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SAND LAKE #2 BLK 3 LT 15
,Sand Lake Block 3 Lot 15 #011-134-10 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: _______________ Date of Issue: ____-____-____ Parcel Identification Number: ____-____-____ Legal Description Block Lot Property Owner Name & Address: Pump Installation Date: _____-_____-_____ Pump Intake Depth Below Top of Well Casing: __________ feet Pump Manufacturer’s Name: ___________________________ Pump Model: _____________________________________ Pump Size: ____________hp Pitless Adapter Burial Depth: _________ feet Pitless Adapter Manufacturer’s Name: _________________________ Pitless Adapter Installer: ____________________________ Well Disinfected Upon Completion? XX Yes No Method of Disinfection: _____________________________ Comments: Pump Installer Name: __________________________________ Company: ___________________________________________ Mailing Address: ______________________________________ City: ___________________ State: __________Zip: _________ Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. Municipality of Anchorage e Development Services Department Building Safety Division On-Site Water & Wast,water Program, 4700 South Bragaw St, P.O. Box 196650 Anchorage, AK 99519-6650 wv~v.ci.anchorage.ak.us (907) 343-7904 Pug, 1 of On-Site Wast,water Disposal System and/or Well Inspection Report r.,.... ..... Number:. SW020020 PID Number:. 011-134-10 '°rne:KIM AND PATRICK MOORE Wastewater System: I-I New · Upgrode 81;32 SEAVIEW STREET * ANCHORAGE, AK 99502 ABSORPTION FIELD Phone:(907) 242--0408 ;3 · Deep Trench n Shallow Trench ri Bed ~3Mound ·Othere LEGAL DESCRIPTION *o.7 ~ 5 15 SAND LAKE #2 2.01 MAXIMUM WELL: O New f-I Upgrade 2.5 ~ 1 -- K A+ HOME SERVICES 7-8/2002 SEPARATION DISTANCES us.,u. ,",.o,.~r,. ,s.r.c,. T..__~o S~pUcTo.k ~b~omUonr.~d St~uonUft Ho=.gTo.k ~s~.~' ANCHORAGE TANK 1500 Well *el 00'+*'130'+ - - 25'+ STEEL 2 s~o=o woto~ ~oo'+ too'+ - - - LIFT STATION .ut Un* 5'+ 1'+ -- -- -- 1500 ANCHORAGE TANK/ORENCO SYSTEMS Foundofion 5'+ 10'4- -- -- -- TIMER TIMER 46" Curtein Dmin NONE KN0~ ~20 OSI 05 HHF M.O.A. I Remarks: *THIS IS AN ADVANTEX TREATMENT UNrT BENCH MARK · *SEE D.E.C. WANER I.['n'ER DATED TOP OF GAS METER (PLASTIC METER CASING) JANUARY 26, 2002 100.00 Inspections performed by: AKWWC, INC. Dates: 1st 5/7/2002 2nd 5/8/2002 3rd 5/8/2002 s.: Development Servicers Depactmej3t Approval 7953 SW020020 - 011-134-10 ~ ~ / ~ ~ // N / ~1 31.5 16.3 ~~ MH1 39.2 26.7 --N~ D~.n~ MH2 41.0 29.6 X MT1 36.2 43.0 / ~ MT2 60.3 55.8 GON~ULTANT$, lNG. KlM AND PATRICK MOORE (907) 242-0408 2 OF 5 ~ ~ Je ~e ( ~.~G~m~ .: j AS-BUILT DRAWING ~OR SEPTIC SYSTEM UPGRADE (ADVANTEX SYSTEM) '~~ ,~ ~o~: AS-BUILT DRAWING SW020020 011-134-1 *, ~""~--.- ~ ;~r;~~ I _ ~ ~w'~ .,5~, :.-- ... .~/~/2oo~ ....~~ ~S~ ~TER & ~STEWATER ~ CONSULTANTS, INC. KI~ A~D PATRICK ~OOR[ (907) 242-0408 3 OF $ ~l".a ~ o~:.~o.: 0~," , {~-**~* ..'"~'~ SAND ~KE SUBDIVISION ~2; LOT 15. BLOCK 5, ~,. "'A ........ '"~.~ ~E OF WORK: PROFILE AS-BUILT DRAWING OF SEPTIC SYSTEM UPGRADE 05/14/2002 13:22 FAX 9078686770 A+ J~omo Ser¥1ces, Inc. ~]001 ~,..~.~...~...~..~.~?~,~'~;~. ?..~:,.:..~.~,::? ~,:- .::. . .... ' · .:. ,', ::~MuI~W~,~~~ ' . ~:~::~.~ o~ ......... " ' ' · ..: , , ..'~ ~ ~ · II MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewafer Program 4700 South Bragew Street P.O. Box f96650, Anchorage, AK 095f9-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Feb 06, 2002 Expiration Date: Feb 06, 2003 Permit Number: SW020020 Legal Description: SAND LAKE #2 BLK 3 LT 15 Design Engineer: 0041 AK Water & Wastewater Consultan' Owner Name: Klm & Patrick Moore Owner Address: 8132 Seaview St. Total Bedrooms: 3 ANCHORAGE, AK 99502-0000 Parcel ID: 011-134-10 Site Address: 008132 SEAVIEW ST Lot Size: 6750 SQ. FT. Permit Bedrooms: 3 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 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, Date: Date: 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.cLa nchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 011-134-10 Permit Number ~'t4,/O2, 0020 Property owner(s) KlM AND PATRICK MOORE Day phone 242-0408 Mailing address (1) 8132 SEAV1EW STREET * ANCHORAGE. AK Mailing address (2) Zip Code 99502 Legal description (Lot, Block & Sub'd.) LOT 15. BLOCK 3: SAND LAKE SUBDMSION Legal description (Section, Township & Range) N/^ Lot S~.e ~ ~ ~'"~) Acre ~s~'~ Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade Well Only Water Storage THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Jacuzzi Water Softening Unit 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. ALASKA WATER & WASTE'WATER CONSULTANTS~ INC. Permit Fees: '~~/'/~0 Date of Payment: (~ ~ 1 (~', Receipt Number: OI ~"q'~ ~'- Waiver Fees: ~/~J~-~) Date of Payment: ;;;2/~"/~3 ~ Receipt Number. ~)/~--~'//7 ~ ALASIG WATER & WASTEWATER CONSULTANTS, INC. January 8, 2002 Municipality of Anehorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic System Upgrade for Lots 15, Block 3, Sand Lake Subdivision//2 ADVANTEX'r'~ TREATMENT SYSTEM To whom it may concern: 1. GENERAL: The existing 3 bedroom home is served by a private well and septic system. The septic system is surcharged and must be upgraded prior to the sale of the house. As can be seen on the attached site plan and design drawings, there is no area available to upgrade the septic system without obtaining waivers to the two closet class "C" wells. We are requesting waivers from A.D.E.C. from the class "C" well on Lot 16, Block 3, and the class "C" well on LOt 10, Block 3, to a proposed septic system upgrade. Due to the existing septic system location, the poor soils conditions, the small lot size, and the well radii, we are proposing to use an Advantex treatment system and a pressurized deep trench type drainfield. The proposed drainfield is to be installed within the 30 foot radius of TH#1. 2. SOILS: See the attached log, which shows the soil classifications, groundwater monitoring, and the percolation test results. 3. DRAINFIELD APPLICATION RATE: The intent is to install an Advantex Treatment System that will allow the use of a small drainfield in the area around the 30 foot radius of the test hole. Two percolation tests were performed in test hole #1 at different depths. The upper bench percolation rate was 48 minute/inch and the lower bench percolation rate was 80 minutes/inch. We are proposing that the size of the drainfield will be based upon an application rate of 0.7 GPD/FT2, which is an average between the two allowable application rates. 4. TRENCH DESIGN: a. Percolation Rate: 48 & 80 minutes/inch b. Allowable Application Rate: 0.7 gallons/day/fi2 c. NumberofBedrooms: 3 d. Design Flow: 450 gallons per day 6901 Debarr Road, Suite 2B ~ Anchorage, AK 99504 ~ Ph: (907)337-6179 ~ Fax: (907)338-3246 e. Minimum Absorption Area: 643 R2 f. Total Depth: 12 feet (max.) g. Effective Depth: 10 feet h. Width: 2.5 feet i. Minimum Length: 33 feet long j. Effective absorption area = 660 ft2 5. ORENCO PACKAGE SYSTEM: The STEP tank with the Advantex Treatment System will be manufactured by Anchorage Tank & Welding to meet the latest design criteria established by Orenco Systems, Inc. The point of contact at Anchorage Tank is Lowell McNutt. As with their standard STEP tank, it is equipped with a high water alarm per M.O.A requirements. 6. SURFACE WATER: There is no surface water within 100 feet of the proposed septic system upgrade. 7. TOPOGRAPHY: The area for the proposed septic upgrade is generally fiat. In short, there are no slope concerns. 8. LOT LINE ~,VAIVER AND SEPARATION DISTANCE BETWEEN DRAINFIELDS: We request that a I foot lot line waiver be granted from the south property line to the proposed drainfield. We are unaware of any adverse effects on the neighboring property with the granting of this waiver. Also, we request that the separation distance between the proposed drainfield and existing drainfield be waived from 20 feet to 12 feet. Given the fact that the drainfields will not be used simultaneously, it is our opinion that there is little risk with the requested separation distance. 9. CLOSING: I am open to any suggestions from your department that would be an improvement to the proposed system. I am unaware of any negative impacts that this installation would impose on adjacent wells, or septic systems. If you have any questions, please call us at 337-6179. ~er~~ i e ~' P.E., M.S. Pre NOTE: Attached is a site plan drawing, a design drawing, an Advantex detail, a trench detail, a two page soil log, and a 7page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B ~ Anchorage, AK 99504 ~ Ph: (907)337-6179 ~ Fax: (907)338-3246 '---~/~,,~ ~~ r ..... "~ .. ~{ ' ,_~.~~ . , 1/ ~g. e~ ~;~~ / ~, ~ ~(S~ D~, P~E 2 OF 4) ~ ' ' ~ ~ , I ' ' ' I %%% I ~ B~K ~; // ~ 13. B~K 3; m ~ 12, ~K 2; ~ 13, I "-~ Z ~.-~_. j :~_~._ /~ ....... ~ ~ WE~ 82ND A~UE / ~ 1. B~K 5; ~ 24. B~ 5; ~ '...- ....... ~-.', ,' I ' "' ~ 4. ~K 5; ~ 21. B~ 5; ". ' a .' ' ~ ~ ' ' '"~ ~ 5. B~K 5; ~ 20. 8~K 5; K 6: ~ 1~ B~ 6; I , I , 1/8/2002 KlM AND PATRICK MOORE (907) 242-0408 1 OF 4 m~ SAND ~K[ SUgOIVI$ION ~2; LOT 15, BLOCK ~. L ...... ~E OF ~RK: ~Profess~o~ SITE P~N FOR SEPTIC SYSTEM UPGRADE (ADVANTEX SYSTEM) t, ~.-PROPOSED ADVAN11D( TREA'IMENT UNff ~ \ pUUP VAULT I~IAT HAS DUN. OU~..ETS ~ ~ . ~ ~ / / I~Y ~a~ P~ u.P.c. ,,, I~, __~~-.:- ~ ' ~p~ D~N~ U~ ~VA~ A ~ ~ ~ t~l ~, ~D 10 ~ OF C~, W~H~ / ~ ~ ' I~l~ ~ W~ REOU~ ~OU ~E ~NG C~ 'C' ~ ~ ~ 10, ~/ ~ ~O~ ~E CO~TOR S~ B~K 3. ~ ~E ~ ~ON OF~E ~ ~ SO~ PROP~ UN~ ~D ~ ~ ~ll W~ ~NG ~D P~ S~C ~1~ ;HOWN ON ~]S D~ ~G~ ~ A REGI~I~ED / ~D SU~ PRIOR TO KlM AND PATRICK MOORE (907) 242-0408 2 OF 4 " ~' . ' . .... SAND ~KE SUBDIVISION ~2; LOT 15, BLOCK ~E OF ~RK: '~, rofe~o DESIGN DRAWING FOR SEPTIC SYSTEM UPGRADE (ADVANTEX SYSTEM) '~A%~ ~/~-~ ~4~ LAKESUBD6/ISION ~ ~PRO~S~ ~ ~ UN~ ~ ~~ ~ PUMP V~LT ~T ~ ~ O~ ~ ~ . ~ ' / / ICOU~Y ~N~ P~ U.P.C. / '~ ~ '~ x ~ '~,, ', ~ ~ , ~~ ~'~-, ~ ~_ ~:, ..:~ ......,.... ~x ~ ~,-~q,x~-~% '~ - .,,,.:.~..~...~.: - - ~ X ~ --I~UNEW~ REQ~ ~ ' ~PRO~ D~N~ U~ ~VA~ A 1~5 I~H ~H. ~ ~ ~ 1/4 I~H ~NG ~ '~ ~ ON ~ 10, ~ ~NO~ ~g CO~TOR S~ ~ ~E NO~, ~T, B~K ~. ~ ~E ~ ~ON OF ~[ ~ · SO~ PROP~ UN~ ~D ~ ~ ~ll W~ ~ ~D P~ S~C ~ SHO~ ON ~IS D~WINO ~G[D ~ A REGI~ / ~D SU~OR PRIOR ~ ~ CONSULTANTS, IN~, KlM AND PATRICK MOORE (907) 242-0408 2 OF 4 Y$)V~ ~ OF WORK: ~A~rofea~o~ DESIGN DRAWING FOR SEPTIC SYSTEM UPGRADE (ADVANTEX SYSTEM) AdvanTex Treatment System ~ .o~..._ .~'uTHr.c~.~ ADVANT[X MANUAL AX Series - Mode 1 a Three (3) 34x48 Pods ' ' NOTE: THE BOARD INSULATION TO Br. .I. INSTAl t PT) OVE~ THE SEF11C TANK z. 4 BEYON~ ON ALL SIDES EXC~ UNDER I THE ADVANTEX FILLER. THIS WlLL ALLOW FOR H'-~T TO ESCAPr. FROM TANK & TANK TO F1L1ER INLET THE AX-lO PODS SHALL BE: PLUMBED J SO THAT THEY CAN EACH BE ISOLATED. lg4' 'n~R~: (3) /0(-10 FILTERS CONNr.CT~ TO~r.~ER. PUMP VAULT WITH DUAL OUll. LqS TO r.X1ST1NG DRNNFIEI. D TO PROPOSE~ DRNNFIEI. D PASSIVE AIR 2' INSULA'nON INLETI__ I~OO BIO,BE SCREENED VAULT ALASICa. WATER & WASTEWATER CONSULTANTS, INC. PREPARED FOR: PHONE NUMBER: KlM AND PATRICK MOORE: (907) 242-0408 SAND LAKE: SUBDIVISION ~2; LOT 15, BLOCK $, DETAIL DRAWING OF ADVANTE:X TREME:NT UNIT 1/8/2002 J.Lbl. SCald. E: N.T.S. PAGE NUMBS: 30F4 EFFLUENT PUMP .... .::!....;..! ~o~o~_'~. ~'~h9~i....'<,.7 'u~;,*,2 "...._~ .... .': ~ 30 ~.tt~ LONC I ~- _ ~. ............... _~ VAULT L OIS'~BUTION uNr IS TO er 1.2.5 iNCH / MONITORING 'I1JB£ Sell 40 ~ WtTH 1/4 I~CH 01AMEIT:R HOLES SPACED EWRY 25 ~CHES OH CENW. R (30 HOLE~ IOTAL). MONITORINO TUBE UT /--FINAL GRADE J.L.M. ' ~' t ALASKA WATER & WASTEWATER ~ r~,.. ~ r, ~ · PREPARrn FDR: PHONE NUMBER: PAG£ NUMBER: .... .~. , [; ~ [' .f ........ ."... KlM AND PATRICK MOORE (907) 242-0408 4 OF' 4 ~ ~., h e~l.~.Corness. SAND LAKE SUBDIVISION 11~2." LOT *IS. BLOCK ;5, (J~.."e2_".XL,,,,.._ ........- ~=,'"~'~"'~ ~E o~ WO,K= '~,~.-~*ro~.,,~o~'---.~ DETAIL DRAWING OF PRESSURIZED DRAINFIELD ~'~.%~:~,~,~"~<~ ALASI~ WATER & WASTEWATER ~: !l~/lti'""~ CONSULTANTS, INC. · ISOIL LO(; - PERCOLATION TES[I ! ..,, [.j/.. ~ .. ......... :....~ LECAL DESCRIFTiON: SAND b~E SUBDMSlON f2; LOT 15. BLOCK 3q/l~l t~ ".%~'~-'-'~ Je I~e~ A. ~C~ ness.. PERFORMED FOR: KlM AND PATRICK MOORE DATE: 12/21/200' 'Qh.'~,'" , '~ -7953 ..,"~ v. ~ Pr o~°~ (f ORC, ANICS ~TEST HOLE #1I PACE I OF 2 I I I t I SM GM CL GC OL Ix [ i --~l NO DEPTH TO DATE /I ~ ~' - .. .... - GROUNDWATER / - - DRY 12/21/01 // I '°II]IIIllI 11 DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) 12/27/2001 1 2:25 - 6- - 12 SM TO UPPER 2 2:55 ,30 5-3/8" 5/8' I~IIIIIIII SM/ME --BENCH 4 .3:25 30 5--3/8' 5/8' 14 5 ,3:25 -- 6' 6 3:55 30 5--3/8' 5/8' 15 16 17 18 19 PERCOLATION RATE 48 (HIN./INCH) PERC, HOLE DIA, 6" (INCHES) TEST RUN BETWEEN 4,0 FT, AND 4.5 FT, 2 COMMENTS: SOILS LOGGED BY JODY MAUS, PERCOALTION TEST PERFORMED BY CALEB C..,ALL IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: ALAS WATER & WASTEWATER ISOIL. LOG - PER¢OLA'I'ION TESII ~ ....... ~r..a?.x...x ........... LEGAL DESCRIPTION: SAND LAKE SUBOMSlON f2: LOT 15, BLOCK PERFORMED FOR: K~M ~D PAm~CK M00R[ DA~: 12/2~/e001 ~[r~I ITEST HOLE ~1 1- PAGE 2 Of 2 I I ._ . . GW :====:OrG 3-- ~ GP ~ ML ~ ~ GM,~ff~ CL 4-- 0 GC OL SW MH ~ SP CH S- ~ SM OH SEE SITE P~N ~ SC ON PAGE 1 OF 1 6-- 7~ Z DEPTH TO DATE 0 GROUNDWATER 8~ Z 10~ ~ CLOCK NET TIHE WATER LEVEL NET DROP ~ DATE READING 11 -- ~ TIHE (HINUTES) READING (INCHES) 12__ ~ 12/26/2001 1 2:58 - 6- - LOWER 2 ~:28 ~0 5-5/8' ~/8' ~ ~BENCH ~ ~ ~:28 - 6' - ~=-- ~ 4 =:ss =o 5-5/8' =/s' 14-- 5 3:58 -- 6' - ~ 5-5/a' =/s' ~ 6 4:28 ~0 15-- 16-- 17-- 18-- 19-- PERCOLATION RATE. 80 (HIN./INCH) PERC. HOLE DIA. 6' (INCHES) I TEST RUN BETWEEN 7.0 FT. ~D 7.5 FT. 20--~ COHHENTS: P~CO~ON ~ PERFORM~ BY JOE M~CHLilii. PERFORMED ~ ~ WATER ~ W~A~R I, JE~R~ ~ G~NESS, CE~ T~T THIS ~/PERFORMED IN ACCORD~CE WI~ ~ ~A~ ~D MUNlClP~ GUlDEUNES IN EF~CT ON TONY KNOWLES, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION DIVISION OF ENVIRONMENTAL HEALTH DRINKING WATER and WASTEWATER PROGRAM 555 CORDOVA STREET ANCHORAGE, AK 99501 http://www.state.ak, us/dec/hom e/btm Jeffery A. Garness, P.E., M.S. Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B Anchorage, Alaska 99504 Telephone: (907) 269-7696 Fax: (907) 269-7650 January 26, 2002 Subject: Lot 15, Block 3, Sand Lake Subdivision, #2;Wastewater Disposal System Waiver Request from Two Existing Class C PUblic Water System Source Wells; Review Dear Mr. Gamess: This is response to your letter received in this office on January 15, 2002 in which you the Department to grant three separation distance waivers between the proposed wastewater treatment and disposal system to be located on Lot 15, Block 3, Sand Lake Subdivision, #2 and two different Class C public water system source wells located in the same subdivision. I have completed my review of the files covering the two public water systems and the submitted information. Based on this review and our telephone conversatioh of January 23, 2002, I believe that the requested waivers are reasonable. As noted above, you have requested the Department to grant three separation distance waivers between the proposed wastewater treatment and disposal system to be located on Lot 15, Block 3, Sand Lake Subdivision, #2 and two different Class C public water system source wells located in the same subdivision. With the wastewater being generated on Lot 15, Block 3, Sand Lake Subdivision #2 receiving additional treatment, the waiver requests are reasonable. Therefore, in accordance with the Drinking Water Regulations [18 AAC 80], the following waiver is being granted: The horizontal separation distance between the Class C public water system source well located on Lot 16, Block 3, Sand Lake Subdivision, #2 and the proposed Advantex Treatment system and the existing drainfield located on Lot 15, Block 3, Sand Lake Subdivision, #2, serving a single family home has been waived from 150 feet to 100 feet. · The horizontal s~paration distance between the Class C public water system source well located on Lot 16, Block 3, Sand Lake Subdivision. #2 and the proposed drainfield located on Lot 15, Block 3, Sand Lake Subdi,Jision, #2, serving a single family home has been waived from 150 feet to 130 feet. · The horizontal separation distance between the Class C public water system source well located on Lot 10, Block 3, Sand Lake Subdivision, #2 and the proposed drainfield located on Lot 15, Block 3, Sand Lake Subdivision, #2, serving a single family home has been waived from 150 feet to 130 feet. Jeft'ery A. Garness Page 2 01/26/02 Thc above noted distances were taken ii'om your submittal. If the prOposed wastewater disposal system located on Lot 15, Block 3, Sand Lake Subdivision #2 fails or needs to be upgraded, this waiver becomes invalid. Please provide a copy of the record drawings of the installation o£the Advantex Treatment System and Soil Absorption Systems to ensure that the above noted separation distances are being maintained. Thank you for your cooperation with this office. If you have any questions, please do not hesitate to contact me. K K Kleweno, P.E. Environmental Engineer Cc: Jim Cross, P.E., MOA Municipality .of Anchorage Bttilding S,'ffcty D~vas~on P.O. Box 1OGG$0 · 4700 S. Bragaw Street Anchorage, Alaska OOS19-C-C~0 · (907) B43-8301 http://www.cl.nnchoragc.ak.us 2/6/2002 Jeffrey A. Gamess, PE Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B Anchorage, Alaska 99504 Subject: Waiver Request for Sand Lake/12 Subdivision Block 3 Lot 15 Waiver Request #WR020004 Parcel ID/1011-134-10 Wastewater System Construction Permit Number 8W020020 Public Works DearMr. Garness: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to property line has been approved. The approved separation distance is 1.0 foot. This waiver approval applies to the existing absorption field to property linc separation only. Any future upgrade to thc on-site wastcwatcr disposal system will require all separation distances bc met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Daniel J. Roth Civil Engineer On-Site Water & Wastewater Program M-nlcipality of Anchorage · Development Services Department Building Safely Division On-Site Water and Wa.sic. water Program 4700 Bragaw Street P.O, Box 196650 Anchorage, AK 99519-6650 www.cLanchorage.ak.us (907) 343.7904 Waiver Review Worksheet Wl~: WR020004 PID~: I}11-134-10 HA#: Permit~: Date Received: 2/06/02 Legal Description: Sand Lake N2 Block 3 Lot 15 Engineec Jeffrey A, Gamese PE Alaska Water & Wastswatsr Consultants Applicant: Klm & Patrick Moore Waiver Requested: I foot from South lot line to dralnfleld Cdteda: 'Geology A. Water Table B. Soil Sorption C. Permeability D. Watar Table Gradient E. Horizontal Separation Points: Total: Waiver is Granted: ~/ Waiver is not Granted: Llst Conditions or Reasons for above: ~'JE/[ ~1 ~7"/~.&'-/y,~'~:} ~'./V ~//V~/~' .~; L Name of Reviewer Rec~: 16475 Amount: $160.00 Date Paid: 2/6/2002 MIJNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAl.. PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L. Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT , [] UPGRADE MAI LING ,~DDR ESS I~/ 4-11ol DF V6 LEGAL D EscR I~'-TI O N LOCATION NO, OF BEDROOMS ~ DISTANOETO: Well lO0+ Absorption area ~/ Dwelling 14' *~ Manufacturer ~~ Material No. of compartmems ~¢ Liq. ~allons IF HOMEMADE: Inside length Width Liquid depth ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O ~ ~ Manufacturer Material Liquid capacity in gallons ~ Well Foundation i~ Nearest Jot line ~ ~ PER~T~O~ No. Of linesI Length of each ,ine~ Total length of lineal Trench ~, inches Material beneath tile Total effective absomtio~re~ Io8 ,nc.e. Length Width Depth PERMIT N ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ¢ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS REMARKS~ I -- ' I APPROVED DATE LEGAL 72-013 (Rev. 3/78) F'E:RH Z T NCL ~: F'F:'L I 7.: F.l',,Fr LOE:RT Z :' I'.. [-...-r 7,.. :['sT CONS'T'. t L.:t5 EE~: E, Fi.N[::, LRF.:E d.76± HF-!RE; E R' ! ',,'E 99~3I:[~7' t 3T E ! 2E T'fF'E O[:' :BOIL ¢qB'Ei'*F'F'T'.riN S¥S'I"EH ]1:5: '_5C '[ [. F:FIT '[ ?,1 '3 ';: Si;-! F'T,-"'E~F: ', = ;:;~'~ E~ ................. ::,_,x..,:_ OF THE ~qOf_L. .P.,'EF.E;OF.:F'~rI3?-~ '£;'¢:STEH Z:5- THE L.ENGTH EZHEt',ISZON .T.S THE L. ENGTH '.'.'IN FEET) OF THE TF::E:NCH TFIE DEPTH OF R TF.'ENC:H OR F'ZT :[~1 THE D;f.E;TF~,NCE E=E'F!qEEN THE ~;UF:FRC:E OF' THE GF.:OUI'4[::, FIN[/, THE E~O'T'TOH OF' THE E:XC:R',,,'RTZCtN ,::_TN FEE:]"). THE: GRFI',,,'EL E:,E:F'TH :iS THE: H:[NIH!.Ji"! E:,EPTH OF' GF..'FI',?EL E',ETFIEEN ]"HE OUTFRLL F'ZPE: FIN[> 'THE DOTTOJ"! OF THE E;:<:CW,,--'RTION <iN FEET::,. F,u*~,.,. ........ .... T IaF'F'L. ZCRNT L-IRS '['HE I~:ES;F'ONSIE~!LZ'r"¢ 'TO Ii',!FE$::F! TH.'[':_: r"£:'~zt-"F.'""hlU*'t'¢'~..-,. .................. [:,URI ' ':i ]-HE: Z'~ ':"CFll i ':;~"""'~ iN:F;F'ECT:[EII',!E; (/iF' RB!'¢ HELLE; F!r.:,JFfl:::ENT TO THJiS F'F::OF'E:F:T'-? Ft!',I[:, THE t-Jt_t',IE.F'Ft OF: F.:EE;!OENCEE; TI.aRT THE HILL HIN!HUH Di:E;TRNE:E E;ET.'dEEN F! HEL. L RND R.N'.¢ ON-<SITE !SE!.,.!F!GE DIL:;POE;FIL :5'-.¢:5-f'EH :LTL.: :i. OE'~ FEiE]" FOF.: R F'RI',,,'F!TE !qELL. ('.'iR :£50 TO 200 FEET F'ROH Fi PUBLIC I.,.!ELL [:,EPENr~,i[NG UP.CS,! THE T'¢PE 0[:' PUBLIC !.dELL. I'"!:[NIHUH ©!%'TFINCE FF?OPI FI F'RI',,,'R'f'E [JELL TO Fi F:'F.::[',,,'RTE SE[,.!E[~'. LINE 12; 25 FEET RN[::, 'TO R E:OHr,!UN:[Tb' %E[qEF: LINE I2:.; 75 FE:ET. OTHER RE:QU:[RE:FIENTS P'ff:¢'r' RPF:'L¥. :E;PEE:iFI'E:FFFION:5 RND CO.N2;TRUCTiON D):,q. GF;tFIH::.:, FiRE P,'.'..,'F::[ L_RBI....E ]"0 I_NSURE F'ROPE[;:: I NS'f'RLL. RT ! ON. I CEF:T]:F'?' 'THRT !.: I FiH F:FI.hi:I:L. ZRR F!I'TH 'THE f~:E:~i&.!IF?EHENTE; F'OR ON-E;ZTE ~JE[,.!ERE: FIND P.tELL2; Fl:~; :SET FOFRTH E:? THE HUN:[ C:IF'RL.I'f'%' OF' ~NCHORFIGE. 2: i HZLL iNSTR!...L. THE SMSTEH ]:N RCCOF:DRNCE i,.!ZTH THE CODE:S. 7X:: Z UB!E:,E:F'.STRND T[-ff~T THE ON--.S:[TE :~;Ek!EF? S'¢STEH HR'[ REE!UiRE E:NL..RF:GEHEN'I" IF THE F~tESZDE?,ICE :[E; Fq:EHODEL.ED 'i'O INCLUDE HORE THF!N 1 2 /~_11 12 13 14 15 16 17 18 19 20 /.. ,.--.~ J~ SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEAL'FH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PERCOLATION TEST PERFORMED FOR; LEGAL DESCRIPTION: - 'l CQMMENTS PERFORMED BY: . 72-008 (6/79) WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Reading Date PERCOLATION RATE TEST RUN BE'f'WEEN [] PERCOLATION TEST DATE PERFORMED: SLOPE SITE PLAN Gross Time .:~; 0.5 Net JDepth tO Ne~ Time,, ._~....L Water Drop · ~' -- 0,~ ~ CERTIFIED BY: • Municipality of Anchorage r��= On -Site Water and Wastewater Program K (907) 343-7904 S f C T Y Certificate of On -Site Systems Approval Parcel I.D. 011-134-10 1. GENERAL INFORMATION: Expiration Date: g- 12-,20 W Complete legal description SAND LAKE #2: BLOCK 3, LOT 15 Location (site address) 8132 Seaview St. *Anchorage 99502 Current Property owner(s) Eugene Berg Day phone 612-309-9952 Mailing address Real Estate Agent 2. TYPE OF DWELLING: LX Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well 0 Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 55D /iia°50 Date of Payment 5-11A1 Receipt Number t- r% ffL�4 COSA # (35-- Waiver 3`- Waiver Fee $ Date of Payment Receipt Number Waiver # COVID-19 257o DISCOUNT APPLIED 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, snows 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: G_arnessEngineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 J1140Engineer's Printed Name: Jeffre A. Garness Date: In conductin,e ur,s evaluation, GEG provided an engineering evaluation of the well and/or septic system n accordance with the guidelines and regulations established by the Munic oality of Anchorage and ``• ':_ nd rstry practices. The reported results describe the condition of the system/s on the datels of the - _•r - 1 . .. ,"/ . . e.alua:ion Separation distances mHidden defects or ....... .'�_re measured to readily identifiable features. -�- . encroachments may exist that were not identified during the evaluation. The operational life of all wells and septc systems depend upon a variety of variables, including but no: limited to, soil conditions, R r, groundwater levels (that may fluctuate during the year), quality of construction (materials and r" r1 :workmanship), and the :nater usage of the family utilizing the systemis. These conditions can vary, and �! "�' ""' (L, are outside the control of GEG. Satisfactory test results do not guarantee future performance of the systemis: therefore. GEG makes no warranty (express or implied) regarding the future performance of ......... .........;f the well or septic system. GEG makes no representation whether an alternative well or septic system ter ti '• r ' r' c e= can be installed on the property in the event either of the current systems fail to perform adequately in v{ Imo, '• 7�J c �• the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right WI18t5oeVe(, mAECC884 6. DSD SIGNATURE `PL1TY(Q�(��//, System #1 Approved for , bedrooms �J��,\Qy�r� System #2 Approved for bedrooms Q_,T� O Disapproved 4 o I�/A7� f�iAsx,- ; �lVp n, Conditional approval for bedrooms, with the follgwtg stla'7�SIi�TR �a AAS o� �,� {c, Original Certificate Date: S / ZrZc.�ZC7 The Municipality of Anchorage Development Services Division (DSD)' issues Certificates of On -Site Systems Approval (COSA) based only upon the representations giver in paragraph 5 by an independent professional civil engineer registered in the State of Alaska: The klunicipality or Anchurage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: y COSA Checklist ) Nitrate Advisory Septic System Advisory Arsenic Advisory -, e Well Flow Advisory Other COSA Checklist Legal Description: SAND LAKE 1,12; BLOCK 3, LOT 15 Parcel ID: 011-1314-10 Ii more than 1 septic system on lot: COSA Checklist -1 1cf Structure served by this system 1 A. WELL DATA j `Nell log is filed ti=:pith Onsite (or attached) Well�producticn at time of test gpm Date drilled Water storage tank volume ' gallons Total death ft Well disinfected for coliform test? F Yes Fm1 No Cased to ft F031 Coliform bacteria is Negative 7 Sanitary seal is functioning correctly Nitrate mg/L, Fffi Nitrate Tess thanttrIRL (NDt VV res are properly protected Arsenic 48.1 ug/LEl Arsenic less than MRL (ND) Casing -,eight ,above Crops, �d) in. Collected by GEG, LTD, Date o I locv test for COSA Date of Sample "127"0 z Static :•rater revel at beginning of test ft. Comments FORMERLY" P,IVSIO r 216546 B. TANK DATA C. LIFT STATION Age of tank(s) 18 years 1 Required maintenance completed I't Tank type/materia l "' "` Age of lift station 18 years ' i leasured operating fluid levet in septic tank 41,i Lift station material STEEL 1L Standpipes/foundation cleanout per record drawing Comments: '"ADVANTEX Date Cf a,lrrlping 518120 i r ,i D. ABSORPTION FIELD DATA �`"r��, s .:��rs -, -' %Nhich` system tested (date installed) 518fJ2 Adequacy test date ' 127`20 c ` l F�) ALL standpipes present per record drawing Results Q Pass For 3 bedrooms c To:al'measured depth from grade 1'.?+ft (max) Fluid depth prior to test 0 in 2' M.,easured depth to pipe invert from grade _ ft (min) Water added 522 -gal z u IVA — pressurized held 33 l Newdeokh in t�I Mionitor tubes go to bottom of effective. if not, state 125 depth into effective Elapsed time ;min Code -required soil cover over i eId Final fluid depth DRY in System presoaked Absorption rate X50+ clod i Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) c ate of test; NIA Gallons introduced NIA` gallons If yes, enter date ror�ii�ierts/Deficiencies. ,.a.•..._„_, ..., ._�.�..�..,.�.:, .�._...>r�... , .���.Fu ,��.'�x .v,.,_,ti��.,,i„�xi,�,4,..x._,,,� E . .��:.... .; COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than renquired or if community well) G Tanta'; ift Station on Lot > 100' Community Sewer Manhofe,Cleanout > 100' ❑ Yes if No ft !7 Yes if No ft Neighboring 'Tank 100' a if No ft --Private SeweriSeptio Line 3 25' Yes' if Na ft ~""` l�) Ill- i L�sGi titin Field on Lot > 100' p _ ❑ Yes if No G€ding flank > 9 ti0' EI Yes if No it Neighooring Absorption Fields > 100' Animal Co— ra z ant > 50' ❑ Yes if No ft FI Yes if No ft Manure/Animal Excreta Storage Com=artunity Sewer Main > 75' ❑ Yes if No ft Q Yes ir,�.ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Buildina Foundal ons > 110' Q Yes i-$ iJo ft Surface Witer > 100' ❑ Yes if No `a,+ ft Property Lire > 5' ❑ Yes if No ft VVells on Adjacent Lots: Acs-orption Field > 5' Q Yes if No ft Private Olelis _ 100' ❑ Yes it No 50'+ ft xK� ^laver Main > 10' 0 Yes if No It Community Wells > 200' ❑ Yes if No ft kxk ':'ater Service Line > 10' ❑ Yes if No ft If septic tank is under driveway comment beloVil From Absorption Field on Lot to: (Please enter distances if less than required) Butiding Foundatieri > 10' C3 Yes if No xx0 ft if atisorpticn field is under driveway comment belovi Property Line > 10' ❑Yes if No ft Wells on Adjacent Lots: V\tater €:rain > 10' v Yes if No ft _ ❑ Private Wells > 100' _ El Yes if No, ft Water Service Line > 10' 0 Yes if No ft Community Neils > 200' fi Yes if No ft Surface Water > 100' ❑ Yes rf No 50'+ ft F. ENGINEER'S COMMENTS ,VVIR020004 **ONEDRAINFIELD IS UNDERNEATH A SHED -SEE LETTER FROM OWNER REGARDING FREEZING ...ASSUMED -THERE APEARS TO BE A 12' PUBLIC WATER SYSTEM EASEMENT ALONG EAST LOT LINE. (SEE ATTACHED AS-BUILT SURVEY FOR BLOCK 3, LOT 17)._ G. ENGINEER'S CERTIFICATION f� I cerinv that l have determined through field inspections and l reviewr ol, ilvllmicipal r aoor-ds that the above systems are in coriforrlrrnce vfith / s -f: r ; �,-' `t iv1UA COSA guidelines in effect on this date. ;` :.. `���.: �fl '� • � `f r VtA CO-S- 2hecklist yellow sheet ci a AEGG88d Arsenic Advisory Certificate of On -Site Systems Approval # OSC201186 Subdivision: Sand Lake #2, Block 3, Lot 15 A water sample revealed an arsenic concentration of 48.1 micrograms per liter (ug/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. S -D,6770 Annual Inspi: ction ;`-.P.rf Cv;nt-17mr'-Sil; ; Fuclene Berg sptcn Sox ....... 8', 32 Seaview Str"! :t, Anchorage AK 995102 AX -100088 SW020020 Retrieve O&M Into Dallyfi2w-- R^cim raft -r4ncr rn:-z;r.q,-,: Perform Field Sam:' Ing/Observations NTU (15 a N-rlel Odor of Sample Typical 1_7mu-. i ❑Ea,,hY L7 m a i d y On - -; p; c, a I Cab b aga F—',Decay oily illm In PVU Yes No Foam in tank Yo= No Check Contrql P011! I pyCdra Amps ,ta Amps 9 Audible and vitv,04-1 nrs [Z -OK 7 Dial Tone (talemctry. 11y) J-Jyc:• V-1 No inspect/Clean Pun, , System Inspect Clean Comments -�- �V- op.) -Al - Larry Betts AnchorageTank 907-272-3543 cnn!—i vhvq^ 612-309-9952 FM f FnU PIUL; Date tl Lf,ct RU100285 1 04/22f2319 jAeasure Sludge/SC"m Sludge Scum t Cu , .11. Previous Carrel PM-vtous 2nd cominwtrneW, current prevlouS Currant I inspect/Glean AdvanTex Filter Odor, ;7Normal Pungent ajornat: NorrnatExcessivO Sddging/Pondlng- Nonc-��'&,Icr 0 Excessive inspect/Clean Discharge Pump System Wset/Ud Splice Box ccrda InspeotpService other System components Wpect Cle- DisInfectlon EqUIPMOnt r'7 r-1 /E) Disp Inspect Cl+�,'Wl Additional Servicer Rendered sptcn Sox ....... ........... Pod Bottom Floa, Cards....... boats . - - - - . .... Pu,no ............ 8jo*un,Y!' Filtor ..... slutut3a Purno vaul, P,t>,,irculatIna spli"t, , ........... 7 ........... B .... .... 71i . . ......... Valve, ...... C� V 171111 selection) w 13 item Number Comments -�- �V- op.) -Al - Larry Betts AnchorageTank 907-272-3543 cnn!—i vhvq^ 612-309-9952 FM f FnU PIUL; Date tl Lf,ct RU100285 1 04/22f2319 jAeasure Sludge/SC"m Sludge Scum t Cu , .11. Previous Carrel PM-vtous 2nd cominwtrneW, current prevlouS Currant I inspect/Glean AdvanTex Filter Odor, ;7Normal Pungent ajornat: NorrnatExcessivO Sddging/Pondlng- Nonc-��'&,Icr 0 Excessive inspect/Clean Discharge Pump System Wset/Ud Splice Box ccrda InspeotpService other System components Wpect Cle- DisInfectlon EqUIPMOnt r'7 r-1 /E) Disp Inspect Cl+�,'Wl Additional Servicer Rendered Cloancd texdfle sheets? Pod Bottom RqpIaC,0djLjse-d ator ila=l Intalt.. %k'nt Parts Used, W = Warranty, B . BAlable (,/ appropriate ln".pect Chan FlostE Pump Irespect01-an o Ob Additional Servicer Rendered Cloancd texdfle sheets? Replaced Uv ttem,,? RqpIaC,0djLjse-d ator ila=l Parts Used, W = Warranty, B . BAlable (,/ appropriate selection) w 13 item Number Flnaysafety inspection falostalir'd�Uds b;Ped (jr,RSV flunh va!140- ClosLcl n activated Con -,raj panelre, Summ9tylRecommencixitions [`1, system performing: no further 3cilon nestlod 17 Call for service Date rr Signature S' �j C 1.866-384-7404 Fa)( completed f6rm- 0 0 rloods pumping K - L 'IS nk qe 7a, i f — --- ------------ 'P.J 4 - 7 4 10 LOT 10 N 00"02'00" W 50.00' S 00'02'00"E 50.00' L ----J ---------- SEAVIEW STREET EASEMENTSOF RECORD.OTHER THAN THOSE SHOWN ON THE RECORDED SUBDIVISION PLAT (P•176) ARE NOT SHOWN HEREON. THIS DOCUMENT DOES NOT CONSTITUTEA BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THATA SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE UNDER NO CIRCUMSTANCES SHOULD ANY OF THE DATA HEREON BE USED FOR CONSTRUCTION OF FENCES, IMPROVEMENTS. OR FOR ESTABLISHING PROPERTY BOUNDARIES. NO CORNERS SET THIS DATE sa:agTH , Buku Sni LS -11637' ' AS -BUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: LOT 15, BLOCK 3, SAND LAKEADDITION No, 2 ANCHORAGE RECORDING DISTRICT, ALASKA AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST EXCEPTAS INDICATED. DATED THIS 9th DAY OF MAY. 2020, AT ANCHORAGE. ALASKA FIXED HEIGHT, LLc [W- _ SHED uxo iv 0 LOT 15 M 6,750 sq, ft. - •R ' LOT 16 U a: m \ z DEGI< O +� L6 LOT :`a.'. N M 26.0' W O O 1 -STORY iD UJ ro FRAME W HOUSE - 26.0' u � ., 17.7' — S 00'02'00"E 50.00' L ----J ---------- SEAVIEW STREET EASEMENTSOF RECORD.OTHER THAN THOSE SHOWN ON THE RECORDED SUBDIVISION PLAT (P•176) ARE NOT SHOWN HEREON. THIS DOCUMENT DOES NOT CONSTITUTEA BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THATA SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE UNDER NO CIRCUMSTANCES SHOULD ANY OF THE DATA HEREON BE USED FOR CONSTRUCTION OF FENCES, IMPROVEMENTS. OR FOR ESTABLISHING PROPERTY BOUNDARIES. NO CORNERS SET THIS DATE sa:agTH , Buku Sni LS -11637' ' AS -BUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: LOT 15, BLOCK 3, SAND LAKEADDITION No, 2 ANCHORAGE RECORDING DISTRICT, ALASKA AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST EXCEPTAS INDICATED. DATED THIS 9th DAY OF MAY. 2020, AT ANCHORAGE. ALASKA FIXED HEIGHT, LLc MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this Day of � of 20 , by and between ij ein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as ' t located at (legal description) 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) 0A 1, Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. cl-, 1,f It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to S600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Pagel of 3 G? E Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. c,u 13 Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Oib n Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. C,11 ', Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. C.-}. `' Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement 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 Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By: == (signature) Date: &I W Ttr ,% nDA4 CY5 T—, t') (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this _ day of , 209D by la ag- . �-- -� STATE of ALASKA NOTARY PUBLIC FOR ALASKAU NOTARY PUBLIC My Commission expires: NatalleTraversSmyre My Cama lwlon Expires March 7, 2021 MUNICIPALITY: (signature) (print name) Date: —'5-- 12- r2 © Z v Title: (rev. 05/18/2018) Page 3 of 3 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 011-134-10 1. GENERAL INFORMATION Expiration Date: ~ -,..~ ~ - 0 ~ Complete legaldescription SAND LAKE SUBDIVISION #2; LOT 15~ BLOCK .3 Location (site address or directions) 81332 SEAV1EW STREET * ANCHORAGE, AK 99502 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address KlM &: PATRICK MOORE Day phone 24-2-0408 8132 SEAV1EW STREET * ANCHORAGE, AK 99502 Day phone MARY COX w/ REMAX PROPER~ES Dayphone 2600 CORDOVA * ANCHORAGE~ AK 995033 257-0112 Unlessothe~/~erequeste~ HAAwillbeheldbyDSD~rpick~. 2. NUMBER OFBEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class "¢" Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual 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 4 by an independent professional civil engineer registered in the Slate 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. Note: Alaska Water and Wastewater Consultants, Inc. shaft be paid $~, ~[~O.~at, or pdor I to closing for the engineering services provided. ' ] 4, STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown be/ow, 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 vedfy that based on the information obtained from the Municipality of Anchorage fi/es and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with ali applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER &: WASTE'WATER CONSULTANTS, INC. Phone Address 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 337-6179 Engineer's Comments: In conducting this evaluation, AWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reporied 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 condi§ons are outside the control of the eva/uator of the system. Satisfacto~ test results do not guarantee future performance of the system, horde they guarantee that there are no hidden defects or encreachments. A t444/C, Inc. 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 tight whatsoever. 5, DSD SIGNATURE Approved for ,~' bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: [ '. WASTEWATER .: = · FRu RAM . -. Attachments: HAA Checklist Septic System Adviso~ Well Flow Advisory Manitenance Agreements Supplemental Engineer's Recrt Other "/JJJJ))]]))))'l~I Original Certificate Date: .~'-' ,~ ~' 0.2-_ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (~0~) Legal Description: A. WELL DATA HEALTH AUTHORITY APPROVAL CHECKLIST SAND LAKE SUBDIVISION 1~2; LOT 15~ BLOCK ,3 ParcellD: 011-1,34-10 Well t~oe ~ c If A, B, or C provide PWSID~t 21654~ ~ Date complet~ ~$ properly protected (Y/N) _ , Cased to lt. Casing height (above ground) in. Date of test Static water level FROM WELL LOG jJ lt. g.p.m. Well production ..- WATER SAMPLE RESULTS: ~CLASS "C' WElL LOCAir..u ON LOT 16, BLOCK AT INSPECTION Coliform 0 colonies/100 mi. Arsenic: N/'A mg./I.. SEPTIC/HOLDING TANK DATA Tank Type/Material Tank size 1500 gal. Data of sample: 5,/10/2002 Collected by: gl'HIS IS AN ADVANTEX TREATMENT UNIT Foundation cteanout (Y/N) YES Data of pumping. NEW A~$ORPTION FIELD DATA Date installed Lengm `33 fl. Number of Compartments 2 Depression over tank (Y/N) NO Pumper Soil rating (~or It ~/'edrm)**0.7 Width 2.5 lt. 0 colonies/100 mi. AkWWCm INC. Date installed 5/7-8/2002 Cleanouts (Y/N) YES High water alarm (Y/N) YES **APPUCATION RATE FOR ADVANTEX TREATMENT UNIT System type DEEP TRENCH Gravel below pipe 10 Totalclapth *12.1,~ lt. Eff. aDsorpflonarea 660 fi= Monltortngtube YES Depression over fleld NO Data of adequacy test NEW Results (Pass/Fall). - For `3 bedrooms Fluid depth in absorption field before test - in. Water added - gal. New depth - in. Elapsed TIme: - min. Final fluid depth - in. - g.p,d. Any mjuvenatlon treatment (past 12 mo.) (Y/N & t~pa) If yes, give date - Absorption rote >= D. LIFT STATION Date installed 5,,/7/2002 "Pump on" level at TIMERIn. Datum BOll'OM OF TANK E. SEPARATION DISTANCES Size in gallons 1500 'Pump off" level at TIMERn. Cycles tested. NEW SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tsnk/lllt station on lot Absorption field on lot Public sewer main Manhole/Access (Y/N) YES High water alarm level at 46 .in. Meets alarm & circuit requirements?. YES COMMUNITY WATER On adjacent lots Holding lank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: *SEE D.E.C. DATED JANUARY 26,2002 Building foundation 5'+ Water main 10'+ Wells on adjacent lots '100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line '1 '+ Water service line 10'+ Curtain drain NONE KNOWN · Property line 5'+ Water service line 10'+ Building foundation 10'+ Surface water 100'+ Wells on adjacent lots. "130'+ Absorption field 5'+ Surface water 100'+ *WAIVER WR020004 **SEE D.E.C. LETTER DATED JANUARY 26, 2002 Water main 10'+ Driveway, parking/vehicle storage 30'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Munlcipe/ records that the above systems em in conformance w~h MOA HAA guidelines in effect on this date. Engineer's Printed Nap~e Date JEFFREY A. GARNCSS HAA Fee $ 3~'~, Date of Payment Receipt Number (Rev. 12/0t) Waiver Fee $ Date of Payment Receipt Number / ;;~: EA~MENTS OF RECORD, OTHER 'THAN ~.:'.. '"'r~ SHOWN ON THE RECORDED ;-.4 PU~T ARE NOT SHOWN HEREON. -14 ' MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Mu. st be completed prior to submittal) (a) Legal Description (include 10t, bloCk, subdivision, section, township, range) Lot 15; Block 3; Sand Lake Subdivision #2 (b) Location (address or directions) 8132 Seaview, Anchoraqe, Alaska Property owner HUD ~111-027-668-203 Mailing Address Telephone: (home) Business (c) Lending Institution Mailing Address Telephone (d) (e) MARSTON PROPERTIES/John Anchorag~ Al ~.qka Real Estate Company and Agent Address 4105 ~urnagain, Telephone 24R-] 717 Mail ihe HAA to the following address: (or check here I~, if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING/694-2979 17034 Eagle River Loop Road, Suite 204 Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single-Family ~ Number of bedrooms 3. WATER SUPPLY Individual Well [] Community [~ Public [] Note: If community well system, must have written confirmation.from the State Department of EnvirQnmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site [~ Public [] Community;~: Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION .. ,~s certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of th Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional end adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & ~ ENGINEERING 17034 Eagle Ri~er Loop Road No. 204 Add ress E~I, River, A as~.a 9957'/ Date Telephone 6. DHHS APPROVAL Approved for~-~ bedrooms by ~0(~¢'~[ ~/~'-Y~ Date Approved ,X~ Disapproved Conditional Terms of Conditional Approval The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 ~ MUNICIPALITY OF ANCHORAGE (MOA) (~}~r~ Oi: ANcl~eaJta~Authority Approval (HAA) JUN [ ]- l~°Jg0 Legal Description: ~ A. WELL DATA Well Classification Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) RECEIVED Date Completed Depth of Grouting If A, B, C, D.E.C. Approved ~N) Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot--:=)¢"'~, ~ I,~ To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments'~ ~d,~-'~ ~ [~~ ~:~ ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole ; Date B. SEPTIC/HOLDING TANK DATA / Date Installed ~¢'/~¢"' Size Standpipes ~/N) y ! ~ No. of Compartments Air-tight Caps ,~.~N) 7 Foundation Cleanou~TN) ~ Depression over Tank (Y~[~ Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Property Line To Water Main/Service Line To Stream~ Pond, Lake or Major Drainage Course Comments /~//~te Last Pumped ~--~'~O-- ~'~ ; for Temporary Holding Tank Permit (Y/N) f4//~ To Building Foundation To Disposal Field 72-026 (Rev. 7/85) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~'/~-- Width of Field Type of System Design Length of Field -~ / Depth of Field ! ~ Square Feet of Absortion Area Depression over Field (Y~B::J> Results of Last Adequacy Test Grav(~l Bed Thickness ~ ~/~ '~ Statndpipes Present ¢~N) ~ Date of Last Adequacy Test Y SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well ,/Cy) I,./L To Property Line To Existing or Abandoned System on ; On Adjoining Lots ~ ./ To Cutback (if present) i/C:)c~ t. Jr- To Building Foundation / Lot To Water Main/Service Line /O To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments '¢~ D. LIFT STATION Date Inst~ed Dimensions ,S, ize in Gallo'r'rs,_ Manhole/Access (Y/N) Pump On" Level at'~~_ "Pump Off" Level at High Water Alarm Level at ~_ Vent (Y/N) _ Tested for ~~ P-umping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in e..f~4"~t~l~date of this inspection. Signed S &S ENGINliiERING 1703~ Eagle River L~p Road No. 2~ ~ 7 ~ % ~,~ Receipt NO. ~ / ¢ % ~ /~/ Receipt NO. '.. Date of Payment ~¢ '-//~? O Waiver Fee: $ Amount: $ /~O-~ Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 ANCHORAGE, ALASKA 99503 June 8, 1990 STEVE COWPER, GOVERNOR 563-6775 S & S Engineering 17034 Eagle River Loop, Suite 204 Eagle River, Alaska 99577 PWSID: ~216546 According to the records on file in this office, the Sand Lake ~2, B. lk ~3, Lots 13-18 Water System is in compliance with the State of Alaska Drinking Water Regulations. Sincerely, Env i r onmen t al icer VEC:bas ~' ~' DEPT O~ ENVIRONMENTAL CONSERVATION PUBLIC WATER SYSTEM SANITARY SURVEY AND INVENTORY UPOATE FORM *Indicates requi~ed response .. ~\~¼k~*PWSID #1~ .CLA~.~(A,I~C} I .RESDNT POPULATIONi *SYSTEM NAME MAILING ADDRESS MAILING CITY OWNER NAME SYSTEH PHONE ,NON-RESDNT POPULATIONIQf~ce Use=' _ IStatus:A Z 0 -- ~Smpl Req__ Targeted y N Lab Accessy~ a. Waivery N Seafood # SPIF # :arbon Copy OWNER ADDRESS IOWNER PHONE · OWNER CITY I OWNER STATE tOWNER ZIP CODE '' OPERATOR NAME OR RESPONSISLE AGENT OPERATOR PHONE # LOCATION OF WATER SYSTEM: SEASONAL OPERATION= Is system operational? YES/NO Operation Oates / to , /, Days Open per Year Is system permanently closed? YES/NO If YES, closure date:' / / (MM/DO). FACILITY TYPE. CCIRCL£ALLTHAT APPLY) FS Food Servtcm BR Bar C~Campgroun~.- " SD Subdivision ~ Municipal SF Seafood Processor PRODUCTION (GAL/DAY) AVG DALLY:, MAX DAILY:, STORAGE : SC School R~'Residonttal AK State of Alaska WH Water Hauler U1Military, Govm't l~Logging Camp M~ Mobile Home Park ~ Oaycare Preschool Rest-"~'ental care ~ Public Accomodation: HoT~I, Motel, Showers, Toilets ~T~ Industrial Facility: Drill Rigs, Pump Stn, Construction Camps, Mining Camps PE Public Facility: Food Processors, Stores, Markets, Barber/Beauty Shops, Dairy XX Other, specify . SOURCEI (CIRCLE ONE) G Groundwater S_. Surface W~ter C CombinatiOn Surface & Groundwater 'P~; Purchase&6roun~uatee Pg Purchased Surface Water PC Purchased Combination If'Purchase~y PNfl'D& Nmme of system provid/ng water:PWSIO NA~: = ~.; . .. ...... "TREATMENT USED (CIlaR.E ALL THAT APPLY) AR Aeratton CO Coagulation A~Chlortnation Filtration 'Activated Carbon Ultraviolet Light ]~None Sedimentation ~Oisinfection FI-Fluoridation Softening agent FM [ton & Mngnese TO Taste & Odor Control 'l~-Iodinatton ~XX Others specify WELL DATAz NUmber or Name Date ulze Total Depth' Uepth Hell Pump Drilled (in) Depth of of Yeild Capacity ~UR;ACF WATER DATAz . -'- . Source Name Location Type of [ntake Pump Cagacity .... structuc! (gpm~.. . # SERVZCE CONNECTZONSz COMMENTS= COMPLETED BYz (NAME & TITLE) RECEIVEDBY~ DATEg DATEz Time Time he Date Date Date Inspector Inspector Inspector Comments Conditional Approval (~) Approved Gedrooms ( ) D:,sa??'oved ( ) Co;~j~t~o;~al Approval Date Sewer Installed Permit No. Septic Tank Size Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Owner ~[~L~O~ '~g>[ ~1~, Phone Mailing Address ~7~f ~r5 ~r. " Buyer Address Lending Institution Phone Address Realty Co. & Agent [~e~,(~ {~'~' /[~/,f'~m~ ~ ~u ~,,~,.,~ Phone Street Location Typ~ of Residence ~ Single Family ~ Multiple Family No. of Bedrooms , ~ Other Water Supply Individual A~ACH WELL LOG. A well log is required for all wel~s ~rilled since June Community 1975. For wells drilled prior to that date, give well depth (attach log if ~ Public Utilit~ available.) Sew~e Disposal ~ Individual Year Individual Installed: ~ Public Utility When Connected to Public Utility:. ~ Holding Tank NOTE: THE INSPECTION. FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.