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HomeMy WebLinkAboutEAGLE RIVER HEIGHTS BLK 8 LT 11 N2Municipality of Anchorage On -Site Water and Nillastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE 1411ASTEWATER INSPECTION REPORT Permit Number: OSP201165 PID Number: 050-281-14 Dwelling: N Single Family (SF) El with ADU El Duplex (D) El Two Single Family Project: El New N Upgrade Name WADE HODGES (C/O AGENT: BROOK STILTNER) ABSORPTION FIELD Site Address 011 Deep Trench E] Wide Trench F-1 Bed El Mound 10316 LEE STREET, EAGLE RIVER, AK 99577 0 Other Phone Number of Bedrooms Soil Rating Total depth from original grade 244-6742 1 4 1.2 GPD/SF1 12.5 (MAX.) Ft, LEGAL DESCRIPTION Depth to pipe invert from original grade SEE DWG. Ft. Gravel depth beneath pipe 6.04 Ft. Subdivision Block Lot EAGLE RIVER HEIGHTS 8 N1/2 OF 111 Fill added above original grade SEE DWG. Ft. Gravel length 42+ Ft. Township Range Section Gravel width 2.50 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES TO Septic Absorption Lift Station Holding Sevier Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 507+ Ft= Ft. Well 100+ 100+ 25+ TANK H Septic [I S.T.E.P. E3 Holding [] Other Manufacturer Capacity GREER TANK 1250 Gal. Surface Water 100+ 100+ Material Number of compartments HDPE PLASTIC 2 Lot Line 10+ 10+ NA Foundation 10+ AION Manufacturer Capacity Remarks Gal. < Alarm location Electn .", called by PIPE IVIATERIAL House to tank Tank EXIST- drainfieOD3034 d Installer NORTHERN EXCAVATION Drainfield D3034 CO/MT D3034 Inspector GEG, LTD. BENCH MARK (Assumed elevation) 100.00 ft Inspection 1,t 6/15/20 6/15/20 Location and description dates: 2` 3'd 6/16/20 4" TOP OF GARAGE SLAB 1 ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's StaInp Conditional Approval: Date OF ��P �_ �H ....................... ......... ... . .......... Septic System rq �®rnesls A 795� 40 Approved ZV Date Note: this approval does not include well permit requirements. raEccasa���Oppoo�a©� (Nev uoluzl It$) PERMIT OSP2NUMBER: RECORD DRAWING PARCEL 1NUMBER: OS P201165 050-281-14 B C _. DBL1 35,2 16.5 PAGE NUMBER: DBL2 36.2 15.9 2 OF 3 MH 37.3 15.2 EAGLE RIVER HEIGHTS; BLOCK 8, NORTH 1/2 OF LOT 11 STI 41.8 13.4 DBL" 42.8 13.3 Jtr . -�3 DBL4 44.3 133.0 FD 44.9 13,0 C01 - 54.1 52.5 MT -I 55.5 60.7 CO2 69.1 57.33 MT2 67.0 55.7 60354.6 '16.7 36.7 SUMP 84.3 43.5 55.7 \ uj w EXISTING n DRAINFIELD O w \ Z zz NEW XDRAINFiFLD— 1 100 INSTALLED ALLED DOUBLE CLEANOUTS (DBL1 & DE NEW 1250 GALLON GREER 1, HDPE SEPTIC TANK INSTALLED DOUBLE CLEANOUTS (DBL3 & DBL4)� INSTALLED POLYLOK FLOW DIRECTOR (FD) EAGLE RIVER HEIGHTS; L BLOCK 8, LOT 12 —CONTRACTOR HAD EXISTING SEWER LINE FROM, HOUSE TO TANK CAMERAED BY ONE STOP SERVICES. SEIA'ER LINE HAD NO BELLIES OR BREAKS. f� — EXISTING / GARAGE NOTE: OLD SEPTIC TANK WAS REMOVED AND DISPOSED OFFSITE PER THE CONTRACTOR. I N —RESERVE SITE I ' � I ASEPTIC ARE I i00 FOOT 1lELL RADIUS / I� RADIUS! I I / / I NOTE: ALL WELL RADII WERE FLAGGED BY \ A REGISTERED LAND SURVEYOR DURING CONSTRUCTION PER THE CONTRACTOR EAGLE RIVER HEIGHTS; BLOCK S. SOUTH HALF OF LOT 11 i/ /I lr_s 77.1 \O�[ - GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS 3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE, AK 99507 - PHONE (907) 337-6179 ` FAX (007)33P-3246 ` WEBSITE: www.garna& enpu:errfng.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: WADE HODGES CO AGENT 2 OF 3 PROJECT/LEGAL DESCRIPTION: DRAWN BY: EAGLE RIVER HEIGHTS; BLOCK 8, NORTH 1/2 OF LOT 11 J.L.M. TYPE OF WORK: • + �• RECORD DRAWING OF SEPTIC SYSTEM UPGRADE 1 I. Jtr . -�3 S 4 Z 0 w ,Y LI \' s NOTE: OLD SEPTIC TANK WAS REMOVED AND DISPOSED OFFSITE PER THE CONTRACTOR. I N —RESERVE SITE I ' � I ASEPTIC ARE I i00 FOOT 1lELL RADIUS / I� RADIUS! I I / / I NOTE: ALL WELL RADII WERE FLAGGED BY \ A REGISTERED LAND SURVEYOR DURING CONSTRUCTION PER THE CONTRACTOR EAGLE RIVER HEIGHTS; BLOCK S. SOUTH HALF OF LOT 11 i/ /I lr_s 77.1 \O�[ - GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS 3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE, AK 99507 - PHONE (907) 337-6179 ` FAX (007)33P-3246 ` WEBSITE: www.garna& enpu:errfng.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: WADE HODGES CO AGENT 2 OF 3 PROJECT/LEGAL DESCRIPTION: DRAWN BY: EAGLE RIVER HEIGHTS; BLOCK 8, NORTH 1/2 OF LOT 11 J.L.M. TYPE OF WORK: DATE: RECORD DRAWING OF SEPTIC SYSTEM UPGRADE 6/22/2020 • 4..i 0 49 ... r...... 0 / ...�s... I .. ........ ..... 1 0 .. Garn ss �Si bilk, ,ICES-7 ) i LICENSE t,-R'it % #AECC884 / PERMIT NUMBER: RECORD DRAWING PARCEL ID NUMBER: OSP201165 050-281-14 FINAL GRADE ST1 TOP OF MH LID = 99.83 = 99.35-99.54 MH TOP OF TANK @ INLET = 93.79 TOP OF TANK @ OUTLET = 93.79 INVERT OF BUNG @ INLET = 93.08 NEW 1250 GALLON INVERT OF BUNG GREER HDPE @ OUTLET = 92.95 SEPTIC TANK MT1 C01 FINAL GRADE MT2 CO2 ORIGINAL GRADE TH#1 = 97.34-97.38 @ HIGHEST POINT= 96.81 FILTER FABRIC INVERT OF PIPE = 90.35 BOTTOM OF TRENCH =84.31 RELATIVE ELEVATIONOF BOTTOM OF TEST HOLE = 78.31 (TEST HOLE DRY ON 6/15/2020) of 4LGARNESS ENGINEERING GROUP, Ltd ;• ` 4 CIVIL & ENVIRONMENTAL ENGINEERS 3701E. TUDOR ROAD, SUITE 101 'ANCHORAGE, AK 99507 -PHONE (907)337 -6179 -FAX (907)338.3246 WEBSITE: mm.gamessenglneedng.com ,•• •••••••••••••••••••. .0 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0 (� ';� rey A. arpess 'E wC/ WADE HODGES CO AGENT 3 OF 3 ����' ; C 795 c �_AV PROJECT/LEGAL DESCRIPTION: DRAWN BY: ♦�♦ kj 40, EAGLE RIVER HEIGHTS; BLOCK 8, NORTH 1/2 OF LOT 11 J.L.M. 1 cep•••••••..... •• •'^'\ �, • TYPE OF WORK: DATE: LICENSE,I��>,ss" ��• RECORD DRAWING OF SEPTIC SYSTEM UPGRADE 6/22/2020 #AECC884 Q 4 CD s� W, 133g1S 33-I - -- `"! 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OQ� , o LLI wZ0w W0OcI3 •`��_ VMJ U a•\•` W C/) N z=w0 Co Thh F C'J wF-Q-n CJ v� S N m T U w V U � � N C O p O W m N t N N N w m 3 c � m � r 5, Q � � U E m C p N 7 O Q V- 9 E O C3 ._ u> c` o w w a 0 0 C OCU > 0 o Cos N � a N m U 3: O O yN J p E a U o w � L O N V W O �ooN� E O N O � � c ao w N � N � � o J C L '3 h [6 N y � C O] W p C'O N U 2 - N O •O— O N N U � � N CC,, C C p 0 O E o o c E o o m U c m c D s t O U O o .v cap O N I— O h L C3 v O 0)0- 8,D) N 3 a v cu a) o m 'o` -F pEo y 7 N N Q i w.. i1 O C .12 O O F EU U ol- 3 [2 6 e a m N� p o � o v CD (^OEn CL T {: NN mm LL LLz Q LU LU (� WHO C� f 0 w d' o af LLJ w �— 12fwZO _j LLI wZ0w W0OcI3 U O�Ow C/ �0z� z=w0 Co w�C') WuaQ(Cj F 4T-QZ wF-Q-n CJ v� S N m T U w V U � � N C O p O W m N t N N N w m 3 c � m � r 5, Q � � U E m C p N 7 O Q V- 9 E O C3 ._ u> c` o w w a 0 0 C OCU > 0 o Cos N � a N m U 3: O O yN J p E a U o w � L O N V W O �ooN� E O N O � � c ao w N � N � � o J C L '3 h [6 N y � C O] W p C'O N U 2 - N O •O— O N N U � � N CC,, C C p 0 O E o o c E o o m U c m c D s t O U O o .v cap O N I— O h L C3 v O 0)0- 8,D) N 3 a v cu a) o m 'o` -F pEo y 7 N N Q i w.. i1 O C .12 O O F EU U ol- 3 [2 6 e a m N� p o � o v MUNICIPALITY CJFANCHORAGE On -Site Water & Wastewater Program POBox 1yas5n 4rO0Elmore Road Anchorage, Alaska y9519-6650Phone: (9m)343py04Fax: (907) 343-7997 On -Site WastewaterD^sposal System Permit Permit Number: OSP201165 Work Type: Septic Upgrade Tax Code Number: 05028114008 Site Legal Address: EAGLE RIVER HEIGHTS BLK 8 L 11 N2 8�0053 Site Mailing Address: 1O31GLEE ST, Eagle River Owner: HOOGESVVADEA&S|LKEM Design Engineer: GARNESSENGINEERING GROUP LTD This permit isfor the construction of: Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 6/11/2020 6111/2021 2 Disposal Field Z Septic Tank [] Holding Tank [] Privy 0 Private Well [] Water Storage All construction shall beinaccordance with: 1 The attached approved design. 2. All requirements specified inAnchorage 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.S5.Provide notification bycalling (QO7)343'78O4(24/7). 4 From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall beeither: a Opened and Closed onthe same day, or b. Covered, sealed, and heated to prevent freezing Received Date: 6 111,2-0 Date: (o 1142OVo 4 MUNICIPALITY OF ANCHORAGE Development Services Department T,#` Phone: 907-343-7904 On -Site 'Water & Wastewater Section Fax: 907-343-7907 ON-SITE SEPTIC/WELL PERMIT APPLICATION f` Parcel I.D. 050-281-14 Property owner(s) WADE HODGES (C/O AGENT: BROOK STILTNER) Day phone 244-6742 Mailing address 10316 LEE STREET, EAGLE RIVER, AK 99577 Site address 10316 LEE STREET, EAGLE RIVER, AK 99577 , Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (Z all that apply) Single Family (SF) Absorption Field 0 Initial ❑ (w/wo ADU) Q Septic Tank 0 Upgrade 0 Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage . ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: j: 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: QrJ2' Il Waiver Fees: Date of Payment: LI l l ! a (1 a0 Date of Payment: Receipt Number:�kL15SL7 Receipt Number: Permit No. 0_5p90l1(06_ Waiver No. G:\DevelopmentServices\Building Safety\On Site Water and Wastewater.TormsUient FormsTermit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201165, Rebecca Carroll, 06/11/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201165, Rebecca Carroll, 06/11/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201165, Rebecca Carroll, 06/11/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201165, Rebecca Carroll, 06/11/20 01 I m CV) I Mll m cn 13381S 331 I T-97,9 3,,00,M:,00N uj < Q (11!nq ION) J -S i1 I I I z r P 0 of Ul LU a z Xw Q 0 yy 0 ly LU UJW 0 Z Z Z L a z z 01 LU < V) Ul V'l U� C00 -j < Z Lli h a. -j Ql Ul f c6 C) 'u 05 L9 0-u '5 Q" C") luaLueses qj! -010 astlOH;3wejj .16ZIS Z'OF fi +1 uj < Q (11!nq ION) J -S i1 I I I z r P 0 of Ul LU a z Xw Q 0 yy 0 ly LU UJW 0 Z Z Z L a z z 01 LU < V) Ul V'l U� C00 -j < Z Lli h a. -j w Ul f c6 C) 'u 05 '5 Q" W -010 4-1 0 to Z 0 cri 0 Fri > ix c LL Ui m CL Zi W Z a) So 2 uj < Q (11!nq ION) J -S i1 I I I z r P 0 of Ul LU a z Xw Q 0 yy 0 ly LU UJW 0 Z Z Z L a z z 01 LU < V) Ul V'l U� C00 -j < Z Lli h a. -j Ul f c6 'u 05 '5 Q" -010 x to Fri > ix c LL Ui m CL Zi W Z a) So 2 eT J: 6 cz Co' 7F '2' Q� 8IL > 0 EChi . TM T w f E r5 :9- -0, 8 9-0 u < U-1 -0, M T) C3 =7 > uj < Q (11!nq ION) J -S i1 I I I z r P 0 of Ul LU a z Xw Q 0 yy 0 ly LU UJW 0 Z Z Z L a z z 01 LU < V) Ul V'l U� C00 -j < Z Lli h a. -j  MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME 1PHONE [~NEW MARLING ADDRESS LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS Wel!~/ / AbsorpVon yea Dwelling{~LO / PERMIT NO. ~ ~ DISTANCE TO: ~ ~ [0--  Liq. capacity in gallons Inside length Width Liquid depth ~ OOO IF HOME.DE: ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O Z ~ Manufacturer Material Liquid capacity in gallons ~ Well , Foundat,on / Neares~,i~ PERS~3' g= DISTANCE TO: / ~O + ~--~ ~e Total lenX ~ ~nes Trench width ~ No. of lines ~ Length ~hfiine inches Distance between lines Q ~ Top of tile to finish grade q ~ Material beneath ti,e 8~ inches T°ta' e~7 ~°rpti°n area Length Width Depth PERMIT ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ CI~o~ Depth Driller Distance to lot line PERMIT NO. ~ : Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS ~0~ ~ SOILTESTRATING [ ~0 ~ INSTALLER ~ [0r- ~ REMARKS APPROVED ~ DATE LEGAL 72-013 (Rev. 3/78) RIf:'I:;:'L i ()FII",!T f I,'~:,~i;"';;.;,~., (:C;,':Z:",r,r:"JC::T 5 C!N LOCFt-r'tON ERGL. E R:I',/ER HT'S; L. EOF4L. L_:LJ.. N:i./L?: E:=~!~ EEI::.IGL_E R',,,'R: H'T".S L:i~ :E;g!UFtRfiE FEET 'I'¢F'E OF:' 'ZOIL FIErSEd:;;:E:TION Z"r'STEM IS:;' '[R:ENE:H MFIXIFILlr,'I t'-4L~ME:EF.: F)F E:E_:E:,I;?OL'LH':'~ := ::7OIL RFITING (L:-ig! FT,-."E:R>:--: ::LSE:~ THE: I-~Eb.L:(FtE[:, SI:ZE CIF THE ZOIL t-:.IE:'SFff;.'P"f'ICN S';"r'FTEH IS:;' FFIE LENGTH [:,IHENS;I~ THE LEr.4GTH I:: I1'.,I FEE'T::, OF THE 'I"R:ENE:H O1:;;: [:,RFIII'.,fFIEL.D. THE: E:,IEF'TH OF Ft ~.,IF:H O1~ F'IT ~S; "E'~E E:,ISTFli"~CE E:E:T!.,.IEEN THE 5UR:FFICE OF THE GR:OI. Ii'.,~[) ~~',~¢ TOI"t OF1 THE T~ 6I[:'T.I'-t FCF.: TR:f~NCHES. 'mE ,:,,_,TR'FIU Rt',fi> "f HE E:OTTOH OF: 'T~'i~ E:?::CFIVFIT ~¢ZIl",l ,:: ! N FEET >. / -' - ~' ' 'FI~F'F'[ Ir": ...... , .... , .... , .-: _ . : ' . '::, [:,EF:'RF4:I"I"tEI"4'f' DLIR I NLq THE fI[11.,~_. -IE ILl T'T' T-I Ii',IFFIfqfl 'l'HI '-:::i:l" ~iF~]] ''['f::lT~[ I!~.'f,I- F]J',fT][i,.,~.~p[_~C__;.HFt-~OI"4~";THE oF-F'~--FI;:,Ir~-t,.IELL~;FI F'I[:,.I'FIC~I'.iT TO TH]~; .f::'R:L')PE~:T'T' FIND THE NI~R: AF PE':.;IDIFNF:EC; l'l--If:t'l' THE! !-,.IELL P.II. Li.. E',I:::tC.:I':::F]:/...LII',If3 EF' Fti",l"r' _:-,~.:,FEfl .b. IITHOUT F~NFIL II',ISF'EC:T~qN FIi",IB~ FIPPF::C%'I::,~L [:,EF'RR:THEt',IT ,t.I ILL BE SI E:JEC:T 'f'O F'R'. _3':~EL':I.jT t"t:[NIMI.JH [:,I%'['FINCE E:ET.klEEN FI !.,.IELt_. Fti'-,t[> FIN"r' ON'-:[::ITE :.'T'.;E.~'tFII3E [:'ISF:'OL:;FIL. "S;'¢S';TEH I::T, :L(i!I([~ FEET FOR: FI F:'F;:I"/F:ITE .b.lEt_L..; J..SE~ ]'3 2~;3E'~ FEET FREIH R PL.tE:LIC !-'.IEL. L [:'EF'ENDING UPL-IN YI"fE T"r'F'E CIR' f:'UE:LIE: I.'.IELL. O[HER: F::Eg!LIIF-:EMEI"O"5; MFt'T' FIF:'F'L"r'. ':.:,PE:::IFI2FIT'[ON'.5 RfN[:' COi",tfSTI~:L.IC:T~Cd"4 [:'IFII3RFff'IS FIF::E Fff'/FIII...F:fE',LE TF.) IN:SUI::;:E: PR:OPEF.: It",iSTRL. LFtl"II3N. F" EE !;;4' tr'-"l~ Lt. -I I(:Z; ::-:: I1:::' I II::;;." E: "::; [::, F:' C: E I-"1 E." E:::; I CERTiF"r' THFIT :[.: t FtH FFIH I L I FIR: !41 TH THE REIi.!U I REHENTS F'OR O1"4--'_:; I -FE S';EP~E:Rt~ FIND .WELL"_:': FIS S;ET FOF::'FH B"r' THE HUN I C: I F'FIL.. I T'¢ L')F: Ri",IC:HO~,;:FtGE. 2: i 14ILL. IN'.:3TRLL THE S;"r'STEM IN FICE:OR:DRNCE P~IIT'H THE C:OI3'E£S. 2;:: I UIq[:'ER:L:,TlaND TI"iFtT THE EII"4-SITE 'ZE~-'.IER ?¢S"FEM MFI'T' F::Eg!UIRE Et"~LI::!R:C:iEEf'tE:I",IT IF '['HE F;'.E'.5![:'ENCE I5 REMOE:'ELED TEl INC:LIJDE MORE T'HFtN _-.J: BEE:,ROCIHS. ~ 2204 Cleveland Anchorage, Alaska 99503' Performed For ~~.. ~k~ D~te ~erformed_. ~-/0-~ _ Leaal ~escrintion: Lo aBloci: ~ Subdtvisinn~~  Perc This Korm Renorts Soils [o~ :~ation Te neuth Feet 2 - 8 - k0-- 14 [6 , Soil Characteristics Was Ground Water Encountered? IF Yes, At what Depth? IReadinq Date Grnss'Time ? - L - F Net Time Depth to H20 r~et Dron Fercolation Rate Hinute Prnposed Instillation: Seenaoe Pit Drain Field ' -- Bot Den. th of Inlet Depth To tom .Of Pit Or Trench Test Performed By Data Certified ~: Date: Mlinflelpalfty of Anchorage On -Site +Nater and VVastewater Program V (907) 343-7904 Parcel I.D. 050-281-14 Certificate of On -Site Systems Approval Expiration 1. GENE RAL INFORMATION: Complete legal description EAGLE RIVER, HEIGHTS: BLOCK 8, -IW N1/2 OF LOT 1 11 Location (site address) 10316 LEE STREET. EAGLE RIVER. AK 99577 - i Current Property owner(s) WADE HODGES. Day p one C/O AGENT Mailing address P.O. BOX 1249. DOUGLAS. WY 82633 Real Estate Agent BROOKE STILTNER _ Day p lone 244-6742 2. TYPE OF DW�tLLIMG: Z Single Family (w/wo AD.U:) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. 4. TYPE OF WATER SUPPLY: TYPE OF WASTEV.VATER DISPOSAL: Individual Well Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community Public Water System ❑ Public Sewer ❑ WaivedVariance request for _ _ Distance: Received by: _ - Date: COSA tone released to the engineei. unless-ollienvise requesled.by the engineei COSA Fee ` q% 334- Waiver Fee $ Date of Payment _ - �d2�( o�o1 Date of Payment Receipt Nunlber - Receipt Number I. COSA:#Q5C oL-U1;L7? Waiver# 1 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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Roatl Suite 101- Anchorage, Alaska 99507 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; C >� industry practices. The reported results describe the condition of the system/s on the date/s of the j evaluation. Separation distances were measured to readily identifiable features Hidden defects or i) -- encroachments may exist that were not identified during the evaluation.. The operational life of all wells / i i '�� and septic systems depend 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), and the water usage of the family utilizing the system/s. These conditions can vary, and ....... ... are outside the control of GEG. Satisfactory test results do not guarantee future performance of the (r f r f ('Cr, -s systemis; therefore, GEG makes no warranty (express or it regarding the future performance of .l=? r_a- •x the well or septic system. GEG makes no representation whether an alternative well or septic system vli 1t� ti5� .j can be installed on the property in the event either of the current systems fail to perform adequately in �f� �� jt 1Z .71� 1 the future. The content of this report is for the sole benefit of the person/party that retained GEG to ,� cf111e5s4pr \ perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not ,authorized. nor will it confer any legal right whatsoever. #AECC884 6. DSD/SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms ``\`AQP\\�� OFHp Disapproved `V� SATES Conditional approval for bedrooms, with the followi tips. gsp, STATER Q q \NR -. 1))))?)1111 By; q Original Certificate date: j b (� 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 COSA blue sheet 10-10-12.doc. Legal Description: EAGLE RIVER HEIGHTS; BLOCK 8, LOT N1/2 OF LOT 11 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑■ Well log is filed with Onsite (or attached) Date drilled 8/11ne Total depth 108 ft Cased to UNK ft ❑■ Sanitary seal is functioning correctly ■❑ Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 5/14/20 Static water level at beginning of test 68.1 ft. Comments B. TANK DATA Age of tank(s) NEW years Tank type/material SEPTIC HDPE Measured operating fluid level in septic tank NEW ❑■ Standpipes/foundation cleanout per record drawing Date of pumping NEW D. ABSORPTION FIELD DATA DEEP TRENCH Which system tested (date installed) 6/2020 ❑■ ALL standpipes present per record drawing Total measured depth from grade 13.1 ft (max) Measured depth to pipe invert from grade 7.0 ft (min) ❑ N/A — pressurized field Al Monitor tubes go to bottom of effective. If not, state depth into effective FE -1 Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 050-281-14 Structure served by this system I Well production at time of test 4+ gpm Water storage tank volume NONE gallons Well disinfected for coliform test? ❑ Yes ❑■ N ❑■ Coliform bacteria is Negative Nitrate 3.38 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑E Arsenic less than MRL (ND) Collected by GEG,LTD. Date of Sample 5/14/20 STATION ❑ Requir aintenance completed Age of lift stationye Lift station material Adequacy test date NEW Results Q✓ Pass For 4+ bedrooms Fluid depth prior to test NEW in Water added NEW gal New depth NEW in Elapsed time NEW min Final fluid depth NEW in Absorption rate 600+ gpd Any rejuvenation treatment (past 12 months) NONE If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑✓ Yes Community Sewer Manhole/Cleanout > 100' ❑✓ Yes if No ft ❑✓ Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' ❑✓ Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' Yes if No ft Water Main > 10'✓❑ Animal Containment > 50' 0✓ Yes if No ft ✓❑ Yes if No ft Yes if No ft Water Service Line > 10' ❑✓ Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway comment below Community Sewer Main > 75' Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑✓ Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5' ❑✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q✓ Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10'✓❑ ft Yes if No ft Community Wells > 200'✓0 Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10'✓❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓Q Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Service Line > 10' M✓ Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' ✓0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l 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. COSA Checklist yellow sheet #AECC884 a Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FoR A SINGLE FAMILY DWELLING Parcel I.D. 050-281-14 1. GENERAL INFORMATION Expiration Date: Complete legal description Location (site address or directions) 10516 LEE Curren[ Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address EAGLE RIVER HEIGHTS SUBDIVISION; N2 OF LOT 11r BLOCK 8 STREET * EAGLE RIVER, AK * 99577 TOM HARTZ451~/3 ~ Day phone 652-9118 10516 LEE STREET * EAGLE RIVER, AK * 99577 Day phone Day phone Unlessotherwise~queste~ HAAwillbeheldbyDSD ~rp~k~. 2. NUMBER OFBEDROOMS: 2 TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well [] Individual On-site [] Individual Water Storage [-"] Individual Holding tank E] community Class Well ]--] Community On-site E] Public Water System D Public Sewer D The Municipality of Anchorage Development serVices Department (DSD) Issues Certificates of 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 samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Cedificates 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 be/ow, 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 wast·water 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 fi/es 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. NameofFirm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysis of the system in accordance wfth ADEC and MOA DSD Guidelines & Regulations.. The reported results described the performance of the system under the conditions encountered at the time of the test, and separetion distances measured to readily identifiable features. The operational life of ali wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outs/de the control of the eva/uator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide any warranty or future estimate of how long the system wi//continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. AnY reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. Phone ,,337-6179 , DSD SIGNATURE ~ Approved for ~ bedrooms.' ': ''; "' Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: Attachments: HAA Checklist 'Septic System 'Advisory Well Flow Advisory (Rev. 12/01) · - . , ~.'~ ...... ~' Man tenan~ Agreements Supplemental Enginee¢s Reod Other Original Certificate Date: MuniCipality of Anchorage Development Services Department. Building Safety Division On-Site Water,& Wastewater Program 4700 South Bragaw St. P.O. Box :,196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us ' (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST , t ~. : ~ , . ' .~l Leg~l~Description:EAGLE RIVER HEIGHTS: S/D~ N2 OF LOT 11, ,BLOCK 8 Pa~-cel ID: Well Log (Y/N) A. WELLDATA .... : W~;II' ~p~"-PRIVATE If A, B, or C Provide PWSID# N/A Date 6ompleted 8/11/1978 sanitary seal (Y/N) YES To{al D~ni~ ot;.test Static water level Well production WATER SAMPLE RESULTS: Colifo~rm 8/11/1978 i 34' 108 ft.- · Casedt(~ 108 ft. FROMWELL LOG ~ : ~. g.p.m. 0 colonies/100ml. · Niti'ate 1.6 mg./L. :,~: - ' . - ! . . Ar~Jnic:., N/A mg./L.. , Date of sample: 6/15/2004 ' ,,' . "~ .... Collected ;by: TANK DATA ": '; ' ·.*INSIDE FOUNDATION B. SEPjTICIHOLDING Tank ~i'ype/Material ~ SEPTIC/STEEL Date iri~tali~d Tank~ize 1000 :gal. Number of C°mpadments 2 Fo~i~dati°n cleanout (Y/N) *YES DepresSion Over tank (Y/N) NO 050-281-14 Wires properly protected (Y/N) Casing height. ,,, (above ground) AT INSPECTION. .: '6/15/2004- - 6.0, g.p.m. Otherba~t~da 0 . Cl'ean~btS" N) : ,;'. ,., ~ , 'High war?' alarm (Y/N) "JR'S :;PUk4PING YES YES 12+ in. colonies/100 mi. GEG, Ltd. 8/14/1978 YES Date ,of pumping ~ 6/7/2004 ; Pumper C. A ,~R~TIO" FIELD DATA. · ii'BELOW E:X;S'nN(~ ¢I~I)EI '" : iii Dato'in~talled 8/14/1978 ·S0il rating ~rffYbdrm) 15°,: S~st~ type.:: TRENCH. · ir!r: i' ' ' · , . ~' , '. ~: ,'~ ,~ ,!.Ler~"t~; il:, 33 · ft. . . ,"WidtJ3, . 'UNKNOWN . ft.'- ;. Gra~l below pipe 8~ . 'ft. ·Total'delJth 12.3 ft.',Eft, absorption area 528 ft': Monitoring tube YES , IDepression over field NO ' Dateof, adequacy test 6/15/2004~. i~.Results(Pass/Fad) PASS.. ~.? ~ '. -·.'For 2 bedrooms Fluid depth in absorption field before test 24.5 in. Water added 1195gal. ,~ { : . .New dept~ 10o EI~s~ ~ime: 1220 min.. ,' Final fluia dePth 80.5 in.. ':: ...... : Absor~fio~'~ate >=' 300+ g.p.d. ',~'~ ~ L , ' , . . ~:'. ' ' ' ' ' :' . ~: ~ ~ ~.. Ahy~ju~enation {reatment (past 12 mo.) ~/N & tyPe) :; NONE KNOWN I; '~ if yes, give date - **~ 378 GALLONS INTRODUCED ONLY CAUSED 18.5~,INCHES OF RISE D. LIFT STATION r" J Date installed '. i "Size in gallonsr- ' r ~ · ,Pump o~', level at ~n:. ~. i _ iHigh watertlarm Ievel at ._ ~in~ ~ : . Cycles tested. . : ... _ Meets alarm & circuit requirements?.. E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic taCk/lift station On Ioi 1 oo'+ On adjacent lots ' ' - ~eld Absorptio,. T~ on' lot 100'+, ' , on adjacent lots Public se~ver main . ' N/A sewer/s~ptic service line ' 25'+ Holding tank 'SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation. 5'+ ~ Property line 5'+. Water m~in - N/A . Water service line 10'+ Wells °n'adjacent Iots'i'- '100'+ ... SEPARATION DISTANCE FROM ABSORPTION FIELD ~)N LOT TO: Property ;!jne 10'+'.' Building foundation'~ ,10'+ Water service line 10'+ Surface water 100'+ .-Curtain d~ain - NONE KNOWN Wells on adjacent lots '100'+ F. COMMENTS .. " .. ;' ii! '150'+ TO CLASS C WELLS : ;i.,i ,.: -, ',' ". - " I certify that I have determined through field'inspections and · :review 'oLMunicipal records that the above systems are in ' conforma'nbe with MOA HAA guidelines in effect on this date. Engine,eff, s Printed Name JEFFREY A. CARNESS Date !: i!i " !' 100'+ - ~ " 100'+ ' ~" Public sewer manhole/cleanout : ':, N/A ~Absorption field 5'+ ;. Surface water. 100'+~ Water main Driveway, parking/vehicle storage 10'+ G. ENGINEER'S CERTIFICATION Waiver Fee $ Date of payment Receipt Number 'ii' rI, 6--17--04; 4:43PM; ;907 5615301 # 2/ 2 Laboratory Analysis Report :GS Ref.# ;lient Name ?roject Name/# 21lent Sample ID /latrix l~mple Return-ks: 1043343001 Gamcss Enginecring Group, Ltd. NI/2 ofLl 1,BS,Ea~le River Hts N1/2 of L11,Bg,Eagle River Hts Drinking Water All Dates/Times are Alaska Standard Time Printed Date/Time 06/17/2004 16:33 Collected DatetTime 06/15/2004 12:07 Received Date/Time 06115/2004 13:04 Technleal Director / Stephen~.~. Ede Allowable Prep Analysis 'aramcter Results PQL Units Method Container ID Limits Date Date Init ~aters Department Nitrate-lq 1.60 0.100 mg/L EP~ 300.0 B (<=10) ' 06/16104 JJB I Member of ~e SG$ Group [$oci~etA G,~n~rale de Surve]lanc~] APPLI¢-NT FILLS OUT UPPER HA! ' ONLY Phone Property Owner Mailing Address ~' "' ....)i','~ ~.~- ?i'1; ~U- tiL Zip Code t' /"[ ._~ ';1-? ('?/¢?/ ~' / ' Buyer ' ,~ ~'J , i:'~ / ' ~ /' Zip Code Address ~ · j Lending Institution : ;" ?' i~~ ¢''~. ~ ', ,'.,. / / / , / / ., -Jr ,~ ',;'~ , , Phone Address .' ~ Phone Realty Co. &A~nt j,~,~ ~.., ~ ..' ~ [ , ~ . ~ i',,' / ~ , Legal Description ~. ' , Street Locati~ /.,% ~ ~,,:., Type of Resi~nce Single Family Multiple Family No. of Bedroo~ ~ Other Water Supply lndivid A~ACH WELL LOG. A w~l log is required for all wells drilled since June 1975. Community For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility Sewer Disposal lndividl Year Indiv~ual Installed: Public UtBity When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED. Time Time Time Time ~. 7~. Date Date Date Date ~/~/._ Inspector Inspector Inspector Inspector ~-~,~'-~ '~" JUN 2 9 1983 ( ) DISAP~OVED Envir0nm~ntai ( ~ CO.D~T~ON*L*PPROVAL' Soils Rating Date ~wer Installed / / Well To Absorption Area Well Log Received ~ fi/?~ Well ,o Tank Septic T.k Size EXCAVATION ROBERT A. SHAFER .WORK July 10, 1983 CIVIL ENGINEER 694-2979 Dynamic Realty . ATTENTION: Charlene Skeet P.O. Box 1796 Eagle River, Alaska 99577 Dear ?,s. Skeel, Reference: Lot 11: Block 8~ Eagle River Heights Subdivision N1/3 A sewer system adequacy test was performed on the system located on the referenced property, as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The absorption trench was tested by a continuous flow of water over a period of 48 hours without any ~dverse effect on the system. It can be concluded from this test that the waste water disposal' system serving the three bedroom residence located on this property is currently functioning adequately. However, the system cannot be guaranteed against subsequent failure. If we m~ be of further service, please do n6t hesitate to call. / Sincere ~/J/? ?. . · /~A~DB~-~'A/ ~HAFER, P.E. ~S/ss .. cc: Municipality oE Anchorage Department o~ Health a~d ~nv~ronmenta[ Protection SRB 19~X EAGLE RIVER, ALASKA r ' INSPECTION APPOINTME T~ME TIME TIME DATE DATE DATE . INSPECTO MUNICIPALITY OF ANCHORAGE DEPT. OF H~ALTH &  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI~iRONMENTAL PkOTECTION 825 L Street * Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION 5Ui'~o ~ 1981 Telephone 264-4720 o. DIRECTIONS: Complete all parts on page 1. Incomplete requ~ will not be proceed. Please allow ten (10) days for processing. 1. PROPERTY OWNER [ PHONE MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS ~. [ENDIN61NSTITMTION [ PHONE I MAILING ADDRESS 4. REALTOR/AGENT ~ ~ PHONE MAILING ADDRESS * D-. STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One [] Four {~ SINGLE FAMILY ~ Two [] Five [] MULTIPLE FAMILY [] Three [] Six [] Other 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available.) 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX , PERMIT NUMBER 2. WATER SUPPLY [] INDIVI DUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] I NDIVI DUAL/ON -SITE DATE INSTALLED []PUBLIC UT'L'TY Connection Verified INSTALLER [~Septic. Tank or [] Holding Tank Size: ('(~dO If Tank is homemade I SO~LS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area ]Sewer Line I Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5. COMMENTS [] CONDITIONAL APPROVAL (letter must accompany certificate) [~-'-~ISAPPROV ED 72-010 (Rev. 6/79) 825 "L" STREET ANCHORAGE, ALASKA 99501 ({)07) 264~41 i I GE()RG£ 4,{ SULLIVAN. June 10, 1981 Edward Phay 104 Lee Street. Eagle River, Alaska 99577 Subject: N½ Lot 11 Block 8 Eagle River He. ights Subdiv:ision Approval for the [n~.'[vidual sewer and water facilities cannot be gran:ed urtil the following items have been completed: (1) wa~e~ a_.'~alvs~s ~-~no~t needs to be submitted to this office from "~ t~c Chcm Lab, 5633 B Street~ for our review. I. ff_ct..z~ June 1, i , the lab fee is $20.00 {2) A well log subm.~tted tO this office for our ..evz_w (3) The well that ~s not being used needs to be abandoned and rei. nspec[. ,'~ ?," this offic~ (4) The septic I:.an~- }.~,n~e.d with a ..... ~,. ,. · -" ;~) ....... ]~ submitted ~o this office. If t:het:~a are any f~:~:ther questions, pi_ease cai]. this off[ce a~ 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ijw CC; First Nat].o:nal Bank of Anchorage % Kathy Cia]thorne Post Office Box 720 99510