HomeMy WebLinkAboutSUNNY VALLEY LT 22BOnsite File
#050-354-34
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP 191437 PID Number: 050-354-34
Dwelling: ❑Q Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New iE Upgrade
Name
Judith Glafke
ABSORPTION FIELD
®❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound
Site Address
9346 West Lake Drive Eagle River
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
3 BR
0.8 GPD/SF
9.8 - 10.0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
3.8 - 4.0 Ft.
Gravel depth beneath pipe
6 Ft.
Subdivision Block Lot
Sunny Valley 22B
Fill added above original grade
0.5 Ft.
Gravel length
47 Ft.
Township Range Section
Gravel width
2.5 Ft.
Beds: Number of Lines
1
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
I Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
564 Ft2
1
Ft.
Well
>100'
>1 OQ'
NA
NA
TANK 0 Septic [:1S.T.E.P. [IHolding 1771Other
Manufacturer
Infiltrator
Capacity
1060 Gal.
Surface Water
>100'
>1 00'
NA
NA
Material
Number of compartments
Lot Line
>10'
>10'
NA
NA
NA
plastic
2
Foundation
> 10'
>10'
NA
NA
L�� TATION
Manufacturer
Capacity
Remarks 2" INSULATION OVER TANK
Gal.
Alarm location
i installed by
PIPE MATERIAL House to tank D3034 Tank to D3034
drainfield
Installer
Territory North Constructors
Drainfield D3034 CO/MTD3034
Inspector Curtis Townsend, PE
BENCH MARK (Assumed elevation) 100 ft
Inspdection 1M 10/17/19 10/18/19
Location and description
2�d
31' 10/19/1{a 4'h 10/21/16
nail in tree near site
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Conditional Approval: Date
Ak
o ... �b1.�� • .. • •
9 •' �`t' fur is L • send +?
��� � .. D to
�/9j E 1�QoM1
Septic System /
' C he,�
Approved � lj U��� DateD
PP C
.,No. V
�k��F�FROFE5S10�:''�'
Note: this approval does not include well permit requirements.
tKev uoiuz its)
1. ABANDONED EXISTING FIELD. REMOVED EXISTING
SEPTIC TANK IN ACCORDANCE WITH ANCHORAGE
MUNICIPAL CODE.
2. PLACED NEW INFILTRATOR 1,060 GALLON SEPTIC \
TANK AND NEW 47' LONG x 30" x 6' EFFECTIVE \
DEPTH ABSORPTION TRENCH. THE TANK WAS �,� LOT 30 WELL
i PROVIDED WITH 20"0 MANWAY RISER SERVING FIRST ` \RADIUS
COMPARTMENT. r \
3. ALL CONSTRUCTION WAS IN ACCORDANCE WITH ALL
REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL }
CODE C APT S 15.55 AND 15.65. \ \ l
540
WE to /
1 2 BR HODS
F k
LOT 22A
\ I LL y�P
100' p�ST I I
/
co\ VACANT LAND
V)` A N
�\— GARAGE
C 1
\ B
n B
\ \ _ NEW 1060 I j
\ 14% SLOPE ` ~ — — DCO GAL TANK I O
\ 0 I Y
\ RESERVE I Q
\ 41i'
FIELD AREA 30' I .i
LOT 22B
\ 47' x 30" x 0
WELL RADI 4-3 /ED TRENCH I
1 I
DESIG PA AMETERS
PRIMARY SEPTIC SYSTEM
0. BEDROOM: 3 (450 gpd) \ WE� RADIUS 535
TANK SIZE: 1000 G h o I
SOIL RATING: 0.8 GPD/SF / h'
AREA REQUIRED: 564 S.F. /
SYSTEM TYPE: DEEP TRENCH
47' x 30" x 6' EFFECTIVE DEPTH, /� LOT 23
4' COVER, MAXIMUM DEPTH OF YRFACE WATER i
EXCAVATION NOT TO EXCEED 10'. / SWING TIE DIMENSIONS ON PAGE 2 > 25'
Septic As Built Prepared for
Judith Glafke .O��E OF ++111
9346 West Lake Drive, Eagle River Alaska 99577 ? `?•�' Iii
Sunny Valley Lot 22B 'V �49R
�.....:: r.........................::.....f
OSP 191437#.�.
LLC s......... ........................... .
EKLUTNA ENGINEERING, LLC DATE: 3/2/2020 0�?,CURTIS TOWNSEND
�j�iAF
19162 MOUNTAIN ROAD DRAWN: CLT Na. E 11904
CHUGIAK ALASKA 99567
' SCALE: 1" = 50' 11••. ...�...••`' ��
(907) 355-9820 .�
PID: 050-354-34 SHEET 1 OF 2 1#444
MARK
A
B
C
SV1
53'-6"
Q Q
Q
O
b
W
In
DC 1
61'-7"
62'-1 •'
J
F�
E b
62'— 3"
o�
zW
zw
mQ
z
LQ
�U
tiU
F�U
Od
O 4¢i
O
110'-9"
b U
L�
F�
2° INS
All
OB
1,060 G
1
PLASTIC TANK
NEW 47' K ED TRENCH
4
SOIL RA 77A G 0.8 GPD/SF
SM
NO GROUNDWATER OCT 2019
MARK
A
B
C
SV1
53'-6"
63'—B"
SV2
57'-4"
62'-9"
DC 1
61'-7"
62'-1 •'
DC2
62'— 3"
62'-1 „
CO
66'-0"
62'-5"
CO
104'-6"
114'-2"
MT
108'-9"
110'-9"
Septic As Built Prepared for
Judith Glafke
9346 West Lake Drive, Eagle River Alaska 99577
Sunny Valley Lot 22B
OSP 191437
EKLUTNA ENGINEERING, LLC I DATE: 3/2/2020
19162 MOUNTAIN ROAD DRAWN: CLT
CHUGIAK, ALASKA 99567 SCALE: 1" = 10'
(907) 355-9820
PID: 050-354-34 SHEET 2 OF 2
STANDARD MORTGAGE SURVEY NOTE: THIS SURVEY IS PREPARED IN ACCORDANCE TO A.S.P.L.S. MORTGAGE LOCATION
SURVEY STANDARDS. THIS SURVEY REPRESENTS SURFACE CONDITIONS FOUND AT THE TIME OF LOCATION SURVEY AND
DOES NOT CONSTITUTE A BOUNDARY SURVEY. THIS SURVEY IS SUBJECT TO ANY INACCURACIES THAT A BOUNDARY
SURVEY MAY DISCLOSE. THE INFORMATION SHOWN HEREON SHALL NOT BE USED TO ESTABLISH FENCES, STRUCTURES,
OR OTHER IMPROVEMENTS. UNLESS GROSS NEGLIGENCE IS DISCOVERED, LIABILITY OF THE PREPARER IS LIMITED TO
THE FEES COLLECTED FOR SERVICES IN THE PREPARATION OF THIS PRODUCT.
OF
go,-)� ��L-187 62'
4 9 T
0
SEPTIC
®� Max A. Schillinger
��F�z LS 12039 ��®® 000
9/27/19, REV 10/29 NEW SEPTIC
WELL`S'
yo /
l
41.3'
(�
(R=203.05')
A_=(52'56'34")
'(Chord Brg=S 63°31'43" W)
(Chord Len=181.02')
(T=101.11');
J i '
1 �
64.6' 40
\ � I
55.0'
1SEl.
1!
i I
j;
86.0'��
�� 'UFifC/1VG /
t`arnklCD
o
_ otank2 C°
100' WELL RADIUS ®dcol N
oco
145.5'
NEW SEPTIC
LOT 22B INSTALLED OCT, 2019
PLAT #84-351 8�onitor
x�o O
—UTIL. EASEMENT
LOT 21 B F SEE PLAT #84-351
ORIGIN (NORTH 187.61)
AS -BUILT DRAWING OF:
LOT 22B
SUNNY VALLEY SUBD.
1 .1
M=
535
SCALE: 1 "=60 FEET
DATE: 9/29/2019, REV 10/27
FILE: 19-107
PROPERTY ADDRESS: 9346 W LAKE DRIVE. EAGLE RIVER, ALASKA
LEGAL DESC: LOT 226, PLAT 84-251, ANCHORAGE, ALASKA
I ALL POINTS NORTH LLC - PO BOX 4207. PALMER, AK 99645 TEL: 907-746-4185 1
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
h1tp:/1www.muni.orglons4to
On -Site Wastewater Disposal System Permit
Permit Number: OSP191437
Work Type: Septic Upgrade
Tax Code Number: 05035434000
Site Legal Address: SUNNY VALLEY LT 22B G:0057
Site Mailing Address: 9346 WEST LAKE DR, Eagle River
Owner: GLAFKE WILLIAM B & JUDITH S
Design Engineer: EKLUTNA ENGINEERING, LLC*
This permit is for the construction of:
Q Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy
Effective Date
Expiration Date
Q, r
llrpartrnenr
Lot Size in Sq Ft:
Total Bedrooms
10/1412019
10/13/2020
70445
❑ Private Well ❑ 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 (2417).
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 &
Issued By:
Date: r I r}
Date: 10 19 q 1 t
2
p«AJS
MUNICIPALITY OF ANCHOkAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax 907-343-7997
ON-SITE SEPTICIWELL PERMIT APPLICATION
Parcel I.D. 050-354-34-000
Property owner(s) GLAFKE JUDITH
Mailing address PO Box 770344 Eagle River 99577
Site address 9346 West Lake Dr Eagle River 99577
Legal description (Sub'd., Block & Lot) SUNNY VALLEY
Legal description (Township, Range & Section)
Lot Size. 70,445 Sq. Ft. Number of Bedrooms 2
Day phone.
LT 22B
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(® all that apply)
Absorption Field 0 Initial Single family (SF) El
Septic Tank 0 Upgrade (w/wo ADU)
Holding Tank ❑ Renewal ElDuplex (D) ❑
Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify th above information is correct. I further certify that this is in accordance with
applicabI M icipal Codes.
5�
(Signatur of broperty owner or authorized agent)
Permit/Rush Fees: n"5--
Date of Payment: lQ 11 �q
Receipt Number: 0qw? In
Permit No. 05R8f 13?
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
G1Development Services\Building Safety\On Site Water and WastewaterTFormskMent FormslPermit Application.doc
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191437, Rebecca Carroll, 10/14/19
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191437, Rebecca Carroll, 10/14/19
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191437, Rebecca Carroll, 10/14/19
STANDARD MORTGAGE SURVEY NOTE: THIS SURVEY IS PREPARED IN ACCORDANCE TO A.S.P.L.S. MORTGAGE LOCATION
SURVEY STANDARDS. THIS SURVEY REPRESENTS SURFACE CONDITIONS FOUND AT THE TIME OF LOCATION SURVEY AND
DOES NOT CONSTITUTE A BOUNDARY SURVEY. THIS SURVEY IS SUBJECT TO ANY INACCURACIES THAT A BOUNDARY
SURVEY MAY DISCLOSE. THE INFORMATION SHOWN HEREON SHALL NOT BE USED TO ESTABLISH FENCES, STRUCTURES,
OR OTHER IMPROVEMENTS. UNLESS GROSS NEGLIGENCE IS DISCOVERED, LIABILITY OF THE PREPARER IS LIMITED TO
THE FEES COLLECTED FOR SERVICES IN THE PREPARATION OF THIS PRODUCT.
L= 187.62')
49 Tri \\ OR—(52'56 34")
\(Chord Brg=S 63°31'43" W)
SEPTIC (Chord Len=181.02')
Max A. Schillinger�� (T=101.1 1 ')�
LS -12039 �®Aw
o
l
9/27/2019
64.6' /
W
41.3'
WELL
@55.0'
mil` 55.0'
WELL
0
i
145.5'
D' WELL RADIUS
LOT 22B
PLAT #84-351
\B0
LOT 2SEE PLATEMEN#84T 351
ORIGIN
AS -BUILT DRAWING OF:
LOT 22B
SUNNY VALLEY SUBD.
i I
86.0' 7
0
c5 SEPTIC
I o'
SEPTIC
0
(NORTH 187.61')
0 60
o
�
o
I
Q
N
I
Ll
'I
I
I
I
I
I`
i
SCALE:
1"=60 FEET
DATE:
9/27/2019
FILE:
19-107
PROPERTY ADDRESS: 9346 W LAKE DRIVE. EAGLE RIVER, ALASKA
LEGAL DESC: LOT 22B, PLAT 84-251, ANCHORAGE, ALASKA
I ALL POINTS NORTH LLC - PO BOX 4207. PALMER, AK 99645 TEL: 907-746-4185 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
Environmental Health Division
CASE REVIEW WORKSHEET
CASE NUMBER: DATE RECEIVED: COMMENTS DUE BY:
S-7722 June 12, 1984 June 29, 1984
SUBDIVISION OR PROJECT TITLE:
I L
ot~)~1 22A, 22B Sunny Valley Subdivisioi//~.~
( BLIC WATER AVAILABLE /~ [y~UBLIC SEWER AVAILABLE
((/ ) COMMUNITY WATER AVAILABLE
COMMENTS:
71-014 (Rev. 5/83)
~.~t/IUNICIPALITY OF ANCHORAGE ~
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska ~9501 264-4720
SOILS LOG -- PERCOLATION TEST
~ SOILS LOG
[] PERCOLATION
TEST
PERFORMED FOR: /'/,~ ~-~,'3 /'3~ ~ 3"~. ~,'~$~r ~ cf''~
LEGAL DESCRIPTION:
(FEET)
2 ////
__.
7
8
9-
10-
11
12
13~
~?
20
SITE PLAN
YES, ATWHAT / E
WAS GROUND WATER
ENCOUNTERED?
DEPTH?
Gross Net Depth to ~ Net
Reading Date Time Time Water Drop
TEST RUN BETWEEN
-- FT AND , FT
PERFORMED BY:
:i~.~.o o ~ 16/79)
CERTIFIED BY:: ~~'
772 2 JUL 02 1984
DATE:
Municipality of Anchorage
Community Development Department
On -Site Water & Wastewater Program
4700 Elmore St. a P.O. Box 196650 ■ Anchorage, AK 99507-6650 ■ w 907 343-7904
Well Decommissioning Log
Legal Address: q t.(� _ ikvr
Subdivision=-- Block Lot�.
T R I Section Lot
On-site Water & Wastewater Program certified contractor performing the well decommissi in
(Name: Signature
Company:
P
Well decommissioning date:9 7/ 1 Method of decommissioning: AMC 15:55.060L1
a. ❑ b. ❑ c.
Location: Use the space below to provide a drawing of the property showing the following items;
• North Arrow
• Decommissioned well,
• Other water wells on the property,
• Two separate swing -tie distances for each well shown in the drawing,
Note: The swing -tie distances shall be measured from ether permanent structures of property corners.
r /
1
V
rv'TYW'
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 050-354-34-00 Expiration Date: —be C 1
1. GENERAL INFORMATION
Complete legal description Sunny Valley L22B
Location (site address) 9346 W. Lake Dr.
Current property owner(s) William & Judith Glafke Day phone _
Mailing address P.O. Box 770344 Eagle River, AK 99577
Real estate agent
2. TYPE OF DWELLING:
Fx1 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
Day phone 230-0700
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Private Well 0 Private Septic E
Water Storage ❑ Holding Tank ❑
Community Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
Waiver request for: Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ Waiver Fee $
Date of Payment 9 5 oC d•2 Date of Payment
Receipt Number 019 3 (o d y Receipt Number
COSA # O S C 2115 L/8 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. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm Eklutna Engineering, LLC. Phone 406-1058
Address 19162 Mountain Rd. Chugiak, AK 99567 y�
Engineer's Printed Name Curtis Townsend Date
6. DSD SIGNATURE
System #1 Approved for 3 bedrooms
System #2 Approved for
Disapproved
Conditional approval for
bedrooms
.� OF AL` N
..... ........
