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HomeMy WebLinkAboutMEADOW RIDGE ESTATES NORTH ADD BLK 5 LT 7Meadow Ridge Estates North Addition Lot 7 Block 5 #051-531m=15 \ (' MUNICIPALITY OF ANCHORAGE 1 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I ENVIRONMENTAL ENGINEERING DIVISION \ 825 L Street • Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ' NAME PHONE w ❑ UPGRADE MAILING ADDRESL VC#s C_ LEGAL DESCRIPTIO L -V LOCATION NO. OF BEDROOMS U Y DISTANCE T0: Well Absorption area Dwelling PER J Ma L No. of compartments Z_ Lnufxturer a aciIV in gallons IF HOMEMADE: nsitle 1I n��— Wirlth Laud Aenth d6 DISTANCE TO: Wall Dwelling PERMIT NO. /Y _?1. Manufacturer �t Material Liquid capacity in gallons = DISTANCE TO:Fength 17YFoundation IVIs Nearest to Ina PEH�61j ,,, Z f W No. of lines pip lige G Total �t Was CP Trench wi I chat Distance between lines s� !J- I.. Top of tile to lin;/h grad — Material beneath Lila D Total of lectiva rst� arak g inches 71 W Length Width Depth -7fit• PERMIT NO. f7 n F W Type of Crib Crib diameterCrib depth Total effective absorption area DISTANCE TO: Well Building foundation Nearest lot line J Class^ epth Drilaqce to lot line PERMIT NO. W DISTANCE TO: BWld ng foundation Sewer line Septic tank Absorption area (s) OTHER 01, m s PIPE M ERIALS SOIL TEST RATING1. A INSTALLER CC s REMARKS Q LL ,.. 4 it A• • J I t ••lob ut A. Shah W C' .,• Iro. 1 St t .. A V DATE LEGAL F:IpINEERING '` S St ► Q q y z .S2 Z 'l��/ f LE FINER, ALASKA 1:577 `-+G LJ 71 ev. 3178) MUNICIPALITY OF ANCHORAGE Department. Health and Environmenta ^?rotection 3 825 u Street, Anchorage, AK. 79501 X93 264-4720 Permit #* * * HANDWRITTEN PERMIT WELL AND/OR ON-SITE SEWER PERMIT T I� Applicant: ��C, C/C�X)) r l Mailing Address:/' Location: Phone Number: Legal Description: % /5CS? Lot_ Size: Type of Soil.Absorption System.Is: Trench: -?Z— Drainfield: _ Seepage Beds Holding Tank- Maximum'Number of Bedrooms: 3 Soil Rating(sq.ft/br) y li The Required Size of the Soil Absorption System Is:' / I ' c. DEPTH �; LENGTH ` . GRAVEL DEPTH S WIDTH L' 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 _ _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(Z) INSPECTIONS ARE REQUIRED Backfilling of any system without final inspection.and approval by this departmen will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fee for a private well or 150 to 200 feet from.a public well depending.upon the type of 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, 1 9 3 3 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) 429r§x!;,V,/ Install the system in.- accordance with codes. (3) tha e.on-site sewer system may require enlargement if emodeled.to include more that 3 bedrooms. Signed: Issued by:� irtti�a t. / Date: SWP/024(1/81) pa �1 >,-' SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ❑ PERCOLATION TEST 825 L. Straat, Anchorage, Alaska 99501 2644720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: 0-C— l, CA-) r,1 57- ` DATE PERFORMED: A)-(0-83 � LEGAL DESCRIPTION: I J �-' K, rM 1 `e -Ad k E Z - q SLOPE SITE PLAN 1_' T 1 b 2 (01an11 G 1117 2- -3- 4- 5 - 6- 7 8- 9- 10- 11- 12- '13 - 14- 15- 16- 1T� 18- 20- PERFORMED 8-20• PERFORMED STtnIf�Y Cie -AVC -L 49 L1L.1iT C LAY WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? �T TONS- D'F .■■■.■■■_. n mommWEEN pRombommomm ■■■■■.■■■■ PERCOLATION RATE TEST RUN BETWEEN FT 72008 (6/79) l�k Municipality of Anchorage �\ .�� Department of Health and Human Services}� Division of Environmental Services 1 On -Site Services Section 825 V Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING r�C Parcel I.D. 051-531-15 HAA# r OCCC%/JO Expiration Date: 1. 2. 3. GENERAL INFORMATION Complete legal description Lot 7 Location (site address or directions) Block 5, Dleadow Rid 25226 Homestead Road Estates, North Addn. Current Property owner(s) John Stringer Day phone 229-7978 Mailing address 25226 Homestead Road Chugiak, AK 99567 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: NUMBER OF BEDROOMS: Three (3 ) TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site `m Individual Water Storage ❑ Individual Holding Tank ❑ Community Class _.A_Well Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 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) on properties served by a single family on-site wastewater disposal and;or water supply system. DHHS also issues HAAs upon request to home owners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 01001' 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 based on procedures outlined in the Health Authority Approval Guidelines for the Health Authority Approval application show 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson P E Date 4/20/00 6. DHHS SIGNATURE ✓ Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following Additional Comments stipulations.. lTi� Attachments: HAA Checklist Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: A/ - dEc"r Original Certificate Date: - 25 O o Expiration Date: -7- 9- S- o o Reissue Date: 75 025 Mov. 01:001• i j Municipallty of Anchorage C, • Department of Health and Human Services 't Division of Environmental Services On -Site Services Section 825 V Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-4744 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 7, Block 5, Meadow Ridge Estates Parcel I.D.: _ North Addition 051-531-15 A. WELL DATA Well type A if A, B, or C provide PWSID # 211431 Well Log Date completed Sanitary seal Wires properly protected Total depth ft Cased to It Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level It ft Well production 9 -P.m g•p•m WATER SAMPLE RESULTS: - Public Water System Coliform oolonies/100 ml Nitrate Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA TankType/Material Steel mg/I Other bacteria colonies/100 ml Date installed 9/83 Tank size 1.000 gal Number of Compartments 2 Cleanouts Y Foundation cleanout N Depression over tank N High water alarm N Date of pumping 9199 Pumper JR's Pumping C. ABSORPTION FIELD DATA Date installed 9/83 Soil rating (g.p.d./ft2 or ft2/bdrm)140 SF System type Deet:) Trench Length _18—ft Width 2.5' ft Gravel below pipe 7.5 ft Total depth1 5 ft Effective absorption area 420 ft2 Monitoring tube Y Depression over field N Date of adequacy test 9 / 12 / 99 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 37 in Water added 660 gal. New depth 48 in. Elapsed Time: 24 Hrs.min Finalfluiddepth 37 in Absorptionrate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date N/A 72.026 (Rw. 01/00)' D. LIFT STATION - N/A Date installed Size in gallons _ Manhole/Access "Pump on" level at in "Pump off" level at in High water alarm level at in Datum Cycles tested Meets alarm & circuit requirements_ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: No Well on Lot - PWS Septic tank/lift station on lot On adjacent lots Absorption field on lot Public sewer main Sewer /septic service line On adjacent lots Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation > 5' Property line >51 Absorption field >51 Water main >10, Water service line >10' Surface water > 100' Drainage >100, Wells on adjacent lots > 100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >101 Building foundation > 10 1 Water Service line > 10' Surface water —> 100' Curtain drain None Noted Wells on adjacent lots >1o0, F. COMMENTS G. ENGINEER'S CERTIFICATION Water main >10, Driveway, parking/vehicle storage Adi acent 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 Mi nhaal r Andprann , P.E. Date . ],^ ln, HAA Fee $ _3G -b Waiver Fee $ _ Date of Payment/20 /� Date of Payment Receipt Number 6 83 Receipt Number_ 72026 (Rev. O V00)' AF ER'S - :44x low Parcel l.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 051.531-15 ✓ HAA k IM&!Z 1. GENERAL INFORMATION Complete legal description Lot 7, Block 5, Meadow Ridge Estates, North Addn. Location (site address or directions) 25226 Homestead Road Property Owner Brian Sprague Day phone Mailing address 25226 Homestead Road Lending agency Day phone Mailing address Agent Arlene Meyers Day phone 688 1236 Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: Three (3) ✓ RECEIVED 3. TYPE OF WATER SUPPLY: Individual well MAY V 1997 Community well xxxxxxx Municipality of Anchorage Dept. Health & Human Services Public water 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 xxxxxxx Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-02S)Rw.1I91) Front MOAF21 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 furtherverifythat 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 Anderson Engineering Phone 563 7155 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's signature Ke�czue' Date 5/7/97 'h �.1, � 511 �<•1 tii!'Mx:1:A �: a 1. . Yr. au• .G dJ 46 10 6. DHHS SIGNATURE Approved for ��+� 3 bedrooms. Disapproved. 0 Conditional approval for bedrooms, with the following stipulations: F E ATTa- HEs) A DL C (-t-77E, Z Miy 23, 1`/? K2cCsR,iDl��c THE W471:3t_ SySi n S wu•:c- rlil5 ?2�'6,z7y 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. noss M" W) 8. MOA m MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DMSION Municipality of Anchorage MAY 0 7 1997 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division V E 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) Health Authority Approval Checklist Legai l]1escriphon: 4 7 SLOGc. S, Ni�1ooJ.F466C Parcel l.D.: 05/- 531- Ir A. WELL DATArrF>'6t� Well type P 0. 5. If A, B, or C, attach ADEC letter. ADEC water system number Pw SI D z// 431 Log present (YM) Total depth Sanitary seal (YM) Date of test Static water level Well production Date completed FROM WELL LOG 9 -13 -m - WATER SAMPLE RESULTS: Puawc. IJ 4rdsm Coliform Nitrate Casing height (above ground) Wires property protected (YM) AT INSPECTION 5ySrnyN Other bacteria of sample: /I/A Collected by: A//4 9 - p.m -Data B. SEPTIGHOLDING TANK DATA Date installed $j_Tank size / 000 Number of Compartments _ Cleanouts (YM) Y Foundation cleanout (Y/N) A) Depression (Y/N) %J High water alarm (Y/N) ^/1A Date of Pumping Zl. Q7 Pumper XNAC. 5 C. ABSORPTION FIELD DATA Date Installed Soil rating (g.p.d.Nts or ft=Podrm) /4AP lir: System type -7 c-AJC4 r ! Length Z$ Width Z 5 Gravel thickness below pipe 7 S , Total depth /S* � Effective absorption area -pr-'Monitoring Tube present (YM) Y Depression over field (YM) NI Date of adequacy test S / A 7 Results (PassiFail) PASS For Tcc bedrooms Fluid depth In absorption field before test (in.); _0 Immediately after y 42gal. water added (in.): 0 Fluid depth 0 (ins) Minutes later: to Absorption rate = > 450/ c.p.d. Pero:dde treatment (past 12 months) (Y/N) /j% If yes, give date /�! A 72-028 (Rev. 3198)' Date installed Manhole/Access (Y/N) High water alarm level at' _ Cycles tested E. SEPARATION DISTANCES "Pump 'Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Size in gallons "Pump off" level at' MAY 0 7 1997 Municipality of Anchorage Dept. Health & Human Services Septic/holding tank on lot > 7.001 On adjacent lots ,o,,j 1A Absorption field on lot > Z/ -0O' On adjacent lots N lA Public sewer main /� %A Public sewer manhole/cleanout A// A r 140 / Sewer /septic service line > 240 Lift station /KOM6 0ni 1 r - SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation 30, Property line >/0 Absorption field S Water main/service line WO Surface water/drainage >140 Wells on adjacent lots ;0' Z00 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line >/0' Building foundation > 'f'.Sr Water main/servics line > �O r r Surface water >/l!0 Driveway, parking/vehicle storage area � r Curtain drain N o tic OLn-r- Wells on adjacent lots > ZOOr F. ENGINEER'S CERTIFICATION I certify that I have determined Mru field inspections and review of Municipal rec in conformance with MOA HAA guidelines In effect on this date. Signature*•��^�, 0� F_ a A,4—,. n..© Engineer's Name A41C4A" JG' ?A/QV?X Son! Date 541 i 197 HAA Fee $ .3G . CID Date of Payment Receipt Number 7%S_ 72-026 (Rev. 3/98)' Waiver Fee $ Date of Payment Receipt Number 14, wad+ u ',,.,.'• ^" ' yc .._.......... ; lYryr�`: ANDERSON ENGINEERING P.O. BOX 240773. ANCHORAGE, AK 99524 563-7155 563-5389 FAX June 12, 1997 John and Catherine Stringer c/o Country Realty P.O.Box 670495 Chugiak, AK 99567. O of the septic mz a property by o' Municipality revealed that Q C- cleanouts for the septic tank had been raised to grade by the previous owner of the property. Please So h has two cleanouts, one for each compartment. Both cleanouts �> are sometimes necessary for access to adequately clean am sludge from the tank. You may wish _m nm cleanout to 8 Subject: Lot 5, Block 7, Meadow Ridge Estates, North Addition 25226 Homestead Road Septic System Inspection Dear Mr. and Mrs. Stringer: A recent inspection of the septic system on your property by representatives of the Municipality revealed that one of the cleanouts for the septic tank had been raised to grade by the previous owner of the property. Please be advised that the tank has two cleanouts, one for each compartment. Both cleanouts are sometimes necessary for access to adequately clean accumulated sludge from the tank. You may wish to raise the other cleanout to provide this access. They also noted a portion of the drainfield had been blocked off from the driveway/parking area. A section along the north edge of the parking area however was not blocked. Although the distribution piping is nearly 12' below the surface, problems may occur with freezing if parking is allowed over the field. Additional blocking should be considered. The results of the inspection are sent to you at the request of the Municipal inpspector for your information and action. Sincerely, Michael E. Anderson, P.E. xc: Jim Williams, DHHS J •. o..; c'37 MEMORANDUM DATE: May 23, 1997 TO: Jim Williams, MOA- DHHS FROM: Mike Anderson, P.E: SUBJECT: Lot 7, Block 5, Meadow Ridge Estates, North Addition Health Authority Approval Certification The owner of Lot 7, Block 5, Meadow Ridge Estates, North Addition recently replaced the cleanout missing from the septic tank. In addition, a railroad tie retaining wall was placed as a barrier between the driveway/parking area and the absorption trench. This work was accomplished in accordance with comments received after your recent site visit. Attached is a letter from Mr. Keven Kleweno, P.E., from ADEC. In the letter he states his non objection to the issuance of a Health Authority, Approval for the property. We are therefore requesting the certification be issued as all of, the problems have now been " addressed. �jr� M' w �, i `•1, 9 � i �� Y ' ./ • . I r _ - � _ �'Y ..n - �'� .. 1 •' - . :� \� ; . �� _ ... )1 ..:i ... .. ___ TONY KNO WLES, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION DIVISION OF ENVIRONMENTAL HEALTH DRINKING WATER PROGRAM 555 CORDOVA STREET ANCHORAGE, AK 99501 http://ivi,,,iv.state.ak.us/decniomei%tm May 23, 1997 Mr. Jim Cross, P.E. Program Manager, Environmental Services Municipality of Anchorage Department of Ilealth & Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: (907)269-7696 Fax: (907) 269-7655 Subject: Lot 7, Block 5, Meadow Ridge Estates, North Addition, Dawn Water Company, Class A Public Water.System (PWSID Number 211431) Dear Mr. Cross: The Department has been notified that the buyers of the above referenced property have been made aware of the issues concerning the Dawn Water Company Class A Public Water System (see attached fact sheet). After being made aware of the concerns and possible solutions, they are still willing to complete the transactions related to a home sale. The Department has reviewed the submitted test results for total coliform bacteria and nitrates (as nitrogen) and have found them to meet State Drinking Water requirements. At this time, we have no objection to the issuance of a "Ilealth Authority Approval" by your agency. Thank you for your cooperation with this Department. If you have any questions, please do not hesitate to contact me. Sincerely, Keven K Kleweno, P.E. Environmental Engineer cc: Anchorage/Westem Public Service Area Office Anderson Engineering KKK:esr(home:U:even\noajc97.dw3 ) ,� pruned an recycled paper by C.D S n E OF US 9 n TONY KNOWLES, GOVERNOR DEPT. OFF ENVIRONMENTAL CONSERVATION Dear Customer: This letter is to inform you of recent concerns regarding the Dawn Water System. Some of these concerns are: low water pressure, lack of water, and absence of monitoring required by Alaska Administrative Code (AAC). The system owner has not responded to requests to resolve these issues. The Alaska Public Utilities Commission and the Department of Environmental Conservation (ADEC) are attempting to meet with the representative of Dawn Development Corporation to resolve current and outstanding issues. Dawn Water System is a Class A Public Water System serving more than 150 homes and businesses in eight subdivisions: • Dawn Subdivision Vern Haik Subdivision • Eklutna East Subdivision Wynter Park Subdivision • Eklutna West Subdivision Meadow Ridge Estates (Meadow Ridge ► Eklutna Heights Subdivision Homeowners treats bulk water ► Daniels Heights Subdivision purchased from Dawn Water System) The alleged violations, and regulatory citations, are listed below: The water system was modified without the required written approval from ADEC which arc violations of AS 46.03.720 (b) and 18 AAC 80.300 (c). 2. The loss of water service and/or low water pressure creates a potentially hazardous condition due to the possibility of cross connections within buildings, or infiltration of groundwater into leaky water mains. 3. Water is being provided to residents of Vern Haik Subdivision without obtaining ADEC's final operation approval. 4. This water system is responsible for conducting a series of routine water samples to verify safety of the water. Unsatisfactory test results and absence of sampling arc noted below: a. Coliform Bacteria. System failed to repeat tests after being notified of unsatisfactory results. System failed to collect samples at locations that are representative of water quality according to a written sample siting plan. (18 AAC 80.610, 18 AAC 80.605). ..... n'" b v C. C b. Volatile Organic Chemicals. Failed to sample two source wells located on Lot 112, Dawn Subdivision annually, (I8 AAC 80.200). c. Arsenic, Barium, Cadmium, Chromium, Fluoride, Mercury, Selenium. Failed to sample two source wells located on Lot 112, Dawn Subdivision triennially. (18 AAC 80.200) d. Nitrate. Failed to sample two source wells located on Lot 112, Dawn Subdivision annually (18 AAC 80.200) for the two source wells located on Lot 112, Dawn Subdivision. Failed to resample Nitrate quarterly when high values were detected in the well located on Lot 22, Block 2, Wynter Park Subdivision. e. Failed to sample the initial four quarters, and to sample annually for Gross Alpha Radiation, (18 AAC 80.200) for the two source wells located on Lot 112, Dawn Subdivision. f. Failed to collect lead and copper samples (I8 AAC 80.850). 5. Dawn Development Corporation failed to notify all persons served by the water system of these violations and their failure to monitor (18 AAC 80.900). 6. Dawn Development Corporation failed to respond to repeated requests for information. Until all three parties agree upon a compliance schedule, information is collected on the existing water system, and presented in a usable format, we have no way of knowing the final results. Worst case is yes, there could be a rate increase. This will be addressed through the Alaska Public Utilities Commission to ensure a response to all questions. If you have any questions, please do not hesitate to contact Kevcn K Kleweno, P.E., Environmental Engineer at (907)-269-7696. MUNICIPALANCHORAGE • • . '� DEPARTMENT OF HEALTH 8 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. H (i�, t — enN- 16 HAA ti 1 OS S0-1-16 1. GENERAL INFORMATION Complete legal description Lot 7; Btoch 5; Mea&v Ridge Eatatea North Addition Location (site address or directions) Home6tead Road Property owner ASSOCIATES RELOCATION Day phone (202)-626-5000 Mailing address 1325 "G" Stheet, Suite 600 Washington D.C. 20005 Lending agency Day phone Mailing address Agent Pat Cne6s/Reatty Centex Day phone 344-0501 Address 8400 Haktzett Road Ancho4age. AK 99507 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well XXX Public water 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 Xvx Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. n.M(R".1191) Front MOA021 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 1 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 furtherverify 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 Address Eagle River, Engineer's signature 6. DHHS SIGNATURE / Approved for bedrooms. Disapproved. Conditional approval for Additional Comments • Phone oT 5Z'7,y7 9 vbar. A. bedrooms, with the following stipulations: Date -/z" -;'4; 5 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 purchasersof homes and their lending Institutions in order to satisty 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. 72-02S (Rw. 1/91) Back MOA Ki Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description:ter-] tyj-,5 Ae-_4,,bnJ l( -ML& Parcel I.D. oval Ava, A. Well Data Well type If A, B, or C, attach ADEC letter. ADEC water system number Log present (YM) Total depth Sanitary seal (YM) Date of test Static water level Date completed Driller Cased to Casing FROM WELL LOG Wires properly Well flow / g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot —__�ATINSPECTION rn n 7 t -n 9�• o i tT7 w i z� rn G o" z On adjacent lots Absorption field on lot 20,n ti, ; On adjacent lots Public sewer main Sewer service line WATER SAMPLE RESULTS: sewer Nitrate Other bacteria sample: Collected by: B. SEPTICIHOLDING TANK DATA Date installed Ll "$3 Tank size 1 c;=> o Compartments RM Cleanouts Y3N) 4 Foundation cleanout (Y6 il Depression NO .� High water alarm (Y®l ) r' Alarm tested (Y/N) ^� `a Date of pumping Iti 1'i- `13 Pumper SPS GF�cSPa o r - SEPARATION DISTANCES FROM SEPTICIHOLDING TANK TO: Well(s) on lot On adjacent lots AA, Foundation 30 To property line i o Absorption field S , Water main/service line t� µ Surface water/drainage 10 b �~ 4- 72-02e (3M3)* Fmt -72-02e(3M3)•Fmm CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Manhole/Access (YM) Vent (YM) High water alarm level 'Pump on' level at 'Pu_r p,aff'Cevel at Meets MOA electrical codes (Y/N) SEPARATION LIFT STATION TO: lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Soil rating (GPD/Ftz) I13t, System type Length i7"Z Width •S Gravel thickness %,S Total depth 15 - Total STotal absorption area 41'LJ Cleanout present O/N) XDepression over field (Ya Date of adequacy test ResultSQrlfail) tl'7?,:rx for Water level In absorption field before test / 1> & After test 0 //Al Peroxide treatment (past 12 months) (Ya .l°,4� "s •!ted If yes, give date .G,41 SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Bedrooms Well on lot a t L On adjacent lots 13tow Property line I o } To building foundation 4&1 To existing or abandoned system on lot �lr On adjacent lots 3 Cutbank /S Water main/service line !o Surface water Gb Driveway, parking/vehicle storage area (S Curtain drain rp E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or Signature Engineer's Nj� Date Eagle 99677 HAA Fee $ 3Da ' QD Date of Payment % .rf- —/6 Receipt Number 72-026 (397)' Back to all MOA and HAA guidelines in effect on the #ate of this inspection. a. „ /�•� Ho. 1157-8 Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE ' • Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744: CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF, ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING,-: Parcel I.D. # 1- 4?,1 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description.(include lot, block, subdivision, section, township, range) Meadow Ridge Estates North Addition, Lot'7�131ock 5, T15N. R1W,'Sec.! 2 Location (address or duecUonsf 6414, Homestead Road (b)Prop ertyowner H.U.D. _.Telephone:(home) Business 271=4342' W. 8th'Ave." (Box N-64) Anchorage, Alk. 99813 Mailing Address 9 (c) Lending Institution" 'L Telephone Mailing Address (d) Real Estate Company and Agent Associated Brokers Address 640 W. 36th Ave. Suite #1 Anchorage, Ak. 99503 Tele phone: ..563 .3333. (e) Mail the HAA to the following address: (or check here b, if hold for pick up) y ; List contact person and day phone number below: V ' Pickup by Engineer ;.• Y rr� NI • '•-.'-fit •T_l'1i�a 2. TYPE OF RESIDENCE , Single -Family J? Number of bedrooms �- 3. WATER SUPPLY Individual Well ❑ ' Community ❑ Public ❑ Note: If community well system, -must have written confirmation from the State Department of Environmental <` Conserve ion attesting to th legality and s{atua ""'•''"` -' "' ? '� `'•"" "'"" 4 r" "''' rr,"xr f' Y " 'r. .' . �s�:. }"`r.`, �� • M:/iiYl Nl. ,•I, 111n ..71r .; Jay. Il.� } .t ,`• 1�{^i 4 SEWAGE DISPOSAL �:+:ri. •.>u+. Jac c.wut.r aJ..!r : n fi7 r`.r7 .an,�t i`/ [j:.7 (7/1!i�j Yil V t),E^0 J•.i :. ,U •,e17f Uf.0 tik'i1 tl .: R�;f C(ii ..^.' site Wf)x-Public❑a.--(Community❑>1nHolding Tank❑an? "i ,�N-•"4=+T^Yt'IfT^ll1:f^+:j!"J•"-rf'r r..-nf.Y.f:r•:p. of rig •'t'M ,Tlilrrnl iti•e }Y,tn tjt :: i.i fA(l{�:fs^J;ra.:So il•'fn ote .If community,well, system, must have written confirmation, from the State Department'o3Environmental Conservation attesting fo the 1@gailty and status . i� -= - • �� �'1 ,., .:... - ... , ; .: ` .x .�'N 1. iC 7 'A, r,, r•/ . 1 ' r M1 M=(Ra. 7/113) . , ..... '. Page 1'of 2' - _ ,•-,••••• -- Z to Z shed . mm (ml ••.w smu •XJoM sJaau!6ua leuo!ssaloJd eyl u! suolss!woJosJaJJaJolelq!suodsoijou sia6eJoyouyloA1!led!o!unyyayl•ponssls!eleolpliaoeeJolage3epez,QeueJo . suo!loodsul lonpuoo lou op SHHO to soa (oldw3 •sluawaJ!nbei eie3s pue leJapal u!elJaoAls!les olJapJo ul suoilnl!lsui 6u!pual Jlayl pue sawo4 to sJeseyoJnd of LsolJnoo a se slyl saop SHHO ayl elsely to elelS 0141 u! paJa3sI681 Jaau!6ua leuo!ssajoid luapuadopu! uv Aq enoge 5 4doiBeJed ul uaA16 suolle3uasaJdaJ eyl uodn Aluo paseg paleollpeo lenoJddVq!joylnV WIL'OH sonssl (SHHO) sao!AJaS uewnH pue 431e9HtoluawlJedaO e6eJoyouVtoAl!led!olunyy eyl l -._ _ - _ _ /, PA j,,ddV leuoµiPuoO to suijej. {•i. r C` leuOIIIPUOO _ panoJddes!O I7/pan ;ddV , P _ slopJtq swooJpagTiol panaJddy.,, L IVAOHddV SHHO •9 !< %%m �dN01SS3d0ydh ` '���. .. •..M•. .• •J. 1.••x•••••..1/ do TiTAs: 0 . . _ . 0661 TZ 43aW :., elea r; lc LLS66'%tt'."MATII aT p3 '66Z£LL XO$ 'O'd ssalppv 1 56T5-669.. suo4dalel: seOTAaaS BUTaeauTBU3 ZOATH 51 eg wnj lO eweN uolloodsul s!yl to slop eyl_uo;oallo, u! suollLInBaj puL,'saoueulpjo sapoo DIE;S pue !ed!olunlry Ile 4p'm eouepdwoo ul sl waliks lesodslp JalemalseM io/pue Alddns JeIEM ells uo eiji'uolloadsul pue uoj1e613sanuj �(w�woil pue se!!1 e6ej'oyouV Io'Aj!IEdlolunygl'eyi woJl paulelgo uoilewiojul eyl uo peseq 3e4i A1!Jan Ja4>Jn! I 'uleJey palsolpul emloruls to adl(i pue swooJpaq jo iagwnu eyi f of elenbape pue lauollounl sl waists=lesodslp:JaleMalseM-Jo/pue��tlddns>aleM_el!s-uo eyl;layisMoys lenoJddV:'itliJoylnV_ylleeH--- -- s!yllouolle6llsanul�twleylAjuan1'MolaquMoysalepyoljep!lenoyl)osepueoleJaypazlllejeasXwAgpall!yaosy ,. —" NOI1VWUOdNI ONV V.LV0'HO!lV3S 3lld'S1S31'SNOLLOUSNl JNIOIAOUd VMW ONIH33NION3 'S;- • � E Ur�\PP\\r�gEP�_'ZION • t3� 2 Q MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST- FEBRUARY 1984 343-4744 l Legal Description: Meadow Ridge Estates Lot 7 Block 5, T15N, R1W, Sec. 2 A. WELL DATA Well Classification N/A Class 'A' If A, B. C, D.E.C. Approved (Y/N) Y Well Log Present (Y/N) Date Completed Total Depth Cased to Depth of Grouting Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Cleanouf/Manhole ; Date Date Installed 9/83 Size 1000 gal No. of Compartments TWO Standpipes (Y/N) v Air -tight Caps (Y/N) Y Foundation Cleanout (Y/N) N Depression over Tank (Y/N) N Date Last Pumped 8/89 Issac's Pumping/Maintenance Contact on File (Y/N) N/A ; for N/A Holding Tank High -Water Alarm (Y/N) N/A Temporary Holding Tank Permit (Y/N) N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well +200'to active well To Building Foundation30' -185 to abandoned well To Property Line = 20' To Disposal Field 5' To Water Main/Service Line +10' To Stream, Pond, Lake or Major Drainage Course +100' Comments 72-M (A". 7/8a) From Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 140 Type of System Design 'French Date Installed Sept. 1983 Length of Field 28' Width of Field 3' Depth of Field 9' +fill material as per "insp. rep. Gravel Bed Thickness 7.5' Square Feet of Absortion Area 41u Statndpipes Present (Y/N) Depression over Field (Y/N) N Date of Last Adequacy Test - 7/26/89 Results of Last Adequacy Test Satisfactory absorbtion rate for 3BR usage SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well +200' to active well To Property Line 15' To Building Foundation 40' To Existing or Abandoned System on Lot N/A : On Adjoining Lots +30' To Water Main/Service Line +10' To Cutback (if present) 10' to reveg. road bank To Stream, Pond, Lake, or Major Drainage Course N/A To Driveway, Parking Area, or Vehicle Storage Area 6' (+6' soil cover) Comments D. LIFT STATION N/A Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) **Check Permitted Bedroom Rating Against HAA Request" "Pump Off" Level at Vent(Y/N) certify that I have checked, verified, or conformed to all MOA and HAA inspection. Signed Signed Company Date ��464 P. o. Box 773294 E,�,r!e frrom; 7c:rs9s n MOA No. fO195 Receipt No. c;? 17i! ( ( oO el Date of Payment 3— —F a Amount: $ ./ : /�9- 0e) Receipt No. _ Waiver Fee: $ Date of Payment 72-M (11". VN) Back Page 2 of 2 Pumping Cycles during Adequacy Test. Qes'4T8Pf _iz t1f.n the date of this yr r� "r9 14w = fl �':�' •'rt ryf�J "Eh'gieer's Seal Louis A. Butera : Va. CE -6736 t or U&SM STfVF COWPER, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION. ANCHORAGE WESTERN DISTRICT OFFICE 563-6775 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 March 20, 1990 FOR: EAGLE RIVER ENGINEERING PWSID -#21111.-- According to the records on file in this office, the Dawn Water Co., Meadow Ridge Subdivision Water System is in compliance with the State of Alaska Drinking Water Regulations. Sincerely, n- Richard Sundet i Environmental Field Officer RS:bas MUNICIPALITY OF ANCHORAGE Department of Health &Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # C',!�� ( -'5t 11- 1--'4 HAA # FNQIR9e� `Z 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivi ion, section, township, range) ncn4n Ayi-bglol Meadow Ridge Estates, Lot 7, Block 5 T15N, Location (address or directions) 6414 Homestead Road R1W, Sec.2 (b) Property owner H.U.D. Telephone: (home) Business 271-4342 Mailing Address 222 W. 8th Ave. (Box N-64) Anchorage, AK 99813 (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent Associated Brokers Address 640 W. 36th Ave.. Suite #1 Anchorage. AK 99503 (e) Mail the HAA to the following address: (or check here ❑, if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single -Family ® Number of bedrooms 3 3. WATER SUPPLY Individual Well ❑ Community Ix Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site 12 Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 Oa«.VN) ., Page 1 of 2 Z 1 Z abed we Wu'"Vtl Smu •)IjoM s,jaaui6ua leuolssa;ad oql ut suo!ss!woiosiajajol alq!suodsai lou si a6ejogouy;op!led!o!unlry a41 •panss! si aleo!; liaoe ejo;aq elep azAleuejo suo!loodsu!lonpuoolou opSHHO;o saa�(oldw3 •sivawannbaj mels pue lejapa; u!eljaoApgrsoliapio u! suo!lnl!lsu! 6u!pual �!ayl pue sawoy;o sjaseyo�nd o3 �(saljnoo a se s!yl saop SHHO ey1 e�Isely;o alelS ey3 u! paials!6a� jeau!6ua leuolssa;ad luapuadapu! ue Aq anoge 5 ydei6eied u! uaA!6 suo!leluasajdaj a4l uodn Aluo paseq paleo!1!jao lenaddy Aiuo43ny4lleaH sanss! (SHHO) sao!nuaS uewnH pue 4l!eaH;oluawlmdaO e6ejoyouy;o A3!Iedio!unlry a41 NOLLny3 lenaddy Ieuop!puo--k;o swial Ieuo!3!PuoO panaddes!O X Panaddy aleO Z�, �tq swoapaq-7—Jo; panaddy 'IVAOHddV SHHO '9 •.�:- Rt $ SWO LLS66 KV ze^?11 aT p366ZELL �S'O' ssa'ppy 5615-669 euoydalal snag u?�aau? ug zan?d a1 e3wJ!j;oeweN •uo!loadsui s!41 ;o alp ay3 uo loa;;a ut suope!n6aj pue 'saoumpio 'sopoo elelS pue led!oluny4 Ile 4l!m eoue!Idwoo u.i s! wals (s lesods!p japmalseM Jo/pue Alddns jamm ops-uo a43 'uo!loodsu! Pup uolie6!isanu! Aw wal pue sail; e5ejoyouy ;o Apled!olunlry a43 wa; pau!elgo uollewio;ui a43 uo paseq 1e43 ApJOA ja43jn; I 'u!aja4 paleo!pu! ejnlonils;o adAj pue swoapaq;o jagwnu e43 jo; alenbape pue leuopun; 'ales si walsAs lesods!p Jawmalsem, jo/pue Rlddns jalm alis-uo ay3 1e43 sMo4s lenaddy Al!jo43ny y3leaH s!yl;o u011e611sanu! Aw le43 A;uan I'rnolaq UM04S a3eP uo!lep!IEn ayl;o se pue olaja4 pax!;le leas Rw Aq paipljao sy NOIIVWFIOdNI ONV VIVO'HOUV3S 3lld'S1S31'SN01103dSNl JNIOIAOIid WHIj JNIH33NIJN3 'S ! MUNICIPALITY OF ANCHORAGE (MOA) �pF 0.��p . • Health Authority Approval (HAA) .• JvPP��P C CHECKLIST -FEBRUARY 1984 Jr.�c� 6,��` 3434744 Legal Description: lot 7 'Afar -r— CC����� le.rse Err xr Tit iv oe /w Se•.Q A. WELL DATS�" . Well Classification n'/A ` GG.rr A If A. B, C, D.E.C. Approved (Y/N) ay Well Log Present (Y/N) Date Completed Yield Total Depth Cased to Static Water Level Casing Height Above Ground , Electrical Wiring in Conduit (Y/N) Depth of Grouting SEPARATION DISTANCES FROM WELL: r • To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) On Adjoining Lots On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole Date B. SEPTIC/HOLDING TANK DATA Date Installed P 3 Size 10do 3'- <No. of Compartments 2 - Standpipes (Y/N) r Air -tight Caps (Y/N) y Foundation Cleanout (Y/N) ✓✓ Depression over Tank (Y/N) Date Last Pumped 8/p5 .IJJ9<, Pumping/Maintenance Contact on File (Y/N) for Holding Tank High -Water Alarm (Y/N) A/A Temporary Holding Tank Permit (Y/N) 0,44 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well rte» r, r '<riK ­eC1rJ To Building Foundation 30 ` To Property Line .20 To Disposal Field S To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course #A/0.V Comments 72-M (A". 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata �° Type of System Design Date Installed y- X983 Length of Field Width of Field - 3 ' Depth of Field 9 r f .-.,t. ,: ( .r /a"s` ,,.. Gravel Bed Thickness Z S Square Feet of Absortion Area �a0 Statndpipes Present (Y/N) Depression over Field (Y/N) N Date of Last Adequacy Test Results of Last Adequacy Test 5.75:rA,,�., A6r.—fir,..;' R..k .+. ? t.e a,_Qey-r SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well Y'on A,M1.4 A. ler. To Property Line /S"' To Building Foundation y° To Existing or Abandoned System on Lot y/A ; On Adjoining Lots *310 To Water Main/Service Line —To Cutback (if present) /0'40 x+ws. ret. agy, e To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area d (rs0 S* ;l ea, . -) A✓/.r Comments D. LIFT STATION N1 Date Installed Size in Gallons "Pump On" Level at — High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent(Y/N) Pumping Cycles during Adequacy Test. "Check Permitted Bedroom Rating Against HAA Request I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in a Iect'orl• the date of this inspection. Signed o � �''y'�t?;r' ..1e` �,,; •• a'` i', Eagle Fir Engineering ServicesLe .4,.; 7`Tis ►&XCompany . o. : 77379a L? " t ' ..,�...'...- 9' Eagle River, AK 99577 .. r� En1 peer's Seal � Date ��t/f4 6Qe 515 - ................... MOA No. fr—.26,1' Receipt No.,2 ` ��J I ` Date of Payment Amount: $ 72-026 (Rev. 7/68) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 Louis A. eutero 1T ;� CE -6726 Ca��p�OFESsw�:�.�SS US �%%1II"""nSTEVE COWPER, GOVERNOR DEPT.OF ENVIRONMENTAL CONSERVATION 11{ ANCHORAGE WESTERN DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 563-6775 DATE: July 31, 1989 PWSID: 211431 To Whom It May Concern: According to the records on file in this office, the Dawn Water Company/Meadow Ridge Estates, Ridge Estates, Lot7, Block SBlock 5 , Water System is in compliance with the State of Alaska Drinking Water and Wastewater Regulations. Th(aank, �You, (� Cindy Thomas, Environmental Engineer CT: gd n r� MUNICIPALITY OF ANCHORAGE • DIVISION OF ENVIRO&'IENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE Z 1. General Information Application Date ' JQ ' D (a) Legal Description (include lot, block, subdivision, section, township, L_07 '7 13Lk< S MP* vu70Rlrr�t' LEM e'S iii S Lqcation (address or directions) - �� „ J/ _J A . vnv. (�Yfl'� I (b) Applic nts Mame TeLlephone - ome Buslnes Applicants Address ,0 (c) Applicant s (check one) Lending Institution Buyer; Other (d) Lending Institution Address (e) Real Be Address Q ; Owner/builder Q ; Telephone (f) Mail the HAA to the following address: ,�/i .P I/1 S N J D9+Gf��J11JD.f•liJ,sf_ v 2. Type of Residence Single -Family 5n Multi -Family Other (describe) Number of Bedrooms 3 3. Water Supply - Individual Well = Community = Public KI Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite ^n Public Community Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 21 5. Engineering Firm Providing Inspections, Tests, File Search, Data and Information 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 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 regula- tions in effect on the date of this inspection. Name of Firm p Telephone 1JJ_--- S{�£.EyQ�NEz=Qtura •.. x.,01@ FPH G 4. lel $STT JZ OZ� Date (ENGINEER SEAL) 6. DHEP Approval Approved for .S bedrooms Approved _X__ Disapproved Terms of Conditional Approval By CAUTION Conditional THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. E24PLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR 014ISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/D18 (Page 2 of 21 7-19-84 J+WN,ICIPAUTY OF ANCHORAGE DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MoArIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HM) pDEC 3 19H� CHEMIST - FEBRUARY 1984 1t 14 V_E /� Legal Description: - 2rvdoCJ A. WELL DATA Well Classification l ✓ If A, B. cr C, D.E.C. Approvveed`(Y/N) Well Log Present (Y/N) Date Cmpleted / Yield Total Depth Cased to Deptt'of Grouting Static Water Lever PLmp Set At Casing Height Above Ground— Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) Separation Distances frau Wells To Septic/Holding Tank cn 2 �� Own Adjoining Lots To Nearest Edge of Absscption Field on Loth = = -Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleancut/Manbol Th Nearest Sewer Service Line on Lot Water Sample Collected By t Date Water Sample '!test Results � Caaaents B. SEPTIC/HOLDING TAIL DATA Date Installed 9r192 Size 1000 No. of C=Wtmsnts Standpipes AM Air -tight CapsY )Y Foundation Cleanout ( ) Depression over Tank �1 Date Las�t,Pumped ILle-C ) Pumping/Maintenance Oontract to File Y l' /1- f for 1000/4 Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) 1p /Z Separation Distances frau Septic/Holding Tanks To Water -Supply well 2dd ' -/- To Building Foundation 33 / To Property Line 'go 'f To Disposal Field v� To Water Maiwtervice Line To Stream, Pond, fake, cr Major Drainage Course /0 © -^ Ccrosents Receipt I Q JL.t3 Date Paid: Amount: '-iS.C)U [Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA _ I Soils Rating in Absorption Strata Type of System Date Installed ,�� OS Length of Field Z v Width of Field 30 ��f Depth of Field 9 wIi7 F1,111v A77 Gravel Had Thick'ne'ss -- 70 Square Fleet of Absorption Area 17o Standpipes Present ( ) Depression over Field MAV Date of Lest Adequacy Test -4/ Results of Last Adequacy Test / z- Separation Distance fran Absorption F ld: To Water -Supply Well 2 00 f To Property Line /O To Building Foundation f6 To Existing or Abandoned System on Lot ,OVO "JO = On Adjoining Lots K Al DE' 0. To Water Main/Service Line JZ 4-- To Cutbank(if present) 2'0 To Stream/Pand/Lake% Major Drainage Casae AAO-^_rA£ To Driveway, Parking Area, cr Vehicle Storage Area I o' VO - Comments Comments /Vo ..JAf D. LIFT SUMCN Date installed Dimensions Size in Gallons Manhole/Access (Y/N) "Rump On" Level at " f" Level at High Water Alarm Level at nt (Y/N) Tested for Pumping Cykea during Adequacy Test. Meets MDA Electrical Codes(Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that i have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. I --_ Signed 8 a el.NGIUWMIMNo Date 2 D7i comparri V..as _ OK EC79 MOA No. xB1/d5/s (Page 2 of 21 2-15-84 MT. EKLUTNA DR I T0NJE55 u �' ' I I � zsl.s I I v • , IIlIH 23163 PARK / Ylosl QQ\NCE 1 I N930 pllM w{� a 14 I s =49 1 I 241113 NK1 23221 • •y ro I 2ll.s oa23 I I 2!220 I 1 230.3 21321 2.351 2.9n JESSE LEE CT. 250p III363 2+350 219e 2.910 a SII1324 { I 21'N9 21523 25295 j 21531 " 21!10 I I zsns II 1 I M•.�a..ol •1.132 IM•1 � zszls mu ME w p II123• \ �• 2 252.9 9 • 212.0 ` 24"RID MEA "/ `J IIlzzs W n, • 21225 8212 3 1115! zsls .r,vr o _ N�A �MrAiELE^CT I (' _:: M—E—A�OOW RIDGE Cf I/ 1 COUNTRY VIEW 95.09 ,a P. , I..t MaaMa NUING PARK NW 1462 1 17 A 24 23 -.4®p North Municipality Area Reference Map -1B Y ® COPYRIGHT 1989 JMR 31 EKL UTNA 104M1Ae DN —> DOLLY AYE �YIS31 40>2 II10M NIM 1D 4lENH f MWY. a . g 214 CSR c YL046 „MU p O 0 ano J 21]O7 EAST S2)E MT EKLUTNA DR. 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OFENVIRONMENTAL CONSERVATION / ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITEE 303 ANCHORAGE, ALASKA 49501 DATE�'II i /R. eA- :;�. ��] ✓�� PWS I.n.k To Whom it May Concern: BILL SHEFFIELD, GOVERNOR Telephone: (907) Address: 274-2533 According to records on file in this office the �:ifa(�u}4lri� Yti�.ti , e.(,7XpL40 � Water System is in compliance -with the State Drinking Water Regulations Sincerely, t