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HomeMy WebLinkAboutSHANGRI-LA LT 4han.qri -Ln Lot 4 #020-043-22 Municipality of Anchorage Page 1 of 3 Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street P.O. Boz 196650 Anchorage. AK 99519-6650 www.ci.anchorage.ak.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT Permit Number. SW040194 PID Number. 020-043-22 Diamond Builders Inc. Wastewater System: New Aedreae P.O. Box 221233 Anchoracie, AK 99522 ABSORPTION FIELD prone 522.4826 Seven(7) 5' Wide Trench LEGAL DESCRIPTION teR"w Trr Depth IV=rVn gr s Blotl,'. Lp Subd w : 4 .8 cpc*e Dap" b pPe Wtan kom V. FZ 6 Ft. C+err ,egn kenerh pPe Shan rl La 2 FI. 4 To.fwvP R&V.sed n Fr AGCaEaoov M"QFFb FL Grey L-9 7.9 Ft. 134 Ft. Well: New c,e.r `""' LA.ek. a i.,... o.rr,n w" e.n knp 5 Fr. 2 >10 Ft C We,["w (Pmete. A S. CI. T" Dewe c8aw b Private d a p.m W. w "W. 476 F(. 20 Ft 11117/04 1,340 Fe ASTM 3034 PVC Dhl r. Alpine Drs Dnsee su..e wrr teei 167 Ft Red Dog Twe 10125.2712004 YeW. PraP sr r. Cewq Akwe DIG. r. 1.5 om R >2F, TANK SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Lift Holding ubiiUPmrate From Tank Field Station Tank sew une Anchorage Tank 2,000 weF >100' >100, N/A N/A >25' Steel Two (2) surece wrr >100' >100' N/A N/A LIFT STATION — NONE ON LOT to Lw >5' >10, NIA N/A cr Fo..dew >5' >10' NIA N/A "'"°� .e � "'"° ` " m in h h Cr Dren I None Noted Pune Mde &LkWI IaWrrl h.peduq,N.lr k, RemrMr BENCH MARK «, av Concrete Slab Fronting Door West Side of House Lower Level. 100.0 Ft Engineer's Stamp '•••••sasnnrt''♦s P.._J1L4�♦i� Inspections performed by: MEA Dates: 1" 10125/04 ; �` 49tH ! \ 1 •00 r..... _.. -0 ddd 2nd 10/26104 Department of Health and Human Services approval • -.. _.....__.....,.. . ! ,. n , M CNAIL E. ANO! NSOV W Reviewed and approved by: te:♦♦�p•fa-Z•-9 ♦ f • /a�1 F; o g — . *ice'. N OI QF♦ I0` St. c{ i CL v N. ,01'991 3,£0.£0.00 N I ,0'99 I I I I I I I I I Iz:j I n O I IIw C.) I I I lob l o z I (no I Z O t 1 w 10 Q IN I I J m� Q� O to I Cn a 3 I m o v I I L..L o0¢ `0 1 c= d I I o u) E `4 1 v I i W ¢U c N a I h I I 1O > w `o > o `4 1 1 I PZ m 11 N m co o n I I I -. �I �oc cWT tnI o� Ha^ N � o 09— �iN I _ rn I co z M ~ I N I V) o pLn Icy I 1 ®� j Z I I I p I ®€ v m +viraonr: 1 In nrov>vmnn I i I I I mro0n.-NN I I v W I < n:uNiCol MOO T I I m �' I InIN/ UNUal I I I In iT N °p .00.99 1 3,Z9.Z0.00 N d N I E z 2 U' z CL 2 V) 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 Number. SWO40194 U Y L m M Y N � P4.5 cum of N UU .68 Page 3 of 3 PID No. 020-043-22 s v It 82.9 r,N U i 78.8 94.2 EAST LEG Drolnfleld Rock 67' (Trench Length) WEST LEG PROFILE AS -BUILT No Scale CU X U 49th f t>3 NICINEL L ANDERSON MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT/BUILDING SAFETY DIVISION ON-SITE WATER AND WASTEWATER PROGRAM 4700 SOUTH BRAGAW ANCHORAGE, AK 99519 SOILS LOG - PERCOLAT PROJECT #: ION TEST PERFORMED FOR: Diamond Builders In DATE PERFORMED: 10/25/04 LEGAL DESCRIPTION: —Lot 4. Shanari la Subdivlsion :oar TEST HOLE # F SI OPF Organic 1 layer - OL 2 3 4 5 6 7 8 9 10 12 VA WAS GROUNDWATER ENCOUNTERED') No IF YES, WHAT DEPTH DEPTH OF WATER None AFTER MONITORING: DATE: 10/27/2004 s wx'x1' aCLLL9R. — a � I i � b 7�t '� i 'V 1. AG eMIC la w a wean' uTae• S L 0 E SITE PLAN 5% READING DATE GROSS TIME. • DEPTH OF WATER �' ' �' Gravel •' ' with Sand 9.5• GP/GM 1 11:05 30 6.25" 3.25" Recharge �' ' • Silt Content Varies 9.13" 2 11:36 30 6- 313" Recharge 11:37 1 19.25" 3 12'07 30 6.9" r BOH -13' Bedrock WAS GROUNDWATER ENCOUNTERED') No IF YES, WHAT DEPTH DEPTH OF WATER None AFTER MONITORING: DATE: 10/27/2004 s wx'x1' aCLLL9R. — a � I i � b 7�t '� i 'V 1. AG eMIC la w a wean' uTae• S L 0 E SITE PLAN 5% READING DATE GROSS TIME. NET TIME DEPTH OF WATER NET DROP Scarf 10/25 10:35 9.5• 1 11:05 30 6.25" 3.25" Recharge 11:06 9.13" 2 11:36 30 6- 313" Recharge 11:37 1 19.25" 3 12'07 30 6.9" PERC RATE: 11_ MIN./INCH FERC. HOLE DIAMETER:._ TEST RUN BETWEEN-11—FT. AND 3.5 T. COMMENTS: Test Hole Pre Soaked Prior to Percolation Test. TEST PERFORMED BY: MFA I, MICHAFI F. ANDFRSO . CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 10/2/2005 i d 03 05 12:02p Diamond Builders INC. 24'x5733 p,1 ■ '- -- '--`••-� ••.••��nan• cnccrprr ses (9071 346-B057 p.l Municipality of Anchorage Department of Health and Human Services P.O. Box 196650 A2e Anchorage, Alaska 99519.6650 J G"r 4mp'Uwww.darcnom9e.ak us Permit Number: #SW 040051 Date of Issue: 4_12_04 Date Started; 1-Completed: Parcel Identification Number: 020-443-20 �1 Description: Date Comp) n 11-7:34- Is well located at approved permit location? ® ger Q Na Property Owner Nese do Address: Anchorage Development &Cons. 9441 Abbott Loop Rd Borehole Data: SOU 7)M ihicknen & Water Strata stick-up grave#y sandy st7t bedrock Depth (ft) From To 0 2 16 2 Method of Drilling ® air rc Calling type: steel Wan Thickness:.250 inches cable tool 16 Diameter ¢ inches Depth: 20 feet 476 User Type: Diameter inches Depth feet Casing stickup Above ground:.2feet Static water level (f=rom ground level): 167 fect Pumping kveL 476 feel after 12 hours pumping 1.6 spm Recovery Rate: 1.5 gpm Method of Testing: airfft wen Intake Opening Type. Open End ® Open Hole ❑ Screened Stan feet Stopped feet ❑ Perforations Start feet Stopped feet Grout Type: bentonite orarrules Volume: j Depth: Stank7leet Stopped ?feet Pump: Intake Depth feet Pttm size Brand Name Well Disinfected Upon Completion? ® Yes ❑ No Method of D feetiion:chforhw tablets Comments: Wetl DrIller• Alpfrre Drf!lfng Q• Ente0wfSes PO BOX 110496 Anchorage Alaska 99511 Attention: The well drillershall provide a well to to the .__.. _ . _ .. . �. ,_t.•. _ ..... R ProPM}' owner within 30 drys of completion and the property MUNICIPALITY OF ANCHORAGE Development Services Department Onsite Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519.6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Permit Number: SW040194 Legal Description: Shangri-La Lot 4 Design Engineer: 0014 Anderson Engineering Owner Name: Diamond Builders, Inc. )D/a5iti 1t06 Date Issued: Jun 15, 2004 Expiration Date: Jun 15, 2005 Parcel ID: 020-043-22 Site Address: Unknown Lot Size: 47699 SO. FT. Owner Address: P.O. Box 221233 Total Bedrooms: 7 Permit Bedrooms: 7 Anchorage . AK 99522 - This permit is for the construction of: ❑,/ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specked In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (1BAAC72 ) 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. Received By. Issued By. Date: ALL.' � Date: (a r e Municipality of Anchorage • Development Services Department Building Safety Division _. On -Site Water and Wastewater Program ' 4700 South Bragaw St. ' CT 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. 020.043.22 Permit Number SW Property owner(s)Diamond Builders. Inc. Day phone 522-4826 Mailing address (1) P.O. Box 221233 Anchorage, AK 99522 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) _ Lot 4, Shangd La Subdivision Legal description (Section, Township & Range) Lot Size 47,699 SF Acre$O THIS APPLICATION IS FOR: Number of Bedrooms _Seven (7) 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. (Signature of property owner or authorized agent) Permit Fees: 46 D 4. Waiver Fees: Date of Payment: S- zSF-py! Date of Payment: Receipt Number: Set, Z f C Receipt Number: (Rev. 12100) -11 ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 11 F MEMO DATE: 10/26/2004 TO: Joe Goodall WITH: MoA/OnSite Water and Wastewater FROM: Mike Anderson -M 20L SUBJECT: Lot 4, Shangri-La Subdivision Well and Septic System Permit No. SW040194 Revised Well Location Attached is a new Site Plan for Lot 4, Shangri-La Subdivision. The well location has been moved to the south. Placement of the well at this location will not impact adjacent wells or septic systems. The 100' protective radius is shown on the plan and does not encroach on the septic system location proposed for this lot. Please let me know if you have any questions. 06'586 ��IZS�z OON 0. so � - oc 17 00 . I • I . � oo��ey�3 r4) ' I • ` • *W I I ~~orj h` yC? ,. 0 AP 39 G 9 tJ y �y' o Nr r i tri L W��y m c� > 4fi Y• r ��1 � Ws eJ c c CJ th co -�rCoaly IZY V) j o % . < I mCZI C91 Ll co 1 I! 1 to i I. LIcuI • I �N� xoeQ7es 6;X.S.SL •..�, • ,� Ur . 0 00'S8.6 ElIZ91ZOQOON �•� .. • Ste`:, � `: � � a� ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) May 22, 2004 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 4, Shangd La Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer. The owner of Lot 4, Shangri La Subdivision intends to construct a seven -bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new septic system to serve the new home. A private well is currently in place on the lot to serve the new home. The Site Plan and backup documentation identify the location and configuration of the proposed septic system and alternate site. The well to this lot is also shown. Existing spot elevations and the current drainage pattern are also identified on the Site Plan. The drainage pattern will be maintained after development of this tot is complete. A test hole placed on the lot during the subdivision phase indicated clean gravel with some sand and silt in the area of the absorption trench. The accepting soils were tested and found to have a percolation rate of 5.7 minutes per inch. No groundwater was found during excavation and none was noted during the monitoring period. Bedrock was found at 13', however and the bottom of the absorption trenches will be constructed 7' above the bedrock level. Our design includes the placement of a new 2,000 -gallon septic tank along with 2 - 66' long by 5' wide by 4' effective depth absorption trenches to collect and treat the sewage generated in the house. The bottom of the trenches will be 6' below the surface to provide the required separation from the bedrock. The distribution pipe will be 2' below the surface. A minimum of 3' of cover will be placed atop the trenches and a minimum of 4' of cover will be placed atop the new septic tank. A flow splitter valve will be placed to assure even now to each of the trenches. The ground surface on the lot slopes at shallow grades from southeast to northwest as ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 FAX May 22, 2004 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 4, Shangd La Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer. The owner of Lot 4, Shangri La Subdivision intends to construct a seven -bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new septic system to serve the new home. A private well is currently in place on the lot to serve the new home. The Site Plan and backup documentation identify the location and configuration of the proposed septic system and alternate site. The well to this lot is also shown. Existing spot elevations and the current drainage pattern are also identified on the Site Plan. The drainage pattern will be maintained after development of this lot is complete. A test hole placed on the lot during the subdivision phase indicated clean gravel with some sand and silt in the area of the absorption trench. The accepting soils were tested and found to have a percolation rate of 5.7 minutes per inch. No groundwater was found during excavation and none was noted during the monitoring period. Bedrock was found at 13', however and the bottom of the absorption trenches will be constructed 7' above the bedrock level. Our design includes the placement of a new 2,000 -gallon septic tank along with 2 - 66' long by 5' wide by 4' effective depth absorption trenches to collect and treat the sewage generated in the house. The bottom of the trenches will be 6' below the surface to provide the required separation from the bedrock. The distribution pipe will be 2' below the surface. A minimum of 3' of cover will be placed atop the trenches and a minimum of 4' of cover will be placed atop the new septic tank. A flow splitter valve will be placed to assure even flow to each of the trenches. The ground surface on the lot slopes at shallow grades from southeast to northwest as Lot 4, Shangri La Subdivision May 22, 2004 Page Two shown on the Site Plan. The absorption trenches 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 100' from all wells. It will 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: 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, E_04'__k� Michael E. Anderson, P.E. Attachments MOM 3,,Z5,ZOo00N CIS 1 '5�J %A C IN I I �. co W l Z W �I.E W JILNosgles sPIS 19Z Iolo t�lrlf 4 oo` 00'991 211iZSiZOXON, r� W LOT 4, SHANGRI LA SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Seven Bedroom House 5' Wide Trench System Perc. Rate: 5.7 Min./Inch 2,000 Gallon Septic Tank Application Rate: .8 GPD/SF 4' Drainfield Rock 7 Bedrooms X 150 GPD/.8 GPD/SF (Ap lication Rate) = 1,312.5 SF Absorption Area 1,312.5 SF/5 LF/LF".5(Red. Factor) = 131.25 LF Trench Length THEREFORE: Construct Two 66' Long x 5' Wide x 4' Effective Depth Absorption Trenches. Flow Line Elevation in Trench to be 2' Below Original Ground Surface. Total Depth to be 6' Below Existing Ground. Maintain 100' Separation From Well on Lot. Provide T of Cover Over Trench and 4' Over Septic Tank or Provide 2" Insulation and 2' of Cover. Maintain 100' Separation Between Open Surface Water and Septic Tank and Absorption Trench. Place Flow Splitter Valve to Assure Even Flow to Each Trench. Natural Backfill 1'6" Geotextiie Fabric g" 4" Perforated PVC (Holes Down) 4-0-1 1 �Drainfield Rock 5' F1 TYPICAL DEEP TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. �. Minimum 4' Separation From Groundwater. Minimum 100' Separation From Wells in the Area. 7' Minimum 100' Separation From Surface Water or Streams. . 14, Minimum 10' Separation From Water Service Line. i l Depth (Feet) 111® ORC — rootmat SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Cround water encountered' NO CP—brown dense sandy gravel Depth to water after mo=utonng'' NA sand lense CP—dense dark brown sandy gravel Loeallylg boulders >3' Dark black weathered shale B.0.11. bedrock Reading 1 2 3 4 5 6 7 8 9 10 11 12 Date Cross Time 8/10/00 1100 1130 • 1131 1201 • 1202 1232 • Water Added What depth? NA Date? 08/14/00 Net Depth to K,!'.� D ENGINEERING '4 Water S 20441 PTARMIGAN BLVD 11" EAGLE RIVER, AK 99577-8736 30 min I: '�' .�f '%�'1,.."lr`�$'w-'.��"'�i..`� 1:ir-i`�'�t'%�i43➢r°.,.�..:a."-n`•...+R...""^.."'r"�aI O C':, K• • d19Fo SOILS PERCOLATION TEST e 512/16" o� Performed for Earl Ford Date Performed 08/0$/00 Project Lot 4Shangrila TEST HOLE R MS Depth (Feet) 111® ORC — rootmat SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Cround water encountered' NO CP—brown dense sandy gravel Depth to water after mo=utonng'' NA sand lense CP—dense dark brown sandy gravel Loeallylg boulders >3' Dark black weathered shale B.0.11. bedrock Reading 1 2 3 4 5 6 7 8 9 10 11 12 Date Cross Time 8/10/00 1100 1130 • 1131 1201 • 1202 1232 • Water Added What depth? NA Date? 08/14/00 Net Depth to Net Tune Water Drop • 11" 30 min 512/16" 5 4/16" • 11" 30 mm 512/16" 5 4/16" • 11" 30 nun 512/16" 5 4/16" HOLE PRESOAKED Percolation Rate 5.7 (nun/in) Perc Hole Dtameter__V= PRIOR TO TEST Test Run Between 2 feet and 3 feet L Kenneth M Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date • Municipality of Anchorage On -Site Water and Wastewater Program a (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 020-043-22 Expiration Date: 1. GENERAL INFORMATION Complete legal description Shangrl La, Lot 4 Location (site address) 16409 Sandpiper Drive Anchorage, AK 99516 ' Current Property ownerPaul& Wendy Landes s) Day phone Mailinoaddress 16409 Sandpiper drive Anchorage, AK 99516 Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Seven 4. TYPE OF WATER SUPPLY: TYF .Individual Well El l Individual Water Storage ❑ F Community Class Well ❑- C Public Water System' ❑ - F WaiverNariance request for: Received byC' umber 65C! G VASTEWATER DISPOSAL: I � rank ❑ ity ❑ ;wer ❑ Distance:. e: 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 Anchoragefiles 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 8/4/20i 5 'Ale; AV 010: 4c 6. DSD SIGNATURE00 °t .•• "' System #1 Approved for bedrooms ;rnlelfgDeRsoly.All CE -x3381 : a System #2 Approved for bedrooms ! s��•., ��� DisapprovefJ 0 ®'s" Conditional approval for bedrooms, with the following stipulations: 0'� ON-SITE;;, mP `WA.;TFUt/AM= z R RAM t!)1))1) }311115 By; Original Certificate Date: Th U orage Development Services Division (DSD) issues Certificates of Onsite Systems Approval (COSA) based only upon the representations given imparagraph 5 by an Independent professional civil engineer registered in --the Stale of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work: 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory:., Other CASA blue sheet E 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: Shangri-La, Lot 4 Parcel ID: 020-04322 A. WELL DATA Well type Private Date completed 11/7/04 Total depth 475 ft Date of test Static water level Well production If A, B, or C provide PWSID #, Sanitary seal (Y/N) Cased to 20 ft. FROM WELL LOG 11/7/04 167 WATER SAMPLE RESULTS 1.5 Well Log (Y/N) Y Wires properly protected (YIN) Y Casing height (above ground) >24 in. AT INSPECTION 8/4/15 ft. 45.4 ft. g.p.m. 6.7 g.p.m. Coliform 0 colonies/100 mL Nitrate •668 mg/L Arsenic ND ug/L Date of sample: 7/8/15 Collected by: Anderson Engrg. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 2,000 gal. Number of Compartments 2 Date installed 10/25/2004 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (YIN) N High water alarm (YIN) N Date of pumping 8/5/15 Pumper Around the Clock Pumping C. ABSORPTION FIELD DATA Date installed 10/26/05 Soil rating (g.p.d./ft2 or felbdrm) •8 GPD/SF System type 5' Wide Length 2 @ 67 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 13-15 ft. Eff. absorption area 1,340 fe Monitoring tube Y Depression over field N Date of adequacy test 8/4/15 Results (Pass/Fail) PASS For 7 bedrooms Fluid depth in absorption field before test 0 in. Water added 1,804 gal. New depth 0 in. Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 1,050 g p d Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date D. LIFT STATION Date installed _ "Pump on" level at Datum Size in gallons _ in. "Pump oft" level at _ Cycles tested - Manhole/Access (Y/N) in. High water alarm level at in. Meets -alarm & oircuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot >100' On adjacent lots >1 00' Absorption field on lot >100, On adjacent lots >1 00' Public sewer main >75' Public sewer manhole/cleanout > 100' Sewer /septic service line >25' Holding tank >75' Animal containment areas >50' Manure/animal excrete storage areas > 100' SEPTICIHOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Water main >10' Water service line X10' Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water Service line >10' Surfacewater >100, Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS Absorption field >5' Surface water_ >100' Water main N/A Driveway, parking/vehicle storage 0 G. ENGINEER'S CERTIFICATION .4!t 4! 0..A4 1o, I certify that / have determined through field inspections and = �P'�•• ��Id, review of Municipal records that the above systems are in * 491L _._,... conformance with MOA COSA guidelines in effect on this date. 0... ;:' ° Engineer's Printed Name Michael E. Anderson, P.E. f • ;•••s:� o wI�MICHAEL E. ANDeRSON Date 8/4/2015 ,dC.: GE -4387 Id1i�Fn� •5..:•'�.•,:��4�� COSA brown sheet -1 0-10-1 Municipality of Anchorage • Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 995196650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 020-04122 1. GENERAL INFORMATION Complete legal description Lot 4. Shangri La Subdivision Location (site address) 16409 Sandpiper Drive Current Property owner(s) Diamond Builders, Inc. Mailing address Lending agency Mailing address Real Estate Agent Mailing Address P.O. Box 221233 Anchorage, AK 99522 COSA # h CP 05C 1 Expiration Date: t Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Seven (7) 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone 5224326 Day phone Day phone Lel TYPE OF WASTEWATER DISPOSAL: Individual On-site IZI 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 Onsite Systems 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 homeowners. Certificates of OnSfte 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 seat affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -She 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 Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 11/112006 b. DSD SIGNATURE t / Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: ( Original Certificate Date: ft IJ6 (Re. tiros) r 1; Municipality of Anchorage • Development Services Department Building Safety Division On-Ske Water 6 Wastewater Program 4700 Bragaw, Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsle (907) 3437904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lor 4, Shmyo La Subdivwion Parcel ID: 020-048.22 A. WELL DATA Wen type Private If A. B, or C provide PWSIO # Date completed 1111A.1004 Sanitary seal (Y/N) Y Total depth 476 ft. Cased to FROM WELL LOG Date of We 1111/2004 Static Water level 167 ft. Wen production 1.5 g.p.m. . WATER SAMPLE RESULTS: Coliform o colonies/100 mL Nitrate 1.71 Mg& Arsenic: ND mg/I Date of sample. 10H7/2006 B. SEPTICIHOLDING TANK DATA Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) >24 in. AT INSPECTION tL'as-{ os- /qz ft. 5 GPM g.p.m. Other bacteria 0 colonies/100 mL Collected by: F. LeDoux Tank Type/Material SepdoStW Date installed 1025MN Tank size 2.000 gal. Number of compartments Two Cieanouts (Y/N) Y Foundation cleanout (YM) Y Depression over tank (YM) N High water alarm (Y/N) N Date of pumping 11/1842008 Pumper A Plus Hone Services C. ABSORPTION FIELD DATA Date installed 10426/2005 Length 194 R Total depth 13.15 fL Soil rating (g.p.d.11tr or ft°/bdnn) •8 GPMF System type 5' 144de Trench Width 5 ft. Gravel below pipe 4 Eff. absorption area 1.940 fe Monitoring tube Y Depression over field N Date of adequacy test Now C raL Results (Pass/Fall) 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. ft. Any rejuvenation treatment (past 12 mo.) (Y/N & type) I/ es, give date Y D. LIFT STATION Dace installed Size in gallons ManhoWAccess (Y/N) 'Pump on' level at _ in. 'Pump otr level at _ in. High water alarm level at in. Datum Cycles tested Meets alarm It circuit requeemenls9 E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAtItstation on lot >1W On adjacent lots >Iw Absorption field on lot >10(r ' On adjacent kits >1W Public sewer main NIA Public sewer manhoWckaraut NIA Sewer /septic service fine >2F Holding tank NIA Animal containment areas None Manumfenimal excrete storage areas None SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO Building foundation >5 Property line >g_ Water main WA Water service line >10 Absorption field >6' Surface water >IW Wells on adjacent lots >lw SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >1a Building foundation >16' Water main NIA Water Service line >10' Surface water >1W Driveway. paftVtvehide storage >2W Curtain drain Noris NOW Wells on adjacent lob >1W F. COMMENTS: Septic SY510^ Wes Irrlalled APROAMM* 1 year Aga Adsqueq Test Umecessery. O. ENGINEER'S 1 certify that I have determined through Aeld kLVecdons and review of Munkpat records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 11/18/2006 �'as•�� COSA Fee E T--�V Waiver Fee $ Date of Payment «I �Lp IOjo Date of Payment Receipt Number $00qc�q Receipt Number (Rev. 1 I/M NOV-27-2006(MON) 12:37 Diamond Builders, Inc. (FRX)9072455733 P.002/002 F LE AAROWPump & WrISERVICE, LLC P.O. Box 110496 Anchorago, AK 99511 Office: (907) 346-9355 - Fax (907) 333-8976 Palmer. (907) 745-9077 - Eagle River. (907) 622-9335 CUSTOMER I— J013 SITE WOKE 6977 -i 30 �a�% INULDEPT14 OWL I CtILORMM I MAV OEM I SALFWMON A 1.'OUANT1TYA:.—.. ':.'::DESCRIPTION: ''.4 PRICE '!!'i ,=;:AMOUNT!';%,i-! Fre e tz:%/K-QS-6-70 t�p 116 tAL /)/7 7� Ale 0�t 7z-, 2�z A-P7�-rte /0 a nia w crueW /o du e i-1' ti re- 7& LABOR HOURS RATE AMOUNT TOTAL MATERIAL TOTAL LABOR WORK ORDERED IIYJ DATE COMP, ITOTAL LABOR PAY THIS AMOUNT Thank You SIGNATURE (I Hereby Acknowladge tha Sadsfactory Compiction of the Above Described Work) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. NOV-30-2006 11:20A FROM: M JI -L••I Y W -M M >•1 Cond owaert'�mN���IIInnn Jn n�� Well LOeaeloat ,J Well Tato Clow h 70:6777766 I WATERWELL - TWI PUMP REPORT A • 1 ;� Addrem. ToW Depth: Depth of C*dng; ` sc=an Beome — Toe Gula Blur Scam ID n// A Rema=rk: r ro efCr Scrtua Blot. Pump Intorn"on IotaU Dopthi VAL Pomp Size 1�•�, Alr Line Depth: - 9tatirWaterLeveis-•/�/�! �.Dlsft e-. VPMrMazDmw&m:,U Pump on Tum: fg�Dah: Pump OH: Time: Date: P.2/2 MME W -M ���n. / s • JVmm ; � P.2/2 SCS Ref.N 1066274001 Client Name Anderson Engineering Project Name/N 16409 Sandpiper Drive Client Sample ID 16409 Sandpiper Drive Matrix Drinking Water Sample Remarks: All Dsles/rimes are Alaska Standard Time Printed Date/rime 10/30/2006 9:14 Collected Date/time 10/172006 12:54 ReceiredDate/rime 10/172006 13:30 Technical Director Stephen C. Ede Allossahle Prep Analysis Parameter Results POL Units Method Container ID Limits Date Date Init Waters Department Nitmie•N 1.71 0.100 Microbiology Laboratory Total Coliform 0 mg/L EPA 353.2 D (<I0) 10/17/06 AZS col/100mL SM209222B A (<I) 10/17/06 DPT 11-20-06;10:03 ; ;907 561 5301 # 2/ SCS Rcf 4 Client Name Project NometO C6cal Sampla ID Matrix Sample Remmb: 1066639001 Anderson Engineering 16409 Sandpiper Dr 16409 Sandpiper Dr Drinklnp Water All Datea/19mea are Ataxka Standard Tlme Printed Date/flme 11/14/2006 14:07 Collected Date/17me 11/02/2006 1230 Received DateMme 11/02/2006 15:10 Technlut Director Steatite C. Ede Allowable Prep Analysis Parameter POL Units Method ContainerlD Llmin Date Doe Init Mauls by ICY/Mg Arsenic ND 5.0o u;/L EP200.E A (c10) II/06/0611/OR/06 M14 Nytj4vvlaaez -� Municipality of Anchorage • Development Services Department �• Building Safety Division Onsite Water and Wastewater Program ` 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. D20-04322 HAA # 015,65// Expiration Date: 1. GENERAL INFORMATION Complete legal description _Lot 4. Shanori La Subdivision Location (site address or directions) Ii ei!481 Sandpiper Drive Current Property owner(s) Diamond Builders, Inc. Day phone 5224826 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address _P.O. Box 221233 Anchoraae. AK 99522 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 Seven 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 (NAA) based only upon the representations given in paragraph 5 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 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 engineers 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. 1 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 Enalneerina Phone 522.7713 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 100412005 0/49th .� 5. DSD SIGNATURE j lM104AM c MDERSM ;z N4, • No. CE 4361 f+ _j4 Approved for �_ bedrooms. e� ' �� r w •' f eha',y, Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By:—� l "` ` " t / Original Certificate Date: Mft. ,7000) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw, St. P.O. Box 190050 Anchorage, AK 99519-050 www.ci.anchorage.ek.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST 1 _ r1 < tTr+ -T-15,'117-, • yrs 11- r A. WELL DATA Wen type Bkltfi It A. B, or C provide PWSID f _ Date completed 11lIQ444 Sanitary seal (Y/N) Y Total depth —gLfL Cased to _n _fL FROM WELL LOG Date of test 11//12004 Static water levet 167 fl. Well production 1.5 g.p.m. WATER SAMPLE RESULTS: Coliform —t—colonies/1W ml. Nitrate AL mg.11. 1 Tr& . B. SEPTICIHOLDING TANK DATA Tank Type/Material SeoOdSteel Tank sae 1000 gal. Number of Compartments z Foundation cleanout (YM).y Depression over tank (Y/N) H Date of pumping C. ABSORPTION FIELD DATA Well Log (Y/N) Wires properly protected (Y/N) Y Casing height (above ground) >24 in. AT INSPECTION ft g.p.m. Other bacteria _.4_ colonies/100 ml. Cleanouts (Y/N) Y High water alarm (Y/N) N Data Installed l0@61200S Soo rating (g.p.d./ft? or fe/bdrm) A GPDISF System type S Wlde Trench Length 134 ft Width 6 ft Gravel below pipe 4 ft. Total depth 11-11 ft Eft. absorption area 1.3411 A' Monitoring tube X Depression over field tj Date of adequacy test Results (Pass/Faiq Fluid depth in absorption field before test _ In. Water added_ gal. Elapsed Time: _ min. Final fluid depth _ in. Absorption rata >_ For _ bedrooms New depth_ in. Any rejuvenation treatment (past 12 mo.) (Y/N 8 type) _N If yes, give date g.p.d. D. LIFT STATION Date installed Size In gallons Manhole/Access (YIN) 'Pump on' level at _ in. 'Pump cC level at _ in. High water alar level at In. Datum Cycles tested Meets alarm 3 dradt requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankniR station on lot >10T On adjacent lots MOT Public sewer main WA Sewer /septic service one 4T On adjacent lots MW Public sewer manhoie/deanout _ WA Holding tank KIA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation W Property one W Absorption field W Water main WA Water service one >10' Surface water MW Wags on adjacent kns >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line NO' Building foundation >10' Water main >10' Water Service ffne >10' Surface water >100' Driveway, paftVWNde storage >19 Curtain draln None Noted Welts on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION �p�� M •• 'eje 1 certify that I have determined through ne/d inspections and review of Municipal recalls that the above systems are in . 49th conformance with MOA HAA guidelines In effect on this date. srowi c ANDD t M: Engineer's Printed Name Michael E Anderson, NE ` No. cc -4= Date 10=5 e, /1i ieet0 : HAA Fee S 57 oz, Date of Payment /0 S-- © S Receipt Number L f V VV (Rev. 1S/aa) Waiver Fee $ Date of Payment Receipt Number ON 10-04-05:10:41 ; Ctlent Name: Anderson Engineering Project Name: Shangri-La SID, L4 SGS Ref, M 1056372 Ctlent Name: Anderson Engineering Project Name: Shangri-La SID, L4 Client Sample ID: Shangri-La SID, L4 Matrix* Drinking Water PWSID Sample Remarks: ;907 661 5301 # 1/ 2 SGS Environmental Services Inc 200 W. Potter Drive Anchorage, AK 99518 Tel: (907) 562-2343 Fax: (907) 561-5301 An dates/times are Alaska Standard Time Printed Date/rime: 10/04/05 10:00 Collected DaleMme: 09/27/05 10:30 Received DatelTlme: 09/27/05 14:20 Technical Director. Stephen Ede, Released Allowable Prep Analysis Parameter Results POL Units Method Limits Date Date Init Bacteria 608, WI Fecal 92220 0927105 09/27/05 d Nitrate 1.40 0.10 mglkg EPA 300.0 10.00 0927105 0927/05 mx §�G� D §° ° \/\/�k \p\rrl�jkU_� CU » mco (.n Do FA En � p. X-- Ul ) ®2®= 9R §A� d§//E/§�#� F�rri k§ 2k7E§ 22�£ m °§5�§co5Km>>-< am z(f) =z n 3 \°L§/°°G222 S 0 r_ mrnp z rn M ozmu)m(n-U)po ) §§�o§kzEm�-1 °0GGmom � noan)o/_ §{§$®�q�) / m23°E®>0 �Gq`b§imA�@ 0Gk= o -Rim 2 [Ez#@ §zo m §g�yG2\§§§ -Dz 3\\q§8§ f _ >. P m * � 'v*s It �■ •�.:E; ■ 00 AV k o -n0 � � � •; \ ' i . N»o520E,ao ` |2 �\ 0 j ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX MEMORANDUM DATE: October 19, 2005 TO: Julie Makela, P.E. FROM: Mike Anderson, P.E. SUBJECT: Lot 4, Shangri La Subdivision Certificate of Health Authority Approval We have modified the inspection report for the septic system for the subject lot to agree with the health authority checklist for the total depth of the absorption trenches. We have also provided a shop drawing from Anchorage Tank showing the maximum depth of bury above a 2,000 gallon septic tank is 6.13'. We have also included a signed copy of the original permit application. Please let me know if you have additional concerns. Steel Residential Septic ® Anchorage r Tank & Welding Inc. Nome L r71__ ♦ n T Weight Burial Depth 9 lIp Approx. 19---- Diann. INLLT Length L ' .� �T Gallons Gauge \ ♦'0 IG1E (feet) CompL 1 WWARTPENr One GOMPMrMENT TVtl 3,508 (A) (B) (C) e Features: • Constructed to the requirements of the Uniform Plumbing Code. • Watertight manholes prevent seeping of groundwater. • Coated inside and out with coal tar pitch. • Custom tanks, including special interior and/or exterior coatings, are available. • Dimensions and weights are approximate. • Approved by the Municipality of Anchorage. Weight Burial Depth (LBS) Anchorage Approx. Steel Diann. Length Length Length Tank Model Gallons Gauge (inches) (feet) CompL 1 CompL 2 Number 3,508 (A) (B) (C) (D) AT1000S 1,000 12 58 8 5'-4" 2'-8" AT1250S 1,250 12 58 10 6'-8" 3'4" AT1250S10 1,250 10 58 10 6'-8" 3' -4 - '-4"AT1500S ATI 500S 1,500 12 58 12 8'-0" 4'-0" AT150OS10 1,500 10 58 12 8'-0" 4'-0" --------> AT2000S 2,000 10 58 16 10'-8" 5'-4" AT2500S 2,500 3/16 64 17 11'-4" 5'-8" AT3000S 3,000 3/16 76 15 10'-0" 5'-0" AT3500S 3,500 3/16 76 16 101-8" 5'-4" AT4000S 4,000 3/16 76 18 12'-0" 6'-0" Back to Septic Systems home page. Shipping Maximum Weight Burial Depth (LBS) (feet) 927 6.79 1,061 5.45 1,177 8.75 1,203 4.01 1,377 7.22 1,772 6.13 .4-- 2,650 11.85 3,508 3,508 3,757 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.muni.orglonsite (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Anderson Engineering Legal description: Shangri La Subdivision. Lot 4 ZD The attached paperwork has been reviewed and Is being returned for the following reasons: ® Original signature or stamp missing on permit application documents ❑ Calculation error in design. _ ❑ Additional soils information needed. ❑ Water monitoring results inadequate. _ ® Discrepancy in information submitted. Total depth inconsistent between NAA and Inspection Report ❑ Topographic information missing or inadequate. ❑ Incomplete; missing _ ❑ Incomplete; missing ❑ 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. 1.) Please indicate manufacture maximum burial depth of septic tank Name of reviewer: Julie Mokela, P.E. Date: 10/10/2005 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK