HomeMy WebLinkAboutHOMESTEAD HILLS #1 BLK 3 LT 7Homestead
Hills
lock
Lot
7
015-173
-29
STATE OF ALASKA 13659
DEPARTMENT OF NATURAL RESOURCES
DIVISION OF MINING, LAND & WATER
Alaska Hydrologic Survey
_ o
WATER WELL LOG Revised 08/18/2016
Drillinq Started: / / ComDleted: 11 / 3 / 1979 Pumn Install: /
Cit /Boron h
Subdivision
Block
Lot
Property Owner Name & Address
DALE R 11 C O N N O R,
Municipality of Anchorage
HOMESTEAD HILLS
B3
L 0 7
Well location: Latitude Longitude
Meridian S Township 012N Range 003W Section 22 , SE 1/4 of SW 1/4 of SW 1/4 of NW 1/4
BOREHOLE DATA: (from ground surface)
Drilling method: it rotary, able toolE]Other
Suggest T.M. Hanna's hydrogeologic classification system*
httt)s:HmV.ngwa.org/NC Product?id=a185000000BYub3AAD
Well use:QPublic supply,ODomestic,OReinjection,E]Hydrofracking
El commercial, []Observaflon/Monitoring, []Test/Exploratory,[] Cooling,
D Irrigation/Agdculture,E]Grounding,E]Recharge/Aquifer Storage,
[]Heating, []Geothermal Exploration,DOther
Fluids used:
Depth
From To
Depth of hole: 263 ft Casing stickup: ft
Casing type: Casing thickness: inches
Casing diameter: inches Casing depth: ft
Liner type: Depth: ft Diameter: inches
Note:
Well intake opening type:[. Open end,: pen hole,■ Other
Screen type: , Screen mesh size:
Screen start: ft, Screen stop: ft, PerforatedDYesE]No
Perforation description: Perf from: ft, Perf
to: ft, Perf from: ft, Perf to: ft
Gravel packedE]Yes QNo Gravel start: ft, Gravel stop: ft
Note:
Static water (from top of casing): ft on / / Artesian well
Pumping level & yield: feet after hours at gpm
Method of testing:
Development method: Duration:
Recovery rate: gpm
Grout type: Volume
Depth: From ft, To ft
Include descHption or sketch of well locationinc ude road names,
buildings, etc.):
Final pump intake depth: ft Model:
Pump size: hp Brand name:
Was well disinfected upon completion? Yes J•j No
Method of disinfection:
Was water quality testedfjYes F-jNo
Water quality parameters tested:
Welldriller name: ..................................................................................
Company name: .MOONl7RILLING.........................................................
Mailingaddress: ....................................................................................
+
City: State: AK Zip:
Phone number: ( )
AS 41.08.020(b)(4) and AAC 11 AAC 93.140(a) require that a
copy of the well fog be submitted to the Department of Natural
Drillel's signature:
Resources within 45 days of well completion. Well logs may
be submitted using the online well log reporting system
available at:
https:Hdnr.alaska.gov/welts/
Date:
Anchorage Municipal Code 15.55.060(1) and North Pole Ordinance 13.32.030(D) require
that a copy of this well log be submitted to the Development Services Department/City
within 30 days of well completion.
OR email electronic well logs to
City Permit Number:
Date of Issue:
dnr.water.reports(a)-alaska.gov
Parcel Identification Number:
vuiue for using me nyorogeologic ciassmcation system Tor Logging
Water Well Boreholes by Thomas M. Hanna NGWA Press
Municipality of Anchorage
Development Services Department .~
Building Safety Division
On-Site Water & Wastewater Program, 4700 Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 5
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: OSP101061 PID Number: 01 5--1 7,3--29
Name:
KEITH BARTOW Wastewater System: [] New · Upgrade
Address:
11441 BEAR PAW ST, ANCHORAGE, AK, 99516 ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 762-3125 3 · Deep Trench [] Shallow Trench [] Bed []Mound []Other
LEGAL DESCRIPTION Sol, Roting: Total Depth from original grade:
2.5 (CAT III) GPD/S,. rt. 10 (MAX) rt.
Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe:
5 7 HOMESTEAD HILLS #1 5 Ft. 7 rt.
Township: Range: Section: Fill added above original grade: Grovel length:
SEE DWG. Ft. 55 Ft.
Gravel width: Number of lines: Distance between lines:
WELL: [] New [] Upgrade 2 Ft. 1 - rt.
Classification (Pr'rvate, A,B,C): Total Dep~[:~~ Cased TO:(BEDROCK) Total absorption area: Pipe material:
...--~/ Ft. Ft. 490 se. rt. D 3034/ F-810/SCH 40
Drillen ~'\~',~..3/- Date Drilled: Static Water Level: Installen Date installed:
rt. A+ HOME SERVICES 9/16-17/2010
Pump Set At: Casing Height Above Ground:
GPM rt. Ft. TAN K
SEPARATION DISTANCES [] Septic r-I Holding · S.T.E.P. [] Other*
T~.~'~......~To Septic Absorption Lift Holding Public/Private Manufacturen Capacity in gallons:
Tank Field Station Tank Sewer Lines GREER 1500
Material: Number of comparfments:
Well 100'+ 100'+ - - 25'+ STEEL 2
Surfaoe Water 100'+ 100'+ - - - LIFT STATION
Lot Line 5'+ 10'+ _ size in gallons: J Manufacturer:
- - 1 500 QUANICS
"Pump on" level at: "Pump off" level at: High water alarm at:
Foundation 5'+ lO% - - - TIMER TIMER 44
Curtain Drain ' NONEi KNOWNi . PUmpp_sE_41Make & Model:_T Electrical Inspections performedM. O.k. by:
Remarks: BENCH MARK
Location and Description:
NOTE: OLD TANK WAS ABANDONED IN PLACE PER UPC BOil'OM OF VERTICAL TRIM, SE CORNER OF HOUSE
Assumed Elevation: 100.00 Ft.
ENGINEER'S SEAL/i
Inspections performed by: GEG, Ltd. Dates: 1st 6/16/2010 ~-~CV OF/~m~/_~/~
Development Services Department Approval ( ~ X:_j.',~.~/.-~ ~...~
NUMBER: AS BIJIL DRAWING PARCELID NUMBER:
OSP1 01061 - 01 5-175-29
DRAINFIELDS
CONNECTED AS
RESERVE SITE.
A B
ST1 24.04.21.83
RISER 33.60 27.95
ACL1 132.97 37.05
ACL2 35.00 37.49
JV 38.51 38.99
DVR 40.57 40.34
C01 41.20 41.02
C02 40.44 40.00
C03 59.11 54.39
MT1 58.48 53.63
C04 31.88 41.55
SCALE:
I I
1" = 30'
DOUBLE
CLEANOUTS
EXISTING 3
BEDROOM HOUSE
NEW 1500 GALLON
S.T.E.P. TANK
NEW DRAINFIELD
NOTE: APPROXlMAIE LOC^lION OF WATER
100' WELL RADIUS
NO ." ." '~. '.' ..:
DIVERTER ~.':, .-i ~.:-. ,~
TH# · '~;
· .;,. '., ';~ :'-~
,l .:- -~"" ''. !.'..
: . .., '!..:..~ ', · '
~: i'.,. ,:.
'..: .: ,...;..,.~'
GARAGE W/
OFFICE -' '-' :~'. ~ '" ' ,..
. ~,...~..'?.":
OF WORK:
AS-BUILT DRAWING OF NEW SEPTIC SYSTEM
I 6/25/2010
(Rev. 01/05)
PERMIT NUMBER: AS BUILT DRAWING PARCEL ID NUMBER:
0SP101061 - 015-17,.529
FINAL GRADE ='-~ TOP OF MAN ~ JANDY VALVE 650 QUANICS
= 101.07 ~ AEROCELL
. - . . ... . .~ . .... . . .~ _ ~.
TOP OF TANK
'NL~ = 92.00~
~~ ~~~~INFIELD
INL~ = 91.52 ~ J OUTL~ = 92.00 TO THE DRAINFIELD
1500 GALLON 10 GAUGE S~EL- ~ ~ WITH 4" INSU~TION
DEEP BUR~L S.T.E,P TANK -
/
MT 0
FINAL G~DE = ~ POINT
103.86-104.34 ~ ~ ~ ORIGINAL G~DE =
~ RESTIVE EL~ATION OF
GROUNDWATER = 87.5~
~ RESTIVE EL~ATION OF BOSOM
OF TESTHOLE = 86,0~
~.~ ~o.: ~.o.~ .~.~: ~ .~.~: ~1.1.1~ ...... ~ ..... :....~
K~T, ,ARTOW I C/O AO~NT I
L~AL DESCR~.T~ON: DRAWN BY: ~%l/'~vc~--~ '" Z~/
DESigN Or PROPOSED SEPTIC SYSTE~ ~/2~/20~0
(Rev. 01/05)
06/22/2010 13:25 8686~70 APLUS
CUN-~-~OI~ I~:~SP FROM:ED $ ~L~CTRTC~p,~tio~INC ~ 459~ Repo~tTQ:868~??O
Municipality of Anchorage, Building Safety Division
4700 Elmore Road
iN;~O & HELP (907) ~43-8211
INSPECTION: VOICE (907) 343-1~300. FAX (907)249-7777. www.muni~org
PAGE
P.1
Name same
Cempany sds electric
Address 11441 BEARPAW ST
Grid SW2636
Subdivision HOMESTEAD' HILLS #1
Work Deecrlptton septi.c lift. station
Insp. ;3erformed/pre%id 2 / 2
Permit Technician BARGANIER, TONY
Comments or DireCtions call to meet AM
Permit # I 0.7757
Inspeetion Date 22,Jur~-2010 AM
I=hone 272-4591.
LOT 7 BK 3 TR n/a
Inapeetio, n Type Electr!cahRetro Electrical
Comments (for inspector uae only)
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: OSP101061
Tax Code Number: 01517329000
Work Type: Septic
Permit Effective Dates: June 11, 2010
Design Engineer: GARNESS ENGINEERING GROUP LTD
Subdivision: HOMESTEAD HILLS #1
Site Legal Address: HOMESTEAD HILLS #1 BLK 3 LT 7
Owner/Address: BARTOW KEITH JR 50% &
Upgrade
to June 11, 2011
Department
G:2636
STACK TAMRA T REV TRUST STACK TAMRA T/TR 6443 LONE TREE CIR ANCHORAGE AK 995076940
Site Mailing Address: 11441 BEARPAW ST, Anchorage Lot Size in Sq Ft: 53466
Total Bedrooms: 4
This permit is for the construction of:
Y Disposal Field Y SepticTank 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.
Received By: ~--'--~..~
Issued
Date: L//~/'//O
Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Bragaw St.
P.O. Box 196650
Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
o_~P lO~o ~ I
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015-17.3-29
Property owner(s) KEITH BARTOW
Day phone 727-7077
Mailing address
644.5 LONE TREE CIRCLE ANCHORAGE, AK * 99516
Site address 11441 BEAR PAW CIRCLE * ANCHORAGE, AK Zip Code 99516
Legal description (Sub'd, Block & Lot ) HOMESTEAD HILLS S/D #1; BLOCK .5, LOT 7
Legal description (Township, Section & Range)
Lot Size ~'~, L~ ~ ~ Sq. Ft.
N/A
Number of Bedrooms
4
THIS
APPLICATION IS FOR ( [~all that apply):
Absorption Field []
Septic Tank []
Holding Tank []
Privy []
Private Well []
Water Storage []
THIS APPLICATION IS AN:
Initial []
Upgrade []
Renewal []
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal codes.
GARNESS ENGINEERING GROUP, Ltd.
Permit/Rush Fees: 5 ~ L7
Date of Payment: f~/~'///0
Receipt Number: ~ V 5 ~'/ i ¢1
(Rev. 11/05)
Waiver Fees:
Date of Payment:
Receipt Number:
GARN-ESS ENGINEERING GROU?, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
May 27, 2010
Municipality of Anchorage
Development Service Department
On-Site Water & Wastewater Program
4700 Elmore Road,
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907) 343-7904
Ref: Proposed Septic Upgrade for Homestead Hills S/D #1; Block 3, Lot 7,
To whom it may concern:
The existing 3 bedroom house and additional office are served by a private well and septic system. The
septic system is in a state of failure and needs to be upgraded (both the 1979 trench and the 1994 trench
are grossly surcharged). We are proposing to install a new 1500 gallon S.T.E.P. tank with Quanics
controls and floats, and a deep trench type drainfield. One test hole was excavated on the property. The
drainfield will be designed around the 30 foot radius of this test hole. Comments regarding the design are
summarized as follows:
1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the
percolation test results.
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system.
4. TOPOGRAPHY: As can be seen on the attached design drawing the average topography below the
drainfield is a 10-15% percent slope running approximately southeast to northwest. In short, there are no
slope concerns.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems.
If you have any questions, please contact us at 337-6179. Thank you for your assistance.
i ,P.E., M.S.
resid
NOTI: 4ttached is a site plan drawing, a design drawing, one soil log, which are all part of the design package for
this septic system. (Contact G.E. G. Ltd. for 7page construction specification letter.)
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com
II I / I \ HOMESTEAD ~ I HOMESTEAD
I II I / I / HILLS#I BLOCK 3, i~ tHILIS#1 BLOCK
I ~, ~ / ~o~ ~/~ ~o~
, II I / ~ ~ ........ ~PTIC AR~I I I W~O
~ / Ill / /~~;~ SYSTEM /~J;~~/ / / ~~~~ XX~
~ II HOMEST~D
Ill
' III ~~[ X /~ ~I~LS~I BLOCK
Bo
CONCERN
- III XX
I II I TALUS WEST~2 ~ ----~ ~
I II I BLOCK 4, LOT 11 / .............. ~ TALUS WEST~2
' ~, / ~;;~.;t;;';o~ ~lO~ .. lOt ~
/
I ~~~ ~00' WELL _ ~1 ~~
II , II ~ ~q ' / / /
, ~ II I
I I II I / / //
GAINES g~ '
o ~ c o~s ~... .j..'lT.~.l...~.~ ....... : ....
PREPARED FOR I PHONE NUMBER- I PAGE NUMBER: ~., .14..~ ~ ....... ~ ............
~;,: ~,~,o,: ~w, ~: ~'~~..~. --~,/tl I ~7~5~ ... ~.~/
SITE PLAN 5/27/2010
(Rev. 01/05)
!
DESIGN CRITERIA:
NUMBER OF BEDROOMS: 4
GALLONS PER DAY (GPD): 600
PERCOLATION RATE/S: B & 120 MIN/IN
PROPOSED APPLICATION RATE: *2.5
MINIMUM DRAINFIELD SQ.FT.: 240
*ADVANCED TREATMENT SYSTEM
DRAINFIELD DESIGN:
MAXIMUM DEPTH: 10'
WIDTH: 2'
LENGTH: 35'
M.O.A. APPROVED SAND FILTER: N/A
EFFECTIVE: 7'
REDUCTION FACTOR: N/A
ACTUAL SQ.FT.: 490
NOTE: GARAGE HOUSES a
SMALL OFFICE. DESIGN
WILL ACCOUNT FOR AN
EXTRA BEDROOM TO
ACCOMODATE THIS.
JgEG, Ltd. HAS A 7 PAGE SPECIFICATION
JLETTER THAT PERTAINS TO THIS DESIGN.
! TO OBTAIN A COPY OF THE LETTER
CONTACT GEG. BY PROCEEDING FORWARD
JWlTH THIS INSTALLATION, THE ENGINEER,
I WELL DRILLER, CONTRACTOR AND
IPROPER3Y OWNER AGREE THAT THEY
]HAVE READ THESE SPECIFICATIONS AND
AGREE TO ACCEPT THE TERMS AND
CONDITIONS OUTLINED.
FLAGGED BY A REGISTERED LAND
SURVEYOR PR,OR TO CONSTRUCT, ON. I
CONTRACTOR SHALL HAVE THE WATER
SERVICE LINE BETWEEN THE HOUSE I '~ I
AND THE GARAGE PROFESSIONALLY J~
Prior TO CONSTRUCTION~ I
EXISTING DRAINFIELDS TO BE
CONNECTED TO AS RESERVE SITES
/
/
/
/
/
INSTALL FLOW
DIVERTER
AEROCELL
BEDROOM
HOUSE
PROPOSED 1500 GALLON
S.T.E.P. TANK W/ QUANICS
CONTROLS/FLOATS
RECIRCULATING LINE
100' WELL RADIUS
REMOVE EXISTING
SEPT C TANK
100' WELL RADIUS
PROPOSED DRAINFIELD
;ii.:': ": I"' .°
GARAGE W/
OFFICE
NEW TRENCH
35' LONG
GARN'ESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS '/'
3701 E. TUDOR ROAD, SUI3E 101 * ANCHORAGE, AK 99507 * PHONE (907)337-6179 * FAX (907)338-3246 * WEBSITE: 'eww.gameseenglneerlng.com
PREPARED FOr: I PHONE NUMBER: I PAGE NUMBER:oF 4 i
HEITH BARTOW I C/O AGENT 2 JDRAWN BY:
LEGAL DESCRIPTION:
TYpEHOMESTEADoF WORK: HILLS #1; BLOCK .3, LOT 7 IDATE~SI A.J.G./ ~
DESIGN OF PROPOSED SEPTIC SYSTEM 27/2010
(Rev. 01/05)
SCALE:
I
1"= 40'
y a ness.-'
r~ __~jg~r n ..s..-'.~q.~/
I/ HILLS#I BLOCK 3, /
I ~!/ ,OT~ / ~
I /~ ~ / ~ /' x ~o~~--"~ .....
J ~ ~ /~ ~ j w ~~ ~ / ,~ ~ ~--~ ~ ~ LOT 12
~ ', ~ iii , ~ PT /7 ,'} ~ ~,,~o~o~c~
- ~ ~ / '~ ~ / // / / I ~',
~ ~---~~~-~-~:~---~ ...... t,t~ ....
I ~1~ / ~
, ,, / / /
I J I I
I
I ~ I I E.,
~ ',
KEITH B ~ ~ '.
LEGAL DESCRIPTION: ' ' DRAWN BY: ~/~. /CE~gS~ .-'
. .. -7~.
HOMESTEAD HILLS ~1 BLOCK 3, LOT 7 A.J.G. ~~"~.~ ~-"~/
~PE OF WORK: DATE:.. ~~o fe ss~~
TOPO DRAWING OF SITE 5/27/2010
(Rev. 01/05)
GARNESS ENGINEERING GROUP, Ltd. /~5.~4~-T~ ~ '"'X~,I'
CONSULTANTS & GENERAL CONTRACTORS
p . Ol tio. ...... """"'"" ....
PERFORMED FOR: KEITH BARTOW DATE: 5/25/2010
DEPTH ~
(feet) ORGANICS TEST E N C H
HOLE #1 UPPER B
i SOIl_ CI_ASSIFICAIIONS
~ GW =~~~; ORG ~ C-~SEPT? AREA
GC OL
o o~ SW NH
~ SP CH
S[vl OH
SC
DEPTH TO DATE
GROUNDWATER
DRY 5/25/2010
15.5' 6/1/2010
/
10 / 1" = lOO'
11 DATE READING CLOCK NET TINE WATER LEVEL NET DROP
TINE (PIINUTES) READING (INCHES)
ML 5/26/2010 1 1:10 - 6,, _
12
2 1:40 .30 1"
13 .3 1:40 - 6- _
4 2:10 30 2 1/4" 3 3/4"
14 5 2:10 - 6- _
6 2:40 .30 2 1/4" 3 3/4'
15
16
17
18
19 PERCOLATION RATE 8 (NIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN .3.0 FT. AND 4.0 FT.
20 A FOUR HOUR PRESOAK WAS PERFORHED: · YES [] NO
SOILS LOGGED BY: ROB CAMPBELL PERCOLATION TEST PERFORMED BY: ANDREW GRAY
CONP1ENTS:
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WASj PE/RFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: ~: ]Ir',
DEPTH TO
GROUNDWATER DATE
DRY 5/25/2010
15.5' 6/1/2010
ORGANICS
TEST HOLE #1 LOWER BENCH
GARNESS ENGINEERING G'ROUP, Ltd.
