Loading...
HomeMy WebLinkAboutROCKHILL BLK 2 LT 21Onsite File 7vu 30'a > 1rozv VJ/VG/ 10) Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191273 PID Number: 015-362-33 Dwelling: [9 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New X Upgrade Name Follett Richard Family Trust ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 9601 Main Tree Drive El Other Phone of Bedrooms Soil Rating Total depth from original grade TNumlo, GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Rockhill 2 21 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic I Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ftz Ft. Well 100,+ TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Infiltrator Capacity 1094 Gal. Surface Water 100'+ Material Number of compartments Lot Line 51-I- NA Plastic 2 Foundation�' {- LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by Installer PIPE MATERIAL House to tank 3034Tank to 3034 drainfield A+ Home Services Drainfield CO/MT3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 477.0 ft Inspdection i51 7/10/2019 n 7/15/2019 Location and description 3rtl 2 4th East Side Bottom House Trim ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date 0F ALgS�� 9TH .. . N �; !y0 iic��l"i N. t�Cl rl rl p!qg Septic Sy s ;�. • + r �; 4.. Approved Date Note: this ap royal does not include well permit requirements. 1rozv VJ/VG/ 10) Vp-r to C)O�� _ D C -iZ -0 N Dp m m z• W D m Cn o �� �mc�+(T1 OpmOrX m mu m I �Czcr"in 0 cn C CD NmO, O N '-� r!ip N — 0 Z c�W�,zZZ�� D I—mAm>OtZ7 � 0 = � r. T_zi ED �-I�OC rn I r O C7D m C~ Z Z z _ 0� N pW�mo rZi mD n ccn-<> O O C m D aQ 7' _I Z FTl n Cm \ Cf) \J m 01� -� �EF NN �� f \\ �' i `\ r ACID \ r -q -i -Z+ oM- s \ m D I.P v v o m ^ 71 / m � - } c U CLEAN OUT m ` 3 i g / �© Q D A CD CLEAN OUT X' T / c CLEAN OUT V O > tT iN CLEP.N OUT I / "L0 O�m MF K,r zm ( _ p V D� G rS in X 00> m I / O'Z Z p / I� m mmN 0 N n N _. -- — L n '> z t� (A c,i L4 y u a iD a cc NOTES: PANNONE ENG SVC, LLC7 PALMER, AK 99645_�����\\\� FAX i�.P� OFA(gs�it� REVISIONS DATE `2/,9 RECORD DRAWING PHONE (907) 748082 0 907) 745-8207 SCALE ROCKHILL B2 L21 FOLLETT RICHARD FAMILY TRSU i 9601 MAIN TREE DRIVE •••• tev n7z: aanore / �a'�-� CE e,4s t�l��\\cry.-� i, = 60, P.I.D. NO 015 62-33 DRAWN ACP —PERMIT NO. . OSPI91273 SITE PLAN ANCHORAGE, AK 99507 SHE2 OF 2 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://wvAv.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP191273 Work Type: SepticTank Upgrade Tax Code Number: 01536233000 Site Legal Address: ROCKHILL BLK 2 LT 21 G:2438 Site Mailing Address: 9601 MAIN TREE DR, Anchorage Owner: FOLLETT RICHARD FAMILY TRUST Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms llepartnlent 7/2/2019 7/11/2020 48546 ❑ Disposal Field Z 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: ' Issued By: , Date: I Date: % 3 MUNICIPALITY OF ANCHORAGE Community Development Department' ~ ' Development Services Division Phone: 907-343-7904 On -Site Water & Wastewater Program Fax: 907-343-7997 ON-SITE SEWERIWELL PERMIT APPLICATION Parcel I.D. 015-362-33 Property owner(s) Follett Richard Family Trust Day phone Mailing address 1601 Main Tree Drive Anchorage, AK 99507 Site address Same Legal description (Sub'd., Block & Lot) Rockhill B2 L21 Legal description (Township, Range & Section) Lot Size 48546 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: (® all that apply) Upgrade Absorption Field ❑ Septic Tank Q Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ APPLICATION IS AN: Initial ❑ Upgrade ❑X Renewal ❑ TYPE OF DWELLING: Single Family (SF) ❑X (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Dis tance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. ature of property owner or authorized agent) Permit/Rush Fees: �� 00Waiver Fees: Date of Payment:_ 2 1120 �] Date of Payment: Receipt Number: _1K Receipt Number: Permit No. DS )o 1 �! Io?7�j Waiver No. +.Kan � Ru s4{ �k Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191273, Rebecca Carroll, 07/02/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191273, Rebecca Carroll, 07/02/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191273, Rebecca Carroll, 07/02/19 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELl_ INSPECTION REPORT MAILING ADDRESS LEGAL DESCRIPTION LOCATION PHONE DISTANCE TO: Manufacturer Absorption area Dwelling Materi~ ~ ~, NO. OF BEDROOMS PERMIT NO. No, of co~artments Liq, capacity in gallons IF HOMEMADE: Inside length Width Liquid depth DISTANCE TO: Well ] Dwelling PERMIT NO. Manufacturer Liquid capacity in gallons DISTANCE TO: No. of lines Length of"each line. Top of tile to finish grade ,.~/~ I Foundation Material Nearest lot line Material beneath tile Depth [Trenchwidth~,~inches Width PERMIT N O~4~} 5/~ Distance between lines PERMIT NO. ~t~1 EW [] UPGRADE Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: Depth Driller Distance to lot line Building foundation Sewer line Septic tank DISTANCE TO: PERMIT NO. E,~20~,fL Absorption area(s) OTHER PIPE MATERIALS SOl L TEST RA~rl NG /ooh INSTALLER REMARKS APPROVED DATE LEGAL RF'F'L ! CFiNT L 3 '_-'qT '[ 3i'4 L.E'GRL. DE:F:'FtRTMENT ~%~ HERLTH FIND E:N',,,'I RON.HENTRLi/"'~4:O'TECT I ON 825 '" LS'TREET., FINCHORRGE., RK. 9::..Si 2r54-,~72Ei · ]' FI K LT2::L BLk:2 F:O3k'HILL_,,. ¢' '"[. 'I"'.,.'F'E ..... '~::'. :.'7, OIL AE~E:ORPT!ON c.,., .":::"r'F'l_, .... 1:5: TF,'ENCM 3:4 4 -~3:5'i i / J~ 2 L;: .... FEET :50IL F.:R"FING ,::~;[.:! F'T/E~R::,= :L(~E; THE' LENGTH [:,tP'!ENS.;ION t5; THE LENGTH <tN FEET> OF THE TRE'NCH OR [:,RRtNF:ZEL. E:,. TF!E DE?TH OF FI TRENE:FI .OF;: PiT I'.5 THE DZ:~;TRNCE BETb~EEN THE S;URFF~CE OF THE GROUND FiND THE BOT]'OH OF THE EXCFI',,,'RTi0N (ZN FEET). 'THERE i:5 NO :E;ET i.,ttDTH FOR TRENCHEE;. THE .GRRVEL. DEPTH IS THE HtNIHUH E:,EPTFI OF GRRVEL. BE'i"F.!EEN THE 'OIJTFRLL PIPE RNE:, THE BOTTOM OF' THE E>:;CFF/FFTION <IN FEE:T). F'ERHZT F]PF'LiCFINT HR'E; ................. THE F..'F/.!::P-I'. '::: TI:: I '['Tu TE !hlF'C6;:.'H 'I"Ht:E; r'r;'PF F."F,I_I',' F T. I>LIR!N3 THE l N:i.!:TRL. L. FFT I ON "' I N:SF'ECT ! Oi'.,t:~{; OF ' RN? ! ,!.:'£LL.':'~: FI[: TR Z'ENT TO TH t '.'-~; PROPE'.RT'¢ FINFJ, THE i'J; t ',t;:: F:'I:,, 'IF7 .................. ' ' ....... ~:._IL.,_~,k..E_, THRT THE HELL I.,.IILL. :SER"E. -' ........ -~';~:~ ' 'T i~..~ C~ ,:"' ;~4~", ][' If'g :Z~5 F" E': ~:::": 'TT" % r-"~ ~'..~ ":::; IF~ F: E'~ F..:: E.-'Z (.;:~ L~. :E tF~" tEE' E:: ~;FiCt.::'F.T.! i 'INA ;::iF: R!'.4'¢ '-' '"'"'T'-*'~ ............ ....... :,~.:.',.