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SCHROEDER EAST BLK 7 LT 9
Schroeder East Block 7 Lot 9 #050-071-11 Municipality of Anchorage •e •- .. Development Services Department Building Safety Division a 4arr ' ' "'� On -Site Water & Wastewater Program, 4700 South Bragaw St P.O. Box 196650 Anchorage, AK 99519.6650 www.d.anchorage.ak.us (907) 343-7904 Page 1 of 3 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SW000453 PID Number. 050-071-11 Name: JOHN THOMSON Wastewater System: ■ New O Upgrade Address: SANTA MARIA DRIVE • EAGLE RIVER. AK 99577 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 240-2020 3 13 Deep Trench ■ Shallow Trench O Bed a Mound a Other LEGAL DESCRIPTION Sse Rawq: 1.2 Total Dom treat ervp peas: 3.5-5.0 on/n,. n rL Lot Block: Subdivision: Depth to pipe bo"" from erqunl Paas: or" e.qh beneath pipe: 9 7 SCHROEDER EAST 1.5-3.0 Ft 2.0 n Township: Range: Section: s9 addW aesw wvnel peas+ onow Nepn: — — — 1.5-2.5 n 55 n WELL: O New O Upgrade Gram .wth: 5 Runb.r of sees: 1 DWl bet~ sne — rL rL CW."*atb P&wts, Ae,C : Tow Depth:Cased T. Total absorption area: ripe ltrslrlak EXISTING — PRIVATE 41 rt 40.5 rL 392 so. fe ASTM D-3034/F810/HDPE Dia . M—W DRILLING Dose Droved: 6/28/83 p3Mn aCCC CONSTRUCTION Dde kwtolled: 11/1/2000 r 50 Rwnp sal u UNKNOWN Caeme Hasp.'crena 1.5++ TANK cp„ R i< SEPARATION DISTANCES ■septic 0Holding aS.T.E.P. 0Other To Septic Absorption Lift Holding bne/Pnw1e mono . PREMIER PLASTIC eap°`ro' rt e0 ` 1300 From Tank Field Station Tank sees un.. Well 100'+ 100'+ — — 25'+ wd«Ick PLASTIC Rwae. ~ a.,w 2 Surface water 100'+ 100'+ — — — LIFT STATION Lot Una 5'+ 101+ — — — Sue h raaemtw Foundation 5'+ 10'+ — — — an IwM et ump a aC K0 eater abrm ab p• w da w 0 --fila k" --U— p w""d br. Curtain Drain NONE KNOW BENCH MARK Remarks: Looftion WW Desw". BOTTOM OF BACK DOOR THRESHOLD Aw w,m d 0..ouara 82.46 R trNo.e:Exs seen QF •q ��DO oo���. Inspections performed by: AWWC, INC. Dates: lst 11/1/2000 .. : 4 °a�0 . .... . .. ..... . 2nd 11/1/2000 D 3rd 12/28/2000 DO a QO Department of He alt d Hu se ices approval a �J •. C7953 p� Reviewed/0and approved by: Date: -2 -0/ �a' 0 OpO0000�000 PERMrr NUMBER: PARCELID NUMBER: SWO00453 AS-BUELT DRAWING 050-071-11 a►D(us I GRINDER PUMP I I \ IN CRAWLSPACE I / eom�S \ CL r / / NEW DRAINFIELD I/ B \ / ST1 66.98 93.45 A ST2 67.24 91.39 / DBL1 67.50 88.26 DBL2 67.65 87.52 C01 67.31 87.15 MT1 67.20 86.19 CO2 93.75 70.78 MT2 93.02 70.31 / ALASKA WATER & WASTKNVATKR CONSULTANTS, INC. 6901 DFSA ROAD. SUTE 29 • A HORAGF. AI( 9950.' PHONF (907)317-0179' FAX (907).77"24 IPREPARED FOR: PHONE NUMBER: JOHN THOMSON (907) 240-2020 LEGAL DESCRIPDON: SCHROEDER SUDIVISION EAST: LOT 9. BLOCK 7. AS—BUILT DRAWING OF NEW SEPTIC SYSTEM e JEW 1300 GALLON PREMIER PLASTIC SEPTIC TANK 1 ,„,I// / / j ALTERNATE SITE L / J 0 !/5/2001 WN BY. J.L.M. � I" = A. GGmess. —7953 30r . E NUMBER: 20F3 A. GGmess. —7953 PERMIT NUMBER: PARCEL R) NUMBER; swo00453 AS—BUILT DRAWING 050-071-111 fcPOff", Af N.ef -102.0 f•NERr or vm- Af uef -100.95 ORIGNN. am -101.95 (ON pmm 50)— DOANiL 5" of fZN01 WA5 N91%Vt %m ON Powqu 5" Of 1WN01 WA5 GRADED f0 LE55 M A 25 F=N'r.OPE. `A11T' PNN.GXPDE-10524.105b1 SRfI 5fR1 I I I I f-cL Lg =DO NSW 1300 6AI.I.ON "PITMU PLA511C11 %P11C TANK Mf DOrfOM Or InNCN - 98.4 (AV(4.) \_mw oP DING Af CUMff -10061 am -1042-101.95 cca%CR/OE -104.5 (ON LPHI15m) 'LTR fmm - NVERf GP PPE -100.5 (AVO 2/5/2001 DRAWN BY: ALASKA NVATI:R & WASTKWATLRSCALE. J.L.M. CONSULTANTS, INC. N.T.S 6901 DEeARR ROAD, SUITE n • AWHMAGE. AK 99504 • PHONE 07)537-6179 • FM 071318-5266 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: JOHN THOMPSON (907) 240-2020 3 OF 3 LEGAL DESCRIPTION: SCHROEDER SUBDIVSION EAST; LOT 9. BLOCK 7. TYPE OF WORK: PROFILE AS—BUILT DRAWING OF NEW SEPTIC SYSTEM GOr ess: 79 To: FAX COVER SHEET Creta Bloxom Northrim Bank/ Construction Lending Fax Number: 907-261-3387 Voice Number: 907-261-3335 From: Eva Loken The Prudential Vista Real Estate Inc. Fax Number: 907-689-6477 Voice Number: 907-689-6476 RE: C&T Schroeder E. Lot 9 blk 7 Em's Appla— she hmlthr choir In Rat auus. Eva Loken, ABR, CRS, GRI Associate Broker P.1 Message: here is well log. it says lot 10, but they actually drilled it on lot 9, see notes on the well log by me.. cc.; AWWC Date sent: 01/11/2001 Time sent: 09:48am Page 1 of I7 v .16635 Centerfield Drive • Eagle River, AK 99577 800.610-6464 907.689-6476 Di AK VhttpV/i~v.evasapples.eom • e-inailwasaplsi.net atdc (bPrudentlal I Realaul Estale (a 13 ME 1p. rra rb Prudential .."" "•"" "" ."`° -�' M -W DRILLING, Inc. r'1 P.O. Boa 14373 • 10300 Old Seward Highway (907) 349-8535 ANCHORAGE, ALASKA 83511 DRILLING LOG Well Owner IAM Ivaco Use of Well Dorestic Location (address of: Township, Range, Section, if known; or distance main road .._Iat-49 Bic,&, 7 Schzveder Fist s Size of casing--L)--Depth- of Hole—LI—feet Cased to 40.5 reet Static water level 3 rt. (ib3ki (below) land surface. Finish of well (check one) open end ); Screen ( ); Perforated ( ). Describe screen or perforation '0c^4' Well pumping test at50 gallons per 0119: (minute) for -11 --hours with --------12,T n`• of drawdown from static level. Date of completion Tme 28, 1903 WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness TO 2 2 TOS_ 8 TO 9 9 TO 12 12 Tp16 _lam TO 14 19 TO 21 21 TO cif) [,I Tp �1 TO TO TO TO Casing, sti.cl-1T FI11 zrlye1 _ MUNICIPALITY OF ANCHORAGE Silt? "ravel Fuck ill= SPn&r Fra,m1 r edrock - broken tr) NWA Certified Contractor - Carl iAe, 1e P; Tr. R t F. 3—CONTRACTOR Well M -W DRILLING, Inc. P.O. Bot 10.378 • 10300 Old Seward Highway (907) 349-8535 ANCHORAGE. ALASKA 99511 Location (address of: Township, Range, Size of casing 6" nepth of Holl Static water levet 3 ft. ) bel Screen ( ); Perforated ( ). DRILLING LOG if known;,or Cased to 40.5 feet of Well DIrxstic land surface. Finish of well (check one) open end (=a ); Describe screen or perforation lb e Well pumping test at50 gallons per (FA%Y)= (minute) for I1 ---hours with 100 trc of drawdown from static level. Date of completion Jane 28, 1983 WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness Casinr stick _. I'll 1ftrnyel. TO 2 c TO G TO A 6 To 9 9 12 TO12 TO 16 _V; TO 14' l� TO 21 21 TO 40 4� TO 6i TO Casinr stick _. I'll 1ftrnyel. Ornt*ti c Si 1 ty rrmml Sandy travel (tuft` ) Pack - orec:i Silty travel Fnck imam .;m&r rrave.1 (ftp ) ri�dmck - brdren tm TO NWWA Certified Contractor TO ^ Cilie ile Aie's F11 c. 973 TO A45-0107- ,7 3—CONTRACTOR Permit Number: SW000453 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 3434744 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial _1 �wpcctio,--, ik�vem� Id cao CJic�.w, /I /DD Date Issued: Oct 26, 2000 Expiration Date: Oct 26, 2001 Parcel ID: 050-071-11 Legal Description: SCHROEDER EAST BLK 7 LT 9 Design Engineer: 0041 AK Water & Wastewater Consultant Site Address: Owner Name: John Thomson Lot Size: 22352 SO. FT. Owner Address: 17343 Santa Maria Dr. Total Bedrooms: 3 Permit Bedrooms: 3 Eagle River , AK 99577 - This permit Is for the construction of: Q Disposal Field n✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 1 BAAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: xk'O "p J Date: Issued By: V a,Gw r• Date: /a - 2o, — 00 ALASKA WATER & WASTEWATER CONSULTANTS, INC. October 12, 2000 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Proposed Septic System for Lot 9, Block 7, Schroeder East Subdivision To whom it may concern: The proposed 3 bedroom house will be served by a private well and septic system. There is already a well that has been drilled on the property. Test holes were excavated on the property in the area of the proposed septic system. The proposed septic system will be designed around the 30 foot radii of these test holes. We are proposing that a grinder pump be installed in the crawlspace, a 1000 gallon septic tank and a five foot wide drainfield be installed. Comments regarding the proposed design are summarized as follows: 1. SOILS: A soil log which shows the soil classifications, groundwater monitoring, and the percolation test results are attached. It is our opinion that due to the overall appearance of the soils, an application rate of 1.2 gallons/day/ft2 should be used. 2. TRENCH DESIGN: a. Percolation Rate: 3.3 & 4.7 minutes/inch b. Allowable Application Rate: 1.2 gallons/day/ft2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 375ft2 f. Total Depth: 5 feet (max.) g. Effective Depth: 2 feet h. Width: 5 feet i. Reduction Factor: 0.70 j. Minimum Length: 55 feet long k Effective absorption area = 393 ft2 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com 4. TOPOGRAPHY: The area for the proposed septic system is greater then a 25 percent slope running east/southeast to west/northwest. The area downhill from the septic system is to be filled with clean fill in order to decrease the slope to be less than 25 percent. We do not anticipate any slope concerns after the fill is added. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179, or 244-9612. Thank you for M.S. NOTE: Attached is a sire plan drawing, a design drawing, a profile drawing, two soils logs, and a 7 page 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 * Website: akwwc.com 1 I I I I I I SCHROEDER S/D EASTI LAT 14, BLOCK 7, SCHROEDER S/CK EBST '/ I 1 -] I PROPOSED /, ! / r nol SCHROEDER S/D EASLAT 7, BLOCK 0.i; SCHROEDER S/D EAST LAT 12, BLOCK 7, I / r / r r j �r SCHROEDER S/D EAST LOT 11, BLOCK 7, EAST 7, mil SYSTEM 2 O 3) A. SCHROEDER S/D EAST ALTERh / _ ' ♦ / LOT B, BLOCK 7, CLOTOB BAST / AR� BLOCK Q / SCHROEDER S/D EAST LOT 7, BLOCK 7, / ' SCHROEDER S/D EAST LOT B, BLOCK 7, 1 I I DATE: 10/2/2000 / t DRAWN BY: ALASKA «'XrER S «'ASTLWXI RCONS J.L M. SCALE: ~ - 100' DEBARR ROAD. TS FB • ANCRORA EuAK OOSOtTSPMONE (0077111-0t79 •FAX (907UJ6-]266 6001 BU PREPARED FOR PHONE NUMBER: PAGE, NUMBER: JOHN THOMSON (907) 240-2020 1 OF 3 LEGA- DESCRIPTION: SCHROEDER SUBDIVISION EAST; LOT 9, BLOCK 7, TYPE OF WORK: SITE PLAN FOR PROPOSED SEPTIC SYSTEM mil SYSTEM 2 O 3) A. 1/ II 1Do..NEtl. w�NspON I � ' APPRox1�� LDS wDlus \ \ 100 WELL I' / / / / \4 GRINDER PUMP I/ IN CRAWLSPACE / SEE PROFILE DRAWING, PAGE 3 OF 3, FOR / DETAILS ON FILL MEA NOTE: THE CONTRACTOR SHALL HAVE ALL THE 100 FOOT WELL RADII THAT ARE SHOWN AND THE SOUTH/SOUTHWEST PROPERTY LINE FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO ANY CONSTRUCTION. r,7 m -PROPOSED 1000 GALLON SEPTIC TANK (STALL DBL CO PROPOSED DRMNFIELD. EXCAVATE A TRENCH THAT IS 5 FEET DEEP MAXIMUM (ON UPHILL SIDE) BY 5 FEET WIDE BY 55 FEET LANG. ADD 2 FEET OF CLEAN. WASHED SEWER DRAINROCK. INSTALL THE TRENCH PARALLEL TO CONTOURS. 10/2/2000 KA « DRAWN BY: ALAS 'A1�rR 8 WASTEWATER � J.L.M. CONSULTANTS, INC. 1 = 30� 6901 DERARR ROAD. 50TE 28 • ANCHORAGE. AK 9950! • EH" 907)331-0179 • F" 071338-3266 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: JOHN THOMSON (907) 240-2020 2 OF 3 SCHROEDER SUBDIVISION EAST; LOT 9. BLOCK 7 E OF WORK: DESIGN OF PROPOSED SEPTIC SYSTEM SITE 7953 PROPOSED CRADE. THIS I IS TO BE FILLED WITH Cl FILL IN ORDER TO CREA1 SLOPE THAT IS LESS THAN PROPOSED 3 BEDROOM HOUSE OSED GRINDER PUMP IN CRAWLSPACE. PROPOSED 1000 GALLON SEPTIC TANK -n PROPOSED CRADE ALASKA «TATER & «'ASTENATATER J•L M• CONSULTANTS, INC. SCALE: , ani maeea even • mw m • euruMeff elf o ,m • f+ H( e!F......37..70 • F" fe6711]6•]tf.6 N.T.S. DOi ••.. PARED FOR: PHONE NUMBER: VwL NVMULN: Y JOHN THOMSON (907) 240-2020 3 OF 3e' G SCHROEDER SUBDIVISION EAST; LOT 9. BLOCK 7. PROFILE DESIGN OF PROPOSED SEPTIC SYSTEM ALASKA WATER & WASTEWATER CONSULTANTS, INC. 69UI ULEI&ONE ROAD, SUITE6 9ZB - (907 —3246 J.E. AK. 69504 I SOIL LOG — PERCOLATION TEST I LEGAL DESCRIPTION: SCHROEDER EAST S/D: LOT 9, BLOCK 7, PERFORMED FOR: EVA LOKEN DATE PERFORMED: 8/23/00 DE feet �___ TEST HOLE #1 (_�= ORGANICS BEDROCK 11.5'-14' DEPTH TO DATE GROUNDWATER DRY 8/23/00 DRY 8/31/00 SCHROEDER S/D FAST LOT B. BLOCK 7. C;E;TC E\�A 1 EAST 7. SITE DATE READING � NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 8/31/00 1 C .1 — 6' — 2 2:58 10 0' 6' 3 2:58 — 6' — 4 I11111111t ML 10 2• 4' 5 3:08 6' %//%CLt 6 1�� 10 1 3/4' 1111, 7 GC •CH — 6' — 9 3:28 0 0 SW MH 2 7/8' 10 3:28 — 6' — 11 3:38 10 3' 3- 12 3:38 • 6' — 13 3:48 10 .. Sc BEDROCK 11.5'-14' DEPTH TO DATE GROUNDWATER DRY 8/23/00 DRY 8/31/00 SCHROEDER S/D FAST LOT B. BLOCK 7. C;E;TC E\�A 1 EAST 7. SITE DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 8/31/00 1 2:48 — 6' — 2 2:58 10 0' 6' 3 2:58 — 6' — 4 3:08 10 2• 4' 5 3:08 6' — 6 3:18 10 1 3/4' 4 1/4- 7 3:18 — 6' — 9 3:28 10 3 1/8' 2 7/8' 10 3:28 — 6' — 11 3:38 10 3' 3- 12 3:38 — 6' — 13 3:48 10 3' 3' PERCOLATION RATE 3.33 TEST RUN BETWEEN 7.0 AKED FOR 4+ HOUR PERFORMED BY ALASKA WATER do WASTEWATER I. THIS WAS PERFORM ACCORDANCE WITH ALL DATE. DATE: I Do PERC. HOLE DIA. 6' (INCHES) I 7.5 FT. CERTIFY THAT I GUIDELINES IN EFFECT ON THIS ALASKA WATER & WASTEWATER CONSULTANTS, INC. 690PHONEE((9071 337-6179 2B FAX (((90� 338 324695D4 I SOIL LOG — PERCOLATION TEST I LEGAL DESCRIPTION: SCHROEDER EAST S/D: LOT 9, BLOCK 7, PERFORMED FOR: EVA LOKEN DATE PERFORMED: 8/23/00 DE 81�H-H_-H"-HHH" ORGANICS ITEST HOLE #2 1 � 6 7 8 9 10 11 12 13 14 15 16 17 GM/SM DATE 20' I SCHROEDER S/D EAST LOT 10, BLOCK 7, PROPOSED 3 BEDR HOUSEDLf- ��` PROPOSED \ I/ SYSTEM \ 4 n / it /1 -ALTERNA SITE 1 12 SCHROEDER i LOTS. S/DBLOCK EAST 7. LOT S. BLOCK 7, C�ac SIIT POLO N DATE READING CLOCK TIME ILI WATER LEVEL READING NET DROP (INCHES) 8/31/00 1 2:48 — 6" — 2 2:58 111111111 3 3/8- 2 5/8- 3 2:58 - 6" - 4 3:08 HNH • OR 5 3:08 IIIIIIIII 6" Mw 6 3:18 0000. 3 3/4" 10111i 7 3:18 V"' 6" Au 0 9 3:28 10 DATE 20' I SCHROEDER S/D EAST LOT 10, BLOCK 7, PROPOSED 3 BEDR HOUSEDLf- ��` PROPOSED \ I/ SYSTEM \ 4 n / it /1 -ALTERNA SITE 1 12 SCHROEDER i LOTS. S/DBLOCK EAST 7. LOT S. BLOCK 7, C�ac SIIT POLO N DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 8/31/00 1 2:48 — 6" — 2 2:58 10 3 3/8- 2 5/8- 3 2:58 - 6" - 4 3:08 10 3 1/2- 2 1/2- 5 3:08 6" - 6 3:18 10 3 3/4" 2 1/4- 7 3:18 - 6" - 9 3:28 10 4" 2- 10 3:28 - 6" - 11 3:38 10 3 7/8" 2 1/8" 12 3:38 - 6" - 13 3:48 1 10 3 7/80 2 1/8" :0TEST 9 l PERCOLATION RATE 4.71 (MIN./INCH) PERC. HOLE DIA. 6" (INCHES) RUN BETWEEN 8.0 FT. AN 8.5 FT. BEDROCK TO 22' COMMENTS: PERC HOLE PRE-SOAKED FOR 4+ HOURS PERFORMED BY ALASKA WATER do WASTEWATER I, THIS WAS PERFORMED INI ACCORDANCE WITH ALL DATE. DATE: 1011111w CERTIFY THAT I ;T ON THIS WATER & WASTEWATER CONSULTANTS, INC. I JUIL- LUU — rLr%L UL.A I IUN I LJ I I LEGAL DESCRIPTION: SCHROEDER EAST S/D: LOT 9, BLOCK 7, PERFORMED FOR: EVA LOKEN DATE PERFORMED: 8/23/00 DEPTH ____ TEST HOLE #1 (feet) ORGANICS ' t NET TIME (MINUTES) WATER LEVEL READING SOIL CLASSIFICATIONS 8/31/00 1 1 — [I — 2 2:58 10 0' •. • IE — it ML 4 3:08 10 2' uGP 5 3:08 6' GC OL 6 E 10 11CIL SWIIIIIIIIIMH 7 E — 1 ISP%//%CH 9 i 10 1 I 3lillllf • 10 3:28 — 6' ScRI 11 3:38 10 1 3' DEPTH TO .� ' i [ NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 8/31/00 1 1 — 6' — 2 2:58 10 0' 6' • IE — it — 4 3:08 10 2' 4' 5 3:08 6' — 6 16- 17- 18- 19- 20 617181920 COMMENTS: BEDROCK 11.5'-14' DRY SCHROEDER S/D EAST LOT 8.�EppEBLOCK 7. CARAC EAST 7. I SrrE I DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 8/31/00 1 2:48 — 6' — 2 2:58 10 0' 6' 3 2:58 — 6' — 4 3:08 10 2' 4' 5 3:08 6' — 6 3:18 10 1 3/4' 4 1/4- 7 3:18 — 6' — 9 3:28 10 3 1/8' 2 7/8' 10 3:28 — 6' — 11 3:38 10 1 3' 1 3' 12 -3:38 — 1 6' — 13 3:48 10 1 3' 1 3- PERCOLATION RATE 3.33 (MIN. TEST RUN BETWEEN 7.0 FT. PRE—SOAKED FOR 4+ HOURS/1 / PERFORMED BY ALASKA WATER do WASTEWATER I. THIS WAS PERFOR EQ/IN ACCORDANCE WITH ALL DATE. DATE: 0 PERC. HOLE DIA. 6' (INCHES) I 7.5 FT. . CERTIFY THAT GUIDELINES IN EFFECT ON THIS • �� ' MUNICIPALITY OF ANC!-iOFtAGE "" l� DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET? ANCHORAGE, AK 99501 2264-4720 O N— S I T E S E W E R P E R M I T PERMIT NO: 850009 DATE ISSUED: 01/08/85 APPLICANT: EVA LOKEN ADDRESS: ST RT BOX 9123 EAGLE RIVER, AK 99577 CONTACT PHONE: 694-9555 LEGAL DESCRIP: SUBDIVISION:SCHROEDER EAST LOT: 9 BLOCK: 7 SECTION: 1 TOWNSHIP: 14N RANGE: 2W LOT SIZE: 20000 (SG.FT. OR ACRES) MAX BEDROOMS: 17 Listed below are the options available to you in designing your septic system. Choose the option that best fits your site. I certify that: 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of -Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back: distances from any existing well, wastewater disposal system or public sewerage system on this or any'adjacent or nearby lot. 4. I understand that this permit is valid for a maximum of 3 bedrooms and any enlargement will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS=BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORE•'. MUST P DONE BY A LICENSED ELECTRICIAN. SIGNED. _ DATE: APPLICANT: EVA LOKEN 1Iu �y! % ,,I ISSUED BY /� _ _ _ DATE /8A _ tk lUK" TRENC E13 lnJ _ I}RA I N DEPTH TO PIPE BOTTOM (FT.) 4.0 4.0 4.0 GRAVEL DEPTH (FT.) 4.0 0.5 3.5 TOTAL DEPTH' (FT.) 8.0 4.5 7.5 GRAVEL WIDTH (FT.) 2.5 21.0 5.0 GRAVEL LENGTH (FT.) 69.0 40.0 60.0 GRAVEL VOLUME (CU.YDS.) 28.8 31.2 44.5 TANK. SIZE (GALS) 1,000.0 ** 1,000.0 ** 1,000.0 ** SOIL RATING (SO.FT./BR) 103 183 183 * TANK MUST HAVE AT LEAST - - - - - - - - - - - - - - TWO COMPARTMENTS - - - - - - - - - - - - - - - - - - - - - - - - - - I certify that: 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of -Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back: distances from any existing well, wastewater disposal system or public sewerage system on this or any'adjacent or nearby lot. 4. I understand that this permit is valid for a maximum of 3 bedrooms and any enlargement will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS=BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORE•'. MUST P DONE BY A LICENSED ELECTRICIAN. SIGNED. _ DATE: APPLICANT: EVA LOKEN 1Iu �y! % ,,I ISSUED BY /� _ _ _ DATE /8A _ tk lUK" P.O. EOI�GE, /-L•""-�"'s'� ANCHORAGE, ALASKA 99E02 -0E50 (907) 26:-4111 TCN Y N7;C 151E5 !.,.:Yin' DEPARTMENT OF HEALTH & HUMAN SERVICES January 10, 1986 TO: Permit Applicant Subject: Permit 0 850009 Lot 9 Block 7 Schroeder East Subdivision A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1985. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system the original as -built inspection report(three part form) must be sent to this office for review and approval,and for documentation. If there are any further questions, please call this office at 264-4720. Sincerely, Susan E. Oswalt Program Manager On-site Services SEO/ljw enc: Copy of Permit ..._ .• trjUN I C I PAl- I TY OF ANCHORAGE DEPARTMENT OF HEALTH SINDENVIRONMENTA99501TECTION g25 L STREET, ANCHORAGE264-4720 S Y TE SEWER PERM I T PERMIT NO: 840316 DATE ISSUED: OS/03/ rAPPLICANT: ADDRESS: CONTACT PHONE LEGAL DESCRIP: LOT SIZE: BEDROOMS: SR'OX 9123 EAGLE RIVER, AK 99577 ''694-9555 SUBDIVISION: SCHROEDER EAST SECTION: 1 20000 (50. FT. OR ACRES) 3 MAX BLE TO YOU LISTED BELOW ABET HE 015TIONSPTION THAT BEST TS YOUR SYSTEM. ____----- TRENCH 4. O DEPTH TO PIPE BOTTOM (FT-) �4 GRAVEL DEPTH (FT*) 5 TOTAL DEPTH CFT. ) ,GRAVEL WIDTH (FT.) GRAVEL LENGTH (FT.) GRAVEL VOLUME (CU. YDS. ) TANK SIZE SOIL RATINGGA(SO. FT. /BR) «* TANK MUST HAVE AT 0 7 ** LOT: RANGE: BLOCK.: 7 DESI NING YOUR SEPTIC ITE. �Ep W. [?RAI N 4.0 4.0 3.5 0.5 7.5 4.5 5.0 21. 0 60.0 40.0 44.4 3j..l. 1, 000. 0 ** 1, 000. 0 ** 183 183 5T TWO CoMPk TM I CERTIFY THAT: TS FOR ON-SITE SEWERS AND WELLS AS SET 1. I AM FAMILIAR WITH THE EQUIREM ion) AND THE STATE 10 H RLL MOR CODES AND REGULATIONS. FORTH BY THE MU7HEISYSTE>tl IN AC OOROANCECIITH LL MORERMIT. OF ALASKA. 2. 1 WILL INSTALL GN CRI TER ACK AND IN COMPLIANCE WITH THE C EXISTING WELL, WASTEWATER DISPOSAL LOT. SYSTEM OR PUBLINO 3. 1 WILL ADHERE TO RLE MOR AND STATE OF ALASKA REQUIREMENTS FOR THE SEA B DISTANCES FROM ANY THIS OR ANY ADJACENT OR NE SEWERAGE SYSTEM ONOR A VALID F 4. I UNDERSTAND THAT THISLL PERM'ET AN ADDITIONAL PERMIT - ANY ENLARGEMENT IF R LIFT STATION I5 INSTALLED IN AN AREA CODES, EA COVERED BY MOA B THEN C1> AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; �2) AS -GUILTS 11 WILL N07 BE APPROVED WITHOUT BY EECTRICALLICENSED ELECTRIC NNSPECTION REPORTs'RND <3) THE 'ELECTRICAL WORK. MUS DATE:*/______ ,SIGNED 'APPLICANT: EVA LOKEN L S DATE: --- )' ISSUED EY �� • f L\ PERFORMED LEGAL DESCR MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 625 L. Street, Anchorage, Alaska 89501 264-4720 SOILS LOG — PERCOLATION TEST __!;7v12/XfG r/- 9 /1'7 Nr' bloe rl c/ 9 10 Q, �ry 11 YO 11 t4► Q� c 12- 13 2 13 LC a i 14 15- t ` �e 2- Depth to , •, 3- 3 PF h 4 4 P, v` {0 18 ,s ..•t�akr 7 04J'••e• S/LTy !o a /3/` �r ESN^ ��, Nw es 20 it 40a .mitis /� `� /S 9 10 Q, �ry 11 YO 11 t4► Q� c 12- 13 2 13 LC a i 14 15- t ` �e v63 16 Depth to , •, PF h 17 P, !` v` {0 18 ,s ..•t�akr 19 04J'••e• Ho. 1477-E : - �'• .'p !o a /3/` �r ESN^ ��, Nw es 20 it 40a .mitis SLOPE WATER D7 IF YES, AT WHAT I _4 / DEPTH? _� ❑ SOILS LOG Gross Time v63 16 Depth to PERCOLATION TEST TE PERFORMED: /J _3— 53 ,I■ Reading Date Gross Time Net Time Depth to Net Drop /0 "(S-A (Water D r2 3 << /0 'Sy/) !o a /3/` �r ��/6 It it SA /� `� /S PERCOLATION RATE I -5'w (minutes/inch) /S -- TEST RUN BETWEEN FT AND FT 6 77G e4 E 'e A -X S<ftG t_ Lrh PERFORMED BY: o2£ V21AP rp —CERTIFIED »� SRB 13ox (� OLE,S)VER. ALASKA 09577 72-009 (6/79) PH. 694-297�J DATE/ 1 ; THE 9-1 CC xPORATION ROBERT C. JOHNSON REGISTERED LAND SURVEYOR P.O. BOX 456, EAGLE RIVER, AK. 99577 - �- - -- i - — ??• cue% L ' � � — MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 050-071-11 Certificate of On -Site Systems Approval Expiration Date: ( Z 2-o 2 Legal description SCHROEDER EAST BLK 7 LT 9 Site address 12623 SPRING BROOK DR Eagle River AK Current property owner(s) LAG UNAS X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 8/21/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist Absorption Field Advisory Tank Age Advisory Other X Well Flow Advisory Nitrate Advisory Arsenic Advisory COSA Approval_June 2022 MUNICIPALITY OF ANCHORAGE PU5H 0 Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 050-071-11 Complete legal description Schroeder East Block 7 Lot 9 Location (site address) / 262 jSpring Brook Dr. Eagle River, AK Current property owner(s) Isacc Lagunas Day phone 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: © Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel V Plastic ❑ Concrete ❑ Fiberglass Age 23 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench © Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ Waiver Fee $ Date of Payment-0///k/s, Date of Payment COSH # D�Gz31 ?�O Waiver # COSA Application—June 2022 Legal Description: Schroeder East Block 7 Lot 9 Parcel ID: 050-071-11 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA n Well log is filed with Onsite (or attached) Date drilled 6/28/83—Total depth 41 ft Cased to 40.5 ft 0 Sanitary seal is functioning correctly 0 Wires are properly protected Casing height (above ground) 27 in. Date of flow test for COSA 8/14/23 Static water level at beginning of test 2$ ft. Comments B. TANK DATA Measured operating fluid level in septic tank 47" Date of pumping 8/15/23 ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 11/1/2000 ✓❑ ALL standpipes present per record drawing Total measured depth from grade 5.25 ft (max) Measured depth to pipe invert from grade 3.2 ft (min) ❑ N/A — pressurized field. Q Per record drawings, field is insulated.* ❑✓ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Well production at time of test 2.7 gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ✓❑ Ne ] Coliform bacteria is Negative Nitrate 2.02 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Arcterra Consulting Date 8/1/23 FT STATION ❑ Require tenance completed Age of lift station Ls Lift station material Comments; Adequacy test date _ Results Q Pass Fluid depth prior to test 8/14/23 Water added 450 gal New fluid depth 2 in Elapsed time 30 min 0 in Final fluid depth 0 in Absorption rate 450+ god FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 24 in Effective depth used 0 in Effective depth remaining 24 in Comments/Deficiencies: *West half of field insulated per MOA documents. COSA Checklist June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Yes if No ft Field to Property Line > 10' Community Sewer Manhole/Cleanout > 100' MYes if No ft ✓0 Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' © Yes if No ft Absorption Field on Lot > 100' ❑✓ Yes if No ft Holding Tank > 100'✓❑ Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50'✓❑ Yes if No ft Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Q Yes if No ft Q Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' ,/❑ Yes if No ft Surface Water > 100' . Q Yes if No ft Tank to Property Line > 5'Q Yes if No ft Field to Property Line > 10' ❑✓ Yes if No ft Water Main > 10' © Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft F. ENGINEER'S COMMENTS Wells on Adjacent Lots: Private Wells > 100' Community Wells > 200' ✓❑ Yes if No ft ✓❑ Yes if No ft If tank or field is under driveway comment below G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Areterra Consulting Plione (907)-696-6111 Engineer's Printed Name Kenneth Duffus Date A/, ;L� 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 i G7 f'� �'t,, *�t and the water usage of the family being served by the system. The operational life of all well and septic � 4, ¢g IH systems are subject to these various and dynamic characteristics and are outside the control of the evaluatorM � 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. /` r-2 KENNETH D FUSi� CE COSA Checklist June 2022 yam.. Municipality ®f Anchorage 6 7 s 9 70 P�oz On -Site Water and Wastewater Program (907) 343-7904 nV ti �.. E T JUL 3 1 2019 n Certificate of On -Site Systems App al 6 �µ ti Parcel I.D.`050-071-11 Expiration te. 1. GENERAL INFORMATION: Complete legal description Schroeder East; Block 7 Lot 9 Location (site address) 12623 Spring Brook *Eagle River, AK 99577 Current Property owner(s) Ben Reyna Day phone 952-5933 Mailing address 12623 Spring Brook *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: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual: Well ,. ® Individual ;Individual Water Storage: ❑ Holding Tank Community'Class 1Nell _❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariande request'for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ J�J� Waiver Fee $ Date of Payment l' $ Date of Payment Receipt Number Receipt Number COSA # I15cl R 15,5E Waiver # 12 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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 1 Engineer's Printed Name: Jeffrey A. Garness Date: In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in 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 whatsoever. 6. DSD SIGNATURE 4\7 System #1 Approved for System #2 Approved for Disapproved Conditional approval for Sbedrooms bedrooms bedrooms, with the 4/11P T .......... ........ f�,c y A. Gorn ss, ��`d pro r essic°°�o #AECC884 �kk �OF�4 t m By __r vim., 1�C�� Original Certificate Date: 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10-12.doc i Legal Description: Schroeder East; Block 7, Lot 9 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 6/21/83 Total depth 41 ft Cased to 40.5 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 7/15/19 Static water level at beginning of test 13.1 ft Comments B. TANK DATA Age of tank(s) 19 years Tank type/material '°°"W'4'S` Measured operating fluid level in septic tank 39 ❑ Standpipes/foundation cleanout per record drawing Date of pumping A t'4 � _�, c' i 1 _ D. ABSORPTION, FIELD DATA Which system tested (date installed) 2000 ❑ ALL standpipes present per record drawing Total measured depth from grade 5.25 ft (max) Measured depth to pipe invert from grade 3.08 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective. E) Code -required soil.cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced n/a gallons Comments/Deficiencies: 'Assumed COSA Checklist yellow sheet Parcel ID: 050-071-11 Structure served by this system Well production at time of test 2.75+ qpm Water storage tank volume n/a gallons Well disinfected for coliform test? ❑ Yes ❑ Nc ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by GEG, Ltd. Date of Sample 7/15/19 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Adequacy test date 7/15/19 Results QPass For 3 bedrooms Fluid depth prior to test 9 in Water added 495 gal New depth 17 in Elapsed time 135 min Final fluid depth 13 in Absorption rate 450+ gpd Any rejuvenation treatment (past 12 months) no If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 0 Yes if No Community Sewer Manhole/Cleanout > 100' ❑v Yes if No ft 0 Yes if No Neighboring Tank > 100' ❑r Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No Absorption Field on Lot > 100' ❑r Yes if No ft Holding Tank > 100' Q Yes if No Neighboring Absorption Fields > 100' Surface Water > 100' 0 Yes Animal Containment > 50' Q Yes if No ❑r Yes if No ft *Met code at time of installation Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0 Yes if No ft 0 Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No *5+ ft Surface Water > 100' ft ft ft ft ft Q Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑r Yes if No ft