• Data—��`�c`�
No.CE11,•;�,
s EdpR0FES
bedrooms, with the following stipulations:
otA
�ATEAl,R,t ER o-
W OGS' AM
%"IZfV)) 5tjlil��l
By: T'%h ic%lurki Original Certificate Date: / �y o70Zf
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
COSA Checklist
Legal Description: Sunny Valley L22B
If more than 1 septic system on lot: COSA Checklist # 1 of 1
Parcel ID: 050-354-34-00
Structure served by this system 1
A. WELL DATA
❑ Well log is filed with Onsite (or attached) Well production at time of test 6.8 gpm
Date drilled unk Water storage tank volume nla gallons
Total depth unk ft Well disinfected for coliform test? ❑ Yes ❑■ No
Cased to unk ft ❑■ Coliform bacteria is Negative
❑1■ Sanitary seal is functioning correctly Nitrate mg/L ❑■ Nitrate less than MRL (ND)
❑■ Wires are properly protected Arsenic ug/L ❑■ Arsenic less than MRL (ND)
Casing height (above ground) 22 in. Collected by Brandon's On -Site Services, LLC.
Date of flow test for COSA 8123121 Date of Sample 812121
Static water level at beginning of test 23.4 ft.
Comments 2 wells on this property. Well under deck decommissioned. Well shown in 2019 inspection report is still in use.
B. TANK DATA
Age of tank(s) 2 years
Tank type/material plastic
Measured operating fluid level in septic tank 45
Al Standpipes/foundation cleanout per record drawing
Date of pumping 5/02/21
D. ABSORPTION FIELD DATA
C. T STATION
❑ Require aintenance completed
Age of lift station years
Lift station material
Comments:
Which system tested (date installed) 10!19!19
Adequacy test date 8/23121
❑E ALL standpipes present per record drawing
Results QPass For 3 bedrooms
Total measured depth from grade 10.9 ft (max)
Fluid depth prior to test 39 in
Measured depth to pipe invert from grade 4.9 ft (min)
Water added 550.7 gal
❑ NIA — pressurized field
50.5
New depth in
0 Monitor tubes go to bottom of effective. If not, state
Elapsed time 1440 min
depth into effective
❑E- Code -required soil cover over field
Final fluid depth 41 in
❑ System presoaked
Absorption rate 4551 gpd
(Required if vacant for greater than 30 days prior to
Any rejuvenation treatment (past 12 months) no
date of test)
Gallons introduced gallons
If yes, enter date
Comments/Deficiencies: all standpipes are present. Foundation Geanout is present, not captured by surveyor.
COSA Checklist yellow sheet
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
Community Sewer Manhole/Cleanout > 100'
❑✓ Yes
if No
ft
0 Yes
if No ft
Neighboring Tank > 100' ❑✓ Yes
if No
ft
Private Sewer/Septic Line > 25'M Yes
if No ft
Absorption Field on Lot > 100' ❑✓ Yes
if No
ft
Holding Tank > 100' ❑✓ Yes
if No ft
Neighboring Absorption Fields> 100'
Yes if No ft
Water Main > 10'
Animal Containment? 50' ❑✓ Yes
if No ft
0 Yes
if No
ft
Yes if No ft
Water Service Line > 10'
❑
Yes
if No
Manure/Animal Excreta Storage ? 100'
If septic tank is under driveway
Community Sewer Main? 75' Yes
if 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'
0
Yes
if No
ft
Wells on Adjacent Lots:
❑
Absorption Field a 5'
0
Yes
if No
ft
Private Wells > 100'
Yes if No ft
Water Main > 10'
0
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
G. ENGINEER'S CERTIFICATION
1 certify that 1 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. ENGINEER'S
COSA Checklist yelfow sheet
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