HomeMy WebLinkAboutLAKE RIDGE TERRACE BLK 10 LT 6Lake Ridge
Terrace
Block 10
Lot 6
#051-323-20
.SUBM11, 11AC
Municipality of Anchorage DCT A2
On -Site Water and Wastewater Program - (907) 343-7904 PAof 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP121194 PID Number: 051-323-20
Dwelling:❑ Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New Upgrade
Name:
James & Judith Anderson
ABSORPTION FIELD
❑ Deep Trench ❑N Shallow Trench ❑ Bed ❑ Mound
Address
14231 Harold Loop
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
1.2 GPD/SF
4.0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original gradeGravel
1.5 Ft.
depth beneath pipe
2.5 Ft
Subdivision Block Lot
Lake Ridge Terrace 10 6
Fill added above original grade
1.0 Ft.
Gravel length
64.0 Ft.
Township Range Section
Gravel width
5.0 Ft.
Beds: Number of Lines
N/A
Distance between lines
N/A Ft
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
1
From
Tank
Field
Tank
Line
507.8 Fe
1
N/A Ft.
well
100.0
113.7
N/A
N/A
95.2
TANK ❑ Septic 0 S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Anchorage Tank
Capacity
1250 Gal.
Surface Water
100+
100+N/A
N/A
Material
Number of compartments
Lot Line
24.7
10.5
N/A
N/ANA
Steel
2
Foundation
12.7
23.0
N/A
N/A
LIFT STATION
Manufacturer
Capacity
Curtain Drain
N/A
N/A
N/A
N/A
Anchorage Tank/ Orenco
250 Gal.
Remarks
Pump on level at
43 in.
Pump off level at
40 in.
High water alarm at
45 in.
Pump make and model
P2005
Electrical Inspections performed by
S, P ttac-rm—L C—
PIPE MATERIAL House to tank PVC Tank todrainfield PVC
Installer
JR's Septic Pumping
Drainfield PVC CO/Mr pVC
Inspector Pannone Engineering Services
BENCH MARK (Assumed elevation) 100 ft
Inspectiontri 8/24/12 8/24/12
Location and description
dates: 2-
3'° 8/25/12 4" jV471511
Threshold of front door
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Engineer's Stamp
Conditional Approval: Date
..• •c4�9��
.✓yg�
*� 49 Mi
,.,I e . 1 n .A. pan `liririe Y
CE 8149
Approved
Inspection Rep rt 9-1-12.doc
\� �\ V /� Q
\ ��ww W / L WELL (E)
� o0
v0
-A �.
DRAIN FIELD (E)
ABANDONED PER CODE o
REMOVED ANY PART OF FIELD �-
WITHIN 20' OF PROPOSED FIELD -
(E) �' / 113.7
1000g SEPTIC TANK (E)
ABANDONED PER CODE
kY\
i
\g
A
z
4j 4BR
HOUSE
\ (E) i
A B
T1
14.4
39.7
LS
23.6
47.8
M1
38.9
60.1
M2
41.4
24.6
7
SEPTIC AREA
I(E)
i -
nn/
NEW DRAIN FIELD %h
TH-1 65LF, 5'W, 2.5'ED, 4.0'TD \41
-REMOVE AND REPLACE FOR RESERVE
NEW�1(500g S.T.E.P. TANK/
100.9
1
i. WELL (E)
3
NOTES: PANNONE ING SVC, LLC pF A(\ l Date
RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 . A !-... .. 1
PHONE (907) 272-8218 FAX (907) 272-8211 /!0)-- S 70,
, Scale
, *: 49 h1 • *16 1"-501
..... ... .... � P.I.D. NO
LAKE RIDGE TERRACE, BLOCK 10, LOT 6 `• 051-323-20
JAMES & JUDITH ANDERSON S'te'ven 'R. 'P annon, e PERMIT N0
14231 HAROLD LOOP �+o•. CE 614s j OSP121194
EAGLE RIVER, AK 99577 +� s (�,Q.**' . Sheet
PLAN �1j��OTs13 2 OF 3
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE
STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE
WASTEWATER DISPOSAL SYSTEMS.
2. ALL WORK WAS IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS.
3. SCOPE OF WORK: INSTALLED NEW 1250g S.T.E.P. TANK AND SOIL ABSORPTION SYSTEM.
4. GROUNDWATER WAS OBSERVED AT A DEPTH OF 10.0' AS EVIDENCED BY THE SOIL TEST HOLE. AN APPARENT WATER
TABLE WAS NOT OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 10.0 FEET BELOW EXISTING GRADE.
1500g
S.T.E.P.
TANK (P)
DESIGN PARAMETERS
PRIMARY/RESERVE SEPTIC SYSTEM
NO. BEDROOM: 4 (600 gpd)
TANK SIZE: 1500g S.T.E.P. (E)
PERC RATE = 1.05 MPI
SOIL RATING: 1.2 GPD/SF
AREA ROD: 500 SF
SYS. TYPE: WIDE TRENCH 2.5' E.D.
