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HomeMy WebLinkAboutUS SURVEY 3200 LT 12D-1U55 #3200 Lot 12D #090 - 041 - 15 Mark Begich Mayor Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.orq/onsite (907) 343-7904 Pump Installation Log Well Drilling Permit Number: SW Parcel Identification Number: &90. Oy/• S-2 Date of Issue: Legal Description US 3260 L lza -I Property Owner Name & Address: -DANT iaz"t,N6 / `a 'Vaal) ion T.rse9 ,an 9951/1 Pump Installation Date: 7, /41- / C Pump Intake Depth Below Top of Well Casing: 52 feet Pump Manufacturer's Name:a9 D -,,,KA - Pump Model: / 25 g Pump Size % hp Pitless Adapter Burial Depth: / 2• feet Pitless Adapter Manufacturer's Name: Pitless Adapter Installer: atifl4 Well Disinfected Upon Completion? KYes ❑ No Method of Disinfection: J ii Comments: Pump IUstaller Name: (A►c`. ANCHORAGE WELL & PUMP SERV. • '. , L q- 330 EAST 76TH AVENUE ANCHORAGE, AK 99518 PHONE: 907-243-0740 AWPS.COM Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. •12.C— ste /00.00 0 c 0 1' o en _ S0/12¢'0o' W seeder i « ¢O' V s 514A.trely 32_a Lt., /0 4-/o 6 044153556 a i< /2.6-/ c #SS63z i<�'k t.t„ tO,suu. brf 0 -OI 8/ /a t � 5 594 y Geese, GcJJ Re erl;/'ed 7-22.8/0/ �.s 61'; it Sto-�:y . 1"" ! 1 hen ty cert:& trait 1 have sur. eyed the fetl.m. i c:i Kopf. r:;•:..4 /2. L.}s_13 t 13, U. S� SMrv<y OF 411 el4S .•........;45,11 "149TH t .fit i i f 4/!v p � re tee% 11r.a waqt1a f e ; ti AY 1. 32S� It. n seasre t k ' Ssl:xatL °" a0^ 14S:pp EASEMENTS CF flCC C, OTHER TnAN THOSE SMOWN ON THE RECOWED ?tAT ARE NOT SHOWN HE:UO!'L Ip. "••d time. asrnnst mon•v /hill he frrN.itPl' ••,. 4•^•-r Z0'd t7BZ-1 ONI .111035 2101Od 14138.4 • • An. 1•M•A c. itCclddj11s T •IYrintl. ' Al.rk:.. i.nd thn; •••• • 1::1:r4•:•c:nrnt' situ.!.-1 1 nenKm ::re w 11 it n ;he 1••1.1'••1•• itr.c.' nu: n:• ng.! evenar or enrrn,rh on tr.• pr. ;,.:•. ' !:, .: 11des( nt Mundt,. that n1• .....vvrinr::•• • p•, r;••• ;r1':::,ijuerr.• 14E00 1:nn.;n 1.r.:"r• rr:l .. •1:.11 :.i;t! Thad :n• rr hre rn: dtv:.t•s, 1'...+:r: 1 • bl .1: he: t•1:1!is an stat! r11•;.t1::• t:rt;• i r.a :td.c:,1'd herr6:: ; r.:a r.! at Anrh..r:.vc. Aihv.•r t'.::,...Z• --`'ay of IGad .n.M.ol.�..... FIir1P WAI 1Tt< A S. "ci:T:'1.1TIS T:I.t k.I .. S... •,.•. . t? F6 C080LLZL06 Di H£:0T 16. 9T d3S GRE* ^R ANCHORAGE AREA BOR �'GH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 _ yn�_ INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAMES , ' % / '- 1� n MAILI ADDESS A�'S ,�p !.7OL i / PHONE g. LOCATION > V v. ka Get PI -`LEGAL DESCRIPTION! 0-7 -' CR' GGNI"• jLt�w'�'-yam �v SEPTIC TANK: DISTANCEn NUMBER OF FROM WELL fie?' MANUFACTURER .5614•440.AMATERIAL COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY )PSVALLONS. TILE DRAIN FIELD: 33 NEAREST LOT LINE`! 0LO # DISTANCE FROM WELL FOUNDATION NUMBER OF LINES ezi DISTANCE BETWEEN LINES As' n o so TRENCH WIDTH 9S ABSORPTION AREA 9S / SQ FT LENGTH OF EACH LINE(e �d / / DEPTH OF FILTER /! ! /1 DEPTH: TOP OF TILE TO FINISH GRADE 9Z" MATERIAL BENEATH TILE `g IN ABOVE TILE i IN TOTAL LENGTI) _ j J OFVLINES" a�� +� IN TOTAL EFFE TIVE S6 ' ,c) _1" WELL: TYPE12VOf BUILDING FOUNDATION CESSPOOL APPROVED CONSTRUCTION DEPTH DISTANCE FROM: NEAREST NEAREST LOT LINE SEWER LINE SEPTIC TANK , OTHER SOURCES DISAPPROVED SEEPAGE SYSTEM REMARKS DISTANCES: 4/0 A.Y/ t -Q-3 . hJau- ad" INSTALLED BY Q1.0 /� SEWER LINE DEPTH• �p lP( tria�'�r PIPE MATERIAL LOT SLOPE: /I/4 3 REMARKS: rrid •-•Yb!/ DIAGRAM OF SYSTEM Form EQ -032 DATE CPPROVED G.A.A.B. t�wVt e-) 9 GRE =R A CHOR Sec. 7I0A,1 ,elio\ %UGH .. _ M s�,� ,y /D-/ /?» DEPARTME 3330 "C" STREET,. TEL $WELE- SEWAOE DISPOSAL SYSTERA - APPLICATION AND PERMIT 271- 79-1546 PHONE NAM OF APPLIC MAILING ADDRESS INST LATION LOCATION LEGAL DESCRIPTION Y , L4T 62-D OS, Goo, dvv2.td 3 2oO INSTALLATION OF: SEPTIC TANK I./e SEEPAGE NT /Aye' DRAIN FIELDtoge:Oaa. OTHER bI1 1 TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH �+ �/(Ia 1I/' SOIL TEST RESULTS (2' P /¢ �iMt / 7` / CNOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED v✓ TO BE INSTALLED BY L FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL(QUALITY AUTHORITY WILL BE SUBJECT TO _PgROSECUTION. D'F^ j{�J�%%�l % SEPTIC TANK SIZE 1000 TYPE C0 a^S`--av SEEPAGE AREA SIZE / ?SF' v'wITYPG '"-•o"c •`� •'�"id MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT _ DRAIN FIELD SEPTIC TANK TO SEEPAGE NT WALL SEPTIC TANK SEEPAGE PIT DRAIN FIELD DIAGRAM OF SYSTEM TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD /00' WATER MAIN TO SEPTIC TANK DRAIN FIELD e� SEPTIC TANK, f ° 01 SEEPAGE PIT DRAIN FIELD SEEPAGE PIT ALSO CONSIDER AREA WELLS. SEEPAGE PIT 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. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. OR LICENSED DESIGNER r I- 4 - I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORD CE WITH SAID CODE f.� J DATE7� 1 —7.3— APPLICANT'S SIGNATURE ( �.--f '"` FORM NO. EQ -016 M -VV DRILLING, Inc. P. 0. Box 4-1224 • 1310C International Airport Road (907) 274-4611 LI ANCHORAGE,- ALASKA 99509 I 1 Well Owner Gcorcie B Walls DRILLING LOG Use of Wel] ''`-'' Location (address of: Township, Range, Section, if known; or distance main road Lot. 7.2•,.0 Rand Avon ?zziz .n � �777,4 3 a a o Size of casing (j" Depth of Hole F;.''. feet Cased to 50 feet Static water level ft (abo`fic) (below) land surface. Finish of well (check one) open end ( ) ; Screen ( ); Perforated(: Describe screen or perforation_ inn )' • Well pumping test at 9 gallons per (holm): ): (minute) for s hours wit of drawdown from static level. Date of completion .15 Auc,n'-1.715 WELL LOG ft Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness u TO 10 TO '20 29 TO ?0_ ;ii- TO ;it TO 7r} 70 TO 2716 TO TO TO TO TO TO TO TO TO Sa:l=tv tx Ct.>1)bl.ns; Silt 3 tor �a Pra{lf:l fir W for' rl rc-1 1 • Certificate No's. 814 & 973 2 —STATE it GREATER ANCHORAGE AREA BOROL., Department of Environmental Quality 3330 "C" Street Anchorage, Alaska 99503 O(LS LOU - PEROLA'PION TEST Performed for 4.9e 01/5. / Date Performed 171 -- Le ga 1 Legal Description:7ct /%? -7) r•-',a7c { Gsc 3goo ALL (4/ Tii; E; \jla This form reports: Soils log Percolation test Depth Feet 1- 2- 3- 4 - Slope 14 - Was ground water encountered? /1e) If yes, at what depth? Reading Date Gross Time Net Time Depth to [Nater Net Drop -r F Percolation rate minute. -Proposed installation: Seepage Pit Drain Field Depth of Inlet Depth to bottom of pit or trench COMMENTS: Performed By: j� Ei£�2 J Ci i� Certified By: F(]-nan (A/7a) 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I D # cc\n - nL11 - 1 Ll HAA# 1-\ 16-11n5gn 1. GENERAL INFORMATION Complete legal description U- S. S. 3 Z-G0J Ga T"fOn% RJO, 5c -c 6'1 S.Ail. l\ IC 14 Location (site address or directions) PAt-J1 AJ -0•10 C OF F iJ .0 - -i 12-0+�iD /1.15 n (h(S. AlLA1.3L Property owner CN,-\mn\mv(-. 9 \h Day phone Mailing address Lending agency Day phone Mailing address Agent POLA-IL )ZCA-t y -- 6 t /2,46 .4 'Day phone 349- 7LS1 Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 3 NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer K NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Roy 1/91) Front MOA#21 LZM VOW )IBB (1.6/t old) 9 O L •>110M s,ieeuleue leuolssa}oad aql ul suo!ss!wo JO saoiie ao} a glsuodsei lou sl a6eaogouy }o Rlledlolunw eql •penss! s! e1Eol;luao E aao}aq elep ez/leue .(o suolloedsu! lonpuoo lou op St -H4 SeeAOidw3 •sluewealnbei owls pue 1Eaapa} uleueo /yslles olaapao u! suollnlllsu! 6u!puei alagl pue sewoq jo siesegoand of (sepnoo ase slgl scop SHH4 e1u •eNsely 10 ams ew ul peJelsl6aa aaaul6ue leuolssa;oad luepuedepul ue Aq enoge g gdea6eaed ui uanl6 suolleluaseadei eql uodn/quo paseq saleol;luau lenoaddy A1laoglny U1IE9H miss! (SHH4) saOIMas uewnH pue U11eeH;o luewuedea ebeaogouy }o lllledlolunol oql NOI1f1V0 t- -/ alae sluawwo0 leuolllppy :suollelndlls 6u!Mollo} eql gum 'swooapaq ao; lenoadde leuolllpuo0 •panoaddesla •swooapaq ao} panoaddy k 3Hf11VNDIS SHHO '9 / b�a 2�/i 63ea --171-"0 '�^>io aanleuB!s s,aaau!6u3 %ZSbb 794e71OHnr / 11 LLL O/ Z nps ©C saw ppy 0itb-cniz auogd 0rr/'2J="L9("/9N3 (v0SZ13Cr •uolloedsu! slgl }o alep eql uo;oella ui suoileinbeJ pue 'seaueulpao 'sepoo ems pus led!olunr 112 glint eouelidwoo u! s! wals%ts lesodslp aalWMalseM ac/pue Aiddns aaleM alts-uo aql 'uolloadsu! pue uolle6llsanu! Aw WOa; pue sell} 9Deaogauy;o (l!ledlolunw eql WW1 peulelgo uollewao;ul aql uo peseq legl!}uenaaqun; l •ulaaaq peleolpu! einlonals }o adAl pue swooapaq;o iegwnu eta ao} elenbape pue leuolloun;'a;es s! welsAs lesodslp aaWMalseM ao/pue Aiddns JejeM alts-uo aql legl smogs uolleolldde lenoaddy Awowny UlleaH s!ql }o uolle6!lsanul (w legl Anion l 'Molaq uMogs alep uo!lepllen eql;o se pue olaaaq pax!;;e leas (w Aq pal}llieo sy Wild 40 OWEN 1:133NIDN3 AS NOI103dSNI JO 1N3W31V.S 9 Legal Description: Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Lof 12.2, 32.DC Parcel I D NGia, TI��, RNA/ A. WELL DATA Well type iMhIVIDUAV Log present (Y/N) Date completed el Driller MW 1702,114 Total depth a' Cased to 5o Casing height Zr If A, B, or C, attach ADEC letter. ADEC water system number iJ/A. Sanitary seal (Y/N) Date of test Static water level Well flow Pump level Y FROM WELL LOG 611617% 9 WNK SEPARATION DISTANCES FROM WELL TO: Septic/hetding tank on lot O6 Absorption field on lot 1t7,1 rJ/4 Public sewer main Wires properly protected (Y/N) ) gpm Public sewer service line N/�t WATER SAMPLE RESULTS: Coliform Date of sample: a Nitrate B. SEPTIC/Mot`D G TANK DATA Date installed 51075 AT INSPECTION s ; On adjacent lots > iib ; On adjacent lots -> 150 v -f Do :+ c o -o 7 w. xo gpm3y o rn 0 2 m o m N Public sewer manhole/cleanouttI N/11 Petroleum tank WA 7ily1. i— jO�th�err bacteria 0 / Collected by. /��I1�/✓(l - Tank size Cleanouts (Y/N) I Foundation cleanout (Y/N) y High water alarm (Y/N) N Alarm tested (Y/N) Date of pumping. i /3 `J l h Compartments 1 Depression (Y/N) N SEPARATION DISTANCES FROM SEPTIC TANK TO: Well(s) on lot �Jb/ To property liner 92/ i7.00' Surface water/drainage 72-026 (Rev. 3/91) Front MOA 21 On adjacent lots >10 t Absorption field 19 Foundation 13I Water-thein/service line r CONTINUED ON BACK PAGE C. Date installe. Manufacturer Size in gallons Manhole/Access (Y/N) f- - Vent (Y/N) "Pump on" leve -----"Pump 'Pump off" level at High water alarm level cles tested Meets MOA electrical codesco(Y/mss `f SEPARATION DJSTANCE F OM LIFT STATION TO: We' lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed„dd Length 1ti'd't Width 3/ Soil rating 125 5•f I,R System type 014VW 9RA11JF1bl i7 n 1 Gravel thickness ' 1� Total depth >i} Total absorption area 09 s.4 Cleanouts present (Y/N) I Depression over field (Y/N) N Date of adequacy test 10 I2 191 Results (pass/fail) PGtzis for 3 bedrooms Peroxide treatment (past 12 months) (Y/N) N If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot4O/ On adjacent lots >1%).1 Property line 30' To existing or abandoned system on lot KJ/A On adjacent lots >7-40 Cutbank FJ Waterwrain/service line > 20 Surface water N k Driveway, parking/vehicle storage area =50 To building foundation >f701 2 Curtain drain E. ENGINEER'S CERTIFICATION 1 certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this. inspection. OF /T1t) Signature Engineer's Name Date HAA Fee$ Date of Payment Receipt Number �2D O3 933 72-026 (Rev. 3/91) Beck MOA 21 Waiver Fee' $ i'\\L% 00: Date of Payment la -1\-A \ Receipt Number 2,?2'tP3 Tom Fink, Mayor Municipality of Anchorage Ai* Department of Health and Human Services dhhS 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 January 7, 1992 Michael E. Anderson, P. E. Anderson Engineering PO Box 240773 Anchorage, Alaska 99524 Subject: Waiver Request for USS #3200 Lot 12D Waiver Request #WR910057, PID #090-041-15, HAA #HA910580 Dear Mr. Anderson: Your request for waiver of the required 100 foot horizontal separation of a septic system to a private well has been approved. The approved separation distance is 86 feet from private well to the septic tank. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Concur: Daniel J. Roth Civil Engineer On-site Services ljm:#6 L ohn Smith, P. rogram Manager On-site Services MUNICIPALITY OF ANCHORAG: Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# WR910057 PID# 090-041-15 HA# HA910580 Permit # Date Received: December 4, 1991 Legal Description: USS #3200 Lot 12D Engineer: Michael E. Anderson, P. E. PO Box 240773, Anchorage, Alaska 99524 Applicant: Commonwealth West Mortgage ****** Waiver Requested: Private well to septic tank - 86 feet Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: \ Waiver is NOT Granted: List Conditions or Reasons for above: 51 ,e /q /TM rife- 77 Date: 1- 7- 7/ By: ( Rec #: 23263 Amount: $ 410.00 Name Of Reviewer Date Paid: 12-4-91 . W/ill/ER llEQuFST A, i? u #3200 JOT /2 0 ! us/vER gEeitts T /i/4,'t8EIQ wr9/005-7 iIW /91✓ER REQ u ESTEO FOR 9( FEET FIfGH YELL To fEP'T/c rM,vA- —i vl/FLI j%TM - -IsEpr/c t FflT/3 — ; • %k6 SEPT/ r r tipx w &s /N it/n t Ed /t, F - 7s tieing To Tut" k E LL D(1NG (Oti3Tie 4i ere -rce %`nN/( /J 4 l 2 5-0 (, AL L On, $ w Njer aryt3illic ri},v/s-f N 6 /y ergs E. L E v,¢T/04QJ R, oictfrE Tk'9T T/4£ SET/c 7 -4 -wk /1 //PPfjak /m.vTEL r 7 lI 1 fit/PE 001A -an RD Fin 1. --ELL To T/'it. SEPric ricbvir. Itimin" PL/yfT/c Tfn>Kf L. -EKE F/TnJ) t..i/ai rr_L'vEy /A, /%75 S0 it ,./DIAI V) Pc --m r -c 7 as eel ,... r r-LInr Q.-1: mT-cn11Z M'T i i..,0//4./_s Aec II —i vl/FLI j%TM - I I rnE ivELL. b -/t.5 PRittEp Di q t 4iPPRo.ti/,v/aret r 12 t-6EKs ' FZfg T?IE SEPT/c fYfrE Ai I,./9x/•L STIjhLED / KERF_Ls A/o A-Pt4-/tENT IQ61Son� FD/'{ %/!E 4-Et(86//v6 /O/P/Lev 5 Tic CLOSE fl, rile { 4 rHt I, FLA_ Is FEET OEEP To Iw irk FP Rock 5t/1vo F.v (c&i#va-4w Ar 70 FE5 T; CrER _ft }ls ENcNuNTFp Blit -EFA, 0 ` 70' FEF/ BFLot,_ r/ -/E 5cidepf/C/E /5 /9- CLE.4it. 6R.v1L 5Eei ,t4_ Tke�z s/L rY _6/9/9vEL Fl?UM S 0 FEET 7--/4E S F/9 -CE, nit- fr.&T'E w,L re/q LE L I'S />T 3S- FEET. riffs 4-6u4P >,-121c57r r/bi.r rHF 14-6rtj IN 71f6 (L!E/P y 6Jfjgj L /S co.vF/rtP Flo --c 5 uIPF.QciE COn-TkHt/w47/ON, A c. ELI LO( FfoM Lor /2 O l4PPRUxjngritf "co Fro 9-c/for_VawA-5LoP( R'ott T/y, Su0IECT WELL /tiD/69TEs rW/FT 5 ttOSu /Pre f 0/4 L 4rE/?S 4RE io/-nsf w7 kj O 1Pjw P/9 Rfr 4 L L 5G TO iwr 6 R 0 kti S GL /QF» ei . v, 1i. rEe S f}Mpi_ FS /N0/CNTE Ili 17,7- THE go" /¢IPE A/O 8, cregm PAESe,vr novo 2.2/1.0 Ain -Rh -re PRE)" 4-4.7-, F/?0•.--c fin k -ELL f "9-mei-Cr u /,SLCPF F/Pon ra Ikon( u -EG L /,v2Zlt#Tfs it-( e itE /f A 04CK6R0c4-.c'0 LEvE'L Of/TflrE3 /.- T/ae WELLS /ti TRE .9REA. rT IS CtieM - me Nirim T515- l"' THE 5"ertC_i ivF[ I fllr Aec F/Zo"-cr'1F Stt/3TEcr FA/CRohten/#4, 5EPr/c T/3-A4e i S,of/3,D.F. C.5,p Gam, 5. for 5.C.ft, a gottiTS w/*rE,? th0LE So' -7'2t'3 ' k =3 xson - r^- :! So/t se/tin-In/ 3.6 1 3�4,FtLilyLS= I PfRH.E40u. , r e ()3 (CAC= C= 2. 3 wi-rER T/}QcE 6'?)30/Eovr q /4rlur - k.O1?1F CnS£ 4% . • 2. / tieliza,n-AJ 5 F698f}TION n e ` z 2. 1 ,' Zr� b -.yam i'e1,ri, %0 Tilt /o..3 {ctii/ kfivti &i?»#- U-A/VER •Noveinber 27, 1991 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Reference: U.S. Survey 3200, Lot 12D Subject: Separation Distance Waiver Dear On -Site Services Engineer: /9)0910031 RECEIVED DEC 41991 Municipality of Anchorage Dept. Health & Human Services We are hereby applying for a separation distance waiver between the private well and the septic tank located on the referenced lot. The drainfield exiting the tank is located more than 100' from the well and is therefore in compliance with Municipal regulations. The tank, which appears to be sound with no apparent leaks, is located 86' from the wellhead. The static water level in the well is 18.5' lower than the bottom of the septic tank and 30.5' lower after drawdown. The soil type between the bottom of the tank and the water level is predominantly a silty gravel with the ground surface sloping away from the well at a 10% gradient. There is currently no development on the north, south and east boundaries of the property. The static water level in the well on Lot 12C is 149' below the ground surface. This well is 185' from the well on Lot 12D with the wellhead 12' higher than the 12D wellhead. With the static water level on Lot 12D at 37.5' below the surface the hydraulic gradient appears to drop rapidly in a westerly direction at a slope of nearly 54%. The attached detail illustrates the hydraulic gradient in the area. Separation distance waivers have previously been issued on Lot 12D and also on 12B by Municipal inspectors. No evidence of contamination of the water table is evident in this area and the separation distance between the septic tank and the well on Lot 12D is not a threat to present any future contamination. Sincerely, 71' y,i(',.ct t . Michael E. Enclosures Anderson, P.E. Jos US$ 3 ao or n.b SH=ET NO OA CALCULATED BY M EADAT- ','z 7/9/ CHECKED EY Dr= S^A, •ccic ? C1) reAIN AV CAR T.S ............. .................. (2-07> CP -7 y ........ rrel PL - .. .. . . . ........ . .ktream% AradsZt 95 • .1,f• 411Ih 41- ieg‘. a.940.47.,pti\ %.* • "* c; et,SeeeseEece •octstdflgove ts.:a41100C tosonemeetlt&.. i4)ei°7s. fib it0\.042. JOB USS 31o0 1-07 /L-0 SH•trT NO OF CALCULATED BY frigTh DA"c i1/47 /I / CHEOKED EY SCALc I . I D7r0 re% or TA -1,c 70 SlrAn c_.. 14y ccica. t is., s" B.0 !to m 0 F TA pa 1C-• y0 -bk-AQ tX).µ.10 /40 LCliCL ............ . .... ...... . .............. vir%1-1- t- I' 7 usg, at: t, Petit; VE Vitar.r.0 °-Et-rc' '11 -FAN-, ROCKY - : ritKI PKAI %I 4 'el. I, ) 7 g 57 AT K.. b42D 14-vcz.. 4k),r2I %rile-- fir1/41-1K DEA t -P000 FILD LEJL-7 —qq 4 aa7871fainfec Pri-onicId'5cv..1 4 h /74,41" t. • ; 9 12-7 _ (VXitt ...19 ..-. IA% * Alv r tr" : P.1.2_,-_-, 2,, fe, , ,..3 p , c 1.4 m i : --ro v,z_..- 7Lf r 1 ;,:c1113-taLeitil, ea, sc_e4._ tie: '114‘.% Michael.. E. Anderson :‘,H4r $4 ' IP- It 4-81 .. E 14:44:7 °I ;;:.- Lt. ',./ C L. , ii,...1 t-e.L.r. „., 0„,.„00caz,..•..........ra,,ii, e, 5. 0„ ., 1/4 it c2•-eest. ..t9C ' t . Teo ' ".""'"c 0\ •# 0 k t;;)80IrESSk° €rir ' ' ‘‘StaTirltr•g4a242‘ JOF SHEET NO CALCULAT=D BY CHECKED BY SALE s 310oLon- /zb OF DATE DATF 11i 0'/gJ. c.:77= -V7 Lyc. A- tJOTE (Ai A -r -C)._ CEVEL ti tOr (ZQ. WAS PAE.4.5%V.00 o• ///z 7 /9/. Lot' / Z. C.-• Vr" (0)tfi //1 Lor b / atne OF Al .1141% ATI:cte a na28:4 CO . . C. a ..,i- A .srg.tai Os Air Ill e49T 4 4,4 e* el, t vtlefittec .pi ' feSllcyrpai ti'..eoco00e-ensocainiseas:r7,5,5.i* I4 /b72AuLIc„c7r_4bENy;ifichael E. AhT&rson::::t?isi6#o1 pc:s 4 A; i`ote . . • c. ag .}. ytkA'oe2"-..••••°` Cc. as N ti Attu rz.,,,,sz1,013,„"ta Alo Sc: "1UHll.l Yr:vl I I vY Department'M Health and Environmentar rotection 825 Street, Anchorage, AK. 5501 264-4720 * ` ~ HANDWRITTEN PERMIT * • * WELL AND/Vt. ON-SITE SEWER PERMIT Mailing Address:4 ia:. z&t./ 10e rlrsv% Applicant: A) £Y6QTv,er ocation: 10,S new Ter 1g Phone Number: 797-40/ Legal Description: Lot Size: .fes, goo Type of Soil Absorption System Is: Trench: !/ Drainfield: Seepage Beds Holding Tank: Maximum Number of Bedrooms: 3 Soil Rating(sq.ft/br) gSr The Required Size of the Soil Absorption System Is: • DEPTH 9 LENGTH Z & , GRAVEL DEPTH WIDTH 30 The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = /000 GALLONS :Permit applicant has the responsibility to inform this department during the 'installation inspections of any wells adjacent to this property and the number of residences that the well will serve. • • • TWO(2) INSPECTIONS ARE REQUIRED Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet ;:or a private well or 150 to 200 feet from a public well depending upon the type uf public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER •31, 1933••• • • • • • I certify that: I am familiar with the requirements for on-site set forth by the Municipality of Anchorage. I will install the system in accordance with codes. I understa d t = the on-site sewer system may require enlar the resiode ed to include more thh,93 bedroo Issued by: �/(/83 Signea: sewers and wells SWP/024(1/81) NO1C . f/!/C- yip/ e. Julia 74' as Date: �4 d $74W tt otA nt Y 0-y- .r/a_vel/�J re/ / le - /ate J,c t/.✓/r_ 0 ro rt 1U0.12M OU NOIIVW11011N1-13S1141 P:5 0 4•1 Al 00 OLftif:.0 tr1 01 03 in V1 1 41 41 4, • A 7.1 Al z A 000000000 -... a• v. ins MW to NOLINIS1101 :10 (INN .••• • m 011/1V IS - 31\ - 74 4 4 :1 4 4 4 4 4 4 4 •••4 0.1 ••••1 ••••I 0 0 0 0 0 0 0 0 0 0 0 44 01 Pa 4-4 1-4 4.31 .0D VI 0 N 03 74 z r. fl tIn CD 0 0 )poi painqoua; li 0 0. N D {3O1 paarnovii )1301 painqoei; 1-71 U110-4SICICTO* 13 "01 •01 r11 r AA X 73 z73 A X A 000000000000 ;•••• ..••• •••• ••••• -1 0 0 0 0 0 ••r• 'X 'X 7474 r4 -1-4 4 -4 •-s 0 0 0 0 0 0 1 74 0 4 rrs zre441 rri cp PacmiTO T9E gd 09 Pas". It (INV1 :10 I11N4% 11341 :1011143(1 POST OFFICE BOX 42 - CHUGIAK. ALASKA 99567 V)ISV1V 11V3M:13S 3M Well Owner ;,407) 274-4611 ANCHORAGE, ALASKA 99509 DRILLING LOG — _ Use of Well Location (address of: Township, Range, Section, if known; or distance main roul_ l of "le 'A, Sim6 T7o.1/. e�6[l S ,t Size of casing Depth of Hole feet Cased to 50 feet Static water level - _ft. OHM/4) (below) land surface. Finish of well (check one) open end ( Screen ( ); Perforated ( ), Describe screen or perforation_: •' ); Well pumping test at o gallons per (hour) (minute) for S _hours with 2 n ft of drawdown from stage level. Date of completion Depth in feet from )' ',tic-, )97S WELL LOG ground surface Give details of formations penetrated, size of material, color and hardness TO __n TO TO -LTO -r 1_TO 7'', TO --._TO TO TO _._ TO ______TO TO TO _.. TO Ca-a1r:.] s c; ( -i•f.l - i:atr. 2 — STATE FIELD PUMPING TEST DATA SHEET PROJECT: DATE OF TEST: LOCATION OF WELL (Legal Description): 1-01- IZ--0 U,S SI -I-V 3Lrrip WELL 1)E2Tr: 86 FT. CASI?4G:_ ;"-D FT SCREE:I:/,JO DATE DRILLING COMPLETED: $iI�I7G DRILLER: STATIC WATER LEVEL (Top of Casing): 37r ---- FT I IV5Ia► I 1 Elapse^ Time Since lock I Pumping Started/ ime Stooped, iiin. 0:1 - 0•24- /1•^A - '•2 -ll'A II ,y l:q 0 1 5 10 10 20 25 Ju 35 40 45 ! 09 :0 j bei 11 Hour) 1/4-8 i 90 1:0 120 (2 nouns) 150 Depth to Water, ft. 37.5 (s ail ) 38= 41.5 .>5 4M.7 _/'19 123 13 hours) . .2L412. I - 210 311, 2. ;d Hours) •49„ RECOVERY /..- 3',39 0 1,, 15 2) Drawdown/ Recovery q.R 4:5 Pumping Rate, GPM Gc 0 Start Remarks 25 .:O 3J 45 50 b: 63 r1 noun) .v C') _ :'.ours) APPLIC' `NT FILLS OUT UPPER HAI ThONLY Property Owner Vol_ Aro i A «SIS 99 f 71-.0 t /� Mailing Address jl`- I.ty7A g86? f o3 A��LA5 k4 Zip Code / /40 Phone 6,5 3 7a0g Buyer ETF/4 J/ V J E Address s. R. &K KYi (� .-).1 `-lk.-Al\ A -4.A k -A- Zip Code 79 546 Lending Institution 6 L -/%E 2J <_ 6ac c7Z t ,?/o(acs AAcSE Address 401 E. {\..)O[Lilleat) I tGMT S A AJC. . A_ Zip Code /' S(� -j Phone 85 Ssk Date Zip Code Phone Realty Co. & Agent -- r ' _� --- NO ,R= Address Legal Description Loy 1 a b LASS 3 ZOp Street Location RF,j() AOC i-A1-TAt,A ALASKA Type of Residence CSC Single Family 3O Multiple Family No of Bedrooms ❑ Other Water Supply 'r 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). Sewer Disposal V Individual O Public Utility - ❑ Holding Tank Year Individual Installed: When Connected to Public Utility Date Sewer Installed NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date `� -\q,-RI uVl v _ Inspector Inspector Inspector Inspector Fiel Wes:, 0 _ / MUNICIPALITY OF ANCHORAGE _ DEPT. OF & �,..-`ALL -' ��L(—� ENVIRONMENTAL PROTECTION 4+" ,- 5e -- s MAR I i i ,3 t r., C" &/c-c,_s0_ -r RECEIVED (3) APPROVED BEDROOMS ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE ^ 2) - 'CONDITIONS OF APPROVAL BY: - 1 _r'' Soils Rating " - / Date Sewer Installed Well To Absorption Area Well to Tank Well Log Received 42 x Septic Tank Size � y, C 0 72023 (3/821 hcr% am-) `7 -:5O-q I ad k±1 ✓S �lrv� e - IL` -,W10 _1 MUNICIPALITY OF ANCHORAGE MUNICIPALITY .\& DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF • 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL OF ANCHORAGE 7/ HEALTH & I PROTECTION 2 7 1981 t(.1 ENVIRONMENTAL ENGINEERING DIVISION JUL ,.:. Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEVRIEIQEILVIEO DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days fo processing. 1. PROPE TV OWNER �e©e6 td /41_1_3 PHONE o272 -4S// MAILING ADDRESS S o t /9s7- V �Q1, aikMeg,�� fico #026 / PHONE PROPERTY RESIDENT (If different from above) 2. BUYER JJmes f9PIO Cl/40E ge(2e y PHONE MAILING ADDRESS B� Q `'�/') 9 [�, _ S) 26 .TAJo//» 4- / 2 G/o 5END)rGINSTI II PUBLIC. UTILITY. TO,.1( 1 RL ASKe «S 17 eee»L l 2Pou- L/zJ/ w PHONE c2x - S%OO /6 MAILING/ADDRESS / /I,, ��%% plc /—/('/ 02 6 D LJ A 1-)e LA2e R.cJC-14 A< s--- 4.77-N: Z6 / r�1 cu //flpp 4. REALTOR/AGENT Ge2At Oa te 6sPISMO/C. PHONE 77-66S.5-12MAILIN G ADDRESSf,sT L/) - &Ade 2c / 5. LEGAL DESCRIPTION / Id /et) ,D R42,0,„„-- of LnIs /a w / 3 GIS S/P /tag y 3024O STREET LOCATION in /9 ..- V(01f9.) IIt1+Srcp q,J0 6. TYPE OF RESIDENCE NUMBER OF BEDRO MSd�- 111 One • Four • Other r� SINGLE FAMILY '�", El Two ■ Five • MULTIPLE FAMILY IN Three ■ Six 7. WATER SUPPLY 91., INDIVIDUAL* *ATTACH WELL LOG. A well log is 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 %7 **If individual/on-site, give installation date /� . yi_ INDIVIDUAL/ON-SITE** If system is over two (2) years old an adequacy test is required II PUBLIC. UTILITY. by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS 0 THREE FIVE SIX 0 OTHER ■ SINGLE FAMILY IN ONE ■ O MULTIPLE FAMILY 0 TWO • FOUR • 2. WATER SUPPLY O INDIVIDUAL PERMIT NUMBER DEPTH OF WELL • COMMUNITY DATE DRILLED IIS PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM OINDIVIDUAL/ON -SITE OPUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER OSeptic Tank or • Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS .„,,^jL ,, plut.Udi Agri"�% ? - ,P„, I----APPROVEDFOR-f BEDROOMS certificate) (letter mu accompany R l • CONDITIONAL APPROVAL PV -DISAPPROVED /^1 — DATE -3 d8 ( (Title) LEGAL DESCRIPTI N V 72-010 (Rev. 3/78) LtL2L Mho GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 Street, Anchorage, Alaska 99503 274-4561 Date Received December 31, 1975 Time of Inspection ()/)fl,liyl 1.7ba.„10 Date of Inspection s-) A 09;5 Spo REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Cony. Approval requested by: First National Bank of Anchorage % Dixie Mailing Address: Post Office Box 720, 99510 Phone: 279-4481 x _'231 2. Property Owner: George E Walls Phone: 279-6541 o ttarb s r•lorisc (tjohn oras b . alls: Mailing Address: 5,f, gey 6b' 97590 3. Legal Description: NE 1/4 T1ON R1W Lot 12-D Sf=G G 4. Location: Indian, Alaska 5. Type of facility to be inspected 6. Well Data: Individual A. Type C. Construction 7. Sewage Disposal System: A. Installed 8-6-75 Single Family No. of bedrooms B. Depth 3 s y D. Bacterial Analysis On-site system. 13pc` .(4 t/ �"���"``"���0 B. Installer " 2. Manufacturer C. Septic Tank: 1. Size D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: ,7 A. Well to: Septic tank Qe�S i , Absorption area Nearest lot line 8 0 'f Other contaminationfilo Alk-• B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line Sewer Lines _, EQ -034 (1/74) Page 1 of two pages Pale 2 of two pages - Re"—.t for Approval of Individual -r & Water Facilities Legal Description NE, 1/�4_ ;T10N R1y4 Lot 12D , Indian, Alaska Comments r o _. ,fl. Approved Disapproved Date /- 7-74i A royal ,Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Date / MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 — 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA FHA 2. Property Owner: Mailing Address: Barb's Florist Day Phone 279-6541 3. Name of Buyer: Mailing Address: 4. Name of Lending Institution: Mailing Address: Post Office Box 720, 99510 Phone 279-4481 5. Name of Realtor or Agent: Mailing Address: Phone George E. Walls MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION Litt; 31 1975 RECEIVED CONV xx n/a Day Phone Anchorage First National Bank of n,la x 231 6. Legal Description: Location: NEa T1ON R1W Lot 12D Indian, Alaska 7. Type of Facility to be inspected: Single Family No. Bdrms. 8. Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility Individual (on-site) xx 8-6-75 xx 3 If Individual, date of installation EQ -037 (1/74) V3 att5 kala 5ko (t tr'itr ltilo tj ac (- rd get -71rc — 4 t 1/a41.27'e/ (k) D i(Qauokk %Qgive ,141 ;u� co ,f Co to 1 C Caws P d)ybuud154'4 .L5 {-,Ar Vesi /> auk q Aar, c� %s }kore • 1,1 11: y (11,7.92 . FOEc'-" .. i.SU:c /JO,2g /o o,c vv�J e P F f+an uofo„yps v� ,00c� oy. uSC 0 %_ s‘-'12\40 ly t 4' C N ity er \ o "•ns,�o� t l. !!ct v. C) I-2 ho?qh —�c ' L#70 er'`•ces0�\ r—-.# ia ao. z n0..4/ • - a ore: e Ioi/t;z y l 'I.� C� r 0:C5 -i_ ° • o ss 0 1 0 v o 0 t T' 0 h \E h't \ plv/� 41) - f �� Nat•:.) 4i� c Oo///_, ALASKA CfUIROnn1CnJAL COfTROL SCRUICCS, Inc. 8/4/81 AK USA FEDERAL CREDIT UNION POUCH 6613 ANCHORAGE AK 99502 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION AUG 1 0 1981 RECEIVED SELLER — GEORGE WALLS SUBDIVISION—US SURVEY 3200 BLOCK—REPLAT OF LOT 12 & 13 TAT -12—D ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN UNKNOWN AREA. THE SYSTEM 1S CAPABLE OF ACCEPTING 450 GALLONS OF WA1HR PER DAY. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON 8/4/81 SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. -qv��(▪ f�°A°.eo ;4,-AlpPb 14910. ° * 9� 0o so:l000,0 B o • C. &old. Jr. • W.. c ° No. 921514PROFESSfre 1220 West 25th Anne • Anchorage, Alaska 99503 • (907) 276-1361 • - Municipality of Anchorage 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION July 31, 1981 Geroge E. Walls 520 East 4th Avenue, #201 Anchorage, Alaska 99501 Subject: USS #3200 Lot 12D of Lots 12 and 13 Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (1) (2) t(3) Ve (4) (5) The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. A well log submitted to this office for.our files and review. The septic tank pumped with a receipt submitted to this office. The standpipes to the on-site sewer system need to be located so that distance measurements can be made between the well and on-site sewer system. An adequacy test needs to be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this office for our review. If there are any further questions, please call this office at 264-4720. Sincerely, James S. Roberts Associate'Environmental Specialist J5R/ljw cc; Alaska USA Federal Credit Union