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HomeMy WebLinkAboutTHUNDERBIRD HEIGHTS #3 BLK 4 LT 24Onsite File un CIRO IF HeIg ' " * hts 3 • i The 1981 field is not to be tested for a 5 bedroom Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221195 PID Number: 051-582-43 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name TAMMY & KENNETH RHEIN ABSORPTION FIELD - EXISTING ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 24505 TEAL LOOP, CHUGIAK, AK 99567 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 5 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot THUNDERBIRD HEIGHTS #3 4 24 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ftz Ft. Well 200'+ __ 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1500 Gal. Surface Water 100'+ -- Material Number of compartments Lot Line 101+ __ NA HDPE 2 Foundation 10'+ __ LIFT STATION Manufacturer Capacity Gal. Remarks Alarm location Electrical installed by Installer JRS PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Drainfield CO/MT 3034 Inspector FWCS BENCH MARK (Assumed elevation) 100 ft Inspection 15' 7/29/22Location dates: 2"d 7/30/22 and description 3rd 11/1/22 4t TOP OF MH RISER ON-SITE WATER AND WASTEWATER SECTION APPROVAL Conditional ' Approval: Date r • 00 -49 TH •• •• •••• •••••••••• Septic System Approved % �•.• Curtis Huffman - / ��(� 2 rz •: CE 128991 �� c�s�F ►�-� Date ) "Z 7 • . 11/03/22• . • '���� lllF� pROFESSION.��� OPRO SS1~ Note: this approval does not include well permit requirements. PID: 051-582-43 PERMIT: OSP221195 39.5' � I A—C=30.0' B—C=12.8' A—D=32.1' B—D=17.1' A—E=33.7' B—E=19.7' LOT 23 S89°58'50"E 199.00' 7D '" u N aj Cd[ SHED EXISTING 11.2' V CO CH C 16.2' EX\Sj 198, T FIELD VERIFIED 5' TO NEW 3 `t' EXISTING S.T. & EXISTING FIELDS & HOUSE0 10' TO FOUNDATION 13.0' 16.0' MT 0 DIV MT EXISTING 1999 TRENCH r- 6 FCO ® DC av 4.0' <30' DECK BM: MEH TOP CO z --1 N 32.0' \ APPROX. WATERLINE 9°58'50'E 199.26' LOT 25 An -owl' SEPTIC SECTION SCALEt NTS THUNDERBIRD HEIGHTS #3 BLK 4 LT 24 PREPARED FOR: TAMMY AND KENNETH RHEIN 24505 TEAL LOOP CHUGIAK, AK 99567 FIRST WATER CONSULTING 13030 SUES WAY ANCHORAGE, AK 99516 907-350-9566 FirstWaterAK®gmail.com �urrvn 1 5tKv1(:t5: OF ALj VIA "S� �� C 9 TH JIr 0. DATE: 10/25/22 rtis Huffman wx SURVEY: JLS CE 128991 w DRAWN: FWCSc 10/25/202V SCALE: 1 = 30'AV '% o' OpzssioK d' �h PAVED p p0 D/W ED CD ( J J W Q LLJ CD CD W ( BLOCK CD >- WALK z J H t- l77 / A—C=30.0' B—C=12.8' A—D=32.1' B—D=17.1' A—E=33.7' B—E=19.7' LOT 23 S89°58'50"E 199.00' 7D '" u N aj Cd[ SHED EXISTING 11.2' V CO CH C 16.2' EX\Sj 198, T FIELD VERIFIED 5' TO NEW 3 `t' EXISTING S.T. & EXISTING FIELDS & HOUSE0 10' TO FOUNDATION 13.0' 16.0' MT 0 DIV MT EXISTING 1999 TRENCH r- 6 FCO ® DC av 4.0' <30' DECK BM: MEH TOP CO z --1 N 32.0' \ APPROX. WATERLINE 9°58'50'E 199.26' LOT 25 An -owl' SEPTIC SECTION SCALEt NTS THUNDERBIRD HEIGHTS #3 BLK 4 LT 24 PREPARED FOR: TAMMY AND KENNETH RHEIN 24505 TEAL LOOP CHUGIAK, AK 99567 FIRST WATER CONSULTING 13030 SUES WAY ANCHORAGE, AK 99516 907-350-9566 FirstWaterAK®gmail.com �urrvn 1 5tKv1(:t5: OF ALj VIA "S� �� C 9 TH JIr 0. DATE: 10/25/22 rtis Huffman wx SURVEY: JLS CE 128991 w DRAWN: FWCSc 10/25/202V SCALE: 1 = 30'AV '% o' OpzssioK 30' 39.5' P N d - n O PAVED D/W p O O o N —� LdI Q 13.0' � O O I..,. W CLOCK w N p WALK o i17 ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: THUNDERBIRD HEIGHTS ADD No3 LOT 24 BLOCK 4 PLAT 80-116 LOT 23 '58'50"E 199.00' ° c a SEPTIC VENT C' (typ) EXISTING HOUSE 16.0' W,H ®� @� LOT 24 DECK BLK 4 4,0' 0 8W CANT SURVEY CERTIFICATE: I, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shoul( any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. AUG 