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HomeMy WebLinkAboutDAWN LT 105�2w+r►^ '�uc��' **05.1 C)61 �-4 1 MUNICIPALITY OF ANCHORAGE ellill -' DL .RTMENT OF HEALTH AND HUMAN SER ;ES(� �,, qEnvironmental 0 Health Division O S 1, 825'•L" Street, Anchorage. Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES TO FROM SEPTIC TANK ABSORPTION FIELD WELL Aaare. WELL Yerma No. No of beat oms Ynonetsl Z 4 I LOT LINE '21 In 1 tEGAL OESCRIPT,OR LOI 1177 bloc SUOalwson� TVA FOUNOA110N Iownsnip. Flange. Section AS -BUILT DIAGRAM ISnow location of well. septic system. property lines. lounaaeon. V' •�— anveway- vi lry boales. etc) TANKS >� I SEPTIC ❑ HOLDING Mariu,auu,er Capacitymganona 1 p F Material No. of compartments TYPE OF SYSTEM l ITl (► `TRENCH ❑ BED ❑ W. DRAIN ❑ OTHER Depih to p -pe Dunum Irum Iota, depth Irom ongmal glade ongmal grade FT S FT C— Fm soma atwve oegma, grade e+ p,n nm eapipe Gravcece � FT r I v t.,la.erlengtn ZI Gravel *.dill FT FT co 1 Total absorption area 1 108 I Distance between tines IA SOFT FT Number or ,Ines So.1rating Pipe material 1 �+ � � e I S I SO FT (1 mstaner Date installed h-21 -tee WELLS ❑ PRIVATE X OTHER (Identify) Y 7 Lm>vL�elwn IA.b.CI 101al De•pin Cased to FT FT tr i. WWWWl •�17. ��. • i/\� Datteinstaned J REMARKS: 01 .t; InsDechons�Ve�fAor •d by. + E G]kq%S SEAL r. jt' til\ , 4y; , OF Data •,'�'•� �� 4, l/, _ T/L al, h��•- ►; •tee,. ,} •'arm- y that this spec S & S ENGINEERING17034 ihoon was perlormed according to all ill I -sop load -11,19,104— ' `eerb "Sit" eoc7� 7 /2. ?_ / /�7T Municipal T#aR{taaEYtA,i71F�fR,;rlrt,Tmsdate: . Ne. IUI-E -�a�� ,�O.t=q,��y,.'•� Health Department Approval: Date. 72-019 (9,85) n n M U N I C I 1= A L I T Y O F A N C f l 0 F? A C E Dopartment of Health & Human Services 825 L Street, Anchorage,, Alaska 99501 015-4720 Day Phone: 694-2979 Parcel Id: 051-061-44 Lot Legal: 'Subdivision:lano;;l SUD-DIVICION- Lot: 105 'block: - Section: 3 township: ISN Range: 10 Lot 9izo 20000 (sq.ft., or aeras) I1:.;: B->drnoms: This Pormit.: 2 Total Capacity: 4 S/N61E fAn/Gy /I'EI�DEt�C6 !:_F'TIC TAtll'.: Minimum total septic tank: capacity: 1,250 gallons. Each septic tank musL have at least 2 compartments. Depth to Lop of =_,rptic tank(s) <. 4.0 1w<ai_ req,.ures insulation over tank(s). j1Jt>".Li.-E'[R FiNfEFiS ATTACH=_D tPF'FtL1VED DESIG°l irr=7T-LND-IN'SP'ECTIONS VY FNGINEEK _Ci..Mr"SQOE Al :�4 -46$1 IF 1 L:F_T;r1 Y IHAI: 1, 1 <.m familiar with the requirements for on -mite sewers and wells as set With by the Municipality or Anchorage (MOA) and the State or Ala_ba. _. 1 will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. T will adhere to all MUA and State of Alaska requirements for the set back: distances from any oxisting well, wastewater disposal system or public sawnrage system on this or any adjacent or nearby lot.. 4. I rrndur5tand that this pe=rmit is valid for a maximum of 2 bedrooms. I also und"rstand that the capacity of the total system is 4 bedrooms and any enlargement will requiro an additional permit. Sign..i;: 1 DATE: /49p At_A� AV I NC3/C3` • & LOAM r Isn,_rc,d E;y: DAfE: CI fl - S I T E S E 41 E R P E R M I T F'crmit Numbor: 8300 2 Upgrade P to Issued: 04/20/88 Engineer Dcnigned DATE FXfJRU: /2/31/88 0/0 Owner Name: ALASKA SAVINGS & LOAN CD Ownpr Addre5s:1170=4 EAGLE RIVER LOCP ROAD 4{204 EAGLE RIVER, AK 99577 Day Phone: 694-2979 Parcel Id: 051-061-44 Lot Legal: 'Subdivision:lano;;l SUD-DIVICION- Lot: 105 'block: - Section: 3 township: ISN Range: 10 Lot 9izo 20000 (sq.ft., or aeras) I1:.;: B->drnoms: This Pormit.: 2 Total Capacity: 4 S/N61E fAn/Gy /I'EI�DEt�C6 !:_F'TIC TAtll'.: Minimum total septic tank: capacity: 1,250 gallons. Each septic tank musL have at least 2 compartments. Depth to Lop of =_,rptic tank(s) <. 4.0 1w<ai_ req,.ures insulation over tank(s). j1Jt>".Li.-E'[R FiNfEFiS ATTACH=_D tPF'FtL1VED DESIG°l irr=7T-LND-IN'SP'ECTIONS VY FNGINEEK _Ci..Mr"SQOE Al :�4 -46$1 IF 1 L:F_T;r1 Y IHAI: 1, 1 <.m familiar with the requirements for on -mite sewers and wells as set With by the Municipality or Anchorage (MOA) and the State or Ala_ba. _. 1 will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. T will adhere to all MUA and State of Alaska requirements for the set back: distances from any oxisting well, wastewater disposal system or public sawnrage system on this or any adjacent or nearby lot.. 4. I rrndur5tand that this pe=rmit is valid for a maximum of 2 bedrooms. I also und"rstand that the capacity of the total system is 4 bedrooms and any enlargement will requiro an additional permit. Sign..i;: 1 DATE: /49p At_A� AV I NC3/C3` • & LOAM r Isn,_rc,d E;y: DAfE: 4i dt +t 4c 3,yos e v Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR:`i"J:�C` I1f--tel J DATE PE o��io®�Gi4'�70 LEGAL DESCRIPTION: ✓e- 1 ` I D 5 Township. Range, Section: 'f 1 v6 2 [ 3- to,/�1� W/ GJ1Vr�i 5- o��io®�Gi4'�70 6 6- Or4-7 Oro - 7 � O 8- 9- 10 to -f. le - 11 s"moo os 12-- 13- 14- 15- 16- 17- 18- 19- 20 21314151617181920 COMMENTS C'r't 61- }*aLt' SLOPE WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT L O DEPTH? P E Depth to Witter Alter ,�, iota Monitoring] _ Date: _Lke SITE M N PERCOLATION RATE t9 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN —, AND FT PERFORMED BY: S �� /lPli X r I CERTIFY THA'HHIS TESWAS PERFORMED IN r ACCORDANCE WITH ALLSTATE AND MUNICO"�L GUIDELI 1 FFECT ON THIS DATE. DATF < / o V apT�` 72-008 (Rev. 4185) , o��io®�Gi4'�70 N PERCOLATION RATE t9 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN —, AND FT PERFORMED BY: S �� /lPli X r I CERTIFY THA'HHIS TESWAS PERFORMED IN r ACCORDANCE WITH ALLSTATE AND MUNICO"�L GUIDELI 1 FFECT ON THIS DATE. DATF < / o V apT�` 72-008 (Rev. 4185) , \ MUNICIPALITY OF ANCHORAGE 1 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street • Anchorage, Alaska 99501 Telephone 264.4720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ❑NEW XUPGRADE r MAILING ADDRESS LEGAL DESCRIPTION lJ � IO R OJ LOCATION NO. OF BEDROOMS � U Well Absorption area / Dwelling 7 PEHMIT NO. U DISTANCE T0: ,j i r E , EQ Manufacturer'C Material L No, of compartments y� Ligc�acity in al Ions IF HOMEMADE: Inside length Width Liquid depth aj