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Home My WebLink AboutT15N R1W SEC 4 LT 4 N2 NW4T15N RIW ec. 4 Lot 4 N2 NW4 #051-043-57 Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT 'J Permit Number: Q S PZ 512 83. PID Number: C) Q4Z3 57 Dwelling: [Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project:New ❑ Upgrade Name: EAff f iC ABSORPTION FIELD ❑ Deep Trench ,Shallow Trench El Bed ❑ Mound Address �� (� 7 I % ❑ Other Phone c / p Number of Bedrooms Soil Rating Total depth from original grade GPD/SF „S Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3, Ft. Gravel depth beneath pipe 14 Ft. Subdivision Block Lot Fill added above original grade Gravel length Township Range Section /\. Ft, Ft. Gravel width S Beds: Number of Lines Distance between lines SEPARATION DISTANCES (IV Z/Vw Ft. -- — Ft. To Septic Absorption Lift Station Holding Sewer. Total absorption area Number of trenches Dist. between tFenches From Tank Field Tank Line 430 Fe — Ft. Well — .- TANK 5Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer 1. Capacity Gal. Surface Water/ %�0 f _- Material Number of compartments Lot Line NA. Foundation 2-0 ZLO �� _ _ LIFT STATION Manufacturer Capacity Gal. Curtain Drain SU r So , Remarks n �� Pump on level at in. Pump off level at in. High water alarm at in. d �► D Pump make and model Electrical Inspections performed by Installer PIPE MATERIAL House to tankTank to bJa3cf drainfield D30 rY, C Drainfield a CO/MT��ji� Inspector ^ y/ c`(w q BENCH MARK (Assumed elevation) Q Q ft �, Inspection 1Q (5 2"d 4G , S dates: 3rd 4m Location and description 4�) rK COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp I G 0 Conditional Approval: Date _ F� -a�� °: 0`.Q CSS °°,',��adti��,�. �. Approved `�.C�R. l �1U Date 1/��L,9_,� �T�;r��n�: s In on4inn Der,nrF n1 d0 A.... NOR THRIM ENGINEERING PO Box 770724 Eagle River, Alaska 99577 907.694. 7028 KNIK VISTA ST Water STl A 26 B 54 ST2 32 58 DCO 35 60 C❑1 39 62 MT/CO 81 94 NOR THRIM ENGINEERING PO Box 770724 Eagle River, Alaska 99577 907.694. 7028 KNIK VISTA ST Water Valve Key Box 1 I -P 1 C voe £ Alternate Trench\ MT/CO 01 1 Ln f" W Y/ TH 1 New 1000 Gallon DC ❑❑11 c Septic Tank Sit J I m c 0 House Sits On A �i 1 U u Raised Knoll 8dr� 1 ) M Barn I 1 1 d / 1 3 sy N i A 1 T15N R1W SEC 4 LOT 4 N2 NW4 WASTEWATER RECORD PUBLIC WATER 1" = 100' RECORD LAYOUT 12/27/1812 of 3 C u c F- 06 y c C5 I -- -U -P n LA 4-> :5 0 c C5 -a, �Lj U 00 0) co Ul 0 Cdl QL 0 (1 -P m 0 C5 ;p > C5 -2� > Ljj Qj 1-d In :3 0 C- oj w C3 73 ad u y LL -C u c 0i C4- 0 0 CL I 75 c- LLI 0 I-- 0 -P IW -Q Z:f d 00 W z 0 L3 d c 0 06 C5 c LL - flu! CD 00 0 :p A A M I Lr? Ln o Ln :p d > LLJ d 0 L LD 0 z CD CJ 0 -P d oi L.1 k cv Y 0 F— Ln > co c 0 LLJ I U @i u III ry n 0 c- 0 CT0 Li L0 L- W - -P C:) u C:) C u d c) < 0 > --4 n 0i LLL 0 -P IW -Q Z:f d 00 W z 0 L3 d c 0 06 C5 c LL - flu! CD 00 0 :p A A M I Lr? Ln o Ln :p d > LLJ d 0 L LD 0 z CD CJ 0 -P d oi 3 W L.1 0 Ln LLJ I Cy 1--1 W u 3 W L.1 Ln LLJ I Cy 1--1 W u III ry n \Y/ W Li u W W ry n r) LLL Oj 00) C� CL Lu Z On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP151283 Tax Code Number: 05104357000 Work Type: Septic Renewal Permit Effective Dates: October 08, 2015 to October 07, 2016 Design Engineer: NORTH RIM ENGINEERING Subdivision: T1 5N R1W SEC 4 Site Legal Address: T15N R1 W SEC 4 LT 4 N2 NW4 G:1558 Owner/Address: BARKER JOEL & YVETTE PO BOX 672167 CHUGIAK AK 995672167 Site Mailing Address: 21720 RANKIN RD, Chugiak This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy /�5�i� 1><, Lot Size in Sq Ft: 217800 Total Bedrooms: 3 N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. 451 Received By: Issued By:/'(� ��t/ /C/ Date: O S i 1-> (e Community Development Department t.� Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWERANELL PERMIT APPLICATION R JSH! Parcel I.D. 0 S/ U 3 5- 7 Property owner(s) 6A& 111%E(p. Day phone Mailing address opo CX 6'72/6' 7 Site address C ar /24 Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T/,5A/ &/ V/ "_'7— SL NZ GVW c f Lot Size 2J 7 Sf Qd Sq. Ft. APPLICATION IS FOR: (® all that apply) Absorption Field Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms 3 APPLICATION IS AN: TYPE OF DWELLING: Initial Single Family (SF) �❑ (w/woADU) Upgrade Duplex (D) ❑ Renewal Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE i WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. No Permit/Rush Fees: IG •.Bina/ Waiver Fees: Date of Payment: Q Date of Payment: Receipt Number:Receipt Number: Permit No. _ Waiver No. 05P 15 /z93 Permit App_9-1-12.doc On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141227 Tax Code Number: 05104357000 Work Type: Septic Initial Permit Effective Dates: July 09, 2014 to July 09, 2015 Design Engineer: NORTH RIM ENG Subdivision: T1 5N R1W SEC 4 Site Legal Address: T15N R1W SEC 4 LT 4 N2 NW4 G:1558 Owner/Address: BARKER JOEL & YVETTE PO BOX 672167 CHUGIAKAK 995672167 Site Mailing Address: Lot Size in Sq Ft: 217800 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By: By: Date: Date: ! y MUNICIPALITY OF Community Development Department Development Services Division 00*_� On -Site Water & Wastewater Program ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. O 5 7 Property owner(s) TO L Aft Its 2 Day phone 4< 00 6��6 Mailing address.. P Q 6010 6 r(21 6 7 { e H t)6 1A K. 9 9 5 6 7 Site address 44H Legal description (Sub'd., Block & Lot) T/ S N' R / in/ S Ee L,/ L O! Legal description (Township, Range & Section) Lot Size 217 J00 Sq. Ft. Number of Bedrooms APPLICATION IS FOR: (0 all that apply) APPLICATION IS AN: TYPE OF DWELLING: Absorption Field Initial Single Family (SF) ;R1 Septic Tank Qt Upgrade ❑ (w/wo ADU) Duplex (D) ❑ Holding Tank Li Renewal Privy❑ SLF8MiTiWt DwellingsEland/or D) Private Well ❑ Water Storage ❑ JUN 2 5 2014 THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. i ur autrlorizea Permit/Rush Fees: cJ Waiver Fees: Date of Payment: / Date of Payment: Receipt Number: [54YrA_ Receipt Number: Permit No. 05 191 Ll II&I Waiver No. Permit App_9-1-12.doe Nwy TH 12 M ENGINEERING MEMO Steve Eng, PE, PH P.O. Box 770724, Eagle River AK 99577 (907) 694-7028 tel northrimeng@aol.com Date: 7/8/14 Number of Pages: To: MOA On -Site Services Subject: T15N R1W Section 4 Lot 4 N2 NW4 New Septic System A new house is planned for the subject lot. A new soil test was completed, sandy soil and no groundwater. The design calls for a 5' wide trench with new septic tank. The entire subdivision is on public water and septic systems. The terrain slope is near flat, except for the house site which sits on a raised knoll. This is a large lot at 5 acres. Please review the wastewater system design for the new single family home. I have included design plans & specs, design guidelines, & soil tests. If there is need for additional information or clarification please give me a call. Thanks -Steve ,Yy mape =a m..a pmt vQ aA �sRq .