HomeMy WebLinkAboutT15N R2W SEC 25 LT 53 S2T15N R2W
SEC 25
Lot 53 52
#051-281-05
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
_ On -Site Water System Permit
Permit Number: OSP221163 Effective Date:
Work Type: Well Upgrade Expiration Date
Tax Code Number: 05128105000
Site Legal Address: T1 5N R2W SEC 25 LT 53 S2 G:0753
Site Mailing Address: 16011 SHIMS ST, Eagle River
Owner: DESJARLAIS KENNETH &
Design Engineer:
This permit is for the construction of:
❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy
cnt
De, partment
6/3/2022
6/3/2023
Lot Size in Sq Ft: 54450
Total Bedrooms: 3
Q 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:
1. The site plan shows the driveway for the proposed shop will be over the tank and possibly the field. Per
the wastewater code, the driveway shall not be over the septic system. The building design will have to
be changed so that the shop door is removed and the driveway adjusted.
2. To close this permit please submit:
1. Well Log
2. Pump Install Log
3. Water sample results
4. Well Decommissioning Log
Received B)
Issued By:
Date: L 3
Date: 49Z31:0-7
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. V4-744 Q 051— 2.4bI -O6
Property owner(s) �iP_J phone
Mailing address 601( A'Cs Sf� Egde- jbxe✓
Site address SaVyLQ.
Legal description (Sub'd., Block & Lot) l2. L.Of SP.chto a5. —1—IT-5
Legal description (Township, Range & Section) �� 2 s • Ni • Pr�
Lot Size Sq. Ft. Number of Bedrooms
APPLICATION IS FOR: APPLICATION IS AN:
TYPE OF DWELLING:
(N all that apply)
Absorption. Field ❑ Initial ❑
Single Family (SF) 19
(w/wo ADU)
Septic Tank ❑ Upgrade ❑
Duplex (p) ❑
Holding Tank ❑ Renewal
Multiple Dwellings ❑
Privy ❑
(SF and/or D)
Private Well
Water Storage ❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that
this is in accordance with
applicable Municipal Codes.
(Signature of property owner(o f authorized agent)
Permit/Rush Fees: $2-Z-6 Waiver Fees:
Date of Payment: SrZ6/zZ Date of Payment:
Receipt Number: 277/07 Receipt Number:
Permit No. 0SP?,2_I (r Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
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%UNICIPALITY OF ANCHORAGE
Heal' ) and Environmental Protect' Nn
• Fourth Floor West
825 L Street
Anchorage, Alaska 99501
264-4720
` INSPECTION_ REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME Jcz� !9-MQ����-� MAILING ADORESSA,n UR- PHONE
LOCATION YSN.�S'---^'1>:�'r LEGAL DESCRIPTION
SEPTIC TANK: aE-C TflN1. W 1Tl1�uT rkC41R'MV-
Idl�O1VIDWk. NUMBER OF ��jj
DISTANCE ��� r ( _CCMZLE'TF COMPARTMENTSJL—
FROM WELL`1__ \00 MANUFACTURERy�0 7--
MATERIAL
INSIUE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY17,SS GALLONS.
TILE DRAIN FIELD: 11 ,� TOTAL LENGTH
DISTANCE FROM WE LL`IAAn FOUNDAT ION ASL—NEAREST LOT LINE _OF LINE z8
# of Lines I DISTANCE BETWEEN LINES O TRENCH WIDTH IN. TOTAL EFFECTIVE
Z 7� �. SQ. FT. LENGTH OF EACH LINE
ABSORPTION AREA �%J y
pCPTII OF FILTER � IN
UEPTI I: TOP OF TILL TO FINISH GRADE=1�DEPTII F BENEATH TILE ��IN. ABOVE TILE
SEEPAGE PIT:
DIAMETER _OR WIDTH_. LENGTH_. DEPTH
Log Crib -_Rings_ Crib Size:! DIAMETER_DEPTH__ DISTANCE FROM: WELL
TOTAL EFFECTIVE
BUILDING FOUNDATION_-, NEAREST LOT LINE ABSORPTION AREA (WALL AREA) SQ. FT.
Well
Class: Depth:
Well distance To: Lot Line _
Bldg: Sewer Line: tt
Pipe Materials:'U00
.-?
