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HomeMy WebLinkAboutT12N R2W SEC 30 E2NE4SW4NE4SE4TI 2N R2W
Sec . 30
E2NE4,SW4NE4SE4
#021-022- 20
Municipality of Anchorage
Development Services Department
Building Safety Division °• .,
On -Site Water and Wastewater Program, 4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650 Pagel of 4
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: E✓ j> 111040 PID Number. 021-222-00
Name:
Wastewater System: ❑ New ® Upgrade
Address:
ABSORPTION FIELD
Phone: Number of Bedroom&
O Deep Trench 0 Shallow Trench 0 Bed 0 Mound ❑ Other.
LEGAL DESCRIPTION
Soil Rating:
GPD/FtBlotic:
Total Depth from original grade:
Lot: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe:
2n e4se4
+2.5 Ft.
0.5
Township: Range: Section:
Fill added above original grade:
Gravel Length:
5 Ft.
40 Ft.
Well: El New ❑Upgrade
Gravelwicith:
Number of lines: Distance between lines:
15 Ft.
3 5 Ft.
Classification (Private, A. B, Cr
Total Depth:
Cased lo:
Total absorption area:
Pipe Material:
Existing Private
Ft.
P,.
600 Fe
3034 PVC
Driller:
Date Drilled:
Static Water Level:
Installer:
Data Installed+
FL
Beek
7/27/2011
Yield:Pump
Set at
Casing Height Above Ground:
TANK
GPM
Ft.
FL
SEPARATION DISTANCES
❑ Septic ❑ Holding ® S.T.E.P. ❑ Other:
To
Septic
Absorption
Lift
Holding
ublifJPrivate
Manufacturer:
Capacity
From
Tank
Station
Tank
Sewer Line
Anchora eTank
1250Gal.
Well
105.9
OField
1 V 0+
95
Material:
Steel
Number of Compartments:
2
Surfacewaler
100+
100+
LIFT STATION
Lot Line
15
14.9
Size:
250
Manufacturer:
Orenco
Gal.
Foundation
23
107
'Pump on" level at:
40
'Pump off level at
43
High water alarm at:
45
in.
in.
in.
Curtain Drain
50+
50+
Pump Make & Model
P2005
Electrical Inspections performed by
SDLnJGlzovAjb j5�Gpc-T 1_1_e
Remarks:
Existirig tank removed old field abandoned in place.
BENCH MARK
Location and Description:
Garage man Door
Assumed Elevation:
100.0 Ft
Engineer's Stamp
Inspections performed by: PES. LLC Dates: 1517/25/2011
Ar ; H `:♦♦�
2 n07126/2011
i
Development Services Department approval
..... ..............
ste�en R. Pannone00
Conditional Approval by:Date:
♦� s'•. No. CE 5149
♦j
%
Reviewed and approved by: Date: /`�
•L . E/. ..0*
�41\�U
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE
STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE
WASTEWATER DISPOSAL SYSTEMS.
2. ALL WORK WAS IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS.
3, SCOPE OF WORK: INSTALLED NEW 1250 GALLON S.T.E.P. TANK, AND NEW SOIL ABSORPTION SYSTEM. DOCUMENTED
WELL.
4. NO GROUNDWATER WAS OBSERVED DURING EXCAVATION OF THE SOIL TEST HOLE. AN APPARENT WATER TABLE WAS NOT
OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 4.0 FEET BELOW EXISTING GRADE.
88.4INEW 1250
S.T.E.P. TP
DESIGN PARAMETERS
PRIMARY/RESERVE SEPTIC SYSTEM
NO. BEDROOM: 3 (450 gpd)
TANK SIZE: 1250g S.T.E.P.
PERC RATE = 1-5 MPI
SOIL RATING: 0.8 GPD/SF
AREA ROD: 562.5 SF
SYS. TYPE: 15'W BED 0.5' E.D.
MIN LENGTH: 7.5
USE:
40 LF X 15' WIDE, 0.5' E.D.,
+2' TD
TOTAL AREA: 600 SF
1 1/4" PVC F.M.
SLOPE VARIES
ABBREVIATIONS
40.OLFX15'WXO.5'ED BED
PROFILE
CU
COPPER
DIP
DUCTILE IRON PIPE
TH
2" RIGID INSULATION
FC
FOUNDATION CLEAN OUT
T#
6" TOPSOIL AND VEGETATE
C#
CLEAN OUT NO.
1 1/4"0 DRAIN PIPE A" HOLES
MONITOR TUBE NO,
R.I.
RIGID INSULATION
DCO
DOUBLE CLEAN OUT
30" 0. C. TYP. OF 3
DIVERTER VALVE
FS
FILTER FABRIC ABOVE DRAIN ROCK
5.O'
5.0' DRAIN ROCK 4" ABOVE PIPE
INV.
95.8
1.0'
3:1 SLOPES11
2
-
-
TEST
HOLE 1&2
92.7
90.7
2.
-2' OR
-4.0
SM 4.5 88'2
DRAIN ROCK 0.5' BELOW PIPE INV.
BOH
15.0'
SAND FILTER MATERIAL
SECTION
2'-3' MOA TYPE IIA
o'
REMOVE ORGANICS
o�
0
w
wz
70
1 1/4" DRAIN LINE
w
w
mo
a o
o
a
o
W/ 1 /8" h HOLES ON 30" CENTERS
~ o
�z
z
~
�_
v
�_
a
J
J
W
Q
z W
O
w o
[7
91.9 EG
ZO
m
88.4INEW 1250
S.T.E.P. TP
DESIGN PARAMETERS
PRIMARY/RESERVE SEPTIC SYSTEM
NO. BEDROOM: 3 (450 gpd)
TANK SIZE: 1250g S.T.E.P.
