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HomeMy WebLinkAboutROSEBERRY PARK ESTATES BLK 1 LT 1Roseberry Park Estates Block 1 Lot 1 #050-315-26 Certified Drilling Log IR BILL & COLE OC CO d6a � P.O. Box 670269, g ULLIVANWATER WELLS OWNER OF LAND: Michael Quinn ADDRESS: PO BOX 772641 Eagle River, AK 99577 Bore Hole Data Depth From To LEGAL DESCRIPTION Roseberry Park Estates Ll B1 DATE: 2-2-16 0 2 Casing Stickup PERMIT NUMBER: OSPIS1302 DATE OF ISSUE: 9-10-15 TAX IDENTIFICATION NUMBER 05031526000 Is well located at approved permit location: ®Yes No Method of Drilling: ®air rotary ❑cable tool Depth of Well: 300' Casing Type: Steel Wall thickness ,250 inches Diameter: 6 inches, depth 104 feet Liner type Static Water Level: 39 feet Recovery Rate 1 gpm gph Method of Testing Air Well Intake Opening Type: ❑open end ®open hole ❑ Screened Start feet Stopped ❑ Perforations Start feet Stopped Grout Type: Bentonite Volume: SO lbs Depth: from 2 feet, to 42 feet Well Disinfected Upon Completion: yes no Method of Disinfection: Chlorine 50 PPM Comments: 2 4 Overburden 4 18 Silty Sand & Gravel Tight 18 21 Boulder 21 40 Hardpan 40 41 Silty Sand &Gravel 41 43 Boulder 43 48 Hardpan 48 52 Boulder 52 53 Hardpan 53 54 Boulder 54 93 Hardpan 93 115 Broken Bedrock Dark Gray 115 162 Bedrock Gray 162 202 Bedrock Gray w/ Quartz 202 279 Bedrock Gray 279 288 Bedrock Broken Black 288 293 Bedrock Green Hard 293 300 Bedrock Broken Black Drillers Name: Cole Sullivan ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. Inspection Report 9-1-12.doc Municipality of Anchorage On-Site Water and Wastewater Program a (907) 343-7904 Page / of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: O.S 0 Z PID Number: C.'-%-'3(5—Z6 Dwelling: P3Single Family (SF) ❑ Duplex (D) [)Multiple (SF and/or D) Project: ew ❑ Upgrade Name: tC L ABSORPTION FIELD ❑Deep Trench ❑Shallow Trench El Bed El Mound Address PC 07z 6 Other W/19E Phone /� 6 umber of Bedrooms Soil Rating Total depth from original grade /f� GPD/SF /,.7 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade C 5 FL Gravel depth beneath pipe FL Subdivision pp r� Block Lot �S E& 1"' A1`D I Fill added above original grade 0--7 Ft. Gravel length 7 5z Ft. Township Range Section Gravel width S Beds: Number of Lines Distance between lines SEPARATION DISTANCES FL — Ft. To Septic Tank Absorption Field Lift Station Holding Sewer Total absorption area 520 Number of trenches Dist. between trenches From Tank Line FP Z �� Ft. Well Q ft _ _ f TANK Septic ❑ S.T.E.P. ❑ Holding ❑ Other ManufacturerA /�! (C pacity Ca1-50Q Gal. r r Surface water r04 �� _- _ t94/tl�G Material S 6 Number of compartments Z_ KLot Line l04 7(- _ NA Foundation ((S r{ _ LIFT LIFT STATION AjA Manufacturer Capacity Gal. Curtain Drain 50' 5-0' - Remarks LOT L&(Jz uj.4/vAZ Pump on level at in. Pump off level at in. I High water alar at in. aJ FiS'%� 773 '%' Pump make and model Electrical Inspections performed by MATERIAL Tank to /� t'IYC ---- -- _- - RL House to tank 303 r installer A �,�/} J1� eu% -ramlield x.3303 Drainfield 630-4q CO/MT 0.303 Inspector /V tlr•frK�rrn. BENCHMARK (Assumed elevation) /00 ft Inspection r Location dates: 1 Z Z3l 2n°. 2 2t{!/6 and description s" COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineers Stamp Conditional Approval: Datez7 lRbeaaeawN.w +'... > ,e 6%"n W. 12 'w p PIE 662 Approv tl44�eC6�JO In +. Date ssnJp�,o Inspection Report 9-1-12.doc Existing Well ST1 ST2 Septic DCO R10 C❑1 MT/CO2 C❑3 MT/C04 off/ 9 oQ� 5 N 0 N c v oQ E y e I o v J � Dyvp E E b N W I 6121 Alternate A B 28 13 38 21 48 30 65 47 86 71 76 55 96 78 48,099 s.f ST2 Septic Lot 2 New 1500 Gallon Septic Tank rouble C.O. s � nla yd' Lot 9 ravel Drive do Lot 10 y-/ Septic 2 � I I Septic NOR THR/M ENGINEERING PO Box 770724 Eagle River, Alaska 99577 907.694. 1028 -'t—.°F.Ak N R❑SEBERRY PARK EST, 1" = so' i..' * BLOCK 1, LOT 1 RECORD -"� LAY❑UT ;�- WASTEWATER RECORD WELL RECORD 7/14/16 2 of 3 S u v L H df Y L d H C Q au v v 3 +' N W m ,' 3 O L d 0) �oG 00 0) cai 9 Qr LA M 0 a ° > C a w N w N 3 O L N d-5 N d, HE U 3 0 W MAT W rya ` TwaoC4 Q ' 0 N x Q ro o OZ I W 0� ZW 4a � W 0 � u Q u U 4 Q M V >- -� 3 O 1 W Q Pq L V W H L W C -O 0 + o, L'i-J U H \ O 0 W; Z W': LJ = L f U U z W u Q L d LJ � 0 I O W LO 0 o N j LL] I o f > i� W Q) w cs00 a Q ih ao Cu 13 L > +O L O U N 4 d a > > L Ui W _v O � W W + > M Qj W 00 0 2 ~ cai O LO O4 Cil M } 3 O C5 F- > v L w t°, o ❑ f � p Y ui N L L d InNr . H --77-7777 LO N W 00 O U 0 Cl) @ d W a a l7 LLL OU o W O S P ou ° °Ns f Oi d N w a m 0) A m rn cv o� > O U 4'N TG):Tco-, +0- a > 4 N W W MAT W rya ` TwaoC4 Q ' 0 �Z x Q ro o OZ I W 0� ZW 4a W � u Q e� CL >- -� W W Q Pq �z W W W of� 3 o, L'i-J U H \ O W; Z W': LJ = Q J - U z W u U L W LJ � 0 MAT �Z rya TwaoC4 �W rn �Z x Q ro o OZ rn 0� ZW 4a W 3, S❑ILS LOG - PERCOLATION TEST TIIN_ Lo"'�'.-NHEERINGDate Performed 2/25/16 Performed For: Mike Quinn Legal Description; Roseberry Park Estates Block 1 Lot 1 DEPTH (FEET) Organic SM Sand w/ Gravel Low Silt TR Location; See Attached Design Groundwater? No Depth -- Water Depth After Monitorino.None Date; 3/3/1F # Date Gross Time Net Time Depth Net Drop 1 3/3 0 -- 7' -- 2 3/3 10 10 min. 12' 5- 3 3/3 12 -- 7' -- 4 3/3 22 10 min, 12' 5' 5 3/3 25 -- 7' __ 6 3/3 35 10 min. 12' 5- 7 3/3 37 -- 7' -- 8 3/3 47 10 min, 12' 5' 9 3/3 50 -- 7' -- 10 3/3 1 60 10 min, 12' 5' Percolation Rate 2 min,/inch Perc Hole Diameter 6' Test Run Between 3' and 4' Comments: Presoaked, Mpaqurpd to nearr>st 1/16th inch. Performed By NorthRim Eng, I CERTIFY THAT THIS TEST WAS Performed in Accordance with All State/Municipal Guidelines in Effect ON THIS DATE. DATE: 3/3/16 N OR THRI M ENGINEERING PO Box 770724 Eagle River, Alaska 99377 907.694.7028 TESTHOLE LOG GEOTECHNICAL TH3 /16 12 of 2 ENGINEERING MEMO I Steve Eng, PE, PH (907) 694-7028 SteveEngPE@gmail.com Date: 7/14/16 Number of Pages: 1 To: MOA On -Site Services Subject: Roseberry Park Estates Block 1 Lot 1 Lot Line Waiver During the course of construction last winter, it was specified in the design to maintain 10 feet to the property line from the absorption trench. For some reason, this separation was not maintained and instead requires a lot line waiver to 7'. The waiver to the lot line is to a developed lot, the owner is Mike Quinn, developer of Lot 1. There is no adverse repercussions from this waiver. Fees have been paid- please approve. If there is need for additional information or clarification please give me a call. Thanks -Steve✓ onoc.ow e�.o� -. Steren W Eng PE 623 ARCTIC PUMP & WELL INC. Jim Sullivan '®ryPO Box 770197 Eagle River, AK 99577 wus B 911x[ (907) 688-2510 (907) 243-2282 Pump Installation Log Well Drilling Permit Number: osp151302 Parcel Identification Number: 05031526000 Date Of Issue: 9/10/2015 Friday, April 15, 2016 Legal Description Roseberry Park Est B1 L1 Property Owner Name Address: Quinn Construction Lot: 1 PO BX 772641 Block: 1 Eagle River AK 99577 Pump Installaion Date: 4/15/2016 Pump Intake Depth Below Top of Well Casing: 280 Feet Pump Manufacturer's Name Franklin Pump Model: 10JRD07P4-2W230 Pump Size: 10 GPM Pitless Adapter Burial Depth: 10 Feet Pitless Adapter Manufacturer's Name B-10 Pitless Adapter Installer: u/k Well Disinfected Upon Completion? Yes Method of Disinfection: Chlorine Comments: Pump Installer Name: Arctic Pump & Well, Inc. Friday, April 15, 2016 Jul.11.2016 11:45 AM MICHAEL QUINN CONST. 907 694 4956 Certified Driiiin$ Log oocco oca �lLLIVAN WATER WELLS P.O. Box 670269, Chugiek, AK 99567 868-2766 OWNER OF LAND: Michael Qulnn ADDRESS: PO BOX 772641 Eagle River, AX 99577 LEGAL DESCRIPTION Roseberry Park Estates Ll Bi DATE: 2-2-16 PERMIT NUMBER: OSPIS1302 DATE OF ISSUE: 9.10.15 TAX IDENTIFICATION NUMBER 05031526000 Is well located at approved permit location: Nyes ONO Method of Drilling: [Rair rotary ncable tool Depth of Well: 300' CosingType: Steel Wallthkkness ,250 Inches Diameter: 6 _-- Inehes, depth 104 feet Liner type Static Water Level: 39 feet Recovery Rate 1 gpm� gph Method of Testing Air Well Intake Opening Type: 0 open end open hole C] MScreened Start feet Stopped r—t IJ Perforations Start feet Stopped Grout Type: Bentonite_ —volume: 50lbs Depth: from 2 _ feet, to 42 feet 42 Weil Disinfected Upon Completion: �=no Method of Disinfection: Chlorine 50 PPM Comments: PAGE. 3/ 4 0 2 Casing Stickup 2 4 4 18 Overburden Silty Sand &Gravel Tight~ 18 21 Bourder 21 40 Hardpan 40 41 Silty Sand & Gravel 41 43 Boulder 43 48 Hardpan 48 52 Boulder 52 53 Hardpan 53 54 Boulder 54 93 Hardpan 93 115 Broken Bedrock Dark Gray 115 162 Bedrock Gray 162 202 Bedrock Gray w/Quartz 202 279 Bedrock Gray 279 288 Bedrock Broken Black 288 293 Bedrock Green Hard 293 300 Bedrock Broken Black qj Drillers Name: Cole Sullivan ATTENTION: It Is the responsibility of the property owner to submit a copy of the well leg to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservatlon, MatSu Borough: Department of Environmental Conservation. On -Site Water & Wastewater System Permit 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 Permit Number: OSP151302 Tax Code Number: 05031526000 Work Type: WellSeptic Initial Permit Effective Dates: September 10, 2015 to September 09, 2016 Design Engineer: NORTH RIM ENGINEERING Subdivision: ROSEBERRY PARK ESTATES Site Legal Address: ROSEBERRY PARK ESTATES BILK 1 LT 1 G:0154 Owner/Address: MICHAEL QUINN PO Box 772641 EAGLE RIVER AK 99577 Site Mailing Address: Lot Size in Sq Ft: 48099 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field Y Septic Tank 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. Special Provisions: The Engineer needs to do an additional test hole prior to the construction of the septic field. Construction may proceed at your own risk before the 7 day water monitoring is complete. Please submit stamped and signed results with the As -built Inspection Report. If the results require a design change, construction of the system will stop pending On -Site review and approval. Received B Issued By: By Date: Date: MUNICIPALITY OF Community Development Department Development Services Division On -Site Water & Wastewater Program Phone: W. 1o3a14 ON-SITE SEWERNVELL PERMIT APPLICATION `a1 AUG 2 8 2015 Parcel I.D. 315050 5– 2e Property owner(s) _��LCe5 Q U t Alit/ Day phone ZZ f1 �6 Mailing address PO Z Q/o 7 7Z,iCc./f Site address Legal description (Sub'd., Block & Lot) 4 Legal description (Township, Range & Section) Lot Size y O l%7!?Sq. Ft. APPLICATION IS FOR: (® all that apply) Absorption Field TYPE OF DWELLING: Septic Tank initial Fl�r Holding Tank Receipt Number: Privy ❑ Private Well �t Water Storage ❑ Number of Bedrooms _ 4 APPLICATION IS AN: TYPE OF DWELLING: Date of Payment: initial Fl�r Single Family (SF) Receipt Number: Permit No. 05P15/36a (w/wo ADU) Upgrade ❑ Duplex (D) El❑ Renewal Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. Permit/Rush Fees: ' 7%— Waiver Fees: Date of Payment: Date of Payment: Receipt Number: d Q �7 ib Receipt Number: Permit No. 05P15/36a Waiver No. Permit App_9-1-12.doc Wastewater System Sizing: This is a new 4 -bedroom, single family home. This is a new subdivision and most of the neighboring lots are developed. These lots are large and are served by private water wells. No adverse impacts are expected from development. No conflicts to the other lots will take place by this septic system construction. The easements are located on the drawing and are not encroached upon. A previous subdivision soil test revealed sandy soil with low silt. An additional test hole was recently completed prior to construction. An application rate of 1.2 GPD/FTI with 0.5 reduction factor for utilizing a 5' wide trench. Trench Length = 500 FTI/5' x .5 reduction factor = 50'; 2 lines @ 25' each. No bedrock was encountered or groundwater was evident. 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 septic tank (Owner requested larger tank). Watertight couplings on inlet & outlet. • 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 F soil cover may be used. 2" Minimum thickness for 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, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10' from the tank positioned to provide cleanout access towards the tank and towards the absorption field. • All cleanouts must extend to at least ground level. • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. • Trench to be placed level, minimum of 4' to groundwater, 6' to bedrock from drain - rock. • Drain rock to be '/2 inch to 2 '/2 inch screened. Drain rock to be distributed uniformly throughout the trench. • Perforated pipe to be installed level with perforations down. • Silt barrier (filter fabric) to be installed above the drain rock. • Smeared trench sides must be raked or scarified before drain rock placement. • The finish grade must be mounded to promote drainage away from trench. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope. Septic Tank to be pumped every two years or when required. • Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal) Septic 0 Existing Well a c J Well D)ENTES: w I 1pth of Trench is 7.5'. Slopes South. 2ervice Line minimum 2% slope. 3Water Wells. 4ell/Septic Separation Construction. rench Parallel To Contours. 4 Bdrm House 5 a�. c}� b� 2 Septic i F1 New 1500 Gallon Septic Tank loubie C.O. s Trench e I Old/ ravel Drive Septic 0 2 Septic P� °F `. R❑SEBERRY PARK EST. 1" = so' . NORTHRIM ro PLAN ENGINEERING *r4 m BL❑CK 1, L❑T 1 PO Box 770724 LAYOUT Eagle RlN . Alaska 99577 a WASTEWATER DESIGN _ 907.694.1028 u V: WELL L❑CATI❑N Date; 2/23/16 12 of 3 c- u u 47 i H di Y C d H a a, a, o, 3 N UI i' 3 O d d N U O) L O CL CL El Y HE GO -#1 w V W Q 0 O W N W W ,,C W W MI D J 1 N g (U W 3 —i L'i z � L) z U ~ z uW F W 0 z n A a _ k ILII a, a W U u rn N 4 �� O N CilM � L a$ 3 O W L L7 ~ L 4- O c M ❑ O d I a w > O N � wlu L 1 * o I .a 4' CL c a, L A L > ❑ U N 4- 4- d W U O v, < a N u L v u �, m d >d O O L O U S U U L o as Q a a o a, a u o >, a d N a,vim d a L Vl al NCL 4 UI U >L E CO W 3 -- U d C5�+� C5 L d O_E �+'. M d Ln o v ❑S a- � a- � a,+''4LJ cu L, W o C W L Ui O N m a, £ U (91 Oaf NUI L O �Q a 0 LS L S-- al' p QN US U O N L O_LI- N VI LJOOLO6U O c L� 0,U 0 ai Vl rd3 dU L (ll p L �r+H NH �F al N N O ❑ z CNH L S U]5 L L Cl O 3 L Lo Qat-,aoa,3a,a_ Qv,l v,3v,¢w(IJ q -4 (l) co d- If) �10 I, GO -#1 w V W Q 0 O W N W W ,,C W W MI D J 1 N g (U W 3 —i L'i z � L) z U ~ z uW F W 0 z n A a _ k ILII p O no^. a W t rn a$ ZW W bENGINKRING G0--Z�L- I S❑ILS LOG - PERC❑LATI❑N TEST Performed For; Mike Quinn Date Performed: 2/17/16 Legal Descriptions Roseberry Park Estates Block 1 Lot 1 DEPTH (FEET) Organic SM Sand w/ Gravel Low Silt T.H. Locations See Attached Design Groundwater? No Depth -- Water Depth After Monitorino.None Dates 2/23/16 # Date Gross Time Net Time Depth Net Drop 1 2/17 0 7' 2 2/17 10 10 min, 10.5' 3.5' 3 2/17 12 -- 7' -- 4 2/17 22 10 min, 10.5' 3.5' 5 2/17 25 -- 7' -- 6 2/17 35 10 min. 10.5' 3.5' 7 2/17 37 -- 7" -- 8 2/17 47 10 min. 10.5' 3.5' 9 2/17 50 -- 7' -- 10 2/17 60 10 min, 10.5' 3.5' Percolation Rate 3 min,/inch Perc Hole Diameter 6' Test Run Between 3' and 4' Comments. Performed By NorthRim Eng, I CERTIFY THAT THIS TEST WAS Performed in Accordance with All State/Municipal Guidelines in Effect ON THIS DATE. DATEi 2/17/16 NORTHRIM ENGINEERING PO Box 770724 '!. Eagle RNen Alaska 99577 907694.7028 P`v TESTH❑LE LOG T H 2 GE❑TECHNICALE: 2/17/16 2 0 f 2 S❑ILS LOG - PERC❑LATI❑N TEST Performed For, Lee Coy Groundwater Observed, None Depth To Water After Monitoring, None Date of Monitor, 11/23/03 & 5/1/04 # DEPTH Gross Time Net Time (FEET) Net Drop 1 4/21 Organic -- 4' 1 - 2 4/21 1 1 min. 5' 1' 3 4- ;. -- 5 - {: 4 6 - 5 1 min. 7 - Q SP/GW 8 _ .:., Sand w/ 9 _ :� :' •�. Gravel 10 - �• 1 min. 11 - 1' 12 - 13 14 - 15 - 16 - 17 - 18 - 19 - 20 - 21 - Groundwater Observed, None Depth To Water After Monitoring, None Date of Monitor, 11/23/03 & 5/1/04 # Date Gross Time Net Time De th Net Drop 1 4/21 0 -- 4' -- 2 4/21 1 1 min. 5' 1' 3 4/21 3 -- 4.5' -- 4 4/21 5 1 min. 5.5' 1' 5 4/21 7 -- 4.5' -- 6 4/21 8 1 min. 5.5' 1' Percolation Rate, 1 min./inch Pre -Soak Seeped Away In Under 10 Minutes Perc Hole Diameter = 6' Test Run Between 3' and 4' Performed in Accordance with All State/Municipal Guidelines in Effect NORTHRIM ENGINEERING 77237 Bear Pow Circle £ogle Riro , Alosko 99577 Roseberry Park Est, T. H. 21 GE❑TECHNICAL Dew. 10CET: 121 of 29 Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 USFf [TY yrs c'iu i! CERTIFICATE OF ON-SITE SYSTEMS APPROV ,JUL6 2016 Parcel I.D. 050-315-26 Expiration Date: ft0he S1UII6F 1. GENERAL INFORMATION Complete legal description Roseberry Park Estates Block 1 Lot 1 Location (site address.) Skyline Drive, Eagle River, AK Current Property owner(s) Ouinn Day phone 229-4966 a, Mailing address:, same Real Estate Agent Cindy Wilson Day phone 244-1930 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class C Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer COSA Fee $ = Date of Payment l(J/ 11(o Receipt Number /� f rG` /(,g6� COSA# n)CI&IA AT Date: � a (""- Date of Payment V(6/to Receipt Number C)t/(a0'20 Waiver # C5V (6OlG 1V6 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm NorthRim Engineering Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date Q16 6. DSD SIGNATURE System #1 Approved for q bedrooms. System #2 Approved for M Disapproved. Conditional approval for bedrooms. bedrooms, with the following toxon W. 6ne, / DE 6256 PTSSS1//`6" Original Certificate Date: -7— 2—Co -0C The Municipality of Anchorage Devlopment Services Division (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 9-1-12.doo If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: /C Q S E a 15%r�y /ARK ST B / L (Parcel ID: r3s0 3:SZ � A. WELL DATA Well type P If A, B, or C provide PWSID # _ Well Log (YIN) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N) (�✓ Total depth _eft. Cased to 1Q ft. Casing height (above ground) in. FROM. WELL LOG AT INPPECTION —Afe,6 ) Date of test. e ?/2 o/ 6 Static water level 3 ! ft. ft. Well pnaduPtion i gsp.m. _ g.p.m. WATERSAMPLE RESULTS: Coliform C' colonies/100 mL Nitrate 2• '?5mg/L Arsenic ug/L Date of sample: ��� !G Collected by; ,ifAer>`r"i B. SEPTICIHOLDING TANK DATA TankType/Material S�p'7"/Crf $TEFL Date installed �A3�/�' Tank size Z_§_0 Qal. Number of Compartments Cleanouts {Y/N) Foundation cleanout (Y/N) . Depression over tank (YIN)High water alarm (Y/N) N Date of pumping /\1Fi - Pumper t ' " C. AbsORPOMN FiELb DATA" _ , .... Date installed 2 Z /6 Soil rating p.d./ r felbdrm) % a System type Ewell 5',� 2 . ' Length 2 2 ft. Width -S ft: Gravel below pipe ft. JF Total depth .7. S $: ; ,Eff. absorption area -5-2 Ofe Monitoring tube Depression over field Al Date -of adequacy test--�Results (Pass/Foil) For _ bedrooms Fluid dgp�h in abLsori Id before test in. Water added gal.. New depth in. I sedY AP to min. Final fluid depth - in. Absorption rate >= g.p.d. Any re}.Mrlatliih tii atment (past 12 mo.) (YIN & type) If yes, give date D. LIFT STATION VA Date installed Size in gallons "Pump on" level at in. "Pump off" level