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HomeMy WebLinkAboutSAND LAKE #2 BLK 2 LT 20 Municipality of'Anchorage ~ Development Services Department Building Safety Division "'~' On-Site Water and Wastewater Program, 4700 S. Bragaw SL ~' P.O. Box 196650 Anchorage, AK 99519-6650 Page I of"~ www. cLanchorage.ak, us (907) 343-7904 I ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT- "~ Permit Number: .. ~ ~~77 PID Number:, (~l I'- 1~'~ ,a,~: /m'/Vl ~"e dH.~'~" " [WastewaterSystem: DNew J~Upgrade Address: ,,~--m . ~70/~Jcb~fr~/~f, 4r/,/~r4vz:, r~//~/'/! ~ ABSORPTION FIELD T~a~ De~lh fr~m odgimt grade: I. FI, Well: I--I New I-1 Upgrade ff~=,. ".,.~ 1,,~ FH ~ R. TANK SEPARATION DISTANCES ~SeplJc [-I Holding [] S.T.E.P. [] Other:. Tank Reid SlaUon Tank S~ Une ~F~ ~ ~ I~ BENCH MARK Eh' s · s EN~NEEmN~ . '~-- ,. Inspections pe,ormed by: 17034 Eagle River Loop Road, N~S 1u ~7_0~ Development'Se~ices DepadmentApproval 9,~, cs-8~ol Reviewed and approved by: ~~ / ~ ate: ~-/8- 0 ¢ ~' ~:" '""~ ,~.~' ........... . ..... 'C-'~ i PERM[T NO, SW030477 PACE 2 o? 3 Municip. o[i%v .o.F .A, nch.oFgg.e. DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 e Anchorage, Alasko 99519-6650·Telephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT [.ECA~. LOT 20, BLOCK 2, SAND LAKE #2 P.I.D. NO. 011--133--05 / \~- ,~, / ',,,~ / X ' I ~~ ~ LOT' N ~ / 'r /SEPTIC TANK I ~ -. .~ ~ ~ ~; ~ ~ 1 l 0 ~,-..~~z~_~:'. '-'"-~ eEm,~? ~0. SW030477 ~A~E ,3 oF 3 · Municip. 91. i-I:y_o.F Anchonaoe DEPARTMENT OF Ht:::A1_IH AND HUM'AN SERVICES ENVIRONMENTAL SERVICES DIVISION P,rl. Box 196650 ®Anchorage, Alaska 99519-6650·Tetephone~ 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 20, BLOCK 2, SAND LAKE #2 P.I.D. NO. 011--133--05 FINAL ST1 SF 98.9' , NEW 1000 ~ GALLON I SEPTIC TANK I CO1 e v[?i._lcoi = 98.9' // IC02 = 99.4' ,~/,--FINAL GRADE CO1 = 93.0' C02 = 93.0' ~x"-MT1 = 88.9' A B FCO 23.0' 13.5' ST1 40.5' 36.0' ST2 45.5' 41.5' DBL1 47.0' 43.5' DBL2 48,0' 44.5' DV 49.0' 46.0' C01 13.5' 43.0' MT1 14.5' 41.0' C02 40.5' 28.0' NO · WATER FOUND 82.9' B.O.H. N. T. S. .... : ,'V',,~/'.,./Z /__ /. ROBERT ~ COWAN ~.~ ~ c[-88o~ P~rform~rl I=nr· .... Municipality of Anchorage Development Services Department Building Safety Division On-'Site Water and Wastewater P~ogram 4700 South Bragaw St. P,O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchoraqe.a k.us (907) 343-7904 Soils Log - Percolation Test 3" ~ f' 7'- Legal Descripticm Lox' 3 0 J~LK' "& 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16-'~ 17- 18- 20- COMMENTS 16- O. H. Date P..~o..ed:. I ;)'- ? ~ f{~vDL ft l. C¢.. ~ ~ Township, Range, Section: SIo0e Site Plan WAS aBOUND WATER ENCOUNTERED? s IF YES, AT WHAT DEPTH? ~ L o Depth tn Water Affor p Monitoring? ~')/q' "// E Date:/d~ 7/0.~ Reading Date Gross Time Net Time Depth to WaterNet Drop P.e,', ro,~,<1~)/~,/o~ c) '- ~" - so 3~ ~,~ ~" 3 "' 30 - ~" - ~o 3 o ~,~ ~ ,, ~ ~. ~0 ~o~,~ ~ %* ~ ~/~" PERCOLATION RATE J O ;["~ (minutes,'inch) PERC HOLE DIAMETER (¢:3 TEST RUN BETWEEN "7 FT AND ~ FT PERFORMED IN ACCOJ~I~4:::~IRi*IL.e~-'laPL:~EI~,~JI~,kE G'UIDELINES IN EFFECT ON THIS DATE. DATE'. *i ;;L/'~-'7/'~..~ ~agle Rlver~ Alaska 99577 ROBERT C. COWAN, RE. ROBERTA. SHAFER, RE March 15, 2004 CIVIL ENGINEERS · (907) 694-2979 FAX (907) 694-1211 SEWER & WATER MNN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUOIES AND REPORTS WELl. INSPECTION & FLOW TEST srrE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUC-~'UR,M. & MECHANICAL I~SPECTIONS ONSrTE WASTEWATER DISPOSAL SYSTEM DESIGN MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK 99519-6650 REFERENCE: Lot 20; Block 2; Sandlake Subdivision #2 8046 Wilcox St. Anchorage Request you grant a waiver on the referenced property for the horizontal separation distance between the leachfield and the south property line at 2 feet, and the leachfield and the north property line at 5 feet. ' We do not anticipate any adverse effect on the adjacent property. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/ts 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER. ALASKA 99577, Municipality of Anchorage Mark Bcgich, Mayor Building Safety Dixqsion P.O. Box 196650 * 4700 Bragaw Strcct Anchoragc, Alaska 99519-6650 * (907) 343-8301 * F,mx (907) 3zt3.8200 h ttp://xxaxav.m tm l.org 3/18/2004 Robert Cowan P.E. S&S Engineering 17034 N Eagle River Loop Ste. 204 Eagle River, Ak. 99577 Subject: Waiver Request for Sand Lake #2 Block 2 Lot 20 Waiver Request #WR040015 Parcel ID #011-133-05 SW#030477 HA#050085 Dear Engineer: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to property line has been approved. The approved separation distance is 2.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Jeffrey W. Poet Engineering Technician On-Site Water & Wastewater Program Municipality of Anchorage Development SerVices DePartment Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage, ak.us (907) 343-7904 Waiver Review Worksheet WRg: 040015 PIDg: 011-133-05 HAt/: 050085 Permit: ,,030477 Date Received: 3115104 Legal Description: Sand Lake #2 Block 2 Lot 20 Engineer: Roberet Cowan P. E. S & S En.qlneerin.q Applicant: Mike Just Waiver Requested:..2 feet separation distance absorption field to property line. Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. WaterTable Gradient E. Horizontal Separation Total: mmmmmmmmmmmmmmmmmm-mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm Granted: ~,,,'"/ Waiver is not Granted: Waiver is List Conditions or Reasons for above: "Nafft~of Reviewer Rec#: 3-15-04 Amount: $175.00 Date Paid: 3-15-04 MUNICIPALITY OF ANCHORAGE Deve/oprnent Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Nov 13, 2003 Expiration Date: Nov 12, 2004 Permit Number: SW030477 Legal Description: :SAND LAKE #2 BLK 2 LT:201 Design Engineer: 0003 S & S Engineering Owner Name: Mike Just Owner Address: 8704 Blackberry Street ANCHORAGE, AK 99502-4150 Parcel ID: 011-133-05 Site Address: 008046 WILCOX ST Lot Size: 6750 SQ. FT. Total Bedrooms: 2 Permit Bedrooms: 2 This permit is for the construction of: r~ Disposal Field r~ Septic Tank r~ Holding Tank [--~ Privy [--~ Private Well Water Storage 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. ,.., ... B. Covered, sealed, and heated to prevent freezing. r~ 5. The following special provisions. ~ '~AT THE TIME OF CONSTRUCTION THE ENGINEER SHALL PERFORM A SOILS / WATER MONITOR AND :, BEDROCK CHECK IN ACCORDANCE WITH AMC 15.65 AND SUBMIT IT WITH THE INSPECTION REPORT. Received By: '~/~~Z ~ Date: /J/1~/b-~ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/VVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0~. \--\ ~z'J'~-0~-~ Permit Number SV~O~'O4 7 7 Property owner(s)/&~t']~. D/AS']" Mailing address (1) Mailing address (2) ~~~;~L~~~~~ Legal description (Lot, Block & Sub'd.) Lot ~0, ~/o~- Legal description (Section, Township & Range) ~-,,(f"){--i ~. Day phone 3 g~ "~'~' 7~ Zip Code ~? ~'~, Lot Size ~"7 ~-0 Acre~ . THIS APPLICATION IS FOR: Sewer Only r'"l Sewer and Well [-] Sewer Upgrade [] THIS PROPERTY CONTAINS: Hot Tub D Swimming Pool D Therapy Pool D Number of Bedrooms Well Only [] Water Storage [] Jacuzzi [] Water Softening Unit [] I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. 17034 E.gle River Loop Road No. 204 (Signature of property owner or authorized agent) Permit Fees: Date of Payment: Receipt Number: (Rev. 12/00) Waiver Fees: r2~ _~Rate of Payment: eceipt Number: ROBERTC. COWAN, RE. ROBERTA. SHAFER, RF, HEALTH AUIt'IORIW APPROVALS SEWEn & WATER MAIN EXTENSIONS SEWER & WATER ~SPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST I~[~OLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE W/~TEWATER I~SPO~AL SYSTEM DESIGN November 6, 2003 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE' Development Services Department P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 20, Block 2, Sand Lake Subdivision/t2 It is requested that you issue a permit to upgrade a septic system to serve the existing two bedroom dwelling on the referenced property. % A test hole is proposed to be completed during installation due to difficult accessibility, impending weather conditions, and this area is known for good soil conditions. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage pattems by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/bjj Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER. ALASKA 99577 PERFORMED FOR: . D~'~xV [--~ ,E~A, DESOR,mON; 1--O~' 5' · . MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEAL~'H AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG -- PERCOLATION TEST ~u ~ G o.(_~"(- DATE PERFORMED:. I-I SOILS LOG PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 .13 15 16 17 18 19 20, SLOPE SITE PLAN ~ '/~,N~. WAS~'Z ! GROUND WATER ENCOUNTERED? P IF YES, AT WHAT E DEPTH? Reading Date Gross Net Depth to Net Time Time Water ' Drop 11:4~" ~ 3,0 '50 :~" q': ti: S<;' ~o ,. to (o" ~" COMMENTS PERFORMED FOR.' ..D~"/~ · . MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST DATE PER OR ED: '~tLW'I' 4 ~'~) 5 7 .8 9 10 11 12 .13 14 Ralph biO. 1995-E 16 17 18 19 20 SOILS LOG I"1 PERCOLATION TEST '7 '~ tJ t'-~ t3\ V t .S t o SLOPE SITE PLAN /, WAS GROUND WATER ENCOUNTERED? __ N O [ 0 P IF YES, AT WHAT E DEPTH? Reading Date Orosl Net Depth to Net Time : 'Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND · , FT COM M E NTS PERFORMEDBY=COl,4,T~.c'~i~,3f,,.. ~k.t~,lM-t~:l~..~, ~CERTIFIEDBY=_I~I..~I~ ~-~'O[i¢;~-.L./3~¢ _DATE= I .I ST~;LEY BRL[qT N~D/L~IAll?', 'EF~6INFFRS SURVEYORS' PLN~iE. RS 1610 D~mond Drive, ~Z-16 Phone Anchorage, Alaska 99507 PERFORMED FOR: ...~'--'~-- LEGAL DESCRIPTION: ~/~'~' // / 1 2 7 8 g 10 12 13 14 15 16 17 18 20, f SOILS LOG "SOILS LOG- PERCOLATION TEST SLOPE PERCOLATION TEST SITE PLAN 85-E WAS GROUND WATER //) -O ENCOUNTER ED? P IF YES, AT WHAT E DEPTH? Reading Date Gross Net Deplh to Net Time Time Water Drop PERCOLATION RATE Jmi'nutes/inch) TEST RUN BETWEEN FT AND FT COMMENTS 72-008 (6/79) STMLEY BRUST A~ ASSOCIA~ E~iGI~ SURVEYORS PI..N~'~ 1610 Dtmond Dr~ve, Phone Anchorage, Alaska 99507 '~OILS LOG -- PERCOLATION TEST PERFORMED FOR:. LEGAL DESCRIPTION: DATE PERFORMED: SLOPE 2 3 4 5 6 7 8 g 10 · El'" SOILS LOG r-i PERCOLATION TEST SITE PLAN 11 12 13 14 15, WASGROUND WATER ENCOUNTERED? __ O P IF YES, AT WHAT E DEPTH? Reading Date Gross Net Depth to Net Time Time Water Drop 16 17, ~"; "" 49 T"-H'H 18 NO. 986-E 19 2O PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN . FT AND ~ FT COMMENTS ~ "E"FORMED~V: ._~',~,v"~Z~, ~',~.,.,-z- CERr, F,EO,,.: -'<7'~2'~o,~' D^TE.->--/ZTg"~ · 2.008 (6/79) ROBERTC. COWAN, RE. ROBERTA. SHAFER, EF_ CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AI~'HORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTE'WATER DISPOSAL SYSTEM DESIG~ ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: GENERAL: Lot 20, Block 2, Sand Lake Subdivision #2 November 6, 2003 o The scope of this project includes the replacement of the existing 1000 gallon septic tank with a 1000 gallon minimum septic tank, and installation of a new trench to serve the existing two bedroom residence located on the referenced property. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for :final grading areas subsequently depressed from soil settling. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septiC: tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER. ALASKA 99577 Page 2 Lot 20, Block 2, Sand Lake S/D #2 November 6, 2003 2. The .septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Septic tanks installed with less than 4 fi. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 fi. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a' positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the desigh. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameterd installed hpproximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Page 3 Lot 20, Block 2, Sand Lake S/D #2 November 6, 2003 Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). o A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. Page 4 Lot 20, Block 2, Sand Lake S/D #2 November 6, 2003 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing, between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR / INSTALLER DEPT. OF ENVIRONMENTAL CONSERVATION 555 CORDOVA STRF. ET ANCIIORAGE, AK 99501 http://www.state.ak.usldec/homclhtm TONY KNOWLE$, GOVERNOR Telephone: (907) 269-7696 F:tx: (907) 269-7650 ' March 29, 2002 Robert C. Cowan, P.E.. S & S Engineering 17034 North Eagle River Loop, Suite 204 Eagle River, Alaska 99577 Subject: Lot 21, Block 2, Sand Lake S6bdivision, #2;Wastewater Disposal System Waiver Request from Existing Class C Public Water Syslem Source Well; Review Dear Mr. Co,van: This is response to your letter received in this office on March 14. 2002 in which you requested the Department to grant two separation distance waivers. The sel::--,ratior~ distances to be waived arc between the prop. osed wastewnter treatment and dispersal system to be Io.2ated on Lot 20, Block 2. Sand Lake Subdivision. #2 and one Class C public water system sm:me well I~c:tte:t on Lot 21, Block 2, Sand Lake Subdivi:,iot~., 1!2. I have completed my review ot'~he files coverine this subdivisiou and th submitted i:~bnnation. Based on this review, ! believe ~.hat ll~e rcouest'~.d waivers are reasonable. As noted above, you have requested the Department to grant tw, separation dista,ce waivers between the proposed wastewater treatment and disposal system and one (glass C public x~utcr system source well. Due to the continued low nitrate levels, lack of bacteria, and the great depth of the source wells in the area, the two Waiver requests are i'easonable. :Fherefore, in accordance with the Wastewater Disposal Regulations [18 AAC 72], the following waivers are granted: · The horizontal separation distance betxvecn ~he Class C public water svstem source Well located or, L,6[ 2 l,"BlUck 2, Sand Lake Subdi',isi6n,'~?2 and rite piJoposeci septic tank located on Lot 20, Block 2, Sand Lake Subdivision, #2, serving a sit~gle family home has been xvaived from 150 feet to 100 feet. · The horizontal separation distance between the Class C public water system source 3yell located on Lot 21, Block 2, Sand Lake Subdivision,//2 and the proposed drainfield located on Lot 20, Block 2, Sand Lake Subdivision, #2, serving a single family home has been waived from 150 feet to 90 feet. The above noted distances were taken from your submittal. If the proposed wastewater disposal system located on Lot 20, Block 2. Sand Lake Subdivision #2 fails or needs to lie upgraded, this waiver becomes invalid. If the ne~v system fails, additional treatment to the xvaste stream will be required. Robert C. Cowan bage 2 03/28/02 These waivers do not imply the granting of any additional authorizations, nor obligate any local, state, or federal regulatory bOdy to grant required authorizations. In future waiver requests, please use the waiver checklist that can be found in the Department's publication entitled: "Plan Approval Checklist for Engineering Plans, Wastewater Treatment and Disposal, 18 AAC 72". Thank you for your cooperation with this office. If you have any questions, please do not hesitate to contact me. Cc: Jim Cross, P.E., MOA Keven K Kleweno, P.E. Environmental Engineer MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL DESCRIPTION ' -- Well DISTANCE TO: NAME Absorption area Liq. cap DISTANCE TO: IF HOMEMADE: Well DISTANCE TO: Well Top of tile to finish grade3~¢) Length Type of crib Width Crib diameter Inside length Dwelling Material F°"ndati°n~oi ~E¥~ INearestl°tline ' Total length of lines ~ - i Trench width/ ~'~ ~5~ I ~4~I~t~ c h es Material beneath tile. '~b inches Depth Crib depth PHONE I ~LNEW 2( e$,zqs-3 P RADE NO. OF BEDROOMS~ PERM'TNO' 203S No, of compartments Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT NO.~ ~, Distance between Iines~ Tot~e¢~bo~, tion area PERMIT NO. Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PiPE M~TERIA LS P t/c' SOl L TEST'RATING IN~,LLER APPROVED 72-013 (Rev. 3/78) DATE LEGAL LEGRL H l L ] :' .:':;.-"H. E~OTH L.2Et E:;2 E;F:iND LR..::;E ~2 7E ;3J. RF'_ENE "~',":'¢: OF EOI F~BE;OF..'F'T]:ZiN c',=,,:.. ~:-~ ._. ......... . ....... T,_f', T':- E:'F:RtNF!EL, D LOT E:; .~. ZE mr.:,'::-::z,,-,...,,,~ ~. ?.'.FZ[Ftg: OF EE'r,F';':I','5 = 3: SOIL }~F{T'.[I'.Ji'3 ,::EQ F'"tr',..-'E:¢g:)= T~E REEQUZRED E~TS:% Fd:' TNI::' %OZl H ....... IN. Fi ZCIN '-'"-1 ................ . .:, r o. r:.t'! TI-..E LENGTH E:'Z'"IE'NEZ'ZN ~:5 'f'FIE LENGTH '::]:N F'E:E:T::, OF THE TF4:E?.,ICF.I THE E:,FZF:"Ti4 OF R TRE:NZ:H CE' F'J:T ]:5 THE E:']:E;TRNCE E~ETHEE.'.4 THE St. DF'RCE OF THE: '3R':'~_F.E:, FIND '~'L~' E:OTTOH '"r: THE =".,F.c *:"ZF~N ":IN FEET::,. THE GFtF:F,,'EL. DHF'TH ~'E THE: '" IN:[HUH DE:F'TH OF' GFZF¢,/EL BETHEEN ¢:INF, THE E~OTTOH m: THP F ........ c=,,~-~ ..... ,, ~H_ OIJTFFiL...L F'TF z:. ' - ......... - ....,,, zt..~,i ,::IN FEET::,. - ........ ,~-:' F4:EE;Fu:)NSZEI:[L. iT'¢ TO TNF'r'~F'H ~r..!z.:, ::,EPF?Ft'T'I','IE:~.-." g:,L!Rt~:e. 2 THE T.. :'"r-I ..... ~ -~ ...... ...... r'.._,..MF~U,~ ~N55F'E)2. T ]: Ct i'.~ 5; OF FIN"? ~,~¢:'t ':: F/DJ'RCENT TO 'THZ5 F'~'"IPEFtT'¢ RNE:' THE h ."JE:EF' OF RES J: DENE:E:5 THF!T THE HE'.... HZLL SERVE. ..... '- - , r~g. FiF'F'~:OVRL r::?¢ IHZ'q .................... ~-,E:L..tU HgLL DEF'ENDINGi UPON ~H~ T'¢F'E CF PUE:L. ZC HE_L.. . H'~N~HUH E:,I'STF~NT:E FF:OH R F'F:~VF}TE k. FE_~ TO R F'RI','~TE 5EF.ER L. tNP ~E; 2~; F:P'FT ........................... o HF¢¢ 5PEC~fFZCRTI~h}q RNC, C:Oh, E;T~UCT"FJN r"'r~u-==,~h~,-- RRE 'J: CE:F.:'i" :I: F'":"? 'T'HFi'T' i: T RH FRPI:[L.i:Fil;' i.,.i;[TH 'FpE [4:EgH..!IREHENTE; FOR FK!--':;ITF ::,c....~._~.:, RNE:, il=' '-R': EET -- - ' .... ' ~ · "~'l ;2' ]J I.,J];LL. THE '5"-'5' RCCO}~[::,Fii'.,IC:F' i,.itTF. THE CCDEt5. ~:: I UhCr',F:~-: THRT I'F: 5E:b.tPP '- .... ~'* r4'P-': ~"g'r: E'N ::~P"qE",1F'.a"- ZF' THE ................. ::, ::, F~:~'! ~:E:51 DENC:E ~ c:' .1. i"1CiRE: "'-' :' F'F ......... ...... F, 4 ,t., 2 .=,...L. F ULh STMLEY BRUST ~D ASSOCI^~? B~GII~EERS SURVEYORS P~[~ERS 1616 Dimond Drive, Phone 344-6~ xl Anchorage, Alaska 99507 -SOILS LOG -- PERCOLATION TEST SOILS LOG [] PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 9 lO 11 12 13 14 15. 16 17 18 19 20 COMMENTS DATE PERFORMED: SLOPE SITE PLAN 7 / WAS GROUND WATER ~i¢ S ENCOUNTERED?/>' ' OL P IF YES, AT WHAT E DEPTH? Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT 72-008 ;5179) PUBLIC WATER SYSTEM APPROVAL TO CONSTRUCT .:..~. .. ...- . ' in ~ hC ~O~ ~ ~ ~ - ', Alaska, submitted in accordance wi{h [8 AAC 80.~00 . by ~+~0~t~ ~. '~tv I'[0'~. ,have been reviewed and are approved, ' ' conditionally approved (see attached conditions), . .- DATE If construction has not started within two years of the approval date, this certificate is void and new plans and specifications must be submitted for review and approval before construction. APPROVEDCHANGEORDERS, Change (contract order no. Approved by Date ' * or descriptive re~erence) The "APPROVAL TO OPERATE" section must be'completed before any water is made available to. the public. · · APPROVAL TO OPEflAT~. water system was completed 0n "/'Is -- f/-- )~ ~ - g~anted interim approval lo operate for 90 days following the ~built plans submitted during the interim approval period, or an inspection by the Department has confirmed the system was constructed according to the approved plans. The system is hereby granted final approval to operate, . . I · .ldate). The system is hereby Cpmpletion date. .... . DATE / TITLE DATE CONSTRUCTION'AND OPERATION CERTIFICATE ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION PUBLIC WATER SYSTEM APPROVAL TO CONSTRUCT ' ~-.' .... -,', ' '".- . Plansfortheconstructionof ..~ .4jv ~:) Lt'~. ~_ ~' .:,~ ¢,) ........ '~./r') /A ).~'t. ~ (~ ~ .... ,. ;~ / gfz~" F~g-/(' ~)blic water system located in ~J hC J~o~ ~ ~ '~ ' , Alaska, submitted.in accordance with 18 AAC 80.100 ~ approved, - . _E3 conditionally approved (see attached conditions), .. If construction has' not started within two gears of the approual date, thiscertificate is void and 'new plans and spec[fication~ mu~t be submitted for review and approval before construction. APPROVED CHANGE ORDERS " Change ~contract order no, -' ~'Approved by Date ' ' ' The "APPROVAL TO OPERATE" section must be completed before any water is made available to. the public. . APPROVAL TO OPERATE The construction of the ' public water system was completed on (date). The system is hereby granted interim approval to operate for 90 days following the cpmpletion date. BY TITLE DATE As-built plans submitted during the interim appr~)val period, or an inspection by the Department nas confirmed the system was constructed according to the approved plans. The system is hereby granted final approval to operate. ' ' : '"'-'' .'... BY TITLE DATE Municipality o.f Anchorage~ · Development Services DePartment.. Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak.us (907) 343-7904 Parcel I.D. · CERTIFICATE OF HEALTH AUTHORITY APPROVAL :,., FOR A SINGLE FAMILY DWELLING 011-133-05 1. GENERAL INFORMATION . ·:'Complete legal description Lo t '":Location (site address or directions) 20; Block 2; Sandlake Subdivision g2 8046 Wilcox St. Mike Just Day phone 3'36-5878 8704 Blackberry St. Anchorage, AK' ~502 Day phone Current Property 0wrier(s) 'Mailing address Lending agencY' Mailing address Real Estate Agent Day phone .Mailing'Address . Un/ess otherwise r~que'sted, HAA wi//be held by DSD forpickup. 2.' NUMBER oF,BEDROOMS: . 2 3. TYPE OF WATER SUPPLY: · .Individual Well .- r-] Individual Water. storage [] Community Class C Well ' ~ ' Public Water System [] TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer [] ID I The Municipality of Anchorage DeVelOpment SerVices Department (DSD) Issues CertifiCates of Health Authority Approval (HAA) based only upon the representations 'given in paragraph 4 by an independent' professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are ·required for the transfer of title (except between spouses) for properties served by=a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. CertifiCates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a pdvate or Class C well and may be reissued with new water sample results. (CertifiCates may be reissued for a period of up to one year with valid water samples.) CertifiCates are valid for one year for properties served by Class A or B w611s or a public water ·system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.' m STA;i'EMENT OF INSPECTION BY 'ENGINEER .As certified by my seal affixed hereto and as of the validation date shown below, I verify that my in. vestigaiion, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site ~ater Supply and/or wastewater disposal system is(are) 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Finn S &' S Engineering Address 17034 N. Eagle River Lodp Ste. 204 Eagle Robert C. C0wan Engineer's Printed Name DSD SIGNATURE [.~", ' ApProved for ' ~'-' 'bedrOoms. Disapprove~l. , Conditional :approval for Phone 694-2979 'River, AK 99577 Date __ bedrooms, with the following stipulations: Additional corhm'ents .~-,,.,~ · ON-~511 Ir_ '. 0: · ~: WATER AND :rn ~'-.. ': WASTEWATER : · 32..' ', ......... .v~. · _ . <%4,'. 'fill,,,,,..'''' By: Attachments: HAA'Checklist Septic sYsiem Advisory Well Flow Advisory ,///'/, X Maintenance 'Agreements SupPlemehtal Engineer's Report Other · .Original Certificate Date: . J_/L.-.. / L./- O L/_ (Rev. 0M32) Municipality ot' Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Ancho'rage; AK-99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AtJTHORITY APPROVAL CHECKLIST Legal Description: ,)-. 03- A. WELL DATA Well type C._ ~.O ~2-0Cf< ~ ~',,~,-JOL~'¢- ~ ~ ParcellD: If A, B, or C provide PWSID # ~. J~ '7'7 ~ Bo Co Well Log (~)q) Date completed Total depth ~ ft. Date of test Sanitary seal (Y/N) . Wires properly p~- ' Cased to ft. ~ove ground). FROM WEL~ AT INSPECTION ft. WATER SAMPLE RESULTS: Coliform O coloniesll00 mi. Arsenic: O, oYT~ mg./1. .. sEpTIC/I~(~L~IiI~G TANK DATA Ta'n~':Type/Materiai'.',~' E P T,¢-- / T~nl~ size / 0o'O g~l. g.p.m, Nitrate O. Ii mg./I. Date of sample: 5T6~'L. 'Number of Compartm?nt ft. g.p.m. in, Other bacteria Collected by: Foundation cleanout ((.~N).'Y'fJ Depression over ta~k (Y/~ /¢O aat~ of pumicing /'')//F- - ~'~ ~ Pumper ~ ABSORPTION FIELD DATA Date installed [~/~'~ Soil rating~or?lbdrm)O. ~ Length 3 ~ ft. Width ~' ft. Eagle River, Alaska 99577 Date installed O coloniesll00 mi. S & S ENGINEERING 17034 Eagle River Loop Road N°. 204 Total depth ¢] ~ ft. Eft. absorption area 3,:'i 0 fi2 Monitoring tube ¥~"J' Depression over field ~ 0 Date of adequacy test /4/~ - t~[~.~ Resultsi(Pass/Fail) For ~ bedrooms Fluid depth in absorption field before t~l. New depth in. Elapsed Time: ~fluid depth__ in. Absorption rate >: g.p,d. Any rejuv ' n treatment (past 12 mo.) (Y/N & type) If yes, give date · ft. System type 7- ~ Gravel below pipe High water alarm (Y~) ~ (~ Cleanouts ~)N). 'Y~ ~ LIFT STATION Date installed "Pump on'~ levbl at in. Datum , ~ SEPARA:TION DISTANCES Size in gallons Manhole/A~' "Pump off' leve . ' High water alarm level at ' : ' Cycles tested Meets alarm & circuit requirements? c_ L.,~i$ $ On adjacent lots Public sewer manhole/c eanout SEPARATION DISTANCES FROM WELL ON LOT TO:' .Septic tan~/liff'siation on lot Absorption field on lot Public sewer main Sew~ Holding :.iai nk SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 3 .~ ' Propertyline ' Water main ! 0 ~/- Water service line ) o 4- Wells on adjacent lots ] 0 1 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ~- Building foundation I I Water Service line Surface Water ) O O "/'- Curtain drain .Hd~ COM;I~IENTS'i ENGINEER'S CERTIFICATION :1 I certify that I have determined through field inspections'and review',of Municipal records that the above systems are in ' conformance With MOA HAA guidelines in effect on this date. Engineer's Printed Name PO~7- C.. Cot,~/),~ Date ': "~'//S- //0 ¢// Absorption field Suffade Water Water main ' I 0 ['J~;': Drivew,ay, parking/vehicle storage ) oo 4-;. in. HAA Fee $ Date of Payment Receipt Number (Rev. 12]01) Waiver Fee $ Date of Payment .. Receipt Numu~r, !; , I Z --I mm ..q 0 c~ rq r-r1 ,00'09 3.00,g0.005 X~X .00'0~ M..oo,go.ooN :Z Parcel I.D. # 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 HAA # 1. GENERAL INFORMATION Complete legal description Lot 20; Block 2; Sand Lake Location (site address or directions) 8046 Wilcox Street Property owner Mailing address Lending agency Mailing address Agent Address Ronnie DaltOn Day phone 248-1547 8046 Wilcox Street Anchorage, Ak. 99502 Day phone Day phone At Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 2 ~ TYPE OF WATER SUPPLY: Individual well Community well Public water XX NOTE: 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 Holding tank Community on-site Public sewer XX NOTE: 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 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. Name of Firm ZZ~56 ~lsel~' '~eA!~l ellS"~ Engineer's signature S & S ENGINEERING ~7034 Eagle ~iver Loop Ro~d No. 204 Eagle River~ Alaska 99577 DHHS SIGNATURE ./'~ Approved for ,~ Disapproved. ConditiOnal approval for bedrooms. bedrOoms, with the following stipulations: Additional Comments 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 this 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. 1/91) Back MOA 21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Parcel I.D. A. WELL DATA Well type ~.[R~5~ , If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Totaldepth Sanitary seal (Y/N) A/'/~ Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION J:NV~RuNMENTAL Date of test Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: g.p.m. Septic/holding tank on lot Absorption field on lot Public sewer main Public sewer service line /~J/~ Public sewer manhole/cleanout ; On adjacent lots ; On adjacent lots /' O(~ Petroleum tank MAY ! 4 199! RECEIVED g.p.m. WATER SAMPLE RESULTS: Coliform ~ ~, .'~' .~ ,'~-.."~'~ Date of sample: ~ - B. SEPTIC/HOLDING TANK DATA Date installed ~ --~' - ~ ~--- Tank size / ~c~ ~ ~, / Compartments Cleanouts (Y/N) t,1 Foundation cleanout (Y/N) U~ Depression (Y./N) High water alarm (Y/N) hJ~,_~ Alarm tested (Y/N) /~)/~A Date of pumping /--/- / ~ ~' ) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: ! Well(s) on lot ,/f'2~) -/- On adjacent lots ToPropertyline 3~ ~ ' Absorption field Surface water/drainage [ O~ 'f 72"026 (Rev. 3/91 Front MOA 21 '-~ ~ ~..,~ ~ O~" ~___..~ / CX~ '/~ Foundation '-~ Water main/service line CONTINUED ON BACK PAGE C. LIFT STATION ~ Date installed Size in gallons '%% Vent (Y/N) "Pump~' level at D. ABSORPTION FIELD DATA · Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested Surface water ~ -~'- ¢ Z ' Soilrating /40 ¢/~ Systemtype Date installed Length ~'~- Width Total absorption area ~ Depression over field (Y/N) Results (pass/fail) ,O~_~, ~ Peroxide treatment (past 12 months) (y/N) Gravel thickness ~ ~- ~ Total depth Cleanouts present (Y/N) Date of adequacy test ~ -- / for ~ bedrooms / 11~//24' If yes, give date / SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot / To building foundation / L"") On adjacent lots Surface water Curtain drain .~,,..)//~ E. ENGINEER'S CERTIFICATION On adjacent lots [~ property line To existing or abandoned system on lot Cutbank ~) Water main/service line Driveway, parking/vehicle storage area I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. i~ ¢ ~C, ~:d],a PdV®~* Loop Signature ~:~¢Je River, Alaska 995~g Engineer's Name HAA Fee $ Date of Payment Receipt Number 72~926 (Rev. 8/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number APPLIC-"iT FILLS OUT UPPER HAL DNLY Zip Code ~-~'~.~-~ ~b I Phone Address Zip Code Lending Institution Address Realty Co. & Agent Address Legal Description ~:~'7"- ~' ~ ~__~_)C,~.-~ Z Street Location ~'~//~__ Phone Zip Code /_7~7..~2 t~ _,~_~ Phone Type of Residence [~ Single Family [] Multiple Family No. of Bedrooms [] Other Water Supply [] Individual [~ Community [] Public Utility Sewer Disposal ~ Individual [] Public Utility [] Holding Tank ATTACH WELL LOG. A weil Icg is required for all wells drilled since June 1975. For wells driNed prior to that date, give well depth (attach log if available). Year Individual Installed: When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: MUNICIPALITY OF ANCH©R^GE DFPT /NVIR©i ,Ih': ~t,, A:. : ,,~, 2CI-ION OCi' 1_ 1982 RECEIVED ('2-) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL* DATE /C. ~- ,,~ Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Well to Tank Septic Tank Size 72.023 (3182)