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HomeMy WebLinkAboutROSEBERRY PARK ESTATES BLK 2 LT 10Roseberry Park states lock 2 Lot 10 050- 315 -45 Municipality of Anchorage Development Services Department ~ Building Safety Division On-Site Water and Wastewater Program, 4700 Elmore St. ~ P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 of 3 www. ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: BSP101017 PID Number: 050-315-45 Name: Tr'oy Do, vis WastewaterSystem: [] New [] Upgrade Address: Jessie M~e Circle ABSORPTION FIELD Phone: Number of Bedrooms: 3 5 7- 9 3 9 4 4 ~Deep Trench [] Shallow Trench [] Bed [] Mound [] Other: LEGAL DESCRIPTION soilRati.g: 1,0 GPD/Ft2 Total Depth from original grade:18,~ Block: 8 Lot: 10 Sub~vi~)o~ e b e ~ ~ y P ~ ~ P Depth to pipe bottom from original grade: Gravel depth beneath pipe: 3.5 ~,. 9 Township: Range: Section: Fill added above odginal grade: Gravel Length: 0,5 ~'- 34~,. Well: ~ New ~ Upgrade Gravelwidth: 3 Ft. Numberoflines: 1 ~ Distancebe~eenlines:Ft. Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material: Private 300 ~. 184 600 ~e PVC Sched 40 Driller: Date Ddlled: Static Water Level: Installer: Date Installed: SuLLivan 5/14/ [0 46t. Pommanin~ 9/16/10 Yield: GPM Pump Set~o ' Ft. Casing Height Above Ground: 3 ~ ~. TANK SEPARATION DISTANCES ~ Septic ~ Holding ~S.T.E.P. ~ Other: T~ To Septic Absorption Lift Holding ~ublic/Private Manufacturer: Capacity: ~o~% Tank Field Station Tank Sewer Line ~ n c h o ~ ~ 9 e T ~ ~ k 1 5 00 GaL Number of CompaAments: w~, 100'+ 100'J~ 100+ HA ~5'+ M'~': S~ee[ Su.aceWater100'+ 100' ~ 100+ HA ~ / LIFT STATION Lot Line 10' + 10' + 10'' N ~~ Size:Manufacturer: 1500 ~,.S,T,E.P, (Ancho~oge "Pump 9n" I~ at: "Pump oW level at: in. High water alarm at: Foundation 10/+ 10'+ 10'' HA ~..36 45 in. c.,.,..,~,, NA NA NC NA / ~ P.mp Make & Model Electrical Inspections pe.o.ed by; PSO 051 05 HHF Dove Comepon Remarks: BENCH MARK Lo~fion and Description: Garage S [ ~ b Assumed Elevation: 10ft" Engineer's Stamp Inspections performed byNo~hRim En9ineepin~ates: 1st 9/15/10 ~¢ 0~..4~ Development Se~ices Depa.ment Approval ~:' ~ "~ ~'~'49~ ~ ~.~ Conditional Approval Date: ~. ......... ...~"' ~ ~ ~ Steve · ~~ "y~". P E 6'756 .._" ~ ~/' ..... z,/~~ '~, ~2'.- ~/z 7/~ Reviewed and approved by: z,4 ...... ' ~" ) Date: c~.~ V./O ~ff~a'"~ .... JESSE NAE CR Trench-- Lot 9 Under DevelopMent ReptaceMent Trench 1500 S.T,E.P. Tank 0 FCO- Lo~ 11 Septic System -S~OrM Droin MH Undeveto 4 BdrM Home / / Me~OW Creek MAU MN ST C01 87 18 STCD2 95 28 IMT liS 50I .~-OF 4~i'~, ; ! 1~ = 60' NOR TH R I M .~ ..' '"~. ""~ ! R ........... ~,.~m~..,,. DSE]3ERRY PARK S/D PO Box 770724 ,~-,j~ ............................. 907694 7028 "~" ........ ~ BLOCK 2 LOT 10 c U c Q~ F- O 0 I 0 I,I Ld 0 C -p 0 C 0 Q~ > 0 0 o 0 c x,/ © Q/ Z Ld v Z Zli <~i Z Z SUL_L_!V B/ATER EL_LS Domestic - Commercial - Geotltermal Phoee 907-688-2759 www.sullivaewaterwells.com 109 Well Log Permit Number: #SW Date of lss'ue 5/12/2010 Date Started: 5t13/20t0 Date Completed: 5/14/2010 Property Description ROSEBERRY PARK Lot 10 Block 2 Property Owner Nm~e & Address: Borehole Data: SoiI Type, Thickness & Water Strata From To Casing Stickup 0 3 Overburden 3 5 Sand & Gravel W/Cobbles 5 32 Sand & Silt 32 34 Sand Silt Gravel W/Cobbles 34 84 Gray Sand Gravel Clay 84 101 Yellow Hardpan 101 168 Gray Bedrock 168 185 Yellow Bedrock 185 192 Gray Bedrock 192 251 Brown Bedrock 251 257 Gray Bedrock 257 300 Parcel Identification