Loading...
HomeMy WebLinkAboutOVERLOOK ESTATES BLK 3 LT 6Overlook Estates Block 3 Lot 6 #068 - 041 - 20 Municipality of Anchorage ', On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201098 PID Number: 068-041-20 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name SEAN & GAILLYNN WILLIAMSON ABSORPTION FIELD -EXISTING ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 27601 VANTAGE AVE, EAGLE RIVER ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Fill added above original grade Ft. Gravel length Ft. OVERLOOK ESTATES 3 6 Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well 100'+ -- 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1250 Gal. Surface Water 100'+ -- Material HDPE Number of compartments 2 Lot Line 10'+ -- NA Foundation 10'+ __ LIFT STATION Manufacturer Capacity Gal. Remarks Tank insulated. Alarm location Electrical installed by Tank to PIPE MATERIAL House to tank 3034 3034 Installer NORTHERN EXCAVATION d a nfield Drainfield CO/MT 3034 Inspector FWCS BENCH MARK (Assumed elevation) 100 ft Inspeectio Vt 5/11/20 5/12/20 Location and description : 2nd 3rd 4th GARAGE SLAB ON-SITE WATER AND WASTEWATER SECTION APPROVAL '►or A\l� l Conditional Approval: Date r ' •:}Q .. ....�:* Curtis Nuffman. • .: j Septic System A r -2,92 Dated ;6% • CE 128991 . O� W �� is���• . si20/202Q. •���� 0 pROFESSI0'_i\����1� Note: this approval does not include well permit requirements. .� (Nev ub/uziia) PID: 068-041-20 OVERLOOK ESTATES BLOCK 3, LOT 6 PERMIT: OSP201098 A—C=43.4' B—C=26.7' A—D=46.2' B—D=31.2' SEPTIC SECTION OVERLOOK EST. B3, L6 PREPARED FOR: SEAN & GAILYNN WILLIAMSON 27601 VANTAGE AVENUE EAGLE RIVER, AK 99577 FIRST WATER CONSULTING 13030 SUES WAY ANCHORAGE, AK 99516 907-350-9566 firstwaterAK©gmail.com DATE: 5/27/2020 SURVEY: JLS DRAWN: FWCS SCALE: 1" = 30, SCALE, NTS OF AL 9 TF ' rtis Huffman CE 128991 1 /27/2020 Adgr ��sstoK�' O w n' N 2o.01 SI -IED N°38'29„w LOT 6 8LK 3 37.o—, ----J l4. o'. OEC, EXISTING '9.0 HOUSE C LO /3S 13.5' 10.7'`14 33 g, ti DECK z N 3 �Q CV V m 3 CD PAVED D/W L g7� R,2 0 -, M 00 70 T E ESMr N7 34g, 0 M A IV TA Ge q �E ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: OVERLOOK ESTATES LOT 6 BLOCK 3 PLAT 84-287 220.00 LOT 4 2'x9' 76.61 BW CANT WELL 7S.8' ® = FND 518” REBAR SURVEY CERTIFICATE: I, John L. Schuller, Have conducted a G� F a -`� • . ' ��..�E •' 1� enchroachments exist other than noted. Under no circumstance should 2'x6.5'- Kj :— FP CANT 0) ° �" EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which� i ZSEPTIC • ti VENTS (typ) N°38'29„w LOT 6 8LK 3 37.o—, ----J l4. o'. OEC, EXISTING '9.0 HOUSE C LO /3S 13.5' 10.7'`14 33 g, ti DECK z N 3 �Q CV V m 3 CD PAVED D/W L g7� R,2 0 -, M 00 70 T E ESMr N7 34g, 0 M A IV TA Ge q �E ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: OVERLOOK ESTATES LOT 6 BLOCK 3 PLAT 84-287 220.00 LOT 4 2'x9' 76.61 BW CANT WELL 7S.8' ® = FND 518” REBAR SURVEY CERTIFICATE: I, John L. Schuller, Have conducted a G� F physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no -`� • . ' ��..�E •' 1� enchroachments exist other than noted. Under no circumstance should dd ®* 49 H any information on this drawing be used for construction of fences; structures, improvements, or for establishing boundary lines.' ', O �" EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which� lj .�o '-J ' .. • '' .. ' ' ' ' "' ' ' ' ' ' 6HN L. SCHULLER. ,p, ;.• 0 do not appear on the recorded subdivision plat. ���'eLS-10408 ti SJR WORK ORDER NUMBER: DAZE: AUG 19. 2010 SCALE: 1"=40' E -MA 10-045 DRANK BY: ICHECKED BY OLS GRID NUMBER: SW0465 BOOK/PACE 200193 �® Ofe$SiOn O, 1W N O � __j ti Z zo 91 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater PT*gram P4 BpK 1-96654 4700 Elrnore Road Anchorage, Alasu 9<3:51 9 --MW Phone: (907) 347904 Fax: W7) 343-7997 trttp:#www. rnune.0rgl0nsrte Onsite Wastewater Disposal System Permit Permit Dumber. CSP201098 Work Type; SeptioTank Upgrade Tax Code Number- D6804120000 Site Legal Address: OVERT -00K ESTATES ELIC 3 LT 6 G.,G465 Site Mading Address: 27601 'VANTAGE AVE, Eagle River Owner: WILLIAMSON SEAN M & OAILLYNN Design Engineer: FJR T WATER CONSULTING This pelmIt is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms - n '1 Department 5f8f202D 51812021 51969 ❑ Disposal Field d Septic Tank ❑ Holding Tank Ll Privy ❑ Private Well ❑ Nater Stcrage All construction shell be in accordanee vAth: 1. The attached approved des.gn, 2. All requirements specified in Anchorage Municipal code Chapters 13.55 and 15.65 and the Mate of Alaska Wastewater disposal Reg:.ai"cris (18AAC7 ) and Drinking Water Regulations (18AAC80) 3, The wastewater code requires inspections during the installation_ The engineer shall notify the Development Servioes Depaftent per AMO 15.56. Provide notification by calling (907) 343-7904 X2417). 4. From October 15 to April 15, a subsurfa soil absorption system udder construction during freezing weather shall be either, a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Revived By: Issued By, �1 518!2020 Date: oats: 4 13030 Sues Way, Anchorage, AK 99516 907-350 -9566 / firstwaterAK@gmail.com May 6, 2020 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: OVERLOOK ESTATES BLOCK 3, LOT 6 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install a 1250-gallon HDPE Greer tank to serve the existing 4-bedroom residence. The lot and area are served by private water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201098, Rebecca Carroll, 05/08/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201098, Rebecca Carroll, 05/08/20 No,, 14 18 11 12a A i �11,,) V%,'-&! P u r, � ,� �-, i '__'072430742 Development Services t>epartmegTt ? auNding 5afefy bivisfm Ave On -Site Water & WCSIewater Program 4700 PD Box 19-_'-730 Ar.�,craue, AK 995j*or Pump Installation Log Well Drdfing Perrmt Num ber. SW d� Date of issile.. Pared Idt-atifii:atioa 0411- 20 Allcritivil: 71w pump ins-ailor 5fA7 ; io_,, '.o uie D'3D 4iziin 3D d,).N ti of pu= i- sTjj!atjjDzTj, MUNICIPALITY OF ANCHORAGE 17- / \ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME ID -1- f•-.1-12-L)G-n\ 1i ^a..3 PHONE -slot_ IsIo11 EW ill UPGRADE MAILING ADDRESS 0. 1 -c, --)x 1'13'12- Z s e,,A-c L. -e__ , __1 1M4 . leis /1 LEGAL DESCRIPTION / C—;-A1 L' 1 (J & 1-l4. (...,eV 'rJl4— ) LOCATION Ml,. L3 ✓.`44 1,6,, 2- - n S., NO. OF BEDROOMS T SEPTIC TANK DISTANCE TO: Well 1'4cr - i t -i Absorption area ' Dwelling 1..... c:3 -c- 1 PERMIT NO. ��y `'[)ZAD� 1 1 Manufacturer�a� /a1- -4-iceQ,tt1G� l \ Material S+1-r=r_.-..- No. of compartments Z Liq. capacity in gallons I Z,---; IF HOMEMADE: Inside length ----- Width Liquid depth a �' O z Q 2 I— DISTANCE TO: Well ` i� Dwelling PERMIT N0. Manufacturer Material Liquid capacity in gallons TILE DflAltJ Fi-e-w TRENCH DISTANCE TO: Wel \ �or 1/� Foundation i',..), C-;-1— t�j Nearest lot line I1.. PERI1/J.LT �� �� No. of lines Length of_g,@ch Byte Total lengt of311nres Trenc width ) inches Distance betvigdpilkes F Top of tile to finish grade 1 4 Material beneath tile (B� �6 inches Total effective or on area / SZ a s ' !t v SEEPAGE PIT Length Width Depth PERMIT NO. Type of crib Crib diameter C ii/k depth Total effective absorption area DISTANCE TO: Well dilding foundation Nearest lot line J w Classrs,\ , 15�1� Depth C e , � DrillLer p] I ,�` Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS ?'/ , . 'r-fk-A a 0 SOIL TEST RATING - INSTALLER• tPI-. (—--4s-- '' EW -,0.(v - FiLop, REMARKS- Wy lAi i 6s �Ei V . /J' / 5(1.--',, / OO ,r- i� 7/)?.s: Y ���M...((( - •9f-�'C e, Ut M.r .9j•?)+ _®U f {%ahart A. Ther rr>J `• No. 1457-E •...... er APPROVED 6' S P'vQir$XXt DATE LEG L / r}r �y p' >� l� ALASKA ; list' tlIVtt£,'�R, s��7L r'Vl(A �5 `\/ 1 b'I. 694.29{Y L/ Z� /1 I t 1 72-013 (Rev. 3/78) PERFORMED FOR: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST //a /so 00 LEGAL DESCRIPTION: .6 3 QcX .C1.7A-1.0 Awe, DATE PERFORMED: o���les s-/046-44 -f4 "I 5 16 9a •• "'�'ix r `s+ S getout A. Sho.tor �•afit" `.No. 14574 17 e%� *''. ► NICIPALITY OF ANCHORAGE DEPT. OF HEALTH & YIRONMENTAL PROTECTION 19 20 COMMENTS PERFORMED BY: 72-008 (6/79) APF 1 21985 RECEIVED SLOPE 3 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? SOILS LOG ❑ PERCOLATION TEST SITE PLAN INIMMENIZEI RIE EIrw •uu s L 0 P E -7 Reading Date Gross Time Net Time Depth to Water Net Drop /� li r r Al / /4.1 PERCOLATION RATE TEST RUN BETWEEN FT AND r.:rzp:ll.4.RI SAFI 1987C al, ALASKA p wTral� CERTIFIE (minutes/inch) FT 1P15 IIP,ILE117; T -r iLD ��11=�����11 .. _ DEzARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE;- AK 99501 264 4770 it"..11 -1E1E: ���!F: g � P�RMIT NO: 850099 DATE ISSUED: 04/12/85 APPLICANT: ALLAN OLSON ADDRESS: 3831 DELWOOD PL ANCHORAGE, AK 99504 CONTACT PHONE: 333-8i26 LEGAL DESCRIP: SUBDIVISION: OVFR|nOK ESTATES SECTION: 25 TOWNSHIP: 14N LOT SIZE: • 51969 (SQ.FT, OR ACRF9) MAX BEDROOMS: 4 LOT: 6 RANGE: 1W Listed below are the options available to you in desigli! your site, system. Choose the option that ~ _ • 4.0 8.O 12,0 2.5 / 33 / - ~ / ,� 26.0 / 750^0 • DEPTH TO PIPE BOTTOM (F|,) GRAVEL DEPTH (FT") TOTAL DEPTH (FT,) GRAVE! WIDTH (FT.) GRAVEL LENGTH (FT.) GRAVEL VOLUME <CU.YDS,> TANK SIZE (GALS) SOIL RATING (SQ"FT,/BR) *` TANK MUST HAVE AT LEAS. TWO COMPARTMEN!S . ���, • g your septic 4,5 5.0 0,5 3.0 5,0 8,0 20.0 5.8 38.0 59,0 28"2 38.3 1,250,0 ** 1,250"0 ** 125 125 certify that: 1" I am familiar with the requirem.nts for on-site sewers and wells• as set forth by the Municipality of Anchorage -(MOA) and the State of Alaska. 2" I will install tke system in accordance with all MOA codes and regulations, and •in compliance with the designcriteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system'or public sewerage system on this or ahy adjacent ornearby lot. 4" I understand that this permit is valid for a maximum of 4 bedrooms and any enlargement will require an additional permit. 'IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OB!AINED; (2) AS-BUI!TS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3> THE ELECTRICA| WORK -MUST -DE DONE BY A LICENSED ELECTRICIAN. SIGNED APPLICANT: ALLAN OLSON ISSUED BY DATE: �'' ~����_ . " • dy fY��'l,�Y+Y�' 3':2 1e 1i'Fr iMhl-. riltitrtt DOC Co. tlba SULLIVAN :.ELLS P.Qii BOX 670272, CillIGIAK, ALASKA 99567 o TELEPHONE 688.2759 OWNER OF LAND` ADDRESS FU.K0 DEPTH OF WELL t -J0,30 RA -14 ,-F % <: ST 111C LEVEL OF WATER FI LEGAL DESCRIPTION DATE - Stated PERMIT N 1MBLR' DRAW DOWN FT GALS. PER HR 3013 KIND -OF -CASING - 6Oved KIND:'4 From From From Ft ft3; oh' 60,04.:aA,_F From. • Ft _of, 0047 004- From Ft. From Ft to Ft Ft to Ft. Ft. to, � Ft From .Ft to: F;. �a � s FrorM_.,.Ft. to F.t. From -Ft to_ ' , Ft tttt 4 From Ft to Ft From ftt') -Ft. to LFt. C`''ray ,s e`t» Fromr—_ Ft. to Ft. From_ Ft. to_. -'Ft. 44.11,-747''''' Frim_-- Ft: to Ft. From el Ft. toy, }� Ft. -T=4. 4 1, f 64,1444:.4. i I �aFrom Ft. to Ft. From Ft. to Ft AttR." , fi7 re .. From Ft. to Ft From Ft to Ft. From From Ft to From Ft. to._ -_Ft. From Pt. to---Ft.— From Ft to Ft. From Ft, to Ft. Ft. towFt From Ft. to Ft. FromFt. to Ft. From Ft to Ft From Ft to—6ICIPALITY F DEPT. OF O F ANCHORAGE From Ft to 1IIRCSNMENTAL PROTECTION Front_ Ft to Ft. From Ft. to Ft. DL"2 1986 1 FromFt. to R E€E--I ES From Ft to Ft . 1 MISCL. INFORMATION: DRILLER'S.NAME A-4/ } -- 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. 068-041-20 1. GENERAL INFORMATION Expiration Date: -2 2 Complete legal description OVERLOOK ESTATES BLOCK 3 LOT 6 Location (site address) 27601 VANTAGE AVENUE EAGLE RIVER AK 99577 Current property owner(s) SEAN & GAILLYNN WILLIAMSON Day phone Mailing address Real estate agent 27601 VANTAGE AVENUE EAGLE RIVER AK 99577 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. I COSA Fee $ 5�lI2.S1 Date of Payment 51221=20 Receipt Number Q! 2 oZ f w COSA# OS6961 Z3 Waiver Fee $ Date of Payment Receipt Number Waiver # COVID-19 257' DISCOUNT APPLIED 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 FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 5/21/2020 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the __:�\\\,l�� system and maintenance. The operational life of all well and septic systems are subject to "+AAL these various and dynamic characteristics and are outside the control of the evaluator of the ,r P' ' • �'7�` well and septic system. Therefore, any estimate of how long a system will function satisfactory ����•.' • fig}� for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting &FW[ S . *• -4911'I •'* �, . ... .. ......... 6. DSD SIGNATURE /J '. • Curtis Huffman �/ (r �'F•• CE 128991 System #1 Approved for bedrooms ���'sr4 12,112Q�o••��� System #2 Approved for bedrooms �i>1F PROFESS1oNa Y pp I\\\\>>1•• Disapproved Conditional approval for bedrooms, with the following stipulations: ON -S o WATER AND1A 0 m' 'RO'G''4A44ERo SERAC������\�, By: hn. Original Certificate' Date:...�5 $_'G1s '-2 o The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: OVERLOOK ESTATES BLOCK 3, LOT 6 If more than 1 septic system on lot: COSA Checklist # _of A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 7/1985 Total depth 92 ft Cased to LINK ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 24+ in. Date of flow test for COSA 5/4/2020 Static water level at beginning of test 72 ft. Well production at time of test 2+ gpm Comments B. TANK DATA — NEW TANK Age of tank(s) 0 years Tank type/material SEPTIC / HDPE Measured operating fluid level in septic tank NEW ® Standpipes/foundation cleanout per record drawing Date of pumping NEW D. ABSORPTION FIELD DATA Which system tested (date installed) 7/5/1985 ® ALL standpipes present per record drawing Total measured depth from grade 11.6 ft (max) Measured depth to pipe invert from grade 3_6 ft (min) ❑ N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective Parcel ID: 068-041-20 Structure served by this system Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 0.47 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by NES Date of Sample 5/4/2020 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 5/4/2020 Results Z Pass For 4 bedrooms Fluid depth prior to test 0 in Water added, 600 gal New depth 1 in Elapsed time <5 min ® Code -required soil cover over field Final fluid depth 0 in ❑System presoaked Absorption rate 600+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced gallons FW S Comments/Deficiencies: a== r 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' ® Yes if No ft Wells on Adjacent Lots: Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' Surface Water > 100' ® Yes Animal Containment > 50' ® Yes if No ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ft ft ft ft ft ® Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No _ Water Main > 10' ® Yes if No ft Community Wells > 200' ® 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' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® 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. .... ...�...... Curtis Huffman �$ �°F•• CE 128991 •�``�i e9-..5/20/20. . •����' ��1®�pRdFESS10NP� ft ft ;07 8 9 7017 0 • ' �-� Municipality of Anchora s;g� `�<8 - On-Site Water and Wastewater Progra .Q APR Q 9 2018 Piltn (907) 343-7904 A F E T Y ti Certificate of On-Site Systems Appr. f iv 6 8 c c,;" Parcel I.D. 068-041-20 Expiration Date: 7- 13` I 1. GENERAL INFORMATION: Complete legal description Overlook Estates; Block 3, Lot 6 Location (site address) 27601 Vantage Ave.*Eagle River,AK 99577 Current Property owner(s) Tony Zielinski Day phone 854-2566 Mailing address Real Estate Agent Kathi Olmstead Day phone 244-8020 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 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 ❑ WaiverNariance request for: Distance: Received by: 1'/±..7 Date: V/7le COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 61-(a. — Waiver Fee $ Date of Payment Li H t _ L r Date of Payment Receipt Number QQC°51 6 Receipt Number COSA# c c—t \ 1 Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal',affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness 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 Date: I1qII o .„..,,„.„.„ In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system o� OF 4 4�0 in accordance with the guidelines and regulations established by the Municipality of Anchorage and o n industry practices. The reported results describe the condition of the system/s on the date/s of the O• .•' • V Oh evaluation. Separation distances were measured to readily identifiable features. Hidden defects or ►��" .. vn encroachments may exist that were not identified during the evaluation. The operational life of all wells ���: 4'i T * D and septic systems depend upon a variety of variables, including but not limited to, soil conditions, 0 Q groundwater levels (that may fluctuate during the year), quality of construction (materials and 4 / VA workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and ; .... . ..1 are outside the control of GEG. Satisfactory test results do not guarantee future performance of the i/ •• a f'-r '. . •ess.• a system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of "Oh 9 CE 79. 3 ect;Q• � the well or septic system. GEG makes no representation whether an alternative well or septic system s •�c Q can be installed on the property in the event either of the current systems fail to perform adequately in ��, ,. �'! •l$ ' cAo the future. The content of this report is for the sole benefit of the person/party that retained GEG to :%,ZP,-°fessi°C,° Q perform the evaluation. Reliance upon the information provided in this report by any other person or ��0400� .d party (including subsequent property purchasers) is not authorized, nor will it confer any legal right , O� l�i�{; whatsoever. \` ,.. �,• �. �`�� CC884 6. DSD SIGNATURE „z O Np RP Z . System #1 Approved for . bedrooms s �1Plv0IN1 �` �G—,•. p,S System #2 Approved for bedrooms 0o �N P- OGRP Disapproved Conditional approval for bedrooms, with the following stipulations: r, -----j,A. ,s .< ii 3 `- C;6tVli 4(9 (d 11‘—N-A-41'1-e -P t.te 6 d 41,C'PM rE:c -1--oe,v‘k CS rad y-Fra V- By � �v..� ''((J Original Certificate Date: L(--/ 3 —1 p \.. 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 \, lle( COSA blue sheet 10-10-12.doc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: OVERLOOK ESTATES; BLOCK 3, LOT 6 Parcel ID: 068-041-20 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (YIN) Yes Date completed 7/1985 Sanitary seal (YIN) Yes Wires properly protected (Y/N) Yes Total depth 92 ft. Cased to Unk ft. Casing height(above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 7/1985 3/29/2018 Static water level 57 ft. 82 ft. Well production 5 g.p.m. 2.2+ g.p.m. WATER SAMPLE RESULTS: ! Coliform/ � -�` �co� lonies/100 ml. Nitrate` ' }mg./L. Collected by: GEG, Ltd. Arsenic: ,VO ug./L. Date of sample: 3/29/2018 B. SEPTIC/HOLDING TANK DATA *33 YEAR OLD STEEL SEPTIC TANK IS APPROACHING THE END OF ITS USEFUL LIFE Tank Type/Material SEPTIC/STEEL Date installed *7/5/1985 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout(Y/N) YES Depression over tank(YIN) NO High water alarm (Y/N) N/A Date of pumping 0( -'- I 61, ) c t -f Pumper I. **WEST SUMP HAS SLUDGE/SOLIDS AND APPEARS NON-FUNCTIONAL. C. ABSORPTION FIELD DATA 'BELOW EXISTING GRADE ***EAST SUMP-LIQUID LEVEL REMAINED AT 8.5"WITH 559 GALLONS BEING ADDED DIRECTLY TO THE EAST SUMP. Date installed 7/5/1985 Soil rating (g.p.d./ft2o ft/bd 129 System typeDUAL DEEP TRENCHES Length 33 ft. Width 3.33 ft. Gravel below pipe 8 ft. Total depth *11.7 ft. Eff. absorption area 528 ft2 Monitoring tube"SUMP Depression over field NO Date of adequacy test 3/29/2018 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 614 gal. New depth "`8.5 in. Elapsed Time: 10 min. Final fluid depth 0 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.)(Y/N &type) NONE KNOWN If yes, give date - UPON ARRIVAL, RUNNING WATER WAS OBSERVED IN FCO. OWNER FOUND DOWNSTAIRS TOILET RUNNING (FLAPPER OPEN). PER OWNER, TOILET HAD BEEN RUNNING FROM 6:00-6:30AM(EQUATES TO APPROXIMATELY 2.0 GPM FOR OVER 300 MINUTES PRIOR TO START OF TEST). IT IS BELIEVED THAT APPROXIMATELY 600 ADDITIONAL GALLONS OF WATER WERE ADDED TO THE SEPTIC SYSTEM PRIOR TO TESTING ON 3/29/2018. D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at .. a er alarm level at in. •- •• Cycles tested Meets alarm &circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line *10' Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain None Known Wells on adjacent lots 100'+ F. COMMENTS *SEE ATTACHED AS-BUILT SURVEY.WEST SUMP SCALES RIGHT AT 10 FEET FROM WEST PROPERTY LINE. oo�op�� G. ENGINEER'S CERTIFICATION o OF A •Nps l certify that I have determined through field inspections and ft. 9 Li * review of Municipal records that the above systems are in 9 conformance with MOA COSA guidelines in effect on this Q date. V0 ' e r-, .."arne-s.: Engineer's Printed Name JEFFREY A. GARNESS OC •P :-7 5 eQO Date `� !� Vice,.. '•.'! .1 ' ��!o a /�/ Nk /3zz.zssio�oo �40000� #AECC884 (Rev.11/05) MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT i 0 � 907-343-7904 On-Site Water and Wastewater Section Fax: 343-7997 i www.muni.org/onsite - Septic Tank Advisory Certificate of On-Site Systems Approval # OSC181137 Subdivision: Overlook Estates Block:3, Lot: 6 The septic tank for this property is 33 years old. The average life for a steel septic tank is 20 years. Typical replacement costs range from $6,000 to $9,000. 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 30 year old steel tank may look like! • w` if Isya. r ..M. i. Cyt J [4 y 1 F 'r r /' >l -?4 2t..' • Z,; ,'- , :i4Ygt+^ 1� =t'e ms . '," . • k -,.. • ?, -4- ,-;.- • • .1-4, erz.,"6.7.- ' - -• cf, • ,,,.;'4-4; timp ‘11. '..:,:t. K -, , . - It, fc 7 . ...- -4....47-,.,*,... 4,,4. .. , 4 ` 7 t ' r ` 1 - • 2018. 4 13 v* . r_'� • , b wr • - . • z ‘..,. y 1 t T • : = 4-:,- yo cf > i - ^ "'>. -..46 A ..;fir• - .� `NA-it�t., s r, k .�:'' tiff Mailing Address: P.O.Box 196650*Anchorage,Alaska 99519-6650*www.muni.org Municipality of Anchorage Development Services Department Building Safety Division On -Situ Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muniorg/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. ClikX41 '90 1. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address COSA# 0tsOgle% Expiration Date: i' c2- — .. 9 OVERLOOK ESTATES SUBDIVISION; BLOCK 3, LOT 6 27601 VANTAGE AVENUE • EAGLE RIVER, AK 99577 ALLAN OLSON Day phone P.O. BOX 211521 * ANCHORAGE. AK 99521 C/0 AGENT Day phone EVA LOKEN w/ PRUDENTIAL J.W. Day phone 689-6476 16635 CENTERFIELD DRIVE • EAGLE RIVER, AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer 1 heunWi icipality of Anhc orage evelopment rvices Department(DSD)-IsstTes-Certifiicates-of OnSite'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 axed hereto and as of the validation date shown below, 1 verify 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. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD. SUITE 101 * ANCHORAGE. AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. 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 6 Regulations. The reported results described 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 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 this report by any other person or party Is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for Q/Z6/o&. bedrooms, with the Mowing stipulations: Attachments: COSA-Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory L/ Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other l . rts4/t- Original Certificate Date: 9 —.2 9 - 0 6 YfpF gk�s, : ON-SITE • c : WATER AND Inc WASTEWATER PR4 o ` s�i,' ` .. • . •S �3t l reIrm\N I Fluid depth in absorption field before test 0 in Water added 601 gal. New depth 0 In. Elapsed Time: 235 min. Final fluid depth 0 in Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date — Municipality of Anchorage Development Services Department Building Safety Division On-Sle Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description• OVERLOOK ESTATES SUBDIVISION; LOT 6, BLOCK 3 Parcel ID: OC g -0 ¥/ 'a o A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 7/1985 Sanitary seal (Y/N) YES Wires property protected (Y/N) YES Total depth 93 ft. Cased to 40+ ft. Date of test Static water level Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION 7/1985 7/14/2006 57 ft. 60 ft. Well production 5.0 gpm 2.5+ g p m WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 0.353 mg./L. Other bacteria 0 colonies/100 ml. Arsenic: _HfLug /L Date of sample- 7/17/2006 Collected by GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 7/5/1985 Tank size 1250 gal Number of Compartments 2 . Cleanouts (Y/N) YES Foundation cleanout (WN) YES Depression over tank (Y/N) NO High water alarm (Y/N). NJA Date of pumping 6/7/2006 Pumper JRe PUMPING C. ABSORPTION FIELD DATA Date installed 7/5/1955 Soil rating (g.p.d./ft2ore 129 Length 33 ft. System type DEEP TRENCH Width 3 ft. Gravel below pipe 8 ft. Total depth 12.3 ft. Eff. absorption area 528 ft' Monitoring tube YES Date of adequacy test 7/17/2006 Results (Pass/Fall) PASS Depression over fletd NO For 3 bedrooms D. UFT STATION Date installed Size in gallons Manhole/Access (Y *Pump one level at _in. "Pump or le = — . High water alarm level at in. Datu a Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankfiR station on lot 1001+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line Animal containment areas 25'+ 50'+ On adjacent lots On adjacent Tots 100'+ 100'+ Public sewer manholeldeanout Holding tank N/A N/A Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Water main 5'+ N/A Property line 5'+ Absorption field Water service line 101+ Surface water 100'+ 5'+ 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10' Budding foundation 101+ Water main N/A Water service line 10'+ Curtain drain NONE KNOWN F. COMMENTS Surface water 100'+ Driveway, parkingfvehide storage Wells on adjacent Tots 100'+ 10'+ G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through Reid inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date 924 Ai COSA Fee $ y3�- 00 Date of Payment i 1 7/ O C Receipt Number 3 7 ( G 1 (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number .p 21 06 10:18a Eva Loken 1 61 r . efr„e/G 1 f • f / /r AS8UILT I HEREBY CERTIFY THAT 1 HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: AND THAT NO ENOROACHM_NTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE 'N9 ID DETERMINE THE EXISTENCE OF ANY •_..SEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. (907) 689-6477 p.2 CQ 0.00 SEWARD & ASSOCIATES LAND SURVEYING 694-0829 SCALE: - re) DATE: GRID: F3 iJ /L DRAWN:��ff C�Pd SbTM •rte/"•'%y� s 1 �••L$-�o18 411`."6::�6iStrij s 0 5. ENGINEERING FIRM PROVIDINu INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Date S & S ENGINEERING SR B 196X Telephone 69=L9i� EAGLE RIVER, AK 99577 l//Z:f /e aA Al 04;r.-V:ie b Yqd ;Sf� spy a0 a6.4 bee Stnides„ 4e: tt`u. 14-51•€f lP 9` daeo c„at oaoann)PL 6. DHEP APPROVAL D Approved for ¢/' +'/ bedrooms by 290 �/ / Date / 2 -2 - Approved X' 'Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) A. WELL DATA Well Classification MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & �VIRONMENTAL PROT'"C . N MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) NOV 2 6 ' CHECKLIST - FEBRUARY 1984 RECEIVED ECEIVE D Legal Description: / C. Vr3ZLtx�tc L S„ 5. If A, B, C, D.E.C. Approved (Y/N) Well Log Present ((tIN) Date Completed ) -�S Total Depth 93 Cased to 13 Depth of Grouting Static Water Level S r r-` /441 Yield * 3 no 4A4/HL. Pump Set At Lf. (& Casing Height Above Ground 3 coSanitary Seal on Casing ?N) Electrical Wiring in Conduit t N) Depression Around Wellhead (Y/tflp Separation Distances from Well: To Septic/Holding Tank on Lot /df ; On Adjoining Lots /oat -1- To t To Nearest Edge of Absorption Field on Lot 10014- ; On Adjoining Lots roa - To Nearest Public Sewer Line I -'(A' To Nearest Public Sewer Cleanout/Manhole Wed} To Nearest Sewer Service Line on Lot Z.6 - Water Sample Collected by ..S a-5 cn[L.tn/3c=+u/siC5- ; Date // ZI -8(� Water Sample Test Results 5 11.1-cs p, c,7c a -.y Comments t Fe -OV'. wac.L Lec,Lt. — caNn.1 V`/4=` -`— B. SEPTIC/HOLDING TANK DATA Date Installed 7-4-":81 Size /Z.S v No. of Compartments L Standpipes (ON) Air -tight Caps (ON) Foundation Cleanout (5'N) Depression over Tank (Y/63 Date Last Pumped -- #(./ 4744.1 Pumping/Maintenance Contract on File (Y/N) �1 ; for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well (od rf' To Building Foundation !6 -= To Property Line /v r -f To Disposal Field Zu To Water Main/Service Line (O' Course Comments i\sf IR' To Stream, Pond, Lake, or Major Drainage }-(ou 5cr t/a 5 cic�-+ i £#iLtt /-1cw4.4 W r4'S RutL.� Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata / a i x//3+2 Type of System Design /‘,/ C...."--/ Date Installed ... -5 `�-S Length of Field 31/ Width of Field v0 r/ Depth of Field / Z/ / Gravel Bed Thickness C3 Square Feet of Absorption Area a 8 41 Standpipes Present fg/N) Depression over Field (Y& Date of Last Adequacy Test sysrd.:.+1 Lcss ri-Hi-x4 2. you o-7> Results of Last Adequacy Test �r/A Separation Distance from Absorption Field: /vv74 To Water -Supply Well To Property Line /vo/-r° To Building Foundation zS To Existing or Abandoned System on Lot �1 ,ps ; On Adjoining Lots 30 i -A To Water Main/Service Line /v 74 To Cutbank (if present) N//} To Stream/Pond/Lake/or Major Drainage Course /--1(A- To Driveway, Parking Area, or Vehicle Storage Area /5 1 Comments D. LIFT STATION Date Installed / Dimensions Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.- Signed S & S ENGINEERING Date ///2s/e 6 - Company SR B 196X MOA No. ea' - (-Jo s EAGLE RIVER AK 99577 Receipt No. is / Do 2-7 Date of Payment /72-/72-'4/e‘4/ Amount: $ • oz. Page 2 of 2 72-026 (11/84) np tom• tab/- e f (' s i�.�1� JH�v oo.o