HomeMy WebLinkAboutSTOLLE BLK 3 LT 7Stoll
Block
Lot 7
#020-021 - 19
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WATER SUPPLY PERMIT
Renewal
Date Issued: Oct 31,2007
Expiration Date: Oct 30, 2008
Permit Number: SW070302
Legal Description: STOLLE BLOCK 3 LOT 7
Design Engineer: 0060 DHI ENGINEERING
Owner Name: JACOB & YVETTE DEMPSEY
Owner Address: 10900 FOREST DRIVE
ANCHORAGE, AK 99516-
Parcel ID: 020-021-19
Site Address: 16040 HONEY BEAR CIRCLE
Lot Size: 47091 SQ. FT.
Total Bedrooms: 5 Permit Bedrooms: 5
This permit is for the construction of:
[] Disposal Field [] Septic Tank
E~ 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.
Received By:
Issued By:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
www. muni.org/onsite
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D.
Property owner(s) ~(1 [>~ ¢ ~ ~£,~ ~/'~¢~/~Z/'Day phone -,-_~ :~L~'f - ~ ~<'~
~ ~ ' , /.. ~ / ~--
Mailingaddress ][~.~ p {~.~ /,~ ~/~5[..- ~/~ ~]~?
Zip Code
Legal description (Sub'd., Block & Lot) ~//~_ '~,~ ~ ~
Legal description (Township, Range & Section)
Lot Size L?/~ ii ¢? / Sq. Ft.
Number of Bedrooms
THIS APPLICATION IS FOR ([~ all that apply):
Absorption Field
Septic Tank
Holding Tank
Privy
Private Well
Water Storage
THIS APPLICATION IS AN:
Initial []
Upgrade ~//
Renewal
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 own'er or authorized agent)
Permit/Rush Fees:
Date of Payment:
Receipt Number:
(Rev. 11/05)
Waiver Fees:
Date of Payment:
Receipt Number:
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewaler Program
4700 South Bragaw Street
P.O. Box lg6650, Anchorage, AK g9519-6650
(gO7) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Initial
Date Issued: Nov 01, 2006
Expiration Date: Nov 01, 2007
Permit Number: SW060357
Legal Description: STOLLE BLOCK 3 LOT 7
Design Engineer: 0060 DHI ENGINEERING
Owner Name: JACOB & YVt::I I E DEMPSEY
Owner Address: 10900 FOREST DRIVE
ANCHORAGE, AK 99516-
Parcel ID: 020-021-19
Site Address: 16040 HONEY BEAR CIRCLE
Lot Size: 47091 SQ. FT.
Total Bedrooms: 5 Permit Bedrooms: 5
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Privy
[] Private Well [] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specked 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.
Issued By;,
Date: ////0~/~ 0''''
/
Date:
Municipality o.f Anchorage
Development Serv,ces Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
www. muni.org/onsite
(907) 343-79O4
ON-SITE SEWER/VVELL PERMIT APPLiCATiON
FOR a SINGLE FAMILY DWELLING
Parcel I.D. 020-021-1 9-, ·
Property owner(s)3acob & Yvet:te Dempsey
Mailing address 10900 ~'orest: Drive
Site address 16040 t~one¥ aear CJ. rcle
Day phone 529-5078
Zip Code 99516
Zip Code 9951 6
Legal description (Sub'd., Block & Lot) [,ol: 7t B].ock 3~ Sto].le Subd:l.v.ts:rLon
Legal description (Township, Range & Section) $B1 /4 t N~.I /4 t Sect. J. on 6, '1' 1 1 N, R214, $. M., ,~,].as ka
Lot Size 4 7 t 091 . Sq. Ft. Number of Bedrooms 5
THIS APPLICATION IS FOR (~;~ all that apply):
Absorption Field []
Septic Tank []
Holding Tank D
Pdvy []
Private Well []
Water Storage []
THIS APPLICATION IS AN:
Initial []
Upgrade []
Renewal []
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
($igdature of property owner or a/ut~t~ed agent)
Waiver Fees:
Date of Payment:
Receipt Number.
Permit No.
