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Home My WebLink AboutGLACIER VIEW HEIGHTS BLK D LT 2Onsite File Glacier View Heights Block D Lot 2 #050-491-26 COSA approval is limited to 3 bedrooms until absorption field is upsized. Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221033 PID Number: 050-491-26 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑■ Upgrade Name Robert S Rima Jr. ABSORPTION FIELD ❑ Deep Trench El Wide Trench El Bed El Mound Site Address 22410 Glacier View Dr ❑ Other Phone (907) 301-4515 Number of Bedrooms 3 Soil Rating Total depth from original grade Existing GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Glacier View Heights D 2 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ftz Ft. Well >100' N/A N/A N/A >25' TANK ❑� Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1250 Gal. Surface Water >1 QQ' N/A N/A N/A Material Plastic Number of compartments. 2 Lot Line *4.5' N/A N/A N/A NA Foundation >1 Q' N/A N/A N/A LIFT STATION turer Capacity Remarks Tank installed 1' from field to allow for 100' Gal. separation from well. *See waiver for property line separation. Alarm location installed by Installer PIPE MATERIAL House to tank D3034 drainfield Tank to D3034 Hiland Excavating Drainfield Existing Co/MTD3034 Inspector J. Millette BENCH MARK (Assumed elevation) 100 ft Inspdecctiiosn 15t 3/16/22 Location and description 2 ° 3rd 4/nh Bottom of siding on garage ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp ®F®\\�� ,q 1 Conditional Approval: Date • ��Q'�. • .tS',fl /*: 49TH •1k Septic System Approved ► (-c�Date 3'' / 2a d� �•, Ben)am�r Schiller F� • CE 12592 f 'srF •�� r • 3/17/22 �11`F,PROFESSI* �_� Note: this approval does not include well permit requirements. \��'��® �r�UV VV/VU 10) GLACIER VIEW HEIGHTS, BLOCK D LOT 2 PERMIT # OSP221033 PID # 050-491-26 LOT 1 RETA114 I . NG WALL 755- EXISTINGWEE' Lw/'-"-- 100` RADIUS 735 GARAGE w/ LIVING AREA 1250 -GAL -SEPTIC TANK w/ 20" MANWAY Y 2COI 7 Mrd ADJACENT S LOT SEPTIC CO2 AREA 1p B 725- EXISTIIJG TRENCH TO., REMAIN I SERVICE 715 705 RNGI NEL RI NG /\ ®. 1N-1 Q F- AQ, ;q ,�9�1 -49- 7H Benja i Schiller CE: 2592 3/17/2022 P*R*O*F E s PLAN AS -BUILT 0 30 60 WE ME kM ME FEET 111=30' LOT A B 10M EXISTING WELL W/ 100' RADIUS 2CO1 25.8 37.4 MH 32.7 27.4 SV 35.8 26.7 2CO2 38.0 264 LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPUTTER VALVE MH -MANHOLE MT - MONITORING ORING TUBE SV - SEPTIC VENT TH - TEST HOLE GLACIER VIEW HEIGHTS, BLOCK D LOT 2 PERMIT # OSP221033 PID # 050-491-26 Lr�, 1 �,rH *1 PROFILE AS -BUILT ts�� ' i3enja in Schiller �F� •. CE 12592 11 �sPF�FO ,.,,.zoz...�� lN 61N![rtiNG (NO SCALE) ih,_PROFESSIONP.d MI Mw iu kv IIIIII IMIMM 4IiNFIV, 11 "IIIN w, P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite _Development Services Department On -Site Water and Wastewater Section .,Ncnr S LJcpartmen[ ?fixXTVARMIANCE/ XX?� Waiver#: OSV221011 COSA#: Permit#:OSP221033 PID#: 050-491-26 Legal Description: Glacier View Heights Block D Lot 2 Engineer: First Water Consultinq Applicant: Robert Rima Jr. Your request for a waiver of the required 5.0 feet horizontal separation from the septic tank to the property line has been approved. The approved separation distance is 3.0 feet. See engineer's waiver request for justifications. � 1 1"t / -m ved . )0� This waiver approval applies to the proposed septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ■ a a a a a■■ a a a a a a a a M a a a a a a a e a a■■ a■■ a a a a a a a i a a a■■ a a a v a a a a a a a a a a a a a a a a a a a a a a a a a a a I Waiver is Granted: X Waiver is not Granted: Date: 02 I ),O2 2- Approved by: M U_0� 65?_�W_ Name of Reviewer ■■aaaaaeaaaaaamaaaaeaaaaaaaaaaaaaaaaaaaaaaaaaaaamaaaaaaaaaaaaaaaaaeaaoaaaaaeaa� RRIS Iff A M 1/WA r_q IFN E E R I N G PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) FORGECIVIL.COM March 17, 2022Aup,. 