HomeMy WebLinkAboutMARIE ACRES LT 1Onsite File
Marie Acres
Lot 1
#018-181-22
..... 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: ,~'¢'J ¢J ~o OII ~ RID Number: O[9 ~[ ~.J
N~~ CU~ ~ ~[~ ~t~ Wastewater. SyStem:¢'.B New. ~Upgrade
Address:
~o~ ~o~ ~-~. ~/~ ABSORPTION., FIELD ~,
No. of Bedrooms: -
Phone: ~ -- ~4~ ~ ~ Deep Trench ~hallow'Tr;nch 0'8~ -~ Mound U Other
LE GAL D ES C R I PTI O N sci, Raftng: ~otal Depth from original grade:
Subdivision: Depth to pips bosom from original grade: ' Gr~v¢~ depth beneath pipe
Townshi,:¢~ Range:~ Section~ ~ Filladdedab°V~riginalgrsde: : Ft. Gravellength:~o, Ft.
~ New ~ Upgrad~ Gravel width: ~ ¢ Numberof lines:8sanoebewee. lines:
Classification (Pr~B.O):~ -- Total~D~F,. Cased To: FL Total ab~ea: SQ. Ft. Pipe~,~ateriah ~ ~'~
Driller: ~ ~ StaticWater LevekFt. Instal~¢ ~ Datein~lle~,,/~,
~ GPM I FL
SEPARATION DISTANCES ~ s~¢io u ~o~in~ U S.T.~.P.
TO Septic Absorption Lifl Holding ~ublic/Private Manufacturer: Capacity in gallons:
From Tank Field Slation Tank Se~erLines ~ . ~ [00 0
Wel[ ~ ~' ~ ~& ee~ Material~ ~ Number of Compartments:
SurfaCewater ~ID~ *)00/ ¢,~ ¢~ >,~' ~ LIFT STATION.
Lot Si~ ~ ~ll~s:
Foundation [~,~ ~01~ ¢~ cJ~ ¢ ',Pump on' level ~~water alarm at:
CurtainDrain ~ ~]~ ~}~ ~ ~ ~el lEle~tr?altnspectionsperformedby: .~
Remarks: ~ ~~ ¢&~ BENCHMARK
O~ ~~ 9 ~ ~ ~% Z Location and Description:
, ~ Assumed Elevation: '
Inspections performed by'~ ~'~~ Dates: 1st &~,e/~ ~' ~~ ~':
Reviewed and approved by: (~- ~ ~1~ Date' ~ i ~ '~OFESS~0%~
72-013 (Rev. 9/91) MOA 25 ~
i . · ' ' ~X~ 100 FOOT WELL RADIUS '
, ,
SEPTIC UPGRADE: .LOT 1, MARIE ACRES S/D.
.... ~~'~ ~,....
PREPARED
.PREPARED BY: ALASKA WATER & WASTEWATER SERVICES
DATE: JUNE 20, 1996 DRAWN: GARNESS 1' = 50'
,, , , , , ~ . .. ,
AS-] UILT
NEW 1000 GALLON SEPTIC
TANK, INLET INVERT =
94~00, OUTLET INVERT :
92,74.
CH CIA, PVC LINE FROM
HOUSE, INVERT AT HOUSE
= 94,33, DROP FROM HOUSE
TO TANK = ,33 FT. SLOPE
= 2Y. (APPROX,)
DRAWING
GROUND OVER TANK = 98,8
APPROXIMATELY,
TOP OF TANK = 94,50
GROUND COVER : 4,3
FEET. APPRDX,
GROUNO ELEV. OVER
TRENCH VARIES FROM
lOO,O TO 101.6 ~
FOR LOCATION DF M,T SEE PLAN DRAWING
-- FILTER FABRIC OVER INSULATION
AND DRAINROCK,
A. INVERT DF DRAINPIPE : 93,42
D, BOTTOM DF TRENCH : 89,83
C, ND GROUNDWATER TD 83.55
D. TRENCH LENGTH : 60 FEET
E. TOTAL A]]SDRPTIFIN AREA = 565 SO. FT,
F, 4 INCHES DF INSULATION OVER THE
TRENCH PORTION UNDER DRIVEWAY,
5.00 r .~ ,
!
....... I
I
PREPARED F~:, JOHN & STEPHANIE MOSES I
I
CE
ALASKA WATER
I 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
PERMIT NUMBER:SW960118
DESIGN ENGINEER:ALASKA WATER & WASTEWATER SERVICES
OWNER NAME:MOSES JOHN KENNETH
OWNER ADDRESS:3800 DEARMOUN RD
ANCHORAGE, ALASKA 99516
PARCEL ID:01818122
PAGE 1 OF 1
PERMIT ~- [%-%~
DATE ISSUED: 6/13/96
EXPIRATION DATE: 6/13/97
LEGAL DESCRIPTION:
MARIE ACRES LT
LOT SIZE: 34525 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD 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: ~
DATE:
DATE: -I; -
8471 Brookridge Drive ~ Anchorage ~ Alaska
Phone (907) 33%6179 ~ Fax (907) 338-3246
Consulting Engineers
May 22, 1996
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Sewer Permit for Lot 1, Marie Acres S/D.
To whom it may concern:
The subject property is served by a private well and septic system. The septic system is
currently functioning, but will not pass anadequacy tests. We are proposing to install a new
trench, and a valve, so that flow can be alternated between the new and the old drainfields.
Comments regarding the proposed upgrade are summarized as follows:
1. Soils: The test hole revealed that the soils were primarily GM overlaid with 5 feet of SM
(with lenses of ML) The percolation rate of the GM soil was determined to be 7 minutes/inch.
No groundwater or weeps were encountered, and the soil was generally dry.
2. Trench Design:
a. Percolation Rate: 7 minutes/inch
b. Application Rate: .8gallons/day/ft2
c. Number of Bedrooms: 3
d. Design Flow: 450 gallons per day
e. Minimum Absorption Area: 562.5 ~2
f. System Type: deep trench
g. EffecfiveDepth: 3.5 feet
h. Width: 5 feet
i. Reduction Factor = .54
i. Length: 61 feet.
j. Effective absorption area = 565 ft2
3. Surface Waters: There are no surface waters within 100 feet of the proposed septic
upgrade.
4. Slopes: The lot slopes downhill from north to south at approximately 1% grade, and from
east to west at approximately 2% grade. In short, the lot is relatively flat.
I am unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact me at 337-6179, or on my digital pager at
1-800-481-1162. Thank you.
Sincerely,
Owhc4'/Cc
amess, P.E., M.S.
sultant
Marcil.wps
VACANT LOT PER
M,H,A CHMPUTER
SEARCH,
.J
UNDEVELHPE~ LAND
DEARMHUND
T18N, R3W, SEC 33, LOT 5
PRIVATE WELL & SEPTIC
SYSTEM PER DHHS RECORDS,
HOUSE, WELL AND SEPTIC
ARE >800 FEET FROM THE
PRHPOSED UPGRADES UN
LHT 1, MARIE ACRES S/D,
TISN, R32, SEC 33, LOT 28
VACANT LOT PER DHHS
RECORDS,
WELL
WELL
LOT 2, MARIE
TISN, R3W, SEC 33, LOT 89
LOT IS VACANT PER DHHS
RECORDS,
NEW TRENCH
EXIS I'1~
TRENCH
SEPTIC AREA
T12N, R3W, SEC 33, LOT 3,
PER ]DHHS RECORDS THERE IS
A PRIVATE WELL AND SEPF!C
SYSTEM ON FHIS PROPERLY,
THE HOUSE, WELL, AND SEPI!C
SYSTEM ARE >100 FEET FR(Jr,t
THE WEST PRDPERTY LINE:
SEPTIC UPGRADE, LOT 1, MARIE ACRES S/3
PREPARED FOR~ JOHN AND STEPHANIE MOSES
PREPARED BY, ALASKA WATER & WASTEWATER SERVICES
I I
~ATE~ MAY e~, ~996 ~RAWN~ GARNESS ~CALD l' =
100 FOOT WELL RADIUS
ELEV.=
ELEV. AT
ELEV. :
NORTH PROPERTY LINE
VALVE (NEW)
1250 GAL.
:. SEPT!~ iTANK.
,!: :.iE~(ISTING TRENCH
ASTM D3034
4 INCH DIA. PVC.
C/O(NEW)
2% SLOPE
TRENCH. 61 ~EET
T NEW
~ SHED
TEST HOLE M.T.
LOCAFION. GROUND
ELEV. = 101.55
97.2
lISTING SUMP. CONTRACTOR
SHALL EXTEND IT ABOVE GRADE,
ELEV. = 100.9-
NOTES: CONTRACTOR SHALL HAVE WELL RADIUS FLAGGED BY REGISETERED LAND SURVEYOR. IF THE TANK IS WITHIN THE 100 FOOT
WELL RADIUS, THE TANK SHALL BE MOVED.
CONTRACTOR SHALL EXPOSE THE SEPTIC TANK DOWN TO THE WATER LINE, IF IT HAS HOLES IN IT THEN THE CONTRACTOR SHALL REPLACE
IT WITH A 1000 GALLON, l~NO .COMPARTMENT TANN,
THE PROPERTY OWNER SHALL BE RESPONSIBLE FOR IDENTIFYING ANY EASEMENTS WHICH ARE NOT SHOWN ON THE SURVEY PREPARED BY
LAN TECH SURVEYING
THE CONTRACTOR SHALL BE RESPONSIBLE FOR ALL UTILITY LOCATES,
THE HOMEOWNER/BUYER WILL BE RESPONSIBLE FOR TOPSOIL AND REGRADING AFTER SETTLEMENT OCCURS, FOLLOWING CONSTRUCTION.
THE CONTRACTOR SHALL BE RESPONSIBLE FOR INITIAL TOPSOILING A RESEEDING OF GRASS AREAS WHICH ARE DISTURBED BY CONSTRUCTION.
ALL CONSTRUCTION TECHNIQUES, AND MATERIALS USED SHALL COMPLY WITH M.O.A. REGULATIONS.
SEPTIC UPORAD. E:
FOR:
PREPARED BY:
DATE:
LOT 1, MARIE ACRES S/D.
JOHN & STEpHANIE MOSES
ALASKA WATER & WASTEWATER SERVICES
MAY 22, 1996 DRAWN: GARNESS 1' = 50'
CE-7953
THE TRENCH SHALL HAVE A MINIMUM LENGTH OF 61 FEET, AND A TOTAL
EFFECTIVE ABSORPTION AREA OF 565 SQUARE FEET.
MONITORING TUBE ~TYP.)
PERFORA TED IN DRAINROCK.
OKFILL WITH NATIVE SOIL AND MOUND.
TOPSOIL & RESEEDING SHALL BE RESPONSIBILITY
OF HOMEOWNER. IF HOUSE IS BEING SOLD,
SELLER SHALL COORDINATE WITH BUYER.
__ PROVIDE 2 INCHES OF BOARD INSULATION
IF SOIL COVER IS LESS THAN $ FEET.
INSULATION SHALL OOVER THE ENTIRE
WIDTH OF THE TRENCH.
TER FABRIC SI~-T BARRIER
DRAINROCK SHALL
SOREENED PER M.O.A
SPECIFIOA TIONS.
$9.75 ~
5 FEET WIDE
N 0 TE;'
1.
2..
TRENCH SHALL RUN PARALLEL TO THE SLOPE CONTOURS.
FOR LOCATION. OF CLEAN-OUTS AND MONITORING TUBES
SEE THE SITE PLAN.
3. CONSTUOTION PRACTICES, AND MATERIAL SPECIFICATIONS
SHALL COMPLY WITH ANCHORAGE MUNICIPAL CODE 15.65,
"WASTEWA TER DISPOSAL REGULATIONS".
4. INSTALLATION SHALL COMPLY WITH SPECIAL PROVISIONS
NOTED ON THE SEWER PERMIT.
5, SMEARED BOTTOM AND SIDEWALLS SHALL BE RAKED.
6. BOTTOM OF TRENCH SHALL BE LEVEL. 2 INCH MAXIMUM
VARIATI.ON BETWEEN HIGH AND LOW SPOTS.
DETAIL FOR 5 FOOT WIDE SHALLOW TRENCH:
PREPARED 'FOR:
ALASKA-WATER & WASTEWA TER SERVICES
DATE: ~/z'-~/c/~ DWN: GARNESS
SCALE:
NTS
INCH DIA., ASTM F810
PERFORATED PIPE. HOLES
DOWN. PLACE 2 INCHES
OF DRAINROCK OVER TOP
OF PIPE, AND ACROSS
ENTIRE WIDTH OF TRENCH.
PIPE SHALL BE INSTALLED
LEVEL (WITHIN ,01 FEET).
~BENCHMARK IS TOP OF
FRONT DOOR THRESHOLC
ASSUMED ELEVATION
= 100.00.
PERFORMED FOR:
Municipality o! Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 ';L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTION:
DATE PERFORMED:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19-
20-
SLOPE
SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
$
IF YES, AT WHAT b'J/t'~
DEPTH? P
E
~onitorlng? .0ato:
Reading Oalo Time Tirne Water Drop
PERCOLATION RATE "7 (minutes/inch) PERC HOLE DIAMETER ~ //
TEST RUN BETWEEN 8~'~"~'-FTAND ~'O~'~ FT -'.
CERTIFY THAT THIS TES'T WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE.
72-008 (Rev. 4/~5)
C
~t30NNH.t.
M ,,g~,£O. O0 N
20,7
25.8
50'
50'
0
MUN C PA.T¥ OF ANCHO.AGE
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 ~ PHONE~/ I ~EW
EOC~TION ~ ~ ' '
NO. OF BEDROOMS
~,~.. Manufacturer ~ ~ d'' Materiala'r~' i NO. of ~partments
Liq..caEacity in'gallons ~ Inside length
~ ~'S--~) IF HOME.DE: ~/fl Width ~1A Liquid depth
~ ~ DISTANCE TO: Well Dwelling PERMIT NO,
z--NO Z ( Manufacturer Material Liquid capacity in gallons
Q~ DISTANCE TO: Well I0~ ' ~ FounOation~ j t N~arestlotlinegg,V. PERMITNO.
N ~ ~ ~ inches Total elective absoEp~on are~
~ Top of tile to finish grade H/ Material beneath tile 7 ~ ~s
Length Width Depth PERMI~NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
~ DISTANCE TO:
~ Class Depth Driller Distance to lot line PERMIT NO,
~ DISTANCE TO: Building foundation Sewer linc Septic tank Absorption area(s)
CT. ER
72-013 (Rev. 3/78)
PERMIT hlO:
C, RTE :[E;SUED:
F!PF'L I E:F:IIqT:
RDDF.:ESS:
CONTRCT PHONE:
L. EGRL. DEL=--CR t P:
:940:t..24
F:'!::IUL~ R.' ':"~;EL.L. INS
'.':-.,F;.:R DON ::L]:77
RNCHORF~GE., RI'::.' 99502
L. OT
i-'iR ::.:: BEB, RCu=ihI':5 '
'=;J IEi[:,i'-./TC;T -j'.J · hl'::4r~TF:' I::ICFi:E~ LL]T: ~..
SEC T Z ON: ~:=< T :' i,.il",k::";H :[ F' ' :J_;2N RFIi",iGE':: .7_::W
47 .~ :_:;O ,:: :F:;C-.!. F'T. t:]R FiE:RE:5
BLOCk:: I-,IR
L. ! :.:.;TED 81EL. OW RRE THE OF'T :.,r. Oi",iE; F:!',,,'Fi i L...RDLE TO "COL.! i.~',i. DEE; I GN I i",!.G 'YOUR SEPT I C.
'..'.'-.',"r'STEH. I]HOi]'.'SE THE 0PTI,'.'.)N ]]'"iJ:~]' DEE;T F'iT:5 '~.h.]lLJl~;~: .SITE.
-F ~:;.'-.-~ ~E D..~ ~Z:: IF~ E~ EZ E::. ~,..-~ .. KD. IF.-.:: Fi~ 3E ~'-,~
DEPTH TO PIPE DO'T-i'Oi~'1 <FT;
GRFI'v'EL DEPTF! ,:;F'T'. ;:,
TOTFiL DEPTH ,::FT. >
GRRVEL t.,.!:[DTH ,::FT. >
I~..iF.:R'v'EL LENGTH ,.'.'FT. >
GRF=I'--/EL ',/OLUHE ,::CI...I. "r'[:'~:";. ::'
TFilql'::: E';:[:=-'TE '.'.'GF!L.::'T,::'
:50 .,'[. L. RF:FF I NG ':.' SQ. Fl'. ,.'"E;F.'. >
4. O, 4. O
· 1.:!.. 0 4. 5
2. 5 24. O
5::=.:L t3 4 ~;.
4.0. '9 40. ',:3
:t.., AAA :;i ;.i.::+: ' :L., 700 0
97 F:; ;24 ;2
:+::+:
:d:. 5 '
5.0
:~"_g. 6.1 :+::+:
:1.., 0¢0. O :+::+:
:+::+: _~F.r-I,EL LENSTF. ]:' .;:r,~'~ F'T. ,~'~'~::'I'~iJ]'J'I:~:E'.'~ i:'IULTIF'LE ~'~'J]N~ ,::NOT E':.:;"EEE,.T..NI] ~.~ Fl'. ERIE:H)
:+::+: TF!NK !"lUST "' 'F ' ' _._.I .~. rE
Hl..fv=:. FiT !...E:R:ST TI40 ..... r=,=,,;,- ..... ~ ',='
.i;. CERT]:F'¢ TFFrF:
.% t I::ii'"l F:'F:I!'"II'L]tFtF.: H'r'T'H THE .F-.%';!_i:F;~:EHENT'E'; FEd:;: i]i~..~-.~:]~[TE :SEWEF.':S Rt'.,t[:, WELLE; 85 ~ET
FORTH B"r' THE Hi...iNICIPFfi....ZT'¢ 0.,r':' R.KiCFiORF!GE ,:.'f'qOFl> FIND THE STRTE Ot:: RL. RL:;KR.
I !.,.i:[L.L. iNS'i"FtLL.. THE :E;?E;TEM iN FICCORE:,Fii'.4CE HI]"H RL.L. t"iOl::l CODE:S FtNC, REGULF:ITIONS.,
Fih!b l N COHPL..T. Rh!CE Fi i TH 'THE [.,E:Z Z GN CRt TER ! R OF TH.[ :~"; PER['I]: T.
Z 14iLL FiDI..-IERE !"0 RL.L. HOF! FIN[:, ?¥F:ITE OF FIL. FIE;k'.'F! I;..'EQUIREHENTL=; FOR THE %ET BRCK
[:,]."..?,TR!'-,ICE;E.; F'ROH !"=iN'¢ E::-::iSTIi',tG 1.4EL.! .... HFI'=':;TEWFFFER DISPOE;RL L:;'¢STEH OF.: F'UE:LIC
:r]EI.,.!ERRGE S'¢5TEH ON T!-.'i!% OJ:;.: Fii",i:-r' .¢:!DJ'F:!CENT OR i",iEF!RE:"r' LOT'.
.T. UNDER:STFIhi[:' q"HFFF Tl'-i:[5 PE:RH:i:T !:.5 VRL. ID F'E~F.: Fi i"IFl::.:;Ii'"ii..ti'"i OF 3 E:EB'ROOi"IS FIND
FIF,i'~'" E]qLFIR[~iEf'IE'N]" !.,.i .'[ L.L RE[.:!U i F:E RN R[:,E:, Z T' ! ONFiL PEF::f'i Z T.
]:F R
TFIEN
141 L..L.
EL.ECTF::iCFIL. klORi-::: i'"!.'5T E',E E:,ONE E','¢ R L..:i;:'E!'.i'qE.:i::, EL..ECTI:-::):C.~FIN.
FtF'F'L_TCI::INT: F'I=ii]L ~:. :E;E'].]....iI'.,J'.F5
]!] ~;'S IFF:, [:'l:! TE
LIFT ST!:iT:i:EH"4 iE; !: I"4 :~; 'T .:i .......... E:[:' iN F::iN I:::iFi:[:.:']:! '.":F"v'E'I:;?E:'I":' E.'''' ["il]F! Ed.] ]: L..C, ]; i",JG E:O[>ES.,
Et.E ..... ZC:Fd... PERi"IJ.¥ F.'i'u'"' 'rhlE;PECTiEfi'.,i t,iUST EE E~DTRI!qE[:,.; ,'2':, I=I'.~-I.-]UiLT'~,
!',tOT E',E c,-ll .... F !~.,...~r', ~:.,..r'r., b.I., i'THOI..iT rt'" ',t ............. ,r.:'!' E:E:"FR i CF!L. !Iq:!:~;F',r£F:'T l ON F::EP[IR't] FIN[:' "~"_ THE
SOILS LOG
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
10
MUNICIPALITY OF ANCHORAGE
DEPARTIVlENT OF HEALTH AND ENVIRONMENTAl- PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG- PERCOLATION TEST
SLOPE
/'
'~"/PER CO LATIO N
TEST
SITE PLAN
11
12
13
14
15
16
17
18
19
2O
WAS GROUND WATER
ENCOUNTERED?
O
P
E~
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
/- 7
'PE-'~ATION RATE ¢~ (mi lutes/inch)
· , ! ' T~ES~T RUN BETV~E~EN -.~ -- FT AND ,~ ~) FT
72-008 (6/79)
Date Drilledj
4-2-84
Static Water Level 1.01 feet
Gallons Per Minute 7
Draw Down N/^ feet
Total Feet of Casing i6n
Ope Material Drilledj
0 feet to ~5 ~nd, ~ravel
15 feet
53 feet
160 [eet
to 53 Crave].
tO 160 C].av, ~ravel
tO Cravel w/water
to
to
Hefty Drilling
S.R.A. Box 1553 H
Anchorage,Alaska
99507
MUNMPAUTY OF ANCHORAGE
Development Services Department N^ MI � � Phone: 907-343-7904
On -Site Water & Wastewater Section Fax.- 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 018-181-22
1. GENERAL INFORMATION
Complete legal description Marie Acres L1
Location (site address) 3800 De Armoun Rd
Current property owner(s) Steven Walters
Mailing address
Real estate agent
2. TYPE OF DWELLING:
El Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
Expiration Date: "be - C
Day phone
Day phone
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Private Well Private Septic 171
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.
COSA Fee $ -1 ar �i 0 I - `�� Waiver Fee $
Date of Payment "— 2 a Date of Payment
Receipt Number (9'2.2 09C2 Receipt Number
COSA# OSC�20 9 53 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.
In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with Mol
COSA guidelines and 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 or
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. Therefore we cannot
provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole
benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly
recommends buyers hire their own engineer to evaluate this report.
Name of Firm Pannone Engineering Services
Address P.O. Box 1807 Palmer, AK 99645
Engineer's Printed Name Steven R. Pannone P.E.
6. DSD SIGNATURE
System #1 Approved for –1— bedrooms
System #2 Approved for bedrooms
Disapproved
Conditional approval for
Phone (907) 745-8200
Date
Steven R, onn,one,
CE 8149CPA
bedrooms, with the following stipulations:
C
S1
1 a7us
G
By: Original Certificate Date:3 a, 01.
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based onlyclupon 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
Septic System Advisory
Well Flow Advisory
COSA Checklist blue sheet
Nitrate Advisory
Arsenic Advisory
Other akgI Sor x
Legal Description: Marie Acres L1
If more than 1 septic system on lot: COSA Checklist # 1 of 1
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled 412J1984
Total depth 160 ft
Cased to 160 ft
❑ Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 30 in.
Date of flow test for COSA 72712020
Static water level at beginning of test 81.3 ft.
Comments
B. TANK DATA
Age of tank(s) 24 years
Tank type/material SeptiGSteel
Measured operating fluid level in septic tank
❑ Standpipes/foundation cleanout per record drawing
Date of pumping 7/28/20
D. ABSORPTION FIELD DATA Deep Trench
Which system tested (date installed) 8/13/84
❑ ALL standpipes present per record drawing
Total measured depth from grade 11.7 ft (max)
Measured depth to pipe invert from grade 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 gallons
Comments/Deficiencies:
COSA Checklist yellow sheet
Parcel ID: 018-181-22
_ Structure served by this system 1
�U,
Well production at time of test 2.38 Qom
Water storage tank volume 0 gallons
Well disinfected for coliform test? ❑ Yes ❑✓ No
❑ Coliform bacteria is Negative
Nitrate mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ❑ Arsenic less than MRL (ND)
Collected by Pannone Eng
Date of Sample 7/29/20
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
Adequacy test date 7/2712020
Results El Pass For 3 bedrooms
Fluid depth prior to test 0 in
Water added 453 gal
New depth 7 in
Elapsed time 420 min
Final fluid depth 0 in
Absorption rate '450 gpd
Any rejuvenation treatment (past 12 months)
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'
M✓
Yes
Community Sewer Manhole/Cleanout > 100'
M✓ Yes
if No
ft
M Yes
if No
Neighboring Tank > 100' M Yes
if No
ft
Private Sewer/Septic Line > 25'✓Q Yes
if No
Absorption Field on Lot > 100' Fv Yes
if No
ft
Holding Tank > 100' Yes
if No
Neighboring Absorption Fields > 100'
Yes
if No
Animal Containment > 50' Yes
if No
[D Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' �✓ Yes
if No
ft
rvI 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'✓1
M✓
Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
El
Yes
if No
ft
Private Wells > 100' r7l Yes if No
Water Main > 10'
El
Yes
if No
ft
Community Wells > 200' ❑✓ Yes if No.
Water Service Line > 10'
0
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'
M✓
Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'
El
Yes
if No
ft
Private Wells > 100' QQ Yes if No
Water Service Line > 10'
El
Yes
if No
ft
Community Wells > 200' P Yes if No
Surface Water > 100'
0
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. '2
COSA Checklist yellow sheet
ra,
ft
ft
ft
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT 907‐343‐7904
On‐Site Water and Wastewater Section Fax: 343‐7997
www.muni.org/onsite
Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org
Septic Tank Advisory
Certificate of On‐Site Systems Approval # OSC201458
Subdivision: Marie Acres Lot: 1
The septic tank for this property is 24 years old. The average life for a steel septic
tank is 20 years. Typical replacement costs range from $7,000 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 30 year old steel tank MAY look like.
To: MOA / Whom it may concern
RE: 3800 Dearmoun Road drain fields
I have owned and lived at 3800 Dearrnoun Road since 1998. We have never had
either one of the drain fields freeze,
Regards,
IAI Y��
Steve Walters
p
Scale 1" = 25'
Y
CULVERT
1
,------------- ---------------------
d
I
N
tC1
XTP r
X W
h
N
h.
O
O
44
DEARMOUN " iA i
30.0 R.O.W.
X Electric Meter o= Sign
A !I
LT, Tel. Pedestal :T: Light Pole
A
LES Elec. Pedestal/ Chain Link Fence
Septic
.W; Water Well
`51 Mailbox
General Notes
1. This document is created for the purpose of a single property
transaction and is subject to Federal Copyright Laws.
2. Excepting for gross negligence, the liability for this survey shall not
exceed the cost of preparing this survey.
3. All measurements/setbacks are to the visual/apparent building
footprint.
4. All dimensions to property lines are plus/minus 0.1 ft.
Disclaimer
1. This survey complies with the ASPLS Mortgage Location Standards. The survey represents visible q ' H''��
improvements and conditions at the time of the survey. This document does not constitute a boundary G�
survey and is subject to any inaccuracies that a subsequent boundary survey may reveal. It is the • • • • • • • i
responsibility of the Owner to determine the existence of any easements, covenants, or restriction r i
which do no appear on the record plat. Under no circumstances should this document be used for j .............................
construction or for establishing a boundary or fence line. p pier M. St Bier
N. LS- 22
0 12.5 25 50 09/02/2020
Scale in Feet tIttl>>tSI ONA-1-
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
Parcel I.D. #
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Lega~scription (include 10t, block, subdivision, section, township, range)
(b)
(c)
Location (address or directions) .
Property owner (.-~¢'~[[~b~"~F Telephone: (home)
Mailing Address ~¢/'~2,~' ~-"~~-'?¢t-'/Z~-/'- b~J ~¢'-
Lending Institution ~¢J/,~ Telephone
Mailing Address
(d) Real Estate Company and Agent
Address
Telephone
(e)
Mail the HAA to the following address: (or check here f~hold for pick up.)
List contact person and day phone number below:
TYPE OF RESIDENCE
Single-Family/~ Number of bedrooms - ~
WATER SUPPLY
Individual Well,J~ Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
SEWAGE DISPOSAL
On-site,~¢(- Public [] Community [] Holding Tank []
/
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legality and status.
72-025 (Rev. 7/88) Page 1 of 2
5. ENGINEERING FIRM PROVIDING 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 re,gulations in effect on the date of this inspection.
Name of Fir ,~'/.~/ /'' ~:,--/,4¢7c~. -.~-.~ Telephone ~?z/-5~'' ~ ~/~/~/'~
/
Address
Date
6. DHHS APPROVAL
Approved for .~ bedrooms by
Approved ,~ Disapproved
Terms of Conditional Approval
Conditional
The MunicipalityofAnchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
cerificated based only upon the representations given in paragraphSabovebyanindependent professional engineer
registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHHSdonotconductinspections
or analyze data before a certificate is issued. TheMunicipalityofAnchorageis not responsible for errors or omissions
in the professional engineer's work.
72-025 (Rev. 7/88) Back Page 2 of 2
~ F¢~C'~L~IPALITY OF ANCHORAGE (MOA) ~ '
.eD.th Autho.,y A..rova (.^A)
&%~" ' '~CHECKLIST - FEBRUARY 1984
¢'"~ .. ,~ ',~%~ 343-4744
~ (?.,' .,~ Legal Description:/~/¢
A. WELL DATA
Well Classification' /~/' _~?//~ If A, B, C, D.E.C. Approved
Well Log Presen~ ~ Date Completed ¢- ~ ~/ Yield
Total Depth/~ Cased to./~ Depth of Grouting
StaticWaterLevel ~ /
Pump Set At ~
//
Casing Height Above Ground --~¢
Electrical Wiring in ConduitS)
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot /~
To Nearest Edge of Absorption Field on
Sanitary Seal on Cas!ng~N)
Depression Around Wellhead (Y~~
To Nearest Public Sewer Line
To Nearest Sewer Service Line on Lot
Water Sample Collected by ~-~¢/~/-~--~~-- ~-~ ; Date/
cWoatmerm::~ple Test Results :~
; On Adjoining LOts
; On Adjoining Lots
To Nearest Public Sewer Cleanout/Manhole .-/¢/~-"~
B. SEPTIC/HOLDING TANK DATA
Date Installed '~'~?/~'~/ Size /.~Z.¢'O No. of Compartments
Standpipe~N) / v./~ Foundation Cleanou~)
Depression Over Tank (~__~ ,/~'~ Date Last Pumped
Pumping/Maintenance Contact on File (Y/N) . ;for .?/./'/¢ .
Holding Tank High-Water Alarm (Y/N) ~"~'~' '~ Temporary Holding Tank Permit (Y/N)
SEPARATION DISTANCES FROM S_/EPTIC/HOLDING TANK: /
To Water-Supply Well /~ ¢ To Building Foundation
To Property Line '--~"~ '¢ To .Disposal Field
To Water Main/Service Line -2"'~ / -~ /
To Stream, Pond, Lake or Major Drainage Course
Comments
72-026 (Rev. 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata ,'~'7~"~"/
Date Installed ~ '-/-¢ - ~¢
Width of Field ~,-~ ?
Square Feet of Absortion Area
Type of System Design
Length of Field ~ / '/
Depth of Field
Gravel Bed Thickness
/,
Statndpipes Present~N)
Depression over Field (~ ./'~//~ Date of Last Adequacy Test
Results of Last Adequacy Test ~-~'2~ '~/,r, ,/7.~- ,':7~'-~,'~
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water-Supply Well
To Building Foundation
Lot
To Water Main/Service Line J'~
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments ~ y?/~/~//~¢~
/
To Property Line
To Existing,or Abandoned System on
; On Adjoining Lots /~ // /'~
T o/C u t b a c k ~(JJd~rese~:t.~
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes-(¥?~)'
Comments
Dimensions
Man h ole/Acce~(~,qr~~-
"Puml~"Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test.
**Check Permit~ed BedrooFRating Against HAA Request**
I certify that !~¢v¢¢heck~d;"v~rified, or conformed to all MOA and HA/
inspection //
S gned ,'//,"'"~/~ '~/
MOA No '~
Receipt No. ~ ~'-O"~¢ ¢~' "-~-~"-~
Date of Payment
Amount: $
72-026 (Rev. 7/88) Back
Receipt No.
Waiver Fee: $
Date of Payment
Page 2 of 2
in effect on the date of this
Engineer's Seal
'rEGAL ×//~'~,~/~- /f¢--:-/-.~V~.~c:~ ~ ADEQUACY TEST
/ SEPTIC LEACH
METER GALLONS GALLON~ TANK FIELD
THIS TOTAL PER DEPTH DEPTH
TIME READING PERIOD GALLONS MINUTE INCHES INCHES
OA~A SH£E T
PROJECT:
/ DATE OF TEST:
WELL DEPTH:,~ FT. CASING:_/~c? F~ SCREEN:
Elapsed Time Since
Pumping'StarEed/
Stripped, ttin.
0
1
5
10
20
35
5O
Depth to
fNat~r, ft.
Orawdown/
Recovery
210
Pumping
Race, GPH I
Remarks
Start
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
FEDERAL TAX ID # 92-0040440
ANALYSIS REPORT BY SAMPLE for ~ork Order $ 9810
Date 5eport Printed; OCT 17 88 8 15:44
Cliel~ Sentple ID:L1, )~RIE ACRES
?WSID :UA
Collected OCT 12 S8 ~ 15:00 h-~.
Received OCT 12 88 @ 16:45 hrs.
?reserYed with :COOL
Client Nam : CO,WIN ~ A$SOC
Client Acct: C05WYMP
P.O.~ NONE BEC'D
Req ~
Ordered By :
Analysis Completed :OCT 14 88 Send geporte to:
Laboratory Supe~yl~_o~_ :STEPHEN C./EDE L)CORWIN & ASSOC
Special
Instruct:
Chemlab 5e£ $: 2992 Lab Smpl ID: 3 Matrix: WATER
Allowable
Parameter Teated Result/U~ts Method Limt~
NITRATE-N ND(O.IO) m~/1 EPA 353.2 10
Sample ROUTINE SAMPLE
Remarks: SAMPLE COLLECTED BY J. KRESS.
1 Teats Performed See Special Instrnctions Above UA~UnaYailable
ND- None Detected "' See Smaple Remarks Above
NA~ Not Analyzed LT=Lees Than, GT~Gr~ater Than
·,. ' f " MUN~.CIPAL, ITY OF ANCHORAGE '
DIVISION OF ENVIRONMENTAL ~ALTH
DEPARTMEIfr OF ~EALTH ~ ENVIRONMENTAL PROTECTION
APPLICATION FOR REALTH AIr£HORITY APPROVAL CERTIFICATE
'1..General Information Application Date
(a) Legal Description (include lot, block, subdivision, section, township, range)
__-/~ ~ fY~<..~ ~,~,~ I:~. c~'~'~'~ ~,..~,:~i',~,i'~i?v'~,
Location (address 9r directi,gns).
(b) Applicants Name ~! ,._ I:~,:{~z~.~V,~.L/~f~, Telephone - Home Business
Applicants Address ~(~ '~ f~/~gx Dr-x~ ~ ~?~-~a. c/
one) Lending Institution ~~51dar ~ ;
Applicant. s
(check
Buyer ~'; Other ~ (explain); ~
(d) Lending Institution '. Telephone
Address
(e) Real Estate Co. & Agent
Address
Telephone
(f) Mail the HAA to the following address:
2. ~ype of Residence
Single-Family~'"~
Number of Bedrooms
3. Water Supply,-
Individual Well~------~~
Multi-Family
Other (describe)
Community ~_J Public ~--~
'Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
4. ~ewage D%sposal
Onsite ub tc Community oldi g Tank
Note: If community well system~ must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
[Page 1 of 2]
E_~n_~ineerin~, Firm Providin~_Inspections~ Tests, File Search~ Data and Info
As certified by my seal affixed hereto and as of the validation date s
verify that my investigation of this Health Authority Approval shows that the on-sit~; ~
~ater supply and/or wast,water disposal system is safe, functional and adequate for
the number of bedrooms and type of structure indicated herein. I further verify t.hat~
based on the information obtained from the Mmnicipality of Anchorage files and fro~my
wast,water
investigation and inspection, the on-site water supply and/or disposal
system is in compliance with all Municipal and State cedes, ordinances, and regula-
tions in effect on the date of this inspection.
Name of Firm . '!22/.' ~!~ Telephone ... :,- ....
Address /'~/f-,/.. ) i ~)+']'-- '''~j ' -/2...,'.-.(:~ Ii',
Date ~ ~.
Disapproved __ Conditional __
Approved __~_._
Terms of Conditional Approval
CAUTION
THE bfUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND E~fIRONb~NTAL PROTECTION
(DHEP) ISSUES WEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIOJNAL 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 REQUIRE-
MENTS. 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.
(DHEP SEAL)
RR4/ej/DI8
[Page 2 of 2]
7-19-84
ae
·.
~g\goN~' M[INII2IPA~ITY OF ANCHORAGE (MOA)
Legal Description:
Well Classification
Well Log P~esent ~_~N)
Total Depth lO~) .~j~ Cased to
Date Completed LTL/~_./~
l~-6P-~ Depth of G~outi"g
Static Water Level t~9{ ~+- ... Pump Set At
Casing Height Above Ground ,~_--~z.~
Electrical Wiring in Conduit ~/N)
Separation Distances f~om Well:
To Septic/Holding Tank on Lot 1 ~)'+/ o
Sanitary Seal on Casing ~/N)
Depression ArOUnd Wellhead (Y~)
; On Adjoining Lots
To N%a~est Edge of Absorption Field on Lot
To Nearest Public Sewer Line I~/~
Cleancut/Manhole ~)/pt TO Nearest Sewer serVice L~u]on
Water Sample Collected By ~, ~)4~vO~' ; Date
Water Sample Test Results
IDO..~/0 ; On Adjoining Lots ICC+/O
TO Nearest Public Sewer
B. SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes ~,/N)
Air-tight Caps ~/N)
No. of Ccl~Psoetments
Fc~lndation CleanOUt ~-~)
Depression over Tank (Y~ Date Last Pumped ~J '~'
Pumping/Maintenance Con=act on File (Y~) ~/~,; for
Holdi~ Ta~ High-Wate~ ~am~ (Y~) ~ ~a~y Holdi~ Tank ~t (Y~)
~p~ation Distance ~ ~ptic~olding Ta~:
To Water-Supply ~11 ~0¢)+{ ~ TO ~ildi~ Foundation J~
TO ~o~rty Li~ 701 TO Die.esl Field ~' ~-
To Water Main/service Line
co=se /00+ /
To Stream, pond, Lake, c~ Major Drainage
Corm~nts
[Page 1 of 2]
2-15-84
Ce
ABSORPTION FIELD DATA
Soils Rating in Absorptipn Strata
Date Installed ~/~/
Width of Field
Square Feet of Absorption A~ea
Depression over Field
Results of Last Adequacy Test
'Type of System Design
Length of Field ~? / /
Depth of Field //
Gravel Bed Thickness '~/
~ Standpipes P~esent ~)
Date of Last Adequacy Test
Separation Distance f~om Absorption Field:
To Water-Supply Well !0(3.~/ ¢3 TO P~operty Line
TO Building Foundation ~t/ ~> To Existing or ~ndo~d System
Lot ~ /~ ; ~ ~joining ~ts ~'~ /
TO Wate~ Main/~vi~ Line ~/~ To ~t~Dk(if p~e~nt)
To St~e~ond~ke/~ ~jo~ ~aina~ C~ ~?/~
To ~iveway, Pa~king ~ea, ~ Vehicle St~a~ ~ea ~F3~
Date Installed Di~io~s
Si~ i~6al~ons
"~ ~" ~'~ ~ ~f" ~vel at
High Wate~ ~ ~vel m~.~.,, / Vent (Y~)
Tested fo~ /~i~g Cycles ~ing Adequa~ ~st. ~ets ~A
Electrical Co~s (,~ -'-~'-~ ..........
Common.ts / ~'~-~
** Check Permitted Bedroom Rating Against HAA l~equest **
I ce~rtify that I have checked, verified, o~ conforn~d to all MOA HAA Guidelines in effect
on the date/~j~/_ .~L°f this inspection.
company f~ I'~_-- ~ MOA No.
,
[Page 2 of 2]
2-15-84