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
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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
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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
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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
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