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HomeMy WebLinkAboutT15N R2W SEC 25 LT 129BT15N R2W Sec. 25 Lot 1298 #051-312-34 Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP131263 PID Number: 051-312-34 • New ❑✓ Upgrade Name: Tilleen Anderson ABSORPTION FIELD ❑ Deep Trench ❑✓ Shallow Trench ❑ Bed E Mound ❑ Other Address P.O. Box 771104 Eagle River, AK 99577 Phone Number of Bedrooms 3 Soil Rating •8GPD/SF Total depth from original grade 2.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 0 Ft. Gravel depth beneath pipe 2.5Ft. Subdivision Block Lot 129B Fill added above original grade 2-3 Ft. Gravel length 80 Ft. Township Range Section 15N 2W 25 Gravel width 5Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To From Septic Tank Absorption Field Lift Station Holding Tank Sewer Line Total absorption area 625 Ft2 Number of trenches 1 Dist. between trenches Ft. Well N/A N/A N/A N/A N/A TANK ❑ Septic ❑ S.T.E.P. 0 Holding 0 Other Manufacturer Anchorage Tank Capacity 1,250Gal. Surface Water >100' >100' N/A N/A NA Material Steel Number of compartments Three Lot Line >5' >10' N/A N/A LIFT STATION Foundation >5' >10' N/A N/A Manufacturer Anchorage Tank/Orenco Capacity 250 Gal. Curtain Drain None Noted Remarks Existing Tank and Absorption Trench Pump on level at 28 in. Pump off level at 28 in. High water alarm at 23in. Decommissioned in Accordance With Municipal Code. Pump make and model Orenco Electrical Inspections performed by Installer Royce Martin PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield Drainfield HDPE CO/MT D3034 BENCH MARK (Assumed elevation) 100.0ft Inspector A. Harald Location and description Garage Slab. Inspection 1u 10/23/13 2"d 10/24/13 3" 10/25/13 a2' COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional Approval: Date uiC a 1 sr C.2C j•• - - '•,'�'®® :* 49 Tr' •;7 t 4410 ,•,MICHAEL E. ANL. --.@SON :Let 1467-1.,.... GE - 4381 ,°'t a 4c .• 1aaA. c, — e'_°; !i®`6FE5S1�®®®® awik Approved � Dated/ r Inspection Report_1-1-42.a6c a 6 1n r) D r I I a O KO-IMM0 I� I I I am`0N-. o j0 0 J i' Iao o 0 o N c O cd: 0 0 c HUSKY STREET 0 0 o m o Y -6Z l 401 9696Z 3„OC.OS.68 S no to, rn F H K 0 0 ••► N t0 CO / S 00'16'151V 101.00' O ti W O 0 3 z 3 o- 0 0 0) W • 0 10•3 0 � O W O G CO 0 m O • 0 y0 71i 0 m �c rt Z Din O • rn G 2 < • 0 O °. D 0 xm vco xi. D 0 01;m 10 Z 0 I —1 01 01 01 0 0 z 0 0 £ 10 Z °60d Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP131263 102.8 Finished Grade x 1- 103.0 Page 3 of 3 PID No. 051-131-34 100.0 2 Insulation & Geotextile Fabric 97 5 97.5 80' (Total Effective Trench Length) PROFILE AS -BUILT No Scale 86.0 Groundwater @ 93.2 10/15/13 • x • 49th i yyr y; ;MICHAEL E. ANDERSON j .0 On, .111:4.."' =• No. CE _�F.i ' Oriiginal Ground Drainfield Rock 97 5 97.5 80' (Total Effective Trench Length) PROFILE AS -BUILT No Scale 86.0 Groundwater @ 93.2 10/15/13 • x • 49th i yyr y; ;MICHAEL E. ANDERSON j .0 On, .111:4.."' =• No. CE _�F.i ' WALKER ELECTRIC CLINT WALKER Phone 696-8964 Cell N 223-6304 Email ClintAlan a aoI eom To: Martin Construction Company PO Box 773326 Eagle River AK 99577 Date:10-28-13 Ref:15427 Husky St. Permit: NA 10319 Colville SI. EAGLE RIVER AK, 99577 Licensee 1310 This is to certify that on site sewer lift station at above mentioned property has been wired in accordance with the standards of the National Electrical Code and manufactures specification. Systems were checked and performed as specified in the systems manual. Clint Walker On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP131263 Tax Code Number: 05131234000 Work Type: Septic Permit Effective Dates: August 19, 2013 to August 19, 2014 Design Engineer: ARC TERRA CONSULTING INC Subdivision: T15N R2W SEC 25 Site Legal Address: T15N R2W SEC 25 LT 129B 6:0653 Owner/Address: ANDERSON TILLEEN PO BOX 771104 EAGLE RIVER AK 995771104 Site Mailing Address: 15427 HUSKY ST, Eagle River Lot Size in Sq Ft: 30000 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: Permanant barricades are to be installed to prevent parking over the proposed field. The inspection report must show and describe the barricades. Received By: Date: Issued By: � _ 1 Date: l/ MUNICIPALITY OF ANCHORAGE Community Development Department Development Services Division On -Site Water & Wastewater Program Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 051-312-34 TILLEEN ANDERSON Property owner(s) Day phone Mailing address PO BOX 771104 EAGLE RIVER, AK 99577 Site address 15427 HUSKY STREET, EAGLE RIVER, AK 99577 Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T15N R2W SEC25 LOT 129-B Lot Size 30000 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: (® all that apply) Absorption Field Septic Tank Holding Tank Privy Private Well Water Storage APPLICATION IS AN: Initial Upgrade Renewal TYPE OF DWELLING: Single Family (SF) (w/wo ADU) Duplex (D) Multiple Dwellings (SF and/or D) 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. ybeortacia- (Sign operty owner or authorized agent) Permit/Rush Fees: 530 Date of Payment: $I Ja-II�J f Receipt Number: 0a5DOFi Permit No. 05113 /12145 Permit App_9-1-12.doc Waiver Fees: Date of Payment: Receipt Number: Waiver No. ARC T ERRA CONSULTING, INC 212 E. 51s` Ave, Anchorage, AK. 99503 Office (907) 868-3791, Fax (907) 868-3793 August 9, 2013 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Upgrade Sewer Permit — T15N R2W SEC25 LOT 129-B It has been determined that the absorption field of the subject property is saturated and encroaching groundwater. Subsequently, the owner has requested we proceed forward to obtain a septic permit to upgrade the septic system. The existing system will be decommissioned in place per code. The general slope of this lot is from east to west at a grade of approximately 0-2% over the septic area. On July 8, 2013 a testhole was performed to investigate soils and groundwater. The results of this test are attached for your review. The proposed upgrade will serve the existing 3 -bedroom house. We propose to install a 5' -Wide pressurized trench. Groundwater was not encountered at excavation but was at 12.5' 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- 3792 / FAX 868-3793. Respectfully submitted, ArcTerra Consulting, Inc. Kenneth M. Duffus, Attachments: On -Site Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/ Percolation Test 20441 PTARMIGAN BLVD • EAGLE RIVER, AK 99577-8736 • PH (907) 868-3791 • FAX (907) 868-3793 WELL & WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLAN T15N R2W SEC 25 LOT 129—B PST, I Y .1." de' T6 O c C FLAG PROPERTY LINES WELL RADII & EASEMENTS PRI❑R TO CONSTRUCTI❑N m N_ 0 NO SLOPES >25% W /IN 200' OF PROPOSED SYSTEM z j NO PUBLIC WELLS WITHIN 200' OF PROPOSED SYSTEM. o_ NO PRIVATE WELLS WITHIN 200' OF r PROPOSED SYSTEM EXCEPT AS NOTED m NO SEPTIC SYSTEMS WITHIN 200' OF I PROPOSED WELL EXCEPT AS NOTED. : Ti Q saltook ��3 OF ALS N • 1 /\ KE 11. CE -7118 • (6/le3-. self 134'OFESBIOI3S' \nhi.\"1110"... n\Server\Storage\WE DESIGN DETAILS 3 BDRM X 150 GPD = 450 GPD 450 GPD/ 0.8 GPD PER SQ. FT. (6 MIN/IN.)= 563 SQ. FT (563 / 5'W x .64 RF (2.5' GRAVEL) = 73 FT. TRENCH USE 1 TRENCH - 80' (L) X 5' (W) X 2.5' (ED) Total depth of system is 6.5' from original grade. Total depth of gravel below distribution pipe is 2.5' . NOTES: 1. INSTALL 1250 GAL STEP & INSULATE TANK IF <4' COVER. 2. INSULATE TRENCH WITH 2' HD BURIAL FOAM IF < 3' OF FILL. MIN. 2' FILL WITH INSULATION, >3' COVER NO INSUL REQ. 3. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INTO SEPTIC TANK. 4 CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT WELLS, SEPTICS EASEMENTS, PROPERTY LINES, ETC... Scale: 111= 100' PAGE 1 OF 2 PREPARED FOR: TILLEEN ANDERSON PD BOX 771104 Eagle River, AK 99577 FIELD BOOKS Bo RIDARY: BOUNDARY COMPUTED: DRAMN: BMW STAXDKA STAKING D" KMD • 8/8/2013 NW0653 13-173 AOT` JLS DATE DMT?. RIZ: GRID: ACM FMD FILE JOB Na.: TC ERR oti O zrc 4s pG \AC �l free? NSULTING '0E. • AK. 99577- WASTEWATER DISP❑SAL SYSTEM DETAILS T15N R2W SEC 25 LOT 129-3 LOT 12 S89°50'30" DECOMM. SION EXISTING S.T. & INSTA NEW 1250 -IAL STEP 9 O 2c FLAG PR❑PE"TY INES WELLRADII & EASEMENTS PRI❑R TO C'INST 'UCTI❑N LOT 129—A S89°50'30"E PRESSURIZED DISTRIBUTION SYSTEM HOLE SPACING DESIGN 1. RESIDUAL HEAD = 5' 2. HOLE SIZE = 3/16' = 1.00 GAL. PER HOLE @ 30 PSI 3. 30 GALS <PUMP DELIVERY)/1.00 GALS./HOLE = 30 HOLES 4. 80 LF LATERAL/30 HOLES = 2.6' SPACING PER HOLE 5. ALL HOLES SHALL HAVE CAPS INSTALLED PER MANUFACTURES SPECS. a`a, AlreS? 44-44 111 �� , / CE -7116 4n -'• ESS1011s I. ' KENNETH 11 D Scale: 1"= 30' PAGE 2 OF 2 PREPARED FOR: TILLEEN ANDERSON PO BOX 771104 Eagle River, AK 99577 FIELD BOOKS BOUNDA" BOUNDARY STAIWk STAKING ASSUIIM JLS DOC. FILE: ADHD F' FILE COMPUTEk DRAM: BMW ctca®: KMD DATE: 8/8/2013 ORIk NW0653 13-173 t. Y A a 3 off' es vete e `*k-1 Rifz —.TING, el Pq AK. 99577-575 WCTERR cO leo e o Q►RCTERRq ARC TERRA CONSULTING, INC 212 E. 51st Ave, Anchorage, AK. 99503 Office (907) 868-3791, Fax (907) 868-3793 SOILS PERCOLATION TEST Performed for: Tilleen Anderson Project: Depth (Feet) Date Performed: 07/08/2013 T15N R2W SEC25 LOT 129B TEST HOLE # TH 13-1 17- 18- 19- ORG/OL GM/SM BOH HOLE PRESOAKED 20- PRIOR TO TESTING SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Groundwater encountered? NO What depth? DRY Depth to water after monitoring? 12.5' Date? 8/9/13 Reading Date Gross Time Net Time Depth to Water Net Drop 1 7/9/13 1:00 - 6" - 2 1:30 30 min 15/16" 5 1/16" 3 * 1:31 - 6" - 4 2:01 30 min 15/16" 5 1/16" 5 * 2:02 - 6" - 6 2:32 30 min 1" 5" 7 8 9 10 11 12 Water Added Percolation Rate 6 (min/in) Pere Hole Diameter 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. 1 MUNICIPALITY OF ANCHORAGE • \� r \C // ' DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME TOO 1\ PHONE ❑ NEW XUPGRADE MAILING ADDRESS P O RN( 111 a oge. l ues LEGAL DESCRIPTION L. lz9a 5Z5 7-I5IN-I eat-u Sill LOCATION 14-h/BDCrrE-C. fp NO. OF BEDROOMS 3 SEPTIC TANK DISTANCE TO: Well Absorption area / Dwelling PERMIT NO. Manufacturer EA, I 5 /I / s v G Material No. of compartments Lig. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth O s-' JTZ = Z F DISTANCE TO: Well welling PERMIT NO. Manufacturer / Material Liquid capacity in gallons TILE TRENCH DISTANCE TO: Well / ��Q •� Foundation /1 �I_ 1 Nearest lot lin /b i�� PERMIT / ? 19Uz No. of lines / Length of eai ,l il`!' e/ ± Total length pfvly/�eq . 7I T Trench width 3V inches Distance between Aire /t Top of ti le to finish grade 7 /Material 6— '-7 } beneath tile 48 inches Total effective absorpti Area -L7Z, Weic SEEPAGE PIT Length Width Depth PERMIT NO. Type of crib - Crib diameter Crib depthA / Total effective absorption area DISTANCE TO: Well - ,• Building foun tTdn Nearest lot line _i Class Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foun a i6nx '/ gvy4r II¢ 1/ j Septic tank Absorption area(s) OTHER PIPE MATERIALS /1 LJI/ IV SOIL TEST RATING J9 �j�/� n INSTALLER ROS`f" I fioi""e s REMARKS -1— C: 4 tr 1. 10* - comm t, . A. S. ik;tia No. 1457-E . ,•:%'r•4 $®tA�CfESSt "N\-,,Q' i tai 13 - 61k' `Ly.4>0aa. - J .4111 // AP-'p .e DATE LEGAL/ EMI(Mf-'[7IM'�.. fee r--7--GA °RS &!;®It tqk QS? 72-01.3 (Rev. 3/78) // N...311-4 Ia' tl :Z s fi- m PA e_: -I-I_ FZ IF;I C E DEPARTMENT HEAL_ T H FW) E:Wl I RONt'` ENTAL_ R ITECT 1 ON 825 /I .' STREET.. ANCHORAGE: AK. 995I 1'i 264-4720 P:.:N —7.,"s; .S_ -I- VT. ' _ E. _ fl „_N E F: 9__n. s= =" k Fm,; Fir) E: = FT, E-:" F- .' t' T I _r FERMI T Ni i. 20632 APPLICANT TODD L_ 't AT I ON LEGAL L129B 525 T:LSN R2h! SM SAN BOFLEL DRIVE TYPE OF SOIL ABSORPTION SYSTEM IC: TRENCH MAXIMUM Y.,IIi'9EFT; OF E:ECF:OCII''i:iS; _ LOT SIZE 70000 _QUIFF FEET _OIL RATING ':'Fr! FT/BR).:: 194 THE REQUIRED -'-- -- .H_ : .E. �.F- OF THE _OIL AI=-'•:-�!iF: F''!�I!_ila ��`r==TE t' IS: DEPTH OF..A TRENCH ORTHF ISLTHETI:EISTA CEtaBE?.WEEN THE FI OR C'F.r'ITFFT Ef;. THE LEN 1 MEN ION LENGTH N1 I H I Nt FEET) OF THE TRENCH THE C!- - !SURFACE i !r L'F-il. Fi.?I-II_NF' AND THE BOTTOM TOM !p THE 'y'F t FEET). THERE IS NO .E„1 WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MIP'L:EP'U_M DEATH E!F GRAVEL BETWEEN THE OI.IFFAL-L.. P11 AND THE BOTTOM OF THE EXCAVATION (IN FEET) Fr:E_:a_!u:P: ^EL,n ”} VE:. F -li. i c c _ 7_fi:s!;_2n:'e Caw- P- P._..c_ur-°C= PERMIT EPF'LICANT HAS THE RESPONSIBILITY TO INFIRM THIS DEPARTMENT DURING THE: INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY HI1ti THE NUMBER OF RESICErJ ES THAT THE WELL HI'LL.. SERVE. '_'h i 1 e::_ =- .:} k. rJ P-'=" E I'c ::: ry 1 °._E 5NA "- :: FIR F: E-._: FRAEGUJLEFRIECE EHCK IL_L_.INO OF ANY '-Y_TEYL WITHOUT F:E1'AL... INSPECTION TION APUD APPROS,'AL. BY THIS C'EF'ARTi'IEN`I" WILL. BF SLiBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A M_L_L_ f=!hdF? F!P'd`r' ON-_ITE=,L=d•.IAOF. DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE MEL.i._ OF: 150 TO ;;_CIH FEET FROM A PUBLIC IJE:t-_L. DEPENDING UPON THE T'YF'E OF PLIE!L_IC WELL.. Y'E1Nir'llil''1 DISTANCE: FROM A PRI'V'ATE WELL_ TO A PRIVATE SEWER LINE. IS 25 FEET AND TO A COMMUNITY SEVER LINE IS 75 FEET. OTHER ?:LOi_ITREEMENT.E MAY APPLY. SPECIFICATIONS AND r:OY,sTRU7:.-E'.IEir'L DIAGRAMS ARE Fit,AILFIBL..E TCI INSURE F'ROF'ER INSTALL.ATIC!P+!. E F. -;.:M 17" ........:F' T F_'.!E:EE E RUN'_ Ic:.,,-PE3F-'.F;: I C IFY THAT L' i AM bFIM1LIAF: WITH THE REQUIREMENTS FU4: EIN--'`;ITf ':rH F_ AND WELL_ AS _ET FORTH E_'',' THE MUNICIPALITY OF AN HLIFF,hf • .. I WILL INSTALL. THE '-"--' 1 ._. _. _.,'�.!L_Y', IN A!_Ci1F.:C:,FIP,U:_F; WITH THE CODES. 3:UNDERSTAND _'L' 7. i �PfTHAT THE ON-SITE SEWER SYSTEM MAYREQUIRE ENLARGEMENT -E_IEENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. AF'PL_IDINT TOM C'4P'-YY FIEF7724a V4. 3 PERFORMED FOR: LEGAL DESCRIPTION: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST Z ❑ SOILS LOG PERCOLATION TEST DATE PERFORMED: 4 J rJ Z Cc 2s-' y,o 10 11 12 14 / / CL,Lyvy; v 15 � i 3_ .. too ( S e,coIc-ot I ecf j 511 -Ty S D7 rived ((rn) 16 17 18 nee co •• RaMrt A. �,• f' '°o° Ho. 1957 t+`? 19 ��Fp 4.° r arm h#04OFES �P 20 r,.p-'te . COMMENTS SLOPE [r WAS GROUND WATER ENCOUNTERED? IF VES, AT WHAT DEPTH? O / P / 3 E L F L 7 Reading Date GTrimoss e Ne Time Depth to Water Net Drop ptt /XIGj Z.A 7125 �' 5 /' 3 $ Z. it -7:55I° 3prn/N. q4 ti 3 a o 1 rr...s Cr ti S:isP 5 6 5'zcP iom,N, lig P , PERCOLATION RATE TEST RUN BETWEEN FT AND (minutes/inch) / FT r PERFORMED BY p h. SW1��{ r jilV7wi�i ' A1.flF..rC�a PRIM -297Q 72-008 (6/79) CERTIFIED DATE: /• - MUNICIPALITY OF ANCHORAGE ® \\1825 ,V-1--K__-,>42 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTALENGINEERING DIVISION L Street -Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME/ /94P OONE -, 04-Rat 4 1 6 � 6 �J 2 .S pNEW ❑ UPGRADE MAILING ADDRESS 44/7AI e LEGAL DESCRIPTIO /296 S 5—; 7- �� ,E�2 cam/ LOCATION J /°7 / /% )/ NO. OFBEDROOMS- D Y I- Z 0 DISTANCE TO: Well/ .& /(%Q Absorption area Dwelling f -f- ` lS PERMIT NO. k 11. 1 1 '/��rf%j/(/%jl��,�'y' — OP - ManufacturerM o- ee % rid r «/ No. of compartments c--)wH l ' Liq- a acity in gallons /&)0 IF HOMEMADE: Inside length Width Liquid depth D Y ..i _,02 2MF DISTANCE TO: Well / Dwelling PERMIT NO. Manufacturer / ( Material Liquid capacity in gallons TILE DRAINFIELD TRENCH DISTANCE T( Well F.undation - Neare lot li - - 4 'ER IT NO. No. of lines U Lengt, r each lige2�' �� '-�o : €ti i of I" • T--pfh. • ' .;D-'-ce inc ies between lines Top of tile to finish grade Material beneath ti le inches Total effective absorption area SEEPAGE PIT Length Width Depth PERMIT NO. Type of crib Crib diamye% /1' Crib depth Total effective absorption area DISTANCE TO: Well l/ Building foundation Nearest lot line w Class Cz z, X i ` (Dgptb_ elm✓� Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation-: -.,, , • --3:•Y. $ewer"line Septic tank Absorption area(s) ° F OTHER as i �• / PIPE MATERIALS////�J,( r / C 1 .4'.11i%T A n " y �l �', SOIL TEST RATING INSTALLER I t tr.'!" I REMARKS -F55167/ ow ',qMt •...•.u.i // 9111 1 II 1111 rat s'Jt lJ' c4 ^E111116 0 .Oioie i 7, 'd dere eR 72/ in r DATE LEGAL APPpOVE/y/"/��// f///mayam/ / / -ryf3 (Rev. 3178) MUNICIPALITY OF ANCHORAGE/-' Department' t' Health and Environmenta' ?rotection 825 L Street, Anchorage, AK. 99501 264-4720 * * * HANDWRITTEN PERMIT * * WELL AND/OR ON-SITE SEWER PERMIT DE go,C /ODD Mailing Address: p sX Applicant: Location: Et'., Legal Description: Phone Number: (pA e '.ZS o3 % ism ,.2't) .S 23- 27`, /) Size: Type of Soil Absorption System Is: Trench: Drainfield: Seepage Bed: Holding Tank: X Maximum Number of Bedrooms: Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is:' DEPTH LENGTH GRAVEL DEPTH WIDTH The length depth of a the bottom The gravel the bottom dimension is the length(in feet) of the trench or drainfield. The trench or pit is the distance between the surface of the ground and of the excavation(in feet). There is no set width for trenches. depth is the minimum depth of gravel between the outfall pipe and of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = 1000 GALLONS * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED # * # system without final inspection and approval by this department prosecution. of residences that Backfilling of any will be subject to Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 8 1 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if thc,residence is remodeled to include more that 3 bedrooms Signed: i /2? ,inhz Applicant Issued by: Date: 6— Ala (.4 Temporary holding tank until field is installed Spring 1982. SWP/024(1/81) Existing sewer serving a trailer now that will be abandoned. A bed system including a lift station will be required for new residence. te Ate, { ,€€ . ,9) %l"� •fes/��f cc (-1r.i %4tit" ) f.G= - /L't2.Q6 =iiasC�Y //.�tr>i fir_ /z %2. j /y /7 - a - / a /8 %: ' ®_. 6 ° J 0p ,.o � }}-- Y` ?ta3'' w :� S` /2. r� -/ C20 afar I. u fy.: �,.a ‘A -r- yTt e . 10- c?--2aaree42 �% c'Ltr('-r-2tC30.fIG'Yl.�/ .CL - 4 3- _3 i- 14 4,4, j_ i7, /�/ "�, iva4<1r/;, �,.•, .s�> Ir le LGt f` i',' +t j ay' `Iu` _e '5 ela;Je i • .¢r /✓ .. 2 ` t< r u >../ , ;3 3S > _3 ,c (° 0 ' a 3r ,> A- C{.� �,. ._ /4 • c.../L ... ty /..F _.. el . ,r { 4 9• _ - - (/ 1 1 (. i9 ��utn t t / ,9) %l"� •fes/��f cc (-1r.i %4tit" ) f.G= - /L't2.Q6 =iiasC�Y //.�tr>i GREATER ANCHORAGE AREA BOROUGH Department of Environmental Qualii4R"'a\TER ANCHORAGE AREA BORO• I!�(i 3500 Tudor Road—Pouch 6-650 Anchorage, Alaska 9950 N° 877 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME /eO r , 7-v__, Cdf'/fin/ M 6/'-'- MAILING/t• ���� ADDRESS �Q� /� vv/fc. 7)1,-P HONE LOCATION LEGAL DESCRIPTION boy'/ -1/4 /4.12, _r4r/r SEPTIC TANK: DISTANCE FROM WELL .2s2 T/Lcg � vC� NUMBER OF MATERIAL , COMPARTMENTS GALLONS. INSIDE LENGTH � LIQUID CAPACITY<��� `5Z-��O INSIDE LIQUID WIDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: r / ! / NUMBER OF PITS //�� Q OU�TSSIDDEEp`1IAMETER OR WIDTHID/7 LENGTH /1 DEPTH '"� LINING MATERIAL OLFO ( ^ ) - DISTANCE FROM WELL /00 fie- BUILLDDIING FOUNDATIOI�"'e NEAREST LOT LINE 7 ® w 5 TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) / SQ FT TILE DRAIN FIELD: TOTAL LEN TH DISTANCE FROM W FOUNDATION NEAREST LOT LINE OF LINES NUMBER ABSO LINES TION AREA DEPTH: TOP OF TILE TO FINISH GRADE DISTANCE BETWEEN LINES - TRENCH WIDTH SQ FT LENGTH OF EACH LINE DEPTH OF FILTER MATERIAL BENEATH TILE IN ABOVE TILE TOTAL EFFECTIVE WELL:,, II DISTANCE FROM TYPEIA3a DEPTH , BUILDING FOUNDATION LOT LINE WATER SAMPLE NEAREST NEAREST SEPTIC SEEPAGE OTHER SEWER LINE TANK SYSTEM CESSPOOL SOURCES_ DISTANCES: Oftr' Bee /nQ nLS 4 61�v 1'1A le DIAGRAM OF SYSTEM it) DATE �/6 APPROVED 1>"� : C-"`�'""�� / HEA AUTHORITY ( ATER ANCHORAGE AREA BOROU' DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 CASE # Performed For Robert '7 -odd Date Performed C, — a4- 7 2. Legal Description: Lot/zc/aBlock Subdivision b SE1 Ter. 25- 775N 172W S.n, This Form Reports Soils Log Percolation Test Denth Feet Soil Characteristics 1 2 3 n 5 6 7 8 9 10 4 0 rapso:( (a't) (s, 'r) i4 C-raveI (2-(A C o rSC s, X 4-7 saV.c1 ((of-6%rj) crave/ (6 yj-1t4) iZ 4 s Ground Qater Encountered? If Yes, At what Depth? G1I G M Yes CSec 1 ,r, rake) 04 Reading Date Gross Time Net Time Depth to H2O Net Drop Percolation Rate Minute Proposed Installation: Seepage Pit Drain Field Depth of Inlet Depth To Bottom Of Pit Or Trench COMMENTS;Ff.// / In 1 (rM (�2zv) S®r r�edronv.�. ry[i Je*' I< }prn ba hi y Wa'f'er, wn'1er (f crow, cog r< Swed 14y�r -.I5 ti,+l-c., - o n;1. 1111s CO:,kf,,;„ u occur 4 yy*Anc it retina Lr ata Certified By: Test Performed By 4- A Date: Parcel I.D. 051-312-34 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: r 6 - Complete legal description T15N, R2W, Section 25, Lot 129B Location (site address) 15427 Husky Street Eagle River, AK 99577 Current Property owner(s) Tlileen Anderson Day phone P.O. Box 771104 Eagle River, AK 99577 Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: O Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Three 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual 0 Individual Water Storage 0 Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System 0 Public Sewer 0 WaiverNariance request for: Distance: Received by: COSA to be relea ed to j$e engineer, unless otherwise requested by the engineer. Date: 11`(66 J� COSA Fee $ 0)5' W1 MAO- Waiver Fee $ Date of Payment ioLaii 4 1V'3 C Date of Payment Receipt Number 004055 Receipt Number COSA # Cr- - 1315(8 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. Name of Firm Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name -Michael E. Anderson, P.E. 6. DSD SIGNATURE System #1 Approved for 3 bedrooms System .#2 Approved for bedrooms Disapproved Conditional approval for By: Phone 522-7773 Date 10/27/2013 `vea^sOe. to ct nciatlemakttint,014FF ' 49 See ,6 CE -436'1 pet, % +dc —fele , ®�,b Obbbs bedrooms, with the following stipulate• OF ANCA iii O, = ON-G� J SI it- AND =a WASTFWATER 661_ PROGRAM J i�c &C0 Original Certificate Date: The 191unicip 7•f,arrcnorage Development Services Division (DSD) issues Certificates of On -Site upon the presentations given in paragraph 5 by an independent professional civil engineer registered of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory COSA blue sheet_f X NT raj SERV )mm)111» Systems Approval (COSA) based only in the State of Alaska. The Municipality Nitrate Advisory Arsenic Advisory Other 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: T15N, R2W, Section 25, Lot 129B A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 6/25/74 Sanitary seal (YIN) Total depth 76 ft. Cased to 50 ft. Date of test Static water level ft. Well production 5 g.p.m. FROM WELL LOG 6/25/74 14 WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 2.87 mg/L Arsenic N/D ug/L Date of sample: 10/11/13 B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEP/Steel Tank size 1,250 gal. Number of Compartments 3 Foundation cleanout (Y/N) Depression over tank (Y/N) N Date of pumping New Const. Pumper Parcel ID: 051-312-34 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) >18 in. AT INSPECTION 8/30/13 29 ft .5*. g.p.m. Collected by: Anderson Engrg. Date installed 10/23/13 Cleanouts (Y/N) High water alarm (Y/N) C. ABSORPTION FIELD DATA Date installed 10/24/13 Soil rating (g.p.d./ft2 or ft2/bdrm) .8 GPD/SF Length 80 ft. Width 5 ft. Total depth 4.5-5 ft. Eff. absorption area 625 ft2 Date of adequacy test New Const. Fluid depth in absorption field before test System type 5' Wide Trench Gravel below pipe 2.5 ft. Monitoring tube Y Depression over field N Results (Pass/Fail) For _ bedrooms in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date g.p.d. D. LIFT STATION Date installed 10/24/13 "Pump on" level at 28 in. Size in gallons 250 "Pump off" level at 28 in. Datum Top of Vault Rim Cycles tested New Const. E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot >100' Absorption field on lot >1001 Public sewer main N/A Sewer /septic service line >25' Animal containment areas >50' Y Manhole/Access (YIN) High water alarm level at 23 in. Meets alarm & circuit requirements? On adjacent lots 100' On adjacent lots >100' Public sewer manhole/cleanout Holding tank N/A N/A Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5 Property line >5, Water main >10' Water service line >10' Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water Service line >10 Surface water >100' Curtain drain None Noted Wells on adjacent lots >100' Absorption field >5 Surface water >100' Water main N/A Driveway, parking/vehicle storage >10' F. COMMENTS Well Flow Test Completed by ArcTerra Consulting, Inc. 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. Michael E. Anderson, P.E. Engineer's Printed Name Date 10/27/2013 COSA brown sheet 10-10-12.doc ���°e 4,* SytB el • •e r„ oMICHAEU E. ANDERSON ;Luceo 0 "J e� CE - 4381 ' es fF9FD°',® Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # 131568 During a recent COSA on-site inspection and test of the potable water supply well on Block , Lot 129B of T15N R2W Section 25 subdivision, the well's productivity was determined to be 0.45 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. 0£1 101 -;old uolslnlpgns peploo0J ay{ uo Joaddo 40U op yolgm suoµop;seJ JO 's4uoueAoo `s4uawOSDO AuD ;o eoue{slxe ay{ euluue{ep o{ JOUMO 044 ;o A401gjsuodso. 044 sl 41 o soy 'BBDJOgOuy 40 , cla2, ' v Qoi->� ;o ADO y,}S2 044 0144 P01o0 •uos r4 pe;oolpul SD 4deaxe Ajaedoid plus UO S;UBWOSDB elglslA 40440 JO SOU!! UOJSSfwsuDJ4 'SAOMpDOJ OU 010 01044 ;044 pUD soslwoJd peAenans ay{ uo y000Joue o40Ja44 ;ueoDfpo 6u141 Apedold e4{ uo s;uowenoJdwl ou pogo '0011044 {ueoofpD A;4Bdoid 044 o4Uo y000nue 4ou op puo scull Apedo.d ay; u14l1M CID manna p040n1s s4uowoAoJdwl 044 4044 puo 8ulpiooea e8oloyouy (L£ l—ZL 'oN 401d) 6Z1 101 13V81 11V/14S 1118 .30 '08fS 3H1 01 ON108033V '86Z1 101 :A4Jedold pogposep BulMollo; 094 poAaAJns BAD4 1 4044 A;NJBo Age.aq 1 woo•AeMnsOuol®uo44ouof / woo•Aenans6uoIouen x03 sz94—zzs (Lo6) sJohenans purl pace/sj6es 640£-51566 oIsoly '06DJoyoeu4 y '9denueny I9L49—ZZSAJDO 009l(L061)I Ouil S2+DIOOSSy )' 6u D1 00Z—£1. 'op 4oefo4d V-611 401 ,40'662 M„0£,05.69 N »N3 .9'4 x ,YZ £S9 MN 0160 ,o£ = nl 31V3s NOIIVAN3S3d OV02J MEI ,0Z NVId 101c1 ,00'0£ ni Odd 'ONOO ANtN3 0383A00 GYd '3N00 ,9'91.1 113M 'J'0 toz'o£ 8-6Z l }01 N ,96'862 3„0£,09.69 S 3-611 1017 31011 OLLd3S 0 LLd3sNV310 3dId NMONO ,4'SS z 0 V 41 0 rri 0 c cn m 10/18/2007 06:17 05l'03;207'3 92: 46 180000000000 vboefraW. ti , RCTERRA Corse '1sT1mG. INC 212 E. 51* Ave, Anchorage, AK. 99503 Office [907) 868.3791. fax (9071 868-3793 August 30, 2013 Ti.fleet Anderson. 15427Husky St. Eagle Rivett, AK 99377 RE: T15N R2W SEC 25 tor 129E - ON-SITE WATER PRODUCTION Per your request, we have inspected the on-site water system of the above referenced 3 -bedroom property. This investigation was based on observations of the day in which the well flow test was performed and according to Municipality of Anchorage (MOA) record documents. Prior to commencing the well flow test. the static water level was measured at 29' from the top of cuing. The wellhead consists of 6" steel casing extending 2' above grade with a sanitary seal and conduit. 'The well produced 9.45 gallons per minute for gp 3), which meets minimum MOA water production requirements of 0.31 gpm bedroom single-family 'evidence Per MOAA documents, previous testing hage tank as hown the lesser water production (. garage augments the water system. The assessment of the condition of the well applies only to the conditions as of the day tented. The flow rates may change due to subsurface conditions that may not be observed from the sarence, changes in land al soil levels that may Mutilatet' ate during the year and the water usage of groundwater the fmily being srved by the system. If you have any questions, please feel free to contact me at (907) 868.3791 I Fax (9971 368.3793. Respectfully Arc Terra Consulting,Inc, Kenneth M. Duffu PAGE 01 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anctiorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. or/ :5/ .i3,/ 1. GENERAL INFORMATION 'Complete legal description 1 ,(J .??,414/ X, Location (site address or directions) /rya /47/cfine y �T Current Property owner(s) .A7394 re ,0,,g-, e9.RAN Zzp Day phone 5 - ©� Mailing address /e. >3,9x Lending agency Day phone HAA # D 1 O s-1 Expiration Date: 9 - / 6--- 0 14 - Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) 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 request 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. 4. 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 Health Authority 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. 1 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 ,��Lf d�.� %��-z S • • Phone Address /G9/ 1./x-• 51- ?7 Engineer's Printed Name 4y,/,'5 h/ e'/ Date 5. DSD SIGNATURE I/ Approved for 3 bedrooms. Disapproved. Conditional approval for -- bedrooms, with the following stipulations: . CHRISTOPHER R. WOOD Additional Comments `kkl,-IY�OF(rtr '; �; ON-SITE • •c= WATER AND ; r" WASTEWATER : PROGRAM ; • JJ�I``/J'" S i" Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other (Rev. 01/02) Original Certificate Date: — LC" 0 It Legal Des iption: A. WELL DATA' • Well typeP RMT Date completed G/ZS/jy Municipality of Anchorage Development Services Department Building Safety Division `On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.clanchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST /5",k) 12 r In) SEe 2.5" Li 129 .l3 Parc el ID: 057 - 3/2.= 3'/ Total depth 74 ft. If A, B, or C provide PWSID # Sanitary sea (Y/N) , i Cased to LO ft. FROM WELL LOG Date of test III Static water evel Well production ISI (., /7y ft. g.p.m. Well Log 9N) Y rll't" Wires properly protected®/N) i!'1 i Casing height (above ground) 2 ii r1, AT INSPECTION 1 II :PIT (Qt1; ,i� ft. ; a/q / 3D(1i�94m-/ - l,vaci 6,411q srvQ " 84•4 -DDS r.tisr 4 L t 11 ,14 Other bacteria p (#9 colonies/100 ml. YI WATER SAMPLE RESULTS: 1' Coliform i i. 1/ colonies/100 ml. Nitrate a 93i mg./1 Arsenic. i % mg./I. Date of sample: 3VO. B. SEPTIC/HOLDING TANK DATA f, Tank Type I/Material y�aiy Collected by: .440'1. -_ 4,0e4C rOla-y 11 Date installed II Tank size /D gal. Number of Compartments Cleanouts 'N) yt.5 Foundation'cleanout�l) ° Yffs Depression over tank ( 'tie High water alar 4.4.— O/ Date of pumping . .v, ,,,/D° HI III II i ir- Pumper J �o w,e ip�in/e.,--. C. ABSORPTION FIELD DATA k } ill d 11 ! 'i . 2 2 ' it I rating (g p d./ftor ft /bdrm) /9 ' System type /Air—vie,/ Date installed- /98' Soil j Length I I •i$ ft. Width '1 o? 0 Grave below pipe y i ft. Total depth i ft. Eff. absorption area }�ys72-ft2 Monitoring tube i/ ! Depression over field iC29 Date of adequacy test a/2.2/d �i .Results(/Fail) • f�..,,,, ' 1 For`_ 3 bedrooms Fluid depth in absorption field before test D in. Water added /s 46gal ? New depth Sit in. Elapse Time: min. : Final fluid depth l : .• A , J A r'S 1 il 3yin. Absorption rate >_ '7V •g.p.d. Any rejuvenation treatment (past 12 mo.), (Y4 type) �� f yes, give date 41,4- 7//o /7Z D. LIFT STATION Date installed _ Size in gall "' Manhole/Access (Y/N) "Pump on" level at in. "Pum • = evel at in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot /4/9 / On adjacent lots _ /41-1 Absorption field on lot / 3-2 1 On adjacent lots //D 1 7,3 Public sewer main Public sewer manhole/cleanout 7" /r''D Sewer /septic service line '' 6' Holding tank f /d Di SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 56 1 Property line yZI 1 Absorption field 45 ' Water main 1 to' Water service line / /e, ' Surface water r` /UO ' Wells on adjacent Tots / /e ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line / 7 Building foundation 6 c' Water main / /D Water Service line 71 /Q ' Surface water f /de' Driveway, parking/vehicle storage d tJ2 ldst) • Curtain drain .7' �p Wells on adjacent Tots 1 /DO " F. COMMENTS. cro Q*bee. +. iorn Wi5 Ape'' F 4PtV ,1 '. ms . F, ivF�.e.4 D .414 Y /3,e "// ,5/7'r1:1, zG Asa G. ENGINEER'S CERTIFICATION /joetiisGi- 1�� /301" -4/ ,3t0/4` I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines'in effect on this date. Engineer's Printed Name Gt ZSi c t I2.C.o\ Date " G io4/604 HAA Fee $ 430 0 o Waive r Fee $ Date of Payment 61710* Receipt Number OH 7 2. (Rev. 12/01) Date of Payment Receipt Number �rz6' "so 'Jo `Gr/ z9ep., 96' AS BUILT I HEREBY CERTIFY •THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: /07"—/ZS4 rEG�prws �1. • AND THAT NO ENCROACHMENTS EXIST—EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HFOR OF FENCE LINES,NOR FORBEDTION ESTABLISHING CBOUND- ARY LINES. SCALE: SEWARD & ASSOCIATES LAND SURVEYING 6 9 4— 0 8 2 DATE: /y GRID: "2-'4" 6sp FB: DRAWN: votior000k ;1rOF A I. ►t a • •• • Duane Mark Seward• 1/ Ls - - 6918 •...!..4!) . 4! 05-27-04 03:31PM FROM -CUE ESI, SGS ENV SERVICES 9075615301 T-539 P.02/03 F-281 SGS' SGS Reta1 Client Name Project Name/At Client Sample ID Matrix PWSID Sample Remarks: 1042857001 Eagle River Engineering TI SN. R2W, Sec 25, Lot 12913 T15N, R2W, Sec 25, Lot 12913 Drinking Water 0 MI Dates/Times are Alaska Standard Time Printed Date/Time 05/27/2004 8:46 Collected Date/Time 05/24/2004 11:15 Received Date/Time 05/24/20`)4 14:36 Technical Director J tephe C. Ede Released r - Parameter Results PQL Waters Department Nitrate -N Microbiology Laboratory Total Coliform 0.987 0 0.100 Units Method Container ID Allowable Prep Analysis [.imus Date Date Inst mg/L SPA 300.0 II (<=10) 05/24/04 JJ co1/100mL SMI8 922213 A (<=1) 05/24/04 DK, Jets Pumping PO Box 773415 Eagle River, AK 99577 (907) 694-6454, (Billing Information 1 Debbie Todd Po Box 770411 Eagle River, AK 99577 (907) 696-2503 Job Site Information Chris w/ Eagle River Eng 15427 Husky Street Eagle River, AK 99577 (907) 343.2937 Service Agreement Number: Order Date: Service Date: Technician: Job Description: 1500g H2O drop + 1000g pump P.O. Number: Terms: Net 30 Salesrep; Nikole Map Book: Cross Streets: James Way Job Comments: Tax Percent: 0 008609 08 -Nov -2002 23 -Feb -2004 12:00 am Tony Job Type: Repeat Map Grid: 66 - - Lest service 11/07/02 1250g —Meet w/ Chris from ER Eng @ 2pm for 500g H2O drop, pump tank— , Service Type Qty Price Each x 2 Men Tax Water Drop 1 395.00 No No Septic Service Under 2k 1 $115.00 No No Additional Location Comments: Red stain w/dark brown trlm, dbl car garage, no #'s, bum barreli in front yard Pipes on front by Spruce trees between the 2 buildings Diagram: Extension Actual 595.00 3115.00 Gallons Planned: 1250 Gallons Actual: Hose Length: Double Tank: D Pump System: 0 Baffles Intet: ❑ Baffles Outlet: 0 NonTaxsbie Total Estimated Charges: $210.00 Actual Charges: Taxable Total 30.00 Customer agrees to the terms and conditions printed on the back. THIS IS A BINDING AGREEMENT. Signature and Title of Customer Representative Tax Total 50.00 Grand Total $210.00 Date Accepted by JRs Pumping Date Accepted For your added convenience we accept Visa and Master Card payments over the phone. Ager 30 Days 1.5% WILL BE CHARGED! 7-i3 APPLIi NT FILLS OUT UPPER HAr ONLY Property Owner �"ss ;jy-� 1 \ ;� i V CJ �'i Mailing Address . 3 , `1 1 I - .'-! Coif i I ,) r 1— Zip Code `/ Ci / Phone L' ' > '� (J.- ..0 Buyer /. Address Zip Code Lending Institution L , 1 r« 1C. (vs(s �, Address . h rc J 0.51r 1 Iii 1,.-I is :_i ll . Zip Code, rtri'= 2 7 Phone 17'V- %!=77 i' ..),.>• Realty Co. & Agent --- /0.— Address - Zip Code Phone Legal Description i. I Jr -I - i 1: C:-.. Street Location ...._ . , , IV r. d €;u _ ; � ._ Type of Residence X7 Single Family ❑ Multiple Family No of Bedrooms - ❑ Other +j BY. aZ'ALV Water Supply .> Individual ❑ Community ❑ Public Utility - - ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log If available). 7 ' Sewer Disposal X3 Individual - ❑ Public Utility 0 Holding Tank Well To Absorption Area 4'49 Well to Tank •-F( pv - �'/1 Year Individual Installed: 1'1 •. When Connected to Public Utility ;-- /-y NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Da / /n _ 7-1) Date Date Date Inspector Inspector Inspector Inspector Field Notes: w___,V 1(�, ) f ///�//q/ 1 ( 3) APPROVED BEDROOMS ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' — DATE el.•—�� '„ 'CONDITIONS OF APPROVAL +j BY. aZ'ALV Soils Rating Date Sewer Installed 7 — € I Well To Absorption Area 4'49 Well to Tank •-F( pv Well Log Received Septic Tank Size /0 Uri 7202313/821