HomeMy WebLinkAboutSAUERWEIN LT 1LO 0
t__- A r--=' 1_1 [__ i- o -7.. �_._� r— r-"! r t R._- r i V__I t—:. r -Y wa r_::.
DEPAF:TMEN- OF HEALTH AND E IJ',; IFi itJMf:IJTP' F'F�:C TEC TION
`_:.TFEET, AtlC;HL:IFAI=;f_, hiE;. 5i11.
J l•1F_I__L__ t -hi •#_— 'i� F='E F'f' I I - /cy �'�5�
PER.IlI T NO. c )I"N , r
A `d( 8
AF'PL I CRtJT S �S � �n 5 , pC I F'lS %��
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LOC:ATICIN C�_( ,q J2c(
LEGAL 3 [ Lt S `� C --k u e L( 3 O c(l/ E -C IT [IzE 1(7 (72 :=GIUARE FEET
�cr7wc�0D 1)vric� (i-Crc�_�-5
TYPE CIF :OIL ABSORPTION SY-TEM I`•:
MAX I MUM NI. IMBER IF BEDROC INS
THE RECiIIIRED -17E OF THE SOIL AB'S'ORPTION -YS TEM I:
E E.= F' T F A =:: L_ I= 1'-4 t -i T• F -I =-:
THE
LENGTH DIMEN'=ION
IS THE LENG.111 (IN FEET) OF THE TRENCH OR DRAINFIEI_D.
THE
DEP-T H OF A
TRENCH
OR PIT 15 THE s-CANCE BETWEEN THE SURFACE OF THE:
GROUNC)
ANC- THE
BOTTOM
OF THE F`,CA'v'FiTION (IN FEET.),
THERE
IE 1.40 'SET
WIDTH
FOR TRENCHES.
THE
GRA' -/FL DEPTH
IS THE
MINIMUM DEPTH OF GRAVEL. BETWEEN THE OUTFALL PIPE
AND
THE G:OTTi IPI
OF THE
EXCAVATION (IN FEET''.
F='Ir t Ie l I E�. F _ 1_`�
=: k.=. F '
_ I_ I rr �_. Fl r --i U-:-: I: � :1-: - -- t fl, --f E-- 1. _ (:t r a
PERMIT nF'PI_ I CANT HAS THE. RESPOhL• I B I L I TY T.I:i I NFOF'f'i THIS DE PAR TMENT DI_IF I NCi THE
IN' TFILLATICItJ INSPECTIONS OF ANYtJEI_L 11L',1110EFJ"C TO Chil F'E?C1PER1"Y Htlt; THC
NUMBER OF PT . I DLhU= FS THAT THE WELL WILL SEF,VE.
- -- -- -T- 1....1 r I c: ; r ? I' r-.9 �. F=` E t. -'C• 7C t'a� r-! '� r =a F �. k:=.: tl'� � E=v t � F..1 ]. F<t k� �- t::-° — __.. _
BAC:KF I LL_ I N CIF AN -r' SYSTEN W I -CHOI.IT FINAL I N = PECT I ON AND APPROVAL BY I'H 1 -
DEPARTMENT WILL BE SUBJECT TO f''FCI-ECI_IfI01J.
N I NI MUN D I _ITANC.E RE'TWEEN A WELL
AND ANY ON-SITE
SEWAGE- C: -I SPOSAL SYSTEM
I
100 FEET FOR A F'RI.,'ATE WELL OR
:1.50 TO 200 FEET
FROM A PUBLIC WELL. DEPENDING
IPCIN THE TYPE I -IF PUBLIC: WEI. E_.
M I N I MI_IM CJI : Tf-INC:G FROM R PR I'v'ATE
WELL TV A PRI ,'ATL=
SE NFF" L. I NE_ IS `. FF_ET"
Fit K,
T! i H I CI M M Ur4I1'Y SERER LINE 1':-, 75
FEET.
WELL LOGS ARE REI!UIRED AND f9UST
BE FETURNED TCI
THE DEF'APTMENT WITHIN ?fI
f
OF THE- WFLL CCd•1PLET I CIN.
THERE-r!I.11 REMENT_: MAY APPLY.
SPEC i F I CAT I ONS AND
C:r_IW' Ti-:IJI_ T I I -N D I Fn3F:Af l
F1F=:E
t=I'dA I LAPE_E Ti i I N: I_If= E PRCIPER I hL' TALLAT
I CIN.
-1 -I- F✓ -:: F' T i ^' F '=
Eti E t- F=w t" 1 ! : F: _ F- :5_..• I _ + : =1 e:_ 1
I CEF;T I FY TI -IAT
A. I AN i= AN I L. I FJF: WITH THE FOR Ord- -.[ TE ::[EWERS• AND WELL A'=
"IV HF7CIL. T# t InF'ar.�
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� _- 7z;! C -a', 1 s,
f °t;I14I C Brat.
I "f<- a)Zt L1 �
L E . ;
Fir
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OF, L"st;E,fi[,pi_ti'i' s � _.t_t 11_. 'x:11 I I NO (SQ i= ( : f t 5
TM, is FAQ 41J 1 Sk
F 111%0 = 'F L£Q i'
pp IIV S.S.0Ii_ i {''sit' `1 Fill€ '# sr:? I'! -I [ f
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t PIC MF hctts;r,l H ON 1= E F) t`!11- fili:i: F-'tp. H OR
04:1 t ef—I t-li OF E ]Z1-tst::sy P I f 1'5 Tt i :C) i n T: t,'!±'T t�� t t,t it t i } 't� ?i'; tr":i Frr flit
f; O tND ili'IF? Tri; f-JYTOM OP flHl:E'''t#`',`r'IF"f(M C1'l1 FtJ:r).
3 C NO ' r r tt 10 rill FOR
I'Nf-' 1,11PIT'e'c t_ Dfi. '' 01 1. `i !fit 141 N I14r_111 DZ0 f I1 CY f3fzii%,, E_ t7t_ rI-IlF AFI CtI:; t-pf t rf:'),A_ L, f` I Pf;.'•
rl}14� iS;?z Fi _1Tt't"fEi i:r: THA [ };s;tt`,•'fi`t Is7F'F 4 i€ Ft" 0.
} � f e } tom.+I”- d�%}_.�. fi} 1'�F
U,471RM liiln•a Lyy�..ii(i C *:i�! f.'�)R.�ft] 1TWE
--Idt'% IpI I_a F" I I_t11 t T I OP6 01:' t`it V F?{L.t..,s ICI M15, PROPERPe 81-10
t'11 -18IFY fir THAT T E ;t: Y! IJ. 011-L,
._.� ..._. ,.�-`[,�f:� eb s.,_ - 1 i••Z '�" +��' [ e {. [; i ._ °� "• i�:_ r. i, t r. €"vs "F
11.10, f:rl' t>' :r' t'#'M t,} 1 FHOUT T i 1010_ t i1`=•r_: F I f-111 AND 1'11 'F't{ OWr., Q -1Y rf-f r
DE%r"i,`: R IEU I MIA, Pi 31_0.,4wi. €' ft."
[3r'lT)!; N A Idt "U 111-1C� F11ti` r,t1.#- '� I I s t EdtSf ;{' 4j F :::t='f)'.;;i'it � `t':_: RM F';
F0 21Qo PCf-'r FIRION 8 Pl.tEj1.,1 14_1._(._
r_i-'t:tlt isf F"e ' f_f 1-•I.It?LIC., lshg_I..F...
I`i t t`t 1 i it i1F (, T1j11s_'t: r I'€`-IE'I II }-•„ I tr`tiT 3.11;!,1- 1=1'i m r.: 1571'{ ]-I }'-1•rr i'. (_ t t It' is ',?'; rf c (
111rl_I_ t_ftG'i, t E4:rtfi,ilt�)cL) 3FlLi I`3ii::� E'f. E='vC1_rt I11?I7 If_t I2It; t:�t�}='tir Tl'1;�FtI 1$3 f�tYtd sIJ (tJl'e`j
Ctr t'I r? i ir`t R_ t':C:i1 iF'LL� T 1 f;fti,
i`f I'}i3::F! ;:: r-fhf€J 1 � t� C'it' 11?`'� i'}t f`r' ti:-'F°'i., �`. '; t iE [': t {' 1 f't r i C Citi' iI1']t'� f;,t'�td`� fn'I_r1�: i`;1.;11Q f3 F € if3S:I�It•P,:� t`It^`;:, �:
sI',r1=i r_ I_i GIU: rr, 1. N,' A_+,4:r. ; r t,tr= ER.
1=�°�--`€rA�9� �- '►� �_�_:<<�•` 7r: �r:��..�=, ca�1::f:=:a:-�€��it �1 _C�: "_��'�,.� •;< .-:���_E
t Y CIRTIr Y t lAr
1 I I`it'1 t't il•I I I_ I AR, I'1I Pi THE- r, 1;d! f t 1:ta1'k tt r,;: FOR s to 't 1 C� i 1'li > :` 171110 W$-IA,F,,s ti': '=�. T
FORM e'tt t`t-?i-_` "1i£ I iI']tTU .- - 1
2:I WILL I F'1'e: IJ€i(_E,•' THF-, `?'i `:) 1 c 14 !.lit i'If:'S�:f_t}�i-�f i it.:r .. I'll 111 t M- t_.f:iO r'�,
iF CIN -`a t T'i: _:F:3•?- P, '1'd_ i-€Rtq id1;'f' t:'E €..'L]I pr dot ]I91= f j' ;]•It -u r 1F ISI -i4,
;•-:r e.It t1f:: }:'sr1'N=1t? 3_r 'C,;] Cttt`IJ-if;ta rtf`ff: 1,4141-41 t CECIII �at:tHS.
iI 'i1_{f�1it#f
IvAkunicipality
of RJ.
.corgi_
825 "L" STREET
ANCHORAGE, ALASKA 99501
(907) 264-4111
GEORGEM. SULLIVAN,
MAYOR
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
�
December 31, 1980 U �. � I
Susan S. Pringle
Post Office Box 198
Girdwood, Alaska 99587
Permit # 80042.2
Subject: Lot 38B Girdwood Small Tracts Subdivision
1
A permit issued by this department for well and/or sewer
system has expired as of this date.
Permits are issued on a calendar year basis, as staged on
the permit, by authority of Municipal Ordinance.
If you have drilled the well, a well log should be sent
to this department to document the installation date.
If an engineer inspected the installation of the on-site
sewer system, please have them send us the as-builts for
our files.
if there are any further questions, please call this
office at 264-4720.
Sincerely,
' / 1 4-C
Les N.
Buchholz, R.S.
Senior
Environmental cialist
LNB/ljw
enc: Copy of Permit
SWP/057
\1
C_
r" 6 A._0 P-9 9:--o � ='fl U_ I -IF U-ru U'D F- 9 VA 0 IFA A' F." 6=-o [
C-EF'RF?-I•t'IE N'r HE ALTFI AND EP• V I F:ONP'1EP•4TAI... "OTE.C:TI ON
821)L.. =TREE T. ANCHORAGE.. AK. +9_.01
264-41.20
1T1PF'LIC'F1NT
SUf3FIN
S. PRIhU"iLE
FOST OF7FICE E.C4<; J.9::3 995F
r',I_ 251.9
L.00:FIT10N
AUr'ESP:H
R(: AD
L...EGFIL
LCIT 38B
GIF:GrWC1OD SMALL
TPACJS : LOT SIZE 471-1,12
`:,i-iUriRE F'EE=.•f
1•'11 P•d 1 HUM D I STt-11',I E BETWEEN A WELL. AND ANY ON-SITE '_ E NAGE: D I'S;F'OSAL. E,4'STEM IS
:1.17-10 FEET" FOR A PRIVATE 14ELL OR 150 TO 2C,Cl F'EE:T FROM A PI.,IE,LIC: WELL DEPENDING
UF'OP) THE' T','F:,E OF PUBLIC WELL.
11I.P.JIMUM DISTAt-JC:E FR011 A F'RI%ATE I,IE:LL TO A PRIVATE LEVIER L_IP•,IE IS 25 F'E=ET AND
To A C:(D INUP•1 I TY SEWER L I hIE= IS 75 FEET.
I.,IELI_ I_CIGS ARE REQUIRIED AND I''11_ST BE R(_:TURkIED TO THE: ClE=F'ARTP'1EtIT 1,11-fFaN _0 DAYS
CIF THE 14ELI... COMPLETION.
OTHER, REQUIREMENTS P II='I'r' ADPL',•'. SPEC: I F I C AT I CiNS ANC, C:ONSTF:I_OC T I ON E:l ] A13RArls ARE
AVFilLABLE DD INSURE PROPER INSTALLATION.
^ fl • :: fl"^'9 �: '9 9= w' : F=" a. : E:w ° 4 9 A:,:".= L= I ° 9 = L FK_ - : 9_
1 C:E:I :T' 1F71,.1 THAT
�1, : 1 AI'fI F'AM I L 1 FIR I.,.I I TH THE REI !I_I I REMEhIT S FOR ON-SITE SEWERS AND WELLS FPS:; _5ET"
F'C IRTH BY '1"E IE: P' UP•d I C; I F'AL I TY OF ANCHORAGE.
I kIIL.L it•d-sTALL TFIE 'mY,_::;TE:P'1 IN ACCORDANCE WITH THE CODES.
APPLICANT SUSFIN S. PRINGLE
BY—
M -W DRILLING, INC.'.
DRILLING LOG
Well Owner
Use of Well
Location (address of: Township, Range, Section, if known; or distance main road_
',.-r lf I0
Size of casing - Depth of Holefeet Cased to feet
Static water level ft. (above) (M6'Wi) land surface. Finish of well (check one) open end
Screen ( ) ; Perforated
Describe screen or perforation
Well pumping test at Lt'` gallonsper (hour) (minute) for J hours with_�
of drawdown from static level. ft.
Date of completion
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
--TO-
--TO
TO
TO
TO ,3,i; iesi
TO
TO-
--TO-
TO-
TO-
TO- it Z,_
TO % I
G?Nifft L 61-
TO -
2 — STATE
MUNICIPALITY OF ANC f ORAGE
DEPARTMEN JF HEALTH AND ENVIRONMENTAL PRL CTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-X472.0
Application Date 'QAC'\I P•r(
1. GENERAL INFORMATION
I_ (a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
r ' _C'c C.
'I)
(b) Applicant Name( U- -1—V 1.4L'bP Telephone: Home 2 `.�� (C� _ Business
/
Applicant Address
a, �
(c) Applicant is (check one): Lending Institution El ; Owner; f��RIt r1ZX ; Buyer 0 Other El (explain);
(d) Lending InstitutionjL�1((`r,Ut;�C`. J-.Cati1
Telephone
.-------------_--
C j ----- --- -------------
Address
(e) Real Estate Company and Agent
Address ---- ----------___--
Telephone
(f) Mail the HAA to the following address:
-
�;bUhNI S
--- �'� � =IIS=---�-=��'---------- -- — - -----
2. TYPE OF RESIDENCE
1
Single -Family - Multi -Family 0 Other
l)
Number of Bedrooms
3. WATER SUPPLY
Individual Welt Community D Public 11
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite C7 Publicj Community ❑ Holding Tank 0
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 i2 025(11:84)
6,
A. , -91
5. ENGINEERING FIRM PROVIDING. SPECTIOWS, TESTS, FILE SEARCH, DAI. AND INFORMATION
A -s certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Heat.
Autftoriiy Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the nurnber 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
,waste,vater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of chis inspection.
Name of Firm _i ==r :'_`_.+1 i r_+_rC. t :- I Yu, C -r_ 1 h
ele one
p Addreas
Date -_f2
e
Al
r�oo° 00000�°_ •�'lsoo-•apgar
a3. WAY r: I� SDCtt5gT1
V 1- � l✓
DHEP APP OV%A_L t_,._,
!a$drooms by .�tjate
Disapprov d --___----- Conditional
Terms of Ur�d;t!onal Approval_—
CAUTION
Engineer's Seal
The Mu; �; a !f o" Anchorage Department of Health and Environmental Protection (DHEP) issues Flealth Authority
fppro;al f,cate1 based solely upon the representations given in paragraph 5 above by an independent professional
engjnr� r crj te-ed in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
inst tut .r ,r, orUer to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
anayze data oefore a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
profe-'cfrj,—,;'. c,),�pnrers work.
AZ4141bt1L1WA fflY OF Ah QH0RA C;E
MUNICIPALITY OF ANCHORAGE (MOA/ O#- HEALTH &
HEALTH AUTHORITY APPROVAL (HAA} 1NViRQNMtrN!FAd PROTECTION
CHECKLIST - FEBRUARY 1984r
264-4720 �1'` �� �7 2 i 5,�
c
Legal Descri tion:1A%' m
11
A. WELL DATA
Well Classification _ IPR W &TE If A, B, C, D.E.C. Approved (Y/N)
Well Log Present (Y/N)--ZC451 Date Completed//1/77—Yield-
4
_ Yield D _
Total Depth �C Cased to ��= Depth of Grouting _
Static Water Level Z Pump Set At y �r
Casing Height Above Ground — 3 op Sanitary Seal on Casing (Y/N) / �7
Electrical Wiring in Conduit (Y/N) KOS Depression Around Wellhead (Y/N) /{�®
Separation Distances from Well:
To Septic/Holding Tank on Lot /l%D ; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot — aN� ; On Adjoining Lots
To Nearest Public Sewer Line ! s o $ To Nearest Public Sewer,
Cleanout/Manhole % To Nearest Sewer Service Line on Lot _
Water Sample Collected by
Water Sample Test Results
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes (Y/N)
Depression over Tank (Y/N)
Size
Air -tight Caps (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
Comments
Page 1 of 2
72-026(11/84)
�'*AWW*100 ; Date — &A4 /*S_
No. of Compartments
Foui
Date Last
ped
.:for
ut (Y/N)
Temporary Holding Tank Permit (Y/N)
Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
C. ABSORPTION
Soils Rating in Absorption
Date Installed
Width of Field
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
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
"i
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N) —
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
On Adj Ing Lots
To Existing or Abandoned System on
To �tbank (if present)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent(Y/N)_
S% Pumping Cycles during Adequacy Test. Meets MOA
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I hive checked, vjkifiA, or conformed to all MOA ar d HAA gyideline in
Signe w"° Date —
Compan MOA No. —
E'
Receipt No. rj 5
Date of Payment i� .- a 1 "SSS
Amount: $ qh
Page 2 of 2
72-026 (11!84)
°
r' a T �
0
9 W4
®s••••°•• •••
e
® • O AYNE HEN RSON �
® `® ice•°°• CE -4488 °. 4 41
n the date of this inspection.
Engineer's Seal