HomeMy WebLinkAboutHILLSIDE NORTH #2 TR D-2B�C)u\-031-g(.)
_ Development Services Department
--\ Bui;dinc Safety G;vision
i on -Site ` c/ Ie- & Wastewcter Fro it
gr -t_ it
4700 3rogow Street -
n.0 Bo:- 19665'C)
Mark Begich Anc:•iorcoe, .A': 99519-6650
Mayor wmv.munl ora/onsite
(9007;!343-7904 -
Pump Installation Log
Well Drilling Permit Number: SW_ Date of Issue:
Parcel Identification Number:
Legal Description % A ^ / * Property Owner Name & Address:
Hl' /l 61 6L e, oYtil -2 pq+2-01 Syyoa'{ U,,J tr'r,64-
RoQs�! pMnl�2th
Pump Installation Date: '7 5 -11t
� aK•
Pump Intake Depth Below Top of Well Casing: 'IQ feet
Pump Manufacturer's Name:
Pump Model: -00 1 18 512
Pump Size °sy hp
Pitless Adapter Burial Depth: (A feet
Pitless Adapter Manufacturer's Name: *,,A
-
Pitless Adapter Installer: /VAA
Well Disinfected Upon Completion? R( Yes ❑ No
Method of Disinfection: &.7- P9z& `
Comments: d
Anchorage PUMP & Dell Service
Pump Installer Name: 330 Past 76th Avenue
Anchorage, Alaska 99513
Phone: 907-243-0740
Fax: 907-243-0742
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name DISTANCES
1P 2 (t0 B Erg j 13 o "or -e EN TO SEPTIC ABSORPTION
Address FROM TANK FIELD WELL
3345"
WELL SID +loo
Phone(s) Permit No. No. of Bedrooms '
5t#t_g3&z- Sw 900ogS ,5
LEGAL DESCRIPTION LOT LINE +7_0 +Z,•0 +7,0
Lot Block Subdivision ll
12� 2B /¢!/51067 volzri f L FOUNDATION 30 4. S10 +Z0
Township, Range, Section
1� � � �G � AS -BUILT DIAGRAM (Show location of well, septic system, property lines, foundation, / N / /1 1, driveway, water bodies, etc.) 50 1 W/" -o G/%uCz,
TANKS ., a
SEPTIC E9
Manufacturer Capacity in gallons
Atil5i %fiNIC /SdO
Material No. of Compartments
�tl
TYPE OF SYSTEM
TRENCH ❑\\BED ❑ W. DRAIN ❑ OTHER AD
Depth to pipe bottom from Total depth from original grade V
original grade FT /O -s' FT N
(3/tG Fill added above original grade Gravel depth beneath pipe
Z FT /y. S' FT
Gravel length avel width
-5-0O FT Gr3 FT
Total absorption area Distance between lines
6 -b SO FT N,4 FT
Number of lines Soil rating Pipe material Nj
/ /ZS— SOFT Cs fa 40"P<1 303'f 4eye4 t•
Installer 41, Date Installed
N(EGfotJ glZoS /o& ,/e"le Z /fro F JDG.(�
WELLS S
i
PRIVATE ❑ OTHER (Identitvl
Classification (A,B,C) Total Depth Cased to C
FT FT F D.
Installer Date Installed:
914M PAX i v o
REMARKS:
E
-Pa riii ADDED 0~`1�
Scale: /ns 3p' R'
C E -V /h OA GE — 90 -- 010 11 Inspections Performed by: +r % ,Ms•; �`r' 1
/.E. N• GUlGSOIJ /G�i �/� �3�P so
Date:
No
(� #�{j/GSO�/ GAS certify that inspection was performed according to all ;' 113!
Jtuata 28„ Iwo
Municipal and State guidelines in effect 2,0,90 #��51°
�`►�,pq p���
Health Department ADDroval: "�`�"�� Date: �—L
^ MUNICIPALITY OF ANCHORAGE
Department o� He�lth & Human Services
825 L Street, Anchorage, Alaska 99501 4720
ON�SITE SEWER &
Permit Number: 900035
Date Issued: 02/13/90 Engineer
Owner Name: ROBERT BUNDTZEN
Owner Address: 3345 GEAWINQ CIRCLE
ANC. -A!, AK 99515
SEPTIC TANK 14 WELL PERMIT
Designed
Day Phone:
� 561-4362
Parcel Id: 041-031 ..... 80
Lot Legal: Subdivision: HILLSIDE NORTH #2 Lot: TR D Block: 29
Section: 6 Township: 12N Range: 2W
Lot Size 339780 (sq°ft" or acres)
Max Bedrooms: This Permit: 5 Total Capacity: 5
SEPTIC TANK: Minimum total septic tank
capacity:
11,500
ga1lons"
Each septic
tankmust have at least 2 compartments"
Depth to
top
o� septic
tank(s) < 4`O
�eet requires insulation over tank(s>"
WELL: Log must be submitted to Municipality oi Anchorage Department o� Health
and Human Services within 30 days of well completion,
DEVIATION FROM EN8INEER'S DESIGN MUST HAVE DI -IHS APPROVAL PRIOR
TO CONSTRUCTION, NOTIFY DHHB BEFORE EACH D
EXCAVATION �UST BE OPENED AND CLOSED ON THE SAME DAY OR BE
HEATED OVERNIGHT, THIS PERMIT IS FOR A 5 BEDROOM S.F. RESIDENCE
ONLY, AND EXPIRES ON 12/31/90" A LIFT STATION INSTALLATION WILL
REQUIRE THE APPROPRIATE ELECTRICAL INSPECTION,
l CERTIFY THAT:
1. I any familiar with the requirements /or on-site sewers and wells as set
forth by the Municipality of Anchorage (MOA) and the State of Alaska"
2" I wi1l install the system in accordance with all MOA codes and regulations,
and in compliance w/ith the design criteria of this permit^
3, I wilI adhere to all MOA and State of Alaska requirements Ior the set back
distancrom any existing well, wastewater disposal system or public
sewerage syst�m on this or any adjacent or nearby lot"
it. I understand that this permit is valid Wr a maximum of, 5 bedrooms" I
also understand that the capacity o�� the totaI system is 5 bedrooms and
any enl t ill d ti l permit,
Signed: ~�� �� ����_���
^^ ,�����_�����_^���,��
(Qwner> Miff", AUNITANT1
Issued By: DATE:
.... ��/.......... ...... -^ ~��'~7�-�~-=�;+���~-�� '
� "
14-01141WTAMIT IM111:111M WoM�M
1201 Ramona St. 99515 ANCHORAGEv ALASKA
344-7"79.4
SIX INCH WATER WELL DRILLED --------- OUT TO THE DEPTH OF 140 Peet.
