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Home My WebLink AboutROCKHILL BLK 1 LT 1Onsite File Tank a 2023. A new survey is required for a kmev uoiuu 10/ Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231019 PID Number: 015-362-01 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New n Upgrade Name BEN WESTLEY ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ound Site Address 9200 MAIN TREE DRIVE *ANCHORAGE, AK ❑ Other Phone Number of Bedrooms Soil Rating depth original grade 907-205-0202 4 GPD/SF JTotal Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot ROCKHILL; BLOCK 1, LOT 1 Fill added above original gr Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total orption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well 100'+ 25'+ TANK 9 Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity GREER TANK 1250 Gal. Surface water 100'+ Material Number of compartments Lot Line 51+ 000'NA HDPE 2 Foundation 10'+ LIFT STATION Manufacturer Capacity Remarks PER CONTRACTOR OLD TANK HAULED OFFSITE Gal. Electrical installed by WE REQUEST THE REQUIREMENT FOR AN UPDATED AS -BUILT SURVEY BE WAIVED Alarm location PIPE MATERIAL House to tank EXISTINdrainfield Tank to D3034 Installer GLW Drainfield EXISTING CO/MT D3034 Inspector GEG BENCH MARK (Assumed elevation) 96.58 ft 1st 5/22/2023 Inspectionnd - Location and description ection 2 TOP OF MH 3`d _ 4'" _ ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp _Qo600p OF ��4p Conditional Approval: Date a .• ' s �0 .............. .......... �f D f Septic ste fy A. Gorness.• Approved Date CE qys �. I/ .? Note: this approval d es not Include well permit requirements. � & 00 �p%�o f ess100ao #AECC884 kmev uoiuu 10/ PERMIT NUMBER: RECORD DRAWING P015 362-01BER: OSP231019 A B MH 81.9 55.8 STI 85.3 59.6 DBL3 87.5 61.9 DBL4 88.6 62.8 NOTE: PIPE LOCATIONS ARE SHOWN PER GEG SHOTS ABBOTT ROA D TAKEN WITH LEICA DISTO - S910 LASER DISTANCE T - METER. SWING -TIES TO I HOUSE CORNERS WERE GENERATED IN AUTOCAD. \ - 10'T & E EASEMENT I RADIUS 100' WELL GENERAL LOCATION OF EXISTING FIELD; NEW 1250 GALLV/I CONTRACTOR EXPOSED5' AFTER TANKHDPE GREER TTO CONFIRM iSEPARATION DISTA CEEXISTING 4 1 EBEDROOM HOUSE mMH1IT l� / 1 :�:• .:� .i •-' : ' m `Z I ROCKHILL; BLOCK 1, LOT 2 1"= 40' GARNESS ENGINEERING GROUP, Ltd ENGINEERING a SALES,3 CONSULTING 3701 E. TUDOR ROAD. SUITE 101 -ANCHORAGE. AK 99507 -PHONE (907) 3376179 • FAX (907) 336-3246 ` WEBSITE:w .ga enongineering.00m PREPARED FOR: PHONE NUMBER: PAGE NUMBER: BEN WESTLEY 907-205-0202 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: ROCKHILL; BLOCK 1, LOT 1 D.J.G. TYPE OF WORK: DATE: ,._ SEPTIC TANK RECORD DRAWINGS 5/31/2023 PERMIT NUMBER: PARCEL ID NUMBER: OSP231019 RECORD D RAW I N G 015-362-01 TOP OF MANHOLE = 96.58 FINAL GRADE = 95.37-95.53 MH1 STI TOP OF TANK AT INTLET = 91.59 f TOP OF TANK AT OUTLET = 91.52 INVERT OF BUNG AT INLET = 90.93 INVERT OF BUNG AT OUTLET = 90.70 NEW 1250 GALLON H.D.P.E. SEPTIC TANK SEPTIC TANK IS APPROXIMATELY 2-3 INCHES SHY ON COVER ®Aw ♦ NE S E T INEER.IN IJP `.*..* " ENGINEERING 9 SALES -CONSULTING � : � �� ..� �Y� 0 � ..�. I .� 0 3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE. AK 99507 -PHONE (907) 337.6179 -FAX (907) 336-3246 - WEBSITE: -g-eng neering cam ............ „„..... PREPARED FOR: PHONE NUMBER: PAGE NUMBER; %.� ' BENJAMIN WESTLEY 907-205-0202 3 OF 3 ,le �'t� ffrey A. Gayness •_Aw LEGAL DESCRIPTION: DRAWN BY: O C 7 53 ROCKHILL; BLOCK 1, LOT 1 D.J.G. ®�•'�e3��23•''�•'�®' TYPE OF WORK: DATE: LICENSE�� SEPTIC TANK PROFILE 5/25/2023 #AECC884 IIA 14 �� MUNICIPALITY OF ANCHORAGE ent On -Site Water & Wastewater Program �o PO Box 196650 4700 Elmore Road_ Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 n V http://www.muni.org/onsite 1)eprirtmcnt On -Site Wastewater Disposal System Permit Permit Number: OSP231019 Effective Date: 2/24/2023 Work Type: SepticTank Upgrade Expiration Date: 2/24/2024 Tax Code Number: 01536201000 Site Legal Address: ROCKHILL BLK 1 LT 1 G:2438 Site Mailing Address: 9200 MAIN TREE DR, Anchorage Owner: WESTLEY BENJAMIN & KALYAN TAN Lot Size in Sq Ft: 52713 Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 4 This permit is for the construction of: ❑ 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 Received By: 1 5 5 ui , (). _. Date Issued By: _ %�^-- Date: Z y 20 2 U CIPALITY 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. 