Number: Is well located at approved permit location? Section: Town: TROY DAVIS HOMES 165 E. PARKS HWY. #204B WASILLA, AK 99654 Depth Water Sample Results: Arsenic: ug/l Nitrates mg/l Total Colifbrm Bacteria colonies/100mL Other bacteria: col/100mL 050-315-45 iX iYes l'No Range: Method of Drilling iX] air rotary I { cable tool Casing type: Wall thickness 0.25 inches Diameter 6 inches Total: 184 feet Liner type: Diameter inches Depth: feet Casing stick-up above ground: 3 feet Static Water Level (from top of casing) Pumping Level: feet after 1 hours pumping gpm Recovery Rate 3 gpm Method of Testing: Air 46 'Feet Well Intake Opening Type L } Open End [X l Open Hole [] Screened Start feet Stopped ~. feet {X{ Perforations Start 55 feet Stopped 65 'feet Grout Type: Bentonite dry granular Volume: 150 Pounds Depth 44 Start 0 feet Stopped 44 feet Pump Intake Depth: feet Pump size: HP brand name Well disinfected upon Completion? ix! Yes i i No Method of disinfection CHLORINE 50 PPbl Comments: WELL ONLY APPROVAL 5112/10 BY M.O.A. Well Driller: i cole Sullivan i Sullivan Water Wells 'P.O. Box 670272 i Chugiak, AK 99567 !(907) 688-2759 Attention: The property owner shall provide this log to DSD (onsite) and DNR within 30 days of completion. Pump I~s~sil~io~ Lo~ _ ~rm:t ~'umber: $V¢~ ?arcet tden~-ificadon Number:~ Date: ~ -/ ?u_mp Tmtake De.~th Below Top o[ Welt Casing: ~9 feet ?amp SL~e / hp ?ifless AdapeerBu~ Depth: /L~ feet _~ ,3 Fi-i ;33 e fl 5~: A Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, Alaska 99507 www. muni.org/onsite (907) 343~7904 ON-SITE SEWER/VVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0 Property owner(s)/,.--r---~/~,~ ]~~/,r Mailing address/o//5 E/~ ~.f /~,,j~ Site address ~//~[ ~,~ ~~ Legal description (Sub'd., Block & Lot) ~¢~¢~ Legal description (Township. Range & Section) Lot Size ~A ~¢ ~ Sq. Ft. Day phone Zip Code Zip Code Number of Bedrooms THIS APPLICATION IS FOR (I~] all that apply): Absorption Field ~ Septic Tank ~. Holding Tank Privy [] Private Well ~ Water Storage 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. (Signatur~owner or authorized ag.err0/' Permit/Rush Fees: Date of Payment:. Receipt Number: (Rev. 11/05) Waiver Fees: ,~,~.~' Date of Payment: (-:Receipt N mber: MEMO Steve Eng, PE, PH P.O. Box 770724, Eagle River AK 99577 (907) 694-7028 tel north rimeng@aol.com Date: 5/5/10 Number of Pages: To: MOA On-Site Services Subject: Roseberry Park, Block 2, Lot 10 Septic System Design The referenced property is undeveloped as are the neighboring properties. There is no water or wastewater development within 100 feet of the proposed wastewater & water well site. The lot slopes south toward Meadow Creek. Separation to the creek is maintained. The entire area has clean, sandy soil. Please review the wastewater system design & well location for the 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. Thanks-Steve On-Site Water & Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 EImore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 2 LT 10 G:0154 Permit Number: OSP101017 Tax Code Number: 05031545000 Work Type: WellSeptic Initial Permit Effective Dates: June 02, 2010 to June 02, 2011 Design Engineer: NORTH RIM ENGINEERING Subdivision: ROSEBERRY PARK ESTATES Site Legal Address: ROSEBERRY PARK ESTATES BLK Owner/Address: TROY DAVIS HOMES 1451 E Parks Highway Suite 207 WASILLA AK 99654 Site Mailing Address: 11240 JESSIE MAE ClR, Eagle River Lot Size in Sq Ft: 61645 