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HomeMy WebLinkAboutCHRISTOFFERSEN LT 23B Municipality 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: "~'~-~'.~ ~)~'"~ PID Number: ~)~i I ~~~ . ~t~ ~-. ~U~~astewatersystem: ~ew ~Upgrade ~:~~ ~ t ~~ ABSORPTION FIELD Phone~ ~ ~ ~ 1No. of ~ooms: ~ Deep Trench ~ Shallow Trench ~Bed', Mound ~ Other ~otal Depth from original grade:. LEGAL DESCRIPTION SoilRating: ~'~PD/Sq. Ft. ~~~ Lot: ~~ Block:~~ J~~~~Subdivisi°n: ~ Depth to pipe bottom from original~.~gra~e: Ft~ Gravel depth beneath pipe ~.~( Ft. Township: [Range: Ise~"on: Fill added above original ~d~/ Gravel length: WELL: ~New ~ Upgrade G~e~h:~*~.~ Ft. Ft. ication(Prwate, A.B,C): Total Depth: Cased To: Total absorption area: ~ipe material:~,~ ~~ Driller: Date Drilled: Static Water Level:F,. ~~[¢~ ~ Date instal~ . ~. Yield: OPM [ Pump Set at: F, ICasing Height AbOve GrOund:F,. TANK SEPARATION DISTANCES ~ s.pt~ ~ Ho,din~ TO Septic Absorphon Lift Holding ~ublic/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank SewerL,nes ~~~~ . Malarial: Number of uompartments: w~,, I~1/ I1~' - ~ ~'~ ~~ Surface Water I~f~ IDo~ ~ ~ LIFT STATION Lot ~ Foundation ~ (~ I ~ ~ / 'Pump on" level at: ~ "P~mp. off" level at: High water, alarm at: Pump Make & Model ~ Electrical Inspections performed by: Curtain ~~ ~ ~ - Drain ~ Remarks:~¢~ I~~~ ~¢¢~ BENCH MARK Location and Description:  Assumed Elevation: EN61N~J[ ~II 170~ ~lI River Leap ReI~, Ne. ~ Inspections performed by: E,;i, ~;,-~. AI;;~= ~5~ Dates: 1st ~'~'~~~~~'"" 2nd ~-~ ~ Department of Heal~ a~d Human Services approval ~':~"'-'l-~--"-...,.-..;v~" Reviewed and approved by: Date:/~--/2 -~Z ~ROFESSt~ 72-013 (Rev. 9/91) MOA 25 Permit. No.'~V-~ I ~~) Page of 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:~-~i~l""~ '~------'~~' ~ ~ ?"~:~ PID No.: ~--~t I ~--~ .z~ 72-013 A (Rev, 9/91) MOA 25 by DOC Co. dba SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 ,, TELEPHONE 688-2759 OWNER OF LAND ~._..c. ~ ~ i~ ,~,~ :,2 ADDRESS /-' ~;~F' r~ 7 DEPTH OF WELL z / LEGAL DESCRIPTION DATE - Started PERMIT NUMBER STATIC LEVEL OF WATER FT. DRAW DOWN FT. GALS. PER HR KIND OF CASING KIND OF FORMATION: From ... Ft. to ~ Ft. From ,~. Ft. to '"';~ Ft. From ~:¢ Ft. to t',' Ft. From I ", Ft. to ! Ft. From ~'/ Ft. to ~'~ Ft. From :~'$' Ft. to '7 / . Ft. From_ "7 i' Ft. to ~' c~ Ft. From '-] ~'/ Ft. to./> ~'~ Ft. From? ' : Ft. to ._ From Ft. to 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. __~' dff_ From .... ~.J From O' fl ;- .,~/~] '/~ From From t4-j ~ ~ From From L'; (~,)~c- From ' , ,~t:.l~'~ From icc - From Ft. to__ Ft. Ft, to__Ft. Ft. to Ft. Ft. to . Ft Ft. to Ft, Ft. to Ft. Ft. to Ft. Ft. to Ft. Ft. to Ft. .Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft E Ix/E,Do From FL to Ft. ~rEomp ~ 3 19~to Ft. Niu,-.caoaiity of An~orage Dapt. H~~~tS~'vioe8 Ft. MISCL. INFORMATION: DRILLER'S NAME MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF 1 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW910240 DESIGN ENGINEER:S & S ENGINEERS OWNER NAME:LUEDTKE CLARENCE G & GAIL L OWNER ADDRESS:PO BOX 101873 ANCHORAGE, AK 99510 DATE ISSUED: 8/15/91 EXPIRATION DATE: 8/15/92 PARCEL ID:05110348 LEGAL DESCRIPTION: CHRISTOFFERSEN LT 23B SEC 9, T15N, R1W, SM LOT SIZE: 44969 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 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 (iSAACS0). 3. THE FOLLOWING SPECIAL PROVISIONS. DATE: DATE: ROBERT SHAFER, P.E. ROGER SHAFER, P.E. August 12, 1991 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Lot 23B; Christoph~r~on Subdivision; R~quest you issue a permit to drill a w~l and in, tall a septic system on the referenced property. During the te~t hole groundwater monitoring we found water at 6 ft. b~ow th~ grou~ ~urfac~. D~ ~ ~ ~ow groun~ d~p~ ~ propos~ ~ ins~~on of a mounded ab~orp~on b~d w~h a 1500 g~o~ s~p~c tank ~ff~ p~ping ~y~t~. Although the proposed w~ll location will limit the ar~a on the adjacent property for a septic upgrade, we fe~l the r~maining ar~a will allow sufficient room for at l~ast one more upgrade. If you have any questions or require additional information for your review, please co~c~act us. Sincerely, ROGER J. SHAFER, P.E. RJS/ m 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 SCALE Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: 1 4 5 6 7 8 9 ¢_..~¢¢d,~,-~o¢~'.'l~:)wnship, Range, Section: "~'1~ LAN~~ ~------~ ,~ ' SLOPE SITE tp t 10 11 12 13 14 15 16 17 18 19 20 WAS GROUND WATER ~__.~ ENCOUNTERED? S I L IF YES, AT WHAT ( /~ O DEPTH? ~" P E Deplh to Waler Alter i Moniloring? ~ Date: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND "~ FT COMMENTS PERFORMED BY: ¢~ & s ~:N61HliERIN6 , .i---,=~ /~ ~ ~..~ t CERTIFY THAT THIS TEST WAS PERFORMED IN 17034 Eag~ R~ L~p R~d No. 2~ N ~ V ~-~-~ I ACCORDANCE WITH A~STA~ ~D~C~IDELINES IN EFFECT ON THIS DATE. DATE: ~gle KIV~, AlaSKa ~s / 72-~8 (Rev. 4~85) PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, ALaska 99502-0650 SOILS LOG -- PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 ~.;.~r.~_7~lcl~('~wnship, Range, Section: .'~ ~-t~ ] ~.~b.3 SLOPE SITE PLAN ENCOUNTERED? S IF YES, AT WHAT ~ ~) DEPTH? ~ p Depth t0 Waler After Monitoring? Gross Net Depth to Net Reading Date Time Time Water Drop '5 \ ~ '. ~ . ~ ~ I~' ~ "l~ PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN __ FT AND __ FT COMMENTS PERFORMED BY: S & S ENGINEERING I ~ /~~ - 17034 Eagle Ri~er Loop Road No. 2fl ACCORDANCE WlTl~a~jJ~ '~1'~'~4/~,I~:)$~iJ~L GUIDELINES IN EFFECT CN THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: ~)"1~ 1 SCALE PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8-- 9 10 11 12 13 14 15 16 17 18 19 2O Township, Range, Section: SLOPE I'~ w~s ~ou~ W~E~ IF YES, AT WHAT O DEPTH? Depth Io Water Alter,~-~ / Monitoring? 7-o--,'o / ~,' JSITE PLAN ;,~O/ Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER __ TEST RUN BETWEEN __ FTAND __ COMMENTS ,d~, :,-o,~/,~, ~..Y-~/~ , ,~/~//~ d PERFORMED ~:,~L~ ~l~ ACCORDANCE WITH ~L OTA~~NICIPAL GUIDELI ON THIS DATE. FT CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: ~ ~ I f'~ ~ ~ j-- 72-008 (Rev. 4/85) dN'~3SV3 \ Bg'O0£ ~ ,~ ,SO o00 N N 9~3S0 ~ J.N3~I3S~'3 ~'3~J ,cji / % ,06'6~9 O0'Ogl r.x,j