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HomeMy WebLinkAboutCAMPBELL HEIGHTS BLK 3 LT 19C Well Log ........ : '-. . completed. / .4. .t / ~/ .?. ./. ......................................... Date Depth of well ....... .?...~...../. .............................. ' ...................... ~ .................................... Size of casm~ ............................................................... , .......... , ................................. Distance to water.........~..~4.~..~.,.....~.~.~..~_..~. ....... ..~...~,...~ ................................... Distance to water while pumping .......... .~...~..~. ....... i .......... : ............... at rate Formation from to /3 Driller DELTA DRILL*lNG COMPANY SRA BOX~3O4 B ANCHORAGE. ALASKA 99507 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. # ~ ~ L~ -- ~'"1 ;::k- Q._~ HAA# ~"~ ~~lc~ '~-~ ~O~ 1. GENERAL INFORMATION Complete legal description Lot 19B; Block"3'; Campbell Heights Subdivision Location (site address or directions) 4139 East 67th. Anchorage~ Alaska 99507 Property owner Mailing address Lending agency Mailing address Agent Address David Mader Day phone 349-3399 4139 East 67~h. I Anchoraqe, Alaska 99307 Day phone. Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 2 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. 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 inves.ti_gation 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. Phone / Name of Firm s & - ..... .q :.'c ...... NEE ~agte K,ver. Engineers signature ~~ - D~S SIGNATURE Approved for Disapproved. '~' (~) bedrooms. Conditional approval for bedrooms, with the following stipulations: Additional Comments 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 satis~ 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. Municipality of Ancho.?ge Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: (-~'T iq /~. I,'~UIC~. OAC,~/~E'(_[ A. Well Da~ Well ~pe ~tU~ Log present ~) Total depth Sanitary seal (~N) Parcel I.D. O / ~Z_ o 7'~- - ~'~'" If A, B, or C, attach ADEC letter. ADEC water system number. Date completed (0 (;;).~ I~{ Driller Cased to ';2~ ~ ' Casing height Wires properly protected ~/N) FROM WI~LL LOG Date of test ID I~-~ I~ t Static water level Well flow Pump level1 · '-----SEP. ARATION DISTANCES FROM WELL TO: g.p.m. AT INSPECTION ~, q~ g.p.m, rtl o Septic/holding tank on lot ~ acent lots Absorption field ;~n lot Public sewer main .;C ~ "/- Petroleum tank WATER SAMPLE RESULTS: Coliform (~ Date of sample: II/~"~ e. ~NK DATA Date installed ~ Nitrate (~), "~ Collect~d by: ~ E c.~, ~. o ..r' Other bacteria Tank size Compartments C,eanouts (Y/N) ~anout (Y/N) High water alarm (Y/N) . ~ ~ (Y/N~...~ Date of pumping ~ -- . SEPARATION DISTANCES~I~TANK TO':- ~ ~ Well(s) on lot ~ On adjacent lots Foundation To prope. L1y line'"'""'- Absorption field .Water main/service line ud"~ace water/drainage 72.02e (3/93). i=m~t CONTINUED ON BACK PAGE Size in Vent (Y/N) High water alarm level Meets MOA electrical codes level at Manufacturer .Manhole/Access (Y/N) 'Pump off' Level at .Cycles tested r STATION TO: Well on lot, Surface water D. ABSORPTION FIELD DATA Date installed ,System type Length Width Total absorption area Date of adequacy test Water level in absorption field Peroxide treatment Well on lot,__ To building On I thickness Total depth Depression over field (Y/N) ',pass/fail) ~ for Curtain drain E. ENGINEER'S CERTIFICATION '~ After test FIELD...TO: '~ .On adjacent lots ~Pmpe~ne .To existing or abandoned system on lot '~ .Cutbank Water main/service line Driveway, parking/vehicle storage area I ~em'~ that I have checked, vefified,~ conformed to all MOA and HAA guidelines in effect on~e ~a, te of this inspecfior~ ,-'". S,gnature ,/-~ ~ Engineer's NaI~'3~ ~e ~!;':r '.;~. =__~.' ~,.. --- ~/~"~~'~'~-: ?" ~? /= HAA Fee $ ~ -~"' Wa~r F~ $ Date of Payment Receipt Number ~z-~e (3~3). ~ac'k Date of Payment Receipt Number 11x30/93 12:51 CT&E ENUIRO~.IEtlTAL LAB SEPUICES ESTING & ENGINEERING CO. REPORT of ANALYSIS Chemlab Ref.