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HomeMy WebLinkAboutSEIDLER #1 BLK 3 LT 2Onsite File #050-131-43 (Rev 05/02/18) Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191343 PID Number: 05013143 Dwelling: ❑■ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑■ Upgrade Name Sutherland Donald ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 11835 Birch Hills Drive ❑t Other Phone Number of Bedrooms Soil Rating Total depth from original grade 240-6215 4 5 GPD/SF 4 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade --- - --- - - -_ -- - -- ---2— Ft. Gravel depth beneath pipe - - -- -_ - 2 --__--Ft. Subdivision - - - Block- - -Lot- - -- Seidler #1 3 2 Fill added above original grade 0.5 Ft. Gravel length 30 Ft. Township Range Section Gravel width 3 Ft. Beds: Number of Lines - Distance between lines - Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 120 Ftz 1 Ft. Well 100'+ 100'+ 100'+ na 25'+ TANK ❑ Septic ❑ S.T.E.P. ❑ Holding [9 Other Manufacturer Capacity Advantex-Anchorage Tank 1500 Gal. Surface Water 100'+ 100'+ 100'} na Material Fiberglass Number of compartments 2 Lot Line 5'+ 104 5'+ na NA Foundation 10'+ 10'+ 10'+ na LIFT STATION Manufacturer Anchorage Tank Capacity 500 Gal. Remarks Advantex protected by bollards. Alarm location Electrical installed by Side Of House Rising Son PIPE MATERIAL House to tank Tank to PV G drainfield $GEF Q Installer � d Dean Drainfel CO/MT&yG3114 Inspector North Rim Eng. BENCH MARK (Assumed elevation) 100 ft Inspection 1st 10/18/19 10/18/19 Location and description dates: 2"d Garage Slab 3d 10/24/16 4th ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer:s. Stamp,. Conditional Approval: Date 0 11 W. Septic System ApprovedDate -� P�OFESSIU>>� �r Note: this approval doe not include well permit requirements.*'�''�'" tl1 (Rev 05/02/18) AS -BUILT MEASUREMENTS A B T1 31 31 T2 39 41 LS 37 41 MT1 27 41 MT2 50 60 Devils End Drive 20' Utility Easement Q poi 001. L /�i�AP ISS Ne Tre ch vl New 1500 Gallon Advantex/AX-20 Pod ,`Z0 Decommissioned Old 1j� M�1 Septic Tank/Trench / PER UPC R1 041- 0. q1- `2 5 Bolla ds Lot 4 Well>100' I ILot 3 Septic 1 � I Lot 4 . fes --�,.� N NORTHRIM +���.°F. `h SEIDLER #1 1 = 40 I ENGINEERING 9. ; * :4sm *'; BLOCK 3 LOT 2 RECORD SteveEn com PO Box 770724„ M; LAY ❑ U T �cc-a . " Eagle River, Alaska 99577 WASTEWATER 907-694-702$ ADVANTEX/TRENCH �t10/25/19 2 of 3 0 L -N o d N N D) 0 d u E -W L L I L.� O �LO QJ s U (lJ n u >J;i d 475 — N IW - - -Z --- - - - (U-- — N - - -- - i -0- s— u u W c� -aj � J U D to N p -Q W J of pq Q, as a in n, V) GN u � A cru C) o cdl c c +O O 0 d @1 �o - o uo!�n4S �J!� d o :3 u d> a', `� 0 `n, 3 g d v i, � w w d Liau W W w o 0, o J d w d W W n>, (] z Q °i z Q!� ! W Q w W W W � m co W W M D -- Z o � Q!� 0 c o +' I I N OLL-O j i ; W LLJ W Q(� CD XICD Lai - o b +++ �wwwww��'• d N � h o � d n WWW xQ x O(� > m o o ZW� aQ W S❑ILS LOG - PERC❑LATI❑N TEST CRTH 1 M ENGINEERING Perf ormed For; Owner Date Performed: 10/10/19 Legal Description: Seidler #1 B3 L2 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10 - 11 - 12 - 13 - 14 - 15 - 16 - 17 - 18 - 19 - 20 - 21 - DEPTH (FEET) TA Location: See Attached Test Organic - - - - - --- - ----- �;.; Boring Location Map SP Sand W/ Groundwater? No Depth -- Gravel Water Depth After Monitorino,none Date) 10/18/19 Refusal # Date Gross Time Net Time Depth Net Drop 1 10/10 0 -- 6" -- 2 10/10 10 10 min, 2" 4 3 10/10 10 -- 6° -- 4 10/10 20 10 min, 2" 4" 5 10/10 20 -- 6" -- 6 10/10 30 10 min. 2" 4" 7 10/10 30 -- 6# -- 8 10/10 40 10 min, 2" 4" 9 10/10 40 -- 6" -- 10 10/10 50 10 min. 2" 4" 11 10/10 50 -- 6" -- 12 10/10 60 10 min. 2" 4" Percolation Rate 2,5 min/in Perc Hole Diameter 6" Test Run Between 3' & 4' Comments; Measured To The Nearest 1/16 Performed By NorthRim Eng, I Performed in Accordance eith ON THIS DATE, DATE: Mik, 7'hl N OR THRIM ENGINEERING Ste veEng. com PO Box 770724 Eagle River, Alaska 99577 907.694.7028 CERTIFY THAT THIS TEST WAS I State/Municipal Guidelines in Effect SEIDLER #1 BLOCK 3 LOT 2 TESTH❑LE LOG GE❑TECHNICAL TH 10/24/19 11 Rising Son Electric Services LLC. 4 36784 Eklutna Lake Rd. Chugiak, AK 99567 1f (907) 622-6777 4 -- -- — October_z4,-zo19---- -- -- ------ ---- Re: 11835 Birch Hills Dr. Eagle River, AK 99577 Two whom it may concern: The lift station at the above referenced address has been wired in accordance with NEC and State/Local codes and is wired to the manufactures standards. Please contact Dakota Keller with Rising Son Electric Services LLC with any questions or concerns at (907) 622-6777. Thank you for your business. Sincerely, Dakota Keller, Owner Administrator License Number 2o65 Specialty Contractor license Number 38497 (907) 622-6777 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP191343 Work Type: Septic Upgrade Tax Code Number: 05013143000 Site Legal Address: SEIDLER #1 BLK 3 LT 2 G:0253 Site Mailing Address: 11835 BIRCH HILLS DR, Eagle River Owner: SUTHERLAND DONALD A & Design Engineer: NORTH RIM ENGINEERING This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date Expiration Date: 9� n n Departrneizt 8/14/2019 8/13/2020 Lot Size in Sq Ft: 39746 Total Bedrooms: ❑ 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 l� Special Provisions: A test hole shall be provided prior to construction of the drainfield to confirm separation to groundwater and percolation rate of the accepting soil. A 7 -day groundwater reading shall be taken and recorded, but construction may proceed at your own risk prior to the 7 days. If results require a design change, construction shall stop pending Onsite review and approval of a change order. Please submit results with the inspection report (or change order, if required). Ldp 1 be.Sic�r� J,0_ti" e' � CL �-� - be �+raorrl Y�IJ�JTS based (D re S U, f5 o-� -k S+ V -)c) c� GAJ re�d`�t� 5+;11 needed. Received By: Issued By: HIC11CA, Ca,-L;Tj eA1111 Date: I c� Date: �` r MUNICIPALITY OF ANCHORAGE Development Services Department ` Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 050-131-43 Property owner(s) SIKORA KIRSTEN Day phone 907-761-9279 Mailing address 11835 Birch Hills Dr Site address same Legal description (Sub'd., Block & Lot) SEIDLER #1 BLK 3 LT 2 Legal description (Township, Range & Section) Lot Size 39,746 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field 111 Initial [ Single Family (SF) 0 (w/wo ADU) Septic Tank Upgrade 0 Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings [ Privy n (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. ( nature of property owner or authorized agent) Permit/Rush Fees: 545— Waiver Fees: Date of Payment: Y/57/9 Date of Payment: Receipt Number: �} G((o iggo Receipt Number: Permit No. 05P/ i3c6 Waiver No. G\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc \CRT H I M ENGINEERING SteveEng.com Steve Eng, PE, PH PO Box 770724, Eagle River AK 99577 907-694-7028 SteveEngPE@gmail.com cp 897071 Date: 8/3/19 Number of Pages: 0,011 To: MOA On-Site Services a AUG 0 2019 Subject: Seidler#1 Block 3 Lot 2 Septic System Upgrade �` of 6 9 L a The subject property has been served by a septic system for a number of years.The septic tank is to be decommissioned and a new STEP Tank/trench installed. The design calls for a new 32' long trench with new 1250 gallon STEP tank. The entire subdivision is on private wells and septic systems. The terrain slopes northeast to southwest. A previous soil test is used for design. This 16'test pit did not have a perk test. However review of all the surrounding lots show the most favorable perk rate. An additional perk test can be performed at construction if required. Please review the wastewater system design for the existing home. I have included design plans& specs, design guidelines, & soil tests. If there is need for additional information or clarification please give me a call. Thanks-Ste ENGINEERING SteveEng.com Seidler #1 Block 3 Lot 2 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is an existing 4 -bedroom, single family home. The septic system is failing. The owner wants to upgrade the system to a Category III Advantex/Lift Station. A design is submitted for a new trench & new Advantex. The neighboring lots are developed as indicated in the drawing. New test hole being used- no groundwater. A 4' trench will be excavated. The easements are located on the drawing and are not encroached upon. A Category III application rate of 5 GPD/FT2. Trench Length = 120 FT2/2' x 2 = 30'; 1 line @ 30'. Refusal was encountered @ 8'. Old trench/tank to be decommissioned per UPC. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Connect New Trench To Advantex. Watertight couplings on inlet & outlet • 5' minimum between the tank and trench. 10' to property lines. • 3' of cover is required for trench or add insulation board. • Solid pipe must be set on well compacted, stable soil • 4' of cover or insulation is required for tank; an equivalent of 1" insulation for 1' foot soil cover. Tank & solid pipe must be set on well compacted, stable soil. • 4" diameter cleanouts with airtight caps are required 1' to 4' from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10' from the tank positioned to provide cleanout access towards the tank and towards the absorption field. • All cleanouts must extend to at least ground level. • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. • Force main to be 1.25" Schedule 40 PVC or equal. • Distribution pipe to be 1.25" Schedule 40 PVC w/ 1/8" orifice @ 24" on -center. • Trench to be placed level, minimum of 4' to groundwater, 4' to bedrock from drain -rock • Drain rock to be V2 inch to 2 inch screened. Drain rock to be distributed uniformly throughout the trench. • Silt barrier (filter fabric) to be installed above the drain rock • Smeared trench sides must be raked or scarified before drain rock placement • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, PVC Schedule 40. • Sewer Service Line is minimum 2% slope • Septic Tank to be pumped every two years or when required 44 .� 1�✓J� '.," 4'"�`'� 'i'r� af. ate{'. �.i � rw A yyJ} r. 4 S o P� 5 Rol DESIGN NOTES: ' \0 0--- 1 1. New Trench Depth At 4' Deep. 2. 1.25" Schedule 40 PVC Force Main. 3. 3' Cover Or Insulate Force Main. 4. Lots Served by Private/Public Water Wells. 5. No Conflicts Within 200'. 6. Check Well/Line Separation Prior To Construction. 7. Advantex Tank NOT Under Driveway. 8. Decommission Existing Tank/Trench Per UPC. 9. Drainfield Mound Slopes Maximum 3:1, To Be Top—Soiled/Seeded. / P Devils End Drive 20' Utility Easement ?0 ISy lopP 1Si / S(�pP Ne Tre ch Qt h MT THp ISy / �L Q lat Slope Lot 4 Well>100' joy NOR THRIM ENGINEERING SteveEng. com PO Box 770724 'ogle River, Alaska 99577 907-694— 7028 New 1500 Gallon Advantex/AX-20 Pod Decommission Old Septic Tank/Trench PER UPC R10a 'Septic i � Slew Eng cE-0256'• 10!1'4/14' Well 0 Lot 3 Lot 4 1" = 40' DESIGN LAYOUT 10/14/19 12 of 3 L +' 4 Lam. 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U_ Q �rCL LD LTJ C. 4c: n �Z 0 Nrn h o LU �Z W xQ OZ O 0 0� rn �W O � a W S❑ILS LOG - PERC❑LATI❑N TEST CRTH� I M ENGINEERING Performed For: Owner Date Performed: 10/10/19 Legal Description; Seidler #1 B3 L2 DEPTH (FEET) 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10 - 11 - 12 - 13 - 14 - 15 - 16 - 17 - 18 - 19 - 20 - TA Location: See Attached Test Organic Boring Location Map SP Sand W/ Groundwater? No Depth -- Gravel Water Depth After Monitorino,none Date: 10/14/19 Refusal # Date Gross Time Net Time Depth Net Drop 1 10/10 0 -- 6" -- 2 10/10 10 10 min. 2" 4 3 10/10 10 -- 6// -- 4 10/10 20 10 min, 2" 4" 5 10/10 20 -- 6" -- 6 10/10 30 10 min, 2" 4" 7 10/10 30 -- 6// -- 8 10/10 40 10 min, 2" 4" 9 10/10 40 -- 6" -- 10 10/10 50 10 min, 2" 4" 11 10/10 50 -- 6" -- 12 10/10 60 10 min. 2" 4" 21 - ' ' Percolation Rate 2,5 min/in Perc Hole Diameter 6" Test Run Between 3' & 4' Comments: Measured To The Nearest 1/16 Performed By NorthRim Eng, I CERTIFY THAT THIS TEST WAS Performed in Accordan e ith All State/Municipal Guidelines in Effect ON THIS DATE, DATE: G / NORTHRIM ,-A OFM�� ENGINEERING ,�P���+, SEIDLER #1 TH f* 4s BLOCK 3 LOT 2 SteveEng. com ,j PO Box 770724 ....I ... ... i Eagle River, Alaska 99577 t� � T E S T H❑ L E LOG i 907.694.7028 �f + pate. CrT ����� GE❑TECHNICAL 10/14/19 I1 PLOT PLAN .98• 30,p0 AS BUILT X DEVILS END DRIVE moo. �7 1 0= 1 LOT 1 �1 1 �1 11 JTILITY I 1 MENTS RADIUS r I r L;OT 4 � rr r SCALE 1" = 40' GRID NW 253 Project No. 11-010—JCL Lang & Associates, Inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 (907) 522-6476 Phone �oopppp Registered Land Surveyors (907) 522-4625 Fax alo OFA kglanglsOalaska.net / jclanglsOolaska.net Dv,``C�., <•9 4 I hereby certify that I have surveyed the following described property:. Lot 2, Block 3, SEIDLER SUBD. (Plat No. 71-294) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated this the Day of Alaska at Anchorage, It; is the responsibility of the owner to determine the existence r. -f any easements, covenant,. or renfrictinns which do not annear on the recorded Rubdivisinn nint. 49TH* ............................... i 70 01% G. LANG _ p LS -5202 �Fo Ci ,o NOS 4����FESSIONAI- �4 NAME MAILING ADDRESS LOCATION MUNICIPALITY OF ANCHORAGE '~. ,~,7~,,-.~/~,~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION {.¢T-//~'_-'? ENVIRONMENTAL ENGINEERING DIVISION ~. ,,-.~'~.~.~,~_~ 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NO. OFBEDROOMS Well Absorption area DwelHng ~(..~ ,, PERMIT NO. DISTANCE TO: / ! ~ ! / O*' Material Width No, of co~artments Manufacturer IF HOMEMADE; ~ Inside length DISTANCE TO; Well /~g Liquid depth PERMIT NO. Manufacturer Liquid capacity in gallons Foundation) / Total length of lines tMaterial Nearest Iot~,~l' / Trench width DISTANCE TO: Well Length of each line NO. of lines / Top of tile to finish grade Material beneath tile PERMIT NO. Distance between lines Total effective absorption area inches Length Width Depth PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distanco to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorpt on area(s) OTHER P~.ATER IALS SOIL TEST RATING ~,~.~ ~-~'~' INSTALLER REMARKS APPROVED 72-013 (Rev. 3/78) DATE LEGAL [:,EF'FIRT'MEN'I" Of FIEf:~L..-FI-~ RN[:, Ei'.,1VZ RCINME. NTFIL I-t40'T'ECT .T. Ol'.,i ,"E:~5 '" I_ ." E.:,TREET., FINFX:HL')RFZtEiE., FII<. 2. E;4,-472C~ C:o If'...~l ...... :~Z;; :E '"IF' EE: :~-~; ~: ~..4I [~E Ir~.". ii:::" lEE If;~':: IP"O ]E '"Il'" ( ? ,"]I 0 ~i; :1.. 2 I::1P P I... I C I:::1 hi 'T' L.I~) Cl:::l'r[' I 0 I",t LEX]iF:IL. R I CK MF:I'./ BiP. E:H HII_LS C,R I._2 E:]: SIEII)LER S,..'[:, GEN. L':,IEL. EFI6L. IE RIVER I_OT SIZE: ,!~;94 942;'!5 4X:'.~:.i~;O S[.;!UF:IF~:E FLEET "I"'¢F::'E OF SO I L. FII:":SORE:]' I ON S'-¢STEM :1: S: TRENCH I'"IF:I',,.,;IMUM I'.,IL.IMBER (.'iF:' [!:E[:,ROOi','IS = 4 SOIL. RF:I'TII'.,IG ,::5Q F'T,-."E:R)= 85 THE REQUIRE[:, SIZE OF THE SOIL FIBSORPTIOI'.,I S'¢STEM IS: THE L.ENG'TH [:, I MENS I ON I :F..; THE LENGTH ,:: I N FLEET .':, OF THE TI;iiENCH (:ir,.". DRFI II",IF:' I EL.E:,. THE [::,EF'TI4 OF FI TRENCH OR F:'IT IS THE D ISTRNE:E E:ET!.,~EEN THE SI..IRFF:ICE O1::' THE GROUI'.4[:, FII'.,![:, THE BOTTOM OF THE EXCla',,,'RTIOi'4 ,:: ]:.1'..I FEET). THERE IS i'.,IO SET P.II[:,TH FOR TRENCHES. THE GRFIVIEL. E:,EF'TH lei; THE MINIMUM DEPTH Eft::' GRF:I',,,'EL E:ETIqEEN THE OUTF'RL.L. P II:::'E FIN[:, THE BOTTOM OF THE Ei:O.]:FiVF:fFIOI'.,! ,::IN F'EET). F'ERM I T I':IPPL I I]:F'INT HFIS THE RE:SF'ONS I E: I L. t T'.r' TO I I",IF'ORM "I'H I S [.',EF'FIRTMENT [:,LIR I f'.,IG HI"HE I t",ISTFIL. LFIT :1:O1",1 I i'.,ISF'ECT I Of',l'.t:.-'; OF £':tN°¢ !.4EI_L.S FI[)JRCIENT TO 'T'H I S F:'R(:)F'FJ:RTY' FIND 'THE: f'.,ILIME:Ei'r~: O1:::' RESIDENCES TI-IFIT THE 1.4ELL !.,.IILL SERVE, ........................ *'IF* Il...! C:} ,:: ;;~.". b, ][ Pqt ~S F" E:Z C;: -IF' ][ CE, IPql ."ES ~::.':'-~ IF4;: E: [;:;: E:: (;::~ E_tl % ~;~] Ei: IE; ............................. BI:::IE:I.:::F' I I....L I I'.,IEi OF Ri'..l'-r' SYSTEM 141 TF'IOU]" F I I",IRL I NSI='EE:T I Otq FIN[::, F:IF'PROVFIL. E:V 'I'H I S DEI':'FII';;:TMENT t.41 l..I... BE SIJBJEC:T TO F'ROSEE:LIT 1 ON. M I N I MUM D I S"t"I::tNCE; 8ETI.,.IEEN I:l I,-IEI_I_ FIND RN"r' ON-E; I 'I"E ::/:;EWFtGE D I'."7, F'OSRL. 2;'.r'S'FEI'"I l S ::13.:)~2~ F:EET FOF;,' 8 F:'t:;..'IVFITE !.,.IELL..~ OR ::L50 TO 2OE~ FEET I:::'ROM I::1 F'UE:L..IC: NEL. L DEF'ENDING UF'ON THE 'T"¢F'I!E OF F:'I. JBI...IC 14EL. I .... OTHEI;?. [~'.EQIJ I F..'EMENTS I'"lR"r' F:IF'F'L'¢. SF'E::C I F I E:FIT IONS RI",I[::' COI",tEi;TIRUCT I ON [:' i FIGI:;::RI"IEi; I:::II:;:E FIVFI I LI::IE:LE TO I 1'4'.F.;LIRE PROPER I N:ii;TF:ILLFIT I ON. I I]:ERT I IC"r' THI::IT :1.: I Ftl,1 FF:IMILII::IR I".II]'rH THE RIEQLIIREMENT:':q; FI3F;~: O["t--~!;ITE SEI4ERS FII"ID NEL.t....S FIS SET FORTH B"r' THE: MLINICI PRL I T'T' OF::' FINC:HORRGE. 2.: I NII_L INSTFII.~.L THE :::i;'-r'E;TEM :IN FIC:C:ORI}I::INCE 14!"I'H 'THE CO[:'ES. ]:: I UNDERSTI::IND TFIRT THE ON-SITE :."."';EklER E;k"STIEM Mf:t'¢ F..'E[.;!LIII-;;:E ENL_FIF.'.C~EMENT IF 'THtii: RES I [:'ENCE I'.."'.!; REMODEl_E[:' TO I I",ICLI..II)E MORE THRN 4 BEE:'F::OOM'.:~;. O8 E GEO', CCHNICAL Er DEVEL~,?MENT Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 CO. Russell Oyster Earl Ellis 694~2774 SOIL LOG 688-2280 Soils 6t Foundations Lend Developmont Performed for: Legal Description: D_e, pth (feet) 0 So~ Char_a_cte_Fi st] c) 3 4 5~ 6~ 10~ 11~ 12~ 13 ~5 Ground Water Encountered: Yes If yes, whet depth.~ Proposed Installation: Seepage Ptt____ Drain Field..~~ Comments: :~/'~:'~- ~.~ MUNICIPALITY OF Development Services Department'" % On -Site Water & Wastewater Section Parcel I.D. 05013143 ANCHORAGE Certificate of On -Site Systems Approval Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: '09- Z C) 1. GENERAL INFORMATION /�=cr,r q e t o Seidler_#1_Block_3__Lot 2_ ___ 31' __-- -Complete=legal=description— Location (site address) 11835 Birch Hills Drive Current property owner(s) Donald Sutherland Day phone 240-6215 Mailing address San^C Real estate agent Owner Day phone 240-6215 X67897° 2. TYPE OF DWELLING: � � ti u '.7 17. 0 Single Family (w/wo ADU) J UH: � ❑ Duplex OCT *2019 D ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 � 5 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: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Waiver Fee $ Date of Payment IO�o�lI�1 Date of Payment Receipt Number vat J Receipt Number COSA # �� I S 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm NorthRim Eng. Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name 6. DSD SIGNATURE •... ,.. as •• System #1 Approved for bedrooms '; �stcv.n NE 6") System #2 Approved for bedrooms �� /��zS�►. Disapproved Steve Eng Date 10/25/19 -- Conditional approval for bedrooms, with the following stipulations: \G1PAL% �i�i i 2� O% 696 1 By: Original Certificate Date: The Municipality of Anchorage 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 Legal Description: Seidler #1 Block 3 Lot 2 Parcel ID: 05013143 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) Well production at time of test 2.5 gpm i Water storage tank volume 0 gallons Parcel ID: 05013143 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) Well production at time of test 2.5 gpm Date drilled 9127177 Water storage tank volume 0 gallons Total depth 109.5 ft Well disinfected for coliform test? ❑ Yes ❑ No Cased to 33-bdrk ft ❑ Coliform bacteria is Negative ❑ Sanitary seal is functioning correctly Nitrate 4.6 mg/L ❑ Nitrate less than MRL (ND) - --RE -Wires-are-properly- protected --------- —= --ug/L----❑-Arsenic-less-than-MRL--(ND) - Casing height (above ground) 18 in. Collected by NRimEng Date of flow test for COSA 7/11/19 Date of Sample 9/27/19 Static water level at beginning of test 21.9 ft. Comments Water ceased to flow when drawdown reached 70' B. TANK DATA Age of tank(s) new years Tank type/material Fiberglass Measured operating fluid level in septic tank new ❑ Standpipes/foundation cleanout per record drawing Date of pumping new D. ABSORPTION FIELD DATA New Which system tested (date installed) New ❑ ALL standpipes present per record drawing Total measured depth from grade 4.5 ft (max) Measured depth to pipe invert from grade 2.5 ft (min) ❑ N/A — pressurized field OR 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 Comments/Deficiencies: COSA Checklist yellow sheet C. LIFT STATION ❑ Required maintenance completed Age of lift station new years Lift station material Fiberglass Comments: Adequacy test date New Results Q Pass For 4 bedrooms Fluid depth prior to test 0 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 m E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Q✓ Yes Septic Tank/Lift Station on Lot > 100' ft Surface Water > 100' Community Sewer Manhole/Cleanout > 100' Property Line > 5' r, Yes if No ft M Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25'✓� Yes if No ft Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' M Yes if No ft Water Service Line > 10' Animal Containment > 50'✓Q Yes if No ft �✓ Yes if No ft ._.Manure/Animal-Excreta _Storage > 100', Community Sewer Main > 75' Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' Q✓ Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5' Yes Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' if No Yes if No ft Private Wells > 100'✓❑ Yes if No ft Water Main > 10' ft Yes if No ft Community Wells > 200' M Yes if No ft Water Service Line > 10' 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' Q✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' M✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100' Q Yes if No ft Water Service Line > 10' Q✓ Yes if No ft Community Wells > 200' El Yes if No ft Surface Water > 100' Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION / certify that 1 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. COSA Checklist yellow sheet MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this �`5 Day of CDC++ 40-\— of 20 0 , by and between Somo�t� S! rt- (�oni�e, herein the "OWNER," and the Municipality of - - - u � Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code - ---- (AMQ-15.65..365.-- In -consideration -of the -mutual covenants -contained -herein, the -parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as GtG(UCyhk,�a located at (legal description) De `ac e r 121 k V 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. M4 It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. at A Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give_ at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems_ Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 i OWNER: �'.. By: /'' li signature) dl` / 411, �©ye-VA SlL (print name) STATE OF ALASKA ss. Date: /0-�15-- /-/? THIRD JUDICIAL DISTRICT ) s)�� - --The foregoi � g -instrument - was - acknowledged before- me thi —day of -20 IC , by; 6HA) ,0 i Notary Public NOTARY PUBLIC FO ALASKA SHARON G. CRUZ My Commission expires: A/ �� State x Alaska JMy Commission Expires Sept . 1]2020 MUNICIPALITY: By: (signature) (print name) Date: Title: (rev. 05/18/2018) Page 3 of 3 OWNER: By: (signature) Date: I' /Z_ ) o NOV)t, ca- Bo uz s (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) �j The oregoing instrument�was acknowledged before me thi0�day of Zo, by- NOT�UB FOR LAS Notary Public SHARON G. CRUZ My Commission expires: G �lld� State of Alaska My Commission Expires sept . 1, 2020 MUNICIPALITY: By: (signature) (print name) Date:) c? —.2- 9 `l Z Title: (rev. 05/18/2018) Page 3 of 3 00, N 18'01'00"E 14.24' 0 0 co a c6 ,ri 20' UTILITY--\ EASEMENT Z LO C5 35,7 a �r 03. ` ® l SP P 1 1 l MANH TREATMENT l ..tet 1 ..POD GRAVEL DRNEWA) 1 t 2 IE r� l SEPT 1 WOODEN FENCE i Municipality of Anchorage. Development Services Department' Building Safety Division . On-Site Water and Wastewater Program 4700 South Bragaw St. P.0. Box 196650 'Anchorage, AK .99519-6650 www. cLanchorage.ak, us (907) 343-7904 CERTIFICATE OF 'HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING '1. GENERAE INFORMATION Complete legal description TJo t ,. Location (site address or directions) Expiration Date: c:~ ._ ~_ ~) /7~ 11835 :Birch Hills Dr. Current Property owner(s) Mailing address Lending agency .' Mailing address Marian May Trust Day phone c/o Kathi Olmstead Day phone .2. Real Estate Agent. Kathi Olmsl;e~d Day phone_6q4-&200 Mailing Address 16600 Centerf~le]d ]3r. RI~,_ 201 ~q~l~ ~v~,r_ Ag q9577 .,,, 'c*u'. ' - ' NUMBER OF BEDROOMS: 3 J TYPE OF WATER SUPPLY: · 'Individual Well Individual Water Storage ['-I .'~Community Class ~ Well 'D Public Water System I'-i TYPE OF WASTEWATER DISPOSAL: Individual On,site ~; Individual Holding tank [] Community On-site [-3 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 4 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 pdvate 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. 0 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 wast·water 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 wast·water disposal system is(are) in compliance with-all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Address 17034 N. Ea~;I,e River Loot) St:e. Engineer's Printed Name £obert C. Co,~an 5. DSD SIGNATURE L//' Approved for ~ "' Disapproved. . Conditional ;~ppro{,al for Phone 6q14-2q7q 204 EaFle River, AK 99577 Date 6-/2uSrY' 4 .,,((((((u(r(rrr,~ . ..~;..~.: ....... ".'....,,%.2~., ,~,t~.'¥'~'i' 0FA'~re-,. ~d~'.:.-' ' __/), -',,.:~:~'~., ,,.~ · ~-r~-m ~,ll", · I~l.~",'"'"-' ""'7' ............. ._.. ~__ ~ · ... . ¥¥/",O/L. VVn~.,.-,',. 9 -'L~?,,',''. '""' ..%_~ ~, ........... ~, ~ · . · .e,.--~ ",{. c0.;..'".~"~.,.~%',-,'. 2J~ .-'"',.1¥1 gl.-- .~'~, . . bedrOoi~,~ith~'folloWing stipulations: ' ' Additional Comments Note: The well for this property meets existing ~tate and Municipal (.;odes. 'I'ttere are nitrates present, it is suggested that periodic testing'be performed to insure the weiis continued suitability, Currcut uliraic CUllClClltratlOll' "is $.]7 mg/~; ,, E~A maximum cuuccuiraiiui~, ia iG.G .i.y~a." [',[ul ~ Attachments: HAA Checklist Septic System Advisory.:' ,. Well Flow Advisory By: Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: (Rev. 01/02) MunicipalitY of Anchorage Development Services Department Building Safety Division On-Site Water.& Wastewater Program 4700 South Bragaw St. 'P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us. (907) 343-7904 ?,,: . ; i .HEALTH AUTHORITY APPROVAL CHECKLIST- Legal Description,:.~ ! ~..-, "~ ~ 0 ,Tank ,Type/Material Foundation cteanout (Y/N) of pure' ping II ABSORPTION FIELD DATA - I'!l: '! .... - Date iqsta~e/~,-;I ¢'~' Soil Total idgpth'~ ,.. D' ft.~ .- Eft. Date bf Fluid )tion field Elaps Any .~juvenation treatment (past Final flu 12 re,o.,) Date instalh Clean0ut~ High water'al System t~l~e' O i. ;..ft. . Gravel below · ,.' L' ~ Ion,tor,ng tube, D~p ,/F~i, ., ;, ,, For%~bed~ooms :, I- ' : ~J. Newdepthj~'ln. ' . r,:;, [, · .' · . .:Wat~r~ added gal.~ ~; Absorptio~ '" ' ':' " ' rate >=~,~L~ ~.p.O. If ,Ye,S, ;~ive date D. LIFT STATION Date installed a/r~c "Pump on" level . Datum E, SEPARATION DISTANCES, Size in gallons Manhole/Access (Y/N) "pump off" level at ~ im High water alarm level at Cycles tested "' ' Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELl[ON LOT TO: Septic tank/li~ on lot' Absorption field on lot Public sewer main ' ~d/~/~t ~D~i adjacent lots I d:~O '!'~- On adjacent lots ~' O0 I .tU "Public sewer manhole/cleanout · Sewer '/septic Service line Holding tank SEPARATI0~ DISTANCES FROM sEPTIC/HOLDING TANK ON LOT TO: Building foundation '~ 4- Property line Water main ~.~~~)' ' Water service line , Wells on adjacent lotsI- f""P ' Abso~'ption 'field I0 · Surface water too 14.. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: , . Property line ' , 4- Building foundation 1 (~ I+_ Water main Water Service line I 0 I +, Surface water ' 't O0 _t + Driveway, parking/vehicle storage e:nadjac~nt lots ~¢~0 ~ ~. : F. COMMENTs "" ' ' ' " G. ENGINEERS CER~FI ' _ _ ' , . . .. . ., I ce~fy lhat I have determined through field inspections and review of Municipal records that the above systems are in ..~ ~ 2/ ~"',,~'2 ~. ' conformance-with MOA HAA guidelines in effect on this'date. ' . ~i ~/~,.~ ~%~ .::~,: Enaineer's Printed Name ~0 ~¢4~ C. Co~' Date " ': .... ' ' ' '~/~-/~ ' " 'f6'~_ ~Eu8801' ~(~' H~ee $ .:- '~.~ ~' , ,,.. ' .... ' ..... ,:-waiver Fees ¢~ Receipt Number RecffiRt~umber' 0'~ 2 ~ ~ I '-. ' (Rev. 12/01) -, .... meeemq ROBERT C. COWAN, RE. ROBERTA. SHAFER, RE. May 24, 2004 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUI~ES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ' ROAD DESIGN SOILTEST PE~TION TEST STRUCTURAL& INSPECTIONS oNsrrE WASTEWATER DISPOSAL SYSTEM DESIGN MUNICIPALITY OF ANCHORAGE Development Services Department · P.O. Box 196650 Anchorage, AK 99519-6650 REFERENCE: Lot 2; Block 3; Seidler Subdivision #1 Request you grant a waiver on the referenced property for the horizontal separation distance between the leachfield and the west property line at 0 feet. We do not anticipate any adverse effect on the adjacent property. If you require additional information, please contact us. Sincerely, RCC/ts 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 WR#: 040030 PID#: 050-131.43 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 w~v~v.ci.anchorage:ak.us (907) 343-7904 Waiver Review W;orksheet HA#: 040222 Permit~: Date Received: $12612004 Legal Description: Seidler #1 Block 3 Lot 2 Engineer: ,S & S Engineering 17034 Eaqle River Loop Road #204 Applicant: Marian May Trust Waiver Requested: 0 Foot Lot Line Waiver separation distance from Leachfield to Property Line Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Hodzontal Separation Waiver is Granted: ~ List Conditions or Reasons for above: Total: Waiver is not Granted: Rec#: 52791 Amount: $.175.00 Date Paid: $12612004 ! ~ereb~" cerfit,~ ttzLt, z have survb~,ed u,, ~oll;~na des~be An~omge R~o~ln~ Prec~ct, ~. nn~ t~t ~e Imorow men~ st[uated th~eon ~e .within the property lines ~nd ~ot.overlap.or en~osch on the p~perty lyln2 adjacent zo, that no lmpr~ements on ~roDerty lying a~scant en~oa~ on the ~remis~ in..qu~on and that ~e ere r~dw~s~ ~ansm~sion lin~ oF. othcr ~ible e~sements o s~d ~rope~ except ac Indicated hereon, : · . .Daie~ at F~e Rivor, Al~kn SC~: Regtst~d T,~nd Stt~eyor ~o 1" ~/~ ~ ~0~ ~6, Eagle Rlver, Al=skn , Phone (90~) DAI'E RECEIVED I---- ,NBPEOT, ON APPO,NTMENTB _ '~'-&a TIME TIME DATE DATE DATE ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION  825 LStreet-Anchorage, Alaska 99501 FEr3 1 0 1981 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720R E C E I V E D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please ollow ten (10) days for processing. PROPERTY RESIDENT (If different from above) ~ ~ PHONE 2. BUYER PHONE MAILING ADDRESS 3. L~NDIN~INgTITUTION ~ PHONE I MAILING ADDRESS 5. LEGAL DESCRIPTION (~ , STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS [] One E] Four '~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ~ Three [] Six E~ Other 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY *ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give ,well --,.d_,epth (attach log if available.) ~,, 8. SEWAGE DISPOSAL SYSTEM ~[~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS NSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVI DUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMtT NUMBER [] IN D I VI DUAL/ON -SIT E DATE INSTALLED E]PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [] Holding Tank Size: I~ ~"o If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER~'L~. TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line WELL TO: ~ ~- `% I Absorption Area to nearest Lot Line 5. COIVIMENTS I~/APPROVED FOR Z0i. BEDROOMS [] CO~NDITIONAL APPROVAL (letter must accompany certificate) DATE BY 72-010 (Rev. 6/79) ~,2.~ "L" ,:~ I hie [ /\hJC~IOI,AGE, ,~1_/~51~/:\ 99,501 (90'/} 2644111 August 14, 198]. Rick May % Virginia Kohl_field Re/Max of Eagle River, Inc. Posh Office Box 848 Eagle River, Alaska 99577 Subject: Lot 2 B]_ock 3 Seidler Subdivision Approval for the indiv.i.dual sewer and water faci].ities cannot be granted until tile following items have been completed: i,.-J (1.) The water analysis report .needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. Exposed electrical wires to /.he well head are J.n violation of the Municipality of Anchorage codes and must be encased in conduit and bur_~ed. (3 The cleanout to the septic tank needs to be repaired. The septic tank pumped with a receipt submitted ho this office. Please notify th:ks office for a reinspection when the noted descrepancies have been corrected. If there are any further questions, please call this office at 264-4'720. Sincerely, James S. Roberts Associate Environmental Specialist JSR/ljw