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FIRE LAKE LT 1 TR B
Fire Loke Tract B Lot ! #051-322-02 Municipality of Anchorage Development Services Department :11~i ~1'~I" BuiMing Safety Divislon On-Site Water lind Westewater Pro, ram, 4700 P.O. Box 196650 Anchorage, AK 995'19-6650 Page www.cl.anchorage.ek.us (907) 34:~7904 ON-SITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT "~""'P,ztlTi" +-~At~) ~"U~fvl/J~,J WastewaterSystem: [] New [~,Upgrade ISo~?_. ~'. LA ~'E- f~i"L4.6- b/~ ABSORPTION FIELD LEGAL DESCRIPTION oIC,,4T. SEPARATION DISTANCES [] septic D Holding ~T.E.P. D Othe~ Septic ~so~tton ~ HoMing 3ubl~Hvate ~-. / c~ ~TtT ~M 7~2~J ¢14 ~ BENCH MARK Inspec~onspedo~edby: ~fl~Z5 tAl~Pb Dates: 1" Development5e~ices Depa~entApproval ~{,.. C~I~ ..~ Permit No. SW050418 Page. 2 of Municipality of Anchorage DEVELOPMENT SERVICES DEPARTMENT ON-SITE WATER & WASTEWATER PROGRAM 4700 SOUTH BRA(:;AW STREET P.O, BOX 196650, ANCHORAGE, AK 99519-6650 On-Site Wastewoter Disposol System end/or Well Inspection Report 2 Legal Description: FIRELAKE TRACT B LOT 1 051-332-05 / l, :' CARPI )RT ADVANTEX SYSTEM.-&.l .~._1 ....,. r TH-1 ~ · · ~ ~/// 5'X30' I)RAINFIELD '.' t~:. ;.. ~. , o - c~o~ ~,-~ SEP~C SYSTEM AND RESER~ INGRESS/EGRESS EASEMENT ELEVATIDNS 11--16--05 ~T To s~c) ORIGINAL GRDUN9 ~ T~ ~ ¢~DATI~ AT ~SC ~R LEVEL AT~ tO0 [N~NE/R'S ~AL =f HI Iz ~~TYPAR ~ ADVANTEX ~ ~ ~' ~ ' ' '; ~ Nov 16 2005 4:15PM HP LRS£RJ£T FRX 622-6??? p.l ~916 .~Ve~clLand Dr,ye ngbe I~v'er. Ali-.. 995Y7 (907) 622-67-/7 November 16, 2005 . Eagle PJver Engineering Re: Fimlake Subdivision Tract B Lot]. The llft: sia~ion at the above referenced property has been wired In accordance with NEC and Star. Local codes. Thank you. Kevln S. Hombuclde, Owner Administrator Ucense Number 128,t Spedalty Contractor Ucense Number 27285 MUNICIPALITY OF ANCHORA GE Development Services Department On-Site Water & Wastewater Progrem 4700 South Bragaw Street P.O. Box 190650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Nov 04, 2005 Expiration Date: Nov 04, 2006 Permit Number: SW050418 Legal Description: FIRE LAKE LT 1 TR B Design Engineer: 0848 Eagle River Engineering Services Owner Name: PATTY & DAN BILLMAN Owner Address: 15012 E. LAKE RIDGE DRIVE EAGLE RIVER, AK 99577- Parcel ID: 051-332-02 Site Address: 019071 UPPER FISH HATCHERY RD Lot Size: 138521 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 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. Received By: Issued By: Date:~ Municipality of Anchorage Development Se'rvices Department. Building Safety Division 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 ON-SITE SEWERJWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Permit Number SW Mailing address (1) ~/.~;"t~lZ. ~'. Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) LotSize I~, 5~-I Acre~ THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Day phone Zip Code Number of Bedrooms Well Only [~] Water Storage Water Softening Unit I certify that the above information Is correct. I fudher certify that this application is being made for a Slngle F~/,~,~~pplicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: Date of Payment: Receipt Number: t~. ~oo) Waiver Fees: Date of Payment: Receipt Number: Eagle River Engineering Services Christopher IL Wood, P.E. 10421 VFW RD. Suite 201 (907) 694-5195 tel Eagle River. AK 99577 (907) 694-3297 fax October 3 I, 2005 Dan Roth Manager, On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Fire Lake Subdivision Tr. B, Lot 1 TI5N RIW Sec. 31 Narrative & Permit Application Dear Mr. Roth: Eagle River Engineering Services (ERES) was contracted to perform a Health Authority Approval at the above reference property. It was found that the existing leaehfield was not properly documented at time of construction. However, the existing well on the lot was properly permitted. Due to the steep nature of the terrain on the lot, very limited space is available to install the leachfield and still meet proper setback requirements from Upper Fire Lake, and steep slopes. In order to make the new leachfield fit in the available space, it was determined that an Advantex advanced wastewater treatment system would need to be utilized. It is possible that during the construction of the new leachfield, we will encounter the existing leach pit. If this is the case, we will excavate all contaminated sewer rock within 4' of the bottom of the new leachfield and fill the void space with sand. When the new Advantex septic system is installed, the old septic tank shall be pumped, removed from its existing location, destroyed, and then buried on site. Any old sewer rock that needs to be removed within 4' of the bottom of the new leachfield shall be buried on-site as well. The existing and proposed leachfield and replacement site encroach on the neighboring lot, owned by the same client, and a new ingress/egress easement is in process for constructing the leachfield and reserve site. Please keep in mind that there is NO other area on the lot that meets setback requirements, or has the soil necessary to support an on-site septic system. This system is in close proximity to a steep slope greater than 25%. Actual slope varies from 45% to 65%. The new septic system falls under the guidelines, and will be constructed in accordance with, the Engineer's Bulletin/Memorandum dated April 7, 2004 regarding Slope Setbacks. No other location on the lot exists where a septic system can function and be protective ofhuman health. Every effort will be taken to maximize the distance from the leachfield to the slope. Approximately 5 cubic yards of fill will be required on the downhill edge of the leachfield in order for it to meet the 35' at 25% setback. This is for just one comer ofthe ~003~05-FI RELAKETRBADVANIEXSEPTICIqARRATIVE slope setback for the primary system. Approximately 20 cubic yards of fill, or material cut fi:om the hillside above the replacement site, will be required to construct the alternate site to nleet slope setback requirements, and the We believe that utilizing Advantex technology will be protective of human health environment, and will allow this site to be utilized safely for years to come. The proposed 3 bedroom septic system will have very limited impact on adjacent propertiesI for the following reasons: Installation of this 3 bedroom septic system and well site will not adversely affect the wel septic systems or reserve areas on adjacent lots. The surrounding lots are large, so there is room for wells, septic systems and alternate sites. ~ Immediate neighboring septic systems are all +20' distance, and no private (or community) wells within 10W of the proposed septic system. Drainage will not be affected and is not a major consideration in our design. ~ or Sincerely, EAGLE RIVER ENGINEERING SERVICES Christopher R. Wood, P.E. Principal X2003X0$-FIRE LAKETRBADVANTEXSEPTIClqARRATIVE If you have any questions please call our office at 694--5195. .~ .~."~ ~' EAST 251' PAGE 1 OF' 2 ~ ~ ~ / /-- Lot 1 ~T B ~ ~ ~~?./ ',, ,.~~~'~ ........ ~ ........ ~ ~.~ o - S~ER C~ O~ r~m~ / I~ ~"~[~~ r~t ~ 1. NO SURFACE WATER +100'. 2. NO KNOWN CURTNN D~NS 3. NO SEP~CS WI~IN ~0' UN,SS NOrD 4. NO WE~ ~IN 200' UN,SS NOrD WELL/SEPTIC SITE PLAN LEGAL: FIRE ~KE SUBDIVISION TRACT B LOT 1 OWNER: DAN AND PA~ BILLMAN CONTRACTOR: UNKNOWN EAGLE RIVER, A~ 995~7 (90~) 694-5195 SAX: (90~) 694-3297 NTEX SYSTEM- ---/-: ..... x~ II_J--~ 10~''' WITH AX-20 FILTER PO~) (,~k'~x~,~/o' .. j/~'I[-~ ~.MIN AND ORENCO LIFT BASI~I ( {EQUIRED) ,.- , I. .l'~5, - --/50~. .., ' ~ \ t ~-~ IIDRAiNFiELD ,A : /... '.. · ^l~ ~ II I'J-~ ..... ~_2~'~- ,~ !z~ 'iI , r ........ APPROX 5 CY '--J~ ',~L' - / x~: ~o~. \ ........../ F~LLL TO CREATE ~' X~ i I~ .~-~ ~.~.~ ~.: ': · .'/ FULL 35' SETBACK ~--~ \, i TH-2 F[~'L~[~'E~ S~TE APPROX 15-20 CY / ~ ~ SEP~C SYS~M~ FILLL TO CREA~ / ~ / ~ AND RESER~ ~SEP~C EASEMENT 35' SETBACK FOR { ~ INGRESS/EGRESS TO BE RECORDED RESERVE AREA i ~ ~EASEME~T SE~ACK ~ - ~ST HO~ ..... ~M¢~ I. NO SURFACE WATER +100'. · - MON~OR ~B~ ~- PROPOSED ~CH RE~ 2. NO KNOWN CURT~N D~NS o - S~ER C~ O~ ~ - EXI~NG ~CH ~E~ 3. NO SEP~CS ~THIN 30' UNLESS NOrD + - WE~ ~ - OR--AY 4. NO WE~S WI~IN 200' UNLESS NOTED WELL/SEPTIC DETAIL LEGAL: FIRE ~KE SUBDIVISION TRACT B LOT 1 OWNER: DAN AND PA~ BILL,AN ~"' ~" CONTRACTOR: UNKNOWN ~0~0~-~0 I ~AT~: ~/0~/0~ I SC~L~ ~"=~0' EAGLE RIVER ENGINEERING 10421 VFW Rd., Suite 201 S.E~t ~0. O~ Eagle River, Alaska 99577 (907) 694-5195 c~,~-c~c~ e~,. Fax (907) 694-3297 C~EC~£~O~, ~^~ I I ~ / A', ! .-4 '~' ~1~ ................... i ..... -,~. ....... t ......... ~ ~ ~-- ~ ...... ~ ........ r ................... ~ ........... ~l . I~ ...... ~ J.-...-4 ........................... ~ --.- ........................................ ~ .................. / .............................. ~ .--.-~..- .~ ...... ; .......... ~ ........... --~ ..................................... i -~ ........ F ............................... i.-~ ..-.~ ......... ~ ..... .._ ' J~ ......... I .............. ~ ..... :'~ ........ ~--' F--/j .............. ~-,~' .-g, ~.~J.-~ ....... ; ----i ........... ~ - ,~ ..... -- ~', ................................. ~;"~ '-~ '--h'~ '"-'-~ ........................ ..~., ................................. ~ ..... ,~.._/J/_j , ~ ~ ~, ~ ~ ~ ,~ , ~ ~ "~ ..... i ~ 1 , .................. I-/~ ......... ~ .... .................................. ~ ............................ _~.__~ ............................ ~ ....... ,__ ......................... ,~ i ......... i ......................................... ~ .......... ~ ........ ~ _ -"7 -~:~ .... I ........... ~ ......................... ~ ..... ~ ......................... 'c~ .............. ~: ..... ~-~ '-/,~ ....................... -- ................... F-- '%~7 ........... ~ ............... E ........................ ...................... ...... ................ ............... ~ ................... ~ .... f-~: ..................... ................................................. ~ , t ........................ ~ ~ ................................................. , ............ L~i. ~ ~ -~;L,t '~ ........ r ~: ..... ........ ......... ~ ~. ~j -J~ ~' .~ ......... ~ ............. : ...... l.---jk ..... ~ --- , ~T~"-l-~~ .......................... R ........ z .......... ~---~ ..... ~ .................... ~.-~ ...... ~-~ ............... ~ ............. f .................... l ........ -xJ-- ...... ~ .......... ~'-~ - -~-~ ..................... ~-'~1'~ ............. :--t ..... ~ .... : ............ i ........... ,-"~ .................... ~ ................. :1-~ ............... ~- ---~ ........... ~ I x _ :l~ J i .................. ~;~ .......... ....... ~.~_ ............ ~ .... .) .6; ............................. ] ............... ....... ~ ............ ~,j .--~ ............ ~ ................................. ~ ..... /~ ..................... t ...... ~-. ...................... ~ :~ ........ ~ ............ i~ ............. ~ _ ../.J ............ = ........ l ...... ~_ ...................... = .~ ........... __ J_J I Z ' - ............ /-' .................................. I- ................... I~'- ~ ............ ~ - _,z ~ ":' / ~ ...... ~ -~,- ~::,q: ........................... ~ .......... ~_..,-~-. ~':, ...... ~ ........... ~ ..... ,_--~ ..... ~?: .................... ..... ......... ~ ...... ~ --l',~-~d- g ........... --t ...... ~ .... -/ .... ~:~: ................................ [ ........ t .... : ~-~ .... ~ ~ .............. ~ ......... ~ i---~.,. ................ ~ .............. ~ i I - I I , I /, ...... J ........................................................ Eagle River Engineering Services Christopher R. Wood, P.E. 10421 VFW RD Suite 201 (907) 694-5195 tel 'Eagle River. AK 99577-3294 (907) 694-3297 fax SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM - MOA CERTIFIED INSTALLER LEGAL: Fire Lake Sub. Tr B Lot 1 October 31, 2005 A. GENERAL + k2003~05-FireL~kcTEBdrain field-lift-Advantex spec The septic plan is for a3 bedroom single family residence only. The drawing and or site plan shall be a part of this specification. All materials and workmanship shall meet the Anchorage Department of tlealth and State Department of Environmental Conservation requirements. [ All soil tests arc advisory to the design and are lo be verified or modified in the field by the engineer. All excavations and depths are advisory and arc to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. It is the responsibility of the owner to obtain all necessary permits or easements and lo locate lany adjacent multi-family wells. A licensed surveyor should locate any utility easements and exact t00' radius from the existing and neighboring onsite wells. The excavation is to be exactly in the area shown on the site plan, any deviation requires engii~eer approval. Any remaining open lest hole excavations shall be filled and monitor lube removed. ADVENTEX SYSTEM AND SEPTIC TANK · Septic tank shall be a fiberglass or steel 1500-gallon tank capacity of MOA approved construction for use with Advantex system. Install as per current manufacturers recommendations for conditiods in InstallAlaska.one AX-20 filter pod over septic tank capable of treatingl50 gallons per day of waste flow. If gravity feed can not be achieved, Install Orenco 24" pump basin PB-2496 outside septic tank, with OSI pump model P30-05 and controls to allow 23 gallon dosing of septic leachfield. Set p~mp float lo 13.5" above pump, timer for I minute dose time. Controls to be installed to MOA cod6 by licensed electrician familiar with OSI applications. Controls to include a dedicated phone line and ~eb based monitoring system. A municipal Inspection report or receipt from a licensed electrician shall be provided to the engineer verifying lift station wiring to all applicable codes DRAINFIELD The drainfield is to be located as d~own on the site plan. The total depth of the initial drainfield excavation is lo be approximately 5' deep, relative to existing ground elevation above existing leach field and end in lop of existing drainfield. The excavation Shall remove the topsoil layer, and any sewer rock withing 4' of the bottom of the new drainfield. ~The bottom of the excavation shall be level, plus or minus 1.5". , I lnstall~ of Coarse Sand beneath the sewer rock layer. Use four feet, if required lo get 4 separation above existing sewer rock, if encountered. AN eighteen-inch layer of sewer rock is to be placed over the sand layer (fifieen inches if lift stationi is utilize,d,). The 4" effluent piping (1' if lift station is required) is to be buried within the gravel I&yer with 2' of gravel cover over the pipin.g. . . I The completed drain field gravel and p~ping is to be covered w~th lypar fabric material. I Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed over the bed. Mounded side slopes on uphill side and ends arenot lo exceed 3:1. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' toany Class "C" well, or 200 feet to any community well. SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM - MOA CERTIFIED INSTALLER LEGAL: Fire Lake Sub. Tr B Lot 1 October 31, 2005 Continued: RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH = 5' maximum GRAVEL DEPTtl = 1' undcr effluent pipe, 2" over pipe (!.25 feet total) DRAIN'FIELD LENGTtl = 25' DRAINFIELD WIDTtl -- 5' SOIL RATING -- 6 GPD/ft2 BEDROOM CAPACITY = 3 EFFLUENT PIPE (GRAVITY)-- I run of 4" perforated pipe meeting MOA specifications. EFFLUENT PIPE (IF LIFT STATION IS REQUIRED) ,= 1.2.5" from pump basin to leachfield then 1" m. anifold to I" PVC with I/8" holes oriented down spaced at 1.0' OC. 2 pipe runs in leachfield 2' between p~pes 1.5' from sidewalls and end of trench. SEPTIC TANK = 1,500 Gal Advantcx compatible tank w/AX-20 filter pod and lift basin Twenty-four (24) hours notice required for all Inspections ~2003~$-FircLakeTRBdrain field-liR-Advantex spcc EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99577 (907) 694-5195 ERES Project No.: 05-FlreLake Calculated By: CW Date: 10/31/2005 Legal: Fire Lake Sub. Tr B. Lot I Single Family 3 Bedroom Dwelling TEST HOLE 1 Shallow Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = 450 gallons Percolation rate = 1 minutes per inch Wastewater application rate = 6 gallons per day per square foot Required absorption area= 75 square feet Trench width (W) = 5 feet Graveldepth (D) = I feet Required length = Shallow trench factor * Required absorption area / W Shallow trench factor = (W + 2) I (W + 1 +2 D) Shallow trench factor = 0.88 Total Excavation Depth = ~~eet Required length = ~ feet 05-FireLakeTrB_AdvantexdrainfieldCalc 10:51 AM10/31/2005 uniclpality of Anchorage ' DMevelopment Services Department Building SaFely Division On-Site Water end Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 .. ~w.d-.nch~ra~e.ek, lrl ·(gO7) 343-7gO4 Sods Log - Percolation Test ~ t~ ~ 7 ~ ~ ~- t Township. Range, Section: 5- 6- 7- 8- 11- I~O6fibRoc~ 12- 13- 14- 15- t7- 18- 19- 20- Site Plan WAS GROUND WATER ENCOUNTERED7 IF ~ES. AT ~IAT DEFTH7 Readl~g Date Grose Time Net Time : Dep h Io Water Net Drop PERC HOLE DIAMETER _ C_ TEST RUN BETWEEN -~ FT AND __L~ FT OMMENTS lb ~'*" t"'r_ ' --~"--" PERFORMED BY: ., LL STATE AND MUNICIPAl. ~"'UIDELINES IN EFFECT ON THIS DATE. DATE: ",'o,,,d ~o~. Legal Description: 7- n. 10- 11- 12- 13. 14- 1,5. 10- 17. 18- 19- 20- Municipality of Anchorage Development Services Department On-$;te Water end Wastawater Program 4700 South 8ragaw GL ,.~ Soils Log - Percolation Test OateP,,o.~ed: Io lz ~ Iof- Township, Range, Section: '7'1 ~A~ ~ ) ~ ~6-~_ ~ ( Site Plan Reading Date Gross Time Net Time Depth to Water Net Drop P~RCOLRllONRATE ~ I :..:~__~.~ PERC HOLE DLRME"rER C_ TEST RUN 8ET1N~EN · '"~ FT AND ~ FT TE ,N',ID M ......... GUIDEUNES IN EFFECT ON THIS DATE. DATE: Nov 03 05 11:08a Max and Lisa Rabinowitz 907-222-3932 , p.2 A L A K A 2005-07978 1 -0 Recording Dist: 301 -Anchorage 11/3/2005 10:05AM Pages: 1 of 2 ~;eptJc System £a~em~nt A~reemcnt ~, C- Whereas. the septic system and reserve ingress/egress being construct to provide sewage disposal for Fire Lake Subdivision Tract B, Lot I extends 67 feet more or less onto Fire Lake Subdivision Tract C, Lot I. Whereas, the Ovmers of the subject parcels wish to enter inlo an agreement to allow thc usc of said septic system and reserve ingrcss/cgrcss. An easement is hereby created for septic system and reserve ingress/egress on a parcel of land located within NW I/4, Section 3 I, Township 15 Noah, Range I West, Seward Meridian, more specifically located within Tract C, Lot I, Fire Lake Subdivision, according to Plat No. P- I I I, Records of the Anchorage Recording District, Third Judicial District, State or'Alaska, and more particularly described as follows: Commencing at the northeast comer ofsald Tract C, thence Westerly, along the north boundary of Tract C, a distance or360.00 rect to thc True Point of Beginning; thence Southerly perpcndlcular to thc north boundary orsald Tract C, a dlstancc of 67.00 feet thence Westerly parallel to the north boundary orsaid Tracl C, a distance of 5.5.00 feet; thence Northerly perpendicular to the noah boundary of sold Tract C, a distance of 67.00 feet to thc noah boundary of sold Tract C; thence Easterly along the north boundary of said Tract C, a distance ot'55.00 feet Io the Truc Point of Beginning; Containing 3,685 square feet. Whereas it is understood that thc protection of parties is paramount, the parties agree as follows: I. The easement shall be granted to thc owner of Fire Lake Subdivision Tract B, Lot I and their heirs and successors. Sale or transfer orowncr~hlp by thc owner(s) ofeither lot shall includc transfer ofowncrshlp of thls agreement. 2. It is expressly understood that this easement agreement shall only be valid as long as the existing sepllc system is operating in accordance with Municipality of^nchorage standards. Page I or 2 Nov 03 05 11:08a Max and Lisa Rabinowitz 907-222-3932 p.3 3. It is agreed that the Owner et'Fire Lake Subdivision Tract B, Lot I shall hold the Owner of Fire Lake Subdivision Tract C, Lot I harmless from damage or penalty as follows: a. Sewage spills or overflow. b. Costs in connection with any form of vlolation of'law regarding septic system operation. o. Conflicts with or damage to wells, groundwater or other parts of the enviromnent created solely by Ihe septio system. d. Any cost arising out of inspection, repair, or damage et'the septic syslem. Thls agreement has Ix:on slgned and enterad into the. 2n~ day o£ November ~ 2005 in the Anchorage Recording District, Third Judicial District, at Eagle River, Alaska. Fire Lake Sulxlivision TractB', Lot I £agle River, Alaska & Patti Billman, Owners Fire Lake Subdivision Tract C, Lot I Eagle River, Alaska III11111111111 11111111 2ol 2 2005-079781-0 I..()C:FIT :[ CII"~ F' :[ SH HFt"F('::HEF::'.r' I I:ii:(:~il:::il. t_:1. iZi[~;~Fi: I:!i~ OF t_::l. F']:I:;i:I'!!: t..K '- ..... ./ I..OT ::!!:]:?E ,'1,:~:::.~!!![~ :i:!;(i:!l.,ll:::!!;i:?:' FT.:I::!:'[ t"'l::t'.,l:.:i',l_hl I)ZtL:;'I"I:::IN(:::E I-~:ETI.,.I~[:t.N I::1 I.,.1[~:[..[.. I::Ii'-4E:, FIi",l"r' ::ll~~-,~]:TE: SICHFII:!i[i!: I.::,:['::~F:'t'::!!:[::lt ':::'¥"::2T:::l','. ]::5 :l~F)(i!l FE;[CI" F'OR f:~ F'E:]:',,,'R"FfF I,.IE:t...L...~ :1!:i~(/~ TO ;::::(i)(!) I'::E:E'F FF::OF1 f:l F'LIBI..IC I,.!EI..L I.'.':'EF'EI"4E:,J:N~] I..ll:::'Olq THE "I""r'PE: OF' FI[CI.L. !...OEi:'~; f:lf;~:E: f~:EtT.!U~I:~:[-~D FINE:, i"llJfi'f' E~[~': I:[:ETt. I~:NE[.':, TO 'TlqlE: DEF'FIf;~:TP1Et'.,I'[ OF THE: 14EI. L (:::OF1F'I..[~:T:[()hl. (T'I'HI::!:i~: F:[::~::!LI t REFIEi"~T::5 I"~F:lk' FIF'F'I.."r' SF'E:C: ]: F .'[ C:FIT :[ OI",IS f:~i",l[) CON.':i;TI.;;:UCT Ft'v'f:.l :[ L..FIE:t...[i!: TO :[ N:~:;I..If~:E: F'F.'.OPE:F: I N":T',TFILI..f::IT]: ON, :[ C[!~iRTII-::'¢ 'THFIT ::I.: :[ 1::11"1 [::I::If'IZI_:[Ft[i'. H:[TH THE I:: Ol~;i:'rH B'¢ TFI[~: f,lt.!l'.~ ]: C: :[ F'F:II. Z T"r' ;?: :[ I,I ]: L.!.. I t"~S'TF~I, t TH[::: S'¢STEi"I I)EPFf~:Tt'IE NTr ':' E R P11 T H O. ~ F~T ! ON , t.O£ 'S[;:.?[:C ' ( ' . , , , %rPLFtRE FEET '!hlLIP! NLIhlE:EF: OF E',EDF:OOt, I:5 :: SIZE OF Tt{E ::3Oi(_ RE'.SErd"I'Ir~N ;~'r'S:,I'EH I'.; [HE LENL3TH D~I'IENS~Fli',~ ]:S THE L_E'HCJTI~ ~..[N FE'E1) OF TI~E '[HE [:,EF'.TH CIF [~ TF.:EHCH OF: [:'17 I:5 Ti-fi{ D].'F:,TFaNC'E E$:ff[,IE:[!H THE: :SUR:FFfl.-:E OF THE IJN:QLIN[) Fff-~[) TH[~ BOTTOrfl OF THET E::-::E:R',,,'F~T~(_-ffl (~N FEET) THERE ['E, NO L:,ET H~£:'TH FOR' 'TRENC:HE'::.:. T~tE GRF¢,,,'EL DEF'TH ZS THE I'lZI~PII.IpI DEPTH OF GRFt',,,'[:I_ E:[{]FIEL:.N THF. LqU[FFILI_ F'~F'E C~ND THE E:OTTOH OF THE: EXCR',,,'FiT ~ ON ,:. I H FEI£]'). ~.'1]'[ FflF'F'L~C:[aHT HFI% THE -, 'c':.h ,:.:' ., t;.E_,[ LH._,iE:['..[T"r' -D) [NF't')FfH ~1[c DF:Pf~Ft~hlEHT [)lJ['~:]~']C~ THE *-L[.. tTIOH ]NSF:'ECTIOHS OF F:IH'T' iqEi.LS L:ERt OF ~'ES~E:,Eta:;ES I'HBT THE. NEL_L ':gUPI D~STR!~CE E:ETHEEH FEET TO 200 FEET FR:Ohl F~ F'IIDL ZC H[:TI.L DEF'EHD]NG LtF'(~t] 7tie 'TYF'E OF F'UDI.'[C: N[ZtL. [HE HELL. COhlPLET~CItL ~li: F'EOI. II~:EP1E~i'~S t'IRY BF'F'L"r'. SF'E(71F'IC:RT]I3tI:~; Ffl';[:' C13H:3-[ti'.L.IC:'[~ON DIRGRRHS RN:E :l. RE:L_E !~:')'IFY THRT I PI'I F)3PII I. I RF: blI TH '[ HE [;:EGI. I ~ R:EP1E:t4'FS f:,:,~;: ,:,r.4-S I ] E SEI.F[::R:S [qH[:, I.I[~L t..S his SET 'i'it E:'T' 7'H~ f'll. IN :[ (:: I F;'F~{. I'I'Y OF: ~ HIT.I_ ]HSTRL..L THE S'¢STE:hl IN Hl::l]l]rfi'E:,l-ff.lC:E lqI'ftt THE ~ UN[')ER. SfRND THRT THE Oth-.S.l'lE' SEI,iEF: S'T'S/iE['I f'11::¢~' F:I~Qi.~]RE ETHLFflRGEP1EHT IF THE i(::,E~HC:~-~S ~:;EHOE:,ELEC, 1'0 IHJ:L.I.~D[~ HOP[:: 'T'HF~H :7: i! ~ ' .~-- ,¢ ~ . FIPPL ] C:~N]' EI~RONMENrAL F'i~O FECTION ~o~ ~o. ~ SEP ~ ~ SULLIVAN WATER WELLS ~. o. ~o~ ~, ~,~, ~s~ ~ · ~o~ ~ RECEIVED OWNER OF LAND ADDRESS LEGAL DESCRIPTION DATE - Started PERMIT NUMBER Ended I)EPTH OF WELL STATIC LEVEL OF WATER FT. DRAW DOWN FT, GALS. PER HR KIND OF CASING KIND OF FORMATION: From__Ft. to Ft. From__.Ft. to Ft. From__Ft. to Ft. From Ft. to Ft. From__Ft. to Ft. From Ft. to ,Ft. From __Ft. to Ft. From__Ft. to Ft, From Ft, to Ft, From Fi, to Ft From__Ft, to.__Ft From__Ft, to Ft From__Ft. to.__Ft From__Ft. to__Ft From Ft. to Ft. From__Fi. to Ft. From Ft. to__Ft From Ft. to Ft. From__Ft. to ..... Ft, From Ft. to__Ft, From Ft. to __Ft, From _ _Ft. to.--Fl, From Ft. to Ft From Ft, to Ft From Ft. to .Ft From Ft, to__Ft. From Ft, to.___Ft From Ft, to Ft From Ft. to Ft From__Ft, to__Ft, From Ft, to Ft From Ft. to Ft. From Ft. to Ft, From Ft, to Ft MISCL. INFORMATION: DRILLER'S NAME SULLIVAN WATER WELLS "" ~m /~' O~R OF LAND I)[Iqll Ot WELL ~om: - FI. to ; Ft. I~.m' · ". Ft. to FI. I~m Ft. to · FI. 'DATE.-'$~ed Ended GAL~. eER fir / ~ ~ OF;FORMATIOiq: F~FJ. t~Ft.~~_/~ From Ft ,o FI [rom~F~. ~' Fl F~m ~m ,'., F~'lg ~" ~t ' F~m, ,U~'L.'INFORMATION: From From, From From FI. lo Ft. FI. lo Ft. FI. to Ft. FI. to FI Ft~to Ft. FI. to FI. FI. Io.__FI, ii ~1 O ! / H / © c "LOT /" K © Adjoining Pog¢ No. Adjoining Tox Book Nc Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 0,51-332-02 GENERAL INFORMATION Complete legal description COSA # C~ ~----~ 1 / \ ~ ~' EXpiration Oate: FIRE LAKE TRACT B, LOT 1 Location (site address) 19071 UPPER FISH HATCHERY ROAD, EAGLE RIVER, AK 99577 Current Property owner(s) MARY M SOLSTAD Day phone Mailing address Lending agency Mailing address Real Estate Agent LES BAILEY & ASSOC. Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. NUMBER OF BEDROOMS: TYPE OF WATER'SUPPLY: Individual. Well Individual Water Storage Community Class __ Well Public Water System '4926 WESLEYAN DRIVE, ANCHORAGE, AK 99508 Day phone 3 Day phone TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] Individual Holding Tank [--1 [] Community On-site [] Public Sewer E~] 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, I vedfy 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 20441PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 09/15/2011 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· encroachments, deficiencies or discrepancies exist. ... .~.~!,.".~.. ......... ~. ~ .".' .. DSD SIGNATURE ~J Approved for _'~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: ~: ON-SITE _ . WASTEWATER Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X By: , ~ (Rev. 11/0 Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: ~'-~ 9-//_ Municipality of Anchorage Oevelo.pment Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: FIRE LAKE TRACT B, LOT 1 Parcel ID: 051-332-02 A. WELL DATA Well type PRWATE IfA, B, or C provide PWSID # __ Date cOmpleted 9/6/19~ Sanitary seal (Y/N) Y_ Total depth I40 f. Cased to 20.3 ff. FROM WELL LOG Well Log (Y/N) .Y V~res properly protected (Y/N) Y Casing height (above ground) 24 in. AT INSPECTION Date of test 9/6/79 9]1_~2011 Static water level 28 f. 5I f. Well production 2 g.p.m. 1.91 g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100mL Nitrate 2.0 mg/L Arsenic: ND .mg/I Date of sample: 9/8/2011 Collected by:. ArcTerra B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 11/1412005 Tank size 1500 gal. Number of Compartments _2 Cleanouts (Y/N) ~ FOundation cleanout (Y/N) _Y Depression over tank (Y/N) __N High water alarm (Y/N) ¥ Date of pumping Advantex System Pumper Sewiced by A+ C. ABSORPTION FIELD DATA Date installed 11/15/2005 Soil rating (g.p.d./ft2 or ft2/bdrm) 6__ System type Tre~tc_h Length 30 ft. Width _5 ff. Eft. absorption area 210 ~ Monitoring tube Y Date of adequacy test 9/12/11 Fluid depth in absorption field before test 0 in. Gravel below pipe 1.0 ft. Total depth $.5 fi. (Measured 9/12/11) Depressionover field ~ Results (Pass/Eail) Pass For 3 bedrooms Water added ~SO gal. New depth 0 in. Elapsed Time: 9__ min. Final fluid depth 0 in. Absorption rate i>= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N___lf yes, give date LIFT STATION Date installed I 1/1 6/0.5 Size in gallons 1 500 "Pump on" level at 1 Z in. "Pump off" level at 1 7 in. Datum top of basket Cycles tested Serviced by A+ SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main 75'+ Sewer/septic service line 25,+ Animal containment areas 50'+ Manhole/Access (Y/N) Y__ High water alarm level at 1 0 in. Meets alarm & circuit requirements? y On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout 100'+ Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Water main 10'+ Water service line 10'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Absorption field 5'+ Surface water 100'+ lO0'+ 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. ng~neer s Pnnted Name KENNETH M. DUF]~TS Date 09/15/2011 COSA Fee $490.00 Waiver Fee $ Date of Payment (~ ll~ I /I Date of Payment Receipt Number O ~- ~-- C'~'(~ ~ Receipt Number (Rev. 11/05) *System located across property line - prior ingress-egress easement recorded. Property line *0' Building foundation 10'+ Water Service line 10'+ Surface water 100'+ Curtain drain 50'+ (None Known) COMMENTS Water main 10'+ Driveway, parking/vehicle storage 10'+ Wells on adjacent lots 100'+ 09727720Z~ :05:22 8~8677:0 APLUS PAGE 0i ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN MUNICIPALITY OF ANCHORAGE AND THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this Day of -~/~ ~ th ./~f 20 [ i, by and between , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Memorandum of Understanding agree as follows: 1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as ~. ~J,., ? z~ ~. ?~ ~>~ located at /~[ f-C~ ~. ~/~(.-~ ~.c~ -'fi' ] "-'~"ffz~Anchorage, Alaska. 2. Definitions. A. Alteration. Any change to the design or function of an AWWTS that Includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Prior to performing any alterations to an AWWTS the owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65. B. Certificate of On-Site Systems Approval. An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with AMC 15.65. The term begins on the date of approval by the Municipality of the installed system and shall continue while the AWWTS system is in use or operational or until the property is sold or title is transferred by owner and a new certificate of On-Site approval is issued to the new owner or transferee of the property. 5. Alterations~ Installation and Removal of Additional Equipment. Owner agrees not to make any alterations, removal of parts or additions to the AWWTS without a Construction Permit from the Municipality. 6. Maintenance and Repairs. A. Throughout the term of this Memorandum of Undeistanding, the Owner shall maintain AWWTS in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further, Owner agrees to comply will all applicable ordinance, laws, regulations, rules and orders for the AWWTS. B. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions cohtained in the Owner's AWWTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's AWWTS Operating Permit is: C. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. Owner: Anchorage: Purchasing Officer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of Understanding shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Memorandum of Understanding. 10. Severabilitg. Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum of Understanding. OWNER: Date: q- 7;[ 0 '-- [ I STATE OF ALASKA MUNICIPALITY: By: Title: Date: THIRD JUDICIAL DISTRICT ) The foregoing instrument was ackno.wledged before me thi .s~ day,of .~/~'~/;?~Z./~(/~ 20 i/, by~_f~/_'/_..~/f/~.~_..~)i~i_; the ~~.. ' ~/ . My ~ommission expires: ~/~~ ~ Y~OJ~R~'. ~ '0 '.... :'p?~x 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 ~'~[,~.'~ www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVA~"'~ FOR A SINGLE FAMILY DWELLING Parcel I.D. o ;I - 1. GE.NEPAL INFi3RM~T,[ON Complete.!egal description' I=~'/~E z.~,~gJ 5',4r~, .;~ ~,. · ,:.:.;.~; · ~ ~'. -,Location (site address 6r ~.~ections) I~' 'Current Property owher(s~ ~:l~,4rr'Jc "Mailingaddress ..";.' I.~012, ~.. Lend r~g'agen~y ."' HAA # 0 ~0 Expiration Date: TIZ. I'5 LoT' I Day phone Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless othen~vise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well [] [] [] TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site [] Public Sewer [] 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 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. NameofFirm ~g'A ~,LI;.- I'~'d~'f'(. EM&.T.~J b"EI~;O[,,. ,~d~f;. Phone Address IO~?.-t ~F~ ~. ~,~4~"TFE To! Engineer's Printed Name (--/'/~__.¢ToP,~E~: I?. I.,J~t:> 'Date /I/~/~/~5''' 5. DSD SIGNATURE ~ Approved for ,.~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments Attachments: I-IAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report 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 Legal Description: I--'7'~/:- A. WELL DATA Well type Date completed Totaldepth /~0 ft, IfA, B, or C provide PWSID # Sanitary seal (~N) .y_~_5 Cased to ZD.~ ft. Parcel Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform ~ colonies/100 mi. Arsenic: ~l~- mgJl. B. SEPTIC;|,~LD,~.C TANK DATA We,, Log Wires properly prbtected (~N) Casing height (above ground) ~- .~ in. FROM WELL LOG AT INSPECTION Z g.p.m. Z. ~ g.p.m. Nitrate Z./Z mg./I. Date of sample: Tank Type/Material ,~4Jg- ~E4 Z~ g' Tank size ~ gal. Number of Compartments Foundation cleanout (~I'N) ~//..-,5 Depression over tank (Y/~' Date of pumping Other bacteria ,~ colonies/100 mi. Collected by: ¢ t~d-I~J.J=~. Date installed ' II/1~/~ f Cleanouts ~) High water alarm ~N) y~'.~ Pumper ~ ~ ~. ~o~' ~'~ '~ ABSORPTION FIELD DATA orr/_ ¢4T ~ ...- Date installed ~ Soil rating (g.p.d./ftz or-O~tbd~m) I.~y,/~ System t~pe .,,~-bV&n~T'~K, Length l~t~ ft. Width .~ ft. Gravel below pipe ~ ft. Total depth /.'/ ff. Eft. absorption area ~ ~ ft= Monitoring tube ~ Depression over field ~ O Date of adequacy test ~ /Z£cgtb Results (Pass/Fail) Fluid depth in absorption field before test ~ in. Water added a~ gal. Elapsed Time: ~/,,~-.rnin. Final fluid depth a,~ in. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (Y/N & type) ~d¢;~,,) For ;:~ bedrooms New depth ~. in. /¥~-O gp.d. If yes, give date D. LIFT STATION Date installed ! J//~/~ ~'- 'Pump on" level at IZ in. Datum ~ Size in gallons I 'Pump off" level at J ~- in. Cycles tested Manhole/Access ~)N) High water alarm level at /'~ in. Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 'f"/r.~o ' On adjacent lots Absorption field on lot 'l' I00 r On adjacent lots Public sewer main 't"/' oO ~ Public sewer manhole/cteanout Sewer/septic service line 'P/o 0 ~ Holding tank SEPARATION DISTANCES FROM SEPTIC/HeL-i~h~G TANK ON LOT TO: Building foundation (~ / ~" / Property line Absorption field /~ · Water main ~/~G' ' Waler service line '/' Z .C' Surface water ¢'/O~ · Wells on adjacent lots 'P' I~ ~ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ::~ (~ ~ Building foundation ~ .~ r Water main '/'-f~o ! Water Service line +'Z._~" ~ Surface water 4- I(,~ r Driveway. parking/vehicle storage Curtain drain 'f'J'~ Wells on adjacent lots 't~"l~.3 ~ E.S .EER'S CERT F CAT O" I ce~i~ that I have datelined though field ins~ctions a~ ~=~. _ _ ~.~ review of Mun~ipal r~o~s that the above systems are in ~ ~ ~.~ ~.~ confo~ance with MOA HAA gui~lines in eff~t ~ this date. Engineer's Printed Name C~~ ~. ~ H~Fee $ fl~.~b ~ I~,~ ~.~J WaiverF~$. R~eipt Numar ~ g~ R~eipt Numar (Rev. 1~1) Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.cLanchorage.ak.us (907) 343-7904 Waiver Review Worksheet WF~: 050103 Date Received: 11-17-~f Legal Description: Fi T Engineer:. Chris Wood Eaale River Enalneerlna Sv~. Applicant: Patti & Dan Billman PID~: 051-331-02 HA#: 050613 Permit: 050418 Waiver Requested: Zero feet seoaration distance absorotion field to nrooertv line. Criteria: Geology Points: A. Water Table B. Soil Sotption C. Peffneebility D. Watar Table Gradient E. Horizontal Separation Total: Waiver is Granted: ~ Waiver is not Granted: List Conditions or Reasons for above: Rec#: 11-17-05 Amount: $17~ Date Paid: 11117/200~; Municipality of Anchorage Mayor Mark Beg;ch I!O. Ik~x 19C£~=~0 ·Anchoragc, Alaska ~ k~ I ~C£~"-~) ·Tclcphonc (.~17) ~13-8~}1 * Fax L907} Bulhling S,'d'cty I)ivtslon 11/17/2005 Eagle River Engineering Svcs. 10421 VFW Road Suite 201 Eagle River Ak. 99577 Subject: Waiver Request for Fire Lakr Tract B Lot 1 Waiver Request #WR050103 Parcel ID #051-331-02 HAA# 050613 Permit # 050418 Dear Engineer: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to property line has been approved. The approved separation distance is 0.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Jeffrey W. Poet Engineering Technician On-Site Water & Wastewater Program Community, Security, Prosperity - ,, , - SEWARD & ASSOCIATES LAND SURVEYING '694:'0~Z I HEREBY CF-H~IFY ·THAT I HAVE SURVEYED THE SCA~.~ .- - FOLLOWING DESCRIBED PROPERTY~ - · EX ......... INDIOATED. IT IS THE RESPONmnnrrv n~' '.,.,.,~- /~ ~ D~RMINE THE /E~ENTS, ~VENA~S. OR RESTRI~'n"' WHI ...... /~,.- ~,.~.. ,