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SAMPSON ESTATES BLK 3 LT 12
Sampson Estates Block 3 Lot 12 #051-811-38 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 1 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP 191427 PID Number: 051 811 38 Dwelling: 9 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New X Upgrade Name VITT ABSORPTION FIELD ❑ Deep Trench El Wide Trench El Bed El Mound Site Address 22522 SARAH ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 GPD/SF - Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade - Ft. Gravel depth beneath pipe - Ft. Subdivision Block Lot SAMPSON ESTATES BLOCK 3 LOT 12 Fill added above original grade _ Ft. Gravel length - Ft. Township Range Section Gravel width - Ft. Beds: Number of Lines - Distance between lines - Ft. SEPARATION DISTANCES To Septic Absorption LiftStation Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line - Ft2 1 - Ft. Well +100 - _ _ + 25 TANK XSeptic ElS.T.E.P. El Holding E] Other Manufacturer GREER Capacity 1250 Gal. Surface Water +100 - - - Material POLYETHYLENE Number of compartments 2 Lot Line +10 - - - NA Foundation +10 - - - LIFT STATION Manufacturer Capacity Gal. Remarks old tank demolished per code TANK REPLACEMENT ONLY Alarm location Electrical installed by PIPE MATERIAL House to tank 3034Tank to 3034 drainfield Installer J RS Drainfield - co/MT 3034 Inspector CHARLES BALZARINI BENCH MARK (Assumed elevation) 100 ft Inspection 1s` 10/28/19 Location and description 2 �d BOTTOM OF SIDING 3rd 4m ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp 111t��� of q�gs�l Conditional Approval: Date IMWI. . • • ' ,I l C •'9 *: 49 TH w •.* ..� HARLES G BALZARIIy(� Septic Syste Approved Date ��� �is�F , CE -13854_ OPROFEWQN� i� Note: this appr al does not include well permit requirements. trtev ub/uui ts/ 7/7/19 CHARLES G BALZARINI CE-13854R E GISTEREDPROFE S S I O N A LENGINEER06/29/20 ASBUILT SEMARD & ASSOCIATES LAND SURVEYING 694-0829 1 HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE: FOLLOWING DESCRIBED PROPERTY Al DATE- x r AND THAT NO FINICR664MENTS E' IST jDtCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THrF- 00STENCE OF ANY GRID: EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- Duane Mark Sawa VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB' LS 5 ANY DATA HEREON BE USED FOR CONSTRUCTION ��0,57 11% 4v OFFENCE LINES, OR FOR ESTABLISHIN 9 BOUND 14 ARY LINES. DRAWN: NO 10/10/19 4PLAIVS MUNICIPALITY OF ANCHORAGE Development Services Department -M Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 051 811 39 Property owner(s) Rob Vitt Mailing address Site address 22522 Sarah ON-SITE SEPTIC/WELL PERMIT APPLICATION Day phone 290-3365 Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) Sampson Estates Block 3 Lot 12 Lot Size 40815 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) El Septic Tank ❑ Upgrade ❑ (w/wo ADU) Holding Tank El Renewal❑ (D) ElRenewal Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: I NONE Distance: I certify that the above information is correct. I further certify that this is` in accordance with applicable Municipal Codes. C&M ENGINEERING (Signature of property owner or authorized agent) Permit/Rush Fees: a Waiver Fees: Date of Payment: g�a31 �g Date of Payment: Receipt Number: Qg Receipt Number: Permit No. QcSpI �% ��lo� Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit AppliFation.doc C&M ENGINEERING SERVICES Ph: 907-854-5558 Municipality of Anchorage Onsite Water & Wastewater Program 4700 Elmore Rd Anchorage, Ak 99507 RE: Proposed Septic System Modification for Sampson Estates Block 3 Lot 12 Dear Reviewer, The above referenced property is currently served by an older septic system. The tank has failed and needs immediate replacement. We are proposing that the existing tank be replaced with a new 1250 gallon (minimum) tank constructed and installed in accordance with MOA requirements. A polyethylene or advanced coated tank is recommended. The tank will have an insulated riser and meet current code requirements. The tank shall be covered with a minimum of 2” moa approved insulation and 3’ of cover. The repair shall be performed by a moa certified installer in accordance with MOA requirements. The engineer will inspect the tank before backfilling. Repair of the proposed system will not negatively impact adjacent lots. Upon completion of the installation, a record drawing will be submitted showing the location of the new tank, leachfield, well, and other applicable features. Thank you for your time in reviewing this permit request. Please do not hesitate to contact me at 907-854- 5558 or by email cgbalzarini@gmail.com with any questions or concerns. Sincerely, Charles Balzarini, PE (10/2/19) Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191427, Rebecca Carroll, 10/10/19 CHARLES G BALZARINI CE-13854R EGISTEREDPROFES S IO N ALENGINEER 9/31/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191427, Rebecca Carroll, 10/10/19 r Municipality of Anchorage Page / of Z DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ' -0 2:,''T PID Number: 041 ll/"-3ea -_'1) { Name: Wastewater System: LI New .Q Upgrade Address: ' 475084dPo��, Cif� /42. ��%v-� l � 796 77 ABSORPTION FIELD Phone: 4-'1476:,77- �;:= .3? No. of Bedrooms: ❑ Deep Trench ❑ Shallow Trench .]Bed 0 Mound 0 Other LEGAL DESCRIPTION Soil Rating: _,3 GPD/Sq. Ft. Total Depth from original grade: Lot: , Block: ,,,,r, Subdivision: ny ���' rte, i(:,,, /.i 1 Com/ 1VLl. Depth to pipe bottom from original grade: `'/ '? Ft. Gravel depth beneath pipe cam. S� Ft. Township: Range: Section:^ Fill added above original grade: rrp Ft. Gravel length: el--.. ,,,::- '-) Ft. WELL: ❑ New ❑ Upgrade Gravel width: Ft. Number of lines: >:, •-- Distance between lines: 4 Ft. Classification (Private, A,B,C): /t/i) i ,. , <, Total Depth: Ft. Cased To: Ft. Total absorption area: (S 'SQ. Ft. Pipe material: ' ? --, Driller: - Date Drilled: Static Water Level: Ft. Installer: ?:: , i ''"%-i -, J..-, ori Date installed: 1 9_ , 9a Yield: GPM Pump Set at: Ft. Casing Height Above Ground: Ft. TANK SEPARATION DISTANCES sy7.Septic ❑ Holding ❑ S.T.E.P. To From Septic Tank Absorption Field Lift Station Holding Tank Public/Private Sewer Lines Manufacturer: 61 /eke (Vi/.."- Capacity in gallons: ,.../.{r ';'_. '� Well / / _ Material: 5Lc,,,.j Number of Compartments: .' Surface Water i !r'•'-o_ — LIFT STATION LotSize Line 1/v -/ q 8/ — — in gallons: Manufacturer: /lie, r;._ Foundation !U / Ca s/ "Pump on" level at: "Pump off" level at: High water alarm at: Curtain Drain i)6-c.r Y1c--. — -- Pump Make & Model Electrical Inspections performed by: Remarks: ;i' it;f,,,.• e,,,-1 ,r.,. BENCH MARK ,� ' 'ILe, llf l (-,',c7,' • !-A',., 1 , n;. t- ., Location and Description: -:;/` )d -'s,, - t--', Vi''.; ' :' lea /;,: e. ki;',.21'.;,2:- -• I'1 '_':_, :f.lJ,, : Hf _ + `-, ,, �l�P/' t^-1./Cap okl ` :I -f5 J ' :; Irl i�1/ !\if2./ ri/1 l .� Assumed Elevation: F -- Ft ' 1 1antL `, yc °°poo°oep P�. �v°°°°o° Inspections performed by: � Dates: 1st `% r-' %"l' ifl °°°n,,,:,,.a�r � , ° , ° Ron !4..► L Hstisnbu> '....,°°V ,° ° <1 " 2nd e-,---5-7.7-- '' Department of Health H an Se es approval Reviewed and approved by: Date: �' 72-013 (Rev. 9/91) MOA 25 Permit No 2( `:)e Page ' of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal DIe4 1'cimn a6eaoya(iy 1.0 A,,1rr1;0,,r,F..• Z66L 9 1. d3S a3AIJJ3'd PID No• °`al gll CY57— 1<x -.3r x,77 STEL., vii Cowti/461. rye Ava•leei -Fu i lOt/l _a 4elrti Ind LDak C�C Ira I+1,r. 19oc.t� 1.000061 ELI '*e° 617* :49TH 110aSSO� 42 72-013 A (2/91) MOA 25 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920245 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:KOSBERG STEVEN P & MARY H OWNER ADDRESS:P. 0. BOX 672051 CHUGIAK, ALASKA 99567 PARCEL ID:05181138 LEGAL DESCRIPTION: SAMPSON ESTATES BLK 3 LT 12 LOT SIZE: 40815 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 8/25/92 EXPIRATION DATE: 8/25/93 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: 1. TOTAL DEPTH OF SYSTEM MAY NOT EXCEED 4.5 FEET. 2. ENGINEER WILL VERIFY UNIFORMITY OF SOIL THROUGHOUT BED DURING CONSTRUCTION. 3. SUBMIT SPEC'S ON DIVERSION VALVE IF USED, AND ENGINEER WILL DETAIL VALVE ON FINAL INSPECTION DRAWING. 4. IF NEW SEPTIC TANK IS INSTALLED, TWO CLEANOUTS MUST BE ADDED AFTER yTTANK AS PER AMC 15.65. RECEIVED BY: (.16 /4y'L% ISSUED BY: &27.L% -ti% DATE: DATE: L - 11 Ln -r- 12 B L1^t . 3 r 5 2to 0 TESTI-Foc. E6WT MoNtroe rage_ V, IF Inl pjmp,i,p.r4� ATTA-414 ,-/z) Pot Ve774it-5) Ext sr. SE® C, 5EPri- 9 N V RI • 176. C Pz P .,5.et' 5MP7-1 as 1'11 K Tit uzain7 K1 -2 -as 1r'1e2 LoT 1a, B LV. 3 3A11.5o»1 Es-rAm DAtE I EX do' S -za z' DATE: IR- 24' SHT.: 2 OF 2 - PREPARED PREPARED BY: SUBJECT Zeas/,sn/ GD=?,277oA/ w, 0.4r 92x,84 -51-1F-or 2 cae C MF F� ENGINEERS SURVEYORS PLANNERS PROJECT MANAGERS �` LIMITED \\� 139 East 51st Avenue, Anchorage, Alaska 9960303 B (907) 662-1630 FAX (907) 562-1831 PROJECT: LIZ he3 X 11/10 /5-ap �L,= Cel ea,1772,4e•7 cIcy v. tr 2514A rQa?fIN 1s 4 a .4 eAelg /r 3# 1.,: v(r ayeAtAt 2 42A /F PE2e 4r 785'4 LF. Mad/ re20 ryea ern AlAr data., 4 664,exit. w/ GO#ITe.v2Z .44 fo rthil Ye:4✓ Kees 0 Gac%r- ie) s6, rRaN r+dir EV EG, l� coe,�.1n.n v 5 .e.41/rs F A3 a 5 RECEIVED AUG 1 1 7992 Municipality of Anchorage ePt Health & Human Services Furuu.� Sat) Lr I Bus. Thsr Ko�E- e -\ - r4 5E Pri r Q Llri1-VTY EASErAegT N1� ss v�/ 8'N /3"1- gP•ri PLA til vE. TNUge-pTc7 LOT IZ, B LK. 3, JA Sod ESTT� `� SLAt_E DRWN 13`t' tiAT BK. 140' Pt - LMC F PERFORMED FOR: LEGAL DESCRIPTION 10 11 12 13 14 15 16 17 18 19 ENGINEERS SURVEYORS PLANNERS PROJECT MANAGERS LIMITED 723 West Sixth Avenue Anchorage, Alaska 99501 M11!t 7-1-10e Z7� 0 SOILS LOG RECEIVED A PERCOLATION TEST AUG 1 1 1992 Municipality of Anchorage Dept. Health & Human Services q e74, 9�+ G%3 DATE PERFORMED: 7//�/ /Z Drt:.t--,- I,-J!,j . gAsJ vrzi 1lmen 177i (es( -14 t/ fJ r,:, e-;) I /`V? .ro Lp WITfi Pis vri-TOy' EL) \ co v r.4?-' " 1 -rt Rt) SLOPE WAS GROUND WATER ENCOUNTERED?4/69 IF YES, AT WHAT DEPTH? Reading / Date Gross Time SITE PLAN 11111111111171111111111111 1111111111111__111111111Md lse111 11111111111M111111111111 1111111111111111111111111111 Min IiiiiI111111 151.E■■. ■■1111111111 iiiiiiiiii 11111111111111111111111111111 1 s L 0 P E Net Time /0 --2" Bo Depth ro Water Lti 5%1 Net Drop J L i „, I” p '�ri�i =3i11 urg u 20 /i0( --/Y /9(.63) 2 1/ PERCOLATION RATE /0c) 71/k S.$ (minutes/inch) i / r- FT FT AND /orh . /`-fi J %�7/9TEST RUN BETWEEN r COMMENTS MO4/5'.L � J �'I:?��r;-.! 7/7/9"4 fin. ;--Iarc /�% arc -4("/ -n"Wu v1-1 600 ."2C/a r� J43/ p)/ - d,5 r7 l�7ra1�. a ,1 ��,-'l e':iv�� , /ileznl'rr.�:-' ��td /r)� :� ..<.r `rta �': �/ �J . t� ��. CERTIFIED BY: Cn.r_ DATE: PFR F(1RME0 BY: � �1. :�t�✓�x-. -- -- - August 10, 1992 Municipality of Anchorage Dept of Health and Human Services On-site Services P.O. Box 196650 925 L Street, Suite 502 Anchorage, Alaska 99519-6650 Attn: Susan Oswalt Re: Lot 12 Block 3 Sampson Septic System Upgrage Dear Ms. Oswalt: ENGINEERING SURVEYING PLANNING PROJECT MANAGEMENT saovuesuewnH 1fl H'ldap a6eaogou`d 4o Sii(edpiunL 2661ll9f1V a3A13J3� Attached for your inspection is a site plan of the proposed septic improvements for Lot 12 Block 3 Sampson Estates. TOPOGRAPHY Topography at the site slopes gently downward away from the street toward the back of the lot. Slope is about 2% to 4% with no areas of excessive slope. SURFACE DRAINAGE PATTERNS Surface drainage is toward the back of the lot. From there surface drainage continues to flow away from the site through heavily forrested birch. Abutting lots to the north have houses on them and are heavily covered with birch trees as well. The proposed septic system sites, both proposed and located such that continued positive drainage During the percolation test a monitor tube was feet and monitored for 7 days. No groundwater was PROPOSED SYSTEM future shall be is maintained. installed to 14 noted. The existing bed system does not meet municipal standards of 450 gpd for a 3 bedroom residence. The existing system is currently 139 East 51st Avenue, Suite B • Anchorage, Alaska 99503-7205 • Phone: (907) 562-1830 • Facsimile: (907) 562-1831 Page 2 Oswalt August 10, 1992 being used and is functioning. The proposed system is a new bed system complete with a valve to alternate between the existing bed and the new bed. The existing septic tank will remain in place, and is an MOA -approved 1,000 gallon two-compartment tank according to the original inspection report. Sincerely LCMF Limi ed L. Hattenb Scott g, P.E. Principal • \ MUNICIPALITY OF ANCHORAGE \\� , • DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ► f 1ENVIRONMENTAL ENGINEERING DIVISION \ // 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NA n . /7 N` �> ,/7 � PHONE NEW ❑UPGRADE MAILING A ////// x /50o a `— 6 2 6d - s7 t L/ 4-i{ LEGAL DESCRIPTION L. / 2 t 3 ,Sat,"7 5* LOCATION <7 3 7-7(-- ,Lf ,P ) ',LI NO. OF BEDROOMS SEPTIC TANK el` 47 / f DISTANCE TO: oV Absorptionares Dwelling ,� ` PE IT JV O. �� (�-c.j Manufacturer re L_ ' iWeft-+Yia-�„� % �Widt�h / No. of compar nts Liq. agacityig gaIIons IF HOMEMADE: Inside length Liquid dept _--.---_____ a = z DISTANCE TO: Well Dwelliryg PERMIT NO. Manufacturer Material Liquid capacity in gallons TILE DRAINFIELD TRENCH DISTANCE TO: Well Foundation Nearest lot line PERMIT NO. No. of lines Length of each li e 4"p�al length of lines F Trench width inches Distance between lines Top of tile to finish grade Material beneath tile inches Total effective absorption area SEEPAGE rte LengthWidth ,f/' / Depth / .� 4 f b. ak 6 Our' PER T 220 Type of c ib Crib diameter Crib de h _ Total effective absorptjonareag / iJ DISTANCE TO: �C-! Kll� f Building�Eg©datiof Nearest lot line �iZ �j j J w � Class� `��) p Driller - Distance to lot line PERMIT NO. DISTANCE TO: Building f /ndation Sewer line Septic tank Absorption areals) OTHER 4T- C PIPE MATERIALS C l� J / SOIL TEST RA NG Z3,5- 'j s' ' 2 w �Fi c �� _ INSTALLER / `Ub — r �V r 46 / Ft /toe 60 47 ' 0 `i —.-----V t R ARKS CD 5” i.U// S�� 4 77'- ' /`' tlkm (eGx , it 2- Ov.e. �J C / 1,67k.) //8e 1 nJtr/ dookss". �� vthee_ J--e- ..,,,torsi . OA Ratwrt3���A. Siraior W .el cNo. 1447-E .. 00 (4. ,.••... ... .•. aI • r-zi" fi• -+ APPROVE Y ra 1 1LEGAL Y� 19 .,,-,^ I / /,/ ,( 72-013 (Rev. 3/78)` �/ PERMIT NO: DATE ISSUED: P1 1: 1 -IF nle ri FE Fl u1 - DEPARTMENT OF HEALTH AND ENV IRONMENTHL PROTECTION 825 L STREET, ANCHORAGE: HK 99501 • 264-4720 P -d EE: EE: ET H.: F°������� 840221 04/20/84 APPLICANT: BRYAN ROFF ' ADDRESS: BOX 15000~2 WHSILLH/ HK 99687 CONTACT PHONE: 376-7567 LEGAL DESCRIP: SUBDIVISION:- SAMPSON ESTATES SECTION: ] TOWNSHIP: 15N LOT SIZE: 40815 (91 Fr OR ACRES) LOT LOCATION: SARAH .CIRCLE MAX BEDROOMS-: 3 LOT: 12 RANGE: 1W BLOCK: ] LISTED BELOW ARE THE OPTIONS AVAILABLE TO YOU IN DESIGNING YOUR SEPTIC SYSTE1 CHOOSE THE OPTION THAT BEST FITS YOUR SITE. ,_` / / 11UR'8EP....BC1".:U.-1 ED. UEDi DEPTH TO PIPE BOTTOM (FT. ) 4.0 /4. 0 GRAVEL DEPTH (FT. ) 4. 0 / 0L 5 TOTAL DEPTH (FT. ) R. 0 4.5 GRAVEL WIDTH (FT. ) 2. 5 27. 0 5`0 GRAVEL LENGTH (Fr ) 99.0 ** 46.0 850 GRAVEL VOLUME (CIYDS ) 41.2 39. 1 62.9 TANK SIZE ( GALS ) 1,000.0 ** 1/000.0 * 1/000.0 SOIL RATING (S(lF'[/BR) 262 2]5 / ' 262 iR P-.1 4. 0 I5 ** ** ** GRAVEL LENGTH } 75 Fr REQUIRES MULTIPLE `^ N��'w«OT EXCEEDING 75 Fr CH) ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS ' I CERTIFY THAT: 1. I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE (MOH) AND THE STATE OF ALASKA. 2. I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH ALL MOH CODES AND REGULATIONS' AND IN COMPLIANCE WITH THE DESIGN CRITERIA OF THIS PERMIT. ]. WILL ADHERE TO ALL MOH AND STATE OF ALASKA REQUIREMENTS FOR THE SET BACK DISTANCES FROM ANY EXISTING WELL/ WASTEWATER •DISPOSAL SYSTEM OR PUBLIC SEWERAGE SYSTEM ON THIS.OR ANY ADJACENT OR NEARBY LOT. 4. I UNDERSTAND THAT THIS PERMIT IS VALID FOR A MAXIMUM OF 3 BEDROOMS AND ANY ENLARGEMENT. WILL REQUIRE Al ADDITIONAL PERMIT. IF A LIFT STATION.IS INSTALLED IN AN AREA COVERED BY MOH .BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED: (2) HS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REpORT/ AND (3) THE ELECTRICAL WORK MUST BE DONE BYH LICENSED ELECTRICIHK -__ � ~ SIGNED DHTE� ���� ISSUED BY DATE: ,/,;��������� APPLICANT: BRYROFF JNICIPALITY OF ANCHORAGE \' •p 7Z, DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 PERFORMED FOR: SOILS LOG — PERCOLATION TEST Roff's Construction, Jnr. LEGAL DESCRIPTION: 10 11 12 13 14 15 DATE PERFORMED: SOILS LOG PERCOLATION TFST�U Y T. 15N, R.1W, Section 3, Lot 12, Block 3, Sampson Estates Subdivision, Peters Creek, Alaska Organic Topsoil GRAVELLY SILTY SAND (SM) Brown, Moist, w/Organics SILTY SANDY GRAVEL (GM) Brown, Slighty Moist, Dense, Cobbles Present Difficult Drilling Total Depth 12' 1sOF Ait, 17 18 1s 20 COMMENTS SLOPE 1 WAS GROUND WATER .ENCOUNTERED? No Allan W. N,uiiiq No. '977-L OFES`...l' IF YES, AT WHAT DEPTH? s L O P E SITE PLAN N 0 z co Reading Date Gross Time Net Time Depth to Water Net Drop Y/izM j '1o04;, Io ,�;fr, .' 354 ,i /g 'i/t9 /8`i 5O wt:,n to ,. Li l8 2 N/IS/S`i 4.0 <.:„,. Ii, ,40,1.% 4" 3/glt ,3 71(7" N/I'd/$`i Sbu4;,n to wt:vl 5% %6,, PERCOLATION RATE TEST RUN BETWEEN FT AND 14•5 FT It is suggested that the septic field be i_nsulat d with 2" of rigid board insulation. Reccomend 260 sq. ft. per bedroom. PERFORMED BY: Douglas C. Bonham CERTIFIEDBY: Allan W. Murfitt DATE: 04/19/84 (minutes/inch) A. W. Murfitt Co. M.O.A. No. ST84-015 MUNICIPALITY OF ANCHORAGE Development Services Department p p --3 Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-811-38 Expiration Date: 2 f Z 3 Legal description Sampson Estates Block 3 Lot 12 Site address 22522 Sarah Current property owner(s) X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: I I z Z This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory X Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 G11I1UHMpQUTY OF AHC HORQOE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 051 811 38 Complete legal description SAMPSON ESTATES BLOCK 3 LOT 12 Location (site address) 22522 SARAH Current property owner(s) 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: ❑■ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ❑■ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: [:]Steel ❑■ Plastic L]Concrete F-1Fiberglass Z Age J - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS X Bed _ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: NONE Distance: Expedited review requested: ❑ By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 5-56 Date of Payment /I Uf a COSA # 85d ya/-199 Waiver Fee $ Date of Payment Waiver # COSA Application—June 2022 COSA Checklist_June 2022 COSA Checklist Legal Description: Parcel ID: If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank Date of pumping Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes go to bottom of effective. If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Adequacy test date Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in Comments/Deficiencies: COSA Checklist_June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F.ENGINEER’S COMMENTS G.CERTIFICATION & 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, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Phone Engineer’s Printed Name Date C&M ENGINEERING CHARLES BALZARINI 11/17/22 Nitrate Advisory Certificate of On -Site Systems Approval # OSC221539 Subdivision: Sampson Estates, Block: 3, Lot: 12 A water sample revealed a nitrate concentration of 6.06 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. ' Mailing Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org' From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Madmg Address P O Box 196650 * Anchora a Alaska 99519 6550 �` www7muni org ,; k pp {' x i I0514 NICIPALITANCHORAGE?1 Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051 811 38 1. GENERAL INFORMATION Expiration Date: Cf Z©Z:U Complete legal description SAMPSON ESTATES BLOCK 3 LOT 12 Location (site address) 22522 Sarah Cir Current property owner(s) Mailing address Real estate agent VITT 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: NONE Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the. engineer. COSA Fee $ 6.60 COU I D Date of Payment Zq Az_ C) Receipt Number OW02g i COSA # 05G20/? S5 Waiver Fee $ Date of Payment Receipt Number Waiver # 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, based on procedures outlined in the Certificate of On -Site Systems Approval 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 files and from my investigation and inspection, the on-site water supply 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 C&M ENGINEERING Phone 8545558 Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Date 7/28/2020 i OF A�'gskll ico49 TM 6. DSD SIGNATURE... . • • • • • • r 'r✓' System #1 Approved for bedrooms r >:HARLES G BALZARIKf System #2 Approved for bedrooms ��F��� CE•13854 Disapproved ���iF�pROFE5S10Na� ��� Conditional approval for bedrooms, with the following stipulations: By: Original Certificate Date: 2 ZD The Municipality of An orage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet `l<<<«cc t t t trr�r� rte. ON-SITE WA E , J l PROGRAM nr By: Original Certificate Date: 2 ZD The Municipality of An orage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist yellow sheet COSA Checklist Legal Description: Parcel ID: If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date of Sample Comments __________________________________________________________________________________ B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank Standpipes/foundation cleanout per record drawing Date of pumping C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA ______________________ Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Code-required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Adequacy test date Results Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Property Line > 5’ Yes if No ft Absorption Field > 5’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10’ Yes if No ft Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft F. ENGINEER’S COMMENTS G. ENGINEER’S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC201385 Subdivision: Sampson Estates, Block: 3, Lot: 12 A water sample revealed a nitrate concentration of 5.5 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 05-1-211-38 COSA # 04,0303 Expiration Date: 1. GENERAL INFORMATION Complete legal description , YYI pSnh c*RA-OCktTh L. lel FV Location (site address) 22 Ci 22 Sat ah 0, t r (At. Current Property owner(s) f 1 YYl_ d() — Day phone (o $g' S(032 '' Mailing address 1n Rox WTOS(o % y Chwr3lnIcy Ak Ggs(o7 Lending agency Day phone 10 -I8 -OG Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested. COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 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 On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems 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. (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 engineer's work. 4. 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, based on procedures outlined in the Certificate of On -Site Systems Approval 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 files and from my investigation and inspection, the on-site water supply 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. Eagle River Engineering Services 10421 VFW Rd., Suite 201 Eagio Pivot', AK 905?' Engineer's Printed Name CNRrs ]oP+{BR- R• Woo Name of Firm Address 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for By: Phone (OSI 1— J� 95 i CHRISTOPHER R.W000 �,'•., CE10387 bedrooms, with the following stipulations: Additional Comments ••yo e• ON -STYE t Ge. WATER AND : t^= WASTEWATER : • PROGRAM 7 4- Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory (Rev. 11/05) Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: 7- / — E7 6 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SaYy\pcon F-S+a,t4D L12 B3 Parcel ID:05-/- SII - 3$ A. WELL DATA Well type t " .*,L If A, B, or C provide PWSID # _ Well Log GN) y eS Date completed 5-11 - $ 9 Sanitary seal ON)4,1t5 Wires properly protected )N) y PS Total depth 1(o 0 ft. Cased to 1(00 ft. Casing height (above ground) 20 in. FROM WELL LOG Date of test S ' I I ' R'j Static water level l3c ft. � Well production 12- (2_ g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate (4•1 -Ii mg/t. Arsenic: mg/I Date of sample: (ej 19 B. SEPTIC/HOLDING TANK DATA Tank Type/Material septi c r s i eP Tank size 1000 gal. r Number of Compartments 2 Foundation cleanout ON) Depression over tank (Yep £40 Date of pumping la -7- n(o Pumper J R 1S AT INSPECTION In -2I- Oto 13 A ft. t(0.S g.p.m. Other bacteria colonies/100 mL Collected by. Chair' I2 C 80,1 to, Y i n i Date installed I - 3 - 9 2. Cleanouts ON) \IF'S' High water alarm (Y41 N O C. ABSORPTION FIELD DATA Date installed c Q 2. Soil rating (g.p.d./ft2 or ft2/bdrm) 0.3 Length CIO ft. Width -3R Total deptht1.S ft. Eff. absorption areal If tit2 Date of adequacy test (p' 0 t- O(o Results Fluid depth in absorption field before test in. Elapsed Time:I1O min. Final fluid depth in. System type Fi.Q d ft. Gravel below pipe O.5 ft. Monitoring tubetlLD Depression over field NO Fail) _D For 3 bedrooms Water added450 gal. New depth5.5 in. Absorption rate >= 4S0 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) rent k f\Ot1Jr If yes, give date N1 Pk D. LIFT STATION Date installed 4/o Size in gallons Manhole/ /N) "Pump on- level at _ in "Pumpol" level a _ in. High water alarm level at Die Cycles tested�� E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 4- 1001 Absorption field on lot '1- 106 Public sewer main 1- 100' Sewer /septic service line 1 25' Animal containment areas t IDUi Meets alarm & circuit requirements? On adjacent lots -4 1001 in. On adjacent lots '4 1 0 0 1 Public sewer manhole/cleanout i 100 Holding tank + ic 1 Manure/animal excrete storage areas 4 100 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 1 1 t Building foundation '} cj Property line A- S Absorption field + s Water main -- I U � Water service line '4" 10 1 Surface water t 100' Wells on adjacent lots -F t 00 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 4 ID Water Service line '1-101 Curtain drain 4 90 1 F. COMMENTS G. ENGINEER'S CERTIFICATION Building foundation "iso t Water main t 1 0 Surface water 'f 100 Wells on adjacent lots 4-100', 1 certify that I have determined through field inspections and review of Municipal records that the above systems we in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name COIO 7tAtt6'R P. 0006 Date 7//2/' G Driveway, parking/vehicle storage 'S 6 • r COSA Fee $ L130 Waiver Fee $ Date of Payment lin 310 7 Date of Payment KaReceipt Number oa� ! f Receipt Number (Rev. 11/05) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 060303 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 3 , Lot 12 of Sampson Estates subdivision. This inspection revealed a nitrate concentration of 6.24 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. 06/27/2006 18:51 JRA Pumping PO Box 773415 Eagle River, AK 99577 (907) 694-6454 9073449821 BlRino Information Tim & Judy Jose Po Box 670581 Chugiak, AK 99587.0561 (907) 688.8832 Job Site Information Tim 22522 Sarah Circle Chuglak, AK 99567 (907) 688-8632 Job Desc#ptlon: P.O. Number Tema: Sale/mop; Map Book: Cross Streets: Job Cornments: 1000g Net 30 Karlia Sampson Drive PAGE 01 Service Agreement Number: 020036 Order Date: 02 -Jun -2006 Service Date: 07 -Jun -2006 12:00 Technician: Gene Tar %: 0 JcbTyw: Repeat Map Grid: 15 . . Last Sery 09/10/04 1000g Pump Tank - Heavy Solids Additional Location Comments Diann: $i: Latxamst14432txnp #'s are on the Home w/Blue Steel Roof Septic Q back of home Service Type Septic Service 15K. Qty Price Each 1 50.00 Tax? No Gallons Planned: 1000 Gal. Actual: Hose Length: 3 Double Tank: ❑ Pump System* E Baffles Inlet: 0 Baffles Outlet: 0 Extension Actual $0.00 NonTaxaMkTotal TntI. Total Estmatad Charges : 30.00 Aetud Charges: 30.00 Tax Total 30.00 0raad Told 30.00 Customer gram to the Norms and conditions shown. THIS ISA BINDING AGREEMENT. Signature and Title of Customer Representative Dale Accepted by JR. Pumping Dais Accepted For your added corwenlwnce we accept American Express, Dtcov.r, Vies and Mader Card payments owe the phon.. Aha 30 Days accounts will be turned over to ccOxtlons. 32500 Fee NSF Checks Returned. SCS Ref.# Client Name Project Name/ll Client Sample ID Matrix 1063242001 Eagle River Engineering Sampson Estates Lot 12, Blk 3 Sampson Estates Lot 12, Bik 3 Drinking Water All Dates/Times are Alaska Standard Time Printed Date/Time Collected Date/Time Received Date/Time Technical Director 06/24/2006 11:13 06/19/2006 11:20 06/19/2006 17:20 Stephen C. Ede Sample Remarks: f Parameter h Results PQL Units Method Metals by SCP/MS i! Waters Department Arsenic Nitrate -N Microbiology' Laboratory Total Coliform ND 6.24 0 5.00 ug/L EP200.8 0.100 mg/L EPA 333.2 co1/100mL SM20 922213 Allowable Prep Analysis Container ID Limits Date Date !nit C (<10) 0620/06 06/21/06 SCL 13 (<10) 06/20/06 ALR A (<1) 06/19/06 TLF Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cLanchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING/4102 / HAA# H"2UOgg- Expiration Date: i a ' oZ it - O42-- Parcel I.D. 05 1 — 811— 3 8 1. GENE;2AL INFORMATION Complete legal description Lot 12, Block 3, Sampson: Estates S/D Location (site address or directions) urrent Property own;;;‘; Clare Snoozy 22522 Sarah Circle — --Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Chugiak, Ak. 99567 Day phone 907-746-1609 P. 0. Box 773053 — Eagle River, Ak. 99577 Joe Miller — Remax Unless otherwise requested, HAA will be held by DSD for pickup. 3 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System Day phone Uayphone 257-0149 ia" ,7 Z 2774*-- 94.,/0 2 - TYPE 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.) Certifieales 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. 4. 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, based on procedures outlined In the Health Authority Approval 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 files and from my Investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) In compliance with all applicable Municipal and Stale codes, ordinances, and regulations in effect at the time of Installation. Name of Firm S & S Engineering Phone 694-2979 Address17034 N. Eagle River LP. RD., Eagle River, AK Engineer's Printed Name Robert C. Cowan Date q a 3 Z. 2 5. DSD SIGNATURE Approved for g Disapproved. Conditional approval for By: Additional Comments OF bt,,t6INEE*Ncy. ISA ROIERT C. COWAN y CE -8801 ' \ f.2 bedrooms. 4- bedrooms, with the following stipulations: PnoT OFre�y C 3 ON-SITE WATEK AND : sn WASTEWATER : PRO76. zz, eon 0:\`� Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other (Rev. 12/001 Original Certificate Date: C - 2. 4/ - 0 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water b Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lora; aot:h 3 ; Mi i ot0J Parcel ID: Os/ -8 0- 36 e sr A. WELL DATA Well type L If A, B, or C provide PWSID # = Date completed 5 jl1 Sanitary seal (WN) Total depth J(00/ o ft. Cased to 140 ft. FROM WELL LOG Date of test 5111104 Static water level / 3C ft. Well production 21- g.p.m. WATER SAMPLE RESULTS: Coliform 0 colo ies/100 ml. Date of sample: g 07-- B. SEP13 SHOLPING TANK DATA / 'Penh Type/Materfat .'SGP t l G Nitrate S.4 /mgii. Collected by: S s 9rif s" Well Log (Y/N) y Wires properly protected (YM) Casing height (above ground) , /R. In. AT INSPECTION '2/4/02- /4 ft. S 3 g.p.m. Tank�alte /APO gab Number of Compartments Z Foundation cleanout (Y/Ny Depression over tank (Y/N) /v • Date of pumping i C.`•t1BSORPTION Date installed Length S U Total depth -la ft. Date of adequacy test DATA Soil rating (g.p.d./ft2 or ft2/bdrm) 0.3 ft. Width 3 7 ft. Eff. absorption area/,9) ft2 Monitoring tube 9/7/ 0Z Results (Pass/Fail) eld before test 0 in. Water Pumper �2�5 /Other bacteria 0 colonies/100 mi. FCs/G-,tJ(r ►2-/�I � Date installed ' y y High water alarm (WN) Cleanouts (Y/N) 2) System type i Gravel below pipe O . S ft. 1 Depression over field _ �1 ss Fluid depth in absorptionadded gal. 1 Elapsed Time: /8(% min. Final fluid depth $` in. Any rejuvenation treatment (past 12 mo.) (WN & type) fa Absorption rate >= For 3 bedrooms New depth (0 in. If yes, give date g.p.d. D. LIFT STATION Date Installed "Pump on" level at Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: '4 Size in gallons "Pump off' level at _ in. Cycles tested Septic tankfilLtsfatitin on lot Absorption field on lot Public sewer main S.,evetirseptic service line /W , .f- Manhole/Access (YM) High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots /et) r- /00 rr- In. Public sewer manhole/cleanout /I/ 4 - Holding tank Nt SEPARATION DISTANCES FROM SEPTIC/HQI.BflQG TANK ON LOT TO: j( Building foundation �J # Property line . 5 " Absorption field Water main N/�" Water service line ► Wells on adjacent lots /00'r � Surface water /00 /f SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: r ► Property line / 0 t Building foundation /0 f- Water main Water Service line /49 it, urface water /00 i:- Curtain drain 4/o e-4 t/ Wells on adjacent lots /W 4.- F. COMMENTS Alfrt Driveway, parking/vehicle storage I G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA MA guidelines in effect on this date. Engineer's Printed Name ie 44r C. Carweir. Date °413 le t HAA Fee $ 3 7r- o g1AT/0i 02S-9to/ Date of Payment Receipt Number (Rev. 12/00) L Waiver Fee $ Date of Payment Receipt Number ate\ seks OF 1. t i cirF 8+1 µ le At 131 1S 6-716-1 « IN ;/n a �• ....... j°a4 Ark ••co • ' � 9 • v m Ja., u:a.a, / u -sin ..,i ,'•••....... ��0'' 'moi 0 • ,Por,' A. S BUILT . SUR VE Y SURVEYOR: 3%c—oaoZ(!i 0 JOHN SHADRACH, R.45. P.O. BOX /497 WAS/LLA, ALASKA 996E DESCRIPT/ON:4 r /2, ezoce g -trA.v/PSM/ ESTI17CS SCALEE: DRAWN Br: DATE' G MI 600K No.x? rc 4 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1. GENERAL INFORMATION (a) Legal Dgscription (include lot, block, subdivision, section, township, range) Location (address or directions) t.o � .G.0 (b) Applicant Name?ti.A�% Telephone: Home 6 I % l�� Business� � Applicant Address �®"/�7 /s6 Y �'� �Y �� 7 (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder; Buyer 0 ; Other 0 (explain); - (d) Lending Institution . q// -v _ Av.1 f3PX efiKdrle Address (e) Real Estate Company and Agent (f) Address Telephone Mail the HAAtQ�ie t�tolidr gE�d'r�es° SR B 196A 2. TYPE OF RESIDENCE Single -Family Multi -Family 0 Other Number of Bedrooms 3. WATER SUPPLY Individual Well Community 0 Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite f Public 0 Community 0 Holding Tank 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11/84) Page 1 of 2 5. ENGINEERING FIRM PROVIDIN.2 INSPECTIONS, TESTS, FILE SEARCH, DA IA 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 compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this . insp c io 5ENGINEERING Name of FirmgR B 96X Telephone Address EAGLE RIVER, AK Date 6 4'4-z-9 i f 6. DHEP APPROVA Approved for 1'I<Q-.� bedrooms by Approved Disapproved Terms of Conditional Approval 7M/6 .1 -Pt OF 4Clittl 674, ° e. e 4.° 4b, y P C, •.'� :04..%.bc 0 41 2kil r Seal *�� o °1; aa.n. i.- a°.00w7ae . y . O;f�.OMM 161, 13ab4rt A. 8tivbxr C 414;! # �` ' F Ma. 14674 sear ar °°96. • 65 IA%PROF Fc T/./g-e Conditional CAUTION The Muncipality of Anchorage Department of Health and Environmental 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 lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) RPGR 1,1•4- b MUNICIPALITY OF ANCHORAGE (MOA) al a� OE VttP% OItiC kALTH AUTHORITY APPROVAL (HAA) �Ot P CHECKLIST - FEBRUARY 1984 VW c 264-4720 014 0 `IV Legal Description. /- %G t IL 3 �` i.r\ADSC"i-v IRSo A. WELL DATA R�iC Well Classification SY?_j V M.1.--- ' If A, B, C, D.E.C. Approved (Y/N) Well Log PresentCY>N) Date Completed 5/8c Yield 0 ; &yla Total Depth /('' Cased to /00' Depth of Grouting Static Water Level t 3 ' Pump Set At /91 Casing Height Above Ground. Sanitary Seal on Casing r) 1/N) Electrical Wiring in ConduittN) Separation Distances from Well: To Septic/Holding Tank on Lot /c`% Depression Around Wellhead (Y To Nearest Edge of Absorption Field on Lot Wei To Nearest Public Sewer Line , Cleanout/Manhole u//1 Water Sample Collected by Water SaleTest Results Comments ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer 411 ice`' To Nearest Sewer Service Line on Lot SS /,-) ; Date AT/ SP► -1D) y B. SEPTIC/HOLDING TANK DATA Date Installed / Size /0.12:7641- No. of Compartments Standpipes ON) Air -tight Caps (ON) Foundation Cleanout ON) Depression over Tank (Y.& f Date Last Pumped .��� Pumping/Maintenance Contract on File (Y/N) N` ; forO }� Holding Tank High -Water Alarm (Y/N)A` Temporary Holding Tank Permit Separation Distances from Septic/Holding Tank: /0t/ !D To Water -Supply Well To Property Line To Water Main/Service Line N7 plc Course To Building Foundation /0/ To Disposal Field iS To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata � .S °/ Date Installed Width of Field wwi y, Type of System Design y'r Length of Field Depth of Field Gravel Bed Thickness Square Feet of Absorption Area / / Zc43b Standpipes Present ON) Depression over Field (Y41) Date of Last Adequacy Test L 154, Tfri lki i T VVC' Y . Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well To Building Foundation N/A Lot ((Z' To Property Line To Existing or Abandoned System on ; On Adjoining Lots 3�-7 To Water Main/Service Line /CJ To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course N`or NI/A To Driveway, Parking Area, or Vehicle Storage Area �U t Comments e`PT L, Le 3`j 'THXN TWo Y1 -5 We.. 5 Me). L 1) ,— C,CL,4l'AN4' Y D. LIFT STATION Date Installed Dimensions Size in Gallons v{71, Manhole/Access (Y/N) "Pump On" Level at "Pump Off" Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Sig neds Date /9/ CompaR B 196X MOA No. 6'ao_g Receirg4pLE RIVER, AK 99577 400 1 O 0eto ' Date of Payment Amount: $ Page 2 of 2 72-026 (1-084) MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date /0- 2.-6-6`V (a) Legal Description (include lot, block, subdivision, section, township, range) /z 'r 3 ..,5SC oar-, Location addreri directions)ca g A -0 (b) Applicants Name ,glyCl.f Aerie Telephone - Home Applicants Address fit, >e. /Sa(Jt ®�Z 4.1664-#4e. ,, r 376-7,x6 7 Business (c) Applicant Buyer is (check one) Lending Institution 1 ;sr/builder ; Other (explain); (d) Lending Institution Address ®tJ2rJ ..J 7 Telephone (e) Real Estate Co. & Agent Address Telephone (f) h ®HAA to the following address: a - jell/�F A.T A KA 'r^ 7 G94 -n79 2. Type of Residence Single -Family Multi -Family Other (describe) Number of Bedrooms 3. Water Supply Individual Well XI Community 11 Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite:54 Public Community 1 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] 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 compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm 6' IAi° E.K;111Vbili\tz SRB 198X Address r::i i ct1VER. ALASKA 172,577 PH 694-297O Telephone . Date /V (ENGINEER SEAL) awe eVaty OF At 1t4 • %r . la 41 • Robert A. 5hmfer ; A. TELL DATA Well Classificati Well Log Presen' Total Depth 6 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Static Water Level Cased to Casing Height Above Ground If A, B, or C, D.E.C. Approved(Y/N) Date Completed Mal 4".41 Dept of Grouting At /5-V/ /6 o Pump Set A Yie ld` O iSy�u^ Electrical Wiring in Conduit Separation Distances fromWell: ( To Septic/M d g,Tank on Lot d !' 4' Amor' Sanitary Seal on Casing Depression Around Wellhead ('f ; On Adjoining Lots /00 .,L To Nearest Edge of Absorption Field on Lot /12. ; On Adjoining Lots /00 'f To Nearest Public Sewer Line /1/4.%/4 - To Nearest Public Sewer Cleanout/Manhole /.`)//4- To Nearest Seer Service Line on Lot 2S 1,4 Water Sample Collected By.$' /5 0it_y //heUI'2 y; Date /O/2 t3 /8 Water Sample Test Results S e Tv/ -S. ,,of G/To 2 y / Comments /.J p N r B. SEPTIC/HOLDING TANK DATA Date Installed s5/67 Standpipes Depression over Tank Pumping/Maintenance Contract on File (Y Holding Tank High -Water Alarm (Y/105( Separation Distances from Seppttic/Hx..1gg Size DD Air -tight Caps i No. of Compartments Foundation Cleanout z Date Last Pumped e c.✓ i ;for A- Temporary Holding Tank Tank: To Building Foundation /0 To Water -Supply tell /0 To Property Line /D To Water tike rr/Service Line /0 (74 To Stream, Pond, Lake, or Major Drainage Permit (Y*1/4 To Disposal Field / Jr I Course N� J Comments /V d [Page 1 of 2] 2-15-84 "7..�ILi�iIG?� C. ABSORPTION FIELD DATA Absorption Strata 23.x" �c NOV .� 19B4 Type of System Dksigrr ' °% a Soils Rating in Date Installed Width of Field Square Feet of Absorption Depression over Field (Y e Length of Field Depth of Field • Gravel Bed Thickness 6' /72 e Standpipes Present ( /11) Results of Last Adequacy 'lest Date of Last Adequacy Test N l �.- Separation Distance from Absorption Field: To Water -Supply %e 11 //Z- To Property Line To Building Foundation ,&. e 3 n To Existing or Abandoned System Lot /J b 01.../ AT ; On Adjoining Lots .3C (7. To Water MftWService Line /0 .4- To Cutbank(if present) cn To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Convents ,k b 50 D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) Comments Dimensions Manhole/Access (Y/N) leOff" Level at Vent (Y/N) during Adequacy cy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all on the date of this inspection. Signed °ori_,�iGi6�axlwi'�!(vi Date / d « i� Co,lq�ati „�iG IVER, ALAsKA C571 MOA N KB1/d5/s Ili/,/3L (Page 2 of 2] MOA HAA Guidelines in effect yAiN4 ;C..V.• n o/r of uoYr no.a iol73 A, fi P Ribor1 A. Shw$ar [n`'e No. 1457.& ..351 G; Y4 2-15-84