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HomeMy WebLinkAboutCONTOUR ACRES #4 BLK 4 LT 5 Municipality of Anchorage Page ! of _-~ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6050 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: .,VI4,/?¥ o 31& PID Number: O I ~ ~ ~ ~7 Name: ~hn Se~ll Wastewater System: ~ New ~ Upgrade AddresS:~ooo ~DO ~F'~;j ~C~ ?~5--lff ABSORPTION FIELD Phone: i No. of Bedrooms: _ , ~ ~ Deep Trench D Shallow Trench ~ Bed D Mound ~ Other LEGAL DESCRIPTION, ~oil Rating: O, ~ GPD/Sq. Ft. Total Depth fromj ~,o°riginal grade: Lot: ~ Block: ~ CO0~O~Subdiv~i°n:~'~ .~ Depth to pipe bottom~,from~ original grade: Ft.Gravel depth beneath~. ~pipe Ft. Township: i ~N I Range: ~ ~ [Section: ~7 Fill added above original grade: Gravel length: , , ~ I Ft. ~ Ft. WELL: ~ ~l& ¢ D New ~ upgrade ~rave~ width: Number of lines: [Oistance~ween lines: ~, ~' Ft. I Ft. Classification (Private, A.B,C): Total Depth: Cased To: Total absorption area: Pipe material: ~. ~/O Ft. Ft. 108~ SO. Ft. D'307~ Driller: Date Drilled: Static Water Level: Installer: Date installed: Yield: GPM.[ Pump Set at: . Ft.['[ Casing Height Above Ground:Ft. TAN K SEPARATION DISTANCES s Se..c ~ Ho~Uing ~ S.T.E,.. To Septic Absorption Lift Holding =ubllc/PrivateManufacturer: Capacity in gallons: F~om T.nk Field Station Tank Sewer u.. ~n ~o¢¢~¢ ~ ~ I OOO Material: Number of Co~artments: Well- 117' I ~1' - - Eo' + Surface Water I~'~ we'* - - - LIFT STATION N.~, Lot I Line I ~ ~ . . ~ Sizein gallons: Manufacturer: Foundation ~1' ,~, _ . -- "Pump °n" level at: J "Pump off" level at: I High water alarm at: Curtain Pump Make & Model ~ Electrical Inspections performed by: Drain ' ' ' -- I Remarks: Or, q,~l ~ep~C ~ o~a~,~tv BENCH MARK ~ ' ~ ' ' Location and Description: ENGINEER'S SEAL ~ '." : ~'~ Inspections performed by: Fl~k~f ~ ~c Dates: 1st ¢1~1¢V .'~*: ~';'->; .... ~'" · . 2nd ¢/7 ./¢~ ~ ~" .......... '"'"'~"'~' ~'' Department of Healt~d Hu~ervic. es approval ¢ ~...,.,,.~.~""°~°*~ ,. ,,~,oo,~:. , '~'.,' '"~;:, '. CE - 3589 Reviewed and approved by Date: / ~".~,~;,~'~ ........ ~ ., .,~. 72-013 (Rev. 9/91) MOA 25 PERMIT NO: SW940318 PID NO: 01738127 G NEW 68' LONG SOIL ABS. TRENCH WITH 8' GRAVEL H SWING TIES FROM: TO: S.T.C.C. "C" 96' S.T.C.C. "D" 101.5' DBL. C.C. "E" 107.5' DIV. VALVE "F" 109' TRENCH C.C. "G" 145' TRENCH M.T. "H" 142' TRENCH C.O."I" 133' COR. "A" LOT 5 BLOCK 4 COR. "B" 85' 88' 91.5' 92.5' 118' 103' 86' PAGE 2 OF 3 -- "BULL RUN" DIVERSION VALVE NEW 1OOO GALLON SEPTIC TANK '"' / WELL ', ~ 3 BDRM ',,,,,,,, HOUSE ' t ',, R 100' ~ ?e---'------~'', REPLACEMENT W ', LOT 5, BLK. 4, CONTOUR ACRES ', SEPTIC SYSTEM UPGRADE ', AS-BUILT INSPECTION REPORT , FLATTOP TECHNICAL SERVICES SCALE: 1" = 30'-0" ', 14530 ECHO STREET DRAWN BY TFM ANCHORAGE, ALASKA 99516 SEPTEMBER, 1994 PERMIT NO: SW9403181 PAGE 3 OF 3 PID NO: 01738127 TBM (GARAGE ~LOOR) i 1000 GALLON SEPTIC TANK INV. 86.6' GROUND SURFACE @ T.H. #2 ELEV. 87.4' HORIZ. DIST. PIPE INV. 83.4' (BOTH ENDS BOTTOM TRENCH ELEV. 75.4' BOTTOM OF TEST HOLE #2 69.4' (MONITOR TUBE DRY)~ LOT 5, BLK4, CONTOUR ACRES S/D SEPTIC SYSTEM UPGRADE AS-BUILT PROFILE FLATTOP TECHNICAL SERVICES 14530 ECHO STREET ANCHORAGE, ALASKA 99516 JVERT. SCALE 1" = 5' NO HORIZ SCALE DRAWN BY TFM SEPTEMBER 1994 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 996650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 0N-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940318 DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES OWNER NAME:SEAWELL JOHN L &iSAMMYE OWNER ADDRESS:5000 REBANO DR ANCHORAGE, AKi 99516 PARCEL ID:01738127 LEGAL DESCRIPTION: CONTOUR ACRES #4 BLK 4 LT 5 DATE ISSUED: 8/25/94 EXPIRATION DATE: 8/25/95 LOT SIZE: 71874 (SQ. FT.) NUMBER OF BEDROOMS: 3 THISiPERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANKiSYSTEM ALL CONSTRUCTION MUST BE IN!ACCORDANCE WITH: 1. THE ATTACHED APPROVED D~SIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THEiSTATE 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 343-4744 (24 HoURs) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDERiCONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER:i A. OPENED AND CLOSED ONi THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: DATE: DATE: PI-I: (907) 345-1355 August 10, 1994 ANCHORAGE, ALASKA 99516 M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: The purpose of this letter is to provide the required design narrative in support of our application for a permit to upgrade the wastewater disposal facilities on Lot 5, block 4, Contour Acres S/D, located at 5000 Rebano Drive. Soils logs, perc test results, a site plan, design drawings and specifications are enclosed for your review. The proposed system will be constructed between test holes 4/1 and #2. As can be seen from the soil log for test hole #1, the native material between 2.5' and 13.5' is a variable gravelly sandy silt with a measured perc rate of 54 minutes per inch. There are lenses of cleaner material in this stratum, and in test hole//2 we measured a perc rate of 2 minutes per inch in a stratum of silty sand. Using the soil application rate of 0.45 gal/sq, ft./day specified in the wastewater ordinance for soils with perc rates between 30 and 60 minutes per inch, this 3 bedroom residence requires a total absorption area of (3 x 150)/0.45 = 1000 square feet. With 8 feet of sewer gravel beneath the horizontal distribution pipe, the required trench length is 63 feet. The proposed 80 foot long trench design has a total absorption area of 1280 square feet. A diverter valve will also be installed allowing reconnection to the original trench at a future time. The topography of the lot in the area of the proposed construction slopes downwards towards the west at 15%. ~ The proposed project will have no impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any significant impact on reserved space/surface and subsurface, or on drainage. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ted Moore, P.E. LOT 4, BLOCK 4//~ VALVE ~ ,~, 7:~E E PTIC TANK ~ '. ..... ~- ',.~< '. (~P) BE ABANDONED) ~ "-,,, NEW 1000 GAL '- '"~ NEW 80' LONG SEPTIC TANK ,,' ' ' ', '~ SOIL ABS. ,, .. W. 8' SEWER GVL. .' ' ' " ' ~ 100, T.H. LOT 5 BLOCK 4 ,' ', 3 BDRM , HOUSE ORIGINAL '. WELL '.. LOT 5, BLK, 4, CONTOUR ACRES SEPTIC SYSTEM UPGRADE SITE PLAN FLATTOP TECHNICAL SERVICES 1 INCH = 50 FEET 14530 ECHO STREET DRAWN BY TFM ANCHORAGE, ALASKA 99516 AUGUST, 1994 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE. .p, ~0d//~ REPLACEMENT ' LOT 6, BLOCK 4 ', . , - ' TO ORIGINAL TRENCH "BULL RUN" DIVERTER VALVE _~DOUBLE C.C. ~--'-'"-~'---'~ O (~ ~ FROM EXISTING RESIDENCE ~--NEW 1000 GALLON SEPTIC TANK "A" ~ NEW 80' LONG SOIL ABS TRENCH WITH / / 81,5' SEWER GVL BETWEEN 3.5' AND 12' 80 ~ ,iAi, C.O, PLAN VIEW SCALE: 1" = 15'- 0" -- MONITOR TUBE .CLEANOUT -- SOIL COVER 3 1 GRADE FABRIC DIA PERF. DIST. PIPE 8.5' SEWER GRAVEL (8.0' BELOW PIPE INV.) BOTTOM OF EXCAVATION SECTION "A - A" SCALE: 1" = 5' LOT 5, BLOCK 4, CONTOUR ACRES SEPTIC SYSTEM UPGRADE PLAN AND CROSS-SECTION FLATTOP TECHNICAL SERVICES SCALE: AS SHOWN 14530 ECHO STREET DRAWN BY: TFM ANCI~ORAGE, AK, 99516 DATE: AUGUST, 1994 Flattop Technical Services 14530 Echo Street, Anchorage, AK99516 Phone (907) 345-1355 Lot 5, Block 4, Contour Acres 5000 Rebano Drive Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope of the project consists of abandonment of an existing 1250 gallon septic tank and installation of a new 1000 gallon septic tank and an 80 foot long soil absorption trench containing a total of 8.5 feet of sewer gravel. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform with Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 The contractor shall provide adequate cover material and rough grading over all system components to ensure that proper drainage is achieved after settlement and that there are no residual depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas. 1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction. 2.0 Septic Tank: 2.1 The existing 1250 gallon septic tank must be properly abandoned by thoroughly pumping, removing the top and backfilling with soil. 2.2 The new 1000 gallon, 2 compartment septic tank shall be Municipally approved and shall be set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial type, rigid insulation. 2.3 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4'" per foot, and the waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. A double cleanout shall be installed within 5 feet downstream of the septic tank. 2.4 A "Bull Run" diverter valve shall be installed downstream of the double cleanout allowing future diversion of the septic tank effluent back into the original soil absorption trench. 3.0 Soil absorption system: 3.1 The soil absorption system shall be constructed by excavating a 12 foot deep trench parallel to the natural contours of the land. 3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked to allow proper infiltration. 3.3 A total of 8.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with the perforated distribution pipes laid level such that the pipe inverts are no less than 8.0 feet above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. 3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 3.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A minimum of 2 feet of soil cover is to be placed over the filter fabric. 3.6 The top surface of the cover material shall be raised a minimum of 6 inches higher than the surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill slopes shall be no steeper than 3:1. 3.7 Unless specifically agreed otherwise the homeowner shall be responsible for arranging to have the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and seed to promote rapid revegetation of all areas disturbed by the construction. 4.0 Inspections: 4.1 A minimum of 4 engineering inspections will be required during the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the, infiltrative surface to ensure that it is level and at the right elevation,' and conforms with the soil test information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of filter fabric, and (4) after rough backf'fll and grading is complete. The septic tank requires one inspection after it is set level and the piping connected, but prior to backfill. This inspection may be incorporated with any of the above inspections. 4.2 The instfiller shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. TEST HOLE# I FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: Lot 5, :Block 4, Contour Acres DATE PERFORMED: Suly 27, 1994 PERFORMED FOR: John Seawell DEPTH (feet) Pt. 1 SM Reddish sandy loam 11 SM/ML Gray gravelly sandy silt variable, lenses of fine sand SP Clean medium sand ML Gray silt B.H. SLOPE Depth to Groundwater Date No groundwater 7/27/94 M.T. Dry 8/9/94 SITE PLAN T.H. °°9'4 ................ o, Clock Net Time Percometer Net Drop Date Reading Time (minutes) Reading (inches) 7/27 12" Preso,~& 2:40 P.M. 27 1/2 3:45 25 5/8 4:45 24 7/28 2:15 P.M. Dry Add water 2:19 24 7/8 start 3;00 24 1/8 #1 3:30 30 23 9/16 9/16 Add water 3:30:15 24 5/16 #2 4:00:15 30 23 3/4 9/16 Add water 4:00:30 24 318 #3 4:30:30 30 23 13/16 9116 PERCOLATION RATE 54 (minutes/inch) PERC HOLE DIAMETER 7 TEST RUN BETWEEN 7.5 FTAND 8 FT , COMMENTS: S0il stratification is indistinct and variable within the test hole as well as between test holes. This perc test was conducted in material which visually appeared to have a higher silt content than much of the material encountered in the test hole, and thus may be somewhat conservative. PERFORMED BY FLATI'OP TECHNICAL SERVICES. I ~'..¢..~'~'~,.e,.~_ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: .~f~?'c4.j'/- {~,, /~)~ TEST HOLE LEGAL DESCRIPTION: DATE PERFORMED: PERFORMED FOR: DEPTH (feet) COMMENTS: FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION TEST Lot 5, Block 4, Contour Acres July 27, 1994 John Seawell Pt SM Reddish sandy loam SM/ML Gray gravelly sandy silt Dense, with lenses of sand SM Gray silty sand Soft, variable with gravel and silt lenses SM/ML Gray sandy silt damp B.H. SLOPE Depth to Groundwater Date No groundwater 7/27/94 M.T. Dry 8/9/94 A _,,,T4, ....... .* ~ . ,, ~. SITE P~N T.H. " : t5%: : : : : : : Clock Net Time Percometer Net Drop Date Reading Time (minutes) Reading (inches) 7/27 12" Presoak 1:36:45 27 3/8 1:39:25 23 3/8 Add water 1:40:15 27 3/8 Start 1;44;05 23 3/8 #1 1:47:05 3 22 1 3/8 Add water 1:47:30 23 1/2 #2 1:50:30 3 22 1/8 1 3/8 Add water 1:51 23 3/8 #3 1:54 3 22 1 3/8 Add water 1:54:45 23 1/4 #4 1:57:45 3 21 7/8 1 3/8 PERCOLATION RATE 2 (minutes/inch) PERC HOLE DIAMETER 8" TEST RUN BETWEEN 8 FTAND 8.5 FT Soil stratification is indistinct and variable within the test hole as well as between test holes. The measured percolation rates demonstrate the range in permeability encountered within a short distance. PERFORMED BY FLATTOP TECHNICAL SERVICES. I ~7"'~ ~LOw, rW,~ ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: /~q'~" t/~ /'9"¢y SAY ~ILLIAH$ ~RILLING $76B447 P.O1 '~UNICIPALITY OF ANCHORAGE Hea 'and Environmental Prote¢ ,n Fourth Floor West 825 L Street Anchorage, Alaska 99501 279-2511, x 224, 225 INSPECTION REPORTON-SITESEWAGE DISPOSALSYSTEM " -.,~ ~ ~ . _. _ Ac_ re_..5 SEPTIC TANK: DISTANCE . FROM INSIDE LENGTH_ NUMBER OF .^..~:^~T..~. ~--~i~~----.^',~.,^. :__T__~. ! COMPARTMENTS INSIDE WIDTH ~ LIQUID DEPTH ~__ LIQUID CAPACITY .. ALLONS, ! DISTANCE FROM WELL FOUNDATION f'~O ~ of Lines ..... / DISTANCE BETWEEN LINES ABSORPTION AREA _____,~/~:b'--~ SQ. FT. LENGTH OF EACH LINE __ DEPTH OF FILTER DEPTI{: TOP OF TILE TO FINISH GRADE ! TOTAL LENGTH NEAREST LOT L,NE OF L,NE MATERIAL BENEATH TILE 7 / ';N.-ABOVE TILE ~ IN, SEEPAGE PIT: Log Crib Rings DIAMETER ~ OR WIDTH _ Crib Size: DIAMETER .... BUILDING FOUNDATION .... NEAREST LOT LINE ., LENGTH , DEPTH DEPTH_ DISTANCE FROM: WELL TOTAL EF-FECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. Class: ]..207/Z:), Depth: Well Distance To: Lot Line Bldg: Sewer Line: Pipe Materials: # of Bedrooms: Installer: ,,'~.o~T~ ~' Remarks: ./~-~ iziJ:::'J:::'J 'i' I'":i:::tl'.,! .... !t"ii(":t::;J"J' ii' I'"ll'.,i t..'T'i!!:i :i::i.J.:',::t. C:Oi',i"j'Cii..iF;.: "!" H t:!!: t .. Ii:i; .i'.,!r:ii"l" H [) :!: !'"!ii:i: h,I !!:~; :1: O !:',t ]i :ii!; "i" H!!ii: i. !::i;!'.,!t:;ii'T' F! ,:: ] J",! F: ii!i:l:ii: 'T' ::' l'.i:Jj:::' 'T' H!!!i: "i' i:;.: E Hr::: I"-J I:::t Fi: I:::,Fit !:::i '?'Hi!i!: !":,I~!?'T'I...I CIF: tq T F;i: !ii!: !'.,! ('?.t O!:;it F:']:"t' ;ii:!!!;-I'I-'-JE: [) ]: :~i;"J"F:lHC:!i!i: !i!!', E: "i" !.,J !!~Z E N "I" .F..! 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I::; Ii!i: ::.:i C !:.:!',,,'!::;I 'r' :[ !":! t'.,t ,:: ]: (,.,t I:::' Ii!!: i~!!:"!" ). ~ment of Health and Environmen' "rotection Anchorage, Alaska 99507 S()II,S I,()(; I'I.;I{(~I,A'I'II),N 'I'I.:ST I'~,rf'orm(:d for -.~-' l, ~ 3,, ~,/{ , , . , ~ lhis l~r'm rcl)arLs: Soils log ~ ............ i~'~-r~i~Ti~h"(~ .................. - Ih:p th aL Wl,dL dui, th? / / Septe,~d:)er 23~ 1977 %76721 John Seawell 4710 Kershner Anchorage, Alaska 99503 Subject; Permit Expiration Dear Mrt Seawell= A permit issued by this department for well and/or on-site 8ewer installation on Lot 5 Block 4 Contour Aores Addition ~1 Subdivision has expired since the iesue date exceeds one (1) year. In the event you still plan to install the well and/or on-site ~ewer system, a new permit is require~. The original soil test may be used to obtain a current permit. If the well has been drille~, a well log should be sent ~o this aepart~ent to ~c~ument the installation date. If you have any q~emtions regaraing the above matter, pleaU dO not hesitate to contact this office imme~iately at 264-4720. Pratt, R. S. :i; E:iE t:;::"1" :!: I::: "r' T H i:::I'T' ::I..: :1: t:::11"t I:::1:::11"'t ]: L.. :1: I:::t1:;i: H :1: 'T'H 'HIE I:;i:li~;l:.::.!l...l t:::'i::)i:;i:'T'H E',"r' TH[ii; i"'jl...ll",1:1: E: :1: I::'I:::IL.. I""r' 01:::' ;;ii:: :i: i.,.I :[ I...I .... :f: I",l'.iii;Tl:::ll....I .... 'T'HE: :iii ii:FI :1:I",1 1:::1( :ili; :i: G t",t[E [':' ' I:::1 t:::' t:::' I.,.. :1: I !. M-W DRILLING, Well Owner Location DRILLING LOG Use of Well (address of: Township, Range, Section, if known; or distance main road Lot ~ Bloc~ Contour Acres A~,'' Size of casing f~'~ Static water level Screen ( Depth of Hole 16:) ft. (~) ); Perforated ( ). Describe screen or perforation N/A Well pumping test at ]' / 3 gallons per ~1~,~) of drawdown from static level. Date of completion (i / 2 5 / 7 7 550 feet Cased to 158 feet (below) land surface. Finish of well (check one) (minute) for 1 hours with open end ( .x.-< ); ft. Depth in feet from ground surface WELL LOG Give details of formations penetrated, size of material, color and hardness Casing stickup Fill 7 .TO. TO. ~' Organics Silty graw~l Snnd Silty gravel, cgbbly Sand gravel _Loose sandy 8rave. 1 Silty sandy gravel TO, i 0 0 TO. 120 .~ .....TO TO, '! 2 -- STATE Well Owner Location DRILLING, INC. DRILLING LOG Use of Well (address of: Township, Range, Section, if known; or distance main road Size of casing. .Depth of Hole Static water level ft. (above) Screen ( ); Perforated ( feet Cased to feet (below) land surface. Finish of well (check one) ). Describe screen or perforation . Well pumping test at gallons per (hour) of drawdown from static level. Date of completion Depth in feet from ground surface ]. 5 0 TO. 1.:: .:_3 ~ TO. - [.~ 0 TO /:20 TO, 475 475 TO. 550 TO. TO. TO. TO, TO, TO, TO. __TO. TO. TO, open end ( (minute) for hours with WELL LOG Give details of formations penetrated, size of material, color and hardness Soft bedrock Gray bedrock Bedrock, fracture zone (soft') bi5 Bedrock Bgdrock, water seaps in sporadic fractures Certified Contractor Cm'tihcmte Nh%_ ,q!4 & 973 ); ft. 2 -- STATE MUNICIPALITY OF ANCHORAGE ' - '- · ;''' ' ' ~ '  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street- Anchorage, Alaska 99501 ' · - ' ' ' ' ' I~'~ ENVIRONMENTAL ENGINEERING DIVISION L_ · ' .... :~ Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER~FAOIEITiEs DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER I PHONE John R Sammye L. SeawallI 279-8586 ~ MAILING ADDRESS Star Route A Box 169K 99507 PROPERTY RESIDENT (If different from above) PHONE 2, BUYER PHONE Same MAILING ADDRESS 3. LENDING INSTITUTION I PHONE First National Bank of AnchorageI 276-6300/482 MAILING kDDRESS ' Post Office Box 720 99510 4. 'REALTOR/AGENT I PHONE n/a I MAI LING ADDRESS 5'; I"E~AL DESCRIPTION Lot 5 Block 4 Contour Acres Subdivision, 4th Addition STREET LOCATION NHN Bainbridge 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [] Four [] Other [~X SINGLE FAMILY ~ Two [] Five [] MULTIPLE FAMILY [] Three [] Six 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTI LITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give wel depth (attach log if available,) 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY **If individual/on-site, give installation date. 19 7 7 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. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOI NTM ENTS TIME TIME TIME DATE DATE DATE INSPECTOR I NSP ECTOR DIRECTIONS: INSPECTOR 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTI LITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] I NDIVI DUAL/ON -SITE []PUBLIC UTILITY Connection Verified []Septic Tank or [] Holding Tank Size: 1~=~,~;'~ If Tank is homemade give dimensions: NUMBER OF BEDROOMS [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SIX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOILS RATING TYPE OF TANK MANUFACTURER... TOTAL ABSORPTION AREA 4. DISTANCES WELL TO: MATERIAL [] OTHER Septic/Holding Tank IAbsorption Area JSewer Line INearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS DATE I~"~APPROV ED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED IBY (Title) LEGAL DESCRIPTION 72-010 (Rev. 3/78) MUNICIPALITY OF ANCHORAG~ Department of Health and Environmental Protection 825 L Street, Anchorage, Alaska 99501 264-4720 ~equest for Approval of Individual Sewer and Water Facilities Property Owner: John R. Seawell Jr & Sanm~e L. S~awel] Day Mailing Address: SRA Box 1691K Phone: 279-8586 Name of Buyer: same Mailing Address: Phone: Lending Institution: 1st National Bank of Anchorage Mailing Address: P.O. Box 720 Anchorage, Ak. 99510 Phone: 276-6300 x.482 4. Realtor/Agent: n/a Mailing Address: Phone: Legal Description: Lot 5 Blk 4 Contour Acres Sub 4th Addition Street Location: NHN Bain Bridge Single Family Residence: (X) Number of Bedrooms: 2 Multiple Family Residence: ( ) Number of Bedrooms: Water Supply: *Individual Well (~ If Individual Well, well depth 550' If Community System, name of system Public/Community System ( ) Sewage Disposal System: *~Dn-site System (X) Public System ( ) If On-site System, date of installation: July 1977 by Newton Excavating *NOTE: 3/77 A well log is required on ALL wells drilled since 6/75. ** If on-site sewer system is over two(2) years old, an adequacy .test is required by this department· A fee of $25.00 must accompany each request before processing can be initiated· Yours Truly, Paula M. Cranmer Loan Processor