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Home My WebLink AboutROLLING HILLS VIEW ESTATES BLK 2 LT 5Rolling Hi'611s View Estates Block 2 Lot 5 #050-322-05 / l Municipality of Anchorage Development Services Department iijF y'j fi Building Safety Division On -Site Water and Wastewater Program, 4700 Bragaw St. 3 / P.O. Boz 196650 Anchorage. AK 99519-6650 Page of www.ci.anchorage sk.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: 11 9 3 PID Number: O S O' 3 2 2— 0 yr Name 9XfA1Y FAY Wastewater System: W New ❑ Upgrade AC«aat I1 -13S AN M R. v ABSORPTION FIELD Plgr /q 3t72 x Betr 3e DmP Tech O Shall" TrerrlO Bal O MwO o1w LEGAL DESCRIPTION 5°'R"'rw ra,lo.wn.«n«w�,•lv.l. '21 GPDrFIt FI Block La 15 bd Vw: Depth to Ppe baro: rrom ong•ui pax Waw own b"aal Poe / 2 E7/ F1. FI Twnwp Range Seamon Fu a0/s0 above anpnel pals/+ Graw Length It. FI. Well: X New ElUpgrade &SVM wan S� NYrM« of IMS 1 Dnta«w wr.ean Inas •- Fl. Ft Clwl1.s-^�,on (Penne. A B. C) terircpto Taal Depen case/ Io • 0 Ft. 44 Ft Tar absorption area 3 5 FI= Pipe Mateno PVC 303L4 Dnner DO. Dnllal Stalk WON Lew nn.IMr 5ovrffFoeK Doe MWao / u 1i ✓/ r' Ft Com. Y.d Pump Sol n 1.5 caNng Hepnl Aoovne Graatl TANK GPM FI. FI SEPARATION DISTANCES ® Septic ❑ Holding ❑ ST.E.P. ❑ Other. To Septic Absorption Lift Holding ublluPnvate AAGtiaI E -1'Q.YLk y djo From Tank Field Station Sewer Line J Gal wan 100 111'7 /00 f `(/ a /�Taank /*A 2_�� Mal«w ST6EL Nurox a c«Tanmana / ' 1 '/ ► 2 SM+eci,WOW /6)'t /00 /7e Q A All4 LIFT STATION La LM /D"re- se Gal .auuo �7a, ' Pulrp on. Mw M 'Pimp oK kro w HIgn woo Mom N Fanlam .1. /6 I 0111A n n in Dunrn Drrn fflA VIA4 Puny Make a MaaM Elearlral 1,spw t ona Pel«MC by Reno s BENCH MARK Louuon and D•krnp on X2002 SLA 6 wMl ovation / FL e(2fwt — Dates: 1a 2 % Oc r11 Engineseg4C , � Inspections performed by: OF q� 11 2"C 30 06 Development Services Department Approval .Y '`V a•Mea.•a „'P •; .•• .0s� '►9 All, ,.� Conditional Approval Date: !=� N••.NN......Ho...• •.»•....- 0� c Sr.wn W. Eng r� d''. PE 6256 ..2go 1 •. .��r Reviewed and approved by: Date: -7-10-0 .......... •' =_� 16 Ilk ' 2. Sewer Service Line minimum • slope. 3. Trench is Minimum 10' from Lot Line & Old Trench. 4. Lots Served by Private Water Wells. i Well vIV IS.T. C\0.1 67.5 1 52 C.O. 1 80 1 57.7 C.O. 2 135 _ _ _1 102 M.T. 136 1 104 3 Bdrin House Site House Wlb WM Tw* Test Hole 10 Alternate Trench Test Hole 2 Absorption Septic System Construction 1: Septic System Construction Does Not Preclude Adjoining Lots From Sanitation Improvements. A` LOT PLAN NOR THRIM yam" ' I AS—BUILT ROLLING HILLS ENGINEERING *49. LAY❑UTVIEW ESTATES 17237 Bear Paw Circle 6. * W: :� -- BLOCK 2, L ❑ T 5 Eagle Rimr. Alaska 99377 •.+CC-4=OOOy Dat 694-7028 PLAN VIEW• --^ —a�•: —. h_« — - -- — - — - — - - ,-- — - - 6/30/061 SE — -I 1'=50' -- --I 2_ S u £ N L F- Y C d F- u CL a, N d w a r a w N +' 3 O C d N U O) C 0 0 U O_ > a CL zr C 3 O W L O zD Q+ II 0 0 41 0 u u 30l o 0 ~ N Cl) L L O £ O t r a L :e O M 4 6 1 3 z in U pi L n +' a u s II O CL nj C 6 A n o > �, u e> > w o C5 W > W W W u , p Y CL c p� d N � U f < Y d £ N d U pis (3) F- O- O L L. O1 U W i U L (•7 +' C 0 O cZ N '4-C a d> 0 a 0 o ho 4 s CL W +1 tl -0 3 U 3 o75 3£ c7 2u +'0 E — < +' d .4 e% Cs C, aOUI N+'4- Nd L tA 0)s £ cs £ to N N O a jn N Oau(JoC LO O O V oca 4- NL) QU tA+' u +, n N�COL� FO -y C� H 4-H NyF- a, -Y o+d' t > Lo Qad 3 w3 Cr a3 °i ti r rnInrn 3 rn ¢ rn 03 W Ij fa .: N vi 4 In O n 0 W F- F— LLJ 3 11.1 LO J J 2 L-3 N � Y J U J O O J 4' i F �Lbid O I� n U, �Z tin Ua i b I c e o I Iz W a i m 2 � U b to 0 ° 2 F� q 2W n0 �' W i log by Doc co. dba SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 -TELEPHONE 688-2759 OWNER OF LAND: /-3& Nlt^J Elf I ADDRESS: LEGAL DESCRIPTION: bulC ' Aji'Ls' J/Eve FS i' DATE: _1P PERMITNUMBER:05-0195Dateoflssuet_-2?.ii-or TAX IDENTIFICATION NUMBER:asa��-0� Is well located at approved permit location? 4Wes U No Method of Drilling: r rotary U cable tool Depth of well: 3_L U Casing Type 5rk"Z_Wall Thickness ' dZ!5"3 inches Diameter inches, depth q4 feet Liner Type: rt) r, " F_ Casing Stickup Above Ground: feet Static Water Level: SS feet Recover Rate: /' S gpm Method of Testing: /9//2. Well Intake Opening Type: U open end bpen hole U Screened; Startfeet Stopped feet O Perforations Start feet topped feet Tc,,..r.7 C#41Djs Grout Type:/3r-^' volumw Depth: from 19 feet, to ►� o feet Well Disinfected Upon Completion? 47�es U No D Method of Disinfection: S' -,p Comments: IZMR ..� rAl S� L? 0- 1 7 I C S' 7-/ /3caQJt,L rye ---j cx_ (moi=rte+ 13p:p%xice- CRk r�J'k-/ �3�,oaacc.. Ea2�c Driller's Name eOIC SU4L,1J*j ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. Matsu Borough: Department of Environmental Conservation. A W P S 19J"7243W�42 07/10/06 01rMpm P. 002 Development Services Department Building Safety Division 1 On -Site Water h Wastewater Program 470^ Brox Street 19 P.O. Box 196650 Mart, eoylcn Anchorage. A< 99519-6650 NIQ A.3yor WAW " M !Iry!%fIYyA (907)343.7904 Pump Installation Log Well Drilling Pertnit Number: S11¢_0 /93 Date of Issue: Parcel IdentiGeatiun Numhcr: 06-322-oS Ixgal Description --_—� I'r operty Qwncr Name & Addre s: RO.UNO HILLS VIEW ESTATE. LOT 5 BLOCK 2 BRIAN FAY 1894 UPPER SKYLINE EAGLE RIVER, AK 99577 Pump Installation Date: 6-8-06 Pump Intake Depth Below Top of Well C3sin;;:3M feet Pump 1lamtfactarer's Name: RED JACKET Pump Model: 15OF311CN25VB Pump Site 1.5 hp Pitless Adapter Burial Depth. 4'INrITroot Pitless Adopter blanufactuter's Name: Pitless Adapter Installer: Welt Disinfected I'pon Cnmr6 ion? 21 Ve9 ❑ No AfethodefDi,Ldcelio,r.CALCIUM.iYP'cROHLOkI1tYtLLklU tiff% Comments: Palnp iostalkr Naure: MARK VANVJINGERDEN. ANCHORAGE WELL d PUMP SERVICE Attention: The pump installer s!lall prrnid,: a pump installation lo; to the DSU within 30 days of pump installation. TH IIM L7r:- Date: 8/10/05 FAX Steve Eng, PE, PH 17237 Bear Paw Circle, Eagle River AK 99577 (907) 694-7028 tel (907) 694-7026 fax NorthRimEng@aol.com To: Julie nlakela, PE MOA On -Site Program Number of Pages: 1 Fax: 343-7997 Subject: Rolling Hills View Estates, Block 2, Lot 5 Septic System Relocation Julie, Per our conversation we are relocating the septic system installation to the TH 2 location. All other design standards are the same. As -Built to be submitted with new location. Thanks -Steve MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519.6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Jun 29, 2005 Expiration Date: Jun 29, 2006 Permit Number: SWO60193 Parcel ID: 050-322-05 Legal Description: ROLLING HILLS VIEW ESTATES SUBDIVISION BLOCK 2 LOT 5 Design Engineer: 0838 North Rim Engineering Site Address: 18943 UPPER SKYLINE DRIVE Owner Name: BRIAN FAY Lot Size: 59677 SO. FT. Owner Address: 17135 SANTA MARIA DRIVE Total Bedrooms: 3 Permit Bedrooms: 3 EAGLE RIVER. AK 99577 - This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. THE MAXIMUM DEPTH OF THE SEPTIC ROCK FROM ORIGINAL GRADE MAY BE NO DEEPER THAN 2' Received By: �i��JL► �' Date: Issued By: Date: (.1Zt.100— Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. f)50- -05 Permit Number SW Propert. Meiling fu"t�-IST Legal description (Lot, Block & Sub'd.) Legal description (Section, Township &&RRange) Lot Size Acres7Snft�) THIS APPLICATION IS FOR: Number of Bedrooms phone Kq Uz-K.? 93 ,ode Code 47767q- z L 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 owrtirr"or authorized agent) Permit/Rush Fees: 11�P0 46 f/7 -eD Waiver Fees: Date of Payment: 6a/] 4D5 Date of Payment: Receipt Number: 1;99 i>7 Receipt Number: (Rev. 09/04) ,Y. M l([c NEERI� 1 NNG— NorthRim Engineering 17237 Bear Paw Circle Eagle River, AK 99577 907.694.7028 June 24, 2005 MOA On -Site Water & Wastewater Program 4700 Bragaw St Anchorage, AK 99519 RE: Septic System Design /Well Location; Rolling hills View Estates, Block 2, Lot 5 A lot is being developed. Suitable soil was discovered in two test holes. This is a new septic system and water well. Some of the neighboring lots are developed. This site should not negatively impact any of the other area lots. The drainage slopes from back of lot towards front of lot toward Skyline Drive. Please review the wastewater system design for the 3 bedroom single family home. I have included design plans & specs, design guidelines, & soil tests. If there is need for additional information or clarification please give me a call. Sincerely, Steve nE g E, Design Enclosures 7 21M �N ,INEERING ROLLING HILLS ESTATES S/D, Block 2, Lot 5 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is a future single family home projected at 3 bedrooms. This requires a 1000 gallon septic tank. This lot is about 1.5 acres in size, as are neighboring lots. Most of the neighborhood lots have been developed. No adverse impacts are expected from developing this lot. The proposed water well is located on the drawing as are the neighboring wastewater systems & water wells. The lot slopes from north to south, toward the Skyline Drive. No conflicts to any neighbor lots is anticipated. Two soil tests were conducted and demonstrated a well percolating sandy soil. An application rate of 1.2 GPD/FT' with 0.5 reduction factor for utilizing a 5' wide trench was utilized. Boulders were encountered at 8 and 9 feet depth. These appeared to be broken bedrock. A separation of 6 feet was maintained from this apparent broken bedrock. A trench depth of 2 feet will be used with an effective depth of 1 foot. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Two compartment, 1000 gallon septic tank. • Watertight couplings on inlet & outlet. • 5 foot minimum between the tank and bed. 10 foot to property lines. • 3 feet of cover or insulation is required for trench; an equivalent of 1" insulation for each foot soil cover. • Tank & solid pipe must be set on well compacted, stable soil. • 4 inch diameter cleanouts with airtight caps arc required 1 to 4 feet from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10 feet from the tank positioned to provide cleanout access towards the tank and towards the absorption field. • All cleanouts must extend to at least ground level. • In solid pipe runs, ASTM D-3034 may be used in lice of cast iron. • Trench to be placed level, minimum of 4 feet to groundwater, 6 feet to bedrock from drain - rock. • Drain rock to be V2 inch to 2 %3 inch screened. Drain rock to be distributed uniformly throughout the trench. • Perforated pipe to be installed level with perforations down. • Silt barrier (filter fabric) to be installed above the drain rock. • Smeared trench sides must be raked or scarified before drain rock placement. • Backfill over drain rock must not be less than 36". • The finish grade must be mounded to promote drainage over the trench. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope. • Septic Tank to be pumped every two years or when required. • Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI or equal) .N' 1. Total De th f Trench is 2'. NORTHRIM ENGINEERING w '' BLOCK 2, LOT 5 LOT PLAN 17237 Bear Pow Cfrcly'.� E*Vo River. Alas 99377 aeras 2. Sewer Service Line mi m 2% slope. 3. Trench is Minimum 1 ' from Lo Line & Old Tench. 4. Lotis Served by Priv to Water Wells. RIO& 0 Hole 1 I/ Absorption Trench // 3 Bclrm Houie Site 1000 Gallon Septic) Tank Test Hole 2 0 Alternate T Septic System Construction Does Not Preclude Adjoining Lots From Sanitation Improvements. OF.k`�� ROLLING HILLS VIEW STATES NORTHRIM ENGINEERING w '' BLOCK 2, LOT 5 LOT PLAN 17237 Bear Pow Cfrcly'.� E*Vo River. Alas 99377 aeras 1� - 40� F PLARiver. 6/21/05 1/a n n n a D M L LI 1� Z Q J L-3 Y. • 4$4, ILi a °o Z e n (q n O v m Obi % AN 2 n h h � LT -91-T noshµ , 2 Lu BZ*6Z"L 111NCN rn W F— ...� p Q 3 LL.J .1191 1 0 LLI �4 % LO o .o Q ... n J L] L) rn _ 1 a wLJ M L_7 N W¢ 3 .. J a 691LZ H1nCS go 0 —J f+. cz N 1 i CL o cl)wi O � W r CL ) od0- Vi- 0 0 d N N 'yr, L� O: '.O to : q N W::.. .. l Z Q .. MisJf W CL al `.,.� H J 9CLZ£ HIHCN $". \ .a �q u �u M L LI 1� Z Q J L-3 Y. • 4$4, ILi a °o Z e n (q n O v m Obi % AN 2 n h h � LT -91-T noshµ , 2 Lu S U c a i s a z 0 v r 0 O cl tl d U 0 _o r a a 0 O r v W ua o Q s c % 1;. 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W O 1 }+ L Qp u i 3 CL a ;:�'.:: C :'; '. a In Q_ O ao ld L N ;• :'', IN . ••�. ` cy�• yrs O y GO F Qp 51;(•I tT''ry LU n 01 L O :., 1 Zw N$a � ^W w X Y SOILS LOG - PERCOLATION TEST 2THRIM Date Performed: 6/14/05 F� 19INEERING Performed For: Brian Fay Legal Description: Rolling Hills View Estates Block 2 Lot 5 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10 - 11 - 12 - 13 - 14 - 15 - 16 - 17 - 18 - 19 - 20 - 21 - DEPTH (FEET) Organic .Qr...• SP '" • ` Sand w/Gravel O' *A Refusal Location: See Drawing Groundwater? No Depth Water Depth After Monitorino.None Date: 6/21/05 # Date Gross Time Net Time Depth Net Drop 1 6/21 0 -- 9.25' -- 2 6/21 2 2 min 10' 0.75' 3 6/21 4 -- 6.5' -- 4 6/21 6 2 min 9' 0.75' 5 6/21 7 -- 9.25' -- 6 6/21 9 2 min 10' 0.75' Percolation Rate 2.7 rain./inch Perc Hole Diameter 6' Test Run Between 1' and 2' Comments:Presoaked Performed By NorthRim Eng. CERTIFY THAT THIS TEST WAS Performed In Accordance with All State/Municipal Guidelines in Effect ON THIS DATE, DATE: 6/22/05 NOR THRIM* TESTHOLE L❑G T. H. 1 ENGINEERING 17237 Boor Pow Circle Eagle Rlw Alaska 99577 a , 907.694.7028'•••••••• = GEOTECHNICAL WWI Ts 6/22/05 11 of 2 S❑ILS LOG — PERC❑LATI❑N TEST THRIM Date Performed: 6/14/05 ��,9 NEERING Performed For: Brian Fay Legal Description: Rolling Hills View Estates Block 2 Lot 5 1 — 2 — 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10 - 11 - 12 - 13 - 14 - 15 - 16 - 17 - 18 - 19 - 20 - 21 - DEPTH (FEET) Organic Qr.._. SP Sand w/Gravel Refusal Location: See Drawing 20 % Slope Groundwater? No Depth Water Depth After Monitorino.None Date: 6/21/05 # Date Gross Time Net Time Depth Net Drop 1 6/21 0 -- 5.5' -- 2 6/21 2 2 Min 6.25' 0.75' 3 6/21 5 -- 5.5' -- 4 6/21 7 2 minj 6.25' 0.75' 5 6/21 8 -- 5' -- 6 6/21 10 2 min 5.75' 0.75' Percolation Rate 2.7 min./inch Perc Hole Diameter 6' Test Run Between 1' and 2' Comments:rresoaKea Performed By NorthRim Eng, I CERTIFY THAT THIS TEST WAS Performed in Accordance with All State/Municipal Guidelines in Effect ON THIS DATE. DATE: 6/22/05 �E CF A44 NOR THRIM •:,�� TESTH❑LE LOG ENGINEERING T. H. 2 17237 Bsar Pow Circle Eagle River. Alaska99377 4�„+., Uw • p ; 4•P GE❑TECHNICAL 6/22/05 12 of 2 zG 8 ® Municipality of Anchorage ° On -Site Water and Wastewater Program (907) 343-7904 5 a E T Y Certificate of On -Site Systems Approval Parcel I.D. 076-031-18 1. GENERAL INFORMATION: Expiration Date: 0-7-4_ Complete legal description RAVEN MOUNTAIN ESTATES #1; BLOCK 5 Location (site address) 191 GOLD CLAIM DRIVE GIRDWOOD, AK 99587 Current Property owner(s) DIANE POWERS Day phone 230-2439 Mailing address Real Estate Agent 2. TYPE OF DWELLING: M Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well M Individual M Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Waiver Fee $ Date of Payment U-1�2/ Date of Payment Receipt Number 05 '� 17 G Receipt Number COSA # 0SC� 21 I -� 6 q Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road Suite 101- Anchorage Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: 3� 1 In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system OI in accordance with the guidelines and regulations established by the Municipality of Anchorage and �G . • / (� practices. The reported results describe the condition of the system/s on the date/s of the �i �. nn industry p •.'7— I evaluation. Separation distances were measured to readily identifiable features. Hidden defects or ` g encroachments may exist that were not identified during the evaluation. The operational life of all wells - (j i, . I f and septic systems depend upon a variety of variables, including but not limited to, soil conditions ...•.. • .......... "'.... groundwater levels (that may fluctuate during the year), quality of construction (materials and O 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 J" ftreess.: system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of QOn (' CE -7953 the well or septic system. GEG makes no representation whether an alternative well or septic system l9 f V .. 3 't, AcG can be installed on the property in the event either of the current systems fail to perform adequately in Q� er ... • `' the future. The content of this report is for the sole benefit of the person/party that retained GEG to 0 0, Professtoo aG perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedroomsOF (� � Disapproved�� Conditional approval for bedrooms, with the following �atiorQN-SITE WATER AND r"= ''1))))))))W)11' �� , ✓ Original Certificate Date: ' Z 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 Septic System Advisory Well Flow Advisory COSA blue sheet_10-10-12.doc Nitrate Advisory Arsenic Advisory Other SA-oe� /I 1c, ddi io 1 COSA Checklist Legal Description. RAVEN MOUNTAIN ESTATES; BLOCK 5 if rnore than i septic system on lot: COSA Checklist ## of A. WELL DATA Well log Is filed with Onsite (or attached) Date drilled 8118198 Total depth 92 ft Cased to 92 ft (1 Sanitary seal is functioning correctly Wires are properly protected C2sing height (above ground) 18+ in. Date of flow test for COSA 6/13/21 Static water level at beginning of test 72.8 ft. Comments B. TANK DATA Age of tank(s) 23 years Tank type/material SEPTIGSiEE Measured operating fluid level in septic tank 51 ;�] Standpipes/foundation cleanouter record drawing Date of pumping i `✓e �{2O C7{— D. ABSORPTION FIELD DATA Parcel ID: 076-031-18 Structure served by this system Well production at time of test 7.3+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes L No Xcoliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by GEG, LTD. Date of Sample 6113/21 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: N/A Which system tested (date installed) 1998 Adequacy test date 6/13/21 FR ALL standpipes present per record drawing Results ❑✓ Pass For 4 bedrooms Total measured depth from grade 7.25 ft (max) Fluid depth prior to test 2 in Measured depth to pipe invert from grade 3.33 ft (1 -nil) Water added 664 gal ❑ NIA – pressurized field New depth *2 , in Monitor tubes go to bottom of effective. If not, state Elapsed time *0 min depth into effective 10"-11" t� Code -required soil cover over field Final fluid depth *2 in [ System presoaked Absorption rate 600+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NONE date of test) N/A If yes, enter dare N/A Gallons introduced gallons Cornments/Deficiencies: 'LIQUID LEVEL DID NOT CHANGE DURING ADEQUACY TEST COSA Checklist yellow sheet 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 Community Sewer Manhole/Cleanout > 100' ❑✓ Yes if No ft ❑✓ Yes if No ft Neighboring Tank > 100' M✓ Yes if No ft Private Sewer/Septic Line > 25' 71 Yes if No ft Absorption Field on Lot > 100' E] Yes if No ft Holding Tank > 100' M✓ Yes if No ft Neighboring Absorption Fields > 100' Yes if No ft Water Main > 10' Animal Containment > 50' ✓/ Yes if No ft ✓� `(es if No ft F71 Yes if No ft Water Service Line > 10' 1771 Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway comment below Community Sewer Main > 75' M Yes if No ft r✓ Yes if No ft From Septic/Holding Tank on Lot to: (Please enterdistances if less than required) Building Foundations > 10' F/ Yes if No it Surface Water> 100' [✓] Yes if No ft Property Line > 5' Fv Yes if No ft Wells on Adjacent Lots: ✓CI Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' F71 Yes if No ft Water Service Line > 10' 1771 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' ✓CI Yes if No ft Private Wells > 100' Q✓ Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' 0 Yes if No ft Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS *APPEARS TO BE 100' EXACTLY PER 1998 INSPECTION REPORT DRAINFIELD HAS DRIVEN STEEL MT INSTALLED BY OWNER 4/16/19. PIPE LABLED C04 ON INSPECTION REPORT IS NOT SHOWN ON AS -BUILT SURVEY; HOWEVER, IT IS PRESENT. G. ENGINEER'S CERTIFICATION 1 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 #AECC884 Q(3 Septic 'Tank Advisory Certificate of On -Site Systems Approval #OSC211369 Subdivision: Raven Mountain Estates #1 Blk 5 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 23 years old. Typical replacement costs range from $8,000 to $11,000 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 20 -year-old steel tank MAY look like. Mailing Address p O Box 196650 *Anchorage, Alaska 995196650 *www muni org Chugoch Notional Forest S 89°34'37" W 288.10' rr 30 Anch'r Ease";. 3 -Story 73.9' -use Ho Lot 5, J" D) 0 , .'51' Block 3 ".p 0 dk, CD cp 5) Gen. G, 0 �F Ay sP. Shed 88*0' TH .�r� l ..:A ��'`g g r*Hurst V�F�pROffSSIOKAL`P� l' �Nl 179 Lot 4,ry Block 3 G00o co \\T 27.5 4.0' LO Ln b Covered 'tied, 'N 3 -Story 7� QCD '. House 4.0' Covered LQ Carport0 :N 0 :3 :12.0'.;...;. 49"th'*�q /Stair C' 4.0' 0 4.0' 7 Lot 3 Block 0 cn 'ar (D C6 7.ua Cl) 0 25 so House Detail: Y = 30' Li–M—Ma US SURVEY NOTES FEET -All dimensions shown are grid bearings and ground distances, Record boundaries, are per Plat No. 66-161. -49th Star has conducted a physical survey of the property and all details shown 0a this Asbuilt Survey are correct. Under no circumstances should any data hereon be used for construction or for establishment of property lines. -It is the owners, responsibility to determine the e.dstence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. AS BUILT SURVEY LEGEND 49t-h Star Surveying Block 5, 0 Found =perty Corner 321 Fireoved DriVe RaVell MOU11tain EStates, 0 Septic SYS. Pipe/Clean Out Anchorage, AK 99508 Unit 1, Solar Panel (907)891-6111 Girdwood, AK O Well Jeremy@49thStarSurveying.com W.O. 19004 DATE Og/10/19 I scma- 1"=50, MUNICIPALITY.OF ANCHORAGE Development Services Department - 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050 322 05 1. GENERAL INFORMATION Expiration Date: Complete legal description Rolling Hills View Estates Block 2 Lot 5 Location (site address) 18943 Upper Skyline Current property owner(s) Bloom Mailing address Real estate agent 2. TYPE OF DWELLING: 0 Single Family (w/ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic Z Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request tor: N O N E Distan Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 55o Waiver Fee $ Date of Payment Qa 3 io a 1 Date of Payment Receipt Number 01 60y 5 �3 Receipt Number COSA 4 0 s C I i 13 5 3 Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm C&M ENGINEERING Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Phone 8545558 Date 6/15/21 OF Al, STH 6. DSD SIGNATURE W•• •••• •�•••• I System #1 Approved for bedrooms t:HARLES G BALZARIKI � System #2 Approved for bedrooms r�{�F��s..• CE -13854 �.�� Disapproved tills PROFESSIONI'ti�=� Conditional approval for bedrooms, with the following stipulations: Y 0F, ON-SITE__ Wo WATER AND - z- �` PROGRAM SER\/ 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 Legal Description: ROLLING HILLS VIEW ESTATES BLOCK 2 LOT 5 Parcel ID: 050 322 05 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA OR Well log is filed with Onsite (or attached) Date drilled 3/27/6 Total depth 360 ft Cased to 44 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 6/15/21 Static water level at beginning of test 48 ft. Comments WELL PIT DECOMISSIONED B. TANK DATA Age of tank(s) 15 years Tank type/material SEPTIC STEEL Measured operating fluid level in septic tank 50 ❑ Standpipes/foundation cleanout per record drawing Date of pumping 7/1/21 D. ABSORPTION FIELD DATA SHALLOW Well production at time of test 1.6+ gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑'Coliform bacteria is Negative Nitrate 0.708 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by C.Balzarini Date of Sample 6/29/21 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Which system tested (date installed) 2006 Adequacy test date 6/15/21 ❑ ALL standpipes present per record drawing Results ❑✓ Pass For 3 bedrooms Total measured depth from grade 4.5 ft (max) Fluid depth prior to test 2.5 in Measured depth to pipe invert from grade 3.5 ft (min) Water added 450 gal ❑ N/A — pre rr-i d-fteel�l— New depth 6 in ❑ Monitor tubes go to bottom of effective. If not, state 1440 Elapsed time min depth into effective ❑ Code -required soil cover over field Final fluid depth 2.5 in ❑ System presoaked Absorption rate 450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) Gallons introduced gallons If yes, enter date NA Comments/Deficiencies: FAR END OF FIELD REMAINED DRY DURING TESTING COSA Checklist yellow sheet WAJ ' 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' P/ Yes Community Sewer Manhole/Cleanout > 100' 77 Yes if No ft M Yes if No ft Neighboring Tank > 100' [✓ Yes if No ft Private Sewer/Septic Line > 25' F71 Yes if No ft Absorption Field on Lot > 100'✓0 Yes if No ft Holding Tank > 100' 7 Yes if No ft Neighboring Absorption Fields > 100' 171 Yes if No ft Water Main > 10' Animal Containment > 50' 0 Yes if No ft F/ Yes if No ft Yes if No ft Water Service Line > 10' F71 Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' ✓Q Yes if No ft ❑✓ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' P/ Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5' Yes Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' if No Yes if No ft Private Wells > 100' 171 Yes if No ft Water Main > 10' Q Yes if No ft Community Wells > 200'✓� Yes if No ft Water Service Line > 10' F71 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' F✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓Q Yes if No ft Private Wells > 100' [✓ Yes if No ft Water Service Line > 10' F/� Yes if No ft Community Wells > 200' Q Yes if No ft Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION / 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. 6/28/21 COSA Checklist yellow sheet of AL.40 : 49 '• j C HARLES G BALZARItaf� Fc . • CE -13854 . • �� ® ROFESSION . 1%junicipality of Anchorage NJ` Development Services Department Building Safety Division •"' On -Site Water and Wastewater Program „ 9 TV U&I 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. COSA # %ip�5 Expiration Date: O — % C7 — 06 1. GENERAL INFORMATION Complete legal description t • Weyl Location(siteaddress) 16945 UPPC--2 SLIL/NC AQIvE Current Propertyowner(s) BRIAN F -AY Dayphone i Mailing address t'# -13r 6ANTA MAC -(A '1>2rv6 E-A G1ERtVER,Akg9V4+ Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 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 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 Onsite 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 engineers 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 Address Phone 694 --4-6? Ak 99s}'k Engineer's Printed Name ATEyE E of 6 Date- 6 X30 / fl to ;: oF S.;?1 �, .........................:... 5. DSD SIGNATURE �' �� ' Steven VI. EngPE Approved for (� Disapproved. 4%. bedrooms. tId�ip•�aOF �?56 Conditional approval for bedrooms, with the following stipulations: Additional Comments Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory ... . _ON.SrrF WATER AND •Rt -- -WASTEWATER—: PROGRAM Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: ��^� �"' 120-4 Original Certificate Date: 7— 10 — Q & (Rev. 11/05) Municipality of Anchorage ••, • -- Development Services Department Building Safety Division On-site water & Wastewater Program : 4710 Bragaw Street P.O. Box 196850 Anchorage, AK 99519.6650 www.muni.orglcnsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: 11:-_ 1.1�.\\L Vietr�f 4ESI&IGS Parcel ID: $IOG�2��rr A WELL DATA Well If A, B, or C provide PWSID # e Well Log (YM) Y Date completed ALU lbfo Sanitary seal (Y/N) wires property protected (Y/N) -- Total depth 3I&Q_ft. Cased to _ft• Casing height (above ground) 24 n. FROM WELL LOG AT INSPECTION Date of test -617-2 1 OLD Static water level 4�;- S- ft. ft. Well production I • S 9•P•m• I 9 -P.M. WATER SAMPLE RESULTS: CdHorm �_colonies/100 mL Nitrate 0.133 fmgL Other bacteria D colonies/100 mL Arsenic: C�3- mgA Date of sample: AlA1 bLo Collected by: darlhkim B. SEPTICIHOLDING TANK DATA ! -►/� Tank Type/Material &VII49AW, TAMt — 57tt�. EL Date Installed �Z JOU Tank size / 0b gal. Number of Compartments 2- Geanouts (YM)y Foundation deanout (YM) Depression over tank (YM) /YL High water alarm (Y/N) d Date of pumping ffe Pumper c. ABSORPTION FIELD DATA Data installed S�bf. Soil rating (g.p.d fe/bdrm) I.2 System type��A 77?�nrG�1 Length GO ft. Width Gravel below pipe Total depth Eft. absorption area3Wfe Monitoring tube Depression over field „- Date of adequacy test PiEW Results (Pass/Fail) Ppt6- For -5— bedrooms Fluid depth in absorption field before test _ in. Water added_ gal. New depth_ in. Elapsed Time: _ min. Final fluid depth _ In. Absorption rate >= 9•p•d• Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION NIA Date installed Size in gallons ManholelAccess (YAV) 'Pump on' level at _ in. 'Pump ofr level at _ in. High water alarm level at In. Datum Cycles tested Meets alar & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot /00' w On adjacent lots 106 -VL Absorption field on lot ,,,I oo � On adjacent lots _ /nn'*- Public sewer main 3 " //{ Public sewer manhole/cleanout N/A Sewer /septic service line 2s rr Holding tank N / A Animal containment areas NSA Manure/animal excrete storage areas YA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation "7' Property line Absorption Water main / clN Y Water service line / n r Surfacewater ! l�[Yf Wells on adjacent lots / a n 1*.* - SEPARATION . - SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line / % r -t Budding foundation 10 v I` Water main / () r >•- Water Service line / D t r Surface water _ 1 h U r� Driveway, parkingNehide storage 1 d-,4 Curtain drain nCO Arknot Wells on adjacent lots l U t) r r' - F. COMMENTS G. ENGINEER'S CERTIFICATION �OF 4Cq1� I cerfify that I have determined through field /n J y�..e �g inspections and review Of Municipal records that the above systems are in % * f4si►1 conformance with MOA COSA guidelines In effect on this date. �" '•' 1 ........... Engineers Printed Name 5 TE V B {J-yCa p Fst / .� /v I C Steven W. Eng Date_ (n%D/liCi If 0'J'.,� PE 6256 COSA Fees t 7 50 Date of Payment Receipt Number 82587(% (Rev. I I/DS) Waiver Fee $ Date of Payment Receipt Number ASBUILT SI-VARD h ASSOCIATES LAND SURVEYING 694 I HEREBY CERTIFY -THAT I HAVE SURVEYED THE SCALE• " FOLLOWING DESCRIBED PROPERTY: OF At GAY!%YG�YillrY/ /err. ll�� Z'g' iq; Z ' DATE. r �� ..... X45 �0 AND THAT NO ENCROACHMENTS EXIT F,CCEPT AS �� 'w h •' ,� ' INDICATED. IT IS THE RESPONSIBILITY OF THE i.'J;' e} TH:q OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: �"' }�"'•'�i' "•i EASEMENTS, COVENANTS, OR RESTRICTIONS /�'✓�zS/ � f, ... �?......... • WHICH DO NOT APPEAR ON THE RECORDED SUBDI— �VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB' t+'� tS-6918 fig• s ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES.