HomeMy WebLinkAboutNORTH WOODS UNIT 3 BLK 14 LT 4
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP251032
Work Type: SepticTank Upgrade
Tax Code Number: 05173232000
Site Legal Address: NORTH WOODS UNIT 3 BLK 14 LT 4 G:1459
Site Mailing Address: 23026 LIVE ALDER AVE, Chugiak
Owner: BELL DEBRA
Design Engineer: NORTH RIM ENGINEERING
This permit is for the construction of:
Effective Date:
Expiration Date
Lot Size in Sq Ft:
Total Bedrooms:
2/20/2025
2/20/2026
26081
❑ Disposal Field LSI Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From Octoberl5__to_April 15, a subsurface_soiLabsorption system under construction during freezing weather
shall be either: ✓� �� / ��
a. Opened and Closed o the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions:
• Prior to tank installation, the edge of the bed is to be located to ensure that the required tank -to -
field separation will be met.
Received -By: )__ _S �5 CACA _�o lVoi r'� tl� i 1ryl Date:
Issued By: Date:
3
MUNICIPALITY OF ANCHORAGE
Development Services Department
Phone: 907-343-7904
On -Site Water & Wastewater Section
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 05173232000
Property owner(s) BELL DEBRA
Mailing address 23026 LIVE ALDER AVE
Site address 23026 LIVE ALDER AVE
Day phone 907-223-7934
Legal description NORTH WOODS UNIT 3 BLK 14 LT 4
Number of Bedrooms 3
Engineering Firm NorthRim Eng.
Building Permit Number
Not Applicable FK
APPLICATION IS FOR:
APPLICATION IS AN:
(Z all that apply)
Absorption Field
El
Initial El
Septic Tank
El
Upgrade Fx_1
Holding Tank
❑
Renewal ❑
Privy
❑
Well
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Permit/Rush Fees: I 2-2_,�
Date of Payment: 7_Z1g2:Z
PermitNo.
Waiver Fees:
Date of Payment:
Waiver No.
Distance:
SteveEng.com NORTH WOODS # 3 BLK 14 LT 4
SPECIFICATIONS & DESIGN GUIDELINES
Wastewater System Sizing: The current septic tank has failed- the field still functions.
Replace septic tank near same location, decommission old tank per UPC. This lot is over
half an acre and on public water. Separation measurements to be made prior to
construction. No adverse impacts are expected from tank replacement. No easements are
on the lot. The slope is negligible in the area of the septic system. No conflicts to
neighbor properties.
Specification Requirements: All components and work must comply with the
Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water
Regulations and Wastewater Regulations.
New 1000 gallon steel septic tank. Watertight couplings on inlet & outlet.
5 minimum between the tank and trench. 5 to property lines & 10 to house.
4 of cover or insulation is required for tank; an equivalent of 1 insulation for 1 foot
soil cover. Tank & solid pipe must be set on well compacted, stable soil.
No large rocks for tank bedding. Plastic/fiberglass tanks require special bedding per
MOA- sand or pea gravel.
4 diameter cleanouts with airtight caps are required 1 to 4 from foundation wall,
prior to any 90 degree bend in 4 inch line, in 2nd tank compartment, and two adjacent
opposing cleanouts between the tank and the absorption field, not more than 10 from
the tank positioned to provide cleanout access towards the tank and towards the
absorption field. Manhole Riser required in 1 st tank compartment.
All cleanouts must extend to at least ground level.
In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron.
Insulation must be placed over any pipe installed under driveways or parking areas.
Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789,
ABS ASTM D2661,
Sewer Service Line is minimum 2% slope.
Septic Tank to be pumped every two years or when required.
Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal)
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251032, Deb Wockenfuss, 02/20/25
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251032, Deb Wockenfuss, 02/20/25
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251032, Deb Wockenfuss, 02/20/25
NAME
MAI LING ADDRESS
LEGAL DESCRIPTION
LOCATION
Well
DISTANCE
i ¢ (,)~) IF HOMEMADE:
DISTANCE TO:
DISTANCE TO:
No. of lines
MUNICIPALITY OF ANCHORAGE Mo~ $=T ~ O~_~
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
PHONE I /~NEW
Well
Length of each line
Top of tile to finish grade
ffl
Length
Absorption area Dwelling
Material --
Inside length Width
Dwelling
Material
Foundation /~0"~' ~,5 I Nearestl°tline/o~ -~
Total length of I nes Trench width
I nches
Material beneath tile
inches
NO, OF BEDROOMS
PERMIT NO.
8q
No, of compartments
Liquid depth
PERMIT N~ .
Liquid capacity in gallons
PERMIT NO,
Distance between lines
Width Depth PERMIT NO.
Type of crib Crib diameter Crib depth
Well Building foundation
DISTANCE TO:
Class Depth Driller
DISTANCE TO; Building foundation Sewer line
OTHER
PIPE MATERIALS
SOl L TEST RATING
INSTALLER
REMARKS
APPROVED
72-013 (Rev, 3/78)
Total effective absorption area
Total effective absorption area
Nearest lot line
Distance to lot line PERMIT NO.
Septic tank Absorption area s
F'ERI'"I ~ T I'.,tEJ:
[:'RTE 1 .::,z, LI[:E .
AF:'F'L I C:ANT:
A [:,D F.:E S';S:
E:CINTFICT FtHONE '
LEGI"~L [:'ESCF.: I F' '
L. OT SIZE'
DEPF:tE:TMENT OF HEALTH FtND ENVIF.:ONMENTFIL. PF.'.OTECTION
825 L STREET., ANCHORAGE, RK 9S~5C4:1
264-4720
SI'EVEN L. Sf<RC-iGS
P.O. BO'/,D.
CHUGIAK., AK 99577
688-...28]:::L
MAX E:EDROOMS -
SUE:[:, I ',,,'I S I ON: NOF-.':THWOOD ¢ ~.¢b~ ~
5;ECTION: ~,-~'.:4 TOWNSHIP: ::LSN
(SQ. FI". OF.'. ACRES)
].-: ,,,,'
LOT: 4
RANGE: ±W
E,L ]_.K. t4
LISTEP E:EL. OW I=IRE ]"FIE OPTIONS FIVAILF:IBLE TFI YOU IN [:,ESIGNII'.,IG YOLIR =,EFTI_.
SYSTEM. CHr3C'EE THE ':F'TIEN THAT BEST FITS YOUR SITE.
-If F-.
DEPTH TO PIPE BOTTON (FT. ') 4. 0 4. 0 4. 0
GRR',/EL PEPTH (FT.) 2.. 0 0. 5 2. F~
TOTAl... DEPTH ,::FT. ::, 6. 0 ~" 4.. 5 6. 0
GRFIVEL WIDTH (FT.) 2. 5 20. 0 5. 0
GRFIVEL LENC"iTH ,::F"T'. > !29. O :~'.:+: 2i:9. O 73:. 0
GRAVEL VOLUME (CtJ. YDS..':, 2.9. 8 28. 8 ~:2. 7
TANK SIZE <GALS) :L., 000. 0 :+::+: 1., 000. 0 :+::+: 1, OBG. 0 *:+:
SOIL RATING <SQ. FT. ,."DF;:) 172 172 172
:+::+: GRA',,,'EL. L..E]'.,IGTH :::. '-"~':;, ._ FT. REQUIRES HLIt. C'FIPLE RUNS ,:'NOT. E::'::CEEDING ~'~',' ~, FT. EAC:H)
:+::+: "FRNK ML.IST HF¢,,,'E FIT L. EFIST TWO ]:OMF'RF.'TMENTS
I CERTIFY THFIT:
1. I FtM F'FIMILIAR WI'TH THE REQUIREMENTS FOR ON--SITE SEWERS AN[.', WELLS AS SET
FORTH BY 'THE MUNICIPFILITY OF' ANCHORAGE (HOB) AND .THE STATE OF ALASKFL
2. ]: 14IL. L iNSTALL THE SYS-';TEM IN f:ICCORDFINCE WITH ALL MOA COPES AND ,REGULFiTIONS.,
FIND IN COMPLIFINC:E WITH TNE [:,ESIGN CRITERIA OF THIS PERI*'IIT.
2. I I.,.IILL FIDHERE TO ALL. 1'101=1 AND STATE OF ALASKA RELT).UIREHENTS FOR THE SET BACK
DiL:'.;TANCES FROH ANY EXISTING HELL, I,.IFISTEWATER [:,ISPOSFIL SYSTEM OR PUBLIC
'.'.-..]EWERAGE SYSTEM ON THIS OR ANY ADJACENT OR NEARBY LOT.
4. I UNDERSTAND THAT THIS PERMIT IS ',,,'FILID FOR A HFIXIHUH OF 3: BEE:,ROOMS AND
ANY ENL. FIRGEHENT WILL REf.:c. UIRE PIN ADDITIONAL PERi*lIT.
IF' FI LIFT STFITION IS INSTFt[_L. ED IN AI'.,i AREA COVERED BY MOA BUILDING CODES,
THEN (:1.) AN EL. ECTRICFlL PERMIT FIND INSF'ECTION HUST BE OBTAINED; (2) RS-BUILTS
HILL NOT BE FIPPROVED WITHOLIT AN ELECTRICAL INSPEC]"ION'REPORT.~ FIND (3:) THE
ELEC'f'RICF]L WORK MUST BE DONE BY FI LICENSED ELECTRICiFIN.
S I GNE[., ~ ~ ~-'~'- '/'~ [,M]'E _~,~
iSSUEr.:, PATE:
Permit
Il
MUNICIPALITY OF ANCHORAGE,
Departmen?-qf Health and Environment~Protection
825 ~ Street, Anchorage, AK. 39501
264-4720
* * * HANDWRITTEN PERMIT * * *
~{~k~DR ON-SITE SEWER PERMIT
Applicant: <L~"~"Uc~'~~--~c~%C~,,, ~ Mailing Address:
L'~cation: ~3 ~ t~30 O~ ~ Phone Number:
Legal Description:
Type of Soil Absorption System Is:.
Trench: Drainfield:
Maximum Number of Bedrooms:
'9~s% 7
Lot Size:
Seepage Bed: Holding Tank:
Soil Rating(sq.ft/br) I~
The Required Size of the Soil Absorption System Is:
DEPTH ~ LENGTH cC~ GRAVEL DEPTH ~)-~' WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = ;000 GALLONS * *
~ermit 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
oflpublic 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 $1~ 1 9 8 3 * * *
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the residence is remodeled to include more. that 3 bedrooms.
Signe~: Issued by: ~__~ ~ ~---~ ~'~
Applicant
Date: ~ ~'~ A
S~P/024(l/81)
· [.,EF'FIRTi"IENT HEFILTH RN[:, El,I, II:._l',li"lEi',l]ltL .
,: ........ '"L.'" ':E, TREET., IIN_.,'I...E,'I.~E,
;.E.;'G4""',4.72E : I:tt",IE HC RRGE 694."-2:1_:.E~:::[ · EFIGLE R .I ',,,'ER
IqF'F'L'Z CI'":INT ' SI':::I::tG:.3S CONSTR F'HONE: ~::,,:,,::,'"~. .....'.i.
F][:'DF.:ESS: F'O BOX
CHUG I FIt':::., FIK ::~::~._,,:'- '- .... ,'
L. EGFIL -. ~-,.".'--r~," r,','" -,~, . , ' .....
.... .~- .r~ ...... ~, SUE:DIVISION I",IORTHI4OOE:~'~, ~2; E, LDL. k: :24 LOT:
LL-IT SIZE O E;Q. FT. TOt4NSHIF': "- 'F-':F41"~GE: .... E;ECTION: -
HFI:"~:If'IUM,~,_*"' ,'"'r~rn::,,_,,_,,. Eli':' BEB'F. tOOME; = 3 SOIL RIq'T'INI:3 = ..... ':hq?; Z¢=" '"= .... "::L~,._'-.~ ':::.E;,6L FF. "EF...' ,'"
[...i$TEB' E~ELL3',4 Ftt~IE THE: UF'TiLqN':']; FI'v'FI.T.L. FfE~LE TI:'.'~ ~i"OU :[i",1 DE::E, tGI",III",IG "r'I_'IUF.': .=,Et-1 I_.
:3,.=,1E1t. CFIE~¢?SE' TI'tE 2. PTION Tt'"IIqT E,E;:,I FITS 'T'I.EIIJR E;I'TE.
'IF ~.. ,~ f¢",~ ....... I~'~ lC:" EE :'~ % ~
IdI£:'TH = 2. 5 F']-.
L~I"~:~TI'"I = ,_,°"""'-... O .FT. NOTE ~ - _. ._ FI". F::EE..'U]CREE; TI.,.IO TF.':ENCHES
TOTFfL [:'EF'TH = ~5. 1-21 FT. NO-I-E ~ -I:~:EQUIRES INSULF:ITION
GRF:I","EL [:'EF'TH = 3. ~2~ F-T. i'4OTE ~ MFI"r' 'F.".ES!LI I RE L I FT .:,'[ t .~.
GF-'II::IVEL VOL. LII'"IE = 26. :B E:U. "r'D:~,.
TRNI.':.' E;IZE = % E~¢E:.L tF .... GRLLFflq':"X ':'Tt40 L..tlF't~F..]fll:dq~-'- ' .....
I.,.I]:DTH = 2E~.,E~ FT.
LENGTH = 44.3 E~
TUTFIL E:,EI::'7[H = 5. E~ F'T'.
C'-E'"';'..'". iE.,EF:'TH = E~. 5 FT.
E!¢'::'.'"f "i. '~'"'" "'
.............. ~...Ut IE. = 'Z::!;L E; CLI. VE.':~.
T;-,:'.!i:.i :;:[2;E: = :2, -'::"%
I=:,1, ....... E!~ 'Eil::ll..L _-INS(: ]"[..iE~ COi'iF'FIRTMENT 'T'l';:ti'-,tl'=:: ',
~..,,.i; '!" :Z..', i~!ZZ!: I_F..'::~ F:i:: E::~ % ~"-4t F:" ~EZ IE::'-Z; L.. EZ:' EZ::* Ei!i~Z ":'::;; Z][ [.'~
1.,.I ;~: tZZ-" 5. ~.-3 F'T.
~ ~?'"' .... ~ 7'EL '": ~.:...r.
~ ...... : ...;.~ 11t = E;. !21 FT.
u:'=.: ...... ,;.:. , ,~'l == Z:. ¢ F"T.
,. LLt ,,- = 32....,. ''~ CU. "~"D:~,.
'T'f:';;' !; ......,.~' ,:...,....'"~'"'" = :2., E'~.~;fE!L O '-" ..... ' L,~ ...... '-"~.[::':'" .... "'"'~,..f" .... CE;',NPI:'tRTI'"IENT TI'":II'-,II'( >
.......... TI...t!UlT:
::I ......... l,,~ ......t'F.'. I.,.I]:TH ]"liE:'. ~.EL..!UZI';.Et' :., .. FOR ON-:.5tTE 2;EI.,.IEt':::E; FIND 14ELL£i; FI'-:".'; SET.
F'C,~'i:"!' D',' THE t"tUNZCTF'f':IL.~T"r' I'-d::' t:::lHr_":Hr'_'l:?:"';;'..["; .";NE:= 'T'~.tE '.E;Tt..'::I"f'E 17.1E."
':'=:i...L .......... .;:N:..E;TFiLi_. ]'HE E;=.~-%'i"E:H ZN I":K:.~: '"'~'"', = .~ ..... i,, ~:.r'" LII'FH THE CAE:,E5 I~:INE:, t.-IRVIF RECE1VEE,
I:::i C::. ' .'.':4:': TI.IE CODE '-t t' ' "-,*'"',' :-'~ '~ '-l-' . ' : ' :;
.::,_ - .. FIND E:,ZFIG;:::.:"i, i ~.,, , ~ t_.1111EN I _ !,II...I ]: CH ]:::.E; F:'F:IRT L-IF:' 'T'I...I :I: :.E;
F:' E ;"::
:Ei ....... ER.,,I. ~,~_. ]-HFFF .,'~k.:. ')N. '-;'[]"E :~!;;ZF.;2]'::: .:2-,%;TEH MR'.r' I.I:L.! .....I.E. ENLRRGEMENT :fF' THE
f;i:i; 'i'h::;.E t:;!; RE:t"IO[:,E:L. EE., i"O ]'N[L_iDEH""'""' ..... ........ 'T:, if]N _E: EEDF.'_-
.... , I, F ..... -~N, f'lF:i5 TI'El !.~.=K ~ ......... , ...... TF .T. NFOI;:i"1 F:'ERSONNEL E:4JRING
T¢ , .... ' ..... .... , ,¥ -.~ * I N'::;F:'E .......... '" "t" ]' '" H'.'E; OF' FIN'¢ ~..., ............. FIE:,J'FtCE;N-f' Till TH I f~, F' t'""_tF E'RT'¢
'T':2.: "EifiER OF RE~7,]:DENC[~;:E; T'HRT 'i"t4E; ,- ................ i.,.IILL
'EF F:i L;[FT S'T!::FFIE4",I i% .IN::_:';Tf"E...L.2D. FiN ELECTF.:I_.hLi-'-' F:'EF.!t"'~ZT FIND I,,,:,f~ ......... E_.TZON' I"IUST
.... ,-'_ OEFI"tqIt'.IEE:,. !r:I:::E,'"'E~UZL. T:.'7, C:F:!NNO'T' E=E FIF'F'RL3',,,'EEE:, I.,.I.ITHUL.tT FIN E'LE:CTF.:!L-:FIL.
REPFdE:T. THE EL. ECTF.'~"_'.F'. NURt=: ........ 1 BE DONE BV 1:1 L. TCEN:.:~;E:D E. EL.~I'.IC:TI=IN..
2, I GNEf'):
"IF F L t ~.--~N t':
ISSUED '~"' 0~,.~,.C6,~
~, : [;,RTE: 12,.."i2,."'E:3
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SOILS LOG
PERCOLATION
TEST
~ERFORMED FOR:
'LEGAL DESCRIPTION:
1
SLOPE
DATE PERFORMED: J
SITE PLAN
55'
11
12
15-
16
17-
18~
Reid,
22~1-E
20-
COMMENTS
WAS GROUND WATER S
ENCOUNTERED? po OL
IF YES, AT WHAT
DEPTH?
Reading Date Gross , Net Depth to Net
Time : Time Water Drop
PERCOLATION RATE /0 - ~ (minutes/inch)
\
I~EST RUN BETWEEN Z~2' FT AND "~ FT
CERTIFIED BY:
PERFORMED BY: ~r-t 3
DATE:
72-008 (6/79)
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parce,,.D. # Z-,CZ HAA#
1. GENERAL INFORMATION (Mus! be completed prior to submittal)
(a) Legal Description (include lOt, block, subdivision, section, township, range)
Lot 4; Block 14; North Woods #3
Location (address or directions)
Live Ald¢_r Au¢_~u~_
(b) Property owner ~t~5
Dobson
Mailing Address .¢~)(.~) Dc)ct';-/'
(c) Lending Institution
Telephone: (home) . Business.
Telephone
Mailing Address
(d) Real Estate Company and Agent TARGET, INC.
Address 770~,~ Nor~_~_ Fag~_¢ R!:,er toop Road
Telephone 694-2388
Attn: Dic~ Brown
(e) Mail the HAA to the following address: (or check here J~Xf hold for pick up.)
List contact person and day phone number below:
$ & $ ENGINEERING
17034 Eaqle Rib, er Loop Road
Eagle River, Alaska 99577
2. TYPE OF RESIDENCE
Single-Family ~ Number of bedrooms ~
3. WATER SUPPLY
Individual Well [] Community [~X Public []
Note: If community well system, mus~ have written confirmation from the State Department of Environmental
Conservation attesting to 'th i~aiity and status. " ' :
4. SEWAGE DISPOSAL
On-site [:~ 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.
72-025 (Rev. 7/88) Page 1 of 2
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
' A~ certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of th is
Health Authority Approval 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
Telephone
S & S ENGINEERING
Address ~.7034 ~51e Ri~er Loop Road No. 204
Eagle River, Alaska 995:77 ?.~/~/~,.//~
Date /~'~ '" ~
6. DHHS APPROVAL
Approved for -.~
Approved_
bedrooms by
Disapproved
Terms of Conditional Approval
.Conditional
Date
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer
registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. 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. 7/88) Back Page 2 of 2
MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)
L4 ~;"-:~ '/',~i1C~ECKLIS~c~FE B R UARY 1984
A. WELL DATA
Well Classification
Well Log Present (Y/N)
Total Depth__ Cased to
Static Water Level
Casing Height Above Ground
Date Completed
Depth of Grouting
Legal De.scrlptlon:' ' ~'5~ ~ '~L.,~4-~ ~'
Electrical Wiring in Conduit,(Y/N)
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption FielC on Lot
To Nearest Public Sewer Line
To Nearest Sewer Service Line om Lot
Water Sample Collected by
Water Sample Test Results
Comments '~ ~'1~,
If A, B, C, D.E.C. Approved (~N) ~-__
Yield
Pum p Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/~')
; On Adjoining Lots
~ 1 ~ ; On Adjoining Lots
To Nearest Public Sewer Cleanout/Manhole
Date
B. SEPTIC/HOLDI~NK DATA
Date Install9d ~y~v'~¢. Size
Standpipes ~'N) '~ Air-tight Caps ~¢~'N)
Depression over Tank (Y~:)
Pumping/Maintenance Contact on File.(Y/~/
Holding Tank High~Water Alarm (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
No. of Compartments
~ Foundation Cleanout
DZe Last Pumped
i ; for
Temporary Holding Tank Permit
To Building Foundation
To Disposal Field
To ,WaterLSupply Well ~ ! 'Y
To Property Line ~ L.~ tj¢
To Water Main/Service Line \ c:> ~ Jr'
To Stream;'P0nd, Lake. or Major Drainage Course
Comments
72-026 (Rev, 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorptio~:~/~ ~ ~,c~t~=' ':~--- Type of System Design
Date Installed Length of Field ~ I
Width of Field \ ~
Square Feet of Absortion Area
Depression over Field (Y~)
Results of Last Adequacy Test
Depth of Field
Gravel Bed Thickness
"lz~-'t-~<~ Statndpipes Present(~i~/N)
r'~ Date of Last Adequacy Test
To Water-Supply Well
TOLotBUilding Fou ndl~o/~~
To Water Main/Service Line
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
SEPARATION DISTANCE FROM ABSORPTION FIELD:
~ ~J~ To Property Line t
~ ~"~ To Existing or Abandoned System on
; On Adjoining Lots '~"~<c:>~ ~--
~ C::)~ J¢~ To Cutback (if present)
LIFT STATION I~ /, ~~ ~ ~~ ~'
D~alled _ ' ' _ .... Dimensions
..... n °.e,.ccess
"~mp O~' L~el ~ "Pump Off" Level at
High Water Alarm Level at ~ Vent (Y/N)
Tested for ~~ Pumping Cycles during Adequacy Test.
Meets MOA Electrical Codes (Y/N)
Comments
**Check Permitted Bedroom Rating Against HAA Request**
I certify that I have checked, verified, or conformed to ali MOA and HAA guidelines i.r~e~Ji~,~l~o, the d~t~!of this
inspection.
Company 17034 Eagle Ri~er k~p ~oad No, 2~
Eagle ~ver, A~sk~ ~v577
Date ~/ ~ ~/ ~ ~ ~~~ ~'s Seal
.o.
,.,
Receipt No. ~ ./~ ~/. ~ZZ~ Receipt NO.
Date of Payment / ~ ~ ~/' ~ Waiver Fee: $
Amount: $ '~ ~ Date of Payment
72-02~ (R.v. 7/Se) B~ck Page 2 of 2
STEVE COWPER, GOVERNOR
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE WESTERN DISTRICT OFFICE
3601 C STREET, SUITE 322
ANCHORAGE, ALASKA 99503
December 8, 1989
563-6775
S & S Engineering
17034 Eagle River Loop, Suite 204
Eagle River, Alaska 99577
PWSID: #213001
According to the records on file in this office, the Chugiak
Util~ties/Northwoods-Deerhorn , Subdivision Water System is in
compliance with the State of Alaska Drinking Water Regulations.
Sincerely,
~nEv~roE~meCn~aI~ Field ~~icer
VEC:bas
' 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
GENERAL INFORMATION
(a) Legal Description (include lot, bloCk, subdivision, section, township, range) Lot 4 Block 14 North Woods Subdivision #3
Location (address or directions)
(b) Applicant Name Suzanne Cool Telephone: Home Business 694-/-+994
Applicant Address Heritage HOmes
(c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other ~]~ (explain);
(d) Lending Institution United Bank of Alaska Telephone
Address
(e)
Real Estate Company and Agent
Address
Telephone
(f) Mail the HAA to the following address:
TYPE OF RESIDENCE
Single-Family:l~:× Multi-Family []
Number of Bedrooms three (3)
Other
WATER SUPPLY
Individual Well [] Community I';1× Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsite [~X Public [] Community [] Holding Tank []
Note: If community welt 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)
ENGINEERING FIRM PROVIDI",~-'~INSPECTIONS, TESTS, FILE SEARCH, D'~'~ AND INFORMATION
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 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 Telephone
Address
Date
Engineer's Seal
This department has received written confirmation from the engineer,
S & S Engineering, regarding the conditional approval of March 11, 1986.
The work has been completed an~s now fully approved.
DHEP APPROVAL ~ / ~./ / _
Approved for three(.3) bedrooms . ,~ May 28, 1986
Approved xxxxxxxxxxxxxZt~sapp roved 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)
May 25, 1986
ROBERTA. SHAFER
CIVIL ENGINEER
694-2979
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOILTEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
Municipality of Anchorage
Department of Health and Human Services
825 L Street
Anchorage, Alaska 99501
ATTENTION: Susan 0swalt
REFERENCE: Lot 4; Block 14; Northwoods 3
As required by the conditional Health Authority Approval issued in February
1986, two monitoring tubes were i~talled, one on each side of the seepage
bed located on the referenced property. At the time the test holes
were drilled no water was encountered to a depth of 5 feet below the
bottem of the seepage bed. After 10 days the monitoring tubes were
checked and found to still be dry.
Request you issue a final approved Health Authority Certificate for
this property.
AS/ss
MUNICIPALITY OF ANCHORA(~E
DEPT. (JF ~-fE,,:,,LTH &
ENVIROI-,~Mb h,'l .% PROTECTION;
RECEIVED
SRB 196X EAGLE RIVER, ALASKA 99577
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
264-472Q
Application Date ~--'--~--~[-_~{-,
GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, ran, ge)
Lc-r q / q 1'4 =¢ 5
Location (address or directions)
(b) Applicant Name~=~l'-t~-- ~_Oo~_- Telephone: Home Business
Applicant Address.
(c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Othe~explain);
(d) Lending Institution I,~t,4. tTI¢.~ '~d~ I'..__ O~' I~rV-- ·Telephone
Address
(e) Real Estate Company and Agent
Address
~.~f~lephone
(f) .Mca~l-the HAA to the following address:
S 8, S E.glneerlng
S~ 196x
TYPE OF RESIDENCE
Single-Famil¢,l~- Multi-Family []
Number of Bedrooms ~)
Other
WATER SUPPLY
Individual Well [] Community [] Public ~
Note: If community welt system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
OnsiteJ~ 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)
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
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 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 $ & 5 El~gineering Telephone
Address
Date
Approved for ~/-~ bedrooms by~
Approved __ Disapproved
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 $ above by an independent professional
engiheer 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 befor'e 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
WELL DATA
MUNICIPALITY OF ANCHORAGE (MO~l
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984
264-4720
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
FEB 2 5
Legal Descriptio, n' L..~)'T' q~, r~: ~'] ~ J~
Well Classification
Well Log Present (Y/NJ
Total Depth
Static Water Level
A
Cased to
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
Comments '~ ~'~.
If A, B, C, D.E.C. Approved~¥'~.N~
Date Completed ./ Yield
DepthO~D ,r~uting
__ Pj~mp Set At
SanJ~l~eal on Casing (Y/N)
Depression Aroun(~ Wellhead (Y/N)
; On Adjoining Lots
~qr- : On Adjoining Lots
To Nearest Public Sewer
Nearest Sewer Service Line on Lot
: Date
B. SEPTIC/HOLDING TANK DATA
Date Installed ~'JJJ ~g
Standpipes (~
Depression over Tank
Size J,C~C~ ~ No. of Compartments ~
Air-tight Caps ~J~ Foundation Cleanout~N-)'
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/~ Tank:
To Water-Supply Well ~00 [ ~
To Property Line /~) l ~-
To Water Main/Service Line J~ ~ '~
Course
Date Last Pumped ~ ~ [=- [~ ~-'
*"~/~' :for ~'//x*-
Temporary Holding Tank Permit {Y/N) ~/~
To Building Foundation
To Disposal Field
To Stream Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date installed ~,/,~/
Width of Field ~ ~ I
Square Feet of Absorption Area
Depression over Field,('~
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well ~:::>~ ~ +'
To Building Foundation
Lot
To Water Main/Service Line ';/~ ~''
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Type of System Design
Length of Field ~/~'-
Depth of Field
Gravel Bed Thickness
Standpipes Present
l.of Last Adequacy Test
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots
To Cutbank (if pres/ent)
Comments
D. LIFT STATION
Date installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access [Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed S 8, ~; En~ln~erln~ Date
SEB 1~6x MOA No.
Company Ea~;e x~ver, ~las~ca
Receipt No.
Date of Payment ~ ~ -~
Amount: $
Page 2 of 2
72-026 , 11/84)
DEPT. OFENVIRONMENTALCONSERVATION
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA g9501
BILL SHEFFIELD, GOVERNOR
Telephone:
Address:
274-2533
MUi'qlCIPALITY OF ANCHORAGe.
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
~ ~ 2 5 1986
RECEIVED
To Whom it May Concern:
Accordin~ to records on file 'in this office
~]J_ Q/[~L~._~} LL, Water System is in compliance--/with the State Drinking
Water Regulations
Sincerely,
MUNICIPALITY OF ANCHORAGE
DIVISION OF ~NS/IRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information
Application Date
(a) Legal Description (include lot, block, subdivision, sectionv township, range)
Lot 4 Block 14 Northwoods Subdivision Phase III
Location (adcl~ess or directions)
(b) Applicants Name James Harkey
Telephone 688 - 9603
Applicants Add~ess Post Office Box 410 Chugiak, Alaska 99567
(c) Applicant is (check one) Lending Institution ~; Owner/builder~-~
;
Buyer~-~; Other x~x_~ (explain); Constru~ti6n~ Inc.
(d) Lending Institution I%lephone
Address
(e) Real Estate Co. & Agent
Address
Telephone
2. Type of Residence
Single-Family~
Number of Bedrooms
3. Water Supply
e
Multi-Family
three
Other (describe)
Note: If ccmmunity well system, must have w~itten confirmation frc~n the State
Department of Environmental Conservation attesting to the legality and status.
Is the well adequate for the number of bedrocms specified in this HAA (Y/N)
_Sewage Disposal
Onsite ~ Public ~-~ C~t~,~nity ~--~ Holding Tank ~--~
Is the wastewater disposal system adequate fcr the numbe= of bedrooms (Y/N)
[Page 1 of 2]
2-15-84
5. E_ngineering Firm P~oviding Inspections, Tests, Data and Information
I certify that I have ch~cked, verified, c~ ~onfotm~d to all MOA HAA Guidelines in
effect on the date of this inspection.
signed Date
Nam~ of Firm
Telephone
Add~ess
Signed by
Date
This Department has received
written confirmation from the
engineer(A.E.C.S.) regarding
the conditional and this has
been completed as per required.
This is now fully approved.
( ENGINEER SEAL)
6. DHEP Approval
Approved for three bedrocms
Approved ~ Disapproved
Te~ms of Conditional Approval
Conditional ~-~
June 6, 198
The Municipality of Anchorage Department of Health and Envi~orm~ntal P~otection dces
not guarantee t~ continued satisfactory performance of the water supply and/c~ the
wastewater disposal system. ~nis approval indicates that, as of the validation date
shown above, based on the data and info~,~tion furnished by an engineer ~egistered in
the State of Alaska, the water supply and wastewater disposal system is safe and func-
tional for the number of b~d~ocms and type of structure indicated.
(DHEP SEAL)
7. Mail tt~ HAA to the following address:
KB2/d5/s
[Page 2 of 2]
MUNICIPALITY OF ANCHORAGE
DMSION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
I. General Information Application Date '?/'i-:/,/,K~/
(a) L~gal l~sc~'iption (in¢lu~d~ lot, bl~k_.~ sul:x:livisicl'l, section, to.ship, tango)
Location (add~ess or directions)
(b) Applicants Nam~j'-~._~:,.~..~' ~' ,,~- ~IKF~?' Teleaphone ~:- ::~. :_
(c) Applicant is (che~ o~) ~nding Institution ~ ~ ~r~uil~r ~ ~
(d) Bndiw institution ~lepho~
Address
(e) Real Estate Co. & Agent
Address
Telephone
2. Type of Residence
Single-Family ~
Number of Bedrooms
3. Water Supply
Individual Well [~
o
Multi-Family
Other (describe)
Cc~munity ~ Publico
Note: If cc~unity ~11 system, must have written confirmation from the State
Department of Environm~=ntal Conservation attesting to the legality and status.
Is the ~11 adequate for the number cf bedrcx~ns specified in this HAA [y.~)
_S~. wage Disposal
Onsite ~ Public ~ C~nunity ~--~ Holding TapX ~-~
Is the wastewate~ disposal system adequate fox' the number of bedrocras ~,~)
[Page 1 of 2]
2-15-84
5. Engineering Firm P~oviding Inspections, Tests, Data and Infornmtion
I ~=tify that I have checked, verified, o~ conformed to all MOA HAA Guidelines in
effect on the date of this inspection.
ar~ of Fire
Si~d ~
Date
, i/ . / / ~(~GINE~ S~)
6. DHEP Approval
Approved for
Approved ~
Terms ._q~/~ nditional Approval
Telephone
Disapproved ~ Conditiona~ ~
~ne Municipality of Anchosage Department of Health and Environmental Protection dces
not guarantee the continued satisfactory performance of the wate~ supply and/or the
wastewater disposal system. This approval indicates that, as of the validation date
shcwn above, based on the data and information furnished by an engineer registered in
the State of Alaska, the water supply and wastewatec disposal system is safe and func-
tional for t3~e number of bedrocms and type of structure indicated.
(DHEP SEAL)
7. Mail the HAA to the following add~ess:
KB2/d5/s
[Page 2 of 2]
2-15-84
ae
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AU/~ORITY APPROVAL (HAA)
Well Classification ~/a~ ~
Well Log P~esent (Y/N) ~L//;~
Total Depth ... ;~/~- Cased to
Static Water Level
Casing Height Above Ground
Electzieal Wiring in Conduit (Y/N)
Separation Distances f~cm Well:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
C leancut/Manhole ~7
Water Sample Collected By
Water Sample Test Results
C~tt~ents
CHECKLIST - FEBRUARY 1984 NOI/D]lOad
Desc ' ' ~ lW~H ~O 'iago
r~ptlon.
; On Adjoining Lots
;t//~ ~-; On Adjoining Lots ,,
~- To ~est ~blic
~ ~est ~r ~rvi~ Li~ on ~t
~/~ ; ~te
B. SEPTIC/HOLDING TANK DATA
Date Installed ~/~'~
Standpil~es ~)
Depression over Tank (Y~
Size /~3~3 D
Air-tight Caps ~/N)
Date Last Pu~ped
No. of Compartments
Foundation Cleanout [~/N)
Pumping/Maintenance Contract on File (Y/N) ~7//~; for
Holding Tank High-Water Alarm (Y/N) ~3~/~ Temporary Holding Tank Permit (Y/N)
Separation Distances f~cm Septic/Holding Tank:
!
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, c~ Major Drainage
To Water-Supply Well
To P~operty Line
To Water M~in/Service Line
Course
Cora~nts
[Page 1 of 2]
2-15-84
C. ABSORPTION FIELD DATA
Soils Rating in Absorpt. ion St=ara
Date Installed ~/f ~ / ~ f
Width of Field
Square Feet of Absorption A~ea
Depression over Field (Y~
Results of Last Adequacy Test
Separation Distance f~cm Absfrption Field:
/~ . Type of System Design
Length of Field ~ /
· Depth of Field ~,S
Gravel Bed Thick~ess
7~-&~ Standpipes P~eeent ~/N)
Date of Last Adequacy Test
To Water-Supply Well
To' Building Foundation ~'/~;~ ~
Lot ~3/~ .; On Adjoining Lots
To Water Main/Service Line ~(~o To Cutbank(if present)
To St~eam/P°nd/Lake/c~ Ma jo= D~aina~e Course
To D~iveway, Pa=king A~ea, c~ Vehicle Stc~age A~ea
Cc~m~nts
To P=operty Line ./t? '+
To Existing or Abandoned System cn
D. LIFT STATION
Date Installed
size in Gallons
,,p~p On" Level at
High Water Alarm Level at ~[/c Vent (Y/N) ~/.4'
Tested fo~ ~J{$A Pumping Cycles ~ing A~q~ ~st. ~ets ~A
Elec~ical Co~s~ ' ~ ~
Co.~ents . --
** Check Permitted Bedroom Rating Against HAA Request
I certify that I have checked, verified, c~ conformed to all MOA
on the date of this inspection.
Company /~Sd~ MOA No.
KB1/d5/s
[pa~e 2 of 2]
HAA Guidelines in effect
2-15-84
437 "E" STF~EET, SUITE 200
Ai~CHORAGE, ALASKA 99501
T~lephone:
Address:
274-2533
To Whom It May Concern:
cording to records on file in this office the ~_r~J~
gL~i~l~iO/~J Water System is in compliance with the State Drinking
Water Regulations.
cerely,
ALASKA e dlRO[lme[/TAL CO[1TROL I[1C.
June 1, 1984
Department of Health and
Environmental Protection
825 L Street
Anchorage, Alaska 99501
Attention: KeithBandt
Re: Lot 4, Block 14, Northwoods Addition #3
Dear Mr. Bandt:
I visited Lot 4, Block 14, Northwoods 93 on May 31, 1984, at
approximately 8:00 p.m., I observed there was a jim cap on the
cleanout near the foundation. I further observed that all minor
drainage problems over the system have been resolved. I recc~nend
removal of the conditional Health Authority Approval for the
Certificate issued May 29, 1984.
~R~na~l'd ]~. Godden
Environmental Engineer
RG/caj
Approved By:
MuNJC%PALtTY OF ANcHOP, A(3J~
DEPT, OF i~tALTH &
ENVtP. ONM~i'4~ AL pP, oTF..CTiOF[
RECE X/ -D
1200 J. Ucsl 33rd Aucnu¢, Suik [~. Anchoroq¢, Alaska 99503-(907) 56~-50z10
