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HomeMy WebLinkAboutJEM LT 2Jem Lot 2 #015-242-65 Municipality of Anchorage :• ': Development Services Department Building Safety Division On-S4e Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 Page I of 'L www ci.anchorage ak.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: _54 O 7 O 2_3J PID Number: _O_ IS' — 2Yt ^ 6.S— Eve mem o(F}-A Wastewater System: ❑ New ® Upgrade biers 121 Y/ 6:6 teAa Ce;Xle ABSORPTION FIELD Pnpne Nu of B.darm 3-YS--G'YS-I 3 13 Daae Tr.no 0 r T,« 0 Bee 0 Mdne LEGAL DESCRIPTION SW RaI'.g TWOo.pnn ,.p, yi paee GPD � FI Baw Ld S"Il Vm Depen W Pae W= ham wgp pad. eapn Wham p0, FI Tp«:snp Rang* Sedan Fr a00eG dove dgnY papa Gravel laryin FI Ft Well: EN cr ❑ New ❑ Upgrade a, ""0° Nump«aine, Dnlanpe W .In„ FI DNSML:aLOrl lPmaO A B Cl TWO Depen C.wpw TdMa Ulan«H Pa. M.urui Fi. FI FI' D -707Y DfW« Dale Dnllp Slala Wal«Lav« YYlanar DSI. mval." FI A --t• 9/1Y!07 .» P,^, S.1 al caNnQ iNpnl APOre Grp GPM FI. FI TANK SEPARATION DISTANCES N Septic ❑ Hording ❑ S.T.E P. ❑ Other: To Septic Absorption Litt Holding lubl.crPrivate dove, From Tank Field Station Tank Sewer Line A'% hb1.efe -r•Qh IV (O&OG« Wan 1 t � ICBG �' � •f /� 7 `i Mam"al C L NumPer d COnaanmMla srK.w.l« fOo� > Iiva LIFT STATION N.A, LN 4M 6 w 12. ^ •• ,a G,w FpuneYan S--9 .••�V �1 � 'Pump on' i.r« M 'Pump oK ler« n N�p� wal« a•«m al ti -Y n n n C f.«n Dren _ \ Pump Mare 6 Mdlai Eie o:ai MapKbMs pMd W R. .a.,° Dri .naJ CitJ 29'1 r6 ,•1 BENCH MARK Lp 1,. «,a asUlpppn a,7 dez 01 ¢1• Cim ci4e c Fronf ae&P r 1111 tY(4/tu.. Shtaru FINmN .a•al..]rl on d- •OFt •- "` •, , fEngineer's ' Inspections performed by: F(ed-Aeg T�c4 rvc- Dates: 1" i114"/tF7IT Stamp '% •::; 2nd @.p.:aea�t OF A4 It Development Services Department Approval P :1'w b •:4Jill, C,1 4 �� � r Conditional Approval Date: r * , •u.. H..NN NNaei ea. y...........J. ,d t1 . THEODORE F. RLOOR: k �jt:>'. CE 35E9 C1 f Reviewed and approved by: Date: 11 IS t'.^ PERMIT NO: SW070234 PID NO: 015-242-65 TEST ; HOLE ' i DBL. -E" C.O. 11 c� 0 TBM LOT 2, JEM SID N R = 100' WELL—)p ELL— DBL. C.O. ------------ SWING TIES FROM: COR. "A" COR. "B" EXISTING LOG CRIB SEEPAG PIT TO: DBL. C.O. "C" 51' 47' .W 1000 -GALLON SEPTIC TANK S.T. C.O. "D" 85' 81' S.T. C.O. "E" 91' 88' DBL. C.O. "F" 93' 90' PIT C.O. "G" 81' 74' PAGE 2OF2 PLAN VIEW SCALE: 1" = 30' 12'+ SOIL COVERT /--2- RIGID INS. INV._ NEW 1000 -GALLON I \_INV. ab. 93.4 SEPTIC TANK 93.6• f : THEODORE F. MOORE �� 1 CF -3509 A'A ati.;:�:; PROFILE VIEW SCALE: 1" = 5' MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW070234 Legal Description: JEM LT 2 Design Engineer: 0019 FLATTOP TECHNICAL SERVICES Owner Name: EVE MEREDITH Owner Address: 12141 GALENA CIRCLE ANCHORAGE. AK 99516-2542 Date Issued: Sep 07, 2007 Expiration Date: Sep 06, 2008 Parcel ID: 015-242-65 Site Address: 012141 GALENA CIR Lot Size: 60164 SO. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. 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. Date: - 9 l /o /07 Municipality of Anchorage 1.1 `\ '" •.t` / CO. IARC 19668) - Anchomgl', Alaska J!)11ID'GIAMI • Telephone (!M)7) 3i& V I •1'm (!X)7) 34,34 X) ii 47M nmgmr Si mcl • Anchomgc, Alaska 99707 """111ml.org Mayor Mark Begicll Iluilcling S:►fcl}• Division September 7, 2007 Ted Moore, P.E. Flattop Technical Services 14530 Echo Street Anchorage, AK 99577 Subject: Waiver Request for Jem Lot 2 Waiver Request WR#: 070045 Parcel ID # 015-242-65 SW070234 Dear Ted Moore, P.E.: Your request for a waiver of the required 5 feet horizontal separation from the septic tank to the property line has been approved. The approved separation distance is I foot. This waiver approval applies to the existing septic tank to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, ��% Ke0_�ll Deb Wockenfuss Civil Engineer On -Site Water & Wastewater Program CommunRy, Security, Prosperity rtr 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.ci.anchoragc.ak.us (907)343-7904 Waiver Review Worksheet WR#:070045 PID#:015-242-65 HA/Permit# SW070234 Date Received: September 7, 2007 Legal Description: Jem Lot 2 Engineer. Ted Moore, P.E. Flattop Technical Services 14530 Echo Street Anchorage, AK 99577 Applicant: Eve Meredith Waiver Requested: 1' lot line waiver for tank. Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Points: ................................................................ desse.... Waiver Is Granted: X List Conditions or Reasons for above: Waiver is not Granted. Dale: 917107 By: Deb Wockenfuss Name of Reviewer .......................................................................... Rec#: 99540 Amount: $175 Date Paid: 9/712007 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 ON-SITE SEPTICMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Ors - 2-Y2-- GS' - t Property owner(s) Day phone 3 'Y4-- o*7S Mailing address I't rYf G•Ie^Q ""Cfk Zip Code 9%5107 Site address I Code Legal description (Sub'd, Block & Lot) Lot 2 Te' S iA Legal description (Township. Section & Range) Lot Size (00, 'I'lDA Sq. Ft. THIS APPLICATION IS FOR (®all that apply): Absorption Field ❑ Septic Tank to Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms THIS APPLICATION IS AN: Initial Upgrade Renewal ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: G `= Waiver Fees: _ Date of Payment: ! Date of Payment: Receipt Number: 79374) Receipt Number (Rev. 11105) I -,r,. �a,",:�_ ::-FLATTOP TECHNICAL SERVICES . CML b ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS TED MOORE, P.E. 14530 ECHO CANYON ROAD PHJFAX: (907)345-1355 ANCHORAGE, AK 99516 E -Mail: tgmoore@gcl.net September 1, 2007 M.O.A. DSD P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: The purpose of this letter is to provide the required design narrative in support of our application for a permit to install a septic tank on Lot 2 of Jem SID, located at 12141 Galena Circle. The attached site plan and specifications provide the necessary septic tank design documents. We are also requesting issuance of a lot line waiver allowing the new septic tank to be installed as close as 1 foot from the property line common with Lot 3. The need for the lot line waiver is to allow the tank to be installed the required 5 feet away from the existing log crib, into which it will discharge effluent. The reason for wanting to install the new tank in the location shown on the south side of the log crib seepage pit is to allow room for a replacement soil absorption system to be constructed when needed in the vicinity of the test hole. Granting the requested waiver will not have any significant effect on the ability to develop future replacement wastewater systems on Lot 3, because they also could be as close as 5 feet from this septic tank. Issuance of this permit is intended to bring the presently undocumented wastewater system on this lot into compliance with Municipal requirements. The owner of the residence has lived therefor approximately 40 years and now needs to sell in order to move into an easier living situation. After the tank is installed we will need to obtain a COSA certificate, so I am herewith providing documentation for your review and approval pertaining to the construction, condition and adequacy of the existing log crib seepage pit. The existing wastewater disposal system was apparently constructed around the time the house was built in 1968 and was thought to consist of a septic tank that discharges effluent into a log crib seepage pit. To document the construction of the system components we arranged for a backhoe to excavate down to expose the tops of both system components on August 14, 2007. In doing so we discovered that what had been thought to be a septic tank was in fact a log crib cess pool, which has never been approved for use in the Borough or Municipality. This discovery is what led to the need to install the requested new septic tank. When we dug down to expose the second system component of the wastewater system we encountered the top of a log crib seepage pit at a depth of 6 feet below ground level. The log top has horizontal dimensions of approximately 7 feet by 7 feet and appeared to be in sound condition. By measuring down through the crib standpipe I determined that the bottom of this seepage pit is at 10 feet below ground level. To verify the vertical separation from groundwater we dug a 15.5 foot deep test hole at a location approximately 25 feet north of the seepage pit standpipe where the ground surface elevation is approximately 3 feet lower than at the seepage pit. Please refer to the attached soils log and percolation test results. No groundwater was encountered at the time of the test or during the following 10 days of monitoring. As I discussed with Jeff Poet at the time, this test hole indicates that there is no groundwater for greater than 6 feet below the bottom of the seepage pit at this time. Because I was still not confident of the adequacy of the present seepage pit I conducted a percolation test in the sand stratum that extends between 4 and 10.5 feet below ground level at the test hole and determined that the percolation rate is less than 1 minute per inch in this sand. Finally, since the well is a low producer I arranged for a water truck to bring 1000 gallons of water on 8/24/07 to test the absorption capability of the seepage pit. The initial fluid depth in the seepage pit was 17.5 inches, and the addition of 1000 gallons of water caused the fluid depth to increase to a maximum of 44.75 inches. After letting the water absorb for 105 minutes 1 measured the new fluid depth of 39.5 inches, which indicates that the seepage pit is still functioning adequately for a 3 -bedroom residence. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ted Moore, P.E. wrs *' 49 ...................... THEODORE F. MOORE s i ., CEq- 3589 t6 j 1► f%ofesslo��� LOT 2, JEM S/D SEPTIC SYSTEM UPGRADE SITE PLAN FLATTOP TECHNICAL SERVICES 1 INCH = 50 FEET 14530 ECHO CANYON ROAD DRAWN BY TFM ANCI IORAGE, ALASKA 99516 ' AUGUST, 2007 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE. FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ---- - - ANCHORAGE, ALASKA 99516 TEST HOLE # 1SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: _ Lot 2, Jem S/D.-....... .. DATE PERFORMED: . _ ,._.August 14, 2007_. _. - PERFORMED FOR: _-, Eve Meredith _ DEPTH PL (feet) 1 SM Reddish sandy loam 2- MUSM Gray sandy silt 30 Dry, sidewalls smear 4 5- 6 7- SP/SM Slightly silty sand Coarser and cleaner with depth 8 SLOPE I T 0% SITE PLAN _ TEST I HOLE 77 N HOUSE 82 11 LOG WELL CRIB , 9 .. . .. 10 Depth to Groundwater Date tt -No Groundwater. _-._._8/14/07 `Monitor tube dry -- 15% . _, _8/24/07 SLOPE 12 ML Gray somewhat sandy --- - -- _7 13 - gravelly silt -_ ... damp _. _ ...... ..... . ..... -. - . 14 - Clock Net Time Percometer ! Net Drop ' Date Reading Time (minutes) Reading (inches) 75 _ --- - •27 - 8/14 - -12•' Presoak — _ _ - _ .: - 5/8 . -_._ 273/4 - - B.H. 12"_resoak.. -- -. .... _.. Start _ 5:05:4823 _..._.. 318 i ! 16 " - --- #1- �- 5:07.48 2 193/4 _35/8 -- Add water _. , _ ; 23 318 I _ if2 _5:08:11 2 .....197/8. ._3112.. .. 17 ------- ;Add water.__.__....._.5:10:38.._. ---5:10:11 _ 23318 i #35:12:38. 2 _20 --__ 33/8 .. 18 - ... Add water..._ ..__.. .'.-- 5:13:05 _ ...233/8 -' :. 5:15:05 2 :. 20 _ - _ i .. 3 318 20 " PERCOLATION RATE _ <1 - _,. (minuteslnch) PERC HOLE DIAMETER _6"_. TEST RUN BETWEEN 6.0 -. FT AND . 6.5 FT COMMENTS: Test hole location is approximately 3 feet lower than ground elevation at seepage pit PERFORMED BY FLATTOP TECHNICAL SERVICES. I _ /! wt� _, _ _. CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: TYattop 7echnicaCServices 14530 Echo Canyon 4jpad,,9nchomge,,9X 99516 Thone (907)345-13SS Lot 2 Jem S/D 12141 Galena Circle Septic Tank Installation Specifications 1.0 General: 1.1 The scope of the project consists of abandoning an existing log crib cesspool and installing a new 1000 -gallon septic tank that discharges effluent into an existing log crib seepage pit. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform to Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. The new tank shall be located no closer than 1 foot from the property line. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 Unless agreed otherwise, the contractor shall be responsible for any tree clearing and grubbing necessary to complete the project. The contractor shall come to an agreement with the owner regarding disposal of all trees cleared in conjunction with the project. 1.5 The contractor shall provide adequate cover material and rough grading over all system components to ensure that proper drainage is achieved after settlement and that there are no residual depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas. 1.6 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction. 2.0 Septic Tank: 2.1 The existing log crib cess pool must be properly abandoned by thoroughly pumping, removing the top and backfilling with soil. 2.2 The new 1000 -gallon, 2 compartment septic tank shall be Municipally approved and shall be set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial type, rigid insulation. 2.3 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4"' per foot, and the waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. If an existing foundation cleanout cannot be located a double cleanout shall be installed in the line upstream of the tank as well as a second double cleanout within 5 feet downstream of the septic tank. 3.0 Inspections: 3.1 A total of 3 engineering inspections will be required during the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the tank is installed and level but before backfill, and (5) after rough backfill and grading is complete. 3.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. 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.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D. o l 57 - Z Y Z - 6S- COSA # Oq 020-7 Expiration Date:Q n q_ 1. GENERAL INFORMATION Complete legal description Lor 2 Teti, S /b Location (site address) 12l Y l GO I en a Lse-el Current Property owner(s) 9w,* PtA ted%/ ji Day phone 3'!.!' -e 7S7 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 17-1&11 Galena eirrIe,, Anek, Ilk 9922d' Day phone 7trt�sa L3[l1 1ttllt� W+Ilrai.t Day phone ZYd Unless otherwise requested, COSA will be held by DSD /or pickup. PI eale, &-411 re ertec 07& 11 -Zy0-2LVR when COCA rl 2. NUMBER OF BEDROOMS: pa.ry %r 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 wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm F'fetl-A g TectinieG/ Phone 3 yS- r3s's^ Address ty.C?V Ecko eanyoe, Rd , fMcl, 99S 1d" Engineer's Printed Name '%1v go do.r f=. r-tuo rrn Date _7-u h G Zoog X• l i Yv �� • • . lN j'� L"&'; i f.fl:...........:....� 5. DSD SIGNATURE ip V ;T(�000ta P. nsooae ; _� Approved for _� bedrooms. �sti'��._'•.n?/�ioyf't,;•;;f' Disapproved. ...e Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other O BY: 1 e Original Certificate Date: %— 1 0 — 4F- (Re, H105) Municipality of Anchorage Development Services Department ; Building Safety Division " On -Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: 1_o f 2 fton SI -6 ParcelID: 01&--2Y2-40T A. WELL DATA Weli type If A, B, or C provide PWSID # = Well Log (Y/N) Al Date completed 6 Sanitary seal (Y/N) *r Wires properly protected (Y/N) Y Total depth KO t. Cased to sO ft. Casing height (above ground) _min. FROM WELL LOG AT INSPECTION Date of lest 6:1 2-1/ / o -7 Static water level ft. 27 ft. Well production g.p.m. D. `/ Pi g.p.m. WATER SAMPLE RESULTS: Coliform O colonies/100 mL Nitrate 340 E mg/L Other bacteria _0 colonies/100 mL Arsenic: <5 ug/L date of sample: 6 /IS/ 200 9 Collected by: F ler 1±3e Tech C L c B. SEPTICIHOLDING TANK DATA Tank Type/Material Sep 1i*c / S/-« / Date installed 9 / 1 y /07 Tank size 10V61 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Depression over tank (YIN) N High water alarm (Y/N) _ N• +. Date of pumping ,<7'2-3 /09 Pumper A4- /fon, Stracrai C. ABSORPTION FIELD DATA Date installed 11966 Soil rating (g.p.d./ft2 or ft2/bdrm) f System type _ L!y Cr45 • rti � Length 7 ft. Width 7 ft.. Gravel below pipe `/. D ft. cRr3 cnia Total depth MR ft. Eff. absorption area * ft2 Monitoring tube 1r Depression over field _I Date of adequacy test 8/2-1//0 Results (Pass/Fail) Pea/ For 7 bedrooms Fluid depth in absorption field before test 17 --cin. Water addedI&Wgal. New depthtiY.P.in. Elapsed Time: 105 -min. Final fluid depth39; in. Absorption rate >= W-0 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) Naot I-r?e c. ^ If yes, give date N• A% * Sy_0- r ton vee ce4olenirce xt- i*Prne Of jntia//afrb.rDJmin.c'iani c� r%f 2xoa t,«fzan un Itnawi). Sep ltffr� rer0l-i Ce4l-eo( 9///07 D. LIFT STATION (V. A. Date installed "Pump on" level at _ in. Datum E. SEPARATION DISTANCES Size in gallons 'Pump off" level at_in. Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Ito' Absorption field on lot 106, Public sewer main N• A Sewer /septic service line �, 7-3- Animal S Animal containment areas N• A Manhole/Access (YIN) High water alarm level Meets alarm & circuit requirements? On adjacent lots 7> too ' On adjacent lots � loo ' Public sewer manhole/cleanout N• 11 . Holding tank "..4. Manure/animal excrete storage areas N• If SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 12 r Property line 9!r Absorption field S Water main V. A. Water service line 7 l0' Surface water > 10C Wells on adjacent lots > IUG SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line -,� 12- Building foundation S'O' Water main N• A. Water Service line > Io Surface water > IOo' Driveway, parking/vehicle storage > tb ' Curtain drain Alone SCPn Wells on adjacent lots > too F. COMMENTS in. G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and rr,,, � •;,,,� �•� ��•�•�•� ty, review of Municipal records that the above systems are in >� �`//j� i �► conformance with MOA COSA guidelines in effect on this date. �t .�,`^•'.`.'.�».,.; ..:.....,..;,. Engineer's Printed Name T7�wcPo•'Y F. t�roo.e- r. Date ./rLC, 2009 T, ts: COSA Fee $ = _ Date of Payment Receipt Number (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number lam Dow wam I 1 St RAN +r.wr r 1 r Py.Wr rNM .�rrWrrrrrr r. r�r friw�rr..ri w r. �r wry w"Im ILS-91LT rr .��r=ArrEw w r�i. rr.r AL WWAChffiE AS -WALT W.IC Arr a.rw wwAl EFMrrr1 . wrr. rw. r. r r rrrr-r rw w. tm moray 5UKVCT TTYL FDISBAIIM 064PAT tit Crim 00.0W.7 wAr Rlr ... AA.A.IT ... ROr_fr..ET Prepared by Robert E. Johns, Jr. & Assoc. Professional �LaWInd rs rveyo mc AftCHCPAOL. ALIWWA 98504 .rt' i w r C O r oe LAe SF. JRa PYR M W D(AA SvMTk 5-22-09 : briml Vo w yJMK Del. Drowe: 5_22-09 0.1t d. 1mvW.D. LvW Q;;-0 100! Lot 2 Jan $TMBOLS W SET RMAR M WIAOC ASPHALT O FOIRO 198M 4� WOOD FE1rC6 co"Co E _At:O1.040 ATIY. *-44--IF YRK IMOC WOOD OCC i'LUI F'LA.NS at LVI : IT 15 THE RL9PONSISKYTY Or TME BUN -M OR OWNER. PRIOR TO ONLY 7MOM ADC'VE MOUND AND VIOiLC WELL OF CO11STRUC'TON. TO %VWY PROPOWD BIALOK Rp WIO CIIADC RCLATIwo"m nNCC1ySL OEPTC CLKAMU 3. Sww"im DrWKWMYS TO F� CRADE AMD UIRM CQNCCrKWS AAD TO DFTERYMC CTC.. ARC SNOVII N TNR APPROIOMATi LOCATON. ONLY. FICA THE ESTTEMM OF AMY (ASF1fOVTSI. COVENANTS Ow RESTKICTION9 MAY PR(v£NT WDEIC WAPROKNL7(IS /ROY SONO OWI AND LDOAIM, "41CH DO NOT APPEAR CN 711E PrOORIMT) SLIBDIM9I0N PIAT- ALL DIBTANC" ARE RECORD UN OTNERWIGIC NOTF.'D. DOER 14D ORCUISTANORS SWOUID AM AS -SUET LTC I194D OM CONSTRUCTION At FOR LETMLISHM OOYOARY OR TERM LINIM THE SUW 'M TAKES REWINS OE1Tf FOR THE 047LAL TRANSACTION ONLY AM ASSUIKS nNANC'J LL LW WRY ONLY FOR 4E ODST Or M %P EY. USHD DICTAN,= POEVAL OVER SCM)10. RETRODUCU M WY CAUSE OR O" N SCALL ww SCS Reta 1092645001 Client Name Flattop Technical Srv. Project Nome/# Water Samples Client Sample ID Lot 2 Jcm SID 111atria Drinking Watcr PWSID 0 Sample Remarks Printed Date/time Collected Date/time Received Date/rime Technical Director 0624/2009 8:23 06/152009 11:30 06/152009 15:15 Stephen C. Fade Allowahlc Prep Analysis Parameter Results PQL Units Method Container ID Limits Date Datc [nit Metals by ICP/M3 Arsenic ND 5.00 u8/L CP200.8 C (<10) 06/17/09 06/22/09 NRB Waters Department Total Nivatc/Nitritc-N Microbiology Laboratory Colony Count Total Coliform Feral Coliform 3.18 0.100 mg/L SM204500NO3-r 13 (<I0) 06/18/09 LCC 0 coUlOOml. SM209222O A (Q00) 06/15/09 DLC 0 col/100mL SM209222U A (<I) 06/15/09 DLC 0 col/100ml. SM209222B A (<I) 06/15/09 DLC