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HomeMy WebLinkAboutROLLING HILLS VIEW ESTATES BLK 3 LT 1Roll ing Hills View Est. Block 3 Lot 1 #050-322-26 Municipality of Anchorage Community Development Department Page 1 of i On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP141096 PID Number: 050-322-26 ❑ New ❑✓ Upgrade Name: Christopher & Anne Wilson ABSORPTION FIELD ❑✓ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other Address 19210 Upper Skyline Dr. Phone Number of Bedrooms Soil Rating Total depth from original grade 3 0.6GPDISF 7.5-9.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2.5-4 Ft. Gravel depth beneath pipe 5/5 Ft. Subdivision Block Lot Rolling Hills View Est. 3 1 Fill added above original grade 0/0 Ft. Gravel length 40/40 Ft Township Range Section Gravel width 3/3 Ft. Beds: Number of Lines I N/A I Distance between lines N/A Ft. SEPARATION DISTANCES To From Septic Tank Absorption Field Lift Station Holding Tank Sewer Line Total absorption area 800 Ftp Number of trenches 2 Dist. between trenches 15.7Ft. Well 95.9"' 103.0 N/A N/A 45.2 TANK I] Septic ❑ S.T.E.P. ❑ Holding ❑ Other ManufacturerCapacity Anchorage Tank 1,000GaI. Surface Water 100+ 100+ N/A N/A Material Number of compartments Lot Line 45.5 5.1 ` N/A N/A NA Steel 2 Foundation 53.5 64.0 NIA N/A LIFT STATION Manufacturer Capacity Curtain Drain NIA NIA N/A N/A Gal. Remarks* Lot line waiver on file OSP141097 Pump on level at in. Pump off level at n. High water alarm at in. 2" rigid insulation over west trench See attached waiver request Pump make and model Electrical Inspections performed by Installer PIPE MATERIAL House to tank 3034 Tankto drainfield 3034 JRs Septic Drainfleld 3034 CO/MT 3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 100ft Inspection�' 7/22/2014 dates: 2 "a 7/23/2014 Td 7/24/2014 0 7/25/2014 Location and description Lower Level Finished Floor COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date .' kk1 OOF:....., W 'teven ennome', CE 8149 s P ... li A?ESSt�,. � Approved t r"� Date ' � a umpeuuun Rupuii_rr �.uuu DRIVEWAY USE 101.0 GARAGE (E) AND REPLACED WITH CLEAN FILL T2 FDC1 RESERVE ]DRAIN FIELC (P) Cl M4 TH-1 100,OG CONCTETE SEPTIC TANK (E) NEW DRAIN FIELD -C VERIFIED INTEGRI'TY AND INSTALLED INSTALLED NEW 1,000g SEPTIC TAN K REOCRD DRAWING DRAWN BY NJC PLAN � SEPTIC AREA (E) PHONE (907) 272-8218 FAX (907) 272-8211 Scale ROLLING HILLS VIEW ESTATES, BLOCK 3, LOT I CHRISTOPHER & ANNE WILSON 19210 UPPER SKYLINE DRIVE EAGLE RIVER, AK 99577 CE 8149 Q, C50-322-26 PERW —TN 0 OSPI41096 Sheet SPECIAL PROVISIONS TO SPECIFICATIONS 1, ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS AND ATTACHED PES SPECIAL PROVISIONS. 2. SCOPE OF WORK: VERIFIED INTEGRITY OF EXISTING 10009 SEPTIC TANK (CONCRETE), INSTALLED NEW 1,000g TANK (STEEL), AND INSTALLED DCO AND FS. INSTALLED NEW SOIL ABSORPTION SYSTEM. 3. GROUNDWATER WAS NOT OBSERVED TO A DEPTH OF 18.5 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. NO APPARENT WATER TABLE WAS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 18.5 FEET BELOW EXISTING GRADE. - OG/FG (E) 921 DESIGN PARAMETERS UPGRADE SEPTIC SYSTEM N0. BEDROOM: 3 (450 gpd) TANK SIZE. 1,0009 (E) 1,0009 NEW PERS RATE — 20 MPI SOIL RATING: 0.6 GPD/SF AREA ROD: 750 SF SYS. TYPE. DEEP TRENCH 5.0' E.D. MIN LENGTH: 75 LF USED: (2EA) 40 LF X 3' WIDE, 5.0' E.D., 7.5-9.0' TD TOTAL AREA: 800 SF LEGEND W WATER LINE/ WELL RADIUS SS NEW SEPTIC NOTES: PANNONE ENG SVC, LLC RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AIR 99510 PHONE (907) 272-8218 FAX (907) 272-8211 DRAWN BY: I N�Ic DESIGN DETAILS OG/FG (E) 915 TH-1-1996 OG/FC (W) 88.0 (ROBERT C_ (E) 86.35 (w) 855 5 0 Gros 51 11.0 69.5 BOH NO GROUND WATER ENCOUNTERED ABBREVIATIONS Cu COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT Tn TANK CLEAN OUT N0. CA m a ¢ w z' RIGID INsuurlory C wEsr rRErvctl m z 3 =o '- R.I. w O W FILiER O P DRAIN ROCK 6' ABOVE PIPE INV l T I DIVERTER VALVE FS of IOG/FG 97.3 1 �' 0 4" m DRAIN PIPE o ORIGINAL GRADE - OG/FG 965Ij I DRAIN ROCK T I I " _ I 4.0 -- - 1,000 g SEPTIC ( NEW 1,000 g 92.7 (E) 86.o x ^"" �" f TANK (E) SEPTIC TANK (w) SS.o '� :.,n s��sa$NO ' 92.9 OC (E)SI_'f �",.€_=F arh`-�,rad-; ' (w) 80 5 40.0 -I PROFILE DESIGN PARAMETERS UPGRADE SEPTIC SYSTEM N0. BEDROOM: 3 (450 gpd) TANK SIZE. 1,0009 (E) 1,0009 NEW PERS RATE — 20 MPI SOIL RATING: 0.6 GPD/SF AREA ROD: 750 SF SYS. TYPE. DEEP TRENCH 5.0' E.D. MIN LENGTH: 75 LF USED: (2EA) 40 LF X 3' WIDE, 5.0' E.D., 7.5-9.0' TD TOTAL AREA: 800 SF LEGEND W WATER LINE/ WELL RADIUS SS NEW SEPTIC NOTES: PANNONE ENG SVC, LLC RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AIR 99510 PHONE (907) 272-8218 FAX (907) 272-8211 DRAWN BY: I N�Ic DESIGN DETAILS OG/FG (E) 915 TH-1-1996 OG/FC (W) 88.0 (ROBERT C_ (E) 86.35 (w) 855 5 0 Gros 51 11.0 69.5 BOH NO GROUND WATER ENCOUNTERED ABBREVIATIONS Cu COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT Tn TANK CLEAN OUT N0. CA CLEAN OUT NO. M MONITOR TUBE N0, R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPUTTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL & VEGETATE 01F, *: AQ IF �...F.. gin.:.. ROLLING HILLS VIEW ESTATES, BLOCK 3, LOT 11 '-- ...... `L— CHRISTOPHER & ANNE WILSON Steven R. Pannone' 19210 UPPER SKYLINE DRIVE �� Fps, BE 8149�� EAGLE RIVER, AS 99,577 Octe 9/22/2016 Scale NTS PO. NO BSD -322-26 'ERI IT No. OSP141096 Sheet 3 OF3 Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 httP:11www. m u n i.ora/Onsite Development Services Division On -Site Water and Wastewater Program „t �o s� Department **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV161114 PID#:050-322-26 COSA#:OSC161435 Permit#:OSP141096 Legal Description: Rolling Hills View Estates Block3 Lott Engineer: PES Applicant: Christooer Wilson Your request for a waiver of the required 100 feet horizontal separation from the septic tank to the Well has been approved. The approved separation distance is 90 feet. This waiver approval applies to the existing well and septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. x Adjacent properties are not affected by this waiver. ............................................................................... Waiver is Granted: X Waiver is not Granted: Date: ! '� 1 Approve a e of Reviewer ................................................................. .. .. . Rolling Hills View Estates Block 3 Lot 1 ParcellD:050-322-26 Waiver from existing tank to well 9/29/2016 General See the engineers waiver request for mitigating factors. ADEC Criteria Water Table Depth to water bearing layer Depth of tank Soil Sorption Soil descriptions per well log for L7 Points 46 feet 8.8 feet 37.2 feet 4.7 DEC PTS Depth From Depth To Thickness Calc. Pts Silty sand & gravel 2.5 8.5 32 23.5 1.57 Clay and Gravel 4 32 46 14 1.49 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 37.5 3.06 2.9 Permeability Soil descriptions per well log for L7 DEC PTS Depth From Depth To Thickness Calc. Pts Silty sand & gravel 2 8.5 32 23.5 1.25 Clay and Gravel 4 32 46 14 1.49 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 37.5 2.75 1.0 Water Table Gradient - Not calculated XX Horizontal Separation 90 2.6 Total Points 11.2 As per ADEC waiver guidelines, with a minimum point value of 11.2, contamination is unlikely from bacteria but could be possible from chemicals or virus. If the well was redrilled to meet the 100' separation, the points calculation would be within the same points interval, therefore waiver approved. Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve(a)panensak.cpm 28 September 2016 Subject: ROLLING HILLS VIEW EST 133 L1 Well to Tank Separation Waiver Request 1. Waiver: We would like to request a waiver for separation distance for the septic tank to the well located on the subject property. CN�W� a. Tank (E))to Well (E): A separation distance waiver between existing well on Lot 1 to the existing septic tank also on the same lot. The distance between the existing septic tank and the well is 95.9'. We are requesting a waiver for the septic tank to the existing well for a distance of 90' on Lot 1. i. DEC Criteria: The well on Lot 1 is a private well with a depth of 300 feet and a static water level of 37.4 feet and is cased to 78' depth which is well into the subsurface bedrock layers. The well data for this lot and Lot 7 to the west is summarized as follows: LOT# WELL STATIC YIELD Well Data H2OTest Soil Well Nitrate 2.80 DEPTH WATER Date Date Characteristics Log Level LEVEL Data ROLLING HILLS 300' 28.5' Unknown Unknown 9/9/16 N N unk VIEW EST 83 L1 (need results) ROLLING HILLS 300' 81' 5 gpm 11/91 6/17/14 y y 2.3 VIEW EST 83 L7 The ground water in this area typically flows from the east to the west as seen by the depths of the above listed wells and others in the area. The soil cross-sections are similar across the area and a homogenous cross-section was used to calculate the DEC criteria for all components. As outlined under 18 AAC 80.020 and 18 AAC 72.021(a), I have calculated the following points: Summit Estates 131. L1 Septic Svstem to Well Distance from sewer system bottom to groundwater 7.99 Soil sorption below sewage system 4.59 Soil permeability below the system 1.91 Water table gradient 2.90 Horizontal separation 2.80 Total Points 20.30 "The sum of the above values could equate to the following conditions: 16-24 Almost sure to be free from any form of contamination from household sewage." In my opinion, this waiver request meets the above criteria for approval and does not constitute risk to health. I hope the above information will assist you in determining that the waiver should be granted. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 The proposed installation will not affect the future development of the surrounding or existing lots. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 lstl� m -- D On -Site Wastewater Disposal System Permit Permit Number: OSP141096 Tax Code Number: 05032226000 Work Type: Septic Permit Effective Dates: May 07, 2014 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Upgrade to May 07, 2015 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: ROLLING HILLS VIEW ESTATES Site Legal Address: ROLLING HILLS VIEW ESTATES BILK 3 LT 1 G:0255 Owner/Address: WILSON CHRISTOPHER A & ANNE M 19210 UPPER SKYLINE DR EAGLE RIVER AK 995777936 Site Mailing Address: 19210 UPPER SKYLINE DR, Eagle River Lot Size in Sq Ft: 53143 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N 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. Tha e>ct4 v.� CrA s%a14 %e Received Issued By Municipality of Anchorage / P.O. Box 196650 • 4700 Elmore Road Anchorage. Alaska 99519-6650 • (907)343-7904 • Fax(907)343-7997 epartment N http:ihvww.muni.org/Onsite Development Services Division On -Site Water and Wastewater Proaram **** VARIANCEIWAIVER REVIEW **** Waiver#: OSP141497 COSA#: Permit#:OSP141096 PID#: 060.322-26 Legal Description: Rolling Hills Estates, Block 3. Lot 1 Engineer: PES Applicant: Christopher & Anne Wilson Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 5.0 feet. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ® The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. ❑ Adjacent properties are not affected by this waiver. ................................................•.............................1 Waiver is Granted: X Waiver is not Granted: Date: S Approved by Name of Reviewer .............................................................................. MUNICIPALITY OF Community Development Department 3 Development Services Division On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT Parcel I.D. 050-322-26 Property owner(s) Christopher & Anne Wilson Phone: 907-343-7904 Fax: 907-343-7997 APPLICATION, a' Day phone Mailing address 19210 Upper Skyline Drive, Eagle River, AK 99577 Site address 19210 Upper Skyline Drive Legal description (Sub'd., Block & Lot) Rolling Hills View Estates, Block 3, Lot 1 Legal description (Township, Range & Section) Lot Size 53,143 Sq. Ft. Number of Bedrooms _3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank MUpgrade ❑X Duplex (D) F1Holding Tank F-1Renewal F-1 Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Lot Line Distance: 5 certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 45(,9— Date 5(,9—Date of Payment: o f ,2,7jl U Receipt Number: Permit No. Permit App__.: Waiver Fees: 4 C2 /K'J Date of Payment: (1.42,w 1 /Ll Receipt Number: Waiver No. 65 cc) I Pannone Engineering Services uc Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak.com April 25, 2014 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: Rolling Hills View Estates, Block 3, Lot 1 Septic System Upgrade Permit Request Ladies and Gentlemen: I am writing to request a permit to install an upgrade septic system be issued for this property. The proposed systems will serve an existing two (2) bedroom house with a garage that contains an ADU, for a total of three (3) bedrooms. Currently the lot is developed. The two existing 2BR drain fields are in failure. With the use of ap i w' be reused as one 3BR reserve. The proposed system will utilize a 10008 septic to tn9 d ta>ieaani a deep trench type drain field. The surrounding lots are served by private e e �P s on surrounding lots within 100 feet of this system. 1. Soils. One test hole was performed by Lee Reid in 1981 and one test hole was excavated in the area of this drain filed by Pannone Engineering Services in April of 2014, and groundwater was monitored for seven days. Ground water was not encountered in the test hole after the seven day monitoring period. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 0.6 gallons/day/square feet should be used for a conventional wastewater system. 2. Soil Absorption System Design. a. See Sheet 2 of the design package. 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The existing topography slopes from the northwest to the southeast at less than 25% in the area of the proposed drain field. There are no steep slopes within 50 feet of the drain field. 5. Mailing: P.O. Bax 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 6. Waiver Request: I am requesting a waiver of the minimum distance to the lot line to a distance of five feet (5.0'). Granting this waiver will not affect the health or safety of this lot or the surrounding lots. 7. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of the surrounding or existing lots. There are no surrounding wells within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-822.8 FAX: (907) 272-8211 Co ?0 - "XI \Z WELL (E) -)3 13 "j /01 213 HOUSE Z/ (E) INSTALL SEWER SERVICE W/ FCO ,FROM ADU TO TANK 4, 100.2 GARAGE (E) (2EA) 213R DRAIN FIELDS (E) W 1 BR ADU REMOVE BIOMATTED MATERIAL AND REPLACE WITH CLEAN FILL. WE'LL"E) 'kk RESERVE DRAIN FIELD (P) --100.31" vv -7- (2EA) 40LF x 3W x 5.0'ED x 8.0'TD 11.6 AA -� �LEE REID (1981) H-1 it, SERYIn DRAIN FIELD P) 1000G CONCTETE SEPTIC TANK (E) (2EA) 40LF x 3W x 5.0'ED x 9.0'TD VERIFY INTEGRITY AND INSTALL P4r- D.1A., DCO AND FS .__\-77 ..... . SEPTIC AREA (E) WELL (E) ddd 01- yG NOTES: PAMONE ING SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 W: ...... .. Steven Pan *n o' Re E 8149 illFRossioNa� Date 7/17/2014 FOR CONSTRUCTION CHANGE ORDER I Sca le — 1 "=50' ROLLING HILLS MEW ESTATES, BLOCK 3, LOT 4z, CHRISTOPHER & ANNE WILSON 19210 UPPER SKYLINE DRIVE EAGLE RIVER, AK 99577 �;.I.D. NO 4=i()--322-26 PERMIT NO OSP141096 PLAN meet 1 OF 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS), FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS AND ATTACHED PES SPECIAL PROVISIONS. 2. SCOPE OF WORK: VERIFY INTEGRITY OF EXISTING 1 OOOg SEPTIC TANK AND INSTALL DCO AND FS. INSTALL NEW SOIL ABSORPTION SYSTEM. 3. GROUNDWATER WAS NOT OBSERVED TO A DEPTH OF 14.0 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 14.0 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. TH-1-1996 (ROBERT C. COWAN) 4" 0 DRAIN PIPE FILTER FABRIC DRAIN ROCK 6" ABOVE PIPE INVERT 9'0 GM 5.0 M M -I 3.0 I--10.0 — 3.0 (- SECTION 1000 g SEPTIC TANK (E DESIGN PARAMETERS UPGRADE SEPTIC SYSTEM NO. BEDR 0 TANK E. 0 Og PERC - P SOIL RATING: 0.6 GPD/SF AREA ROD: 750 SF SYS. TYPE: DEEP TRENCH 5.0' E.D. MIN LENGTH: 75 LF USE: (2EA) 40 LF X 3' WIDE, 5.0' E.D., 9.0' TD TOTAL AREA: 800 SF PROFILE LEGEND W WATER LINE/ WELL RADIUS SS — NEW SEPTIC NOTES: PL"1L`Il`IONE i'i1VG SVC, LLC CHANGE ORDER P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 ROLLING HILLS VIEW ESTATES, BLOCK 3, LOT CHRISTOPHER & ANNE WILSON 19210 UPPER SKYLINE DRIVE DESIGN DETAILS EAGLE RIVER, AK 99577 ROCK ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH 0s s FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. <� OH So FILTER FABRIC R o O J 21 J -18.5 o DRAIN ROCK 6" ABOVE PIPE INV i n n,-4° BFG 0 DRAIN PIPE 2. 1000 g SEPTIC TANK (E DESIGN PARAMETERS UPGRADE SEPTIC SYSTEM NO. BEDR 0 TANK E. 0 Og PERC - P SOIL RATING: 0.6 GPD/SF AREA ROD: 750 SF SYS. TYPE: DEEP TRENCH 5.0' E.D. MIN LENGTH: 75 LF USE: (2EA) 40 LF X 3' WIDE, 5.0' E.D., 9.0' TD TOTAL AREA: 800 SF PROFILE LEGEND W WATER LINE/ WELL RADIUS SS — NEW SEPTIC NOTES: PL"1L`Il`IONE i'i1VG SVC, LLC CHANGE ORDER P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 ROLLING HILLS VIEW ESTATES, BLOCK 3, LOT CHRISTOPHER & ANNE WILSON 19210 UPPER SKYLINE DRIVE DESIGN DETAILS EAGLE RIVER, AK 99577 ROCK ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R. 1. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL & VEGETATE /2014 ��P��vrHLgs�it' I Scale *¢7!THTH *rl P.I.NTS NO �... .......... 