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Home My WebLink AboutBONNIE VIEW LT 14Bonnie View Lot 14 #017-422-23 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAl. PROTECTION ENVIRONMEN'rAI.. ENGINEERING DIVISION 82,,5 L Street- Anchorage, Alaska 99501 Telephone 264-47:~0 - ON-SITE SEWAGE DISPOSAl._ SYSTEM AND/OR WELl_ INSPECTION REPORT LECsAL DESCRIPTION LOCATION~ ~~ NO, OF BEDROOMS DISTANCE TO: I~¢ .,~' ~ ~ Z Manufacture~ ~ -- Materi~ ~ No. of c~partments ¢ Liq' t~ gall°ns IF HOMEMADE: Inside length Width Liquid depth Well Dwelling PERMIT NO. DISTANCE TO: O~ ~ -- ~ Manufacturer Material Liquid capacity in gallons n~ ~:__~~ ~ Foun~tion -- Nearest 'lot Ii PERMIT NO Q Wel , ' [ ) 7t~f Tren~¢th Distanc~/~en lines ~Z ~ No. oflines~ Le Total e lines ' · inches ~ Top of tile to finish grade ~( - Mate~ia~ ben, ath tile ~ inches Total eff~rption..~ area Length Width Depth ' PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER SOl L TEST RATIN~ a.r' " " " - APP~ED ~ ) DATE LEGAL 72-013 3/78) ........................................ ,,. ....... · ...... .... -; .... . .... .............. .., ... ¢' F:'ERHIT NC ':; S2058E; '.) ~ P'tF:!F::t MUM NUHBER OF E:EE:,ROOMS .... ¢ SO:IL RRT I NG ,::E;I;:¢ FT/BR) = ;2.;25 TF.IE ......... F::E:[;:!U IRE[:, 'E: 'r ZE F F' ]"HE 'E;F t L FtE:~;ORPTI ON ::,'r.:, i' E.I I t :5 ' THE LENGTH [:'tHENE;ION IE; THE LENGTH (IN FEET> OF:: THE ]"RENCH OF;: [':,F.::FtINF!EL.i:). T!'..IE [:,EPTH (:)F F! TF:ENCH OR F:']:'t' tS THE [:,ISTFtNCE BE'I"HEEN THE 5URFFICE OF THE GI:;.'tOI...INE:, FIND T'HE BO'T'T'OH OF THE E:,':;CFI'v'FITION ,:: Z I'.,I FEET). THERE t::.:; NO SET IqI[':,'!"H FOR TRE:]",IC:HEE;. THE GRFf'v'EL DEF"TH l:'.:.; THE hlINlMt.if,'! DEPTH OF:' GRR'v'EL E:ETHEE:N THE OUTFFfl...L PIF'E FINE:, THE DO'T'TOH (::it:: "['HE EXE:FWF4. TION ,.':IN FEET). PEF.:H I T' FIPF'L. t' C:F!NT' HFIE; THE: F.'~E:SF'OIq:.:.:; I B ! L. I T';' TO I NF'ORM TH I ::5 [::'EPF~.R'I'HEN]" [:)(.IR I I",tG THE I I",iE;'T'FILLFt'T 1' ON I NSF'EC T I Ot'.,k.{.: OF I::!I'.,W' i.,.!ELLS I"~DJFI. CEt'-,!T TO 'TH I S F'ROPERT"r' FIN[:, THE IqUMBER O!::' RES Z[:'ENCEE; "f'HFFF THE t4ELL, t.,.!ILL. E;ER"v'E. E~FICKF'!L. LtNG C','F Fff',!"r' "2',~'E;"FEH t.4ITHOUT I::'INFIL INSPECTION FIN[':, RPPRO'v'RL. B'.'r.' 'THIE; [:,EPFfi:;.'.TMENT t4IL. L. E:E :E;UEL:rEC:T TO F'ROSECI.J'TION. HINIMUH [:,IS"t"RI'.,E::E BETI.,.!EEN F~ !.,.IELL RN['.', Ftl",l"r' ON-'SITE SEHRGE [':'ISPOSF~L :[.OO FEET' F'OR F~ F'RI'v'I::Fr'E HELL OR ::L50 TO 200 FEE]:' F'ROM Fl PLIErL. iC HEL. L [':'EPEN[:,II'-,IG UPC. tN THE T?PE (."iF' F'LIBL. iC I,,.fELL. H I N t MUH E:, I S"FFtNCE FROM F! F'R I VI::FFE f,.!EL.L. ]'O F~, F'F.: I ',,,'F!TE :SEI.4ER L ]: NE i E; 25 FEET' F:IF,![:, TO F:~ C':OMHLIN~:T'¢ :SEI.4EF.: LINE: .'[:5 7'5 FEET. i.,.IELL LOG:E; FIRE F-tE[i)UtRE[:, FIN[:, HUE;T E¢E F.:ET'URNED 'T'O THE [:'EF'F!RTt"iENT HIT'HIN ::~:O [:, F1'¢ :.:5 OF THE HELL COHF:'LETION. OTHER F.'.'E(;:.!U t' Fi:Eh'lENT::_'.; HF!:'r' FIF'F'L'.¢. :::.:;F'EC ! F' t CFtT I ON% RI".![:, CONSTRUCT' I FF,,'F:!IL. RBLE TO I!",iSURE F'ROF'ER IF,!:STRLLR]"iON. :1.: I F:ff't FRMIL. I~.R H!TH THE REQUtF4::Er,'!ENT$ FOR OF,!-E;ITE E;Et4EFi:S RN[:, I.,.tEL. L.E; RE; SET F:'ORTH B'¢ TFtE MLiF,! I C ! F'FfL. I 'T"¢ OF' F:INCHORF~GE. ;.:?.: I H t LL. I N'E;TFtLL. T'HE 5;'¢E;TEM :[ f'..t Ffl::::CORE:,F!NCE !.41 TH TF!E (::ODE:E;. 3: I UN[:,ERE;TF~!..,![:, 'T'FIF'FT' THE ON-:E, ITE SEI.,.tER $¥E;'T'EM MF:W F?.EE:!L!IRE E:.!'.,ILRRGEMENT tF THE RE.'ii!;:[[:,EI'qCE'.' IS R[.:.:MODELE[:, TO INCI_IJ[:,E PIORE THF~N 4 BE[:,ROOMt.E;. 0 0 0 0 0 0 0 0 0 0 0 ~ 0 0 ~ 0 0 0 0 0 0 0 0 0 0 ~ 0 o o o o o o o o o o SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERCOLATION TEST SLOPE PLAN WAS GROUND WATER I~ ENCOUNTERED? · ~) ~ O P E IF YES, AT WHAT DEPTH? /z ",3 /,ole Reading Date Gross Net Depth ~-~ ~'~' Net Time Time Water .~ Drop ..... 2 ~ 10 t3 . /o~ ~.~F ~.~ PERCOLATION RATE ~' 7 (minutes/inch) ~'~O FT AND ,_~'~ (~ FT TEST RUN BETWEEN CERTIFIED BY: DATE: 72-008 (6/79) CONSULTANTS, INC. ANCIIORAGE FAli~IiANKS JI_~NEAU ~24~ t='AST .~IST AVENUE ' P,O, BOX 6087 ANCHORAGE, ALASKA 99503 * TELEPHONE 907-279-0483 TELEX 090-35419 August 22, 1975 Terrel Rees 3204 Latouche Apt. #9 Anchorage, Alaska 562101 RE: Test Hole and Soil Log Report for Sanitary System Lot 14, Bonnie View Subdivision Dear Mr. Rees: We are submitting herewith the test boring results and our comments regard- ing soil conditions encountered at the subject site. This investigation was performed in accordance with your request of August 19, 1975, and those procedures outlined in a letter dated July 15, 1975, by Mr. Rolf Strickland of the Greater Anchorage Area Borough Department of Environ- mental Quality. A single test hole was put down within the Lot 14 area for the purpose of defining general subsurface soil conditions for the proposed sanitary system. Excavation was accomplished with an auger type drilling rig and the test hole was extended to a total depth of 20.0 feet below ground surface. The final log prepared for the test hole has been included in Drawing A-01. Ground water was not encountered in the test hole. We appreciate being given this opportunity to be of service to you. Should you have any questions with regard to the above, please do not hesitate to contact us. Very truly yours, R & M CONSULTANTS, INC. James W. Rooney~) Vice President JWR/ja xc: GAAB R Log represents Lot 14 Bonnie View Subdivision Consultants Inc. ANCHORAGE FAIRBANKS OATS 8--22--75 ]~_ ALASKA T.H.-1 8-20-75 ORGANI CS SILT, TRACE SAND (ML) 0o0~ 0.5' 1.5' SAND, TRACE GRAXXEL TRACE SILT (SP) 1,.%~0 SILT, TRACE SAND (ML) 8.5~ SAND, SOME SILT TRACE GRAVEL (SP'SM 200 sq'~t/bedroom) 16.0' SILTY SANDY GRAVEL (GM) NO WATER TABLE 20.0' T.D. JUNEAU WED ICHKD 8Y WED Terrell Rees Property Log of Test Hole Anchorage, Alaska 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. # O! '~ "" CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description Location (site address or directions) 0 Property owner Mailing address Day phone Lending agency Mailing address Day phone Agent '~.r.J.,t Address Day phone "7(¢,2.- S I10 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 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: X If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1/91) Front MOA #21 · ~tJo~ s,Jaeu!l~ue leUO!SSejoJd eq~ u! suo!ss!uJo JO sJoJJe Jo~ elq!suodsaJ ~ou s! ebeJoqou¥ bo Xl!led!o!unlAl eqJ_ 'penss! s! eleo!~ilJeo e eJojeq e~ep @ZXleUe Jo suo!~oedsu! ~onpuoo lou op SHHQ bo saaXolduJ3 's~ueLueJ!nbaJ ale,s pue leJepej u!eMeo ~sges o~ Jap Jo u! suo!~n],p, su! bulpuel J!eq~ pue sauJoq jo sj@seqaJnd o~ XselJnoo e se s!q~ seop SHHQ @q/'e)lSel¥ jo e~e~S eql u! peJ@~s!baJ jaeu!eue leUO!SSejOJd 1uepuadepu! ue ~q e^oqe 9 qdeJbeJed u! ua^lb suo!~elueseJdeJ @q~ uodn /quo paseq seleoiJ!]Jeo le^oJddV X~!Joqln¥ q~leeH senss! (SHHQ) seaFdeS ueLunH pue q~leeH jo ~ueuJ]~edecI eeeJoqouv jo ~l!led!o!unlAI eq.L sluewwoo euo!~!ppv :suo!lelndi~s 5U!MOIIO,L eql H3,!M 'SLUOOJpeq Jo,[ leAoJdde leUO!~!puoo 'peAoJddes!a 'SLUOOJpeq JOJ. pe^oJddv ~ 31:In.L'VNglS SHHa LUJ!-I ~tO @LUeN · uo!~oedsu! s!q~ jo e~ep eq~ uo ~oej~e u! suo!~eln[~e~ pue 'seoueu!pJo 'sepoo m,e~S pue led!o!unR lie q~!~ eoUe!ld~oo u! s! ~e~s~s lesods!p ]e]e~eise~ ~o/pue Xlddns Je~eM e~!s-uo eq~ 'uo!~oedsu! pue uoi~ee!~seAu! ~oJ~ peu!elqo uo!lemJo~u! e~ uo peseq ~eqj X~paA JeM~n~ I 'u!aJe~ pe~eo!pu! eJnjonqs jo edX~ pue s~ooJpeq ~o Jeq~nu e~ Jo~ e~enbepe pue leUO!]oun~ 'e~es s! ~e~sXs lesods!p jeleMelSeM Jo/puc Xlddns JeleM e~!s-uo emi le~ SMOqS uo!leo!ldde leAoJddv X~ leM1XJ!JeA I 'MOleq UMOqS e~ep uoReP!leA emi '9 I:I33NIIDN:I AG NOI.I.O=IdSNI JO .LN~IlN=I.LV.LS Legal Description: Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST I/'~/// ~::)~,v'//'~ [/)j-.g. CLT' Parcell.D. ~)/'7 ,---¢-[Z.2..--,~"~ A. WELL DATA Well type Log present (Y/N) Total depth Sanitary seal (Y/N) / Date completed '7/Z'O/E~--- Driller Cased to ~-z~',~c ~. Casing height If A, B, or C, attach ADEC letter. ADEC water system number i,,2 ,r../- Wires properly protected (Y/N) Date of test Static water level Well flow Pump level FROM WELL LOG AT INSPECTION [' ~' g.p.m. "~''~ g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot //',~ Absorption field on lot / Z-~C~ Public sewer main /"///~ Sewer service line /~/~ ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout F~'///~.. Petroleum tank WATER SAMPLE RESULTS: Coliform ~ Date of sample: //'~0/~ Nitrate Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed ~/°O~ Cleanouts (Y/N) ~ Tank size . /,~- ~ O Foundation cleanout (Y/N) N High water alarm (Y/N) Date of pumping ~ Compartments Depression (Y/N) Alarm tested (Y/N) ["~//'~ Pumper /S O,,¢~ C 'J~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot [/~ On adjacent lots To Property line ~LO Surface water/drainage Foundation Water main/service line 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION I ~,/~.~. Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) "Pump off" level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Length //~7' Width Total absorption area Depression over field (Y/N) Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) Soil rating ~ ~ Gravel thickness /~ Cleanouts present (Y/N) Date of adequacy test for ~ System type /,~z4,~ c ~ Total depth If yes, give date bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: -F Well on lot / ~'C-~ On adjacent lots J ~ Property line To building foundation ZT/O ~ To existing or abandoned system on lot On adjacent lots ,~-O ~ Cutbank t"~//,c~ Water main/service line Surface water ~//c~ Driveway, parking/vehicle storage area ~> ~"' O Curtain drain /4) E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name Date HAA Fee $ / 7/~' Date of Payment Receipt Number ,,~z~ ~) ~,~,/~/~ 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number LEGAL: LOCATION: OWNER: RESIDENCE: 20~ WEST 15YH. AVENUE SUITE 206 ANCHDRASE~ ALASKA ?9502~3904 (907) 279-3916 SEPTIC SYSTEM ADEQUACY TEST Lc.q: 14,~ Bonnie View S/I} 12620 Neher' F:k::,ad Ray Wood Single Family, 4 Bedrooms WELL: F:'r':i. vat~ (In Site SEPT IC SYSTEM: FROM MUI~I[]IF'AL. RECORDS: 4 Bedrc)om System ]"ANK: Greet' Steel 125() Gal. Two Comparts. ABS[)RF'T I OIq SYSTEM: Trench ABSORPTION AREA: :[080 Sq. F:t. S 01 L R A'T' I N G ~ 225 I NSTAI...I...AT I ON DATE: 7/8/82 DATE OF LAST PUMPING: Isaacs F:'eb. 4~ 1992 DATE OF TEST: ,January 30~ :L992 TEST PROCEDURE: E')ystem was ir)spec:ted ar'~cl measured, 'T'ank was ~::ound with 3 .feet o~ c(~ver and with a liquid level o.f 48 inches, Trench sump was 5,5 .~eet deep w:i. th 26 inches ('.).~ sludge, 670 gallons (:).~ clean water wa.~ added t.o the trencl'~ whi].e the water levels :i.n tl'le 'l'.'.anl< and the ~;ump wer'e monit:or'ed, '1"he water level :in the tank did not change,~ while the level in the sump immediate].y rose 9 inches arid stayed at that level during the test,, ]"l"~e next day the water level in t. he wa~:~ back to pre..-.test I eve]. s ,, TEST RESULT: This sys.~te.,m meetr.¢ the cc)cie r'equ:Lremen'ks (::).f the Heal th and Sacial Ser"vices Depar'kmer)t o~ 'khe I'fltm:L c:L pal i. ty (:)~: anch(:]rage. NOTE "Fhe c)perational l:i.~:e o~: all iseF)'l'.'. :k c: systems depends on the local soil conditions~ groundwater leve].s that may 'fluctuate (::lurir'~g 'L:he year'~ arid t:he war:er" usage (]~ t'.he ~amily be:Lng served by the system,, "l"hese cc:)rlditioris are outside the control o'f the evaluator o.f t:his sept:i(::: system. We car) there.F(::)r'e not'. give any est:Lmate o.f flow long this syste[l) will .Furlc:t:ior) satis~:actory for NEST 15TH. AVENUE SUITE 206 ANCHDRAGE~ ALASKA 99502-5904 (907) 279-~916 RESIDENTIAL WELL INSPECTION LEGAL: LOCATION: OWNER: TYPE OF WELL: WELL LOG AVAILABLE: Yes INSTALLATION REQUIREMENTS MET:Ye~ WELL YIELD FROM WELL LOG: 1,5 Gallons per M:i. nute PUMP YIELD FROM TEST: 6 Gallons per Minute DATE OF INSPECTION: JAnuary 30~ 1992 TEST PROCEDURE: Well was I:)umped at a constant rate whi:Le the drawdown was mc)r) i tored wi t.h an ac:oust i c probe. At the begiJ"~ning o.F the test water' leve) was -Found at 24 .feet below top o.F casing. At a pumping rate (:)¥ 6 gallons per m:i.r'~ute the water' the well went dry a-Fret' '.,'!;5 minLr~:.es o~ pumping. A total (:~: 2()0 gal lc)ns were pumped. Well recow-:.:.:ry was mon:i, tor'ed for' three heurs. Initial r'ecover'y rate was ,75 gpm ~or t. he .First 90 minutes,, Dur":Lng the ]Last 20 mir~utes the rate was .375 gpm. The nex'~ day the well was back to 24 'Feet. TEST FOR E.COLI AND TOTAL NITROGEN: Water' was tested ~or E.Coli and tcJtal nitrogen on January 31, 1L992 E. Col :i. 0. Total Ni troger"~ O. 81 rog/1 , Max. a]L:Lowable Total N:L'~rc:)gen 10 rog~l,, TEST RESULTS: T h :i. s ML.~r'J i c i pal i ty o.F Anchorage. well meets t. he requir'ements c:)~ the The Municipal r'equirement ~or well ~:low is .L,::~(., galloris o.f water per bedroc)m per day. "l"l'~.i. s wel ]L exceed this rec:tu:L rement. Tl"Je ,::~ ....... ~ ....... mt....i i:: o"F the cond:Ltion o.F t. he well appl Les only 'Lo the cond:L't~.i(:)ns as o~ t. he day tes'L".ed. 'l"l")e .FI. ow ra'L'.e may change due to !i.~L.IJ:)sLU'"~Cac:e C:C.:)FId:J. tic)I']~.~ 'l::J"ta.'.:tt. flliay i"~c:)'J~. J].)e (:3Jl,:)sE.:.~r'vec:J ~Cr'c)ffl 'J:'.J"le and (::l")ar')ges in the land use anc.i c:)ther .Factors tha. t may impact the aqu:i. ~F(.:.:.:,r' .Feed:i. ng the wel 1 . CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 ANALYSIS RESULTS for INVOICE ~ Chemlab Re£.~ 92.8373 Sample ~ J Matrix: WATER FAX: (907) 561-5301 Cll.nt Sample ID : 3.2620 ZEHA RIDGE RD. Client Name :TOBBEN SPURKLAND, P.E. PWSID : UA Client Acct :TOBBENS Collected : JAN 30 92 @ 13:00 hrs. BPO{ : PO~ :NONE RECEIVED Received : JAN 30 92 @ 16:~0 hfs, ~aq~ : Preserved with : AS REQUIRED Ordered By : Analys~s Completed : JAN 31 92 Send Reports to: L abo,ator¥ Supe. viso..: STEPHEN / Paramete~ Results Units ~let hod Allowable LimJ NITRATE-N 0.81 ~/1 EPA 353.2 ROUTINE SAMFLE COLLECTED BY: STUART. Test~ Performed * See Special Instruction~ Above UA-Unavailable None Detected ~' See Sample Remarks Above Not Analyzed LT-Less Than, GT~Gzeatex Than ~SGS Member of the SGS Group (Soci~t6 G~n6rale de Surveillance) · bIUNICIPALITY OF ANCHORAGE ~ DIVISION OF ENVIRONMENTAL HEALTH DEPAR2MENT OF [LEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date .. (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) z%,,,. (b) Applicants Name ~'~'~.., ~'~"~ ~ .... Applicants Address (c) Applicant is (check one) Lending Institution Buyer ~--~ ;.Other (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: 2. Type of Residence Single-Family~ Number of Bedrooms Multi-Family ~--~ 7 Other (describe) 3. Water Supply Individual Well~ Community I ..'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. Sew____ase DJ~s_posal Ons ite ~ Public ~-~ Community [--~ Holding Tank / Note: If community well system, must have written cor~firmation from the State Department of Environmental Conservation attesting to the legality and sta[us. ~[Page I of 2] 5. En~ineerin~ Firm Providing. Inspections, Tests, File Search~ pata and Informstion 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 ~lchorage 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 Firm ,.. [.///r" . Address. ,, /' i;17[]> , ~/(i'i .' ~ i'~ ,~ ? "/' /];7. <'~.! (ENGINEER SEAL ) Date Cond ft ionkl DHEP A.pj~r ov al Approved for ~"/~ bedrooms By ._d(_c'.tZT~.~ Approved / Disapproved __ Telephone ",i:~,~2j/ ,~,,: , :. ' Te~nns o=,. Conditional Approval CAUTION THE I~NICiPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER F32GISTERED IN TI~ STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES ggD THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. 'tHE MIINICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/Di8 [Page 2 of 2] 7-1 9-84 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 A. WELL DATA Well Classification Well Log P=es. ent ~_Y/~) Total Depth /~! Cased to Static Water Level Casing Height Above Ground. .~.~/ ~'~' Elect=ical Wiring in ConduitS) Sepa=ation Distances f~cm To Septic/Holding Tank on Lot //~/ Be If A, B, C~ C, Date Comple~d If.2. ' Pump Set At Depth of G~outing /t)/-~- d! . Sanitary Seal on Casing ~N) Dep=ession Around Wellhead ~ ; On Adjoining Lots... To Nearest Edge' of Abso=ption Field on Lot. /J~" ~-; On Adjoining Lots To Nearest Public Sewer Line /u/~ To Nea=est Public Sewer Cleancut/Manhole /~//~ To Nearest Sewer Service Line oP. Lot Wate~ Sample Collected By ~ ; Date ~///~/~ Water Ss~e~Test Rssults _)~%~/D/~;~¢; ~ Date Installed .~h/~F~_ Size I k~ No. of Compartments Depression over Tank (Y~ Date Last Pumped Pumping/Maintenance Contract on File (Y/N)~//~ ; fo~ . ~t~ Holding Tank High-Water Alamn (Y/N) ~//~ Tempo~a~ Holding Tank Permit Separation Distances f=cm Septic/Holding Tank.' To Water-Supply Well //~/ To Property Line ~ 1-~' TO Water Main/service Line Course +/~O ! Foundation Cleanout ~ [Page 1 of 2] To Building Foundation To Disposal Field , TO Stream, Pond, Lake, c~ Major D=ainage ,,- i 2-15-84 C. ABSORPTION FIELD E~TA Soils Rating in Absorption Strata Date Installed ~/~2__ Width of Field -- ~ / Square Feet of Absorption A~ea Depression over Field (Y~ %...- ~22~-- ~ Type of System Design ngth of Field //7' Depth of Field , , ~ / Gravel Bed Thickness ~// ~ Standpipes I~esent 6~) Date of Last Ad~gu,acy Test .~3/,~ TO Water-Supply Well /25 ~TF- To P~operty Line . .// To Building Foundation ~/~ /~' To Existing c~ Abandoned System cn Lot ~/~ ; On Adjoining Lots ~ ~9 / To Water Main/Service Line ~/0' ~.b To Cutbank( if present) To Stream/Pond/Lake/c~ Major D~ainage Course . 7~ / D~) ' To D~iveway, Parkirg A~ea, c~ Vehicle Stc~age A~ea F~9 D. LIFT STATION Date Installed 4__ ~/menslons ~ Size in Gallons ~nhole/Ac~/.~_~-f~_~. "Pump On" Level at ~/~_~/~a~'~f" Level at .. High Water Alarm 'Level ?_._.,~I.~-...~''''''~at Vent _(Y/N) Tested for ~Pumping Cycles du~ing Adequacy Test. ~ets MOA Electrical Code~ ** Check Permitted Bed~ocm Rating AGainst HAA R~quest I ~ertify that I have checked, verified, o~ eonfo~n~d to all MOA on the date of ~ion. Signed Company~ MOA No:IsTA,' / KB1/dL/s [Page 2 of 2] 2-15-84 APPLIC NT FILLS ~UT UPPER HAL ONLY ~ ~- -' ~ Phone Malline,Addre~ '~. Zip Code Buyer Address Zip Code Lending Institution Phone Address Zip Code ,' . Phone Realty Co. & A~nt ~ Type of Resi~nce ~Single Family ~ Mulflplo Family ~o. ~ Otho~ Wate[Supply ~ Individualk r~ ~ A~ACH WELL LOG. A wal log is required for all wells, drilled since June 1975. ~ Community ~--~ For wells drilled prior to that date, give well depth (atlach log if available). ~ Public Utility Sewer. Disposal ~lndividual Year IndivMual Installed: ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Dar Inspector Inspector Inspector/"~ r ¥L_.,1~ ' I n spect~v./~ Field Notes: ~ ~ MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH C.,JJ ~...~/'~_~ ENVIRONMENTAL PROTECTION AUG 2 i9~3 R CEIVED, (~) APPROVED BEDROOM8 'CONDITION8 OF APPROVAL ( ) DISAPPROVED ( ) DATE . Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received ~ ~ ~--~ Well to Tank Septic T~k Size 72-023 (3182) APPLI(' NT FILLS OUT UPPER HA! ONLY Phone Property Owner . j, Brooks. . . Mailing Address ...4-6021 Driftwood ,.' Z~pCode 9750.2.. 349-8014/ 4 Buyer J. Brooks Address Zip Code kendlngl,~l~tilution First National Bank of A~chorage Phone Address poSt .Offic, e Box 4~2090 Anchorage ZipCode 99509 Realty Co. & Agent Phone Address Zip Code Legal Description Lot 14 Bonnie Vie? Subdivision Street Locatlo~ Type of Residence ff, ml~llBIIIB '~ Single Family [] Multiple Family No. of Bedrooms [] Other Wate, r Supply ~ Individual 8 20 58 6 ATTACH WELL LOG. A wetl log Is required for all wells drilled since June 1975. [] Community IlO log on file For wells drilled prior to that date, give well depth (attach log if available). [] Public Utility Sewe[ Disposal ~" Individual 8 2 0 5 8 6 Year Individual Installed: [] Public Utility I. 7- 8- 8 2 When Connected to Public Utility: [] Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector 71 APPROVED BEDROOMS ~' 'CONDITIONS OF APPROVA~ ( ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL* Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received 72.023 (3182) Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING 017-422-23 1. GENERAL INFORMATION Complete I~gal description BONNIE VIEW SUBDIVISION: LOT 14 Location (site address or directions) 12620 NEHER RIDGE ROAD Property owner ERIC AND SUE TOLLEFSEN Mailing address 1:~620 NEHER RIDGE ROAD Lending agency Mailing address Agent BONNIE MEHNER w/PRUDENTIAL JACK WHITE Address 3201 c STREET. SUITE 200 Unless otherwise requested, HAA will be held for pickup. 2, NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well xxx Community well Public water Day phone [907) 345-3388 Day phone. Day phone (907~ 441-2925 NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. .- - 4, TYPE OF WASTEWATER DISPOSAL: r~dividual on-site xxx Holding Tank Community on-site Public sewer NOTE: If community wastewater system, provide wfitten confirmation from State ADEC lng to the legality and status of system. 72-025 (Rev. 1/91) Front MOA#21 Computer Version Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $1530.00 at, or prior to, closing for the engineering services provided. 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 Municipa, l,~ id State cedes, ordinances, and regulations in effect on the date of this inspection. __ ,~/_ NameofFirm ALAsKAW~v~rA/ST~ATE~'OONSULTANTS'INc' Phone (907)337-6179 Address 6901 DEBARRf~OAD. S{.IJ/'~/B~NOt'ORAGE,ALASKA 99504 ,~/ / Engineer, ssignature (~.~),~~'~d .' D~te ~_~/~o/~. In conducting this evaluation, AWWC, Inc./at~el~o~=d to prot~de a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DHf~ Guidelines & Regulations. The reported results described the performance of the system under the conditions ~ncountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWC, Inc. can therefore not provide any warranty for future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DHHS. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or pady is not authorized, nor will it confer any legal right whatsoever. 6. DHHS SIGNATURE ~' Approved for z~ Disapproved Conditional approval for bedrooms bedrooms, with the following stipulations: Additional Comments, Date ~"- ]! - 04? The Municipality 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 DHHS does this as a courtesy to pumhasers 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. 1191) Sack MOA #21 Computer Vemlon Legal Description: A. WELL DATA Well Type PRIVATE Log present (Y/N) Total depth Sanitary seal (Y/N) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825 "L" Street, Rm 502 Anchorage, Alaska 99501 (907) 343-4744 Health Authority Approval Checklist BONNIE VIEW S/D; LOT 14~ BLOCK 1 Parcel i.D.: IfA, B, or C, attach ADEC letter. ADEC water system number 017-422-25 YES Date completed 142' Cased to 16' YES Date of test Static water level UNKNOWN Well production WATER SAMPLE RESULTS: Coliform 0 Date of sample: 4/3/2000 B. SEPTIC/HOLDING TANK DATA Date installed 7/8/82 Tank size. Foundation cleanout (Y/N) YES Date of Pumping 3/20/2000 C. ABSORPTION FIELD DATA Date installed 7/8/~82 Length 117' Effective absorption area Date of adequacy test Fluid depth in absorption field before test (in.); Fluid depth 25 (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)* Computer Veto/on FROM WELL LOG 7/20/82 7/20/82 Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION 3/21/2000 24' 1.5 g.p.m. 1.56 mg/L Nitrate (resampled 5/5/00) Collected by: N/A 1 6I~ YES 0.56 g.p.m. Other bacteda 0 A.W.W.C., INC. 1250 Number of Compartments 2 Cleanouts (Y/N) Depression (Y/N) NO High water alarm (Y/N) N/A Pumper ISAACS YES Soil rating (g.p.d./ft2 or ft2/bdr~) 225 System type Width 3' - Gravel thickness below pipe 4' Total depth 936 SQ FT Monitoring Tube present (Y/N) YES Depression overfield (Y/N) 5/24/2000 Results (Pass/Fail). PASS For 4 21.5 Immediately after 750 1350 Absorption rate = NONE. KNOWN If yes, give date TRENCH NO gal. water added (in.): __ 600+ Bedrooms 36" D. LIFT STATION Date installed Manhole/Access (Y/N) High water a~ Size~ .~ "Pump off' level at* *Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line 100'+ 100'+ N/A 25'+ On adjacent lots On adjacent lots Public sewer manhole/cleanout. Lift station 100'+ 100'+ N/A N/A 5'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5'+ Property line 5'+ Water main/service line 10'+ Surface water/drainage 100'+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property line Surface water Curtain drain 10'+ Building foundation 100'+ Absorption field Wells on adjacent lots NONE KNOWN ENGINEER'S CERTI I certify that ~ c of MunicipaFreco~{ with MOA ~AA gfi~, Signature [~.~.i/ Engineer's Nam% / Date CAI;II 100'+ 10'+ Water main/service line 10'+ Driveway, parking/vehicle storage area 10'+ Wells on adjacent lots 100'+ ~ru field inspections and review ore systems are in conformance bct on this date. JEFFREY A. GARNESS HM Fee $ Date of Payment, Receipt Number 72-026 (Rev. 3/96)° Computer Version Waiver Fee $ Date of Payment · Receipt Number. ~- 05-08-00 13:4T FROrd-CTE EHVIRON~EHTAL 5615301 T-841 P.g2/OZ F-214 CT&E Environmental Services Inc, Laboratory Division 200 W. Potter Dr~ve Anchorage, AK 99518 Tel: (907) 582-2343 Fax (907) 561-5301 CT&E Re~', ~: Client Name. Project Name- Client Sample Matrix: PWSID 1001958002 AK Water & Wastewa~er Cons. n/a 12620 Neher Ridge Hose 1~13 Drml~n9 Water n/a Sample Remarks: Parameter Client PO~. Printed Datefr~me: 05/08100 13:40 Collected Dale/Time: 05/05100 09.20 Received Datefr~me: 05/05/00 09:30 Technical D~mctor: Stepl~en Eae Released~~+~~~ Nit,'ate Re s PQL Units .. ~ 1.8~.~.~.5 mg/L Allowable Prep Analys~s Me,hca ginl~ts Date Date Init EPA 300 10 0 05105/00 SCI. MUNICIPALITY OF ANCHORA. GE MEMORANDUM WATER WELL ADVISORY HEALTH AUTHORITY APPROVAL NO.I'/~OOd142 During a recent Health Authority Approval on-site inspection and test of tt~e potable water supply well on Lot Block -- of B~NN/f VI~ Subdivision, the well's productivity was determined to be o~6 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a per minute. production capacity of the well may fluctuate. of non-critical water uses such as washing cars lawns and gardens may be required. This advisory must be attached Health Authority Approval. 4 bedroom residence is .~ gallons all parties concerned are advised that the Restriction and watering to all ~opies of the subject Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Sewices On-Site Services Se~on P.O. Box 196650 Anchorage, AJaska 99519-6650 (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING 017-422-23 1, GENERAL INFORMATION Complete legal descriPtion BONNIE VIEW SUBDIVISION: LOT 14 Location (site address or directions) 12620 NEHER RIDGE ROAD Property owner ERIC AND SUE TOLLEFSEN Mailing address 12620 NEHER RIDGE ROAD Lending agency Mailing address Day phone Day phone (907) 345-3388 Agent BONNIE MEHNER w/PRUDENTIAL JACK WHITE Dayphone Address 3201 c STREET. SUITE 200 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well xxx Community well Public water NOTE: (907~ 441-2923 If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4..TYPE OF WASTE-WATER DISPOSAL: Individual on-site Holding Tank Community on-site Public sewer NOTE: XXX If community wastewater system, provide wdtten confirmation from State ADEC lng to the legality and status of system. 72-025 (Rev. 1/91 ) Front MOA #21 Computer Version INote: Alaska Water and Wastewater Consultants, Inc. shall be paid $1400.00 at, or prior to, closing for the engineering services provided. 6. STATEMENT OF INSPECTION BY ENGINEER As certified by my sealaffixed 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 Ins ection, the on-site water supply and/or wastewater disposal system is in compliance with all MunicI. p~3 and State cedes, ordinances, and regulations in effect on the date of this inspection. . Address 6901 DEBARR[ROA[ ,}S .¢~fI~2.B/./~NC-~ORAGE, ALASKA 99504 /- / Engneer'sSgnature ~'----~'-~J'~'k/~('''''''' -'~'"---' Date ~L~/~'/0° In conducting this evaluation, AWWC, I,~ 'laCerated to pro"'-'~e a thorough, conscientious engineering al nalys,'~ of the system In accordance with ADEC and M( ~A DH/IS Guidelines & RegUlations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features.~ The operational life of all wells and Septic systems depend on the local soils condition, ground water levels that may fluctuate during the year, and the water usage Of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWC, Inc. can therefore not provide any warranly for future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DHHS. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this rupert by any other person or party is not authorized, nor will it confer any legal right whatsoever. 6. DHHS SIGNATURE Approved for z~. Disapproved Conditional approval for bedrooms bedrooms with the following stipulations: Note: The well for this property meets existing S~aCe and M~m~r~p~l medes_ There are nitrates present. It is suggested that periodic testing be performed t~ ~n~r~ ~h~ we!!~ ccntinucd suitabiliLT. Cu~nt nitrate concentration is 5.31 mg/1. EPA maximum concentration is 10.0 mg/1. More info~manion on nmtrates is available from the On-site Services Program, DHow, Date The Municipality 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 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 professional engineer's work. 72.025 (Rev. 1/91 ) Back MOA #21 Computer Vemlon Legal Description: A. WELL DATA Well Type PRIVATE Log present (Y/N) Total depth SanitaPJ seal (Y/N) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825 "L" Street, Rm 502 Anchorage, Alaska 99501 (907) 343-4744 Health Authority ApProval Checklist BONNIE VIEW S/D; LOT 14, BLOCK 1 ParcelI.D.: IfA, B, or C, attach ADEC letter. ADEC water system number 017-422-23 YES Date completed 142' Cased to 16' YES Date of test Static water level UNKNOWN Well production 1.5 WATER SAMPLE R~.~JLTS: Coliform ~ Date of sample: 4/3/2000 B. SEPTIC/HOLDING TANK DATA Date installed 7/8/82 Tank size Foundation cleanout (Y/N) YES Date of Pumping 3/20/2000 C. ABSORPTION FIELD DATA Date instal[ed 7/8/82 Length 117' Effective absorption area Date of adequacy test Fluid depth in absorption field before test (in.); Fluid depth 25 (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev, 3/96)* Computer Vemion FROM WELL LOG 7/20/82 7/20/82 Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION 3/21/2000 24' Nitrate N/A YES g.p.m. '~ 0.36 g.p,,m. ~ '~ ~' ~ / ~/~ Other bacteria Colle~ed by: A.W.W.C., INC. 1250 Number of Compartments 2 Cleanouts (Y/N) Depression (Y/N) NO High water alarm (Y/N) N/A Pumper ISAACS YES Soil rating (g.p.d./fl2 or fl2/bdrm) 225 System type Width 3' Gravel thickness below pipe 4' Total depth 936 SQ FT Monitoring Tube present (Y/N) YES Depression overfield (Y/N) 3/24/2000 Results (Pass/Fail) PASS For 4 21.5 . Immediately after 750 1350 Absorption rate = NONE KNOWN If yes, give date TRENCH 8' NO gal. water added (in.): __ 600+ Bedrooms 56" D. LIFT STATION Date installed Manhole/Access (Y/N) High wa~ Slze~ ,~ "Pump off" level at* *Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line 100'+ 100'+ N/A 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Lift station N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation. 5'+ Property line 5'+ Water main/service line 10'+ Surface water/drainage 100'+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property line Surface water Curtain drain F, ENGINEER'S C,~.I I certify that I h~lvE of Munic/pa/ re/ or with MOA HAJ~ Signature '---- Engineer's Nam~~ Date 10'+ Building foundation 10'+ 100'+ ,lONE KNOWN Wells on adjacent ' e//q~in, O~fh field inspections add review h~t~/ti~ jabo systems are in conformance ~n this date. IIU ,JEFFREY A, GARNESS .Absorption field. Wells on adjacent lots 5'+ 100'+ .Water main/service line 10'+ . Driveway, parking/vehicle storage area 10% lots _~~ HAA Fee $ Date of Payment ~ ~ --/~2 --- 49 ~ Receipt Numbor 72-020 (Rev. 3/96)* Computer Version Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OP A~CHOP~_GE M E M 0 R A N D g M WATER WELL ADVISORY HEALTH AUTHORITY APPROVAL NO. H~OQOI42 During a recent Health Authority Approval on-site inspection and test of tt!e potable water supply well on Lot /4 Block -- of ~0~N~E V~W Subdivision, the well's productivity was determined to be ,~ gallons per minute. The minimum well productivity required by this Department (~MC 15.55) for a ~ bedroom residence is .~ gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be recuired. This advisory muet be attached to all copies of the subject Health Authority Apprcva!. 04-10-00 08:35 FRO~A-CTE ENVIRONEENTAL ZtK CT&E Environmen,al Servicss Inc. 601630T %166 P.02/03 ;-283 CT&E Re£# Client Name Project Namc/~ Client Sample ID MaTrix Ordered By PWSID 1001431001 AK Water & WasTewaler Consuilan[~ IRc. Bonnie Vue S/D Bommie Vue S/D Drinking Water 0 Sample Remarks; Client pO~ Printed Date/Time 04/09/2000 21:59 Collected DateYrime 04/03/2000 16:00 Received Dag~qTime 04/04/2000 13:00 ALLowable Prep Analysis Limits DaTe DaTe Inlt 5.31 0.500 mg/L EPA 300.0 (<10~ 04/0~/00 SCL HICRO LAB Total Coliform 5 OB, No COLi ¢ol/1O0mL $M18 9222B 06/0¢/00 rdlP