4� C MOA Development Services, On -Site Water & Wastewater Program*, 'M •, 4700Elmore d K An99507 .. ......... ' Benja In Schiller CE 12592 3/17/22 Subject: Glacier View Heights, BD L2 — Glacier View Drive Waiver revision request-"�- Dear On -Site Services Engineer: - Due to the difficulty of the project and efforts to maintain 100' separation from the existing well, the septic tank was installed 1.0' from the existing drain field. Historical test holes indicate relatively tight soils and a lack of groundwater. We expect no adverse impact on the tank or existing field due to this encroaclunent. We therefore request a revision to the existing waiver to include a separation of 1' from septic tank to drain field. Sincerely, Benjamin Schiller, PE ` \ riLr F /RETAINING �✓ \ WALL S /� / S3. Cb �0 2&,3. Lot 1 WELL N. 1.2'x3.8' ROT \ CANT FCT/L SEPTIC- MANHOLE� PIPES � 1 WOODEN FENCE Lot \ ` / S.. I hereby certify that I have surveyed the following described property: LOT 2, BLOCK D, GLACIER VIEW HEIGHTS SUBDIVISION (PLAT No. 70-151) 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 no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated this the _L--- Day of __— W14CAk J at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. 49TH KENNETH G LA st s Q4 'PFD' •.LS -5202.•'• 5�d ��4pR0FeSSIONA- `pow AECC963 22,588 S.F. 1_0 BALCONY OFGlr / `Q C�u'S' RETAINING WALLS �� \ ;•. , SEPTIC PIPE rS1h \ G�VF< h / S,`�' ` \O' OR/P : " "'tK� Lot 3 SAO., ROT //yy 96 Rgo��s 1.zA � WELL I \ C_ \� \ 4 PLOT PLAN —_— AS BUILT _X_ SCALE 1 _= 40' _ GRID _ SW 0059 Project No. 22-0601A2 Lan & Associates, (n C 11500 Daryl Avenue, Anchorage, (907) 522-6476 Phone Alaska 99515-3049 `' Professional Land Surveyors (907) 522-4625 Fax aoO A�� ken®langsurvey.com Jonathon®longsurvey.com I hereby certify that I have surveyed the following described property: LOT 2, BLOCK D, GLACIER VIEW HEIGHTS SUBDIVISION (PLAT No. 70-151) 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 no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated this the _L--- Day of __— W14CAk J at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. 49TH KENNETH G LA st s Q4 'PFD' •.LS -5202.•'• 5�d ��4pR0FeSSIONA- `pow AECC963 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP221033 Work Type: SepticTank Upgrade Tax Code Number: 05049126000 Site Legal Address: GLACIER VIEW HEIGHTS BLK D LT 2 G:0059 Site Mailing Address: 22410 GLACIER VIEW DR, Eagle River Owner: RIMA ROBERT S JR Design Engineer: FORGE ENGINEERING This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date Expiration Date: 2/11/2022 2/11/2023 Lot Size in Sq Ft: 22588 Total Bedrooms: 4 ❑ 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 Veronica Pope GE 2022.02.11 Received By: 16:23:29 -09'00' Date: Issued By: Date: Municipality of Anchorage P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Section WT vARIANC1'r,/WAIVER REVIEW Waiver#: OSV221011 COSA#: Permit#:OSP221033 PID#: 050-491-26 Legal Description: Glacier View Heights Block D Lot 2 Engineer: First Water Consulting Applicant: Robert Rima Jr. ��ienr S rC fi L>e mrtment Your request for a waiver of the required 5.0 feet horizontal separation from the septic tank to the property line has been approved. The approved separation distance is 3.0 feet. See engineer's waiver request for justifications. This waiver approval applies to the proposed septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. m m ■.e ■ m e mm m m m m m m m m m. m m m m m m m m■ s_®.m m r..■..m..m.■.m.■.■..■.■..■.■.■.■.■.mmm_mmmmmmmm.mmmm.■ ■.■.m_mmmmm.■ ■.mmam.■ m.