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HomeMy WebLinkAboutT12N R3W SEC 33 LT 131A Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191059 PID Number: 01828121 Dwelling: ❑■ Single Family(SF) ['with ADU [' Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name Skelton ABSORPTION FIELD Site Address ❑■ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound 3900 Twilight Lane ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 727-2227 4 0.8 GPD/SF 13 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 3 Ft. 10 Ft. 131A Fill added above original grade Gravel length Township Range Section 0.5 Ft. 40 Ft. 1 2N 3W 33 _ Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 3 Ft. - Ft. To Total absorption area Number of trenches Dist. between trenches Septic Absorption Lift Station Holding Sewer From Tank Field Tank Line 800 Ft' 1 _ Ft. Well 1001+ 1001+ na na 25'+ TANK ❑ Septic ❑S.T.E.P. ❑ Holding ❑Other Manufacturer Capacity Surface Water 1001+ 100'+ na na • Gal. Material Number of compartments Lot Line 101+ 10'+ na na NA LIFT STATION Foundation 101+ 1 0'+ na na Manufacturer Capacity Remarks Splitter Valve Confirmed Between 2 Old Anchorage Tank 500 Gal. Fields. Diverter Valve Installed After Existing Concrete Tank. Alarm location Electrical installed by Side Of House 0 k PIPE MATERIAL House to tank D3034 Tank td fVC/o Installer drainfielPNC- A+ Drainfield5C49/V C.CO/MT D3034 Inspector NorthRim Eng. BENCH MARK (Assumed elevation) 100 ft Inspection 151 5/7/19 5/7/19 Location and description dates: 2"° 3rd 5/8/19 4th Deck ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date c.0., , A 4 �.tevun W. Eng ° r1/. Septic System _ 4 .._ P- 6< < • r Approved _ ( w- t-�E�' Date S -21 .,5-115, `/r Note: this approval does not include well permit requirements. '`i�oaNa.�a� '''" (Rev 05/02/18) Twilight Lane 3' RII1 W AS-BUILT MEASUREME TS A B C DV 16 25 w ST1 17 23 1 1 4' ST2 17 20 a MT1 44 46 J 101 MT2 54 43 L MT3 50 26 _ 1 1 1 a • 3 Well 157. Slope 1001 f f 104 Slope 10% Slope 10„,.....— Small Retaining Wall 3'-4' High I 20% Slope / -- fsi S(oAP O Z O O 3 F •t Slope -- 1 n vi I Existing 0TH2 Trenches o` Diverter �Valve500 Gallon 1 Flat Slope ST Existing Concrete Tan ��SLift Station Driveway A , Force fco "./Main y C7 Z 4 Bdrm 0 0 Flat Slope �,Z"� 9 0 0 5% Slope h .+nE£ Ml 1 D U1 1 N 1 Flat Slope j a a W LSA u w Flat Slope M ''...........1 `j2 New Trench w/ 0 0 1.25' Schedule 40 PVC -. -» Pressure Distribution Flat Slope 10' T&E Easement a. No 10% Slope Conflicts R100-Well NORTHRIM ��+°`".'q'���, T12N R3W SECTION 33 1° = 40' ENGINEERING .... . y� SteveEng.com * '4 Ili >C.. i OLOT 131A RECORD PO Box 770724 • mop .• :` WASTEWATER ` LAYOUT Eagle River, Alaska 99577 • 907. 694. 7028 ��� FIs �� UPGRADE SEPTIC Date:5/14/19 SHEET: 3 Tank Cleanout Elevation @ 93' Diverter Valve Final Grade INSULARDRISER i / 4 Foot Cover I or Equal '1 -j -----.--To New Trench �� / levation @ 88.5' _ 5, Elevation @ 89' a a Mound For 3' Cover Or Insulate ' Monitor Tube Final Elevation @ 97.5' • 500 Gallon Original Ground @ 97' STEP Tank 3' Elevation @ 94' 1 ' ' Effective Depth •: 10' Elevation @ 84' TH Elevation @ 77.5'-Dry @ 5/7/19 --3.0_4.- NORTHRIM _.....(*.• ... of ENGINEERING ='�"••'... TRENCH END VIEW T12N R3W SECTI❑N 33 I �.4 Di ��. * steveEng.com , STEP TANK/TRENCH PO BOX 770724 -. • • t L ❑T 131A Eagle River. Alaska 99577 Vas . tam 907-694-7028 ° 5- ,s r9 UPGRADE RECORD Dot. /19 rra" BY: SE rcal.. 1• = 5 ' ISHEET 3 of 3 SE 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: OSP191059 Work Type: Septic Upgrade Tax Code Number: 01828121000 Site Legal Address: T1 2N R3W SEC 33 LT 131A G:3135 Site Mailing Address: 3900 TWILIGHT LN, Anchorage Owner: SKELTON BARRY C & HEATHER E Design Engineer: NORTH RIM ENGINEERING This permit is for the construction of: Q Disposal Field Ll Septic Tank ❑ Holding Tank ❑ Privy Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: �1�Zcnt ))C'I)Fll'CI71Crii 3/28/2019 3/27/2020 49461 ❑ 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: 1. The existing system has a 'Diverter Valve" between the two fields. Please confirm that this is a splitter valve and address on the IR. If it is a diverter valve please contact Onsite, it should probably be replaced. -1 0>& N he Engineer needs to do an additional test hole prior to the construction of the septic field, minimum 17.5' deep with percolation test. Construction may proceed at your own risk before the 7 day water monitoring is complete. Please submit stamped and signed results with the As -built Inspection Report. If the results require a design change, construction of the system will stop pending On -Site review and approval. Received B� Issued By: 4 '� C �i 30 1 °1) "Co, C c�r� own a Soo �r`"v -� J I 0 h s-� �w12 `r Sub rn� � ,Y1C Deh ,�k s-�-a.-h Te �f 3 � Date: C / Date: �S MV UHMPAUTY OF ANCHORAGE Development Services Department _ Phone: 907-343-7904 On -Site Water & Wastewater SectionF 9x 77 Q7=34.3-7997 i i I n :i r�wi • "; of �� ON-SITE SEPTICMIELL PERMIT APPLICATION (0 /i� 1 ,l 20;9 � Parcel I.D. 01828121 Property owner(s) Skelton Mailing address 3900 Twilight Lane Site address Same Z68L Day phone 230-7927 Legal description (Sub'd., Block & Lot) Lot 131A Legal description (Township, Range & Section) T12N R3W Section 33 Lot Size 49,461 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field n Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank ElUpgrade El Duplex (D) ElHolding Tank ElRenewal 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. 0 (Signature of property owner.br authorized agent) Permit/Rush Fees: 1mg � . 6 0 Waiver Fees: Date of Payment: 0/144A Date of Payment: Receipt Number: ®����� Receipt Number: Permit No. OrP A 059 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc OATH: I M ENGINEERING Date: 3/14/19 To: MOA On -Site Services SteveEngxom Steve Eng, PE, PH 907-694-7028 SteveEngPE@gmail.com Subject: T12N R3W Section 33 Lot 131A Septic System Upgrade Number of Pages: During a COSA inspection it was discovered that the existing trenches were in failure. A previous soil test reveals silty sand and no groundwater. The design calls for two new trenches, utilizing the existing concrete septic tank. The existing trenches to be connected via diverter valve. The water wells and easements are depicted on the drawing. The terrain slightly slopes north and is flat slope at the trench site. The system size is a single family at 4 bedrooms. Please review the wastewater system design for the existing 4 bedroom home. I have included design plans & specs, design guidelines, & soil test. If there is need for additional information or clarification please give me a call. Thanks-Stev • 711 tt 3 TH! Imo- ENGINEERING SteveEng.com T12N R3W Secion_33 Lota31A SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is an existing 4 -bedroom, single family home. This is a developed subdivision. This is a large lot with many easements. The existing concrete tank will be used. A Diverter Valve will allow the use of existing trenches in the future. No adverse impacts are expected from STEP/trench upgrade. No conflicts to the other lots will take place by this septic system construction upgrade. A new soil test reveals silty sand. An application rate of 0.8 GPD/FT 2. Length = 750 FTZ/10'x 2 = 37.5' trench (10' effective); Say 1 trench @ 40'. Water wells are drawn. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Existing Concrete Septic Tank To Remain. Diverter Valve to be installed; "ON" to New STEP/Trench. • New 500 Gallon STEP tank. MOA -Approved. • Force main to be 1.25" Schedule 40 PVC or equal. 4' of cover and insulation is required for force main; 2" Minimum thickness for insulation. • Distribution pipe to be 1.25" Schedule 40 PVC w/ 1/8" orifice @ 18" on -center. • 10' minimum to property lines. • 3' of cover or insulation is required for trench; 2" Minimum thickness for insulation can substitute for 1' cover. • Tank & solid pipe must be set on well compacted, stable soil. • 4 inch diameter cleanouts with airtight caps are required F to 4' from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10' from the tank positioned to provide cleanout access towards the tank and towards the absorption field. • All cleanouts must extend to at least ground level. • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. • Trench to be placed level, minimum of 4' to groundwater, 6' to bedrock from drain -rock. • Drain rock to be %2 inch to 2 inch screened. Drain rock to be distributed uniformly throughout the trench. • Silt barrier (filter fabric) to be installed above the drain rock. • Smeared trench sides must be raked or scarified before drain rock placement. • The finish grade must be mounded to promote drainage away from trench. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope. • Septic Tank to be pumped every two years or when required. • Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal) Well r -R 10 0 M Z O O -h n C+ V) Twilight Lane W DESIGN NOTES: 1. Total Depth of New Tench is 13'. 2. Sewer Service Line mi imum 2% slope. 3. Private Water Wells. 4. New Diverter Valve After Tank. 5. Diverter Va e "ON" T New STEP/Trench. 6. Connect isting Trenches Via Valve. 7. Measure ell Separati n Prior To Construction. 8. 1.25" chedule 40 PV Force Main. 110% Slope 110% Slope Mall Retaining Wall 3'-4' Hlgh 20% Slope % SAO �o AP F t Slope ExIstTren ngches� Tren 0 Flat Slope " co v °' m I Flat Slope N d d W W New Trench w/ W Flat Slope 1.25' Schedule 40 PVC r Pressure Distribution Flat Slope �� A O 5% Slope +-u + r0 ro Ln 10' T&E Easement J No 10% Slope Conflicts R10 Well N OR THRI M 5Nq, O " " - +�+��oF� T12N R3W SECTION 33 1 - 40 ENGINEERING =�,'�P' Ste veEng. com s'* *�s �'�'��� �'� � LOT 131A DESIGN PO Box 770724 ......_ LAY ❑ U T=Ev9 e River, Alaska 99577 WASTEWATER 19ate. r�907.694.7028 UPGRADE SEPTIC 4/29/19 2 of 3 Diverter OTH2 Valve Existing oncrete Tan \ Flat Slope 500 Gallo fco If Sta Ion Driveway Force 4 Bdrm Amp Mo rA11 in 0 Flat Slope " co v °' m I Flat Slope N d d W W New Trench w/ W Flat Slope 1.25' Schedule 40 PVC r Pressure Distribution Flat Slope �� A O 5% Slope +-u + r0 ro Ln 10' T&E Easement J No 10% Slope Conflicts R10 Well N OR THRI M 5Nq, O " " - +�+��oF� T12N R3W SECTION 33 1 - 40 ENGINEERING =�,'�P' Ste veEng. com s'* *�s �'�'��� �'� � LOT 131A DESIGN PO Box 770724 ......_ LAY ❑ U T=Ev9 e River, Alaska 99577 WASTEWATER 19ate. r�907.694.7028 UPGRADE SEPTIC 4/29/19 2 of 3 K Q) 4 M 5 N F– 4- +� O d O mS'� Ln}� �— —► O i M �' C� O — 2_ i z Ln O 0 H II i Qj > miiU a u W (,) o d L ° °' U 3 Q LL- o 5 4" S �I p ten, o 0- m ; d S N -N rl O i :3 (/) A z o a c 3 a, v CLJ i LO u > i 0 iu � ~ _ N 4- coa (• V LL. 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S❑ILS ITh I M EN INEERING Performed For; Barr LOG - PERC❑LATI❑N TEST Date Perf ormed: 4/18/19 Legal Descriptions T12N R3W Sec 33 Lot 131A DEPTH (FEET) 1 - 2 Date o. 3 - 4 _ Net Drop .0 4/26 5 -- 6" -- 7 4/26 30 30 min, V 2" 3 4/26 9 - -- -� -- 10 4/26 60 30 min. 11 - 2,5° 5 4/26 12 - -- 6" -- 13 - 4/26 0 30 min, 14 - 2,5° 7 4/26 15 - -- 6" -- 16 4/26 120 30 min, 17 - 2,5n 9 4/26 18 - -- 6" -- 19 - 4/26 150 30 min, 20 - 2,5° Organic SM Silty Sand W/ Gravel TR Locations See Attached Test Boring Location Map Groundwater? Seeps Depth -- Water Depth After Monitoring, None Date) 4/26/19 # Date Gross Time Net Time Depth Net Drop 1 4/26 0 -- 6" -- 2 4/26 30 30 min, V 2" 3 4/26 30 -- 6„ -- 4 4/26 60 30 min. 3,5" 2,5° 5 4/26 60 -- 6" -- 6 4/26 90 30 min, 3,5" 2,5° 7 4/26 90 -- 6" -- 8 4/26 120 30 min, 3,5" 2,5n 9 4/26 120 -- 6" -- 10 4/26 150 30 min, 3,5" 2,5° 21 - Percolation Rate 12 min/in Perc Hole Diameter 6" Test Run Between 2' & 3' -omments; Pre -Soaked- Measured To Nearest 1/16", 'erformed By NorthRim Eng, I CERTIFY THAT THIS TEST WAS Derformed in Accordance with All State/Municipal Guidelines in Effect IN THIS DATE. DATE; 4/29/19 NOR THRIM ENGINEERING+T12N R3W Sec 33 TH3 SteveEng.com s* 49Il..... .... ' LOT 131A PO Box 770724 f sev. is Eagle Rlven Alaska 99577 4f� CE -e = TEST ❑ L E L ❑ G 907.694.7028 �y / 29/19 r 1$H EU- GE❑TECHNICAL ��4/29/19 11 ✓" _0T 131A -IAS 49,462 SO.rT. OF AREA 73% OF 7HE LOT IS LEVERED. } TWILIGHT LANE J w 1 I Sl _ ! i, ,:, 19.8 , 3.6' EAST 164.85' ° 1. ._...-_. �. -- -- -.- r • �3' RESERVE3 IN PATENT FOR R.C.V. TBJRPOSES \t , I WE_L I i I I h I - \ ,O•P ? 4.7.A e9 I I I d -�1 s I �I 4, I i I I ±= 1A. ! :n ° "' CLEANOUTS o o - 0 o v in I` LOT 58 0 NO 1 \ ENTRY�6 ° • e� _ CLEANOUTS 36.12' o If • AK DIM.*'.IWSE -2'COST I NI � 4 •aW .41W I 4. 4'O / %/1100v Cf.'7 9 O� CJS ti 1 IJU -J7.71.10 U WW WW IoW 'pW I^~ . h O oi10' ESC. L .1._ , - 64.90• � TELECOM. ESMT. N89'59'33"E i 64.9C' GRAPWC SLK£ 7 Not-X toot WELL RECERT: 8/31/98 l5 T's b Ts ID 10 al RECERT: 8/21/98 VERTICAL DATUM WAS ASSUMED FOR: BRUIN BUILDERS Date Scale Legal Description 08-07-98 1"=30' Lot 131A Block LanMark Grid ASBUILT r.,ngi sem`f Sunrivig 1°r' 3135 981216 LOTS 131 A & 131R 5631 Silverado Way. suite _201 Drawn byField Book Located in Sec. 33, Anchorage, Alaska 99518eT12N. R3W, 5M, AK (907) 562-6050 R.J.W. 12II `.F �•i = I hereby certify that the property described hereon has been surveyed by me. or at my direction, and that the improvements situated thereon F.,.•• •. are within the property lines and do not overlap or encroach on the ,`P,• •S�I, property lying adjacent thereto unless otherwise shown. that no improvements on the property lying adjacent therto encroach on the r 07•: t premises in question and that there are no roadways, transmission r a.: 49 •'.la/ lines or other easements on said property except as shown. r j'' • se It In the resposibility of the owner or builder, prior to construction, so. to verity proposed buildingade relative to finishgrade and utilityCHARLES E.FOR8E5 :;7"" lr Igo,. 1r connections and to determine the existence of any easements. covensn•r. I.1•. LS-7326 .•+ or restrictions which do not appear on the recorded subdivision plat. 1, • ,•Sa • Listed distances prevail over scaling. o • •,\ c.o Reproduction may cause distortion. 1 11r�\S�"%• Municipality of Anchorage Page DEPARTMENT OF HEAL'FH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O. Box 196650 e Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater DiSposal System and/or Well Inspection Report Permit Number: .%vO c~O<P! / PIaNumber: ¢~:) Name: ~¢~ ~0~ /~0~'~ WastewaterSystem: ~New DUpgrade Address; , ABSORPTION FIELD Phone: I NO. or, Bedrooms: ~Deep Trench. ~ Shallow Trench ~ Bed ~ Mound ~ Other Total Depth fro o 'ginalgr de: LEGAL DESCRIPTION SoilRating: ~¢ GPD/Sq. Ft. Lot: Block: Subdi~ion: Depth to pipe bottom lrom original grade: Gravel depth~neath pipe . Gravel lan th~ ~ Secti~ ~ Fill added above origidal grade; Number of lines: D~stAnce baleen lines: WELL: ~New ~ Upgrade 3ravel width: ~ Ft. ~ [ ~ ¢ Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: . }ate installed: Date Dril ed: ;talic Water Level: Installer: W ~ CasingHeightAboveGround: I PumpSet at: TANK SEPARATION DISTANCES ~eptic a Holding ~ S.T.E.P. To Septic Absorption Lif[ Holding Public/Private Manufacturer: ~ Capacity in gallons:  Material~. ¢ ~ Number of Compadments: Well tOO~ fO0+ ~ [00 ~ 0¢¢~ Line ~** /¢1 ¢~* ,Pump on,, leve;~~~h. ;~ter alarm C;l::~n ~/~ ~/~ ~ ~ ~ ~k~odd I Electrical Inspections pedormed bY: Remarks: BENCH MARK Location and Description, Inspections performed by: ",ck~e(~. &.~.o. Dates:~, ¢/~,/.'~._ Department of Health and ~ma~Se~ices approval 72-013 (Rev. 9/91) MOA 25 Permit No. SW980011 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 543-4744 On-Site Wastewater Disposal System end/or Well Inspection Report Legal Description: Lot 131A, Sec 33, T12N, R3W, SM, AK PID No.: 018-281-21 TWILIGHT LANE 3' RESERVED IN PATENT FOR R,O.W. PURPOSES NEW WELL ASBUILT I I EASEMENT EASEMENT i"=50' J COORDINATE OISTANCES iN DECIMAL FEET A 8 6.0 23J 12.5 24] 16.5 27.7,1 40 2Si 25.5 48.5J 263 I 48.61 43.8 ,~9.8 I69t_ OF WELl. t,lo,¢. -<0. 199~- ~-5: 51d RI'I PO'- STATE OF ALASKA DEPARTNIENT OF NATURAL DIVISION OF MINING & WATER WATER WELL RECORD LOCATIONI~:K~TCH: DF, PTHS NIEASURED FROM:[] ca~.irto top []ground surfaco BOREHOLE DATA; Depth rvlateflal Type and Color ~'rom WELL DEPTH: / DATE OF OOMPLETION Depth of Doplh of DEPTH TO~T, ATIC WATER L~EL; ~ cable tool METHOD OF DRILLING: ,~ otar¥ [] othor G~3NTIIAOTOI~ INFORMATI/rON: /'/ REMARKS: ~ .,'~ ~,,, ~ { // ~/~. ~ I LEASE MAIL WHITE COPY OF LOG TO'. ~ ....... .~: ......... "-- ~ /~ DNR/DIVISION OF MINING ~ WATER ~,u-~u[~ u~ ~u[rmn~ea ~espreso~muve 'Date : 3601 ~ St, ~ulte 800 ANCHORAGE AK 99B03-B93B Phono i9071260,8639, Fax (9071662.13g4 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW980011 DESIGN ENGINEER:ANDERSON ENGINEERING OWNER NAME:HOFMANN MARK D & DIANNA L OWNER ADDRESS:3900 TWILIGHT LN DATE ISSUED: 2/02/98 EXPIRATION DATE: 2/02/99 PARCEL ID:01828121 LEGAL DESCRIPTION: T12N R3W SEC 33 LT 13lA LOT SIZE: 49461 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL PIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72} AND DRINKING WATER REGULATIONS {18AAC80). 3. THE ENGINEER MUST NOTIFY 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 ADSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZINGI 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: January 15, 1998 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 131A Septic System Design Impacts to Adjacent Properties Dear On Site Services Engineer: We hereby apply for a permit to construct a well and an onsite septic system on Lot 131A. The attached site plan and backup documentation identify the size and location of the well and new system to serve the four bedroom home to be constructed on the lot. Testholes performed on the property revealed silty sand with some gravel which percolated at rates just over 30 minutes per inch. No groundwater was found in the testholes nor was any noted during the monitoring period. We have therefore designed a deep trench system with 6' of gravel beneath the distribution piping. Total depth of the system will be 9.5'. The soil conditions encountered in the testholes was very similar indicating the subsurface soils on the lot are probably fairly uniform throughout. We are confident the system designed for these conditions will function adequately. The ground surface of the lot is gently sloping from south to north at a rate of 6 to 8%. The ground surface also slopes from east to west at a rate approximating 5%. Toward the eastern boundary the surface drops off into a ravine at a slope of 20%. Sufficient surface area exists for both the primary absorption trench and a reserve site. No conflicts were noted between the new septic system and wells in the area. Lot 131A January 15, 1998 Page Two If the system is constructed as designed the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. The subdivision is served by a community water system. The system, if constructed as designed, will: have no adverse impact on existing septic systems in the area or those to be constructed in the future. The system, if constructed as designed, impact on reserved space, either surface located in the area. will have no adverse or subsurface, on any lots The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments · TH1 AREA PLAN SCALE 1" = 100' TWILIGHT LANE TH1 ~ FOUR BEDROOM' HOME Alternate site .131-A -SITE PLAN', SCALE 1" = 40' I 131'[B ' zabel Flow Splitter ~2' Total Length (56' Each Lateral) 6' Effective Depth 1,250 Gallon Septic Tank ~oundation Cleanout Four Bedroom Home SYSTEM PLAN NO SCALE LOT 131A DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home Perc. Rate: 32 Min./Inch Application Rate: .45 GPD/SF Deep Trench System 1,250 Gallon Septic Tank 6' GraVel Beneath Dist. Pipe 4 Bedrooms X 150 GPD = 600 Gallons Per Day 600 GPD/.45 GPD/SF /12 SF/LF = 112 LF Trench Therefore: Construct a Deep Trench System with Two Laterals Each 5 6' in Length. Splitter Valve to be Placed to Evenly Distribute Effluent From Septic 'rank. Distribution Piping to be Placed at 3.5' Below Original Ground Level. Natural Backfill 3.5 ' Geotextile Fabric 6" NOTE: 6.0I PVC (Slots Down) Drainfield Rock 3.0I DEEP TRENCH SECTION (NO SCALE) Grade Area to Drain Away. Municipality of Anchorage DEPAR'rMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alasga 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: Mark~of fman LEGAL DESCRIPTION:_ Lot J3L1A § 6 7 8- 9- 10- 11 Township, Range, Section: SLOPE 13 14 15 16 17 18 19- 20- SITE PLAN Reading Date Time Time/' Water Drop ,~1/~/.~7 I~:~ , '/ ~'~'~'"' -- PERCOLATION RATE ..?~' -- {m~nutes/,nch) PERC HOLE DIAMETER TEST RUN BETWEEN -~ Fr AND? · , - - .~ · z '~/~ ACCORDANCE WITH ALL STATE AND MUNICIPAL GUID~INES IN PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST Mark Hof fman ~, 0 k ~[. ~. A ~, ..... {:7 °ATE PE.FO.MEO:/ . LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9- 10- 11 13 14 15 16 17 18 19~ 20~ Lot 131A Township, Range, Section: WAS GROUND WATER ENCOUNTERED7 IF YES, AT WHAT DEPTH? Depth to Water Afar Gro~ Net Depth to Net Readln~ Date Thne Time Water Drop 1~5~ ~ ~,~ ~,. /4-;~1 ~ 2,~ · ~ PERCOLATION RATE ~.-.~-~ {mlrlute~/mCh) PERC HOLE DIAMETER ~:> TESTRUNBETWEEN~---LFT^ND----~,e~FT< __ / ACCORDANCE WITH ALL 8~ATE AND MUNICIPAL GUIDELINE8 IN EFFECT ON THIE DAT~ DAT~ ///~ ~ ./dj ~ PERFORMED IN 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 Parcel I.D. 018281-21 Expiration Date: g —1 ? 1. GENERAL INFORMATION Complete legal description T12N R3W SEC 33 LT 131A Location (site address) 3900 Twilight Lane Current property owner(s) SKELTON BARRY Day phone 727-2227 Mailing address Real estate agent Buyers RE Day phon ,7-2227 A 2. TYPE OF DWELLING: Single Family (w/wo ADU) E iV:k� 16 LJ i3 li ❑ Duplex �a ti Multiple Dwellings (Single Family and/or Duplex) z ,`� 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well El Private Septic H Water Storage ❑ Holding Tank ❑ Community Well n Community ❑ Public Water System n Public Sewer n Waiver request for: Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ oR D 0Waiver Fee $ Date of Payment 5-11q1 16Date of Payment Receipt Number Q342g'b Receipt Number COSA# ©JC P4 1 I(o$ 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 NorthRim Eng. Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 5/16/19 •7 t. .F 6. DSD SIGNATURE •• KSystem #1 Approved for i, bedrooms — `n°' o e„, System #2 Approved for bedrooms �? s�/S�gfs",.� Disapproved 17 Conditional approval for bedrooms, with the following stipulations: a`Ik®41.416. iro �����,of OF( f(f ((t 1( ``-GHQ O ,- J ON-SITE L WATER AND a WASTEWATER o PROGRAM J�-III4fIVr SERV\('.� ,` By: 1./N-- •�l Original Certificate Date: 2_ 1 _l q 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 COSA Checklist Legal Description: T12N R3W SEC 33 LT 131A Parcel ID: 018-281-21 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system A. WELL DATA ❑■ Well log is filed with Onsite (or attached) Well production at time of test 2+gpm Date drilled 4"0198 Water storage tank volume 0 gallons Total depth 495 ft Well disinfected for coliform test? ❑ Yes ❑■ No Cased to 247 ft ❑� Coliform bacteria is Negative ❑■ Sanitary seal is functioning correctly Nitrate mg/L • Nitrate less than MRL (ND) ❑� Wires are properly protected Arsenic ug/L ❑■ Arsenic less than MRL (ND) Casing height(above ground) 24 in. Collected by NRimEng Date of flow test for COSA 4/26/19 Date of Sample 3/12/19 Static water level at beginning of test 167 ft. Comments B. TANK DATA C. LIFT STATION Age of tank(s) 6J2 '98 years Required maintenance completed Tank type/material • Corce1e Age of lift station new years Measured operating fluid level in septic tank 46" Lift station material steel ❑� Standpipes/foundation cleanout per record drawing Comments: 500 Gallons Date of pumping D. ABSORPTION FIELD DATA new Which system tested (date installed) new Adequacy test date new ❑■ ALL standpipes present per record drawing Results Q✓ Pass For 4 bedrooms Total measured depth from grade 13.5 ft (max) Fluid depth prior to test in Measured depth to pipe invert from grade ft (min) Water added na gal ❑■ N/A—pressurized field New depth in ❑■ Monitor tubes go to bottom of effective. If not, state Elapsed time min depth into effective Final fluid depth in 0 Code-required soil cover over field ❑ System presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: 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' Community Sewer Manhole/Cleanout > 100' Ej Yes if No ft n Yes if No ft Neighboring Tank > 100' El 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' Animal Containment > 50' 0 Yes if No ft Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ✓0 Yes if No ft ✓0 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' 0 Yes if No ft Property Line > 5' El Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No ft Private Wells > 100' El Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' 0 Yes if No ft 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' 0 Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' ✓0 Yes if No ft Private Wells > 100' El Yes if No ft Water Service Line > 10' ✓l Yes if No ft Community Wells > 200' 111 Yes if No ft Surface Water> 100' El Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION „erydi ah r.47 � .o�'„.�C �1 I certify that I have determined through field inspections and review w co ,. *.e.,....9 4. 1(.1 of Municipal records that the above systems are in conformance with , MOA COSA guidelines in effect on this date. f1 ,7X:13--<., . ,e) : i ,.. Stevan W.Eng ' f� `� '6+0 ` $8 opRhhOFESSro�" . COSA Checklist yellow sheet ���O%.O�o�'. 1 TWILIGHT LANE x, a, COC Q I } 1 N 89'51'01"E 164.85' r —®- - * ►— _ J 1 Private Use Easement for 3 Reserved Lot 131 B use Right of Way (Doc. No. 2016-049373-0) -‘,.��\\\I � �ji01Lot / O . rH * r Lot 1 i 13)1 A o c / .. 7 -.. Maxwell ., /f refttY �HUfSf Subd. ,0 - . 4 r/rr - e 17 a .-.�� ` _ Green co f F '•• 11.1 I Oc.eCI>A House �" ,� 9F4P- •• ••• i N ll, ROFESSI0NA1�� ;; SD �\\\��~~ ko O i C . CD Si Ch i • *.� I @ M ' / P o O Lot 131 B s o \ i / � , ® O 49th Star oi oto ?8 35.4' \ / '. I6.04..ti \ Surveying . •,, 2-Story ti --'•L.. . " ,. < House o`r' 4' \ 0 25 50 62.8' . 4 6•3ti ?o0, r• 0 '> ' © US SURVEY Lot 2 I I FEET Maxwell $h .' o Subd. I o m @ Private Use Easement for yf a� Lot 131 A use It! (Doc. No. 2016-049373-0) 5L 10' Util. Ease. N 89'50'34"E 164.90' x x -r Lot 159 ' NOTES I -All dimensions shown are grid bearings and ground distances,Record boundaries are per Plat No. 77-200. -49th Star has conducted a physical survey of the property and all details shown on this Asbuilt Survey are correct.Under no circumstances should any data hereon be used for construction or for establishment of property lines. -It is the owners responsibility to determine the existence of any easements,covenants,or restrictions which do not appear on the recorded subdivision plat. AS BUILT SURVEY LEGEND 49th Star Surveying Power Pole ® Septic vent/Co 321 Fireoved Drive BLM Lot 131A, Section 33, A Utility Pedestal 0 Septic Lid Anchorage,AK 99508 T12N, R3W, S.M., -- OHE — © Gas Meter (907)891-6111 Anchora e, AK overhead Utility Line Jeremy@49thStarSurveying.com g x x x ® Elec.Meter Fence W.O. 19006 DATE:05/13/19 WO Water Well SCALE 1'=50' Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P~O. Box 19~650 Anchorage, AK 99519-6650 ~,wz.ci.anchorage.ak.us (907) 343-7904 ParcelI.D. Ot,~- ~'!,"' CERTIFICATE OF HEALTH AUTHORITY APPROVAL -. .FbR ASINGLE FAMILY DWELLING ............... Expiration Date: ,~g"-' / ~_ - O L~,. GENERAL INFORMATION Complete legal description,_ Lobation (site address or directions) Current Property own(~r(s) ~ 'rv'l Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone · . Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOIVtS: -- 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 Health Authority Approval (HA/k) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon reqdest to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality of AnCho iag Development Services Depa ment Building Safety Division: On-Site Water & Wastewater P?ogram 4700 South Bragaw St.. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ' A. WELL DATA Well type .~_¢_..~ ~'(- ~., Date completed zq/~/r~ Total depth ~'~ ~'tg'- ft. If A, B, or C provide PWSID # ~ Sanitary seal (Y/N) ~ Cased to %ff~2 ft. FROM WELL LOG I, g.p.m. Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform ¢ coloniesll00 mi. Arsenic: / mgJI. B. SEPTIC/HOLDING TANK DATA Nitrate (-PC/ mg./I. Date of sample:. 'Tank Type/Material ~ Tank size Foundation cleanout (Y/N) 'y . Date of pumping ~"/7,//o ff C. ABSORPTION FIELD DATA Date installed ¢). 7/~ Length /o0[r// ' Total depth [ ~,! r , ft. gal. Numberof Compadments ~" Depression over tank (Y/N) /'~ Pumper ,,4.~'~r,~. +'kc Soil rating (g,p.d./ft{ or ft~ibdrm). 0, t4 ¢ Date of adequacy test Fluid depth in absorption field before test "~(¢ in. Elapsed Time:/N'¢~ min. Final fluid depth .~ Any rejuvenation treatment (past 12 mo.) (YIN & type) Parcel ID: in. Well Log (Y/N). · Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION / G.¢'- ft. /-~ g.p.m. Other bacteria __~ colonies/lO0 mi. Collected bY: Date installed Cleanouts (Y/N). High water alarm (Y/N) 'ft. Width ' 'Z., ID ft. Eft. absorption area[GOc:~ ft= Monitoring tube. y ~-/7,//~ Results (PasslFail)..,~O ~ ~ Water added 'F~ g+aal. ~ in. Absorption rate >= /-,(, System type., Gravel below pipe ~r', ~ ft. Depression over field ,Ah'/ 'For ~ bedrooms New depth z?r~;/in. ~ ~O '/' g.p.d. If yes, give date SGS EeL# Client Name l'roJect l~ame/# Cllen! Snmple ID Matrix 1040447001 Mike lq. Anderson, TI2N, K3W, S~c 33, Lot 131A T12N~ R3W, Sec 33~ Lo: 13lA Drinking W~tc: Sample Remarks: All DatesFrimes are Alaska Standard Time Printed Date/Time 01/27/2004 15:53 Collected Date/Time 01/23/2004 13:00 Re~civcd Date/Time 01/23/2~904 13:50 Technical Director / Step/hj~(C. Ede Unit~ Me~hod Allowable Prep Analysis Container ID l~ialil~ D~e Date Init Water~ Department Nitmte-N O.lOOU 0.100 mg~L EPA 300.0 B (<=10) 01123/0at JJB ~Ltcrobiology Laboratory Total Coliform col/lO0:nL SM18 9222B A (<-1~ 01/23/04 DKC 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAl- FOR A SINGLE FAMILY DWELLING ?--[ NAA# 1. GENERAL INFORMATION Complete legal description ~_¢ ~-- Location (site address or directions) Property owner _.j',,1~, ~c- Mailing address '-5'~¢o 4--d~, t~ ,~ F, Lending agency Day phone Day phone Mailing address Agent __ Day phone Address Unless otherwise requested, HAA will be held for pickup, NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATEB DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 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 investigation 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 Address, Engineers signature DHHS SIGNATURE Approved for __ ¢ _ bedrooms, Disapproved. Conditional approval for ~ bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does th is as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72~)25 (Rev. 1/91) Back MOA ¢21 , DEC 22 199B Municipality of Anchorager. ~ ~u~c~P/,u'~ gi -- -NCHO~eE DEPAFtTMFNT OF HEAL'Fbi 8, HUMA~v~'~d~.~L~[Wlc~ D~V~I©N Envbonrnenl~l Se~viee~ Room 50~ · Anehom§e, Alask~ 9950~ · (907) 848-4'744 Health Authority Approval Checklist LegalDescription: Lo ~--~r- "Ff'~/q. ¢.'"5~,,.~ 5~ Parcel liD.: (~l ~.o~( ?...[ A. WELL DATA Well type -~v~ ~. If A, B, or C, attach ADEC letter. ADEC water System number Total depth ~2~ Cased to ~.~ '7 ~.L- CaSi~ng height (above ground) Sanitary seal (Y/N) ' '~ ¢ 5 Wires properly protected (Y/N) Date of test Static water level Well production FROM WELL LOG WATER SAMPLE RESULTS: Coliform Date ~)f s'ample: B. SEPTIC/HOLDING TANK DATA Date installed r~/:27/,~¢ Tank size AT INSPECTION 'g.p.m. Foundation cleanout (Y/N) / Date of Pumping ~/'/~ C, ABSORPTION FIELD DATA Date installed Length I ~1~ '~" Width Nitrate __ Other bacteria Collected by: ~'~ ,6 ~ ~ or~,~ ( ~. ¢ 5"¢ Number of Compartments '7._-- Cleanouts (Y/N) /;, Depression (Y/N) ~ _ High water alarm (Y/N) /'////~ Pumper g.p,m. Soil rating (g.p.d./fF or fF/bdrm) P~ /--t 5- System type Gravelthickness below pipe ~ J~ ~ Total depth Effective absorption area [f,~' ~ ¢-.~ Monitoring Tube present (Y/N) '%' ¢5_ Depression over field (Y/N) ¢q o Date of adequacy test ~, e~ ~.~ Results (Pass/Fail) ~0 ~ ~ For Immed ately after gal. water added (in.): Absorption rate = ~ -e ~ g.p.d. If yes, give date Fluid depth in absorption field before test (in.);. Fluid depth ~--~,,~_co (ins) Minutes ater: Peroxide treatment (past 12 months) (Y/N). bedrooms 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) ~" level at* High wa~ ~Datum Cy_cles'l-este d "Pump off" level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line Public sewer manhole/cleanout Lift station On adjacent lots On adjacent lots SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation / O '~¢ Property line ~f' ~/~ Absorption field Water main/service line ,'z. 5- Surface water/drainage / ¢0 -F loc % Wells on adjacent lots ,' o o 4-- SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Surface water Curtain drain Building foundation ~ O + Water mam/servme Driveway, parking/vehicle storage area Wells on adjacent lots [o r~ F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records ~ffe~ov~¢ms are in conformance with MOA IdAA guidelines in effect on this date / /'/ . H~Fee $ ~ ¢ '~ Waiver FeeS Date of Payment ~ /~ ~ fX Dato of .agmont Receipt Number ~~L¢¢~ '~] Receipt Number 72-026 (Rev. 3/96)* ~II~I~ CT~E r~vi~on.,~nttii Servlas~ Inc, CT&E Ret,// CIieot Name Project Client Sarnpl~ ID PWS~ Cllenl PO# Pdllted Date/Time 12/03;98 10:36 Collecledl)ate!Time ll/19/98 I0:~5 Receiv~ Dare/T~e 11:19/98 ~1,30 Tec~lcal Director: ~tephen C. Ede .. Rej~q~d By EP300 Niltate Mudtud blat2< was de ¢~ ,' hie for nitro e (0 78rag.'I_). S,xmple value ,x, as < PQI_, no further action taken. RECEIVED DEC 22 1998 Municipality of Anchorage Oept. Heallh & Human Services DEPARTMEHT OF HEAI_TII AND E~,~IRONMENTAL PROTECTION PLAI'TING Oil PLANNING AND ZONING CASE REVIEW CASE NUMBER S-4232 ?ETITION FOR Rezoning Special Exception ~...~V~CAT I Olq t~.SUBDIVISION Date Received Comment to Planning by __9-24_-1ti Oi: T,J~ILI.GIJl: LANE .Lp.ts l~_lA & 13__] B sec $3 T12_.N R3W Subdivision containing 2,498 acres moremr le~S for meeting oF COMMENTS: ENVIRONMENTAL SANITATION: j ~_ o~ ,~9 ~. PUBLIC WATER N~OT_ AVAI~ABLE Cases PUBLIC SEWER NOT AVAILABLE TO SERVICE PETITION AREA. ~"'ENVI RONMENTAL 'ENGINEERING