Y Jaz DISTANCE TO: Well welling PERMIT NO. _ F Manufacturer Material Liquid capacity in gallons ell Foundation Nearest lot line J. PERMIT NO. p DISTANCE T0: 12-4r No, of lines Length of e h1' ae Total lengt f Trench wi Distance between lines i-CPP .i a inchesTop of tile to finish grade i Material beneath tile -19 Total effective absorp tirea inches Length Width Depth PERMIT NO. WAll d f Type of crib Crib diameter Crib depth Total effective absorption area w� w Well Building foundation Nearest lot line DISTANCE TO: - J Class e r Dri C Distance to lot line PERMIT NO. J J w �+ Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO: OTHER PIPE MATERIALS vc SOIL TEST RATI NG INSTALLER VlNb CICCIEK REMARKS S•i t'°ht4 ` '`1�� s �'Y YpL •• •Y ••,•:V • � :7 • A. shah. ,W �► �� • No. 1457-E ••< e 4.0519`.." [APP'Well DATE LEGAL of (Rev. 3/78) MUNICIPALITY OF ANCHORAGE 1- Departmenj"')f Health and Environmentf�Protection 1- 825• L Street, Anchorage, AK. 99501 264-4720 * * * HANDWRITTEN PERMIT Permit # WELL AND/OR ON-SITE SEWER PERMIT Applicant: C . Mailing Address: Location: Phone Number: Legal Description: LOS' �aAvr Lot Size: 1n�606 Type of Soil Absorption System Is: Trench: L.--_ Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms: y�_ Soil Rating(sq.ft/br) % The Required Size of the Soil Absorption System Is: DEPTH 8 LENGTH S:-7_ . GRAVEL DEPTH WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = lee O GALLONS Permit applicant has the responsibility to inform this department during the installation inspections of.any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(Z) INSPECTIONS ARE REQUIRED Backfilling of any system without final inspection.and approval by this departmen will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fee for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 3 3 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 b ro�omms. Signed: Issued by: C fit! Applicant Date: S—/ 7--83 SWP/024(1/81) n n ❑ SOILS LOG MUNICIPALITY OF ANCHORAGE `i DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOULS LOG — PERCOLATION TEST PERFORMED FOR: JB�rl Li(�E1 L K !;XCAU DATE PERFORMED: L;—) M6V 1983 LEGAL DESCRIPTION: L . IO SLOPE I 1✓Q. U� z 3 c 4 5 6 7 °C 8-0 9-0 10 O` r71 11 O 12 / 13 14 15 16 17 ,6 19 zo COMM f-} W boc�niC. Si I ty �artil a- Gr6.0t L_ CIGL�ey Sara* GQ(W<L_ WASGROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? PLAN P ■IMMMI■MEN ■AORMES :5800 ROMMOMMMEN .■.■■.■■■■ Reading Date Gross Time Net Time Depth to Net Drop n SrWate`r/ so 30 3 1 .' 30 4 19 11 5�' ,57'6 PERCOLATION RATE 45 (minutes/inch) TEST RUN BETWEEN _L. FT AND S FT PERFORMED n unit TSLY CERTIFIED DATE) PH. 1504-2070" `'`' 7 72.008 (6/79) -- MAM ANCHORAGE AREA BOROUGH bdparttnant ofEnvironmentalQualitIG RFATER ANCHORAGE AREA BOROUGH NO Todcr Road —Pouch 6.650 r Np 8�1 {4nehorage, Alaska 99502; ' INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING v Lf /CS �ilvlrJ�� LOCATION��'T�rf ' � LEGAL DESCRIPTION SEPTIC TANK: OF DISTANCE FROM LIQUID LIQUID CAPACITY—Z GALLONS. INSIDE LENGTH INSIDE WIDTH—DEPTH- SEEPAGE IDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS / OUTSIDE DIAMETER — OR WIDTH �� , LENGTH �-s , DEPTH �JL� LINING MATERIAL r' �L-v'�) . DISTANCE FROM WELL �'r� , BUILDING FOUNDATION'�L NEAREST LOT LINE /O '�' TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) <<'� SO. FT. TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELL , FOUNDATION , NEAREST LOT LINE , OF LINES NUMBER OF LINES DISTANCE BETWEEN LINES NCH WIDTH IN. TAL EFFECTIVE ABSORPTION AREA $O. FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL; l f/%j/� DISTANCE FROM WATER TYPE DEPTH , BUILDING FOUNDATION. SAMPLE . NEAREST NEAREST SEPTIC SEEPAGE OTHER LOT LINE . SEWER LINE-. TANK , SYSTEM , CESSPOOL . SOURCES_ DIAGRAM OF SYSTEM DISTANCES: RCTE.' . S'r-LF ilo} lv&el� ;Z) py;�F F t yr Tee's/ /c ,Y nr! �r-o- �CSS 3J so%/ ion DATE 51 `ZS 7L GREA I ER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 5 9500 TUDOR ROAD POUCH 6.650 ANCHORAGE. ALASKA 99502 TELE,NONE 279.6606 NAME OF APPLICANT SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT PERMIT NO.lxnos?� MAILING ADDRESS c-• e, aq I nen% PHONE A � '-?9 INSTALLATION LOCATION LEGAL DESCRIPTION Z•f/ /e95 eoZ INSTALLATION OF: SEPTIC TANK ^v 7 SEEPAGE PIT DRAIN FIELD �1-. OTHER TYPE AND SIZE OF FACILITY TO BE SERVED J � ' ' "�Rm I }(�� FINANCED THROUGH 1-01 Pmt TO BE INSTALLED BY S's L� SOIL TEST RESULTS , _ NOTE, THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION, 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE 1 L- TYPE MINIMUM DISTANCES. REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT .2o DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL I / SEPTIC TANK SEEPAGE PIT �O DRAIN FIELD TO NEAREST LOT LINE, /� WELL TO SEPTIC TANK ` SEEPAGE PIT K " 0 / DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD SEPTIC TANK, a '�- SEEPAGE PIT io n ' DRAIN FIELD s� Z 3�Sr'f °"x AREA SIZE TYPE CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION S FEET INTO UNDISTURBED SOIL. N SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BAr•rvll I CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. HEALTH AU RITY O LICENSE ESIGNER 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE/�APPLICANT'S SIGNATURE DIAGRAM OF SYSTEM BOROUGH ORDINANCE NO. 20.66 AND THAT THE ABOVE k rR?P.TLR Ai:C'r' AP.EA. BORA :;ii ' ❑L'ALT!i Di'PAt.TY,E!+T 327 EA,,!.E £.TREET A::CNORA�E, AL SM 99501 Perfcrmed ror^ HjC16 'n- �rry Date LE:tal Descriptio, ot5 sock This Fcr-, Reports a. soils Lo" Depth __.eet Scll C: arlc-rristics 3 JCa�c? � Qv Lo 14 -in Rat, 6tt]<.1 wt{;,gRdepjk Has Ground Fater Encountered? ---Li i? Q. If Yes, At What :epth CASE 4 e Locaticn skprrh Frcposcd installaticn. 