~ Client Sample ~D :L19B B3 CAMPBELL HEIGHTS t~atrix :WATER NO. '884 $~33 B STREET ANCHORAGE. AK Client Name :S & S £NGINEi~IN6 Ordered By :R. Project Name ProJect~ : PW$ID :UA sampl~'~emarks, ROUTINE SAMPLE ~ECTEO BY: UA. WOP~ Order Report Coppleted :11/30/93 Collected :11/23/93 @ 11:20 h Recelved :11123/93 @ 13:15 h Technical Director:$'~%~tEN~. £DC Hale,Ged /- OC Allowable Ext. Anal Parameter Results Oual Units ~ethod Limits Date Da~e In Nltrate-N 0.34 ~/L }~A 353.2/300.0 10 11/24 * See Special Instructions Above UA - Unavailable ** See Sample Remagks Above NA - Not Analyzed U - Undetected, Reported value is th~ practical quantification l~mit. ET c Less Than D - Secondary dilution. GT ~ Greater Than £NVINONME~JTAL SERVICES IN ALASKA COLORADO, UTAH. ILLINQ!~. OWIO, ~ ARt'LAND. WiST VIRO;N A'. NEW JED$-'Y, SOUTH CA~OgI~-- MUNICIF;ALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY'DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) (b) (c) Legal Description (include lot, block, subdivision, section, township, range) on (a, ddre~s or Locat directions) , '. Prope~,;6~ner ..... "~'~'~'~: "' Lending rnstit~tion · Mailing Address · Telephone: (home) Business Telephone (d) Real Estate Company and Agent Address Telephone ~,~'4, ~- (e) Mail the HAA to the following address: (or check here"~ if hold for pick up.) List contact person and day phone number below: . . '. 2. TYPE OF RESIDENCE Single-Family'S' Number of bedrooms 3. WATER SUPPLY Individual WelI~E~- Community I-I Public r~ Note: If 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~J2~ Community ~ Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 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, 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 Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in com, pliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection· Date 6. DHHS APPROVAL Approved for' Approved bedrooms by Disapproved Conditiona~ Terms of Conditional Approval The Municipality of Anchorage 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 DHHS do not conduct inspections 0 r analyze data before a certificate is issued. The M u nicipality of Ancho rage is not responsible for erro rs or omissions in the professional engineer's work. 72~s(.~,. 7~) S,=k Page 2 of 2 .,~'~ ct~ Health Authority Approval (HAA) y,.~-~,~tk,.~ CHE. CKMST - FEBRUARY 1984 · '. ' · Legal Description: /- ~,~/(~z-/_./- A. WELL DATA Well Classification ' ~'~////~/'~' : If A, B. C, D.E.C. Approved (Y/N) Well Log Present Y~) Date Completed /~-~4/'-~/ Yield -,~, v.~ Total Depth 7~ Cased tO 7~~'/ Depth of Grouting /*)//+' .. Static Water Level ~/' Pump Set At ~J/,~r / Casing Height Above Ground ,/ --- Sanitary Seal on Casing(~) ~' Electrical Wiring in Condui N) "" Depression Around Wellhead ( SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot ; On Adjoining Lots ; On Adjoining Lots /O ~' · To Nearest Public Sewer Cleanout/Manhole ; Date ,J / 7'/'~-'/-~ o. / ? --- To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot ,~'.~ Water Sample Collected by /~'"'"~--"~ Water Sample Test Results ~/~.~'7'" ~ Comments ~J'~t/- ~"/.~ -/"'~"~7"" /~-Z-*~-~*. B. SEPTIC/HOLDING TANK DATA ~# ~z./(~ ~'~/~--- Date Installed Size No. of Compartments )N) Air-tight Caps (Y/N) Foundation Cleanout (Y/N) · Date Last Pumped ~ __ PumpinglM.ain,.t.e~a~c.e Co ,~,.~n File (Y/N) ~ ~; for ~ __ ~~.t'er_A la r m~_ Temporary Holding Tank Permit (Y/N) ,~ ..'. ~..- : '..".,..\',, ~ ~EPABATIO~. DI,ST..,~N.CES FROM SEPTIC/H~G TANK: 7o. atar -,pply e,"'°: o .Foundation :[o Pr..opg~[~;?.~e;~.;.',"7' ~' To DisposaT'Fie~ _ . · %'% ;.:..., ...... .';&'~, ~ To Stream;. ,Pehd. J.~ke;or Major Drainage Course Comments'"'" '~ " Page 1 Of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata , D~nstalled Width~ Sq~re Feet of Abso~io~ Depression o~ield ~/N) Type of System D,.e.sign Length of Field Depth of Field '~ ~ Gravel Bed Thickness Statndpipes Present (Y/N) "': Date of Last Adequacy Test Results of Last Adequacy Test SEPARATION DIsTANcE FROM ABSORPTION FI~'c{~ To Water-Supply Well _ :. T ' ~To~:~r~e~y Line To Building Foundation ~- To Existing or Abandoned System on , Lot ; On Adjoining Lots To Water Main/Service Line To Stream, Pond, Lake. or Major Drainage Course To Driveway, Parking Area. or Vehicle Storage Area Comments To Cutback (if present)'~ ~ D. LIFT STATION 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 g~ inspection.~/~--.~- ~ ~,~ /~ /. /~__... . ' .... .' Signed " ,- Company Date MOA No. Receipt No. Dateof Payment ~ -~,~-,, 7'-~ ~ Amount: $ t/2 0,-'~OC~ 72-026 (Re~. 7/88) Back Receipt No Waiver Fee: $ Date of Payment Page 2 of 2 MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (ad~l{ess o~irection, s) · .. (b) Property 0V~' ",'~ ~Y~,~'~":" '," Mailing Address ' .. Telephone: (home) Business (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent Address I Telephone (e) Mail the HAA to the following address: (or check here'S, If hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single-Family,~ Number of bedrooms ~ 3. WATER SUPPLY Individual Well~.. Community [] Public n Nole: If 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 I-1 Public ~ Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. Page I 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, 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 end 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 ,.'~-~'~" ~ Telephone Address Date 6. DHHS APPROVAL, ~~~ Approved for ~,,~* ' bedrooms by Approved ~ Disapproved Conditional · Terms of Conditional Approval The Municipality of Anchorage Department of Health and Human Sen/ices (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 DHHS do not conduct inspections o r analyze data before a certificate is issued· The M u nicipality of Anchorage is not responsible for error? or omissions in the professional engineer's work. Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 A. WELL DATA Well Classification '~'"//-'"~'7~ Well Log Present j~) Total Depth ::~Z:~ / Cased to' Static Water Level .~ ~Z:! Casing Height Above Ground Electrical Wiring in Conduit SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot /~//~ / To Nearest Edge of Absorption Field on Lot' To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water sample Test Results _ ~'-'"/"~ If A, B, C, D.E.C. Approved (Y/N) Date Completed .//)-Z' ,~--~'./ Yield _~. -~- ~(~',,o/,?~ ~/ Depth of Grouting Pump Set At ~ // Sanita~ Seal on Casin~) Depression Around Wellhead (~ W/~ ; On Adjoining Lots TO Nearest Public Sewer CleanouUManhole ~ / ;Date /~-~ ~-~ Comments B. SEPTIC/HOLDING TANK DATA ~ Date Installed Size ' No. of Compartments Standpipes (Y/N) ' Air-tight Caps (Y/N) .~ Founda ~o~n Cleanout (Y/N) Depression over Tank (Y/N) / t~Pumped Pumping/Maintenance Contact on File (Y/N) ~/1~/~''f I ', for ~. Holding Tank High-Water Alarm (Y/N) ~l/~-~/~-;mporary Holding Tank Permit (Y/N) . SERA~ATJO~ST~CES FROM SEPTIC/~IN~ANK: - ~o ~at~[-Sbpply weLb~,'. _/ TO Building Foundation . . ;'TP ~/PP2~Y,~Jg~-~.;'.;./~ ~ -/ TO Disposal Field _ . '=T0. W~ter Main/Se~ic~ ~~ , . , = . . TO Stre~m.~h~ajor Dra,nage Course ..... ...:... Comment * ~. ~' - , t2-~ (,~,.?,'~) ~,~t Page I of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absortion Area Depression over Field (Y/N) Type of System Design Length of Field Depth of Field Statnd pipes Pr~3t-(~/N) Date of La,~equacy Test Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIEL~' ' To Water-Supply Well ' ,,~ To Property Line To Building Foundation J To Existing or Abandoned System on Lot J ; On Adjoining Lots To Water Main/service Line J To Cutback (if present) To Stream, Pond, Lake,~C.Major Drainage Course · ~ ' To Driveway, Pa.~.~j~Area, or Vehicle Storage Area Comments ,~ D. LIFT STATION ~ Date Installed Di Size in Gallc~n's -- . £ I ~ . a.M~nhole/Ac~ess (Y/N) "Pump On" Level at J~_~ ~J High Water Alarm Level at Tested for "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAh Request** I certify that I have checked, ~erified, or conformed to all 'MOA and HAA guidelines in effect on the date of this inspection. Signed Company Date uOA No. Receipt No. 0_~ Date of Payment Amount: $ ~'..-'~%.: ' ~ine~eal ~e eeee eee~e~eee ee~ e~ · ~ Receipt No. Waiver Fee:. Date of Payment Page 2 of 2 CHEMICAL & GEOLOGICAL LABORATORIES OF,AlASKA, INC. / ~,~_;t-.-.-~" ~ ' 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 ~""~.~o~,~ FEDERAL TAX ID # 92-0040440 Date lispers }'~lntsd: OC! 27 88 t 15:13 ~W$ID :UA ~eceive~ OCI 24 88 ¢ 15:30 h~l. Client ~a~e :A[C$ L&bozeto~ ~upervleo~ :$T~PE~ C. ~O! l)l~C3 Tested ~esult/~nlts 0.18 ~/1 [er~xke: 3A.~LE COLL!CHD BI L.[. ~- ~one Detected "See ~a~le [eaatke Above XA- ~ot in~l~e~ ET-Less ~han, GToG*eats: Than .. . APPLICANT. FILLS OUT UPPER HAL~-'~NLY .a;;,ng Add,*. z,p me q7 ~-(> ~ Street L~atim Type of Re~ Ule Family ~ Indlvld~l Yeat lndlvUual InstallS: ) ~ ~ ~ ~llc~illty When ~ted to Publlc Utility: / ~ ~ Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspec or MUNICIPALITY (6) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Well to Tank Septic Tank Size :1~ DATE RE CE,V ED ~ INSPECTION APPOINTMENTS IME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR~ MUNICIPALITY OF ANCHORAGE / DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTE~I~JNi~PA[i~ OF A~CHO~GE ~ L Strm - A~or~, Al~a ~1  [~dlRC~M~NIAL ( ENVIRONMENTAL SANITATION DIVISION T~e~e~47~ ~]0~7 2 1981 DIRECTIONS: ~mplete all pe~s o~t page ~. I~eomplete r~u~ will net ~ pr~. Ptease allow ten (10} days for pr~essing. MAILING ADD~ ~ PROPERTY RE$~rent from abo~} PHONE 2. BUYER PHONE MAILING ADDRESS MAILING ADDRESS 4. REALTOR/AGENT I PHONE I MAILING ADDRESS 5. LE6AL~)ESCRIPTION ~ &/-- /?/< STRE OCA22 6. TYPEOF RESIDENCE ~ SINGLE FAMILY NUMSER OF~EEDROOMS .~ One [:::] Four [] Other Two [:] Five MULTIPLE FAMILY I'-I Three I--1 Six 7. WAT R UPPLY :~ INDIVIDUAL* [::::] COMMUNITY [] PUBLIC UTILITY ATTACH WELL LOG. 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'* [~ PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) L ' THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS f--1 SINGLE FAMILY I--I ONE I--I THREE [] FIVE [] OTHER [] MULTIPLE FAMILY I--I TWO I'-I FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [--I PUBLIC UTILITY 'Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER DINDIVIDUAL/ON -SITE DATE INSTALLED f--IPU BLIC UTILITY Connection Verified INSTALLER f--ISeptic Tank or [] Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TO: Sept,c/Hold,ng Tank IAbsorpt,on Area ISewe~' Line J Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS {Z~--~APPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY ~ 72-010 (Rev. 6/79) unicipalit¥ of Anchor ¢ MEMORANDUM DATE: TO: FROM: SUBJECT: November 10, 1981 Laura Crow Senior Office Assistant Sewer and Water Program Request for Refund - Account ~2460 Please make arrangements for the following refund. A private engineer has made the inspections rather than this office. Quest Enterprises 4325 Laurel Anchorage, Alaska 99507 Receipt ~161631 $25.00 Sewer and Water Other Lot 19B Block 3 Campbell Heights Subdivision Thank you. Sincerely, Laura J. Ward Senior Office Assistant Sewer and Water Program attachments 91-010 (5i78) WATER DELIVERY SYSTEM INSPECTION LOT 19B, BLOCK 3, C;%~PBELL HTS. On November 4, 1981 at 12:00 Noon I visited the subject property for the purpose of inspecting the exterior water delivery system and to obtain a water sample for chemical analysis. At the time of the inspection it was snowing with an accumulation of 6" on the ground. The well is located approximately in the middle of the lot ~0'+ from the front lot line. Backfill around the well is good with a mound around the riser which will eliminate runoff water from flowing down the casing. The casing is capped with a sanitary fixture. The control wire exits the casing through flexible conduit. The conduit continues into the ground. With the snow cover it was impossible to determine the actual topography of the surrounding terrain. It appears the yard around the well is flat. The builder said the back yard would be landscaped in the Spring and all irregularities would be corrected at that time. A sample of the water was taken from the Kitchen tap. The aerator was removed from the tap and the water run for three minutes before the sample was taken. The sample was then taken to the Chem Lab for analysis. Michael E. Anderson,