015-362-01 Property owner(s) Ben Westley Mailing address 9200 Main Tree *Anchorage, AK Site address 9200 Main Tree *Anchorage, AK Day phone 907-205-0202 Legal description (Sub'd., Block & Lot) Rockhill; Block 1, Lot 1 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) Q (w/wo ADU) Septic Tank FJ 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. 1 further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: ZZ15- Waiver Fees: Date of Payment: o919312J9-3 Date of Payment: Receipt Number: 11(0a712C7 Receipt Number: Permit No. 05AQ 31019 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\FormsUient FormsTermit Application.doc Gj Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231019, Curtis Townsend, 02/24/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231019, Curtis Townsend, 02/24/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231019, Curtis Townsend, 02/24/23 IVIUNICIPALITY 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 NAME PHONE LEGAL DESCRIPTION Well ~ ~- I Absorption are~ t I Dwelling ~ PER~T NO. ~ Z I Manufacturer iJ I Mated~, ~ No, o~compartments w ILiq. capg~ty in gallons F HOMEMADE Inside length Width Liqui~pth ~ /~.~O : - ~ ~ I~oll ~ ~ Foundation ~ I~earestlotline ~ ~[BMIT~O. ~ · ~ I No. of lines _ , I Length of each line / Total I~n¢ &f I~ ~ Trench ~dt~ Distance between lines ~ ~ I Top of ti~e to finis~ ~rad~ ~ MaterisI beneath tile ~ ~otal effeotive abso~tion area ~ Length ~ ~idtk Depth PERMIT NO. ¢~ ~ Depth Driller ] Distance ta lot line i PERM,T NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s} OTHER PIPE MATERIALS SOl k T ~'3~- RATING INSTALLER REMARKS DATE LEGAL Box 1369~ ~TAR I~OUTE A AI~iCHORA(iE~ ALASKA 9950~ 344"7714 SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH DRILLED AT THE rate OF ~21o00 PER FOOT. ProPErtY OWNEr #~'t.o ~ ;7-e~--~ 182~ g. 7~ ~3 99~07 LOCATION OF WELL SITe ~' ~' ~' DRILLER WELL LOG: 76--700~ f~. A c~ ~. ~ 100 ~ ~ o~ ~o~o~. 1/2 ~o~ S~~Ze ~ Coo.t.o.fi ~~: 100 ~,¢e,e X $21.00 /:ze.~ fit., Co~g o~ geJ~ Sew. L: ~2_.2.00 COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF THANK YOU VeRY MUCh. DATE BERNie CLAUS OF RAMPART DRILLING WORKS PERMIT NO. RPPLICBNT JIM JETT PO SOX t0-454 995i± LOCRTION 8BBOT ROBD?MBIN TREE LEGRL L i B 1 ROCKHILLS S?D LOT SIZE TYPE OF SOIL RBSORPTION SYSTEM IS: TRENCH MR×IMUM NUMBER OF BEDROOMS = 4 SOIL RBTING (SD FT?BR)= 85 THE REQUIRED SIZE OF THE SOIL BBSORPTION SYSTEM [:.EF"T'H= .J_4. I_E{~-~]'TH~= dL]~ I]R~]%-'E~_ DEPRRTMENT .... - HERLTH RN[:' ENVIRONMENTRL. >UTE_.'FION 825 "L" STREET, HNCHOR~GE, RK. 9950~ ~G4-47~8 ( 8i0t78 ) ~49-34ti 55000 SQURRE FEET THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS ]'HE DISTRNCE BETWEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET). REL-]L~ ][ E:E[:. SEF'-F I Ft': 'T F~'-~.c] S; I ZE = it ~:--~ 5 ~-2'~ G~FIIL_L PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTRLLRTION INSPECTIONS OF RNY WELLS RDJRCENT TO THIS PROPERTY RND THE NUMBER OF RESIDENCES THRT THE WELL WILL. SERVE. TII..-t O ( 2 [:~ I ['-.ISF'EC:T :[ C~l'-l,'~. RF~.'E F;:E~]LI I RE[) BRCKFILLING OF RNY SYSTEM WITHOIJT FINRL INSPECTION RND RPPROVRL BY THIS [:,EPFtRTMENT WILL BE SUBJECT TO PF.'.OSECUTION. MINIMUM DISTRNCE BETWEEN R WELL AND RNY ON-SITE SENRGE DISPOSRL SYSTEM IS 100 FEET FOR ~ PRIVRTE WELL OR t50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE 'TYPE OF PUBLIC WELL. MINIMUM DISTRNCE FROM R PRIV8TE WELL TO R PRIVRTE SEWER LINE IS 25 FEET 8ND TO R COMMUNITY SEWER LINE IS; 75 FEET. WELL LOGS RRE REQUIRED RND MUST BE RETURNED TO THE DEPRRTMENT WITHIN ~0 DRYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MRY RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE RVRILRBLE TO INSURE PROPER INSTRLL~TION. F'EF4.'I-.1 X T E::-::F" I F-.'ES i2:..EC:E~'-IE:ER 2:- ~-.. I CERTIFY THRT t: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH 8¥ THE MUNICIPRLITY OF RNCHORRGE. 