HomeMy WebLinkAboutKIMBERLY MANOR BLK 1 LT 4Onsite File
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Municipality of Anchorage Page I of 2
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number:. SW990419 PID Number:. 017-07,3-21
ROBERT YOUNG
7601 COX DRIVE
Ph°ne:(907) 345--4184 5
LEGAL DESCRIPTION
4 1 KIMBERLY MANOR
To.nahlp: ' IRan~e: _ ISectlon: _
WELL/ [3 New lB Upgrade
PRIVATE 282 n 282
ALPINE DRIMJNO &: ENTERPRISES 12/9/99 149
15 ~ 280 r~ 2
SEPARATION DISTANCES oS. puc
I%ld Stat;on Tonic ~S~/P'~
Well 100'+ 100'+ -- -- 25'+ ~
Water 100'+ 100'+ -- --
Lot
Une §'+ 10'+ --
FoundoUon 5'+ 10'+ -- --
Curtain
Droln NONE KNOWY
Remarks:
Wastewater System: r"l New n Upgrade
ABSORPTION FIELD
Deep Trench [:] Shallow Trench 0 Bed O Moun.~,,~ Other
TANK
[] Hola~ng ~.,,,~$.'r.~P.
- LIFT STATION
BENCH MARK
Inspections performed by: AWWC, INC. Dates: 1st 3/3/00
2nd
3rd
Department of Health and Human Services approval
R~viewed and approved bY:c:~'~y/¢-~, /c~¢~.- Dote:
PERUff NUUBER:
'SW990419
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD. $UI1~ 2B. ANCHORAGE, AK. 99504
KIMB£RLY SUBDIVISION; LOT 4. BLOCK 1
T'fp£ OF WORK:
AS-BUILT OF' NEW WELL LOCATION
ROBERT YOUNG (907)
mT[:~/7/00 I J.W.U./J.LId. 1 = 40' 2 OF 2
Department of Health and Human Services
825 'L' Street
P.O. Box 196850 Anchorage, Alaska 9§519-6650
P./ck M.ysfrom http~l/www cl anchorage ak us
Mayor
Permit Number:. #SW9904~L9 D~'~ ~fl,~.~ -/./-_?.3-.g9
Date Started: 12.R-.q9 Date C'.om.rd,,ffed: 1P-.q--09
l~operty Owner ~Name & Address:
Borehole Data:
Sell Type, Thickness &Wata' S~u~a
stick-up
organic and ~Tt
gravelly silt
silty sandy gravel
silty gravel
water sand & gravel
appears to be high in manganese
gravelly silt
silty water sand & gravel
wa{arsenal gravel
Parcel Identification Number:. 017-073-2f
In well lacatcx] at approved !~mlt lc, cation? [] Yes [] No
kimberiy menor blk 1 tt 4
Rot)err & Trucly Young
PO Box 111871
Depth (ft)
From To
0 2
2 9
g 141
141 148
1#~ 215
215 222
RECEIVED
FEB 24 2000
Mur~iclpality of Anchorage
Dept. He,!th & Human Services
222 265
265 279
279 282
Method of Drilling [] air rotary. [] cable tool
Casing ~ype: steel
Wall Thickness: .2.5 inches
Diameter: _6 inches Depth: ,282 feet
Liner Type:
Diameter: __ i~ches D~pth: ~ feet
Casing stickup above ground: 2 feet
Static water level (from ground level): 14g feet
Pumping level: 280 feet after
_2 hours pumping/5 gpm
Recovery Rate: 15 gpm
Method of Testing: airlift
Well Intake Opening Type:
[] Open End [] Open Hole
[] Screened Start ~ feet Stopl~'d __ fee~
[] Pcfforatlons Start ~ feet Stopped feet
Grout Type: bento.ite ~ 8 Volume: 2 b~*
Depth: Sta~t~ f~et Stopped feet
Pump: Intake Depth feet
Pump size ~ hp Brand Name
Well Disinfected Upon Completion? [] Yes [] No
Method of Disinfection: Clorine tablets
Comments:
Well Driller: Alpine Drilling & Enterprises
P. O. Box 110496
Anchorage AK 99511
AftentiAn: Th~ ~~;d~, ~ w~ll lr~o tn fl*~, nrnr~,~tv ~wn~' whf,;,, ~h~d,~vq nf~,nmfll~tlnn nncl the nr,nnerrv
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ON-SITE WATER SUPPLY PERMIT
Upgrade
Date Issued: Nov 23, 1999
Expiration Date: Nov 22, 2000
Permit Number: SW990419
Legal Description: KIMBERLY MANOR BLK I LT 4
Design Engineer. 0041 AK Water & Wastewater Consulta
Owner Name: Robert & Tmdy Young
Owner Address: PO BOX 111871
ANCHORAGE, AK 99511-1871
Parcel ID: 017-073-21
Site Address: 007601 COX DR
Lot Size: 34500 SQ. FT.
Total Bedrooms: 5 Permit Bedrooms: 5
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Privy
[] Private Well [] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either. A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
5. The following special provisions.
EXISTING WELL SHALL BE PERMANENTLY DECOMMISSIONED IN ACCORDANCE WITH AMC 15.55.060, J.,
2. PRIOR TO THE WELL DRILLER LEAVING THE PROPERTY.
Date: /'/'-
Date:
Alaska Water & Wastewater Consultants, Inc.
6901 DeBarr Road, Suite 2B ~ Anchorage, AK ~ 99504
(907) 337-6179 ~ Fax (907) 338-3246
Consulting Engineers
November 12, 1999
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Reft Well Upgrade for Kimberly Manor Subdivision, Lot 4, Block 1
To whom it may concern:
The existing 5 bedroom house is served by a private septic system and a private well. We are
proposing to install a new well on the reference property because of water quality concerns in the
existing well. The old well will be abandoned in accordance with the municipal water well
ordinance (AMC 15.55.060). Dave Harper with Alpine Drilling will be drilling the proposed
well. Attached is the site plan which shows the proposed well location. I am unaware of any
adverse impacts this installation would have on adjacent wells or septic systems. If you have
any questions, ple~7 contact me at 337-6179, or 244-9612. Thank you for your assistance.
(~ e----..~Sincerel' ~
~;[~ ~ ~' '~" ~'~'
· \ 11. BK 1 t/ LOT 10 BIC I ~ LOTg. B~ 1
KIUBERLY MA.NOR KIUBERLY IRANOR & ~MB~LY ~OR ~ I KIMB~LY ~OR / KIUB~LY ~OR
~ ~ ~ ~ ~ J /'~' _/
KIUB~LY ~OR
~TZeK~ ~1 ,' ~ I'--~l _L~ /
KIMB~LY ~OR I~1 ~ ~-- I ~ /
~AS~ WA~R ~ WAS~WA~R CONS~T~S,
6901 D~R R~. SU~ 28. ~C~ ~. 99504
PHON~ (907) 337-8179/F~: (907) 338-3248
~ D~CRIPT~N:
KIUBERLY MANOR SUBDIVISION, LOT 4, BLOCK 1
TYPE OF WORK:
SITE PLAN
PREPARED FOR: PHONE NUMBER:
ROBERT YOUNG (907) 545-4184
J.W.M. 1 = 100' 1 OF 1
· . '~,~ .~ MUNICIPALITY OF ANCHORAGE
~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PRO37ECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
LEGAL DESCRIPTION
LOCATION
DISTANCE TO: I Weft / OO /
' ' ' Inside length
L,q.jca~t~n gallons IF HOME.DE:
Dwelling
~ g T~ of tile to finish grade & / Material ~nealh tile
NO. OF BEDROOMS
i Ab,o,P,iOn , Dw~lli.gq [:, PER~l~i~, ~J 0
Width Liquid depth
~ ~ Type of crib Crib diameter Crib depth
uJ Well Building foundation
m DISTANCE TO:
~ DISTANCE TO: I~uilding foundation Sewer line
Material
~/ inches
PERMIT NO.
Liquid capacity in gallons
Distance between lines
Tolel e(~e~.ebsorption area
PERM}T NO.
Nearest lot line
Distance to lot line
Septic tank
PERMIT NO.
Absorpt on area(s)
OTHER
PIPE MATERIALS
1~ 3o 3q
SOIL TEST RATING
! 5'O
INSTALLER
REMARKS
'7~t
APPHOVED
72-013 )Rev. 3178)
DATE LEGAL
8 -3- 78
PERMIT
~ 11Jl'-.I T C.. I PAL I T"~' C,F A~-ICHORF-IGE
' DEPARTMEHT~"""'"HEALTH AND ENVIRONMEHTAL/--""qTECTION
i ,, 825 '_-.STREET, nr]CHORAaE,
m3~--S I TE SEI.JER UPGRADE PERI"11 T --
APPLICANT- JAMES.I.IYSONG
LOCHTION COX DR/HILLSIDE DR
LEGAL L4 B1 KIMBERLY MANOR
TYPE OF SOIL ABS~RBTION SYSTEM
SRA BOX 404C
TRENCH
LOT SIZE
~44 52~9
41000 SQU~RE FEET
MAXIMUM NUMBER OF BEDROOMS = 5 SOIL RATING (SO. FT/BR)= t50
THE REQUIRED SIZE OF THE SOIL ABSOP,_~ON SYSTEM IS:
THE LENGTH DIHErlSION IS THE LENGTH (IN FEET> OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTFINCE BETHEEH THE SURFACE OF THE'
GROUND 8ND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETHEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE E×CRYATION (IN FEET).
REIg..U I RED SEPT I C T~NF~-. S I -~'E= 1500 GALLOI'-.I$
PERMIT APPLICANT HAS THE RESPOHSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY HELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE HELL WILL SERVE.
TI-10 ( 2 ,-" I I'-ISPECT I OP-.IS ARE REQL~ I RED
BACKFILLING OF ANY SYSTEM HITHOUT FINAL INSPECTION ArID APPROVAL BY THIS
DEPARTMENT HILL BE SUBJECT TO PROSECUTIOH.
MINIMUM DISTANCE BETHEEN A HELL AND AHV ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL~ OR
i5~ TO ~0~ FEET FROM A PUBLIC HELL DEPENDING UPON THE TYPE OF PUBLIC HELL
OTHER REQUIREMENTS HAY APPLY. ~ SPECIFI~TIONS AND CONSTRUCTION DIRGRArl: PRE
8VRILAE:LE TO IN~URE PROPER IN~TRLLR~ON.
I
1:
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
~: I UNDERSTRHD THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO IHCLUDE MORE THAN 5 ~EDROOMS.
...........
CERTIFY THAT
I RM FAMILIAR HITH THE REQUIREMENTS FOR ON-SITE SEHERS AHD HELLS AS SET
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6.6~,
SOILS LOG - PERCOLATION TEST
[] SOILS LOG
/t~ PERCOLATION
TEST
.E.FORMED
LEG^
OEPTH
(FEET)
2-
3-
4-
6-
7-
8-
9-
10-
11-
- 12-
13-
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
SLOPE SITE PLAN
14-
15-
17-
18-
19-
20-
COMMENTS
Reading
Date Gross Net Depth to Net
Time Time Water Drop
'72-008 (7/76)
.. ',certified Well
Db~ to water,hie p~Hn~..~)? .~,~..,~.. ~'"c" '~ ....... :.at ram ,,
.,.. ~.. , . :',... ~.~~.-. ~--,~: ..~ ~ ~ ,-,
,'. ,,. '..:. ' I ~dffy the ~e;t~ue ~ mrr~t.L ' ,.x,.; -
,.:', , '-.' "',..~.: '" .., '. '..,:....~.~...~...:z..~:' ~ " ' ~ ..... ~.~ .............
. ,____
.. ".. . · WELL DRILLING' ~ '::
",,,/ '.' ',." ..'.: ~ ~ 0~-~' ' ~ .~ ': ~':
"' ' ..... ~ ..~b ~ "~Z~ -,~'-¢'~,"
DATE
INSPECTOR
CE';~ ~ ~:'~J
. .l>.l - ,~" : ~ t. r ~ C,
I~PECTION AP~INTMENTS
~U~ICIPALII~
MUNICIPALITY OF ANCHORAGE DEPT. OF HE~ &
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROT~I~[~
SEP ~ 9 1~,
ENVIRONMENTAL SANITATION DIVISION
RECEIVED
BEQUEST FO~ APPROVAL OF INDIVIDUAL WATE~ AND SEWEfl FAOILITIE~
DIRECTIONS: Complete all parts O, page 1. Incomplete requests will not be proce~ad. P~ease allow ten (10) days for processing.
1. PROPERTY OWNER
M~LIN(~ ADDRESS
2. 8UYER
MAILING ADDRESS
& ~ENOING
4~EALTOR/AGENT
L,/ONE
,~ SINGLE FAMILY
[-'1 MULTIPLE FAMILY
7. WATER SUPPLY
INDIVIDUAL*
[] COMMUNITY
r-I PUBLIC UTILITY
8. SEWAGE DISFOSALSYSTEM
'~ INDIVIDUAL/ON-SITE**
r-'l PUBLIC UTILITY
/q'%'~ }q D r'
NUMBER OF~BEDROOMS
[] One [] Four
[] Two .[~[ Five
[] Three [] Six
r-i- 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.)
~//~7~c~ YEAR ON-SITE SYSTEM WAS INSTALLED.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
~2-010 IRev. 6/79) ]~T~
1. TYPE OF RESIDENCE
[] SINGLE FAMILY
[] MULTIPLE FAMILY
THIS SIDE FOR OFFICIAL USE ONLY ·-"
NUMBER OF BEDROOMS '
[--I ONE ~- I-'1 THREE [] FIVE
I-'1 TWO I-"1 . FOUR i'-I . SlX
OTHER~
2. WATER SUPPLY
PERMIT NUMBER
r-i INDIVIDUAL ,
r-I COMMUNITY
[] PUBLIC UTILITY
Connection Verified
3. SEWAGE DISPOSAL SYSTEM
[]INDIVIDUAL/ON -SITE
[] PUBLIC UTI LITY
Connection Verified
[]Septic Tank or •Holding Tank
give dimensions:
TYPE OF TANK
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
PERMIT NUMBER
DATE INSTALLED
INSTALLER
If Tank is homemade SOILS RATING
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELLTO:
Absorption Area to nearest Lot Line
SepticlHoldmg Tank
IAbsorption Area
ISel~er IJIne I Nearest LOt Line
5. COMMENTS
~ED FOR '-~ BEDROOMS
[] ' CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE
72-010 (Rev, 6/79)
ANCHORAGE CESSPOOL PUMPING
Star Route A, Box 144
ANCHORAGE. ALASKA 99502
Phone 344.2632 er 344.2453
,,%
CHEMICAL & GEOLOGICAL LABORATORIES ~,," ALASKA, INC.
TELEPHONE (907}-279-4014 ANCHORAGE INDUSTRIAL CENTER .' c~/
274-3364 .-- ~ ~ 5633 n Street
Drinking'Water Anaiysis Report for Total Co!!!orm Bacteria
TO BE COMPLETED BY WATER SUPPLIER
TO BE COMPLETED BY LABORATORY
Mo. Day year
SAMPLE TYPE:
1:3 Routine
[3 Check Sample (for routine ~ample
with lab ref. no. )
D Special Purpose '-
SAMPLE
NO.
I
I
I
I
I
Treated Water
El-Untreated Water
Time Collected
Collected By
READ INSTRUCTIONS
~Analysis shows this Water SAMPLE to be:
[~]:Satisfactory
.1~-] Unsausfactory
[] '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 /'~ -/- ~'/1
Time Received /
Analytical Method:
13 Fermentation Tube
.... '13 Membrane Filter
Lab Ref. No.
Result* Analyst
I ~
BACTERIOLOGICALWATER ANALYSIS RECORD
BEFORE '" ~ "~"
COLLECTING SAMPLE
MUNICIPALITY OF ANCHORAGE ..... */
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ~"
B25 L Strum. Anchm'~e, AlCoa ~501 J~/L
ENVIRONMENTAL ENGINEERING DIVISION ~ : i
Telephone 264,4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTION~: Cont~et~ all pitts on p~ge 1. Im~em re~ue~ wlil not bi pr~. I~l~tl~ a41ow ten (10) d41y$ for proc~ng,
3. LENDING iNSTITUTION
MAILING ADDRE~
PHONE
4. RF-~LTOR/AG ENT
MAILING ADDRESS
PHONE
c~ ............ i'--I One [] Four [] Other
~ o,,~<3~.= r~m,~.~ [] Two ~ Five
[] MULTIPLE FAMILY [] Three [] Six
7. WATER SUFPLY
~ INDIVIDUAL* * ATTACH WELL LOG. A well Io~ is required for ail wells drilled
[] COMMUNITY since June 1976. For wells drilled prior to tha~ da~, give
[] PUBLIC UTILITY depth (ettechlog if available.) / ~/i, ~ ~./
-
~- ~ --- ' /' If system is over two (2) years old an adequacy test is required
TIME
DATI~
THIS SIDE FOR OFFICIAL USE ONLY
INSPECTION APPOINTMENTS
TIME
DATE
INSPECYOR
INSPECTOR
DIRECTIONS:
DATE RECEIVEO
TtME
0ATE
INSPECTOR
1. TYPE OF RESIDENCE
r"] SINGLE FAMILY
r-'l MULTIPLE FAMILY
2. WATER SUPPLY
[] INDIVIDUAL
I-1 COMMUNITY
I--1 PUBLIC UTILITY
Connection Verified
3, SEWAGE DISPOSAL SYSTEM
[] INDIVIDUAL/ON -SITE
[]PUBLIC UTILITY
Connection Verified
[~"ptlc Ta'0,k or [] Holding Tank
Size: /..~'-~u If Tank is homemade
gi~ dimensions:
TYPE OF TANK
TOTAL ABSORPTION AREA
4. DISTANCES
WELL TO:
COMMENTS
[] ONE []
[] TWO []
PERMIT NUMSER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
PERMIT NUMBER
DATE INSTALLED
INSTALLER
SOILS RATING
MAN U FACTUR ER./~t,./L.~
MATERIAL
~e~iC/HoIdil~ Tank IAblO,pfio~ Ar.
NUMBER OF BEOROOM~
THREE [] FIVE
FOUR [] SiX
[] OTHER
Lot Line
~'"/'APPROVED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
°ATE //'
72-010 (Rev. 3/78)
CiL~_,gRLQ OEOLOCI~ L~.DO'R/:.TO?J~3 O, ~,~[L-R., IL, ·
P.O. BOX 4-1276 ANCHORAGE, ALASKa, 99509 4649 BUSINESS PARK BLVD.
Drinking Water Analysis Report for Total Col~form Bacteda
TELEPHONE
(~)7) 279-4014
· TO BE COMPLETED BY WATER SUPPLIER
TO BE COMPLETED BY LABORATORY
PUBLIC WATER SYSTEM:
Mo. Day Year
SAMPLE TYPE:
r'] Routine
D Check Sample (for routine sample
-- with lab ref. no ....
[~:)eclal Purpose
SAMPLE
NO.
1
2
3
4
LOCATION
I I
Code
I-I Treated Water
[] Untreated Water
Time C.=llected
Collected ~¥ -
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
Form NO. 18-310(3-78)
LABORATORY:
CHEM & GEO LABS OF AK., INC.
NAME
4649 BUSINESS PARK BLVD.
ADDRESS
ANCHORAGE, ALASKA
CITY
Date Received
Time Received
Analytical Method:
Fermentatipn Tube
Membrane Filter
06-~220 (b)
Rev. 1978
Date Collecte4
Lab Ref. No. Result* Analyst
BACTERIOLOGICAL WATER ANALYSIS RECORD
]Omi ]Omi 2Omi ]Omi ]Omi 1.0mi
OJml
GREATER ANCIIORAGL AREA ~OROUb..
Department of [nvironmenLal quality
3330 "C" Street
Anchorage, Alaska 99503
M()II,S I,O(; - I'I~I{OI,ATION TEST
Perfo~d~ for :_..~.~ ._f~.?_.-_.-_.-_.-_.-_.~..~.~?"~ Date
This fom reports: Soils log x / Percolation test
Depth
Feet
1-
2-
3-
4-
5-
6-
7-
8-
9-
10-
ll-
-.12-
14 - l/
Was ground water encountered?
~> ___ If yes, at wi~at depth?
Reading Date Gross Time. Net Time Depth to Water
Net Drop
Percolation rate -----~inute.
-Proposed installat--i-6'n?-~-ge Pit Drain Field
Du)th of Inlet . Depth to lf6'E't~ of pit or trench
co,.~,~s. __. ~z _ ~~ ~ ~.~.,~~- -
~erfo~d By.~~~---.Sertified By:
E(~-040 (6/74)
~Ja te: ....
,,,o, Street,.i h.o.ry,'Alaska ggso,
--~,~.~ .~0' . ~ Date Receiv~
~ ~ '~~ Date of Inspection
~ X ~x ' ~ .)MDIVIDUAL SEWER & WATER FACILITIES
1. Approval 'requested by: ~ ~~ ~
Mailing Address:
2. Property Owner:
Mailing Address:
e
,- Phone:
4. Location:
5. Type of facility to be inspected
6. Well Data:
A. Type~'
c. constructtorf?F-
Sewage Disposal System:,-'/~'~/
B. Depth / ~'~'
D. Bacterial Analysis
A. Installed
C. Septic Tank: 1. Size
B. Installer' ~
,s~
2. Manufacturer sn~w~ ~c,~s~
D. Seepage Pit: 1. Absorption Area
2. Material
E. Disposal Field: Total length of lines
8. Distances:
A. Well to: Septic tank
Nearest lot line
, Absorption area
Other contamination
, Sewer Lines
B. Foundation to septic tank
· Absorption area
C. Absorption area to nearest lot line
EQ-034 (1/74) Page 1 of two pages
.' j~ 2 of two pages - Re ~t for Approval of Individual '~r & Water Facilities
'Legal bescrtptton ~ ['~"/ .~¢/~,~ /'~'~'~ .~'//~Y'J
p,..,e, cr_
r/-~j ~proval~alid for one year frm date ~gned
Greater Anchorage Ar~a Borough, Depar~ent of Enviro~ental Quality
DIAGRAJq OF SYSTEM
I certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED Date
EQ-034 (1/74)
April 17, 1975
To whom it may concern:
I hereby certify that the sewer system is
functioning without overflow.
· ,,'Une 3,
Y~'. ~ ~
P. O. ~ox 8~73
J~, J~u~J
ggS08
&)
b)
soil, ~ a
you hisv~ ~ qu~t/C~, plense ~ i~ee t~ ~u,~.a~ aa at; 274-4561,
an~-i,',', 133.
4040 "B" STREET,
ANCHORAGE, ALASKA' 99503
PHONE: 907-279-2581
May 22, 1975
W.O. 817331
51r. James Wysong
P.O. Box 8973
Anchorage, Alaska
99508
SUBJECT: Lot 4, Block 1, Kimberly Manor. Subdivision
Dear Mr. Wysong:
In response to your request, a percolation test was performed
on the subject property this date. The test was performed.as
directed by Mr. Lynn Coad of the Greater Anchorage Area
Borough, Environmental Quality Department. Location of the
test was on the 4.5 foot to 6.0 foot level as approximately
situated on the attached map. The percolation rate of this
soil, field classified as Sandy Silt ML, was 37.5 minutes
per inch or approximately (interpolate~) 275 square feet per
bedroom by Greater Anchorage Area Borough standards.
If we may be of any further service to you in this matter,
please contact our office.
Very truly yours,
ALASKA TESTLAB
~,~)zias M. }latch Geologist
OMH/vms
Attachment
.4
0
0
0
0
Q
Z !
0
0
0
0
0
0
0
A~t! Z4, lg76
4-1
First Illtto~li
P. O. Box 720
Anchorage, Alaska
~510
ATTENTZ~: Paul& crm~r
SUBBECT: ' Sever and ~ster fectlltte$ serving Lot 4, Block 1, i~t~berl~
Hano~ Su~ilvlston
Dear Hrs. Crd,-r:
An Inspection of the subject lot revealed tho following discrepancies:
&) The extsttng se~er $~$tam t$ a~ unapproved
b)
cesspool. The subject lot Is tfl & poor
soll ar~ tbere¢ore · sotl test an the
ts requtred ~o detemlno the n~
se~er s~stma size nd insure sufficient
cr~ funds are set astde.
The vel1 15 In a pti end mst be upgraded
extending the casing 12' abm the 4" va11
dratn~lpe. Escrov funds ~111 be required.
This department vtli '~tthold 1ts &pprov&l until sot1 test results ire
tn ~nd the ss~er s~stem design meisur~qts relayed to Xou for accurita
'esttmtlm of escr~ f,mds. The vel1 airy be up~aded at · lat~r
~ cmpleti~an date v111 be requested for the ~ell and sewer
upon receipt of sotl t_,~t results.
Sincerely,
Les Buchholz, R.S.,
S aa t ta~t I~
La/ko
6111 Scofleld