HomeMy WebLinkAboutPARK HILLS #1 BLK 1 LT 7Park Hills
Block
Lo, 7
#017-142-10
Municipality of Anchorage
Community Development Department Page 1 of 3
On-Site Water&Wastewater Program
4700 Elmore St. •P.O. Box 196650 Anchorage,AK 99519-6650 •http://www.muni.org/onsite •(907)343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: 05P171040 PID Number: 017-142-10 ❑ New ®Upgrade
Name: ABSORPTION FIELD
TAMMY AND TIM GILLSWEST/EAST
Address: ❑ Deep Trench ® Shallow Trench ❑ Bed ❑ Mound
14630 PARKHILLS DRIVE *ANCHORAGE, AK 99516 ❑ Other
Phone No. of Bedrooms: Soil Rating: Total Depth from existing grade:
(907) 727-81 15 4 1.0 GPD/Sq. Ft. 4.59/4.11 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade: Gravel depth beneath pipe:
SEE DWG. Ft. 0.5/0.5 Ft.
Subdivision: Block: Lot: Fill added above original grade: Gravel length:
PARK HILLS #1 1 7
SEE DWG. Ft. 60/60 (120 TOTAL) Ft.
township: Range: Section: Gravel width: Beds Number of lined Distance between lines:
5/5 Ft. — — Ft.
SEPARATION DISTANCES Total absorption area: Number of trenches: Diet. between trenches:
To Septic Absorption Lift Holding Public/Private
From Tank Held Station Tank Sewer Lines
600+ SQ. Ft. 2 10 Ft.
Well 100'+ — 25'+ TANK ❑ Septic ❑ S.T.E.P. ❑Holding ❑0 •-r
Manufacturer. Capacity:
Surface Water A-k. 100'+ —
Gal.
Material: Number of comp• ants:
Lot Line <v 10'+ 1.t.i — N/A
Foundation 10'+ — LIFT STATION
Curtain Drain _ NONE KNOWN Manufacturer. C�- '\C9Capacity:
V� Gal.
'Pump on' level at: •ump off` level at: High water alarm at:
Remarks:
Pump M. . do Model: Electrical Inspections performed by:
PIPE MATERIAL EXISTING/
House to tank EXISTING Tank to D3034
drainfield
Installer
ARM SERVICES LLC. Drainfield EXISTING CO/MT D3034
Inspector GEG, Ltd. BENCH MARK (Assumed elevation)
Inspection 100.36 Ft,
Dates: 1st 4/20/2017 2nd 4/20/2017 Location and Description:
__ __ 3rd 4/21/2017 4th 4/21/2017 TOP OF MANHOLE
ENGINEER'S SEAL
Community Development Department Approval a.,„-, 0000
OFA1_ N
Conditional approval: Date: 1../. �o4T .. v �a
D' . . d 0aff l'� .. Gar ess•U00 . —795 m,
0- s-- I--t7 mpp�� p. :131° i�:,,,,.o
Approvey dam- t.' 4 + ' Date: Dia fess
%, ::,,es
Inspection Report _1-1-12.doc
i PERMIT NUMBER: PARCEL ID NUMBER:
OSP171040 RECORD DRAWING 017-142-10
A B C '
40.40)
MT1 56.0 48.8 71.8 ` a
CO1 56.1 49.7 73.2
MT2 107.1 106.5 128.7 \
CO2 106.5 106.3 128.6
AII
MT3 66.2 49.8 69.8 W RELL OFESS ONALLYE
CO3 65.9 50.2 70.7 SURVEYED PRIOR TO /
MT4 115.1 106.8 126.7 \ CONSTRUCTION /
004 114.4 106.3 125.9 N. /
FS 81.4 79.8 102.5 \
NEW DRAINFIELDS
.. \
N
EXISTING PUMP VAULT
\
AND SEPTIC TANK
.. 10
•
$ A \
t• N
/ 1 B 4 \
/ I BEDROOM \
HOME
)k
/
I .., , \
/
/
• ..f�• •�+.
I '�• ..:4.,.4
1
•"•
100' WW. RADIUS •• ..: :� S ALE'
1
'a-... '•�' 1' = 40'
I
GARNESS ENGINEERING GROUP Ltd s 4• •
��� •'.
CIVIL&ENVIRONMENTAL ENGINEERS k if i
3701 E.TUDOR Ra40,SURE 101 •ANCHORAGE.AK 99507•PHONE(907)337-6179• FAX(907)339-3246•9E9ST1E:....ganw»wwi,..dng.c n
•PREPARED FOR: PHONE NUMBER: PAGE NUMBER: t •�� G. ess c 4�i it
TIM & TAMMY GILLS 727-8115 2 OF 3 V.(11.: CE-795
LEGAL DESCRIPTION: DRAWN BY: / •• ..
