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Home My WebLink AboutHULSE #2 LT 4 DAT~= RECEIVED ,5 INSPECTION APPOINTMENTS TIME TIME TIME INSPECTOR INSPECTORp ¢ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEC~I~I~pATL. IT~YFOHFEAALNT~H&ORAGE 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL PROTECTION ENVIRONMENTAL SANITATION DIVISION TelephOne 264-4720 S~F~ :[ 1981 REQUEST FOR APPROVAL DIRECTIONS: Complete all parts oll page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing. J PHONE 1. PROPERTY OWNER MAILING ADDRESS PROPERTY RESIDENT (If dif e) ~J PHONE 2. BUYER ,/~ /.,q PHONE MAILING ADDRESS 3. LENDING INSTITUTION ,//~ IPHONE MAILING ADDRESS 4. REA~,~/AGENT ~ ~ PHONE 5. LEGAL DESCRIPTION STREET LOCATION~~-'-'~ 6, TYPE OF RESIDENCE SINGLE FAMILY [] MULTIPLE FAMILY 7. WATER SUPPLY ~ INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY N__UMBER O F ,B E DROO~S~t-~ I_J One k0' Four [] Other ~ Two [] Five []. Three [] Six *ATTA(~H WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled 'prior to that date, give well depth (attach Icg if available.) 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/0N-SITE** 77 [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVI DUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED [--iPUBLIC UTILITY Connection Verified INSTALLER []Septic TaD_k or [] Holding Tank Size: J}~.~ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TO: Septic/Holding Tank IAbsorption Area ]Sewer Lin. I Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS BOVEOFOR BEDROOMS [] CONDITIONAL APPROVAL (lette}/r~ust/~company certificate) t/111 [] DISAPPROVED ,/'3 I/.~Y~I DATE (~.~ ~~ 825 "l." STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 ( [b)lb::;C M, StJLLIVAN, t)EPA8 YMENTOF HEALTH AN[) ENVIRONIVI[ I~ll AL September 3, 1981 Jack Jordon 1658 Eagle River Road Eagle River, Alaska 99577 Subject: Lot 4 Hulse Subdivision #2 Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (2) The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. The septic tank pumped With a receipt submitted to this office for our, review. If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw CC: Valda Drake % Dynamic Realty 501 West Northern Lights Boulevard 99503 STATEMENT 8K 882 ~ ]VlUNICIPALI~' OF ANCHORAGE 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 ~1 ~?IO~S: Complete all parts on page 1, I~omplet~ requests ~ill ~t b~ process~, Please allow ten (10) days for processing. PHONE 1, PROPERTY OWNER PROPERTY RESIDENT (If ~fferent from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3, LENDING INSTITUTION I PHONE I MAILING ADDRE88 4, REALTOR/AGENT I PHONE I MAILING ADDRESS 5. LEGAL DESCRIPTION ;TR EET LOCATI ON . TYPE OF RESIDENCE ' ' ./ NUMBER OF BEDRO~)MS [] One ~. Four [] Other~ ~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY * 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.) 8. SEWAGE DISPOSAL SYSTEM ~/~ ~ INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date ~ J¢ If system is over two (2) years old an adequacy test is required [] PUBLIC UTILITY by this Department. ~ il~z ~.~ II>g NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78)~U THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED Connection Verified - INSTALLER Size: .~_,~__~O If Tank is homemade SOILS RATING give dimensions: t TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL ~T~ -~ 4. DISTANCES Septic/Holding Tank Absorption Area ISewer Line I Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5. COMMENTS [~'PPROV ED FOR ~" BEDROOMS [] CONDITIONAL APPROVAL (letter must acco/~y certificate)r LEGAL DESCRIPTION 72-010 (Rev. 3/78) August 28, 1979 Jaek W. Jordan 1658 Eagle River Road Hagle River, AlasP~ 99577 Subject: ~t 4 ~{ulse Subdivision Approval for your individual sewer and water facilities can not be granted until the following irons have been completed: (1) The water analysis report be delivered to this office from Chem Lab~ 5633 B Street, for our review. (2) A w~ll log submitted to this office. If there are any further questions, please contact this office a&t 264-4720. Sincerely, RDbert C. Pratt, Associate Specialist RCP/lJw cc: Peoples Bank and Trust Mortgage Loan Department Pouch 7~007 99510 /'~UNICIPALITY OF ANCHORAGE~! He~ ~h and Environmental Prote ion Fourth Floor West ; 825 L Street Anchorage, Alaska 99501 264-4720 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL S~-STEM LOCATION MAILING ADDRESS SEPTIC TANK: DISTANCE ['~ FROM W ~. L L ~¢Jft~ --. INSIDE LENGTH MANUFACTURER ~__MATERIAL INSIDE WIDTH LIQUID DEPTH NUMBER OF COMPARTMENTS LIQUID CAPACITY/'~4~"''~ GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL~___FOUNDATION ~ of Lines DISTANCE BETWEEN LINES ABSORPTION AREA_~.- ___ SQ, FT. LENGTH OF EACH LINE DEPTH OF FILTER / DEPTli: TOP OF TILE TO F:INISH GRADE MATERIAL BENEATH TILE_~ TOTAL LENGTH ___NEAREST LOT LINE_. _OF LINE ~Z/~" TRENCH WIDTH ~'.-~IN. TOTAL EFFECTIVE IN. ABOVE TILE IN, SEEPAGE PIT: DIAMETER OR WIDTH ILENGTH .... DEPTH Log Crib Rings Crib Size:i DIAMETER .... DEPTH .... DISTANCE FROM: WELL -- TOTAL EFFECTIVE BUILDING FOUNDATION__ NEAREST LOT LINE ABSORPTION AREA (WALL AREA) SQ. FT. Well Class: Depth: Well Distance To: Lot Line Bldg: Sewer Line: Pipe Materials: ~ ~ of Bedrooms: ~ Installer: ~ Remarks: F F L I ..MN [ JRCK ..TOR[:,~F~ LOC~T I ON LEGRI_ LT. 4 HIJLSE :,,-'D .l: ,2: ): F'aL. ]: T%." E:,EPRRTMENT' HERLq H HN[.:, E. NVZRUNMEN1 825 '"L" STREET., ANCHORRGE., AK. 19F1R W I LE:,WOOD LOT S I ZE ,.~.~..~:. ,~.L '=,¢~11RRE FEET 'T'¥PE OF SOIL. RBSORBTION SYSTEM IS: TRENCH I"IRX I PlUM NUMBER OF BE[:,ROOMS = '4 SO I L RRT I. NG (SQ FT,.."BR) = :1.]:5 THE REQUIRED SIZE OF THE SOIL RBSORPTION SYSTEM IS: THE LENGTH DIMENSION IS THE L..ENGTH ':.'IN FEET) OF THE TRENCH OF.'