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Home My WebLink AboutHOKAMA HEIGHTS #1 LT 3Onsite File Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201240 PID Number: 017-342-16 Dwelling: Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New X Upgrade Name PHILLIP CALHOUN ABSORPTION FIELD Site Address ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound 5400 DEARMOUN RD ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot HOKAMA HEIGHTS #1 LT 3 Ft. Ft. Fill added above original grade Gravel length Township Range Section Ft. Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft. To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches Tank Field Lift Station Tank Line Ft2 From Ft. Well 100'+ 50'+, TANK ta❑ Septic ElS.T.E.F. [I Holding [I Other Manufacturer Capacity Surface Water 100'+ GREER /ANCH TANK 12550 Gal. Material Number of compartments Lot Line 10'+ NA PLASTIC 2 Foundation 1 �'+ LIFT STATION Manufacturer Capacity Remarks TANK HAULED OFF Gal. Alarm location Electrical installed by Tankto Installer PIPE MATERIAL House to tank 3034 d anfield 3034 MIKE N ANDERSON, P.E. Drainfield CO/MT3034 Inspector MIKE N ANDERSON, P.E. BENCH MARK (Assumed elevation) 100 ft Inspection 1u 8121/20 2"0 Location and description dates: 31a 41h TOP OF MANHOLE ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer:'s Stamp Conditional Approval: Date��L': • • "' >'' �. ' *:'4 9 H �•.? r Septic Syste MICHAEL N. 4N�DEPSCN•; r`j Approved Date / / �-( �J�f^• • C� - 9469 . •L, ;.',A 7— 1 =' Note: this appro does not include well permit requirements. llll P ROFfSSIJ v\, (Rev 05102/16) ȭ 10' T&E EASEMENTS Lot 4 HOUSE DETAIL Scale: 1" = 30' 2 STORY RESIDENCE w/ WALKOUT BSMT. NOTE: ON THE SOUTH SIDE OF THE HOUSE THERE ARE BEAMS FOR A BALCONY AND BRACKETS IN THE GROUND FOR A DECK. NEITHER HAVE BEEN BUILT AS OF THE DATE OF THIS SURVEY. \� DEARMOUN ROAD iIL- PORCH OVERHANG =316.37. 8-857.06' 0 30' NATURAL - u M / _ cRnyeL .: \ m ISI/ EASEMENT M GRIFFIN ROAD GRAVEL Lot ----------------------------- I RETAINING Lot I Ld WALLn ED PLOT PLAN AS BUILT X SCALE 1" = 60' GRID --2W 2937_ Project No. I I I SEE F) opo �p HOUSE ' 0O o oo DETAIL Z o .. .• ,9 jonathanOlangsurvey.com a�P ..• .,S QO SEPTIC PIPES- m iIL- PORCH OVERHANG OVERHANG / PORCH JG WALL / 12.2' x 162' SHED IWITH END RAMP Lot 3 74,062 S.F. 10' T&E EASEMENT Lot 2 =316.37. 8-857.06' 0 30' NATURAL - LANDSCAPING M EASEMENT _ _ cRnyeL .: \ 20' ACCESS EASEMENT OVERHANG / PORCH JG WALL / 12.2' x 162' SHED IWITH END RAMP Lot 3 74,062 S.F. 10' T&E EASEMENT Lot 2 I hereby certify that I have surveyed the following described properly: LOT 3, HOKAMA HEIGHTS SUBDIVISION – ADDITION No. 1 (PLAT No. 95-93) Anchorage Recording District, Alaska, and that the Improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission Imes or other visible easements on said property except as Indicated hereon. Dated this the 14- �AA Day of J"–" g " `I at Anchorage, Alaska } .• 49TH �*� I(ENNE'fFl• a �•LAN� : o • � -5 02.•'oy�p� (pn��SSIONA� �o It Is the responsibility of the owner to determine the existence of any easements,-"V4�ooc covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 N 89'51'45"W 310.22' 0 0 M 7� GRIFFIN ROAD MI Lot ----------------------------- I Lot I I Lot 4C I PLOT PLAN AS BUILT X SCALE 1" = 60' GRID --2W 2937_ Project No. 21-347/R1 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, in C . (907) 522-6476 Phone opo �p (907) 522-4625 Fax o oo F A ppbQ Professional Land Surveyors kenOlangsurvey.com o .. .• ,9 jonathanOlangsurvey.com a�P ..• .,S QO I hereby certify that I have surveyed the following described properly: LOT 3, HOKAMA HEIGHTS SUBDIVISION – ADDITION No. 1 (PLAT No. 95-93) Anchorage Recording District, Alaska, and that the Improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission Imes or other visible easements on said property except as Indicated hereon. Dated this the 14- �AA Day of J"–" g " `I at Anchorage, Alaska } .• 49TH �*� I(ENNE'fFl• a �•LAN� : o • � -5 02.•'oy�p� (pn��SSIONA� �o It Is the responsibility of the owner to determine the existence of any easements,-"V4�ooc covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP201240 Work Type: SepticTank Upgrade Tax Code Number: 01734216000 Site Legal Address: HOKAMA HEIGHTS #1 LT 3 G:2937 Site Mailing Address: 5400 DE ARMOUN RD, Anchorage Owner: CALHOUN PHILLIP J & SONNET I Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING This permit is for the construction of: Effective Date Expiration Date Lot Size in Sq Ft Total Bedrooms: r, �1 f DeI)artIII ell t 7/14/2020 7/14/2021 74062 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Date: Issued By:�------- 3 MUMMPALITY OF ANCHORAGE \,K-) Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 017-342-16 Property owner(s) Phillip Calhoun Mailing address 5400 DeArmoun Rd. Anch AK Site address SAME Day phone Legal description (Sub'd., Block & Lot) HOKAMA HEIGHTS #1 LT 3 Legal description (Township, Range & Section) Lot Size 74062 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) El (w/wo ADU) Septic Tank El Upgrade El El (D) Holding Tank ❑ Renewal F-1Duplex Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: oo (Cvjlt3-1q Date of Payment: 7//L-) Receipt Number: 010 �{2� Permit -No. — 0 sP 20.1 2AU__ Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc July 14, 2020 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: New septic tank permit Legal: HOKAMA HEIGHTS #1 LT 3 To Whom it may concern: This is a request for a septic tank permit on the above referenced lot. This tank replacement will not impact any of the neighbors or encroach on any wells, septic or open water issues. Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201240, Deb Wockenfuss, 07/14/20 1"=50' PROPERTY LINE EXISTING HOUSE-10' UTILITY EASEMENT-CO 1250 GALLON PLASTIC TANK W/ 20" RISER, DECOMMISSION OLD TANK PER UPC SCALE: DJRDRAWN: DATE: HOKAMA HEIGHTS #1 LT 3 Anchorage, Alaska PHILLIP CALHOUN 7/7/2020 100' WELL RADIUS 10-12%FCO -10' UTILITY EASEMENT- DCO CO EXISTING 100' WELL RADIUS Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201240, Deb Wockenfuss, 07/14/20 ~ Municipality of Anchorage Page i of ''~ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O, Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal Sys~em and/or Well Inspection Report Permit Number: NO. of Oe~irooms: LEGAL DESCRIPTION LaC BIocI(: ~, ~ ..~ SubQivisie~: WELL: Q New Q Upgrade C;~sdicatmn (PrWate. A.8.C~: Cnller: )ate Orille~: tat~c Water Level: Ft, Pump Se{ al: Casing He{grit Above GPM Ft. SEPARATION DISTANCES Lift Hoichng $1ation Tan~ PlO Number: OIT~',/.Z, IZ. Wastewater System: O New '~Upgrade ABSORPTION FIELD _h~'~ee~ Trench r"l Shallow Trench O Bed r-1 Mound I Total Deptl~ from original grade:, Soil Rating: ° t3/'~' GPO/So. Ft. /~.?' I Death to pipe t3ottom imm original gm,e: Gravel c~apth Oeneatl~ pipe Fill acldeci above original graae: O we. Surface Water Lot Cu~ain Drain Remarks: :Gravel length: Number of lines: ~=t'-%%~.. lines: ~ ~' Ft. Total absorption area: Pipe material: A~r'~ TANK Ft. ~J~Septic [~ Holding Manufacturer:~ ¢1 S.T.E.P. I~0o0 nber of Compartments: -r-'~J o L! FT STAT! 0 N Size in gallons: Manufacturer:. on" level at: Pump Make & Model on.. and Description: bur~d~ AT' piT' Inspections performed by: /14~ Dates: 1st Z~//~ 2n d ~//? Department of Health an~Ft~an S~ervices app~°~al "Pump off" level at: I High water alarm at: Inspections pertormed by: BENCH MARK 'l)o Og' Elevation: /DO & ENGINEER'S SEAL Mich(~el E. Anderson 4381 - E ' ' ' Municipality of Anchorage pag, S' of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report M-ri ~'.'rl 70 ~ (,Iz ,Vdchael L 4381 . . Municipality of Anchorage Page ~ of -~ .. ~ DEPARTMENT OF HEALTH AND HUMAN SERVICES ,- ENVIRONMENTAL SERVICES DIVISION P.O. Box 1966~0 · Anchorage, Alaska 99519-6650 · Telephone:.343-4744 On-Site Wastewater Disposal Sys',~em and/or Well Inspectlo. n Report P~.rmit Number: 5 LJ q ~' O I ~,~ PtO Number: Or7,~ I I ,~?~'~ ~ i~, ': I~, : II / I t~l! I ~.;~ .......... .... ...,..:~... 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) PAGE 1 OF 1 PERMIT PERMIT NUMBER:SW950133 DESIGN ENGINEER:ANDERSON ENGINEERING OWNER NAME:HOKAMA FRED SHINJIR0 JR OWNER ADDRESS:5400 DEARMOUN RD ANCHORAGE, AK 99516 DATE ISSUED: 6/27/95 EXPIRATION DATE: 6/27/96 PARCEL ID:01734212 LEGAL DESCRIPTION: T12N R3W SEC 27 SW4NE4SE4 LOT SIZE: 436055 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION 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 (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THE TRENCH MUST NOT EXCEED 12.0 FT DEEP.DURING CONSTRU- CTION OF THE TRENCH, IT MUST BE CONFIRMED THAT NO BEDROCK EXISTS TO A DEPTH OF 18.0 FEET. RECEIVED BY: ISSUED BY: DATE: DATE: ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, ALASKA 99524 June 15, 1995 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 3, Hokama Heights Subdivision Septic System Design Impacts to Adjacent Properties Dear On Site Services Engineer: The existing house on the subject lot is currently served by an absorption crib which does not meet Municipal Standards. This system must be replaced by a conforming system in order for the new subdivision plat to be recorded. We hereby apply for a permit to upgrade the system by installing a deep absorption trench in the location shown on the attached Site Plan. The crib will be demolished, backfilled with sand or other suitable material and abandoned in place. Work will take place at the location shown on the Site Plan. Lots to the East and West are currently vacant and all setback requirements are met at the location of the proposed absorption trench. Once construction is complete the ground surface on the lot will be regraded to its present condition. Surface drainage will not be impacted by the upgrade to the septic system. If the system is installed as designed the following statements may be made: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. Lot 3, Hokama Heights Subdivision June 15, 1995 Page Two o The system, if constructed as designed, will have no adverse impact on reserved space, either surface or subsurface, on any lots located in the area. The system, if constructed as designed, will have no adverse impact The current drainage pattern will on drainage patterns in the area. be maintained. Sincerely, Michael E. Anderson, P.E. Attachments 660.91, N 89'52'19" W . ~ .- LOT 3 HOKAMA HEIGHTS SUBDIVISION SITE -PLAN Lot 3, Hokama DESIGN FACTORS: Three Bedroom Home Perc. Rate: 31 to 60 Min./Inch Application Rate: .45 GPD/SF Heights Subdivision SYSTEM REQUIREMENTS: Deep Trench 1,000 Gal. Septic Tank Min. 2' Accepting Soils 3 Bdrms. X 150 GPD / .45 GPD/SF = 1,000 SF of Absorption Area 1,000 SF / 18 SF/LF = 55.6 LF Length Therefore: Construct a Deep Trench System With 9' of Drainfield Rock and 56' Long at the Location Shown on the Site Plan. Distribution Pipe Placed at 3.5' Below Original Ground Surface. Existing Absorption Crib to be Demolished, Filled with Sand and Abandoned in Place. I TYPICAL DEEP T~NCH SYSTEM NOTE: Trench to Be Installed Paralell to Slope. Grade Area Over Trench to Drain Away. Trench Must Be a Minimum of 50' Upstream From a 30% Break in Grade. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PT'/ A.~ ~ a . ,Jo. I OL. 5 6 7 8 9 10, 11 bT<-'{' DATE Township, Range, Section: SLOPE 12 13 14 15¸ 16 ~0'rro M oF 18 19 20- COMMENTS WAS GROUND WATER ENCOUNTERED? S L IF YES, ATWHAT O DEPTH? p E SITE PLAN Depth t° wate~ A~tAr ~'/~ ~ Monitm'ing? d~Q~~' Oaie: Reading Date Gross Net Depth to Net Time Time Water Drop · ' ~,r_.. _~: ~s' ~S' '~ ~'J,g" ~tg" PERCOLATION RATE__~7~ (minute~inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND ~ FT MUNICIPALITY OF ANCHORAGE Development Services Department %� Phone: 907-343-7904 On -Site Water & Wastewater Section �� Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 017-342-16 1. GENERAL INFORMATION Expiration Date: L - --7,7_Z 0 Z d Complete legal description HOKAMA HEIGHTS #1 LT 3 Location (site address) 5400 DE ARMOUN ROAD ANCH, AK Current property owner(s) Mailing address Real estate agent FRED HOKAMA 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well E Private Septic 7 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ S S O e__0 Date of Payment 3LZ- ZZ90 ZO Receipt Number COSA # 0 SC 26 112 Date: Waiver Fee $ Date of Payment Receipt Number Waiver # Distance: 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 3-25-20 6. DSD SIGNATURE System #1 Approved for 3 System #2 Approved for _ Disapproved Conditional approval for _ f2___ S °P Vl drt2 FleAA�p V\ O�P_ SAG ��iI:AM Z� "J))))))))))))1W,, Original Certificate Date:_ C7 27 2� D 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 engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic�� Well Flow Advisory Other (�__V COSA Checklist blue sheet C e � 49TH W`V J o e o. e• o e e e e e e .. o 0 0 0 o e�� bedrooms •e MICHA1 Lt -N. ANDERSCU n *� bedrooms `='°= C 9 e`a _ bedrooms, with the following stipulations�ii�A�-4^ §� 3 �—,..e ��iI:AM Z� "J))))))))))))1W,, Original Certificate Date:_ C7 27 2� D 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 engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic�� Well Flow Advisory Other (�__V COSA Checklist blue sheet ..; Legal Description: HOKAMA HEIGHTS #1 LT 3 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled UN Total depth *220 ft Cased to UN ft ® Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 24"+ in. Date of flow test for COSA 3/20/20 Static water level at beginning of test 207 ft. Comments * well information from Fred H. current owner B. TANK DATA Age of tank(s) 25 years Tank type/material STEEL Measured operating fluid level in septic tank 48" ❑ Standpipes/foundation cleanout per record drawing Date of pumping AROUND THE CLOCK PUMPING D. ABSORPTION FIELD DATA Which system tested (date installed) 911995 ❑ ALL standpipes present per record drawing Total measured depth from grade 12-13 ft (max) Measured depth to pipe invert from grade 4.5 ft (min) ❑ N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced 0 gallons Com ments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 017-342-16 Structure served by this system Well production at time of test 2+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ Nc ❑ Coliform bacteria is Negative Nitrate 1.47 mg/L ❑ Nitrate less than MRL (ND) Arsenic 5.3 ug/L ❑ Arsenic less than MRL (ND) Collected by MNA Date of Sample 3120/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 3/20/20 Results ❑✓ Pass For 3 bedrooms Fluid depth prior to test 24 in Water added 500+ gal New depth 32 in Elapsed time 1440 min Final fluid depth 22 in Absorption rate 500+ gpd Any rejuvenation treatment (past 12 months) UN If yes, enter date 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' F✓ Yes if No Community Sewer Manhole/Cleanout > 100' Q✓ Yes if No ft Q Yes if No Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25FT Yes if No Absorption Field on Lot > 100' FV -1 Yes if No ft Holding Tank > 100' Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' Yes if No F,7/ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Fl� Yes if No ft ❑✓ Yes if No 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' ft ft ft ft ft ❑✓ Yes if No ft Property Line > 5' F✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' CI✓ Yes if No ft Private Wells > 100'✓�, Yes if No. Water Main > 10'✓Q Yes if No ft Community Wells > 200' 0 Yes if No. Water Service Line > 10' 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' 2✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' El Yes if No ft Wells on Adjacent Lots: Water Main > 10' ✓v Yes if No ft Private Wells > 100' Q✓ Yes if No Water Service Line > 10' 0✓ Yes if No ft Community Wells > 200' 0 Yes if No Surface Water > 100' ✓V Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet ft ft ft ft Septic Tank Advisory Certificate of On -Site Systems Approval #OSC201123 Subdivision: Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 25 years old. Typical replacement costs range from $8,000 to $11,000. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 20 year old steel tank MAY look like. 18' T&E EASEMENTS Lot 5 DEA ~- �� A RA40UA� ROAD � � ' , x� ��°� �� _ . / | / | / |/ |/ GRA L-316 2 STORY RESIDENCE |\bo | \ �tl� 78.9' C14 91; 10�'x14.1' occx 5.6'x6.6' SHED � / SEPTIC PIPES 1u1' 6;4' sxso SHED —30' NATURAL LANDSCAPING EASEMENT GHAVtL EASEMENT �^ �wn �m� � 74,062 8.F 10' T&E EASEMENT � GRIFFIN ROAD —17 Lot 3 Lot 4C PLOT PLAN AS BUILT _2�_ SCALE 1 60' GRID _ SW 2937 Project No. 20-121/ 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Long & Associates, inc. (907) 522-6476 Phone (907) 522-4625 Fox Professional Land Surveyors ken0longsurvey.com | hereby certify that | have surveyed the following described property LOT 3, HOK4W4 HEIGHTS SUBDIVISION — ADDITION No. 1 (PLAT No. 95-93) Anchorage Recording District, Alaska, and that the Improvements o0uohod thereon are within the property lines and du not encroach unto the property od}ocon| thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, ironom/yo}mn lines or other visible womamon+m on said property except as Indicated hereon. Dated this the nf , Y��u , ot �nuhoroge. Alaska U is the responsibility of the owner to determine the existence of any monty -"~m�mxmuoy� oovonontm, or restrictions which do not appear on the recorded subdivision plot. AECC963