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ROLLING HILLS ESTATES BLK B LT 2
Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231352 PID Number: 011-072-17 Dwelling: ® Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ® Upgrade Name: CHRISTY L HUPP ABSORPTION FIELD ® Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 7239 VIOLET PLACE, ANCHORAGE ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 2 (**5) 0.45 GPD/SF 13 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 6 Ft. Gravel depth beneath pipe 7 Ft. Subdivision Block Lot ROLLING HILLS ESTATES B 2 Fill added above original grade VARIES —1.85' — 2.40 Ft. Gravel length 50 Ft. Township Range Section Gravel width 2 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 700 Ft2 1 -- Ft. Well 100'+ 100'+ NA NA 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity 1 Surface Water 100'+ 100'+ NA NA GREER 1500 Gal. Material Number of compartments Lot Line 10'+ 10'+ NA NA HDPE 2 NA Foundation 10'+ 10'+ NA L NA LIFT STATION — Manufacturer Capacity Curtain Drain NA *NA NA I NA Gal. Remarks *None known. **Augmented existing 3BR trench Pump on level at in. Pump off level at in. High water alarm at in. w/ new 2BR trench & 5BR CATIII reserve for a 5BR septic system. Pump make and model Electrical Inspections performed by Installer MIKE N. ANDERSON PIPE MATERIAL House to tank 3034 d a n Tank to 3034 ld Drainfield 3034 CO/MT 3034 Inspector MNA / FWCS BENCHMARK (Assumed elevation) 100 ft Inspection dates: 1" 1/17/2024 2nd 1/18/24 Location and description 3`d 1/18/24 4'h TOP OF MANHOLE Conditional Approval: Date �rg�Q:•' !fes TH .... ....`....... j Curtis Huffman CE 128991 }t�lFgFOF Approver - DatL� OFESSIOO�'�� �._ PID:020-042-72 PERMIT:OSP191386 FIRST WATER CONSULTING ROLLING HILLS EST. BLK B, L2 1 " = 40' 30' 30' C C C Lf Ir - LA_ ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: ROLLING HILLS ESTATES LOT 2 BLOCK B PLAT P-486 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shoul4 any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DATE- SCALL. E-MAJU FEB 7, 2024 1'1=30' schullerokogmail.co 24-007 DRAM BY, ICHECKED BY: GRID NUMBER: - BOOMPAGE: JLS SW2124 240106 * = FND 5/8" REBAR .%411 SU AM, OF L A IV AW Pool 0 S "P 4 TH 9TH .............. -.J HN L. SCHULLER:0 7'11� LS -10408 • i831 Talkeetna Street ?� .Z4 ... Anchorage, Alaska 99508 ®'`,40 (907) 227-1455 office Ofession 0\ 'QW (907) 274-4992 fax MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP231352 Work Type: Septic Upgrade Tax Code Number: 01107217000 Site Legal Address: ROLLING HILLS ESTATES BLK B LT 2 G:2124 Site Mailing Address: 7239 VIOLET PL, Anchorage Owner: HUPP CHRISTY L Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date: Expiration Date -'o� V r r I v Department Lot Size in Sq Ft: Total Bedrooms: 11/14/2023 11/13/2024 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ 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 Issued By: Date: Date: - I , - 3 MUNICIPALITY OF ANCHORAGE a r Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section — Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 011-072-17 Property owner(s) CHRISTY L HUPP Day phone _ Mailing address 6152 VANGUARD AVE, GARDEN GROVE, CA 92845 Site address 7239 VIOLET PLACE, ANCHORAGE, AK 99502 Legal description (Sub'd., Block & Lot) ROLLING HILLS ESTATES, BLOCK B, LOT 2 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field © Initial ❑ Single Family (SF) (w/wo ADU) Septic Tank Upgrade x (D) ❑ Holding Tank El Renewal Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (5lgnature of property owner or authorized agent) tIb/Z3 Permit/Rush Fees: 70 Waiver Fees: Date of Payment: °b2 Zo 2 3 Date of Payment: Receipt Number: Q 22 1-fi o Receipt Number: Permit No. oS (7 1-3/3 C—_1 Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Clie nt FormsTermit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! !! November 2, 2023 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: ROLLING HILLS ESTATES BLOCK B, LOT 2 The owner has now decided to upgrade the system to 4 bedrooms and has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot and septic field. We propose to install a 1500-gallon HDPE tank along with an augmented deep trench per the attached design to serve the existing 4-bedroom residence. No groundwater was noted in the MOA on-site file, but if groundwater is encountered during installation an epoxy coated steel septic tank may be required with a change in design. The design is based on the recent test hole conducted on October 31, 2023 . No groundwater was observed at test hole excavation and 7-day groundwater monitoring will be done prior to construction and noted on the inspection report. The slopes are moderate at 0-3% at the proposed upgrade location. The lot and area are served by private water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231352, Deb Wockenfuss, 11/14/23 FIRST WATER CONSULTING DESIGN CALCS: NO WELLS WITHIN 100' OF PROPOSED SEPTIC SYSTEM NO SLOPES >25% WITHIN 50' OF PROPOSED FIELD. ROLLING HILLS ESTATES BLOCK B, LOT 2 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231352, Deb Wockenfuss, 11/14/23 FIRST WATER CONSULTING ROLLING HILLS ESTATES BLOCK B, LOT 2 DESIGN DETAILS: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231352, Deb Wockenfuss, 11/14/23 13030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350-9566 firstwaterAK@gmail.com SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: ROLLING HILLS EST. BLOCK B, L2 PERFORMED BY: FWCS / FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 11/08/23 DEPTH FEET OG SOILS 1 ORG/OL 2 3 4 5 6 7 8 SM/ML w/ no cobbles 9 10 11 12 13 14 15 16 17 18 19 20 BOH Reading Date Gross Time Net Time Depth to Water Net Drop 11/1/23 30 min 6 1 4/16 30 min 6 1 4/16 30 min 6 1 3/16 PERCOLATION RATE 25 (MIN / INCH) TEST RUN BEWTWEEN 5 & 6 FT PERC HOLE DIAMETER 6 PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. GROUND WATER ENCOUNTERED: NO IF YES, AT WHAT DEPTH: NA DEPTH TO WATER AT MONITORING: 11/08/2023 DATE: DRY TESTHOLE # 23-1 DATE PERFORMED: 10/31/23 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION PERFORMED FOR: CHRISTY HUPP 11/08/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231352, Deb Wockenfuss, 11/14/23 1 " = 40' 30 I 30' ft C C C LL I ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: ROLLING HILLS ESTATES LOT 2 BLOCK B PLAT P-486 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shoul4 any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER, DATE: SCALE.E-MAIL; E -MAI , P SEPT 18, 2023 =30' schullerOak,net 23-104 DRAWN BY. ICHECKED, BY: GRID NUMBER: F& -7F JLS SW2124 230316 * = FND 5/8" REBAR SUR MW AW OF AWA.� ®A Aw I -P r1o, .� .ter � .y &Y Ile AQTH�,, OWA At %.`f - * .......... ........ ?A V� ... .................. %JOHN L. SCHULLER.• 0 s a LS -10408 1831 Talkeetna Street Anchorage, Alaska 99508 AW V 0 f —1455 office essionak (907) 227 �11 (907) 274-4992 fax MUNICIPALITY Of ANCHORAGE 7 DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmenlal Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES Address Phone<s) Per'it NO. ' 'No,'of 'Bedr~o~ WELL Township, Range, Section ~ AS-BUILT DIAGRAM (Show location of well, septic system, properly lines, foundation, i I ~ ~ , J~ 1 W , _~ ~C..~ driveway, water bodies, etc.) TANKS N TYPE OF SYSTEM '~ TRENCH ~ BED ~ W. DRAIN ~ OTHER Depth to pipe bottom from Total depth from~riginal grade original grade ~ j Gravel de~b~neath pipe ~ FT F~ Total absorption area ~ S~ Distance between lines Number of lines J Soil rating Pipe material ~r )ate Installed ~ PRIVATE ~ OTHER (Identify) Instammer Date Installed: ~ ,~" ~ 1 ~ J ' Scale: ~,~:S, ENGINEER'S SEAL ~ ~ ~ ~INEERIN6 , l:::' E R H :l: T S:I:TE (::~DDI::;~E:SS '72';57 V:I:CIL, E:T I"l,:~:t::-( i:({edr'c)cims~ l'l"l:i::;~i !;;:'ef'mJ.'L[: ::!!; 'T'cfl:.,:~t]. C~'~p,',,'..tc::i.'t'..yr[ TANK,',' P'IJ.r~J.~'m..u'fJ t.c,,'L,:..'.~:l. ¢.~el:;)'l:..J.c:: t. anl.:: (:::ai::)ac:it.¥~ :L~,O()C) ga:l.:l, or'~,.~!~,, leach '~i~el::t.:Lc: F:'EiiI::;:H]:T IEXF:'i[F:;tlES DE:C',IEH!i!;E:F;: Z';J.~, NC:}'T :I: FrY DF'IHS C)F' :1: I',IE~F::'E:C::'I" ]: (::]lxl~:i~ (..Y'f' :5/:l.:3'""Zl.'Tq'4' DF;,' :3zt.:::.!;'"":!!;¢..~S :1. ~ HUST' (::)t:::'[EN ¢-:fiqD CL..(3SEi: "I'I::~ENE;H E)N SF:~Ht!?. D,qY ('.')R I"'IE:,/"~F['' lEl",ii3:l:h!l!!i:l!i;:F;'. T'O YE:F:,'.]:FrY F:'F~C:[I:::'IEI::;'. r:'~f[iff':'d\lDE)t",ll¥11ENT [:)1:::' C~L..:C' 'r~qi',lt::: ,qhlD F: ]', E:I...D ,, A..l. I -/ /._J_ f/ , O/ O0 ' O~ I 3AZ~O JL-~-vOI/1 ~lVOg Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION; ,C-.eT 2; ~ IgC. U "&'~ ~tl,'.~ /~;Ih. ~'~f.,{-rT.s°~'~,n,ship' Range, Section: SLOPE BoH WAS GROUND WATER ENCOUNTERED? ~U 0 SITE PLAN 1 2 3 4 5 6 7 8 9 10- 11 12 13- 14- 15- 16- 17 18 19 2O S L IF YES, AT WHAT O DEPTH? p E Oepth l0 Water Alter Monitoring? ~,c~ Date: Io-lq-8'l ~ Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE /-tLO (minutes/inch) PERC HOLE DIAMETER Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE PERFORMED: ~LEG4G~A~DESCRIPTION: /-ol- 2. = ~loc k' 'A'~ Z./h',~/4;'~. ~f,~L~'1-~O~,ship, Range, Section: SLOPE SITE PLAN :liP' N WAS GROUND WATER ENCOUNTERED? J~U 0 S IF YES, AT WHAT ~ DEPTH.;' PE Depth tO Water After Monitoring? ~ o' ? Date: ./~ - ! ~- ~'~ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O Gross Net Depth to Net Reading Date Time Time Water Drop I Ir, -II -gl /Io5- ~ 4 PERCOLATION RATE /3[0 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN _.~¢_..,,~_~__ F T A N D ~ FT COMMEmS V0¢ II Of: 17034 Eagle Ri~. L~p Road No 2./://~//- PERFORMED BY: , , .---- ' 'V / ~/ L / CERTIFY THAT THIS TEST WAS PERFORMED IN Eagle River~ AlaSKa ~u// / QG ,ER ANCHORA6E AREA BOF d6H Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ~' iC~,'~)~z MAILING ADDRESS ~--~ ~ ~///~/~:'~- ~<')~' PHONE LOCATION ~-'~'/q~I/~ /:t/r'C, LEGAL DESCRIPTION t7 ~ [:~/~.,-, /."~ ~Ot~///V&' SEPTIC TANK: DISTANCE / FROM WELL 9 '7 MANUFACTURER INSIDE LENGTH '~ INSIDE WIDTH MATERIAL >¢//~ / NUMBER OF COMPARTMENTS LIQUID DEPTH -- LIQUID CAPACITY_/(7OC2 GALLONS. SEEPAGE PIT: NUMBER OF PITS DIAMETER OR WIDTH ~-~~, LENGTH-b0,'~ DEPTH ~' LINING MATERIAL CRIB SIZE: DIAMETER $ DEPTH Z¢] DISTANCE FROM: WELL /-~'~ BUILDING FOUNDATION G//~ i , NEAREST LOT LINE ~ ) TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ? ~/? SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE DX,//~.-~o CONSTRUCTION.I~'/O//~/~,- ,.~,9~¢~'ZgZ~/S DEPTH : DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION_ LOT LINE SEWER LINE TANK SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: INSTALLED BY: :/~'?~½ g/r-,~-, PIPE MATERIAL: ~'~' /z~*O./V LOT SLOPE: ~r~ ~ · ~//,e ,4107~ R E M A R KS: DIAGRAM OF SYSTEM ,¢ 7o/ ,ax/n APPROVED GReATEr ANChorage AREA Borough DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO.. TYPE AND SIZE OF FACIL[TY TO "ESERVED ~ ~'t~"'~ ~,~.A ~,/~,' GOMPLETION DATE ANTICIPATED / 77f PHONE , OTHER NOTE: THIS PERMIT IS NOT YALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE TYPE SEEPAGE AREA SIZE TYPE DIAGRAM OF SYSTEM MINIMUM DIBTANCEB, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT .~O , DRAIN FIELD SEPTIC TANK TO SEEPAGE Pit WALL SEPTIC TANK , SEEPAGE PIT r DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN F~ELD WATER MAIN TO SEPTIC TANK SEPTIC TANK. / SEEPAGE Pit//~- / .~ _2~ ALSO CONS[DER AREA WELLS, SEEPAGE PiT /~ TO RIVER, LAKE STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CR~B CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE MUNICIPALITY OF ANCHORAGE Development Services Department- Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel 1. D. 011-072-17-000 Expiration Date: 1/18/2025 Legal description ROLLING HILLS ESTATES BLK B LT 2 Site address 7239 VIOLET PL Anchorage AK 99502 Current property owner(s) HUPP CHRISTY L XThe On-site system(s) is/are approved for 5 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: _2/21 /2024 ,This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory X Other COSA Approval—June 2022 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 011-072-17 Complete legal description ROLLING HILLS ESTATES BLOCK B, LOT 2 Location (site address) 7239 VIOLET PLACE, ANCHORAGE AK 99502 Current property owner(s) CHRISTY L HUPP Day phone 2. ON-SITE SYSTEMS SIZED FOR 5 BEDROOMS 3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ® Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ® Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Application.doc COSA Checklist.docx COSA Checklist Legal Description: ROLLING HILLS ESTATES BLOCK B, LOT 2 Parcel ID: 011-072-17 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled *CIRCA 1965 Total depth *125 ft Cased to *40+ ft (*UKNOWN & PER MOA DOCS) Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 10/05/2023 Static water level at beginning of test 81 ft. Well production at time of test 5.4 gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate ND mg/L Nitrate less than MRL (ND) Arsenic 12.3 ug/L Arsenic less than MRL (ND) Collected by Date 1/18/2024 Comments B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping NA – NEW SEPTIC TANK Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA – EXISTING **3BR FIELD AUGMENTED WITH A 2BR FIELD Which system tested (date installed) 12/15/1989 ALL standpipes present per record drawing Total measured depth from grade **12.7 ft (max) Measured depth to pipe invert from grade **6.5 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective (ED). If not, state depth into effective **6.7’ of 7’ED Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 2000 gallons 10/4/2023 date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 3BR FIELD 10/5/23 Results Pass Fluid depth prior to test 5 in Water added 650 gal New fluid depth 23 in Elapsed time 1400 min Final fluid depth 0 in Absorption rate 450+ gpd (**3BR field) FIELD STATUS – NEW SYSTEM Effective depth (per record drawings) 84 in (MOA 7’ ED) Effective depth used 4 in (Final fluid depth + missing ED) Effective depth (ED) remaining 80 in (Of **3BR field) Comments/Deficiencies: Approximate total measured depths from existing grade & appears 0.3’ or 4” of ED is missing per measurements of existing 3BR septic field. New 2BR septic upgrade field was 15.4’ deep from grade & 7.9’ to the invert – see inspection report for OSP231352. COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 2/13/2024 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. 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 in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. 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, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 02/13/24 Arsenic Advisory Certificate of On -Site Systems Approval # OSC241030 Subdivision: Rolling Hills Estates, Block: B, Lot: 2 A water sample revealed an arsenic concentration of 12.3 micrograms per liter (ug/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING _/)//- HAA #$ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) Lot 2; Block B; Rolling Hills Estates Subdivision Location (address or directions) 7259 Violet, Anchorage, Alaska (b) Property owner Mailing Address First Federal Bank :Telephone: (home) Business 276-'7884 813 West Northern Lights Boulevard, Anchorage, Alaska 99503 (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent Address Telephone (e) Mailthe HAAtothefollowing address:(orcheck here ~,ifholdforpick up.) Listcontactperson and day phone numberbelow: S & S ENGINEERING/694-2979 17034 Eagle River Road, Suite 204 Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Sing le-Family~ Number of bedrooms ATTENTION: Tucker Hearn RE0'~9361 3. WATER SUPPLY Individual Well ~ Community [] Public [] Note: If community well system,.must have written confirmation, from the Sta~e Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site,S( 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 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION" As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional .and adequate for the number of 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. Telephone ~ ~"~'""~-~/~ ~ Name of Firm Address Date S & S ENGINEERING 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 6. DHHS APPROVAL Approved for ..~ Approved ~' ' Terms of'Conditional Approval Disapproved Conditional The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 ~ j~;M~NICIPALITY OF ANCHORAGE (MOA) (,~,¥ '~,,' ?;' Health Authority Approval (HAA) ~?'~' CHECKLIST ' FEBRUARY 1984 ' ' ,? 343-4744 A. WELL DATA Well Classification ~ Well Log Present (Y/N) Total Depth_/~_Cased to ~O~'f- Depth of Grouting If A, B, C, D.E.C. Approved (Y/N) Yield Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) ~ SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot / 0O To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line _,,.J/iA' To Nearest Sewer Service Line on Lot Water Sample Cc Ilected by Water Sample Test Results Pump Set At (2 I~ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots / / ~::>O 'f- ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole / I Comments B. SEPTIC/HOLDING TANK DATA Date Installed i..~ ~ I$'-'~Size ~No. of Compartments Standpipes (Y/N) 1.~ Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well (::2 To Property Line ! ~ To Water Main/Service Line / (D To Stream, Pond, Lake Or Major Drainage Course [ ~&2/'~ Foundation Cleanout (Y/N) Date Last Pumped AJ/~ ; for ' Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field Comments 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata .-~>~ ~/ Date Installed ./-~- -- ! ~"--- ~;) ~' Width of Field Type of System Design Length of Field ,.~ c/ ~ Depth of Field I ,~ Square Feet of Absortion Area / Depression over Field (Y/N) Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: Gravel Bed Thickness Statndpipes Present (Y/N) Date of Last Adequacy Test To Property Line [ O t 3~' To Existing or Abandoned System on To Water-Supply Well To Building Foundation Lot ~--~ ! ~ To Water Main/Service Line ,/ O ~ '/'' To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area ; On Adjoining Lots '~ O To Cutback (if present) Comments D. LIFT STATION "Pump On" Level at ~ % ~ "Pump Off" Level at High Water Alarm Level at j~ %~/~ Vent (Y/N) _ Tested for % Pumping Cycles during Adequacy Test. ~1~ emt Sm :nOt sA Electrical C°des (Y/N) ; ~,%, **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in eff6ct ~8 the date of this inspection. Signed ~ .~, f[ FhlC, INEEI~ING 17034 Eagle Ri~er Loop Road No. 204 Company I~agJe !~iverj,,Aia ska~ yy3// Date ,,/.~-~X~,J~' ~ MOA No. ~'~- oc'~/~c-°~ ~ Date of Payment Amount: $ /2 72-026 (Rev, 7/88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 ]. Approval requested by: ~ailin§ Address: Croperty Owner: ~ailin§ Address: Legal Description: Location: 4. 5. 6. GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality "C" Street, Anchorage, Alaska 99503 274-4561 Date Received February 11, 1976 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Co nv. Alaska Bank of Commerce Pouch 7-012, 99510 Phone: John C. Preston Phone: 7239 Violet Place, 99502 279-5641 x 132 349-1202 Lot 2 Block B Rolling Hills Estates Subctivision 7239 Violet Place Type of facility to be inspected Single Family Well Data: IndividDal C. Construction ~/..~/~_~__~_~ D. Bacterial Analysis Sewage Disposal ~tem: On-site A. Installed 6-7-74 B. Installer C. Septic Tank: 1. Size D. Seepage Pit: 1. Absorption Area E. Disposal Field: Total length of lines 8. Distances: 2. Manufacturer A. Well to: Septic tank Nearest lot line , Absorption area , Other contamination B. Foundation to septic tank C. Absorption area to nearest lot line 2. Material , Sewer Lines , Absorption area FN_NqI1 [1 /7~% Priam 1 n~ +wn 3330 MUNICIPALITY OF ANCHORAGE GREATER ANCHORAGE AR~'A BOROUGH ;~V!I,~,~,~,,,~;.~'/,~.PI~OT[OIO~ Department of Environmental Quality "C" St., Anchorage, Alaska 99503 - 274-4J~qR?, 19~6 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES Type of Inspection: CMRO VA FHA CONV xx Property Owner: Mailing Address: Name of Buyer: Mailing Address: Preston, 'John C. 7239 Violet Dr., Anc. Ak .995~y-~ Phone Requa~ Rene L. & Demma M. ~.L~9,-T202 99503 2917 Spenard, Rd.,, Ant. Ak. Day Ph,one, 274-8465, , 4.: Name of Lending Institution: Alaska Bank of Co~uerce Mailing Address: Pouch 7012, Anc. Ak, 99510 Phone 5. Name of Realtor or Agent: N/A 279-56/~1 X-341 Mailing Address: . Phone 6. Legal Description: Lot 2 Blk. B Rolling Hills Estates Subd. Location: 7239 Violet Dr. Anchorage, Alaska 7. Type of Facility to be inspect'ed: Resid~nge..' 8. Water Supply Type of Supply: If Individual, No. Bdrms. 3 Public Utility ..... Individual number of dwellings presently served 1 If Individual, depth of well 1,25 feet 9. Sewage Disposal-System Type ,of S~stem: If Individual, Public Utility date of installation Individual 6-7-74 (on-site) 1. Type of Inspection: 2. Property Owner: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES CMRO VA FHA CONV X JOHN C. PRESTON Mailing Address: 7239 VIOLET PLACE ¢~. ~-I!gRAGE~ AK. 99-5'OD2ay Phone RENE L. REQUA & DEMMA M. REQUA Name of Buyer: 3)49-1 202 Mailing Address: ALASKA BANK OF COMMERCE 4. Name of Lending Institution: POUCH 7012, ANCHORAGE, ALASKA 99510Phone Mailing Address: NONE 5. Name of Realtor or Agent: 2917 SPENARD ROAD , ANCHORAGE, AK.995~ Phone 27L~-8L~65 279-55~1 x-132 Mailing Address: Phone Legal Description: Locat ion: Lot 2, Blk. B ROLLING HILLS ESTATES SUBDIVISION 7239 VIOLET PLACE, ANCHORAGE, ALASKA 99502 HOUSE No. Bdrms. ~ 7. Type of Facility to be inspected: 8. Water Supply Type of Supply: Public Utility Individual X If Individual, number of dwellings presently served If Individual, depth of well 125 £ee% Sewage Disposal System Type of System: Public Utility 0I~S Individual (on-site) X If Individual, date of installation 6-7-?2 EQ-037 (1/74) Page 2 o~ two pages - Re'" st for Approval of Individual er & Water Facilities Legal Description Lot 2 Block B Rolling Hills Estates Subdivision ~ ' ' /' ' ~- '~' '~"/~, ~'/-'/ Date '~ -'~ '-~ Approved / Di sa pprovea~_ ~-~'_ .~.~'~m Approval Valid for one year from date s'~ed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for aDproval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date E0-034 (1/74) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Mailing Address: :~-~ ,~ ~¢,.~0,',_ Phone: 2. Property Owner: .~-~.~'~z~/~ /~?z~x~/' Phone: Mailing Address: ~ 3. Legal Description: 4. Location: 5. Type of facility to be inspected 6. Well Data: A. Type C. Construction ~//~'~_ No. of bedrooms B. Depth ~ D. Bacterial Analysis 0/<~ Sewage Disposal System: A. Installed /~/ B. Installer .~/~ C. Septic Tank: 1. D. Seepage Pit: 1. Absorption Area 2. Manufacturer ? ~<~? 2. Material E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank ~ ~ , Absorption area Nearest lot line ~'?z_ , Other contamination B. Foundation to septic tank ~ , Absorption area ? C. Absorption area to nearest lot line ., Sewer Lines ~'.~ FO-R~a (1/74~ Page 1 of two pages ~Pas~ 2 of two pages - K~e~st for Approval of Individual ~ ,~er & Water Facilities Legal ~escription ~. ~ J~<'i, I,~ /~o/,~/W~ /'~'/Z£ ~ Comments / Approve . Disapproved Date ~oval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality J~.~.~/~ IAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date j 4. 5. 6. GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Time of Inspection Date of Inspection Mailing Address: f~..;~.~_.c~, . Phone: ~7~-~0/~ q v-.,.,, -~- - o"' ~ 7~- ~ , ~ .~ .~ ~.) Mailing Address: /~. ~ ~ . (~' ' Wel 1 Data: ~ / A. Type ~ C. Construction Sewage Disposal System:~_~__~c~ A. Installed B. Depth D. Bacterial Analysis B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank , Absorption area , Sewer Lines , Nearest lot line , Other contamination B. Foundation to septic tank Absorption area C. Absorption area to nearest lot line __ Fn-N~4 (1/74/ Paqe I of two paqes GREATESt-1 ANCHORAGE ARE. BOROUGH Department of Environme~tal Ouality 33,30 "C" St., Anchorage, Alaska 99503 274-4561 REQUEST FOR APPROVAl_ OF INDIVIDLIAL SEWER & WATER FACILITIES 1. Type Of Inspection: CMRO VA xx FHA CONV Property Owner: -L-em~y_A. Anderson o Mailing Address: 7239 Violet street D_a.y P h o n e unknown 3. Name of Buyer: John Preston Mailing Address: 1411 43rd Avenue ...... D.~J/ Phone 272 7573 4. Name of Lending Institution: KASSLER & CO. Mailing Address: 319 west Fifth Avenue Phone 272-9501 5. Name of Realtor or Agent: Action Realty - Marlene Garten Mailing Address: 302 W. Fireweed Lane Phone 279 7422 6. Legal Description: Lot 2, Block B, ROLLING HILLS S/D Location: 7239 Violet Street 7. Type of Facility to be inspected: 8. Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal'System Type ,of S~stem: Public Utility If Individual, date of installation water & septic tar~o. Bdrms. 3 XXX Individual (on-site) .xx uknown KASSLER & 319 5TH AVENUE ANCHORA.GE, ALASKA 99501 Page ~ of two pages - Request for Approval of Individual Sewer & Water Facilities L~gal Description Comments Approved Disapproved~ Date ,~ned Approval Valid for one year from date Greater Anchorage Area Borough, Department of Environmental Quality certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. Date SIGNED