HomeMy WebLinkAboutT10N R2E SEC 17/18 LT 29 PART 1T1ON R2W
Sec. 17 & 18
Pczrt 1
Lot 29
#075-061-20
November 7, 1974
William Hume
General Delivery
Girdwood, Alaska
99587
SUBJECT: Sewer system on part of Lot 29 of Birdwood U.S. Survey 3043
Dear Mr. Hume:
An inspection of your sewer system on the subject property was performed
by the State Department of Environmental Conservation.
It was noted that the leach pit was 94' from the well and that the dis-
tance would qualify for a waiver.- However, the 39' distance from the
well to the septic tank cannot be dpproved.
The system cannot be approved until the violation is corrected. If the
septic system is used as is, this Department will bring legal action
against you. _
If you have any questions, please feel free to contact me at 274-4561,
extension 137.
Sincerely,
Hobert C. Pratt,
Environmental Control Officer III
RCP/ko
Certified Ho. 740402
CJr-AI.1�tL�L�3
11} 11 811AS
(\CA\ /
DEPT. OF ENVIRONMENTAL CONSERVATION
October 7, 1974.
Mr. Rolf Strickland -
Dept. of Environmental Quality
Greater Anchorage Area Borough
3330 C Street
Anchorage, Alaska 99503
est
if
SOUTHCENTRAL REGIONAL OFFICE / 338 DENALISTREET
MACKAYRU/LOING-R00M850
ANCHORAGE 9.9501
Reference: M{r$. fwtno, Girdwood, MnsKa
Dear Mr. Strickland:
Mrs. Hume of Girdwood contacted this office by letter with a
request for a waiver on distances from her well to her septic tank
and leach pit. Tuesday, October I, 1974, Gary Garthwait and I went:
to Girdwood to measure the distances between the well and septic
taPk and leach pit. The seatei_c tank is.391-fes from..:the We l I the
leach pit is 94 feet from the same well. We feel that the leach
pit would qualify for a waiver, however, the septic tank is much
too close to the well for this department to grant the requested
waiver.
On October 3, 1974, 1 spoke with Mrs. Hume. She did not
intend to move the septic tank further from the well at this time.
This situation should be looked into further to insure she does
not use this system before it meets the required distance from
the well.
Sincerely yours,
//0 c
obert C. Flint
Environmental Field Officer
CCie,ire .f zo
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT
PERMIT NO
NAME OF APPLICANT
l 3 da.a;;„
INSTALLATION LOCATION AO
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH €-P-4a4 // TO BE INSTALLED BY
SOIL TEST RESULTS ( // ?j-�
.15GnZ9O/✓
MAILING AL )114/p4±-10, ADDRESS , `
1 f 11 L �j 114/p4
SEEPAGE PIT DRAIN FIELD , OTHER
P SR -1,0',,i
PHONE -1F3 T6732_
COMPLETION DATE ANTICIPATED
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE 00 d TYPE SEEPAGE AREA SIZE /f 6- TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
1
FOUNDATION TO SEEPAGE PIT 65
SEPTIC TANK TO SEEPAGE PIT WALL
. �,
SEPTIC TANK SEEPAGE PIT DRAIN FIELD
DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN FIELD
tool
WATER MAIN TO SEPTIC TANK
%UI
SEEPAGE PIT (0 U
ALSO CONSIDER AREA
SEEPAGE PIT
DRAIN FIELD
1
SEPTIC TANK. IOU , SEEPAGE PIT 6 (} DRAIN FIELD
TO RIVER, LAKE, STREAM
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGGULATIONS REGARDING TALLATION.
7
Q
OR
LICENSED DESIGNER
fe%/gym 27,41771,4" /U
DIAGRAM OF SYSTEM
Marna mula0M00
11111111.1
I 11 111.111111
1.1111 iiiIIIIII1
PMMMIT
MIMEO m
ME 0 MOWN moll
?ram
m min
min mon 0 .011
.007 0•.
1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE /� - 7
APPLICANT'S SIGNATURE
Part,#1 Girdwood
XX
back -
With the exception of
the Gw backfill, the
sediments were compact
Top.. with a high water content.
-`.so11 There was a moderate
e
4 to high boulder and
!Gm ? cobble content also.
All contacts are erratic.
There was some water
seepage at the backfill; ?.
7 '""t ': topsoil contact but
Gm not enough to __._„i,
"Fto } a water table. c_'
Gw
22 July 74.
5 f
3.ft of Gm at 225sgft/bdrm,,,_
t Gm to Gw_,at 155sgft(bdm
Calculated average,8�gf;/11Tm
_..14.Feet.
Municipality of Anchorage
On -Site Water & Wastewater Program
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
o-75-061- 7.0
Parcel I.D.
1. GENERAL INFORMATION
Complete legal description
Location (site address)
Expiration Date: / -2 I
T10N, R2E, SEC 17 & 18, LOT 29, PART 1
153 BRENNER *GIRDWOOD, AK
Current Property owner(s) RANDY SULTE
Mailing address
Real Estate Agent
2. TYPE OF DWELLING:
•
153 BRENNER *GIRDWOOD, AK
Day phone 301-1484
Single Family (w/wo ADU)
Duplex
Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
4. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
WaiverNariance request for:
n/a
•
3
Day phone
JUL 1 6 2014
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
Community On-site
Public Sewer
•
Distance: —
Received by
COSA to be released to the engineer, unless otherwise requested by the engineer.
Date:
COSA Fee $ —�1J 2-(0 _
Date of Payment [ I) 10 b y f l�
Receipt Number 01194' G 00
COSA# 0!41335—
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, 1 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. l 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 & 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 bedrooms.
System #2 Approved for
Disapproved.
Conditional approval for
bedrooms.
Phone 337-6179
Date %/n/rF
bedrooms, with the following stipulations:
By: �( �. Original Certificate Date: 7 .(52
Th orage 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:
COSA Checklist
Septic System Advisory
Well Flow Advisory
RPV Ives
Nitrate Advisory
Arsenic Advisory
Other
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
Legal Description: T1 ON, R2E, SEC 17 & 18, LOT 29, PART 1 Parcel ID: 075-061-20
A. WELL DATA *PER GEG INSPECTIONS **PER SURROUNDING WELL LOGS
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) NO
Date completed PRE -1974 Sanitary seal (Y/N) YES Wires properly protected (YIN) YES
Total depth *108+ ft. Cased to **40+ ft. Casing height (above ground) 12+ in
FROM WELL LOG AT INSPECTION
Date of test NO WELL LOG 6/20/14
Static water level /ft. 37 ft.
Well production / g.p.m. 3.0+ g.p.m.
WATER SAMPLE RESULTS:
Coliform a colonies/100 ml. Nitrate NO mg./L. Collected by: GEG. Ltd.
Arsenic: N 0 ug./L. Date of sample: 6/20/14
B. SEPTIC/HOLDING TANK DATA PUBLIC SEWER
Tank Type/Material Date installed
Tank size gal Number of Compartments Cleanouts (Y/N)
Foundation cleanout (Y/N) Depression over tank (Y/N) High water alarm
Date of pumping Pumper
C. ABSORPTION FIELD DATA
Date installed Soil rating (g.p.d./ft2or ft2/bdrm System type
Length ft. Width ft. Gravel below pipe ft
Total depth ft. Eff. absorption . • . ft2 Monitoring tube Depression over field
Date of adequacy test Results (Pass/Fail) For bedrooms
Fluid depth in absorpt. geld before test in Water added _gal. New depth in.
Elapsed Ti - min. Final fluid depth in. Absorption rate >= g.p.d.
As ejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N
"Pump on" level at in "Pump off' level - High water alarm level at in.
Datum Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot N/A On adjacent Tots 1001+
Absorption field on lot
Public sewer main
Sewer /septic service line 25'+ Holding tank
N/A
75'+
On adjacent lots 100'+
Public sewer manhole/cleanout 100'+
N/A
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT 10:
Building foundation Property line Absorption field
Water main Water service line Surface water
Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD e OT TO:
Property line Buil ' undation Water main
Water service line Surface water Driveway, parking/vehicle storage
C
rain Wells on adjacent lots
F. 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 Printed Name JEFFREY A. GARNESS
t/a'00
Date
(Rev. 11/05)
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Municipality of Anchorage
Development Services Department
\\\ Building Safety Division
On -Site Water and wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519.6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 076' ac l., pQ
1.y GENERAL INFORMATION
Complete legal description Lot 29, Part 1, U.S. Survey 3043
COSA # t&)0 I LJ!21
Expiration Date: R — dZ — c9 t o
Location (site address) 4a Brenne} `Gwirdwood, Alaska 99587
.,.Current Property owners) David L. Kennedy
Mailing address 10700 Kasilof Blvd., Anchorage, Alaska 99507
Day phone 907-317-0979
Lending agency Residential Mortgage Day phone 907-222-8823
Mailing address 100 Calais Drive, Anchorage, Alaska 99503
Real Estate Agent Not Applicable
Mailing Address
Unless otherwise requested, COSA will be held by DSD /or pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual Well 0
Individual Water Storage
Community Class Weil El
Public Water System 11
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding Tank
Community On-site 0
Public Sewer n
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given In paragraph 4 by an Independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval
are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my Investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) In compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm M2C1 Construction and Engineering
Address P.O. Box 1750. Delta Junction, Alaska 99737
Engineer's Printed Name David L. Kennedy
5. DSD SIGNATURE
✓ Approved for 3 bedrooms.
Disapproved.
Phone 907-895.5441
Date 404106
Conditional approval for bedrooms, with the following stipulations:
n1L.11III 1.I I..
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: `L Original Certificate Date:
(R. 1105)
Municipality of Anchorage
Development Services Department '
J Building Safety Division •
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 190850
Anchorage, AK 995198850
www.muni.org/onsite
(907)343.7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Lot 29, Pert 1, U.S. Survey 3043 Parcel ID:
A. WELL DATA
Well type Private If A. B, or C provide PWSID # WA Well Log (Y/N) N
Date completed 1974 Sanitary seal (YM) Y Wires properly protected (Y/N) Y
Total depth 120 ft. Cased to >100 ft. Casing height (above ground) 24 in.
FROM WELL LOG AT INSPECTION
Date of test 11/17/98 (Last Test) 4/9/08
Static water level 37 ft, 38 ft.
Well production >3 g.p.m. 3.2
g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mL Nitrate •142 mg/L Other bacteria 1 colonies/100 mL
Arsenic: 0 mWI Date of sample: 4/10/06 Collected by: D. Kennedy
B. SEPTICIHOLDING TANK DATA
Tank Type/Material N/A Date installed N/A
Tank size WA gal. Number of Compartments N/A Cleanouts (YIN) N/A
Foundation cleanout (YM) N/A Depression over tank (YM) N/A High water alarm (Y/N) N/A
Date of pumping N/A Pumper N/A
C. ABSORPTION FIELD DATA
Date installed WA Soil rating (g.p.d./ft2 or R2/bdrm) N/A System type N/A
Length N/A ft. Width WA ft. Gravel below pipe N/A ft.
Total depth WA R. Eft. absorption area N/A ft2 Monitoring tube N/A Depression over field WA
Date of adequacy test N/A Results (Pass/Fail) WA For N/A bedrooms
Fluid depth in absorption field before test N/A in. Water added N/A gal. New depth N/A in.
Elapsed Time: N/A min. Final fluid depth N/A In. Absorption rate >= N/A g.p.d.
Any rejuvenation treatment (past 12 mo.) (YM & type) N/A If yes, give date N/A
D. LIFT STATION
Date Installed NIA Size in gallons WA Manhole/Access (Y/N) N/A
'Pump on' level at N/A in. 'Pump off" level at NIA In. High water alarm level at N/A In.
Datum N/A Cycles tested N/A Meets alarm & circuit requirements? N/A
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAift station on lot >100'
Absorption field on lot >100'
Public sewer main >100'
Sewer /septic service line >25'
Animal containment areas >100'
On adjacent lots >1W
On adjacent lots >100'
Public sewer manhole/cleanout >100'
Holding tank >100'
Manure/animal excrete storage areas >100'
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation N/A Property line N/A Absorption field NIA
Water main N/A Water service lure N/A Surface water N/A
Wells on adjacent lots N/A
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property lire NIA Building foundation N/A Water main N/A
Water Service line N/A Surface water NIA Driveway, parkingNehicie storage N/A
Curtain drain NIA Wells on adjacent lots N/A
F. COMMENTS: None
G. ENGINEER'S CERTIFICATION
I certify that I have detemrined 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 Printed Name David L. Kennedy
Date 4/24/06
COSA Fee $ � 3 O
Date of Payment �t — e2 g 0 (o
Receipt Number 7
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
- MUNICIPALITY T ANCHORAGE
• DEPARTMENT OF HEALTH d HUMAN SERVICESAla
Division of Environmental Services low
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING /1 22
Parcel I.D. # 07�l –2_0 HAA a 9g0l (OJ
1. GENERAL INFORMATION
Complete•legal description 7 a
Location (site address or directions) Ary-
Property
-k
Property owner � I �L_ uAAZ D,�ayy phone
Mailing address —? C), a6 K S /�j (rJMWOoo 77S -E7 -OS? -:7
Lending agency
Mailing address
Agent
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:. 3
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
Day phone
Day phone
NOTE: if community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
nmsMW M) Fom wwm
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 furtherverifythat 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 L 1�N� Nrr Phone 314p 7/C)03
Address .C�,f� 1lz- A4t `mll
Engineer's signature Malhi, Date y ?A Yy
6. DHHS SIGNATURE
Approved for bedrooms.
By:
Disapproved.
Conditional approval for
Additional Comments
4
N0. NO3
��c'•. C.E.
bedrooms, with the following stipulations:
The Municipality of Anchorage Department of Health and Human Services (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 courtesyto purchasersof homes
and their lending institutions in orderto 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.
rampw•+.M) e.k MOA Q1
� .,. Municipality of Anchorage
{tCEIVt
DEPARTMENT OF HEALTH & HUMAN SERVICES APR k u 1999
Environmental Services Division
825 L Street, Room 502 • Anchorage, Alaska 99501 • (907 9�QP�F ANCHORAGE
E IK*M Al. SERVICES DIVISION
Health Authority Approval Checklist
V-?Ov3
Legal Description: N lti) Po,2-r10" 'A-V:n 1 A. C. S-A"E Parcel I.D.:
A. WELL DATA
Well type �a1 UA Z� If A. B, or C, attach ADEC letter. ADEC water system number 4J�IA
Log present (YA3 N o Date completed
Total depth I () i 1- Cased to Ll 61 J\ Casing height (above ground) cZ 4 N '1"
Sanitary seal (Y/N) ES. - ((A wD�rs �/ duw=-A eat \Wires properly protected �7 I) Y 6S
^FROM WELL LOG l 5q q � / AT INSPECTION
Data of test 11 N A V A -t L -
Static water level I I
Well production t l
3.� r
WATER SAMPLE RESULTS: /
Coliform e M O IL `I`!� Nitrate C) � � pOther bacteria
Date of sample: 4-S -C(`I Collected by:
Iy&PTICh10LDINOTANK DATA lih �utuc
Data Tank size Number of Compartments _
Foundation dean ►_ Depression (YM) Hgh water
Date of Pumping Pumper
C. ABSORPTION FIELD DATA
Soil rating
Length Widlh
Effective absorption area
System type
pipe Total depth
Tube present(YlN)',`, Depression over field (Y/N)
Date of adequacy fast � Results (PasslFaiq
Fluid depth in absorp Meld before test (In.): Inunedately after gal.
Fluid depth (ins) Minutes later. Absorption rate = _
Pe -treatment (past 12 morHhs) (YM) If yes, give date
(Rev. &W*
On.):
lim
Date Installed Size
Manhde/Access (YM) on" level ar
High water alarm
E. SEPARATION DISTANCES
'Pump off" level ar
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot IJIA On adjacent lots 0 1
Absorption field on lot A14 On adjacent lots r Uy
r
Public sewer main Public sewer manhole/cleanout I Uy
Sewer /septic service line as Litt station fj ff
DISTANCES FROM SEPTICIHGN(3 TANK ON LOT TO:
Foundation
Water main/service line
SEPARATION DISTANCE FROM
Property fine
Surface wate
jCu n drain
F. ENGINEER'S CERTIFICATION
Property line
water/drainage
ON LOT TO:
Wells on adjacent
on adjacent lots
Water main/service line
storage area
I certity that I ve detemmyneeeddd duu field inspections and review of Maddpat records that Ote 640v9 wsystems are
01 with H4 kws in effect on Ods date.
Signature
Engines Name
17/Awv.� Wll�Ll Rstil , i 6
J • �
Dam
nO
HAA Fee
Data of Payment �—/1 — 91' L,/
Receipt Number
72-026 (Rev. 3MS)1
Waterer Fee S
Date of Payment
Receipt Number
O \°LNO e�D 6.40. (PLA, 03-2:5 ` 4 /
s
C /70.71 • .. 11 O2— ii" )PIC)
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STORY rv000 / i 3 k
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FRAME NOUS£ \ ft. P/ "J
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� errr uK / , \ •O
cARACClet-
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NOTE. \
ALL BEARINGS AND DISTANCES SHOWN ARE RECORD, UNLESS NOTED OTHERWISE.
EXCLUSION NOTE:
IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, L'q
COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT.
UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR
ESTABLISHING BOUNDARY OR FENCE LINES.
AS—BUILT CERTIFICATE:
I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY:
A PORT/ON OF LOT 29, us. SURVEY No. 3043
AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICAILU.
oe•` s41e LOT ERIC P. FUGLESTAD
• �� �� _ LAND SURVEYOR
•����.'•',••�'�.` •S. SUEOMSION.9 J500 CR//)ENO£N
- qg L U.S. SURVEY Ara 3043 NOUCR, AK 996W
_ ?JS -1911 FAX 2S5-8639
10 SECTION 18 TOWNSHIP 10 N RANGE 2 E DATE. Joe NWBIR: C.J. NUrBCk
.......5.�.. /:
� � SEWARD MERIDIAN/� � 98-01.06 EPF10.66
Eric P. Fug!estad %�� DEED AT: BOOK 462 PAc[ 304 s.at. MAW. acacD:
f'`•ti NO.7218—$rfrSl B ANCHORAGE RECOROINC CIS mICT 1"=40r EPF
0,9'S�� ch:o4813 OwTE OF SUm'Er:
10/16/98 A S -BUIL T