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Home My WebLink AboutMIDNIGHT SUN LT 1Midnight Sun Lot 1 #051-154-68 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 hftp://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP231213 Work Type: SepticTank Upgrade Tax Code Number: 05115468000 Site Legal Address: MIDNIGHT SUN LT 1 G:1257 Site Mailing Address: 19775 OLD CRANBERRY DR, Chugiak Owner: WILLUPS WILLIAM C & KENNA J Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date: Expiration Date: »ent c ° sir G r'1 Department Lot Size in Sq Ft: Total Bedrooms: 7/27/2023 7/26/2024 40825 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing =SCA e A fi Issued By: Date: Date: Z7 Z 4 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-154-68 Property owner(s) WILLUPS, WILLIAM & KENNA Day phone. Mailing address 19775 OLD CRANBERRY DR CHUGIAK, AK 99567 Site address 19775 OLD CRANBERRY CHUGIAK, AK 99567 Legal description (Sub'd., Block & Lot) MIDNIGHT SUN LOT 1 Legal description (Township, Range & Section) Lot Size 40,825 Sq. Ft. Number of Bedrooms In APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (M all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) El (w/wo ADU) Septic Tank 0 Upgrade 0 Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes.__, (Signature of property owner or authorized agent) Permit/Rush Fees: Waiver Fees: Date of Payment: Date 3 Date of Payment: Receipt Number: 091-67-3 Receipt Number: Permit No. o S P 1312,13 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! !! July 14, 2017 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: MIDNIGHT SUN LOT 1 The owner has requested that we obtain a septic permit to upgrade the existing STEP tank on the above referenced lot that appears that the integrity has been compromised. We propose to install a 1500-gallon epoxy steep STEP tank with possible anchors. Shallow groundwater was noted in the MOA on-site file. The lot and area are served by private water as noted and there are no wells within 100’ of the proposed STEP tank. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231213, Deb Wockenfuss, 07/27/23 FIRST WATER CONSULTING MIDNIGHT SUN LOT 1 DESIGN DETAILS: NO WELLS WITHIN 100' OF PROPOSED SEPTIC TANK Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231213, Deb Wockenfuss, 07/27/23 V //y / 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 • httpl/www.muni.org/onsita a (907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP11131 i PID Number: �5�.5--1 j? ® New [I Upgrade Name:ABSORPTION MIKE ANDERSON W/ MIDNIGHT SUN CONSTRUCTION FIELD ❑ Deep Trench ❑ Shallow Trench ® Bed ❑ Mound Address: 19735 OLD CRANBERRY RD. *CHUGIAK, AK ❑ Other Phone: No. of Bedrooms: Soil Rating: Total Depth from original groda: (907) 727-1433 �K y 0.5 & 0.7 GPD/Sq. Ft. 4 MAX Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade: Gravel depth beneath pipe: SEE DWG. Ft. 0.62 Ft. Subdivision: MIDNIGHT SUN S/D Block: Lot: Fill added above original grade: Gravel length: — 1 SEE DWG. R. 80 Ft. Township: — Range: — Section: — Grovel width: Bed. Number of lines: Distance between linea: 15 Ft. 1 3 5 F. SEPARATION DISTANCES Total absorption area: 1 200 umber of trenches: — Dist. between trenches: — TO Septic Absorption Lift Holding Public/Private From Tank Field Station Tank Sewer Lines SQ.Ft. Ft. Well 100'+ 100'+ 100'+ — 25'+ TANK ❑ Septic ® S.T.E.P. ElHolding El Other Manufacturer: capacity: Surface water 100'+ 100'+ 100'+ — ANCHORAGE TANK 1500 Gal. Lot Line 5'+ 10'+ 5'+ — N/A Matedal. STEEL Number of compartments: 2 LIFT STATION Foundation 5'+ 104 5'+ - Curtain Drain NONE KNOWN Manufacturer. Capacity: ANCHORAGE TANK 1500 G.I. Pump on' level at: Limp afflevel at: High water alerts at: Remarks: 42" 42" 46" Pump Make & Model: OSI-05—HHF Electrical Inspections perfomt ....v:: lf'. PIPE MATERIAL House to tank D3034 Tank to SCH40 drainfield Installer WHITTERS EXC. Drainfield D3034 CO/MT D3034 Inspector GEG, Ltd. BENCHMARK (Assumed elevation) 100.00 Ft. Inspection Loca6°° anal De.adptian: Dates: 1st 4/11/12 2nd 4/13/1 3rd 5/2/12 4th 5/3/12 TOP OF DECK ® BACK DOOR P.N6INEEWS Community Development Department Approval oo F o� OF v Conditional approval: Date: .............qSN ............................ 0 '• J f r y A. rness: Approved: Date: - poodProfessl°^°o ��00000�� V //y / f PERMIT NUMBER: AS -BUILT DRAWING PARCEL INUMBER: I - OSP111311 051-11 54-25 NEW WELL— F i T15N, RIW, SEC 8, LOT 177 TENADA AVENUE \ \ \ \A0S \ 1 1 I I I NEW 15' X 80' BED NEW 1500 GALLON MT C04 \ \ // STEP TANK / / /04 NEW 4 M BED HOUSE I .T ST2MH MT C01GO / \\ CO3\, T�H. 2 1 1 RESERVE SITE 1 (REQUIRES ADVANCED TF I MIDNIGHTI SUN S/D LOT 2 I L / GARNESS ENGINEERING GROUP,, Ltd. CONSULTANTS $ GENERAL CONTRACTORS 3701 E NCOR R . SUDS 1D1 - MCKME, M 99W7 • PHONE (807)337-6198 * FM (609)S.ID-3246 * MY66DE: r .gnmmm6mmnn6.wm PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ` MIKE ANDERSON 727-1433 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: MIDNIGHT SUN S/D LOT 1 (T15N, R1W, SEC8, N2 OF LOT 192) PNB TYPE OF WORK: DATE: ASBUILT DRAWING 1 6/12/12 (Rev. 01/05) k H W A B FCO 16.74 37.78 ST1 64.88 51.05 ST2 72.00 58.43 MH 73.65 60.52 MT1 83.48 81.12 MT2 87.04 91.49 MT3 154.87 141.94 MT4 157,041147.83. C01 83.45 81.75 CO2 84.84 86.13 CO3 86.00 89.70 C04 151.97 139.63 C05 153.41 142.98 C06 153.74 144.73 I NEW 15' X 80' BED NEW 1500 GALLON MT C04 \ \ // STEP TANK / / /04 NEW 4 M BED HOUSE I .T ST2MH MT C01GO / \\ CO3\, T�H. 2 1 1 RESERVE SITE 1 (REQUIRES ADVANCED TF I MIDNIGHTI SUN S/D LOT 2 I L / GARNESS ENGINEERING GROUP,, Ltd. CONSULTANTS $ GENERAL CONTRACTORS 3701 E NCOR R . SUDS 1D1 - MCKME, M 99W7 • PHONE (807)337-6198 * FM (609)S.ID-3246 * MY66DE: r .gnmmm6mmnn6.wm PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ` MIKE ANDERSON 727-1433 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: MIDNIGHT SUN S/D LOT 1 (T15N, R1W, SEC8, N2 OF LOT 192) PNB TYPE OF WORK: DATE: ASBUILT DRAWING 1 6/12/12 (Rev. 01/05) k H W ; I M I I OW *w w I 1'r Om --------------- T&C MI) Wa"T M • ---------- IA AVENUE MMWAMMMWFR�� I is rj�4,k, PLOT PLAN AS OWLT _2L SCAjr I - w W OW Long & Associates A,inic. "NO Duty' Avanw. mobora". AkmL tam I "515-300 PERMIT NUMBER: AS -BUILT DRAWING PARCEL INUMBER: OSP111311 051-11 54-25 A 8 T15N, R1W, SEC 8, LOT 177 FCC' 14.86 45.40 ST1 21.59 49.51 ST2 26.10 52.74 -- -- MH 27.09 53.80 TENADA AVENUE MT1 112.79 89.20 MT2 133.99 107.13 \\ MT3 102.13 88.27 \\ MT4 123.28 106.00 \ C01 83.45 81.75 CO2 84.84 86.13 100 N+E`� \� CO3 86.00 1 89.70 I C04 151.97 139.63 NEW WELL ______L______ C05 153.41 142.98 I C06 153.74 144.73 I NEW 15' X 80' BED I NEW 1500 GALLON MT 04 �� ! STEP TANK / C00.15 NEW 4 I \\ .'.i':`•':T •': ;'+'; "''•�I BEDROOM HOUSE I /\\ STI ST2MH MTI \\\ COO / TH2 CO3 T2 11 IFCO / \ RESERVE AL � ��'�/ II (REQUIRES I TE ADVANCED TREATMEP I 700, MIDNIGHT, SUN S/D LOT 2 ! a oo�o 06 OF �a4 p0��. GARNESS ENGINEERING GROUP, Ltd, p, : 4 CONSULTANTS 8 GENERAL CONTRACTORS �....... .. ..... .......... 3)01 E N00R ROM. WM 101 r M HORME. M 90.W/ F W (907)3]7-81]9 • FM (907)339-3919 0. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ... MIKE ANDERSON 727-1433 2 OF 3 p f y G ness: LEGAL DESCRIPTION: DRAWN BY: Q ,�p. 1CE-7 m'G MIDNIGHT SUN S/D LOT 1 (T15N, R1W, SEC8, N2 OF LOT 192) PNB O4oe �O p TYPE OF WORK: DATE: D�Qd Pr4o\�� ASBUILT DRAWING 6/12/12 �04 00�0000 PERMIT NUMBER: ASBUILT DRAWING PARCEL INUMBER: — OSP111311 051-11 54-25 /rrFINAL GRADE = 98.75-99.81 ST1 I ST2 MH TOP OF TANK AT INLET = 93.05 (I NEW1500 GALLON INVERT OF BUNG S.T.E.P. TANK AT INLET = 92.43 10' BURIAL TANK INAL GRADE = 102.93+ P OF SAND = 98.08 — TOP OF TANK AT OUTLET = 93.06 FILTER FABRIC — ORIGINAL GRADE = 99.92 0 HIGHEST POINT ;T OF DISTRIBUTION UNE = 98.70 BOTTOM OF BED = 95.92 RELATIVE ELEVATION OF BOTTOM OF TESTHOLE RELATIVE ELEVATION OF BOTTOM OF TESTHOLE = 88.92 (GW ® 92.92) = 88.92 (GW ® 92.92) oo6�pp p 4 GARNESS ENGINEERINNG GROUP, Ltd. T CONSULTANTS & GENERAL CONTRACTORS ....... .. .. .. .............. 3701 E TUDOR 9 , SUM 101 • MCOp FU M 90.50] MOSS (907)33)-6179 • FM (907)336-3248 • NE9911E mw.9amewn900ear1n999m PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ....••• MIKE ANDERSON 727-1433 3 OF 3 OOnnP fr A. a ess: LEGAL DESCRIPTION: DRAWN BY: V09s E-7 •''� MIDNIGHT SUN S/D LOT 1 (T15N, R1W, SEC8, N2 OF LOT 192) PNB Q�fe 613 I. TYPE OF WORK: DATE 400d'Orofess.00�a� PROFILE ASBUILT DRAWING 6/12/12 O�ppoo�� n 13 2012 10:14RM 10, 2012 RISING SON ELECTRIC 907-622-6777 �— Rising Son Electric, Inc. 14916 Woodland Drive Eagle River, AK 99577 (907) 622-6777 night Sun Construction 1: Mike Anderson Assured Business Services, Inc. 1 Scenic View Drive horage, AK 99504 Lot 1 Midnight Sun Subdivision MIA 3-M 1e lift station at the above referenced address has been wired in accordance with EC and State/Local codes. you. c: file Hornbuckle, Owner trator License Number 1284 Contractor license Number 27285 pace 1 Jun 13 12 04:04p Sullivan Water Wells 907 688 2759 p.2 U _ WATER WELLS Dewane-Cmo rola1-Geogwnw r vhow 907bee-2759 www.ewavw.waren.ew.csm Well Log Permit Number: OSP 111311 Date oflssue Iffl= 1 Date Started: 4MM12 Date Completed: 413/2012 Property Description MIDNIGHT SUN Lot 1 Block NONE Parcel Identification Number. os1iwmoo Is well located at approved permit location? fx] Yes UNo Section: Town: Range: Property Owner Name & Address. MIDNIGHT SUN cousTRUCTioN 22750 MCMANUS OR. CHUGIAK, AK 99567 Borehole Data: Soil Type, Thickness & Water Strata Casing Stickup Overburden Silt Sand Gravel Silt Sand Gravel WIClay Hardpan Silt Sand Gravel W/Clay Silt Sand Gravel Water Sample Results: Arsenic: Nitrates Total Coliform Bacteria Other bacteria: +M Pump Intake Depth: feet Pump size: HP brand name Well disinfected open Completion? Yes Ll No Method of disinfection CHLORINE 50 PPM Comments: 3 GPM @ SW - 3GPM @ 6C. WATER IN SMALL SEAMS IN HARDPAN_ ug/l Depth Method of Drilling ^] air rotary n cable tool C01e Sulrnan From To Casing type: P.O. BOX 5T0ZTZ Chugiak, AK 99567 0 2 Wall thickness e-zs inches 2 4 Diameter 6 inches Total: 04 feet Limer type - 4 12 Diameter arches Depth: feet 12 19 Casing stick-up above ground: ^ 2 feet Static Water Levell top of casing) 13 feet i9 76 711 80 Pumping Level: feet after 80 84 1 -hours pumping — _gpm Recovery Bate 5 gpm Method of Testing: Air Well Intake Opening Type Open End f 1 Open hole Screened Start feet Stopped feet i _ Perforations Start feet Stopped feet Groot Type: Bentonite dry granular Volume: 50 Pounds Depth 44 Start o feet Stopped 44 feet Pump Intake Depth: feet Pump size: HP brand name Well disinfected open Completion? Yes Ll No Method of disinfection CHLORINE 50 PPM Comments: 3 GPM @ SW - 3GPM @ 6C. WATER IN SMALL SEAMS IN HARDPAN_ ug/l Well Driller: C01e Sulrnan mg/l Sullivan Wafer Wells colonies/100m], P.O. BOX 5T0ZTZ Chugiak, AK 99567 coV100tnL (907) 658-2759 Attention'. The property owner shag provide this log to DSD (onsite) and DNR within 30 days of completion- Jun 01 12 08:49a Sullivan Water Wells 907 688 2759 p.2 Development Services Department ^ Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Mark Begich Anchorage, AK 99507 Mayor www.munb2rcj/onsi'e (907)343-7904 Pump Installation Log �� 1 Well Drilling Permit Number: SW_U3 1\ Date of Issue: Parcel Identification Number: 051 �S`)60W a SarErr Legal Description Property Owner Name & Address: ftocvu-L9 Dr. Ir Pump Installation Date: Pump Intake Depth Below Top off Well Casing: 70 feet Pump Manufacturer's Name: &"45 Pump Model: 55?054 t �,1—L. Pump Size YO), hp Pith Adapter Burial Depth: feet Pitless Adapter Manufacturer's Name: Aaiox,5�vv-\, Pitiless Adapter Installer: Well Disinfected Upon Completion?I Yes ❑ No Method of Disinfection: Comments: Pump Installer Name: Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Y Municipality of Anchorage Community Development Department On -Site Water and Wastewater Program 4700 Elmore St • P.O. Box 19665D Anchorage, AK 99519-6650 • http:11www.muni.orglonsi1e • (907) 343-7904 Well Decommissioning Log Legal Address: Subdivision i V Block �'Lot� T-15 AU R >1. Section �_ Lot 9 On-site Water & Wastewater rogram certified contractor performing the well decommis /7sionin ///JJJ Name: f 1- 44 Cf o fo atm 45 JA r vA•t`t I Signature: Company: 51l1 �i - v Well decommissioning dateAwLk Avcx Method of decommissioning: AMC /15.55.060L1 a. ❑ b. ❑ c. Location: Use the space below to provide a drawing of the property showing the following items; r „� �0pO—Cs�o /,,r{—,n • North arrow +ll(,! Lam, 50 l%��^I^,�t J\ • Decommissioned well, rA1iEi t / r Tri l e +"� . Other water wells on the property, �� c • Two separate swblg-tie distances for each Well shown on the drawing, 1QQ�� ih -�o 6;�f ` kArk V! Note: The swing -lie distances shall be measured from either permanent structures or The properly corners.6m �m� b ems w� I CRTMT ^GEO. Bf PROCEEDNC FORWARD I \ REDUCTION WITH THIS INSTALLATION. THE. ENGINEER, \l ACTUAL SO.Fr.: 195 t WELL DPoOM AGREE. THA AND p �,,PROPERTY READ OYRIER AGREE THAT THEY µ 'M HAVE READ THESE SPEGFlGR MS AND ! `C� AGREE TO ACCEPT Tri- TERMS AND CON➢mOr+`5 OLLTLINED_ z � f CD MH PRO?' PROPOSED 100' RADIUS � i i T 4 - Tr+/3 3 PROPOSED f� - ADEVANCFJ' TaJ.-F+.7 f f I ROOM HOUSEI ! J—P=.C?JSED 150➢ GALW1 STEP 7ANK r � I ----J 1f6 1.25` Pv- LINE rFr; s;4- ORInCES SPA."ED AT 3' O.C. 5 HOLc'S SEER t REX=H. 1S HCS TOTAL /R/` 1` v40' I 31 12 09:54a Sullivan Water Wells 907 688 2759 p.1 GACommunity DevelopmemlDevelopment Services\Building SeletylOn Site Water and WastewatenFOrmslClient FormslWell Decorrmisioning form.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: OSP111311 Tax Code Number: 05115425000 Work Type: Septic Initial Permit Effective Dates: November 01, 2011 to October 31, 2012 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: T1 SN R1 W SEC 8 Site Legal Address: T15N R1 W SEC 8 LT 192 G:1257 Owner/Address: MIDNIGHT SUN CONSTRUCTION LLC 22750 MCMANUS DRIVE CHUGIAK AK 995675478 � -//-l2 C,-2;C'>� Site Mailing Address: 19735 OLD CRANBERRY DR, Chugiak Lot Size in Sq Ft: 108900 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy Y 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 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. n5k— �-5q— a5 Property owner(s) MIKE ANDERSON Day phone 727-1433 Mailing address 19735 OLD CRANBERRY DRIVE *CHUGIAK AK 99567 Site address 19735 OLD CRANBERRY DRIVE *CHUGIAK, AK 99567 Legal description (Sub'd, Block & Lot ) T15N, R1 W, SEC 8 LOT 192 Legal description (Township, Section & Range) (PROPOSED MIDNIGHT SUN S/D LOT 1) Lot Size Sq.Ft. Number of Bedrooms THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (Z all that apply) Initial Absorption Field ® ❑ Upgrade Septic Tank Renewal ❑ Holding Tank ❑ Privy ❑ Private Well � I4 Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) A100 Permit/Rush Fees: 536) Waiver Fees: y//✓;�z Date of Payment: /'Ola l Date of Payment: 02630% Receipt Number: 6I5 -5t G Receipt Number: Permit No. G5 V M3i\ Waiver No. (Rev. 01/11) GARNESS ENGINEERING GROUP, Lid. r _ ,,rte• CONSt1LTANTS & GENERAL CONTRACTORS � =:� October 24, 2011 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Proposed Initial Septic System for T15N, R1W, Sec 8, Lot 192 (Proposed Midnight Sun S/D, Lot 1) To whom it may concern: The referenced property is currently vacant. The owner is proposing to build a 4 bedroom house that will be served by a proposed private well and septic system. We are proposing to install a 1500 gallon STEP tank and a bed type drainfield. Attached are a site plan and a design drawing showing the proposed septic system. Two test holes were excavated on the property. The drainfield will be designed around the 30 foot radii of these test holes. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which show the soil classifications, groundwater monitoring, and the percolation test results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There are no surface water concerns. 4. TOPOGRAPHY: As can be seen on the attached design drawing there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. P.E., M.S. NOTE: Attached is a site plan drawing, a design drawing, two detail drawings, and two soil logs, which are all part of the design package for this septic system. (Contact G.E.G. Ltd. for 7 page construction specification letter.) 3701 E. Tudor Road, Suite 101 *Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com CPGP�� I T15N, RlW SEC 8, LOT 177 T15N, R1 W, SEC 6, LOT 176 / / / / \ TENADA AVENUE PROPOSED NEW \\WELL EXISTING WELL TO BE ABANDONED PER \ UPC AND A NEW WELL TO BE DRILLED. ------1--------- T15N, R1W, SEC 8, LOT 193 T15N, R1W, SEC 8, LOT 208 tJ / .1PC'P / APPX WELL \\ / LOCATION \ 1100' WELL RADIUS I I I 1 STANLEY LOT 2 T15N, Ri W, SEC 8, LOT 191 GARNESS ENGINEERING GROUP, Ltd. CONSULTANT'S & GENERAL CONTRACTORS+.:�=_ 5701 E. T100R RM. SME 101 x MCHORAOE, M 99507 * PHORE (901)33)-61n - FM (907)3M0 " • WE n. xxw.9an1e9fen91neeHn9.mm Q PREPARED FOR: PHONE NUMBER: PAGE NUMBER: MIKE ANDERSON 727-1433 1 OF 1 LEGAL DESCRIPTION: T15N R1W SEC 8 LOT 192 TYPE OF WORK: SITE PLAN PNB 10/18/11 WELL NO CONCERN I �O�VS v 1 V1FY \\ND° APPX WELL \ LOCATION GRENIER LOT 210 AL.{GI•f \ <z' ROPOSED / /T "' HO USE (PROPOSED LOT ,Y/ TN#2 <v> IUU ELL RADIUS � I I 7 iLLT- z' PROPOSED LOT 2 l_J CTIC !— AR J 0 T15N, R7W, SEC 8, LOT 209 / APPX WELL \\ / LOCATION \ 1100' WELL RADIUS I I I 1 STANLEY LOT 2 T15N, Ri W, SEC 8, LOT 191 GARNESS ENGINEERING GROUP, Ltd. CONSULTANT'S & GENERAL CONTRACTORS+.:�=_ 5701 E. T100R RM. SME 101 x MCHORAOE, M 99507 * PHORE (901)33)-61n - FM (907)3M0 " • WE n. xxw.9an1e9fen91neeHn9.mm Q PREPARED FOR: PHONE NUMBER: PAGE NUMBER: MIKE ANDERSON 727-1433 1 OF 1 LEGAL DESCRIPTION: T15N R1W SEC 8 LOT 192 TYPE OF WORK: SITE PLAN PNB 10/18/11 WELL NO CONCERN I �O�VS v 1 V1FY \\ND° APPX WELL \ LOCATION GRENIER LOT 210 NUMBER OF BEDROOMS: 4 GALLONS PER DAY (GPD): 600+ PERCOLATION RATE/S: <1 & 7.05 APPLICATION RATES: 0.7 & 0.5 PROPOSED APPLICATION RATES: 0.5 MINIMUM DRAINFIELD SOFT.: 1200 MAXIMUM DEPTH: 4 FEET WIDTH: 15 FEET LENGTH: 80 FEET M.O.A. APPROVED SAND FILTER: 2 FEET EFFECTIVE: 0.5 FEET REDUCTION FACTOR: N/A ACTUAL SQ.FT.: 1200 LETTER THAT PERTAINS TO THIS DESIGN. TO OBTAIN A COPY OF THE LETTER CONTACT GEG. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND 1pp 1 EXISTING WELL TO BE 1 ABANDONED PER UPC. o PROPOSED 4 BEDROOM HOUSE T15N, RIW, SEC 8, LOT 177 NOTE: THE CONTRACTOR SHALL HAVE THE NORTH & EAST LOT LINES, AND ALL WELL RADII FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. 50' BLM EASEMENT F- PROPOSED 15' X 68' BED . 21_ TENADA AVENUE NUMBER OF BEDROOMS: 4 GALLONS PER DAY (GPD): 600+ PERCOLATION RATE/S: <1 & 7.05 PROPOSED APPLICATION RATE: -3.0 MINIMUM DRAINFIELD SQ.FT.: 200 'ADVANCED TREATMENT MAXIMUM DEPTH: 4 FEET WIDTH: 15 FEET LENGTH: 15 FEET M.O.A. APPROVED SAND FILTER: 2 FEET EFFECTIVE: 0.5 FEET REDUCTION FACTOR: N/A ACTUAL SQ.FT.: 225 I MT CO CO PROPOSED 1500 GALLONO STEP TANK Atly2 8uriwl / MT v Y `RESERVE SITE (REQUIRES 2ADVANCED �TME ND RESERVE SITE COC`O TH S/ (REQUIRES ADVANCED TREATMEI CO \ PROPOSED LOT LINE PRO OSED LOT 1 'TSED LOT 2 1 G� wil GARNESS ENGINEERING GROUP, Ltd. p —:::�. ,•,,: .- `^ CONSULTANTS & GENERAL . T `.� 3701 E. WOOR ROPO. SURE 101 * <NCHOWE. PN 99507 •PHONE (907)331-8179 • fM (90))339—]2N • WE950E: xwx.9mnene„91nee,in9.cam (/ PREPARED FOR: PHONE NUMBER:PAGE NUMBER: ........ ••..... MIKE ANDERSON 727-1433 2 OF 2 OOn A J e A. Gar ss. LEGAL DESCRIPTION: DRAWN BY: yot0 CE— T15N, RiW, SEC 8, LOT 192 (PROPOSED LOT 1) PNB TYPE OF WORK: DATE: 044d professio�oo°o INITIAL SEPTIC DESIGN 10/18/11 ��O000�a GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS _... SOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: T15N, Riw, SEC 8, LOT 192 PERFORMED FOR: MIKE ANDERSON DATE: 2/22/1 DEPTH — _= ORGANIC (feet) —=-- TEST HOLE #1 1 ••� GP TO SP W/ SILT �••� (HARDPAN) 12 13 14 15 16 17 18 DATE READING CLOCK NET TIME TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 2/23/11 1 SM W/ 6.00" — 2 — <1 0.00" 6.00" 3 — — ROOTS SOIL CLASSIFICATIONS 4 — <1 2 6.00" 5 — — 6.00" — 6 — <1 I 6.00" w GW ORG 3 GP ML SM GM CL 4 GC OL N °o oao o SW MH 5 •��•• : SP CH SEE ATTACHED SM OH 6- SC SITE PLAN CP TO SP DEPTH TO °'•::�; GROUNDWATER DATE 8 !r s!.'' SEEP ® 8.5 2/22/11 ''�• 8' 2/25/11 ?••• g' $/2/11 •;;�� GP TO SP W/ SILT SCALE: 10. • • i I0 2 f 1" = 100' ••� GP TO SP W/ SILT �••� (HARDPAN) 12 13 14 15 16 17 18 DATE READING CLOCK NET TIME TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 2/23/11 1 — — 6.00" — 2 — <1 0.00" 6.00" 3 — — 6.00" — 4 — <1 0.00" 6.00" 5 — — 6.00" — 6 — <1 0.00" 6.00" 19�PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) I�JI TEST RUN BETWEEN 5 FT. AND 6 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: 0 YES ❑ NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: JODY MAUS COMMENTS: NO PERC PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS1 PE FORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 3 .13.411 GARNESS ENGINEERING GROUP, Ltd. -. CONSULTANTS & GENERAL CONTRACTORS * 7 101 E MOOR ft0.1D, 500E 101 • ANCHORAGE, N. 99507 • PHONE: (907)337-8179 • FM: (90])3]8-398 • 91E99f1E: gameece 9"werirg.com O 1 SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: T15N, R1W, SEC 8, LOT 192 Pe PERFORMED FOR: MIKE ANDERSON DATE: 2/22 11 (f et) ORGANIC TEST HOLE #2 1;I SM W/ 7 8 9 1 11 12 13 14 15- 16- 17- 18- 191 516171819 20 SOILS LOGGED GP TO SP SEEP ® 8' GP TO SP W/ SILT GP TO SP W/ SILT (HARDPAN) DEPTH TO GROUNDWATER DATE SEEP ® 8' 2/22/11 ROOTS 2/25/11 8' 3/2/11 -V 1412.411t 2 5:41 30 1.75" 4.25" 3 5:41 — 6.00" — 4 6:11 30 1.75" 4.25" GW . �ML — 6.00" — 6 SIMGMCL 30 IIIII1111 4.25" GCNHN • :' IIIIIIIIIMH I !SIR %//%CH II111!II11 OH villC�F�FSC 7 8 9 1 11 12 13 14 15- 16- 17- 18- 191 516171819 20 SOILS LOGGED GP TO SP SEEP ® 8' GP TO SP W/ SILT GP TO SP W/ SILT (HARDPAN) DEPTH TO GROUNDWATER DATE SEEP ® 8' 2/22/11 8' 2/25/11 8' 3/2/11 -V 1412.411t *'vtil.l ness. SEE ATTACHED SITE PLAN DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 2/23/11 1 5:11 — 6.00" — 2 5:41 30 1.75" 4.25" 3 5:41 — 6.00" — 4 6:11 30 1.75" 4.25" 5 6:11 — 6.00" — 6 6:41 30 1.75" 4.25" PERCOLATION RATE 7.05 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 3 FT. AND 4 FT. A FOUR HOUR PRESOAK WAS PERFORMED: 0 YES ❑ NO JODY MAUS PERCOLATION TEST PERFORMED BY: ROB CAMPBELL PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PEfjFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 31311, Parcel I.D. 051-154-68 APR 0 6 2016 iJ Municipality of Anchora On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description MIDNIGHT SUN; LOT 1 Expiration Date: Location (site address) 19775 Old Cranberry Dr. *Chugiak 99567 Current Property owner(s) Cheryl Lundy Day phone 618-406-4844 Mailing address Real Estate Agent Travis McGrann Day phone 907-406-0191 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 Well ❑ Public Water System ❑ WaiverNariance request for: N/A Received by: TYPE OF WASTEWATER DISPOSAL: Individual Holding Tank ❑ Community ❑ Public Sewer ❑ COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Date of Payment Receipt Number bfo��E v1 COSA u o:'� l (�' 1 ! D] Date: `i / _'1(6 Waiver Fee $ Date of Payment Receipt Number Waiver # N/A 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 Gayness Engineering Group, Ltd. (GEG) Phone (907) 337-6179 Address 3701 E. Tudor Road, Suite 101 Anchorage AK 99507-1259 Engineer's Printed Name Jeffrey A. Garness Date In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation.'Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic 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 conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the 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 alternative well or septic system can be installed on the property in the event either of the current systems fail. The content of this report is for the sole benefit of the person/party who retained GEG. Reliance upon the information provided in this report by any other person or party, including but not limited to subsequent property purchasers, is not authorized. In short, GEG disavows any legal duty to anyone other than the person/pany who paid for this report. 6. DSD SIGNATURE e2 System #1 Approved for 3 bedrooms System #2 Approved for bedrooms Q��CY OFq Disapproved �Q C Conditional approval for bedrooms, with the following stii ation9N-SITE WATER ANn m 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 ChecklistNitrate Advisory Septic System Advisory / Arsenic Advisory Well Flow Advisory Other COSA blue sheet 9-1-12.doc S 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: MIDNIGHT SUN; LOT 1 Parcel ID: 051-1.54-68 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N A Date completed 4/3/12 Sanitary seal (Y/N) YES Total depth 84 ft. Cased to 84 ft. Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 18+ in. FROM WELL LOG AT INSPECTION Date oftest 4/3/12 3/15/16 Static water level 13 ft. 19 ft. Well production 5 g.p.m. 5.7+ g,p:m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate NO mg./L. Collected by: GEG. Ltd. Arsenic: ND Ug./L. Date of sample: x/16/16 B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEP/STEEL Date installed 4/11-5/3/12 Tank size 1500 gal. Number of Compartments E Cleanouts (YIN) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) N3 High water alarm (Y/N) YES Date of pumping 3/24/2016 Pumper JR'S SEPTIC PUMPING C. ABSORPTION FIELD DATA BELOW EXISTING GRADE Date installed 4/11-5/3/12 Soil rating (g.p.d./ftlor bdr 0.5&0.7 System type BED Length BQ ft. Width 15 ft. Gravel below pipe 0.62 ft, Total depth *4.8+ ft. Eff. absorption area 1200 ft2 Monitoring tube YEj'�Depression over field NO Date of adequacy test —**,3/W/1 6 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 600 gal. New depth 0 in. Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 450 g.p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date – **2000 GALLON PRE–SOAK PERFORMED ON 3/14/16. 4ri�–Song �"a� od `1-ve Sdw E ' G) ` D. LIFT STATION *SECOND COMPARTMENT OF 1500 GALLON STEP TANK Date installed 4/11-5/3/12 Size in gallons *500 Manhole/Access (Y/N) YES "Pump on" level at 31 in. "Pump off' level at 31 in. High water alarm level at 36 in. Datum TOP OF MANHOLE Cycles tested 3 Meets alarm & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent Absorption field on lot 100'+ Public sewer main 75 + Sewer/septic serviceline25'+ On adjacent lots 100'+ Public sewer manhole/cleanout 100'+ Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation— 5'+ 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 i have deter�iff6d 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 Nam JEFFREY A. GARNESS Date 'A)to 1b (Rev. 11105) oo6�4p�� . DO`S r :..arness•- O CE— 53 �,.e � - rofessioreo� HOUSE MA&S SokLL-,11'�30, i-4211115 •il Long a ' !I • e�� R0919tOrOd Land t a s„ a ml Municipality of Anchorage ' Development Services Departm Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.ei.anchorage.ak.us (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 051-154—'> ('08 COSA# Q1SCrIa I�a(o23 1. GENERAL INFORMATION Expiration Date: Complete legal description ktIDNIGHT SUN S/D LOT 1 Location (site address) J17Z�,50LD CRANBERRY RD *CHUGIAK AK 99567 Current Property owner(s) IKE ANDERSON Day phone Mailing address Lending agency Mailing address Real Estate Agent Mailing address i`OLD CRANBERRY RD *CHUGIAK, AK 99567 q 776 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 Day phone Day phone 727-1433 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates maybe reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 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. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name Engineer's Comments: JEFFREY A. GARNESS, P.E. In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGATURE Approved for AL bedrooms. Disapproved. Phone 337-6179 Date 006o`�4p0 oa .x-00 -H OO . .J f e A. . ess. Q o E-753 up 2, f e s slor`�o Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Nitrate Advisory �`l p Other By > (Rev. 11/05) ON-SITE WATER AND WASTEWATER PROGRAM Original Certificate Date: 7-16-12,_ Municipality of Anchorage oa Development Services Department �= Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: MIDNIGHT SUN S/D LOT 1 A. WELL DATA Parcel I D: 051-15-4=60- Well 51-15-4=6S Well type PRIVATE If A. B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 4/3/2012 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 84 ft. Cased to 84 ft. Casing height (above ground) 24+ in. FROM WELL LOG AT INSPECTION Date of test 4/3/2012 NEW WELL Static water level 13 Well production 5 g.p.m, g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate NO mg./L. Collected by: GEG. Ltd Arsenic: ND ug./L. Date of sample: 6/5/12 B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEP/STEEL Date installed 4/11-5/3/2012 Tank size 1500 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES Date of pumping NEW C. ABSORPTION FIELD DATA Date installed 4/11-5/,3/2012 Soil rating (g.p.d./ft2or /bdrm)0.5&0.7 System type BED Length 80 ft. Width 15 ft. Gravel below pipe 0.62 ft. Total depth *4.85+ ft. Eff. absorption area 1200 ft2 Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test = in. Water added =gal. New depth =in. Elapsed Time: = min. Final fluid depth = in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date - D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off" level ' . High water alarm level Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankllift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ Animal containment areas 50'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole%leanout N/A Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION 1 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. y Gar ss; Engineer's Prited Name JEFFREY A. GARNESS o�49 CE -795 Date 7� z 112 j rj:Z 'foo COSA Fee S `G 7 Waiver Fee $ _ Date of PaymentDate of Payment Receipt Number (� $ �ntReceipt Number (Rev. 11105)