HomeMy WebLinkAboutMANN BLK 1 LT 1AMann
Block 1
Lot i A
#020-041-26
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: ____-____-____
Legal Description Block Lot Property Owner Name & Address:
Pump Installation Date: _____-_____-_____
Pump Intake Depth Below Top of Well Casing: __________ feet
Pump Manufacturer’s Name: ___________________________ Pump
Model: _____________________________________
Pump Size: ____________hp
Pitless Adapter Burial Depth: _________ feet
Pitless Adapter Manufacturer’s Name: _________________________
Pitless Adapter Installer: ____________________________
Well Disinfected Upon Completion? XX Yes No
Method of Disinfection: _____________________________
Comments:
Pump Installer Name: __________________________________
Company: ___________________________________________
Mailing Address: ______________________________________
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 I_ Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME ' �'
PHONE (�
C/ Ll
CzJ NF -W
^^
--(/�}�'�;"l'yV.�', •��
❑UPGRADE
MAILINGADDRESS
LEGAL DESCRIPTION
L on
LOCATION
NO. OF BEDROOMS
-� V
U Y
Well - Absorption area -
DISTANCE TO:
Dwelling
PERMIT NO
D
H Z
hQ
Manufacturer
er'al
No. of co
�npartments
V)
Liq. ca acity�n gpllons Inside length
l� IF HOMEMADE: .`
ti_�
dth�
CSU
Liquid depth
®�
DISTANCE TO: Well elling
PERMIT N0.
0 FQ-
Ma ufa er rial
Liquid cap yin yallon
V PERMIT N0. nj ` Cl
J
O
-�
w
Well
DISTANCE TO:�
Founda ' n Nearest lot line/
_
J LL z
_z w
~
No. of lin Length of clt line
Total length q£ Trench widtt ��°-
_e
Distance lin
be ger
�F/
Q H
Top of tile to finish grade ^
�
Material beneath t Ie 7s
ff?cke_TP
Total effective absorpt_ =
w
Lenyth Width
Depth
PERMIT NO.
l7
a
Crib diameter
Crib depth
Total effectiv Iwrption area
t"Weld
rDISTANCE
ui mg foundation
p✓
Barest lot line
a
I
Depth
Driller
Distance to lot line
PERMIT NO. '
LU
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
-
- —
-
PIPE MATERIALS
D'303(-i,pert
SOIL TEST RATING
15 L)
�.
INSTALLER
.r
�;
7-
. ,.j
.,2. t;..,..:•
REMARKS
G1ti
rR
'1
s
APPROVED T DATE LEGAL
,on,,I . oi4o� - �—
V
rl k__q VA TE U." 1 � M_" B -u L_ I ".1_ ° r° 1; II F u u 1""4 a U-1 w m F,m,,
DEPARTMENT HEALTH AND ENT, IRON MENdTAL "OTEC:T'II_INd
"L STREET; ANCHORAGE, AK.
T'
2 C. 4-4 7'220
A 1➢ 1 _ _..- -T' _ =: C.:1-"4 IF fr-w: A°' EF 1 ° r 1 X. -I""
PERt�I:IT NO. ( ,i 0i ir;RI k'
APPLICANT JAMES 13. JUDGE PCI BOX, IC -i-,=::9..'9 2
LOCATION LONAOScu��if (;�
LEGALL1 81 MANN LOI SIZE 1E;B 600 SQUARE FEET
I'YPE OF SOIL ABSORPTION SYSTEM I S : TRENCH l�
t'11�;;:Itll.itl
NUMBER OF BID1=:CICIMS _ ilii_ F:ATTtIC, ::ul! FT;'E:k:)-. 150
THE REG TIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
G'�-. • -1,._I e r-:... "s 1 t' d 1 a 1-1-.1 o!7-5 1:3 F- : ! -1 °°,•° IF.:1._.
THE LEhIGTH DIMENSION I'S THE LF.•.'NGTF f (IN FEET', OF THE TRENCH OR CERN I FaF I EL._G:,.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE E'e-?CF•iVATIONa (IN FEET).
'THER'E IS P-40 SET WIDTH FOR TRENCHES.
THE: GF -.,A E:L DEPTH IS THE MIN'dIt'P_M DEPTH OF I3I<:t=VEL BETWEEN THE OUTFALL F'IF'E
FINE:- THE E"OTTCIt'I OF THE E,;C:F=1'VATIONd ::INS FEET).
IFS
I--- a R._u TL gw. Fz:-1-: ° °"; p= F-' _" 31 1�7- "i' F•-1111"-41-^-. =, 1: ZE I:—:;- p_ 9D-- NEW 1E A a F1 L,. 1__ 1l� I' -d ::
PERMIT FIPPI...ICANdT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
iN•ds"r'ALLATICINd INSPECTIONS OF FINN WELLS HE JAl_—:ENaT TO THIS PROPERTY AND THE
NUMBER BER IMF RE -.I U-EN•aC:E' � THAT THE NELL_ WILL SERVE.
1 PA y, F° E-: F" p _E
F+F11 k:F"]:LLINaI3
OF Ht'a'T SYSTEM WITHOUT FINAL_ INSPECTION AND APPROVAL BY THIS
DEF'F•iF:TME:NdT WILL BE SUBJECT TO PROSE131_ITICINd.