# of Bedrooms: •- R
Installer: V\tym,LTati/ m),
Remarks: l
�4�oti 1.! _ i.._i- yes: IC - -- I- -i - - N
! +!-
T- I Ij
Ij-
OATE\P\%5"I APPROVED
rlUI PAL I TY CA F= F=1HCAF FyC3E
DEPARTMENT Oq>NEALTH AND ENVIRONMENTAL Ppn;ECT ION
825 'L, ,TREET, ANCHORAGE, AK. 995L 10: 3o �LP
26'4-4720
• WELL n"[7 C1t4—:=_ I TE S~EWEF PEF:tl I T
PERMIT NO. ( 77936 )
APPLICANT JnE THOMPSQN 4110 DEBARK 337-1200
LOCATION ANDREW STREET
LEGAL L53 SEC 25 T15N P,2W LOT SIZE 108000 SQUARE FEET
TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH
MAXIMUM NUMBER, OF BEDROOMS = 7'41 1�cP SOIL RATING (SQ FT/BR)= 85
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
C>EF'TH= fLCA L_E=rACiTH= :' GF:A� EL DEPTH= �
THE LENGTH DIMENSION IS THE LENGTH (IPJ FEET) OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET). ', So A?Gr
FR E= CA LJ I FSE[} BERT I Cl TANK to I 2E E= MY550- 1 C3ALILCAtA01
PFAClViAC3E PL_F1r4T CART I CA r4 ---------
A PACKAGE PLANT MAY BE INSTALLED AT THE PERMITTEE'S OPTION SUBJECT TO THE
FOLLOWING CONDITIONS:
1. EITHER. A CLASS I OR II NSF APPROVED PLANT MAY BE INSTALLED.
2. A CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF A MAINTENANCE
AGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SOIL
ABSORPTION SYSTEM RND/OR YOU MAY BE SUBJECT TO PROSECUTION.
-------------------------------------
- -jr WCl 4 � ] I M115PE(1T I C "t. f=l F:E F EG!U I F2E0.
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 200 FEET FOR R PUBLIC WELL.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DRYS
OF THE WELL COMPLETION.
OTHER. REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F'EF:t•1 I T EX F' I F:EIs G>EC:EtlEDEF: .TALs 1.<2 77N
I CERTIFY THAT
1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IPJ ACCORDANCE WITH THE CODES.
3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS.
SIGNED: ----
APPOCANT JOE THOMPSON
ISSUED BY %�-----
V3. 0
0 & E GEO-;.CHNI CAL & DEVELL,?MENT CO.
Boz 90, Davis St., Eagle River, Alaska 99577
694-2774 or 689-2280
Earl Ellis
Russell Oyster SOIL LOG 6882280
6942774 Land Development
Soils Er Foundations
Performed for: Name: Tel. No.337-/Xadv9s0'/
Mailing Address: ///o Di�.t'.�J�� /�✓F • X"7r c.�uc'd`44,
Legal Description: Lor-' �� �Ec..1s , T/a�, A27- 'Al' -:5• Ni•
Depth (feet)
Soil Characteristics
0
1 A/Z 5.z-- -7-eio Sa,�
2
3
iq
5
6
7
9
10
11
a 7:�
12
13
14 Bo TTD�/ Of T�T
15
16
Ground Water Encountered: Yes No L:L If yess what depth
Proposed Installation: Seepage Pit Drain Field
Comments:
Performed by: tL Date: IOZ4Z7
0
Municipality of Anchorage
On -Site Water and Wastewater Program
(907)343-7904
Certificate of On -Site Systems Approval
Parcel I.D. 051-281-05-000
1. GENERAL INFORMATION
Complete legal description
USHfif
s�
o-�
n
Expiration Date: - t '
1/4
T15N, R2W, SEC 25, Lot 53 S2
Location (site address) 16011 Shims St
Current Property owner(s) Jessica & Jeremiah Jennings Day phone
Mailing address
Real Estate Agent
16011 Shims St. Eagle River, AK 99577
Jason Trouts
Day phone
717-9485
2. TYPE OF DWELLING:
Single Family (w/wo ADU) y� ^
❑ Duplex SUBMITT
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
3 JUN 10 2014
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
0
Individual
0
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Pilhlir. Water Svctem
❑
Piihlir gP%Aiar
❑
WaiverNariance request for:
Received by: � �f "�_ Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
Release to Vanessa Melarvie
COSA Fee $ 52(+/ 315-.0 �S�
Date of Payment (, [/0.h
Receipt Number
COSA# 0/Qq 1-2-6-D
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
S. 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 Alaska Rim Engineering, Inc.
Address 9131 E Frontage Rd. Palmer, AK 99645
Engineer's Printed Name Charles A. Leet, PE
6. DSD SIGNATURE
System #1 Approved for
System #2 Approved for
Disapproved
Conditional approval for
Phone 745-0222
Date 6/10/14
®®� OF F,( x911,
*�P49TH �•1..,.•��4yo6P
— bedrooms
_ bedrooms Charles A.0eer
CE1s.
�i�ett0 PRSa
bedrooms, with the following stip' llb�fs: r
BY �� ' Original Certificate Date: 62
Th uni nchorage 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.
ATTACHMENTS:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
COSAbluesheet r . c
Nitrate Advisory
Arsenic Advisory _
Other ', f ---!•
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:
T1 5N, R2W, SEC 25, Lot 53 S2
A. WELL DATA
Well type Private
Date completed 1977
Total depth 40+ ft.
If A. B, or C provide PWSID # N/A
Sanitary seal (Y/N) Y
Cased to 40+ ft.
FROM WELL LOG
Date of test No well log
Static water level ft.
Well production g.p.m.
WATER SAMPLE RESULTS
Parcel ID: 051-281-05-000
Well Log (Y/N) NO
Wires properly protected (Y/N) Y
Casing height (above ground) 23 in.
AT INSPECTION
6/5/14
24.4 ft.
2 a 06 g.p.m.
Coliform ND colonies/100 mL Nitrate 1.3 mg/L
Arsenic ND ug/L Date of sample: 5/20/14 Collected by:
B. SEPTICIHOLDING TANK DATA
Tank Type/Material Concrete
Brandon Jones
Date installed 10/15/77
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N)
Date of pumping 5/20/14 Pumper JR's Septic Pumping
N/A
C. ABSORPTION FIELD DATA
Date installed 10/15/77 Soil rating (g.p.d./ft' or ftz/bdrm) 85 ft2/bdrm System type Trench
Length 28 ft. Width 3 ft. Gravel below pipe 6 ft.
Total depth 10 ft. Eff. absorption area 336 ftz Monitoring tube Y— Depression over field N
Date of adequacy test 6/5/14 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 0 in. Water added 489.7 gal. New depth 0 in.
Elapsed Time: 240 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NO If yes, give date
D. LIFT STATION
Date installed N/A
"Pump on" level at N/A in.
Datum N/A
E. SEPARATION DISTANCES
WELL ON LOTTO:
Size in gallons N/A
"Pump off"level at N/A
Cycles tested N/A
Septic tank/lift station on lot 100'+
Absorption field on lot 100'+
Public sewer main
Sewer /septic service line 25'+
Animal containment areas >50'
Manhole/Access (Y/N) N/A
in. High water alarm level at N/A in.
Meets alarm & circuit requirements? N/A
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout > 100'
Holding tank25 ' A
Manure/animal excrete storage areas >100'
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5' Property line 5'+
Water main 10'+ Water service line 10'+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+
Water Service line 10'+
Curtain drain NONE KNOWN
F. COMMENTS
G. ENGINEER'S CERTIFICATION
Surface water 100'+
Wells on adjacent lots 100'+
Absorption field 5'+
Surface water 100'+
Water main
+
Driveway, parking/vehicle storage 110'+
I certify that I have determined through field inspections and ``egohe�e'eti
review of Municipal records that the above systems are in ���,; F A�fl�,f:p
conformance with MOA COSA guidelines in effect on this date.
m uj T 9 i
Engineer's Printed Name �����1 -> E� . L✓C,QA *� 491—"
Date
S Ism: iolc W
C� '. Charles A. Last
J'p CE10480 • ci.�
COSA brown sheet 10-10-12.doc
Municipality of Anchorage
Development Services Department
Building Safety Division c s A . E..
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
Water Well Advisory
Certificate of On -Site Systems Approval (COSA) # 141250
During a recent COSA on-site inspection and test of the potable water
supply well on Block , Lot 53 S2 of T15N R2W Section 25
subdivision, the well's productivity was determined to be 0.8 gallons per
minute. The minimum well productivity required by this Department (AMC
15.55) for a 3 -bedroom residence is 0.3 gallons per minute. Although the
subject well currently exceeds this minimum requirement, all parties
concerned are advised that the production capacity of the well may fluctuate.
Restriction of non-critical water uses such as washing cars and watering
lawns and gardens may be required.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
_�
75
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Municipality of Anchorage
Development Services Department:
Building Safety Division '•
\_ On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 19 1231
Anchorage, AK 99519519 -6650
� p
www.muni.org/ons to
(907) 343-7904 (Q
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. O5 COSA# nQ�
1. GENERAL INFORMATION
Expiration Date:
Complete legal description TISN, R2W SECTION 25 LOT 53 SOUTH 2
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
16011 SHIMS STREET ' EAGLE RIVER AK 99577
LILLIAN PERSON Day phone 688-3678
24120 RAMBLER ROAD • CHUGIAK AK 99567
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
Day phone
Day phone
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
0
❑
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
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 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 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 samples. (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 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. l further verify that based on the
information obtained from the Municipality ofAnchorage files and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with at/ applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179
Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date ?Ob
Engineers Comments:
In conducting this evaluation, GEG, LID. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines 8 Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational fife of all wells and
septic systems depend on the local soils condition, groundwater levels that may
tiuctuato during the year, and the water usage of the family being served by the system.
Those conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or enoroachmonts. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report Is for
the sole benorit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
V Approved for 3 bedrooms.
Disapproved.
Conditional approval for bedrooms, with the flowing stipulations:
o'er
WATER D •; fn=
--WASTEYYATER : =
PROGRAM
Attachments:
COSA Checklist
Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineers Reort
Nitrate Advisory Other
By'—�� �'�� /—lJ-�(
OOriginal Certificate Date:
tel/ d
fpr IIml
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water 8 Wastewater Program
4700 Bragew Street
P.O. Box 168850
Anchorage, AK 99519 -MM
www.muni.org/onsite
(907) 3437904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: T15N R2W SECTION 25. LOT _53 S2. Parcel ID: D S/
A WELL DATA 'PER SURROUNDING WELL LOGS NO INDICATION OF BEDROCK
OR PERFORATIONS IN CASING SHALLOWER THAN 40 FEET.
Well type PRIMATE If A, B, or C provide PWSID# N/A
Date completed —1977 Sanitary seal (Y/N) YES
Total depth 40+ ft. Cased to •40+ ft.
FROM WELL LOG
Date of test
Static water levelft-
Well production g.p.m.
WATER SAMPLE RESULTS:
Coliform a colonies/100 mi. Nitrate 0.576LmgJL.
Well Log (Y/N) NO
Wires properly protected (YM) YES
Casing height (above ground) 12+ in.
AT INSPECTION
5/19/2006
30 ft.
2.57 g.p.m.
other bacteria _n colonies/100 mi.
Arsenio NO ug,n„ Data of sample: 5/18/2006 Collected by: GEG, Ltd.
B. SEPTICIHOLDING TANK DATA
TankType/Mated8l CONCRETE Date installed 10/15/1977
2 Ciesnouts M YES
Tank size 1250 gat. Number of Compartments _ (Y )
Foundation cleanoul (Y/N) YES Depression over tank (Y/N) NO High water alar (Y/N) N/A
Date of pumping 12/5/2005 Pumper JR'S PUMPING
C. ABSORPTION FIELD DATA
Date Installed 10/ta/t977 Soil rating (g.p.d./ft'oriq§j�D 85 System type TRENCH
Length 28 ft. Width 3 ft. Gravel below pipe 6 ft.
Total depth *9.17 ft. Eff. absorption area 336 fe Monitoring tube YES Depression over field NO
Date of adequacy test 5/19/2006 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth In absorption field before test 3 in. Water added 529 gal. New depth 8 in.
Elapsed Time: 23 min. Final fluid depth 3 In. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N 8 typo) NONE KNOWN If yes, give date —
MONITORING TUBE ONLY EXTENDS APPROX. 5 FEET INTO DRAINROCK.
D. LIFT STATION
Date installed Size in gallons Manhole/Access _
"Pump on" level at _in. "Pumpofa High water alarm level at
Cydes tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAiQ station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+
Public sewer main N/A
Sewer /septic service line 25'+
On adjacent kms 100'+
Public sewer manhole/deanout N/A
Holding tank N/A
Animal containment areas 50'+ Manurelanimal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line
10'+
Building foundation
10'+
Water main _ N/A
Water service line
10'+
Surface water
100'+
Driveway, parldnglvehide storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I cerdly that I have determined through held inspections and t
review of Municipal records that the above systems are in F-
Engineers
conformance with MOA COSA guidelines in effect on this
date. ........
Print Name JEFFREY A. GARNESSeas.Date le t 2J4G0�c�
COSA Fee Ste'g3o. U c,
Date of Payment (,,, /u G
Receipt Number
(Rw. 11/0) U r4
Waiver Fee $
Date of Payment
Receipt Number
MMJRS
05/25/2006 12:48 9073449821
Tu Total
SEPTIC PAGE 01
�.
$0.00
$0.00
$130.00
Elm
02
III
JRs Pumping
PO Box 773415
Service Agreement
We River, AK 99577
(907) 694.6454
Number: 018849
Order Date: 02 -Dec -2005
Service Date: 05 -Dec -2005 12:0
��
Technician: Butch
Billing Intormallorl
Lillian & Richard RPC
Joe Description:
12509
24120 Rambler Road
P.O. Number.
Terms:
Ne130 Tax %: 0
Chugiak, AK 99567
Selesrep:
Nikole Job Type: Repeat
(907) 088-4678
Map Boot:
Map Grid: 62
cress streets:
Pioneer Drive
ob Its Infotmlatfon
Job comments:
Last service 10/28/04 5009
Rental -Richard
-- Don't leave invoice, bill —
16011 Shims Street
Checked and pumped tank- levels normal
Lot 53
Eagle River, AK 99577
(907) 688.4678
Gallons Planned: 1250
Atlditianal Location Comments Diagram:
Comer of Shims & Pioneer - white
Gal. Actual:
trailer w/green trim
Hose Length: 1
Pipe on front of tank separated from
Double Tank: O
tank
pump System:
Baffles Inlet: O
Baffles Outlet: O
qty Price Each Tax? Extension Actual Septic Service 15K 1 $130.00 No $130.00
WonTaxabla Tett
Tuabla Total
Tu Total
Grand Total
EaamAed Charges: $130.00
$0.00
$0.00
$130.00
Aduzi Charges: .r
Customer agree, to lire terms and codldons shown. THS IS A BINDING AGREEMENT.
signature and Tlds d Customer Rrgresentativa Date
Accepted by JRs Pumping Data Accepted
For Yom added convenience we accept: American Express, Dieom. Visa and Master Card payments ova the phone.
After 30 Days accounts w fl be turned over to oullactwk 525.00 For NSF Chocks R.tumad.
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Client Name
Project Name/#
Client Sample ID
%lair!%
Sample Remarks:
1062491001
Games En mccring Group, Ltd.
T15N ec 25 Lot 53 S2
TISN WS cc 25 Lot 53 S2
Drinking Water
All Date%/fimes are Alaska Standard Time
Printed Date?!me
06/022006 12:03
Collected Date/time
05/182006 9:30
ReceivedDate/fime
05/182006 13:40
Technical Director
Stephen C. Ede
Allowable Prep Analysis
Parameter Results PQL
Units Method Conmincr ID Limns Date Date Init
Metals by ICP/MS
ND 5.00 ug/L EP200.8 C (o-10) 05/19/06 0522/06 MII
Arsenic
Waters Department
Nitrate -N 0.576 0.100 mg/L.
CPA 353.2 0 (<-101 05/18!06 ALR
Microbiology Laboratory
col/IOOmL SA12092226 A (<-I) 05/18/06 TLF
Total Coliform 0