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Home My WebLink AboutSHANGRI-LA LT 8Shangri-La Lot 8 #020-043-26 Municipality ofAnchorage. Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 S. Bragaw St. '~ ~' P.O. Box lg6650 ,~nchorage. AK S9519-~650 Page/ of www. ci. anc~orage.ak, us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/ORWELL INSPECTION REPORT Permit Number:, ~w~'bt.~ C./3 O ~- ? 7' PID Numbe~ ~ ~.O ""~"': ~'~n ~- I~,-~vn ~,r Wastewater System: [] New [] Upgrade P.o. t~o~ {I~OZ~x ~r~c~. ~ c)95't/ ABSORPTION FIELD Nun'.ber,~ee~'¢cm$* ~"OeepTmtmch 0 ,~l~l{{owTfefl(~ {'{ Bed 0 LEGAL DESCRIPT{ON O. ~ c,o~ We{{: ~ New ~ Upgrade ~. ~ ~,. I{ -- ~' Y~eM: ~ GPMI Pu~ Set aC I ~ ~ ~ve ~ . ~} 2 ,~ TANK SEPARATION DISTANCES ~ Sep~c D Holding ~ S.T.E.P. D Othec Septic Abso~tlon LiR Hol~no Tank Fietd StaUon Tank S~er~e ~ ~ · ~ Cu~aln ~e..,~,: BENCH MARK EnglneeCs Stamp .Inspections pedormed by: FIo~ ~c4 ~C Dates: 1't ~/V/O; ~Y49~ 2"~ ~/~/o~ ~.-..-........,..,.,,... Developmen~ Se~ices Depa~ment Approval .~ ........ ~,,,,.,,,., Reviewed and approved by: ~ ~ Date: "/~p] PERMIT NO: SW030277 SANDPIPER DRIVE PAGE 2 OF 2 PID NO: 020-043-26 SWING TIES: FROM: PROP. COR. "A" TO: S.T.C.O. "E" 204' S.T.C.O. "F" 208' 69-FOOT LONG SOIL ABS. TRENCH DBL C.O. "G" 210' w. 5.5' EFF. SEWER GRAVEL / TR. C.O. "H" 218' / TR. M.T. "1" 219' / TR. C.O. "J" 226' REPLACEMENT . / WELL 100' TRENCH SITE ~ ,.;;;/ . ,,,~' z~.~/y ,," LOT8 TBM ,' -' -' -~ ,,,, ~.r. ,~Y..~..~C~ ,,- SHANGRI-LA SID ,?' ,/~'y ,,' SEPTIC TANK 100'/ PLAN VIEW SCALE: 1" = 30" PROP. COR."B" 180' 190' 192' 163' 196' 229' 183' CROSS~SECTION NOT TO SCALE WELL ~4' SOIL COVER :i15"~'~:(~XLt:.O~ '~'~. LOT 8, SHANGRI-LA SID SEPTIC SYSTEM INSTALLATION AS-BUILT INSPECTION REPORT FLATTOP TECIINICAL SERVICES 14530 ECHO STREET ANCtlORAGE, ALASKA 99516 SCALE: AS NOTED DRAWN BY TFM OCTOBER. 2003 FROM : ;~IN~ DRILLING FAX NO. : 9~? ~5 ~ Jul. 31 ~3 ll:~$AM P2 Rick Mystrom Mayor Permit Number:. #SW 030184 Date of Issue: ,6-11-03 Date Started: 6-14-03 Date Completed: 6-15-03. Legal Dc~crlption: ProperD' Owner ]%me & Address: Boreholc Data: Sol! Ty~:. Thie&ness & W~er S~rata Stick-up gavelly cobbly silt bedrock Parcel Identification Number: 020-043.26 Is reel! located at approved permit location? [] Yes 1-1 No [] cable tool Casing t)pe: 1ffeel Wall Thickness: ,~5~ inches Diameter: _~ inches Depth: ~7 feet Liner Type: , Diameter:. ~ inches Depth: ~ Casing sfickup above ground: 2 feet ,Shanqd-la Lo( 8 Anchorage Development & Construcffon 944f Abbott Loop Road Anchom~le, Alaska 99507 Depth (ft) Method of Ih4111ng [] ail' £otary From To 0 2 8 300 Static water level (from ground level): 8__feet pumping level: ~00 feet after ~ bouts.pumping _5 gpm Recovery Rate: _5 gpm Method of Testing: Well Intake Opening Type: [] Open End i~ Open Hole [] Screened Start__ [] Perforations St,m Stopped feet Stopped ~ feet Volume:/kg Grout Type: bentonite granules' Depth: Start Q.0 feet Stopped .9 feet Pump: Intake Depth feet Pump size hp Brand Name ...... Well Disinfected Upon Completion? [] Yes [] No Method of Disinfection: chlodne tablets Alpino Ddlling & Enterprises PO Box 110496 Anchorage Alaska 99511 Comments: Well Driller:. Attention: The well driller shall provide a well log to the prope~y owner withhq 30 days ofcompletion mad the properU, MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-79O4 ON-SITE WATER SUPPLY PERMIT Initial Date Issued: Jun 11, 2003 Expiration Date: Jun 10, 2004 Permit Number: SW030184 Legal Description:JSHANG~i'~!LA SUBDIVISION LOT 8 Design Engineer: 0019 Flattop Technical Services Owner Name: EARL FORD Owner Address: 9441 ABBO'iq' LOOP ROAD ANCHORAGE, AK 99507- Parcel ID: 020-043-26 Site Address: NHN SANDPIPER DRIVE Lot Size: 48483 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] SepticTank [] Holding Tank [] Privy [] Pdvate Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O, Box 196650 Anchorage, AK 99519-6650 w~vw,ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWERfVVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Permit Number SWO;~O/8~ Property owner(s) Mailing address (1) Mailing address (2) Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) LotSize '~4~.~ Acres~ . ~. ~(.~ A,~4o~-o¢~ D~ue/o!..~. f Day phone Zip Code Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool [] Well Only [] [] Water Storage [] [] Jacuzzi [] [] Water Softening Unit [] I certify that the above information is correct. I further cedify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: Date of Payment: (Rev. 1 Waiver Fees: Date of Payment: Receipt Number: / ~ REPLACEMENT TRENCHi i SEPTIC I ,,' /-- PROPOSED TRENCH iiii~ia~a ,~' PROP SEPTIC TANK' ~ =' BEDROCK' '~ ,'" / // X,' ,~:~ ~ ~ ~ ~,, ~:~::~ LOT0 ~ ~ / ~ ~ee,.eee~eeeeeeeeeeeeeee~e~ SHANGRI-~S/D ~0'~ SS' ~' / ''' ':::~::~' :::::: : :::::::' ~OT ~DIUS FROM LOT ~ACAN~ / ~:~/ 14 WELL (ALR~DY DRILLED) ~ / .... ~ PROPOSED WELL LOCATION ~ SITE P~N NOTE: CONFLICT WITH PREVIOUSLY DESIGNATED FLA~OP TECI~ICAL SERVICES 1 INCH = 50 FEET SEPTIC RESERVE AR~S. THERE APP~RS TO BE 14530 ECtlO STREET D~WN BY TFM AMPLE SPACE FOR MINOR ADJUS~ENTS TO ANCHO~GE. ALASKA 99fl6 JUNE. 2003 NOTE: THIS IS NOTA SURVEYED P~T. BOUNDARIES OF SEPTIC RESERVE AR~S ALL LOCATIONS SHOWN ARE APPROXIMATE. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 020-043-26 1. GENERAL INFORMATION ComPlete legal description Expiration Date: c~'i'/~,~'~// SHANGRI-LA ESTATES LOT 8 Location (site address) 16380 SANDPIPER DRIVE, ANCHORAGE, AK 99516 Current Property owner(s) THOMAS & KAREN MARSHALL Mailing address Lending agency Mailing address Day phone 16380 SANDPIPER DRIVE, ANCHORAGE, AK 99516 Day phone Real Estate Agent Mailing Address THE RAMSEY TEAM - DYNAMIC Day phone Unless otherwise requested, COSA will be held by DSD for pickup.. NUMBER'~OFBEDROOMS: '~P'E OF WATER 'SUPPLY: ', Individual We? 'lndividU~l:Watet Storage com~Uhity Class'__ Well Public Water System 4 TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [~ [] Individual Holding Tank [--] [] Community On-site r'-] [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. DSD SIGNATURE ~ Approved for ~ Disapproved. Conditional approval for Name of Firm ARCTERRA CONSULTING, INC. Phone 868-3792 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 04/08/2011 Engineer's Comments: This investigation was completed in corn pliance 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 ~.. ~"'~i~"i~!'~.~~':~::i'i!i.:':i~, ..: . -.~'. ~,~;....., !.'~. - . ...,:~.. occupants or can ArcTerra guarantee that no unseen ~t~¢~':'... ' '~"~'~:""' ;~~'~:'~':.'~~. encroachments, deficiencies or discrepancies exist. ... .... .~...... .. ....... · .... ~,: bedrooms. ~~ bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Mai'ntenance Agreements Supplemental Engineer's Report Other ~dginal certificate Date:. Municipality of Anchorage Development SeWices Department Building Safety DiVision' On-Site Water& Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SHANGRI-LA ESTATES LOT 8 A. WELL DATA Well.type ~A:~:.lf A,:B,rOF C provide PWSID # . - Well Log Cf/N)_Y Date completed'6/ZS/2003 Sanitary seal (Y/N) Y_. Total depth 300 f. Cased to 8 ft. (INTO BEDROCK) FROM WELL LOG Date of test 6/1.5/03 Static water level $ ft. Well produCtion 5.0 g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100mL Nitrate 0.876 mg/L Arsenic: ND. mg/I Date of sample: 3/?.5/2~1 Collected by: ArcTezza B. SEPTIC/HOLDING TANK DATA Tank Type/Material Sepfic/SteeJ Date installed 8/4/2003 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 3/25/11 Pumper A+ C. ABSORPTION FIELD DATA Date installed 8/4/2003 Soil rating (g.p.d./ft2 or ff2/bdrm) 0.8 Length 69 ft. Width 2.5 ff. Gravel below pipe 5.5 ft. Eft. absorption area 759 it2 Monitoring tube Y Date of adequacy test 3/2.;~1 Fluid depth in absorption field before test 0 in. Wires properly protected(Y/N) Y_. Casing height (above ground) 24+ in. AT INSPECTION 3/25/2011 5.21 g.p.m. Elapsed l~me: 0__ min. Final fluid depth 0 in. Absorption rate >= 600+ g.p.d. Any rejuVenation treatment (past 12 mo.) (Y/N & tyPe) N__lf Yes, give date --_~- Depression over field _N_ Results (Pass/Fail) Pass For ~t bedrooms Water added 600 gal. New depth 0 in. Parcel ID: 020-043-26 System type Deep Tzeach Total depth 8.~9 ft. (Measured 3/25/11) F= D. LIFT STATION Date installed "Pump on' level at in. Datum E. SEPARATION DISTANCES Size in gallons "Pump off' level at Cycles tested in. SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100+ Public sewer main SeWer/septic Service line 25'+ Animal containment areas 50'+ ' Manhole/Access (Y/N) High water alarm level at in. Meets alarm & circuit requirements? On adjacent lots 100'+ On adjacent lots 100'+ Publicsewermanhele/cleanout :tO(Y+ Holding tank.. 10~+ Manure/animal excrete storage areas lo0'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Water main 10'+ Wells on adjacent lots :tOO'+ Property line .5,+ Water service line 10'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line :tO'+ Building foundation 10'+ Water Service line 10'+ Surface water 100'+ Curtain drain 50'+ (None Known) COMMENTS Absorption field Surface water 100'+ Water main 10'+ Driveway, parking/vehicle storage 10'+ Wells on adjacent lots 100'+ G. ENGINEER'S CERTIFICATION I certify that I have determined through r~ld inspections and review of Municipal records ~het the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name KENNETI-I M. DUFFUS Date 4/08/2011 COSA Fee $490.00 Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number SGS Ref.# 1111053001 Client Name ArcTerra Engineering and Surveying Printed Date/Time 04/06/2011 11:53 Project Name/# SHANGRI-LA Lot 8 Collected Date/Time 03/25/2011 11:45 Client Sample ID SHANGRI-LA Lot 8 Received Date/Time 03/25/2011 14:45 Matrix Drinking Water Technical Director Stephen C. Ede PWSID 0 SamDle Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 03/31/11 04/04/11 NRB Waters Department Total Nitrate/Nitrite-N 0.876 0.100 mg/L SM20 4500NO3-F B (<10) 03/30/11 AYC Microbiology Laboratory E. Coli Negative 1 100mL SM20 9223B A 03/25/11 DLC Total Colifom~ Negative 1 100mL SM20 9223B A 03/25/11 DLC Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196550 Anchorage, AK 99519-6550 w,~w.muni, org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. /")~-~) -~'J~ ' -,~"~ 1. GENERAL INFORMATION COSA# Expiration Date: I ~ - I '7 - O 7 Complete legal description Location (site address) Current Properly owner(s) Mailing address Lending agency. Mailing address Real Estate Agent Mailing address SHANGRI LA ESTATES SUBDIVISION; LOT 8 16380 SANDPIPER DRIVE FLOSSIE BRYNER 16380 SANDPIPER DRIVE ANCHORAGE, AK . Day phone, 345-4168 · ANCHORAGE, AK Day phone DONNA ORR w// REIdAX PROPERTIES Dayphone 240-7493 110 W. 38th SUITE 100 * ANCHORAGE, AK 99505 Unless othen/vise requested, COSA will be held by DSD for pickup. 2. NUMBEROF BEDROOMS: 4 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 On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site waste, water disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEI~,ENT 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 Certificale of On-Site Systems Approval Guidelines forthis 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 ali applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 357-6179 Address 3701E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY' A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation. GEG, LtD. affempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on tho local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being sec'ed by the system. These conditions ara outside the control of the eva/uator of the system. Satiafactoq/ test results do not guarantee future performance of the system, nor de they guarantee that there are no bidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA D~D.~he content of the ao/e benefit of the owner listed above. Any reliance upoe or use of this report by any other ~eraon or party is not authorized, nor wi//it confer any legal right whatsoever. $. DSD SIGNATURE -' ~' Approved for L./L bedrooms. Disapproved. Conditional approval for __ bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other By:~'. Original Certificate Date: ~ 7 [ '~ Municipality of Anchorage ~~ .... , Development Services Department Building Safety Dhdsio~ On-Sih. Water & Wastawater Program 4700 Bragaw S~mt P.O. Box 196650 Archoroge, AK 99519-6650 wwv.munL org/onsite (9O7) 343-79O4 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Descdption: A. WELL DATA Date of test Static water level .ft. Well production 5.0 g.p.m. SHANGRI LA ESTATES SUBDIVISIONi LOT 8 *CASED TO BEDROCK Well t~13e ~mVA~ If A, B, Or C provide PWSID# N/A Date completed 6/1.5/2005 Sanitary seal (Y/N) YES Total depth 500 ft. Cased to *8 lt. FROM WELL LOG 6/~`5/2oo`1 8 WATER SAMPLE RESULTS: Callfom~ (~ colordes/100 mi. Arsenic: .J~ ug./L SEPTIC/NOLDING TANK DATA Tank Type/Matedal SEPTIC/STEEL Tank size 1.500 gal. Number of Compartments 2 Faundation deanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping 7/25/2007 Pumper ABSORPTION FIELD DATA Date installed Length 69 ft. N,,~. tq ma~-. Date of sample: 8/6/2007 Pane ~O: O-~ 0- O/-/g Well Log (Y/N) w~es pmm~y pmtect~ (Y/N) Casing height (above ground) AT INSPECTION 7/25/2007 26 .ft. 3.7 .g.p.m. YES YES 18+ in. Other bacteria 0 cnionies/100 mi. Collected by: GEG Ltd. Date installed 8/4/200,1 ~leanout~ (Y/N) YES High water alarm (Y/N) N/A Mc0ONALD'S PUMPING p~IELOW ~XISTING GRAO~ O UTI Soil rating ~ ~"tbdnn) 0.8 Width 2.5 .ff. Total depth .8.92 [ Eft. absoll)Uon area 7.59 ifa Monitoring bJt:a~ YES Date of adequacy test 7/2`5/2007 P~sults (Pass/Fall) P~S Fluiddepthlnabsarptionfleldbefomtest 7 in. Wateradded 70~gel. F_tepsed Time: 0 min. Final fluid depth 7 in. Any rejuvena~on treatment (past 12 mo.) (Y/N & type) System type DEEP TRENCH Gravel below pipe. 5,5 fl. Depression over field NO Far 4 bedrooms 7 in. g.p.d. New depth Abs~ rate >- 600+ NONE KNOWN If yes, give date D. UFT STATION Date installed Size in gallons ~ ~ "Pump on" level at ~lgh wa~ alarm level at in. ~ ~ Cycles testa([ Meats alarm &circuit requirements?. E. SEPARATION OISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/IR station on icl Absorption field on lot 100'+ Public sewer main N/A Ses~r/septic sedco line 25% Animal containment areas 50'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/ctaanout N/A Holding tank N//A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Water main N/A Water service line 10'+ Walls on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation. 10'+ Water sewice line . 10'+ Surl'aco water 100'+ Cu~lain drain NONE: KNOWN Wells on adjacent lots 100'+ COMMENI~ Absorption field 5'+ Surfaco water 100'+ Water main N/A Driveway, parking/vehicle sterage 10'+ G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspec~x~ and review of Municipal recorda that the above systems are in conformance ~ MOA COSA guidelines in effect on this date. En~nes~s Printed Name JEFFREY A. GARNESS Date Receipt N.mbel' ~ ~' ~/q ~ (Rev. ~ ~mS) Waiver Fee $ Data of Payment Receipt Number SANDPIPER DRIVE S BcJ 57' OB" E ~ 1 5.48 65.8 SGS Ref. N Client Name Project Name/# Client Sample ID Matrix 10739330O1 Garness Engineering Group, Ltd. Shangri La lot 8 Shangri La Lot 8 Drinking Waler All Daleqrimes are Alaska Standard Time Printed Date/Time 08/1:5/'2007 16:25 Collected Date/Time 08/06/2007 13:45 Recek'ed Date/Time 08/06/2007 14:00 Technical Director Stephen C. Ede PWSID 0 Sample Remarks: Allowable Prep Analysis parameter Results PQL Units Method Container ID Limits Date Date Init Met&ls b~ ICP/MS A~cnlc ND 5.00 ug/L EP200.g C (<10) 08/13/07 08/14/07 Mil Waters Department Total Nitrate/Nitrite-N 2.19 0.100 mg/L SM204500NO3-F B (<I0) 0g/09/07 JDS Mic~ob~olo~ Laborator~ TotalCollform 0 col/100mL SM209222B A (<1) 08/06/07 SDP 5432 E. Northern Lights Blvd, Suit~ Anchorage, Alaska 99508 (907) 338-4476 Description Price ~,mlt ~mount Septic tank pumped Sludge in tank Leach treatment Bio-mat in leach Water level in leach Cfip on Stand Pipes Other: r'~.o~c' r>,.,X~,,. Recommendations: Total 1.5% interest will be charged monthly on unpaid bills until