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HomeMy WebLinkAboutSANDHILL LT 5Sandhill Lot 5 #050-522-07 Beard, Anthony D. From: Gary and Julie Foster <fosters4@mtaonline.net> Sent: Wednesday, June 9, 2021 8:52 AM To: Beard, Anthony D.; kagartman@yahoo.com Subject: FW: As built 24923 Hamann Rd. Eagle River, AK Attachments: COSA as built.pdf; Gartman Asbuilt.pdf [EXTERNAL EMAIL] Good Afternoon Tony, Please review and forward as necessary the COSA as built and the recertified as built for this project. ✓On comments Number 1- I have applied to reactivate and close permit numbers 96E3246 and 04E3054. This will be needed for those. Number 2 - We will be amending the proposed green house with plans included once we clear up the two house designation from the Appraisal Department. Number 3 - The owners have had contact with the appraisal department to try to get this cleared uPermit 04E3054 is for the outbuilding that is there that somewhere along the line someone designated it as a house. It is used for storage and is not a living dwelling. Number 4 - Traffic has given approval for the driveway as is with to alterations. No paving required. Number 5 -1 have made contact with Fire and will be sending them a letter for consideration. -Number -6 -'There is not a driveway to the outbuilding. It is not a house. I am having my surveyor amend the plot plan to reflect the Two Story house is an Out Building. Appraisal division lists it as a ranch style house. I appreciate any help and feedback that may help us move forward. Thanks, Gary From: Kristin Gartman <kagartman@yahoo.com> Sent: Thursday, June 3, 20214:07 PM To: Gary and Julie Foster <fosters4@mtaonline.net> Subject: As built r i 021 f�r'nP e d be S� Y �2 rob fn - Here is the as built that was with the COSA approval frorn 2018. Let me know if it doesn't suffice. I am also including an older as built file that I had. Kristi Gartman 405-788-1340 LU 30 WIL46/Vt/9U H3J- BVILI-2:3113 JJITN ILl- iZ:Bor I ,05=.1:31V SS31 80 38OV4 S380V 061 ONINIV1N00 Nd `WS 'U'd 'Ntl'1 `2Z'03S *N NIH11M 031VOOI 1OIdisIa ON 1080018 30V80HONV (911 -Fs 1 d7d) NOIRA14g11S 771HONYS .9107 MCA a Ofl •'.,a�Yn�' `� 4i1be��cj SZSI# 3SN3011 SS3NISn8 ML-W(L06) 54966 VASV1V '83fllVd '3AV 033M38IJ '3 90£ SNOIln10S aNVI NOSNVH zvv IV An^~ \ (911—.`6) � \ _9% NOS 9/,?S 7 7/1-ICIN VS `�j,3ddn l eez l "o , 89L 313 \l< Al lr J N 10 11 n 8 ` ino . \ r 1.333 , 3Adns sn 413 • 001 9L Os 0 9Z ��. 969 31 EP 3" /' ° + . •C� �' � �, 11VM ON I N I V138/aVd 3138M Vk OV08 IIVHdSV ri$4:., / 1 AVM3A 18a 13AVNO ole, ON 1 al I n8 a3SOdO8d NO3a MUM �O << �, 60L 313 .?w 4 ti ow ; � Ol OMS. \ � 1SOd 1HJ I l -ST O ( �' I a \ � 1nONV310 011d3S ti Q did d ` x s/ ° ° s« 831N30 aVOI 01810313 k:x�j MOHAIR ' 1ViS3a3d cv 113M 831VM W, - (sll-£6) 1VId 83d a80038 (,oL �sz)`\ ( 9tJLN), Viva mnSUA , .0 '.SYe M„ 11, 8S, ALN 8VS38 .% a383AO038 • \ :l -`CS 8V838 N , NO dV0 311SVId a383A0038 ,1 �� / , �• • - 91,E r'• ! .` (911-,'6) NO/SM lGgnS 7 7/ICON VS ,A \ \ IN \\� , 65L • 313 \ �\ Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181157 PID Number: 050-522-07 Dwelling: ® Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ® Upgrade Name: SCOTT & TAMARA JOHNSON ABSORPTION FIELD Address ❑ Deep Trench ® Shallow Trench ❑ Bed 111 Mound 24923 HAMANN ROAD, E.R., AK 99577 111 Other Phone Number of Bedrooms Soil Rating Total depth from original grade 5 0.8 GPD/SF 3 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 4.93 Ft. 2.5 Ft. SANDHILL 5 Fill added above original grade Gravel length Township Range Section Varies 2.21 to 3.5 Ft. (2 0 60') 120 Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 5 Ft. Ft. To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Lift Station Tank Line 1034 Ft' 2 6 Ft. Well 100+ 100'+ NA I NA NA TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Surface water 100'+ 100'+ NA NA ANCHORAGE TANK 1500 Gal. Material Number of compartments Lot Line 5'+ 10'+ NA NA STEEL 2 NA Foundation 10'+ 10'+ NA NA LIFT STATION Manufacturer Capacity Curtain Drain NA *50r+ � NA NA Gal. Pump on level at Pump off level at High water alarm at Remarks *None known. Existing tank decommissioned per code. in. in. in. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank 3034 Tank to 3034 Installer Northern Excavation drainfield Drainfield 3034 CO/MT 3034 Inspector ARCTERRA BENCH MARK (Assumed elevation) 100 ft Inspection 1s' 7/26/18 2nd 7/27/18 Location and description 3rd 7/27/18 4t°7/28/18 Bottom of siding COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engin -4•:"1"- Conditional Approval: Date !, S� 01' 4L`9� 1 *. 9iH i_, -. KENNETH e / 4i 71 . J ' Approved___- . . Date _3- pror ol. 4111r.7:581 eer's Stamp Inspection Report_9-1-12.doc WELL & WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLAN SANDHILL SUBDIVISI❑N LOT 5 " •• \ \ h \ DECK 6 II 2' CANT o S h. 111111.i -41- •s. i 1' CANT16.0' b 14 0 16.0' ��Sr� NG-'6o s• .°h o kS o EXISTING FCO NG , ' 2.5' CANT 114—BR HOUSE As°' 00' Vd G.�jj�� 10.0' DECOMMISSION EXISTING 6 7, L��'�,� or`-. TH y12.5 1250-GAL S.T. & 1 22.0 0 / Co INSTALL 1500-GAL S.T. IN COVERED ,j / �C0 STALL DIVERTER & SPLITTER ENTRY ♦ p 0 /EXTENSIVE FILL \ A. �`i FIND ORIG. GRADE pi 0/k' \,VNe- 6 y 6' MT CO T VE: / H #2 ZESERVE TO BE{pX--04.T E T / 1- t'5-BEDR00M� �' � 1pISTAU ADVANCED WASTEWATER �/ \ MT C0 p��J SYSTEM „O z.c FLAG PROPERTY LINES 0 WELL RADII & EASEMENTS PRIOR TO C❑NSTRUCTI❑N J,0°( Scale: 1'= 40' 0 0 DESIGN DETAILS 5 BEDROOM ❑PTI❑N PAGE 3 OF 3 5 BDRM X 150 GP = 750 GPD (Lll' 750 GPD/.8 GPD ER SQ. FT, 38 SQ. FT (938 / 5 x . (2.5'ED) 113 FT. TRENCH N I USE 2 TRENCHES 7_55' (L) X 5' (W) X 2.5' (ED) I - Tota cep o systerl Is 3' max from original grade. Total depth of gravel below distribution pipe is 2.5' , • NO PUBLIC WELLS WITHIN 200' OF T:j PROPOSED 0, NO PRIVATEWELLSWITHIN 200' OF STEM. NOTES: tu ▪ PROPOSED SYSTEM EXCEPT AS NOTED. 1. INSTALL 1500-GAL S.T. & INSULATE IF <4' COVER. CO200' O • PRPOSED WELL EXCEPT SEPTIC SYSTEMS WITHIN AS NOTED• 2. INSULATE TRENCH WITH 2' HD BURIAL FOAM IF < 3' OF FILL. ✓ MIN. 2' FILL WITH INSULATION, >3' COVER NO INSUL REQ. LZ 3. CONTRACTOR WILL ENSURE MINIMUM 2X SLOPE INT❑ SEPTIC TANK. I 4. CONTRACTOR WILL ENSURE ALL SEPARATI❑NS TO ADJACENT 0 WELLS, SEPTICS EASEMENTS, PROPERTY LINES, ETC... mi mi /<S� OF• `•'L•1.\1 PREPARED FOR: CTE D D V i ts� `) - 1 SCOTT & TAMARA JOHNSON ti �R {\l[� 24923 HAMANN ROAD ° �����\\ °�,, o• /* 9TH /N * EAGLE RIVER, AK 99577 �,���.'�„\ ��� / / 202-286-8212 t / s : / 1111)•311111111 x o i' . FIELD BOOKS COMPUTED: `' BOUNDARY: DRAWN: Z R ` CE-711._/ • w� N/A BMW �, 111211,1111111�``/,' 1 fit' L�Z�J/8• scs~� STAKING: N/A CHECKED: KMD D$ `��!Lail'', , iii �'` . 1 N T1AS' �seuaT: SLS DAIS 6/21/18 ...��9' \W' cbof4. E r'ESS10 = D . FILE: GRID: SW0262 c<<" Ct7 Z4, (si1 \�`_ ACRD Fill; JOB No.: Ril-F.`VSUL.TING >�56 FILE 18-162 AK. 99577 AS-BUILT SYSTEM DETAILS/SITE PLAN Permit OSP181157 SANDHILL SUBDIVISION LOT 5 PID# 050-522-07 34' DECK A 2' CANT EX/ST/ O 6' g6 1' CANT 16.0' 014.0', %/LO A /NC S S• ,A0• c 1 16.0' o '• h0 /. EXISTING oFco 6 7A ss•--1 2.5' CANT— ,Ti 4—BR HOUSE N CO °' o•s• �o •M • 10.0' ri 14.0' BM 6 >>' 22.0' O ...." 111......B NEW 1500-GAL S.T. �yjiili CO a�.ii ` TH C RESERVE: ,m,1,, COVERED t, / �O \ DIVERTER 5-BR RESERVE TO BE EX OUT & REPLACE ENTRY OF D COs PROPOSED 5-BEDROOM FIELD &/OR EX OUT I c,79- T C�' ORIG.SYST. & INSTALL ADVANCED WASTEWATER ` / --- SYSTEM ,OT 5 TH '2 \ °RA y� CON DAV MTM * I � ' 6' , 1)4, MTJ CO y c,ry K� T / L CO / g5 A-C=45.7' B—C=28,6' SCALE' 1' = 40' A-D=55,8' B-D=37.7' A—G=62.6' N 00.4 100. 98.3 MONITOR . B-G=39.9' o a �aur aeMaur ,;�_� ITOR TUBE FINAL GRADE TUBE95.71 A—H=64,7' (99.21 B-H=42,4' EL, FILTER FAIRIC\ I RaGIN L GRAZE-I=116,3' A sm mUAT + = VAS o B—I=99.3' y — 1500-GAL *- --,55.21) (-9-ff-D---2" t A-J=116.6' y N SEPTIC B-J=98.5' a o, TANK SEWER ROCK >x A—K=126.0' UPPER TRENCH B—K=105,0' 95,61D 95.4* RT-92,7 C_9__2,7J_ I C82 71) icii A-L=127.6' I 60' B-L=105.6' -MONITOR TUBE MDNITOR TUBE cuA,OJT cii A—M=82.6' SCALE' NTS 97.04 FINAL GRADE 98.13 94,8 B-M=5 5,7' FILTER FABRIC\\N IN:ILLATIIIN vA_tsI °t1G°'"L GRAM A-N=81.1' 0 B—N=54,4' 94,3 T C94,3�� •8 SEWER ROCK e.,. 91.8 LOWER TRENCH X18 I WATER T cn _�� �81,83� TXz OFN\ I SCALE' NTS 1<9 /x'S 4� 1 PREPARED FOR: C E 3 ir( ' •e ' SCOTT & TAMARA JOHNSON04 �Rr .,),,_,, R� / "1 %� ' h 24923 HAMANN ROAD y°�E * A 4 in . * EAGLE RIVER, AK 99577 cn / 4•//7• .0 202-286-8212 ,,'A• � / FIELD BOOKS COMPUTED: ; 1 �/ KENNETH x rf Z ` �' 8 �,� BOUNDARY:N/A DRANK: ❑MW �I \ w V 1 STAKING N/A CHECKED' KMD .'I R, t B///oB / Al ASBUILT: SLS DAM 7/31/2018• •t "'his"' 14' FESSIO�� DWG. FILE GRID: SW0262 'c4" \. Y�C-0550 4' kl `' AGAR nil'FILE doe Na: 18-162 4%,,E.4,‘vs AK.99577-0 N,"P""rr MUNICIPALITY OF ANCHORAGE On-Site Water&Wastewater Program \‘' : . :_ r.'S y fiJ PO Box 196650 4700 Elmore Road _ • Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 ` httpa/www.muni.org/onsite \ e • lhellartnirnt On-Site Wastewater Disposal System Permit Permit Number: OSP181157 Effective Date: 6/27/2018 Work Type: Septic Upgrade Expiration Date: 6/27/2019 Tax Code Number: 05052207000 Site Legal Address: SANDHILL LT 5 G:0262 Site Mailing Address: 24923 HAMANN RD, Eagle River Owner: JOHNSON SCOTT Lot Size in Sq Ft: 82843 Design Engineer: ARC TERRA CONSULTING INC Total Bedrooms: 4 This permit is for the construction of: 0 Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: 1. Existing drainfield appears to be less than 10 feet from the property line. Please confirm and submit waiver request, as required, with inspection report. 2.If the aux. building is to be built out with a bedroom, the septic tank and drainfield will have to be upgraded to a 5-bedroom system. Received By: /Laa =-�-� Date: v- 7 / Issued By: taltCrA (2a Date: r M cr MUNICIPALITY OF ANCHORAGE Community Development Department Akii; Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On-Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 050-522-07 Property owner(s) SCOTT & TAMARA JOHNSON Da hone 202-286-8212 Mailing address 24923 HAMANN ROAD, EAGLE RIVER, AK 99577 Site address 24923 HAMANN ROAD, EAGLE RIVER, AK 99577 Legal description (Sub'd., Block & Lot) SANDHILL LOT 5 Legal description (Township, Range & Section) Lot Size 82,843 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field I>I Initial n Single Family (SF) (w/wo ADU) Septic Tank Upgrade Duplex (D) Holding Tank I Renewal n Multiple Dwellings Privy I I (SF and/or D) Private Well Water Storage THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (SiggatGre f operty owner or authorized agent) Permit/Rush Fees: �j cog Waiver Fees: Date of Payment: C9 - Date of Payment: Receipt Number: 010I32E Receipt Number: Permit No. OS el ' 1167 Waiver No. Permit App_9-1-12.doc • ts.RC'IERR� \ ARC T ERRA CONSULTING, INC 212 E. 5151 Ave,Anchorage,AK.99503 Office(907)868-3791, Fax(907)868-3793 June 22, 2018 Municipality of Anchorage Development Services Department On-Site Water& Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Upgrade Sewer Permit—SANDHILL LOT 5 It has been determined that the absorption field of the subject property is saturated. Subsequently, the owner has requested we proceed forward to obtain a septic permit to upgrade the septic system. We propose to install the reserve field per the original permitted design. We've also added a 5-bedroom option as shown on page 3 of the design. The general slope of this lot is from northeast to southwest at a grade of approximately 3-8% over the septic area. The proposed upgrade will serve the existing 4-bedroom single-family residence. The property and adjacent lots are served by private water. There is no surface water within 100' of the proposed system and there are no known curtain drains within 50'. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 868- 3791 / FAX 868-3793. Respectfully submitted, ArcTerra Consulting, Inc. Kenneth M. Duffus, P.E. Attachments: On-Site Sewer Application Wastewater Absorption System Details/Site Plan 20441 PTARMIGAN BLVD • EAGLE RIVER,AK 99577-8736 • PH(907)868-3791 • FAX(907)868-3793 Carroll, Rebecca M. From: Brent <brentwestern@gmail.com> Sent: Tuesday, June 26, 2018 12:01 PM To: Carroll, Rebecca M. Cc: Dea Duffus (Dea@ArcTerra.net) Subject: Re: SANDHILL LT 5 Thanks Becca, There's extensive fill over the site, the auxiliary structure is not connected, nor does it have water, it's just stubbed out with septic I'll swing by to discuss comments. - Brent Sent from my iPhone On Jun 26, 2018, at 11:54 AM, Carroll, Rebecca M. <CarroIlRM@ci.anchorage.ak.us>wrote: <Onsite Review Comments.pdf> 1 WELL & WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLAN SANDHILL SUBDIVISION LOT 5 \ \ `4,'114 ft7M\I, i b2o ` %.o. Ai irlA wps II. .1i.'—. r it-,--„ �/c...."........,“ / m wv be / !Q i \ 0,00 Anifil.VIP . &V in FLAG PROPERTY LINES WELL RADII & EASEMENTS PRIOR TO CONSTRUCTION scale: 1'= 100' DESIGN DETAILS a'�y 14' PAGE 1 OF 3 4 BDRM X 150 GP = 600 GPD 600 GPD/.8 GPD ER SQ. FT,/= 750 SQ, FT 7 (600 / 5 x . (2.5'ED) ' FT. TRENCH r o USE 1 TRENCH - $I (L) X 5' (W) X 2,5' (ED) total depth of' system is 3' max from original grade. ° Total depth of' gravel below distribution pipe is 2.5' . NO PUBLIC WELLS WITHIN 200' OF o PROPOSED SYSTEM. NOTES: Q' NO PRIVATE WELLS WITHIN 200' OF .; PROPOSED SYSTEM EXCEPT AS NOTED. 1. CONNECT TO EXISTING 1250-GAL S.T.. CO200' O PROPOSED WELL MS NO SEPTIC SYSTEXCEPTHIN AS NOTEDF 2. INSULATE TRENCH WITH 2' HD BURIAL FOAM IF < 3' OF FILL. MIN. 2' FILL WITH INSULATI❑N, >3' COVER NO INSUL REQ. f 3. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INTO SEPTIC TANK. I 4. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT WELLS, SEPTICS EASEMENTS, PROPERTY LINES, ETC... OF AL A,c��� • <Q� , PREPARED FOR: CTE �rr` . ' + 1 SCOTT & TAMARA JOHNSON EI / 1 �" 24923 HAMANN ROAD oti �g �`� �s * . �9 TH /\ ,k EAGLE RIVER, AK 995774 �����\' `�� r/ y,/,4_,-y..,,,, ,-1...V____ / 202-286-8212 — 4'.4 �, ��..11\ O_� N I KENNTH .. D • / FIELD BOOKS COMPUTED: i 1I`i3_..",11 X / CE-7118 �W� / BOUNDARY:N/A DRAWN: BMW Z 1,11,`�14� N1' \ \ 1a,�i�Q. p /8,e�`'S. STAKING: N/A CHECKED: K M D ���^r1�o/p'1�� '�U $$1����' ASBUILT: SLS DATE 6/21/1 8 c(`�a 60� GRID: 9 \\A,,c\ 0 E �\� DWG. FILE: SW0262 _ c(F �p C. o�, > ACAD Fill: JOB No.: 4'4,4 SUITING •$i'36`9 \ FILE 18-162 AK. 99577— WASTEWATER DISP❑SAL SYSTEM DETAILS SANDHILL SUBDIVISI❑N LOT 5 / \JO 10 0 \ itti iti 4, yam. 73.4' DECK 2' CANT I S ho 16.0' 0 O 14.0'_ ^ `s" 4 1' CANT`! N 16.0' 8U/LD/NC b°A ss`D EXISTING o FCO 2.5' CANT- 4-BR HOUSE N °' os• �o M 80.3' 10.0' N 14.0' TH //12.5 0 7 0 Illimmmnr 22.0' _ / COEXISTING 1250-GAL S.T. COVERED �\: / CO AC D INSTALL DIVERTER ENTRY O 6' Os ,� !f U•L . ��F. X41- I ____ F1N r ` EA s�r 6. P1" /ENTER MIDPOINT k \ '.�`� AS CLOSE AS \ i GRA ^� • POSSIBLE 0' O/�E V 3 w N. -o —', 1TH //2 Lo f.' \ M7TC0 wco T I 9 0 J a N t -vC 0 CO 0\1A r °61 O . FLAG PROPERTY LINES 1,7 WELL RADII & EASEMENTS I PRIOR TO C❑NSTUCTI❑N scale: 1'= 40' al 410:olb..\O�\T� PAGE 2 OF 3 cn Di /<S� OF `�1Q\ , PREPARED FDR: CTER W o �rr�� '� 1 SCOTT & TAMARA JOHNSON oti A�,�N��\� �6� o / 24923 HAMANN ROAD "44* . 9TH �� ,t EAGLE RIVER, AK 99577 eil / :' �•� •I 202-286-8212 A �,A�.'1,�\ i� I M. D iii • , FIELD BOOKS COMPUTED: D /IIIIS..11,11 0 / G�� CE-7116 ► �j / BOUNDARY:N/A DRAWN: BMW 111 EM` `/1� L 2.4J- STAKING NSA aiea<ED: KM `�� .��//'�ln° ' ASBUILT: DATE ,�"'ti.�•+. FESSIO11t) SLS 6/21/18 F9° \\�„/� 0�� DWG. FILE GRID: SW0262 e. C• 011 \`_ ACRD FILE: JOB No.: �4,�R 80Ln NG .X36�9 FILE 18-162 AK.99577 WELL & WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLAN SANDHILL SUBDIVISI❑N LOT 5 �.. \ DECK , 2' CANT o S �O 1' CANT16.0' 014.0'0 ,• 'S• /Ao CV d' 16.0' s, C. B COIN co. Ss EXISTING b FCC 0. s 2.5' CANT , 4-BR HOUSE N o s• �0 ''4.1Z, M • can 10.0' N 14.0 0 TH #12.5 DECOMMISSION EXISTING �� 1250-GAL S.T. & t� 22.0' / C0�INSTALL 1500-GAL S.T. COVERED irli \. / �C0 INSTALL DIVERTER �& SPLITTER ENTRY IOF Os T 5 I %9- T r l4 — • /�rA. \ q�It�_,� /EXTENSIVE FILL \ ���tttyyyi FIND ORIG. GRADE a1 ORA A1C 1,\// v- 6' /W �✓ 1 Rob.. 6 MT CO TN #2 IESERVE TO BE VE: / fi pµ� y E -=8 5-BEDROOM T ADVANCED WASTEWATER ^� MT CO GJ SYSTEM k tk�p. FLAG PROPERTY LINES WELL RADII & EASEMENTS PRI❑R TO CONSTRUCTION n°`( ScaLe: 1'= 40' DESIGN DETAILS 5 BEDROOM ❑PTI❑N PAGE 3 OF 3 5 BDRM X 150 GP = 750 GPD ILS ' 750 GPD/.8 GPD ER SQ. FT. 938 SQ, FT �, (938 / 5 x . (2.5'ED) = •1 9 FT. TRENCH USE 2 TRENCHES ' (L) X 5' (W) X 2.5' (ED) (At) TOt6.1 depth o system is 3' max from original grade. , Total depth of gravel below distribution pipe is 2.5' , NO PUBLIC WELLS WITHIN 200' OF 5 PROPOSED SYSTEM. NOTES: 0' NO PRIVATE WELLS WITHIN 200' OF -J PROPOSED SYSTEM EXCEPT AS NOTED. 1, INSTALL 1500-GAL S,T, & INSULATE IF <4' COVER. ,., NO SEPTIC SYST200' m PROPOSED WELLEMS EXC PTHIN AS NOTED.F 2. INSULATE TRENCH WITH 2' HD BURIAL FOAM IF < 3' OF FILL, MIN. 2' FILL WITH INSULATI❑N, >3' COVER NO INSUL REQ. 12 t� 3, CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INT❑ SEPTIC TANK. I 4. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT WELLS, SEPTICS EASEMENTS, PROPERTY LINES, ETC... as � r W AIr O. 1�4� t PREPARED FOR: gcTER , ' SCOTT & TAMARA JOHNSON '[ o /* TH�� , 24923 HAMANN ROAD roti �����\`� ��� a / • /' • * •/ 202EAG-286E -82 2 VER, AK 99577 >D // 41141 •111111L ��� N I •- • ' 'I FIELD BOOKS COMPUTED: 1 1/53.."'1 X CE-711 �'� / BOUNDARY:N/A DRAWN: BMW 3 11�� ER�` 1' °, _/ 'S / STAKING: CHECKED: r a 1 ' • L,Z�J/Pj ,T�¢ti N/A KMD ° ���% ./,//' - iri F'ESSION� _' ASBUILT: SLS DATE: 6/21/18 • '""+F9"' \ -4. 06� \ � DWG. FILE: GRID: SW0262 'be �'Oi,„.,_ �ZyG 96\ `_ ACRD FILE: ”No.: i�FR SIJ-TING •�,e L Z FILE 18-162 A K. 99577' EA tv 0)�� RIVE Q \ �AD \ \ \ NS6 21 36 k w ` ® WELL \ iS' \ \ L4NOSCAp Pr" \ BUFF es \ \ SMT X02 9 \ 3 �Q 7 \ \ \ \ 7.7 h \ in \ ro o SS' /40• o \ DD �,SS, S h 0S �• t EXISTING t° , os o 4 BUILDING .o 2 CANT r< 7.7' CK of v 14°- o' 73.4' \Pt% 16-6 N0 16. c 1• CANS EX1S,-, N• pUSE ._o H . 2 5 CANT M 10.0 c:i 2 CANT • 0 22.0' o • •SEPTIC 80.3' _ 10 ,J•)• VENT CORE/�: �FO>r M OW) ENVY GRAVEL • 4; D/W IkC0. N LOT 5 toN (7 ce LOT 6 15' U',Li r L=33 FSMI R=5,9*-..5'R=5s' v 0 HAMANN ROADV-- \ apo e.` E ANCHORAGE RECORDING DISTRICT ASBUILT OF: ® =FND 5/8"REBAR SANDHILL SUBDIVISION LOT 5 PLAT 93-116 '`"` v,��LANj SURVEY CERTIFICATION: I,John L. Schuller, have conducted a ,�� OF A\� 'S�•�•O 5�� ,-. physical survey of this property as shown on this drawing and that the ��.• L,'I improvements situated thereon are within the property lines and no /9�"'•• `l— ... 1,11 ''' ,74,,, �,''0 enchroachments exist other that noted. : 49 / 1/ ,�a N. EXCLUSION NOTES: It is the owners responsibility to determine the % / d x r G � G...G. � G U a existence of any easements,covenants,or restrictions which do not g tI1 fi` n appear on the recorded subdivision plat. Under no circumstance should f'0• •.J L. SCHULLER. r ,q any information on this drawing be used for construction of fences, +'c'� LS-10408 .• �;/ _` k' ' ' structures, improvements, or for establishing boundary lines. k c�a • <0.-2/:1-0. a`'��/ •��`• •1831 Talkeetna Street WORK ORDER NUMBER: DATE: SCALE: E-MAIL `� lif V fessionoo\ Anchorage, Alaska 99508 JUNE 21, 2018 1"=40' \N.N.01.1 18-035 DRAWN BY: CHECKED BY GRID NUMBER: BOOK/PAGE: (907) 227-1455 office JLS SW0262 180163 (907) 274-4992 fax Municipality of Anchorage Page / of Z 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: 6W q(eQ 3ZU PID Number: 050 -52Z 'P7 Name: fNitr I Wastewater System: New ❑ Upgrade Gvt0.� Qll, trl � �(� Y) c -u is tnev. alai) MVA Zb Address: Po 2& C 5' ABSORPTION FIELD Phone: No. of Bedr oms: O Deep Trench Shallow Trench D Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: Q Total Depth from original grade:, GPD/Sq. Ft. Lot: Block: Sub%%��tvisio A l 1 Depth to pipe bottom from original grade: r .5 Ft. Gravel depth beneath pipe�/ Ft. Township: Range: Section: Fill added above original grade: Ft. Gravel length: p // / (O Ft. WELL: New ❑ Upgrade Gravel width: Numberoflines: Distance between lines: /� & Ft. / 1� Ft. Classification (Private, A,B,C): J Total Depth: Cased To: Total absorption area:: Pipe material: ( Yl al 2 Ft. z, Ft. { .J D SQ. Ft. r L Z /— Driller, // �c !' Q4eP ell s Date Dr%'lied: /U! �v Static Water Level: D Ft. Installer: n CCii Wvt.5]r4A_d/ 1921� Date installed: y Yield: / 6 Pump Set at: Casing Height Above Ground: TANK GPM Ft. Z Ft. SEPARATION DISTANCES Q(Septic O Holding O S.T.E.P. To From Septic Tank Absorption Field Lift Station Holding Tank Public/Private Sewer Lines Manufacturer: --�f' A h g_kofr CL. e_LQ. n Capacity in gallons: L X ✓ O Well' t t _ t Material: Number of Compartments: ee Surfac Water lov'+ rvo'a- — - r LIFT STATION Lot Line 1 I 104-1 1 10 Size in gallons: Manurer: Foundation /v 1 10 '� _ _ _ "Pump on" level at: "Pump off' leve t: High wat alarm at: Curtain Drain Alone /jA(oW — Pump Make & odel Electrical Insp ctions performed b Remarks: BENCH MARK Location and Description: 111C,5/ / / �i G_!/ec ire 07 Ao"s �e Assumed Elevation: IDD• d E.N`G�I`UE1?.�S�AL ��®��� �� � e 444h AW 00440 Inspections performed b : ��E� vle ex 11 22 46 P p y Dates: i s foe *0 •° •° °.o •°••e•.� O 2nd /f 3 9 I �;t............. V.. cc Kenneth M. Duf .' Q 1x % Department of Heal and an ervices app ov 17 ®� e CE 7116 :• �® ®t y;4 ��1� Reviewed and approved by: G Date: Z7 `%T ���� °HOF�>ONP��O c -u is tnev. alai) MVA Zb AS—BUILT SYSTEM DETAILS/SITE PLAN Permit SW960320 SANDHILL S/D, LOT 5 PID#050 522 07 0 WELL A -C=46.25 B -C=28.1 A -D=54.7 B -D=35.6 A -E=60.0 B -E=32.3 A -F=139.3 B -F=120.3 4 BDRM SFD i OF. AL' \ 1 Vr // KENNETH M. DUFF / CE -7116 a' \ °hOFESS10�l1� F 104,01 FCO BM H #1 CD M �❑ TH #2 �l PSE'h w 103,22 a 'oz =o wf uu 97.64 Nl AMN FILTER 7 N 1250 GAL N N SEPTIC 94,96 zf TANK 98.81 98,47 2, 936 PREPARED FOR: MICHAEL QUINN CONSTRUCTION P.D. BOX 772641 EAGLE RIVER, ALASKA 99577 rimary Sy FINISHED GRADE SEWER ROCK L•I.N SCALE NTS SCALE: 1' = 50' w 0 0' r i �w o� a u 98.17 I 00 9 2.3 4 86.65 BUH KND ENGINEERING 20441 PTARMIGAN BLVD EAGLE RIVER, AK, 99577 (907)696-6111/Fax (907)696-8111 DATE: 3/9/97 DRAWING it SCALE: AS NOTED I 96081-S1 Cp'rfieit Ia afsn g Kr16o by 00cSr_' r .4 ,5 7 W,.l FT�-- 1.,, %4r },i+ ,j _ �` ,: P.O. BOX 670272, CHUGIAK, ALASKA 99567 -TELEPHONE 688-2759 f` OWNER OF LAND:._.,&a.1i &4r/91 ADDRESS: LEGAL DESCRIPTION: DATE: :7/'20/01 PERMIT NUMBER: Date of Issue--_ TAX IDENTIFICATION NUMBER: Is well located at approved permit location? _t Yes J No Method of Drilling: rotary � cable tool Depth of well: 39c0 Casing Type Wall Thickness-2� inches Diameter F+ inches, depth _ / .�1 r 3 r feet Liner Type: N%o &Jr -z Casing Stickup Above Ground: feel Static Water Level: L 05 feet Recover Rate: • S gpm Method of Testing: x4,12— Well Intake Opening Type: u open end -.t 6Pen U Screened; Start feet Stopped feet .:I Perforations Start feet Stopped feet Grout Type: Volume Depth: from feet, to_/ feet Well Disinfected Upon Completion? S No Method of Disinfection: Comments: L4 -AE--" �•=c�ri �• i D I YCa M ;�.LO To 3 bo r 7/-:� A,PjS Driller's Name.. IZ4e- ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. Matsu Borough: Department of Environmental Conservation. DOC C..... SULLIVAN19/LWATER WELLS P.O. BOX 670272, CHUGIAaK, ALASKA 99567 • TELEPHONE 688-2759 OWNER OF LAND dJC.__�C a /nf.N ��"S t DEPTH OF )NLLI. ADDRESS .. -_ ST A71C LEVEL OF %� Al F:R FT. LEGAL DESCRIPTION-/.C-'L�AA JIO �«__..___ URA)t DOWN FT. DATE. - Started Ended E+ _ (;ALS. PER HR 3f:�.% PERMIT NUMBER _. KIND OF CASING& KIND OF FORMATION: FromFr. toF[. � 64Sf� From.__ Ft. to --Ft. From _Ft. to�Ft. 61Uc=,�R ,�pc� From Ft. to Ft.. FromFt. to r+3_ Ft. < i `/ . S S p�� --�tpFL / 6�oT �Frum_F[. Fr. dt ��77 From r_-27�9•�'Ft. to 7 Ft./�� /% _. From Ft. to___F[ From 157Ft.toJ—J-Ft. -511 i J'- 60C4 Z.. Fl. -- to Ft From Qi Ft. to /;:rO Ft. I�lr t}t K___ From Ft. To From. FL to-Lig—Ft. %396:gp < 44AY <%erz From Ft. to___ .Ft. Ft. - From 1 7 / Ft. t. / Ft./,Cr% cL�jGtC. ( t%��Q Frottt. -L757 Ft. to__Ft. FromFt. to Ft, f C P4'� _ From FL to Ft. L%QJC K 9Xlf7' From -Ff. to Ft. From -Ft. tom/—Ft. &E-d-eAC Q itft 1 2' From From to Ft. i--___ _.._Ft. From—Ft. to Ft. S? -it Pm Froin_ F, to Ft. From �N, Ft. t' -R-2 ?�DSO From._.__Ft. tn______. Ft. From Ft. to—Ft.—­­ From ­—Ft. From Ft. to _Ft. From____.__F:. From Ft. to Ft. From ----Ft. to—Ft- oFt.FromFt. From—Ft.to Ft. _ From Ft. to Ft MISCL. INFORMATION: Ids 3 DRI LLER'S NAME 9 �A,OACdY PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 O� pc7 .•�-!/2J S6 ON—SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW960320 DESIGN ENGINEER:KND ENGINEERING OWNER NAME:BEST KENNETH R OWNER ADDRESS:22238 SHADOWY SPRUCE DR. CHUGIAK, AK. 99567 PARCEL ID:05052207 LEGAL DESCRIPTION: SANDHILL LT 5 LOT SIZE: 83843 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 DATE ISSUED: 9/26/96 EXPIRATION DATE: 9/26/97 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM 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 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: PERMIT REVISED PER ENGINEERS REQUEST AND REPORT DATED 10/1/96 FROM 3 TO 4 BEDROOM (REVISED 10/4/96). RECEIVED BY: DATE: f0 -7-t(6 ISSUED BY:DATE: %D D a ND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 October 1, 1996 Municipality of Anchorage Dept. of Health & Human Services On -Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: Sewer/well permit - Lot 5, Sandhill SID Gentlemen: RECEIVED OCT 2 1996 Dept Healthy& Anchorage Ser�cee The owner has requested that we modify our original permit to increase the number of bedrooms from 3 to 4. Accordingly we have modified our site plan and calculations to accommodate this change. Our design assumes a total depth of the trenches will not exceed 3.0' from original grade. A single 96' trench will be installed, and additional fill will be added to insure a total of 3' of cover over the system. If you have any questions regarding this application, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, XND Engineering Kenneth M. Duffus, P.E. attachments: Modified Wastewater Absorption System Details/Site Plan SITE PLAN WASTEWATER DISP❑SAL SYSTEM LOT 5, SANDHILL S/D * 49TH* *+ L -I I- KENNETH M. ` CE -7116 _......... t I'7''Oh'ESSIUNPS' -ow DESIGN DETAILS 4 BDRM X 150 GPD = 600 GPD 600 GPD/0.8 GPD PER SQ. FT. = 750 SQ. FT. 750/5' X .64 R.F. (2.5' GRAVEL) = 96' L. TOTAL DEPTH OF SYSTEM IS 3.0' TOTAL DEPTH OF GRAVEL IS 2.5' N❑TES: 1. USE 1250 GALLON SEPTIC TANK. INSULATE TANK IF <4' COVER. 2. INSULATE TRENCH WITH 2" HD BURIAL FOAM.. 3. CONTRACTOR WILL ENSURE MAXIMUM 27 SLOPE INTO SEPTIC TAI 4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE MIN. 3' COVER. 5. FILTER FABRIC WILL BE INSTALLED OVER PIPE. PREPARED HIR: MICHAEL QUINN CONSTRUCTION P.U. BOX 772641 EAGLE RIVER, ALASKA 99577 KND ENGINEERING 20441 PTARMIGAN BLVD EAGLE RIVER, AK, 99577 (907)696-6111/Fax (907)696-8111 7 9/12/96/rev. 10/1/96 DRAWING A :ALE: V = 100' 1 96081-si MOA COP/- - . Y PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW960320 DESIGN ENGINEER:KND ENGINEERING OWNER NAME:BEST KENNETH R OWNER ADDRESS:22238 SHADOWY SPRUCE DR. CHUGIAK, AK. 99567 PARCEL ID:05052207 LEGAL DESCRIPTION: SANDHILL LT 5 LOT SIZE: 83843 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 DATE ISSUED: 9/26/96 EXPIRATION DATE: 9/26/97 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM 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 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING S. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED ISSUED BY: BY : DATE:Z ATE./!� DATE • 07 oG0 �b ND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 /FAX (907)696-8111 September 13, 1996 Municipality of Anchorage Dept. of Health & Human Services On -Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: Sewer/well permit - Lot 5, Sandhill S/D Gentlemen: Attached are soil test and water monitoring results for the above lot. Although a total of four holes were excavated during the subdividing process, we we able to locate only one of those. There were no monitoring tubes left intact. Our water monitoring results show no water present; however, the previous soil tests/water monitoring show the highest water table to be 75, recorded October 24, 1991 (TH #33 by Wayne Henderson). Therefore our design assumes a water table of 7.0' and the total depth of the trenches will not exceed 3.0' as a precaution. Our percolation results produced somewhat different results. As a result, we have designed for the slower percolation rate. A single 72' trench will be installed, and additional fill will be added to insure a total of 3' of cover over the system. This land has previously been utilized as grazing land and the slope is quite uniform. There is little organic material, thus allowing our design to be installed very shallow. There are no surface water sources within 100' of the proposed design. Drainage along Eagle River Road is carried in ditching along the right-of-way to the east. There are no known curtain drains within 50' of the proposed trenches. The development of this lot will not negatively impact lots surrounding Lot 5. If you have any questions regarding this application, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, KND Engineering 'OP. E. Kenneth M. Duffu MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION SEP 16 1996 RECEIVED attachments: On -Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test SITE PLAN WASTEWATER DISPOSAL SYSTEM LOT 5, SANDHILL S/D OF A lo'* `49TH *� KENNETH M DELIS `- CE -7116 W`t AWr \ AR01''ESSID�Ay � DESIGN DETAILS 3 BDRM X 150 GPD = 450 GPD 450 GPD/0.8 GPD PER SQ. FT. = 562.5 SQ. FT. 562.5/5' X .64 R.F. (2.5' GRAVEL) = 72' L. TOTAL DEPTH OF SYSTEM IS 3.0' TOTAL DEPTH OF GRAVEL IS 2.5' NOTES: 1. USE 1000 GALLON SEPTIC TANK. INSULATE TANK IF <4' COVER. 2. INSULATE TRENCH WITH 2' HD BURIAL FOAM.. 3. CONTRACTOR WILL ENSURE MAXIMUM 21 SLOPE INT❑ SEPTIC TA 4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE MIN. 3' COVER. 5. FILTER FABRIC WILL BE INSTALLED OVER PIPE. MICHAEL QUINN CONSTRUCTION P.O. BOX 772641 EAGLE RIVER, ALASKA 99577 KND ENGINEERING 20441 PTARMIGAN BLVD EAGLE RIVER, AK, 99577 (907)696-6111/Fax (907)696-8111 12/96 DRAWING # ' = 100' 96081-S1 0*:� Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: A4 e -12a e,I QLtdn/t CD_Y( St ✓LiC-1-z®� -' 4- I� DATE PERFORMED: LEGAL DESCRIPTION: LCs-, Township, Range, Section: DEPTHI U, OR.(, SLOPE SITE PLAN 2 / LKI 3 Slh��y rna/sf 4 5 6- 7- 8- 9- 10- 11 7a91011 12- 13-- 14- 15- 16- 17 21314151617 18 19 20 COMMENTS e o !d *+e"a 1 WAS GROUND WATER j ENCOUNTERED? O S IF YES, AT WHAT L /n O DEPTH? / P E Depth to Water After , Monitoring? // 8 Date: L Reading Date Gross Time Net Time Depth to Water Net Drop X41 � �-7 8 a. �' 4A -1 ' *7 3S� 8 9 57 Z !o'V�- I PERCOLATION RATE 8,0 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 2" D FT AND 3' L FT 1�hLSOcike4 PERFORMED BY: K/�O�K�a �y�7�Uq' I 4L2 22 /;Ca CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) • eG1N6Ef •°•• • �� ' •�E Municipality of Anchorage �:•'�� •t B Boc •nose Bue••• o000 •eeo •e s DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 •••:• •• SOILS LOG — PERCOLATION TEST Kenneth Ms ; �? ®� ••• CE 71.16 :•.��u I_ .n. PERFORMED FOR: IVI LCJ/111f� QLC1liY) lonsrf /wclkta`l DATE PERFORMED: ®0 •EM N to LEGAL DESCRIPTION: L(J-t �lY ll C LC Township, Range, Section: DEPTH )ill r> p� SLOPE SITE PLAN 1 2 3 4- 5 6 7 8- 91011 9- 10- 11 12-- 13- 14- 15- 16- 17 21314151s17 18 19 20 COMMENTS N ni :50mo Sn2aL1 a^ac(�s , C_o bh 4es -t? S �2 S -fir to WASGROUND WATER . %'v ENCOUNTERED? J�/ S IF YES, AT WHAT L DEPTH? O P E Depth to Water After p �� Monitoring? D q Date:�L1S2 Reading Date Gross Time Net Time Depth to Water Net Drop — 2 3 3ls � b7 a 8 0/7 e11 -1319 8 3 i9 y 77/if 4 91 3a1 2- g'/'� 3•� 10 3zs 2 6-3y H I, aqo L 7 '/4, - / , 7/y PERCOLATION RATE 5'Q (minutes/inch) PERC HOLE DIAMETER] TEST RUN BETWEEN 2 FT AND `315 FT PERFORMED BY: ��/k1J D I1 � , I Ale4 1"-)U F PUS CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) 6 L Municipality of Anchorage "P' On -Site Water and Wastewater Program <r o� (907)343-7904 s E,. CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcell.D. 050-522-07 1. GENERAL INFORMATION Complete legal description SANDHILL LOT 5 Expiration Date: z q " Location (site address) 24923 HAMANN ROAD EAGLE RIVER AK 99577 Current Property owner(s) KENNETH & LINDA BAHR Day phone Mailing address Real Estate Agent 2. TYPE OF DWELLING: 24923 HAMANN ROAD EAGLE RIVER AK 99577 ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 4 Day phone TYPE OF WASTEWATER DISPOSAL: ® Individual ❑ Holding Tank ❑ ❑ Community ❑ ❑ Public Sewer ❑ Received by: 'P7 : f� ��C �' Date: /—le COSA to be released to the engineer, unless ots quested by the engineer. COSA Fee $ Date of Payment n Receipt Number COSA # 05C_1 00(p Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 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 ARCTERRA CONSULTING, INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 01/03/2013 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen Al encroachments, deficiencies or discrepancies exist. 6. DSD SIGNATURE System #1 Approved for. bedrooms. The System #2 Approved for. bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Original Certificate upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.. t c ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory CCSA ivoe s.e= t t s X Nitrate Advisory, Arsenic Advisory Other IIrl; , If more than 1 septic system is on the lot: COSA Checklist # of _ Structure served by this system _ Certificate of On -Site Systems Approval Checklist Legal Description: SANDHILL LOT 5 Parcel ID: 050-522-07 A. WELL DATA Well type PRVT If A, B, or C provide PWSID # Date completed 1011996 & 712004* Sanitary seal (YIN) Y Total depth 360 ft. Cased to 121 ft. FROM WELL LOG Date of test 1011996 Static water level 105 ft. Well production 6 & 0.5 9 -13 -m - WATER SAMPLE RESULTS: Coliform /_colonies/100 mL Nitrate rJ,5�5 mg/L Arsenic: tV0 ug/L Date of sample: 12126112 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC l STEEL Tank size 1250 gal. Number of Compartments 2 Foundation cleanout (YIN) Y Depression over tank (YIN) N Date of pumping 9119112 Pumper JRs C. ABSORPTION FIELD DATA Well Log (YIN) Y Wires properly protected (YIN) Y Casing height (above ground) 18 in. AT INSPECTION 9121112 ft. (•JI120 Collected by: ARCTERRA Date installed 11123196 Cleanouts (YIN) Y High water alarm (Y/N) N Date installed 11123196 Soil rating (g.p.d./ftZ or ft2/bdrm) 0.8 System type Shallow Trench Length 96 ft. Width 6 ft. Gravel below pipe 2.5 ft. Total depth 6.0 ft. (Measured 9121/12) Eff. absorption area 1134 ftZ Monitoring tube Y Depression over field N Date of adequacy test 813112012 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 19.2 in. Water added 860 gal. New depth 25.2 in. Elapsed Time: 1440 min. Final fluid depth 20.4 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date D. LIFT STATION Date installed "Pump on" level at _ in. Datum Size in gallons "Pump off' level at in Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 1001+ Public sewer main 751+ Sewer /septic service line 25'+ Animal containment areas 50'+ SEPTIC/HOLDING TANK ON LOT TO: Manhole/Access(YIN) High water alarm level at Meets alarm & circuit requirements? On adjacent lots 1001+ On adjacent lots 100'+ Public sewer manhole/cleanout Holding tank 1001+ Manure/animal excrete storage areas 1001+ Building foundation 5'+ Property line 51+ Absorption field 54 Water main 104 Water service line 104 Surface water 100'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 104 Water main 101+ Water Service line 10'+ Surface water 1001+ Driveway, parking/vehicle storage 104 Curtain drain 50'+ (NONE KNOWN) Wells on adjacent lots 1001+ F. COMMENTS *Well deepened by Sullivan 2004 —see attached log Water system is augmented by 630 -gallon water storage (3 210 -gallon tanks) G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name KENNETH M. DUFFUS Date 0110312013 COSA brown sheet 9-1-12.doc OF' Al ' w '54 j. ral Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # 131006 During a recent COSA on-site inspection and test of the potable water supply well on Block , Lot 5 of Sandhill subdivision, the well's productivity was determined to be 0.29 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 4 -bedroom residence is 0.41 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. A jbUUi TS5 LAND 6UKVL'Y1NG 694-0529 I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE: FOLLOWING DESCRIBED PROPERTY 60 �+ OF A/ R S�lif/-Gh/GL sr�,o.� eor s - DATE ,t Q'�' �S tr4 AND THAT NO ENCROACHMENTS EXIST EXCEPT AS � INDICATED. IT IS THE RESPONSIBILITY OF THE r W rH s.., OWNER TO DETERMINE THE EXISTENCE OF ANY GRIDS M•"•" ••� EASEMENTS, COVENANTS, OR RESTRICTIONS xAc'-,WHICH DO NOT APPEAR ON THE RECORDED SUBDI- �,e M rk saw.rdVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD F& 4. S-5 8 �? 0 ANY DATA HEREON BE USED FOR CONSTRUCTIONS ✓rte/� `��+ OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. DRAWN , l_w_s � • • QPGE 8, Municipality of Anchorage On-Site Water and Wastewater Program (907) 343-7904 SA S A cry CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-522-07 Expiration Date: I 3- g 1. GENERAL INFORMATION Complete legal description SANDHILL LOT 5 Location (site address) 24923 HAMANN ROAD, EAGLE RIVER,AK 99577 Current Property owner(s) SCOTT&TAMARA L.JOHNSON Day phone Mailing address 24923 HAMANN ROAD, EAGLE RIVER,AK 99577 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ® Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class Well ❑ Public Sewer ❑ Public Water System ❑ WaiverNariance request for: Distance: Received by: Date: �r°/ COSA to be releas the e�• -er,unless otherwise requested by the engineer. COSA Fee $ 2(o$ 0 Waiver Fee $ Date of Payment t 8 Date of Payment Receipt Number Receipt Number COSA# Ott ' I Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING,INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD,EAGLE RIVER,AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 7/31/2018 THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC...ASSOCIATED WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore,ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen ���►\ encroachments,deficiencies or discrepancies exist. OF ALS ArA * i 9 T H7\ 6. DSD SIGNATURE System #1 Approved for c bedrooms. ��' � 1C S Y pp # •?,., KENNETH�N.System #2 Approved for bedrooms. 1;'F 3r °ei Disapproved. \ .1o1'1A+ Conditional approval for bedrooms, with the following stipulations: RIE WA E rn W7-1 AST ANC PROGRArEh, .,, AIVj Original Certificate Date: cr-3 -1F The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10-12.doc If more than 1 septic system is on the lot: COSA Checklist# of_ Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: SANDHILL LOT 5 Parcel ID: 050-522-07 A. WELL DATA Well type PRVT If A, B, or C provide PWSID # Well Log (Y/N) Y_ Date completed 10/1996&7/2004* Sanitary seal (Y/N)Y Wires properly protected (Y/N) Y Total depth 360 ft. Cased to 121 ft. Casing height(above ground) 18 in. FROM WELL LOG AT INSPECTION Date of test 10/1996&7/2004 _ 6-12-2018 Static water level 105 ft. 186 ft. Well production 6&0.5 g.p.m. 0.27 _ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate •SO2-mg/L Arsenic: ND ug/L Date of sample: 7/23/2018 Collected by: ARCTERRA B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 7/26/2018 Tank size _1500 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping NA-NEW TANK Pumper C. ABSORPTION FIELD DATA Date installed 7/27/2018 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.8 System type SHALLOW TRENCH Length (2 @ 60') 120 ft. Width 5 ft. Gravel below pipe 2.5 ft. Total depth 6.+ft. (W/INSUL.) Eff. absorption area 1,034 ft2 Monitoring tube Y Depression over field N Date of adequacy test NA-NEW FIELD Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) _ If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at _ in. Datum _ Cycles tested _ -__ Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+__.__ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line _5'+_ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 10'+_ Building foundation 10'+ Water main 10'+___ Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 100'+___ F. COMMENTS 'Well deepened by Sullivan in 2004. Water system is augmented by 630-gallon water storage. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance _.,Ibk Nik with MOA COSA guidelines in effect on this date. OF AL Ar Engineer's Printed Name KENNETH M.DUFFUS /�`z"' 4- , °Y Date 7/31/2018 _ �4 9 TI-� * Air * ✓.::i/" COSA canary sheet_2-6-15.doc KENNET M. • is nkOFY s.10!NP� "``_f MUNICIPALITY OF ANCHORAGE • DEVELOPMENT SERVICES DEPARTMENT f \i 907-343-7904 On-Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite \� Well Water Advisory Certificate of On-Site Systems Approval # OSC181381 Subdivision: Sandhill ,Lot: 5 This well's productivity was determined to be .27 gallons per minute. The minimum well productivity required under (AMC 15.55) for a 5-bedroom residence is .52 gallons per minute or 150 gallons per day per bedroom. The production capacity can fluctuate. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. Mailing Address:P.O.Box 196650*Anchorage,Alaska 99519-6650*www.muni.org EA C GLE R IVEh, ,Q ��pAD \\ --_ NS �.. 6 2j'3g•,w ,,, WELL 13' , gNaSCgp ; _l f (�(JFFF`T t fiSti;r 402 93, Q Y' O sS ,, • '� Ib EXISTING ;^s, ° 4;' 0 BUILDING c�' s3' ', /4 SS o 2' 0°11 <0� 7.7' CK 73.4' 06 so A4 o }6.0' 16.0 c a }• cAKT EXIS.nOUSE %• H ei 10.0 N}4.0 , -o, o • 80.3' 22.0 -f'ti'( `b D� -«SEP DC VENTSi 04./R,? (tYP) I O� 5 GRAVEL '' c§:' ,}t r. 00N 10 1 k rii ./ rr oQ\� ��_ V� LOT 6 77r--- 1 ®WF..l_,.. . 3 -\------\-,......., HAMANN -- 1 - ROAD ` --"— ------„tr ) 9... ANCHORAGE RECORDING DISTRICT i' ASBUILT OF: O =FID 5/8 REBARii SANDHILL SUBDIVISION LOT 5 PLAT 93-116 SURVEY CERTIFICATION: I,John L. Schuller, have conducted a ,.+����F��� physical survey of this property as shown on this drawing and that the of��.. F•.AL \`t improvements situated thereon are within the property lines and no o/��':• `�_'... �) enchroachments exist other that noted. �•• 49TH I\ � / , 01 0 EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants,or restrictions which do not J 1? /1 a401 appear on the recorded subdivision plat. Under no circumstance should v( .•..JOHN L. SCHULLER: / , any information on this drawing be used for construction of fences, $ ,X.,•-.• LS-10408 . ,c ' - structures,improvements, or for establishing boundary lines. Nk as •.. •• k., ..•* •• `'of WORK ORDER NUMBER: DAZE SCALE: E-MAIL t gi, fess••••• �'2� 1831 Talkeetna Street JULY 31, 2018 1 =40 \AV"���► Anchorage, Alaska 99508 18— 055 DRAWN BY: CHECKED BY:GRID NUMBER: BOOK/PAGE: (907) 227-1455 office JLS SW0262 180211 (907) 274-4992 fax MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES- Division ERVICESDivision of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING, Parcel I.D. # 0:5-0 - $2Z D'% HAA # - LISA-) M'� 9, 1. GENERAL INFORMATION Complete legal description Location (site address or directions) N961 Aa "I aV1 ri lZva.ri Propertyowner 7�15�rucIrcrl�—Dayphone Mailing address �0 v 7AK_ Lending agency Day phone Mailing address Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well /` Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev.1/91) Front MOA#21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Phone 20441 Ptarmigan Blvd. Address Engineer's signature 6. DHHS SIGNATURE X Approved for bedrooms. Date) FA44%111 Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date 3— 2 7— i 7 By: ' e The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-M(RW.1191) Back MOA#21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division a 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: Lo+ 5 5cz.ri c� L1 t't 1 1 5"a . Parcel l.D.: 0510 0 J -z2. 07 A. WELL DATA Well type I rtc If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) V Date completed Total depth U0 Cased to Casing height (above ground) 2 Sanitary seal (Y/N) Y Wires properly protected (Y/N)_ FROM WELL LOG AT INSPECTION Date of test i Static water level Well production iv g.p.m. 9 -13 -m - WATER SAMPLE RESULTS: Coliform CU Nitrate Other bacteria Date of sample: 9Co Collected by: KNE) B. SEPTIC/HOLDING TANK DATA Date installed 1910 Tank size /2SU Number of Compartments .2 Cleanouts (Y/N)--Y— Foundation cleanout (Y/N) T Depression (Y/N) 61 High water alarm (Y/N) /VA Date of Pumping C. ABSORPTION FIELD DATA Pumper Date installed /l 23 Soil rating (g.p.d./ 2 or fFBxlrrn) c�3 System type `�2a��oWl✓e� Length Width la Gravel thickness below pipe. 5 Total depthS�� Effective absorption area 750 sf Monitoring Tube present (Y/N)__�_ Depression over field (Y/N) Date of adequacy test Al Results (Pass/Fail) For % bedrooms Fluid depth in absor ion field before test (in.); Immediately after_ gal. water ad d (in.): Fluid depth (ins) Minutes later: Absorption rate = g.p.d. Peroxide t atment (past 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)" D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at' Cycles tested E. SEPARATION DISTANCES "Pump on" leve *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot / D U f On adjacent lots ! O o Absorption field on lot L 4 On adjacent lots cab Public sewer main j oo I + Public sewer manhole/cleanout !leo Sewer /septic service line f DO Lift station Al` -A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: I Foundation / U Property line /U + Absorption field 1 Water main/service line _Mo + Surface water/drainage /DD -F Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: I ' Building foundation / U "F Water main/service line L 00 + Q Property line L 4 - Surface Surface water / (�>a + I Driveway, parking/vehicle storage area ! (� Curtain drain /V�H, Wells on adjacent lots I UD F. ENGINEER'S CERTIFICATIONOF'A4. `� I certify that I have determined thru field inspections and review of Municipal reco ��i�at3tre'� s are in conformance with MOA HAA guidelines in effect on this date. �Oeie 4610_ la. ae .aaa o Signature X ate• `M a.eeeeas a** •e•r.`� S S Kenneth M Fu ;• 4 Engineer's Name 11 c ae � c> -7114 �® Date 3 Ile-IV,7 �4FESSX HAA Fee $ 3� Date of Payment —T/ Receipt Number Irc0 J 72-026 (Rev. 3/96)" Waiver Fee $ Date of Payment Receipt Number