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HomeMy WebLinkAboutPARADISE VALLEY BLK 7 LT 4Paradise Valley Block 7 Lot 4 #020-413-17 Jun 30 1105:01 p Beau Maxim 19073391985 Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Mark Begich Anchorage, AK 99507 Mayor www.muni.org/onsite (907)343-7904 Rump Installation Log Well Drilling Permit Number: SW. Parcel Identification Number: Date of Issue: ILegal Description Property Owner Name & Address: PARADISE VALLEY BLK 7 LT 4 Diana Strcok Pump Installation Date: 6/20/11 Pump Intake Depth Below Top of Well Casing: 185 Pump Manufacturer's Name: GOULDS Pump Model: 7SS07422C Pump Size 3i4 hp Pitless Adapter Burial Depth: .10 feet Pitless Adapter Manufacturer's Name: CAMBEL Pitless Adapter Installer: N1A feet 5911 Austria Dr Anchorage AK Well Disinfected Upon Completion? ✓❑ Yes ❑ No Method of Disinfection: RECIRCULATED USING CHLORINE PELLETS Comments: Pump Installer Name: BEAU MAXIM p.7 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation_ <o x. Q C. Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation_ Municipality of Anchorage •%'' ' ° Development Services Department Building Safety Division Onsite Water and Wastewater Program, 4700 S. Bragaw SL P.O. Box 196650 Anchorage, AK 99519.6650 Page I of Z www.ci,anchorage.sk.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW020439 PID Number: 02041317 Name: Diana Strzok stem: Wastewater S y ❑New ❑ Upgrade Address: 5911 Austria Dr., Anchorage 99516 No Ch Mi e, ABSORPTION FIELD Prone. 348-0114 Number of Bedrooms: 3 Trench ❑Shellew Trsnch❑sed ❑Mand ❑other: LEGAL DESCRIPTION Sal Rating: NA Total Depth from original grade: GPDIFP Ft. Bleck: LOI: Subdivision:Depth 7 4 Paradise Valley to pipe bottom from on 1 grade: Gravel depth beneath pipe: Ft. FL Township: - Range: ....... Section: Fat added above original grade: Gravel Length: . Ft. Ft. We [:1 New ❑Upgrade Gravel vAdth: Number nes: Distance between llnes: Ft. FL Classification (Private, q Total Depth: Cased to: Total absorption area: Pipe Material: Ft. I FL FP DNler. Dae Static Water Leval: Installer. Date Installed: FL Yield:Pump Set at: Casing He; Ground: TANK GPM Ft. SEPARATION DISTANCES []Septic []Holding 17S.T.E.P. ❑Other: To Septic Absorption Lift Holding lublictPrivate a aaurer: pacity. From Tank Field Station Tank Sewer Line Anchorage Tank '1250 Gat. Well NA 104 102 NA NA Material. steel Number rof Compartments: Suriacewater NA 100+ 100+ NA LIFT STATION Lot Line NA 16 55 1 NA V X rze: 1250 Gal. Manufacturer; Anchorage Tank 'Pump on' level at: 'Pump oM level at High water alarm at Foundation NA 18 13 NA 46 In. 42 1,. 51 In. Curtain Drain None None None NA Pump Make & Model or«Ko P200511 Electrical Inspections periormd by: NA Rerna`t" : No change to existing mound drainfield. BENCH MARK Insulation (2" blue board) installed over tank. and Location Description:Top of Manhole on STEP tank Installed by A+ Home Services 12/13/02. atbn FL 96.37 Engineer's Stamp 49TH Inspections performed by: Cindy W. Ellis, P.E. Dates: 1`t 11/26/02 *' 2nd 12/13/02 _ DevelopmenServices Department Approval ,I% Cindy W. Ellis 49 Reviewed and approved by: Date:I1► Il. � : CE-los77 Permit No. SW020439 Page 2 of s. 2 - Date: Date: 12/13/2002 Munici alit of Anchora e P Y 9 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LOT 4, BLOCK 7, PARADISE VALLEY SUBDIVISION PID No.: 020-413-17 1.5' PVC MANHOLE 1 ° •WELL / I ° \ 1,250 GALLON I r \ STEP TANK I \ r I \ / I / I LOT 2 10 / 1 Gray\ 1 / / Fti i i LOT 3 100' WELL RADIUS 100' WELL RADIUS — S( NOTE: STI iFINAL GRADE ewil L.", FROM HOUSE- -. EAST 1,250 GALLON STEP TANK SEPTIC SECTION N.T.S. ASQUILT ALE: 1"= ORIGINAL MOUND RETAINED MT ORIGINAL 1,250 GALLON / LIFr STATION ABANDONED / IN PLACE A ti STI OGJ B 2 LOT 4 LOT 5 (UNDEVELOPED) WELL • �ekl EL 96.37' 2* BLUEBOARD INSULATION WEST TO ORIGINAL MOUND 491.H 14 W. Eats CE.10617 'e, MARK A B STI 16.3 47.0 MANHOLE 24.5 53.2 ORIGINAL MOUND RETAINED MT ORIGINAL 1,250 GALLON / LIFr STATION ABANDONED / IN PLACE A ti STI OGJ B 2 LOT 4 LOT 5 (UNDEVELOPED) WELL • �ekl EL 96.37' 2* BLUEBOARD INSULATION WEST TO ORIGINAL MOUND 491.H 14 W. Eats CE.10617 'e, I -W,-20-2003 07:298 FPO[ -1:A+ F6or1E SEPUICES, I11 907-868-6770 A March 27, 2003 ED'S ELECTRIC INC. P.O. BOX 210767 ANCHORAGE, AK 99521 A+ Services 7501 E. 140' Avenue Anchorage, AK 99516 i Attn: Mike Subj: New septic control panel, 5911 Austria Dr. T0: 3-}9193- P:111 ANCHORAGE 1907) 272-4591 Fax: (907) 272-4590 Installed new control panel to subject project meeting all code requirements of the National Electrical Code and all requirements of the Municipality of Anchorage. Thank you. Dwayne R. ns Ed's Electric, Inc. '1AR-20-ZW3 FPI 07:26RI IU:A+ HOME SERVICES. IN:. R'6E:1 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water& Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Oct 28, 2002 Expiration Date: Oct 28, 2003 Permit Number: SW020439 Parcel ID: 020-413-17 Legal Description: PARADISE VALLEY BLK 7 LT 4 Design Engineer: 0844 Watkins Engineering, Inc Site Address: Owner Name: Diana Strzok Owner Address: 5911 AUSTRIA DRIVE ANCHORAGE. AK 99516-6019 Lot Size: 25380 SO. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: 10-30 -02- Issued 0Z Date: t?J Municipality of Anchorage '�s•„ ,ear • Development Services Department Building Safety Division 4 On-Site Water and Wastewater Program , e 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 020-413-17 Permit Number SWOZO439 Property owner(s) Diana Strzok Day phone 279-6617 Mailing address (1) 5911 Austria Drive Mailing address (2) Anchorage, AK Zip Code 99516 Legal description (Lot, Block & Sub'd.) Paradise Valley, Lot 4, Block 7 Legal description (Section, Township & Range) Lot Size 25,380 Acres/Sq.Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade 0 THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. P�. (Signature of Vroperty owner or authorized agent) Permit Fees: GC,I Waiver Fees: Date of Payment: lb- 7,5 - b 2 Date of Payment: Receipt Number. 