PARK HILLS #1; BLOCK 1, LOT 7 D.J.G./L.K.B. '� • 3'•'' �♦♦
TYPE OF WORK: DATE: /1.I'1�/I SS\�,.♦
RECORD DRAWING 4/24/2017 J
PERMIT NUMBER: PARCEL ID NUMBER:
OSP171040 RECORD DRAWING 017-142-10
ORIGINAL GRADE AT HIGHEST POINT
PER 1 2/1 9/2000 INSPECTION
REPORT - 101.50
T.H.#3
FINAL GRADE =
ORIGINAL GRADE AT HIGHEST POINT 103.99-104.13
0 EAST
PER 12/19/2000 INSPECTION NEST
REPORT = 98.86 2' INSULATION MT CO
T.H. 3 MT CO FINAL GRADE = 101.12-101.49
2' INSULATION
III LTER FABRIC
1 411111111W
ri..}1111.1°1-
PP:-
FILTER FABRIC
:;:;:•;
:� r..�-,c•. � •.•,
;; • ;';•;••';:�'�';:;:; TOP OF SAND . } ' As INVERT OF PIPE }
�, a• � t' 100.65
)h.�•e Z',, ''~cY INVERT OF PIPE = 100.15 ',` t::?C.tr _ •
TOP OF SAND = 97.38
.i..;.,..;
L=�' D� �r}'fir' 97.88 5.-I
I-- 5' BOTTOM OF EXCAVATION (AS BOTTOM OF EXCAVATION (AS •
REQUIRED FOR REMOVAL OF REQUIRED FOR REMOVAL OF
CONTAMINATED SAND): 95.91 CONTAMINATED SAND) = 99.17 •
•
ti RELATIVE ELEVATION OF •
BOTTOM OF T.H.= 92.0
GW AT 95.0 PER
OCTOBER 1999 SOIL LOG
k RELATIVE ELEVATION OF = 10 FEET :
BOTTOM OF T.H.= 89.36
GW AT 92.36 PER
OCTOBER 1999 SOIL LOG
i �G . ••,
GARNESS ENGINEERING GROUP, Ltd : / 4. iI•. \'f •••
CIVIL&ENVIRONMENTAL ENGINEERS 0
3701 E.TUDOR ROOD.SURE tot •MIC140101.0E.Mc 91007•PHONE(907)337-6179•FAX(907)336-3246•NEHSITE:m.ger r . . . 4.f • •
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: •f �� fir•, •. Gar ess: it
TAMMY & TIM GILLS (907)727-8115 3 OF 3 •• -i' CE-7•
LEGAL DESCRIPTION: DRAWN BY: S • •
PARK HILLS #1; BLOCK 1, LOT 7 D.J.G. •��+�'•P�••'�.�... A���+~
TYPE OF WORK: DATE: ICENSE4�I' FE�\ 44
RECORD DRAWING 4/26/2017 fAECC884
·' Municipality of Anchorage Page I af 3
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 Report
Permit Number:. SW000015 PID Number:. 017--142--10
a°ma:TlM AND TAMMY GILLS Wastewater Syetem: · New I-I Upgrade
'~*': ~'~""/~-~"~ABSO RPTION FIELD
2251 INNES CIRCLE ANCHORAGE, AK 99515
NO. of Bedrooms:
Ph°ne:(907) .345-8571 4 nDeep Trench · Shallow Trench rlBed r~Mound mOther
LEGAL DESCRIPTION 1.o ~ "` 1.58 v~x. To ToP or
7 I PARK HILLS =! -0.95-0.95/0.7-1.01 r~ 0.5 0.5 "`
Township: IRo~e: ISectj°n: Fe ~ .t.~ ~ ,me.: ~ ~
- - - SEE PROFILE DRAWING,. 120 (2 ~. 60') "`
WELL: · New I-I Upgrade 5 ~ 2J 15'+
PRIVATE 247 "` 247 "` 600 so. "` ASTM D-3034/F-810
~ ~. ~: s~ ,~., ~.~: '"'~'OWNER INSTALL ~' '~'"~: 7/6/2000
ALPINE DRILUNG 3/9/00 61 ~
15 ~. 247 "` 2 "` TANK
SEPARATION DISTANCES · s,.u: =.o,d~ng
To SepUc ~o~Uo, Uft H~n~ ~"~/P~'"~ (~REER TANK 1250
well 100'+ 100'+ - - 25'+ STEEL 2
s.,a:, ~oo'+ ~oo'+ - - - LIFT STATION
Water
Lot 5'+ 10' - - -I GREER
Une 500
Found¢=tlon 5'+ 10'+ -- -- - 42" 51 '
CurtalnDm[n N(I,NE KNOWi LS500-81600 M.O.A.
,er. ar~: BENCH MARK
GOOD SOILS ENCOUNTERED IN TRENCH EXCAVATION. TOP OF LIFT STATION MANHOLE LIDE.
ORENCO SCREENED BASKET WAS INSTALLED IN UFT STATION.
._-:..__ r..-,~. 100.36
6/,/2ooo " ..... "1f .....
3rd 6/3/2000 ~ ~ ,. ,: c..~..... ~.~..:....,
4th 6/4/2000 ~ *J Je frd A. O~J ess:
6/4/ ooo a:-Tg
Department of Healtl;t-and I-I,u~,~lal~ Serylce. s,approval ~.~o." ............ -'
,,-,,,Reviewed(,... ,/~,)and~ approved= by: _/v..j? ~ .~ '/'~c~ Date:4t -/~ -0/ ~1~[~. ~, a, e, ,,o~°_~='~
AS BUILT DRAWING .~,D N~D~:
PERMff NUMBER:
SW000015 017-14.2-10
RIVERTON AVENUE ~
°o.~~ls ~N~ ~ /
~ I ~ I ~' I I
X / / ~ · '
~ ~~'~/' / / co, ,~.* ,,~.o,
~.~_ ~~~/ // :"
~ ~ /
.... ·
P~ HI~ D~
AI~[SI~ ~VATER & ~STE~FER c.J.o./n.~.w. ~¢..~j¢~ ~'~,~. .
CONSULTANTS, INC.
TI" AND 'AUU' GIL~ (go') '45-8571 2 OF' ~~...
PARK HIL~ ~UBDIVISION; LOT 7, BLOCK 1,
AS-BUILT DRAWINO OF NEW WELL LOCATION AND SEPTIO SYSTEM
SW000015 017-142-10
/~ N~W 12~0 ~LON ~ N~W ~ ~LON
~ST ~ ~ST ~CH
"OP OF ~D ,SI Mf~ 1' /
CONSULTANTS, INC. ~ N.T,S,
~E OF WOR~
PROFILE AS-BUILT DRAWING OF NEW SEPTIC SYSTEM
· ' FROtl : FP~ NO, : D~c, 15 ~ 03:23P~1 P1
DEC 13
INSP. ECTOP,:
08/09/00 14:13 FAT 907 5625449 Alaska ~map&Supply ~.
~-le*.-~ 1~'.39 HD FOULER - oCYt'IPI~
12" Biotube® Pump Vaults
~r use with Omnco 4" Submersible Effluent Pumps
General
3~ 4:3~ 6'~1
SubmitS1 ~
~P ~ ~
Data Sheet
.Ore,co 1Z' Bintube Pump Vau~ am
O~_neo I:Z" I~Jmp VaukS am '~":ed~ m
semi. efllue~l~ng pumped
s~ tad~s or sep~ram d~ l~n~
X4~1248~1819, X6S1254-1819,
X4S1Z54-161g. X5S1260-2424,
X451260-2424, X5512'/2-3~6,
X4512'/2.3636.
Specifications
Md~efials d
TOTP/- P.I~2
Rick Mystrom
Mayoc
Municipality of Anchorage
Department of Health and Human Services
825 'L' Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
hit p:l/www.ct.a ncho ra ge.I k.us
Permit Number: #SW 000015 Date eflssue:.2-10-O0
Date Started: 3-8-00 Date Completed: 3-9-00
Legal Deacriptio~i
Property OwnerName & Address:
Borehole Data:
Soil Type, Thickness & Water Strata
Parcel Identification .Nh rn he~ .017-142-10
Is well located at approved pe~iiilt location? [] Yea [] No
Park Hills #1 blk 1 It 7
stick-up
organic & silt
gravelly silt
gravel
gravelly silt
sandy silt
bedrock
Tim & Tammy Gills
2251 Innes Circle
A~'herage, Ak ~515
Depth (ft)
From To
RECEIVED
IVlAR 1 ~ ~000
Municipahty ol Anchorage
Dept. Health & Human Servlcel
0 2
2 4
4 11
11 22
22 51
51 59
59 247
Method of Drilling [] air rotary [] cable tool
Casing type: steel
Wall Thickness: 025 inches
Diameter: 6 inches Depth: ~ feet
Liner Type:
Diameter: inches Depth:
Casing stickup above ground: 2 feet
feet
Static water level (fi.om ground level): 6_.L/feet
Pumping level: 247 feet after
_2 hours pumping ~ gpm
Recovery Rate:/5 gpm
Method of Testing: airlift
Well Intake Opening Type:
[] Open End [] Open Hole
[] Screened Start feet Stopl~
[] perforations Start feet Stopped
Grout Type: bentonite#8 Volume: ~bgs
Depth: Start.q0 feet Stopped:feet
Pump: Intake Depth __ feet
Pump size hp Brand Name
Well Disinfected Upon Completion? [] Yes [] No
Method of Disin fection:~ clorfne tablets
Comments:
Well Driller: Alpine Ddlling & Enterprises
P.O. Box 110496
....... Anchorage AK 99511 · - ·
~ "Yfl~'we~'~'~ll provide a well log to the property owner with~ 30 days of completion and the property
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 WASTE1NATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Initial
Date Issued: Feb 10. 2000
Expiration Date: Feb 09. 2001
Permit Number: SW000015
Legal Description: PARK HILLS #1 BLK 1 LT 7
Design Engineer: 0041 AK Water & Wastewater Consultant
Owner Name: Tim & Tammy Gills
Owner Address: 2251 thnes Cir.
Anchorage. AK 99515-
Parcel ID: 017-142-10
Site Address: 014630 PARK HILLS DR
Lot Size: 50945 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Privy
[] Private Well [] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. Ail requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours 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 day.
B. Covered. sealed, and heated to prevent freezing.
Received By:
Issued By:
oo
ALASKA WATER
CONS .U LTANTS, INC.
lanuary 7, 2000
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Well and Septic System Design for Lot 7, Block 1, Park Hills Subdivision
To whom it may concern:
The proposed 4 bedroom house will be served by a private well and septic system. Several test
holes were excavated on the property. The proposed septic system will be designed around the
30 foot radii of test hole/13 and//4. Comments regarding the proposed design are summarized as
follows:
1. SOILS: Attached are logs which shows the soil profile, and the pemolation test results. In
TH#3 and TH#4, the soils below the organic layers are a GP material to a depth of 4 feet in
TH//3 and to a depth of 3 feet in TH#4 and then the soils transitions to a ML material to a depth
of 6 feet in TH//3 and 4 feet in TH#4. At 6 and 4 feet the soil transitions to a GM material to a
depth of 9.5 feet in TH#3 (bottom of test holes) and 9 to 10 feet in TH//4. At 9 to 10 feet, the
soils transitions back to a ML material to a depth of 11.5 feet in TH//4 (bottom of test hole).
Groundwater was encountered during the excavation of the TH//3 at a depth of 8.5 feet. After 8
days, the monitoring tubes were checked and groundwater was found to be at 6.5 feet in TH#3
and at 8.0 feet in TH#4. Two percolation tests were performed in TH#3; one between the depth
of 3.5 feet to 4.0 feet which had a percolation rate of<i minute/inch and one between the depth
of 5.5 feet to 6.0 feet which had a percolation rate of 10 minute/inch. One percolation test was
performed in TH#4 between the depth of 5.5 feet to 6.0 feet which had a percolation rate of 12.6
minute/inch. We are proposing that the drainfields be installed in the GP material with the use of
a leveling sand. Given the percolation rate of <1 minute/inch for the GP material, it is our
opinion that the insitu soils should act as a sand filter and that a 1.0 application rate should apply.
2. TRENCIt DESIGN:
a. Percolation Rate: <1 minutes/inch
b. Allowable Application Rate: 1.0 gallons/day/ft2
c. Number ofBedrooms: 4
d. Design Flow: 600 gallons per day
e. Minimum Absorption Area: 600 fi2
f. Total Depth: 2 feet (max.)
RECEIVED
FEB 08
'4VIIK)Nh, Mh~ql'AL Srr. JI ¥1C~s ~
6901 Debarr Road, Suite 2B ~ Anchorage, AK 99504 ~ (907)337-6179 - Fax: (907)338-3246
g. Effective Depth: 0.5 feet
h. Leveling Sand: 0.5 to 1 feet
i. Width: 5 feet
j. Reduction Factor: N/A
k. Minimum Length: 120 feet total length (2 I~ 60 feet long each)
1. Effective absorption area = 600 ft2
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed
upgrade.
4. TOPOGRAPHY: As can bee seen on the attached topography site plan, the average
topography of this property is a 15 to 20 percent running from approximately east/northeast to
west/southwest; in short, there are no slope concerns. The trenches are to be installed parallel to
slope contours.
I am unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you
for your assistanj/c~.
Sincerely,i .~ I
'-a ri v^l aamess, ?.E., M.S.
Pr~id~nt!
NOTE:/lttached is a site plan drawing, a design drawing, a detail drawing, a topography site
plan, fottr soils logs and a construction specification letter which are all part of the design
package for this septic system.
RECC,.IVED
6901 Debarr Road, Suite 2B ~ Anchorage, AK 99504 - (907)337-6179 - Fax: (907)338-3246
P
i i
' / \ II
I I II
~AS~ WA~R~ WAS~WA~R CONS~T~S, ~C.
P.O~e (.07) ~7-~/r~: (,07) ~-~2~ ~b'"- ~' ,'.~
PARK HIL~ SUBDIVISION; LOT 7, BLOCK 1 ~; ..........................
SITE P~N FOR PROPOSED WELL LOCATIO~ A~D SEPTIC SYSTEM
~45-8571
TIM AND TAMMY GIL~ (907)
J.LM. 1 : 100' I OF 5
-L
I~VO TRENCHES THAT ARE 2 FEET
DEEP (REMOVING ALL ORGANICS BY
/5 FEET WIDE BY 60 FEET LONG EACH.
· ADD 0.5 TO I FOOT OF M.OJL APPROVED
LEVEUNG SAND AND THAN ADD 0.5 FEET
OF CLEAN, WASHED SEWER DRAINROCK.
(SEE DETAJL DRAWING, PAGE
/ I
/ I
/ /
I /
I /
NOTE: THE CONTRACTOR SHALL HAVE THE NORTHI
PROPERTY UNE AND THE NEIGHBORING 100 FOOTI
WELL RADIUS FLAGGED BY A REGISTERED LAND
SURVEYOR PRIOR TO ANY CONSTRUCTION OF THE
SEPTIC SYSTEM.
\
%
ALTERNATE srTE. MAY REQUIRE
1~£ US[ OF A UFT ~TATtON
A INNOVAllV~ SYSTEM ~
ALASKA ~/A~ AND 'vVASTE'~VATEE CONSLU~TANT$, INC.
6905 DE~R ROAD. SUITE 2B. ANCHORAOE. AK. 69504
PHONE (907) ~.37-6179/FAX: (907) 338-5246
DESCRIPTION:
PARK HILLS SUBIDVISION; LOT 7, BLOCK 1
OF WORK:
DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM
PREPARED FOR: PHONE NUMBER:
TIM AND TAMMY GILLS (907) 345-8571
1/7/2000 J.L.M. 1 = 40' 2 OF
FLOW SPU1TER
DBLCO
~ROPOS£D 1250 GALLON
SEP~C TANK
LOCATION
FINAL
ORIGINAL
FINAL
CO
ORIGINAL
MT
--ADD 0.5 TO 1 FOOT OF
M.O.A. APPROVED SAND FILTE
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
6901 D~ARR ROAD, SUITE 32. ANCHORAGE, AK. 99504
PHONE: (907) 357-6179/FAX: (907) 558-3246
.[GAL DESCRIPTION:
PARK HILLS SUBDIVISION; LOT 7. BLOCK 1
Ft'P£ OF WORK:
DETAIL DRAWING OF SEPTIC SYSTEM
~REPAR£D FOR: PHONE NUMBER:
TIM AND TAMMY GILLS (907) 545-8571
~Z~l/7/2000 ID~w" ~: Isr-~'u-~ IP~'
J.L.M. N.T.S. 5 OF' 5
ALASKA WATER & WASTEWATER CONSULTANTS, INC. ,=.,-
ISOIL LO0 - PERCOLATION TESTI F~...-'~F~
~GAL ~SCRIPTJON: P~K HIL~ SUBD~SlON; LOT 7, BLOCK 1
PERFORUED FOR: ~. ~D T~ 0'~
DATE PERFORUED: 8/2/9g
TEST HOLE ~1
OR~IC (PAGE I OF 2)
ou ~ ow _~ oR~
~ ~, SW MH
SP CH
SM OH /
10
UL (~SU~Y
11~ IMPERM~) DATE RE. lNG CLOCK NET TIHE WATER LEVEL NET DROP
TINE (HINGES) RE, lNG (INCHES)
12j~u~j 8/3/99 PERC. HO~ W~ PRESO~ED 4+ HOURS PRIOR TO ~NG
1 3:45 ~
13 2 4:15 10 I' 5'
3 4:16 ~ 6'
14 4 4:46 10 1 1/8" 4 7/8'
5 3:45 ~ 6'
15 6 4:15 10 I 5/8' 4 3/8'
16 7 4:16 ~ 6"
8 4:46 10 1 15/16' 4 1/16'
17 9 4:15 ~
10 4:16 10 2" 4'
18 11 4:46 ~ 6"
12 4:16 10 2 1/16" 3 15/16'
19
PERCO~TION ~TE 2.5 (HIN./INCH) PERC. HOLE DIA. 6 (INCHES)
2 TEST R~ BETWEEN 3.5 FT. ~D 4.0 FT.
COHHENTS: P~CO~ON DATA ON ~IS PAGE FOR UPPER BENCH PERC. HO~ ONLY.
PERFORMED BY A~ WATER A W~ATER. I, JEFFR~ A. GARNESS, CERTI~ ~T ~IS
W~ PERFORMED IN ACCORD~CE W~ ~ ~ATE ~D MUNICIP~ GUlDEUN~ IN EF~ ON
DATE:
DEPTH TO DATE
3ROUNDWATER
DRY 8/2/99
8.2 8/9/99
ALASKA WATER & WASTEWATER CONSULTANTS, INC. ~-~'~ 0~.
6901 DEBA~R ROA~. SUITE 2B * ANCHORAGE. AK. 99.504 ~:~.~/.'~'°'
[SOIL LOG - PERCO~TION TEST] ~j/~
LEGAL DESCRIPTION: P~K HI~ SUBD~SlON; LOT 7. BLOCK 1 ~~~' ~ ......... ~ .......
PERFORMED FOR: ~M ~D T~ Cl~ ~.~f~ A. Oame.~: ,
DAT~ PERFORUED: ~/2/~. '~-~3 ....'
.~ TEST HOLE ~1 '~,_'%.~....:...'
1 ~ (PAGE 2 OF 2) '~%[?o~essto~.~~
2-- I I N ~~,X',,/
'- °,,I/
5-- I SP CH
7-- ~ DEPTH TO DATE
. GROUNDWATER
10-- ~ I /
11-- ~ DATE RE. lNG CLOCK NET TINE WATER LEVEL ~ NET DROP
~ TINE (N N~ES) RE.lNG (INCHES)
~ 8/~/99 PERC. HO~ W~ PRESO~ED 4+ HOURS PRIOR TO
12--
°
~ 1 ~:45 ~ 6'
13--
~ 2 4:15 ~0 6~ O"
~.- [ ~ ~=~.--_~-__ --
~ 4 4:46 ~ 6' O"
~5- o ~
19~ PERCO~TION ~TE. 120+ .(HIN./INCH) PERC. H~ DIA. 6 (INCHES)
20 TEST R~ BETWEEN 5.5 FT. ~D 6.0
COHHENTS: PERCO~ON DATA ON ~IS PAGE FOR LOWER B~CH PERC. HO~ ONLY.
PERFORMED BY A~ WATER & W~ATER. I. JEFFR~ A. C~NESS. CERTI~ ~T ~IS
W~ PERFORMED IN ACCORD~CE W~ ~ ~ATE ~D MUNIClP~ GUIDEUNES IN EF~ ON
DATE:
ALASKA WATER & WASTEWATER. CONSULTANTS, INC.
PHONI~ (907) ,3,,37-6179 "FAX (907) 338-3246
ISOIL LOG - PERCOLATION TESTJ
PERFORMED FOR: TIM AND TAM~,,~f GILLS .... ~. ............. : ....
DATE PERFORMED: 8/2/99
TEST HOLE #2
I~ SOUTH HOL~
ORC, ANIC
IsP , CH
DEPTHTO DATE
GROUNDWATER
SEEPING 0 8' 8/2/99 mi
8.2 B/9/99
10~ ML (VISUALLY I :~.~~
_t-~IUPERUEABLE) CLOCK NET TIME WATER LEVEL NET DROP
11 DATE READING TIME (M)N~ES) READING (INCHES)
12 8/3/99 PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESllNG
1 3:43
13 2 3:53 10 2 1/2' 3 1/2'
3 3:53
14 4 4:03 10 2 15/16' ;3 1/16'
5 4:04 ~ 6"
15 6 4:14 10
16 7 4:15 ~ 6"
8 4:25 10 3' 3"
17 9 4:26
10 4:36 10
18 11 4:37
12 4:47 10
19
PERCOLATION RATE ,3.3 (MIN./INCH) PERC. HOLE DIA. 6 .(INCHES)
2 TEST RUN BETWEEN 4.5 FT. AND 5.0 FT.
COMMENTS:
PERFORMED BY ALASKA WATER & WASTEWATER. I, JEFYAEY A. OARNESS, CERTIFY THAT THIS
WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEUNES IN EFFECT ON
DATE:
DEPTH TO DATE
GROUNDWATER
SEEPING 0 S' 8/2/99
8.2 8/9/99
ALASKA WATER & WASTEWATER CONSULTANTS, INC.
6901 OEBA~R ROAD. SUITE 28 ' ANCHORAGE. AK. 99504
PHONE (907) 337-6179 * FAX (907) 358-5246
PERFORMED FOR:. 11U AND TAU~Y 6~LLS
DATE PERFORMED: 10/4/99
ITEST HOLE #3I
OR N CS (NOmWEST .Om)
2 CP ~ GW ~ ORG
' 66 OL
% T~ST HOLE LOCATIONSl / y
ML SP CH
5 ~ SH OH
DEPTH TO ; .THI'~
GROUNDWATER DATE '-
8.5' 10/4/99
7.2' 10/5/99
11 DATE RE'lNG CLOCK NET TIHE WATER LEVEL NET DROP
TIHE (HINGES) READING (INCHES)
12 10/5/99 PERC. HO~ W~ PRESO~ED 4+ HOURS PRIOR TO TE~NG
1~ 1 5:07
2 5:~7 ~0 2 15/16" 5 ~/16"
14 ~ 5:~8
4 6:08 ~0 2 15/16' 3 1/16'
15 5 6:09 6'
16 6 6:39 30
17
18
19 PERCO~TION ~TE 10.0 (HIN./INCH) PERC. HOLE DIA. 6 .(INCHES)
~ TEST R~ BETWEEN. 5.5 FT. ~D 6.0 FT.
PERFORMED BY A~ WATER & W~ATER. I, JEFFR~ ~ GARNESS, CERTI~ ~T THIS
W~ PERF¢R~D IN ACCORD~CE WEH ~ ~ATE ~D MUNIClP~ CUIDEENES IN EF~CT ON
DATE:
DEPTH TO
GROUNDWATER DATE
8.5' 10/4/99
7.2' 10/5/99
6.5' 10/12/99
ALASKA WATER & WASTEWATER CONSULTANTS, INC. ,=-,- o.F....A_ ~[~
[SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: PARK HILLS SUBDNI$ION; LOT 7, BLOCK 1
ORGANICS TEST HOLE #4 ~;.,',,,.. · .... o~.?
1 -~- (NORTHEAST HOLE)
GC OL ,~r ~ lOCATIONS
SW MH
SP CH
SM OH
OM DEPTH TO DATE
GROUNDWATER
lO_jljjjjjI-jljllljj ML CLOCK NET TINE WATER LEVEL NET DROP
11 DATE READING ITINE (NINUTES)READING (INCHES)
12--~ 10/5/99 PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING
15 1 5:01 6"
14 3 5:52 6'
4 6:02 30 3 9/16' 2 7/16"
15 5 6:05 6" __
16 6 6:55 30 5 5/8' 2 3/8'
17
16
19 PERCOLATION RATE 12.6 (HIN./INCH) PERC. HOLE DIA. 6 (INCHES)
2 TEST RUN BETWEEN 5.5 FT. AND 6.0 FT.
CONNENTS:
PERFORMED BY ALASKA WATER & WASTEWATER. I, JEFFREY A. GARNESS, CERTIFY THAT THIS
WAS PERFOJRMF, D IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON
DEPTH TO DATE
GROUNDWATER
DRY 10/4/99
9.3' 10/5/99
8.0' 10/12/99
•
Municipality of Anchorage
-
On-Site Water&Wastewater Program
(907)343-7904 " mid r
Certificate of On-Site Systems Approval
Parcel I.D. 017-142-10 Expiration Date: e-
1.
j 1
1. GENERAL INFORMATION
Complete legal description PARK HILLS#1;BLOCK 1, LOT 7
Location (site address) 14630 PARKHILLS DRIVE"ANCHORAGE,AK 99516
Current Property owner(s) TAMMY AND TIMOTHY GILLS Day phone 519-5133
Mailing address
Real Estate Agent Day phone
2. TYPE OF DWELLING:
IN Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings(Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well S Individual On-site U
Individual Water Storage ❑ Individual Holding tank ❑
Community Class Well ❑ Community On-site ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for N/A Distance: -
Received by: Date: Vi t 7/7
COSA to be released to the engineer,unless otherwise requested by the engineer.
COSA Fee$ Ia2 - Waiver Fee$
Date of Payment K1 /9" Date of Payment
Receipt Number 03CReceipt Number
�}
COSA# U 5 C/71 ,3 Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my
investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is(are)safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the
information obtained from the Municipality of Anchorage files and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are)in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP,Ltd. Phone 337-6179
Address 3701 E.TUDOR ROAD,SUITE 101 'ANCHORAGE,AK,99507
Engineer's Printed Name JEFFREY A.GARNESS,P.E. Date 4 I3'3')tq—
Engineers Comments:
In conducting this evaluation,GEG provided an engineering evaluation of the well andlor septic system in accordance with the �. �r«a a i ,`
guidelines and regulations established bythe Municipality ofAnchorage and industry practices.The reporedresults describe the •��(� CF ' �.
condition of the systems on the date's of the evaluation.Separation distances were measured to readilyidentifiable features. ` 4 ��
Hidden detects or encroachments may exist that were not identified during the evaluation.The operational life of all wells and septicv 1►,
systems depend on a variety of vanables including,but not limited to,soil conditions,groundwater levels(that may tuctuate duringtI— o
the year),quality of construction(materials and workmanship),and the water usage of the family utilizing the system's.These
cri. ........,
4 %N ';* I.
conditions can vary,and are outside the control of GEG.Satisfactory test results do riot guarantee fu(ure pedonnance of the
..11,...1.11, t 0
system's;therefore.GEG makes no warranty(express or implied)regarding the future performance of the well or septic system. • (7
GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the .. f 1
current systems fail.The content of this report is for the sole benefit of the person/party who retained GEC.Reliance upon the f f A G a me- r s
intonation provided in this report by any other person or party.including but not limited fo subsequent properly purchasers,is not f;t�: CE-795 I F
authorized.In short.GEG disavows any legal duty to anyone other than theperson/parry who paid for this report. •'J) .. i •
6. DSD SIGNATURE ��,♦r, , ESS\ 1 P .•
* C LICENSE ���1r�r
�
�t,
J\JC/ iJAECCfi84
System#1 Approved for t bedrooms.
System#2 Approved for bedrooms.
..\,..\-' \(
q
a� N
Disapproved. Q 06,
go
Conditional approval for bedrooms,with the following stipulati ams: ON-SITE Y.'0'.
WATER AND ill'.
WASTEWATER o
PROGRAM .
9<') ���
07 rp\l1[.
r��
By: '<I--vin LOriginal Certificate Date: 6 / — r 7
The Municipality or Anchorage Develop,emt Services Division(DSD)issues Certificates of On-Site Systems Approval(COSA)based only
upon the represenatations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTCHMENTS:
COSA Checklist Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
(Rev.10/12/121
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system
Certificate of On-Site Systems Approval Checklist
Legal Description: PARK HILLS#1; BLOCK 1, LOT 7 Parcel ID: 017-142-10
A. WELL DATA *PER CONVERSATIONS WITH ARROW PUMP AND WELL ON 4/27/2017
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed 3/9/2000 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 247 ft. Cased to *60+ ft. Casing height(above ground) 18+ in.
FROM WELL LOG AT INSPECTION
Date of test 3/9/2000 3/30/2017
Static water level 61 ft. 74.8 ft.
Well production 15 g.p.m. 2.6+ g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml. Nitrate 0.128 mg./L. Collected by: GEG, Ltd.
Arsenic: ND ug./L. Date of sample: 3/30/2017
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Date installed 6/3-4/2000
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout(Y/N) YES Depression over tank(Y/N) NO High water alarm (Y/N) YES
Date of pumping 8/22/2016 Pumper A+ HOME SERVICES
C. ABSORPTION FIELD DATA L*BELOW FINAL GRADE WEST/EAST
Date installed 4/20-21/2017 Soil rating Cp.d. r ft2/bdrm) 1.0 System type SHALLOW TRENCH
Length 60/60(120 TOTAL) ft. Width 5.0&5.0 ft. Gravel below pipe 0.5/0.5 ft.
Total depth *3.7-4.1 ft. Eff. absorption area 600 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test NEW Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test - in. Water added - gal. New depth - in.
Elapsed Time: - min. Final fluid depth - in. Absorption rate>= 600+ g.p.d.
Any rejuvenation treatment(past 12 mo.) (Y/N &type) - If yes, give date -
*PER DATA PROVIDED BY ARM SERVICES WHEN LIFT
STATION WAS SERVICED ON 4/24/2017
**PER 2000 INSPECTION REPORT
D. LIFT STATION
Date installed 6/3-4/2000 Size in gallons 500 Manhole/Access (Y/N) YES
"Pump on" level at *38 in. "Pump off' level at *34 in. High water alarm level at *40 in.
Datum BOTTOM OF TANK Cycles tested * Meets alarm & circuit requirements? **YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main 75'+ Public sewer manhole/cleanout '100'+
Sewer/septic service line 25'+ Holding tank 75'+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 104- Building foundation 10'+ Water main 10'+
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
.•••ssiiiii'II
G. ENGINEER'S CERTIFICATION =' ;•• '' t.4 41.•.•
irc-,.:' '... •..
♦♦♦.
I certify that I have determined through field inspections and ' 4 '• .. •* ♦.
review of Municipal records that the above systems are in •• , •
••• •
conformance with MOA COSA guidelines in effect on this •• •
date. • � - A. or -ss c i
Engineer's Printed Name JEFFREY A.GARNESS •• Li> •
E-795 :'���
Date ♦ •
Fp''•p• • ....1 .1",_\� ••
���1�� LICENSE It ESSIm:•••
#AECC884 ,��sv,
(Rev.10/12/12)
•
RIVERTON AVENUE (Not built) 8454K
S89°47'24"E 218.15
0,
cb
Septic Jet`
0
//Manhole
e � She
8
t�
Septic vec*
Oi C• 6. 2°. r)
Q nuwn 0 N ,0 $
C''") 4, 1650 44
,, ,,, 25
". - Co
63. O.)`' a I
r,) .z::, N Lot 5
Lot 8 - 1O6. -
25•
Q
ZSCALE: 1"= 50'
b Wel l cy'
Lot7 / r MV'
1 / / w
I // // M
/ /.. /oer •NN♦\\
QC)
OF % 1
� /: / //� _ PMI �F' • • A ;gsll
'/ J' 'L? Lot 6 • 49th j\ •`7 �,
— —. J h i link �^:/fY•.FCriLed`/1Wa l a t k a ; a f
_ /oham C,
15' T& E �� ' �$ `'1:,• 3255 - S ••�e��
Easement I J
Q R-300.81 L`1 `l$ `�4OFeSSIONA�•`p��
Cr) 03.97 \ 1\\X.S.%�
PARK HIL 7'c
LS pRIVE I hereby certify that I have performed a Mortgagee's inspection
\ of the following described property LOT 7. BLOCK 1,
PARK HILLS,.SUBDIVISION, ADDITION No. 1
Anchorage Recording Precinct,Alaska,and that the
improvements situated thereon are within the property lines
and do not overlap or encroach on the property lying
adjacent thereto,that no improvements on the property lying
adjacent thereto encroach on the premises in question and
that there are no roadways, transmission lines or other
visible easements on said property except as indicated
hereon.
Dated at Anchorage,Alaska
this 24th day of APRIL , 2017.
EASEMENTS OF RECORD, OTHER THAN
THOSE SHOWN ON THE RECORDED FRED WALATKA&ASSOCIATES
PLAT ARE NOT SHOWN HEREON. FSS, FB 17-3, 9 Engineers and Surveyors
P9 BE (907-248-1666)
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
., _ .. ~ ...4700 South Bragaw SL. ·
" -' I~'~. Box 196650 Anchorage AK 995196650
· . .. ·w,~v.cLenchorage.ak.us
" ' ..... [907) 3437904
( ERTIFICAT'E. HEALTH AUTHORITY APPROVAL
FO 'A'SiNGLE FAMILY DWELLING
Parcel I.D. 017:142-10
t. GENERAL INFORMATION
HAA
Expiration Date:
Complete legal description PARK HILLS SUBDMSION; LOT 7~ BLOCK 1
LocaUon (site address or directions)
-
Real ~s~te ~enF~
Mailing address
PARK HILLS DRIV~
TIM AND TAMMY
2251 INNES CIRCLE * ANCHORAGEt AK
Day phone
99515.
Dayphone
345-8571
Day phone -
Unlesso~erv~semqueste~HAA~llbeheMbyDSD~rplck~.
2. NUMBER OFBEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual Well ~
Individual Water Storage
Community Class Well [~
Public Water System
TYPE OF WASTEWATER DISPOSAL'.
