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HomeMy WebLinkAboutTIMBERLINE LT 6Timberline Lot 6 #015-164-02 Or _ Municipality of'Anchorage Department of Health and Human Services Building Safety Division On -She Water and Wastewater Program, 4700 South Bragaw Street P.O. Box 1%650 Anchorage. AK 99519-6650 Page 1 of 5 www.ci.anchorage.sk.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SWSWO10070 PID Number. 015-164-02 ram.: Wastewater System: ❑ New ❑ Upgrade Aaa.ss: 4701 GrummannrivP. 99-5137 ABSORPTION FIELD Prno.: ro.oe., a n.amem. D O..n lrwch ®sh.00.Twch Os.d ❑rww ODa.r. LEGAL'DESCRIPTION 90R.bnp0.6 TaWt>epdk.m.d°kwp.d.: BMOk: Lot aub&Aslo - . t Trimbertine D.Pth b pip. boa.m km uW •da� P.d.: 3 FL Grv.l dspet b.twai pip.: 2.0 lro~W: Fa.dd.d obwo orylnal prad.: Gr...I Lwgm: Ft. 60180 n. Well: New Upgrade C' "width` M.nb.rof1w 1)1 n bot. k": 5/5 n. 2 10 R. CMssae.km (PM.M, ^ 6. Cy: Private TOW Dnpth: ISO Casal b: TaW .Magbn rcn: PCPs ktNWW: Ft. 2 700 Ft6 f810/3034 DdFrr: AI ine Drillin D.a OtR.a 6/29/2001 SM W.h.Lw 13 Ft MWr. Beek Excavating D.M kaak.0: 7/12/2001 TMu:Punps" k na 16p D•"ragnt law.Gr : 6 cPu 'STS n. 2 Ft TANK SEPARATION DISTANCES 0 Septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption 1111 Holding Pubwprivate Manif� D.P•r7 From Tank Field Station Tank se Lkw Anch Tank =1 250 W" 137 102 100+ M.b.im Steel Na of cwnp.m.tm 1 2 at.r o.w.w 100+ 100+ LIFT STATION wt. FouWtlat 6 10 TP Pon wIti .. 'Pt.np mr MMK ttgn.mt,anm r. r ti ti cuMM ot.:t 100+ 100+ P.mp a".♦mo" EMcbkrkawbprkmrdby: R.twtka BENCH MARK Back Door Threshold Assunwd EMv"w6: 100.0 Ft Engineer's Stamp .& - 111111 OF • \ N.N. �,.•• Inspections performed by: Pannone Eng. Svc Dates: 1`7/12/2001 j 49TH 2"°07/12/2001 i Department of Health and Human Services approval •R. Reviewed and approved by:Date: y :StevenPonnone.:'Fr NO CE 8149 11�', c3s,Q .•• PERMIT NO, SWO10070 AS -BUILT P.I.D. NO, 015-164-02 WASTEWATER ABSORPTION SYSTEM LOT 6 TIMBERLINE S/D nI iii /� pl O nl � 1 m � � I I F, N W F I pm g F I % � h� % S N, W DRIVEVAY 7% ��H W I j O N 0 1 ��a 1 �7H EXf 'GISPRI PROPOSED 480a HOUSE H I 1 � � Ha I = N I �ON PROPOSED 1250 ,n Y gffi I X EPTIC TANK ��D1 g I C2 J, W DRI L FLOW I/ B P1�y SPLITT III II M2It 41 PRIMAR DRAINFIEl D SREA III l'-1 x5 x2'EFFT'V 1 TH 1 111 I( % 02.1 III I MEV It 1 ""--- I WELL CO A B 1 Tl 1 44.6 RVE DRAINFIELD AREA NO WELLS OR SEPT S 140LFx5'x2'EFFT'V T2 11. 52.1 1 WITH 200' OF PROP SED Cl 32. 75.7 1 SEPTIC SYSTEM AREA Ml 30. ,g 1 IS UNDEVELOP C2 53, 9.5 1 C3 43 78.9 M2 36 47.0 j 1) ALLWORK SHALL BE PFORMED C4 50. 32.7 1 IN ACCORDANCE WITH AMF.65. AS=BUILTi 1 2) MATERIALS USED SHALL BE IN PERC RATEi 19 MIN INCH Cl\Wo \6 RA LSEND. WG ACCORDANCE WITH THOSE SPECIFIED SOIL RATINGS 0.6 G D/SF IN AMCI5.65, WASTEWATER DISPOSAL. 250 SF/BEDROOM, 4 BEDROO � 3) CONNECT POST TANK LINE TO MID- 1000 SF REQUIRED, P(� ��� OF POINT OF DRAIN FIELD. TYPICAL. 12508 SEPTIC TANK :••�� •�•w'"•,` 40#' 4) INSTALL DRIVEWAY AT LEAST 5 FT 5 -WIDE TRENCH, 2' EFFECTIVE AWAY FROM DRAINFIELD. DO NOT INSTALL REDUCTION FACTOR=0.70 ' *!#O' DRIVEWAY OVER DRAINFIELD. 5' TOTAL DEPTH, 140 LF, i 49� 5) MAINTAIN 10' SEPARATION TO ALL 700 SF TOTAL LOT LINES. Steven R. Pannonef opPREPARED FOR PANNONE ENG. SVC, LLC No. CE 8149 f��� 4701 Wendett GrunThomason P' O• BOX 102954 jp•r•�•• Anchorage, AK 99507 ANCHORAGE, ALASKA 99510 i0,,' "1 •�• (907) 223-4891 DATE - A E2-8225102Phone & Fax us AS -BUILT PERMIT NO, SW010070 AS -BUILT DETAILS P.I.D. NO, 015-164-02 WASTEWATER ABSORPTION SYSTEM LOT 6 TIMBERLINE S/D d .Q - a NOTE, o 1) ALLWORK SHALL BE PERFORMED s IN ACCORDANCE WITH AMC15.65. L. 2) MATERIALS USED SHALL BE IN L 0 c ACCORDANCE WITH THOSE SPECIFIED e IN AMC15.65, WASTEWATER DISPOSAL. Lt } a 3) CONNECT POST TANK LINE TO MID- irem3m POINT OF DRAIN FIELD. TYPICAL. 4) INSTALL DRIVEWAY AT LEAST 5 FT AWAY FROM DRAINFIELD. DO NOT INSTALL DRIVEWAY OVER DRAINFIELD. i 5) MAINTAIN 10' SEPARATION TO ALL -tOT LINES. o+ a, a', o N W {2 W Z W W W F N 38111 WI NN W t3 2z O 1 J Z N. n IOD' Q N H LLJ a, ° W J H 1nONV313 E3 ci I N m 3.0 ++ M o a oc mr o s s u 0c; C1 1 1 N i 1fY1NV313 rl Ln NV313 C% 1nIlN= � L+ o Su CI\Work\5TRAILSEND.DWG 1 n NOtivarnoa 49R ♦♦ i i ♦ i�Steven R. Pannonei � ♦1 PREPARED FOR: PANNONE ENG. SVC., LLC No CE 8149 ��� i Wendell Thomson P. O. BOX 102954 ♦i!`�Q?1)3?�.'�i�'•� 4701 Grumman Drive ANCHORAGE, ALASKA 99510 �44,,' �;� r• Anchorage, AK 99507 ATE? 32580 PHONE & FAX (907) 223-4891 NOT TO SCALE AS—BUILT PANNONE ENGINEERING SERVICES :•�+� y', ♦♦ P.O. BOX 102954 4921 ♦j ANCHORAGE, AK 99510 (907) 272-8218 • ♦,\Steven R. Pannonef ♦♦� No.CE 8149 rf�� ♦♦ Qo'•1 PERPOR11Bd FOR. � ��0°D DATE PERFORMED, 7-12-01 4�,,�:'��.� LEGAL DESCRIMON: TH4 OR Onix ! Topma Z� a 4 TEaT H01S a 6 7 GM T a 9 Gm MW 9md rm! D� 10 11 14 BON 19 WAS GROUND WATER teoetc 14 ENCOUNTER= No IS IP YES, AT WHAT 16 DEPTH? -0-' TWTHOTE 17 DEPTH TO WATER AFTER NONnIORING? Dr 1a DAML, 83-01 19 90 PEROIATION RATE 19 (min/hed11 PERO HOLE DIAH&1 nd 8R 6 TBSP RUN BEW18EK 9 PT a 4 FT COMIEN 'S: Test hole eoo.vated by Dan Beek. Test Hole was pre9oalmd before pew test PERFORWM BY: Steven R. Pannone. P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH AIT. STATE AND 1[MCTPAL OUIDIINES IN EFFECT ON THE DATE OF THIS TEST: elor. i p+tu 1 O 1 1 X i 1 I 1 1 1 1 1 � 1 i I t H i 1 1 I I 1 1 READ= Milt O.al. ILLT 110I1H al• !LLT tan mis �eTtot DOW 1236 6• --- 1306 30 1 7/16• 1 9/16• 1306 — 6• (A36 30 1 7/16• 19/16' 1106 — 6• _� t1�30 36 1 7/16• 19/16 • Pannone Engineering Services, LLC P.O. Box 102954 Anchorage, AK 99510-2954 (907)272-8218 April 1, 2002 Municipality of Anchorage On -Site Water and Wastewater 4700 South Bragaw Anchorage, Alaska Re: Lot 6 Timberline Inspection Call -Ins Gentlemen, According to my records I called in two inspections for the installation of the septic system on the above referenced lot. The first inspection was called in on 7/12/01 at 8:00 A. M. and the second was called in on 7/12/01 at 1:00 P. M. Please call me at 227-3522 if there are any questions. Sincerely, Steven . Pahnon , C. E. Steven R. Panna CE -8149 i Mayor Municipality of Anchorage Department of Health and Human Services 825'L' Street P.O. Box 196650 Anchorage, Alaska 99519-6650 http:Hwww. c1.anch0rape. aK.us Permit Number. #SW 010070 Date of Issue: 4-16-01 Parcel Identification Number. 015-164-02 Date Started: 6-29-01 Date Completed: 6-29-01 Is well located at approved permit location? ® Yes ❑ No Legal Description: Timberline Lot 6 Property Owner Name & Address: Wendell Thomason 11101 Trails End Road Anchorage, Ak 99516 Borehole Data: Soil Type, Thickness & Water Strata Depth (ft) From To Method of Drilling ®mr rotary ❑Cable tool Casing type: steel stick-up 0 _ _ 2 Wall Thickness: 025 inches cobbley silty gravel 2 11 Diameter: 6 inches Depth: 25 feet Bedrock 11 172 Liner Type: Diameter: inches Depth: feet H2O 65 140 75 160 Casing stickup above ground: 2 feet Static water level (from ground level): 13 feet Pumping level: 1172 feet after 2 hours pumping 6 gpm Recovery Rate: 6 gpm Method of Testing: airlift Well Intake Opening Type: ❑ Open End ® Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet Grout Type: Bentonite#8 Volume: Depth: Start0 feet Stopped ± feet Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? ® Yes ❑ No Method of Disinfection: Clorine Tablets Comments: Well Driller. Alpine Drilling & Enterprises P O Box 110496 Anchorage AK 99511 Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property muni nr fhe well Ar;ller shall nrmrirle a well Inn fn fhe rle t nr W"Ith k 44nman Cen.inec ,.;thin f tla.a nFrmm�ler;nn MUNICIPALITY OF ANCHORAGE Development Services Department Onsite Water B Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM 1 WATER SUPPLY PERMIT Initial Permit Number: SWO10070 Legal Description: TIMBERLINE SUBDIVISION LOT 6 Date Issued: Apr 16, 2001 Expiration Date: Apr 16, 2002 Parcel ID: 015-16"2 Design Engineer: 0062 Pannone Engineering Services Site Address: 11101 TRAILS END ROAD Owner Name: WENDELL THOMASON Lot Size: 49665 SQ. FT. Owner Address: 11101 TRAILS END ROAD Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE. AK 99516 - This permit Is for the construction of: Q✓ Disposal Field E Septic Tank Ej 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 fora 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, seated, and heated to prevent freezing. Received By: Issued By: Date: Date: 4 ' Zb —01 �- Municipality of Anchorage • -�1 Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0/.5" / 64 — 02 Permit Number SWO/0070 Property owner(s) Wendell Thomason Day phone 223.4891 Mailing address (1) 4701 Grumman Street, No.1 S'!rF ,Mm gaddress (2) Anchorage, AK / / !D/ T'RA►LS END RD Zip Code 9955/6 Legal description (Lot, Block & Sub'd.) Lot 6 f&. T 1 M6E RL 1A/E Su a Legal description (Section, Township & Range) Lot Size t.+* —Acre(ED Number of Bedrooms 49 66F THIS APPLi'CATION IS FOR: 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. (Signature of property owner or authorized agent) Permit Fees: Date of Payment: Receipt Number: (Rev. 12/00) Waiver Fees: 01 Date of Payment: Receipt Number: -------- r- inect ne Sen•ices. LLC Anchorage, Alaska, 99510 March 25, 2001 Municipality of Anchorage Development Services On -Site Water & Wastewater Program P. O. Box 196650 Anchorage, Alaska 99519 Subject: Lot 6 Trails End S/D Well & Septic Permit Gentlemen: My firm was contacted to investigate the possibility of installing of a new system at the above referenced property. Currently the lot is undeveloped. Two test holes were excavated on the property on February 10, 2001 and are attached. Ground water was checked on March 3, 2001. No water was found at the time of excavation. Bedrock was ;encountered at the bottom of the test hole. e The lot is approximately 1. 136 acres in size. Lot 6 slopes to the northwest at a rate of approximately 20 percent. The proposed installation will be located in northern portion of the lot perpendicular to the slope on a relatively flat section. The proposed location will be greater than 100 feet away from the proposed well serving this property and 25 feet from the water service lines. The surrounding systems are located greater than 100 feet from the proposed installation. The lots surrounding this lot are developed, and do not conflict with the proposed installation. The proposed installation will not impact the future development of the surrounding or existing lots. See attached design. The new system will maintain over six feet vertical separation to the bedrock and over four feet vertically to the ground water. The owner may install both the primary and reserve drain -fields at the time of installation. Please contact meat 272-8218 or 227-3522 if you have any questions.PP�..� (. app `p r .... Sincerely, �•'' ,r9 7. . i ti 0... �.... ....................... teven R. Pannone, P.E. 0 i� iSteven F. Ponnone � ♦ c� CE 0��� �n ,oln32s Attachments:•°t'�: C: \ WORK\ LE7ERS\STRAILSEND.001.DOC PERMIT NO, SWOT DESIGN P.I.D. NOi 015-164-02 WASTEWATER ABSORPTION SYSTEM LOT 6 TIMBERLINE S/D R NJ � III O III III III DRIV........ ....... ...` �...:YX DoH NM 1- j g5y EXI 'G�SPRIN PROPOSED 4B a �.. „ HOUSE � Qp, W i -.11 TA FLOW g a PLITTE :, ....... __.._... H PROPOSED 1250 rn g H 'X SEPTIC TANK wu I IIIc �N DRIVEVAY:--� PRIMARY DRAINFIEL SREA �...<5 TH II III III Irf �-PROPOSED WELL i i RESERVE DRAINFIELD AREA I NO WELLS OR EPTICS 140LFx5'x2'EFFT'V I WITH 200' PROPOSED I SEPTIC SY EM - AREA IS UND ED NOTE, 1) ALLWORK SHALL BE PERFORMED IN ACCORDANCE WITH AMC15,65. DESIGN, 2) MATERIALS USED SHALL BE IN PERC RATEi19 MIN INCH Cl\Wo \6 RA LSEND. VG ACCORDANCE WITH THOSE SPECIFIED SOIL RATING, 0.6 G D/SF aaaa IN AMC15,65, WASTEWATER DISPOSAL 250 SF/BEDROOM, 4 BEDROO ������ a���•• CONNECT DRAIREQUIRED,1000 SF N F ELD. TYP CAL. MID- 12500 SEPTIIC POINTOFTANK �►��P� w�` "1 4) INSTALL DRIVEWAY AT LEAST 5 FT 5 -WIDE TRENCH, 2' EFFECTIVE AWAY FROM DRAINFIELD. DO NOT INSTALL REDUCTION FACT13R=0.70 �} ♦ DRIVEWAY OVER DRAINFIELD. 5' TOTAL DEPTH, 140 LF, 49—TH 5) MAINTAIN 10' SEPARATION TO ALL 700 SF TOTAL '� ' " s LOT LINES. -� PREPARED FOR, PANNONE ENG. SVC, LLC 7.jSteven R. Pannone/ .P, O, BOX 102954 � Wendell Thomason ,. No. C 149 4701 Grumman Drive ANCHORAGE, ALASKA 99510 Anch(907) 223- 9 99507 272-8218 Phone a Fax • , �ld� � C907) 223-4891 •• �� ATEi 3 -25 -DI DESIGN aaa. PERMIT NOi SWOT DESIGN DETAILS P.I.D. NOi 015-164-02 WASTEWATER ABSORPTION SYSTEM LOT 6 TIMBERLINE S/D m a. FL NOTE, c 1) ALLWORK SHALL BE PERFORMED .O° u IN ACCORDANCE WITH AMC15.65. L° a 0 2) MATERIALS USED SHALL BE IN L e ACCORDANCE WITH THOSE SPECIFIED a e IN AMC15.65, WASTEWATER DISPOSAL. L 3) CONNECT POST TANK LINE TO MID- uoN POINT OF DRAIN FIELD. TYPICAL. 4) INSTALL DRIVEWAY AT LEAST 5 FT AWAY FROM DRAINFIELD. DO NOT INSTALL DRIVEWAY OVER DRAINFIELD. 5) MAINTAIN 10' SEPARATION TO ALL LOT LINES. C Z mr E7 H U Ld :inoN t—JJof > L3 N ln@N3m inaw= LnONV3M C,\V ork\5TRAILSEND.DWG ""12%51 PKLVAKLil FUN, mnone w 149 4 i Wendell Thomason 4701 Grumman Drive Anchorage, 99507 (907) 223-4899 1 H W Z W W W �— N Qu .. z 3, o � J thz N PANNONE ENG. SVC., LLC P. 0. BOX 102954 ANCHORAGE, ALASKA 99510 DESIGN SOILS LOG - PERCOLATION TEST PANNONE ENGINEERING SERVICES P.O. BOX 102954 ANCHORAGE, AK 99510 (907) 272-8218 PERFORMED FOR Wendell Thomason DATE PERFORMED: 2-30-01 LEGAL DESCRIPf10N: 1At 6 T1Al1s End 8/D Organic OR TopwO I —r�.Z 2 ML/OM 3 a 9 10 11 12 13 14 15 16 17 IB 19 20 OY BOH Grey 90(y Easy DIW 49TM W ren R. No. CE E-1 WAS OROUND WATER ENCOUNTERED? No IF YES, AT WHAT DEPTH? -0-' DEPTH TO WATER AFTER MONITORING? Dry DATE: 3-3-01 TEST HOLE READING DATE GROSS TWE NET TIME DEPITIOP WATER NET DROP 2-10-00 1236 6• 1346 30 4 7/16• 1 9/160 1346 6• — 1336 30 4 7/16• 1 9/16• 1336 -- 6• 446 30 4 7/16• 1 9/16' PEROLA77ON RATE 191n1InAnchl PERC HOLE DIAMETER TEST RUN BEWTEEN 2.5 FT and 3.5 FT COMMENTS: Test hole excavated by Dan Beek. Teat Hole was presoaked before pert test. PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WPPH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. *0 OF toff,, SOILS LOCI - PERCOLATION TEST �•��p , �- +ti •��i PANNONE ENGINEERING SERVICES P.O. BOX 102954 49—" S ANCHORAGE, AK 99510 i (907) 272-8218 j�Fj Steven R. Pa non i �1 No. CE 8149 PERFORMED FOR Wendell Thamsaoa DATE PERFORMED: 2-10-01 �1■ `"""' )Q11�'••• LEGAL DESCREMON: Lot 6 TmHa End S/D ',�■ � O�ullo- SLOPE PLAN OR TopeoO 1 �3 2 ML/GM s 4 TEST HOIZb 6 7 GM b 9 10 1l 14 BOH 13 14 IS 16 17 18 19 20 PEROLATION RATE 19 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BEWTEEN 3 FT and 4 PT COMMENTS: Teat hole excavated by Dan Beek. Teat Hole was presoaked before pert teat. PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. d �x WAS GROUND WATER SLOPE lil1ADIN0 DATE GROW Tum NCr Tam DEPTH OF WATER NCI' DRO(' 2-21-00 1236 6• 1106 30 1 7/36• 1 9/16• 1106 6• 1136 30 4 7/16• 1 9/16• 1406 6• 1436 � 1 7/16• 19/16• ENCOUNTERED? No IF YES, AT WHAT DEPTI{7 -0-' TEST HOLE DEPTH TO WATER AFTER MONITORING? D DATE: 3-3-01 lil1ADIN0 DATE GROW Tum NCr Tam DEPTH OF WATER NCI' DRO(' 2-21-00 1236 6• 1106 30 1 7/36• 1 9/16• 1106 6• 1136 30 4 7/16• 1 9/16• 1406 6• 1436 � 1 7/16• 19/16• MMMMpAUTY OF ANCHORAGE 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. 015-164-02 1. GENERAL INFORMATION Expiration Date: Complete legal description Timberline, Lot 6 Location (site address) 11101 Trails End Road Anchorage, AK Michael Aaanvi & Roxanne urrent property ownei=(s)-------Mailing address - --- 111.01 _T_rails End Road, Anchorage, -AK 99507 Real estate agent Rona Florio 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Muitiple Dwellings (Single Family and/or Duplex) Day phone 748-4500 3. NUMBER OF BEDROOMS: ` 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well®❑ Private Septic W Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ �s 5 i d �� Waiver Fee $ Date of PaymentZ/B1Zd Date of Payment Receipt Number 08791 -p Receipt Number COSA # IS C-2 0 150 50 S' Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, i verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply anti/or wastewater dignncal cyctem 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone (907) 522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE Ll Date 9/16/2020 OF°°a�►� 49th_ •' System #1 Approved for bedrooms _�k 641CHAEL E. ANDERSON ; a System #2 Approved for bedrooms 0, X, �..,..'�ocE-4381 =�=Q Disapproved �116120 4$©epi'ORGFESS�C�P®��� om 0 °aR1%,a Conditional approval for bedrooms, with the following stipulations LIZ Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist Legal Description: Timberline, Lot 6 Parcel ID: 015-164-02 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA no Well log is filed with Onsite (or attached) Date drilled 6/29/01 Total depth 160 ft Cased to 25 ft 0 Sanitary seal is functioning correctly on Wires are properly protected Casing height (above ground) >18 in. Date of flow test for COSA 9/10/20 Static water level at beginning of test 13.95 ft Comments B. TANK DATA Age of tank(s) 19 years Tank type/material SEPTIC/STEEL Measured operating fluid level in septic tank 50 ❑■ Standpipes/foundation cleanout per record drawing Date of pumping 5/21/20 - Isaac's Pumping D. ABSORPTION FIELD DATA 5' Wide Trench Which system tested (date installed) 7/12/2001 0 ALL standpipes present per record drawing Total measured depth from grade 5.5/5.8 ft (max) Measured depth to pipe invert from grade 4.3/3.9 ft (min) ❑ N/A — pressurized field ■❑ Monitor tubes go to bottom of effective. If not, state depth into effective 1211.9 ❑E Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced N/A gallons Comments/Deficiencies: COSA Checklist yellow sheet Well production at time of test 2.5 gpm Water storage tank volume None gallons Well disinfected for coliform test? ❑ Yes ❑ Nc F0 Coliform bacteria is Negative Nitrate 4.86 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L 0 Arsenic less than MRL (ND) Collected by FORGE ENGINEERING Date of Sample 9/4/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Gravity flow system. Adequacy test date 9/10/20 Results F1 Pass For 4 bedrooms Fluid depth prior to test 2/6 in Water added 699 gal New depth 7/13 in Elapsed time 1385 min Final fluid depth 2.5/6.5 in Absorption rate '600 gpd Any rejuvenation treatment (past 12 months) No If yes, enter date ***The north clean out for the west trench could not be found. E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ✓� Yes if No Community Sewer Manhole/Cleanout > 100' 0 Yes if No ft ❑✓ Yes if No Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25'✓71 Yes if No Absorption Field on Lot > 100' 0✓ Yes if No ft Holding Tank > 100' ❑✓ Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50'✓0 Yes if No ❑✓ Yes if No ft if No ft F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0✓ Yes if No ft 0 Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0✓ Yes if No ft Surface Water > 100' ft ft ft ft ft 0 Yes if No ft Property Line > 5' ✓� Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0✓ Yes if No ft Private Wells > 100'✓0 Yes if No Water Main > 10' ✓0 Yes if No ft Community Wells > 200'✓0 Yes if No. Water Service Line > 10' 0✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10'✓❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓❑ Yes if No ft Private Wells > 100' Yes if No Water Service Line > 10' 0✓ Yes if No ft Community Wells > 200' 0 Yes if No Surface Water > 100'✓Q Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l 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. COSA Checklist yellow sheet ©oQ�o l aIIq pp� I.. AL ©00 a�P • S� 0© /-9 th• � o ..... �................. �...... a ...un.n.................... unuuuuu... � 0.MICHAEL E. ANDERSON 4., � p QO ��':�•� iJo. CE -4381 ,�\�ZF o �@ F/> '•••9/16/20. ,.••�••Fr a pFp •........... PROF ®b®®Dlatio�®0�� ©®® ft ft ft ft 8440J cn X m m D TRAILS END ROAD m=Z m Z o cn — - ------ -- — O O ozm o a NORTH 165.00 Mo mx _ M m o >'�` 10' Utility Easement O x _ •^;?. z m 'Y. z GfIt � •.!,"/fie. /� o • CO m r: i3 0 00 M00 d rn 06E7` V r ®`p 0 :,,, o AMV AMW co O c Ile 000 a O 35. a 22.0 -0 0 a 28.0 - c M O T. 2:p s< j m m v D to % o o- °' a n o io' p o 0 24.0 0 A m 3 (V =3 o m° m o K a a o N deck r•, �` 76. _ Sip � n cn � � � ,:..,,:�•;:``'<jr'�s� i' rt.' ,.1•,•1. 6i D to m .0.. ro ip r O :Oz. �r coi .� GD ro < o z C S (� ro �_ N ro tc] CD wt:i'Yi ,'N'•i`•'Y,�,•,n.1� :•�:�.. � 0 -1+6 o m o m 5 � o ?'.ss- �r,; ,:i x ,: � r;�• ,.: ;b_�•°x� °i D w o o ro Qio Z 28.0 m °� Q N_ @ .s.f•. : M"n 0) m a co rn Fa o QCD S7 0 o o ;U tg•Om o -8 +3 0 o Om o Z m m ro o m w Z m CD c- 3 v 3 m (n mD X a m rj) w .w o a �a o m S -i C w z �D i.� e'acb�am co cn o� o o N ro D aon °' tv `� N NORTH 165.00 00 I a � n x' Cl) U w Parcel I.D. 015-164-02 Municipality of Anchora On -Site Water and Wastewater Program (907)343-7904 �1 ASG Q �Z Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description TIMBERLINE; LOT 6 Expiration Date: f I — Q9 ! SCJ Location (site address) 11101 Trails End Road `Anchorage 99516 Current Property owner(s) Michael Faust Mailing address Day phone 717-9193 Real Estate Agent Kathy Fernandez Day phone 441-9000 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 19 ------- -4. TYPE OFWATERSUPPLY:_____ ❑ Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ WaiverNariance request for: N/A 1914:2 =11150 911115V_FI I ArJ/_1111 I =1 zip] 6Yael-f 1 1; Individual 19 Holding Tank ❑ Community ❑ Public Sewer ❑ Received by: / Date: v l% COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 52-U,00 Date of Payment Rt 5lgol(v Receipt Number 0151,0C COSA # ©KI (0 f 3'fD Waiver Fee $ Date of Payment Receipt Number Waiver # N/A 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-siteter supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of be&6erns and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Garness Engineering Group, Ltd. (GEG) Phone (907) 337-6179 Address 3701 E. Tudor Road, Suite 101, Anchorage AK, 99507-1259 Engineer's Printed Name Jeffrey A. Gayness Date In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the systems on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend on a variety of variables including, but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the systems; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail. The content of this report is for the sole benefit of the person/party who retained GEG. Reliance upon the information provided in this report by any other person or party, including but not limited to subsequent property purchasers, is not authorized. In short GEG disavows any legal duty to anyone other than the person/party who paid for this report. 6.- DSD SIGNATURE System #1 Approved for bedrooms 0 System #2 Approved for bedrooms Disapproved 0/3/16 Conditional approval for bedrooms, with the following �\QP��CY OF�ry�y Ja ON-SITE �. WATER AND PROGRAM Original Certificate Date: -&` The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work. ATTACHMENTS: COSA Checklist_ Nitrate Advisory �C Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 9-Y12doc 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: TIMBERLINE; LOT 6 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N A Date completed 6/29/01 Sanitary seal (YIN) YES Total depth 160 g, Cased to 25 ft, FROM WELL LOG Date of test 6/29/01 Static water level 13 ft. Parcel ID: 015-164-02 Well Log (YIN) YES Wires properly protected (YIN) YES Casing height (above ground) 18+ in. AT INSPECTION 6/20/16 20.7 ft, Well production 6 g.p.m. 2.6+ g,p;m, WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 5.31 mg./L. Collected by: GEG. Ltd. Arsenic: NO ug./L. Date of sample: 6/21 A6 B. SEPTICMOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 7/12/01 Tank size 1250 gal Number of Compartments E Cleanouts (YIN) Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (Y/N) N/A . Date of pumping .t o l® Pumper 14(h e, St iu:c,0-5 C. ABSORPTION FIELD DATAfl aE�ow ExISTINc cRAOE EAST/WEST . Data installed 7/12/01 Soil rating p.d. or 0_6 System type TRENCH Length 80/60, i {{, ,Width 5/5 ft. Gravel below pipe 2/2 ft. Total depth *5.8 5 4R: Elf. absorption area 1000 ft2 Monitoring tube YES Depression over field NO Date of adequacy test ' 6/20/16 Results (pass/Fail) PASS Qpr�bkrooms Fluid depth in absorpt[. n field ;before testL in. Water adde378/304 l. New dep h12 5 o 1 . Elapsed Time: 0 min. Final fluid depth 9 13 in. Absorption rate >= 6a0+ g,p,d, Any rejuvenM&n'*ebtf16ilt,(past-12 mo.) (Y/N & type) NONE If yes, give date D. LIFT STATION Date installed Size in gallons "Pump on" level at in. "Pump off leve . E. SEPARATION DISTANCES y_, Manhole/Access water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank(lift station on lot 100'+ On adjacent lots 100'+ Absorption Feld on lot 100'+ On adjacent lots Public sewer:main Sewer /septic service line 25'+ Public sewer manhole/cleanout 100'+ Holding tank Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line UNKNOWN Surfacewater 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line UNKNOWN Surfacewater *100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *EXISTING SPRING NOTED ON PANNONE RECORD DRAWING DATED 3/25/02 COULD NOT BE FOUND. G. ENGINEER'S CERTIFICATION I certify that l 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. Ehdineer's Rrr//'y�j��Is Name JEFFREY A. GARNESS Date (Rev. 11/09) -* &Ede (3 sLf Municipality of Anchorage Pxkinrt" ik.5�::.< Development Services Department Building Safety Division p 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 # OSC161340 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 6 of Timberline subdivision. This inspection revealed a nitrate concentration of 5.31 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. Nitrate Fact Sheet 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. Municipality of Anchorage C Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. _012- / a COSA#. Q S 10 C --?0 Expiration Date: a / 3 — / o 1. GENERAL INFORMATION Complete legal description Lot 6; Timberline Subdivision Location (site address) 11101 Trails End Rd. Current Property owner(s) Wendel & Twilla Thomason Day phone 277-0077 Mailing address same Lending agency Day phone Mailing address Real Estate Agent Bill Babylon Day phone 351-4762 Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well ❑Q 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 Onsite 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 S & S Engineering Address 15861 S. Birchwood Loop Rd. Chugiak, AK! Engineer's Printed Name Robert A. Shafer 5. DSD SIGNATURE Approved for _� bedrooms. Disapproved. Phone 694-2979 Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Cil/ Original Certificate Date:_,_' 3 / (. „M) V Municipality of Anchorage e 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: f, oi- 'T7+abe,-Itn,L S/b Parcel ID: O /S / r 1 0.2_ A. WELL DATA Well type iJc 4-e,- If A, B, or C provide PWSID # _ Well Log (Y/N) Y Date completed4 2ii/l32't Sanitary seal (Y/N) Wires property protected (Y/N) Total depth Lto ft. Cased to ZS ft. Casing height (above ground) n. + FROM WELL LOG AT INSP C ION Date of test 6 Zq ( S 3 / o Static water level /3 ft. Z. ft. Well production ro g.p.m. o g.A- WATER SAMPLE RESULTS: Coliform colonies/100 mL NitrateZ •'���(_ mg/L Other bacteria colonies/100 mL Arsenic: S ug/L date of sample: 7Z -L110 Collected by: 5 5 S C k%$) C#,41r -'ice B. SEPTIC/HOLDING TANK DATA ,- Tank Type/Material `J �IS t ` e T L��- Date Installed -7 1 Z V Tank size_ gal. Number of Compartments Z Cieanouts (Y/N) �f Foundation cleanout (Y/) �% Depression over lank (Y/N) L/ High water alarm (Y/N) _ _J Date of pumping S S O Pumper A { C. ABSORPTION FIELD ATA Date Installed 1 J I Soil rating g.p.d./f or ft2/bdrm)y • (o System type S%o Lw '{"Ac Length (00/Go ft. Width s/5 ft. Gravel below pipe 2 ft. Total depth S ft. Eff. absorption area—ft' Monitoring tube .�.* Depression over field AJ Date of adequacy lestJt� !J /D Results (Pass/Fail) ?0155 For L bedrooms Fluid depth in absorption field before test r3 in. Water addedCOD gat. New depth i'S in. Elapsed Time: I2r7 min. Final fluid depthlc in. Absorption rate >= 11�00 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) 0 o If yes, give date D. LIFT STATION Date installed Size in gallons 'Pump on'level at _ in.,!Pu o levw Cycles tested E. SEPARATION DISTANCES (YIN) at _ in. High water alarm level at SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot too r -t Absorption field on lot D O t -F Public sewer main If %} Sewer /septic service line 25�r�_ Animal containment areas 6c),4 Meets alarm & circuit requirements? in. On adjacent lots /Do 4 On adjacent lots t n D r-fr-f Public sewer manhole/cleanout��- Holding tank��h Manure/animal excrete storage areas& i)n -+- SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation * Property line + Absorption field IS- Water main to rlrl Water service line 1014- Surface water /U d '4 Wells on adjacent lots t O 1'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line !J r4 Building foundation /Ora Water main / O r* Water Service line I 0#+ Surface water L O eD 1f Driveway, parkinglvehicle storage to Curtain drain naek ^cK-% Wells on adjacent lots 101) + F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have detemtir review of Municipal records conformance with MOA CO$) Engineer's Printed I Date s� ughfield inspections and that e a6pppve (((sss are quid �es ih e�y th�`�� COSA Fee 3 0 Date of Payment 5 rb Receipt Number (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number Nor,.. P400 UV4 7n(1 1( cx c.,r SCS Ref.M Client Name Project Namdp Client Sample ID Matrix 1101728001 S & S Engineering L6 Timberline SD L6 Timberline SD Drinking Water Printed Datt/17me Collated DateMme Received Datefrime Technical Director 04/302010 8:57 0426/2010 13:30 04262010 13:55 Stephen C. Ede Sample Remarks: 4500NO3 - Total Nitrate/ Nitrite - NIS recovery did not meet QC criteria; biased low. The LCS recovery is within QC criteria. Allowable Prep Analysis Results Lt3 Parameter O Units Method Container 11) Limits Date Date Init Metals by ICP/MS Arsenic Waters Department Total Nitratc/Nitritc-N Microbiology Laboratory Colony Count Fecal Coliform Total Coliform 5.000 5.00 ug/L EP200.8 C (<10) 04/28/10 0429/10 NRB 2.31 0.100 m8/L SM204500NO3-F B (<10) 0427/10 AYC 0 coVI00mL SN1209222B A (<200) 0426110 DLC 0 coV100mL SM209222B A (<I) 0426/10 DLC 0 coVIOOmL SN1209222B A (<D 0426/10 DLC CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-164-02 COSA # OLP O I'a Z2 Expiration Date: 8 — / S — O & 1. GENERAL INFORMATION Complete legal description Lot 6 Timberline SID Location (site address) 11101 Trails End Drive, Anchorage, AK 99516 Current Property owner(s) _ Wendell & Twvla Thomason � A Municipality of Anchorage Mailing address 11101 Trails End Drive, Anchrome, • Development Services Department Building Safety Division Onsite Water and Wastewater Program , A , r, 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-0650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-164-02 COSA # OLP O I'a Z2 Expiration Date: 8 — / S — O & 1. GENERAL INFORMATION Complete legal description Lot 6 Timberline SID Location (site address) 11101 Trails End Drive, Anchorage, AK 99516 Current Property owner(s) _ Wendell & Twvla Thomason Day phone 561-3201 Mailing address 11101 Trails End Drive, Anchrome, AK 99516 Lending agency Day phone Mailing address Real Estate Agent Vivian Werth Coleman/Dynamic Prop Day phone 261-7653 Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 13. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ 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 Onsite 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, 1 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. 1 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 ±annone Engineering Services LLC Phone - 272-8218 Address P.O. Box 102954 Anchorage AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date Engineers Comments: In conducting an adequacy test, l attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. thC operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system These conditions are outside the control of the evaluator of this system All Systems eventually fail an satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. PES can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or parry is not authorized nor will it confer any legal right whatsoever. S. DSD SIGNATURE Ll__� Approved for _4 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: I Original Certificate Date: - / j - oto (Rev 11/05) Municipality of Anchorage ,• Development Services Department Building Safety Division On -Site Water & Wastewater Program 47W Bragaw Street P.O. Box 196650 Anchorage, AK 99519-650 www.muni.org/onstte (907) 3437904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 6 Tlmbedine SID Parcel ID: 01516402 A. WELL DATA ^ I Well type P If A, B, or C provide PWSID a _ Well Log (Y/N) Date completed 417$1M. Sanitary seal (YIN) Y Wires properly protected (Y/N) Total depth _¢Q _ft. Cased 10 eft. FROM WELL LOG Data of test 612912001 Static water level 13 fL Well production 6 9•P•m• WATER SAMPLE RESULTS: Coliform _I_oolonies1100 mL Nitrate 2.79 m91L Arsenic: mgn Date of sample: AMM B. SEPTICIHOLDINO TANK DATA Tank TypelMaterial 6021101806 Tank Steel Tank size 1250 gal. Number of Compartments I Casing height (above ground) 24• in. AT INSPECTION 21.2 fL 5.3 g.p.m. Other bacteria 0 oolonies/100 mL Cleanouts (Y/N) Foundation cleanout (YM) Y Depression over tank (Y/N) h High water alarm (YIN) HNA Date of pumping NEW Pumper A+ Home Servim C. ABSORPTION FIELD DATA Date Installed 7112/2001 Soil rating (g p.d./ft? or felbdrm) 0.6 System type Shallow Trench Length 601¢0 ft. Width 3 ft. Gravel below pipe 2 fL Total depth I& R Eft. absorption area We Monitoring tube Y Depression over field if Date of adequacy test 31512006 Results (PasslFail) Paas For 4 bedrooms Fluid depth in absorption field before test 49 in. Water added§M gal. New depth) 1� in. Elapsed Time: 40 min. Final fluid depth 02 in. Absorption rate >= 600+ g p.d• Any rejuvenation treatment (past 12 mo.) (YIN & type) No If yes, give date 1 D. UFT STATION Date installed 'Pump on" level at _ in. Datum Sizein oal "Pump off" level at Cycles E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 137 Absorption field on lot _102 Public sewer main 100+ Sewer /septic service line 25+ Manhole/Access (Y/N) in. High water alarm level at in. Meets alarm & circuit requirements? On adjacent lots _100+ On adjacent lots 100► Public sewer manhole/cleanout 100+ Holding tank J00+ Animal containment areas 100+ Manurelanimal excrete storage areas 100+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation _6 Property line -.V+ Absorption field 10 Water main 100+ Water service line 25+ Surface water 100+ Wells on adjacent lots 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 100+ Water Service line 25+ Surface water 100+ Driveway, parkingIvehicie storage 25+ Curtain drain None Observed Wells on adjacent lots100 F. COMMENTS G. ENGINEER'S CERTIFICATION cethat 1 have determined through field inspecdons and review of Municipal records that the above systems are in conformance with MOA COSH guidelines in effect on this date. Engineer's Printed Name Steven R, Pannone. P.E. r� � s:e,e r< Fa • "K r+ CE &140 r=` Date Q fy: COSA Fee $ q30 -On Date of Payment Receipt Number z71467 r7 9?ti9 (Rev. 11/05) Waiver Fee E Date of Payment Receipt Number OVCUM6 17:27 343:934 WATK1NS ENGR PAGE 02 SG9 SC: "0 1061901001 CUMNaue WakJ=Enginecirg pM*t`4wweur TimberkneLot 6 Client 3aepkID Tbrbatxe Lot6 Marta DcinklOg WSW PWSID 0 Sample Remarlm: All Deke?iwe ere Alaelu 8tanderd Tier PAPWDoeMme W -02,C06 13:90 Cog mod DoWThae 04M82006 20:55 4ertlrrd Datemme 04119QOC616:14 TedmhalDlroewr et.wo Cldr All w We " Aarlyri !a�era ROWU POT. Unite Me" C.atrhffm Lnniq Dam lkr tre 3"tala tepa>•r.at K.n1uu4 u CaCO3 174 3.00 mt2 SKIN 20403 C 04'21)6 0627)6 WAW Water* Depazl>etat A'tuarN 179 0.103 mart. EPA 3332 D (o-10) O4/1S/6 AIA Mr.wN ND 0.100 syL EPA 5332 B ("I) 04/19,'06 ATA feivate, Individual Analysis Aluminum RTO :0.0 e8L MOM C 0421/6 0427/6 WAW Andmmv ND 1.00 mat MY).$ C 04!!1/6 0427/6 WAW Arwic ND 3.00 0p/L En30.8 C (-10) 04,/1/06 0427/6 WAW Buiem 57.1 3.00 oat EMS C (-WWI 042t/0 04127td WAW C64s1•Jm ND 0.300 GSL EP200.8 C ("D 042406 0427.'06 WAW Calcium 43800 900 NFL LP2M).8 C 04/2 LU6 0427;06 WAX Chrmnium ND 1.00 nal. EP200.8 C (< 100) 0421/6 0427/6 WAW corm 77.3 1.00 %SfL EMIM I C f -130C) W. A7d 0427)6 WAW Iron ND 230 art EP2004 C ("YX) 0421/6 04270 WAW [add 1.16 0.200 agt, EM0.8 C (—U5) 0421,96 0427,06 WAW Mnrerium 10800 S).0 Oat. EP200.8 C 042Ld9 04r27.W WAW Mengmw 228 too salt EMU C (�30) 04,21)6 04,27,M WAW Phoephorer ND 2nO Sgt EP200,4 C 04.21.06 Ot=IOS WAW Fluoride ND 0.100 mg'L FPA 3CO.0 8 (M) 0421M 0622)6 JET( Chio•ide 13.8 0.100 mgt. EPA 300.0 B !-250) 0421ft 0432/4 im Pomafam NO !00 Wt. EP20C.8 C 0421)6 0(.27/6 WAW Selenium ND 3.00 UIL EMS C (<►50) 0421,o6 067))6 WAW Sodium 4430 300 got V=4 C (c 270000) C42M 04127,16 WAW S:liarn 1190 290 agL EP200.8 C 0421)6 0427.06 WAW k 05/01/2006 17:22) 349:334 WATKINS ER3R PAGE 03 SCS /oral Client None Projeat!4as'Y Client Semple ID Mule MRID 1061901.001 wa:klra Ea6mrwnS Tuaberl:aeLot 6 Tbnberliae Lot 6 Ddnkmg Water 0 AD Datafnma on Aluka Standard Twee Trkrad DtwMme 04J2Sl2006 15.33 Co6ecwDataTlme 04113!2006 2015 Reolved Dat frimt 04119/2C06 16.24 Tedu al Dtravr Secolren C.Edo ADowtie ?IV Analrei+ Pcaerw R..oW PCL V2)." Ma6od Corbin ID 1+rb DR* 0.a lay Private individual AMIYaia Silver ND 1.00 cVL EnW.S C (—I30) 04x21/06 D4,71,6 9►Aw SLlfatc 23.6 0.100 mdL FPA 300.0 B (<-230) "21,6 UMM 1EM ThJlium 1TJ 1.M stilt E=.6 C (e:-2) 042106 04.27n6 WAW TatLI Di"vod Solids 1.71 10.0 my'L. &%=254CC D (x300) 04,21,06 l:? Zine ND 3.00 ur, EMM/ C (< SM) 04!11/)5 04+27,6 WAW MOW ND 2.00 ve/L EPSD0.2 C ("100) 04/21106 04.27,6 WAW HCC10 Alkallaf y 112 20.0 m&L 3M202320B D 041".1.06 PLW CO3 Af almity ND 20.0 tort SM202320B D 0421,6 PLW CH ADaIIaity NO 20.0 mS'L SM2023= D 0112M PLW Cceduc6vity 290 t.00 amborom SM2025108 D 092=6 KP 014 7.90 0.100 OH oritn EPA 150.1 D (6.5a.r 04')906 PLw Alkallaby 112 20.0 oti'L SM202320B D 64M.106 PLW TOW Coliforms 0 col!=mL Skt2092223 A (�-1) 04!1906 TLE 05/01/2006 17:24 3491934 WATKINS ENGP, PAGE 04 SGStCTtE EWROr4MENTAL SERVICES 200 W. POTTM CRIVE ANQQRAV_ALASKAM51G Td: M ww2.2EYa; - FfX W074%1Z301- I' Drinking Water Anelysb Report for Total -Coftrm Bacterid I 1Oral 901-� aEAo namua++ou. oN.avan.o..noi. aouwona ♦a+ta ... I ���� MMOeCOMPLRM2YWATnWJ"UIR-•••-. .. - .... - . QPUMXIkAM aTa7aM Ia1 „-� �� _ , %A iwn A.or AM- 13 WO PAwm' Olwi M.olea1.. &.wa C=rzr1 9AMFI E TYPE . mma bate: O f` ?! ` C3 ROYwM 0 1'MAdWWr a+ LM.N., "rnibeeliple -- — .. "weelob m eat i H_ 1',s — ap`°I.t►KPaa' TMAOM y totae M: oaur.0 r"' ' r Olw. TO bE COMMinM ■`( LABORATORY Owftky iR-+o,� ❑LMtwwfOlrwr•a • .. [3 RUM MMPLs 14aMI/Yr 5'i j10.Yw IF. _ _ _ MfiMslY taMlwr Fat., Ca "W : .... w........ w w w. w. w. w. w w..... w........................ w. w...... w... m w ws w w w . w... u. w. w.. o w w.. w. w . w. n ...... w . 1r Atm. ' "O"M P" R MIT/:A4C AN dIR Mdvd.wwatr. *�,4Vdjg /7'rr' TOW OA1anc Anwyft 'T- L0* aaat Aaaytlal Mahe! MMMAWa R.TO11iMRTIk PhOrtwC ❑ Faad ❑ Dem Oswt CeloNa►'100iaf. Mwobmn F*w YaAOftn: ,wa I�- L LM04VS(PIA) wr .J -L UrawwwwryY .�. P. P. r :. Fa w FW mm 12/1710') TaseduaalVW!LCeolpOeY'P farm 121T00,7M Municipality of Anchorage Development Services Department Building Safety Division �.t; �u On -Site Water and Wastewater Program "' "" 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.enchorage.ek.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-164-02 HAA #_ Expiration Date: % - 1. GENERAL INFORMATION Complete legal description , Lot 6 Timberline SID Location (site address or directions) 11101 Trails End Drive Current Property owner(s) Wendell Thomason Day phone 223-4891 Mailing address 4701 Grumman Drive, Anch, AK 99507 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Department of Health and Human Services (DHHS) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) on properties served by a single family cn-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. 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 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. (Rw. 11,99) 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation based on procedures outlined in the Health Authority Approval Guidelines for this 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Eno. Svc. Phone 272-8218 Address P.O. Box 102954, Anch. AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date 312512002 Engineers Comments: In conducting an adequacy test, I attempt to protide a thorough, conscientious engineering analysis of the system in accordance with MOA DIMS Guidelines $ Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily idcmitiablc features. The operational life craft wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions arc outside the control of the evaluator of this system. All ssicros eventually fail and satisfactory ten results do not guarantee future performance of the sstem, nor do they guarantee that there are no hidden defects or encroachments. PES can therefore not provide any warranty for future performance nor give any estimate of hoty long the system will continue to meet the operational requirements of the ADEC or N10A.DIMS. The content of diis report is for the sole benefit of die owner listed above. Any reliance upon or use of this report by any other person or party is not authorized nor will it confer am• legal right whatsoever. 5. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Expiration Date: (Rw. 11.99) X Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: 14 - / - c-2- Reissue 2 Reissue Date: I1�pp\\�� Municipality of Anchorage ,. ``; Development Services Department Building Safety Division ^ i On -Site Water and Wastewater Program r 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 6 Timberline Parcel I.D.: 015-16402 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID # Date completed 6/2912002 Sanitary seat Y Total depth 160 ft Cased to 25 ft FROM WELL LOG Date of test 612912002 Static water level 13 It Well production 6 g.p.m , WATER SAMPLE RESULTS: Colifonn— C=colonies/100 ml Nitrate o��r✓ mg/l Date of sample: 3125102- Collected by: LRP B. SEPTIC/HOLDING TANK DATA Well Log _v Wires properly protected Y Casing height (above ground) 24 in. AT INSPECTION 6/29/2002 13 It 9 -p.m Other bacteria "e— colonies/100 ml Arsenic mgA Tank Type/Material STEEL Date installed 7/12/2002 Tank size 1250 gal Number of Compartments 2 Cleanouts Y Foundation cleanout Y Depression over tank N High water alarm N/A Date of pumping Pumper NEW INSTALLATION C. ABSORPTION FIELD DATA Date installed 7/12/2002 Soil rating (g.p.d.M2 or HZ/bdrm) 0_6 System type 5 -WIDE Length 92M ft Width 5 ft Gravel below pipe 2.0 ft Total depth 5 It Effective absorption area 700 fl? Monitoring tube Y/Y Depression over field N Date of adequacy test Results (Pass/Fail) NEW For 4 bedrooms Fluid depth in absorption field before test in Water added gal. New depth in. Elapsed Time: min Final fluid depth in Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date (Rev. 11199) D. LIFT STATION Date installed Size in gallons 'Pump on' level at in"Pump off' level at Datum Cycles tested Manhole/Access _ in High water alar level at _ in Meets alarm & circuit requirements? _ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 137 On adjacent lots 100+ Absorption field on lot 102 On adjacent lots 100+ Public sewer main NIA Public sewer manhole/cleanout NIA Sewer /septic service line 102 Holding tank 100+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 6 Property line 34 Absorption field 10 Water main N/A Water service line 25+ Surface water 100+ Drainage 100+ Welts on adjacent lots 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 16 Building foundation 10 Water main N/A Water Service line 25+ Surface water 100+ Driveway, parkinglvehicle storage 25+ Curtain drain 100+ Wells on adjacent lots 100+ F. COMMENTS 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 HAA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone, P.E. Date 3-25-02 HAA Fee $ Date of Payment 3017 OZ Receipt Number (Rev. 1 IM) Waiver Fee $ Date of Payment Receipt Number iStSven F.. Np�nGner� T[ t I' S., m 1@0', 10 M o, o� 3D*- EAST 301.GO'-.._._.- �R "490 665 S.F Iri / oov. circ 1 l9 tOr I J I v� PP s�PT/C SRys to s 0 4 = EXISTING • . STRUCTURE c to 70`— 431 Em • ^• % .501I M/00 LOT7 OFqC�g�s11Lo! Block rn Subr�ivisio� 49 . Anchorage Recording District, Alaska Easement@ of record other than those oho the Plat of record are not eho.n hereon •• tees. •«« •� otherwise noted. LOT SURVEY CERTIFICATION LEGEND ti, tv� •••.•.,� I m«ey Canty That •hoes Tweeted the Property ehe.n end described 0 Bross or Aluminum Capped monumett♦ �i d nnorveraor.arm within paOxn2dcrobot dve,R••. 2 D."warty :s and dodImprovements ne.oeh ar cowenaop•rty and hub 6akrecoveeES'm no improremenfe on adjacent poperty overlap or encroach on the pnmlse• • 5/8a x 30" robot set Wt survey \�\\�0�4• In oseflon and that thele are ho raad.aye, Utility tines, Or other visible/$ O /ERT/CAL Q4TUM easements an said wowrry except as Indicated hereon. , /927 A/ $. 197,9 A VO57.. Score //0, ^ y Date Prepared by: R. L. BUTTON / e C.� C O6 /9 �O/ ReOistardOLono' Surveyor Q ($07/279-6200 5/9 W.60&hAve. Anchorage Aiosko99501 Ret./ F. B.No. �—a9 Property of: W__ _/CII T�%K%5Y�!'i YAR-ZT-02 05:097V FRCu-CTLE ENVIR:IAOTAL SRV CUR EmIronmental Carvloaa M0. . �rrrr�irrrrrrMrrr� 90756753W T -i TZ F.arIoo r -ire CTAE RAO 1021520001 art "m Chum Nan* Pamwne Eng. Srv. Pdotod DmmTlme 03/27.1002 15:49 Project Name't Timberline Lat 6 Collected Date/11me 03125CO02 13:30 CUM Sample W xirehen Sisk Seethed DatWUnae 03/2512002 13:50 Morin Dnnking Water Tttbnftal D�Clstepkem C.C. EE Ordered By Role 0 mad aaad Sel•.ple Rem -ILS Allowable Tree Mortis Por"Wa Pw*ntm TQL Umm Maw Lhmts Dam Date leit Water Dapartmant N!aate•N 2.54 0.200 mWL EPA 300 0 (<10) 031,15/2 JDT Microbiology Laboratory Tom!Colifonn 0 mUICOmL SN1992223 (<1) 03125/02 ICU'