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HomeMy WebLinkAboutSOUTHPARK #2 BLK 3 LT 1 Municipality of Anchorage Page 1 of. 5 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 545-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW000415 PID Number: 020--052--74 RICHARD LOPEZ Wastewater System: [] New · Upgrade Address: 4540 SOUTH PARK BLUFF DR, ANCH AK g951~ ~Esvc~/~]ABSORPTION FIELD[wE~/CTR/~-~ No. of Bedrooms: Ph°ne:(907) 545--2888 5 DDeep Trench BShallow Trench DBad DMound rl0ther LEGAL DESCRIPTION ~,, Rating: 0.8 GPD/Sq. Ft, Total oo~ ,~oms.5/2.7/5.5on¢o, ~.~o: 1 5 SOUTH PARK #2 2.5/1.7/2.3, .. 1/1/1 ~ Township: Range: Section: RII added above orig[nai grade: (:;revel lengUt: - - - 0- 2' Ft. 54/33/35 Ft. m. 575 SO. Ft, D 3034/ F-810 ~ A+ HOME SERVICES lO/21/o0- 10/22/00 ., Ft. TANK SEPARATION DISTANCES · Septic [] Holding [] S.T.E.P. From Tank Raid Station Tank Sewer u.e* ANCHORAGE TANK 1000 Well 200'+ 200'+ - - 25'+ STEEL 2 SurfaCewoter 100'+ 100'+ - - LIFT STATI. ON ~-/ Lot 5'+ 10%{- -- -- ~aJ Foundation 5'+ 10'+ - - Drain NONE KNOWN I ~emarks: BENCH MARK ~ ~.~o ~ ~ GARAGE MAN-DOOR THRESHOLD. I~.um.~ m.,oUo.,: 98.0~ Ft '.......' .... Inspections performed by:. AWWC, INC. Dates: 1St 10/21/2000 }/~.~.'!~/j~' ~'~1-~ 3rd 10/25/2000 ) 'p · & ~fr, ~ A. ~ar~ess.:" Department of Health and Human Services approval ~,~ .... ..... Reviewed and approved bY~'~'~/~/~?,,///C/ /'~* ,~,'~ Date:_ ~O -..Q. (~-~ -%~,"~:,~ ' ~.,~So f e ss~o~,~=~.=~ ....... ~ ~"~:~ 12-013 (Ray. 9/91) Ilea 25 PERMIT NUMBER: swooo4',~ AS-BUILT DRAWING P.~OE'-,B020_0~2_..,.,UMBER: / ~db~ '~"L C06 54.2 76.6  ~0~: HOOSE LOOATIO~ IS ~PROXI~TE. SO~ERN 20' ~EMENT WHICH WAS SU~OR PRIOR TO CON~RUC~ON. [ i Al ASB WATER & W~TEWATER ~.~.w. PREPPED FOR: PHONE NUMBER: PAGE NUMBER: SOUTH PARK S/B ~2; LOT ~, BLOCK 5 ..'" AS-BUILT OF SEPTIC SYSTEM UPGRADE PE.*.**R:SW0004,S AS--BUILT DRAWING 5fl / ~1~ ~ gf CON (AfHI~SfPOI~ WESI TRENCH ............. , ...... CONSULTANTS, INC.**:-: 1" : 30' RIGHARD LOP[Z (007) 345-2888 3 OF 3 AS-BUILT PROFILE Of SEPTIC SYST[M UPGRADE MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Oct 03, 2000 Expiration Date: Oct 03, 2001 Permit Number: SW000415 Legal Description: SOUTHPARK ADDN 2 BLK 3 LT 1 Design Engineer: 0041 AK Water & Wastewater Consulta Owner Name: RICHARD LOPEZ Owner Address: 4540 SOUTHPARK BLUFF ANCHORAGE , AK 99516- ParcellD: 020-052-74 Site Address: 004540 SOUTHPARK BLUFF DR Lot Size: 29702 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] SepticTank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must 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 engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soiJ absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. ALASIO- WATER & WASTEWATER September 19, 2000 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Proposed Septic System Design for Lot 1, Block 3; South Park S/D #2 To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The septic system is in a state of failure and needs to be replaced. A test hole was excavated west of the existing system where the proposed septic system upgrade will be located. We are proposing that a 1000 gallon septic tank and a 5-wide trench type drainfield be installed. Comments regarding the proposed design are summarized as follows: 1. SOILS: Attached is a soil log which shows the soil profile, groundwater monitoring, and percolation test data. It is our opinion that due to the soils classification and percolation rate an application rate of 0.8 gallons per day per square foot should be used. 2. TRENCIt DESIGN: a. Percolation Rate: <1 & 12.9 minute/inch b. Allowable Application Rate: 0.8 gallordday/ft2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 563 ft2 f. Maximum depth: 3.5 ft. g. Effective Depth: 1 ft. h. Width: 5 ft. i. Reduction Factor: 0.87 j. Length: 99 ft. (3 ~ 33 ft.) k. Effective absorption area = 569 ft2 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: As can be seen on the topographical drawing, the a proposed trench is to be installed on a section of the lot that has an approximate 20% slope rurming from approximately east to west. The trench is to be installed parallel to all slope contours. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907)337-6179 * Fax: (907)338-3246 * Website: akwwc.com 5. WAIVER REQUEST: There is a 100% cutbank approximately 35 feet from the proposed upgrade. This cutbank was made during the original construction of Southpark BluffDrive, over 20 years ago. The slope is vegetated, which will help minimize any potential daylighting. Given the porosity of the soil it is reasonable to believe that effluent will move downward rather rapidly through the soil, limiting its lateral migration. Further justification for this encroachment is the fact that the completed system will consist of t~vo drainfields (old bed and the new' trenches) so that flow can be alternated periodically. Given the aforementioned facts, we are requesting that a waiver be granted for 35 foot separation to the subject cutbank. I am unaware of any adverse impacts this installation ~vould have on adjacent wells or septic systems. If you have any questions, please contact US at 337-6179. Thank yon for your assistance. Presi P.E., M.S. NOTE: Attached is a site plan drawing, a design drawing, one soils log, a topographical drawing, and a 7page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907)337-6179 * Fax: (907)338-3246 * Website: akwwc.com NOTE: ALL PROPERTIES IN~ / ! SOUTH PARK S/D ARE ~ ! SERVE~ "Y A COMUUN~'~ / / ,WATER SYSTEM, ! ~ ~ / ~ ~ PAge 2 OF LOT 12, ~OCK 1, ~ ~ ~ SO~H P~K S/D ~1 I I / ~ ~ LOT 19, BLOC'K 3~ J ~ ~ LOT 18, BLOCK 3, I J I I ~ 9/11/2000 PREPPED FOR PHONE NUMBER: PAGE NUMBER: RICHARD LOPEZ (907) 545-2888 1 OF 2 LEGAL DESCRIPTION: SOUTH PARK S/D ~2; LOT 1, BLOCK 5, SITE P~N FOR SEPTIC SYSTEM UPGRADE ~ EX[STING 1000 GALLON SEPTIC : ~E CONTgCTOR MUST HAVE THREE TRENCHES Trot ~E ~CH ~ ~20 UTILI~ ~SMENT F~GGED B~ FE~ DEEP ~IMUM, BY 5 FE~ ~ A ReGiSTERED ~ND SURV~OR PRIOR WIDE, BY 35 FE~ LONG. ADD ONE 10 ANY CONSTRUCTION. D~NROOK, IN.ALL TRENCHES P~LEL TO SLOPE CONTOURS. PREPPED FOR: PHONE NUMBER: PAGE NUMBER: RICHARD LOPEZ (907) 345-2888 2 OF 2 ~pe OF WORK: DESIGN OF SEPTIC SYSTEM UPGRADE /~LASI~2A_ WATER & WASTEWA~'I~R CONSU!L,T3dXfI'S, INC. ~ PHONE (907) 337-6179 * F~ (907) 358-5246 [SOLE LOG - PERCOLATION TESTJ ,....~ ...... ~ .... PERFORMED FOR: RICHARD LOPEZ ~ ':/J~fEe/ A. Cornes¥ ~*T[ ~[o.us~: ~/~/2ooo ~0~'..:'1~_~ ... ~ ~ · ~ '_~.~ DEPTH~ I TEST HOLE ~1 I ~, o~" ............. '~,.~ (fee ORGANICS (PAGE 1 OF 2) SOIL C~SSIFICATIONS ~ I / I SM/ME G~ CL I GC OL II ~ ~ ~ SW HH ~ SP CH / /~¢~ S~ * 0H ~T. T0 ~*T~ ~ eX ~*0U~W*T~ ' I 6W/eM aRy 9/~/2o0o ~- I 10 11 DATE READING CLOCK NET TIHE WATER LEVEL NET DROP TIHE (HINUTES) READING (INCHES) 12 9/7/2000 PERC. HOLE WAS PRES_~AKED ~+ HOUR~ PRIOR TO TESTING 1 12:0~ 10" O" 10" 15 ML __ 2 12:07 & ~-0,, -- ~ 12:07 1~ ~ 12:11 & O" ~ 10" ~ 5 12:11 10" ~ ~ O" __ 10" 7 12:16 16 8 12:21 5 - 0,, 10,' 17~ 9 12:21 10" 10 12:26 5 0" -_ 10" 18 19 PERCOLATION RATE <1 (NIN./INCH) PERC. HOLE DIA. 6 (INCHES) 20 TEST RUN BETWEEN 4.5 FT. AND 5.0 FT. COHHENTS: PERCO~TION DATA ON THIS PAGE FOR UPPER BENCH PERC. HOLE ONLY. PERFORMED BY A~SKA WATER & WASTEWATER. I, JEFFR~ A. GARNESS, CERTI~ THAT THIS WAS PERFORmED/IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON DATE: ~//~/~ DEPTH TO DATE GROUNDWATER DRY 9/1/2000 9' 9/7/2000 ALASKA WATER & WASTEWATER CONSULTANTS, INC. ~' ISOIL LOG - PERCOLATION TESTI ~..~...~].zJ..~/~.~..(./~..~, "..~,,l LEGAL DESORIPTION: SOUTH PARK SUBDIVISION ~2; LOT 1, BLOCK ~ DATE PERFORMED: 9/1/2000 qO~."L.~ ~-795~..'" (feet) TEST HOLE ~1 ~ "k] ......... 