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HomeMy WebLinkAboutALPINE WOODS BLK 1 LT 5Alpine Woods Block 1 Lot 5 #015-234-06 Municipality of Anchorage a° Development Services Department • Building Safety Division • E, On-Site Water and Wastewater Program, 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 of 3 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: O,5P 111185 PID Number: 015-234-06 Name- irramna Millar Wastewater System: ❑ New ® Upgrade Address: ABSORPTION FIELD Phone: Number of Bedrooms: ® Deep Trench 0 Shallow Trench 0 Bed I] Mound t] Other. LEGAL DESCRIPTION Soil Rating. n_R GpnIF2 Total Depth from original grade: 12.5 Ft. Block: Lof: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: 1 Alpine Woods 3Ft. 9Ft. Township: Range: Section: Fill added above original grade: Gravel Length: 0.5 Ft. 45 Ft. Well: ❑ New ❑ Upgrade Gravel widen: Number of lines: Distance between lines: 3 Fl. 1 0 Ff. Classification (Private, A B, Cl: Total Depth: Cased to: Total absorption area Pipe Material: Class A Po. FL 812 Fe 3034 PVC Driller: Date Drilled: Stant Water Level: Installer: Date Installed: FL A+ Home Services 8/12/2011 Yield: Pump Set at: Casing Height Above Grouts: GPM Ft. Ff. TANK SEPARATION DISTANCES ❑ Septic ❑ Holding ® S.T.E.P. ❑ Other: To Septic Absorption Lift Holding ublir✓Private Manufacturer. Capacity: From Tank Field Station Tank Sewer Line Existing Gal. Well 200+ 200+ Material Number of Compartments: Surface Water 100+ 100+ LIFT STATION Let Line 10+ 32.6 Size: Manufacturer. Manufactu Gel. Foundation 5+ 58 "Pump Wlevel at: °Pump ofr level at: Highwateralermai: in. in. in. Curtain Drain 50+ 50+ Pump Make & Model Electrical Inspections performed by: Remarks: IS ng Field to be reused. BENCH MARK Location and Description: Assumed Elevation: 100.0 Ft. Engineer's Stamp OF ,f . �P ,....... �♦ �?,.• �i Inspections performed by: PES. LLC Dates: 18/11/2011 49TH r........... .. .....i 2n°08/1212011 i Development Services Department approval r :Steven"R.' Pennone� �_ Conditional Approval by: Date: �� s •. No. CE 81 9� 1� f(lr7(�o••'�'i Reviewed and approved by: Date: ' / 13�� � ��Ie�FESS 1 • '�+ 01 48R USE �E) APPROXIMATE LOCATION w OF WATER MAIN UPGRADE SAS (P) — 45LFx9'EDx2.5'W, M2 1 2.5'TD EXIST�IN SEPTIC AREA A. N 'a) C4 > 1 - 49.7 Ci EC I T 1 Nri -LIS D/W T2 T1 DRAIN FIELD (E) IN FAILURE TO BE RE -USED V B 4BR I " CU WATER VERIFIED INTEGRITY OF E HOUSE SERVICE LINE 1500g S.T.E.P. TANK (E) 7�9 17 CREEKIOR swwQx&-'_ AiNACE CO A 8 ECI 41.6 48,6 E02-43-8-49.9 EC3 67.5 61.7 EC4 68.8 " 1 mT_zsz67:2 M2 86.2 86.5 T1 28 ' 1 14.5 T2 32 8 22.0 LS 34:2 23.4 N NOTES: PANNONE ENG SVC, LLC Date RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 OF. A4.. too 1/19/12 —8218 —8211 A� Scale PHONE (907) 272 FAX (907) 272 TH 1"=50' ........ P.I.D. NO ALPINE WOODS, BLOCK 1, LOT 5 015-234-04 RAYMOND & LORRAINE MILLER Steven R. *a'n'on'e" IERIIT NO, CE 8149 12020 GILLETTE DRIVE 01 %. PLAN ANCHORAGE, AK 99516 ...... 9 ." Sheet SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: INSTALL NEW SOIL ABSORPTION SYSTEM. 4. NO GROUNDWATER WAS OBSERVED AS EVIDENCED BY THE SOIL TEST HOLE, IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 19.0 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. S 9/ -FILTER FABRIC ,. 