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Home My WebLink AboutHIGHLAND HILLS #3 BLK 2 LT 14GREt-...'R ANCHORAGE AREA BOR. Glt Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAl. SYSTEM SEPTIC TANK: DISTANCE FROM WELL t~J-g~ INSIDE LENGTH MANUFAC'FURER. INSIDE WIDTH MATERIAL LIQUID DEPTH 0 ,' /' NUMBER OF ·-~--'J~ .~.~-I COMPARTMENTS LIQUID CAPACITY/~,5~) GALLONS. TILE DRAIN FIELD:'*}~A_e.~,..~.~. DISTANCE FROM WELL--'~'- NUMBER OF LINES ABSORPTION AREA DEPTI-I: WELL: TYPE FOUNDATION NEAREST LOT LINE DISTANCE BETWEEN LINES SQ. FT. LENGTH OF EACFI LINE , DEPTH OF FILTER ! TOP OFTILE TO FINISH GRADE '~-¢/~;'-~ MATERIAl BENEATH TILEd'~_~:~/;' IN. ABOVE TILE TOTAL LENGTH OF LINES TRENCH WIDTH~-'t~_ IN. TOTAL EFFECTIVE CONSTRUCTION _ _DEPTH DISTANCE FROM: BUILDING FOUNDATION NEAREST NEAREST SEPTIC LOT LINE __ SEWER LINE , TANK SEEPAGE SYSTEM___ CESSPOOL ...... OTHER SOURCES APPROVED DISAPPROVE[)__ __ REMARKS DISTANCES: _. INSTALLED BY: LOT SLOPE: REMARKS: DIAGRAM OF SYSTEM / G.A.A.B. "f'Hli~ L[.~NG'r'FI E:, I I't[:.iN~; I ON :[ .'E; TFIE L,E:NG"f'H ,:: ]: N F'Ei:[']:T ::, O1::' THE: "r'I~:E:NCH "t"HE DE::t::'TFI OF FI "I"F:F_'NCH Ot:;?. F':[T I:i~; 'I"HIiE E:,.T.F~;TFINCE:: E:ETI4[i:Ei:I'.,t THE: '.~;[..II:,::I'::'FI[:::E [:)F:' GF:'.OI...INE:, FIN[:, THE: E:OTTOH OF:' 'THI[~: IF£;:.,:[3F:I',,,'F:IT]:L":it'.,t (]:1'.,I F:'E[E:T.'.',. 'I"4"IE~f~:',E:: ]:~ii; I'.,tEI SET H:[DTH F:I:iIR TB:EI'.4[i:HE:~:i. THI:.:.: ~3fRFI',,,'Ii!:L DE:F'TH ;t: S THE H ]: N .'[ HUH I:::,~L'F'"I~H O1:: I:~I~:I:::IVEI... E:FFH.,.IIEEN 'T'HE: OI...tTF'F:IL.L. F::' :[ I:::'[!i: FINE:, 'I'HE:: I;~:OTTOhl OF-" 'T'HE: E.Z:;CI:."I'v'I::Yf' :[ O1'.,I ,:: ]: N F'E~E!:T ::,. I'"1 :[ t'.,t :1: l','ll...Ih'l D I !STF:If.,1C:E E:E"FHE:E:N Ft I.,I[EI...I... FlblC, FIN"r' ON'"-E; .'[ 'I"E: '.:.i;E:HFI[3E t:::' :[ :~i;l::'[):'~;[::ll... E!;"r':~i;"['Ei:H :[ 'J.OO Fti~:li,'E~'l'' [:OIR [::1 F:'F:I.T.',,,'FYI"E t.,.I[EL.I.,. O[R ;~OO F:'I:"ZE:"Ir' F'OF:: F~ F'IJE:I_..T.C H[::L.I .... I.,.ItZL. I.... L..[:)(Z.:;' FII:~I:E [;.~[~."QI..I :[ RE[:, FIND, P1L.I:~'T' E:[i[ F?.['~:TLIF?.NE:ED TO Tt"IFZ [::,[!!:I::'FtFitTH[.~NT I.,t]:'THIN :i!:O OF:' THE: HE:LL. C:OHF'LE:'.'T':[ON. :ii;F:'['EC:[F':I:[::F:ITION$ I::IND (:::[)F,t'J~.:,TI~i:I.JCT:[OI'.,t I) :[ I::IGI::':'.F:IH:E; I'::II:RE:': F'I'v'F':IILF::IE:L. Ei: TO :I.'N.':ii;I..IF~:I:E ]: I",IF!; T [:IL L., FIT :[ I CE:I:;,'"F :[ F;"r' TFII::TT' :t: :[ F:IH FF'tHIL];F:I[R I,.I]:TH T["IEi: [RE:~]:!I...IIREHE:NT':'ii; F'"OF.: ON"'":i!!;:['T'E t~J;E].'-IEi:F?.::.'5 FII"4E:, I,.IE[LI....~.:; I:l'.i~; F:'OF.".'T'H B"r' TH[i: HLIN ]: C :1: F'I:::II.. :[ 'T"r' OF:' FiNCHOF?.FtGE:. ;?.: I I.,.I ]: LL. :[ I",ISTFtLL. THE '.E9'r'~!;l"[ii:H :1:1"4 FICCOF:'.E:'FINCE H :1: ']q'"l THE COI]:'E:.':~;. Zi:: ]: [..Ii",IE:'EiF?.F;TF~NE:' TH[::Ft" THE: [:)N"-'.E;]:TI~:i FJ;Eb. IFiF'. L:.;"r'EFI"EH I'"lFl"r' I:;.':[:Z..':!LI:[Fi:E [ENLF:tI~i:[]iI~EH[~t",IT IF:' 'TH[E I::'::Ei::i~;:I:E:'[?.NCE': :l:'.:i; I~:["J:I'IOE:'Ei:L[EE:' "FO :[NCI..I. JE:'Ei; F'IOI;.'.E 'T'I~IF:IN 4 ~ ~"'~' --~:n'l",lT k~'GF~R, [.Ir~llll..L -'-"-' ,v,"-" ...... , ~.* /\nchora!lo, /\l,tsha 9' *, ' " / ~" "'-" ~)II,S I,(}(', - I'I';]~()I,A'I'I()N TI<ST Performed for This v,,,, -u~u~b: bOllS /0~_~-~ ........................ ~'. z_.~ ....... .................. Percolation l)el)til '?ol~soi]. 3~ 10- 11 - 12 - 13 - ld - ]z_-if_ 7. Was ground water encoun[ered? yes, at what d(;pth? A & L DRILLING COMPANY BOX 97, EAGLE RIVER, ALASKA 99577 · TELEPHONE 694-2588 OWNEROFLAND (L',/'G": T' (::~ !,'L,';?Ct, ADDRESS LEGAL DESCRIPTION Zr,'/ /~i'~ /)4/.: ) DATE- Started //" '/ / -:, Ended PERMIT NUMBER DEPTH OF WELL /' ~ -' STATIC LEVEL OF WATER FT. / DRAW DOWN FT. GALS. PER HR KIND OF CASING KIND OF FORMATION: Fromm." ? Ft. to " Ft. /:;/4 L From From ~':. Ft. to~j [ Ft. ['~ Frolll From / ]'j Ft. to_ Ft. From From ~Ft. to Ft. From From~Ft. to Ft. From From~Ft. to _FI From From Ft. to_ Ft. From From ~Ft. to Ft From From Ft. to Ft From~ From _Ft. to _FI, From From ~Ft. to~ Ft, From~ From Ft. to Ft. From From Ft. to Ft. From From ~Ft. to Ft. From _Ft. to_ Ft Ft. to___ Ft. ____ Ft. to_ Ft. ___Ft. to_ Ft. to__._ Ft Ft. to Ft. .Ft. to FI. __ Ft. to .Ft. Ft. to Ft. _Ft. to__ _Ft. Ft. to_ Ft Ft. to _FI Ft. to_ Ft Ft. to___Ft __Ft. to Ft. __Ft. to Ft. _Ft. to _Ft MISCL. INFORMATION: DRILLER'S NAME 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 Parcel I.D. # ~_/-~-3 - ~-,¢,,~ ~ ~-i~- ~J_.~ --O~LI HAA # /-~ 1. GENERAL INFORMATION Complete legal description Lot 14; Bloc~ 2; Highland Hills Subdivision Location (site address or directions) NHN Wild Mountain Drive Eagle River, AK Property owner Mailing address Lending agency Mailing address Agent Address Mike Meyer P.O. Box 770122 Ea~l¢ River, Day phone AK 99577 Day phone 694-0660 Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. XXX 72-025 (Rev. 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I 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 ~ Phone Address ~ 7c~.14 ir~l~ River Loop Road No. bngineers signature DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: ,/~~ ~ Date The Municipality of Anchorage Departmeqt of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in 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 profe,~sional engineer's work. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description:/--cT /dr- ~'(-K Z- /'L//(~F{/-/SCJ~ ~[f-~ Parcel Well Data Well type Log present~_~N) Total depth Sanitary sealskiN) I~L~,f(,,/'[~6~ (-.- If A, B, or C, attach ADEC letter. ADEC water system number yE%' Date completed r~/--~°/¢~ Driller ,~ '¥' (_. Cased to d¢-O ' -U Casing height ~'~'~.~ Wires properly protecte~"~) '-~'~'~' Date of test Static water level Well flow Pump level1 FROM WELL LOG AT INSPECTION ._ ..- ~ -.~ ,'4- c'~ ,~ .g.p.m. ~, X g.p.m. OI~ SEPARATION DISTANCES FROM WELL TO: Septic/~g-tank on lot Absorption field on lot Public sewer main /Uo~JE Sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform 0 / {'00 ~ Date of sample: ~, l ?---I /~; Nitrate ~/--~ Other bacteria Collected by: ~c~.~- ~.~(~//u~'~/¢~/¢.~ SEPTIC/~ANK DATA Date installed ~/Z-:5 Cleanout,~) High water alarm (YN~ Date of pumping ~' / ~..(¢ [ ~..~ Tank size Foundation cleanou~ (~,1) Compartments Depression (Y/O¢'~'o Alarm tested (Y/N) Pumper ,.'~/~, ~ SEPARATION DISTANCES FROM SEPTIC/~TANK TO: Well(s) on lot //5/' '¢'~ On adjacent lots To property line _~:~_(¢- Absorption field ,.~ Surface water/drainage //~0 72-026 (3/93)* Front Foundation Water main/service line CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent(Y/N) "Pump on" level at "Pu~~ High water alarm level Cycle.~s_teeted~ Meets MOA electrical codes (Y/N) ~ SEPARATION TO: ~ On adjacent lots Surface water D. ABSORPTION FIELD DATA Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Soil rating (GPD/FF) Gravel thickness System type '~KE'/,J¢-. ~ Total depth I Z. / Depression over field (Y,~ ,/0~ for /¢ou/"'/- ('~-~r' } Bedrooms After test ~¢ // ~lZ. Hou*t rz~¢/~c,) ,,,t,/O ~ ~. ~¢~'A2 ~(,dA,~ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots ~ Surface water /(~D, r_./- Cudain drain /(~d~,~ E. ENGINEER'S CERTIFICATION On adjacent lots / ~ ~ r'7~- Property line To existing or abandoned system on lot Cutbank ,/,~o .,~¢~/~."LE~E'/J~Water main/service line Driveway, parking/vehicle storage area "'-' ~ / I certify that I have checked, verified, or conformed to all MOA and HAA guidelines Signature ~ ~ Date EaOb Myer, A;a~ka 995zZ HAA Fee $ Date of Payment Receipt Number 72-026 (3/93)~ Back Waiver Fee $ Date of Payment Receipt Number 09/28/95 11:28 CT&E ENU[N COMMERCIAL, TESTING & p. NGINI;I;RING CO. I~NVIRONMENTAL LABORATORY SERVICE~ ............. REPORT o~ ANALYB[B Chemlab Ref.$ :93.5004-7 Client Sample ID :L~4 B~ H[GBLAND HItLS Matrix ~WATER WORK order Client Name :$ & S E~GIN~ING Report Completed 5633 B STREET ANCHORAGE, AK !~9518 TEL; (907) 58','-2343 FAX: (g07) $61-5301 :71332 :09/28/93 :09/21/93 hr6 · Ordered By :R. SHAF~ Project Name Pro~ect~ : p~SID :UA Sampl~ Remarks: ROUT~NC ~AMPLE---/-C-~O~c~D BY: R~Y, Parameter Collected Received :09/22/93 @ 16:00 hrs. - r:$T~Ph~. EDE Technical D[~c~o , ~'~ Relea~ Y /~.,.~' Allowable ~×t. Anal OC Limits Date Date Init Result~ Qual Units Method .... 2.8mg/L~?A 353.2/$00.0 10 09/~3 CaR N~trate~N = NA = Not Analyzed =See Special in,tr~;ion~ A~ve = ............. UA ~ Unavailable see Sample Remarks Ak~ve GT = Greater Tha~ = Undetected, geported value is the practical quantification limit, LT = LeSS Then = Secondary dilution. .......... .~c~^~iw~EY. SOUTH CAROLINA APPLI ' NT FILLS OUT UPPER HA, ONLY Mailing Address Zip Code ./~:'7 ~ Buyer Address Zip Code Lending Institution Phone Address Zip Code Realty Co. & Agent Phone Address Zip Code Street Location Type of Residence ~ Single Family ~ [] Multiple Family No. of Bedrooms 7 [] Other Water Supply ~ Individual ATTACH WELl. LOG. A weg log is required for all wells drilled since June 1975. [] Community For wells drilled prior to that date, give well depth (attach log if available). [] Public Utility SeC'er Disposal ..:i~'¢'lndividual Year Individual Installed: Public Utility When Connected to Public Utility: ?}:[~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE P~OCESSING CAN BE INITIATED. 'rime Time l'ime Time Date Date Date Date Inspector Inspector Inspector Inspector · ~-- ......... ~ *CONDITIONS OF APPROVAL ( ,i~,~ONDITIONAL ~' Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Well to Tank Septic Tank Size 2.'1., 1983 I', Oo !}ox 5-373 Pt, Richa~:dson, AR: 99505 subjech~ Lob 3.4, !~lock 2, Uighland l[.[l]_s %3 (jrallix)d Lint il the roi. lowing itel~n have }'~c{~c~ o ,,..bt., top off the well ' ~ ~" ' ...... ~,..I.c.,< wa LeIr tight, o }ixposed electuical wires to the well h(~ad are in violation of i:hu NuHicipality of Anchorage codes aFtd mtu;t be i.n conduit, o The wate~r analysis ~'eport needs to he mlbmitted to this o The :ieptic tank pumped with a r'ecoipa submi'Ltcd to khis o L}?he stand{M, pc to tho sawer syst~m nc:~d caps ]?lease notify this ])epartment for a reinspeckioa wl~m thc noted discrepancies have been cc)ri,'ected, if i:h~nFe are any JXlrthe~' qt~()stioils, please call Lhis offJ. ue at JiF~ Robert~ AHsociate Enviccmmenta! Spec:Lalisl: Ai1choK'a::lU, Ak !)9503 top ,.~l the wtd. l (:'.~sJ.i'~g should be ,q,..~a}.ed sn L.qat i'c i;~ ,.:)i::,: i,.;(; fL~()u~ the (.:J~em t,ab, 5G33 5.; f',tr,.~'etr .~.~)r our notify hhJ. s i)e;-~;-~rt~uent for S i,qce re ]-5', March 21, 1983 Commonwealth Area, Inc. Eva Loken-Barbaua Kenney P. O. Box 249 Eagle River, Ak 99577 Subject: Lot ]_4, Block 2, HJ. ghland ll:i. 1].s ~i3 '~'~ App~coval for the individual sewer and water facil:i.t:i, es cannot be granted untiJ the following items have been completed: o The top of the well casing should be sealer] so that it is water tight. Exposed electrical wires to the well head are in violation of the Municipality of Anchorage codes and must be encased in conduit. o 'Phc water ana].ysis Feport needs; ho be submitted to this e[lf:[ce frora tile Chem Lab, 5633 B Street, for ouF review, The septic tank pumped with a receipt submitted to this department. ° The standpipe to the sewer system need caps on them. Please notify this Department flor a /einspection when the noted discrepancies have been corrected. If there are any further' questions, please call this office aL 264-4720. Since re ly, Jim Roberts Associate Environmental Specialist JnlS2/ej/El Time [)ate Time Date Inspector Inspector IDate , ~ ~ \~ -'%,. Inspector Comments Conditional Approval MUNICIPALITY OF ANCHORAGE DEPT. OF HqALTH 2: ENVIRONM[NTAL PRO[ECTkDN Date Sewer Installed Soils Rating Property Owner Mailing Address Buyer Permit No. Well To Absorption Area Well to Tank / APPLICANT FILLS OUT LOWER HALF ONLY a~d ]',irs. G. Wall P.O,~l~xBox 5-575, Ft. Richardson, Ak. 99505 and Mrs. Ta~e Septic Tank SIzoREL k j V E D Holding Tank Size Wetl Log Received Phone 428-204.2 Address Lending Institution Colonial Mortgage Co. AddressT01 Ii. Tudor ltd. Suite 107~ Anchoz'age~ Ak. Realty Co.&Agent j~o]~ulto~wealt]). Are a~ I~Q, / ~va Lokell- Address P.O. Box 249, Bagle River, Ak. 99577 ~e~alOssonvtio~ Lt 14~, B.2 Highland Hills f3 Slreet LoGatiom NHN Wild Mountain Dr. 99503 Barbara Kenne Phone 562-2181 Phone 69_4-9555 Type of Residence I~ Single Family [] MuLtiple Family [] Other No. of Bedrooms 4 Water Supply ~ Individual [] Community [] Public Utility Sewa. ge Disposal [] Individual [] Public Utility [] Holdin~ Tank ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled crier to that date, give wel' death (attach log If available.'L Year Individual Installed:/~ When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACli REQUEST BEFORE PROCESSING CAN BE[ INITIATED. MUNICIPALITY OF ANCHORAGE DEI~ARTPAENT OF HEALTH & ENVIRONMENTAL PROTECTION Environmental Sanitation Di¥1slon 825 L Street · Anchorage, Alaska 99501 · Telephone 264-4720 CEFITIFICATE' OF. IN_S~,CI'__I_O_N Dale Title This Approval riot valid Without Departmental Seal APPLICANT FILLS OUT LOWEIq HALF ONLY Properly Owner tXir. ~lld ~ll's . (~ . Wa] 1 Mailing Address P.OJ4bAzBox 5-373, Ft. Mr. and Mrs. 'Fate [Phone 4Z8-2042 Buyer Add~;ss · c) r kichardson~ Ak 9. 50~ Lending Irlstitution CO].OllJ ~.t] ~' O}'t ~:~,[:t,~.? (;O , Address 7_~J~J_ Ii, Tudor Rd. Suite 107,_ Realty Co. & Agent J]OIiIIIIOIIW~J a l t: h J\Ff."(]~ [11(2. // Address P,(k, Bp~<jg_% Eu!,~e ,t. ver~ Ak. 99577 LegalDescription L'L 14m, B.2 H:igh:Land llills ti5 Street Location NIIN Wild i',Iouuta:in I)r. Type of Residence 99503 Barbara Konne, Phoebe 562-2181 · Phone .~94-9555 _ ;2,.: Single Family t J Multiple Family [ ) Other Wate) Supply No. of Bedrooms Individual CommurHty Public U t i I i.t_,,L_ Sewage Disposal LX Individual LJ Public Utility E; Holding Tank ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells dtilled prior Io that date, give well depth (attach log if available). Year Individual Installed; When Connecled to Public Ulili y: .... SANITAJJ'f PUMPERS P.O. BC)X 346 EAGLE RIVEq, AK 9c7577 694-2400 Z ..< oo · ,~UNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE ENVIRONMENI'AL PF~OTECTION C¢~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION C'''''j 825 LStreet-Anchorage, Alaskag9§01 JLIL 1 9 1~¢ ENVIRONMENTAL ENGINEERING DIVISION R E C E 1 V E REOUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not b~ processed. Please allow ten (30) days for processing. ~AILING ADDRESS // ~ 7~- F~d~ PROPERTY RESIDENT (If different from above) ' PHONE 2. BUYER PHONE M~LING ADDRESS ~ENDING INSTITUTION PHONE MAIL~ ADDRESS 4, REALTOR/AGENT ~/__ PHONE' MAILING ADDRESS / /, is, LEGAL DESCRIPTION ' 6. TYPE OF RESIDENCE NUMBER OF BEDR~MS ~ SINGLE FAMILY ~ One Four Z] Two ~] Five [] MULTIPLI-- FAMILY ~Z] Three ----] Six Other 7, WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY ATTACH WELL I_OG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** ** findividual/on-site, give installation date ("~/-_./]~ /d~2.~'¢ If system is over two (2) years old an adequacy test is required [] PUBLIC UTILITY oy this Department, (. ?~/~_4~ ./~/~-~ ~~w_ NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE NITIATED. THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS r TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE E~ OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER L-~Septic Tank or [] Holding Tank Size: ~.~-(D If Tank is Ilomemade SOILS RATING give dimensions: / -~YPE OF TANK MANUFACTURER .~ TOTAL ABSORPTION AREA MATERIAL Absorption Area to oearest Lot Line 5. COMMENTS ~ APPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY (Title) LEGAL DESCRIPTION 72;010 (Rev, 3/78) July 25, 1979 Gary G. Wall Star Route 2 Box 9369 Eagle River, Alaska 99577 Subject: Lot 14 Block 2 Highland Hills Subdivision #3 Approval for your individual sewer and water facilities can not be granted until the following items have been /"~pleted: (ix The depression or pit around the well casing needs to ~ be filled with impervious type soil so that it slopes ~ ..... away from the well casing. (2) The water analysis report be delivered to this office from Chem Lab, 5633 B Street, for our review. Please notify this department for a re-inspection when the noted descrepancy has been corrected. If there are any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: Home Federal Savings and Loan Attention: Donna Nail 535 D Street 9950].