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HomeMy WebLinkAboutROLLING HILLS VIEW ESTATES BLK 4 LT 2Onsite File Rolling Hills View Estates Block 4 Lot 2 #050-322-14 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page Of ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231151 PID Number: 050-322-14 Dwelling: W Single Family (SF) El with ADU n Duplex (D) E] Two Single Family Project: F] New 0 Upgrade Name A ORPTION FIELD Existing House on a Hill LLC ❑D Trench E] Wide Trench 0 Bed F1 Mound Site Address 19031 Upper McCrary Rd. Other Phone Number of Bedrooms Soil Rating depth from original grade 13 DISF ITotal Ft LEGAL DESCRIPTION Depth to pipe invert from original de Gravel depth beneath pipe Ft, Subdivision Block Lot Rolling Hills View Estates 4 2 Fill added above original grade Ft, Gr el length Ft, Township Range Section Gravel width Ft. Beds: Number of Lines Dist between lines Ft. SEPARATION DISTANCES To, Septic Absorption Holding Sewer Total absorption area ' Number of trenches Dist, between ches From Tank Field Lift Station Tank Line Ft2 Well 10 0 + 25+ TANK o septic E] S.T.E.P. ❑ Holding r_1 Other Manufacturer Greer Capacity 1000 Gal. Surface Water 100+ Material Plastic Number of compartments 2 Lot Line 10+ NA �!��ATIO N Foundation 10+ Manufacturer Capacity Gal Remarks Alarm location Electn ailed by to PIPE MATERIAL House to tank D3034 Tank drainfield D3034 Installer PCN Drainfield CO/MT D3034 Inspector Arcterra Consulting BENCH MARK (Assumed elevation) 100 ft Inspection 1" 4/30/24 4/30/24 Location and description dates: 2iw 3"1 _5_/3_/24 Vh Bottom of door frame ON -SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date 0 F 444 Z* map 9 IH 0 10 0 Septic System Approved Date z KENNETH CE 7,1'71 16 Note: this approval does not include well permit requirements. E (Rev 05102/18) AS -BUILT SYSTEM DETAILS/SITE PLAN Permit 11SP231151 ROLLING HILLS VIEW ESTATES BLOCK 4 LOT 2 PID# 050-322-14 A—C=22.8' 94 B—C=34.3` A—D=20.6' y B—D=38.4' o A—E=18.4' B—E=43.3' CR A—F=19.1' A B—F=48.1' o SCALEi NTS AtW OF AZ4 Ilk l� * 49 TH . ,. xEiax>,rx 'D ` S _CE-7116 oo �FESSIO�1`1. aH +. A._ e; NEW 1000 GAL TANK / 000 GAL SEPTIC PREPARED FOR: HOUSE ON A HILL LLC 15849 N 61ST STREET SC❑TTSDALE, AZ 85254 FlE1D BOOKS BOUNDARY: N /A ST"NG: Nl/A AsauiLT: 00SCF M. FILE ACAD RM FILE COYPUIE'D: DRA' KSd c"EcKED: KMD DAIS: 5 /131 GRID: NW02! "N- 22113 OUVEWAY MR \I SCALE, 1' = 40' SCALE, NTS LOT 3 � LOT 9A 1.115 ACRES \ \ PLAT 2009-57 O� ��oG� o� C^C TWO-STORY / HOUSE R= .001 r 119 LOT 2 1.09 ACRES GRAVEL DRIVEWAYIk Ap. - O \ \ \ ------------ �'/ N w \ \ \ DILAPIDATED !� \ \ \ FENCE \ � o HOUSE DETAIL �� \ I 20.3' 'a> M � 16.0' r o C o6 4.0' TWO-STORY 8.0' HOUSE !DECK �--- 31.9' co 7.4' DECK SCALE: l "= 20' LOT 1 0.94 ACRES \ \ \ LJ 0 \ \ 24 g00, s, SURVEYOR CERTIFICATE: AS -BUILT I HEREBY CERTIFY THAT I HAVE PERFORMED AN AS -BUILT SURVEY ON THE PROPERTY SHOWN HEREON AND THE IMPROVEMENTS EXIST AS SHOWN. FIELD SURVEY:5/10/24 -T;�Dmck 5/13/2024 TAYLOR L. DOSCH, PLS 189892 OWNER, BLUE ARROW SURVEYS, LLC 50' 25' 0' 50' 1'=50' LEGEND LOT BOUNDARY — — — — ADJACENT LOT BOUNDARY R/W CENTERLINE ------- EDGE PAVEMENT ® RETAINING WALL ------ GRAVEL EDGE —a WOODEN FENCE BUILDING -------- DECK (-P SANITARY SEWER MANHOLE �)CO SANITARY SEWER CLEANOUT m SANITARY SEWER STAND PIPE ELECTRIC PEDESTAL 41- Lr UTILITY POLE W/ TRANSFORMER Zt TELEPHONE PEDESTAL tpi WELL PIPE NOTES 'O /, `t ,•��P� F A qs�l low rr, • :• Taylor L. Dosch ``ems •. No. 189892 • �� TFy • ,5/13/24• •'Sp�� i OFES810004 1. RECORD DATA SHOWN HEREON IS PER PLAT P-624, ROLLING HILLS VIEW ESTATES, ANCHORAGE RECORDING DISTRICT. 2. DIMENSIONS FROM THE BUILDING TO THE BOUNDARY SHOWN HEREON ARE MEASURED FROM THE FOOTPRINT OF THE MAIN STRUCTURE. 3. THIS SURVEY WAS CONDUCTED WITHOUT THE BENEFIT OF A TITLE REPORT. ADDITIONAL EASEMENTS MAY EXIST THAT ARE NOT SHOWN HEREON. 4. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION. THIS AS -BUILT SURVEY SHOULD NOT BE USED FOR CONSTRUCTION. s 5. THIS SURVEY IS IN ACCORDANCE WITH ASPLS MORTGAGE SURVEY STANDARDS. 6. THIS SURVEY IS NOT A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES A BOUNDARY SURVEY MAY DISCLOSE. 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: OSP231151 Work Type: SepticTank Renewal Effective Date: Expiration Date: Tax Code Number: 05032214000 Site Legal Address: ROLLING HILLS VIEW ESTATES BLK 4 LT 2 G:0254 Site Mailing Address: 19031 UPPER MC CRARY RD, Eagle River Owner: HOUSE ON A HILL LLC Design Engineer: ARC TERRA CONSULTING INC This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy `,T1„cnt CC a v fi Department 6/16/2023 6/15/2024 Lot Size in Sq Ft: 47480 Total Bedrooms: 3 ❑ 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 Received By: S 5�r � j 10 f� /l -C, Issued By: _ k Date: Date: 'o Z Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231151, Curtis Townsend, 06/16/23 .MUNICIPALITY OF ANCHORAGE 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. 050-322-14 Property owner(s) House on a Hill LLC Day phone Mailing address 15849 N 61st Street, Scottsdale, AZ 85254 Site address 19031 Upper Mc Crary Rd. Eal4le River AK Legal description (Sub'd., Block & Lot) Rolling Hills View Estates Block 4 Lot 2 Legal description (Township, Range & Section) Lot Size 47,480 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) (w/wo AD U) Septic Tank RX Upgrade Duplex (D) ❑ Holding Tank ❑ 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. Dea Duffus _ (Signature of property owner or authorized agent) Permit/Rush Fees: / S Date of Payment: % I Receipt Number: Z ( ( G Permit No. 0.510 23 1151 Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc ANCHORAGE WELL & PUMP SERVICE, INC. 7640 KING STREET ANCHORAGE, AK 99518 PH. 907-243-0740 Invoice Invoice #:20222145 Bill To: Kroto Contracting, Inc. 15849 N 61st Street Scottsdale, AZ 85254 Ship To: Kroto Contracting, Inc. JOB: 19031 Upper McCrary Road Eagle River, AK 99577 SALESPERSON David J. VanWingerden YOUR NO. 34802 SHIP VIA COL PPD SHIP DATE TERMS Net 30 DATE 8/5/2022 PG. 1 QTY.ITEM NO.DESCRIPTION PRICE UNIT DISC %EXTENDED TX. We appreciate your business. Thank you! Sale Amt.: Freight: Sales Tax: Total Amt.: Paid Today: Balance Due: 1 HYDRO-FRACK R&I pump, pipe and wire. Install equipment and frack well. Chlorinate. Flush and test well production. NOTE: Although hydro-fracking is the best technology for improving the production of low producing bedrock wells, there are always risks involved when rehabilitating any well. Therefore we cannot guarantee improved or continued water production. We are not responsible for potential uncontollable underground activity such as cave-ins, sand or silt issues. By accepting this quote you acknowledge that you understand and accept the risks and limitations associated with hydro-fracking and that no guarrentee or warranty is offered or implied by AWPS, Inc. WELL FLOW TEST RESULTS: 7.69 GPM $6,000.00 $6,000.00 ANCHORAGE WELL & PUMP SERVICE, INC. 7640 KING STREET ANCHORAGE, AK 99518 PH. 907-243-0740 Invoice Invoice #:20222145 Bill To: Kroto Contracting, Inc. 15849 N 61st Street Scottsdale, AZ 85254 Ship To: Kroto Contracting, Inc. JOB: 19031 Upper McCrary Road Eagle River, AK 99577 SALESPERSON David J. VanWingerden YOUR NO. 34802 SHIP VIA COL PPD SHIP DATE TERMS Net 30 DATE 8/5/2022 PG. 2 QTY.ITEM NO.DESCRIPTION PRICE UNIT DISC %EXTENDED TX. We appreciate your business. Thank you! Sale Amt.: Freight: Sales Tax: Total Amt.: Paid Today: Balance Due: ST1-Dave Service Tech ST5-Tyler Service Tech ST18-Maynard Service Tech Helper $6,000.00 $0.00 $0.00 $6,000.00 $6,000.00 $0.00 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: OSP221077 Work Type: SepticTank Upgrade Tax Code Number: 05032214000 Effective Date: Expiration Date: Site Legal Address: ROLLING HILLS VIEW ESTATES BLK 4 LT 2 G:0254 Site Mailing Address: 19031 UPPER MC CRARY RD, Eagle River Owner: WILLIAMS KERRY A Design Engineer: ARC TERRA CONSULTING INC This permit is for the construction of: ❑ Disposal Field Septic Tank ❑ Holding Tank ❑ Privy „"e,rit S G h i n l�epa-rtment 4/13/2022 4/13/2023 Lot Size in Sq Ft: 47480 Total Bedrooms: 3 ❑ 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 Received By: r Q/ Issued By: �iZf Date: Date: `� I3 a0�7 MUNICIPALITY OF ANCHORAGE Development Services Department' s Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 050-322-14 Property owner(s) ON-SITE SEPTICIWELL PERMIT APPLICATION Keay Williams Day phone Mailing address 4001 El Sarino Ct. Homer, AK Site address 19031 Upper Mc Crary Rd. Eagle River AK Legal description (Sub'd., Block & Lot) Rolling Hills View Estates Block 4 Lot 2 Legal description (Township, Range & Section) Lot Size 47,480 Sq. Ft APPLICATION IS FOR: (® all that apply) Absorption Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms 3 APPLICATION IS AN Initial ❑ Upgrade 0 Renewal ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: TYPE OF DWELLING: Single Family (SF) 0 (w/wo AD U) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. Dea Duffus (Signature of property owner or authorized agent) Permit/Rush Fees: AZZ 65 Waiver Fees: Date of Payment: Lff laa,�.2 Date of Payment: Receipt Number: 6015 90 Receipt Number: Permit No. C)—'5,0 2,2- / 0 7 7 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221077, Rebecca Carroll, 04/13/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221077, Rebecca Carroll, 04/13/22 Municipality of Anchorage p.ge ~, ,f '2.. DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~'V~ ~,O"~--"~, PID Number: ~~ ~ Ad~e~ ~ ~~~ ~,~ ABSORPTION FIELD Phone: No. of B~ooms: ~Deep Trench Q Shallow Trench Q Bed ~ Mound ~ Other LEGAL DESCRIPTION SoilRating: ~,~ GPD/Sq. Ft. Total Depth from original~e: Lot~ ~'BI°ck: ~ '~¢~'~ ~~Subdivisi°n: ~[~'' Depth to pipe bottom from originat~de: Ft. Gravel depth beneath pipe Range: ~ ~ ~ Gravellength: Township: ection: Fill added above original grade~ Ft. Number of bnes: Distance ~tw~en lines: WELL: ~New ~ Upgrade Gravel width: ~ Ft. ~ ~-'~ Ft. C~ication~Private. A.B.C): Total Depth: Case~To: Total absorption area: Pip, mater?: ~ Driller:~ ~/~ / ~ ~ ~ ~/~a~ Dril~ed:~ /~Stati¢Waterl Level:Ft. Ins~ ~ Date~installed:¢. ~ Yield: -- Pump Set at: Casing Height Above Ground: TAN K ~ ~ GPM ~ ~ Ft. ~ Ft. SEPARATION DISTANCES ~e~tic ~ Holding ~ S.T.E.P. To Septic Absorption Lift Holding ~ublic/Private ~n~facturer: / z Capacity iR gallons: From Tank Field Station Tank S .... Lines ~~~ ~ ~ Surfac~ LIFT STATION Water ~1~ ~ / / / Lot [~ (~f o~ Line / / / Size in gall Foundation ~ ~ "Pump on" level at: "Pump off" leve~rm at: CurtainDrain ~ ~( ~' ~ ~ ~ ~ =ump Make & Model Electrical inspections performed by: Remarks: BENCH MARK Loc~ Description: Inspections pe¢~l~f[~u6 DateS: l'st~ " "' ...... 17~4 EaCe Riv~ L~ ~oad, No. 2~ 2nd~ ,~ ~ ~ ROGER J.~SHAFER ~¢e River, Alaska ~5~ ~ ~ ~ ¢.,~.~%G~ ~ ........ ~. ~¢ ~-¢ Department of Healt~n~ Human~e~ices ap roval '~:¢~%. ,evie.edanda,,roved 72-013 fRev. 9/91) MOA 25 P~ermit No. ~/~J '~-~-~¢~?- Page ~ of ~" Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744, On-Site Wastewater Disposal Syst~ ,m and/or Well Inspection Report Legal Description: L.~=;'C ~-- ~:::;~Y-- Z¢- PID No.: \ , SHAFER NO. PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW920352 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:WILLIAMS KERRY A OWNER ADDRESS:9231 SHORECREST DRIVE ANCHORAGE AK 99515 DATE ISSUED:10/15/92 EXPIRATION DATE:10/15/93 PARCEL ID:05032214 LEGAL DESCRIPTION: ROLLING HILLS VIEW ESTATES BLK 4 LT 2 LOT SIZE: 47480 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AACS0). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THIS SYSTEM HAS BEEN APPROVED FOR OWNER INSTALLATION. THE SYSTEM WILL BE INSTALLED ON A SLOPE GREATER THAN 25% BUT NOT GREATER THAN 40%. RECEIVED BY: ~-~/~' ISSUED BY: -~O[-~lq ~d~- DATE: September 12, 1992 ROBERT SHAFER, P.E ROGER SHAFER, P.E CIVIL ENGINEERS (907)694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL ~NSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street Anchorage, AK 99519-6650 REFERENCE: Rolling Hills View Estates, Block 4, Lot 2 We request you issue a permit to install a septic system to serve the proposed 3 bedroom house on the referenced property. A test hole was excavated and a percolation test performed in the area of the proposed septic system. The approximate location of the test hole is located on the attached site plan. The monitoring tube within the hole has been checked and found to be dry. This property has enough area for future septic upgrades, which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. If you have any questions, or require additional information for your review, please contact us. Sincerely, Roger J. Shafer,? P.E. RJS/LSU/lsu 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR:~ DATE PERFORME LEGAL DESCRIPTION: ~,~'~" ~' l~,,-.V-... ~ Township, Range, Section: SLOPE SITE PLAN lO 11 12 WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? P E 13 14 15 16 17 18 19- 20- Depth to Water~.Nt~,~.., .; ~ .~ Monitoring? .,~ Date: ~ Gross Net Depth to Net Reading Date Time Time Water Drop ,o "'' PERCOLATION RATE __ TEST RUN BETWEEN __ (minutes/inch) PERC HOLE DIAMETER .FT AND .~FT COMMENTS PERFORMED BY: S & S ENGINEERING ~ ~ ~ ~-' CERTIFY THAT THIS TEST WAS PERFORMED IN 17034 Eagle River Loop Road No. 204 c=~ \'-L-~. ~ ACCORDANCE WITH A~~,~O~UtDELINES IN EFFECT ON THIS DATE. DATE: RECEIVED OCT 1 4 1992 Dept. Health & Human Services Mt-. John Smith Well and Septic System Permits 5700 Tudor ;Road Anchorage, AK November 8, 1992 9231 Shorecrest Drive Anchorage, AK 99515 Dear Mr. Smith: This letter is to comfirm that I will be installing the septic system myself on my property in Eagle River. That property is Rolling Hills View Estates, Block 4, Lot 2. I have had considerable experience both as an operator (mostly on backhoes, with more than 10,000 hours on Cat 245's alone), and as a field engineer. I am currently working as the line and grade man for Tam Construction on the Raspberry Road Sewer Extension project. Sincerely, Kerry Williams P.O. BOX 6650 ANCHORAGE. ALAS?~A 99502-0650 ~9071 264-411~ TOA~ K~%'OWLES. DEPARTMENT OF HEALTH & HUMAN SERVICES January 10, 1986 TO: Permit Applicant Subject: Permit # 850013 Lot 2 Block 4 Rolling Hills View Estates Subdivision A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1985. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit muse be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installatioB of the on-site sewer system the original as-built inspection report(three part form) must be sent to this office for review and approval,and for documentation. If there are any further questions, please call this office at 264-4720. Sincerely, Susan E. Oswalt Program Manager On-site Services SEO/ljw enc: Cop{ of Permit DEF:'AF;.:'T~'~E]",IT OF HEALTF] AND ENV!F;,'ONMENTAL PF;..'OTE-C] 825 L. S'I"REE'I" ~ ANC',H[)RA(3I!i!i ~, Al'::.' 9950 2. 6 ,q. '"" 4 7 2 0 C .] N T A E. T F':'H 0 N E :: L. [)'l" F) '] A T ]] [) N ~: MAX .,..I ........................ SLiBD]:VIS:I:ON:~ REll....I...I!\I[.il HILL, S V:I:EN Iii:: LO"F,", 2 · E;I!i'_'C"{" I [:)hi: 6 TOWNSH I F:': :l. 4N RANGE :', I I/.~ :L,, 09P (SQ, FT,, OR ACRES) MCCRARY ROAD q. 'Eq_OC.-'K: 4 DEF:'TH '!"O F:'IPE B[:)TT[]M (I::'T,,) DF?.AVEL.. ).:)E':F:']'H (FT,, ]"OTAL.. :{)EF:'TH (F'T.) GRAVEl.. WIDTH (F'I",, {}:')RAVEL. L. ENG]"H (I:::'"1",,) C'~RAVEI.... VDL.iJMIE (CLJ,, YDS. ]"ANK SIZE (GAL. S) SOIL RATING (Sg!,, F:'T /Br.:;'. ":'c)r"[.h ~v 'J' hE.? , Jug(J, 1,_ .L I..~ ¢,. ]. .L .. v C){ '"~ ' I ' ,:: .... 1[ ~,',J ]. ]. J.'", ~ ':= ,..~ .:::~ .,.'~ ]. thE.} ~:~vs'[:. E.)f~.:Lr'~ at C:{::: C:,P C] ~:':d'],':::e~. atFiCJ iF] C::C):t]j::) ]. :i. an(:::e w:i. th the d.es i. gn ct' iter' :i.a c:}F th :i.s perm:i.!:.,, 3,, I J/,~J.].]. adher, e 'J' ") a:L 1 MOA :.':d"T] Stats} CI:i.~?ti. ar'H::(.:(HB ~'r'{::}m any Eg: :i.s't:. J.r'H~,,,,~ ....... .,.'J .,. '~ ~ ,,,J:'.t~::t' ,.:..:,,,~..: +, IFF:' A L..IF:'T 8"FA]"ION ];.9; ];NS'I"ALLED IN AN ARE:A COVE~]::;'.E!:I} BY MOA BLJ]iL. DINEg CODE:S, ]"I"E!:N (I) AN E].I:C'FF:;:ICAL.. F:'ERHIT AND INSF:'EC],".!:ON HLJST 13E: OB"I"A]:NED~; (2) AS'"'.BLJIL.TS MILL. NO]" BE AF:'PROVED NI'T'HOLJT AN EL_EC]"F?.IC;AL. INSI:::'E:C]'ION F;:E:POFN"~; AND (:];) 'I"HE ELJECTR:I:CA!... MOI::~K MUST BE DONE BY A L..ICE]~tSE:O EL. iECTR]:CiAN,, D ....~ ........ ~-..I' I I .......... H ....... ..,;::.~-~ ~ ,...~ ,.-,, ........ i.....,. ~...~ ...... ................... D A "1" IE :: , PIUN I C ]~ F"AL_ I -I'¥' [)F DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, AK .99501 264-4720 ON---~ ][ 'T'E SE~ER PEF~M I T PERMIT NO: DA]'E ISSUED: APPLICANT: ADDRESS: LEGAL DESCRIP: LOT SIZE: LOT L~]CATION: MAX BEDROOMS: 840548 KERRY A WILLIAMS P 0 BOX 773508 EAGLE RIVER~ AK 99577 SUBDIVISION: ROLLING HILLS VIEW E~X~LOT: 2 SECTION: 6 TOWNSHIP: 14N RANGE: 1W 1.09A (SQ. FT. OR ACRES) MCCRARY ROAD 4 BLOCK:~ 4 Listed below are the options available to you in designing your septic system. Choose the option that best. £its your site. TG'~ENE]H DEPTH TO PIPE BOTTOM (FT.) 5.0 GRAVEL DEPTH (FT.) 4.0 TOTAL DEPTH (FT.) 9.0 GRAVEL. WIDTH (FT.) 2.5 GRAVEL LENGTH (FT.) 45.0 GRAVEL VOLUME (CU.YDS.) 17.9 TANK SIZE (GALS) 1~250.0 ** SOIL RATING (SQ. ET, /BR) 85 ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS I certi£y that: 1. I am Familiar with the requirements ~'or on-site sewers and wells as set £orth by the Municipality o~ Anchorage (MOA) and the State o£ Alaska. 2. I will install the system in accordance with ali MOA codes; and regulations~ and in compliance with the design criteria o£ this per,it. 3. I will adhere to all MOA and State o~' Alaska requi~'ements ~or the set back distances ~rom any existing well~ wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid ~or a maximum o£ 4 bedrooms and any enlargement will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES~. THEN (1) AN ELECTRICAL F'ERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHSUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL. WORK MUST BE DONE BY A LICENSED ELECTRICIAN. APPLICANT: KERRY A WILLIAMS Permit Applicant Location: Legal Description: Type of Soil Absorption System Is: Trench: Drainfield: Maximum Number of Bedrooms: ~ ~UNICIPALITY 0f ANCHORAGE Department( ;Health and Environmenta]~ ,~rotection 825 ~ Street, Anchorage, AK. ~501 264-4720 * * * HANDWRITTEN PERMIT * * * WELL AND~ ON-SITE SEWER PERMIT ~1 1I(~4~ ..... Mailing Address: Phone Number: ~ ?. ~ c,f ~6((~'~q ~{5 ~i~U3 Lot Size: Seepage Bed: Holding Tank: Soil Rating(sq.ft/br) ~ The Required Size of the Soil Absorption System Is:' DEPTH ~ LENGTH ~"~0 . GRAVEL DEPTH ~ WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = /~O GALLONS * * Permit applicant has the responsibility'to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection.and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 1 9 8 3 * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if that 3 bedrooms. the residence is remodeled to include more ~'- ~7~ .. ,~ {~ ~'~ Signe~:Applicant Issued by: ~?~,, f'"~%~ i,,/~-~<.~/_ ~ Date: SWP/024 ~ Department OE H~altha~d ~nviro~m~a~ ProteCtion - 825 ~ ~t~eet~ ~=~, ~. 9950~ ' 2~4-4720 ~':'~a length d~s/o~ is ~he l~gth(~ ~eat) of the b~nch Or draLnE~. depth of a ~nch Or p~t ~e the dis~ce ~ween the ~urface of the ~he ~tC~ of ~he excavat~on(~ ~eet). ~ere i~ no set w~4th loc the ~tt~ O~ the ~oavakion(in feet). · · REQUIR~ SEPTIC(~[~) TANK ~[ZE ' I~[~ ~LLON$ ~ * . a · ~(2) INSPECTIONS ~E REQUIRED * * · ::' ~ck~L~g Of ~y Sysb~ withou~ final fne~tiOn a~ ap~coval by ~is will ~ s~J~t to pro6~tio~. wel~, .or i50 to 200 f~t ~r~ a publ/e well depend~g u~ pub~%C We%~. Min~ dish, ce fr~ a private well to a p~Lvate e~c ~ 25 feet and to a ~ity s~er line is 7~ feet. ~11 I~ are - a~ ~Gt ~ ~et~c~ to thi~ de~r~t within 30 days of ~he we%% Other r~'u~r~ent6 may apply. ~p~tfioabions a~ co~sk~tion diagr~s a'ce available to insure pro~c instaiLat%on. · * ' P~RMIT ~PIR~S D~C~R 31, I 9 8 3 * * ' Z ~ f~ilia~ wi~h the ~ain~nt8 for ~-site ~w~rs amd ~I1~ set ~or~h b~ ~ M~ici~ali~ of ~c~rage. I u~e~ta~ ~at the on-~tte ~we~ syst~ may ce,~e e~%a~t 110 Ah-,4:a a_01 -294 ,720 AERFORMVD F R:jr _. ��,r �' ` a'� ; I{ L� iIE N�t4FtW�i,F •.r ��.,.{ �t rss r SLOPE stir } LAA r ' a 4 tx -T J a`/ e M . W E* OWNIERED? O p }V Y wt AT VfHAl £ MATT i of s 94 - - -- gs x 5 -IBs7 RUN 5EWMEN - - _ CEt,z1FiE[lkjj ENDATE �j - � r MUNICIPALITY OF ANCHORAGE Development Services Department " ' Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 050-322-14 Certificate of On -Site Systems Approval Expiration Date. f , _ Legal description ROLLING HILLS VIEW ESTATES BLK 4 LT 2 Site address 19031 UPPER MC CRARY RD Eagle River AK Current property owner(s) HOUSE ON A HILL LLC X The On -site system(s) is/are approved for bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: new tank installed, well hydrofracked so no need for water storage, new survey provided with IR submittal Original Certificate Date: 5/45� �& L 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 X Tank Age Advisory Arsenic Advisory _ Other COSA ApprovaIjune 2022 COSA Checklist Legal Description: Rolling Hills View Estates Block 4 Lot 2 Parcel ID: 050-322-14 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 6/23/83 Total depth 400 ft Cased to 17 ft © Sanitary seal is functioning correctly W Wires are properly protected Casing height (above ground) 24+ in. Date of flow test for COSA 8/4/22 Static water level at beginning of test 50 ft. Comments B. TANK DATA Measured operating fluid level in septic tank New Date of pumping New Install 4/30/24 ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 10/18/92 Q ALL standpipes present per record drawing Total measured depth from grade 9 ft (max) Measured depth to pipe invert from grade 4 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced __,,,_gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: Well production at time of test 7.69 gpm Water storage tank volume None gallons Well disinfected for coliform test? ❑ Yes 21 Nc 0 Coliform bacteria is Negative Nitrate 5.32 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L © Arsenic less than MRL (ND) Collected by Arcterra ConsultinL Date 3/8/22 STATION ❑ Requireiri�n>ntenance completed Age of lift station7� 3 rs Lift station material Comments: Adequacy test date 3/8/22 Results Q Pass Fluid depth prior to test 1 in Water added 500 gal New fluid depth 39 in Elapsed time 30 min Final fluid depth 1 in Absorption rate 450+ and - FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 60 in Effective depth used 1 in Effective depth remaining 59 in COSA Checklist June 2022 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' Community Sewer Manhole/Cleanout > 100' 0 Yes if No ft ❑✓ Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25' JQ Yes if No ft Absorption Field on Lot > 100' ❑✓ Yes if No ft Holding Tank > 100' ✓V Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ✓❑ Yes if No ft ❑✓ Yes if No ft Manure/Animal Excreta Storage? 100' Community Sewer Main > 75 7 Yes it No ft ❑J 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' Tank to Property Line > 5' Field to Property Line > 10' Water Main > 10' Water Service Line > 10' F. ENGINEER'S COMMENTS Fv Yes 0 Yes .7 Yes ❑✓ Yes Fv� Yes if No ft if No ft if No ft if No ft if No ft Surface Water > 100' Wells on Adjacent Lots: Private Wells > 100' Community Wells > 200' J❑ Yes if No ft © Yes if No ft Q Yes if No ft If tank or field is under driveway comment below 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 Areterra Consulting Phone (907)-696-6111 Engineer's Printed Name Kenneth Duffus Date 4 Engineer's 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 encroachments, deficiencies or discrepancies exist. COSA Checklist June 2022 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 FNS .• F ; y r t(' 4t-'' ;CERTIFICATE OF ON-SITE SYSTEMS APPROVAL ".iR-W �.:kA.:+1hv °' g-,3 2n2Z Parcel I.D..Q�-322-14 Expiration Date: 1. GENERAL INFORMATION (/pq�{� e e Complete legal description Rolling Hills View Estates Block 4 Lot 2 Location (site address) _19031_ Upper Mc Cary Rd Current Property owner(s) Kerry Williams Mailing address Real Estate Agent 4001 El Sarino_Ct. _Homer, Ak 99603 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone Day phone __ 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: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer_ COSA Fee $__f 3 L( �- Date of Payment S `Z—ZZ Receipt Number © S (JT7 t COSA# OSG.2_2ll_Zg Date: Waiver Fee $ _. Date of Payment Receipt Number Waiver # Distance: W - On -Site Municipality of Anchorage Water and Wastewater Program (907) 343-7904 s F Y (!NERTIFICATE OF ON-SITE SYSTEMS APPROVAL :.....lfJ�.'�:Cis�i.4::'z.N:..i•..zt.v..s.•.:t:-.aP.".in...�+c:�:r::.r fr;Yau�sl.xae •'s: ultel��. _.Six..srJ ivCa>.e ,*, ra•_`:s'. �'�.at:fF, Y�: _.5 ss,. •.'-rd�i#r+ a-w.n-.iti+'ao:dY:ir,zyk,. .e2acf7.. k`aE 0-1v Parcel 1.D. W6-322-14 1. GENERAL INFORMATION Expiration Date: U "J — Z 21Z' Complete legal description Rolling Hills View Estates Block 4 Lot 2 Location (site address) 19.031_Upper Mc Cary Rd Current Property owner(s) Kerry_Williams Day phone Mailing address 4001 EI Sarino Ct. Homer, Ak 99603 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 ❑ Sewer El Public Water System ❑ Waiver/Variance request for: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ / 3 y (- Date of Payment Receipt Number ©S �[_g7j COSA# OSC2_Z__ 11 7 g Date: Waiver Fee $ Date of Payment Receipt Number Waiver # _ Distance: 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 696-6111 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name .KENNETH M. DUFFUS Date '51/Xy/ 2 Engineer's 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 i OF -AL\ encroachments, deficiencies or discrepancies exist. S 1 - 6. DSD SIGNATURE System #1 Approved for System #2 Approved for Disapproved. bedrooms. bedrooms. KENNIE•Pll M. DL;'- c 1 Y y �. ' Conditional approval for � bedrooms, with the following stipulations: �'190S, PPJA 4 ��Q l� �S 1 ��1 i � � S _(i✓�� i Original Certificate Date:_J _3-20L 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 Septic System Advisory Well Flow Advisory COSA blue sheet 10-10-12.doc X Nitrate Advisory - _ ___ Arsenic Advisory _ Other S`kca I 'f a6w Legal Description: Rolling Hills View Estates Block 4 Lot 2 Parcel ID: 050-322-14 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 6/23/83 Total depth 400 ft Cased to 17 ft 11 Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 20 in. Date of flow test for COSA 3/18/22 Static water level at beginning of test 49 ft. B. TANK DATA Age of tank(s) 30 years Tank type/material .Septic/Steel Measured operating fluid level in septic tank 28' Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA Which system tested (date installed) 10/18/92 11 ALL standpipes present per record drawing Total measured depth from grade 9 ft (max) Measured depth to pipe invert from grade 4 ft (min) ❑ N/A — pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Structure served by this system Well production at time of test 0.04 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes N No Coliform bacteria is Negative Nitrate 5.32 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L 0 Arsenic less than MRL (ND) Collected by Arcterra Consulting Date of Sample 3/8/22 STATION ❑ Requi aintenance completed Age of lift station years Lift station material Comments: Adequacy test date 3/8/22 Results Q Pass For 3 bedrooms Fluid depth prior to test 1 in Water added 500 gal New depth 39 in Elapsed time 30 min 10 Code -required soil cover over field Final fluid depth 1 in ❑ System presoaked Absorption rate 450+ and (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) _ date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: COSA Checklist yellow sheet From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No ft Wells on Adjacent Lots: Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No ft Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25'21 Yes if No ft Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' Animal Containment i 50' ® Yes if No ft ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' 1Z Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 0 Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No ft Wells on Adjacent Lots: Water Main > 10' ® Yes if_No ft : , .: Private Wells > 100' ® Yes if No ft Water Service Line >1 0" . ®`des Jf No ft Community Wells ,> 200' ® Yes if No ft Surface Water > 100' Yes if No ft - F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that / 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. COSA Checklist yellow sheet 9 ,49IU CE 711 CONSULTIN(�;, INC 20441 Ptannigan Bld, Eagle River, AK 99677 Office (907) 696-61 1 1, Fax (907) 868-3793 `SGL71 14C AK. F9i»- April 29, 2022 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Conditional COSA — Rolling Hills View Estates Block 4 Lot 2 We have been requested to obtain a conditional COSA to close the sale of this property and transfer ownership to the buyer who will be providing the funds for the upgrades to the septic system and water storage requirements. The septic tank replacement permit has been issued and the leachfield passed our adequacy on 3/8/22 and field inspection does not show any indication of failure. The property is served by a private well that does not meet current requirements and a 1000 gallon water storage tank will be installed as part of this COSA. The house is currently vacant, and we see no health and safety issues at this time. Attached are the escrow hold back letter, and bids for providing the necessary upgrades. The adjacent lots are developed and are served by private wells. There is no surface water within 100' of the proposed tank. The septic leachfield on property did pass the adequacy testing for 3 -bedrooms during our inspection. The new tank will be outside the protective well radius. We do not expect there to be any adverse effect on adjacent lots by the development of this tank. If you have any questions, please contact me at 696-6111 /FAX 868-3793. Respectfully submitted, ArcTerra Consulting, Inc. 1 ennet Duffus, P.E. Attachments: COSA Certofocate Inspection Report Escrow Holdback Letter Septic Tank Replacement Bid Water Storage Tank Bid 20441 PTARMIGAN BLVD • EAGLE RIVER, AK 99577-8736 • PH (907) 868-3791 • FAX (907) 868-3793 Z — 0 N O. W DCED O� G) 0rr- D n co 0 U) 0 -0D� D Sz0 Z o S o S 40-0 N Ta z :o W G) cn G) Om -I m � Dm� 0Am M ��� Q° 0 C m m c7 m < O 0. Q (UD (D *k z C7 kJ -i v ' m z � D zmmmmw T 0 0 cn O �mC "D c- � x x 0 -I m � X ,nom _-I m o D��•zcrnm m m m O m m frTl M r-�v O ocp y o -„ m o o , 90rvD W N D D m D S W m oo z z 0 7 � c/)-0 0 N O z z C o C31 oO D r W V � Ul W < < -G O c � SmO C Z�<�C77�O DW cnC- SrDC°�)oD W W N—{—?� =ooDm�z0� z O v�g - -izmC�K -uWXXO-u >M �cn Dm0 r-n-W-4-�o r-:5 Z26cn--mr—gr-0i-O Z O> - D r O T N -a OZ 0. �, ��—ic-)CS m =iD_r° hoc °i c)OU)T < r<n x moum X o m S v DO00 DD�D�C N -i -i cn n < Moz xz -irn=� G) -u n 0 p D D 00- G)00* D-0 mS= �c :zm > ; m D � cn r-cf)� m (� O O m O O O SI m �D -o p m m r X -u0 = S -Cnl Z m p o m r- E v v cn m K m m o z m DG Z - 0 Y c- co O m o 00 mz = m N{fy ffl (fl {fl {q -e9 W � O Ui 0-4 N co m D m 0000Orn - 000000 co oo 0 p 0 Z SOD nD 000000 0 0 o Z r �- m m O co oD-IG)D O o � m �� x�7 o 0 m X --i m 0 0P0 00 Z m W O 000 _U900 -01 Hi 00 00 N0 -6909 EA (09 ffl fA O � m O O 00 000 0 0 0o0 00000- N O co o C7 N booboo b 000000 o b O o o m O Z — 0 N O. W DCED O� G) 0rr- D n co 0 U) 0 -0D� D Sz0 Z o S o S 40-0 N Ta z :o W G) cn G) Om -I m � Dm� 0Am M ��� Q° 0 C m m c7 m < O 0. Q (UD (D *k z C7 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT On -Site Water and Wastewater Section i www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC 221178 Subdivision: Rolling Hills View Estates Block 4 Lot 2 907-343-7904 Fax: 343-7997 Awater sample revealed a nitrate concentration of 5.32 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/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. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval.