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HomeMy WebLinkAboutMEADOW RIDGE ESTATES BLK 2 LT 8Municipality of Anchorage On-Site Water and Wastewater Section ^ (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191501 PID Number: 051-461-14 Dwelling: ®❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name LONNIE & RONNI SULLIVAN ABSORPTION FIELD El Deep Trench FEN Trench ❑Bed ❑Mound Site Address 20820 COUNTRY VIEW DR, CHUGIAK, AK 99567 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 2 1.2 GPD/SF 7.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.1 (DOWNHILL SIDE) Ft_ Gravel depth beneath pipe 2.5 Ft. Subdivision Block Lot MEADOW RIDGE 2 8 Fill added above original grade 0-1 Ft. Gravel length 32.0 Ft. Township Range Section Gravel width 5.0 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank —1-100+ Field Tank Line 250 Ft2 1 Ft. Well � 00 } TANK ❑ Septic [:1S.T.E.P. ❑ Holding El Other Manufacturer Capacity Surface Water 100+ Gal. Material Number of compartments Lot Line 43.5 NA Foundation 10+ LIFT STATION Manufacturer Capacity I Remarks Gal. Alarm location Electrical installed by PIPE MATERIAL House to tank Tank to 3034 drainfield Installer Jr's Septic Services Drainfield 3034 CO/MT3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 620 ft Inspection 1,t 12/2/19 Location and description 2 NW Bottom house trim 3rd 4`' ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp 0F mA, Conditional Approval: Date �� ?Cq TH 19 : �� P. 9 �• Septic System Approved Date c aox kk.,. Note: this approval does not include well permit requirements.����' kmev uoiuzi iu) �$ri cm ->nm -.:3 � D M C p r O r x A m n � zt Z zj � C n oz D r70-0>O0p0-1 0 rr9 0 C Z W X00 (n r O D z 0 C NOTES: RECORD DRAWING DRAWN I JRL SITE PLAN n --i W e(n ONlvy n %U D m -0 -I Z -<Om�Om>0 z(nc-0mr -rm DX O �Z r- DCD nzCA N nU .. z--O(n�OD y� 0 m� �m�OZOz_i!�0 N n N S -0 (n WW \ Co Om NmOnoJNOO'* r-� D00Ili K10 - Z � cn m0 W m;0 v -mo \'' U)r mm v m0 p p n D \ m -D D r Q rn L -' 41 TI Q -r 22 I\ N � n rC m \ Q . r9 0 In Tl NOTES: RECORD DRAWING DRAWN I JRL SITE PLAN n K n c N N -• n N Z \ f \ 4I i (n r \ Co CO \ I - 4 J so •tt � \ I I\ v \ t\ 1'C) 1 � 1 II ttl\ I l 11l\ \ 1 1 \ \ \ �� ��11 VJI I 'I m mt u) �I I—=d lOr Iil C-) � z rl I 1 z)o f c() s II o� O ( I n � I O N I ( Za 0 <� 1 I I l I i I 1I m tD 1 I f i I i 1 I ! i f ! NOTES: RECORD DRAWING DRAWN I JRL SITE PLAN n K n c N N -• n N N U7 (n W Co CO Co 00 - > 1'C) C.0 N 'n x R*OUl V) � D n D O -# x N cc nl CI L -110M o p mRa-:+.I M. me u cs 1 PANNONE ENG SVC, LLC P.O. BOX 1807 PALMER, AK 99645 PHONE (907) 745-8200 FAX (907) 745-8201 MEADOW RIDGE ESTATES B2 L8 ..:� SITE ADDRESS: 20820 COUNTRY VIEW DR R. =66oRe LONNIE & RONNI SULLIVAN CE 8149 PO BOX 671414 y CHUGIAK. AK 99567 REVISIONS 12/13/2019 CALE 1" = 50' .I.D. NO 051-461-14 ERMIT NO. OSP191501 HEET 2OF3 N I r1 So d dl, 4 p d Ch - / / or L7.1 LL cu a LI) W U� _U aa> �� 2w �O c Y m U 'v D ti E �r ao°o t,- W _ to Qj 0) (� (� cu 1\'+ d / 3 v .3t ? rn U � co 0 3 t ¢ it KSCOY m O/\ \ lV C41 \\ oc Z i-' ah `\ \\ �� J of _ oU� Coto , ^` 3 a3 i Q Zr \ c \ w P ter\ r N Z m M U ip 'a T Lij CPD 11 O o 2 2 o'cu d �!Y : V_ : a _rte. (1) o c rnQ In a� ice'• _ >, v� (n c� Q o W / O J rrl : ¢ 6) rrfill cs, 't\\1\\\\\\\\���� : REQ\c) — N O o 9 t\ w r N cl Z Qj W i\ O • C�� U O U t" U r a N � �(O � '� N '� • L C� d.1 N ca c.7 y U13 n o Q N U N2i w '^i` r• U = U � ;r _• m `" 30 w` •U 0 0 0 0 C'. cam. oj N E to 0 3 J d U ..� cd U —" -0 U IIA � b U� CC C "dL. CL G O O N I> N >,3 0-0 � yw QJ O D bA d m ro rn � 2 2 a- �P \ a >) ' C'; o E5 N (D N \ \ \ til • `Go U CO V N �� c y m Z O n > o N dY ^ w N ca w W N O 1 0) O Q, L V U "'� cq V7 'V N W = O C •. c�J epi z p O? O CL E 3 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://mvw.muni.org/onsite ©n -Site Wastewater Disposal System Permit Permit Number: OSP191501 Work Type: Septic Upgrade Tax Code Number: 05146114000 Site Legal Address: MEADOW RIDGE ESTATES BLK 2 LT 8 G:1362 Site Mailing Address: 20820 COUNTRY VIEW DR, Chugiak Owner: SULLIVAN LONNIE R & RONNI R Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 11/21/2019 11/2012020 34716 Q Disposal Field ❑ 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 Received By: A llrl4� Issued By: /�"a Date: Date: 2 MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER[WELL PERMIT APPLICATION Parcel I.D. 051-461-14 Property owner(s) LONNIE & RONNI SULLIVAN Mailing address PO BOX 671414, CHUGIAK, AK 99567 Site address 20820 COUNTRY VIEW DRIVE Day phone Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) MEADOW RIDGE ESTATES B2 L8 Lot Size 34,716 Sq. Ft. Number of Bedrooms 2 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 ❑ Upgrade 0 Duplex (D) ❑ 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 Municipal Codes. (Signature of property owner or authorized agent) SDatePermit/Rush Fees: 5 ?S- Date of Payment: // A-, Receipt Number: IQ 9��)G Permit No. 41 SO Permit App--'- :• :-.,:c; Waiver Fees: Date of Payment: Receipt Number: Waiver No. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191501, Rebecca Carroll, 11/21/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191501, Rebecca Carroll, 11/21/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191501, Rebecca Carroll, 11/21/19 . - �S,:a•c- Lis; �� �. '- ., . .r I - . • 7 4" At r4. • s � ••y-,�t fib•! - •r � •'Yt t a- .. - V. AS BUILT J4 I: hereby. cerW�r:: that I.hta�tepsuFy.�S*ed the t C} f (Y t ~'sr'G � � � Er � I .f •� t�^•r�Yy fi�F�•�!� • - (-1 - •I [� ,,.., r' ;�xt-�t.l ,. s n✓ r .�� �ty ,�y-y� �/. ��batir'�� tY+fihOt�gt� . Rr tTeCfllCx; crrseriis.•situate4 tberccxn �x w'i�' •fat• the Y+, .• -Yt7Y ' , " .�. -fines : shin ilo - not 0%, qua• ttse•.••p 'A 't9 -lYih.9 AI.i%lao t then t ar met: on f5e t +ty j t i ndt:tl� {�BYQti�4 07f1 nrnn. erty''t' flc� Stant theret' - i p t'13,Ci�f?ilCll• [?ii til �ueat l� Ad ftt the' 4a#e, no roadvva ; tinea OX atb visible' ex"M4lrits, at! Osidi P pe4y except, �:_ ;ia t ,�� , , ag incitc�r2ed' hereon. V.gIe 'R!ver, Kaska this.. ',_ur: -day oL-.. ROB 't C JOHNSON •.. SCAL.F. Regfsiized lAnd Surveyor No.. 84 -LS Bak 4W, �Ple 9 !i ane 'hives . Aiasta . Carroll, Rebecca M. From: David Stroda <dstroda@mac.com> Sent: Thursday, November 21, 2019 11:16 AM To: Carroll, Rebecca M. Cc: Robertson, Roy A (DEC); Brannan, Thomas W (DEC) Subject: Re: Meadow Ridge Estates water system Ms Carroll The well that is located near block 3 lot 9 hasn't been active for the 17 years that I' been president of Meadow Ridge HOA. In this time the well hasn't been connected to our water system. At this time we have no intention of using this well due to a lack of water. We have abandoned but not decommission the well as of now. If you have any further question fell free to call me. David Stroda Meadow Ridge HOA President On Nov 21, 2019, at 10:43 AM, Carroll, Rebecca M. <rebecca.carroll@anchorageak.gov> wrote: Hello Dave, The homeowners have a contractor lined up to do their septic drainfield install on Meadow Ridge Estates Block 2 Lot 8 and they are just waiting on the MOA permit. The proposed drainfield is within the 200 ft radius of the well on Meadow Ridge Estates Block 3 Lot 9, so I am trying to determine whether the well is still serving as a community well. This is the only outstanding item that I need before I can issue the permit. Is this something you can confirm or is there someone else we can contact? Thank you, Becca Carroll Onsite Water and Wastewater Municipality of'Anchorage 343-7908 From: Robertson, Roy A (DEC) <roy.robertson @ alasl<a.gov> Sent: Tuesday, November 19, 2019 1:10 PM To: dstroda@mac.com Cc: Brannan, Thomas W (DEC) <thomas.bra nnan@alasl<a.gov>; Carroll, Rebecca M. <rebecca.carroil@anchorageal<.gov> Subject: FW: Meadow Ridge Estates water system Dave, The Municipality of Anchorage received a set of plans for a septic system for Meadow Ridge Estates Block 2 Lot 8, which is across the street from one of your inactive wells on Meadow Ridge Estates Block 3 Lot 9. You are listed as the administrative contact and I was hoping you would be able to speak for the Public Water System. MOA needs to Know the following: 1. Is the well still there? 1 2. Is the well connected to the water system? 3. Is the well within 200 feet of the proposed septic system? 4. Do you have any intention of ever connecting the well to the public water system? 5. If the well is disconnected from the water system and you don't intend to use the well in the future does the water system have any objection to the well being de -classified from a Community Water Well to a private well? Roy Robertson, P.E. Engineer II Drinking \Dater Program Alaska Department of I"iwironmental Conservation 555 Cordova Strect A11chorage AK 99501 11.e1: (90 7) 269-763 1. Fax: (907) 269-7650 From: Brannan, Thomas W (DEC) Sent: Tuesday, November 19, 2019 12:18 PM To: Robertson, Roy A (DEC) <roy.robe rtson@a laska.gov> Subject: FW: Meadow Ridge Estates water system Information requests From: Brannan, Thomas W (DEC) Sent: Tuesday, November 19, 2019 8:47 AM To: Carroll, Rebecca M. <rebecca.carroll@anchorageak.gov> Subject: RE: Meadow Ridge Estates water system I pulled the file but hadn't had a chance to look yet. From: Carroll, Rebecca M. [mailto:rebecca.carroll@anchoragea!<.gov] Sent: Monday, November 18, 2019 1:10 PM To: Brannan, Thomas W (DEC) <thomas.brannan@alaska.gov> Subject: RE: Meadow Ridge Estates water system Importance: High Happy Monday T.W., Did you happen to have a chance to look into this further? This is the last thing I need to confirm prior to approving the permit. If weather improves, they are probably going to be in a rush to get this installed. Thanks! Becca Carroll Onsite Water and Wastewater Municipality of Anchorage 343-7908 2 From: Carroll, Rebecca M. Sent: Thursday, November 14, 2019 3:45 PM To: Brannan, Thomas W (DEC) <thomas.brannan@alaska.gov> Subject: RE: Meadow Ridge Estates water system Hey T.W., Is it possible to verify for sure that the Meadow Ridge SD well (on block 3 lot 9) was disconnected from the public water system and is no longer serving as a public well? Our records indicate that at one point, Meadow Ridge SD was served by the Dawn Water System to the north, but that the well on Lot 9 was tied in to provide additional water. We do not have any records that indicate that the well was disconnected when they switched over to the PWS on Wynter Park #1 B2 L22. We just want to be sure that we are not approving the installation of a septic system within 200 ft of a public water system. Thanks! Becca Carroll Onsite Water and Wastewater Municipality of Anchorage 343-7908 From: Brannan, Thomas W (DEC) <thomas.brannan@alaska.gov> Sent: Wednesday, November 13, 2019 10:02 AM To: Carroll, Rebecca M. <rebecca.carroli@anchorageal<.gov> Subject: RE: Meadow Ridge Estates water system I don't think so, but we'd have to jump into the physical files to be certain. Looks like the Meadow Ridge SD is a consecutive system served by Alpat water PWS from a well on WYNTER PARK #1 BLK 2 LT 22. The well(s) that used to serve meadow ridge would have likely been disconnected from the rest of the systems when the systems got connected. In theory they could have DC'ed the well from the distro system and then hooked up the home/property that the well sits on. in that case that would result in it becoming a private well which we wouldn't regulate. Hope that helps, -T.W. <image001.jpg> From: Carroll, Rebecca M. [mailto:rebecca.carroll@anchorageak.gov] Sent: Tuesday, November 12, 2019 3:51 PM To: Brannan, Thomas W (DEC) <thomas.brannan@alaska.gov> Subject: Meadow Ridge Estates water system Hi TW, I am reviewing a septic permit for Meadow Ridge Estates Block 2 Lot 8. The plat for the subdivision (72-261) indicates that there is a community well site across the road on Meadow Ridge Estates Block 3 Lot 9. We also have some information that seems to indicate that Meadow Ridge Estates is served by a community well on an adjacent subdivision, or at least a portion of it is. Do you have as-builts of the community water 3 systems in this area? Just trying to figure out if there is still a community well on Block 3 Lot 9 that would require the 200 ft separation. Thank you, Becca Carroll Onsite Water and Wastewater Municipality of Anchorage 343-7908 GRr '-C.R ANCHORAGE AREA BO '""IGH O Department of Environmental quahw 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ./~,;¢.,////2r ,/]// ~-'. ~.~//.¢',/' _ MAILING ADDRESS_ '-'¢,/ /~"~" ,/*t~ LEGAL DESCRIPTION /~'/J -F~'''~'~ LOCATION SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH ~¢'/f // /,.-/' ,¢/¢ ~/~-~ NUMBER OF ~ MANUFACTURER ,J'~/A/C,~ ,,~7(¢'.~,~/_ MATERIAL _ '"'(~¢~"~"" COMPARTMENTS --~--" INSIDE WIDTH -~--~' _LIQUID DEPTH_ ~ .LIQUID CAPACITY ,/o~) GALLONS. SEEPAGE PIT: NUMBER OF PITS_ / . DIAMETER /~2' _OR WIDTH /~'~ LENGTH / '/// DEPTH LINING MATERIAL ~¢~"-~ CRIB SIZE: DIAMETER ¢g"~DEPTH_ ~/DISTANCE FROM: WELL TOTAL EFFECTIVE BUILDING FOUNDATION , NEAREST LOT LINE ABSORPTION AREA (WALL AREA)_ SQ. FT. ADDITIONAL ABSORPTION WELL: 'TYPE CONSTRUCTION BUILDING NEAREST FOUNDATION LOT LINE CESSPOOL- OTHER SOURCES_ APPROVED__ DISAPPROVED NEAREST SEWER LINE_ REMARKS DEPTH DISTANCE FROM: SEPT lC SEEPAGE TANK -- SYSTEM DISTANCES: INSTALLED BY:_ PIPE MATERIAL: LOT SLOPE: REMARKS: DIAGRAM OF SYSTEM Form No, EQ-031 GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 , IC" sTREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAG£ DISPOSAL SYSTEM --- APPLICATION AHD PERMIT pERMIT NO. '~' LEGAL DESCRIPTION -- \/ X' DRAIN FIELD · --, OTHER - LLED BY ~ ~& .... FINANCED THROUGR {~L TO ~E 'NSTA -- NOTE= Ttll5 PERMIT IS NOT VAIJD WITHOUT SOIL I~IN~I- INSpEcTION: 24 HOUR ~oTlCE REQUIRED. BACKFILLING OF ANY SysTEM WlTSOUT FINAL iNsPECTION BY THE DEPAUtTMENT OF ENviRONMENTAL, QUALITY AuTHOrITY WILL, BE SUBJECT TO PROSECUTION. SEEPAGE AREA SIZE I 3/ SEPTIC TANK SIZE .... TYPE MINIMUM D I S¥AN C;E,S, FOUNDATION TO SEPTIC FoUNDATiON TO SEEPAGE pIT .... DRAIN FIELD DRAIN FIELD - SEEPAGE pit ~ SEEPAGE pit ALSO CONSIDER AREA WELLS. SEEPAGE pIT ~' GRAVEL EIAC;KI~ILL CONFORM TO ~3OROUGH ~EGULATIONS REGARDING iNSTALLATION- I CERTIFY TdAT I AM FAMILIAR V¢ITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA ~OROUGH ORDINANCE NO. 28-68 AND TNAT THE ABOVE 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) Location (address or directions) (c) Business Applicant Address (~7~?, ~f..~_' &f~ ~'//~./,,,¢' 7 ~'~,~¢~ ~/~ Applicanl is (check one): Lending lnstitution ;Owner/builder~;Buyer~;Other~ (explain); (d) Lending I nst,tullon ~_~c./~-~- Address (2.~.-1 C ~ Telephone (e) ~eal Estale Company and Agent Address Telephone (0 the HAA to the following address: S & S ENGINEERING SRB 196X EAGLE RIVER, AK 99577 TYPE OF RESIDENCE Single-Family,,~ MuFti-Family [-I Number of Bedrooms -~ Other WATER SUPPLY Individual Well [] Community I~ Public~/ Note: If comrnunity well syslem, musl bare written confirrnation from the State Deparlment of Environmental Conservation attesting to the legalily 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 altesting to the legality and status. Page 1 of 2 72-025 n t,a4) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown beJow, 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 tile Municipality of Anchorage files and from my investigation and inspection, tile on-site water supply and/or wastewater disposal system is in compliance with ali Municipal and State codes, ordinances, and regulations in effect on the dale of this inspection. Name of Firm Address _ Date EAGLERI-V~R-,AK_995;%~, MAY 1.4 1986 Approved for 72L--'-o(-~ bedrooms . ~.~.42¢.,.-,-...-z.-¢J,~ Approved ,,~' Disapproved Conditi~ona 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 WELL DATA 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: TQ Septic/~l~diTrg Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Man hole Water sample Collected by Water Sample Test Results Comments ~,, MUNICIPALITY OF ANCNORAGE (MOA; tC, UNICIPALITHr~~I~RITY APPROVAL (HAA) DEPT, OF HE~tI~6KLIST - FEBRUARY 1984 ENVIRONMF. NTAL PROTECTION264-4720 RECEIVED A If A, B, C, D.E.C. Approved~C~/N) Date Completed Yield Depth of Grouting /,,,j// Pump Set At · -/S,~nitary Seal on Casing (Y/N) /../'% BelSression Around Wellhead (Y/N) '2.--¢~¢~ ~J¢- ; On Adjoining Lots '?...4~,/4 ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date SEPTIC/I,,I~M~-TANK DATA Date Installed ~- Size /~.S'-/) No. of Compartments ~ Standpipes ~/N) Air-tight Caps¢/N) Foundation Cleanout'~YN) Depression over Tank (Y,~) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/NoldJ,m~j Tank: To Water-Supply Well ~ O To Property Line ! ~ To Water Main/Service Line / ~/.ff.. Course 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(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~,,,z'~ Width of Field Square Feet of Absorption Area Depression over Field (Y/~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot /~/,A b,,.//,./ Type of System Design Length of Field /~" Depth of Field ! / Gravel Bed Thickness Standpipes Present Date of Last Adequacy Test To Water Main/Service Line / o ~¢- To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Property Line To Existing or Abandoned System on ; On Adjoining Lots '~z~ ~ To Cu.tbank (if present) 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 (~,~. ~vt~ ~ie(,~, or conformed to all MOA a~d HAA guideli nas in effect on the date of this inspection. Signed ~.~ ~ ~-~, Date Compan~,.~ ~ ,,.: ':~, ~'~' MOA No. Receipt No. ~ Date of Payment Amount: $ (¢~' MAY !986 Page 2 of 2 72-026 (11t84) ANCHORAGE/WESTERN DISTRICT QFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA q9501 BILL .SHEFFIELD, GOVERNOR Telophono: (DO7) Address: 274-2533 DATE: May 13, ].986 PWS I.D.~ 211431 To Whom-it May Concern: According to records on fi]~ in this office the DAWN WATER CO/WYNTER PARK Water System is in compliance with the State Drinking Water Regulations Sincerely, Michael P. Lewis Environmental Engineer MUNICIPALITY OF ANCHORAGE Di¥ISION OF ENVIRONME~]?AL HEALT.~H DEPkIY£ME~ OF H~TH ~D 5~I~NT~ PR~ECTION APPLICATION I~R HF~ ~ORITY ~PRO~L CERTIFICATE 1. ~n~ral Info, rotation Application Date (a) I~a]~ ~sc~iption (inclu~ lot~ blcDk, subdivision, ~ction, t~mship, ranwe) L~ation (add~ess or directions) , ie 1 Other (¢t~scr:iba) Note: if oo~amnity ~11 system, must haw w.~'itten ~nfi~,mation fr¢~ the State De. pa~.~ta~nt of L~viror~-mtal Conservation attestin~ to the legality a~d status. Is the well adequate fo~? the number of bec~:oc~ s~cified in this [~A ]is hhe wastewate~ di.slya~:al system adequate f~ the n~'~.r of tedroans [Page 1 of 2] 2-15-84 I certify thalami ha~'e c~,cked, ve~ifie¢t, or confonred to all ~OA [~ ~i~li~s in effect on t ~date f :)~ s ~)s~ction. Nanm of Firm Telepho~ Adclress Signed by Date ( ENGINEER SEAL) Api~, ove d for Approved [~/.._[ Disapp~mved L~]] Conditional Te.mtts of Cond..t~onal Approval 7he Municipality of Ancho~,a. ge D~paFtm~-)nt of t~alth and Enviro~rental Protection dc~s not 9uarantee the continued satisfactory [~rformance of t}~ watez~ supply and/or the wast~wate~, disposal system. This approval indicatss that, as of the validation date sh~.m above, based on the data and inforr~tion f~nished I%, an engir~er registered in the State of Alaska~ the water supply and wastewater disposal system is safe and func~ tional foe the r~umbez, of ~droc~s ~d type of structu~e i~dicated. (DHEP SEAL) 7, Mail the HAA to tim following address: KB2/d5/s [Page 2 of 2'1 2~15-84 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Well Classification Well LoG P~esent (Y/N) Total D~pth Cased to Static Water Level At Casing Height Above, Ground Electrical Wiring in Conduit (Y/N) Separation Distan~,~s from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line C leanout/Manhole Water Sample Collected By ; Date Water Sample Test R~sults Legal Description: c, ~p~o~d~) ~te ~le~d Yield ~pth of G~outin~ Sanitary Seal on Casing (_Y/N) Depression A~ound Wellhead (__Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nea~est Public Sewer To Nearest Sewer Service Line on Lot C~rents Bo SEPTIC/~-TANK DATA  /~ '~ Size /.'~--g) ~A No. of C~)aJztmmnts ~te Installed ,~ / .... Standpims ~) Ai~-tight Caps ~) Foundation Cleanout ~pression o~ Ta~ ~ ~te ~st '~ P~ing~intenan~ Con~aet ~ File (Y~)~4 ; fo~ . Holding Ta~ High-Wate~ Ala~ (Y~) ~ '~=a~y Holdi~ Tank ~r~t (Y~) Sep~ation Distances J~ ~ptic~ Tank: / To Wate=-Supply ~11 ~$L3~¢~ ~c> (~ fi.~*To ~ilding F~ndation__~Z/ To ~o~ty Li~ /~ /'~ ~'. TO Dis~sal Field ?~ / To ~ter Main/~vi~ Li~ ~ / To S~e~, Pond, ~e, ~ ~jor D~aina~ Co~ [Page 1 of 2] 2-15-84 ABSORPTION FIELD DATA ~ Soils Rating in Abso=ption Strata ~//y/Z/J¢t~/ Type of System Design Date Installed ~ / /~ 03 Length of Field Width of Field /~/ / Depth of Field_ ~ / Square Feet of Absorption A~ea Depression over Field (Y~ Results of Last Adequacy Test Separation Distance f~om Absorption Field: / To Water-Supply Well P~//~-IC To P~operty Line /O /'~ ~--~3 fL~ TO Existing or Abandoned System cn To Building ,F~undation Lot /%//A ; On Adjoining Lots 3 ,LO TO Water Main/Service Line .~ To Cutban~(if present) To Stream/Pond/Lake/o~ Major D~ainage Course ./~ To D~iveway, Pa~king A~ea, o~ Vehicle Sto~age A~ea ~ /~ Co~ents .~ Cravel Bed Thickness ~ ~/~--/ Standpipes P~esent Date of Last Adequacy Test D. LIFT STATION Date Installed Size in Gallons "l~zmp On" Level at High Watt= Alarm Level at Tested fo~ Elect=leal Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) '~:sOff'' Level at Vent (Y/N) Pumpin du~ing Adequacy Test. Meets MOA ** Check Pe=mitted Bed~ocm Rating Against HAA Request ** I certify that_/L~ checked, verified, o~ confo~mad to all MOA HAA Guidelines in effect Slgned Date ~ .~.¢. y.%,~,. I~ / 2-15-84 SOUTHCENTRAL REGIONAL OFFICE 437 "E" STREET, SUITE 200 ANCHORAGE, ALASKA 99501 BILL SHEFFIELD, GOVERNOR Telephone: (9077 Address: 274-2533 To Whom It May Concern: According to records on file in this office the ~>~ W~ter System is in compliance with the State Drinking Water Regulations, Sincerely,