50-322-26 Steven R. Pannone "I" PERMIT NO. P •. CE 8149 OSP141096 2 OF 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 TEST HOLE 1 OR ORGANICS SILTY SAND W/ SM/ SMALL GM AMOUNTOF GRAVEL SOILS LOG - PERCOLATION TEST SLOPE X TH F M — TH-1 LEE REID (1981) WAS GROUNDWATER BOH ENCOUNTERED? N IF YES, AT WHAT DEPTH DEPTH TO WATER AFTER MONITORING? DRY DATE: 4/24/2014 DATE PERFORMED: 4/4114 SLOPE TH X READING DATE CLOCK TIME NETTIME WATER LEVEL READING NETDROP 1 4/4/14 11:00 ___ 5.70 --- 2 11:30 30 MIN 7.25 1.55 s 11:30 -- 5.70 -- 4 12:00 30 MIN 7.21 1.51 5 12:00 ___ 5.70 --- 6 12:30 30 MIN 7.22 1.52 PEROLATION RATE 19.9 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 4 FT AND 5 FT COMMENTS: Test hole excavated by JR'S SEPTIC PUMPING. Perc hole was presoaked. Perc test ran for at least I hour. Last 3 readings recorded. PERFORMED BY: Steven R. Pannone P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: PAM NE EN _�\� Date FOR CONSTRUCTION P.O VBOX 1j01022117 ENG SVC, s9s1i0 'C�OF:Al jkkl 5/6/2014 Q PHONE (907) 272-8218 FAX (907) 272-8211 Scale /g 9 ROLLING HILLS VIEW ESTATES, BLOCK 3, LOT CHRISTOPHER & ANNE WILSON 19210 UPPER SKYLINE DRIVE SOILS LOG EAGLE RIVER, AK 99577 ,t: �� ' -4g TH ,t NTS P.ILD. NO 050-322-26 Steven R. Pannone % PERMIT NO. (�PF6" CE 8149. moi OSPI41096 ��l�R� o ssioNP SheetOF 3 4-AUAA MUNICIPALITY OF ANCHORAGE / • DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION _ 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ❑ NEW ewz 46 XUPGRADE MAILING ADDRE ,� Q Cz r l! SIJ S� LEGAL DESCRIPTION �� 14sq'Ick- // l� 3 f/ I /D`+ /' l/s LOCATION L .y� / ,,/� NO. OF BED 0MS Well Absorption area Dwelling PERMIT /NO. S� �2s+C ``A DISTANCE T0: I r �,.A,;I- Uy F Z Manufacturer Material No. of compartments aQ wF w Lie. capacity in gallons Inside length Width Liquid depth IF HOMEMADE: Well Dwelling PERMIT NO. L' JUZ DISTANCE TO: Z < Manufacturer Material Liquid capacity in gallons 2 Well Foundation Nearest lot line PERMIT NO. -�= w DISTANCE TO: u- z Z w No. of lines Length of eache Y sS Total length Jiss „5 3 Vis~ Trench wi th Z inches Distance between lines A � P Top of tile to finish grade - Material beneath tile Total effectiv bsorpti/o�n area V�-7 4 cc 7�. inches Length Width Depth PERMIT NO. Lu Qa F Type of crib Crib diameter. Crib depth tion Total effective absorption area wa Lu (6 Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. J J LU Buildingfoundation Sewer line Septic tank Absorption area(s) DISTANCE TO: OTHER PIPE MATERIALS I� S AC , SOIL TEST RATING 000 d N INSTALLER P4 1) s ,e REMARKS Sollu>IN XaNe f of t APPROVED DATE LEGAL Sr�2a- Irl , / g 3 r-1 UP -4 I r.-- I 1F=4 $� L- I -T- k- `-A 9.--� F-:- #=-I P-4 �-1 9:79 K.", n- 4--i E -- DEPARTMENT HEALTH AtID ENVIRONMENTAL '70TECTION 825 STREET, ANCHORAGE., Fib'. 915- -j]-1 2E54-4720 fc.-A EP -j a -=l 1 7, PERMIT NO, 810886 .1 694-2662 APPLIf.' ' ANT GERALD SUDKA111P PO BOX 895 99577 LOCATION UPPER SKYLINE LEGAL L I B 3 ROLLING HILLS VIEW EST LOT SIZE 40000 SQUARE FEET TYPE OF* SOIL ABSORPTION SYSTEM IS: TRENCH NUMBER OF BEDROOMS = "3 -SOIL. RATING (50 FT, -'BR)= 20,21 THE REC-lUIRED SIZE OF 'THE SOIL ABSORPTION SYSTEM IS: -7`-3-`.' THE LENGTH DIMENSION 15 'THE LENGTH lf.IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION 'IN FEET). 'THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE E' CAVATIOhl (IN FEET). FRE--:::v7-9LJ I FiCFC: ll:% -' EF' F�,T- I KZ1- Y 1: PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING 'THE I Nd • T ALLAT ION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY ANI) THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. BAC KFILLINf.2 OF' ANY SYSTEM WITHOUT F*INAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSE f. -'UTI ON. MINIMUM DISTANCE BETWEEN A WELL AND ANY (-.IN-,SITE SEWAGE DISPOSAL STEM IS 100 F'EET FOR A PRIVATE WELL OR 150 'TO 200 FEET FROM A PUBLIC WELL.. DEPENDINf.3 UPON THE TYPE OF F,t.)Bt-!C WELL. MINIMI -IM DIST, ANI,",`E F*ROr-1 A PRIVATE WELL To A PRIVATE SEWER LINE IS 25 FEET' FIND 'TO A COMMUNITY '-5EWER LINE TS• 75 FEET. OTHEF.' R-EQUIREMENTS MAY APPLY. SPECIFICATIONS AND cor4sTRucTION? DIAGRAMS ARE R'--.*lILABLE 'TO INSURE PROPER INSTALLATION. F,"E"F`rl ' -T- .1 FRvF:E"fF- I CERTIFY THAT 1: 1 AM FAMILIAR THE REQUIREMENTS FOR Of -J --SITE SEWERS FORTH BY THE MUNICIPALITY Of"' ANCHORAGE. 2: 1 WILL INSTALL T11E SYSTEM IN ACCORDANCE WITH THE CODES. 3- .3 ,I UNE DRSTAND THAT THE ON ... SITE SR S EWEYSTEM MAY REOUIRE RESIDENCE IS REMODELED *170 INCLUDE MOF'.E THAN 3' BEDROOMS. APPI ICANT GERALD SzUDKAMP �. S-41 -1- AN[) WELLS AS ENLARGEMENT IF THE 15-S'UED V4. 0 MUNICIPALITY OF ANCHORAGE • Department ----'\f Health and EnvironmentE')Protection 825 L Street, Anchorage, AK. J9501 264-4720 HANDWRITTEN PERMIT # # ON-SITE SEWER PERMIT iaipc�-� Applicant: p Mailing Address: ? C20YEx2A Location: L_4I Phone Number_: Legal Description: L_ 1 9 Lot Size: r (70 Type of Soil Absorption System Is: Trench: Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms: �IIV Soil Rating(sq.ft/br) © C1 The Required Size of the Soil Absorption System Is: DEPTH LENGTH_ GRAVEL DEPTH WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). # # REQUIRED SEPTIC(HOLDING) TANK SIZE _XIS-4In GALLONS * # 'ermit applicant has the responsibility to inform this de artment during the .nstallation inspections of any wells adjacent to this property and the number ,f residences that the well will serve. # # TWO(Z) INSPECTIONS ARE REQUIRED # # ackfilling of any system without final inspection and approval by this department rill be subject to prosecution. tinimum distance between a well and any on-site sewage disposal system is 100 feet 'or a private well or 150 to 200 feet from a public well depending upon the type rf public well. Minimum distance from a private well to a private sewer line .s 25 feet and to a community sewer line is 75 feet. Well logs are required .nd must be returned to this department within 30 days of the well completion. 7ther requirements may apply. Specifications and construction diagrams are vailable to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 3 1 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as, set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 edrooms. Signed:'_ Issued by:_ AA Applicant e f V-9 Date: SWP/024 (1/81) Jam, LW SOILS LOG MUNICIPALITY OF ANCHORAGE • ae DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: G ara�/lj Sudkaxno n jDATE PERFORMED: `i 75'� aO"OI LEGAL DESCRIPTION: Lo 1 01L 3 ikol l I n q fl1 1 1 D� EPTHI SLOPEIJ SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS �fne M PERFORMED BY: Ri f0f /t - /-Z Row�J.. AS GROUND WATER S JCOUNTERED? O L 0 P YES, AT WHAT E _PTH? Reading Date Gross Time Net Time Depth to Water Net Drop /I to, to 9=•-70 / /% 11,001, 10 'f�cSJ r L « tIE ioff- !v a.+® S S " i r a a- l© 9L• L7 RCOLATION RATE (minutes/inch) f TEST RUN BETWEEN b'> FT AND —24-0— FT 1zs�a • > w 1 4- (vy%eG- CERTIFIED BY! 1 46 e / I _f C4r/ 'V 5,o l IJ e ,, 44P fpv -d / �s e/are DATE: �� O Cons v' -lin Soil Engineers andj e o 1 o g i s t s o1 Bortng 40yT.AT 1011' ..W_ — SLYVATIOH AND DATUM J ,..• Jia J I rr ., 4 A- ....... ' '' NNN DSY�LLI��G PV,RM �V OATS PR-LRZAD J I -3 DATE, TIHI9N90 niY�LLINa cQ��ICw+4 ��� - COMVL[TIOH DY VTM rOCH DTVTH fNy�♦;"p Ii S12£ 4,41) TYPE OF SITDIR �°- T. / uNOIflT. cows w ►- Color, moisture particle m IIfl DT COMVL. 2i NM. CASING size, consistency CASING HAMMER: [WEIGHT IbRtlP SAMPLER 1 Geologist e I4�. SAMtPLES SAMPLE DESCRIPTION (drilling fluid, depth of IZ Ii 'G �°- ►-� casing, casing bions, w ►- Color, moisture particle m .— ulw �;�, �,�,_ _ �, size, consistency _a oma. 0-w a� fluid loss bit condi- tion crowd, rpm, etc.) p At- Cs it i—, te� 3,:. S�. iY �; at h _ r > i _ ;fi t /A UU S ( I E3,?-atA I (M� '' Fi✓�-r P II ULA 11-1 IV jam, 7 �� 4° Cp{llZS�' S•^r)'�' _._.— ^ _ �j �flGltG S£era`�f1�C1�.� 1 i - - j I [ I VV VVUVVHMV LV IV V VR LIN IX F 000 .IHI LO Mumci ali of Anchorage Department of Health and Human Services — 825 'U' Street Rick Mystrom, P.O. Box 196650 Anchorage, Alaska 99519-6650 Mayor July 11, 1996 Robert C. Cowan, P.E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 1 Block 3 Rolling Hills View Subdivision Waiver Request # WR960032, PID #050-322-26, HA960278 Dear Mr. Cowan: Your request for a waiver of the required 100 foot horizontal separation of an on-site wastewater disposal system to a private well has been approved. This approved separation distance is a private well to the on-site seepage crib of 93 feet. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met for another approval from this department. If there are any further questions or concerns regarding this waiver request, please call our office at 343-4744. Sincerely, Robert W. Robinson Civil Engineer On-site Services RWR/1jm:Lanz ~" \MUNICIPALITY OF ANCHORAGE <_- Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# WR960032 PID# 050-322-26 HA# HA960278 Permit # Date Received: July 5, 1996 Legal Description: Lot 1 Block 3 Rolling Hills View Subdivision Engineer: Robert Cowan, P.E., S & S Engineering 17034 Eagle River Loop Road, Suite 204, Eagle River 99577 Applicant: Robert Lanz Waiver'Requested: Private well to the seepage crib of 93 feet Criteria: 1. Geology: Points: A. Water Table .Z B. Soil Sorption /�-5r— C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: Waiver is NOT Granted: List Conditions or Reasons for above: /, /S fyps"%,ne, Date: By. Nay me o ewer Rec #: #02017/503 Amount: $ 920.00 Date Paid: July 5, 1996 0&6AI� 1,114Z -S. vlew 00 -Z 174,o Y r fr T- PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW910292 DATE ISSUED: 9/16/91 DESIGN ENGINEER:DUMMY COMPANY EXPIRATION DATE: 9/16/92 OWNER NAME:LANZ ROBERT C & MICHELLE L OWNER ADDRESS:19210 UPPER SKYLINE DR EAGLE RIVER, ALASKA 99577 PARCEL ID:05032226 LEGAL DESCRIPTION: ROLLING HILLS VIEW ESTATES BLK 3 LT 1 LOT SIZE: 53143 (SQ. FT.) NUMBER OF BEDROOMS: 2 THIS PERMIT: 2 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PI RECEIVED 1 ISSUED BY DATE: DATE: , �o 6� \� a �. y.0row .� \ /til v�:9' ft.G C"9'.��iy!•iVOif�. ... .. '/ �i 3(� i Oo 7a. \ zpo \ � •. � u Vo t `. 4 SGB. iaOJ✓"/iJ /C7.'l/.4� D� GGf' r%J�l//cLt' ♦`���j • • • • •A • : N� g� ! L,umin l,lnrk Sc.vard - c~' 'St :•�•. LS - 6916 • : <. ••. •• �wm I ;I ©dmbcoweoo�4o� As+DUILT'No corners get this date w I hereby certify that I have performed a Mortagee'e `il':P1FNTS OF RGCURD, O'LIiP;R T'11A[Q 'll[0.(iF, SI[OIJN ON 'Lill% rpectlort of the following dencrlbcd properly: ;CURllEU PLAT ARU; NOT SICUWN IIBRhUN Rolli.nf; View Estates Subs. Loll, Anchorage Ltecortling Precinct, Ala_ska, and that tare IMP' �t l ai Orllltt�tlOn hCreOtl is for the Liss of letl(.litll, ,nests situated thereon are within the property lines arc � I.,Citutions shot%iii& the •relationship of cxiStint, -nut overlap m encroach on the property l lytta adjacent effic" e W, that no improvements on property lying ndJacent the c ructures and platted easements and lot lines. encroach on the'prernisca In question and that there ar: o r(md.vuyo, irrvrsrniasion lines or utlrer visible easamantr t is not to be iised for posi.LiOtlinp additional calrl Properly exc•cpt ns Indicated heteutt :•uctures or fencelill('_S. Dated at Anchorage, Alaska 1G $9 April _— lhig 2 day of h118-4566 SEWARD & ASSOCIATES LAND SURVEYI ,' /ot a • Municipality of Anchora u� '' 2 On -Site Water and Wastewater Progra (907) 343-7904 SEP 3 2 M6 s E r. a ^A Certificate of On -Site Systems Appy Izz Parcel I.D. 050-322-26 Expiration Date: 1. GENERAL INFORMATION Complete legal description Rolling Hills View Est. Block 3, Lot 1 Location (site address) 19210 Upper Skyline Dr. Current Property owner(s) Wilson, Christoper & Anne Day phone Mailing address 19210 Upper Skyline Dr. Eagle River, AK 99577 Real Estate Agent Day phone y� 8 9 10 2. TYPE OF DWELLING: 77 ❑ Single Family (w/wo ADU) RUSH! A3 ❑ Duplex SEP 27 2016 s ❑ Multiple Dwellings (Single Family and/or Duplex) �6 ti 3. NUMBER OF BEDROOMS: 3 0[689 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Q Individual 0 Individual Water Storage ❑ Holding Tank .❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5a (a ' Waiver Fee $ 11 _ l Date of Payment 0 ,"13� (� Date of Payment q/�1/ Receipt Number ( Receipt Number b-75 -33L COSA# 1q�5 �fh Waiver #_ osylS 1}Il 5. STATEMENT OF INSPECTION B EN'GWEER As certified by my seal affixed hereto and 0 of th'9 vaP8ationaate shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval°`13SiSelines 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; frothe Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal'sy5te'm`isre) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, zftlhe water usage of the family being served by -the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any, warranty, for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benel]A-4 f. the owner listed above. Name of Firm Pannone Engineering Services LLC Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE System #1 Approved for 3 bedrooms System #2 Approved for bedrooms Disapproved Phone (907) 272-8218 Date 9/22/2016 r •.. A0*. *1 ��even i2. nonan � —8149 Conditional approval for bedrooms, with the following stipulations: By: "`��Original Certificate Date: L� O • l The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSAbluesheet E ', c If more than 1 septic system is on the tot: COSA Checklist # !_of + Structure served by this system 1 Certificate of On -Site Systems Approval Checklist 007 OG Legal Description: Rolling Hills Estates, Block 3, Lot 1 parcel ID: e519"��'��' A. WELL DATA DSoeLai —oZCo Well type Private If A, B, or C provide PWSID # Well Log (Y/N)- N Date completed Unk6own Sanitary seal (Y/N) Y **res properly protected-JY/N)'Y *297 .4+ . Unknown 12+ Total depth ft., Cased to ft. Casing height (above gMund) in. Date of test Static water level FROM WELL LOG Unknown Unknown ft Well production UnknOWn 9 -P.M. WATER SAMPLE RESULTS: Coliformcolonies/100 mL Nitrate .?J mg/L Arsenic Q)J�_)_ ug/L _ Date of sample: 9/9/2016 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size LOW 1'0M gal. Number of Compartments1_2 Foundation deanout (YIN) Y Depression over tank (Y/N) .N Date of pumping 9/15/2016 pumper A -Two Septic AT INSPECTION 9/9/2016* 37.4* ft. 1.49* Collected by: Sullivan Water Wells Date installed Unknown & 7/25/2016- Cleanouts (Y/N)- Y High water alarm (Y/N) N Cr ABSORPTION FIELD DATA Date installed 7/22/2014 2 0.6 GPD/SF Deep Trench Soil rating (g.p.d./ftz or ft /bdrm) System type Length 40/40. ft. Width3/3 ft. Gravel below pipe: 5/5 - ft. Total depth 7.5-9,0 ft. Eff. absorption area 800 ft2 Monitoring tube Y Depression over field N Date of adequacy test' 97.12/2016 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 3/0 in. Water added 476 gal. New depth 3/0 -in. Elapsed Time: 70 min. Final fluid depth 3/0 in. Absorption rate >= 400+ g.p.d Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (WN) "Pumpp on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO Septic tank/lift station on lot 95.9 On adjacent lots 100+ Absorption field on lot 100+ On adjacent lots} Public sewer main 75+ Public sewer manhole/cleanout 100+ Sewer /septic service line 25+ Holding tank 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Absorption field 5+ Water main. 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOTTO: Property line.5** Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+ Driveway, parkfhg/vehicle storage 10+ - Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS * Results from Sullivan Water Wells test. 0/ l( ,s ,.,4 C C -W ** Waiver on File OSP141097. *** See attached waiver request.. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformancewith MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven Pannone Date - 9/22/2016 COSA canary sheet -2-6-1 5.doc Meven no CE 8149 �S fe. . -�` LOT I BLOCK 3 trGryr 6 Ar,Etat ' I Not of ReoarW -. Ae N East (( ak 14% Pat 156-157 pofth 0'/' '\ r 10' Po C: nt 00. \\\ R= 50.00' E4ctrlo tJ» \ SK 316.. 1 \ 3p' 1 \�\aN Elxblc LiM \\\ °' 4b tw 3� LEGEND e \\\ 71r «�+ of Power Pole Tel, Ped, 4> flfl ® Septic Pipe6c°36 o-�' house I hereby certify that I have surveyed the following described `4 9 '21 ... property; Lot 1, Block 3, Rolling Hills View Estates, Plat No. P-624, Anchorage Recording District, and that no encroachments exist except as indicated hereon. This As -built will only show the *� horsy F Bonata. easements that appear on the recorded subdivision Plat No. P-624 and of those jf L5-10393 described by Book and Page, Anchorage Recording District; under no circumstances �r11 A�,,,� should this data hereon be used for the construction or establishing of boundary or fence lines, t tt1, Pft' 1E 4" e S".,IN FM st IN FM 1" = 50' Surveyed: Sept. 8, 2016 Rolling Hills View Estates Lot 1 Block 3 As Depicted on: Plat No. P-624 Anchorage Recording District GRID: NW0255 ASBUILT SURVE Wilson Christopher A & Anne 19210 Upper Skyiktaive- Eagle RNer, Alaska 99577 eusrm:6�r I � APB Land Surveying 12204 East Prince of Peace Drive Eagle River, Alaska 99577 (907) 227-1361 MUNICIPALITY OF ANCHORAGE IiL • DEPARTMENT OF HEALTH & HUMAN SERVICES iWELL Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # D 50 — 32 2 — 2t, HAA # 6� Q) S x,1_1 L, 1. GENERAL INFORMATION Complete legal description I I + 14 t It _S i'/1 _'& . f. [3u.3, Lai I Location (site address or directions) I9a.l D V Qpr-✓ Property owner Ze_twt w UN/d_t�" Day phone G Mailing address l J�fOy� A�2" D'V- Lending agency 14!"o Day phone .5-63-3120 rt rt / n Mailing address 32o f C �4, L +4 3a5 Agent Arid racc Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 0- 3. TYPE OF WATER SUPPLY: Individual well Community well Public water Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm oWcvr V L ct �, L Phone Address — A s IV"/ -54-4 2a &,,4,,L A- V Engineer's signature 6. DHHS SIGNATURE _ Approved for T W D bedrooms. Disapproved. Conditional approval for Date 91?lf 8' bedrooms, with the following stipulations: Additional Comments The well on this property produces less than 300 gallons per day However, with the water storage tanks, the Municipal requirements for water supply have been met. If there are any questions regarding the water supply, please call DHHS On–Site services at 343-4744. By: Date al The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA a21 a + Municipality of Anchorage R�� EI !9 �® DEPARTMENT OF HEALTH & HUMAN SERVICES f Environmental Services Division SEP 10 199 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4 ,chorage Municipality an Services ept. Health &Hum Health Authority Approval Checklis R01144,4 Legal Description: � els V yu tJ" � Parcel I.D.: d 5 0 b A. WELL DATA Well type IZ If A, B, or C, attach ADEC letter. ADEC water system number 1` /A Log present (Y/N) N Date completed V. K, Total depth ^' v 0_0 Cased to LID Casing height (above ground) 1195i d•e ttov s e Sanitary seal (Y/N) Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test 9 - /' Q Static water level N04 a✓w,' t4j01e S�& m. Well production g.p.m. � r � """.