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HomeMy WebLinkAboutHENKINS BLK 2 LT 6Henki*ns Block 2 Lot 6 #051-292-11 i Grfif r 4:5r b,. -'-DOC Co. oba - - SULLIVAV NATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 995,67, • TELEPHONE 688.2759 3 OWNER OF LAND r* % I9 0.5I'dl DEPTH OF WELL ADDRESS ?`� ++ J ()0 7Ol0 AP9C H STATIC LEVEL OF WATER FT. ley LEGAL DESCRIPTION ' `ZI X Q HeAN161f sl u60 DRAW DOWN FT. DATE • Started �I—dl Z Ended 2 � hP GALS. PER HR -,00 PERMIT NUMBER _7iK-SR- �- J_ KIND OF CASING 'KIND OF FORMATION: From Ft: to--H?—Ft. AXIAJ d From Ft. to- -Ft. From Ft.ao Ft. Q Q1500 f')� From, Ft. to Ft. From Ft. to d / Ft. From Ft. to Ft. From 1 Ft. to_Ft. 6'edv� — From Ft to Ft From Ft. to , � Ft " Ll "® 6504454 4'C3r l -From , FL to Ft '5 FromFrom �Ft. to��_Ft. �-�of-3r<.}4 ��e� Ft. to Ft. From_ Ft.to Ft ��G " From Ft. to Ft. From t?� Ft to Ft. j?,j j R 0 � From Ft. to Ft - MUNICIPALITY OF ANCHORAGE. From Ft, to&�_Ft. L1.967 ' PFtOF HEALTH & � From Ft. toCE ENVIRONMENTAL PROTECTION From -- Ft. to - Ft. _f 11 fi ' From Ft. to - Ft. q 2 19B 7. >L1 From Ft. to f�gf3 1 From �? - Ft. to—Ft. From Ft. to --R From Ft. to—Ft. From Ft.'to Ft From Ft. to Ft From Ft. to—Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. — From Ft. o Ft. From Ft. to Ft.' Ft. o Ft. From F From Ft. to Ft MISCL. INFORMATION:, 1. m - + �....... ...-- --h H ::� DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, 1 264~4720 oil W~- ]L ;E--. HE:H: IL ...... `2 :1K Y PERMIT NO: 870015 DATE ISSUED: 01/30/87 APPLICANT: NIKKI MOSER ADDRESS: P. u. BOX 100720 ANCHORAGE, AK 99510 CONTACT PHONE: 265~3093 LEGAL DESCRIP: .— U DIVV,:l :f3�NKI ���,�' -'/' ��LOI: �6 � .BLOCK: 2 SECTION: 30' ` TOWNSHIF": 15N RANGE:' 1W LOT SIZE: 20000 (PHS. FIT. OR ACRES) I cery ihat: 1" I am familiar with the requirements [or on-siie sewers and wells'as set {orth by thp Municipality o4' Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3" I will adhere to all MOA and State of Alaska requirements or the set back distances from any existing wastewater disposal system or public sewerage `well, system on this or any adjacent or nearby lot. SIGNED ` . APPLICANT: NIKKI MOSER ISSUED BY ---�9-------_'`--�-r~~~_�~. DATE: /gF 7- ~.... ~__..... ... ..... DATE: /_2�d� �����^~..... .... ..... .... ���� U, January 18, 1987 Mr. Steve Morris Civil Engineer, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, Alaska 99519 REF: Lot 6, Block 2 Henkins Dear Mr. Morris: On behalf of my client, Mr. Bill Sullivan, I am applying for a permit to construct a well on the above referenced lot. Despite the fact that this lot is served by a Class "C" well, the shared well will not meet FHA loan requirements so the owner wishes to drill his own well. The cross hatched area specified on site plan will allow the driller the option to locate after water Witcher and access will permit. An exact location will be forwarded to ,your office upon completion with a Well log. This area is not in the problem area of Henkins Subdivision. If there are any questions, or if additional information is requested, please feel free to contact me at 694-5195. Thank You, Lou Butera, P.E. Nc Sep t•� Y/u0 /,�`' - NO 2 CQl P __- 1 pJ 'lu C Selo Y1 0 - 'j r l / WELL/ p tlou rAfiK I 4 ; Imo, i j. \\ VU SePtu '*/UO ipp a l -u7 7 Tst•✓K E�'��Lo sa as take �g - . _ �'e oonho�abc ,eooaao•oau ,� �� . - iv o.. 1. G� Louis A. Buterct • t4;� CE -6736 p •r�; Uy 00 WELL SITT AN AS -BUILT. • .. I hereby certify that, .1 hove surveyed the following described property: L- o $ j �''k j n ft i nA SU6 cf Olt-, A'! ��� AnchoiaSe RecordinG Precinct, Alaska. and that the itnpzo' do v.. .� eNa•w. �?',, ;1�r•e ,•e;� �7,'^fir menta situated thereon are within thytproPestyd ansa and o a not overlap or encroach on the property lying ] cenVthere-< ' �'' `' �'•w ��. to,.that no improvements on. property lying ad]acel;t I,hereto , • i K a th .;. t �Il'ili �%`� s •n encroach on a premises to question and'that.thera ue.,Ao: c�aw.+a»..aa+....o.r• +.• - ••• roadways, transmission ]fines or other Visible 'easntnenta':gn' �,: •?l _ n�,-.0 L said property except as Indicated Hereom i w•e MM•• w+• •raw.;+�• i... •. ,,;:.: • Dated it Eagle River, Alaska' this day of JWn� 19=.x.►=-.': a =. ;+x ROBERT C. JOHNSON s..• 0'w `� '`+'•^. c ;' SCALE: Registered Land Surveyor Aa. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISIONN A00*) 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME P/H(ON/EL- NEW / nn ❑UPGRADE MAILING ADDRESS LEGAL DESCRIPTION /61 LOCATION NO. OF BEDROOMS Well Absorption area Dwelling PERMIT NO. U Y DISTANCE TO: 7a0_-) / RI© H Z W a ~ Manufacturer 61 .*-, Material No. of compartments N Lin. capacity in gallons Inside length Width Liquid depth tJ IF HOMEMADE: DISTANCE TO: Well Dwelling PERMIT NO. J �=Z O z Q 2—F Manufacturer Material Liquid capacity in gallons Well Foundation Nearest lot line PERMIT NO. i2= DISTAN CETO: J LLz No. of lines Length of each line Total length of lines Trench width Distance between lines H ? W I inches F- Top of tile to finish grade Material beneath tile Total effective absorption area p inches Lengtha�� Width Depth , f PERMIT NO. _ LU /6S 12-0 93_S QType-�ef�rib Crib -�'-^K-aer Crttul h Total effective absorption rea W < W DISTANCE TO: Well -i�(j�( Building foundation / Nearest lot line J Cj9ss Depth Driller Distance to lot line PERMIT NO. W ss — -- �- DISTANCE O: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING INSTALLE /¢4 44/2Se42 A6,C, iC �d REMARKS D G) t ` APPROVED D%%AATE LEGAL ^ PERtItI T NO. I I F=f _ " 9 I _FV OF=" F=l Nr, - 1-1 P-�Fe n in F=- DEPARTMENT C HEALTH AND ENVIRONMENTAL 3TECTION 825 `L" STREET, ANCHORAGE.- AK 99501 264-4720 ID 820925 (RO4 APPLICANT AL LARSON/RUSTIC HOMES PO BOX 594 EAGLE RIVER 99577 --694-9555 LOCATION LEGAL LG 82 HENKINS S/D LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: DRAINFIELD MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ FT/BR)= 85 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: CA F= F=• _r " �4 1 FE " ID _r " � '_5- 13F;;? =l%- E=- I U-- F= F=' -r " THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR CERA INFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). r " E_ -IF F;? E-= r-4 1:= " L4 I r -.n -F" l o !a;_ C-1 "ERD THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). F-oF=lavUllF-:mE=r_-d -rF=ir-JK !E-l=E= _110100 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. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET 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 R PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. IF" I=F;�M I -r F= X 1=* I FR IF _�� ED- F= r,E= M ED F= FR 2z -1 , -1 _�:2--:2 I CERTIFY THAT 1: 1 AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: 1 UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE I'S, REMOD LED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED:-/., --- a ----------------- APPLICIINT AL LARSONc,RUSTIC HOMES on - ISSUED V4. 0 'al ti ❑ SOILS LOG 11 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ❑ PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 _ 264.4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: L L Gross Time LEGAL DESCRIPTION: / r� Net Drop OTH (FDE 110_Y��:� 1 2 3 -�-4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 A,I,00f t COMMENTS PERFORMED BY: . °lno J/6IJ SLOPE DATE PERF RIVED: WAS GROUNDWATER G' L ENCOUNTERED? 0 P IF YES, AT WHAT E DEPTH? eW Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT CERTIFIED DA Time d Time .ane Date Date Date Inspector Inspector Inspector Comments Conditional Approval i I I Date SeWer-In ailed Permit No. Septic Tank Size ! Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Owner F- Phone Mailing Address G�4Gt,�,40 Buyer�/,� Address 7-�t/ 11t/ 57- ;7,5 7-1-1 = 2 tJC��J f��y j IY/<• Lending Institution ice Affy: LrnA Phone 0/03 Address Realty Co. R Agent Phone Address �?D. 15OX 04/ �A�L� lel az: l X/� , x%%57% q �/4—l- -6-5 Legal Description i Street Location TypeAf Residence ❑ Single Family ❑ Multiple Family No. of Bedrooms ❑ Other Water Supply T/7 Individual cLAss G. ATTACH WELL LOG. A well log is required for all wells drilled since June ❑ Community 1975. For wells drilled prior to that date, give well depth (attach log if ❑ Public Utility available. Sewage Disposal lc7g '❑ Individual Year Individual Installed: ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE FAUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 3, • Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval pp Parcel I.D. 051-292-11 Expiration Date: iR�I��E�:7_ti�l►l�il:7di/_ri[�7. i Complete legal description HenkinS Block 2, Lot 6 Location (site address) 19707 HENKINS RD Current Property owners) Mathew D Nloore and Shawna R Amsden Mailing address P.O. Box 671743 Real Estate Agent .. 2. TYPE OF DWELLING: 171 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 907.440.1553 Day phone G3 0 - 7 Z 7 1.� 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class c Well F-1 Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: Received by: _��� Date: '11011te COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ �,9(a. � Waiver Fee $ Date of Payment (.01Z 118 Date of Payment Receipt Number na2 Receipt Number CASA # OSC I L0 12 i i (D Waiver # 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 Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water 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 riles 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 Firm Luke Randall, P.E. Address 3330 E 41 st Ave, Anchorage AK 99508 Engineer's Printed Name Luke Randall 6. DSD SIGNATURE System #1 Approved for bedrooms M System #2 Approved for Disapproved Conditional approval for bedrooms Phone 480.540.0390 Date 6/10/16 J�P��• OF AC�S�ee 49TH '•� ............ bedrooms, with the following ..................0 : Lucas M. Randall ; �s CE, -12595 .4-" sem' • .til = ' t��' pu�atobf' is Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet � . c ff more than 1 septic system is on the lot: COSA.Checklist # _of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: A. WELL DATA Henkins Block 2, Lot 6 Well type Community C Date completed 2/2187 Sanitary seal (Y/N) Y Total depth 63 ft. Cased to 37`8 ft. FROM WELL LOG 212187 15 ft. If A, B, or C provide PWSID # 21436 Date of test State water level Well production 10 g.p.m. - WATER SAMPLE RESULTS: Coliform L,0t,.__colonies/100 mL Nitrate mg/L Arsenic M— ug/L Date of sample: ('1411V B. SEPTIC/HOLDING TANK DATA Parcel ID: " 051-292-11 Well Log (YM) Y Wires properly protected (YIN) Y Casing height (above ground) 30 in. AT INSPECTION NA ft. Collected by: •4 e" & `k` Tank Type/Material STEEL Date installed 1982 Tank size 1000 gal. Number of Compartments 2 Cleanout's (+/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) NA Date of pumping August 2015 Pumper Sanitary Pumpers C. ABSORPTION FIELD DATA Date ins 1 go f 9% Soil rating (g.p.d./ftZ or ftZ/bdrm) 8585 gpd System type BED � Len��jt `�.' '''a1^� Width t5 ft. Gravel below pipe 0.5 ft. TIepthst AEf eb`aePrption area 390 ftZ Monitoring tube Y Depression over field N %*: I.................,B.... a. PASS /8116� D�t�'8ia.lequacy test , �_. ► Results (Pass/Fail) For 3 bedrooms Flep{fii�R, Fetti• �ore test 0 in. Water added 450 gal. New depth 0 in. r '� •' S1 450 Elapsitne,,_ rit< Final fluid depth 0 in. Absorption rate >= g.p.d. Any rejuv'�mtt♦'Igjytyae,�Qprwi�nt (past 12 mo.) (Y/N &type) NO if yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in in. "Pump off" level at E. SEPARATION DISTANCES WELL ON LOT TO: Cycles tested Septic tank/lift station on lot 159+ Absorption field on tot 109+ Public sewer main Sewer /septic service line 100'+ 25'+ Manhole/Access (Y/N) in. HlggTr ecalann level at Meets alarm & circuit On adjacent lots 100' + On adjacent lots 100' + Public sewer manhole/cleanout 100' + Holding tank 75'+ Animal containment areas 100'+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Buildingfoundation 5 + Property line 10,+ Absorption field 5'+ Water main 101+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 4' Building foundation 16' Water main l0,+ Water Service line 10'+ urfaoe water 1001+ Driveway, parking/vehicle storage 5 ue� Curtain drain NA . N•W Wells on adjacent lots 100'+ F. COMMENTS ' WELL CASED TO BEDROCK. HOME IS CONNECTED TO COMMUNITY WATER SYSTEM AND HAS ANOTHER k ONSITE WELL THAT IS USED FOR GARDENING PER OWNER. G. ENGINEER'S CERTIFICATION i certify that ! have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Luke Randall Date fr`20Ice COSA canary sheet 2-6-16.doc in. SGS Ref.# 1163469001 Client Name 907 Water Well Services Project Name/# Henidns Block 2 Lot 6 Client Sample ID Henkins BLK2 Lt6 Matrix Drinking Water Sample Remarks: .d,r�c,t�'Ow\ wcll a- 1a4 (19 Printed Date/Time 07/01/2016 12:33 Collected Date/Time 06/27/2016 14:00 Received Date/Thne 06/27/2016 16:38 Technical Director Stephen C. Ede Parameter Results LOQ Units Allowable Method Container ID Limits Prep Analysis Date Date [nit Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 B (<10) 06/28/16 06/28/16 EAB Waters Department Total Nitrate/Nitrite-N 0.183 0.100 mg/L SM214500NO3-F C (<to) 06/29/16 NEG Microbiology Laboratory E. Coli Negative I IOOmL SM21 9223B A 06/27/16 ICW Total Coliform Negative 1 I00mL SM219223B A 06/27/16 K.W �1�LIV ✓fL {Or �i1L��•<l 7�f�OS<f l9Cf I unL rS. a i�/�r� -.rz/ ASBWLT RVM &ASSOCIATES LAND SURVEYING 694-0829 1 HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE$ FOLLOWING DESCRIBED PROPERTY: OF *0� .%`v�iys DATE. r'�ti , ....... +4 AND THAT NO FNCRbACHMENTS EXIST D(CEFr AS INDICATED. IT IS THE RESPONSIBILITY OF THE&nLH OWNER TO DETERMINE THE EXISTENCE OF ANY GRID$ �",•...•,•• EASEMENTS, COVENANTS, OR RESTRICTIONS u✓ 7ss A WHICH DO NOT APPEAR ON THE RECORDED SUBDI- Dunce Mwk p VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB'1A'•. LS- a Jr ANY DATA HEREON BE USED FOR CONSTRUCTION /�� 68 4�� �. e. OFFENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. DRAWN= r tiga�p�sFX�4. ASSUILT SEWARD & ASSOCIATES LAND SURVEYING 694-0829 1 HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE= FOLLOWING DESCRIBED PROPERTY=Q �O y 4 f✓�,F..yf fUli. DATE= 'q � AND THAT NO F.NCPi'OACHMENTS EXIST EXCEPT A5 7�j�er i �� •' sf INDICATED. IT IS THE RESPONSIBILITY OF THE ,!;'� 7H ' OWNER TO DETERMINE THE EXISTENCE OF ANY GRID= �er� - * M EASEMENTS, COVENANTS, OR RESTRICTIONS ,�v F✓ mss A WHICH DO NOT APPEAR ON THE RECORDED SUBDI- 0ou,ne Mork Sever p VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD F$= ANY DATA HEREON 13E USED FOR- CONSTRUCTION iiz- AROFFENCELINES. INES, OR FOR ESTABLISHING BOUND- DRAWN,rT�44"{ Municipality of Anchorage Development Services Department Building Safety Division / On -Site Water and Wastewater Program 4700 Bragaw Street P.O.196650 Anchoragerage,,AK 99519-6650 P. ,� ww 907) 3.3-790 site A1 (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. ��J(-o`�i� -fir' COSA# nteo5n Expiration Date: to -a.4- O G .1. GENERAL INFORMATION Complete legal description Hon V i S Lby a Location (site address) l97oq .> (V,3 IQ ti. 12vao Current Property owner(s)TJA B\) Y Y Day phone Mailing address �� piv-Pv 11 ht 99577 Lending agency Day phone Mailing address Real Estate Agent !;:I i rn o P rICP Day phone t_;q9 -q I as Mailing Address I I Li I 1 nl Ci 6 (Pywt HV:>l l rfagtp �'� Ay- Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: R 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: , Individual Well Vie" Individual On-site Individual Water Storage El Individual Holding tank ❑ Community Class "G" Well / Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Onsite Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems 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. (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 wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 4. 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 Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water 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 Firm Eagle River Engineering Services a 042 1 VFW Md., Suite 201 Address Fagle River. AK 99577 Engineer's Printed Name Chris+nVhlz r wXY-i 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Phone /rfi`I Si�iS Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: 4�� / �(�. �a�tJ( Original Certificate Date: 7- 2 �L- 0 6 (Rn. 11A5) Municipality of Anchorage *Noll Development Services DepartmentBuilding Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: o,�% �- Parcel ID: D S I - - A. WELL DATA * pr -i ✓o4 -t Well type If A, B, or C provide PWSID # a I b 3Well Log ON) Date completed 2 /g-7 Sanitary seal (DN) J#L4- Wires properly protected ON) Total depth f93,_ft. 4Cased to 32- —8ft. Casing height (above ground)�o in. FROM WELL LOG Date of test a/ a y 8 1 Static water level 15 ft. Well production i o g.p.m. WATER SAMPLE RESULTS: Co.. -...N :4,j / P.•�n�a i . o•f / Coliform S/0 colonies/100 mL Nitrate ry a mg/L Arsenic: V/ jr ug/L date of sample: &0/0(- B. /p(- B. SEPTIC/HOLDING TANK DATA Tank Type/Material : ztoc_ S� r AT INSPECTION Tank size 1. COO gal. Number of Compartments a -- Foundation cleanout ON) f tom- Depression over tank (YQ -no Date of pumping Pumper C. ABSORPTION FIELD DATA (�/,29 1 Cb 3 ft. -# fc . y g.p.m. Other bacteria Z / O colonies/100 mL Date installed 1 ei %a Cleanouts (DN) - High water alarm (Y/61) Date installed Soil rating (a.p.d./ft? or ft2/bdrm) 9 6 _ System type 13.&d Length Info ft. Width is, ft. Gravel below pipe 0. 5, ft. Total depth 4 ft. Eff. absorption area 3oft2 Monitoring tube Depression over field _hd_ / Date of adequacy test fo�}`1 I Ob Results ( Pa Fait) YA! For bedrooms Fluid depth in absorption field before test _Cr in. Water added gal. New depth cg in. Elapsed Time: O_ min. Final fluid depth -,Z in. Absorption rate >= N so g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) L!,n 4jn If yes, give date n /a D. LIFT STATION Date installed Size in gallons Manhole/Access-". LIFT `Pump on' level at _ in. `Pum _ in. O High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot __:t l 0 ' On adjacent lots Absorption field on lot + I to o' Public sewer main +too' Sewer /septic service line On adjacent lots + t(-t�,' Public sewer manhole/cleanout I00 ' Holding tank +-'7S ' Animal containment areas ' Manure/animal excrete storage areas _ . I oS2' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation t S ' Property line 4 c,-_' Absorption field_ + s ' Water main + I t.) , Water service line + i o' Surface water Wells on adjacent lots + I00' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line IBuilding foundation t 10 1 Water main t 10, Water Service line + 10 Surface water + i o CL Driveway, parking/vehicle storage 5' Curtain drain --± -o' Wells on adjacent lots + I o() ' F. COMMENTS * CAse of -Fo �caiv t lc Elr � . G. ENGINEER'S CERTIFICATION Nyo SVS4t-*, I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Date Z.I 1 p� COSA Fee $_ `430 - l 7,11 C AU'Ish) Date of Payment '41a q10& Receipt Number_ 835gz (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number -dA4-J- pr;Vafe, ©ov -e- well SCS ReLN 1063551001 Client Name Eagle River Engineering Pro1at Name/N Henkins Lot 6 Blk2 Client Sample ID 1lenkins Lot 6 DIk2 1lfatds f Drinking Water Sample Remarks: All Dates/rimes are Alaska Standard Time Printed Date/time 07/112006 15:17 Collected Date/time 06292006 13:00 Received Dale/rime 06292006 17:00 Technical Director Stephen C. Ede i. t Allowable Prep Analysis 1. Roults PQL Units Method Container ID Limits Date Date Init Parameter Mettle by ICP/M3 ND 5.00 ug/L EP200.9 C (<10) 07/03/06 07/07/06 M11 Arsenic t Waters Department Nitrate•N }i 0.643 0.100 mg/L EPA 353.2 D (<10) 06/30/06 ALR i 1' w r i. t Sc CII Project Na Client Sam Matrix Sample Remariks: yF� Parameter + j {� Microbiology t' Total Colifot Fj OI er Engineering flcnkins L6 D2 flcnkins L6 D2 Drinking Water 0 All Dates/rimes are Alaska Standard Time Printed Date/Time 07/21/2006 14:02 Collected Date/Time 07/14/2006 9:30 Received Date/Time 07/14/2006 16:25 Technical Director Stephen C. Ede Allowable Prep Analysis Units Method ConleinerlD Limits Date Date Init coV100tnL SM209222B A f< 1) 07/14/06 TLF i C(a5S'`C" Well SCS ReEd k 1063241001 All Dalesfrimes arc Alaska Standard Time Client Name Eagle River Engineering Printed DaterTime 0624/2006 11:12 Project Name/H I I Jenkins Lot 6 Block 2 Collected Date/time 06/192006 11:05 Client Sample ID i Henkins Lot 6 Block 2 Received Date rime 06/192006 17:20 Matric I Drinking Water Technical Director Stephen C. Ede 4� Sample Remarks I' Allowable Pmp Analysis Parameter j' Results PQL units Method ContainerlD Limits Date Date Init Metals by ICP/ms Arsenic i. I ND 5.00 ug/L EP200.8 C (<10) 0620/06 0621106 SCI. Nitrate -N 11, G 1.04 0.100 mg/L EPA 333.2 D (<10) 0620106 ALR Total Coliform I' 0 cot/100mL SM209222D A (<I) 06/19/06 TLF Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program s .8 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051— ag HAA#�OCJ Expiration Date: / d - / 7- OZ 1. GENERAL INFORMATION Complete legal description Hen k t'vt5 f-b.,6-� Location (site address or directions) Current Property owner(s) hat) j k ?- TYPE OF WASTEWATER DISPOSAL: Day phone /A 0,- 1 4 q lG Mailing address o 30X 2 MI OLI t�Lk�1e_ l tJp ✓ .844 C S 7% Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 Day phone Day phone /OR 4 -21.1 P S.- 3. 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site 19 Individual Water Storage ❑ Individual Holding tank ❑ Community Class C Well © Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) 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) 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 private or Class C well and may be reissued with new water sample results less than 30 days old. (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 wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. 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 this application, shows that the on-site water 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 Firm Eagle River Engineering Services Phone &Otq - 5 I QS Address ox 4, age 'ver, AK 99577-3294 Engineer's Printed Name t r02 S A e L -VR- Date 5. DSD SIGNATURE _Inf, Approved for Disapproved. 3 bedrooms. Louis A.Buisra CE -8736 Conditional approval for bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory ........ ;'-Ar' ON-SITE WASTEWATER Maintenance Agreements Supplemental Engineer's Report Other By:! ii. / �� lljoeec Original Certificate Date: -7-17-02. ill". 12"00) Municipality of Anchorage • �' Development Services Department Building Safety Division ` On -Site Water 8 Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 995196650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Ye"AN10-VC 47, 6.4 Xlv'r Parcel ID: 017--29 A. WELL DATA Well type C- If A, B, or C provide PWSID # Well Log (Y/N) Date completed _ Sanitary seal (Y/N) _ Wires properly protected (YIN) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level h. ft. Well production g.p.m. 9 - p.m -WATER SAMPLE RESULTS: Coliform 4--colonies/100 ml. Nitrate Def S mg.A. Other bacteria 6 colonies/100 ml. Date of sample: 4//klo -I- Collected by: frrS eer-,v S. SEPTICIHOLDING TANK DATA TankType/Material S7Tre/ _ Date installed /S'4F2 Tank size fbJP _ gal. Number of Compartments Cleanouts (Y/N) Y Foundation cleanout (YAV),LV 'Depression over tank (Y/N) High water alarm (Y/N) 'y1A Date of pumping 7- 3 6 - o / Pumper J /2 C. ABSORPTION FIELD DATA Date installed /9!1 Soil rating (g.p.dN odE�) Fr System type ee/ Length 26 ft. Width / S` ft. Gravel below pipe O • S" ft. Total depth!.1 ft. Eff. absorption area -990 ft= Monitoring lube Y Depression over field N Date of adequacy lest -1-.2c - 6.2 Results (Pass/Fail) of -w.,, For 3 bedrooms Fluid depth in absorption field before test O in. Water added`1� gal. New depth O in. Elapsed Time: NSI min. Final fluid depth AA in. Absorption rate >= +'f *v g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N 8 type) Nv If yes, give date i { D. LIFT STATION `✓// Date installed Size in gallons Manhole/Access (Y/N) 'Pump evel at _ in. "Pump otr at _ in. High water a level at in. um Cy tested M alai 8 circuit requirements? E. SEPARATION DISTANCES l/M�nMIr� SEPARATION DISTANCES FRONYWELL 1tGT TO: Septic tankflift station on lot .?1S Absorption field on lot 27,71, Public sewer main NIA Sewer /septic service line *"A00' On adjacent lots On adjacent lots Public sewer manhole/deanout ^',40 Holding tank -ear' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation _ 5 / Property line -7S " Absorption field S Water main Al /A Wells on adjacent lots 'Y roo ' Water service line /s./ Surface water boa r SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: / Property line 'Y " Building foundation / 6 Water main fro Water Service line t /o / Surfacewater f zw c'l Driveway, parking/vehicle storage vrto e Curtain drain A1.4 Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and go f 9� *�) review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name , %� //- U>- _ �,+i Date y., HAA Fee $ 3-5•"� Date of Payment ?I,z/nz Receipt Number O Z 5'2,8 (Rev. 12/00) Waiver Fee $ Date of Payment Receipt Number ` MUNICIPALITY OF ANCHORAGE ��Jec� %o�s% • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. #`�` -`Z�- �, HAA# 1. GENERAL INFORMATION Complete legal description Lot 6 Block 2 Henkins Subdivision Location (site address or directions) 15849 Old Glenn Highway `Chugiak Property owner Louis and Sandra Butera Day phone 242-5577 Mailing address POR 773294 Fag]P Rjypr, AK 99577 Lending agency Greatland Mortgage, Eagle Rivpgy phone 696-3899 Mailing address 13135 Old Glenn Hwy. #100, Eagle River 99577 Agent Jim "Young Kathy Geraci Day phone 694-9125 Address Old Glenn Hwy. Eagle River 99577 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 ti 3. TYPE OF WATER SUPPLY: Individual well Community well X Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 5. ISTATEMENT 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 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 Phone Address O Engineer's signature Date ' Z`� SCS 6. 1)H" S SIGNATURE Approved for /�kEL bedrooms. Disapproved. Conditional approval for .°49TH*je W 9 �� M 11_`• DOURA8TNENLEY �J�•'• CE 6176 c bedrooms, with the following stipulations: 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 cou rtesy to purchasers of homes and their lending institutions in orderto 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 (Fs4: 1/81) Back MOA M21 Additional Comments By: _ ,�/U�✓✓( C7c� I ��/%/�!) Date ` Z6,' C% 9 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 cou rtesy to purchasers of homes and their lending institutions in orderto 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 (Fs4: 1/81) Back MOA M21 DECEIVED Municipality of Anchorage JAN 2.5-1999 DEPARTMENT OF HEALTH & HUMAN SERVICESuNICIPALITY OFANCH Environmental Services Division ENVIRONMENTAL SERVICES 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: Lot 6, Blk 2, Henkins Sub. Parcell.D.: A. WELL DATA Well type _ C If A, B, or C, attach ADEC letter. ADEC water system number # 214 5 3 6 Log present(Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well production Date completed Cased to FROM WELL LOG WATER SAMPLE RESLILTS:- Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Nitrate Casing height (above ground) Wires properly protected (Y/N) g.p.m. Collected by: AT INSPECTION Other bacteria Date installed 1982 Tank size 10 0 0 a Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression (Y/N) N High water alarm (Y/N) _N Z A Date of Pumping 1/19/99 Pumper JR, C. ABSORPTION FIELD DATA Date installed 1982 Soil rating (g.p.d./ftz or ft2/bdrm) 85 System type BED Length 2 6 ' Width 15 ' Gravel thickness below pipe 6 " Total depth 4 ' Effective absorption area 390 SF Monitoring Tube present (Y/N) Y Depression over field (Y/N) N Date of adequacy test 1-19-99 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test (in.); 0 Immediately after'4_5Ogal. water added (in.): 0 Fluid depth 0 (ins) Minutes later: 5 Absorption rate = +450 g.p.d. Peroxide treatment (past 12 months) (Y/N) N If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION N/A Date installed Manhole/Access (Y/N) High water alarm level at* _ Cycles tested E. SEPARATION DISTANCES Size in gallons "Pump on" level at* *Datum "Pump off" level at* Communit SEPARATION DISTANCES FROM WELL GMtOT TO: Septic/holding tank on lot 215 ' On adjacent lots +150 Absorption field on lot 2 3 0 ' On adjacent lots +150' Public sewer main n / a Public sewer manhole/cleanout n/ a Sewer /septic service line + Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 51 Property line 2 5 ' Absorption field 5' Water main/service line 15' Surface water/drainage +100 ' Wells on adjacent lots + 10 0 ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 41 Building foundation 16 ' Water main/service line + 10 ' Surface water +100, Driveway, parking/vehicle storage area 51 Curtain drain n / a Wells on adjacent lots +100, F. ENGINEER'S CERTIFICATION l certify that I have determined thru field inspections and review of Municipal in conformance�� w�ith� MOA HAA guidelines in effect on this date. Signature Engineer's Name L _ � ( � Date ' 2`i ` a HAA Fee $ Waiver Fee $ _ .cg Date of PaymentLl Receipt Number / , L�Y 72-026 (Rev. 3/96)* Date of Payment Receipt Number t-t"e•a6 Ve ,s are 9' D0JUG S,,�kh ILEY. F 7 19- CEO 6 �, l _ •tai ; • .... • _..w\. w JAN -23-1999 20:10 CT&E ESI ANCHORRGE 9075615301 P.03/03 I" "ZtIL C7&E Environmental Services Inc. r�entai Laboratory Qivion r ent al �.iro'rw���►�•�i�r�arr��ar�+��rar�r 's�r�siow�sis®� 'Drinking Water Analysis Report for Total Coliform Bacteria F -4D hVS7RVCTIti1vS O,V REVERSE 57DE BEFORE CO LLZCrhVG SAMPLE MUST BE CO,iPLETEDeL sr TER SUPPLIER TO BE CO4t1 `r PUBLIC NATER SYSTEM I.D. i1 C B PRIVATE WATER SYSTEM ��----- d Saw/nvorkV Send Rtsurts C3 SendRdurel - O $.nd Inroiee SAMPLE DAZ'Te: Montt C E19. � Vay Year SAMPLE TYPE.,'_ ... Q Treated Water ly C with tab ref, ea toe randne €tl�� Untraateet Water ❑ Special Purpose Time -Collected SAMPLE LOCATION CaUnetaAf. B7' 200 W'Potter Qrive Anehoragf. AK 995113.1606 T4B (907) 562.2343 Fax: (907) 561.5301 Anaiysis shows this Water SAMPLE to be: Satisfactory C Untatistictory t3 Sample over 30 hours old. results nuy betrnreifablr q Sample too long in transit sample should not be over 43 hours old at exantina601t to indiem reliable results. Please send new sampie via special delivery mail. � e Date Rtceiv.d --- 'fire# Received Analysis BeKan I Analytical i6lttho:3: ' �Iliv1��1UGilter 100 mi. Result* Analyst �� tTaM SeR:ta.� D.I=C: neh FKA Jun 0 Faxtd p, Time Client notified oPunsatisrsetory results C3 rQ py�.d Speln with DAA, BACTERIOLOGICAL WATER ANALYSIS RECORD �tytU-itit[]C Raatat Total caxarm E. coa Corauier/1r}0 tri Membrane inter- Dirt cavor vtrifleattee: LTN Feett Cotlrerm Caafireratloe Coiita,mliQO eai Finai Membnee FlIta i -0$01f r ix.peet.a 13y �. Otte i/ r TIme �U�— hn Comments: _ T. cwt+ i i� JAN -23-1999 20:10 CTpE ESI ANCHORAGE CT&E Environmental Services Inc. ►�s4YJCivlJiigGr7�i+i5iil�rrmllL'QwI1It! CT&E fief.# Client Name Project Name/# Client Sample ID Matrix Ordered By PWSID 990292001 Douglas Kenley P.E. Lot 6 Blk 2 Henkins Subd Lot 6 Blk 2 Henklm Subd Drinking Water 2I4536 9075G15301' P'.02/05 Client PO# Printed Date/Time 01/23/99 20:01 Collected Date/'Time 01/19/99 13:22 Received Date/Time 01/19/99 14:30 Technical Director: Stephen C. Ede Released By N D 0 p Q "L l aampie rcemarKs: EP300 Nitrate: Method blank was detectable for nitrate (.171mg/L). Sample value was greater than 10X the blank value. No further action taken. Allowable Prep Analysis Parameter Results PQL Units Method Limits Date Date lnit Nitrate -N 6.25 0.100 mg/L EPA 300.0 10 max 01/19/99 01/19/99 SCL Total Coliform 0 col/100mL SM18 92228 01/19/99 KAP EAGLE RIVER ENGINEERING SERVICES 11.... P. O. Box 773294 EAGLE RIVER, ALASKA 99577 Phone 694.5�1/995y To -S'I-e t,'e r." __. /n Od r- e.- j'._._.. Date Subject ❑ Please reply >�4.No reply necessary 11 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: 40 A. WELL DATA Well Classification PeR / UA rz: If A, B, C, D.E.C. Approved (Y/N) 4�A Well Log Present (Y/N) X Date Completed Yield /D Crf� Total Depth G Cased t037 � R=« r Depth of Grouting Static Water Level 1,5-1 xfe%u Pump Set At e Casing Height Above Ground ;2 3 Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) %� Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot /�2 ;On Adjoining Lots To Nearest Edge of Absorption Field on Lot fay On Adjoining Lots t/00 To Nearest Public Sewer Line /VA? To Nearest Public Sewer i Cleanout/Manhole /✓/4 To Nearest Sewer Service Line on Lot Jd Water Sample Collected by ""' �rys�^ ez" ;Date �� �'� Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) Depression over Tank (Y/N) Size No. of Compartments — Air -tight Caps (Y/N) Foundation Cleanout (Y/N) Pumping/Maintenance Contract on File (Y/N) Date Last Pumped for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well To Property Line To Water Main/Service Line Course Comments Page 1 of 2 To Building Foundation To Disposal Field — To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well To Building Foundation L of To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course _ To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION j Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test . To Property Line To Existing or Abandoned System on On Adjoining Lots To Cutbank (if present) — Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent(Y/N) Pumping Cycles during Adequacy Test, Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed �%��� '�� - Date o7O/u%;> Company �r _r MOA No. S/ K5— Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/64) J-; nigineer's Seal 9 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL �� �� _ �(p ca OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date December 19, 1986 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 6, Block 2, Henkins subdivision T15N R1W Sec. 30 Location (address or directions) Birchwood (b) Applicant.Naine Myrna Johnson Telephone: Home NSA Business 694-9555 Applicant Address P•0. Box 770249 Eagle River, Alaska 99577 (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ❑ ; Buyer ❑ ; Other M (explain); real tor (d) Lending Institution Lomas & Nettleton Telephone 563-3542 Address 4300 B St. Suite 103 Anchorage, Alaska 99503 (e) Real Estate Company and Agent Coldwell Banker Area Realtors Address P.O. Box 770249 Eagle River Alaska 99577 Telephone 694-9555 (f) Mail the HAA to the following address: pickup by engineer 2. TYPE OF RESIDENCE Single-Family[2 Multi -Family ❑ Other Number of Bedrooms 3 e 3. WATER SUPPLY Individual Well ❑ Community IN Public ❑ 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 ® 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 2 72-025 (11/84) 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 regulations in effect on the date of this inspection. Name of Firm Telephone Address PAGUE RIVER €NGPIEE ING SERVICED Date EAGLE RIVER, AK 99577 P. 0. BOX 773294 694-5195 6. DHEP APPROVAL Approved for Approved Q,� n3� 'a oyouoo v0 }, p 0 i } 0 f3nginet r'-§ Seal �00ea�sy�c�(3° - a.a OZp00o 000000 ^x.049 CLG.T 0.000 100000nz E'J 6�?^ Louis A. Mora o W ,1 f, . •u� °u Ci u7s5 ° � e ,*I' bedrooms by �,-o Date � Disapproved Conditional Terms of Conditional Approval ,i 4� CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations 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 requirements. Employees of DHEP 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. Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MG.) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: 7/5"V seJ A. WELL DATA Well Classification �� s C If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Date Completed Yield Total Depth Cased to Depth of Grouting Static Water Level Pump 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 from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA ; On Adjoining Lots — On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date Date Installed Size 21,;/ No. of Compartments Standpipes (Y/N) y Air -tight Caps (Y/N) y Foundation Cleanout (Y/N) y Depression over Tank (Y/N) N Date Last Pumped Pumping/Maintenance Contract on File (Y/N) forl� Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well ��S To Building Foundation / To Property Line ��� To Disposal Field y To Water Main/Service Line i�� To Stream, Pond, Lake, or Major Drainage Course ;l/tea Comments Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata // z/�/p Type of System Design Date Installed Length of Field Width of Field /S' / Square Feet of Absorption Area ssv ol Depth of Field y Gravel Bed Thickness d Standpipes Present(Y/N) Depression over Field (Y/N) Date of Last Adequacy Test /-O Results of Last Adequacy Test Sti �� 5 4/ 6 SAY ��i��> i�4 t� � ��y; �✓Q Separation Distance from Absorption Field: To Water -Supply Well ��rU To Property Line To Building Foundation Lot Alm To Water Main/Service Line f /U On Adjoining Lots To Stream/Pond/Lake/or Major Drainage Course f/av .31 To Existing or Abandoned System on f -,? o 1� To Cutbank (if present) To Driveway, Parking Area, or Vehicle Storage Area f�a Comments - l ✓� vP� o F 3 7'0 �rapGr7�j �i �Y �v-vies r y ✓�4 r� /��i2/�G , D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off' Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed>- Date Company axe C S MOA No. S T 'o2G Receipt No. Date of Payment Amount: $ e� MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION Page 2 of 2 nI-U 19 low 72-028 (11/84) RECEIVED Pn'g{Reer's Seal A o , ; C4Y D 4'l'OCO C +90 > 4< 0'r" :m., !rSms _ Q BILL SHEFFIELD, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION I Telephone: (907) Address: ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 274-2533 ANCHORAGE, ALASKA 99501 DATE: l J, 1/ '/t( PWS I.D.# To Whom it May Concern: According to records on file in this office the oafs S, 6, l Q- /0 Water Regulations S/4Water System is in compliance with the State Drinking Sincerely, MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date / b 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) ApplicantNam ��s�r Telephone: Home Business Applicant Address � � a_ (c) Applicant is (check one): Lending Institution X Owner/builder ❑ ; Buyer ❑ ; Other ❑ (explain); z (e) (f) Lending Institution �<r� r�,J Q�i�,�� Telephone Address Real Estate Company and Agent Address Telephone Mail the HAA to the following address J 2. TYPE OF RESIDENCE Single -Family Multi -Family ❑ Other Number of Bedrooms 3. WATER SUPPLY Individual Well ❑ Community W Public ❑ 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 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. 72-025 (11,84) Page 1 of 2 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 regulations in effect on the date of this inspection. �? vGlfdEGt3i{L+� Name of Firm Address ALAS'K4 TOW P Date _... 6. DHEP APPR VQ &k Approved for 7 V(�t _ bedrooms by _ Approved - k_*�-- Disapproved Terms of Conditional Approval Telephone Cond CAUTION 4� °iv,,(yeri:.a:o a b- rago .+ i tWbart A. gtln"r �4 P°o0 No. 1457•Eoz a 0 cop =PtlP19"`;.hY �C�''q'0.^••ti :dam- y;��` �> The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations 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 requirements. Employees of DHEP 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. pano 9 of 9 A. WELL DATA Well Classification MUNE-PALITY OF ANTI%-)`" ' S. OF HEALTH & ENVIt-1,4MENTAL PROTECTION) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA)' JUN CHECKLIST- FEBRUARY 1984 RECEIVED E® 264-4720 Legal Des iption: M1 If A, B, C, D.E.C. Approveda) Well Log Present (Y/N) Date Completed Yield Total Depth Static Water Level Cased toDepth of Grouting _J A Pump 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 from Well: I To Septic/Mefdrng Tank on Lot ���C ; On Adjoining Lots i To Nearest Edge of Absorption Field on Lot On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments B. SEPTI -TANK DATA To Nearest Sewer Service Line on Lot ; Date Date Installed Size ( CN®0 No. of Compartments StandpipesCYJN) Air -tight Caps ON) Foundation CleanouOY N) Depression over Tank (Ye Date Last Pumped Pumping/Maintenance Contract on File (Y/N) 0 /t:�' ; for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from SepticAkleidimftg Tank: I To Water -Supply Well I To Building Foundation To Property Line To Water 4kein/Se�rvvice,Line Course Comments Page 1 of 2 To Disposal Field To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata fix' If3f� Type of System Design Date Installed �'7�G�� Length of Field Width of Field l Depth of Field IV r 1 It Square Feet of Absorption Area Depression over Field (YAO_ Gravel Bed Thickness Ccs °' L• ' urJDcfL- V t P %C� Q Standpipes Present (Y/� s Date of Last Adequacy Test Co,`tet Results of Last Adequacy Test 15 k�, oPtc-"z)(��/ Separation Distance from Absorption Field: To Water -Supply Well S To Property Line To Building Foundation To Existing or Abandoned System on Lot 01A On Adjoining Lots 0 1 To Water tvtatn/Service Line (+ Tq Cutbank (if present) A To Stream/Pond/Lake/or Major Drainage Course _ To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments .t Dimensions Manhole/Access (Y/N) "Pump Off” Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ..a Date �/i AS -J 11D �uG1t ,F. Compaq)„rRVEII, Ali MOA No. �U 0 3 �; : �'e Q t�1..)9%+�'irf"f ��i �'J L/ t/�1 / P.:If'r{�• °e°0 Receipt No. I i�IC>/Fr y' Date of Payment -1'7 -�55� b ° 4, Y Amount: $ Itagbmt R. 3h®far u,) G)'° Page 2 of 2 72-026 (11/84) CONSTRUCTION AND OPERATION CERTIFICATE ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION . PUBLIC WATER SYSTEM APPROVAL TO CONSTRUCT Plans for the construction of CA) K]� IVB. -- j�%(�C K ;2 Ln TS S ��,�� �� rig AI7) n (it,4yS �) public water system located in *4V--ftt�:-At L e-y�1����rska, submitted in accordance with 18 AAC 80.100 by ki A -A) � f9 e S tQ have been reviewed and are d approved. ❑ conditionally approved (see attached conditions). XX I rlT,?o�Ji�i' Jri[. NE�ivJFfc�— WT TIT � --�- TIT E AT 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. APPROVED CHANGE ORDERS Change (contract order no. Approved by Date or descriptive reference) The "APPROVAL TO OPERATE" section must be completed before any water is made available to the public. APPROVAL TO OPERATE S The construction of the"Aj'^�s �? i fc< r ' i" public water system was completed on ' _SIF --I/ (date). The system is hereby granted interim approval to operate for 90 days following the cpmpletion date. 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. eY .t ' '( TITLE �^ DATE Henki*ns Block 2 Lot 6 #051-292-11 IV a It- o. u ! f I r > N3,u - -.f I i AS -BUILT. I hereby certify that T have surveyed the following described ' property: L.o 7" G $ J,n c• �e� ski ¢:, Anchorage'Recording Precinct, Alaska, BYid that :the impro?e ments situated thereon are within thgtproperty lines•and do not overlap or encroach on the property lying. adjacent: there-• to,.that no improvements on_property Iying.adUacetti thereto encroach on the premises in ,question"and that„therik are .no roadways, transmission lines or other. visible.'easen"n .0 said property except as indicated hereon, . Dated it Eagle River, Alaska:' th;t 27 day nf y1 2 I9 ROBERT C. JOHNSON.. W f SCALE: Registered Land Surveyor XZ.Wo LS V = 7p O ' Box 256; Eagle River, Alaska 7,; Tthf.,« r971634-2593 a A 30 1 1.1 V, e, W AN 30 l?y P certify that i have surveyed the..f, proper.tik... I I IM Anchorage Recording Precinct, Alilikso and.'Wat ments situated thereon Are within the pro 0 ' not overlap or encroach.an the I Flift aajacent. th6��S", to, that no Imr. provdment3 on property: lying adjoteAt"' th6retb;- encroach on the premises in question and:'that.th are `other ! roadways, traiismission lines or her -visible" eaW encs on said property e5ccept as indicated hiercom' Dated .st Eagle River, Alaska day ROBERT C. JOHN 28 Od SCALE Registered Land -S !4 � V X Box 43o, Eagle River,' ask ploiv� I P :�v I .% 110, MAIN ..,.N W 4, - 4 f J NJ it q M l?y P certify that i have surveyed the..f, proper.tik... I I IM Anchorage Recording Precinct, Alilikso and.'Wat ments situated thereon Are within the pro 0 ' not overlap or encroach.an the I Flift aajacent. th6��S", to, that no Imr. provdment3 on property: lying adjoteAt"' th6retb;- encroach on the premises in question and:'that.th are `other ! roadways, traiismission lines or her -visible" eaW encs on said property e5ccept as indicated hiercom' Dated .st Eagle River, Alaska day ROBERT C. JOHN 28 Od SCALE Registered Land -S !4 � V X Box 43o, Eagle River,' ask ploiv� I P :�v I .% 110, MAIN ..,.N W 4, - 4 J q M 'A IF I.x - - 1A w3 7 AS -BUILT. M. l?y P certify that i have surveyed the..f, proper.tik... I I IM Anchorage Recording Precinct, Alilikso and.'Wat ments situated thereon Are within the pro 0 ' not overlap or encroach.an the I Flift aajacent. th6��S", to, that no Imr. provdment3 on property: lying adjoteAt"' th6retb;- encroach on the premises in question and:'that.th are `other ! roadways, traiismission lines or her -visible" eaW encs on said property e5ccept as indicated hiercom' Dated .st Eagle River, Alaska day ROBERT C. JOHN 28 Od SCALE Registered Land -S !4 � V X Box 43o, Eagle River,' ask ploiv� I P :�v I .% 110, MAIN ..,.N K November 12, 1986 P.O. b _ X 196650 ANCHORAGE, ALASKA 99519-6650 (907) 264-4111 TONY KNOWLES. MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES Tobben Spurkland, P.E. 203 W. 15th Avenue Anchorage, Alaska 99501 Subject: Lot 6 Block 2, Henkins Subdivision Dear Mr. Spurkland: This letter is written in response to your request for clarification of our policy of requiring additional ground water monitoring as a condition of Health Authority Approvals in Henkins Subdivision. It is true that we have required verification of water table depths in this subdivision because of problems that have resulted from a rising ground water table. At the present time, this rising water table appears to be confined to a specific area in Henkins. The subject lot is located at a substantially higher elevation than the problem area in Henkins. Other monitoring in the immediate vicinity of the subject lot has indicated that the water table has not risen from previous measurements. There is no reason to believe that the water table on the subject lot has risen to a significantly higher level than measured in the September 1982 soils test. For this reason, additional monitoring of the water table will not be required as a condition of Health Authority Approval for this lot. Your request for a property line waiver has been approved. The property line setback has been waived from 10 feet to 3 feet. This waiver is based on your assessment that the present location of the absorption bed will not impact the function of the septic system on the lot to the south nor will it limit the availability of a replacement site for that lot. Sincerely, Stephen S. Morris Civil Engineer On -Site Services 03 W. 15th AVE "C" SUITE 203 'T6 ® M 8P J�I�I�(j-,IJ�y�9 ®�® 2 ANCHORAGE, ALASKA 99501 CONSULTING ENGINEER TELEPHONE: (907) 279-3916 October 31, 1986 Mr. Steve Morris Municipality of Anchorage Civil Engineer, On -Site Services P.O. Box 196650 Anchorage, Alaska 99519 REF: Lot 6, Block 2, Henkins Subdivision On behalf of my client, I would like to obtain a letter clarifying several subjects regarding future Health Approvals for the above referenced lot. This lot was granted a 3 bedroom Health Approval on 6/10/85 based on a report submitted by S & S Engineering. It is known that Henkins subdivision is under scrutiny by the Municipality of Anchorage due to ground_ water problems. I have noticed in my review that the previous Health Approval was given without requiring a ground water check. My client would like to be certain as to whether this lot is excluded from the problem area or if this is simply an oversight on the part of the Municipality that would cause a problem with obtaining any future Health Approval. My research of the septic system layout also shows the leach bed to be located 3' from the south property line as shown on the attached plot plan. This discrepancy from the previously referred distance of 10' requires a waiver of separation' distance to the lot line which I am requesting at this time. The location of the septic system on Lot 6 should not interfere with the septic system on lot 7 as the septic systems are +30' distant and there are replacement areas available on lot 7 due to the community well service. Please provide us with a letter providing a response to these questions. Thank You, Tobben Spurk] MUNICIPALITY OF ANCHORAGE ENORONME F HEALTH OF PROTECTION RECEIVED a / ` t L . G 3 ' -. _ `.•�BOi. a1 F10300(00003'�.33Z 3dT0 6oN % �•�/{ry 1y a ) - 9 nn o LGUIs . _3u .a' o° t I _ ��l'i�h��F£FiS10�1.����, =zS .rte.;,.-.•r t AS-BUILT I: hereby certify that I huve surveyed the'following described - � property — t-�.� � 1 �, � .��jr16 dam�^• ; " n.� .. -��- i ti '� :•,y'e• . i-- JC:J�!v f`'7. �ynt w• r' >f. ° K'rn i , a Anchorage Recording Precinct, Alas'ca and that the improve- �� menu situated thereon are property lines'and do not, overlap or encroach on the property lying- adjacent there-< not t-; a that no improvements on': property lytng'.adjacent-- to, thereto- encroach on the premises in:' question and that there are no �arrz>Zrjts.>d.; :•roadways, transmissions linesor other- visible easementson said property except as indicated hereon, Dated at Eagle River, Alaska V", : Ftii v �� j lflv;•r" day <this ROBERT C. JOHNSON 'SCALE: Registered Land Surveyor No. 880-IS d`