Private Wells > 100' ❑✓ Yes if No Water Main > 10' 0 Yes if No ft Community Wells > 200' ❑✓ Yes if No Water Service Line > 10' El Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ❑ Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' Yes if No Water Service Line > 10' E1 Yes if No ft Community Wells > 200' Q Yes if No Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *Met code at time of installation G. ENGINEER'S CERTIFICATION o OF q 4 I certify that 1 have determined through field inspections and review �O`� ' s�40� of Municipal records that the above systems are in conformance with op Com: g H �* MOA COSA guidelines in effect on this date. . • . _ :... _ .. .. ....... ....... .... .. . ...... ...... f A. Gor ss; VO ! E 04 9 � JJI T -1 � G • •`c�G Op , COSA Checklist yellow sheet 4Qea pro f e s s1 f\0 #AECC884 ft ft ft ft DEVELOPMENT SERVICES DEPARTMENT (� On -Site water and Wastewater Section www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC191355 Subdivision: Schroeder East , Block: 7, Lot:9 .�an=�.. t s a A water sample revealed a nitrate concentration of 5.38 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/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. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. 6gso:.s�^:z�«,�a� ^ifi `� A -'k'"95 wi Municipality of Anchorage • • On-Site Water and Wastewater Program I_ (907) 343-7904 _ CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-071-11 Expiration Date: q - 1`Z -17 1. GENERAL INFORMATION Complete legal description Schroeder East Block 7 Lot 9 Location (site address) 12623 Spring Brook Drive, Eagle River,AK Current Property owner(s) Porter Day phone 244-1930 Mailing address same Real Estate Agent Cindy Wilson Day phone ,4:_1930 ,.c-3 `I 2. TYPE OF DWELLING: `: \ Z Single Family (w/wo ADU) ' �� J`.;Y L v, I_ ❑ Duplex `,, t f ❑ Multiple Dwellings (Single Family and/or Duplex) ,„ 4 �a a L /� 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage El Holding Tank ❑ Community Class C Well El Community ❑ Public Water System El Public Sewer ❑ Received by: .,, Date: b�+�� / 2 COSA to be released to the engineer, unless of ise requested by the engineer. COSA Fee $ 524 Date: Date of Payment 4/Fr/fl Date of Payment Receipt Number O15b20 Receipt Number COSA# 135GI9l2Z1 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 NorthRim Engineering Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 6/15/N17 tV )r. 6. DSD SIGNATURE - System #1 Approved for 3 bedrooms. ��;- : System #2 Approved for bedrooms. O `e: s'�FE �v. ung 256, op Disapproved. �o p°DD� • •-•- s-C. ' Conditional approval for bedrooms, with the following stipulatiibes:-'` ON-SITE= 'Y • WATER AND fr` c WASTEWATER PROGRAM - ,0,› By: tit. . rr .40/ Original Certificate Date: q ( 7 The Municipality of Anchorage Devlopment 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 Agplogpit .. Septic System Advisory Arse Well Flow Advisory Other *it COSA blue sheet_9-1-12 doc I of)6 Peg/ 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: ' CJt jEO,tf/ 5(J% 7 49 Parcel ID: 10-5-6 0 7/ /( A. WELL DATA Well type P If A, B, or C provide PWSID# Well Log (YIN) X Date completed 6-(z3/83' Sanitary seal (Y/N) �! Wires properly protected (YIN) 7' Total depth �I ft. Cased to r{Q 5 ft. r Casing height (above ground) a ci in. FROM WELL LOG AT INSPECTION Date of test -/e.e83 64417 Static water level 3 ft. 7 ft. Well production —5-0 g.p.m. e-f g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 6-. 3trng/L Arsenic /V 1.. ug/L Date of sample:/c0" 7 Collected by: "NO,"Or' / h 4? 5 J B. SEPTIC/HOLDING TANK DATA / Tank Type/Material SEPT/G/ P cs[1 C- Date installed f r/i/ o7Q4G Tank size /3 66 gal. Number of Compartments 2 Ai/ Cleanouts (Y/N) y Foundation cleanout (Y/N)\ Depression over tank (Y/N) /V High water alarm (Y/N) iV Date of pumping 61/6 ( 7 Pumper I - G'f2-1Nr PuP/a-o i/I c.R4-1.w. S/4e0-- C. ABSORPTION FIELD DATA ,� 1-{�L.KacJ Date installed /1///076 CO Soil rating (g p.d./ft2 or ft2/bdrm) r,a System type 'T-R, ;..-cif Length 55 ft. Width S ft. Gravel below pipe Z ft. Total depth 51-75-ft/ Eff. absorption area 3? ft2 Monitoring tube 1 /41 Depression over field Date of adequacy test ‘/(2/ 1 7 Results (Pass/Fail) P For 3 bedrooms Fluid depth in absorption field before test l6 in. Water added 4,4_5-(1. gal. New depth LS in. Elapsed Time: 36 min. Final fluid depth /6 in. Absorption rate >_ V-SO g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) C//1//< If yes, give date D. LIFT STATION "VA 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 /44 1 On adjacent lots /QQ Absorption field on lot /i Q On adjacent lots (aG �- Public sewer main /QG Public sewer manhole/cleanout /46 4- Sewer/septic service line .25- 14" Holding tank /4a Animal containment areas 5D Manure/animal excrete storage areas /Co fi SEPTIC/HOLDING TANK ON LOT TO: Building foundation !GI 7 Property line 5 1 Absorption field S Water main / G � Water service line /G f Surface water /GG Wells on adjacent lots /66 'fi ABSORPTION FIELD ON LOT TO: Property line /O ; Building foundation /d Water main /Q /1` c- r Water Service line /6 ''t Surface water /GQ ''{" Driveway, parking/vehicle storage J Curtain drain U/Vt& Wells on adjacent lots /Q() �f F. COMMENTS G. ENGINEER'S CERTIFICATION �Z.; I certify that I have determined through field inspections and F • review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Date ‘/lS// • 7 _ • COSA yellow sheet_2-6-15.doc Municipality of Anchorage E_ , , i''° Development Services Department Building Safety Division 4 - On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On-Site Systems Approval # osc171242 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 7, Lot 9 of Schroder East subdivision. This inspection revealed a nitrate concentration of 6.34 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/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. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. Parcel I.D. 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 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 050-071-11 1. GENERAL INFORMATION HAA # 0904W Expiration Date: Complete legal description int q- Rlnrk 7- SehrnAdnr Snhrifuininn Racer Location (site address or directions) 17694 S rfy innhrnnk nC Rag1P uiypr Current Property owner(s) Lilly Lopez Day phone 696-0106 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address same Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well [X�C Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone 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 State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water 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 Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm _ S & S Engineering Phone 694-2979 Address 17034 N. Eagle River Loop Ste. 204 Eagle River, AK 99577 Engineer's Printed Name _ Rohan C. Cowan Date 6/-7 IG r `I 9 ROBERT C. COWAN 5. DSD SIGNATURE 40, CE -8801 ,+t Approved forq _ bedrooms. ttt,rvp,`f�; Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other By: W. Poz;t Original Certificate Date: G- 9-05, -Q., (Rw. 01N7) Municipality of Anchorage • �` Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST' Legal Description: k,- 9; f WQ-- 7 , Se-(+190EJ15-C- A. WELL DATA Well type�td If A. B, or C provide PWSID # Date completed J�L>:S3 Sanitary seal(ON)11105 r r Total depth �_ft. Cased to I 5 ft. FROM WELL LOG Date of test 1 Q$ 3 r Static water level Well production SD 9 -p.m WATER SAMPLE RESULTS: Coliform colonies/100 ml. Nitrate-?, q_ mg./l. Arsenic: mg./I. Date of sample: ��rCI5 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEQTtt /aet2 1If e Tcn-T/C Tank size (' gal. Number of Compartments ID: 060-071- II Weil Log6 N) yES Wires properly protected (4m Yt~s ' ry it Casing height (above ground) l LJ + in. AT INSPECTION �r ft. ISM g.p.m. Other bacteria '4 colonies/100 ml. Collected by: `j4- S r4`K/'2I%e-10-1, Date installed_ II 1 CleanoutseYN) N �s Foundation cleanoukf?)N) � '9 'Depression over tank ()(A LLO High water alarm (Y4V Date of pumping '711,5104 Pumper 72's f omp-lno6, C. ABSORPTION FIELD DATA Date installed II t �00 Length SS t ft. Soil rati (g.p.d .d/ft felt>drm) I_2 Width SI f'1 System type Sknicc�� P�Ea�C1a Gravel below pipe Total depth S7511. Eff. absorption area f�?ft2 Monitoring tube YES Depression over field kxll� Date of adequacy lest 5 LwkS Result as ail) For For 3 bedrooms i Fluid depth in absorption field before test Y in. Water addedJ= gal. New depth /� in. Elapsed Time: � min. Final fluid depth -Mi in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Ye& type) NO If yes, give date D. LIFT STATION Date installed "Pump on' level at _ in. E. SEPARATION DISTANCES Size in gallons n ole/Access (Y/N) 'P evel at _ in. High water alarm level at Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot I Ct714- Absorption field on lot IOf!4 Public sewer main IJ►i Sewer /septic service line 25 Meets alarm & circuit requirements? On adjacent lots l00+ On adjacent lots j CC) 14 - Public sewer manhole%leanout �1 q Holding tank N h SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 1 t r Building foundation 5 - Property line S t' Absorption field 5 f Water main 9A Water service line I D 1 F Surface water I m 14 - Wells on adjacent lots 100 1 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line le) r 4- Building foundation 10 ��- Water main 13ft; Water Service line 1014- Surface water /UO f.} Driveway, parkingrvehicle storage I O 4 Curtain drain ntc&R - Ic Wells on adjacent lots F. COMMENTS Fco lk.,,srbe G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this dale. Engineer's Printed Name RBes e;- C. Con✓.4^j Date fp J"r /0.f HAA Fee $ hf'3 0 •o Date of Payment G / -7/o S Receipt Number M110 (Rev. 72/01) Waiver Fee $ Date of Payment Receipt Number OF ROPERT C. COWAN CE • 8801 .•r4~i in. s�rrtt_TwaK, 6-27-06; 4:62PM; ;007 6616301 w 2/ 6 SCS Rets/ 1052945001 Cgent Name S & S Engineering Project Namem Lot 9: 117: Schroeder Eut Add Client Sample ID Lot 9; B7; Schroeder East Add Matrix Drinking Water Sample Remarks All Dstes/rlma are Alaska Standard Time Printed Date/That 05/27!2005 15:01 Collected DateMme 05/20/2005 14:20 Received Daterrime 05/20/2005 15:28 Technical Director Stephen Q Ede Pusmear Results Allowable prep Awl7ais !QL Unita Method ContainerID Limits Date Date snit metals by ICP/IL4 Lead 7.28 0.200 ug/L EP200.9 C (C-15) 05!23)05 0525105 TK Nates Departruaint Nitmto-N 2.40 0.100 mg/L EPA 300.0 B (<-10) 0520/05 JIB Nitrit" 0.100 U 0.100 mg/L EPA 300.0 B (<.1) 0520105 IIB Wicrobiology Laboratory Total Coliform 7 OB, No Coll coV100mL SM20 9222D A (o-1) 0520/05 TLF Municipality of Anchorage Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 South Bragaw St P.O. Box 196650 Anchorage. AK 99519-6650 www.cl.anchorage.ek.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-071-11 HAA# NAol oo,48 1. GENERAL INFORMATION Expiration Date: 5'—,2 t? — Complete legal description SCHROEDER SUBDIVISION EAST: LOT 9 BLOCK 7 !2623 Location (site address or directions) SPRING BROOK DRIVE • EAGLE RIVER AK Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address JOHN THOMSON Day phone 240-2020 17343 SANTA MARIA DRIVE • EAGLE RIVER AK 99577 Day phone EVA LOKEN W/ PRUDENTIAL VISTA Day phone 689-6464 16635 CENTERFIELD DRIVE " EAGLE RIVER AK 99577 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well El Individual On-site Individual Water Storage ❑ Individual Holding tank O Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Note: Alaska Water and Wastewater Consultants, Inc. shall bo paid $1,000.00 at, or prior 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 below, I verffy that my Investigation, based on procedures outlined In the Health AuthorftyApproval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system ls(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 ofAnchorage files and from my investigation and Inspection, the on-site water supply and/or wastewater disposal system ls(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER do WASTEWATER CONSULTANTS, INC. Phone 337-6179 Address 6901 DEBARR ROAD, SUITE 213 • ANCHORAGE, AK 99504 Engineers Printed Name JEFFREY A. GARNESS, P.E. Date 2-;&/0 I Engineers Comments: In conducting this evaluation, AMW, Inc. attempted to protide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines & Regula lions. 