HomeMy WebLinkAboutLAMPERT ESTATES BLK 2 LT 6
Municipality of Anchorage Page of.
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: PID Number: ~'~ ,~\- -'!,°/,\-(~-
Name;~'f//'~-¢~"~'?~'/z"'? ~ * ~ Wastewater System: ~D C~New-~'~' f U Upgrade
Address:
~o~ ~/~ ~,~ ~ ~7 ABSORPTION FIELD
Phone: No. of Bedrooms:
~_ ~-~ ~ ~ DeepTrench D Shallow Trench ~Bed ~ Mound ~Other
LEGAL DESCRIPTION Soil Raling: : Total Depth from original grade:
/~0 3F/~GPD/Sq, Ft. ~
Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe
Township: Range: ~ Section: Fill added above original grade: Gravel length:
/
Ft. ~ ~ Ft~
WELL: ~ D New ~ Upgrade
Humber of
lines:
Distance ~tween lines;
Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material:
Driller; Date Drilled: Static Water Level: Installer: Date instalred:
Yield:GPM Pump Set at: Ft. Casing Height Above Ground:Ft. TAN K
SEPARATION DISTANCES ~ septic D Holding ~ S.T,E.P.
To Seplic Absorption Lift Holding ~ublic/Privale Manufacturer: Capacity in gallons:
Material: Nember of Compa~ments:
Surf~. ~ ~" LIFT STATION
Lot /¢ ~ Size in gall~ufacturer:
Fouedation ~/ /~/ ~ "Pump on" leve~ at; ~~el at: High water alarm at:
~rain
Remarks: ~,)~,Zr ~yc~ ~v~ ~2 BENCH MARK
Location and Description:
. I Assumed Elevation:
Department of Health and Human Service~
Reviewed and approved by: Date' '~" ' ~''~''
72-013 (1/91) MOA 25
STATE OF ALASKA '
DEPARTMENT OF ENVIRONMENTAl- CONSERVATION
APPROVAL OF ON-SITE RESIDENTIAL. WATER AND SEWER SYSTEMS
PROPERTY DESCRIPTION
ILot Subdivision or U,S. Survey
The Department of Environmental Conservation does not guarantee the continued satisfactory perform-
ance of the water supply and wastewater disposal systems. The validation dates are based on evaluation
of the systems using accepted engineering practices and assuming satisfactory maintenance.
WATER SUPPLY
~"~~eater system has been evaluated and found to comply
with
18
AAC
80,
satisfying
system co~ion and water quality of Class C water supplies and for minimu[TJ-~ff~l'a~on distances
as appropriate. ~_
This approval is valid for ~---~--t'~Water~ Supply System from date of issuance, pro-
vided the system is properl ' '~T~ed--
WASTEWATER DISPOSAl
The domestic wastewater treatment and disposal system has been evaluated and has~een found to be in
compliance with 18 AAC 72 for a [] single family ~[.multi-family unit with -~T-' total bedrooms,
satisfying the requirements for design, sizing and construction of a wastewater disposal system.
This certificate is valid for ~F_~ months for the Wastewater ,Disposal System
from
date
of
is-
suance, provided the system is properly maintained. Receipts for Septic Tank Pumping, which is required
every 24 months, must be retained for a valid approval.
18.0404(6 82)
Distribution: White -Bank/Lending Institution; Canary · Applicant; Pink - Department
Ca~tJ.~
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. # 051-791-07
1. GENERAL INFORMATION
Complete legal description
Lampert Estates
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING ~.~ ~.~(~\~ -~ ~'!(.'_~'1 \ '~-~_
[o~ 6, ~[ock 2
Chuqiak
Location (site address ordirections)
22521 Lampert Circle,
Property owner Melody Bear Day phone 696-3582
Mailing addEess P.O. Box 671623, Chugiak, AK 99567
Lending agency N/A
Mailing address
Agent '
Don McKenzie R.E./Bob Brown
Day phone
Ad dress
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: 4
13135 old Glenn Hwy, Eagle R~ver. AK
Day phone
99577
694-9035
TYPE OF WATER SUPPLY:
NOTE:
Individual well
Community well
Public water ×
If community well system, provide written confirmation from Stat.~:'~DEC attesf¥~
lng 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.
72.025 (Rey. 1/91) Front MOA #21
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 verifythat 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 Eagle River Enqineerinq Services
Address P.O. ~ox 773294. Eagle River, AK
Engineer's signature ~ ---'~'-
Phone 69___4-5195
99577
Date ~
DHHS SIGNATURE
APproved for ~/~)bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
The Mu,n!cipality of'Anchorage Department 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 DH HS 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 professional engineer's work.
72-025(Rev. 1/91) Back MOAfr21
MUNICIPALII'Y fJl~/4NL, HOF, A~b
[NvIRONMENTAL SEP, V ICES DIVISION
Municipality of Anchorage DEC
DEPARTMENT OF HEALTH & HUMAN SERVICES J~ j~ ~' j:
Environmental Services Division ~,- ",'
825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744
Legal Description:
A, WELL DATA
Well type
Health Authority Approval Checklist
/...,/¢/F//)~/~_ -~ ~---~'~"/J 7'~"/-~%-,'¢ Parcel I.D.:
/'~/,)~/,./g_.~ If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Date of test
Static water level
Well production
~/~iFfoErRmSAM PL~/
Da!
0¢/--??1- o?
Date completed ~
Cased to ~ Casing height (above groun~'~''~
.... Wires properly prote~Y/N)~
FROM WELL LOG AT I CTION
g.p.m, g.p.m.
B. SEPTIC/H~L-BtN6 TANK DATA
Nitrate Other bacteria
Collected by:
Date installed /¢~ Tank size //~OO Number of Compartments ~ _ Cleanouts (Y/N).
Foundation cleanout (Y/N) _,/¢~ Depression (Y/N) /A/D High water alarm (Y/N)
Date of Pumping /-)¢ ¢(,2(,¢ Pumper
C. ABSORPTION FIELD DATA
Date installed /Ca°3'"¢ Soil rating (g.p.~.dEft'~ fF/bdrm) /~'~ System type
Length /-/2// Width / ~" ~ Gravel thickness below pipe / i Total depth ~¢ /
Effective absorption area ¢ ~ ~ z/~¢ Monitoring Tube present (Y/N) Y~'~ Depression over field (Y/N) ,
Date of adequacy test _ ~'- 6 ~ q 6 Results (Pass/Fail) __/~4~'~' For ~ bedrooms
Fluid depth in absorption field before test (in.); /, 75' Immediately after¢5",~ gal. water added (in.):
/?¢~ g.p.d.
Fluid depth ~' (ins) Minutes later:
Peroxide treatment (past 12 months) (Y/N)
Absorption rate =
If yes, give date
72-026 (Rev. 3/96)*
LIFT STATION /~/'/.~
Date installed Siz~
Manhole/Access (Y/N) ~t* "Pump off" level at*
water a~ *Datum
High
Cyc es d
SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
On adjacent lots
~ Public sewer manhole/cleanout
· line Lift station
SEPARATION DISTANCES FROM SEPTIC/HeL-BhN~ TANK ON LOT TO:
Foundation /~ / Property line /0 / Absorption field
Water main/service line 7~/{) / Surface water/drainage ~/0(~ / Wells on adjacent lots
/
ZOo
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
Property line / 0 /
Building foundation / ~. t Water main/service line
Surface water -/'/(¢20 Driveway, parking/vehicle storage area
Curtain drain ./Y'O/(/~ ./¢p/2,/¢,~/~' Wells on adjacent lots
ENGINEER'S CERTIFICATION
I certify that I have determined thru field inspections and review of Municipal records tb~t the ~bove Sys'tems are
in conformance with MOA HAA guidelines in effect on this date. - ·
,~ '-, ,: . '.'.. ., '..'/:
72-026 (Rev, 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
F=c;R'a'o 11~at of{eot tht,~mmk~atabiil{y el ti~ Om'/~'~tl~ In tD.e neiqhi~hood (p~xx~ily lo t~m. pk6,m~nt ~ umertilie~., e.,m,p~¥ment lilab~{1V, aDOeat to m, arko~.
T}~ O{5'NUF, AL .NJ~;.iOHDf)Rif~_YOD iS COMPRt6;i~ OF AVe & AI:IOV'E~ AVG Q,UA~,ITY S..I.,,H~,,LE FAMILY RESIDENCES ,
'['HE A(X?ESS 'PO SCHOOLS,SHOPPING AND EI~LOYMENT IS TYPICAL FOP. TIlE AREJ%, POLICE,FIRE PRt'Ti'ECTION
[-'UBLIC' ;~;~.ANSPOR'UAT1OI'q IS AVIF41AG]~ FOR ~ ~{~A. ~ SUBJECT NEIGIi 1[,'~ LOC~T~ID [N THE PETE, RS
AREA AND' IS M~X WITH VARIOUS AGES:,-qlZ~S ANU qUALiTY OP' SI? ~B'~ &. ~'MYTt~ ?,D~_LITY IS
~rket ¢ol'diH~ {n the subject .eiShbo~ho:~ (in~k~tin0 UC~ ~ t~ ~ ~ ~ ~ Ih~ I~ of p~y ~s. ~/~. ~ mu~fi~ ~l
Ocmrt~ot~ {aPl:.~nt ed%rse eaaem~mls. ¢,nrg~l~enl~, .r,p~ a~;sos,.;ments, slide emus, ille~l~i or te~l aocm~folmir~i zC, mng use, etc.): NO APP~
ADVERSE EASEblF~rs OR ENC. ROA~S NOTED PER AS BUILT PROVIDED DA1ZF. D 6-18-85
, i i e, UUgNUUM ~R COYd, dLq~rS ON FUNCTIONAL ,AND PHYS[(,.6i, DEPRF. CIATION.
¢flce/Gt~ Ch', A~
........ I bllLl~ NE
3( 1 ! 9.900
44,05 73.13 61.~,4
1 ~p/LnO ~2/96 C9/96
' I ' F~
16/96
~'~ FQ~ ' '1 Fee ' {
--3000 ~ -3000 -3000
~IOR 8~ERIOR -3000 ~O~IOR __l -3000
[-21 1982 E~14 I ~5000 1983 E-9 -12000 g-~
L 6 I 3 I z 3 [3 j I ~ +2000 1 +20~ 2
~one ] NOIt~ I 192 SF Abv ....
8td I 8 td t SrO ,
None OrA . I '~gP None [ ' -12000
UNFIN STG I ~500 I - lO00
,
Fer~e, I~<q. etc.
OTItl~ ]Tt~S gV RI/D ~1000
-2000'
400 9O0
80.60O 86. (mO
Commenl~ on 8ales Como~ti~:o (ll~b~ t~ a~l ~a ~i~iy I0 ~ ~, ~,):__~[TE '~ ~ t.~,,OF ~
~i~0 HIG~R.~/F~~ ~9.R~ ~ ~_9~p~S ~JOffl~: .~.L 4 S~ES ~ .~ZOg ~N qp~'Ty &..--
~f)gal, '[p~.~Ig SUBJE(n' C~'S 1 & 2 S~.ZS DATE ~ O~%R 6 ~Os, C~t ~s A S~LER
~I~ WITH A 1 C~ G~';E, C~IP~2 [~ A 81MI~ SIZE R/DWEbkI~ WITH NO GARDE. ~3
}~S A L~R ,
Mb.~I,LING WIT~ a 2 C~ GA~E. ~4 ~ A g~ ~ ~E~. * ,
w~hb~ar~a~~ J~E ~'rgg NO~ Ntd, ~ Ntd None Ntd,
LISTED AT ~81 t2OO
~11~ ~ ~(~a~: ~ ._ ~ x ~;~ ~m ~ ~'l'~, ....'.- '
~lbrili~o~,oM~ikslvo~Oefin~tares~T~ini~tt~F~4~Ol;~mtO~a(R~. 6T93 _
NOV, 15,
.................
MEMORANDUM
DATE: August 12, 1985
¥O:
Laura Crow, Accounting
FROM:
Environmental Health Division
SUBJECT: Request for Refunds - Account # 2460
Please make arrangements for the following refunds. Most were due to over-
payment or should not hav'e even come to this office to begin with.
Thank you.
Jack White Company
3201 C Street, Suite 100
Anchorage, Alaska 99503
Receipt # 349242
Amount $45.00
Account # 2460
U.S.S #3042 Lot 74 W~ SE¼ - Health authority approval which is a duplex
and should have gone to State D.E.C.
David Plunkett
200 West 34th A~enue
Anchorage, Alaska 99503
Receipt # 347121
~,ount $45.00
Account # 2460
Lot 6 Block 2 Lampert Estates Subdivision - Health authority approval which
is a multi-family and should have gone to State
D.E.C.
Billy G. Andrews
P.O. Box 100-560
Anchorage, Alaska
99510
Receipt # 341204
Amount $145.00
Account #2460
Lot 9 Block 4 Rockhill Subdivision - Applicant paid for a MOA inspection,
however, had a private engineer perform the
necessary installation inspections. Only being
charged for the permit fees of $30.00.
S & S Engineering
SR B 196-X
Eagle River, Alaska
99577
Receipt #349351
Amount $45.00
Account # 2460
Lot 2
Sleepy Acres Subdivision - Health authority approval as a conditional
this appplication was to remove the conditional
approval and should have not been charged a second
fee.
S & S Engineering
SR B 196-X
Eagle River, Alaska
99577
Receipt # 346953
Amount $20°00
Account # 2460
Lot 7A Block A Timberlux Subdivision, Permit # 850317 -- Applicant was charged
for a permit, by mistake, that did not belong to
them.
Laura Crow - Accounting
August 12, 1985
Page Two
Marvin Johnson
4300 Arctic Boulevard #46
Anchorage, Alaska 99503
Receipt # 332980
Amount $15.00
Account # 2460
Lot 3B Groll Subdivision - Well permit #850069, applicant obtained a well
permit without realizing his engineer(S&S Engineering)
had obtained it for him.
Bill/Cheryl Tatom
1744 Bellevue
Anchorage, Alaska
99515
Receipt #346901
Amount $15.00
Account # 2460
Lot 1 Block 2 Potter Heights Subdivision - Well permit #850283, applicant
obtained a duplicate well permit for the same property.
He obtained an On-site Sewer/Well Permit on July 26, 1985
(#850450), therefore, this is a duplicate on the well.
· ' ~,. ~ ~ ~ ~% ~.~ ! ~ '~<
Laura J. Ward
Office Associate
LJW
cc: Subdivision files
attachments
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEAL'rH AND ENVIRONIViENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOB HEALTH AUTFIORI'I-Y APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
GENERAL INFORIVIATION
(a) Legal Description (include lot, block,
Location (address or directions)
Application Date
subdivision, seclion, township, range)
(b) Applicant Name ~¢~L~ n
Applicant Address
(c) Applicant is (check one): Lending Institution []; Owner/builder/~.; Buyer ['-I; Other [] (explain);
(d)
(e)
Lending Institution ~:"?'~_ /?~'.]~.~.2.~__ Telephone
Address ~?,c,6'- (.M ~ ~'~.~[ ../>¢,~. ~¼../-.~_ /¢¢~';
Real Estate Company and Agent ~t,/,~-~.
Address
Telephone
(f)
Mail the HAA to the following address:
2. TYPE OF RESIDENCE
Single.lFamily [] Multi-Family'~ Other
Number of Bedrooms _9
WA'|'E I:t SUPPLY
Individual Well[] CommunityX Public[]
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attestingtothelegalityandstatus. C /,. .~- s ~ ..'¢/~0,~- ~,.'~, / ;'~-,~ /~',.L / o:,~ (~--~ /-e ~- J~,,c x~,~
SEWAGE DISPOSAL
Onsiti.'~, Public EJ Community [] Holding Tank []
Note: If community well systern, must have written confirmation from the State Dopartmont of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 7:*(~2s u~ 84~
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, I verify that my investigation of this Health
Aathority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for tile 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 __ ~//~ ~7~i'_~- ~A/_~_ -./~.5 ,',,~.¢',~2':?"~*,f_ Telephone /~"~'~/-'/'~
Date
Engineer's Seal
'"', / k/./ /
DHEP
APPROVAL
~ ' '¢;'"~' : --) ' Conditional
Approved / ...... _~_ Disapproved
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Depmlment of I-lealth and Envirom'nental Protection (DHEP) issues Health Authority
Approval certificates based solely upon tho 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 Ancherage is not ~esponsible for errors or omissions in the
professional engineer's work.
Page 2 of 2 ~
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984 ~, ~O ~ NNfi
264-4720
~OI-L'~O~cl 'IV-~N-3 ~/NO~IAN~I
Legal Description: ,~- o P ~ ~O~ ~~'
WELL DATA
Well Classification
Well Log Present (Y/N)
Total Depth _ Cased to
Static Water Level
Casing Height Above Ground
Electrical Wiring itl Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
Comments
,~r ,', If A, B. C, D.E.C. Approved (Y/N)
Date Completed Yield
Depth of Grouting
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
; On Adioining Lots
; On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
; Date
B. SEPTIC/HOLDING TANK DATA
Daie Installed
Standpipes (Y/N) _ ~ ____Air-tight Caps (Y/N)
Depression over Tank (Y/N)
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well ,~'
To Property Line /~ i
To Water Main/Service Line /O c-
Course .
Size. ,/~-~o No. of Compartments _
Foundation Cleanout (Y/N)
Date Last Pumped
; for
Temporary Holding Tank Permit (Y/N)
To Building Foundation /,¢ /
To Disposal Field ;;::[,¢ x
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 /'9 ,:~ 5'-
Width of Field ?¢¢ /
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well ~--"~¢'~ '~'
To Building Foundation ,/~ ·
Lot ,/-'/'/'/'/'/'~ /~"~ ~
To Water Main/Service Line ,/¢ ¢'
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments .$',-..o/~, ~.
Type of System Design
Length of Field /-¢,;Z /
Depth of Field d' /
Gravel Bed Thickness /-'g- /'
Standpipes Present (Y/N)
Date of Last Adequacy Test
Y
To Property Line /¢
To Existing or Abandoned System on
; On Adjoining Lots '~ ~ '~'
To Cutbank (if present)
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Dimensions
Manhole/Access (Y/N)
"Pump Off'" Level at
Vent '(Y/N)
pumpin-g Cycles during Adequacy Test. Meets MOA
Electrical Codes (Y/N)
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify tha~hecked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed~ ,,,~2~_ ~,¢,¢/..~.~ Date_ ¢/~ 2/.~.~..r-- '
Company
Receipt No.
Date of Payment i4"~:' 4~;%~¢'0g Engineer's Seal
Amount: $
STATE OF ALASKA
DEPARTMENT OF ENVIRONMENTAL CONSERVATION
APPROVAL OF ON-SITE RESIDENTIAL WATER AND SEWER SYSTEMS
Lot, 8lock & Subdivisioll or U,S, Survey
PROPERTY DESCRIPTION
The Department of Environmental Conservation does not guarantee the continued satisfactory perform-
ance of the water supply and wastewater disposal systems. The validation dates are based on evaluation
of the systems using accepted engineering practices and assuming satisfactory maintenance.
WATER SUPPLY
"'"'""~T~s~/stem has been evaluated and found to comply with 18 AAC 80, satisfying s.~ta~fo~
system co'i'~u~on and water quality of Class C water supplies and for minimu~.separglfl0~ distances
as appropriate.
This approval is valid for ~ ~i Water Supply System from date of issuance, pro-
vided the system is prope~l~y..~air1't~j'~'e~. -~
WASTEWATER DISPOSAL
The domestic wastewater treatment and disposal system has been evaluated and has~een found to be in
compliance with 18 AAC 72 for a []single family ~multi-family unit with /' total bedrooms,
satisfying the requirements for design, sizing and construction of a wastewater disposal system.
This certificate is valid for ~ months for the Wastewater Disposal System from date of is-
suance, provided the system is pr~)perly maintained. Receipts for Septic -~ank Pumping, which is required
every 24 months, must be retained for a valid approval.
1B-O404(B/82) Distribution: White-Bank/Lendlng Institution; Canary - Applicant; Pink - Department
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA g9501
BILL SHEFFIELD, GOVERNOR
Telephone: (907)
Address:
274-~533
&(~~4~)~6_'Water $¥stemi$ in compliance with the State ~ri-nking
Water Regulations
Sincerely,