3.5 95.4 � �- � 0.5 GRAVEL BEDDING DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 15009 S.T.E.P. PERC RATE = 6-15 MPI SOIL RATING: 0.8 GPD/SF AREA RQD: 750 SF SYS. TYPE: DEEP TRENCH 9.0' E.D MIN LENGTH: 41.7 LF USE: 45 LF X 2.5' WIDE, 9' E.D., 12.5' TO TOTAL AREA: 810 SF r rcv n L.F_ " 0 DRAIN PIPE W/ Ya" HOLES 0 24" O.C. SECTION Ya" DRAIN PIPE DEEP TRENCH SEE DESIGN LEGEND W WATERLINE/ WELL RADIUS — SS — NEW SEPTIC ABBREVIATIONS 86.4 CU COPPER DIP 86.4 I I - FC FOUNDATION CLEAN OUT T# -I2. s.s 5I - M# MONITOR TUBE NO. R.I. No groundwater DCO DOUBLE CLEAN OUT DV monitored FS 79.9 SAS z O o z O F 00 z �d W a N OV DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 15009 S.T.E.P. PERC RATE = 6-15 MPI SOIL RATING: 0.8 GPD/SF AREA RQD: 750 SF SYS. TYPE: DEEP TRENCH 9.0' E.D MIN LENGTH: 41.7 LF USE: 45 LF X 2.5' WIDE, 9' E.D., 12.5' TO TOTAL AREA: 810 SF r rcv n L.F_ " 0 DRAIN PIPE W/ Ya" HOLES 0 24" O.C. SECTION Ya" DRAIN PIPE DEEP TRENCH SEE DESIGN LEGEND W WATERLINE/ WELL RADIUS — SS — NEW SEPTIC ABBREVIATIONS 86.4 CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER SAS SOIL ABSORPTION SYSTEM NOTES: PL]L\1\Ol\l'� Lil\G SVC, LLA. �+,—�`�\\\�h- Date RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 ,� '(�QF.... 1/19/12 PHONE (907) 272-8218 FAX (907) 272-8211 /�g�P S�y`+' Scale "' "' P.I.D. NO ALPINE WOODS, BLOCK 1, LOT 5 / 015-2e4-04 •fP. RAYMOND & LORRAINE MILLER ♦♦ Stev Pa not P MIT N0. ' ?F`'. CE 8149 .;G�j OSPI11185 12020 GILLETTE DRIVE �+ 6, DETAILS ANCHORAGE, AK 99516�Is�%... .. sheet l� PRoFEs'so�a�c - _ ��\\���� 3 OF 3 On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP111185 Tax Code Number: 01523406000 Work Type: Septic Upgrade Permit Effective Dates: August 10, 2011 to August 09, 2012 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: ALPINE WOODS Site Legal Address: ALPINE WOODS BLK 1 LT 5 G:2738 Owner/Address: MILLER RAYMOND G & LORRAINE I 12020 GILLETTE DRIVE ANCHORAGE AK 995162472 Site Mailing Address: 12020 GILLETTE DR, Anchorage Lot Size in Sq Ft: 60167 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By: -e a', o o �z-arc— y:a0 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: ALPINE WOODS Site Legal Address: ALPINE WOODS BLK 1 LT 5 G:2738 Owner/Address: MILLER RAYMOND G & LORRAINE I 12020 GILLETTE DRIVE ANCHORAGE AK 995162472 Site Mailing Address: 12020 GILLETTE DR, Anchorage Lot Size in Sq Ft: 60167 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By: MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program Mayor Darr Sullivan ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel 1. D. O IS- 230- 06 Propertyowner(s) P#YAjoyo 94Ao /,O2eAINE 411Lc�e Day phone Mailing address _ )Zozo G-azF-r>&: o2rv,& I A �cNc zA�r a SIC 9caS16 Site address 12020 6-uL,&Z7d�" Dzr✓E= Legal description (Sub'd., Block & Lot) &&?F weaCs r 24,k f , tors— Legal description (Township, Range & Section) Lot Size 60,16-7 Sq. Ft. Number of Bedrooms y THIS APPLICATION IS FOR: THIS APPLICATION IS AN: IN all that apply) Initial E] Absorption Field Septic Tank Upgrade Holding Tank ❑ Renewal ❑ Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE f WAIVER REQUEST FOR: I certify that the above information is correct. I further certify that this application is being made for a Single Fapily Dwelling and is in accordance with applicable Municipal Codes. (Signature or autnonzed agent) Permit/Rush Fees:#530 Date of Payment: 22 Z��// Receipt Number: 0609Y 125 Permit No. 0S9 1 [ /1 S5 Waiver Fees: Date of Payment: Receipt Number: Waiver No. G:\BuildingVOn SiteTorms\Client FormsTermit App_010411.doc (Rev. 1/11) Pannone Engineering Services u.c Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve(cDpaneneak.com July 28, 2011 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: Alpine Woods, Block 1, Lot 5 Septic System Permit Upgrade Request Ladies and Gentlemen: I am writing to request a permit to construct an upgraded septic system be issued for this property. The proposed systems will serve an existing four-bedroom house. Currently the lot is developed. The lot is served by a community well. The existing drain field is in failure and shall be re -used as a reserve. A new drain field will be installed northwest of the existing field and will be sized to handle a four-bedroom waste stream. The surrounding developed lots are served by the same community well. The community well is located over 200 feet from the proposed soil absorption system. 1. Soils. One test hole was excavated by Pannone Engineering Service in July of 2011. See the soil log attached. Ground water was monitored for seven days. No ground water was monitored to a depth of nineteen feet (19') below ground level after the monitoring period. Bedrock was not encountered in the test hole. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 0.8 gallons/day/square feet should be used, using a conventional wastewater treatment system. 2. Soil Absorption System Design. a. See Sheet 2 of the design package 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and the existing drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The average topography in the area of the proposed septic system is approximately 2 percent based on the survey information in the area of the septic system. There are no steep slopes within the vicinity of the proposed drain field. Mailing: P,O. Box 100217, Anchorage, AK 99510-0217 Physical: 615 East 82"d Ave, Cuite 136, Anchorage, AK 99503 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells within 200 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Attachments: Mailing: P.O. Box 100217, Anchorage, AK 99510-021.7 Physical. 615 Fast 82"d Ave, Suite B6, Anchorage, AK 99503 Telephone: (907) 272-8218 FAX: (907) 272-8211 / '4BR / HOUSE (E) � ' LlF4eiFY MiNINi�M S€PH�AT70✓ Fea�i iJA7EK AlAi✓ BY LdG31t 1EXISTING / c SEPTIC AREA ry 11 X121 46 142.8 <�\ \DRAIN FIELD (E) IN FAILURE TO BE RE—USED 4BR \ VERIFY INTEGRITY OF EXISTING HOUSE E 15009 S.T. E. P. TANK REPLACE IF FOUND TO BE LEAKING TH APPROXIMATE LOCATION OF WATER MAIN* UPGRADE SAS (P) 'EDx2.5'W, 12.5'T 12.5D r � � D/W 1" CU WATER SERVICE LINE I I / NOTES: A7�T7�T 7�7�. ENG PANNONE ENG SVC, LW�\`,l P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 i .•'• • qS �� /�g�Q ?A ... .. ... ... � .......... .. Steven R. Panna ae �GS• CE 8149/ t��,`"H70FES5pES�r Date 8/9/17 FOR CONSTRUCTION Scale ALPINE WOODS, BLOCK 1, LOT 5 RAYMOND & LORRAINE MILLER 12020 GILLETTE DRIVE ANCHORAGE, AK 99516 P.I.D. NO 234-04 PERMIT NO. OSP111185 PLAN sheet 1 OF 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: INSTALL NEW SOIL ABSORPTION SYSTEM. 4. NO GROUNDWATER WAS OBSERVED AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 19.0 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. /—FILTER FABRIC T 0.5 \—GRAVEL BEDDING 9.0 �1) G J2.5 6.5 II2.56.5 No groundwater monitored " 0 DRAIN PIPE W/)6" HOLES ® 24" O.C. SECTION m po z ox 'y 2w OF DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1500g S.T.E.P. PERC RATE = 6-15 MPI SOIL RATING: 0.8 GPD/SF AREA RQD: 750 SF SYS. TYPE: DEEP TRENCH 9.0' E.D MIN LENGTH: 41.7 LF USE: 45 LF X 2.5' WIDE, 9' E.D., 12.5' TO TOTAL AREA: 810 SF LEGEND —W— WATER LINE/ WELL RADIUS — SS — NEW SEPTIC ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER SAS SOIL ABSORPTION SYSTEM NOTES: PANNONE ENG SVC LLC �����\l Date r��OFA�4II, 8/9/11 FOR CONSTRUCTION PHONE (907)12728218N0HORAGE, AK 99510 FAX (907) 272 8211 ig •'- sy f r- . Scale *.-*49 TM '*II 1"=50' ..... P.I.D. NO ALPINE WOODS, BLOCK 1, LOT 5 '':' 015-234-04 RAYMOND & LORRAINE MILLER tevenPannone PERMIT NO. ' P•. CE 8149] OSP111185 12020 GILLETTE DRIVE �� �Sf ., DETAILS ANCHORAGE, AK 99516 illi��ESS10N=� Sheet \>,��� i 2 OF 3 TEST HOLE i SOILS LOG - PERCOLATION TEST SLOPE W ]PLAN \. ` 1 OR ORGANICS \1. 