HomeMy WebLinkAboutDUNCKLE LT 84Bt)unckle
Lot 84B
#051-092-60
Municipality of Anchorage Page 1 of 3
Department of Health and Human Services
Division of Environmental Services
Onsite Services Section 825V Sheet Room 502
P.O. Box 196650 Anchorage. AK 995136650
www.c1.anchtxage.sk.us (907) 3434744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SWO10039 PID Number: 051-092-60
MM"
MM&M Contracting
Wastewater System: New
P.O.AftABSORPTION
P.Box 670495 Chu iak AK 99567
FIELD
s
5' Wide Shallow Trench
688-1236 Three�3
Sal Rung:
Taal Depn fan 0,9+ qr a :
LEGAL DESCRIPTION
1.2 rraFP
4 Ft.
Btalf: Lot .SVDOWIa1:
Depn b" bnaan fan ag.W Ftg:
Grn own th ppe:
84B Dunckle
2 Ft.
2 FL
Tayslap: Rage: Sacmn:
Fi aoaaG M age tF+ee:
G,e Length:
1.5 Ft.
53
Well: Existing
ct.w.ah:
5
wnw d tn.s:
1
OotM¢e fat.een rw:
N/A
Ft.
n.
cLnV atn (Prnae. A0.c):
ToW Dapth: Ceaed b:
T" efwrpe Mx
378
PM Mata W:
ASTM D3034 PVC
Private
Ft. >40 FL
F
DN .
Dete on*" Sww Wua Levu:
65 Ft.
fe, a
MM&M Contracting
DMeftWaeG:
5/7-8/01
YW.
PWVset M:",„°
tAfa»Ct :
TANK
1.5 GPM
Ft.
>2 Ft.
SEPARATION DISTANCES
O Septic O Holding ❑ S.T.E.P. ❑ Other.
To
Flom
Septic
Tank
Absorption
Field
Uft
Station
Holding
Tank
iidPrivate
sew u,.
ef'
Anchorage Tank
Y.
1,000
WM
100'
>100'
N/A
N/A
>25'
wt
Steel
Mo�fer
Two (2)
seteawMa
>100'
>100'
N/A
N/A
LIFT STATION — NONE ON LOT
Lal:»
>5'
5'**
N/A
N/A
Gr.
>5'
>10'
N/A
N/A
°" "
PW level aL
140 -ata M:
Fow u
None
Noted
PvmpMM. aMoOM
E� kop mae Pat by.
CiMan DrMn
Ftw h
BENCH MARK
2" Insulation Over Septic Tank and Drain Field. Well
Production and Static Water Level Determined From
Front Porch Deck
4 Hour Flow Test.
AMU.W tDevafon:
100.0 FL
" See Lot Line Waiver.
FRgineEr,{Stamp
Existing Septic Tank Crushed Backfilled and
4 ''Q rr
Abandoned. Existing Absorption System Backfilled
PCS:'•"'
S
and Abandoned.
4
Inspections performed by: MEA Dates: 1" 5/7/01 '
2nd 5/8/01
A : M104AEL E. A L"SON •,
Department of Health and Human Services approval
cE -4331
yfc�s��
Reviewed and approved by: llJ. Date: A • 2 3- C11
-.
r�1 �F� PROFESS�ONa�ott .
at�
t. 1099)
Municipality of Anchorage
DEVELOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK 99519-6650 -343-7904
Onsite Wastewater Disposal System or Well Inspection Report
Permit Number SWO10039 PID No. 051-092-60
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1 • NI04AEL E. ANDERSCN
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PLAN AS -BUILT
SCALE I"= 40,
SCENIC DRIVE
H2 THt .I
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S1
A B '
tHome
e
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LOT 84B,
DUNCKLE SUBDIVISION I
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Page 2 of 3
A
B
S7
228
34.0
S2
29.6
39.3
C4
34.1
30.7
M7
73.5
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C5
74.6
80.2
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1 • NI04AEL E. ANDERSCN
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PLAN AS -BUILT
SCALE I"= 40,
SCENIC DRIVE
H2 THt .I
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S1
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tHome
e
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LOT 84B,
DUNCKLE SUBDIVISION I
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Page 2 of 3
Municipality of Anchorage
DEVELOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK 99519.6650 - 343-7904
Onsite Wastewater Disposal System or Well Inspection Report
Permit Number SWO10039 PID No. 051-092-60
r r N NM
.. rn rn rlft
98.0
2" Insulation
.•Drainfield Rock
ru
Page 3 of 3
..86.0±
.53'
49
<��. ,NDr�sONPROFILE AS -BUILT '2,0- CE.4381
"_
�rlit4CROFESVJ ���'
Municipality of Anchorage
Department of Health & Human Services
825 L Street, Anchorage, AK 99502-0650
SOILS LOG - PERCOLATION TEST
Performed For. MM&M Contracting Date Performed:
Legal Description: Lot 846- Dunckle Subdivision
SLOPE SITE PLAN
17
OG/01-
2
G/OL2
3
4
GW
5
Well Graded
6 Gravel
71 1 Some Silt
8
Was Groundwater
9
Encountered? No
If Yes, What Depth?
10
Depth to Water
After Monitoring 9.
11
Date: 5!7/01
Bottom of
Test Hole
See Site Plan
�P�� OF • �' ��Sc'a
o
p, c. MICHAEL E 43D�E'kSCN
CE-
f sig •. ,.•�� o
O`ev
41% PROFESSO 41
577101
Pere. Rale: <5 MinAnch Perc. Hole Diameter.
Test Run Between FL and FL
Comments: Same Material as Test Hole No. 1. Pere. Rate < 5 MinAnch.
Performed By: Mike Anderson, 1, Michael E. Anderson Certify That This Test Was Performed
In Accordance With All State and Municipal Guidelines In Effect On This Date: 8715/01
MunicipaUty of Anchorage
George P. ]Vuerch, Mayor
Bttild id Safety Ditisiotl
P.O. Box 196650 • 4700 S. Braga«• Strcct
Anchorage, Alaska 99519-6650 • (907) 343.8301
httlt://%%�%l •.cl.anchomge.ak.us
Anderson Engineering
ATTN: Michael E. Anderson, PE
PO Box 240773
Anchorage, AK 99524 -
August 23, 2001
Subject: Waiver Request forDUNCKLE SUBDIVISION LOT 84B
Waiver # WR010071 Lot Line Request for Parcel ID 051-092-60
Dear Engineer:
Depart mens of
Public Works
Your request for a waiver of the required 10 feet horizontal separation of the on-site wastewater
disposal system to the lot line has been approved. The approved separation distance is 5 feet.
This waiver approval applies to the current on-site wastewater disposal system and lot line
separation only. Any future upgrade to the on-site wastewater disposal system and lot line will
require all separation distances to be met or another waiver approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office at
343-4744.
Sincerely
Jeff Poet
Engineering Technician III
On -Site Water Quality Program
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
On-Slte Services
Waiver Review Worksheet
WR#:010071 P1D#: 051-092-60 HAM 010449
Date Received: 8 15-01
Legal Description: Dunckle Subdivision Lot 84B
Engineer. Anderson Engineering
P. O. BOX 240773 ANCHORAGE AK, 99524
Applicant: MM&M Contracting
..........
Waiver Requested: Absorption field to lot line of 5 feet
Criteria: 1. Geology Points:
A. Water Table
B. Sal Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
2. Special Conditions:
3. Other.
Waiver Is Granted:
List Conditions or Reasons for above:
Date: a —a3-0/
Rec#:-818-01 Amount $115.00
..........
Permit#:ws 010039
Waiver is not Granted:
By: (v
Date Paid: 8 18-01
Reviewer
ANDERSON ENGINEERING
'. P.O: BOX 240773;; _
ANCHORAGE; -AK 99524 =
522-7773.. ' 522-6779 (FAX)
August 15, 2001
Municipality of Anchorage
Department of Heath & Human Services
825 "L" Street
Anchorage, AK 99502-0650
Subject: Lot 84B, Dunckle Subdivision
Separation Distance Waiver
Absorption Trench to Lot Line
Dear On Site Services Engineer:
The absorption trench on Lot 8413, Dunckle Subdivision was inadvertently constructed
within 5' of the east lot line to provide sufficient area for the new house and driveway on
the lot. Lot lines were not well defined during the construction process and accurate
measurements were not available until the final as -built for the house was surveyed. It
was also necessary to provide as much distance as possible between the new
absorption trench and the steep slope to the northwest. Soils on this lot were found to
be very effective for the absorption of septic effluent and placement of the trench at this
location will not pose a problem to neighboring lots. We therefore recommend the
waiver be issued allowing the trench to be within 5' of the property line.
Sincerely,
Michael E. Anderson, P.E.
N...
N,ICHPEI E. ANCERSCN.�a
�•e� CE -4331 .o
MUNICIPALITY OFANCHORAGE
Development Services Department
On -Site Water& Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SWO10039
Legal DescriptionLD_1k1~1 ESUBDIVISION'LOT84B
Design Engineer: 0014 Anderson Engineering
Owner Name: MM & M CONTRACTING
Owner Address: P.O. BOX 670495
CHUGIAK , AK 99567 -
5--q-0/ P, 7:C0
Date Issued: Mar 22, 2001
Expiration Date: Mar 22, 2002
Parcel ID: 051-092-60
Site Address: 21121 McKINLEY AVENUE
Lot Size: 45195 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit Is for the construction of:
F,/ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specked in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 1BAAC80 ).
3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Date:
Date: 3—?2-0-1
Municipality of Anchorage
• Development Services Department
Building Safety Division
Onsite Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 05-1-0172-60 Permit Number SW 010039
DAv10 c. f $kARvv A. OUArCKLE
Property owner(s) MM&M Contracting Day phone 688.1236
Mailing address (1) P.O. Box 670495 Chualak, AK 99567
Mailing address (2) 21131 H z k1A1L E y A VEM14 r= Zip Code 9g5_67
Legal description (Lot, Block & Sub'd.) Lot 84B, Dunckle Subdivision
Legal description (Section, Township & Range)
Lot Size 45.19s Acres f.F
THIS APPLICATION IS FOR:
Number of Bedrooms Three (3)
Sewer Only ® Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
.M 4f
(Signature of property owner or authorized agent)
Permit Fees:`$i� Waiver Fees:
Date of Payment: So I HC lJ tlJ 1 Date of Payment:
Receipt Number: 8�Q Receipt Number.
(Rev. 12/00)
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 FAX
March 14, 2001
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 846, Dunckle Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 8413, Dunckle Subdivision intends to construct a new three-bedroom
home on the lot. The lot is currently occupied by a mobile home which is served by a
septic system constructed in 1970. Both the septic tank and the absorption crib from
that system will be abandoned in accordance with Municipal and ADEC requirements.
We are hereby applying for a permit to construct a new septic system on the lot to serve
the new home. The attached Site Plan and backup documentation identify the location
and configuration of the new septic system and the parameters used in the design. It
also shows the location of the alternate site, existing absorption crib and the existing
well for the lot. Existing drainage patterns are also shown and will not be altered by the
development of the lot.
Several test holes have been placed on this lot over the past years. All of these holes
reveal well to poorly graded gravels with percolation rates between 3 and 5 minutes per
inch. A test hole at the proposed location for the new absorption trench revealed well
to poorly graded gravel with some silt to various depths. No groundwater was noted in
the test hole during excavation but was noted at 14' below the surface during the
monitoring period. We are therefore proposing to place a 3' wide by 32' long absorption
X 6' effective depth absorption trench to treat the septic effluent. The pipe will be
placed at 2.5' below the existing ground surface and the total depth of the trench will be
9'. A minimum of 3' of cover will be placed over the bed to prevent frost penetration
and possible freezing.
The ground surface on the lot slopes as shown on the attached Site Plan with a
substantial drop from the bluff line shown. The area for the new absorption trench,
however, is fairly flat. The new trench will be constructed parallel to the contours of the
surface in conformance with Municipal requirements. The trench will be placed as far
as possible from the edge of the bluff. We will try to maintain the 50' separation from
any break in grade greater than 25%. Grading will be accomplished to assure surface
drainage is away from the new trench. The existing drainage pattern on the lot will not
be affected during development.
Lot 8413, Dunckle
March 14, 2001
Page Two
If the system is constructed in accordance with our design the following statements
apply:
The system, if constructed as designed, will have no adverse impact on the wells
in the area or those to be constructed in the future.
2. The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
3. The system, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
4. The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,
Michael E. Anderson, P.E. �ai�P' AAs y�A
49?H
Attachments i_:>7 ••y ...... VY.
. MICHAEL E. ANDCRSCN
�� CE -4381 .��`�
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NOTE: No Conflicts With Wells in the Area.
F..OF •A4 144
• *�P49^h/*A�i
,�....�.......:isAREA MAP :4�.....
SCALE 1" = ()() OF � ;MICHAEL E. ANDERSCN
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:55.2a
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OT 84A
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THIS PROJECT
'M
3
LO 84B
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NOTE: No Conflicts With Wells in the Area.
F..OF •A4 144
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,�....�.......:isAREA MAP :4�.....
SCALE 1" = ()() OF � ;MICHAEL E. ANDERSCN
�� J� CE - 4381
32' Long X 3' Wide`"'
X 5' Effective Depth
Absorption Trench
—'I
1,OOU Gallo
Septit Tarik
ODI 1
h
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LOT 84B
DUNCKLE
uamoDow
TH1
lter
site
Th ee
Bedrroom
House
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In
Existing
w
well
III >1
..
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x
rn
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SITE PLAN
SCALE 1" = 40'
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*.MICHAEL E. ANOERSCN : W ,0.
��'•. CE -4381
1 Ji` ••. . • a�' o
LOT 84B, DUNCKLE SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Three Bedroom Home Deep Trench System
Perc. Rate: 2-5 Min./Inch 1,000 Gallon Septic Tank
Application Rate: 1.2 GPD/SF 6' Drainfield Rock
3 Bedrooms X 150 GPD / 1.2 GPD/SF = 375 SF of Absorption Area
375 SF/12 SF/LF = 31.25 LF Trench Length
Therefore: Construct an Absorption Trench 32' in Length by 3' Wide With 6' of Drainfield
Rock Beneath the Distribution Lateral. Distribution Lateral to Be Placed 2.5' Below
Existing Ground. Total Depth of Trench to Be 9' from Existing Surface. Mound Over
Trench If Necessary to Provided Minimum Cover of 3'.
21611
600
6'
Natural
Backfill
Geotextile
Fabric
4" Perforated
PVC (Slots Down)
3.
TYPICAL DEEP TRENCH SECTION
(NO SCALE)
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 10' Separation From Lot Line.
Minimum 4' Separation From Groundwater.
Minimum 50' Separation From Break in Grade >25%
eld
0
��•OF •q� SlF-d�o
• 491H
*.MICHAEL DERSO
*4� �• CE -4381 :���!
Municipality of Anchorage
Department of Health & Human Services
825 L Street, Anchorage, AK 99502-0650
SOILS LOG - PERCOLATION TEST
Performed For: MM&M Contracting
Legal Description: lot 84S. D n .kl - Subdivision
SLOPE
1 � OG/OL
GW
5
Well Graded
6 Gravel
71 1 Some Silt
8
9
10
11
12
13
14
Bottom of
15 Test Hole
16
17
16
21
Was Groundwater
Encountered? No
If Yes, What Depth?
Depth to Water
After Monitoring 14'
Date: 3/11/01
W'W
* : 491H AA�
Date Performed
CHAEL E. ANDERSON
CE - 4381
gyp'•• ...•• P� �
10/24/00
See Site Plan
Reading
Date Gross Net
Time Time
Depth To Net
Water Drop
1
24 -Oct 11:35
1.5"
2
11:45
5.63" 4.13"
3
11:46
1.25"
4
11:56
5.25" 4-
5
11:57
1.38"
6
12:07
5.38" 4"
Perc. Rate: 2.5 Min./Inch Perc. Hole Diameter: 6"
Test Run Between 5 Ft. and 6 Ft.
Comments: Perc. Cavity Presoaked Prior to Test.
Performed By: Mike Anderson. I, Michael E. Anderson Certify That This Test Was Performed
In Accordance With All State and Municipal Guidelines In Effect On This Date: 3/14/01
ELALT� ^7L: NI
327EAGLE STREET
Performed For (-Scl.T 11 r+i n•�'T`
Lena' Descri� .tT� _oc< ='
?} 5 Fc -m. Re-ort5'a: L%'�,
Des"
eet
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Ti c. 5aa.:v and 5i.•o
Is wet, 5z:;_4ea
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irtLf.F.0.S:.c t�:'�.� dG�a�•
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5:- —vac. d
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7---4
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IC —fes—{
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Pate Fer �raed 7-'!'L -7 0
Lcc3t. . 5na-':
Was Gr-und'later Eac-..nterea? tic
Lrf i.1 I£v"
--r-
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t 1 1 I
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?rco rstallat:cn See;.age Fit ✓ _Drain .ie'_C -
�erti. Of ...:et 3 1 De,^.ta To Bottoc 0: Pit Or Tre-_^
^.0?".'2E3i?s: S' rs't)1 5W ic-S
64 am.-. 1,�.-rY� w 7,,z5 t•, H]P.
Test ?erfor:red BY: POQU.O {)C 1 cQ[A,}iz� %:It
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' •
Lmt 4B
�
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i
Was Gr-und'later Eac-..nterea? tic
Lrf i.1 I£v"
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t 1 1 I
' 1 L
?rco rstallat:cn See;.age Fit ✓ _Drain .ie'_C -
�erti. Of ...:et 3 1 De,^.ta To Bottoc 0: Pit Or Tre-_^
^.0?".'2E3i?s: S' rs't)1 5W ic-S
64 am.-. 1,�.-rY� w 7,,z5 t•, H]P.
Test ?erfor:red BY: POQU.O {)C 1 cQ[A,}iz� %:It
I
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GAAP. - MDI GRFATER ANCHORAGE AREA BOROLI ,H
HEALTH DEPARTMENT
_ 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING C/f /;7
.1150� _ADD RESS�C�GL/-�� �PHONE��,
R:
SEPTIC TANK:
NUMBER OF
DISTANCE FROM WELL -Z ha —MATERIAL ����—�'� COMPARTMENTS
LIQUID CAPACITY_ 50 GALLONS. INSIDE LENGT� ___INSIDE WIDTH LI `�H
SEEPAGE SYSTEM: SEEPAGE PIT:
n
i
NUMBER OF PITS ---/--OUTSIDE DIAMETER `— ORWIDTH c�� 7°5� LENGTH_ze/ ,DEPTH
LINING MATERIAL—_'_��" �/_. DISTANCE FROM WELL 5 BUILDING FOUNDATION ��,�
NEAREST LOT LINE_ n - K! TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) 9 '�` .SQ. FT.
TILE DRAIN FIELD
DISTANCE FROM
F
NUMBER OF -LINES DISTANCE BETWEEN LIN
N AREA_ _SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE__
NEAREST LOT
TRENCH WIDTH
TOTAL LENGTH
DF LINES
IN. TOTAL EFF
OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE–_
WELL: DISTANCE FROM, �� WATER
TYPE DEPTH_ _,BUILDING FOUNDATION.--- SAMPLE_
NEAREST t/SEPTIC �� SEEPAGE
LOT LINE _, SEWER LINE_ , TANK_ SYSTEM—_CESSPOOL
DIAGRAM OF SYSTEM
DISTANCES:
DATE
��
NEAREST
OTHER
SOURCES TPA
If,
G^A7-nD.2 GREATEFa kNCHORAGE ARIA ' `)ROUGH Case No. _�.�
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
®- SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
---------,fir----�
NAME: OF APPLICAN"FL�p�a/-�-tA'LING ADORES' PHONE
RESIDENCE ADDRESS LOCATI N OF INSTALLATIONS ��1
LEGAL DESCRIPTION
APPLICATION 1'0 INSTALL: SEPTIC TANK— , SEEPAGE PIT_—, DRAIN FIELD_—_, OTHER
TO SERVE THE FOLLOWING FACILITY_L��
FINANCED THROUGH _ ---- TO BE INSTALLED—
wl ANTICIPATED DATE OF COMPLETION_ ���/7CAE
= M�ig TEST RESULTS----- ANTICIPATED DATE OF COMPLETION w
LOW
ESULTS_— --
THIS IS TO SERVE AS
AS DESCRIBED BELOW. SIZE OOFUNIT TO BE SERVED �p�2
SEPTIC TANK SIZE � —TYPE S1.?L_N�.--SEEPAGE AREAS TYPE _ J�
^2,0) DIAGRAM OF SY EM
LOW TO BE FILLED OUT BY HEALTH DEPARTMENT
, PERMIT TO INSTALL A
DISTANCES:�ini
i
HEALTH AUTHORITY
OR
LICENSED DESIGNER
I certify that I am familiar with the requirements of Greater Ar ehorage Area Borough Ordin nce No. 28-68 and that th
above described system is in accordance with said code. Cor ,Az /P7 (iL' du
DATE _ APPLICANTS SIGNATUR
r t'in r)rjgY n
WITA
397 EAGLE 'TRFE'
AMor•.r E, ntr; PYA spec:.
11 1 gat( her-
pox-formed
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MUNICIPALITY OF ANCHORAGE
0
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 051-092-60-000
Legal description DUNCKLE LT 84B
Site address 20420 SCENIC DR Chugiak AK 99567
Current property owner(s) ROBERTS KURDEL
Expiration Date: 11 /1 /2023
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: 8/1/2023
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 X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory x
Tank Age Advisory Arsenic Advisory
Other
COSA Approval_June 2022
HUHMPAUTY (OF AHCHOO RQOC
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. 051-092-60
Complete legal description Dunkle Lot 84B
Location (site address) 20420 Scenic Drive, Chugiak, AK 99567
Current property owner(s) Kurdel Roberts
2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS
Day phone
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: 0 Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ®❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age 22 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench X 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 $ - qS Waiver Fee $
Date of Payment 7�3�z 3 Date of Payment
COSA # 0 C 2--3 y 6 Waiver #
COSA Application—June 2022
Legal Description:
Dunkle Lot 84B
Parcel ID: 051-092-60
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled UNK Total depth UNK ft
Cased to 40+* ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA 7/11/23
Static water level at beginning of test 63.9 ft.
Comments *Per pump installation log in muni file
B. TANK DATA
Measured operating fluid level in septic tank 4
Date of pumping 7/14/23 JR's
❑ Required maintenance completed, if AWWTS
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 5/8/01
❑ ALL standpipes present per record drawing
Total measured depth from grade 5.0 ft (max)
Measured depth to pipe invert from grade 3.2 ft (min)
❑ N/A — pressurized field.
❑ Per record drawings, field is insulated.
❑ Monitor tubes go to bottom of effective.
If not, state depth into effective 1.8
❑ Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced N/A gallons N/A date
Any rejuvenation treatment (past 12 months) N/A
If yes, enter date
Comments/Deficiencies:
COSA Checklist June 2022
Well production at time of test 1.6 gpm
Water storage tank volume N/A gallons
Well disinfected for coliform test? ❑ Yes ❑ No
❑ Coliform bacteria is Negative
Nitrate -10. 7 mg/L E]Nitrate less than MRL (ND)
Arsenic ug/L ❑ Arsenic less than MRL (ND)
Collected by Forge Engineering
Date 6/26/23
C. LIFT STATION
Age
ired maintenance completed
of lift station years
Lift station material
Comments:
Adequacy test date 7/11/23
Results ❑ Pass
Fluid depth prior to test 0 in
Water added 2422 gal
New fluid depth 0 in
Elapsed time 1440 min
Final fluid depth 0 in
Absorption rate ' 450 gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings) 24 in
Effective depth used 0 in
Effective depth remaining 24 in
Benjamin Schiller, P.E.7/13/23
5*
*Waiver #010071
(907) 522-7773
RE: 20420 Scenic Dr
Chugiak Alaska
7/29/2023
99567
Dunkle L84B
A Water well camera inspection was requested for the above-
mentioned property. With camera inspection being conducted on 7/29/2023 at
2:16pm, below are the following findings per downhole visual inspection.
Total depth 68 ft 5”
Cased to 68 ft 5”
Static water level 61 ft 3”
Top of pump measurement 65ft
Pitless burial depth 8ft 5” from top of casing
Casing height above grade 1ft 7”
The well was video inspected. The water level in the casing was visually
monitored upon start of inspection to ensure well was in fact at static. No
movement of water rising above the mentioned 61ft 3” was viewed. The well was
determined to be in a static condition. The pump was activated and well was drawn
down following. The pitless adapter was viewed to ensure no leaking or spraying.
Pitless was sealed and in operating condition. The water level was monitored and
no perforations, cracks, breaks or any other mentionable damage to the well was
viewed. No other incoming water was found or observed. Casing is in good
condition although visible normal iron deposits along sidewalls were visible.
Casing above ground is good and secure with a proper well cap and conduit being
present at time of inspection.
If there are any further questions please feel free to contact us at the contact
information listed below.
John @ 907 Water well Services
907-230-1868
907waterwells@gmail.com
www.muni.org/onsite
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC231246
Subdivision: Dunkle, Block: , Lot: 84B
A water sample revealed a nitrate concentration of 10.7 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. Since nitrates are known to slowly increase, we recommend
you monitor the water quality. 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.
Ma�lmg Address P O Box 196650 * Anchora e, Alaska 99519 6650 *www muni or
annnom =--
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
Ma�hng Address tP O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org
MUHMPA UTY OF ANCHORAGE
RAGE
DEVELOPMENT SERVICES DEPARTMENT 0/r(. ff'�
., . ,
On -Site Water and Wastewater Section
www.muni.org/onsite
Septic Tank Advisory
Certificate of On -Site Systems Approval #
Subdivision: Dunkle Block: , Lot: 84B
907-343-7904
Fax: 343-7997
The septic tank for this property is 22 years old. The average life of an asphalt
coated steel septic tank is 20 years. Typical replacement costs are $10,000 or more,
not including engineering, surveying or MOA permitting fees.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
This is an example of what the metal of a 30 year old steel tank MAY look like.
MUMCPAUTY OF ANCHORAGE
Development Services Department c
Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 051-092-60
1. GENERAL INFORMATION
Complete legal description DUNCKLE LT 84B
Location (site address) 20420 Scenic Dr
Current property owner(s) DUNCKLE
Mailing address
Real estate agent Cindy Wilson
2. TYPE OF DWELLING:
Q Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or. Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY:
Private Well
Water Storage
Community Well
Public Water System
Waiver request for:.
Expiration Date: _ JM 9' I 0,2
,
Day phone 244-1930
Day phone 244-1930
TYPE OF WASTEWATER DISPOSAL:
R
Private Septic
0
❑
Holding Tank
❑
❑
Community
❑
❑
Public Sewer
❑
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 7 a. 50 cvq I b -1 `} Waiver Fee $ _
Date of Payment 90 aeao Date of Payment
Receipt Number 0 6 2 00 D Receipt Number.
COSA # 0 8 C x015 y a Waiver #
Distance:
S. 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, base{
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 o
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 it
effect at the time of installation. I acknowledge that On-Ske staff may visit the site to verify the information submitted.
Name of Firm NorthRim Eng. Phone 694-7028
Address PO Box 770724, Eagle River
Engineer's Printed Name Steve Eng Date 19/3/20
r
6. DSD SIGNATURE�4\9TM°fl *,�
-
✓ System #1 Approved for .3 bedroomsSte..
System 92 Approved for bedrooms es9 c%
Disapproved ®4� 1 Q %` 3'% 2 IT
Conditional approval for bedrooms, with the following stipulations:
By: �c'.�1a (� Original Certificate Date:
The Municipality of Anchorage Development Services Division (DSD) Issues Certificates of On -Site Systems Approval {COSA) based only upon the
representaffons given in paragraph b 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 vrork.
T. ATTACHMENTS: F q
COSA Checklist X Nitrate Advisory x
Septic System Advisory Arsenic Advisory
COSA Checklist
Legal Description: DUNCKLE LT 84B Parcel ID: 051-092-60
If more than 1 septic system on lot: COSA Checklist # of Structure served by this system
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled unk
Total depth unk ft
Cased to 40+ ft
❑■ Sanitary seal is functioning correctly
❑■ Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA 9/21/20
Static water level at beginning of test 64 ft.
Comments
B. TANK DATA
Age of tank(s) 19 years
Tank type/material septicStl
Measured operating fluid level in septic tank 50
❑■ Standpipes/foundation cleanout per record drawing
Date of pumping 10/3/20
D. ABSORPTION FIELD DATA 5/8/01
Which system tested (date installed) same
❑■ ALL standpipes present per record drawing
Total measured depth from grade 6 ft (max)
Measured depth to pipe invert from grade 3.5 ft (min)
❑ N/A — pressurized field
❑■ Monitor tubes go to bottom of effective. If not, state
depth into effective
Well production at time of test 1.5 gpm
Water storage tank volume 0 gallons
Well disinfected for coliform test? ❑ Yes ❑■ No
❑■ Coliform bacteria is Negative
Nitrate 7.42 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ❑■ Arsenic less than MRL (ND)
Collected by NRimEng
Date of Sample 9/21/20
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
Adequacy test date 9/21/21)
Results ❑✓ Pass For 3
Fluid depth prior to test 0
Water added 450 gal
New depth 6 in
Elapsed time 30 min
❑E Code -required soil cover over field
Final fluid depth
0
in
❑ System presoaked
Absorption rate
450
gpd
bedrooms
in
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) no
date of test)
Gallons introduced gallons If yes, enter date
Comments/Deficiencies:
COSA Checklist yellow sheet
E. SEPARATION DISTANCES
From Private il'liell 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 7 104'
[! ] Yes
if No
ft
M Yes
if Na ft
Neighboring Tank > 100' El Yes
if No
ft
Private SeweriSeptic Line 5 25` Q Yes
if No ft
Absorption Field on Lot > 100' 71 Yes
if No
ft
Holding Tank > 100' ] Yes
if No ft
Neighboring Absorption Melds > 100'
if No
ft
Animal Containment > 50' 0 Yes
if No ft
Yes
if No
ft
ft
If septic tank is under driveway
comment below
Manure±Animal Excreta Storage > 104'
Community Sewer Main > 75' [ Yes
if No
ft
0 Yes
if No ft
From Septi 0HoIdling Tank on Lot to: {Please enter distances if less than required}
Build! ng Foundations > 10'
0 Yes
if No
ft
Surface Water > 100'
U Yes if No ft
Property Line 5 5"
0 Yes
if No
ft
Wells on Adjacent Lots:
Wells on Adjacent Lots:
Absorption Field > 5-
� Yes
if No
ft
Private Wells > 100'
lies if No ft
Mater Alain > 10'
0 Yes
if No
ft
Community Wells > 200'
0 Yes if No ft
dater 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`
Q
Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
❑
Yes
if No
ft
Wells on Adjacent Lots:
Water Alain > 10'
El
Yes
if No
ft
Private Wells > 904' Q Yes if No ft
Water Service Line > 94'
[j
Yes
if No
ft
Community Wells � 200' 0 Yes if No ft
Surface Water > 100'1
Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
f certify that f have determined through fie?d inspections and review
of Municipal records that the above systems are in conformance with
MOA COSA guidelines in effect on tho date.
AV
* .�49 TH •• ter'
io............
Steve Eng
1�
C-6 256
TAMP
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT • '�
On -Site Water and Wastewater Section
www.muni.org/onsite
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC201542
Subdivision: Dunckle, Lot: 84B
907-343-7904
Fax: 343-7997
A water sample revealed a nitrate concentration of 7.42 milligrams per liter (mg/L).
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. Since nitrates are known to slowly increase, we recommend
you monitor the water quality. 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.
ARCTIC PUMP & WELL INC.
'APOSullivan
PO Box 770197
CAYREIIi71j[Hmill Eagle River, AK 99577
u[s a s®rxt (907) 688-2510
? (907)243-2282
jim ,arcticpump.com
Pump Installation Log
Well Drilling Permit Number: SW Date of Issue:
Parcel Identification Number: 051-092-60-000
u
�=
Arctic Pomp & Well, Inc.
Page 1 of I
Legal Description: Dunckle
Property Owner Name & Address:
Lot: 84 B
Block:
Sharon Dunckle
21131 Jayhawk Dr
Chuiziak AK 99567
Pump Installation Date: 10-8-20
Pump Intake Depth below Top of Well Casing:
Pump Manufacturer's Name:
Pump Model: e
Pump Size:
Pitless Adapter Burial Depth: 1
Pitless Adapter Manufacturer's Name:
Pitless Adapter Installer: U/K
Well Disinfected Upon Completion? Yes
Method of Disinfection: Chlorine
Comments:casing 40' + with no perforations verified with camera
Pump Installer Name:
Arctic Pump & Well, Inc.
Arctic Pomp & Well, Inc.
Page 1 of I
Dunkle Lot 84B 051-092-60
1.6
UNK UNK N/A
40+*
10.7
18+
7/11/23 Forge Engineering
63.9 6/26/23
*Per pump installation log in muni file
48"
7/17/23 JR's
5.0
3.2
N/A N/A
N/A
7/11/23
0
2422
0
1440
0
> 450
24
0
24
Individual Water Storage
Community Class Well
Public Water System
❑ . 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 5 by an independent professional civil
engineer registered in the Slate 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.
I
' 4 STATEMENT OF INSPECTION BY ENGINEER, �+.; #ri fta+it1! a '
"r +
( As;cerlif, by my, seallat hereto -am ' fie alklati Well s
1 based on procedures`ou0lned.in the H T i 1h A�prov�dlioes s a pir�d
d on-sde wale[ supply and/or wastewater disposp�sysjem•.m(are)'safe; tont tl "1 •;
j' bedrooms and type of structure indicated herein I iDHHer verdy ttf�hba' 11 _ n '� e
j Mumapality of,Anchorage'files and from my investigation and'InspecHon
a` wastewater disposal'system is(are) in compliance wrth`all applicable Municipa e d 6 n� c
- and regulations in effect at the bine of installation -�
Name of Firm 'Anderson Engineeri"no hone 22•
Address P 0. Box 240773 iAnchorage AK 99524
is Engineer's Fnnted Name Michael E Anderson P E Y- ,D�te� •.;:..811512001"
r ^�r
I a • Y. ., i ir.M �� r� Lt,/L R.in
y lHN H.a.. Ja'�y.t a
`v°„ MIOiAKV 37N(f$t$GN da.
5: • DSD.SIGNATURE . 0 % CE •4'.81'
`
Approved for bedrooms * �Er� Fkorf55to�y�
i 'a
-Disapproved
Conditional approval for bedrooms with the foll *wing sbpulatiwns Pt���(pF
j ON-SITE •�
AND m;
WA$7EWATER
P r
Additional Comments
Note 'The well for.this property meets -existing State and Municipal+Codes .There arc m .itJg911))))111 ,
pr"ont,J"sSn(;gCS C:IOdIC tCSt10g 1)e PCrfOrnlCd t0 insff rr tho avrllc'rnnhmferl cuitahilify _,
. _. ..
Current nitrate concentrption i's 6.16 mg/1- EPA'maximum concentration is 10.0 rng/1.' More
int Drina wn on m ra cs is aval a c roin a n- 1 c ervlce , -
Attachments:.
HAA Checklist X Maintenance Agreements.
Septic System Advisory Supplemental Eng ineers Report
Well Flow Advisory Other
By: W • Original Certificate Date: ^2 3 W
(Rev. I2L=)
Municipality of Anchorage
• Development Services Department
Building Safety Division
On.Sne 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 Desciiption: Lot 946. Dunckle Subdivision Parcel ID: 051-092.60
A. WELL DATA
Well type P"e
Date completed
Total depth ft.
Date of test
Static water level
Well production
If A, B, or C provide PWSID #
Sanitary seat (YIN) Y
Cased to»0 ft.
FROM WELL LOG
WATER SAMPLE RESULTS:
ft.
g.p.m.
Conform 0 coloniesl100 ml. Nitrate 6.16 mg.A.
Date of sample: 61312001 Collected by: JMA
B. SEPTICIHOLDING TANK DATA
Tank Type/Materiat SeptIdSteel
Tank size 1.000 gal. Number of Compartments 2
Foundation cleanout (YIN) Y Depression over tank (YIN) N
Date of pumping
C. ABSORPTION FIELD DATA
Pumper WA
Well Log (Y/N) N
Woes properly protected (YM) Y
Casing height (above ground) >2 + in.
AT INSPECTION
6f4R001
65 ft.
1.5 g.p.m.
Other bacteria _L colonies/IW ml.
Date installed 9712001
Cleanouts (YIN)
High water alarm (Y/N) N
Date installed 516x1001 Soil rating (g.p.dJfe or f'lbdr n)12 GPDISF System type S Wide Trench
Length 53 ft. Width 5 ft. Gravel below pipe 2 ft.
Total depth 6 ft. Eff. absorption area 178 ft' Monitoring tube Y Depression over field N
Date of adequacy test Results (Pass/Fal) For _ bedrooms
Fluid depth to absorption field before test _ in. Water added_ gal. New depth_ In.
Elapsed Time: _ min. Final fluid depth _ in. Absorption rate x g.p.d.
Any rejuvenation treatment (past 12 mo.) (YM & type) N If yes, give date WA
D. LIFT STATION
Date installed Size in gallons Manhole/Access (YIN)
'Pump on' level at _in. •Pump off' level at _ in. High water alarm level at in.
Datum Cycles tested Meets alarm ti circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankilift station on lot AW
Absorption field on lot MW
Public sewer main WA
Sewer /septic service line >25'
On adjacent lots MW
On adjacent lots >100'
Public sewer manhole/deanout WA
Holding tank WA
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
Building foundation >T Property line >T Absorption field >T
Water main WA Water service line >10' Surface water MW
Wells on adjacent lots >200•
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line T "' Building foundation >10' Water main >10'
Water Service fine MW Surface water. >100' Driveway, parking/vehicle storage >25'
Curtain drain None Noted Wells on adjacent lots >200•
F. COMMENTS
See Lot Line waiver allwho encroachment to within T of ommly Noe. QF
G. ENGINEER'S CERTIFICATION �Q:•••• „-i�) �'� f �1
�'_• 49111 'v „ *.
I cerh7y that /have determined through field inspections and
review of Municipal records that the above systems are in g
conformance with MOA HAA guidelines in effect on Itis date. ra , . ,,,l t{ iEERf
°GSTAW
Engineer's Printed Name Michael E. Anderson. RE 00� ✓i�9., �r
DatettnSA1 �4��;Ef Som pv`
HAA Fee $ '100-00 Walver Fee $ /hr, a o
Date of Payment g • J S =10 ( Date of Payment g- Is -IN l
Receipt Number 9731
(Rev. tsrao)
Receipt Number S 7 3?
AS -BUILT
I hereby Certify that I have surveYed the following described
pr erty:
��Y.�.F� ,� .....
.a• ,
VAnchorage
F
t c r -r•.c
OF A
•,.
•.
Recording Precin& Alaska, anti that the ?.fit rove-
¢. n ;,�.�s�� � ;�°�
ew .K Y
'"y�
mems srivated the are within the roperty lines. and if¬
a t. y
o ,�
PIP•;
t
avertap-car aricroach on tine property lying adjacent t6re#o�; thaE
no arovemeri on prs�perty. lyun thereto
"
g..
adracent encroach
on the premise's in
# `
Ci -r a v -0f
transmission bines or dElier visible easements or7 said property
t
G u � ROb Zrtnil.Son : ;; .•;
i
e, Opt as; in4iK t@d hereon".
paled at "E: tgle River. Ala4ka
.�ef� �ryy'
day of200 /
q'
>�. • ra ?•
SCALE: ltt3lT C. JOHIStOI�i; :.
Reg'ste 'ed Land Surveyor I`fo, g8?
�=
-LS
Box 77-0456; Eagle River, Alaska 4$577
P1,10ne (947) 544-2543
AS -BUILT
I hereby Certify that I have surveYed the following described
pr erty:
��Y.�.F� ,� .....
.a• ,
VAnchorage
1..-[i ldtr,� v 1 Al S vhf t"f
OF A
•,.
Recording Precin& Alaska, anti that the ?.fit rove-
¢. n ;,�.�s�� � ;�°�
ew .K Y
'"y�
mems srivated the are within the roperty lines. and if¬
a t. y
o ,�
PIP•;
t
avertap-car aricroach on tine property lying adjacent t6re#o�; thaE
no arovemeri on prs�perty. lyun thereto
"
g..
adracent encroach
on the premise's in
# `
questton and that there. are no .roadh!ays,
transmission bines or dElier visible easements or7 said property
G u � ROb Zrtnil.Son : ;; .•;
i
e, Opt as; in4iK t@d hereon".
paled at "E: tgle River. Ala4ka
.�ef� �ryy'
day of200 /
q'
>�. • ra ?•
SCALE: ltt3lT C. JOHIStOI�i; :.
Reg'ste 'ed Land Surveyor I`fo, g8?
�=
-LS
Box 77-0456; Eagle River, Alaska 4$577
P1,10ne (947) 544-2543