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HomeMy WebLinkAboutJUHNKE LT 1JUHNKE Lot 1 #051-171-33 Municipality of Anchoragee'°' a`' Development Services Department Building Safety Division %• On -Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.cLanchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW040423 PID Number: 051-171-33 Name: Dorothy P Hanson Wastewater System: ❑ New ® Upgrade Address, ABSORPTION FIELD 19426 it L k 7 Phone: Number of Bedrooms: ®Deep Trench 0 Shallow Trench [3 sod ❑Mound D Other: LEGAL DESCRIPTION Boll Rating: Total Depth from original grade: 0.6 GPD/Fe 11.0 F[. Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: 1 Juhnke 4.98 Ft. 6.02 Ft. Township: Range: Section: _ Fill added above anginal grade: Gravel Length: 0.58'2.08 var. Ft. 126 Ft. [:1New El upgrade Gravel width: Numberof lines: Di%tancebetween lines: Well: 3.0 Ft. 2 12 Ft. Classification (Private, A, B. C): Total Depth: Cased to:Total absorption area: Pipe Material: Class C Ft. Ft. 1500 Fe D3034 & F810 Driller: Date Drilled: Static Water Level: Installer: Date Installed: RPC 10/18/04 Ft. Yield: Pump Set aCCasing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding Public/Private anuacturer:a From' --,Tank Field Station Tank Sewer Line Anchorage Tank 2000 Gal. Well 100'+ 100'+ NA NA 25'+ Material: Steel of Compartments:pacity: Number 1 2 Surface Water 100'+ 1001+ NA NA LIFT STATION Let Line 5'+ 10'+ NA NA a,e: Manufacturer. Gal. 5'+ 10'+ NA NA "Pump on" level at: "Pump ofr level at: High water alarm at: Foundation in. in. in. NA *50'+ NA NA Pump Make & Model Electrical Inspections performed by: Curtain Drain Remarks: BENCH MARK *none known " Location and Description: Diverter installed Bottom of siding (garage) Assumed Elevation: 100 Ft. Engineers stamp ,tee OF AC '1 s Inspections performed by: KND Engineering, Inc.Dates: 1 Bt 10/18/04 of- yr` 9TH '; h , 2nd 7 Development Services Department A proval ...... .. .....�.... Kenneth k fii CE 7 7 .• _� Reviewed and approved by: Date: �% - ° •9 oe �FF••e! �y `5.•'" •••..N.• (Rcv. 12/00)® li Fp ®ROFESS\� ©.0 Re] A—C=29.4" B—C=57.1' A—D=34.9' B—D=62.0' A—E=44.6' B—E=70.7' A—F=30.9' B—F=44.0' AS—BUILT SYSTEM DETAILS/SITE PLAN Permit# SWo40423 JUHNKE LOT 1 PID# 051-171-33 x SEPTIC 3' ROW Es OF AL / * 9 TH� RES %P CE— A: FEss1G�� TH- EXISTING 2000 GAL TANK ZABEL SPLITTER Kol FINISHED GRADE nm rAwe � SEWER ROCK FINISHED GRADE rvmr rewc � PREPARED FOR: TONY VARGO 1801 E. DOWLING RD. ANCHORAGE, AK 99507 227-5593 FIELD BOOKS COMPUTED: BOUNDARY: DRANK: STAWNG CHECKED: AsBUaT: MARTIN DATE: DWG. FILE: GRID: ASB.DWG SEWER ROCK 04077 SYSTEM 150' RAD absorbtlon bed) TH04-1 Scale: SCALE: NTS TW ID ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 KND ENGINEERING, INC. 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 Kenneth M CE 71 SOILS PERCOLATION TEST Performed for: TOnyVargo Date Performed: 10/19/dT�'� Project: 1uhnke Lot 1 TEST HOLE # 04-1 Depth (Feet) SEE ATTACHED SITE PLAN 1- Org/OL FOR HOLE LOCATION 2- Date 3 - Net Time Depth to Water GM 4- 10/19/04 5- PERC AT CONSTRUCTION 6 - - 2 Materials consistent along 7- trench. 8- 23/16" 9- 10- 11- - 12- 13- 30 min 14- 2" 15- 16- 17- - 18- 19 - 30 min 315/16" HOLE PRESOAKED 20- PRIOR TO TEST SLOPE <5% Was Ground water encountered? NO What depth? NA Depth to water after monitoring? NA Date? Reading Date Gross Time Net Time Depth to Water Net Drop 1 10/19/04 1:00 6" - 2 1:30 30 min 313/16" 23/16" 3 1:31 6" - 4 2:01 30 min 4" 2" 5 2:02 6" - 6 2:32 30 min 315/16" 21/16" Water Added Percolation Rate 14.55 (min/in) Perc Hole Diameter 6" Test Run Between 5 feet and 6 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. o � 70��l O c° N 2000 ° GAL TANK° 1,50' RAD 7"7 r—, EL DIVERTED/ FLAG V ZABEL SPLITTER-- PRIOR TO 7-12% co CONNECT MT N SDP <s��n', EXISTING MT � �O co S E PTI C PROP D PRIMA Y SYSTEM 1 155.21 150' RAD rn !: 30 Td WUF2 :bO £00Z ST -add : 'ON XUJ : WOJd K V D ENGINEERING, INC. 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 October 25, 2004 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Sewer Upgrade — Juhnke Lot 1 Gentlemen: Attached are the documents of construction of the existing failed system approved by ADEC and the newly constructed upgrade approved by the MOA. The existing ADEC documented system was not abandoned. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, IKHID Engineering, Inc. l Kenneth M. u s E. Attachments: MOA Inspection Report HAA ADEC Documents of Construction Water Analysis As -Built Survey MUNICIPALITY OFANCHOR4GE l� Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Oct 08, 2004 Expiration Date: Oct 08, 2005 Permit Number: SW040423 Parcel ID: 051-171-33 Legal Description;"'JMRKE'LT:-"1 Design Engineer: 0070 KND Engineering Site Address: 019426 BIRCHWOOD LOOP RD Owner Name: DOROTHY P. HANSON Lot Size: 52491 SQ. FT. Owner Address: 19426 S BIRCHWOOD LOOP ROAD Total Bedrooms: 6 Permit Bedrooms: 6 CHUGIAK , AK 99567 - This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. lcll/ 104- ORrn.Y(/cn�)9)Ck/[cFD / %12,v i/c6- r9 r,r,e'144, S tp' rR✓'eaAicw�A< TO Af'PI2�vl !% Pe Sid Al /A(�rct�l;✓c Tr9 au/SS u�✓Jr,Cu.K✓ +TF_O C/�/!j G5 -7L7' FL i r QRFA-; Sd syaPL,o vb r er-16- 14 %'R0OLI�" Received By: Issued Date: Date: o 0 a Municipality of Anchorage Development Services DepartmentR Building Safety Division g On -Site Water and Wastewater Program 4700 South Bragaw St. s., c"'' P.O. Box 196650 Anchorage, AK 99519-6650 e www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR^^��A SINGLE FAMILY DWELLING Parcel l.D.JrI-1�—J3 Permit Number SW __...,_ Property ownerx+.. s) �—moo f+Aalipg address J Day phone Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) _luhnke Lot 1 Legal description (Section, Township & Range) Lot Size 01 4611 Acres/Sq.Ft. Number of Bedrooms 6 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only El Sewer and Well ❑ Water Storage Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi Swimming Pool ❑ Water Softening Unit Therapy Pool ❑ 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. property owner or.authorized agent) Permit Fees: $9/(/0 j" Date of Payment: /19 Receipt Number: (Rev. 12100) Waiver Fees: Date of Payment: Receipt Number: KND ENGINEERING, INC. 20441 PTARMIGAN BLVD. October 6, 2004 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Sewer Upgrade — Juhnke Lot 1 Gentlemen: The owner has requested we proceed forward to obtain a septic permit to upgrade and replace the existing undocumented septic system and tank for the subject lot. The existing septic tank encroaches into the 150' class C well radius and will be abandoned in accordance with municipal standards. In the fall of 2004, Brent Eaton, PE performed one test hole for the proposed system and subsequently we conducted the percolation test and ground water monitoring on October, 4, 2004. The results of this test are attached. The general slope of this lot is from west to east at a grade of approximately 5-127o. We have designed our system utilizing the testhole that was excavated for the 6 - bedroom house. The lot is served by an individual well. We propose to install two deep trenches. Water was not encountered during monitoring. There are no public or private wells within 200' of our proposed system location except as noted. There is no surface water within 100' of the proposed system and there are no known curtain drains within 50'. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111 /FAX 696-8111. Respectfully submitted, IKHID Engineering, Inc. Kenneth M. of E. Attachments: On -Site Well and Sewer Application Wastewater Absorption System Details/ Site Plan Soils Log/ Percolation Test Owner/ Contractor Specs WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLAN JUHNKE LOT 1 68-102 S89'49'38'E 9.9J 75-90 33 1 125.00 174.97 30 J �O1 10' Wil E.t 0 125.00 N O O j M m EXISTING 8 102i (6� Oo CLASS WELL 00 M m 901 2 % J m 11y E Mt a� m x om M\ J N I N M M I n 3 .■ I ►V•■■■NVIIIII oro SEPTIC 'µ �e Ui Z a.a r° ABANDON EUNDOCG � � SEPTIC 'O 125.00 3' 155.2 ,P 2 YyO .tee:�,� pat m� 329.fiZ30 330.03 75-90) 74 Q D 89'S8'42"W I{� I Ve 33' Patent R.O.W. Ras M Vol 155 Pg 27 33 O 0 I v O b o EXISTING 6 mCLASS C WELL" DESIGN DETAILS 6 BDRM X 150 GPD = 900 GPD 900 GPD/0.6 GPD PER SQ. FT. (21 MIN/IN.)= 1500 SQ. FT 1500/2X6' GRAVEL = 125 FT. TRENCH USE 2 TRENCHES — 63'(L) X 3'(W) X 6'(D) PPUeLC WELLSWTHIN 200 OF Total depth of system is 11' from original grade. SYSTEM. PROOSENO PRIVATE WELLS WITHIN 200' OF Total depth of gravel below distribution pipe is 2'. PROPOSED SYSTEM SYSTEMSW111IN 0'F NOTES: PROPOSED WELL EXCEPT As NOTED. 1. USE 2000 GALLON SEPTIC TANK. INSULATE TANK IF <4' COVER. 2. INSULATE TRENCHES WITH 2" HD BURIAL FOAM. 3. CONTRACTOR WILL ENSURE MAXIMUM 2% SLOPE INTO SEPTIC TANK. 4. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT WELLS & SEPTICS, ESMTS, PROPERTY LINES, WATER LINES, ETC. ldw��, OF Aq t PREPARED FOR: TONY VARGO 9 1801 E. DOWLING RD. Scale: 1"= 100' * 9 LH* AK 99507 227H5593E, / PAGE 1 OF 2 KE' S FIELD BOOKS COMPUTED: 71 ID ENGINEERING CE-711 a BOUNDARY. DRAWN: wAc STAKING: CNECIKED: KMD 20441 PTARMIGAN BLVD. AssuILT °A E EAGLE RIVER, AK 99577-8736 `OhbFESSI0T1= SEWARD to-07-04 ..... DW'3. FILE: GRID: NW1155 Ff :: :. � :. ACAD FlLE: JOB No.: 04077.DWG 04077 (907)696-6111/pg 907 696-8111 WASTEWATER DISPOSAL SYSTEM DETAILS JUHNKE LOT 1 Act0 0 / 2000 ` 150' RAD GAL TANK ^�y 0 0 o. KND ,90 CO —CO CCM LU T MT U) V) } FLAG WELL RA S Q PRIOR TO CONST UCTION (T 7 -12%b. BAN - a EXI 0 -EATON U Lunj a SE M aa. M 15 5.21 Mt m t Co CO ZABLE SPLITTER 90 degrees to midpoint of field 150' RAD PF Air�� `��QS , PREPARED FOR: TONY VARGO 1601 E., G RD. SCOI2: ��= 20' * TH * A ANCHORAGE, AK 99507 / 227-5593 PAGE 2 OF 2 KE o —� CE- / FIELD BOOKS COMPUTED: I�{p�}5I^�\5I1� �\.' ENGINEERING IE LYS V BOUNDARY: DRAWN: WAC �4. / 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 sTAKiNc �EED KMD ABBUILT:SEWARD DALE 10-07—04 DWG. FILE: GRID: NW1155 ACAD FILE04077.DWG JOB NI.: 04077 (907)696-6111/FAX (907)696-8111 Municipality of Anchorage Development Services Department Building Safety Division y,4 On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Soils Iils Log -,^Percolation Test Performed For:. o1�--F/!'t �A+-J�SCW Date Performed: 1' Legal Description: W I 1 C? Uaktil W e5;IU8. Township, Range, Section: � 7 4- 15-1 n 1 16- 1 ENCOUNTERED? J0._ID S IF YES, AT WHAT DEPTH? L Depth to Water After 7- 78- Monitoring? E 8- 3 9- , 10- 11-)" 12- 2-13-14- 13- 14- 15- 16- 1 7- oorrMV�_ oto 18- -jY v'r 4"L6 19- I% 20 - COMMENTS WAS GROUND WATER t ENCOUNTERED? J0._ID S IF YES, AT WHAT DEPTH? L Depth to Water After o Monitoring? E Date: 000000�0�4 ��• �F'q � ;95;40 ' BRENT . EATON CE -9126 �p�oaRpoo"�'oNPo`o`�� Reading I Date I Gross Time I Net Time I Depth to Water I Net Drop PERCOLATION RATE (minutesfinch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT PERFORMED BY: I �N, I I/�'t'1 VA1 CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ONTHIS DATE. DATE: 10 -C3-C4 Performed for: Tony Vargo Date Performed: 10/04/04' Project: Juhnke Lot 1 TEST HOLE # Eaton Depth (Feet) SEE ATTACHED SITE PLAN / 3 - SM --PERC BENCH 4- i 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20 - FOR HOLE LOCATION Was Ground water encountered? NO What depth? NA Depth to water after monitoring? DRY Date? 10/04/04 Reading Or At q"�1 KND V•,IL� ENGINEERING, INC. �i* , 1 L 20441 PTARMIGAN BLVD. ••• ••• ••_ •••• EAGLE RIVER, AK 99577-8736 ys',•,••• :'c °• 2 Kenneth A4 tJ , • �• _. .... ,.. .. ___.. .. ���c�P•S CE 7iI a SOILS PERCOLATION TEST f1:�F� �_ ..• _„Q�`�� Performed for: Tony Vargo Date Performed: 10/04/04' Project: Juhnke Lot 1 TEST HOLE # Eaton Depth (Feet) SEE ATTACHED SITE PLAN / 3 - SM --PERC BENCH 4- i 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20 - FOR HOLE LOCATION Was Ground water encountered? NO What depth? NA Depth to water after monitoring? DRY Date? 10/04/04 Reading Date Gross Time Net Time Depth to Water Net Drop 1 10/4/04 1:00 6” 2 1:30 30 min 45/16" 111/16" 3 * 1:31 6- 4 2:01 30 min 48/16" 18/16- 5 3:02 6" - 6 2:32 30 min 49/16" 17/16" * Water Added Percolation Rate 20.86 (min/in) Perc Hole Diameter 6" Test Run Between 4 feet and 5 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. KND ENGINEERING, INC. 20441 PTARMIGAN BLVD. ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES AND MATERIAL SPECIFICATIONS LEGAL DESCRIPTION: Juhnke Lot 1 GENERAL: 1. The scope of this project includes the installation of a septic tank and/or drainfield to serve a single-family residence on the referenced property as delineated on the attached Municipality of Anchorage (MOA) permit and site plan. 2. Construction shall be in accordance with the approved site plan and design drawings; MOA permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. KND Engineering, Inc (KND) assumes no responsibility of the accuracy of the as -built survey provided by the owner or owner's representative. 4. The owner or contractor is responsible to notify the engineer of any discrepancies noted on the design plans or drawings prior to commencing work. These discrepancies could be, but not limited to, possible encroachments, surface water, varying soils, unplatted easements, types or use of dwellings on or adjacent to property, nearby public wells, etc. 5. The contractor shall be responsible for locating any necessary underground utilities, easements, property lines and surface water. The owner and/or contractor shall ensure, if deemed appropriate, that a registered land surveyor prior to construction flags all setbacks. 6. The contractor shall be responsible for verifying all pertinent separation distances and component layout. 7. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. 8. The MOA Development Services Department On -Site Water & Wastewater Program must certify contractors installing wastewater disposal systems. Owners installing their own systems must also receive prior approval from said MOA Department. SEPTIC TANK / HOLDING TANK / LIFT STATION INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded with proper material and compacting to prevent damaging, settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above the final grade. 4. Septic tanks installed with less than 4 foot of cover shall be insulated. The contractor will ensure that the fill over the tank does not exceed the burial depth rating. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 feet from the tank. The second cleanout, in line, shall be to clean toward the septic tank: 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. Po 1 ..£ 1 Reference: Iuhnke Lot 1 Date: 10/04/04 Page: 2 of 3 7. All H.D.P.E. tanks shall have a vertical length of 4 -inch perforated drainpipe besides the tank extending to the bottom of the tank to above grade to monitor ground water. 8. All tanks shall be anchored when there is not enough adequate soil cover to resist buoyancy forces in high -groundwater areas. 9. All holding tanks and lift stations shall have an audible and visual alarm inside the residence. 10. All lift stations shall be wired incompliance with the Uniform Electrical Code and all MOA guidelines. 11. The contractor shall remove the old tank, or abandon it in compliance with the Uniform Plumbing Code. The contractor is solely responsible for the abandonment procedure. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavaction become smeared, they must be raked or scratched (roughed -up) before gravel (sewer rock) placement. 2. Once the sewer rock is installed, the distribution pipe is installed level with the perforations facing downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitoring tubes shall be four- (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. 5. Backfill over the final gravel layer must not be less than twenty-four inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. 6. All advanced technology waste water disposal systems (Advantex, Biocycle, Intermittent Dosing Sand Filter, etc...) shall be constructed, installed, maintained and monitored per manufacturer's specifications and MOA requirements. MINIMUM MATERIAL SPECIFICATIONS: 1. A MOA approved septic tank manufacturer must construct any septic tank proposed for installation. 2. The following pipe materials are MOA approved for use in septic system installations: Type of Pike Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. If deemed necessary, a sieve analysis should be performed. 7. When sand is being used as a filter material, its gradation specification must conform to current MOA or DEC requirements. Reference: Juhnke Lot 1 Date: 10/04/04 Page: 3 of 3 INSPECTIONS: Typically there will be three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the sewer rock, distribution lines, standpipes, and cleanouts, but before the placement of the silt barrier, insulation, or any other backfill 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required, especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. The inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractor's activities. The owner shall contract with the contractor to perform the work outlined in these specifications and attached plans and in accordance with the attached MOA permit. All materials, components, and construction practices shall comply with the MOA's and the State of Alaska's latest ordinances, regulations, or policies regarding wells and septic systems. The failure of the inspecting engineer to notice a material or construction non-compliance does not relieve the contractor of his/her responsibility to correct such deficiency. There will be no contractual arrangement existing between the contractor and KND Engineering, Inc. KND shall be the owner's representative and will inspect the work as stated above to document the contractor's activities. Final acceptance of the contractor's work rests with the owner and the MOA. KND shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. KND's inspecting engineer will not be responsible for the construction means, methods, and techniques, sequence, procedures or the safety precautions incident to this project. BY PROCEEDING FORWARD WITH THE INSTALLATION OF THE WATER AND/OR WASTEWATER SYSTEM (S), THE PROPERTY OWNER, CONTRACTOR, AND WELL DRILLER ACKNOWLEDGES HAVING READ AND ACCEPTED THESE SPECIFICATIONS. FROM :KND FAX NO. :8693793 Oct. 27 2004 08:45AM PS SO Rb... DEC DW&WW o7%a0/ad, abe2b F ,Z, JUI•I��YG—F 9' R FAAEAGLE WE 15:15'9. Mcd'-L IFl7oGK L+--�R N{ sNEY Lou Hulls, P,9, Jnae 19, 1999 Mr. Afixv_Lewia, P.E. Dept. of dnviY'oamentai Cnxtcarvation 3601 0 Streeett, suite 1114 Anchora9 r Rx: bat 1 luhnke Chugiak, AU - Rear Mr • LVWis, 0r uahaXf Of our O'Sont Mra• 'gle"st. for apy ave.1 at Wastewater il Dorothy Hansen we are M%mittinq a system ecnstvuotion tar a 6 bedroom duplex dwel PR, The existing well 6Dd tatt3t wexe g. The��ioipaX"? atithat�ti e the HunicSFaiity for a duplax dwofldwe We are therefore asking bad jurisdiction for this tyK+a of avaailsaq, for 3esPprovs of tie Tne',�ttdthadaa installed' existing stic� Pa erwcrX descries tbs existing seto ptiosyam"O allatlom racardo And prSor aPPraval9• t 11at� as The 6,ti,c *ywtet,.dee V— per"1eas4.0• installer" Soil tdi4- If you hnVe ar►y sincerely, Louie suterar P•x KM oort.j O R -o D Jbe,�.�- W A-, n-5 is a bea type system to on Ind a Jel,ines, Attach0d are ®peoificat lgns and ao concerns please call me at e9 ;.1"' 90 'd 9SUDEL06 'ON XHi 9NId008 d008d Nld8 WH 81:60 3RI, b00d-ZI-100 FROM :KND FRX NO. :8683793 Oct. 27 2004 08:47AM P10 KVJUlu U7/1U/41 08.28 FAX 90724978 DEC Dwo, p Jam Aqg FJ PRY {6 J: 9 McCLF NY Ol: i< LS•�FR E�'N II G'12 -0 .Yl hf, Y..^� LOT 1 1 52.491 S•F• I a MASS V I� LW 1 J I , J. � z w =�3 I al 98? 4W TIC --SITE PLAN ung L CXANtlOT - Ix M& AN AMILT 5U MTRACTOR. AL Jcgsri�.a, ., e . 55-067 PATE: 6/2.1/$5 SCAT ? .. = 60 EAGLE VIVER EjVCjXPER1NG SoRVIaNs 1'.0, boas3294 .gACE LE RIVER, AX 95577 (907) 694--5195 TAX' (907) 694--W" 6nuh A. WO tuysd IS 01 'd 99££66CL06 'ON X43 9NI3o08 30088 NM WV 61:60 3RI fi00E—Zl -100 FROM :KND FAX NO. :8683793 Oct. 27 2004 08:47RM P11 WAUaa 07/30/04 08 RA PAI 9072607AP DEC AW&WW FM NGE1 1„04 7Vi4•»$X—R9I PRI... (.q M"c,cLYh1T OGI< LS—BR Uf Speo m eATION8 FOR oN-9ITe OPTIC SYSTEM LEGAL; JuHNKZ SUR, LOT 1 ,fA. eENERAL and septic plan are far a a1x bedraom duplairc rmzidenac Only- The n1y.The ws11 ' I A11 drawingQd or 64tw plan worknan6hip shall meat the Anchorage Dppartm ntpof a. Health And state Department of Environmsntal Conservation L ki r0qu1r8m&nt9- 4. All soil tests are advisory to the design and are to ba verified or modified in the field by the ongincer. bQ 1• All excavations; ed in FfieldpbyaChe cantraatcrntoameet rm aMunicipality of Ancherdgo, Dspartmwnt of Snvirnnmantrl consarvatIO0 resquiramants' g It is the rospor1416111ty of the owner to obtain allIPIOO"riary permits yr 6aosmenta And to locate any adib oont multi-familY:wolls. Tari. ittr4- The locate is tkc-bo exactly in the area ahown on the site Y any deviation requires snoinear appraysl. g, 1t is always roaommonded that A .surveyor locate the nearest lar line position chd the location of any sasemonta, 0. 8E0 1. The bed is to iollew rho natural land oentour to maintain uniform total depth of the be bottom. hall be loyal, p tS lug or minus 9."- 2, The bq%%OM of the bad s 2. The total depth a, the bed oxatvation 1e net to exceed 2.5' at any point.hexisting sswor line that loads to ta- The sewer line is to replaco the the oxi%ting Pit - 5. The bed gravel io to be covered with sypar, fabric Materia . Q, Soil or aomb1natlon of sallaand l plot veer the leanhfieldboard n to s depth of A' or equivalent is to b P did to ppevont ponding of T. The area over the bad in to be finich pre I surfaoa water runoff- cloadr than 100' to any 9. The septic tank and leachfiwld mutt not be or 200 fact to any existing Private w-1t1l" 950' to any Claes "p" wall, community W401 I. RCCOMM OMD LFACHFIELD DIMENSIONS TOTAL DEPTH = ?.S' GRAVEL DEPTH = B" TRO LENGTH b A4 ' IBED W101`14- 36" • 5011 Rating m 132 .bedroom Capacity, to 6 6 Seps7ia Tanta 5-126 c 2000 gallon exioting . Absorption Area= 1"915 X -f - ***NOTE: INSULATE FLOW LINS AND gseb WITH 2" BURIAL FOAM AND a' EARTH MATERIAL, MOUNDED. 11 'd 98££6b6L06 'ON Xdd ONIA00N And NIV9 Nle 61:60,2fal t00d-ZI-100 FROM :KND FAX NO. :8683793 Oct. 27 2004 08:46AM P6 •. — — l¢Itl0(i DEC DWk� P - 65 07/Stl/tl4 08:28 FAX 9072E97C o.IJ1rGp=. y3 ;� nRI i..a0a,• MaGI_Y WTOG:G L,.9^Ele 6W �` SOILQ L04�1 ,. s uN—�--I,R RIVER ENGIIlEERII�S MAW WLEBNAK 00571 , ; POaCOLATinN "'''• u P. 06415195=1A ' TisT •�; SOILS LOG PFRCOGATIO" 165T . ,. ' DATR p6RFORMl11L, . +•S:, ►WaO�M1:D Fops • 'T4,• r N.Ie i LEGAL. .r,;/ r,...ry ,AAS cROUNG WATh'n ENcoumanaat N� :h TlB, AT vMAT pl ACCLAT:oN KATE _S FT TMST M1UN DDTWREN PTAND �- E10N RNet 5�puwet. ' BAr^,.n _r• r1h/01tME0Mn yIIWU,AKOSS'� ........ 90 'd 99££66£L06 'ON 99A 0NId00N .d00Nd NM NU 81:60 3% W3-31-100 FROM :KND FAX NO. :8683793 Oct. 27 2004 08:46AM P7 08:25 FAX 90728976' DK DW&wN F, . e s 97iS8/94 G FbILS tali Mucl..xt-f'1'OCI+� t �s—f.lx ENe.+--'Nia.6R .7 UHC-.. •+�j �r EA&LR RIVER FNGfIi€RING 5ERVIGF.S � � :. EAGLE RIVER, AK 98511 P.O, PbX 773294 p rLR00CATI0H .. .694.9195 TMsT ., SOILS LOG -- PFRCOLATI ON TEST LeGAL r6p" s .,,fj s.J,6 o"FAI 1oui1 A, "lo CU736 s�7' ImlmnglMchl reptCCLATION RAY! 1 �.r—�+ pT AND 7641 RUN sETWl<fn „�� — :OMM6NYS„�i% . �_cfiR7lc.ab EY: r[flFDAME17 YYf P, 0. sax 77m LO 'd 98Efi66EL06 'ON Zvi 041.3008 .d0O2N8 NTV9 WV 91:60 BU GOOZ-6I-130 FROM :KND FAX NO. :8683793 Oct. 27 2004 08:45AM P2 jqi uuz DEC DWINW a7%�0/Od q 23 FAX a6728A7o ry V WSSURN DiSMgiCT pk"FZCR Ar10Eioc �� EIMTZ 322 3£41 C $'�'� WWCRORAGEr ALASKA 99503 ",y 16r 1989 £axle River zn0ineexiaS 8'eel'CO5 po Box 713294 AnehoraAe., AR 99577 SVB=CTI Tuh3*8 S/P Lot 1. Chugittiat AX (9021 -VM -003) rateW�?i DA Cr20)ion Waiver 1563.6775 bear xr, gutesai - auojeat we have received the •plans and apca let letter is co that** � � re by A.S. &6.03.720 M) $orc written Mr fal reuctian of the ewel. The i =tment-haa also revietied t;m subj�xt waivez request and hereby waiv34 feet on the Subs at g 4pexty gor the well and p �y 83nai approve, will x*Vire the a 6-bearoo+a subx4ssion 09 engineered As -built Plazz- inspection an9 sign off of as -built Plans the State @ of lackaa pXo£casioifat engineer register rk i6 the resyonsibilby of the A7Ctan48menta Lor this ina develoaez. Xf eonatructibn or opera tion-lt*q-V&t bI ark w 8bAn t years After issuance of plan approval, the approve st b6 'resubmitted to tate Department for review and 8,pprova1. s3an of the subject project will require di,tionwl ply ut�trn s s nen a uhould 2t�xovai Eros this office; All future come p� Includo thw above assigned project namber. i Thank Your CWly Thoaaa Environmental -Enainepz cMs s$ .. . ' EIiCi�050RE ?�� 'd 98££66£!.06 'ON Xdd ONI�OON d008d Nlk�B 1 41:80 3U 600d -di -100 FROM :KND FAX NO. :8683793 Oct. 27 2004 08:45AM P3 07j50/04 OBDEC DW&WW:2S VAX 9072897E r , .v by EAGLE RYVER ENGINEEIITNG SERVICES Lou 111110ra, IX ggvamhrar 13 r 1909 �'. MI� Y E V NOV y 1989 Ms, oindp ThCmaa ANCHORM t%W40imN D.B.C. gISTR1Cf ©FFI 2501 0 stress, suit* 322 Anchorage, A% 99503 I Rat ruhnke Sub., LO% 1 Maar Ms. Thomas, Thi+ attached asibuilt glans are for ,cork aaspleted under a permit fog Lot 1, Juhnka SubdiV1810n. Tht leachfieeld was installed With no siguilicaut changoe from thA original P IOLns Sincerely, Laois A. BUXRx'w, P.B. ..U`� �b'Zt_ £0 'd 99££Bb£LOB 'ON Xdd ONI.d008 JOONd NIdN W8 LI M x[11 bOOZ-?1-100 FROM :KND FAX NO. :8683793 Oct. 27 2004 08:45AM P4 ..-._. ..- Wj UU% 00748978' FAX D&C DWAWW ' ' OTi90/04 08:23 FAXJ • „ • 583^677"a A14C4iol"s WEVERN ntsTR:CCT p1+r"CE 3601 C %TMT, au"W 521 p,•sguov.sag,. Ala= 99503 November l4r 1989 Lagle River MVineer1a7 Services r. 0. BCA 773294 Vas31e River, Alaeks. 99577 P=uTyo it Hr. i,on Hutiara 8UWaCTt Lot. 1► 'gubnk& MA Chugiak, Alaska (9021 -VA -0034 9021-03t 0101 Dear Mr. BUterat 1 The pgp1 But has reviewed the snsineer AG -built paws 'for the M%bject project, rjAAl aepwval is hereby silvan, #or the 00wet' system, Any future axpsnsion Of the #+bject project will require additional'approval from th.la office. ink y`oo. Clody TAomas Environmadtal Rragineer. gTsbas 60 'd 99neveLO6 'ON 04 9NId008 2008d HIVE WH 81:60 BIL b00a-z[-100 FROM :KND FAX NO. :6683793 07lS0i0a 08:21 FAX 90128978• DRc DNaiWw Q ) _�.. f Cl 9 ;v r— .. O 0, yv C. 0Ra G 0Y,. (yam.. 7 �+ U (p .'f VA7 N as�° N f�1Jy 1 r7i . � � � V e�p AV i,^�i ^ W Q eD 5 (4 N -001, py ea do vl a doe 0 a° 2,4 ro 04 I � ul 'S C 9 od No 30. Ch a a \ rn 4Q t Q jk I '9-..g m yr rm Oct. 27 2004 08:46AM PB V310uu .A ro t IE 90 'd 9$££6b£L06 'ON XVd DRIJO08 A008d NIVB Wd BI:60 3(id b00Z-ZT 100 FROM :KND 111(�4Q/OQ O0:R0 FAX 90720916' FAX NO. :8683793 DEC AW&WW •r \c� m C� w '�:�:•.• � Crj"` Iii ry ' ~r BIRCHWOOD LOOP .ROAD 60 'd 89£EmL06 'ON KH Oct. 27 2004 08:46AM P9 IVIyua ONId00u d0oud NIHB WH 61:60 2n1 tr00Z-Z4-,6o0 GREATER ANCHORAGE AR~A BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Time of InspeCtion Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR l. Approval requested by: I~rzTjuknke Mailing Address: $.R. ~ 788 (:~ug±ak~ ~. Phone: 2. Property Owner: same Phone: Mailing Address: 3. Legal Description: Lot 33, Section 18, T15N, R1W~ S.M. 4. Location: mile 2~ BirchwoodLoo~ Boad 5. Type of facility to be inspected duplex No. of bedrooms 6. Well Data: A. Type C. Construction Sewage Disposal System: Upgraded existinq semi-public B. Depth 128' standard D. Bacterial Analysis satisfactory-6-10-75 (on-site syste~n, originally installed in 1973) A. I):~)~!~ic)9~ 6-13-75 2 C. Septic Tank: 1. Size 1000 gal. ea. D. Seepage Pit: 1. Absorption Area ~dclitional E. Disposal Field: Total length of lines 8. Distances: B. Installer Hamiltc~ Excavating 2. Manufacturer 1-Stack Steel & 1-H~m%ilton Concre 1000 gal. leaching tank 2. Material ~ 59' oran~ebtur~ with w~he~ qravel A. Well to: Septic tank 128' , Absorption area 180' , Sewer Lines , Nearest lot line 20'+ , Other contamination nonekncr~ approx B. Foundation to septic tank 20' , Absorption area approx. 40' .. C. Absorption area to nearest lot line 50'+ J4 (1/74) Page 1 of two pages Page 2 of two pages Leg~ 1 9escripti~o~ for Approval o'~., Individual Lot 33, Section 1,8, T15N~ R1W~ S.M. & Water Facilities Comments Upgrade inspected and a~roved by John Lee 6-13-75 Approved Appro~al ~l id for one ye--~r fr-'~m date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operat" ' ' SIGNED . Date EQ-03 / :R ANCHORAGE AREA B ,~ JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME~Iv~I~ J..IJ,~ MAILING ADDRESS ~' ~3, /~o~ '~o~ d~,.~x'~. PHONE LOCATION ~t~ ~W~ L~ LEGAL OESCRIPTION~ S;-~ [~ TJ~J~ DISTANCE ~'t.- .~'ZT~ ~RN6) O ~-~ , FROM WELL -- MANUFACTURER MATERIAL INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH NUMBER OF COMPARTMENTS LIQUID CAPACITY. GALLONS. NUMBER OF Pits // DIAMETER//, ~ / OR WIDTH LENGTH DEPTH LINING MATERIAL(~,~'¢/~-e~'~' CRIB S'IZE://- (~I,~I~ETER DEPTH DISTANCE FROM: WELL TOTAL EFFECTIVE BUILDING FOUNDATION__, NEAREST LOT LINE.~O/~'. ABSORPTION AREA (WALL AREA) ADDITIONAL ABSORPTION ,~ - - ' ~, //~-' .~'~'-- ~"~- SQ. FT. TYPE ~el~L BUILDING FOUNDATION CESSPOOL APPROVED CONSTRUCT,ON NEAREST ~/~ NEAREST LOT LINE ~."O , SEWER LINE OTHER SOURCES DISAPPROVED REMARKS ! DEPTH / ~ ~ DISTANCE FROM: SEPTIC . ~. I SEEPAGE TANK / ~4~ SYSTEM /-- DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: PIPE MATERIAL: LOTSLOPE: REMARKS: DATE ~/'¢~- APPROVE~'~ ~ ~, ~.A.2.~. 4f 8 • Municipality of Anchorage On -Site Water and Wastewater Program164 (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL _ Parcel I.D. 051-171-33 Expiration Date: /01 `I ©_d 1. GENERAL INFORMATION Complete legal description JUHNKE LOT 1 Location (site address) 19426 S BIRCHWOOD LOOP ROAD CHUGIAK AK 99567 Current Property owner(s) ANTHONY & CHERYL VARGO Day phone Mailing address PO BOX 773063, EAGLE RIVER AK 99577 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ET_ DupTx ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 6 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class _ Well n Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for:, Date: COSA to be released to the engineer, unless COSA Fee $ Waiver Fee $ Date of Payment Receipt Number Date of Payment Receipt Number COSA # OSC121045 REISSUE 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-ARCTERRA CONSULTING, INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 6/1113 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate ofhow long a ��r of A \ system will function satisfactory for current or future y I� occupants or can ArcTerra guarantee that no unseen ' t encroachments, deficiencies or discrepancies exist. *.1 i1 Cl Ti -I 6. DSD SIGNATURE System #1 Approved for (10 bedrooms. System #2 Approved for bedrooms. Disapproved. P,�KENNETH AL C'IJ F y> q / ` 7 16 6� r / t � r \P F \'F.'lOtih�' Conditional approval for bedrooms, with the following stipulations: Original Certificate Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory COSA blue sheet 1e-10-12.doc 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: JUHNKE LOT 1 Parcel ID: 051-171.33 A. WELL DATA Well type CLASS C If A, B, or C provide PWSID # Date completed 1973 Prior Sanitary seal (Y/N) Y Total depth 136 ft. Cased to 40+ ft. FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS: ft. 9Pm- Coliform Nea colonies/100 mL Nitrate ND mg/L Arsenic: 10.7 ug/L Date of sample: 5131113 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC / STEEL Tank size 2000 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Date of pumping C. ABSORPTION FIELD DATA Pumper Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 24 in. AT INSPECTION 212212012 ft. g.p.m. Collected by: ARCTERRA Date installed 1012012004 Cleanouts (Y/N) Y High water alarm (Y/N) N Date installed 1011812004 Soil rating (g.p.d./f:2 or ftZ/bdrm) 0.6 System type DEEP TRENCH Length 126(2 X 63') ft. Width 3 ft. Gravel below pipe 6.02 ft. Total depth 11 ft. Eff. absorption area 1500 ft Monitoring tube Y Depression over field N Date of adequacy test 2122/2012 Results (Pass/Fail) PASS For 6 bedrooms Fluid depth in absorption field before test 58.810 in. Water added 1420 gal. New depth 58.8138.4 in. Elapsed Time: 1380 min. Final fluid depth 58.8110.8 in. Absorption rate >= 900+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed "Pump on" level at _ in. Datum E. SEPARATION DISTANCES WELL ON LOTTO: Size in gallons "Pump off' level at _ in. Cycles tested Septic tank/lift station on lot 150'+ Absorption field on lot 150'+ Public sewer main 754 Sewer /septic service line 254 Animal containment areas 504 SEPTIC/HOLDING TANK ON LOT TO: Building foundation 54 Property line 54 Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots Public sewer manhole/cleanout 100'+ Holding tank Manure/animal excrete storage areas 100'+ Absorption Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 104 Building foundation 10'+ Water main 104 Water Service line 101+ Surface water. 100'+ Driveway, parking/vehicle storage 104 Curtain drain 50'+(NONEKNOWN) Wells on adjacent lots 1004 F. COMMENTS Well data from MOA records. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name KENNETH M. DUFFUS Date 61112013 COSA brown sheet_10-10-12.doc OF�AiL4 10 KENNETH M. DU (W / 7118 '`Lo f'AOF>SSIDq'A�' in. Municipality of Anchorage Y�i1± 9fi • J"' Community Development Department �° "• �_,, Development Services Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Arsenic Advisory Certificate of On -Site Systems Approval # OSC121045 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Lot 1 of Juhnke Subdivision. This inspection revealed an arsenic concentration of 10.7 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.org/onsite or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval: EPL/ S • Municipality of Anchorage 4 On-Site Water and Wastewater Program ail I i (907) 343-7904 Certificate of On-Site Systems Approval Parcel I.D. 051 171 33 Expiration Date: J`5 1. GENERAL INFORMATION Complete legal description JUHNKE LOT 1 Location (site address) 19426 S BIRCHWOOD LOOP ROAD Current Property owner(s) GWENDOLYN WOLVERTON Day phone Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: H Single Family (w/wo ADU) [J Duplex ri Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 6 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual 0 Individual Water Storage ❑ Holding Tank U Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer.unless otherwise requested by the engineer. COSA Fee $ 52f Waiver Fee $ Date of Payment t([ 1(B Date of Payment Receipt Number 0(D5566 Receipt Number COSA# 05C1�162 ID 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 C&M ENGINEERING Phone 907'854-5558 Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Date 11/20/18 .C_•... ;4 ,.5%1 57 a if',.. 4,9 .1' '.* lr 6. DSD SIGNATURE •••0.,..A *••-t••fro t '{ System#1 Approved for C3 bedrooms j s �, CHARLES G BALZARIN1 / System#2 Approved for bedrooms Av y pp o.. • CE-13854 •.•fir,/' Disapproved e ` i•••. ••'.„� Conditional approval for bedrooms, with the following s.h �� V\���t 1 J 'i1'1. `.. fC, ON-SITE %, WATER AND m WASTEWATER � - PROGRAM 70 \-. 1,`Air.S,FR\I'' F' By: t.�-- �� ` Original Certificate Date: I ?--- - ( e 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 X-- Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet_f . c If more than 1 septic system is on the lot: COSA Checklist# 1 of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: JUHNKE LOT 1 Parcel ID:051-171-33 A. WELL DATA Well type private If A, B, or C provide PWSID# Well Log (Y/N) yes Date completed pre 1973 Sanitary seal (YIN) V Wires properly protected (Y/N)V Total depth 136 ft. Cased to +40 ft. Casing height(above ground) +12 in. FROM WELL LOG AT INSPECTION Date of test - 11/11/18* Static water level - ft. 82 ft. Well production - g.p.m. +3 g.p.m. WATER SAMPLE RESULTS: Coliform neg colonies/100 mL Nitrate 5.77 mg/L Arsenic ND ug/L Date of sample: 11/13/18 Collected by: C&M Engineering B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/Steel Date installed 10/20/2004 Tank size 2000 gal. Number of Compartments 2 Cleanouts (Y/N) yes Foundation cleanout(Y/N) yes Depression over tank (Y/N) no High water alarm (Y/N) no Date of pumping 11/08/2018 PumperAlaska Quality Septic C. ABSORPTION FIELD DATA Date installed 10/18/06 Soil rating (g.p.d./ft2 orft dxm) 0.6 System typetrench Length 126 ft. Width 3 ft. Gravel below pipe 6 ft. Total depth 1 1 ft. Eff. absorption area 1500 ft2 Monitoring tube yes Depression over field no Date of adequacy test 1 1/11/18 Results (Pass/Fail)pass For 6 bedrooms Fluid depth in absorption field before test 6/0 in. Water added +900 gal. New depth 22/0 in. Elapsed Time: <144 min. Final fluid depth 6/0 in. Absorption rate >= 900 g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) none known If yes, give date na D. LIFT STATION Date installed -- Size in gallons -- Manhole/Access (Y/N) -- "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 +100 On adjacent lots +100 Absorption field on lot +100 On adjacent lots +100 Public sewer main +100 Public sewer manhole/cleanout +100 Sewer/septic service line +100 Holding tank +100 Animal containment areas +100 Manure/animal excrete storage areas +100 SEPTIC/HOLDING TANK ON LOT TO: Building foundation +10 Property line +5 Absorption field +5 Water main +10 Water service line +10 Surface water +100 Wells on adjacent lots+100 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 +5 Curtain drain +50 Wells on adjacent lots +100 F. COMMENTS * Well is a private community well flowrate and static water level may vary. G. ENGINEER'S CERTIFICATION Or AC• nl I certify that I have determined through field inspections and �kP•' ' '� review of Municipal records that the above systems are in /C►) • •'9 conformance with MOA COSA guidelines in effect on this date. *:,4 9TH :* �� Engineer's Printed Name Charles Balzarini4101 _ Date 11/20/18 " " " ' " " " fin CHARLES G BALZARINI 11'F• G�. CE-13854 .•��� +1F�Fo, A.• PROFESSION COSA canary sheet_2-6-15.doc MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT je 907-343-7904 On-Site Water and Wastewater Section ' Fax: 343-7997 www.muni.org/onsite Nitrate Advisory Certificate of On-Site Systems Approval # OSC181610 Subdivision: Junke, Lot: 1 A water sample revealed a nitrate concentration of 5.77 milligrams per liter (mg/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. Mailing Address: P.0. Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org Nitrate Fact Sheet From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids,and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Mailing Address: P.O.Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org Municipality of Anchorage Development Services Department • � r <a Building Safety Division On -Site Water and Wastewater Program` 4700 Elmore Road S" "' P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-171-33 COSA I i) Q,5 Expiration Date: & % 1. GENERAL INFORMATION Complete legal description TUHNKE LOT 1 Location (site address) 19426 S BIRCHWOOD LOOP ROAD, CHUGIAK AK 99567 Current Property owner(s) ANTHONY & CHERYL VARGO Day phone Mailing address PO BOX 773063, EAGLE RIVER, AK 99577 Lending agency Day phone Mailing address Real Estate Agent ` Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup_ 2. NUMBER OF BEDROOMS: 6 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 F] Public Water System ❑ Public Sewer n 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 sample results. (Certificates may be 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, 1 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 ARCTERRA CONSULTING. INC. Phone 868-3792 Address 20441 PTARMIGAN BLVD., EAGLE RIVER AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 02/24/2012 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a „ system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen # y encroachments, deficiencies or discrepancies exist.": 5. DSD SIGNATURE Approved for K bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory WASTEWATER Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By, ✓ ( Original Certificate Date:_ R —1 (Rev. 1 vas) Municipality of Anchorage o vE • '� Development Services Department Building Safety Division a On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: fUHNKE LOT 1 Parcel ID: 051-171-33 A. WELL DATA Well type Class C If A, B, or C provide PWSID # Well Log (Y/N) N Date completed 1973 Prior Sanitary seal (YM) Y Wires properly protected (YIN) Y Total depth 136 ft. Cased to 40+ ft. Casing height (above ground) 24 in. FROM WELL LOG AT INSPECTION Date of test 2/22/12 Static water level ft. 90 ft. Well production g.p.m. 5.26 9 - p.m -WATER SAMPLE RESULTS: Coliform NEG colonies/100mL Nitrate ND mg/L Arsenic: 10.7 mg/I Date of sample: 2/15/2012 Collected by: ArcTerra B. SEPTIC/HOLDING TANK DATA Tank Type/Material fttic/Steel Date installed 10/20/2004 Tank size 2000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alarm (YIN) N Date of pumping 12 Pumper C. ABSORPTION FIELD DATA Date installed 1018 2004 Soil rating (g.p.d./Ftz or ftz/bdrm) 0_6 System type Trench Length 126 (2 x 631) ft. Width 3 ft. Gravel below pipe 6.02 ft. Total depth 11 ft. Eff. absorption area 1500 ft Monitoring tube Y Date of adequacy test 2122112 Depression over field N Results (Pass/Faip Pass For 6 bedrooms Fluid depth in absorption field before test 58.8/0 in. Water added 1420 gal. New depth 58.8/3&4 in. Elapsed Time: 1380 min. Final fluid depth 58.8/10.8 in. Absorption rate >= 900+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date - D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "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 SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 1501+ Absorption field on lot 1501+ Public sewer main 751+ Sewer /septic service line 251+ On adjacent lots On adjacent lots Public sewer manhole/cleanout 100'+ Holding tank Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 51+ Property line 51+ Absorption field 51+ Water main 101+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 150'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 101+ Water main Water Service line 301+ Surface water 1001+ Driveway, parkingNehicle storage 101+ Curtain drain 50'+ (None Known) Wells on adjacent lots 150'+ F. COMMENTS G. ENGINEER'S CERTIFICATION / 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. j Engineer's Printed Name KENNETH M. DUFFUS Date 2/24/2012 COSA Fee $490.00 Date of Payment &J�1 J a Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage • y` Community Development Department Development Services Division � SM1 £TY On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Arsenic Advisory Certificate of On -Site Systems Approval # OSC121045 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Lot 1 of Juhnke Subdivision. This inspection revealed an arsenic concentration of 10.7 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.or /o nsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval: Page 1 oft Wockenfuss, Deborah M. From: bmw.kndeng@ak.net on behalf of Brent Western [bmw.kndeng@ak.net] Sent: Tuesday, February 28, 2012 2:19 PM To: Wockenfuss, Deborah M. Cc: Dea Duffus Subject: Re: Comments Deb, Per your comment sheet: 1. MOA record documents for both Junke Lot 1 & Lot 2 designate the well as a Class C well. These documents are from 3 different engineering firms over the course of the years, which include items (letters, design, COSA/HAAs, ...) submitted to ADEC and MOA, etc... However, we could not find a PWSID#. 2. We'll bring in the pumper receipt. 3. Total depth of field was measured at approximately 11.8' and 12.7' at time of recent adequacy test. Thanks, Brent M. Western ArcTerra Consulting, Inc. 907-440-4601 Cell 907-868-3792 Office 907-868-3793 Fax "Quality is never an accident; it is always the result of high intention, sincere effort, intelligent direction and skillful execution. It is the wise choice of many alternatives." --William A Foster 2/28/2012 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 wi ww h .c.anc orage.ak.us v (907) 343-7904 O CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D. 051-171-3-4 GENERAL INFORMATION HAA# �4tUJ�Ce� Expiration bate:.. 2 r7 — O Complete legal description JUHNKF I OT 1 Location (site addressor directions) 19426 Sn r h Birchwood nnn Road, rh_ „a; ak AK 99567 Current Property owner(s) Dorothy P. Hanson Day phone Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 2. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer El The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of11 Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority 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 sample results. (Certificates may be 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 Health Authority 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 KND ENRINFFRINA, Inc Phone (907) 69— 6 fi Address 20441 Ptarmig, n� Blvd_, Eagle River, AK 99577 Engineer's Printed Name Kpnnath M_ 0uffuc Date 10/26/04 Engineer's Comments This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, KND can not give any estimate of how long a system will function satisfactory for current or future occupants or can KND guarantee that no unseen encroachments, deficiencies or discrepancies exist. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Condifional approval for bedrooms, with the following stipulations: ti Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other v WASTEWATER o-r-i�ef '•..... per: By: /it/. Original Certificate Date: I ®- a7- D q % y err 0, SITE pppT 13 AND ' rr v WASTEWATER o-r-i�ef '•..... per: By: /it/. Original Certificate Date: I ®- a7- D q OWN fpl 3519=565tl 93 ft "�: '°° .n gpm i . tra a �ma. O er actena _colonies tl m`�. � samp e. dol ecte y .lL+g M a. � �n ,»e�w.� 4�-•e.�.. ^4 .�`��'`t`�� : ,...,._u.. baa a e insta e�0%ba size 2bgo gal eanouts ss,' epressio o e an ('lYthh���figli war ala �/N�r1 rj�C, Pumper Y _$oil ra mg g/ft2 or ft /bdrmj � 'ys"�em` type i�li�C� ff �r bfith � FSravP Plnw nmP (i A i. ft on 16t1 501+ On adjacent lots 1 5'0'+ ity that I have determined through field inspections and or, • •F •••. .•. ' d w of Municipal records that the above systems are in•9. •• • e irmance with MOA HAA guidelines in effect on this date �Cenneih M. U f r .' 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