HomeMy WebLinkAboutRAMERT LT 2P,amert
Lot 2
#060-342-08
Municipality of Anchorage "
Development Services Department
O g
,
Building Safety Division
On-Site Water and Wastewater Program, 4700 S. Bragaw St
P.O. Box 196650 Anchorage, AK 995136650 Page I Of
www.chanchorage.akus (907) 343-7904
ONSITE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
1WASTEWATER
Permit Number: SW Q3Oa69' PID Number 0— 3`��—��j
Name: �/
>'' A ✓l B� Wastewater System: NdNew ❑Upgrade
Aeeresg--Og , 'Hidn Id on Ie IVB . 77 ABSORPTION FIELD
Phone: 52`2-670`9Number or Bedracnrs: 41
❑Deep TrerK'h Ksbtow Trdgh O Bed Q Ma,M ❑ Other.
LEGAL DESCRIPTION So"m V ,
®P V GPDiFlt
Total Depthlrpnodglndgraoe:
SFt.
Block: Lot: Subdivision: Depth to pgp Oodanfnromongthd
=
Gravel depth beneath PW
Q Ft.
Township: Range: Section: FJI Addeo above odgrl yade: /
j FI.
®6 FI.
Criv+
Well: ® New ❑ Upgrade d�"�
xan�e er,� Dlslana beav,eiri Ines:
�`
Ft.
Classification Pri,�vra°7i te, A, B, C): Total Depth: Cased to: Total absorption area: `yam^ ^�/
! C /00 Ft. o FL
11 Ft.
Phe Mah sok (�C, 'I. v /Q
45T/11 Q3
J / Fle
Dnller. Date Imtaller
Ileo: Slatm Water Level:
s„LL-iVR� 0))) 3 is FL tr c�ec6
Date lnatdYlQ
IO-f7-c3
Yield: Pump SH at /� Casing Height Above Grouts:
S GPM Uri MG Qq TANK
4' 1 FL FL
SEPARATION DISTANCES
Sep6c 11 Holding ❑ST.E.P. ❑Other.
To
From
Septic
Absorption
Field
Lift
Station
Holding
Tank
ublinPrivate ruanarawaer. Capaolr.
5^e1wrerune L7-i^L9/�ir12,-15 las(�ca.
well
/Taa�nk
�'
t i Materiel: ` (_oA' N ar Compartmen45:
TC-
"++ll ✓` C—
Surtax Water
LA—) y
(���
^�/{,.
/ y ) t
LIFT STATION
Lot Line
I� t
1
I a 1
e. ^zo
n rer. t 1
�,)6s P LSC
a() G�.
- 3�
Foundation
\
' a
_
\
�Xt
.� \
Pump on' level at
I'Lig in_
•Pump or level al Hi water alarm al:
fi I "
5-/,::) m. �7i-
Cunam Drain
x%11
�l/V/1
aMakeE �Moydqel�tt
I S+e'-X 4
in.
mcfri a mspecdon5 pertamiMby,
Remarks:
BENCH MARK
Loaaa and Oesrnpoa:
ry"I 0-(t
Smit
AssuQW0 Eievauon:
Of 17 60 Ft.
En'4
!z r 7AIN
wr ...........
r
ENGINEERING
Inspections performed by: 171134 EagleRivertoopRoad,MO 1st!U-/(,—®3
j
Engle Rim,:�;mk. 9957r
/.•
Developrin t Services Department Approval
ROBERT C. COWAN i �2
l� Zj,w
ed and approved
Review p by: Date:
Cj, • CE - 8601 �P
_ i
PERMIT NO. SW030266
PAGE 2 OF 3
Municipa(lt of Anchora e
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Ataska 99519-6650 • Telephone: 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL LOT 2, RAMERT S/D P.I.D. No. 060-342-08
------------------ ---------------
STONEHILL DRIVE
oR/�\�qY
41R M
USEO
4
NN rs'r�-1TH$tA `NEW TRENCHES
NEW 250 GALLON \-
S.T.E.P. BASIN
\ETON
SaLE. 1' = 50'
Wt
HILA A 7�
AND - ROAD
_ _ COWAN—
�,� ROBERT C. CN
— LL111'l1
�c�,:� CE -8801
PERMIT NO. SW030266 PAGE 3 OF 3
Muricipa(lty of Anchora e
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 O Anchorage, Alaska 99519-6650 6 Tele hone 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL LOT 2, RAMERT S/D P.I.D. NO. 060-342-08
FINAL GRADE
97 9,/ NEW 1250
GALLON 97 7'
SEPTIC TANK
MT2 MT4 MTl MT3
98.8, -\CO2 /- 99.2' 99.9'
(l / FINAL GRADE �C01 /-99,8'
.-2" INSULATION-,
96.9'-[ j SR DISTRIBUTION PIPE SR 97.9'
MT2 = 94.9 �MT4 = 94.9'
MT1 = 95.9-
A
\TOP
99.5'
C
Z'
INSULATED
2 INSULATION
-
12.0'
ST1
---EFFLUENT OUTLET
97 9,/ NEW 1250
GALLON 97 7'
SEPTIC TANK
MT2 MT4 MTl MT3
98.8, -\CO2 /- 99.2' 99.9'
(l / FINAL GRADE �C01 /-99,8'
.-2" INSULATION-,
96.9'-[ j SR DISTRIBUTION PIPE SR 97.9'
MT2 = 94.9 �MT4 = 94.9'
MT1 = 95.9-
A
NO WATER FOUND
83.11' B.O.H.