2: I WILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES. Z~: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN 4 BEDROOMS. SIGNED: RPPLICRNT JIM JETT 264-4720 * * * HANDWRITTEN PERMIT * * * WELL AND/OR ON-SITE SEWER PERMIT Applicant: Mailing Address: Location: ~ ~ ~ ~ //~?~-~C~_Bhone Number: ~.~/~- ~ Legal Description: 6-- / ~ / ~~/~/~ ~-~ot Size: ~'-~ ~-- Type of Soil Absorption System Is: Trench: /Drainfield: Seepage Bed': Holding Tank: Maximum Number of Bedrooms: ~ Soil Rating(sq.ft/br) The Required Sihe of, the Soil Absorption System Is DEPTH /.cz/ LENGTH /~' GRAVEL DEPTH WIDTH / / / The lengt~dimension is the'length(in feet) of the trench or drainffeld. 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 = 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. ~-~MUNICIPALITY OF ANCHORAGe-, Departmen~ ~f Health and Environmenta ~rotection 825 L Street, Anchorage, AK. 99501 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 1 * * * I certify that: (1 I am familiar with the requirements for on-sit~ 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 r/e~uire enlargement if t~~den~e is remodeled to include mo~~s~ ~ ~ ~ Signed: ~~ ~ ~ Issued b~:/ Date: SWP/024 (1/81) PERFORMED FOR: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 99502 276-222~ SOILS LOG - PERCOLATION TEST LEGAL DESCR'PT'O": LO--F-~ / Ov~RSURPEN SOILS LOG PERCOLATION TEST DATEPERFO.MED,¢O 8 / SLOPE SITE PLAN 10 11 12 13 14- 15 16 17 18 19- 20- WAS 6ROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? PERFORMED Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN ,. FT A~ FT CERTIFIED CERTIFICATE FOR A Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 OF ON-SITE SYSTEMS SINGLE APPROVAL FAr"llLY DWELLING Parcel I.D. 0~5 - ~:~Lp;.-~ - O'~ '1. GEI',IERAL INFORMA'rlON COSA# ~.~?P (~ \ !\ ~ ~ .x, i t,on Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address ROCKHILL S/D; BLOCK 1, LOT 1 9200 MAIN TREE DRIVE * ANCHORAGE, AK * 99516 DWIGHT & NANCY SMITH Day phone 2801 DAGGET AVENUE *KLAMATH FALLS, OR 97601 346-2026 Day phone Day phone Unless otbem/, iSe rectuested, COSA will be held by DSD for pickup. NUM~BER OF BEDROOMS: 4 TYPE OF wAT~R;SUPP,L~: TYPE OF WASTEWATER DISPOSAL: Individual Well , · Individual On-site · Indi{,idual Water Storage [] Individual Holding tank [] Community' Class Well . [] Community On-site [] Public Water System [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are requited for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. 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 GARNESS ENGINEERING GROUP, Ltd. Phone 537-6179 Address 5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. DSD SIGNATURE Approved for /---[ Disapproved. Conditional approval for Attachments: COSA Checklist v"'"' Septic System Advisory Well Flow Advisory Nitr?¢Adviso~ .~ ~ (Rev, 11/05) Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: i// Municipality of Anchorage Development Se ices Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Legal Description: ROCKHILL S/D; BLOCK 1, LOT 1 A. WELL DATA Well type PRIVATE IfA. B. or C provide PWSID# Date completed 5/12/1981 Sanitary seal (Y/N) YES Total depth 100 ft. Cased to 100 ft. FROM WELL LOG Date of test 5/12/1981 Static water level 45 ft. Well production 10 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mi. Arsenic: ND ug./L. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Tank size 1250 gal. Number of Compartments Foundation cleanout (Y/N) YES Date of pumping --~"./'/? ,, C. ABSORPTION FIELD DATA Date installed ' 4/21/1981 Length 21 ft. N/A CHECKLIST Parcel ID: Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION 4-/13/2009 64 4.52 Nitrate 7.14 mg./L. Other bacteria __ Date of sample: 10/20/2011 Collected by: 2 Depression over tank (Y/N) NO Pumper. A+ HOME SERVICES [*BELOW EXISTING GRADEI Soil rating (g.p.d./ft~or~ 85 Width 3 ft. YES YES 12+ in. ft. g.p.m. colonies/100 mi. GEG Ltd. Date installed 5/12/1981 Cleanouts (Y/N) YES High water alarm (Y/N) N/A Total depth 13.5 ft. Eft. absorption area 420 ft~ Monitoring tube YES Date of adequacy test 10/20/2011 Results (Pass/Fail) PASS Fluid depth in absorption field before test 50 in. Water added *940gal. Elapsed Time~'~ 0 min. Final fluid depth 60 in. Absorption rate >= System type DEEP TRENCH Gravel below pipe 10 ft. Depression over field NO For 4 bedrooms New depth 60 in. 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date - *THE LAST 500 GALLONS INTRODUCED (OVER A PERIOD OF 89 MIN.) ONLY CAUSED 1" RISE IN THE DRAINFIELD. PORE SPACE OF 1" OF DRAINROCK EQUALS ROUGHLY 13 GALLONS. IN SHORT, ROUGHLY 485 GALLONS OF THE 500 GALLONS INTRODUCED WAS ABSORBED. D. LIFT STATION Date installed "Pump on" level at in. Size in gallons "Pump off" leveJ~. Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: 100'+ Septic tank/lift station on lot Absorption field on lot 100'+ Public sewer main N/A Sewer/septic service line 25'+ Animal containment areas 50'+ Manhole/Access~ J High water alarm level at Meets alarm & cimuit requirements?. in. On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout Holding tank N/A Manure/animal excrete storage areas N/A 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Water main N/A Water service line. 10'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Absorption field 5' + Surface water 100'+ Property line 10'+ Building foundation 10'+ Water service line 10'+ Surface water 100'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ COMMENTS Water main N/A Driveway, parking/vehicle storage 10'+ 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 Printfld Name JEFFREY A. GARNESS Date t , J"z. / l lj COSA Fee $ q Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number. GARNESS ENGINEERING GROUP, Ltd. November 9, 2011 Municipality of Anchorage Development Service Department On-Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650, Anchorage, Ak 99519-6650 Reft Rockhill Subdivision, Block 1, Lot 1, Septic System Adequacy Test To whom it may concern: The purpose of this letter is to clarify issues regarding the adequacy test we performed on the subject septic system. Upon our arrival (10/20/2011), there was 50 inches of standing liquid in the drainfield. Over a period of 82 minutes we introduced 440 gallons into the system, which caused a rise of 9 inches (total liquid depth of 59 inches). We then proceeded to introduce an addition 500 gallons (total of 940 gallons introduced) over a period of 89 minutes, which only caused an additional rise of one (1) inch in the drainfield. The pore space in 1 inch ofdrainrock in the subject trench is roughly 13 gallons; therefore, of the 500 gallons introduced (which caused a 1 inch rise), roughly 487 gallons had to have been absorbed during the 89 minutes. Based upon this data, the absorption rate of the drainfield was deemed to be greater than 600 gallons per day. If you have any questions, please contact me at 337-6179. m.s. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com Municipality of Anchorage Community Development Department Development Services Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On-Site Systems Approval # 111437 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 1, Lot 1 of Rockhill subdivision. This inspection revealed a nitrate concentration of 7.14 milligrams per liter (mg/L) was reported for the property's well water sample. 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. Municipality of Anchorage D~ve[oprnent Services Depsrtment Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6650 www.munLorg/onsit~ (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. O I {~'"'-3 ~'~-(,.,) 1. GENERAL INFORMATION cos^. Expiration Date: //~ / O Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address ROCKH1LL S,/D; BLOCK 1, LOT 1 9200 MAIN TREE DRIVE * ANCHORAGE, AK * 99516 DWIGHT &: NANCY SMITH Day phone 9200 MAIN TREE DRIVE * ANCHORAGE~ AK * 99516 546-2026 Day phone AVALON RICHELLE w/ DYNAMIC Day phone 5111 C. ST * ANCHORAGEI AK * 99503 261-7600 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site · Individual Holding tank [] [] Community On-site [] [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-S~te Systems Approval are valid for 90 days from the date of issue for prolJerties {~'r~d by a'pfivate or Class C well ahd may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineers work. 5o STATEMENT OF U~SPECTION BY ENGINEER As certified by my seal a~xad hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Ce~ificate of On-Site Systems Approval Guidelines for this app§cafio,;. shows that the on-site water supply and/or wastewater disposal system is (are) safe, functiona! and adequ'ate 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 GARNESS ENGINEERING GROUP, Ltd. Address 5701E. TUDOR ROAD, SUrE 101 * ANCHORAGE. AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Phone Date 337-6179 Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being se~/ed by the system. These conditions are outside the control of the evaluator of the system. Safisfacto~y test results do not guarantee future performance of the system, nor do they guarantee that there ere no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operatJonat requirements of the ADEC or MOA DSD. The content of this report is for t[3e sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal 6ght whatsoever. DSD SIGNATURE t/' Approved for /'-/" bedrooms. Disapproved. Conditional approval for '. PROGRAM : bedrooms, with the fllowing stipulations:~ ~.-c,". ."/5""'..~' Y/My/) t))))))) Attachments: COSA Checldist L/'/ Septic System Advisory Well Flow Advisory Nitrate Advisory .,: ,,'1, ..-/..,-_ / Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: Municipality of Anchorage Development Services Department Building Safely Division On-Site Water & Wastewater Program 4700 Bragaw Street P.Q Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF 0N-SITE SYSTEHS APPROVAL CHECKL ST Leg,~l Description: ROCKHILL S/D; BLOCK 1, LOT 1 Parcel ID.~/.~-3~)// WELL DATA Well type PRIVATE 'If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 5/12/1981 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Totaldepth 100 ft. Cased to 100 ft. Casing height (above ground) 12+ .in. FROM WELL LOG AT INSPECTION Date of test 5/12/1981 4/13/2009 Static water level 45 ft. 64 .ft. Weil production 10 g.p.m. 4.52 g.p.m. WATER SAMPLE RESULTS: Coliform qD colonies/100 mi. Arsenic:' I,,lj) ug./L. SEPTIC/HOLDING TANK DATA Nitrate (~° t~'~mg./L. Tank Type/Material SEPTIC/STEEL Tank~size 1250 gal. Number of Compartments 2 Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping 3/26/2009 Pumper Other bacieria.. ~ colonies/100 mL Collected by:. GEC Ltd. Date installed 5/12/1981 Cleanouts (Y/N) YES High water alarm (Y/N) N/A MCDONALDS PUMPING ABSORPTION FIELD DATA Date installed 4,/21 ,/t g 81 Length 21 ft. ELOW XISTING Soil rating (g.p.d./ft~or~_'/~"~ 85 System type DEEP TRENCH Width 3 ft. Gravel below pipe 10 Total depth 15.5 ft. Eft. absorption area 420 ft~ Monitoring tube YES Date.of adequacy test 4,/15,/2009 Results (Pass/Faill PASS Fluid depth in absorption field before test 60 in. Water added .690 gal. ; Elapsed Time: 270 min. Final fluid depth 60 In. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (Y/N & type) Depression over field NO For 4 bedrooms . New depth. 66 in. 6O0+ g.p.d. NONE KNOWN 'If yes, give date -- D. LIFT STATION Date installed .Size in gaIIons~Manhole/Access (Y/N~ ------- 'Pump on" level at in. Pump off" ~vel at Datum ~Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot in. 100'+ 100'+ Public sewer main N/A Sewer/septic service line 25'+ Animal containment areas. 50'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N,/A Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field Water main N/A Water service tine 10'+ Surface water We/Is on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation. 10'+ Water main Water service line 10'+ Curtain drain NONE KNOWN 5'+ 100'+ Surface water 100'+ Wells on adjacent lots 100'+ N/A Driveway, parking/vehicle storage 10'+ F. COMMENTS 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 JEFFREY A. (;ARNESS COSA Fee $ ~/~' ~" Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number, Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 wwxv.muni.org/onsite (907) 343-7904 .Nitrate Advisory Certificate of On-Site Systems Approval # 090263 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block I, Lot I of Rockhill subdivision. This inspection revealed a nitrate concentration of 8.49 milligrams per liter (mg/L) was reported for the property's well water sample. 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. 0'£9 I ~3. ~ 3g.O ,og I I ,00'09 [ ~.I?~,~O. OON MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description /__.-~.D'7 / / g~l~ ~ / L~(.~L~/'~f<-o '~/~ Location (site address or directions) Property owner Mailing address Day phone Lending agency Mailing address Day phone Address ~"~ ~U~O~i,JTl~ L_ Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: IndividUal well Community well Public water Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written Confirmation from State ADEC attesting to the legality and status of system. 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 of this Health Authority Approval application 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 corn ~liance with all Municipal and State codes, ordinances, and regulations in effect on the date of t Name of Firm Alaska Water & Wastewate~ 7320 Ba~st-Cheste~ J-[ ts. ~ Anchnrn~e. AJ/a~,ka 9~5~ Address Engineer's signature ~ 6. DHHS. SIGNATURE ~ Approved for ~~ bedrooms. is inspection. Phone Date Disapproved. Conditional approval for bedrooms, with the following stipulations: Note': The well for this property meets existing State and Municipal Codes. There are niCraL~ p~esent. IL i~ ~ug~L~d Lh~L pu£iudi~ Lu~ti~ bt performed to insure the wells continued suitability. Current nitrate concentration is 5.b5 mg/1. EPA maxzmum concentration zs IO.O mg/l. More information on nitrates is available from the On-site Services Program, DH~S, 343-4744. Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates 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. 1/91) Back MOA RECEIVED Municipality of Anchorage MAY' 1 1' DEPARTMENT Of HEALTH & HUMAN SERVICE~),~UNICiPALiT¥ o,': ANC Environmental Services Division ENVIRONMENTALSERViCE,~.~;~ 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist Legal Description: L-l! gl/' ~(..~KH~Cr.. "~/~) Parcel I.D.: A. WELL DATA Well type ~-~[U~-('~ If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Y~-~ Date completed Total depth Sanitary seal (Y/N) Date of test Static water level Well production OIS- 1 - 0oo FROM WELL LOG /6 g.p.m. Casing height (above ground) Wires properly protected ~t'/N) AT INSPECTION g.p.m, WATER SAMPLE RESULTS: Coliform ~'~ Date of sample: ,~ I Nitrate ~'~,/C:> -~ Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed 4'~/~/{~[ Tank size Foundation cleanout (Y/N) Date of Pumping C. ABSORPTION FIELD DATA Date installed Length ~, J" Width Number of Compartments o~. High water alarm (Y~_.~ ~,/' ~------~ Depression (Y(~ Pumper ~+ ~ /0 __ Cleanouts~Y~N) ~ Soil rating (g.p.d./ffa or~ 8-~ Gravel thickness below pipe System type "~ Total depth Effective absorption area L~~'0 g~ Monitoring Tube present ~IN).~,~ Depression over field (Y/{~ Date of adequacy test C~lr'~[~ Results(Pass/Fail) ~:)f~$ For ~)d.~ Fluid depth in absorption field before test (in.); ~,~" Immediately after ~>'~gal. water added (in.): bedrooms 6~ ~' Fluid depth ~',~ (ins) Minutes later: Peroxide treatment (past 12 months) (Y/~ 72-026 (Rev. 3/96)* c~(~/4~ Absorption rate = ~)O'/- g.p.d. J~)O~. ~'~.~' If yes, give date /"5//Or C ested E. SEPARATION, DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line ~ ~On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~0 ~- Property line /0 ~'+ Absorption field Water main/service line [0.4- Surfacewater/drainage t00~+ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line I0 ~,'~ Building foundation /0 ¢~- Surface water Ioo Curtain drain /~J~)~J~ ENGINEER'S CERTIFICATION ~f~ I certify that I ~det~ined/~ e in conformCe w/~/~ H~A~ ide,, Signature ~/~/¢~" ~/v( ¢ Engineer's NaJ 0~-~ Date Water main/service line /O ~ Driveway, parking/vehicle storage area ~ % Wells on adjacent lots [ O(~ ~ :1 inspections and ~es in effect on this date. HA,& Date of Payment ~"~-//:a--/~ Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* (a) Legal 'Description (include lot, block, subdivision, section, township'range)~ ~ ' ' r Location address or directions) . '..: . i ':' -!' ' . ~ ' (b) ',App cantName~, ~l~ ~ 4: 'A~ ~.+'A~.X~o?~'''''~';~' (c) ~ Applicant is (check one)'Lending Jnstitutib~:U ::owne~/6~ider'u (d) Lending Institution ~elephone Address . .: ~i'(e) ~' BeaI Estat,e Col 'ii:I .:? ,, '!:'Ada~ess ' Telephone {f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single-Family~ Multi-Family I-I Other Number of Bedrooms ?' WATER SUPPLY ndividual Wellx Community [] Public Note: If community well system, must have written confirmation from the State Department of E~ attesting to the legality and status. SEWAGE DISPOSAL '*'.' Onsite~:iiii.' PubliX'El ~'~ Community [] Holding Note:/'1~ community well system, must have written Confirmation fron attesting to the legality and status, i. ~i~" :: ;onservation Page 1 of 2 " 72-025 11/84} v~-~'~¢;'5~<~ENGINEERINGFIRM PROVIDIhG'INSPECTIONS~TESTS,,FILE SEARCH, ~, AND IN.FORMAT ~'~ fib~'b¢'mu,~d hereto'and'as'of t~eva dat on date shown below ~fy that my ~nvest~g ~ea ~'~'A~thorit~p~l ~ t~A~'~he ~d~it~WAt~'~b~ An'd/~ Wast~water d spo: al system is safe, funct,onal a.nd adeq~at~ for the h'~'mber of b~dt~om~ and type of StructUre ind cated herein. I fu~her verify that based on ~e mformatmn obta~e from the Municipalit~¥Of Anchorage fll~s'and from"my investigation 'and inspection, the on-site water supply ano/or wastewater disposal system is in compliance with all Munici pal and State codes, ordinances, and regulations in effect on the date of ection. Date' ~!?~ :~ ':; '"~ ~ "'';;" neer's .Seal DHEP APPROVAL Approved for ,¢Z~u~-- (~)bedrooms by Approved ' ~ Disapproved Terms of Conditional ,~pproval Conditional 'ION ' The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations 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 inst tut ohs in Order t° Satisfy certain federal and State requirements. Employees of DHEP do not conduct inspection§ or ~ iSSued.:The MUnicipality ~f AnChorage ~s not responsible for errors Or omissi°ns in the inee~'~!~rk; WELL DATA Well Classification ~ Well Log Present (Y/N) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Le~].~ Descripti.on: ~/~ 2' /, 7~/-Ap / ? Total Depth //~O/ Cased to Static Water !~evel 6~ / Casing Height Above Ground ~.// Electrical Wiring in Conduit (Y/N) 7 Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot Line - TO Nearest Public Sewer ~-~,,~-F Cleanout/Manhole Water Sample Collected by Water Sample Test Results ' If A, B, C, D.E.C. A/pproved (Y/N) Completed ' ~"/P-//'~'~ Yie d Date / /-- - /Depth of Grouting Pump Set At ~ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots 'P/z~/ .' ;On Adjoining Lots ~)/~"7_f') / To Nearest Public Sewer To Nearest Sewer Service Line on Lot -~ /'%%~Pl/~ / ; Date Comments B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) / Depression over Tank (Y/N) /'~/ 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 Size ,/~) ' No. of Compartments Air-tight Caps (Y/N) F Foundation Cleanout (Y/N) d Date Last Pumpe /'~'~/~. ;for Temporary Holding Tank Permit (Y/N) .~.,/~ TO Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Type of System Design Length of Field Depth of Field /..~ Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test Separation Distance from Absorption Field: TO Water-Supply Well //~ TO Building Foundation Lot To Water Main/Service Line ~/~ / To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Property Line ~'.~ To Existing or Abandoned System on On Adjoining Lots To Cutbank (if present) 27 D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that l have checked, ,ve~fied,~r conformed to,al~ MgA and HAA guidelines in effect on the date of this inspection. Signed ~ ~ Date ~/~ Company MOA No. Page 2 of 2 72-026 (11/84) Receipt No. Date of Payment Amount: $ Engineer's Seal CONSULTING ENGINEER 203 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 LEGAl: LOCATION: SEPTIC SYSTEM ADEQUACY LOT 1, BLOCK 1, ROCKHILL 9200 MAINTREE TEST OWNER: RESIDENCE: WATER SYSTEM: J. PULLEN SINGLE FAMILY, FOUR BEDROOMS ON SITE WELL SEPTIC SYSTEM: DATE OF PUMPING: DATE OF TEST: TEST PROCEDURE: FROM MUNICIPAL RECORDS: TANK: GREER STEEL, TWO COMP. 1250 GAL. ABSORPTION SYSTEM: TRENCH ABSORPTION AREA: 420 SQ. FT. SOIL RATING: 85 INSTALLATION DATE: APRIL 1981 JULY 1, 1986. ANCHORAGE CESSPOOL PUMPING JUNE 30, 1986 SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND WITH 4.5 FEET OF COVER AND 49.5 INCHES OF LIQUID. TRENCH SUMP WAS FOUND 13 FEET DEEP WITH THE TOP OF PIPE LEVEL WITH GROUND AND WITH 56 INCHES OF LIQUID. WATER WAS ADDED TO THE SUMP AT A CONSTANT RATE OF 6 GALLONS PER MINUTE. THE WATER LEVELS IN THE TANK AND SUMP WERE MONITORED. A TOTAL OF 310 GALLONS WERE ADDED. NO RISE IN EITHER OF THE WATER MONITORS WERE OBSERVED. TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These. conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requi- rements of the Municipality and State. CONSULTING ENGINEER /"~203 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 RESIDENTIAL WELL LEGAL: LOCATION: OWNER: TYPE OF WELL: WELL LOG AVAILABLE: LOT 1, BLOCK 1, ROCKHILL 9200 MAINTREE J. PULLEN SINGLE FAMILY YES INSTALLATION REQUIREMENTS MET: YES WELL YIELD FROM WELL LOG: 10 GPM. INSPECTION PUMP YIELD: DATE OF INSPECTION: TEST PROCEDURE: 6 GPM JUNE 30, 1986 WELL WAS PUMPED AT A CONSTANT RATE oF6 GALLONS PER MINUTE WHILE THE DRAWDOWN WAS MONITORED WITH AN ACOUSTIC PROBE. THE WELL WAS PUMPED TILL THE DRAWDOWN STABILIZED. STATIC WATER LEVEL WAS FOUND AT 65 FEET BELOW TOP OF CASING. AFTER 10 MINUTES OI? PUMPING THE WATER LEVEL WAS AT 77 FEET. DURING THE REMAINER OF THE TEST WATER LEVEL FLUCTUATED BETWEEN 72 FEET AND 77 FEET. TOTAL WELL DEPTH IS 100 FEET. TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON JULY 1, 1986. TEST WAS NEGATIVE. TEST RESULT: THIS WELL MEETS THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The Municipal requirement for well flow is 150 gallons of water per bedroom per 24 hours.This well surpasses this requirement. The assessment of the condition of this well applies only to the conditions as of this date. The flow rate of the well may change due to subsurface conditions that may not be observed from the surface, and changes in land use and other factors that may impact the conditions of the aquifer feeding the well. ~U~ICIPALITY OF ANCHORAGE l MUNICIPALITY OF ANCHORAGE DEPT, OF HEALTH & DEPARTMENT oF HEALTH & ENVIRONMENTAL PROTECTIONENVJRONMENI'AL P~%OTFCTION 825 L Street-Anchorage, Alaska 99501 U [,i i4 ~. ~ 198i ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 .~E C ~S~~ REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILI I DIRECTIONS: Complete all parts on page 1. Incomplete ~equests will not be proce~ed; Pleas~ allow ten (10) days for processing, PHONE MAILING ADDRESS ) ~/ 2.~UYER ~ MAILING ADDRES~ I~STITUTIO~ PHONE MAILING ADDRESS . 4. R~ALTOR/AGENT 'J I PHONE MA~LING ADD~ESS 5. LEGAL DESCRIPTION STREET LOCAT.IONt-~'~ 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [Z~/' SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six [] Other 7. WATER SUPPLY [2~y'/i N DIVI DUAL* [] COMMUNITY [] PUBLIC 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 --[~'/I N DI VI DUAL/ON-SITE** [] PUBLIC UTILITY **If individual/on-site, give installation date '~ If 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) THIS 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 [] INDIVIDUAL/ON -SITE DATE INSTALLED F-IpUBLIC UTILITY~ 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/H°lding Tank IAbs°rpti°n Area Isewer Line INearest LOt Line Absorption Area to nearest Lot Line 5. COMMENTS [] APPROVED FOR ('~z/'" BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED LEGAL DESCRIPTION 72-010 [Rev. 3/78)