Individual On-site
Indivlduai Holding tank
Community On-site
Public Sewer
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given In paragraph 5 by an Independent professional civil
engineer registered In the State of Nast~a. Ce~ficates of Health Authority Approval are required for the transfer
of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or
water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority
Approval are valid for 90 days from the date of Issue for prope~es served by a private or Class C well and may
be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of
up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B
wells or a public water system. The Municipality cf Anchorage Is not responsible for errors er omissions In the
professional engineer's work.
Note:Alaska Water and W. astewater Consultants, Inc. shall be paid $615.00 at, or pdor I: . "
t°d°sinof°rtheengineenngservicespr°vided'/'~':"""':~:*'~"" ;'" "'~ ~' :~*" ~: ~,1~',~"! ,. *.~
As cerUfied by my seal affixed hereto and as c~ the valldaUon date ~.below, l verify ~t m~ ... ,, ~ ,-:..
snows mat the on-site water supply and/or wastewater disposal sys~m Is(am) safe~, func~onal ~md a'deq~ate ,
for the number'6f bedrooms and lype of structure Indicated hemln, d ~rther verify that besed on the?;
on-she wa!er, sUpp~, and~ wa, stewater disposal.system Is(am)
and State codes, ordinances, and mguisffons ln effect at the tlme of lnstallatton.* '
Name of Firm ' ALASKA WATER &:'WASTE'WATER CONSULTANTS.' INC. Phone 357=6179
Address 690J-D£BARR-ROAD. SUITE 2B *,ANCHORAGE..AK:99504-- '
Engineer's Comments:
In conducting this evaluation, AWWC, Inc attempted to provide a thorough,
consdenttous engineering anal/sis of the system In acc~denoe with ADEC and MOA
system under the conditions encountenad at the time of the tse~ end separation .
distances tneasured to readi~y ldentiflable features. The operaffonal life of all wells and
septic systems depend on the Iocal seiTs condition, groundwater levels that may...
results do not guarent~e f~ure pen~manoe o~ ~ system, n~ do they guarantee that
there are no hidden defects or encroachments. A~4/C, Inc. can therefore not provide
any warren~y or future eSb'rnate of how long the system w#l continue to meet the '
operational requirements of the ADEC or MOA DSD. The content of this report Is f~r
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other persen or party Is not au~horized, nor will lt c~nfer any legal dght whatsoever.
5. DSD SIGNATURE
Approved for ._._~
Disapproved.
Conditional approval for __
bedrooms. . ,.k~.%~ ,.-., - · ... ~.~,~
' ON-SITE
bedims, wi~ ~e fllo~ng sUpulaUons:~ · WATER AND
: WASTEWATER
Attachments: I-IAA Checldist
Septic System Advisory
Well Flow Advisory
(P,~.
Manitanance Agreements
Supplemental Engineer's Reort
Other ·
Original Certificate Date:
Municipality of Anchorage
Development Services Department
On-8~ Water & Wast~w~m Program
4700 So~h Omgaw 8L
P.O. Box 196650 Anchorage, A~ g951g-6650
HEALTH AUTHORITY APPROVAL CHECKLIST
PARK HILLS; LOT 7~ BLOCK 1 Parcel ID:,
017-142-10
A, WI;LL DATA
Well type
rote competed 3/9/00
Total daptb 247 ft.
IfA. B, orC provide I:'WSID~ N/A
Genital/seal (Y/N) YES
wen Log (Y/N).
Vv~s pmpe~ protecte~ (Y/N)
Da~ng be~;ht (abeve ground)
24
Date of test
Steflc water level
Well prodl..,cffcxl 15
WATER SAMPLE RESULTS:
Collf~m 0 colonies/100 mL
Date of sample: ~'
FROM W~ l LOG
3/9/00
51
B. SEPTICDIOLDING TANK DATA
.lt.
g.p.m.
AT INSPECTION
AWWC, INC.
F~?..D~, pmsslon over teak (Y/N) NO
Date Inst~ed 6/4/00
C~anoute (Y/N) YES
High water almm (Y/N) N/A
NEW
8ystemtype SHALLOW TRENCH
Gmval below pipe 0.5 ft.
Total depth. ~.~ .It. Fit'. absc~n ama 600 It' Monitoring tube YES Depression over field, NO
Date of edaquacy test NEW Re~ult~ (Pass/Fail) PASS Fox 4 bedroom~
Fluid depth In ebseepfion field before test In, Wa~r~
nt (past 12 mo.) (Y/N & type) ffyes, give date
D. UFT STATION
Date Installed 6/4/00
'Pump on' level at 42 In.
OBtum BO1TOM OF TANK
E. SEPARATION DISTANCES
Size in gallons ' ~t~o
· Pump ofi' level at ;51 In.
Cycles tested NEW
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tenk/lift ~atlon on lot 100'+
Absorption field on lot 100'+
Public sewer main N/A
Sewer lesptic esrvloe line 25'+
Hlgh water alarm level at 51
Meets alarm & dmult requirements? YES
On adjacent lois 100'+
On adjacent lote 100'+
Publio eswer manhole/cleenout
tank N/A
25'+
Buliding foundation 5'+ Property line 5'+
Water main 10'+ Water eswlce line. 10'+
Wel~ on adjacent lots 100%
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Absorption field. 5'+
Surface water, lOO'+
Water main
Proper~ llne 10'+
Water esntlce line. 10'+
Curtain drain NONE KNOWN
F. COMMEN'r~
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT ~
Bu~a'ing foundaUon 10'+
Surface water 100'+
Wells on adjacent lots. 100'+
10'+
Driveway, peddng/vehlcte storage
ill.
50'4-
, FeeS ,e
(Rev. ~2~o)
Waker Fee $
Date of Payment
Receipt Number
10/14/00 IS:lO '~' ~003/003