2 / \ 3- 4— X yl u., g X TH �� / \'- TH 1 7 0/W 8 ` \g SM/ SILTYGRAVEL GM SILTY GRAVEL \ 4BR 10 HOUSE h 11 ' _ IE) 12 ;J5 13 \J WAS GROUNDWATER SLOPE 14 ENCOUNTERED? N 15 IF YES, AT WHAT TH 16 DEPTH? -0-' X 17 DEPTH TO WATER AFTER MONITORING? -DRY- 18 DATE: 7!2811 19 BOH DATE PERFORMED: 7121/1 PEROLATION RATE 1.7 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 4 FT AND 5 FT COMMENTS: Test hole excavated by A+ HOME SERVICES. Prec hole was presoaked. Test run for one hour. Last 3 readings reported PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: ��� \� Date PANNONE ENG SVC, LLC FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 ��..... >t11 8/9/11 PHONE (907) 272-8218 FAX (907) 272-8211 /�g�P �y�� Scale 1"=50' �••'• '•� P.LD. NO ALPINE WOODS, BLOCK 1, LOT 5 .. .. .... 5-234-04 RAYMOND & LORRAINE MILLER 5'teven R. Gnnoae / PERMIT NO. ' PFi, CE 8149 OSP111185 12020 GILLETTE DRIVE �+ s ._ i SOILS LOG ANCHORAGE, AK 99516 +�1 .......sioa.� Sh3et 3 CLOCK WATER READING DATE TIME NET TIME LEVEL READING NET DROP 1 7/21!11 3:10 -- 4.10 --- z 3:20 10 MIN 10.19 6.09 3 3:20 -- 4.10 -- 4 3:30 10 MIN 10.13 6.03 s 3:30 -- 4.10 ___ s 3:40 10 MIN 10.10 6.00 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name Address �I DISTANCES FROM TO SEPTIC TANK ABSORPTION FIELD WELL WELL Phone(ss))j 3 f/7 -- 7l� Permit No. oan s9 No. of Bedrooms LOT LINE LEGAL DESCRIPTION Lot S Block .� Subdiw i n FOUNDATION Township, Range, Section I� �'I/ rIZ41 y��//C��� AS -BUILT DIAGRAM (Show location of well, driveway, water bodies, etc.) septic system, property lines, foundation, TANKS SEPTICS �t ❑ HOLDING ManufacturerCapacity in ga I s /ff 16Material No. of Compartments � 2 TYPE OF SYSTEM ❑ TRENCH ® BED ❑ W. DRAIN ❑ OTHER Depth to pipe 1p4tom from T I depth from original grade original graA _ j FT FT Fill added above original grade Gravel depth beneath pipe 2.0--3.0 FT O•S FT Gravel length .7 - rGravel width FT � FT Total absorption area Distance between lines SO FT w FT Number of lines Soil rating Pipe material FSI p ACO/ 32. SO FT M 3�- Berl Installer OD Date Installed WELLS/ ❑ PRIVATE 9 OTHER (Identifv) Classification (A, T ` Total Depth FT Cased to FT Installer Date Installed: REMARKS: „ice— � Scale: � - s /, Inspections Performed by: t V 41-1 L Date: S y t;,4t31NEERING artily that is inspection was performed according to all Municip�a�l�laj��ye�ioid�IliPcl��s�dale: Health Department Approval: ""` Date: 72-013 (3/85) 0 L. H.3Construction 5223892 P.01 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES PO BOX 196650 ANCHORAGE, ALASKA 99519 343-4744 HAND WRITTEN PERMIT Permit Number: SW90J�=�c*\ Permit Type:,s1fGVJF1? Date Issued:—,3,(i40 Expiration Date:12-Y1 `?0 Design Engineer• Owner Name:AAy4A*4 f XM& 118WROAl owner Address:P� A VON 2304/4 AW HMO E, AK 17V23 Parcel ID:0/3'-234 -•06 Lot Legal: Subdivision:/g40#0 W00AF Section: 2.3 Townshi * Lot Size:6of/67 q.f g> or Day Phone : X?7- 7667 Lot : ,_ Block: Range:.? W acres) Max Bedrooms: This Permit: =_ Total Capacity:¢ SEPTIC TANK: Minimum septic tank capacity:/.2 .f*O gallons. Each septic tank must have at least 2 compartments, insulation is required if depth to top of septic tank(s) is less than 4.01. Lift stations require an appropriate electrical inspection. WELL LOG: A copy of the well log must be sent to DHHS within 30 days of the well's completion. C oN,r rieuc T PER f&61w,eE,6 #77,40yFn I CERTIFY THAT: 1. I will install the on-site sewer system and/or well in accordance with all codes and regulations of the Municipality of Anchorage (MOA) and State of Alaska , and in compliance with the design criteria of this permit. 2. I will adhere to all MOA and State of Alaska requirements for separation distances from any existing well, septic system, or surface water on this or any adjacent or nearby lot. 3. I understand that this permit is va id for a single family dwelling with a maximum of + bedrooms. I also understand that any enlargement will require an additional permit. 4. I understand this permit is issued for the calendar year and expires on December 31 of the year issued. 