at in. Manhole/Access (YIN) High water alarm level at Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tankflift station on lot ��0� f On adjacent lots /00 IL - Absorption field on lot On adjacent lots / 0-0 f Public sewer main /.00 f Public sewer manhole/cleanoutrd- Sewer /septic `seryice line 2 3 t Holding tank Animal containment areas 50 It Manure/animal excrete storage areas Ida � f SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line Absorption field JS Water main / d f Water service line /40 + Surface water ./40 r� Wells on adjacent lots 160f ABSORPTION FIELD ON LOT TO: Property line 7 / Building foundation Water main Water, Service line Surface water Driveway, parking/vehicle storage Curtain drain Wells on adjacent Iota F. COMMENTS REC OS S j WAVER I TREA1Gf Ta - . , — #, At�^_._iA,A A .r. -J/-1 .._.._..�., G ENGINEER'S CERTIFICATION A jt�ip l certify that I have determined through field inspections and review of Municipal records that the abovesystem,.qfb in conformance with MOA COSA guidelines in effect on this date. S F ...�.... Engineer's Painted Name T._..FV Date st"" W. rMo ti COSA yellow sheet 2-6-15.doc - OMuni Ii {� _ i Anchorage. Alaska cipality of Ancho Development Services Division On -Site Water and Wastewater Program � n 54 Department **** VARIANCEIWAIVER REVIEW **** Waiver#: OSV161080 COSA#:OSC161287 Permit#:OSP151302 PID#:050-315-26 Legal Description: Roseberry Park Estates Block 1 Lot 1 Engineer: North Rim_ Applicant: Michael Quinn 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 7 feet. This waiver approval applies to the existing 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. X of non -objection have been received from the owner(s) of the affected adjacent property7FoLIL,- ( 4-a M%'(GQ 6uthh re: Wawvar, ly Fttw I- z(o• l6 Adjacent properties are not affected by this waiver. ............................................................................... Waiver is Granted: X Waiver is not Granted: Date: / ZG—I li Approved by: 1 wv E Name of Reviewer .............................................................................., WELL SEPTIC AND FOUNDATION ONLY Lot 1 A Lot 1 I I S 89'23'20"E 207.26' ICASEMENT Lot 1 48,099 s.f. �I 33' SECTION UNE EASEMENT 49.3 24.9 63.4' M w 41.2' \ I r Z SEPTIC PIPES w \ \ N 89'29'481 33.00° Lot 10 PL.O'i PLAN\1 _ AS BUILT X SCALE1" = 50= GRID _ NW 154_ Pro]ec -- 11500 Daryl Avenue, Anchor( Long A CJ S o c i a t s S t 1 n C� (907) 522-6476 Phone (907) 522-4625 Fax Professional Land Surveyors kenotangsurvey.com jonaihan*longsurvey.com I hereby certify that I have surveyed the following described property: LOT 1, BLOCK 1, ROSEB£RRY PARK ESTATES (PLAT 2005-155) Anchorage Recording District, Alaska, and that the Improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no Improvements an the property lying adjacent thereto encroach on the surveyed promises and that there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. Dated this the — Day of _ at Anchorage, Alaska It Is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. Cq 0 N N Lot 2 Lot 9 Alaska 4951 o ��. 4 � KENNETH i t G: LANG ct to Io -Q43 ' ".1-S-5202 A �QnRQ�SSI(}NAL NO�o �� AECC963