MIN LENGTH: 64.0 LF
USED:
65 LF X 5.0' WIDE, 2.5' E.D., 4.0' TO
TOTAL AREA: 507.8 SF
PROFILE
LEGEND
W WATER LINE/
WELL RADIUS
— SS — NEW SEPTIC
TRENCH SEE DESIGN
NOTES: PANONE i'il`IG SVC, LLC
RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
ABBREVIATIONS
CU
COPPER
DIP
RIGID INSULATION
TH
TEST HOLE
FC
MTER FABRIC
T#
TANK CLEAN OUT NO.
C#
1Y B GRAIN PIPE W/ 1/8" HOLES 18" O.C.
M#
MONITOR TUBE NO.
R.I.
DRAIN ROCK 6" ABOVE PIPE INV
DCO
TH-p98.4
DV
DIVERTER VALVE
FS
FLOW SPLITTER
OR
97.4...�.
2.0—L_
_
ORIGINAL GRADE
-1.0
FINISH GRADE
-r
95.9
2.5
2.5
-93.4
SW/
50-1
DRAIN ROCK
6.0
I
-1D.D
SECTION
GN
-13.5 BOH
m m
RIGID INSULATION
F
rc F ILTER FABRIC rc
o
z
f1T11r1-1
o DRAIN ROCK 6" ABOVE PIPE INV
7Y!B DRINPIPEW/
2
IT /B" HOLES i R" C. n
1500g
S.T.E.P.
TANK (P)
DESIGN PARAMETERS
PRIMARY/RESERVE SEPTIC SYSTEM
NO. BEDROOM: 4 (600 gpd)
TANK SIZE: 1500g S.T.E.P. (E)
PERC RATE = 1.05 MPI
SOIL RATING: 1.2 GPD/SF
AREA ROD: 500 SF
SYS. TYPE: WIDE TRENCH 2.5' E.D.
MIN LENGTH: 64.0 LF
USED:
65 LF X 5.0' WIDE, 2.5' E.D., 4.0' TO
TOTAL AREA: 507.8 SF
PROFILE
LEGEND
W WATER LINE/
WELL RADIUS
— SS — NEW SEPTIC
TRENCH SEE DESIGN
NOTES: PANONE i'il`IG SVC, LLC
RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
ABBREVIATIONS
CU
COPPER
DIP
DUCTILE IRON PIPE
TH
TEST HOLE
FC
FOUNDATION CLEAN OUT
T#
TANK CLEAN OUT NO.
C#
CLEAN OUT NO.
M#
MONITOR TUBE NO.
R.I.
RIGID INSULATION
DCO
DOUBLE CLEAN OUT
DV
DIVERTER VALVE
FS
FLOW SPLITTER
BFG
BELOW FINISH GRADE
OG
ORIGINAL GRADE
FG
FINISH GRADE
Date
9/14/2012
NTS
LAKE RIDGE TERRACE, BLOCK 10, LOT 6 -;„ k41051-323-20
JAMES & JUDITH ANDERSON / Steven R. Pannone PERMIT N0.
14231 HAROLD LOOP I %F'.. CE 8149 "SP1 21194
EAGLE RIVER, AK 99577 ++��ES�`"r sheet
DESIGN DETAILS 11. a��RK;D�ta�-.►
3 OF
asp Vv 4W4 J CWCUrJattvu LG tivr-.iVQV po90 a
J ELECTRIC LLC
6732 E. 99th- AVE.
ANCHORAGE, AK. 99507
August 30,2012
Flintstone Enterprises
1300 Oren 5t.
Anchorage, Ak. 99515
44
James or Judy Anderson
14231 Harold Loop
Eagle River, Ak. 99577
This lettex is to certify the J Electric LLC wired septic
lift station and alarm at the above address in accordance
with the NEC and HOA codes.
Contr. Lie # 34469
T T'd TT282L2:0i
r
T286"2LO6 9NIdwnd OIid3S S.6f:WOJd S0:80 2T02-e2-d3S
On -Site Wastewater Disposal System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP121194
Tax Code Number: 05132320000
Work Type: Septic Upgrade
Permit Effective Dates: July 30, 2012 to July 30, 2013
Design Engineer: PANNONE ENGINEERING SERVICE
Subdivision: LAKE RIDGE TERRACE
Site Legal Address: LAKE RIDGE TERRACE BILK 10 LT 6 G:0553
Owner/Address: DIETRICH JUDITH A
AKA ANDERSON JUDITH A 14231 HAROLD LOOP EAGLE RIVER AK 995779247
Site Mailing Address: 14231 HAROLD LOOP, Eagle River
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank
All construction must be in accordance with:
Lot Size in Sq Ft: 22500
Total Bedrooms: 4
N Privy N private Well N Water Storage
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Any part of the existing field within 20' of the proposed field will be removed.
Received
Issued By: /17.x" XC"L9'� Date: 0 / Z
MUNICIPALITY OF
T_
Community Development Department,
Development Services Division (�
On -Site Water & Wastewater Program
Mayor Dan Sullivan
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. CK;S' 323— 70
Phone: 907-343-7904
Fax: 907-343-7997
Property owner(s) J OYr# OIETre-iclJ +k N.3joiT#Awose!;ndDay phone
Mailing address )qZ-3i hwgott3 c.00P jea&Lic Rtvetc'4K 94s"77
Site address INZ-31 Wd2oto s,boP
Legal description (Sub'd., Block & Lot) L-AkC 4,676
Legal description (Township, Range & Section)
Lot Size ZZ, f� Sq. Ft. Number of Bedrooms 41
THIS APPLICATION IS FOR: THIS APPLICATION IS AN:
(® all that apply) Initial ❑
Absorption Field Upgrade K
Septic Tank
Renewal ElHolding Tank ❑
Privy
❑
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
I certify that the above information is correct. I further certify that this application is being made
for a Sing)e Family Dwelling and is in accordance with applicable Municipal Codes.
owner or authorized agent)
Permit/Rush Fees: 4.5.36.14 Waiver Fees:
Date of Payment: 4-/!a%/ a Date of Payment:
Receipt Number:Z' /G Receipt Number:
Permit No. 0SP1a � qL Waiver No.
GABuilding\On Site\Forms\Client FormsTennitApp_010411.doc (Rev. 1/11)
Pannone Engineering Services uc
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steveaDoanenzak.com
July 11, 2012
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
4700 S. Bragaw Street
P. O. Box 196650
Anchorage, Alaska 99519
Subject: Lake Ridge Terrace, Block 10, Lot 6
Septic System Permit Upgrade Request
Ladies and Gentlemen:
I am writing to request a permit to construct a new well and septic system be issued for this property. The
proposed systems will serve an existing four (4) bedroom house. Currently the lot is developed. The
existing drain field is in failure and will be abandoned per code. The new drain field will be built along the
north-east property line. The reserve system will be in the same location as the proposed system. The lot
is served by a private well that is located over 100' from the proposed system. The surrounding lots are
served by private wells that are all located over 100' from the proposed system.
1. Soils. One test hole was excavated by Pannone Engineering Services in June, 2012, and the ground
water was monitored for seven days. Ground water was monitored in at a depth of 10.0' after the
monitoring period in TH-1. Bedrock was not encountered. It is my opinion, based on the results of the
percolation tests and overall soils appearance; an application rate of 1.2 gallons/day/square feet should
be used for a conventional wastewater system.
2. Soil Absorption System Design.
a. See Sheet 2 of the design package
3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain
field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage
ditches.
4. Topography: The topography slopes at approximately 3% to 5% in the area of the proposed drain
field.
5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification
Mailing: P,O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (947) 272-8211
Page 2 of 2
that the review is complete and that there are no further comments is received from MoA On -Site
Department, the note will be removed and 'Issued for Construction" drawings will be issued.
The proposed installation will not affect the future development of the surrounding or existing lots. There
are no wells within 100 feet of the proposed septic location.
If you have any questions or concerns, please contact me at 272-8218.
Sincerely,
Steven R. Pannone, P.E.
Owner/Civil Engineer
Attachments
-Soils Log
-Septic System Design
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor Ave, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
WELL (E)
o°
2/ v
\�'a\ 9 \
M
APPROXIMATE LOCATION OF
DRAIN FIELD (E) --
ABANDON PER CODE
REMOVE ANY PART OF FIELD ,
WITHIN 20' OF PROPOSED FIELD ss
(E) /105.
3
1000g SEPTIC TANK (E)
ABANDON PER CODE
4"�
Z'
.y� 4BR
HOUSE
3
V (E)
SEPTIC AREA
I(E)
cTH-1
0'
DRAIN FIELD (P)
,--65LF, 5'W, 2.5'ED, 4.0'TD \2�,
"-REMOVE AND REPLACE FOR RESERVE
115.8/
...... __
S
1500g S.T.E.P. TANK (P)
� WELL (E)
W - \
NOTES: PAMONE ING SVC, LW
FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
LAKE RIDGE TERRACE, BLOCK 10, LOT 6
JAMES & JUDITH ANDERSON
14231 HAROLD LOOP
PLAN EAGLE RIVER, AK 99577
g�Q,•. x-911
*:
TH. •.*
Steven •f2. •Pannone
•, CE 8149 ,
�+cif•.
1"=50'
PERMIT NO.
OSP121194
1 OF 3
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
ON—SITE WASTEWATER DISPOSAL SYSTEMS.
2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS.
3. SCOPE OF WORK: INSTALL NEW 1250g S.T.E.P. TANK AND SOIL ABSORPTION SYSTEM.
4. GROUNDWATER WAS OBSERVED AT A DEPTH OF 10.0' AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER
TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 10.0 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER
IMMEDIATELY.
S
0
1500g
S.T.E.P.
TAN K (P)
OF
) INSUTATION
ER FABRIC
0 DRAIN PIPE W/ 1/8" HOLES 18" O.C.
N ROCK S" ABOVE PIPE INV
TH-2
2S
SM
SW/ I 'SRZDRAIN ROCK
6.0
GN a SECTION
w
m
m
e
z
�
RIGID INSULATION �
0 o
oGRAIN
FILTER FABRIC &
ROCK 6" ABOVE PIPE INV
f
IX. B DRAIN PIPE W
B
/ �1 /8" HOLES 18" D.C. 17
DESIGN PARAMETERS
PRIMARY/RESERVE SEPTIC SYSTEM
NO. BEDROOM: 4 (600 gpd)
TANK SIZE: 1500g S.T.E.P. (E)
PERC RATE = 1.05 MPI
SOIL RATING: 1.2 GPD/SF
AREA RQD: 500 SF
SYS. TYPE: WIDE TRENCH 2.5' E.D.
MIN LENGTH: 64.0 LF
USE:
65 LF X 5.0' WIDE, 2.5' E.D., 4.0' TD
TOTAL AREA: 507.8 SF
uZomm
LEGEND
W WATERLINE/
WELL RADIUS
— SS — NEW SEPTIC
TRENCH SEE DESIGN
NOTES: PANNONE ENG SVC, LLC
FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
LAKE RIDGE TERRACE, BLOCK 10, LOT 6
JAMES & JUDITH ANDERSON
14231 HAROLD LOOP
DESIGN DETAILS EAGLE RIVER, AK 99577
F.Alojo-Tiollyff.Aviro11
CU
COPPER
DIP
DUCTILE IRON PIPE
TH
TEST HOLE
FC
FOUNDATION CLEAN OUT
T#
TANK CLEAN OUT NO.
C#
CLEAN OUT NO.
M#
MONITOR TUBE NO.
R.I.
RIGID INSULATION
DCO
DOUBLE CLEAN OUT
DV
DIVERTER VALVE
FS
FLOW SPLITTER
BFG
BELOW FINISH GRADE
OG
ORIGINAL GRADE
FG
FINISH GRADE
/23/2012
*.'ggTM *r, NTS
..... .. .. ... P.I.D. NO
051-323-20
€teven .*Pannone PERMIT N0.
CE 8149 j OSP121194
Sh2 eOF 3
TEST HOLE 1 SOILS LOG - PERCOLATION TEST
SLOPE OQ 51 PLAN
OR ORGANICS O
t � Q SEPTIC AREA
%QUO + �E) r
2 .�
3 �M
a �n
SM! SILTY SAND
6 SW ANDSAND6 X
i
TH-1 �C1`
_.
TH Cr
7 3
8
s 41 \6
Z
4BR
10 7110/2012 �� i 'b HOUSE -
GM SILTY GRAVEL WELL )
12 MOIST
13
WAS GROUNDWATER SLOPE
14 BOH ENCOUNTERED? N
15 IF YES, AT WHAT TH
is
DEPTH? -DRY-' X
17 DEPTH TO WATER AFTER
MONITORING? -10'-
18 DATE: 7/10/12
DATE PERFORMED: 6129/72
PEROLATION RATE 1.05 (min/inch) PERC HOLE DIAMETER 6 inches
TEST RUN BETWEEN 3 FT AND 4 FT
COMMENTS: Test hole excavated by FLINTSTONE ENTERPRISES. Prec hole was presoaked.
Test run for at least one hour. Last 3 readings reported
PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDILIINNES IN EFFECT ON7THE
�DATE OF THIS TEST.
NOTES: PAMONE ENG SVC, LLC ,�''pF A ��l Date
FOR CONSTRUCTION P.O. BOX 102954 ANCHORAGE, AK 99510 '(�••" �qSl�� 7/23/2012
PHONE (907) 272-8218 FAX (907) 272-8211 /r�j'�py �� Scale
�*. .*�/ NTS
.... ... .. :.. P.I.D. NO
LAKE RIDGE TERRACE, BLOCK 10, LOT 6 / 051-323-20
Steven R. annope
JAMES &JUDITH ANDERSON /PERMIT N0.
' P�,•, CE 8149 O% OSP121194
14231 HAROLD LOOP � c
SOILS LOG EAGLE RIVER, AK 99577 }+�\��tOFESS*........ Sheet
l�� 30F3
READING
DATE
CLOCK
TIME
NET TIME
'NATER
LEVEL
READING
NET DROP
t
6/29/12
3:40
---
4.75
--
z
3:45:30
5.5 MIN
10.75 (DRY)
6.00
a
3:46
--
4.75
___
a
3:51:50
5.8 MIN
10.75 (DRY)
g,Op
5
3:52
__
4.75
e
3:58:19
6.3 MIN
10.75 (DRY)
6.00
X^�u��
GR,EA►E,R ANCHORAGE AREA BW,,JGH
"-�-l�; Department of Environmental Quality
°�".,Y,`•� 3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME:' Ila'Y if-�- MAILING ADDRESS �OX � tfY' C -t P�HOONNE
Li
LOCATION LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE�,(,- NUMBER OF
TIrly
FROM WELL 107 MANUFACTURER C[�� ATERIAL COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY GALLONS.
TILE DRAIN FIELD:/
TOTAL LENGTH
DISTANCE FROM WELL FOUNDATION NEAREST LOT LINE-OF
"OF LINES
NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH= U��IN. TOTAL EFFECTIVE
ABSORPTION AREA / SQ. FT. LENGTH OF EACH LINE
DEPTH OF FILTER J
DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE) IN. ABOVE TILE IN.
WELL:
TYPE- CONSTRUCTION DEPTH DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION LOT LINE , SEWER LINE , TANK , SYSTEM
CESSPOOL , OTHER SOURCES
APPROVED DISAPPROVED REMARKS -
DISTANCES:
INSTALLED BY
SEWER LINE DEPTH:
PIPE MATERIAL:--
LOT
ATERIAL: -
LOT SLOPE: f
S
REMARKS: ' tro
DIAGRAM OF SYSTEM
G.A.A.B.
DEPARTMENT'OF HEALTH AND ENVIRONMENTAL &.0TECTION -003, 0,,
25:10 E. TUDOR RD. ANCHORAGE., AK. 99507
276-2221
7-
01F -
ERM IT NO,
APPLICANT UMEEF,
,�l ETR I C H BOX 674 CHUG IHK: L6 B10 LAI'
LOCATION HAROLD LOOP
LEGAL L6 B10 LAKERIDGE TERRACE, LOT SIZE 22500 SQUARE FEET
TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SO FTeBR) = 275
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
Ci F? f=1 %.-F E: U F:" -F
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD.
- THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE_ OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (*IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
EITHER A CLASS I OR IT NSF APPROVED PLANT MAY BE INSTALLED.
A CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF A MAINTENANCE
AGREEMENT 15 NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SOIL
ABSORPTION SYSTEM AND/OR YOU MAY BE SUBJECT TO PROSECUTION.
IF A CLASS I SYSTEM IS USED THE LENGTH IS 30.0 FEET.
IF A CLASS IT SYSTEM IS USED THE LENGTH IS 28.0 FEET.�-
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION FIND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL.
SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER
INSTALLATION.
F="E=- F;; -m M I -F V"I I C-- F= BZ® FR Cl 1-4 EE: -'e E:: " FZ F= FZ "_ r-1 J1 —'=- --S L. 0 E -L
I CERTIFY THAT
1: 1 AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET'
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
�: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS.
SIGNED: ---
APPLICANT MANFRED DIETRICH
7
ISSUED B�r,�_
0 Et E GEOTe-CHNI CAeL & ®EVELC_o BENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Russell Oyster' Earl Ellis
694-2774 SOIL LOG 688-2280
Soils Et Foun,�iations Land Development
Performed for: Name: .�oyel. No.
Mailing Address:
t
Legal Description: I (� �� P� ��• �s `F j�
Depth (feet)
AgiL ChAEaeter—is t c
2�
8
10
11-._._s- as l
12,.,:.__-- '3 ib z JLC
13 `>>a
14
15
,S
i `` tsn-
Ground Water Encountered: Yes-- HO- if yes® what depth
Proposed Installation: Seepage Pit_ Drains Field
1-751
Comments:
Vi✓ F �` 1 ��i V IGT � •-� -`� ` _`ey �� "�-
{
nqa+{�&. q�(�� may/
�rY..�f% / (Q'
825 „L„ STREET
ANCHORAGE, ALASKA 99501
(907) AAA 11 1
GEORGE Al. SULLIVAA,
M11 YOR
-�'i )I- HEA[ 1fI/"JD INVIHO!ViJ9 N'Al i'i"Of EL ON,
January 4, 1982
Manfred Dietrich
P.O. Box 23
Eagle River, AK 99577
Permit 4 810004
Subject: L 6 B 10 Lake Ridge Terrace
A permit issued by this department for a well and/or sewer
system has expired as of December 31, 1981.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal Ordinance.
If you have drilled the well, a well log should be sent to
this department to document the installation date.
If an engineer inspected the installation of the on-site
sewer system, please have them send us the as-builts for our
files.
If there are any further questions, please call this office
at 264-4720.
Sincerely,
Les N. Buchholz R.
Program Manager
Sewer and Water Program
Enclosure: Copy of Permit
, �0�I��I������e 9D F=' ���"I- '�i F-0 Fli C]i�
^
DEPARTMENT L � HEALTH AND ENVIRONMENTAL /.-0TECTION
° 825 'L/ STREET/ ANCHORAGE., HK. 99501
264-4720
PERMIT NO. ( 810004 )
APPLICANT MHNFRED DIETRICH PO BOX 23 EAGLE RIVER 99577 688~2039
LOCATION HAROLD LOOP ROAD
LEGAL L 6 B 10 LAKE RIDGE TERRACE LOT SIZE 72500 SQUARE FEET
MINIMUM DISTANCE BETWEEN A WELL AND ANY 8N -SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL
MINIMUM DISTANCE FROM H PRIVATE WELL TO A PRIVATE SE14ER LINE IS 25 FEET AND
TO H COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLYSPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
�F=VeM I -IF 1 :3:1 , ���"I
I CERTIFY THAT
1: I HM FAMILIAR WITH THE REQUIREMENTS FOR 8N -SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
SIGNED: ----------------------------
APPLICANT MHNFRED DIETRICH
1-111 r -a I I- I F=' F -i L_ I -T- ■T' . ID F_- FA i -a 1= " I -A S•--_ " 1_3 r_-
DEPARTMENT OF?_iEALTH AND ENVIRONMENTAL F�TECTICIN
;' ?5 'L'-TREET. ANCHORAGE, AK. 9Cs -t
720
F•aEL_L. 1 ... F'EP1�1 I T
_._
PERMIT NO. C.
APPLICANT�/ pp��
LOCATION d� q�?
LEGAL p/�
LOT SIZE %�15� SQUARE FEET
-
6.v`T
TYPE OF SOIL ABSORPTION SYSTEM IS:
MAXIMUM NUMBER OF BEDROOMS =
THE REQUIRED SIZE OF THE SOIL ABSORPTION
C■EPTH= O L Et-aGTH= Z -
SOIL EATING (SQ. FT.'EP•.)=
SYSTEM IS:
t F,,t=j ■EL G■EF=--r
THE LENGTH DIMENSION IS THE LENGTH CIN FEET? OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DI=TANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET?.
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION CIN FEET?.
F En�_F I F?ECti SEPTI 0 TF=lr4K a GF lL_L_C+r--1
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
--- -rL4 1 C :2 ? I "*_SPEr-T I O"!F- F-':IF;,"E F= E:QUl I FRECN ---
BACKFILLING OF ANY SYSTEM WITHOUT FINAL IN'=PECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM I
100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC: WELL.
MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 20 DAYS
OF THE WELL COMPLETION.
OTHER. REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAM'= ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
PERM I T E:>< -F=- I F=fE= C�Ec amE-:EF
I CERTIFY THAT
1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL -THE SYSTEM IN ACCORDANCE WITH THE CODES.
3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS.
S I GNED : ----- --- ------ ------------------
APPLICANT /
ISSUED B'; -- --�-�T�c -Q E__ �r
V4 0
- t G¢:24 sa
DEPARTMENT
tfAYE ptv $ y
i'SSYV s`_t i � ���di�§�'�� £ •-"Y`5�4� 1 'G�� � Z �1��
sTp`.ceT. P&4rlvffif-oXa '54'95t3-1
§1N. --
.- f.g
L % ` .411 ev
.. -
/YN LO -r size
.' �-
ry'PrE OF SOIL ABSORPTION Vf T0t Is.
d g l ►t3 .; ., IL RRTrHG 4542 FTISR10
rrW- f6z0jfJ I RF -0 SIZE OF THE 501L f0SOPPTION S t�S TIEt#
IS-
aI`MCI
T � Tr It t � I T €'sT�E < I F T> � T TPENCH OP DRA "'F i�(>.
THE DEPTH OV A Tl W -H OR PIT I S TH9 D I S V41 eETMEEN THE ZIJWSCE OF THE
�jROLWD tri THE 130TTOM OF rriE EXCRVATION < IN FEL=T)_
TWA IS N10 SET 14IDTH FOR TM�j-
T DEPTH IS THE MiNt"JM I"'TH �t-L T CR1�T�t�� PIPE
t*0 T BOTTOM 13F THEChWATI <IN F T")-
, IT FPI€ ANT HRS THE RSM IBILITY T INFORMTidy DEPARTMENT NJfzIm THC
;INSTSL TI IN CTIO MW i �. AOJ T T#�i t T' Aflo THE
ILLIIG OF Vi�STC! toL'niWT F [NFL IY+t° CTroN Rm RPPROYAL GY THIS
TMgNT WILL BE SUBJECT TIS PROSECUTIM
41 I D t S Tait- -Z TIXiEI! A MLL ANO ANY � --S I TF- SEWAGE D I SPOS1- SYS Tet IS
,:LOO FEET PR I VRTE WELL IR 1-50 To e---oo FEET rROM n P'JeLIC WCLL G+EPEm url
_ Id THE TY OF PueL Ir, WELL
4tNI"jM DISTANCE FROM 8 PRIVATE 14ELL 7'0 A PRIVATE SCHER SINE Iij 25 FEET AW
Pei A �OM"jtj[TY SES i I tv' ES 7-5 FCCT.
4ELL L+:'� ARE REQU I D M10 NlJST SE RCTURNC0 To THE DEFIIAId Tmilff W I TH I N 30 DAYS
THE SAOLt_ COMPLETICHIC
3T PIRY SPY_ SPEC IFICATD-Xi5 wiD cionsrAticiIpit{ OtWiRAMS
.:jvAILRL4LE To IA4`_uRE Piz+)M utSTMLATIOK
�q81_
I CEp T I it THAT _ _ Qn �y y � � � �
-- S y; FAMILIPR
yT+ , ReQUI�dt� LENTS FC L.5�7-SITS 0' 5 i�� �{��a,a !7? i
ORTH
CF
I UNDERSTP140 THAT THE SITE P 5 -r -STEN t'iy -WIRE R&'RR'SEMtT- IF THE
Y
-----------
[579JEED SY
DEPARTMEt4T O. !qEALTH AND ENVIRONMENTAL i rECTION
25:l0E.'TU[.',PJRRD. t^ ANCHORAGE, AK. 99507
76-2221
L4 F= L L. Fz-E-=F;Zrll"r
PERMIT NO. ( 76168 )
APPLICANT MANFRED DIETRICH BOX 674 CHUGIAK
LOCATION HAROLD LOOP ROAD
LEGAL L6 B10 LAKERIDGE TERRACE LOT SIZE 22500 SQUARE FEET
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM 15
100 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT' WITHIN 30 DAYS
OF THE WELL COMPLETION.
SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER
INSTALLATION.
F=p1EF;?Ml-r V O L IE-- I=OF;? r)"j-= R-eE="F,:C F=F�C.PM I !S:R3 U
I CERTIFY THAT
1: 1 AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
S I G N E D : - - - - - - _�_ 6: ---------
APPLICANT f MANFRED DIETRICH
ISSUED BY --- ------=-'- '--E ------- DATE
(�e��t�ie� �rtllirig ung
by
A`& I, DRILLING COMPANY
BOX 97, EAGLE RIVER, ALASKA 99577 • TELEPHONE 694-2588
OWNER OF LAND I,�/.. J �t 1 DEPTH OF WELL fF
ADDRESS % Pik LE STATIC LEVEL OF WATER FT.
LEGAL DESCRIPTION ,C4-U-�L-x,�CllC) -£ %A@WOOWNFT.
DATE - Started f,,6 `� Ended 76 1 GALS. PER HR
p
PERMIT NUMBER ,jd 77 69 0 .-- KIND OF CASING h ��
KIND OF FORMATION
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MISCL. INFORMATION
ilDii 7 DD°G NATAF -
Vaterans Knioistratio;i
42) 0. strest
Anchora, A 19551
SUBJECT: Lct C, Block 10, Lakerioge Terrace.
jear Sir:
The 5jAnct lot is not availawle to puubc sawar, an.0 is not ccononically
f"asialn to 3arvu the lot AW puolic soaar at this tuna.
Tho sowar system, in installod to local specificaLions, WM proviA
aucquaLa supay, AWposal woLij such time as puolic swwQr is availablc.
he watcr supply, wNicm mun Ow ao iodividual drilled well placed at least
Aw NO frow L"a sawor symn, sooild provive a putablc supply of water if
i0stallou to statu aid local specificatio"S.
Siocerely,
John A. W, N.S.
Lagle over District Sari ariaii
sr
MUNICIPALITY OF
Development Services Department
On -Site Water & Wastewater Section
Parcel I.D. 051-323-20
ANCHORAGE
Certificate of On -Site Systems Approval
1. GENERAL INFORMATION
Phone: 907-343-7904
Fax: 907-343-7997
Expiration Date:.—2 0
Complete legal description LAKE RIDGE TERRACE BLOCK 10, LOT 6
Location (site address) 14231 HAROLD LOOP, EAGLE RIVER, AK 99577
Current property owner(s) ROGER & MICHELLE DENNY Day phone
Mailing address
Real estate agent
PO BOX 770752. 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.
COSA Fee $ 35v / uta -50 Waiver Fee $
Date of Payment �J-e W X) Date of Payment
Receipt Number RD3/5Z Receipt Number
COSA # (35('26119 8 Waiver #
COVID-19
25% 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 5/11/2020
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 ��ilill
system and maintenance. The operational life of all well and septic systems are subject to I.�
these various and dynamic characteristics and are outside the control of the evaluator of the P.• •''
well and septic system. Therefore, any estimate of how long a system will function satisfactory Ai t�•' ''•9
for current or future occupants or guarantee that no unseen encroachments, deficiencies or *;'� 7H ••*
discrepancies exist can be given by First Water Consulting & F 5 • ' ' • • ' ' ' .........
r... ..... .
6. DSD SIGNATURE �% • '. • Curtis Huffman •:
-� System #1 Approved for bedrooms �� • CE 128991 .%
1'`�F�P' •5/111202 F, Aw
System #2 Approved for bedrooms ��` R+�
Disapproved
Conditional approval for bedrooms, with the following stipulations:
.�►tllllli((((l��._
J y
J PR
By: V1.
e111nCT4-v\t,Aitm 0=
AV,
J
Original Certificate Date:
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is
not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
Legal Description: LAKE RIDGE TERRACE BLOCK 10 LOT 6 Parcel ID: 051-323-20
If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system _
A. WELL DATA
® Well log is filed with Onsite (or attached)
Date drilled 6/17/1976
Total depth 81 ft
Cased to 59.7 ft
® Sanitary seal is functioning correctly
® Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA 5/6/2020
Static water level at beginning of test 57 ft.
Well production at time of test 2.3+ gpm
Comments
B. TANK DATA
Age of tank(s) 8 years
Tank type/material STEP / STEEL
Measured operating fluid level in septic tank *40"+
® Standpipes/foundation cleanout per record drawing
Date of pumping 5/6/2020 -
D. ABSORPTION FIELD DATA
Which system tested (date installed) 9/5/2012
® ALL standpipes present per record drawing
Total measured depth from grade 5.2+ 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 2000 gallons
Comments/Deficiencies:
Water storage tank volume NA gallons
Well disinfected for coliform test? ❑ Yes ® No
® Coliform bacteria is Negative
Nitrate 3.79 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ® Arsenic less than MRL (ND)
Collected by Fwcs
Date of Sample 5/6/2020 —
C. LIFT STATION
® Required maintenance completed
Age of lift station 8 years
Lift station material STEEL
Comments: *Float level.
Adequacy test date 5/7/2020
Results E Pass For 4 bedrooms
Fluid depth prior to test 0 in
Water added 600 gal
New depth 10 in
Elapsed time 1170 min
Final fluid depth 0 in
Absorption rate 600+ gpd
Any rejuvenation treatment (past 12 months) N
If yes, enter date ,
FUCS
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
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 CERTIFICATIONo®"® "or—a;\N
1 certify that l have determined through field inspections and review
p
al records that the above systems are m conformance ,or Q`• • • • �L,,,� a
of Munici r r ��1
� • :'�'
with MOA COSA guidelines in effect on this date. '.
•
Curtis Huffman '
rf��Fc CE 128991 .•c4`�s
i
ft
MUNICIPALITY F ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Lift Station/Pump Vault
Maintenance Log
Owner Street Address 1'% i 140% VC) Loa
Septic Tank:
-Sludge level inches Pumping: required @ no -Pumping completede no
Lift station: —
-Pump basket cleaned e no -Effluent filter cleaned es no
-Control floats cleanedes tno
•Proper float settings confirmed e no
•Operation satisfactory es
Alarm System:
-Dedicated electrical alarm circuit e no -Audible and visual alarm inside dwelling (@ _no
-Alarm system operation satisfacto not satisfactory
Manhole Riser
Ground water intrusion at riser to tank connection es no
Ground water intrusion around pipe penetrations es o -Weep hole functional es no
es
-Manhole lid; Functional no Insulated es no Properly Secured es no
Other
-All manufacturer required inspections and maintenance completed es no
C�mm¢nt��
Qualified Maintenance Provider:
Technician �
Company tae
Signature
Date of maintenance Mg '�
Date
// \
Q0.
/
/
/ Lot 1
10' UTILITY
EASEMENTS
/ 10' UTILITY
EASEMENTS \ 2�� �� / / / Lot 2
Lot 5 /
Lot 3
PLOT PLAN __— AS BUILT _X_ SCALE 1. = 40__ GRID _ NW 0553Project No. 20-25Z/Al...
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Long & Associates, inc. (907) 522-6476 Phone 4000�Q�4
(907) 522-4625 Fox o4
Professional Land Surveyors ken0longsurvey.com v O F q( Op
jonothan0longsurvey.com�s44�
1 hereby certify that I have surveyed the following described property:
LOT 6, BLOCK 10, LAKE RIDGE TERRACE SUBDIVISION (.PLAT No. P-549) * 49TH 4 P.
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 Q
no Improvements on the property lying adjacent thereto encroach on the surveyed � • • • •
KENNETH G. LANG
premises and that there are no roadways, transmission lines or other visible
easements on said property except as indicated hereon. OQ's� 1'UJ2�
.LS -5202.••• ori
Dated this the _=- Day of ___Sti 5_' _, at Anchorage, Alaska
ppOROF�SSIONA\- c�Q
It is the responsibility of the owner to determine the existence of any easements,
covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963
