMMENTS I~PROVED FOR . ~ BEDROOMS i-'l CONDITIONAL APPROVAL (letter must accompany certificate) I--1 DISAPPROVED LEGAL DESCRIPTION 72-010 (Rev. 3/78) ' ~ THIS SIDE FOR OFFICIAL USE ONL~-'''~' ' DATE RECEIVED INSPECTION APPOINTMENTS ~ATE DATE DATE INSPECTOR i NSPECTOR I NSFECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS r-I THREE []'~ FIVE [] oTHER ONE SINGLE FAMILY [] MULTIPLE FAMILY [] TWO I-1 FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connect[on Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY ~,- ~ ~' .Connection Verified INSTALLER []Septic Tank or []Holding Tank Size: If Tank is homemede SOILS RATING . give dimensions: I ~ ~-~ : TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 5. COMMENTS [~- APPROVED FOR ~-~ BEDROOMS I'-1 CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED~ DATE BY (Title) LEGAL DESCRIPTIOI~ o o, 724)10 (Rev. 3/78) ' .~. Telel~one 2644.720 ~ . . REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES MAILING ADDRESS PROPERTY RESIDENT (If different from abowl BUYER MAILING ADDRESS PHONE 6 4-3175 PHONE PHONE 3~' LENDING INSTITUTION 4. REALTOR/AGENT MAILING ADDRESS PHONE PHONE 5. LEGAL DESCRIPTION STREET LOCATION B. TYPE OF RESIDENCE NUMBER OF BEDROOMS P~ SINGLE FAMILY ~ One ~ Four D Two ~ Five MULTIPLE FAMILY ~ ~r~ ~ Six r-i Other 7. WATE SUPPLY ~ INDIVIDUAL* I-'l COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL $¥5; ~=~ * ATTACH WELL LOG. A well log s requ red for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) INDIVIDUAL/ON-SITE" PUBLIC UTILITY If ind v dual/on-s te, g~ve lnsta atlon date ~/'*~ . If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72~I0(3/78) ./' · - TELEPHONE '~ _H~"u~_J& · eEOLOelGAI- LABORATORIES OF ALASKA, INC . o oox..t2?e ^.CHORAOE. A.ASKA ~ '~* .US,.ESS.^.K.LVv :-' --. Ddnking Water Analysis RepOrt for Total Coliform Bacteria TO Bt COMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY LABORATORY: PUBLIC WATER SYSTEM: ~, I.D. NO. NAME p~)WoIM Syetem Nome . '" Me#,~ Add~'eee City ~ State Zip Code SAMPLE DATE: [~ ~ ~ Date Received / SAMPLE TYPE: Analytical Method: [] Routine [] Fermentation Tubs [3 Check Sample (for routine sample with lab ref. no. I [] Treated Water ..~Membrane Filter [] Special Purpose [3 Untreated Water SAMPLE Time Collected Lab Ref. No. Result' Analyst NO. LOCATION Collected By ~,~' . 06-1220 1~) BACTERIOLOGICALWATER ANALYSTS RECORD .~ READ INSTRUCTIONS''' ' '""' BEFORE COLLECTING SAMPLE M....,. Tube R'l)o~'tt ).Orn, TUl)e. pos~tl./'Total ]Omi Form No. 18.310 (~78) ~ ~ Time-