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Home My WebLink AboutMAY HEIGHTS LT 2 Jun 13 22 06:23p Anchorage Well & Pump Ser 9072430742 p.1 MUNICIPALITY OF ANCHORAGE Development Services Departmentt Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: Parcel Identification Number: 014 311 07 Date of Issue: Legal Description MAY HEIGHTS Block Lot 2 Property Owner Name & Address: PARSONS, MARGARET ANN 8819 BROWNING DRIVE ANCHORAGE, AK 995107 Pump Installation Date: 06 - 08 - 2022 Pump Intake Depth Below Top of Well Casing: 145 feet Pump Manufacturer's Name: M EYERS 75m311 -$m12 Pump Model: Pump Size: .75 hp Pitless Adapter Burial Depth: 10 feet Pitless Adapter Manufacturer's Name: unknown -no visible name Pitless Adapter Installer: Well Disinfected Upon Completion? )( Yes ❑ No Method of Disinfection: PELLETS I Comments: Pump Installer Name: _ ANCHORAGE WELL & PUMP SERVICE 7640 KING STREET Company: ANCHORAGE, AK 99518 Mailing Address: 907-243-0740 City: State: Zip: Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. oGRE""'ER ANCHORAGE AREA Bor",UGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME /~/9/g~ LOCATION MAILING ADDRESS /~O~v c~'~/g)3 '~/~'(~/ P'~(~E <~,~ '~, LEGAL DESCRIPTION /g~- ,.~ .~/~,~,,~..~//7~ , SEPTIC TANK: DISTANCE FROM WELL/0 INSIDE LENGTH MANUFACTURER MATERIAL /~,,~,5~/~'- NUMBER OF COMPARTMENTS INSIDE WIDTH -- LIQUID DEPTH ~ LIQUID CAPACITY//~ GALLONS. SEEPAGE Pit: NUMBER OF PITS / DIAMETER__OR WIDTH/~', , I ) LINING MATERIAL ~')('~'/(~ CRIB SIZE: DIAMETER BUILDING FOUNDATION~2"4", NEAREST LOT LINE ~-~) I ADDITIONAL ABSORPTION ~ LENGTH /--~' ) , DEPTH DEPTH ¢ ! DISTANCE FROM: WELL //--20 TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~'~'.~OA*~'I,SQ. FT. WELL: TYPE 012f//(L~) , CONSTRUCTION BUILDING NEAREST NEAREST FOUNDATION LOT LINE SEWER LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK SYSTEM DISTANCES: INSTALLED BY: /~-~//)L~- PIPE MATERIAL: LOT SLOPE: REMARKS: [~/~'7'~ ,'~ Form No. LQ-031 DIAGRAM OF SYSTEM rv]-W' DRILLING, Inc. P. O, }~ox 4-1'/28 · 2911 Dawson A C 907~279-1741 ANCHORAGE, ALASKA. 99509 DRILLING LOG Well Owner Richard J. Miller Use of Well Dom Location (address of: Township, Range, Section, if known; or distance mahu road Abbot Lp. Road Size of casing_~ Depth of Hole 175 feet Cased to_. 17~ Static water level--95 ft. (a~e,~e) Screen ( ); Perforated ( Describe screen or perforation_ Well pumping test at 50 -gallons per (IX~Y~ of drawdown from static level. feet (below) land surface. Finish of well (check one) open eqd ( X ). None (minute) for.. 1 hours with:. 100% ); ft. Date of completion t~ Aug 75 Depth in feet from WELL LOG ground surface Give details of formations penetrated, size of material, color and hardness 0 TO_ 1 1 TO_ 16 21 TO_ - ~ TO - ~ TO_ 110 _ ll0 TO_ 155 _ . 155_TO_ 175 - _TO TO .TO_ TO_ TO. TO_ TO Surface 0~an i c a Silt_~ Cobble Gravel Sandy Gravel Sand Sandy Gravel _ Silty Sand w/ small__gravel seams; 1 GP_M ~n g~r.avel ~e.~m e 890 __ Small Gravel, vy Gla~y~y to~avelly cl_ay __ Cobble. Gravel f ggoxi~y.3, ayne E. Weetber~r RECEIVED 8EP ~ ,:. '1992 V LI 'liO}!)? Ji y Of Anchorage ~m, a:': Services 1 ~ CUSTOMER GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION LOCATION LEGAL DESCRIPTION ~ - INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO SE SERVED FINANCED THROUGH SEEPAGE PIT , DRAIN FIELD TO BE INSTALLED BY cOmPLETION DATE ANTICIPATED . OTHer ,/? 77' NOTE~ THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO seePAGE Pit .~(('-J DRAIN fieLD - / SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK TO NEAREST LOT LINE. WELL TO SEPT,O TANK / NO DRAIN FIELD ./ ('9/) ' WATER MAIN TO SEPTIC TANK DR^,N FIELD t0 . SEEPAGE PIT ~(~ / DRAIN FIELD SEEPAGE PIT //0/~)~') / · SEEPAGE PIT IL) SEPTIC TANK, .//('~'~ ' , SEEPAGE PIT ~/L'9~;)7 DRAIN FIELD //O() / TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL, 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE Pit FITTED WITH AIRTIGHT REMOVABLE CAPS. DIAGRAM OF SYSTEM GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. I CERTIFY THAT ] AM FAMILIAR WITH THE REQUIREMENTS OF GREATE~iANcHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE APPLICANTS SIGNATURe flREATIiR ANCHORAGE ^REA DOROUGH BEPARTI,IENT OF ENVIRONMFNTAL QU3I. ITY 3330 "C" Street ANCHORAGE, ALASKA 99503 Case PerFormed For__ ~C~le__ Bo~tc~,N',s~y~ Oated Performed I0--c~-'7~ This Form Reports Soils Lofl~' Perco~acion~ ~- T,~ic~t - Soil Test Must Be Logged To 4' Below Proposed Seepage System Soil Characteristics Depth Feet Was Ground Water Encountered? A/c'] 2/~^ If Yes, At What Depth? Reading Date Gross Time Net Time Depth to H20 Net Dro~ Percolation Rate Minute Proposed Installation: Seepage Pit Drain Field Depth of Inlet Depth to Bottom of Pit or Trench COMMEHTS: Test Performed BY._ ,~ Date Certified BY: Date: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ~,\L/ - ~'~\- ('-t"-'~ .~..-~ NAA# ~_~ ~%'~d'~ ~0 (r~, ~/ 1. GENERAL INFORMATION Complete legal description Location (site address or directions) - ~'¢1~1 L~c',~,~,L~ ~¢-?¢¢- ,~.~(~ I~¢'g~- Property owner ~r', ~l~fy !_~¢.J/~ J'ZI, C,~\D=f~, _\0. . Mailing address -1~¢-~~1 [~¢,¢,~,g,~ b~¢¢ ~.¢~ Lending agency ~o~ Mailing address Day phone Day phone Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community weil NOTE: _ Y . Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site NOTE: Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev 1/91) Front MOA~21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Nameof Firm ~i4~ d"~A'~/~i~"T l F-~-;?,~'.¢'_~ ~ ~, Phone Engineers signature ,:~ Date ~ ~ .; ;i: 6. ~'~b~? ur ~'~:' ;. :.::f~ DHHS SIGNATURE X Approved for ~/-H¢~=-~(~¢) bedrooms' Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: ~'~"~""'-- ~-~'~'--c'~C Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does th is as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev, 1191) Back MOA //21 Legal Description: Municipality of Anchorage Department of Health & Human Services . HEALTH AUTHORITY APPROVAL CHECKLIST Parcel I.D. If A, B, or C, attach ADEC letter. Date completed Cased to I~/ ~' A. WELL DATA Well type Log present (Y/N) Total depth b"/.~ / Sanitary seal (Y/N) FROM WELL LOG Date of test' Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: / Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line .~J/.~ ADEC water system number ./~//~ i~ A~'~~ Drilter Casing height Wires properly protected (Y/N) g.p.m. ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform ~ Nitrate ~, ?~ v~ ),~. Other bacteria 'gl Date of sample: )"] 5~p+ ~¢-- Collected by: B. SEPTIC/HOLDING TANK DATA ,~. Date installed 15 ~9~"~ "~ I../ Tank size /Lg~D,.¢,-1, I Compartments - I Cleanouts (Y/N) '~ Foundation cleanout (Y/N) '~ ~t,,¢~J~'~. Depression (Y/N) ~.l/~ Alarm tested (Y/N) High water alarm (Y/N) . ..,. Date of pumping . h,J//~ Pumper ~.~,¢..~ ~,~p.,,,~(,, SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot !~/2 On adjacent lots ~g 1¢0 To property line + ~.O / Absorption field Id2 Surface water/drainage ~.P~ .Foundation Water main/service line CONTINUED ON BACK PAGE 72-026 (Rev. 7/91) Front C, LIFT STATION Date installed . Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off"'level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STA'TION TO: Well on lot On adjacent lots D. ABSORPTION FIELD DATA Date installed I Length )~ Width '~,~.~ Total absorption area Surface water Gravel thickness. ~ ~ ' Total depth Cleanouts present (Y/N) _ Depression over field (Y/N) ~,~ Results(pass/fail) ~c~r ~ ~ ~ ~ ¢ Peroxide treatment (past 12 months) (Y/N) /XP/~¢ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellon lot '~ 1oo To building foundation On adjacent lots Surface water Curtain drain Date of adequacy test. for If yes, give date E. ENGINEER'S CERTIFICATION On adjacent lots. Ibc Property line_ To existing or abandoned system on lot Cutbank . ~/A- Water main/service line Signatu re~-~~~¢--~-- ~'~ Engineer'.s .Name. ¢~O,.Vi ~ Date I.~,l ~f ~ ~r bedrooms Driveway, parking/vehicle storage area +.~ lO ~ I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. HAA Fee $ 1-1 Date of Payment. ~-~:~A~'~ Receipt Number 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number .,/ ..... . ~&~'E~ JOB NO. SEPTIC SYSTEM FILL STAGE OA~E ~,/? .... DAlE TIME I ~TIME J DEPTH AD xD I Q ~O 2G ~G/~D I ........... ~ ~ ---~ /~ lO __2-Z.~ .... i~ 5 __ $ ....... ~_ ~ ~ 6 .~ ................. __z,,~ ......t ~6 ___ 5 -- ....................... CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 ANALYSIS RESULTS for INVOICE $ 58528 Chemlab Ref.$ 92.5063 Sample $ I ~atri×: WATER FAX: (907) 561.5301 Client Sample ID PWSID Collected Received Preserved with L2 )~Y HEIGHTS SUB UA SEP 17 92 @ 14:30 hrs. SEP 17 92 @ 16:55 hrs. AS REQUIRED Analysis Completed : SEP 18 92 Laboratory Super~iso~ :,_~EP~ENC. ~DE Client Name :HIGH PHUKAN CONS ENGR Client Acct :HIGHPHU BPO# : PO~ :NONE RECEIVED Req$ Ordered By Send Reports to: 1)HIGH PHUKAN CONS ENGR 2) Parameter Results Units Method Allowable Limits NITRATE-N 0.79 mg/1 EPA 353.2 10 Sample ROUTINE SAMPLE COLLECTED BY: E.K.B. NO INFOR~TION ON TAG. JOB $ Remarks: P92509. 1 Tests Performed ' See Special Instructions Above UA-Unavailable ND- None Detected '* See Sample Remarks Above Nh= Not Analyzed LT=Less Than, GT=Greate~ Than Member of the SGS Group (Soci6,O G6n~rale de Surveillance) PROJ£C"i JOB NO. ?¢~._~O¢,f "PAOE SEPTIC %Y%TEM,,,, FILL STAGE 'I-~ME /&TIME DEP~-H ~ D E O Q ~O )CO ~ O/Z~D (MIN) , (MIN) (IN) (.li'l ) (IN) (GPM) (Q)(A T)=QAL 4,,~ ~); ~%~__-- 5 ~ 3 ~ .......................... /I ,,po ~ o 2 I.I