Loading...
HomeMy WebLinkAboutEKLUTNA HGTS STEWART ADDN LT 2Eklutna Heights Stewart Addn . Lot 2 #051-063-19 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME"� L w [/-BiYI , PHONE 691(- .29 3 NEW ❑ UPGRADE MAILING ADDRESS 4,0, 73e-)e- 1107 -if- oe - 9 9,'27 LEGAL DESCRIPTION L a. ?-m. LOCATION NO. OF BEDROOMS v DISTANCE TO: WellAbsorption !OQ area I' Dwelling/ r PERMIT NO. _Y I- 2 W f Manufacturer Materi No. of compartments H Liq. capacity in gallonsInside 1000 IF HOMEMADE: length Width Liquid depth C Y JUZ DISTANCE TO: Well Dwelling PERMIT NO. SF Manufacturer Material Liquid capacity in gallons 0 W = DISTANCE TO. Well 100/+ Foundation / Nearesj o ine (( PERM►I�Ip ,, II -70 ?9 8 LU LL Z F ? W No. of lines Length of each11�ne Total Ieyytb n ines `Ti Trench w' tb (o Inches Distance between lines H p Top of tile t,pP finish grade Ips Material bene h tile inches Total effective absorption area UA C7 Length Width Depth PERMIT NO. a.— W Type of crib Crib diameter Crib depth Total effective absorption area y DISTANCE TO: Well Building foundation Nearest lot line Jk�A Class Depth Driller Distance to lot line PERMIT O DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS e. SOIL TEST RATING aaa INSTALLEA"Ar' . REMARKS ajj X'kL IQ Q v APPROVED 73,E-I DATE LEGAL 5 —// — 7CY 72-013 (Rev. 3/78) 'MUNI�:IPALITY OF ANCI ;E av DEPARTMENT OF HEALTH AND ENVIRONMENTAL PRO N 825 'L' STREET, ANCHORAGE, AK. 99501 264-4720 t I - 3'��'ir-��► WELL F=l "E] ED SITE :E;EWEF' F=>EFRP1II-f�. ,-1 PERMIT NO. f 770998 ? �1 W APPLICANT L & W GEN CONTRACTORS P.O. BOX 1107 E R. 99577 694-2832 LOCATION LEGAL L 2 EKLUTNA HTS;STW ADD LOT SIZE 8400 SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ FTrBR)= 220 THE REQUIRED SIZE_r]F THE SOIL ABSORPT� SYSTEM IS: 7 S'-" CsEF'TH= L_ 17-i TH= CiFch114sEL C}EF=-TH= THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENT PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOT OM OF T ECCAVATI N (IN FEET). THERE IS NO SET WI FO -H THE GRAVEL DEPTH IS TH "IFEET E EEN THE OUTFALL PIPE AND THE BOTTOM OF T E FZE��!U I F2EGx �EF}T I �G TFI"E�= :JLClc�la CiHLLLU"t�- F}A CFCF:i1iE FALP T I Ut-•1--------- A PACKAGE PLANT MAY BE INSTALLED AT THE% E`S OPTION SUBJECT TO THE FOLLOWING CONDITIONS: 1. EITHER A CLASS I OR II NSF APPROVED PLANT MAY BE INSTALLED. 2. A CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF A MAINTENANCE AGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE TW SO — — — ABSORPTION SYSTEM AND/OR YOU MAY BE SUBJECT TO PROSECUTION. — — TWCI <;R 3 I FiF;ZE c4U E --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AN AL B DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISP L S TEM I 100 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WE4. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPR T THIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCT a DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F'EFZM I T EXP I F4E� C}E�E-=ME3EFR �1 - ��7 r I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF T RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. 14 04 Is 4460.75 5�� - = ------------------- o. �►� -- _ APPLICA L & W EN CONTRACTORS T CC1 1= . 61J P n= S: a r4 O Ft E GEC _;CHNI CAL Ft DEVEL✓PMENT CO. ' ✓ - Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or6BB-2280 Russell Oyster Ead Blis 694-2774 SOIL LOG 6OB-229D Soils & Foundations Land Development 46,711- 2B 32 Performed for: Name: L• X W, 4 6;"4e•4L enrn2ht710-¢S Tel. No. 69=3_ Mailing Address: Legal Description: 1-07 e. 6144 7AI-1 ,S7-xwlRer Depth (feet) y Soil Characteristics 1 AIL 2 3 4 5 GNI, Gf' a/✓/, .SP 6 7 8 Qc, % Err 9. J`/crY �QA�FG/ S,4Npy 6rl�4vE[- J� �c/CETS o F C�F.q/V ��• �odQLEs 4/ U6o".s is /° D6h!•SE T8 (/E, V i7EN.S' 10 -"U-M vs 12 S 3/1 13 6 14 7 Ye 15 7/-, M O/a.6 zzo MB.R. /.HE S" 30 '3 ='? Ground Water Encountered: Yes No ✓ If yes, what depth Z/y- 6%t /#I Proposed Proposed Installation: Seepage Pit Drain Field Comments: Date: Performed by: - '4 ?D VIB e FT Alasketn Builders videi ye;l R_N�74R,'-_ *t�'T 99577 -,,-T-Lot 2 Eklutna-Heights-_ .4Z - well- Be per jr -6 �htless asap. 10 eNz �X &W 24 - valve 3G , 36 f , YMedium 'gravel �f, -A AM aU_7 4rO 3-4 M.- __66 * 7. 6 U-87 72 18 Sandy -gravel and-I_arge 'rocks ti -84 - Large boulder -90 _9 W 6 102 Static level 81 _C 108� 0i -F, - 14�tV , Sr. aller c. ean eriatloas- - 414 20 130--f 38 1 1-26 W Ap 132---- 138 pan graver p�ave sandy, 7®rave 44 -AL7 - -Pipe. I* -gal G anit --- Prod exon all bested b L6Z_ W% -3 conductor 2-5 kal Per, L6k 11 wire Zm 7Te -z-- C:I 00�v - --- Greens one a I il 4� out, -$F I !�tages �7 08 33_i )894&�-b 04 kz Bill Black sonesone-mr,-sin u— C-zt+er&--Ya5m1S':n Drilling Gree stone -t227 2 1aaskz,n Builders water well BOX 214 Eagle )River, Ak. 99.577Lot 'i Eklu'tna Heights 1) O!r f .12 Ar rp �21 -Pitless adapt 101 18 C, d-iack ---TB1 eL81 e - valve At& t7 30 3C 04 P C/ 3 ;x Medium-kravel -48 4z :54 —;U Ink - A 3 Dram I oft 8 tz 2 ' d -S_an y gra .08 5 g- - O A --: W7til. car- 'Plipe. Ilt.tzgalv. �cona�uctt6or ... well %rxe c azfd large ro'c -79 Z Qik6-me on tested -9tr T bail fesu d Z 5 Ai 168 L7C Greenst one L012' L GA S�nd lozge(1-'by'. a�- rf l 11 -7 �:-- Z 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: Eklutna Heights Stewart Addn., Lot 2 A. WELL DATA Well type Date completed 1978 Total depth 234 ft Date of test Static water level Well production If A, B, or C provide PWSID # Sanitary seal (Y/N) Y Cased to 145.3 ft FROM WELL LOG 1978 98 ft. 2.5 9 - p.m - WATER SAMPLE RESULTS Parcel ID: 051-063-19 Well Log (Y/N) N Wires properly protected (YIN) Y Casing height (above ground) >12 in. AT INSPECTION 9/2/16 102 ft 1.0 Coliform 0 colonies/100 mL Nitrate 5.95 mg/L Arsenic ND ug/L Date of sample: 9/12/16 Collected by: And. Engineering B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 5/4/78"" Tank size 1,000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y* Depression over tank (Y/N) N High water alarm (YIN) N Date of pumping 12/12/2015 Pumper JRs Pumping C. ABSORPTION FIELD DATA Date installed 5/4/%8 S 1. oil rating (g.p.d./ftz or flz/bdrm) 1.2 GPD/SF 1_00th 0'L4 f . _. Width JY 3 ft. Total depth 1 1 ft. Eff, absorptionarea Monitoring tube. -Date of adequacy test 4/26/16 Results (Pass/Fail) Pass 'FlV(4tldoth in absorption field before test U in. Elapsed Time: 1,440 •min. Final fluid depth 0 Any rejuvenation treatment (past 12 mo.) (Y/N & type) _ System type 5' Wide Gravel below pipe 'A7 5 ft. Y Depression over field N Water added 990 gal. in. Absorption rate > N For 3 bedrooms New depth 44 in. 450 - g.p.d. If yes, give date * Foundation Cleanout in Crawl Space. ** Septic Tank is more than 38 years old and nearing the end of its useful life. D. LIFT STATION Date installed "Pump on" level at in. Datum E. SEPARATION DISTANCES WELL ON LOT TO: Size in gallons "Pump ofr level at in. Cycles tested Septic tank/lift station on lot 80'*** Absorption field on lot >100' Public sewer main X75' Sewer /septic service line >25' Animal containment areas >50' Manhole/Access (Y/N) High water alarm level Meets alarm & circuit requirements? On adjacent lots On adjacent lots 87'*** 98'*** Public sewer manhole/cleanout >100, Holding tank >75' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5t Property line >51 Water main >10' Water service line >10' Wells on adjacent lots 921/94'*** ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water Service line >10' Surfacewater >100' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS ***See Waiver No. WR930002 G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Ben Schiller, P.E. Date 9/28/2016 COSA brown sheet -1 0-10-1 2.doc Absorption field '51 Surface water >100' Water main >10' Driveway, parking/vehicle storage > 10' S• in io 1592Y4 -P ° Municipality of Anchorage a 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 Nitrate Advisory Certificate of On -Site Systems Approval # osc161451 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 2 of Eklutna Heights Stewart Addition subdivision. This inspection revealed a nitrate concentration of 5.95 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. OF FENCE LINES, OR FOR ESTABLISHING BOUND- DRAWN, ARY LINES. �� Daans ASBUILT-NO CORNERS SET THIS DATE. SEWARD S I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE. FOLLOWING DESCRIBED PROPERTY: DATE= mak« 9 9 t is' _roc% o !J.r'Z ' 7ST AND THAT NO ENCROACHMENTS EEXCEPT AS ro�f INDICATED. IT IS THE RESPONSIBILITY. OF THE GRID; OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENT$, COVENANTS, OR RESTRICTIONS 2G srSG WHICH, DO NOT APPEAR ON THE RECORDED SUBDI- FB` VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR -CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- DRAWN, ARY LINES. �� Daans MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services in On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # (", Lir, 1)- \t1 HAA # 0 o� CI.1-rrI 1 fl 1. GENERAL INFORMATION Complete legal description Lot 2, Ektutna. Hecghta S.tewa4.t Addition Location (site address or directions) 21619 Beak View Property owner John Hatzj.ieed Day phone Mailing address Patmen, Ata6hQ' Lending agency Day phone Mailing address Agent Vi4ginwa Koh6.ieed RE/MAX OF EAGLE RIVER Day phone 694-4200 Address 16600 ContohL%OP/i Dkivo #_201 EaBte Riven, Ataska 99577 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well XX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5. 6. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm 3 & S ENGlNEERING Phone Address 17034 Eagle River Loop Road No. 204 act a Kiver, Alaska 995?, Engineer's signature DHHS SIGNATURE 2 Approved for ✓ bedrooms. Disapproved. Conditional approval for Date ( — 9 3 Or Al. '44 �we.ea..w.��•q it • ws ,j GER . SHAFER No. 8215 .ew• t1 � 0900.000 p••.•w•e ! 190FESStO bedrooms, with the following stipulations: Additional Comments SFE_ 9M90.1ED WAIVER AfPiPOvg[ 4 EMER r:: The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025(Rw.1/91) Beck MOAM21 Municipality of Anchorage AL Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST IN Legal Description: �2 �d` 1'216kS Parcel I.D. A57D ri-L� A. WELL DATA Well type��`Nkr, If A, B, or C, attach ADEC letter. ADEC water system number Log presentoN) `% Date completed L B Driller G�-f1' �►��� F Total depth 21;x�_ t + Cased to �'�� `t''� Casing height \2 + Sanitary seal0?N) i Wires properly protecteoTON) B. SEPTIC/HOLDING TANK DATA Date installed�J_-`tt,l 8 Tank size ` Compartments 2 Cleanouts#?N) High water alarm (Y/N) Foundation cleanout (),2 Depression (Y&-;, s Alarm tested (Y/N) Date of pumping i - 1n-113 Pumper Jy__ S SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot h On adjacent lots 4� Foundation To property line ca 14- Absorption field (�1 Water main/service line lit+ Surface water/drainage 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE Y FROM WELL LOG AT INSPECTION H 0 Date of test M O) Static water level it ^ Well flow Q N � _� LU ( g.p.m. g•p.rq v Pump level vGi. �i ,�Gv 2 v LL p/ Z SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 0` ; On adjacent lots Absorption field on lot I On adjacent lots Q Public sewer main Public sewer manhole/cleanout Sewer service line /1�, 1 Petroleum tank N WATER SAMPLE RESULTS' Coliform li�? Nitrate Ze Other bacteria Date of sample: 9-oZ-8 9 2— Collected by: -S J� S � V_ B. SEPTIC/HOLDING TANK DATA Date installed�J_-`tt,l 8 Tank size ` Compartments 2 Cleanouts#?N) High water alarm (Y/N) Foundation cleanout (),2 Depression (Y&-;, s Alarm tested (Y/N) Date of pumping i - 1n-113 Pumper Jy__ S SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot h On adjacent lots 4� Foundation To property line ca 14- Absorption field (�1 Water main/service line lit+ Surface water/drainage 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots "Pump off" level at Cycles tested Surface water _ Date installed a5,4 -7e Soil rating ZZvrrL System type Length Width Gravel thickness .S Total depth Total absorption area �� �� Cleanouts presentlYN) Depression over field (YAP 7J Date of adequacy test Results "fail) ��� for Peroxide treatment (past 12 months) (Y2�tp. t4QJL .1>J If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: 1 C:>-21 G e -- Well on lot ��� On adjacent lots �� k Property line pt To building foundation �j , To xisting or abandoned system on lot a A On adjacent lots ( Cutbank Water main/service line I 'r Surface water j �� I '� Driveway, parking/vehicle storage area Curtain drain E. ENGINEER'S CERTIFICATION bedrooms I certify that I have checked, verified, or conformed to all 140A and HAA guidelines in effeclQQ�"e of this inspection. Of eA tigd'��1 S & 5 ENGINEERING dw, 17034 Eagle Rlver Loop Road No. 404 ye • 9 oo Signature �* a %! k �� 66:40060 •N•Ne ise • Engineer's Name / 11 q �..00 .a•. 0 . N•ar ,•F / Date 1 r �� I I, �� ROGER J. AFER: d 6, e• No. 82 5 Z� 4t PROFESSI�NP����= HAA Fee $ k-k:>-CDO Date of Payment 1- (o-Sh Receipt Number '� Q 3 (0-1 1 Z, � 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment 50(v, 00 k—L_o-a3 Receipt Number D L-( 14(O-� / S5 g°) Aw Munk Apality of Anch; rage Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 March 3, 1993 Roger Shafer, P. E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 2 Eklutna Heights Stewart Addition Waiver Request #WR930002, PID #015-063-19, HA930015 Dear Mr. Shafer: Your request for waiver(s) of the required 100 foot horizontal separation of a septic system to a private well has been approved. The approved separation distance(s) are a septic tank and private well on property of 80 feet; the septic tank to private well on Lot 1 of 94 feet; the septic tank to private well on Lot 3 of 92 feet and well on property to septic tank of 87 feet and leachfield of 98 feet on Lot 3. This waiver is conditional based on the water quality from the well meeting federal and state primary drinking water standards. Should the water quality fail to meet these standards, this waiver will become void. As a further condition to this waiver DHHS may periodically collect and analyze water samples to confirm water quality. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Daniel J. Roth Civil Engineer On-site Services ljm:#6 Concur: ohn Smi, , P.E. Program anager On-site Services MUNICIPALITY OF ANCHORAGE Departmeat of Health and Human Services On -sib -Services Section Waiver Review Worksheet WR# 9 I(YY\ Tol PID # HA# 'Permit # Date Received: January 6. 1993 Legal Description: Lot 2 Eklutna Heights Stewart Addition Engineer: Roger Shafer, P. E., S & S Engineering 17034 Eagle River Loop Road Suite 204, Eagle River, Alaska 99577 Applicant: John Hatzfield Waiver Requested: Septic tank and private well on property - 80 feet; septic tank to well on Lot 1 - 94 feet; septic tank to well on Lot 3 92 ft. well on property and septic tank (87 Feet) and leachfield (98 feet) on teria: 1. Geology: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Points: Waiver is Granted: 15/— Waiver is NOT Granted: List Conditions or Reasons for above: SFE 4 ZrA Ct/ED Date: 3-- /- 93 By: Rec #: 24367/5589 Amount: $ 590.00 rr xeviewer Date Paid: 1-6-93 W AivfR R E 4 u Es r fOR L 0 T 2 EKL u TNA NE/69T VE 09MIT/aty / bvpIvER I?EgUEST A11411 PER W6730002 (p _ ;jv/9/ ✓fR REQ l! F_s T It on SFPT/C 7-/9Nk OAv SUBJECT L Or TO k✓fLL a/ S u BTEC r j O r T O 90 FEET T o w E L l ow L Or 1, 9¢ FEE T, r0 by ELL OA/ L or .3 ro 92 TEEr� Oa -LOT W ESL TO SrPT/c rANk AND N F/FL ON L OT 3 OF 8 7 FEET /iND 99 FEf7 ME,tPECT/✓EL j', . THE SUBJECT SEPT/C ri9A'k Gv /gS /a f r6l "P /N /978 THE SE Pr/ c T/3Nk CON S rN M CTEO AT TYIC r/ HE B i G R'Efl TAuk Av/9.t /yf}'j/E w l TH JA/UFRTS 04/ /NL Er - OurL Er- /1/gAIRA, E CLEAA/ OuTJ TO lir/L/7E rV#frERT►GHT COuPL/ads THE I.�Elif I.�ER£ C0A/SrRNcrfA IFrER T/-rF SEPT/c Sj'JTE.4.r '-,E ROE /AI �/�Cf• ALL SEPTIc S YS TENT /AwOL ✓ED tv/ rH Tff/iC t-/i/vER lvEi4E ('rRa rEO /N 1979. SEf t,*6f 41of OF rN/s 1,-.9/vER STk dr. S. of A. 0 F. C. S. D. W. G far 5.- Pai�Ts y ATER 7-/9gz. F NOON c �9 / (90 > z r t (9v� G PfRtf U PIS / YY 0 -i -V f (Fo> t�741 4VQ7-FR /AAI F C RJU2-444 T 1.2 NoR/2 oa17}l- S EjPAI?hT v 80If : L - Y �_ .2 t2 zs s �%�/9Na TUTi�3 L 16, 3 77 /. I 2.2 /a. 9 :5'EPA'Rf3T/oA. D/1TIA.CE REfu IXto B Y i> �. C. )9a/.0 TS /S 300'r...... 3/6 _2-4- 93 R)f N BOLLS f ji,#Av ROTH W ENT MW TO THF S rE *Wp )I ge4Ep .fl #0VAMIAIE PYE /NTD THE lyowi TOR TGc OE OF rAIE TME A0 f 0MPT/acv rN E.v{H, WE T NE* li SED r1Y E G /¢LL o v C awrlVA ER ..re X00 ,S GALL Otis OF wl9TER /Ai THE lio llraffl TN BE AS rRE _.ORA/NFIELD NRS DRY. ..AT rHIf T/HE wE rank .4 N/T/fATE 5hAfAte r44*�yl) AAIR A S/4HfLE Of TME w,9TfR ro CNEOf{ Foy D19C1r6RO4,vD FCau9ESE+�E. N6 FLOUREiEti[F- PRC-SEA,r iN 7-Hlf I -ELL 1✓A7E2 .. ADDED W47 -ER wjrN A yOle FRaAf THE wnT6R Fo9kCET ow TkE RACk S/DE OF THE HOASE TO Tl/F i}BSD/QPT/OAv IREWCH r1440 (Sy TKE HOA -1170A TUDE. w9TER w& -r *PPEV FfOH rHF_ [.,,CLL 47- /9 RA7-6 OF S GALL oAvf/i-t/Nu TE (Fa LL Flow) FOR .3D Ml.vk TES , APPI?ox�rIATELY ISO GALL owf LIF u-� ra&. I%?N/AvF/F_Ld 141As PRY AT THF_ BE6/A,1k/iv6 OF rH/S APPIrloAl A*ivD AQMY OArER THE APD/T/O/v. TOpk 5A,4rPLf Fon DYE AA,9 0%'v 2-/8- 93 /gVpE P 64--,R7-ER w / T/4 HOSE F/P0h rHe 4.ig TER F1¢k C E T oN rfsE Qf}[KS/DE OF TqE HokSE To riff ROSonOTio,v TA'EA CH THIQOuGhy _TWE MON/Toil 7-k3E. 14,/97,ER It oq-5 ltDDED FIPOH 7 -UF- WELL AF _.A RATE OF S 6HLLoNf/,yiMuTf Kf14LI Fiat..) FOR 40 H/AkTE5 0,0 ...APNNOx/nJgTFLY 20 GALLONS OF L,�ATER. fIELO w.4s DRY 67- 7WC- t?E 6//A/A/ ING OF THIS /PDO/ T/ a v AAP D/9 Y R FTER THE 4R.7T.nN. 0 TAIR A : ARAE MR DYE AND SHOLoED D 7. .2- 2¢- 93 T001c F/NAL SRAtPj E FOR Pyf (� %> AFr4FR ALL THE W A TER To FL Ow F u L L FOR 7 H i,vu rES APPR ar1H A+TEL r 3SldW /9N0 A/o QYE PRESENT, r- ouC L us/oti rxF, STRUCTuRF OF T1.11f 1,.ELL IS TO7',9L OF_PTH OF 23¢fAET. 7"H15 w ELt /S CASED To /38 1:EEr W HERE BEDROck 8E4griwS. ..THE C1}SI,vG /f PERFORATE/> FROr! /3O TO /38 T/lE C U RREA,T S T1+T1 C INI3TER LEVEL /S 102 FEET AAW PROD4,eE5 3 6Pr/. FROn rHE 5ujgF,9CE TO TY4 fRPROCR IS BOk[DE?s R0cHS/ 6R4vE1-. - THUS WELL u-HE.N Fu[LY _CH>gRGED HOLDl 4fff0x1H,*7fLY 173¢ Gf/LL dV5, THE 1907-ENTII91- SOURCE OF CoA. IlW.g1A,hT14.v 8E1W6 Tf/E pyAauePCOY f}B5oRPT10A/ f1ELDI /N 4114E5T/ON AREA yPGRAO1fW7- FROM THE __WELLS IN Q u ES T 1 ov T. -YE S a RFi4CE GrQAOJE.vTS OX, THis L O j 40fe ;ROk.GHLe L EVEL, .:BY PUTTING DYE 1N r�fE PR191NF1RL0 Z 91TEHP7-EP ro PISCDVER IF THE SISSkRFACE /Y,17-eR1415' G. ERE AS CDU r YE /}S 1 ob rWF, 1., ELLAjruD CA-rES TSEi ARE, fFeAu,sE rNERE 1s av0 OWE L/Vlu6 IN THE HOUSE ALSO 1u7EcTEn 1,ATE13 1N70 THE __HON/ T01? %u 0E' /.v TI -r£ TiJ//tjA F1Et0 ODER TME COU f57E OF THREE 4.EEK3 %o 611UE THE PYE A 1`1EAAII TO 1100E. Du APP/TION/ Ry 14S/NG TNF WELL TO ADP 7///1 GIATF_14, 1. wAS PR/9w/N6 TKF_ lvELL GOWN P43 -T THE PERFO-1,097-70ias fN Ti-eE C,4f/,vG FOR Aa EaITEQ/DED PE►p/OAJ OF 7/ME ND OOGBT R COA,,E OF /NFLuE,vCE TH.sT i4,,O'./LD ,E x T FNP A U,#7-"5 AA If Ou.ID ri•+E lAo E LL. p �N My oP/wlOA,� 8Y AOO/NG rWE Q4.4A.rJ7y OF c.NTE/Y TD 7 -HE i»)q/,�FfELp —BEA4/N,P TKE P75 ADD Th -(E to, ELL POL-N T'`IF IPAFAZ 0'?Cu�*s74x1CF5 TO DR,gw 7"A/AF PYE l�To 7-1YE wEGL /F THERE wAS A'OT 017YER A F1L TEil,.v6 L A jyFR 7-1fE ivEGL Pc.v ET/PATED o/P R C ON F/NI r+ G L A Yf R. Iti step/ r/ oti, T�/s PRO lEpu/4F R ,E PFA rEY TH1? E E T//4f57. .fi-VOTMF_R .fuPPoRTjAI, F19IC70R FOtT TREE ISJu.y.vCE of T/Ws 6,/q/vE,p 1S TIJe fC-CE.vT N/ r/f,q-TE LEVEL OF �•�J.y�l, .THII 3*mPLE rglefW FEP OF �73. TKE AN/T/?ATE L EvEL /,V SFOT '%2 !v65 ( 7, 7 -WF 0,4Tf7 <ottFOTFD DY T7 -FJ• OFF1CG 1✓N/LE If OA'/TORM,61 N7F L Fr vELS AR Ou aP FA(E 41.a.)9. I x19164 TES T7 -IAT SE/°Tf/S/DEI�S fiRE TYP1l,►[LY LOw LEVEL 10E90os OF rHE yF.4,R L-H/L1� FEMN,9RY I AleE HIPI fly )PEqD/A,6f r�cTaqu j' PnOPEED /N FEBRI(,11?Y. TK(1 wauCD 1AIP/CA7-E THAT PYJ' ,v1 ri?1*TE L EvECS /ti 7HEfE LLJ 1A, FA -AU r�A ../GTJ, STFws)ajf /IDDM. ARE EITF-fEIR Fira-i ANOTHEIQ fou RCE BEs/DES SFwriGE O/� L'OAr1kG Fk!?T14 )R Ac✓AY "CA A/,E/ 6 MBo/QS oN /90T,4CEA,r L aT S To THE f a BJEc T L oT &ERE !� E/7TF0 ro THE IirE TEST AAuD WERE TOL Pro C,04,7AC7- IfE /F TNEY ##p DYf *ppE.9R /.v rHEAfR Lvttt lN�4TEli. �/�/TNFjZ Aid/loHQo/� /DEPORTED NOT/[FABLE Oj�l•. d ur /- u 5'1 Oe fi 4 /PESuLT OF THE f.XTEAI IWE %-FSTIAIG I RE— :CoMKEAND 7 -HE 9E 6R19-A-rF!% MUNICIPALITY OF ANCHORAGE MEMORANDUM DATE: January 29, 1993 TO: John Smith, P.E., Program Manager, On -Site Services FROM: Daniel J. Roth, Civil Engineer, On -Site Services SUBJECT: Waiver Request For Lot 2 Eklutna Heights Stewart Addition, P.I.D. #051-063-19 The property owners and their engineer have recently applied for waivers of the required 100 foot separation distances that do not exist for their own well and the wells on both sides of their property, Lot 1 & Lot 3. Attached is an A.D.E.C. point calculation. The points are 10.9. I do not believe even with a colorful imagination more points could be derived to even come close to the required 16 to pass minimum waiver points. To meet points the actual separation would have to be over 300 feet. Well logs indicate primarily course gravels & cobbles. Bedrock is encountered around 140 feet. The subject lot is perforated from 130 to 138 feet where bedrock begins. This well produces 1.3 gallons per minute. Lot 4 well is cased into the bedrock approximately 3.8 feet. This well produces .5 gallons per minute. This shows me that most of the water supplying the wells in this area are drawing from above the bedrock. Nitrate levels in the area have increased during the same month (Sept.) 1988 to 1992 from 2.2 mg/1 to 4.7 mg/l respectively. Because of the geological structure of the subsurface materials and the increase in nitrates in the last 4 years, it is my opinion that the nitrates are directly attributable to the septic tank effluent. While it can be surmised that because the level of nitrates in the well on lot 2 still remains less than 50% of the E.P.A. drinking water standard there is no reason to get excited, it is well documented that coliform/bacteria have appeared in wells from septic tank effluent prior to the nitrate levels exceeding the 10 mg/l E.P.A. maximum. Also, the nitrate levels obtained above are typically lower during September and could potentially elevate at the typical high times of the year. There are no mitigating measures in my opinion that exist to justify the issuance of this waiver. The only point that can be made to support the encroachment is it has been this way since 1978 with no problems yet. This should not be a basis to justify the granting of the waiver in question. As stated above, coliform/bacteria potentially could appear in well water tomorrow, next year, never... Waiver Eklutna Hgts. January 29, 1993 (page 2) The final reason for denying this waiver request is, as stated in the Memorandum from Bruce Erickson of D.E.C. dated January 3, 1985; "This guide is offered to assist in determining if a lesser separation distance will meet the intent of the regulation and protect public health." Also, for us to allow the encroachment to exist on the basis that Dan Bolles will put it on his monitor program to sample and watch would be irresponsible. Dan Bolles could be gone tomorrow or worse yet, with the lack of a user fee, the on-site section may be eliminated entirely. Possible solutions to this situation: 1. The Northwoods public water system is approximately 1000 feet away from The lot in question. 2. The Eklutna water line passes this subdivision approximately 1/2 mile away. 3. Grout existing wells past the casing/bedrock interface. (Remember, this could cause wells to become inadequate) 4. Septic systems could be upgraded to pressure distributed bottomless sand filters which would eliminate concerns of bacterial/viral contamination. Public sewer is located miles from this subdivision thus not feasible. hPp R ROBERT SHAFER. P E ROGER SHAFER, P.E CIVIL ENGINEERS 19071694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 SEWER &WATER MAIN EXTENSIONS REFERENCE: Lot 2; Eklutna Heights Subdivision Stewart Addition Request you issue the attached Health Authority Approval and grant the SEWER&WATER INSPECTION following separation distance waivers: The separation distances between the septic tank and the well on the referenced property; as well as the wells on the adjacent Lot 1 and Lot 3 at 80 ft., 94 ft., and 92 ft., respectively. We also request separation distance waivers between the well on the referenced property and the septic tank and ENGINEERING STUDIES AND REPORTS leachfield on the adjacent Lot 3 at 87 ft. and 98 ft. respectively. As can be seen from the attached site plan there are several separation distance waivers needed on several lots in this subdivision. WELL INSPECTION &FLOW TEST We have performed an investigation into nearly every lot in the small subdivision and found that there are numerous separation distance violations within the entire subdivision. These encroachments have several origins including Municipal inspections in error, wells drilled SITE PLANS without inspections, and Municipal waivers which were deleted by the State Department of Environmental Conservation. Compounding the problem is several Health Certificates being issued based on private engineers' inspections which erroneously recorded the existing separation distances. ROAD DESIGN The well depths in the area are reasonably deep averaging around 200 j ft. However, there does not appear to be a confining soil layer separating the aquifer from septic effluent being discharged into the SOIL TEST subsurface soils. There have been nitrate samples taken on various properties over recent years. Comparison of these samples indicate the nitrate levels in the PERCOLATION aquifer are slowly rising. For instance, a nitrate sample taken on the TEST referenced property in September, 1988 showed a level of 2.2 mg/l whereas a recent sample taken September 28, 1992 shows a nitrate level of 4.7 mg/1. STRUCTURAL& Due to this information, I submit this approval request with great MECHANICAL INSPECTIONS reservation. Obviously I feel there is a potentially unsanitary condition which requires immediate investigation. The investigation should be conducted by the Municipal department due to its scale. ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 Page Two Lot 2; Eklutna Heights Subdivision At this point I wish to explain my justifications for requesting approval: 1. The major source of encroachment on the referenced property is the location of the septic tank. Since septic tanks are rarely a continuous source of contamination (as would be a leachfield) I do not believe the existing separation distance violations are the source of the problem. In other words, even if the septic tank was moved outside the 100 ft. protective well radius, the nitrate levels may continue to rise, indicating an influence on the aquifer by septic systems. 2. At this point, the nitrate and bacteria levels within the aquifer meet State Drinking Water Standards. Issuance of this approval would be similar to other Health Certificates on wells with high nitrates, in which the potential buyer is alerted to high nitrate levels indicative of possible future problems. These approvals suggest periodic nitrate sampling to and in the detection of a Drinking Water Standard violation. 3. Issuance of the approval with the associated waivers will enable the owner of the referenced property to continue the use of the well and septic. This will allow occupancy by the owner, an informed buyer, or an informed renter. Denial of the approval will "blacklist" the property, possibly causing vacancy and financial loss to the owner. Whereas, his neighbors, with the same problem, will continue to occupy their homes. While continuing your review, I request you keep in mind that what I feel exists is a septic tank in violation of State Regulations, which is not contributing to the condition in which the regulation was created to avert. Whereas, a leachfield (several leachfields) exist, which are in compliance with regulations, but appear to be influencing a drinking water aquifer. If you require additional information for your review, or if we may be of further assistance with your investigation into this matter, please contact us. Sincerely, ROGER J. SHAFER, P.E. RJS/tv Attachment cc: Virginia Kohfield RE/MAX OF EAGLE RIVER 16600 Centerfield Drive, Suite 201 Eagle River, Alaska 99577 (Agent for John Hatzfield, the owner) MUNICIPALITY OF ANCHORAGE DIVISION] OF LVIIIROiNMENTAL HEALTH DEPAIFnNE:?I OF HEALTH AND EM71RO. ENTAL PROT TIS"l APPLICATION FOR HEALTH AUr-iORIT't APPRMrAL CERTI IF IGATE L. General Irformatior. Application: Date (a) LeQa1 De scs on/min ludeAlot, k, subdivision.., section, tgar�hip, range) �S'r�wAc 07 - Location Location (c3rdress or diticns) o r.;PCI ,04s&efw«�� ac arc. Z/ 47 //U%�� . L Z '0 (b) applicants Nam Applicants Address ,why aSG j U1 /4�/ — (c) Applicart is (c^ec'< cre) Lending Insti tier, ; Owier/builder Buyer �( Other (explsin)); A,P��L��� � (d) Lending Irstituticr.`S��-�/J-�y ,� Telephcre Address (e) Real Estate Co. & Agent Address Telephone 2. Ty -,e of Rasiderce Single -Family Number of Bedroom 3. ;meter Supply Multi -Family ,.-3 fit — "t Other (describe) Individual Well � C xmunity �—j Public Note: If ccrmunity well system, must have written ccrfirmatior. fran the State Department of Environmental Conservation attesting to the legality and status. Is the well adequate for the number of bedrooms specified in this HAA ( ) 4. Sewage Disnosal Onsite Public Ccrmunity Holding Tank Is the wastewater disposal system adequate fcr the number of bedrocns ('C [Page 1 of 21 2-15-94 5. Engineering Firm Providing Inspections, Tests, Data and Inf, I ion I certify that I--ha-checked, verified, or confcQmed to all MOA EMA Guidelines ir. effect on t, date pectior. Signed / Date CS LSO Name Te le phom f/� � 2y 7� Address SFQ i3:4 Signed by i a, G .Ow.. + A �1 Date SR�s a9 /% �. 3 (ENGINEER SEAL) Approved for '. bedroom Approved — Disapproved Terms of Conditional Approval pb,.w A. Saw 169. 14674 I1OPaE��4*.t E9y bete or Conditional The Municipality of Anchorage Department of Health and Envircrmntal Protection does not guarantee the continued satisfactory performance of the water supply and/or the wastewater disposal system. This approval indicates that, as of the validation: date shown above, based on the data and information furnished by an engireer registered in the State of Alaska, the water supply and wastewater disposal system is safe and fury tional for the r miber of bedrooms and type of structure indicated. (DHEP SEAL) 7. Mail the HAA to the following address: KB2/d5/s [Page 2 of 21 2-15-84 PRMCIPALXrY OF ANCHORAGE (MOA) HERM ALrMIRITY ApPR JAL (HAA) CHEcxL.Isr - FEBRmW 1984 Well Clasaificai Well Log Presbd Total Depth Z Static Water Level Casing Height Above Electrical Wiring in Cori _ If A, B, or C, D.E.C. ApW ;n _ Date Omplebed Y4 WieldZ_O740&7 I to, 190 Dep of Q=tiea �l2 Pump Set At ZC3 3 / 10/ Sanitary Seal on Cas (Y on Depression Around Wel ) Separation Distances from Well: r ,,4� To Septic wg Tank ai Lot lDU /N' /on Adjoining bots To Nearest Bdge of Absorption Field on Lot 1� : Cn Adjoining Lots lop To Nearest Public Sewer Line A) J /4 To Nearest Public Sewer MeancutManhole /V 1 i+ To Nearest Sewer Service Line an Lot Water Sample Collected By Water Sample Mast Results Camaents B. SEPrICM DATA CVtoa Date Date Instal -51 Size No. of Cavartments Z Standpipe (Y Air -tight Caps Fam tion Cleanout (Y Depression over Tank (Jl ) Date Las Pumped Pumping/haintenance Contract on File E for Holding Tank High -Water Alarm ( ) Temporary Holding Tank Permit (Y Separation Distances from Septi lding Tank: / To Water -Supply Wall / � To Building Foundation To Property Line 3T�LTo Disposal Field To Va6w Main/Service Line is f To Stream, Pond, Lake, or Major Drainage Course Comments [Page 1 of 21 2-15-84 C. ABSORPPICN FIELD DATA Soils Rating in Abscrpticn Strata Gv Type of System Design Date Installed Length of Field 4,/4,e( Width of Field _ / Depth of Field Gravel Bed Thickness Square tweet of Abscrptia3 a 660 Standpipes Presse Depression over Field Date of Last Adequacy `tbst ✓ � Results of Last hbquacy-lbft40971AILC ?PV Separation Distw= frau Abs@p rion-F To.imtsr-Supply Mbil lPv, To Property Line /O To Building tion l To Wating Cr Abandoned System on Lot /y On Adjoining Lots �� f To tater .Mai~ice Line a To Chtbark To Stream/Pcnd/Lake/ar Majcu Drainage Cease To Driveway, Parking Area, cr Vehicle Storage Area A11112- Ccmaents Dee/!/C 1A.3 D. LIFT STTICN Date Installed Diaensicns Size in Gallons Manhole/Access (Y/N) *Pup On* Level at Off" Level at High Water Alarm Level at Vbnt (YM) Tested for -4 les (Iming Adbquacy Test. Meets MDPT Electrical Codes(Y/N) CCmaents *' Check Aemi redroom Rating Against HAA Request ** I certify I ,verified, cr confcrmed to all MOA HAA Guidelines in effect on the da Si Date A C MDPT No. 7 r e ti RBl/d5/s ».t m : e.e.a A. Na 1457-E ,•' �� [Page 2 of 21 , � ti•. •�.• 15-84 /I: 6 AAl MUNICIPALITY OF ANCHORAGE fyLu e / DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 Subdivision ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 NUMBER OF BEDROOMS REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER ❑ MULTIPLE FAMILY PHONE Walter J- Kurka 694-3493 MAILING ADDRESS ❑ COMMUNITY Post Office Box 214 99577 ❑ PUBLIC UTILITY PROPERTY RESIDENT (If different from above) 8. SEWAGE DISPOSAL SYSTEM PHONE 2- BUYER "If individual/on-site, give installation date 5/78 PHONE Alfred Romaszewski 688-3037 MAILING ADDRESS by this Department. 3. LENDING INSTITUTION PHONE Security Pacific 276-1933 MAILING ADDRESS 1011 East Tudor Road Suite 190 99507 4. REALTOR/AGENT PHONE Virginia Kohfield 694-9555 MAILING ADDRESS Post Office Box 249 99577 5. LEGAL DESCRIPTION Lot 2 Eklutna Heights Subdivision STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS ED One 1:1 Four ED Other Lex SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY PUC Three ❑ Six 7. WATER SUPPLY XN INDIVIDUAL` 'ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM "If individual/on-site, give installation date 5/78 30 INDIVIDUAL/ON-SITE" If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) L6 724 Sitev.3t7BI THIS SIDE FOR OIFTICt lL USE-ONt . iNSP ECTI Ok A1PIKMTMENTS ATE RECEIVED TIME ' tw DATE DATE 70ATE ECTOR 1.'TYREOf REMDENE -❑ SINGLLI -fA Ly ❑ A LTIPLE FAMILY - iitl'l1NEA RCK31� 0 ONE ❑ THREE ❑ FIVE ❑ OTTER 0 rNo ❑ FOUR ❑ SIX 2.AVATI RAIPLY ❑ INDIVIDUAL ❑COMMUNITY D PUBLIGUTFLITY -Connecthm Verified ITNLIMBER -DEPTH OF -WELL - DSTI= DRILLED A.oGAECEtVfD 3. L SYSTEM ©#NBIVI DUAL/GN -SITE OPU1 LtC UTILITY CDn neetion'Feri€red PERMITNUMBER DATEINSTALLED IAlMLLER D5b0cTsnk=w ❑ NWiding Tank -Stm A400 tfTank is tmmemade I dimension: =WtU RATING TYIFE OF T:MANUFACTI315Z�J /f TOTM AREA MATERIAL 4.—Dt$TONM _ WELL T{3: !ding Tank rption Area Lim 799=t Une A bsorparen Area to marestA_ot Line S. W Jkp — M":I`':ED FOR __I_ -BEDROOM ❑ CDNMTIONAL APPRDV-Ai- (Iettw c wlMcate) ❑ UISA7PROVED -- DATE- t , '—� f itlel L#GAL ♦3ESl;iIPTION 724 Sitev.3t7BI