HomeMy WebLinkAboutWILLIAMSON #1 BLK 1 LT 23Williamson #1 Block 1 Lot 23 #015-073-40 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: OSP231223 Work Type: Septic Upgrade Tax Code Number: 01507340000 Site Legal Address: WILLIAMSON#1 BLK 1 LT 23 G:2437 Site Mailing Address: 5310 VALLEY VIEW DR, Anchorage Owner: KOVAC DUSAN & Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING This permit is for the construction of: Effective Date Expiration Date: ,dent S .moo U � n � Department Lot Size in Sq Ft: Total Bedrooms: 7/27/2023 7/26/2024 14127 Q Disposal Field ❑ 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: Inspection report and tank profile drawing to be submitted to close out permit OSP181387. Received By: 5 S-� 0/,/ Date: Issued By: Date: Z �� -L3 K /� P V, ';�D rH MUNICIPALITY OF ANCHORAGE CHAaE Development Services Departments Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 015-073-40 Property owner(s) Dusan Kovac Day phone Mailing address 5310 Valley View Dr Site address Same Legal description (Sub'd., Block & Lot) Williamson # 1 Blockj. lot 23 Legal description (Township, Range & Section) Lot Size 14,127 Sq. Ft. Number of Bedrooms 3 APPLICATION 15 FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field 0 Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank ❑ Upgrade 0 (D) ❑ Holding Tank ❑ RenewalDuplex ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. 1 further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Q,SZ Waiver Fees: Date of Payment: Date of Payment: Receipt Number: �`t- �.� Receipt Number: Permit No. 05 P2 7) 12 ZWaiver No. WDevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.dac Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231223, Curtis Townsend, 07/27/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231223, Curtis Townsend, 07/27/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231223, Curtis Townsend, 07/27/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231223, Curtis Townsend, 07/27/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231223, Curtis Townsend, 07/27/23 ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: WILLIAMSON SUBD ADD NO 1 LOT 23 BLOCK 1 PLAT 70-192 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shout( any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any casements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DATE- SCAI.E.. E -MAIL - MAY 31, 2023 1 30' schuller0ak.net DRAWN BY. ICHECKED BY: GRID NUMBER: K PAGE 23-048 -577 I JLS SW2437 230157 * = FND 5/8" REBAR Aw OF�� L A AW • A;7 i10 49TH' ............... J N L. SCHULLER..* o —ox� 0.0 LS 10408 00 ..Fw 1831 Talkeetna Street C' Anchorage, Alaska 99508 ANW (907) 227-1455 office ®�� sslo`�,`.... —4992 fax (907) 274 VNC1PA" MUNICIPALITY OF ANCHORAGE c / ' On-Site Water&Wastewater Program 10 mnc 0 to l c1 PO Box 196650 4700 Elmore Road :� Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 http://www.muni.org/onsite "Etaf 1)t•pal tntcnt 44cNoapot On-Site Wastewater Disposal System Permit Permit Number: OSP181387 Effective Date: 10/25/2018 Work Type: SepticTank Upgrade Expiration Date: 10/25/2019 Tax Code Number: 01507340000 Site Legal Address: WILLIAMSON #1 BLK 1 LT 23 G:2437 Site Mailing Address: 5310 VALLEY VIEW DR, Anchorage Owner: KOVAC DUSAN & Lot Size in Sq Ft: 14127 Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field Q Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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 Received By: Date: ( Issued By: -UCCek, Date: MUNICIP,i L1° Y sof ANCHORAGE (7---,,--;.\\ Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section f� Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION • Parcel I.D. 01S- O7. - `t o Property owner(s) K pU G C, US oti✓1 Day phone Mailing address 5310 \Ja L/l /' Site address Legal description (Sub'd., Block & Lot) w 1 1( 1 co' If- 1 13 ( K J (c2 z3 Legal description (Township, Range & Section) Lot Size tq/(27 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) g" (w/wo ADU) Septic Tank la Upgrade Duplex (D) ❑ Holding Tank ❑ Renewal Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. ( ignature o property owner or authorized agent) Permit/Rush Fees: a 21S•op Waiver Fees: Date of Payment: (D(-7 lg Date of Payment: Receipt Number: 06i B Receipt Number: Permit No. 0SI- i2i3e1 Waiver No. G:1Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms1Permit Application.doc 10-18-18 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage,Alaska 99519-6650 Fax 249-7847 Re: Septic Tank Replacement Legal: Williamson#1 BLK 1 Lot 23 To Whom it may concern: This is a request for a septic tank permit on the above referenced lot. We intend to replace the failing existing steel septic tank with 1060 gallon HDPE septic tank We are having the well radius staked to maintain 100' separation. The surrounding properties will not be impacted by this septic tank permit. All required separation distances will be meet per code Please call me if you have any questions. Sincerely /7 Michael N. Anderson, P.E. 4661 Natrona Anch,Ak 99516 Ph 727-8864 V / TRACT 2B // (VACANT) / / LOT 24 N J«, / (VACANT) _,...‘CV ...,._.._,---------____, _\,\:,(// • 15% 4T LONG TRENCH GVL. 1) W.3.5'SEWER GVL A DRIVEIt, h� g / .r';Y" ,' 0% L0 �" (�•P '1 �' z �,,i, 1 • ,, r O (SCA LOT 22 ���, 'Co�4 •t o6) • �K4}' sui-Si*4' ' - 3 BEDROOM ell '`h # _ 1000 GAL. HOUSE SEPTIC TAN ' �C WELL SEPTIC __ - _ ----------SYSTEM , ° LOT 23 • - BLOCK 1 r�- �.w�at HOUSE „- OF �Xd9 , QAC •'• • • r ' ,` 0; 4� s T H •� .$, 14, WELL _y2. ..._. .. , - - ' / •• M HAEL N. ANDERSON .......,?7, P - LOT 20 r a- CE 94L9,� ..411 ,,;; ' .(VACANT) +?1/F9...,�1(.'d' " .; ' It�`\`'e`~Y`� 1 d L 23, ELK.1,WILLIAMSON SID#1 WELL AND SEPTIC SYSTEM 1 m {_.LOT.'t.1 . SITE PLAN ci•.• ? FLATTOP TECIL'JICAL SERVICES 1 INCH 40 FEET �- • I •%1• 711 •'L• {t' 14530 ECHO STREET DRAWN BY TFM I 0 •• ..41,„---/ •• ,;;, ANCHORAGE.ALASKA 99516 AUGUST,1996 •;-• '' . 1•�.^+% NOTE: THIS IS NOTA SURVEYED PLAT. OD- ''.-0::E F. ' .�,�'� 1 I �• a� . i' > J. ALL LOCATIONS SHOWN ARE APPROXIMATE. ' • f . MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Septic System Owner-installer Agreement The On-site Water and Wastewater Section (On-site) may issue an approval for a homeowner to perform work on an on-site wastewater disposal system to serve that individual's owner- occupied, single-family or duplex home if the homeowner meets and agrees to the following requirements: 1. The property owner and excavation equipment operator may perform work on no more than one owner-installation project in a 12-month period. 2. Owner's projected active involvement with the installation: 3. The name of the excavation equipment operator: Ducat✓ 1(00QC_ 4. I agree that there will be no monetary compensation for installation services rendered. 5. The name of the inspecting engineer: X\k4,e Ar.,z6 Wok 6. I agree to discuss the following items with the inspecting engineer: a. Permit design criteria and specifications. b. Inspection requirements set forth in AMC 15.65.070. c. Advance notice given to the On-site Water & Wastewater Section for all required municipal inspections (AMC 15.65.070A). 7. I agree to have the project-specific On-site Wastewater Disposal System Permit available at the construction site for the duration of all related work. 8. I agree that if the system is an advanced wastewater treatment system (AWWTS), I will obtain additional installation instructions and approval from the equipment distributor. As owner of (legal description) E. 3 10 ' Vet 1(eV Val �r I agree that the information above is true and accurate. / Owner's printed name: V s 0.1A cnlac- "1 Owner's signature: (0Date: Mailing Address: P. O.Box 196650*Anchorage,Alaska 99519-6650*www.muni.org  MUNICIPALITY OF ANCHORAGE $ ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchora§e, Alaska 99501 Telephon0 264-4720 ON-SITE SEWAGE DISPDSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL DESCRIPTION LOCATION NO. OF I~E~. ROOMS Abso r pti.~g.r ~a Dweging ~. PER~y~ D'STANCETZ' [Weg ~F' ~ Manufacturer /O~ Mater~~[~t ~' ~ No. of cotangents Liq, c~¢~n gallons IF HOME.DE: Inside length Width Liquid depth , ~ Well [)welling PERMIT NO. ~Z DISTANCE TO: O ~ ~ Manufacturer Material ~- ~iq~id capacity in gallons ~ No.DI~T~NC~ TO;o, liner. ~WellLength~of e~h line ~ Tot~g~ of linos Tr~n:~Oth inches Dist.noe b~twp?Js Z I ' ~ k' i,,ches T~aleff~t>~ption area Material beneath tile ~ ~ ~ Top of tile to finish grade ~ .~ Length Width Depth PERMIT NO, .E ~ 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, ~ -- ~uildin9 foundation Sewer line Septic tank ~ Absorption area(si ~ DISTANCE TO: OTHER PiPE MAT RIALS SOILT RATING RE~ ~ ' ' ?'(Hit.[ .,,""1,~ [~ "'".. ,,.,,,., ;~ - -- ~ --- 72-013 (Rev. 3/78) U ~3 <~' co' mi ~i ~-i ' m:: e~i -~.:: ,o:: ~ ~ ~,: .), oL · I.[:..::,t _1,. ,t. 1:,).1..t. t TC[ :[I",ff::CII(:H 't"I't]'E; I::'I!i:F:'I:::IF:Ti~'iE:f",II !:)IIl:;t:]:Nl:ii Fill!: I::'li?l"t :[ T FII:::'I:::'I.. ]' C:l::ff',l'l" I'lF:l!il; ]'IIEE '; ...... . I ......... 'J:FI:!~'I'I:::ILI_.t::I'r]:cff.,! ]1,1:,[[:...f.[..I,I, i::1I:: f:ll.,l¥ I,.IE:l.l.:ii; t:::i[)..]'F:iC:I!::bI'I TCi ]'1..1['::~ t.I Fill F'INf) t'.,ll..ll','l[:i:[!l:ii: Cfi: F~tlE::!i~J:[::,I~:i'..IC:[E'.!~; TIIF:I'F TILE: I.,[[!:!.1. 1,1:[11. ,[:t. [.. i',l:[l'.,!:[I,1LIhl I]:,]::ii!;TFlt.4C:[E E:[!!;'[I,][~:Ii;I'.,! f::l I,Iti-:[.[ t:::11'.,t[) nH',' (:tlq..:!!;:['i'f: '_.i;!iEh.tF'l(:iili: D]:::-;I:::'O:~i;F'II :ii;'.?:E;l'l]i:H 11.(!1(:) I:::E;!:::"I 1:::OI;i: I::t I:::'l:;;'.]:',,,'F:l"l[i!; HEJLI...., :I!!H~!i '11:::f ;?.[~11;!ii I:'t!iJl:!i;'l' I:::'1;~:1:];11"1 t'::1 [::'I.II:?,I..:(C I..IE:I_.I.. I:)[:Jl:'[~]h41)];l'..l(~i I. ff:u:)i'.,~ 'i'I1E: "l'"r'[::'[E (:EIF: t:::'I.JE~:L:I:C !,.E~/L.I [,.![:1 [. LCi(]i'::~; !:::t1:;;:1~: I:,;:I[~QIJ]:?.[E[)f::ff',lE:~ I"ll...l~;'i" []:[~-: [;~'.EE"I"L.I[;;'.f',I[~:;[:) T(:) -[tiE: [::,IEI:::'I'::IF'.i'f"IIJ}:i",lt H]:'I-!~:[I".I [:i'E[ [)~:::l~'r':~; (':11::' 'IHE: i'IF::[..I ()THE:I;?. [~:1~:.1~:~1..I :l: I;~:lJ~:l'"l[~:l",f-I':~; h'lF:l"r' I::IF:'I:::'I .?. :~;F:'IEC: ]: [: ]: CFI'[' :1: I:1[",I:]'~; I::ff',!l) CCfl",f??I'F?UC:T ]: Cfl",J I:::' ]: F!t::ih~:t:::ff'l?; I:':I¥1:::I]:I.F:IE?,t..I~: I"0 :[N:~;t_I[;::E: t::'[;~:l::l[:'[::!:;~: :1: C[i:F?.'l']][::'"r' TI'II'::I'[' ::!.: :[ l::lf"l I:::'["ll'"l:!:l..Zf::ll~: I'I]:TFI F'OF:'.TH !2,? TILE: HIJN:[C:[F'F:II..:[T¥ O1:::' ;ii~: :1: t,I]:I..L. :[[",!:::;TI::IL.I. I'[IE: ::?'~"!':;l'l:Ji:H ?::: ]: UNI)[]i:t'?.'Ji['I'I:::INI]:' TI'fi:IT I::i:E::!!;]:E:,[ii:HC[~: :['5 F~:E:t'ICH::'t'::I...[il:) Mr. Kenneth Simpson P.O. Box 10-1648 Anchorage, Alaska 99511 ARCI lC SUBA[~L'I h MICHAEL, B. BEFIGMANr I u 'E, OC@NSULTANT Rl~cl!lV~Jl~ne 12, 1979 Subject: Soils investigation for sanitary sewer system on Lot 23, Block 1, Williamson Subdivision, Anchorage, Alaska. Dear Mr. Simpson: At your request of June 6, 1979, I conducted a soils investigation at the proposed location of a sanitary sewer system on the subject lot. This investigation, which was accomplished on June 7, 1979, consisted of the inspection of soils removed during the digging of a 12.0 foot deep test pit, using a wheel mounted backhoe. The soils encountered are graphically shown on the accompanying test hole log. The soils consisted of a series of interbedded sands, silts and sandy gravels. The soils column and the interrelationships of the strata are shown clearly on the test hole log. Water was encountered at two levels, one small seep at 8.5 feet and a larger quantity at 11.0 feet. The upper seep trickled into the pit approximately one quart in 30 minutes. The water encountered at 11 feet was more extensive and would have filled the test pit to the level of the seep in one day if the pit were left open. The topography of the lot consists of a northerly facing hill dropping to a relatively flat area on the northern most portion of the lot. A profile of the lot on a line running in a northerly direction is included with the location sketch. Vegetation present on the lot consists of common tall spruce and birch, with some alders and willows, and a low ground cover of mosses and grasses. An accompanying sketch shows the subject lot with the approximate location of the test hole in relation to the property lines. The area where the system will be located will have 3 to 4 feet of fill placed over it after construction of the drainfield. This fill will come from the spoil derived by the removal of soil from the hillside at the construction site. I appreciate the opportunity to be of service to you. Please contact me if you have any questions regarding this soils investigation. Very truly yours, Michael ~. B~fgmann Consulting~eologis t Attachments: Drawing of test hole log with location sketch and profile sketch. xc: Department of Health and Environmental Protection. 35.48, A L=54'98' R=420 · 00 ' 30' 73' TH#i Proposed well . Util! Easement 90.00' N53°00'00"E n > NOT TO SCALE [ ~i? ~? Distances are approximate and have not been measured by surveying methods as to test hole location. aI Lot topography profile along line A-A'. NOT TO SCALE Profile is approximate and was not defined by surveying methods. Michael B. Bergmann Consulting Geologist Box 191, Star Route A, Anchorage, Alaska 99502 (907)344-9150 T.H. No. 1 /, 6-7-79 anics: grn to brn. anic Silt: loose, moist, med brn. (OL) --% \ ~and: pred fn to med, fair ---- ~sorting, loose to med dense, ~ moist, grybrn. %-- ....... 2.5' w/some Gravel, loose to med dense, moist, sand pred med to crs, grybrn. (SW) .......... 5.0~ nferbedded discontinuous and and Silt seams. Sands fn to crs. Silts contain trc Clay. S1 moist to moist, loose to med dense, grybrn. (SP and ML) 'WD & AB Sandy Gravel: w/occ Cobble, vy moist to wet, med dense to dense, grybrn. 'WD & AB (GW) Water was encountered at 9.0' and12'0'TD 11.0'. The water encountered at 9.0' was a very small amount probably less than 1 qt. trickled into the pit in 30 mins. and then only in one small portion of sidewall. The water at 11.0' was more extensive and would have filled pit to 11.0' depth in less than one day. Test Hole Log represents soils encoun- tered on Lot 23, Block 1, Williamson Subdivision, Anchorage, Alaska. 01O kuic- y' "SY"; LaajA) ar�coo cc,S. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw SL - P.O. Box 196650 Anchorage, AK 99519-6650 www.d.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-073-40 1. GENERAL INFORMATION 10.5 HAA# HA 0(0309 Expiration Date: 7- .a 1- 0 1 Complete legal description WILLIAMSON SUBDIVISION #1; LOT 23, BLOCK 1, Location (site address or directions) 5310 VALLEY VIEW DRIVE ANCHORAGE, AK Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address ROBERT SURYAN 99516 Day phone 267-2150 5310 VALLEY VIEW DRIVE ANCHORAGE. AK 99516 Day phone Day phone Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site ❑ Individual Holding tank ❑ Community On-site ❑ Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an Independent professional civil engineer registered In the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineers work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by ray seal affixed hereto and as of the validation date shown below, I verify that my Investigation, based on procedures outlined In the Health AuthorityApproval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system Is(are) 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 Iles and from my Investigation and Inspection, the on-site water suppty and/or wastewater disposal system Is(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations In effect at the time of Installation. Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone 337-6179 Address 6901 DEBARR ROAD, SUITE 28 • ANCHORAGE, AK 99504 Engineers Printed Name JEFFREY A. GARNESS, P.E. Engineers Comments: In conducting this evaluation, AI4WC, Inc. attempted to provide a thorough, conscientious engineering anatysls of the system In accordance with ADEC and MOA DSD 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 madly Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and We water usage of the family being served by the system. t) These conditions are outside the control of the evaluator of the system. Satisfactorytest results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWC, Ina can therefore not provide any wananty or future estimate of how long the system will continue to moot the operational requirements of the ADEC or MOA DSD. 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 party Is not authorized, nor will It confer any legal right whatsoever. Date 5. DSD SIGNATURE Le Approved for 3 Disapproved. Conditional approval for bedrooms. A. Gamessr E-7953 I'S' QdproressIonooc 040000�� •'.Ciel �: re - ? ON -SITE •• `9� WATER AND m— bedrooms, with the filowing stipulations`pRRA WASTEWATER • 1Q Fly,,,' v. ��1r�4,TSEVtiGEsl�� • Attachments: HAA Checklist • Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineer's Reort Other Original Certificate Date: 6 — 2 / - 0 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.danc horage.ek.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: WILLIAMSON SUBDIVISION; LOT 23, BLOCK 1 Parcel ID: 015-073-40 A. WELL DATA Well typePRNA If A, 6, or C provide PWSID# N/A Well Log (YIN) YES Date completed 8/24/79 Sanitary seat (Y/N) YES Wires properly protected (YIN) YES Total depth 220 ft. Cased to 40'+ R. Casing height (above ground) 12+ in FROM WELL LOG AT INSPECTION Date of test 8/24/79 3/2/01 Static water level UNKNOWN t 187 ft Well production 9 g p m 7.19 g p m WATER SAMPL RESULTS: Coliform colonies/100 mt. Nitrate 0' S mgJL. Other bacteria 1 colonies/100 ml. Date of sample: 6/8/01 Collected by: AWWC, INC. B. SEPTIC/HOLDING TANK DATA Tank Type!Materlal STEEL Date installed 9/11/79 Tank elze 1000 gal. Number of Compartments E Cteanouts (Y/N) YES Foundation deanout (YIN) YES Depression over tank (YIN) NO Date of pumping 3/2/01 C. ABSORPTION FIELD DATA Date installed 9/11/79 Soll rating Length 47 11. Width High water alarm (Y/N) N/A Pumper NORTHLAND PUMPING I'SULIP EXTENDS 46" BELOW iNVERT r fe/bdmh) 115 3 ft System type TRENCH Gravel below pipe 3.5 ft Total depth 7,6 t Eff. absorption area 329 ft' Monitoring tube 'YES Depression over field NO Date of adequacy test 3/2/01 Results (Pass/Fail)PASS For 3 bedrooms Fluid depth in absorption fleld before test 31 in. Water added 650 gal New depth 47 in Elapsed Time: 260 min. Final fluid depth 41.5 in. Absorption rate >= 450 + g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) SEpxICLEAR If yes, give date 2/1 /01 D. LIFT STATION Date installed Size in gallons Manhole/A I 'Pump on" level at in. "Pump • n High water alarm level at in Datu Cydes tested Meets alarm & drcuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot '96' On adjacent Tots Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/deanout N/A 'SEE 1996 WAIVER 100'+ Sewer /septic service Ilne 25'+ Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent Tots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line '8' Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehlde storage 5'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS WATER WAS 9.5" BELOW THE INVERT ON 6/8/2001. G. ENGINEER'S CERTIFICATION certify that I have determined through held inspections end review of Municipal records that the above systems are In conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Na e JEFFREY A. GARNESS Date Glie . Gorness: 7953 ;' s AT47 of•s8p^d HAA Fee $ Stn . ao Date of Payment &/(q pi Receipt Number Loan (2 (Rev. 1V®) Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICFS Division of Environmental Services On-Site Services Section P,O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Ol,~'- O-Z.~ ~ HAA# 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency. Mailing address Day phone Agent Address Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. NOTE: Individual well ~ Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. 'TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 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 disposaJ system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm FI~/-,~? Address I ~5~30 Engioee¢s sig.ature Phone ~ ~/..C- 13,.c5- Date /-]'~¢ ~ /~¢~" DHHS SIGNATURE Approved for --~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments 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. MUNICIPALIrY OF ENVIRONMENrAI~ ~iERVICE$ DIVI~iION Municipality of AnchoragE; AUg DEPARTMENT OF HEALTH & HUMAN SERVICES~ Environmental Services Division - ~' ([ E ~ V E D 825"L" Street. P, oom 502 · Anchorage. Alaska 995()1· (907) 343-4744 Health Authority Approval Checklist LegalDescription: Jo e, ~t '~. r~/~' I/ bt/tlllco~ro~ S/~) Parcel I.D.: WELL DATA Well type Log preseat (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well production WATER SAIVlPLE RESULTS Coliform O Col /lO0 Date of sample: '7 B. SEPTIC/HOLDING TANK DATA ifA. B. or C. attach ADEC letter. ADEC water system number Date completed I~' / ~' y~._7 9 Cased to 'E ~0' Casing height (above ground) Y' Wires properly protected (Y/N). FROM WELL LOG AT INSPECTION 8/Z¥/79 7/~t /~o/ ~'" ~7..' 9 ~/';~, g.p.m. ,5". R 't' g.p.m. Nitrate rT, ..~02~ r.~/'.g.. Other bacteria /X/one rel, orl-~4 Collected by: FIcW'~'/) Teel~ Date installed a) [ I I ! 7.0 Tank size J 00~7~- Nmnber of Compartments Foundation cleanout (Y/N) Y' Depression (Y/N) ~ . High water alm~n (Y/N) _ N. ,4. Date of Pumping j~lq/~ff Pumper tsPla4' fiT'C/)O0~ C. ABSORPTION FIELD DATA Date installed ~ / t ~ / '79 Langth t4 '1 t Width Effective absorpuon area ~2P r'.'d ~ Date of adequacy test '7 [ 71 / ?ff Fluid depth in absorption field before test (in.); bt (oc,o Fluid depth ~ n (ins.) Minutes later: Peroxide treaunem (past 12 months) (Y/NI Soil rating (g.p.d./ft2 or ft2/bdrm) t_.O_~._~_ System type Gravel thickness belmv pipe _ J'.,~~' Total depth Mmfitofing Tube present(Y/N) ¥ Depression over field (Y/N) Results (Pass/Fail) Pa~$' _ For .,~ bedrooms __ Inunediately afterd'q I gal. water added (in.):. o./" Abs0rpu0n rate = _~.> t/,5-'O g.p.d. In:,~owr, Ifyes, give date Iq. A. D. LIFF STATION Septic/holding tmflc on lot Absorption field on lot Public sewer maiu Sewer/septic service line Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: 99 t_._~___..c'. ~, ...... ; On adjacent lots Size in gallons "Ptonp on" level at* *Datum r,f, ; On adjacent lots Public sewer manhole/clemxout Lift station "Pump oft" level at* Wells on adjaceut lots ~ tom 1 certi~ that I h~e determined thmtfield inspections and review of Municeal records that the above ~stems are in cot~orntance with MOA H~ guidelines in effect on this date. Engineer's Name .............. , Date of Payment ~ Building foundation ~O ~ Surface water~ '~ I OO ' Curtain drain None Xeen ENGINEER'S CERTIFICATION SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: PropertyLine ~3' (?~" '~.x/,. ~e/,~r$)~ ,a Water maitffservice line ~;~ to ' Driveway, parking/vehicle storage area Building foundation ~ $ ' Property line ~ I o ' Absorptiou field Water main/service line >. t O ~ Surface water/drainage ~ t OO ~ Wells on adjacent lots SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Rick Mystrom, Mayor Mumc pality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 October 1, 1996 Ted Moore, P.E. Flattop TecNfical Services 14530 Echo Street Anchorage, Alaska 99516 Subject: Waiver Request for Lot 23 Block 1 Williamson Subdivision #2 Waiver Request # WR960045, PIE) #015-073-40, HA960365 Dear Mr. Moore: Your request for waivers of the required 100 foot horizontal separation of an on-site wastewater disposal system to a private well and the required 10 foot separation of the soil absorption trench to the west property line have been approved. The approved separation distances are 96 feet from the private well to the septic tank and 1 foot from the west property line to the absorption trench. Ttfis waiver approval applies to the existing septic system to well and lot line separations only. Any future upgrade to either will require all separation distances be met or another approval from this department. If there are further questions or concerns regarding this waiver, please call our office at 343-4744. Sincerely, Daniel J. Roth Civil Engineer On-site'Services DJR/1jm:Kneaper MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-s~Lte Services Section Waiver Review Worksheet WR~ WR960045 PID= 015-073-40 HA~ HA960365 Date Received: August 20, 1996 Legal Descripn]_on: Lot 23 Block 1 Williamson Subdivision Engineer: Ted Moore, P.E., Flattop technical Services Permit 14530 Echo Street, Anchorage, Alaska 99516 Applicant: Marvin Kneaper Waiver Requested: Private well to on-site septic tank of 96 feet Criteria: 1. Geology: A. Water ~able B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal[ Separation TOTAL: 2. Special Conditions: Points: 3. Other: Waiver ls Granted: _ ~ List Conditions or Reasons for Waiver is NOT Granted: above: ~ ~~ Rec ~: 1;02166/1815 Amount: Name of Reviewer $ 625.00 Date Paid: August 20, 1996 C' C) A/ £ L ~ : / o,4/ MUNiCiPALiTY OF ANCHOP. AGJJ F. ixNI~ONM~:NTAL SERVtCE8 DiVISJOJ~ AUG 1990 CIYIL & ENVIRONMENTAL ENGINEERING · ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E, PH: (907) 345-1355 M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 Dem- Sirs: August 20, 1996 14530 ECHO ST, ANCHORAGE, ALASKA 99516 RECEIVED AUG 2 3 1996 Municipality ot Anci~orage Dept, Health & Human Service~ By means of this letter we m'e requesting issuance of a waiver recognizing and allowin_!g_l)_e locatiou of the existing septic tank serving the residence on Lot 23, Block 1, Williamson S/D-to~oe~ 96 feet from the well serving the stone lot, instead of the normally requh'ed 100 feet. We are also requesting that the waiver allow the existing soil absorption trench to remain as close as 1 foot from the west property line. A site phm and relevaut back-up documents from your files m'e enclosed, along with a ttAA application and water sample test results. According to the &iller's log, the well was drilled in August of 1979 aud bas a total depth of 220 feet and a yield of 9 gpm. On July 31, 1996 the static water level stood at 192 feet below. the top of the casing. During a well test conducted on that date, steady pumping of 845 gallons of water from the well at the maximum pump output of 5.8 gpm caused the water level inside the casing to be drawn down to 193 feet, but no further. Based on our test data we concluded that the total yield of the well is in excess of 5.8 gpm. Water samples collected on July 31, 1996 were satisfactory, showing 0 coliform or other bacteria per 100 ml., and 0.303 mg./l, of nitrate-N. According to the as-built inspectioa report on file in your office, the wastewater disposal system was installed in September of 1979 and consists of a 1000 gallon steel septic tank which discharges into a 47 foot long soil absorption trench contaiinng 3.5 feet of sewer gravel. The Municipal inspector reported the septic tank to be 100'+ fi'om the well, whereas our measurements indicate that the septic tank cletmout is 99 feet from the well. This waiver request is for 96 feet to allow roi' additional underground projection of the septic tank closer to the well. The Municipal inspector also showed the trench to be 8 feet from what appem's to be the north property line, whereas our measurements indicate that it is approximately 40 feet from that property line. Conversely, our plot of the probable subsurface configuration of the soil absorption trench on the site plan indicates that the west end of the trench is probably very close to the west property line abutting Lot 22. Accordingly, we m'e also requesting a lot line waiver to recognize aud approve the location of fl~e trench possibly being as close as 1 foot from the west property line. As can be seen from the site plan, this existing configuration will have only minimal impact on the ability to develop replacement septic systems on Lot 22, when they are needed. The overall topography of the lot in the vicinity of the septic system slopes downwards towards the northwest at approximately 15%; thus any effluent from a failed or overflowing septic tank would tend to flow almost directly away from the well. The topography in the vicinity of the well slopes in the same dkrection, but more steeply. North and northwest of the septic system the topography becomes flat and poorly drained. No standing surface water was present within 100 feet of the septic system components on the date of our inspection. The following is a breakdown of how waiver analysis points could be assigned using D.E.C.'s 1985 "Separation Distance Waiver Guidelines for SCRO": Category Points Distance to water table (192' - 2' - 12' = 178') 7.41 Soil sorption (predmninantly clay and sand) 4.5 Permeability (predominantly soil with a perc rate > 50 min./in.) 3 Water table gradient (+5%) 4.5 H0riz0n~l ~epar~ti0n (96') 2.84 Total 22.25 Based on this assignment of points, it appem's that tbe waiver can be safely granted without concern as to contamination of the well due to the proximity of the septic tank. The fact that the water smnples indicate no contmnination after 17 years of service lends fm'ther support to that assessment. Please feel free to give me a call if you have any questions. cc: Marvin Kneaper Sincerely, Ted Moore, P.E. TRACT 2B (VACANT) LOT 22 / LONG TRENCH ;EWER GVL ,o 1000 GAL. SEPTIC TANK o SEPTIC 3 BEDROOM HOUSE LOT 24 (VACANT) WELL 0 .p..~o. , LOT 23 / ~,-..:,, BLOCK 1..' ,, ', LOT 20 ',(VACANT) LOT 19 ,' (VACANT) ,' L 23, ELK. 1, WILLIAMSON S/D #1 WELL AND SEPTIC SYSTEM SITE PLAN FLAITOP TECHNICAL SERVICES 1 INCH = 40 FEET 14530 ECHO STREET DRAWN BY TFM ANCHOiL~GE, ALASKA 99516 AUGUST, 1996 NOTE: THIS IS NOT A SURVEYED PLAT. ALL I.OCATIONS SHOWN ARE APPROXIMATE. INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE DEP'r. OF HEALTH & DEPARTMENT OF HEALTH · ENVIRONMENTAL PROTECTIO~NVIRONMENTAL  825 LStreet. Anchorage, Alaska 99501 FEB A ? 1981 ENVIRONMENTAL SANITATION DIVISION REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts ou page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing, ~PRQPEFPR PERTYOWNER PHONE ~bPERTY RESIDENT-(If different from above) I PHONE ~ BUYER PHONE ~AI LING ADDR ESS ~ ~-~ .... 4, ~TOR/AGENT PHONE ~. LEGAL DESCRIPTION ~-TR E E'T L OCAT4'O N ~'. TYPE OF RESIDENCE ./ ~SINGLE FAMILY NUMBER OF~BEDROOMS ~ One ~ Four ~ Other __ ~ Two ~ Five ~ ~U L.TIPLE FAMILY ~Three ~ Six 7. WATER~LY NDIVIDUAL' ~ ATTACH WELL LOG, A well log is reouired for a I wells drilled ~ COMMUNITY since June 1975. For wells drilled prior to that date, give wel ~ PUBLIC UTILFrY depth (attach icg f available.} 8. SEWAGE D~OSAL SYSTE~ ~ iNDiViDUAL/ON.SiTE~- ~O~ YEAR ON-SITE SYSTEM WAS INSTALLED ~ PUBLIC UTI LITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [~ THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX 2. WATER SUPPLY PERMIT NUMBER [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY (~' Corlnection Verified INSTALLER [~Septic Tank or [] Holding Tank Size: !O©Q If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holdin9 Tank Absorption Area Sewer Line Nearest Lot Line WELLTO: I00¥ Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY 72-010 (Rev, 6/79) March 3. iL981 Jay M./l). Chanda Ch~:]shensen % I)iane Atl)erk Century 2]. - MeLropolitan Rea].ty 523 West 8Lb Aventtc Ancherage, Alaska 99501 SubjecL: Lot 23 B]t(.x ]. Wiltiamson Subdivision Approva] Eor t:h~; ind:ividual sewer and war_or cannoh /;)e granked unttJ] hhe fo].lowing items compleLed: facJ. lJ L:Jes (]) Tile water analysis report needs [o be deJ. ivered ho this office ~]7om Lbo Chem Lab, 5633 B SL:ree/, our review. .ns[ 1 ] (2) A four(4) inch cast: iron sl:andl?ipe needs to be i ~ a [~ ~o t:he ].eaching area. [h .o wi. iL1 need t:o be reinspected by this depa]:Lmenl: when compl, eted. If [here are any further quesf:ions, please call this o[fJce aL 264-4720. Sincerely, Roi)el:l; C, ]?ratt, R.S. Asso :Lcatte Sl)ec J.al i s L RCP/ljw cc: Brokers "-' 2 ].h]_e 4797 Business Park 99503 Bou].evard ~ ' iNSPECTION APPOINTtv~ENTS i, DATE RECEIVED ~NSPECTOR ENV RONMENTAL SANITATION DIVISION ~ [~ ~ ~J Te,ephone 264-4720 RE -- DIRECTIONS: Complete all parts OH page 1. Incomplet~l requests will not be processed, Please allow ten {10) days for processing. 1. PROPERTY OWNER PHONE MA~LING AD~RE~S / -' PERTY REolDENT (If different from above) PHONE ~BUYER PHONE MAILING ADDRESS ~LENDINGINSTITUTION ~ PHONE MAI'LInG ADDRESD REET LOCATION TYPE OF R~>IOI~NCE [~'/SINGLE FAMH_Y [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One ED :our E] Two E:3 Five ~/Three [] Six [] Otl~er WATER{SUBPSU LY ~ iNDIVIDUAL~ ~ ATTACH WELL LOG. A wall log is reau~red for aH wells drilled ~ CC ~/1MUNITY since June 1975. For wells drilled prior to that data, give well [~] PUli LIC UT[ LITY depth (attach log if aw~ilable.) S, SEWAGE DISPOSAL SYSTEM ~ IND)VIDUAL/ON-S)TE*+ /~.fT~' YEAR C~J-SITE SYSTEM WAS INSTALLED, [] PUBLIC UTI LITY NOTI": THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SIX [] OTHER 2..~ER SUPPLY [~J INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified iSN WAGE DISPOSAL SYSTEM DIVIDUAL/ON -SITE E~PUBLIC UTILITY Connection Verified []Septic Tank or [] Holding Tank Size: ~ If Tank is homemade give dimensions: PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCES Septic/Holding Tank Absorption Area WELL TO: // ¢ C) / Absorption Area to nearest Lot Line Sewer Line JNearest Lot Line 5. COMMENTS ~APPROVEDFOR ,, -~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE ~ 72-010 (Rev. 6/79) August 26, 1977 George. Wi]m~o't h 308 G Street An(~hor age ~ Alaska. 99501 · Subje¢;t: Willi~JJson SL~divi$ion According tO thi~: (~epartment's water ~:am, pl~ moniter list, W~ hav~ no'~ as yet.~r~ceivod a water ,a~m~pl8 for '~h~ abov~ subJe¢:t wel~l system for the ~n'~h of July', 1977. O%uc rooords ~nd~,cate that you are r¢~.sponsibl~ for turning ~hese mandatory ~sa~{pl~,s i.n for tho subject water system, tf you have not don~ ~o ~s yet~ please obtain a water bottle from the St~teLab, 527 East 4th Avenue, as soon as possible and return tho sample to the same address for analysis. If you ar~ no longer iii ¢~harge of the subject water system, ))l~2ase notify us i~m~ediately to any name. and/or addre~s chaag~So If there are any further questions, please contact this Of'~iCE~ at 279-2~11, ~xtension 224, or at th~ above address. ~hank yo%~ for your co-.operation ~in'this matter. Stnce~:ely, L~n Bringl~ I~rincipal Environm~ntal Centrol Offic~r n~]/lJn REC, EJP'i' F,[)}~ CE,q'J'IFI~D P~IAIb-30~ (pills postago) OR DATE · PS Fo~,,~ 3800 NO 1[4glJI{AN~E