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Home My WebLink AboutSKY RANCH ESTATES #1 BLK 4 LT 11 Onsite File Sky Ranch Estates # 1 Block 4 Lot 1 1 #015 - 301 - 01 Municipality of Anchorage Community Development Department Page 1 of 3 On-Site Water&Wastewater Program 4700 Elmore St. •P.O. Box 196650 Anchorage,AK 99519-6650 •http://www.muni.org/onsite•(907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181255 PID Number: 015-301-01 ❑ New ■Upgrade Name: ABSORPTION FIELD C/O JONATHAN HARVEY Address: ■ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound 5711 WHISPERING SPRUCE DR., ANCHORAGE,AK 99515 ❑ Other Phone: No.of Bedrooms: Soil Rating: Total Depth from original grade- 242-4541 3 1.2 GPDrsq.Ft. 9.5 (MAX.) Ft. Depth to pipe invert from original grade: Gravel depth beneath pipe. LEGAL DESCRIPTION SEE DWG. Ft. 4.5 Ft Subdivision: Block: Lot: Fill added above original grade: Gravel length. SKY RANCH ESTATES#1 4 11 SEE DWG. Ft 45 Ft Township: Range: Section: Gravel width: Beds Number of linos. Distance between lines: - 2.5 Ft. - Ft. SEPARATION DISTANCES Total absorption area Number of trenches- Dist between trenches: To Septic Absorption Lift Holding Public/Pevate From Tank Field Station Tank Sewer Lines 405 SQ.Ft. 1 - Ft. Well *801+ •80'+ - - 25'+ TANK IN Septic ❑ S.T.E.P. ❑Holding ❑Other - Manufacturer Capacity. Surface Water 100'+ 100'+ - - INFILTRATOR 1060 Gal. Matenal: Number of compartments: Lot Line 5'+ 10'+ N/A PLASTIC 2 Foundation 10'+ 10'+ - - LIFT STATION Curtain Drain NONE KNOWN Manufacturer. C'• I Gal Remarks: *WAIVER GRANTED.WAIVER#OSV181058 'Pump on level at 'Pump off"level at High water alarm at Pump Make&Model Electrical Inspections performed by. PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield Installer WILCO EXCAVATION Drainfield D3034 CO/MT D3034 Inspector GEG, Ltd. BENCH MARK (Assumed elevation) Inspection 100.00 F, Dates: 1st 8/27/2018 2nd 8/27/2018 ovation and Descriptio 3rd 8/28/2018 4th - BACK DOOR THESHOLD ENGINEER'S SEAL Community Development Department Approval . .00,..m.„,•• • Conditional approval: Date: . � • '• . ••' �� . .Lr; ,\ ••• * �o • •0i:Irey •.Garners # !p • CE-7f53 •'�Ci i .j♦IF�•.,•••� ti •: 7 .••' <<- , Approved: ke" W �ti... Date: C�Z�g LICE, 4E b. OFESS\ �•.4 #AECC884 ��\i\\\ Inspection Report_1-1-12 doc /� PERMIT NUMBER: PARCEL ID NUMBER: OSP181255 RECORD DRAWING 015-301-01 A B NOTE:THE 10'UTILITY EASEMENT, FCO 25.8 30.2 THE 80 FOOT WELL RADIUS FOR ST1 33.4 64.7 THE WELL ON THIS LOT,AND THE ST2 36.9 63.6 100 FOOT NEIGHBORING WELL TANK MT 36.4 67.5 I RADIUS WAS STAKED/FLAGGED DBL1 41.8 63.2 BY SHANE HOLT,RLS,RETAINED DBL2 42.8 63.3 BY WILCO EXCAVATION PRIOR TO I CONSTRUCTION.TIM EKLUND CO1 47.5 62.6 —NEW 1060 INFILTRATOR SEPTIC WITH THE MOA ONSITE MT1 46.5 61.3 TANK(2 COMPARTMENTS)WITH SIDE ENTRANCE INLET ' DEPARTMENT WAS PRESENT CO2 74.9 49.7 DURING THE FIRST INSPECTION I MT2 73.0 48.7 NEW DEEP TRENCH TYPE DRAINFIELD' OF THE DRAINFIELD. EXISTING DRAINFIELD WAS I NOTE:THE OLD SEPTIC TANK DECOMMISSIONED IN PLACE ' WAS DECOMMISSIONED PER UPC I — — _ — — — PER THE CONTRACTOR / 10'UTIL.ESMT. , r----5STI I I Illi- CD, -=_-_____=_=__-____- 52_____I___' — — — _ - TANK MT S MT1 �' — _ i / i \ N — / s)�� \_.00 / `YTH#1 \ I • T / tv to0 INSTALLED DBL CO'S 5� \\ / // (DBL,&DBL2) ` \ N ` \ // ,\\ RAISED PLUMBING IN \ CRAWLSPACE AND • / \ INSTALLED FOUNDATION i I / \ _ CLEANOUT(FCO) iii i —I h \ EXISTING ' N� Q \ \ 3 BEDROOM Y�' ; O 4 r \ HOUSE Ce 1 ' 1 \ 1 2 I III /�% • I gi ccI _ ----\--- 0 • H D CCI / II Ip / •: DI2IV�WAYi`• EXISTING WELL \ • �'C _--- -• ' ' ' I I _0 --T I N I / // \ N I N / / \ \ / \ I N I/ / \ \ \ WHISPERING SPRUCE DRIVE \ / —__ 0 -\—-— -— - _ _i________________ __\___ _ _ / \ SCALE: \ I \ // I \ \ / \ / I \ 1•-30 \ i \ i •4-\ .... 4 We r41. 1•'�0• ''•4 GARNESS ENGINEERING GROUP, Ltd : 4t/ 41% - CIVIL&ENVIRONMENTAL ENGINEERS „�� 0 3701 E.TUDOR ROAD,SUITE 101•ANCHORAGE,AK 99507•PHONE(907)337-6179•FAX(907)338-3246*WEBSITE:www.gamessengineering.00m •/ • PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0 . 1 0 ;ey A.Gamess : . CIO JONATHAN HARVEY 242-4541 2 OF 3 • 0 ' C_E 95 PROJECT/LEGAL DESCRIPTION: DRAWN BY: . ' • yy /'Z 't3 SKY RANCH ESTATES S/D#1; BLOCK 4, LOT 11 J.L.M. ..FO P••d. •••'•',',��P�- .� 4 P TYPE OF WORK: DATE: REVISED LICENSE,,� °Fvi ��• RECORD OF SEPTIC SYSTEM UPGRADE _ 9/12/2018 #AECC884 1 I PERMIT NUMBER: RECORD DRAWING PARCEL ID NUMBER: \ OSP 181255 015-301-01 FINAL GRADE=98.75-98.82 ST2 ST1 0 * * a a a a TOP OF TANK @ 2"OF INSULATION TOP OF TANK OUTLET=95.50 PER THE CONTRACTOR @ INLET=95.51 INLET 1•II I IA OUTLET-- OF PIPE INVERT OF PIPE @ INLET=94.96 i @ OUTLET=94.66 NEW 1060 INFILTRATOR 2-COMPARTMENT U SEPTIC TANK Lj MT1 C01 THN1 MT2 CO2 /—FINAL GRADE= ( ORIGINAL GRADE — ® / 99.30-99.60 =98.35-99.27 • ." FILTER FABRIC AF :i :•:".:•:i:i :i :i:,:i:46i ;• ;•;•.•;•;i :i :i:i:•:i:i INVERT OF DIST.LINE=94.27 :• :•,:•:•:i Ai :•:•:•:•:i :• ;i:•:•:•:di ;• :i:V:.:l:1 ;i :i:r:•:i,:i :• :•:0:0:0::i BOTTOM OF TRENCH=89.77 V RELATIVE ELEVATION OF GROUND WATER ON 7/27/2018=83.57 RELATIVE ELEVATION OF BOTTOM OF TEST HOLE=82.77 •` E OF ��,• 0,- drietelgr . Al ,..� al.C...\)2*** "41.......... ••••.. ,�. • I GARNESS ENGINEERING GROUP, Ltd •; f • =.� ��'� • CIVIL&ENVIRONMENTAL ENGINEERS if • 3701 E.TUDOR ROAD,SUITE 101•ANCHORAGE,AX 99507•PHONE(907)337-6179'FAX(907)338-3246•WEBSITE'www.gamessengineedng.aom _ r PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0(n• . 1; •• .A A. Ga ess :•�a C/O JONATHAN HARVEY 242-4541 3 OF 3 *AG'� •53. �� J' •• . PROJECT/LEGAL DESCRIPTION: �f V SKY RANCH ESTATES S/D#1; BLOCK 4, LOT 11 D�J.L.M. *0/\<4. ••''••% 3 0\., - •• � TYPE OF WORK: DATE: LICENSE FESS\ ,44 RECORD OF SEPTIC SYSTEM UPGRADE �►'•�w,� J 9/4/2018 #AECC884 712NR3WSEC 22 !I! NE 1/4 NE 1/4 SE} UNSUBDIVIDED MOAII PARK LAND BOD AND ARLENE CROSS PARK waLKwav N. 889°59'33°E 110.00' to a-X-:-X--X-1 50' i 10' UTILITY EASEMENT ,,T� t .%._Ss soe SY / �,, t I • .=---A-ss 110>11 1 LOT11 8 S I a LOT 10 Q. ss. W 1 v 56.1' 30.9' b�`, V I U Bo 0 o m O N EXISTING HOUSE N g 0 Z N) '�—21.5 56.1' J 16,/,',•,...,;,2, .�_S x JXF L V "�'A.. :.. $ 50 "''"--- I N89°59'331W 110.00' I I I SPRUCE DRIVE i If 4'0FpAC�4�4 1.NOTES: 0 1. THIS DRAWING SHALL NOT BE MODIFIED FOR USE AS A PLOT PLAN ooP.��.. ••..gsppo WITHOUT THE EXPRESSED WRITTEN CONSENT OF LCG LANTECH. •0 • G'�-. TH X N 2. A PORTION OF THE SEPTIC SYSTEM APPEARS TO BE ON LOT 10. D CALLA HAN; O PLAT NOTE: _ NO DIRECT VEHICULAR ACCESS WILL BE ALLOWED TO BIRCH ROAD vo, L 12034 ,•' -,p FROM LOT 11,BLOCK 4. 0447 /• /..•,6,=, 'a,OJessionoV Low' �4pp000‘' ' ADDRESS: 5711 WHISPERING SPRUCE DR. ORDERED BY: JONATHAN HARVEY PARCEL#: 015-301-01-000 SURVEY CERTIFICATION:LCO LANTECH,INC HAS CONDUCTED APHYSICAL SURVEY OF THE PROPERTY AS SHOWN ON THIS DRAWING AND CERTIFIES THAT THE LEGAL DESCRIPTION: IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO AS—BUILT ENCROACHMENTS EXIST OTHER THAN NOTED. EXCLUSIONARY NOTE:RIS THE OWNERS RESPONSIBILITY TO DETERMINE THE LOT 11,BLOCK 4, EXISTENCE OF ANY EASEMENTS,COVENANTS.RESTRICTIONS OR RIGHT.OF.WAY TAKINGS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT.UNDER NO SKY RANCH ESTATES,UNIT 1 CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION,FOR ESTABLISHING PROPERTY LINES.OR FOR PLOT-PLAN PURPOSES. LEGEND. SS _ An H Street SEPTIC STANDPIPE Anchorage,Alaska 99501 ,,,, '�'�=ss�: -...-. WATER WELL .;y _ p�_y .��•Coner°t°.. ., FENCE —X—X— Survey Department DRAWN DATE: 99/2018 ••• WORK ORDER:16126 ' Ptrone 562-5291 Mr-Oen Inct€C51 % -) btalnlInc DRAWN BY: AP PLAT: 71-166 Phone 243-8985 -- aAditedute• e"9"Tee u"9'o"nueYinf AECC 668 CHECKED BY: SC GRID: SW2737 SCALE: 1.4 30' FB/PG:609/47 i %�""—"rr� MUNICIPALITY OF ANCHORAGE ��ent t On-Site Water&Wastewater Program \a Ste^ PO Box 196650 4700 Elmore Road �. Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 r` http://www.muni.orgionsite N �, j Department 4'YCNp Rn�E On-Site Wastewater Disposal System Permit Permit Number: OSP181255 Effective Date: 8/10/2018 Work Type: Septic Upgrade Expiration Date: 8/10/2019 Tax Code Number: 01530101000 Site Legal Address: SKY RANCH ESTATES#1 BLK 4 LT 11 G:2737 Site Mailing Address: 5711 WHISPERING SPRUCE DR, Anchorage Owner: MARCIEL THOMAS F Lot Size in Sq Ft: 12375 Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 3 This permit is for the construction of: 2 Disposal Field El Septic Tank ❑ Holding Tank ❑ Privy 0 Private Well 0 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 Received By: v� �� Date: /1 p $ Issued By: l/A 0,0,..„.,, L_____ Date: 9400 Municipality of Anchoragegermi- P.O. Box 196650-e-4700-Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.orq/Onsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW x x x x Waiver#: OSV181058 COSA#: Permit#: OSP181255 PID#: 015-301-01 Legal Description: Sky Ranch Estates#1 B4 L11 Engineer: Garness Engineering Group Applicant: Thomas Marcie) Your request for a waiver of the required 100 feet horizontal separation from the absorption field and septic tank to the private well has been approved. The approved separation distance is 80.0 feet. This waiver approval applies to the proposed absorption field and septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date: S//07/4 Approved by: lji/ r Name of Review **'k* VARIANCE/WAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE Community Development Department �- Phone: 907-343-7904 Development Services \--- Fax: 907- 343-7997 On-Site Water & Wastewater Program Mayor Dan Sullivan On-Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 0/5- WI-0\ Property owner(s) THOMAS MARCIEL(CIO OF JONATHAN HENRY) Day phone 301-3309(242-4541) Mailing address 5711 WHISPERING SPRUCE DRIVE,ANCHORAGE,AK 99515 Site address 5711 WHISPERING SPRUCE DRIVE, ANCHORAGE,AK 99515 Legal description (Sub'd, Block& Lot ) SKY RANCH ESTATES#1; BLOCK 4, LOT 11 Legal description (Township, Section & Range) Lot Size Sq.Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: (®all that apply) Initial Single Family (SF) Z Absorption Field ® (w/wo ADU) Septic Tank ® Upgrade Duplex (D) (l Renewal Holding Tank Multiple Dwellings Privy n (SF and/or D) Private Well Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR: WELL TO NEW SEPTIC TANK/DRAINFIELD Distance: 80 FEET I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: 6Q -9 Waiver Fees: ' l fc 1 Date of Payment: Olppq,1in1 Date of Payment: C1/17- Receipt Number: OSP IS (2% Receipt Number: 07-g/3G Permit No. OSP ` o `a Waiver No. c6V IcLQ53 (Rev.01/11) I GARNESS ENGINEERING GROUP, Ltd ENGINEERING SALES CONSULTING August 7, 2018 Municipality of Anchorage Development Services On-Site Water & Wastewater Program 4700 Elmore Roade Anchorage, Alaska 99507 Phone: (907) 343-7904 Reference: Septic System Upgrade, Waiver Request, and Conditional COSA for Sky Ranch Estates S/D#1; Block 4, Lot 11 To whom it may concern: The 3 bedroom house on the referenced property is served by a private well and septic system. Per MOA records, the septic system serving the subject property consists of a 1,000 gallon steel septic tank and a deep trench type drainfield. The septic tank was installed on 6/28/1972 and the drainfield was installed 6/19/1986. The existing drainfield is currently located partially off property. A test hole has been excavated in the area for the proposed upgrade drainfield has been designed around the 30 foot radius of this test hole. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: No surface waters were observed within 100 feet of the proposed septic system. 4. TOPOGRAPHY: Attached is the MOA contour map of the area. As can be seen on this contour map, there does not appear to be any slope concerns with the proposed upgrade. 5. WELL WAIVER TO NEW SEPTIC TANK AND DRAINFIELD: As can be seen on the attached site plan and design drawing, we are proposing that an 80 foot separation distance waiver be granted from the well to the proposed new septic tank and drainfield. The following are mitigating factors for the justification of the waivers: • The existing 1972 steel septic tank is approximately 45 feet away from the well. Given the age of the tank, 46 years old, the tank most likely has holes in it and has been leaching into the native soils within 50 feet of the well head. The existing drainfield also is slightly within the 100 foot well radius (approximately 97 feet away from the well) as well. We pulled water samples and found nitrate levels to be Non-Detect (ND); and negative for total coliform bacteria. Given that the existing tank and drainfield are within 3701 East Tudor Road,Suite 101 *Anchorage,Alaska 99507-1259 Phone: (907)337-6179*Fax: (907)338-3246*Website: www.garnessengineering.com Page 2 of 2 the 100 foot well radius with no apparent adverse effects on the water quality, it is our opinion that there is minimal risk with granting an 80 foot waiver from the well to the new septic tank and drainfield. • The proposed septic tank is to be an Infiltrator plastic tank. This should be a lifetime tank and should prevent any leakage from the tank during the lifespan of the septic system. • Attached are some of the surrounding well logs and/or HAA/COSA data for neighboring properties. As can be seen, the majority of these well logs and HAA/COSA data indicate; the aquifer to be fairly deep (approximately 200 feet below ground surface) and there appears to be confining layers of clay and silt above the aquifer that have served to protect the aquifer. • In regard to surfacing effluent, the house is located between the well and the proposed septic system. In the unlikely event of surfacing wastewater, it is not physically possible for effluent to reach the well head. Based upon these mitigating factors, it is our opinion that there is minimal risk with granting these waivers. 6. CONDITIONAL CERTIFICATE OF ON-SITE SYSTEMS APPROVAL (COSA): The current owner does not have the funds or the ability to accrue the funds to upgrade the septic system for the sale of the home; therefore, we are requesting issuance of a conditional COSA. The buyer of the property is going to escrow funds for the proposed septic system upgrade and is in the process of obtaining three (3) bids from contractors. The buyer will than obtain a letter from the mortgage company stating the escrow account has been set-up. The new buyer is planning on upgrading the system by the end of the summer/fall of this year. We have discussed this with your department (Tim Eklund) at the beginning of the design process and we were assured that a conditional COSA could be obtain if we provided the aforementioned information/ documentation. Please do not hesitate to call us at 337-6179 if you require further information. Thank you for your assistance. incerely, (S Jeffr- . . (r..rn- .S . M . Presisy/n 3701 East Tudor Road, Suite 101 *Anchorage,Alaska 99507-1259 Phone: (907)337-6179'Fax: (907)338-3246*Website: www.garnessengineering.com i I I I 1 . T12N,R3W,SECTION 22; NE4,NE4,SE4 BOB &ARLENE )I(\i I I CROSS PARK SEPTIC � OP �� PROPOSED I I N L.U��O�J�� UPGRADE (SEE DESIGN, I I SCALE: PAGE 2 OF 2) ii EXISTING 1'=100' DRAINFIELD I I EXISTING EXISTING RAVENCREST SID;LOT 4 3 BEDROOM -- I SEPTIC TANK SERVED BY PRIVATE HOUSE WATER AND SEWER I 1 LOT 8,BLOCK 4; a A" u /\ I \SKY RANCH EST.#1\ :_-__ -Y�- / I YIF / \ tb1 w11 \ --i ��v %\ 1 Ox I\ I /�// \\ 00z\., \ Imo \ \ / / \ r2ga /\ \ko I• LOT7,BLOCK 4; \\// j \\ �1_ \\ �o , I , j I SKY RANCH EST.#1 A / \ =-I—- - I\m ;t 44 (i I ' I / \ I - ' _ N. I/ 1\i ; l �1--- \ \\//WHISPERINGISPRUCE DR. __7.1/ I \I // y \ I .....i...- �� ( \ \ / \ / I T12N,R3W,SECTION 23; I \\ /��-. �.'' I I\ \ \� / I // PARCEL 218 1 1\ /L \ / / I- -- --T— cT E k I \\ �7-1 /' \/�,/--II \ 1 //----_-___I- I I SERVED BY PRIVATE ��-L_- \_....1--‘"" / 1 /' �r �� I 1 I ,J I I I WATER AND SEWER --- -\ \\III/' i / _ I _ \\ SRI �� \ I 1 vim viF i / I S.kNbtt tet? — =\ /// coo m c=Zi I( I (✓►O A .� I �� \ \ LOT 3,BLOCK 5: \ /X z .Q I \ /_� \ \ \SKY RANCH EST.#1'.. \ / \\� ~O //I I I (ZE.LO�f \ \ \ \ r-, O2 2 1 1 p 1 1 I 1 \ \ \ \ -yL------N �= -- --U I Q I I I \ T-- —� I / \ LOT 4,BLOCK 5; l\ `,..-�- -� / HOLDING I I \ 1 \ SKY RANCH EST.#1 \ \ i-- i- \ // TANK 11 \ \ �--� \ LOT 6,BLOCK 5; / I U ` SKY RANCH EST.#1 / I \ \ %�% \\ // I Ct TRAPPER TRAIL RD. ��.A\\ \` \\\ ,/ / \\ // I m --------- // // , LOT 5,BLOCK 5; / LOT 7,BLOCK 5; I \ \\ / SKY RANCH EST.#1 3....---....„.....z/ SKY RANCH EST.#1 \` \.. / / /\\ \ \�.j /,/I / \ // \ `N ` &- __// \� / ` I RAVEN WOODS SID / \\� `\`'---------I / _—_ _ I I STEEPLE CHASE CIR. // --H / I --T -I.- I I / I I \ / I I 1 I 4. GARNESS ENGINEERING GROUP Ltd •; *! 4'11• I . • * CIVIL&ENVIRONMENTAL ENGINEERS - 0 I , ; :14./ • 3701 E.TUDOR ROAD.SUITE 101*ANCHORAGE,AK 99507•PHONE(907)337.8179•FAX(907)338-3246•WEBSITE:www.gamessenglneenn9.com10 . . PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ;fn• - •"' •.Gam:ss C/O JONATHAN HARVEY 301-3309 1 OF 2 •j J,:. E-7 '�� PROJECT/LEGAL DESCRIPTION: DRAWN BY: t♦(�.l••.•••.g 1.'( •(,� SKY RANCH ESTATES S/D#1; BLOCK 4, LOT 11 J.L.M. 14 ♦ "p��•,.. j� "P\, �� TYPE OF WORK: DATE: LICENSE,,�1 ESS\ 1•• SITE PLAN FOR SEPTIC SYSTEM UPGRADE 8/7/2018 LICENSE �� I I I GEG,Ltd.HAS A 8 PAGE SPECIFICATION 1 NOTES: DESIGN CRITERIA: I 1. THE SEWER LINE EXITING THE NUMBER OF BEDROOMS: 3 LETTER THAT PERTAINS TO THIS DESIGN.TO 1 FOUNDATION MUST BE RAISED BY : ( ) GEG.BY PROCEEDING FORWARD WITH THIS GALLONS PER DAY GPD 450 OBTAIN A COPY OF THE LETTER CONTACT APPROXIMATELY 1 FOOT TO INSURE 4 I PERCOLATION RATE/S: 2.8 MIN./INCH INSTALLATION,THE ENGINEER,WELL DRILLER, FEET BURIAL DEPTH ON INFILTRATOR PROPOSED APP.RATE: 1.2 GPD/SOFT. CONTRACTOR AND PROPERTY OWNER AGREE i TANK IS NOT EXCEEDED.THE NEW MINIMUM DRAINFIELD SOFT.: 375 THAT THEY HAVE READ THESE I SEWER LINE WILL REQUIRE CORE SPECIFICATIONS AND AGREE TO ACCEPT THE 1 DRILLING THOUGH FOUNDATION ABOVE DRAINFIELD DESIGN: TERMS AND CONDITIONS OUTLINED. FOUNDATION FOOTER(SEE ATTACHED MAXIMUM DEPTH: 9.5'@ ANY POINT I PHOTO). WIDTH: 2.5 FEET PROPOSED 1060 INFILTRATOR ' 2. PRIOR TO ANY CONSTRUCTION,THE LENGTH: 45 FEET LONG SEPTIC TANK(2 COMPARTMENTS) I CONTRACTOR SHALL HAVE THE 80 EFFECTIVE: 4.5 FEET WITH SIDE ENTRANCE INLET ; FOOT WELL RADIUS FOR THE WELL ACTUAL SOFT.: 405PROPOSED DEEP TRENCH TYPE I SERVING THIS PROPERTY,THE 100 DRAINFIELD(SEE DESIGN CRITERIA) : FOOT WELL RADIUS FOR NEIGHBORING LOT TO THE WEST;AND THE NORTH EXISTING DRAINFIELD TO BE I AND WEST LOT LINES DECOMMISSIONED IN PLACE I _ — — — — — _ ' FLAGGED/STAKED BY A REGISTERED i. LAND SURVEYOR.A / 10'UTIL.ESMT. PRE-CONSTRUCTION SITE VISIT -_-- , BETWEEN THE CONTRACTOR AND --- +++------ j� ENGINEER TO LAYOUT THE _ — _fir —D 1�f I I%Ir c•. _ '"0 INSTALLATION IS MANDATORY TO - / iAE . ENSURE THE SEPARATION DISTANCES \ \ \� T // - /�/ TH#1 00 -.AN BE MET. \ EXISTING SEPTIC `�� • /A. N DBL COS • INSTALL TANK TO BE : ` \ / N , DEC PER USSSIONED I • \ • �— / \/• RAISE PLUMBING IN i ♦ \ / \ CRAWLSPACE AND N\ I INSTALL FOUNDATION , I / CLEANOUT(SEE NOTE) I • \L // \ iii ' •• \ Os / \\ I. � \ t+l'$) C \ --1----1-- \ 3 BEDROOM • I 1�EXISTING .7.` O 1 I \ HOUSE I III I U I f ___ , , - - - .., wi , , . ti , , I CO i I I Io I / I ' : D IVEWAYi�•. EXISTING WELL \ I 1 •—0 - -T 1- - I •N I ! / \ I \ / / � / \ \ I / / \ 1 \ 1/ / \ \ \ WHISPERING�- - SPRUCE DRIVE \ / - �-- - - - - �-- - - / - 0 \ / \ / \ \/\ALE: S I \ / / I 1'=30' \ 1 \ / • GARNESS ENGINEERING GROUP, Lt ; • •• -, CIVIL&ENVIRONMENTAL ENGINEERS I ••• 3701 E.TUDOR ROAD.SUITE 101•ANCHORAGE.AK 99507•PHONE(907)3378179•FAX(907)338-3246•WEBSITE:www.gameesengYreemM g.00m `(( a PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ♦D ff':s A.Game :° C/O JONATHAN HARVEY 242-4541 2 OF 2 ♦♦ ! : • . •?,, PROJECT/LEGAL DESCRIPTION: DRAWN BY: I, 8 / i e. SKY RANCH ESTATES S/D#1; BLOCK 4, LOT 11 J.L.M. .• D"p. ..... 10, .� TYPE OF WORK: DATE: LICENSE ii 1 "S`1Ct84. DESIGN OF SEPTIC SYSTEM UPGRADE 8/2/2018 #AECC884 - F'/41:4. 4, t , all Nil. x r c)N. ftc•-'.'` • • GARNESS ENGINEERING GROUP, Ltd A *44 ��* •• 0 CIVIL&ENVIRONMENTAL ENGINEERS 0 0 3701 E.TUDOR ROAD.SUITE 101•ANCHORAGE.AK 99507•PHONE(907)3376179'FAX(907)338-3248•WEBSITE:www.gamessengi,eedng.oan 041.4.144:•• i 6�•e Ga ess c�: SOIL LOG - PERCOLATION TEST • 6• •• C�7 a ;�`�(Q LEGAL DESCRIPTION: SKY RANCH ESTATES S/D#1;BLOCK 4,LOT 11 •vI e<,�o.•.•O M' IU°•s•�•(`C4:• PERFORMED FOR: C/O JONATHAN HARVEY DATE: 7/19/2018 ♦♦ f'ROFESS\111 LICENSE DEPTH #AECC884 11,�w"`'•• (feet) 3"-6" OVERBURDEN ;�,�• TEST HOLE #1 I ti SM TO GM SOIL CLASSIFICATIONS SITE PLAN 2 , (FILL) d,:a'> GW ORG ll 4 ' s e GP ~ ML --: ORGANICS h GM J e CL Qo �; SW ! .)) MH �Q� lii ':. SS SP CH � 5 Gj • SM � /1// OH �O PG 7 ik ,. `6 1 i DEPTH TO i*1 GROUNDWATER DATE �4 n\l 8 SM W/ POCKETS 16.0' 7/19/2017 OF SP AND 15.7' 7/27/2018 SCALE: ''-100 1 iYi,i. GRAVEL THROUGHMIX 9 s OUED T. LARGE BOULDER 10I BO ENCOUNTERED ON SOUTH SIDEi iiii COCK NET TIME WATER LEVEL NET DROP 11 OF TEST HOLE DATE READING TIME (MINUTES) READING (INCHES) 7/20/2018 1 11:12 - 6" - 12 i Niiiii 2 11:22 10 2-1/4" 3-3/4" 13 ilii 3 11:22 - 6" - 4 11:32 10 2-3/8" 3-5/8" 14i ii - 5 11:32 6" 6 11:42 10 2-3/8" 3-5/8" 15 ii 7 11:42 - 6" - • 8 11:52 10 2-3/8" 3-5/8" 16 9 11:52 - 6" - B.O.H. , 17 — 10 12:02 10 2-3/8" 3-5/8" 11 12:02 - 6" - 18 — 12 12:12 10 2-3/8" 3-5/8" PERCOLATION RATE 2.8 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 19 — TEST RUN BETWEEN 5.0 FT. AND 6.0 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES U NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: ERIK WIDGER COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH. PERFORMED BY GEG,Ltd. I,JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PE FbRMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: /�"//1 0 0 WAX DRILLING LOG MILT DRILLING CO. ISM Seward HIstway P. O. IVA 'IS Aacbstage, Alaska MSC Telspkaus $41$$3 ARekatage,.Alaska MIMI OWNER OF LANDIA .12; ilh.r.c-)1,• -e r DEPTU OF WELL__...... . ....4._—• -- -------..-•-.. j, / ADDRESS. .s. ,.. ____.. A .&._____4_./..F1( )-4.-- STATIC LEVEL OF mu& FT— .,• "-- —...- .- ..... .- rnzu.-8m. _Stefi_9(24713.ci.....,... _,24 .5_.. ..._.. DRAW DOWN FT. --------..... ••-. -----— DATE-STA&TED /C--al• Z.40 /f 7.1-'1,-- GALS. PER R1L. . _3794 DATE-ENDED. /-.7.7...:4.°? •347-..i.__i... /?.b.7‘2-- KIND OF CASINO. ./. . X ..°. q.3.-12. .....2.7 4...Az KIND OF FORMATION -....rr.To... .' -,___....Jim. ..7%.?-5--•.i FROM .10.4 ....rr. Ta.... it/ Arr....C.1/1 ............_. i FROM_ ......_.... . ....rr. TO _..---FT....-- .. . . most 2 .?.1 ....IT.To...-0... .........rr 4-Q\ICtiNe i mom.. _ . „Am TO . .._. . moat.4..?..• _ Lir. Toka s3 ntoiga.3. . .r02TrC11 * C;Lv_..- .- e_-1 -. ........._rt...._ . ..._ . r. To/.... 7 MOM . . rr.TO . FROM FT. To.... . . . .FT.... _..,..t.R ...._ - mom/14-7Arr TO 12, _IFT07..iity...e./it_4( 1FROM. -_—-ST.TO . .-.—IT..-.-- 2* ---- F110111 I x..._FL TO al......4....._rr..Cgnii..-1 FROM ....._.-AFT.TO.- —-.-FT----.— FLOM.. . .—ST.TO----FT.-------...-- — FROM _FT TO mow:._.—IPT.TO_ ...---PT.,..„--..— FROM-, ...__._._.IT.TO---.......PT..-----. ....... WIROIL-_—_ T.TO.... ...-.--.17...--.--.--. IFROM____-,-FT.TO-_,.---.ST..„—.__—...- !AWL.INFORMATION: -----------------=I-=cn—Trs ----- =gums mast.../ei , . ---AA" ..•••••••• 1\4001 .........---- MUNICIPALITY OF ANCHORAGE DE~ ,TMENT OF HEALTH AND HUMAN SER, ES Environmental Health Division 825 'L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Address YZ// Phone(s) ] Pelm~t No. :5¢5'.- o781J 8601b~, No el ~:~ooms Towl~sh~p, Ran§e, Secborl TANKS SEPTIC [] HOLDING TYPE OF SYSTEM ~L~TRENCH [] BED [] W. DRAIN OTHER original grade .,/,.~ (~_.. Fill added above or~ggnal grade FT FT Gravel length ~.~ FT .,2 installer sQ FT Total depth from original grade Gravel depth benealh pipe 7,£ FT WELLS ~PRIVATE [] OTHER(Identify) '~s[Hh~t~on~(A.B,C) Tolal Depth ]Cased to DISTANCES ~ SEPTIC ABSORPTION _ TANK FIELD WELL WELL LOT LINE FOUNOATION AS-BUILT DIAGRAM (Show Iocahon of well septic syslem, property hnes. foundation. REMARKS: 72-013 (3/85) u icipality of Anchorage MEMORANDUM DATE: July 2, 1986 TO: FROM: SUBJECT: File Civil Engineer, On-site Services, Environmental Services Division Lot 11 Block 4 Sky Ranch Estates Subdivision Property Line Setback Waiver The required ten foot lot line setback between the absorption trench and north property line was waived to five feet. This lot is bordered on the north by park land. No septic systems are affected by this waiver. Stephen S. Morris Civil Engineer On-site Services SSM/ljw DATE; [ ~ ~.:::,Lh: ,::~ ii: I,) t. \ I ,:~ I. H I,, SKVI::/(-~NI::',[--I ESTA'T'ES I...(::)'1' c I :!. ,.I.t.. I I .)11 ...... TOWN.'.;31'IIF'= :[2N I::;IAI',~i'-')Ec :1,~:':~O()O (SCi., FT ,, I::)l:;~ AC, RE:S) ~::: I.:,)r' t :i. f y t h a t: :1.,, I am famJ.:l.:i,a~- w:i,t',.h 't..h6) I'eClt..iiP~::)fli~:91'l'[.!i5 {'(;:)i' (:)l'i'-'i:i;:i.t():.) i:seWel"E; a~',:l wc,!lJ.s as set lot'.th by 'Lh(~.~ Mur'~ic:i.l::)a].:i,'t:.y (:~{' Arlchor'ag(:? (MOA) ar'id the ,%t,':':rLe i::){ Alaska. ;;'!,, i ~/,; :i, ]. :l :i,F,!:~tall 'LI~,? 9Fy!:!Ft'.¢.)fn J.r] accl:lr'danci::.:. (.,):i,t'.h all MOA and :i,r~ c:c)mp ]. :i, al'H:::c;, i,~:i,'Lh the design t:::r,'.i.t(,H',:~a'( ~:)~ th:is p(:.)l'm:i.L,, 3,, ]: ~,.~:i,].l adh(:::,r'6~ '~'..~::~ all HC)A d :i s'L af'~(::: ,,,:,2, s I: r' c;,m ,'.]1"~ y (::.:,x :i. s'L :i. I'"~9 wi,:7¢ 1 ]. ~, b,,~.~,~!~'l:. {ickl~).'L (,::)P (:~ :i. iisi:] (:)!!!id:/ ], !iS"/!ii~t (':?:'iR C) I" !3 LtD ], J, C: i~;(?w(..:,)l'~][,l~:? i~i.¥!ilit(.))fl'l (:H'] th :i. ~;~, (::)i, any adj EiC:E':'I'V(, (::)1' II¢':'&'d'l:i"..v' ]. C)t ,, :t:I::: A [..]:F:]' I~YI-A]':I:E)b.I :1:13 Ib. IS'FAL.[..I!:!:I} :1:l'4 Abl (;~I:;.:I!!:A f'iiVIFI:;'E.)) BY ME:iA i::qJILD]:N]):':~ f'cr)F:'F,, ' .. ~ 11,)'"J~t, J ..... 'II"IEN ( :1 ) AN E:I...E:[TfRICAI.. F:'EI::;tHI T ANi) INSI:::'ECT:I:CiN MLIS"I EII;~: OE{I"A:I:NED:i (';:::') W:[t,L I"I[)T )3E: AI::'P!':;:CY~/I~:D I,dI]'HC)UT.. AN I~E:[,..I~]::;'I I::(:[CAL .!.N.:d'h,' ....................... ... I ]:OIq kt:l" ~)K I ',',. AND AF'F:'},. :!: CANT ~ Iq CONSULTING ENGINEER 203 W. 15th AVE "C' SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O.BOX 6-6650 ANCHORAGE, ALASKA 99502-0650 JUNE 10, 1986 Subject: Up-Grade permit for Lot ll,Block 4, Skyranch Estate Gentlemen; The original absorption area for this lot has failed and must be replaced. Transmitted herewith is a soil log and percolation test results, and a site drawing showing the location of the proposed trench. Design calculations shows that a 30 feet long trench, 12 feet deep and with 7.5 feet of rock is needed. To place this trench on the property without enchroaching on the well separation distance of 100 feet, a waiver from the suggested off set from the lot line is needed. We propose to install the trench 5 feet from the lot line and ask for your approval to do so. Yours ~~Tobben Spurkl~?nd P E~ ~/~''~)'t¢' ~,~/~i"~.t,~ 5 FT. QFF PRDPERTY LINES ~nl~ ~ST~LL EX[ ' I VACANT [~[~LLi ~~-W ~ ~ 1_~`~ '~ , WHISPERING SPRUCE INSTALL 30 LF, OF TRENCH _~0 + 10 FT. Q) Dc' L[3T 2 t]L[]CK 5 LOT 1 }?LEICI< 5 50 GRAPHIC SCALE ]"=' 50' TI]BtIEN SPURKLAND P,E. 203 \./EST 15TH. AVENI.JK ANCHI[]RAGE, ALASt<A, 99501 APRIL 18, 1986 SEPTIC SYSTEM UPGRADE LOT 11, $LDCK 4 SKYRANCH ESTATE: PETE MARTIN &,cc ~./0, , ,'/~ ,,. dx Y. V,¢ SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 2(34-4720 SOILS LOG - PERCOLATION TEST PERCOLATION TEST PER,OR=ED EOR: LEGAL DESCRIPTION: lc'ILL. 1 4 ~1 5 8 9 10 11 12 13 14 15 16 2225,-F. ~.r: 2,5. 14oL. p__ 18 19 DATE PERFORMED: ~'~/~ -- SLOPE SITE PLAN 0 P E IF YES, AT WHAT /,~,¢~,.. / DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop 20 PERCOLATION RATE __ TEST RUN BETWEEN 72-008 (6/79) MUNICIPALITY OF ANCHORAGE Development Services Department f` °� p p-` �' Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-301 -01 Expiration Date: ZS -ZD2Z 1. GENERAL INFORMATION Complete legal description Sky Ranch Estates #1 Block 4 Lot 11 Location (site address) 5711 Whispering Spruce Dr, Anchorage, AK 99516 Current property owner(s) Jonathan & Janna Harvey Day phone (907)242-4541 Mailing address PO BOX 110662, Anchorage, AK 99511 Real estate agent Day phone 2. TYPE OF DWELLING: ❑■ Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well O Private Septic Q Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ -5.50 Date of Payment a i a a Receipt Number 05 q,5 i-6 COSA# 05G221157 Date: Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering (M.J.) Phone (907) 522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Benjamin Schiller, P.E. Date 4/20/22 0 Ad AW TH TH •* / • 6. DSD SIGNATURE ........... System #1 Approved for 3 bedrooms % �. Ben an 5 chiller .% rr� System #2 Approved for bedrooms CE 12292 •'��``, Disapproved ,i�%PROFESSIQ0 \aa� Conditional approval for bedrooms, with the following stipulations: By Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Sky Ranch Estates #1 B4 L11 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA 0 Well log is filed with Onsite (or attached) Date drilled 2/25/1972 Total depth 216 ft Cased to Unknown ft W Sanitary seal is functioning correctly W Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 3/29/22 Static water level at beginning of test 203 ft. Comments *Flow rate limited by well pump B. TANK DATA Age of tank(s) 3 years Tank type/material Septic/Plastic Measured operating fluid level in septic tank 44 Standpipes/foundation cleanout per record. drawing Date of pumping 3/23/22 Around The Clock Pumping D. ABSORPTION FIELD DATA Deep Trench Which system tested (date installed) 8/28/2018 F01 ALL standpipes present per record drawing Total measured depth from grade 9.9 ft (max) Measured depth to pipe invert from grade 5.3 ft (min) ❑ N/A — pressurized field RE Monitor tubes go to bottom of effective. If not, state depth into effective Q Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 015-301-01 Structure served by this system Well production at time of test +4.7* gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No 0 Coliform bacteria is Negative Nitrate mg/L®❑ Nitrate less than MRL (ND) Arsenic ug/L ❑Q Arsenic less than MRL (ND) Collected by Forge Engineering Date of Sample 4/13/22 STATION ❑ Requir aint� Age of lift station Lift station material Comments: nce completed Adequacy test date 3/29/22 Results [y�/ Pass For 3 bedrooms Fluid depth prior to test 23 in Water added 625 gal New depth 41 in Elapsed time 1440 min Final fluid depth 25 in Absorption rate '450 gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' $O* Community Sewer Manhole/Cleanout > 100' if No ❑ Yes if No ft M Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25' F✓ Yes if No ft Absorption Field on Lot > 100' ❑ Yes * if No 80 ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' Fv� Yes if No ft Animal Containment > 50' Yes if No ft 0 Yes if No ft Q Yes if No ft Water Service Line > 10' Yes Manure/Animal Excreta Storage > 100' ft If septic tank is under driveway Community Sewer Main > 75' �✓ Yes if No ft ❑✓ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' ❑✓ Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q Yes if No ft Private Wells > 100' Fv� Yes if No ft Water Main > 10' ft Yes.. if No ft Community Wells > 200' Q Yes if No ft Water Service Line > 10' Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ®✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓❑ Yes if No ft Private Wells > 100' Water Service Line > 10' Yes if No ft Community Wells > 200' Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS *Waiver # OSV181058 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 COSA guidelines in effect on this date. COSA Checklist yellow sheet 0 Yes if No ft R Yes if No ft .OF A kt Beniarr�n Schiller CE 12592 4/20/22 ��®��PROFESSI4NP .� MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, s.ubdivision, section, township, range) Location (address or directions) (b) Property Owner Mailing Address ,'~$r~ . . ~, T, elephone: Home ~-~/~-'~ ¢0¢0c (c) Lending Institution [_]Mt(N~;,~v,Nt. ' Telephone Mailing Address (d) Real Estate Company and Agent Address Business ?~- 77~5' Telephone (e) Mail the HAA to the followina address: or: Check here ~, if hold for pick up. List contact person and day phone number below. TYPE OF RESIDENCE Single-Family']~ Number of Bedrooms WATER SUPPLY Individual Well']~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite~., Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 fRev 81861 Front ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. /~¢¢ Telephone '~' Name of Firm Address ,/~¢/f" ~'/ ~ ] ~"'-~ "~¢ / 7"~¢' ~ /~'/' Date Approved for ~,¢/~" ::2 bedrooms by Date_ Approved ~.~/'~ Disapproved Conditional Terms of Conditional Approval CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 fRev 8/86~ Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION JUN 1988 wE.L ,C E IVE D MUNICIPALITY OF ANCHORAGE (MO~) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: /_..o~// 0/5 Well Classification Well Log Present Total Depth (~ ,~l~'~f Cased to ~ ~'~/~ Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (~}N) Separation Distances from Well: To Septic/Holding Tank on Lot '~,,~/I//'¢~' If A, B, C, D.E.C. Approved (Y/N) Date Completed ~;~,(~1% /~) ~?,~.- Yield Depth of Grouting ,'~/~ Pump Set At ~/~ Sanitary Seal on Casing(~)'N) Depression Around Wellhead (Y~ ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line ~.~ Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Test Results ~L' 'T~--I~ /J/7~¢1~85 ~ B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes~)N) -- Air-tight Ca ps ~f',l) Depression over Tank (Y~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) /-)/~' Separation Distances from Septic/Holding Tank: To Water-Supply Well {~ To Property Line To Water Main/Service Line /O Course Size /¢;~¢O No. of Compartments Foundation Cleanout (Y..~ Date Last Pumped ::~,2-~ ,-~'~ .,r.)/~ ;for ~,//4- Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026(11/84) ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Type of System Design Length of Field Depth of Field Square Feet of Absorption Area Depression over Field (YO Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot _ Gravel Bed Thickness - Standpipes Present,N) Date of Last Adequacy 'Test / To Property Line To Existing or Abandoned System on ; On Adjoining Lots _ To Water Main/Service Line /~)/''~ To Cutbank (if present) _ To Stream/Pond/Lake/or Major Drainage Course ~/*¢'d To Driveway. Parking Area. or Vehicle Storage Area _ Comments e ~,,'¢'¢V0,~ d'~ FI/-E~, '~'7-Z~8 D. LIFT STATION ~ Dimensions . Size 'm Gallon~'""'~'"'"~~ Manhole/Access (Y/N) - "Pump On" Level at ___-- ~'Pump Off" Level at - High Water Alarm Level at ~N) - Pumping Cy~~? Adequacy Test. Meets MOA Tested for Electrical Codes (Y/N) Comments ..... ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I hav.,e~ec.~jCd, v. erilied, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed -- ~'~%/'~' ~//"~'~ Date ~'~"¢I~;Y~ /~-"~ MOA No. Company Receipt No. Date of Payment ~_~-~ Amount: $ -- Page 2 of 2 72-026 {11/84) RECEIVE[) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-,3720 Application Date GENERAL INFORi~/IATION (a) LegalLo~.Descriptionjj,~(include,.~ ~'~ Iot,/.,~,block,~_.¢ ~ ¢'"0..4,~ O..~subdivisi°n' section, township,.E?,~ ~ ¢..Lrange) ~4~ ~ ~2 7, 7~--I Location (address or directions) (b) Applicant Name [~ ~~/~ Telephone: Homel ~_¢~¢L Business Applicant Address _ %__%4/ .... ~.,~,~ ¢ ¢,~) ~{~ ,¢ C~ (c) Applicant is (check one): Lending Institution ~; Owner/~; Buyer ~; Other ~ (explain); (d) Le n d i n g J nstit u tic n __:/~ [ c~-"~-Ok-,,-- _~.4 ~--1d=~_ ¢'~_. ..... Telephone Address ~- ~,% ~ _/~ .... ~ , (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE ,..---~ , Single-Family~]~ Multi::'~~ Other m..~ily L~Number of Bedrooms 3. WATER SUPPLY Individual Well/~ Community [] Public E~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4, SEWAGE DISPOSAL Onsite~/~( Public [] Community [] Holding Tank [] / Note:/f'f community well system, must have written confirmation from tile State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11,84) ENGINEERING FIRM PROVIDIN. ,~ISPECTIONS, TESTS, FILE SEARCH, DA.. AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Heat Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequatq for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtain[~j from the Municipality of Anchorage files and from my investigation' and inspection, the on-site water supply and/or wastewater disposal system is in compliance with ali Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. -- Address ~ ~ /~ Date Engineer's Seal DHEP APPROVAL Approved ~ /.~ Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conducf inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (I ~/84) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Descri~ption: --L~:)"T~ WELL DATA Well Classification ~'~.' ~-'~ If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) N Date Completed '~.r-~- if~?''~- Yield Total Depth -~--~-~¢~ _ Cased to ~ Depth of Grouting Static Water Level _ ~ ~ .~ Pump Set At . ~" Casing Height Above Ground Electrical Wiring in Conduit (Y/N) _ Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot. To Nearest Public Sewer Line_ ~ O N ~" Sanitary Sea~ on Casing (Y/N) V Depression Around Wellhead (Y/N) _ '~ ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments NO ~ ~ To Nearest Sewer Service Line on Lot ~ I'~ .-,~..--, , 'ot//~/~/o i,- ~. ; Date . Date Installed Standpipes (Y/N) Depression over Tank (Y/N) SEPTIC/la~8ili~ll$~ TANK DATA Size __[ ~ O f.~ No. of Compadments O ~ ~ Air-tight Caps (Y/N) _ ?-- Foundation Cleanout (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well _ To Property Line - To Water Main/Service Line Date Last Pumped 6' 1~,. ;for Temporary Holding Tank Permit (Y/N) _ To Building Foundation To Disposal Field _ Course To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 72-026(11184) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 3 L2 J¥~_. Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well I To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design "~'/~ Length of Field Depth of Field Gravel Bed Thickness '7. ~"'"' Standpipes Present (Y/N) Date of Last Adequacy Test _NJ _ To Property Line ~ /'~ / To Existing or Abandoned System on ; On Adjoining Lots t'"JO/'JL'~ To Cutbank (if present) I'"J OJs¢~~:=? NoN >, ,Cc) D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Date Signed Company Receipt No. Date of Payment Amount: $ MOA No. -moo/ Page 2 of 2 72-026 (11/84) Seal CONSULTING ENGINEER 203 W. 15th AVE 'C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE; (907) 279-3916 SEPTIC SYSTEM ADEQUACY TEST LEGAL: LOCATION: OWNER: RESIDENCE: WELL: SEPTIC SYSTEM: LOT 11, BLOCK 4, SKYWAY ESTATE 57tl WHISPERING SPRUCE pET~MARTiN · SINGLE FAMILY, THREE BEDROOMS PRIVATE, oN SITE FROM MUNICIPAL RECORDS: TANK: STEEL FABRICATORS, STEEL, ONE COMPARTMENT 1000 GAL. ABSORPTION SYSTEM: TRENCH ABSORPTION AREA: 450 SQ. FT. SOIL RATING: 150 INSTALLATION DATE: TANK JUNE 1972 TRENCH JUNE 1986 DATE OF PUMPING: 6.16. 1986 DATE OF TEST: NOT TESTED. SYSTEM UPGRADED IN 1986 TEST PROCEDURE: TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requi- rements of the Municipality and State. CONSULTING ENGINEER 203 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 LEGAL: LOCATION: OWNER: TYPE OF WELL: RESIDENTIAL WELL INSPECTION LOT 11, BLOCK 4~ SKYRANCH ESTATE 5711 WHISPERING SPRUCE PETE MARTIN SINGLE FAMILY WELL LOG AVAILABLE: NO INSTALLATION REQUIREMENTS MET: YES PUMP YIELD:. DATE OF INSPECTION: TEST PROCEDURE: 6 GALLONS PER MINUTE o~TOBER 6, 1986 WELL ~AS .>PUMPED AT A CONSTANT RATE OF 6 GALLONS ·~PER MINUTE WHILE THE DRAWDOWN WAS MONITORED WITH AN ACOUSTIC PROBE. THE WELL WAS PUMPED TILL THE DRAWDOWN STABILIZED. STATIC WATER LEVEL WAS FOUND AT .203 FEET BELOW TOP OF CASING. AFTER FIVE MINUTES THE WATER LEVEL HAD DROPPED TO 207 FEET AND REMAINED AT THAT LEVEL FOR 30 MINUTES. WELL RECOVERED TO 204 FEET WITHIN FIVE MINUTES AFTER PUMP SHUT DOWN. A TOTAL OF 160 GALLONS WERE WITHDRAWN. TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON OCTOBER 7, 1986. TEST WAS NEGATIVE. TEST RESULT: THIS WELL MEETS THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The Municipal requirement for well flow is 150 gallons of water per bedroom per 24 hours.This well surpasses this requirement. The assessment of the condition of this well applies only to the conditions as of this date. The· flow rate of the well may change due to subsurface conditions that may not be Observed from the surface, and changes in land use and other factors that may impact the conditions of the aquifer feeding the well. ~ ~'. JUNE 25. L9/i ,.~ GRBATER ANCHORAGB AR~A BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska 99507 279-8686 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SHWER & WATER FACILITIES FOR , Type of Facility.to be Inspected: Number of Bedrooms: C. Construction fO 7. Sewage Disoosal Syatem: Phone Ph one C. Septic Tank: D. Seepage Pit: / B. Depth~. L ~j~ / '~ Disposal Field: D. Bacterial Analysis' Distances: A. Well To: Septic Tank -~/~ / z , Absorption Area /cOc~ ,., Sewer Lines / (5 ~/~ .., Nearest Lot Line /D z~ , Other Contamination_/,z.~/t~ ~*,~-*~.~.~ Foundation to Septic Tank Q~/ "~ AbsorPtion Area ~L~ E%~/' . / C. Absorption Area to Nearest Lot Line .......... ,,.~ · Request for Approval of i,.dividual Sewer & Water Faeilitte~ Page Two 9. Comments: Approved ~><~.__ Disapproved Date Approval Valid for One Year From Date Signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for appreval to be a true and accurate representation of %he subject sewer and water facilities located at: Signed Date 6 ~ . ..... 99'""~v... 3..0,,) Tudo~ Road, Arlchn~'ec~e, Alaska .... Date Received Time of I~s~ecLion DaLe of Insr~ecl'ion F O? ' ~ .,' : ..... ~~Q~.,...~~ I .............. L 2, Prooertv O>mer: 5~ ~ Phone: 3. Legal. Description: .......................................................................... ~ //J ~/~ ~7 ~ ~~ , Type of Facility t;o be ,,. ........ . Number of Bedx'ooms: 6. Well Data: ~//~ c. co~,,~.~o~._d~5..:~~ .... ~ ~¢;e~i,~ ,~,',~' 7, Sewage Disoosal Svskem: ~,=. Disposal Field: Tol;a] T~'ng~'b,~. ., . of Lines 8, Distances: Ao Well. Yo= Septic Tank .......~&/ , Abso~p'i;ion Area /~ / , Se~¢er Lines /'o/~ , F]ee~er;i: Lot, Idr~e /~/~ . Ot:.her Contamination Bo }~ot~l/datJ. o:~ bo SePtJc Tapk ~/ '~, ":' ' .... , Area ~ / / C. Absorption A~'aa t:o Diem)Feat, Lot fane _~ ._~ ....... ~ .................................... · t;a ~,cr Faci I J.t_~ n" [iac[uest for Approval Two Comments: [[ certify '[:hat; the :tnfoYmation contained i~1 tl'~i.~ request for app):oval to be a true and accurate represer~tat~on of i-.he s,~biect sew,::'c ar,,r~ wa'ter ?:ac~.!~_ties located .......................................... ?ate j% • • Municipality of Anchorage On-Site Water&Wastewater Program 13 s,�rt a (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 015-301-01 Expiration Date: /Oft/le 1. GENERAL INFORMATION Complete legal description SKY RANCH ESTATES SID#1;BLOCK 4,LOT 11 Location (site address) 5711 WHISPERING SPRUCE DRIVE,ANCHORAGE,AK 99515 Current Property owner(s) JONATHAN HARVEY Day phone 242-4541 Mailing address 5711 WHISPERING SPRUCE DRIVE,ANCHORAGE,AK 99515 Real Estate Agent Day phone 2. TYPE OF DWELLING: 111 Single Family(w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well I Individual On-site a Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: N/A Distance: - Received Date: T/R JIB COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 697 So Waiver Fee$ Date of Payment g�a f 143 Date of Payment Receipt Number 0661..O Receipt Number COSA# OSG 1 S1{o1 Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm 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 /L/i. 4& Engineer's Comments: In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septic system in accordance with the 110111. 44 guidelines and regulations established by the Municipality of Anchorage and industry practices.The reported results describe the �4•c OF 11 condition of the systems on the date/s of the evaluation.Separation distances were measured to readily identifiable features. _mac t \, Hidden defects or encroachments may exist(hat were not identified during(he evaluation.The operational life of all wells and septic 4 \r • •`� �• systems depend on a variety of variables including,but not limited to,soil conditions,groundwater levels(that may fluctuate during •'••• the year),quality of construction(materials and workmanship),and the water usage of the family utilizing the system's.These 14. � • l f t conditions can vary,and are outside the control of GEG.Satisfactory test results do not guarantee future performance of the L,.....1fr. , 4 \ , •0 system/s;therefore,GEG makes no warranty(express or implied)regarding the future performance of the well or septic system. / GEG makes no representation whether an aftemative well or septic system can be installed on the property in the event either of the , rJicurrent systems fail.The content of this report is for the sole benefit of the perso'party who retained GEG.Reliance upon the mi�• information provided in this report by any other person or party,including but not limited to subsequent property purchasers,is not /•C'� J rey Games authorized.In short,GEG disavows any legal duty to anyone other than the person/party who paid for this report. �� ifl� g 7.753--.'" _= 6. DSD SIGNATURE ♦ P ',l(((```P��\`p, LICENSE ,��1i„S;`lim. System #1 Approved for #AEccaea Y PP bedrooms. System#2 Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: , \NATE V1(Ac:•.. • H• r. By: 1 7)6,16 a Original Certificate Date: 9/2-//0 The Municipality or Anchorage Develop,emt Services Division(DSD)issues Certificates of On-Site Systems Approval(COSA)based only upon the represenatations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTCHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev.10/12/12) 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: SKY RANCH ESTATES S/D#1; BLOCK 4, LOT 11 Parcel ID: 015-301-01 A. WELL DATA -51ffR=PERAII008+14Get q14. Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (YIN) to 4 Date completed 2/25/1972 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth *216 ft. Cased to UNKNOWN ftCasing height (above ground) 18+ in. FROM WELL LOG AT INSPECTION Date of test 2/25/1972 7/20/2018 Static water level 14' ft. 205 ft. Well production 9.0 g.p.m. 4.7+ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 ml. Nitrate ND mg./L. Collected by: GEG, Ltd. Arsenic: <5 ug./L. Date of sample: 7/19/2018 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC TANK/PLASTIC (INFILTRATOR) Date installed 8/27-28/2018 1060 2 Cleanouts (Y/N) YES Tank size gal. Number of Compartments Foundation cleanout(Y/N) YES Depression over tank(Y/N) NO High water alarm (Y/N) NO Date of pumping NEW Pumper - C. ABSORPTION FIELD DATA •BELOW FINAL GRADE Date installed 8/27-28/2018 Soil rating cp.d./Ior ft2/bdrm) 1.2 System type DEEP TRENCH Length 45 ft. Width 2.5 ft. Gravel below pipe 4.5 ft. Total depth •9.5-9.8 ft. Eff. absorption area 405 ft2 Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) - For 3 bedrooms Fluid depth in absorption field before test - in. Water added - gal. New depth - in. Elapsed Time: - min. Final fluid depth - in. Absorption rate >= - g.p.d. Any rejuvenation treatment (past 12 mo.)(Y/N &type) NONE KNOWN If yes, give date - D. LIFT STATION Date insta e• Size in gallons Manhole/Access ► "Pump on" level at in. "Pump off' le - - -. Hi.h water alarm level at in. Datu • Cycles tested Meets alarm & circuit requir- - . E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: "WAIVER GRANTED. SEE WAIVER#OSV181058 Septic tank/lift station on lot y80+ On adjacent lots 100'+ Absorption field on lot X80+ On adjacent lots 100'+ Public sewer main 75+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10'+ Property line 5'+ Absorption field 5'+ Water main 10'+ 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 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION ..• •, • '. ♦♦♦♦ I certify that 1 have determined through field inspections and ; 4. �I •'* ♦/ review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this • . ..••• •I date. ♦ r- Garn•ss • �. Engineer's PrintedName JEFFREY A. GARNESS ♦♦♦�� CE-7953 ...' ' ',,7 Date c-t2,/ . F• •p t. -J'. " <c 444' OFESS\ t4• LICENSE it%""� #AECC884 (Rev. 10/12/12)