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HomeMy WebLinkAboutSOUTHPARK #2 BLK 3 LT 29Southpark Block 3 Lot #020-502-27 Ahs 201%11111 Inspection Report1-1-12.doc Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water and Wastewater Program 'I? I'M i 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP151221 PID Number: 020-502-27 ❑✓ New ❑ Upgrade Name: Hagmeier Homes ABSORPTION FIELD ❑✓ Deep Trench ❑ Shallow_ Trench ❑ Bed ❑ Mound Address 15750 Stanwood Cir. ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 5 - 1.2GPD/SF 13 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 4 Ft. Gravel depth beneath pipe 9Ft. Subdivision - Block . Lot Southpark #2 - 3 29 Fill added above original grade 0 Ft. Gravel length 45 Ft. Township Range Section - Gravel width 3.0Ft Beds: Number of Lines N/A- Distance between lines N/A Ft. SEPARATIONDISTANCES TO Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 810 Ft 1 N/A Ft. Well N/A N/A N/A N/A N/A TANK O Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 1,500Gal. - Surface water 100+ 100+ N/A N/A Material Number ofcompartments - - Lot Line 58.2 27.8 N/A NIA Steel 2 NA Foundation 5.8 25.4 N/A NIA LIFT STATION Manufacturer - Capacity Curtain Drain 50+ 50+ N/A N/A Gal. - Remarks — Pump on level at in. Pump off level at in. High water alarm at in. - Pump make and model Electrical Inspections performed by Installer. PIPE MATERIAL Housetotank 3034 Tankto drainfield 3034 John Hagmeier Homes, LLC Drainfield 3034 CO/MT 3034 Inspector Pannone Engineering Services LLC. BENCH MARK (Assumed elevation) 100ft Inspection1� 10/19/15 ^ 10/19/15 Location and description dates: 3,d 10/19/15 4'" - Finished Floor - COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL ` " Engineers Stamp , Conditional Approval: Date �,� A/',�'tl ,.• 4s ,.r�����,• '*: 49 7H ' k� even nnome CE 8149 Y A PProve Date ggpFES s ` Inspection Report1-1-12.doc 1� � I_ I � j 1 SEPTIC AREA(E) ' 5' i 1 28 1 • / SLOT UNDEVEL PED NO WELLS OR SLPTICS ,v t 59.7\ / T2 FC / C1 DC i T1 A � SBR M1 W -I HOUSE i i C1l ��b `v B 10.6 NEW PRIMARY/ RESERVE DRAIN FIELD } M,2 1 45LF x 2.5'W x 9.0'ED x 13.0'TD IIL C2 j/ Ca 4 WITH CLEAN OUT AND MONITOR - AT EACH END TH-1 1 J `� \\ 1500g SEPTIC TANK NEW E) \ \ WITH DCO &INTALLED FCO LOT29__��` \ \ \ \ \ — z SE \\\-- \ PTI AREA (E) \ NOTES: PANNONE ENG SVC, LLC , — ��� Da1e .FA 1 / RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 (� `�s'li 4 1s zols PHONE (907) 272-8218 FAX (907) 272-8211 %rj��49A �9�, Scale j *: / .... SOUTHPARK #2, BLOCK 3, LOT 29 % . % 020-502-27 JOHN HAGMEIER / HAGM EIER HOMES Steven R: an PERMIT N0. STAN WOOD CIRCLE �F'. CE 8149 �// OSP151221 I cs . .. �r PLAN ANCHORAGE, AK 99516 �1�l�F�HO�ESSIONP Sheet 2 OF 3 A B FC 8.9 T1 12.6 17.4 T2 21.6 22.4 DC- 24.2 - 24.3 C 1 53.9 58.2 M 1 55.5 59.0 C2 42.8 26.7 M2 40.7 24.9 1� � I_ I � j 1 SEPTIC AREA(E) ' 5' i 1 28 1 • / SLOT UNDEVEL PED NO WELLS OR SLPTICS ,v t 59.7\ / T2 FC / C1 DC i T1 A � SBR M1 W -I HOUSE i i C1l ��b `v B 10.6 NEW PRIMARY/ RESERVE DRAIN FIELD } M,2 1 45LF x 2.5'W x 9.0'ED x 13.0'TD IIL C2 j/ Ca 4 WITH CLEAN OUT AND MONITOR - AT EACH END TH-1 1 J `� \\ 1500g SEPTIC TANK NEW E) \ \ WITH DCO &INTALLED FCO LOT29__��` \ \ \ \ \ — z SE \\\-- \ PTI AREA (E) \ NOTES: PANNONE ENG SVC, LLC , — ��� Da1e .FA 1 / RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 (� `�s'li 4 1s zols PHONE (907) 272-8218 FAX (907) 272-8211 %rj��49A �9�, Scale j *: / .... SOUTHPARK #2, BLOCK 3, LOT 29 % . % 020-502-27 JOHN HAGMEIER / HAGM EIER HOMES Steven R: an PERMIT N0. STAN WOOD CIRCLE �F'. CE 8149 �// OSP151221 I cs . .. �r PLAN ANCHORAGE, AK 99516 �1�l�F�HO�ESSIONP Sheet 2 OF 3 1 28 1 • / SLOT UNDEVEL PED NO WELLS OR SLPTICS ,v t 59.7\ / T2 FC / C1 DC i T1 A � SBR M1 W -I HOUSE i i C1l ��b `v B 10.6 NEW PRIMARY/ RESERVE DRAIN FIELD } M,2 1 45LF x 2.5'W x 9.0'ED x 13.0'TD IIL C2 j/ Ca 4 WITH CLEAN OUT AND MONITOR - AT EACH END TH-1 1 J `� \\ 1500g SEPTIC TANK NEW E) \ \ WITH DCO &INTALLED FCO LOT29__��` \ \ \ \ \ — z SE \\\-- \ PTI AREA (E) \ NOTES: PANNONE ENG SVC, LLC , — ��� Da1e .FA 1 / RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 (� `�s'li 4 1s zols PHONE (907) 272-8218 FAX (907) 272-8211 %rj��49A �9�, Scale j *: / .... SOUTHPARK #2, BLOCK 3, LOT 29 % . % 020-502-27 JOHN HAGMEIER / HAGM EIER HOMES Steven R: an PERMIT N0. STAN WOOD CIRCLE �F'. CE 8149 �// OSP151221 I cs . .. �r PLAN ANCHORAGE, AK 99516 �1�l�F�HO�ESSIONP Sheet 2 OF 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF. ON—SITE WASTEWATER DISPOSAL SYSTEMS AND ATTACHED SPECIAL PROVISIONS. 2. SCOPE OF WORK: INSTALLED NEW 1500g STEEL TANK AND DOUBLE CLEAN OUT AND SOIL ABSORPTION SYSTEM. 3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH. OF 19 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. NO APPARENT WATER TABLE WAS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 19 FEET BELOW EXISTING. TH-1 -1.0 6.0 NO GROUND WATER -19.0 72.0 � t 0 0 o- o wo J J OJ U U p[J PE 901500g TANK 89.2 PROFILE DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 5 (750 gpd) TANK SIZE: 1500 GAL PERC RATE: 1 MPI SOIL RATING: 1.2 GPD/SF AREA ROD: 625 SF SYS, TYPE: DEEP TRENCH 9.0'ED MIN LENGTH: 34.7 LF USED: 45 LFx3.0'Wx9.O' E.D., 13.0' TD TOTAL AREA: 810 SF SECTION TRENCH SEE DESIGN LEGEND W WATER LINE/ WELL RADIUS SS NEW SEPTIC ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE N0, R.1. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL AND VEGETATE NIC NOT IN CONTRACT NOTES: PANNONE ENG SVC, LLC of`q-kk Date RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 r '(�•" "�qsl�o 4/18/2016 PHONE (907) 272-8218 FAX (907) 272-8211%g2`p �y�� Scale DRAWN BY: NTS NTS NJC P.I.D. NO POTTER HIGHLANDS PHASE I, BLOCK 1, LOT 1020-502-27 Steve JOHN HAGMEIER /HAGMEIER HOMES IT ann n PERMIT NO. GREECE CIR. (t 9cs. CE 8149 ��/ OSP 151221 DESIGN DETAILS ANCHORAGE, AK 99516 tt,l�FpAaFE5A0Np� r Sheet � 3 OF 3 Permit Number: OSP151221 Tax Code Number: 02050227000 Work Type: Septic Permit Effective Dates: July 29, 2015 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 Initial to July 28, 2016 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: SOUTHPARK #2 Site Legal Address: SOUTHPARK#2 BLK 3 LT 29 G:3236 Owner/Address: 7-3 FOXTROT LLC 704 228TH AVE NE #792 SAMMAMISH WA 980740000 Site Mailing Address: 15750 Stanwood CIR, Anchorage Lot Size in Sq Ft: 28000 Total Bedrooms: 5 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 By: ,~'/ Issued By: ,~ ,~ ..~? ~//,~/~f/.. / MUNICIPALITY OF ANCHORAGE Community Development Department '~.~.~/ Phone: 907-343-7904 Development Services Division ~ Fax: 907-343-7997 On-Site Water & Wastewater Program t UBMtTTA' · ON-SITE SEWER/WELL PERMIT APPLICATION~t"'~ [JUL 1 3 2015 - Gretchen Stuller Parcel I.D. 020-502-27 Property owner(s) 7-3 Foxtrot LLC Day phone Mailing address 704 228th Ave Ne #792, Sammamish, WA 98074 Site address NSN Stanwood Circle Legal description (Sub'd., Block & Lot) Southpark #2, Block 3, Lot 29 Legal description (Township, Rarige & SectiOn) Lot Size 28,000 .Sq. Ft. Number of Bedrooms.5 APPLICATION IS FOR: ([~ all that apply) Absorption Field [] Septic Tank [] Holding Tank - [] Privy '[] Private Well [] Water Storage [] APPLICATION IS AN: TYPE OF DWELLING: Initial [] Single Family (SF) (w/wo ADD) 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. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: '~'1~,.~ [ Receipt Number: ~ Permit No. /~,~ Waiver Fees: Date of Payment: Receipt Number: Waiver No. Permit App_2- :. :'.Cc; Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve ~ paneoaak.~.om July 27, 2015 Subject: Southpark #2, Block 3, Lot 29 Septic System Permit Request Design Narrative This is a design narrative for a permit to install a septic system to be issued for this property. The proposed systems will serve a proposed five (5) bedroom house. Currently the lot is undeveloped. The system will utilize a 1500g septic tank and conventional drain field. This lot and the surrounding lots are served by a class 'A' water system (PWSID#: 211091). There are no wells within 200' of the proposed septic system 1. Soils. One test hole was performed in the vicinity of this system by Pannone Engineering Services in June of 20:15, and groundwater was monitored for at least seven days. Ground water was not observed to a depth of 19' below the surface in the test hole monitor tube in July of 2015. Bedrock was not encountered in the test hole. Based on the results of the percolation tests and overall soils appearance; an application rate of 1.2 gallons/day/square was used for a conventional wastewater system in the area of these test holes. Soil Absorption System Design. a. See Sheet 1of the design package. 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The existing topography slopes from the east to the west at approximately 20%-25% in the area of the septic system. There are no steep slopes within 50' of the proposed drain field. The proposed drain field will maintain 50' separation all steep slopes. 5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written-notification that the review is complete and that there are no further comments is received from MoA On-Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the futu~edevelopment of th is or the surrounding lots. Mailing: P.O. Box ~002~7, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 SPECIAL PROVISIONS 1-O SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALTY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATER ALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS. 2. SCOPE OF WORK: INSTALL NEW 1500g SEPTIC TANK AND SOIL ABSORPTION SYSTEM. 5. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 19 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE, IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 19 FEET BELOW EXIST NG GRADE NOTIFY THE ENGINEER IMblEDIATELY. "X ~-x~'l~ 'R ..... [ \ / i r -LOT UNDE~VEL©PED / ', a~ibx EX~L~, ~ ~ I . NOWELLS OSSEPTCS ,// , ', ~x,~ ~. ~ .' ', , ,~ . : 5~w w~ . ,, , . , . , PRIMARY/ RESERVE DRAIN FIELD (~9 ~ ~ ~/, / / / '. *SLF ~ 2.s'w ~ 90'ED ~ ~S.~ x ... , ~ '. .~ / / ~ WITH CLEAN OUT ANO MONITOR TUBE ' x ', [ / 735 / / I A~C,Z~ LOT297. - " WITH DOUBLE CLEAN OUT~-~ , / ', '. INSTALL FOUNDATON CLEAN OUT , ' ,' ' .,.. '., .. ~,.,. .__ ~ ~>~ / .... . -_ ., ,, ~ --_ ~ t~-~ --_ -.. ~. ~, '.. -. -... , DESIGN 'PARAMETERS ~E~',~T -,,./ '~ ~ '-.., ~, NO. BEDROOM: 5 (750 gpd) t ~ ' ' -,2~ ' , - . TANK S ZE: 15009 ~ / ~ '. 'x, R ~,. '. ~E~C~A~ ,~ -' ~ ~ ' SOILRAT~Nm ~.2 GPD/SZ ~ ~ ~ ,' "' "" '~ W ~BBREVIAT ONS AREA ROD: 625 SF ~ ~ ~ / ', -. '-~ SYS.~PE: DEER TRENCH 90'ED / ~ * ' '~ ,(P) PROPOSED "MIN LENGTH: 34.7 LF /~ ~ ~ ~- / ~ _ (E) EXISTING -USE: . ., CO CLEAN OUT NO. 4~ LFxYWx9 O' E.D., 13.0' TD / ,., '%MT MONITOR TUBE NO. TOTGL ARE~: 810 SF / TYP TYP GAL ' No~s.' p~o~ ENG ~C, LLC FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 ~,~.' SOUr~PA~ ~2, ~OC~ 3, kO7 29 o2o-so2-27 JOHN HAOMEIER / HAOMEIER HOMES ~- CE 81~9 .~ ~RUITNO. STANWOOD CIRCLE PLAN ANCHORAGE, AK 99516 Shee( SOILS LOG - PERCOLATION TEST TEST HOLE 1 14 -- ENCOUNTERED? ~N DEPTH? -DRY X ·est .~ for ~t least o~e bout. LAst 3 readings reposed. ENG LLC PHONE (907) 272-8218 FAX (907) 272-8211 ~g~ PID NO SOUTHPARK fi2, BLOCK 3, LOT 29 . ~~ n~0-502-27 JOHN HAGMEIER / HAGMEIER HOMES ' ' N NO ~1~', CE 8149 .'~ PERMIT STANWOOD CIRCLE ~.~.. .~ 0SP151221 SO[LS LOG ANCHORAGE, AK 99516 'l~s~ Sheet WATER CLOCK NET TIME LEVEL NET DROP READING DATE TIME READING 1 6/24/15 10:18 ... 5.55 ... 2 10:23:48 5.8 MIN 11.55 6.00 3 10:24 ... 5.55 .- 4 10:29:42 5.7 MIN 11.55 6.00 5 10:30 ... 5.55 ... 6 10:36 6.00 MIN 11.55 6,00 F N 14X X698970 tx �7 c ® Municipality of Anch®ra . RUSH! On -Site Water and Wastewater Progra z (907) 343-7904 a APR 1 5 2016 �6 eLJ.�� ti Certificate of On -Site Systems Appr2 s ` _ B L 'v ®®®Parcel I.D. 020-502-27 Expiration Date: -1 q- 1. GENERAL INFORMATION Complete legal description Southpark #2, Block 3, Lot 29 Location (site address) 15750 Standwood Cir. Current Property owner(s) Hagmeier Homes Day phone Mailing address 2204 Cleveland Ave. Suite #201 Anchorage, AK 99517 Real Estate Agent 2. TYPE OF DWELLING: Fx_1 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual F-1 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System El Public Sewer ❑ WaiverNariance request for: Received by:/ Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee O tL 9—`t iylib 1 ` Waiver Fee $ Date of Paymentl'lffS�l� Date of Payment Receipt Number iDW—t 3 7 Receipt Number COSA # oSU,b ! iZ� 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The repoked results describe 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 soil condition, ground water levels that may fluctuate during the year, and the water usage.pf the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is -for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 4/15/2016 6. DSD SIGNATURE j System #1 Approved for bedrooms d tSteven R.•Poririorie:' A, CE -8149 System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: Original Certificate Date: 7 -fes -1 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSAbluesheet r - If more than 1 septic system is on the lot: COSA Checklist # + of Structure served by this system I Certificate of On -Site -Systems Approval Checklist Legal Description: Southpark #2, Block 3, Lot 29 A. WELL DATA Parcel ID: 020-502-27 Well type Public If A, B, or Cprovide PWSID # AWWU Well Log (Y/N)-- Date completed Sanitary seal (YIN) _ Wires properly protected (YIN) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m. g.p-m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA - Tank Type/Material Septic/Steel Date installed 10/19/2015 Tank size 1,500 gal Number of Compartments 2 Cleanouts (YIN) Y Foundation deanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumpingNew Pumper NIA C. ABSORPTION FIELD DATA Date installed 10/19/2015 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 GPD/SF System type DeepTrench Length 453 Width 3 ft. Gravel below pipe 9 ft. Total depth 13 ft. _: Eff. absorption area 810 fl? Monitoring tube Y Depression over field N Date of adequacy test' New Results (Pass/Fail) PASS For 5 bedrooms Fluid depth in absorption field before test New in., , Water added New gal. New depth New in. Elapsed Time: New min. Final fluid depth New in. Absorption rate >= 750+ g,p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date .I D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Holding tank Animal containment areas Manure/animal excrete storage areas 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 200+ 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 50+ Wells on adjacent lots -200+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that i have determined through field inspecfions.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 Steven Pannone Date 4/15/2016 COSA canary sheet_2-6-15.doc I.s . CE -8145 ■ 111=30' PLAT NO. 83-213 SOUTHPARK SUBDIVISION, ADDN. NO. 2 LOT 29, BLOCK 3 28,1)00 S.F. GASTALDI LAND SURVEYING, LLC JEFF A. GASTALDI, R.L.S. 2000 E. DOWLING RD., SUITE 8 ANCHORAGE, ALASKA 99507 PHONE 248-5454 GRID SW3236 16-01 DATE 4/14/2016 JOB NO. SWP293 I HEREBY CERTIFY THAT 1 HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT, ALASKA NOTE= NO CORNERS SET THIS DATE I e,�� OF A4 19 i * 497.E . * now". w :Jeffery; Gastaldi o` . �:• 6091 a� ANWOOD ,IRCLE