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HomeMy WebLinkAboutRICHARD LT 2015- 521 Municipality of Anchorage On -Site Water and Wastewater Program - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181085 Dwelling: W Single Family (SF) F71 Duplex (D) E] Multiple (SF and/or D) Project: El New X Upgrade Name: Hillside Baptist Church ABSORPTION FIELD FE -1 Deep Trench F-71 Shallow Trench 0 Bed ❑ Mound Address 5200 O'Malley Rd Anchorage, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating depth from original grade � 4 JTotal 0.8 GPD/SF 9.1 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2.1 Ft. Gravel depth beneath pipe 7.0 Ft. Subdivision Block Lot Richard 2 Fill added above original grade 1.9 Ft. Gravel length 54 Ft. Township Range Section width Beds: Number of Lines Distance between lines —,Gravel SEPARATION DISTANCES 3 Ft. Ft. Toy Septic 11 Absorption I Holding Sewer Lift Station I Total absorption area Number of trenches Dist. between trenches From Tank Field i i Tank I Line 2 756 Ft 1 Ft. ' Well >100' l >100' N/A 1 25' N/A > TANK 91 Septic [I ST.E.P. ❑ Holding 1771 Other Manufacturer Anchorage Tank Capacity 1250 Gal. Surface Water > 100'' >1 00' N/A N/A Material Steel Number of compartments 2 Lot Line i >10' >10' N/A N/A NA Foundation >10' >10' N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain None Noted Gal. Remarks Pump on level at in. Pump off level at in. High water alarm at in. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 Installer Denali Excavating Drainfield D3034 CO/MT D30-4 Inspector J. Millette BENCH MARK (Assumed elevation) 100 ft Inspectes:tion 1" 5/31/18 nd 6/01/18 Location and description da2 3'd 6/04/18 4" 6/05/18 1 Bottom of siding on north wall. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp OF Conditional Approval: Date T't4 Approved Date 41 CE112599 10/9/18 _J Inspection Report-9-1-12.doc RICHARD LOT 2 PERMIT # OSP181085 PID # 015-521-06 XTEFFECTII DE / O'MALLEY ROAD X 7' EFFECTIVE DEPTH ABSORPTION TRENCH ------ �C 1 -- TH2— — — — — — — — — — j/ 1,250 GALLON 1 FD CO 1 SEPTIC TANK O :r SV2 I e i SV1 N FOUR \ /BEDROOM / HOME PRIVATE \ \ WELL LOT 2 / \SHEDS \ CHURCH / WATER SERVICE LINE \ (LOCATION NOT EXACT) 2p0 ?\kol G�\�E RP I LOT �/� A B C CLASS A WELL • • • Benja Schiller . •' CE 12592 ,��jsTFP•' P22.2818••'F��'�.r �ilF�PROFES510NP � FCO 6.8 10.7 SV1 19.1 23.4 SV2 49.5 30.1 2C0 50.2 31.0 FD 56.3 40.8 MT 62.9 46.9 C01 34.2 37.1 CO2 67.0 50.8 — — — — — — — — — — / LOT 2 LOT 1 LOT 28 0 50 100 FEET 111=50' LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANC FD - FLOW DIVERTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE RICHARD LOT 2 PERMIT # OSP1 81085 PID # 015-521-06 V cl. 1.) 5.6 0 99.5 FINISH GRADE X/- 97.6 ORIGINAL GRADE n 95.5 11 '1-- 95.5 GRAINFIELD ROCK 88.5 54' 83.6 r NO GROUNDWATER 10/9/17 October 9, 2018 PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) FO RG EC IV 1 L.COM MOA Development Services, On -Site Water & Wastewater Program 4700 Elmore Rd Anchorage. AK 99507 Subject: Richard Subdivision, Lot 2 Septic system record drawings Dear On -Site Services Engineer: OF A;! 491 CE 1125992 10,19/18 The test holes dug for the septic design on this lot were dug to 14'. The design was for a total depth of 9, with the requirement that the test hole be deepened to show 6' separation to bedrock. In researching the two immediately adjacent properties, we found 7 test holes done over the years which show depths between 15-20', with no bedrock or groundwater: Huisingh Lot 1, 10/24/80 TH: 19" Huisingh Lot 1, 7/' ) 0/95 TH3: 18' Huisingh Lot I, 8/3/95 TH 1: 15' Huisingh Lot 1, 8/3/95 TH2: 18' Huisingh Lot 1, 10/5/95 TH: 211 Huisingh Lot 2, 7/26/86 TH: 17" Huisingh Lot 2, 9/29/97 TH: 16* We feel these demonstrate that the bedrock is not shallow on this property. We request that this data be accepted in lieu of digging another test hole deeper on this property. Sincerely, Benjamin Schiller, PE I TRI -1 �, R��,,E�l I- �ID- VF'/Vc� cn M x y f7 co Cf) ).J� x 0 0 W 0, 12.o ryl H I 6/4I I8 t3oM ,,,"°""lr MUNICIPALITY OF ANCHORAGE O �,Daocnr On-Site Water&Wastewater Program -,` ., --,�:-vS i -bge PO Box 196650 4700 Elmore Road _ "`�. Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax: (907)343-7997 r. 1 A i http://www.muni.org/onsiteir U•r 3. "NI),.,„„ t„„„• 9'YSN0RaOc. On-Site Wastewater Disposal System Permit Permit Number: OSP181085 Effective Date: 5/18/2018 Work Type: Septic Upgrade Expiration Date: 5/18/2019 Tax Code Number: 01552106000 Site Legal Address: RICHARD LT 2 G:2637 Site Mailing Address: 5250 O'MALLEY RD,Anchorage Owner: HILLSIDE BAPTIST CHURCH Lot Size in Sq Ft: 108735 Design Engineer: FORGE ENGINEERING Total Bedrooms: 4 This permit is for the construction of: 0 Disposal Field Q Septic Tank ❑ Holding Tank 0 Privy 0 Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907)343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: The Engineer needs to do an additional test hole prior to the construction of the septic field. Construction may proceed at your own risk before the 7 day water monitoring is complete. Please submit stamped and signed results with the As-built Inspection Report. If the results require a design change, construction of the system will stop pending On-Site review and approval. Received By: ( 4 ppat4 71'7,/14/ Date: ` Issued By: .(NP7/ZtAvi-- Date: 6 /% MUNICIPALITY OF ANCHORAG 5 6789t, �� _ N Community Development Department r" Phon.a '07-343- 904,E Development Services Division Fa 107-343-7997 a On-Site Water& Wastewater Program 6gG9 7c ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-521-06 Property owner(s) Hillside Baptist Church Day phone 350-0120 Mailing address 5200 O'Malley Road Anchorage, AK 99516 Site address 5250 O'Malley Road Anchorage, AK 99516 Legal description (Sub'd., Block & Lot) Richard, Lot 2 Legal description (Township, Range & Section) Lot Size 108,735 Sq. Ft. Number of Bedrooms Four (4) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X Septic Tank ❑X U p9rade (w/wo ADU) ❑X Holding Tank ElRenewal Duplex (D) ❑ ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. )11 tar (Sig ature of •erty owner or authorized agent) Permit/Rush Fees: 6-1p9 Waiver Fees: Date of Payment: Si/till Date of Payment: Receipt Number: Crt3 Receipt Number: Permit No. OjPii1086 Waiver No. Permit App_:• c fir GE • ENGINERRING PO BOX 240773 ANCHORAGE,AK 99524 522-7773 677-7766(FAX) May 10, 2018 Municipality of Anchorage Development Services Dept-On-Site Water& Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Richard Subdivision, Lot 2 Septic system design and permit application Dear On-Site Services Engineer: The septic system on the subject lot has failed and must be replaced. We are submitting this permit application for the construction of a new septic system to serve the four bedroom home on the lot. The attached site plan identifies the location of the home as well as the water service line from the adjacent Class A Well and the existing and proposed septic locations. No conflicts exist between this proposed and existing system and any wells on adjacent lots. Drainage arrows are shown on the site plan showing the direction of flow.The drainage pattern in general will not be changed by the construction. The test holes placed on the lot indicate silty sand. No groundwater or bedrock was found down to 14'. The percolation rate was determined to be between 3 and 8 min/in. An application rate of .8 gpd/sf was used in the design of the absorption system which is conservative considering the disparity in the percolation rates found. We are proposing to place a new 1250-gallon septic tank with a absorption trench 3' wide x 54' long x 7' effective depth. The elevation of the distribution line will be 2' below the surface for a total depth of 9'. Soil will be mounded 1.5' above the trench. A minimum of 3' of fill will be placed over the absorption trench and 4' over the septic tank, or insulation with 2' of fill. The test holes were excavated to a depth of 14' which is only 5' below the bottom of the proposed trench. We are confident no bedrock or impermeable layers are within 6' of the bottom of the prosed trench. We request a condition be added to the permit requiring the test hole be deepened to a minimum of 15'to verify the absence of bedrock or impermeable layers. A new test hole log will be submitted to document the results. The ground surface on the lot slopes moderately to the north, but there aren't slopes steeper than 25% on the lot. In general, the ground slopes at a 5% slope, with some flatter areas. The new trenches will be constructed parallel to the slope as much as possible. They will be a minimum of 200' from the Class A well, 100' from all private wells and surface water, and more than 5' away from the septic tank. The existing absorption trench will remain for possible future use and is located more than 14' away. There are no well or septic systems that impact the locations shown. The lots to the east do not have records available, but they are greater than 100' from the well and septic areas. If the system is constructed as designed, it will have no adverse impact: • On the wells in the area or those to be constructed in the future. • On existing septic systems in the area or those to be constructed in the future. • On reserve space, either surface or subsurface, on any lots located in the area. • On drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Benjamin Schiller, PE ,,- *• 49Th 1 ' *til �•el- Be Schiller :� tl++;.., . •&125c$••(. 4 A",.0*•&(0 ,.. k • Rw'PRoFEsstows''� '\\\\���~ RICHARD L2. - 5250 O'MALLEY RD 547 EFTI DE O'MALLEY ROAD XT X EFFECTIVE DEPTH / ABSORPTION TRENCH 5% 15°k / _ t_ TH2 MT e ► - — — -eco co — A 4 gyp) �rencln XH1 „• reA y v 5%1,250 GALLON 5% • EXISTING AB?ORPTION ) 5 0.l eu� v WG S� 11 SEPTIC TANK FD• TRENCH TO EEMAIN IN PLACE co� • lite� MGA . �% • �0; �SV •�CONNECT TO EXISTING . DECK S • ABSORPTION TRENCH FOR ...'. .. .' • .. ,t/4 110. I POSSIBLE FU"URE USE. DECOMMISSION EXISTIf�SEPTIC TANK IN NW FOUR 'ACCORDANCE WITH MU IICIPAL CODE / :EDROOMEM HOPRIVATE \ \/ WELL i J I 4 / SHED i / \CHURCH ' i WATER SERVICE LINE , i (LOCATION NOT EXACT) l \ CIOS LOT V20LOT 1 LOT 2 CLASS A WELL i i LOT 2 T . , ; /j NOTE: LOT 1 i LOT 28 ,���\\\‘ NO SLOPES>25%WITHIN 50'OR SURFACE WATER WITHIN 100'OF THE `�OF AC,q�l PROPOSED SEPTIC SYSTEM LEGEND �Ax.•• CO-CLEANOUT 04:•49 H %\ *r9 ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS 2CO DOUBLE CLEANOUT • "• "• " r'' ��-� PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC FCO-FOUNDATION CLEANOUT O 7�� �"�' j ' SYSTEMS. FS FLOW SPLITTER VALVE '. Michael E.Anderson : / MH-MANHOLE rr to- _SE4381 •'��/� 0 50 100 r0 s4.? -/7-/.8-*,- NM MI FEET11.11 SLOPES>25% MT MONITORING TUBE �l\�/'ROFESs10N-� 1"=50' =SLOPES>46% SV-SEPTIC VENT ����..- TH TEST HOLE LOT 2, RICHARD SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW DEEP TRENCH SYSTEM PERK RATE: 6-15 MIN/IN 1,250 - GAL SEPTIC TANK APPLICATION RATE: .8 GPD/SF 600 GPD / .8 GPD/SF/ 7' DEEP/2 SIDES = 53.57 LF TRENCH REQUIRED (54 LF SPECIFIED) BOTTOM OF TRENCH: 9' BELOW GRADE FLOW LINE ELEVATION: 2' BELOW GRADE TOP OF TRENCH: 1.5' ABOVE GRADE f I=1 11=1 11=1 11=_ I 1=1T1=111 1Tf==1 11=71- 1'-6" 1 =11-1—=1 i 1=1 11=111=111-1 TI-I 11=1 I I-I 11=1T IT= =1 I�f- j 1=IiIII-rf=IT1-III7-1 III-T I-TI-111-11-IT-111-111 -111- 1T=1 I(=-I T1 Ras 111-11 1T�111- I 1'6" I =1 I(-1 =1 11=T=1 1 111=I I I-TT=-1 I I=11( I I j I I-1 I- I 111. I I-I I I 6" 4" PERFORATED PVC (HOLES DOWN) 9::•:.:99 ;9999•:::::...:.:.,: DRAINFIELD ROCK 7' ZY :::.:.;::...:•...:.:..:9;9 999: 3' - TYPICAL DEEP TRENCH SECTION (NO SCALE) NOTES: ._..: ..^' .......... 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' . Ben' min Schiller WITH 2" OF INSULATION 'fo •, CE42 •2 •�Qr 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER /0k €9F'• '•'0`°6'•`� � THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY `���' MUNICIPALITY OF ANCHORAGE .4.5.----.0F �� NII\V DEVELOPMENT SERVICES DEPARTMENT . AG,q� 1, 4700 ELMORE ROAD ANCHORAGE, AK 99519-6650 j c;y�P'��• Jç- V*4• 9l SOILS LOG AND PERCOLATION TEST %4C.T 5 r • Benjami chiller : / LEGAL DESCRIPTION: RICHARD SUB LOT 2 ���F4%. cE/2y5s ��i PERFORMED FOR: FORGE ENGINEERING ilk PROFES\O — DATE: 10/9/17 PROJECT No.: �������`~ PARCEL ID#: 015-521-06 TECHNICIAN: J. MILLETTE Professional Engineers Stamp: DEPTH TEST HOLE 2 (feet) 1 . `... .I .I SLOPE SITE PLAN 2 . 3 , :_`.. 4 SANDY SILT 5 SNI SEE SITE PLAN 6 A 7 .; 8 9 ` 10 WAS GROUND WATER ENCOUNTERED? NO SANDY WI IF YES @ WHAT DEPTH? - 11 SOME GRAVEL DEPTH OF WATER AFTER MONITORING: NO DATE OF MONITORING: 10/27 12 13 DATE READING DEPTH To ,;, GROSS TIME NET TIME WATER NET DROP (MINUTES) (MINUTES) (INCHES) (INCHES) 14 10/26 TEST HOLE PRESOAKED PRIOR TO TESTING: 15 10/27 I 6:20 0 16 2 6:30 10 3-14/16 3-14/16 17 ... INTERMEDIATE TESTS NOT SHOWN 9 7:04 0 18 10 7:14 10 3-5/16 3-5/16 19 II 7:15 0 20 12 7:25 10 3-5/16 3-5/16 PERCOLATION RATE: 3.0 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 3 FT. and 4 FT. COMMENTS: MUNICIPALITY OF ANCHORAGE __`��\'‘‘\ DEVELOPMENT SERVICES DEPARTMENT ~.(�9t `1l 8 4700 ELMORE ROAD ANCHORAGE, AK 99519-6650 *� •TM .; •9*+A/ d. SOILS LOG AND PERCOLATION TEST •• .Benja in Schiller LEGAL DESCRIPTION: RICHARD SUB LOT 2 001os•.•, CE 2592 .•<.%/� FORGE ENGINEERING i`\ PROFESS\0 Fvr PERFORMED FOR: lU, ROFESSO .: DATE: 10/9/17 PROJECT No.: ������~' PARCEL ID#: 015-521-06 TECHNICIAN: J. MILLETTE Professional Engineers Stamp: DEPTH TEST HOLE 1 (feet) I SLOPE SITE PLAN 2 3 4 5 — :•:•:..... SEE SITE PLAN NS'it,•."6 ..' • SANDY SILT W/GS M 7RAVEL 8 9 1 O WAS GROUND WATER ENCOUNTERED? NO IF YES C WHAT DEPTH? - 1 ] DEPTH OF WATER AFTER MONITORING: NO DATE OF MONITORING: 10/27 12 13 DATE READING GROSS TIME NET TIME DEPTH To WATER NET DROP r '�' (MINUTES) (MINUTES) (INCHES) (INCHES) 14 10/26 TEST HOLE PRESOAKED PRIOR TO TESTING: 15 10/27 1 6:18 0 16 2 6:48 30 3-10/16 3-10/16 17 3 6:49 0 4 7:19 30 3-6/16 3-6/16 18 5 7:20 0 19 - 6 7:50 30 3-6/16 3-6/16 20 - PERCOLATION RATE: 8.9 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 3 FT. and 4 FT. COMMENTS: O'MALLEY ROAD — — — — — — , N i s\ r .J.: 'cr . N 90'00'00"E 164.75' SEPTIC PIPE Q. : ; I TEST HOLES SEPTIC PIPES • Q HOUSE DETAIL • t SCALE: 1"=30' • • 16.0'x8.0' b 19.3.• N 104.9' DECK N Z �R 8 0, DECK o cd tris 8.0' 102 �00 II STAIRWELL N o /a 8.1 \ 100. z (n r.9. �� i N m C) , 0 \ 0 qj c ' 0 12. 2'x16.2' SHED o N C) 1 o w/ 6'x8' RAMP o X4.2• Lot 1 0 m 1.9'x6.4' u ' u, CANT 0 S co o o�SC�NE RP \O o0 20° P I Lot 1 i WELL Lot 2 I 2.296 Acres l / / <> / > Lot 2 / N 90'00.00"W 164!75' / / / Lot 1 7 Lot 28 / PLOT PLAN AS BUILT _X SCALE 1" = 50' GRID SW 2637 Project No. 18-149/A1 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates , nc . (907) 522-6476 Phone �opppp4 (907) 522-4625 Fax o 0 F A L X44 Professional Land Surveyors kenOlangsurvey.com o jonathanOlangsurvey.com ��P ' .16k1 I hereby certify that I have surveyed the ofollowing O described property: Q(. 49TH -\ ..-�, 0 LOT 2, RICHARD SUBDIVISION (PLAT N ) Q D Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that a o no improvements on the property lying adjacent thereto encroach on the surveyed h 3 KENNETH premises and that there are no roadways, transmission lines or other visible �r easements on said property except as indicated hereon. a ui�, o Z I -- 00 4� -PF ,s-5 02.- 5�0 Dated this the 2(.4,- Day of , , at Anchorage, Alaska Q AR - Nc)c 4QOZSSI0NAL N� It is the responsibility of the owner to determine the existence of any easements, '�4000�� covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 Municipality of Anchorage Page / of _.:.~ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Repor~t~. Permit Number: ,~//dc(~ f__..)~';~c(~- ~. ~ ~ q~o 5~)~ PID Number: ~/~" ~ / Name: ~ ~/~O ~]~4~-- WastewaterSystem:o New ~ Upgrade ~¢ ~/~ ABSORPTION FIELD Address: ~)~ ~O~TO~_~/No. of Bedroo¢~ / ~; %hone: s~ ~Deep~rEEch~ ~ ~hallow Trench Q Bed B Mound Q Other Total Depth from original grade: LEGAL DESCRIPTION so, .atinge~ GP~ Depth ~o pipe boSorn Irom original grade: Lot: ~ Block: Subdiv~ion: ~ / Gravel depth beneath pipe WELL: B New ~ Upgrade Gravel width: ~' ~- fFt. Number ollines:/ Oistance beln~e~e~/~/~eenlines:Ft. ;lasslfication (Private, A,B,C): ~tal Deptb: Cased To: Total absorption area: Pipe material: Date installed: ~ Ft. ~ GPMI Ft.I ~t. TANK/)*¢*~ ¢¢ SEPARATION DISTANCES ~Septio U Holding U S.T.E.P. TO Septic Absorption Lift Ho,ding ~,Private Ma.ufaoturer:~_~d Capacity in gallons: From Tank Field Station Teak Sower Lines ¢ Number of Compartments: Well .... ~// ~ ....... Material: ~.~ s~ /00 :~-/OO~ A/lA ;~/~ /OO~- LIFT STATION/ Lot / Size in gallons: Manufacturer: Remarks: ~ ~ ~r~4,.~ ~ r~ x BENCH MARK I Assumed Elevation: I~spections performed by: ~ 7G ~&/~C~&Datos: 1st /~/~ 2nd,7~'~/77 ~ ~ ................... ~E-880~ Department of Head, and Humen Services approval ~~;~ ~ Date:/. ~.-- "'~" ' ' ........ Reviewed a,,d~ approved by: . "' '.-:' 72-013 (Rev, 9/91) MOA 25 PERMIT No.S~W990394 ~. ¢w~¢~ ~rt$' PAGE 2 OF 2 ivlunici~ckLi~ of Anchor'aqe DEPARTMENT OF HEAETHAND BU~AN SERVICES ENVORONNENTAL SERVICES P.B. Sox 196650 eAnchonage, ~asko 99519-665peTe[ephone:. 343-4744 ON=SITE WASTEWATER DOSPOSAL ~YSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 2, RICHARD SUBDIVISION P.I.D. NO. 015-521-06 1140 WATER STORAGE ?ANK ADDED IN BASEMENT '----...Of MALLEY MI1 A B FCO .... 6.3' ST1 -¢2.6' 47.6' ST2 48' 55' DBL.~ 49.5' 56.5' DI3L2 50' 57' C01 ....... MT1 ...... C02 ....... MT2 NEW 1250 GALLON SEPTIC TANK DBL2 FINAL GRADE / EXISTING LEACH FIEI.,D [,El T IN USE 100' WELL RADIUS LOT 1 ST1 ST2/ 99,6' ,, ~.~, .0..' ,..,~ ~_,, SEPTIC TANKI 5 , ~ ~ 94.8 e PRO FAX To: Michael Clare Compq.ny: S&S En_g~.~eerin9 Phone: 907-694-2979 Fax Phone: 907-694-1211 Reference: Lot2, Hillside Baptist C.C. Pastor Matthew REMARKS: [] Urgent [] Foryour review MESSAGE: Mike, 6400 Woodmont Drive Anchorage, AK 99516-1890 Date: 1tl23/99 Number of pages including cover sheet: 1 From: Wesley E. Saunders Electron Chaser Phone: 907-346-8240 Fax: 907-346-8230 File Name: Fax S&S Mike 3hr use lot2 E- Mail: tecPRO~tec.cc [] ReplyASAP [-1 Please comment Per your request please note the following as Hillside Baptist Church's understood use for Lot 2 Richards sub. property. It is understood that this residence located at 5250 O*Malley road, recently purchased by Hillside Baptist Church, will not be used as a residence with more than (3) bedrooms. This understanding is to be in compliance with the provided water storage system and it's size. It has always been HBC's Intent to aquire this property for it's land and to use this lend in conjunction with a future building project. HBC does not have any long term plans et this time that include use of this residence other than mentioned above, Sincerely, VVesley E. Saundere Masterplanning Committee Chair An Alaslmn Woman Owned Enterprise MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Oct 20, 1999 I--xpiration Date: Oct 19, 2000 Permit Number: SW990395 Legal Description: RICHARD LT 2 Design Engineer: 0003 S & S Engineering Owner Name: Richard Miller Owner Address: % City Mortgage Anchorage, AK 99503- Parcel ID: 015-521-06 Site Address: Lot Size: 108735 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: /~ Disposal Field [] Septic Tank [] Holding Tank I~ 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 ( t 8AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior 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 (lay. B. Covered, sealed, and heated to prevent freezing. Date:/¢ - 2'¢- ??_ MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box '196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WATER SUPPLY PERMI'r Upgrade Date Issued: Oct 20. 1999 Fxpiration Date: Oct 19.2000 Permit Number: 8W990394 Legal Description: RICHARD LT 2 Design Engineer: 0003 S & S Engineering Owner Name: Richard Miller Owner Address: % City Mortgage Anchorage, AK 99503- Parcel ID: 015-521-06 Site Address: Lot Size: 0 SQ. FT, Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [, Disposal Field ~ Septic'rank ~ 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 ( 18AA072 ) and Drinking Water Regulations ( 18AA080 ). 3. The engineer must notify DHHS at least 2 hours prior 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 (lay. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. THE WELL SHALL BE PERMANENTLY DECOMMISSIONED AT THE TIME THE WATER STORAGE SYSTEM IS CONSTRUCTED PURSUANT TO AMC 15.55. Date: Municipality of Anchorage DEPARTME:NT OF HEALTH AND HUMAN SERVICES Environmental Services Division Telephone: 343-4744 ON-SITE SERVICES FEE DOCUMENTATION Name of Payer: (Name on Check) Mailing Address: (Off of check) Le. gal Description(s): OS.- 0532 Permit Number: S & S ~NGINEERING Receipt #: 17034 Eagle River Loop Road NO, '~04 Eagle River, Alaska 9957? Check #: Type of Payment: (In,cate Amount Paid) ¢ lealth Authority: ~ ('~:' ' ~ E~ator Permit: Sewer & Well Permit: Fngineer Permit: Well Permit: /-¢~ ~ ' ~-~ Pumper Permit: Sewer Permit: D-- O · dTb WAIVERS: Lot Line: Well to Tank: Well to Field Copy Request: 72-034 (Rev. 10/87) Well Driller Permit: Tank Manufacturer; (Waste Treatment) DISTRIBUTION: Field to Surface Water Tank to Surface Water WHITE--MASTER FILE CANARY--PROGRAM FILE WR~ WR99008] PID= Date Received: October 4, 1999 Leqal Description: Lot 2 Richard Subdivision Engineer: Applicant: MUNICIPALITY OF ANCHORAGE Deparnment of Health and Human Services On-site Services Section Waiver Review Worksheet 015-521-06 HA~ Permit # Robert C Cowan, PE, S 6 S Engineering 17034 EAgle River Loop Road, Suite 204~ Eagle River~ Alaska Richard Miller 99577 Waiver Requested: Private well on Lot 2 __Ssptic system to the Private well on Lot 2 to the proposed septic tank to 70'; and septic system to 90 feet; lot line of 0 feet. Criteria: 1. Geology: A. Water Table B. Soil Sorptmon C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2o Special Conditions: Points: 3. Other: Waiver zs Granted: Waiver is NOT Granted: List Conditzons or Reasons fo~ above: Name of Reviewer Rec #: 05328/0088 hraount: $ 920.00 Date Paid: 10-4-99 SEWER&WATER ~N B(TENSIONS SEWER&WATER INSPECTION WELL INSPECTION &FLOWTEST SITE pLANS SOIL TEST STRUCTURAL& MECHANIC~. INSPECTIONS ROBERT C. COWAN, P,E, October 1, 1999 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Human and Health Services PO Box 196650 Anchorage, AK 995'19 P, eference Lot 2, Richard Subdivision Request a permit to install a replacement septic tank at the referenced property. The existing septic tank is leaking. We also request you grant the following waivers for the referenced property: 1. Waiver the horizontal separation distance between the private well on Lot 2 and the proposed septic tank to 70 feet. 2. Waiver the horizontal separation distance between the private well on Lot 2 and the septic system to 90 feet. 3. Waiver the horizontal separation distance between the septic system and the lot line to 0 feet. A risk analysis was performed using the State of Alaska, Department ef Environmental Conservation's Separation Distance Waiver Guidelines. Our results are as follows: a. WATER TABLE: At present time no historical information is available for the onsite well, (including a search of municipal records). Additionally, the static water level has not been measured because the well head seal can not be removed without a well service rig. 17034 NORTH EAGLE RIVER LOOP· SUITE 204 · EAGLF RIVER, ALASKA 99577 From the well logs of the surrounding properties we can see that the static water levels of wells completed in the same aquifer indicate the water table slopes to the north/northwest. This slope is in excess of 3%, away from the referenced onsite well towards O'Malley Road. Based on a drawdown of approximately 50 feet, and a separation of 70 feet, the hydraulic gradient is 35 degrees. b. SOIL ABSORPTION: From the soils log used in the design of the Lot 2 (Richard) existing septic system, the receiving soils for the septic system have silt with some sand which should provide excellent septic effluent treatment. From the surrounding well logs there appears to be layers of silt with some sand, clay and gravel mixes. c. PERMEABILITY: The silt soils in the area should provide a confining layer, providing a good barrier, isolating the onsite well from contamination. d. HORIZONTAL SEPAF~TION: The horizontal sep. aration distances between the well and the proposed location for the tank is 70 feet. e. ADDITIONAL. CONSIDERATIONS: 1. The existing system has been in service for nineteen years with no apparent adverse effects to the surrounding properties. 2. The water samples from the Lot 2 well show: A. nitrate level at 4.26. B. 0 colonies coliform bacteria. C. 0 colonies other bacteria. 3. As shown on the attached site plan, the topography is such that surfacing effluent from waiver contamination sources would flow away from the well. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas, or drainage patterns by the installation of the proposed septic system or the granting of the waivers. If we may be of further service please contact us. Sincerely, Robert C. Cowan, P.E. RCC/mjc = 50' SIT~ UPGRADE SCALE Z 0 0 0 ,-:j © 0 ~j AUG-2?-g9 I3:)B FROM-CTE ENVIRON~NTAL 581530l T-.300 P,02/03 F-43B ~ll~i~. CT&E Environmental Services Inc. CT&£ Ref,# Clien~ Name projec~ Nam,'/# Client %topic ID Ma;ri~ Ordered By PWSID Lo; 2 Richard S/D Lot 2 P. ichard Dnnking Water gampie R~mrks. Client PC,# Pri.t;.d bat~/'l'im= 08127199 Coll~ctt, d Date/Tirno 08124/99 11;00 Received Date/Time 08/24/99 14'15 Technk';t, Director: Stephen C. Ede Releu,ud By ~ ~ units metno~ ....... ~.~6 0.500 n~§/L EPA 1bO.) 0812~/99 KAp 0812a/99 08/2&199 SCL I°qol 641 3O ~ENTH DAY 'NI- 15T- ADEPT 3/ 187 200 -'4~)> 202 Hidden Lake Area Refer~ 5140 5200 5250 7 / 11010 i- 11041 AV~'. 5320 AVE. / 2 Date Received: Legal Description: Engineer: Applicant: MUNICIPALITY OF ANCHORAGE !partmen5 of Health and Human Services On-site Services Section Wa'iver Review Workshee'~ Waiver A. Water Table B. Soil Sorpnion C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: List Conditions or Reasons for Waiver is NOT Granted: above: ~,ate, //- 2 2 - 77 ~y, Name of Reviewer Rick Mystrom, Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, ALaska 99519-6650 http://www ci anchora§e.ak us S & S Engineering ATTN: Robert Cowan, PE 17034 Eagle River Loop Rd, #204 Eagle River, AK 99577-0000 November 22, 1999 Subject: Waiver Request forRICHARD LT 2 Waiver # WR990089 Lot Line Request for Parcel ID 015-521-06 Dear Engineer: Your request fora waiver of the required 10 feet horizontal separation of the on-site wastewater disposal system to the lot line has been approved. The approved separation distance is 0 feet. This waiver approval applies to the cnrrent on-site wastewater disposal system and lot line separation only. Any future upgrade to the on-site wastewater disposal system and lot line will require all separation distances to be met or another waiver approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-4744. Civil Engineer II On-Site Water Quality Program MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR~wRg§O0Q5 PII)~ _si Date Received: 11-1-99 Legal Description: Richard Subdivision, Lo~ 2 Engineer: HA~ HA990546 Permit S&S Engineering 17034 Eagle River Loop Road, Eagle River. AK 99577 Applicant: Richard Miller Waiver Requested: Lot Line Waiver ~ Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver ls Granted: .~ Waiver is NOT Granted: List Conditions or Reasons for above: ~/¢~;~/F~_~7 ~;F.~ Name of Reviewer Rec ~: 05358 Amount: $ ~]]~ no _ Date Paid: 11-1-99 MUNICIPALITY OF ANCHORAGI~ 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 I I O UP ,RADE MAILING ADDRESS LEGAL DESCRIPTION LOCATION NO. OF 13EDROOMS PERMIT NO. DISTANCE TO' [Well No, of compartment~ Liquid depth PERMIT NO. Manufacturer Liquid capacity in 9aliens t4aterial 'Neare t Iol IP e Inside length Dwelling E)ISTANCE TO: Fou ndation/(.~ /¢. PERMIT NO. Distance between tines Total length of lines Top of tile to finish grade Mate,'iai beneath tile Total effective absorption area inches Width D0pth PERMIT NO. Crib diameter Total effective absorption area Crib depth WelJ Building foundation Nearest lot Ih]e Depth Driller Distance to lot line !PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Fbsorption area(s) J. OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS .- ( . / ) PERMIT NO. RPPLICRNT RICHRRD HILLER LOCRTION OMRLLEY RD LEGRL ET~2 RICHRRD S/D LOT SIZE 100000 SQURRE FEET TYPE OF SOIL RBSORPTION SYSTEM IS: TRENCH MFtXlMUM NUHBER OF' BEDROOMS = 4 SOIL RRTING (SQ FT/BR)= 250 THE REQUIRED SIZE; OF THE SOIL RBSORPTION SYSTEM IS: [::' E'.:- P T H = ~L¢._~ L E r4~8 Ir'H-.,= :1~ ~=~)0 L.~R t'~ VEL_ DE:P-tH= 6 THE LENGTH DIMENSION IS THE LENGTH (IN FEE]') OF THE 'FRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE I)ISTRNCE BETWEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET). THERE IS NC) SET WIDTH FOR TRENCHES. THE GR~VEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE RND 'THE BO'I'TOI~ OF THE EXCRVRTION (IN FEET). PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFORM INSTRLLR'FION INSPECTIONS OF RNY WELLS FII)JFICENT TO NUMBER OF RESIDENCES THRT THE WELL WILL SERVE. THIS DEPRRTHENT DURING THE THIS PROPERTY RND THE ...... TI.,JO~ < 2 ) I I".-~'.=];PEECT IONS; HRE F4EQLI I REC:, BRCKFILLING OF RNY S~STEH WITHOUT FINRL INSPECTION RND RPPROVRL 8~ THIS DEPRRTHENT WILL BE SUBJECT TO PROSECUTION, HINIMUM DISTRNCE BETWEEH R WELL RND RNY ON-SITE SEWRGE DISPOSRL SYSTEM IS 200 FEET FOR R PRIVRTE WELL OR t50 TO 200 FEET FROM Iq PUBLIC WELL DEPENDING UPON THE T'T'PE OF PUBLIC WELL. MINIHUH DISTRNCE FROM R PRIVRTE WELL TO R PRIVRTE SEWER LINE IS 25 FEET RND TO R COI"IHUNIT~ SEWER LINE IS 75 FEET. OTHER REQUIREHENT5 HRY RPPL.~.'. SPECIFICRTIONS RND CONSTRUCTION DIRGRRHS RRE RVAILRBLE TO INSURE PROPER INSTRLLRTION. I CERTIFY THRT i: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS F)ND WELLS RS SET FORTH B'¢ THE HUNICIPRLI'rb' OF RNCHORRGE. 2: I WILL INSTRLL THE S~¢STEM IN RCCORDRNCE WITH THE CODES. ~: I UN[)ERSTRND THRT THE ON-SITE SEWER SgSTEM MRY REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN 4 BEDROOMS. SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PFRCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION:_ ~.~'T ~.,__ 4 5- 6 7 8 9 SLOPE PERCOLATION TEST SITE PLAN 10 11 12 13 14 15 16 17 18 19 20 0 E IF YES, AT WHAT DEPTH? Reading Date Gross Net Deptl~ to Net Time Time Water Drop 'PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT COMMENTS PERFORMED BY: ~ CERTIFIED BY: "~i ~'~ 72-008 (6/79) SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch I~SSO, Anchorage, Alaska 99602 276-2224 SOILS LOG - PERCOLATION TEST PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 7 8 9 10 11 12 13- 14- 15- 16- 17- 18- 19 2O DATE PERFORMED: ~'t¢~1 ~ ~ 7!/qG¢'O SLOPE SITE PLAN ~A-ND/fig. AVE. PIL. d~ P ENCOUNTERED? IF YES, AT WHAT DEPTH7 Gross Net Depth to Net Reading Date Time Time Water Drop _ ............. ~ / OF- PERCOLATION RATE '~ minutes/inch) 72 008 (7/76) MUNICIPALI'rY 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. # 1. GENERAL INFORMATION Complete legal description CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWFLLING Lot 2, Richard s/D ECEIVEb NOV 0 1 1999 MuHICIPALII'Y OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION Location (site address or directions) 5250 O'Malley Road, Anchorge, AK ~ : ' · Richard Miller property owner Day phone ~,ailing address .iLending agency City Mortgage/DeLynn B~ouillet Day phone 263-0714 'Mailing address 121 W. Fireweed Lane, Suite 121, Anchorage, AK 99503 Agent. Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~ TYPE OF WATER SUPPLY: I~ XXX Community well Public water NOTE: in~' to the legality and status of system. TYPE OF W TEWATER r)ISPOSAL: Individual on*site If community well system, provide written confirmation from State ADEC attest- NOTE: Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 724)25 (Rev. 1191) Fronl MOA#21 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 Appr~)val 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 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. S & S ENGINEERING Name of Firm ~.7034 r~,~l,~ glv,,, Laap Rond No. 204 Address Eagle River, Alas[(a 99577 Engineer's signature ~,~ ~ ~7.--__ Phone 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 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 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. t4ECEIVfb, Municipality of Anchorage ~_~ DEPARTMENT OF HEALTH & HUMAN SERVICES r~0V 0 '~ 1999 Environmental Services Division MUNJCIPAL]I'¥ OF ANCH~,: 825 L Street, Roorn 502 · Anchorage, Alaska 99501 · Health Authority Approval Checklist Legal Description: _~t.42~' ~ ~-'~___/-/-,'~,4L.L) Parcel I.D.:~?/~--- -~-~:':~ / '~-),~ A. WELLDATA t~ ~c ~-s Well type ~3~ If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed Total depth Sanitary seal (Y/N) Date of test static water level Well production D~of sample: Cased to Ca~h~height (above ground) ,.--'W~res properly protected (Y/N) FROM WI=LL LOG ~/ AT iNSPECTION g.p.m, g.p.m. ~.~('"':- ~.,~1f¢¢ I"?I4,L p~2 / AI'I~-' Nitrate Other bacteria Collected by: B. SEPTIC/HOI. DING TANK DATA Date installed /(~/~'4 _Tank size ~,~-,~'~ Number of Compartments ~- Cleanouts~¢/N) Foundation cleanout~N) ~ Depression (Y~ ~ ~igh water alarm (Y/N) Date of Pumping ' ~ Pumper %/~- (~,' ) C. ABSORpTIoN FIELD DATA / [ / t Length /~ Width ~ Gravel thickness below pipe ~ Total depth Fluid depth;in absorption field before teat (in.); J/" __ Immediately after~Z~gal, water added (in.): F,uiddep,h_Z/J~~ (i?~inu,es ,ater: ~ AbBorp,ionra,e= ~'~ g.p.d. Peroxide treatment (past 1 ~ months) (Y/N) .~0~- ~W If yes, giVe date 72-026 (Rev. 3/96)* D. LIFT STATION / Date installed Manhole/Access (Y/N) / Size in gallons "Pump on" level at* "Pump off" level at* High water alarm level at* *Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic ~ Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation ~-/'/-- Property line ~'/~'- Absorption field. / / Water main/service line Z:~- "/'- Surface water/drainage/~ ~'~ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: line .~ Building foundation ,./~)/'¢- Water main/service line Property Surface water/ /~:2~ /¢-- Driveway, parking/vehicle storage area /O ~'-/-- Curtain drain/'[////~/X-- ,~A,,/~7/M,/V'' Wells on adjacent lots /(_2(_~ F. ENGINEER'S CERTIFICATION :;: ......... O-F.4, "~. ~ I certify that l have determined thru field inspections and review of Municipal record~'j~!~.¢,abeB~s are in conformance with MOA HAA guidelipes in effect on this date. ~ ~/¢ ' .A ' %, ~ ~ ~ $ ROBERT C~COWAN ~,~ ~ Date /I/ I -- ~ "] *~,~,'., ..,',c~ ~/ Date of Payment Receipt Number Waiver Fee $ //J~'"'~ ~f") (~/~¢-~-~ Date of Payment ////.//¢~' Receipt Number ~':~'--'~'C'~¢/ J 72-026 (Rev. 3/96)*