HomeMy WebLinkAboutVIKDAL LT 2 Onsite File
Vikdal
Lot 2
#051 - 161 - 35
Municipality of Anchorage�
On -Site Water and Wastewater Program • (907) 343-7904 UBM TPI f
ON-SITE WASTEWATER INSPECTION REPOR
OCT 1'S 2018
Permit Number: OSP181062 PID Number: 051-161-35
Dwelling: ® Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ® Upgrade
Name:
Jeffrey & Tabatha Vikdal
ABSORPTION FIELD
❑ Deep Trench ® Shallow Trench ❑ Bed ❑ Mound
Address
19825 Dolie's Drive, Chugiak, AK 99567
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
6
0.45 GPD/SF
6.8 - 8 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
2.8 - 4 Ft.
Gravel depth beneath pipe
4 Ft.
Subdivision Block Lot
VIKDAL 2
Fill added above original grade
Varies 0.10 — 2.7 Ft.
Gravel length
200 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
2000 Ftz
2
10 Ft.
Well
100+
100'+
NA
NA
TANK M Septic 0 S.T.E.P. ❑ Holding ❑ Other
Manufacturer
GREER
Capacity
1 2000 Gal.
Surface Water
100'+
100'+
N R
NA
Material
Steel
Number of compartments
2
Lot Line
5'+
10'+
NA
NA
Foundation
10'+
10'+
NA
LIFT STATION
Manufacturer
Capacity
Gal.
Curtain Drain
NA
*50'+
NA
NA
Remarks *None known. Existing field decomm.
Pump on level at
in.
Pump off level at
in.
High water alarm at
in.
in place per code. Majority of fields <7' TD
except last portions of E side — see TH18-1
Pump make and model
Electrical Inspections performed by
PIPE MATERIAL House to tank 3034 Tank to 3034
drainfield
Installer Daniel Schuetter — Schuetter Trucking
Drainfield 3034 CO/MT 3034
Inspector ARCTERRA
BENCH MARK (Assumed elevation) 100 ft
Inspeection 1" 7/12/18 7/14/18
Location and description
2nd
3rd 7/13/18 4"' 9/21/2018
Garage Slab
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Engin
Conditional Approval: Date
OF AL \
10,
/ 49 TH
KENNETH P tic 1001
'
Approved ���� Date /11/13F
D/1!/if 8G~
° f",
eer's Stamp
Inspection Report_9-1-12.doc
Jna�1�
3 A—C=54.3'
IN B—C=16,5'
A—D=57.3'
N B—D=28.6'
Y A—E=96.2'
B—E=80.8'
N A—F=105,7'
J B—F=942'
A—G=66,3'
B-15=96.6'
Y A—H=63,5'
— B—H=94.3'
A—I=44.1'
B—I=78.6'
cn
A—J=42.7'
B—J=78.1'
I
AS -BUILT SYSTEM DETAILS/SITE PLAN Permit ❑SP181062
VIKDAL SUBDIVISI❑N LOT 2 PID# 051-161-35
3
ti lu�u_
oC
0
�
I- W
p INSIAATIIB!
j N 2000—GAL
cl N SEPTIC
m TANK
SCALE, NTS
*:9 TH *�
/ KENNE M. D S
` CE -7116 S
/
1f� . Www/
LOT 1
_El 1' = 50'
TUBE FINAL GRADE
MONITOR TUBE,CLEAtIOUT
99.30
96,60
FILTER FABRIC / MSULATIDN
F—
VARIES
MMIML MATIX
30 93.80
SEWER ROCK
TRENCH 1
30
89.80
I 100'
I,rONITOR TUBE
4s sin FINAL GRADE
FILTER FABRIC / iNSULATIIB!
\
SEWER ROCK
TRENCH 2
PREPARED FOR:
JEFF VIKDAL
19827 D❑TIES DRIVE
CHUGIAK, AK 99567
907-317-5273
FIELD BOOKS
BOUNDARY: IN /A
STAKING: N /A
ASSUILT: SLS
DWG. FILE:
AGAD FILE: FILE
100'
COMPUTED:
DRAWN: BMW
CHECKED: KMD
DATE_ 10/10/2018
GRID: N W1255
"No.: 17-217
MONITOR TUBE,, d CLEANOUT
VARIES
ox
T
4' TEIIB-1 15' BW
DRY 9/21/18
81.60 —
SCALE: NTS
o �RJERRq AIZCTERRA
^� CONSULTING, INC
212 E. 5151 Ave, Anchorage, AK. 99503
Office (907) 868-3791, Fax (907) 868-3793
C'0 ANG X11
a�E NSULTI
'P• AM. yfl5T1'�
SOILS PERCOLATION TEST
Performed for: TEFF VIKDAL Date Performed: 7/16/2018
Project: VIKDAL LOT 2
Depth
(Feet)
1- Org/OL
2-
3-
-3-
10-
10-
14-
15-
B.O.H.
14-
15-
B.O.H.
16-
17-
18-
19 -
HOLE PRESOAKED
20- PRIOR TO TEST
N" OFA10, Lq \ 1
�y
49T���� i
KE,NnETH M. l /F - /
7116 /
o% Arr
TEST HOLE /f TH 18-1
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
Was Ground water encountered? NO What depth? NA
Depth to water after monitoring? NA - DRY Date? 9/
Reading
Date
Gross
Time
Net
Time
Depth of
Water
Net
Drop
1
7/17/18
1:00
-
6"
-
2
1:30
30 min
4 13/16"
l 3/16"
3
"`
1:31
-
6"
-
4
2:01
30 min
4 14/16"
1 2/16"
5
2:02
-
6"
-
6
2:32
30 min
4 13/16"
1 3/16"
7
8
9
10
11
12
*
Water
Added
Percolation Rate 26 (min/in) Perc Hole Diameter 6"
Test Run Between 4 feet and 5 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State
and Municipal guidelines in effect on this date.
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d,.1„opAAt,r).o,. MUNICIPALITY OF ANCHORAGE mens ,
r On-Site Water&Wastewater Program �o� 5�
\ PO Box 196650 4700 Elmore Road
Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 ,`
_ http://www.muni.org/onsite N
Dcp irtittcnt
9NCHONpGF
On-Site Wastewater Disposal System Permit
Permit Number: OSP181062 Effective Date: 5/23/2018
Work Type: Septic Upgrade Expiration Date: 5/23/2019
Tax Code Number: 05116135000
Site Legal Address: VIKDAL LT 2 G:1255
Site Mailing Address: 19825 DOTIE'S DR, Chugiak
Owner: VIKDAL JEFFREY & TABATHA Lot Size in Sq Ft: 55811
Design Engineer: ARC TERRA CONSULTING INC Total Bedrooms: 6
This permit is for the construction of:
2 Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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
S/23//�
Received By: Date:
Issued By: Al�_ ,_ .----- IAI l Date: 5®18
MUNICIPALITY OF ANCHORAGE
iiri4)t .
Community Development Department \ ?i1 Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On-Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D.
051-161-35
JEFFREY & TABATHA VIKDAL 317-5273
Property owner(s) Day phone
Mailing address 19827 DOTIES DRIVE, CHUGIAK, AK 99567
Site address 19827 DOTIES DRIVE, CHUGIAK, AK 99567
Legal description (Sub'd., Block & Lot) VIKDAL LOT 2
Legal description (Township, Range & Section)
Lot Size 55'811 Sq. Ft. Number of Bedrooms 6
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(N all that apply)
Absorption Field > Initial ❑ Single Family (SF)
Septic Tank I>] Upgrade (w/wo ADU)
Duplex (D) x
Holding Tank ❑ Renewal H
Multiple Dwellings I I
Privy (SF and/or D)
Private Well I I
Water Storage H
THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signatuce-a rty peowner or authorized agent)
. �r
Perr)iit/Rush Fees: Waiver Fees:
Date of Payment: t_1 J P.51 re Date of Payment:
Receipt Number: 030QJ/D Receipt Number:
Permit No. 03,91 81 dW. Waiver No.
Permit App_9-1-12.doc
•
ARcTERRA
• gR CONSULTING, INC
o 212 E.51st Ave,Anchorage,AK.99503
AIS ppp17'
Office(907)868-3791,Fax(907)868-3793
April 24,2018
Municipality of Anchorage
Development Services Department
On-Site Water& Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Upgrade Sewer Permit—Vikdal Lot 2
1,vtt�eN
The owner has requested we proceed forward to obtain a septicifermit to
upgrade the septic system. The existing documented field on the east -- portion
of the lot and the existing undocumented field on the west i side will be
decommissioned. CASlegev
The general slope of this lot is from southeast to northwest at a grade of
approximately 5-10% over the septic area. On October 4, 2017 two testholes were
performed to investigate soils and groundwater. The results of this test are
attached for your review. We propose to install two shallow trenches.
Groundwater was not encountered at excavation or at monitoring.
The property and adjacent lots are served by private water. There is no surface
water within 100' of the proposed system and there are no known curtain drains
within 50'. We do not expect there to be any adverse effect on adjacent lots by the
development of this system. If you have any questions, please contact me at 868-
3791 / FAX 868-3793.
Respectfully submitted,
ArcTerra Consulting, Inc.
Kenneth M. Duf s, P.E.
Attachments: On-Site Sewer Application
Wastewater Absorption System Details/Site Plan
Soils Log/Percolation Test
ADEC Record Docs
20441 PTARMIGAN BLVD • EAGLE RIVER,AK 99577-8736 • PH(907)868-3791 • FAX(907)868-3793
WELL & WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLAN
VIKDAL SUBDIVISI❑N LOT 2
BLU LOT BB
NNWI ¶ I
;HED B
INTER CT p
tf%,mow`' Lars ... �-
LOT I
�r���u �_!:_�
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if; +aft ..... I il
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tili
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JP, ,At . .
R DDTIWS DRIVE
I
FLAG PROPERTY LINES
q WELL RADII & EASEMENTS
.
o PRI❑R TO CONSTRUCTION Scale: 1'= 100'
DESIGN DETAILS PAGE 1 OF 2
a 6 BDRM X 150 GPD = 900 GPD
900 GPD/.45 GPD PER SQ. FT. = 2000 SQ. FT
(2000 / 5 (0.5 RF) = 200 FT. TRENCH
U) USE 2 TRENCHES - 100' (L) X 5' (W) X 4' <ED)
B. Total depth of system is 6' Max from original grade.
Y Total depth of gravel below distribution pipe is 4' .
Q NO PUBLIC WELLS WITHIN 200' OF
6 PROPOSED SYSTEM. NOTES:
v NO PRIVATE WELLS WITHIN 200' OF
ZI PROPOSED SYSTEM EXCEPT AS NOTED. 1, INSTALL 2000 GAL & INSULATE TANK IF <4' COVER.
& PROPOSED WEL EXCEPT AS NOTEDF 2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM IF < 3' OF FILL.
- MIN. 2' FILL WITH INSULATION, >3' COVER NO INSUL REQ.
LD 3. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INT❑ SEPTIC TANK.
I 4. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT
F WELLS, SEPTICS EASEMENTS, PROPERTY LINES, ETC...
a.
41 F t '\
W /���• . <Q� 1 PREPARED FORI RCTERR
,c JEFF VIKDAL ti ,9 �,
o
• or(
' �� 19827 DEITIES DRIVE i
o ��� s��,* :49 Tx i * CHUGIAK, AK 99567 / �m / .- .I 907-317-5273 I'
r / cid S / FlELD BOOKS COMPUTED: ; X
N ` CE-7 w� /
BOUNDARY:BOUNDARY DRAWN: BMW Z 1 407 ,t�/
or STAKING: CHECKED: ` A
1 Vag �g �{ STAKING KMD t it •1 n
q '� . . to�� / ASBUILT: JLS DALE: 4/24/2018 . .,,��9 . \ 064
C \ FESS DWG. FILE GRID: ��
'� N W1255 ",Q eoNS„ \�c`16,1
Z `_ ACAD FILE: FILE '�No.: 17217 SFR• ^K.99577'6
WASTEWATER DISPOSAL SYSTEM DETAILS
VIKDAL SUBDIVISI❑N LOT 2
II
TH17-2
TH17-1
iv u L W/---":"r'
QS 18
'` 900GPD ®'1 GPD
/S TER R
P..•"� ppVANCEO WASTEWA L(
GIP
• �i, _; ` MT CA
./ S CO
CO 1 O'—
� ` MT � MT
i
SPLITTER
A CO :
e CO
cr CO V(7' --.I
2
ak
79.6' 111 iii
Co W
N
N
N , INSTALL FCO CO Q;
0 •\ COCO 1641 COO O O O 'z
CO 41.0'
NI O
l,/ 84.
GARAGE M No
� �j•,
N 11. 41.0' 44
w_
tf) milliminepor
rn I'lII,
.,
DECOMMISSION EXISTING
.2 IOC & UNDOC. SYSTEMS
0.
Opfic
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J
.0
11,414P% 51 a
e
FCO
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' �� 32.0'
0 a-
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U,
U
t'j IND A\ICI 0 Nl ; I , r m
2 FLAG PROPERTY LINES
WELL RADII & EASEMENTS state: 1"= 30'
N _��� k\ PRIOR TO CONSTRUCTION PAGE 2 OF 2
W / N. -F ` •44,�1 PREPARED FOR: RCTER
\ ��• , JEFF VIKDAL ti
/ �\ 19827 DUTIES DRIVE 4o 0611s��* : TH . * TCHUGIAK, AK 99567 �,9 907-317-5273 /c / 1
. KENNETH ,. S . / FIELD BOOKS COMPUTED: C lS g
o ` ' • CE— w� / BDUNDARY'BOUNDARY DRAWN' BMWZ ` 1 •� P �I
,, 4 r A, co
x`f ld�yti� / STAKING: STAKING CHECKED: KMD = • j '�
04::,.. .
�5+.' ASBUILT: JLS DATE: 4/24/2018 •`'''.:�•--
°' FESSI0TZ�' / `�>c+ �it 6
E \ _� DWG. FILE CHID: NW1255 lie C ��
`_ ACRD FlLE: JOB No.: 1 721 7 �II.�R SULT I NG , 6 190
FILE AK.99577-1'
0cTEARCTERRA ERRA �A��, OF AL
4 �RRRq ^ S
CONSULTING INC / '' �(
1' 212 E.51S'Ave,Anchorage,AK. 99503 I 17( y
• Office(907)868-3791,Fax(907)868-3793 / * 49 TU
1,,4'
9�'sit
rING •'''cS # A KENNETH M. DIS (� /
SOILS PERCOLATION TEST Ir5, 7 vi °•��
rhbi..vssiol:a�,
Performed for: JEFF VIKDAL Date Performed: 10/04/2017 \N Illh.`gb:IIIP-
Project: VIKDAL LOT 2 TEST HOLE: IJ TH 17-1
Depth
(Feet) SEE ATTACHED SITE PLAN
1 Org/OL FOR HOLE LOCATION
Was Ground water encountered? NO What depth? NA
2-
i
D Depth to water after monitoring? NA-DRY Date? 10/11/17
4
0 GM/sro Reading Date Gross Net Depth of Net
5- o. Time Time Water Drop
6 1 10/11/17 1:00 - 6" -
7- 2 1:30 30 min 5 3/16" 13/16"
8-':- 3 * 1:31 - 6" -
9- 4 2:01 30 min 5 4/16" 12/16"
10- ' 5 * 2:02 - 6" -
6 2:32 30 min 5 4/16" 12/16"
12- 7
B.O.H.
13- 8
14- 9
15- I0
16- 11
17- 12
18- * Water Added
HOLE PRESOAKED
19- PRIOR TO TEST
Percolation Rate 40 (min/in) Perc Hole Diameter 6"
20- Test Run Between 4 feet and 5 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State
and Municipal guidelines in effect on this date.
....--.\\\
. T,c ER„, ^ ARCTERRA / ��' OF' AL 1 \
CONSULTING, INC
a. tS
212 E. 51 S`Ave,Anchorage,A K.99503Ar ` ‘Y. ,
Office(907)868-3791, Fax(907)868-3793 / * A 9 T I I*
' al' r vie it
��f9 f ,<d.TI NG.�N��W
.wen-�" 4 KENNETH M. DUE �� /
SOILS PERCOLATION TEST , '°a� 7 's �hi 2g/ �. /
f40 : ,ss. ,‘' ...wPerformed for: JEFF VIKDAL Date Performed: 10/04/2017 �\`-**,:.-
Project: VIKDAL LOT 2 TEST HOLE II TH 17-2
Depth
(Feet) SEE ATTACHED SITE PLAN
I- i'iii: Or /OL FOR HOLE LOCATION
g
;y Was Ground water encountered? NO What depth? NA
�*
2- `• > *'
Depth to water after monitoring? NA-DRY Date? 10/11/17
3- 44'.:x".4
Y ,
4-
• ®.: GM/sm Reading Date Gross Net Depth of Net
5-- 4::': Time Time Water Drop
6 « 1 10/11/17 1:00 - 6" -
7 ' 2 1:30 30 min 5" 1"
3 * 1:31 - 6" -
9- ' -'•P 4 2:01 30 min 5" 1"
10-': ,,- 5 * 2:02 - 6" -
11-'', 6 2:32 30 min 5 1/16" 15/16"
12-- : ",_'` 7
B.O.H.
13- 8
14- 9
15- 10
16- II
17- 12
18- * Water Added
19-
HOLE PRESOAKED Percolation Rate 32 (min/in) Perc Hole Diameter 6"
20- PRIOR TO TEST Test Run Between 4 feet and 5 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State
and Municipal guidelines in effect on this date.
BLM LOT 68
N89'59'35"W 108.60'
x x x x x x x x x x x x
1
f ,
cc;
LOT 2
LOT 3 LOT 1
20 2
N
1111
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1111
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M GARAGE • • SEPTIC
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41.0' O
. nrunu�
Mimi 01
2 0'
0 •
co 5'1.8
32.0•
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GRAVEL . ;,1 ti N
O/W ter: -0
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Li
32.0'
IL
WELLI WELL
® X GRAVEL ® „Li
PARKING M
1P/H -♦ f♦ 0/H ; _
15' T&E ESMT N
N90'00 0• W 251.32
3' REMAINDER DOTIE'S DRIVE o
M
"X—x X- X -x----X—X X X X X X X X X X X X X X
•
ANCHORAGE RECORDING DISTRICT,ALASKA
AS-BUILT OF:
VIKDAL SUBDIVISION O = FND 5/8" REBAR W/ YPC
LOT 2 PLAT 2007-176
�_.������.A‘
� OD S U
SURVEY CERTIFICATE: I, John L. Schuller, Have conducted a
physical survey of this property as shown on this drawing �,' ,....... .... \`, y0 j, LAND ;',4'
and that the improvements situated hereon are within the /� �,,. ' ' `Q� �' •Cti Sl„ r
property lines and no enchroachments exist other than ti fF'
noted. Under no circumstance should any information on / :' 49. A • ,,/ �" 47 o :4,1
noted.
this drawing be used for construction of fences, structures, * : i, ( 4 , 44 ,A
improvements, or for establishing boundary lines. ► r,
EXCLUSION NOTES: It is the owners responsibility to ,i• s,,� r
determine the existence of any easements, covenants, orva ID ;,�
OHN L. SCHUJ•T.FR.: ��� 0 ;\
restrictions which do not appear on the recorded LS-10408
subdivision plat. +� �' . -�'•
WORK ORDER NUMBER: DAM SCALE E-MMU , ^ '•. .§Of '�•-1831 Anchorage, Alaskatna Street
MAY 22, 2018 1'-40' l eaA ...at 'ea ,� 99508
10-057 DRAM a an CR10 Niwe Booxir �N °fessional (907) 227-1455 office
JLS NW1255 180141 ��\N��`�� (907) 274-4992 fax
MUNICIPALITY OF ANCHORAGE
DEPARTMEN" OF HEALTH&ENVIRONMENTALPROTECT~ON
ENV RONMEN"I'AL ENGINEERING DiViSION
825 L Street Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPQSAL SYSTEM AND/OR WELL INSPECTION REPORT
MAILING ADDRESS
LEGAL DESCRIPTION ;
Well '"-~sorptionarea--~ [ PER~)N~0
~Liq. capac~win ga ons~ .......... ~ [ Inside}ength Liquid depth
IMalManufa~turer [ / Material Liquid capacity in gallons
Top of tile to finish grade Material bonoath tile Total effoctive absorption area
C~ass Depth ] Driller Distance ~o lot I~no Pr~RMIT NO.
OTHER
PIPE MATERIALS p/&
.
SOIL 'TEST RATING
INSTALLER p4 D C,,~,s'/~"~' .
REMARKS
APPROVED DATE LEGAL
_?1
72 013 (Rev. 3/78)
I ELIIIT NO.
E:,EF'II:tR-['MENT
H~FIII...TH FIN[:, FZNY I I*:':ONMF:N1-FIL ')TEF:'r I ON
o ..... -'L:,11. EF.E_ f, 41L.l-4...kl-lbF., FIK. .:~; _,dj_
2 E; 4 - 4 7 :ti:
LEGFIL LOf q~:' "' '. '"'
I TFE [)F SOIL E_...EF FI J I S~ s'rEr,'ll :Is:
Si;:: :1_., E, ... ,> .... .~- , ....[}HI...1611::IK qgr: 67
..,.c E: I RF:FI!,.IFC~[:, _-I r' F F'
LOT ~.,.[~-L ::I.';::'42,::i~ii!~ L::;12!UFII:~?.E:' FEET
TFIE REQUIRE[) SIZE OF: THE SOIL FIBSORP'II'ION S, YSTEM IS:
;%,
THE LENGTH O IMENSI ON i S TF E'. L. EN(~TI'4 ( IN FEET) OF THE T'F;ENC:H OIR [:,RRINFI ELF:,.
THE DEPTH OF FI TRENCH*'' OE F ];~ !S" THE P ISTf~NCE E:ETI,.IEEN THE SII..IRFFICE OF THE
(~I:~:OUNI) FIN[:, THE 80TTII)M OF TH~ E,:.:,CRVFITIFIN (IN FF;ET).
J
TflERE IS NO SE:T HIE:,TH FOR TRENC:HES.
THE GRRVEL [:,EF"I"H IS THE h'IIN;IMLIM [:,EF'TH OF GRFIYEL [3E-rFIEEN THE OII.ITFFiLL PIPE
!zIP,ID THE BOTTOM OF THE; EXCF:IV~:ITION (II'.,I FEET).
NI...IMF:EP. OF I;'.ES]:E)L:'NCES THFIT THE [,.IELI.. HILL
E:FIF:KF: ILL ]: NG ElF' ANY S:;YSTEM l,.lI Tl"{i)lJl' FI NFIL. }6 NSPErYl' i ON Il:IN[) FIPPf;:OVF:III.. E:Y TH I S
[:,EPFII;?.TI','IENT klILL BE SUBJ'ECT Til) PROSECIIJTION.
HINIf,IIIJM DISTFINCE E~ETI.,IEF]'.,I Il:i I.,IEL[.. FINP RNY ON--SITE SEI,.IFIGIR [:,ISF'II):'$F~L. SYSTEfq ZilS
:~.r:-iEi F'F;E'F FOR FI PRIVATE HELL [l~;~: 15~1 TFI 2(i)$ FEEl' FROM II:l PUBLIC I,.IELL [aEPEI'-~DJ;F,h3
UPON 'T'HE T'r'PE OF F'UF,'LIC I*IELL.
NINIMIIJf'~ I)ISTFli',!CE FRIIX"! FI F'F'.IYFITE kIEL. L. TO FI PF:IYFf'FE SEHER L.b',IE IS 25 FF;ET FIN[:'
TO FI COMMUNII'¢ SEklER II...II'.,IE IE; '?t~; F'EET.
OTHER .F,?.EQU Z REHEi'.,IT:5 MRY FIPPLY. SF'EC I F I CFFI' ;Il LiNS Fliq[:, COi'.,I'_:E; Tf;~:II..ICT.~ ON E)I FIFiRI::IHS FII:~:E
I "ERTl'·"'
..... r 'r '1"1'"1~::1-['
t: I FIH F:'FIM!II..IFIF~ klITH THE kELIJ1F.EIILI,IF_ F'-F' Jfl _IrE ..[.IIE. F ..... FINE:, I,.IEI_..!_.S :': SE1'
FORTH E:"r' THE I"IUN :[ Il:Z: :[ F:'FIL I l"'f Il:iF FIf'I :'; HI' f~'f:] 3E.
" ....... ':'":'"':' ]:N FE:F:CIRE:,FINCF: I,!ITI"I THE .... E'ES
2: I I,IILL. [N.:,I[-.I TI"E': ._,~...,11.21
'2: I I...II'.,![:,EF;:STFff,][:, THR-I' 'rile _il ,I .:, .. f E .:,EI..IEE :, ~..:, ! [..fl MFff RE ~!1... I RE EF!I.r.F¥;:GE]'"IF:hrT :[ F '[FIE
IRES!E:,ENII::E ]:F REHO[:,ELE[) TO IN-I. [')E HORF: 'FHFIN 3: E:EE:,ROOHS.
F:IF'PI_ I CFINT .., 1,1[. ~;.I- MF'NI"
[~//SOILS LOG
PERFORMED FOR:
MtJ~IIClPAL, ITY OF ANCHORAGE
DEPARTMENT OF~ HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
DATE PERFORMED::
//PERCOLATION
TEST
1
2
3
5
6
7
9
10
11
12
13
14
15.-
16-
17-
18-
19-
20-
COMMENTS ~(~
SLOPE
SITE PLAN
~NCOUNTERED?
O
P
E
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
~ERCOLATION RATE
jTEST RUN BETWEEN ~'~ O - FT/AND ~-----~'~' FT
72-008 (6/79)
(minutes/inch)
Rick Mystrom,
Mayor
Municipality o:fAnchorage
Departmedt of Health and Human Services
825 "L" Street
P.O, Box ~196650 Anchorage, Alaska 99519-6650
~ 343-4?44
May 10, 1995
John A & Sandra L Me~o
HC 78 Box 2445
Birchwood Loop
Chugiak, Alaska 99567
Subject: T15N R1W Section 7 Lot 95
Permit ~SW940120, PID ~051-161-23
The subject permit, %ssued May 10, 1994 by this office for a
single family well and/or on-site wastewater system, has
expired as of May 107 1995o
A new permit must be obtained from this office for a well
and/or on-site wastewater system NOT installed by the
expiration date.
If you have drilled ~he well, a well log must be sent to
this office for documentation of the installation and to
close the permit.
If a licensed Professional Engineer has inspected the
installation of the on-site wastewater system, the original
as-built inspection report must be sent to this office for
review, approval andidocumentation. All inspection reports
~st be submitted within 30 days of construction completion.
When applying for a new permit, the fees are: $320.00 for an
on-site wastewater permit; $120.00 for a well permit and
$440.00 for a combined on-site wastewater and well permit.
If you have any questions, please call this office at 343-4744.
/~erely,
On-site Services
enc: Copy of Permit
PAGE 1 OF 1
MUN£CIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL SYSTEM (UPGR3~DE) PERMIT
PERMIT NUMBER:SW940120
DESIGN ENGINEER:DL/MMY COMPANY!
OWNER NAML.MENO JOHN A
OWNER ADDRESS:19923 DOTIE'S Dk
CHUGIAK, AK 99567
PARCEL ID: 05].16123
LEGAL DESCRIPTION: T15N RiW SEC
7 LT 95
DATE ISSUED: 5/10/94
EXPIRATION DATE: 5/10/95
LOT SIZE: 99999 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRU~TION OF:
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 (18AACS0).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION.! PROVIDE NOTIFICATION BY
CALLING 343-4744 OR 343~4681 AFTER BUSINESS HOURS
FROM OCTOBER 15 TO APRIL ~5 A SUBSURFACE SOIL
4.
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER: ~
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVEDB~."b~~ /~.~
ISSUED BY: ~~ ~-~-~--
/
DATE:
DATE:
EAGLE
;R ENGI[NEER[NG SEI ,'VI CES
Lou Ilulera P.E.
P.O. Box 773294
Eagle River, Alaska 99577
Telephorm (90'/) 69d-5195
Mr. Steve Morris
Municipality of Anchoralge
Department of Health anld Human Services
825 "L" Street
Anchorage~ Alaska 99502D650
Ref:Lot 95, T15N R1W Se:c.7
10/7/85
MUNICIPALITY OF ANCHoRAGIi
DEPT. O1: J'~EALTFt &
ENVIRONMENTAL PROTECT/ON
1985
RECEIVED
Dear Mr. Morris;
On behalf of my slient, Sandra Meno, I am applying :For a
wavier of horizontal Separation distance for a private well to
septic tank of 85' ~
The well is located as shown on the enclosed plot plan and
was in place previous to the septic system. The well was drilled
before ~975, there is: no well log available and the depth is
known to be +95' with~ a static water level of 87' The well
has been recently per~orated at a depth of 50' in an attempt
to obtain more water.I The topography is such that 'the ground
surface slopes away fro¢ the well toward the septic system direct-
ing any possible seepage away from the well. The soil stat:mn
from 110' is rated as ~ GM type and perc. 'tested at 225 sq.ft/BR.
The placement of 'the ~septic tank was approved at 'the time of
installation by the Muhicipality as shown on the inspection re-
port. The well at that time was located in a pit and has been
raised above ground as per Municipal[ cede. Original water samples
were showing contamination but after chorination two check samples
were satisfactory. WO are asking that this wavier be granted
upholding the previous ~unicipal approval.
If there are any questions or concerns please call me at
my office 694-5195.
Sincerely~
Lou Butera P.E.
~ .................................. ~ ................................. J
EAGLE RIV i
ENGINEERING SERV~OE$ INC.
P. O. Box 773294 i
EAGLE RIVER, ALASKA 99577
Phone 694-5195 I
SCALE
' ~T
~UNICIPALITY OF ANCNORAGE
DEPARTMFNT O'F HFALTH AND ENVIRONMENTAL. PROTECTION
DIVISION OF ENVIRONMENTAl. HEALTN
CERT F CATE OF INSPECTION FOR IlEAL'TH AUTHORITY APPROVAL
OF oN-SITE SEWER AND WATER FACILITY
264-4720
GENERAL INFORMATION
(a)
Legal Description (include lot, ble
Lot 95 T15~ R1W Sec
Location (address or directions)
Dot b:i. es Circle
Application Date ~/.5.z~"¢//'~"-~'-~-
;k, subdivision, section, township, range)
2.
Telephone: ltomo _~_8_.~Z3_83~8
(b) Applicant NameSandra Metro Business
Applicant Address S~?.~_..~pt~];_cf_..l__._~._(2~:_ 2_/_t~!~____C__~!u._g. iak AK. 99567
(c) Applicaet is (check one): Lending!institution []; Owner/builder E~,; Buyer []; Other El (explain);
(d) Lending Institution ~est.h3¢~3.g[~iVio~d2g~3.ge _ Telephone
Address t~~l/~3l~_i;~
(e) Real ~state Company and Agent
Address .......
..... dZ_q - 7 8 7 2
Telephone
Mail the HAA to the followieg address:
TYPE OF RESIDENCE
Single-.Family~l~ Multi-Family [] Other
Nurnber of Bedrooms ..~__ _
3. WATER SUPPLY
*Individual Well []
Comrnunity[~ POblicE] ':~suppling single family residence only
Note: Il community well system, must have written confirmation from the State Department of Environmental Censervation
attesting to the legality and status.
SEWAGE DISPOSAL
OnsiteT{'~ Public [] Community [] Helding Tank []
Note: t[ community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2
ENGINEERING FIRM PROVIDING INSP~ECTIONS, TESTS, FILE SEAFtCH, DATA AND INFORMATION
As cedified by my seal affixed hereto and ~s of the validati on date shown below, I verify that my investigation of this Health
Authority Approval 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 ~tructure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage file~ and from my investigation and inspection, the on-s e water supply and/or
wastewater disposal system is in complia~ce with all Municipal and State codes ordinances, and regul~tioes in e ecl on
the date of this inspection.
Name of Firm Telephone
Address ~61. E ~lV~ ENglNE[~S:~O~
Date
I~0X77329~
694-5195
Engineer's Seal
DHEP APPROVAL /'r, ~.
Approved for _.:E_._~ bedrooms by!_/~'/__~_'~'~
Approved Disa~ed ConSign al
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Depadm~nt el Health and Environmental Protection (DHEP) issues klealth Authority
Approval certificates based solely upon the representations given m paragraph 5 above by an iedepeeden~ professional
engineer registered in the State of Alaska, Yhe DhlEP 0des this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirernents. Employees of DHEP cio not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for error,'; or omissions in the
professional engieeer's work.
Page 2 of 2
WELL DATA
~UHICIPALITY OF ANCHORAGE (MOA)
IEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984
264-4720
Legal Description:
~"~ c 7
~UNIcIPALITY OF ANCHoP, AG~
DEPT. OF HEALTt-I &
ENVIRONMENTAL PROTECTION
, o 3 1985;
Well Classification /g:),~?/~'/I 7',~'i If A, B, C, D.E.C. Approved (Y/N)
Well Log Present (Y/N) __ '/~'~ !Date Completed z~'e /2 7.~'- Yield
Total Del)th//~,-,¢¢¢~ ¢'~"~' Cased tol_ 4/~) ~- Depth of Grouting
Static Water Level -~' 7 '"
Casing kleight Above Ground /~1
Electrical Widng in Conduit (Y/N) _ ]
Separation Distances from Well: ~'
To Septic/Holding Tank on Lot ~,¢f' ; On Adjoining Lots
To Nearest Edge of Absorption Fieldl°n/ Lot ///'/" ~-~' -; On Adjoining Lots
To Nearest Public Sewer Line //,~-.-A. To Nearest Public SeWer
Cleanout/Manhole ,/Z,/~,3-,,~p To Nearest Sewer Service Line on Lot
Water Sample Test Results
Comments
SEPTIC/HOLDING TANK DATA
Date Installed /~/ _ Size
Standpipes (Y/N) _ /V
Depression over Tank (Y/N)
Pump Set At _ ~¢ '"
· Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
No. of Compartments
, i?-tight Caps (Y/N) _ ,~ __ Foundation Cleanout (Y/N)
,/~ i Date Last Pumped ~'(,~,¢ Y'
Pumping/Maintenance Contract on ~:ile (Y/N) /~//,~ __ ; for __
Holding Tank High-Water Alarm (Y/N) /~//,4 Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well ~' ~'" '
_ ;~/¢"~" I~-~'-~'~/ _ To Building Foundation
To Property Line /"~ ¢- . To Disposal Field ¢~"
To Water Main/Service Line /¢
Course
Comments
Page 1 of 2
72-026(11/84)
TO o
otream, Pond, Lake, or Major Drainage
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata ~'~-~.- ~ ,¢2~f~__~,¢,~ Type of System Design
Date Installed /'~ '-¢? Length of Field ~.~~ /
Width of Field ,,~¢.~ //
Depth of Field ~;' '~- ~"
Gravel Bed Thickness z~ ./
Square Feet of Absorption Area ~'-.~- ~
Standpipes Present (Y/N)
Depression over Field (Y/N) ~ Date of Last Adequacy Test
Results of Last Adequacy Test .-~/¢', J"~ ¢ :~;,~- ~ ~' · ~/Z¢'~¢¢;.~-~.c¢~.,.. .,~.,,,~
Separation Distance from Absorption Field:
To Water-Supply Well / / ~/ /'
To Property Line /~'
To Building Foundation /-'/~ ¢'
To Existing or Abandoned System on
Lot ,'~¢>'"~ ; On Adjoining Lots ~z] ~
To Water Main/Service Line /O ¢'
To Cutbank (if present) /~'~'>'"~--
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area ¢'/~:~ ·
Comments
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed ~--~"~-~¢~¢'~ Date
Company ~',/~
Receipt No. ,=¢~ ~--)
Date of Payment
Amount: $
MOA No. ,.~' 7'
Engineer's Seal
Page 2 of 2
72-026 (11/84)
P.O. BOX 66,'50
ANCHORAGE, ALASKA 99502-0650
(907) 264-4111
IONY KNOWLES
MA
DEPARTMENT OF HEALTH & HUMAN SERVICES
October 11, 1985
Lou Butera, P.E.
Eagle River Engineering Services
PO Box 773294
Eagle River, Alaska 99577
Subject: Waiver Request WR85-040, T15N R1W Section 7 Lot 95
Dear Mr. Butera;
Your request for a w~iver of the required 100 foot separation
distance for a private well to a septic tank on the subject lot
has been denied. Ifi the septic tank can be shown to be equipped
with watertight, cau%der type couplings this waiver request will
be reconsidered.
If you have questions regarding this matter, I can be reached
at 264-4720.
Sincere]y,
Stephen S. Morr:Ls
Civil Engineer
On-site Services
ALASKA IIUlf
',orlmenTAL COFTFROL
~n~ineerin~ ~, ~nuironmenl~l $1u~lies
October 21, 1985
Munclpality of Anchorage
Department of Health &l Human Services
825 L. Street
Anchorage, Ak. 99501
SEI UICt S, IFIC.
After a review of our !records and the records of John Long (P & D
Construction). I can isafely state that the caulder couplings were
used on inlet, outlet ~and both vertical standpipes of the septic tank
located on Lot 95, Seciion 7, T15N R1W, ~)M.
If you have any questlbns please feel free to contact me.
Sincerely,
Presi~ht ~'
PE
1200 LUesl 33rd J~ucnu¢. Suil¢ [~, Anchoreq¢, Alosko 99503 ,(907) 561-50/40
U5ft
•
Municipality of Anchorage
On-Site Water and Wastewater Program a
(907) 343-7904 SA F ETY
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 051-161-35 Expiration Date: 1))Q1-,c,1') (:) .1°1
1. GENERAL INFORMATION
Complete legal description VIKDAL LOT 2
t`i ,21
Location (site address) 19825 DOTIE'S DRIVE, CHUGIAK, AK 99567
Current Property owner(s) Jeff&Tabatha Vikdal Day phone
Mailing address 19825 DOTIE'S DRIVE, CHUGIAK,AK 99567
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 6
TYPE OF WASTEWATER DISPOSAL:
4. TYPE OF WATER SUPPLY: Individual
Individual Well
Holding Tank ❑
Individual Water Storage ❑ Community ❑
Community Class Well ❑ Public Sewer ❑
Public Water System ❑
Waiver/Variance request for: Distance:
Received by: Ai . Date: a /
COSA to be released to the engineer,unless othe l�sted by the engineer.
COSA Fee $ `IoZ.e)/-&O Waiver Fee $
Date of Payment 12.031r3 Date of Payment
Receipt Number 357 Lib Receipt Number
COSA# 0SC 191(,94 Waiver#
•
i
5. STATEMENT OF INSPECTVN 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.
Name of Firm ARCTERRA CONSULTING, INC. Phone 907-696-6111
Address 20441 PTARMIGAN BLVD.,EAGLE RIVER,AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date 12/17/2018
Engineer's Comments:This investigation was completed in compliance with ADEC and MOA regulations. 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 inland use, local soil characteristics,groundwater levels that may fluctuate
during the year and the water usage of the family being served by the system. 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,
ArcTerra can not give any estimate of how long a
system will function satisfactory for current or future
occupants or can ArcTerra guarantee that no unseenOf Az X
encroachments,deficiencies or discrepancies exist. 4 ,
/1-
-`4-• Til _=
6. DSD SIGNATURE �� •
�/
.� System #1 Approved for (D bedrooms. , `ENNET-W�',
71
r,
System #2 Approved for bedrooms. ,, 4',0 /a.27
Disapproved. \'‘41.4116:°'
Conditional approval for bedrooms, with the following stipulations:
ON-SITE �.
WATER AND
WASTEWAT
PROGRAM ER
/1`^rn 1'r`
G
1(!
By: '' kfi;Ci(',�I LiUt�9'l ,` Original Certificate Date: �eC 10 l g
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: r••;."'.• ,
4 ;
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory II.
Well Flow Advisory Other � •+ • 1;
COSA blue sheet 10-10-12.doc
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system _
Certificate of On-Site Systems Approval Checklist
Legal Description: VIKDAL LOT 2 Parcel ID: 051-161-346 :35
A. WELL DATA
Well type PRVT If A, B, or C provide PWSID# Well Log (Y/N) N
Date completed per 1975 Sanitary seal (Y/N)Y Wires properly protected (Y/N) Y
Total depth unk ft. Cased to 40+ft. Casing height (above ground) 24 in.
FROM WELL LOG AT INSPECTION
Date of test 1010311985*(COSA) 12117118__
Static water level 89* ft. 77 ft.
Well production 1.5* g.p.m. 2.31 g.p.m.
WATER SAMPLE RESULTS:
Coliform neg colonies/100 mL Nitrate ND mg/L
Arsenic: ND ug/L Date of sample: 12/17/18 Collected by: ARCTERRA
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC I STEEL _ Date installed 7112118
Tank size 2000 gal. Number of Compartments 2 Cleanouts (Y/N)Y
Foundation cleanout (Y/N)Y Depression over tank (Y/N) N High water alarm (Y/N) N
Date of pumping new Pumper
C. ABSORPTION FIELD DATA
Date installed 7/14/18 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.45 System type_SHALLOW TRENCH
Length (2 @100) 200 ft. Width 5 ft. Gravel below pipe 4.0 ft.
Total depth 6.8- (Measured 8/3/16) Eff. absorption area 2000 ft2 Monitoring tube Y Depression over field N
Date of adequacy test new Results (Pass/Fail) PASS For 6 bedrooms
Fluid depth in absorption field before test in. Water added 0_gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date
D. LIFT STATION
Date installed _ Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off' level at _._._in. High water alarm level at in.
Datum_ Cycles tested Meets alarm&circuit requirements? _
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main 75'+ Public sewer manhole/cleanout 100'+
Sewer/septic service line 25'+ Holding tank 100'+
Animal containment areas -50'+ Manure/animal excrete storage areas 100'+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 54 /0 '-}_ Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
Property line 10'+ _ Building foundation 10'+ Water main 10'+
Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ _
Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in conformance
with MOA COSA guidelines in effect on this date.
Ar ) OF A1,4 \ '
Engineer's Printed Name KENNETH M.DUFFUS / � ;I"
Date 12/.2 *4 TH
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COSA canary sheet_2-6-15.doc =iOff3
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