I''1I1'-11 MUM D I'm -TAN CE BETWEEN FI WELL- AND ANY ON ---:I T'E. SEWAGE D I SPC,ISAL .=SYSTEM is
: K"I FLET FOR H F'F!I',;'FITE WELL OF: 150 TO 200 FEET" FROM R PUBLIC WELL. DEPENDING'
UPON THE TYPE OF PUBLIC: WELL,
11 I hd I N1UM DISTANCE FROM H PRI',,—'ATE WELL TO A F'R I'-r'HT'E SEWER WE:R I_INE IS 25 FEET AND
TO t•1 C(.1N111UNdITY SEkIER LINE IS 5 FEET.
EITHER REQI_FIREMEh'IT.S MAY APPLY. SPECIFICATIONS AND CONaSTRUC;TIONd DIACjRNI''1_; ARE
AlvIAIl_ABL."E TO INSURE PROF',ER INSTALLATION.
IC`° I� A_. E-_ jr-1 FD E. Fn-.
I CERTIF',' THAT
I AM FAMILIAR WITH 'THE REI!L.IIREMENdTS FOR OlF+-'ITE SEWER:'= FIND WELLS AS SET
FORT FI BY THE hUUNd I C:I PAL I T',•' OF ANCHORAGE.
: I HILL.. INSTALL THE SYSTEM IN FIC CIF:DF114 E WITH THE CODES.
I LR-dI::,E::Rs"rAND THAT THE ON ---SITE '=EWER SYSTEM MAY RE131_iIRE ENLARGEMENT IF THE.
RESIDENCE IS REMODELED TO INCLUDE LUDE MORE THAN 3 E,EDROI':II''1,::.
SI QNdEE):
APPLICANT JAMES G. :TI. DGE ! � �
$L
�60
tl- v
V4. 0
/-V)
c. %a qX
I
I
I t_s�ts�;t�T'1a�t�+
€�3�'i'6a
t}?fifF'St E_ tt 3._;Fi itF'1GitiflFdF'=�'Fiti!_ f�fi€IFs. i5?
SHOW
JIIME,5, Ax. .31-1013F
t_.UNR T
t_'l .131. F'INNN
ON-
344
N�
{_t E1' `5 rs is: atS4 '14"ts_tFi�, Fzi_qj
TYFIF QW, SOIL au'50111 N ON _` Y,3 FF't'i V;: 1"I -;e F•#+:;11
I
MV [1,11-M t-V,tt ;DF -R I-IBCORQ1NIS -; 3 SOIL 1FRRYINIj (1159 i= I'.r Op'
I
' 11
R131x.11€ UN
'5t4�
154-
THE
'50R. A8S13 # j1 T D}F(
e+Fr`,3 r0l
I S :
i—. 01TH CIUMd>€SIfps,a is TM FXNJITH ( Un IN [ € A 131 THE TRUM-11 E_€R
€ s 1la:3mi cm= A y'; ;-`:A#_'.g ter; d5 L ir r; Tiii E) t s i #itis,'
Ii
s ;Y sE3pd�3 I NI) THE 89r14:
DEPTH
FFET
SOIL
DESCRIPTION
NOTES
1'
Orange Topsoil & SA - GRV
B
j
'mss �y'
COBS T RJCTION
1800 W. 48TH AVE. STE.
Bel, Dr "
TEST
LAB
ANCHORAGE, ALASKA 99503
248-1333
and Boulders
Dense -
PERFORMED FOR:
JIM JUDGE
5 5'
DATE PERFORMED: 7/31/80
LEGAL DESCRIPTION: Lot_ _
Block I Q ewer, _Subdivision
i
MANN
THIS FORM REPORTS: O Visual Soils
Examination
_
i� Percolation Test TEST HOLE #2
DEPTH
FFET
SOIL
DESCRIPTION
NOTES
1'
Orange Topsoil & SA - GRV
7 • 5
Brown_=GU
Brown GRV - b1 s
Bel, Dr "
Brown GRV - SA w/Cobbles
Dry
and Boulders
Dense -
5 5'
Brown GRV - SA
Rel.
-
Loose
--6.
-SP-
Silty Sand w/Cobbles and
- 11'
Boulders
—16
WAS iGROUND WATER ENCOUNTERED`. Yes
,F YES, WHAT DEPTH 11',-
_EGEND•
- 'Pert zone
3 S -' ample taken
;F Frozen zone
7 - Water table
ZEADING I DATE I GROSS TIME. , I t
C;, Kinney R. 6 ler •:
3656. E .•' C�
3:
a'
U
Z
GENERAL SITE SLOPE
'ERCOLATION .RATE: 7 Min/Inch DRAINAGE REQUIREMENTS' 140 S.F. /B. R.
'ROPOSED INSTALLATION: o SEEPAGE. PIT 0 DRAIN`:' FIELDO OTHER,--
'OMMENTS
NET DRAINAGE
"EST PERFORMED BY: LB DATA CERTIFIED BY: Kinney R. Baxter, P.E.
DATE: 8/1/80
l3ox 1369, STAN Houmo A ANcmouAGEs Ax,AsiKA 905o2
344-7714
SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF 120 Teet• _
DRILLED AT THE RATE OF $19.00 PER FOOT. MU _ NcIpAory OF ANc
PROPERTY OWNER .� e
279-8550 344-6340 — ENVIRONMENTAHEA�ry&ORALE
LOCATION OF WELL SITE Lt_ 1 BLS.. i Sttlf_ MA"A)
DRILLER Be4 to gu &mpaat D .e l l inn 4Jaa�u
WELL LOG:_
0-----76' S.i i t<7. 4andk clad, w.t A 35/ cNiavet mate j4' ,t S4A&, . auA&ace watet at 73 to
15 deet. Rot phodac t i,ve ion L7e U u4e-,
16-.:-38' Handpaa w.t th 15%yzwe,t to the 4,zma rz..
38--720' Bedtock. R .jed imen� Hack. Thdrr anea.�a wa-tet Geon Ronou4 nock.
93- 98 .deet an area o� g ar� nock which iycoved out to produce two g?ln.
Th.i4 a2ea and th-tn anea4 above .jh outd .in.c&eaoe 30 .ta 40% with u4e. 7h&Uffl and
erten.
Seve,tat mane ,thin a)=4 of-p.onou/j nock. Thom 705 to 778 Peet.
Tota C c teed .jhou ld tac to we to a aa44 bte 59AW wi th u4c. Ou" 770 feet o-� wat-vi
,dtanc my in ca4-iaq. 1.6 qa 4 pet foot. 176 ga(4 of wateA on demand on pt U
necove�.
7/3 on 7/2 HOA4c Su inawzzZ&-te 7'uaa 4hou td &e ina.tai t ed 5 .to 10 feet og ,bot tom.
CO -A of $19 X 120 4: 92280.00
C04 t al- Nett Seat: 922.00
COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING.
WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF $2302.00
THANK YOU VERY MUCH.
BERNIE CLAU:i_OF RAMPART DRILLJNG WORKS t
'TE— �e 7-th.R 7.80 \ Q s (
SERVICE CHARGE 0 F 1 %a% PER MONTH WILL 13E ASSESSED ON PAST DUE ACCOUNTS.
-PARTMENT HEALTH AND ENVIRONMENTAL OTECTION
802:5 'L-' STREET.- ANCHORAGE., AK 99501
264-4720
PERMIT NO. 8001778
APPLICANT JAMES B. JUDGE PO BOX 10-2192 344-6340
LOCATION LONG DR
LEGAL LiBi--MANN S/D LOT SIZE 111400 SQUARE FEET
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON—SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 130 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET FIND
TO A COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIF',.'ED AND M1_Gt'BE RETURNED TO THE DEPARTMENT WITHIN2,cl DAYS
CIF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
I CERTIFY THAT
1 : I Ail FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS FIND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: 1'. 14ILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
SIGNED
I
---- DATE_J�__; V4. 0
f;!E: -JEf N A t EU— AND ANY QN-~ :I N6 .=Ct+t;Jr3C- .t] I�,l P.1'� � -i` l;,3l i J4 T `S
l0j.�'i k,w t r1q t3 PR. ;Rf 1ts i__u op, t�r� ro 2)-1 Ivr'iEt i=rfnm Fi pt".i
►.$�n't_i_. E��;'�I'It>il°d��
1.1Pi iii THC T'rf F' O
t'1mkl°t11vi o¢ lrnnbcF- H plyll-iFtEE {'I1EtJ. Y0 R PIPI:W:F#z_ SI -:1-1-R L, F. C.' (%S :y5 VFtom1'
FiIVI-y_ ))_.iris PARC )�:E!{a#�rFRED i�t'10 ttUSr 0C �'.£zi`i-121-10) O T=�=" DEPTIl�` MIEN! t•ti'fHIN 3 £�R
OF _j 1 i i` ti G..1_ i3O,l�4 k_ F T li4..
OTHE.R i'1't"i'r' tv,f-'t.'t'. ams 1:I1 l+ ftF[t plz ? tt? ).7-P5 Firth"{ Ii1I# DCt`tPARIVr5
y a rr; tI 111 T IEL t'#i,NIGIt tif_[Tj�
I' '.d igit, iII` , il1.l T;1+.= OPRO�I•>CF. 144 M 'f`,�L C,i3t ES.
V4. 0 +
[ oma.- Tis €.."_ T I- Y,e j�+..� { _,'
10 P --c T 1 Ott
1-3 IL __. L T-
f" i" �..� L{-.1 fP•S 4
�J t 7P't'.e �S . 'rt i� w
� [ S✓�.JX io _' 1 `�E�
i• 14
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11
LEGAL
Uol. i'lrINN 131 -JD
LOT
m IZE l`Lt4h,Y0
`"rOt,tAP
f;!E: -JEf N A t EU— AND ANY QN-~ :I N6 .=Ct+t;Jr3C- .t] I�,l P.1'� � -i` l;,3l i J4 T `S
l0j.�'i k,w t r1q t3 PR. ;Rf 1ts i__u op, t�r� ro 2)-1 Ivr'iEt i=rfnm Fi pt".i
►.$�n't_i_. E��;'�I'It>il°d��
1.1Pi iii THC T'rf F' O
t'1mkl°t11vi o¢ lrnnbcF- H plyll-iFtEE {'I1EtJ. Y0 R PIPI:W:F#z_ SI -:1-1-R L, F. C.' (%S :y5 VFtom1'
FiIVI-y_ ))_.iris PARC )�:E!{a#�rFRED i�t'10 ttUSr 0C �'.£zi`i-121-10) O T=�=" DEPTIl�` MIEN! t•ti'fHIN 3 £�R
OF _j 1 i i` ti G..1_ i3O,l�4 k_ F T li4..
OTHE.R i'1't"i'r' tv,f-'t.'t'. ams 1:I1 l+ ftF[t plz ? tt? ).7-P5 Firth"{ Ii1I# DCt`tPARIVr5
y a rr; tI 111 T IEL t'#i,NIGIt tif_[Tj�
I' '.d igit, iII` , il1.l T;1+.= OPRO�I•>CF. 144 M 'f`,�L C,i3t ES.
V4. 0 +
I
MLinicipality of Alhchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragaw, Street
P.O. Box 196650
Anchorage, AK 99519.6650
www.muni.org/ortsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Ob
FOR A SINGLE FAMILY DWELLING
Parcel I.D.
D. D o -O LI F 9_4o Cos it Pla) 96
1. GENERAL INFORMATION Expiration Date: -7-5--07-
Complete
-"Jr-0
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
MANN SUBDN4SION LOT 1A. BLOCK 1,
16021 ELIZABETH STREET
JIM ROGERS Day phone 770-4112
12450 MCLAIN ROAD " ANCHORAGE AK 99516
Day phone
BARBARA BOWDEN w/PRUDENTIAL VISTA Day phone 727-2272
16635 CENTERFlLED DRNE • EAGLE RIVER,_AK 99577
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual Well
N
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
N
Individual Holding tank
❑
Community On-site
❑
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 On -Site 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 samples. (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
5.
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 onsite 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
onsite 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 Finn GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179
Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE. AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date Z
Engineer's Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system In accordance with ADEC and MOA
DSD Guidelines 6 Regulations. The reported results described the performance ofthe
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 local soils condition, groundwater 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 the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or Arturo estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party Is not authorized, nor will confer any legal right whatsoever.
Conditional approval for
bedrooms, with the flloWng
Attachments:
COSA Checklist �5.�
/
Arsenic Advisory
Septic System Advisory
Maintenance Agreements
Well Flow Advisory
Supplemental Engineer's Reort
Nitrate Advisory
Other
By: Original Certificate Date: �I " 07
(Rw.IIM)
Municipality of Anchorage ,
Development Services Department
Building Safety Division
Onsite Water & Wastewater Program
4700 Bmgaw Street
P.O. Box 196850
Anchorage, AK 995198650
www.munLory/onslte
(907)343.7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: MANN SUBDIVISION LOT 1A, BLOCK 1, Parcel ID:
A. WELL DATA *PER WELL LOG, CASED TO 120 FEET, HOWEVER, IT IS PROBABLY OVER
Well type PRIVATE If A, B, or C provide PWSID# N/A
Date completed X7/1980 Sanitary seal (YIN) YES
Total depth 120 ft. Cased to ' 120 ft.
FROM WELL LOG
Date of test 6/7/1980
Static water level 10 ft.
Well production 2 g.p.m.
WATER SAMPLE RESULTS:
Coliform 0_ colonies/100 ml. Nitrate _J q+_ mg./L.
Well Log (YIN) YES
Wires properly protected (YIN) YES
Casing height (above ground) 24 in.
AT INSPECTION
3/20/2007
22 ft.
2.5 g.p.m.
Other bacteria 0 oolonies/100 ml.
Arsenic: _bLQ ug./L. Data of sample: 3/20/2007 Collected by: GEG. Ltd.
B. SEPTIC/HOLDING TANK DATA
Tank TypelMaterial SUNSET/PLASTIC Date installed 9/27/1980
Tank size 1000 gal. Number of Compartments 2 Cleanouts (YIN) YES
Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) N/A
Date of pumping 3/20/2007 Pumper MCDONALD'S PUMPING
C. ABSORPTION FIELD DATA
Date installed 9/27/1980 Soil rating (g.p.d./Wo(q!!EE0 150 System type WIDE TRENCH
Length 64 (2032) ft. Width 4 A. Gravel below pipe 3 ft.
Total depth '9.3 ft. Eft. absorption area 458 ft' Monitoring tube YES Depression over field NO
Date of adequacy test /22/07&3/30/07 Results (Pass/Fail) PASS For 3 bedrooms
12 380 27
Fluid depth in absorption field before test 33 in. Water added 452 gal. New depth 49 in.
1112 18
Elapsed Time: 150 min. Final fluid depth 44 in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN 8 type) NONE KNOWN If yes, give date —
'PRESOAK BOTH TRENCHES WITH 1000 GALLONS EACH
D. LIFT STATION
Date installed
"Pump on" level at _in.
E. SEPARATION DISTANCES
Size in gallons
"Pump ofP
Manhole/Access
water alarm level at
Cycles tested Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main N/A
Sewer /septic service line 25'+
Public sewer manhole/cleanout N/A
Holding tank N/A
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line
10'+
Building foundation
10'+
Water main_ N/A
Water service line
10'+
Surface water
'95'
Driveway, parking/vehicle storage 2'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS "PER 1994 HAA. NO SURFACE WATER NOTED DURING 3/22/07
SITE VISIT; HOWEVER SNOW WAS COVERING GROUND.
G. ENGINEER'S CERTIFICATION
I cagily 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 JEFFREY A. GARNESS
Date tk J04
COSA Fee S v/ 310 • 0o
Date of Payment Il—,5—()-7
Receipt Number 7 6 .S e I
(Rev. 11105)
WaiverFee$_i1 -75.00 but
Date of Payment
Receipt Number
NOTE:
LOT lA INC
IS ACROSS
ELIZABETH
LOT 2
r
M
O
m
t7
3
O
O
N
0
O
Kj
S B9'55'00"E 150.05
I OR.V[L
I .RLA ND I
�I� I
S/krR
210
EE -9
L..LMLNT
W.4;�®
O
.•6LN ��YpoH SE �
EaP 3
0
rO+ r
N
LOT 1 B
DY,[LL - o OF A....�
v,�E......... 4
oo�P•.. S 001
paw' 49T --~e
Vol'.'PBHHOLT.'
LB -6914 ;`
N B9°59'16"E 150.00'
AS -BUILT SURVEY
SCALE: I' -4(r
1 HEREBY CERTIFY THAT 1 HAVE PERFORMED A
MORTGAGEE'S INSPECTION OF THE FOLLOWING
DESCRIBED PROPERTY.
LOT IA. BLOCK /. MANN SUB.
EXISTING STRMTURES MO PLATTED LOT LINES OR EASEMENiTS AND IS HOT TO BE USED FOR PMITIOMNO ADDITKINKN
ANCHOR THAT
IMPROVEMENTS RIOT. ALASKA AND
ANCHORAGE RECORDIMENTNG S SITUATED THEREON
EONME
STRUGTuRES OR FENCELWESWITHIN
LE
THE PROPERTY LINES AND THAT NO VISIBLE
1
ENCROACHMENTS EXIST OTHER THAN NOTED.
NOTE ANY FENCELw S SHOWN ME LOCkMOAPPROXBMTELY AND ME NOT TO BE USED TO DETERMINE PROPERTY LINES
DATED AT ANCHORAGE. ALASKA THIS _15TH_
OR LOCATE STRUCTURES
OXATE DUE TO SNOW CONDTIONS_
ANY PAYING SHOWN MAv BE APPRAI
DAY OF DECEMBER 2008_
HOLT LAND SURVEYING 5211. FS 5028.126-51
TEL. 345 5513
O
.•6LN ��YpoH SE �
EaP 3
0
rO+ r
N
LOT 1 B
DY,[LL - o OF A....�
v,�E......... 4
oo�P•.. S 001
paw' 49T --~e
Vol'.'PBHHOLT.'
LB -6914 ;`
N B9°59'16"E 150.00'
AS -BUILT SURVEY
SCALE: I' -4(r
1 HEREBY CERTIFY THAT 1 HAVE PERFORMED A
MORTGAGEE'S INSPECTION OF THE FOLLOWING
DESCRIBED PROPERTY.
LOT IA. BLOCK /. MANN SUB.
EXISTING STRMTURES MO PLATTED LOT LINES OR EASEMENiTS AND IS HOT TO BE USED FOR PMITIOMNO ADDITKINKN
ANCHOR THAT
IMPROVEMENTS RIOT. ALASKA AND
ANCHORAGE RECORDIMENTNG S SITUATED THEREON
EONME
STRUGTuRES OR FENCELWESWITHIN
LE
THE PROPERTY LINES AND THAT NO VISIBLE
EASEMENTS OF RECORD. OTHER THAN THOSE SHORN ON THE RECORDED PLAT. ME NOT SHORN HEREON.
ENCROACHMENTS EXIST OTHER THAN NOTED.
NOTE ANY FENCELw S SHOWN ME LOCkMOAPPROXBMTELY AND ME NOT TO BE USED TO DETERMINE PROPERTY LINES
DATED AT ANCHORAGE. ALASKA THIS _15TH_
OR LOCATE STRUCTURES
OXATE DUE TO SNOW CONDTIONS_
ANY PAYING SHOWN MAv BE APPRAI
DAY OF DECEMBER 2008_
HOLT LAND SURVEYING 5211. FS 5028.126-51
TEL. 345 5513
SGS ReEN
Client Name
Project NamdM
Client Sample ID
Atatrix
PWSID
Sample Remarks:
1071121001
Garness Engineering Group, Ltd.
Mann Subdivision Lot IA Bk 1
Mann Subdivision Lot IA Bk 1
Drinking Water
0
All Dates Thnes are Alaska Standard Time
PrintedDatetrime 04/032007 15:55
Collected Daterrlme 03202007 13:50
Received Datdrhne 03202007 15:25
Technical Director Stephen C. Ede
14etals Department
Hardness as C&CO3
Private individual Analysis
Aluminum
Antimony
Arsenic
Barium
Cadmium
Calcium
Chromium
Copper'
Iron
Lead
Magnesium
Manganese
Phosphorus
Chloride
Fluoride
Potassium
Selenium
'Sodium
Silicon
Silver
Thallium
Sulfate
233 5.00 mg/L SM202340B C 0327/07 0329107 TK
ND
-
ug/L
EP200.8
Allowable Prep Analysis '
Paramder
Results PQL
unit
Mcdad
Com&ai ID Limits Date Date Init
Nitrate -N
Nitrite•N
3.94 0.100
ND 0.100
mg/L
mg/L
EPA3532
EPA 3532
B 0320/07 IDS
B 0320/07 IDS
14etals Department
Hardness as C&CO3
Private individual Analysis
Aluminum
Antimony
Arsenic
Barium
Cadmium
Calcium
Chromium
Copper'
Iron
Lead
Magnesium
Manganese
Phosphorus
Chloride
Fluoride
Potassium
Selenium
'Sodium
Silicon
Silver
Thallium
Sulfate
233 5.00 mg/L SM202340B C 0327/07 0329107 TK
ND
20.0
ug/L
EP200.8
C
0327/07 0329!07
TK
ND
1.00
ug/L
EP200.8
C
(<6)
0327/07 03/30107
TK'
ND
5.00
ug/L
EP200.8
C
(<10)
0327/07 0329/07 .
TK
893
3.00
ug/L
EP200.8
C
(2000)
0327/07 0329107
TK
ND
0.500
ugh
EP200.8
C
(<5)
0327/07 0329107
TK
69300
500
ug/L
EP200.8 .
C
0327/07 0329/07
TK
ND
1.00
ug/L
EP200.8
C
(<100)
0327/07 0329107
TK
20.9
1.00
ug/L
EP200.8
C
(<1300)
0327/07 0329107
TK
345
• 250
ugh
EP200.8
C
(<300)
0327107 0329/07
TK
ND
0.200
ug/L
EP200.8
C
(<15)
0327/07 0329/07
TK
14500
50.0
ugh
EP200.8
C
0327/07 0329107
TK
2.18
1.00
ug/L
EP200.8
C
(<50)
0327/07 0329107
TK
ND
- 200
ug/L
EP200.8
C
0327/07 0329/07
TK
23.5
0.100
mg/L
EPA 300.0
B
(-*50)
0327!07 0323/07
IDS
ND
0.100
mg/L
EPA 300.0
B
(-*)
0327/07 0323107
IDS
ND
S00 .
ug/L
EP200.8
C
0327/07 0329107
TK
ND
5.00
ug/L
EP200.8
C
(<50)
0327/07 0329/07
TK
6430
500
ug/L
EP200.8
C
(-*50000)
0127/07 0329/07
TK
6250
200
ugh
EP200.8
C
0127/07 0329/07
.TK
ND
1.00
ug/L
-EP200.8
C
(<100)
0327/07 0329107
TK
ND
1.00
ugh
EP200.8
C
(-*)
0327/07 0329107
TK
22.1
0.100
mg/L
EPA 300.0
B
(-*50)
0322107 0323/07
IDS
SGSRcE#
1071121001
Gamess Engineering Group, Ltd-
Client Name
ProjeclName/q
Mann Subdivision Lot IABkI
Client Sample ID
Mann Subdivision Lot IA Bk I
Matrix
Drinking Water
All Dates7Cimes are Alaska Standard Time
Printed Date/time 04/032007 15:55
Collected Date/time 03202007 13:50
Received Date/time 03202007 15:25
Technical Director Stephen C. Ede
Allowable Prep Analysis
ftnuoC.er
Results PQL Units Medved Container ID Limits Dam Dam kris
Private Individual Analysis
241
10.0
mg/L SM20 2540C
D
(<500)
0324/07
ACF
Total Dissolved Solids
ug/L EP200.8
C
(<5000)
0327107 0329/07
TK
Zinc
8.56
5.00
2.00
ug/L EP200.8
C
(<100)
0327107 0329/07
TK
Nickel
ND
460
1.00
umhos/em S)M0 2510B
D
0327/07
KP
Conductivity
6.91
0.100
pH traits EPA 150.1
D
(6.5-8.5)
0321/07
AZS
pll
eoVl00mL SM20 9222B
A
(<I)
0320/07
DPT
Total Coliform
0
MUNICIPALITY OF ANCHORAGE
• DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # -� ` 04.1 `A�" HAA # L- nc)i y
1. GENERAL INFORMATION /
Complete legal description �� ( �� �-
���
Location (site address or directions)
Property owner
Mailing address
Lending agency
Mailing address /
Agent
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual well _
Community well
Public water
Day phone S-"' S
Day phone
Day phone
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
Holding tank
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
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I 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 (��� �G�-r�r�(��G�T,� Phone
Address l
z
Engineer's signature � Date
+' 9
6. DHHS SIGNATURE `,
Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Additional Comments
By.Date 2 -2- - qy
1l1TIC.
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 inorderto 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 (Rev. 1/91) Back MOA N21
.K Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: L-0-1 11 A4 g Y, I Parcel I.D. 0,20
A(N N s
A. Well Data
Well type t2 If A, B, or C, attach ADEC letter. ADEC water system number N 'JA
Log present (Y/N) Date completed t4 i•( �-D Driller RO-yyt.r�a.v-`i
Total depth 120 Cased to E"4 00.� Casing height
.9-0
Sanitary seal (Y/N) Wires properly protected (Y/N)
n
z
FROM WELL LOG AT INSPECTION
A
/ p
1017 18 d Z/7
o Z
Date of test (R
Static water level L D C .- L4
t
a
C
Well flow m. m
gp gp
F
S., <p
Pump levelt ��t"�� i F®�-
l
n J
C
-i
SEPARATION DISTANCES FROM WELL TO:
o
zr
Septic/holding tank on lot On adjacent lots >> (�
_
Absorption field on lot > /,'z2 ; On adjacent lots % /D eZ
Public sewer main Iy/A Public sewer manhole/cleanout N
Sewer service line > 50 Petroleum tank \,-I Io
WATER SAMPLE RESULTS:
Coliform Nitrate c2_ 7 J Other bacteria �✓
Date of sample: 17 /9 L/ Collected by:
-7`�S,
B. SEPTIC/HOLDING TANK DATA
Date installed ?�a.2/a0 Tank size Inn Compartments I
Cleanouts (Y/N) —/ _Foundation cleanout (Y/N) N Depression (Y/N) N
High water alarm (Y/N) N�/-\ Alarm tested (Y/N) N��l
Date of pumping L Awr! s�Jf l3 Pumper
-.,- or
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot 112" On adjacent lots >i ) 0"> Foundation .3 p L_
To property line �z 10 Absorption field (0 Water main/service line 0
Surface water/drainage >.100
72-026 (3/93)• Front CONTINUED ON BACK PAGE
C. LIFT STATION
l
Date installed
rer
Size in gallons Manhole/Access (Y/N)
Vent (Y/N) "Pump on" level at "Pump off" Level at
High water alarm level
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot
D. ABSORPTION FIELD DATA
On adjacent lots
Cycles tested
Surface water
Date installed gJA7(,-o Soil rating (GPD/Ftz) j Gad System type l (_tMC,4
Length o2 X3,2- Width
Gravel thickness
Total depth
Total absorption areaqq L/ 5 A—Cleanout present (Y/N) i Depression over field (Y/N) Nj
"Z
Date of adequacy test 7/Q K Results (pass/fail) for Bedrooms
�r/
Water level in absorption field before test o7C6J After test z�o
Peroxide treatment (past 12 months) (Y/N) /Y If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot > /;?-Z On adjacent lots "� /&-0 Property line
To building foundation
To existing or abandoned system on lot NSA
On adjacent lots > ! n-&� Cutbank No K e,- Water main/service line >50
Surface water 40ko> 9 Driveway, parking/vehicle storage area
Curtain drain /�f (D -K
E. ENGINEER'S CERTIFICATIONQ `i�C + 4�1 -�
ci{a.w
I certify that l have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
HAA Fee $
Date of Payment
On •c)?)
�Z_ -/4-
Receipt Number e5_4 (n e
r--' 7
72.026 (3/93)' Back
Waiver Fee $
Date of Payment
Receipt Number
s.,c, __E
COMMERCIAL TESTING & ENGINEERING CO.
ENVIRONMENTAL LABORATORY SERVICES
Drinking Water Analysis Report for Total Coliform Bacteria
6633 B STREET
READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE ANCHORAGE. TEL(907) 562-2343518
62 2343
FAX: (907) 5615301
=• ' ` � Qlviri.C. triJ BY WATER SUPPLIER
❑ PUBLIC WATER SYSTEM I.D. R
C PRIVATE WATER SYSTEM
❑ Send RerulLs ❑ Send Invoice i '
lPz;c Sys: Nsae'co .?'y:: z -v
Cc-ar..^s:.e
Ynonei um cr
tax, umoer
❑ Send ResuUs 7� ❑ Send Invoice
CN A
SA-`4PLE DATE:
Month
E1J
Day
SAMPLE TYPE:
Routine
❑ Repeat Sample (for routine sample
with lab ref, no.
❑ Special Purpose
SAMPLE LOCATIOir'
91
Year
0 Treated Water
Untreated Water
Time Collected
Collected By
L,e>-�IA Bk 1 MAH i—;S
TO BE COt1WLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
Satisfactory
❑ Unsatisfactory
❑ Sample over 30 hours old, results may
be unreliable
❑ Sample too Iona in transit; sample should
not be over 48 hours old at examination
to indicate reliable results. Please send
new sample via speciallive
Date Received Z �/
Time Received p /
Analysis Began Z-7— ( ( 00-0
Anal} -tical Method Membrane Filter
❑ MIN40-MUG
Number of colonies/100 rnl.
Lab Ref. No, Result* Analyst
l u4"0595 5 I�
Sent to A D.E.C. Lch lbks JunEl
Faxed
Date: Tim;:
Client notified of unsatisfactory results:
Phoned Spoke with
Fazed
Date Tim,
BACTERIOLOGICAL WATER ANALYSIS RECORD
-MUG Result: Result: Total Coliform
E. Coll
Membrane Filter: Direct Count Q
Colonies/too ml
Verification: LTB
Fecal Coliform Confirmation
ME
COLIFIRAi T•\7C=Too,Vu,. r... To Col,
Final A4embr2ne Filter Results
Coliform/loo ml
Comments:
Reported By *V�g Date d Time �00
h rs
03 =0lk rr Bc: vi¢
� �sas r.tem _r ;r,. scs FART ONE OF TYdLI:
co! G REMAINDER TO FOLLOW
Cas In A_As{;,. =.,co. UTAH. I_un�o!s
Commercial Testing & Engineering Co.
zfL Environmental Laboratory Services®����������������®�����,����s���a
SINCE 1908
REPORT of ANALYSIS 5633 B Street
CT&E Ref.# :94.0596-1 Anchorage, AK 99618-1600
Client Sample ID :L1A B1 MANN Tel: (907) 562-2343
Matrix :WATE:R Fax: (907) 561-5301
Client Name :TOBBEN SPORKLAND, P.E.
Ordered By :TOBBEN SPURKLAND
Project Name
Project#
PWSID :UA
Sample Remarks: ROUTINE SAMPLE COLLECTED BY: T.S.
Parameter
Nitrate -N
WORK Order :75663
Printed Date :02/10/94
Collected Date :02/07/94
Received Date :02/07/94
Technical
Director
Released By
@ 12:40 hrs.
@ 11:35 hrs.
@ 16:45 hrs.
QC Allowable Ext. Anal
Results Qual Units Method Limits Date Date Init.
2.75 mg/L EPA 353.2/300.0 10 02/09 LGH
* See Special Instructions Above UA = Unavailable
** See Sample Remarks Above NA = Not Analyzed
U = Undetected, Reported value is the practical quantification limit. LT = Less Than
D Secondary dilution. GT = Greater Than
_ _ _ _
r Member of the SGS Group (Soci�td G�nrsrale de Surveillance)
ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO, UTAH, WEST VIRGINIA
-
DATE RECEIVED
INSPECTION APPOINTMENTS
�.
TIME
TIME
TIME:
NUMBER OF,BEDROOMS
Ell-�Sl NGLE FAMILY
lC:� ,
DATE
DATE
DATE
Ed----r`hree ❑ Six
7. WATERRSUPPPPLY
64
*
INSPECTOR
INSPECTOR
INSPECTOB--
MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH &
PROTEC-AAbYJRONMENTAL PROTECTION
DEPARTMENT OF HEALTH & ENVIRONMENTAL
B25 L Street - Anchorage, Alaska 99501
• 11.P!231981
ENVIRONMENTAL SANITATION DIVISION
Telephone 264-4720 RECEIVED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTYOWNER
PHONE
Ame S &
MAILING ADDRESS _
P.O. eoX
PROPERTY RESIDENT (If different from abov I
�NiJ
PHONE
21-3 a %)eb eA4
2. BUYER
PHONE
MAILING ADDRESS - -
3. LENDING INSTITUTION
i bt'U L 649AIL D 2
PHONE
MAILING ADDRESS
4. REALTOR/AGENT -
PHONE
MAILING ADDRESS
5. LEGAL DESCRIPTION
Lam- /.4 '61
('
Mann rJUL),'siQr7
STREET LO/`CATION
_ c� L
L U4 42— CSL ie to T
6. TYPE OF RESIDENCE
NUMBER OF,BEDROOMS
Ell-�Sl NGLE FAMILY
❑ One CI Four ❑ Other
❑ Two ❑ Five
❑ MULTIPLE FAMILY
Ed----r`hree ❑ Six
7. WATERRSUPPPPLY
64
*
INDIVIDUAL*
ATTACH WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTI LITY
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
E!r' INDIVIDUAL/ON-SITE**
1qR0YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. 6/79) /
I\,.o
72-010 (Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE ❑ THREE ❑ FIVE
❑ TWO ❑ FOUR ❑ SIX
❑ OTHER
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON -SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED
c)
INSTALLER
❑Septic Tank or ❑ Holding Tank
Size: /000 If Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK
MANUFACTURER Q
TOTAL ABSORPTION AREA
MATERIAL !1 j
4. DISTANCES
WELL T0:
Septic/Holding Tank
Abs rption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
7? -"APPROVED FOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE
BY
72-010 (Rev. 6/79)
June 25, 1981
825 "1.." STRI L:f
AJCHOfiAG[_, ALASKA 99501
(90-/) 264-11111
GEOHC M. SULLIVAN,
MAYUH
DEPAH"fMC'N`10 FII:ACTIIj-."jr l'-V'UIRONMf_N7nLPHo7Ccl1oN
i
P �
James G. Judge
Post Office Box 10-2192
Anchorage, Alaska 9951-1
Subject: Lot 1A Block 1 Mann 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 i:o be delivered to
this offices from the Chem Lab, 5633 B Street, for
our review.
(2) The top of the well casing sealed with a sanitaxy seal.
so that- it is water tight. Tf 'there is a seal_ on the
well. head, this needs to be,tightened.
(3) Exposed electrical wires to the well head are in
violation of the Municipality bf Anchorage codes and
must be encased in conduit.
(4) A cleanout to the sewer system is broken and needs to
be replaced.
Please notify this office for a reinspection when the noted
descrepancies have been corrected. if there are any further
questions, please call this office at 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist
RCP/ljw
cc: First National Bank of Anchorage
Post- Office Box 720 99510