PERC RATE = 1-5 MPI
SOIL RATING: 0.8 GPD/SF
AREA ROD: 562.5 SF
SYS. TYPE: 15'W BED 0.5' E.D.
MIN LENGTH: 7.5
USE:
40 LF X 15' WIDE, 0.5' E.D.,
+2' TD
TOTAL AREA: 600 SF
1 1/4" PVC F.M.
SLOPE VARIES
ABBREVIATIONS
40.OLFX15'WXO.5'ED BED
PROFILE
CU
COPPER
DIP
DUCTILE IRON PIPE
TH
TEST HOLE
FC
FOUNDATION CLEAN OUT
T#
TANK CLEAN OUT NO.
C#
CLEAN OUT NO.
M#
MONITOR TUBE NO,
R.I.
RIGID INSULATION
DCO
DOUBLE CLEAN OUT
DV
DIVERTER VALVE
FS
FLOW SPLITTER
LEGEND
W WATERLINE/
WELL RADIUS
SS — NEW SEPTIC
NOTES: ���\\ _.
PANNON21 ING SVC, LLC �� OF At q 010/15/11
RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 ? �� • . >I
PHONE (907) 272-8218 FAX (907) 272-8211 Aw, TH 59�+r Scale
...NTS
.. .. ...... P.I.D. NO
T12N, R2W, SEC 30, E2NE4SW4NE4SE4 021-022-20
GEORGE GEISTAUTS Steven . �Oanno,;e PERMIT N0.
2440 E TUDOR RD. PMB 102 r111
*.•.cE 8149 �/ Osp111040
DESIGN DETAILS ANCHORAGE, AK 99507 (l ...... sheet
3 OF 3
ALP
i'
A
T2
LS
LOT UNDEVELOPED
NO WELLS OR SEPTIC
WITHIN 100'
41
DRIVE
fWELL (C)
5.9 TO BE DOCUMENTED
CAMERA WILL BE USED TO CHECK
FOR PERFORATIONS IN THE CASING
3BR HOUSE
(E)
\N�
T1
VG 10OOg
' TANK REMOVE
AND. REPLACED WITH
NEW 1250g %T.E.P. TANK
TH
EXISTING FIELD IN FAILURE —27.5�/—
ABANDONED IN PLACE m1i
...... . M4
. ....... 14.9 (UP) (A , W l PIRIWARY FI
(nu) 4 F$15'WxO.5'ED, 1,5'TD
�SWING TIES
C 0 B 1-2, TH2
FC 6.9 A
T 1 23
M1'
M4
U,,Pu, 4
TH2
20.5
26.9,�6.5
27.8 8.0
M1 107.9 82.d
�
M2 12.9
CO 91 M2
M3 / 37.3 11.8
M4`
4 11.8 38.1�-
NOTES: PAMONE EKG SVC,FA
RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK �c ff951 0 Ile
AwA
PHONE (907) 272-8218 FAX (907) 272-8211 ..' r-
T12N, R2W, SEC 30, E2NE4SW4NE4SE4
GEORGE GEISTAUTS
2440 E TUDOR RD. PMB 102
PLAN ANCHORAGE, AK 99507
-a:% CE 8149
L\
Date
10/15/11
Scale
1"=50'
P.I.D. NO
021-022-20
DERMIT NO.
OSP1 11040
Sheet
2 OF 3
TEST HOLE 2
DATE PERFORMED: 7/15/11
SOILS LOG - PERCOLATION TEST
SLOPE
K
TH
SIT[
l
3BR HOUSE
(E) /
t % /
TH
i
1 \
WAS GROUND WATER SLOPE
ENCOUNTERED? N
IF YES, AT WHAT TH
DEPTH? X
DEPTH TO WATER AFTER
MONITORING? -
DATE: 4/17/11
READING DATE
OR
ORGANICS
2
NET DROP
1 7/15/11
0830
3
SM
SILTYSAND
4
10 MIN
9.37
5
BR
FRACTURED
---
5.27
BEDROCK
6
8:50
10 MIN
9.39
BOH
58:50
7
__
5.27
8
6
9:00
9
9.42
t 4.15
10
,2
13
14
15
16
17
18
DATE PERFORMED: 7/15/11
SOILS LOG - PERCOLATION TEST
SLOPE
K
TH
SIT[
l
3BR HOUSE
(E) /
t % /
TH
i
1 \
WAS GROUND WATER SLOPE
ENCOUNTERED? N
IF YES, AT WHAT TH
DEPTH? X
DEPTH TO WATER AFTER
MONITORING? -
DATE: 4/17/11
READING DATE
CLOCK
TIME
NET TIME
WATER
LEVEL
READING
NET DROP
1 7/15/11
0830
--
5.27
—
28:40
2
10 MIN
9.37
4.10
3
8:40
---
5.27
---
4
8:50
10 MIN
9.39
4.12
58:50
__
5.27
_—
6
9:00
10 MIN
9.42
t 4.15
PEROLATION RATE 2.4 (min/inch) PERC HOLE DIAMETER 6 inches
TEST RUN BETWEEN 3 FT AND 4 FT
COMMENTS: Test hole excavated by BEEK'S CONSTRUMON. Prec hole was presoaked.
Test run for one hour. Last 3 readings reported
PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMEI
WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST,
NOTES:
PAMONE ENG SVC, LLC
P.O. BOX 102954 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
��` A\
�F A�gsl�l
Aw. C y*�r
/ TH W
`.... .. ....
Steven 5'• none /
/Iti CE 8149
oil'Fp..p�
1i\
Date
10/15/11
RECORD DRAWINGS
Scale
NTS
P.I.D. NO
t-022-20
PERMIT N0.
OSP111040
T12N, R2W, SEC 30, E2NE4SW4NE4SE4„
GEORGE GEISTAUTS
2440 E TUDOR RD. PMB 102
ANCHORAGE, AK 99507
SOILS LOG
sheet
-j
3OF3
Wags cV gzxr "r V axgi gtgrrg z 4mgegnoia
Solid Ground Fteciric, U.0
IM I Savage Drive
Eagle Raves, AK "577
solidgroundelectri00yah....
This letter is to state that the electrical
19434 Alpweg was installed in accorda;
Corte and the Municipality of Anchoragi
Sincerely,
scptt C6aarn r$
Sold Ground Electric LLc
J g. V . I1f V.:,
m
■
On -Site Wastewater Disposal System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP111040
Tax Code Number: 02102220000
Work Type: Septic Upgrade
Permit Effective Dates: May 06, 2011 to May 05, 2012
Design Engineer: PANNONE ENGINEERING SERVICE
Subdivision: T1 2N R2W SEC 30
Site Legal Address: T12N R2W SEC 30 E2NE4SW4NE4SE4 G:2943
Owner/Address: GEISTAUTS GEORGE A
2440 E TUDOR RD PMB 102 ANCHORAGE AK 995071185
Site Mailing Address: 13434 ALPWEG, Anchorage Lot Size in Sq Ft: 54450
Total Bedrooms: 3
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage
e %0'o0
3 c)
e 9 , o -D
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 wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either.
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Receiv
Issued
-(rs'-2-
67 U c7ue✓�J, n�� ✓Dr/ d l—e5��y�%7 1 yt2W�SC
�.a 14/�`"'d`2.� w r f� �(! 2✓7� sem%, W/',q© j! L7/ -p
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Division — Fax: 907-343-7997
On -Site Water & Wastewater Program
Mayor Dan SutPfvan
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. OZf - b'ZZ- Zo
Property owner(s) &a)F*-F 6 -Ci Sr t1TS Day phone
Mailing address 2yqo €• -ro" Roan fAJ5 lozi AWA09416-/✓
Site address _134;3y ALpug�-G-
Legal description (Sub'd., Block & Lot)
Legal description (Township, Range & Section)'TIZA✓ ?\ZW a SeL,&j t'2 NEN 5wt (( UErf d
Lot Size ¢—Sq. Ft. Number of Bedrooms _3
THIS APPLICATION IS FOR:
THIS APPLICATION IS AN:
(M all that apply)
Absorption Field
Initial ❑
Septic Tank
Upgrade
Holding Tank ❑
Renewal ❑
Privy ❑
Private Well 19I No
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
I certify that the above information is correct. I further certify that this application is being made
for a Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: J Waiver Fees:
Date of Payment: �� 1 / Date of Payment:
Receipt Number: _/ Receipt Number:
Permit No. oSP 1 I I u Waiver No.
G:1Bui1d1ng\0n Site\FormsUient FormsTermit App_010411.dm (Rev. 1A 1)
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steve@panengak.com
May 5, 2011
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
4700 S. Bragaw Street
P. O. Box 196650
Anchorage, Alaska 99519
Subject: T12N, R2W, Sec 30, E2NE4SW4NE4SE4
Septic System Permit Upgrade Request
Ladies and Gentlemen:
I am writing to request a permit to construct an upgraded septic system be issued for this property. The
proposed systems will serve an existing three-bedroom house. Currently the lot is developed. The lot is
served by a private well. The existing septic system is in failure. The surrounding lots are undeveloped.
1. Soils. A single test hole was excavated by Pannone Engineering Service in March of 2011. See the
soil log attached. Ground water was monitored for seven days. No ground water was monitored to a depth
of 4 feet below ground level after the monitoring period. Bedrock was encountered at 4 feet in the test hole.
It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate
of 0.8 gallons/day/square feet should be used, using a 1,250 gallon S.T.E.P. tank and bed type drain field.
2. Soil Absorption System Design.
a. See Sheet 2 of the design package
3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and the
existing drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water
and drainage ditches.
4. Topography: The topography in the area slopes approximately 10 percent from northeast to
southwest.
5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification
that the review is complete and that there are no further comments is received from MoA On -Site
Department, the note will be removed and "Issued for Construction" drawings will be issued.
l.i.�.«. ..
.✓ 0 9) L
72-S218 4"" S , r i ... k, 2.M �w ......, .w..
Page 2 of 2
The proposed installation will not affect the future development of the surrounding or existing lots. There
are no wells or septic systems within 100 feet of the proposed septic location.
If you have any questions or concerns, please contact me at 272-8218.
Sincerely,
41 !.
C'�
4 ll
9 T
1W......•..... ........... . . ......
..... A
0
............ .... ..... ............
St.v.. R. P.nnone
n,-
AF
CE 8149 AV
5/4/2011
Steven R. Pannone, P.E.
Owner/Civil Engineer
Attachments:
DX 'UL"'Zll I,
M TQM
/� .... ALP EG DRIVE
WELL (E) j
105.9 TO BE DOCUMENTED
CAMERA WILL BE USED TO CHECK ' ,'
• FOR PERFORATIONS IN THE CASING
S1 /
3BR HOUSE
• (E)
EXISTING 1000g
SEPTIC TANK
LOT UNDEVELOPED TO BE REMOVED,
NO WELLS OR SEPTIC N AND, REPLACES WITH
WITHIN 100' 1250g S.T.E.P. TANK (P)
j10.0
EXISTING FIELD IN FAILURE 27.5 NN +�
ABANDON IN PLACE tPNNN N
L
H=-1 PRIMARY ;FIELD (P:) ;
40LFx15'Wx0.5'ED; 1.5'TD
\ z
Q
cc I
a G .
o
N •
FOR CONST UCTIONOTES: PAMONE ENG SVC, LLC r pF q� �l
.�� \ Date
P.O. BOX 100217 ANCHORAGE, AK 99510 �� '4slij 5/5/11
e
PHONE (907) 272-8218 FAX (907) 272-8211Scale
1"e � * • *��� Scal
..., l.s.. 1:.. f.... P.I.D. NO
T1 2N, R2W, SEC 30, E2NE4SW4NE4SE4-;..;_,.,./ 021-022-20
GEISTAUTS r �steveR8149 Pannone -;e -
GEORGE
% PERMIT NO.
CE
2440 E TUDOR RD. PMB 102 ,� Fc •,� OSP111040
PLAN ANCHORAGE, AK 99507 ��1�/rED p�F��� Sheet
1� pROFESSIO`�� 1 OF 3
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
ON-SITE WASTEWATER DISPOSAL SYSTEMS.
2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS.
3. SCOPE OF WORK: INSTALL NEW 1250 GALLON S.T.E.P. TANK, AND NEW SOIL ABSORPTION SYSTEM. DOCUMENT WELL.
4. NO GROUNDWATER WAS OBSERVED DURING EXCAVATION OF THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS
OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 4.0 FEET BELOW EXISTING GRADE, NOTIFY THE ENGINEER
IMMEDIATELY.
2" RIGID INSULATION
6" TOPSOIL AND VEGETATE 1 1/4"0 DRAIN PIPE �" HOLES
30" 0. C. TYP. OF 3
4.0
NEW 1250 40.OLFX15'WXO.5'ED BED
S.T.E.P. TANK 1 1/4" PVC F.M.
SLOPE VARIES PROFILE
DESIGN PARAMETERS
PRIMARY/RESERVE SEPTIC SYSTEM ABBREVIATIONS LEGEND
NO. BEDROOM: 3 (450 gpd) CU COPPER W WATERLINE/
TANK SIZE: 1250g S.T.E.P. DIP DUCTILE IRON PIPE WELL RADIUS
PERC RATE = 1-5 MPI TH TEST HOLE
SOIL RATING: 0.8 GPD/SF FC FOUNDATION CLEAN OUT SS NEW SEPTIC
AREA ROD: 562.5 SF T# TANK CLEAN OUT N0.
SYS. TYPE: 15'W BED 0.5' E. D. C# CLEAN OUT NO.
MIN LENGTH:37.5 M# MONITOR TUBE N0,
USE: R. 1. RIGID INSULATION
40 LF X 15' WIDE, 0.5' E.D., DCO DOUBLE CLEAN OUT
+2' TD DV DIVERTER VALVE
TOTAL AREA: 600 SF FS FLOW SPLITTER
NOTES: PAMONE ENG SVC, LLC
FOR CONST ;' pF q�ll Date 5/5/11
P.O. BOX 100217 ANCHORAGE, AK 99510 '�� 'q
PHONE (907) 272-8218 FAX (907) 272-8211 %co s�y` Scale
*:
49 TH NTS
....,�.;` .,..� ..... P.I.D. NO
T12N, R2W, SEC 30, E2NE4SW4NE4SE4 ���?�, < �e_ / 021-022-20
GEORGE GEISTAUTS Stev'en'ff. 'Pc?nnone %PERMIT N0.
r+s CE 8149�� OSP111040
2440 E TUDOR RD. PMB 102 ti � _
DESIGN DETAILS ANCHORAGE, AK 99507 pssi =� Sh2e0F 3
FILTER FABRIC ABOVE DRAIN ROCK
5.0' 5.0/1 Z DRAIN ROCK 4" ABOVE PIPE INV.
4:1 SLOPES
1.0'
TEST HOLE 1
2 0
-2' OR
-4.0
SM 4.5'
15.0'
BOH
SECTION
DRAIN ROCK 0.5' BELOW
PIPE INV.
SAND FILTER MATERIAL
Of
Li
w
zo
z
wz
m o
1 1/4" DRAIN LINE
m Of
o
z
o
� 0
W/ 1/8"0 HOLES ON 30"
� o0
Q
o z
o
z
Q
o u
CENTERS
o=
�Q
Zw
Q
cn
�Q
0�
z w
0Q
w
o0Q
4.0
NEW 1250 40.OLFX15'WXO.5'ED BED
S.T.E.P. TANK 1 1/4" PVC F.M.
SLOPE VARIES PROFILE
DESIGN PARAMETERS
PRIMARY/RESERVE SEPTIC SYSTEM ABBREVIATIONS LEGEND
NO. BEDROOM: 3 (450 gpd) CU COPPER W WATERLINE/
TANK SIZE: 1250g S.T.E.P. DIP DUCTILE IRON PIPE WELL RADIUS
PERC RATE = 1-5 MPI TH TEST HOLE
SOIL RATING: 0.8 GPD/SF FC FOUNDATION CLEAN OUT SS NEW SEPTIC
AREA ROD: 562.5 SF T# TANK CLEAN OUT N0.
SYS. TYPE: 15'W BED 0.5' E. D. C# CLEAN OUT NO.
MIN LENGTH:37.5 M# MONITOR TUBE N0,
USE: R. 1. RIGID INSULATION
40 LF X 15' WIDE, 0.5' E.D., DCO DOUBLE CLEAN OUT
+2' TD DV DIVERTER VALVE
TOTAL AREA: 600 SF FS FLOW SPLITTER
NOTES: PAMONE ENG SVC, LLC
FOR CONST ;' pF q�ll Date 5/5/11
P.O. BOX 100217 ANCHORAGE, AK 99510 '�� 'q
PHONE (907) 272-8218 FAX (907) 272-8211 %co s�y` Scale
*:
49 TH NTS
....,�.;` .,..� ..... P.I.D. NO
T12N, R2W, SEC 30, E2NE4SW4NE4SE4 ���?�, < �e_ / 021-022-20
GEORGE GEISTAUTS Stev'en'ff. 'Pc?nnone %PERMIT N0.
r+s CE 8149�� OSP111040
2440 E TUDOR RD. PMB 102 ti � _
DESIGN DETAILS ANCHORAGE, AK 99507 pssi =� Sh2e0F 3
TEST HOLE 1 SOILS LOG - PERCOLATION TEST
SLOPE SIT PLAN
OR ORGANICS 3BR'HOUSE
2 (E) �/
—
3 SIM SILTY SAND vv---
4
5 BR FRACTURED
BEDROCK
6
BOH
7
8
9 x
TH
10 //
12 TH-1
13
WAS GROUND WATER SLOPE
14 ENCOUNTERED? N
15 IF YES, AT WHAT TH
16 DEPTH? --- x
17 DEPTH TO WATER AFTER
MONITORING?
18 DATE: 4/17/11
READING DATE CLOCK NET WATER
DATE PERFORMED: 3/30/11 TIME TIME LEVEL NET DROP
READING
1 3/30/11 6:30 --- 1.90 ---
2 6:40 10 MIN 6.12 4.22
3 6:40 --- 1.90 ---
4 6:50 10 MIN 6.01 4.11
5 6:50 --- 1.90 ---
6 7:00 10 MIN 5.95 4.05
PEROLATION RATE 2.5 (min/inch) PERC HOLE DIAMETER 6 inches
TEST RUN BETWEEN 3 FT AND 4 FT
COMMENTS: Test hole excavated by BEEK'S CONSTRUCION. Prec hole was presoaked.
Test run for one hour. Last 3 readings reported
PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
NOTES: PAMOM ENG SVC, LW 1!k� Date
FOR CONSTRUCTION P.O. BOX 102954 ANCHORAGE, AK 99510 5/5/11
PHONE (907) 272-8218 FAX (907) 272-8211 lose Scale
TH NTS
...... P.I.D. NO
T12N, R2W, SEC 30, E2NE4SW4NE4SE4 421-022-20
Steven R. Pannone GEORGE GEISTAUTS PERMIT NO.
-,eo * - CE 8149 P,-,W
2440 E TUDOR RD. PIVIB 102 OSP1 11040
�p AV
101 A-W
SOILS LOG ANCHORAGE, AK 99507 Sheet
PROSS101 Sheet
3
GRE, ANCHORAGE AREA BOR A
(�T �I Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME f -'d Sc V _--MAILING ADDRESS �) X --3- _) 3 3 IZ PHONE Ct 4'
LOCATION __- LEGAL DESCRIPTION 6 (PPIJ_0T--
SEPTIC TANK:
DISTANCE NUMBER OF
FROM WELL -011 MANUFACTURER reeV- MATERIAL- S'i-P e_( -- COMPARTMENTS
INSIDE LENGTH--- ' .—INSIDE WIDTH_ __— LIQUID DEPTH _ -LIQUID CAPACITAP-0- GALLONS.
-1� ✓° �' --^Fac � -- - -
TD:
t r ' TOTAL LENGTH r
DISTANCE FROM WELL J LI�_FOUNDATION Q0 --NEAREST LOT LINE-_{
.l_OF LINES _��
NUMBER OF LINES----- DISTANCE BETWEEN LINES .. TRENCH WIDTHH—. IN. TOTAL EFFECTIVE
C
ABSORPTION AREA -��� -- SQ. FT. LENGTH OF EACH LINE - ---. (7 ,-- ----- - — -
i DEPTH OF FILTER
i ' 3
DEPTH: TOP OF TILE TO FINISH GRADE _ MATERIAL BENEATH TILE _.1<<
- 0. ABOVE TILE . _� IN.
WELL:
TYPE--_PV'LJ CALL'—_. - —CONSTRUCTION- 0PPr0-
___DEPTH___ _DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC'�'�, SEEPAGE
FOUNDATION__, LOT LINE-_ SEWER LINE_. TANK_ /00 , SYSTEM- --
CESSPOOL _- _. , OTHER SOURCES -_- _ ---
APPROVED - -----
-- --DISAPPROVED-- .---REMARKS
DISTANCES: V I�----
INSTALLED BY: -
SEWER LINE DEPTH: -
PIPE MATERIAL:.
LOT SLOPE: _t7wN T✓e�2-�-F�S
REMARKS:. -_t _UA`Q-
Form EQ -032
DIAGRAM OF SYSTEM
DATE U/J�/%APPROVED
G. A. A. B.
NAME OF APPLICANT
GRE. ANCHORAGE AREA BOF
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
H
PERMIT NO. ---
ue, e0; mt ?\
%71
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
INSTALLATION LOCATION )V/
LEGAL DESCRIPTION - /�O
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
1 -
MAILING ADDR ESS�4�-�.'i' 2'� �' - PHONE / �"e 7
SEEPAGE E P I//T,
DRAIN FIELD
I v S -<,, '
7S�
OTHER
FINANCED THROUGH .] TO BE INSTALLED BY %
S—�
SOIL TEST RESULTS"`} NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION GATE ANTICIPATED
L✓h �- Sc'i5o I✓
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL_ QUALITY AUTHORITY WILL BE SUBJECT TO PROSECCUTIOJI.
SEPTIC TANK SIZE / TYPE �•1 C t - SEEPAGE AREA SIZE
MINIMUM DISTANCES. REQUIREME MTS
S,•
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT / .[ DRAIN
FIELD
SEPTIC TANK TO SEEPAGE PIT WALL_ -
SEPTIC TANK-'� SEEPAGE PIT fid.--. DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK� 4 �� ` SEEPAGE PIT
DRAIN FIELD -. ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK
DRAIN FIELD -
SEEPAGE PIT
SEPTIC TANK, (SEEPAGE PIT Q 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 13ACKFILL.
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
/L, /1. S '
G.A.A.B.
OR
LICENSED DESIGNER
TYPE
DIAGRAM OF SYSTEM
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO, 28-6B AND THAT THE ABOVE
DESCRIBED SYSTEM ISINACCORDANCE WITH SAID CODE. .�
DATE - - APPLICANT'S SIGNATUREAkZ1:�
FORM NO. EO -016
,;RLATER ANCIIORIIGI P,I(i..A 1AROUuu
Y�Y Department of Invironmental Quality
•��� �_` 3330 "C' Street
Anchorage, Alaska 991A3
`MILS I,OG PEROI,AI ION TlIS f
performed for �<�.� �_ '�� ;ate Pcrforr,,,J
- - -
Legal Description CL .ZU4'q
5_��ej /U��y 5<y2 a_:_�� (i; G'. �Cz�_
— - -- -
This form reports. Sd�ls l07 Percolation test
Depth
Peet
5-
6 -
7-
R -
9 -
10
i
12 -
13 -
14 -
Was ground water encountered?
S/O/ e
If yes, at what cle,,th? __ _-_.--_-
Readiny
Date
Gross Time
Net Time
Depth to Water Wet Drop
Percolation rate minute.
Proposed installation Seepage Pit Drain Field
Depth of Inlet Depth to hottom of pit or treici
COHMEWTS 1��L, iz�Y�cci-1 jf :cl �__ � ��, - a < ll ��C - --
— -- - - date
perf.ormed 13y:�«���_J 5���«-� Certified By
HO 040 (s/74)
A
GH
7J 1\,J
ality
03
03 274-4561
eceived �f�)-af ��___
of Inspection - [ot
f Inspectionn /,Q-Aq--%�i
TIES /Ybi
t Ujor bi 1=iu ir�c e
�i o t no 44Lw wed hcuoC
4nusClud-Ub-j
1. Approval requested by:
Mailing Address: 0"'A �,nn Phone:
2. Property Owner: Mm � t a F )An `'Q0 th doh r+�, Phone:
Mailing Address: LalyL I Mi AQ g L�x S3,�
3. Legal Description: nP, ')Li �I I)'ILI Q?Jkj LLa-
0,
La-
0aLL-) L, M.
4. Location: "
r
5. Type of facility to be inspected �a No. of bedrooms
6. Well Data:
A. Type --�f _ B. Depth _ )LL. I _
C. Construction a A wQ D. Bacterial Analysis _
7. Sewage Disposal System: Cu -r3 -k --3a X,O,(LL�av �e
A. Instal led ,�f_1�_1�, B. Installer _
C. Septic Tank: 1. Size 2. Manufacturer
D. Seepage Pit: 1. Absorption Area 2. Material
�
E. Disposal Field: Total length of lines
8. Distances:
A. Well to: Septic tank Absorption area Sewer Lines
Nearest lot line Other contamination
B. Foundation to septic tank , Absorption area
C. Absorption area to nearest lot line
EQ -034 (1/74) Page 1 of two pages
GREA E'R ANCHORAGE ARL 1, BOROUGH
Department of Environmental Quality
3330 "C" St., Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
1.
Type of Inspection: CjMRO
VA
F11A CONY xx
2.
Property Owner:
Edmond and
Elizabeth
£. ICS
-7`74_ _
Nailing Address:
�SRA box 393R
Day Phone 1-44-0967
3.
Name of Buyer:
George A_&
Ilike Gerstauts_
hailing Address:
5350 Lake
Otis Parkway ID
Duy Phone _272-5522
4.
Name of Lending Institution:
National Bank. of
Alaska -Mort a e Loan De t
Nailing Address:
P.O. Box
3-3859
Phone 279-2596
5.
