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HomeMy WebLinkAboutBRUIN PARK BLK 5 LT 143 z t � r� Y , �...2.n- Municipality of Anchorage Community Development Department Page 1 of 2 On-Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP171258 PID Number: 016-111-32 ❑ New ❑✓ Upgrade Name: June Goard Revocable Trust ABSORPTION FIELD Address ❑✓ Deep Trench ❑ Shallow Trench ❑ Bed El Mound 11331 Polar Drive ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 1 GPD/SF 12.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 5.0 Ft. 7•0Ft. Bruin Park 5 14 Fill added above original grade Gravel length Township Range Section 0 Ft. 35.0 Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES 2.5Ft. N/A N/A Ft. MI Septic Absorption Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Lift Station Tank Line 490 Ft2 1 N/AFt. Well 105.9 120.9 N/A N/A 25+ TANK p Septic ❑S.T.E.P. ❑Holding ❑Other Manufacturer Capacity Surface Water 100+ 100+ N/A N/A Anchorage Tank 1000Gal. Material Number of compartments Lot Line 41.9 16.7 N/A N/A Steel 2 NA Foundation 33.6 48.6 N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain 50+ 50+ N/A N/A Gal. Remarks Pump on level at Pump off level at High water alarm at in. in. in. Pump make and model Electrical Inspections performed by Installer PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield A+ Home Services Drainfield 3034 CO/MT 3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 100ft Inspection Location and description dates: 1st9/27/17 25d 9/27/17 p 3`d 9/27/17 a"' 3/13/18 Bottom of Trim Nearest House Corner COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date , .�OF A� 4k ' Dteven k. t"Oflnor CE 8149 • Appro .� v - F/ / Date 3 '2 0 'IV �ill�`Dp�, �p� ... Inspection Report_1-1-12.doc M iN. ill --- 4/ f \ A B /, 14, / O�Jc • Nw�� _�W T1 37.8 54.8 C2 75.7 57.2 N / 'N/ s OR71'F • \<\ PER DECOMMISSIONED I STONED EXISTING CRIB / oP / ��r N� •1NEW UPGRADE DRAIN FIELD 35LF x 2.5'W x 7.0'ED x 12.0'TD i B INSTALLED MT AND CO AT EACH ENDz WELL (E) 3BR SHEDS R HOUS / (NO FOUNDATION) ~ " \ E ��AQ•S • 105.9 ( ) 3 ♦ . i /ON' To�� • `goo p� I N A4P<<7\•$` , N . NN r 1 0 0,- DECOMMISSIONED SEPTIC TANK ' A _ )- ,. PER CODE AND INSTALLED TH 1/J\�• �P 16 NEW 1000g SEPTIC TANK J 0 WITH DOUBLE CLEAN OUT BEFORE AND AFTER 3, aO '`p �p �<<,, iy v GAZEEBO • ��2- ----- �(NO FOUNDATION) N NN N o w m w a)D D D D j FILTER FABRIC r D w0 0 0 w 0 0 CC 0 Edi z m z z DRAIN ROCK 6"ABOVE PIPE INV o Di.,, w �� w z z 00 0 0 0 0 0 4"0 DRAIN PIPE o DRAIN ROCK TH-1 — - — —99.6— - -0G/FG:98.9 -OG/FG:98.9 -0R^-0.5 GM ��) L�� - OR/OL-4.O 94.9/�.� 10 \94.7 93.9/� 'r NSW," _ r!- F ,r� :cz 4• r�v�j r� 939SEPTICIII— PROFILE TANK - ' - - - 90 •86.9 , .r. ceto, -' ;le3�J.,),v t+ [0 ,�`-, A.- 'fc4 s''4.SV k SP DESIGN PARAMETERS UPGRADE SEPTIC SYSTEM LEGEND 80.9 (DRY) -18.0 NO. BEDROOM: 3 (450 gpd) W WATER LINE/ TANK SIZE: 1,000g WELL RADIUS PERC RATE: <1MPI ABBREVIATIONS SOIL RATING: 1 GPD/SF SS NEW SEPTIC TH TEST HOLE AREA ROD: 450 SF (P) PROPOSED SYS. TYPE: DEEP TRENCH: 7.0'ED MIN LENGTH: 32.1 LF — – -GB- - — GRADE BREAK (E) EXISTING DCO DOUBLE CLEAN OUT USED: 0 0 RETAINING WALL CO CLEAN OUT NO. 35LFx2.5'Wx7.0' E.D., 12.0' TO MT MONITOR TUBE NO. TOTAL AREA: 490 SF TYP TYPICAL NOTES: —\\�\ Date RECORD DRAWING PANNONE ENG SVC, LLC J` of A/ `kl 3/13/2018 P.O. BOX 100217 ANCHORAGE, AK 99510 -.1-%T....••••• 4a k1 PHONE (907) 272-8218 FAX (907) 272-8211 %g�P '�y�+ Scale DRAWN BY: *; ...k? 1"=50' DRM _ BRUIN PARK, BLOCK 5, LOT 14 % P.I.D. NO JUNE GOARD REVOCABLE TRUST / 016-111-32 Steven Pannone PERMIT NO. KATHRYN FLANAGAN �+�� . CE 8149 .•c�// OSP171258 PLAN ANCHOIRAGOE,AR AKD91VE 9516 +0il� �oF-ES•s10NP`'�` �. Sheet AN.\\X. " 2OF2 0A`_'.r.�0, MUNICIPALITY OF ANCHORAGE ,„„ „r On-Site Water&Wastewater Program '1; PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 http://www.muni.org/onsite Dupdititiritt 9'oCI onr, On-Site Wastewater Disposal System Permit Permit Number: OSP171258 Effective Date: 9/14/2017 Work Type: Septic Upgrade Expiration Date: 9/14/2018 Tax Code Number: 01611132000 Site Legal Address: BRUIN PARK BLK 5 LT 14 G:2633 Site Mailing Address: 11331 POLAR DR, Anchorage Owner: GOARD JUNE K REVOCABLE TRUST Lot Size in Sq Ft: 20000 Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 3 This permit is for the construction of: El Disposal Field El Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well El Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72)and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: lS �4. �'+ , i u Date: 1 I 1 I ®Issued By: te/' �4' Date: 0/ MUNICIPALITY OF ANCHORAGE Community Development Department Pho e: -343- Development Services Division - - . •- On-Site Water & Wastewater Program SEP 01 2017 1' ON-SITE SEWER/WELL PERMIT APPLICATION a of Parcel I D 016-111-32 << 01 6 8 Property owner(s) June Goard Revocable Trust, CO Kathryn Flannagan Day phone Mailing address 11331 Polar Drive, Anchorage, AK 99516 Site address 11331 Polar Drive Legal description (Sub'd., Block & Lot) Bruin Park, Block 5, Lot 14 Legal description (Township, Range & Section) Lot Size 20.000 Sq. Ft Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (M all that apply) Absorption Field Ll Initial I I Single Family (SF) L] (w/wo ADU) Septic Tank Q Upgrade LX Duplex (D) ❑ Holding Tank ❑ Renewal (—] Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: '4,67A Waiver Fees: Date of Payment: Irr `AI / I �//�17 Date of Payment: Receipt Number: W Y6-) Receipt Number: Permit No. eLS� la. Waiver No. Permit App_ - c Pannone Engineering Services ac Steven R. Pannone, Principal Registered Professional Engineer E-mail:steve@panenaak.com August 31, 2017 Subject: Bruin Park, Block 5, Lot 14 Upgrade Septic System Permit Request Design Narrative This is a design narrative for a permit to install an upgrade septic system to be issued for this property. The proposed system will serve an existing three (3) bedroom house. The existing drain field is in failure and will be decommissioned. The system will utilize a replacement 1000g septic tank and conventional drain field. This lot and the surrounding lots are served by private wells, and the lots to the southwest are served by AWWU. There are no wells within 100' of the proposed septic system. 1. Soils. One test hole was performed in the vicinity of this system by PES in August 2017, and groundwater was monitored for at least seven days. Ground water was not observed to a depth of 18' below the surface in the test hole monitor tube in August of 2017. Bedrock was not encountered in the test hole to 18'. Based on the results of the percolation tests and overall soils appearance; an application rate of 1.0 gallons/day/square was used for a conventional wastewater system in the area of the test hole. 2. Soil Absorption System Design. a. See Sheet 1 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 existing topography on the lot generally slopes from northeast to southwest, with a slope of approximately 3% in the area of the drain field, steepening to approximately 20% downhill of the field. There are no steep slopes in the vicinity of this system. The proposed drain field will maintain 50' separation all steep slopes. 5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification 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 this or the surrounding lots. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 / /M �M ` 7/// I t�` \ , / At- a \K.\ / O • DECOMMISSION EXISTING CRIB F � , 61//1/4)7/41.- �/��.�q� `? PER CODE � ,� • 1 UPGRADE DRAIN FIELD (P) _ W <1" ---. �• 35LFx2.5'WxI7.O'EDx 12.O'TD INSTALL MT AND CO AT EACH END WELL (E)—\/� O3BRUS SHEDS HODS • (NO FOUNDATION) A' 100.3 (E) 3 1 / 04� �, I / 1 TO `. t , X0 0� 1 rwa at. - ss • •(;) SEPTIC TANK (E) ' y1 y> DECOMMISSION PER CODE AND INSTALL TH 1�/J�� `\▪ `- � P 1 6 10008 SEPTIC TANK (P) \c-?S y�J QWIIH DOUBLE CLEAN OUT BEFORE AND AFTER,•iI ,�/ J<vGAZEEBO . / ��` w�— W--(NO FOUNDATION) / `c� O 1 5 I I DESIGN PARAMETERS UPGRADE SEPTIC SYSTEM NO. BEDROOM: 3 (450 gpd) LEGEND TANK SIZE: 1,000g w WATER LINE/ PERC RATE: <1MPI WELL RADIUS ABBREVIATIONS SOIL RATING: 1 GPD/SF AREA ROD: 450 SF TH TEST HOLE SS NEW SEPTIC SYS. TYPE: DEEP TRENCH: 7.O'ED (P) PROPOSED MIN LENGTH: 32.1 LF — — _Ge— — — GRADE BREAK (E) EXISTING CO CLEAN OUT NO. USE: MT MONITOR TUBE NO. 35LFx2.5'Wx7.0' E.D., 12.0' TD 0 ;> RETAINING WALL TYP TYPICAL TOTAL AREA: 490 SF NOTES: PATNI O LLC ,>��~�c\, Dote FOR CONSTRUCTION PANN�NE ENG SVC, ..-.."-s.pF 14C h 9/13/2017 P.O. BOX 100217 ANCHORAGE, AK 99510 � ' .:46,14 :74- ••'F $ Scale e DRAWN BY: PHONE (907) 272-8218 FAX (907) 272-8211 *• •`a ; *fj� 1"=50' DRM BRUIN PARK, BLOCK 5, LOT 14 % "" % P.I.D. NO � e16-111-32 JUNE GOARD REVOCABLE TRUST 0" teveri'•"15a'n'rior;e'� PERMIT NO. KATHRYN FLANAGAN 'ht. CE 8149 .g.1OSP171258 11331 POLAR DRIVE th`% p•EP. Sheet PLAN ANCHORAGE, AK 99516 A. `�\\\�t�� 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 AND AND IN ACCORDANCE WITH AMC 15,65 AND 15.55. 2. SCOPE OF WORK: REPLACE SEPTIC TANK. INSTALL NEW DRAIN FIELD. 3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 18 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 18 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. 4. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION AND SEPTIC LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK. 5. THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE ATTACHED. 6. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES. 7. THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING AND LOCATES SHALL BE IN PLACE PRIOR TO NOTIFYING THE ENGINEER. 8. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITS CONDITIONS/LIMITATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN. 9. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED—LINE AS—BUILT DRAWINGS TO THE ENGINEER. THE RED—LINES SHALL INCLUDE PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND TANK ELEVATIONS. 10. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF EXCAVATION, TOP OF PIPE WITH CLEAN—OUTS AND MONITOR TUBES INSTALLED. INSTALLED TANK AND FINAL GRADING. 11. THE CONTRACTOR PROVIDED DATA (UPON WHICH THIS RECORD DRAWING IS BASED) APPEARS TO REPRESENT THE PROJECT AS CONSTRUCTED. THIS DATA IN CONJUNCTION WITH THE PERIODIC FIELD OBSERVATIONS BY THE ENGINEER (OR HIS DESIGNEE) AS REQUIRED BY AMC 15.65 DOES NOT GUARANTEE THAT THERE ARE NO HIDDEN DEFECTS BY THE CONTRACTOR. 12. THE CONTRACTOR SHALL SIGN THE FOLLOWING: I CERTIFY THAT ALL WORK WAS PERFORMED IN ACCORDANCE WITH THE APPEND PERMIT, AND ANY AND ALL CHANGE ORDERS, AND THAT THE AS—BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS CONSTRUCTED. CONTRACTOR: BY: . TITLE: DATE: NOTES: ��� \ Dote PANN�NE ENG SVC, LLC pF AL`�l 9/13/2017 FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 i'` ' qS �, PHONE (907) 272-8218 FAX (907) 272-82114,.1.;,1 Scale DRAWN BY: v*: �� *l0 NTS DRM BRUIN PARK, BLOCK 5, LOT 14 %••• '' P.I.D. NO JUNE GOARD REVOCABLE TRUST • • .. .. / QtR IT 32 �teven '� �onnor�e�� PERMIT NO KATHRYN FLANAGAN �r -V.• CE 8149 . �� OSP171258 11331 POLAR DRIVE 9/%1„..'• • ``4 DESIGN DETAILS ANCHORAGE, AK 99516 kk;; SSI*- ` Sheet 3 \\\�"` OF SOILS LOG - PERCOLATION TEST TEST HOLE 1 C OR ORGANICS SLOPE -- \ SITE PLAN I ii,\ 2 GM FILL 1/ LL E 3 OR/OL ORGANICS AND �f p 4 • ORGANIC SILTS 4BR '/ GM SILTY GRAVEL HOUSE 715 iL I 6 \ TH (E) STH-1 6 LU GARAGE 8 3 w, 9 :0'1 1 11SP SAND / I 12 2 � n 13 WAS GROUND WATER SLOPE 14 ENCOUNTERED? N 15 IF YES,AT WHAT TH DEPTH? -DRY x 16 17 DEPTH TO WATER AFTER MONITORING? -DRY 18 DATE: 8/31/17 BOH WATER 19 READING DATE CLOCK NET TIME LEVEL NET DROP READING 20 1 8/24/17 2 PERCOLATION RATE TOO FAST DATE PERFORMED:8/24/17 3 TO ACCURATELY READ 4 5 6 PEROLATION RATE <1 (min/inch)PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 5 FT AND 6 FT SEE SIEVE ANALYSIS SAMPLE(a),8' COMMENTS:Test hole excavated by A+ HOME SERVICES PERFORMED BY: Dan Moran. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: D���T �I LLC l��xt�‘ Dote 7R CONSTRUCTION PANNONE ENG SYL1 L,L,CF A�q�, Date 017 • P.O. BOX 102954 ANCHORAGE, AK 99510 ....1-4..':-:-. S �'tQ-•. '- Scale PHONE (907) 272-8218 FAX (907) 272-8211 Avco.• �) 9 DRAWN BY: ;*.• ..! /\ f/ NTS DRM "� •'•• , P.I.D. NO BRUIN PARK, BLOCK 5, LOT 14 /_ + 016-111-32 JUNE GOARD REVOCABLE TRUST 0#..'s'e'ven R. =annone KATHRYN FLANAGAN 0 PERMIT NO. �Fc. CE 8149 .'��� 05P1 71 258 11331 POLAR DRIVE f1 �'' • •• . Sheet SOILS LOG ANCHORAGE, AK 99516 <% a?orESS\ 2 OF 3 040.002 Crowther Associates Client: Pannone Engineering Services Projects: 211 r.,icA-Brivc $A01N p41 :_ , 13 at S, LT l y a 1 33i pot-AR I -i✓c Date: August 30, 2017 l Particle Size Distribution Table Sample Source Sieve Size 3 inch 1-1/2 inch '/4 inch 100 #4 98 #10 95 #40 36 #100 5 #200 2 0.02 mm Classification Sand(SP) 1632 Bellevue Circle/Anchorage.Alaska 99515 Telephone(907)349-2198/E mail:crowther@alaska.net GAAB-HD-I ~,,iN'~'AII:I( ANk, I'IUKAkJ, I:: AKI:A I~UKUI"~I'I HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 27'/-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION ADDRESS f--, LEGAL DESCRIPTION SEPTIC TANK: DIST'ANCE FROM WELL LIQUID CAPACITY GALLONS. MATERIAL ~ ~'~"' NUMBER OF COMPARTMENTS / INSIDE LENGTH ~ I LIQUID INSIDE WIDTH /~.1 DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS LINING MATERIAL NEAREST LOT LINE OUTSIDE DIAMETER OR WIDTH ~ ,LENGTH ~' ,DEPTH ~ DISTANCE FROM WELL BUILDING FOUNDATION ~"~', TOTAL EFFECTIVE ABSORPTION AREA IWALL AREA) SQ FT. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA. DEPTH: TOP OF TILE TO FINISH GRADE NEAREST LOT LINE TRENCH WIDTH FOUNDATION DISTANCE BETWEEN LINES SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER MATERIAL BENEATH TILE' TOTAL LENGTH , OF LINES IN. TOTAL EFFECTIVE N. ABOVE TILE WELL: LOT LINE TYPE ~ , DEPTH NEAREST SEWER LINE DISTANCE FROM , BUILDING FOUNDATION SEPTIC SEEPAGE , TANK SYSTEM WATER · SAMPLE__, NEAREST OTHER , CESSPOOL , SOURCES DISTANCES: C- 0 = DIAGRAM OF SYSTEM HEALTH AUTHORITY DATE APPROVED ~-~-~./~ GREATE,, .aNCHORAGE AREA , .)ROUGH . 7 Eagle St. Anchorage, Alaska 99501 279-2511 k, // S WAO. SPOS^ SVS; a - ^PPUCA O & Case N o. ~ ~ ~ APPLI6ATIONTO I~STAkL: SEPTI6TANK )~ ,SEEPA6EPiT ~ ,BRAI~ FIELD ,0THER TO SERVE THE FOLLOWING ,I:ACJ~Y PER60LATION TEST RESULTS. TO BE INSTALLED BY .~7~. _F.J ANTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS . (~~ t'~) ,~' , PERMIT TO INSTALL A AS DESCRIBED BELQ~;'"SIZE OF UNIT TO BE SERVED ,..,g ,-, D~,,r, U) · SEPTIC TANK SIZE TYPE '~.~A.~, ....... sEEI~AGE AREA DIA OF DISTANCES: Health Authority I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. DATE / 5 '~ APPLICANTSSlGNATURE.....-.."':E/~ ~REATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT 327 EAGLE STREET ANCHORAGE, ALASKA 99501 CASE # This Form Reports a: Soz-r~-Log ~ ~ i/?ercolation resti_~i~i~/: :',,'i~,,,' Depth Feet Soil Characteristics Location Sketch wa, ~rou w ¢~r~ ........ .- . . , nd ater Encountered? ~o ' ~ /I ! -I i l'-:- " .... . ' I__ i._ ~ ,,l, fF_J.. [ ..... Zi i ' ~ t ,a~e I G~oss T/me 'j Net Time J Depth To H O Net g~o ~__~. ~ ~ ~ ....... ~ .......... :~ ..... .... ~ . ==,,,~ ,,, ......... , ....... ..... , ~~~~~ ...... , ............. ;, . ~ _;.%~.~_ ~ P~o~'~ed ~nstal~Seepa~e Pi~ ~~ ~aln Field De~th.~ Inlet_ _ ,, Dep~ To' Bo~tOm'Of Pit OP TPenc~- - ''/ c0~: 1~ ~ ~ , '~ ,. - Test Performed By: ~c~ '~ ~ ~ ~'-' ~". .... ~' ~ '- _---._ ~ - y- . . . ,UCrh q~ HEALTH & ;~~~ ~VIRONMENTAL ENGINEERING DIVISION R EQU ~T FO R A~ROVALO F IN DJ V I DUAL WAT E R AND SEWER FACI LI TIES DiR~ON8: ~mplete a I parts on page 1. In~l~e req~= will n~ ~ proo~d, Please SHow ~en (q0~ days ~or proces;ing. ' ' ' ~W ER ' " - .... ~ ~ ~PHONE 1. PROPERTYO . . J . BA1LI~6 ADDRESS _ - '- ..... ' ' -' ~R0~RTY RESIDENT (l~differ~t-from ahoy) ~-- - . ~PHONE . (:~:n 2ar:, ::oc~. ~,'.~: ~4.. ~t=:eS3 ~ ~oZar ~=t~e. ) -3, LENDING INSTITUTION~/- . ' I PHO MAt LING ADDR ESS ~ - /Pauch 7-02~, Anchorage. Alaska 99510 , - 4."REALTOa/AG~T Attention: LarrY, CampbellJ PHONE ..... 'Mit LInG idbRESS ....... - TI ME'/ DATE THIS SIDE FOR OFFICIAL USE ON LY DATE INSPECTION APPOINTMENTS x- 'TIME DATE iNSPECTOR ' 'I'NSPECTOR' '. ' ' ' D,.EcT ONS: ' : [] ONE TWO ' PERMIT NUMBER DEPTH OF'WELL DATE R C VEb IC, TYPE'OF RESiD"-; C ' ~':-[] 'SIN~LE'FAMILY :' [] MULTIPLE FAMI'LY 2; WATER SUPPLY ~ ~ F-I~ INDIVIDUAL · ~'~ PUBUCUTiLiTY _'~" ' Connection Verified , , 3, ;SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON -SITE ~ ~UBLIC UTI LITY Connection Verified TIME DATE INSPECTOR NUMBER F ' -' ~' ~ ' ' ;~'~ - ' O BEDROOMS .. '--?--:: I THREE ' ~1--1 FIVE . ' - [--I~ ~OTHER ' I FOUR" , [] SiX~' -~' ~ -- ~.'.: ~. PERMIT NUMBER DATE INSTALLED -~Septi_c Tank or [] HoldingTank S'ize:~ If Tank is homemade give dimens OhS: TYPE OF TANK TOTAL ABSORPTION AREA 4. DISTANCES WELL TO: Absorption Ar~a tO nearest Lot Line 5. COMMENTS DATE LEGAL DESCRIPTION 72-010 (Rev, 3/78) .[~//'APPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED I BY (Title) ~ I'NSTALLER iSOILS RATING ~NUFACTURER July 4, 1979 Municipality of Anch. Dept. o£ Health and ~nvironmenta! Protection Anchorage, Alaska Enclosed is a check in the amount of ~25.00 to cover the cost of approving the water supply and sewage facilities for Gerald T. Goard residence--BRUIN PARX Lot 14, t~lock 5, Anchorage. Also enclosed is a check in the amount of ~t5.00 for the anaylysis o£ our water. I really do not understand all the things you want, and hope this will su££ice and that you get the things 'that you want. Please send original copy of these inspections to: National Bank ~'£ Alaska ~ortgage Loan Dept. Pouch ~-025 Anchorage, Alaska 99510 Attn: Larry Campbell... also, send a copy to us . /G. erald T. Goard SRA, Box ]-785 t~nchorage, Alaska 99507 .Also is enclosed is a receipt for the septic tank and cesspool pumped. The test of our sewage system will be sent. MUNICIPALITY OF ANCHORAGE DEPT. OF }',~ALTM & ENVIRONMENTAL pF<O'i'ECTION JUk t 9 1979 RECEIVED 3uly 5, 1979 ASI No. 02579 Mr. Jerry Goard SRA Box 1785 Anchorage, Alaska 99507 Re: Adequacy Test For Existing Septic System on Lot 14, Block 5, Bruin Park Subdivision. Dear Mr. Goard: At your request our office conducted a percolation adequacy test on your existing septic system at the above-reFerenced location during the period July 2 to 4, 1979. You reported that your septic system consists oF a septic tank and log er£b. The septic tank and seepage pit had been pumped approximately 10 days prior to the percolation adequacy test. Since the 2-bedroom house had been occupied up to the time oF the test, a normal degree oF saturation within the leach field is assumed. In accordance with the Anchorage Municipal Code, Chapter 15.65, Waste Water Disposal Regulations, any on-site sewage disposal system "shall have adequate capacity to properly dispose of the maximum daily sewage flow." The maximum daily Flow is oomputed at 75 gallons per capita-day (gcpd). Since "the population oF dwellings shall be estimated at two persons per sleeping room," the maximum daily sewage Flow For your 2-bedroom house is 300 gallons per day (gpd). To test the soil absorption capability as well as the surge capacity oF your system, 110 percent of the maximum daily Flow or 350 gallons of clear water was added in 50-gallon increments to the seepage pit. The water was obtained From your on-site private well at its maximum sustained rate of about 4 gallons per minute. The liquid levels were monitored closely to detect any backup in the septic system. Mr. Jerry Goard July 5, 1979 Page -2- The attached Table of Test Data represents the depths of liquid in the septic tank and seepage pit, and the quantities of water added. The septic tank was determined, to be 7.4 feet deep (bottom of tank to ground surface) with an initial depth of 3.7 feet in the tank. The seepage pit was measured to be 10.6 feet deep with an initial depth of 1.2 feet. Ground elevation at the septic tank standpipe is approximately 1 e v e 1 w i t h the seepage pit standpipe. The attached Summary of Test Results indicates that the liquid level in the seepage pit at the beginning of testing on Day 2 fell to 0.1 feet aboveits initial static level on Day 1, during a recovery period of 24 hours. On Day 3, the level had fallen to 0.1 feet below its static level on Day 2, during a recovery period of 24 hours. The level in the seepage pit at its highest level during the test ( 1.9 feet) was approximately 5.6 feet below the liquid level in the septic tank. Based on two days of testing, a minimum percolation rate for your existing septic system of approximately 300 gpd is indicated. Since an on-site sewage disposal system for a 2-bedroom dwelling must be capable of disposing of 300 gallons of sewage per day, your septic system appears to be functioning satis- factorily at this time. Hany factors affect the operation of a soil absorption type of sewage disposal system. Soil type, groundwater depth, age and history of maintenance of the system, and types of waste are a few. This test has been performed in an attempt to determine actual soil absorption capabilities of your septic system under normal useage by considering the degree of saturation of the leach field and surge loads that might be imposed on the system. This test can only evaluate apparent performance at a given point in time, and cannot deter'mine either the condition of the leach field, seepage pit or other components of the septic system, or the depth of the water table. We appreciate the opportunity given to perform this adequacy test. If you have any questions regarding this test, please contact this office. Very truly yours, ALASKA SOILS INVESTIGATIONS ~ Shrader, P.E. Project Hanager Mr. Jerry Goard July 5 , 1979 Page -3'- ASI No. 02579 Wtr Added, Seepage Pit Rise in Seepage Pit Rise in Septic Tank Gallons Wtr Added per Ft of Rise (gal/ft) SUMMARY OF TEST RESULTS 350 gal gal 0.65' 0.66' 0.00' 0.00' 538 530 Recovery Time between Test (Hours) Drop in Rit during Recovery Average Rate of Fall (ft/hr) Average Absorption Rate (gal/day) 24 0.55' 0.02' 296 24 0.76' 0.03' 403 Adequacy Test for E~isting Septic System Ouner: Hr. Jerry Goard Project No. Address: · 'SRA" Box. 1 785 Anchorage, Alaska 99507 02579 Legal Desc.ription: Lot 14, Block 5, Bruin Park Subdivision" Components of Septic. SY~'{em:.. Septic tank; log-crib, seepage pit. Number of Bedrooms: 2 Occupied prior to test: Yes XX No How long vacant:.., na . Last pumped: o/a June 22, 19.79 Test performed by: S. Shrader/D. Shell§n-Water meter/S.N. #22812186 oerger Initial Static Levels:- Septic Tank 3.70' ; Seepage Pit 1.20' '~ . TEST DATA Time Septic Tank Seepage Pit Added, gal Reading, gal Remarks Ck levels. 8:30 4.7' 11.1' -0- 12,049 7/2/79 8~45 " 11.0' 50 12,099 8:58 " 10.9' 50 12,149 9:25 , " 10.7' 50 12,249 9:38 " t0.6' 50 12,299 9:50 " 10.55' 50 12,349 10:03 " 10.45' 50 12,399 End Test Day 1. 350 gal. 350 gal. 8:50 4.8' 11.0' -0- 12,409 7/3/79 Ck levels. 9:02 " 10.89' 50 12,459 9:08 " 10.79' 50 12,509 9:18 " 10.71' 50 12,559 '9:26 " 10.64' 50 12,609 9:36 " 10.53' 50 12,659 9:44 " 10.44' 50 12,709 9:55 ," 10.34' 50 12,759 End Test Day 2. 350 gal. 350 gal. ** Top of Standpipe to liquid level. Owner: Mr. Jerry Goard Project No. 02579 Legal Description: Lot 14', Block 5, Bruin Park Subdivision. TEST DATA (Cont'd) · Liquid De~th,' ft' Water Meter Time Septic Tank Seepage Pit Added, gal Reading, gal Remarks 9': 00 5.0 ' 11 . I ' -0- _ 7/4/79 Dnv 3. Form Approved ~HA Form 2573 u.s. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Budget Bureau No. 63-R296.8 Rev. July 1958 FEDERAL HOUSING ADMINISTRATION ~' HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.--TO BE COMPLETED BY FHA INSURING OFFICE MORTGAGEE SERIAL NO. MORTGAGOR OR SPONSOR PROPERTY ADDRESS SU,D,V,S,ON NAME th, Ri, Rutr [ ~6cK NO. TOTAL NUMBERz Con attic er other area be mede into BASEMENT ~ New installation additional bedrooms? LIVING UNITS BEDROOMS BATHS {If Yes, how man)f) WATER SUPPLY BY, SYSTEM DESIGNED FOR O Public system J'--J Community system [-~ Individual ,o. o, ,o,,s. GA,,^O,'O,S,OS^L SEWAGE DISPOSAL BY, ~ Public system D Community system Iii Individual ~ D Yes [] No PART fl.--TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT INSPECTOR'S SKETCH , ...... ,--4 .... ~. --. [..__ -.-~ . ...... . ' _.~ .... ~--- _~ ~ - ..... ~ ~-~ ........ ~- L--- t , ...... ~- . ~--~ .... ~_~- ..... ,.,,. - -- .,.~ ~- ..... ..., ~.,_~ .... ~ .---..- ~ ..........., ~ .--~ .... ...~_._ -q ~---_~- ' -4 I ..... .' ~ '-Z .......... '~ ' .... ' ~- -~ ~- ....................... -~ ..... -q ~- J ~ -~ ~ ~ -~.- .... .~_~ ~- -4 ~- -1 ..... - ......... ~ ~ Z~ -' ........ ' ..... ~_ ...... ~ .~ .... -~-~ . . [.. ...... ~ -4 L.. ...... It is the opinion of the D State [--1 County [~ Local Department of Health that this individual water-supply [-~ is D is not satisfactory as a domestic water supply for the subject property. It is the opinion of the ~ State [--] County ~] Local Department of Health that this individual sewage-disposal sys- tem with proper maintenance: ~ Can be expected to function satisfactorily, and N Cannot be expected to function satisfactorily is no~ likely to create an insanitary condition D---ATE SIGNATURE /, ,.' J TITLE NOTE, Tho hoelth ea~rl~y/h~"jd:~, - -.,. *-_ __,,ropiere'~ ~""~'--- -- --:--thoePPrOPrIOtoOPieIoa stoteme.t ,.bore and affix dote, signet,re ..d title In the spaces provided. t:s® Dj tho above grid ~or Health Department InspeCtor's Sketch as well es use of tho back of this form is at the option of the health authority. PART III.~FOR USE OF FHA OFFICE TO THE CHIEF UNDERWRITER~ I have reviewed the foregoing and the pertinent FHA Compliance Inspection Report, and recommend that the Individual water-supply system be considered J'--J Acceptable J-'] Not Acceptable Sewage disposal be considered J--J Acceptable J~l Not Acceptable. DATE SIGNATURE D CHIEF ARCHITECT I--I OEPUn' FOR CHIEF ARC,ITECT HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA Form 2573 Rev. July 1958 REPORT OF INSPECTION--INDIVIDUAL SEWAGE-DISPOSAL SYSTEM PRIMARY TREATMENT consists of [] Septic tank. Septic Tank: Distance from well .... feet. Material Total liquid capacity, Inside length, feet. Inside width,· Celspool: Distance from: Well, feet; foundation, Inside diameter, feet. Depth, SECONDARY TREATMENT consists of [] Tile disposal field. 'TiM Disposal Field: Distance from: Well, Total length of tile lines,. Trench width Length of each line gallons. Capacity inlet compartment, feet. Liquid depth, [] Cesspool. Number of compartments feet. gallons. feet; nearest lot line at [] front, [] side, [] rear,. feet. Liquid'capacity, gallons. Lining material [] Seepage pits. Other. ,.. feet; foundation, feet; nearest lot line at [] front, [] side, [] rear, feet. Number of lines, Distance between lines inches. Total effective absorption area in bottom of trenches feet. Depth, top of tile to finish grade, Type of filter material: [] Gravel. [] Broken stone. Other. Depth of filter material beneath tile,~ inches. Depth of filter material over tile. Seepage Pits: Number of pits ..... Outside diameter, feet. Depth,. Distance from: Well, feet; building foundation,__ Inspedlon made by: [] State. Date of inspection feet. square feet. inches. feet. Lining material feet; nearest lot line at [] front, [] side, [] rear, [] County. [] Local Health Authority. Inspected by 19__ (TITLE) inches. feet. REPORT OF INSPECTION--INDIVIDUAL WATER-SUPPLY SYSTEM Distance to nearest public water main,__ __feet. Size of main, inches. Individual wells [] are [] are not custotnary in neighborhood. Give most recent record of failure of wells in immediate vicinity to furnish adequate supply of water Properties in neighborhood [] are [] are not being deveh)ped with both individual water-supply and sewage-disposal systems. Lot size: feet wide ____feet deep. Dwelling set back from front property line, feet. Individual water supply from: [] Drilled well. [] Driven well. [] Dug well. [] Bored well. Distance of well from: Building foundation cast iron sewer, seepage pit, Well construction: Diameter, feet; tile sewer, .feet; cesspool, feet; nearest lot line at [] front, [] side, [] rear, __ feet; septic tank, feet; disposal field, feet; other sources o£ possible pollution, ~'eet. inches. Total depth, Approximate depth to pumping level of water in well,. Sealed watertight to depth of feet. Exterior space around casing sealed with: [] Cement grout. [] Puddled clay. [] Ordinary backfill. Well cover: [] Concrete. [] Wood. [] Metal. Openings in well cover watertight: [] Yes. [] No. Pump: [] Shallow well. [] Deep well. Length of drop pipe,, feet. Pump capacity, Ix)cated in: [] Basement. [] Pumproom off basement. [] Pumphouse above ground. [] Pump pit. Pumproom properly drained: [] Yes. [] No. Pump mounting watertight: [] Yes. [] No. Type of storage: [] Pressure. [] Gravity. Capacity, gallons. Has bacteriological examination of water been made? [] Yes. [] No. If answer is "yes," give date Quality of water [] is [] is not satisfactory for human consumption. Installation [] does [] does not comply with approved exhibits, if any. Inspection made by: [] State. [] County. [] ITT'al Health Authority. Inspected by Date of inspection 19__ feet. Type of casing,. Depth of casing, feet. Approximate yield, gallons per minute. .gallons per minute. (TITLE) feet; .feet. HUE~.WaBh., D. C. REQUEST.FOR APPROVAL OF i: INu~VIDUAL SEWAGE AND WATER FACILITIES (Fill out in Triplicate) ~. Name of person requesting approval ......... 2. ,~. o~ ~o~:ow~ :~,~~ ~_~ ...... ~ er: ~,,z .~ "~ , , Numb~z of.bedrooms in house ~ater~.nal~slS:' .~.~ .. ~,,-,¢~,( ....... . Casing Distance from well to closest existing or proposed: 8ewer line 3. Seepage Area__ Cesspool' .. 5. Property Line 6. Other sources of Possible contamination, i.e., creeks, lakes, houses~ barn, drainage ditch, e%c. Sewage disposal system. a. Age of syste~n ~ ~? ~ ' b. Septic tank capacity in galions ~ /~'~)O , .... c. Name of septic tank manufactu,~ _, ~ ~ . '~' i~ ....... ~z ....... ' ..... 1. If "home made" show diagram on ~everse ~ide of this foPm. d.' Disposal field om seepage pit size and type Perco,Latio~ Test '~es~Lt.s f. Percolation Test performed by Use the reverse .side of this form to show diagram. Diagram should include ~--,he foilowlng information: p?operty llnes,.well location, house location, ~utic tank location, disposal area location, location of percolation test, an~ direction of ground slope. 9. The~m-~,~.~t~ ~'on .on this form is' true and correct to the best of my knowledge. '~'ig~ature of Applicant' TO BE FILLED OU'f BY HEALTH DEPAET~.~ENT PERSONNEL above described sanitary facilities are hereby approved, subjec~ to the ~'l!owing con~l,~ions: ~ - ..... Conditions: The above described sanitary facilities are disapproved for the followin~ Approval is valid for one year following the date of approval. CPJ:cw • Municipality of Anchorage 14 -•• On-Site Water and Wastewater Program • M� { u�yQ!rl (907) 343-7904 t J• Certificate of On-Site Systems Approval /0668 • Parcel I.D. 016-111-32 Expiration Date: o —1 1. GENERAL INFORMATION Complete legal description Bruin Park Block 5 Lot 14 Location (site address) 11331 Polar Drive Current Property owner(s) June Goard Revocable Trust Day phone Mailing address 11331 Polar Drive Anchorage, AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 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. l41 S ego kW' Date: )1a.010 COSA to be released to the engineer,unless otherwise requesteld by the engineer. COSA Fee $ oZ.cASWaiver Fee $ Date of Payment (1(b )1S Date of Payment Receipt Number (A03i1 G Receipt Number COSA# �C�0 n 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 It 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 MoA 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 on the local soil condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system,nor do they guarantee that there are no hidden defects or encroachments.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. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 3/15/2018 OF Ak Ale 4,9_11-1 �\ 9 �I 6. DSD SIGNATURE 0""'. ' '!� System #1 Approved for bedroomse enR.'�anrione, r��� �. CE-8149.• s System#2 Approved for bedrooms s•. •� ,r Disapproved kl �\```� Conditional approval for bedrooms, with the following stipulations: \G\���`�v OF/41v '0 F/Ilv 'Ci ON-SITE ' WATER AND '`rk s�� WASTEWATER PROGRAM o liAdr Srfl'CFS Original Certificate Date: 20-C 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 COSA blue sheet S • c If more than 1 septic system is on the lot: COSA Checklist# 1 of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: Bruin Park Block 5 Lot 14 Parcel ID:016-111-32 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) N Date completed 1969 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 103 ft. Cased to UNK ft. Casing height(above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test UNK 3/15/18 Static water level UNK ft 60.7 ft Well production UNK gpm 5.7 g p m WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate ND mg/L Arsenic 5.67 ug/L Date of sample: 3/12/18 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 9/27/2017 Tank size 1000 gal. Number of Compartments 2 Cleanouts(Y/N) Y Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N/A Date of pumping NEW Pumper N/A C. ABSORPTION FIELD DATA Date installed 9/27/2017 Soil rating (g.p.d./ft2 or ft2/bdrm) 1 GPD/SF System type Deep Trench Length 35.0 ft. Width 2.5 ft. Gravel below pipe 7.0 ft. Total depth 12.0 ft. Eff. absorption area 490 ft2 Monitoring tube Y Depression over field NJ Date of adequacy test NEW Results(Pass/Fail) For 3 bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. N Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES 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 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundations ' IO" Property line 5+ Absorption field 5+ Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ 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 50+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION �kpF ALikkk / certify that ! have determined through field inspections and Al ti eb.- • �)�•�:9' vA review of Municipal records that the above systems are in *; .. /\ -.*To conformance with MOA COSA guidelines in effect on this date. 0 :l! Steven Pannone Engineer's Printed Name . r•• S1everi 12.•�annore• 04 Date 3/15/2018 61:.. CE-8149 il ‘Wi‘,,*.%Z: :ESS113tio.- COSA canary sheet_2-6-15.doc / / /• ,,N, , °o / ,...<v / // , Na /,-.1 77 -x +w "10 3.9'x6.2' / °p Lot 13 °t / O,Q,4.44:‘,frECK ; GRAVEL RV PAD / )0 `elf, • 0, '/ / Lot 14 ?0, ��/ NIN/ 20,000 s.f. 4/I o p �• ,09�B�Nh 2*.� �� \ WOODEN / WELL °' } FENCE / o t111146' ip ham ' 7.9' DECK o ^ / c:jk- 9.0'x10.0' \ / / \\ 1 \ h Q4/ SHED / h /,..z•-j1 �� "S' / 4►/ / -.\4/ c.) s> • / Lot 16 \ ��V ? SEPTIC •/ ; 8.1'x12.1' SHED O X \ Q2 �O q7 PIPES/ `�6'0 / '`�/ \^4° ��s� N GREENHOUSE / AP / \ o"' OA / \ — F /Lot15 \ 10' UTILITY N EASEMENTS N N <N N N PLOT PLAN _ AS BUILT _ SCALE 1" = 40' GRID SW 2833 Project No. 18-080/A1 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc . (907) 522-6476 'Phone �o� (907) 522-4625 Fax Q� Professional Land SurveyorskenOlangsurvey.com 8 OF q �pp(��,, jonathanOlangsurvey.com '�. .. '. ..''gs"h_ I hereby certify that I have surveyed the following described property: LOT 14, BLOCK 5, BRUIN PARK SUBDIVISION (PLAT No. P-2229) 41-9Th y Anchorage Recording District, Alaska, and that the improvements situated thereon ore within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the properly lying adjacent thereto encroach on the surveyed •• •• premises and that there are no roadways, transmission lines or other visible '• KENN G easements on said properly except as indicated hereon. �j► 2l1 �e ,.' {{� �� � . S-5202. Doted this the > Day of MI6/[,14 , 2.0 lB , at Anchorage, Alaska ,off •••• O ION It is the responsibility of the owner to determine the existence of any easements, CSA covenants, or restrictions which do not appear on therecorded subdivision plat. AECC963