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HomeMy WebLinkAboutFIRE LAKE #2 BLK 2 LT 6Fire Lake #2 Block 2 Lot 6 #051-351-18 Municipality of Anchorage Community Development Department Page 1 of 2 On-Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP151227 PID Number: 051-351-18 ❑ New ❑✓ Upgrade Name: RAYMOND & GEORGENE REEKIE ABSORPTION FIELD Address ❑ Deep Trench ❑✓ Shallow Trench El Bed ❑ Mound 13711 SAVAGE DR. EAGLE RIVER, AK 99577 El Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 1.2 GPD/SF 6.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 3.0 Ft. 3•0Ft. Fire Lake#2 2 6 Fill added above original grade Gravel length Township Range Section 0 Ft. 45.0 Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES 5.OFt. Ft. To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Tank Line 387.9 Ft2 1 Ft. Well 103.8 112.6 113.2 N/A 50+ TANK ❑ Septic ❑. S.T.E.P. ❑ Holding 0 Other Manufacturer Capacity Surface Water 100+ 100+ 100+ N/A ANCHORAGE TANK 1000Ga1. Material Number of compartments Lot Line 12.5 0.5 14.0 N/A STEEL 2 NA Foundation 31.0 38.0 40.2 N/A LIFT STATION Manufacturer Capacity Curtain Drain 50+ 50+ 50+ N/A ORENCO 250 Gal. Remarks Pump on level at Pump off level at High water alarm at 40 in. 36 in. 45 in. Pump make and model 'Electrical Inspections performed by P2005 MOA BUILDING SAFETY PIPE MATERIAL House to tank 3034 Tank to 3034 Installer drainfield A+ HOME SERVICE Drainfield 3034 CO/MT 3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 657.5ft Inspection s, Location and description dates: 1 7/8/15 2"d 9/22/15 _ s`° 9/22/15 4`h 1/6/16 SW BOTTOM TRIM COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp '' �� OF AC Conditional Approval: Date .. " ••sA'41it ••V•te.ven•I '•0annofae.p v,•. E 8149 Approved I 1 li✓l Date 3—Z0 ~)a ht.� l 1\�1 1 6e c c-a ��L Inspection Report_1-1-12.doc D ii -,...,. I I DESIGN PARAMETERS /Q�� �. UPGRADE SEPTIC SYSTEM �\ NO. BEDROOM: 3 (450 gpd) \\ TANK SIZE: 1250g S.T.E.P. / \\ PERC RATE: 1.6 MPI SOIL RATING: 1.2 GPD/SF / \ AREA ROD: 375 SF / \ SYS. TYPE: 5' WIDE TRENCH 3' ED MIN LENGTH: 43.5 LF / __.--1---I1 1 �,- I J }',` USED: // i /i LL (E) ,I l \� / 45 LFx 3' E.D.x 5' WIDE. 6' T.D. / / �/ / /I r I \ TOTAL AREA: 387.9 SF { /., /��� ,' �,�/ -/ / �' ! I" �III r \ U A B1 /965 590 ;600, 5 610 615 620_625-_630 633 640 i 1 1 II FC 1.5 27.1 --- - / / ; ,,/ / / / �/ /I 1 \ • \.��-//-,/ /,/ / /7 /�/ i'� __� Ii \ Ti 32.6 57.8 • /',.- ,'/ , / , , //—-- _66of 1 T2 38.8 63.0 ' k-,- - / ,/1// /' / , /// / -' 1 1 LS 40.7 65.0 ,----,' ,'/ /" \',--- '// 'r / / /./ / I I ( / WELL l ' /- �! -�!,/ 1'I; / 3 BDR SFD I 1 M1 41.0 69.5 /j/,/i i`)/ ,' ,• //, / i 4F. I AREA UNDEVELOPED M2 79.1 107.1 / 6,,,,,,,.......4.„"i,/,/ ,/ /- 1 j( NO WELLS OR SEPTIC W/IN i , /�/ , / , / a: _ / 1 I -- I ( 200 FEET. / / ,' / / / /- �� '�L.J._—• \ /1^`,`-~'-"�`'� i/ / i / 1' �'/ ( 1 i I r 1 I / / / / , \ 112.6 V / -�/ / ,'' i / ( ' �A� ; \.I; 1 • `103.8, i r/ /" // W �� ; ( // 1 , 1000. PTI TANK / <„11 --- -- / 1' I ,�•\N.' /// / /� .,/ // / ABANDONED PER CODE j < I. , 1 , / i r r// / `' r V / //. I -- r� r / / , r r { /— �... /h , j J i j / I / / / M2 i-r/ T1 .."---1-1/ 11-x/rte.-- j I r r r / / r i M1 MH T2CL / f ' ! j// TH 665 670 /675 . 1 I DRAIN FIELD /\INSTALLED 1250q S.T.E.P TANK REMOVED AND REPLACED WITH / 45LF x 5'W x 3.0'ED x 6.0'10 EXIST'G SEPTIC� ' N.N. AREA r N N / \ / \ j/ 7 I IAREA UNDEVELOPED j i i NO WELLS OR SEPTIC W/IN r 1 1 I 200 FEET. Z . w 1 1 4"0 PERFORATED PIPE '" of r j j j 1/8"0030"O.C. m ¢Z) 8 0 a Z ZZ 1S z Eli TER FABRIC od - U a z D.G./F.G 0 m 655.0 O.C./E.G. 650.0 — TEST HOLE 1 xl � OR ® ? ssD.4� 1 ,250 g 5ci.o 3'E.D. GRAVEL 647 S.T.E.P. TANK PROFILE 6� 5/20/20'0 SCALE 1"=10' eEoaacx -12 NOTES: -- OF . PANNONE ENG SVC, LLC — OF A� t 1 3/15/2018 RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 .�4-''•.. q l PHONE (907) 272-8218 FAX (907) 272-8211 /i*o.•49 TM �\ s:57 7 Scale 60 qp••? ,0 P.I.D. NO FIRE LAKE S/D No.2 Blk 2 Lt 6 =� \ i51-351-18 RAYMOND & GEORGENE REEKIE Steven R. Pannone Ai PERMIT NO. DRAWN BY: ACP 4 f;.. CE 8149 '�j OSP101070 13711 SAVAGE DR. s ,� PLAN EAGLE RIVER, AK 99577 +'l1F'QFppr?'•"'•0\-( ' 2 oF12 On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP151227 Tax Code Number: 05135118000 Work Type: Septic Renewal Permit Effective Dates: July 15, 2015 to July 14, 2016 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: FIRE LAKE #2 Site Legal Address: FIRE LAKE #2 BLK 2 LT 6 G:0454 Owner/Address: REEKIE RAYMOND JOHN & GEORGENE T 13711 SAVAGE DRIVE EAGLE RIVER AK 995777509 Site Mailing Address: 13711 SAVAGE DR, Eagle River Lot Size in Sq Ft: 49658 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received B� Issued By: Municipality of Anchorage went S �N P a' G L n a w Department **** VARIANCE/WAIVER REVIEW **** Waiver#: 0SV151081 COSA#: ' Permit#: OSP151227 PID#: 051351-18 Legal Description: Fire Lake #2. Block 2. Loth Engineer: PES Applicant: Raymond Reekie Your request for a waiver of the required 50 feet horizontal separation from the absorption field to the 25% or greater slope has been approved. The approved separation distance is 20.0 feet. This waiver, approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal' 'system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. Adjacent properties are not affected by this waiver. Waiver is Granted: X Waiver is not Granted: Date: Approved by: a o Reviewer Municipal of Anchora Q Inrnr i e �w 4 � Q, n d% w 7997 Department Development Services Department On -Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** WR#: OSP101071 HAM — Permit#: OSPt01070 P[D#: 051.35148 Legal Description: Fire Lake #2. Block 2. Lot 6 Engineer.'SES Applicant: Raymond Reekle Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 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. Waiver is Granted: �_ Waiver Is not Grante Date: 6/1Ian0110 Approved b. p Name of Revlewer .aa..0 u ■ ua...■■■•■... ■.....•u ■■u•■■..■ ...■■.■■..■.■■■■...■■■■■..■■■■■.. Rec#: 058297 Amount $200.00 Date Paid: 6/9/2010 **** VARIANCE/WAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division QD Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 051-351-18 Property owner(s) Raymond Reekie Mailing address 13711 Savage Drive, Eagle River, AK99577 Site address 13711 Savage Drive Day phone Legal description (Sub'd., Block & Lot) Fire Lake #2, Block 2, Lot 6 Legal description (Township, Range & Section) Lot Size 49,658 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field Initial ❑ Single Family (SF) Septic Tank Q Upgrade ❑ (w/wo ADU) Duplex (D) ElHolding Tank ElRenewal ❑X Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FORM aO� qtr rlictan a• I certify that the above information is correct. I further certify that this is in applicable Municipal Codes. of property owner or c Permit/Rush Fees: v"WeWv, I Waiver Fees: Date of Payment: Date of Payment: Receipt Number: Permit No. Permit App_- :-1(...:c; Receipt Number: Waiver No. Os i S(Og Col Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steverraoanengak.com July 1, 2015 Subject: Expired On -Site Water and Wastewater Permit Permit Renewal Request Permit Number: OSP101-070 Legal Description: Fire Lake #2, Block 2, Lot 6 This is a request to renew the permit for the above mentioned lot. We are submitting a change order (attached) to modify the design. We will remove and replace the existing drain field for a better fit into the small space available. See slope waiver request. All site conditions remain the same and the construction still will not affect the health, safety, or development of the surrounding lots. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 C o1 Pannone Engineering Services Lac Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve0paneneak.com July 1, 2015 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. b. Box 196650 Anchorage, Alaska 99519 Subject: Fire Lake #2, Block 2, Lot 6 Slope Waiver Request Ladies and Gentlemen: I am requesting a waiver for the minimum distance to a grade over 25% to 20 feet from the drain field. The closest possible daylight point is 42.5 feet from the drain field, and this is unlikely due to the well draining nature of the soil. Granting this waiver is not likely to affect the health and safety of this lot or the surrounding lots now or in the future. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve0aaneneak.co,-m June 17, 2010 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: Fire Lake No. 2 SID, Block 2 Lot 6 Septic System Permit Upgrade Request Ladies and Gentlemen: I am writing to request a permit to construct an upgraded septic system be issued for this property. The proposed systems will serve an existing three-bedroom house. Currently the lot is developed. The lot is served by a private water supply. The existing septic system shall be reused. A new drain field will be installed south of the existing field and will be sized to handle a three bedroom waste stream. The surrounding developed lots are served by private water systems. The private wells are located over 100 feet from the proposed soil absorption system. 1. Soils. A single test hole was excavated by PFS on May 11, 2010. See the attached soil log. Ground water was monitored for over seven days. No ground water was monitored to a depth of 12.5 feet below ground level after the monitoring period. Bedrock was encountered in the test hole at a depth of 12 feet, It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 1.2 gallons/day/square feet should be used, using a conventional wastewater treatment system. 2. Soil Absorption System Design. See Design Drawings sheet 2 of 3 for the design calculations. 3. Surface Yater: There is no surface water within 100 feet of the proposed septic tank and the existing drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The average topography in the area of the proposed septic system is approximately 10 percent based on the survey information in the area of the septic system. The north side of the drive way slopes steeply (50%) to the northwest. The proposed installation will be approximately 35 feet from the shoulder of the steep slopes. The attached detail shows the assumed infiltration line of the effluent from the lower proposed field will have a possible daylight 59 feet downhill from the field. Though it is not likely. The existing field has been in failure for 12 months that I know of and I have not seen any effluent day - lighting down slope. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 615 East 82nd Ave, Cuite B6, Anchorage, AK 99503 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 5. Lot Line Waiver. PES requests a lot line waiver for the drain field to zero feet to the property line. The area available for the upgrade system outside the well radius is limited. The neighboring septic system is located greater than 20 feet from the proposed upgrade. Granting this waiver will not affect the future development of this or surrounding lots. 6. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and there are no further comments received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Attachments: Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 615 East 82nd Ave, Cuite B6, Anchorage, AK 99503 Telephone: (907) 272-8218 FAX: (907) 272-8211 Col I I EXIST'G SEPTIC AREA 1 %-'-'--- I AREA UNDEVELOPED i ��•�, NO WELLS OR SEPTIC W/I �ii �\ I 200 FEET. // V 1' � 1 \ / 1 \ j-CNELL (E) 3 BR HOUS (E) `-2% / PLACE 2y/' R.I. L"J`.� OVER LINES IN �. DRIVEWAY-TYPICALWELL r X E C9 1 AREA UNDEVELOPED 103.5 101 1 1 NO -� WELLS OR SEPTIC W/'IN 1250 g STEP TANK (P) 200 FEET. / 0 2% 50% 1 CCOg SEPTIC)/ TANK (E). /k�ANDONE PER COpE. DRAIN FIELD (E) IN FAILURE ---1- --� REMOVE AND REPLACE WITH 45LF x 5'W x 3.0'ED x 6.0'TD(P) TH0% 209 A.. EXIST'G SEPTIC // / AREA�i" i � 1 / \ I i 7 \ I AREA UNDEVELOP NO WELLS OR SEPTIC 200 FEET. WELL (E) I o - 1 I ! I �a \ / I \ / 1 � � I NOTES: PLyMOl`IL' ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 r (� �F A�gsl�1 �y+) Date 7/1/15 Scale CHANGE ORDER PHONE (907) 272-8218 FAX (907) 272-8211 %GD�p %...... . . e • • • • • .. . one / R. P St even annone FIRE LAKE S/D No.2 Blk 2 Lt 6 Ra d Reekie Raymond y P.LD. No 051-351-18 PERMIT NO. 13711 Savage Drive/+ River, P CE 8149 00c' - osR101070 Sheet PLAN Eagle AK 99577 (907) 696-2257 E � i110nFEs"." 1 of 4 Cr SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. _ 3. SCOPE OF WORK: 3 BR HOUSE REMOVE AND REPLACE EXISTING DRAIN FIELD WITH NEW SEPTIC INSTALL, 1250g-S.T.E.P. TANK, 45 LF X 5' W X 3.0' E.D., 6' T.D. ABANDON OLD TANK PER CODE. 4. GROUNDWATER IS NOT EXPECTED TO BE ENCOUNTERED DURING EXCAVATION, AS EVIDENCED BY THE SOIL TEST HOLE INFORMATION ABOVE 12 FT. IF AN. APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 10 FEET BELOW EXISTING GRADE, NOTIFY THE ENGINEER IMMEDIATELY. ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT N0, C# CLEAN OUT NO. M# MONITOR TUBE NO, R_I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER (E) EXISTING (P) PROPOSED (N) . _ NEW PROFILE DESIGN PARAMETERS UPGRADESEPTIC SYSTEM NO. BEDROOM: 3(450 gpd) TANK SIZE: 1,250g'S.T.E.P. PERC RATE: 1.6 MPI _ AREA ROD: 375 SF SYS. TYPE: 5—WIDE TRENCH, 3' ED RF=0.58, MIN LENGTH 43.5 LF DESIGN: 45LF X 3'E.D. X 5' WIDE,: 6' T.D. LEGEND ww WATER LINE/ WELL RADIUS ss ss — EXIST'G SEPTIC ss — ss — NEW SEPTIC CHAINLINK FENCE NOTES: PANNONE ENG SVC, LLC -'�0F. a� Ott D 7/8 15 P.O. BOX 100217 ANCHORAGE, AK 99510 r �� .. CHANGE ORDER PHONE (907) 272-8218 FAX (907) 272-8211 %aj�p sy,+� Scale NTS FIRE LAKE S/D No.2 Elk 2 Lt 6 % P.LD. NO 51-18 Raymond Reekie "Steven 'R. Pan one -3 Y � � PERMIT No 13711 Savage Drive ✓t 1c'.• CE 8749 -'127 OSP101070 DESIGN NOTES Eagle River, AK 99577 +�IS'fpFo•.....•P�p sneer (907) 696-2257 t\\� `F"`�� 2 OF 4 C o'1 Y U 0 Cr ]SOH 1S31 D J 0Cn N 0 W o 0 C) N - O O d- Q Q Cn 7 CD U U 0 N O Q O X 71- U O O W U d W o W U� zJ - o co 00 o G' D' O ,,- O w z� 0 ` m ( o i= � O O� � I z Q 0 0 aLLJ \ o o J CD � r. O Q_ C) N O d NOTES PANNOaNE7ENGRASsEVCK sLLo (�OF.ACgate s!4' rCpp' •'�9 +' D7/1/1s CHANGE ORDER Scale PHONE (907) 272-8218 FAX (907) 272-8211 *: Ij NTS FIRE LAKE S/D No.2 Blk 2 Lt 6 Raymond Reekie 3711 Savage Drive %..."' ' " " ' "" / Steven R Pannone / P-I.D. No 51-351-18 PERMIT N0. Eagle River, AK 99577 % CE 8149 \ �� f sr OSPI01070 Sha eOF DESIGN NOTES (907) 696-2257 •._ (l`1\\ orEsso�-r 4 SOILS LOG - PERCOLATION TEST SLOPE 1 SITE PUN \ f -2% TEST I WAS GROUNDWATER ENCOUNTERED? N IF YES, AT WHAT DEPTH? -w DEPTH TO WATER AFTER MONITORING? - DRY - DATE: 51=10 50% THS 10% SLOPE TH 1 READWO DATE TEST HOLE 1 NET TIME WATER LEVEL READING NET DROP OR TOPSOIL 1 4.68 0 + 2 10 FILL FILL SAND 8 3 2:18 P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE 272-8218 FAX SILTS 3 4 2:28 10 10.92 6.09 4- 2:26 4.32 0 58 5- 238 10 10.92 6.09 6 Raymond Reekiey4 /�teven �I�. � annarie / 4 SAND. POORLY 7 � ,Drive�I� c� •, CE 8149 r= SPI GRADED. Eagle River 99577 SM FINER 8 (907) 696-2257 WIDEPTH 4OF 4 a . 10 11 12 bedrock sr 13 BOH 14 15 18 17 to SOILS LOG - PERCOLATION TEST SLOPE 1 SITE PUN \ f -2% TEST I WAS GROUNDWATER ENCOUNTERED? N IF YES, AT WHAT DEPTH? -w DEPTH TO WATER AFTER MONITORING? - DRY - DATE: 51=10 50% THS 10% SLOPE TH 1 READWO DATE CLOCK TIME NET TIME WATER LEVEL READING NET DROP 1 5.11.10 2:08 4.68 0 + 2:18 10 10.92 6.24 3 2:18 P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE 272-8218 FAX 4.32 0 4 2:28 10 10.92 6.09 S 2:26 4.32 0 4 238 10 10.92 6.09 7 Raymond Reekiey4 /�teven �I�. � annarie / 4 1 oAK � ,Drive�I� c� •, CE 8149 r= PEROLATION RATE 1.6frninAnchl PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 4 FT AND 5 FT COMMENTS: Test hale excavated by FLINTSTONE CONSTRUCTION. Test ran for 1 hour. last three reading reported. Test bole was presoaked before pert test. PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITII ALL STATE AND MUNICIPAL OUIDLINES IN EFFECT ONTTHE OF THIS TEST. NOTES: �DATE PANNONE ENG SVC, 1.W ,r b \\ kj � A�q0,- Dote 6/17/10 ISSUED FOR CONSTRUCTION P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE 272-8218 FAX ,: A -4c Q- �y�j •'..* Scale (907) (907) 272-8211 o * .',9 7}i I� NTS FIRE LAKE S/D No.2 BIk 2 Lt 6 % ..... P.I.D. NO Raymond Reekiey4 /�teven �I�. � annarie / 1 oAK � ,Drive�I� c� •, CE 8149 r= N18 PERMIT PERMIT NO. SWxxxiaK SOILS LOG Eagle River 99577 'l�oai4��-'� Sheet (907) 696-2257 4OF 4 . On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP101070 Tax Code Number: 05135118000 Work Type: Septic Upgrade Permit Effective Dates: June 18, 2010 to June 18, 2011 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: FIRE LAKE #2 Site Legal Address: FIRE LAKE #2 BILK 2 LT 6 G:0454 Owner/Address: REEKIE RAYMOND JOHN & GEORGENE T 13711 SAVAGE DRIVE EAGLE RIVER AK 995777509 Site Mailing Address: 13711 SAVAGE DR, Eagle River Lot Size in Sq Ft: 49658 Total Bedrooms: 3 This permit Is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either. A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: Permit includes waiver OSP101071 allowing the drainfield to be within zero (0) feet of the south property line. As a condition of the waiver, the following items shall be completed: The south property line and 100 foot well radius shall be flagged by a registered land surveyor prior to construction of the drainfields. Received Issued By Municipality of Anchorage 11 • Development Services Department On -Site Water and Wastewater Program menr Department ** VARIANCE/WAIVER REVIEW ** * WR#: OSP101071 HAM _ Permit#: OSP101070 PID#: 051-351-18 Legal Description: Ere Lake #2, Block 2. Lot 6 Engineer: PES Applicant: Raymond Reekle Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 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. ........ .................... assess .... someone ... ........... ............... seems Waiver is Granted: X Waiver Is not Grante, Date: 61IM010 Approved b t �1�1PliL/j1pZ'(2_ Name of Reviewer .............................................. son ...... seems .......... gas ... a Rec#: 058297 Amount $200.00 Date Paid: 6/9/2010 **** VARIANCE/WAIVER REVIEW **** Municipality of Anchorage Development Services Department Building Safety Division i On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onshe (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION Varia^c` 05O iolo7l FOR A SINGLE FAMILY DWELLING 05P,101070 Parcel I.D. 051.351.18 Property owner(s) Raymond Reekle Day phone 696.2257 Mailing address13711 Savage Drive, Eagle River Zip Code 99577 Site address 13711 Savage Drive, Eagle River Zip Code 99577 Legal description (Sub'd., Block & Lot) Fire Lake SID No. 2 Block 2. Lot 6 Legal description (Township, Range & Section) Lot Size 49658 Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms 3 THIS APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. Pannone Engineering Services, LLC (Signature of property owner or authorized agent) Permit/Flush Fees: U Waiver Fees: Gpj Date of Payment: �l [` fit/ Date of Payment: ` �v Receipt Number: U Y"r/ ?� Receipt Number: (Rev. 11/05) Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steveftanenaak.com June 17, 2010 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: Fire Lake No. 2 S/D, Block 2 Lot 6 Septic System Permit Upgrade Request Ladies and Gentlemen: I am writing to request a permit to construct an upgraded septic system be issued for this property. The proposed systems will serve an existing three-bedroom house. Currently the lot is developed. The lot is served by a private water supply. The existing septic system shall be reused. A new drain field will be installed south of the existing field and will be sized to handle a three bedroom waste stream. The surrounding developed lots are served by private water systems. The private wells are located over 100 feet from the proposed soil absorption system. 1. Soils. A single test hole was excavated by PES on May 11, 2010. See the attached soil log. Ground water was monitored for over seven days. No ground water was monitored to a depth of 12.5 feet below ground level after the monitoring period. Bedrock was encountered in the test hole at a depth of 12 feet. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 1.2 gallons/day/square feet should be used, using a conventional wastewater treatment system. 2. Soil Absorption System Design. See Design Drawings sheet 2 of 3 for the design calculations. 3. Surface Nater: There is no surface water within 100 feet of the proposed septic tank and the existing drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The average topography in the area of the proposed septic system is approximately 10 percent based on the survey information in the area of the septic system. The north side of the drive way slopes steeply (50%) to the northwest. The proposed installation will be approximately 35 feet from the shoulder of the steep slopes. The attached detail shows the assumed infiltration line of the effluent from the lower proposed field will have a possible daylight 59 feet downhill from the field. Though it is not likely. The existing field has been in failure for 12 months that I know of and 1 have not seen any effluent day - lighting down slope. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 615 East 82 n Ave, Cuite B6, Anchorage, AK 99503 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 5. Lot Line Waiver: PES requests a lot line waiver for the drain field to zero feet to the property line. The area available for the upgrade system outside the well radius is limited. The neighboring septic system is located greater than 20 feet from the proposed upgrade. Granting this waiver will not affect the future development of this or surrounding lots. 6. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and there are no further comments received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Attachments: t7 Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 615 East 82nd Ave, Cuite B6, Anchorage, AK 99503 Telephone: (907) 272-8218 FAX: (907) 272-8211 EXISVIS SEPTIC AREA \ / 2% A PLACE 2 R.I. V OVER LINES IN DRIVEWAY -TYPICAL - �2% \� 1250 g STEP TANK (P) \ LINES TO BOTH (P) & (E) \ FIELDS 0 2% 50% �J N �50% o �507 BE REUSED-TH EXIST'G SEPTIC AREA 7 WELL (E) i 1 AREA UNDEVELOPED \I I NO WELLS OR SEPTIC W/I i 200 FEET. I�I I I I �\ (E) I e I -WELL (E) AREA UNDEVELOPED WELLS OR SEPTIC W 200 FEET. i Efflill 1000g I TANK PER C 10%d t-4 DRAWINFIELDS (P) I 11033LF, 1015 LF 5'W, 3'ED. 6'TD I IREQUEST WAIVER OF 0' TO LOT LINE AREA UNDEVELOPI NO WELLS OR SEPTIC 200 FEET. NOTES: ENG PP.O. BO/1000022/17 ANCHORAGE, AK 99510 PHONE (907) 272-8216 FAX (907) 272-8211 _�������\\ ��OF 4�40,.k4 ig�p' �y0 %•'• ........ / % / teven POnnOnej C /' E 8149 a'4� I \\ �� ucte 6/17/10 ISSUED FOR CONSTRUCTION Scole P.LD. NO 51-351-18 PERMIT NO. swxxxxxx FIRE LAKE S/D No.2 Blk 2 Lt 6 Raymond Reekie 13711 Savage Drive Ea (907)gle v 696 2257 er, AK 77 PLAN Sheet 4 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: 3 BR HOUSE NEW SEPTIC INSTALL, 12509 S.T.E.P. TANK, 2 EA 5—WIDE TRENCHES 30 LF X 5' W X 3.0' E.D., 6' T.D. ABANDON OLD TANK PER CODE. REUSE EXIST'G DRAIN FIELD. 4. GROUNDWATER IS NOT EXPECTED TO BE ENCOUNTERED DURING EXCAVATION, AS EVIDENCED BY THE SOIL TEST HOLE INFORMATION ABOVE 12 FT. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 10 FEET BELOW EXISTING GRADE, NOTIFY THE ENGINEER IMMEDIATELY. ABBREVIATIONS PROFILE CU COPPER DIP DUCTILE IRON PIPE TH FC TEST HOLE FOUNDATION CLEAN OUT DESIGN PARAMETERS LEGEND T# TANK CLEAN OUT NO. UPGRADESEPTIC SYSTEM —w—w— WATER LINE/ C# CLEAN OUT NO. NO. BEDROOM: 3 (450 gpd) WELL RADIUS M MONITOR TUBE N0. TANK SIZE: 1,250g S.T.E.P. PERC RATE: 1.6 MPIas — — — as EXIST'G SEPTIC R.I. RIGID INSULATION AREA ROD: 375 SF DCO DOUBLE CLEAN OUT SYS. TYPE: 5—WIDE TRENCH, 3' ED &' 8e — NEW SEPTIC DV DIVERTER VALVE RF=0.58. MIN LENGTH 43.5 LF FS FLOW SPLITTER (E) EXISTING P I N� 2 TRENCHES, 1033 LF. 1015LF-0 CHAINLINK FENCE (P) PROPOSED 3'E.D. X 5' WIDE. 6' T.D. (N) NEW NOTES: 7�� T 7 PAM P111`Il\Ol\L ING �C� l.lh.SOF P.O. BOX 100217 ANCHORAGE, AK 99510 272-8211 A4q\k) tp� •' `Sf�) ate O6 /17/10 ISSUED FOR CONSTRUCTION Scale PHONE (907) 272-8218 FAX (907) j* .49 TM /'• .% [even annome j NTS FIRE LAKE S/D No.2 Blk 2 Lt 6 Raymond Reekie S1D351O PERMIT NO. 13711 Savage Drive Eagle River, AK 99577 (� �4. CE 8149 �/ (\��� SW,....x DESIGN NOTES Sheet (907) 696-2257 `��� 2 of 4 I j I � I ' i I I i U O J 310H ! N 0 ui m 1S31�o I $ I o I ' i I I I o N Q Lr) O - ; - -- O V O Q 1 O d a Q=I > I ¢ Cr. �� a I O J O I V) i �� x I U W j 0 w I to z _' I CD 00 0= I O c� (L 1- I I I NU) i w OZ r0 m J L'0 Z O J Z } N 00 I CL O _ I ! I m I N I O I I i I I O N I I � I I I I NOTES: 7 � T�T� �T LLC PAMONE ENG SVC, LLA. PAM P.O. 80X 100217 ANCHORAGE. AK 99510 �\ (� OF A� q� 11 0 D6/17/10 FOR Scale Scale ISSUED CONSTRUCTION PHONE (907) 272-8218 FAX (907) 272-8211 j*� TM / ttE en R: �Of none % �� �•, CE 8149 �� 04 (� .... NTS FIRE LAKE S/D No.2 Blk 2 Lt 6 Raymond Reekie 13711 Savage Drive Eagle River, AK 99577 (907) 696-2257 P.I.D. NO SI-351-18 PERMIT NO. swxxxxxx DESIGN NOTES DESIGN Sheet e OF 4 \� `�� SOILS LOG - PERCOLATION TEST TEST HOLE 1 SLOPE 1 617E PIAN � I 1 OR TOPSOIL satao Y FILL FILL, SAND 6 \ SILTS / / 3- = 2:18 \ 10.92 4 4— 2% 2:18 50% I 5- 6 2:28 SAND, POORLY \ I T SP/ GRADED. \ SM FINER -2% 50% \\ B W/DEPTH 4.32 9- 10 10 �50% I I 2:38 xTEST �$"1% 107d 11 HOLE '�� 4 t _--t• 12 s1 Bedrock 50% I TH 10% 1 13 BOH WAS GROUND WATER SLOPE 14 ENCOUNTERED?—N 15 IF YES, AT WHAT TH 1 DEPTH? -0-' 18 15 17 DEPTH TO WATER AFTER MONITORING? - DRY - t8 DATE: 5/20/10 CLOCK READING GATE TIME WATER NET TIME LEVEL NET PEROLATION RATE IA min(nch) PER( HOLE DIAMETER 6Inches TEST RUN BETWEEN 4 FT AND 5 FT COMMENTS: Test hole excavated by FLINTSTONE CONSTRUCTION. Test ran for 1 hour. last three reading reported. Test hole was presoaked before pert test. PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITI-I ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: PANNONE ENG SVC, LLC P.O. BOX 102954 ANCHORAGE, AK 99510 _ ��pFA ��� .- �� qo ioj�p'• �y �) Date 17 ,o Scale ISSUED FOR CONSTRUCTION PHONE (907) 272-8218 FAX (907) 272-8211 00*:' 49 TH * '. * �� /••••• y/y �I151-18 NTS FIRE LAKE S/D N Re Be 2 Lt 6 Reymond Reekie P.I.D. NO 13711 Savage Drive Eagle River, AK 99577 696-2257 /"'t'teven R:' Gnnone ��f 9CE 8149 1's' •.� (� PERMIT NO. Swxxxxxx SOILS LOG sheet (907) R�`uw 4 OF 4 . READING DROP t satao 2:08 4.68 0 = 2:18 10 10.92 6.24 � 2:18 4.32 0 4 2:28 10 10.92 6.09 8 2:28 4.32 0 e 2:38 10 10.92 6.09 7 e MUNICIPALITY 01' ANCHORAGE Hey I and Environmental PT-oLc nn Fourth Floor West - 325 L Street Anchorage, Alaska 99'01 219--2511, x 224, 22'� INSPECTION REPORT ON-SITE SEWAC_-.E DISPOSAL SYSwFM NAME' .. 1`' _ -- -_ MAH IPU, AUI+RLS`. lax loci _ P-,Xh .1 141_"IT,�)D4t. LOCATION i, t2. - Ll GAI Ia Si RIPT1(>N L S �f-.cr6 ..__ SEPTIC TANK: GISTANU �j NUMEIFR OF FROM WLLI_MioJUI A( lUR1 H Mi,Il itlr�,i_ S�� COMPARTMLNI'; INSIDI. LIEN(; III _ _ _ _IN',11)E JJIOIll I'I)IIII) t)I PTH t 1,')Mr) (:APACITY 000GAI_I.ON' TII-E DRAIN Flf_LD: Well Class : 1rJ. Depth: )u00 WL -11 Distance To: Lot Line Bldg: 3 0Sewer ,ine: - I I { j Pipe Materia].: ���.� •- 1 - # o: Bedrooms: Installer: Remarks. TJX , ' I I �V / TOTAL t_LN .TH.4/ / DISrANCF F Rr)M WII_I_ _ 1 O� rOlINDA1 WN _ 5 J/ 'J ARI ,I t W I TNI r)r L INC # of Lines IW,I Vj(A I,I I'dJIi :J LIt11 p a rI( II vJltl1l II.I TOTAL 1 r rLr I;` 0 Y Ali'l-1URPI ION AMA -1_ _ bO I I I NGrll OI f ,;( I, I IN( ULPTI. i)i I Il TIP DEPTII: TOL' 01 1ILI. 10 1-INIbil GRAIIL '315 Mall I( tr. ^ll /A1!t I it I (e IN ABOVE. IIL.F SEEPAGE. PIT: DI<<MLTLP — __OR WII,TN _ _.. I I ru.,tlr(A PIII-- Log Crib _ Rings — Crib Size: I%I%n�tTl R _, Ll ilt f'ISTANUf FROM: WELL._._. 101 /it LI I LC'TIVF BUILDING F-0LINDAIION. -___._, NEARLSI t -Of I IN1 _ A MMPTION ARI i\ (WML AREA) _..__ -SQ. I' Well Class : 1rJ. Depth: )u00 WL -11 Distance To: Lot Line Bldg: 3 0Sewer ,ine: - I I { j Pipe Materia].: ���.� •- 1 - # o: Bedrooms: Installer: Remarks. TJX , ' I I 1 1.11 1: 1 II )ill,! .I I l' -.J I I Ph I! : I !-!1 11-1 v.,I) IplI::;f 1':' 1 11 1 i1:.:1 I it il-l' , : ,:::,I 1 1 1 ! 1: 1 1 J. II if I f t 1:;) 1. 1: 1 :ij is H41 I "v - I !i-'-11 W I., if Z— / Jill !I '-) CL-) IF ::', ii if. !I ,11 Im it n If 4V, 0 0 R: 11 1 v I:: !I II if ii J('�11 . ...' ..' ..' ... 1 11 li - is 11 II 11 :' " 11 :" q : I : 11 1 To Q44 ' W: 0 LI ,; II o- t v m. 1) 1� : P:1 I I I I . I 'I I . , W", -11 in 6 i Lijiury 1 f NA1. . TIIy+ t:; "i I , i , ( 11'1'11 IIlihjj NQ i h I TCj 1Q f 00 A-1 I T 1111'.1. I 'J I 11°I I :- T c PH 0 0111 WK N yl bod I LINO PANY '"W"d I I 11Ill I- . I': P: :I 1111 v Iof MA 11 1,11 L 1 4+157 ITT: A 1`1 IN 1 IN 1 1 1-.11 :1 . 1 1 1 n;,:=: 1: 1 J, j , I I:! I 'I I ':' 17 1 :� I !1 .11., J':! 1 11 1 J.! ''! I I; 1 1 i 1 1 I i A li-11 Of , i 1 1 1 ill P'I 1,.11 �i I !,y.;1;11,. kl I'.NI ill" I:.:1 l'i Ill A f 1XIS full) 74401 Al Q! AM I I v w blip* 1 f IRA I I AS K 1 it ! NO -1 1101 FORf NATO I WO PH I All 1 101 ,I.:::: 1, T 1 b ll 00 H ""W S 11 ,II; NA bzoy: 11 h , 1, �v 0 Et E GEC .:CHNICAL Et DEVEL Russell Oyster 694-2774 Soils Et Foundations Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 SOIL LOG ?MENT CO. Earl Ellis 688-2280 Land Development Performed for: Name: ">At X Tel . No- 4 W% Mailing Address: R4.1x14;9 --/i 1*7z Legal Description:/- r,2— - &crW- "5, wrrilld `E,/ LC.r ,it c:. = i, i /��; Death (feet) Soil Characteristics M 1 _ , 2 3 4 ' 5 7 -7o r 1 C Gr 10 12 PI-n/„fr % d rr' T'i ��! f !f 44--6 1/ 14 15 Ground Water Encountered: Yes— No l✓ If yes, what depth Proposed Installation: Seepage Pit Drain Field Comments: Performed by: /moi -t � �:�� r��� - Date: °? 7 r� 177 c ��go, fy, 10 41 vvi M -W DRILLING, INC. C, DRILLING LOG Well Owner Location (address of: Township, Range, Section, if known; or distance main se of Well Size of casing --Depth of Hole feet Cased to feet Static water level ft. (above) (below) land surface. Finish of well (check one) open end Screen ( ) ; Perforated Describe screen or perforation Well pumping test at gallons per (hour) (minute) for with of drawdown from static level. Date of completion WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness TO— TO- TO- TO- TO- TO— TO— TO- ice, TO TO TO -lei C('11;'i­f1 Coiviawtor LN'os. 614 & 973 2 — ST' GO TER ANCHORAGE AREA BORO' 4 HEALTH DEPARTMENT NO 818 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ! SEPTIC T K: DISTANCE FROM WELL TERI NUMBER OF // COMPARTMENTS LIQUID CAPACITY / �( r-) GALLONS. INSIDE LENGTH' IL (INSIDE WIDTH SEEPAGE SYSTEM: SEEPAGE PIT: PH NE LIQUID DEPTH. NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH / LENGTH DEPTH r LINING MATERIAL> , DISTANCE FROM WELL BUILDING FOUNDATION - , NEAREST LOT LINE TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELL FOUNDATION NEAREST LOT LINE OF LINES NUMBER OF LINES---- - DISTANCE BEtW-EEN LINES - TREN`CPhWIDTH___ _ -- IN.�TAL EFFECTIVE ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE l r "t✓'�'(! ( iL MAILING NAME / )/I ��L/ 1� 141, DISTANCE FROM WATER ADDRESS L LOCATIONS '� �) :V f i� llC{ IFrel nFSrPIPTInI ! SEPTIC T K: DISTANCE FROM WELL TERI NUMBER OF // COMPARTMENTS LIQUID CAPACITY / �( r-) GALLONS. INSIDE LENGTH' IL (INSIDE WIDTH SEEPAGE SYSTEM: SEEPAGE PIT: PH NE LIQUID DEPTH. NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH / LENGTH DEPTH r LINING MATERIAL> , DISTANCE FROM WELL BUILDING FOUNDATION - , NEAREST LOT LINE TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELL FOUNDATION NEAREST LOT LINE OF LINES NUMBER OF LINES---- - DISTANCE BEtW-EEN LINES - TREN`CPhWIDTH___ _ -- IN.�TAL EFFECTIVE ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: 141, DISTANCE FROM WATER TYPE DEPTH BUILDING FOUNDATION. SAMPLE , NEAREST NEAREST SEPTIC SEEPAGE OTHER LOT LINE , SEWER LINE-, TANK , SYSTEM , CESSPOOL , SOURCES_ DISTANCES: DIAGRAM OF SYSTEM DATE ' ri , /I APPROVED HEALTH AUTHORITY I 9 'Aelrnj- ,f': DATE ' ri , /I APPROVED HEALTH AUTHORITY 72.010 (Rev. 3)76) THIS SIDE FOR =OFFICIAL USE ON -' DATE = INSPECTION APPOINTMENTS TIME 4.-` TME TIME �- DATE DATEI DATE -_ - INSPECTOR INSPECTOR DIRECTIONS- IRECTIONS 1. TYPE OF RESIDENCE 1i NUMBER OR BEDROOMt SINGLEPAMILY - ❑ ONE 0 THREE 0 FIVE ❑ bTR L` MULTIPLE FAMILY In TWO ❑ FOUR ❑ SIX 2. WAfiERUPPLY PERMIT NUMBER INDIVIDUAL DEPTH OF WELL - -- ❑ COMMUNITY - DATE DRILLED ❑ PUBLIC UTILITY Co[inection Verified' LOG RECEIVED 3,-SEWA(It-'DISPOSAL SYSTEM PERMIT NUMBER _ ❑ [NDIVIIMAL/ON -SITE ❑PUBLIC4ITI LITY DATE"INSTALLED Ccnneeti n VBrI#18d_ INSTALLER Septic Tank or ❑ Holding Tank -Size: If Tank is homemade" 'SOILS RATING give,dirnanaitsns:. _ TYPE 0FTA1yK MANUFACTU R -_ TOTAL ABSORPTION AREA MATERIAL - 4.'-DI$TAIV6`ES Septl HHolding ask- Absorption Area- Sower Line eEree WELL TO: r - Absorption Area to newest LotLine - - [ a^APPROVEDFOR wZ BEDROOMS CONDITIONAL APPROVAL (letter must accompany certificate) - DISAPPROVED -DAT / p-- BY it e - / - LEOAL D 0CRIPTION` - 72.010 (Rev. 3)76)