'Ec epage rit�/ Drain M T Depth Of Inlet � � Deptn o bottom Of Pit Or Tr Test ?er formd ' &_; ; 1 Data Certified BY' \ ; Date. r r ('1 n MUNICIPALITY OF ANCHORAGE d DEPARTMENT OF HEALTH b HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 x -122-X1)-18 Application Date Apa.Lt 5, 1988 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot. block, subdivision, section, township, range) Lot 105• Dawn Subdivi6.Lon Location (address or directions) (b) Property Owner Ata6ha Savxng6 Telephone: Home Mailing Address (c) Lending Institution GMAC Telephone Business Mailing Address (d) Real Estate Company and Agent RE/IMAX OF EAGLE RIVER - Vikginta Koh,S.Letd Address 16600 Cen#e)tAieCd DA,Lve Suite 201 Eaqte RiveA, Ataska 99577 Telephone 694-4200 (e) Mail the HAA to the followina address: or, Check here M, if hold for pick up. List contact person and day phone number below. S d S ENGINEERING1694-2979 17034 Eagte Rivet Loop Road, Suite 204 Eagte R.i.veA, Ataaka 99577 2. TYPE OF RESIDENCE Single -Family n Number of Bedrooms 4 3. WATER SUPPLY Individual Well ❑ Community ❑ Public b Note: If communitywell system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Q Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of.Environ mental Conservation attesting to the legality and status. Page 1 of 2 72-025 (R" SIM F. l PUG Pe,s Nyr szo-ZL Z to Z abed •Hiom s,jaaul6ua leuoissaloid ayl ul suolsslwo jo sjaia jol elglsuodsai lou sl 96ejogouy to AplediownVy ayl -panssl sl aleollluao a aiolaq elep azAleue jo suolloadsul lonpuoo lou op SHHO to saaAoldw3 •sluawajlnbaj alels pue Iejapa) uleuao Alslles of japio ul suollnigsul6ulpuelilayl pue sawoy 10 siaseyoind of Asaunoo a se slylsaop SHHO ayl'eNselyto alelS ayi ul pajalsdai iaaul6ua leuolssalad luepuadapul ue Aq anoge S ydeAcied ul uanl6 suolleluasaidai ayl uodn Aluo paseq saieollluao lenwddy (iuoylny ylleaH sanss! (SHHO) saowaS uewnH pue ylleaH to luawueda0 06eioyouy to Lllledlolunyy ay1 NOI1nVo lenwddy Ieuollpuo0 to swial IeuolllPuoO panaddesl0 -v -- panaddy 88-9Z _ aleo '7 Aq swoapaq �sol Panaddy o IVAOHddy SHHO '9 `�' 3cnl art :7•i.......^. Tv LLS66 e>Isely �Jen(b olBe3 ama ssajppy t�2Z suoydalal nNlavaNlnNg e $ S wnj 10 aweN ,uolloodsul slyl 10 alep ayi uo Ioago ul suolleln6ai pue'saoueulplo'sapoo a1eiS pue ledlolunyy lie yllm aouelldwoo ul sl walsAs lesodslp jalemalsem io/pue tlddns Jalem ails-uo ayl 'uogoadsul pue u01le6ps8nul Aw woal pue sal!1 eBeioyouy to AUledlownpy ayi woal . paulelgo uogewJolul ayl uo paseq leyl bpuaA malum I vlaiay paleolpul ainionils to adAj pue swoapaq to jagwnu ayi jol alenbape pue leuollounl'ales sl walsAs lesodslp ialemalsem io/pue Alddns Jalem alts-uo a41 legl smogs lenwddy Aluoylny ylleaH slyi to uolie6lisanul (w iegl AjU9A I'molaq umoys aleP uollePlleA ayi 10 se pue olaiay paxllle leas Attu Aq pallluao sy NOIIVWHOdNI CNV V1VC'HOHV3S 3lld'S1S31'SNOIlO3dSN1 °JNIOIAOHd WHId JNIH33NIJN3 'S muN1CIPALITY Of MORNUTHORITY APPROVAL (HAA) OF ANCHORAGE (MOA) Et�YIROtEM� CHECKLIST - FEBRUARY 1984 APR 2 5 1988 2644744 D Legal Description: 10� RECEIVE s A. WELL DATA Well Classification If A. B, C, D.E.C. Approved &N) Well Log Present (Y/N) Date Completed Yield Total Depth Cased to Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (VIN) Separation Distances from Well: 1 To Septic/Holding Tank on Lot Loo '� ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot �-©�) : On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by ; Date Water Sample Test Results Comments—— Lo P•�'S �Q 211sk31 B. SEPTIC/HGU1WG TANK DATA Date Installed LO -1-025 Size 11:5E' No. of Compartments Standpipes t?N) Y Air -tight Caps ON) !— Foundation CleanoutC DN) Depression over Tank (YdV lJ Date Last Pumped 4 Ih "- Pumping/Maintenance Contract on File (Y/N) ; for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Q Separation Distances from Septic/Hekding. Tank: 1 To Water -Supply Well � )-� To Building Foundation To, Property Line r. '� )'� To Disposal Field To Water jAain/Service Line `� + To Stream, Pond, Lake, or Major Drainage Course Comrnents'��SiPo��L� PageIof2 72-0261R" $10 F,Onl C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 1 S 1 '!!''!2- Type o1 System Design Date Installed --I e07 h --Ll Length of Field r Width of Field Depth of Field' �r Gravel Bed Thickness Square Feet of Absorption Area dg Standpipes Present (9N) V Depression over Field (Yo Date of Last Adequacy Test -88 Results of Last Adequacy Test Separation Distance from Absorption Field: 20 1- t To Water -Supply Well `� 5 To Property Line To Building Foundation 2� Lot �� t 4- ; On Adjoining Lots 1 — To Existing or Abandoned System on To Water Main/Service Line 1 :::> -r- To Cutbank (if present) P To Stream/Pond/Lake/or Major Drainage Course of l'4'- r To Driveway, Parking Area, or Vehicle Storage Area�- Comments D. LIFT STATION N 1 / Da tailed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) _ Comments Dimensions Manhole/Access (Y/N) - "Pump Off' Level at Check Permitted Bedroom Rating Against HAA Request •• " Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, orconformed toall MOA and IJAAguidelinesineffect onthe date ofthis inspection. SignedS & S EntG1NEERING Date L -- b' 034 Eagle Rivw Loop Road No. 204 Compa� C = - cv� 3 Eag a v , 99677 ` MOA No. Receipt No. O 7 U Date of Payment o2 ` �S Amount: $ - 1;76 d U -�- �2va-7% Page 2 of 2 72.026 (Rev a'661 BMF • n STEVE COIVPER, GOVERNOR F RUM DEPT. OF ENVIRONMENTA1, CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 563-6775 3601 C STREET, SUITE 1334 ANCHORAGE. ALASKA 99503 DATE: April 20. 1988 PWSID: 211431 To Whom It May Concern: According to the records on file in this office, the DAWN WATER COMPANY Water System is in compliance with the State of Alaska Drinkinq Water Regulations. Please note that departmental records indicate that the public water system was installed prior to the 1978 implementation of the Alaska Drinking Water Plan Review regulations. No as—built Plans have been reviewed or approved by the department, nor are any necessary. Since the system has submitted acceptable water samples on a regular basis and received a satisfactory sanitary survey evaluation by the department. the system is acceptable under the standards in effect at the time of installation. An official "Certificate to Operate" may be issued upon receiving a complete set of as—built plans. Any expansion of the water system after 1978 will require plan review and the issuance of a "Certificate of Operation" Permit. Sincerely. Ronald S. Klein Environmental Field Officer RSK/MPL:Pkk CC., Mike Lewis. ADEC. Anchorage