HomeMy WebLinkAboutT14N R1W Section 17 NE4 SE4 NW4 Unit 10T14N RIW
Sec. 17
E2 SE4 NW4
(Whitestone Estates Unit#10)
#067-311-01-010
Municipality of Anchorage
. Development Services Department •"°E @° <°
Building Safety Division ,E - ,
-EE
On -Site Water & Wastewater Program, 4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SW050310 PID Number. 067-311-01
Name:
RANDY WEDDEL
Wastewater System: ❑ New ■ Upgrade
Address:
20740 PTARMAGIN BLVD * EAGLE RIVER, AK 99577
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 349-1183 5
O Deep Trench ■ Shallow Trench 13Bed UMound Mother
LEGAL DESCRIPTION
$°° "°" 2 0
Total 0pa from orbit
GPD/Sq
FL 75 MAX Ft.
Block: Lot: Subdivision:
— 10 WHITESTONE ESTATES
Depth to pipe bottom frau original grade,
SEE DWG.
Gravel depth beneath pipe
1.02
Ft. in,
Township: — Range: Section:
FII added above or heal grade:
GMVN *10:
_ —
SEE DWG.
Ft. 75 pt,
WELL: ❑ New ❑ Upgrade
Growl Wow
5
Number of Ares:
1
DIetono beNwn Ilrx .
—
R
Ft.
Claninostlon drab. A&C): Total Dpth: Cased Ta
Told oboorption area:
Pipe material:
Ft.
375+ so. Ft.
D 3034/ F-810
Ddwr. dkd: static Yater Levo:
Imtaler:
GEG, Ltd.
pate pieta
8%24-25/2005
Ft.
YNId:
Pump set AaCoring
Height Above Ground:
CPM
FT.
FL
TANK
SEPARATION
DISTANCES
■septic 13 Holding OS.T.E.P. Gather
To
From
Septic
Tank
Absorption
Feld
uft
Station
Holding
Tank
pubga/pdvate
S.ra Ynea
M0"'dOLt11e"
ANCHORAGE TANK
Gapoft In gam
1000
Well
too'+
too'+
—
—
25'+
STEEL
Nwnbir at compartments
1
Surface water
too'+
too'+
—
—
—
LIFT STATION
Lot Line
5'+
10'+
—
—
—
sb. In gallons:
Yamdooluren
Foundation
5'+
10'+
—
—
—
ca Neal al: jTump off" level at: olorm at
Curtain Drain
NONE
KNOW
Pump Yob k
htpeelNn performed try:
Remarks:
BENCH MARK
Location and Description:
BOTTOM OF "STUCKO" SIDING NEAR POINT "A"
Assumed GrmVoru
100.00 R
ENGINEER-$$
Inspections performed by: GEG, Ltd. Dates: 1st 8/24/2005
I *O�
............ ...........:....
2nd 8/24/2005
3rd 8/25/2005
Q J r y A. Garness.: Q
Development Services Department Approval
O " ' . CE -795 O
''.
�p °'�f 65-
��4p�P
Reviewed and approved by: Date: a Z o
fo \
(run. 12/01) 1 41
or'
0
VI
PERMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER:
—
SW050310 067-311-01
d <<
d
NEW 1000 GALLON
SINGLE COMPARTMENT
SEPTIC TANK
EXISTING 1500
GALLON BIOCYLE (
Itf��=tel
ST1
12.35
14.31
ST2
17.04
17.78
DBL1
18.63
19.03
D131_2
20.02
20.31
FD
70.32
82.06
C01
82.66
95.80
CO2
109.72
121.56
MT1
107.84
119.74
CO3
94.38
114.64
MT2
94.23
114.46
s F+
yq gp,tio
s1 °y
rALLED FLOW
DIVERTER
TH#6
TH#l1+
ALTERNATE
SITE
GARNESS ENGINEERING GROUP, Ltd.
.:_. -. _... CONSULTANTS & GENERAL CONTRACTORS. .
3701 E. 1000R POPA SURE 101 - MCWO E, M 99507 • PWW (9V/)M7-8179 • FM (907)338-3218 • v0b M www.9ormc gin dn9.00m
PREPARED FOR:PHONE NUMBER: PAGE NUMBER:
RANDY WEDDEL 694-8376 2 OF 3
LEGAL DESCRIPTION: DRAWN BY:
WHITESTONE ESTATES SUBDIVISION; LOT 10 C.J.G.
TYPE OF WORK: DATE:
AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE 8/26/2005
(Rev. 01)05)
:XISTING DRAINFIELD
TO BE USED AS A
RESERVE SITE
e.,...:H...°.
JRf�(ITay A. Gci-ness:�
POtMFr"UMBER` AS -BUILT DRAWING PARCEL ID NUMBER:
SW0 -
SW050310 067-311-01
TOP OF TANK AT
INLET - 98.02 -
INVERT OF BUNG
AT INLET - 97.50
ORIGINAL GRADE
83.59-83.71
FINAL GRADE =
101.34-101.48
NEW 1000 GALLON
SINGLE COMPARTMENT
SEPTIC TANK
ST2
TOP OF TANK AT
OUTLET - 98.00
KIM OF BUNG AT
OUTLET - 97.14
-FINAL GRADE
= 85.83(AVG.)
INSULATION
FILTER FABRIC
INVERT OF PIPE
- 82.98 (AVG.)
BOTTOM OF TRENCH /
80.88 (AVG.) —/ GROUNDWATER 78.96)
TOP OF SAND BOTTOM OF TEST HOLE 7 .71
= 81.96
GARNESS ENGINEERING GROUP, Ltd. TH
CONSULTANTS& GENERAL CONTRACTORS �•••• •••••••
S/01 E NOON Rl1D. SIAIE 101 • ANOWUM Nt (0w)00o-�+• • Y ..�Ygmm
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:• • • • • • • • . . . • . .
RANDY WEDDEL 694-8376 3 OF 3 fre arness.
LEGAL DESCRIPTION: DRAWN BY: PO o C -79 3 e�G
WHITESTONE ESTATES SUBDIVISION; LOT 10 C.J.G. r S•�GjR �adg
TYPE OF WORK: DATE:�po'Profsssiot`a,�5-
PROFILE AS -BUILT OF SEPTIC SYSTEM UPGRADE 8/26/2005 p0000o00�'
Rising San Electric Inc
Bill To
20740 Ptarmigan
Eaglc River, AK 99577
907 622 6777 08/19/09 12:41P P.001
Rising Son .electric, Inc.
14916 Woodland Drive
Eagle River, AK 99577
(947)-622-6777
Invoice
Date
Invoice #
8119/2005
8113
P.O. Number TermsDue Dsle Project
Due on receipt 811912005
Ovsntlty Description Rate Amount
4 service Call 80.00 320.0
At the above referenced properly Rising Son Electric, Inc. made the
following electrical corrections
1 change 50amp breaker to 208Imp (corrcct size)
2 Installed blunt tip screws at panel
3 Campleted the exterior outlet below Tager main. (no charge)
4 Installed new weather proof cover at deck outlet.
5 Corrected panel labeling
Rising Son Electric was the original electrical contractor at this
house. Water pipe grounding was completed and inspected by a
private inspector hired by Master Piece !domes.
Total MOM
EFFECTIVE JANUARY 2005 THERE WILL BE A 3% SURCHARGE ON ALL INVOICES PAID BY CREDIT CARD.
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Aug 23, 2005
Expiration Date: Aug 23, 2006
Permit Number: SWO50310 Parcel ID: 067-311-01 to
Legal Description: T14N R1W SECTION 17 NE1/4, SE1/4, NW1/4 WHITESTONE ESTATES#P
Design Engineer: 0855 Garness Engineering Group, LTD Site Address: 20660 Ptarmigan Boulevard
Owner Name: RANDY W EDDEL Lot Size: 47349 SO. FT.
Owner Address: 20740 PTARMIGAN BLVD Total Bedrooms: 5 Permit Bedrooms: 5
EAGLE RIVER, AK 99577 -
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. 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 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:
Date:
Date: 0 73 °S
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.cl.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. d/o'? - 31(-7)1 Permit Number
Property owner(s) RANDY WFDDFL Day phone (907) 694-8376
Mailing address (1) 20740 PTARMAGIN :• AR AK.
Mailing address (2)
Zip Code 99577
Legal description (Lot, Block & Sub'd.) WHITESTONE ESTATES: LOT 10.
Legal description (Section, Township & Range) T1U Al /moi I lei/ Srr, 1 02504 NWL4
Lot Size Acre q.Ft Number of Bedrooms
THIS APPLICATION IS FOR:
Sewer Only ❑ Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade 0
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal codes.
GARNESS ENGINEERING GROUP, Ltd.
Permit Fees: " I(d) Waiver Fees;_
Date of Payment: q- 1605 Date of Payment:
Receipt Number: (-) 7_26-71 Receipt Number:,
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
August 12, 2005
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907) 343-7904
iv 1+ � �S �oN � �s'T�+�S � L 1 D
Ref: Proposed Septic Upgrade for T14N, R1W, Section 17, NE4, SE4, NW4; Unit #10
To whom it may concern:
The existing 5 bedroom house is served by a private well and septic system. The existing septic system
consists of a 1500 gallon Biocyle unit and a 5 -wide drainfield that was installed on 10/13-21/00 and is sized
for 4 bedrooms. The drainfield is currently in a state of failure and needs to be upgraded. We are proposing to
upgrade the septic system to serve five bedrooms. We are proposing to install a 1000 gallon septic tank
between the house and the biocycle unit. The reserve trench is to be installed as shown by Dean Karez P.E. and
will be sized for 5 bedrooms. The alternate site will be below the existing drainfield. Comments regarding the
design are summarized as follows:
2. TRENCH DESIGN:
a.
Percolation Rate: 6.7 minutes/inch
b.
Proposed Application Rate: 2 gallons/day/ft
c.
Number of Bedrooms: 5
d.
Design Flow: 750 gallons per day
e.
Minimum Absorption Area: 375 ft2
f
Total Depth: 2.75 feet (maximum)
g.
Sand Filter: 1 foot
h.
Effective Depth: 1 foot (minimum)
i.
Width: 5 feet
j.
Reduction Factor: 0.87
k.
Minimum Length: 75 feet long
1.
Effective absorption area = 431 ft'
We are unaware# any adverse impacts this installation would have on adjacent wells or septic systems. If
you have any quosfions, please contact us at 337-6179. Thank you for your assistance.
P.E., M.S.
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: gamessengineering.com
TH111
EXISTING
♦TMS SEPTIC SYSTEM
SITE
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
1 E TmY NON. 81111E f01 . YYYIONSOF. Y[ menf . aYvs 10101.1{]JI1M � nv lenTeaN_�eu � wem•e. �. ...
RANDY WEDDEL (90
ti DESCRIPTION:
WHITESTONE ESTATES SUBDIVISION
i OF WORK:
SITE PLAN FOR PROPOSED SEPTIC
(Ke . anal
:R: PAGE NUMBER:
694-8376 1 1 OF 3
LOT 10,
R.A.L.
8/16/2005
CE -79t93
sh!?.¢5
'j.y :. '• t'.
PROPOSED
1000
EXISTING
SEPTIC TANK
\
5 BEDROOM
\
HOUE
/
,J7
'
PROPOSED
TH111
EXISTING
♦TMS SEPTIC SYSTEM
SITE
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
1 E TmY NON. 81111E f01 . YYYIONSOF. Y[ menf . aYvs 10101.1{]JI1M � nv lenTeaN_�eu � wem•e. �. ...
RANDY WEDDEL (90
ti DESCRIPTION:
WHITESTONE ESTATES SUBDIVISION
i OF WORK:
SITE PLAN FOR PROPOSED SEPTIC
(Ke . anal
:R: PAGE NUMBER:
694-8376 1 1 OF 3
LOT 10,
R.A.L.
8/16/2005
CE -79t93
sh!?.¢5
EXISTING
DOUBLE
-INSTALL
DOUBLE —
CLEANOUT
BIOCYCLE UNIT
INSTALL jTH#6
FLOW
DNERTER PROPOSED
`DRAINFIELD
C_
ALTERNATE
SITE
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
A01 E 10o9R Wb. 9 101 • MOMO L M 99 W] • R91NE (Wi)bb] In • FM (W])]]8 -Y!+! • MF6511C n.agnrwgnxYqsmi
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
RANDY WEDDEL (907) 694-8376 2 OF 3
LEGAL DESCRIPTION: DRAWN BY.
WHITESTONE ESTATES SUBDIVISION; LOT 10, R.A.L.
TYPE OF WORK: DATE'
DESIGN FOR PROPOSED SEPTIC SYSTEM UPGRADE 8/16/20
(Rev. OVMS)
CE
••B jl6 .ff'�eSQ
,.
DESIGN CffM=-
NUMBER OF BEDROOMS'5
• 7 .•,•..' '
GALLONS PER DAY (GPD): 750
. • ° : ' a • ;
PERCOLATION RATE/S: 6.7 MIN./INCH
,•
• a
PROPOSED APPLICATION RATE: 2.0
•'.
MINIMUM DRAINRELD SQ.FT.: 375
DRAINFIELD DESIGN:
f
�,
MAXIMUM DEPTH:2.75 FEET
a '.
WIDTH:5 FEET
I .•
.
LENGTH:75 FEET
I •
M.O.A. APPROVED SAND FILTER:1 FOOT
• a : '
EFFECTIVE:I FOOT
y ,
REDUCTION FACTOR: 0.57
1 '
ACTUAL SQ.FT.: 431ULU.
.�..
LW. HN', A / PACE SPECIFICATION
LETTER THAT PERTAINS TO THIS DESIGN.
TO OBTAIN A COPY OF THE LETTER
CONTACT GEG. BY PROCEEDING FORWARD
WITH THIS INSTALLATION, THE ENGINEER,
WELL DRILLER, CONTRACTOR AND
PROPERTY OWNER AGREE THAT THEY
HAVE READ THESE SPECIFICATIONS AND
AGREE TO ACCEPT THE TERMS AND
CONDITIONS UTLIN .
PROPOSED
—
EXISTING
DOUBLE
-INSTALL
DOUBLE —
CLEANOUT
BIOCYCLE UNIT
INSTALL jTH#6
FLOW
DNERTER PROPOSED
`DRAINFIELD
C_
ALTERNATE
SITE
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
A01 E 10o9R Wb. 9 101 • MOMO L M 99 W] • R91NE (Wi)bb] In • FM (W])]]8 -Y!+! • MF6511C n.agnrwgnxYqsmi
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
RANDY WEDDEL (907) 694-8376 2 OF 3
LEGAL DESCRIPTION: DRAWN BY.
WHITESTONE ESTATES SUBDIVISION; LOT 10, R.A.L.
TYPE OF WORK: DATE'
DESIGN FOR PROPOSED SEPTIC SYSTEM UPGRADE 8/16/20
(Rev. OVMS)
CE
••B jl6 .ff'�eSQ
TO EXISTING
DRAINFIELD
FINAL
FILTER
1* 235' MAX.
7
1
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS S GENERAL CONTRACTORS ••••••• ••••• •••••• •••••...•••
Rol L Haas xum. scare 101 • mx"m X m m oar) &•aPM • NFE91re:19
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: • •+ • • • • • • • • • • • • • •
RANDY WEDDEL (907) 694-8376 3 OF 3 f e G mass:'
O
QAo — `cp
LEGAL DESCRIPTION: DRAWN �� Y '
CE
WHITESTONE ESTATES SUBDIVISION; LOT 10, R.A.L. �pao_'$.'(bJ65
OF WORK:
(Rev.01/05)
8/1
Rising Son Electric Inc. 907 622 6777 08/22/06 09:19A P.001
August 22, 2005
Randy Weddell
Rising Son Electric, Inc.
14916 Aloodland Prive
F_agle River. 44 99577
(907) 622-6777
Re:20740 Ptarmigan Blvd
4
To Whom It May Concern:
The lift station at the above referenced property has been wired in accordance with NEC.
and State/Local codes.
Rising Son Electric, Inc. was the original electrical contractor on the job and wired this
house in accordance with the NEC and State/Local codes.
Thank you.
Sincerely
Kevin S. Hornbuckle, Owner
Administrator License Number 1284
Specialty Contractor License Number 27285
wz/w R I L) pec / 14
4 7r iT fJ /t I_
1
BioCycle ALASKA WASTEWATER %? ok
TREATMENT
SYSTEMS
Between: RandCheryl Weddal And: BioCycle Alaska (The Company)
Address: 1 0� 43630 Strawberry Road
h�orae,�DAK a ry 5�Q 7tC9 �3/y� Kenai, AK 99611
,�.0%� ���� 907-283-9003/283-8118 fax
Legal: Lot 10, Whitestone Estates %I, email: biocyclealaska@alaska.com
A.GUARANTEE
The Company guarantees to repair or replace r.: of charge any parts of the System requiring repair or replacement due to defective
manufacture:
a. within five (5) years of the Installation, except for defects in the aeration pump, the discharge pump, and
the electrical circuitry for which .: n period of warranty shall be one (1) year.
b. and other than under exceptional circumstances, the company shall respond within 24 hours of the Customer's call for
service.
B. MAINTENANCE
1. On a quarterly basis (once each 3 months) beginning from the date of installation of the System and continuing throughout the life
of the System, and where necessary, the Company agrees to perform the following maintenance tasks:
a. Adjust the air intake in the clarification chamber (every 3 months).
b. Clean the inside of the clarification and. discharge chambers (every 6 months).
c. Replenish the supply of chlorine tablets, if chlorination of effluent is being performed (every 3 months).
d. Check the aeration pump, discharge pump, electrical system (every 3 months).
e. File a copy of the Maintenance Report with the Department of Health and Human Services, Municipality of
Anchorage, and/or with the Department of Environmental Conservation, State of Alaska, or any other local
regulatory agency having jurisdiction over the area in which the System is installed.
f. Once every three (3) months the filter in the air blower will be changed.
2. In the event the Customer requests the Company to perform maintenance to the system other than that specified in B.I. above or
where the Customer requests work to be performed which is not a part of the above guarantee, the Customer shall pay the Company's
reasonable additional charges for the work done as well as for any associated equipment and or supplies. Additionally, the Customer
shall pay the Company's reasonable charges where the need for work is a result of the Customer's failure to ensure compliance with
the operating instructions, from loading the system in excess of the design flow for the installation, or where the problem is the result
of force rnajeure (i.e. earthquake, flood, lightning, land slip, or from persons not authorized by the Company interfering with the
system in any way, or as a result of the Customer failing to comply with this Agreement.
3. Commencing at the end of one (1) year from the date of this contract, the Customer agrees to participate in BioCycle's ongoing
maintenance program, as required by the MOA and/or ADEC, and agrees to pay for such maintenance services at an annual rate of
$250 which shall be invoiced to the Customer by the Company at or about each anniversary date of this Agreement, with annual
renewals of the maintenance contract deemed to be automatic. The Company shall be entitled to alter the annual service charge from
time to time as reflected in the increase in the national cost of living.
C. CHLORINE WARNING
1. Due to the risk and danger involved in the nd.;ag of different chlorine compounds, the Customer hereby agrees to refrain from
adding chlorine compounds of any kind directly to the BioCycle system.
2. The Customer is also advised against using and/or discharging compounds to the system, such as chlorine, drain cleaners,
insecticides, biocides, medications, etc in amounts that would be harmful to the system and cause it to cease functioning in a normal
manner.
Custo er's Signature
Date: lkI d — #0
C e s A to ke7
Company Representative
Date: if1�f�//Df�
BIOCYCLE ALASKA Aerated Wastewater Treatment Systems
Randy and Cheryl Weddal November 2, 2000
20740 Ptarmigan Drive
Eagle River, AK 99577
Re: BioCycle Aerated Wastewater Treatment System
Dear Randy and Cheryl:
During October 2000 we installed the BioCycle system at your new home. This letter
will provide you with information regarding the history, performance, approvals,
maintenance and operation of your system. I have also included two copies of our
standard maintenance agreement that is required by the municipality of Anchorage.
Please sign one copy and return to us in the enclosed envelope; keep the second copy for
your records.
HISTORY
The BioCycle system was developed 17 years ago in Australia. In October 1994, we
installed two systems in Anchorage which were the first two BioCycle installations in the
United States. These two systems were monitored from November 1994 through
November 1995 on a monthly basis per state of Alaska and municipality of Anchorage
guidelines. Several other installations were monitored during 1995-1996 to satisfy the
two-year testing period for MOA approval.
11►69111:1 a WN 9 [IN K
At this time, we have installed a total of 98 systems in the following locations: two
systems for FAA (on Middleton Island in Prince William Sound and in Sitka), 84
systems in Anchorage/Eagle River, nine in the Homer/Anchor Point area, two in
Ninilchik, and one in Unalakleet. Eight of these installations were for commercial
establishments such as Eagle Crest RV Park (Anchor Point), Laidlaw Bus Barn Facility
(Eagle River), Unalakleet Native Corporation River Lodge (Unalakleet), and the Lynx
Golf Course (Homer). The remaining 90 systems were for single or multi -family
dwellings.
MOA/DHHS APPROVAL
We ended our second year of required testing for the municipality of Anchorage in
October 1996. This testing program was monitored by the Department of Health and
Human Services/On-Site Servicrs Division. The municipality approved this package
treatment system in August 1997 and is granting a 50 per cent reduction in drain field
size for BioCycle installations.
43630 Strawberry Road Kenai, AK 99611 907-283-9003/283-8118 Fax
blocyclealaska@alaska.com
BIOCYCLE ALASKA Aerated Wastewater Treatment Systems
STATE OF ALASKA (ADEC) APPROVAL
In November 1995, we completed a one-year testing program at the request of the state of
Alaska, Department of Environmental Conservation, Wasilla office. Based on the one
year testing program and 30 consecutive days of testing, ADEC approved BioCycle for
installation at single and multi -family residences. ADEC has also granted a 50%
reduction in drainfield size, horizontal waivers to surface water and vertical waivers to
ground water (up to 2 feet vertical separation) all on a site by site basis. We have also
been granted surface discharge permits for installations in Anchor Point, Unalakleet, and
Middleton Island.
SYSTEM MAINTENANCE
The municipality of Anchorage as well as the state of Alaska ADEC require a continuing
maintenance agreement for all BioCycle installations. As I mentioned earlier I have
enclosed two copies of our maintenance agreement for your review and signature. Our
cost for maintenance is $250 per year._The first vear maintenance cost has been Haid by
the builder. Your maintenance year will run from October to October and you will be
invoiced in October 2001 for the next maintenance year. We have found that continued
maintenance is the key to the success of the BioCycle system.
6Zmll 30 [61-94R. 1 Y e"L
The standard BioCycle treatment system is sized for a four-bedroom home and is
contained in a 1500 gallon fiberglass tank with four separate compartments. Additional
treatment capacity has been achieved by installing a 1000 or 1250 -gallon septic tank in
line ahead of the BioCycle. In the two tank arrangement, the BioCycle system is
converted to a double aeration system and treated water is recycled back to the septic
tank. The recycling of aerated water provides biological treatment to the septic tank.
BioCycle treats domestic wastewater through aerobic biological processes with the
assistance of a small, 60 or 80 liter/minute air blower in combination with highly efficient
flex disc diffusers. The final effluent is discharged through a Meyers 0.4 hp pump to the
drain field. The power requirements for the air blower and the discharge pump cost less
than $5 per month.
The BioCycle system works by using naturally occurring bacteria that come from the
household. As a result of air being pumped into the system, the bacteria thrive and grow
in much greater numbers than would naturally occur. The entire contents of the system
are continually aerated prevendag the production of hydrogen sulfide and/or methane
gases. Therefore, there is no typical septic odor to the system.
The resulting "over population' of aerated bacteria speeds the process of breaking down
the sewage to make it safe to discharge to the drain field. The final effluent is a very
clear liquid that extends the life of the drain field indefinitely. There is an audio/visual
alarm plate that is installed inside the residence that alerts the homeowner if the blower
43630 Strawberry Road Kenai, AK 99611 907-283-9003/283-8118 Fax
biocyclealaska@alaska.com
BIOCYCLE ALASKA Aerated Wastewater Treatment Systems
loses air pressure, the discharge pump malfunctions or there is a loss of power to the
BioCycle system. We have.a service technician in Anchorage that will respond to a
service call within 24 hours of an alarm.
Hopefully, the enclosed information will answer most of your questions regarding the
BioCycle system. However, if you have any immediate questions or need additional
information, please contact us at the numbers below.
Sincerely,
BioCycle Alaska
rt! A e .l.
Gus Andress. P.E.
43630 Strawberry Road Kenai, AK 99611 907-283-9003/283-8118 Fax
biocyclealaska@alaska.com
Municipality of Anchorage Page __L 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 Report
Permit Number: J' L > PID Number:
Name:
iPIF�E i�M�S, —1 kC .
Wastewater System: New ❑ Upgrade
Y P9
Address:
ABSORPTION FIELD
Phone: ` r', j
No. of Be rooms:
p Deep Trench kShallowTrench ❑ Bed ❑ Mound ❑ Other
1 r+ LEGAL DESCRIPTION
Soil Rating:
019
Total Depth from original grade:
Ii1-l\ I
GPD/Sq. . Ft.
t%rJ
Lot: �r 1 5 1 C�: , i Ij Subdivision:
1,'T I
Depth to pipe bottom from original grade:
Gravel depth beneath pipe
t t
Z`J Ft.
Ft.
Township: I
Range: y , , /
1 W
Section:
i
Fill added above original gratle:
Gravel length: // L^
6 15:3
l" Ft.
Ft.
WELL: New El Upgrade
Gravel width:
Numbero lines: Distance een lines:
Ft.
Ft.
Classification (Private, A,B,C):
Total Depth:
Cased To:
Total absorption area: n�'t
Pipe material: 1!
3�I
1"��rKI
O Ft.
O Ft.
h� SC. Ft.
Driller: ,��(� �y� J
5u �"'rt IN��s
Date Drilled:
UD
Static Water Level:
/r
Installer:
Date installed:
lob- kU
L k\itt t* I LM1-
! ,2-
Ft.
Yield:mp
AlA/l
Set at:
Casing Height Abo Ground:
�
-
TANK
GPM
Ft.
Ft.
SEPARATION
DISTANCES
❑ Septic ❑ Holding ❑ S.T.E.P.
To
Septic
Absorption
Lift
Holding
Public/Private
Manufacturer:
Capacity in gallons:
From
Tank
Field
Station
Tank
Sewer Lines
Wel h
N 1A
(
11 r2
�1
�d�j_�
Material:
Number of Compartments:
Surface
Water
��3 Q
iii �.O
����
LSI�'fCt�
Lot
D
Siz�Lillons:
Manufacturer.,,�CcJr��L /ODU
Line
Foundation
"'J
I°2c r �J
� 7:
"Pum on" level at:
P
"Pum off" level at:
P
High water alarm at:
9
Curtain
„ n ;�,
/Cq�
is��l
`%
Pump Make & Model
Electrical Inspections performed by: C
L LTXi 4
Drain
J(?-V
(
Remarks:
BENCH MARK
Location and Description:
jJll.�(�'1W S LL SUS G7�'dIE� ��
Assumed Elevation:
Ft
ENGINEER'S SEAL
Inspections performed by: ✓ 'Z— Dates: 1s a°° °°°°� ° �«•°a°°°�
2nd 7TT, a ».. °a°..... .
Dean A. Karat •• °
Department of Health and Human Services approval e�°"°°.,° �Es3os
••;��®
Reviewed and approved by: Date: ®\®R®®®0 A`®®
72-013 (flee. 9/91) MOA 25
Permit No. SI.'j ocx)J 2.0
Page C'�_ of C'?_
Municipality of Anchorage
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
WLT �v
Legal Description: t4E'r { 5E'14 gIJiI4 'Tigi(I ! 4 int';I7PID No.:
CURTAIN DRAIN 6�
/ (APPROX. LOCATION)
PRIVATE WELL
62C
J
A
TH STH 7 /
LECiBD G • 610-
0 TEST PIT BY PTS
a- CLEANOUT
O.T.MONITORING TUBE
SCALE 1" = 50' BIOCYCLE MODEL DISTANCES
6000 A — C 25.2
/600B — C 2564
rH s e - D 124.2
UNIT 10 PRIMARY TRENCH 0UNIT 10 RESERVE TRENCH
/5' X 65.3' /— 5 i 65.3'
SYSTEM PROFILE
(NOT TO SCALE)
93.2
u
TBM — WINDOW SILL. SW BLDG CORNER
— (ELEV. = 100)
590
TN
n 75
dF°qc
ov;
749E
66.2 aes o°aeq ° e o
GW
9!° q oeaose°° u°
7f�2` Dean A. Kares
64 4 -04-- CE -0303
%Lerfifi eb Priffing ?EvS
by
Doc co. dba
SULLIVAN WATER WELL§ C E i V E D-
P.O. BOX 670272, CHUGIAK, ALASKA 99567 • TELEPHONE 688-2759
OWNER OF LAND 0145-7—jF& A e ce,wr L1 el BORE HOLE DATA
DEPTH
ADDRESS uv -l— :_ 9=.t--- - I Fmm T
LEGAL DESCRIPTION "T / 4 kJ k u,Ii,C c
PERMIT NUMBER 4O -t] gQ-; Date of Issue (a -
TAX INL?EN-TIFICATION N MBER1i�0 - 2 °Z
Is well located at approved permit location? Q es No -12
Method of Drilling: it rotary Q cable tool
Depth of well: //
44
Casing Type ,ATF yy _Wall Thickness .. S`J inches
tAD-
Diameter (n N inches, depth gE/ feet
Liner Type: fttc
Casing Stickup Above Ground:feet
Static Water Level (from ground level): !1 Ste- feet
Pumping level: - feet after hrs. pumping cpm
Recover Rate: d O gpm
Method of Testing: R 7 P
Well Intake Opening Type: 43-epen End Q Open Hole
C3 Screened; Start feet Stopped feet
Q Perforations SYait" .ffe Stopped feet
Grout Type: _ T1.� it ` `°Volume I�L�La j
Depth: from C i feet, to feet
Pump Intake Depth:
Pump Size hp Brand Name
Well Disinfected Upon Completion? des Q No
Method of Disinfection:
Comments:
-7
N O V 21 2060
;vturncrpality of Anchorage
?dept. Health & Human Services
C.4, ,.,e . 17-1e/<J4—',
,� ic s i S -A-44 : t!' ed QXL
1 -I'd"
+�
744 A60 r5't, ,, a
Driller's Name T7
ATTENTION: It,is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipalit.
of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. Matsu Borough
Tv1s
Pro
912 East
November 1, 2000
Avenue, Suite #102, Anchorage, AK 99501 (907) 561-6237 fax. (907) 563-3813
Municipality of Anchorage
Department of Health and Human Services
On -Site Services
825 'U' Street, Suite #502
Anchorage, AK 99501
Subject: Whitestone Estates, Unit 10
Permit No. SW000-201
Dear Sir/Madam:
RECEIVED
NOV 02 2000
Nfunicipahty of Anchorage
Deft. Neatth & Human Services
Enclosed please find the Onsite Waste Water Disposal System and Well Inspection
Report for Unit 10, Whitestone Estates. , -
If you have any questions or comments, please call me at 561-6266.
Sincerely,
PROFESSIONAL & TECHNICAL SERVICES, INC.
c��
Dean A. Karcz,-
Vice President
Enclosure
ALASKA PROPERTY DEVELOPMENT SPECIALISTS
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services J jpr -)
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 / WATER SUPPLY PERMIT
Initial
Date Issued: Jun 29, 2000
Expiration Date: Jun 29, 2001
Permit Number: SW000201 f Parcel ID: 050-362-0
Legal Description: T14N R1 W SEC 17 NE4SE4NW4
Design Engineer: 0098 PTS L,C l�ttt7 16 Site Address: 020610 PTARMIGAN BLVD
Owner Name: Masterpiece Homes Inc. Lot Size: 8712000 SQ. FT.
Owner Address: PO Box 773471 Total Bedrooms: 4 Permit Bedrooms: 4
Eagle River , AK 99577-3471
This permit is for the construction of:
C Disposal Field ❑/ Septic Tank 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 ( 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.
5. The following special provisions.
THt$,Pgii M!T, 6UED FOR UNIT 10
DG�h CLt �IGd 4w� S;";d -lky 10e✓1vrl,cm1_ o_^a-f1w4_ p-evk -fC,t'7�'
6,a We IO Movfj .S yjftYk Ii Cc.flOh h /4wA4.
10 F FA,(
Received By:
Issued By:
Date:
Date: 6-2 / — ilO
°
Profess/ona/a,90TVA ftM 91iAN ACOS /a
912 East 15'" Avenue, Suite 102, Anchorage, Alaska 99501 (907) 561-6237 tax. (907) 563-3813
October 17, 2000
RECEIVED
OCT 17 2000
Municipality of Anchorage
Municipality of Anchorage Dept Health & Human Ser&ea
Department of Health and Human Services
On -Site Services Section
825 "U' Street, Suite #502
Anchorage, AK 99501
Subject: Whitestone Estates Condominiums Unit 10 Permit Revision
Permit No. SW -000201
Dear Sir/Madam:
Transmitted with this letter, please find a revision to the septic system for Permit
No. SW -000201 for Unit 10, Whitestone Estates Condominiums, located on an
unsubdivided tract of land south of Ptarmigan Boulevard.
A revised Site Plan is attached showing the proposed configuration of the septic system
and well location. A new location for the septic system has been designed, moving the
disposal field closer to the house. A log and percolation test form are attached for the test
pit dug at the site of the new disposal field. The test pit was excavated to 11 feet and the
disposal field is to be located in the sandy gravel encountered from 2-1/2 to 5 feet below
ground surface. Ground water was encountered at a depth of 6.8 feet below the ground
surface, and a percolation rate of 6.7 minutes per inch was measured.
The following information summarizes the calculations for the revised septic system
drain field for Unit 10:
Maximum flow: (GPD) = 600
Percolation rate: (Min/in.) = 6.7
Application rate: (GPD/SF) = 0.8
Length of 5 -foot wide trench (feet) = 150
50% reduction for biocycle (feet) = 75
Gravel depth beneath perforated pipe (feet) = 1
Reduction factor for gravel depth = .87
Revised length of 5 -foot wide trench = 65.3 feet
ALASKA PROPERTY DEVELOPMENT SPECIALISTS
2of2
10/17/00
The new disposal field location is not anticipated to have negative impacts on adjacent
properties. The topography for the area of the disposal field slopes to the south within an
area greater than 100 feet from the disposal field. The disposal field is located
approximately at 100 feet from the west property boundary, and over 200 feet from the
south property boundary.
Thank you for your prompt review of this additional information. If you have any
questions, please call me at 561-6266.
Sincerely,
PROFESSIONAL & TECHNICAL SERVICES, INC.
i\
�° 4'
Dean A. Karcz, P.
Vice President
Enclosures
ALASKA PROPERTY DEVELOPMENT SPECIALISTS
1
PROPOSED
WELL
/
v
R
7
BIOCYCLE
MODEL 6000
iH 6
UNIT 10
RESERVE TRENCH
n 5' X 653'
-
TH ii •
T'
UNIT 10
PRIMARY TRENCH
5' X 653'
IN 8
a
In ISI
Innis FF1
TA ' ���
LEGEND
0 F
• TEST PIT BY PTS
...............
�P��
CLEANOUT
49T °-7. �..
4
•KT. MONITORING TUBE
�...
m°° . ° °°°°° °
w
'Dean on A. A. Karcz /
SITE PLAN
AW
UNIT 10
°
�
PFB
WHITE STONE ESTATES
i�,"`O�O:'
FIGURE i I SCALE 1"=60' 10/17/00
4" DIA. PVC
FROM HOUSE,
S = 27
BIOCYCLE
MODEL 5000
MONITORING
TUBE
1.5'
MANHOLE COVER;
3" INSULATION ON
LID
MOUND SURFACE
FOR DRAINAGE
NA 77 VE SOIL
BACKFILL
4" PERF. PIPE
NOTES
1. GROUNDWATER DEPTH 6.75' BELOW GROUND SURFACE.
2. BEDROCK GREATER THAN 15' BELOW GROUND SURFACE.
J. LENGTH OF BED = 65.3'.
4. PLACE 2" INSULATION OVER DISPOSAL FIELD.
''fix\\\\��'
=�P�E OF
e.
i co 14QTV
1-1/4" DIA.
PVC FROM
BIOCYCLE
Dean A. Karcz i SECTIONS
o0ooaCE 8303._+� UNIT 10
WHITE STONE ESTATES
'OROFESSIONP `��
11,��\\`` FIGURE 2 1 SCALE NONE 10/17/00
e Municipality of Anchorage .
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: U4V l� }Ottl.T `� lr ti---�X� "XJ -I-%5 DATE PERFORMED:
'Fd' -�j•11C4��('1=.2 ��lEGc-- FtDf�IEJ
LEGAL DESCRIPTION: N�`(� 51v �I� ulN Township, Range, Section: /Jp.l jz. Sof, f 7
PT
/F(() SLOPE SITE PLAN
FEET) O �L,f I
t
2 ip\
3
4-
5
6-
7
8
s
_SAS
to -
11
o 11
--
12-
13-
14-
15-
16-
17-
18-
19-
20
21314151617181920
COMMENTS —
PERFORMED BY:
�a-c;�-A)
�:T1k 7�-i'iN
SILT LAS FAM
WAS GROUND WATER
ENCOUNTERED?
S
p I IF YES, AT WHAT L
DEPTH? _4 O
P
Depthl� stu yy E
(�P l to Water After
Monitoring?
Monitoring? 2 gate:
ACCORDANCE WITH ALL STATE AND
72-008 (Rev. 4/85)
Reading Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
1� "J.0 DO /U)—,q)
—e.
F-Llli�
3ti,`
/0 Zo
i Z `
`2 3
Iz�nt[:
-1z.
t'
PERCOLATION RATE �` (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND 3 FT
I 6 EA74 CERTIFY THA THI$ TEST WAS PERFORMED IN
GUIDELINES IN EFFECT ON THIS DATE. DATE: IO /O Zotb
AMOSSieN►a/aodTect 41/SeJVcea /roc
4155 Tudor Centre Drive, Suite 103, Anchorage Alaska 99508 (907) 561-6237 fax: (907) 563-3813
June 16, 2000
Municipality of Anchorage
Department of Health and Human Services
On-site Services Section
825 "L" Street, Suite #502
Anchorage, AK 99501
Subject: Whitestone Estates Condominiums, Unit 10 Permit
Dear Sir/Madam:
This letter transmits the application for the well and septic system permit for Unit 10 of
Whitestone Estates Condominiums located on an unsubdivided tract of land south of Ptarmigan
Boulevard in Eagle River. The legal description for the property is: E %x of the SE'/4 of the NW
%4 of Sec. 17, T 14 N, Rl W Seward Meridian. Unit 10 is the tenth condominium to be
constructed on this 20 -acre parcel. The DHHS has issued previous permit applications for Units
1 through 9.
A Site Plan is attached, showing the proposed configuration of the septic system and well
location. Additionally, the location of the test pit utilized for the design of this septic system is
shown on the Site Plan. A log and a percolation test form are also attached. Test Pit 10 was
excavated to 15 feet, and the disposal field is to be located in the sandy gravel encountered from 1
%z to 5 -feet deep. Ground water was encountered 6.1 feet below the ground surface. The
percolation rate of 11 minutes per inch was used to size the drain field.
A Biocycle system is to be incorporated into the septic system for Unit 10, allowing the reduction
of 50% of the required drain field area. The intent of the drain field design is to install a 5 -foot
wide drain field with a gravel depth of 1 -foot beneath the perforated pipe. The following
information summarizes the calculations for the septic system drain field for Unit 10:
Maximum flow: (GPD) = 600
Percolation rate: (Min/in.) = 11
Application rate: (GPD/SF) = 0.8
Length of 5 -foot wide trench (feet) = 150
50% reduction for biocycle (feet) = 75
Gravel depth beneath perforated pipe = 1 foot
Reduction factor for gravel depth = 0.87
Revised length of 5 -foot wide trench 65.3 feet.
ALASKA PROPERTY DEVELOPMENT SPECIALIST
2 of 2
06/16/00
The proposed disposal field for Unit 10 is not anticipated to have negative impacts on adjacent
properties. The topography for the area of the disposal field and Unit 10 slopes to the south
within an area greater than 100 feet from the disposal field. The proposed disposal field is
located approximately 100 feet from the west property boundary, and 140 feet from the south
property boundary. Presently, the property to the west and south of Unit 10 is unsubdivided.
Surface drainage from the area around Unit 10 drains to the south. The reserve area for the
disposal field is also shown on the Site Plan.
Thank you for your prompt review of the application information. If you have any questions,
please call me at 561-6266.
Sincerely,
PROFESSIONAL & TECHNICAL SERVICES, INC.
Dean A. Karcz, P.E.
Vice President
Enclosure
ALASKA PROPERTY DEVELOPMENT SPECIALIST
PROPOSED
WELL
p�® /
A—
..TH
] / ----------
�
&OCYCYE
MODEL 6000
Ri 6
I \
/ UNIT /E59�
—/
PRIMARY TRENCH
5'X 653' Tyf/ UNIT 10
RESERVE TRENCH /
5'X 653'
I I r\ r\ I I I f� F— r\
LEGEND
• TEST PIT BY PTS
CLEANOUT
s * 49TH * / '"' MONITORING TUBE
°•v
�..•... ....°. °° °°°°°e.°..°..�
j.... °.....,°,°................ e� oo SITE PLAN
De CE 8303T� aw
UNIT 10
s
'o'?0FESSI00� Aw PFB
WHITE STONE ESTATES
FIGURE 1 SCALE I"=100' 1 6/16/00
t
4" DIA. PVC
FROM HOUSE,
S = 27
•���F
OF A4 j
* A* 492iA `.
Dean A. Karcz �ml
CE 8303
BIOCYCLE
MODEL 6000
MONITORING
TUBE
MANHOLE COVER;
3" INSULATION ON
LID
MOUND SURFACE
FOR DRAINAGE
NATIVE SOIL
BACKFILL
4" PERF. PIPE
NOTES
I. GROUNDWATER DEPTH 6.1' BELOW GROUND SURFACE.
2. BEDROCK GREATER THAN 15' BELOW GROUND SURFACE.
J. LENGTH OF BED = 65.3.
4. PLACE 2" INSULATION OVER DISPOSAL FIELD.
1-1/4" DIA.
PVC FROM
BIOCYCLE
SECTIONS
UNIT 10
pysWHITE STONE ESTATES
FIGURE 2 SCALE NONE 1 6/16/00
It
e Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES °'i°'""" •••••
825 "L" Street, Anchorage, Alaska 99502-0650 A ..........„ „
SOILS LOG — PERCOLATION TEST Dean A. Karxz
••• CE•8308 �,• ��
I
PERFORMED FOR: "r,FO n "••f.,. • �, �
DATE PERFORMED:
LEGAL DESCRIPTION: IVC IIS{ SE. �I� !`I („i �'� Township, Range, Section: f(44 1`1W S�`�, I -7
DEPTH SLOPE SITE PLAN
11
12
13
14
15
16
17
18
19
20
COMMENTS
p l'i -F
5.A,4aH ��VCL vj;/
Si UT ij (l�
LFaJ5F5
• Ir WAS GROUND WATER- 1
(� ENCOUNTERED? l 5
S
IF YES, AT WHAT ' L
DEPTH? O
P
E
Depth to Water After
Monitoring? L' `' Date: Calot,
ilk
Reading Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
3 z sc /v
J
Z"
�? Zzb
PERCOLATION RATE / 1 (minutesiineh) PERC HOLE DIAMETER `0 -
TEST RUN BETWEEN—LE—FT AND �' S FT
PERFORMED BY: W LWAv1 i1A -1 I r tS I E� CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THAATE. DATE:
72-008 (Rev. 4/85)
-u,5,
Municipality of Anchorage
• Development Services Department"AGE
Building Safety Division
On -Site Water and Wastewater Program s . ET y
4700 Elmore Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D 06-4-311-01 COSA# ®SG
Expiration Date: -%-
1. GENERAL INFORMATION
Complete legal description _: hi}c S bAe �5fA&5 W 10
Location (site address) _ Z0140 KgeMioarN Alva,
Current -Property owner(s) J4nEs NcLolas Day phone 865- 65 95
Mailing address
Lending agency Day phone
Mailing address
Real Estate Agent Irk Mows Day phone g%S- 659,5
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
�o
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
®
Individual On-site
R
Individual Water Storage
❑
Individual Holding Tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my. investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of
Address
Engineer's Printed Name Lars Siziekland
S. DSD SIGNATURE
Jz Approved for bedrooms.
Disapproved.
Phone 279- 341 6
Date
ell
�x @ �iA
€`' `PURKI ANDD2: Q, r
Conditional approval for bedrooms, with the following stipulations:
Attachments
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
By:41
(Rev. 11/05)
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date: L/ — /;Z 71L
L.5
Municipality of Anchorage
• Development Services Department"
Building Safety Division a
On -Site Water and Wastewater Program s A E. r
4700 Elmore Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel l.D. O(-4- it -0i COSA# 05C 1013SS
Expiration Date: cl
1. GENERAL INFORMATION
Complete legal description whiie. S400', ESLOo Lo} to
Location (site address) AV {ND Vtarm144n tjkV t,
Current Property owner(s) .t. a"e6 !tUrchc�GS
Mailing address -; -
Lending agency
Mailing address
Real Estate Agent
Mailing Addiesp
Dayphone &-GsiSl
Day phone
kir, k kig5 Day phone 8� 5 - 65TS
Uniess orhetwise re os;ted, COSA will be held by DSD for pickup.
2. NUMBER OF. BEDROOMS:
3. TYPED - F'WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual We11
Individual On-site
Individual Water Storage
❑
Individual Holding Tank
❑
Community Class Well
❑
Community On-site.
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my. investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of
Address
Engineer's Printed Name L us - apgzttl t7riA
5 DSD SIGNATURE
Approved for bedrooms.
Disapproved.
Phone M_37/Gp
Date 5 14 2010
X\
.OF ....q �P
�•,1.,4RE. SPURKIANC: • .�
•• 1 500 \�
0 ES
Conditional approval for bedrooms, with the following stipulations:
Attachments
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: Original Certificate Date: ' OZ Ti/ Q
(Rev. 1110.5)
Municipality of Anchorage
• Development Services Department p
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Oiri je Done EstrjeD Lot 10 ParcelID: 064-311-0l_
A. WELL DATA
Well typeFt_-'VC is If A, B, or C provide PWSID #
Date completedZ��f2cx` 1 Sanitary seal (Y/N) y
Total depth 1 b ft. Cased to I�ft.
FROM WELL LOG
Date of test 7_5 2000
Static water level 115 ft.
Well production 20 9.p -m.
WATER SAMPLE RESULTS:
Coliform _colonies/100 mL Nitrate IVO mg/L
Arsenic: ug/L date of sample: Z010
Well Log (Y/N) NO
Wires properly protected (YIN) !
Casing height (above ground) + in.
AT INSPECTION
B. SEPTICIHOLDING TANK PATA j
Tank Type/Material Ae� r�OLW[C t f�r�`'t- ` ib 1ra151L&AYJC
!DDq i'�,
Tank size &z gal. Number of Compartments � ,
I Ilp ft.
.33 9—
p.m-
Other bacteria colonies/100 mL``
Collected by: Lags S dar A
,,,,// 2e�5
z 2y -ZS
Date installed to 13 Lda(�
Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Depression over tank (YIN) High water alarm (Y/N) 7t�f*t 1E5 c.s,
Date of pumpin 9 111 21 Zo I Pumper T14 -sol yr te-
C. ABSORPTION FIELD DATA
4/zy-Zs Zb05
Date installed I0 G3 0 Soil rating (g.p.d./ft2 or ft2/bdrm) a.0
Length 15 653 ft. Width -5 ft.
ti •^ }2
System type
Trench
Gravel below pipe 1,0-1 .i I ft.
Total depth 4 ft. Eff. absorption area 315:112 Monitoring tube �_ Depression over field W
Date of adequacy test 2ot0 Results (Pass/Fail) Pco5 For J bedrooms
Fluid depth in absorption field before test in. Water added ( Q0 gal. New depth 1_5 in.
Elapsed Time: i'4`{0 min. Final fluid depth 1— in. Absorption rate >= 150 g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) None Voowrl If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (YIN)
"Pump on" lev — in. "Pump off" level at in. High wateA=Ircit
in.
Dat Cycles to Meets alar,rements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100 4
Absorption field on lot 100 f
Public sewer main NIA
Sewer /septic service line 25 +
Animal containment areas 0' +
On adjacent lots 100,
On adjacent lots No t i
Public sewer manholelcleanout N LA
Holding tank N.JA
Manure/animal excrete storage areas 10D it
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
Building foundation i Property line + Absorption field 5'+
Water main /VIA Water service line �D + Surface water 1(i +
—T ,
Wells on adjacent lots DoJ +
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
i
Property line + Building foundation 1D + Water main N A
t
Water Service line`�� + Surface water ! DO + Driveway, parkinglvehicle storage () F
Curtain drain AIMQ 1�nawn Wells on adjacent lots 00 t
F. COMMENTS
G. ENGINEER'S CERTIFICATION
1 certify that 1 have determined through field inspections and
review of Municipal records that the above systems are in10,
conformance with MOA COSA guidelines in `effect on this date. 0
Engineer's Printed Name Ldt,C
Date `
911M120tt3 ,!l��FI��.
h` PRO E�_�
COSA Fee $ LH b
Date of Payment I off$ h D
Receipt Number IP 1 L4 WI,-)
(Rev. 11105) J�
Waiver Fee $
Date of Payment
Receipt Number
} Spurt Land Engineering
Environmental Consulting and Design
Municipality of Anchorage March 31, 2011
Development Services Department
On Site Water and Wastewater Program
4700 Elmore Road
Anchorage, Alaska 99519
Subject:
Ladies and Gentlemen:
Septic System Certification
20740 Ptarmigan Blvd.
I am writing to request that the certification for the septic system at the above referenced property be
upgraded from 5 bed rooms to 6 bed rooms.
The septic system consists of a 1000 gallon septic tank, a BioCycle advanced wastewater treatment system
and two drain 'fields. This configuration of septic tank and BioCycle unit is regularly approved for 6 -
bedroom systems and the absorption area of the two drain fields is also sufficient for 6 bedrooms.
The septic system was inspected on August 276i, 2010 and the both drain fields were dry. The 2005 septic
system drain field was pre-soaked and then on August Wh, 2010 it was tested. Nineteen hundred and
twenty gallons of clean water was added to the drain field. Over a 24 hour period, the liquid level dropped
to the pre-test level, indicating that the drain field is capable of disposing of over 900 gallons per day.
If you have any questions or concerns, please contact me at 279-3916.
Sincerely, Sh',i�Pn tti�UZ iv s���a�� 4�1�� z` tl
Lem 1
Lars Spurkland, P.E.
Civil Engineer
203 West 15`t' Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland@gci.net
ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND
REPAIR AGREEMENT
MEMORANDUM OF UNDERSTANDING
BETWEEN I!CIIPf1I,I �� ANCHORAGE
AND ✓_X _ j"�--
THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this
�ay of I 8M4"-� of 20_�, by and between ule -tl#)
herein the "OWNER," and the Municipality of Anchorage, herein the
'AWNICIPAUTY." In consideration of the mutual covenants contained herein, the
parties to this Memorandum of Understanding agree as follows:
1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality
grants permission to Owner to utilize and operate an Advanced Wastewater
Treatment System (AW WTS), described as I10 located
at A�CtY"^Li ce /lc-;,c� Anchorage, Alaska.
2. Definitions.
A. Alteration. Any change to the design or function of an AW WTS that
Includes the installation or removal of any parts, components or pieces not
included in the original construction permit and design. Prior to
performing any alterations to an AW WTS the owner must obtain a
Wastewater Disposal System Construction Permit from the Municipality
pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65.
B. Certificate of On -Site Systems Approval. An approval by the
Municipality of existing water and wastewater disposal systems given at
the time of property sale and title transfer in accordance with AMC 15.65.
These approvals certify that the systems are adequate for the homes that
they support and meet the codes that were in place at the time of system
construction.
C. Damage. Any man-made or natural change in a system that would inhibit
the system from performing as designed.
D. Maintenance and Repair. The scheduled and as needed replacement of
existing parts, components and pieces of an AWWTS that were included in
the original design which would allow the AW WTS to continue to
perform as designed.
E. Permit (Construction) An On -Site Wastewater Disposal System
Construction Permit as defined by AMC 15.65.
F. Permit (Operating) An Advanced Wastewater Treatment System
Operating Permit. An annual permit, issued by the Municipality, that
allows the Owner to operate an AW WTS, upon meeting all the
requirements of this agreement, the conditions of Operating Permit, the
requirements of the On -Site Wastewater System Construction Permit and
all relevant provisions of AMC 15.65
3. Fee. Owner shall pay to Municipality an annual fee of _ 7_'e✓`o
($ wU0), payable on or before the issuance of the operating permit and annually
thereafter. The annual fee is due on or before the anniversary date of the approval by the
Municipality of installed system.
4. Term. The term of this Memorandum of Understanding shall be for the life of the
AW WTS.
The term begins on the date of approval by the Municipality of the installed system and
shall continue while the AW WTS system is in use or operational or until the property is
sold or title is transferred by owner and a new certificate of On -Site approval is issued to
the new owner or transferee of the property.
5. Alterations, Installation and Removal of Addifional Eauimment. Owner agrees
not to make any alterations, removal of parts or additions to the AW WTS without a
Construction Permit from the Municipality_
6. Maintenance and Repairs.
A Throughout the term of this Memorandum of Understanding, the Owner shall
maintain AW WTS in good repair. In addition, it shall be the responsibility of the
Owner during the term of this Memorandum of Understanding, and any extensions or
renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2)
maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs.
Further, Owner agrees to comply will all applicable ordinance, laws, regulations,
rules and orders for the AW WTS.
B. Owner agrees to provide the Municipality a written schedule of routine
maintenance and repairs which have been performed on the system pursuant to the
terms and conditions contained in the Owner's AW WTS Operating Permit This
schedule shall be submitted to the Municipality annually upon the renewal of the
permit. The schedule of maintenance and repair contained in the Owner's AW WTS
Operating Permit is:/ Lt��x �(
C. Owner acknowledges that the fine schedule for failing to maintain and repair an
AW WTS are codified in AMC 14.60.
D. Owner agrees that only maintenance, repair personnel certified by the
Municipality will inspect and make any necessary maintenance, repairs or permitted
alterations to the system.
E. Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS upon 24 hours written notice.
F. Owner agrees that any sale or transfer of title of the property will not occur
without a new Certificate of On -Site Systems Approval.
G Owner agrees that the relevant provisions of the standard specification guidebook
for AWWTS is the goveming professional guidelines for the construction,
maintenance and repair of the Owner's AWWTS.
7, Nonwaiver. The failure of either party at any time to enforce a provision of this
Memorandum of Understanding shall in no way constitute a waiver of the provisions,
nor in any way effect the validity of the Memorandum of Understanding or any part
hereof, or the right of such party thereafter to enforce each and every provision
hereof.
8. Amendment.
A. This Memorandum of Understanding shall only be amended, modified or changed
by a writing, executed by authorized representatives of the parties, with the same
formality of this Memorandum of Understanding was executed and such writing shall
be attached to this Memorandum of Understanding as an amendment.
B. For the purposes of any amendment modification or change to the terms and
conditions of this contract, the only authorized representatives of the parties are:
Owner: a i h % k"'1'l-i
Anchorage: Purchasing Officer
C. Any attempt to amend, modify, or change this contract by either an
unauthorized representative or unauthorized means shall be void.
9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of
Understanding shall be brought in the Superior Court for the Third Judicial District of the
State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and
obligations of the parties under this Memorandum of Understanding.
10. Severability. Any provisions of this Memorandum of Understanding decreed
invalid by a court of competent jurisdiction shall not invalidate the remaining provisions
of the Memorandum of Understanding.
OWNER:
By., ,, C66/J�!��`) "
Date: CC%`I"���
T
STATE OF ALASKA
THIRD JUDICIAL DISTRICT
MUNICIPALITY:
By:
Title:
Date:
ss.
t ��
The foregoing }}��strument was acknowledged before me this i day of % I. a
a0L by /_�a.iL." ! X �.
NOTARY PUBLIC FOR ALA., S j�
My Commission expires: IMY tbammm �
esp. 3 i- 13
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www. c i. a n c h o ra g e. a k. u s
(907)343-7904 1111
ik+
CERTIFICATE OF HEALTH AUTHORITY APPROVAL''
FOR A SINGLE FAMILY DWELLING"
Parcel I.D. tt7 3 I l- eo I " 1 0
1. GENERAL INFORMATION
HAA# #g" 0�0 qTF
Expiration Date: t J Za ato
Complete legal description WHITESTONE ESTATES SUBDIVISION: LOT 10
Location (site address or directions) 20740 PTARMIGAN BOULAVARD * EAGLE RIVER, AK 99577
Current Property owner(s) RANDY WEDDEL Day phone 694-8376
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
20740 PTARMIGAN BOULAVARD * EAGLE RIVER, AK 99577
Day phone
BETH WEISER w/ PRUDENTIAL JW Day phone 762-3111
3801 CENTERPOINT DRIVE * ANCHORAGE, AK 99577
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 5
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
0
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
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 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates 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 properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the Health Authority 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.
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, Ltd. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
l✓
Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
IWITSi 2
337-6179
Date B A-cl oS
ttttl(tOF ((fl(fff/�Kt(r
�ipns: • . •♦•� r
• ON-S1TE : ��^
,ATE �y
WASTEW nnn c`
Maintenance Agreements
Supplemental Engineer's Report
Other
By: __ Original Certificate Date: Z ��
(Rev. izroi)
Municipality of Anchorage
' Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: WHITESTONE ESTATES SUBDIVISION: LOT 10, Parcel ID:
A. WELL DATA *PER 2000 INSPECTION REPORT
Well type PRIVATE If A, B, or C provide PWSID# N/A
Date completed *7/25/2000 Sanitary seal (YIN) YES
Total depth *181 ft. Cased to *181 ft.
FROM WELL LOG
Date of test *7/25/2000
Static water level *115 ft.
Well production 20 g,p,m,
WATER SAMPLE RESULTS
Coliform 0 colonies/100 ml. Nitrate 0.1 mg./L.
Well Log (Y/N) NO
Wires properly protected (Y/N) YES
Casing height (above ground) 18+ in.
AT INSPECTION
8/10/2005
113 ft,
5.4 g.p.m.
Other bacteria 0 colonies/100 ml.
Arsenic: N/A mg./L. Date of sample: 8/10/2005 Collected by: GEG, LtD.
B. SEPTIC/HOLDING TANK DATA
Tank T e/Material STEEL/BIOCYCLE 8/24-25/2005
Type/Material Date installed 10/13/2000
1000/
Tank size 1500 gal. Number of Compartments i -4- Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A
Date of pumping 8/17/2005 Pumper JR'S PUMPING
C. ABSORPTION FIELD DATA BEtow FltJAL GRADE
NEW TRENCH/
Date installed 8/24-25/2005 Soil rating 02> ft2/bdrm) 2_0 System type **OLD TRENCH
Length 75/65.3 ft. Width 375+/ 5/5 ft. Gravel below pipe 1.02/1 ft.
Total depth *3.87+ 3.47 ft. Eff. absorption area 372 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test NEW Results (Pass/Fail)
Fluid depth in absorption field before test = in. Water added =gal.
Elapsed Time: = min. Final fluid depth = in. Absorption rate >=
For 5 bedrooms
New depth =in.
Any rejuvenation treatment (past 12 mo.) (YIN & type) - If yes, give date -
**OLD TRENCH IS SIZED ONLY FOR 4 BEROOMS.
D. LIFT STATION
Date installed
"Pump on" level at _in.
E. SEPARATION DISTANCES
Size in gallons
High water alarm level at in.
Cycles tested Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+
Absorption field on lot 100'+
Public sewer main N/A
Sewer /septic service line 25'+
On adjacent lots 100,+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Holding tank N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10,+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
1 certify that /have determined through field inspections and ,t ;' —
1 '••�
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
'.J a omess.:
Engineer's Printed Name JEFFREY A. GARNESS O°� •. C —79 3 .•'`ek
4 e,e'az�ofi��
Date �2ri�D� D�rofessto���
Opp000
HAA Fee $ T 1 15
Date of Payment �
Receipt Number q 3 151
(Rev. 12101)
Waiver Fee $
Date of Payment
Receipt Number