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HomeMy WebLinkAboutROSEBERRY PARK ESTATES BLK 2 LT 7Roseberry Park Estates Block 2 Lot 7 #050-315-42 Well Drilling Permit Number: SW Parcel Identification Number: BILL S COLE C COdba t►,RLL VANWATER WELLS RO. Box 670269, g www.sullivanwaterwells.com Pump Installation Log Date of Issue Legal Description Property Owner Name & Address ely ry C & T Construction —John Thomson — _ 11404 Jessie Mae Circle, Eagle River, AK 99577 Pump Installation Date: 7-28-15 Pump Intake Depth Below Top of Well Casing: 45 Pump manufacturer's Name: Goulds Pump Model: 1OH505412CL Pump Size: 1/2 Pitless Adapter Burial Depth: 10 Pitless Adapter Installer: Green General Disinfected Upon Completion? ® yes ❑ no Method of Disinfection: Chlorine 50 PPM Comments: Pitless Manufacturer: Martinson B10X Pump Installers Name: Sullivan Water Wells feet hp feet Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Municipality of Anchorage . Development Services Department Building Safety Division On -Site Water 8 Wastewater Program, 4700 Bragaw St.l' P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW070235 PID Number: 050-315-42 Name: JOHN THOMSON Wastewater System: ■ New ❑ Upgrade Address: 17434 SANTA MARIA a EAGLE RIVER, AK 99577 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 240-2020 4 ClDeep Trench ■ Shallow Trench Cl Bed ClMound 0Other LEGAL DESCRIPTION Sve "° "°` 1 2 TotalDpU f 8 MAXe GPD/Sq. rL n Block: Lot: Subdivision: 2 7 ROSEBERRY PARK ESTATES Depth b pipe beams num odpbd gruee: SEE DWG. Grovel depth bwoth Pfp.: r,. 4.10 n Township: _ Range: _ Section: he added above odbinal grade: GrwN Wgth: _ SEE DWG. <t 50+ n WELL: ■ New ❑ Upgrade croe.I .blh: 5 NurnDer of fine.: 1 Dielanee W. five: — FL n Cb.fsotwn (Prnate. AS.c : PRIVATE Tald Depth: 51 CaeM To: 51 Total absorption erw: Ape molerld: n n 500 so. rt D 3034/ F-810 Drw. SULLIVAN WATER WELLS We arm": 9/13/07 Stotb Mater Lw : 31 kut~ GREEN GENERAL We kud 9727-12/7/07 n rield: s Pmnp Set AuCoving Nwght Move Gr : CPN 42 n 2 r< TANK SEPARATION DISTANCES ■Septic 0Holding 0S.T.E.P. 0Other* To Septic Absorption Lilt Holdingubac/Prlvote MervAwc .. Ca eq b ya We: From Tank Field Station Tank sewer unw, ANCHORAGE TANK 1250 Well too'+ 100'+ — — 25'+ STEEL N� ofCOe1°m"""t` 2 Surface water 100'+ too'+ — — — LIFT STATION Lot Line 5'+ 10'+ — — — sizeM D� wO'"'tactMe" Foundation 5'+ 11 tD'+ _ _ _ p on, W.* al:..= at Nph .atm abrin al Curtain DrainNONE KNOWN Y0Y' Ebctrk krpecbmne penonned by. )e. Remarks: 't .BENCH MARK Locaaun ane ow npbma BOTTOM OF SIDING NEAR FCO A.eumed E,.vocan: t 111.42 , rL /� GEV Ltd. Inspections performed by: � Dates: 1st 9/27/07 ENGINEER'SSEAL 2nd 9/27/07 ooaoo 06 OF 4��4 3rd 12/7/07 SjrO 00 Development Services Department Approval . Conditional approval: Dote: .. ......... ...� ••. f r y A..ess.: Q DOA E-79 :p 0���°^°dP �1��U Reviewed and approved by: �� ' E Date I L� ��oo (Rw. 4/0e) �Q rofesslor' oo �40000�� PERMIT SW0NUMBER: AS DRAWING PARCEL ID NUMBER: SW070235 050-315-42 - - - - -- OVERLOOK DRIVE - - - --------_-__ ------- --���_�� I I I A B ST1 49.20 1 12.11 ST2 DBL1 53.36 54.92 18.97 21.48 DBL2 55.29 22.84 FCO 46.07 6.32 C01 45.53 41.20 MT1 43.78 40.40 CO2 58.47 89.82 MT2 54.51 85.42 ALTERNATE SITE WILL REQUIRE AN ADVANCED TREATMENT UNIT NEW 1250 GALLON SEPTIC TANK DBL1 DBL2 FCO NEW I / 4 BEDROOM I f l C01 MTI / HOUSE ---- �� I / A I I H I I I ITN1/2 / LJ iIf foo WELL RADIUS �2 2 c z I +1/ , / NEW DRAINFIELD 1 1 / GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS 3 GENERAL CONTRACTORS �•�+�.--�..�.a...,. •....... 3701 L T0011 p Alli[ lot ...hll0R L m 1030) . otlp( (9071007-o1T . INI (00713.b -JON . oosl ................y,.,ny,m,,, PREPARED FOR: PHONE NUMBER: PACE NUMBER: JOHN THOMSON 907-240-2020 2 OF 3 Q .-.J( LEGAL DESCRIPTION: DRAWN BY: QO'p,.•� ROSEBERRY PARK ESTATES LOT 7. BLOCK 2 K.D.M. TYPEOf WORK: DATE: �01 ASB 4/23/2008 (R. 01105) PERMIT NUMBER: ASPARCEL DRAWING PARCEL ID NUMBER: SW070235 050-315-42 INSULATION FINAL GRADE 110.33-110.62 STI ST2 TOP OF TANK /� TOP OF TANK AT INLET = 105.34 / AT OUTLET = 105.34 INVERT OF BUNG AT INLET = 104.73 FILTER FABRIC NEW 1250 GALLON SEPTIC TANK INVERT OF BUNG AT OUTLET = 104.56 FINAL GRADE = 107.99-109.12 r ORIGINAL GRADE = 98.23 RELATIVE ELEVATION OF BOTTOM OF TEST HOLE = 84.23 (NO H20) OF PIPE = 94.33 OF TRENCH = 90.23 GARNLSSCo NGINLL'R �oNG GROUP, Ltd. p* �.... I C T.UM Ig10. fUi[ 101 . AMDEMO(. IN N907 . FI.MC (YO�JJJ)-Il» � /AY (M1)lb-3]M . YQLIC w�.pnrnnynwwq.nml O 'SPARED FOR: PHONE NUMBER: PAGE NUMBER: JOHN THOMSON 907-240-2020 3 OF 3 LEGAL DESCRIPTION: DRAWN BY: ROSEBERRY PARK ESTATES. BLOCK 2. LOT 7 P.N.B TYPE OF WORK: DATE: PROFILE ASBUILT 12/17/: .................. A. Go ess �ertftieb OrtHing Log by Doc CO. dba SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 89567 *TELEPHONE 688-2759 OWNER OF LAND: C i' eoNS. ADDRESS: LEGAL DESCRIPTION: Q o.� l3r=d l i' piQrt/� DATE Q ?Ab -4- PERMIT NUMBER: Q! -Q 35' Date of Issue_ TAX IDENTIFICATION NUMBER: _az Is well located at approved permit location? 0-Ye's O No Method of Drilling: Ver rotary O cable toot Depth of well: S` Casing Type -STEEL Wap Thickness • _74�v inches Diameter --6 inches, depth feet Liner Type: Ai?. a`. Casing Stickup Above Ground: n' feet Static Water Level: i feet t�-3 Recover Rate: gpm Method of Testing: Ar .*?- Well Intake Opening Type: Q dj;;n end O open hole G Screened: Startfeet Stopped feet Q Perforations Start foot Stepped feet f Grout Type: %3� maw e i E= �o ume Depth: from ✓ feet, to .20 feet Well Disinfected Upon Completion? aNr' D No Metltotl Of Disinfection: _Si Comments: z CeE reit En e,,eJ � 0 %J 4-7j< 649 tOtZAJ I S,4-4 6,if ./r C,- fit Driller's Name. 41. u to s w i-cli-4ei 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:nom Department of Environment: Conservation. Ir i TO/T0 39C: NCAI'tYIS 69ZZ889 TS:LT L00Z/LT/ZT �% ARCTIC PUMP & WELL INC. Jim Sullivan, CPI PO Box 770197 awnrnma Eagle River, AK 99577 (907) 688-2510 (907)258-2510 (907)745-2510 ar wn gci.net Pump Installation Log Well Drilling Permit Number: SW070235 Parcel Identification Number:050-315-42 Date of Issue: 9-10-07 Legal Description:Roseberry Park Property Owner Name & Address: Estates John Thompson Lot:7 17434 Santa Matia .,�__�... Ranh Rk,.r AV 0"77 Pump Installation Date: 2-20-08 Pump Intake Depth Below Top of Well Casing:42 Feet Pump Manufacturer's Name: Dempster Pump Model:H-75 Pump Size: 11/2 hp Pitless Adapter Burial Depth: 14 feet Pitless Adapter Manufacturer's Name: Martinson Pitless Adapter Installer: Arctic Pump & Well, Inc. Well Disinfected Upon Completion? Yes Method of Disinfection: Chlorine Comments: Pump Installer Name: Arctic Pump & Well, Inc. Arctic Pump & Well, Inc. Page I of I MUNICIPALITY OF ANCHORAGE Development Services Department .1 `7 /Z.z /07 1-70C) On -Site Water & Wastewater Program 4700 South Bragaw Street / P.O. Box 196650, Anchorage, AK 99519-6650 l -C/U7 AUC) (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Date Issued: Sep 10, 2007 Expiration Date: Sep 09, 2008 Permit Number: SW070235 Parcel ID: 050-315-42 Legal Description: ROSEBERRY PARK ESTATES BLOCK 2 LOT 7 Design Engineer: 0855 GARNESS ENGINEERING GROUF Site Address: NHN JESSE MAE CIRCLE Owner Name: JOHN THOMSON Lot Size: 47045 SO. FT. Owner Address: 17434 SANTA MARIA Total Bedrooms: 4 Permit Bedrooms: 4 EAGLE RIVER. AK 99577 - This permit is for the construction of: ❑✓ Disposal Field 0 Septic Tank Holding Tank E] Privy 0✓ Private Well Ej Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received BY. Issued By - Date: G Date: D Municipality of Anchorage ••, Development Services Department Building Safety Division , On -Site Water & Wastewater Program 4700 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. Property owner(s) JONH THOMSON Day phone 240-2020 Mailing address 17434 SANTA MARIA ' EAGLE RIVER. AK Site address mk) -, c�sE mke i�+ ark _ Zip Code 99577 Legal description (Sub'd, Block & Lot) ROSEBERRY PARK ESTATES, LOT 7. BLOCK 2 Legal description (Township, Section & Range) N/A Lot Size 41, Dy5 Sq.Ft. THIS APPLICATION IS FOR ( ®all that apply): Absorption Field Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well Water Storage ❑ Number of Bedrooms THIS APPLICATION IS AN: Initial Upgrade ❑ Renewal ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. PermittRush Fees: _JLo_} 1 % S wt11 Waiver Fees:_ Date of Payment: Date of Payment: Receipt Number: a Receipt Number:, (Rr. n/os) GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS September 4, 2007 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Proposed Well and Septic System for Roseberry Park Estates; Lot 7, Block 2, To whom it may concern: The proposed 4 bedroom house is to be served by a private well and septic system. We are proposing that a 1250 gallon septic tank and a 5 -wide trench type drainfield be installed. Two test holes were excavated on the property. The drainfield will be designed around the 30 foot radii of these test holes. The proposed well will drilled in the area shown on the attached site plan and design drawing. Comments regarding the design arc summarized as follows: 1. SOILS: See the attached logs which show the soil classifications, groundwater monitoring, and the percolation test results. The insitu sandy soils and the SM to GM material at 12 to 13 feet will negate the requirement for a sand filter. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPHY: As can be seen on the attached design drawing the average topography within 50 feet of the drainfield site is a 1 to 10 percent slope running approximately east to west. There is a road cutbank greater than 25 percent north of the proposed drainfield. The drainfield will be 50+ feet from this cutbank. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. .E., M.S. NOTE: Attached is a site plan drawing, a design drawing, one soil log, e•hich are all part of the design packagefor this septic system. (Contact G.E.G. Ltd. for 7 page construction specification letter.) 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507-1259 Ph: (907) 337-6179' rax: (907) 338-3246' Website: www.gamessengineering.com ROSEBERRY RIDGE ESTATES, LOT B. BLOCK 1 C� --- -_--OVERLOOK ROSEBERRY RIDGE ESTATES, LOT 7, BLOCK 1 CPc?2 DRIVE -— PROPOSED 4 1 I FT BEDROOMHOUSE PROPOSED SEPTIC SYSTEM I I I I (SEE DESIGN. PAGE 2 OF 2), I I 1 II II 11 0 I TH12 I � I I I I D I I ROSEBERRY I y�o I OrW I I I I I I I I I I I I 1 I 70 0 (n m 70 r m 1 I I I RIDGE ESTATES, LOT 6, BLOCK 2 I I ALTERNATE SITE - I I C�12 II II II II II II ROSEBERRY RIDGE ESTATES. LOT 6, BLOCK 1 GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS 6 GENERAL CONTRACTORS iAl G IIIOOrt Ibb. 4118 101 . N:b:00.00. M KS02 . A04 (902)M7 -6:A • !M (W)M-32N • �.- PREPARED FOR: PHONE NUMBER: PACE NUMBER: JOHN THOMSON 240-2020 1 OF 2 LEGAL DESCRIPTION: DRAWN BY: ROSEBERRY RIDGE ESTATES, LOT 7. BLOCK 2 K.D.M. TYPE OF WORK: DATE" SITE PLAN OF PROPOSED WELL AND SEPTIC SYSTEM 9/4/2007 IRri M1n1: II I (n I I RIDGEEBERRY ESTATES. LOT 1, BLOCK 3 C ROSEBERRY RIDGE ESTATES, m I I ROSERRY LOT 8, BLOCK 2 III RIDDGEGE ESTATES. ES. LOT 2. BLOCK 3 V I I I I U PROPOSED II TH/I RADIUS I I \I W RADNS I I /I I 11 I GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS 6 GENERAL CONTRACTORS iAl G IIIOOrt Ibb. 4118 101 . N:b:00.00. M KS02 . A04 (902)M7 -6:A • !M (W)M-32N • �.- PREPARED FOR: PHONE NUMBER: PACE NUMBER: JOHN THOMSON 240-2020 1 OF 2 LEGAL DESCRIPTION: DRAWN BY: ROSEBERRY RIDGE ESTATES, LOT 7. BLOCK 2 K.D.M. TYPE OF WORK: DATE" SITE PLAN OF PROPOSED WELL AND SEPTIC SYSTEM 9/4/2007 IRri M1n1: II I (n I I RIDGEEBERRY ESTATES. LOT 1, BLOCK 3 C ROSEBERRY RIDGE ESTATES, m I I I LOT 8, BLOCK 2 III �100' WE RADIUS I I I I - iROSEBERRY RIDGE ESTATES. I I LOT 5, BLOCK 2 \1 ROSEBERRY RIDGE ESTATES, LOT 9, BLOCK 2 \\ ` \ 1I (TI\ \ \ GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS 6 GENERAL CONTRACTORS iAl G IIIOOrt Ibb. 4118 101 . N:b:00.00. M KS02 . A04 (902)M7 -6:A • !M (W)M-32N • �.- PREPARED FOR: PHONE NUMBER: PACE NUMBER: JOHN THOMSON 240-2020 1 OF 2 LEGAL DESCRIPTION: DRAWN BY: ROSEBERRY RIDGE ESTATES, LOT 7. BLOCK 2 K.D.M. TYPE OF WORK: DATE" SITE PLAN OF PROPOSED WELL AND SEPTIC SYSTEM 9/4/2007 IRri M1n1: DESIGN CRITERIA NUMBER OF BEDROOMS:4 GALLONS PER DAY (GPD): 600 PERCOLATION RATE/S:1 MIN./INCH PROPOSED APPLICATION RATE: 1.2 MINIMUM DRAINFIELD SOTT.: 500 — DRAINFIELD DESIGN: OVERLOOK DRIVE — MAXIMUM DEPTHA FEET WIDTH:5 FEET LENGTH: 50 FEET M.OA APPROVED SAND FILTER: N/A EFFECTIVE:4 FEET —_ I REDUCTION FACTOR:0.50 ACTUAL SO.FT.: 500 SPECIFICATIONCEG. Ltd. HAS A 7 PAGE LETTER THAT PERTAINS TO THIS DESIGN. TO OBTAIN A COPY OF THE LETTER PROPOSED CONTACT GEG. BY PROCEEDING FORWARD 1250 GALLON I WITH THIS INSTALLATION. THE ENGINEER. SEPTIC TANK I WELL DRILLER. CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY INSTALL HAVE READ THESE SPECIFICATIONS AND FOUNDATION I I AGREE TO ACCEPT THE TERMS AND CLEANOUT CONDITIONS OUTLINED. •, .��', INSTALL DOUBLE CLEANOUTS PROPOSED PROPOSED / - :�ti.,�' +' •�,.ra \ DRUWFIELD 4 BEDROOM = ; %c v :; Y: .• ._t4T✓ HOUSE :. _•.4 •• ��. •� �1 �'''.y: ,•.r: .`tet. 1 1 1111 I // I SED WELL I 1;^ ALTERNATE SITE PROPOSED 100 WELL RADIUSTHI I I NOTE: THE CONTRACTOR SHALL HAVE THE SOUTH & yD� I \ 5 E:I WEST LOT LINES. AND ALL WELL RADII FLAGGED BY A I 1y aADl�s 1' REGISTERED LAND SURVEYOR 100 PRIOR TO CONSTRUCTION. GARNESS ENGINEERING GROUP, Ltd. +w� CONSULTANTS 6 GENERAL CONTRACTORS •- SAI CTCM 0YM0. 1110C 101 • 0001.0L M! 09!01. May( (007)M? %" • FM (0071]00 " • \CRL2 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: JOHN THOMSON 240-2020 2 OF 2 LEGAL DESCRIPTION: DRAWN BY:K.D.M. O ,G ROSEBERRY PARK ESTATES, LOT 7, BLOCK 2 00` TYPE OF WORK: PROPOSED WELL AND SEPTIC SYSTEM DESIGN DATE. 9/4/2007 (Rev. OIM5) ltd® GARNESS ENGINEERING GROUP, Ltd. ..- CONSULTANTS E GENERAL CONTRACTORS.+•�•�•�-•��•• 3701 L TJOdi PW O. S E 101 • AMCHOPAGL M. NW? • R E4 (W7)M7-41n • FM; i0 -3IM • wEBLR V^^••••"Y^•^�^V.w° SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: ROSEBERRY PARK SUBDMSION, LOT 7, BLOCK 2 PERFORMED FOR: JOHN THOMSON w/CT CONSTRUCTION DATE: 8/13/2007 DEPTH (feet) .. ORGANICS TEST HOLE 1 N 3 4 6°Qowb? SW TO GW °O°4 '= w/SOME 7 > o.k--,= COBBLES/BOULDERS 8 9 10 11 12 13 14 15 16 17 18 19 SM TO GM DEPTH TO GROUNDWATER DATE DRY 8/13/2007 DRY 8/14/2007 14' 8/23/2007 6• - 2 5:56 6 II1111111 6• 3 ,, 1111!11 - 6' �//�i 4 6:02 6 0• 6• 5 6:02 - 6• - 6 6:08 IIIIIIIII 0• 6• T v immm • DEPTH TO GROUNDWATER DATE DRY 8/13/2007 DRY 8/14/2007 14' 8/23/2007 6• - DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 8/14/2007 1 5:50 - 6• - 2 5:56 6 0• 6• 3 5:56 - 6' - 4 6:02 6 0• 6• 5 6:02 - 6• - 6 6:08 6 0• 6• PERCOLATION RATE 1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 5 FT. AND 5.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ENO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: KYLE MAUS COMMENTS: PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 9�o x GARNESS ENGINEERING GROUP, Ltd. .,...__�.,..,„..�.-.,..,....,...e-+. CONSULTANTS S GENERAL CONTRACTORS LEGAL DESCRIPTION: ROSEBERRY PARK SUBDMSION. LOT 7. BLOCK 2 PERFORMED FOR: JOHN THOMSON W/CT CONSTRUCTION DATE: 8/13/2007 DEPT — (feet == JM ORGANICS TEST HOLE 2 1 SW TO GW w/SOME :OBBLES/BOULDERS SM TO GM DEPTH TO GROUNDWATER DATE DRY 8/13/2007 DRY I •' • ' 6" 111111111 2 11191 6 0" 6- 3 WWI — N/NH• • ism 6:03 IIIIIIIII 0• 6- int 6:03 — 6" !111111 6 D'.6� • 0" 6" DEPTH TO GROUNDWATER DATE DRY 8/13/2007 DRY 8/14/2007 DRY 8/23/2007 6" — SEE ATTACHED DRAWING DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 8/14/2007 1 5:51 — 6" — 2 5:57 6 0" 6- 3 5:57 — 6" — 4 6:03 6 0• 6- 5 6:03 — 6" — 6 6:09 6 0" 6" PERCOLATION RATE 1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 19 TEST RUN BETWEEN 5 FT. AND 5.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES 0 NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: KYLE COMMENTS: PERFORMED BY GEG. Ltd. I, JEFFREY A. GARNESS. CERTIFY THAT THIS WAS PE FORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: GE B f Municipality ofl Ainchorage a On -Site Water and Wastewater Program �W_"/ (907) 343-7904 S A F E 7 Y Certificate of On -Site Systems Approval Parcel I. D. 050-315-42 1. GENERAL INFORMATION: Expiration Date: I -26 " 9-02— 1 Complete legal description ROSEBERRY PARK ESTATES; BLOCK 2 LOT 7 Location (site address) 11404 JESSIE MAE CIRCLE EAGLE RIVER AK 99577 Current Property owner(s) JOHN THOMSON Day phone 240-2020 Mailing address Real Estate Agent 11401 JESSIE MAE CIRCLE, EAGLE RIVER AK 99577 2. TYPE OF DWELLING: © 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 ® Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $3/9' 5 b hov I -i `� Waiver Fee $ Date of Payment IN -1 q- Z. n Date of Payment Receipt Number 67 7 q 6 q Receipt Number COSA # O SC D0 15ry 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: 101 (4 IZ-D In conductingthis evaluation, GEG provided an engineering evaluation of the well and/or septic stem P 9 9 P Y � � r in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the �Q,.�,• , ! ,.� ' evaluation. Separation distances were measured to readily identifiable features. Hidden defects or ��rr �1 encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, % (j t s 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 .. /.vs are outside the control of GEG. Satisfactory test results do not guarantee future performance of the v �d, (zy A. Gcriness." system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic sstem. GEG makes no representation whether an alternative well or septic sstem can be installed on the property in the event either of the current systems fail to perform adequately in �l the future. The content of this report is for the sole benefit of the person/party that retained GEG to U`�1NC��of9E5 ono` 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 bedrooms Disapproved Conditional approval for bedrooms, ,LITY OF,q,a rir,�i with the follo�i�stipltE y0�i'� Z::o.WATER ``may ANn rn �m OrAIVIT i B Original Certificate Date: 10 - 2C9 -?_0 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 _ Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10.12.doc Legal Description: ROSEBERRY PARK ESTATES; BLOCK 2, LOT 7 Parcel ID: 050-315-42 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA n Well log is filed with Onsite (or attached) Date drilled 913107 Total depth 51 ft Cased to 51 ft ❑® Sanitary seal is functioning correctly N Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 9/29120 Static water level at beginning of test 37.8 ft. Comments B. TANK DATA Age of tank(s) 13 years Tank type/material STEEL Measured operating fluid level in septic tank 47.5" Fn� Standpipes/foundation cleanout per record drawing Date of pumping 10/6/2020 Well production at time of test 6.5 gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes 0 No Coliform bacteria is Negative Nitrate l - Y -mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by GEG,LTD. Date of Sample 9/29120 FT STATION ❑ Requir aintenance co Age of lift station ye - Lift station material Comments I�/7c � D. ABSORPTION FIELD DATA 5 -WIDE TRENCH qr Which system tested (date installed) 9rafa � I �-:1' wiC '' * Adequacy test date 9/29120 X ALL standpipes present per record drawing Results 0 Pass For 4 bedrooms Total measured depth from grade *19.3 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade *8.9 ft (min) Water added 856 gal ❑ N/A — pressurized geld New depth 2 in F0 Monitor tubes go to bottom of effective. If not, state Elapsed time 210 min depth into effective Final fluid depth 0 in N Code -required soil cover over field 600+ Absorption rate gpd ❑ System presoaked N/A (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: `CLEANOUT ON NORTH END IS 15.3' B.G. MONITORING TUBE ON SOUTH END IS 15.9' B.G. 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 if No Community Sewer Manhole/Cleanout > 100' Yes if No ft Q Yes if No ft Neighboring Tank > 100' M Yes if No ft Private Sewer/Septic Line > 25' M Yes if No ft Absorption Field on Lot > 100' Fv� Yes if No ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' R Yes if No ft P Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0 Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No 5+ ft Surface Water > 100' ❑✓ Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Fv-1 Absorption Field > 5' Fv� Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10' El Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' El Yes if No ft If absorption field is under driveway comment below Property Line > 10' [D Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' Water Service Line > 10' Fv-1 Yes if No ft Community Wells > 200' Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *MET SEPARATION DISTANCE AT TIME OF INSTALL. G. ENGINEER'S CERTIFICATION l certify that 1 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 El Yes if No ft [l Yes if No ft #AECC884 Parcel I. D. 050-315-42 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION: Expiration Date: -7t 16p --Z/ Complete legal description ROSEBERRY PARK ESTATES; BLOCK 2 LOT 7 Location (site address) 11404 JESSIE MAE CIRCLE, EAGLE RIVER, AK 99577 Current Property owner(s) JOHN THOMSON Day phone 240-2020 Mailing address Real Estate Agent 11401 J_ESSIE MAE CIRCLE, EAGLE RIVER, AK 99577 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 ❑ Waiver/Variance request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee TO Waiver Fee $ Date of Payment —� 19'-2 y Receipt Number Q (_ COSA # (� Sr' z � i 17 y Date of Payment Receipt Number Waiver # 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-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: Gamess 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: I zl 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 system/s 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 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 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 system/s; 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 to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to 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. 6. DSD SIGNATURE System #1 Approved for System #2 Approved for Disapproved Conditional approval for 9 _r 7, u - i r ' Gorn . s,: 1\ rro`ess o�— ``DOC�b��" #AECC884 bedrooms bedrooms � \\QP�\�� OF ANcy,�� j2 ON-SITE �� _ bedrooms, with the fog ng �1►� r�`'0 o WASTII v__' ER o � Original Certificate Date: r O Zt',%r -70 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 ^� Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet -1 0-10-1 2.doc 4 Legal Description: ROSEBERRY PARK ESTATES; BLOCK 2, LOT 7 Parcel 1D: 050-315-42 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 9113/07 Total depth 51 ft Cased to 51 ft OR Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 9129/20 Static water level at beginning of test 37.8 ft. Comments B. TANK DATA Age of tank(s) 13 years Tank type/material STEEL Measured operating fluid level in septic tank 47.5" ❑ Standpipes/foundation cleanout per record drawing Date of pumping 10/6/2020 D. ABSORPTION FIELD DATA 5 -WIDE TRENCH Which system tested (date installed) 9/21/07-12/7/07 ❑ ALL standpipes present per record drawing Total measured depth from grade *19.3 ft (max) Measured depth to pipe invert from grade *8.9 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective Structure served by this system 1 Well production at time of test 6.5 gpm Water storage tank volume NIA gallons Well disinfected for coliform test? ❑ Yes ❑ No ** g Coliform 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 STATION *9/29/2020 **4/8/2021 ❑ Requir aintenance com Age of lift station ye Lift station material Commen Adequacy test date 9/29/20 Results C]✓ Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 856 gal New depth 2 in Elapsed time 210 min 01Code-requiredsoil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 600+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: 'CLEANOUT ON NORTH END IS 15.3' B.G. MONITORING TUBE ON SOUTH END IS 15.9' B.G. COSA Checklist yellow sheet N/A 48 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' E✓ Yes if No ft Yes if No ft Neighboring Tank > 100'✓Q Yes if No ft Private Sewer/Septic Line > 25' E Yes if No ft Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' FV -1 Yes if No ft 0 Yes if No ft if No ft F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' [D Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No 5+ ft Surface Water > 100' R Yes if No ft Property Line > 5' ❑✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 7 Yes if No ft Private Wells > 100' ✓0 Yes if No ft Water Main > 10' ✓0 Yes if No ft Community Wells > 200' ✓D Yes if No ft Water Service Line > 10' Cj✓, 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' 0✓ Yes if No Water Service Line > 10' M✓ Yes if No ft Community Wells > 200' ❑✓ Yes if No Surface Water > 100' ✓Q Yes if No ft F. ENGINEER'S COMMENTS *MET SEPARATION DISTANCE AT TIME OF INSTALL. G. ENGINEER'S CERTIFICATION `� �F "%04 I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with p ' MOA COSA guidelines in effect on this date. , , , , , , , .. J f ey A. s::... CE 7 53 s `czG COSA Checklist yellow sheet �QO o �'ro f e s si000\v—� #AECC884 4OOD000gc ft ft oji Municipality of Anchorage ��• Development Services Department r`� ��`• Building Safety Division 1• On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.munl.orglonsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 15CosA9 AM I K9 1. GENERAL INFORMATION Expiration Date: $3 — CD ' R Complete legal description I Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address JOHN THOMSON Day phone 240-2020 17434 SANTA MARIA • EAGLE RIVER AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (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 verity 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 (les 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. Address 3701 E. TUDOR ROAD, SURE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LID. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the lost and separation distances measured to readily Identifiable features. The opera tiona I life of all wells and septic systems depend on the local soils condition, groundwaterlevels 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or 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 party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved.. Phone 337-6179 Date o '• '• wS0 ........ . ...... 1.. ........ .. ....... ........ -.Jet Gar ess; 'P '•• OQll:e� GE—7953 ? :< '•S.1I'V-0�cq�pG Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineers Reort Other tlui!!/ `�<<P�\ZY OFrgN>�% Cr�Q • ' •C'sp G •ON-SITE : WATER AND • •rn^ : WASTEWATER �•, PROGRAM : By: � � UZ �Original Certificate Date: .�'— 6 _p R � (R". I IMS) \ Municipality of Anchorage �l Development Services Department Building Safety Division ` On -Site Water 8 Wastewater Program 4700 Bragaw 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: ROSEBERRY PARK ESTATES, LOT 7, BLOCK 2 Parcel ID: A. WELL DATA Well type MOTE If A, B. or C provide PWSID# N/A Date completed 9/13/2007 Sanitary seat (YIN) YES Total depth 51 ft. Cased to 51 ft. FROM WELL LOG Date of test 9/13/2007 Static water level 31 ft• Well production 8 9•p -m• WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Arsenic: NO ug./L. B. SEPTICIHOLDING TANK DATA Well Log (Y/N) YES Wires properly protected (YIN) YES Casing height (above ground) 24 in. AT INSPECTION ft. g.p.m. Nitrat • (.7 mg./L. Other bacteria Q_colonies/100 mi. Date of sample: 4/24/2008 Collected by: GEG Ltd. Tank Type/Material SEPTIC/STEEL Date installed 9/27-12/7/07 Tank size 1250 gal. Number of Compartments E Cleanouts (YIN) YES Foundation cleanout (YIN) YES Depression over tank (Y/N) N0 ' High water alarm (Y/N) N/A Date of pumping NEW Pumper - C. ABSORPTION FIELD DATA [-BELOW FINAL GRADE Date installed 9727-12/7/07 Soil rating (g.p; d.lfeo /bd 1_2 System type TRENCH Length 50+ ft. Width 5 ft. Gravel below pipe 4.10 g, *17.76- NO Total depth 18.89 ft. Eff. absorption area 500 f? Monitoring tube YES Depression over field Date of adequacy test NEW Results (Pass/Fail) PASS 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 >= 600+ g.p•d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date - � ry vv Vl.�w �: �•S S N �J J ASBUILT VVI 11• IIIV I.IJVI• lwfoaoovit P.1 S'Syotr �d-PJ�E tX ItA S� s o r �• e •.• .vo9 y�f z/� 6tf 1 HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE: � FOLLOWING DESCRIBED PROPERTY= AND THATO ENCROACHMENTS ST E,SCCEPT AS DATE INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: £ASEMENTSfCOVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD F8 ��� oyA ANY DATA HEREON BE USED FOR CONSTRUCTION OFFENCE LINES$ OR FOR ESTABLISHING BOUND- EF AWNI ARY LINES. 0 Ifo INAMS Du..l. Muk S. -..d A tp,� D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off" level High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Sewer /septic service line 25'+ Public sewer manhole/cleanout N/A Holding tank N/A 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 N/A Water service line 10'+ Surface water, 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION o! off`. O'). I certify that I have determined through field inspections and I V l '•y* review of Municipal records that the above systems are in 0' • • • • • • •' • • • • • • • • • • • • •' •.. conformance with MOA COSA guidelines in effect on this Q date. A. G ness: Engineer's Printed Name JEFFREY A. GARNESS / Op � '•••S r u.2�•'• a��G Date�eq-r o 6 SAO \ 00 reeslo 0 COSA Fee $ 5 %. so Date of Payment S Receipt Number (Rev. r 1105) Waiver Fee Date of Payment Receipt Number SCSRef.N 1081618001 Client Name Garncss Engineering Group, Ltd. Project Name/N Roseberry Park L7 B2 Client Sample ID Roseberry Park L7 B2 Matrix Drinking Watcr PNN'SID 0 All DatesfTimes are Alaska Standard Time PrintedDatelfime 05/012008 10:14 Collected Date?ime 04242008 8:15 Received Datelfime 0424,7008 10:10 Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Paramaer Results PQL Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 0428/08 04/50/08 NRB Waters Department Total Nitmic/Nitritc-N 0.678 0.100 mg/L SM20 4500NO3-F B (<10) 0428/08 LCP Microbiologry Laboratory Colony Count 0 coVl00mL SM209222B A (<200) 0424/08 DLC Total Coliform 0 coVI00mL SM209222B A (<I) 0424/08 DLC Fecal Coliform 0 col/100mL SM209222B A (<I) 0424108 DLC