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EAGLE CREST #1 TR A LT 38
Eagle Crest Tract A Lot 38 #050-303-33 Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP171052 PID Number: 050-303-33 Dwelling: ❑■ Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ❑■ Upgrade Name: WILLIAM BUCHLEITNER ABSORPTION FIELD ❑ Deep Trench ❑Shallow Trench ❑Bed X Mound Address ❑ Other Phone Number of Bedrooms Soil Rating Total depth from o4g4fie4 grade 4 2.0 GPD/SF IP-&- :6 "*y' Ft. LEGAL DESCRIPTION Depth to pipe invert from efKiaat grade 111 ' Gravel depth beneath pipe Subdivision Block Lot 2.5 Ft. 0.5 Ft. EAGLE CREST #1, TR A, LOT 38 Fill added above canal grade Qg5 g Ft. Gravel length 25 Ft. Township Range Section Gravel width 13 Ft. Beds: Number of Lines 3 Distance between lines 5 Ft. SEPARATION DISTANCES To Septic AbsorptionHolding Lift Station I Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 325 Ft', Ft. Well 100'+ 100'+ 100'+ 50'+ TANK A Septic [k S.T.E.P. ❑ Holding ❑ Other Manufacturer C H TANK �,) y � ,,.' Capacity 500 Gal. Surface WaterAN 100'+ 100'+ 100'+ Material STEEL Number of compartments 1.0 Lot Line 10'+ 10'+ 101+ NA Foundation 10'+ 10'+ 10'+ LIFT STATION Manufacturer Capacity Curtain Drain LIN U N UN AN C H TANK �y �' 1250 Gal. Remarks EXISTING TANKS INSPECTED, OK, Pump on level at PRE-SET in. Pump off level at PRE-SET in. High water alarm at PRE-SET in. NEW PUMP INSTALLED IN STEP TANK NEW AIR PUMP INSTALLED IN HOUSE Pump make and model 20 OSI Electrical Inspections performed by EXISTING Installer PIPE MATERIAL House to tank 303 Tank to drainfield 3034 MIKE N ANDERSON, P.E. Drainfield 3034 CO/MT 3034 Inspector MIKE N ANDERSON, P.E. BENCH MARK (Assumed elevation) 100 ft InspectionLocation dates: 15 7 / 2°° and description 3 d 4u, BACK STOOP COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL �n�i'Cp Conditional Approval: Date t • • • ' 71�,1� � h •. �— �°�p.•°• •� , 1�,• MICHAEL N. ANDEpSCN ;�� 3 CE AApproved Date ! pp g Zai �� ?• `' ' • '� .> 1, pRQfESS17";�� ." Inspection Report_9-1-12.doc 11 Permit No. OSP171052 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: EAGLE CREST #1 TRACT A, LOT 38 PID No.: 050-303-33 MT2 /— T CO3i o CO21 C01' 61 Ti _ — TCI _ —.0 �H#, CH MARK / J J i i i NEW REBUILT 13 X 25 SAND FILTER j r AIR LINE CO ACCESS 1 EXISTING 1250 STEEL STEP TANK PUMPED—AND CLEANED SECUNDA X SITE 1-9TC0,3 — — TM 3 o_TD6 F% f \ _4 ))g C 3 500 GALLO STEEL T*K T \ PUMPED y41V 4 CLEANED 1 "i i FCB/ NEW A(R PUMP, LOCATED ` IN THE' GARAGE CRAWLSPAQE GAGE PESS 'RE 3PSI Ik EXISTING WEL?( wf�o `i I EXISTING WELL RIVEWAY ASBUILT i I CU SCALE: 1"=30' E I r-COt t('CO2 ( MH2 +f -.AIR LINE CO j( -COS -S �A!F?3 i IIAT 9B M�i7 t �4WL............. .L� . 'A+t;(•,^— Ni H ynALE._ _— ( 1�� •J�Lf-._ y �� # � I I W5l'tAiION ANO EA3RE � { � • I i i— _� . 1 4 g TIH --- ------a—a�—{— �— u — �s ,. .. SM GALLON o, / GALi 2'A CAiLCN ��.�� /��,,���,� STEEL TANK $TE STEP TANK M,1CHIAEL N, ANDERS01N F 6Z` of uE 469 41,) AF No• °' eAV �®�;�'••., fig .�, .•''4t=� •m' SEPTIC SECTION Esq .fir N.T.S. to 7Jy *e�� MARK A B MT1 47 53 MT2 53 72 C01 47 67 MT2 /— T CO3i o CO21 C01' 61 Ti _ — TCI _ —.0 �H#, CH MARK / J J i i i NEW REBUILT 13 X 25 SAND FILTER j r AIR LINE CO ACCESS 1 EXISTING 1250 STEEL STEP TANK PUMPED—AND CLEANED SECUNDA X SITE 1-9TC0,3 — — TM 3 o_TD6 F% f \ _4 ))g C 3 500 GALLO STEEL T*K T \ PUMPED y41V 4 CLEANED 1 "i i FCB/ NEW A(R PUMP, LOCATED ` IN THE' GARAGE CRAWLSPAQE GAGE PESS 'RE 3PSI Ik EXISTING WEL?( wf�o `i I EXISTING WELL RIVEWAY ASBUILT i I CU SCALE: 1"=30' E I r-COt t('CO2 ( MH2 +f -.AIR LINE CO j( -COS -S �A!F?3 i IIAT 9B M�i7 t �4WL............. .L� . 'A+t;(•,^— Ni H ynALE._ _— ( 1�� •J�Lf-._ y �� # � I I W5l'tAiION ANO EA3RE � { � • I i i— _� . 1 4 g TIH --- ------a—a�—{— �— u — �s ,. .. SM GALLON o, / GALi 2'A CAiLCN ��.�� /��,,���,� STEEL TANK $TE STEP TANK M,1CHIAEL N, ANDERS01N F 6Z` of uE 469 41,) AF No• °' eAV �®�;�'••., fig .�, .•''4t=� •m' SEPTIC SECTION Esq .fir N.T.S. to 7Jy *e�� N,"°""'� MUNICIPALITY OF ANCHORAGE • On-Site Water&Wastewater Program `(, oent 5.;, PO Box 196650 4700 Elmore Road '; - Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax: (907)343-7997 http://www.muni.org/onsite 1 epartment On-Site Wastewater Disposal System Permit Permit Number: OSP171052 Effective Date: 4/27/2017 Work Type: Septic Upgrade Expiration Date: 4/27/2018 Tax Code Number: 05030333000 Site Legal Address: EAGLE CREST#1 TR A LT 38 G:0055 Site Mailing Address: 19509 SECOND ST, Eagle River Owner: BUCHLEITNER WILLIAM JOHN IV& Lot Size in Sq Ft: 17820 Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Total Bedrooms: 4 This permit is for the construction of: El Disposal Field 0 Septic Tank El Holding Tank ❑ Privy El 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 Special Provisions: An as-built survey is to be submitted along with the inspection report/record drawings, prior to issuing the unconditional COSA. Received By: ,4Date: S /zy7 Issued By: ?Ce4. caitzet, Date: Ar/7 . r MUNICIPALITY OF ANCHORAGE (0,,„ti( c,.---) . Community Development DepartmentPhone: 907-343-7904 Development Services Division Fax: 907-343-7997 On-Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. (sq. 0 -- 3 03 ^ 3 Property owner(s) (3, / ( , c (4 1 rt f-r r r. Day phone Mailing address 0:=f S 0 ¶ 21, 4, 47-1-\ Site address 4c/4.1."-c-,, rr /f Legal description (Sub'd., Block & Lot) N S( e. C.--c 47+ i Tru e t �T 4v Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms q APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field C2K Initial ❑ Single Family (SF) 121. (w/wo ADU) Septic Tank CN Upgrade Holding Tank ❑ Renewal Duplex (D) ❑ ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well E Water Storage ❑ 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: 5- Waiver Fees: Date of Payment: Zi/iuil - Date of Payment: Receipt Number: (2_10113 Receipt Number: PIS-105A Permit No. 05 I S-I05A Waiver No. Permit App_9-1-12.doc April 12, 2017 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: New Septic with Conditional COSA Legal: Eagle Crest #1, Tract A. Lot 38 To Whom it may concern: This is a request for a conditional COSA and excavation permit to replace the existing sand filter. The sand filter has failed and needs to be reconstructed with new filter sand. The original design showed 3 test holes with no issues therefore the old sand filter will be replaced. The justification for granting the conditional is the leach field is working well enough fora family of 5, but not enough to pass the adequacy test. The new owners would like to wait for better weather to do the rebuild. The lot is in a small basin with zero slope in the area of the proposed installation, see the drawing. No slopes or cut banks exist within 50 feet of the this site due the site being in the bottom of a small basin. This replacement system will not impact any of the neighboring properties due to the lot layout. Please call me if you have any questions. Sincerely ii&it —" Mike Anderson, P.E. 4661 Natrona Ave. Anch, Ak 99516 J }DESIGN CRITERIA: MOUND OVER AND VEGETATE /NEW GRADE 4 BDRM X 150 = 600 GPD 5 SOILS = 600/2.0 = 300 GPD 1 5'rvl - FILTER FABRIC&INSULATION 300 GA/13 = 23' _, H 1 0.75"0 PIPE W/6"PEA GRAVEL +1 r'. HOLES PER ORENCO (1) BED (TH#2 BY OTHERS) `MOA FILTER SAND +1.75' DEEP 0.5' EFFECTIVE 0 5 —ORG -0 5 EXISTING AIR LINE TO REMAIN 13' WIDE I 13.0' 25' LONG i,r,,1 7 SEPTIC FIELD SECTION PROPOSED ii I i/ REBUILT ! `� \� ,/ 1 . DRAINAGE FIELD PERMITTED _ SECONDARY -- — i ,`– –__ —DRAINAGE FIELD- I PROPS TY LINE �` ---,,--------CA 1 I ,((SEPTIC 1 / �CYx •-•- \I .. EXISTING HOUSEIN \ I II 1 1 j l I I WELL II I I i I WELL • ', CL i I I° I — I I 1 I I 1 tiI 1 / \ -2ND STREET- �1 / / / - - - - - \' - - —‘.._. /___,,_- - - i- \ \ , / / i / ,� ♦, I I ,.� -_,-� �'~I--I-- I I I EXISTING WELL IL Z 100'RADIUS I II I w - - - L— u , , -J 1 �--_ -1ST STREET- , Septic Design Prepared for iNpaih+•iiM ii la WILLIAM & CHRISTINA BUCHLEITNER +•,�� OF qCq 4i� EAGLE CREST #1 , TRACT A, LOT 38 :; 49TH j\ '";' ��o Eagle River, Alaska • i:Iiiit - • Michael N. Anderson, P.E. DATE: 4/11/2017 0 -2)i. MICHAEL N. ANDERSON, 4601 NATRONA AVE �',Ns- ` No. E 469 DRAWN: DJR , i ANCHORAGE, ALASKA 99516 •s .'y l'.i47••• • er (907) 345-3377/FAX: (907) 345-1391 SCALE: 1"=100' 441,.5 S\ .69 r' , / 1 11 / J 1 1f , 1 S' 1 1 1 I 1 I WELL /)--- `— r r `, I 1 1 fr SEPTIG 1 1 rr / 1 1 I/ r 1 1 • i 1 1 1 `_-" 1 1 / I \\ \ •` NO CUT BANKS OR SLOPE ` \\ •� GREATER THAN 25%WITHIN 50' // ^\ `• `\ OF THE NEW BED SYSTEM,OLD r .1 `\ `.\ SYSTEM IS AT THE BOTTOM OF 11 SEPTIC �`\ A VALLEY ( i r r EXISTING SAND FILTER BED TO BE REBUILT PER ORG. ----- MT TYP(2) DESIGN.,CLEAN/FLUSH EXISTING PIPES AND SLASH CAPS. ' -- ,RESERVE BED LOCATION 10'UTILITY EASEMENT J / __ _ PREVIOUS SEPTIC —L_—.—.1 `\ A F—_ -- \ EXISTING 1,250/500 GALLON TANKS TO BE LOCATION —_—�_--- ,_ i�^�j • \ PUMPED&CLEANED AND INSPECTED FOR j 1 - f 1 .- HOLES, IF DAMAGED THEY WILL BE REPLACED 1\1 Kos%• k //�' ��` ' 1 i�\`e •. // % \`\ 1\SEPTIC/ rnaA / / —--/ I I • �• // EXISTING 4 •`k` \�� �`� EXISTING 500 GALLON ``\ /� // BEDROOM 'S� \ Y TANK \1 / / HOUSE / TN 'r~ \ I I I \ / / / \ / / 1 \1 I I \1 r / // PROPERTY LINE 11 11 I I 11 / / r I r ` I 111 I I 111 r r l r 1 I 1 1 f 1 1 1 1 I I WELL ® �( LL � � 1 I I® 1 1 1 I I f II I 1 f 1 1 1 1 r I I 1 I r r r 1 1 1 r r r 1 1 1 r / r 11 11 -2ND STREET- 1 r / / _3_ — •\ — — — — 1 r / — — — — — / - 1 \ \ / / / \ 1 \ / / / ` 1 \ / / / \ \ \ / / / \ \ \/ / , \ / . \ - • .. i\ 1 1 ' a /, < . \ • I I 0 \\ • 7'''// \\ / I I / `/ _ << fY EXISTING WELL ~ EXISTING WELL 11 w 100'RADIUS Fa 100'RADIUS _ I I I I ' Septic Design Prepared for WILLIAM & CHRISTINA BUCHLEITNER `��P-\E OF 44'4.#,. EAGLE CREST #1 , TRACT A, LOT 38AI. '• ��� �� TH Eagle River, Alaska .' 4g- �� '; r r Michael N. Anderson, P.E. DATE: 4111/2017 ' MICHAEL N. ANDERSON. ! ,c •,•: 4601 NATRONAAVE DRAWN: DJR ,+.4�� •. /yE 9;•' ANCHORAGE,ALASKA 99516 •• 'V f .. �� (907) 345-3377/FAX: (907) 345-1391 SCALE: 1"=50' .411b' r;:+a`�64 Municipality of Anchorage :....:!!ii Development Services Department ~ i]r~ "- Building Safety DMsion On-Site Water and Wastewater Program, 4700 S. Bragaw SL "~ P.O. Box 196650 Anchorage. AK 99519-6650 Page/ of w,,¥w ci.anchorage ak. us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT Permit Number:. _~3x,.I ~ .TOO ?¢-1f PID Number: .,,~/,~' (~j//,.rf../' WastewaterSystem: ~'New [] Upgrade "'"'£0. ~'6x 77.~"c/. ~<-,_~ ~,,~ ABSORPTION FIELD LEGAL DESCRIPTION ~.,,.,~ - -/-/.75',,. d.~-5' ,,.i ZS" ,,. Well: [~ew [] Upgrade o,~,..,,~. """~"~" I 7 G.~ //AY& TANK SEPARATION DISTANCES [3 septic I-I Ho d ng ~ S T E P ~" ,,~0 0~6.~~t ~-- ' ' .teZ"~ L [] Other:. TO Sept:c Absorpbor Lift Holding 'ubhc/Pnvate M~,~- ~ Tank Field Station Tank SewerUne W~--'fO//~dCE ~-..,~/~'~- 10~'(~ % s..w.,. I/')O 9- I,Od'.~ mO "," -- ~/'/ LIFT STATION "'~ ~/C~ ~/n/o~ A?~o~ BE~CH MARK lO0 ~ ~.. . .. ~. ~ ~'..' ~ '.~ . ~~ ........ , 2~ Iof/~ ~ DevelopmentSe~ices Depa~entApproval' ' ~N ~ ~ .~7~ Reviewed and approved b~~~ ~. ~ Date:/O-~-0~ %'~',,. AS-BUILT MEASUREMENTS A B F,C.D, 33 5 S.T, C.EI, 50 46 STEP C, ri. 1 55 52 STEP C,rl,2 60 57 STEP Mc~nhote 63 60 FLush Vcdves 53 73 M,T, 55 61 R Water Bo;toMtess InterMIttant Sand Filter en~ Site \ 25 10' EoseMen'~ Gallon STEP Tank 500 GaLLon Merit Sep'~ic qk _~ase By 5' Well eng'th Septic System Construction Well Does Not Preclude Adjoining Lots FrOM S~nlt~%lon IMproveMents. N OR THRIM EN GINEERIN G 1' = 40' EAGLE CREST ~1 LOT 38, TRACT A ~ ........ ~',--~ ...................... AS-BUILT PLAN LAYOUT -- . 0 > <W II OW oU C W(~ (~ I-- v ._j 7 IS THRIM , SO LS ' FEI~INEERING LOG - PERCOLATIDN TEST Date PerFormed: 3/23/05 PerFormed For: Mike Quinn m Legai Description: L3B, Tract A DEPTH (FEET) 5- 0';.~:::' 8- 9- 10- 11 - 12- 13- 14 - 15- 16 - 17 - 18 - 19- 20- 21 - Organlc GN SRty Grave[ 4/21/05 Monitor 7/18/05 NortH;or EagLe Crest T,H. Location; See Attached Design Groundwa~er?,No Dep%h -- Wa~er Depth AFter Monl~orlnc,5' Da~e: 3/30/05 & Date Gross Time Net Time Depth Net Drop 3/23 0 -- 5, __ 3/23 3 3 Min, 5.25' 0.25' 3/83 35 -_ 5, __ 3/23 38 3 mln 5.25' 0.25' 3/23 70 -- 5, __ 3/23 73 3 mln 5.25' 0.25' Percota~lon Ra~e 12 Min./Inch Perc Hole ])iame~er 6' Tes~ Run ' , ~F I E ]3e~ween .2' and 3' PerFormed By--g, , ~~ CERT]FY THAT TH[S Per?ormed in Accordance w~th ~(T State/Municipal GuideUnes ON TH]S ])ATE. ])ATE~ 10/~B/05 TEST WAS In EFFect TESTHOLE LBG T.H, 8 , GEOTECHNICAL __ 10/18/05 ~Js~mj? 3 iX THRiM ,.Sn LS ' E,_~N..~!.NEERING LOG - PERCOLATION TEST Dote PerFormed: ,7/18/05 PerFormed For: Mike Quinn Legal Description, L38, Trac% DEPTH (FEET) ] - 2- 3 - .~ · i. ':.:'.' - "" · :'t '.'.'L ]] - ]2 - 13 - ]4 - ]5- ]6- 17 - ]8 - ]9- 20- 21 - Comments: PerPormed PerFormed In ON THIS DATE, Organic GP Sandy Gr~vel w/ Low Silt 10/5/05 Monitor' 7/86/05 Monitor- A Eagle Crest T.H. Location, See Attached Design Groundwater? ~o Depth -- Water Depth AFter Honitorln ,5' Date~ 10/5/05 Date Gross Time Net Tlme lDepth Net Drop 7/26 0 -- 4, __ 7/26 2 2 rain 4.25' 0.85' 7/26 5 -- 4- __ 7/26 7 2 rain, 4,25' 0.25' 7/26 10 -- 4, __ !7/26 12 2 Min, 4.25' 0.25' Percolation Rate 8 min./Inch Perc Hole Diame~cer 6' Te$% Run Between .8' and 3' By Nor~chRim Fng, I ~ CERTIFY THAT THIS Accordance with All S'ta'te/Municipa~ Guidelines DATE, ..10/18/05 TEST WAS in EFFect TESTHOLE LOG iT, H, 3 GEBTECHNICAL :~.? ........ ~ ..... ......................... J.~O~_13of_3_ EU C1111C CUNT IIVlU,KER ~ooe &9~89&4 Cel# 223~304 En~il Cli~oh:om To: Michael Quinn Const. PO Box 772641 Eagle River AK 99577 Date: 10-10-05 Ref "~8 Eagle Crest Permit: 10319 Colville St. ,~'~GLI~ ~ AK. 995T7 Lioen~e # 1310 This is to certify that on site sewer lift station at above mentioned property has been wired in accordance with the standards of the National Electrical Code and manufactures specification. Systems ~vere checked and performed as specified in the systems manual. Clint Walker ~trti[itO ~ritting "~oE SULLIVAN WATER WELLS p.O. BOX8702'/~CW~tGiAK,~7 ° "'- ' ' MUNICIPALITY OF ANCHORAGE �✓ Development Services Department` On -Site Water & Wastewater Program 4700 South Bragaw Street 47>t P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Date Issued: Apr 22, 2005 Expiration Date: Apr 22, 2006 Permit Number: SW050094 Parcel ID: 050-303-33 Legal Description: EAGLE CREST #1 TR A LT 38 Design Engineer: 0838 North Rim Engineering Site Address: 019509 SECOND ST Owner Name: MIKE QUINN CONSTRUCTION Lot Size: 17820 SQ. FT. Owner Address: 19509 SECOND STREET Total Bedrooms: 3 Permit Bedrooms: 3 EAGLE RIVER , AK 99577 - This permit is for the construction of: 0 Disposal Field F,?] Septic Tank ❑ Holding Tank ❑ Privy 0 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. 5. The following special provisions. -NEED TO DO GROUND WATER MONITORING DURING CONSTRUCTION AND SUBMIT WITH AS -BUILT INSPECTION REPORT. ANY CHANGES TO DESIGN NEED TO CONTACT ONSITE DEPARTMENT. -NEED TO DO ADDITIONAL TEST HOLE DURING CONSTRUCTION FOR THE RESERVE LOCATION AND SUBMIT WITH AS -BUILT INSPECTIION REPORT. /pl IT I O S -' SF_a� `v02%�t �:.•. F.v�,r�/cc/�.n.S Dig i5N C L1an5� �A-f(y' /O I �,� /� � ' �P5 �`fnr � R �'`'f,� H-pp17 o Received By: Issued By: Date: Date: Z 4617 Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0)..�� Permit Number SW Property owner(s)t'C1.Jc n �.. I 'I_1�(&h CTL Day phoney �%L — Ll Mailing address o Ro 'X 7 702 y l , 61s/e /2Zip Code p S 7 Site addressf _ , ��� R d"'d Zip Code Legal description (Lot, Block & Sub'd.) F% CL F CZ -C- d ! �Z 4077 3do' 7W,4C774 Legal description (-qAction, Township & Range) Lot Size_ . IlSg D �/. Number of Bedrooms THIS APPLICATION IS FOR: 3 Sewer Only ❑ Well Only ❑ Sewer and Well M-14, Water Storage El Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owneZ a(authorized agent) Permit/Rush Fees: 165- d �� fit!�Waiver Fees: Date of Payment: 4'11Date of Payment: Receipt Number: 105"_ 444 Receipt Number: (Rev. 09/04) ENG,INEERING NorthRim Engineering 4 _ October 12, 2005 MOA On -Site Water & Wastewater Program ATT: Joe Goodall 4700 Bragaw St Anchorage, AK 99519 RE: DESIGN REVISION: Bottomless ISF DESIGN; Eagle Crest #1, Lot 38, Tract A 3 Bedroom to 4 Bedroom Revision Dear Mr. Goodall: During our meeting today we discussed upgrading the design from a 3 bedroom to a 4 bedroom. This will require additional septic tank volume. A volume of 250 additional gallons is required. The smallest septic tank available is a 500 gallon size. We propose adding the 500 gallon tank prior to the 1250 gallon S.T.E.P. tank. This will increase primary sedimentation and enhanced treatment. Three compartments in series will provide superior solids reduction over two compartments. Separation distances will be maintained. We also propose extending the ISF length by 5'. The length will be increased from 25' to 30'. This will meet the Category III Bottomless ISF requirements for a 4 bedroom home. Thank you for expediting this request. Sincerely, Pteve7g, PE, PH Design Enclosures ��Tf- I� M ENGINEERING REVISED DESIGN EAGLE CREST S/D #1, Lot 38, Tract A SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is a new 4 -bedroom, single family home. The design has been revised from a 3 bedroom to a 4 bedroom home. This design revision requires adding a 500 gallon single compartment septic tank ahead of the 1250 gallon S.T.E.P. tank. The ISF length will also require a 5'extension from 25' to 30'. This is located in a developed neighborhood except for several vacant lots. Groundwater was monitored at two test holes: 5' below the surface & 8.25' below the surface. Due to the limited area, a Bottomless Intermittant Sand Filter (ISF) will be utilized. This will require a S.T.E.P, manufactured by Anchorage Tank & Welding per Orenco Systems specifications. This lot is almost 1/2 acre in size; nearby lots have been laid out in similar fashion, with wells in front & septic systems at the rear of the lot. No adverse impacts are expected from development. The easements are located on the drawing and are not encroached upon. Soil tests revealed silty gravel. The application rate for an ISF: RATE = 2 GPD/FT 2. Required Area = 600 GPD/2 GPD/FT2 = 300 FT2. An ISF with dimensions 10'x 30' will be constructed. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Two compartment, 1250 gallon S.T.E.P. tank, conforming to Anchorage Tank & Welding/Orenco Systems Specifications, allowing gravity -flow from outlet. • 500 gallon single compartment septic tank before the S.T.E.P. tank. • Watertight couplings on inlet & outlet • 5' minimum between the tank and ISF. 10' to property lines. • 2' of cover is required for trench + 1 inch insulation board. • Tank & solid pipe must be set on well compacted, stable soil • 4 inch diameter cleanouts with airtight caps are required 1 to 4 feet from foundation wall, prior to any 90 degree bend in 4 inch line. • All cleanouts must extend to at least ground level • ISF to be placed level, minimum of 4' to groundwater, 6' to bedrock • Allowable application rate for ISF: 2 GPD/FTZ • Air Supply: "Anchorage Tank" Thomas Industries, Model 5070 or equal. • Air Supply Line: "Anchorage Tank" "Wasteflow" emitter line, %2 inch I.D. HDPE • Sand Material: In accordance with MOA latest Sand Filter Spec. • Pea Gravel: 100% passing 3/8 inch sieve, less than 20% passing the 1/4 inch sieve, & less than I% passing the #8 sieve. • Header pipe shall be 1.25" Schedule 40 PVC. Lateral pressure lines shall be 0.75"Schedule 40 PVC w/ 1/8" orifices @ 27" on center, w/ Splash Caps & Flushing Valve Caps per "Anchorage Tank" specifications. • Force main shall be 1.25" Schedule 40 PVC, conforming to Anchorage Tank & Welding/Orenco Systems specifications. Force main burial to be 4' minimum. • Silt barrier (filter fabric) to be installed above the pea gravel. • Smeared trench sides must be raked or scarified before ISF construction. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, PVC Schedule 40. 011r-Th'�INEERING REVISED DESIGN EAGLE CREST S/D #1, Lot 38, Tract A • Sewer Service Line is minimum 2% slope • Septic Tank to be pumped every two years or when required • Insulation board shall be extruded direct burial polystyrene (Dow Styrofoam HI or equal) DESIGN NOTES: 1. Total Depth of Trench is 0.5' @ T.H. 2 I �� Terrain Slopes Toward NW. 2. Sewer Service Line minimum 2% slope. 3. Trench is Minimum 10' from Lot Line. 4. Lots Served by Private Water Wells. 5. Air Compressor is Thomas Industries Model 5070 ("Anchorage Tank"). 6. Air Line is 1/2" Diameter HDPE, Within Insulated Sch. 40 PVC Pipe. 7. S.T.E.P. Tank to Meet Installation Requirements Per "Anchorage Tank". 8. Upper 6 Inches of Mound To Consist of Top—Soil & Be Vegetated. CHECK SEPARATI❑N DISTANCE TO AREA WELLS PRI❑R TO EXCAVATI❑N Bottomless Intermittant Sand Filter \ Replacement Site T,H 5 slope 10' Easement T. H. 1 4—BecirOom House Si Proposed Water \Well 1250 Gallon STEP Tank ,Add 500 Gallon lin Compartment Septic nk Increase F ength B y 5' ter Well NIE Septic System Construction Does Not Preclude Adjoining Lots From Sanitation Improvements, 1" = 40' ++�.�•.".•.owaapa ''P��.or=.�.�. e++ REVISED NOR THRIM �* .4sm *s EAGLE CREST #1 ENGINEERING PLAN 17237 Bear l3aw Circle f Ste" Eng _ LAYOUT Eagle River, Alaska 99577 ��cs-else 907.694.7028 LET 38, TRACT A Date_ _ 10/12/05 r1 of 4 Q'N LLJ L3 U n LLJ 0 a CN n ON 6 +> (4- LLI LLJ 0 Ld L -P I C) CU ry i i n CC) (y) L0 LD C:) r--1 0 o ON 6 +> N LLI LLJ Ld L -P I C) CU i i n <z ry ON 6 is N LLI Q� Ld L L.L W F- 3 � Q U z N N S a f� O ty W 0 M i O O Z5 O F- F- Q d S -F' Z Z � U i O O W = C3 O H H F- LL- rL Q D H O << IL IL O Li N Q U O 0 O iii iii z d 1 -5 Qa Z Z = 75 Qi O 2: 2: W i U :5 i tet- �D = 00 i Z Z z LL > Qi H H O N> Q Q W > U L O F- F- LL- U 4- rZi H ~ tL _O d Q (4- N c (u Q) d dd U i -P 0 i d i 'o F- d 1 O U Q) S i d >UO O- O c S d EUNU -E O LC Q, U cY) -P d i >, E 006 Q, L N a0 -u Q) U 0 ai O o: U n 4-> U N(U-d O 4 :54 - Ln E LA :3 O iii -5 -Fl E~' d O a� Q) N 2� LnUi-Qr -- m - Q, S in c -fes o p Ca iO 0J:5YO i was UU d Q1 Y > S cU U C5 u OI F- a -F' s ai dSNaF- N :5q �° .4 cu ri 14- tri ,,D a I o N ID Q Z 0 U �J W +, O W n d :p > N -N d Q LnL > Q H Ld 06 IL O M L7 1-1 t M Q- 0 F- Pa O F - Ln N S U H i ~ Q� a W OL D Z I— r-I ry J Q Q Z L7 0 Q U I- 0 LOI r -i J I— Q Z C- R H LTJ Q(/)() LO E U') 0 N_ 0 Q) 75 d i U d c 0) t Um W d i O ~ d �0 m N : �W � °i a.. w° m 0 0 U U d d d i Y -P � U O y O 0- S d O W o U i(U Q d O o N ID Q Z 0 U �J W +, O W n d :p > N -N d Q LnL > Q H Ld 06 IL O M L7 1-1 t M Q- 0 F- Pa O F - Ln N S U H i ~ Q� a W OL D Z I— r-I ry J Q Q Z L7 0 Q U I- 0 LOI r -i J I— Q Z C- R H LTJ Q(/)() LO E U') 0 N_ 0 Q) 75 d i U d c 0) Um fZ— W N d �0 m N : �W � a.. w° Ld W (4- 0 Lr) 4-> Q CJ II • 0 (L I C/) ry LDLLJ ~ L'i 0c � -P u 00 (Y) LLJ m Y V., Ln cz) U —j (U aj pq 0 4Z. At. �v Ld W Ti LLJ ry LLJ OL Ln 6 1 21 Ln (4- 0 Lr) 4-> Q CJ II 75 c u :3 0 (L I C/) ry LDLLJ ~ L'i 0c � -P u 00 (Y) LLJ m Y u 0 < ED Ln cz) U —j (U aj pq 0 Ti LLJ ry LLJ OL Ln 6 1 21 Ln NodhRlm Englneeflng 17237 Sear Pow Circle Eagle River, AX 99577 907-694-7028 Apd121, 2005 MOA On-Site Water & Wastewater Program ATT: Joe Goodall 4700 Bragaw St Anchorage, AK 99519 RE: REDESIGN: Bottomless ISF DESIGN; Eagle Crest #1, Lot 38, Tract A The system was redesigned based on the Category III Bottomless ISF. The separation was increased to 3 feet to the bottom of the pea gravel based on 4/21105 monitoring. Other items from the "Comment Sheet" are: * Notes were added for topsoil & vegetation on mound. · General down-gradient slope is westerly & was included in drawing. · Notes for depth of excavation were included and additional detail on profile drawing. · In a telephone conversation you were concerned over the location of the sanitation systems on the lots to the north; the lots to the north were re-inspected and the well/ septic areas were verified. The elevated system vail be constructed in native gr6und to ramn~a,n separation. Design Enclosures NorthRIm Englneerlng 17237 Bear Paw Circle Eagle River, AK 99577 907-694-7028 April 8, 2005 MOA On-Site Water & Wastewater Program 4700 Bragaw St Anchorage, AK 99519 RE: Bottomless ISF DESIGN; Eagle Crest #1, Lot 38, Tract A A well & septic system permit are submitted for your review. This is a vacant lot which is being developed in an established neighborhood. Nearby lots utilize conventional septic systems. An ISF is required due to the high groundwater and the limited area. This lot and nearby lots have gravel fill located in the front half of the lot. The wastewater system will be located in native ground. General drainage flows to the northwest through a glacial outwash formation. Please review the wastewater system design for the planned 3 bedroom single family home. I have included design plans & specs, design guidelines, & soil tests. Ifthere is need for additional information or clarification please give me a call. Sincerely, Design Enclosures RING EAGLE CREST SfD #1, Lot 38, Tract A ~;PECIFICATIONS & DE~;I(~N GUIDELINES Wastewater System Sizing: This is a new 3-bedroom, single family home. This is located in a developed neighborhood except for several vacant lots. Groundwater was monitored at two test holes: 5' below the surface & 8.25' below the surface. Due to the limited area, a Bottomless Intermittant Sand Filter (ISF) will be utilized. This will require a S.T.E.P, manufactured by Anchorage Tank & Welding per Orenco Systems specifications. This lot is almost ½ acre in size; nearby lots have been laid out in similar fashion, with wells in front & septic systems at the rear ofthe lot. No adverse impacts are expected from development. The easements are located on the drawing and are not encroached upon. Soil tests revealed silty gravel. The application rate for an ISF: RATE -- 2 GPDfFT2. Required Area = 450 GPD/2 GPD]FT~ = 225 FT2. An ISF with dimensions 10'x 25' will be constructed. Specification Requirements: All components and ~ork must comply with the Municipality of Anchorage Specifications (AMC) & State of Alas~ Drinking Water Regulations and Waste~ter Regulations. · Two compartment, 1250 gallon S.T.E.P. tank, conforming to Anchorage Tank & Welding/Oreneo Systems Specifications, allowing gravity.flow from onflet. · Watertight couplings on inlet & outlet · 5' minimum bet~cn the tank and lSF. 10' to properly lines. · 2' ofcover is required for trench + 1 inch insulafion hoard. · Tank & solid pipe must be set on ~:I1 compacted, stable soil · 4 inch diameter clcanouts with airtight caps are required I to 4 feet from foundation wall, prior to any 90 degree bend in 4 inch line. · All clcanouts must extend to at least ground level · ISF to be placed level, minimum of 4' to groundwater, 6' to bedrock · Allowable application rate for ISF: 2 GPD/I' 1' · Air Supply:. "Anchorage Tank" Thomas Industries, Model 5070 or equal. · Air Supply Line: "Anchorage Tank" "Wasteflow' emitter line, ~ inch I.D. HDPE · Sand Material: In accordance with MOA latest Sand Filter Spec. · Pea Gravel: 100% passing 3/8 inch sieve, less than 20% passing the ~A inch sieve, & less than 1% passing the #8 sieve. · Header pipe shall be 1.25" Schedule 40 PVC. Lateral pressure lines shall be 0.75"Schedule 40 PVC w/1/8" orifices ~ 27" on center, w/Splash Caps & Flushing Valve Caps per "Anchorage Tank" specifications. * Force main shall be 1.25" Schedule 40 PVC, conforming to Anchorage Tank & Welding/Orenco Systems specifications. Force main burial to be 4' minimum. · Silt barrier (filter fabric) to be installed above the pea gravel. · Smeared trench sides must be raked or scarified before ISF construction. * 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 t~vo years or when required · Insulation board shall be extruded direct burial polystyrene (Dow Styrofoam HI or equal) DESIGN NOTES: 1. Total Depth of Trench is 0.5' © T.H. 2 Terrain Slopes Toward NW. 2. Sewer Service Line minimum 2% slope. ~ 5. Trench is Minimum 10' from Lot Line. 4. Lots Served by Privote Woter Wells. 5. Air Compressor is Thomos Industries Model 5070 ("Anchoroge Tonk"). 6. Air Line is 1/2" Diometer HDPE, W~thin Insuloted Sch. 40 PVC Pipe. 7. S.T.E.P. Tonk to Meet Instollotion Requirements Per "Anchoroge Tonk". 8. Upper 6 Inches of Mound To Consist of Top-Soil & Be Vegetoted. CHECK SEPARATIDN DISTANCE TD AREA WELLS PRIDE TD EXCAVATIDN Bo .~4;oniess In'cernli;'tan'l: Sand Fiji:er Replacement Site I 10~ Easement I' I Gaiton STEP Tank 5~ s~ope 1 3-Bedr House R Septic System Construction posed ~a%er Does Not Prectude ^dJolnlng Lots From Sanitation Improvements. 1' = 40' NOR THRIM ENGINEERING ~.*.:~ EAGLE CREST ~1 PLAN ~"~. '"-'. ~ '"~ ~;~".~Z~ LAYOUT ~o~.,,,.~o~ -,~ .... ~ LOT 38, TRACT A 4/~/05 b m m -..I I ~, 0 ~ 5 l"' 0 '-he' ~:o ~'o < I~-m ipo :~ '"l 0"5 n,~ n:~ ~"50. on<~ ~ ~.-~ n ~,- CiD m .o=o .og o..~n <~,0 m~,< 0 3 0 (-~ 0 Z 0 I-- b- 0 Z n ~- U · SOILS LOG - HRIM ' F~.~(~J_.NEERING; Date PERCDLATIDN TEST PerFormed, 3/83/05 PerFormed For, Mike Quinn Legat Description: L38, Tract A Eagte Crest Ill DEPTH (FEET) 3- 4 - 10 - ".~.'.'; ' 11 - ..~... 7 12 - .::',-.,~:'.: 13- 14- 15- 16- 17- 18- 19- 80- 21- Fitt T.H. Location, See A't'l;ached Design Groundwater?Yes Depth 10,~' Water Depth AFter Monitoring.8,~E Date, 3/30/05 GM Sitty Gravet Do~e !Gross TIMe Ne'c Time!Depth Ne~ Drop 3/23 0 -- 8.25, -- 3/23 7 7 mln 8.75' 0.5' 3/23 38 -- 8.5, -- 3/83 45 7 rain 9' 0.5' 3/23 76 -- 8.5, -- 3/83 84 7 Min 9' 0.5' Percotatlon Rc~te 14 MIn./Inc;:h Test Run Between 5' and 6' COMMents, PerFormed Byl~%fJzI~J~l_~qg, I PerFormed In Accordance with ON THIS DATE. DATE. 3/30/05 CERTIFY Att Store/Municipal Perc Hote Diameter THAT THIS TEST WAS Guidetines in EFFect · SOILS LOG - EERING Date PERCOLATION TEST PerFormed, 3/23/05 PerForMed For, Hike Quinn Legal Descrlptlon: L38, Tract A Eogle Crest #1 DEPTH (FEET) 5" "~:' ' ' "" 7- '"" : Organic GM Silty 10- 11- 12- 13- 14 - 15- 16- 17 - 18- 19- 20- 81- Grovel, T.H, Locotion,' See Attoched Design Groundwater? No Depth -- Water Depth AFter Monitoring.~' Date, 3/30/05 D~te Gross TIMe Net TIMe Depth Net Drop 3/23 0 -- 5- -_ 3/23 3 3 mln 5.25' 0.85' 3/23 35 -- 5, -- 3/23 38 3 mln 5.25' 0.25' 3/83 70 ---- 5- ---- 3/23 73 3 rain 5.85' 0.25' Percolation Rate ll2 Mln./Inch Pert Hole Diameter 6' Test Run Between 8' end 3' CERTIFY Att State/Municipal Comments: PerFormed BX~Q. I PerFormed in Accordance with ON THIS DATE, DATE, 3/30/05 THAT THIS TEST WAS Guldetines In EFFect Municipality of Anchorage Development Services Department ~. .. Building Safety Division ??~' ~ t,,,Jt~ L'~ 2.'~,~ '~ On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWERJVVELL SUBMITTAL COMMENT SHEET To: North Rim En.qlneertnq Legal description: Eaqle Crest #1 Tract A Lot 38 The attached paperwork has been reviewed and is being returned for the following reasons: Original signature or stamp missing on Calculation error in design. [] Additional soils information needed. [] Water monitoring results inadequate. NEED TO DO GROUND WATER MONITORING THRU MAY 15TM, TO DETERMINE HIGH GROUNDWATER, TO DETERMINE THE ELEVATION OF BoTroM OF SEPTIC DESIGN. D iscrepancy in information submitted. Topographic information missing or inadequate. [] Incomplete; missing PROPOSAL NEEDS TO STATE UPPER SlX INCHES OF THE MOUND SYSTEM MUST CONSIST OF TOP SOIL AND THE MOUND MUST BE VEGETATED SUFFICIENTLY TO PREVENT EROSION. [] Incomplete; missing NEED TO SHOW SLOPES DOWN GRADIENT OF SEPTIC DESIGN. PLEASE BE MORF SPECIFIC OF DEPTH OF TRENCH DESIGN WITH RESPECT TO ORIGINAL GRADE ON SPECS. & DESIGN GUIDELINE-q AND CROSS-SECTIONAL VIEW. HOW DEEP DOES THE EXCAVATOR NEED TO DIG? Additional adequacy test information needed. Water sample unacceptable. Measured/proposed distances/dimensions missing. Locations of all soils, percolation and water monitoring tests not shown. Proposed system too deep for soils information submitted. Well log required. Omission in narrative. Insufficient fill over tank or field. [] Other. THE SITE PLAN NEED TO SHOW MEASURED DISTANCES TO ALL WASTEWATER DISPOSAL SYSTEMS, WELLS, SURFACE WATER OR DRAINAGE COURSE% ROADS, PROPERTY LINES AND STRUCTURES WITHIN 200 FEET OF THE LOCATION OF ANY EXISTING OR PROPOSED ON-SITE WASTEWATER DISPOSAL SYSTEMS, Name of reviewer: Joe Goodall Date: 4/13/2005 P/ease supply the necessary information and re-submit your request. _ /?Fp,,,,„&MUNICIPALITY OF ANCHOGE ' Development Services Department ) Phone: 907-343-7904 On-Site Water & Wastewater Section ^ Fax: 907-343-7997 Certificate of On-Site Systems Approval rr1 Parcel I.D. 050-303-33 �� ?' Expiration Date: Zn ` 1. GENERAL INFORMATION Complete legal description EAGLE CREST #1 TR A LT 38 Location (site address) 19509 SECOND ST, EAGLE RIVER AK Current property owner(s) RUTH SMITH Day phone Mailing address SAME Real estate agent 2. TYPE OF DWELLING: i Ri..i� �4- ❑ Single Family (w/wo ADU) RG60 MlaY1o2019 ❑ Duplex H Multiple Dwellings (Single Family and/or Duplex) ti. 3. NUMBER OF BEDROOMS: 4 li Ol 6 8 9�� 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic ❑ Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: a/ Date: 'S'//V((p COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ J5 7)t 3 Z'b Waiver Fee $ Date of Payment 67/3Y/9 Date of Payment Receipt Number 01/04!// If 21 g9 Receipt Number COSA# OSCI Q Wib _ 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 MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 5-15-19 OF At \It ' fr:4gTH +r' '•1- d0 6. DSD SIGNATURE System #1 Approved for 4 bedrooms 10:•MICHAEL N. ANDERSON . System #2 Approved for bedrooms +�`•••• 10 / 49 0,0 Disapproved t \��P:( • •10���'� - Conditional approval for bedrooms, with the following stipulations: lllllltl((El(!!!( . .:.':: G` patTY OF,q ��i//i ON-SITE 1$6-4' WATER AND o WASTEWATER a; PROGRAM Q1 -Ail. c....Ci., f '111)))))i)+0. ..- / _�o�/�' By: - c.- V 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 COSA Checklist Legal Description: EAGLE CREST#1 TR A LT 38 Parcel ID: 050-303-33 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system A. WELL DATA D Well log is filed with Onsite (or attached) Well production at time of test 5+ gpm Date drilled 5/2/05 Water storage tank volume 0 gallons Total depth 275 ft Well disinfected for coliform test? ❑ Yes 0 No Cased to 275 ft ■❑ Coliform bacteria is Negative ■❑ Sanitary seal is functioning correctly Nitrate 0.861 mg/L ❑ Nitrate less than MRL (ND) El Wires are properly protected Arsenic ug/L Arsenic less than MRL (ND) Casing height(above ground) 24+ in. Collected by MNA Date of flow test for COSA 5/6/19 Date of Sample 5/6/19 Static water level at beginning of test 240 ft. Comments B. TANK DATA C. LIFT STATION Age of tank(s) 2007 years ❑l Required maintenance completed Tank type/material STEEL Age of lift station NEW years Measured operating fluid level in septic tank 48 Lift station material ❑ Standpipes/foundation cleanout per record drawing Comments: SYSTEM WAS TOTALLY REBUILT IN Date of pumping SYSTEM WAS REBUILT IN 2017 2017, W/TANK CLEANED. D. ABSORPTION FIELD DATA IDSF SAND FILTER Which system tested (date installed) 7/7/17 Adequacy test date 5/6/19 ❑I■ ALL standpipes present per record drawing Results ❑✓ Pass For 4 bedrooms Total measured depth from grade 4.5 ft(max) Fluid depth prior to test 2 in Measured depth to pipe invert from grade 2.5 ft(min) Water added 600+ gal ❑■ N/A— pressurized field 4 New depth in ❑■ Monitor tubes go to bottom of effective. If not, state Elapsed time 1440 min depth into effective ❑■ Code-required soil cover over field Final fluid depth 2 in Absorption rate 600+ gpd ❑ System presoaked UN (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: COSA Checklist yellow sheet . E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot> 100' Community Sewer Manhole/Cleanout> 100' ❑✓ Yes if No ft ❑✓ 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' E Yes if No ft Neighboring Absorption Fields > 100' Animal Containment> 50' E Yes if No ft 1=I Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' E Yes if No ft ❑✓ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ✓❑ Yes if No ft Surface Water> 100' ❑✓ Yes if No ft Property Line > 5' ✓❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' E Yes if No ft Private Wells > 100' ✓0 Yes if No ft Water Main > 10' ✓� Yes if No ft Community Wells > 200' Q Yes if No ft Water Service Line > 10' 0✓ 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' ✓❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ✓Q Yes if No ft Private Wells > 100' EI Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' 0✓ Yes if No ft Surface Water> 100' ✓0 Yes if No ft F. ENGINEER'S COMMENTS OF A[qs ll G. ENGINEER'S CERTIFICATION ie 4,, -. t .•171/ 1 certify that 1 have determined through field inspections and review /.k . 49TH of Municipal records that the above systems are in conformance with 00..; .. •.. ••••••••• ''re MOA COSA guidelines in effect on this date. / j;.,4del. •' •••..... ,v .Ø. MICHAEL N. ANDERSCN rr .. CE- 4 9 ...:,-":'-'..,,.% Il PROffSS10'L%i 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 q Day of MP: of 20 (q , by and between �]fQ E,01\.) ,herein the"OWNER," and the Municipality of Anchorage, herein the"MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 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 19509 Second Street - Eagle River,AK 99577 located at (legal description) Eagle Crest#1 Tract A Lot 38 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) 8C 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. /1--) 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). SPOwner 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. SeOwner 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 iFOwner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. )4P 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. )019 Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. tiF Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing )42 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 he 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 OWNER: By: hkrOalI (signature) Date: J 2- kAk'ot.j i12)., (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT The foregoing instrument was acknowledged before me this 'day of 20 , by ltaron PoLp •jr. �%, moor —f NOTARY PUBLIC •TARY UBLIC FOR ALASKA SAVANNAH N. MELENDEZ My Commission expires: ,(,fdrth lyi W 2,2 STATE OF ALASKA MY COMMISSION EXPIRES March 14,2022 MUNICIPALITY: (signature) Date: .5;-4(19—( q (print name) Title: (rev. 05/18/2018) Page 3 of 3 -iiii tr,, '•:.7v * . - . *Ai'$$ .0114.11 4 141,!,,t!4‘,',110 la ii ' . ., . .., - .-.... - . . .. __— ___... -, ,av n,,,- : . , I) , ..,,, -A-tik,site\yaw et waste-.atm-Program i • ' ' , .., 4-i . • .z, ...,,,-„r.t 1 It ,, , •.,• , ,,.,, .01/4 ts.1.19.04,kii.11{11. VOA,,, irM ,Org Intermittent Dos,rq Sand Filter Maintenance Log Owner Street Address ick 5-0,1___ 1 Si- , Phone__ Legal Desc, RID_ ..__. _ 1 .apsilsjiL...1k: 1 1 ...Sludge:. level C.,--K_Inches •Pumping required yes cow -Pumping completed yes no i AbsorptionFi Igi i -Liquid level Li inches •Flushing valves per approved design Mt no 1 •All flushing valves opened, distribution lines flushed, and flushing valves closed at_ELo, II Lift station: 1 1 *Pump basket cleaned es • no -13iotube effluent filter cleaned s"0o I 'firmer float Setting2Linches -High level float setting ii) inches -Reference point rof 4 r4nt. I 'PLIrilP on...., seconcts -Pump off ho minutes -Cumulative lifetime cycles i -Cumulative run time 3(t. 0\‘-i hours •Operation satisfactoryZgid..._LT I Air System: 1 •Air pump filter cleaned e no •Air pressure Li PSL l 1 ' N . Date of latest install or rebuild Ci.(.3\ 3,0\?, -Air system operation satisfactory ' not satisfactory 17 I Alarm System: ,---.4.7., -Dedicated electrical circuit (ves,j. no I •Audible and visual alarm inside dwelling e no _....,, . •Float setting 6,C.) inches •Atarrn system operation atisfacto N not satisfactory l j Comments: ..- 1 1 li 1 / Maintenance Provider: Date of ma ] 7 A ,ICI I intenance / 1 1 Technician 1- c7'-y 1 3g- \-V-‹ • I c.Q Company L-4- e9AA ..,"'' Date ( i Mkt/ f Ia t , Signature _. . ? L------ - , ----,, . ,,,, ,, ,. echn I 0.•"I•• • . . ,: C°rn h. �� Municipality of Anchorage ~ On -Site Water and Wastewater Program � (907) 343-7904 001 CERTIFICATE OF ON-SITE SYSTEms APPROVAL rnjol /~ \ Parcel J.D. 050-303-33 0117 Expiration Date: a_ 017 1. GENERAL INFORMATION Complete legal description EAGLE CREST 91 TRACT A, LOT 38 Location (site address) 19509 2ND ST, EAGLE RIVER AK Current Property owner(s) BILL BUCHLEITNER Day phone Mailing address Real Estate Agent 2. TYPE [>FDWELLING: N Single Family kw/wmADU\ Fl Duplex El Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OFBEDROOMS: 4_ 4. TYPE OFWATER SUPPLY: TYPE OFWASTEWATER DISPOSAL: Individual Well Individual M Individual Water Storage 0 Holding Tank 0 Community Class Well 0 Community 0 Public Water System EJ Public Sewer D WaiverNariance request for: Distance: Received by: -,� O8te: COSamme��eoedmthe engm� engineer, otherwise requested the / ' ' C[)8AFee Waiver Fee $ Date ofPayment Date ofPayment Receipt Number Receipt Number CO8/\# VVaiver# 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 MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE. Engineer's Printed Name MIKE N ANDERSON, PE Date 8/2-5/17 DSD SIGNATURE 1/SISystem #1 Approved for L. bedrooms System #2 Approved for bedrooms. Disapproved. � T P PAICHAR N. ANDER50id� C °4Lr 9�%t59 �F E M 1113 Conditional approval for bedrooms, with the following stipulations: By: Original Certificate Date: i7 The Municipality of Ani Drage 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 blue sheet 10-10-12.doc Ifmore than 1septic system isonthe lot: C[}SAChecklist # -of ____ Structure served by this system Legal Description: Parcel ID: 050-303-33 Well type Private |f/\ B. or provide PVVS|D # Well Log (Y8N) Dote completed 5-2-05 Sanitary seal (YYN)I Wires properly protected (\/N) y Total depth _275_ft Cased tu275_ft. Casing height (above ground) _24"+ FROM WELL LOG AT INSPECTION Date oftest 5�05 4/3/2017 Static water level 240 ft. 240 ft. Well production 7 g.p.m. g.pm. WATER SAMPLE RESULTS: Coliform NEG Loo|onies/10OmL Nitrate _AWmg/L Arsenic: - ND ug/L Date of sample: -4an4st- Collected by: Mike Anderson B. SEPTIC/HOLDING TANK DATA N TanhType0Moteha| Date installed 7-7-07 Tank size _1250 +500 gal. Number ofCompartments 2�� C|eanouto(YYN) ' Foundation cleanout (Y7N)y Depression over tank (\YN) N High water alarm (\YN) NA Date ofpumping Pumper Alaska Quality Pumping C. ABSORPTION FIELD DATA - Dateinsta| Soil rating (GPO/SF)2li_ Syshamtypa BED/ ZpSAC Length _25ft. Width _13ft, Gravel below pipe _0.5ft, ` Total depth __5_ft. Ef[absorption area 325 ft2 Monitoring tube Depression over field _N__ Date ofadequacy test Results (Paoa/Fai|)NEW For _4_bedrooms Fluid depth in absorption field before test in. VVoterodded___goi New depth in. Elapsed Time: ____min. Final fluid depth __in. Absorption rate >=_g.p.d� Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Size ingallons anho|e/Axx*ss(Y7N)_y "Pump on" level at 65 in. "Pump off" level at 70 in. High water alarm level at 60 in. Datum RISER TOP — Cycles tested 3 Meets alarm & circuit requirements? Y E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station onlot Absorption field on lot Public sewer main Sewer /septic service line Animal containment areas SEPTIC/HOLDING TANK ONLOT TO: Building foundation 10' Property line 10' On adjacent lots (Jnadjacent lots Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas 100'+ Absorption field Water main Water service line Surfauewaba Wells onadjacent lots _1O{'+�____ ABSORPTION FIELD ONLOT TO: - Property line Building foundation 10'+ Water main UA zap` Water Service line 50'+ Surface water Drivenay, parking/vehicle storage 50'+ Curtain drain VVe||s on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION / certify that / have determined through field inspections and review ofMunicipal records that the above systema are in conformance with MOA CO3Aguidelines /neffect onthis date. Engineer's Printed Name MIKE N. ANDERSON, PE Dote 8/25/2017 CoS*canary sxoeLe-6'1o.dox -----L------------1--- I ® F o 7 ----- 100' well radius / 0 0 L6 r-> 7 0 0 O O ii WELL* S 89`56'00" E. 132.00 10' UTILITY EASEMENT ------------------------------- • I SEPTIC I • • Q I I \ I \ I �- 6' WOODEN FENCE \ \ \ I �\ I � I � I [ 2' cant. 38'0 \ \1 I 6' WOODEN hNCE� I TWO S \ I WOOD RAMS \ HOME o M \ I \ I 17.0 14.4: 21.0 ^ 1 I 1 I WELL '.. ".:. N I I Bobby F. Burnett 2941 arriage Drive Anchorage, Alaska 99507 (907) 350-5541 ate Scale 7/10/2017 1" = 30' -rid AS -BUILT NW 0055 raven by Field Book BFB ASB -2017 S 89'56'00" E. 132.00 GRAPHIC SCALE 1 Inch = 30 Feet 15 0 15 30 60 f— 0 z 0 w I w _ 0 r ZD _J O z 0 CA 0 I I I I I I I I I I I I I I ' 39 I I I I I I I I I I I I I I I I I No property corners were found or set during this survey. House placement is based on an As—built survey dated 8/29/09 by Seward & Assoc. Land Surveying. Improvements from previous survey have been Re—Certified during this survey, and are as shown. �__� i OF AL�� i� " TH �.....9... ........, / -- .... . - ...� .� A BOBBY F. BURNETT / LS -5464 1 \ ftsSIOAOr NAL S' �� De Lot 38 1 Tract A EAGLE CREST SUBDIVISION FIRST ADDITION PLAT #63-70 I hereby certify that the property described hereon has been surveyed by me, or at my direction, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto unless otherwise shown. That no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other easements on said property except as shown. • ° .� Municipality of Anchorage r< { On-Site Water and Wastewater Program sill II la (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-303-33 Expiration Date: 1/2- c;20 ti 1. GENERAL INFORMATION Complete legal description EAGLE CREST#1 TRACT A, LOT 38 Location (site address) 19509 2ND ST, EAGLE RIVER AK Current Property owner(s) BILL BUCHLEITNER Day phone Mailing address SAME Real Estate Agent Day phone 2. TYPE OF DWELLING: ® 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 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: 71:;z7 Date: / " 2.7-/7 COSA to be released to the a sneer,unless otherwise requested by the engineer. COSA Fee $ 5-I ',5O Waiver Fee $ Date of Payment f 1til/ " Date of Payment OP Receipt Number a`o Receipt Number COSA# 66C 1?// 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 MIKE N ANDERSON,P.E. Phone 727-8864 Address 4661 NATRONA AVE. Engineer's Printed Name MIKE N ANDERSON, PE Date 4/12/17 „, • es. .e • _J ^. -r�\ C.) y: 6. DSD SIGNATURE s+ MICHA.2. N. ANDERSON CE System #1 Approved for bedrooms. `" '•,•s� System #2 Approved for bedrooms. n flu:• Disapproved. II Conditional approval for `7 bedrooms, with the following stipulations: S p+c S, n vvti \3e•, lT D rade ci o e/-n f•4- OSP .'.7 1 OS r n o'd `— • 6 0 7ii c / 4S4 he inS r ss QP O ON-SITE• WATER AND WASTEWATER oz: c PROGRAM •e,' By: !t ' e _4' ���� Original Certificate Date: 27 /7 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 blue sheet 10-10-12.doc 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: EAGLE CREST #1 TRACT A. LOT 38 Parcel ID: (I50-303-33 A. WELL DATA Well type Private If A, B, or C provide PWSID # Well Log (Y/N) Y Date completed 5-2-05 Sanitary seal (Y/N)Y Wires properly protected (Y/N) Y Total depth 275 ft. Cased to 275 ft. Casing height (above ground) 24"+ FROM WELL LOG AT INSPECTION Date of test 5-2-05 41312017 Static water level 240 ft. 240 ft. Well production 7 g.p.m. 5+ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate `-1, 5 ,mg/L Arsenic: ND ug/L Date of sample I10 Collected by- Mike Anderson 3/ /� B. SEPTIC/HOLDING TANK DATA /r Tank Type/Material SEPTIC 1 STEEL Date installed 10.18.05 Tank size 1250+500 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) NA Date of pumping 4-3-17 Pumper Alaska Quality Pumping C. ABSORPTION FIELD DATA– Date installed Soil rating (GPD!SF) 2.0 System type BED Length ft. Width ft. Gravel below pipe 0.5 ft. Total depth ft. Eff. absorption area ft` Monitoring tube Depression over field Date of adequacy test Results (Pass/Fail) For—bedrooms Fluid depth in absorption field before test in. Water added gal New depth in. Elapsed Time min. Final fluid depth _ in. Absorption rate >= g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date - D. LIFT STATION Date installed 7-19-05 Size in gallons 1250 Manhole/Access(Y/N) Y "Pump on" level at 65 in. "Pump off' level at 70 in. High water alarm level at 60 in. Datum RISER TOP Cycles tested 3 Meets alarm&circuit requirements? Y E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 1001+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 251+ Holding tank 100'+ Animal containment areas 1001+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10' Property line 10' Absorption field 5' Water main 100'+ Water service line 25'+ Surface water 100'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line Building foundation _ Water main Water Service line Surface water Driveway, parking/vehicle storage Curtain drain 50'+(None Known) Wells on adjacent lots F. COMMENTS CONDITIONAL APPROVAL G. ENGINEER'S CERTIFICATION 4 P Zi I certify that / have determined through field inspections and r ` �.• •°•'sf.�t review of Municipal records that the above systems are in h•• • •'q' conformance with MOA COSA guidelines in effect on this date. o �`: 4 9T fr: :_^d� •••.1711/1---• Engineer's Printed Name MIKE N. ANDERSON, PE v••MICHAEL N. ANDERSCN Date 4112/2017v CE-9469 ••!';> �/`t tip.. � Ff ss COSA canary sheet_2-6-15.doc Proposal Michael N. Anderson, P.E. Civil/Structural Engineering and Construction 4661 Natrona Ave. Anchorage. Alaska 99516 Phone 727-8864 Fax 345-1391 April 21 , 2017 Nancy. Audrey & Brent Mason Re/Max of Eagle River 907-622-3344 Re: Septic Excavation Legal: I.AGED. ('REST #1 TRACT A. LOT 38 Description of Excavation services Proposed: 1. Excavation for installation of a new sand filter located in the same spot as the existing filter. Also includes plumping and inspecting of the existing tanks for holes. If the two tanks are found to be damaged then they will be replaced. Total Proposal $ 6,650.00 R - SID -- NTIAL k;.1 -, ,,01 1 VORTGAGE LLC V LS # 167729 4-25-17 Re: 19509 Second Street Eagle River, AK 99577 To Whom It May Concern: Residential Mortgage LLC will collect a minimum of$13,300 for a septic escrow on this property. We are awaiting an additional bid.The figure above is based on the first bid. We will hold two times the amount of the largest bid. The escrow will not be released until we have a fully approved COSA. Please feel free to call me with questions or concerns. Sincerely, Tr cy Ottinger Mortgage. o.n Officer 411 License#196900 9o7— 6 9. -Fp4/ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-303-33 GENERAL INFORMATION Complete legal description Location (site address) COSA # ~_.~./ Expiration Date: Eagle Crest #1, Tract A, Lot 38 19509 8nd Street Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Greg Kopeck 19509 8nd Street Day phone 810-383-9883 Day phone Jan ]:leering RE/HAX o¢' Eagle River Day phone 840-4858 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class ~ Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank Community On-site Public Sewer [] [] [] The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems Approval (COSA) based ,only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site System's Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeownem. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my. investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the MuniciPality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Nor'thRim Engineer-,in9 Phone 694-7028 Address P.D, 3ox 770724 Engineer's Printed Name S-I:eve Eno Date 12/1/18 DSD SIGNATURE p"'"' Approved for ~ Disapproved.. Conditional approval for bedrooms. bedrooms, with the following stipulations: 'F'~_'...~ ON-SiTE '. ;'""' :~: WATERAND ". '. PROGRAM - By: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other (Rev. 11105) Municipality.of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Street P.O, Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: EagLe Crest #1, Tract A, Lot 38 Parcel ID: 050-303-33 A. WELL DATA Well type P Date completed 5/8 / 05 Total depth 275 ft. If A, B, or C provide PWSID # Sanitary seal (Y/N). Y Cased to 2 7 ~. Well Log (Y/N) Y Wires properly protected (Y/N) Y casing height (above ground) 30 in, FROM WELL LOG AT INSPECTION Date of test 5/2 / 05 Static water level p zt n ft. 7/!3/09 P.qg ff. Well production 7 g.p.m. ., 6,5 g.p.m. WATER SAMPLE RESULTS: aw Coliform 0 colonies/100 mL Nitrate Arsenic: 0,2~1_ date of ~ample: <MR~ng/L 10/20/10 Other bacteria 0' 'colonies/100 mL Collected by: NorthEim Tank Type/Material Tank size ~-~ O~al. Foundation cleanout (Y/N). Y Date of pumping 6/29/10 ABSORPTION FIELD DATA Date installed 10/18/0b~oil rating (g.p.d./ff2 or ft2/bdrm) Amchorage Tonk Number of.Compartments ~ + Depression over tank (Y/N) ..... N Pumper Length 25 Total depth , 4,,~. Date of adequacy test Fluid depth in absorption field before test 0 in. Elapsed Time: 2i~iPn. Final fluid depth Date installed 10/18/05 1 Cleanouts (Y/N) y High water alarm (Y/N) Y Sanitary Pumpers 2 ff. Width 13 ~'~- ft, Eft. absorption area 3P,-~t~ Monitoring tube ~ 7/13/09 Results (Pass/Fail) Pass IDSF System type Gravel below pipe 0,25 ¥ Depression over field N For 4 bedrooms Any rejuvenation treatment (past 12 mo.) (Y/N & type) Water added 60~al. New depth 0 in. in. Absorption rate >= 600 g.p.d. If yes, give date De LIFT STATION 7/19/05 1250 Date installed Size in gallons 65 . 70. "Pump on" level at __ ~n, "Pump off" level at ~n, Riser Top 4 Datum Cycles tested Y Manhole/Access (Y/N) 60 High water alarm level at in. Y Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: 100' + Septic tank/lift station on lot 100' + Absorption field on lot NA ~ Public sewer main 25' + Sewer/septic service line 100' + Animal containment areas 100' + On adjacent lots On adjacent lots Public sewer manholelcleanout NA Holding tank . Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10'. + Property line~10' + Absorption field Water main NA water service line 25' '~urface water 100' + NA 100' · Wells on adjacent lots 100' + 5/ -I- 100' + SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 1 O' + 10' + Water Service line NA Curtain drain Building foundation 10'+ Water main NA 100' + Surface water Driveway, parking/vehicle storage 100' + Wells on adjacent lots 25' + F. COMMENTS ~ ~ ~ysteM Rechecked 11/10- RebuiLt Air PUMp Installed 11/30/10 .~-' OF -~-~,~. G. ENGINEERS CERTIFICATION review of Municipal records that the above systems am in confo~ance w~th MOA COSA guidelines ~n effect on this date. Steve En9 Engineer's Printed Name D ate ' cosA Fee $ Waiver Fee · ~ / Date of Payment /~/~ ~ Date of Payment R eipt Nu be C/--5 W e ipt Numbe (Rev. 11/05) Municipality of Anchoragi P.O. Box 1%' *65o • Anehorage, Alaska 99,51)-MV)o • Telephone (907) ,3'Ii3.8301 • FWX (SM)7) 3443-8200 47tH) I3ragaw Street • Anchona e, Alaska W507 Mayor Mark Becgich January 6, 2009 Major Gregg Kopeck 21511 Bubbling Creek San Antonio, TX 78259 wx%v.III uni.org Building Safety Division Re: Eagle Crest #1 Subdivision Tract A Lot 38, PIN 050-303-33, Permit Number SW050094 Dear Mr. Kopeck: Thank you for your letter received in our office on December 29, 2008. We have received a letter from the most recent engineer, Jeff Garness, PE, of the Garness Engineering Group, Ltd. Mr. Garness states that you have hired him to assess the problems you are experiencing with your on-site wastewater disposal system. In Mt. Garness's letter to you dated November 6, 2008, he describes repairs he performed on November 5 & 6 of 2008 to the lift station delivery line to the Intermittent Dosing Sand Filter (IDSF). While repairing this line he noted insufficient insulation and soil cover on this line. This is contrary to what the original design submitted in April and the inspection report submitted in October of 2005 by your engineer (Steve Eng, PE) stated. Also, in Garness's letter he describes that he installed a monitor tube in the southeast corner of the IDSF. While installing this monitor tube, Mr. Garness documented biomatting of the pea gravel, high water levels saturating the IDSF and soil/dirt that was contaminating the filter sand. These are improper conditions for an alternative wastewater system of this type to have and to function in the manner in which it was intended. These conditions are also contrary to what the design and subsequent inspection report submitted to this office in 2005 indicated. Past performance of alternative wastewater systems of this type, designed and constructed properly, will function adequately for the purpose intended indefinitely. This adequate function will also be dependent upon proper use of the system by the resident(s) occupying the home for which it serves and the code required annual maintenance check of the system by a certified professional. As a result of the items described above this office is dependent on the professionals tasked with the duties as described in the On -Site Wastewater Code, AMC 15.65, and the property owner to see to the proper installation and use of on-site wastewater disposal systems. Community, Security, Prosperity January 6, 2009 Major Gregg Kopeck Page 2 of 2 I recommend you continue to work with your engineer to resolve the problems with your wastewater system. Because of the numerous variables that cannot be controlled by this office with the construction and the use of wastewater systems, we are not in a position to assist in the repairs when they malfunction. It is the responsibility of the property owner to have repairs performed on the wastewater system in question so that it will function properly and be in compliance with the wastewater code. Thank you for your letter concerning your wastewater system. If you have further questions please contact me by phone (907) 343-7907 or email at RothDJ@muni.org . Sincerely, Daniel J. Roth Program Manager On -Site Water Well & Wastewater Program Cc: Jeff Garness, PE, Garness Engineering Group, Ltd. Poet, Jeff W. From: Sent: To: Cc: Subject: Thompson, Ron J. Friday, August 21, 2009 4:15 PM Poet, Jeff W.; Wockenfuss, Deborah M.; Crewdson, James A. Jones, Greg RE: Eagle CrestS1, Tract A, Lot 38 Septic Issue Engineering Rp Jeff. Please copy this letter to the file and this will justify that the Gamess Engineering report has been addressed adequately by Steve Eng. Steve has justified that his Engineering and the current installation is adequate and the COSA can be approved as this system is operating as designed and as per manufacturers guidelines. I view all issues noted in Garness Engineering letter have been repaired by Gamess Engineering or addressed per Steve Eng, P.E. Please copy this e-mail in the file as well. Rm P.E. Director/Building Official Development Services Department Municipality of Anchorage (907)-343-8301 (907)249-7412 fax From: .]ones, Greg Sent: Friday, August 21, 2009 8:28 AM To: Thompson, Ron .1. SubJect: FW: Eagle Crest#z, Tract A, Lot 38 Septic Issue Engineering Rp Let me know if this clears this issue up. I/Greg From: KlebesadeI,Tawny H. Sent: Friday, August 21, 2009 8:22 AM To: Jones, Greg Subject: Eagle Crest#l, Tract A, Lot 38 Septic ]ssue Engineering Rp << File: Eagle Crestl .Tract A.Lot 38.Septic Issue pix.jpg >> << File: Eagle Crest. i .Tract A.Lot38.Septic Issue Engineers Rpt.pdf>> Tawny Klebesadel. Assistant to the Executive Director M unicipality o fAnchorage Office o£Economic & Community Development 632 W.6th Ave.; Suite #870 Anchorage, AK 99501 Phone: (907) 343.4365 Fax: (907) 249-7976 Email: Klebesadeltm~muni.org MEMO Steve Eng, PE, PH P.O. Box 770724, Eagle River AK 99577 (907) 694-7028 tel NorthRimEng@aol.com Date: 8/10/09 To: Greg Jones, MOA Subject: Eagle Crest #1, Tract A, Lot 38, Air System I was asked to comment on the air system for the subject IDSF. The IDSF in use on the subject property is a proprietary system manufactured by Orenco Systems Inc. (osr), and distributed locally by Anchorage Tank. I have spoken extensively with OSI and Anchorage Tank concerning air gage specifications. OSI has no air gage specifications for the IDSF and any claims made concerning air specifications are false. The air system was properly installed within the sand filter. The notion that one could see air bubbles at the surface is very questionable; this is not part of any OSI testing or maintenance checks. I have monitored the system since early February, 2009 and the monitor tube has been completely dry except for a couple times, with less than one inch of water in the monitor tube. The monitor tube installed by GEG was not located in the absorption field, but was offin the embankment edge- fids would yield no useful information. · The recent COSA inspection was performed over a 3 day period and the monitor tube was completely dry. The IDSF appears to be working very well. F%.I~INEERING MEMO Steve Eng, PE, PH P.O. Box 770724, Eagle River AK 99577 NorthRimEng@aol.com Date: 8/4/09 Number of Pages: I To: Jeff Poet & Jay Crewdson, MOA On-Site Program Subject: Eagle Crest gl, Tract A, Lot 38 A recent COSA inspection was conducted on the subject property. The mounded sand filter was completely dry and performed well under several days &observation. The mound has been monitored continuously throughout the 2009 spring breakup period to ensure it has been working correctly. A buyer recently decided not to purchase the property, based on a letter in the MOA file by Gal'ness Engineering Group (GEG). The engineering data in the letter is fundamentally flawed: 1. The monitoring tube that was installed by GEG was not installed in the absorption field, but rather in the fine-grained embankment slope that supports the absorption field. This flawed monitor tube was also installed at a lower level than the original correctly installed monitor tube. Observations &this incorrectly installed tube, lead to incorrect conclusions on the performance ofthe absorption field. 2. The air pressure specifications cited by GEG have no basis as ORENCO, Inc. specifications. The recent COSA inspection revealed that the GEG air pressure gage was not working correctly, indicating a I psi reading when the air pump was turned off, with no pressure in the line. 3. The other listed work in the letter was also questionable. Digging through frozen ground to check for a broken plastic line, will likely break the plastic line. Bentonite clay as a backfill material is also questionable. Depressions were evident from the winter excavation. This work xvas detrimental to the wastewater system and should not be allowed in the future. This flawed letter should also be removed from the file. CC: Properly Owner/Realtors 21511 Bubbling Crk 1 " San Antonio, TX 78259 23 Dec 2008 Ref: 19509 Second St, ER (Legal: Eagle Crest Lot 38 Tract A) Happy Holidays, My objective in writing to you is to seek official sponsorship to legally compel Northrim Engineering to fix our septic system, 19509 2nd St, Eagle River, AK. I feel the Muni is obligated to do this since they are responsible for certifying the system. Several months ago I discussed a problem with your experts at the muni who certify on-site water systems. I was told that the muni engineer who certified my septic -system was subsequently `released' from his job after several issues with septic system installations gone awry. I have consulted with three separate engineering firms who agree that the system that was installed at my house in Eagle River was inadequately designed. During my lengthy conversation with OSW&W I was very pleased with the genuine concern and advice I received; but it was plainly obvious to me that this one "slipped through the cracks", and I continue to deal with the fallout. As I emphasized during our teleconference, I'm interested in making my septic system operational. I currently do not reside at this residence; we purchased the house in 2005, when assigned to Elmendorf AFB. Almost immediately we were hit with Base Realignment and Closure (BRAC) and reassigned to San Antonio, TX. Unable to sell but "assured" by our builder our septic problems were fixed, we rented to another military family. Now they and I are sharing the nightmare that consists of flooded basements, endless septic alarms, holding tank pumping, etc. The costs associated with this, of which I'm finding harder and harder to find justification for, are becoming obscene for new construction. Please help. Again, my objective in writing to you is for OSW&W to legally compel Northrim Engineering to fix our septic. Northrim, incidentally, has returned exactly one phone call in the past two years, and that was to refer me to someone else to do the work. I'm currently working with Garness group to control the current situation at the house. The builder is Mike Quinn of Quinn construction. I have discussed this entire problem with the state inspector and Muni ombudsman. Tank YOU u / Maj Gregg Kopeck GkopeckOOI@satx.rr.com 210-383-9823 GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS November 6, 2008 Gregg Kopeck 19509 Second Street Eagle River, Ak 99577 Attention: Gregg Kopeck Reference: Eagle Crest #1 L38 Tract A Gregg, On I115108 and 11/6/08 our crew completed repairs on the existing septic system on the addressed property. In addition to these repairs, details regarding the systems initial installation were observed. Both the inlets and outlets of the 500 gallon, and 1250 gallon tanks were inspected for leaks and bung integrity. All of the connections appeared to be sound and free of leaks. The connections had been bedded in pea gravel. The depth of this bedding material was not verified. Bentonite chips were placed and compacted by our crew surrounding all inlet and outlet connections. The pressurized line running from the lift station to the field is approximately 12' long. This 1.25" line was cracked approximately 3' from the pump vault. Although it was leaking at this point, effluent was still reaching the intermittent sand filter. This line was completely replaced by our crew with higher-grade schedule 40 thick wall 1.25" PVC. Ground settlement was observed under the pressurized line approximately 10' away from the outlet of the lift station. This line settled approximately 3". This "belly" in the line was a potential freeze point in the system. The outlet of the lift station was completely encased and surrounded with bentonite chips by our crew and the belly in the line was fixed to achieve positive drainage from the drain field to the lift station. This line ~s also found to have inadequate soil cover so our crew placed 4" of insulation over the line. While exposing the South East comer of the bed, biomatting was observed throughout all of the pea gravel. The standing liquid level in the field was observed at the invert of the distribution line in the bed. In Short. the ISF was surcharged to the invert of the pressurized line. This is an indication that the ISF is either hydraulically overloaded, failed due to biomatting, or undersized. Our crew installed a monitoring tube approximately 3' offset of the South East comer. While installing this pipe, dirt was observed just underneath the top of sand in the sand filter. This dirt or mud can be observed by looking down this newly installed monitoring tube. 370l E. Tudor Road, Suite 101 * Anchorage, AK 99507 (907) 337-6179 * Fax: (907) 338-3246 * Webslte: gamessengineering.com Our crew installed a pressure gauge in the line just after the ISF's air pump in the house. This gauge showed a constant 3.5 PSI of air pressure. This is within the normal operating range we would expect. It should be noted that during the entire time of the work, no air bubbles were observed rising to the surface in the ISF. This raises some eoncerus that air is not being distributed properly throughout the chainfield. It is our belief that the ISF system is not operating as designed. This is based upon the biomatt that was observedfi~roughout the system and the liquid levels that were documented. /I ~,e conta~; ilyou have any questions. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: garnessengineering.com Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program · 4700 South Bragaw St. ~,P.O. Box 196650 Anchorage, AK 99519-6650 ~ www c anchorage ak us CERTIFICATE OF HEALTH AUTHORITY APPRO~/AL FOR A SINGLE FAMILY DWELLING Parcel I.D.. ,:'~ ~. 1. GE~.INFORM~TION :' Lo~bon (s,te address or~irections) Current; ;", Prope~y.. owner(s).,.v Mailidg add~es~', ' :-:;.;;-..~.',. z ~ Lending agency 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System Day phone, Mailing address Real Estate Agent L.,~I~ Mailing Address ' -- -ts" Un/ess otherwise requested, HAA will be held by DSD for pickup. NUMBER OF BEDROOMS: TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank /h Community On-site .[] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 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 private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The MunicipaIity of Anchorage is not responsible for errors or omissions in the professional engineer's work. e STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,.ord[nances, and regulations in effect at the time of installation. Name of Firm ~//'~ V"'~/'~,,,~ ~----.~,~._ Engineer's Printed Name ~ ~ ~ 5. DSD SIGNATURE .. Approved for Disapproved. Date x Conditional approval for 4 bedrooms, with the following stipulations: At rh~ e~m~ nf ~1~ ~r~nef~. the new property owner shall sign the at~ached maintenance agreement which shall be returned to this o'ffice before · an unconditional approval is issued. Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: / 0 - ~ (3' '0 ..9'" Municipality of Anchorage Development Services Department Buitding Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchoroge.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST ' Legal Description: ~"~/~'~/..~___. A. WELL DATA 7"~7",,,~ z~r~ ParcellD: 05'"0 - ~O~- 3~' Well type P Date completed Total depth ~--~ "~,.~ft. IfA, B, or C provide PWSID # Sanitary seal (Y/N) ~ Cased to ~_..'~,.5" ft. Date of test ., · Static water level Well production WATER SAMPLE RESULTS: Cohform (~ coloniesll00 mi. Arsenic: ~ mg/l. SEPTIC/HOLDING TANK DATA FROM WELL LOG ,~/-3/ O ft. '7 g.p.m. Nitrate .~,~/.. m g./I. Date of sample: ~'/,,~ Well Log (Y/N). Wires properly prote.cted (Y/N) Casing height (above ground) /t ~ in. AT INSPECTION g.p.m. Other bacteria ,, (~ colonies/100 mi. Collected by: ~,.~~,..~. Tank Type/Material,,~J ~. B/")/~ ~ C~_ ~M[~ ~o~ C4~'~.r~u~e ~nsm,eo Tanksize S~o gal.~.~ NumberofCompa~ments~ ~ ~ Foundation cleanout (Y/N) ~ Depression over tank (YIN) ~ Date of pumping' ~h_ Pumper ABSORPTION FIELD DATA Date installed/~/Z~ ~ Soil rating (gp.d./ft~ or~)..~ Length ~ fl. Width / $ ft. Cleanouts (Y/N) y High water alarm (Y/N) y System type ~..~'(Z a ~..~,¢,~L,,J.~_,.,,~'~j"~.'' Gravel below pipe (~ ~$"ft. Total depthS, 5' ff. Eft. absorption area .~'.5" ft2 Date of adequacy test ,/~-(,~ Results (Pass/Fail) Fluid depth in absorption field before test in. Water added gal. Elapsed Time: min. Final fluid depth in. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (YIN & type) Monitoring tube _~ Depression over field ,,4,/' For ~ bedrooms New depth in. gp.d. If yes, give date D. LIFT STATION Date installed '"]//?/0..5" 'Pump on" level at qr. in. Datum '7",~4a~' E, SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot / 0 0/4,- - -. Absorption field on lot / Public sewer main /df,4 Sewer/septic service line Size in gallons //~.- 5 0 'Pump oW level at_~t~ in. Cycles tested ~.~ Manhole/Access (Y/N) y High water alarm level at qJ~. in.. Meets alarm & circuit requirements? ~ On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK O1~ L~)T TO: Building foundation t/C) ~ Water main /t//4 .... Wells on adjacent lots /0 O' *+' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation Surface water tt O ~1 t' .f.. Wells on adjacent lots f/~O ~'~' Fo COMMENTS HAA Fee $ Date of Payment Receipt Number (Rev. 12101) ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name ~ 7"~---~,J~ ~ ~' Water main Driveway, parking/vehicle storagi 2 ~- ¢'~ Waiver Fee $ Date of Payment Receipt Number Property line t/O/'t~'' Water Service line ~. Curtain drain Property line / (3 cfi Absorption field · ~/~'' Water service line /~/'~- S~rfac~ ~ater- ~&O ~' ASBUILT ~ HEREBY CERTIFY THAT I HAVE SURVEYED THE cOLLOWING DESCRIBED PROPERTY: ND THAT NO ENCROACHMENTS E)~I~'; EXCE/F~ AS INDICATED. IT IS THE RESPONS~31LITY OF THE :.~VNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ¢NY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTAE ISHING BOUND- ,~RY LINES, SEWARD & ASSOCIATES LAND SURVEYING 694-O82q SCALE: ./ ' I 'DATE: - GRID: FB.' bRAWN: