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Home My WebLink AboutTONJESS ESTATES BLK 3 LT 2Tonjess Estates Block 3 Lot 2 #051-831-09 Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page / of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number D TPI S/Z(S PID Number: an 8310 9 Dwelling: 0Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ■ New gJ Upgrade Name: 61_ SCA! t-EON4RD ABSORPTION FIELD Address _terDeep 2 y Rgo J ess0 Lit, GT Trench ❑Shallow Trench ❑Bed ❑Mound ❑ Other Phone 21/4/—/ 930 Number of Bedrooms 3 Soil Rating tea / GPD/SF Total depth from original de Ft. LEGAL DESCRIPTION Depth to pipe Invert fromoriginalgrade Gravel depth beneath pipe Subdivision Block Lot 3 2 Z. 5 Ft. L_ Ft. / 3- S-r err Fill added above original jaade_ Gravel length Township Range Section C.J, J+ Ft. 8 Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 5 Ft. — — Ft. To From Septic Tank Absorption Feld Lift Station Holding Tank Sewer Line Total absorption area 4 80 Ft2 Number of trenches / Dist. between trenches Ft. Well /Oa — /00 /f — Zs tTANK IgiSeptic El S.T.E.P. II Holding IN Other t�( Manufacturer Capacity/ Capacity/ Surface Water da f f.- 4 _ — A /i Ni HQ 4 /Y CE 7-4/Vu A,. 0 Gal. r/ �a Q Material Number of compartments Lot Line /Q/4 (0 rf — — NA SYe L 2 Foundation - S ii-1 (J /-ii- --— � LIFT STATION AM Manufacturer Capacity Curtain Drain ".r- j0 t— — Gal. Z i. Remarks ` S .: � Pump on level at Pump off level at High water alarm at /� 0 VC' /2 ref A k pc 7/z a' in. in. in. / Pump make and model Electrical Inspections performed by Installer/ PIPE MATERIAL House to tankPt/�3o3ydrainTankfield to P✓C b/� AN �I Drainfield L CO/MTSOn Inspector �a r fit FOA BENCH MARK (Assumed elevation) /00 ft InspectionLocation dates: 1 7/2 7/15' 2th is and description 3'" U (3II S 4" S'T40t L-4N6IN 6' COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional Approval: Date Engineer's Stamp t.. ?a I'. m 1 ,'4+ 9$ ..••gl Approved i PdX Date 2 .. 7— /s' ItkJ.:- 9nti W. Eng 11' . tia V�`oo aa1� n4o Ey o ' nspection HepoW 9-1-T2.dec Existing Well R100 Lot 1 A Ne 1000 Gallon Sep .'c Tank w/DCO's AS -BUILT MEASUREMENTS A B ST2 19 55 DCO 21 58 MT1 44 81 T 82 98 CO2 86 100 Existing Well 0 R10 0 Lot 3 NOR THR/M :.49mt •. ENGINEERING ••• ••� PO fax 770724En r Eagle Rhnr, Alaska 99577 t 4,- 907.694.7028 T❑NJESS ESTATES BLOCK 3 LOT 2 WASTEWATER RECORD UPGRADE SEPTIC RECORD LAYOUT 1° = 40' Dob: EET: 8/3/15 2 of' 3 oo b b ri to aV ZO a co LO o TNo - c q 1 ` T NI 0 V are OOP., • = n n a en 2 (AY• O'- 3 e n D 7C HI Ai 1 v d m Ad ri (/)D D I 1 -IZ Enc 1 uoi}ona13 uoi4.ona13 Final Ground Elevation @ 93 ,26 = uoisonal3 2 _h O 3 + CO 3 o run T1-1 n ° ao O 33 0 0"+3 -5 -- N ✓ o cn n r0 3 O O< A N -I OS N3 P e+ 3 0 h N 3 a ,8'16 = uon_vna gouaJl do a.uiod-pu3 0l 0 -o n o 1/40 • N 3 jo (O Q1 n N 3 3 O h ro h PO(0 3 3 (4 I'D U '4 1=1- 2 O 3 r 90 - 5 -H (o 3 n S P1 (0 A h O 3 = uoi}onal3 1/40 UI n) [\JaRTHRIM ENGINEERING S❑ILS LOG — PERC❑LATI❑N TEST Performed For: Cindy Wilson Date Performed: 7/24/15 Legal Description: Ton jess Estates B3 L2 1 2 3 4 5 6 7 8 9 10 - 11 - 12 - 13 - 14 15 - 16 - 17 - 18 - 19 - 20 - 21 DEPTH (FEET) Organic SP Sand w/ Gravel T.H. Location: See Attached Design Groundwater? No Depth Water Depth None # Date Gross Time Net Time Depth Net Drop 1 7/24 0 -- 11' -- 2 7/24 10 10 min. 16' 5' 3 7/24 12 -- 11' -- 4 7/24 22 10 min. 16" 5" 5 7/24 25 -- 11" -- 6 7/24 35 10 min. 16" 5' 7 7/24 37 -- 11" -- 8 7/24 47 10 min. 16' 5' 9 7/24 50 -- 11" -- 10 7/24 60 10 min. 16' 5" Percolation Rate 2 min./inch Perc Hole Diameter 6" Test Run Between 5' and 6' Comments: Presnakpd, Measured to nearest 1/16th inrh. Performed By NorthRim Fng I 5'C CERTIFY THAT THIS TEST WAS Performed in Accordance with All State/Municipal Guidelines in Effect ON THIS DATE. DATE: 8/4/15 41577 NORTHRIM *.4smi� . ENGINEERING Eagle River, Alaska 99377 907.694.7028 PO Box 770724 '•r+t: Ee TESTH❑LE LOG GE❑TECHNICAL TH1 Dake: 8/4/15 EET: 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: OSP151215 Tax Code Number: 05183109000 Work Type: Septic Upgrade Permit Effective Dates: July 23, 2015 to July 22, 2016 Design Engineer: NORTH RIM ENGINEERING Subdivision: TONJESS ESTATES Site Legal Address: TONJESS ESTATES BLK 3 LT 2 G:1462 Owner/Address: OLSON LEONARD 0 639 WRIGHT DR CUSTER SD 577300000 Site Mailing Address: 24850 JESSE LEE CT, Chugiak Lot Size in Sq Ft: 54271 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. Special Provisions: PRIOR TO CONSTRUCTION: Additional testholes are required to verify the permitted design. If design revisions are required, an approved change order shall be acquired prior to construction. Testhole results shall be submitted with the inspection report. Received By: // i Issued By: I,i/V)L�L _J Date: • MUNICIPALITY OF GE Community Development Department Development Services Division On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 051- one: 907-343-7904 Fax: 907-343-7997 Property owner(s) OLSON/ Day phone 2414/1—/ 930 Mailing address Z4/8So 56SJ'S 4 -EF 0o(AT Site address .S,¢/'► C Legal description (Sub'd., Block & Lot) TONfsx-f' ESTff7€S $3 G2 Legal description (Township, Range & Section) Lot Size J9/, z 7/ Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field 0 Initial ❑ Single Family (SF) p (w/wo ADU) Septic Tank Upgrade [� Duplex (D) ❑ Holding Tank ❑ Renewal 0 Multiple Dwellings 0 Privy 0 (SF and/or D) Private Well ❑ Water Storage 0 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. ePE. (Signature of property owner o uth�orized agent) Permit/Rush Fees: 51A — Waiver Fees: Date of Payment: 1-110/15 Date of Payment: Receipt Number: 03'Sa3 D Receipt Number: Permit No. 35 P151a:15" Waiver No. Permit App_9-1-12.doc JCRTFRI M ENGINEERING MEMO Steve Eng, PE, PH P.O. Box 770724, Eagle River AK 99577 (907) 694-7028 SteveEngPE@gmail.com Date: 7/10/15 To: MOA On -Site Services Subject: Tonjess Estates Block 3 Lot 2 Septic System Upgrade Number of Pages: 5— An An existing trench has failed on the subject lot. A number of soil tests in the area reveal sandy soil and no groundwater. The design calls for a 5' -wide trench, and a new septic tank. A new soil test will be completed prior to construction to verify the soil. The entire subdivision is on wells and septic systems. The terrain slope is flat. The system size is a single family at 3 bedrooms. Please review the wastewater system design for the existing 3 bedroom 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 -Stec [bRT1-..RIM ENGINEERING ;4 t1' , � 1 . Steven W. ins 4U 1 1.1} 19 • •. "7/jam flr Tonjess Estates, Block 3, Lot 2 SPECIFIeA ,i&^DESIGN GUIDELINES Wastewater System Sizing: This is an existing 3 -bedroom, single family home. This is a developed subdivision. These lots are large and are served by private water wells. No adverse impacts are expected from trench/tank upgrade. No conflicts to the other lots will take place by this septic system construction. The easements are located on the drawing and are not encroached upon. Many soil tests in the area reveal sandy soil. A test hole will be completed prior to construction. An application rate of 1.0 GPD/FT2 with 0.5 reduction factor for utilizing a 5' wide trench. Trench Length = 450 FT2/5' x .5 reduction factor = 45'; 1 line @ 45'. A new 1000 gallon septic tank will be installed; Decommission old tank per UPC. 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, New 1000 gallon septic tank. Install new Double Cleanouts. • 5' minimum between the tank and trench. 10' to property lines. • 3' of cover or insulation is required for trench; 2" Minimum thickness for insulation can substitute for 1' cover. • 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 inch to 2 %2 inch 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. • Backfill over drain rock must not be less than 36". • 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) bb 43 4 - or Cr: '•tee$ Flat Slope Septic New Tre Septic Lee Court 15' Utility Shafer TH 0 MT/CO - Existing Well 0 R100 - Slope New 1000 Gallon Septic Tank w/ Existing Well R100 5% Slope Dec Se P rirnission Old is Tank/Trench UPC Flat Slope DESIGN NOTES: 1. Total Depth of Trench is 6'— Insulate. Terrain Slopes Slightly North. 2. Sewer Service Line minimum 2% slope. 3. Private Water Wells. 4. Decommission Old Trench/Tank Per UPC. 5. Test Hole Prior To Construction. Septic 5% Slope NOR THR/M ENGINEERING PO Box 770724 Eagle River, Naska 99577 907.694. 7028 T❑NJESS ESTATES BLOCK 3 LOT 2 WASTEWATER DESIGN UPGRADE SEPTIC 1" = 40' PLAN LAYOUT Dote: Ern 2 of' 3 Foundation Cleanout Opposing Cleanouts Between Septic Tank & Trench > 0 U d 3 O O 0- 0 LJ OW o To End -Point of Trench a 0 -P (41— c O g da L L7 S U o Uw o¢i LI Monitor Tube Final Ground on Compacted, Effective Depth , _ M r oc a o tri o, O U 0 >, a U L a u LN aN sa £ .Th#- o U io O £3 g i-' N P21 L d +; O U - a£ N -I + L t0a Vi N £ U N S Ui > nt5+ m CVO- 0-0 L a 4._ U(n LJ a 0CID ds N N dfLi_ NU PUN O U 6 L O LS 4Mt— N U CS a)O)-- 0 0'-vv~aLL C ZS U-' L L(4 O-- d aa+ a v v vi av "v,3v ¢� ra -: cu CO fl D N W 0J C I-- F— L1 V J W V JJ l J V W /� U Z m END VIEW 0 •1 MUNICIPALITY OF ANCHORAGE el DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 46f Ie ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME MAILING ADDRESS LEGAL DESCRIPTION LOCATION D2 Q � i w f' CXCf7viv t En/6/n/FER.s P. O. Bax 1q - 3 9 C/ -1v&'/ le) flt tor Z $LK. 3 -MN 7ES5 ES'T. DISTANCE TO: Well ± 150 Absorption area / t ,.p— is. Dwelling ± / Manufacturer - 6R-en2 Material SEL Liq. capacity in gallons) , no ID IF HOMEMADE: (Inside length Width SiOZ DISTANCE TO: Well A/ 0 E 4 ManufacturerZ 1- .. O Well Foundation / Nearest lot Ime / PERMIT NO. e � = DISTANCE TO: t 110 .f ZS -F 5. �r F. = No. of lines Length of each line , Total length of li ps / ¥rench width Distance between lines A// f ▪ — C t $�(< •i',�(O f .i0 Inches /� GF- Top of tile to finish grade f Material beneath tile R inches Total alt �rptliin area Length Width Depth PERMIT NO. iirr�� W /� a. F Type of crib Crib diameter / V grib depth Total effective absorption area wd la to DISTANCE TO: Well Building foundation Nearest lot line .0 Class pt' l s�IA/& Driller Distance to lot line I PERMIT NO. t) W DISTANCE TO: Building foundation Sewer line Septic tank Absorption weals)i (PHONE 9�I57,7 I ANEW D UPGRADE NO. OF BEDROOMS 3 PERMIT NO. c g. No. of compartments Liquid depth PERMIT NO. 2. Material Liquid capacity in gallons -- OTHER PIPE MATERIALS CAS? Er PYC SOIL TEST RATING INSTALLER /ro 4'/Rrc. EXC/?►A77Alt Cry IAle eIZS REMARKS r /las• J • .• •1 •' 4 r : aobort A. Shako; ;.. a' LP` oI No. 119.E i ! it ¢ `C0 aea.".. DATE LEGAL rriteb '—S s s E`IaIF1°=RI L3 r ;OLE.FIV R� ALASYJl 0-577 11.CIt. J MUNICIPALITY OF ANCHORAGE Department(p Health and Environmentafrotection gtipuAtti ?}I 825, Street, Anchorage, AK. '.,.'3501 ' • 264-4720 ----- Permit # (47,77�� * * HANDWRITTEN PERMIT * * * WELL AND/OR -ON-SITE SEWER PERMIT /� Applicant: cirAr, e.1 Mailing Address: l�&c8K -39 0 Location: , / Phone Number: Legal Description: Lo+ 2 A R 76 -t -r pss cry/Lot Size: Type of Soil Absorption System Is: l/ Trench: k Drainfield: _ Seepage Bed: Holding Tank: Maximum Number of Bedrooms: es Soil Rating(sq.ft/br) /SD The Required Size of the Soil Absorption System Is: ' Attecti i DEPTH LENGTH S G .GRAVEL DEPTH 17 / WIDTH Oil The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLD.LNG) TANK SIZE = / 0(90 GALLONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * *.* TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this departmen will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fee for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * I certify that: PERMIT EXPIRES DECEMBER 31, 1 9 3 3 * * * (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. : (3) I understand that the on-site sewer system may require enlargement if the reside ce is remodeled to include more tha 3 rooms Signed: /I?.14,¢A�,CJ Issued by:, Applicant`-' S --/6 — Date: U . SWP/024(1/81) 1' • • PERFORMED FOR: n MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage. Alaska 99501 2644720 SOILS LOG - PERCOLATION TEST EXCfVP tNb Er.1GINIF?ra-C LEGAL DESCRIPTION: L.S 2 DEPTH 1 '.! 2c a c 3 Q ' S_ 4 —° 5- - 6-&,- b4` - 8 - -Q-. V s= � o� 10=cam 11- -. 12 13- og-GRN tc I. SOILS LOG in PERCOLATION TEST DATE PERFORMED: s1l `83 B• 3 ToMtrPss t:�T_ RED SiL-T`( 5I4iND SW 125 / tz SP 14- —��pF q oZ3 ch 15- . A r 16- rh •.s' ': •le .. •.., o -I li — Jl� Ro srt A. Shafer • L.,/ , Ho. 1457-E - der 19 - `u5\::Ew,a��•' 20 - SLOPE SITE PLAN PL WAS GROUND WATER ;/��O L ENCOUNTERED? s`1 0 P IF VES, AT WHAT DEPTH? COMMENTS PERFORMED BY: *s a E",1CINETAI I i- unl3LW. :+'n t,RIVER. AI.ASIC1 £ri`77 72.006 (6/79) _PN.694-2$7D Reading Date PERCOLATION RATE TEST RUN BETWEEN CERTIFI E RoRb rpo' c„ _,,krest. Itt Gross Net Depth to Net Time Time Water Drop 'r1 'JAIL (minutes/inch) FT N 37�2 . DATE: Trralfirb artuing'tng by OOC co. Eba SULLIVAN WATER WELLS P. 0. BOX 272. CHUGIAK, ALASKA 99567 • TELEPHONE 688-2759 OWNER OF LAND s" Ili a E Piz. /0 Ti ADDRESS pa do if ,J{'/ eN‘t6iHK LEGAL DESCRIPTION / 7) '; e K 3 DATE -Started 57,#/F3 ' Ended PERMIT NUMBER KIND OF FORMATION: read Ezr CX/6/F3 DEPTH OF WELL I Do e STATIC LEVEL OF WATER FT, 6 3 DRAW DOWN FT, GALS. PER HR / ro KIND OF CASING G 'c From n Ft. to T»»2 Ft. AOR °F" From _Ft. to Ft.' From -a Ft to_ii__Ft fA"JO 6'4.rit`jC `-•' From' Ft to Ft." From Ft. to Ft. 'lock 0 t4! _j' From Ft to -Ft From /a Ft to 7a Ft. •Sts..O (ene-'V'L From Ft to '/ Ft. From 7r, Ft. to rt, Ft. /ic u 6 C "—÷.1 From _Ft. to Ft From , ( Ft to 4 C Ft. S /4 r`-''0 W/ -01ftCt-From Ft to Ft From r L Ft. to I,) 1 Ft. frl-d,i C,'4 -'S2 4 From Ft to Ft. From Ft to Ft. 1 LUua i%� From 'Ft to~ Ft. From Ft. to Ft. From Ft to Ft. From Ft to Ft. From Ft to Ft. ' From Ft. to Ft. From _Ft. to' Ft. ' t From Ft. to Ft ' . !--.From -From Ft. to Ft. - From Ft. to—Ft. From Ft. to Ft. From Ft. to Ft. _ From Ft. to' Ft. From Ft to Ft. From ` Ft to Ft. From Ft to Ft. From Ft to Ft. I____ 1 ..-., From Ft. to Ft. ' From Ft. to Ft MISCL. INFORMATION: ` ‘‘..• i - . v DRILLER'SNAME '?/111 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-831-09 Expiration Date: 2 Z— t d 1. GENERAL INFORMATION Complete legal description Tonjess Estates Block 3 Lot 2 Location (site address) 24850 Jesse Lee Ct, Chugiak, AK Current Property owner(s) Griffin Day phone 244-1930 Mailing address same Real Estate Agent Cindy Wilson, Partners Day phone 244-1930 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: Individual Well Individual Water Storage Community Class C Well Public Water System TYPE OF WASTEWATER DISPOSAL: ® Individual El ❑ Holding Tank ❑ ❑ Community ❑ ❑ Public Sewer ❑ Received by: COSA to be released to the engineer, unless otherw se requested by the engineer. Date: c510 G COSA Fee $ 2_ G Date: Date of Payment g -/Hs Receipt Number (97/1( ,7 Date of Payment ,r7 Receipt Number COSA # (/ �.. ( /( 00 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 NorthRim Engineering Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng 6. DSD SIGNATURE System #1 Approved for bedrooms. System #2 Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stiplil t?ons!ss By: Phone 694-7028 Date 5/23/2016 O ct = ON-SITE r9G. WATER /AND WASTEWATER o PROGRAM ca 523 -147 Original Certificate Date: c)'7—I.) The Municipality of Anchorage Devlopment 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 Septic System Advisory Well Flow Advisory COSA blue sheet 9-1-12.tloc X Nitrate Advisory Arsenic Advisory Other 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: /-#04/3ESJ &J 47E j 21 62 A. WELL DATA P Well type If A, B, or C provide PWSID # Date completed She/PS Sanitary seal (Y/N) Total depth mi ft. Cased to /D/ it FROM.WELL LOG Date of test . She/ 8 3 Static water level 6'3 ft. Well production go" g.p.m. Parcel ID: (551-23/- Q9 Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION ft. g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 3.5'2 mg/L Arsenic ug/L Date of sample: $f/o//C Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material S tP% r Cis % t -EL Date installed 7/2 Ins Tank size /OO(l gal. Number of Compartments 2 Cleanouts (Y/N) >/ Foundation cleanout (Y/N) y Depression over tank (Y/N) N High water alarm (Y/N) / 4/ Date of pumping Ate& Pumper C. ABSORPTION FIELD DATA. Date installed 7/30//S Soil rating (g.p.d./ft2 or ft2/bdrm) Length il 8 ft. Width 5 Total depth C ft. Eff. absorption area de0 ft2 Monitoring tube y Date of adequacy test /V� Results (Pass/Fail) Fluidiepth in absorption field before test in. Water added gal. , New depth in. t Elaps cTime: . - min Final fluid depth in. Absorption rate >= g.p.d. Any rejuaertation treatment (past 12 mo.) (Y/N & type) If yes, give date 0 System type 7;e54,10/1 ft. Depression over field A/ Forbedrooms ft. Gravel below pipe D. LIFT STATION ,AM Date installed "Pump on" level at in. Datum Size in gallons "Pump off" level at in. Cycles tested Manhole/Access (Y/N) High water alarm level at in. Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic'tank/lift station on lot /00 On adjacent lots Absorption field on lot /ac' -0- On adjacent lots Public sewer main boa r'A Sewer /septic service line .2 5 • Animal containment areas Cato, - Public sewer manhole/cleanout /00 's - Holding tank /00 KO '4" Manure/animal exgrete storage areas /19 `* SEPTIC/HOLDING TANK ON LOT TO: Building foundation Water mainfa 5"r Wells on adjacent lots /60 .� ABSORPTIO7:FIELD ON LOT TO: Property line /Q �� Building foundation S 'f' Water main /0 I" Water Servioili Curtain drain Property line /D 17" Water service line /O ''~ Absorption field 5- ft Surface water /00 F. COMME ft" Sar* Surface water / CO 't`. ` Rriveway,;parking/vetiicle storage Wells on adjacent Tots /rid 'f- /O't G. ENGINEER'S CERTIFICATION • I certify that I have determined through field inspections and review of Municipal records that the above systems as in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name S rEl/ . EA./61 5-4 s/t'( Date COSA yellow sheet_2-6-15.doc Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROV Parcel I.D. 051-831-09 Expiration Date: 11 - 7- /5 1. GENERAL INFORMATION Complete legal description Tonjess Estates Block 3 Lot 2 Location (site address) 24850 Jesse Lee Ct, Chugiak, AK Current Property owner(s) Olson Mailing address > :same Day phone 244-1930 Real Estate Agent . -' Cindy Wilson, Partners Day phone 244-1930 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: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class C Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Received by: -� COSA to be released to the engineer, unless otherwise requested by the engineer. Date: /7 7/-5 COSA Fee $ 0[(e0 Date: Date of Payment gI�'11(5 4-0y Date of Payment Receipt Number b t1 .]`7 Id Receipt Number COSA# o'SC.1 Sl"Qf 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 NorthRim Engineering Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng 6. DSD SIGNATURE By: System #1 Approved for 3 bedrooms. System #2 Approved for bedrooms. Disapproved. Phone 694-7028 Conditional approval for bedrooms, with the following stipulations: \SY 0 y c' WATE:., , m= O', c WASTEWATER z� -RAM rQ- •;\ Original Certificate Date: Sj "7 - / ,r The Municipality of Anchorage Devlopment 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 blue sheet 9-1-12.rloc D. LIFT STATION la Date installed Size in gallons "Pump on" level at in. "Pump off" level at in. Datum Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot /08 r'I Absorption field on lot /d7`1 Manhole/Access (Y/N) High water alarm level at in. Meets alarm & circuit requirements? On adjacent lots On adjacent lots /60 Public sewer main / 0 0 ' I` Public sewer manhole/cleanout /CC0 ' - Sewer/septic service line a7 5 t'f' Holding tank Animal containment areas 50 •t SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5 'H /e o't Manure/animal excrete storage areas /00 rt Property line Absorption field orf Water main / 0 'f Water service line / /J '1 Surface water l40 f Wells on adjacent lots /&o 't ABSORPTION FIELD ON LOT TO: Property line /0 f i WaterServiceiine /6 f Building foundation S-14" Surface water / 0 0 f Driveway, paiksng/vehicle storage / a Water main /a r� Curtain drain SG f Wells on adjacent lots /Ca /14 F. COMMENTS 2'` fNSu4-4fioAl ova 1 AM ifttEid C ty G. ENGINEER'S CERTIFICATION I certify that l 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. Engineer's Printed Name S 1T"i eAic Date 0//0 5- COSA COSA yellow sheet_2-6-15.doc ..< PitOF..4S,0i • sta.w. Eng : � � Sfa�•ae 1%� * Roa Sc 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: 723N .resr Fit B 3 L 2. Parcel ID: 05/ 83t 0? A. WELL DATA P If A, B, orC provide PWSID# Well Log (Y/N) Well type Date completed 5!(6/23 Sanitary seal (Y/N)tL. Total depth . I D1 ft. ! : Cased to /0/ ft. FROM. WELL LOG Date of test 5/16f 83 Static water level 63 ft. Well production 30 g.p.m. WATER SAMR.La RESULTS: Coliform 0 colonies/100 mL Nitrate 3. Ss mg/L Arsenic yi/b ug/L Date of sample: 61l67/3" B. SEPTIC/HOLDING'TANK DATA Tank Type/Material SEPT/C. / /� S net Tank size /006 gal. Number of Compartments 2 Foundation cleanout (YNe.---(!ti /NN) Y Depression over tank (Y/N) /1% Date of.purnplrig /i> t 6sJPumper Y Wires properly protected (Y/N) 7 Casing height (above ground) 2t( in. AT INSPECTION 7/ an r �i S ft. ('r g.p.m. Collected by: !Va✓Ket 5. Date installed 7/27/15' Cleanout§(Y/N) High water alarm (Y/N) C. ABSORPTION FIELD DATA Date installed %l3drt s Soil rating (g.p.d./ft2 or ft2/bdrm) /. 0 System type r%IetllJ et/ Length . l t t$:- Width 5 ft. Gravel below pipe V ft. Total depth .41ft. ft Efkebsorption area +/80 ftMonitoring tube )/ Depression over field /✓ Date of adequacy test • •. Nig N % Results (Pass/Fail) ( For ? bedrooms Fluid depthip absetiptio11'fi$f0Oefore test in. Water added gal. New depth in. ^ . EIap d•Tirr "' 'I `, �cp.Y Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation truant (past 12 mo.) (Y/N & type) If yes, give date JESSE LEE COURT 0 Lot 1 A W 0 0 2 Lot 2 54,271 s.f. SEPTIC PIPES 70.3' 7 9'59 -1-E 164.97' wt. - WE 1--. - CIE 6.0' x 18.9' DECK CIR CO M P 0 2.0' x 6.8' CANT 27.9' 12.2' x 16.2' SHED 1 2' CANT 16.0' x 20S WOOD PATIO Lot 3 WOODEN FENCE ON ADJACENT LOT S 89'53'15"W 164.97' Lot 1 Lot 2 PLOT PLAN AS BUILT SCALE 1- = 40' GRID NW 1462 Project No. 15-221/A1 Lang & Associates, Inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Registered Land Surveyors (907) 522-4625 Fa 9 y (907) 522-4625 Fax kenOlangsurvey.com / jonathanulangsurvey.com I hereby certify that I have surveyedthe following described property: Lot 2, Block 3, Tonjess Estates (Plat No. 81-72) Anchorage Recording District, Alaska, and that the Improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the properly Tying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. Dated this the 7'tuj> Day of 47vcoppp1 fir : 49Th D. _}...h ... OKENN LANG'../(10 'CV • :z,y5), at Anchorage, Alaska Qt •'d -S-6202..•' r.; it Is the responsibility of the owner to determine the existence of any easements, �QRO'ess�ONALeo"^ covenants, or restrictions which da not appear on the recorded subdivision plat. �OpQ��s' Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES - Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY - APPROVAL FOR A SINGLE FAMILY DWELLING C1 -R21 1. GENERAL INFORMATION Complete legal description HAA# Q`Infm S�In Lot 2; Stock 3; Tonjeaa E4tate4 Location (site address or directions) 24850 Jease Stteet Property owner V.A. 0284123 Day phone Mailing address 935 Etmt 8th Avem,P Anchorage. Alaska 99501 Lending agency Day phone Mailing address Agent Pat Johnson ALLSTAR REALTY Day phone 561-7821 Address 2207 EAs.t Tudon Road #23 Anchoaage. Afa4fca 99503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 N 3. TYPE OF WATER SUPPLY: Individual well Community well - Public water - NOTE: If community well system, provide written confirmation from State ADEC attest - Ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. XX 72-025 (R... +/1+) Front MOA 121 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 of this Health Authority Approval application 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. Name of Firm s &S ENGINEERING Phone Address 17034 Eagle River Loop Road No. 204 Eagle Ride,, Aloka 99577. Engineer's signature DHHS SIGNATURE % XApproved for rti L bedrooms. Disapproved. Conditional approval for • Date 43-2b=12 ?Pt£a.........�4 its f4972. ..�._ .r A ROGER.. 01AFER`: tee kVitoFEsSos- dier Additional Comments By: ,a,..�- l5iz-,-u�-�" bedrooms, with the following stipulations: 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. n-025(Rev.1/91) Back MOA 021 Municipality of Anchorage Department of Health & Human Services . -_ _ HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lo r Z Pia--1"7'ro,SXS4S Et-rparcel I.D. 6 5 /— 13 / - D 9 A. WELL DATA ... Well type?C14N11- If A, B, or C, attach ADEC letter. -ADEC water system number °IK • Log presentof/N) 1 Date completed s' 110 -83 Driller S01-4-4•1 p..( Total depth 1011 Sanitary seal (bN) • Date of test Static water level Well flow Pump level Cased to FROM WELL LOG 's— Ib=133 • 1 : SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line WATER SAMPLE RESULTS: Coliform 0 1,3o1 t0' Afic. 4°` -`is cos,/ \0 1 1 Casing height Wires properly protected $PN) 'l AT INSPECTION • � -zhfli Lo.O't•._ _. L.. ov— g.p.m. ; On adjacent lots ; On adjacent Tots Public sewer manhole/cleanout �If 17.2 g.p.m. 1001} Nitrate Date of sample: 9) -11,-412.— B. 11,-412.— B. SEPTIC/HOLDING TANK DATA ' Date installed. •'�'tit:•122'4, Cleanouts&/N) • y High water alarm (Y•Q) Date of pumping Tank size Petroleum tank z.? '141-1-t. Collected by: t 00 0 Foundation cleanout 6/N) I', e Other bacteria Oa 4 E- s a S ENGINEERING 17034 Eagle River Loop Rad No. 404 Eagle River, Alaska 99577 • Compartments Depression (Y& l Alarni tested (Y/N) (/4 Pumper - SL, (CESS roe SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on ' tyi... '( r1- O Onadjacentlots loo Foundation 10' To property line10 "Absorption � 1 .__-_ Watermair/§erviceline. Surface water/drainage 100 I X '' 72-026 (Rev. 7/91) Front 10I#2 CONTINUED ON BACK PAGE • C. LIFT STATION Date Installed Size in gallons • Vent (Y/N) High water alarm level _ Meets MOA 'electrical codes • " ' ' ' • • MentifaCturer ••-• '1? Manhole/Access (Y/N) "Pump on" level at ' ' ump off" le‘tel at f. Cycles tested r -r• 1-1 SEPIARATIO TANCE FROM LIFFSTATION-‘ TO: • - 4- • • ' --------- on lot - • On adjacent jots 2 ( t '::D;ABSORPTION FIELD DATA ' :•C.',1'; N,":: r Date installed cm- zi -Is; Soil rating -• 1 a • sir _ _ _ Lengthr7"19 Width 7-•"7 Toial absorption area — n ^ Depression over field (Y6) • "i •J _ _ Result •a 4:il) F744s '1 surfacewater _ P"'• System type 1-g4-4 - ' - 4 t £3 ' Gravel thickness Total depth Cleanouts present6f/N) Date of adequacy test 8- r _1 1 qr ( "a) bedrooms Peroxide treatment (past 12 months) (Y& Plb .1 a- 124) kat 't -If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: 4 , !•1 r :* I. Well on lot Ito On adjacent lots too Property line To building foundati on. To existing or abandoned system on lot • A •%ci`k" On adjacent lots Cutbank lob t 1 . 0A1213,13413 2 2 E. ENGINEER'S CERTIFICATION ttatr dyc ;0;.S ,ily19 mipt3 1 certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect4iNae of this inspection • • _ .41.• r. -1,14 r• ,•. Surface water r - Curtain drain Water main/service line I 0 I '+'• Driveway, parking/vehicle storage area n;c. 41: I __‘ •-": • • _ ' ---s (`-‘ • • - - •• • • • s A S ENGINEERING — Signature 17034 Facile River Loop Road Net 204 _ _ _ Eagle River, Alaska 99577 Engineer's Name Date 11* 49/li • "I' I - •r. 11,1111.441 VI IMO 00 • --- •••••• 'ATLI; ROG R J. HAFER • Cot rep% No. 15 14.4.0 r ; r 4irte;S•s.:. :/‘ ‘'‘32 _ _ , • , 1 _ _ 0 , : ' I t°4;06 La 0.,04; k : • HAA Fee $ fix) 6(n) Date of Payment TZr 7 -- Receipt Number • 177217 ( 1150 72-026 (Rat 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number n . n 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 O S / p 3 264-4720 • Application Date '11'g'8' 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Loy 01,11 > r, Location (address or directions) Ttr✓ (b) Applicant Name Applicant Address 292 . (c) (d) (e) Telephone: Home 0133 Pte. Business Applicant Is (check one): Lending Institution 0.; Owner/builder�Buyer 0 ; Other.❑ (explain); Lending Institution w (�tt�)PVt - Address • t"t—'LI-1-o(t-4, Real Estate Company and Agent I��— Telephone 1d{•4-1'fL 13,6-re5 Address P0 'P»/ -111611 t t t-t.-1— Telephone • (f) 'Ntaifthe HAA to the following address: 1d1�� SSoo • 2. TYPE OF RESIDENCE Single -Family- Multi -Family 0 Other Number of Bedrooms 3 S & S ENGINEERING 17034 Eagle RWar Loop Road No.2 4 Eagle River. Alaska 99577• - 3. WATER SUPPLY Individual Well. Community 0 Public 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. .1 e 11 • 4. SEWAGE DISPOSAL Onsite. Public 0 Community 0 Holding Tank 0 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 (1Ii84) 5. 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. Name of Firm Telephone a f44 -2.-9i 71 Address Date 7/6-1/47) 6.. DHEP APPROVAL Approved for %Zj--t bedrooms by Approved' " "- Disapproved Terms of Conditional Approval ' Conditional Date .7.4. 1.:,� /2171714:02 CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DI -IEP) 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 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: c .. i . Page 2 of 2 72-025 (71/54) A. .tp,GE 01 Meg PGSEQ�AGESOtv�S Eoadv scp1-' 101 vo WELL DATA `` Well Classification Well Log Present&l1 Total Depth \ 271 Static Water Level MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4744 Legal Deiption: n L01- z 1 >,L.3 6P Cr -S74 e2e. If A, 8, C, D.E.C. Approved (Y/N) Date Completed 5 - Yield Cased to 101 1 lob' 0,014 Casing Height Above Ground Electrical Wiring in Conduit $N) Separation Distances from Well: To Septic/Nelding Tank on Lot Depth of Grouting Pump Set At ' Sanitary Seal on Casing CAN) Depression Around Wellhead (Y,(®' 01/-- PIN 1'— PIP 5 , (P3 &i? -8 V7701 ' ; On Adjoining Lots To Nearest Edge of Absorption Field on ot - 1 1 0 ; On Adjoining Lots To Nearest Public Sewer Line 't' j ! P - ' To Nearest Public Sewef .'`: _1 c j • .� Cleanout/Manhole P To Nearest Sewer Service Line on Lot tis '-- Water Sample Collected by S 1 `X'r I rs F -t p-% ; Date cl -8 - g% Water Sample Test Results 12GTlS b( �7P�T f —t �' k f -)r112 'S Comments /- A- Pt—&) 1-169-71✓ 9 -ritom L5+- 15-124 r�)uJIMJH c S.P�GP►'I. B. SEPTIC/I DtUfW TANK DATA Date Installed S /LI --e3 Size 1 01017 Standpipes49N) Air -tight Caps ON) Depression over Tank (Y/6P Pumping/Maintenance Contract on File (Y/N) Alarm (Y/N) P No. of Compartments Z Foundation Cleanout�N)' —Is -s7 Holding Tank High -Water AI Separation Distances from Septic/bleldrngTank: r 01 f To Water -Supply Well To Property Line To Water Main/Service Line Course 1 on -1— Comments '��S f ,S1'ro 1. ei t -A 91,36 S1' $-) -cat, Date Last Pumped ;for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field Jo,Stream, Pond, Lake, or Major Drainage 72-026 IR'v 81861 Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 1 `5"-U IQ -03 Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y&P Results of Last Adequacy.Test Type of System Design 1 Length of Field Depth of Field Gravel Bed Thickness se". Standpipes Present ON) Date of Last Adequacy Test Oj —1 { —.F57 lj�-nsF�a.y - 3 ,3("2 13( I 1/ Separation Distance from Absorption Field: 1'1 r, To Water -Supply Well 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` SG (464) = 998 ovitirsa oIA- I To Property Line ` 1 n "r • To Existing or Abandoned System on : On Adjoining Lots 30 To Cutbank (if present) %ler 301+ .e.f• ' 49 107M D. LIFT STATION -1 Date Installed • Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) • Comments .Dimensions Manhole/Access (Y/N) "Pump Off' Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA •• Check Permitted Bedroom Rating Against HAA Request •• I certify that I have checked, verified, or conformed to all MOA and HAA guidelines Signed Date /77r/F� Company MOA No. e%—Oo -S Receipt No. – d 0 J-0 O/ y Date of Payment 7//a7F7 Amount: $ / 0 C Page 2 of 2 72-026 (Rev 8/861 Back in effect on the date of this inspection. ••.% •. / I .............2. , f L + yb.i s% rto. t 51a A WORKORDER # : 2741 CHEMLAB REF # : 7633 DATE PROMISED : SEP 11 87 CLIENT REPORTS TO #1 : S & S ENGINEERING : R SCHAEFER EAGLE RIVER, AK 99577 694-2979 PURCHASE ORDER #: VERBAL REO # SPECIAL INSTRUCTIONS: Chemlab Client Sample # Sample Description LAB INSTRUCTIONS Report Printed: SEP 14 87 e 08:02 ACCT NO : SNSENGP WO DATE : SEP 13 87 VIA : HAND DELIVERED REPORTS TO #2 SAMPLES RECEIVED : SEP 9 87 ORDERED BY Parameter Matrix To Test Method Units Result 1 L2 83 TONSESS EST 9-9-87 KITCH 1 20153 -NITRATE -N mg/1 1, 9 WOnkORDER N : 2741 CHEMLAB REF 4 : 7633 DATE PROMISED : SEP 11 87 CLIENT REPORTS TO 111 : S & 5 ENGINEERING : R SCHAEFER EAGLE RIVER, Al; 99577 694-2979 PURCHASE ORDER 4: VERBAL REO SPECIAL INSTRUCTIONS: Chemlab Client Sample 11 Sample Description LAB INSTRUCTIONS n ACCT N0 WO DATE VIA Report Printed: SEP 14 87 @ 08:02 REPORTS TO 42 ': SAMPLES RECEIVED : SEP 9 87 ORDERED BY Parameter Matrix To Test Method : SNSENGP : SEP 13 87 : HAND DELIVERED Units Result 2 L2 B3 TONSESS EST 9-9-87 KITCH 1 20005 -TOTAL COLIFORM col/100m1 0 II APPLICNT FILLS OUT UPPER HAL' ONLY PropertyOwner E��/-7O n7 ._, /!✓�7C 4'' %rin Address flt2.Zoy ��j//7 ! 1,.,y ,,9/ ,.47jf Buyer 6.-4/,1% C/c .c A Address ✓a 60,,, Se/ -g C. hj,9 yL Lending Institution /,y ^/„ /r o-..-, / Address Realty Co. & Agent Address Legal Description Street Locatim e" -is /rFis/cl- oto alo<<�r� r„jesS. fl/ -7. s ,T r. <e c Jr c C ,,cii 11— Type of Residence E. Single Family 6 Multiple Family ❑ Other Water Supply f� Individual ❑ Community ❑ Public Utility Sewer Disposal Individual ❑ Public Utility ❑ Holding Tank No. of Bedrooms Zip Code Zip Code Zip Code Zip Code Phone Gyy-in/v 771-9de o iNPg•zrYcl Phone Phone ATTACH WELL LOG. A well log Is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log 11 available). Year Individual Installed: // a When Corrected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. f -E 0 rr�-tQ.V' Time Time Date Inspector Field Notes: Date Inspector at.r 4 c. k t:3.�,a>3- a K. (3) APPROVED BEDROOMS ( ) DISAPPROVED ( )CONDITIONAL APPROVAL' r\'4 DATE D ,, —•,,e Solis Rating LTD 72023 01112) Date Sewer Installed 5'tS . IWell To Absorption Area / }O Time Date Inspector • its-<tbw ClRCASCIA. O` to Time Date 0- T. /0-r3-73 :tor MUNICIPALITY OF ANCHORAGE DEPT. OF I*ALTII f, ENVVRON,'.CNTAL PROTECTION c Afti- A_ Clik-T q 21983 ' ECEIVED T,t.l, •C NDITIQ SOF APPROVAL Well to Tank !3O Well Log Received Septic Tank Size /VCD ea).