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HomeMy WebLinkAboutTAILWIND LT 1Onsite File OA G� Lo V 46& (20�::vLS6� /z4,/? -3 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: 0SP221351 PID Number: 017-462-05 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name CAROLE NEWTON ABSORPTION FIELD Site Address ❑ Deep Trench ❑ Wide Trench ❑ Bed ound 12700 GANDER STREET *ANCHORAGE, AK ❑Other Phone Number of Bedrooms Soil Rating Total depth original grade 907-301-0631 3 GPDISFil Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot DRAKE; BLOCK 4, LOT 5 Ft Ft. Fill added above original gr Gravel length Township Range Section Ft, Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft. To Septic Absorption Holding Sewer To�talorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line Ftz Ft. Well *75'+ 25r+ TANK ❑o Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Surface Water 100'+ GREER TANK 1250 Gal. Material Number of compartments Lot Line 5r+ NA HDPE 2 1001 Foundation **101+ LIFT STATION — z I I - Manufacturer Capacity Remarks OLD TANK DECOMMISSIONED PER UPC Gal. PER CONTRACTOR *WR#OSV221064 **5'+ TO DECK POST/STAIRS Alarm location Electrical installed by PIPE MATERIAL House to tank D3034 Tank to D3034 Installer drainfield RED DOG Drainfield 1)3034iexisTiNG CO/MTD3034 Inspector GEG BENCH MARK (Assumed elevation) 99.$6 ft Inspection ection 151 1/9/2023 2�c - Location and description 3b - 41h _ TOP OF MH ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp �ob�Op� oQ OF A ���4 Conditional Approval: Date oo �� • -9 O q TH -- Q 0 1...............:...o Septic System , e f y A�Garnes 9 —7953 -J p Approved Date Note: this approval doe not include well permit requirements. #AEcc ���04pp000aQ� (Raw nFm911 u) PERMIT NUMBER: OSP221351 A I B DBL1 37.4 29.1 DBL2 37.8 29.9 MH 39.8 31.9 ST1 44.2 33.7 DBL3 46.5 34.8 DBL4 47.4 35.0 NOTE: PIPE LOCATIONS ARE SHOWN PER GEG SHOTS TAKEN WITH LEICA DISTO S910 LASER DISTANCE METER. SWING -TIES TO HOUSE CORNERS WERE GENERATED IN AUTOCAD. RECORD DRAWING 10' UTILITY EASEMENT -7 - - BOUNDARY OF SEEPAGE PIT IS UNKNOWN. CONTRACTOR CONFIRMED 5'+ FROM NEW SEPTIC TANK TO SEEPAGE PIT; DISTANCE FROM EDGE OF SEEPAGE PIT TO GARAGE IS UNKNOWN; PER 1970 INSPECTION REPORT, SEEPAGE PIT IS 99.5 FEET FROM WELL -7 DRAKE; BLOCK 4,LOT4 WNEW 1250 GALLON GREER TANK O &2 Cn- GARAGE EXISTING 3 \ B BEDROOM HO( vIS�o 1�26�z3 ARCEL ID NUMBER: 017-462-05 GARNESS ENGINEERING GROUP, Ltd ENGINEERING SALES - CONSULTING - 3701 E. TUDOR ROAD, SUITE 101 -ANCHORAGE, AK 99507 -PHONE (907) 337.6179 -FAX (907) 336J246' WEBSITE: w gwnessengmn ng. o PREPARED FOR: p PHONE NUMBER: PAGE NUMBER: N -t—aj 907-330IN" 2 OF 3 LEGAL DESCRIPTION: 3 DRAWN BY: DRAKE; BLOCK 4, LOT 5 D.J.G. TYPE OF WORK: DATE: SEPTIC TANK RECORD DRAWINGS 1/18/2022 I At SCALE: 1"=40' AV .. • * .. 0 .... ........... .........0 It / � J re y k. Ga7••ess i A �'. IE -7953 : 23 W (`_ • LICENSE OP O\\5�. . � #AECC884 / PERMIT NUMBER: PARCEL ID NUMBER: OSP221351 RECORD DRAWING 017-462-05 TOP OF MANHOLE = 99.86 C 1 4 6L4 L✓ C� FINAL GRADE = 99.76-99.83 --- 5 1 TI GV VFJL O, MH1 ST1 `r�i\"96 TOP OF TANK AT INTLET = 95.85 f TOP OF TANK AT OUTLET = 95.81 INVERT OF BUNG AT INLET = 95.23 INVERT OF BUNG AT OUTLET = 94.94 NEW 1250 GALLON H.D.P.E. SEPTIC TANK GARNESS ENGINEERING GROUP, Ltd ;� .. .. -- - - — - ENGINEERING -,SALES CONSULTING - ---- - --- - = .....�. ...�.�......�,i 3701 E. TUDOR ROAD, SUITE 101 'ANCHORAGE. AK 99507 - PHONE (907) 337-6179 -FAX (907) 336-3246' WEBSITE: w .garnessenAneenng m , , , • • ,,,.10 , PREPARED FOR: PHONE NUMBER: PAGE NUMBER: T ey •••arn ♦ ; J rey . Garn ss : W i CAROLE NEWTON 907-301-0631 3 OF 3 �j�'i E-79 3 ' _F LEGAL DESCRIPTION: DRAWN BY: ��,���•.,�� .) �•j, (o�Z3 ; � Air DRAKE; BLOCK 4, LOT 5 D.J.G. c 4W TYPE OF WORK: DATE: ♦� cO P • ,,,,,,,,,,,•••P� �1 LICENSE/41to FSS\ SEPTIC TANK PROFILE 1/26/2023 #AECC884 GARNESS ENGINEERING GROUP, Ltd Aeroceir ENGINEERING SALES CONSULTING � AW*9 Autnorind Deofcr January26, 2023 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Crib to Garage To whom it may concern: The separation distance from the 1969 seepage pit and garage is unknown. Per the 1969 inspection report (IR), the perimeter of the seepage pit is 16'x18' feet (including gravel). Per the as -built survey, the seepage pit pipe is approximately 17 feet from the garage. Assuming the seepage pit pipe is near the center of the crib, the "log crib portion of the seepage pit" should be at least 10 feet from the garage slab. Additionally, the garage is "slab on grade" and does not have a "daylight basement". We feel there is minimal risk in having the edge of the effective depth less than 10 feet from the edge of the garage foundation. If you have any questions, please contact us at 337-6179. Thank you for your assistance 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com Grovel Driveway Encroaches onto Lot 5 Lot 3 Lot 4 . • . . . • N90'00'00"W 300.08' 10' Utility Esmt ............................ ............ — 239.0— --f 60.6' 55.6' 30' 'S 38.2' �••�c 135.1'0 O A = - 36.2' °yea. O e O O 0 Lot 5 0000000044 O o OF q� �4 90, 754 sf QQ) TH �� N ...... . QO .........oO ff 0c 0 ', ' Benjamin Holmstrom .11Q U Q �t l r- LS`-1111-88708 J Lot 2 p04 Po �`��, 40 2°fessiono% R=30.01 L= 47.1 c N89'59'00"W 270.01' 0 Flyway Ave. Legend: Asbuilt Set Rebar with Cap O AL. Monument Legal Description: Found Rebar O Lot 5, Block 4, Monument Wel I Drake Subdivision Septic QS Gravel Survey Certification: I hereby certify that a Mortgagee's Overhang Inspection was performed on the described property. Notes: It is the owner's responsibility to determine the Wood Deck existence of any easements, covenants, or restriction which are not shown on the recorded subdivision plat. Concrete" This asbuilt shall not be used for construction or for Fence establishing property lines. Checked by. BH Drawn by. CB Scale 1" = 50' Grid SW2834 Job 2023-1 Field Book: 151 Plat 65-106 Date: 1/18/2023 Permit Number:OSP221351 Tax Code Number:01746205000 Work Type:SepticTank Initial Effective Date: Design Engineer: Site Legal Address:DRAKE BLK 4 LT 5 G:2834 Owner:GARNESS ENGINEERING GROUP LTD Site Mailing Address:12700 GANDER ST, Anchorage Lot Size in Sq Ft:90140 Total Bedrooms:3 This permit is for the construction of: Disposal Field 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 9/16/2022 9/16/2023 GARNESS ENGINEERING GROUP LTD Special Provisions: •Contractor must expose 5' from tank to confirm 5' separation to seepage pit. Expiration Date: ¨þ ¨¨¨¨ Received By: Issued By: Date: Date: 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 http://www.muni.org/onsite On-Site Wastewater Disposal System Permit Deborah Wockenfuss 9/16/22 Municipality of Anchorage P.O. Box 196650 ⚫ 4700 Elmore Road Anchorage, Alaska 99519-6650 ⚫ (907) 343-7904 ⚫ Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV221064 COSA#: Permit#: OSP221351 PID#: 017-462-05 Legal Description: Drake Blk 4 Lt 5 Engineer: Garness Engineering Group Your request for a waiver of the required 100 feet horizontal separation from the septic tank to the private well has been approved. The approved separation distance is 75.0 feet. This waiver approval applies to the proposed septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: ____X_______ Waiver is not Granted: ______________ Date: ___9/16/2022__________ Approved by: ____Deb Wockenfuss________________ Name of Reviewer **** VARIANCE/WAIVER REVIEW **** 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. 017-462-05 Property owner(s) CHRIS MABEUS Mailing address 12700 GANDER *ANCHORAGE, AK Site address 12700 GANDER *ANCHORAGE, AK Legal description (Sub'd., Block & Lot) DRAKE; BLOCK 4, LOT 5 Legal description (Township, Range & Section) Lot Size Day phone 907-240-8987 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial 0 Single Family (SF) ED Septic Tank Q Upgrade pg (w/wo ADU) ❑ Holding Tank ❑ Renewal ❑ Duplex (D) ❑ Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: SEPTIC TANK TO WELL Distance: 75' 1 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) erm' ush Fees: Waiver Fees: MID Date of Payment: Rl212Z Com_ Date of Payment: Iba Receipt Number: DoP436, Receipt Number: 00643E Permit No. 01�eZ2 I _�6 \ Waiver No. 05V 2-21 ()�Lf GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221351, Deb Wockenfuss, 09/16/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221351, Deb Wockenfuss, 09/16/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221351, Deb Wockenfuss, 09/16/22 GR['A?I~ ANCH©RAGE AREA ~O~OL~N NEALTH DEPArTmENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-251] INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL , ~TZ / ~// NUMBER OF __ ___MATERIAL .~~--/~ COMPARTMEN[S ' ........ / ~' ' LIQUID LIQUID CAPACIrY~ ~,'~ .... GALLONS. INSIDE LENGTH _ , INSIDE WIDTH ~DEPTH SEEPAGE SYSTEM: NUMBER OF PITS / LINING MATERIAL ,~_~"~?~ ~'2~ NEAREST LOT LINE ..... ~'~2 '/ SEEPAGE PIT: _OUTSIDE DIAMETER__ .... ~ OR WIDTH ,~__~::' / LENGTH~ //, / DEPTH DISTANCE FROM WELL ' "_ ~ /~' ~, BUILDING FOUNDATION TOTAL EFFECTIVE ABSORPTION AREA (WAIL AREA)., /~/'~2 ~ SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL FOUNDATION ., NEAREST LOT LINE NUMBER OF LINES_,,,.,, ................. DIST,~CE BETWEE~ [ll~"~~. '"'~' - ____ ~NC"..~....,.:W DTI:J ABSORPTIon,ON ~'REA _ .~'."~'~'~ LENGTH OF EACH LINE__ DEPTH: TOP OF TILE TO FINISH GRADE ~_DEPTH OF FILTER MATERIAL BENEATH TILE-- TOTAL LENGTH OF LINES IN. TOTAL EFFECTIVE IN. ABOVE TILE WELL: LOT LINE NEAREST ..... SEPTIC SEWER LINE .... TANK DISTANCE FROM ,//. WATER , BUILDING FOUNDATION. ,~/'~? ~/~) NEAREST SAMPLE. , '" /" SYSTEM~''~ ~' ,~ OTHER ~7/ ~ SEEPAGE __ fO/- , , CESSPOOL__ ~ , SOURCES DISTANCES: DIAGRAM OF SYSTEM DATE APPROVED. HEALTH ALJTHORIIY GAAB-HD-2 GREATE 327 Eagle St. ANCH@RAGE AREA HEALTH DEPAI~TS~ENT Anchorage, Alaska 995{)] 279-25 Case N0.~ SEWAOE DISPOSAL SYS~E~ = AF~LICA~'ION & ~*E~l? LEGAL DESCRIPTION ~&~ 4 & o r' S~ _~ ~~~, APPLICATION TO INSTALL: SEPTIC TANK , SEEPAGE P~TfS~, 9RAIN F~ELD ~ TO SERVE THE FOLLOWING FACILITY_~ ~ PERCOLATION TEST RESULTS ,:~,iii, / ANTiCiPATED DATE OF COMPLETION BElow $0 BE F~LLED OUT BY HEALTH DEPA~T~aENT , SEPT'C TANK SiZE ~ _TYPE ~SEEPAGE AREA~TYP* ~ I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. d' I-- C) `o 0') rnrn ti- �� �I- CD 0 CY) (') c M O LL V _r_ 0 i V Z U- 01 7-7 c CE Cn L ® Q Z Q U L N 06 ^L^ll c � a O > C/) a c 00 N O a. Q Q U) a) cn a U) /a) v J C 0 O a) U W A LO N O N O N 6 M C O .Q X W Co r LO rn rn Q W L. 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L c ++ z +� 3 a L +.+ •� a E _ L Q '" �+ z 4- CL U z o o ms 0 F- o •0 z L ° v Q °) o T ° u a �-0 w m v w v c ra t +' a " +� U a 03 E O a c Z O U O V1 +' o „ V) U '�' °c° m tw u Q L a c= N 3 �= v f° L a c c 'x O X O 0 +� +� a +, ai ul c C ° O E ° O EMA O, X p o = �° v w Q tin OR r o LO "-) N O L O O. U V Lz, 0- o 0 -o- C, O C C" v1 O �t �aEa�-C ° p 00 ,�.N0 ° >Z Ln d d U M N 00 O n N c C -0 O N O N U 00N O TN - c ` `�- -0 O Y ¢ O N O U 0 O U C V L7 y U 0 U O O > c In O D O N c 7 C CU Eo�Q) cn M E 0 3:110 1 L 00 o o- c0 3 aci � p U a, U 0= U L U O T I N N E Y m o n O O•xLL - N V) iz N UJ O E v p � N ° O pi C — U7 J p O N > O 0 O U C O W N U7 ¢ L, (n 0 O � U L- J L OR r o LO "-) N O L O O. U V Lz, 0- C, O C C" v1 O N �aEa�-C ° p 00 ,�.N0 ° >Z Ln d d U 00 O n N c C -0 O N O N U TN - c ` `�- -0 O Y ¢ O N O U 0 O U C V L7 y U 0 T L O O > c In O D O N c 7 C CU Eo�Q) ° E 0 3:110 E °>,-C 00 o o- m p C� U a, U 0= U L U O T I N N O N o- N,°mo m o n O O•xLL - N V) iz N U � MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 017-462-05 Legal description DRAKE BLK 4 LT 5 Site address 12700 GANDER Expiration Date: 4/28/23 Current property owner(s) NEWTON JAMES M & CAROLE, X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: By:,�owaR 2 Original Certificate Date: 1/31/23 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA ApprovaLiune 2022 MUMURAUTY OF :,- V1CH0R GE Development Services Department ^~` �a p P - :-7 Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 017-462-05 Complete legal description DRAKE; BLOCK 4, LOT 5 Location (site address) 12700 GANDER STREET *ANCHORAGE, AK Current property owner(s) CAROLE NEWTON 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 907-782-8241 3. TYPE OF WATER SUPPLY: X Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel 0 Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ®❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ _�_50 / Waiver Fee $ Date of Payment //Z 5`23 Date of Payment COSA # 03G2310) 2 Waiver # 0630ZG COSA Appli w une2022 �(-94z 3 COSA Checklist Legal Description: T`-2N-R3W'�G-T-I©N-M-LOT-52 (10 q4 Parcel ID: 17-4p-05 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 1970 M Total depth *68' ft Cased to UNKNOWN ft Q Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) I Z• -t' in. Date of flow test for COSA 7/15/2022 Static water level at beginning of test 26.2 ft Comments *PER 6/5/1970 INSPECTION REPORT B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping N/A '� ❑ Required maintenance completed, if AWWTS Comments: NEW INSTALL - RECORD DRAWINGS ATTACHED c. 1 4 D. ABSORPTION FIELD DATA Which system tested (date installed) 6/5/1970 j ❑� ALL standpipes present per record drawing yd Total measured depth from grade 8.9 ft (max) o- Measured depth to pipe invert from grade 'SUNK ft (min) ❑ N/A - pressurized field. p. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. (` If not, state depth into effective Q Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 2005 gallons 1/20/23 date Any rejuvenation treatment (past 12 months) NO If yes, enter date N/A yb�Z3 I Well production at time of test 6.4+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes 0 No ❑■ Coliform bacteria is Negative Nitrate mg/L Q Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by GEG Date 7/15/2022 C. LIFT STATION ❑ Required maintenance Age of lift station years Lift stati aterial Adequacy test date 1/20/23 Results Q Pass Fluid depth prior to test 38.75 in Water added 486 gal New fluid depth 40 in Elapsed time 120 min Final fluid depth 36.5 in Absorption rate 450+ gpd FIELD STATUS - POST RECOVERY Effective depth (per record drawings) 72 in Effective depth used ** in Effective depth remaining 6:5in AS5JM4-�v 11 16.5 co Comments/Deficiencies: *UNK SEEPAGE PIT **PER GEG FIELD MEASURMENTS, THE BOTTOM OF THE SEEPAGE PIT IS 53 INCHES BELOW THE POST TANK DOUBLE CLEANOUTS. MAXIMUM LIQUID LEVEL.,WAS 40 INCHES (13 INCHES BELOW INVERT OF THE PTCO) STRUCTURAL INTEGRITY OF 53 YEAR-OLD LOG SEEPAGE PIT IS UNKNOWN �! A TOCOSA Checklist June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' ❑Yes if No *75'+ ft no Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' OYes , if No ft Absorption Field on Lot > 100' M Yes if No *'99.5 ft Holding Tank > 100' Q Yes if No ft Neighboring Absorption Fields > 100' **** Animal Containment > 50' © Yes if No ft 0 Yes if No ft — Community Sewer Main > 75' Yes if No ft Manure/Animal Excreta Storage > 100' Fill Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft Surface Water > 100' M Yes if No ft Tank to Property Line > 5' © Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' © Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' Q Yes if No ft Water Service Line > 10' M Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS *INR#OSV221064 **PER INSPECTION REPORT IN MOA RECORDS ***SEPERATION DISTANCE FROM SEEPAGE PIT TO GARAGE IS UNKNOWN PER THE INSPECTION REPORT FOR BLOCK 3, LOT 8; DRAINFIELD IS 20' FROM LOT LINE. IT IS ASSUMED TO BE 100'+ G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Garness Engineering Group LTD (GEG) Phone 907-337-6179 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. ao�'bO�p Separation distances were measured to readily identifiable features. Hidden defects or encroachments may o6 OF A��0� exist that were not identified during the evaluation. The operational life of all wells and septic systems depend ©o . • t 95�� upon 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),C % and the water usage of the family utilizing � � � H the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not ]uarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regardin Q 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 to performref y Arrss. adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG Q �' to perform the evaluation. Reliance upon the information provided in this report by any other person or party Q4' C —7953 c (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. COSA Checklist June 2022 LICENSEE Professio°°ate #AECC884 �D�p000©