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HomeMy WebLinkAboutHERITAGE PARK BLK 1 LT 1Onsite File
Heritage Park
Block 1
Lot 1
#050-211-29
(Rev 05/02/18)
Municipality of Anchorage
On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP201501
PID Number: 050-211-29
Dwelling: FIR Single Family (SF)
E] with ADU [:1 Duplex (D) El Two Single Family Project: M New 110 Upgrade
Name
AB -SORPTION FIELD
Kaye and Andrew Laughlin
'*6�
De Trench El Wide Trench El Bed ❑ Mound
Site Address
10719 Tradition Ave
Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
D/SF
Ft.1
LEGAL DESCRIPTION
Depth to pipe invert from original de
.
Gravel depth beneath pipe
I Ft.
Subdivision
Block Lot
Heritage Park
1
Fill added above original grade
Ft.
Gr el
Ft.
Township Range Section
Gravel width
Ft.
Beds: Number of Lines
Dist e between lines
Ft.
SEPARATION
DISTANCES
To
Septic
Absorption
Holding
Sewer
Total absorption area
N umber of trenches
ches
Dist. between 11�1
From
Tank
Field
Lift Station
Tank
Line
F t2
t.
Well
>100'
NA
NA
NA
TANK 9 Septic [I S.T.E.P. El Holding El Other
Manufacturer
Greer
Capacity
1250 Gal.
Surface Water
>1010'
NA
NA
NA
NA
Material
plastic 12
Number of compartments
Lot Line
>10'
NA
NA
NA
Foundation
>1 O
NA
N =AN
A
LITATION
FT -5
Manufacturer
Capacity
Capacity Gal.
Remarks 2" INSULATION OVER TANK
Alarm location
Electric11 db
PIPE MATERIAL House to tank 3034 drainfield Tankto 3034
Installer JRs Septic
Drainfield C01MT 3034
Inspector Curtis Townsend
BENCH MARK (Assumed elevation) 100 ft
Inspection 1st6/18/2021
8/9/2021
Location and description
dates:
2nd
door threshhold near A
3`d
4th
concrete pt
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
law
Conditional Approval:
Date
L wns
Curtis L
Date, Zo
Septic System
Approved
Date 1110AIao2l
7
PROFESS0
Note: this approval does not include well permit requirements.
(Rev 05/02/18)
Is
I
I
DOUBLE CLEANOUTS
AFTER TANK
\\
\t\
THIS PROPERTY IS SERVED BY AWWU
THERE ARE NO WELLS WITHIN 2O0,,
)'z
/f.
(
I
=
I\
:
t\
\
/.WATER LINE ALIGNMENT WAS
,,,VERIFIED PRIOR TO CONSTRUCTION
STTNG 28' x 60" x 6'.ECTIVE DEPTH TRENCH
SLOPE
ry
't,/a
,/ NEIGHBORING SEPTIC IS, FROM PROPERTY LINE
-----7
10'
AND
t.
,rw
SCOPE OF WORK
1. RIMOVID EXISTING SEPTIC TANK.
2. PLACED NEW 1,250 GALLON PLASTIC SEPTIC TANK AND TIED INTO
EXISTING ABSORPTION SYSTEM. THE TANK WAS PROVIDED WITH
MINIMUM 20,' @ MANWAY RISER SERVING THE FIRST COMPARTMENT.
3. ALL CONSTRUCTION WAS IN ACCORDANCE WITH ALL RTQUIREMENTS
SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND
15.65.
,,--J
Tcnk Replocement Record Drowing Prepored for
Kaye and Andrew Laughlin
10719 Tradition Ave, Eagle River Alaska 99577
HERITAGE PARK BLOCK 1 LOT ,
osp201501 iffi
EKLUTNA INGINEIRING, LLC
19162 I./OUNTAIN ROAD
CHUGIAK, ALASKA 99567
(e07) 406- 1 os8
DATE: 111112021
DRAWN: CLT
SCALE: 1" =40'
PID: 050-211-29 SHEET 2OF 3
ffiftrr;;iilhr-:
"''$.#gjs$t
z_
LLJ_rIoca
)<z-.s:
Z.
tl
".r-F- (./)
FloLI
=<) L_)C)_rOO
r- a\
I\-]7.7
)<z.={lr- \J
2,, INSULATION
OVIR TANK
.MARK A E
STl 39'- 11"z/ - I I
ST2 44'-10"28'-5"
DCO 47'-10"24'-2"
1 ,250 G
PLASTIC TANK
Tcnk Replocement Record Drcwing Prepored for
Kaye and Andrew Laughlin
10719 Tradition Ave, Eagle RiverAlaska 99577
HERTTAGE PARK BLOCK 1 LOT,
osp2015o1
EKLUTNA ING/NIIRING, LLC
19162 NIOUNTAIN ROAD
CHUG|AK, ALASKA 99561
(e07) 406- 1 OsB
DATE: 111112021
DRAWN: CLT
SCALE: 1" = 5'
PID:050-211-29 SHEET 3 OF 3
Dayna M. RumfeltREGISTEREDPROFESSIONALL
A
N
D
S
U
RVEYORNo. LS 13322NORTH11/18/21
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP201501
Work Type: SepticTank Upgrade
Tax Code Number: 05021129000
Site Legal Address: HERITAGE PARK BLK 1 LT 1 G:0055
Site Mailing Address: 10719 TRADITION AVE, Eagle River
Owner: LAUGHLIN ANDREW & KAYE
Design Engineer: EKLUTNA ENGINEERING, LLC*
This permit is for the construction of:
Effective Date:
Expiration Date
,cnt
a �-
G.
f
1: epartIII ent
Lot Size in Sq Ft:
Total Bedrooms:
12/22/2020
12/22/2021
21560
❑ 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
Special Provisions: The water service line shall be professionally located to confirm minimum 10 ft separation
to septic system. Water line routing shall be shown on final record drawings.
V�
Received By:
Issued By:
(Z Zz-2-D
Date:
Date: 1X 4 -fe-&
4
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201501, Rebecca Carroll, 12/22/20
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201501, Rebecca Carroll, 12/22/20
· ~,~ , 't,,~j MUNICIPALITY OF ANCHORAGE ~ /
O,.,.~['~,-~",~'~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
~t~.-?'?."?~'l~(!;~r ~" ENVIRONMENTAL ENGINEERING DIVISION
.,:~z~' 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
PHONE
MAILING ADDRESS
k~L ~IPTlO~
"~ DISTANCE TO: Well ff Absor~io~r Dwelling2 2 FI PERMIT NO.
~ ~= Manufacturer/'~ ~ ~ Materi~ ~ ~ ~o. o, com~art~nts
Uq. c~oaciw in ~allons Inside Ion~th ~idth ~iquid depth
' I~O IF HOME.DE:
~ DISTANCE TO: Well ~ Dwelling PERMITNO.
~ ~ ~ Manufacturer~ ~ Material Uquid capacity in
D ~ell ~ Foundation ~earest lot tine ~ ~[8~lT ~0.
~ ~ DISTA~C[ TO:
--~=~ No. oflines Lengthof~chl~ez~ U. Totall~gof,~. TrenchwC¢ inches Distance between lines ~/~
"~ Top of tile to finish grade ~ ~.~ Material beneath tile ~ inches Totaleffectiv~3tion
Length Width Depth PERMIT NO.
~ N Type of crib Crib diameter Crib depth Total effective absorption area
~ Well B~ilding foundation Nearest lot line
~ DISTANCE TO:
j Class Depth Driller Distance to lot line PERMIT NO.
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
OTHER
PIPE MATERIALS- I / ~ ~ ~
SOIL TEST RATIN~ ~ ~ ~ ~
iNSTALLER
REMARKS ~0~
-~'"~ ~" ":(_ ~, t.) k ~.
..., ,. ,.~
APPROVED DATE LEGAL
72-013 (Rev. 3/78)
Permit ~ ~/~)~2 ~
Applicant: ~3'~ ~ )~;~)~L)
Location:
Department, 'f Health and Environmenta: '?rotection
825'>~' Street, Anchorage, AK. k~9501
264-4720
* * * HANDWRITTEN PERMIT * * *
~ ON-SITE SEWER PERMIT
Mailing Address:
Phone Number:
Legal Description: /~ ~ / ./,~/,~/ ~ ~/~?-/~ ~/~' ~Lot Size: ~/'~-
Type of Soil Absorption System Is:
Trench: /Drainfield: Seepage Bed: __ Holding Tank:
Maximum Number of Bedrooms: ~___ Soil Rating(sq.ft/br) ~
The Required Size of the Soil Absorption System Is:
DEPTH [~ ~ LENGTH ~,<~'/ GRAVEL DEPTH ~>'/ WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = /~-c~) GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection and approval by this departmen~
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 fee~
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31, 1 9 8 3 * * *
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may~quire enlargement if
the residence is remodeled to include more tha~ 3~ bedrooms. ~
Signe~: Issued by ~z~
App lc~-~nt' Date: UL~/~-~ >//~ ~j '
SWP/024(1/81)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAl. PROfEC'flON
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
LOG
PERCOLATION
TEST
DATE Pe~roRmeo: ./~///~'/~-'~
5-
6
7
8
9
~---, 10
11
12
13-
~ 14
15
16
17
18'
20'"
COMMENTs
SLOPE
WAS GROUND WATER S
ENCOUNTERED? kO L
P
E
IF YES, AT WHAT
DEPTH?
SITE PLAN
Reading Data Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN FT AND
CERTIFIED BY:
72-008 (6/79)
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
Parcel I.D. #
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include 10t, block, subdivision, section, township, range)
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
/J-em(-~V¢.4. Pacr'~' ,5/0
Telephone: (home) ~¢ q-'7~8~ Business
Telephone
Location (address or directions)
(b) Property owner
Mailing Address IO?1~
(c) Lending Institution
Mailing Address
(d) Real Estate Company and Agent
Address ~ 00 6:~ ~ " ~.
Telephone ~ ~ - 7K~
echo_7
~rrl n ~_
(e) Mail the HAA to the following address: (or check here [], if hold for pick up.)
List contact person and day phone number below:
'7-ec-Z ,=,," C4*'U 5' ¥'5--
2. TYPE OF RESIDENCE
Single-Family [~ Number of bedrooms ~
3. WATER SUPPLY
Individual Well [] Community [] Public []
Note:.lf community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site [] Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legality and status.
72-025 (Rev. 7/88) Page 1 of 2
5, ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, Iverifythat my investigation of th is
Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe,
functional .and adequate for the number of bedrooms and type of structure indicated herein. I further verify that
based on the information obtained from the Municipality of Anchorage files and from my investigation and
inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and
State codes, ordinances, and regulations in effect on the date of this inspection.
Name of Firm
Address /
Date
Seal
Approved Disapproved Conditional
Terms of Conditional Approval~ .,~l . ,/L/~ff/,~Z;~.~'-~
The MunicipalityofAnchorage Department of Health and Human Services(DHHS) issues Health Authority Approval
cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer
registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHHSdonotconductinspections
or analyze data before a certificate is issued. The MunicipalityofAnchorageisnot responsibleforerrorsoromissions
in the professional engineer's work.
72-025 (Rev. 7/88) Back Page 2 of 2
A. WELL~~
WelJ Classification ~ ~ ~ ~
Well Log Present (Y/N)
Torsi Depth Ossed to
~t~tio Wster Level
C~sing Height Above ~round
Electric81 Wiring in Conduit (WN)
~EPARATION DISTANCES FRO~ WELL:
To ~eptio/HoldJng Tank on Lot
To Nesrest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
To Nearest Sewer Service Line on Lot
Water S~mple Collected by
Wster Ssmple Test ~esult8
Comments ~ ~ ~o~
MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)
CHECKLIST - FEBRUARY 1984
343-4744
Legal Description: L
Date Completed
Depth of Grouting
If A, B, C, D.E.C. Approved (Y/N)
Yield
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer Cleanout/Manhole
; Date
SEPTIC/HOLDING TANK DATA
Datelnstalled IIl~'~ Size 125'o ~, No. of Compartments ~-
Standpipes (Y/N) ',/ES Air-tight Caps (Y/N)
Depression over Tank (Y/N) NO
Pumping/Maintenance Contact on File (Y/N)
Holding Tank High-Water Alarm (Y/N) N,/~.
Foundation Cleanout (Y/N)
Date Last Pumped zC~/ZS//~o
;for I~,
Temporary Holding Tank Permit (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water-Supply Well ltl, A.
To Property Line ~ $O ~
To Water Main/Service Line ~ /'/'-~ ¢
To Stream, Pond, Lake or Major Drainage Course
To Building Foundation 20' F,~o~ C.O.
To Disposal Field
Comments
72-028 (Rev. 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Abso[ption Strata
Date Installed II/~:~
Width of Field S '
/
Square Feet of Absortion Area ,:~(~O ¢/
Depression over Field (Y/N) No
Results of Last Adequacy Test ,4 ~¢ q.~,~(-¢ :~,/*
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water-Supply Well ^/~/~,
To Building Foundation 21' F~ot4 C..o,
Lot ~J,/~.
To Water Main/Service Line ~ ~' '
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
z2'/~'P/~Pt Type of System Design
Length of Field ,~ 8
Depth of Field
Gravel Bed Thickness
Stagndpipes Present (Y/N)
Date of Last Adequacy Test <~/~z//,~O
!
To Property Line ~ /~
To Existing or Abandoned System on
/
; On Adioining Lots S'~
To Cutback (if present) N,~,
~ 1oo
Comments
D. LIFT STATION NONE
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test.
**Check Permitted Bedroom Rating Against HAA Request**
I certify that I have checked, verified, or conformed to all MOA and HAA guid~l~r~s._in effect on the date of this
inspection. ~ O~
Signed ~~ ~ ~ .~ ~C~ o.
l~ ...................... ~...~ Engineers Seal
MOA No. ~0 -Ol~ ~ ............. ~'"~
~ ~:'~ ,.IHEODORE F. MOORE.,
Receipt No. D,5 -' ~ ~ ~9-0 ~ ~/' o
- Receipt No.
Date of Payment -¢'/70~--"'-- ,**~ Waiver Fee: $
Amount: $ ¢ -/~ -¢O Date of Payment
72-026 (Rev. 7/88) Back Page 2 of 2
1. General Infcrmaticn Applicaticn Date -~--9~'~7~ _~
(a) Legal E~cripti_cn (inc]X~e lot~/block, s~vi.s}on., section, to, reship, rarx]e)
i~ ( ~ess or irec ~ ~/ / ~-~ ~
(e) Appi. ieant is' (check o~) ~ding Institution ~ ~ ~r~il~%~
(d) ~nding Institution ~/-.~.~,~
(e)
Address
Real Estate Co. & Agent
Address
Te lephor~
2. Tyt>e of Residence
S ing le-Famil~.~
Nur~e~ of ~ed~c~
3. Water Supply_
Well~
Individual
,.Multi-Family
OtJ]e~ (describe.)
Commu n ity/~---~ Public
Note: If community ~11 system, must have w~itte..n confir~ticn from ~-2'.e State
Depa~r~nt cf k%nvir©p~rental Conservation attesting to the legalihy arid status.
Is the ~11 adequate fo~ the nuu~er of bedrccr~s specified in this HAA (Y/~)
Se wao_q~_e Disposal
Onsite[~ ~blic L----~ Comnunity ~, Holding ?ank
Is the wastewater dis~sa! system adequate
[Page 1 of 2]
St
Engineering Firm'Providin~ Inspections ~ Tests, Data and Infocmation
I oertify that I have~ecked, verified, or conformed to all MOA HAA Guidelines ~
effect on the da(~ Of x~/.~ _inspectioq?
Name of Firm
(ENGINEER SEAL)
Disapproved[---1
6. DHEP Approval
Approved fore
Approved ~ '
Terms of Conditional Approval
The Municipality of Anchorage Department of Health and Envircr~entat Protection
not guarantee the continued satisfactory perforr~-~nce of the wate~ supply and/ct
wastewater disposal system. This approval indicates that, as of the validation
shcwn e~c%~a, b~sed cn the data and information furnished by an engir~.~er registere
the State of Alaska, the vrater supply and wastewater disposal system is safe a?.d
tional fo~- tha numbe~ of bedrocks and type of struct,J~e indicated.
( DHEP SFJM3)
7. Mail the HAA to the fol!cwing address:
KB2/d5/s
[Page 2 of 2]
2-15-84
Well Classification :
We.il .Log P~esent (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/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Neacest Public Sewer Line
Cleanout/Manhole
Water Sample Collected By
Water Sample Test He~ults
Cc~ents
MUNICIPALITY OF ANCHORAGE (MOA)
MUNICIPALITY OF
HEALT~ AUTHORITY APPROVAL (HAA) DEPT. OF H~ALTH &
ENVIRONMENTAL PROTECTION
CHECKLIST - FEBRUARY 1984
· .REC ED
If~.B, c~ C, D.E.C. Approve~/~:
Date Completed Yield
Depth of Grouting_
Pump Set At
Sanitary Seal on Casing (.Y/N)
Depression A~ound Wellhead (Y,/N)
; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewer Service Line on LOt
; Date
Bt
SEPTIC/J~B~G TANK [1ATA
Date Installg~ /~; /~ Si~ /2~ No. of C~nts ' ~
Standpi~s ~Ta~
~p~ation Distan~s ~ ~ptic~olding Ta~:
To Water-Supply ~!1 ~/~/~ To ~ilding F~ndation ~ ~
To P~ope~ty Line _ J~)
TO Water Main/Service Line
Course
To Disposal Field /~Z ?
TO Stream, Pond, Lake, c~ Major D~ainage
[Page 1 of 2] 2-15~84
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata ~
Date Installed //~/~d~ /~.~
Width of Field ~ //
Square Feet of Absorption~ea
/..I
Depression over Field (~
Results of Last Adequacy Test
Type of System Dosign,
Length of Field ~
Depth of Field °/~
Gravel Bed Thickness ~,~
Standpipos P~esen~
Date of Last Ad~=quacy Test /t/~? ~c/
Separation Distanoo f~omAbsorption Field:
To Water-Supply Well~l~/t)~ To P~ope~ty Line
To Building Foundation ~.~ / ! To Existing or Abandoned System cn
Lot /~//-~ ; On Adjoining Lots ~ ~t~/
To Water .Main/Service Line /~ ~ To Cutback(if present) '
To Stream/Pond/Lake/c~ Majo~ D~ainage CooL, se /C/~ ~-
To D~iveway, Parking A~ea, c~ Vehicle Storage A~ea //%3 /~
Co, rents
D. LIFT STATION
Date Installed , / ~ ~ ~ Dimensions
Size in Gallons ///b/ //¥_~Manhole/Access (Y/N)
"Pump On" Level at V l/ ~J "Pump Off" Level at
High Water Alarm Level at Vent (Y/N)
Tested fo~ Pumping Cycles du~ing Adequacy Test.
Electrical Codes (Y/N)
Comments
~ets MOA
,.,
** Check Permitted Bedroom Rating Against HAL IR~qUest
certify tha~ have checked, verified, o~ conformed to all MOA HAA Guidelines in effect
~'~o/.. ..... ~¥~, .~ ....... M~A ~O. ~ ~ . ~
.... .....
KB1/dB/s ..,.~':,, ~ _,. ~ :-',~
[Pa 2 of 2]
2-15-84
DEPT. OF ENVIRONMENTAL CONSERVATION
SOUTHCENTRAL REGIONAL OFFICE
437 "E" STREET, SUITE 200
ANCHORAGE, ALASKA 99501
BILL SHEFFIELD, GOVERNOR
Telephone: (907)
Address:
274-2533
To Whom It May Concern:
According to records on'file in this office the ~~~ ~Lkg[l~O~%!6~
Water System is in compliance with the State Drinking
Water Regulations.
Sincerely,