MT3 = 95.9
N. T. S.
A
B
C
FCO
50.5'
-
12.0'
ST1
47.0'
-
21.0'
ST2
46.0'
-
28.5'
CO3
46.0'
-
31.0
MH
46.0
-
32.5'
C01
74.0'-
76.0'
-
0O2
83.0'
75.0'
-
MT1
75.5'
77.0'
-
MT2
86.5'
78.5
-
MT3
25.5
49.0
-
MT4
33.0'
40.0
-
A
NO WATER FOUND
83.11' B.O.H.
MT3 = 95.9
N. T. S.
01/01/1999 00:01 6882259 SULLIVAN PAGE 01/01
Cerffffeb mritting -tog
by
Doc Co. dba
SULLIVAN WATER WELLS
P.O. BOX 670272, CHUGIAK, ALASKA 99687
OWNE13OF LAND• . f 3Q 1 &_ i L3'44_.
ADDRESS:
LEGAL DESCRIPTION: A✓+1 h e'' �'"" +CO�
DATE: r
PERMIT NUMBER: 0344R K Date of issueZ -92�3-e_13
TAX IDEtMRCATION NUMBER: 1266 -1 0
, 2 -- _r
�
Is well located at approved permit location? �S a No
Method of DnTI•mg fillrotary n Cable tool
Depth of well: j OO
Casing Type S ,5 ' 6L Wal Thickness a5� inches
Diameter (t I kt PXM depth 35> leek
Liner Type: y Ol le _P_ (fie- fS�
Cas{ng Stickup Above Ground: feet
Stalic Water Levet I d feet
Recover Rate:.—s—gpm
Method of Testing: At ,6L
Well Intake Opening Type O open end U open hole
Screened; , Start feet Stopped fleet
r���,,�,
!.i Perforations Start n feet %pped � feet
Grout Type: 13 �'„� f'o -4 I'M vol m/e
Depth: from feet, to o1 fJ feet
Well Dimfected Upon Completion? �es ❑ No
Method of Diisintection: _ CA& a AeAl'a S� PP✓n .
Comments:
A
02-095'f-jr, S-F1CIC j -R
up< to
mfr 1 CvF � i,&,f- Xe•
Drfller's
ATTENTION: It Is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality
)f Anchorage: Department of Health 8 Human Services and/or Department of Environmental Conservation. Matsu Borough:
)ePartment of Environmental Conservation.
05/07/2004 00:09 9076962135
FILE No.%9 05/M '04 16.47 ID.
MAY b 2004
ELEMUCAL WORK: LIFT STATION
RAMERT SUBmisiON LOT 2
COLBRY111111 1111 PAGE 02/02
FAX:190.73441245 PAGE 1
1, KURT LOVEJOY, PERFORMED THE FOLLOWING TASK.
CONTROL BOX MOUNTED ON HOUSE
CONNECTIONS WERE MADE AND TERMINATIONS LANDED BY ME
PUMP CONNECTION AND FLOAT CONNECTIONS WERE MADE BY ME
*Connections are temporary due to cable routing above ground. Connections wig have to
be broken and wires buried then reestablished to proper cozm bons. I WILL NOT BE
HELD RESPONSABLE for connections or burial of underground wiring once my
terminations are broken.
Best of my knowledge the lift station is functioning normal and works fine.
Journeyman
KURT LO Y
MUNICIPALITY OFANCHORAGE f a _ t7 - 3 E ��
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT
Initial
Permit Number:
SW030266
Legal Description ' ame ' o ` 1
Design Engineer:
0003 S & S Engineering
Owner Name:
Brian Bell
Owner Address:
5128A Hiland Road
Eagle River , AK 99577 -
Date Issued: Jul 23, 2003
Expiration Date: Jul 22, 2004
Parcel ID: 060-342-08
Site Address: Unknown
Lot Size: 69670 SO. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
fciOTix-t' >Gv�svv'7—lcz
2- 5 (✓trrS i 3'x
Received By:
Issued By:
Date: ' k
Date: 7/23/O.3
"twidpiity bid' Atithadge
beifeiopttteHt t owlees bepatmeht
building Safely bivislon =
on-site Water and Waslevmier program
4704 South bregaw St.
0.0. box i9665o Anchorage, Ak 99519-6650
www. cl.ahchor2ge. ak.0 s
(907) J41a904
ON-Sltr_ SI=WEiziWIEELL PlEIRMit APPLICATION
rolz A SINGLt rAMILY bWELLING
Parcel I.D. fl -3u 7 'LJ % permit Number SW 030266
property owners) 13 R I A" N 6 +z. L' t- bay phone
Mailing address (1
Mailing address (2) fZgF.LC RrV6✓L
Legal description (Lot, block & Sub'd.) �
zip Code 9 9 S- 7 7
Legal description (Sec(loh towhship & t2ange)
Lot Size -4- 6 1Acr lSg.Pt: Number of Bedrooms _
tNls OPLIcAtION Is Pok:
Sea/er Only d Well Only
Sewer and Well Water Storage
Sealer Upgrade
this pl 0PIEktY tONTAiNS:
Not tub t] Jacuzzi
Swimming Pool d Water Softening Unit
therapy Pool L�
bertity that the above Informalioh Is correct. I further certity that this application is being trade for a
slhgle Pafhlfy b*LIlthg and is In eiccotdahce With applicable Municipal Codes.
