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Home My WebLink AboutDAWN VILLAGE BLK 2 LT 8Onsite File Dawn Village Block 2 Lot 8 #014-061-46 AI~ICHORAG~, ~I_ASKA gg~0'/ SUBSURFACE EXPLORATION Shift Report of Operations P~EI:GON CONSTRUCTION, INC. Da~m Su'bdivision, T,ot # 8, Block 2 6" Domestic Well · WESTERN STATES ASSOCIATES CONTRACTOR 22W TO .- TIME DISTRIBUTION HOURS Herb Johnson ROTARY RIG HOURS CASING LOG NO. ? 8 ll 12 13 14 ll ' 0" 18'3" 24,3,' 36 '8½" ~2'~½" 49'n½ 57'6" 6~ll" ,o. SOILS LOG. DEPTHS NO. FROM TO Water level: 20 feet. DRILLER MATERIALSAND REMARKS sand and 6~-~vel with rocks interbedded. water. Tight s~ndy clay interbedded with 6~vel ~nd rocks. No water. Water bearing sand and gravel from 81-93' 12 gallons per minute production. INSPECTOR PERHIT II'~ll--J[~ I [--~ ] [--'~1 : I T~r" OF F~[~_.~! ]RAGE DEPARTMENT OF HEBL]'H AND ENVIRONI4ENTAL FROTECTION ~51~ E. TUDOR RD. ~ ANCHORAGE, ~K. 9~5~7 276-2221 14ELL PE~r,1 I T 77~i9 > APPLICANT LOCATION LEGAL ~ETERSON CONSTRUCTION TESHCRR ST L8 B2 DANN VILLAGE SRA BOX LOT SIZE 344-8~3:8 10000 SQURRE FEET ltINII4UH DISTfiNCE BETHEEN fi ~IELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEH IS i00 FEET FOR A PRIVATE NELL OR 200 FEET FOR R PUBLIC NELL HELL LOGS 8RE REQUIRED 8ND MUST BE RETURNED TO THE DEP~RTHENT I,IITHIN OF THE NELL COHPLETION. SPECIFICATIONS AND CONSTRUCTION DIBGRAHS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERI"1 ~' T '-."i--I- L ! D FOR I ONE '~-'EAR [----~-.Oll'1 I CERTIFY THAT : 1: I Ali FAI'IILIRR I,I~TH THE REQUIREHENTS FOR ON-SITE SEHERS AND HELLS AS SET FORTH 8'¢ THE HUNICIPALITY OF ANCHORAGE, 2: I HILL INSTALL THE SYSTEH IN ACCORDANCE 14ITH THE CODES. r", /),,-, . F'., / ¢/ ~-", ' d" "~'~ ..... FIp~L_ZCANT 'P[~.EP~01'.,I CONSTRUCTION . ' ISSUED BY__ _~ .............. [ ATE__ S 89°57'20"E 32986 __ ~e~oo~ __ Ia'UTILITY £ASEMEN* GROUND 12 II 5 I(~ZgO Sg F'T. I0 I 1,8 ro $c~r'1 EASE. 3 · 8,9~4 SQ. FT. EAST ? / sw co~ I WEST 1,42 329 76 _ ~ '-' I$ODO m (Basis of Beari~gg)BLM . -'~ES:r ~ __1319.08 (meos.) RASPBERRY i F.~ r"~ ~ LEGEND "' - Set Ibis survey Found Description , f 3,698 543 FT 8 7 6,994 SQFT. N ~18'~0" E NR TE) 6 EASE. 5 6,250 SQ IrT 2~24 4 ".,"..,~ 8,783 S0.1rT S 89052'14'E hR ISI.64 3 9,267 50 EAST 154.69 9.2.82 SQ FT EAST 154 I 9,9?2 SQFT. 5/8"x 30" Rebor w/ Alum cap set flush w/pvmt. Propor lion 5/8"x 3~' Eebcr USK Man. 3"x:~:O°' Alum Cop UTILITY EASEMENT ROAD. PC SE T 0 SC~'A&BovE GROUND SEE: '/SET "A" S-3ZS4 SURVEYOR'S CERTIFICATI plat of DAWN VILLAGE ,~ se~taticx~ of lands actually shown correctly and that all monuments and lot Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 - 5 A .F E Certificate of On -Site Systems Approval Parcel I.D. 014-061-46 1. GENERAL INFORMATION: Expiration Date: j)M a 0, a 0a a Complete legal description DAWN VILLAGE; BLOCK 2, LOT 8 Location (site address) 6641 Teshlar Drive *Anchorage Current Property owner(s) Mary Harvick-Anderson Day phone 230-1074 Mailing address Real Estate Agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer 0 WaiverNariance request for: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ ZOO Date of Payment Lozm Receipt Number 05(i3226 Date: Waiver Fee $ Date of Payment Receipt Number COSA # 0 SC 21 161(3 Waiver # ris1i 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 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: Garness Engineering Group Ltd (GEG) Phone: 907-337-6179 Address: _3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: r� 13 Zf In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of - the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, /ffr� A�Garnes VE -7953 PSP ) E} �.13 . -Z'; oa- t�1,,\?ro r e s sio�_oo #AECC884 J� ON-SITE with the followin APIJl4VATER AND m By: WMZZ,6, \ Original Certificate Date: lobo/`0.21 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 05, COSA Checklist Legal Description: DAWN VILLAGE; BLOCK 2LOT 8 |fmore than 1septic system unlot: COSAChecklist #of A. VVELL DATA 1*1VVe|| log iofiled with Onsite (or attached) Date drilled PRE 1118 Q3 Total depth ��ft Cased to 93 ft WE -1 Sanitary seal isfunctioning correctly ��VVireaare properly protected Casing h `eight (above ground) 18+ in, Date ofO9124/21oetestforCDSA Static water level atbeginning oftest 23.3 ft� Comments B. TANK DATA A of tank(s) years M eaSUred op ting fluid level in septic tank tandpipes fOUn tion cleanout per record drawing I Ing Date of pumpi D. ABSORPTION FIELD DATA t4 Which system tested (date installed) [J1 ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth topipe invert from grade ft(n/n) E]N/A — pressurized field Fl Monitor tubes go to bottom of effective. If not, state depth into effective Code -required soil cover over field ElSystem presoaked (Required ifvacant for greater than 3Odays prior to date of test) Gallons introduced _gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 014-001-48 Structure served by this system Well production ottime oftest 64+ ~pm Water storage tank volume. N/A gallons Well disinfected for coliform teat? Fl Yes NO No F-01 Coliform bacteria is Negative Nitrate 8.523 mg/L E] Nitrate less than MRL (ND) Asenicug/L MArsenic less than MRL (ND) Collected by GEG ' LTD Date ofSample 9/24/21 C. LIFT STATION M'Required maintenance completed Age oflift station ____yearn Lift station material Comments: ____ Adequacy test date Results [J Pass For bedrooms Fluid depth prior to test in W added _ gal New de in de In ed Elapsed time min 0 in mi n Absorption rate g p ny rejuvenation treatment (past months) If yes, enter date AWWU SEWER E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station onLot >1UO' — �/A� Commun�ySewer K�anho|e8�|oanou �iOO' rl Yee if No ft Yes`- �No��ft Neighboring Tank >100' FvqYee ifNnft Private Sewer/Septic Line >25^[_}Yes if No ~~uwx ft Absorption Field onLot >10O' 1771 Yes if No N/A ft Holding Tank >1O0' 0Yeo ifNoft Neighboring Absorption Fields >1U0' Animal Containment >50' Yes ifNn____� ��Yea ifNoft °50'+ Manure/Animal Excreta Storage > 100' — Community Sewer Main >75' IlYea ifNoft Yea ifNoft From Septic/Holding Tank onLot to: (Please enter distances if less than required) Building Foundations >1O' El Yes ifNoft Surface VVater>1OO' Property Line >5' 1771 Yes ifNoft Wells onAdjacent Loto� AbaorptionFie|d>5' F-1YesifNoft Private Wells >1OO' MYeo if No Water Main > 10' 171 Yes if No ft Communi 00, n Yes if No Water Service Line >18' [-71 isunder driveway comment below From Absorption Field onLot to if|�mnthan �qui�d) Building Foundahon>1U' El Yes ~W��____� |fabsorption field inunder driveway comment below ^\ �Property Line > 101 Yeo ifNoft Wells onAdjacent Lots: � []Yes JNuft Private Wells >1O0' Yeo if No ~° ine>1O' 1771 Yes ifNoft Community Wells >2OO' Yes if No Surface Water >1UO' �]Yea if ft _ ~ � ' F. ENGINEER'S COMMENTS � °SEPER/\TIOKj REQUIREMENT AT TIME OF SEWER CONSTRUCTION /PRE -1983\ ~° ^°NOREQUIRED GEPERAT/[>N/PRE-1S83>'NOCONNECT CARD /YJA|LIBLEWITH AVVVVU-"DYE TEST" WAS PERFORMED BY AWWU ON 11/30/77 TO CONFIRM HOME IS SERVED BY AWWU SEWER / certify that / have determined through field inspections and review ofMunicipal records that the above systems are /noon/hnnonnewith MOA COSA gUidelines in effect on this date. COSA Checklist yellow sheet #AECC884 ft ft ft ft 2 N C) 00 FF- CO0 SBlt/1S3 331 3NtIHS00 � / z o 0 J j .'' O 1a 56"6�� 3X930.00S z J_ 1� C4 luawese:; /gjmn .o Cb 26.3 W. • deck 1 39.0 d o z= N� X1.2 j QQ g co LU :z- cm: Q ch LU 0 > c� r c" coca ca �+ ..L�.. Q ,�' m a vCy� N 4'i Z _ C RS Q O O Gj • ' ....mow. MOZ w; s `��• vs2o p. Ci N 0000 • • C3 I o Lo /O; 00 so 5 i �?'• V • L •• llI d C o m >_ c w oc.. o w a.Q nO �M�°vifl cam U- ti m � mLa-= � N� o I o n m'm m co L. m= d Of R O d IO m L C @ rte.. O, ...+ @ W -510 V '!� m _O O O (D (D tm Ep co C A _O m V' Q� @C 0 0 0 cm m c o Cay..��—�m v_� Q d E CA w m ch LU 0 > c� r c" ul -j � C'ri Gj • ' a S c) w; s `��• • o • .' ti� Z 0000 • • C3 I o Lo /O; 00 i �?'• V • L •• llI 'C �� • • •LL . Q AW W \1� m R M LO T - m U - z �o w LUo =w0 oWw aaz Ofwz woo a0� 11z woz LU CO X uaU)¢ u F- U) w�-n SANG UVIHS�l1 LU 0 > m Jd -j � U u H R M LO T - m U - z �o w LUo =w0 oWw aaz Ofwz woo a0� 11z woz LU CO X uaU)¢ u F- U) w�-n Erik Widger From: Reisher, Michael S. <Michael.Reisher@awwu.biz> Sent: Wednesday, September 22, 2021 5:43 PM To: Erik Widger Subject: 6641 Teshlar Dr, Sewer Service Attachments: rd003646.tif Erik, We do not have a connect card for 6641 Teshlar Drive. I attached a record drawing that shows the service running from the sewer main to the southwest side of this lot. There is a positive dye test the following year (11-30-1977) that shows the service was in use. Michael Reisher Permit Office Supervisor Anchorage Water & Wastewater Utility Direct: 907-786-5645 Michael.Reisher@awwu.biz 1 8 ;�j4i1 tj 5.52 ' 36.1 N O 4J N x U) r_ 0 .1 4J ro r -I 7 tP v P4 N v m 3 • 0) A (1) ty fa 41.11 o OOo tr {� W N•ri N OOtnN O C. O 3 OaU -+N�H.-i z ro z O a-' .G r -i U I rt r -- ix O o o �n in OON N m o O r N 4J 4J E-1 a) V) a Q a v •� C ro N Oo r a) o in cn r G ooh N a) N a) C H ri H - •a r H ra ma r1 < C N C N a) al 0000 n icli 0 C o0o LO rWEi 0 v o �ao z ONo r U cl) U �rGW CN W W WHW WH OU - 'l Ei W +� cn U w C 4 j cn O Pa to 1-10 C 0 0 0 00 to 0 0 0 o i W i W a1 C fa 3 C a) u) o N ao N 0 N o o Ln O am , .-1 N N r -i r -i rn co H N (n U U 61 N E -i E - .Fr-. 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N co 00 41 i7 1 1 U 04 m Q r in 0 1:4i z • V ® Municipality of ranchra NiAt 2016 On -Site Water and Wastewater Program (907) 343-7904 Parcel LD 014-061-46 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description Location (site address) Expiration Date: 6 — �& Dawn Village, Block 2, Lot 8 6641 Teshlar Dr. Current Property owner(s) Robert Eidson Day phone Mailing address Real Estate Agent 444 NE Winchester St. Pmb 23c Roseberg, OR 97470 2. TYPE OF DWELLING: Fx� Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well E Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer fl Waiver/Variance request for:, Received by v Date: /qo t 1p COSA to be released to the engineer, unless otherwise requested by the engineer. - COSA Fee $ w(� Waiver Fee $ Date of Payment �J! l tP Date of Payment Receipt Number (D ��i2G Receipt Number COSA rf a5c I (' 0p ✓ Waiver ;# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal r ;'[§-and as`of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On- ife 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 appTcable Municipal and State codes, ordinances, and regulations in effect at the time of installation. In conducting an adequacy test, I attempt to provide a thorough; conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The. operational life of all wells and septic systems depend on the localsoil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining'life of the system. The content of this report is for the sole benefit of the owner listed above, Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE System #1 Approved for q bedrooms 0 System #2 Approved for bedrooms Disapproved Date 2/17/2016 Sieve R. Pannone. Conditional approval for bedrooms, with the following stipulations: 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 f If more than 1 septic system is on the tot: COSA Checklist # + of + Structure served by this system + Certificate of On-Site Systems Approval Checklist, Legal Description: Dawn Village, Block 2, Lot $ Parcel ID: 014-061-46 . A. WELL DATA Well type Private If A, B, or C provide PWSID # Well Log (Y/N)'Y Date completed Unknown Sanitary seal (YIN) _Y_ - Wires properly protected (Y/N) L Total depth 93 ft. Cased to 93 ft. Casing height (above ground) 12+ in. FROM WELL LOG . AT INSPECTION Date of test Unknown 2/16/2016 Static water level 20 Well production 12 g.p.m; 6.3+ g.p:m: WATER SAMPLE RESULTS: ColiformNeg colonies/100 mL Nitrate 0.422 mg/L Arsenic ND ug/L Date of sample: 2/16/2016 Collected by: 'PES ' B. SEPTIC/HOLDING TANK DATA Tank Type/Material Date installed Tank size gal'. Number of Compartments _ Cleanouts (Y/N) Foundation cleanout (Y/N) _ Depression over tank (Y/N) _ High water alarm (Y/N) ` Date of pumping. Pumper C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft2 or felbdrm) System type Length ft. Width ft. Gravel below pipe- ft. Total depth ft. : Eff. absorption area ftz Monitoring tube Depression over°field Date of adequacy test Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Water added_gal. New depth in. Elapsed Time`. Miri. Final fluid depth in. - Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date G. ENGINEER'S CERTIFICATION -;0' Al I certify that t have determined through field inspections and �� review of Municipal records that the above systems are in #t4�TFE SAF conformance with MOA COSA guidelines in effect on this date. Engineer's Printed NameSteven PaC1f10I1@�eVan l f gnnone:�` Date 3/3/2016} COSA.canary sheet 2-6-15.doc - - D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "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 WELL ON LOT TO`. Septic tank/lift station on lot N/A On adjacent lots 100+ Absorption field on lot' -N/A On adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout 100+ Sewer /septic service line 25+ Holding tank 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line Absorption field Water main Water service line Surface water Wells on adjacent lots - ABSORPTION FIELD ON LOT TO: Property line Building foundation Water main ..- . Water Service line Surface water Driveway, parking/vehicle storage Curtain drain Wells on adjacent lots F: COMMENTS G. ENGINEER'S CERTIFICATION -;0' Al I certify that t have determined through field inspections and �� review of Municipal records that the above systems are in #t4�TFE SAF conformance with MOA COSA guidelines in effect on this date. Engineer's Printed NameSteven PaC1f10I1@�eVan l f gnnone:�` Date 3/3/2016} COSA.canary sheet 2-6-15.doc - - "~ ' INSPEcT(ON'XPPOINT~NTS ~./ MUNICIPALITY OF ANCHORAGE MUNICIPALITY F ~cALTH & DEPAR~E~ OF "~LTH & E~RONME~AL P~~ ~w~o~T~ SAm~*O~ mwsm~ JUL T. le~one 2~720 REOUE~ FOR ~PROVAL OF I.DIVIDUAL WATER A.~~ DIRECTIO~: Co.leto all ~r~ mt ~ 1. I~1~ ~u~ ~11 n~ ~ pr~. ~ease all~ ten (10) d~s ~r pr~ing. 1. 'ROP~ ~ ~ , PHONE ~ROPERTY R~IDENT (If ~i~nt fr~ ~) PHONE BUYER PHONE ~ENDING INSTITUTION~ t ~ PHONE R~O~AGENT ~ PHONE ..... STREET LOCATION 6. TYPE 01; RESIDENCE SINGLE FAMILY [] MULTIPLE FAMILY 7. WATER sUPPLY INDIVIDUAL' COMMUNITY [] PUBLIC UTILITY ~. P,UBLIC UTILITY NUMBER OF BEDROOMS [] One [] Four [] Other [] Two [] Five Three [] Six ATTACH'WELL LOG. A well log is requi~ad for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) ,YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEF~,JVIUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. ..... .,/Ii THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE E [] FIVE ' [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] sIX 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY 0 Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED •PUBLIC UTILITY Connection Verified INSTALLER . []Septic Tank or [] Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL Absorption Area to neare~ Lot Line 5. COMMENTS ,/~APPROVED FOR BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) ~ DISAPPROVED 72-010 (Rev. 6/79) [-3o Anchorage 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M, SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION July 27, 1981 Janet de Jony 6641 Teshlar Drive Anchorage, Alaska 99507 Subject: Lot 8 Block 2 Dawn Village Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (1) The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. (2) The seal on the well head needs to be tightened and then reinspected when this has been completed. If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: Alaska School Employees Federal Credit Union 3500 Eide Street 99503 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ~2E L Street - Aneitorage, Ata~ka 99501 ~~ ENVIRONMENTAL ENGINEERING DIVISION Telephone 2~7~ REQUE~ FOR ~PROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES. DIRE~IO~2 ~lm ~l para ~ ~p 1. IKomple~ ~ will tim M p~. ~eaw all~ ~n (10) ~yl for p~in& 1. PROPERTY ~NER 'MAILING ADDRE~ . ~ILING ADDR~ ~ L~DI~GINSTIT~ION ~ PHONE I MAI LING ADDRE~ STREET LOCATION B. TYPEOF RESIDENCE /J~ SINGLE FAMILY I--1 MULTIPLE FAMILY WATER SUPPLY ,,~ INDIVIDUAL* COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL BYSTEM [] INDIVIDUAL/ON-SITE** PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACC /24)10(3/78) NUMBER OF BEDROOMS One [] Four [] Other Two [] Five · Three [] Six * ATTACH WELL LOG. A well log is required for ell wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) **If individual/on-site, give installation date '~./'~ ' : llVR IVNOILVNII]INI tlOJ /ON P. ~ s) , '--Q]OlkOffd ]gVll]k03 ]3NVIIrlSNI ON ................................... {pe.ll~beJ eej oJlxe) At~]^I.I_]Q .lVl3],~S__ ]LVa VO (e~elsod snld) ~OC--llVIAi 031111a33 ~lOJ .l. dl;3;~ -' THIS SIDE FOR OFFICIAL USE ONLY :DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME ' TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOM~ ~ SINGLE FAMILY [] ONE ~ THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY 'J~'[] COMMUNITyINDIVIDUAL DEPTH OF WELL C~ ~ DATE DRILLED r-'l PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED J~UBLIC UTILITY r'Connect on Verified INSTALLER [--Iseptic Tank or []Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL ' 4. DISTANCES ~-~e~r~o~ Septic/Holding Tank lAbsorption Area IE~%'.~F Line I Nearest Lot Line WELLTO: \~'I j \O;T J ~.~.~=T' , Absorption Area to nearest Lot Line 5. COMMENTS [] APPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter m,k~t accompany certificate) [~ DISAPPROVEO DATE BY (Title) LEGAL. DESCRIPTION 72-010 (Rev. 3/78)