HomeMy WebLinkAboutGREENLAND BLK 7 LT 7Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP251080 PID Number: 015-171-18 Dwelling: E Single Family (SF) El with ADU FI Duplex (D) n Two Single Family Project: El New E Upgrade Name SARA ANN CARTER ABSORPTION FIELD E Deep Trench n Wide Trench El Bed n Mound Site Address 11251 LIPSCOMB STREET, ANCHORAGE El Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 1 1 GPD/SF 10 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3 Ft. Gravel depth beneath pipe 7 Ft. Subdivision Block Lot GREENLAND 7 7 Fill added above original grade VARIES 0.05'- 1 Ft. Gravel length 51 Ft. Township Range Section Gravel width 3 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES ToSeptic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches Lift Station 1 d Tank Line From Tank I Field 714 F t2 1 Ft. Well100'+ 25$+ TANK [I Septic 0 S.T.E.P. ❑ Holding 0 Other Manufacturer EXISTING Capacity Gal. Surface Water 100'+ Material Number of compartments Lot Line *2'+ NA Foundation 10'+ LIFT STATION Manufacturer Capacity Gal. Remarks REMOVED REPLACED, RAISED & AUGMENTED FIELD W/ INSULATION. *WAIVER WR#080075 - ------ --------- ___ ------- ----- ----- - Alarm location Electrical installed by PIPE MATERIAL House totank Tank to 3034 drainfield Installer NORTHERN EXCAVATION - Drainfield 3034 CO/MT 3034 Inspector FWC BENCH MARK (Assumed elevation) 100 ft Inspection 15' 5/7/25 d 5/8/25 Location and description dates: 2 3rd 5/9125 4th IBOTTOM OF SIDING ON-SITE WATER AND WASTEWATER SECTION APPROVAL Mlykk Conditional Approval: Date low itowl, AW 7H .... .... . ......... . Septic Syst Approve Curlis CE128991 Huffman Date Note: ZIP :� AiW 05/16/25. . 0 O --X� FESS_O- this approval does not include well permit requirements. (Rev 05/02/18) S 0 ° 0 2 ' 3 0 ' ' W 1 8 0 . 0 0 ' S 89°54'47''E 99.00' S 0 0 0 1 ' 0 2 " E 1 8 0 . 0 0 CONCRETE PATIOCO N C . PO R C H X X X 2 9 . 8 28.1' 38 . 1 LI P S C O M B S T R E E T 20' ALLEY 26.4 PID:015-171-18 PERMIT:OSP251080 FIRST WATER CONSULTING GREENLAND BLOCK 7, LOT 7 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP251080 Work Type: Septic Upgrade Tax Code Number: 01517118000 Site Legal Address: GREENLAND BLK 7 LT 7 G:2636 Site Mailing Address: 11251 LIPSCOMB ST, Anchorage Owner: CARTER SARA ANN Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 4/23/2025 4/23/2026 17833 Q Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: Percolation rates are less than 1 mpi for this soil. A sieve analysis must be performed to confirm that this soil does not require a sand filter. If results require a design change, construction shall stop pending approval of a change order. Please submit results with the inspection report (or change order, if required). V V A I V!F- (L � G 0 J. 5 lit i L I G. S 7 7- Received By: C_ Date: Issued By: Date: In MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section ON -SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 015-171-18 Property owner(s) SARA ANN CARTER Day phone Mailing address 11251 LIPSCOMB STREET ANCHORAGE, ALASKA 99516 Site address 11251 LIPSCOMB STREET ANCHORAGE, ALASKA 99516 Legal description GREENLAND BLOCK 7 LOT 7 Number of Bedrooms 4 Engineering Firm FIRST WATER CONSULTING Building Permit Number Not Applicable 0 APPLICATION IS FOR: APPLICATION IS AN: (Z all that apply) Absorption Field Initial ❑ Septic Tank ❑ Upgrade El Holding Tank ❑ Renewal ❑ Privy ❑ Well ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Permit/Rush Fees: -#.5-4 Date of Payment: Permit No.i Waiver Fees: Date of Payment: Waiver No. Phone: 907-343-7904 Distance: 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! !! April 22, 2025 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: GREENLAND BLOCK 7, LOT 7 The property owner has requested we obtain a permit to upgrade the failed septic field of the above referenced lot. It appears that the existing absorption field installed in 2008 sandy soil has developed biomatted material that does not allow proper effluent absorption. It is proposed that this biomat be removed and the trench reinstalled. We propose to install one trench per the design to serve the existing 4-bedroom residence. The design is based on the test hole information provided by Ted Moore, PE performed in 2008 and within the MOA file that shows no groundwater was observed at test hole excavation or monitoring. An additional test hole TH25-1 was recently conducted. Given the area and observations it has been determined to raise the existing field by 2’+ with MOA sand and extend the trench per the attached design to be conservative and provide additional absorption. The slopes are moderate to flat at the proposed upgrade location. The lot and area are served by private water. The lot lines & well radius must be staked prior to construction & request continuation of the existing waiver (WR#080075) of 2’ to lot line from the proposed trench. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251080, Curtis Townsend, 04/23/25 S 0 ° 0 2 ' 3 0 '' W 1 8 0 . 00 ' N 89°56'57''E 99.45' S 89°54'47''E 99.00' S 0 0 0 1' 0 2 " E 1 80 . 0 0 SHE D CONCRETE PATIOCONC . PO R C H X X ASPHALT DRIVEWAY OWELL X X X X 19.3' 9.1' 1 7.5 34 . 0 28.2' 24 . 2 6.2' 1 8.0 23.6 29.8 28.1' 38 . 1 EAST 113TH AVENUE LI PS C O M B S T R E E T 20' ALLEY 10. 2 26.4 OWELL FIRST WATER CONSULTING GREENLAND BLOCK 7, LOT 7 REMOVE & REPLACE DESIGN CALCS: NO SLOPES >25% WITHIN 50' OF PROPOSED FIELD. STAKE ALL PROPERTY LINES & WELL RADII PRIOR TO CONSTRUCTION. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251080, Curtis Townsend, 04/23/25 S 0 ° 02 ' 3 0 ' ' W 1 8 0 . 0 0 ' S 89°54'47''E 99.00' S 0 0 0 1 ' 0 2 " E 1 8 0 . 0 0 CONCRETE PATIOCO N C . PO R C H OWELL X X X X 1 7.5 6.2' 1 8. 0 23.6 29.8 28.1' 38. 1 LI P S C O M B S T R E E T 20' ALLEY 26.4 FIRST WATER CONSULTING NO WELLS WITHIN 100' OF PROPOSED / EXISTING FIELD. DESIGN DETAILS: GREENLAND BLOCK 7, LOT 7 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251080, Curtis Townsend, 04/23/25 3030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350-9566 FirstWaterAK@gmail.com SOILS LOG - PERCOLATION TEST LEGAL : GREENLAND B7, L7 PERFORMED BY: FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 4/22/2025 DEPTH FEET OG SOILS 1 2 ORG/OL 3 4 5 6 SP/gp 7 8 9 10 11 12 13 14 SM 15 16 BOH 17 18 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop NA PERCOLATION RATE NA (MIN / INCH) TEST RUN BEWTWEEN & FT PERC HOLE DIAMETER 6” PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. GROUND WATER ENCOUNTERED: NO IF YES, AT WHAT DEPTH: NA DEPTH TO WATER AT MONITORING: DRY DATE: 4/22/2025 TESTHOLE # 25-1 DATE PERFORMED: 4/15/2025 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: GROUNDWATER MONITORING TEST HOLE. BOH WAS DRY, BUT MUDDY / MOIST 4/22/25. VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION PERFORMED FOR: SARA ANN CARTER 4/22/25 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251080, Curtis Townsend, 04/23/25 ,TER ANCHORAGE AREA B IOtJGH Department o[ Environmental Quality 3500 Tudor Road Anchorage, Alaska 99507 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTE/Vt MAILING ADDRESS ~,O,,'L,~-~ I("¥JL"'~-/' ,~""~//¢?'';' -.%7/,' · PHONE SEPTIC TANK: DISTANCE FROM WELL '~-$-/ INSIDE LENGTH MAN U FACTU RE R ~/2//'d o.:~'/~ - ~ INSIDE WIDTH ~' MATERIAL NUMBER OF COMPARTMENTS_ / LIQUID DEPTH LIQUID CAPACITY ,:-' .~ (] GALLONS. SEEPAGE PIT: ¢/.' / t z NUMBER OF PITS / DIAMETER ___OR WIDTH'~Z, LENGTH[~~', DEPTH ~ LINING MATERIAL/DF/ {V~¢II';", CRIB SIZE: DIAMETER(~,c~ DEPTH /~," DISTANCE: FROM: / / ,' TOTAL EFFECTIVE BUILDING FOUNDATION/-~[ NEAREST LOT LINE/'D WELL ABSORPTION AREA (WALL AREA) z~/[~ ~-, SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE BUILDING FOUNDATION CESSPOOL APPROVED / CONSTRUCTION ~'~" [ ~'/_(,?iL},~ I)L)~.;)?<,~//~13b DEPTH __ NEAREST f NEAREST f.t~ SEPTIC ;/,..~_ LOT LINE /0 '¢ SEWER LINE lO TANK OTHER SOURCES__ DISAPPROVED REMARKS DISTANCE FROM: SEEPAGE SYSTEM DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: d'l,)/~i/td/../;":'./~r~'r PIPE MATERIAL.:L?~? /~'~-'~!. LOT SLOPE: APPROVED I"'~':l,.f.:2--~. (.-. ~¢,-f'l.,: .~, G.A.A.B. SEWAGE GRIEATFLiR ANC;,PtOFRAGE AIREA E3Of~OLJGH DISPOSAL SYSTEM- . APPLICAT[OFI AND PERMIiT t~INIM!JI~4 DI~tTAAI~;B~, EII~QUIRF:M[NT5 SIP%lC TANK TO SEEPAGE PIT WALL- 15 TO N[AREST LOT LINE. ,~ [ WATER MAIN 1'O SEPTIC TANK -- 1]~&9 ..... SEEPAGE PIT __].0 DRAIN FIELD ].0 AREA $1ZE~ · TYPE GREATER ANCHORAGE AREA BOROUGH DEPAR'FMF£NI' OF ENVIRONMENTAL QUALITY 3330 "C" Street ANCHORAGE, ALASKA 99503 Case # Performed For ~T~]~,_~_~ T.<el/;~,oA(~e Dated Performed Legal Description: Lo-~-~-~ /Bl~ck __ Subdivision This Form Reports Soils Log_/ Percolation Test - Soil Test Must Be I.ogged To 4' Below Proposed Seepage System Depth Feet Soil Characteristics 10-- 11-- 12-- 13=- 14-- Was Ground Water Encountered?_j~x If Yes, At What Depth? Reading Date Gross Time Net Time Depth to li20 Net Prep L 1 'Percolation Rate Minute Proposed Installation: Seepage Pit Drain Field Depth of Inlet Depth to Bottom of Pit or Trench ....... CO?ENTS_] ~_~ .~,0 4' }'~' b~?' F~ ~ , '__ __ ~ _, ~- " Test Performed BY. ~,~ ~.~ Date Certified BY: Date: MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC251178 Parcel ID 015-171-18 Expiration Date: 5/8/2025 Legal description GREENLAND BLK 7 LT 7 site address 11251 LIPSCOMB ST Current property owner(s) CARTER SARA ANN X The On-site system(s) is/are approved for 4 bedrooms Z Conditional approval for bedrooms, with the following stipulations: Comments or conditions: No comments Original Certificate Date: 5/21/2025 This,C,,�p ftificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject syst�(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory X Tank Age Advisory Arsenic Advisory Other MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section Phone: 907-343-7904 Fax. 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-171-18 Complete legal description GREENLAND BLOCK 7 LOT 7 Location (site address) 11251 LIPSCOMB STREET ANCHORAGE, ALASKA 99516 Current property owner(s) SARA ANN CARTER 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: FM Private Well serving # 1 dwelling units El Other Non-public well as regulated by MOA F-1 Water Storage ❑ Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: 5@ Private Septic E] Private Septic serving 2 dwelling units n Holding Tank El Community Septic or Public Sewer 5. SEPTIC TANK: RN Steel F1 Plastic ❑ Concrete F-1 Fiberglass Age 17 _ See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: F-1 A\/WVTS F] Bed nN Deep Trench n Wide Trench n Seepage Pit Waiver request for: Expedited review requested: R Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ Date of Payment z COSA # Waiver Fee $ Date of Payment Waiver # COSA Application_Apr2025.doc COSA Checklist.docx COSA Checklist Legal Description: GREENLAND BLOCK 7 LOT 7 Parcel ID: 015-171-18 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 1972 Total depth *78 ft Cased to *UNKNOWN ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 3/27/2025 Static water level at beginning of test ARTESIAN PLUG Well production at time of test 6 gpm Water storage tank volume None gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 5.26 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 5/8/2025 Comments *Previous MOA docs state 78’ & 40’+. B. TANK DATA Measured operating fluid level in septic tank NA* Date of pumping 3/27/25 Required maintenance completed, if AWWTS Comments: *Pressure System / Floats C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) NEW SYSTEM ALL standpipes present per record drawing Total measured depth from grade 11 ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective (ED). If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date NEW SYSTEM Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – NEW SYSTEM Effective depth (per record drawings) 84 in (MOA 7’ ED) Effective depth used 0 in Effective depth (ED) remaining 84 in Comments/Deficiencies: COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No *2+ ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS *WAIVER TO WEST & NORTH PL – WR#080075 G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 05/16/2025 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. 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 in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. 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, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 05/16/25 MUNICIPALITY OF ANCHORAGE Phone: 907-343-7904 Development Services Department Fax: 907-343-7997 On -Site Water & Wastewater Section 0— Owner Septic Tank: -Sludge level inches Lift Station/Pump Vault Maintenance Log Street Address/ l2,-� /L i n -Pumping: required esno -Pumping completedey s no Lift station: -Pump basket cleaned es no -Control floats cleaned es no -Operation satisfactory es no Alarm System: -Effluent filter cleaned es no -Proper float settings confirmed es no -Dedicated electrical alarm circuit es no -Audible and visual alarm inside dwelling -Alarm system operationsatisfacto not satisfactory Manhole Riser -Ground water intrusion at riser to tank connection es no -Ground water intrusion around pipe penetrations es no -Manhole lid: Functionale no Insulated es no Other -All manufacturer required inspections and Comments: Qualified Maintenance Provider: Technician ko vc-q t>J.Jp- Company L -t-$ es no -Weep hole functionales no Properly Secured es ,no maintenance completed 6e no Signature Date of maintenance Date MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907-343-7904 M On -Site Wafer and Wastewater Section =: Fax: 343-7997 www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC251178 Subdivision: Greenland, Block: 7, Lot: 7 A water sample revealed a nitrate concentration of 5.26 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Nitrate Fact Sheet From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. ALLEY S 89054'47"E 99.00' • � ai u FE E —.� SHED 1 0 OMH a IJ O C5 Oo O O O OQ 26.4 xaz i p i po 0000000�OO OF A CD o �` 0 �. 49 TH 919 U)ae, 17.5 O SHANE A. HOLT w11 L G ex Q04 ° LS -6914 y�QO � �A,O�essiona� �o ,$ NOTE: O NO EASEMENTS APPEAR ON [-Zt; THIS LOT ON THE RECORD ASPHALT DRIVEWAY __.,• 5 PLAT GRAIII P"k11VGAREA o N 89056'57"E 99.45' EAST 113 TH A VENUE AS -BUIL T SURVEY f 11 = 30' NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT7 BLOCK7 GREENLANDSUR THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EASEMENTS OF RECORD '0 ANY LEGAL ENTITY, OTHER THAN THOSE APPEARING ON THE RECORD PLAT ; ARE NOT SHOWN HEREON( UNLESS INDICATED) EXIST OTHER THAN NOTED. >2 TH NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE DATED AT ANCHORAGE,ALASKA THIS DAY OF PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. MAY , 2025 ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. ONLY VISIBLE IMPROVEMENTS ARE SHOWN HEREON HOL TLAND SURVEY/NG THESURVEYDATA ON THIS DRAW/NG /S PREPARED FOR THE OWNER OFRECORD ONL Y. 9309 GROVER DR/VE ANYCOPYING, OR UTILIZING THE DATA HEREON IS PROHIBITED UNDER COPYRIGHT LAW ANCHORAGE,AK 99507 10869 134-2 135-2 241-42 223-8615 MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section - Parcel I.D. 015-171-18 ANCHORAGE Certificate of On -Site Systems Approval 9. GENERAL INFORMATION Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: "I — k(- Z0 2-0 Complete legal description GREENLAND BLK 7 LT 7 Location (site address) 11251 LIPSCOMB STANCH, AK Current property owner(s) Mailing address Real estate agent SCOTT & JAIME SCHMUNK 2. TYPE OF DWELLING: [71 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic Fx� Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ `J 3-0 � Date of Payment 2- af/ Z U Receipt Number _1L 1 (17 Z COSA# t�C. Z© 10 5�0 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On-Site staff may visit the site to verify the information submitted. Name of Firm MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 6-3-20 49TH •°: 6. DSD SIGNATURE System #1 Approved for 4 bedrooms •'°''s •.✓zs._.✓. V MICHAEL N. ANDERSON ; System #2 Approved for bedrooms CE- 9 69 Disapproved ��§ l�£� 2t2f7,.•.�co�� k ��pROrESS10'A��'� Conditional approval for bedrooms, with the following stipulatlb�i3�0���� JI►iU11� , I By: Original Certificate Date: .-^/'ZC) z -y The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: GREENLAND BLK 7 LT 7 if more than 1 septic system on lot: COSA Checklist # of A. WELL DATA W Well log is filed with Onsite (or attached) Date drilled UN Total depth 40'+ ft Cased to *Un ft ® Sanitary seal is functioning correctly 7 Wires are properly protected Casing height (above ground) 20"+ in. Date of flow test for COSA 1127/20 Static water level at beginning of test 32 ft. Comments * From MOA records depth is 78' B. TANK DATA Age of tank(s) 12 years Tank type/material StEt'ISt EEL Measured operating fluid level in septic tank 28" Q Standpipes/foundation cleanout per record drawing Date of pumping 1/27/20 D. ABSORPTION FIELD DATA Which system tested (date installed) 11/25108 ❑ ALL standpipes present per record drawing Total measured depth from grade 12.4 ft (max) Measured depth to pipe invert from grade 3.3 ft (min) ❑ N/A — pressurized field W Monitor tubes go to bottom of effective. If not, state depth into effective ❑® Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced 0 gallons Comments/Deficiencies: none COSA Checklist yellow sheet Parcel ID: 015-171-18 Structure served by this system _ Well production at time of test 5+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 1.89 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by MNA Date of Sample 5/27120 C. LIFT STATION ❑ Required maintenance completed Age of lift station 11 years Lift station material steel Comments: See L&S Services did the service Adequacy test date NEW Results Q✓ Pass For 4 bedrooms Fluid depth prior to test 86 in Water added 600+ gal New depth ' u4 in Elapsed time 1440 min Final fluid depth 84 in Absorption rate 600+ gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 0✓ Yes Community Sewer Manhole/Cleanout > 100' r, Yes if No ft j]✓ Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' Yes if No ft Water Main > 10'✓Q Animal Containment > 50' 7 Yes if No ft 0 Yes if No ft Yes if No ft Water Service Line > 10' F✓ Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' 0 Yes if No ft M Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0✓ Yes if No ft Surface Water > 100' MM Yes if No ft Property Line > 5' Q✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q✓ Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10'✓Q ft Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10' F✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 21 Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No *3'0 ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS * 2' Lot line waiver in MOA file. G. ENGINEER'S CERTIFICATION I certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet sea o .%?e 4eeeooioea A 'M'ICHAEL a es osoe0000ese < MICHAEL N.. ANDERSON MUNICIPAUTY9F ANCHORAGE !40�-343 7904 K" }} L if'a S'! , Maintenance e Log =?^ ,'S .p . 4 SC'j�t(GI�?C; 41- 4 rC}Cti +S kd>F t s, w e,>r •# kSt ?iii j' ' tJl d C? �1t� Pui''3pin, C)Rt j ' F Ci ; # Lift Station: h plur v ba ke -Effluent f4€er cleaned •'-c trot `loaf cleaned }es, iso -proper float settings confirmed � s L.. 1per&�;tion ` attstac ,ory 4f�.-"*.E9-0 t (so .Alarm Systern: -Dedicated electrical alarm chrct,,it ,,res r i o -Audible and visual alarm inside dvieliing �no "rola °'.' S}rStetT? O ratlUr'?at'CSrc GtC3 riot SatiSfa-tQr Manhole Riser -Ground water intrusion at riser to tank connection es no' -Ground water intrusion around pipe penetrations es no•bleep hole functionales no -tvlanhote lid Functional insulated es no Properly secured es no Other I -All manufacturer required inspections and maintenance completed0,Les no Comments': D~te: To: From: Subject: MUNICIPALITY OF ANCHORAGE MEMORANDUM March 15, 1995 DHHS Accounting & Budget On-Site Services, DHHS Request for Refund - Account #2570-9426 Please make tile necessary arrangements for the following refund. The Engineering firm withdrew the request for Health Authority Approval. Please refund the $300.00 fee and send it to the address listed below. S & S Engineering 17034 North Eagle River Loop Rd, Suite 204 Eagle River, AK 99577 Recept#25788 Amount: $300.00 Account # 2570-9426 Legal Property Description: Lot 7, Block 7, Greenland Subdivision Kathy Bouschor On-Site Services cc: File ROBERT C. COWAN, RE. ROBERT A. SHAFER, RE. HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN E~TENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST March 13, 1995 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of H~lth and Human S~rvices Attn: Robbie Robinson P.0. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 7; Block 7; Gr6e~and Subdivision 11251 Lipscomb Street D~ar Robbie, The attempt to obtain a Health Authority Approval on the referenced property has been cancelled. Please d~continu~ any review that is b~in9 done on this property and refund thc M.0.A.H.A.A f~ that was paid by S & S Engineering. If you require additional information please contact us. PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ONSITE W/~ST EWATE R OISPOSAL SYSTEM DESIGN RECEIVED MAR 1 I. 1995 ~V~uruo,Pahiy ol Anchorage [:,)¢pt. H¢¢l~h & Human Service~ 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # _.~ ~J__~ ._ \ ~ ~ .. \ 0~ NAA# 1. GENERAL INFORMATION Complete legal description Lot 7~ Block 7; Greenland Subdivision Location (site address or directions) Property owner Mailing address 11251 L~pScomb Street Anchorage, AK Clair Floyd ~.. Day phone 11251 Lipscomb Street Anchorage, AK 99516 346-3580 276-2174 Lending agency Mailing address Agent Address Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: XXX If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: XXX Public sewer If community wastewater system, Provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/9~) Front MOA#21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is 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 inves_ti_gation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm $ & $ ENGINEERING Phone 17034 Eagle River Loop ~°ad Address E~c,!e ~!~~. Alnslca [ncneer's signature ~ DHHS SIGNATURE ~ ~ __ Approved for '~ bedrooms. __ Conditional approval foP~.~_ _~ Additional C bedrooms ,ith the g stipulations: By: Date Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L-o7 A. Well Data Well type Parcel I.D. Log present (Y~) Total depth Sanitary seal If A, B, or C, attach ADEC letter. ADEC water system number ~//'/~ Date completed ~ / ~' 7Z- Driller ~1~ Cased to ~LE.3 L/.- Casing height //~' Wires properly protectedL~) '7/E3~ AT INSPECTION FROM WELL LOG ..// Date of test Static water level Well flow Pump level1 ,/ SEPARATION DISTANCES FROM WELL TO: Septic/l:~t~ir~ tank on lot Absorption field on lot Public sewer main Sewer service line ~ m ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout / O0 Petroleum tank WATER SAMPLE RESULTS: Coliform ~)~/~t/~ ~- Dateofsamp(e..f~.~/g~¢/~- Nitrate .~/Z $/¢/,~ ~ Collected by: Other bacteria ~///o~ ~ B. SEPTIC/HCL3:NC TANK DATA Date installed lO~/Z~ /~ Tanksize /~'O -~:l/__ZO/~' Compartments / Cleanouts ~N) Y~- ~ Foundation cleanout (Y~__~ /'U)C3 Depression~N) High water alarm (Y/~. ,Av/O Alarm tested (Y/N) /f///.~ Date of pumping ?/~1/ ~ Pumper 0_¢~.L27'~ po//tc/o//t)~ _ SEPARATION DISTANCES FROM SEPTIC,~ ........ TANK TO: Well(s) on lot '75" ~''-~'- On adjacent lots ~(~ To property line / 0~¥ Absorption field Surface water/drainage /~/~ .~ ~~ /~& ~~%/o~ ~u/~/~ 72-026(~)*Fr~, ~__ ~ ~ ~¢~%~/~/~ ~/~¢ CONTINUED ON BACK PAGE Foundation /0 Water main/service line C. LIFT STATION Date installed Size in gallons /Wo 6 P/?~ ~-~'~ ~- Manufacturer ~ Manhol~ "Pump on" level at ~ "Pump off" Level at ~ Cycles tested Vent (Y/N) High water alarm level Meets MOA electrical code~ ~ SEPARATION DI/$.T-AI~E FROM LIFT STATION TO: /.W. elPo~n lot On adjacent lots Sudace water D. ABSORPTION FIELD DATA Date installed "~'[~¢-/?~-~-~ Soilrating(GPD/FF) /o~/~ ~c Systemtype Length -7~. "~- Width '~-7w~ Gravel thickness Total absorption area 7Vt--7~-~ Date of adequacy test 3/30 / ~( ~ Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Cleanout present ~_)N) Results ~/fail) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: '-~-"-~, Total depth ~¢-~,~ 0 ) Depression over field (Y/N) After test ~ If yes, g~e date ~/~ Bedrooms Well on lot >~/~ To building foundation On adjacent lots '-/'~,'~ Property line To existing or abandoned system on lot Cutbank ,,,t./Oj',Jd. /~e$~ ~f'--~Water main/service line HAA Fee $ -~ O O .- (~-"~ Date of Payment Receipt Number (~ ~ 5/ "~ Receipt Number Waiver Fee $ :. ' :' Date of Payment Date On adjacent lots /O Surface water/JO/,J~ ~J/#,.)/CO F ?/'/..~r-d'y. Driveway, parking/vehicle storage area Curtain drain /~0/JF~ E. ENGINEER'S CERTIFICATION I ce~'fy that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature "' Engineer's Name N.(; ..... DEPARTM 825 MUNICIPALITY OF ANCHORAGE OF HEALTH AND ENVIRONME~ _ PROTECTION L Street, Anehorao~. Alaska 99501 264-4720 Date Received: December 28, 1977 Time (~,'~'~'~') ~nl __ Date #2: Time #3: Time Date Date Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institution Request: Peoples Bank and Trust Mailing Address: Pouch 7-007 99510 Phone~79-7511/242 Property Owner: Clair A/Bemma Lue Floyd Mailing Address: Star Route A Box 1721 99507 Phone: 344-2154 3. Legal Description: Lot 7 Block 7 Greenland Subdivismon 4: '7. Single Family Residence: (x) Multiple Family Residence: ( ) Number of Bedrooms: Four Number of Bedrooms: Well System: Permit ~ Construction Individual well (x) Community/Public System ( ) Depth of Well ~ Well Log on File ~[~ _ Bacterial Analysis Sewage Disposal System: On-site System (x) Public Utility ( ) Permit # Installed ~c'~ 7'2-- Installer Septic Tank Size ;_2~O Manufacturer _~[~~% . Absorption Area ~6~ Soils Rate ~ Material Distances: Well to Septic Tank '7~' to Absorption Area __~Q[ .... to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line MUNICIPALITY OF ANCHOllAGE DEPARTMENT OF HEALTH AN[) ENVIRONMENTAL PflOTECTION 825 L E;~reet.~ Anc:horo,~je.~ Alaska !)950:1. 2']9-~25].1~ exi:. 224, 22b REQUEST FOR APPROVAL OF INDIVIDUAL SEWER ami WATER i::hOll,,ll"lES 1. Type of Inspection: VA ....................... FIIA ..................... CONV__~ .......... 2. Property Owner: ........... ~Z. ~_&¢._ ~ .~. ~_ _~ Ma.ling Address:_.S~ ~_~..~?.~,...~_~O~.~,. ~ ......... Day Phonu ...... ~J~_~SA ................. 3. Name of Buyer: .......... _~%~.~.~. dress' S~ Da~ Mailing Ad .................................................................. 4. Name o[ Lending Institution: ........ Mailing Address: ........................................................................... ~U~ 7007 ~ ~or e ............... .. 279-7511 E~ 242 5. Name of Realtor or Agent: ............~..~_ Mailing Address: .................. [o "m ~ LIPS~ 7. Type of Facility to bo Inspected: ........ _S_~_I~_ ............................................... No. 8drms .......... 8. Wa!er Supply W~,T, & S~IC ~P~V~ 'l'yp~ of Supply: Public Utility ............................. Individual ............................................. If Individual, number of dwellinD; presently served If Individual, depth of well 9. Sewage Disposal System ~ & S~ZC ~P~V~ Type of System: Public Utility ........................... Individual (on-sit0) If Individual, date of installation 72-003(3/713) Page Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 7 Block 7 Greenland Subdivision Comments: Affadavit Attached: (' Letter Attached: ( ) Approved: Disapproved: Department WorksheeL: Febr~a'ry 1, 1978 Clair A./B~m~a Lue Floyd $~:ar Route A Box 1721 Anchor a~3e, Alaska 99507 Subje~t~ Request for Approval of Child Care ~acilitias Lot 7 Block '7 Greenland ~gubdivision On the basis of your letter dated January 26~ 1978, this department can not approve your plan~ for a day care center for the fo!lowing' reasons: ~Total of twenty(20) (:hildren would require you to have a mint~tlm of 150' protective radius between your w~ll and any se%~r sy~%e~o (2) The sewer syst~,~ is not large ~nough to acco~aod~te this type of condition. The main reason for the disapproval is the n~muber of children at tho day care center, even tho%~gh you h~ve only five(5) to six(6) ~hildren at on~ timbale, the 'total v;outd reach twenty(20) throu~jhout a day~ If t~re are any further questions, pleas(~ contact this offic(~ at 26~.~4720~ ~?~obert C. Pratt, Sanitarian RCP/ljh Mike Brunet Permit Officer GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska Date Received ;-~' ~, ( J' (~1~' "' ~ ,~ /vt ./,/' ,t REQUUST FO~ APcROVAL OF 2. Prooer~y O~ner Location: Type of Facility to be I~specked: · , Number of" 3edrooms: ..... __ 6. Well Time of Insoection (~' '%F~) ...... Date of Insoection Phone.. Phone: '7. 0'' C°nstructi°nZ~{JT'LZ~-k~f ___ D. ~aoterial Analysis Sewage Disoosa]. Svstem: lO ~ A. %he,ailed ~¢ /'~ ZZ~ 8. Installer ~J~.~?. Zda:/'~ C. Septic 'rank= 1. Size /Z5-'6 2. D. Seepage Pit: ].. Size.~Z~'3J~¢ 2. Disposal Field: Total Length of Lines Distances: A. Well To: / Septic Tank_f/_¢~ ...... , Absorption Area /0o , Sewer Lines , Nearest, Lot I,ine ~(-~ /- , Other Contamination~:~¢~-¢/ ,.'-*, · Foundati o~ to Seot:i c, Tank~ '5'/ "~ Ab~orotion. Area.___:,:Z.~//. Absorption Area to Nearest Lot Line ~P,5' · Recc~eg.t for Approval of Individual Sewer & Water Facilities Page Two 9, Comments: A.ooroved -¢/,~'~4. ..,,/~x2~.'~.,' " ' Disapproved Date d~3~2tz /¢~/~ Approval Valid for One Year From Date Signed Greater Anchorage Area Borouah, Deparfimen~ of Environ~ren%a] Quality DIAGRAM OF SYSTE~ I certify that the information contained in this request for approval to be a true and accurate representat~.on of the subject sewer and water facilities located