Name of Realtor or
Agent::
none
Mailing Address:
Phone
E 1/2 , NE 1/4, SW1/4, NEI/4,SE 1/4, Sec 30
6. Legal Description: _ T1 2N, R2W, Seward Meridian
Location: Glen Alps S/D L.r>r .4o
7. Type of Facility to be inspected: SFR No. Bdrms.
8. Water Supply
Type of Supply: Public Utility Individual xx
If Individual, number of dwellings presently served 1
Is Individual, depth of we11
9. Sewage Disposal Sy step
Type of
System:
Public Utility ,_-
Individual
(on-site) xx
If Individual,
date of installation_
£. ICS
-7`74_ _
Thank You,
1
H. Mason
Mortgage Loan Dept
Page 2 of two pages - Rec st for Approval of Individual F :r & Water Facilities
Legal Description
ILL)`Id
n1 -'k�
IZ J-1 LC
_f an L a � _rn .
G Lo
C-\ n5
Ldp :-QU
Comments
Approved
Disapproved
Date 10—;11�1re17s
AppWal Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
EQ -034 (1/74)
Date
EPCPINS
MUNICIPALITY OF ANCHORAGE
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. ( 1 -072--Z d Expiration Date: 9- z ?-r
cti
1. GENERAL INFORMATION
Complete legal description T12N R2W SEC30 E2NE4SW4NE4SE4
Location (site address) 13434 AlpWeg
Current property owner(s) George GeistautS Day phone
Mailing address 2440 E Tudor Rd Pmb 102 Anchorage, AK
Real estate agent Day phone
2. TYPE OF DWELLING:
0 Single Family(w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Private Well Private Septic
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 $ 55O Waiver Fee $
Date of Payment 113)1 q Date of Payment
Receipt Number 4(04 1067 Receipt Number
COSA# 35C/9t '232. 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.
In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA
COSA guidelines and regulations. The reported results describe 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 soil condition,ground water 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 this system.All systems eventually fail and satisfactory test results
do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments.Therefore
we cannot provide any warranty for future performance,nor can we estimate remaining life of the system.The content of this report is for the
sole benefit of the owner listed above.
Name of Firm Pannone Engineering Services Phone (907) 745-8200
Address P.O. Box 1807 Palmer, AK 99645
Engineer's Printed Name Steven R. Pannone P.E. Date /Q4CP bi r7-- -
6. DSD SIGNATURE *149311 il :*•••
System #1 Approved for 3 bedrooms •• •t\•1.
Y pP ••$seven annope
System #2 Approved for bedrooms : C4E ...
8149
Disapproved
Conditional approval for bedrooms, with the following stipulations:
kow(i(((ffl((
J. ON-SITE t�
�� WATER AND
z
t2 WASTEWATER
PROGRAM -
SJi O,
F ,EC
iSR� ON
)))) ) )11‘
7--Z)21?
By: tom-- (-=F�� Original Certificate Date: (7'
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 Check!st blue sheet
COSA Checklist
Legal Description: T12N R2W SEC30 E2NE4SW4NE4SE4 Parcel ID: 021-222-00
If more than 1 septic system on lot: COSA Checklist# of Structure served by this system 1
A. WELL DATA
❑Well log is filed with Onsite (or attached) Well production at time of test 3.0 gpm
Date drilled uk Water storage tank volume n/a gallons
Total depth uk ft Well disinfected for coliform test? ❑Yes 0 No
Cased to uk ft II Coliform bacteria is Negative
0 Sanitary seal is functioning correctly Nitrate 0895 mg/L ❑ Nitrate less than MRL(ND)
0 Wires are properly protected Arsenic ug/L Q Arsenic less than MRL(ND)
Casing height(above ground) 20 in. Collected by Pannone Engineering Services
Date of flow test for COSA 6/4/19 Date of Sample 6/4/2019
Static water level at beginning of test 36.5 ft.
Comments No well log
B. TANK DATA C. LIFT STATION
Age of tank(s) 8 years 0 Required maintenance completed
Tank type/material 5"" Age of lift station 8 years
Measured operating fluid level in septic tank 48" Lift station material Steel
Standpipes/foundation cleanout per record drawing Comments:
Date of pumping 06/05/2019
D. ABSORPTION FIELD DATA Bed/ Mound
Which system tested(date installed) 726/2011 Adequacy test date • 6/4/2019
0 ALL standpipes present per record drawing Results ['Pass For 3 bedrooms
Total measured depth from grade 3.1 ft(max) Fluid depth prior to test 0 in
Measured depth to pipe invert from grade ft(min) Water added 450 gal
0 N/A—pressurized field New depth 0 in
ID Monitor tubes go to bottom of effective. If not, state Elapsed time 150 min
depth into effective
© Code-required soil cover over field Final fluid depth 0 in
Absorption rate >450 gpd
0 System presoaked
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) n/a
date of test)
Gallons introduced 2000 gallons If yes, enter date
Comments/Deficiencies:
COSA Checklist yellow sheet
i
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' Community Sewer Manhole/Cleanout> 100'
0 Yes if No ft 0 Yes if No ft
Neighboring Tank> 100' 0 Yes if No ft Private Sewer/Septic Line >25' 0 Yes if No ft
Absorption Field on Lot> 100' 0 Yes if No ft Holding Tank> 100' 0 Yes if No ft
Neighboring Absorption Fields> 100' Animal Containment>50' 0 Yes if No ft
0 Yes if No ft
Manure/Animal Excreta Storage> 100'
Community Sewer Main > 75' 0 Yes if No ft 0 Yes if No ft
From Septic/Holding Tank on Lot to:(Please enter distances if less than required)
Building Foundations> 10' 0 Yes if No ft Surface Water> 100' 0 Yes if No ft
Property Line>5' 0 Yes if No ft Wells on Adjacent Lots:
Absorption Field > 5' 0 Yes if No ft Private Wells > 100' 0 Yes if No ft
Water Main > 10' 0 Yes if No ft Community Wells>200' 0 Yes if No ft
Water Service Line> 10' 0 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' 0 Yes if No ft If absorption field is under driveway comment below
Property Line> 10' 0 Yes if No ft Wells on Adjacent Lots:
Water Main> 10' 0 Yes if No ft Private Wells> 100' 0 Yes if No ft
Water Service Line> 10' 0 Yes if No ft Community Wells>200' 0 Yes if No ft
Surface Water> 100' ✓❑ Yes if No ft
F. ENGINEER'S COMMENTS
•
G. ENGINEER'S CERTIFICATION -• 4F A� ;
' i
I certify that l have determined through field inspections and review �c0.* .9 �jf
of Municipal records that the above systems are in conformance with �'' 4 .l . f
MOA COSA guidelines in effect on this date.
40 ._.
-w
COSA Checklist yellow sheet
•I S89'51'09"F. _
f
•
5/8" Rebar-� �� Wet 763.31' S/8' Rebar--/�} • ( '
j ••
> i 1
• o
I
• I i
ood Deck
Cone. i
Pod-\. 24.3' �
--. Bi-Leve: Wood Frame
14.8 -e- .i ,rte Residence on Concrete
16.1'
• Foundation `'Jt '
oc 23
�l`trt,
n b' 23.5. E{ Cont;lever + J�
16.8'°'•
16.3'-
11\-Lifl. Station Monhcle
\
,\
• 1 i
rntW
N.
.
�'
n o ;n
5 a �
m a
o z
Dn om I ,
z z O,
000,
`Riser Pipes ForF/Pa le, 111I
l
Mound
Systems Co6jes . i
i
1
I LOT 2
1
i
1
I
t
i
i
;
v
j I
I RI
----- -'- 164.45'
-___.--- _.._.__ _ ......f 30'
N89'52'43"W
I
LOT 1 UNSUBDIVIDED •
SCAL•
E 1" = 30'
. r-11111111111111111111-/-15.11.11211
N. C' 75' 30' 60' , •
1. Dimensions ore measured to the wood trim.
2. Bearings and distances token from a field survey of the NE1/4, SE1/4, Sec. 30. I PRE~'ARM FOR:
T'2N. R2W, Seward Meridian Alaska preformed by Wore L. Brickey Jr. doted Jury 19, i
1965 Registration Vumber 542-S. on file with the Municipality of Anchorage as
Fie No. 1998-93. GEORGE GEISTAUTS
—.JI hereby certify that an accurate survey of the following described t
•..i property: - n t
:,P�r''GF'A(9S�fxl F1/2
1/2•SEWARD MERIDIAN,4. W1/ ALASKA E 1/4, SEC. 30, T t 2N r' i — -. J I I- f
,r 6";
; June 7, 2019 DM. TE I 4 N.
9. was made on and that the improvements OWt`I. DATE ,GRID I 44-4
:49LI " • situated thereon ore within the property lines and do not overtop orn
P P Y p DM.
6/20/2019 12943 x
! 7�Swk� •encroach on the property lying adjacent thereto, that no
• .tc. Lee xerabt'ww rt ':improvements on the property lying adjacent thereto encrooeh on FILE NO. F.B. 2019 I JOB NO. -
,A„ti, s's-s the premises in question and that there ore no roadways, 11905 PG. 3 1907
`t`D - transmission lines or other visible easements on sold property except �,
+,a ••'.... as indicated hereon. rosements other than those shown on the t _
'i.. ,,: record plat may not appear on this drawing. , /'(/-t/�A l�EL l�1 i+l� L/FF `^
/2=izof� SUP YIN G W
Anchorage Alaska, this_ 10th day of .lune 2019. VE fao�)asr-sas•r y
1
•
MUNICIPALITY OF ANCHORAGE
Develop:Tient Services Department. ti •• Phone:907-34::.; 7904
On-Site Watei &Wastewater Section
Fax:907 '.: ci
Station/Pump Vat
Maintenance Log
owner_-.' '� ?f.-/�•,'�.cck sty lc: Address_
Septic'tank:
•S:udgc leve! �2 inches •Pumprnh'required yes``0; -pumping completed (jilts r
itf'tstatieD:
•:'•.-,:p basket ciearw:d (a. 'LC? -Effluent filter cleaned �..t4:..i!Q
•C nntroi floats cleaned xa rtQ -Proper tloat setting confirmed •x aC
•Operalion satisfactory s:no.
Alarm Svs rn'
•Dedicattaa electrical alarm circuit �..no -Audible and v1sual alarm inside dwelling (; =. ,_r1.
-Alarm:system operation :far_ fact.Ory' not s�TtS =9►at
Manhole Riser
•Ground water intrusion at riser to tank connection y_es...Cg.
•Crou,1i water intrusion urrtznepenetr?t)orm -tigeoe holyfundona1 _ f:!
•ManhO!a lid: Functional �s- oInsulated J .•. Properly Secured �e .
Other 1
.All manuf.r turer required inspections aro maintenanr.n completed t: s n3
omments•
MintcnanCe PrQyider:
Dnte-.,f -ainten„nca ' ='; !•
Company r ! _
- f.> ; .•... -.
Sip ature = !:atr_L; ... \ct,
ff
I