HomeMy WebLinkAboutTHE TABLELANDS BLK 7 LT 3The Tablelands
Block 7
Lot 3
#051-801-35
"Gond. Approvals"
Municipality of Anchorage Page 1 of 3
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SW040300
PID Number: 051-801.35
Name:
S inell Homes Inc.
Wastewater System: New
Add. s:
19EW. Northern Us. Blvd., Ste. 200 Anch., AK 99517
ABSORPTION FIELD
Phone:
Number of Bedroom s:
344.5678
Five 5
LEGAL DESCRIPTION
Soil Rating:
Total Depth from original grade:
,4 GPD/Ft'
0.1 n.
Block: Lot: Subdivision:
Depth to pipe bodom from original grade:
Gravel depth beneath pipe:
7 3
The Tablelands
+.5 Ft.
.5 Ft.
Township: Range:
Section:
Fill added above original grade:
Gravel Length:
34 Ft.
140 Ft.
Well: AWWU Water System
Gravel width:
Number of lines:
Distance between lines:
15 Ft.
6
5 Fl.
Classifcation (Private, A, B, C):
Total Depth:
Cased to:
Total absorption area:
Pipe Material:
Ft.
Ft.
2,100 Ft=
ASTM 3034 PVC
Driller:
Date Drilled:
Static Water Level:
Installer:
Data 1. lied:
Ft.
Pisano's Dirtworks
5120-2412005
Yield:
Pump Set at:
Casing eight Above Ground:
TANK
GPM
Ft.
Ft.
SEPARATION DISTANCES
STEP
To
$epflC
AbBOfpflOn
Lift
Holding
ublic/Private
Manufacturer
Capapty in Gallons:
From
Tank
Field
Station
Tank
Sewer Line
Anchorage Tank
2,000
Well
>200'
>200'
>200'
NJA
>L5r
Material:
Steel
Number of Compartments:
Three (3)
Surface Water
>100'
>100,
>100,
N/A
LIFT STATION
Lot Dne
>5'
>10,
>10,
NIA
Size:
250 Gal.
Manufacturer.
Anchorage TanklOrenco
Foundation
>5'
>10'
>5'
NIA
"Pump on" level at:
"Pump off' level at:
High waler alarm at:
42 in.
42 in.
44 in.
Curtain Drain
None
Noted
Pump Make&Model
Orenco
Electncal Inspections performed by:
Allied Alaska Electric
Remarks:
BENCH MARK
Insulabon Over Entire Septic System.
Location and Description:
Finished' Floor. ;r
Assumed Elevation:
a 100.0 Ft.
Engineer's Stamp
.:
OF 11
�.� PSE........, .
:.
Inspections performed by: MEA
Dates: 1" 5/23/2005
i,,,? 49th ♦i
h.....�
......A....
•ANDERSON,�'t��
1 k
/0501] 4n ene-IA�'lon (Lp�arreA
A U ,
/
,thy 7L4.p na
1 � 5I2412005
0... .....L...EL •E.
I
[� /.�i/5 2
:;MICHAEL
Health
and Human Services approval
♦i s ND. CE
Cond?iOna�
Reviewed an approved b . Tie
!,a_�
i°lakela 1F77(V) Date: ! 200
.
♦1 TF''•.�,p ^nO' i
♦♦fF�pp'""""'"\P
(Rev. 10/99) —
♦'
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ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
MEMORANDUM
DATE: November 4, 2012
TO: Jeff Poet
FROM: Mike Anderson, P.E.
SUBJECT: The Tablelands, Block 7, Lot 3
Septic System Permit No. SW040300
Topsoil and seeding has taken place on the septic system area serving the subject lot.
Revegetation is complete and there is no danger of erosion to the slopes of the
completed mound. The conditional status of the inspection report should be removed.
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit No.: SWO40300
Ro4j0 00
Lo32.0 \, k E ESpI((.
414111
MM 28.25 20'
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M2 I 43.T 158.6 THE TABLELANDS SUBDIVISION
M3 1 95.5'167.1' LOT 3, BLOCK 7
M4 175.2-1 37.T
„ 40,332 S.F.
S
138,74
PLAN AS -BUILT
SCALE I' = 40'
Page 3 of 3
PID No. 051-801-35
Permit No. SW040300
TBM =
Municipality of Anchorage Page 3 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
PID No. 051-801-35
INSULATION
INSULATION
f 4'i 49th '
PROFILE AS -BUILT ;..y _
.. _.
Sc0le: 1 a yo' I CMIGMEL E. IWOERSON
t May 25 05 03:22p Allied nlaska Electric (907) 373-3(194
� ■ p.l
■ _ A
%E!%%Py ELCCTR/CA L
-ao3r CONTRA CT/NG
May 25, 2005
FAX: (907) 522-6779
Anderson Engineering
Attn: Mike Anderson
P.O. Box 240773
Anchorage, AK 99524
Subject: Lift Station Inspections at properties stated below.
This letter is to confirm that the lift stations at Lot 3, Block 7 Tablelands, and, Lot S, block 1
Glennview were wired by a licensed Journeyman Electrician in accordance with the 2002
National Electric Code requirements.
If you would like any further information, please feel free to call our office at the numbers listed
below.
Thank you.
Sincerely,
ALLIED ALASKA ELECTRIC, L.L.C.
kvvlzm
Janette L. Brown,
Vice President/CFO
cc: file
P.O. Box 876310, TVavilla. Alaska 99687 (907) 373-3893 ofa/(907) 232-8687 cc111(907) 373-3894 fax
/ MUNICIPALITY OFANCHORAGE
Development Services Department
Onsite Water 8 Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Date Issued: Jul 27, 2004
Expiration Date: Jul 27, 2005
Permit Number: SW040300 Parcel ID: 051-801-35
Legal Description: 7HE'TABLELANDS SUBDIVISION BLOC_K__7 LOT 3
Design Engineer: 0014 Anderson Engineering Site Address: NHN SAMBAR LOOP
Owner Name: SPINELL HOMES, INC Lot Size: 40332 SQ. FT.
Owner Address: NHN SAMBAR LOOP Total Bedrooms: 5 Permit Bedrooms: 5
EAGLE RIVER. AK 99577 -
This permit is for the construction of:
❑-' Disposal Field E 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.
qvigos mo..\ k1, oxo5 d �� ov'000 .
�m
Received By:
Date:
Issued BY Date: Z¢
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 SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 051- $ W - 35 Permit Number SW
Property owner(s) Soineil Homes, Inc. Day phone 3445678
Mailing address (1)1900 Northern Lights Blvd.,
Suite 201
Anchorage, AK 99517
Maki g address (2)--"(
Sfw1iYt r
UAOP
E • 1?. Zip Code
CICICJi�
Legal description (Lot, Block & Sub'd.) Lot 3. Block 7. Tablelands Subdivision
Legal description (Section, Township & Range)
Lot Size 40.332 Acre lSq.Ft.
THIS APPLICATION IS FOR:
Number of Bedrooms Five 151
Sewer Only ® Well Only ❑
Sewer and Well ❑ Water Storage ❑
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.
4E a--,
(Signature of property owner or authorized agent)
Permit Fees:
Date of Payment `
Receipt Number.
(Rev. 12100)
Waiver Fees:
Date of Payment
Receipt Number.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 FAX
May 17, 2005
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 3, Block 7, The Tablelands Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Permit Number SW040300
Dear Onsite Services Engineer.
The groundwater at Lot 3, Block 7, The Tablelands Subdivision has unexpectedly risen
and is currently encroaching into the recently constructed absorption trenches. We
therefore propose to replace the existing 1,500 -gallon septic tank with a 2,000 -gallon
STEP Tank and replace the 5' wide absorption trenches with 2 new 63' long by 15' wide
absorption beds. The bottom of the beds will be at the existing ground surface, which is
approximately 6' above the apparent water table at this time.
The existing septic system construction permit issued for this lot does not expire until
July 27, 2005. We are proposing to complete this work under this permit and will
provide a certified as -built once the work is complete.
Test holes recently placed on the lot indicated silty gravel with minor amounts of sand in
the area of the absorption trench and alternate site. The accepting soils were tested
and found to have a percolation rate of between 16 minutes per inch and 30 minutes
per inch. The system is designed with an application rate of .4 GPD/SF. A minimum of
3' of cover will be placed atop the beds and a minimum of 4' of cover will be placed
atop the new septic tank.
The ground surface on the lot slopes at varying grades from north to south as shown on
the Site Plan with steep slopes near the south end of the lot. The absorption beds will
be constructed parallel with the slope of the ground surface as much as possible in
conformance with Municipal requirements. The new septic system will be constructed a
minimum of 10' from the water service proposed for the lot and on adjacent lots. It will
Lot 3, Block 7, The Tablelands Subdivision
May 17, 2005
Page Two
also be constructed a minimum of 100' from any surface water in the area.
If the system is constructed in accordance with our design the following statements
apply:
1. The system, if constructed as designed, will have no adverse impact on the wells
in the area or those to be constructed in the future.
2. The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
3. The system, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
4. The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,
744-d�
Michael E. Anderson, P.E.
Attachments
THE TABLELANDS SUBDIVISION
LOT 3, BLOCK 7
40,332 S.F.
SAMBARi-�
/—/ 0'
E ,94 �'i•
,s\C
tDOINC-
� Existing 5' Wide Trenches
0eae
De
Remove Existing 1,500 Callon
Septit Tonk and Replace With
2.000 Callon STEP Tank.
2 — 15' Wide x 63' tang
Absorption Trenches
t' Pvc
(See Detail)
Excavate and Remove Distribution
Piping From Existing Tranches. Replace
with Coarse Sand to Surface.
PLAN
SCALE V = 40'
Existing Ground
LOT 3, BLOCK 7, THE TABLELANDS
SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
5 Bedroom Home Raised Bed System
Perc. Rate: 16-30 MinAnch 2.000 Gallon STEP Tank
Application Rate: .4 GPD/SF Coarse Sand (As Required)
5 Bedrooms X 150 GPD/.4 GPD/SF = 1.675 SF Absorption Area
1.875 SF/15 SF (Wdth) =12$1Fj Bed Length
THEREFORE: Construct 2 GG-(Afff ng x 15' Wide Raised Beds as Shown Below.
Place Distribution Piping at glnal Ground Surface. Remove Organics and Place
Coarse Sand to Provide 4' Separation From Groundwater (Minimum). Place Insulation
and 2' of Cover Over Bed or Mound Over Bed Minimum of 3'. Place 4' of Fill Over Tank.
.5'
.5'
As
Required
Top 6' of Mound Must Be Topsoiled
and Vegetated to Prevent Erosion.
Natural Backfill
2' Insulation & 2' Cover (Min.)
O O O
Drainfield Rock
Coarse Sand (See Specification)
As Required for Levelling
In Situ GM Soil
2.5' 5' 5' 2.5'
1' PVC
�4
1
Existing
NOTE: Grade Area Surrounding Bed to Drain Away. ""4L .•' i W
Minimum 6' Separation From Bedrock. i49
th W
Minimum 4' Separation From Groundwater.
Minimum 200' Separation From Wells in the Area. •
aa Anderson d µ
Minimum 100' Separation From Surface Water or Streams.1Ach9el E. 2"
Minimum 10' Separation From Water Service Line. �e aye No. CE 381
r
P • . �? 5�.
PRESSURE DISTRIBUTION
CALCULATION
Elevation at Highest Discharge Point
Pressure at Highest Discharge Point
Liquid Level in Tank (Elevation)
Diameter of Holes In Distribution Line
Diameter of Distribution Line
Hole Spacing in Distribution Line
Length of Transport Line
Diameter of Transport Line
Q = 12.4d h = 12.4(.1875)(.1875) 5
_ .9748 GPM/Orifice
_ .9748.32
= 31.2 GPM
TDH = (100-91) + .0192(31.2)(31.2) + .000995(45) (31.2)
(1.5)
9 + 18.7 + 1.2
28.9
95'
5' Head
91'
.1875" (3/16")
1.0"
11.6'
15'
1.5"
Therefore 32 Orifices @ 11.6' Spacing With 28.9' of Total Dynamic Head.
5 Holes Per Lateral
MUNICIPALITY OF ANCHORAGE
• DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: LOT 3, BLOCK 7, TABLELANDS S/D
PERFORMED FOR: SPINELL HOMES
DATE: 6/23/2004 PROJECT No M0442
PARCEL ID,#• TECHNICIAN: T.L. KIMBROUGH
DEPTII TEST BOLE # 1 Type of Test: ❑ Percolation ❑ Visual
(rm)
1
2
READING
OB/OG
DRY POORLY GRADED GRAVELS
NET TIME
(MINUTES)
D ATERF
(INCHES)
N�T DROP
(INCHES)
GP
3
6/23
1
10:05
4
8.38"
2
10:35
6
7.25"
1.13"
7
3
MOIST GRAY SILTY -SANDS
30
6"
W/GRAVELS SOME COBBLES TO 10'
8
4
MEDIUM COMPACTION
30
4.25"
GM
9
5
12:05
10
3"
1.25"
11
WATER SEEPAGE
12
13
14 BOH
15
16
17
18
19
SLOPE
0%
SITE PAN
THIo
SFF FUTURF ASSUII_T
a�
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
D ATERF
(INCHES)
N�T DROP
(INCHES)
TEST HOLE PRESOAKED PRIOR TO TESTING:
6/23
1
10:05
8.38"
2
10:35
30
7.25"
1.13"
3
11:05
30
6"
1.25"
4
11:35
30
4.25"
1.25"
5
12:05
30
3"
1.25"
PERCOLATION PATEL(MIN/INCH) PERC. HOLE DIA,_INCHES)
TEST RUN BETWEEN: 4 FT. and 5 FT.
WAS GROUNDWATER ENCOUNTERED? YES IF YES @ WHAT DEPTHS II FT
DEPTH OF WATER AFTER MONITORING: 11.5' DATE OF MONITORING: 609114
COMMENTS:
NO IMPERMEABLE LAYERS ENCOUNTERED. TEST HOLE PRESOAKED PRIOR TO TESTING.
TEST PERFORMED BY VETECH ENGINEERING TECHNICAL SERVICE. 1, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 7/23/2004
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: LOT 3, BLOCK 7, THE TABLELANDS SUBDIVISION
PERFORMED FOR, SPINELL HOMES
DATE: 8/24/2004 PROJECT No
PARCEL ID.- TECHNICIAN: T. L. KIMBROUGH
DEPTH TEST HOLE # 2
(fcv)
1
2
3
4
5
6
7
8
9
1C
11
12
13
14
15
16
17
18
19
OB/OG
SILTY -SANDS W/ GRAVELS
SM -GM
SOME COBBLES
DRY
ItIllem
SITE PLAN
SEE SITE PLAN
ti Ab 4RDUND NATER ENOOUNTEREDY Na
IF YES 9 %% HAT DEPTH'
DEPTH OF NATER AFTER MONITORING: 0%
DATE OF MONITORING:
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)(INCHES)
DWATERF
NET DROP
(INCHES)
8/24/0Z
TEST HOLE PRESOAKED PRIOR TO TESTING:
I
11:14
12.0"
CHARGE
2
11:44
30
10.75'
1.25'
3
12:14
30
9.63'
1.12'
4
12:44
30
8.5"
1.12'
5
1:14
30
7.38"
1.12"
PERCOLATION RATEL27 (MN/INCII) FERC. HOLE DIA. INCHES)
TEST RUN BETWEEN: 4_5 FT, and 5_5 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
I, MICI IAEL E. ANDERSON CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL
STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: S%—O �
C_ . t(W 4-1A/
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.cl.anchorage.ak.us
(907)343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 051.8 01.35
1. GENERAL INFORMATION
Complete legal description
Location (site address or dir
•
•
,"011r.11LO11myr.1t
Current Property owner(s) Soinell Homes, Inc. Day phone 344-5678
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
1900 Northem Lights Blvd. Anchorage, AK 99517
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
Five 5
Day phone
Day phone
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 Health Authority
Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil
engineer registered in the Stale 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 less than 30 days old. (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 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, ordinances,
and regulations in effect at the time of installation.
Name of Firm Anderson Engineering Phone 522.7773
Address _ P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E. Date 51912005
5. DSD SIGNATURE
--Z
Approved for bedrooms.
Disapproved.
4<i 49th
NICMM L ANDERSON
9rs-
Conditional approval for
—,2_ bedrooms, with the following stipulations:
Six inches of ton soil must be placed on the mound absorption field and
be sufficiently vegetated to prevent erosion. The work shall be completed
Attachments:
HAA Checklist X
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: , 0_ C oo � Original Certificate Date:_ 14( 1a2xjC;'
(Rev. 72/00)
Municipality of Anchorage
• �' Development Services Department
Building Safety.Division `
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: Lot 3. Block.l, The Tablelands Subdivision Parcel ID: 051.80135
A. WELL DATA
Well type
Date completed
Total depth ft.
Date of test
Static water level
If A. B. or C provide PWSID # _
Sanitary seal (Y/N)
Cased to ft.
FROM WELL LOG
ft.
Well Log (YIN)
Wires properly protected (Y/N)
Casing height (above ground) in.
AT INSPECTION
Well production 9 -
P.m -WATER SAMPLE RESULTS:
Coliform colonies/100 ml. Nitrate mg./I. Other bacteria
Date of sample: Collected by:
B. SEPTICIHOLDING TANK DATA
ft.
colonies/100 ml.
Tank Type/Material STEP/goo Date Installed 51238005
Tank size 2,000 gal. Number of Compartments 3 Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) Y
Date of pumping Pumper New Construction
C. ABSORPTION FIELD DATA
Date installed 5848005 Soil rating (g.p.d./ftz or fP/bdrm) .4 GPDISF System type Raised Bed
Length 140 ft. Width 15 ft. Gravel below pipe .5 ft.
Total depth 0-1 ft. Eft. absorption area 2.100 ft= Monitoring tube Y Depression over field N
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
Any rejuvenation treatment (past 12 mo.) (Y/N & type) h
Absorption rate >= g.p.d.
If yes, give date
D. LIFT STATION
Date installed 512312005 Size in gallons 250
'Pump on' level at 42 in. 'Pump off" level at !g in.
Datum Boftom of Tank Cycles tested New Construction
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Manhole/Access (Y/N) Y
High water alarm level at 44 in.
Meets alarm & circuit requirements? Y
Septic tankAift station on lot NIA On adjacent lots NIA
Absorption field on lot NIA On adjacent lots NIA
Public sewer main NIA Public sewer manhole/cleanout NIA
Sewer /septic service line NIA Holding tank NIA
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >T Property line >5' Absorption field >5'
Water main >10' Water service line >10' Surface water >100'
Weiss on adjacent lots >200'
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, parkinglvehicle storage >5'
Curtain drain None Noted Wells on adjacent lots >2W
F. COMMENTS
G. 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 Michael E. Anderson. P.E.
Date 5125105
HAA Fee $ 5 7. t5t�'
Waiver Fee $
Date of Payment i!51 COS Date of Payment
Receipt Number
�— Receipt Number,
(Rev. 12/00)
�� f�aocs
�? 49th / ► `:
2004-25
THE TABLELANDS SUBDIVISION
LOT 3, BLOCK 7
40,332 S.F.
AS -BUILT
GASTALDI LAND
SURVEYING, LLC
JEFF A. GASTALDI, R.L.
4726 WEST 88TH AVEN
ANCHORAGE, ALASKA 99'
PHONE 248-5454
GRID DATE
NW, 1559 2/11/2005
F.B. JOB NO.
05-01 TLS37
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT NO
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
IT IS THE RESPONSIBILITY OF THE OWNER TO
DETERMINE THE EXISTENCE OF.ANY EASEMENTS,
I6OVENANTS OR RESTRICTIONS WHICH DO NOT
SPEAR ON THE RECORDED SUBDIVISION PLAT.
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
HEREON BE USED FOR CONSTRUCTION OR FOR
ESTABLISHING BOUNDARY OR FENCE LINES.
ANCHORAGE RECORDING DISTRICT, ALASKA
NOTE: NO CORNERS SET THIS DATE.
"= 40'
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