HomeMy WebLinkAboutEQUESTRIAN HEIGHTS BLK 2 LT 12Eqestri'oan Heights
Block 2
Lot 12
I Vw To -16M 0 LO
Municipality of Anchorage
On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP241317 PID Number: 017-092-66
Dwelling: ❑Q Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: X New ❑ Upgrade
Name
Hultquist Homes Inc
ABSORPTION FIELD
El Deep Trench ❑N Wide Trench ❑ Bed ❑ Mound
SiteAd
Address ddress
Equestrian Circle
❑ Other
Phone
Number cf Bedrooms
Soil Rating
depth from original grade
4
1.2 GPD/SF
JTotal
8.0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
4.0 Ft,
Gravel depth beneath pipe
4•0 Ft.
Subdivision Block Lot
Equestrian Heights 2 12
Fill added above original grade
0 Ft,
Gravel length
50.0 Ft.
Township Range Section
Gravel width
5.0 Ft.
Beds: Number of Lines
na
Distance between lines
na Ft.
SEPARATION
DISTANCES
To
Septic
Absorption
Lift Station
Holding Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank ! Line
500 Ft 2
1
na Ft.
Well
100'+
100'+ NA
NA j 25'+
TANK 0 Septic E:1S.T.E.P. ElHolding 1771Other
Manufacturer
Greer
Capacity
1250 Gal.
Surface Water
100'+
100'+ NA
NA
Material
Number of compartments
Lot Line
5'+
10'+ NA
NA j NA
plastic (deep bury)
2
Foundation
10'+
10'+ NA
NA j
LIFT STATION
Manufacturer
Capacity
Remarks
Gal.
Alarm location
Electrical installed by
Installer
PIPE MATERIAL House to tank 3034 Tank
drainfield 3034
Hultquist Homes
Drainfleld 3034 CO/MT 3034
Inspector PES
BENCH MARK (Assumed elevation) 100 ft
Inspeection
1s' 12/17/24 12/19/24
Location and description
2nd
ction
31d 12/20/24 411 1116/25
Top of adjacent deck
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Conditional Approval: Date
�•••.,
40
Septic Syste
wes4 s t es s••ss
annoma
C£19 -
Approved Date/-�
- 1. -
•*. ,•#
••.•,.,
L-
N :this proval does not include well permit requireme ts.
(Rev vb/UL/1ttrY
46 VACANT LOT
NO WELLS OR SEPTICS \
o m
w �
LOT 1 2 WELL (P) v
18A ' � .
ti 4 CONTOURS `I
DECK \ z
(ON DRIVEN PILES) U
17 I C2
M 2 8.0 ` NEW \
B 4BR 1 Z
I /ITH— I HOUSE DRIVEWAY O v
INSTALLED NEW GRAIN FIELD I �s.s
50LF x 5.0'W x 4.0'ED x 8.0' TD A � Z
INSTALLED CO & MT AT EACH END T 1
FC` DESIGN PARAMETERS
C1 T2I PRIMARY/ RESERVE SEPTIC SYSTEM
M1 INSTALLED NEW 1250go1 SEPTIC TANK NO. BEDROOM: 4(600 gpd)
DCO INSTALLED FC BEFORE & DCO AFTER TANK SIZE: 1250ga1 STEP
' `,.- -PERC RATE: <1 MPI
CONTRACTOR VERIFIED LOCATION RESERVE AREA (NIC) SOIL RATING: 1.2 GPD/SF
OF NEWLY DRILLED WELL ON CAT 111 AREA ROD: 500 SF
EQUESTRIAN HEIGHTS B2 L16 VACANT LOT SYS. TYPE: WIDE TRENCH 4.0'ED
PRIOR TO CONSTRUCTION NO WELLS OR SEPTICS RF: 0.50
—_ MIN LENGTH: 50.0 LF
o
0
A
B
FC
1.7
w O o
�0
16.2
m m
T2
z
40.9
DCO
23.1
42.0
U
o U
z
o O z
36.153.2
7 G
97.0-
C2
w
U
z z w
O O
0 o U
M2
44.1
30.9
EG/FG: 94.4
TH-1
FILTER FABRIC
OR -1.0
DRAIN ROCK 6" ABOVE PIPE INV
GM/
4" 0 DRAIN PIPE
SM
- -
.._..
9
9 ,
-90.4
-3.5
12SOG GREE
POLVTANK
4.0' SEWER ROCK
86.41
-86.4
SP
PROFILE SCALE: NTS
80.4 "-1
(DRY 9/17/24)
DATE PERFORMED:
9/10/2024
USED:
50LF x 5.0'W x 4.0'E.D. x 8.0'TD
TOTAL AREA: 500 SF
RECORD DRAWING
THIS RECORD DRAWING REPRESENTS THE
AS—BUILT CONDITION OF THE PROPERTY
IMPROVEMENTS DESCRIBED ABOVE.
THE DRAWING AND ANY OTHER SUBSEQUENT
ATTACHED OR INCLUDED INFORMATION IS
BASED ON PERIODIC VISUAL OBSERVATION
BY A REPRESENTATIVE OF PES ALONG WITH
NOTES, PHOTOS, AND OTHER INFORMATION
PROVIDED BY THE INSTALLER OF THE
SYSTEM.
THE INFORMATION PROVIDED IN THE RECORD
DRAWING APPEARS REASONABLE AND
REPRESENTS THAT THE PROJECT WAS
DESIGNED AND CONSTRUCTED IN GENERAL
CONFORMANCE OF 18 AAC 72, THE ADEC
ONSITE WASTEWATER SYSTEM INSTALLATION
MANUAL, AND AMC 15.65 WHERE
APPLICABLE. PES SHALL NOT BE HELD
LIABLE FOR SYSTEM DEFICIENCIES WHICH
FALL OUTSIDE THE SCOPE OF THE REQUIRED
VISUAL OBSERVATIONS OR SUBSEQUENT
OBSERVATIONS IF REQUESTED BY THE
INSTALLER. SEPTIC SYSTEM INSTALLERS ARE
TRAINED AND APPROVED BY THE
MUNICIPALITY OF ANCHORAGE AND OR ADEC
AS APPLICABLE. INSTALLERS ARE
RESPONSIBLE FOR CONSTRUCTING THE
SEPTIC SYSTEM AS DESIGNED AND ENSURING
THEIR WORK CONFORMS TO THE CODES AND
POLICIES STATED ABOVE.
NOTES: PANNONE ENG SVC, LLC .... 9
Date
RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 p'�'• S ae2o25
PHONE (907) 272-8218 FAX (907) 272-8211 "y
...... ....... P.I.D. NO
DRAWN BY: DRM EQUESTRIAN HEIGHTS, BLOCK 2, LOT 12 017-092-66
HULTQUIST HOMES INC �ie,3eCE ►ron anrio�e PERMIT NO.
14274 EQUESTRIAN CIRCLE 814 OSP241317
PLAN ANCHORAGE, AK j Sheet
2 OF 2
A
B
FC
1.7
T1
16.2
38.9
T2
20.2
40.9
DCO
23.1
42.0
C 1
39.2
55.6
M 1
36.153.2
C2
43.1
29.1
M2
44.1
30.9
PROFILE SCALE: NTS
80.4 "-1
(DRY 9/17/24)
DATE PERFORMED:
9/10/2024
USED:
50LF x 5.0'W x 4.0'E.D. x 8.0'TD
TOTAL AREA: 500 SF
RECORD DRAWING
THIS RECORD DRAWING REPRESENTS THE
AS—BUILT CONDITION OF THE PROPERTY
IMPROVEMENTS DESCRIBED ABOVE.
THE DRAWING AND ANY OTHER SUBSEQUENT
ATTACHED OR INCLUDED INFORMATION IS
BASED ON PERIODIC VISUAL OBSERVATION
BY A REPRESENTATIVE OF PES ALONG WITH
NOTES, PHOTOS, AND OTHER INFORMATION
PROVIDED BY THE INSTALLER OF THE
SYSTEM.
THE INFORMATION PROVIDED IN THE RECORD
DRAWING APPEARS REASONABLE AND
REPRESENTS THAT THE PROJECT WAS
DESIGNED AND CONSTRUCTED IN GENERAL
CONFORMANCE OF 18 AAC 72, THE ADEC
ONSITE WASTEWATER SYSTEM INSTALLATION
MANUAL, AND AMC 15.65 WHERE
APPLICABLE. PES SHALL NOT BE HELD
LIABLE FOR SYSTEM DEFICIENCIES WHICH
FALL OUTSIDE THE SCOPE OF THE REQUIRED
VISUAL OBSERVATIONS OR SUBSEQUENT
OBSERVATIONS IF REQUESTED BY THE
INSTALLER. SEPTIC SYSTEM INSTALLERS ARE
TRAINED AND APPROVED BY THE
MUNICIPALITY OF ANCHORAGE AND OR ADEC
AS APPLICABLE. INSTALLERS ARE
RESPONSIBLE FOR CONSTRUCTING THE
SEPTIC SYSTEM AS DESIGNED AND ENSURING
THEIR WORK CONFORMS TO THE CODES AND
POLICIES STATED ABOVE.
NOTES: PANNONE ENG SVC, LLC .... 9
Date
RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 p'�'• S ae2o25
PHONE (907) 272-8218 FAX (907) 272-8211 "y
...... ....... P.I.D. NO
DRAWN BY: DRM EQUESTRIAN HEIGHTS, BLOCK 2, LOT 12 017-092-66
HULTQUIST HOMES INC �ie,3eCE ►ron anrio�e PERMIT NO.
14274 EQUESTRIAN CIRCLE 814 OSP241317
PLAN ANCHORAGE, AK j Sheet
2 OF 2
www.sullivanwaterwells.com
Pump Installation Log
Well Drilling Permit Number: OSP 241317 Date of Issue 9/20/24
Parcel Identification Number: 01709266000
Legal Description Property Owner Name & Address
Equestrian Heights BLK 2 LT 12 Hultquist Homes
14274 Equestrian Circle
Anchorage, AK 99516
Pump Installation Date:
12/26/24
Pump Intake Depth Below Top of Well Casing:
352 feet
Pump manufacturer’s Name:
Grundfos
Pump Model:
10SQE15-330
Pump Size:
1.5 hp
Pitless Adapter Burial Depth:
10 feet
Pitless Adapter Installer:
Pitless Manufacturer:
Disinfected Upon Completion?
yes no
Method of Disinfection:
Chlorine 50 PPM
Comments:
Pump Installers Name:
Sullivan Water Wells
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
Merrill.
Unknown
Certified Drilling Log
OWNER OF LAND: Hultquist Homes
ADDRESS: 14274 Equestrian Circle Anchorage, AK 99516
LEGAL DESCRIPTION Equestrian Heights B2 LT 12
DATE: 10/1/24
PERMIT NUMBER: OSP241317 DATE OF ISSUE: 9/20/24
TAX IDENTIFICATION NUMBER 01709266000
Is well located at approved permit location: Yes No
Method of Drilling: air rotary cable tool
Depth of Well: 420’
Casing Type: Steel Wall thickness .250 inches
Diameter: 6 inches, depth 124 feet
Liner type 320’ of 4.5” PVC
Static Water Level: 74 feet
Recovery Rate 2 gpm gph
Method of Testing Air
Well Intake Opening Type: open end open hole
Screened Start feet Stopped
Perforations Start feet Stopped
Grout Type: Bentonite Volume: 50 Lbs.
Depth: from 2 feet, to 42 feet
Well Disinfected Upon Completion: yes no
Method of Disinfection: Chlorine 50 PPM
Comments:
Bore Hole Data
Depth
From To
0 2 Casing Stickup
2 4 Overburden
4 29 Silty sand and gravel
29 57 Silt and sand with some gravel
57 77 Silty sand and gravel wet
77 101 Clay and gravel
101 105 Clay, silt and gravel, water
105 110 Clay
110 129 Broken bedrock
129 269 Bedrock gray with quartz seams
269 390 Bedrock soft
390 402 Bedrock gray, hard
402 420 Bedrock soft
Drillers Name: Cole Sullivan
ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority.
Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation.
MatSu Borough: Department of Environmental Conservation.
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Water & Wastewater System Permit
Permit Number: OSP241317
Work Type: WellSeptic Initial
Tax Code Number: 01709266000
Site Legal Address: EQUESTRIAN HEIGHTS BLK 2 LT 12 G:3038
Site Mailing Address: 14274 EQUESTRIAN CIR, Anchorage
Owner: DIME DEVELOPERS LLC
Design Engineer: PANNONE ENGINEERING SERVICES
This permit is for the construction of:
Effective Date
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
�o
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,
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,
t)cl>artnr�nt
9/20/2024
9/20/2025
22262
0 Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Q Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
-R e (jad 3y:
Issued By: G(/
Date:
Date: 20 2
4
MUNICIPALITY OF
Community Development Department
Development Services Division
On -Site Water & Wastewater Program
ANCHORAGE JR L)5 "
Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 017-092-66
Property owner(s) Hultquist Homes Inc Day phone
Mailing address 12570 Old Seward Highway Anchorage, AK
Site address NHN Equestrian Circle
Legal description (Sub'd., Block & Lot) Equestrian Heights B2 L12
Legal description (Township, Range & Section)
Lot Size - 22,262 —Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(N all that apply)
Absorption Field fx] Initial Ed Single Family (SF) nx
(w/wo AD U)
Septic Tank Qx Upgrade
Duplex (D) ❑
Holding Tank ❑ Renewal
Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well nx
Water Storage n
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: -/312 Waiver Fees:
Date of Payment:
Receipt Number:
Permit No. 0-5 P ?,-(1317
Permit App_'-'- :• :-'.,:c -
Date of Payment:
Receipt Number:
Waiver No.
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steve@panengak.com
Mailing: P.O.Box 1807, Palmer, AK 99645
Telephone: (907) 745-8200 FAX: (907) 745-8201
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, Alaska
Subject: Equestrian Heights B2 L12
Well and Septic System Permit Request
This is a design narrative for a permit to install an initial well and septic system on the subject property. The systems
will serve a proposed four (4) bedroom house. This lot and surrounding lots are served by private wells. Currently
there are no wells within 100ft of the proposed installation.
1. Soils: A test hole were performed on this lot by Pannone Engineering Services, LLC on 09/10/2024. The soils log
is attached, and approximate locations are shown on the site plan. Groundwater was not observed during the
excavation of the test hole, and bedrock was not encountered. Groundwater was not observed in the test hole
monitor tube after 7-days. Based on the results of the percolation test, overall soils appearance, and the
attached sieve analysis an application rate of 1.2 gpd/SF was used for the design of a conventional wastewater
treatment system in the area of the test hole.
2. Soil Absorption System Design: See Sheet 1 of the design package.
3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field.
4. Topography: See attached site plan for area topography.
5. Drawing Markings: The Drawings are marked “For MOA Review Only”. When written notification that the
review is complete and no further comments are received from MoA On-Site Department, the note will be removed
and “For Construction” drawings will be issued.
The proposed installation will not affect the future development of this or the surrounding lots.
If you have any questions or concerns, please contact me at (907) 745-8200.
Sincerely,
SRP
Steven R. Pannone, P.E. F. ASCE
Owner/Civil Engineer
11 September 2024
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241317, Deb Wockenfuss, 09/20/24
PA
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Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241317, Deb Wockenfuss, 09/20/24
PA
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2.2. SCOPE OF WORK: INSTALL SYSTEM IN ACCORDANCE WITH THE ATTACHED DESIGN AND SPECIFICATIONS.
14 FEET
14 FEET
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241317, Deb Wockenfuss, 09/20/24
PA
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COMMENTS: Test hole excavated by HULTQUIST HOMES.
PERFORMED BY: PANNONE ENGINEERING SERVICES, LLC. I CERTIFY THAT THIS TEST
WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN
EFFECT ON THE DATE OF THIS TEST.
·<1.0 (min/inch)
·6"
·4 FT AND 5 FT
SOILS LOG & PERCOLATION TEST
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241317, Deb Wockenfuss, 09/20/24
040.002 Crowther Associates
1632 Bellevue Circle / Anchorage, Alaska 99515
Telephone (907) 349-2198 / E mail: 907crowther@gmail.com
Date:
Client:
Project:
September 16, 2024
Pannone Engineering Services, Dan
Equestrian Heights, Block 2, Lots 8 and 12
Anchorage, Alaska
Particle Size Distribution Table
(percent passing subject sieve size)
Sample Source Lot 12 Lot 8
Moisture
Content
3.3%2.2
Sieve Size Percent Finer Percent Finer Percent Finer Percent Finer
3 inch 100 100
1-1/2 inch 100 100
¾ inch 100 87
#4 82 58
#10 38 45
#40 8 9
#100 5 3
#200 5 1
0.02 mm xx xx
Classification Gravelly Sand
(SP)
Gravelly Sand
(SP)
Invoice 223
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241317, Deb Wockenfuss, 09/20/24
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: (907)343-7904
On -Site Water & Wastewater Section Fax: (907)343-7997
Parcel ID 017 -092-66
Certificate of On -Site Systems Approval
OSC251159
Expiration Date: 4/24/2026
Legal description EQUESTRIAN HEIGHTS BLK 2 LT 12
Site address 14274 EQUESTRIAN CIR
Current property owner(s) HULTQUIST HOMES INC
X The On-site system(s) is/are approved for 4 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
No comments
M
Original Certificate Date:
6/11/2025
This ertificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
s em(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage,
evelopment Service 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 submittal.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
MUNICIPALITY OF ANCHORAGE
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. 01709266000
Complete legal description Equestrian Heights B2 L12
Location (site address)
14247 Equestrian
Current property owner(s) Hultquist Homes, Inc
2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS
Day phone
3. TYPE OF WATER SUPPLY: FNI Private Well serving k-1— dwelling units
0 Other Non-public well as regulated by MOA 171 Water Storage
F-1 Community Well or Public
4. TYPE OF WASTEWATER DISPOSAL: � Private Septic R Private Septic serving 2 dwelling units
F1 Holding Tank R Community Septic or Public Sewer
5. SEPTIC TANK: [-] Steel RN Plastic R Concrete R Fiberglass
Age new - See advisory if steel or fiberglass older than 20 years
6. ABSORPTION FIELD: EJ AWWTS E] Bed R Deep Trench X Wide Trench R Seepage Pit
Waiver request for:
Expedited review requested: R
Distance:
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 $ '� Waiver Fee $
Date of Payment -2 & Date of Payment
COSA # 5 J 5 Waiver #
COSA Application—Apr2025.doc
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.
In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in
accordance with ADEC & MOA guidelines and regulations. The reported results describe the performance of the system
under the conditions encountered at the time of the test, and separation distances measured to readily identifiable
features. The operational life of all wells and septic systems depend on the local soil 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 this system. All systems eventually fail, and satisfactory test results do not guarantee future
performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore, we
cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this
report is for the sole benefit of the owner listed above.
Name of Firm
Phone
Engineer’s Printed Name
Date
Asbuilt
Land Surveying
Land Development Consultants
Subdivision Specialists
Construction Surveying
AEC# 173042
S4
Group
124 E 7th Avenue
Anchorage, Alaska 99501
(907) 306-8104
mail@S4AK.com
Lot 12, Block 2,
Equestrian Heights Subdivision
1/29/2025