3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK. 99507 * PHONE: (907)357-6179 * FAX: (907);~58-3246 * WEBSITE: gamessengineering.com
LEGAL DESCRIPTION:
PERFORMED FOR:
GM
ML
SOILS LOGGED BY:
COMMENTS:
SOIL CLASSIFICATIONS
GW
GP
GM
GC
SW
SP
Shl
SC
ORG
ML
CL
OL
MH
CH
OH
DEPTH TO DATE
GROUNDWATER
DRY 5/25/2010
15.5' 6/1/2010
~SEPTIC AREA
/
/
/
/
SCALE:
I
"= 100'
DATE READING CLOCK NET TIME WATER LEVEL NET DROP
TIME (MINUTES) READING (INCHES)
5/26/2010 1 1:10 - 6- _
2 1:40 ..'50 5 5/4" 1/4"
3 1:40 - 6,, _
4 2:10 30 5 5/4" 1/4"
5 2:10 - 6,, _
6 2:40 30 5 3/4" 1/4"
PERCOLATION RATE 120 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 6.5 FT. AND 7.5 FT.
A FOUR HOUR PRESOAK WAS PERFORMED: 1YES [--]NO
ROB CAMPBELL PERCOLATION TEST PERFORMED BY: ANDREW GRAY
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS iPER~-ORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: ~/.:,/'2.,/J~
oJ
-"< ~
rq
I
t_ I
-~ 0 0
0
-q
//
IDRAWN BY:
DATE:5/27/2010 I PNB
LEGAL DESCRIPTION:
HOMESTEAD HILLS #1; BLOCK 3, LOT 7
TYPE OF WORK:
DESIGN OF QUANICS AEROCELL SYSTEM
PREPARED FOR:
KEITH BARTOW
JPHONE NUMBER:
T
Z
r--
c_-~m
>. r-'-
--< ._~
f~
m
727-7077 I
Municipality of Anchorage Page
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number.~Sb~ O Iq l PID Number: (:~1~'- I::~"~-~-'~'
Name:
~ c ~ ~o~ Wastewater System: D New ~Upgrade
Address:
//~ ~l ~~ ~ ~ ~ ~/~ ABSORPTION FIELD
Phone:~ ~--~ No. of Bedrooms:~ ~Deep Trench ~ Shallow Trench ~ Bed ~ Mound ~ Other
LEGAL DESCRI PTI O N so, Rating: Total Depth from original grade:
Lot: Block: Subdiv~ion~~ ~' ~ ~ GPD/Sq. Ft. ~ -- ~
Depth to pipe bosom from original grade: Gravel dept~be~eath pipe
Township: Range: ~ Section: Fill added above original grade: Gravel length:
-- ~ ~ Ft. ~1 Ft.
I
WELL: D New ~ Upgra~ Gravel width: , Number of lines: Distance between lines:
Classification (Private, A,B,C): ~ Cased To: Total absorption area: Pipe materiaJ:
Driller: /~~ Date Drilled: Static Water Level: Installer: Date inst~l[ed:
Pump Set at: ~ Casing Height Above Ground:
TANK
SEPARATION DISTANCES ~Septic ~ Holding : S.T.E.P.
TO Septic Absorption Lift Holding ~ublic/Privat( Manufacturer: Capacityin gallons:
From Tank Field Station Tank SewerLines ~C[~ ~ ~ $ ~ ~
Material: Number of Compa~ments:
Wel~ /~ ~ ~ ~ /~~ ~anufacturer: ~
Sudace
wa~ /~+ /~+ LIFT STATION
Lot ~ t Size in gallons:
Line /~ ~
Foundation ~ ~ ~ "~mp on" level at: ~1 at: High w,tot alar~ at:
BENCH MARK
Remarks: ~,~ ~~
Location and Description:
Assumed Elevation:
~t,
Inspections pedormed by: ~,~~:~,~ Dates: 1st ~[~llq&
Depadment °' He~/~~a~ ~es ap~r~l/~
Reviewed and approved by: ~'~ ' (Date: ~
72-013 (Rev. 9/91) MOA 25
AS-BUILT
WASTEWATER ABSORPTION SYSTEM
Lot 7, Block 3 Homes'l;ec~d HI(ts S/I), No, 1
proper~y-Llne
C,n, A C ' B,"',"
FC ~g,~" ~.4"
T~ 11,9~ ~.0'
DV 1~.3~ a7.3'
~C1 1E.9' ~8,~'
C1 ~5,0' 46,5'
C~ 97,3' 113,8'
~T B4,7' 99.8
E1 B3,3~ 110,6'"
Lo~ 6, Block 3
Nee sys~en,
6' eFFect;Ire; 85'
Nelloors well Is
Loc~ed g~'e~t:er'
~h~n 100' ~rom
~he new system
Lot; 8, ~ock 3
Do~ole
Cle~n-ou~s
Nelbors well Is
located greater
th~n 100' FPom
~he new system
Lo~ 6 Is
~tong
edge,
e~$~
house
Septic ~Q~
Lo~ 7, IRock 3
Homes~eAd Hills No.1
L%
]Or~wlng C,SWorkX,7-3HMSTB,dw
Soils= 333 s?/br
3 Bedroom House
1000 SF Rqd
DESIGN, 6' E?Fec'tlve
9' To~L Depth
2' Wide, 85' Long
To~t Absorption = 1020
PREPARED FOR,
Mr, Scott Conner
11441Be~rpcw Ro~d
Anchor~oe~ AK 99516
(907) 346-1998
P~nnone Eng. Svc,
P, 0, BDX 142025
ANCHDRAGE. ALASKA 99514
878-8818~ 878.8818 FAX
DATE, 8-31-96 ] AS-BUILT
CALE, I'=60'
t
AS-BUILT DETAILS
WASTEWATER ABSORPTION SYSTEM
Lot 7, ])lock 3 Homestead HItLs S/D, No,
lflDN¥3q3
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lnaN¥393
i,i
1ABN¥393
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lnDNV393
lfllC]N¥393
ND~I¥~NflD3
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PREPARED FOR'
Mr. Sco~t Conner
11441Be~rp~w Ro~d
AnchorcQe, AK 99516
(907) 346-1998
P~nnone EnQ. Svc.
P. D, BOX 142025
ANCHORAGE, ALASKA 99514
874-0308, 272-8218 FAX
DATE, 8-31-96
NOT TO SCALE AS-BUILT
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM UPGRADE) PERMI
PERMIT NUMBER:SW960191
DESIGN ENGINEER:STEVEN R. PANNONE
OWNER NAME:CONNOR DALE R II & SUSAN L
OWNER ADDRESS:il441 BEARPAW ST
ANCHORAGE, AK 99516
PARCEL ID:01517329
PAGE 1 OF ;
%~C~ ,4%
DATE ISSUED: 7/11/96
EXPIRATION DATE: 7/11/97
LEGAL DESCRIPTION:
HOMESTEAD HILLS #1 BLK
3 LT 7
LOT SIZE: 53466 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK 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 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED BY.~.~ ~
I ssumD BY:
ENTER SEWERLINE FROM SEPTIC TANK AT OR NEAR
MIDPOINT OF DISTRIBUTION LINE.
IF EXISTING TANK IS FOUND TO BE OF GOOD
INTEGRITY AND IS TO REMAIN IN SERVICE, THEN
A SECOND COMPARTMENT CLEAi~OUT MUST BE INSTALLED.
INSTALL BARRIERSOR W?tATEVER IS NECESSARY TO
PREVENT DRIVING OR PARKING ACCROSS THE TRENCH.
DATE:
Steven R. Pannone, P.E.
Consorting Engineer
(907) 272-8218
P.O. Box 142025
Anchorage, Alaska, 99514
(907)272-8218 Fax
June 30, 1996
Municipality of Anchorage
Dept. of Health & Human Services
On-Site Services Section
P. O. Box 196650
Anchorage, Alaska 99519
Subject:
Lot 7, Block 3 Homestead Hills No. 1 Subdivision
Upgrade Permit
Gentlemen:
My firm was contacted to investigate the possibility of installing of a replacement system at the above
referenced property. The existing trench type system has failed. The owners report slow draining of the
lower fixtures and minor backing-up of the drains. The system was installed in 1979. I was requested to
investigate the possibility of installing a new system adjacent to the existing system. A single test holes was
excavated on June 24, 1996. The soil report and percolation test results are attached. Additional soils will
be verified at the time of installation. No ground water was encountered.
The lot is approximately an 1.25 acres in size. It slopes to the north at a rate of approximately one to three
percent. The proposed installation will be located greater than 100 feet away from the well and 25 feet from
the water service lines. The surrounding systems are located greater than 100 feet from the proposed
installation. Both neighboring wells are located greater than 100 feet from the proposed system. The
existing septic tank will be inspected and if found competent, reused. A new tank will be installed if the
existing tank is not found competent. The existing soil absorption field will be reused. A diverter valve will
be installed between the septic tank and the two drain fields. The new drain field will be selected for use.
If you have any questions about the proposed installation, please contact me at 272-8218
Sincerely,
one, P.E.
Attachments:
C:\WORK~7-3HMSTD. 001
DESIGN
WASTEWATER ABSORPTION SYSTEM
Lot 7, ])lock 3 Homesteacl HIlts S/D, No, 1
Addl~lon~t solts
Lo~¢ 6, ~tock 3
Lo-l: 6 Is
~led~oo~
Lo~ 8, ~lock 3
Nelbors well Is
loc~ed
~h~n 100' From
the proposed
system
Lo't; 7, ~llock 3
Homest;eo, d Hilts No,I
~%
])r~wlng C,\Work\7-3HM~TD,dw
Soils= 333 s?/br
3 Bedroom House
1000 SF Rqcl
DESIGN, 6' E??ective
9' Total Depth
2' Wl~e, 85' Long
Tot:( Absorption = 1020 sF
PREPARED FORm
Mr, Score Conner
11441Bearpow Road
Anchorage, AK 99516
(907) 346-1998
P~nnone Eng, Svc,
P, D, BOX 148025
ANCHORAGE, ALASKA 99514
872-8218, 272-8218 FAX
I]ATE, 7-1-96 I DESIGN
$~ALE' 1'=60'
I
DESIGN DETAILS
~/ASTE~/ATER A}ISDRPTInN SYSTEM
Lot 7, Block 3 Homes'be:d Hills S/I), No, 1
Z
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PREPARED FOR,
Mr, Scott Conner
11441Bearpow Road
Anchorage, AK 99516
(907) 346-1998
.J.r~DN¥393
InDNV3'13
NDI / VlINfln-~
P~nnone Ems, Svc,
P, [], BOX 142025
ANCHORAGE, ALASKA 99514
274-0308, 272-8218 FAX
I)ATE, 7-1-96 I
NOT TO SCALEI DESIGN
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
DATE PERFORM
LEGAL DESCRIPTION:
6
7
8
9
10
11
12
13
14
15-
16
17-
18-
19-
20-
COMMENTS
Township, Range, Section:
SLOPE
WAS GROUND WATER
ENCOUNTERED?
S
L
IF YES, AT WHAT ~ O
DEPTH? p
E
Depth to Water After
Monitoring?
Date:
SITE PLAN
Gross Net Depth ~o~' Net
Reading Date Time Time Water Drop
PERCOLATION RATE __
TEST RUN BETWEEN __
(minutes/inch) PERC HOLE DIAMETER __
FT AND "~ ET
PERFORMED BY: ~:), ~-_~;~ ~.~j~J(~ e~. { ~;::>- ~-, I - -~'~'~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~__~4/'_c~,
72-008 (Rev. 4/85)
MUNICIPALITY OF ANCHORAGE
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
PHONE
NAME
LEGAL DESCRIPTION
Well Absorption~a~e , Dwelling
D~STANCE TO: I ~0f-e]CCDE-~--D
Manufacturer ~ Mater~
Liq. cap, acity in gallons I ........ Inside length
ManCr ~ ~ ~ ~M~~ ~
DISTANCE TO: F~n~i~ iO [~ot li~ W
No. T~f lin~ ~ Trench width,
Top of tile to finish grade
Material beneath tile
Length Depth
eter
Depth Driller
DISTANCE TO: Building foundation
NO. OF B~,~ROOMS
PERMIT NO. 3..-~
No. of c~..partments
Liquid depth
PERMIT NO.
A ~
PERMIT NO,
Distance betw~l I~s
Total effective absorption area
PERMIT NO.
depth
Totel effective absorption area
OTHER
PIPE MATERIALS
SOl L TEST R,.~,TI NG
PERMIT NO.
Sewer line Septic tank Absorption area(s}
6::; :[ GNE[):
I"ILi f-.i I C: T F'RL_ .-[ T'-r' ElF RN,2':F-'ICI~ F-". t--'tlGE
DEPRRTI"IENT,;'~] HERLTH AND ENVIRONMENTRL/-~E~TECTION
'-' .... L. _,TREET., RNL,.HERIRL~E~ Af ...... ..~.~± .'/) . --
'. L-Iii . b RI'-.ID OI'-.I--S I TE SEI..-.IE-ZF-: F'ERM I T
PERM I T NO. ( ) 2 ~ ~¢- ~a G y'
LEGAL Z_ ~ ~ % ~/~4~¢._c~ ~ LOT SIZE~-4 c/~¢ SQLIRRE FEET
TYPE OF SOIL RBSORBTION SYSTEM IS' ~ ~
MAXIMUM NLIMBER OF BEDROOMS = ~ SOIL RATING <SQ FT,.."BR)= :~'~
- ~/~-' '~ -. '-- , 7~_, .
THE REQUIRED SIZE OF. THE _OIL RB_~URPTION. SYSTEM IS:
[:,EPTH= / LEI'-.iuTH= /2(~ 6RR%~EL [:,EPTH=
THE LENGTH DIMENSION IS THE LENGTH (iN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND aND THE BOTTOM OF THE EXCaVaTION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OLITFRLL PIPE
aND THE BOTTOM OF THE EXCRVRTION (IN FEET),
._ EPT' I C: TAN[--.' _~ I ZE: /} 0 ~ ,3RI_LO~$
PERMIT aPPLICaNT HaS THE RESPONSIBILITY TO INFORM THIS DEPRRTblENT DURING THE
INSTaLLaTION INSFECTILN~ OF ANY WELLS ADSRCENT TO THIS PROPERT? aND THE
NUMBER OF RESIDENCES THaT THE t4ELL WILL SERVE.
TI-,.IC~ ( 2 ) INSPECT I Ell'4_ aRE REQU I RED
BACKFILLING OF ANY SYSTEM WITHOUT FINFIL INSPECTION AND APPROVAL BY THIS
~ _
DEPARTMENT WILL BE _UBJECT TO PROSECUTION
MINIMUM DISTANCE BETWEEN R WELL aND aNY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR 8 PRIY~TE WELL; OR
i50 TO 200 FEET FROM A F'UBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL.
WELL LOGS 8RE REQUIRED 8ND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DaYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MaY aPPLY. SPECIFICATIONS aND CONSTRUCTION OlRGRRMS aRE
aVaILaBLE TO INSURE PROPER INSTALLATION.
PER~I I -F E~:F' I RES [)ECEMBE~:--~-±~' ..... 19-79
I CERTIFY THaT
l: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MLINICIPALITY OF aNCHORaGE.
2; I WILL INSTALL THE SYSTEM IN RCCORDANCE WITH THE CODES.
~: I UNDERSTAND THaT THE ON-SITE SEWER SYSTEM MaY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THaN ~ BEDROOMS.
Y3. 2
MUNICIPALITY OF ANCHORAGE'=
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6-650, Anchorage, Alaska 99S02 276-222~
SOILS LOG -- PERCOLATION TEST
PERCOLATION
TEST~
'PERFORMED FOR:
· LEGAL DESCRIPTION:
SLOPE
DATE PERFORMED: /O-/, ,~:~',
SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Gross '" Net ' Depth th: '" ;;~::'l~et ' 'J.'
Reading Date Time ', Time , Water ." -~ Drop, :'.:
.~. ~ ~ ~.,", ~
. ~, ,7~: "''"r '~
PERCOLATION RATE
TEST RUN BETWEEN
.' ~. ·~PERFORMED B'~: ~
CERTIFIED BY:
~ ~ I DATE RECEIVED
TIME, ~ /~1 TIME
TIME
INSPECTOR
INSPECTOR ,NSPECTOR~ ~
,MUNICIPALITY OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE DEPT. OF
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECT~,)'~4/IRONME;J,I,.L ;;,, 'i~CTION
825 L Street - Anchorage, Alaska 99501
ENVIRONMENTAL SANITATION DIVISION ,~\~R ~ ~ ,~U
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SE
DIRECTIONS: Complete aH parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTY OWNE/~ ~. PHONE
PROPERTY RESIDENT (If different from above) PHONE
2. BUYER PHONE
MAILING ADDRESS
4. REALTOR/AGENT PHONE
MAILING ADDRESS
5. LEGAL DESCRIPTION i(~
6. TYPE OF RESIDENCE ~ SINGLE FAMILY
[] MULTIPLE FAMILY
NUMBER OF~BEDROOMS
[] One [] Four
'~ Two [] Five
[] Three [] Six
[] Other
7. WATER SUPPLY
INDIVIDUAL~
[] COMMUNITY
[] PUBLIC UTILITY
*ATTACH WELL LOG. Awell log is required for all wells drilled
sihce June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
~ INDIVIDUAL/ON'SITE~*
[] PUBLIC UTILITY
YEAR ON-SITE SYSTEM WAS INSTALLED.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
~ SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVI DUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified INSTALLER
[]Septic Tank. or E~] Holding Tank
Size: /~-~'"~ If Tank is homemade SOiLSRATiNG
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES Septic/Holding Tank IAbsorption Area Sewer Line I Nearest Lot Line
I
WELL TO:
Absorption Area to nearest Lot Line
5. COMMENTS
[~'"~APPROV ED FOR ~/~BEDROOMS
[~ ~i0s~ADp:'I'~O0~ APP R 0VA L (letter must acc°m~rtificate)
This well is~produci~g -
gallons ,~vater per hour.
SR B~3X 668, BOGARD ·
PALMER, ALASKA 99645
TELEPHONE 745-4071
Set pump ~'~-- feet.
INVOICE NO._
DATE
YOUR P, O. NUMBER
TERMS
SALESMAN
WE LL LOG
Lot , ,RIK ,~uo ,
DEPTH )EPTH DEPTH CABIN FORMATION
IN FT. CABIN FORMATION IN FT. CABIN FORMATION IN FT.
4.-~ ~105~ 205
9~ ~110 ~210
~11 ~ ~112 ~212--
~117 ~217~
._22~ --123 --223--
24 -- --225--
--126~ ~226--
26
--128
__29 --130~ --230
._81 ~132~ 232
~32 ~133 ~233
~B3 ~134 ~234--
~S4~ ~135 ~235--
~35~ --136 236
__36~ ~137-- ~237--
~87 ~138~-- --238--
39 --140--~ 240
~42~ ~142~ ~242--
--144 244--
~45 --146 ~246
47 ~148 -- 248~
~48 ~14B-- --249
~49 ~150-- --
~50 151 2§1
--§1 152 252
~52 153 253
~BB 154--: '254
~54 '155 255
~§5 156 256
~56 157 257
57 158 258
~58 159 259
~59 160 260
~60 161 261
~ ~61 162 262
62 163 263
~~63 164 264
65 166 2S6
-=66 167 '267
67 168 268
~68 269
----69 160
170 270
71 172 --272
~73 173 ~273
~74 174 274
175 '275
75 176 276--
~76 177 277 --
~77 178 -- 278,
~78 279
~79 179
180 '280--
~80 181 281
~81 182 282~
~82 283
~88 183
184 284 ,
94 285
~85 185
186 286
~86 187 287
189 289
~89 190 290-- --
~91 192 292
92
~93 193 203
~94 194 294
195 -- 295--
~95 196 296
~96 197 -- ''297
~97 198 ..... 298
----98 ~99 -- ~299
~99 200 300
lO9
PLEASE PAY FROM THIS INVOICE ~o, foot AMOUNT
GE BV
• -� Municipality of Anchorage �°H314`a
On -Site Water and Wastewater Program v
(907) 343-7904
Parcel I.D. 015-173-29
Certificate of On -Site Systems Approval
Expiration Date: 3 2 0Z
1. GENERAL INFORMATION:
Complete legal description HOMESTEAD HILLS #1; BLOCK 3, LOT 7
Location (site address) 11441 Bearpaw Street *Anchorage
Current Property owner(s) Jeremiah & Bettina Thibodeaux Day phone 947-5291
Mailing address
Real Estate Agent
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
Day phone
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
®
Individual
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver/Variance request for:
Distance:
Received by:
Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 5-5-0 Waiver Fee $ _
Date of Payment �J o2 02 D Date of Payment
Receipt Number 0 y 05 Receipt Number
COSA # Q 5 G 221 O 6% Waiver #
rk
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: _Gamess Engineering Group Ltd (GEG) Phone: 907-337-6179
Address: 3701 East Tudor Road, Suite 101- Anchorage Alaska 99507
Engineer's Printed Name: Jeffrey A. Garness
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system
in accordance with the guidelines and regulations established by the Municipality of Anchorage and
industry practices, The reported results describe the condition of the system/s on the date/s of the
evaluation. Separation distances were measured to readily identifiable features. Hidden defects or
encroachments may exist that were not identified during the evaluation. The operational life of all wells
and septic systems depend upon a variety of variables, including but not limited to, soil conditions,
groundwater levels (that may fluctuate during the year), quality of construction (materials and
workmanship), and the water usage of the family utilizing the system/s. These -conditions can vary, and
are outside the control of GEG. Satisfactory test results do not guarantee future performance of the
system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of
the well or septic system. GEG makes no representation whether an alternative well or septic system
can be installed on the property in the event either of the current systems fail to perform adequately in
the future. The content of this report is for the sole benefit of the person/party that retained GEG to
perform the evaluation. Reliance upon the information provided in this report by any other person or
6. DSQ SIGNATURE ?
System #1 Approved for 3 bedrooms
System #2 Approved for
Disapproved
Conditional approval for
bedrooms
bedrooms, with the foll
Date: i )27,
ON
so
uInsti�h'gN�
By V r Original Certificate Date:
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an Independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
rd
Legal Description: HOMESTEAD HILLS #1; BLOCK 3, LOT 7
Parcel ID: 015-173-29
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 5.2+ gpm
Date drilled ""3R9 Water storage tank volume N/A gallons
Total depth 263 ft Well disinfected for coliform test? ❑Yes Fol No
Cased to UNKNOWN ft
❑ Coliform bacteria is Negative
1
❑ Sanitary seal is functioning correctly Dll� Nitrate � .3,mg/L ess-thanrMRt-(Nth)
❑ Wires are properly protected L Arsenic ug/L 1 ❑ Arsenic less than MRL (ND)
Casing height (above ground) 12+ in. Collected by GEG, LTD.
Date of flow test for COSA 2/16/22 Date of Sample
Static water level at beginning of test 230.4 ft
Comments *PER 2010 COSA - DATE IS ILLEGIBLE ON WELL LOG
B. TANK DATA
Age of tank(s) 12 years
Tank type/material STEEL
Measured operating fluid level in septic tank -
❑ Standpipes/foundation cleanout per record drawing
Date of pumping SEE ATTACHED MAINTENANCE
D. ABSORPTION FIELD DATA DEEP TRENCH
2/16/22
C. LIFT STATION
N Required maintenance completed
Age of lift station 12 years
Lift station material STEEL
Comments: QUANICS
Which system tested (date installed) 6/17/10
Adequacy test date 2/16/22
❑ ALL standpipes present per record drawing
Results Q Pass For 3 bedrooms
Total measured depth from grade "10.4 ft (max)
Fluid depth prior to test 0 in
Measured depth to pipe invert from grade '3.41 ft (min)
Water added 635 gal
❑ N/A — pressurized field
33
❑ Monitor tubes go to bottom of effective. If not, state
New depth in
depth into effective 6.75'
Elapsed time 120 min
❑ Code -required soil cover over field
Final fluid depth 24 in
❑ System presoaked
Absorption rate 450+ gpd
(Required if vacant for greater than 30 days prior to
Any rejuvenation treatment (past 12 months) NONE
date of test)
Gallons introduced N/A gallons
If yes, enter date N/A
Comments/Deficiencies: '2010 TRENCH- SUMP FOR 1979 RESERVE TRENCH EXTENDS 4.16' BLOW THE INVERT- PIPES FOR 1996 RESERVE TRENCH NOT FOUND
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
0 Yes
*50'+
Sewer Manhole/Cleanout > 100'
❑ Yes
if No
ft
Q Yes
if No ft
Neighboring Tank > 100' El Yes
if No
ft
Private Sewer/Septic Line > 25' M Yes
if No ft
Absorption Field on Lot > 100' ❑ Yes
if No
*50'+ ft
Holding Tank > 100' M Yes
if No ft
Neighboring Absorption Fields > 100'
*50'+ ft
**
Animal Containment > 50' Q Yes
if No ft
21 Yes
if No
ft
ft
Water Service Line > 10'
El Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' M Yes
if No
ft
Q 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'
❑ Yes if No
*50'+ ft
Property Line > 5'
Iv Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
n,' Yes
if No
ft
Private Wells > 100'
❑ Yes if No
*50'+ ft
Water Main > 10'
Il Yes
if No
ft
Community Wells > 200'
[E]Yes if No
ft
Water Service Line > 10'
El 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'�]✓
Yes
if No
ft
if absorption field is under driveway comment below
Property Line > 10'
Q Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'
Q Yes
if No
ft
Private Wells > 100'
❑ Yes if No
*50'+ ft
Water Service Line > 10'
Yes
if No
ft
Community Wells > 200'
Yes if No
ft
Surface Water > 100'
❑ Yes
if No
*50'+ ft
F. ENGINEER'S COMMENTS
*ADVANCED WASTE WATER TREATMENT SYSTEM. AS -BUILT SURVEY SHOWS
THAT 1996 TRENCH MAY HAVE A SMALL PORTION UNDER THE DRIVEWAY
**100'+ TO ALL PIPES FOUND ON TALUS WEST #2;B4, L11 ***PER 2010 LOCATE
G. ENGINEERS CERTIFICATION
oF'..-�4s4p
I certify that I have determined through field inspections and review
of Municipal records that the above systems are in conformance with T y Q
MOA COSA guidelines in effect on this date.
g .: �. ...
T/*�.....:.'�. �0
O JefJr y k-.---6ornes 1 .:...
s:
Q� CE -7 53
O
COSA Checklist yellow sheetQ�4d Pro f e s s1o�'o,
#AECC884
VIA
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE ASID REPAIR AGREEMENT, herein the "AGREEMENT" made and
¢k
entered into ps of phis Day of i s of 20 } , by and between
<< 1`
herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced W.
described as
Y � f
.Ee
Treatment System (AWWTS),
A 177
located at (legal description)
. t � �.s, t..-. °. � ,,""ro f t,�"A •' '��. i,+t..i � t 1 3i. u,' s f � '� �' :+ � f x
2. Maintenance, Re airs and Alterations. a
(Owner is required to read, understand and initial each section)
iT Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
accordance with the equipment's approval for operation in the Municipality.
t�ti
It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
i includes an annual maintenance fee (typically $400 to $600).
Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
% f 3 Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Page 1 of 3
A
Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
f�fE ,a -
j Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
t Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
/N/I, a. Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
'A^ Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nomvaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/2018) Page 2 of 3
OWNER:
By: (signature) Date:
/V 1 n .fir 4n�, � „ (print name)
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT )
h
The foregoing instrument was acknowledged before me this day of
20?Z, by X,7a-X 0r./ f-jw
NOTARY PUBLIC FOR ALASKA MENG MOUA
My Commission expires: " Notary Public U Z -5-State of Alaska
My Commission Expires Aug 26, 2025
MUNICIPALITY•
BY: _IVV (signature)
(print name)
Date: 3 —,3 — Zt
Title:
(rev. 05/18/2018) Page 3 of 3
ARM Septic Services, LLC
Maintenance Checklist: Advanced Treatment System
Operational Checklist: Advanced Treatment System
Legal Description:
Street Address: [ t �I .0 -ft -Ir Da'AAt )t
Service provided on: Date: -3-- .2- Time: /- On Pyr
noi+�+++rrao:w�a�nim nea ,
Service provided by: Company: M 5 C f �('.P.S Technician: Imo' y1 ' L �' 4j. '°G'"
Date of last service:
By: You Other.
1. Type of Aerocell Treatment System:
�t Cat If -AeroCell Treatment System
Cat III -AeroCell Treatment System
2. Conditions at media filter: (Acceptable ❑ Unacceptable
a. Evaluate presence of odor within 10 ft of perimeter of system:
None _i Mild ❑ Strong ❑ Chemical ❑ Sour
b. Source of odor, if present: 1
3. Manhole Risers and Pipe Caps: $@Acceptable ❑ Unacceptable
a. Coverls intact: -.Yes U No
b. Method of securing cover: 5(—
c. Insulation present on all lids? XYes 17 No
d. Any plumbing leaks or water intrusion: ❑ Yes S No
e. Surface water/infiltration into components: El Yes "ANo
d. Venting/Air supply: Acceptable ❑ Unacceptable
a. Air supply unit operating properly. YYes ❑ No
b. Venting appears operable. S Yes ❑ No
5. Media surface: NAcceptable ❑ Unacceptable
a. Biomat on surface. �O"(es LIN
b. Uniform spray pattern. ❑.YesM 0-
d. Ponding inlon media. w t ❑No
e. Plugging/clogging of nozzles. 'Yes ❑ N
f. Media appears to be settling. ❑ Yes No s n
g Appropriate maintenance performed. [ Yes ❑ No Ui E
h. Pest activity at surface. ❑ Yes 1-�R No
6. Effluent quality
a. Effluent odor after passing through media filter:None Milo C Strong
b. Effluent color after passing through media filter: *44 Clear ❑ Brown ❑ Black
17933 Old Glenn Highway *Chugiak, AK 99567
office/fax: (907) 688-9433 Email: AWServicesAKCLoutlook.co(PAGE 1 of 3)
ARM Septic Services. LLC
7. Tasks for recirculating/discharge flows: IXf Acceptable ❑ Unacceptable
a. If applicable, Jandy valve functioning.
KYes
❑ No
❑ N/A
b. If applicable, Jandy Valve basin dry:
IR Yes
❑ No
❑ N/A
c. Cleaned collection system in Aerocell unit:
❑ Yes
RNo
❑ Not Necessary
d. Design recirculation ratio:
80:20
N,
e. Actual recirculation ratio (Estimated):
'76 : d
8. Pump System: Acceptable DUnacceptable
a.
L•'7
C.
d-
M.
Control panel in Auto: 1 Yes ❑ No
Timer settings !FS Panel (No Override timer): i_ Yes �1
ON: 111_ OFF: PA
Override ON: Override OFF: � _ L N/A
Floats in correct placement: Yes No
Floats working properly: 'Yes No
High water alarm operational: �q Yes L_j No t ,
Hi h water alarm count'
9
Pump Run Counts: X20
Pump Run Time: 93 (, � rut
5-wide Deep Trench
Float Error Counts.
�N/A
Total Override Counts._____—
PN/A
Effluent Filter serviced:
M'' Yes
Tank lids secured after inspection:
�i Yes
\Afeep hole functional
Yes
9. Primary Tank. ❑Acceptable QUnacceptable
a. Sludge and scum level checked *Yes
Y. -N
b. SludaelScum levels. 1s' 2nd: '01– 1,l 3rd:
c. Tank needs to be pumped: U�y
d. Water softener backwash discharging on systern? ❑ Yes
e. How many people live on the system?:
f. Tank lids/caps secured after inspection: Kyes
g. Last Date Tank pumped:
10. Drainfield:
No
No
Y' v v
❑ No
❑ No
❑ No
❑ No
a. Type of Drainfield (circleian�
5-wide Deep Trench
b. Design EireCKie depth: s/feet
c. Checked Liquid Levels in Drainfield:
Yes ❑ No
MT#1 Liquid Level: 0 j^ V Inches
MT#2 Liquid Level:
Inches
MT#3 Liquid Level:
Inches
MT#4 Liquid Level:
Inches
d. is there any surfacing effluent?: El Yes
( No
17933 Otd Glenn Highway *Chugiak, AK 99567
office/fax: (907) 688-9433 Email: ARMServicesAK@outtook.Cor(PAGIErr2 of 3)
ARM Septic Services, LLC
11. Is the remote monitoring system functioning? (if no, describe in comments) Yes ❑ No
a. Type of Monitoring system: )q
b. Phone line working? Ej Yes ❑ No N/A
12. Does this system receive an advisory notice/warning? (if so, describe in comments) UYes 4 No ti �
13. Is the system in satisfactory condition/pass inspection? (if no, describe in comments) 4 Yes ❑ No }
Other Comments:
Service Provider.
17933 Old Glenn`Righway `Chugiak, AK 99567
office/fax: (907) 688-9433 Email: ARMServicesAK@outloc
CERTIFICATE
FOR A
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
OF ON-SITE SYSTEHS APPROVAL
SINGLE ' AMILY DWELLING
Parcel I.D. 015-173-29
1. GENERAL INFORMATION
Complete legal description
Location (site address)
Expiration Date: / - / _/~ ' / /
HOMESTEAD HILLS S/D; BLOCK 5, LOT 7
11441 BEAR PAW STREET * ANCHORAGE, AK * 99516
Current Property owner(s)
Mailing address
KEITH BARTOW Day phone 346-1217
6445 LONE TREE DRIVE * ANCHORAGE, AK * 99507
Lending agency
Mailing address
Real Estate Agent
· Mailing address
Day phone
KATHI JOHNSON W/ PRUDENT AL Day phone 762-,.5125
3801 CENTERPOINT DRIVE, #200 * ANCHORAGE, AK * 99505
Un/ess otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. 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 On-Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On-Site Systems 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 COSAs upon request to homeowners. Certificates of On-Site Systems
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 samples. (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, t verify that my
investigation, based on procedures outlined in the Certificate of Qn-Site Systems Approval Guidelines for this appfication,
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 GARNESS ENGINEERING GROUP, Ltd.
Address 5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Phone 557-6179
Date
Engineer's Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at thc time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the COntrol of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of th~s report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
DSD SIGNATURE
Approved for
Disapproved°
Conditional approval for
bedrooms, ON-SITE
: WATER AND.
bedrooms, with the fllowing stipulations:
....
Attachments: COSA Checklist
Septic System Advisory
Well Flow Advisory
~traLe Advisory
.:/
(Rev, 11105)
Arsenic Advisow
Maintenance Agreements
Supplemental Engineer's Report'
Other
Original Certificate Date:
Municipality of AnchOrage
Development Services Department
CERTIFICATE OF
Legal Description: HOMESTEAD HILLS #1; BLOCK 3, LOT 7
WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# N/A
Date completed 11/3/1979 Sanitary seal (Y/N) YES
Total depth 264 ft. Cased to 263 ft.
Date of test
Static water level
Well production
FROM WELL LOG
11/3/1979
UNSPECIFIED
12
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mi.
Arsenic: ND ug./L.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material
Tank size 1500 gal.
Building Safety Division
On-Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
ON-SITE SYSTEMS APPROVAL
g.p.m.
CHECKLIST
Parcel ID: I~ J o~',J
Well Log (Y/N)
Wires properly protected (Y/N)
Casing height (above ground)
AT INSPECTION
5/12/2010
25,3 ff.
5.6 g.p.m.
YES
Nitrate 0.764 mg./L. Other bacteria __
Date of sample: 9/29/10 Collected by:
*ADVANCED TREATMENT SYSTEM
*S.T.E.P./STEEL Date installed
Number of Compartments 2 Cleanouts (Y/N)
· YES
12+ in.
Foundation cleanout (Y/N) YES Depressio~ NO
Date of pumping NEW Pum
ABSORPTION FIELD DATA I'BELOW FINAL CRADEI
Date installed: 6/16-17/'2010Soil rating ~or ft2/bdrm), **2.5
0 colonies/100 mi.
OEO Ltd'.
6/16-17/2010
YES
High water alarm (Y/N) YES
Length 35 ,ft. Width 2 ft.
Total depth*1o.8-11.3ft. Eft. absorption area 490 ft2 MOnitoring tube YES
Date of adequacy test NEW Results (Pass/Fail) PASS
**ADVANCED TREATMENT SYSTEM
System type TRENCH
Gravel below pipe 7
Depression over field,~
Water added - gal.
in. Absorption rate >=
NONE KNOWN If yes, give date
1996 TRENCHES WERE CONNECTED AS RESERVE SITES.
ARE DOCUMENTED AT THE MOA.
Fluid depth in absorption field before test - in.
Elapsed Time: - min. Final fluid depth -
Any rejuvenation treatment (past 12 mo.) (Y/N & type)
NOTE: 1979 AND
BOTH TRENCHES
ft.
NO
For - bedrooms
New depth - in.
- g.p.d.
D. LIFT STATION
Date installed 6/16L17/2010 Size in gallons 1500
"Pump on" level atTIMER in. "Pump off" level atTIMER in.
Datum BOTTOM OF TANK Cycles tested. NEW
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on lot 100'+
Public sewer main N/A
Sewer/septic service line 25'+
Animal containment areas 50'+
100'+
Manhole/Access (Y/N) YES
High water alarm level at 44
Meets alarm & circuit requirements?
YES
in.
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout
Holding tank N/A
Manure/animal excrete storage areas
N/A
100'+
Building foundation
Water main
Wells on adjacent lots
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
5'+ Property line 5'+
N/A Water service line 10'+
100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
ProPerty line 10'+
Water service line 10'+
Curtain drain NONE KNOWN
COMMENTS '1979 AND
SEPARATION
Absorption field, 5'+
Surface water 100'+
Building foundation. 10'+ Water main N/A
Surface water 100'+ Driveway, parking/vehicle storage
Wells on adjacent lots. 100'+
1996 TRENCHES WERE INSPECTED AND LEFT AS RESERVE SITES.
DISTANCES WERE VERIFIED.
10'+
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field ~ions~
review of Municipal reCords that the above ~ arei~:?
conformance with MOA COSA guidelines in'~t on this
date.
Engineer's Printed Name JEFFREY A. GARNESS
Date
COSA Fee $
Date of Payment
Receipt Number
(Rev. 11/05)
WaiVer Fee $
Date of Payment
Receipt Number
Lot 6
Lot 11
c~e~n out~
2 ~ cut.T Existln~
Lot 7
__ !0' Telephone & Electrical Easement .L
N 89'57'46" E
t
'0,
Lot 8
359.60'
Lot 10 I Lot 9
NOTE:
THIS DRAWINg SHALL NOT BE MODIFIED FOR USE AS A PLOT
, / PLAN WITHOUT THE EXPRESSED WRITTEN CONSENT OF I.ANTE:CH.
D~lcHptlon:
AS-BUILT
LOT 7, BLOCK 3,
HOMESTEAD HILLS ADD.
NO. 1
JLAND & CONSTRUCTION SURVEYORS-PLANNERS-ENGINEERS
4.40 West Benson Bouleverd, Suite 200 Phone: 562-5291
Anchoro~le, Ncsko 99503 ......... Fax: 561-6626
Pmt~ 78-151 J~rk~ SW2636
w~ ~ 2010_L_119 jr,~.= 759/42-43
CX, dered B~
Kathi Johnson/Prudential
SURVEY (~'RllRCAllON: L~ITECH he, conducted c ph)~lGel eun~y of
property c, ehown on thle drawing and =ertlfle~ thctthe lmpro~ement~
· ttuoted thereon =re within the property lln# ~nd no en~'oc~hment,
exlet other thgn noted.
EXCUJ~IONARY NOTE: It I~ the o~nem' re~i~nJlblllty to determine the
exlatenee of ~ny e~eementJ, covenonta, reatrlotlona or rlght-of-~oy
toidng~ which do not appeor on ~e re~erded ~ubdlvMkm pill Under no
clroumetoaoea .hould ony doto ha. een be uJld ~ c~nsb~U~, f~
I)~ October 5, 2010 Omen e~ PL
s=~ 1"=50' Caecked B~ ,NIZ
ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND
REPAIR AGREEMENT
MEMORANDUM OF UNDERSTANDING
BETWEEN MUNICIPALITY OF ANCHORAGE
THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this
~ Day of C~; c.:~¥, ~-- of 20'/O, by and between 5~-e,~d.~t.x
herein the "OWNER," and the Municipality of Anchorage, herein the
"MUNICIPALITY." In consideration of the mutual covenants contained herein, the
parties to this Memorandum of Understanding agree as follows:
I. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality
grants permission to Owner to utilize and operate an Advanced Wastewater
Treatment System (AWWTS), described as located
at It cqq I ?~e~-:~.,,~ ~?~4e,.. ,Anchorage, Alaska.
2. Definitions.
A. Alteration. Any change to the design or function of an AWWTS that
Includes the installation or removal of any parts, components or pieces not
included in the original consmaction permit and design. Prior to
performing any alterations to an AWWTS the owner must obtain a
Wastewater Disposal System Construction Permit from the Municipality
pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65.
B. Certificate of On-Site Systems Approval. An approval by the
Municipally/of existing water and wastewater disposal systems given at
the time of property sale and title transfer in accordance with AMC 15.65.
The term begins on the date of approval by the Municipality of the installed system and
shall continue while the AWWTS system is in use or operational or until the property is
sold or title is transferred by owner and a new certificate of On-Site approval is issued to
the new owner or transferee of the property.
5. Alterations~ Installation and Removal of Additional Equipment. Owner agrees
not to make any alterations, removal of parts or add/tions to the AWWTS without a
Construction Permit from the Municipality.
6. Maintenance and Repairs.
A. Throughout the term of this Memorandum of Undcrstanding, the Owner shall
maintain AWWTS in good repair. In addition, it shall be the responsibility of the
Owner during the term of this Memorandum of Understanding, and any extensions or
renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2)
maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs.
Further, Owner agrees to comply will all applicable ordinance, laws, regulations,
rules and orders for the AWWTS.
B. Owner agrees to provide the Municipality a written schedule of routine
maintenance and repairs which have been performed on the system pursuant to the
terms and conditions contained in the Owner's AWWTS Operating Permit. This
schedule shall be submitted to the Municipality annually upon thc renewal of the
permit. The schedule of maintenance and repair conta/ned in the Owner's AWWTS
Operating Permit is:
C. Owner acknowledges that the fine schedule for failing to maintain and repair an
AWWTS are codified in AMC 14.60.
D. Owner agrees t~hat only maintenance, repair personnel certified by the
Municipality will inspect and make any necessary maintenance, repairs or permitted
alterations to the system.
E. Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS upon 24 hours written notice.
F. Owner agrees that any sale or transfer of tide of the property will not occur
without a new Certificate of On-Site Systems Approval.
G. Owner agrees that the relevant provisions of the standard specification guidebook
for AWWTS is the governing professional guidelines for the construction,
maintenance and repair of the Ov~er's AWWTS.
7. Nonwaiver. The failure of either party at any time to enforce a provision of this
Memorandum of Understanding shall in no way constitute a waiver of the provisions,
nor in any way effect the validity of the Memorandum of Understanding or any part
hereof, or the right of such party thereafter to enforce each and every provision
hereof.
8. Amendment.
A. This Memorandum of Understanding shall only be amended, modified or changed
by a writing, executed by authorized representatives of the parties, with the sanae
formality of this Memorandum of Understanding was executed and such writing shall
be attached to this Memorandum of Understanding as an amendment.
B. For the purposes of any amendment modification or change to the terms and
conditions of this contract, the only authorized representatives of the parties are:
Anchorage: Purchasin~ Officer
C. ^ny attempt to amend, modify, or change this contract by either an
unauthorized representative or unauthorized means shall be void.
9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of
Understanding shall be brought in the Superior Court for the Third JudiciaI District of the
State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and
obligations of the parties under this Memorandum of Understanding.
10. SeverabiliW~. Any provisions of this Memorandum of Understanding decreed
invalid by a court of competent jurisdiction shall not invalidate the remaining provisions
of the Memorandum of Understanding.
MUNICIPALITY:
k.~ "~c.~ ~ Title:
Date: ~C-D .~--I~. ['~ Date:
STATE OF ALASKA )
) SS.
zme. JUDiCiAL InSTruCT )
The .foregoin~ instmme~was acknowled~eabeforem~this~ day of
i NOTARY PUBLIC ~:'
, ch i ti, Wort
,~' My Commission Expires April 21,2011]
'Parcel I.D.
Municipality of Anchorage
DeveloPment Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw Street
P.O. Box 196650 Anchorage. AK 99519-6650
www.ci.anchorage.ak.us'
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMiLy DWELLING
' 015-173-29 R P,T'I FI #
.. Expiration Date:.
'GENERAL INFORMATION "
_.Complete legal d, escription Lot 7 Block 3 Homestead Hills #1
Location (site address or directions) .. 11441 Bear'Paw, Anchora.qe, AK
Current Property owner(s)
Mailing address
Lending agency
Dale R. & Susan L. Conner ' Day phone. (775) 853-9001
P. O. Box 19850, Reno, Nevada 89511
Day phone
Mailing address
Real Estate Agent ........... %. LSC. r't~ f c..~._ ~_~O,.~- - "' "_, Day phone z . ._ ._
Mailing Address
Unless .othen~/ise requested, HAA will be held by DHHS for pickup. HAA picked up by:.
NUMBER OF "BEDROOMS: 3
TYPE OF WATER SUPPLY:'
Individual Well
Individual Water Storage
~ Community Class ..
Public Water System
Well
TYPE OF WASTEWATER DISPOSAL:
I~ Individual On-site
E] Individual Holding tank
[--I Community On-site [--~
E] 'Public Sewer ' D
The Municipality of Anchorage: Development Services Depadment (DSD) Issues 'Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 5 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) on properties served b~, a single family on-site wastewater disposal and/or water
· - supply system; DSD also issues HAAs upon request to home owners. Certificates of Health Authority Approval are
'valid for 90 days from the date of issue for Pr0Pedies served by a private or Class C well and may be reissued with
new water sample results less than 30 days old. 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.
(Rev. 11/99)
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 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 applicable Municipal and State
codes, ordinances, and regulations in effect at the time of installation.
Name of Firm Pannone Enq. Svc. Phone 272-8218
Address P.O. Box 102954, Anch~ AK 99510
Engineer's Printed Name Steven R. Pannone, P.E.. - ' Date
Engineers Comments: In Conducting an adequacy test, I attempt to provid~ a thorough, conscientious . ·
en ineerin anal is of the stem in accordance with MOA DSD Guidelines & Regulations The
g g ys ys __ ·
reported results describe the performance of the system under the conditions encountered at the time of
the test, and separation distances measured to readily :dentlfiable features. The operational life of all
wells and septic systems depend on the local soil condition, D'ound water levels that may fluctuate '
during the year, and the water usage of the family being served by the system. These conditions are ~. : ..,.~,.~ ~
outside the control of the evaluator of this system. All systems eventually fail and satisfactory test
do not guarantee future performance of the system, nor do they guarantee that there are no hidden defe~,,'~,,,,~.
or encroachments. PES can therefore not provide any wai'ranty for future performance nor give any ~. ¢5~.Steven R.
estimate ofhow long the system will continue to meet the operational requirements of the ADEC or
MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon
or use of this report by any other person or party is not authorized nor will it confer any legal right
whatsoever. . . ,
6. DSD SIGNATURE . . * -
~ Approved for .-~ bedrooms.
Disapproved. ..
'Conditional ap'pmval fOr ,- bedrooms, with the following stipulations:
Additional Comments
Attachments: HAA Checklist
Septic system Advisory
Well Flow Advisory
Expiration Date:
X
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Cedificate Date:
Reissue Date:
(Rev. 11/99)
iMunicipality of Anchorage
' DeVeloPment ServiCes Department
..~ Building Safety Divisi~)n ~ .,I
-" On-Site Water and Wastewater Progr,a.m
, 4700South BragawStreet '"
P.O. BdJ( 196650 Anchorage, AK 99519-6650
~. ~ : www.ci.anchorage.ak~us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST,
Legal Desci'iption:
A. WELL DATA
Well type P
Date completed 1113i1979
Total depth 263
LOt 7 Block 3 Homestead Hills #1
Date of test ,
Static water level
If A, B, or c provide PWSID # ,-
Sanita,ryseal _Y ,,:!,,
Casedto 40'+ ,ft,
FROM WELL LOG
111311979
12
ft
Parcel I.D.': 015.173.2!
Well LOg y ,
,. Wires properly prOtected
'Casing height (above ground)., 24+
AT INSPECTION ,
712512003
237
ft : '
in,
Well production
WATER SAMPLE RESULTS:
Coliform .. 0 col°nies/100 mi
Date of .sample: 41212004
B. SEPTIC/HOLDING TANK DATA
,g.p.m ~:
'" 5.92+ g.p.m '
Nitrate' 0.485; mg/I Other bacteria ,.. 0
Collected by: .,. Steven R. Pannone~ P.E. ,
colonies/100 mi
'Tank Type/Material' Anch. Tank Steel . ' .,
~ Date insta?ed.8/3111996~ Tank size 1250 gal Number, of Compartments 2
Cleanouts Y Foundation cleanout Y ,~ Depression over tank N High water alarm NIA
Date of pumping 7125/2003 Pumper A+ Home Services ,!
C. ABSORPTION FIELD DATA
Date installed 8/3111996. ,, S~il rating (g.P.d./ft= or ft2/bdrm) 333., System type.Deep Trench .,,
Length.85 ft . -Width 2 :ft Gravel below pipe 6 ft " '' .......
Total dePth ,t 0.5 ft .Effective 'abso~ptioh ~rea .1020 ft= Monitoring tube Y Depression over field N
Date of adequacy test 712512003 Results (Pads/Fail) .'P For 3 bedrooms : "" :
Fluid depth in absorption field before test Dry in Water added592 gal.
Elapsed Time: 1440 min Final fluid depth Dry in
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N
New depth26 in.-
Absorption rate >= .450+ g.p.d.
If yes, give date
(Rev, 11/99)
.~ D. EIFT STATION
:. Date installed
"Pump on" level at~
Datum ~ Cyclc=~s tested ';'
SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:'"
Manhole/Access
H!gh water alarm ,level at in
Meets alarm & circuit requirements?
Septic tank/lift Station on lot 108'
Absorption field on Iot--107' ~% ': ~"
. .On adjacent.lOts--100+ "~ '.. , .
On adjacent lots 100+
Public sewer main N/A
Public sewer manhole/cleanout ' N/A
Sewer/septic service line 25'+
Holding tank . 100+'
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK 'ON'LOT TO:
Building foundation 8' ' Property line 70' Absorption field 34'
Water main N/A · .': Water service line 50'+ ~. 'Sui'facewater 100'
Drainage 100'+" Wells on adjacent lots ' 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Propertyline 10' Building foundation 13'
Water Service line 25'+ "'" Surface water 100'+
Water main NIA
Driveway, parking~vehicle storage 8'*
Curtain drain None Observed Wells on adjacent lots 100%
F. COMMENTS
* Flower boxes inplace to prevent drivin~ on field. Undocumented conn't0 tank ~~~fte~ install.
G. ENGINEERS CERTIFICATION , -'
. .I ce~ify that I have d~ter~ined through ~eld inspections and .
~ 'review of ~uni~ipal records that fhe above systems are in ~""~"~"~ ...............
conformance with ~OA H~ guidelines in effect on thi~ date. '
' ~Steven R. ~annone~
Eng~neer. s Pnnted Name Steven R. Pannone, P.E.
Date of Payment
Receipt Number
{Rev. 11/99)
Waiver Fee.$
· Date of Payment
Receipt Number
Municipality of Anchorage e7 -
Development
Development Services Department \0 =° t,
C�, 4
Building Safety Division Z
On -Site Water and Wastewater Program $A "`
4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
��
Parcell.D. 015-173-29 HAA#
Expiration Date: l i- Co -- D 3
1. GENERAL INFORMATION
Complete legal description Lot 7 Block 3 Homestead Hills #1
Location (site address or directions) 11441 Bear Paw, Anchorage, AK
Current Property owner(s)
Dale R. & Susan L. Conner Day phone
(775) 853-9001
Mailing address
P O Box 19850 Reno
Nevada 89511
Lending agency
Day phone
Mailing address
Real Estate Agent
Kathy Fernandez - Prud/Vista R. E. Day phone
441-9000
Mailing Address
4241 B Street, Anchorage,
AK 99503
Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by:
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
®
Individual On-site
Individual Water Storage
❑
Individual Holding tank
❑
Community Class
Weil ❑
Community On-site
❑
Public Water System
❑
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 5 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) on properties served by a single family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to home owners. 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 less than 30 days old. 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.
(Rev. 11/99)
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 Health Authority Approval Guidelines for 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 applicable Municipal and State
codes, ordinances, and regulations in effect at the time of installation.
Name of Firm Pannone Eng. Svc. Phone 272-8218
Address P.O. Box 102954 Anch AK 99510
Engineer's Printed Name Steven R. Pannone, P.E. Datei2�%
Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious
engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The
reported results describe the performance of the system under the conditions encountered at the time of
the test, and separation distances measured to readily identifiable features. The operational life of all
wells and septic systems depend on the local soil condition, ground water levels that may fluctuate
during the year, and the water usage of the family being served by the system. These conditions are
outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results
do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects
or encroachments. PES can therefore not provide any warranty for future performance nor give any
estimate of how long the system will continue to meet the operational requirements of the ADEC or
MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon
or use of this report by any other person or party is not authorized nor will it confer any legal right
whatsoever.
6. DSD SIGNATURE
I/ Approved for
Disapproved.
3 bedrooms.
Conditional approval for
bedrooms, with the following stipulations:
Attachments: """'
HAA Checklist X
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: [1,c,/�. Original Certificate Date: 9-G-03
Expiration
(Rev. 17199)
Reissue Date:
G. ENGINEER'S CERTIFICATION A•�P,,.••"' •••.,S��'
AV �. �.
AV p 'i
1 certify that I have determined through field inspections and : 49
/.....
review of Municipal records that the above systems are in ..............
conformance with MOA HAA guidelines in effect on this date.. ...... .., +
j-R.Steven R. Pannone i
Engineer's Printed Name Steven R. Pannone. P.E. +1�% °•,. No. CE 8149 •,o
Date l��1r73i•1.3o�?g'.•
HAA Fee $ � Waiver Fee $
Date of Payment , T 1 0 3 Date of Payment
Receipt Number. c Cly 7 Receipt Number
(Rev. 11/99)
A) -/-
D. LIFT STATION
Date installed
Size in gallon Manhole/Access
"Pump on" level at in"Pump ofF' level at in High water alarm level at in
Datum
Cycl ested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 108' On, adjacent lots 100+
Absorption field on lot- 107'
On adjacent lots 100+
Public sewer main NIA
Public sewer manhole/cleanout NIA
Sewer /septic service fine 251+
Holding tank 100+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 8'
Property line 70' Absorptionfield 34'
Water main. N/A
Water service line 50'+ Surface water 100'
Drainage 100'+
Wells on adjacent lots: 1001+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO;
Property line 10'
Building foundation 13' Water main N/A
Water;Service line 25'+
Surface water 100'+ Driveway; parking/vehicle storage 8'*
Curtain drain None Observed
Wells on.adjacent lots 100'+
F. COMMENTS
* Flnwar hnYAiQ inninro to nra\/ant firiVinn nn flalrl I IndnrYman4u'L rnnn +N4 n4'fr�f�ll6 a`x.,'!ilinn. �(ie.' in..Mll
G. ENGINEER'S CERTIFICATION A•�P,,.••"' •••.,S��'
AV �. �.
AV p 'i
1 certify that I have determined through field inspections and : 49
/.....
review of Municipal records that the above systems are in ..............
conformance with MOA HAA guidelines in effect on this date.. ...... .., +
j-R.Steven R. Pannone i
Engineer's Printed Name Steven R. Pannone. P.E. +1�% °•,. No. CE 8149 •,o
Date l��1r73i•1.3o�?g'.•
HAA Fee $ � Waiver Fee $
Date of Payment , T 1 0 3 Date of Payment
Receipt Number. c Cly 7 Receipt Number
(Rev. 11/99)
L'~. (,,~)
............ /~,: ~ ~~ : - ; ---
,SURLY C~CA~ON ~~/- ~ Prepared by
~ -" R b t E h A
~o~ ,,z~.s. ............ ~,~ · o er do ns, dr. ~ 8~oc.
"~--~~"~' ~.~' ~ Professional Land Surveyors
m~ ~. ~ ~ ~O~. ~A 99~1
~NDA~ON AS-BUILT ~ '
h~ ~ m ~t ~ d ~. ,~......~ i Date ~: Dr~ b~ ~e~ed b~
,~-.-,~-~ ~ ~ ~ul~ 30~ 2003
"~o~-~L~ 21 ~**.~ ~UZy 3~ 2003 2636 23--2~4
~'~'"'~'~'~ '~p,,~o.~ ~ LOT 7, BLOCK 3, HO.t-~ESTEAD HILLS
~"'~ -mmm~%~ SUBDIVISIONS, ADDITIOM NO. 1
~ LOT SUR~ SURLY ~E
~ F~NDA~ ~B~LT -- S~BOLS
~ n.~ ~u~ AS-~T ' SET R~ ~ ~ DR~NAOE ~ ~HALT
~ ~TP~... ~-B~LT... LOTSU~... T~y O F~ND REB~ C O O ~ ~ ~ C~CRE~
AS-B~t.T . NO N S R~ n A A T T ~ ASSUMED E~. ~ M~AL
PLOT PLANS ~ LOT SUR~YS
IT IS ~E R~SPONSIBILI~ OF ~E ~UI~ER OR O~R, PRIOR TO ONLY ~OS~ IMPRO~M~N~
TO ~NISN~D GRAD~ AND U~ CONN~C~ONS AND TO D~MIN~ ~,, AR~ ~HO~ IN ~BIR APPROXIMA~ LOOA~ON, ONLY. SNOW
THE EXIS~CE OF ANY ~ASEM~NTS, ~O~AN~ OR R~IC~ONS MAY PRB~T ~OM~ IMPRO~N~ ~OM BBIN~ S~ AND LOOA~D.
~ICH DO NOT APPEAR ON ~ R~CORD~D SUBDI~SION PLAT. ALL DISTAN~E~ AR~ RBOO~D UNLESS
UND~ NO ~RCUMSTANCES ~ ~ ~-BUILT B~ U~D FOR C~UC~ OR F~ ~STABU~IN~ B~NDARY OR ~ UNES.
~E SUR~Y~ T~ES R~PON~BI~ F~ ~B INI~ ~SAC~ON ~LY ~D ~M~ ~N~ U~IU~ ONLY F~ ~E COST OF ~E SURLY.
U~D DI~S PREVAIL O~ S~NQ. R~RODU~0N MAY CAUS~ ~R~S IN ~.