5 & 5 ENGINEERING
17034 Eagle River Loop Road No. 204
Pm6 P-6Rivar Al,,k. 99e77
(Signature of propetty owner or authorized agent)
hermit trees: 000 �"" -I- ! SO. " Waiver keel
bale of payment:
bate of aaytnehl•
kieceipt Number: O 3 `6 3 '7 / ttecelpl Number:
(Rev, 12/00)
HEALTHAUTHORITY
APPROVALS
SEWER&WATER
MWNEICTENSIONS
SEWER& WATER
INSPECTION
ENGINEERINGSTUDIES
ANDREPORTS
WELL INSPECTION
&FLOWTEST
SITE PLANS
ROAD DESIGN
SOILTEST
PERCOLATION
TEST
STRUCTURAL"&
MEOHANIOAL
WSPECTIONS
ONSITE
WASTEWATER
DISPOSALSISTEAI.
DESIGN
ROBERT C. COWAN, P.E.
ROBERTA. SHAFER, P.E.
CIVIL ENGINEERS
(907)694-2979
FAX(907)694-1211
July 6, 2003
MUNICIPALITY OF ANCHORAGE
Development Services Department
P.O. Box 196650
Anchorage, AK 99519
REFERENCE: Lot 2, Ramert Subdivision
It is requested that you issue a permit to install a well and a septic system to serve the
proposed four bedroom dwelling on the referenced property.
Two test holes were excavated and percolation tests performed. The approximate locations
of the test holes are located on the attached site plan. At the time of excavation (6/11/03),
water was found at 8 feet. After seven days of monitoring, ground water was found at 7.5
feet.
We do not anticipate any adverse effects on neighboring wells, septic systems, reserve
areas or drainage patterns by the installation of the proposed septic system. The
construction of this system will not prevent any future development on any of the adjacent
properties.
If you require additional information, please contact us.
Sincerely,
*oert44��
RCC/bjj
Enclosure
17034 NORTH EAGLE RIVER LOOP i SURE 204 EAGLE RIVER, ALASKA 99577
9
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Municipality of Anchorage sy�ta�ERs S Ftta;
Development Services Department AW19r
Building Safely Division 4
• �.r On -Site Water and Wastewater Program ""p •.'^
4700 South Bragaw SL
P.O. Box 196650 Anchorage, AK 99519-6'650 7A i ROBERT C. COWAN
www d anchorace.ak.us t^ \
607) 343-7904 CE - 8801
Performed For:
Legal Description:
Depth
O. ,
4-
5-
_0
-5 0
7-
8-
-
8-
10-
11-
12-
13-
14-
15-
is-
17-
13-
19-
20-
10-
11-
12-
13-
14-
15-
1517-
1a-
19-
20-
-9'
O'
Soils
Soils Log - Percolation Test
yz t /J,� r Date Performed: 4
LDT Zt 2qy i EyLq S/� Township, Range, Section:
Stood Site
-M-* 1A
COMMENTS
OOH
WAS CROUNDR
Date I
=RVT
EkCOUNT=RED?
�S
Depth to Water
/ 5
IF YES, AT WHAT DEPTH?
L0
Depth to Waver After
M1t6niroring?J_,_
�,Z-) p
E
Date:
03
3
Reading
Date I
Gross Time
Net Time
Depth to Water
Net Drop
-Z "
O
r n
�I`�
_
0
I
t/2"
130
11I
I
I
i
I
I
P=R"OLATION PATE (G (r. inc;essrcq FERC HOLE DIAMETER ('2.1TEST RUN 6:1 NEEM 5 FT PND 4 FT
PERFORNIED BY: N&&eLt,4CT I ��% �/%L-G >�. CERTIFY THAT T'r,IS TEST/ WAS.
FERFOR,MED IN ACCOkDANCE 4YITH P.LL STATE A.ND %IUmUPAL GJ!DELIPIES IN EFFECT ON THIS DATE. DATE: 7 / !G �O 3
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: abti� ~F=fLT DATE
LEGAL DESCRIPTION:�i6gi rzgA1{IIpq geovTownship, Range, Section:
SLOPE
COMMENTS
L,07
WAS GROUND WATER VES.
ENCOUNTERED? _ '=]_
IF YES, AT WHAT 4 `
DEPTH?
Depth to Water Ager pp `
Monitoring? Date: iLWTI_
.11
ROBERT C. COWAN '11c:
"�°•.� CE -8801 r '
T14,44`—
Reading Date Gross Net
Time Time
^�
p(2(igNIGS
2
10
r
.1 U tw
3
J ntiw
&M/Sw
�%1J�8
i'/L'1
a
1"
05
yp
./
6
74
8-
9
to
-
12
13
14
15
16
17
18
19
20
�tt,l
COMMENTS
L,07
WAS GROUND WATER VES.
ENCOUNTERED? _ '=]_
IF YES, AT WHAT 4 `
DEPTH?
Depth to Water Ager pp `
Monitoring? Date: iLWTI_
.11
ROBERT C. COWAN '11c:
"�°•.� CE -8801 r '
T14,44`—
Reading Date Gross Net
Time Time
Depth to
Water
Net
Drop
LL
f 'ep
r
.1 U tw
J ntiw
�%1J�8
i'/L'1
lU kl�
1"
1 S to
yp
./
PERCOLATION RATE r •7 f (minutes/inch) PERC HOLE DIAMETER V '�
TEST RUN 13ETWEEN J FT AND r FT
S S S ENGINEERING
17D34 Eagle River Loop Read N6. 2W I
PERFORMED BY: Its t CERTIFY THAT THS TE/$T WAS PERFORMED IN
ACCORDANCE WI ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: r /
72-008 (Rev. 4/85)
I
HEALTHAUTHORITY
APPROVALS
SEWERBWATER
MAINEXTENSIONS
SEWER 8 WATER
INSPECTION
ENGINEERINGSTUDIES
ANDREPORTS
WELL INSPECTION
6 FLOWTEST
SITE PLANS
ROAD DFS10N
SOILTEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ONSITE
WASTEWATER
DISPOSALSYSTEM
DESIGN
ROBERiC. COWAN, P.E.
ROBERT A. SHAFER, P.E.
CIVIL ENGINEERS
(907)694-2979
FAX(907)694-1211
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
MATERIAL SPECIFICATIONS
REFERENCE: Lot 2, Ramert Subdivision
July 6, 2003
GENERAL:
1. The scope of this project includes the installation of a 1300 gallon HDPE
septic tank and drainfield trenches to serve the proposed four bedroom
residence located on the referenced property.
2. Construction shall be in accordance with the approved site plan and design
drawings, Municipal permit with any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal Regulations.
3. The contractor shall be responsible for obtaining any necessary underground
utility locates.
4. Unless specifically agreed otherwise, the property owner shall be responsible
for final grading areas subsequently depressed from soil settling.
5. Contractors installing wastewater disposal systems must be certified by the
Municipal Health Department for system installations. Owners installing their
own systems must also receive prior approval from the Municipal Health
Department.
SEPTIC TANK INSTALLATION:
1. A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4" cleanouts for pumping access.
2. The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
17034 NORTH EAGLE RIVER LOOP 4 SURE 204 • EAGLE RIVER, ALASKA 99577
Page 2
Lot 2, Ramert Subdivision
July 6, 2003
3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade.
4. Septic tanks installed with less than 4 ft. of cover shall be insulated.
5. A foundation cleanout shall be installed one to four feet from the building foundation. In
the line between the tank and the leachfield there shall be two adjacent cleanouts (unless
an effluent pumping system exists within the septic tank). These cleanouts shall be
located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line,
shall be to clean toward the leachfield. The second cleanout shall be to clean toward the
septic tank.
6. Final grading over the septic tank shall be such that a positive slope exists away from the
septic tank.
ABSORPTION TRENCEUDRAINFIELD INSTALLATION:
1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the
excavation shall be within 2 inches of level. If the sidewalls of the excavation become
smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock)
placement.
2. Once the gravel is installed, the distribution pipe is to be installed level with the
perforations faced downward. Gravel is then to be placed over the distribution pipe to
provide a minimum of 2 inches of cover over the pipe.
3. A silt barrier must be installed between the final gravel layer and the native soil backfill.
Ensure the silt barrier covers the entire gravel surface before placing backfill.
4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations
shown on the design, and extend a minimum of 12 inches above final grade. The portion
of the monitoring tube extending through the gravel shall be perforated from the bottom of
the trench to the invert of the distribution pipe. This is equivalent to the effective depth of
the gravel as noted on the design.
5. Backfill over the final gravel layer must not be less than twenty-four (24) inches.
Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The
finish grade over the trench must be mounded to prevent the formation of a depression
after settling.
Page 3
Lot 2, Ramert Subdivision
July 6, 2003
MINIMUM MATERIAL SPECIFICATIONS:
Any septic tank proposed for installation must be constructed by a Municipal approved
septic tank manufacturer.
2. The following pipe materials are approved for use in septic system installations in the
Municipality of Anchorage:
Tyne of Pipe Perforated Solid
Cast Iron Yes Yes
ASTM D3034 (PVC) Yes Yes
ASTM F810 (HDPE) Yes No
ASTM D2662 (ABS) Yes Yes
Use of a type of pipe other than listed above must be approved by the inspecting engineer.
3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical
Company Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or
equal).
5. A permeable nontoxic silt barrier (Typar 3401, Miraf. 140N, or equal) must be installed
between the final leachfield gravel layer and the native soil backfill.
6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3%
passing the #200 sieve.
7. When sand is being used as a filter material, its gradation specifications must conform to
current M.O.A. or D.E.C. requirements, which ever requirement applies.
INSPECTIONS:
Typically there will be a minimum of three (3) inspections required during the installation of the
wastewater disposal system. These inspections will occur as follows:
Page 4
Lot 2, Ramert Subdivision
July 6, 2003
1. The first inspection must be conducted after the excavation of ditches, pits,
trenches, or beds and before the installation of any gravel. A septic tank may be
set in place, but may not be backfilled before this inspection.
2. The second inspection must be conducted after the placement of the silt barrier,
gravel, distribution lines, standpipes, cleanouts, and insulation, but before the
placement of any other backfill.
3. The final inspection is to occur upon final grading of the property.
Often there will be more than these 3 inspections required. Especially with the installation of
multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer
is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -
construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or
control in any way the contractors activities.
The owner shall contract with the contractor to perform the work outlined in these specifications
and plans and in accordance with the attached M.O.A. permit. There will be no contractual
arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be
the owner's representative and will inspect the work as stated above to document the contractors
activities. Final acceptance of the contractors work rests with the owner and the M.O.A.
S & S Engineering shall have no liability to the owner or to others for acts or omissions of the
contractor or any other persons performing work on this project or the failure of the contractor to
carry out the work in accordance with these construction documents. S & S Engineering's
inspecting engineer will not be responsible for the construction means, methods, techniques,
sequence, procedures or the safety precautions incident to this project.
CONTRACTOR/INSTALLER
. ..v ,,... .. a. rrr e, v.., wv vYv,• •Ivv Yw Malw Ivyvvllla .v Inpw tVl wlv }V14Vnl}la 19C}DVlli
❑ Orf in signature or stamp missing on
❑ Calculation error in design.
Lj Additional soils information needed
Q Water monitoring results lnadequate.
Discrepancy m Iinformation submitted
„.i.e,.: ... ., «_
Q Topographic information missing or inadequate
x + y
❑ Incomplete, missing
Incomplete, missing
Additional -adequacy test information needed,
❑ Water'-sarnple unacceptable
Measurecflproposed distances/dimensions missing.
❑ Locations of all soils, percolation and water monitoring tests not shown.
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Date s 11-0q-03
Ndfilcipaiity of Anchorage
DEPARTMENT OF 11HALTII AND lIUMAN SERVICES
825 L Street
P O4 Sox 196650
Anchotggey Alaska 99519-6650
REFERENCE:
er S D
nosEn r c. COWAN, P.E.
nOBEnT A. SHAFER, P.E.
CIVIL ENGINEMS
(907)694-2979
PAX (907) 694.1211
The septic n
inspectios for t17e a erenced property were
performed on 10-17-03 and t . Prior to submitting
the On-site Wastewater DisposalSystem and/or Well Inspection
Report we are ' waiting for the 4S 1.;14.3ttrVeV to be
completed.
It we may be of further service please contact us.
SincetelyA
Q
t C: Cow E.
a
1704 NohTN EAGLE hivo 1.000 i SUITE 20 • EAGLE nIVEn, ALASKA 99577 "
•
• Municipality of Anchorage �!`` __`,
i_ On-Site Water&Wastewater Program
(907)343-7904 SA STY
6789
CERTIFICATE OF ON-SITE SYSTEMS APP'4 A US f
JUL . ., r f8
Parcel I.D. 060-342-08 Expiration D (0 —
1,
ce
<< cu 01
1. GENERAL INFORMATION 6 8 L 9 9 h
Complete legal description RAMERT S/D; LOT 2
Location (site address) 19730 STONEHILL DRIVE, EAGLE RIVER,AK 99577
Current Property owner(s) JASON DECOURCEY Day phone 227-3894
Mailing address 19730 STONEHILL DRIVE, EAGLE RIVER,AK 99577
Real Estate Agent KATIE LIKKEL Day phone 313-7929
2. TYPE OF DWELLING:
II Single Family(w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well • . Individual On-site II
Individual Water Storage ❑ Individual Holding tank ❑
Community Class Well ❑ Community On-site ❑
Public Water System ❑ Public Sewer ❑
WaiverNariancerequest for N/A Distance: -
Received by: 41 Date: 0061
COSA to be released to the engineer,unless otherwise requested by the engineer.
COSA Fee $ v 41''° Waiver Fee$
Date of Payment h/t3jI8 Date of Payment
Receipt Number 013 (4 G Receipt Number
COSA# °SG IV 33S Waiver#
C1
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 GARNESS ENGINEERING GROUP,Ltd. Phone 337-6179
Address 3701 E.TUDOR ROAD, SUITE 101 *ANCHORAGE,AK,99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 71( 2/8
Engineer's Comments:
In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septic system in accordance with the 4;6 wil.IM\►ii.
guidelines and regulations established by the Municipally of Anchorage and industry practices.The reported results describe the �4 G
condition vr
of the system/s on the date/s of the evaluation.Separation distances were measured to readily identifiable features. 4, \ . • 4 4•♦
Hidden defects or encroachments may exist that were not identified during the evaluation.Theoperationallife ofall wells and septic ir � ...•••••,••• • ..vane ty
the year),quality of construction(materials and workmanship),and the water usage of the family utilizing the system/s.These 4*
1.A\ •...7�♦1•
conditions can vary,and are outside the control of GEG.Satisfactory test results do not guarantee future performance of the
system/s;therefore,GEG makes no warranty(express or implied)regarding the Mum performance of the well or septic system. 0 r
01
GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the •
current systems fail.The content of this report is for the sole benefit of the person/party who retained GEG.Reliance upon the # J-- - A. Go ess : :
information provided in this report by any other person or party,including but not limited to subsequent property purchasers,is not ♦ C3 • / Ji
authorized.In short,GEG disavows any legal duty to anyone other than the person/party who paid for this report. I.�ri> • 9 • •:-_Jr
•
6. DSD SIGNATURE • ♦♦4 PRQfFESS\�Pi4.•
LICENSE II1jsis***
/ System#1 Approved for V bedrooms. #r,Eccaaa
System#2 Approved for bedrooms.
( Vic`'. Of.iI/�rC,
�
Disapproved. G�
J�� ON-SITE z
Conditional approval for bedrooms,with the following stipulations: WATER AND �'
r�r�► WASTEWATER<- .
PROGRAM :
,,,,..----e--7.------.7____„:1(`----__ Original Certificate Date: (3 "1
The Municipality or Anchorage Develop,emt 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. ATTCHMENTS:
COSA Checklist _ Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
(Rev.10/12/12)
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system
Certificate of On-Site Systems Approval Checklist
Legal Description: RAMERT S/D; LOT 2 Parcel ID: 060-342-08
A. WELL DATA
WelltYP e PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed 9/15/03 Sanitary seal (YIN) YES Wires properly protected (Y/N) YES
Total depth 100 ft. Cased to *30 ft. Casing height (above ground) 24+ in.
*CASED TO BEDROCK
FROM WELL LOG AT INSPECTION
Date of test 9/15/03 6/29/2018
Static water level 12 ft. 12 ft.
Well production 5 g.p.m. 4.8 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 ml. Nitrate 3.38 mg./L. Collected by: GEG, Ltd.
Arsenic: <5 ug./L. Date of sample: 6/29/2018
NOTE:ONLY MEASURED TO HAVE 17"-20"OF COVER OVER
B. SEPTIC/HOLDING TANK DATA TOP OF TANK.TANK IS INSULATED PER INSPECTION REPORT.
NO FREEZING ISSUES-SEE EMAIL STATEMENT FROM OWNER.
Tank Type/Material SEPTIC/STEEL Date installed 10/16-17/03
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout(Y/N) YES Depression over tank(Y/N) NO High water alarm (Y/N) YES
Date of pumping 5/2/2018 Pumper JR'S PUMPING
"BELOW EXISTING GRADE.MT3 IN SOUTH TRENCH IS BELIEVED TO NOT EXTEND
C. ABSORPTION FIELD DATA TO BOTTOM OF DRAINROCK AND HAS DEBRIS IN IT.MONITORING TUBE STILL
TO BE FUNCTIONAL.7.75"OF LIQUID LEVEL IN MT3&MT1 WAS FOUND TO BE DRY.
Date installed 10/16-17/03 Soil rating cp.d./I'or ft2/bdrm) 0.8 System type SHALLOW TRENCH
Length 106 (2 @ 53) ft. Width 5 ft. Gravel below pipe 2 ft.
Total depth *3.67-4.83ft. Eff. absorption area 757 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test **6/29/2018 Results (Pass/Fail) PASS For **4 bedrooms
***0/ ***18.75/
Fluid depth in absorption field before test 0 in. Water added 788 gal. New depth 0 in.
***0/
Elapsed Time: 10 min. Final fluid depth 0 in. Absorption rate >= 600+ g.p.d.
Any rejuvenation treatment (past 12 mo.)(Y/N &type) NONE KNOWN If yes, give date -
**NOTE:TESTED NORTH TRENCH ONLY.ADDED WATER TO MT4 AND MONITORED LIQUID LEVEL IN BOTH MONITORING TUBES (MT2&MT4)
NO CHANGE IN LIQUID LEVELS IN SOUTH TRENCH DURING TEST.CONDITION OF SOUTH TRENCH IS UNKNOWN.
***MT4/MT2 (NORTH TRENCH)
*SEE ATTACHED LIFT STATION/PUMP VAULT MAINTENANCE LOG.
D. LIFT STATION **PER 5/6/04 ELECTRICIAN REPORT.
Date installed 10/16-17/2013 Size in gallons 280 Manhole/Access (Y/N) YES
"Pump on" level at * in. "Pump off' level at * in. High water alarm level at * in.
Datum * Cycles tested * Meets alarm & circuit requirements? **YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main 75+ Public sewer manhole/cleanout 100'+
Sewer/septic service line 25'+ Holding tank 75'+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation `5'+ Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main 10'+
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage **0'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
*MET SEPARATION DISTANCE AT TIME OF INSTALLATION.TANK PARTIALLY UNDER DECK. DECK SUPPORTED BY PIER BLOCKS.
DECK HEIGHT IS LESS THAN 24"TALL.
*.MT4 IS UNDER DRIVEWAY AND HAS A PAVER TYPE COVER.NO ISSUES WITH FREEZING PER OWNER (SEE ATTACHED EMAIL)
00.111slivi vi
_.• OF .r 0,
G. ENGINEER'S CERTIFICATION ••,`P�*•........a •!�,1..
I certify that l have determined through field inspections and lir • %..* �•
0
review of Municipal records that the above systems are in NI
conformance with MOA COSA guidelines in effect on this
date. I�^ : J•ff :I A. .•rne-s•c i
Engineer's Printed Name JEFFREY A. GARNESS �-j-, .. E-7951 '�
•
Date -7/I / •♦•1� 3••..•• - •?*1P-ci.
•
LICENSE ,4•1� ESS1 *�.
#AECC884 ��"�
(Rev. 10/12/12)
esceOieo new
•
On(ASSUMED) mom _- _. _ _ _,—-_._.�._._..-.._. __,....._ —-�—_ ..Y...
fe.rektitttfleptIri0 OORNFA
m ' fST'ONEHILL DRIVE
FRONT OUOORIO SMACK Lf)
906 swum SITOAGIt
589°50'36"W 300.00' •
REAR RU0.0INo MAACC E
WELL a
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HILAND ROAD
UNDER NO CIRCUMSTANCES SHOULD AN AS-BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES,
THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL UABIUTY ONLY FOR THE COST OF THE SURVEY.
USTED DISTANCES PREVAIL OVER SCAUNG. REPRODUCTION MAY ERRORS IN SCALE.
�or SURVEY SURVEY TYPE SYMBOLS
ElFOUNDATION AS-BUILT a SET REBAR 'W0 1•`
DRAINAGE :"`;:"':11
ASPHALT
❑ FINAL STRUCTURE AS—BUILT
0 FOUND REBAR h` =A
PLOT PLAN...AS-0%AT• . . LOT SURVEY. ,, TOPOGRAPHY e-�'�• wow0� FEPICE �' •e CONCRETE
ati-euILT. . .NO CORNERS SET 0RECERTIFICATION A `.uu.T.. . .NO CORNERS SET OD r] ASSUMED ELEV. X )( X METAL FENCE rigni.ril WOOD DECK
PLC F PLANS Sc LOT SURVEYS NOTE:
IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER. PRIOR TO ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL GE
CONE. 'RUCTION, TO'VERIFY PROPOSED BUILDING GRADE RELATIVE SHOWN. FENCES, WELLS, SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS,
TO FINISHED GRADE AND UTIUTY CONNECTIONS AND TO DETERMINE ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW
THE I XISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED, '
WHICI DO NOT APPEAR ON THE RECORDED SUE3DIVISION PLAT. ALL DISTANCES ARE RECORD UNLESS OTHERVWSE NOTED.
SURVEY CERTIFICATION ®���a���EppggB Prepared by
PLOTPLAI 4441-r„CF,,,• 44e Robert E. Johns, Jr, & Assoc.
I horoby awlIfy bat I hate Oriskany eravoyed ®� Pe.•e �•�.
the let drawn and described harem,and that I Q, \ ,, e,. ®6 Professional Land Surveyors
halve found ar eMdYl hod er of the tot owner* Av --J o 4, V 1700 Artnk Drive.
et aharn of Tho plan and to Ma beat of my
hnododbe and abiltNa.ad mna,elene have boon y C• t,, `67 •� ant ANCHORAGE, ALASKA 99504
mutative We and aonoal. ® : • +tl l r : V '
` Scala: 1 n = 501 Rec. Lot S.F. Rec. PILI Fne No.
FOUNDATICI AS-BUILT if' e••,”
410 L Robert I.Jeldle.U..hereby wetlly that I I'
Date Surveyed: 09/05/13 '`
howl performed on Ae—Buaki sunny of the
Drawn b RE.! Checked byR A�
feunaNlon an i lot and that oh the •• •e•e••••••e�• ' u� G J IV'
dY.emNeae and tlfamot!o ea ehorn hereon I tl . ,e', t
are tea end n,encroachments valet union O' `-BERT E.�t JR. ; i Act Dote Drnwn: CA•Id: W.O.
FINAL ahem eSIRt ;IURE AS-BUILT ®0 l' ''', 41 —S •�••: e 09/06/13 SW355 13-456
t ttabart L h.to.Jr,hereby earthly shot I ', '•., ....how prime' 5 a�'
blanc ore m Ode let and that ell M. .A d d
dw,a,ota°o end Mfamatkn or dtoan haw e�4 rofessionekk..t‘
Lot 2
we lnA,and Ar.a etaaohatada natal teniae %����.n�'0 RAMERT
ettaee�oNarala.
•
MUNICIPALITY OF ANCHORAGE
fr �
Development Services Department Phone; 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
Lift Station/Pump Vault
. Maintenance Logi
t� o�
i sg3t7 5.�c.,,.Q h.
Owner jc co— pe Lvc�r <j'�1" Street Address f_Ay le a", A K
Septic Tank: ,1
'Sludge level .4- inches 'Pumping: required ves p 'Pumping completed vej no
Lift station:
•Pump basket cleaned KS no -Effluent filter cleaned no
'Control floats cleaned 1 no 'Proper float settings confirmed v no
*Operation satisfactory Ola no
{ Alarm System:
'Dedicated electrical alarm circuitir/ *A2 'Audible and visual alarm Inside dwelling a no
-Alarm system operation skis--4toy/ not satisfactory
Manhole Riser
-Ground water intrusion at riser to tank connection yes no
'Ground water intrusion around pipe penetrations yes na 'Weep hole functional ves no
•Manhole lid: Functional no Insulated es no Properly Securedtii-s, no
Other
•Ali manufacturer required inspections and maintenance completed yes no
Comments:
Qualified Maintenance Provider:
Technician ��l2- Date of maintenance f/% _'1/ I'
Company
Signature '
Mailing Address. P. 0. Box 19E650 * Anchorage, Alaska 99519-6650 'www.muni.org
Municipality of Anchorage
On -Site Water & Wastewater Program
(907) 343-7904
CERTIFICATE OF ON—SITE SYSTEMS APPROVAL
Parcel I.D. 060-342-08 Expiration Date: / - / /�" -"
1. GENERAL INFORMATION
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Real Estate Agent
2. TYPE OF DWELLING:
RAMERT LOT 2
19730 STONEHILL DRIVE *EAGLE RIVER. AK 99577
BRIAN & AMANDA BELL Day phone 529-6708
19730 STONEHILL DRIVE *EAGLE RIVER. AK 99577
ANNELIESE COOPER W/ KELLER WILLIAMS Day phone
N Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY:
865-6549
TYPE OF WASTEWATER DISPOSAL:
Individual Well
E
Individual On-site
0
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
Received by: ['6 r�'"+� Date: LC t i
COSA to be released tdthe en¢neer, unless otherwise requested by the engineer.
COSA Fee $ Ljg01,9) Waiver Fee $
Date of Payment 10177 13 Date of Payment
Receipt Number 004W6 Receipt Number
COSA# Q sC/36b1(,:;7 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 GARNESS ENGINEERING GROUP, Ltd.
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Phone 337-6179
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date I 01ILd 13
Engineer's Comments:
In conducting this evaluation, GEG, UD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described 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 soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
6. DSD SIGNATURE
System #1 Approved for _ bedrooms.
System #2 Approved for
Disapproved.
Conditional approval for
0
bedrooms.
bedrooms, with the following
VW
A. ornessr
OF
ON-SITE
MATER AND
Original Certificate Date: / 0 — / 0 1, 3
The`Municipaldlol-,rndhorage Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the represenatations 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. ATTCHMENTS:
COSA Checklist Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
m— iiinq%
If more than 1 septic system is on the lot:
COSA Checklist # _of_
Structure served by this system _
Certificate of On -Site Systems Approval Checklist
Legal Description: RAMERT; LOT 2 Parcel ID: 060-342-08
A. WELL DATA
Well type PRIVATE
*CASED TO BEDROCK
If A, B, or C provide PWSID# N/A
Date completed 9/15/03 Sanitary seal (YIN) YES
Total depth 100 ft. Cased to *30 ft.
FROM WELL LOG
Date of test 9/15/03
Static water level 12 ft.
Well production 5 g.p.m.
WATER SAMPLE RESULTS:
Coliform Q colonies/100 ml.
Arsenic: N D ug./L.
B. SEPTICIHOLDING TANK DATA
Nitrate':Z_�3 mg./L.
Date of sample: 9/17/1
Well Log (YIN) YES
Wires properly protected (YIN) YES
Casing height (above ground) 24+ in.
AT INSPECTION
9/17/13
20 ft.
3.79 4 g.p.m.
Collected by: GFr Ltd.
Tank Type/Material SEPTIC/STEEL Date installed 10/16-17/03
Tank size 1250 gal. Number of Compartments 2 Cleanouts (YIN) YES
Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) YES
Date of pumping — Pumper 0
C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE
Date installed 10/16-17/O3 Soil rating (g.p.d./Wor '/bdrm 0_8 System type SHALLOW TRENCH
Length 2 ® 53 ft. Width 5 ft. Gravel below pipe 2 ft.
Total depth *3.83 ft. Eff. absorption area 757 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test **9/17/13 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test 3 in. Water added 850 gal. New depth 7-5 in.
Elapsed Time: 121 min. Final fluid depth 3_5 in. Absorption rate >= 600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE If yes, give date —
**NORTH TRENCH TESTED ONLY. SOUTH TRENCH HAD 18 INCHES OF LIQUID AT TIME OF INSPECTION.
D. LIFT STATION
Date installedl0/16-17/03 Size in gallons 280 Manhole/Access (Y/N) YES
"Pump on" level at 61 in. "Pump off" level at 61 in. High water alarm level at 57 in.
Datum TOP OF LID
E. SEPARATION DISTANCES
Cycles tested 3 Meets alarm & circuit requirements? YES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tanknift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main
Sewer/septic service line 25'+
Animal containment areas 50'+
Public sewer manholeldeanout N/A
Holding tank N/A
Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 1 '
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
...:..... ..
1 certify that t have determined through field inspections and p
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this
date. �. .J. .A .... ness:
Engineer's Printed Name JEFFREY A. GARNESS 3
CE -79
Date lo/�t�13 O�f"^e i��t3'�
��a000
410Prof.ea'100�\ o
(Rev. 11/06)
Sep 04 13 09:04a Rmanda Hell 19076220433 p.l
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