�6 a•W mm ma Saab m 'i N i Gt mipiCi6E1e'•5 TH, IZJ ` e Steven V!. 9 ENGINEERING "�a ' cae� 4�-��"� 15N Rl W, Section 4, Lot 4 ND N W'/V SPECIFICATIOI iCr L1�;SIGN GUIDELINES — Wastewater System Sizing: This is a new 3 -bedroom, single family home. This is a very large lot in a developed neighborhood. This is a 5 acre lot with no conflicts due to the large size. No adverse impacts are expected from development. No conflicts to the other lots will take place by this septic system construction. Public water serves the area lots and this lot. The easements are located on the drawing and are not encroached upon. Soil tests revealed sandy soil with low silt. An application rate of 1.2 GPD/FTz with 0.5 reduction factor for utilizing a 5' wide trench. Trench Length = 375 FT2/5'x .5 reduction factor = 37.5'; 1 line @ 40'. No bedrock was encountered or groundwater was encountered. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Two compartment, 1000 gallon septic tank. Watertight couplings on inlet & outlet. • 5' minimum between the tank and bed. 10' to property lines. • 3' of cover or insulation is required for trench; an equivalent of 1" insulation for 1' soil cover may be used. 2" Minimum thickness for insulation. • Backfill over drain rock must not be less than 24", with the 2" insulation. • Tank & solid pipe must be set on well compacted, stable soil. • 4 inch diameter cleanouts with airtight caps are required 1' to 4' from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10' from the tank positioned to provide cleanout access towards the tank and towards the absorption field. • All cleanouts must extend to at least ground level. • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. • Trench to be placed level, minimum of 4' to groundwater, 6' to bedrock from drain - rock. • Drain rock to be 1/2" to 2 %z" screened. Drain rock to be distributed uniformly throughout the trench. • Perforated pipe to be installed level with perforations down. • Silt barrier (filter fabric) to be installed above the drain rock. • Smeared trench sides must be raked or scarified before drain rock placement. • The finish grade must be mounded to promote drainage away from trench. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope. • Septic Tank to be pumped every two years or when required. • Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal) DESIGN NOTES: 1. Total Depth of Trench is 7.5'. Terrain Slopes Northwest. 2. Sewer Service Line minimum 2% slope. 3. Public Water. NOR THRIM ENGINEERING PO Box 770,724 Eagle River, Alaska 99577 907.694.7028 KNIK VISTA ST -k.`.q' T15N R1W SEC 4 asm LUT 4 N2 NW4 � .7�......... aq t ®..fCry �� WASTEWATER DESIGN PUBLIC WATER 1" = 100' PLAN LAYOUT tee: � ______ 7/8/14 2 of 3 Key Box Water Valve/ / 4� / I+ v e Alternate Trench N C W �4 or New Trench c MT/CD TH C D 0 Double CD's u New 1000 Gallon v I N Septic Tank 3 Bdrm House ro Barn House Sits On A Raised Knoll a 3 d i A -k.`.q' T15N R1W SEC 4 asm LUT 4 N2 NW4 � .7�......... aq t ®..fCry �� WASTEWATER DESIGN PUBLIC WATER 1" = 100' PLAN LAYOUT tee: � ______ 7/8/14 2 of 3 S u c QjL F- 06 06 Y i C5 H U_ a v N v 3 w N pq LA 5 O d d N U O) O a a 0 �-E i' 3 O i C5 a, U i O v C5 75 c O L, t N O N �Z it U M d F !o aj 4 oa O H LO d �L LO � W O a CO CO z v O o R 0 H N E uu 1 cm) z W 3 -i I N �Z it U W � o !o aj 4 oa rn �� W (no �I d �L LO � W a CO CO v R N uu N W d M O 0 F � N +' i Ol U W Cl) C5 > d CL O i O U U U i O N O u 0 T a d U t aia -P d V F a Lcu a v �~ s� �c O