�"� g•p• �4P rr, .2t!irs i $Or>Ki+? WATER SAMPLE RESULTS: ' Coliform — Nitrate VQ' (o Other bacteria ri t7 Date of sample: �' ` Collected by: B. SEPTIC/HOLDING TANK DATA Date installed l I ?a> Tank size /OV40 Number of Compartments _ I Cleanouts (Y/N) Y Foundation cleanout (Y/N) Depression (Y/N) N High water alarm (Y/N) t4 Date of Pumping C001'? Pumper 13 C. ABSORPTION FIELD DATA Date installed /Q73 t 194V Soil rating (g.p.d./ft2 or ftz/bdrm) A012 System type Crib t Length /0, '33,r Width /br 2 Gravel thickness below pipe Total depth 1.10 Effective absorption area.2YO, 140'z— Monitoring Tube present (Y/N)--Y-- Depression over field (Y/N) Date of adequacy test R` r R S"� Results (Pass/Fail) ? For bedrooms Fluid depth in absorption field before test (in.); q b Immediately after gal. water added (in.): Fluid depth 57 (ins) Minutes later: o4rs Absorption rate = '> 3b't7 g.p.d. Peroxide treatment (past 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)" D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* _ Cycles tested E. SEPARATION DISTANCES Size in gallons "Pump on" level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot > I "Pump off" level at* On adjacent lots > 1170 Absorption field on lot 43 V60, uwy' On adjacent lots > t� Public sewer main rV Ac Public sewer manhole/cleanout 14/A Sewer /septic service line > A5 Lift station N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation �0 f Property line �D Absorption field j0 Water main/service line /0'0 f Surface water/drainage t! O Wells on adjacent lots LV -t7 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line b Surface water N Curtain drain N10 F. ENGINEER'S CERTIFICATION {- Building foundation 'LID ` Water main/service line 93 Driveway, parking/vehicle storage area Wells on adjacent lots > 6cs-6 5Z I certify that I have determined thru field inspections and review of Municipal records thpithe'above systems are in conformance with MOA HAA guidelines in effect on this date. Signature _ / SF Engineer's Name f o fol0�► U VA4_La Date � , HAA Fee $ 'fit Y) , (-)r ) Waiver Fee $ Date of Payment 10l -1C)-Gly Date of Payment Receipt Number nkA \-Vn ( 5195 / Receipt Number 72-026 (Rev. 3/96)* CT&E Ref.# Client Name Project Name/# Client $ample ID Matrix Ordered By P'VVSlD 21:U,U I uiE E'-1 HNCHUHHUE ri&�E Environmental Services Inc. 982386013 Tobben Spurkland RE. n/a Rolling Hills View 3/1 Drinking 'Water Parameter Results TotaL Coliform 0 Nitrate•N 2.36 0 Client PO# Printed Date,/Time 09/08/98 20:52 Collected Date/Time 09/01/99 17:00 Received Date/Time 09/02/98 12:00 Technical Director: Stephen C. Ede Released By� , f PWL Units Method ccl1100mL smis 9222D 0.100 mg/L EPA 300.0 AltowabLe Prep Analysis Limits Date Date Jnit 09/02/98 KAP 10 max 09/02/98 09/02/98 GrP SEP -08-1996 21:11 CT;F::E ESI ANCHORAGE JID/U f' CME Environmental Services Inc. ,ztlL Lafsorstory Division rs`.r�r .►� r►asr►•frara �i,�,o��rri�,►o�.r.�.a��rmw,�.r, Drinking Vater Analysis Report for Totai Coliform BacteriaAncaPotternse, IifR1RIN, 0 PE4D lrVSrRUC7T0jVS OX REY$RS`ESTDE BEFORE CdLLEC 2%VCr SAjtjPLC Tel: (9071562-2343 Fax: 1907) 515f•5301 MUST BE COMPLETED BY WA Q PUBLIC WATER SMEM M M K PRIVATE WATER SYSTE4M 0 s.wf.+ arYaxwa`IT t:r s.w rYwftlic. - ?Peer • wz wI M 1 13 Stwd dretwlw (I{, �S%I fd ra woor SAMPLE DAM- 0 SAMPLE TYPE - )K !Routine a Repeat Sample (foes noodsis 140plr with lab reit no. a Special Purpose SAMPLE LOCATIONZO , o Treated wet" ustfea" WSW TEme Calm 4rsi[eete& my &MMU TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to beta 5attis 0 UwaoisGtetory Cl Untie ovear 36 hours old. results may be uardiiabiv 0 Satttple too long in transit, sample should rte be over 43 hours old at examination to indicue reliable tpuln. Please mid new sen We via spww dolim6y M#1fete Received { 1 Tlrpie Atceived Analysis lops Aeelyd ai Method- , wribme Filar 12 IMMO-MUG '� !`i1tR:bSl`ofeo{®niec!{{�0 n91, Mesulto Aa€aziytt ifetoo•J�®, ,tach Plilm 1„f %�xad Doe+ ..m,...v.e.a. Yimgr,- Met notified of ansad3iselo rlr rsttults: SpvwWNW, BACTERIOLOGICAL WA!�ALYSIS RECORD Nsmo ,riuc Rtaerlaa-real Celifitrfe Membraae Plltarr affect Coreg f tr9lenitdlOq frAf Ve iflatatitnw Lie BCD reel CGUAM ®a; Det et{eN rw .aa�iva N 9t x ewva. a l M0111614raws M1111, flapsrted fly - DatehfS Comments; % •a—�..�d.Y.e tll l9l P_c�..r. �YY+e: s.a P_laL�l®.Yet.....-.uaYwe MM - neoe'4P. 0 n Cru MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650- Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D.#; HAA# i�ta�►(o�a`1�S 1.GENERAL INFORMATION ...Complete legal description Lot 1; BJ-pCk 3; P.o1 ingi HiIT3 View S12bdivicion I° 19210 Upper Skyline LocauQn,Asite,4.ij dress or directions) PPe Y r r ....... , ? ^ ' . Eagle Ri., er, AK perty owner Cobert & Michelle Lanz Day phone a.r..1tia. 3 p M \t� ," 5`Mailing address C%O�Tnax of Eagle River Attn: Virginia Kohfield 2!f00 Centerfield Drive Eagle River AK ' 99577 . ` 'Lending`agenc 7°R a Day pone 5- RJ,Mailing address° :Agent*- Day phone„ . r Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 2 3. '_ TYPE OF WATER SUPPLY: ..... Individual well _ XXX Community well Public water Is NOTE: If community well system, provide written confirmation frorr, State AD.EC attest- ing to the legality and status of system. ! � 4. TYPE OF WASTEWATER DISPOSAL: - y t, Individual on-site Holding tank Community on-site Public sewer NOTE:- If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev.1/91 ) Front MOA N21 S. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. l furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection: 5 & 5 ENGINEERING Name of FirmEagve.ool,RoaPhone y Address, Eagle River, Alaska 99577 Engineer's, signature Date �.` C2 , •: A 3 ROBERT C COWAN Q t � Ov ' l.h .,..' -Hr +.:e E��ir s e�-�'f v w,• 7 a -k t�� >.a 'd ,�" 6 W .. .,.._,. epi 6 DI -111-11W SIGNATURE %Approved, for '�' bedrooms. _... _ Disapproved. Conditional approval for bedrooms, with the following stipulations: " f 7_ Additional Col A 6 i r By: Date °l�'� a The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. MUNICIPALITY OF At ENVIRONMEWAL SERVI Municipality of Anchorage JUL ®519 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division BUT 11 j 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 3 r Health Authority Approval Checklist Legal Description: /_,r 1 ., 6toa.x 3 e Cmo6wJG Nv,y� Parcel I.D.: 0503z.z.z ViEJ EST. A. WELL DATA Well type P0,j\1A1'6 If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y,® N Date completed Total depth N 300 Cased to y'0 -+ Sanitary seal (ON) k. Casing height (above ground) Wires properly protected 4&N) _ z* FROM WELL LOG AT INSPECTION Date of test S "3 t "9 L Static water level V� - ��e ��+TS T" P or - Well production g.p.m. • `f g.p.m. WATER SAMPLE RESULTS: Coliform Nitrate Z I Other bacteria 56 Date of sample: -25� - `� � Collected by: S 4. S F-fd%' /.1 B E L IIS Cs B. SE IC HOLDING TANK DATA Date installed I9 'J 3 Tank size /000 Number of Compartments 1 Cleanouts &N)--- )�-- Foundation cleanout (Y/& /-J Depression (Y/8) f� High water alarm (Y/4% f� Date of Pumping Pumper PI r- L? C. ABSORPTION FIELD DATA ; Date installed 1ii3 f i9kt - Soil rating (g.p.d./ff2 orft2/bdrm) 2na6rzSystem type Gam¢ { LL � Length lo, 33.5 Width{ Gravel thickness below pipe boy LoTotal depth 1 t 1 b' Effective absorption area f l Monitoring Tube present WN)_-� Depression over field (Y/� Date of adequacy test - IS ,i6 Results ail) 4.x$5 For z-- bedrooms Fluid depth in absorption field before test (in.); �_ Immediately after7?-0 gal. water added (in.): 56 Fluid depth 1 (ins) Minutes later: -060 Absorption rate = 3o a � ` 0 g.p.d. l Peroxide treatment (past 12 months) (YNR r If yes, give date '` A 72-026 (Rev. 3/96)* 1913 G�P- t (0--'7iD—� 1, D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* cycles k ees�"d E. SEPARATION DISTANCES Size in gallons "Pump on" level *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic olding tank on lot 100, On adjacent lots Absorption field on lot II 91� On adjacent lots Public sewer main y`P- Public sewer manhole/cleanout Sewer /septic service line Zs Lift station SEPARATION DISTANCES FROMISEPTICfHOLDING TANK ON LOTTO: Foundation 1t�:) `k Property line tt o � at* Absorption field 5;-kk Water main/service line l0 1�- Surface water/drainage 1 o o '�- Wells on adjacent lots l n� SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line 1c--, 1 Building foundation 1 n I J,- Water main/service line l o 4-- A- 1+ 541 -PR-•Ore. r�er Surface water low �Driveway, parking/vehicle storage area S " 1a 064-, Curtain drain '110 Wells on adjacent lots l�b,la F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records� < in conformance wi h MOA HAA auld lines in effect on this date. y.4.. "•. �S„� Signature 7 G *7 49th . M..N M ♦. . Engineer's Name %1 r� /� �.�( r C• Co �.✓ .1 �✓ � � .•//"%-rr-,+ i. > nY, eF. ry Nuur. % / S J �! / -A R08ERS C €dWAN � Date ( bc'� f�1 CE 8801 HAA Fee $ Ua A =6---7 Date of Payment Receipt Number fit' 7 1 �a-32 72-026 (Rev. 3/96)* Waiver Fee $►//� Date of Payment Receipt Number ,`7� are LtE CT&E Environmental Services Inc. Laboratory Division rs®®®®®s®®®®®®®®®® 200 W. Potter Drive Anchorage, AK 99518-1605 Tel: (907) 562-2343 Fax: (907) 561-5301 CT&E Ref.# 962571.962571002 Collected Date 06/25/96 Client Sample ID Lot 1 Blk 3 Rolling Hills Matrix Drinking Water Technical Director: Stephen C. Ede PWSID 0 Released By_.,—,,.,, Sample Remarks: Parameter Results QC PQL Units Method Allowable Prep Analysis Init Qual Limits Date Date Nitrite -N 0.100 U 0.100 mg/L EPA 353.2 06/28/96 _ ESC Nitrate -N 2.21 0.200 mg/L EPA 353.2 06/28/96 ESC Total Coliform 0 0 col/100mL SM18 92228 06/26/96 TAV U - Undetected LT - Less than GT - Greater than D - Secondary Dilution J - Below the calibration range r ��, 86iB Member of the SGS Group (SociAtd GAnesrale de Surveillance) ENVIRONMENTAL FACILITIES IN ALASKA_ CALIFORNIA. FI ORIDA. 11 1 INOIS. MARYI AND MICHIGAN_ MISSOURI_ NEW .JERSEY. OHIO. WEST VIRGINIA C CT&E Environmental Services Inc. Laboratory Division rars�•o//.iii Ivo//iid-vii//s,�,iaery.�.�,�,�./,�,///oe//o Drinking Water Analysis Report for Total Colifo READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPI MUST BE COMPLETED BY WATER SUPPLIER ❑ PUBLIC WATER SYSTEM I.D. R % PRIVATE WATER SYSTEM F-5OSend-Results ❑ SendInvoice -y risme mun name htuhnq Hearns 'ry sum Z.P co SAMPLE DATE: (O Z S Month Day Year SAMPLE TYPE: 6- Routine ❑ Treated Water ❑ Repeat Sample (for routine sample ❑ Untreated Water with lab ref. no. ) ❑ Special Purpose Time Collected SAMPLE LOCATION Collected By L Comments: 3 L Plcuc ,in Bacteria 200 W. Potter Drive E Anchorage, AK 99518-1605 Tel: (907) 562-2343 Fax: (907) 561-5301 TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: Satisfactory ❑ Unsatisfactory ❑ Sample over 30 hours old, results may be unreliable ❑ Sample too lona, in transit; sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received r &6 Time Received 1 X113 o Analysis Began Analytical Method: Membrane Filter ❑ MMO-MUG " Number of colonies/ 100 ml. Lab Ret. No. Result* Analyst 02e D FTn 962571A3 Sent to A.D.E.C. nc . Fbks Jun ❑ Faxed Date: / Time: Client notified of unsatisfacton' results: ❑ ❑ Phoned Spoke with Faxcd Date: Time: BACTERIOLOGICAL WATER ANALYSIS RECORD NIMO-MUG Result: Total Coliform /� E. Coli Membrane Filter: Direct Count Il Colonies/100 ml Verification: LTB BGB COLIFIRM y+p ens daa Fetal Coliform onfirmation i 39 t Final Membrag4ilter esu .V��% E "Colitorm/100 ml Reported Da Time / 0= hrs T:\'TC � Tnrr Nurnonur Tn Cnunr Oil - Orhn Havens Xlunicipality of Anchorage i Department of Health and Human Services 825 L Street Rick Mystrom, Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 July 11, 1996 Robert C. Cowan, P.E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 1 Block 3 Rolling Hills View Subdivision Waiver Request # WR960032, PID #050-322-26, HA960278 Dear Mr. Cowan: Your request for a waiver of the required 100 foot horizontal separation of an on-site wastewater disposal system to a private well has been approved. This approved separation distance is a private well to the on-site seepage crib of 93 feet. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met for another approval from this department. If there are any further questions or concerns regarding this waiver request, please call our office at 343-4744. Sincerely, Robert W. Robinson Civil Engineer On-site Services RWR/1jm:Lanz MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION JUL 05 1996 R E C E I V E D ROBERT C. COWAN, RE. ROBERTA. SHAFER, P.E. nG July 3, 1996 CIVILENGINEERS (907) 694-2979 FAX (907) 694-1211 CZrn 3aa-lq(-o Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ( 4 )a -4A HEALTHAUTHORITY APPROVALS nC(0?)a 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 SEWER & WATER MAIN EXTENSIONS REFERENCE: Lot 1 Block 3 Rolling Hills View Subdivision Request you issue a Health Authority Approval on the SEWER&WATER referenced property and grant a waiverfor the horizontal INSPECTION separation distance between the following well and the crib serving this property at 93 ft. The mitigating factors involved which support the issuance of ENGINEERING STUDIES ANDREPORTS the waivers are as follows: 1. Reference to the site plan/topo, surface effluent would not flow toward the wells. WELL INSPECTION &FLOW TEST 2. The well is located in the home and is protected by the foundation walls. 3. Nitrate sample taken from the well located on the SITE PLANS referenced property indicated 2.21 mg/1. In our opinion, the separation distance requirement prescribed by 18AAC.021 is not necessary in this case. ROAD DESIGN fi}7-7Af't o4E4 }}Q, WH,L4 Vo -G'S �Ro,n 7(y¢ sur4 Raju Ui�G. A. RlS lT•. If we may be of further service please contact us. Sincerely, SOILTEST 4XIZ lrt� Robert C. Cowan, P.E. PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 - EAGLE RIVER, ALASKA 99577 m i r- r - m J 1" = 50' I SITE PLAN L J I I • sifP 9f,a /1--z>Po . r r O i 77 w m 9v , o X70 U) �{ \ 7 U , �� r n r Z \ n z A / G) W ` m M r oo-i� nvirn I—' n CA -Ni 0 NDmN n�C x NpZ AZAy�N Z� O n m�47) CW o� n> Nm��r=Zvi 1-4 C z vni Nom-' _' 'z C N N vmZ Ainm �lTid �JC111� A Z Nm m (.O 'om Z o _vii �prbp�qy-� m <M mGMA�N 0 O ::E Z O rcr Z m / N o m -,d. m Z 1 n \�� A m 0a N om -. 3DzOlJNn AnAC� =o= O �o-n�i z N O � � i{ r• COp A fi t_•o ...' O O �.a. ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E.: CIVIL ENGINEERS (907) 694-2979 FAX(907)694-1211 PERFORMED FOR: e� T ✓ 'y DATE PERFORMED: LEGAL DESCRIPTION: Lo -r , 1✓r-K 3 t'rlw`.LLt Township, Range, Section: 4"a -'a SLOPE SITE PLAN aaaftey e. CaWAN s CF -8801 1 (� 2- 3- 4- 5 3 45 6- 7 7 8- 9— WAS 9 15 r 16 c� 17 18 19 20-1 1 COMMENTS. td --- --- ���� PERCOLATION RATE TEST RUN BETWEEN (minutes/inch) PERC HOLE DIAMETER FT AND FT, I PERFORMED BY: 17034 Eagle River Loop Road Mo. 90 IGFfd�- — CERTIFY THAT THIS TEST WAS PERFORMED IN Eagle Rioter, Alaska 99577 7 6 ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: WAS GROUND WATER \ b 10 ( ENCOUNTERED? ffA S 11 t IF YES, AT WHAT , Si 0 a DEPTH?' _Lh— P 12 E 13 her Depth to Water Monitortng7 Date: -1/15--1 6 15 r 16 c� 17 18 19 20-1 1 COMMENTS. td --- --- ���� PERCOLATION RATE TEST RUN BETWEEN (minutes/inch) PERC HOLE DIAMETER FT AND FT, I PERFORMED BY: 17034 Eagle River Loop Road Mo. 90 IGFfd�- — CERTIFY THAT THIS TEST WAS PERFORMED IN Eagle Rioter, Alaska 99577 7 6 ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: r O N n r rri 0mo 1/�KN'm 7ZNA s,. �hC y Ji .. 1" - 50' 'SCALE SITE PLAN Seiqric AS -BUILT O --i W i I r W v i ' A O � f � C X lj A i DZ xVI y\t� O mX O O vI o �dN z 7myr02,Z ?oN��Nw K (Y)4< o C \2c �N\lS1X� z -N—i s an�ao c) 4 Wy-, O`<N\ j00Z k i rc� z D z \ m m'v�m A N 0 z m m D 1 m nh;N rii /p>oz VI AyDO O0y Z z z WO / n I00. i o • m cn N O TI L embleolam Pere ddd.00.60 Stood, ROLL 2. a" &too of We" Lot*#$" So see C, WELL LOS Too Det"miltserial ?to* Gravels soil 0 13--07T If a& s—t–o–n—e - with re 210 24 roc seam owaer ........... m ow'. drum, dl� -toed~ ar T 7 Sol 001 D. weage GO? SELL' Mr a chuck Dowrick, se 2 Box 7327 Refused: Bogle Itiverg Ak* 4, WELL DCPTM*- It1ed'61 commiLvevw g I 41. 0 Otloo I 0 poll Auger 0 0 pols"S Bowl 0 19#06,07 0 0 aObtN (3 goomwisol, n Toss wait 0 otaort ------ CASJMG+ 0 Vike ad Xm(wolded 17 diem. to. Depta we'$0 It Death P14111101 D. i1NI1N 07 WELL: Two@! $$$I/v4Sa sllo-_- L*oVb zdd_� set boto"o it. a" 11601,11111419 SOPOWSO veto nn 23 Tic WATER LIvCL: ft. 10. STA Dole 0 460.0 or UYPIOW Is" owsoom, Coeipareal 001. It PwOPINO LEVEL 110,0410 64" 040"" a" vKL9 0~ Iwo. itatoodoo a 64010740"G WDM od,e : 0 vol, 0 to poop J'a opmesems Led.040 Of one ft" �" emommally •0 • 0 see- 13 Aaa 0 c 1 0 MteO *4 0,10,80011 Froductim of 4eO Gal per day ►_- �3 O O O �Og a a O V Z Z O O O a a w z 'vin i v' wj Q � k, W QTY J y� 0 W W K w chi, w w z 3 m CO) u W u= ci a J 0 0 w w 0 w 0 www 0 0 ►_- 1 K �t cvy PCI Lo i F O r n t W a w t i Z o a F. F 0 ¢ 3 0 a �3 O O O O O O O O O O O O 'vin i v' i 0. p• k, W W W w chi, w w z 3 a CO) u 1 K �t cvy PCI Lo i F O r n t W a w t i Z o a F. F 0 ¢ 3 0 a .2 � 5 rJ O O O O O O O O O O O O 'vin i v' i 0. p• k, W W W IFx. 0 0 w w 0 w 0 www 0 0 0 w 0 w 0 w 0 w 0 w 0 w .2 � 5 rJ �i 'vin i v' i 0. p• O O O O O O O O O O O O F F F F F F H H h F H H w w w Q M: �' c p 0 d O W w O W w OO W w a w O M w O x w O W w O W w O W w O x w O x w O cx w z .2 � 5 rJ by DOC Co. dba SULLIVAN WATER WELLS P.O. BOX 670272, CHUOIAK, ALASKA 99567 • TELEPHONE 688.2759 /.,'DATE- D,iQTEGL C p✓VS / DEPTH OF WELL j %%O r1/O F IC STATIC LEVEL OF WATER FT. Q<it l IQc "o od d � cc 3RAW DOWN FT. Ended �rl— GALS. PER HRO O PERMIT NUMBER KIND OF CASING '� d F, a ..,� .�, J,. .a•.. KIND OF FORMATION:' From 0 Ft. to 07 Ft. CAS/aJ 6 S% / JP From Ft. to Ft. FromC� Ft. tos_Ft, VCS /3a4d� From Ft. to Ft. FroinyFt. to__CL__�Ft. Slov 0 06004A; <. From Ft. to Ft. From_!�_Ft. to -J -s), -Ft. S'/ A. % % J -4r) 14' From Ft. to Ft, From Ft. to Ft From t. to Ft From_.3ml_Ft. to___q�a_Ft-/1C L4 Y % tr�Q�Jc'4 _e , From ft. to FL From_ _Ft. to _Ft. A t4 ksc.& Al) S 7'< Y/ZJ4 Ft. to Ft. From Ft. to Ft. 4% r i r'e C/{.9nJGi+ From Ft. to Ft. From1904 Ft. to. JY_x_f_Ft yGALJt,tG (�rC,Gr ) From Ft. to Ft. From Ft. to_a_YA_Ft 66,04og-t- dRJr:cd r From Ft. to Ft. From Ft. to FtQJ A4 / Z From Ft. to Ft. Fromta?AtFt. to -,fl D Ft.Aa 4O�bC Ot�- t 7✓16� From Ft. to - Ft. MiomL_Ft.'to K. 7, t ! From' Ft t&_' FN; From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft._ From - Ft. to Ft. From - Ft. to Ft MISCL. INFORMATION: From Ft. to Ft. From Ft. to Ft DRILLER'S NAME Drittim Illij AA-� DOC Co. tlba . S ULLi"N WATER WELLS CHUGIAK ALASKA 99567 • TELEPHONE 688-2759 , e � ,• t :i#Y."�i �[ ri: ,<'xir M 1vk* r{` 4;,. , ,fii :. I i ,,,. ii 5.Y r_ R OF L,1ND _ A-tiCW r: F 1«.a dAr F F, r r �DEPTIi OF WELL c+t4.X fi 1 h1jRESS1�____�-� r t r n't STATIC LEVEL OF WATER FTk t ` " yy n " ,.—w—•u—� .Fo PThF'% i�N01^���A}}A�JS4 1 1FV' LEGAL DESCRIION. ry f )I W DOWN FT t t ♦1 { f� tr` ,rr 1�, alstYlln3 a i U.11 F Started _��— Enc{ed i, _� is l' GALS PER iFR o. t, f . " . KIND OF CASING II'1 NUMBER__--_-- _ ___—_ - —� ---- MA t✓a rfwL�'iN �tk�.!IP 4a'1 ,eFa �(4lurl ijy+� yrF! KIND OF FORMATION tr t y,Aq #t 5." 1, ; SP y i t i ' d}� yy�rdSi`i ``4q•(�! ' 1 rom�Ft. to Ft '' '�J 11 Ff Ms a F to Js . ' r yf� +r{+� i : S i nY;� $* t } : ,P t° j Si: j,4C a.>irz'1Mr'f• �, a 1'Lr, t FSL �r 4# ..• From- ANN � x1`1111f From, f' rom +k . 'r ' lif` ✓ �,' , d L t{. x 7°� � o�7i,, )♦'yi. i �,. '}��.. � ,y � i�', r Front'' +! •!f : t r r ` V � 1 Y n.d� l k ♦• ,� � _... � I w�a"" 1e1�" ✓ g Z' From ] t. to }e F1 it 1:11 �V yv q t r<I � r }y�r t0 iCai y F��r'Av i ivvv l 2 ll f ,F�frO1,,c �. K 1+. a a ';f � �. �'" i. "i„P9� J* r• Y yx 1° i.udq �` t �y ih l k 1X k ry t0 't h' . dt;�lA H li: from _'�',�Ft. to,��1,_,Ft r ' !-,--I-X-- fi, .ryIT. I , :r :t A'i•) M71"(✓ ! ,. yet t v i 4! •�N,k} i4 A 'IT. t ,p1Alva t)1� •Y F't trl ti, - .f Ft.' i t Fruin_.c—'7Ft. tu.�i__L_t.tr Nir.:�'dt�tin� ).` 5t r_T Ft' , r ,1 FuI f it t ,a �a 1Ii From__! 3 Ft. to '� t_ From i A'' I Ft' to,' Ftt_— '�#. _. i, �r'}q C is tr t r',+ r t , + •. � ar > +,Vi?' moi.. F to•—yFl P e ' ” From " Ft to�,F1'r._ _ ':i a r.+r ?'+"ttr. #t .x#M /Y F ,', rr� ''I ♦�r e,f fiA rt liG ;sc' , � ( `,t Q ... + ,'1 1,3yy is' 1 !1 7' � �r w M t: �y ., i r l I.L li , , ' � t, , r 1. 1 l ,T r fY � + e ° r.. • Froin___ Ft. to— Ft. Frorr�l ' _Ft to Ft. From. Ft. to Frum-.._Ft. to— -r-- ——_...---- ° t fi+��;A t 1 { a , 'y p. •�:r r Frortl, , Ft: to Ft.-- Prum____---Ft. to—Ft._�.�____- . Z ',jf r. c _ r Frum._..—Ft.to Ft.— .From — Ft.to�TFt — — `yj y y' Frum �' Ft. (0— to--Ft. o Ft From --__.—Ft. to Ft. --- --- ', ;; From _rl, to to— Ft. __ -- ---Ft.—,-- ---- From _____Ft. to Ft. -- x• I ' From _ Ft. to Ft.__,_____-""_---- MISCL.INFORMATION: ,)CA � -- _. a,�' hd.., 5 it .♦♦..0 r j�yy !^p�ii},��}�i 4 i DRit LER S,NAME q er �r '. .:i .FL,.. ... .'S. 4'vYd'F wu��_x.�}'.?itk�"8 � 'Xt?Wbre�'°fYR: ,0..lm li.� �._.Yt...' ,4 h.>>tr1G. G'§_O::J+v�t .�.. .S ' At .h .r, .. 'x�.lVi x v... •, .... m4 .... .. r� r x > r ° C OOsl i s or y p n r D fr 011 0 At* 0 E A i O m m m m m m m O O O O O O p. fill i «. ) 2 O O O O O O O O O O O O i �t S i a� i y ^3 m > r ° C OOsl i s or y p n r D fr 011 0 At* 0 E A i O 14 p. fill i «. ) 2 m > r ° C OOsl i s or y p n r D fr 011 0 At* 0 i Oia" fan. 00 ao w (D o T m i s or y p n r D fr 011 0 At* 0 i Oia" fan. 00 ao w (D o T m h D s or y p n r D fr 011 0 At* 0 ami b N m Lpaj "` >'T TfimiliTt"' w(DiMIKO STAR izDuirE A ANCHORAGEy ALASKA 00502 344=7714 SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF 310 -leet DRILLED AT THE RATE OF $24000 PER FOOT. PROPERTY OWNER ldoak o&de&ed bLp llyt bJeo Thomp.4oa, Yammer Corwt 349-2571 LOCATION OF WELL SITE Lt 3 B tk, 3 Sub Timber Ridge #1 DRILLER Bee Ctaim of- RalnpaAt D&ttUnq b)o&kw WELL LOG: 0----191 Tt U. and 4u&�ace bou,Cdvw. 40% 4.itL 4 ctaiy Made t, 19---78' Come ghcure.t. 20% o.i lAf, mate,'& a- 78--126' lia&dpan.. R cemented gA weL wt h. 15,04 4arzd* ctaV .in .the A&aahton. 126-310' R congtom Ante mate Uat. R weathered Pm of be Aock.; mane 4Aeci f, cut4v 4ha& nock. (a jt44i a &ock) OntV a m,Fn.i.mat amount o.- 114 tGt 1, wake& at 245-247 fit. Thio weU d4 cowed c&U the wa4 out to 302 .deet, into a Qood cteoA watet beaking g)uswe.L congtom Ante. at .that dewet. T2om 302 to 310 4et .IA open hate In bet�tock. Th.i..I area t4 plwduc W orU# &,pout 3/4 g.PJW & .tom a &x4e not t aiea. 9t t4 doubt.,u t .that .thele .4 aruj. new watet &ea4,iW a2ea4 olt a j gni l leant natuAe, beyond 310,, �t. T otat watvt p�toduct f on, m04t of- U com aq Aon 302 At z4 a: Tutt 180 gal torw pe1i hour. The wawa pumped cLecA to two hou&w. One ko&4e Sujmvr 6Z&te- Pump mu4t be .uwtaGted at 299 A. 9n tde the atee.L ecw.ing. The bottom .dew .fit near 310 may. be 4ttt.ly. Rtthough it i4 &athe t urwAua.t! .thele t4 orU# 25 A oj� Ovate& 4tan4tn# ag bottom. 12oaetheLe44p t ti4 Vett tuAnAe-L out to be a we ty. flood phoducva! Total Coot o� the J)AtV,ing Opehat t ca: $24 per. A X 310 "fit: $7440.00 J COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. 12� per, �t�t t� a ��� 4�r tnt� n G �J_ _ ......._._,, WRITE CHkC'Kt PA 'ABL "rt0 1VAfi9w DaRILL?l * WORKS FOR THE SUM OF 97440*00 THANK YOU VERY MUCH. Thank You We4. BERNIE CLAUS OF RAMPART DRILLING WORKS DATE Decembe2 17th. 1984 7 Alts\. v 0 CAI L2i- SERVICE CHARGE 0 F IV,% PER MONTH WILL BE ASSESSED ON \PAST DUE ACCOUNTS. MUNICIPALITY OF ANCHORAGE • Department of Health & Human Services `1 DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # >~�' - i� HAA # iU IM L a �)9 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, Location (address or directions) (b) Property owner t'�� �3`1�� Telephone: (home) Business Mailing Address (c) Lending Institution Telephone Mailing Address % (d) Real Estate Company and Agent'�� �6'g a lea Address Telephone (e) Mail the HAA to the following address: (or check herej, f hold for pick up.) List contact person and day phone number below: S & S ENGINEEIUNG 17024 Eagle River Loop Road.Ne '20.4 - Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single -Family 3. WATER SUPPLY Number of bedrooms I— Individual Wely2'__� Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7ie8) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional .and adequate for the number of bedroomsand type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Telephone S & S ENGINEERINO Road No. 204 1703 Address Eagle River Looe Eagle River, Alaska a 995 Date 6. DHHS APPROVAL Approved for �� bedrooms by Date Approved < Disapproved Conditional Terms of Conditional Approval�� CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description:ox- ,, 11 t 3 A. WELL DATA I�4 Well Classification ` Ui ����%b If A, B, C, D.E.C. ApprovedO/N) Well Log Present (Y/PJ_ Date Corr�pleted J�- Yield �% 4_6f i 7-'' l Total Depth" ')Ab ✓Cased to Depth of Grouting Static Water Level "7S 1 '/- Pump Set At ^ 3r Casing Height Above Ground Sanitary Seal on Casing (SRV) Electrical Wiring in Conduito?N) Depression Around Wellhead (Yd SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot k�P>r / - ; On Adjoining Lots ) To Nearest Edge of Absorption Field on Lot l � lji,' / ; On Adjoining LotsTo Nearest Public Sewer Line f To Nearest Public Sewer Cleanout/Manhole A t To Nearest Sewer Service Line on Lot Water Sample Collected by Date (10 Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed J)� Size tca� No. of Compartments Standpipes P/N) J Air -tight Capso�N) _ 4 Foundation Cleanout (Y&4 r -A Depression over Tank (Y/40 Date Last Pumped �- Pumping/Maintenance Contact on File (Y/N) t _ ' '?� O ; for Holding Tank High -Water Alarm (Y/N) N P Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well. l+��r To Building Foundation Vis, To Property Line'- ire r-- To Disposal Field I� To Water Main/Service tine + 1 To Stream, Pond, Lake or Major Drainage Course a" Comments 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Svc, 1 Type of System–Design Date Installed at �tP.� Length of Field i Width of Field Depth of Field 1 �) Gravel Bed Thickness b Square Feet of Absortion Area Statndpipes Present ON) Depression over Field (Yo rJ Date of Last Adequacy Test Results of Last Adequacy Test — \ CL A SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well ao 14 To Property Line To Building Foundation To Existing or Abandoned System on Lot lo, ; On Adjoining Lots To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course - To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION IJ P Date Ina iled Size in Gallon "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments To Cutback (if present) Dimensions Manhole/Access (Y/N) "Check Permitted Bedroom Rating Against HAA Request" "Pump Off" Level at Vent(Y/N) r�%/A ng Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in E inspection. S & S ENGINEERING Signed 7034 E.gie River- loop Road N® ?aA a Company Eagle River, Alaska 9957771, Date MOA No. Receipt No.,�_ 1.2 V y Date of Payment 7 1 Amount: $ 1/ 7 /, 4i Receipt No Waiver Fee: $ Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 '10400 A. sne►sc No. AA814 Df t i �n CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FEDERAL TAX ID # 92-0040440 A_l LyQTS � EPM fox asCr&x # 1-11344 a- . T BY UnflF Repolt pxintpel: 20 89 eax; ID:Llatm cz HILLS VIEW EST aieclt : & 3 'L !D ('1—oilt Accl 51'13BU CWlecut" ars e, 14:4S ht2. t01 YQNI, REC ± la a,2 3 lao. Req # OtaG�od 9v '�("RkDV eases with: W Nf)tll ul-lvss "ou'lpleted :W P) 39 �olld Repor's to, llaborat ox v Supervi8or 3TEPWI 01, ll',M 1):&:;p Pole,eo. By 7 I s« T.nstl',LC' k1l"an I lah Pef 4: 4006 :ate ! ID: I as W'ATER stall iJ oe Ep;k 2 I ju -U"E SUM,, SMATLE C.01.eCTL" e »r 1"'mr a- 30h&,l «a hboa C CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. TELEPHONE (907) 562-2343 5633 B Street _ Anchorage, Alaska 99518 v `*"^ "^•• Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY ❑ PUBLIC WATER SYSTEM I.D.# I i I0 Analy is shows this Water SAMPLE to be: PRIVATE WATER `SYSTEM � Satisfactory —� 1 r"r�l ; i"ioZi,`� ❑ Unsatisfactory Name Phone No. ��si4 �— Z� ❑ Sample too long in transit; sample should not be over 30 hours old at examination Mailing Address b ,C to indicate reliable results. Please send i--, new sample via special delivery mail. City tate Zip Code � Date Received (a` a Tsi SAMPLE DATE: (Z[ - ] F�Y I& v -D Mo. Day Year Time Received SAMPLE TYPE: outine Check Sample (for routine sample with lab ref. no. ) ❑ Treated Water ❑ Special Purpose ❑ Untreated Water SAMPLE Time Collected NO. LOCATION Collected By 2 UL, 3 1 I 4 5 Analytical Method: Membrane Filter * No. of colonies/100 ml. Lab Ref. No. Result* Analyst i FP71 ED U m U m L� m C BACTERIOLOGICAL WATER ANALYSIS RECORD �( READ INSTRUCTIONS Membrane Filter: Direct Count BEFORE COLLECTING SAMPLE Verification: N BGS Coliform/100mi Final Membrane Filter Results � Coliform/100ml Reported ByDate Time: �� a.m. p.m. TNTC = Too Numberous To Count OB = Other Bacteria INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE -DATE DATE SINGLE FAMILY INSPECTOR INSPECTOR INSPECTOR ❑ MULTIPLE FAMILY MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 • ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPER W R PHONE MAILING AYVESS cl;�5a_19 .� ev_ since June 1975. For wells drilled prior to that date, give well PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE _ MAILING ADDRE§5 755on��� YEAR ON-SITE SYSTEM WAS INSTALLED. 3. LENDING INSTT TION , � PIJONE� /,311 it / MAILINGADDRESS 4. REALTOR/AG P ONE MAILING ADDRESS e 2 ,5. LEGAL DE CRIPTION STREET LOCATION 6. TYPE O RESIDENCE k, NUMBER OF,BEDROOMS SINGLE FAMILY X_ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY [jZ_ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM LefDIINDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER of R�toFd DATEINSTALLED IN LER [�Keptic Tank or ❑ Holding Tank Size: /004i If Tank is homemade give dimensions: SOILS RATING 2 O (� TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/ Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS CD C fL n- 4 D�(o NO APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY 5. LEGAL DESCRIPTION DA I E RECEIVED INSPECTION APPOINTMENTS ✓1�(3/ TIME TIME TIME p 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS DATE DATE DATE �1 INSPECTOR INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & & ENVIRONMENTAL PROTECT[ 8WVIRONMENTAL PROTECTION DEPARTMENT OF HEALTH INDIVIDUAL* 825 L Street - Anchorage, Alaska 99501 ❑ COMMUNITY 0* J UL. 1 3 1981 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 RECEIVED ECCI\/E REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER SUD fire PHONE 6`Y� -a66d. MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE 40-14--azo-3 MAI LING ADDRESS S',-'.. /3 4) _X t5 F- 3 S'77 3. LENDING INSTITUTION PHONE Rf�IN/6R In0ATe,gG,P G®„ MAILING ADDRESS -- 42 y-? Qty �lvSS BAR k OAc>� 4. REALTOR/AGENT PHONE MAI LING ADDRESS 5. LEGAL DESCRIPTION Lam-; / v3coc k _; ROLL.i-lJG Otte _S Vii, z,, E:5-rA-rCs STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS SINGLE FAMILY ,K One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) Va6LL 46-ptN S. SEWAGE DISPOSAL SYSTEM 29. INDIVIDUAL/ON-SITE** i) - #73 YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. a 72-010 (Rev. 6/79)17 THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS t ---APPROVED FOR _BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY Municipality ®f Anchorage MEMORANDUM DATE: September 18, 1981 TO: Laura Crow Senior Office Assistant FROM: Sewer and Water Program SUBJECT: Request for Refund - Account #2460 Please make arrangements for the following refund; a private engineer has completed the inspection of the installation of the sewer system, not this office. Gerald Sudkamp 2230 Chandalar Drive Anchorage, Alaska 99504 Receipt #154993 Amount: $20.00 fee Permit # 810886 Thank you. Laura J. Ward Senior Office Assistant Sewer and Water Program rytt�Jvla� p/�G.IT� n}a pNGt6oR�i� �wu�axx,lvi rn,-r�bt, 1-t� AG7'N D)V, 99wr%A A&Z WAr8k A k SEPI', 14) l98`1 MUNICIPALITY OF ANCHORAGE DEPT. OF 5:` -.LTi I & ENVIRONIMENT,;!. P{ -,LECTION RECEIVED be-� srv,s i HE K-) X iR6c-9:WT'LY ,;aZp my Zaust IQ E A GL 4'0v]6k I -Z V, s R6 cru i latA) T6 1) A s60T/c s ys7'd An uP6-PA/b youk M8/UT NgP&c--tt ani C66ce1,P # r jiAb AP f- IRA-) bo -rHE /0S -f6< T)z) W , r WbULb A'PPAccr)V7& A REFulu,D ht= 7"N,ff t2o Z. jauRs TRU RL% "p -C GFa4,La L, SO bf-L-AM P aa,36 cKAn,JA4AK OA. APc-46kA6E; Ak. i55"a MUNICIPALITY OF ANCHORAGE POUCH 6-650 •ANCHORAGE, AK 99502 •PHONE 264-6400 FINANCE DEPARTMENT CASH RECEIPT No. 1.54993 RECEIVED S l n i� _,---.. OATS FROM C"k. C 1 C' $r' zir ADDRESS EsZ�— AMOUNT - t.:' ±-�—,y-S�Lt�- — I r f Ar• DAVID A.SLENKAMP MECHANICAL ENGINEER • 694-9055 August 8, 1981 7 Gerald Sudkamp P.O. Box 895 Eagle River, Alaska 99577 Dear Mr. Sudkamp, ROBERT A. SHAFER CIVIL ENGINEER 694-2979 MUNICIPALITY OF ANCHORAGE DEPT. OF HF-ALTH & ENVIRONMEWTAL PI;OTECTION Reference: Lot 1; Block 3; Rolling Hills Subdivision AUG 1 RECEIVED A sewer adequacy test was performed on the system located on the referenced property as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The seepage pit was full of water and had to be pumped. Approximately 1000 gallons of fresh water was placed in the crib and after a period of 24 hours approximately 80 gallons had percolated out of the crib. As a result of the above test it can be concluded that the septic tank is adequate, however, your seepage pit cannot be considered adequate for the one bedroom residence located on this property. It will be necessary for you to have the absorption area upgraded before it can be considered adequate. If we may be of further assistance, please do not hesitate to call. Si P.E. cc: Coast Mortgage Municipality of Anchorage Department of Health and 8nvironmental Protection 4 SR6196X EAGLE RIVER, ALASKA 3201 Spenard Road Anchorage,Alaska 99503 (907) 272-2407 Raymond Lundgren WOODWARD-LUNDGREN & ASSOCIATESINC. George ElHervert CONSULTING ENGINEERS AND GEOLOGISTS B.A.Vallerga AN AFFILIATE OF WOODWARD-CLYDE CONSULTANTS William T. Black June 19, 1973 Job No. A12109-12 Needles and Son P.O. Box 8 Chugiak, Alaska 99567 Dear ;sir. Needles: Basement Excavation Inspection Lot 1, Block 3 Rolling Bills View Estates Eagle River, Alaska At your request, the undersigned inspected the subject exca- vation and logged the vertical soil profile on June 18, 1973. A sketch of our understanding of the proposed development is shown as Figure 1 and the soil profile of the basement is shown in :Figure '2. The soils were visually classified and absorption values as- signed accordingly on the basis of our experience and by k,ritten guidelines of the Greater Anchorage Borough. Absorption values are given under. "Remarks" in Figure 2.. It should be noted that this inspection was not made at the pro- posed seepage pit location and is therefore contingent on the assumption that soils remain consistant with those observed. It should also be noted that small seepages were observed in the uphill side of the basement excavation from a more pervious sand layer. The continuity of this layer could not be deter. - mined at the time of the inspection. It is recommended that this office be called when the pit is excavated so that our assumptions can be verified. Very truly yours, WOODWARD-LUNDGREN &I ASSOCIATES Rodney P. Kinney, P.E. Chief Engineer RPI:: nck OAKLAND - SAN JOSE - - SAN FRANCISCO - ANCHORAGE, ALASKA AjQ&A %/o WOODWARD-LUNDGREN & ASSOCIATES f j AjQ&A %/o WOODWARD-LUNDGREN & ASSOCIATES CHEMICAL & G&, " GICAL LABORATORIES m ALASKA, INC, TELEPHONE (907) 562-2343 ANCHORAGE INDUSTRIAL CENTER C5633 B Street Drinking Water Analysis Report for Total Colifor m' Bacteria TO BE COMPLETED BY WATER SUPPLIER TO BE,,CQMPLETED BY LABORATORY WATER SYSTEM: A alysis shows this Water SAMPLE to be: I.D. NO. gill Satisfactory AIII, 0 Unsatisfactory water System Name Ph ❑ Sample too long in transit; sample should not bq_over 48 hours old at examination Mailing Address to indicate reliable results. Please send Ran new sample. RT BE Code -city Ai Zip St Z' WKA Date Received E T,-1 SAMPLE DATE: Day -F Year Wlk Mo. 111111me Recelv6d Sun W i SAMPLE TYPE: NO IF N 3.1 " 1�& un FAft A lytical Method: 31 0 Routine 'j `Fermentation Tube AMP ,, % Ann ",'g- %­__ ,It TH6 h N • Check Sample (for routine,14' moleo,5 =a -1gft ........ 1=0 with lab ref. no. M", g-, at lllil �nMembrane Filter • Special Purpose ml In m SAMPLE NO. 1 2 3 4 5 LOCATION I— / rr� 3 1� a W Rev. 1978 Date Collected READ INSTRUCTIONS Hours BEFORE Time Received colonies/ 100 Source — a.m. -p.m. Lab. No. 0ml 10ml Result* Analyst EMB Broth 24 hours: -Broth 48 hours: COLLECTING SAMPLE Multiple Tube Report: 10ml Tubes Positive/IrOtsl 10111111 Portions Membrane Filter: Direct Count Collform/100ml Verification; LTB BGB Final Membrane Filter. Resu Collform/100ml Reported By L t Clate I � I , 111 Barr la y`Mi Y o L - Ili llmesl Cir U \ 04v ° I Mal musks u, 0 - R 01 11 'l S t�N, •Y _ rnxA[gr Ilk e HiuY.e ITrla, an r. Y N K. 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