HomeMy WebLinkAboutREED LT 14
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
· 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
IPHONE i ,~r,,l EW
NAME
MAI LING ADDRESS/,?
LEGAL DESCRIPqION
DISTANCE TO: /~) ~ f ~. Absorptioe~area/
I ,~ I Manufacturer ..'1 ,
Dwelling
: ~ jM.~.fa~t.~or ' '
~ ~'~ ............ Well Fouedation
J ~z DISTANCE TO:
L~ ~ ~ No. of Idles Lengd~ of each line To[al tength of lines
~--~:[ ~,~:. Top of tile to finish grade
NO. OF BEDROOMS.~
Width
PERMIT NO,
No. of compartments
Liquid depth
PERMIT NO.
Material Liquid capacity in gallons
Nearest lot line PERMIT NO.
Trench width Distance between lines
inches
Material beneath tile Total effective absorption area
Crib depth
Lenoth~.~/-/ ¥idth / ~' ./
Type of crib /t~)/,,~ Crib diameter
DISTANCE TO: /~O /
Clas~o~~ Depth
DISTANCE TO: Building foundation Sewer line
OTHER
PIPE MATERIALS
b3o3 ¢
SOl L TEST RATING
INSTALLER
REMARKS
Buil¢~g foundation
Driller /
Total effective absorption area
Nearest et ne ../O./
/I~APPROVED DATE LEGAL
~¢,' ,
PERMIT NO,
Distance to lot line
Septic ta?~} ~ /
PERMIT NO,
Absorption area(s)
/CO /
[~"~SOI LS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
[] PERCOLATION
TEST
SLOPE
10
WAS GROUND WATER
11 ENCOUNTERED?
12
I IF YES, AT WHAT
DEPTH?
13
14-
15
16
17
18
19
2O
DATE PERFORMED:
LITE PL/AN
COM,ENTS 2
q
TEST RUN BETWEEN FT AND FT
(minutes/inch)
PERCOLATION RATE
Gross Net Depth to Net
Readin9 Date
Time Time Water Drop
EAS !;tdt!',NTS FOR WEDL AND WATER LINES
Ti~e Grantol:, Finis Shelden, d/b/a Finis Construction
Company, whose mailing add~ess is P~O~ Box 67~1087, Chugiak~
Alaska 99567~ fou valuable consideration the receipt of which
is hereby acknowledged, being the owner 'of certain adjacent
~eal properties hereinafte~ ~efer~ed to as Parcels A~ B~ and C~
Pete~s Creek~ Alaska, more
situated in Reed Subdivision~
particularly described as follows~
t ARCLb A. Lot Fourteen (14) Reed Subdivision,
~{i!r~'S]r~T~i~ to the official plat thereof~ filed under
Plat No. P--390 records of the Anchorage Recording
' State of Alaska;
D~str~cL~ Third Judicial Djshrict~
~5 'P ~ -' Lot Thirteen (].3) ~ Reed subdivision~
l. ARC},I~ I3, chef eox filed under
......... ' Pla[ No, P--390~ records of the Anchorage Recording
District, Third Judicial Districht State of Alaska;
a n d
i? ARC F,L ~._~ ~ Lot [~welve (12) Reed subdivision~
i[i'~'~5'~i[~i~9 ko the official ]platt thereof~ ~i].ed under
Plat No. p--.390 records of the Anchorage Recording
" ' orate of Alaska~
District, Third Judicial Dl. st~_~ct~
.... / ~' hereby grants from said Parcel A to said Parcels b and
lt'~ the use and maintenance of two wells and two waterl
1~[ easement for those existing wells and water lines
~:~3~}articula~ly shown on the as-.buil% survey athaohed hereto as
~ "A" ~ . be lO feet in width~
{~ Exh.kbih ~ oald Easeraent shall
'. thy
~ commencing at a point 30 feet West of the Southeast prope
cerner of Parcel A, wi~h the southern property boundary of
~ parcel A as the Easement's sounherly boundary~ and shall extend
~ to the common lot line between Parcels A and B
Further, the Grantor hereby grants~ from Parcel' B~ a 10
foot easement for the existing water line to _azcel C~ said
~ easement is ho be located along the South 10 feet of Parcel
],
drawing attached hereto as Exhibit A, and by this reference
made a part hereof° The easement hereby created and granted
shall be binding upon and inure to the benefit of parties
S successors and
hereto, their heirs~ legal representat.Lve ~
assigns¢ and shall exist and run with the land¢
During the existance of the herein-granted easemen't-~ the
owners of Parcel A and B sha].l not utilize the easement areas
in any manner which will prevent the owners of Parcels B and/or
C from having fu].l~ free~ exclusive an~ uninterrupted use of
the two respective water wells to which the respective water
lines from each lot are connected, :including maintenance
purposes of the said well. and water line~ Nothing herein
contained shall be construed to imply any warranty by the
owner(s) of Parcel A as to the quantihy or quality of water to
be obtained from said wells¢ liability for any damages caused
by non-del: very of water ~ no~ Ii. ability :Ln any way r~or
upkeep and maintenance of the wel].~ serving Parcels B and C,~
no~ shall the owne~(s) of pa~ *~ A in any way be esponmib].e
i for Zhe upkeep of the wells o~ water;Lines and, ifurther, the
owner(s) of Parcel A shall not be liable for any damages
injury ho persons or pnoperty occurring within the easement.
area.
DATED this /-~''5~? day of
STATE OF ALASKA
.... Chugiak ~
· ~ - ,< ' 1985 ~t '
THIRD jUDICIAL DISTRICT ) tel [' ,. (~ ?~r~
,,, ,' ,' that on the .I ....... day of ...~ .......
THIS :[S TO CERtifY -
1985~ before me, a notary publ:i.s :Ln anti for the '~=~['[e oE
Alaska, duly commissioned and sworn as such~ personal, l)?
, ~ =. 5, known b.o me to be the :i. nd iv' dual narnefl
appeared r, INIS SHI~LDLN, ~ ,
herein, who acknowledged to me that he executed the ~:,,~oqoS. ucj
,~.~t-n~'JlV for the uses an, [][j[][~
1200 Wast 33rd Aw ,, Sultu B
ANCHORAGE, ALASKA 99503.
(907) 561,5040
MUNICIPALITY OF ANCHORAGE
DEPT. OF IJEtd. I'H &
[:N\/IROI'%/~EIqT/'~.L PROTECTION
WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geologicol 6 GeophysicoISurveys
An,.q hdr Reed 1 ~ _of_of_of- s~
Ic.J~DISTAHCE AND DIRECTION FROM ROAD INTERSECTIONS 3. OWNER OF WELL:
Finis
Realt~~
Co~t~
Sand Gravel Boulders 25 S(} 7. US~: ~ Dom,,)ic
Boulders Sand O~svel 63 140 ~ I,,,W,II OOther:
~r~ter ~ O~ve~ 180 q~h ~,p,: Open ~oZe
Bock filling
Date
~ Above or ~ Belo~ land lurfoce
Equipment us*d;
ti. PUMPING LEVEL be)ow lend $urfoce end YIELD ~
.... 12.GROUTING Wet[ Grouted: ~ Ye~ ~No
Moleriol: ~ Neot Cement
Lenglh of Drop Pipe ~ft. copocity g.p.m.
14.REMARKS:
STATE OF ALASKA
DEPA,,,MENT OF NATURAL RESOURES
Division of Geological 8~ Geophysical Surveys
0rHlin~ PermH No.
LOCATION OF WELL {Pteale complete either ia, Ih or lc.) ..u.~-.
i~.lBorough'' Subdivieion Lot 81ack ~.[ I/4qt,` Section No. ,ownlhiPN~ Renge E~
~DISTANCE AND DIRECTION FROM ROAO INTERSECTIONS 5. OW"~" OF w~c:Finls 3. eait~' ~onst,.
Cu;i~k~ Ak.
Street Address and Area of Well Location
Feet Below 4. WiLL DEPTH: { final) 5 DATE OF COMPLETtON
2 WELL LOG Surface
Sand Grave~ H20 Se,p~';'e Gr. c~j ~_iO 16: ..c~sm~= ~Threoded ~ Welded
~ ~¢ ~ 7~% diam. in fO ft. Depth Stickup~
:~c~, r ' ~' ~ ~d ~,'
H20 ~ Or.~vel 3SOl ~;j~ l~C)
Water & Gravel 150 154 T~,,: O~en Eo!e o~o~,,,~:
D~PT ~F H~ T~ ~. Equipment USed: ~-J~O
~HVIRONMENTAL P
II.PU~PING LEVEL below land lutfoce and ~ ~'
M~teriol: ~ Ne~t Cement ~ Other:
I~, PUMP: (if ovoiloble} HP
t6, WATER WELL CONTRACTOR'S GERTIFICATION: 15, Water Temperoture o ~ F ~ C
-~egist~r~ Business ~ome Conlracl License Number
Parcel I.D. #
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH &HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
,~EA LIT Y OF
NTAL SERVICES DIVISION
OCT 2 9 1997
RECEIVED
1. GENERAL INFORMATION
Complete legal description
Lot 14; Reed Subdivision
Location (site address or directions)
Property owner
Mailing address
Lending agency
Mailing address
23139 Rosebud Row
Chuqiak, AK
Linnia & Raldo Estridqe
C/o Remax of Eagle River
Day phone
16600 Centerfield Dr,
Day phone
~ag].e R'i vt_r, AK
Agent Bob Wambolt/ Remax of Eagle River
Address
· Day phone
694-4200
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: 3 '~
TYPE OF WATER SUPPLY:
Individual well
Community well
NOTE:
xxx
Public water
If community well system, provide written confirmation from State AD£C attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
NOTE:
Individual on-site xxx
Holding tank
community on-site
Public sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 {Rev. 1/91) Front MOAiI21
STATEMENT OF INSPECTION BY ENGINEER
As certified bymY 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.
S &S ENGINEERING
Name of Firm 17C34 =&9~u ~;¥ur Loop r-:¢,ad i~O. , Phone C ¢"~/- ~- 9 '7 ~
Address Eagle River, Alaska 99577
Engineer's signature ' , -- , -J'""~--- Date /o/~¢//q ?
Sm
DHHS SIGNATURE
Approved for 3
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
! T,h~e MUrlicip~!ity of An~b?rage Department of Health and Human Serv ces (DHHS) issues Health Authority
'APproval Ce~ificates b'aSed only upon the representations given in paragraph 5 above by an independent
professional engineer'reg stered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending in§Ututions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a 6ertificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
724~25 (Rev. 1/91) Back MOA ~21
Municipality of Anchorage :NVlRONMENTAL,SFRUi~jli~N
DEPARTMENT OF HEALTH & HUMAN SEFWIC;ES
Environmental Services Division "OCT 2 9 1~
825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-~744
ECEIV[D
Health Authority Approval Checklist
LegalDescription: )-.o 7- ~5/ /~¢-g,~ .~'//_) ParcelI.D.: O£'/ - )o
A. WELLDATA ~o_~.~.~.-- ' ~,~,.)-,,/u_,~y,
Well type ~ ,o./~ ,-- ,%,~-,~ IfA, B, or C, attach ADEC letter. ADEC water system number
Casing height (a~~
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Date of test
Static water level
Well production
Dat~'.
Date completed
Cased to
W~ rlye~protected (Y/N)
FROM WELL LOG ~,~"' AT INSPECTION
~ g.p.m.
Nitrate Other bacteria
B. SEPTIC/HOLDiNG TANK DATA
Collected by:
Date installed / o J ~ ~J / ~-.F'- Tank size
Foundation cleanout (Y/~_~
Date of Pumping /o/~.z-/e 7
g,p,m,
Number of Compartments '~ Cleanouts C/N)__
0 Depression (Y/I~)) ,,~ 0 High water alarm (Y/~) .,~ o
Pumper 3-' ~ ,¢~,,~/%~C-
C. ABSORPTION FIELD DATA
Date installed io //3/~j'-
Length 3 ~y / Width
Effective absorption area ,~'- 7~' ,~
Date of adequacy test /o/~ 3/~ 7
Soil rating (g.p.d./ft2 o~ )DS'- System type /-~ '~-
/ 7 / Gravel thickness below pipe ¢, 5~ Total depth
Monitoring Tube present ~/N). Y'CJ'Depression over field (Y/~I'~ /v
Results (Pass/Fail). /%¢-~'J' For
Fluid depth in absorption field before test (in.); D ~y Immediately after ~"~-~'gal. water added (in.):
Fluid depth 0A.¥ (ins) Minutes later: 6) Absorption rate =
Peroxide treatment (past 12 months) (Y/N) ¢''~,''¢ k:~,o ~,,,,./ If yes, give date
z/-~'° ¥- g.p.d.
bedrooms
,~,,~ y
72-026 (Rev. 3/96)*
D, LIFT STATION
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Cycl~~~'~
Size in gallons
"Pump on'~mp off" level at*
~~*Datum
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
,,
Foundation t o '¢-- Property line
Water main/service line /~ ~h- Surface wateddrainage /oa
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
!
Property line / o ¢- Building foundation / O
Absorption field
Wells on adjacent lots
Water main/service line ? o ".-.,z
Surface water t 0 o ~-'
ENGINEER'S CERTIFICATION
Driveway, parking/vehicle storage area
Wells on adjacent lots
?Oo
I certify that I have determined thru field inspections and review of Municipal records t~a'~Tc¢ ~vc{$~'~aems are
in conformance with M ~/,~idelines in effect on this date. ~4, ,~','....'* ~"....~o,~...'~A
Signature
Engineer's Name
Date )O
HAA Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*
Waiyer Fee $
Date of Payment
Receipt Number
HEALTH AUTHORITY
APPROVALS
SEWER&WATER
MA~N EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SiTE pLANS
ROAD DESIGN
SOILTEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
ON SITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN
ROBERT C. COWAN, P.E.
November 13, 1997
CIVIL ENGINEERS
(907) 694-2979
FAX (907) 694-1211
Municpality of Anchorage
Attn: Dan Roth
D.H.H.S.
P.O. Box 196650
Anchorage, AK 00519
REFERENCE: Lot 14; Reed Subdivision
RECEI'VED
NOV '7 'i997
Municipality of Ancho~ age
Servk, e,~
Dept. Health &Human ..... ~"
Dear Mr. Roth,
This letter is to inform you the two private wells located on the referenced property have
been properly o e,~,,,,u.a,,~in accordance with the Municpality of Anchorage Well
Ordinance. Thc well abandomnent was performed by Tweed Excavating on November 6,
1997.
If you require additional information, please contact us.
Sincerely,
Robert C. C , · ·
RCC/gk
17034 NORTH EAGLE RIVER LOOP ° SUITE 204 ° EAGLE RIVER, ALASKA99577
OCT ~8 '97 1073 ~E,-'MAX OF EAGLE ~VR~ ,'"".-CS ....
d
ASBUILT ,, . ............ · ......
HEP, EBY CE TIF .THAT I HAVE SURVEYED THE
FOLLOWING DESCRIBED PROPERTY;
~ND THAT NO ENCROACHMENTS EXIST EXCEPT AS
NDICATED, IT I$ THE RESPONSIBILITY OF THE
OWNE~ TO DETERMINE THE EXISTENCE OF ANY
EASEMENTS, COVENANTS, OE RESTRICTIONS
WHICH DO NOT APPEAR ON THE RECORDED SUBDI'
VISION pLAT. UNDER NO CIRCUMSTANCES SHOUtJ
ANY DATA HEREON BE USED FOR CONSTRUCTION
OF FENCE LINES, OR FOR ESTABLISHIN~ BOUND-
ARY LINES.
OCT E8 '9? 09:04 RE/MAX OF EAGLE RIVR
P.1
[ herebx certif~ that LOT
.,~'~.~ ~ ~ ~ IS/o/,./
~nchoraQ¢ Recordln~' ]istrict, Alaska, has been surv~ed by me and
that' no encroachments e~iSt except as ~houn hereon, It is the
'esponsibiltty or the ouner to determine the existence nf ~ny
~se~ents, covenants, or restrictions uhich do not appe.w on the
'.¢cor~ed subdivision pla~. Listed distances prevail and
ihould not be attempted to determine unshown dimensions. This
:urvey [~ not ad¢quate foe~ nor should It be used Foe
~t~bll~hing boundary o~ ~ence
~.' . . ~
LAND SURV.EY COblPANY
P,O. Box 671089
Chugiak, Alaska 99567
Fhone (907) 688-4.499
0 ~
1o General Infoznnation
(a) Legal~ De~cription
Location (address or directions)
MUNICIPALITY OF ANCIt0tLAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONI.~NTAL PROTECTION
APPLICATION FOR IiEALTH AUTHORITY APPROVAL CERTIFICATE
Application Date /~'~ '>~ '~'
(include lot~ blocl% subdJvision~ section~ to~,mship~ range)
· ' Pi ~.J '<'~';
(b) Applicants Name /?,¥,;'- -
Applicants Address /~.0- "TM ~
(C) Applicant is (check one) Lending institution ~-~[ ; Owner/builder "~"'
Telephone
(d) Lending Institution
Address
(e) Real Estate Co. & Agent
(f)
Address
Telephone
Mail the IL~A to the following address:
%Zp~_of Restdesc~
Single-Family'~
Number of Bedrooms
Multi-Family~
Other (describe)
3o Water Sup_pl.yj
Individual Well ~I Community .
Note: If community well system, must have vrcitten eonfizmmtion from the State
Department of Environmental Conservation attesting to the legality and status°
4o S__ew~.~e
Onsite ~1 Public ~-1 Community .~i1 ltolding Tank
Note: If community wail system, must have written cor~irmation from the State
Department of Environmental Conse~ation attesting to the legality and status.
[Page 1 of 2]
Engineering Firm Providing I~__?j)ections~ Tests, File Search, Data and Informatiou
As certified by my seal affixed hereto and as of the validation date sho~,ra below~ !
verify that my investigation of this Health Authority Approval shows that the on-site
water supply and/or wastawater disposal system is safe, function~-I and adequate fo~
the number of bedrooms and type of structure indicated herein° I further verify that~
based on the information obtained from the Municipality of ~,~chorage files and from my
investigation and inspection~ the om-site water supply and/or wastewater disposal
s ,qram is in compliance ~.rith aJ. 1 Municipal and State codas~ o'~-~dinanc-es~ and regula--
~Y
tfons in effect on the date of this inspection~
Telephone
e
(ENGINEER SEAL)
DH~P Approval
App- -oved for
Approved
Tea_mis of Conditional Approval
,
CAU- ION
T'ftE 14UNICIPALITY OF ANCHORAGE DEPAR2>fENT OF IN~ALTH AND ENViROh~iENTAL PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON TIlE tLEPRESEi~'-
ATIONS GIVEN IN PARAGRAPIt 5 ABOVE BY AN j.~DEPENDEN% PROFESSIO¢~kL ENGII~ER ~J~GISTERED
IN TILE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PUl{CHASERS OF HOMES AND
THEIR I~]NDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN.FEDERAL AND STAT. E REQUIRE-
MENTSo EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ~AIJYZE DATA BEFORE A
CERTIFICATE IS ISSUED° TIlE MUNICIPALITY OF ~CHORASE IS NOT RESPONSIBLE FOR ERRORS
OR OHISSIONS iN THE PROFESSIONAL ENGI~fEER'S WORK°
(DHEP SEAL)
RR4/ej/D18
[Page 2 of 2]
7=19--84
MUNICIPALITY OF ANCHORAGE (MO~,~
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Description:
i
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROT[CTION
1985
WELL DATA
Well Classification
Well Log Present
~ /
Total Depth /~'~ Cased to
Static Water Level .
Casing Height Above Ground /'
Electrical Wiring in Conduit (~'"N)
Separation Distances from Well: /
To Septic/Holding Tank on Lot .,/O
To Nearest Edge of Absorption Field on Lot _ //¢"~ /
To Nearest Public Sewer Line /~/~
Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
If A, B, C, D.E.C. Approved (Y/N) -
Date Completed ~" '~/--¢ %~'"" Yield
; On Adjoining Lots
; On Adjoining Lots
Depth of Grouting --
Pump Set At . ' '~/t¢
Sanitary Seal on Casing(~N)
Depression Around Wellhead (YI~
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
/¢'- /4~E~/ ;Date
Comments
B, SEPTIC/HOLDING TANK DATA
Date Installed ~"/~"'~""
Standpipes~N)
Depression over Tank (Y~
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N) - /J'/)~
Separation Distances from Septic/Holding Tank:
To Water-Supply Well /~
To Property Line
To Water Main/Service Line
Size ./¢/U',~
Air-tight Caps~)N)
Course
No. of Compartments
Foundation Cleanout (~N)
Date Last Pumped ////~
,,for
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(11t84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field /7 /
Square Feet of Absorption Area
Depression over Field (Y(~)
Results of Last Adequacy Test
Type of System Design
Length of Field ~" /
Depth of Field ,Z-'~''''/
.~:'?~' ¢,/ L~ravel Bed Thickness (--)o ~'
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
Comments
Standpipes Presentl~N)
Date of Last Adequacy Test
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots
To Cutbank (if present)
D. LIFT STATION /?
~i'e¢.. Dimensions
Size in Gailons-"~'~---~._,...~ Manhole/Access (Y/N)
"Pump On" Level at "Pump Off" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments
Vent (Y/N)
~m4C~during Adequacy Test. Meets MOA
** Check Permitted Bedroom Rating Against HAA Request **
I certify that ~¢che~ked, vitrified or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed /'¢/'~- ({ '/F4~ ' Date
Company ~¢:~' MOA NO.
DEPT. OF EN%'IRONMENTAL CONSERVATION
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA 99501
BILL SHEFFIELD, GOVERNOR
Telephone: (907)
Addre~s:
274-25S3
October. it, i985
Mr.. Finus Sheldon
P.O. Bo,.,, ' 67-i087
Chugiak, Alaska 995,57
SUBJECT: Lbts 13 & 14, Reed Subdivision, Chugiak, Alaska
(8621 -[IS-024)
[lear. Mr.. Sheldon:
The Department has received current water analyses for- the
subject lots and her. eby issues the Certificates to Oper-ate
for the water systems. Any future expansion of the subject
project will require additional approval fr. om this office.
Sin,:erel y~
Mi,:hael P. Lewis
Environmental Er, gineer
MPL/ms~,
MUNICIPALI'EY OF ANCHORAGE
DEPT. Oi: HEALTH 8.
ENVIRONN'~ENT/,L pi~QT£CTiON
"! ', 1985