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Home My WebLink AboutMOUNTAIN SHADOWS BLK 1 LT 10 Mar 14 22 09:31 p Anchorage Well & Pump Ser 9072430742 p.1 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: Date of Issue: Parcel Identification Number: 017 401 08 Legal Description MOUNTAIN SHADOWS Block 1 Lot 10 Property Owner Name & Address: MCLAUGHLIN,JOSEPH 8235E130THAVENUE ANCHORAGE, AK 99516 Pump Installation Date: 03 11 2022 235 Pump Intake Depth Below Top of Well Casing: feet RED JACKET Pump Manufacturer's Name: Pump Model: 75C211 -8S 16 Pump Size: '75 hp 14 Pitless Adapter Burial Depth: feet MARTINSON Pitless Adapter Manufacturer's Name: Pitless Adapter Installer: Well Disinfected Upon Completion? Yes ❑ No Method of Disinfection: PELLETS I Comments: Pump Installer Name: _ ANCHORAGE WELL & PUMP SERVICE Company: 7640 KING STREET p y' ANCHORAGE, AK 99518 Mailing Address: 907-243-0740 City: State: Zip: Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME .. ' ' PHonE I [] NEW MAILING ADDRESS 1241 I_ah LEGAL DESCRIPTION / LOCATION NO. OF BEDROOMS - PERMITNO.~, -- DISTANCE TO: Well/2 ~)' [Absorption area') O/ Dwelli'4 ~ ~ Material/,, No. of compartments ¢ Liq. capacity in 9allons Inside length ~ Width Liquid depth /~ {-¢ IF HOMEMADE: ~O Weft Owelling PERMIT NO. DISTANCE TO: O ~ < Manufacturer Material Liquid capacity in gallons ~ Well ~ F~ndation ~' Nearest I'o't line PERMIT NO. DISTANCE TO: / 2 ~ ~' ,.¢~ / :.uJZ ~2 Nd. of lines ~ I_engtl~ of each line 36' Tota]lengthoJlb]es~/ Trench ~" ~ ~ Top of tile to finish grade z ' Material beneath tile Total effective absorption area Length Width Depth PERMIT NO. ~ p Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance ~o lot line PERMIT NO. ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER SOIL TEST RATING ~EMARKS lU -APPROVED 'DATE LEGAL 72-013 (Rev. 3/78) Department MUNICIPALITY OF ANCHORAGE f Health and Environments Protection 825 ~ Street, ~ulchorage, AK. ~9501 264-4720 * * * HANDWRITTEN PERMIT Permit 9 ~ ~f - WELL AN~t% 0N-SITE SEWER PERMIT Applicant: ~D~J /~.'~L~-- Mailing Address: /~'///r~/w-~./~ ~/. Location: ~.~~ ~_/. ~, Phone Nu~er: ~ Legal Description: ~..'~/~-~ Lot Size: Type of Soil ~sorption System Is: ~c~/ ~/~2~'~ ~ Trench: Drainfield: Seepage Bed: Holding Tank: Maximum N~ber of Bedrooms: ~ Soil Rating(sq.ft/br) The Requi~ed Size of the Soil ~sorption System Is: DEPTH LENGTH GRAVEL DEPTH WIDTH 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 minim~ depth of gravel between the outfall Pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = /~O 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(2) INSPECTIONS ARE REQUIRED * ~ * Backfilling of any system without final inspection and approval by this department will be subjec% 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 upo~ the type of public well. Minim~ distance from a private wei1 to a private sewer line is 25 feet and to a co]~unity 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 DECEMGER ~1, 1 9 8 3 * * * I certify that: I ~ f~iliar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remo~led to include more t~3 bedro~/. S ign~~~/~/~_ _ ~ssued SWP/024(1/81) ALASKA ENVIRONM=NTAL CONTROL SERVIC: INC. 1220 West 25th Avenue Suite B ANCHORAGE, ALASKA 99503 276-1361 279-2917 JOB S,~EET NO. CALCULATED BY CHECKEO BY OF DATE DATE ALASKA DUIROFIf'Flt I]] AL COFITROL S. ,IUIC $, IFIC. ~nqin~¢rinq ~ ~nuironm~nl~l Slu(li~s May 2, 1983 Paul Palmer 411E 36th Avenue Anchorage, Alaska 99503 Dear Mr. Palmer: Mountain Shadows Subdivision Lot 9, 10, 11. All 3 lot's did not percolate at an intermediate depth which would be required for a septic system of a trench design. Test holes were redone with a post hole digger 1 foot below the OL layer on Lot's 9, 10, and 11. The percolation tests were done at these depths because original test holes showed increasing tightness of silt and gravel with depth, and' did not perc~ These lots can accept a septic system but it must be of a shallow surface design (mound system.) This letter and drawing are rough draft of a conventional trench system and that of a mound system on each lot. They ara not the final engineered design but a draft to use for cost estimates of ~ound versus trench. Pete Sapala Civil Engineer 1200 LU~sI 33Fd Au~Du~, ~uil¢ ~ · ADcHoro§~, Al~s~o 99503 ALASKA ehuIROnFII-eTAL CONTROL Serb,dS, InC. CLIENT ADDRESS PERCOLATION TEST DATA SHEET ZIP CODE LEGAL LOCATION ._.~O].Lq ~/~3,d()L~]~ ~l)~'"¥!\1'1~(')V-'' -;, ~)/OC,~/\ / TOTAL DEPTH OF HOLE ft. ZONE TESTED ~ ft TO ~'/2_ ft ) READING # CLOCK TIME NET TIME DEPTtt TO NET DROP RATE (min/in) DATUM , q-~0 , ' FINAL PERCOLATION RATE ~ (min/in) PERFORMED BY ~200 LUrst 3ara Au~,~u~, $u,,.,.So A.iBor.¥, Alosko 99.503 * (907} 276-1361 ALASKA FIUIIgOFIm DTAL CODTROL SlglgUIC $, ' ~nclin¢~rin~I CLIENT _C~IF ~d~ ADDRESS PERCOL~IO~ TEST DA'TA"SHEET" ' : UU~I'!~J-~;~_ u,:~- DATE . Ju\¥ .1~, ES..z ZIP CODE LEaL LOCATION _~(~)LL~'1JKO~k'~. ~~L~ TOTAL DEPTH OF HOLE ft. ZONE TESTED _.._:11/6: _: : ft TO. _ . ~ .. , ft FINAL PERCOLATION RATE '~, ..~ (min/in) . ~- , .. ~A~.~ . 1200 ~sl 33rd Au~nu¢. Su,,~.~. Anchoroqe. Alaska 99503 · {907) 276-t~ READING # CLOCK TIME NET TIME DEPTH TO NET DROP RATE (min/in) DATUM q:.Hzo, - I ~;o~-1.5 l.'lS,rrlqo , ID T~O ~ ~o~-~o J mm ,~0 ',/0 , .- ,dO, . -- ;'B~O'~ ~ ' ' ~: ~.-/> .-,~.,v. ~.~ m,n dO ~'~zd ...... ~ ~: ~ o /5 .,.' '.~::,:~' ~,n' ,~ ,/0 ~, J _ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAl- PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOl LS-LOG PERCOLATION TEST LEGAL DESCRIPTION: 9 ~ / SLOPE DATE PERFORMED:Z/b~"~ ~// ~__.. /vo ,z ID. SITE PLAN '11 WAS GROUND WATER NO l~ ENCOUNTERED? O ~ 12 P ;;;a.--..... IF YES, ATWHAT E DEPTH? -- 1 3 _J Gross Net Depth to Net Reading Date Time Time Water Drop / 14 15 16 17 18 19 rvl-W DRILLING, Inc. P.O. Box 10-378 · 10300 Old Seward Highway (907) 349-8535 ANCHORAGE, ALASKA 99511 DRILLING LOG Well Owner Cf)P./~')~ ' J"~!,}~' Use of Well Location (address of: Township, Range, Section, if known; or distance main road Size of casing ~" Depth of Hole Static water level :15' ft. Screen ( ); Perforated ( ~7~ feet Cased to 2~..q feet (below) land surface. Finish of well (check one) ). Describe screen or perforation i:(~¥; Well pumping test at ~ .gallons per (l~O~t): of drawdown from static level. Date of completion ,,d ,, .: ,, (minute) for 1 hours with_ '~ =')'~ WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness .TO. .TO open end ( )~-7, ); TO. .TO. .TO. .TO .TO TO TO. TO .TO TO. __.TO. TO. .TO. ~edzock 3--CONTRACTOR ALASKA u,,UIROFIITII FITAL COIIIROL SFz,. ,JIC $, IFlC. ~n§incerinq $ ~nuironmcnlaJ $1udies January 11, 1984 Department of Health & Environmental Protection 825 L. Street Anchorage, Alaska 99501 Attn: Cory [qil lis