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field Y SepticTank N Holding Tank N Privy Y Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: ~ Date: ? / IX TH IM ~ ,E~..GJNEERING MEMO Steve Eng, PE, PH P.O. Box 770724, Eagle River AK 99577 (907) 694-7028 tel northrimeng@aol.com Date: 9/14/10 Number of Pages: 3 To: Debby Wockenfuss MOA On-Site Services Subject: Roseberry Park S/D, Block 2 Lot 10 Changeorder Debby, This follows our telecons concerning the subject change order. After review of the 4/7/2004 slope setback memo from James Cross, slope measurements were made. The septic system is actually downgradient of the cut-bank as depicted in sheet 1. We have included a revised sheet 3. The water well is drilled and the location was also slightly adjusted. The contractor is anxious to begin work. Sincerely, Steve Eng PE, PH NorthRim Engineering JESSE NAE CR Lo~ 9 Under Developnen~ Shor~ Cu~-Bank 0? lO' Drop @ 45% ~ 1500 Gallon S.T.E.P. Tank Trench ReplaceMent l~ 0 TH HT Lo~ 11 Septic System -S~orn Drain MH 4 BdrM HoMe Undeveloped dow Creek Meadow Creek DESIGN NOTES: 1. Totol Depth of Trench is 12.5'. Terroin Slopes Southwest. 2. Sewer Service Line minimum 2% slope. ,3. Privote Woter Wells. 4. Neighbor Lots Are Undeveloped. 5. Septic System Downgrodient Of Cut-Benk. ~.T,~. ~ 4~7%. l' = 60' ?_.~.~/~../~ [~.>-~;~~'~. ~DSE~ER~Y PARK S/9 CHAN~r~D~ 907694 7028 ~%?/~' BLOCK 2 LOT 10 ............. L ............. :. ............................................................................................ U C q- © © C U 0 o<5 ~ OJ 0 <:5 q'- 0 0 0 0 b_ ~ C £ (_) 0 U 0 q- '-0 0~ 0 u ~ o5 ~ 5.°_ U -~ U 0~ W Pq W Z m T m L I'--I 13_ W W Z <E -F- ..p ..-Q d ..p~- > _C 0 UO ~ 0 Od U ~ C · ~ Q~ O O~ C- Q~ ~ 0 > --l_m_ 0 ct_l(- C 0 ..p Y C EL. U Z L~ Z L Ld ~ Q~ Q~ z THRIM I~.~EERING CHANGEORDER- Roseberry Park Est, Block 2, Lot 10 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is a new 4-bedroom, single family home. This is a new subdivision and some of the neighboring lots are undeveloped. These lots are large and will be served by private wells. This development is in line with how the site should be developed. No major conflicts to other lots will take place by this septic system construction. The easements are located on the drawing and are not encroached upon. Soil tests revealed sandy soil with low silt. An application rate of 1.0 GPD/FT2 with a 3' wide trench and 9' effective depth. A new soil test was completed to 20' depth with groundwater monitored ~ 18'. Trench Length = 600 FT2/9' x 2 = 34'; 1 line ~ 34'. No bedrock was encountered or groundwater was encountered. A S.T.E.P. Tank will be utilized in the Change-Order Design. 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, 1500 gallon S.T.E.P. tank, conforming to Anchorage Tank & Welding/Orenco Systems Specifications. · 5' minimum between the tank and bed. 10' to property lines. · 3' of cover or insulation is required for trench; an equivalent of 1" insulation for each foot soil cover. (2' Cover + 1" insulation) · Distribution pipe shall be 1" Schedule 40 PVC w/1/8" orifices ~ 2' on center. · Force main shall be 1.25" Schedule 40 PVC, conforming to Anchorage Tank & Welding/Orenco Systems specifications. Force main burial to be 4' minimum (Or 2' Cover + 2" insulation). · Tank & solid pipe must be set on well compacted, stable soil. · 4 inch diameter cleanouts with airtight caps are required 1' to 4' from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment. · All cleanouts must extend to at least ground level. · In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. · Trench to be placed level, minimum 4' to groundwater, 6' to bedrock. · Drain rock to be ½ "to 2 ½" 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. · ]'he 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, Schedule 40 PVC · 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/equal) c_THRIM INEERING SOILS LOG - PERCOLATION TEST Date Per?armed', 5/12/10 Per?armed For~ Troy Davis LegaE Description: Roseberry Park, Block B, Lot 10 DEPTH (FEET) ~ - 6 .... ':.'....-'4 :.." 1~ .' 1¢ - :-.: ~ ..... "'": 14 - 15 - 1~ - 1c) - ~0 - ~1 - Organic SW Sand w/GraveL w/ Low SiLt T,H, Location~ See Attached Design Groundwater? No Depth Water Depth AFter Monitoring,None Date: 5/20/10 ~ Date Gross Time Net Time Depth Net Drop 1 D/lB 0 -- 3. -- 2 5/1P 10 10 rain, 9" 3 5/1P 1E -- 3,, -- 4 5/1P PP 10 rain, 9" 5 5~lB ~5 -- 3" 6 5/1P 35 10 min, 9" 7 5/1~ 37 -- 3" __ S 5/i~ 47 lO rain, 9" 9 5/1P 50 -- 3" 10 5~lB 60 10 rain, 9" PercoEction Rate 1 min,/inch Perc Ho(e Diameter Test Run Between 3' and 4' Comments: Presoaked, Per?ormed ByNop~hRim Eng, I Per?ormed in Accordance with BN THIS DATE, DATE: 5/12/10 CERTIFY THAT THIS TEST WAS All State/Municipa~ Guidelines in E?Fect N OR THRIM EN GINEERIN G PO Box 770724 Eogle River, AIosko 99577 TESTHOLE LOG GEFITECHNICAL ROSEBERRY PARK BLOCK 2 LOT 10 T, H, 5A SOILS LOG - PERCBLATIFIN TEST Performed For; Lee Coy DEPTH (FEET) 9- 0 .... "': 10 - ,' ii - : 1P - 13 - -.'" 14 - 15 - 16 - 17 - 18 - 19 - PO - P1 - PerFormed in Organic SP/GW Sand w/ Gravel CobbLes Accordance Groundwater Observed: None Depth To Water AFter Monitoring: Date oF Monitor: 11/a3/03 None ~ Date Gross Time Net Time Depth Net Drop 1 11/11 0 -- 8,P5,, -- 8 11/11 1 1 min, 6,5" 1,75" 3 11/11 38:) __ 8,0,, -- 4 11/11 33 1 min, 6,a5" 1,75" 5 11/11 64 -- 8,85" 6 11/11 65 1 min, 6,5" 1,75" Percolation Rate: 0,6 min,/inch Pre-Soak Seeped Away In Under Perc HoLe Diameter = 6~ Test Run Between 4' and 5' with ALL State/MunicipaL GuideLines 10 Minutes in EFFect DE: TESTHOLE LOG GEOTECHNICAL ROSEBERRY PARK ~BLBCK 2 LOT 10 T, H, 5 n/n/os 15 or 8s hL'RTH21M SB]'LS LB(3 - PERCBLATTFIN TEST Dote Performed~ 8/31/10 Performed For~ Troy Davis Le9ct Description~Rosebepr¥ Perk, Brock B, Lot 10 DEPTH (FEET) O: 4 - 11 - 1~ - 14 - 16 - 17 - ~1 - Organic SW Send w/Grave[ w/ Low Silt T,H, Locction: See Attcched Design Groundwater? No Depth Water Depth AFter Monitorinq,18' Date: 9/10/10 # Dance Gross Time Ne~c Time Depth Ne~c Drop 1 8/31 0 -- 3,, -- 2 8/31 10 10 rain, 9" 6" 3 8/31 1P -- 3. -- 4 8/31 22 10 min, 5 8/31 25 -- 3. -- 6 8/31 35 10 min, 7 8/31 37 -- 3,, __ 8 8/31 47 10 mir, 9" 6" 9 8/31 50 -- 3,, __ 10 8/31 60 10 rain, 9" 6" Perco(otion Rote 1 min,/inch Perc HoLe Diometer 6' Test Run Between 3' ond 4' Comments: Pnmsnaked, Performed By NopthRim En9, I ~-- CERTIFY THAT THIS TEST WAS Performed in Accordcnce with A[[ 3tcte/Municipc[ Guidelines in Effect nN THIS DATE, DATE: 9/10/10 ~-~-.~'"~, TE S THOLE LOG N OR THI~IM ~.."' ~~i -~ ,, ,- EN GINEERIN G .~~ __,'"~~':"'"1~ GEOTECHNICAL 907 694 7028 ~I' -IllU I~ ' ~e EET ' ' ' © Parcel I.D. Municipality of Anchorage - Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING 050-315-45 GENERAL INFORMATION Complete legal description Location (site address) Expiration Date: Current Property owner(s) ' Mailing address Lending agency Roseberry Perk, Brock 8, Lot 10 Jessie Hoe Circte Troy D6vis Day phone 357-9394 165 E, Porks Hiw~y 99654 Day phone Mailing address Real Estate Agent Mailing Address Audrey M~son RE/MAX o¢ Eagte. River Day phone 622-3344 Unless otherwise requested, COSA will be held by DSD for pickup. 4 2. ' NUMBER OF BEDROOMS: 3.. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class ~ Public Water System Well TYPE OF WASTEWATER DISPOSAL: iX] Individual On-site [] [] Individual Holding Tank' [] [] Community On-site . I--] [] 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 System's 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.) Cedificates 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 theprofessional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER 5. 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 obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site ~t~r. supply and/Or wastewater d sposa system is(are) in compliance with all appliCable Municipal and State code~/ '?" ordinances, and regulations in effect at the time of installation. Name of Firm Nor'-I;hRim Engineer-in9 Phone 694-7028 Address P,D, 3ox 770724 Engineer's Printed Name S~eve En9 Date 9/27/10 ..-_7. ct ' ~ ~; Steven W. Eng . ~ ~ bedrooms, ~th the following stipulations: DSD SIGNATURE %-' ..... Approved for Disapproved.. Conditional approval for bedrooms. Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory /// (Rev 1 X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: C~_ ~. c~,_ / O Municipality Anchorage 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: Roseb.er'r'y Park BLock 2 Lo"c 10 Parcel ID: 050-315-45 A. WELL DATA Welltype P IfA, B, orC provide PWSID # .. Date completed 5/14/10 Sanity seal (Y/N)..Y Totaldepth 300 ft. Cased to 184 ft. · FROM' WELL LOG Date of ~est ~" 5/14/10 Static water level: 46 ft. Well production 3 g.p.m. Well Log (Y/N) Y Wires properly .protected (Y/N) casing· height (above ground) AT INSPECTtON · , 1'3~W new g.p.m. WATER SAMPLE RESULTS: a;. Coliform 0 colonies/100 mL Nitrate 0,611mg/L Arsenic: 0,159 ug/L date of sample:8/!1/10 SEPTIC/HOLDING TANK DATA Tank Type/Matedal Anch STEP Tank (s't;ee[) Tank size 15'0'0~ gat .... .?umber of.Compartments Y ;34' in. Foundation cJealn~t.(y/N) ~' ,y:. 'L. Depression over tank (Y/N) N Date.of pumping me w~ ' Pumper n e w Other bacteria 0 'colonies/100 mL Collected by: Kourosh Date installed 0/16/10 Cleanouts (Y/N) Y ABSORPTION-FIELD DATA : Date inStalled 9/~1~/10~ Soil~mting (g.p.d./~ or ~/bdrm) 150 Length ~4 ft. " Width :~ ft. Total depth 1;3,5ft. Eft. absorption area~00 ~ Monitoring tube Date of adequacy test new Results (Pass/Fail) new Fluid depth in absorption' field before testna in. Water added~a Elapsed Time: nc~ min. Final fluid depth~a High water alarm (Y/N) y Any rejuvenation treatment (past 12 mo.) (Y/N & type) na System type -I;r-ench Gravel below pipe c) Y Depression over field N For 4 bedrooms gal. New depthna in. in, Absorption rate >_~a g.p.d. If yes, give date De LIFT STATION Date installed 9/16/10 Size in gallons 1500 "Pump on" level at ... 41 in. "Pump off' level at 36 in. Datum Tc~nk Bo~c-I;om Cycles tested 3 E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift statiOn on lot 100' + Absorption field on lot 100' + 'Public sewer main NA Sewer/septic service line ;~5' + Animal containment areas.. ;[00' + Manhole/Access (Y/N) Y High water alarm level at 45 Meets alarm & circuit requirements? Y in. On adjacent lots 100' On adjacent lots 100' Public sewer manhole/cleanout NA Holding tank NA Manure/animal excrete storage areas 100' +., , SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10'. + Property line 10" + Absorption field Water main Nm water service line ?,~, + Surface water I nd, + 'Wells on adjacent lots 100' + SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water Service line 10' + Surface water 100' + Water main NA Driveway, parking/vehicle storage 3' + Curtain drain NA Wells on adjacent lots 100' + F. COMM'ENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal reCOrds that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name $'l:eve Eng Date 9/27/10 ' COSA Fee $ Date of Payment Receipt Number (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number ANALYTICA GROUP Troy Davis Homes Attn: Samantha Davis 165 E Parks Hwy, Ste 204B Wasilla, AK 99654 907-357-9394 Fax: Client Sample ID: Sampling Location: Client Project: Sample Matrix: COC #: PWS#: Residual Chlorine: Comments: 10-2 Roseberry Park 10-2 Roseberry Park Aqueous SP-Analytica, Inc.-Anchorage 4307 Arctic Blvd. Anchorage, AK 99503 Phone: 907-258-2155 Fax: 907-258-6634 Report Date: 8/26/2010 Receipt Date: 8/11/2010 Sample Date: 8/11/2010 Sample Time: 9:30:00AM Collected By: Kourosh Flag Definitions: MRL = Method Reporting Limit MCL = Maximum Contaminant Limit B = Present also in Method Blank H = Exceeds Regulatory Limit M = Matrix Interference J = Estimated Value D = Lost to Dilution ** -- RL higher than MCL; target not detected TNC = Too Numerous to Count - result rejected CF = Confluent Growth - result rejected TCNG -- Turbid Culture No Growth - rejected Lab#: A1008138-01A Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 9223B-PA (Aqueous) - Coliforms in DW E. Coli Pass PASS/FAIL 1.0 Total Coliform Pass PASS/FAIL 1.0 Lab#: A1008138-01B Test was conducted by: Analytica - Anchorage 1 8/11/2010 8/11/2010 CW 1 8/11/2010 8/11/2010 CW Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 4500-NO3E (Aqueous) - Nitrate+Nitrite pres Test was conducted by: Analytica - Anchorage Nitrate-Nitrite as Nitrogen 0.611 mg/L 0.10 10 8/24/2010 8/24/2010 KM Lab#: A1008138-01C Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 200.8/200.8 (Aqueous) - Family Well Water I Test was conducted by: Analytica - Thornton Arsenic 0.159 ug/L 0.15 10 200.8 8/23/2010 8/23/2010 RM Page 3 of 3 I I I I ? / / / / / / / / / / / / / / / I I I I / / I I I I I I I / / /' / / / / / / / / / /' / / / / / / LOT 10 BLOCK 2 HAS 61,645 Sq. FT. OF AREA ./ 0 / I I I /I I I I ~1 I I I I / i t / 9 ~ESSIE MAE CE. / / f / / 1 1 / / / 1 / / t 11 I I I I I I I i I I I I I Ii I II // / I I I I / / CJ?APHIC SCALE: ? inch = 50 Feet ~ ~ ~% ~'o ~oo // / / / / / / / / / / / / / ~FoR: TROY DAVIS HOMES tonMork Surveying. Inc. 9330 Vanguard Drive, Suite 131 Anchorage, Alaska 99507 (907) 562-6050 Date 9-23-10 Grid NW 154 Drawn by cef Scale 1"=50' As-Built 2010112 Field Book 237 Legal Description Lot 10 IBlock 2 ROSEBERRY PARK ESTATES I hereby certify that the property described hereon has been surveyed by me, or at my direction, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto unless otherwise shown. That no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other easements on said property except as shown. it is the responsibility of the owner or builder, prior to construction, to verify proposed building grade relative to finish grade and utility connections and to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. Listed distances prevail over scaling. Reproduction may cause distortion.