. E:,RFIINFIELD. THE DEPTH OF R 'TRENCH OF.". PIT IS THE [:,ISTRN(]E BETWEEN 'THE SURFRCE OF' 'THE: GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET). THERE IS NO SET WIDTH FOR TF.'.ENCHES. THE GRRVEL [:,EPTH IS THE MINIMUM DEPTH OF: GRRVEL.. BETWEEN THE OUTFFlLL PIPE RND THE 80TTOM OF THE EXCRVFITION (IN FEET). F" R C: t-=:::: R ,:~i E F' L R l'-.i 'T C, P 'T ..T. (] i"-.t R PBCKFIGE PL..RNT WRY BE INSTRL..LED BT THE PERMITTEE"S OPTION SUBJECT TO THE FOLLOWING CONDITIONS: i. EITHER R CLRSS I OR I I NSF FtPPROVF-D PL.RNT t'18¥ BE I NSTRLLED. 2. R CONTINUOUS MRINTENRNCE RGREEMENT IS REQUIRED. IF R MRINTENRNCE RGREEMENT IS NOT KEPT CURRENT '¢OU f'lR'¢ BE REQUIRED TO ENLRRGE THE SOIL RBSORPTION SYSTEM RND,,"OR '¢OU MR¥ BE SUBJECT TO PROSECUTION. . * .... -- -" - a ...... "=' F-" E u"~ IUI ][ #.~.. E. E.- c',,,- ' -'"' '" - 1HI:, BRCKFILLING OF FIN'¢ _,~=TEI1 WITHOLIT F'INRL INSF'ECTION RND MFFF.. IqL. BY " '- ;I]" .... Il 'FI DEPFIF.'.TMENT W ILL. BE SLIBJECT' TO PF.: _ :,EL.- T I _ N. MINIMUM DISTBNCE BETWEEN Ft WELL RND RN¥ ON-SITE SENRGE DISPOSRL SYSTEM IS i~'_.'~E~ FEET FOR Fl PRIVFITE WELL OR 2~9~] FEET FOR Fl PUBLIC WELL WELL LOGS FiRE REQUIRED RND MUST BE RETURNED TI:) THE DEPFIRTMENT WITHIN ]:0 DFI"r'S OF THE WELL COMPLE]"ION. OTHER REQUIREMENTS MFl'¢ RPPL¥. SPECIFICRTIONS RND CONSTRLICTION DIFlGRFlMS FiRE FiVRILFIBLE TO INSURE PROPER INSTFlLLFlTION. I CER]"IF'¢ THRT ~L: I FlM FFiMILIFiR WITH THE REQI...IIREMENTS FOR ON-SITE SEWERS RN() 14ELLS FlS SET FORTH 8'¢ ]'HE MUNICIPFlLIT'¢ OF RNCH()RRGE. 2: I WILL INSTRLL THE S'¢STEM IN RC:CORDFlNCE WITH THE CODES. ~:: I UNDERSTFlND THRT THE ON-SITE SEWER S'¢STEM MR¥ REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REM(]DELE(:, TO INCLUDE MORE THRN 4 BEDROOMS. S I GNEt}: ............................................................................... Fl""' 'F F F L. I ~.HN] JRCK 3330 "C" Street Anchorage, Alaska 99503 SOILS LOG - I'E~OLATION TEST Perfo r~d fo~ ~ ~ ~ ~i~ ~ ~__~ ..... ~=s:-~-~ Legal Descr~,t~o~ ~.~ - ~' ~: :. ..... This form repv~'c~; ~v ~ . ............. ~[ .... Depth Feet 2 10- II - Date Pe rformed__~ Was ground water encountered? ...... ~_r~_ ......... If yes, at what depth? Reading Date .~ro~s Time ~Net Time' ::::: :::::::::::::::::::::::::::::: Dept. h to Water Net arop )ercolat~on rate ~ ....... ,_~ p.. , Drain Field ............ '~. r., ,osed installation: Seepaqe ll; , top ueptt~ of Inlet · FROM TO FORMATION ACCIDENT -- SLOPE TEST NAME) ft. WEJGHT ON bit NAME HRS BIT AND COREHEAD RECORD MUD RECORD FILTER CAKE MTL ADDED REMARKS REMARKS TIME RECORD KELLY DOWN FROM SLOPE TEST @ TO ACCIDENT:-- (GIVE NAMEI DEG OFF FOR M ATION ROTARy SPEED BIT AND COREHEAD RECORD MUD RECORD TIME RECORD DRILL STEM RECORD RUN NO WEIGHT DRILLING SIZE D. P i~OT^R~ WEIGHT PUMP NAME HRS I AND COREHEAD RECORD II MUD RECORD TIME RECORD DRILL STEM RECORD BIT RUN NO, F WEIGHT DRILLING SIZE D P. SIZE VI$C. CORING SIZE COLL.