~:~ I.,.IITHOLtT F'tHRL INtE:F'EECTiON F~h![:, 8Pt:'I-:'-~,'F E,? TH:IS [:,EF'I:~tRTHEN'" NtLL. E~E :i.'"::L!E~J'EX::T TO P.:;.'Z'SEZ _T'.'ON. ~tE!E~ F~:{~T F-OF': Iq PF~'.I'¢RTE.t.4ELL OR iSEt TO ;;?EtE~ F'EET FROH F:I PUE:LIC NELL [:,EF'ENDING UPON THE T'¢PE OF F'LIBLIC F.tEL..L. f"IZNIHLIH 'DZSTFINCE FROH i:! F:'RZVR'T'E F!EL.L TO R PR!VFiTE SENER L. ZNE: IS 25 FEET FIN[:,. TO Fi COHHUNZT'¢ :SEF~ER LZNE !S 7'5 FEET. NELL L.OGfE: RRE REQUIRED fqN[:, t"!LIE;T BE RE'i"URNED TO'THE [:,EF'RRTMENT NI"FHIN 3:El OF THE HELL. COHF'LE:'TION. OTHER' E4:E6~U I REHE:hFT'S h'tR'¢ RPF'L'./. '.SPEC I Fr I CFFF IONS Rht[:, CON:STRUCT I ON [:, I RGRFIM:5 FIRE i: I Rid FRHtLIRR [4t.TH THE RE~S!UiREHENTS FOR ON-':E;ITE FOR'TH B'¢ 7'HE HUNZCZF'F!LIT'?' OF RNCHORFIGE. 2: I NZLL ZNSTRLL THE S'¢STEH ZN RCCORE:,RNCE I,.!I"rH THE CODE~;. 3: I UNDERE;TRND THR'F THE ON-SI"FE %E:NER S;'.r'STEH HF:W RE:E:!LIZRE .ENLRRGEHENT :I;F' THE RESIDENCE IS REHODEL. ED "FO INCLUDE HORE THRN 3: E:EDROOH2;. " ~ [~SOI LS ~ ~-~ ' LOG MUNICIPALITY'OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: I.-K 2 3 8 9 ~o 17 19 NO. 1732-E June 22, 1958 20 COMMENTS DATE PERFORMED: SLOPE WAS GROUND WATER //~ / (.'? S ENCOUNTERED? L E IF YES AT WHAT [] PERCOLATION TEST DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE {minutes/inch) TEST RUN BETWEEN FT AND __ FT CERTIFIED ,. '~ ~ / MUNIC. C~ALITY OF ANCHORAGE 5 1982 STREET & NO. CITY DAT~ ' I INVOICE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 I.. Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applican~ Name~~ Telephone: Home B~-~7~D Business Applicant Address ~& O / ~ ~ (C) Applicant is (check one)~ Lending Institution D; Owner/builder ~; Buyer B; Other ~ (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent ,~"' ¢i¢"vt,,¢,,~.~ Address Telephone (f) Mail the HAA to the following address: TYPE OF RES~NCE Single-Familycare, Multi-Family [] Number of Bedrooms --~ Other WATER SUPPLY Individual Well~0' Community [] Public [] Note: if community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite/~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION~ As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional anti adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this insD~ection. _ Name of Firm '~~ ~ -~'' Telephone J~'~' ',,~' ~, Address ~.O ~ I~ r ate ;Z/: lq DHEP APPROVAL Approved for ~ Approved "~'* bedrooms by~ '~¢-~'~'~' ~j~Date Disapproved Conditional Terms of Conditional Approval CAUTIO~i 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 institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legat Description: MUNICIPALITY oF ANCHORt\c~5 DEPT. OF HEALTII & ENVIRONMENT/,,L P:~:C ' i985 Well Classification Well Log Present (Y/N) If A, B, C, D.E.C. Approved (Y/N) Date Completed ~'/~O/,~'~ Yield Cased to Total Depth Static Water Level Casing Height Above Ground __ Electrical Wiring in Conduit (Y/N) Separation Distances'from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments Depth of Grouting ~ Pump Set At ~'~O~'"'T' Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ¢~ C) ; On Adjoining Lots i~ ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on ;Date *MI 's 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 Size /~ No. of Compartments '~"~¢/~ Air-tight Caps (Y/N) ~" Foundation Clean0ut (Y/N) ~'~ Date Last Pumped /~¢/,'~' 'for ~/A Temporary Holding Tank Permit (Y/N) J~/'/-~ To Building Foundation To Disposal Field Course To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 - C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 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 /~/0 /y z,~. ' 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) 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 tha~t I have checked, verifie~l, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed~'~M~~ Date~ Company ~ ~ MOA NO. ~'~" [~'-~'f Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) Engineer's Seal CONSULTING ENGINEER SEPTIC SYSTEM ~03 W. 15th AVE "C" SUITE 203 T E LE PI~ L~3~ E: ~J~ ' ,~,- ,~ :~ ~'\ ~ ~ · ' .-':,',~T;; c.~ £NVIRONME?,!T,',£ P~CTECTIoN RECEIV D ADEQUACY TEST LEGAL: LOT 21, BLOCK 2, ROCKHILL LOCATION: 9601 MAINTREE OWNER: MIKE LAUE RESIDENCE: SINGLE FAMILY, THREE BEDROOMS WATER SYSTEM: ON SITE WELL SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: TANK: GREER, STEEL, TWO COMP. 1000 GAL. ABSORPTION SYSTEM: TRENCH ABSORPTION AREA: 360 SQ.FT. SOIL RATING: 100 INSTALLATION DATE: SEPTEMBER 1982 DATE OF PUMPING: OCTOBER 15, 1985, ANCHORAGE CESSPOOL DATE OF TEST: OCTOBER 14, 1985 TEST PROCEDURE: SYSTEM WAS INSPECTED, BOTTOM TANK WAS FOUND TO BE 10 FEET BELOW GROUNG WITH A LIQUID DEPTH OF 55 INCHES. THE ABSORPTION TRENCH WAS FOUND TO HAVE CLEANOUTS AT BOTH ENDS, NO SUMP. BOTH CLEANOUTS WERE 7.5 FEET BELOW GROUND WITH NO WATER VISIBLE. THE GROUND ELEVATION WAS 24 INCHES HIGHER AT THE CLEANOUT THAN AT THE TANK. 150 GALLONS OF WATER WAS ADDED TO THE TANK. THE LIQUID LEVEL IN THE TANK ROSE FROM 55 INCHES TO 58.5 INCHES. NO WATER SHOWED UP IN THE CLEA- NOUTS. 200 GALLONS WERE THEN ADDED TO THE SOUTH CLEANOUT. THE WATER LEVEL IN THE TANK DROPPED ONE INCH. NO WATER SHOWED UP IN THE OTHER CLEANOUT. LASTLY 100 GALLONS WAS ADDED TO THE NORTH CLEANOUT. THE WATER LEVEL IN THE TANK DROPPED .25 INCHES THE CLEANOUTS REMAINED DRY. ON OCTOBER 18, THE TANK OUTLET WAS EXPOSED BY EXCAVATING WITH A SMALL BACKHOE. IT WAS FOUND THAT THE OUTLET PIPE FROM THE TANK HAD PARTLY COLAPSED AND THAT THE TANK OUTLET WAS PARTLY BLOCKED. A FIVE FOOT SECTION OD ASTM 3034 PIPE WAS INSTALLED. 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 Tobb~'n Spurkland P.E. Lot 21, Block 2, Rockhill Mike Laue October 21, 1985 Page 2 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. ~)03 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 RESIDENTIAL WELL INSPECTION LEGAL: LOT 21, BLOCK 2, ROCKHILL LOCATION: OWNER: TYPE OF WELL: WELL LOG AVAILABLE: 9601 MAI NTREE MUNIctPALi¥,/ O;: ANCh'OR×~GT;: D/PL 0~: HEALTH & MIKE LAUE EhVRON,Xi~NT,L ~ ~' PROTECTION SINGLE FAMILY ? ,'~ ~S'E,5 YES ~ ~-~ INSTALLATION REQUIREMENTS MET: YES WELL YIELD FROM WELL LOG: 100 GPM. PUMP YIELD: 6.5 GALLONS PER MINUTE DATE OF INSPECTION: OCTOBER 14, 1985 TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE OF 6.5 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 40 FEET BELOW TOP OF CASING. AFTER PUMPING AT 6.5 GPM FOR 75 MINUTES THE WATER LEVEL HAD STABILIZED AT 47 FEET. TOTAL WELL DEPTH IS 69 FEET. TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON OCTOBER 21, 1985. 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 impagt .the conditions of the aquifer feeding the well. '..,1 2 2 5-E .?.',% JU~t~: 25, 1971 APPLI(?i' IT FILLS OUT UPPER HA[?' ONLY Property owr~r .~:~'/q, ~..~, d~.2~L.) ~TT~C(CT-/~-A..I) ~_~r~ C , Phone Mailing Address ~/"~/~b ,~,)~ ~/ .~/").~/~'),~c-~?~ ZipCode ~.~.~-O7 Address Zip Code Lending Institution /~/~ Phone Address Zip Code Realty Co.&Agent ~.- ~, /yg~/~,'~/'~.~_... /~//~5....~ d/'~/~,."~O .~.?~ Phone Legal Description /~) 7' ~Q ~ /'~--~ t::A~' fc~, ~. Street Location M/~ / A )'7-,F~,¢:'~,~'' Type of Residence N~ Single Family [] Multi,lo Family No. of Bedrooms [] Other Water Supply ~ ATTACH WELL LOG. A well is for all wells drilled since June 1975. Individual log required [] Community For wells drilled prior to that date, give well depth (attach log if available). [] Public Utility Sewer Disposal ~ Individual Year Individual Installed: [] Public Utility When Connected to Public Utility: [] Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. /'~ Field Notes:---[,~ ~ ~ ~~ ~~ ~ (( ~ APPROVEDDisAP~OvEDBEDROOM~ *CONDITIONS OF APPROVAL ( ) CONDITIONAL APPROVAL* DATE ~~ Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received ~ ~ ~ ~ Welt to Tank Septic T~k Size /~ 72-023 (3182) MUNICIPALITY OF ANCHORAGE Development Services Department ` ;' Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-362-33 1. GENERAL INFORMATION Expiration Date: / I —Z —I Complete legal description Rockhill B2 L21 Location (site address) 9601 Main Tree Drive Current property owner(.) Follett Richard Family Trust Day phone Mailing address Same 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 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Q Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ 8go Waiver Fee $ Date of Payment W-930 Date of Payment Receipt Number 0g6 o Receipt Number COSA # eLC IQ r3aZ ?? Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe 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 soil condition, ground water 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 system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 - _V I Engineer's Printed Name Steven R. Pannone P.E. 6. DSD SIGNATURE System #1 Approved for 3 bedrooms Date System #2 Approved for bedrooms { 8149 Disapproved Conditional approval for bedrooms, with the following stipulatio`KK kkkl((((((((((v�i Piz F� q -0 />�RVICES By: � � I l' "`—tom Original Certificate Date: E-2 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist Legal Description: Rockhill B2 L21 Parcel ID: 015-362-33 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system 1 A. WELL DATA 0 Well log is filed with Onsite (or attached) Date drilled 1982 Total depth 69 ft Cased to 69 ft Q Sanitary seal is functioning correctly W Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 6/27/19 Static water level at beginning of test 41.1 ft. Comments B. TANK DATA Age of tanks) """"2 years Tank type/material Measured operating fluid level in septic tank Q Standpipes/foundation cleanout per record drawing Date of pumping N/A D. ABSORPTION FIELD DATA Which system tested (date installed) 7/9/82 0 ALL standpipes present per record drawing Total measured depth from grade 6 ft (max) Measured depth to pipe invert from grade 3 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. if not, state depth into effective 2-5 ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced N/A gallons Comments/Deficiencies: COSA Checklist yellow sheet Well production at time of test 3.8 gpm Water storage tank volume n/a gallons Well disinfected for coliform test? ❑ Yes ❑✓ N Q Coliform bacteria is Negative Nitrate 11.2 mg/L ❑ Nitrate less than MRL (ND) Arsenic ND ug/L 0_1 Arsenic less than MRL (ND) Collected by PES Date of Sample 6/27/19 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 6/27/19 Results E]Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 450 gal New depth 0 in Elapsed time 110 min Final fluid depth 0 in Absorption rate '450 gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 0✓ Yes Community Sewer Manhole/Cleanout > 100' M/ Yes if No ft / Yes if No Neighboring Tank > 100' F/� Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No Absorption Field on Lot > 100' M Yes if No ft Holding Tank > 100' 0 Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' Q Yes if No EZI Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ✓[� Yes if No ft 0 Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' ft ft ft ft ft [D Yes if No ft Property Line > 5' 0✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' (�✓ Yes if No ft Private Wells > 100'✓� Yes if No Water Main > 10' 0 Yes if No ft Community Wells > 200' [✓ Yes if No 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' ®✓ 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' 0 Yes if No ft Private Wells > 100' Water Service Line > 10' FV -1 Yes if No ft Community Wells > 200' Surface Water > 100' ✓0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that 1 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 ft ft ❑✓ Yes if No ft 0✓ Yes if No ft of A/ , 4,. MISIM-1-1,4112 Ater IMMI DEVELOPMENT SERVICES DEPARTMENT On -Site Water and Wastewater Section www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC191327 Subdivision: Rockhill, Block: 2, Lot:21 # A water sample revealed a nitrate concentration of 11-2milligrams 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. F 'N V"1101 � 'k, ONE"NA WN - From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. NON N Maia. clrP�0 1 5 056, s 9 66ti° uy m� M 0 N Ln CS m - �7031_9c J 626 '� 9£ sr � £2 4>£ tnr O In O @ v i `- 4 a) @ 0 c T wid M'+1 rr t EC a)E H > 0 c ff.` VI OL ON 0 N 9 c a) O y- a O wC% C > C to 0 (G Q � c T a v Oma)m zw� _ @ ° U N � .._ O m cn N O V U a) N Y� 2 Z 3 u c ° Ln ° @ N @ c F a o° v O N ai L @ Q 72 N r 0 @ N @ c ! c O N C U= O C O -0L co (n O (a -c y O 00 c a) O .N @M -i c 0) > L w6Lf) OQ N p D E O Y N J @ T E ° 1n O y a.. Q m @ 0 In u N a) O) p 7 - @ i -i N @ O >`, O ` at.+ T GOD yOy LL 2 @ ..N. 5 %' @ L O v a v � "j N uN, Q O- O O u a E 0 4 a) �O J w O O O w Q4 0T C: J a) I- u M'O 3 15'E v,� s Q j N 2. m U@ c a •- �° ° E C) 0 GD U i Q lD i N oLL C V m @ LDO a) 0 tD 2- N {/� L.. 00 ci c m 0) a'i m � O � a.. r{ .L >' N Ln C5 0 t: ° N > � � n Z L c !L5 0 M0 LL 0 L Ln 0 3 CD LA Qo 0-1 a�> a ' �j�"P• Cpl/i °' ° a '- Q' • 26 // d LLJ C J O Y C I Q :• a m C) Q a) N Z I Z .2 CLU y N Q f o O u O\ LLi I LO m C 0 ff �✓ w Z �`` w O O LL �O O // ` t•• LL ••• �� r cc: Z -°p d a) Ecw 111 �s• • . . • ' c,SyQ` L X E a 1111 0) , w < 4 1' Llllll����` P.O. Box 670269 Chugiak, AK 99567 P: (907) 688-2759 F: (907) 688-2259 TO: Jill & Eric Follett 9601 Main Tree Anchorage, AK 99507 Camera Inspection Report Water at 41' could not get past 65'. Leak at pitiess and weld at 18'. Pitless changed and fixed by Northern Excavation. Lined and grouted well from 15' to 35' with 4" PVC, Shale Trap, and cable. Date: 7-16-19 yi x s � 6 r U L IIN WATER CELLS Drilling - Piling • Pumps P.O. Box 670269 Chugiak, AK 99567 P: (907) 688-2759 F: (907) 688-2259 TO: Jill & Eric Follett 9601 Main Tree Anchorage, AK 99507 Camera Inspection Report Water at 41' could not get past 65'. Leak at pitiess and weld at 18'. Pitless changed and fixed by Northern Excavation. Lined and grouted well from 15' to 35' with 4" PVC, Shale Trap, and cable. Date: 7-16-19