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Home My WebLink AboutMEADOW RIDGE ESTATES BLK 1 LT 7Onsite File d, 45:•§4^x. n '��. � � � � � ; 10 g`.. '•;"��:�. ��,~ �: �' '�� r ;~'� �� '�� 'ice �� ,` x�r r_' Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 e 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181442 PID Number: 051-461-09 OCTO.. a12019 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New R Upgrade Name Ben Stephan ABSORPTION FIELD FMI Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 20928 Meadow Lake Drive ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 1.2 GPD/SF 13.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 6.0 Ft. Gravel depth beneath pipe 7.0 Ft. Subdivision Block Lot Meadow Ridge Est 1 7 Fill added above original grade 0.0 Ft. Gravel length 2@23 Ft. Township Range Section Gravel width 2.5 Ft. Beds: Number of Lines n/a Distance between lines n/a FL SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 644 Ft2 2 14.0'+ Ft. Well 100'+ 100'+ (e) TANK l9 Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 1500 Gal. Surface Water 100'+ QQ'+ Material Steel Number of compartments 2 Lot Line 5'+ 10'+ / NA Foundation Q'+ Q' -I / / LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Installer Northern Contracting Drainfield 3034 Co/MT3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 550.0 ft Inspeection 15, 7/2/19 7/2/19 Location and description ction god 3`d 7/3/19 4'" 9/4/19 1 Bottom Trim At House Point A ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineers Stamp Conditional Approval: Date OF AL,qs�� r,� Rnnnn.:� Septic System �� oa,r,,X evrr ,. r �%®L�C� Approved �C �JVtiCJ` Date 11 5 ( Note: this approval does not include well permit requirements. IKev uo/ux/l t5) m Z+ �gLn00- -t om cnc�o.=Op I 0 ul 9: 0-G >O roDZ moN OJ P.I.D. NO 051-461-09 Imm > 0 Ztnm -�z- r Drn7(w Nm m \ _ I � 00 �� tc�m o-tM �ozoocmvxio(nC I DCN.i m� z�DD-yiDN� G) o- ir�� zn..0 - zZ� v •-t D DO(n0 Z O S Z, IrN DN =C7 rn�? �O mu r;7•0 OC)mO— -+r--1Oc O m '�� L �.� ,ln,'' 0) (,n -P ,gym NJ WCJt �m CP. (it0 00 E-lZ Z Wer I -px 'O [nN O� 0 ^ z (n 0- z �� tj� r� 0p� CJn O Z m O D m ma :Er - O 'gym O O Z \ �m Z O r m cn m n io _ - Cmp Y r rn m Q. N � n Em \ W co V � / 1 co r O m O _ C r N / 0 / C-) m Z+ DDrO \ \ OZOZx \ \ OO moN �o Y� P.I.D. NO 051-461-09 xo z i Nm m \ _ I � 00 r o -u mop - m m O V) -n Z, IrN F, o O) mu on '�� L �.� ,ln,'' 0 O \ \ C z z a z I CC) \ n < m \ \ DDrO \ \ OZOZx \ \ OO moN \ 4, P.I.D. NO 051-461-09 \ \ \ mrno \ m \ \ m z � \ 00 \ ;o !" -. mop O m m O V) -n mo ;0;10 F, o O) mu m I \\ O vi n X \ / n K0 P.I.D. NO 051-461-09 0 -1 Z \ 11� N ` I NOTES: PANNONE ENG SVC LLC RECORD DRAWING P.O. BOX 1807 PALMER, AK 119645 PHONE 907 745-8200 FAX 907 745-8201 MEADOW RIDGE ESTATES B1 L7 DRAWN ACp SITE ADDRESS:20928 MEADOW LAKE BEN STEPHAN SITE PLAN 19439 BEVERLY AVE #2 CHUGIAK AK 99567 K \\ O vi n X \ / n K0 P.I.D. NO 051-461-09 0 -1 Z \ '-? �\ \_ C4 Do a \ -. a)\ \ O - \ mo ;0;10 \ \ O) CP Cat '�� L �.� ,ln,'' c 0 \ \ 00 �l < \ \ D z (n 0- \ \ n m* O O O Am \ u N < \ N0 \ rn m \ J /7 � \ .? co 41 / 1 co r Ut / / n C r N / C, / C-) N NOTES: PANNONE ENG SVC LLC RECORD DRAWING P.O. BOX 1807 PALMER, AK 119645 PHONE 907 745-8200 FAX 907 745-8201 MEADOW RIDGE ESTATES B1 L7 DRAWN ACp SITE ADDRESS:20928 MEADOW LAKE BEN STEPHAN SITE PLAN 19439 BEVERLY AVE #2 CHUGIAK AK 99567 K C7 K n K n K0 P.I.D. NO 051-461-09 0 -1 '-? •P Gr C4 N N -. _. O N -1 -+ O) CP Cat (Jt CP CD -P -P C4 C,a N A P C7t O O O O W P > CO co -P .? 41 41 -P Ut N N C r W C, N N co m CO O co -`OJ - Ut CO J m co N m J Ut O OF AL,js�kt�f f� �te'ven •R. •�onnone / CE 814�f REVISIONS DATE SCALE S 1 " = 50' P.I.D. NO 051-461-09 PERMIT NO. OSP181442 8479U Lot 6 Tract B-1 30" SY3 00 Leptic Vent (typ) Lot 7 tX --co -0 0 01: 0 19 Lot 8 sl� 7 f 0 ti Note: This property is served by a community well. ao RECERTIFIED 08/0612019 AS-BUILT NO CORNERS SET THIS DATE C)F A4 I It I hereby certify that I have performed a Mortgagee's inspection of the following described property: LOT 7, BLOCK 1, MEADOW RIDGE ESTATES SUBDIVISION 49th •0 • Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines .1 ... . ..... and do not overlap or encroach on the property lying 00 A zubeth L Walatka• adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and 8036 - LSthat there are no roadways, transmission lines or other AW eo visible easements on said property except as indicated hereon. SCALE: 1 40' 41 1 Dated at Anchorage; Alaska EASEMENTS OF RECORD, OTHER THAN this 3rd —day of December .2018. THOSE SHOWN ON THE RECORDED 451- FRED WALATKA & ASSOCIATES, L.L.C. PLAT ARE NOT SHOWN HEREON FB 18-8, pg 63 BE907-248-1666 Engineers and Surveyors UNLESS OTHERWISE NOTED. FIB 19-7, pg 2 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:i/wv.^h.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP181442 Work Type: Septic Upgrade Tax Code Number: 05146109000 Site Legal Address: MEADOW RIDGE ESTATES BLK 1 LT 7 G:1362 Site Mailing Address: 20928 MEADOW LAKE DR, Chugiak Owner: STEPHAN BEN Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft Total Bedrooms: a 12/21/20'18 12/21/2019 25419 Q Disposal Field Q 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 October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing / 2�zY�/row Received By: �.�----'"'! Date: r Issued By:t Date:. ar /2 IC i; t M UNUPAUTY OF AHC HO AdE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWERIWELL PERMIT APPLICATION Parcel I.D. 051-461-09 Property owner(s) BEN STEPHAN Day phone Mailing address 19439 BEVERLY AVE #2, CHUGIAK AK 99567 Site address 20928 MEADOW LAKE DR Legal description (Sub'd., Block & Lot) MEADOW RIDGE ESTATES B1 L7 Legal description (Township, Range & Section) Lot Size 25,419 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank ❑X Upgrade ❑X Duplex (D) E]Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Munici al Codes. 2 (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: Permit No. 611`)P l91gL42- Permit App_-'- :- :-.,:c Waiver Fees: Date of Payment: Receipt Number: Waiver No. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181442, Rebecca Carroll, 12/21/18 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181442, Rebecca Carroll, 12/21/18 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181442, Rebecca Carroll, 12/21/18 8479U I � M Lot 6 Tract B-1' � � "V72 -4,6,30,11V CID � // ��// j 30 / Lot 7 / o �}7 ti / Q Lot 8 ,9��7 p� 4 CJ i Note: This property is served by a community well. ¢i `o AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection ® ��, �� • . t of the following described property: LOT 7. BLOCK 1. MEADOW RIDGE ESTATES SUBDIVISION µ 00 Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines ,•.✓`.,' . ,a� and do not overlap or encroach on the property lying 00 ',dElizobe� L. Wolotko : ,o ,m adjacent thereto, that no improvements on the property tying adjacent thereto encroach on the premises in question and "r� • , 8036 - LS• _,q�AW that there are no roadways, transmission lines or other visible easements on said property except as indicated °ROF •VPS "' hereon. SCALE: 1 40' 1 + ssioNA� �®® Dated at Anchorage, Alaska EASEMENTS OF RECORD, OTHER THAN this 3rd day of December , 2018. THOSE SHOWN ON THE RECORDEDFRED WALATKA & ASSOCIATES, L.L.C. PLAT ARE NOT SHOWN HEREON FB 18-8, pg 63 Engineers and Surveyors UNLESS OTHERWISE NOTED. BE 907-248-1666 MUNICIPALITY OF ANCHORAGE ;r DEPARTMENT OF FIEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION ~ 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME ~,~-> LOCATION NO. OF BEDROOM- ~ DISTANCE TO: Well 'r: ~'~ ' Absorptio~e~ / Dwelling , PER~ ~Z. Dwelling~ ~ ~ DISTANCE TO: Well ~F PERMIT NO. O= < Manufacturer .~ Material Liquid capacity in gallons ~ Foundat~n~ ~ Nearest I~e PE IT O ' ~ e Distanceb e nl'nes ~ No. of lines / Length?~. line Total incb. -,*, , __ / M~erial ben.th tile . ~ Total effe~bso~)Non area inches ,~., . Length Width ~eptb / PERMIT NO. ~ W Type of crib Crib diameter Crib dep TotaJ effective absorption area m Well Building foun~on Nearest lot line ~ DISTANCE TO: ~ Class Depth Drille~ Distance to lot line PERMIT NO, ~ DISTANCE TO: Building foundation Sewer li~p~/~. ,~ Septic ta~ ,~ Absorption area(s) OTHER PIPE MATERIALS "~1 ~/"~, % "' ..'~ ,:>..,'"' 72-013 Rev, 3/78_ 1:;;:1::11"4 G E ' :;i.. H :.I.m: 'Fl:::ff',Jl::; J'"lU'.!ii;T ].-.ll::i',,,'!iil I:::l"J" L.l!ii'.l'::liiii;'F ')"l.,.lO '.il ................. . .l::: I', ILl '!~HI:::I"t': ::L.. Z I::il"l l::'l:::li']]il..];FlJq: t.,!'.li"t'l'J "FI.lIE I~?Iii!..]'.t:;iiEI"II[i%F1"~i I::'ii'1:;:' fZIl'-l..-i!ii;]i'T'l~T, ii~;E:.'l.,.tl~iFi'.ii:.'i F:II",IB, I.,.IEL..t...'.~i; l:::l'.:':i; '.ii!;li~;"l' F:'(]] ~:"j"l-j El'.r~ "I'I"IE] J'J . J'q T C: 1] F'I::tJJ.. ]~ ']"¢ Ol:::' J::lt"l Z ]"l ']' I:;]'l:::lf]fil:J:'. ':] I'lOl::l ]:' I::lJ",][) 'THE :~}:]"I::I1"E~] OJ;:' I:::IL.f::I:]~',I'::]FI. 2. ]'. I.,.I]]L.!... ]]N'.EiTI:::II....L. 'HIE ;:, .::,lL.I ]~j",j t:::jFj:(']:EII:;]%'I:::iN(]:i~ I,!~["H"I I:::IL.L. I"lOl:::l IZ:Ol]:d~]~ i:;IJ"~[) F, UEGULFI"f']r'Nq, Fll",lf.~:' ]'. I",J COHI::'L ~[ I::llq(]]:lE H ]l~ TI'I 't"l"ll}~[ [::'t~;:r;;;: ]: ~;;~'~ E:F~t ]~ 'f'E~l:~: ~[ F::I 01:::' 'H"I ]1] ~5 F:'iERI"I '.[ 'T'. ~.. ]] I.'.1][1_!.. !:;:il']:d"l[~[l::~:lE TO Il.l.. I'IOF:I I::lJ",l[)'.~J:"I'F:I"FIE OF::' l::lJ....IZl:~]~J'::]~:l ~:IEI]'.¢J]]REH~]I",I'T~J: F:'OI:;i: 'T'HE[ :~:IE'I" I~II:::IC:~( .~h].~:~F!"FiJ'.,icr~:'?; !:::'r;;'.Ol,l I:::ff.,J'.r~ ~]:",:.::'i'~;'T]]N(] i.,.iE~]i...i ..... i,II::I'.~;'TI~]]I.,.IFI'T'E]I::;: [~:,]]'j:~F'Ci~F:IL. .:, :,IE. II OF,~'. I:::'I..IE~JL.~[C :fJ~E~'.l.,JJ~J~]J:;:!::u'.]iJ~ .::,r.:,l].!t OJ',l "i'J'J]~'J~: ()J:;~: ~:lJ",J"r' i:::l[',.'rl::iJ']:l~]'.,J"F Ol:~'. bll:::.~ I.I, LET. ,::j..]~ I...Ij'.,I[]:,i~]I:;;::E;'i"F:iN[) TI'"II::I'F "J"lJ]];~: J ~.1.. IZ"J" ]i]:~: 'v't:::!L..]]!~'.., F'OI;;: Fl HI:::i',:.:',]~I','II...II,~ OI~' ]]: EFI]:,ROOI','i:~3 Ri'.,I[~:, I:::li'.,t'.r: E]Ni..ir::ff:b]]~iE~l"JE~i",t-r' l,.I ]1~ I...J_ I:~:iZ.(~:¢...I ]J~ F:E'. l:::!bJ FIB, J]) ]J~ "F ]!~ ()h. Ji:::lL.. I:::'~[F~:f'I ][ T. SOILS LOG PERFORMED FOR: LEGAL DESCRIPTION: 2 3 4 ? 10 14 ~7 ~8 2O COMMENTS MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERCOLATION TEST DATE PERFORMED: /PO 7zrO,r~r OF WAS GROU.DWATER ,/t,'O ~ 0 P E S, AT WHAT ~TH? Gross Net Depth to Net Reading Date Time -rime Water Drop PERCOLATION RATE TEST RUN BETWEEN (minutes/inch) FT ,/?///... / · ! D A T E .~/~/~/~_ 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Lot 7; Block I; Meadow Ridge Estates Subdivision Location (site address or directions) ?09¢~ ~f~,~r/nw Ln~.~. D~x'u~; Chugiak; Alas/za Property owner Mailing address Lending agency Mailing address J~u~es D. Kaqotawape Day phone p,~ Roy_ A711R~; ¢:hug/~h, A2~bn qq547 257-5451 wk 688-0747 Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: individual well Community well NOTE: 3 ¼ XXXXX Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: XXXXXXX Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1191) 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 s & s ~,NG~NEE~!NG 17034 Eagle River Loop Road No. 204 Address Eagl~ R;vur, Alaska Engineer's signature DHHS SIGNATURE /~--- App[oved for Disapproved. Conditional approval for Phone bedrooms. bedrooms, with the following stipulations: Additional Comments The Muni¢ipaJity of Anchorage Dep~rtment of Health and Human Services (DHH$) issues Health Authority Approval Certificates b~sed only upon the representations given in paragraph 5 aboYe by ~n independent professional engineer registered in the State of Alaska. '['he DHH$ does ~his ~s ~ courtesy to purchasers of homes and their lending institutions in order to smisfy certain federal and state requirements. ~mployees of DHH$ 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. 724:)25 (Rev. 1/91) 8ack MOA.21 Municipality of Anchorage /~ Department of Health & Human Services HEAL, TH AUTHORITY APPROVAL CHECKLIST Parcel I.D. If A, B, or C, attach ADEC letter. Date completed Cased to ADEC water system number Driller Casing height Wires properly protected (Y/N) Legal Description:~>~"'"~ ¢¢~-'V--- \ A. WELL DATA Well type k Log present (Y/N) Total depth Sanitary seal (Y/N) FROM WELL LOG Date of test Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot '7..--c::, ~ Absorption field on lot Public sewer main Sewer service line g.p.m. AT INSPEC'I'ION ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate Other bacteria Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA 2,, Date installed ,Z~¢ ~ ~ /t ~> ¢>'~ank size {~/~C> Compartments Cleanouts ~N) \/ _ Foundation cleanout (~/N) y Depression ~Y/4~) High water alarm (Y~)) ~'~ Alarm tested (Y/N) Date of pumping ¢ ~ / ¢ ~ Z~ Pumper -,~,~-' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ~-c~ o * .!~ On adjacent lots /-~/./x Foundation To property line /0t''k _Absorption field ~- I Water main/service line Surface water/drainage / OC) t Jr~ 72-O26 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level Meets MOA electr~ SEPAR~ISTANCE FROM LIFT STATION TO: W~I on lot On adjacent lots Manufacturer Manhole/Access ~ ~ "Pump on" level at ~"Pump off" level at ~ Cycles tested Surface water D. ABSORPTION FIELD DATA///_~ Date installed ~ ~ ~r Length ¢'1 ~ Width Total absorption area Depression over field (Y/~) ~ Results ~ail) ¢~'"~ Peroxide treatment (past 12 months) (V~)) Soil rating / ~ S'- ~//~/_ Gravel thickness ~ i Cleanouts present ~N) Date of adequacy test for "~t-~ ¢-~ (~,~ ~ ~[ If yes, give date System type Total depth bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellon lot '~-o~ To building foundation On adjacent lots Surface water Curtain drain On adjacent lots ~,,~/ Property line To existing or abandoned system on lot Cutbank '~LI,A' Water main/service line ! Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA ~ date of this inspection. Signature S & S ENGINEERING 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 Engineer's Name Date HAA Fee $ /? Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number DF~PT. OF EN%]~ONMI~NTAL CONSEf4VATION WALTER J. HICKEL, GOVERNOR SOUTHCENTRAL REGIONAL OFFICE 3601 C STREET, SUITE 1334 ANCHORAGE, ALASKA 99503 July 7, 1992 (907) 563-6529 Mr. Hal Jackson Heritage Real Estate 18550 Eagle River Rd, Eagle River, AK 99577 SUBJECT: Monitoring Status for Dawn Water Co. PWSID#: 211431 Dear Mr. Jackson: As requested, the following is tho current mor~itoring status for Dawn Water Co, (PWSID# 211431): coliform sampling: 6/10/92 ,. last sample date inorganic " ' samp ~ng. 10,,~/,90 .. last sample d~te As a class A publ;c water syster~ supplied by ground water, this rystern is reqLJired to sample for total oo!if:3rm contamination monthly and for it~orga~ic chemical contain;nation every three years, Please contact me if you have any further questions. Sincerely, Marie P, Fried Drinking Water Program Manager MPF~ji (SCRO-dw)dawn.let cc: Keven Kleweno, ADEC/SCRO/ADO-Anchomge MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEAL'I'H AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date August 20, 1986 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 7~ Block I~ Meadow Ridge Subdivision Location (address or directions) (b) Applicant Name Alaska Mutual Bank Telephone: Home Business 258-7890 Applicant Address ATTENTION: Bruce Chertkow/P.O. Box 99003, Anchorage 99509-9003 (c) Applicant is (check one): Lending Institution []; Owner/builder L-'XI; Buyer IZ]; Other [-'] (explain); (d) Lending Institution Ala~k~. MutucZ Bank Address Same as ahoy6 Telephone (e) Real Estate Company and Agent Re/Max of Eagle Rive~£/Laurie Bacon Address _ Eagle River, Alaska Telephone 694-4200 (f) ~<~he HAA to the following address: S & S Engin¢¢J~ng SRB 196X Eagle River, Alaska 99577 TYPE OF RESIDENCE Single-Family~ Multi-Family E:] Other Number of Bedrooms 3__ ordered by Laurie Bacon WATER SUPPLY Individual Well [] Community [] Public Note: If community well system, must have written confirmation from the State Department of Fnvironmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite,~ 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 (~/84) ,~I~IGINEERING FIRM PROVIDh,,,~ INSPECTIONS, TESTS, FILE SEARCH, D,~ ~A 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 insp .. 'o . ~P~ g ENGINEE.ING Name of Firm Address Date Telephone _ . bedrooms _ 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 (I 1/84) WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Well Classification Well Log Present (Y/N) Total Depth _ Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/14eldmg Tank on Lot "~-'C~d:~ I _.~ To Nearest Edge of Absorption Field on Lot 'Z..~ To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results MUNICIPALITY OF ...... DE?'I-, OF HEI,LiH & ~NVIP, QNMENTAL tliR01 ECl IOl'q /'x[J{:', 2 1,986 LegalDescription: L-~I~ n If A, B, C, D.E.C. Approved,(~N) Date Completed Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date SEPTIC/.I'j:OL=OING TANK DATA Date Installed IlJ / ~;~ I'J~ Standpipes(~/N) Depression over Tank (Y/~ Size \~ No. of Compartments ' Air-tight Caps./N) Foundation Cleanoutd~TN) /'4/~ Date Last Pumped Pumping/Maintenance Contract on File (Y/N) ¢4~ ; for Holding Tank High-Water Alarm (Y/N) /~' Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/.14etoT~g Tank: To Water-Supply Well To Property Line To Water Main/Service Line Course 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 LJI' / e Width of Field ¢2o Square Feet of Absorption Area Depression over Field (Y/~),. Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well 'Z..¢~ /4-- ,* ]^ Length of Field Depth of Field Gravel Bed Thickness Standpipes Present~5~/N) Date of Last Adequacy Test 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 Type of System Design To Property Line L ,.~ L-V'- To Existing or Abandoned System on ; On Adjoining Lots "~ u, L(..- To Cutbank (if present) ~/J4, D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I h,~v,~ c~¢~ke.,d.,,ve.r. Jfie._dLor_conformed to all MOA and H,.&A guidelines in effect on the date of this ins Signed S~ ~, Company ~.~-~L~ Receipt No..,~D¢b J Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) ~ection, ANCHORAGE/WESTERN DIS'rRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE~ ALASKA gg501 BILL 5H£FFIELI), GOVERNOR f'etopl~one. (907) A ddz~ss: 274-2533 DATE: August 21, 1986 211431 PWS I.Do/~ l'o Whom it May Concern: According to records on file in this office the Water Regulations I)AWN WA'FER COHPAIIY Water System is 'in compliance wi~h the State Drinking Sincerely, MI[NICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF I{EALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR H~ALTH AUTHORITY APPROVAL CERTIFICATE General Information Application Date ~' '"~ Legal Description (include lot, block~,t 8ubdiv_$sion, section, township, range) Location (ad4ress or directions) ~ . ~! A ' /'~' c (b) Applicants Name ~z_/Z?_ZX)~/~.~/_~z/Z+}~.~ mfe!ephone - Home~~{ Buyer : ; Other :[ (explain); (d) Lending Institution Telephone Address ~fp: of Residence Single-Family ~ Number of Bedrooms Multi-Family Other describe) 3. Water Supp_lz.' Individual Well ~: Community ~I Public ~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewa_ge Di~osal Onsite ~ Public [--~--i Community ~ ltolding 'rank :~_~ Note: If community well system, must have written cmzfirmation from the State Department of Environmental Conset~atJ.on attesting to the legality and status. [Page 1 of 2] 5. _Engineering Firm Providing__I_n_~n_s_t_~Test_s, Fi..le Sear__ch~ Data and Information 6o As certified by my sea]. 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 Mamicipality 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 regula- tions in effect on the date of this inspection. Name of ~irm (ENGINEER SEAL) ptjEP___~roval Approved for'//-h;:~t~[, edrooms Approved .~ Disapproved Telephone ~ - Conditional Terms of Conditional Approval CALrfION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ~IEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH ~JTHORITY APPROVAL CERTIFICATES BASED SOLELY UPOM THE REPRESENT- ATIONS GIVEN IN PARAGt~PH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN TH>~ STATE OF ALASKA. TI~ DHEP DOES ~{IS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE ILEQUIRE-~ bIENTS. EMPLOYEES OF DItEP 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. (DttEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 ae Well Classification /~L _ we 11 'I~x]~e se nt (Y/N) Total Depth ~ Cased to Static Water Level ..... Casing Height Above Ground Electrical Wiring in Conduit (Y/N) ~<~pa~ation Distances from Well: To SepticS-Tank on LOt ~3~ MUNICIPALITY OF ANCHORAGE (MOA; HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Legal Description: MUNICIPALITY OF ANCHORAGE D£PT. OF HEALTH & ENVIRONMENTAL PROTECTION If A, B, c~ C, D.E.c. Approved(Y/N) Date Completed Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (.Y~/N) Depression A~ound Wellhead (Y/N) ; On Adjoi-~-in.~_Lpts To Nearest Edge of AbsorPtion Field on Lottog~ ~.~ To Nearest PublicSewer Line C leancut/Manh~le Water Sample Collected By Water Sample Test Pesults ; C~ Adjoining Lot~ To Nearest l~blic Sewer To Nearest Sewe~ Service Line on Lot ; Date Con~ents B. SEPTIC/HOLDING TANK DATA Date Insta~rd //~j/~! Size /~2OL~ No. of CQ,~a~tm~nts . Foun~t ion StandingS) Ai~-tight Caps~ Cleanou~) [~ession o~ Ta~ (~ ~te ~st P~d ' P~ing~intenan~ ~n~a~ ~ File (Y~ ; for Holding Ta~ High-Wate~ Ala~ (Y~) ~ ~a~y Holdi~ Tank ~r~t (Y~) ~p~ation Distan~s ~ ~ptie~olding Tank: To Water-Supply Well ~ To P~operty Line /'~ '/- To l¢~ter Main/Service Line Course Counts 7/- To Building Foundation To Disposal Field ~- / ~CJ i/ TO Stream, Pond, Lake, c~ Major D~ainage Receipt # Date Paid: Amount: [Page 1 of 2] 2-15-84 ABSORPTION FIELD ~ATA Soils Rating in Absorption Strata Date .Installed Width of Field Square Feet of Absorption/A~ea Depression over Field (Y~No~ /~-- ~ Type of System Design '~/~ ~/~' Length of Field ~ / Depth of Field /~ / Gravel Bed Thickness /OB z~ ~ '~ Standpipes Ih~ssent Date of last Adequacy Test /QT~ To Water-Supply Well To Building Foundation Lot /~3-~29/ii ~ To Wats= Main/Se=vice Line ? Results of last Adequacy Test /<3/~ Separation Distance from A~sorption Field: ~-~ ~- To P~operty Line ~ / To Existing or ~ndo~d System ; ~ ~joining ~ts ~ ~O / To ~t~(if pre~nt) To Stre~ond~ke/~ ~jo~ ~aina~ C~se /~ To ~iveway, Pa~king ~ea, ~ Vehicle St~a~ ~ea ~ Counts ~ ~ D. LIFT STATION Date Installed Size in Gallons "Pla~ O~" Level at High Water Alarm level at Tested fo~ Electrical Codes (Y/N) Meets MOA ** Check Permitted Bedroc~ Rating A~ainst HAA Request I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. KB1/dS/s Date MOA No [Page 2 of 2]