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Home My WebLink AboutSOUTH HILLS BLK 4 LT 6South Hills Block 4 Lot 6 #017-072-15 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION p ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAMEPH/GOOIN ❑NEW E-L•fo/;,V -77 Lj ��. 7��J�J-�1 UPGRADE MAILING ALlDRESS�,�,,/j„A� LEGAL DESCRIPTION L &a 4 „d 23 LOC ON r NO. OF BEDROOMS. v Y Well ,. DISTANCE T0: Absorption area fv Dwelling�U PERMIT NO. F-2 nufacturer Material �,. No. of compartments w� ., �- �. w Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth " . 0 DISTAN T Well Dwelling PERMIT NO. = z H Manufac re - Material Liquid capacity in gallons O Well Foundation Nearest lot line PERMIT NO. w= DISTANCE T o: J LL ZNo. of lines gth of each line Total length of lines Trench width Distance between lines F 2 w inches fTop t -finis Material beneath tile Total effective absorption area of,' e grade p1 inches Length J�/ Width •� Depth �. PERMIT NO. w / QF Type of crib Crib diameter Crib depth Total effective absorption area ay + aFL w J to DISTANCE TO: Well Building foundation Nearest lot line Class� Depth / - C� r Driller Distance to lot line PER NO. Lu DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS//��,, SOI L TEST RATING 2i INSTALLER REMARKS I 1J e of APPROVED --- DATE LEGAL 72TI3 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE 22 Department f Health and Environmenta' Protectio' 825 Street, Anchorage, AK. 9501 264-4720 # # # HANDWRITTEN PERMIT # 3c)("SS Permit Vt DOOR ON-SITE SEWER PERMIT ' Applicant:Mailing Address: m7�7%1 / )VC�t� X19.\Zz7 Location: Phone Number: Legal Description: Z—& 6 cl wu_c_" Lot Size: Type of Soil Absorption System Is: Trench: Drainfield: _ Seepage Bed: Holding Tank: Maximum Number of Bedrooms: 3 Fb Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is: DEPTH LENGTH GRAVEL DEPTH WIDTH 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). # REQUIRED SEPTIC(Mr TfNG) TANK SIZE _ GALLONS # 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. * # * TWO(2) INSPECTIONS ARE REQUIRED # # Backfilling of any system without final inspection.and 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 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 this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 3 3 I certify that: (1) I am familiar with the requirements for on-site sewers set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require the residence is remodeled to include Signed: _ �'cQS Issued Applicant Date: SWP/024(1/81) and wells as enlargement if GR!' "TER ANCHORAGE AREA BOROV`4 HEALTH DEPARTMENT N? 1747 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING .� ADDRESS . %� ._ �.�_=9"- �' � .�.��_��i�� l i'i 1 � . ��t PHONE 'l NAME .� .• -tom LOCATION ,,"I/�`�d� �� ' LEGAL DESCRIPTION,' SEPTIC TANK: NUMBER OF DISTANCE FROM WELL— #! COMPARTMENTS _MATERIAL 'fes/�� ) N/J/� 1' lF• iy/F /. L� �� /�/. //� /%e:L:_ / LIQUID LIQUID LIQUID CAPACITY �� GALLONS. INSIDE LENGTH 6 INSIDE WIDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT:dtii�k�-1//��r�� NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH �� v LENGTH �� DEPTH fJ LINING MATERIAL/%/%/�j� /��i�6�% . DISTANCE FROM WELLd ,//BUILDING FOUNDATION, NEAREST LOT LINE �� / TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) — T`p SQ. FT. TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELL NEAREST LOT LINE , OF LINES NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH IN. TOTAL EFFECTIVE ABSORPTI AREA SQ. FT. LENGTH OF EAC INE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE DISTANCE FROM WATER WELL: DEPTH_ Z2Z' BUILDING FOUNDATION /tel SAMPLE , NEAREST „ TYPE ��'✓�� /./y9 iii- NEAREST SEPTIC-;, SEEPAGE OTHER LOT LINE 1 SEWER LINE �� , TANK /l!� SYSTEM �� , CESSPOOL S! sof' , SOURCES��/` '� DISTANCES: DIAGRAM OF SYSTEM DATE APPROVED HE LIHA HORITY '� GREA' R ANCHORAGE AREA BOR,vJGH DEPARTMENT OF ENVIRONMENTAL QUALITY ' 3500 TUDOR ROAD POUCH 6.650 ANCHORAGE. ALASKA 99502 TELEPHONE 279.0686 NAME OF INSTALLATION LOCAT LEGAL DESCRIPTION SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT 4/4/ 6. MAILING ADDRESS PERMIT NO.�g— PHONE %Z 84(' INSTALLATION OF: SEPTIC TANK /COO _ SEEPAGE PIT__� DRAIN FIELD -'- TYPE AND SIZE OF FACILITY TO BE SERVED v�R !r % /)I,AP YetleoE FINANCED THROUGH -j JY/F TO BE INSTALLED BY �Ikhf.GlYf"!l,JF�a NOTE' THIS PERMIT 601E TEST aesuLTs IS NOT VALID WITHOUT SOIL TES COMPLETION DATE ANTICIPATED FINAL INSPECTION, 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. ' ' O , _ 7 iA TYPE TYPE SEEPAGE AREA SIZE [, SEPTIC TANK 512E /� • `!<<� DIAGRAM OF SYSTEM MINIMUM DISTANCES. REQUIREMENTS FOUNDATION TO SEPTIC TANK / FOUNDATION TO SEEPAGE PIT / f� DRAIN FIELD —' SEPTIC TANK TO SEEPAGE PIT WALL /" / �y0 S/ DRAIN FIELD SEPTIC TANK SEEPAGE PIT TO NEAREST LOT LINE. �I/ / re SEEPAGE PIT WELLTOSEPTIC TANK T-' DRAIN FIELD—::�QD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT ' DRAIN FIELD 'OC/ SEPTIC TANK. 2C/ SEEPAGE PIT DRAIN FIELD TO RIVER. LAKE. STREAM. CAST IS AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON FITTED WITH AIRTIGHT REMOV. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. HEALTH AUTHORITY OR LICENSED DESIGNER IREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 26-68 AND THAT THE ABOV 1 CERTIFY THAT I AM FAMILIAR WITH THE REOU DESCRIBED SYSTEM /'IIS IN ACCORDANCE WITH SAID CODE. 'f FZJ I l APPLICANT'S SIGNATURE DATE F NAME OF APPLICANT t INSTALLATION LOCATION GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE, ALASKA 99502 TELEPHONE 2798686 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT LEGAL DESCRIPTION ze INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED MAILING ADDRESS PIT K DRAIN FIELD PERMIT NO, / PHONE ,)77 /120 OTHER FINANCED THROUGH V / I /' TO BE INSTALLED BY _ SOIL TEST RESULTS ,,�LGG4ivo�'„ NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST, COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT �T/pO PROSECUTION. �jJy ��j/ SEPTIC TANK SIZE 1�16�� TYPE �iCx �t' SEEPAGE AREA SIZE -`""'-� ° TYPE . I MINIMUM DISTANCES, REQUIREMENTS �%I ,r� DIAGRAM OF SYSTEM y I FOUNDATION TO SEPTIC TANK )) FOUNDATION TO SEEPAGE PIT DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL -11 1p SEPTIC TANK 5 , SEEPAGE PIT I DRAIN FIELD TO NEAREST LOT LINE. G.' / CPQ' /. WELL TO SEPTIC TANK �SEEPAGE PIT / DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD ALSO CONSIDER AREA WELLS. SEEPAGE PIT SEPTIC TANK, -) , SEEPAGE PIT ICK" , DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. HEALTH AUTHORITY OR LICENSED DESIGNER 1 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. DATEGLL �� APPLICANT'S SIGNATURE ' ! a J GREA 1 r,R ANCHORAGE AREA BORujGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE, ALASKA 99502 TELEPHONE 279-8686 /SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT `��'AdG� "(hl40` MAILING ADDRESS ;?jg& C PHONE ;%L Ike INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK SEEPAGE PIT—, DRAIN FIELD T OTHER , TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH ",r'� TO BE INSTALLED BY SOIL TEST RESULTS ""3&" Aj-R !1'l 9 — NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT �AUTHORITY WILL BE- SUBJECT TO PROSECUTION. SEPTIC TANK SIZE /�s— TYPE +""/��4 SEEPAGE AREA SIZE �� B TYPE 4"w 41J "oz�s�deI MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT /s" " DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL d'' ! s ®! 40 SEPTIC TANK SEEPAGE PIT DRAIN FIELD TO NEAREST LOT LINE. }y ! I ! WELL TO SEPTIC TANK v SEEPAGE PIT a+e�T DRAIN FIELD r° WATER MAIN TO SEPTIC TANK DRAIN FIELD ALSO CONSIDER AREA WELLS. SEEPAGE PIT SEPTIC TANK, I�' SEEPAGE PIT 1" 1 DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. HEALTH AUTHORITY OR LICENSED DESIGNER DIAGRAM OF SYSTEM 1 CERTIFY THAT 1 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 �111 APPLICANT'S SIGNATURE TATER ANCHORAGE AREA BOROUGH HEALTH DEM16'MENT CASE 0 327 EAGLE STREET ANCHORAGE, ALASKA 99501 Performed For•Di.qw Date Performed b Legral Description; Lots (9 Block 4- Subdivilsion This Form Reports a: 011s Log --Ne—rcolation Test Depth rept Soil Characteristics Location Sketch M Was Ground Water Encountered? I ;e if Yes. At What Depth Reading Date Gross Time Net Time Depth , To 820 Net Drop I n P I e-vA%vvvk cle Q.. vj/ vc%lvE 0 VQ1 b e,# 4cn-h M Was Ground Water Encountered? I ;e if Yes. At What Depth T-o�osed Installation: eepage Pit Drain Field Depth Of Inlet I)e,,)th To Bottom Of Pit Pit 0" I Tw;v Partur-wod Data Certified By: ruo Date Reading Date Gross Time Net Time Depth , To 820 Net Drop I n P I 0 VQ1 T-o�osed Installation: eepage Pit Drain Field Depth Of Inlet I)e,,)th To Bottom Of Pit Pit 0" I Tw;v Partur-wod Data Certified By: ruo Date Reading Date Gross Time Net Time Depth , To 820 Net Drop I n P I T-o�osed Installation: eepage Pit Drain Field Depth Of Inlet I)e,,)th To Bottom Of Pit Pit 0" I Tw;v Partur-wod Data Certified By: ruo Date APPLIC 4T FILLS OUT UPPER HAI. ONLY / PrSaperty Owher t,l'. r ft%'t>f Phone Mailing Address % ` f f ! / %j. c li f % Zip Code l f y �2 4 " Buyer Address Zip Code Lending Institution,�%yam �! y/ Date Phoney/ f Zip Code �% �_.�� '` �✓ fry :J�ii'-) tai 'r`f- Address _r..a� Inspector Inspector Realty Co. & Agent Inspector Phone Address l' Zip Code Legal Description,"-�f,. Street Location Type o esidence Single Family ❑ Multiple Family No. of Bedrooms'- G �� C A ❑ Other MUNICIPALITY OF ANCHORAGE Water upply Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑ Community For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility ENVIRONMENTAL PROTECTION( Sewer 'sposal ❑ Individual Year Individual Installed: ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank 'CONDITIONS OF APPROVAL ( ) DISAPPROVED NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Tim , C Date Date Date Date `s _ ! -� c� -213 -41-1-x- Inspector Inspector Inspector Inspector Field Notes: G �� C A MUNICIPALITY OF ANCHORAGE a DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION( JUL 141933 RECEIVED (,5) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL` DATE —7— B Soils/Rating Date Sewer Installed Well To Absorption.Area Well Log Received Septic Tank Size f G2 (0 ! j 9 '7 / Well to Tank 72-023 (3182) July 13, 1983 ARCTIC ENGINEERS, INC. FN �,'EHRINQ E>'"J.;iiES c D..:il E: N .Ji`S 1 x2'0,1 jt. ANA. F:NIL ! ;`';=Ct Rtt Y'N� Mitch Kolb 7501 Hillside Way Anchorage, AK SEPTIC SYSTEM ADEQUACY TEST LEGAL: Lot 6, Block 4, SouthHill Subdivision OWNER: Mitch Kolb HOUSE TYPE: 5 -Bedroom, 2 -Story, Single Family WATER: On -Site Well SEPTIC SYSTEM: From MOA Records AEI483-013-18 Tank: 1000 gallon, single compartment, concrete Absorption System: Seepage pit, perforated concrete rings Absorption Area: 15' x 15' x 6', 360 sq. ft. Approval Date: June 28, 1971 TEST DATE: July 13, 1983 PROCEDURE: House water use was kept at a minimum on July 13, prior to the adequacy test, which was started at 11:OOam. Water from a tank truck was dumped into the pit in 100 gallon increments with liquid rise in the pit measured after each increment. When 1000 gallons had been added, the pit became full. At that time, addition of water was halted and the septic tank was pumped. ARCTIc ENGINEERS, INC.`iia1'._�i371I—} f' rE=A�l.a 1.-- --- Mitch Kolb Adequacy Test 83-013-18 -2- PROCEDURE: The calculated rate of rise in the pit was 260 gallons per ft. (Cont'd) Absorption monitoring was carried out for 100 minutes after pumping the septic tank. The resultant plot of absorption vs. time, with the extrapolated daily absorption capacity, is included. RESULTS: The plot of absorption vs. time yielded a daily absorption capacity of 1550 gallons per day. The required absorption capacity for a 5 -bedroom house is 750 gallons per day. The soil absorption system meets Municipality of Anchorage requirements. COMMENTS: The septic tank is too small for a 5 -bedroom house by Municipality:; of Anchorage requirements. A 500 gallon tank will need to be added into the existing system between the tank and the seepage pit. 6� CL OF OA C0�%V I '0000- 'G N O v000000800v ?ROFESSYM-4 IT, limillillillill im .a.l a i I 3d MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 L (0 a � ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. P.OPERTYOWNER PHONE NUMBER OF BEDROOMS SINGLE FAMILY MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE &f o INDIVIDUAL* MAILING ADDRESS 3. LENDING INSTITUTION PHONE MAILING ADDRESS 4. RE OR AGENT PHONE - - MAILING ADDRESS 5. LEGAL DESCRIPTION L (0 a � STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY - INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM - - **If individual/on-site, give installation date 19V)/ INDIVIDUAL/ON-SITE** If system is over two (2) years old nn adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) `7 t 80 C THIS SIDE FOR OFFICIAL USE ONL INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM aMDIVIDUAL/ON -SITE ED PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER 216eptic Tank or ❑ Holding Tank Size: /0(30 If Tank is homemade give dimensions: SOILS RATING TYPE OF TAN MANUFACTURER UF ' r p TOTAL ABSORPTION AREA -3(,=.a MATERIAL _ lsx�J = ' 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS 11d APPROVED FOR 3 BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DAT (( BY LEGAL DESCRIPTION 72-010 (Rev. 3/78) GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 DATE RECEIVED:. INSPECT: / TIME: !'v9G1 •//`J'_ REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES FOR 1. APPROVAL REQUESTED BY:e/�G��/� ADDRESS:. PHONE: 2. PROPERTY OWNER: 3. LEGAL DESCRIPTION:® ��®��,✓®�Jt ��- .�— iJ 4. 5. TYPE FACILITY TO BE INSPECTEDTREET: NUMBER OF BEDROOMS: WELL DATA:' A B TYPE DEPTH C. SIZE- D . ED. CONSTRUCTION E. BACTERIAL ANALYSIS 6. SEWAGE DISPOSAL SYSTEM: A. SEPTIC TANK (IF HOMEMADE, SHOW DIAGRAM ON BACK) 1. SIZE '6)0 2 . AGE Z' .,711/ J 3. MANUFACTURER�� 4. INSTALLER APPROVAL REQUEST FOR SEWER & WATER FACILITIES PAGE TWO B. SEEPAGE PIT r � r 1. SIZE 2. L I N I N G�c,� C. DISPOSAL FIELD 1. NUMBER OF LINES 2. TOTAL LENGTH 7. REQUIRED MEASUREMENTS A. WELL TO SEPTIC TANK! B. WELL TO SEEPAGE PIT C. WELL TO SEWER LINE /O D. WELL TO PROPERTY LINE J E. WELL TO OTHER POSSIBLE CONTAMINATION /r�U�s/��s'�i��i✓ F. FOUNDATION TO SEPTIC TANK G. FOUNDATION TO SEEPAGE PIT -;:?® H. SEEPAGE PIT TO PROPERTY LINE' 8. COMMENTS: APPR0VED: v—v-.��''//!v APPROVED: DATE:DATE: i APPROVAL VALID F4 ONE YEAR FROM DATE SIGNED. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY _k - i ... _!' .,, ,. I ::E y: .� � r: 1971 1"s field bavelopment Company ON Swiss Placc Aochnra&v, Alaska 90594 "j": Fwas"lity Of individual Sowyaw Wer UVOWS fur!tc,dua 4 SUM dl; AuNivisiun. Garde I: orSir- " 15 Mabla Wt an approvey Sower ind wntei- syskp can bc inshll?d co W sUbjeCt ,mom rly. ParniK jaw alregy boa" Maud CU insrall d suwar TIMM ac weld, Macorely, Lynn S. Loau San i tarian R: Voterou's Administrotion I. "'�i y 17, lon my. David Qroau':� 1652 U193 011CO AnchorRaln, ofjsja A"Q13,111tv Vuhlic I.azar lot 5. \1«§4,m «h HIM lapf Vr. 000m; PUWC qxvir no! outer fjCjtjtt,, 170 not avallaw to th! SOMInt Wt. Ourouib sowyn 11 awroximmlija1y fiv, IwAy I" it A"I " "to ""N "Irl POW" thn lorouqh Saw" +l! "0 "" AMIRKY? to td smiact tot. L mn A nw; Ado it a rjsn QCg &Wwnln a Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-072-15 1. GENERAL INFORMATION Complete legal description South Hills S/D Block 4 Lot 6 Location (site address) 7501 Hillside Way COSA# Expiration Date: / D -;Z 6 - 67 Current Property owner(s) Danielle Browning Day phone 522-9500 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 7501 Hillside Way, Anchorage AK 99516 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: _`^ 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4 s• a.• CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-072-15 1. GENERAL INFORMATION Complete legal description South Hills S/D Block 4 Lot 6 Location (site address) 7501 Hillside Way COSA# Expiration Date: / D -;Z 6 - 67 Current Property owner(s) Danielle Browning Day phone 522-9500 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 7501 Hillside Way, Anchorage AK 99516 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: _`^ 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined In the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm _Pannone Engineering Services, LLC Phone 272-8218 Address P.O. Box 102954, Anchorage, AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date 7/19/07 Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with h10A DSD Guidelines & Regulations. The reported results describe the perfomance of the system under the conditions encountered at the time of the test, and separation distances treasured to readily identifiable features. •.• • V 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 p�p1�••OF These conditions are outside the control of the evaluator of this system All systems eventually fail and : `�+' •``: �i satisfactory test results do not guarantee future perfomance of the system, nor do they guarantee that 49,„ `� �� there arc no hidden defects or encroachments. PES can therefore not provide any warranty for future �- +--00 performance nor give any estimate of how long the system will continue to meet the operational requirements of the ACOA DSD. The content of this report is for the sole benefit of the owner listed i AK r Steven R. Ponnone?/�' L above. Any reliance upon or use of this report by any other person or party is not authorized nor will it ��C' No CE 8149 f confer any legal right whatsoever. e��;;xJ�iq.•' re.� 5. DSD SIGNATURE ��gaaFlSS,Q�. Approved for -3 -bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: - o//� /It //' Original Certificate Date: �/// (Rev. IV05) / Municipality of Anchorage • Development Services Department Building Safety Division OnSfts Water & Wastewater Program 4700 Bragew Street P.O. Box 196650 Anchorage, AK 99519-0650 www.muni.org/onsits (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: South Hills S/D Block 4 Lot 6 Parcel ID: 017-072-15 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID # _ Well Log (Y/N) No Date completed 7/111971 Sanitary seal (Y/N) M Wires properly protected (YIN) YES Total depth 11a ft. Cased to 40+ ft. Casing height (above ground) lin. FROM WELL LOG AT INSPECTION Date of test 7/1/1971 7/14/2007 Static water level ft. so ft. Well production g.p.m. t.6 9 - p.m -WATER SAMPLE RESULTS: Coliform _Qcolonies/100 mL Nitrate d . y3mg/L Other bacteria 'O colonies/100 mL Arsenic: O ugA Date of sample: Z1,2 - a % Collected by: (y B. SEPTICIHOLDING TANK DATA Tank Type/Material Seotic/Steel &Concrete Date installed 6/28/1971 Tank sine 1000+500 gal. Number of Compartments I Cleanouts (Y/N) yes Foundation cleanout (Y/N) yg} Depression over tank (YIN) ag High water alarm (Y/N) n Date of pumping 7/16/2007 Pumper A+ Home Services C. ABSORPTION FIELD DATA Date installed 6/28/1971 Soil rating (g.p.d.e or fe/bdrm)132 System type cr Length 15 ft. Width 15 ft. Gravel below pipe 6 ft. Total depth / / ft. Eff. absorption area j§Qfe Monitoring tube ygti Depression over field ng Date of adequacy test 7/14/2007 Results (Pass/Fail) Pass For 5 bedrooms Fluid depth In absorption field before test 91 In. Water added7U gal. New depth¢g in. Elapsed Time: 1440 min. Final fluid depth i In. Absorption rate >= 750+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) none known If yes, give date D. UFT STATION Date installed "Pump on" level at _ in. Datum E. SEPARATION DISTANCES Size in gallons N/A Manhole/Access (Y/N) "Pump Or level at _ in. Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 90 & 95 Absorption field on lot 96 Public sewer main N/A Sewer /septic service line 75 Animal containment areas too+ High water alarm level at Meets alarm & circuit requirements? On adjacent lots _1Q0+ On adjacent lots 100+ Public sewer manhole/cleanout N/A Holding tank 100+ Manure/animal excrete storage areas 100+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 15 Property line _11 Absorption field 20 Water main 100+ Water service line 100+ Surface water 100+ Wells on adjacent lots 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 11 Water main 190+ Water Service line 25+ Surface water 100+ Driveway, parking/vehide storage 25+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION .��*�- 1- /,/ 1 car* that I have determined through field inspections and review of Munirvpal records that the above systems are in � ....' :. ...,..,�.., conformance with MOA COSH guidelines in effect on this date. Engineer's Printed Name Steven It. Pannone. P.E. ♦ , °; 1�,�,�; No fE YI<� •• �i Date 7/19/2007 �j�,; .Qi f r/� COSA Fee $ 4�0 I 'lam Waiver Fee $ Date of Payment r4 ll R I D :I- Date of Payment Receipt Number Receipt Number. 7 KG (Rev. 11/05) In. ANALYTICA GROUP Gamess Engineering Group, Ltd. Attn: Jody GEG, Ltd. 3701 E Tudor Road, Suite 101 Anchorage, AK 99507 907-337-6179 Fax: 907-338.3246 Client Sample ID: Sampling Location: Lot 5 Blk 4 South Hills Client Project: Private Well Testing Sample Matrix: Aqueous COC #: PWS#: Residual Chlorine: Comments: Lab#: A0707149-OIA Analytica International, Inc. - 4307 Arctic Blvd. Anchorage, AK 99503 Phone: 907-258-2155 Fax: 907-25M634 Report Date: 7/19/2007 Receipt Date: 7/12/2007 Sample Date: 7/11/2007 Sample Time: 5:50:OOAM Collected By: SO Flat! Definitions: MRL = Method Reporting Limit MCL = Maximum Contaminant Limit B - Present also in Method Blank 11= Exceeds Regulatory Limit M - Matrix Interference J= EstimatcdValuc D = Lost to Dilution • • = RL higher than MCL; target not detected TNC = Too Numerous to Count - result rejected CF - Confluent Growth - result rejected TCNG = Turbid Culture No Growth - rejected Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 92228 (Aqueous) - Membrane Filtration MF Test was conducted by: Ana/)lica -Anchorage Bacteria, Other <�IRL CFU/IOOmL 1.0 7/12/2007 7/12/2007 PL Total Coliform <MRL CFU/100mL 1.0 / 7/12/2007 7/12/2007 PL Lab#: A0707149 -01B .Analysis Method Prep Prep Analysis Parameter Result Units Flags INRL MCL Method Date Date Analyst 500-NO3E (Aqueous) - Nitrate Nitrate as N 1.43 mg/L Test was conducted by: Ana/ylica - Anchorage 0.20 10 7/13/2007 7/13/2007 AJ Lab#: A0707149 -OIC Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 00.8/200.8 (Aqueous) - Family Well Water I Arsenic <MRL ug/L 0.15 eF&-,. Reported by: Krissy Plett, Page 1 of 1 Laboratory Project Manager /0 200.8 7/17/2007 7/18/2007 KS 1 � � ` I E tes i GA4 r- t a-6390.SUBN4117AL - ..~ ter' •N Leh /t"•CI ... � , ; ,;. 02 17 7isapr's of Mom. Crow" THA%j T"CCIE s+c+ N ON TNe VKVcZ v r.AT, Att is=S`+Ovn. Httf'1N. •IO CC'S ,f'. " 1 Iw•M sot%t N.M 1 b.e ew.e+ed Pe Mne.t� deen•�+d Merh. W G t�e!_� + �F 1S a/d:.�.. 'r r.0 .. r dr � • n. i r ew.J�.y ►.w..e, ALS:•. ed It.N M.. �'QS 1 Fp.e.e�eiw eNne•ed *«..� ... �xw AM l.+r«ti IIw WA de r•r *"Asp of Mored n' • �• ; } '+� �q �l w the rpt hw eiiew+ �«.., AMM 4we�..n.M M fyeea•r M•i �:S.IM/ Anti ,i��.�,�� dti OP&OC w w we rc.,w. x *#*OWN e•d uer Mw en ee ,..d..w Mre.Al+�e %.. " ,i....i.4!3v------- I ...,.... rj` uede 9 Jet Its -i ZVI: 4 2:7-1 • :1'SC1Y_YIAaMt rY*AM '!rIjh'XI A40' . ■jp-:++ +•..+.-� Municipality of Anchorage .. Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 198850 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Steve Pannone Legal description: South Hills Block -4 Lot 6 ❑Permit ®C.O.S.A. Dinspectlon Report The attached paperwork has been reviewed and is being returned for the following reasons: 1. This septic system [ absorption field i can only be approved for 3 Bedrooms. 2. 1 made a field inspection today [ 7-20-07 i and found 41' of liquid in the M.T. This is the same level as was reported both before and after the adequacy test of 7-14-07. The soil log of 5-28-71 reports ground water at 7.5'. This indicates that ground water may be infiltrating the seepage pit The sepage pit must be pumped and monitered for a ground water intitralion. Please coordinate with me during this procedure. 3. M.T. is broken above grade and the cap cannot be installed. Please repair. Name of reviewer: Jeff 7-2-5--6-7 Date: July 20, 2007 �OVvi�( /� �Ye✓n),,, -✓ 1j, �71'a(l001 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK Municipality of Anchorage •' 1 1!0.1Wx 1!Nil:ill•.\n�hontgr,.\Inslue!tllil!1(p4i11.1Ncphnnt l!M17)33:5 $NII •ISt<1!Mli ):{$f•!{'�INI 471M)11ntguw Stn'ct 0Anchntngc„\laslut109507 `� w�t�c.nnmt.org Mayor Jlark B q/ich Iluildin't Snfchv Di-0sion July 25, 2007 Steve Pannone Pannone Engineering P.O. Box 102954 Anchorage, AK 99510 Subject: Waiver Request for South Hills Block 4 Lot 6 Waiver Request WR#: 070036 Parcel ID # 017-072-15 IIA070256 Dear Steve Pannone: Your request for a waiver of the required 100 feet horizontal separation from the absorption field and septic tank to the private well has been approved. The approved separation distance is 90.0 feet. This waiver approval applies to the existing absorption field and septic tank to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Joeo l Civil ngineer On -Site Water & Wastewater Program Community, Security, Prosperity • s•rrr• Municipality of .Anchorage 0 CO. Box VON) • Anchoml;c, Alaslm!Yk5l9-C)C 0 • Telephone 1'.Y1713t3.9N)l • I'aa (!Yr) 3[.1R"fYl 3700 Dragaw Slrecl • Anchoru„c, Alaska!YAiU7 mimmunLorg Mayor bark Begicll Ilullding Snfcf}• Division July 25, 2007 Steve Pannone Pannone Engineering P.O. Box 102954 Anchorage, AK 99510 Subject: Waiver Request for South Hills Block 4 Lot 6 Waiver Request WR#: 070036 Parcel ID # 017-072-15 IIA070256 Dear Steve Pannone: Your request for a waiver of the required 100 feet horizontal separation from the absorption field and septic tank to the private well has been approved. The approved separation distance is 90.0 feet. This waiver approval applies to the existing absorption field and septic tank to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there arc any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, JoeWninlcer Civ On-Site Water & Wastewater Program Community, Security, Prosperity State of Alaska: Separation Distance Waiver Guidelines for S.C.R.O. (State of Alaska Memorandum to District Office Engineers dated January 3. 1985) Waiver Request for. South Bills Block 4 Lot 6 Parcel I D#: 017-072-15 Waiver Request Number WR#: 070036 Waiver Requested: 90 foot horizontal separation from well on -lot to septic system Engineer Steve Pannone IIA070256 Septic System Data The septic system has been in place for more than 30 years. Some parts of the system encroach the well on the lot. For the purpose of doing a waiver to cover all parts and components of the septic system, a separation of 90 feet was calculated. Well Data The water sample results are with -in municipal standards. The total depth on the well log is 113 feet deep with a 50 foot static water level. There are soil strata that should inhibit migration to the consolidated aquifer. Municipality of Anchorage Development Services Department e Building SallKy Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 1%650 Anchorage, AK 99519-6650 www.ci.anchoragc.ak.us (907)343.7904 Waiver Review Worksheet WR#:070036 PID#:017-072-15 HAIPermit# 11A070256 Date Received: July 25, 2007 Legal Description: South Hills Block 4 Lot 6 Engineer. Steve Pannone Pannone Engineering P.O. Box 102954 Anchorage, AK 99510 Applicant: Danielle Browning Waiver Requested: 90 foot horizontal separation from well on -lot to septic system Criteria: Geology Points: A. Water Table 7.04 B. Soil Sorption 0.91 C. Permeability 1.09 D. Water Table Gradient 6.00 E. Horizontal Separation 2.6 Waiver Is Granted: X List Conditions or Reasons for above: Total: ____ 17.642; Waiver Is not Granted: Date: 7n5107 By: Joe Goodall Name of Reviewer Rec#: 97786 Amount: $]M Date Paid: 7/25/2007 State of Alaska: Separation Distance Waiver Guidelines for S.C.R.O. (State of Alaska Memorandum to District Office Engineers dated January 3,1985) Waiver Request for. South Hills Block 4 Lot 6 Parcel [D#: 017-072-15 Waiver Request Number WR#: 070036 il- l1:`�:•,�%OrV-y; dP'.'ds Waiver Requested: 90 foot horizontal separation from well on -lot to septic system Engineer: Steve Pannone IIA070256 Water Table Points „« Depth of well: 118 7.04 Depth of septic system: 11 107 Distance from the bottom Point of the system to the highest Value water table In feet 0 0 8 1 17 2 24 3 30 4 40 5 85 6 100 7 290 8 1000 9 10 Straight line Interpolation is permitted between any two values Soil Sorbtion Points 0.91 1 25 2.5 + ( 14 2.5 + (I 107 Soil Type I Point ValuOl 107 Clean Gravel 0 107, 107, l Fractured Rock 1 1 r Course Clean Sand 1.5 + 1 170-71 + � + I—I [7-07—] + I Sand w/ Small Amt of Clay 2.5 l 107 J 107 `107 J `107 Silt 3.5 Clay and Sand Equal 4.5 0.6 + 0.3 + 0 + 0 Clay 6 0 + 0 + 0 + 0 *Use the predominant soil type but values can be averaged for a mixture Permeability Soil Type Point Value Clay(will channel) 0 Silt and Sandy Clay 2 Clayey Sand 3 Fine Sand 1.5 Sandy Gravel 1 Fractured Rock 0.9 Course Sand (30 grit) 0.4 Clean Gravel 0 Points ,,.. 1.09 [ 25 07, g + 10714 , 3 +( 107, 1 + r 107, 1 + [ 107, 1 +( 107, 1 + 107, 1 + [ 107, 1 0.70 + 0.39 + 0.00 + 0.00 0.00 + 0.00 + 0.00 + 0.00 *Use the predominant soil type but values can be averaged for a mixture Gradient % Slope Points Value -60% 0 In Feet -30% 0.3 0 -20% 0.7 -10% 1.2 -5% 2 0% 2.93- .9}5% 5% 4.5 10% 6 60% 7 slopes toward well flat slopes away from well *If the gradient Is unknown, assume the worst case Horizontal Horizontal Point Separation Value In Feet 0 0 25 0.7 50 1 75 2 100 3 150 5 200 6 300 7 Points a.. 6.00 Points ,,.. 2.6 *Linear interpolation between two point value is acceptable. Horizontally means straight line distance to the well not the contaminate travel distance to water table which may be greater. Conclusion: Grant Waiver Total Points: 17.6421 i Y a f - u T inn..^ ,,, •a r i y �wt ♦ r 4 :.' 1 "� r a i♦ T � � 'fit. '�'4 :� � � -r � . � • t1 � i� F . i r .♦ � L 1 . O I V Pannone Engineering Services, LLC P.O. Box 102954 Consulting Engineers Anchorage, Alaska, 99510 rQr171 272-82 1 1 Fax July 19,2007 Municipality of Anchorage Development Services Department On -Site Water R Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: South Ilills S/D, Block 4, Lot 6 Waiver Request/Inspection Notes Ladies and Gentlemen: I am writing to request that a separation waiver be granted between the existing private water well and existing septic tank and drain field. The Original 1,000 -gallon septic tank was installed in June of 1971 and is located 90 feet from the well. This tank was installed in accordance with the regulation in affect at the time of installation. The drain field that was installed at that time was installed 96 feet from the well. Your Department at that time approved the installation, even though the drain field was too close to the well by four feet. A 500 -gallon septic tank was installed in 1983 between the drain field and original septic tank. The 1983 tank was installed approximately 93 feet from the private well. Again your Department approved this installation with no comments and no waiver. Therefore, I request a waiver be granted to the 1971 drain field and the 1983 septic tank to the following distances: • 1971 drain field to well 96 feet • 1983 septic tank to well — 92 feet The system has been in continuous operation since its installation. The ground water typically flows from the south to the north and into Rabbit Creek (approximately 0.5 miles north). The water results do not show an abnormally high level of nitrates or Bacteria. Granting this waiver will not affect the public health of this property or surrounding properties. Inspection Notes During this inspection, I was informed that a repair was performed on the drain field by the Owners ex-husband and brother in-law. I talked with the brother in-law and was told that the extent of the repair was replacing a broken pipe and installing double clean -outs after the 1983 septic tank for cleaning. Based on my inspection it appears to be accurate. If you have any questions or concerns, please contact me at 272-8218. Sincerely, St"n R. Pan CE 0149 Steven R. Pannone, P.E. Owner/Civil Engineer Attachments: Page 1 of 1