HomeMy WebLinkAboutSAND LAKE #1 LT 12Municipality of Anchorage Page of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: Ewa W2 PID Number: 0 1 1 11(Aj�6
Name:
�T
Wastewater System: gNew ❑ Upgrade
Address:
X212 -11k kiL On t
ABSORPTION FIELD
Phone:
No. of Brooms:
eep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other
LEGAL DESCRIPTION
Soil Rating:
Total Depth from original grader
GPD/Sq. Ft.
Lot: Block: Subdivision:
Depth to pipe bottom from original grade
Gravel depth beneath pipe
Ft.
Ft.
Townshi f
Rangg:
Section:
Fill added above original grade:
Gravel length:
1
os '05i�j�"c/.�1.
`v • Ft.
WELL:New ❑ Upgrade
Graveldefe! WrCW:} ,
Number of lines: Distance between lines:
I —
Classif' tion (Private, A,B,C): Total Depth: Cased To:
Ft. Ft.
Ft.
Total absorption area:
1 Q. Ft.
Ft.
Pipe material: 10
Driller:
Date Drilled:
Static Water Level:
Idler:
Date ins alled:
Ft.
Yield:
Pump Set at:
Casing Height Above Ground:
GPM
Ft.
Ft.
TANK
SEPARATION DISTANCES
�eptic ❑ Holding ❑ S.T.E.P.
To
Septic
Absorption
Lift
Holding
Public/Private
Mnufacturer: Capacity in gall0 s:
From
Tank
Field
Station
Tank
Sewer Lines
material: Number of Compartments:
Well
I C0 4
1 j� i
---!�
Watere
15D+
'LQd`
--
—
—
LIFT STATION
Lot
i
10 4'
1
b4-FoLine
104-
Size in gallons:
Manufacturer:
undation
Foundation
lot+
1 o r T -
"Pump on" level at: 'Pum evel at:
High water alarm at:
Curtain
Drain
O1 i
K
Pump Make & Mo
Electrical Inspections performed by:
Remarks:
BENCH MARK
Location and Description:��-►�
I VIS
/^���nn N�/�
C. oR.+� 6.1:--
6-1:--
Assumed
Assumed Elevation: Ft
l
kt1N,fiER
>.
Inspections performed by- S �lCi I���D is tes : 1 st
2nd �- ®
?J°e APEti, P.E.°o �kdl
Roeffin�J.&3
Department of Health Hum n, ervices approval'Pee
...s0� 1,
Reviewed and approved by. heti- a=L Date: _/4
�1� ,,,°„ ..-A
Permit No. _ 0 Page of
le
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: 1 4"_ LT Iti pin ni„ . 73 1 1 1 1 1 n�i
r<vm A t[/L 1J MVAHD
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE �nYi'1
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502 cc
ANCHORAGE, ALASKA 99519-6650 45 S lint,.
0
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT �i.,✓
PERMIT NUMBER:SW910264 DATE ISSUED: 9/03/91
DESIGN ENGINEER:S & S ENGINEERS EXPIRATION DATE: 9/03/92
OWNER NAME:D`AVI_S CHARLOTTE
OWNER ADDRESS:4825 W 80TH AVE
ANCHORAGE, AK 99511
PARCEL ID:01111105
LEGAL DESCRIPTION: SAND LAKE #1 LT 12
SEC 10, T12N, R4W, SM
LOT SIZE: 16800 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD / WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PR
RECEIVED B
ISSUED BY:
DATE:
DATE:
ngr'�
�O�
August 15, 1991
HEALTH AUTHORITY ,, p
APPROVALS Municipa ity o6 -Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L S.tnee-t
P.O. Box 196650
SEWER&WATER Anchorage, Ataska 99519-6650
MAIN EXTENSIONS
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
REFERENCE: Lot 12; Sand Lake Subdtv,i4.ion #1;
Request you .i4sue a permit to dkitt a weft and tn,sta t a septic 4ys.tem
SEWER&WATER to 4eave .the pnopo,sed 4 bedxoom house on .the ne4eneneed pnopetty.
INSPECTION
A4 can be seen {ynom .the attached 4.ite plan .the tot6 .in the area ane
small. The adjacent pn.open..ty .to .the noh-th (Lot 13) .is developed but
AND REPORTS the well and septic system ace undocumented and appear ,to have
ENGINEERING STUDIES se atatcon distance viotatcon4 between .the septic system and take, and
,the septic 6y,6tem and well. The proposed well and septic on .the
neJeaeneed pn.opea.-ty shoutd not h.indeA the upgrade o4 Loi 13. The
adjacent pnopeA..ty .to .the south (Lot 11) .is euxhently vacant. Atthough
the pa.opost.,i
ed weft and septic wiln4tuenee the development o6 Lot 11,
&FLOWTEST CTION
WELit shoutd not hindeA development any mote .than the existing conditions
ES
such as small size and take tocat%on.
I4 you have any quutions on. &equine additional .in6onmation bon. youA
SITE PLANS uview, ptease contact us.
S.incen.ety,
ROAD DESIGN
ROGER J. SHAF�.
RJS/gm
SOIL TEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ON SITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
SCALE
d
r
r,� U
m.o
U
r
0
N
Municipality of Anchorage �•'
DEPARTMENT OF HEALTH & HUMAN SERVICES ®•. g
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: DATE PERF
LEGAL DESCRIF
DEPTH
�('F�EET)
a
2
3
4
5-
6-
7 6 7 1 �*
8-
10-
11 10 11
12 ! t
13
19
20
COMMENTS
Ga
Township, Range, Section:
SLOPE
WAS GROUND WATER - N p
ENCOUNTERED?
L
IF YES, AT WHAT
�PEPTH? P
E
Date: AV-�� � � p
M i oring7 <�P
of_ 4C
O
S' Rg
. vaa w�aasoos6
ov >e aeaa vv BQ/�
s*d A. aR91W i
too. 14971
SITE PLAN
-ag qo
PERCOLATION RATE (minutes/inch)
PERC HOLE DIAMETER
TEST RUN BETWEEN --1=1 FT AND `•' FT
PERFORMED BY -17034 Eagle River Loop Road1y0
Eagle KIVer, Alaska 995z,,
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUI[
72-008 (Rev. 4/85).
CERTIFY THA �THISEST WAS PERFORMED IN
ON THIS DATE. DATE: O
• � T
d—�
F►—
�Td��
Ask
PERCOLATION RATE (minutes/inch)
PERC HOLE DIAMETER
TEST RUN BETWEEN --1=1 FT AND `•' FT
PERFORMED BY -17034 Eagle River Loop Road1y0
Eagle KIVer, Alaska 995z,,
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUI[
72-008 (Rev. 4/85).
CERTIFY THA �THISEST WAS PERFORMED IN
ON THIS DATE. DATE: O
` DEPAA-fMIN7 OF HEALIM AND E ( --'--- -- --- ' -- -----�
-- — -- - p�irl is 3 iL 3A-L.FriQ-A t0tCr�
�_-ALS LOG FEAWATIO d
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3 $
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DOC Co. dba
SULLMN WATER WELLS
P.O. BOX 670272, CHUGIAK, ALASKA 99567 • TELEPHONE 688.2759
OWNER OF LAND r-1- IC h� o S t e3
ADDRESS 7241 15ZE-75/ J /ZL air X21 %C!'n< �?
LEGALDESCRIPTION�°!
DATE -Started _% �� Ended
PERMIT NUMBER
KIND OF FORMATION:
FromFt. tort. , Ft.
Ft. to
From Ft. to Ft.
From
//
Fromi�Ft. to /Ft.
/J y f /
From Ft. to-(2L—Ft.
iT =� �� j,= <:6
From Ft. to 5 a Ft.
From
From�Ft. to L� Ft.
C4,
'"'`Ft. to Ft. /�
From�
?<cr_'0�n16 �lvcDDrrrJ
_ f -
From i Ft. to Ft.
C Y •`� ��%�Jr_ G
From a 35 Ft. to 3 07 Ft.
L
/
From Ft. toz _Ft.
—'J S,4A-.k3 'y6,4rN
14. 1 ,c 6
From -723 Ft. to 3.,L�' Ft.l�r-ni'/
Cir�J�L
Ft.
From
From Ft. to Ft.
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
MISCL. INFORMATION
/
DEPTH OF WELL rn / -7
STATIC LEVEL OF WATER Fr. C`7CZ
DRAW DOWN FT.
GALS. PER HR
KIND OF CASING L/O mob
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft..
From. Ft. to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
From F, to Ft.
From Ft. to Ft
From Ft. to Ft
DRILLER'S NAVE �"`-
RECEIVED
MAY 21 1993
Municipality of Anchorage
Dept. Health & Human Services