� Waiver is Granted: X Waiver is not Granted: Date: o� 1 �D 2 ,Z Approved by: Q�C,� Name of Reviewer ■■mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmammmmmmmmmmmmmammmmmmmmmmmmmmmmmmmmm� 711111, �, 1pill I 0 oil Ro5H MUNICIPALITY OF ANCHORAGE Community Development Department``' Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 050-491-26 Property owner(s) Robert S Rima Jr. Day phone (907) 301-4515 Mailing address PO Box 746, Cooper Landing, AK 99572 Site address 22410 Glacier View Dr Legal description (Sub'd., Block & Lot) Glacier View Heights, Block D Lot 2 Legal description (Township, Range & Section) Lot Size 22,588 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) IN Septic Tank ❑X Upgrade ❑X (w/wo ADU) Tank ❑ Renewal Duplex (D) E]Holding ❑ Privy ❑ Multiple Dwellings ❑ (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. (Signature of property owner or authorized agent) Permit/Rush Fees: 022-5 -� -OL35 Waiver Fees: 13 S Date of Payment: Date of Payment: Receipt Number: Receipt Number: Permit No. O�022210 3-�) Waiver No. OS V a a 9 O I i Permit App_::- :-.,:c February 11, 2022 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 2/11/22 Subject: Glacier View Heights, BD L2 – Glacier View Drive Septic tank replacement Dear On-Site Services Engineer: The septic tank on the subject property has reached the end of its useful life. Additionally, a detached garage with a living area was built on the property so we are submitting this permit application for replacing the existing 1,000-gallon septic tank with a 1,250-gallon tank while utilizing the existing 3-bedroom absorption field. The attached site plan identifies the location of the home as well as the well and new septic tank location. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. Wells on this and adjacent lots are shown. The new septic tank will be a minimum of 100’ from all wells and surface water, and more than 5’ away from the existing field. Due to the amount of space between the field and the well radius, we are unable to meet the minimum separation between tank and property line. We therefore request a variance for 3’ separation between the northwest lot line and the new septic tank. We are proposing swapping out the old tank with a new one in the same exact location. Please refer to the attached plan, slope cross section, and profile pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221033, Rebecca Carroll, 02/11/22 // // // // // // // Benjamin Schiller CE 12592R EGISTEREDPROFES S I O N ALENGINEER 1"=30' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND GLACIER VIEW HEIGHTS, BLOCK D LOT 2 FEET 0 30 60 FCO NOTE: ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. NO SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM. 3-BDRM HOME 2/11/2022 G L A C I E R VI EW D R I V E G L A C I E R VI EW D R I V E GARAGE w/ LIVING AREA EXISTING WELL w/ 100' RADIUS RETAINING WALLS ADJACENT LOT SEPTIC AREA RETAINING WALL EXISTING WELL w/ 100' RADIUS EXISTING TRENCH TO REMAIN IN SERVICE 1250-GAL SEPTIC TANK w/ 20" MANWAY MAINTAIN 5' MIN FROM PROPERTY LINE REMOVE & DISPOSE OF EXISTING TANK INSTALL FCO WITHIN 4' OF FOUNDATION 2CO 755 745 735 725 715 705 3' Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221033, Rebecca Carroll, 02/11/22 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 %" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM A.";=/C~ ~.J REPORT Name Addle$$ Phone(s) ~):~ ~:;2.-'~-~"~7 IPerm~t No~f~ No o~rooms Township, Range, Section LEGAL DESCSIPTION TANKS DISTANCES WELL WELL LOT LINE FOUNOATION SEPTIC TANK / ABSORPTION FIELD AS-BUILT DIAGRAM (Show location et well, septic system, property hnes, Ioundahon, driveway, waler bodies, etc ) .~ SEPTIC Man utact~_,~ Material [] HOLDING Capac,ty in gaU:nL~/~-~ "~ ~1~..~_~.~.~ Nod Compad m.~ TYPE OF SYSTEM ~,TRENCH [] BED ~ W. DRAIN ~ OTHER Depth to p~pe bottom from or,gmal grade~. / added above original grade FT' 4~ / FT ~ / 7.5' FT ~ ! /*~._~-~ SO FT ~ FT SQ FT /g&/C-~ WELLS ~ PRIVATE Classlhcahon (A,B,C) [] OTHER (Identifv) 1 ota~) Cased to REMARKS: I '~J~' ~ ~>- ["'~/~'~l'-Z~ O~ ,c'l:/~ ,hat,hiS ,p~pecl~n was p. mlormed according ,o ,I, Municipal and Slate guidelines in elfect on this dale: /.~¢~ '"~"' ~/~' / Date. SEAL ..... ~, , .~ ~ '~ Health Department Approval: SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 * TELEPHONE 688-2759 OWNER OF LAND ~DDRESS LEGAL DESCRIPTION Started Ended DATE PERMIT NUMBER SI s, ll( LI-VI-I O1' w.s, TER FI t~+ 7:0r,x~ Down F~ (',~LS PER HR /~0 __ KIND OF FORMATION: From_ 0 Et. to ? to~"' Ft.- ~- ~'l ~ ~-''''J ~ From/(o-~ Ft. tot~ ~0 Ft. From~ } I3 .Ft. From Ft. From~ Ft. From~ 0°0 Ft. From___ Ft. From___Ft. From~Ft. From ~3" Ft. From .__Ft. From~ ~ Ft. From Ft. F~om2C%Ft. From Ft. From Ft. From:~? ~ Ft. Frmn From From to__Ft. 16~- Cf~ From From___ Ft. to .... Fl. From____ Ft lo__Ft. Frmu ____ Ft. Io ____ Ft. From ___ FI From ....... II io ~FI Frmn f-1. Io ~ Ft. Frm,~ ___ Ft. to~ Ft. From Ft. to~Ft. From~Fl 1o __ Ft. Frm~ _Ft. to. Ft.. Ft. Ft. {o~ Ft. Ft. to _~ Fl FI. to ~ Ft Fi. to .... Ft. Ft. to Ft. ,o Ft. /~eZ)k911KT../'- O/~_Z) t/~ttfl'''// From .... Ft. ,o __._Ftc__ MISCL. INFORMATION: DRILLER's NAME ~L.~_~ ~-'~-~'___ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME MAILING ADDRESS PHONE ~htEW [] UPGRADE LEGAL DESCRIPTION LOCATION ~ Wed Li~ . c~)acitv in gallons I Ins de I~oth W dth ~ ~ I Well ~ ~ DISTANCE TO: / ~ ~ ~ Top ~f tile~o)inish 9tade Mater al beneat ~ ti e Length Width .,~ /'//' i Depth Type of crib Crib diameter /¥/,~ Cribdeptb DISTANCE TO: Well / / V Buitding foundation CJass x -- Dept~ Driller Di ~A~C~/~: ~uil~a~on~ / ~erli~' Septic tank NO. OFBEDROOMS ,~ PERMIT NO. ..,.- ~.~(. Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT NO ~ Distance between lines Total effective absorption area Nearest lot line Distance to lot line PERMIT NO. Absorption area(s) OTHER PIPE MATERIALS INSTALLER / ' REMARKS '! 72~)/~,~ (Rev. 3/78) /,~4DATE LEGAL ,~ ~,~ .: ~ i I~ 0 C E C MUNICIPALITY OF ANCHORAGE Department ¢ Health and Environmenta- ~rotection 825~Street,264_4720A~nchorage, AK. ~9501 * * * HANDWRITTEN PERMIT * * * Permit ~~/~ ~[;44~~, ON-SITE SEWER PERMIT Applicant: ~ Mailing Address: ~ ~ +~ ~__--~. , Location: Phone Number: Legal Description: L ~ ~ [~ ~ ~,~¢,~/~_..~ ~-~. Lot Size: Type of Soil Absorption System Is: Trench: Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms: 5 Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is: DEPTH ~ LENGTH /O3! ~ GRAVEL DEPTH ~"-- WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = /OC~O GALLONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 1 9 8 B * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set fox, by the Municipality of Anchorage. (2) I will"i~sgall t~system in accordance with codes. (3) I under~ th~he on-site sewer system may require enlargement if the.residUe ~S kemodeled to include more that 3 bedrooms/. ~ S igne~/i 'i~~"~/-~b~/~-~'/'///~ Issued by: ~ ~ t~-,~-~/ · Date: ~-//--~ PERFORMED FOR: LEGAL D~SCRIPT~ON: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION B25 L. Street, Anchorage. Alaska 99501 264 4720 SOILS LOG -- PERCOLATION TEST y/ f L /.- ,/ c-// ' / / DATE PERFORMED LJ SOILS PFRCOLATION TEST 9 10 11 12 13 14 15 16 17 18 19 2O COMMENTS PERFORMED BY: 72-008 (6/79) SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? c..aLE I~,.'cr,, "; IF YES, ATWHAT DEPTH? Reading Date PERCOLATION RATE ~/'? (mimHes/inch) TEST RUN BETWEEN '~'~? FT AND Z~' /~ FT glook i/ acicr Vic'w Heic~hLs Sub'~iv~n~on, , ~_~/ ~ . _.. Eagle }~J. vor A].anka, hereby declare that I am wi}]J~g to [,artJcipaLe in tho water distribution system proposcd to be construcued by ~osse D. Nichols. I understand that after the construction of the said water system is cenpl, eted, it will be owned in jeint ownership by ali parties participeting in ii.. I undersLand further that the cests of consuructJng and maintoinJng the said water system will be borne by all parties participating in it, and t hereby declare thau. t am wil}ing to pay my pro rata share of all such costs, provided thhN a minimum of twenty (20) property owners in the suhdiv:~.s{en wzl] participate in the said water system. I u~derstand further that Jesse D. Nic]}~ls has applied for a water per~.~it to enab].e him to con- struct said water system, and I hereby d(~c]are tJlat I support: Mr. Nicho!s~ application, ask that it b,, granted, and that any other application in henri.icc witll ;,5Lz Nc. denied. // - DA'I'ED this ,;~ day of d~{.-,, K , 1971. MUHMPAUTY OF AHCHO AGE Development Services Department �_ Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050-491-26 1. GENERAL INFORMATION Expiration Date:_(, -1W-2-02?, Complete legal description Glacier View Heights, Block D Lot 2 Location (site address) 22410 Glacier View Dr, Eagle River, AK 99577 Current property owner(s) Rlrna, Robert S Jr Day phone Mailing address PO Box 746, Cooper Landing, AK 99572 Real estate agent Daniel Vernon Day phone (907)301-4515 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 Fol Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distan Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 550 +3 E)Q Date of Payment :� — f 9 % Z Receipt Number rig 99e COSA # 0SG 2,2-1 o S y Date: 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, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering (M.J.) Phone (907) 522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Benjamin Schiller, P. E. 6. DSD SIGNATURE System #1 Approved for 3 bedrooms System #2 Approved for bedrooms Disapproved Date 3/9/2022 - OF *.c•49 • TH '9}I TH •* ... ..5 : .?!.fes.. . w Benjarr rschiller I �'FG, • CE 12592 • j$ 3/9/22 PROfESSIONa�F_�� Conditional approval for bedrooms, with the following stipulations: Verrrrr B � �� - � -�� Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Glacier View Heights Block D Lot 2 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA W Well log is filed with Onsite (or attached) Date drilled 7/1990 Total depth 380 ft Cased to 95 ft W Sanitary seal is functioning correctly ❑® Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 3/9/22 Static water level at beginning of test 179 ft. Comments B. TANK DATA Age of tank(s) <1 years Tank type/material Septic/Plastic Measured operating fluid level in septic tank NEW FE -1 Standpipes/foundation cleanout per record drawing Date of pumping Installed 3/16/22 D. ABSORPTION FIELD DATA Deep Trench Which system tested (date installed) 11/12/83 ❑ ALL standpipes present per record drawing Total measured depth from grade 7 ft (max) Measured depth to pipe invert from grade 4.8 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective 3.6* Parcel ID: 050-491-26 Structure served by this system Well production at time of test 2.9 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Forge Engineering Date of Sample 2/7/22 STATION ❑ Requir aintenance completed Age of lift station ears Lift station material Comments: Adequacy test date 2/17/22 Results Q Pass For 3 Fluid depth prior to test 0 Water added 500 gal New depth 0 in Elapsed time 1440 min 0 bedrooms In ❑ Final fluid depth In Code -required soil cover over field >450 � System presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) 2000 If yes, enter date Gallons introduced gallons Comments/Deficiencies: Grade loses elevation toward MT, depths checked with a laser. Significant debris buildup in monitoring tube. COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No Community Sewer Manhole/Cleanout > 100' ❑✓ Yes if No ft M Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25' M Yes if No ft Absorption Field on Lot > 100' ❑✓ Yes if No ft Holding Tank > 100'✓❑ Yes if No ft Neighboring Absorption Fields > 100' Water Service Line > 10' ❑✓ Yes Animal Containment > 50' ❑✓ Yes if No ft ❑✓ Yes if No ft if No ft F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' MI Yes if No ft ✓❑ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑✓ Yes if No ft Surface Water > 100' Yes if No ft *4 5 Property Line > 5 ❑ Yes if No ft Wells on Adjacent Lots: If absorption field is under driveway comment below Property Line > 10' ✓❑ Yes if No Absorption Field > 5' ❑ Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Main > 10'✓❑ Yes_, if No ft Community Wells > 200' ❑✓ Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation >.10' ❑ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ✓❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ✓❑ Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Surface Water > 100'✓❑ Yes if No ft F. ENGINEER'S COMMENTS *See waiver OSV221011 and revision request G. ENGINEER'S CERTIFICATION AW AW I certify that l have determined through field inspections and review ®'GJ,'"ir of Municipal records that the above systems are in conformance with or T1 H ' MOA COSA guidelines in effect on this date. ' ` ' ' ' ' ' ' ... �.. ... ... . .. ......� '." Benjarr 'r chiller CE 12592 w �® lZC4 3/9/22 • 'V� COSA Checklist yellow sheet MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH& HUMAN SERVICES. Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # ~.~ --5/~/- ~7.~. -,~ 1. GENERAL INFORMATION "ComPlete legal descrip~ior{ ' ' ~/~ ~' ~? Location (site address or directions) ;i:.P'roperty owner Mailing address "'~ ~'-~-,,~-~,.~ ~',~L~ Z:~Z. / 'Le~ding agency Mailing .~dress Day phone Day phone Agent Day phone Ad dress Unless otherwise requested, HAA will be held for pickup. '- 2... NUMBER OF BEDROOMS: ~.? 3 ~PE OF.WATER SUPPLY: : · ,,, ~ ~.~'~.-,.~-~ ........ ~ ........... 'L?;~.:..;-:~ , Individual well . ~}::,~::. :'. Communi~ well t,.. Public wate~ ~ ~3" L: A', ', '~ ' 'NOTE: If communi~ well -system, provide wH~en cOnfirmation from. State AD,~Ga~es~ .". .. ...... ing to the legali~ and status of system. 4. ~PE OF WASTEWATER DISPOSAL: ~,,, (Fy.." ..... r',t~ ,,' Individual on-site NOTE: Holding tank ';': '~: ~L' mU ity ' ..... Corn n on-site " "' · Public sewer ~ ...... ~:, ~ r .~..:~ If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. ~-025(R~.1~1) Fmnt MOA~I o STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further 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. bedrooms. Name of Firm Address Engineer's signature Phone Date /-,'//~'/~-' / , DHHS SIGNATURE Approved for Disapproved. Conditional approval for .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 DH HS does this as a courtesy to pumhasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025(Rev. 1/91) Beck MOA~21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST A. Well Data Well type /~/~ Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump level1 Cased to If A, B, or C, attach ADEC letter. ADEC water system number Date completed -//~o Driller Casing height Wires properly protected (Y/N) AT INSPECTION g.p.m. ~ ~/ Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line ; On adjacent lots /~'~ Public sewer manhole/cleanout Petroleum tank ,,v,//.,4- MuNiCIPALII¥ ~,r ANL id,J,,,~[ ENVIRONMENTAL SERVICES DiViSION g.p.m. ,~T~ 2~ /99,5 FROM WELL LOG SEPARATION DISTANCES FROM WELL TO: _ ~/~/~ 1 . . ~'/.. ~ ~ ~.,,~,~_ ~-~of~ ; Lm'aajacent lots RECEIVED WATER SAMPLE RESULTS: Coliform O Nitrate Date of sample: /,/~,/~: ~- Collected by: Other bacteria cD B. SEPTIC/HOLDING TANK DATA Date installed ///&' ~' Cleanouts (Y/N) ~ High water alarm (Y/N) Date of pumping Tank size Compartments Foundation cleanout (Y/N) y' Depression (Y/N) ,'-///'~ Alarm tested (Y/N)/qr/~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ~'Z'..~' To property line /o ".'/-~ Sudace water/drainage On adjacent lots /o "/- Absorption field ~' ' ~ lc, z:) ~ + Foundation /o Water main/service line 72_026 (3,93)O From ~ ,~- ' _ ',-,~,_o~-.~,.._~ CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DIST,a~J~3Eq~ROM LIFT STATION TO: W~.ih:~~ On adjacent lots Manufacturer ~ Manhole/Access (Y/N) ~ ~evel at Sudace water D. ABSORPTION FIELD DATA Date installed ~ Length~_~ )~ Width Total absorption area /oZ/7~-- Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) -V/ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Soil rating (GPD/Ft2) ~. Gravel thickness Cleanout present (Y/N) Results (pass/fail) /,2" System type Total depth ii ' Depression over field (Y/N) '~-.5-5 for ~=~ Bedrooms After test /,-~" If yes, give date 'V//~ Well on lot To building foundation On adjacent lots On adjacent lots /~ Property line /~, ' ~' To existing or abandoned system on lot 4///~ Cutbank _ .~o,,rr5. ~ Water main/service line Sudace water Driveway, parking/vehicle storage area Curtain drain E. ENGINEER'S CERTIFICATION ~,~,/ ~-~. ~,,u. 7¢;: ,: ~',~,,~,4~/,~1/~'~"'"'~ ~i44. I ce~'fy that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection· Signatu re ;~~. /-~ ,~_ Engineer's Name /'~,~.t~:~ ~. ~,-~,~-~'_N Date HM Fee $ ?~ Date of Payment Receipt Number :' , Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lOt, block, subdivision, section, township, range) CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Location (address or directions) (b) Property owner ~''¢ '¢ ~'¢~'~ ,,¢"/,w,~"~: Telephone: (home) $$5'gS'f/~' Business Mailing Address ¢'~¢' /~---¢2 ~-¢'~,,~ ~,¢__~z-¢¢ /'~.~,~= ,~/4' ~¢_q~ (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent ~C~C:~' ~c~' y' / Address Telephone (e) Mail the HAA to the following address: (or check here~ if hold for pick up.) List contact person and day phone number below: ,, , 2. TYPE OF RESIDENCE Single-Family ~ Number of bedrooms 3. WATER SUPPLY Individual Well,~ Community [] Public [] , Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site,J~, Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72~)25 (Rev 7/88) Page 1 of 2 i~ to ~ e6ed · ~ot~ s,4e~u!Bue leUO!SSejoJd aq~, u! SUO!SS!LUO Jo sJo~Ja ~oJ alq!suodseJ iou's! eBe~oqouv jo,~i!led!o!unl/~ eql 'panss! s! eT~,o!J!Heo ~ eJojeq eiep ezXleue ~o suogoedsu! 3onpuoo ),ou op SHHQ jo sea,~Old LU3 'siu~Lue~!nbe~ e~,e~s pue Ie~aPaJ u!eH@o 4Js!1es o1Jap~o u! suo!1nT!1su! §u!puel ~!eql pue saLuoq Jo s~aseqoJnd o~ Xsa~,Jnoo e se s!q~ saop SHHQ eqj. 'eHs~lV jo re, eTS eq1 u! pe~els!Be4 Jeau!§ue leUO!SSajoJd ~uepuadapu! ue Xq e^oqe ~ qdgJ§eJed u! ue^!6 9uo!Tl.~iue$eJd~J eq~ uodn ,~lUO peseq pe~eo!j!Jeo le^oJdd¥ X~poqln¥ qlleeH senss! 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O:~dSNI 9Nl(]l^Ol:lct INI:II.-I 9NII:I33NIIDN3 VI MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) U N ICIPAt-I~I~ ~ZI~Z,6~'E B R U A R y 1984 RONMENTAL SERVICES DI],4~C~,~44 J I.J L 2 4 1990 A. WELL DATA Well Classification Well Log Present (Y/N) RECEIVED Legal Description: Date Completed If A, B, C, D.E.C. Approved (Y/N) Yield Total Depth / Static Water Level _ __ / ?.~ '-/o" Casing Height Above Ground _ ///Z- Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot ~' ,~ / To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by '~.~,'~-~ Water Sample Test Results ~/~6h~! Cased to ~Depth of Grouting Pump Set At .~,O ~ Sanitary Seal on Casing (Y/N) "/ Depression Around Wellhead (Y/N) To Nearest Public Sewer Cleanout/Manhole ; On Adjoining Lots ; On Adjoining Lots /V B. SEPTIC/HOLDING TANK DATA Date Installed /~//V~'b Size /,-~o No. of Compartments Standpipes (Y/N) "/ Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well ~'~, ,,~ ' To Property Line /~ ' To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course Comments //u Foundation Cleanout (Y/N) Date Last Pumped ; for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field 72 026 (Rev 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed //~//~/~, 2 Width of Field Square Feet of Absortion Area Depression over Field (Y/N) Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well ,/oo. To Building Foundation Lot To Water Main/Service Line ~" '-'~ To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments _..~-~¢/~,,~ 4 ,'- ¢-,-~.~<-,,,' Type of System Design Length of Field ?~ Depth of Field 7 / Gravel Bed Thickness ;7 ' Statndpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on · On Adjoining Lots To Cutback (if present) ~;r.-~: ~ .... ~,-~ /7I D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request'* I certify that I,~¥e checked, verified., or conformed to all MOA and HAA gui, d~tir~e~ in effect on the date of this inspection· /. Company ~/~A Date ~~) ~ ~~~ Engineer's Seal va .~'% ~. 220~ . ~,~ Date of Payment '7- ~-&/' ¢~.) Waiver Fee: $ Amount: $ / -Id. (~) Date of Payment 72-026 (Rev 7/88)Back Page 2 of 2 Tom Fink, Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 August 7, 1990 David R. Dayton, P.E. Hc 78 Box 1026 Chugiak, Alaska 99567 Subject: Waiver Request for Lot 2 Block D Glacier View Heights S/D Waiver Request #WR900024, PID#050-491-26, HA900303 Dear Mr. Dayton: Your request for waiver of the required 100 foot separation of a septic system to a private well has been approved. The approved separation distance is 95 feet from well to septic tank. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Daniel J. Roth Civil Engineer On-site Services Concur: ~ hn Smith,P E~ ~ ~~nag~r' On-site Services ljm:%6 ~,ELL _ff v R ~ Z O ,,t,, 7_,, z D. R. DAYTON, P.E., R.L.S. HC78 Box 1026 Chugiak, Alaska 99567 July 23, 1990 MUNICIPALITY OF ANCHORAQ[ ENVIRONMENTAL-SERVICES DIVISION JUL 2. 4 ]9,90 RECEIVED (907).~-L~:I~ Gq G- ~-4 / 7 Municipality of Anchorage Dept of Health & Human Services 825 L Street Anchorage, AK 99502 RE: Waiver Request Lot 2, Block D, Glacier View Heights The well to septic tank separation distance on Lot 2, Block D, Glacier View Heights has been found to be in non-compliance with 18AAC72. Please review tho attached data and issue waiver. If there are any questions, [3lease contact mo at 696-24]7. S incer~ ly, A ' .C/ ; ./ David R. Dayton -- D. R. DAYTON, P.E., R.L.S. HC78 Box 1026 Chugiak, Alaska 99567 (907) 688-2417 June 26, 1990 WAIVER REQUEST WELL TO SEPTIC TANK SEPARATION DISTANCE Reference: D.E.C. "Separation Distance Waiver Guidelines" A. Water 'fable: Assume water table is at level of perforations in well at 80'. Less 8' depth of septic tank = 72' B. Soil Sorbtion: From well log - Gravel, boulders, hard pan (65-75') and fractured rock. C. Permeability: From well log, 0 to 80'has 70' gravel @ 0, and hardpan (silt) 10'/80' x 3.5 = 0.4 D. Water table Gradient: Slopes away from well, 165' well - 80' W.T. ........... 87~ or 97' dist Assume water table is parallel to ground slope in area of approximately 40% E. Horizontal Separation: 96.8' Total Other Factors: Deep water table, steep ground slope as well as bed rock slope away from the well. Waivers granted to Lot 1, Blk D and Lot 3, Blk D ( neighboring lots ) under like conditions. 5.7 Pts. 1.0 Pts. 0.4 Pts. 6.6 Pts. 2.9 Pts. 16.6 Pts. D. R. DAYTON, P.E., R.L.S. HC78 Box 1026 Chugiak, Alaska 99567 (907) 688-2417 June 26, 1990 ADEQUACY TEST Legal Description: Lot 2, Blk D, Glacier View Subd. Date Performed: June 26, 1990 House Size: 3Bedroom Septic Tank Size: 1000 Gal., 2 Comp., Steel Tank Absorbtion System: 7' effective depth, 75' long trench Soils Rating: 349 S.F./BR Daily Sewage Flow: 3 DR x 150 gal/BR/Day - 450 Gal/Day (DHHS records) (DHHS Records) (DHHS Records) Test: 675 gallons of water was introduced into the system in a 4 hr. period. Results: The system accepted 150% of the daily design flow with no rise ]n the monitor tube liquid level or rise in the septic tank level. Conc]usion: The septic system absorbtion system is currently functioning adequately. PROJECT: LOCATION OF WELL (Legal Description): ~/ 7_ /~c ~ WELL DEPTH: ~m FT. CASING: 9~~' FT DATE DRILLING COMPLETED: //~ STATIC WATER LEVEL {Top of Casing): DRILLER: ~YZ' FT DATE: Elapsed Time Since Clock Pumping Started/ Depth to Drawdown/ Pumping Remarks Time Stopped, Min. Water, ft. Recovery Rate, GPM /o.,/o ~ 0 /;'~9~ (swl) 0 0 Start ..~y 35 ., ~ 40 ,,~ 45 /7~- 7 z-9~ z,~ //.,, ~ 50 / 7D -- ? z -//~ z, z ,,~o 60 (1 hour) I1.' ~o 90 /~(/m /Z-/~ (2 hours) /Z.,Wm 150 ~ ~, ~ .... j~/o 180 (3 hours) /Tq-~ 3~-~/~ Y,/ /.,~m 210 /7~- ~ ~ ~ ~,~ ~.,/o 240 (4 hours) /~- ~ ~- 97~ ~,~ RECOVERY ~ 0 ~' /7~- 7 ~ 0 t/t' .' zo 10 47I-/o ~ - ~ "' 15 20 25 Comments: