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HomeMy WebLinkAboutROLLING HILLS ESTATES BLK A LT 3 Municipality of Anchorage On-Site Water and Wastewater Program - (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP171300 PID Number: 011-072-23 Dwelling: ® Single Family (SF) ❑ Duplex (D) El Multiple (SF and/or D) Project: ❑ New ® Upgrade Name: ABSORPTION FIELD SALLEY MADARA LIVING TRUST Address ® Deep Trench ❑ Shallow Trench El Bed ❑ Mound 7255 SAND LAKE ROAD, ANCHORAGE ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 0.8 GPD/SF 11 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 5 Ft. 6 Ft ROLLING HILLS ESTATES A 3 Fill added above original grade Gravel length Township Range Section Varies -.34 to -1.08 Ft. 47 Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 2 Ft. Ft. To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 564 Ft' 1 Ft. well Z 100'+ 100'+ NA 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Surfacewater 100'+ 1001+ 1001+ NA ANCHORAGE TANK 1000 Gal. Material Number of compartments Lot Line 5'+ 10'+ 5'+ NA STEEL 2 NA Foundation 5'+ 10'+ 5'+ NA LIFT STATION Manufacturer Capacity Gal Curtain Drain NA *50'+ NA NA Pump on level at Pump off level at High water alarm at Remarks *None known. Existing tank decommissioned in place per code. in in. in. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank 3034 drainfield tod 3034 Installer A+ Drainfield 3034 CO/MT 3034 Inspector ARCTERRA BENCH MARK (Assumed elevation) 100 ft Inspeaction tes 1u 10-11-17 2°d 10-12-17 Location and description 3`d 10-16-17 4th Bottom of window sill COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engin 4•_ Conditional Approval: __ Date `\�' `�15" 4 % KENNE M. ,l Al �` 7116 Approved -af, 't�_ (aj,wtODate 10/2L417 ��'tt�t`' ° ii � `'`'s t`,1,...,,,f eer's Stamp Inspection Report_9-1-12.doc Municipality ®f Anchorage a Y"'r 1116M111` P.O. Box 196650 e 4700 Elmore Road Anchorage, Alaska 99519-6650 e (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.orq/Onsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: COSA#: Permit#: OSP171300 PID#: 011-072-23 Legal Description: Rolling Hills Estates Block A Lot 3 Engineer: ArcTerra Applicant: Salley Madara Living Trust Your request for a waiver of the required 100 feet horizontal separation from the septic tank to the private well has been approved. The approved separation distance is 99.0 feet. This waiver approval applies to the existing 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. n The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. n Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. • Adjacent properties are not affected by this waiver. Waiver is Granted: X Waiver is not Granted: Date: 103/2017 Approved by: ied�1.4 Name of Reviewer **** VARIANCE/WAIVER REVIEW **** 14.9,cTEp6,4 ARC ' j CONSUL'T'ING, INC ' ! 212 E. 51st Ave,Anchorage,AK.99503 m,,c/Office(907)868-3791, Fax(907)868-3793 •-s SIKTiP < October 20,2017 Municipality of Anchorage Development Services Department On-Site Water& Wastewater Program P.O. Box 196650 Anchorage,AK 99519-6650 RE: ROLLING HILLS ESTATES BLOCK A,LOT 3—WELL TO TANK WAIVER The contractor had the well radius staked at time of construction, however based on the recently completed survey by Shane Holt it appears that the septic tank is between 99'- 100' to the well. We are therefore requesting a separation distance waiver of 99' from the well to septic tank be granted. We do not expect there to be any adverse effect on the subject or adjacent lots by granting this waiver. The existing well is located up gradient from the septic tank and is located on the opposite side of a house. We therefore respectfully request that the waiver and the Certificate of On-Site Systems Approval be granted. If you have any questions or require additional information, please contact me at 868- 3791 1 FAX 868-3793. Respectfully, ArcTerra Consulting, Inc. 01111 MAO: Ke M. 4 . s, P.E. AS—BUILT SYSTEM DETAILS/SITE PLAN Permit ❑SP171300 PID# 011-072-23 ROLLING HILLS ESTATES BLOCK A, LOT 3 .... ..n . -- -... .. WOOD FENCE SHED DECK 0 t..:.;,;:-, z cI ' /AiiUk\ li+ ' ♦!slit -- - '- s\I/,- /0 B \`.) A+ FLAGGED AT 8 G CONST, Al' INSTALLED ` H CO Y *BM MT 4' INTO 5• ;D GMT WELL U ek c�.o o NEW 1000 �` � GAL. S.T. DIV, i i :p OCO;,�C D .a is G ,A Grp MTF aDECK O.H. DECK CO E 0 _ x C, 3. v ‘:3 m CHAIN LINK FENCE_ Y c. EAST 20.00 Q A-C=45.3' SCALE: 1• = 30' in • B-C=54.2' A-D=48,7' (9338 93.0 g B-D=59.9' A-E=79,5' o 1 89.16 B-E=92.0' _ _ 8808 FINAL GRADE C88.82�_ l � \ A-F=80,0' o . . ce 0 B-F=91.2' 4 FILM FAwu� VAtoEs c. A-G=112.7' —moo GAL i 9 SEPTIC 84.16 84.16 -T- L, B-G=107.0' TANK SEWER ROCK • A-H=113.7' IL B-H=107.0' 88.3D 88,13 _ C,78,16)\_ (70,16 .a CL w �� `, I 47' I No oaa vAT� x ` SCALE: NTS • /t��, • ' •F ` t PREPARED FUR' RCTERD ��� SALLEY MADARA LIVING TRUST {[� ��� 7255 SAND LAKE ROAD tilk, �'sf, E a/* A 9 TH /\ . * T ANCHORAGE, AK 99502 m z KENNETH . D / S FIELD BOOKS co►avuim: r ic CE—•1 •� 4�� / BOUND 447, BOUNDARY DRAM"'` BMW _ 1 /D 7L /�l �' _..e, sumo STAKING CHEMED: KMD = •. Dar%S410 f t f �Ay / Aspull-I' HOLT DATE' 10/4/2017 �'" n 4'T( E SS10� 4� c ` ONG. : DM SW2124 e ch c. til o \ �� 'Pike— IN aP Z ~� ACAD FILE FILE roe NO.: 17-216 tER .TING ,�yc, • AK. stl'sn' MUNICIPALITY OF ANCHORAGE cnr On-Site Water &Wastewater Program �• M S.; �,. PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax: (907)343-7997 http://www.muni.org/onsite 110111.1-11Vepartnient A ft MtNOW On-Site Wastewater Disposal System Permit Permit Number: OSP171300 Effective Date: 10/11/2017 Work Type: Septic Upgrade Expiration Date: 10/11/2018 Tax Code Number: 01107223000 10/IIJ �� 60ti Site Legal Address: ROLLING HILLS ESTATES BLK A LT 3 G:2124 5:30 r 1°1 (1-1 TbP+ Site Mailing Address: 7255 SAND LAKE RD, Anchorage Owner: MADARA SALLEY LIVING TRUST THE Lot Size in Sq Ft: 26400 Design Engineer: ARC TERRA CONSULTING INC Total Bedrooms: 3 This permit is for the construction of: Il Disposal Field El Septic Tank ❑ Holding Tank ❑ Privy 0 Private Well ❑ Water Storage All construction shall 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 shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing /0/// // 7 Received By: Date: Issued By: ( .'vr. -i41 Date: /elfe/7 IP MUNICIPALITY OF ANCHORAGE 1(4)611A Rt s Community Development Department Phone: 9 _- ,L 904 Development Services Division A • 07- -'7 7 On-Site Water& Wastewater Program ,� °� ON-SITE SEWER/WELL PERMIT APPLICATIO no0 F, 3 N, 011-072-23 .1, Parcel I.D. SALLEY MADARA LIVING TRUST 748a0-6 0 Property owner(s) Day phone - Mailing address 22336 WHISPERING BIRCH DRIVE, CHUGIAK, AK 99567 Site address 7255 SAND LAKE ROAD, ANCHORAGE, AK 99502 Legal description (Sub'd., Block & Lot) ROLLING HILLS ESTATES, BLOCK A, LOT 3 Legal description (Township, Range & Section) Lot Size 26,400 Sq. Ft. Number of Bedrooms 3 APPLICATION IS AN: TYPE OF DWELLING: *Zsills. APPLICATION IS FOR: _ A (0 all that apply) J Absorption Field 11 Initial ❑ Single Family (SF) li (w/wo ADU) Septic Tank 12!] Upgrade Duplex (D) ❑ Holding Tank ❑ Renewal III Multiple Dwellings Privy ❑ (SF and/or D) �c, 6 7 8 9 10 �, Private Well ❑ ' R Sii , Water Storage ❑ OCT I 0 2017 THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR: 1 Li Pm ti cu sA Distance: r` 08 L g c> I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signatu 6 p,• •-rty owner or authorized agent) Per it/Rush Fees: 674 /MO Waiver Fees: Date of Payment: /0/G•/f-/10/0 Date of Payment: Receipt Number: d7O2IQ Receipt Number: Permit No. 0SP14/366 Waiver No. Permit App_9-1-12.doc L 1„.:RcTER4,4 a � ARC 1m ERRA •'—v 1 CONSULTING, INC '�QYSI•ITNG• ° 212 E.51st Ave,Anchorage,AK.99503 • i ra�� NyP' Office(907)868-3791, Fax(907)868-3793 October 4, 2017 Municipality of Anchorage Development Services Department On-Site Water Sr Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Upgrade Sewer Permit—Rolling Hills Estates Block A, Lot 3 It has been determined that the absorption field of the subject property is saturated. Subsequently, the owner has requested we proceed forward to obtain a septic permit to upgrade the septic system. The general slope of this lot is from northwest to southeast at a grade of approximately 13-18% over the septic area. On September 27, 2017 a testhole was performed to investigate soils and groundwater. The results of this test are attached for your review. The proposed upgrade will serve the existing 3- bedroom single-family residence. We propose to install a 47' deep trench. Groundwater was not encountered at excavation or at monitoring. The property and adjacent lots are served by private water. There is no surface water within 100' of the proposed system and there are no known curtain drains within 50'. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 868- 3791 / FAX 868-3793. Respectfully submitted, ArcTerra Consulting, Inc. Kenneth M. Duffus, . . Attachments: On-Site Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test 20441 PTARMIGAN BLVD • EAGLE RIVER,AK 99577-8736 • PH(907)868-3791 • FAX(907)868-3793 LL & WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLAN ROLLING HILLS ESTATES BLOCK A, LOT 3 �t irgIaRI t .101. Eric ARA OEM INCA 57 a s Qe ' ' _/�, EAST MOD '4 = CT, CV m FLAG PROPERTY LINES WELL RADII & EASEMENTS y PRIOR TO C❑NSTRUCTI❑N Scoale: 1'= 100' a DESIGN DETAILS PAGE 1 OF 2 o NO SLOPES >25% 3 BDRM X 150 GPD = 450 GPD W/IN 100' OF 450 GPD/.8 GPD PER SQ. FT. = 563 SQ. FT i. (563 / 2 x (6' GRAVEL) = 47 FT. TRENCH PROPOSED SYSTEM. USE 1 TRENCH - 47' (L) X 2' (W) X 6' (ED) Total depth of system is 13' max from original grade. o Total depth of gravel below distribution pipe is 6' . -, NO PUBLIC WELLS WITHIN 200' OF o PROPOSED WELLS WITHIN 200' OF NOTES: ! PROPOSED SYSTEM EXCEPT AS NOTED, 1. INSTALL 1000 GAL & INSULATE TANK IF <4' COVER. IN 200' 00 PROPOSED WELL ENO SEPTIC XCEPT HAS HD EDD. 2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM IF < 3' OF FILL. MIN. 2' FILL WITH INSULATION, >3' COVER NO INSUL REQ. E 3. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INT❑ SEPTIC TANK. I 4. CONTRACTOR WILL ENSURE ALL SEPARATI❑NS TO ADJACENT WELLS, SEPTICS EASEMENTS, PROPERTY LINES, ETC... a _` F ALS c.� 1Q� , PREPARED FOR: CTE D ,c SALLEY MADARA LIVING TRUST �� R�� r o Lij �r� ��; � 7255 SAND LAKE ROAD ° �, o /* g TH * ANCHORAGE, AK 99502 :.4'41411111 �,z,F r KE D y� FlELo BOOKS co�uTEo: X Q4 „ CE-7116 • ��� /if BOUNDARY BOUNDARY °'L`”" BMW a �+ ,q �yti� ST'va"aSTAKING cHEacED: KMD = / '1�A' 1 ����/ ,—/ AsewLT_ HOLT DATE 10/4/2017 "V'•—��.. ��0� " E5 I ovrc. FILE: crno: 0! �� G �1 E SW2124 F,�/coA,s t� -„ `�� ACAD FILE: FILE '10B No' 17-216 `fR AK 99577— • Plill"" WASTEWATER DISP❑SAL SYSTEM DETAILS ROLLING HILLS ESTATES BLOCK A, LOT 3 SHED DECK u vis `r\ �G� DECOMMISSION ���` �? C EXISTING S.T. \��; \ ��� C & INSTALL NEW \�. °, 'x C 1000—GAL. S.T. (c.,.-i- ' i C x � f \INSTALL 4 DIV i� ~I— D� L a o¢ - \C0 w ° ' ADD DCOs J 1 >. N BEFORE & I J y AFTER S.T.. �3 U � i - C 1 / NO SLOPES 725% \ W/IN 100' OF Si / PROPOSED SYSTEM, \ A i CA CHAIN LINK FENCE_ __ ,F�= _ , 0 9.00 \.., J .3 rts FLAG PROPERTY LINES lz WELL RADII & EASEMENTS ,, PRI❑R TO CONSTRUCTION suite; 1'= 20' gi �� \ '� Nk PAGE 2 OF 2 W / �v. OF• <Q,Az ` PREPARED FOR: ` CTER �' 1 SALLEY MADARA LIVING TRUST ti p6R D� • /�"• `I� .`� 7255 SAND LAKE ROAD : yy �4 ri T..% �n /* /I TH I\ :: * I ANCHORAGE, AK 99502 D� m� • t Y. D �� I FIELD BOOKS COMPUTED: n x CE-7116 44?� eaxnurn BOUNDARY D BMW Z '1"•• i 1 t % m 11 �p �/ tisruc�cx STAKING CNECXED KMD _ $0 \ i" I •'1I' �� / �ssulr: HOLT DATE: 10/4/2017 'i'•---+.;-• �� ; ssic 7c ` 1 DM. FIE GRID: SW2124 (--.0A�� G F �_�� ACAD FU 408 NO.: 17—216 'PiYS UT.T I NG •.ra6 laA FILE Mc 99577' 10.RcTER,p4 ARC T ERRA OF AZA 4� I 'tCONSULTING, INC ',AY' I 212 E. 51"Ave,Anchorage,AK.99503 • ill *c Office(907)868-3791,Fax(907)868-3793 4 ppennwd. dry-'SILT,NC• bl # k . �' :co MSTr_6 J. SOILS PERCOLATION TEST rT� �, Ger � i v:1 t F" AV Performed for: Salley Madara Living Trust Date Performed: 9/27/2017 % \_-.4.:41' Project: ROLLING HILLS EST, BLOCK A,LOT 3 TEST HOLE# TH 17-1 Depth (Lim SEE ATTACHED SITE PLAN I FILL./ORG—OL/SM TOP 5' FOR HOLE LOCATION © . Was Ground water encountered? NO What depth? NA Q Depth to water after monitoring? NA Date? 10/4/17 ' -I 0 Reading Date Gross Net Depth of Net o Time Time Water Drop r, 1 1014117 I:00 - 6" SM/SW 2 1:30 30 min 2 12/16" 3 4/16" h 3 * 1:31 - 6" - 4) 4 2:01 30 min 2 12/16" 3 4/16" 10 N 2:02 - 6" 11 6 2:32 30 min 2 13/16" 3 3/16' 12 7 13 8 14 9 15 10 16 ll I- 12 1 * Water Added 19- B.O.H. Percolation Rate 9.4 (min/in) Pere Hole Diameter 6" HOLE PRESOAKED 20- PRIOR TO TEST Test Run Between 5 feet and 6 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. N'"°""'' MUNICIPALITY OF ANCHORAGE On-Site Water & Wastewater Program �� .S ,. M a PO Box 196650 4700 Elmore Road `' Anchorage,Alaska 99519-6650 Phone:(907)343.7904 Fax: (907)343-7997 http//www.muni.org/onsite i On-Site Wastewater Disposal System Permit Permit Number: OSP171300 Effective Date: 10/11/2017 Work Type: Septic Upgrade Expiration Date: 10/11/2018 Tax Code Number: 01107223000 i0/1 g r 1 So 5:30 pr Site Legal Address: ROLLING HILLS ESTATES BLK A LT 3 G:2124 I 1011111-7 Site Mailing Address: 7255 SAND LAKE RD, Anchorage -1-0-1,4- 1Z.:3 Owner: MADARA SALLEY LIVING TRUST THE Lot Size in Sq Ft: 26400 Design Engineer: ARC TERRA CONSULTING INC Total Bedrooms: 3 This permit is for the construction of: I71 Disposal Field Q Septic Tank ❑ Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall 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 shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907)343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing /OA/ // 7 Received By: Date: > Issued By: t rRivrcr Date: Mil e17 MUNICIPALITY OF ANCHORAGE OR Community Development Department Phone: eto i 904 Development Services Division0T-343�-'7"7 On-Site Water & Wastewater Program °c `� 44F1110. c';,, ON-SITE SEWER/WELL PERMIT APPLICATIO a a OCT 0 ti Parcel I.D. 011-072-23 '�aYA(`' ci SALLEY MADARA LIVING TRUST 7-83G-6 0 Property owner(s) Day phone Mailing address 22336 WHISPERING BIRCH DRIVE, CHUGIAK, AK 99567 Site address 7255 SAND LAKE ROAD, ANCHORAGE, AK 99502 Legal description (Sub'd., Block & Lot) ROLLING HILLS ESTATES, BLOCK A, LOT 3 Legal description (Township, Range & Section) Lot Size 26,400 Sq. Ft. Number of Bedrooms 3 APPLICATION IS AN: TYPE OF DWELLING: *Z..- APPLICATION IS FOR: � /� (®all that apply) V J Absorption Field Single Family (SF) 11 Initial ❑ l (w/wo ADU) Septic Tank [�] Upgrade 011Duplex (D) ❑ ole Holding Tank ❑ Renewal ❑ Multiple Dwellings ■ Privy ❑ (SF and/or D) �c, Ek / 8 9 70 /7 Private Well ❑ 1r\,'' RUSH c Water Storage ❑ m OCT 10201/7 THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR: �Q Ji ti Distance: 4, o, 8 g c� I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (----------17 (Signature of p erty owner or authorized agent) Per it/Rush Fees: 6-69 putt, Waiver Fees: Date of Payment: /01G,k9-/1010 Date of Payment: Receipt Number: c7OBiA Receipt Number: Permit No. 0Sp/4l30D Waiver No. Permit App 9-1-12.doc �u�TEF2h'� a; 6 2 ARC 1. ERRA CONSULTING, INC "4`;AuT NG �" 212 E.515`Ave,Anchorage,AK. 99503 "`"" Office(907)868-3791, Fax(907)868-3793 October 4,2017 Municipality of Anchorage Development Services Department On-Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Upgrade Sewer Permit—Rolling Hills Estates Block A, Lot 3 It has been determined that the absorption field of the subject property is saturated. Subsequently, the owner has requested we proceed forward to obtain a septic permit to upgrade the septic system. The general slope of this lot is from northwest to southeast at a grade of approximately 13-18% over the septic area. On September 27, 2017 a testhole was performed to investigate soils and groundwater. The results of this test are attached for your review. The proposed upgrade will serve the existing 3- bedroom single-family residence. We propose to install a 47' deep trench. Groundwater was not encountered at excavation or at monitoring. The property and adjacent lots are served by private water. There is no surface water within 100' of the proposed system and there are no known curtain drains within 50'. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 868- 3791 / FAX 868-3793. Respectfully submitted, ArcTerra Consulting, Inc. Kenneth M. Duffus, . . Attachments: On-Site Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test 20441 PTARMIGAN BLVD • EAGLE RIVER,AK 99577-8736 • PH (907)868-3791 • FAX(907)868-3793 LL & WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLAN ROLLING HILLS ESTATES BLOCK A, LOT 3 .i.. sr]u11• sour.-..x.. '.�S 4 D S'IMI" KM MLA WIC MG - 111LT.'7113)11.1"..'.."" -, '. • i g • 1 • OW T, MG h N • FLAG PROPERTY LINES c. WELL RADII & EASEMENTS o PRIOR TO CONSTRUCTI❑N Scale: 1'= 100' J DESIGN DETAILS PAGE 1 OF 2 0 NO SLOPES >25i 3 BDRM X 150 GPD = 450 GPD W/IN 100' OF 450 GPD/.8 GPD PER SQ. FT. = 563 SQ. FT (563 / 2 x (6' GRAVEL) = 47 FT. TRENCH PROPOSED SYSTEM. USE 1 TRENCH - 47' (L) X 2' (W) X 6' (ED) Total depth of system is 13' max from original grade. .o Total depth of gravel below distribution pipe is 6' . ct NO PUBLIC YELLS VITHIN 200' OF rn VATEYSTEM.YELLS VITHIN 200' OF NOTES PROPOSED S : 25 PROPOSED SYSTEM EXCEPT AS NOTED. 1, INSTALL 1000 GAL & INSULATE TANK IF <4' COVER, >, 200' OF PPRROPPOOSED YELL EXCEPTPTIC SYSTEMS WIHIN AS NOTED. 2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM IF < 3' OF FILL. MIN. 2' FILL WITH INSULATION, >3' COVER NO INSUL REQ. E 3. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INT❑ SEPTIC TANK. I 4. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT WELLS, SEPTICS EASEMENTS, PROPERTY LINES, ETC,.. a. 0 Iii. x I j /O_,.,.., �� OF ' 14kS. PREPARED FOR w, izcTER ` SALLEY MADARA LIVING TRUST ti • ��- �,� `� 7255 SAND LAKE ROAD .° //,����`` 6rr� cE r* 9TH 1\ • * I ANCHORAGE, AK 99502 1111 1 t i r KE . D y�. , FlCE7116 BOUNDARY: DRAN: to 1, ti BOUNDARY BMW a �i _� /,A(/ ti's ST"1°" STAKING C1iEd`E0c KMD _ ` IP 1 • ''•1n1' 1 �� � I T_ HOLT DATE 10/4/2017 . . .� _. _ /lk �7 E \ �S Dm RE cmD: SW2124 Cc^ C' NC Al V' 9° `_� ACAs FILE' FILE roe Mu: 17-216 Rey 99577-"'"►3e 0111111.1 WASTEWATER DISP❑SAL SYSTEM DETAILS ROLLING HILLS ESTATES BLOCK A, LOT 3 SHED DECK X isata ' i / d\ DECOMMISSION '\C4- '.-3' C EXISTING S.T. � ���'' C & INSTALL NEW s-- o 1000—GAL. S.T. k.7- \/� x / C x v . LA\ _ r ----- o ----- • 1 '� CC ~ C D W ao �o�� rC O ¢ - \CO / W ' ADD DCOs , x r BEFORE & / ,� N AFTER S.T.. ( 7 N M n cc CO NO SLOPES ?25% `.c5=. / V W/IN 100' OF X17 PROPOSED SYSTEM, N X CHAIN LINK FENCE— _ -- x — ---------'----)E-x — X X O _ o ,.00 `! cr / \og J FLAG PROPERTY LINES Li- WELL RADII & EASEMENTS PRIOR TO CONSTRUCTION scale: 1'= 20' w 400:116:1‘.1111k NIL PAGE 2 OF 2 ;‘ ■ w Air �F . I PREPARED FOR: RCTE j \ �4,7. - k SALLEY MADARA LIVING TRUST p� f ��, 7255 SAND LAKE ROAD : 4X f I '64' E * .4 TH * ANCHORAGE, AK 99502 }� ill ' L KE M. EV / F ELD BOOKS COMPU1Eo: I •�� X CE-7116 4wa BOUND4"BOUNDARY MANN: BMW w 4F" ..` 41 •. y•e 8' � SIAKNR STAKING CHEOKEn: KMD % 1 i •'lh' • 7.. / A59411LI: HOLT DATE: 10/4/2017 -^F;— N �' 111,.. SSIOo DWG. 111.E cool SW2124 --e, \ �G P� /�, 1 9P ). 116•716:41:11°P ACAD FIE:FILE JOB Na: 17-216 R,`fR5AK 99577-6. L oy �RcTER,44 ,. ARC 1 ERRA Air��, OF AL4, `^ CONSULTING, INC /c�� 1- ? 212 E. 51st Ave,Anchorage,AK.99503 / • TH Office(907)868-3791,Fax(907)868-3793 014 �. __§;a4.4t meg,* 11 6fdv �_... �tt. ...,7,-,--..," LYING ��.`A� 4 p511� '� �S• / SOILS PERCOLATION TEST `'' e Performed for: Salley Madara Living Trust Date Performed: 9/27/2017 \Nli. :41'.- Project: ROLLING HILLS EST. BLOCK A.LOT 3 TEST HOLE# TH 17-1 Depth (Feet) SEE ATTACHED SITE PLAN ka i FOR HOLE LOCATION I I FILL/ORG—OL/SM TOP 5' 'W 9� Was Ground water encountered? NO What depth? NA I In 0 - Depth to water after monitoring? NA Date? 10/4/17 4 1 ; ii. t Reading Date Gross Net Depth of Net .1‘14.1,.4 - Time Time Water Drop ` 6 "` 1 10/4/17 1:00 - 6" .,' `' SM/SW 7 2 1:30 30 min 2 12/16" 3 4/16" a g 3 * 1:31 6" 9 �; 4 2:01 30 min 2 12/16" 3 4/16" IO o. 5 * 2:02 - 6" - I I '' ,' 6 2:32 30 min 2 13/16" 3 3/16" 12 7 I 8 14 9 15 I(1 16 11 17 12 18 * Water Added 19-' B.O.H. Percolation Rate 9.4 (min/in) Perc Hole Diameter 6" HOLE PRESOAKED 20- PRIOR TO TEST Test Run Between 5 feet and 6 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. ' 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 L EGA L);) ESC R.~I PTIOJ~ LOOATION~ ~¢ L ~g ~)~or~tion Well area Dwelling DISTANCE TO: Manufacturer Liq. capacity in gallons : I nside length IF HOME.DE D STANCE TO Well Dwelling Manufacturer I Well Foundation DISTANCE TO: ] No. of hnes [ Length ~chJme Total le~ o~ lines [~ I ~ ' Material beneath til~ Top of tile to fin~r~e Length ~idth De~th Tgpe of crlb Crib Oiameter Crib doPth DISTANCE TO: Building Well foundation IcJass Depth Driller ' ' Sewer line DISTANCE TO Building foundation Material Width Material Septic tank ~-,~UPGRADE NO. OF BED~OMS PERMIT NO. T r e¢..~i dth inches inches No, of compartments Liquid depth PERMIT NO. Liquid capacity in gallons Nearest Io. line PERMIT NO. 7q~ ~)~ Distance betw~qn ~nes Total effe'd1:'i.v~absom.tion area PERM,T Total effective absorption area Nearest lot line Distance to lot line PERMIT NO. Absorption area(s) OTHER PIPE M~TER IA LS SOIL TEST RATING REMARKS APPROVED DATE LEGAL i ~ DEPARTMENT OF HEALTH 8ND ENVIRONMENTAL PROiECTION . = STREET, ANCHORAGE, AK. 9950i 82., "L" 2~,4-4 r ~e ON--S I ?E SE~IER LIPGRACcE, PE~=r"I I T APPLICANT DON M~=oN ,-~ E. 15TH APT ~ t ~4000000 LOCATION SAND LAKE ROAD LEG. L L~ BA ROLLING HILLS EST. LOT SIZE MAXIMUM NUMBER OF BEDROOMS = Z ,,~OIL RATING (SQ FT/BR)= 150 ~'-' THE REeUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: [~EPT.-. ..... 10 LENGTH= % ~3RA'~EL [~EPTH=- THE LENGTH DIMENSION IS THE LENGTH (IN FEET> OF THE TRENCH OR DRAINFIELD. THE DEPTH OF R 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>. PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION IN_PEE. TIuN~ OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. TWO (2> I f-~$PE~2TIO[4$ RF:E REI2LIIREB, BACKFILLING OF ANY SYSTEM WITHOUT FINAL IN=.PECTILN AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS i00 FEET FOR A PRIVATE WELb OR i50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PER~I I T E>:F' I RFC___. DEC:EHBER _'Z<I.. I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND HELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. ' 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. SIGNED- /~-~/,-----~~ ...... - .......... ISSUED BY .......... DRTE--Z ~CONSTRUCTION TEST LAB "One Test is worth a Thousand Opinions" 2204 Cleveland Anchorage, Alaska 99503 277-0231 Perfo~ned for Legal Description: This Forth reports: Don Mason Lot 3 ~Block A SOILS TEST yes Date Performed 7/6/79 Subdivision Rollinq Hills Est, PERCOLATION TEST Depth Feet 1' Peat 10' 15' Soil Characteristics BroWn Silt with occasional Gravel (ML) Brown Gravelly Sand with Trace of Silt (SP) Brown Sandy Silt (MA) Bottom of Test Hole Was Ground Water Encountered No If YES, What depth? Reading Date Gross TUne Net TLme Depth to H20 Net Drainage Percolation Rate Minute Proposed Installation: SEEPAGE PIT DRAIN FIELD Depth of Inlet Depth to Bottom of Pit or Trench C~2~4ENTS: 150 square ft. drainage-area required per bedroom from minus 4' to 10' Test Performed by Data Certified By: CONSTRUCTION T~T LAB Date : 7/9/79 • � VY fly • � � Municipality of Anchorage • On-Site Water and Wastewater Program 2 (907) 343-7904 S A C I V CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 011-072-23 Expiration Date: 1 — 20 -les) 1. GENERAL INFORMATION Complete legal description ROLLING HILLS ESTATES BLOCK A, LOT 3 Location (site address) 7255 SAND LAKE ROAD,ANCHORAGE,AK 99502 Current Property owner(s) SALLEY MADARA LIVING TRUST_...Day phone Mailing address 22336 WHISPERING BIRCH DRIVE, CHUGIAK,AK 99567 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ® Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class Well ❑ Public Sewer ❑ Public Water System ❑ Waiver/Variance request for: Distance: Received by: o the~ f Date: / ) Z4 - ( COSA to be released tefigicreer,unless otherwise requested by the engineer_ COSA Fee $ Q(D$ Waiver Fee $ Date of Payment I13 I I 1 111 Date of Payment Receipt Number (; 501 Receipt Number COSA# tY I � Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING, INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER,AK 99577 — Engineer's Printed Name KENNETH M. DUFFUS Date 10/16/2017 THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC...ASSOCIATED WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. Engineers Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the . system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen y11b-� 1 encroachments,deficiencies or discrepancies exist. - OF AL k'49Tf-1 + 6. DSD SIGNATURE / ` System #1 Approved for j bedrooms. � �/%!► r16 KEN ET 711'8 DU Wfi System #2 Approved for bedrooms. Ctz, /t ati`r +F S O' Disapproved. Air \'116.111":"11"- Conditional approval for bedrooms, with the following stipulations: OF`��littlti(ililrt, • OPT% ON-S�T 11 g �D < Wleg 0, PSTEWP <�p41ENT SFv��,a By: i..... Original Certificate Date: "2-0--`-tics 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 engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-1O-12.tloc 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: ROLLING HILLS ESTATES BLOCK A, LOT 3 Parcel ID: 011-072-23 A. WELL DATA -PER MOA DOCS Well type PRVT If A, B, or C provide PWSID # Well Log (YIN) N Date completed UNKNOWN Sanitary seal (YIN) Y Wires properly protected (YIN) Y Total depth 100'+ft. Cased to 40+ ft. Casing height (above ground) 24+ in. FROM WELL LOG AT INSPECTION Date of test -• 9.27.2017 Static water level ft. 100 ft. Well production _ g.p.m. 5.7+ g.p.m. WATER SAMPLE RESULTS: Coliform _NEG colonies/100 mL Nitrate ND mg/L Arsenic. 5.09 ug/L Date of sample: 9/25/2017 Collected by: ARCTERRA B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC I STEEL Date installed 10/1212017 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping NA- NEW TANK Pumper C. ABSORPTION FIELD DATA Date installed 10/1212017 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.8 System type DEEP TRENCH Length 47 ft. Width 2 ft. Gravel below pipe 6 ft. Total depth 10.7 ft. (Measured 10116117) Eff. absorption area 564 ft2 Monitoring tube Y Depression over field N Date of adequacy test NA_NEW FIELD Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Water added _ _ gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N &type) N ________ _ If yes, give date D. LIFT STATION Date installed _ Size in gallons Manhole/Access(YIN) "Pump 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 ,yep` 9.9 ' On adjacent lots 100'+ Absorption field on lot 1001+ On adjacent lots 100'+ 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 _1001+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 51+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots _100'+ F. COMMENTS atv-P_VN cyvx 6; kt, G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name KENNETH M.DUFFUS �?' - i Date 1011612017 *1 4-9 TI-f-{ �* 0 'Air COSA canary sheet 2-6-15.doc ` I,� re KENNETH M. 1 l7:3 . if -('N 7116 �Cp 1 Air /D /L ice/ - EsslO F`' Air `NIL 1►-0►18. f lEAST 220.00 CHAIN LINK FENCE ._—L.4.RS_._tE.I.�IIdLL__._ I I _.--.._.._.._._.__.._."7:. .- _ C J: -E ti C E - _ . _ GRAVEL GRAVEL r ,w, - I PARKING I 1 AREA SHED „t ------ ILII;., , DECK ' 4 \ ASPHALT Q I RRIVEYIAT 1 ! A = of .. W ocl 1 T r 4*.s u 2 co o v O o '" o / o 0 ul Cn o RG CD \ HELL 0 N \ O a o $ . w 1 W j o = I W i— YI = 1 QI i— o 0c Ji Z 11E O Id q `. m< ... u o NM - = E ON z WOE o= C D.H. DECK au • ; CIG Qi , Ci) i I f - - CHAIN LINK FENS_ _ _ _ _ - - - - - - - - - EAST 220.00 AS-BUILT SURVEY 1" = 20' opoo��� I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF A` ,%, OF THE FOLLOWING DESCRIBED PROPERTY 0��. . - - ' - -. .- .9s�4 LOT 3, BLOCK A, ROLLING HILLS ESTATES SUB . opGjP TH ���� �(I • ( PLAT P- 487) - 49 ,- ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE 6 S �/ / /Q " �o VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN D.� \ '.ASF 7/,i,pl� c.;. THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS Ps CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS EXIST OTHER THAN NOTED. SHANE A. HOLT - GI NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES,IMPROVEMENTS, OR FENCELINES. O DATED AT ANCHORAGE ALASKA THIS 13TH DAY OF Oh'0,. -' LS-6914 O EASEMENTS OF RECORD,OTHER THAN THOSE APPEARING ON THE RECORD PLAT,ARE NOT SHOWN — 4 40 co HEREON( UNLESS INDICATED) _OCTOBER , 2017 . 4�A�°fessiona� La—Z NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE �Q�D�OOpoa PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. HOLT LAND SURVEYING 9309 GROVER DRIVE ANCHORAGE,AK 99507 2255, FB 16-14, 184-33,18-18 345-5513 MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 3; Block A; Rollings Hills Estate Subdivision CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING ~ I J ~) ~ ~ ~ HAA # ~ ~O_~C:{ {~) ~'--'~"~ "Location (address or directions) 7255 Sand Lake, AnehorDe, Alask~ (b) Property owner Freddie Mac Mailing Address Telephone: (home) Business (c) Lending InstitUtion Mailing Address Telephone (d) Real Estate Company and Agent JACK WHITE Cv~P~NY/G~or~e~" A / ~ McCo~ ,,v Address 3201 C Street, Suite I00, Anchorage, Alaska 99503 Telephone 563-5500 (e) Mail the HAA to the following address: (or check here,~ if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING/694-2979 17034 Eagle River Loop Road~ Sui~ 204 Eagle River~ Alaska 99577 2. TYPE OF RESIDENCE 3 Single-Family,[3~ Number of bedrooms 3. WATER SUPPLY Individual Well 1[~( 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-siteJ[~ PubliC [] Community [] , Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. 7/88) Page 1 of 2 ~ ,~o g O§~d ')pOM s,Jeeu!Sue I~UO!SSOjoJd eql u! SUO!SS!LUO ~o s~o]Je ~oJ olq!SuodseJ ~ou s! e§~Joqou¥ jo ~l!l~d!o!unlfl oq.L'penss! s! el~o!l!lJeo ~ eJojeq ~lep ez~l~U~ ~o suo!loedsu! ~,onpuoo lou op SHHQ ~o see,{oldU~:1 'sluecueJ!nbeJ el~s pu~ I~Jepej u!~lJeo A~tsp, es o~ JepJo u! suo!lnlp, su! §u!puel qeql pu~ secuoq ~o sJes~qoJnd o~ ~sm, Jnoo ~ s~ s!q~, seop SHHQ eq.L 'miS~l¥ Jo elm, S eql u! peJe~s!6eJ Jeeu!§ue i~uo!ssejoJd luepuedepu! u~/~q e^oq~ S qde~Se~ed u! ue^!§ suo!l~lueseJde~ eq], uodn/tlUO pessq pe~o!jpeo l~^oJdd¥,{~,poq~n¥ qll~eH senss! (SHHa) seo!^Jes u~cunH pu~ qllSeH jo lueLu~J~deQ e§~Joqou¥ ~o ~l!l~d!o!un~ eq[ I~UO!l!puoo I~^oJdd¥ I~uO!l!puoo to suJJe.L peAoJdd~s!a ... .)( pe^uJddv /~q SLUooJpoa~:)~ JOjpeAo.iddv - 'qV^Ol:ldd~ SHHa '9 @leC] euoqdole~ 'ON peo~l dool ~e~!~l ell3e:J I~$OZL SsoJppv WJL-I ¢0 @WeN ~ MUNIC_I ,PALI~,~^~:~c ANCHORAGE (MOA) ~ NIcIPALI~ 'J" · · ~u~-~,v ..... '~CHECKLIST - FEBRUARY 1984 343-4744 ~AY 1 1988 Legal Description: ~ "~ I:~L~, A If A, B, C, D.E.C. Approved (Y/N) /r-- Yield '~. ~.- d~.F'/~ --/--- Pump Set At Sanitary Seal on Casing ~[?N) Depression Around Wellhead (Y~ RECEIVED ; On Adjoining Lots / O0 --~ ! ~" ~ ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole A. WELL DATA Well Classification .1¢s~\x] t~ Well Log Present (Y/~ ~ Date Completed Total Depth /')/Z.. Cased to .~j-fc~r- Depth of Grouting I Static Water Level Casing Height Above Ground {~. u Jr Electrical Wiring in Conduit~P/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot .) O~ To Nearest Edge of Absorption Field;,~ot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by ~--~.~-~ ~------~ Jh,]~ Water Sample Test Results ~/~r~,~~r~.~-~ - Comments B. SEPTIC/HOLOING~T~N~D2TA ~L~'~'' '~ ~ ~ , ~L. Date lnstalled ~ Size /~ Ne. of Compartments ~ StandpipeS/N) ~ Air-tight Caps~N) ~ Foundation DepreSSion over Tank (Y/~ ' ~ / ~te Last Pumped~ ~g~n~t~tl~tmq~y~ (Y/~ ~rary Holding ~rk SEPARATION DISTANCES FROM 'SEPTIC/HOLDING TANK: To Water-Supply Well · , '-':. . To Property Line ,.. ~.. To water Main/Service Line To Stream, Pond, Lake or Major Drainage Course Comments A'~ .~/"/~-' ~1~-'~-'¢¢' To Building Foundation To Disposal Field 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata / ~'~'~ ¢/~¢z._ Type of System Design Date Installed ~ ~/' '7~ Length of Field Width of Field "~' Depth of Field /c> ~ Gravel Bed Thickness ~- Square Feet of Absortion Area ~"-~---¢~ '~ Statndpipes Present. N) Depression over Field (Y~ /"/ Date of Last Adequacy Test Results of Last Adequacy Test .~,¢~-,!~'., %~-~~ '- .-~ L~)¢--~ SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well To Building Foundation Lot /C;) ~ To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Property Line To Existing or Abandoned System on Adjoining Lots "~o I-~ To Cutback (if present) Comments '~nstalled Size in Ga"'~'~ "Pump On" Level~,at High ~Nater Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at uring Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed _ Company Date MOA No. S & ~ ;NGINEERING 17034 Eagle Ri~er Loop Road No. 204 Eagle River, ~);ask~/~5~7 Receipt No. Date of Payment Amount: $ 72-026 (Rev. 7188) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 MUNICIPALITY OFANC - DEPARTMENT OF. HEALTH AND ENVIRONME~ DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE S EWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Nam~ ~~'~Telephone: Home ~'~ Business Xpplican[Address~~' /~/~7~ ~,~/~ ~ (c) Applicant is (chec~ one): Lending Institutidn ~ ;. 9wner/builder ~; Buyer ~; Other~ (explain); - ~ / ~ ,. (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address (f) Telephone r---- Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family/l~' Multi-Family [] Nu tuber of Bedrooms r~ 3. WATER SUPPLY ndividual WellJ~ Community Other Note: If community well system, must have wr tten conf rmation,f~,o, m the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL r r . : Onsite~ Public [] Community [] Holding Tank ~.' Note: f community well system, must have written confirmat 0r ' and status. Page 1 of 2 )m the State De /~ror ;onservation ENGINEERING FIRM PROVIDII'-,~ INSPECTIONS, TESTS, FILE SEARCH, D*....~. 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 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 ~r'~;' ./,~ ~~~ Telephone Address ~ ~ ~/~ ~ ~~ ~~ Engineer's Seal DHEP APPROVAL Approved for '/~,~.3) bedrooms by ~ (.0¢~¢~ Approved /~' Disapproved Conditional Date Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations g~ven in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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 ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 LegcJ escr'p ' ~: -: WELL DATA Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot Well Classification /.,,4/~//.~/,~:~L//~ If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) ,/~ Date Completed ~/,~/~/~Y-z'-¢¢/ Yield Total Depth -~,~-,2~,¢VfCased to Static Water Level Depth of Grouting Pump Set At z¢~2',~ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot /,~ i ; On Adjoining Lots To Nearest Public Sewer Line ~// To Nearest Public Sewer Cleanout/Manhole ~/~ To Nearest Sewer Service Line on Water Sample Collected by ~ ~~/~ ; Date ~7~Z~ Water Sample Test Results ~~~' ~ ~~ B. SEPTIC/HOLDING TANK DATA Date nsta ed ~,~/,~7~' Size /~¢~'"~ No. of Compartments Standpipes(Y/N) /,~ Air-tight Caps (Y/N) /~ Foundation Cleanout (Y/N) Depression over Tank (Y/N) ~ Date Last Pumped Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) /(/'//~ Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line ~'~¢,~ -'~''' / TO Water Main/Service Line Course ;for Temporary Holding Tank Permit (Y/N) Comments ,~'~~ To Building Foundation ~'~:2) / To Disposal Field ~~____~/~'~-~ ~'~ To Stream, Pond, Lake, or Major Drainage Page 1 of 2 ¢¢¢/f/~//Z¢ ,.,~./,~.,k~/.~,,,,~,/ ¢,~i ABSORPTION FIELD DATA ,~'~~ Datewidthlnstalledof Field /~'// '¢ ' Depth of Field Square Feet of Absorption Area ~ ¢ Standpipes Present (Y/N) Depression over Field (Y/N) ~¢ Date of Last Adequacy Test Results of Last Adequacy Test ~~~' /~ Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Property Line //~ ! To Existing or Abandoned System on ; On Adjoining Lots _-,'J~;~ TO Cutbank (if present) . To Stream/Pond/Lake/or Major Drainage Course TO Driveway, Parking Area, or Vehicle Storage Area D. LIFT STATION Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certif~ that I have checked, vc~rified, or conformed to all MOA and HAA guidelines in effect on t he~l~t;ispection. Date of Payment ~ -- 'O--'' Page2 of 2 72-026 (11/84) MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date November 20, 1984 (a) Legal Description (include lot, block, subdivision, section, township, range) LOT 3~ BLOCK A, ~QLLIN~ ~TT.T,R ~I~D. ESTATES Subdivision Location (address or directions) 7255 SANDT.AW~ R~A~ (b) Applicants Name Deloris Newman 243-5277 Telenhone - Home Business Applicants Address 7255 Sandlak~ Road (c) Applicant is (checK one) Lending Institution ~-~ ; 0wner/builder.~. ; Buyer ~-~ ; 0ther~ (explain); (d) Lending Institution United Bank of Alaska Telephone 7R6-6qT1 Address 7926 Old Seward Highway Suite c-4 (e) Real Estate Co. & Agent Century 21 Award Sue Dvora~ Address 209 w. Dimond Blvd. Telephone 349-6683 (f) Mail the HAA to the following address: Will Pick Up 2. Type of Residence Single-Family~ Multi-Family~-~ Other (describe) Number of Bedrooms 3(three) Water Supp. l?_ Individual Well Community f--q Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Sewase Disposal 0nsite ~ Public ~--~ Community ~--~ Holding Tank ~ Note: If community well system, must have written confirmation from the State Oepartment of Environmental Conservation attesting to the legality and status. [Page 1 of 2] 5. En~ineerin$ Firm Providin~ Inspections~ Tests~ File Search~ Data and Information o 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 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 regula- tions in effect on the date of this inspection. Name of Firm Address Date DHEP Approval Approved for Approved.~ Arctic Engineers, Inc. 1506 W. 36th , Anchorage, Alaska 99503 November 20, 1984 (ENGINEER SEAL) bedrooms Disapproved Telephone 561-1345 Conditional Terms of Conditional Approval CAUTION THE [~ICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL ~ROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. ~MPLOYEES OF DHEP 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. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 ae WELL DATA MUNICIPALITY OF A/~CHORAGE (MOA) HEALTH AU%/qORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Well Classification Individual Well Log FTesent (Y/N) No Total Depth 140' Static Water Level 100' Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Yes Separation Distances f~cm Well: To Septic/Holding Tank on Lot 100'+ ~. To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line N/A Cle ancut/Manhole N/A Water Sample Collected By Duane Maney Water Sample Test Results Satisfactory Conrnents MUNICIPALITY '~F~ ANCHORAGL~ DEPT. OF ItEALTH & ENVIRONMENTAL PROTECTIOI~ N0V 2 'lc:, RECEIVED T,ecjal Description: LOT 3, BI.,OCK A ROLLING HILLS ESTATE If A, B, O~ C, D.E.C. Approved(Y/N) Date Completed ...... Yield 5.5 Cased to Unknown Depth of Grouting Unknown Pump Set At 12" + Sanitary Seal on Casing (Y/N)Yes Depression Around Wellhead (Y/N)No ; (~ Adjoining Lots 100% 100,+ ; On Adjoining Lots lnn,~ TO Nearest l~ablic Sewer To Nearest Sewer Service Line on Lot N/A ; Date November 15, 1984 B. SEPTIC/HOLDING TANK EL~TA Date Installed July 1979 Size 1000 No. of C~%~artments 2 Standpipes (Y/N) Yes Air-tight Caps (Y/N) Yes. Foundation Cleanout (Y/N) Y~e~___ Depression over Tank (Y/N) No Date Last Pumped November 16, 1984 Pumping/Maintenance Contract on File (Y/N) No ; for ...... Holding Tank High-Water Alarm (Y/N) No Tempora=y Holding Tank Permit (Y/N) No Separation Distances from Septic/Holding Tank: To Water-Supply Well 100'+ To Building Foundation 5'± To P~operty Line 5'+ To Disposal Field .5'+ To Water Main/Service Line 10'+ To Stream, Pond, Lake, c~ Major D~ainage Course None Noted Co~nts [page 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed July 1979 Width of Field 3' 150 Square Feet of Absorption A~ea 520 Depression ove~ Field (Y/N) No Results of Last Adequacy Test Adequate Separation Distance f~cm Absc~ption Field: To Water-Supply Well . lQ0'+ To P~operty Line Type of System Design Trench Length of Field 52' Depth of Field 10' Gravel Bed Thickness 5' Standpipes P~esent (Y/N) Yes Date of Last Adequacy Test November 16, 1984 TO Building Foundation 20 ,+ To Existing or Abandoned System cn Lot None ; On Adjoining LOts 30'+ To Water Main/Service Line N/A TO Cutbank(if ~esent) Not present TO Stream/Pond/Lake/c~ Majo~ D~ainage Corpse None noted To D~iveway, Pa~king A~ea, c~ Vehicle Stc~age A~ea 10'+ Cul~nts D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) C~,,~ents Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. Meets MOA ** Check Penm~tted Bedroom Rating Against HAA Request I certify that I have checked, veEified, c~ conformed to all MOA HAA Guidelines in effect on the date of this inspectic~. Signed ~ _. Cc~t~any Arctic Enqin~c. KB1/d5/s Date ///~d/~t / / MOA NO. ST-84-001 [Page 2 of 2] (c3NO'I'I¥~D) N 0 1 .L d El 0 G G V : ' ' MUN CIPAL TY OF ANCHORAGE ..... ~LINiC~A~W 'OF ANCHORAGE t' ~' ' ~ -' · - DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEC3'I'O~ ~ ~ ~ ~ 825 L Strut - Anchora~, Alaska 99501 DI RE,TIOga: Complete all pa~s on page 1. Incomplete r~u~ will not be proceed. Please allow ten (10) days ~or processing. *;: 1. PROPERT~OWNER · - - · .., ~.~ ,- , . .~. PHONE ..: MAILING ADDRESS :~ , .~ - ./ : - -: ....... ........ - _- :~,~.~. PROPERTY RESIDENT (If different from above) -.L , 2. BUYER · - -. - .P~0NEHM243-687: MAILING ADDRESS · -~ ' . . " 3236 W. 81st Ave. .~ Anchorage, Alaska 99502 3. S'ecuritv National Bank ' ' ~'1 27~'~00~ Ex231 MAILING ADDRESS. . · , . ,::~ ,~-._ , . . 2525 C Street~ Suite 502~ Anchorage, Alaska 99503 ' · 4. REALTOR/AGENT , ~oody' Smye~s ~ ~a~ V~ ?eaZ ~sta~e ~ :' : '-349~2522 MAILING ADDRESS ' .' 5. LEGAL DESCRIPTION Lot 3, Block A Rolling Hilis Estate ' :' ~:-'-' .... i,~:;'..-: :.:~.~: ~ . ;TREET LOCATION ' . .. : _ ~ - , 7255 Sand Lake Road, Anchroage, A~a 6. TYPE OF RESIDENCE ~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER Of BEDROOMS !--{ One ~] Four r'-]. Other__ [] Two [] Five [] Three [] Six 7. WATER SUPPLY ~ INDIVIDUAL* [] COMMUNITY r"-"l :'UBLIC UTILITY ATTACH WELL LOG. A well log is required for all wells drilled,- since June 1975. For wells drilled prior to that date, give well depth (attach log if available.} - ' ,- :--.~'- 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/rON-SITE** [] PUBLIC UTILITY ** If individual/on-site, give installation date f system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, 72-010(3/78) rills SIDE FOR OFFICIAL USE ONLY . DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ' ONE [] THREE [] FIVE ' [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SiX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER F-IINDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTI LITY Connection Verified INSTALLER []Septic Tank or []Holding Tank - Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line Absorption Area' tO nearest Lot Line '~. 'COMMENTS [] CONDITIONAL APPROVAL {letter must accompan/~ASficate) LEGAL DESCRIPTION ' L ' FHA Form 2573 u. S, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT ' Rev. July 1958 FEDERAL HOUSING ADMINISTRATION ,r~'' ..... HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM Budget Bureau No. 63-R296,8 INSURING OFFICE Anchorage, Alaska PART I.~TO BE COMPLETED BY FHA MORTGAGOR O" S,'ONSO. Harold Childs SUEDIVISION NAME TOTAL NUMBER: LIVING UNITS BEDROOMS BATHS MORTGAGEE Spokane Mortgage Company PROPERTY ADDRESS SERIAL NO. 111-008377-203 7303 Sand Lake Road Anchorage, Alaska WATER SUPPLY BY: D Public system Rolling Hills Estates EASEMENT [] New installation J BLOCK NO. LOT NO. Can attic or other area bi made Into {If Yes, how manyll) ~ additional bedrooms? []Yes I-Xl No [] Individual SYSTEM DESIGNED FOR DYes ~---]No SEWAGE DISPOSAL BY: [] Public system --] CommuniO] system D Community system [] Individual PART II.--TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT INSPECTOR'S SKETCH It is the opinion of the [~] State [] County [] Local Department of Health that this individual water-supply system [] is [] is not satisfactory as a domestic water supply for the subject property. It is the opinion of the [] State tern with proper maintenance: --']Can be expected to function satisfactorily, and is not likely to create an insanitary condition -~ATE J SIGNATURE [] County [] Local Department of Health that this individual sewage-disposal sys- ~] Cannot be expected to function satisfactorily JTITLE NOTE: The health authority should complete the appropriate opinion statement above and affix date, signature and title in the spaces provided. Uso of tho above grid for Health Department Inspector's sketch os well os use of the back of this form is at the option of the health authority. PART Ill.--FOR USE OF FHA OFFICE TO THE CHIEF UNDERWRITER: I have reviewed the foregoing and the pertinent FHA Compliance Inspection Report, and recommend that the Individual water-supply system be considered [~] Acceptable [] Not Acceptable Sewage disposal be considered r-] Acceptable [] Not Acceptable. IDATE SIGNATURE JN CHIEF ARCHITECT ODEPUTY FOR CHIEF ARCHITECT