0 Z 1 Z 64 Receipt Number: (Rev. 12/00) Watkins Engineering, Inc. P.O Box 110443, Anchorage, AK 99511 (907)349-1851 cwellis@gci.net October 22, 2002 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: Paradise Valley Lot 4, Block 7 Septic Tank Upgrade To Whom It May Concern: Attached please find the application for a permit to upgrade the septic tank / lift station for the referenced 3 bedroom house. The original septic tank / lift station was installed in 1985 and has failed. We propose to abandon it in place and install a new 1250 gallon STEP tank. The existing drainfield is a 24 ft by 32 ft mound with 6 inches of drain rock and a 2 ft sand filter. The field is still dry and does not need to be upgraded. I am not aware of any adverse effect that this upgrade would have on any adjacent properties' water and wastewater treatment needs. Thank you for consideration of this permit application. If you have any questions or need further information, please call me at 349-1851 or 360-3389 (cell). Yours truly, 14i4l�yv`0 &- Cindy W.`Ellis, P.E. Attachments: Permit Application & Fee Site Plan, 100 scale Proposed Upgrade Plan, 30 -scale uNo�`opEo ADJECANT SEPTIC SYSTEM EXISTING SEPTIC / ✓ EXISTING HOUSE EXISTING WELL 100' RADIUS TYPICAL UNDEVELOPED Lj > \ ! I WELL • / 1 %� \\ > Z \ UNDEVELOPED Q \ / l \ ! / / W 1 ' \ UND�LOPED 1 1 \ 1 I --\__-- \ O / q — —�� O Septic Design Prepared For q��� DIANA STRZOK �P��r,.,of• ' LOT 4,BLOCK 7 4,9m PARADISE VALLEY SUBDIVISION _*' Prepared By: Watkins Engineering, Inc. g' DATE: SCALE: 1002 1"="=1oo' Ci , --. y W Elns;.'�y Cindy W. Ellis, P.E. DRAWN: DJR CE•1oan P.O. BOX 110443 ANCHORAGE, ALASKA 99511-0443 CHECKED: CWE 3SION& PHONE: (907) 349-1851; FAX: (907) 349-1934 —EXISTING WELL 100' RADIUS EXISTING MOUND TO BE RETAINED LOT 2 Mi �� EXISTING 1,250 GALLON LIFT STATION TO BE / PROPOSED �� ��` �� ��,'� �� ABANDONED IN PLACE / ' / 1.5' PVC t ' / MANHOLE CO / Lr; — / PROPOSED 1,250 LOT 5 / GALLON LIFT STATION FCO O�'� (UNDEVELOPED) / TANK COF0� o \ r r \ r i \ r i \ \ i WELL \ � I \ i � i \ 1 70. \ , i UTj�� LOT 4 p� LOT 3 ``� \ \ 2\ �' •' � \ \ Jam' \ P EXISTING WELL��` ' 100' RADIUS Septic Design Prepared For DIANA STRZOK LOT 4, �P BLOCK 7 PARADISE VALLEY SUBDIVISION ° 49T Prepared By: z* Watkins Engineerin�r Inc. DATE: 10/21/02 iP.E.g� SCALE: 1 "=30' �' Cl w• Ellis 3 Cin dy W . Ellis, P. DRAWN: DJR CE. +oa77 P.O. BOX 110443 ' •.,, ' ANCHORAGE, ALASKA 99511-0443 CHECKED: CWE �� y.G PHONE: (907) 349-1851; FAX: (907) 349-1934 .�� 'ViUN�-c1,CIPALITY OF ANCHORAGE DEPARTMENT OF WEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENI:AL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE NEW ` r� e/ / o Gf1IZI. ip C� L ✓5 V6TE S .K61 G=(vf-% ❑ UPGRADE MAI LING ADDRESS ,70 130isNES5 Mt( BLVD, La&Svc AKS 4 o� LEGAL DESCRIPTION L.0 T 4 13L,0c r, 7 P41ZA Dish VALLEY 501501V151"J LOCATION NO. OF BEDROOM �..7 L) DISTANCE TO: Well ®� Absorption area L. Dwelling / -d AJ (C PERMIT NO. iQt4 W Manufacturer - Material 191vG ®2F�G� T9N SiEl�L No. of compartments u) +► Lin, rapacity in gallons IF HOMEMADE: Width Liquid depth PERMIT NO. C y _j (D z DISTANCE TO: Well 02 H Manufacturer Material Liquid capacity in gallons 0 w= DISTANCE TO: Well IDS Foundation NU //U 22,1}Gr�12. Nearest lot line PERMIT NO. J W zNo. of lines Length of each line ' Total length of lines` Trench widtf�, Distance between lines F ® a iaefnee� (�/ cccc Fes- Top of tile to finish grad Material b eath tile 1 Total effective absorption area 0 3-011 ed e'di & (4VE 2 5',gUo inchesO. $ r % Length Width Depth PERMIT N w C7 E- Type of crib Crib diameter Crib depth Total effective absorption area a Wa W y Well Building foundation Nearest lot line DISTANCE TO: J J Class l e Depth r 6 ( l Td Driller/9L � Distance to lot linef. / PERMIT NO. W Building foundati n Sewer line Septic tank© Absorption areas) DISTANCE TO: OTHER PIPE MATERIALS PVC \ SOIL TEST RATING 15-5 S4® FT boam INSTALLER GR S 5rem-S REMARKS 00, of !f \� /N6EGT b R ion A.Yffl lft) S PE2 ® CNP Pn "� (t`� V' etT >�• i 2 I*V eC IJ IOM6) 0VEiCc 5 o a. 1y �+ s + aeon• o• C i 0 NSB, r e J. Cor in®' d47..� 44— u -at N® 0 co .. APP ,.' DATE LEGAL v�i4?41' t1. •' 171V ®® f� -----® ��-e3f tS �dt � ,Qll , 7 &�r�4e /4(( ' | ` x �j Vj I C ,, :1 -F ID 1=7 P-1.0 C -I V. -I C F*Z. ....^ . DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET; ANCHORAGE, AK 99501 ' 264-4720 `��#",, UE.-'toP T F"C PERMIT NO: 850682 ENGINEERED DESIGN DATE ISSUED: 10/18/B5 . ` APPLICANT: C/O CORWIN ACREAGE SYSTEMS ADDRESS: 4790 BUSINESS PARK BLVD. ' ANCHORA8Ev AK 99503 CONTACT PHONE: 561~6151 LEGAL DESCRIP: SUBDIVISION: PARADISE VALLEY LOT: 4 � BLOCK: 7 � SECTION: 11 TOWNSHIP: IIIN `RANGE: 3W LOT SIZE: 2538O (SQ.FT, OR ACRES) ' ` I certify that: I 1" I am familiar with the requirements fop on-site sewers and wells as set forth by the Municipality of' Anchorage (MOA),, and the State of' Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliancewith the design criteria of' this Permit" . 3. I will adhere to all MOA and State o{ Alaska requiCements for the set back distances from any existing well, wastewater, disposal stem or public sewerage system on �his or any adjacent ornearby lot" IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CQDE3, THEN (1) AN ELECTRI�AL PERMIT AND INSPFCTIQN MUST BE OBTAINED -9, (2) AS .... BUILTS WILL NOT BE APPROVED WITHOOT AN ELECTRICAL INSPECTION REPORT; ANY) (3> THE ELECTRICAL WORK MUST BE DONE BY`A LICENSED ELECTRICIAN. ` ^ GNED »x ~~�~�`m�/���� � DAT�: SI/N-^ ru��� APPLICANT: C/O C',01 --MIN ACREAGE SySTEMS ^ ISSUDATEED : .... .... ... ~_~�__~___~��__���~_~. p '�" -' ��,m���� ��_�^ ' k i - -..___ . -- -- - - - — - - - --- - --- - -- -- Scum ALV � - — � .I,-. i S77f�A2D l�Sa �U. 5F-,cricr 7�N Al' « ClfJC1/2 fJG U�C/� ✓ NK r / Ass Z o�rm ° /�'a-�-'�t� �•e�C,Gcce-� sG�cc��e �Ji.0%�a�/.C/0 iii ser-md ���a/"T�e�'tiL lw-W- 711i'4r �� #' �i!;% OP DEPTH - -- rrm, >1 77 t WA15Z L-Na� '2- b, wq -INVI I �Zo vim, E5, 1250. t2 1121 145" OH5 of ov� I 0 ITM. c7re-- x'.12 WALL K "L,. 20 7-4 3 IZ GA . x 5° x Cot"fie", 2 �� q LI TANG -;LllU Pi's tib v ._ 12 GA, .41 d All.- _ (,LIP 12 97 1252. 12 I Z -. SL _ 40.5 Oka " f -A° �tdD ; _ _- ._. 150®. , 1.4.5 2 ... g X4 5 —U - Drawn: & ITa 8: Xldl 90 tank wokff".:ac:' - AFpa a. Dasa i �. �. late : 2 G-rL 1"�NK Sht 04� of OIC Rei 4 '6b'r_k ewsce_� tle_ f-�o L 4"4r,5 In i �P,c sc I✓cc.C@cy u.�-cA rt 1, 441 /j/ ,t 11A V- Y)--ev-e C�c f?ovadA� va-oz� fav 3 Vfs A a e F Az, p : and 1 dem G_�v^ Pi �A e ar Municipality of Anchorage Om` a m m d o •mdmmmmmnnou DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650Corw•••• "° SOILS LOG — PERCOLATION TEST ��; Ce J. o. CE --52835283 .• / •dd mm mmm•y�� am PERFORMED FOR:DATE PERFORMED: LEGAL DESCRIPTION: �� �L.K 7 Township, Range, Section: 1:2A OO�-p (ljg Wi(4c.-l..G SLOPE SITE PLAN V -t. a 11\ I I -I 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS 14M FtT #VL� � 41 WAS GROUND WATER NCOUNTERED? IF YES, AT WHAT L O ,,,�yr0 DEPTH? P (ice ` E Depth to Water After Monitoring? Date: PERCOLATION RATE -A 05,minutes/inch) PERC HOLE DIAMETER TEST RUN BE W EN .91 5 FT AND 34FT f PERFORMED BY: H r `1 /y I ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELIN IN 72-008 (Rev. 4/85) < CERTIFY THAT THIS TEST WAS PERFORMED IN THIS DATE. DATE: 10-7-8-5 -r'-04 PERCOLATION RATE -A 05,minutes/inch) PERC HOLE DIAMETER TEST RUN BE W EN .91 5 FT AND 34FT f PERFORMED BY: H r `1 /y I ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELIN IN 72-008 (Rev. 4/85) < CERTIFY THAT THIS TEST WAS PERFORMED IN THIS DATE. DATE: 10-7-8-5 r �••-�, w V � R qptlyy FAfGl �. Municipality of Anchorage • ^. Soso. /aacumme�mnm DEPARTMENT OF HEALTH & HUMAN SERVICES v"---� 825 "L" Street, Anchorage, Alaska 99502-0650 7�11�� ce J. Corwin 4r SOILS LOG — PERCOLATION TEST�cNo. cE•szas PERFORMED FOR: l { C cy-ACi( ti� T� ! DATE PERFORMED: / ®^ LEGAL DESCRIPTION: w .l�-`T �t,4 -7 Township, Range, Section: f%i?-A'v(!5>f--- \AL(-ef SLOPE I I II I I SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 G-1Vj VeV-lei 6F V1 -5U PL- ?4TWq WAS GROUND WATER "" ENCOUNTERED? S L IF YES, AT WHAT C DEPTH? P E Depth to Water After Monitoring? Dater ==Mmm� "" �Iltl Mir I ; •.�� PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUNBETWEEN T— FT AND FT PERFORMED BY: �1L+rW �-"�•£ERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELININ EFFE ON THIS DATE. DATE: 10-7 05 72-008 (Rev. 4/85) 1-, PO "16650 ANCHORAGE. At 0650 (907)264-4111 TONY KNO /[ i S - MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECI;ON <Permit #: 820485 January 31, 1983 TO: Permit Applicant Subject: Lot 4 Block 7 Paradise Valley Subdivision A permit issued by this department for an individual well and/or on-site sewer system has expired as of December 31, 1982. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log needs to be sent to this department for documentation of the installation date and to close the permit. If a private engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files and documentation. If there are any further questions, please call this office at 264-4720. Sincerel � Q`:P, Robert C. Pratt, R.S. Acting Program Manager Sewer and Water Program RCP/ljw enc: Copy of Permit SWP/057 9 MUNICIPALITY OF ANCHORAGE Department --"7 Health and Environmental"-^rotection �825 y Street, Anchorage, AK. _:501 264-4720 C���gS" # # # HANDWRITTEN PERMIT Permit ## # # WELL ANION -SITE SEWER PERMIT Applicant: ( p� % E to r -6o Mailing Address : 6 K �'� Location: % L 10DVr6tcicse Phone Number: 2 L( � Ya((eY -- Legal Description: L L16 -7 66ucc e(c se UCz (((' y Lot Size Type of Soil Absorption System Is Trench: Drainfield: Seepage Bed / - Holding Tank: Maximum Number of Bedrooms: v Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is:' (0 "oder �,��✓� r DEPTH LENGTH a a � GRAVEL DEPTH �— �t_ ��er �TH 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 minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE 0 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 subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community 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 DECEMBER 31, 1 9 3 2 # # # I certify that: (1) I am familiar 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 remodeled o include more that 3 bedrooms. Signed: Issued by: 7* Applicant I� Date: �- �u fo 4e _r aal-es swp/024 (1/81) <s is7 6h-Psf ` . !ns �rlccd.-IQs �� .5 b" r -.e (r -ed, -7,-? 4-h e e J e. -r y-- bedrdc,k- c5 er)eoccr� /1..r r� / , , !/ ALO 7 SOILS LOG A MUNICIPALITY OF ANCH014AWAUTr OF ANCHORAGE pT rrlar �I T'J ^. • +.c DEPARTMENT OF HEALTH AND ENV[ RONME ,PRQTKT1@1 PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG —PERCOLATION TEST '' 119 � PERFORMED FOR: ce �S / 4 !� «'% RECEIVED s�--Z,-/ - DATE PERFORMED: c LEGAL DESCRIPTION: Date Gross Time DEPTH ` 0 c_riCC: Net Drop K U c vt � d lv ik A 2)c/ 2 U 4j114 3- 0'05' t ? 10 p0 0 �j 4- ca A211 ? 19 6 7 o Lea A- 8 s f7o k 'd"-I//ed Jut 10 11 12 13 14 15 16 .T� Ll RY 17 �Iy�f 18�'j1f 19- 20 20 COMMENTS PERFORMED BY: f. A-1 72-008 (6/79) 'b/ G iC / SLOPE WAS GROUND WATER S ENCOUNTERED? L O P IF YES, AT WHAT E DEPTH? I SITE PLAN Reading Date Gross Time Net Time Depth to Water Net Drop 2 U .; '5' L 0'05' t ? 10 p0 0 �j & ? 19 6 PERCOLATION RATE —(minutes/inch) TEST TEST RUN BETWEENFT AND 6LO FT CERTIFIED BY: DATE: —�, —V-2 PERFORMED FOR: LEGAL DESCRIPTI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS .. SOI LS LOG , MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMHAUl L1Fp �f@�1I #ORAG67 PERCOLATION �TT (-c i , .. TEST 825 L. Street, Anchorage, Alaska 99501 Eal'72�V SOILS LOG — PERCOLATION TEST I 'a 1962 t 2. .�Al . r 6, �E h � din ®o ^,�Je'a �f �f c T. V' � d �1' P U� ft�'�1914) / c noc RITP PI LAN TA99re Vero i" 6�Cj{-z2 et . /77 d/ if 4jes t o/ f W /e1 /T , jV l7 i? WAS GROUND WATER 11 ENCOUNTERED? L O P E IF YES, AT WHAT DEPTH? — Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TEST RUN BETWEEN (minutes/inch) FT AND — FT PERFORMED BY: Ca/sn.J / JU�nsd ` CERTIFIED BY: _`_-__ _.—DATE: LOT T / D,E _,-.I FJ b 2 3 4 5 6 7 8 9 10- 11 12 13 14 15 16 17- 18- 19 71819 20 i Li3T A.E.M., INC. 1220 w(. 2-5--M, AVMUE_ DEPTH MCHORAGE, AK, 99501 1 Supplemental Soils Information. Subdivision l__2✓:=c>l s'C '// [310ck _ LOT 4- LOT 5 6- TH '���c`✓tl -. _ C;. .-.t DEPTH (-�Ye:T( tC .. DE PT 1-4 (FEET) 1 9- � 2 a _ �i f �. 2 ( 12- 12131416 3 ti,s �� 3 13- 14- 4 4 4 5 `� d 5 6 � ly'C'c�,c_4 6 18 1 d{•-` `4 v��� II 19- 20- 7 I 7 �1 I k 8 8 g 9 10 10 11 11 12 12 13 13 14 - 14 15 15- 16 16 17 17 18 18- 8-19 19 19- 92020 20-1 20 Li3T _TH DEPTH (FEET) 1 2 3 4- 5 6- 7 6 1 9- 10 10- 12- 12131416 13- 14- 17- 18 1 d{•-` `4 v��� II 19- 20- I �1 I k LOCATION OF WELL (Please complete either to, It, or IC.) WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological a Geophysical Surveys Drilling Permit ,No. A.D. L. No. la. Borough -•I Subdiy ision Lot Block Ib. r I/a gtrs. Section No. Township N ❑ Range. E - Meridian 0f_of—of— S❑ W❑ Ic. DDIrI�STANC�j AND DIRECTION FROM ROAD INTERSECTIONS �- 3. OWNER- OF WELL: �C, �ii . LcIt(€� f!f y r2-fr Address: Street Address and Area of Well Location 2. WELL LOG - Feet Surface 4 WE L o5PT }t (final) ATE O_F o?1 PLE_TI+�W t � a Material Type Top Bottom e 6, ❑ Cable fool 011totory ❑ Driven ❑ Dug ❑ Auger ❑ Jetted ❑ Bored ❑ Other: �y 7.USE;X Domestic ❑ Public Supply ❑ Industry ❑ Irrigation ❑ Recharge ❑ Commerical. ❑ Test Well ❑ Other; - riw /0 8'C ING ❑ Threaded � Welded dad. diam. in. to! 0 ft. Depth Weight �_ lbs./ ft. diam. in, to ft. Depth Stickup- ft. yyr. S 9. FINISH OF WELL.,¢.y-r Type '^L'"T DiametDiameter: r Slot/Mesh Size: Length: Set between - ft. and ft. Backfilling Gravel pock el G. 27/F 10, STATIC WATER LEVEL: ft. ❑ Above or Below gland surfac Date '. Equipment used:c:S�-*'-�" MUNICIPALITY OF ANCHORAOG I I . P M/PING LEVEL below ( nd surface and )IEP ft. after hrs. pumping 9 -P.M. DEPI. 01* HEALTH & ft. after hrs. pumping 9.p -m. MARa A Y11, v `3 12.GROUTING Well Grouted: ❑ Yes ,(n No Material: ❑ Neat Cement ❑ Other: 13. PUMP: (if available) HP CUM Length of Drop Pipe ft. capacity 9 -P.M. -E ❑ Subm. ❑ Jet ❑ Centrifical ❑ Other 14. REMARKS: 16. WATER WELL CONTRACTORS CERTIFICATION: 15. Water Tempe roture _0 ❑ F ❑ C Thiswel w4s dri ljrs and y�j jurisdiction �and this di report is true to the be„gt of my knowledge and belief; Registered BuPyness „t ame A!tdress;� C+", ,;,f1a ,�t':.^r��rr Contract Licens umber,,- _ ,, ,rRRw,�` s•t';:;""'eS Signed :._--_ ,-�'`"'~_�. Date-: ^ Authorized Represtative 10 Form 02-WWR (II/81) Copy Distribution: WHITE -State DOGS, PINK -Driller, CANARY -Customer SITE PLAN b PARADISE VALLEY SUBDIVISION LOT 4, BLOCK 7 SEPTIC TANK lq. iMP ¥~JJt_T DETAIL ON-~JTE SEWAGE DISPOSAL ;, S.,T.E,P. SYSTEM 0Tt001246 oF 1 PRE!ARED FOR ACREAGE SYSTEMS • PG£ BU/ • .7 Municipality of Anchorage u • 6 7.8 9 `0 On-Site Water and Wastewater Program •FF�,.� ,0G P y (907) 343-7904 ©p. MAy • 620118 Certificate of On-Site Systems Approval Parcel I.D. 020-413-17 Expiration Date: �1�� e 1. GENERAL INFORMATION: Complete legal description PARIDISE VALLEY; BLOCK 7, LOT 4 Location (site address) 5911 Austria Drive`Anchorage 99516 Current Property owner(s) FORECLOSURE-VA AFFAIRS Day phone 242-8197 Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: • Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: c(027-3//8 sneer, unless otherwise requested COSA to be released to t g bythe q engineer. COSA Fee $ 524.0 Waiver Fee $ Date of Payment 51 �' 1 Date of Payment Receipt Number G CSR'&i Receipt Number COSA# O 1$/a O Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: C)/ L / 000QOoOp�� In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system OF A Nin accordance with the guidelines and regulations established by the Municipality of Anchorage and � •.-••..•••• Q industry practices. The reported results describe the condition of the system/s on the date/s of the O • ft evaluation. Separation distances were measured to readily identifiable features. Hidden defects or P H -N NOVO encroachments may exist that were not identified during the evaluation. The operational life of all wells / * 4 9 * Qn and septic systems depend upon a variety of variables, including but not limited to, soil conditions, • c� groundwater levels (that may fluctuate during the year), quality of construction (materials and Q workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and Q 1 VA are outside the control of GEG. Satisfactory test results do not guarantee future performance of the a •J f e . A. cm --s, system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of 0 • QO,'. • E-7953 p the well or septic system. GEG makes no representation whether an alternative well or septic system .�p can be installed on the property in the event either of the current systems fail to perform adequately in �/m fP 1 I•r' d the future. The content of this report is for the sole benefit of the person/party that retained GEG to �Q aprotess‘otlodo perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE 11( System #1 Approved for 3 bedrooms .0 OF AiVc, System #2 Approved for bedrooms Disapproved . 0N" "Cc. p G� \N ATE TEgzo. Conditional approval for bedrooms, with the following s �Cild ` PROGRAM - c n0irn rP\'\c�c By: ��� � Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10.12.doc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: PARIDISE VALLEY;BLOCK 7,LOT 4 Parcel ID: 020-413-17 A. WELL DATA *INTO BEDROCK Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 10/27/85 Sanitary seal (YIN) YES Wires properly protected (Y/N) YES Total depth 203 ft. Cased to *10 ft. Casing height(above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 10/27/85 4/26/18 Static water level 12 ft. 21.9 ft. Well production 0.75 g.p.m. 0.7+ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 ml. Nitrate 2.95 mg./L. Collected by: GEG,Ltd. Arsenic: <5.0 ug./L. Date of sample: 4/27/18 B. SEPTIC/HOLDING TANK DATA Tank Type/Material S.T.E.P./STEEL Date installed 11/26/02 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout(Y/N) YES Depression over tank(Y/N) NO High water alarm (Y/N) YES Date of pumping 5/5/18 Pumper ARM SERVICES C. ABSORPTION FIELD DATA 'BELOW EXISTING GRADE AT MONITORING TUBES Date installed 10/31/85 Soil rating (g.p.d.Ift2o ft2/bdrrr) 155 System type BED Length 32 ft. Width 24 ft. Gravel below pipe 0.5 ft. Total depth *2.6+ ft. Eff. absorption area 768 ft2 Monitoring tube YES Depression over field NO 4/27/18 Results (Pass/Fail) PASS For 3 bedrooms Date of adequacy test Fluid depth in absorption field before test 0 in. Water added 500 gal. New depth 2.5 in. Elapsed Time: 54 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) **UNKNOWN If yes, give date - 2000 GALLON PRE-SOAK PERFORMED ON 4/26/18 SUMP ON NORTH SIDE OF BED IS NON-FUNCTIONAL NORTH SIDE OF BED APEARS TO HAVE ONLY 1.63'OF COVER. BED IS INSULATED INVERT OF SOUTH SIDE OF(FIELD.ANLLL WATEER WAS INTRODUE ON NORTH SIDE OF FIELD IS CED INTO SUMP ON THE ATELY 8 INCHES HIGER THEN INVERT ON NORTH SIDE. 2"OF INSULATION OVER ENTIRE BED PER 1985 INSPECTION REPORT **FORCLOSURE-UNABLE TO VERIFY NO CONTACT WITH PREVIOUS OWNERS *SEE 2018 MAINTENANCE LOG BY ARM SERVICES D. LIFT STATION Date installed 11/26/02 Size in gallons 250 Manhole/Access (Y/N) YES "Pump on"level at * in. "Pump off'level at * in. High water alarm level at * in. Datum Cycles tested Meets alarm &circuit requirements? * E. SEPARATION DISTANCES 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 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation *8.5' Property line 5'+ Absorption field 5'+ Water main 10'+ 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 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *TO DECK POST-MET CODE AT TIME OF INSTALL G. ENGINEER'S CERTIFICATION ,`P�,.•• j. 44'4. •. I certify that I have determined through field inspections and a *;1 49,,,' i0i\ .',* •.0 review of Municipal records that the above systems are in • •• • conformance with MOA COSA guidelines in effect on this •• date. 0•0; J= : 7 • • ess.e� Engineer's Printed Name JEFFREY A.GARNESS .�%j;o E 7953 r�'= Date �J I V / �' ��. P �k .1. k' )..... Date / ••• 0 ES�1�P.•• LICENSE •••%„`ll♦♦♦ #AECC884 (Rev.10/12/12) MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907-343-7904 On-Site Water and Wastewater Section % Fax: 343-7997 www.muni.org/onsite Well Water Advisory Certificate of On-Site Systems Approval # 0SC181209 Subdivision: Paradise Valley, Block: 7, Lot: 4 This well's productivity was determined to be .7 gallons per minute. The minimum well productivity required under (AMC 15.55) for a 3-bedroom residence is .31 gallons per minute or 150 gallons per day per bedroom. Although the subject well currently exceeds this minimum requirement, the production capacity can fluctuate. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. Mailing Address: P.0. Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org MUNICIPALITY OF ANCHORAGE • • Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Lift Station/Pump Vault Maintenance Log Owner (`t\tr.�G G• a\ck�,i��v J Street Address .�e! II At)S t' t'6-'_ 001V-Q- Septic Tank: •Sludge level '; inches •Pumping: required yes no " -Pumping complete ye& no Lift station: 'Pump basket cleaned es no -Effluent filter cleaned s no •Control floats cleaned es no -Proper float settings confirmed a no -Operation satisfactory et no Alarm System: /� 'Dedicated electrical alarm circuit (ves? no 'Audible and visual alarm inside dwelling yes no -Alarm system operation atisfactor y 'ro� y Manhole Riser -Ground water intrusion at riser to tank connection es s; -Ground water intrusion around pipe penetrations es 0 •Weep hole functional ,49 no •Manhole lid: Functional 0 no Insulated t es no Properly Secured Ves 'no Other •All manufacturer required inspections and maintenancek connectiI no Comments: . . La.A� tit NOWUr' t,\ .__ \1 C'}h v„'c -r Am M__ 1)t ec " ` i`Y1 C Qualified Maintenance Provider: Technician Nkn Q KJ2 Date of maintenance() S r� a ftn J �ICompany ��(J��� �o�-_- • _,/v(: �. Signature Ct. vaYlt.� ►t-U'�"1�� Date -4] -A_ Mailing Address:P.O.Box 198; • i a" Anchorage;Alaska 995194650*wv .muni.org Parcel I.D. 020-413-17 Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 <<,„ Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description Expiration Date: J a - 3 01 - 1- Paradise Valley, Block 7, Lot 4 Location (site address) 5911 Austria Drive Anchorage, AK 99516 Current Property owner(s) Diana M. StrZok Day phone _ Mailing address 5911 Austria Drive Anchorage, AK 99516 Real Estate Agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Three Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual Q Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by:( -*4 ! I`„ Date a COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ ` qo Waiver Fee $ Date of Payment %&)5115 Date of Payment Receipt Number. L�l a -I iij Receipt Number COSA3 Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Phone 522-7773 Arras P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE _1z System #1 Approved for 13 bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for Date bedrooms, with the followi ng suNwauui b. lam'By: ( r Original Certificate Date: :7,30-0 Theunicipality ofnchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory_ Other COSA blue sheer F ..i c If more than 1 septic system is on the lot: COSA Checklist # _of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Paradise Valley, Block 7, Lot 4- A. WELL DATA Well type Private If A, B, or C provide PWSID # _ Date completed 10/27/85 Sanitary seal (YIN) Y Total depth 210 ft. Cased to 8 ft. FROM WELL LOG Date of test 10/27/85 Static water level 12 ft• Well production 1.5 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate '583 mg/L Arsenic N/D ug/L Date of sample: 7/12/13 Parcel ID: 020-413-17 Well Log (YIN) Y Wires properly protected (YIN) Y Casing height (above ground) >12 in. AT INSPECTION 7/18/13 120 ft. .75 P.P.M. Collected by: Anderson Eng. B. SEPTIC/HOLDING TANK DATA an Type/Material Septic/STEP Date installed 11/26/02 Tank size 1,250 gal. Number of Compartments 3 Cleanouts (Y/N) Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) Date of pumping 9/5/12 Pumper A Plus Home Services C. ABSORPTION FIELD DATA Y Y Date installed 10/31/85 Soil rating (g.p.d./ftz or ff/bdrm) 155 GPD/SF System type Shallow Bed Length 32 ft. Width 24 ft. Gravel below pipe .5 ft. Total depth 5 ft. Eff. absorption area 768 f? Monitoring tube Y Depression over field N Date of adequacy test 7/18/13 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth 0 in. Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 450 g p d Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date D. LIFT STATION Date installed 11126/02 Size in gallons 250 Manhole/Access (Y/N) Y "Pump on" level at 46 in. "Pump off' level at 42 in. High water alarm level at 51 in. Datum Bottom Of Tank Cycles tested 3 Meets alarm & circuit requirements? Y E. SEPARATION DISTANCES 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 Public sewer manhole/cleanout N/A Sewer /septic service line >25 Holding tank. N/A Animal containment areas >50 Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation )5' Property line X51 Water main N/A Water service line" >10' Wells on adjacent lots >100' ABSORPTION FIELD ON LOTTO: Property line >10, Building foundation >10, Water Service line >25 Surface water >100' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that 1 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 Michael E. Anderson, P.E. Date 7/24/2013 COSA brown sheet -1 0-1 0-12.doc Absorption field >51 Surface water X100' Water main N/A Driveway, parking/vehicle storage >10' E-1 V - MICHAEL E ANDERSON CE -4381 ,•'�Vry �I1hPROFESSW*'� ' ®® Municipality of Anchorage s , Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ei.anchorage.ak.us (907)343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) 4 131363 During a recent COSA on-site inspection and test of the potable water supply well on Block 7, Lot 4 of Paradise Valley subdivision, the well's productivity was determined to be 0.75 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. S 1/2 SW Lo I PLOT PLAN AS BUILT X SCALE t" MY GRID SW 3538 Project No. 13-139 Lang $C ,ASSQCICJF@S' inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 (907) 522-6476 Phone oppUp Registered Land Surveyors (907) 522-4625 Fax 4 QoFAC�p" kenolongsurvey.com / jonothanOlongsurvey.com ,.• " . I hereby certify that I have surveyed the following described property. LOT 4, BLOCK 7, PARADISE VALLEY SURD. (Plat No. 70-79) 4.9 9 Anchorage Recording District, Alaska, and that the improvements situated thereon are ....... ......• within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed .. ......... premises and that there are no roadways, transmission lines or other visible KENN easements on said property except as indicated hereon. Dated this the 7A•41 Day of 'Lo 13 , at Anchorage, Alaska It Is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. _ � 2 MUNICIPALITY OF ANCHORAGE I� DEPARTMENT OF HEALTH & HUMAN SERVICES51 '- Division of Environmental Services 9 On -Site Services Section 1 C N T Tin P.O. Box 196650 Anchorage, Alaska 99519-6650 �_ `'f -I Z 2 , 343-4744 G o W c cr n 7✓ CERTIFICATE OF HEALTH AUTHORITY TR APPROVAL FOR A SINGLE FAMILY DWELLING oy Parcel I.D.# tck— 4i3-1-7 1. GENERAL INFORMATION Complete legal description T Q R VAP—Argy 15 L A Ia,. �_ > Location (site address or directions) i a D-f"'� ✓ Q' Property owner *Fa W &f� e Day phone Mailing address Lending agency Day phone Mailing address Agent ?>oeA, D".44W-W-0 Old Day phone Address 3III (2 S Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: -� 3. 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. 4. TYPE OF WASTEWATER DISPOSAL: / Individual on-site Holding tank Community on-site , Public sewer ;:i't :,;.,. NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rw.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 6� �n r���Q vLd �� Phone x`71 J 9 �' Address Engineer's signature, Date e- 74 9 1b 6. DHHS SIGNATURE X Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments SFE A171a r kji cV !v EL L AQ vi soa y Byc,.' Date /2 - 29 - %s ;7he Munibipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Ceitificatesciased only upon the representations given in paragraph 5 above by an independent profeesional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasersof homes and theirleriding institutions in order to 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-M (Rev. 1/91) Beak MOA #21 MUNICIPALITY Or ANCHORAGE M E M 0 R A P D U M WATER WELL ADVISORY HEALTH AUTHORITY APPROVAL N0.IM /5G 66 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Lot 4 Block 7_ of P49,412/5c VALLEY Subdivision, the well's productivity was determined to be .% gallons per minute. The minimum well product ivity re--uired by this Department (AD4C 15.55) for a J bedroom residence is .31 gallons per minute. Although the subject swell currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well m;E_y fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attache' to all copies of the subject Health Authority Approval. Log present (Y/N) Date completed.' Fluid depth (ins:) Minute's later: Absorption rate = 7 '7 t.?y g.pm. a Peroxide treatment (past 12 months)`(Y/N) if yes, give date i a D. LIFT STATION % r� Date installed /0/ �� 1 `Jr Size in gallons 41-2- 5-0 Manhole/Access (Y/N) y "Pump on" level at* .27 "Pump off' level at* a2 1 High water alarm level at*' / i L/ *Datum ��o itOfk t m •� a44, k - Cycles tested A/ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 100 f ; On adjacent lots i / &-0 Absorption field on lot i I,Z ( 10 $ uKaQr C. g ; On adjacent lots �) /d -G N Public sewer main qFk Public sewer manhole/cleanout Sewer /septic service line Qy f- Lift station 1 &0 -� SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10 Property line I D Absorption field a Water main/service line 50 fi Surface water/drainage � Wells on adjacent lots % f SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation I © Water main/service line g 0 fi Surface water 1J Driveway, parking/vehicle storage area 3©-f Curtain drain t,.i I b Wells on adjacent lots �t /UD Property line / O t F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records tha !6g pbove, sysfeqs are in conformance with MOA HAA guidelines in e t on this date. Signature C'•'�Jn^_GL m'3aee � Engineer's Name I k-= i ea e ° 3 r-x'yrd Date Cle- `74 l g S HAA Fee $ C= U ° "�) Waiver Fee $ Date of Payment Receipt Number Rev. 8/95 OSS: haa.wk.doc Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES M}r i • 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 l.D. # ��Ci Lll� -1'1 HAA # 1. GENERAL INFORMATION Complete legal description Lot 4; Btock 7; Paradise VaUey Subdi.v,izion; Location (site address or directions) 5911 Awstkia Property owner Ma&k & Sana G2one Day phone 5101- C270 Mailing address 5911 Ac t)ti.a DtEve, Anchorage, A2az a 99516 �4S - 5417 Lending agency Day phone Mailing address Agent A J J........ r\4 V 1 V JJ Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well XX Community well Public water 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 XX 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 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 furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Phone S & S ENGINEERING Address 17034 Eagle River Loop Road No. 2Q4 Eagle River, Alaska 99577 Engineer's signature Date 6. DHHS SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for Additional Comments M 0a TM** M M ?ROFESSt���" bedrooms, with the following stipulations: Date 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 orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST 44 Legal Description: L- Parcel I.D.- UAL,� A. WELL DATA Well type ' VIX1'6 If A, B, or C, attach ADEC letter. ADEC water system number Log present 49N) Date completed Driller Total depth Cased to ��� +�f2easing height Sanitary seal ,t'N) Wires properly protected4V?N) m B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts a/N) High water alarmo?N) Tank size �2�, o Compartments 7 - Foundation Foundation cleanout (Y) N) Depression (Y/_��Y— �~ Alarm tes /N Date Date of pumping -2. -'2-n "j2- Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: t 1 1 Wei I(s) on lot On adjacent lots I C;,o 4- Foundation To property line �`� Absorption field 2111 Water main/service line ( '� Surface water/drainage k Cid 4- 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE FROM WELL LOG AT INSPECTIONz Date of test 27 - e-�05 zi5 Static water level �2 D �c Well flow T( g.p.m. g.l to o Pump level %Ire M ro �'� to g 20 to GD m SEPARATION DISTANCES FROM WELL TO: z Septic/holding tank on lot 1 r ; On adjacent lots � � 4 - Absorption field on lot Absorption t �� ; On adjacent lots -Public Public sewer main sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform © Nitrate ���M� aG Other bacteria Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts a/N) High water alarmo?N) Tank size �2�, o Compartments 7 - Foundation Foundation cleanout (Y) N) Depression (Y/_��Y— �~ Alarm tes /N Date Date of pumping -2. -'2-n "j2- Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: t 1 1 Wei I(s) on lot On adjacent lots I C;,o 4- Foundation To property line �`� Absorption field 2111 Water main/service line ( '� Surface water/drainage k Cid 4- 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed (4�'- 3\ - 12-`� Manufacturer•%�- Size in gallons Manhole/Accessc4!�*!) Y h a Vent&N) "Pump on" level at "Pump off' level at 4 M�JPE9 F'�� '))��t mF High water alarm level - �/� - �Q %o Cycles tested 9ro h Meets MOA electrical codes 89N) `J SEPARATION DISTANCE FROM LIFT STATION TO: ( Well on lot k >05 On adjacent lots )'t')" Surface water D. ABSORPTION FIELD DATA Date installed In ' 3) ' ' Soil rating ��j n�- System type X � r•3)2 A 1 Length �' Width Gravel thickness to Jln)C = Total depth r1 Xl/ Total absorption area /�g Clean outs present� /N) Depression over field (W Date of adequacy test "I Z Resultsg /fail) 9 % for Peroxide treatment (past 12 months) (Yffl IJOY�- WF1 If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot On adjacent lots '� Property line l�lk I Ah To building foundation �5 To existing or abandoned system on lot A On adjacent lots I k Cutbank Water main/service line J<=�1 Surface water`1 lbOt-1 Driveway, parking/vehicle storage area Curtain drain i` OAA, E. ENGINEER'S CERTIFICATION bedrooms 1 certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. OF'A' S & 5 ENGINEERING 0►'�� C. w Signature 17034 Eagle River Loop Road NO 204 0* �%" Eagle River, Alaska 99577 Engineer's Name Date -)5 _Z-�`j2 dfl HAA Fee $ ! 70 r_ Date of Payment - Z� Receipt Number 3 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number No. i "' •enmwm°' 0FSS1t1AP MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date Mriyl-c—e 4 tgR,Cn 1. GENERAL INFORMATION (a) Legal Description (include loft, block, subdivision, section, township, range) Location (address or directions) 'Cn 2t� t N P�s'�' -C , �(b) Applicant Name Telephone: Home Business Sro f `�' s, Applicant Address 4Ze4o 0 Lt x�. c s� dy ►� ( s ' e AK- �G%�n3 v � (c) Applicant is (check one): Lending Institution ❑'; Owner/builder ❑ ; Buyer ❑ ; Other (explain); 0 (e) Lending Institution Address Real Estate Company and Agent Address Telephone (f) Mail the HAA to the followi 2. TYPE OF RESIDENCE Single -Family R Multi -Family ❑ Other Number of Bedrooms Telephone -c2 1 J 1 3. WATER SUPPLY Individual Well [Z Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite to Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) 5. ENGINEERING FIRM PROVII iNG INSPECTIONS, TESTS, FILE SEARCH, UATA AND INFORMA' As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation` b� t ti a�u M. Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and a for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtain 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 `' W: the date of this inspection. j Name of Firm CORWi Telephone. Address 41 an 1222L 61 Su, rF 7— f&vc 4f I 91C Date �1 f�C� CXi -4 e>gb iq S0�2 r, ybe � 6 �7 C yi utif e 1. Corwin ;Y� CE -5233 +'.�•� Engineer's Seal 6. DHEP APPROVAL Approved for bedrooms by Date -V'6r_9& Approved �• Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) NIQPAUTy OF A MUNICIPALITY OF ANCHORAGE (MOA ENV, D OF LTIf 8, C�tAGE HEALTH AUTHORITY APPROVAL (HAA) PROTECTION CHECKLIST - FEBRUARY 1984 MAR 0 4 , 264-4720 Legal Description: 4 Arc r" � 1-� ts\/ �-�► " . V G V l= A. WELL DATA Well Classification RF'1(r4Tr'= If A, B, C, D.E.C. Approved (Y/N) NIA Well Log Present (Y/N) ES Date Completed 1d/Z1 .I 65 Yield it Total Depth 2-10 Cased to tQ' Depth of Grouting N�A Static Water Level I 1 Pump Set At 210' Casing Height Above Ground 2' Sanitary Seal on Casing (Y/N) �I�S Electrical Wiring in Conduit (Y/N) ���� Depression Around Wellhead (Y/N) Iia Separation Distances from Well: To Septic/Holding Tank on Lot Joel ;On Adjoining Lots_ To Nearest Edge of Absorption Field on Lot 1 vb ; On Adjoining Lots 1001 To Nearest Public Sewer Line N/A To Nearest Public Sewer Cleanout/Manhole N/A To Nearest Sewer Service Line on Lot VIA Water Sample Collected by eF'AJL T7gfl_W(ER_ ; Date 2gz' ac Water Sample Test Results ` Comments * /nl B. SEPTIC/HOLDING TANK DATA Date Installed 110 —SIA S Size 12150 No. of Compartments 4— Standpipes Standpipes (Y/N) T Air -tight Caps (Y/N) y Foundation Cleanout (Y/N) ce Depression over Tank (Y/N) Date Last Pumped NOW Pumping/Maintenance Contract on File (Y/N) N ; for WA Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) MIX Separation Distances from Septic/Holding Tank: To Water -Supply Well JOS f To Property Line 2& wear'e f- To Water Main/Service Line bo' Course Comments Page 1 of P 72-026(11/84) To Building Foundation 1 To Disposal Field 10( + 0 Se.�e- ZCe4-ox A -s -Pv:,c.c 'G40'c su-JM ++04. To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 15,5 `PQ 1r7 /1319 m Type of System Design 1 i) Date Installed - [oJ -3) l85 Length of Field Z FTr Width of Field 2A F% Depth of Field I` Gravel Bed Thickness Square Feet of Absorption Area -7(08 y@ f%T- Standpipes Present (Y/N) uF---S Depression over Field (Y/N) No Date of Last Adequacy Test N41A Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well 110 Fr To Property Line To Building Foundation 21' FT To Existing or Abandoned System on Lot Nhq ; On Adjoining Lots t o' To Water Main/Service Line 04A To Cutbank (if present) N/4 To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed to /-31 IB5r Dimensions -ter a)arc) _ 121 WN Size in Gallons I Z!30 Manhole/Access (Y/N) y�Es "Pump On" Level at )Zu "Pump Off' Level at 0 High Water Alarm Level at I o Vent (Y/N) No Tested for Pumping Cycles /dduring Adequacy Test. Meets MOA Electrical Codes (Y/N) SEE ,ECECT/LICAI- /IJSPEC7,16AJ (! 7-2:4 C419Fb� Comments IJdAlE ** Check P/hYmitted Be room Rating Against HAA Request ** —• 7` rte" " I certify t have the d, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed K Date Company �/� /�OZ^i MOA No. STBS�zlS Receipt No. a`7 377'7 (o Date of Payment Amount: $ Page 2 of 2 72-028 (11/84) �. a Gyi f. i •� t ' Engineer's Seal f� f r � D c, Dana ,,9 >t t� re J. Corwin 'd (�� •� •v o. CE -5203 •",:.:;a; v N ,Sll 1:1 fi: C., T 10 N R F: F, F", 4, f4UNISFIAL.111 OF ANCHORACK,SAFAii:TY D!TVISTON A T U D F". I; z (1) f) D ov INSFIECTIOmS' (907) !.`;63 ....;x'464 A D 11114 11; "f* R ATT 0 N ( 9 7 6 .... E3 2 1 1 N A N Iii: : 1) EK I ... E:C—f ("11C., FIEF1111T NO 85 2 0 Of 2 TREAT AW)FOH:SS : DRIVE: '3*,45....!, -1 L. E: (." A I : F,ARADISIH: Will ... I ... I y 4 E'll ii C i'l Ki F: NT 0 3 0 3 8 6 3:0hi REMIKSTED: ISEXTRICAl... R R R "S, 20 EA F,"C 11V 04; ?dllp An", rj 4 j (11-6 -e w MUNICIPALITY OF ANCHORAGE DEPT, OF HEALTH & ENVIRONMENTAL PROTECTION N'T "S, MAR 0 41996 TANCE: (WERVE:1) 10 F"ll R F: C"ITT N ll.i EXPI—f INED 4 tat: 0 V E: kE " i g oll KI �t I A) I: I ... I... RE-::F:XAMH*i: AT NE:XT I I Do hull. u -rl: I... 1:� Ii FINAL. APFIZOVE'.'D CONDITIONAL. FOR DAYS, FINAL. F'INTISI.-I llilE:; FINIS34 14ILTAGER: START TIME: ST0,14"T mll ... F: A C.;- E: WIRK LUMITS: I N S P'llCll' 0 R4, A.,.f - ji:: -c� - I... FOR !U3-464 W I DO NOT REJUVE THIS NOTICE: i Ali u 411j'q'CIPAL17Y OF DEPT, F HEALT,11 CHORAGE ENVIRON NTAL PROTECTIpN MAR046% RECEIVED 58" 46" I r _I z >N -00= Ali u 411j'q'CIPAL17Y OF DEPT, F HEALT,11 CHORAGE ENVIRON NTAL PROTECTIpN MAR046% RECEIVED 58" 46" I r _I z a c >N -00= .3 T� \mm=<ao r mo nm mz avN= 0 >00 <Do m�� V-nrn -i 9T" xom-4<v_oa I mmz � aTzo n =vm mo N n_N D -1> -1 2 C D O o�"'i w ox mx �m 4 m> m r n� o O w N z Cfady z C mU o r 3; m �mr n rz 0c) '^ ncm a �r ai a r m aiv r z ymm Nr0 x : O oT ro n— A -4�O mZ rm. z Crm• zm< tm i -, m > �' xv g n v oz v x o a zN om m z > v z zxoo r > m �' ti > aN N 7C { 1 ^� f z 0 p rmm- m m am A —O r O z m N ico cm �m,�m a (n��� /r p c�� 3r m� oD �ycz G) mOX mm- C mm zzZa =� =-iA3 < ^' z Ca 3 m rp -1 -i 4" vv -I ; oP z x ? v tiO I O z 24" m 9L r x 0 n z x a c >N -00= .3 T� \mm=<ao r mo nm mz avN= 0 >00 <Do m�� V-nrn -i xom-4<v_oa I mmz � r -4 aTzo n =vm mo