Dear Cory: Here are the copies of the percolation tests we did on lots 10 and 11, block 1, of Mountain Shadows Subdivision. Lot 9 had a visual soils rating of 150 sq.ft./bedroom in the excavated area. Lot 11 had been over excavated so we perced the bottom of the bed and then had 3 ft of sand brought in to bring the bed to 4 feet above groundwater. The way the lots were clea~'ed made it appear that we were deeper than planned. I{owever, we found that the excavator used building excavation dirt to fill around the holes. The soils wer~. much better than what we found earlier with the augers. I hope this answers your questions. Sincerely, Pre~nt 1200 [Uesl 33rd Aue,ue, Suile B · Anchoroqe, Alaska 99503 · (907) 276-1361 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING O )'7~ Ljoi - 0 ~ HAA# GENERAL INFORMATION Complete legal description Location (site address or directions) ~2 ,~ .~ .~- Property owner _ Mailing address Lending agency Mailing address Agent Address Day phone Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev 1191) From MOA #21 T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 James Williams Municipality of Anchorage Division of Environmental Health Department of Health and Social Services 820 I Street Anchorage, Alaska 99501 Subject: HAA 960081, PID 017-401-08 Lot 10, Block 1, Mountain Shadow Gentlemen; A conditional HAA was issued for this property. Please issue an unconditional HAA. May17,1996 RECEIVED Munioil~ality of An, Dept. Health & ~,,..~c2h..°r~qe The conditions for that HAA has now been met. Yours 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 GENERAL INFORMATION Complete legal description CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# __~'/7- ¢~'/- ¢~; HAA# ~\ ¢'~"~[Z~ ~_~"~J Location (site address or directions) Property owner T)L-c,,'i c( T).~.,.~[,41 /._.b,.~L~.~.~-,(¢~- Day phone Mailing address . 1,2, .~,~_~:~ f'--'~'t,C ~ O,-¢~,.-~-f<' Lending agency Day phone ¢4 Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev W91) Front MOA #2! 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/orwastewaterdisposal 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. NameofFirm 't ,,b~.~,~/ wv'~(a~,~-~ "'~-~- Phone Address ,~ '% ~.. / ~--/...~t t'¢ .~C~ 5 Engineer's signature ~.-~(,~..~ ,_,.~/L~,.,.~.~.. Date. 6. DHHS SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. ]--~4¢45F_(-~ bedrooms, with the following stipulations: Escrow monies to perform all work necessary to place fill over existing leachfield bed to achieve a minimum cover of 3.5 feet. Ail work must be completed no later than June 1, 1996. Additional Comments Monies to remain in escrow until final approval is granted from this department. 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. Em ployees 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~O25 (Rev. 1/91) Back MOA #21 Legal Descril)tion: A. WELL DATA Municipality of Anchorage ~ /~X ~i DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division ~'4dNICIPALiW 825"L" Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4-/~VIRONMENTA£, Health Auttnority Approval Checklist ~ tq OOpq TA1N Parcel I.D.: f'~/~ft 1;:7 1996 R£CEIVED Ol-I-Wol- 08 · Log presc,tt (Y/N) 7 Total depth _ ~"/C) l If A. B. or C. attach ADEC letter. ADEC ~vater system number Date completed Cased to ¢~ Il/, {5' ~ Casing height (above grotmd) Sanitary seal fY/N) ? FROM WELL LOG Dateoftes~ '-t ],O ] ~ '~ Static water level ~. ~ I Well production ~ g.p.m Wires properly protected (Y/N) AT INSPECTION 42,, g.p.m. WATER SAMPLE RESULTS: Coliform ¢ Nitrate Dateofsample: °fi/t~ /c~G l ~,~-~ .o~t~J¢-.~ Collected by: B. SE~ICmOLD~G TANK DATA Other bacteria · 1 · ~ Date installed $~ Tank size [fl- ~O Number o£ Compartments ~ Cleanouts (Y/N) ~ Foundation clcanonl (Y/N) / Depression (Y/N) ~ High water alarm (Y/N) /x~ Date of Pnmping '_?~/~ ~ Pnntper P--O~'o ~oe) ~ *v" c. a.so.r'nos toLD nATA Date installed '7/2~ (/~ % Length L//! Width /~3 ¢ Gravel thickness below pipe £ Effective absorption area 7.¢58 ~.] Monitoring Vt,be present(Y/N) Date of adeqnacy test c2'/S/qb Resnlts(Pass/Fail) Fluid depth in absorption field before test (in.); Fluid depth ~._~_%~(ins.) Minntes later: Peroxide treatmentO[past 12 ,nootits) (Y/N) Soil rating (g.p.d./ft2 or ft2/bdrm) / t~O System type ~ ~r7/.~ Total depth ,2C~ -- 8~ · Depression over field (YfN) ~ For ,~ bedrooms hnmediately after t'/~t2l;al, water added (in.): ~ Absorption rate = ~ ~ 5'- {~9 g.p.d. If yes, give date D. LIFF STATION Date installed Size itl gallons Manhole/Access (Y/N) "Pump ou' level at* "Pump ofF' level at* High water alarm level at* *Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot '~ I O O Absorption field on lot ~3 lOCI Public sewer main No Sexver/septic service lille ; On adjacent lots > ] 0'O ; On adjacent lots ~/ I0~0 Public sewer manhole/cleanout Lifistation l~'4o}~e~_ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: t Building foundation 7 Property line -- Absorption field Water main/service lille ~-O ~ t -~ Surface water/drainage ~'4 [ O Wells on adjacent lots / 3o SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation Surface water Curtain drain ~'q ! Water main/service line I Driveway, parking/vehicle storage area Wells on adjacent lots ] ~ 0 "~ Property line~ in c°nf°rmance with MOA HAA g;Rl;lTils, in [ffect °n this date. Signature Date F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records that the ,ab.ove s)Stems a~e, HAAFee $ 3 W ' ~ WaiverFe=$ llO'T ~ Daie of Payment b~/7--- . Date of Payment ~ ~/Z- -- ~' Receipt Number /~ ~['~ ReceiptNamber ~ff>~V ~/~ Rev. 8/95 eSS: haa.wk.doc Rick Mystrom, Mayor M micipality of Anchorage Department of Health and Human Services 825 "L" Street P.O, Box 196650 Anchorage, Alaska 99519-6650 March 28, 1996 Tobben Spurkland, P.E. 203 West 15th Avenue 11203 Anchorage, Alaska 99501 Subject: Waiver Request for Lot 10 Block I Mountain Shadow Subdivision Waiver Request #WR960003, PID #017-401-08, HA# HA960081 Dear Mr. Spurkland: Your request for a waiver of the required 10 foot separation between a leachfield and the property line on the subject property has been approved. The approved separation distance is 2 feet. These approval applies to the existing septic system and lot line separation only. Any future upgrade to the septic system will require all separations be met or another approval from this department. If there are any questions, [)lease call our office at 343-4744. Sipcerely, ,,~ /// ~lames P. Williams Civil Engineer On-site Services Program JPW/Ijm T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Municipality of Anchorage Division of Environmental Health Depat~tment of Health and Social Services 820 1 Street Anchorage, Alaska 99501 _ Subject: Lot 10, Mountain Shadow PID # 017-401-08 Request for Lot Line Waiver RECEIVED MAR 26 1996 M~t~ic~pality ot A~chora Oep/, He~tlth & tqurnan February 9, 1996 Gentlemen; During an HAA inspection is was observed that the drainfield for this property was less than the required ten feet away fi'om the south lot line. The As Built report on file with the Health Department list the offset as 10 feet, no waiver has therefore been requested in the past. The surveyed as built of the property indicates that the field monitor is approximately 4 feet from the lot line. It is possible that the drainfield is even closer to the line. We therefore request a waiver to 2 feet from the lot line. :/ Yours T. Spurllland P.E. ... .~ ~ I+, ~ ~ J ~ ~ .~ A' ~--42.2::~ .... ~ ~ ''~"" ~ ~ x ' () ,' =/.,. : - .~-..,,.., < ~., .. . o I l'~ ..... oO~ ~,;n :357? I , A~ICHO~AGE, ~L~SKA I HEREBY ~E~'f]FY THAT ~ HAVE SIJ~VEYE0 TkI~ FOLLOW~NG DESCR~8~O PROPERTY, ~"'~r~r~ ~, ANO OQ NOT EHC~O,ECH 0~4 THI; PROPERTY LYING AOOACENT TM~P~TO, THAT NO ~PR0VENENTS 0N PROPERTY LY]~G ADdACENT THEqETO ENCR0~CH ON THE PCEH~SES ~N QUESTION AND T~A~ THERE ARE NO ROAOWAYS. TRANSMISSION LINES OR OTHER BATED THIS ~. DAY 0F ~¢~ , ~9~, ANCHORAGE. ALASKA. ~4,',, 1S.3~52 IT IS THE RESPONSIBILITY 0F THE OWNER 0R BUILDER, PRIOR 'tO CONSIRUCT]O~, TO VERIFY P~0POSEO BUILD]NS GRADE RELATIVE TO FINISH gm,NDE AND UIILITY CONNECTIONS AND TO OETERMINE THE EXISTEWCE OF ANY E~SEH~N'fS, COVENANTS OR PESTR~CT~ONS NH]CH BO NOT APCEA~ ON THE RECORDED SU(~ I~V]S]0W PLAT. J .~:T~ ..........................~"i'ig'~l"~-F~ ............ ~'bCqT~: ii-," '~:~; ~;: ,: ........ Property Owner Mailing Address Buyer Address APPLIC" 'fiT FILLS OUT UPPER HAt Gordon Wolfe ] 24P ~'ri~%ty Laz~e~ A_nc~-.ge~ Ak. David & Mary Chakroff ONLY Zip Code 99504 Zip Code Phone ~337-4884 Lending Institution Address Realty Co. & Agent Address First Federal Savings & Loan Arsbic~& Nori~--Li.~ts ~ ......... Zip Code 995-03 Zip Code Phone 274~-6565 Phone Legal Description Lot 10, [~lock 1, Mountain Shallows Street Locatio~ Type of Residence Single Family Multiple Family No. of Bedrooms [] Other Water Supply [~{ Individual ~ Community ~ Public Utility ATTACH WELL LOG. A well log iS required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available). Sewer Disposal .Individual Public Utility t-J Holding Tank Year Individual h'mtalled: 1 9 8 3 When Connected to Public Utility: NOTE: 'rile INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Dale Inspector Inspector Inspector Inspector ~MU'*4 CIPALI'FY OF ANCHO.P, AG~ (~) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received Well to Tank Seplic T~k Size / ~ ~ ~ 72-023 (3/82) ALASKA dlROnmenTAL COIqTROL SgRUIC $, IIqC. December 19, 1983 Municipality of Anchorage Department of Health & Environmental Protection 825 L. Street Anchorage, Ak. 99501 Re: Health Authority On December 15, 1983 our company collected a water sample from the house located on Lot 10 Block 1 Mountain Shadows Subdivision. The property owner is Ken Boyer. The water analysis was satisfactory. A copy of the report is attached. The well is located 100 feet from the septic tank and 100 feet from the leach field. The electrical wires are encased in conduit. All the standpipes are capped. The well casing stands 3 feet above ground and has a sanitary seal. 1200 LUcsl 33rd t~ue~u¢, 5uil~ ~ · J~nchor~§¢, J~laska 99503 ,, [907) 276-1361