EO m 0 3 £ -iO-` d a L Pq E O (T S U U7 a E LL Waj o uf o IriO UL UO) E v o o¢ nay-�L a a aL4� a a, L u v J O O i d5 O W N U U Ul aj U d -- Vl F- i 0 i s H W d0 ai �u E ~ EO Z a,0)1 ai 0) S U:6 L LM O-5 ao-p3aa,3aa, � n3v�a� W p -4 (U (`'l 4 In �6 W 3 -i I N �Z Ua 3 W � o !o ��I ? oa rn �� W (no �I V LO � W o CO CO W 3 -i O n � h �Z Ua 3 W o N ��I ? oa rn �� W (no �I m Z � W S❑ILS LOG — PERC❑LATI❑N TEST prrTH IR MINEERING Performed For: Joel Bar Legal Descriptions DEPTH (FEET) 1 - Date Gross Time 2 Depth lNet Drop 3 - 0 4 - -- 5 - 10 10 min. 10,5" 5,0" 3 8/21 12 -- 5,5" -- 9 - 22 10 10.5" 5,0" 11 - 8/21 25 12 - 5.5" -- 13 8/21 35 14 - 10,5" 5,0" 7 8/21 15 - -- 5,5" 16 - 8 8/21 17 - 10 min, 10.5" 18 - 9 8/21 19 - -- 5.5" 20 - 10 8/21 Organic Date Performed: 8/16/12 TISN RIW See.'{ SP Sand w/ Gravel 4 Na NW4 tgrs.e. T.H, Location: Directed By Joel Barker- End Of Knik Vista Groundwater? No Depth -- Water Depth After Monitorino None Date: 8/25/12 # Date Gross Time Net Time Depth lNet Drop 1 8/21 0 -- 5.5" -- 2 8/21 10 10 min. 10,5" 5,0" 3 8/21 12 -- 5,5" -- 4 8/21 22 10 min, 10.5" 5,0" 5 8/21 25 -- 5.5" -- 6 8/21 35 10 min, 10,5" 5,0" 7 8/21 37 -- 5,5" -- 8 8/21 47 10 min, 10.5" 5.0" 9 8/21 50 -- 5.5" -- 10 8/21 60 10 min. 10,5" 5.0" 21 - Percolation Rate 2 min./inch Perc Hole Diameter 6" Test Run Between 3' and 4' Comments " Performed By NorthRim Fng. I CERTIFY THAT THIS TEST WAS Performed in Accordance with All State/Municipal Guidelines in Effect ON THIS DATE. DATE1 8/21/12 OF NORTHRIM ENGINEERING *:asm' TESTH❑LE LOG T, H. 1 .... Po Box .7028 /� " GE❑TECHNICAL E*9le Rlva4 Alaska 99577 a 907.894.7028 E.t 1� 8/21/12 11 MUNICIPALITY OF ANCHORAGE Ablw Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC251042 Parcel ID 051 -043-57 Expiration Date: Legal description T1 5N R1 W SEC 4 LT 4 N2 NW4 Site address 21720 RANKIN RD Current property owner(s) BARKER JOEL & YVETTE X The On-site system(s) is/are approved for 3 bedrooms By: Conditional approval for bedrooms, with the following stipulations: Comments or conditions: No comments Original Certificate Date: 2/7/2025 This Certificate f On -Site Systems Approval (COSA) is intended to demonstrate the subject syjst2m(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, j, evelopment Service 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 submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other 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. 05104357000 Complete legal description T1 5N R1 W SEC 4 LT 4 N2 NW4 Location (site address) 21720 RAN KIN RD Current property owner(s) BARKER JOEL 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 280-9005 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: X Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑■ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 9.5 - 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 $ 55C% Waiver Fee $ Date of Payment COSA# D5G2� ID�12 Date of Payment Waiver # COSAApplication_June 2022 COSA Checklist Legal Description: T15N R1 W SEC 4 LT 4 N2 NW4 Parcel ID: 05104357000 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) Well production at time of test gpm Date drilled Total depth ft Water storage tank volume gallons Cased to ft Well disinfected for coliform test? ❑ Yes 400066 ❑ Sanitary seal is functioning correctly ❑ Coliform bacteria is Negative ❑ Wires are properly protected Nitrate mg/L ❑ Nitrate less than MRL (ND) Casing height (above ground) in. Arsenic ug/L ❑ Arsenic less than MRL (ND) Date of flow test for COSA Collected by Static water level at beginning of test ft. Date Comments No Well On Lot- Water Provided By Public Water B. TANK DATA C. LIFT STATION Measured operating fluid level in septic tank 50 ❑ Required maintenance completed Date of pumping 2/4/25 Age of lift station years ❑ Required maintenance completed, if AWWTS Lift station material Comments: Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 10/19/15 Q ALL standpipes present per record drawing Total measured depth from grade 7.5 ft (max) Measured depth to pipe invert from grade 3.5 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. 0 Monitor tubes go to bottom of effective. If not, state depth into effective 0 Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 2000 gallons 1/27/25 date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficienci COSA Checklist June 2022 Adequacy test date 1/28/25 Results Q Pass Fluid depth prior to test 0 in Water added 450 gal New fluid depth 1 in Elapsed time 15 min Final fluid depth 0 in Absorption rate 450 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 48 Effective depth used 0 in Effective depth remaining 48 in in COSA Checklist Legal Description: T15N R1 W SEC 4 LT 4 N2 NW4 Parcel ID: 05104357000 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) Well production at time of test gpm Date drilled Total depth ft Water storage tank volume gallons Cased to ft Well disinfected for coliform test? ❑ Yes 400066 ❑ Sanitary seal is functioning correctly ❑ Coliform bacteria is Negative ❑ Wires are properly protected Nitrate mg/L ❑ Nitrate less than MRL (ND) Casing height (above ground) in. Arsenic ug/L ❑ Arsenic less than MRL (ND) Date of flow test for COSA Collected by Static water level at beginning of test ft. Date Comments No Well On Lot- Water Provided By Public Water B. TANK DATA C. LIFT STATION Measured operating fluid level in septic tank 50 ❑ Required maintenance completed Date of pumping 2/4/25 Age of lift station years ❑ Required maintenance completed, if AWWTS Lift station material Comments: Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 10/19/15 Q ALL standpipes present per record drawing Total measured depth from grade 7.5 ft (max) Measured depth to pipe invert from grade 3.5 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. 0 Monitor tubes go to bottom of effective. If not, state depth into effective 0 Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 2000 gallons 1/27/25 date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficienci COSA Checklist June 2022 Adequacy test date 1/28/25 Results Q Pass Fluid depth prior to test 0 in Water added 450 gal New fluid depth 1 in Elapsed time 15 min Final fluid depth 0 in Absorption rate 450 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 48 Effective depth used 0 in Effective depth remaining 48 in in N N W 1% P P ; J6WtLLlL tt HJJUb1ti1GJ LHpL JURV G111Yb Oy4�V8LY 1 HEREBY CERTIFY THAT I HAVE SURVEYED THE CEO.. FOLLOWING DESCRIBED PROPERTY: _ 6�_ OF A(�d'* lc�yy/y7/.sari DATE- -t .......... 4 AND THAT D ENQ20ACHMENTS EXISAS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER N DETERMINE THE OR RESTRICTIONS Of ANY GRIDS `inG s% EASEMENTS, COVENANTS, OR RESTRICTIONS A%�/SSpi i11O WHICH DO NOT APPEAR ON THE RECORDED SUBDI— - o..« M.,k s.w..d VISION PLAT. UNDER NO CIRCUMSTANCES SH= FB A'•_ is -e a ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES.