HomeMy WebLinkAboutATELIER #2 BLK 3 LT 6AOnsite File 1"" W At I io r #2 041 � 031 � 65 5vfl-,W-y a-t,Q "�6 F-OZ- Cosh Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221405 PID Number: 041-031-65 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name JACK NICKEL ABSORPTION FIELD ❑ Deep Trench 0 Wide Trench ❑ Bed ❑ Mound Site Address 7230 MONTAGNE CIRCLE `ANCHORAGE, AK ❑ Other Phone Number of Bedrooms Soil Rating depth from original grade 907-250-5022 3 0.8 GPD/SF JTotal 8.68 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade SEE DWG. Ft. Gravel depth beneath pipe 4.02 Ft. Subdivision Block Lot ATELIER #2; BLOCK 3, LOT 6A Fill added above original grade SEE DWG. Ft. Gravel length 60 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines - Distance between lines - Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 600 Ft2 1 - Ft. Well 100'+ 100'+ - - 25'+ TANK R Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity GREER TANK 1500 Gal. Surface Water 100'+ 100'+ - - Material Number of compartments Lot Line 1 0'+ 1 0'+ - - NA PLASTIC 2 Foundation 1 O'+ 1 0'+ - _ LIFT STATION Manufacturer Capacity Remarks PER CONTRACTOR, OLD TANK WAS DECOMMISSIONED PER UPC Gal. WE REQUEST YOU WAIVE THE REQUIREMENT FOR AN UPDATED AS -BUILT SURVEY Alarm location Electrical installed by PIPE MATERIAL House to tank EXISTIN drainfield Tank to D3034 Installer A+ HOME SERVICES Drainfield D3034 Co/MTD3034 Inspector GEG BENCH MARK (Assumed elevation) 99.16 ft Inspection1st 5/23/2023 20° 5/25/2023 Location and description 31' 5/25/202 4'" N/A ITOP OF MANHOLE ON -SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp ,00�oOp�� OF Conditional Approval: Date �.... ........... ^ Septic System n' Approved / v� Date " 2n ..................p 0�� .J f reCE 79 3 Hess: mop ����Ple � 2 ..��3� �g", Note: this approval does not include well permit requirements. #AEcC884 4p�000000� (Kev ub/urria) PERMPT NUMBER: PARCEL ID NUMBER: OSP221405 RECORD DRAWING 041-031-65 TH TOP OF TANK AT INTLET = 95.01 INVERT OF BUNG AT INLET = ORIGINAL GRADE AT HIGHEST POINT = 94.46 TOP OF MH = 99.16 98.11-98.38 ST1 2" INSULATION TOP OF TANK AT OUTLET = 95.00 NEW 1500 GALLON H.D.P.E. GREER SEPTIC TANK T 4.02' T RELATIVE ELEVATION AT BOTTOM OF T.H. = 77.96 (T.H. DRY ON 5123/2023) INVERT OF BUNG AT OUTLET = 94.13 FINAL GRADE = 94.46-95.23 TER FABRIC INVERT OF PIPE = 89.80 OF TRENCH = 85.78 GARNESS EING11NEERING GROUP, Ltd ENGINEERING a SALES Q, CONSULTING 3701 E. TUDOR ROAD. SUITE 101 -ANCHORAGE. AK 99507' PHONE (907) 337{,179 -FAX (907) 3363246' WEBSITE: rrnw.gamessengineering.cam PREPARED FOR: PHONE NUMBER: PAGE NUMBER: JACK NICKEL 907-250-5022 3 OF 3 LEGAL DESCRIPTION: DRAWN BY: ATELIER #2; BLOCK 3, LOT 6A D.J.G. TYPE OF WORK: DATE: SEPTIC TANK PROFILE 5/31/2023 '♦11,"\t\11� �; •• # ♦0 � .....:..... ........................... � �..........' ..............................� 0. -•r • e ey_6 lGarness IW= ZAV AIV LICENSE'111ROFESS�U:� �♦ #AECC884 ♦A���r / •PERM!T NUMBER: PARCEL ID NUMBER: OSP221405 RECORD DRAWING 041-031-65 ATELIER #2; BLOCK 3, LOT 5A rvn 1 w.7 or.7 CO2 105.7 58.7 MT2 106.4 60.3 NOTE: PIPE LOCATION ARE SHOWN PER GEG SHOTS TAKEN WITH LEICA DISTO S910 LASER DISTANCE METER. SWING -TIES TO HOUSE CORNERS WERE I T.H.#1 GENERATED IN AUTO AD. ' MT2 NEW DRAINFIELD CO MT1 w 1cli n w 2 \ I A NEW 1500 GALLON GREER TANKLU O toLU g� / W U Z I 00 o Q _3 ��'• / N 04 x ' o m \ Z N I-_ I w I / r \ f- U) 0 l7 EXISTING DRAINFIELD I ;i EXISTING 3 BEDROOM HOUSE .0 \ N / SCALE: \ V=40' 5 L I G`R�J9 Ltd ENGINEERING � SALES Y CONSULTING mzz L11- I' °= 3701 E. TUDOR ROAD, SUITE 101 ' ANCHORAGE, AK 99507 • PHONE (907) 3376179 • FAX (907) 339J246' WEBSITE:—.ga ,.g(n ing,-. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: JACK NICKEL 907-250-5022 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: ATELIER #2; BLOCK 3, LOT 6A D.J.G. TYPE OF WORK: DATE: � RECORD DRAWING OF TANK AND DRAINFIELD UPGRADE 5/31/2023 CF i o ( �?• 49 � `• � 1 . • ......�..:... ...... ....................... .......... :............. .. - ♦ •rey mess is �/ �� • • G -795 Z i 4�2 AV LICENSE #AECC884 tee®®®® 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: OSP221405 Work Type: Septic Upgrade Tax Code Number: 04103165000 Site Legal Address: ATELIER #2 BLK 3 LT 6A G:2142 Site Mailing Address: 7230 MONTAGNE CIR, Anchorage Owner: HICKEL JOHANNA L & JACK Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: cnt llehartine nt 10/18/2022 10/18/2023 79659 Q Disposal Field Q 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 Received By: Issued By: Date: Date: D 2 3 MUNMPAUTY OF ANCHORAGE Development Services DepartmentPhone: 907-343-7904 _r On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 041-031-65 Property owner(s) JACK HICKEL Day phone 907-250-5022 Mailing address 7230 MONTAGNE CIRCLE *ANCHORAGE, AK Site address 7230 MONTAGNE CIRCLE *ANCHORAGE, AK Legal description (Sub'd., Block & Lot) ATELIER #2; BLOCK 3, LOT 6A Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field [f Initial ❑ Single Family (SF) El (w/wo AD U) Septic Tank [] Upgrade 0 Duplex (D) ❑ Holding Tank ❑ Renewal ElMultiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 67915- Waiver Fees: Date of Payment: /0 L12 a Date of Payment: Receipt Number: og _-03 64 Receipt Number: Permit No. d 5PQ ,/ t/&5- Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Appllcation.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221405, Deb Wockenfuss, 10/17/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221405, Deb Wockenfuss, 10/17/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221405, Deb Wockenfuss, 10/17/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221405, Deb Wockenfuss, 10/17/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221405, Deb Wockenfuss, 10/17/22 Municipality of Anchorage Page / of_~.._ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: 5 ~/~Do~C~ PID Number: ~/-- Name: M~ ~'~~ WastewaterSystem: ~New ~ Upgrade Address: ?/W ~n~~ ~r ABSORPTION FIELD Phone: ~--~ I N°'°fBedr°°ms:~~ ~DeepTrench ~ Shallow Trench B Bed B Mound ~Other Total Depth from original grade: LEGAL DESCRIPTION SoilRating: /'~ GPD/Sq. Ft. Lot: ~ ~ Block~ ~' ~ubdiv~ion:~,~ ~ Depthv~j~ ~t° pipe bottom~,~from_~.~original grade: Ft. Gravel depth beneath pip~,/ Ft. Township: [ Range: Section: Fill added above original grade: Gravel length: ~ Ft. Ft.  Number of lines: Distance between lines: WELL: New D Upgrade Gravel width: ~ Ft. / ~ Ft. Classification (Pri~te, A,B,C):J~t~ ~ Tota~: Ft. Case~ Ft. Total absorptionarea:~,Z. ~ S~.Ft. Pipe material: / Driller:_ Date D~lled: Static Water Level: Installer: Date installed:~ Yield: / Pump Set at: ~ Casing Height Above Ground: I~-I~ G~ ~n~n ~. ZO'~ F,. TANK SEPARATION DISTANCES ~Septic ~ Holding ~ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines A~ ~ ~ , , I Material: ~~ Number of Compa~ments: Sudace Water J~'~ ~00 + - - loo'~ LIFT STATION LOt t , t Size in gallons:~ Manufacturer: Line ID ~ I0 ~ -- -- I0 * "Pump on" level at: ~' level at: High water alarm at: Foundation /0 ~ Cu~ain.~Drain /~0' + /DO'' ~ -- /OO,~ Pum~ I Electrical Inspections pedormed by: Remarks: ~ ~O ~ ~r ~n ~r~ BENCH MARK Location and Description: Assumed Elevation: /~ n, ~;~:;.. ;ENGINEER'S SEAL .... Inspections pedormed by: KND ~.o~~ Dates: 1st ~JZSJ?~ Department of Heal~ and Human Ca.ices approval J/~ Reviewed and approved by: ' Date:/~.-~ -~7 72-013 (Rev. 9/91) MOA 25 i AS-BOIl_ 1- SYSIBM DETAILS/SIIEi PLAN Per-mi-L SW960089 IRE GA, BLOCK 3, ATELIER ~S SUSB~VISIBN PIS~041-031 65 ~ I BASIS OF E: 1" 50' :~ ORIGINAL GRAgE ~ ~ rlL [ER FABRIC~ I S~--~1500 gal = . ~'~ ~ S~UER RBCK .... , (* 49TH~ * q a D~US ~~~ ~aTa,ii/iS/gGRav.~/30/97 DBA'WING H ~ ORIGINAL GRADE xa c 1500 GAL- ' -,,. _ SEP'I lC ~ - __ ~ ~ SEWER ROCK SCALE: NTS . PREPARED FEB', I<ND ENGINEERING' B044] PTARH]iGAN BLVD MIKE El'CONNER I-'AGLE RIVER, Al<, 99577 7141 MDNTABNE CIRCLE (90'/)696 6111/Fax (90'1)696-8111 ANCHORAGE, AK 99507 SCALE: AS NOTED' sGoso-sl N0V-26-96 TUE 17:21 PE~K ~NOHOR~GE F~× NO, 907 263 7070 P, 02 1201 Ramona St., 995i5 :.. · . .' .¥ . ,: '~. ~ ~,'.' ' ' '"' ....... " ' . ..... ' 84 f~et, ' : ":.. T ,,: .... ' '..' '. · ' ,%' ,' ''" ' e.~:.:'*.'¢,~*:¥ '~ ~."; ;4'" =*" "'""" ': ..... 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'"' " *,%~o~.'~ m~e~,~',~n~.,¢(~. ,:,, ,':: .,.,:~ ':, :, ,..:.:,.,.. . . . : ,.. :, , .... . .' ~ . ,.',*~ .~ "2, .'~ - ~. ;, , , , ~ . . ~.. '~ J,. ,~,..... . ,.,. ', ~.~ ~... . .~ . ; ~ · , , . . ' . ' ,,. ,,~'" ,.~... 4~.¢.. '"". ,..:....,'.,~j;.;*,:.~,,~' · . ,..,..~: .'' ,',' ..;,.' . ,.. ,* ,'. . · '.... . · . ,. * . .: , , .... , :, ....,~ :'.., *. , ..,. ¢~ · . , -/ ,'. . .:,' . ,.. ,,.,.. ...,,..,, .... ..,,.,,,. .... ,...,,., ,...,...,.. ,, .,?,.. : '?:, ';, '::.: '.~ . ~ . ' .' ,. ,' '.~r' ~¢ .~(~ , c .... ~ % . ' .' , * .... ' . ' '. ' ' " '."' ~ ..'~.=':'~;:' ~ r',' · .,...=,. ., * cost AL ' , ,.. ,...: , ." ,:.-' ..~',~:;.,**'..'.';71,:.'" ".. ~ ' ' ", ":~;'.':' , ~=~00,00 ' 'WRITE ·CHECK PA~ABLE TO ~P~RT P"I~LING w°RK$ FoR ~UM OF .--- , -,. . ' .. . . ' . . :. . . ~ *':'¢'~. ~ :~ "'"' . ,~ ., ' ,. ;-':" '.. '... ' . :," ' ' '. :'. :.',.':BERNIE C~Ui OF RAMPA~ DRILLIN6 WO , ..... eec un~, wILL BE ASGE$5~ ~N P~T DUEACCOUN~, ~N~ ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 September 26, 1997 Mr. Dan Roth Municipality of Anchorage Dept. of Health & Human Services On-Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 RECEIVED 29 1997 Municipality of Anchorage Dept. Health & Human Services Subject: Lot 6A, Block 3, Atelier Subdivision #2 - SW 960089 - Final Inspection Report Dear Dan: Attached is a letter of non-objection from the Department of Public Works for the section line encroachment on the subject lot. The well was relocated by the owner due to access problems with the drill rig and to shorten the water line distance. As the septic system is outside the well radius there should be no problem with the relocation. If you have any questions about this application, please call me at 696-6111/FAX 696-8111. Respectfully submitted, I1~i~I1~ Eng~ne?dng c Duffus, P.E. Mike O'Conner attachments: Letter of Non-Objection Mtmicip',flity. Anchorage I'.(). Box Anch(}i'agc, Alaska 99519-66,%0 Tclcpllm~c: (907)~5~-8277 F~x: (907) 561-1057 h tlln//www.ci.anchoragc.ak.us Rick Mystrom, Mayor September 9, 1997 Michael R. and Kathleen A. O'Connor 7141 Montagne Circle. Anchorage, Alaska 99507 Dear Mr. and Mrs. O'Connor: RE: Septic System Encroachment, Lot 6A, Block 3, Atelier Subdivision #2, Grid 2124 Street Maintenance Right of Way Section has reviewed a request from Mr. and Mrs. O'Conner for a letter of non-objection to an existing septic system located in the 33' section line easement on the west side of referenced lot. The as-built survey dated November 15, 1996, submitted with the request, shows the location of the location. If the 33' section line easement according to Plat #82-503 is not within the Municipality's jurisdiction, then this letter of non-objection will not be valid. Street Maintenance Right of Way Section issues this letter of non-objection with stipulations, and by using it the petitioner is agreeing to the following: 1. Municipality of Anchorage (MOA) will be held harmless, now and forever, for any damages or injury to any person as a result of the encroachments. 2. All applicable codes and regulations will be observed and maintained within the easement; 3. This letter of non-objection will in no way preclude MOA from full use and enjoyment of its rights within any portion of the easement. 4. Additional and extraordinary costs incurred during any future required construction, repair or reconstruction of MOA improvements to accommodate any or all of the encroachments shall be paid by the property owner. This letter of non-objection should be retained in your permanent files. Should you have any questions, please call me at 343-8246. Sincerely, ROW Permit Manager 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES PoO~ BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PAGE 1 OF PERMIT NUMBER:SW960089 DESIGN ENGINEER:KND ENGINEERING OWNER NAME:O'CONNOR MICHAEL R & OWNER ADDRESS:7141 MONTAGNE CIRCLE ANCHORAGE, ALASKA 99507 DATE ISSUED: 5/24/96 EXPIRATION DATE: 5/24/97 PARCEL ID:04103165 LEGAL DESCRIPTION: ATELIER #2 BLK 3 LT 6A LOT SIZE: 79659 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15~55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: Ao OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: DATE: Y- 24 - ~D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 May 10, 1996 Municipality of Anchorage Dept. of Health & Human Services On-Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: Lot 6A, Block 3, Atelier Subdivision #2 - Sewer and Well Permit Gentlemen: Following a request from the owner regarding the proposed development of the referenced property, we dug two testholes for the proposed system and replacement field. The results of those tests.are attached. The system will be placed on the west portion of the lot. As indicated on the site plan there is sufficient grade to maintain a gravity system. A 1500 gallon tank will be installed in anticipation of a 5 bedroom house being constructed. There is also sufficient area and grade to maintain a replacement gravity fed field. As indicated by the site plan drainage arrows, natural drainage is away from this site and will be maintained after construction. There is no sUrface water within 100' of the proposed installation. There are no curtain drains within 50' of the proposed installation. No wells exist within 100' of the proposed installation. If you have any questions about this application, please call me at 696-6111/FAX 696-8111. Respectfully submitted, ~) Engineering attachments: On-Site Well and Sewer Application Wastewater Absorption System Details Site Plan Soils Log/Percolation Test WASTEWATER i ISPBSAL SYSTFM LOT 6A, BLOCK 3, ATELIER SUBDIVfSTBN ND WELL WITHIN 800' OF SYSTEM. PROPOSED FIELD RESERVE ~ ND WELL WITHIN 800' DF SYSTEM, i, Contour in't;ervo[ is 1'. ~, Surf gee w~l'ter weis citon9 Mon't(19ne Cir, during -t;e$'thotes, tout dls(ippeo, red dur'in9 wo.'ter' monitoring, PREPARED FOR: MIKE B'CDNNER 7141 MBNTAGNE CIRCLE ANCHDRAGE, AK 99507 KND ENGINEERING 20441 PTARMIGAN BLVD EAGLE RIVER, AK, 99577 (907)696-6111/FAX (907)696-8111 DATE~ 5-10-96 DRAWING # SCALE~ I' = 100' 9630-S'1 DESIGN DETAILS WASTEWATER DISPOSAL SYSTEM LOT GA, BLOCK 3, ATELIER SUBDIVISION --CONNECT TO PROPOSED HOUSE Pepmlt w J I UNCLASSIFIED FILL(FROM TRENCH EX) FILTER FABRIC ~ L 0.5' 1500 GAL --~',,,.-- SEWER ROCK S,T, ~ 53' BOTTOM OF TRENCH~ 7-~ ~-~/-~ //~ BOTTOM OF TEST HOLE 20,0' BOTTOM OF TEST HOLE PROBED TO 22' NO WATER OBSERVED 0 C,O, CONNECT TO PROPOSED HOUSE 53' DESIGN CRITERIA 1, 5 BEDROOMS X 150 GAL/DAY/BEDROOM = 750 GP]] ~. SOILS RATING' a MIN,/INCH = 1,~ GPD/SF(TRENCH) 3. 750 GPD/1,a GPO PER SF = 625 SF 4. 6P5 3F /6'9 x ~ = 5~,08 L (USE 1 TRENCH 53 L) 5, MINIMUM DESIGN SIZE = 53' L x 3' W x 6' D Tmench 6, P' HD INSULATION REQUIRED OVER TANK <4' DF COVER PREPARED FOR: MIKE O'CONNER 714l MONTAGNE CIRCLE ANCHORAGE, AK 99507 KND ENGINEERING 20441 PTARMIGAN BLVD EAGLE RIVER~ AK, 99577 (907)696-6111/FAX (907)696-8111 DATE~ 5-10-96 DRAWING # NOT TO SCALE 96030-sa PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 WAS GROUND WATER ENCOUNTERED? s L IF YES, AT WHAT DEPTH? /~/'A 0 Depth lo Water After 4,4 ~'/~ PE Monitoring? Az/fi" Date: , ..,, ~,oo.?~). DATE PER FOR~'~; °o_ ~/~¢/~ .c~ ~ Township, Range, Section: ~ __ ~r~ SLOPE SITE PLAN Reading Date Gross Net Depth to Net Time Time Water Drop '~/~ ~ ~ :/~ ~ 7~/~ ~/~ ~ ~../q z ~ ~ 20 E o /4 PERCOLATION RATE 'fi' ~ ~' (m~nutes,qnch) PERC HOLE DIAMETER .__ TEST RUN BETWEEN ~ ~ FT AND fi' ''~ FT // ACCORDANCE WITH ALL STATE AND MUNICIP~GUIDELINES IN EFFECT ON THIS DATE, 72-008 (Rev. 4185) CERTIFY THAT THIS TEST WAS PERFORMED IN Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 4 9 10 WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT E Depth to Water After ,j,,/ ~../~k~ Monitoring7 /t?pr Date: 13 14 15 Township, Range, Section: SLOPE SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop o q/~o ~.,o~ - 77~., _ I ' ~:o~ I,~,;~ ,~ ~ ?/~" z 5,.o/ / ~ 9'¢ ~" ~Z~ 5;,7 I'?Ye ~" ~ 5~q i 7/~ I" 20 Eo/¢' PERCOLATION RATE / (minutes/tach) PERC HOLE DIAMETER TEST RUN BETWEEN ~° :~ FT AND 9, ~ FT // ACCORDANCE WITH ALL STATE AND MUNICIP IDELINES IN EFFECT ON THIS DATE 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9-- 10 11 12 13 14 15 16 17 18 19 20 COMMENTS Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 so, s ~~ ~ ~/~/~ Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? , S IF YESo AT WHAT DEPTH? p E Deplh to Water After Monitoring1 , Date: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RAI.E ~" ~ -~ (m~nutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ '~ Fl' AND ~, 5 FT ~./ ACCORDANCE WITH ALL STATE AND MUNICMGUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT]HIS/TEST WAS PERFORMED IN Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: ~'~ 2t_..b Range, Section: SLOPE 10 11 12 13 14 15 16 17 18 19 20 WAS GROUND WATER ENCOUNTERED? . S IF YES. AT WHAT ,/~, DEPTH? p E Depth to Water After Monitoring? SITE PLAN COMMENTS Gross Net Depth to Net Reading Date Time Time Water Drop 5:37 I ~ ~ ' ~ , :,~q I ~ ~ ::~1 / 2 V~ I" :.'VF /, to y: i" PERCOLATION RATE / (m~nutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN q FT AND . . ~ FT ACCORDANCE WITH ALL STATE AND MUNICI~L GUIDELINES iN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THATtHIS/TEST WAS PERFORMED IN unicipality of Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 January 8, 1990 Mari M. Thicks~un & Vernon Collins 1231 Autumn Lane Anchorage, Alaska 99504 Subject: Lot 6A Block 3 Atelier S/D #2 Permit #890089, PID #041-031-65 The subject permit, issued by this office for a single family well and/or on-site wastewater system has expired as of December 31, 1989. Permits are issued on a calendar year basis by authority of the Municipal Code of Regulations. A new permit must be obtained from this office for an well and/or on-site wastewater system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this office for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site wastewater system, the original as-built inspection report (three-part form) must be sent to this office for review, approval and documentation. When applying for a new permit, the fees are: $90.00 for an on-site wastewater permit; $50.00 for a well permit; $140.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. Sincerely, John Smith, P.E. Program Manager On-site Services JW/ljm:200 enc: Copy of Permit "Kids Are Our Future" I....,:::)'L L,~at.~;la:i.~ '.:Sul::)d:i.¥:i.!!!.:.:i.c:¢'l,-, ~TELIER ~ Lot: 6A Block: :~; L. c:,'L S :i. ;~ ~'..',, ;2. ,, 5,~.:~ ( ~ ':::1, f 'L ,, o r' ~ c:: r' ~,~, ~ ) ['la.~-~ E~r.:.:,(::l i" (::,~::~'l~.~. ~[ 'f' I"'~ :i..~ t:::'(~, r' m :i. C ~', '.~ji 'l"~:~t ,~ ]. Cap ~.(:: '.(:)i::) NO'f' IEXE',tEE:,~:) I"'If:~I',.ILff::'AE;"I"t. JF;,'I.:.!:F;'.!i!; I"lf:~X:t:I"ILJI"I P~[...t...C')NE::;(:) BUF;'.:[~'::q .... 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'Lhe ![i~y~.~'t:.em :i.r"~ ac:c:c:.~r'd,.'~!d"~c:e t,.,¢.~.'l:.l"'~ a:l.;I, l"'lE'h'::', (::c:~,de'.,!i.; ¢=',.r"~d a.r"~d :i,n c:c:,mp :!. :i.,?,u-~c:e ~,.,.,:i..l:.h 'f..he (::le~.i~.:i.,(;:]t"i L'::r' .'i.'t.:.er' ;i.~.4. ,::)(f 'l:.l"t :i.,.'5 I:~,er't¥t.i.'t:.. ::i!;,, :I.' ~.~,~:i.:[]. a~..c:ll"~'..:.)r'e 't:,,:::~ a].:t, t"lEh:':~ and 13't:.,';?cLe ~f (..~:l.,'~'¢~s~d,;:,.':'..'~ r'equ.:i.r-em~:..~r"d'..:.,':.~ f(::)r' 't'..he ~:.'I, :i..'.[Fl'..~;~.r"~c::~:)'..;~ I: r' c)m a:',.r'ly e~.;: :i. ~!~Ft'.. :i. r"~g t,,,~e ]. :1.., ~,'~8~...'ii'l'..e~t.~:.:-:,r' ct :i. ~!.~l:)C;:d[ih?..',. ]. !~}/'~i~'l:.efl'~ c:~r' pu.l:::, ]. :i. c: :t: u.r'l(:,~er'.:.i~.'(:.,:,:H'"~d 'LI"'~.~'~.'!:. 't:.t'"~:i.:!~, per'rrt:i.'L :i.r..{!. '.,.,'a ]. ¢. (::l ~"c:,r' a m.,:,~:...,':i, mt..tm c~,':.' 5 bedr'(:::.,cm'~.~i~.,, ~ ;1. !~(:;~ t..tl"'t (::l ,?:.;, f, ~iiF(:.,.'¢~,.l"),[::} 't'..h.;';';'ct'.. 'Lb(.:9 (;:: .:'3. [.L~ ~'..'~ ,:::: :i. t.¥ ,:3 {' 't..h6:.~. 'l'..,.'::)'t.i.':',. :t. ~ii.:.y!i~;t. eift :i. ~ L""J bed r' ,:a. ny er'!:l..~'~r'gl{:-:.m'~er'~'l:. ~.,¢:[:1.:t. r'e,::.lLi:i.i"e a. rt adc:l:i.'L:i.c)r'ia]. 12er'm:i.'t .... I ~OT ~A I I I r eeeeeee CE - 3589 Flattop Technical Servic, 14530 Echo Street /..oT 7A I-OT 8 Co, o ~ O SCA-LB: I".~ /~:~9 ' Ou,,N. f~V : S IT~ PLA N ?t,A-r". ALt, l..ocAr/oN.,f' ,,tl- P p' l~ o X t lUl A T l~ Flattop Technical Service 14530 Echo Street Anchorage, Alaska 995]~ © PLA N V/~ W t"= ~o'-o" ELEVATION LOT 6~/~, 8I-OCH ~ ATELIER ..q /D 5 ~ P 'T'I C .5 Y~ T~ Fl D E'-,c / d t15 Flattop Technical Services 14530 Echo Street ~chorc~qe, ~.laska 9951~ Lot 6A, Block 3, Atelier S/D #2 Septic System Design Notes and Specifications 1. The design of the soil absorption system is, based on a visual soil rating of 150 square feet per bedroom. This requires a total bed area of 1125 square feet for the proposed 5 bedroom residence. This is to be achieved by a soil absorption bed with horizontal dimensions of 30' by 38' and a total gravel thickness of 12", with the bottom of the gravel at an elevation of 12.5 feet below the ground elevation in the vicinity of test hole #4. 2. The configuration of the system shall be as shown on the plans, except that minor modifications may be allowed or required by the engineer conducting the inspections. The finished ground surface shall be graded to drain away from the site. 3. Installation shall be by an excavator approved by tl~e Municipal Health Department, and all construction practices and material specifications shall be in conformance with Municipal requirements. 4. Three inspections will be required: (1) initial stakeout, (2) after the bed is excavated, but before placement of sewer gravel, and (3) after the gravel is placed, the septic tank installed, and pipe connected, but before final backfill. Flattop Technical Services 77. fl. q~: ~ 14530 Echo Street orage, Alaska 99516 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 2 3 4 $? 5 6 7 ~'t7 10 ~2 14 17 18 19 2O Co Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? ~'~ s L IF YES, AT WHAT O DEPTH? p Depth to Water Alter Monitoring? Date: ~'/!~/~ SITE PLAN A Reading Date Gross Net Depth to Net Time Time Water Drop i~" ?r~,e~r ,5'/II ~ :5'~ ,,t~ - ~ 7 v~ _ I~:~ ~y '/~ (minutes/inch) PERC HOLE DIAMETER ~-: ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: "~///~'/~::~ Flattop Technical Services 14530 Echo Street oraqe, Alaska 99516 PERFORMED FOR: LEGAL DESCmPT~ON: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? . j~ ~t,.~¢¢e ,,:( ft,~c~ t/~,.~¢,,,4 s~ IF YES, AT WHAT 0 DEPTH? p E Oepth to Water Alter ~--/~;~/~:~ Monitoring? gale: SITE PLAN A Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER ~ ~L, ~'a TEST RUN BETWEEN __ FT AND __ COMMENTS ~'l~_O /'[~¢1t~' ~'~.~¢ /a.¢~//¢o~ FT PERFORMED BY: ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: Flattop Technical Service~. ~. :~ 3 14530 Echo Street · Orage, Alaska 99518 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 $ 9 10 12 13 15 16 17 18 19 2O COMMENTS 7~, ~ ~( ~,, ~' _._/fi .... '.'7" · I '" MOORE /_ ~ Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? p Deplh to Waler Alter Monitoring? Date: Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FTAND ~FT ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: '~/~'{:~/'~,~ Flattop Technical Services 14530 Echo Street ~orage, Alaska 99516 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12~ 13 14 15 16 17 18 19 2O .9om~ Gl, ~1~ Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? N s IF YES, AT WHAT OL DEPTH? p Depth lo Water Alter 6,"~ r' ~ ~t Monitoring? Date: SITE PLAN Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLAT,ON R^TE '"r:/¢'~, ,,~Y TEST RUN BETWEEN __ COMMENTS ~'~,.z.~¢~ __ (minutes/inch) PERC HOLE DIAMETER FT AND __ FT ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE, 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: ~lattop Technical Services 14530 Echo Street ~nchoraqe, Alaska 99511~unicipa~ity- of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: ~',~f ~"/~ 8lk.,,~ ,4fcft~'~' Township, Range, Section: SLOPE , SITE PLAN 9 ~"' [,~',,'1 WAS GROUND WATER 10 '~ P ~q~'t~,," G/t~'( ENCOUNTERED? N 11 ~cr, IF YES, AT WHAT ~' ~ DEPTH? Depth Io Water After 13 ~, ~, ~onitoring~ Date: s L O P E ,( 14 15 16 17 18 19 2O COMMENTS Reading Date Gross Net Depth to Net Time Time Water Drop ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES iN EFFECT ON THIS DATE. PERCOLATION RATE __ (m~nutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FTAND __FT CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: 72-008 (Rev. 4/85) ! /,, PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O COMM4TS PERFORMED BY: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST 72.008 (6/79) ,Su WAS GROUND WATER ENCOUNTERED? SLOPE ,"tO SOILS LOG PERCOLATION TEST IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop ~ 7-Z3 5":08 ..E' ' ~ Z 5:~3 5 ,5B ~ . 5'.z:~ 5 , "~' ,~o 5 ', r~Fm' 5:z8 5 , ~-0 b / ,, 5:~'~ 3 ,,f0 ,10 7 / 5~:~8 5 ,30 6/' ', 5:,.f~ 5- , ~0 Et " fO' ..5 ', '¢o ..... , PERCOLATION RATI L¢~, ~ \ .(minutes/inch) TEST RUN BETWEEf ~,~, 5 AND I~ FT CERTIFIED BY: PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOl LS LOG PERCOLATION TEST SLOPE SITE PLAN .E.FORMEO.¥: ! 72-008 (6/79) IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time I'~ ;1~ · Water Drop +~z) ,5',~ i 3:z~, O. /.7Z. -.~ 2. '~:6'0 lo I .GZ. ,5 ~/.oo ~0 I. 77 , O~ i.73 u w,'3p ~o 1.78 '7+/4z° q.'5'9 -~ 3 .,~zs" PERCOLATION RATE T/~ BETWEEN '",~,N D CERTIFIED BY: Jtes/inch) MUNICIPALITY OF ANCHORAGE :s Development Services DepartmentPhone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 041-031-65 1. GENERAL INFORMATION Complete legal description Atelier #2 133 L6A Location (site address) 7230 Montagne Circle Current property owner(s) Mailing address Shawn O'Conner Expiration Date: `)2ol u Day phone Real estate agent Day phone 2. TYPE OF DWELLING: E] Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well it Private Septic 0 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 $ 5 5 b Waiver Fee $ Date of Payment 5 ? 7 1 Date of Payment Receipt Number �qJr Receipt Number COSA # OS C 1 I 1 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe 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 soil condition, ground water 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 this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. 6. DSD SIGNATURE VJ System #1 Approved for 13 bedroorns System #2 Approved for bedrooms Disapproved Date .... ... .... ' ... Stever f. Pannone Conditional approval for bedrooms, with the following stipulations: X VIbso r,p4- ayN '1% �70% uSq_jet f�r-ry & S ►�� z, on v N_CAI � � r v o W p, OGhp, J Q � ENT J B Ltd"Vi 'JJ�JJ��pM II��J�G\,\�-, , '���1)11' khN y ate Date: 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 Septic System Advisory Well Flow Advisory COSA Checklist blue sheet Nitrate Advisory Arsenic Advisory Other MeR a R,= &&,lsD ng X CJ Legal Description: Atelier #2 133 L6A If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 11121111996 Total depth 84 ft Cased to 84 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 16 in. Date of flow test for COSA '!2'202' Static water level at beginning of test 53.2 ft. Comments B. TANK DATA Age of tank(s) 25 years Tank type/material Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping 5 - 2- D. ABSORPTION FIELD DATA Deep Trench Parcel ID: 041-031-65 Structure served by this system 1 Well production at time of test 4.5 gpm Water storage tank volume NA gallons Well di infected for coliform test? El Yes �o Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date of Sample ` C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Which system tested (date installed) 81996 Adequacy test date 51121202' ❑ ALL standpipes present per record drawing Results QPass For 5** bedrooms Total measured depth from grade 12.5 ft (max) Fluid depth prior to test 40 in Measured depth to pipe invert from grade 6.2 ft (min) Water added 750 gal ❑ N/A — pressurized field 76 New depth in ❑ Monitor tubes go to bottom of effective. If not, state 1440 Elapsed time min depth into effective RNCode-requiredsoil cover over field Final fluid depth 40 in RE System presoaked Absorption rate 750 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) Gallons introduced 1500* gallons If yes, enter date Comments/Deficiencies: 'Saturated field "System is designed for a 5 bedroom house, house is listed at 3 bedrooms COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ®✓ Yes Community Sewer Manhole/Cleanout > 100' ✓� Yes if No ft M Yes if No Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' [D Yes if No Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' El Yes if No Neighboring Absorption Fields > 100' Yes if No Water Main > 10' Animal Containment > 50' FV] Yes if No 0 Yes if No ft Yes if No _ Water Service Line > 10' 0 Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway comment below Community Sewer Main > 75' E] Yes if No ft [Z] Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ®✓ Yes if No ft Surface Water > 100' [Zl Yes if No . Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No ft Private Wells > 100'✓0 Yes if No Water Main > 10' 0 Yes if No ft Community Wells > 200' Yes if No _ Water Service Line > 10' 0 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' El Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots.- ots:Water WaterMain > 10'✓(] Yes if No ft Private Wells > 100' Water Service Line > 10' Yes if No ft Community Wells > 200' Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS Absorption Field is 70% used, ODeratina in its last 30% of its life. G. ENGINEER'S CERTIFICATION I certify that / 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 ft ft ft ft ft ft ft ft ❑✓ Yes if No ft 0 Yes if No ft >tevein R. Pannone i r CE 8149v MUNICIPALITY OF ANCHORAGE    DEVELOPMENT SERVICES DEPARTMENT    907‐343‐7904  On‐Site Water and Wastewater Section                                                                                           Fax: 343‐7997  www.muni.org/onsite         Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org      Septic Tank Advisory   Certificate of On‐Site Systems Approval # OSC211291  Subdivision:  Atelier #2  Block:3, Lot: 6A  The septic tank for this property is 25 years old.  The average life for a steel septic  tank is 20 years. Typical replacement costs range from $7,000 to $11,000.   This advisory must be attached to all copies of the subject Certificate of On‐Site  Systems Approval.               This is an example of what the metal of a 30 year old steel tank MAY look like.      5z-Lzi 3..SS,za.00ty 0 m QS) r Ql m In In 4w 0 W R Q) d� a w � a m pc � ad m F b y y L v vc2'm5 uc T C O L y N T G E C v u - y 0 K C 2 ga��c2- rA °f v m�a lL7 m m L E n 'o 1 o 9 `mom O o C mv*-c.Q V c � a � x C D 0 � C O Q7 N N •N ¢ N _ W C T j ) 0- J L Q 7 .L-. 4 W ON7 O C w U p) N Y N•� pl Y 9 q3 N iL W C 3 D7 O 5 _ 'C; N = _ H cowu s <Q {• N � v 0 � 2 r x � a v � o ea uau�� P m Z z3 2Mi.''. a 4 � Llj }a Qc x w n m�am �~ [W 5l{iii 0.00 J 4 a4w� o 5z-Lzi 3..SS,za.00ty 0 m QS) r Ql m In In 4w 0 W R Q) d� a w � a m pc � ad m F b y y L v vc2'm5 uc T C O L y N T G E C v u - y 0 K C 2 ga��c2- rA °f v m�a lL7 m m L E n 'o 1 o 9 `mom O o C mv*-c.Q V c � a � x C D 0 � C O Q7 N N •N ¢ N _ W C T j ) 0- J L Q 7 .L-. 4 W ON7 O C w U p) N Y N•� pl Y 9 q3 N iL W C 3 D7 O 5 _ 'C; N = _ H cowu s <Q v � m a ¢r a Ji =5 U ea m u �++ w n L7 �~ [W 5l{iii J - .1 