HomeMy WebLinkAboutSHADY ACRES BLK 1 LT 6014 - Zi2WOW I (�-off
STATE OF ALASKA
DEPARTMENTOF ENVIRONMENTAL CONSERVATION p
CONSTRUCTION AND OPERATION CERTIFICATE
for
PUBLIC .WATER SYSTEMS
A APPROVAL TO CONSTRUCT
Plans.for the construction or modification of
( tF jJ
public water system located
in_�Z / `Alaska, submitted in accordance with 18 AAC 80.100
1
by <> _i _ ti- have been reviewed and are
approved.
0 conditionally approved (see attached conditions).
BY - - TITLE - - - DTE
ii
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.
R. APPROVED CHANGE ORDERS
Change_ (contract order no. or descriptive reference) Approvgd by, Date
'^a O f - a
!J
' ._l /. L., v.✓ `_ �. z (iJ�= 11 a / %!,l "✓'% t ` "�-- �j �'v j^ U c'. rn
i <-.
C. APPROVAL TO OPERATE
The "APPROVAL TO OPERATE" section must be completed and signed by the Department before any water
is made available to the public.
The construction of the %`A a °_ public
water system was completed on (date). The system is hereby
granted interim approval to operate for 90 days following the completion date.
BY TITLE DATE
As -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.
157— -
DISTRIBUTION: 1. WHITE - ENGINEER (Complete Section C)
2. YELLOW - WATER SYSTEM FILE (Complete Section C)
3. PINK - ENGINEER/MUNI-BOROUGH (Complete Section C)
18-0407 (Rev. 11/83) 4. GOLDENROD - MUNI -BOROUGH (Complete Section A)