DRILLED AT THE RATE OF x`22.00 PER FOOT. Steel casing to the full depth.
PROPERTY OWNER Robert W. Bundtzen, M.D. Anchorage 561-4362
LOCATION OF WELL SITE Lt ")lk Sub a
DRILLER
Bernie -Claus of Fampart Drilling 'Norks. \AnLr-u
WELL LOG:
0 - 18' Gravel with 15% silty material.
i8 - 43' Good clean coarse gravel. —
43 - 79' Silty sandy gravel. 204%
-- 122' A hardpan material. 60G
material.
vel. (Cemented gravel) - --
122 - 138' A wet sandy gravel. 400% fine gravel.
138 - 140' Good clean water bearing fine gravel.
'Nater yield of 12 GP', pumping five feet off bottom. 'Nater recovery is
40 feet off bottom. (3/4 horse submersible pump should be installed five
feet off bottom) "oth the quality ?> quantity of this ''Jell commodity is
excellent.
��zll 4� q LY-,(�,ZL
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
"JUN 2 71990
RECEIVED
Total cost of drilling: ;;22.00 per foot X 140 feet: $3,080.00
9t1 ,500.00 paid at start of iNell.
COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING.
WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF 1+1 >580.00
w
THANK YOU VERY MUCH.}
BERNIE CLAUS OF RAMPART DRILLING WORKS
DATE .rune 4, 1990
cccv�rr $wenn= n v ru_ac PFR MnwTH WILL BE ASSESSED ON PAST DUE ACCOUNTS.
• Municipality of Anchorage
x Department of Health and Human Services C"1hS
825 "L" Street
Tom Fink,
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
January 8, 1990
Robert Bundtzen
3345 Seawind Circle
Anchorage, Alaska 99516
Subject: Tract D Block 2B Hillside North S/D #2
Permit #890250, PID #014-031-80
The subject permit, issued by this office for single family
well and/or on-site wastewater system has expired as of December
31, 1989.
Permits are issued on a calendar year basis by authority of the
Municipal Code of Regulations. A new permit must be obtained
from this office for an well and/or on-site wastewater system
not installed by the expiration date.
If you have drilled the well, a well log needs to be sent to
this office for documentation of the installation and to close
the permit.
If a private engineer inspected the installation of the on-site
wastewater system, the original as -built inspection report
(three-part form) must be sent to this office for review,
approval and documentation.
When applying for a new permit, the fees are: $90.00 for an
on-site wastewater permit; $50.00 for a well permit; $140.00 for
a combined on-site wastewater and well permit.
If you have any questions, please call this office at 343-4744.
Sincerely,
John Smith, P.E.
Program Manager
On-site Services
JW/1jm:200
enc: Copy of Permit
"Kids Are Our Future"
inn wq; a
r
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: ./`�- �O/3E21 !J C� C� DATE PERFC
LEGAL DESCRIPTION: /"/rZ ✓ '0� Township, Range, Section: _r/4 A-) /2 2 W
DEPTH / J A,JC0t%� SLOPE S0 �T'Pl !J
(FEET)
1
4
5
6
7
8
IJ �
9
�I�— 10
st�-"oy
� zS
20
Gross
Time
17
12
Net
Drop
13
SrAy��'
14-
4
15
15-
C')
17
8
18-
19-
19
20
WAS GROUND WATER
ENCOUNTERED? Id o
S
IF YES, AT WHAT L
O
DEPTH? P
E
6GG.YS�
Depthto Water A
Monitoring? t I Date: 0
S(�
Reading Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER
J,T�jEST RUN BETWEEN �-» FT AND FT
COMMENTS JSe ��A)�y 4,,2- L ("O(Z �lZ�iiJG`7 • �D/' �PTS��
PERFORMED BY: COO ( v 067 e C I W=CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUI DELI N S IN EFFECT ON THIS DATE. DATE: o
7-4e"ov Y4 Apt AA
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11 X 17 PRINTED ON NO. 1000H CLEARPRINT °
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