5. I will no ' y HHS prior to all inspections by the engine or w 11 driller. SIGNED: DATE: ~ o 0 /designee) ISSUED DATE: db/115 MUNI C!PAL ITY OF ANCHORAGE Oepartment o/ Health & Human Services 825 L Street, Anchorage, Alaska 99501 343-4720 ON - SITE SEWER PERMIT � 0�_I�7 Permit Number: 90O059 Date Issued: 04/02/90 Engineer Designed Owner Name: KAYLEN & JEAN LEBARON Owner Address: P.O. BOX 230414 ANCHORAGE, AK 99523 Day Phone: 337-7667 Parcel Id: 015-234-06 Lot Legal: Subdivision: ALPINE WOODS SUBD. Lot: 5 Block: 1 Section: 23 Township: 12N Range: 3W Lot Size 60167 (sq.ft. or acres) Max Bedrooms: This Permit: 4 Total Capacity: 4 SEPTIC TANK: Minimum total septic tank capacity: 1,250 gallons. Each septic tank must have at least 2 compartments. Depth to top of septic tank(s) < 4.O feet requires insulation over tank(s). INFORM D.H.H.S, PRIOR TO INSPECTIONS BY ENGINEER, IF AFTER OFFICE HQURSp CALL 343-4681 AND LEAVE A MESSAGE. CONSTRUCT PER ENGINEERS ATTACHED DESIGN, THIS PERMIT EXPlRES 12/31/90 AND VALID FOR A SINGLE FAMILY HOME,, I CERTIFY THAI:! 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State o[ 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 for the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maximum of 4 bedrooms. I also understand that the capacity of the total system is 4 bedrooms and any enlargement will require an additional permit. Signed: �KAVHEN (Owner) N LEBARON Issued By c��� �.e Municipality of Anchorage t DEPARTMENT OF HEALTH & HUMAN SERVI 825 "L" Street, Anchorage, Alaska 99502-06E SOILS LOG — PERCOLATION TES PERFORMED FOR: CRF=A, rK F" S Y S I F_.-&' ( IJ r1 EM. ',OkMED: -,w r LEGAL DESCRIPTION: OC -V— ' Township, Range, Section: Oj i 2-3, 7—' 2 -ti 2 3 w S DEPTH A L h L i vi -con j SLOPE SITE LAN 1 �>- aM (�2,1f,) _ 2- oz- - COrc�or v� i c� 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS aM GROUNDWAS NONE M INNEEN MEN MMINNIME ■■■■■■■.E■ IF YES, AT WHAT DEPTH? Depth to Water Alter Monitoring? 0,4 Date: Reading Date (ENGINEER'S SEAL) Net Time Depth to Water Net Drop O, 50 s a 1 .orwin , 4 11 40 R. r / PERFORMED FOR: CRF=A, rK F" S Y S I F_.-&' ( IJ r1 EM. ',OkMED: -,w r LEGAL DESCRIPTION: OC -V— ' Township, Range, Section: Oj i 2-3, 7—' 2 -ti 2 3 w S DEPTH A L h L i vi -con j SLOPE SITE LAN 1 �>- aM (�2,1f,) _ 2- oz- - COrc�or v� i c� 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS aM GROUNDWAS NONE M INNEEN MEN MMINNIME ■■■■■■■.E■ IF YES, AT WHAT DEPTH? Depth to Water Alter Monitoring? 0,4 Date: Reading Date Gros Time Net Time Depth to Water Net Drop O, 50 / 30' 4 s ZS 01501 4%31 OkK M, e2, 36 , so ri PERCOLATION RATE h9, /2 (minutes/inch) PERC HOLE DIAMETER FEST RUN BETWEEN FT AND 8 FT a.7C /6 �O -61-, /b e�rodtyi PERFORMED BY: VZe2 2 1; � �'P' 1 �I. % , K C"— J I (04aERTIFY THAT THIS TES WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) T - Al 7- e KA, 70 p. SqE+c. 4M, xrllr 4 (3o�r home Z- 0 7- e, er vct J4Gn n c � //4 t-1 411 p /7r --rem 4 Aear CPV +42r ` Sewer r?_.r. . *-LOT- 5 G%ovr'D BY coy\-tw-lm-r-y vvr--.-*' SEWER SYSTEM LOCATION PLAN I I LOT I BLOCK I SUBDIVISION 4 NORTH i Clrwin Ao W293 Ao 6 CIO j� c" SECTION/ TOWNSHIP/ RANGE 5ge-7-, 23 , 7-1:?_tiJ 23 W SCALE NOTd THE ACCURACY OF LOCATION OF EXISTING PROPERTY CORNERS, WELLS, AND SEPTIC DRAWN BY, SYSTEMS INDICATED IS NOT EXACT. DIMENSIONS INDICATED HAVE BEEN DETERMINED BY USE OF CLOTH TAPE AND NOT BY SURVEYING TECHNIQUES. PREPARED FORl A-c-r,,e-7Aaa DATE, 1112,.3 /jl-1 I SHEET OF NUMBER OF ENTRYS RESULTS BY LOCATION REPORT FROM DATE: 01/01/80 WATERSHED: WHI TO DATE: 03/29/90 STATION #: 0147 PARAMETERS SELECTED: (%) BELOW DETECTION 0.00 DATABASE ABBREVIATION DESCRIPTION ---------- WELL FLD ------------ GR_TO_WTR ---------------------------- Ground to water surf (ft) WELL FLD GR_TO_WTRI Ground to water surf (in) 7.0000 11.0000 WELL FLD WELL FLD DATE WSH STA# GR TO WTR GR TO WTRI -------- 05/20/88 --- ---- ----------- WHI 0147 ---------- 0.00 11.00 08/30/88 WHI 0147 1.00 11.00 04/12/89 WHI 0147 7.00 6.00 06/27/89 WHI 0147 7.00 2.00 NUMBER OF ENTRYS 4 4 AVERAGE VALUE 3.7500 7.5000 STANDARD DEVIATION 3.7749 4.3589 NUM BELOW DETECTION 0 0 (%) BELOW DETECTION 0.00 0.00 MAXIMUM VALUE 7.0000 11.0000 MINIMUM VALUE 0.0000 2.0000 GEOMETRIC MEAN ******** 6.1729 MEDIAN 7.0000 11.0000 ** end of report ** 03/29/90 pg 1 FO R 1P U C F <O N W lit/ EG �l : z 07 �c%! �9 Pr�E k• ood: /. Sons T'EsT W �t �tOA,,, roREn Fay? WA74E /� rH,� t A TTF R P� 0A J i4NF of / 9r9. T'Hix TN/�N V u IL i�E 1Q► oO ,Otr Ria G 9 rY�, A� pr�� Lvaoo-r SAS �i NIGH RO A,d w I7E13 # tin S4t?F4ee I��T�'►P 7-,veOu6hl,0&r' 7'f!ly T/r4F Su�,dry/tlo�v. G, �TFR �yd�vi TaRi,�G Masi ccul? rM�Gu N 8 F- ul�. R SYS TF�t PER S VEs-1&A,Eo Fob FEE 7- L4 POAO 3, p f %FC OL. /b V TF S i C,* L C SL N TE; /'o / 7 o s -F. -f b,P 40M. S ys E11 PJ66 /GN /J 0,4s00 unaN t FEET df- 6,f 9vEL� u T, i ke PEnFonAT,Eb PIRE /.f tZr Sa eH 7.3- FEET DF 1; 8f ti ,E,* rH 10,#AF, r�P Ea e H s i r rAA1 D.v L Y V f Err sEo OA,, 7 s FFsT. THvJ !70 °%Fq X ¢ = 6 80 2(7.5) - �O L ov TRE',vc� 4. Aiw upas LlOCAPO I Al ,v s M� 7TE n w TK 7WE PEl?M17- APP[ /C,q r/ oiv, A PoR T io.� Of �s k E RE sE R A E AN FA L I ES w I i Heti j M E o r r-xE.,�} T F� i"Hr- A!?TaiMiab gRCEt ro 7 -KF 5'OU7-s-u.,5-fT of 7"!fE Sctaf�CT l oT iS Tf-tE wELL �P6tfr2 ��E L dT Fc�Q TKF_ C a'hV �t Aw Ty' �.. i} -T i? S )Os 2 F --r t 4,P yr t/ .,G *4, rY/f n 2 CC fA9dT Ae TdhCA 14 U s 7- 0 0 CC L ltsi-r o a.,� o �• TSE SF L -Fop s rr T ` f L1C T/bN rLIf&j, !_ . oo'.f 0A- Tiy.9T Al&*O.f 1.0 gE L O C17TEd ON E S OF' oR aa7-"-r Spars of- G 1 L L S ITE Anf i v E, TAP Ao5e r rO Oe L o e4 7W a pu R �a G 1je FA1c up �� OETi� r?�+�,�.,E� 1,F 17- if oW4r g► S k R F R- Ge' �,� �¢ fou /P e ,E FR art A f ti o � Ac .� [ T E O f AIT, v,p Tl'L If,$/ F� Ac AP � s .� s 771-44 K A? Y PIE I / Trotis, VVb �0 1 05 '` o %%4 N o c OCO _ ` 1 N Q Vj pvm aJ h n h /fit �e me h N N kuO ZQ V O o �QW A h~ p v� e � .�HRi12�•,�5„E F 1 I er kQ ti W I h �i �' IT b N R�. 322 6'' S06 oil 43 WS ,►CDh: /0 to p, o'er z _ o Q G C ( h v o K, , to frj 22 3 fo tom. . N Q V 0 NI' t;"� to, v .6f • OZ •1 UA AN o O i c (ENGINEER'S SEAL) 141' n y Municipality of Anchorage • DEPARTMENT OF HEALTH &HUMAN SERVI u eaN+a. 825 "L" Street, Anchorage, Alaska 99502-06 SOILS LOG — PERCOLATION TES g J. orwln • '��./� PERFORMED FOR: 7 \ 1A1- Cre7'A,. F S Y.7 -I-F—&A_2 I Ij) G LEGAL DESCRIPTION: Loi Pd L UGC- Township, Range, Section: SST Z3 2—tj 3S L DEPTH (� 10 1 KfV_- (�i c n SLOPE SITE LAN aM (�07z�-) 2 OL Corea o i c) 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS aM WAS GROUND WATER ENCOUNTERED? � S IF YES, AT WHAT L O DEPTH? p E Depth to Water Atter Monitoring? � Date: 23 9 Reading Date Gross Time Net Time Depth to Water Net Drop 3o ' if ¢ ; 01501 35 4 !n. 361 O, / PERCOLATION RATE /&1, 12- (minutes inch) PERC HOLE DIAMETER a EST RUN BETWEEN FT AND FT ray a,7< 16 �0 -XV, /b e off 727 47 H PERFORMED BY: I vi ram I ,L/ 7 tA-t–�—V C t V, 'CERTIFY THAT THIS TES WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 63 �� 72-008 (Rev. 4185) S�oQe. Pt 5 IT, E. 4• \ \ -fir 4- I3 oLi • h -•t e- T7Z_r_ �l.1STA"Ll, 125a �i�p,�hS,TP,R p e -r - Gm �fon`c 1 3 g4lx "p �` 010 ° 60 P o -t-re-1/C':Vt 11� neat- cav+er 0� {tell GGT �f; 8` Sewer rzc� 14--t-or s r-aviED 8r cow "Am-r"Y f L� SEWER SYSTEM LOCATION PLAN LOT BLOCK SUBDIVISION �peaNec N. SECTION/TOWNSHIP/RANGE •� •,���.� SEAT. 23 t ZtiJ /Z3 W { • °� SCALE$/ � ��.. NOT _�oO.. THE ACCURACY OF LOCATION OF EXISTING � � PROPERTY CORNERS, WELLS, AND SEPTIC • eo•..w3 .40 DRAWN BY1 SYSTEMS INDICATED IS NOT EXACT. ® a •,�,�� •••��,, NORTH DIMENSIONS INDICATED HAVE BEEN EDETERMINED IY USE OF CLOTH TAPE AND NOT BY SURVEYING TECHNIQUES. 0 � A*• � � 4 r PREPARED FOR% i °Socia es,' -i. `. praa S`GS7-EMS' Ihl�, a rkAH 1iZ�' a are DATE. SHEET OF I 23 .� %0: RtftwcF (lol?wtAl Z FOAL - LOTS 8/64 191A1,*E kavas PEFFrcItNf/5S tNiTN Pe/?,,Ar/7- ARAVC.4 T/a,.; I• SOILS rES T W Jt; M0N/% DREV FOR w ATE/P /N THA l 4 r'f R A*Rr of TUNE of /9g9• rhes .4 PRYER rHtl.V USUAL PERIPP pul�i,v� i8"y, ptp/AE G,000 -r HAr H16Y 6R#,4kP WRTEt? 4tiP Sker4ee tA�,groe 7-i4/QOa6#oar rme EA, 7,14f <UOAPIVIXIOA,, w I TER /y otic raR♦�vG �usT Oc cui? rtil1?Da6A1 V)rE A c up. 2 • T -a Oft S Y S TEAl PEPrrf /$ PES -16 RP FOS // FEFlr g/1-SEb uPo� � so/tS jE ST dF l3 FEET, Ty/s �.g,v.v�T 3. f'jRc 0L.*rioti rEs r C,*L c"t.4rEs ry /70 fv. Fr�,�Eb,?ooM. S yf 7 -Em AFS/GN Is 0,4sEP Li/SON rr FEET dE 6/PSS+vE4� 13u1", iKe PElrFon,97'Ev I°/IvF /S SET Su�H rH.�t avLy 7, $' FEET mF 61?* vEL fs 8FtiEA rx1 RI PAF, % RA, eH s,-vs- cA/v va c. Y Of c -4,4 c 4 c p rEP a t sev ati 7 S FFA'T. 7-mAej 0c- v X 2r7. s� _ ¢ �O L o v c Al. 4. 9450 upoN rKE ' sEtVEI? (YfPEM L oe,+rio^. PL,#iV ' Sfkgml1TEn (A, TK rliE PERr,)r 9PPwg7-1oiv1 # Pofr/oAl of rM E RESERVE AREA L / ES IN l H/ti rHE '00'. SF_ T B* c/r .?r. )HC- 4pralw*h pAgtEi ; t`v rKF SGu its-wFs r of rkE SGtawnf[r L oT` /f 7 -HE L-- 6/-/- )fES'dn 104 G 107` FO if r'/fF CvNotK Ai,r ry tr- otroe srs rvov t CPvjt/.-,G *4101O"E w a d,qs. Tk/s w FGc O*A.n 2 0o AOo T Ar 7-Ohc% ccs T t3 E L 0 « rop .7, , rp rl-e0 c.. ti to ti t • e.9- T/ o•v pt *AO' . 6 r1- c-1? E / f AIV R -vv y T/ o v oi- f o /? F.t C E vR 4, /.ANG e r#Ar Al&,Eps 1,0 gE C o tvrEn Qiv ocvE $),A9 ' oR 907-14 s/oCs o f G 1 L L E ilE Pf �,Feor rw 17 L o e4 TE',n OuR�NL/?Faiv,up ��� OET,�,?�+�,�En /f /T A S kRFA-GE' v- 6 rr/? FEarr A SAio,.• ^-4c7- T-1 T, P,r 0 /7" A. C, C. nEF/A-/r#+0�.s. MUNICIPALITY OF ANCHORAGE ' DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services a 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. # 015-234-06 � HAA # �i'�4°la 1. GENERAL INFORMATION Complete legal description Alpine Woods, Lot 5, Block 1 Location (site address or directions) 12020 Gillette Drive, Anchorage3 Property owner Kaolin Lebaron Day phone 345-4737 Mailing address 12020 Gillette Dr. , Anchorage r, Lending agency N/A Mailing address Day phone Agent Bonnie Mehner/Jack White Day phone 762-3110 Address 3201 C Street #100, Anchorage, AK 99503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 4 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. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site X 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. 1/91) Front MOA #21 eau vow MOUS (16n •Aey) BZo-ZL 'NOM s,a99u16u9 leuolssaload ay} ui suoissiwo ao saoaaa ao} algpsuodsoi IOU sl a6eaoyouy ;o Al!led!o!unyy ayl panssi s! aleoll!laao a aaolaq elep azAleue ao suo!loadsul lonpuoo IOU op SHHQ to s99Aoldw3 sluawaalnbaa alels pue leiapal ulel�ao /}s!les olaapio u! suollnl!lsul 6ulpual,(layl pue sawoy to saaseyoand of �(salanoo a se s!yl scop SHH4 ay.L TIN'Seitl to alels ayl u! paaals16ej aaau16ua leuolssaloid luepuadepu! ue �(q anoge g yde,(6eaed u! uanl6 suolleluesaidai ayl uodn �tluo paseq saleo!}llaaC) leno.iddy Al!aoylny ylleaH sonssl (SHHQ) saolnaag uewnH pue ylleaH to luawlJedaa 96eaoyouy 10 Al!ledlo!unw ayl Z Z --,9 alp(] sluewwo0 Isuoll!ppy :Ag :suollelndlls bu!nno1101 ayl qlw► 'swooapaq JOJ lenoidde jeuo!llpuo0 Al •panoaddsslQ -swooapaq JOJ panoiddy 3unIVNJIS SHHQ '9 �• NpISS3�py � AV1d "o : 9£L9 -3J �s•�Lp �/� ma1n8 y s(nol ' y (F • •�+wsasr'�s •s••• rrs�s• •� UstiA1y. •r= i� • •° ff . f / i ®► .40 alp(] ainleu6ls s,a99ul6u3 LLS66 XV ' zanzg aT52S ' V6ZELL X09 'O'd ssaappy 96TS-V69 auoyd s90tnzag 6u? zaauz5ug zanig 9T6eH wa!-� Jo aweN \ uolloadsu! s!yl 10 alep ayl uo 139119 u! suollelnBei pus 'seoueu!p,io 'sapoo 91e1S pus Ied!o!unVy IIs yl!m eoue!idwoo ui sl wels�(s Iesods!p aalpnnalsenn ao/pus Alddns aalsnn ails-uo ayl 'uolloadsul pus u01le61ls9nu! Aw woad pus sal!l 96eaoyouy to Al!ledlolunVy eqj wo.i j pau!elgo uo!lewio�u! ayl uo paseq leyl � j!aan aaylan} I 'ulaaay palpolpui aanlonals j'3 ad�(l pus swooapaq to .iagwnu ayl aol alenbape pup leuolloun j 'ales s! wals�(s lesodslp aalemalspm ao/pus �tlddns aalpm al!s-uo ayl 1pyl savoys uo!leolldds Ipnoiddy �(l!aoylny gjju9 .i slyl jo uo!le6!lsanu! ^ �(w leyl � j!uan I 'molaq uaaoys alsp uo!lep!Isn 941 10 ss pup olaaay pax!jje leas Aw Aq paiplaao sy 833NION3 AS N01103dSN1 =10 LN3W3.LviLS 'S Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: f%1 a/NIC N©OD Parcel I.D. QN 5-Z 3�i Ap 1 OT 5 1�C % A. WELL DATA 4 Well type COMMUNITZ If A, B, or C, attach ADEC letter. ADEC water system number Log present(Y/N)_ Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Date completed Cased to FROM WELL LOG Pump level SEPARATION DISTANCES FROM WELL TO: / Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line WATER SAMPLE DESULTS: Coliform Date o#4ample: B. SEPTIC/G-TANK DATA Nitrate Driller Casing height Wires properly protected (Y/N) AT INSP ION MUNICIPALITY OF ANCHORAGE ERVI'RUMENTAL SERVICES DIVISION 1 192 g.p.m. g.p.m. RECEIVED On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank Collected by: Other bacteria Date installed — 1:5�KA/16) Tank size 45 40 Compartments -2 Cleanouts (Y/N) y Foundation cleanout (Y/N) Depression (Y/N) n% High water alarm (Y/N) l Alarm tested (Y/N) Y of pumping ��AIX- DateZ . PumperS� �' S SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot l �� On adjacent lots t� Foundation To property I ine J Absorption field Water main/service line— Surface ine_Surface water/drainage /'�� 1 4-1v' 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed /q 0Manufacturer A1V6H Size in gallons ��~©U Manhole/Access (Y/N) Vent (Y/N) y "Pump on" level at q,-/ v "Pump off" level at L/ ZL High water alarm level zf ti Meets MOA electrical codes (Y/N) i por �e,—k Cycles tested 6 SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot N/A On adjacent lots O Surface water D. ABSORPTION FIELD DATA Date installed y/ �71' Soil rating System type ,3zr,- Len th �y / / ll�f 0 5 / g Width / Gravel thickness Total depth Total absorption area / Cleanouts present (Y/N) Depression over field (Y/N) /� Date of adequacy test Results (pass/fail) �'55 for ''�% bedrooms Peroxide treatment (past 12 months) (Y/N) /���� If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO/: Well on lot A144 On adjacent lots Property line Z l0 / To building foundation �o / To existing or abandoned system on lot A/ 1A On adjacent lots 7 Cutbank N.IA- Water main/service line 414) Surface water /,R0 Driveway, parking/vehicle storage area 40 Curtain drain /JIA E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect� og, ,Mate of this inspection. jtv.fry Signature v0 ••Qf Wcy¢�Iy�®Ot PE"®' Engineer's Name 1, r esa ®� a Louis A. C'ut9rp d t" Date G/ 7 (PCE 6736 d ` �' '' ee A HAA Fee $ /;za Date of Payment 6 ' ,1(9, -3 OL -1 Receipt Number 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number Sj'k O pp tShh WALTER J. H/CKEL, GOVERNOR LDEPT. OF ENVIRONMENTAL CONSERVATION RECEIVED ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 JUN 3 Q 1992 ANCHORAGE, AK 99503 Municipality of Anchorage Dept. Health & Human Services FOR: Eagle River Engineering June 17, 1992 PWSID # 213598 My review of the records on file in this office reveals that the Alpine Woods Class "A" Public Water System is in compliance with the routine coliform bacteria sampling requirements listed in Table C, and with the inorganic sampling (nitrate, as nitrogen, only) listed in Table B of 18 AAC 80.200. Sincerely, Rachel Clark College Intern RC/cf �11l printed on recycled paper by C.D.