Legal Description:
Municipality of Anehorage
Department of Developmental
ON-SITE SERVICES
Services
Page I of 6
W.O. 06762
Date 10/20/06
P.O. Box 196650' Anchorage, AK 99519-6650' Tel: 343-4744
Well & On-Site Wastewater Disposal System
LOT 7, BLOCK 3, STOI.I.~. SUBDMSION PID No. 020-021-19-000-1-0
SYSTEM DESIGN CALCULATIONS
1. NO. BEDROOMS = 5
2. USE WIDE TRENCH SYSTEM (W=5')
L.~RENCH APPLICA~ON RATE
TRENCH ~D~ (W)
X REDUCTION FACTOR **
IF GRAVEL DEPTH = 3.0'
REDUCTION FACTOR = 0.58**
THEN LENGTH OF TRENCH =
5'
X .58 = 72.5' USE 7Y
PERCOLATION RATE
*1
MIN/INCH
0-1
1-5
6-15
16-30
31-60
GREATER THAN 60
FILTER LAYER
PIT & TRENCH
APPLICATION RATE
WIDE TRENCH
REDUCTION FACTOR
GPD/$F DEPTH OF GRAVEL
NOT SUITABLE 12'
1.2 I ~s'
0.8 24"
0.6 30"
0.45 ** 136'
NOT SUITABLE 42"
1.0 48"
Permit No,
Municipality of Anchorage
Department of HealLh and Human Services
ENVIRONMENTAL SERVICES DMSION
P.O. Box 196650' Anchorage, AK 99519-6650' Tel: 343-4744
Page 2 of 6
W.O. 06762
Date 10/20/06
On-Site Wastewater Disposal System/Well Inspection Report
Legal Description: LOT 7, BLOCK 3, STO~.I.I~ SUBDMSIOI~ PID No. 020-021-19-000-1-0
UNSUBDN~DED
' ' '11
LOT 6 ~00'
' PROPOSED SEPTIC
SEE SHEET ~ ! ~. v~,.OW LOT 5
UND~LOPED
LOT 12
UNDEVELOPED
LOT 7
47.091.28 S.~
1.08
ELEV.-15s.go
I LOT 11 · ·
UNDEVELOPED
EXIS~NG SEPTIC
~ II STUD PIPES
~.. ~--~..
Permit No.
Municipality of Anchorage
Department of Health and Human Services
ENVIRONMENTAL SERVICES DMSION
P.O. Box 196650 ° Anchorage, AK 99519-6650 ° Tel: 84-~-4744
Page 3 of 6
W.O. 06762
Date 10/20/06
On-Site Wastewater Disposal System/Well Inspection Report
Legal Description: LOT 7, BLOCK 3, STOt'.I,~ SUBDMSION PID No.020-021-19-000-1-0
NT'
..-.~ :.~ ~-, ~:~...~
DATE
Permlf No.
Municipality of Anchorage
Department of Health and Human Services
ENVIRONMENTAL SERVICES DMSION
P.O. Box 196650 ° Anchorage, AK 99519-6660' Tel: 343-4744
Page 4 of 6
W.O. 06762
Dale 10/20/06
Proposed Well & On-Site Wastewater Disposal System
Legal Oescriptlon: LOT 7, BI,OCK 3, STO!.l.~. SUBDIVISION PID No. 020-021-19-000-1-0
REDDISH BROWN
SANDY SILT
BROWN GEAVELY SAND
TRACE SILT, ROCK TO
OCCASIONAL BOULDER
~-- MONITORING TUBE
FINISH GRADE /SEE HOT[ 11, SHEET 5.
BACKFILL II I
. l e~4' PERFORATED PIPE SEE
''
~ { ~ ~GEOT~I~ F~RIC. SEE
~ I~ ~sip~c R~. SEE
NO~ I0, SHEET 5
I.5.o, .I
TO SEASONAL HIGH
WATER LEVEL
Permit No.
Legal Description:
DHI CONSULTING ENGINEEES
LOT 7, BLOCK 3, ~'TOT.T.~- SUBDMSION
NOTES:
Page 5 of 6 I
W.O. 06762
I
Date Io/2o/o61
AU. CONSTRUCTION SHALL BE IN ACCORDANCE WITH CHAPTER 15.65. WASTEWATER DISPOSAL REGULAr'IONS
OF ~HE MUNICIPAL CODE, AND MOA STANDARD SPECIFICATIONS FOR STREETS, DRAINAGE, UTIUTIES AND PARKS
(MASS) 1994 AS CURREN~.Y AMENDED, AND AU. APPUCABLE STATE AND FEDERAL REGULATIONS.
INSTALL 1,500 GALLON, 2 COMPARTMENT STEEL SEPTIC TANK.
SiTE TOPOGRAPHIC SURVEY CONDUCTED BY DHI ON 10/12/06. EXISTING STRUCTURES, WELLS, SEPTIC
SYSTEMS OBSERVED WITHIN 200 FT. OF ~HE PROPOSED SYSTEM SITE ARE SHOWN ON DESIGN DRAWINGS.
ANY DEVIATION FROM THE DESIGN MUST BE AUTHORIZED BY THE ENGINEER PRIOR TO ITS INCORPORATION
INTO THE SYSTEM.
CONTRACTOR TO LOCATE AU- UNDERGROUND UTIUTIES, PROPERTY UNES, EXISTING ~E:LLS, WATERWAYS,
SURFACE AND SUBSURFACE DRAINAGE FACIUTIES, LAKES, PONDS, AND OTHER FACIUTIES REQUIRING
SEPARATION DISTANCES FROM THE PROPOSED SEPTIC SYSTEM.
CONTRACTOR TO STAKE PROPOSED SYSTEM & NOTIFY THE ENGINEER O~ ANY OBSERVED
CONFLICTS PRIOR TO CONSTRUCTION. STAKE LOCATION OF EACH TRENCH END. NOTE DEPTH OF CUT ON LATH.
CONTRACTOR SHALL HAVE SURVEY LEVEL AND ROD SET UP ON SITE DURING CONSTRUCTION.
CONTRACTOR TO NOTIFY THE ENGINEER 24 HOURS PRIOR TO COMMENCING WITH CONSTRUCTION.
A MINIMUM OF THREE SITE VISITS ARE REQUIRED. THE FIRST V~SIT SHALL BE OF THE SUBGRADE
PRIOR TO PLACING THE SEWER ROCK. THE SECOND VISIT SHALL BE AFTER THE PLACEMENT OF
SEWER ROCK, DISTRIBUTION PIPING, STANDPIPES, AND OTHER COMPONENTS AS SPECIFIED. THE THIRD
VISIT SHALL BE AFTER THE WORK IS COMPLETED.
7
CONTRACTOR SHALL DEUVER TO THE ENGINEER A SET OF RED-UNED, AS-BUILT DRAWINGS SHOWING AU. DATA
AS SPECIFIED IN SEC. 15.65.F.2, 3, 4, 5, 6 OF MUNICIPAL WASTEWATER DISPOSAL CODE WITHIN FIVE DAYS OF
THE FINAL VISIT. INVERTS AND SWING TIE LOCATES SHALL BE TO THE NEAREST TENTH OF A FOOT.
THESE AS-BUlLTS SHALL BE USED BY THE ENGINEER TO PREPARE AND SUBMIT RECORD DRAWINGS TO DHHS.
8 ALL EXCAVATION DEPTHS ARE ADVISORY. THEY ARE TO BE VERIFIED AND MAY BE MODIFIED BY THE
ENGINEER IF ACTUAL FIELD CONDITIONS VARY FROM THOSE USED TO PREPARE THE DESIGN.
9 BOTTOM OF TRENCH EXCAVATION SHAM. BE LEVEL. SIDEWALLS &: BOTTOM SHALL BE SCARIFIED. RECORD
ELEVATIONS AT BEGINNING, MIDDLE, AND END OF TRENCH BOTTOM.
10 PLACE THE SEWER ROCK TO THE SPECIFIED DEPTHS. DO NOT CONTAMINATE SEWER ROCK.
LEVEL ROCK SURFACE TO · 0.1' PRIOR TO INSTALLING THE PERFORATED PIPE.
11
AU- PIPE SHALL BE PVC CONFORMING TO ASTM D5034. AU- JOINTS SHALL BE SEALED WITH APPROVED GLUE.
CLEANOUTS SHALL BE INSTA))Kn AT THE END(S) OF THE TRENCH(S). 4' MONITORING TUBE(S) SHALL BE
INSTALLED AT THE END OF THE TRENCH, WHERE SHOWN ON PLANS, PERFORATE ONLY THE BOTTOM 3' OF THE
MONITORING TUBE AS SHOWN ON THE PLANS.
12 COVER THE DISTRIBUTION PIPE WITH YIN 2' SEWER ROCK, BEFORE PLACING INSULATION AND/OR GEOTEXTILE,
FILL, AND TOPSOIL.
15 MINIMUM SOIL COVER SHALL BE 3 FEET OVER THE PIPE AND 4 FEET OVER THE SEPTIC TANK. ONE INCH OF
INSULATION MAY BE SUBSTITUTED FOR 1 FOOT OF SO~L COVER, BUT THERE MUST BE A MINIMUM O~ 2' OF SOIL
COVER OVER THE INSULATION. AU- INSULATION BOARD SHAM. BE 2' THICK POLYST~ENE, DOW H1-35
OR ENGINEER-APPROVED EQUAL. CENTER BOARD WIDTH OVER PIPE.
14 AN APPROVED GEOTEXTILE FABRIC SHALL BE INSTALLED BE~EN THE SEWER ROCK AND THE
BACKFILL.
15 MATERIAL USED AS FILL SHAU- BE CLEAN AND FREE OF ORGANICS, TRASH AND CONSTRUCTION DEBRIS.
16 SLOPE AU. FlU. MATERIAL AND TOPSOIL TO DRAIN AT 2% MIN. SLOPE, AND IN SUCH A MANNER THAT
PONDING AT OR NEAR THE DRAIN FIELD DOES NOT OCCUR. THE FILL SHALL BE LEFT 6' HIGHER THAN
SHOWN TO ALLOW FOR SETTLEMENT. THE TOP 4' OF COVER SHALL BE TOPSOIl- SEED SURFACE AFTER
COMPLETING INSTALLATION AS PER MUNICIPAL SPECS.
17 CONTRACTOR TO BE RESPONSIBLE FOR THE REMOVAL AND DISPOSAL OF CONTAMINATED MATERIAL FROM THE
EXISTING TRENCHES, IF ENCOUNTERED.
Permlt No.
Legal Description:
t/ttnicipalAty of Anchorage
Department of Developmental Services
ON-SITE SERVICES
P.O. Box t96650 ° Anchorage, AK 995t9-66§0 ° Tel: 343-4?44
Well & On-Si[e Was[ewaLer Disposal System
LOT 7, BLOCK 3, ST0~.t.~ SUBDt~ISION
Page 6 of 6
W.O. 06762
Date 10/20/06
PID No. 020-021-19-000-I-0
50'
ORIGINAL GROUND
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/
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5' WIDE TRENCH
TOP OF' DRAIN FIELD
GROUND SLOPE FROM
TOP OF' SEPTIC FIELD
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9~=t"l I '~ rm"l' DATE
DHI CONSULTING ENGINEERS
800 ~. ~MOND BLVD.
so,
P~F~ r~: JACOB DEMPSEY
~ D~IP~:LOT 7, BLOCK 3, STOLLE SUBDI~SION
~ ~GANICS
,..~.~:~' REDDISH BRO~ SANDY SILT
2 ~
3
/ BRO~ GRAYLY SAND
-- f.~** .. ~CA~0NAL BOU~
9 4.'/.~
~' ·
'...:.~'* w~s ~D w~
10 ~,/~ ~C~N~ ~ ~0
O~ ?
12 ~'"~ D~ OF WA~
B.O.H. 13.5' (HARD DIGGING) I Io~i~
POSSIB~ BEDROCK
~ST RUN BE~:
~M~:CAT ~B BA~H~. S~LS ~RE PRE~ PRI~ TO RUNNING
~ STA~ ~D MUNIOP~ ~I~N~ IN ~ ~ ~IS DA~ DA~ 10/18/06
DHI CONSULTING ENGINEERS
.oo z. muo. o ScvD. Sunz a-~4S ,*. t~....""...~6,~,~,
so, s Lo -P .co TION EST
~ST HO~ LOG ~2
P~F~M~ F~: JACOB DEMPSEY n~ =~u~ ~nl~ln~ % ~. % .. ~o~, ..-~
~o~ OEs~pn~.LOT 7, BLOCK 3r STOLLE SUBDI~SION
T.H.~2
~GANICS
1 ·
~.~=~ REDDISH BRO~ SANDY SILT
~.~.~ SOME ROOTS ~E
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~ " R~. GRA~LY SAND J _~.
7" - MOIST, MORE ROCKY ~ ~v
~ DEP~
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12 ' * 24' BOMBER ~ M~IT~ING ? ,N~E DA~:
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~ STA~ ~D MUNIQP~ ~N~ IN ~CT ~ ~IS DA~ DA~ 10/18/~ 762CSSBD
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MUMOF L U TYO F HCHO RA G
Development Services Department 4 _ Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 020-021-19-000
Expiration Date: 1/30/2025
Legal description STOLLE BLK 3 LT 7
Site address 16040 HONEY BEAR CIR Anchorage AK 99516
Current property owner(s) REINHARDT RONALD JR & BRANDI
X The On-site system(s) is/are approved for 5 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
Tank to be pumped in the Spring of 2024 on or before 6/15/2024 by One Stop Pumping.
