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SPENARD ACRES BLK A LT 3 S75'OF E150'
penard Acres Block A Lot 3 575' of E150' #010-115-08 REPORT OF INSPECTION—INDIVIDUAL SEWAGE -DISPOSAL SYSTEM PRIMARY TREATMENT consists of 0 Septic tank. ❑ Cesspool. Septic Tank: / Distance from well,i Q feet. Material,Q Numb of compartments Total liquid capacity, ��� gallons. Capacity inlet compartment, gallons. Inside length, feet. Inside width, feet. Liquid depth, feet. Cesspool: Distance from: Well, feet; foundation, feet; nearest lot line at ❑ front, ❑ side, ❑ rear, feet. Inside diameter, feet. Depth, feet. Liquid capacity, gallons. Lining material SECONDARY TREATMENT consists of ❑ Tile disposal field. ❑ Seepage pits. Other Tile Disposal Field: Distance from: Well, feet', foundation, _, _ feet; nearest lot line at ❑ front, ❑ side, ❑ rear, feet. Total length of tile lines, feet. Number of line:;,_- . Distance between lines, feet. Trench width, inches. Total effective absorption area in bottom of trenches, square feet. Length of each line, _ feet. Depth, top of tile to finish grade, inches. Type of filter material: ❑ Gravel. ❑ Broken stone. Other Depth of filter material beneath tile, inches. Depth of filter material over tile, inches. Seepage Pits: � //__ Number of pits�// . Outside diameter, feet. De 2 th,�6feet. Lining material /Distance from: Well, /00 feet; building foundation, S v feet; nearest lot line at ❑ front,12 -• ide, erear, feet. Inspection made by: ❑ State. ❑ County. Local Health Authority. ✓ Inspected Date of inspection , 14 (TI'r1.E) REPORT OF INSPECTION—INDIVIDUAL WATER -SUPPLY SYSTEM Distance to nearest public water main, /a__,o)_2t. Size of main, inches. Individual wells i4are ❑ are not customary in neighborhood. Give most recent record of failure of wells in immediate vicinity to furnish adequate supply of water Properties in neighborhood KI El are not being developed with both individual water -supply and sewage -disposal systems. Lot size: feet wide, feet deep. Dwelling set back from front property.Iine, feet. Individual water supply from: $ Drilled well. ❑ Driven well. ❑ Dug well. ❑ Bored well. Distance of well from: Building foundation, feet; nearest lot line at ❑ front, ❑ side, ❑ rear, feet, cast iron sewer, feet; tile sewer, feet; septic tank, 'feet; disposal field, feet; seepage pit, feet; cesspool, feet; other sources of possible pollution, feet. Well construction:/It , EaDiameter, ( inches. Total depth, feet. Type of casing, -- Depth of casing, feet. Approximate depth to pumping�I II f water in well, feet. Approximate yield, gallons per minute. Sealed watertight to depth of—/�1f S�feet. Exterior space around casing scaled with: ❑ Cement grout. ❑ Puddled clay. 0 Ordinary backfill. Well cover: ❑ Concrete. ❑ Wood. N, Metal. Openings in well cover watertight: K Yes. El No. Pumpt ❑ Shallow well. Deep well. Length of drop pipe, feet. Pump capacity, gallons per minute. Located in: P, 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? XYes. E]No. If answer is "yes,' J give date �% 19 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. ❑ Local Health Authority. nInspected b Date of inspection /�`� 194 (TITLE) • U. S. GOVERNMENT PRINTING OFFICE - 1957 0-F-427038 ADH.HSE+-6-P+ (f) (6-58 !eM) INDIVIDUAL WATER SUPPLY —.{ ALASKA DEPARTMENT OF HEALTH Section of Sanitation and Engineering ACTION ON REQUEST FOR BACTERI9LOGICA1 Your recent request for an analysis of a sample from the Individual Private Water Supply serving 3804 Wilson Wax, was received 320159 and examination has been completed. Records in this office indicate this Individual Private Water sanitary status. Analysis shows this SAMPLE to be V Satisfactoi lar. Souitir,entral Regional OPPicn WATER ANALYSIS Dept, of l eal.th to be ofV/ SatisfactoryQuestionable—Unsatisfactory If an "Unsatisfactory" or "Questionable" status is indicated above, you should take immediate action as recommended below. SANITARIAN'S 1. Boil or chemically treat your water supply to protect your family from water -borne diseases as outlined in en- closed leaflet, "Drink It Pure." 2. Improve your spring—See bulletin HSE -6-2 3. Improve your cistern—See bulletin HSE -6-3 4. Improve your dug well —See bulletin HSE -6-4 5. Improve your driven well—See bulletin HSE -6-5 6. Improve your drilled well—See bulletin HSE -6-6 7. Relocate your well to a safe location in relationship to your sewage disposal system—See bulletin HSE -15 S. Bottle broken in transit, please send new sample. 9. Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample. 10. Contact your nearest ❑ Local Health Department or ❑ Alaska Health Department, Sanitation office for bulletins, consultation, and assistance. 11. This is a surface water source and subject to pollution by man and animals. An approved water supply source should be developed. ALASKA DEPARTMENT OF HEALTH Division of Public Hmlrh Laboratories BACTERIOLOGICAL WATER ANALYSIS _ 3804 Wilson Clay (Jean C Cass) L*tl ri m Source Mr. Waik Mail Report to er ADH Address_ Dates: Collected59 nate Receiv 3 20 59 Lactose Broth MCC I locc locc I loco MCCLocc I 0.1cc 24 hours Ne a g Ave 48 hours _ Lactose Broth, 24 hrs 48 hrs —.Gram's stain Coliform Density (Most probab eo.9per 100cc.) Reported by llat 3 23 5y Absent This analysis ,indicates Coliform Organisms to be: present r ADH -1 fsE-r.-r t (f) (6-59 ]ON, - INDIVIDUAL WATER SUPPLY DiSTII ALASKA DEPARTMENT O): HEALTH J Section of Sanitation and Engineering AC'T'ION ON REQUEST FOR BACTERIQLOGICAI Lab. No 4755 Soutlicentx al Iieg i.onal WATER ANALYSIS Your recent request for an analysis of a sample I'ir• lancer from the Individual Private Water Supply f11 ,m Dept. of lle alth . serving3804 rfz�-3�IF ,tjny was received 3%20/53 _and examination has been completed. / Records in this office indicate this Individual 13rivate Water Suply y to be of- to Satisfactory--_Questionable--Unsatisfactory sanitary status. t Analysis shows this SAMPLE to be V --Satisfactory___-_ Questionable _Unsatisfactory. If an "Unsatisfactory" or "Questionable" status is indicated above, you should take immediate action as recommended below. 1. Boil or chemically treat your water supply to protect your family from water -borne diseases as outlined in en- closed leaflet, "Drink It Pure." 2. Improve your spring—See bulletin HSE -6-2 3. Improve your cistern—Sec bulletin HSE -6-3 4. Improve your dug well —See bulletin HSE -6-4 5. Improve your driven well—See bulletin HSE -6-5 6. Improve your drilled well—See bulletin HSE -6-6 1. Relocate your well to a safe location in relationship to your sewage disposal system—See bulletin HSE -15 8. Bottle broken in transit, please send new sample. 9. Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample. 10. Contact your nearest ❑ Local Health Department or ❑ Alaska Health Department, Sanitation office for bulletins, consultation, and assistance. 1.1. This is a surface water source and subject to pollution by man and animals. An approved water supply source should be developed. SANITARIAN'S REM ADH—HSN:-B-FI (e) This Form Must Be Filled INDIVIDUAL WATER SUPPLY Please Look on Reverse of Out Completely. Sheet for Sample Colleotion ALASKA DEPARTMENT OF HEALTH Instructions. Section of Sanitation and Engineering Request for Bacteriological Analysis 4. �„ 5 Lab. No .................... Water sample collected b 'L' ` "d 6U ...................... (Name of person collecting sa ple) (Date) 7Tltne) Water sample collected fromKitchen tap; E]Bathroom tap; ❑ Basement tap; Other(list) ...... .............. ......... ......... ........ ........... /....... ............................. ......... ......................... Address premise where source is located ................ ......................................................... (Mr.) (Mrs.) v_a Mail reorl, to (Miss) �/........ t/ ? J .......... ......................................../...................................... (Name) (Box No. or street address) (City) Please place an "X" in the box before items which best describe your water supply: SOURCE: Well — ❑ Dug, ❑ Driven, P Drilled, ❑ Bored ❑ Spring, ❑ Cistern, ❑ Other (list) ................ ............................................................................................... ❑ Creek, ❑ River, ❑ Lake, ❑ Pond................................................................................................ .......... DUG WELL OR CISTERN CONSTRUCTION: Walls -- ❑ Wood, ❑ Concrete, ❑ Metal, ❑ Tile, ❑ Brick or Concrete Block Top — ❑ Wood, ❑ Concrete, ❑ Metal, ❑ Open Top LOCATION: F] In basement, [] Basement offset, ❑ Under house, W In yard Other..................................................................................................................................................................................... DISTANCE TO: Building sewer or other drainage pipe..............feet, Septic tank . Y, P....feet, Tile field .............. feet, Seepage pit ..............feet, Cesspool feet, Privy .............. feet. Other possible sources ofcontamination (list) .................................. ....... ................ ....... ......... ---.................................. ................ ............... IVIAT.ERIAL: Building sewer -- Cast iron, ❑- Wood, ❑ Tile, ❑ Fibre pipe, ❑ Asbestos cement Jointmaterial — Type ...................... ............................................................................................................................... GENERAL INFORMATION: Does water become muddy or discolored? ❑ yes, P no When? ............................. Diameterof well ......................................................depth ........................p .. ........ ....... .feet Well casing material....., 1 r�. .1.... diameter .................... de th......Z.. ........ Lengthof drop pipe.. ............. .................................................................................. .......................... Waterdepth from bottom............................................................................................................feet Pump location: ❑ In well, [-] Offset in basement, 1re�� In basement ❑ In utility room, ❑ On top of well ❑ Other (list) .................... ........................................... ....:......................... ........... rhoyou suspect illness from this supply? ❑ yes, ( no iemarks:.............................................................................�.....:.....-............................................................................................................ PLEASE DRAW A SKETCH IN THE SPACE BELOW. THIS SKETCH SHOULD SHOW LOCATION OF HOUSE, WATER SUPPLY SOURCE, SEPTIC TANK, SEWER, DRAIN LINES OR OTHER SOURCES OF POLLUTION AND DISTANCES 3ETWEEN WATER SUPPLY SOURCE AND ANY OF ABOVE: FACILITIES. SAMPLES .MUST BE SUBMITTED IN CONTAINERS PROVIDED BY THE ALASKA DEPARTMENT OF HEALTH to`` 1956 VKOWW9 Adminintration Utiaranty AvA.,iion 'It'll-, :wenu© and 0Uw,- };ay soattle 1, jankington ATT"wTION: Bryan Man Arnat Loan agent Door hr. AlInn: kofor to 3046-013 At the requaqt of Lr. R. K. Schnell, aiw n mpootion a- Wo of the property Moat& at Lot 39 Block i, Spanard Court `''ubtiviriion. tP)th th-a w-ttev sup ply iy-t.u:ti "nd tho qwv ago dkpoonl -,yr4t9r,i war.-) according to Ala: ku, dopurti«r,nt of iIu:l.th loiniliwla s,t,-A;Hard,l 2wid 110w 111C:Ot all A w, iter numplia wa4 t,kkvn on 31 Auwa-t 1956 and waq nega- tivk) ,%t tibio of Collection. 1 rosommanA that thin proparty be approwd for a vatorunIn Wan. Vary truly yourno 13race D. ;Ldarus, ""AnItariarl Wl : Jow cc: illtur" i,.011 I t r! /IV' J,( V, MUNICPAUTY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approva Parcel I.D. 010 115 08 1. GENERAL INFORMATION Expiration Date: 1®-_")_Z `'?6 Z Complete legal description SPENARD ACRES BLOCK A LOT 3 S75 OF E 150 Location (site address) 3904 WILSON Current property owner(s) KING Mailing address Real estate agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic ❑ Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer Fx I Waiver request for: NONE Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Q 1 (Covi b` 1 1 Date of Payment i `'2% -2,0 Receipt Number Q f q 7 COSA# OSC ZO-I '3 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm C&M ENGINEERING Phone 8545558 Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Date 7/17/2020 6. DSD SIGNATURE . ' • .. System #1 Approved for bedrooms Z. RLES G BALZARINI System #2 Approved for bedrooms �� �F��s . CE-13854 Disa roved � F�P ' P��'�'® pp �i®FSS®-®��� Conditional approval for bedrooms, with the following stipulations: By: Original Certificate Date: 7'Z— 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 Checklist blue sheet S c0 eckltist Legal Des(ription: If more than 1 septic system on lot: COSA Checklist 4' She ►moi A -c, res E W- V- A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 1958 Total depth 156 ft Cased to 156 ft ❑E Sanitary seal is functioning correctly ❑■ Wires are properly protected Casing height (above ground) +12 in. Date of flow test for COSA 7/17/20 Static water level at beginning of test 22 ft. Comments B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA Which system tested (date installed) ❑ ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A - pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: PROPERTY IS ON PUBLIC SEWER COSA Checklist yellow sheet N -m-B Parcel 010 115 08 - Structure served by this system 1 LOA -3 C_" 7s- ob C ISO <IIf, Well production at time of test +5.2 gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ■❑ N * Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic 12.6 ug/L ❑ Arsenic less than MRL (ND) Collected by C.Balzarini Date of Sample 7/9/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: PROPERTY IS ON PUBLIC SEWER Adequacy test date Results ❑ Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No ft Wells on Adjacent Lots: Community Sewer Manhole/Cleanout > 100' 42.5 r7 Yes if No ft [7 Yes if No ft Neighboring Tank > 100' ❑7 Yes if No ft Private Sewer/Septic Line > 25' ❑✓ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No ft ❑✓ Yes if No ft 12 Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' F-1Yesif No ft✓❑ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft Surface Water > 100' ® 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 ft Water Main > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No ft 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 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 property is connected to public sewer. Waver granted in 2015 for well to sewer line and well to sewer manhole. Waiver# OSV151123 G. ENGINEER'S CERTIFICATION i certify that / have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. 7/17/20 COSA Checklist yellow sheet co •49 TH �.. CHARLES G BALZARIN,1 CE -13854 .••�`� PROFESSOQ . ft ft Arsenic advisory Certificate of On -Site Systems Approval # OSC201341 Subdivision: Spenard Acres, Block A, Lot 3 S75 of E 150 A water sample revealed an arsenic concentration of 12.6 micrograms per liter (ug/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Parcel I.D. 010-115-08 Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Q Expiration Date: - Complete legal description SPENARD ACRES; BLOCK A, LOT 3, S75' OF E150' Location (site address) 3804 WILSON STREET -ANCHORAGE, AK 99503 Current Property owners) MICHAEL & KAREN KING Day phone N/A Mailing address Real Estate Agent 3804 WILSON STREET *ANCHORAGE, AK 99503 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: Individual Well 19 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone TYPE OF WASTEWATER DISPOSAL: Individual 19 Holding Tank ❑ Community ❑ Public Sewer lid WaiverNariance requestfor: WELL TO SEWER MAIN/MANHOLE Distance: 12', 42' Received by: v 1ti� Date: COSA to be releasof to the engineer, unless otherwise requested by the engineer.. COSA Fee $ Waiver Fee $ Date of Payment Receipt Number —COSA# MQ,61S12 Date of Payment Receipt Number Waiver # OSV t S 1123 4 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Garness Engineering Group, Ltd. (GEG) Phone (907) 337-6179 Address 3701 E. Tudor Road, Suite 101, Anchorage AK, 99507-1259 Engineer's Printed Name Jeffrey A. Garness Date In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the systems on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend on a variety of variables including, but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the waterusage of the family utilizing the systems. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the systems; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail The content of this reportis for the sole benefit of the person/party who retained GEG, Reliance upon the information provided in this report by any other person or party, including but not limited to subsequent property purchasers, is not authorized. In short, GEG disavows any legal duty to anyone other than the person/oarty who paid for this report. 6. DSD SIGNATURE _System #1 Approved for bedrooms By: System 92 Approved for Disapproved Conditional approval for bedrooms bedrooms, with the following ON-SITE . WATER AND WASTEWATER PROGRAM Original Certificate Date: 01 - a 3 45, The 1VruniciAlityy(6jo ehorage 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 emissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist ✓ Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet &i-12.tloc If more than 1 septic system is on the lot: COSA Checklist # _of_ Structure served by this system _ Certificate of On -Site Systems Approval Checklist $-7�'of '5 Wo, Legal Description: SPENARD ACRES S/D LOT 3; BLOCK A Parcel ID: 010-115-08 A. WELL DATA *PER 1959 INSPECTION REPORT. SEE ATTACHED INFORMATION FROM AAROW PUMP & WELL SERVICE"- WEIA. t37•�� Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) NO Date completed 1956(?) Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 156* ft. Cased to 156* ft. Casing height (above ground) 18+ in. FROM WELL LOG AT INSPECTION Date of test 7/17/14 Static water level ft, 24 ft, Well production 9,13.m. 5.63 9 -p.m - WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate ND mg./L. Arsenic: 19.3 ug./L. Date of sample: 9/1/2015 B. SEPTIC/HOLDING TANK DATA PUBLIC SEWER Tank Type/Material Tank size gal. Number of Compartments Foundation cleanout (YIN) _ Depression over tank (YIN) Date of pumping Pumper C. ABSORPTION FIELD DATA PUBLIC SEWER Date installed . Soil rating (g.p.d./ft2or ft'/bdrm _ System type Length - ft. Width ft. Gravel below pipe ft. Total depth - ft. Eff. absorption _ fe Monitoring tube— Depression over field Date of adequacy test Results (Pass/Fail) For—bedrooms Fluid depth in absorp ""field before test _ in. Water added _gal. New depth Tin. Elapsed Ti _ min. Final fluid depth _ in. Absorption rate >= g.p.d. py-rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date Collected by: GEG. Ltd. Date installed Cleanouts (Y/N) _ High water alarm D. LIFT STATION Date installed Size in gallons Manhole/Access(YIN) �---- "Pump on" level at in. "Pump oil level at �iHigh water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanknift station on lot N/A On adjacent lots N/A Absorption field on lot N/A On adjacent lots N/A Public sewer main 12+'* Sewer/septic service line UNK** Animal containment areas 50'+ Public sewer manholeldeanout 42.5'* Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Properly line Absorption Water main Water service line Surface Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON -LOT TO: Property line Buildi dat�n ion Water main Water service line Surface water Driveway, paridng[vehide storage Curta n Wells on adjacent lots- F. ot F. COMMENTS *WELL IS 42.5' FROM MANHOLE AND 12'+ FROM SEWER MAIN. SEWER MAIN INSTALLED AROUND 1961 AND WELL INSTALLED AROUND 1956 ENCROACHMENT HAS EXISTED FOR 54 YEARS. G. ENGINEER'S CERTIFICATION I cerlffy that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSH guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS 1f / Datej4J1s- Municipality of Anchorage Community Development Department Development Services Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Arsenic Advisory Certificate of On -Site Systems Approval # 151512 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block A, Lot 3 S75' of E150' of Spenard Acres Subdivision. This inspection revealed an arsenic concentration of 19.3 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.or /og nsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. e rMunid alIP r of Anchora Ire O Ment 1P �� P� .T 6 ti f; a N ...._.._._ _....--. - --- _-- - ._ _ .- . __ . - . — t--. , -.3 7997 epar tment http://www.rTiuni.orn/Ons!te Development Services Division Onsite Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV151123COSA* OSCIS1513 Permit#: PID#: 010-115-08 Legal Description: Snenardl Acres, Block A. Lot3. S75' of E750' Engineer: Garness Engineering Group Applicant; Michael & Karen King " Your request for a waiver of the required 50 'feet horizontal separation from the South public sewer trwA to the private well has been approved. The approved separation distance is 12.0'feet. Your request for a waiver of the required 50 feet horizontal separation from the East public sewer trunk to the private well has been approved. The approved separation distance is 42, feet.' Your request for a waiver , of the 'required 50 feet horizontal separation from the public sewer manhole to the property line has been approved. The approved separation distance is 42.0 feet. This waiver approval applies to the existing well and sewer facilities only. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this ' waiver. ❑ Notarized .letter(s) of non -objection have been received from the owner(s) of the affected adjacent property.:. ®`Adjacent properties are not affected by this waiver. Waiver is Granted: X Waiver isnot Granted: Date: ' �a2 Approved by: ame of Reviewer ...r........:.ri....•s..................... ..- •�.A ....... r..w i........ r......� - GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS September 14, 2015 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road, Anchorage, AK 99519-6650 Attn: Jay Crewdson, P.E. REFERENCE: Spenard Acres, Block A, Lot 3, S75' ofEl50' — 3804 Wilson Street— Waiver of Separation Distance Between Well and Public Sewer Main/Manhole Mr. Crewdson, The subject property is served by a private well and public sewer. Based upon MOA records, it appears that the well (for 3804 Wilson Street) was drilled in 1956. According to MOA tax records, the home at 3804 Wilson Street was constructed in 1955. In short, the age of the well and the home are in the same time frame.. The property is fronted along the east and south property lines by public sewer mains. It is believed (per AWWU records) that the public sewer mains were installed around 1961. The subject well is approximately 12 feet from the sewer main to the south of the property, 42 feet from the sewer main located in Wilson Way, and 42.5 feet from the AW WU sewer manhole located southeast of the property corner in Wilson Street. Based upon my interpretation of the MOA records and AWWU records, it appears the well existed prior to installation of public sewer. Neither the MOA onsite department nor AWWU have any documentation of a waiver being obtained; however, it is reasonable to assume that the encroachment had to have been recognized at the time public sewer was installed. The subject encroachments were identified on the previous COSA submittal (approved 7/31/2014). The home is being sold again, and a new COSA is being applied for. I discussed the encroachment issue with you and Deb Wockenfuss and it was agreed that a waiver should be formally documented prior to issuance of the next COSA. In addition, it was agreed that the MOA would not charge a waiver fee. At this time, we are requesting that a formal waiver be granted for the following separation distances: • Well on property to the public sewer mains — 12 feet (south sewer main) & 42 feet (east sewer main) • Well on property to a public sewer manhole — 42.5 feet 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com Page 2 of 2 The following is justification for the requested waiver/s: • Water samples on 6/30/2014 indicated no bacteria and a nitrate level of 0.191 mg/L • Water samples on 9/1/2015 indicated no bacteria and non-detectable nitrate level • The existing encroachment is believed to have existed for 54 years with no adverse impact on water quality • According to the 1959 HAA, the well is 156 feet deep; however, a document in the MOA files dated 5/1/1956 indicates the well is 142 feet (and appears to say "drilled"). Per a memo dated 7/16/2014 from Brian Willie at Wheaton Water Wells, the well is 137.5 feet deep with a SWL of 22 feet. The SWL noted on the last COSA was 24 feet. In short, the well is at least 137.5 feet deep, and given the static water level, it appears that the aquifer is confined and under pressure. In short, based upon long history of these encroachments, the confined nature of the aquifer, and the current water quality, I am requesting that a waiver be issued to formally address the subject encroachments. If you have any contact me at 337-6179. 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www. garnessengineedng.com 'Rob Campbell From: Brian Wille [brianw@wheatonwells.com] Sent: Wednesday, July 16, 2014 11:29 AM To: Rob Campbell Subject: 3804 Wilson St Rob, Casing extended 10'. Pit is gone. Casing is 2' above grade with an MOA approved well seal. SWL 22'. Well depth 137.5'. Pump set at 113'. Thanks, Brian Sent from my Android device with K-9 Mail. Please excuse my brevity. 5305"7'6 ,f 19 t1 ` WELL � O � Y m o ,iaK. d C1 C1 � 22. . /50.0' VOT_a S83° 57'W REFa,2 %O .q7T���=+CQ SHcET k7R WA ,'ZAV7Y UEEC1 Lot 3 Block A 5 75OF E /SO' SPENA /R 0 A C M E S SO A„ahorage Recording District, Alaska /5' M Wort. L m Earementa of mord other than those shown on `4 'o? I....... 1p'� the plat of record are not shorn hereon Valees- otherNse noted. �twt-a'a*m. LOT SURVEY CERTIFICATION LEGEND 05_13-14 1 hereby citify that I have surveyed the property shown and aeacri'bod 10 Braes or Aluminum capped monurytent-,=-Ored hero=, and ibct the Improvemats aituafsd Yforeca are within the prop- 0 iron pipe and/or rabor recovered., arty lines and da mat overlap ormeroaoh ort adjacent praparly and that 0 2 x 2 hub 5 tock recovered no Impravemaats an adjacent property overlap w onoNach ars the promises ; 5%8�� X 30w-rebaf set this survey in question and that Mere are no roadways, utility lines, orothor vlel®io --0 Fence Line (ar setox. thisLocsury easamamts as acid property aaadpt as Indicated harson. Scale / 3O / Date Prepared by: R L. 5�f7 TOA/ J (907)279-6200519W 6' .4tlmvii em.horgge A(aska9, 60/ Ret. / 7Z9 B. No. Property of: KE IVIVET H AJ_ AAA 4:) - 39 1 REVOCA6 LE -""L1 !�7' ice-", • R. L button p LS -1192 ,' Earementa of mord other than those shown on `4 'o? I....... 1p'� the plat of record are not shorn hereon Valees- otherNse noted. �twt-a'a*m. LOT SURVEY CERTIFICATION LEGEND 05_13-14 1 hereby citify that I have surveyed the property shown and aeacri'bod 10 Braes or Aluminum capped monurytent-,=-Ored hero=, and ibct the Improvemats aituafsd Yforeca are within the prop- 0 iron pipe and/or rabor recovered., arty lines and da mat overlap ormeroaoh ort adjacent praparly and that 0 2 x 2 hub 5 tock recovered no Impravemaats an adjacent property overlap w onoNach ars the promises ; 5%8�� X 30w-rebaf set this survey in question and that Mere are no roadways, utility lines, orothor vlel®io --0 Fence Line (ar setox. thisLocsury easamamts as acid property aaadpt as Indicated harson. Scale / 3O / Date Prepared by: R L. 5�f7 TOA/ J (907)279-6200519W 6' .4tlmvii em.horgge A(aska9, 60/ Ret. / 7Z9 B. No. Property of: KE IVIVET H AJ_ AAA 4:) - 39 1 REVOCA6 LE -""L1 !�7' SEW MAIN EXISTING 3 BEDROOM HOUSE O.q AWWU SEWER MAIN AND MANHOLES WERE BELIEVED TO BE INSTALLED AROUND 1961 AND THE WELL SERVING THE REFERENCED LOT IS BELIEVED TO HAVE BEEN DRILLED IN 1956. GARNESS ENGINEERING == • GROUP, Ltd = m_ - ;,_ CIVIL ENVIRONMENTAL ENGINEE_RS - 3701 E - ,N R R . $UUE 101 - INCNORTOE. W 99507 • PHONE (900) 337-6179 • FA% (907) 330-3246 • ME M- ww.9omeeamginee0ng.can PREPARED FOR: PHONE NUMBER: PAGE NUMBER: MICHAEL & KAREN KING N/A 1 OF 1 LEGAL DESCRIPTION: DRAWN BY: SPENARD ACRES; BLOCK A, LOT 3 S75' OF E150' PNB TYPE OF WORK: DATE: 5 MH I SEWER MAIN -ftFESS1 Pi 1 � (�Y` o 3 -ftFESS1 Pi Municipality of Anchorage 4, On -Site Water &Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I. D, 010-115-08 Expiration Date: z 0 "o 1. GENERAL INFORMATION Complete legal description SPENARD ACRES S/D LOT 3• BLOCK A SICU' Location (site address) Current Property owner(s) Mailing address 3804 WILSON ANCHORAGE 99503 ESTATE OF MR. ADAMS Day phone Real Estate Agent CHERI MARSTON Day phone 244-4440 2. TYPE OF DWELLING:' Single Family (w/woADU)��� ❑ Duplex 6 JUL 2 5 214 ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well M Individual On-site individual Water Storage U Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ WalverNariance request for, n/o _ Distance: — Received by: y /' Date:7 /� COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $_ 52_,i� —/ Date of Payment 99_ld Receipt Number � ` or l q (o COSA # 05C. [q 13t'* 2 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, i verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. t further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 8 Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for 4 bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following Phone 337-6179 Date '-7/2-2144 OF A ICE -79 3 err ' for o f e s sior0e \vi OF ON-SITE WATER AND o WASTEWATER o= BY Original Certificate Date:�3 / —ILI The eniclpality or Anchorage Develop, emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatations 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. ATTCHMENTS: X COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev. 11105) If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist S75 'oF E Legal Description: SPENARD ACRES S/D LOT 3; BLOCK A parcel ID: 010-115-08 A. WELL DATA *PER 1958 INSPECTION REPORT Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) NO Date completed 1958* Sanitary seal (Y/N) YES WireserI ro p p y protected (YIN) YES Total depth 156* ft. Cased to 156* ft. Casing height (above ground) 18+ in. FROM WELL LOG Date of test Static water level ft. Well production g.p.m. WATER SAMPLE RESULTS: Coliform SVD colonies/100 ml. Arsenic: 14.4 ug./L. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Tank size gal. Number of Compartments _ Foundation cleanout (Y/N) _ De re an c (Y/N) Nitrate 0.191 mg./L. Date of sample:30/14 PUBLIC SEWER C. ABSORPTION FIELD DATA Date installed Pumper PUBLIC SEWER Soil rating (g.p.d./ft2br0bdrm)_ Length ft. Width ft. Total depth ft. Eff. absorption area_ ft' Monitoring Date of adequacy test Results Fluid depth in absorption field before to _ in. AT INSPECTION 7/17/14 24 ft. 5.63 g.p.m. Collected by: QEG. Ltd Date installed High water alarm (YIN) System type _ Gravel below Water added _gal. Elapsed Time: Final fluid depth _ in. An enatioyr on treatment (past 12 mo.) (Y/N & type) Absorption rate >= kion over field For bedrooms New depth _in. If yes, give date M. D. LIFT STATION Date installed Size in gallons Manhole/Axess (Y/N "Pump on" level at in. "Pump ofl I�at, High water alarm level Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot N/A — On adjacent lots N/A Absorption field on lot N/A On adjacent lots N/A Public sewer main 12+'* Public sewer manhole/cleanout 42.5'* Sewer /septic service line UNK** Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Water main Wens on Property line Absorption Water service SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Building foundation Water Water service line Surface water nc vehicle storage 3 Curtain drain ells on adjacent lots s F. COMMENTS *WELL IS 42.5' FROM MANHOLE AND 12'+ FROM SEWER MAIN. SEWER MAIN INSTALLED AFTER WELL. ASSUMED WAIVER WAS GRANTED BY ADEC **FCO COULD NOT BE FOUND. PER MOA RECORDS D rV SEWER SERVICE LINE EXITED HOUSE ON WEST SIDE IN 1959. (OPPOSITE SIDE OF WELL) TLJCDCCnOC IT IC DCACn KIAD1 C Tn ACCI IEAC IT IC UADC TWAKI 9F' PPMA WFI I G. ENGINEER'S CERTIFICATION I01.14 I certify that I have determined through field inspections and 2 �I review of Mun/clpal records that the above systems are in 9 conformance with MOA COSA guidelines in effect on this date. ....... ... ....... . Engineers Printed rNameJ JEFFREY A. GARNESS ;Je r A. Garn ss:' 95311 ,�ov Date 2� tN nfe 7..Ao (Rev. 11105) Municipality of Anchorage p> s Community Development Department Development Services Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Arsenic Advisory Certificate of On -Site Systems Approval # 141362 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block A, Lot 3 S75' of E150' of Spenard Acres Subdivision. This inspection revealed an arsenic concentration of 14.4 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.or /og nsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. David Garness From: Jones, Kaleigh M. <Kaleigh.Jones@awwu.biz> Sent: Monday, July 21, 2014 10:47 AM To: David Garness Subject: 3804 Wilson St Attachments: rd001357.TIF Good morning, We do not have any connect records or a connect location for 3804 Wilson St. It is fronted on the east and south sides by sewer main (see attached record drawing). Any questions, please let me know. Thank you, Have a great day! Kaleigh Jones Engineering Technician H Anchorage Water & Wastewater Utility Office: (907)564-2762 Fax: (907)786-5001 kaleigh.j ones @awwu. biz Septr 1, 1 Kr„ blue lt, AiIIIlund, ChelraAsa+ of tris poard soonard Public utility blstrltt • +ypfal, Rlasita flub Grad, trunk eard c6ilectlon Systom Sub) a.e t-: "Gr Sir,, ti7e ar$ piaatiod EG saarsit 4aorauish our preltminary arrginaari+q design eoiiaxtion and disposal systom to serve the Wins rd roport for 1,01+090 In aoutrdwr,40 ulth thQ torms ar "r eontrta * Public Utility Qistrict` tan Bards definito finsnCing scPaa�s This rgKrt sats forth a d finito p a10etatlan 410h Yostor and for the Project 'Mich has barn devalapn rshall, larwastra�nt mankars and Erti"r1, Of $cattio, #+lrtittl The State aoera of K&alth has been advlsod end has lapel rc4Wthe forthis,pro* to rState pians and spacifitatlQAs and prCliminba rQ This Pralienlnar3' rtgort will serve as a basis far their find review and Wrovarl. Rcipetifully subsitted. TRTC.1c, NTWdi 6 ASSOCIATES c Jf Sanitary y Eng.nr t: -•rank f. 9t9'�"", itarlec t itase Nu, 410-E FEN -.no a NµK� �ONZN Nrr��*N map r gz ml"<z 6�� a mm m m AA 00 �zm n 5po gt*IooT a mm mFT] 0 0 II 1 OD j ooz 15X25TEMP ESMT. — -. rk25`LFMP ESMT WILSON ST.--J-.siol c rn In I _ c 90 O-_ V35! TEMP ESMT IN Mm .� " yaFMYz�p�M \ ol oA yn np I" - T� T2� yp 2�p2A�2A �y \\ I 40Z mopn \ ymn \ aO�m ya � 1 Ili Il 1 �~ Lmm� Ir ! rynJ' s <aaa# aaoe ®o^ I i.l I I I eaia3_9�ca - N m F 9p. m Seo$-s�yo Fp�$e � go g�=�FB��gyg �4a�ao F " c n A "i� p$n dam tine" m �nNi, m AaEas ai mxai on a Am ;€ rims o=�omRmo� SNooE m< g�ba � s`�n m m �n��ms ? fi ommm s Enz yy y PLM SET No. foE 7-301! 9 m 0658 � in G to 0 0 II 1 OD j ooz 15X25TEMP ESMT. — -. rk25`LFMP ESMT WILSON ST.--J-.siol c rn In I _ c 90 O-_ V35! TEMP ESMT IN Mm .� " yaFMYz�p�M \ ol oA yn np I" - T� T2� yp 2�p2A�2A �y \\ I 40Z mopn \ ymn \ aO�m ya � 1 Ili Il 1 �~ Lmm� Ir ! rynJ' s <aaa# aaoe ®o^ I i.l I I I eaia3_9�ca - N m F 9p. m Seo$-s�yo Fp�$e � go g�=�FB��gyg �4a�ao F " c n A "i� p$n dam tine" m �nNi, m AaEas ai mxai on a Am ;€ rims o=�omRmo� SNooE m< g�ba � s`�n m m �n��ms ? fi ommm s Enz yy y PLM SET No. foE 7-301! 9 m 0658