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 fee lures. The operational #to of all wells and septic systems depend on the kcal soils condition, groundwe ter levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do May guarantee that there are no hidden defects or encroachments. AWWC, 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 kr the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE X Approved for 3 bedrooms. Disapproved. kPYIOFr irl_ Conditional approval for bedrooms, with the filowing stipulations: ���`V\Q• • • • •, C.y� Jam': • ON -SI ATER AND • IA/AnV1..,.___ •, f-KuUHAM ,. Attachments: HAA Checklist _� Manitenance Agreements Septic System Advisory Supplemental Engineers Reort Well Flow Advisory Other By: Original Certificate Date -.2-22-0/ (R". hoof Municipality of Anchorage • Development Services Department Building Safegr Division OeSlte Water& WaatewaterProgrem 47W South Bragaw St P.O. Banc 198850 Anchorage, AK 995168850 www.d anchorsge.alc n (907)593-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: SCHROEDER SUBDIVISION EAST: LOT 9. BLOCK 7, Parcel ID: 050-071-11 A. WELL DATA Well type PRIVATE It A. 8, or C provide PWSID# N/A Data completed §Z28/83 Sanitary seal (Y/N`L Total depth 41 fL Cased tD 40.5 R FROM WELL LUG Date of test 6/28/1983 Static water level 3 R Well production 50 — a -p.m -WATER SAMPLE RESULTS: Wen Log (YRS YES Wires property Protected (YM) YES Casing height (above ground) 18+ In. AT INSPECTION 8/8/2000 5'-2" R 12.35+/— g,p,m, CW= 0 colonies/100 mi. Nitrate I I mgA. Other bacterla_6 colonies/100 ml. Date of sample: 1'20-01 Collected by: A. W6 W, LOLK- AWWC. INC. �ToDY� S. SEPTIC/HOLDING-TANK DATA 'THERE 6 A GRINDER PUMP INSIDE THE CRAWLSPACE IN ORDER TO PUMP EFFLUENT TO THE SEPTIC TANK. FCO INSIDE CRAWLSPACE. Tank Type/Materlel PREMIER PLASTIC Date kidded 11/1/2000 Tank size 1300 gal. Number of Compartments 2 Cleanouta (YM) YES Foundation deanout (Y/N)*YES Depression over tank (YM) NO High water alann (YIN) N/A Date of pumping NEW Pumper - C. ABSORPTION FIELD DATA Date installed 1111/2000 Son rating (%[jT] o jYftrm) 1_2 System type SHALLOW TRENCH Length 55 R Width 5 ft Gravel below pipe 2 ft. Total depth 05.e-113% Ef. . absorption area 392 fe Montboring tube YES Depression over fleld NO Date of adequacy test NEW Results (3ass/Fa9) — For 3 bedrooms Fluid depth In absorption field before test= In. Water added =gal. New depth =in. Elapsed Time: = min. Final fluid depth= In. Absorption rate >_ — 9-P.d. Arry mjuvenation treatment (past 12 mo.) (Y/N & type) N/A K yes, give date - D. LIFT STATION Data h-Malled Stm in gaaons 'Pump on' level at_in. E. SEPARATION DISTANCES High water alarm level at in. Cycles tested Meets alar & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankfift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/deanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property ane5+ Absorption field 5'+ Water main 10'+ water service ane 10'+ Surrace water 100'+ Wefts on adjacent kite 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service One 10'+ Surface water 100'+ Driveway. paddnghrehide storage 10'+ Curtain drain NONE KNOWN Wefts on adjacent lots 100'+ F. COMMENTS I certify that I have detemrined through tied inspections and e tlO 1 review of Munidpal records that the above systems aril In conformance wllb MOA NAA guldeAnes in effect on this date. ................... of ey A. se; Englneer's Printed Na% a JEFFREY A. GARNESS CE -7953 Date _�j 0I r•^odProf viood4- HAA Fee S $ J • a) Walver Fee $ Date of Payment �T Date of Payment Recelpt Number �QGoReceipt Number IFW. lam ALASKA WATER & WASTEWATER -- •----- --- - -- CONSULTANTS, INC. — -n-� LEGAL D .SCRIPTION: !94142n no �r 5�� 1 7 `l, 19LoCk7 STRF-F.T ADDRESS, 1'1343 Sc.atq IMAo-A 02, V F CLIENT: -3694 'rI40fASv4 PHONE NUMBER: 24 o –7,62a NUMBER OF BEDROOM: 3 GALLONS PER DAY NEEDED: '450 WELL *SEE H.A.A. SITE VISIT CHECKLIST* DATI? OF TEST: 1. Casing Height Above Ground): 17 l + 2. Sanitary Seal: NO (if "NO", describe in Comments) 3. Wires in Conduit:/ 0 (if "NO", describe in Comments 4. Water Samples Needed: / NQ_ "YES", date taken: GA oo ) 5. Depression around Well: YES / (if "YES" describe in Comments) 6. Does Well need Four Hour Flow Test (FHA): i § / NO 6– 19-7-000 TIME METER READING NUMBER OF GALLONS FLOWRATE C..I'.111. STATIC WATER LEM. DRAR'DONN 5 2 �- 1 F I 0195 13 13.0 S 1j S 11 8ZS`L 0 14.6 C 1 1 10 mjourt S 37-Z I q.0 S 7 11 150%„4„re3 11 S 3113 '11/711 ILI. 1 9 1' 20 ^0 -)-res wl I. --I ISO m a -rc o ZI94 /-24-M13. 5 5 o m or -s 121 4%-72T 6 3 12.35 'fe 'TJlcr•100 cF' S rA10JreJ 5 11 Fy, verojuve WELL PRODUCTION: GPAI ( �2q( 3 GALLONS IN Zya MINUTES) Signature: Date: `MEM8 6901 Mbar Road. Suite 2-1310 Anchon8e. Alaska 99504 - Ph: (907) 337-6179 • rax: (tn4) 338.3246 0 aw s@aluka.net alaska.net P.2 ASBUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE � FOLLOWING DESCRIBED PROPERTY= r�y.Ft��.P.r�B.rq to>9 6a %�7 AND THAT NO ENCROACHMENTS' EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OF At DATE r�Q•; ,qS��+ GRID: � iyw�S� Du.n. Mark y.ward �, FB: 70 1� �, •., tS-b918 ; • �:� ��. pfrK..•.••.r�9��r