Original Certificate Date: 1/16/2024
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
systems) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
COSA Approva"une 2022
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 020-021-19
Complete legal description STOLLE BLOCK 3, LOT 7
Location (site address) 16040 HONEY BEAR CIRCLE, ANCHORAGE AK 99516
Current property owner(s) RONALD JR & BRANDI REINHARDT Day phone
2. ON-SITE SYSTEMS SIZED FOR 5 BEDROOMS
3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age 15 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ® Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $ '55-0 Waiver Fee $
Date of Payment
Date of Payment
COSA # OSC 2 y IOZ7 Waiver #
COSA Application.doc
COSA Checklist.docx
COSA Checklist
Legal Description: STOLLE BLOCK 3, LOT 7 Parcel ID: 020-021-19
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled 10/22/2008 Total depth 306 ft
Cased to 43 ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA 2/7/2024
Static water level at beginning of test 53 ft.
Well production at time of test 1.4 gpm
Water storage tank volume 900 gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate 3.13 mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by Date 1/30/2024
Comments __________________________________________________________________________________
B. TANK DATA
Measured operating fluid level in septic tank 49”
Date of pumping SPRING 2024 by 6/15/24
Required maintenance completed, if AWWTS
Comments: Pumping w/ site visit prepaid. Remote site
inaccessible with winter conditions.
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 12/11/2006
ALL standpipes present per record drawing
Total measured depth from grade 6.6 ft (max)
Measured depth to pipe invert from grade 3.4 ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes (MT) go to bottom of effective. (ED)
If not, state depth into effective
Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months) N
If yes, enter date
Adequacy test date 2/7/24
Results Pass
Fluid depth prior to test 0 in
Water added 800 gal
New fluid depth 1 in
Elapsed time <5 min
Final fluid depth 0 in
Absorption rate 750 gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) 36 in (MOA 3’ ED)
Effective depth used 0 in (Final Fluid Depth)
Effective depth (ED) remaining 36 in
Comments/Deficiencies: Approximate total measured depths from existing grade with winter conditions. ED per elevation
measured shots & appears approximate with 3’+ ED.
COSA Checklist.docx
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Absorption Field on Lot > 100’ Yes if No ft
Neighboring Absorption Fields > 100’
Yes if No ft
Community Sewer Main > 75’ Yes if No ft
Community Sewer Manhole/Cleanout > 100’
Yes if No ft
Private Sewer/Septic Line > 25’ Yes if No ft
Holding Tank > 100’ Yes if No ft
Animal Containment > 50’ Yes if No ft
Manure/Animal Excreta Storage > 100’
Yes if No ft
N/A – Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10’ Yes if No ft
Tank to Property Line > 5’ Yes if No ft
Field to Property Line > 10’ Yes if No ft
Water Main > 10’ Yes if No ft
Water Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No ft
If tank or field is under driveway comment below
F. ENGINEER’S COMMENTS
G. CERTIFICATION & 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, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Engineer’s Printed Name CURTIS HUFFMAN, PE Date 2/8/2024
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. The assessment of the condition of the well and septic
applies only to the conditions as of the day tested. The flow and absorption rates may change
due to subsurface conditions that may not be observed from the surface, changes in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the
system and maintenance. The operational life of all well and septic systems are subject to
these various and dynamic characteristics and are outside the control of the evaluator of the
well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by First Water Consulting &
02/08/24
Thank you for your business!Invoice 26510122
Invoice Date 2/9/2024
Payment Term Due Upon Receipt
Billing Address
First Water
13021 Montego Circle
Anchorage, AK 99516 USA
Job Address
16040 Honey Bear Lane
16040 Honey Bear Lane
Anchorage, AK 99516 USA
Task #Description Quantity Your Price Total
SEPTIC Pumped out the septic tank 1.00 $225.00 $225.00
Sub-Total $225.00
Tax $0.00
Total $225.00
Payment $0.00
Balance Due $225.00
Please call us with any questions or concerns at 907-561-7669.
If you enjoyed our service, please leave us a review on Google.
TO BE PUMPED IN THE SPRING OF 2024 PRIORTO 6/15/24 DUE TO ACCESSIBILITY - SNOW & SITE LOCATION.