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HomeMy WebLinkAboutSPRUCE TREE LT 1 MUNICIPALITY OF ANCHORAGE WATER WELL RECORD DEPT. OF H~/,I.TH & · ,~ STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES ,~.~ ~ ~;~rZ Division of Geological ~ Geophysical Surveys lc.) A.D.L. NO. _An~ S~oruce r~r'~= ~ 1 ~L --of--of--of-- S[~ W[~ DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS S, OWNER OF WELL: Mr. Leroy Gardino Address: P.O. Box 515-A WELL LOe Surface 217 .. 5 - 10 - ~7 Gravel O ~: 6. ~ Ceble tool ~Rotary ~ Driven ~ Dug Sandy Gravel 2 21 ~ Auger ~ defted ~ Bored ~ Other: Bedrock~ greenstene 21 28 7. USE~omestic ~ Public Supply ~ lnd"~tzM Bedrock, black 28 29 ~ ~d~,,.. ~ ~.~ ~ c~.~e~, ~e&~oc~ ~a~e= ~aoZu~e~ [20 2~ 8. CASING: ~ Threaded ~ Welded diam. ~11 in. to~ ft. Depth Weight ~T lbs./ft. Type: ~e~ Hole . Diameter: 6II ~o. s~,c w~E, ~EwL: ~ --. / / ~Above or ~ Below Iond surface I~.GEOUTING Well Grouted: ~ Yes ~ NO Meterle[: ~ Neet Cement ~ Other: 15. PUMP: (if oveileble) HP ~/~ Length of Drop Pipe ~0~ ft. cap~c[ty ~ g.p.m. Bail tested at 5 GPM Magnuson ~illing P.O. Bex 504 Eagle River, ~. 99577 A~: AA 5~85 T~.m~,~L;~NI~IPALITY O~F ANCHORAGE Time ne D~te Date Date '"'"*°'°R.. E CEIV_ _[ D Inspector Inspector Bate Sewer Installed Permit No. Septic Tank Size ~j ~ Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Buyor Address Address ~ ~( Street Location ~~ I~t' ~ Typ~f Residence - ~ Single Family ~ Multiple Family No. of Bedrooms ~ Other W~ Supply ~ Individual A~ACH WELL LOG. A well log is required for all wells drilled since June ~ Community 1975. For we]la drilled prior to that date, give well depth (attach log if ~ Public Utilit~ available.) S~e Disposal -~' ~ Individual Year Individual Installed: ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. ApPLI(- 'NT FILLS OUT UPPER HAll')ONLY Property ~wner · - Phone Patri'c. ia Arnold and Mary Meyers 99577 688-2168 Mailing Address BOX 944', Ea~lex R~ver zip Code Audie B. & Deborah Holloway 99645 Address SR B Box 7503, Palmer Alaska Zip Code Phone Lending Institution National Bank of Alaska '- 99577 694-5375 Address Baqle River Branch -% Zip Code Phone Realty Co. & Agent" - . ERA F~n~,is .Re~,lty ' -' 99567 688-5454 Address BOX 560}. Chu~iak, Ak ; zip Code Legal Description i ~ ' Spruc~'Prree Lot 1 '" "~ Street Looatid~ Bena'iri~- Birch Drive, Chngiak, Ak ~pe of Residence.. 4, !' ultiple Family ~lo.,of Bedroom.A 3 ._.~ Other .~ 'i K '~*' " Wa[~r Supply & " ~' '" ~' ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. bmmunity For wells drilled p or o that date/ give web depth (attach Icg if available). Sewer Disposal .' /:;~ ' ~dividual ¢ , ~ (~: ~' ' Year Individual Installed: 75 ~ When Connected to Public Uglily: ~} Holding Tank NOTE: THE INSPECTION FE~ ~T ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time ~ ~ Time Inspector Insp~tor Insp~tor MAY 1 11983 ( ) DISAPPROVED ~Envir0nCt~l i~f6te~ti~" Soils Rating Date ~wer Installed Well TO Absorption Area Well Log Received Well to Tank Septic T~k Size 72.023 (3182) CHEMICAL & GL LOGICAL LABORATORIES ~.£ ALASKA, INC. ~L TELEPHONE (907)-279,4014 ANCHORAGE INDUSTRIAL~CENTER ?274-3364 5633 B Street' Drinking W~ter Analysis Report for Total ColifOrm Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: Water System Name \ ' Phone NO. Mailing Address City ~j State Mo. Day Year Zip Code SAMPLE TYPE: r- Routine -~ Check Sample (for routine sample with lab ref. no. [] Special Purpose [] Treated Water - Untreated Water aAMPLE NO. , I 4 I LOCATION Time Collected Collected By TO BE COMPLETED BY LABORATORY Analysis shows th~s Water SAMPLE to be: r~], Satisfactory [] Unsatisfactory ~ Sample too long in transit: samele should not 3e over 48=hours old at examination to indicate reliable results. Please send h~w sam 31e. Date Received ~':' ' :~ Time Received Analytical Method: [] Fermentation Tube [] Membrane Filter Lab Ref. No. Result* Analyst READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06-~220 Eh) Rev, ].978 BACTERIOLOGICALWATER ANALYSIS RECORD Date collect eD Source alved ).m..Lab. /9O. 24 HOURS 48 Hours ~onflrmetory 24 Hours 4S Hours Multiple Tutus Membrane Filter: Direct Count Verification= L. TB Final Membrane Filter Results OGB MUNICIPALITY O~ ANCHORAGE /~,~//'L../ MUNICIPALITY OF ANCHORAGE DEPT. OF I~,~ALTH & DEF,ARTIVJENT OF HEALTH & ENVIRONMENTAL PROTECTIO~NVIRONMENTAL P~;OfECTJON 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION AUG 2 0 1979 Telephone 264-4720 DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please alJow ten (10) days for processing. 1. PROPERTY OWNER Leroy Gardino PHONE MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE PHONE 2. BUYER MAI LING A DDR ESS 3. LENDING INSTITUTION PHONE MAI LING A DDR ESS 4. REALTOR/AGENT PHONE Nell Gibbs % Chugiak-Eagle River Realty 694-3355 MAILING ADORESS Post Office Box F Chugiak, Alaska 99567 694-2461(h) 5. LEGAL DESCRIPTION Lot 1 Block 1 Spruce Tree subdivision (T15N R1W Section 16 Lot l) STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [] Four [] Other__ ~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY [~ Three [] Six 7. WATER SUPPLY ~ INDIVIDUAL* * ATTACH WELL LOG. A well log )s required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM :~ I N DIVI DUAL/ON-SII'E** [] PUBLIC UTI LITY If ,nd,vLdual/on-site, give installation date. 7-5-72 If system is over two (2) years old an adequacy test is required by this Department, NOTE: THE INSPECTION FEE MUST ACCOIVIPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72~10(3/78) THIS SIDE FOR OFFICIAL USE ONLY ,: DATE R~=CE[VED 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 UTI LITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ~] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY '~ *- ~-~ 1,._ Connection Verified __ INSTALLER ~[~Septic Tank or []Holding Tank ,~,~ ¢~r~ ~)~I~}V~- Size: I~JC) IfTankishomemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line COMMENTS [] APPROVED FOR BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [~-~ DISAPPROV ED LEGAL DESCRIPTION 72-010 (Rev. 3/78) EXCAVATION ROBERTA. SHAFER WORK CIVIL ENGINEER 694-2979 Hay 22, 1982 Leroy Guardino Box 515A Chugiak, Alaska 99567 Dear Mr. Guardino, Reference: Lot 1; Block 1: Spruce Tree subdivision A sewer system adequacy test was performed on ~he system located on the referenced property as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The seepage pit was charged with 1000 gallons of fresh water and after a period of approximately twenty five minutes all the water which had been added to the crib had percolated out. It can be concluded from this test that the waste water disposal system serving the three bedroom residence located on this property is curr~-ntly functioning adequately° However, this system cannot be guaranteed against subsequent failures. If we may be of further service, please do not hesitate to c~&l. Sincerely, ROBERT A. SHAFER, P.E. RAS/ss cc: Re/Max Realty ATTENTION: Lorraine Miner ..' Municipality of Anchorage Department of Health and Environmental Protection S~RB 196X EAGLE RIVER, ALASKA #1: Time Date Insp ~ MUNICIPALITY OF ANCHORAC~-~ DEPARTM~,~ OF HEALTH AND ENVIRONMEN..<L PROTECTION 825 L Street, AnChorage. Alaska 99501 10:30 a.m. #2: Time 2-13-78 Monday Date Pratt Insp 264-4720 Date Received: February 10, 1978 i ~.'3 © ~3: Time REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: First National Bank of Anchorage Mailing Address: Post Office Box 4-2090 99509 Phone: 2. Property Owner: Mailing Address: Leroy Gardino Box 515A Chugiak, 99567 Phone: 688-9058 3. Legal Description: Lot 1 ~.lo~c.k.1 Spru__ce Tree Subdivision ~ ~ ~?~5N R1W Section 16 Lot~ ~_~=_ ~ "R sidenc~-'x) Number of Bedroom~o 4: Single Family e : % Multiple Family Residence: ( ) Number of Bedrooms: Well System: Permit # Construction Individual well (x~ Community/Public System ( ) Depth of Well 220' Well Log on File Bacterial Analysis Sewage Disposal Permit 9 Septic Tank Size Absorption Area System: On-site System (x) Public Utility ( ) Installed ~J~'~ Installer '7--~~7~-~ /~OO Manufacturer Soils Rate Material Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line Page TWo Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Comments: Lot 1 Block 1 Spruce Tree Subdivision T15N R1W Section 16 Lot 1 Affadavit Attached:~ Disapproved: Letter Attached: Date: ~-- ~} Date: Department Worksheet: (e3e~,sod Snld) ~'Og--llVlN O:ll.-1ll~l]3 ~0.-I 1dl333~1 P · '~ / Department of Health and Environmental P //~/ 825 L Street, Anchorage, Alaska '" ~equest for Approval of Individual Sewer and Water'Faciiit~es 1. Property Owner, ~t~c~[ 0/~_ M--~ Mailing Address:- ~/ ~ ~ C~_,~F~ ~ Phone: &~ q~ 2. Name of Buyer: Mailing Address: Phone: Lending Institution: Mailing Address: ~ Phone: 5~ Realtor/Agent: Mailing Address: Phone: Legal Description: ;~_~ / _~9.~'. J Street Location: ~/~,~,~.~) / ~/~..~ 6. Single Family Residence: ~ Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: Water Supply: * Individual Well (~) Public/Community System If Individual Well, well depth ~.~0/ If Community System, name of system Sewage Disposal System: *~n-site System ~) Public System ( ) If On-site System, date of installation: *NOTE: 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. 3/77 1973 ALA. ., DEPARTMENT OF HEALTH AND SOCIAL S, ICES DIVISION OF PUBLIC HEALTH INDIVIDUAL AND SEMI-PUBLIC BACTERIOLOGICAL WATER ANALYSIS OFFICE INDIVIDUAL [] SEMI-PUBLIC [] CHLORINE RESIDUAL PPM REPORT RESULTS TO NAME )~ [~: l~ ~ ~[ ADDRESS I-'~ COMPLETE THIS SECTION ONLY IF WATER IS A,N INDIVIDUAL SUPPLY ,~ .~'~)- , .L.- ·,,,~'/'-"- · ~?.__ ~.q ,._,).. :) , Feet, Feel. Analysls shows fhls Water SAMPLE fo be: [~] SaHsfactb~y [] Unsatisfactory [] Questionable [] Sample too long Jn fransH; sample should not be over 48 houi's old at examination fo indicate reliable resulls. Please send new sample. [] Botlle broken in frans[t, please send new sample, SANITARIAN'S REMARKS Diameter of Well Depth Feet· Well Casing ~aterial Diameter _ Deplh Length of Water Depth Drop Pipe From Botlom Feel. Offset in ~ In Ufilhy PURPOSE OF EXAMINATION: Illness Suspected? New Source of Supply? [] Yes [~ No READ INSTRUCTIONS REVERSE SIDE BEFORE COLLECTING SAMPLE [] Yes [] No o,s-l~o (bi BACTERIOLOGICAL WATER ANALYSIS RECORD Lactose Brolh 10cc 10cc 10c¢ 10cc 10cc 1.0cc 1.0cc 24 Hours 48 Hours Brilflant Green 24 Hours 48 Hours · EMB AGAR Lactose Broth, 2.4 hrs.. 48 his Gram's slaln Coliform Density . (Most probable No. per ~00cc) · MF' Results ~ Repotted by ~'Z'I Date "['~'~ ' ~ /,,~/ -'-a.m.p.m.., This .nblysis rndicote~:Coliform OlganJsms lo be: ~bs.nt ") EXCAVATION ROBERTA. SHAFER WORK May 22, 1982 CIVIL ENGINEER 694-2979 MUNICIPALITY OF ANCHORAGE Leroy Guardino Box 515A Chugiak, Alaska 99567 ,-,-,, ;3 5/982 RECEIVED Dear Mr. Guardino, Reference: Lot 1; Block it Spruce Tree Subdivision A sewer system adequacy test was performed on ~he system located on the referenced property as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The seepage pit was charged with 1000 gallons of fresh water and after a period of approximately twenty five minutes all the water which had been added to the crib had percolated out. It can be concluded from this test that the waste water disposal system serving the three bedroom residence located on this property is currently functioning adequately. However, this system cannot be guaranteed against subsequent failures. If we may be of further service, please do not hesitate to c~ll. Sincerely, ROBERT A. SHAFER, P.E. anS/ss cc: Re/Max Realty ATTENTION: Lorraine Miner ~/ ~" SRB 196X EAGLE RIVER, ALASKA Municipality of Anchorage Department of Health and Environmental Protection