HomeMy WebLinkAboutHULSE #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.