14, 2022 1"=30' schuiler@,k.net 22-094 DRAYN BY; CNECKM BY GRID NUlABER: BOOh/PAGE JLS NW1865 220318 S89'58'50"E 199.26' LOT 25 © = FND 5/8" REBAR i� c6 N SHED 11.2' ` °.1D SU 'r Ir Y"� 2N t. L .1 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax 4 O 0 0 ry Ln t\ O O z 6/22/22 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-582-43 Property owner(s) TAMMY & KENNETH RHEIN Mailing address 24505 TEAL LOOP, CHUGIAK, AK Site address 24505 TEAL LOOP, CHUGIAK, AK Day phone Legal description (Sub'd., Block & Lot) THUNDERBIRD HEIGHTS #3 B4 LT24 Legal description (Township, Range & Section) Lot Size 20,000 Sq. Ft. Number of Bedrooms 5 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) Q (w/wo ADU) Septic Tank El Upgrade RX (D) ❑ Holding Tank ❑ RenewalDuplex ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. Ignature or property owner or autnorizeci agent) Permit/Rush Fees: a a _ Waiver Fees: Date of Payment: �O 1 3 0� a _ Date of Payment: Receipt Number: 0 13.1 Receipt Number: Permit No. 05Paa I t 5 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com June 10, 2022 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: THUNDERBIRD HEIGHTS #3 BLK 4 LT 24 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install a 1500-gallon HDPE tank per the attached design to serve the existing 5-bedroom residence. The lot and area are served by public water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221195, Deb Wockenfuss, 06/21/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221195, Deb Wockenfuss, 06/21/22 Municipality of Anchorage Page 1 of_ 5 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 545-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW990095 PiD Number: 051--582--43 Na"~":RACHEL SAXBY Wastewater System: [] New · Upgrade Address; 24505 TEAL LOOP CHUGIAK, AK 99567 ABSORPTION FIELD No. of Bedrooms:5 Ph°ne:(907~ 688--7544 rlDeep Trench ,Shallow Trench nBed nMound BOther LEGAL DESCRIPTION so,, Rating: Total Depth ,mm or;glnol grade: 1.2 CpD/scI. F~ 7.5 -- 8.0 24 4 THUNDERBIRD HTS. #3 5.5 - 4.0 ~ 4 - - - 0.5 - 1 n. 64 Ft.  Grovel wldLh: Number of lines: IDiatance between WELL: [] New [] Upgra 5 r~ 1I - F~ F~ ~. 640 s~. ~ ASTM D-3054/F-810 Ft. HAMILTON EXCAVATING 5/18-20/99 SEPA~TION DISTANCES · Septic D Holding D S.T.E.P. From Tank ~eld Station Tonk Sewer Une. ANCHORAGE TANK 1500 Well 200'+ 200'+ 1~ 0"+ 25'+ Matadel: STEEL Number of ~,,,y~,b,,6,,~: 2 su~C~w~t~ ~oo'+~oo'+ ~(o'+ - LIFT STATION Lot 5'+ 10'+ ~ 5 ~ze In gallons; J Manufactum~ .an~,~ Line + -~ Drain NONE KNOWN I I Remarks: ~ A~e~A~ be~ ,~ ~ BENCH MARK 5~e~ ~ o~ ~ ~s BOSOM OF SIDING. 100.0 inspections performed by: AWWC, INC. Dates: 1st 5/18/99 ( ~ :[' '/'~/:~ ~ · '~' · · ' · '~ ~ 2nd 5/20/99 __~ ~ ~.... Depadment of Health and Human Se~ices approval ~".~. ~ E-7953 .." ~ R~viewed and approved by: ~~ ~, ~ Dote: 7- ~?'~? '~P~'~"":o~°~- o,e~s, PERMIT NUMBER: PARCEL ID NUMBER: ,w99oog, A S- B U IL T D R A WI N I t EXISTING TRENCH TO BE~--~ I USED AS A RESERVE SITE I CL~NOUT FOR ~ BEDROOM ~ ~ ~ ~T ~ DRI~AY 5 BEDROOM ~ ~ HOUSE ~ ~ SEPTIC TANK DBL2~ ALTERNATE SITE I B I ~co, ~ ~.~ ~ ST1 ~ 29,0 ST2 ~4~J__ 35.0 ~BL1 36.3 _36.8 I DB~ 37.6 37.7 FD 39~ 38.7 C01 ~_ 39.~ MT1 40.7 39.4 MT2 ~ 94.5 C02 __9~ 95.0 I THUNDERBIRD HEIGHTS ~Y~IVISIO~ ~; LOT 24, BLOCK 4 AS-BUILT DRAWING Of SEPTIC SYSTEM UPGRADE ~f'"~ K.D.W, 1 = 30' 2 OF '~ER.,T ~.'~.E.~ AS--BUILT DRAWING swg90095 051-582-43 ~PllC TANK / ~fOM~ Mfl ~ 905~ ~ ~AS~ WAlK & WAS~WA~R CONS~T~S, ~C. ~ O~..AL~h~ LEGAL DESCRIPTION: THUNDERBIRD HEIGHTS SUBDIVISION ~3; LOT 24, BLOCK 4 ' ~"'~ AS-BUILT DRAWING OF SEPTIC SYSTEM UPGRADE RACHEL SAXBY (907) 688-7544 ~'~x" '- '" '-{~ 0AT[:6--30'99// ,~WN BY: SC~: PAGE: K,D,W, 1 = 30' 3 OF 3 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 995~9-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: May 17, 1999 Expiration Date: May 16, 2000 Permit Number: SW990095 Legal Description: THUNDERBIRD HEIGHTS #3 BLK 4 LT 24 Design Engineer: 0041 AK Water & Wastewater Consulta Owner Name: Rachel Saxby Owner Address: 24505 Teal Loop Chugaik, AK 99567-5113 Total Bedrooms: 5 Parcel ID: 051-582-43 Site Address: 024505 TEAL LP Lot Size: 22172 SQ. FT. Permit Bedrooms: 5 This permit is for the construction of: [] Disposal Field [] Septic Taek [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must 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 engineer must notify DHHS at least 2 hours pdor to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Date: ,~'//7~'~ Date: ~-/7.(~ Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B - Anchorage N Alaska 99504 (907) 337-6179 - Fax (907) 338-3246 Consulting Engineers Apr~ 30, 1999 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic Upgrade Design for Lot 24, Block 4, Thunderbird Heights Subdivision #3 To whom it may concern: The existing 3 bedroom house is served by a private septic system and a community water system. The homeowners are planning to add a 2 bedroom addition onto the house making the house a total of 5 bedrooms. Two test holes were excavated to the south/southeast of the existing drainfield for the proposed upgrade. Comments regarding the proposed design are summarized as follows: 1. SOILS: Attached are logs which shows the soil profile, and the percolation test results. The soils below the organic layers are a GM material with cobbles and boulders throughout to a depth of 5.5 feet in TH#1 and to a depth of 5.5 feet in TH#2. Below the GM material, the soils are primarily a SM material to a depth of 13 feet in TH#1 and 14 feet in TH#2 (bottom of test holes). No groundwater was encountered during the excavation of the test holes. The percolation test for TH#1 was performed between the depth of 6.0 feet to 7.0 feet and had a percolation rate of 2.35 minute/inch. The percolation test for TH#2 was performed between the dep, t)..of 5.0 feet to 6.0 feet and had a percolation rate of 2 minute/inch. 2. TRENCH DESIGN: a. Percolation Rate: 2.35 & 2 minutes/inch b. Allowable Application Rate: 1.2 gallons/day/It2 c. Number of Bedrooms: 5 d. Design Flow: 750 gallons per day e. Minimum Absorption Area: 625 fi2 f. Total Depth: fffeet (max.) g. Effective Depth: 4 feet h. Width: 5 feet minimum i. Reduction Factor: 0.50 !. Minimum Length: 64 feet long j Effective absorption area = 640 fi2 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: The average topography ofthls property is mostly flat; in short, there are no slope concerns. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you for your assistance./~ NOTE: Attached is a site plan drawing, a design drawing, two soils logs and a 4 page construction specification letter which are all part of the design package for this septic system. LOT B, BLOCK G, THUNDERBIRD HEIGHTS LOT 10, BLOCK 6, THUNDERBIRD HEIGHTS LOT 11, BLOCK 6, THUNDERBIRD HEIGHTS LOT 12, BLOCK THUNDERBIRD HEIGHTS LOT 20, BLOCK 4, THUNDERBIRD HEIGHTS LOT 21, BLOCK ¢, THUNDERBIRD HEIGHTS LOT 22, BLOCK THUNDERBIRD HEIGHTS LOT 23, BLOCK ~ I [5' BEOROOMS SYSTEM ', -~', I! il ~ . PROPOSED SE~ (SEE DESIGN, PAGE 2 OF 2) INOTE: ALL PROPERTIES SHOWN ARE SERVED BY PRIVATE SEPTIC SYSTEMS AND A COMMUNITY WATER SYSTEM. LOT 13, BLOCK 6, THUNDERBIRD HEIGHTS #3 LOT ~., BLOCK G, I ~'~ ~ I THUNDERBIRD HEIGHTS #3 THUNDERBIRD HEIGHTS ~3 i ,,,3* RAVEN COURT AI.&SIiA. WATER AND W.A_.STEWATER CONSULTANTS, INC. 6g01 DE~R ROAD SUI3E 2B, ANCHORAGE., AK Og~04 PHONE: (907) 337-B179JFAX: (907) 33B-3246 ~,L DESCRIPTION: THUNDERBIRD HEIGHTS S/D i~-X; LOT 24, BLOCK 4, = OF WORK: SITE PLAN FOR SEPTIC UPGRADE ' PARED FOR: PHONE NUMBER: RACHEL SAXBY , 688-7544. BY: SCALE: 4/50/99 J,L.M. 1 = 100' 1 OF 2 I ~. I · I EXISTING TRENCH TO BE I USED AS A RESERVE SITE.--, ~ ! CO IN PROPOSED h PROPOSED DRAINFIELD UPGRADE. CONCRETE SLAB I FOR RV GUMP~ ~ EXCAVATE 8 FEET DEEP MAXIMUM I ~ ~ BY 5 FEET WIDE BY 64 FEET LONG. I PROPOSED ~ ~ ADD 4 FEET OF CLEAN, WASHED ! 2 BEDRO0~I ~ ~ SEWER DRAINROCK. INSTALL TRENCH i ADDITION ~ \ \ PARALLEL TO SLOPE CONTOURS.-'/ ,, .E^BANDONEDCOMPLETEL¥--% \ \ / EDR '-- -- .... -- ~ ~ 500 GALLON / LiN DIW~ I ~ SEPTIC TANK~ OF DEEPER TEST HOLE) I I I I I NOTES: i 1 THE CONTRACTOR SHALL HAVE THE EAST PROPER~ LINE F~GGED t BY A REGISTERED ~ND SURV~OR PRIOR TO ANY CONSTRUCTION. I I I ~S~ WA~~ WAS~WA~ CONS~TA~S, ~C. LEG~ DESCRIPTION: THUNDERBIRD HEIGHTS S/D ~5; LOT 24. BLOCK 4 ........... r.~ .............. DESIGN FOR SEPTIC UPGRADE ~ ~¥"'"~ ...... :' TM RACHEL SAXBY 688-7544 3ATE:4/30/99 D~WN ~: SCAR: PAGe: J,L.M. 1 30' 2 OF 2 7320 E. CH~3~£R HTS. CIRCLE * N~ICHORAGE. AK. 9950~- PHONE (gO7) 357-617g * FAX (go7) 338-32~5 JSOIL LOG - PERCOLATION TESTJ ~" LEGAL DESCRIPTION: THUNDERBIRD HEIGHTS S/D PERFORMED FOR: RACHEL S~BY )ATE ~E.rO.~ED: ~/~/"" DEP~ ~ 12~ ORGANICS SOIL C~SSIFICATIONS J ~ SITE PL~ .... ~ j HOUSE . I~[J~U~ISILTY GRAVEL ~ GM CL ~ I~ ~ j(N~g~M/ ~EXiS~NG 4~j LIJ[ ~ IIWITH COBBLES GC OL j ~ , Auumu ~ SE~C SM J OH DEPTH TO DATE j i", ~ROUNDWATER ~oPos~D s[P~c D~ 4/25/g9 ~ DATE RE. lNG CLOCK NET TIHE WATER LEVEL NET DROP TIHE (HINUTES) READING (INCHES) 12 4/23/99 1 9:57 1 ~ 2 10:07 10 MIN. 5" 15 5 10:07 1" 5" 4 10:17 10 M~N. '6" 15 7 10:27 6" 16 9 10:57 17 ~ 10 10:47 10 MIN. 1-5/4" 4-1_~4" 11 ~ 10:47 19 PERCO~TION ~TE 2.55 (MIN./INCH) PERC. HO~ DIA. 6" (INCHES) 2 COHHENTS: NO PRESOAK .EQUIREO TH~S w~s ~OR~gl ~N ~OO~DANa~ W~m ALL ~T~ ~'~gN~a~ ~N ~OT ON TH~S 7320 E. CHESTER HTS. CIRCLE * ANCHORAOE, At<. 99504- ISOIL LOG - PERCOLATION TEST I LEGAL DESCRIPTION: THUNDERBIRD HEIGHTS S/D #3; LOT 24, BLOCK 4-, PERFORMED FOR: RACHEL SAXBY ~ DATE PERFORMED: 4/23/99 v~',,!. ITEST HOLE #2I feet) :~' ORGANICS ~ IS TE PLAN SILTY GRAVEL ::~? :.:: GP ML t I ~ HOUSE~ I ~ D I~ WITH COBBLES ~ GM CL ~ (NBV AND BOULDERS GC OL < i ~DmO~a/ ~ SEP~C ~ROUNDWATER  D~ 4/23/99 ', oPos ~ s~P ~ s (SEE DESIGN. PA?E 2 OF PRIMARILY SM ~ , , 11 DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (HINUTES) READING (INCHES) 5 10:50 ~ 5" 19~ PERCO~TION ~TE 2.0 (MIN./INCH) PERC. HO~ DIA. 6" (INCHES) 20~ TEST RUN BE~EEN 5.0 ~. ~ 6.0 MUNICIPALITY OF ANCHORAGE ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL DESCRIPTION LOCATION We Absorption area D,STANCETO: Manufacturer Liq. c~ ity in gallons IF HOMEMADE: DwellinglnSide length Manufacturer Well Well DISTANCE TO: No. of lines / Length of eac Top of tile to finish grade DISTANCE TO: Width Crib diameter Foundation Total length of lines Material beneath the Depth Crib depth Well Building foundation Depth Driller BuiIdin9 foundation Sewer line PHONE I E~'I~W [] UPGRADE W dth Material Nearest lot Trench wi NO, OF BEDROO~ PERMIT Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT NO, Distance between Total effective absorption area PERMIT NO. Total effective absorption area Neare? lot line Septic tan~ Distance to lot line OTHER PI P E MAT ER lA L ~),.~.,~ / SOl L TEST RATING INSTALLER REMARKS DATE LEGAL PERMIT NO, DEFARTMENT~ ,-,P' HESL.~F~ 8ND ENVIRONMENTAL FROTECTION 825 "L'" STREET, ~NCHORAGE, ~K. 995~J, APPLICANT LOCATION LEGAL. G,S.K. CONST. SRA RAVENS LP. LOT 24 BLK. 4 THUNDERBIR~ HTS. PAI..MER AK, LOT SIZE ~0000 SQUARE FEET TYPE OF SOIl.. ABSORPTION SYSTEM IS: TRENCH MARIMUM NUMBER OF BEDROOMS = 4 SOIL RFI'¥ I NG THE REQUIRED SI~E OF THE SOIL ABSORPTION SYSTEM IS: TME L. ENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCM OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF' THE 8ROUND AND THE BOTTOM OF THE EXCR'¢ATION (IN FEET). THERE IS NO 5ET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MZNIMUM DEPTH OF ~RRVEL BETHEEN THE OUTFRLL PIPE ~Nb THE BOTTOM OF THE E~CAYRTION (IN FEET). PERMIT APPLICRNT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS RDJRCENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT TME WELL WILL SERVE, BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL 89 THIS DEPARTMENT WILL. BE SUBJECT TO PROSECUTION, MINIMUM DISTANCE BETWEEN A HELL AND ANY ON-SITE SEHAGE DISPOSAL SYSTEM IS i00 FEEl' FOR A PRIVATE HELL OR i50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL, MINIMUM DISTANCE FROM R PRIVATE HELL. TO A PRIVATE SEWER LINE IS ~5 FEE]' ~ND TO A COMMUNITY SEHER LINE IS 75 FEET, OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION BIAARAM$ 8RE AVRIL, ABLE TO iNSURE PROPER INSTALLATION. I CERTIFY THAT i: I 8M FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF:' ANCNORRE~E, 2; I HILL INSTALL TIdE SYSTEM IN RccORDRNCE WITH THE CODES. ~: I UNDERSTFtND TMRT THE ON-SITE SENER SYSTEM MAY REQUIRE ENL~RAEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN 4 BEDROOMS, ...................... O & E ENG,NEERING & DEVELOr"MENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster 694-2774 Performed for: Name: SOIL LOG ~/~ ~ Tel. No Earl Ellis 688-2280 Mailing Address: Legal Description: Z~7' Depth (feet) Soil Characteristics 10__ 11__ 12 ~7 Y~' ~-- 13w PLOT PLAN PERC. TEST 14__ 15__ 16__ Ground Water Encountered: Yes No__ Proposed Installation: Seepage Pit Comments: ~/If yes, what depth Drain Field Performed by: ~_~ :~.x~/: ! • '� Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 051-582-43 Expiration Date: 5 IV - Z VZ 7 1. GENERAL INFORMATION: Complete legal description THUNDERBIRD HEIGHTS #3; BLOCK 4, LOT 24 Location (site address) 24505 TEAL LOOP, CHUGIAK, AK 99567 Current Property owner(s) KENNETH & TAMMY RHEIN Day phone 907-980-1314 Mailing address 24505 TEAL LOOP, CHUGIAK, AK 99567 Real Estate Agent WENDY WILTFONG Day phone 441-8200 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ® Public Sewer ❑ WaiverNariance request for:, Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ -55O Waiver Fee $ _ Date of Payment -1 zo 2p2 Date of Payment Receipt Number 0,300E G Receipt Number COSA# 0SG22 12 Z �J. 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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 1 Engineer's Printed Name: _Jeffrey A. Garness Date: 5'/ / b f z2� 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 The describe the S��O practices. reported results condition of the systems on the dates of the Q ,• evaluation. Separation distances were measured to readily identifiable features. Hidden defects or 457 T encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, levels Q • • • • • • . • • • • • • • • • • • • • • . • . . groundwater (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and ....... are outside the control of GEG. Satisfactory test results do not guarantee future performance of the =,Je Garr ess: s stem/s; therefore, GEG iiiakes no wariran Y ty (express or implied) regarding the future performance of = < < E— QQ the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed the in the 9 Q �` `F, y �1 L Z on property event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to Vv r° f 110 perform the evaluation. Reliance upon the information provided in this report by any other person or es sio party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD /SIGNATURE �c System #1 Approved for System #2 Approved for Disapproved Conditional approval for rbedrooms bedrooms bedrooms, with the #AECC884 ,G\?NLITYO i o �Wq ON S�TF yo oingQtiiQ FRVICES���1`\S Original Certificate Date: The Municipality of Anchorage Development Serviccbs 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 Septic System Advisory Well Flow Advisory COSA blue shoot_10.10-12.doo Nitrate Advisory Arsenic Advisory Others awy Legal Description: THUNDERBIRD HEIGHTS #3; BLOCK 4, LOT 24 Parcel ID: 051-582-43 If more than 1 septic system on tot: COSA Checklist # 1 of 1 Structure served by this system 1 Pa,IVELL DATA ❑ Well to le Date drilled SERVED BY AWWU WATER with Onsite (or attached) Well production at time of Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly F1 Wires are properly protected Casing height (above ground) in. Date of flow test for C Static water at beginning of test ft. B. TANK DATA Age of tank(s) 23 years Tank type/material STEEL Measured operating fluid level in septic tank 50.5" ❑ Standpipes/foundation cleanout per record drawing Date of pumpingG1�lp ZZq 1 21 Water storage tan me gallons Wel�disi ed for coliform test? ❑ Yes ❑ No bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) is ug/L ❑ Arsenic less than MRL (ND) Date of Sample FT STATION ❑ Requir aint Age of lift station Lift station mated Comment D. ABSORPTION FIELD DATA 5+WIDE DRAINFIELD Which system tested (date installed) 5/99 --:' '`-';I ""� Adequacy test date 5110122 gssi ❑ ALL standpipes present per record drawing i:uoc—,vf Results QPass For 5 bedrooms Total measured depth from grade 9.3 ft (max) J� Fluid depth prior to test *0 in Measured depth to pipe invert from grade 4.6 - ft (min) Water added *885 gal ❑ NIA — pressurized field *16 New depth in ❑ Monitor tubes go to bottom of effective. If not, state *300 depth into effective Elapsed time min ❑ Code -required soil cover over field Final fluid depth *1 in El System presoaked Absorption rate 750+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NONE date of test) Gallons introduced _gallons If yes, enter date Comments/Deficiencies: *IN MT1. ADDED WATER TO C01 WHICH IS RIGHT NEXT TO MT1. MT2 WAS DRY THROUGH TEST. NOTE: CO AND MT FOUND FOR 1981 TRENCH. MT FOR THIS TRENCH WAS FOUND TO HAVE 15.5 INCHES OF LIQUID DEPTH IN DRAINFIELD. COSA Checklist yellow sheet -- E. -SEPARATION-DISTANCES -. _ _ _. S�RVEDvBY AWWU yIIVATER If absorption field is under driveway comment below Property Line > 10' M Yes ft Private Well on Lot to: (Please enter distances if less than required or if community well) 0 Yes if No ft Private Wells > 100' Q Yes if No ft Septic Tank/Lift n Lot > 100'Community if No Sewer Manhole/ > 100' Surface Water > 100' 0 Yes if No Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' ❑ Yes if o ft P ' ewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No Tank > 100' ❑ Yes if No ft Neighboring Absorption Field Animal Containme 171Yes if No ft ❑Yes if No ft _ Manure/Animal Excreta Storage > 1 Co i y Sewer Main > 75' ❑Yes if No ft ❑Yes if No z' From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No *5+ ft Surface Water > 100' ❑✓ Yes if No ft Property Line > 5' n Yes if No ft Wells on Adjacent Lots: -� Absorption Field > 5' Q Yes if No ft Private Wells > 100' Q Yes if No ft Water Main > 10' Yes if No ft Community Wells > 200' rvJ Yes if No ft Water Service Line > 10' Q 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' M Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' Q Yes if No ft Water Service Line > 10' Q Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *MET SEPARATION DISTANCE MET AT TIME OF INSTALL. LOW LYING DECK ON PIER BLOCKS (<30") NEXT TO TANK. **1999 DRAINFIELD IS 10'+ TO FOUNDATION / 1981 DRAINFIELD DISTANCE TO FOUNDATION IS UNKNOWN. G. ENGINEER'S CERTIFICATION o --Z of qw%' I certify that I have determined through held inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. ...'1l AT .... --7 COSA Checklist yellow sheet 1 f r !.'G rness., Q CE 79 3 � ` Ito 4%q rofessio�°bo #AECC884 DEVELOPMENT SERVICES DEPARTMENT On -Site Water and Wastewater Section www.muni.org/onsite Septic 'Tank Advisory Certificate of On -Site Systems Approval #OSC 221224 Subdivision: Thunderbird Heights #3 Bock 4 lot 24 907-343-7904 Fax: 343-7997 Starting at 20 nears of age the MOA issues Advisory's for steel septic tanks The septic tank for this COSA / property is 23 years old. A leaking septic tank may be a source of contamination to the aquifer. Typical replacement costs range from $10,000 to $15,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of a 16 -year-old septic tank. Mailing Address P O Box 196650.* Anchorage, glaska 99519 6650 *www muni org C'a -Im M -4 ;rnm oo0, A MZiZ0 m *=065O� _ Z 3 ZzZ0 0 -rm� o-mM Om�mo0o m� 0_ z a N J, m T c Q-) c g m a NN d 3 w d IX, ur j N N C m ou,fD T _' w ur N m 2 O N A=03, 0 N o c o I : o 30 m n. 0 M n mCL - 3 w m ? in m-3mo 0 (!7 4CL cS 0 m m Nm?N f1 � W C' p� C CD m °c m Er tom om CD m N N CL O C CO x:3 O w 10 �.. CD m , C 3 0 2,omn.o 2D CC DL w . 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(D 0- -0=r 0 - Er lu 0 --, C)p 0- R: M -i M rn Q :3 M 5 Q. 0 XEF 0 -4 0 rr (0, CD Er 0 -0 z ;;,E w 0(,0 to cn oma ID 2; �5- -8, w -a = coCD z ck 0 D; (D CD = CD (13 CA Er M =3 0 .:r < C: CO S. CD r, =0 CA -0 B w ra P� 0 :3 CL :3 CD cn 1 co 0 0 =r ca 0 CD :3 En P� 8501 U C.0 C) N 0001'10" E 100.44 15' Utility Easement — — — — — — — — — – -0 CD 0112 f CD 0 CD C) 0 N cr CL -25.7d: cn 0, tVz — 0 CD FF 03 C CD Cn 3 z CD 0 a: co O*U 0 C.0 0 CD O'ZL(::) (D 01 0 OD M - o*vz C) I CD 0 o 0 24.7 0 a co 9 0 CO rh CD :3 0 cn =r CD S00007'53"E 100.44 (D CD 0 CD 0 cn C: 0 cr CL O CD FF 03 C CD CD MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ~5-! - $~['2 -~ ~ HAA# 1. GENERAL INFORMATION Complete legal description r ~ t 24 ~1oc9c 4 ehunderbir0 ~eights~ 5 Location (site address or directions) 24505 maa~ LOop Property owner R~charo & ,~athy ~enson Day phone 269-2369 Te,.~. Loop Chug~ak, AK 99567 Mailing address 24505 a~ -- Lending agency Mailing address Agent Address Day phone Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. .3 NOTE: Individual well Community well -~".,, .... Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site :;~:x Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verifythat 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm s & s ENGINEERING Phone ~ 17034 Eagle River Loop Road No. Address Eaale Rive~'. Alaska 99577 .' Engineer's signature - ' ~'~/~/L/~ ~";~-~.'~--- Date DHHS SIGNATURE ~ Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Se~,ices (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91 ) Back MOA ~21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~c,-CZ~ ~.v_- L~ '"~o~_c,~DParcelI.D. A. Well Data Well ~pe ~ Log present (Y/N) Total depth Sanitary seal (WN) If A, B, or C, attach ADEC letter. ADEC water system number. Date completed Driller Cased to Casing height Wires properly protected (Y/N) FROM WELL LOG Date of test Static water level Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Z.-c~ ~ ~/' Absorption field on lot -~ ~ ~ Public sewer main Sewer service line AT INSPECTION g.p.m. ; On adjacent lots ; On adjacent lots Public sewer manho e/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample:. Nitrate C611ected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed ~'--~/, Cleanouts~N) y' High water alarm (Y~ Date of pumping Tank size /',~ 5'-~ Compartments Foundation cleanout~JN) ~/ Depression (Y~ ~.~ ~/ Alarm tested (Y/N) '~'~ ~ - 75'~ Pumper ~T_~ SEPARATION D STANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot '"/ On adjacent lots =o~ ~ '/'' Foundation To property line / ,) ~ ~ Absorption field ,~ / Water main/service line Surface water/drainage /~ ~ 72~26(3/93)*Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level Meets MOA electrical codes (Y/N) "Pump on" level at Manufacturer Manhole/Access (Y/N). "Pump off" Level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots .Surface water D. ABSORPTION FIELD DATA Date installed ,.C'-- ~ / Length 5-z, / Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) Width 5//(,, / Cleanout present (~'N) ~_, --2. o -?,5- Results,_~fail) 7 '/ /'.1'o ~.16 d-,~f ,~ Soil rating (GPD/FF) /0¢ ,~.~'" System type '7~:.,/~/-/ ..3' Gravel thickness 'r/ ' Total depth ~' / t Depression over field (y~i) ~ ~,,~-~ J for 5/' Bedrooms After test ,5'" If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ,"~ To building foundation On adjacent lots .~ Surface water Curtain drain On adjacent lots ~.oo / '/' Property line /o / P To existing or abandoned system on lot Cutbank ~,/~ Water main/service line /~0 //'' Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I ce¢'fy that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection, HAA Fee $ Date of Payment Receipt Number 72-026 (~)' ~ck ROBERT C, COWAN CE-8801 Waiver Fee $ Date of Payment Receipt Number DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE ,MUNICIPAL ORAGE DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PROTECTION  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 LStreet-Anchorage, Alaska 99501 /~U~ '1981 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 RECEIVED 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. PROPERTYOWNER I PHONE I GARY S. KOCKLER MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE RICHARD A.. & KATHRYN }t. BENSON 277-0756 MA LING ADDRESS ~109 Medfra. Apt 9. Anchora~.e. AK 99501 3. LENDING INSTITUTION PHONE First Federal Savings and Loan (Franci) 274-6565 MAILING ADDRESS 813 W. Northern Lights Blvd., Anchorage, ~{ 4. REALTOR/AGENT I PHONE WJ1]~am Schlegel/Totem Realty, Inc.I 272-0571 MAILING ADDRESS 724 E. 15th Ave., Anchorage, AK 99501 5. LEGAL DESCRIPTION Lot 2.4, Block 4, Thunderbird Heights Subdivision (Peters Creek) STREET LOCATION NHN Raven Loop Road 6. TYPE OF RESIDENCE NUM~3ER OF~BEDROOMS [] One [] Four [] Other__ [] SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY [~ Three [] Six 7. WATER SUPPLY [] INDIVIDUAL* * ATTACH WELL LOG. A well Icg is required for all wells drilled [~ COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTILITY depth (attach Icg if available.) 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** 1981 YEAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTI LITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-01o (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified iNSTALLER -- L~Septic Tank or []Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS ROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) E~] DISAPPROVED DATE BY 72-010 (Rev. 6/79)