1-- (PAGE 2 OF 2) SOIL C~SSIFICATIONS GW ~ ORG GH CL ~-- GC OL ~ ~ SW NH 5-- ~ SP ~CH / / ~ / ~ J ' m GROUNDWATER m I ~ CLOCK NET TIME WATER LEVEL NET DROP 11 -- ~ DATE READING ~ TIME (MINUTES) READING (INCHES) 12-- ~ 9/7/2000 PERC. HOLE WAS PRESOAKED ~+ HOURS PRIOR TO TESTING Z o 13~ ~ 1 5:40 ~ 6" ~ 2 6MO 30 5 5/8" 2 3/8" 14-- ~ ~ 6:10 6" o ~ 6:40 30 3 11/16" 2 5/16" 15-- ~ ~ 6. ~ 5 6:40 16-- ~ 6 7:10 30 3 11/16" 2 5/16" 17~ 18-- 19~ PERCOLATION RATE 12.9 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 20 TEST RUN BETWEEN 7.5 FT. AND 8.0 FT. COHHENTS: PERCO~TION DATA ON THIS PAGE FOR LOWER BENCH PERC. HOLE ONLY. PERFORMED BY A~SKA WATER & WASTEWATER. I, JEFFR~ A. GARNESS, CERTI~ THAT THIS WAS PERF~M~ IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON DATE: ~ 118 ~ ! MUNICIPALITY OF ANCHORAGE ~ DEPAR;rMENT OF HEALTH & ENVIRONMENTAL PROTECTION ! ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE EW MAILING AD SS LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS ~ ~ Manufacturer ~ .~ [~ Material~ No. of co~artments Liq. capacity in gallons Inside length Width Liqg~ depth . ~ Well Dwelling PERMIT NO. ~z DISTANCE TO: O Z ~ Manufacturer Material Liquid capacity in gaJJons ~ DiSTANCE TO: W°II ~ F°undati°n'~[ .. Nearestlotlino~ ~o. of ~ ken,th of eac~ line ~ Total length o~ lines Trench midth Distance b*t lines '~/~ ~ lotal eff0c 'u0 . sor~tion'aroa ~ TOp o'. tile to finish grad~ ..~ ,,~ Mate;ia~ ,~eneath~tile [Zi, ~ ~ches Length Width Depth PERMIT NO. ~ ~ Type of crib Crib.diameter Crib depth Tote] effective absorption area ~ Well Building foundation Nearest lot gne ~ DISTANCE TO: ~ CJass Depth Driller Distance to Jot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) PIPE MATERIALS OTHER ~ SOILTESTRATING ~~ -~ {~ INSTALLER REMARKS ~%'~ ~ %'. :.:,; ~ . lOt 72-013 (Rev. 3/78) NUNICIPALITY OF RI'4CHORAGE DEPARTHENT OF' NEFIL. TH RND ENYIRONMENTBL PROTECTION 825 L STREET, RNCHOR~3GE, Rk: 795E~i 26;4-472E~ t3t-':,l.--,S~; Z 'TEE '.~,E t4 EIR: F'E P?.t'-I If' T PERi'It T HO: [)RTE ISSUED: FiPPL I CAhlT: ADDRESS: CONTFIE:T F'HOI"~E: E:4E~204 · ENGINEEREP DESIGN L.RN Df'lB R K -',,,'EN T U RE LTD P 0 BOX ii:;LdG~ RhlCFIORAGE, AK S~?5ii 345-.-48Ef7 L_EGRL EEz._RIF: LOT _. ] ....... LOT: it BL. FCK: '~: h. Mhl =E Eq.4 I CERTIFY THFIT; i. ! F-1FI FRHiLIFIR 14ITH THE REQI.JiREI'IENTS FOR ON-SITE SB4ERS RND NELLS RS SET FOR]'N BY TNE I'ILiNICIPRLITY OF RNCHORRGE (["!OR.) RND THE STBTE OF RLRSKR. 2. I !.,!iL.L INSTFiLL TNE SYSTS'I IN HCCORDRNCE NITH RLL HOB CODES RND REGULRTIONS, RND iN COf'IPLIRtgCE 1.4ITH THE DESIGN CRITERtR OF THIS PERNIT. 3. I !4IL. L RDNERE TO RLL MOR RND SI'RTE OF RL. RSKR RE6!UIREf'IENTS FOR. THE SET BRCK DZSTRNCES FRON RNY EXISTING lqELL., NRSTEP~FtTER DISPOSAL SYSTEM OR PUBLIC SEkERRGE sYErE~.I ON THIS OR RNY RDJACENT OR NERR. BY LOT. IF A LIFT' STR'TION I% ZNS'TRLLED IN FIN ARER COYERED BY NOR BUILDING CODES, THEN (:t) RN ELECTIRICRL F'ERNIT RND INSPECTION MUST BE OBTBINED.~-(2) RS-BUILTS klILL NOT BE RPF'ROYE[:, ~,.II'I"FIOI..IT RN ELECTRICRL INSPECTION REPORT.~ RND (]:) THE ELECTRICR!_ I.,.!OR~)f,IUST BE [:,ONE E:Y R LICENSEE) ELECTRICIRN. .... ; ......... " ......................................... , ..... 7 ........ z ..... U ,, · f ~/ ' ~. ~ A ..... B UIRO[/meFITAL COF1TROL Sel4UICe$, Inc. ~n§ina~ria§ $ ~nuiro~m¢~lal $1~ias SPECIFICATIONS FOR ELEVATED BED ALTERNATIVE WASTEWATER TREATMENT SYSTEM - LOT 1, BLOCK 3, SOUTH PARK SUBDIVISION 1.0 GENERAL 1.1 THE DRAWINGS, SHEETS 1 THRU 2, SHALL BE A PART OF THIS SPECIFICATION. 1.2 ALL MATERIALS AND WORKMANSHIP SHALL MEET THE REQUIREMENTS OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERMIT AND REGULATIONS. 1.3 ALL EXCAVATIONS ANDDEPTHS ARE ADVISORY AND ARE TO BE VERIFIED OR MODIFIED IN THE FIELD BY THE ENGINEER. 1.4 IT IS THE RESPONSIBILITY OF THE OWNER TO OBTAIN ALL NECESSARY PERMITS OR EASEMENTS. 2.0 SEEPAGE BED 2.1 THE GRAVEL FOR THE BED SHALL BE SCREENED TO 0.5 TO 2.5 INCHES PER CODE. 2.2 THE SAND SHALL HAVE AN EFFECTIVE SIZE OF 0.4 TO 0.6 MM AND A UNIFORMITY COEFFICIENT OF NOT MORE THAN 4. 2.3 THE BERM AROUND THE SEEPAGE BED SHALL BE CONSTRUCTED OF IMPERMEABLE MATERIAL, AND ON A SLOPE OF 1 FOOT VERTICAL PER 3.0 FOOT HORIZONTAL. 2.4 THE BOTTOM OF THE EXCAVATION SHALL BE RAKED WITH THE BACKHOE BLADE TO INSURE THAT THE BOTTOM HAS NOT BEEN COMPACTED DURING F2fCAVATION. THE BOTTOM ELEVATION SHALL BE PLUS OR MINUS 2". 2.5 AN OBSERVATION PIPE SHALL BE PLACED AS SHOWN IN THE DRAWINGS. IT SHALL BE RIGID PVC, ASTM 3033 D-3034. THE SECTION SHOWN WITH HOLES MAY BE EITHER DRILLED 0.5" HOLES @ 6 INCH CENTERS ON OPPOSITE SIDES OF THE PIPE OR A REGULAR SECTION OF REGULAR PERFORATED SEWER MAY BE CLAMPED TO THE. SOLID SECTION WITH A NO HUB COUPLING OR SOLVENT JOINT. A RUBBER RAIN-CAP (JIMCAP OR EQUAL) SHALL BE PLACED ON THE TOP OF THE PIPE. 2.6 IF INSULATION IS REQUIRED THE INSULATION SHALL BE DOW EXTRUDED BLUE STYROFOAM BOARD OR WESTERN INSULFOAM OF THE THICKNESS SHOWN ON THE DRAWINGS. 2.7 THE TOP AND SIDES OF THE BED SHALL BE PLANTED WITH A WHITE CLOVER AND RED FESCUE MIX OR BLUEGRASS. 1200 I~¢sl 33rJ Auanua. SuJla B oAnchoraq¢. Alaska 99503 , (907) 56t-50zlO .. ALASKA ENVIRONMENTAL CONTROL SERVIC?-"INC. 1200 West 33rd Avenu~ ,~uite B · ANCHORAGE, ALASKA 99503 Phone 276-1361 CHECKED BY SCALE ,/~','1~ Z DATE ALASKA ENVIRONMENTAL CONTROL SERVIC[~'~,INC. 1200 West 33rd Avenue Suite B. ANCHORAGE, ALASKA 99503 Phone 276-1361 CALCULATED DY ~'- ~ ~ ~ h/ CATE CHECKED BY DATE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 025 L. Street, Anchorage, Alaska 99501 264~4720 SOILS LOG - PERCOLATION TEST ,~ SOILS LOG' o >o [] PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: DATE PERFORMED: SLOPE SITE PLAN 3 4 5 9 10 11 12 13 14 15 16 17 18 19- 20- WAS GROUNO WATER ENCO~NTEREO? 0 P E IF YES, AT WHAT DEPTH? ,A?d l Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND -- FT So,'tG'~ q' r~ ~ ,'~ ,*.,.~ ~,,'~,,~//,~ ~ /oo ~'/Z-,- .~/ COMMENTS PERFORMED BY: ~:~ ~ J'~ ~ O y CERTIFIED BY: 7~-oo8 (6/79) ~ DATE: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw Street P,O. Box 196650 Anchorage, AK 99519-6650 www. ci.ancho rage.a k.us (907) 343-79O4 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 020-052-74 1. GENERAL INFORMATION Complete legal description Lot 1 Block 3 Southoark Addition No 2 Location (site address or directions) 4540 Southoark Bluff DHve, Anchora~le, AK 99516 Melanie & Ed Wester¢l~l Day phone Current Property owtler(s) Mailing address 4540 Southpark Bluff Drive, Anchora~ie, AK 99516 L-e~i~ agency US Inspect, Attn: Richard Sheehan Day phone 703-293-1§25 Mailing address 3650 Concorde Pkwy, Ste 100, Chantill¥, VA 20151-1129 Real Estate Agent Jack Blair Day phone345-t828 Mailing Address Unless otherwfse requesfed, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: 3 3. TYPE OFWATER SUPPLY: Individual Well Individual Water Storage Community Class C 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) on properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to home ownem. 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 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 engineer's work. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I vedfy that my investigation based on procedures outlined in the Health Authority Approval Guidelines for 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 heroin. I further vedfy 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 applicable Municipal and State cedes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Enq. Svc. Phone 272-8218 Address P.O. Box 102954, Anch, AK 99510 Engineer's Pdnted Name Steven R. Pannone, P.E. Date Engineers Comments' [~ conducting un adequacy test, I attempt to provide a thoroush, consciuntio~ · ' ' ' ' ' 0 'de ' ' eugmccrm analymsofthc emm~ccv, athM ADSDGm Imes&R auuns. The '~'~ ~ . syst .. m,z . ~'Ixirtcd rcsulL~ describe t~c pcfl'ormanco of Lhc s3~'tcm trade' thc co~diuuns ¢acount~ at ~c ~c o f ~.~.'~Y~..; ......... ',,.'ells and aeptic ~'aterns depcmd on ~c local aoil condition, ground water levels that may fluctuate '=' ~ outside the control orlhe evaluator or fids ay,stem. All s,~'tems evemually 'fail and sat/sfactoty te~t g "'"~'~"~ results do not guazamee futu~ performance of the system, nor do they guarantee Ihat there exe no ~..~'..~, ........... · · ' hidden defects or encmachmunCs. PES can therefore not pro,nde any warranty for future ix'fl'ormance - $,,~- S et ye n nor give any estimat~ of how long the s3~tem vail continue to .cci I~c opcm[io~al rcq~rc~unts of the ~.~f~'..o _No_. ADECorMOADSD. Thecontcnto£thisreportisforthcsolebuneC~toftheownerlistedabove Any %u.~'_.~_ "20o1~4~ rcli~cc upon or usc of this report by any off~cr person or p,3sm/is aot authorized nor.ill it com';~ anylcSal risht whatsoever. '~'/~ -' 6. DSD SIGNATURE Approved for '~"' Disapproved. Conditional approval for __ bedrooms. Additional Comments bedrooms, with the following stipulations: ~ . WASTEWAT~ : · '' Attachments: HAA Checklist Septic System Advisory Well Flew Advisory X Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: ~/? ~-/~'~- Reissue Date: Municipality of Anchorage Development Services Department Building Safety Division ' -. On-Site Water and Wastewater Program 4700 South Bregaw Street P.0.'Box,196650 Anchorage, AK 99519-6650 'www. ci.anchorege,ak.us · i907) 343-79O4 HEALTH AUTHORITY A ROVAL CHECKLIST O Legal Description: A. WELL DATA Well type Community Date completed Lot I Block 3 Southpark Add No 2 If A, B. or C.. pro~'ide PWStD # ~13475 . · Sanitary seal Parcel I.D.: 020..052-74 Well Leg Wires properly protected Total depth ft Cased to Casing height (above ground) Jn. FROM WELL LOG AT~~N WATER SAMPLE~ B. SEPTIC/HOLDING TANK DATA It g.p.m colonies/100 mi Tank Type/Metedal Anchoraoc Tank Ste~l Date Installed 101211~000 Tank size 1~00 gal Cleanouts Y Foundation cleanout Y Depression over tank N Dale of pumping 91161200:~ Pumper A+ Home Services C. ABSORPTION FIELD DATA Date installed 101211~000 Soil rating (g.p.d./it= or It=/bdrrn) ~ Number of Compartments 2 High water alarm N/A ,. System type Shallow Trench Length :~IJ;[13~33 It Win'th ~ It Gravel below pipe 1,0 Total depth 44/40140 ~ Effective absorptio~ area 57S It= Monitoring tube Y Depression over field N_._ Date of adequacy test 91171200;~ Results (PassiFail) P For 3 bedrooms Fluid depth in absoqglion field bofom test Dry in Water added~,~0 gal. New depth.rd.5/4.0 in, Elapsed Time: 40 min Final fluid depth I[:)ry in Absorplion rate >= 450+ g.p.d. Any rejuvenation treatment (pest 12 mo.) (Y/N & type) N If yes, give date (Re~. 1 D."~L-~TATION Date Inst~,,~ Size in gallons Manho~ 'Pump on' level ~,., in'Pump off' level at in~.b-~er alarm level at ~ Meets alarm & circuit requirements? Datum ~ Cycles tested E. SEPARATION DISTANCES~ ~' SEPARATION DISTANCES FROM WEL~<ON LOT TO: Septic tankJlifl station on lot ~ On"~'acent lots Absorption fi.~r~ On adja~ P~ main . Public sewer manh~,~nout ,,~'/"ewer/septic serv'me Dine HoMing lank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Water main 10+ Drainage 100+ Property line Waterse~vice line 100+ We ls o ;aiaceot ots 200+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Absorption field 0+ Surface water 200+ Water ma~'n' 25+ Water Service line 25+ Surface water 100+ Driveway, parking/vehicle storage ll~- Curtain drain 100+ Wells ofi'~djacent lots 200+ T F. COMMENTS As noted in 2000 oil]ina instal ation third trench is located 35' from cutbank. , O. ENOINEER $ CERTIFICATION review of Municipal records that the above systems are in ~....~.,~ ~ _ confommnce with MOA HAA guidelines in effect on this date. ~'~ ' Engineer's Printed Name Steven R. Pannone. P.E. .."' .-,t · Waiver Fee $ Date of Payment Receipt Number EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON, 202. THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND IS NOT TO SE USED FOR POSITIONING ADDITIONAL STRUCTURES OR FENCELINES. "ASBUILT" No corners set Book pg I hereby certlf~ that l have surveyed the follow~ng described property. Lot I SIock ~ , .~O~'P~,,~ ,~ ~D~, **~ Anchorage recording distrl~ Alaska, and that the ,mprovemenls s,tuateo the,eon are ~th:n ~e prop.~ lines and do not o~..ap o, encroach on the prope~ lying adjacent thereto, that no improvements on prope~y ~ing adja:ent thereto encroach o~ the premises In question and t~at Ihere are no roaaways, transmission lines or other ~slble easements on eald prope~ except es ind,cated hereon. Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Sita Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING 020-052-74 1. GENERAL INFORMATION Complete legal description SOUTH PARK SUBDIVISION ¢¢2: LOT 1. BLOCK 5 Location (site address or directions) 4540 SOUTH PARK DRIVE. ANCH AK 99516 Property owner RICHARD LOPEZ Mailing address 4540 SOUTH PARK DRIVE. ANCH AK Lending agency Mailing address Day phone 99516 Day phone (907~ 545-2888 Agent TOM/JAN STEIGLEMAN w./ DYNAMIC PROPERTIES Day phone (907) 261-7670 Address 3111 "c" STREET. ANCHORAGE. AK 99505 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: 3 XXX If community well system, provide wdtten confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding Tank Community on-site Public sewer NOTE: XXX If community wastewater system, provide written confirmation from State ADEC lng to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 Computer Version Note: Alaska Wa ter and Waste wa ter Consultants, Inc. shall be paid $1, BOO. O0 a t,1 or prior to, closing for the engineering services provided. I 5. STATEMENT OF INSPECTION BY ENGINEER As cedified 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 fudher 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 Munici.p~iland State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ALASKA W,,~E 1 &)~ ?~T~,?VA'~ER CONSULTANTS, INC. Phone (907)337-6179 Address 6901DEBARRR'/OA£ /S¢(i--'2~J~Nc~4ORAGE. ALASKA 99504 , , Engineer's Signature ['...---- L~_~ ~/~J Date In conducting this evaluation, AWWC, Inc a~t~n ted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and M~ ~ DH, ~ 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 o )erational 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 party is not authorized, nor will it confer any legal right whatsoever. 6. DHHS SIGNATURE ~ Approved for ~ Disapproved Conditional approval for bedrooms 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 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) Sack MOA #21 Computer Vemion RECEIVI::U OCT ~ 7 ZOO0 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES ~ · ''i n MUNICIPALITY OF ANC Environmental Services Dlvls o ............ ~, 825 "L" Street, Rm 502 Anchorage, Alaska 99501 (907)Ej~I:N/AL S~:~,WL;~I~ Health Authority Approval Checklist Legal Description: SOUTHPARK #2; LOT 1, BLOCK 3 Parcel I.D.: 020-052-74 A. WELL DATA Well Type COMMUNITY Log present (Y/N) Total depth If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~_ ~ Cased to_...---~ Casing height (above ground) Wires properly protected (Y/N) Date of test Static water level Well production FROM WELL LOG AT INSPECTION fi.p.m. J 9.p.m. WATER SAMPLE RESULTS: Coliform Dateofsa, r: · Nitrate Collected by: B. SEPTIC/HOLDING TANK DATA Date installed 10/21/2000 Tank size Foundation cleanout (Y/N) YES 1000 Number of Compartments 2 Cleanouts (y/N) Depression [Y/N) NO High water alarm (Y/N) N/A YES Date of Pumping NEW Pumper - C. ABSORPTION FIELD DATA *[WEST/CTR/EAST] Date installed 10/21/00-10/22/00 Soil rating (g.p.d./ft2 or ft2/bdrml 0.8 Length 34'/33'/53' 5' Gravel thickness below pipe Effective absorption area Date of adequacy test Fluid depth in absorption field before test [in,); ~ Fluid depth ~ Absorption rate = ~past 12 months) (y/N) If yes, give date 72-026 (Rev. 3/96)* Computer Vets[on I**BELOW ~'INAL CRADEI System type *TRIPLE TRENCH Width ' .0' Total depth 575 Monitoring Tube present (Y/N) YES Depression over field (Y/N) NO NEW Results (Pass/Fail) For gal. water added (in.): D. LIFT STATION . ~ Date installed_ _ ~ ______ Manhole/Access (Y/N) ~ at* "Pumpoff" level at* E, SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main N/A N/A N/A .On adjacent lots 200'+ On adjacent lots 200'+ Public sewer manhole/cleanout N/A Sewer/septic service line 25'+ Lift station N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5'+ Property llne 5'+ Absorption field 5'+ Water main/service line 10% Surface water/drainage 100'+ .Wells on adjacent lots 200'+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property line 1 0'+ Building foundation 1 o'+ Water main/service line 10'+ Surface water 100'+ Curtain drain NONE KNOWN F. ENGINEER'S CERTIFJ! I certify that I h~ of Municipal r~cord~ with MOA H~A gu~ ~; Signature "----~l ' Engineers N~ Date ~/?~ JEFFREY A. GARNESS Driveway, parking/vehicle storage area Wells on adjacent lots 10'+ field inspections and review systems are in conformance on this date. HAA Fee $ ~ ~ ' ~ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Computer Version Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE DEPARTEqENT OF HEALi'H AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR EIEALTH AUTHORITY APPROVAL OF ON-.SITE SEWER AND WATER FACILITY 264-4720 1, GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) Name[ '~ ~¥',z~ ~ (b) Applicant ' . , .,, :~ ~J~-N ,~T~l~-'~,~hone: Home Applicant Address 'T~ ~-~~) ) -- J ~'~,~ / I[~. ~,~,¢Jt~'~ ~ (c) Applicant is (check one): Lending Institution []; Owner/builder~J~ Buyer []; Other [] (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Ma the 4AAtotlefolowingaddress: ,. TYPE OF RESIDENCE Single-Family~ Multi-Fa~nil,~ [] Number of Bedrooms _-~__~_~__ ~-~ Other WATER SUPPLY Individual Well [] Community~',',',',',',',','~ Public [] Note: If community well system,~must have written confirmation from the State Department of Environmental Conse~'~,ation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsit6,~ Public [] Community [] Holding Tank [] Note: If corn munity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84} ENGINEERING FIRl'a PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown betow, I verify that my investigation of this Health Authority Approval shows that the on-site water supply end/or wasteweter disposal system is safe, functional and edequate for the number of bedrooms and type of structure indicated herein. I further verify that besed on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply end/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effec4 on the date of this inspection. Name of Firm {,'-~ r'~ i"~-~,.>,,~'~:- ~-~'~-'~z'~Z- (,--~-~'~l'~i~ephone ~-~'~-~-~._~-'~ ~ '7~ .~- DHEP APPROVAL Approved, for~'~ ~ ~. ~ (.7)') bedrooms by r~r'e ~ ~ ,qC, ~--~' [~' '~v-0 ~(~'q hpproved ~ x Disapproved Conditional __ Terms of Cond}tional Approval Engineer's Seal °'°° CAUTION The Muncipality of Anchorage Department of Health and Environmentel Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their Iending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in ~he professional engineer's work. Page 2 of 2 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH Ab~fHORITY APPROVAL CERTIFICATE I. General Information Application Date ' -- (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicants Name [~-~.~l~w~.C~--- b~yv~l~phone - Home Business Applicants Address '~ ~ ,~--~ (c) Applicant is (check one) Lending Institution Buyer ~ ; Other~ (explain); (d) Lending Institution _~ ~ Telephone Address ~ '(e) Real Estate Co. & Agent____~_ Address .... ~ ~ Telephone ~ ~ ~ (f) Mail the HAA to t~/following address.'~ ~ ~'-; , ~ Type of Residence $ingle-Family~ Number of Bedrooms Multi-Family~ Other 'describe) Water S~p~ . Individual Well~-~ Community~ Public~ Note: If community well system, must have written confirmation from the State Department of Environmental Conse~zation attesting to the legality and status° ~ewage Disposal Onsite ~ Public ~-~ Community ~--~ Holding Tank ~_~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] Engineering Firm Providing Inspections~ Tests, File Search, Data and Information As certified by my seal affixed hereto and as of the validation date sho~m 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 A~chorage 'files and from my investigation and inspection, the on-site water supply and/or %mstewater 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 Date (ENGINEER SEAL) DHEP Approval Approved for~'~ bedrooms Approved Disapproved By Conditional _~ CAUTION THE ~0-NICIPALITY OF ANCHORAGE DEPAR~ENT OF HEALTH AND ENVIRO~rMENTAL PROTECTION (DHEP) ISSUES NEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- AT%ONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGIh~ER ~ZGISTERED IN THE STATE OF ALASKA° THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES ~ND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL ~ND STATE .._REQUIRE- MENTS. ~[PLOI~EES OF DHEP DO NOT CONDUCT INSPECTIONS OR ~MALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK° (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Well Classification Well Log P~esent (Y/N Total Depth Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances f~cm Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Fie~ TO Nearest Public Sewer Line // Cleanout/Manhole / Water Sample Collected By/. Water Sample Test l~esuly Cool, Lents /~ MUNICIPALIT'( OF AN~HORAC,~ DEPL OF H~A/T;I & ' £NVIRONMENTAL P'¥3/£CIiON 2 6 1985 R[CEIVED Legal Description: ~ j ~ zf A, ~ ~ c, D.~.c. ~pro~d(Y~) ~ ... ~te ~leted Yield ~pth of Set At Seal on Casing (Y/N) Depression Around Wellhead (Y/N) Lot To Nearest ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Service Line cn LOt SEPTIC/HOLDiNG TANK DATA Date Installed ~kA%?' I~'c..~::~ize J'~ NO. of Compartments' Standpipes (Y/N) ~]~ Air-tight Caps (Y/N)~-~ Foundation Cleanout (y/N)~C Depression over TaDk (Y/N) b~O Date Last Pumped ~/~ ~.~..~,~]~ Pumping/Maintenance Contract on File (Y/N)~f~ ; for ~' Holding Tank High-Water Alarm (Y/N) ~/~- Tempo~az~, Holding Tank Permit (Y/N) ~/~ Separation Distances f~c~ Septic/Holding Tank: To Water-Supply Well ~.~-~ 4-- To Building Foundation To Property Line c~%I'~--~_ ~.~" <A~-~) TO Disposal Field To Water Main/Service Line ?-orH-~ ~To' Stream, Pond, Lake, c~ Major D~ainage Course ~'l ,'~ Commsnts ~q u~ ~J~ "~-~ [~DCV~F'/'~ Fr~.4¥'~ C, ~, [Page 1 of 2] 2-15-84 Co ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field ~ ~! Square Feet of Absorption A~ea J~- .~ Type of System Design Length of Field ~'~ / Depth of Field _~or' Gravel Bed Thickness I ?-~ Standpipes P~esent (Y/N) Depression over Field (Y/N) kSI) Date of Last Adequacy Test Results of Last Adequacy Test Separation Distanc~ from Absorption Field: To Water-Supply Well ~I3.q- ~ To P~operty Line ~ / To Building Foundation ~l ~ To Existing or Abandoned System on Lot ~ /'~ ; On Adjoining Lots c3~f~--F__ ~C~ ~ To Water Main/Service Line ~ -~---- To Cutbank(if present) To Stream/Pond/Lake/c~ Majo= D~ainage Course k3./fPr- To D~iveway, Parking Area, o= Vehicle Sto~age A~ea ~ © ~-- Con~ents D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Leve~t / Tested for Electrical Codo~/S) C~t~l~nts ~--D~ions J ManhOle/Access {Y/N) / ~ent (Y/N) Pumping Cyc~s du~lng Adeq~/Meets MOA ** Check Permitted Bedroom Rating Against HAA Request I ogrtify that I h .~e~checked, verified, o~ conformed to all MOA HAA Guidelines in effect on the ~ ~ ir~Pe~tion. ' ' Signed --~ Date ___~~ Cc~!pany "'~-~I~,C.?i MOA No. KB1/d5/s [Page 2 of 2] 2-15-84 ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 'ANCHORAGE, ALASKA g9501 BILL SHEFFIELD, GOVERNOR Telephone: (907) Address: 27.4-2533 To Whom it May Concern: According to records on file in this office the , C) I ' Water Regulations Water System is in compliance'with the State Drinking Sincerely, N 89°59- . ~~_~0o.~1'