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HomeMy WebLinkAboutFALLING WATER BLK 2 LT 1Falling Water lock 2 Lot - 050-772 -02  '~ MUNICIPALITY OF ANCHORAGE t DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ",~N EW MAILING ADDRESS LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS ~ Dwelling 4 / PERMIT NO. DISTANCE ~ Z Manufacturer Material ~ ~ ~ < ~ ~ E C ~ N°' of compartments Liq. capacity in gallons Inside length Width Liquid depth [ CO O IF HOMEMADE: ~ Manufacturer /j Material Liquid capacity in gallons ~ DISTANCE TO: Well ~/~ Foundation.~ ~--/ Nearestlotline~l PERMITNO. E, ~_ ~o. oflines ~ kon~thofea~lino~, Total len~thoflino~, ~0 Trench~idt~, ~inchas ~ ~ ~ Top of tile to finish ~rade ~ ~ t Material beneath tile~ lotal effocti~abs~tion area ~ Length 'Width ~, ] Depth PERMITNO. ~ Type of crib Crib diameter Crib depth Total e~fective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class ~ ~th ~ ~.~/~riller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING ~ REMARKS ~, ~2,;".:.~,~.~ D13 (Rev. 3/78 FromL Fr'om '7' From ..... From From .From'. Front :" ' 1'' I I 'Ft''tO ,':, 'Ft Frdm" "l Ft: .5:?' ,:' From" ' Ft. to ';'"':l"'f'F~i' From' , I ~:'~FtJ to ' ,I.iIFt. ': From .,.' ' · Ft, to :":'.: ' ...... Ft. :',; Fr~m, "". ':'~ Ft. to 'Ft. ·, ~. ... .... .;.'~:. . · ... Ft. to Ft. · '?: .Ft. to .... "Ft.' ..... . Ft. to FL Permit ~ Applicant: Department 825 - Street, Anchorage, AK. ~9501 264-4720 * * * HANDWRITTEN PERMIT * * * ~ / ,",';ELL A;;J,'OR C:I-SITE SEWER PERMIT MUNICIPALITY OF ANCHORAGE f Health and Environmenta? ~rotection Location: Phone Number: / Legal Description: ~'~/ ~ ~~~ ~/~ Type of Soil Absorption System Is: Trench: y D~ainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms: ~ . Soil Rating(sq.ft/br) The Required Size of the Soil Absorption ~stem Is: DEPTH LENGTH ~ GRAVEL DEPTH ~ / 'ii ,,~ WIDTH The length dimension is the length(in feet)of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall Pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTICS) TANK SIZE = /~D~.Q GALLONS * * Permit applicant has the responsibility to inform this department during the installation inspections 'of any wells adjacent to this property and the number of residences that the well will serve.. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this departmen~ will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fee~ for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 8 3 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the resideD_ce is remodeled to include more ~m/s._ Signe~: ~A p~i~n~ Issued by: Date: ~----~~ OErEGE f~ussell Oyster 694-2774 Soils Et Fmmdations '"ECHNICAL Er DEV[ Box 90, Davis SI , E.~<.lle Hive~, Alaska 99577 694-2774 or 6882280 SOIL LOG Performed for: Legal Description: ~o~ 1, ~epth (feet) Name: F~ub~I~G WATERS SUBDIVISION Hailing Address: Star Route Box 1613 mock 2, ~all~n~ Waters Subdivision Soil Characteristic~ ML - Silt topsoil with roots and organics. 1PMENT CO. Earl Ellis 688 2280 Land Development Tel. No. 694-9239 ~agle River, .&laska 99~77 . 275 sq. ft./Br, GW - Sar~y Gravel with cobbles to 24 inches in diameter. Very clean ar~ loose material. Occasional 6 inch thick lenses of coarse gravel and/or cobbles. 85 sq. ft./Br, 10 , ll ... 12__ 13 16 Bottom of pit.. Ground Water Encountered: Yes No x× If yes, what depth~ proposed Installation: Seepage Pit__Drain Field Comments: All st,,ies of th~ pi,t 1,og.qed the s,~me. Pit measured_,appz,'o~Dn~tel~,.,' ~' K 1~' in plan area. Performed by: Date: May 24, 1977 ., CERTIFICATE FOR A Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 470Q B~aga~.Street P.O. Box 196650 Anchorage, AK 995'19-6650 www.muni.org/onsite (907) 343-7904 OF ON-SITE SYSTEMS APPROVAL SINGLE FAI'41LY DWELLING Parcel I.D. 050-772-02 1. GENERAL INFORMATION Expiration Date: Complete legal description FALLING WATER S/D; BLOCK 2, LOT 1 Location (site address) 51805 EAGLE RIVER ROAD * EAGLE RIVER, AK * 99577 Current Property owner(s) DAN HOURIHAN Day-phone 225-5780 Mailing address 51805 EAGLE RIVER ROAD * EAGLE RIVER, AK * 99577 Lending agency Day phone Mailing address Real Estate Agent MIKE MCLANE W/ PRUDENTIAL Day phone 565-5500 Mailing address 3801 CENTERPOINT DRIVE, #200 * ANCHORAGE, AK * 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. 'TYPE OF WATER ~UPPLY: Individual Well .L::. Individual Water Storage Community Class Well Public Water system 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 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 samples. (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 cedified by my seal ..... ' .... ~- · ~"-'-'~-- -' .... , .....~,~ .... ~mxeo hei'eto and as investigation, based on procedures outlined in the Ce~ificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is Nre) safe, functional.and adequate for the number of bedrooms and type of structure indicated herein. I fu~her veri~ that based on the information obtained from the Municipafity of Anchorage files and ~rom my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with afl appficable Municipal and State codes, ordinances,'and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Phone 337~-6179 Date Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, · conscientious engineering analysis of the system in accordance with 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 separation distances measured to readily identifiable features. The operational life of all 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 outside the control of the evaluator 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 will 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. 5, DSD SIGNATURE . w'/ Approved for -.~ bedrooms. Disapproved. Conditional approval for ~ Attachments: COSA Checklist Septic System Advisory bedrooms, with the following stipulatio~ WATERAND · Arsenic Advisory Maintenance Agreements Well Flow Advisory ,N,~ te Ad¢,sory ~? Supplemental Engineer's Report u~ner Original Certificate Date: (Rev. 11105) Municipality of Anchorage Development 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 Descriptioni FALLING WATER S/D; BLOCK 2, LOT 1 Parcel ID: A. WELL DATA *ASSUMED BASED ON SURROUNDING WELL LOGS. SEE ATTACHED. Well type PRIVATE Date completed 6/1985 Total depth 61 .ft. Date of test Static water level 30 Well production 15 WATER SAMPLE RESULTS: Coliform ~} colOnies/100 mi. Amenic:~'_W. C) ug./L. SEPTIC/HOLDING TANK DATA If A, B, or C provide PWSID# N/A Sanitary seal (Y/N) YES Cased to *40.+ .ff. FROM WELL LOG 6/1983 g.p.m. Nitrated' ~3 mg./L. Date of sample: 1/6/2011 Tank Type/Material SEPTIC/STEEL Tanl~ SiZe 1000 gal. Number of Compartments Foundation cleanoUt (Y/N) YES 2 Depression over tank (Y/N) NO Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION 7/30/2010 39 ft. 8.15 g.p.m. YES 12+ in. Other bacteria O colonies/100 mi. Collected by: GEG Ltd. Date installed 5/21/1983 Cleanouts (Y/N) YES High water alarm (Y/N) N/A Date of pumPing 6/25/2010 ABSORPTION FIELD DATA Date installed 5/21/1983 Length 20 ft. Pumper, ALASKA SEWER AND DRAIN I'BELOW EXISTING GRADEI Soil rating (g.p.d./ft2o~ 85 Width 2.5 .ft. System type TRENCH Gravel below pipe 7 .ft. Total dePth '10.5 ft. Eft. absorption area 280 ft2 Monitoring tube YES Date of adequacy test 7/50/2010 Results (Pass/Fail) PASS Fluid depth in absorption field before test **2 in. Water added 450 gal. Elapsed Time: - min. Final fluid depth **2 in. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN *MT ONLY EXTENDS 22" BELOW INVERT OF DRAINPIPE. TOTAL DEPTH Depression over field NO For 3 bedrooms New depth **2 in. 450+ g.p.d. If yes, give date - IS CALCULATED. YES D. LIFT STATION Date installed "Pump on" level at in, Size in gallons Manhole/Access ~ ~ "Pump off" leve. L~L~, High water alarm level at Cycles tested SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot 100'+ Public sewer main N/A Sewer/septic service line 25'+ Animal containment areas 50'+ ,in. 100'+ Meets alarm & circuit requirements? On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout Holding tank N/A Manure/animal excrete storage areas 100'+ Building foundation Water main Wells on adjacent lots SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 5'+ Property line 5'+ N/A Water service line. 10'+ 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Absorption field *5' Surface water. 100'+ 10'+ 10'+ KNOWN Building foundation 10'+ Surface water 100'+ Wells on adjacent lots. 100'+ Water main N/A Driveway, parking/vehicle storage 1'+ Property line Water service line Curtain drain NONE COMMENTS *PER INSPECTION 1985 REPORT, G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date 1/11}1~ COSA Fee $ Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number SGS Ref.# 1110068001 Client Name Garness Engineering Group, Ltd Printed Date/Time 01/11/2011 8:21 Project Name/# Falling Water B2 L1 Collected Date/Time 01/06/2011 9:00 Client Sample ID Falling Water B2 L1 Received Date/Time 01/06/2011 11:30 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic 5.00U 5.00 ug/L EP200.8 C (<10) 01/07/11 01/10/11 NRB Waters Department Total Nitrate/Nitrite-N 0.843 0.100 mg/L SM20 4500NO3-F B (<10) 01/10/11 AYC Microbiology Laboratory E~ Coli Negative 1 100mL SM20 9223B A 01/06/11 DLC Total Coliform Negative I 100mL SM20 9223B A 01/06/11 DLC Municipality of Anchorage Development 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 ©N-SITE SYSTEHS FOR /I': · APPROVAL A SINgL'E:~'FAHILY DWELLIN6 Parcel I.D. 050-772-02 1. GENERAL INFORMATION .xpiration Date: / / -- "- / 0 Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address FALLING WATER S,/D; BLOCK 2, LOT 1 51805 EAGLE RIVER ROAD * EAGLE RIVER, AK * 99577 DAN HOURIHAN Day phone 223-3780 ,31805 EAGLE RIVER ROAD * EAGLE RIVER, AK * 99577 Day phone MIKE MCLANE W,/ PRUDENTIAL Day phone 563-5500 3801 CENTERPOINT DRIVE, #200 * ANCHORAGE, AK * 99505 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well · Individual On-site · Individual Water Storage [] Individual Holding tank [] Community Class Well [] Community On-site [] Public Water System [] Public Sewer [] 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 samples. (Certificates may be reissue8 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, t verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this appfication, 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. Phone 557-6179 Address 5701 E, TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with 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 separation distances measured to readily identifiable features. The operational life of all 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 outside the control of the evaluator 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 will 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. 5. DSD SIGNATURE Approved for --~ bedrooms. '4 eSS." %. ...' Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory (Rev. 11/05) 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 Bragaw Street P.O, Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF 0N-SITE SYSTEMS APPROVAL Legal Description: A. WELL DATA Well type PRIVATE Date completed Total depth 61 FALLING WATER S/D; BLOCK 2, LOT 1 CHECKLIST Parcel ID: C~,~'"~ - *ASSUMED BASED ON SURROUNDING WELL LOGS· SEE A'I-~ACHED. If A, B, or C provide. PWSID# N/A Well Log (Y/N) 6/198,3 Sanitary seal (Y/N) YES Wires properly protected (Y/N) ft. Cased to *40+ ft. Casing height (above ground) FROM WELL LOG AT INSPECTION Date of test 6/198,3 7/,30/2010 Static water level 30 ft. 59 Well production 15 g.p.m. 8.15 WATER SAMPLE RESULTS: Coliform 0 colonies/100 mi. Nitrate 0.9.3 mg./L. Other bacteria Arsenic: ND ug./L. Date of sample: 7/21/2010 Collected by: 2 Depression over tank (Y/N) NO Pumper ALASKA I'BELOW EXISTING GRADEI Soil rating (g.p.d./ft2o~ 85 Width 2.5 ft. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Tank size 1000 gal. Number of Compartments Foundation cleanout (Y/N) YES Date of pumping ~/~l. ,.~ / ~ O C. ABSORPTION FIELD DATA Date installed 5/21/1983 Length 20 ft. YES YES 12+ in. .ft. g.p.m. 0 colonies/100 mi. GEG Ltd. Date installed 5/21/1983 Cleanouts (Y/N) YES High water alarm (Y/N) N/A SEWER AND DRAIN Total depth '10.3 ft. Eft. absorption area 280 ft2 Monitoring tube YES Date of adequacy test 7/30/2010 Results (Pass/Fail) PASS Fluid depth in absorption field before te~ Water added 450 gal. Elapsed Time: - min. Final fluid de 'Gin. Absorption rate >= 450+ · . ' ent est 12 mo. /N & e NONE__ KNOWN If ves. .'~v date System type TRENCH Gravel below pipe 7 ft. Depression over field NO For 3 bedrooms g.p.d. LIFT STATION Date installed "Pump on" level at~ in. Size in gallons Manhole/Access (Y/_.~ "Pump off" lev~ High water alarm level at in. E. SEPARATION DISTANCES Cycles tested. Meets alarm & circuit requirements~ SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot 100'+ Public sewer main N/A Sewer/septic service line 25'+ Animal containment areas. 50'+ 100'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout Holding tank N/A Manure/animal excrete storage areas N/A 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Water main N/A Wells on adjacent lots 100'+ Property line Water service line 5'+ 10'+ Absorption field *5' SUrface water 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation. 10'+ Water service line 10'+ Surface water 100'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ Water main N/A Driveway, parking/vehicle storage 1'-I- F. COMMENTS *PER INSPECTION 1985 REPORT. G. ENGINEER'S CERTIFICATION I certify that I have determined throughfield inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed ~ame JEFFREY A. GARNESS Date COSA Fee $ L'//d/0 ~ Date of Payment O Receipt Number O_ -7 0 "7 '7 '~ (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number AS-BUILT I hereby ceftin7 that I have surveyed the following described property: /~--~ ?''' /, ) ,~,;u~ ~_ , ments sitUated thereon are within the property ~nes and do not overlap or encroach on the property lying adjacent there- encroach on the premises in ques*ion and that thers are no roadways, transmission lines or other .................... ~z~,~: ~a~=~,~=~,~ on said property except as indicated hereon. Dated at Eagle River, Alaska this. ~ ~ ~ day of ~ &~ r'~ ~.. 19 :k?" .~; SCALE: ~ ~e~istered Land S~eyor No, 886-LS I" = ~ Box 456, Eagle River, Alaska Phone (907) 694-2543 SGS Reft# 1103550001 Client Name Garness Engineering Group, Ltd Printed Date/Time 07/29/2010 8:51 Project Name/# Falling Water B2,L 11 Collected Date/Time 07/20/2010 17:00 Client Sample ID Falling Water B2,L11 Received Date/Time 07/21/2010 12:05 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container iD Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 07/26/10 07/28/10 KDC Waters Department TotalNitrate/Nitrite-N 0.930 0.100 mg/L SM20 4500NO3-F B (<10) 07/23/10 AYC Microbiology Laboratory E. Coli Negative 1 100mL SM20 9223B A 07/21/10 DLC TotalColiform Negative 1 100mL SM20 9223B A 07/21/10 DLC Aug 04 10 07:38a Yvonne 907-892-3165 Alaska Sewer & Drain, L.LC. P.O. Box 221914 Anchorage, AK 99522-1914 Sales Receipt DATE SALE NO. 6/25/2010 47107 Hourihan, Daniel & Pamela PO Box 771252 Eagle River, AK 99577-1252 CHECK NO. PAYMENT METHOD REP JOBSITE 063378 Visa RLS 31805 E. Eagle River Rd ITEM DESCRIPTION QTY · RATE AMOUNT PUMP Pumping Service 1,000 0.22 220.00 BACK WASH Back Wash Septic Tank 2 20.00 40.00 Discount Discount 1 -26.00 -26.00 Return pump. Primary standpipe installed for tank cleaning. Very heavy solids in primary side, extra back washes required. Tank level good. No sign of back up in foundation clean out. Could not locate leach monitor tubes. Recommend pumping in one year. lotal $234.00 CURVE TABLE VICINITY MAI CE,~TIFICAT~ OF OWN£t~$t~P ~ DEDICATION I (we/hereby c~'#%y th~ I am (we are) ~e o~n~] of/h~ ~o~y ~i~d ~or~. ~u~o~asa~provedb/ I~.O.A, DMe: ~ l . I q 77 NOT~FS 4CKNOWLEDG~E~ ~ '?'~ ., . . - 2" Notary for~/~s~ My ~m¢~n ACCEPTANCE OF DED/CATION BY SU~V~YOR~ CERTIFICATE DTI000317 -:- PLAT APP~OV~L APPLI( NT FILLS OUT UPPER HA[ ONLY Property Owner /..~ ~-~ ,~ %//~T ,~ /"""~ ~"/~) ~/,/~" / ,~/t~,,,~ ) Phone MalllngAddre~ ~,0/ ~)~J~d:~)~'J~ ~, ~ ~/~ ZlpCode ~ ~,~ ~'~ ~//~ Buyer / Address Zip Code ~ Phone Realty Co, & A~nt Phone Address Zip Code LegalDescription ~0 t / , /~ 2I ~/~ ~/~/~ ~ ~8 b. Type of Real.nee ~gle Family [~ Multiple Family No. of Bedrooms. / ~ Other WaA~p.,~ I~lndlvidual ATTACH 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 s.%.r~po.~ ¢ ¢~ 3 ~ndividual Year Individual Installed: ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Inspector Insp~tor Insp~tor Insp~tor Field Notes: ~ ~ - JUL 2 (~ED BED OMS ( *CONDITIONS OF APPROV~ ( ) DISAPPROVED DATE BY: ~_ Soils Rating Date ~wer~nstalled Well To Absorption Area Well Log Received ~/~ Well ,o Tank Septic T~k Size 72.023 (31821