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Home My WebLink AboutROCKHILL BLK 4 LT 10 Municipality of Anchorage P.ee 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: ~L~ ~0~-~0 PID Number: Name: ~1 m ~o6HAP Wastewater System: ~ N~ ~ Upgrade Address: ~o ~.~ ~ A~..~ ~s~ ABSORPTION FIELD Phone: No. of Bedrooms: ~ ~. ~ ~ ~eep Tre~c~ ~ Shallow Trench ~ Bed ~ Mound ~ Other Total Depth from original grade: LEGAL DESCRIPTION SoilRating: O. 8 e,~/sq.~t, e,z Lot: Block: Subdiv~ion: Depth to pipe boaom from original grade: Gravel depth beneath pipe Township: ..........I~ Range:I~ Section: Fill added~above~ original~,~lgmde: Ft. Gravel length: ~ I Ft. WELL: ~ New ~ Upgrade Gravel width: ~ ,~t Number of lines: Distance between lines: Ft. J -- Ft. Classification (Private, A,B,C): Total Depth: Cased To:I Toter absorption area: Pipe material: ~) V~~ I~I Ft. IZ~ Ft. ~ SO. Ft. Driller: Date Drilled: Static Water Level: Installer: Date inst~lied: J Casing Height Above Ground: PumpSetat: I =l ~t. TANK Y~e~: ~ G~M I ~ ~ Ft. SEPARATION DISTANCES ~ u Ho~ing U S.T.E... TO Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~ ¢ CHO~ T~ Number of Compa~ments: S~,a~ -- -- LIFT STATION Water IOOt~ 10~14 -- Lot Size~Manufacturer: "Pump on" level at: ~High water alarm at: Foundation Remarks: BENCH MARK Location and DescriEtion: I Assumed Elevat{on: 112. Ft. Department of Health and Human Se~ices ~ppfoval -~-?/%.,?.. ~, .....~¢G-_ _ Reviewed and approved by: ~ ~ Date: ~'/' ~ 72-013 (Rev. 9/91) MOA 95 PARCEL ID NUMBER: ~E.M,~ N~MB~: AS'BUILT DRAwiNG 0,~--08~--29 SW980550 ~ ~ / --'-~ /,,'-NEW 1250 GALLON ~ SEPTIC TANK ~ I ~o~ " ~ ~". 7 ,-" .... ~~ s~.~ ~ 45.9 82.6 MT~ 57.~ 89.B C02 58.2 . 57.7 RN~ G~E ORIGI~L GR~E ~ N N / I = 86.83 - 86.8~ 6901 D~R R~ SU~ 2~, ANCHO~E, ~ 995~ ROCKHILL SUBDIVISION, LOT 10, BLOCK 4, ,.~.: .... ~j...-;}t ..... '"~ ~.~ o~ wo.~: ~ .... ~ ..... ~... AS-BUILT OF SEPTIC SYSTEM PREP~ mR: TIM CROGHAN 244-6255 BUILDERS ATTN: BILL TAYLOR c/o COLONY I I I DA~:12/2/98 D~WN ~: SCOa P~E: ~.L... ~ = ~o' F'r-on~ ," RLP[NE DR~LL 98? 345 8282 Dec, 03, ~.998 't2:t8 RH Pe~ WELL OWNER: ,' : 1 ' ' ..... ' ' ' ' ' '~OREHOLE DATA; DePth Dept~ Of cesidg:~ft ~t ~/~,I . ~ '~ USE OF WELL~ 'WELL iNTAKE OPENING TYPE: '/ ORAVEL'PACK TYPE: · .' ' '. Oept. Health &Hum ~n ServE( ~s ' PUMPING L~L AND YIBLD:' , . ' .. :. , ...... .... ~ ..... , ........... · , , W~L DISINFECTED UPON COMPLETiON~ ~'~E ~:'~D 'N0',~ . :':' ~QNI'RACY'OR,JNFORMATION: :. REMARKs; . ' PLEASE'MAIL wHiTE COPY OF LO~ 'tO: · ',:, DNRiDI¥1SlON OF :M NING &'WATER:MQi~,T i, · 3801C St, Suite 1300 ' ' ,", · ANCHORAGE AK 99B03,593S . :" :.' MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Date Issued: Sep 11, 1998 Expiration Date: Sep 11, 1999 Permit Number: SW980350 Legal Description: ROCKHILL BLK 4 LT 10 Design Engineer: 0041 AK Water & Wastewater Consulta Owner Name: Tim Croghan Owner Address: 2340 Loren Circle Total Bedrooms: 4 Anchorage, AK 99516- Parcel ID: 015-063-29 Site Address: 009920 MAIN TREE DR Lot Size: 48732 SQ. FT. Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage 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 ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Alaska Water & Wastewater Consultants, Inc. 7320 East Chester Heights Circle ~ Anchorage N Alaska 99504 (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers August 24, 1998 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Well and Septic Design for Lots 10, Block 4, Rockhill Subdivision To whom it may concern: The proposed 4 bedroom house will be se~ed by a private septic system and a private well. Comments regarding the proposed design are summarized as follows: 1. SOILS: Attached are logs which shows the soil profiles, and the percolation tests results. The soils below the organic layer in test hole #1 are a SM and SP to SM material to a depth 13 feet. At 13 feet, the soils transition to a SP material to a depth of 16 feet (bottom of the test hole). The soils below the organics in test hole #2 are a SP/SM to SM material to a depth of 11 feet and then transition to a SM material to a depth of 13.5 feet. At 13.5 feet, the soils transition to a GM material to a depth of 16 feet (bottom of test hole). No groundwater was encountered during the excavation of the test holes. The percolation tests were performed between the depth of 5.0 feet to 5.5 feet in both test holes. The percolation rates were 3.6 minute/inch in TH#1 and 6.3 minute/inch in TH#2. 2. TRENCH DESIGN: a. Percolation Rate: 3.6 and 6.3 minutesh'nch b. Allowable Application Rate: 0.8 gallons/day/ft2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day _ e. Minimum Absorption Area: 750 f~2 f. Total Depth: 10 feet maximum (on uphill side) g. Effective Depth: 7 feet h. Width: 2 feet i: Minimum Length: 55 feet j Effective absorption area = 770 ft2 (750 ft2 OK) 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPltY: As can be seen on the attached topography site plan, the average slope in the proposed septic area is approximately between 10-15%. The trench is to be installed parallel to contours. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you for your assistance. less, P.E LOT 7, ~LOQK 4', I '1 LO'[ 8 BLOCK 4-, --~- ', ~ t ', ~~-wE~ ~ ~ 11, ~' ' Ir LOT 6, BLOCK ~. ~ ~ / I ~ ROCKHILL SID ~ LOT 9 BLOGK ~. / ', ~ ~ ~ ROC~HILL S/D ' z I x ,~ // ~x EAST 99th AVENUE // ~ z // '--~ ~ ,~ (SEE DESIGN, PAGE 2 o~ ) / ~ ~ / I :: ~ / --~ ~ WELL ~ ~oC~H~ s/~ ~J ~I ~ / ~ ~ ~ IL ~-L~ .............. ~: ............ ~LC::. ::::::::::::::::::::: (/ %~ LOT 1, BLOCK 5, ~ / J~ ~ /~ / VALLIE--VUE E~ATES ~2 V~UE-VUE ESIATES ~ V~.LIE-~IE ESTA~5 L; w~- :- , / / / ................... AI.&S~& WA~ A~ WAS~WA~ CONS~TA~S, ~C. ~ OF,A L'~ PHONE: (.07) ~7-~17./F~: (BAT) ~.-~2~6 '~' ROCKHILL SUBDIVISION, LOT 10, BLOCK 4, WPE OF WORK: .. , '." .~, ....... SITE P~N ~,Y PREPARED FOR: TIM CROGHAN 244-623~ · c/o COLONY ~UlLDE~S ATTN: BILL TAYLOR ,, "~ ".. .......... ."¢~ J.L.M. 1 = 100' 1 OF 2 TRENCH EXCAVATE I0' DEEP MAXIMUM B(ON UPHILL SIDE) BY 2.5' WIDE Y 55' LONG. ADD 7" OF CLEAN, WASHED SEWER Di~INROCK. INSTALL TRENCH PARALLEL TO SLOPE CONTOURS.--~ II II / I I ~/ALYERNATE / / VERIFY SEPARATION DISTANCE 'FO SEPTICS TO THE NORTH AND SOUTH OF THE PROPOSEB t.OCKIION PRIOR TO SITE PROPOSED 1250 ~LLON SEPTIC T~K' OPOSED WELL LLI ff-- Z NOTE: ] TEST HOI. E LOCATIONS ARE APPROXIMATE. AI.ASKA WA'I'FR. AND WASTEWATER CONSULTANTS, INC. 7320 E. CHESTER HEIGHTS CIRCLE, ANCHORAGE. AK 99504' PHONE: (907) 337-6179/FAX: (907) 338-3246 kL DESCRIPTION: ROCKHILL SUBDIVISION, LOT 10, BLOCK 4, [ OF WORK: DESIGN OF SEPTIC SYSTEM UPGRADE PARED FOR: PHONE NUMBER: TIM CROGHAN 244-6253 . DRAWN BY: PAGE: 8/24/98 J.L.M. 1 = 40' 2 OF 2 ~ OF AidErs, _AI.&SIL& WATER. & WASTEWATER CONSULTANTS, INC. ~¢,¢...,~.~ .... 7320 E. CHESlER HTS. CIRCLE * ANCHORAGE, AK. 99504- PHONE (907)337-6179 * FAX (907)338-3246 l SO,L LOG - PERCOLATION TEST J LEGAL DESCRIPTION: ROCK HILL SUBDIVSION. LOT 10. BLOCK 4~'~'~.'~e~~ PERFORMED FOR: TIM CROGHAN J .................... ' DATE PERFORMED: 8/15/98 DEPTH (feet) ~: I TEST HOLE #1I 1 -- ~ ~ ~; ~ ~ 0 RGAN I CS '~~ ,----, ~ ¢ ~ S01L C~SSIFIOAT[0NS 2~ 3--: ~I ~ GP ML , , , ~,, ~ GM CL / I ," GC OL , ,,,,, SW MH +TH~2 5- ; I ' I SP CH PROP ,, "21' SM & ~ SM ~ OH ~ "~WELL 7--: ~I' J DEPTHTO ' I I' '' ' IGROUNDWATER DATE % Z " 8/13/98 8~ e, DRY gi : , 8/21/98 , ', , DRY ~-~ ~ ............................ SITE P~ ', '%'; SM & CLOCK NET TINE WATER LEVEL NET DROP ~ ~ -- ,,, t,. _SP-SM DATE READING : ' '~, TI~E (NINUTES) R~ADING (INCHES) "' '"o/~/17/98 12--' "~I I (HARDER DIGGING) I 4:40 6" ~'" "" 2 5:10 50 1 1/8" ~ 7/8 &'"',' ......... 6" ¢ 5:¢1 30 1 1/4" 4 3/4 ,,.,'., SP/ 6 6:12 30 1 1/4" 4 314 ~6-''ce''' B.O.H 17--' I 19- PERCO~TION ~TE 6.3 (MIN./INCH) ~ PERC. HOLE DIA. 6" (INCHES) PERFO.ED BY A~SKA WATER ~ WASTEWATEE I, (/~ ~' , CEETl~ THAT THIS WAS PERFOR~ I~ACCOEDANCE WITH ALL ST~~NICI~UlBELINES IN EFFECT ON THIS DATE. DATE: ~/~q~ /f / I DEPTH TO DATE 2ROUNDWATER DRY _ DRY 8/17/98 DRY 8/21/98 ALASI{& WATE~ & WASTEWATF-R CONSULTANTS, INC. 7~:o E. CHESTE. HTS. CJ.CL~ · ^.C.O~GE, AK. ~50'~ [SOIL LOG - PERCOLATION TEST[ }'~e~7~C~.i~5.__t~,lJ~l{ '..?~1 PERFORMED FOR: TIM CROOHAN DATE PERFORMED: 8/13/98 [ IF'SI HOLF #2 ~:°' ........... ¢~' I~EPTH ~ ~ ~ ORGANICS ~ SOIL C~SSIFICATIONS GC ! OL ~ ~ ~ SW MH +TH~2 ~ Sp CH PROF SM ~ , OH SP-SM SC TO SM DEPTH TO DATE Z GROUNDWATER ~ -- DRY ~/~3/9~ DRY S/17/98 lO i J CLOCK NET TIME WATER LEVEL NET DROP 11 DATE READING TIME (MINUTES) READING (INCHES) ~ 2 S M s/17/98 1 ~ ~50 ........................ 6_~ 13 3 3:21 3:31 14 5 3:32 G M 6 3:¢2 10 16 ..... 8 ~:5~ 1~ .......... ~ 1_/8_'.: ....... 2 7/8" ~-- 11 4:05 .......... 6" 19 .... 14 .... 4:26 10 20 PERC. HOLE DIA. ~" (INCHES) PERCO~TION ~TE 3.6 (MIN./I~ ~ ] //// / ~/ COMMENTS: / / ~// PERFOMED BY A~SK~ WATER ~ WASTEWATER I, ~ ~/~ /( ~ ~ , CERTI~ THAT THIS WAS PERFORM~ IN/ACCORDANCE WITH ALL STAT~UNI~GUIDELINES IN E~ECT ON THIS DATE. DATE: ~/~'/~ ~ / DEPTH TO DATE ROUNDWATER ...... p_R_Y_ ...... _~/_! DRY 8/17/98 DRY 8/21/98 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 OSC251047 Parcel ID 015 -063-29 Legal description ROCKH ILL BLK 4 LT 10 Expiration Date: 10/28/2025 Site address 9920 MAIN TREE DR Current propertyowner(s) BURDEN ANDREW & NICOLA X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: No comments By: t " r �� Original Certificate Date: 2/20/2025 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject stem(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Service 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 submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory X Arsenic Advisory Other ZZOZ aunt uoileopddy VS00 # aanleM L h -D SQ # VSOO IuauaAed 10 a}ea 2 2 2 IuauaAed ;o 91ea $ aa3 aanleM $aad ySO0 'papinoid uoileuaaolui ayl jo Awinoae ay; Ajlaan 01 gels a;ls-uo ledioiunw Aq uoi}oadsul ol;oafgns sl Apedaid slyl `;uawaligue sly} aol 6ulAidde Ao :aoue}slQ ❑ :pa}senbaa Malna.l pallpadx3 :ao};sanbai aanleM I!d a6edeaS ❑ youaal aplM ❑ youaal dean ❑■ Pao ❑ S1MMV ❑ :a -131d NOI1dNOS9V '9 saeGA OZ uey; aaplo IaaIs Jl /Goslnpe aaS - Lz 96V ssel6aagl j ❑ 919JOU00 ❑ ollSeld ❑ IaaIS ❑■ :MNVl 011d3S '9 aaMaS ollgnd ao ol}deS Apnwwo0 ❑ � uel 6u!ploH ❑ spn 6ulllamp Z 6ulnaas oildeS a}enlad ❑ ol}daS a}en!ad ❑■ :-lVSOdSIa N31VM31SVM 30 3d ki T a6eJOIS as;eM ❑ ollgnd ao IIaM Al!unwwo0 ❑ spn BUII19Mp +E 6ulnaas IIaM alenlad ❑ shun 6ulllannp Z 6ulnaas IIaM a}en!J(J❑ IIaM C)Ienlad ❑■ :A-lddns N31VM 30 3dAI '£ auoyd Aea SWOO2Iam t7 2103 a3ZIS SW31SAS 311S -NO 'Z NAcnin8 (s)aauMo Ajadoad juaaano �Ja DD�Ji NI` N OZ66 0� i� t,>il8 �THNOMJ (ssaippe a;ls) u0pool uoildlaosep Iebal aleldwoo 6Z -C90 -9L0 'a'llaoaed NOI1VWNO3Nl -IVN3N30 I uolleoilddy IenoaddV suaatsAS atiS-up jo ateoip. jao L66L-C-K-L06 :xe3 uoi}aaS aa�ennalseM R aaneM E4!S-up t706Z-CK-ZO6 :auoud ' juawliedaa saoinaaS juawdolanaa C 3Jb210HONd :]O All-lVdlOINflw COSA Checklist Legal Description: ROCKHILL BLK 4 LT 10 Parcel ID: 015-063-29 If more than 1 welt and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA N Well log is filed with Onsite (or attached) Date drilled 10/1998 Total depth 126 ft Cased to 126 It N Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 10/28/24 Static water level at beginning of test 60 ft. Comments B. TANK DATA Measured operating fluid level in septic tank 48" Date of pumping 5/22/24 ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) SEPT 1998 ❑ ALL standpipes present per record drawing Total measured depth from grade 11.2 ft (max) Measured depth to pipe invert from grade 4.1 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 COSA Checklist June 2022 Well production at time of test 5+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes K No 9 Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic 5.09 ug/L ❑ Arsenic less than MRL (ND) Collected by MNA Date 10/28/24 C. LIFT STATION ❑ Required maintenance completed/ Age of lift station _ years Lift station material Comments: Adequacy test date 10/28/24 Results QPass Fluid depth prior to test `49/46 in Water added 600+ gal New fluid depth 69/68 in Elapsed time 1440 min Final fluid depth 48/46 in Absorption rate 600+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 85 in Effective depth used 69 in Effective depth remaining 14 in MT AT EACH END OF THE TRENCH. 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' ❑i Yes if No _ ft Neighboring Tank > 100' 0 Yes if No _ ft Absorption Field on Lot > 100' [9 Yes if No _ ft Community Sewer Manhole/Cleanout> 100' Q Yes if No _ ft Private Sewer/Septic Line > 25' Q Yes if No _ ft Holding Tank > 100' QYes if No _ ft Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No ft ❑e Yes if No _ It Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑Q Yes if No _ ft �]o 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' Q Yes if No _ ft Surface Water > 100' Q Yes if No ft Tank to Property Line? 5' Yes if No _ ft Wells on Adjacent Lots: Field to Property Line > 10' Yes if No _ ft Private Wells > 100' Yes if No _ ft Water Main > 10' ❑i Yes if No _ ft Community Wells > 200' Yes if No _ It Water Service Line > 10' ❑� Yes if No _ It If tank or field is under driveway comment below F. ENGINEER'S COMMENTS G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm P,4/ OL e 7,A' .rUe h p� Engineer's Printed Name —�9 a yw Q— COSA Checklist—June 2022 Phone 727-8804 Date L/701zS— ajq Nook AvA Nue} baa}s pyo aeaA 0£ a jo Ie}aw ay} }eqm jo aidwexa ue si sigl •lenoaddy swalsAS DI!S-uO 10 a1eJ1J!1aaD pafgns aqj jo sa!doo Ile of papelle aq jsnw AJOSIApe s!yl •uoileaoisai aj!s ao saal Su!l}!waad VOA 'BUTAaAanS 'Su!aaau!.Sua,9uipnpul jou 'aaow ao 000'SZ$ aae s1soo juawa:)eldai le:)!dAl •saeaA OZ s! � uej :)ljdas laals paleo:) jIegdse ue 10 aj!l aSeaane aql •plo saeaA LZ s! Alaado.id sigl aol >luej oljdas ayl L66L-£b£ .xe j ti06L-Etb£-L06 OZ :fol 't,:>l:)Ole II!4>IJOU :uo!s!A!pgnS LVOZSZOSO # lenoaddy swalsAS al!S-u0 jo ale:)!j!laaD . OS!APV 3JuUZ Yid ff5 ajisuo/Bao•iunw•nnmm uoiPaS aalemalse/N pue aaleM alis-uo 1N3W1add34 S3:)1AU3S 1N31MOUA30 3!DVUGH:)NV 30 AillVdl:)INnvm f OF.A CO 49 R `9 h'Ae�— s SHANE A. HOLT �� G LS -6914 ,\,°fessiona� �-Qo N 89 55'20"E262.63 N 89 53'24 " W 250.00 THESURVEYDATA AND MEASUREMENTS HEREONAREPREPARED FOR THE OWNER OFRECORD AS OF THEDATE OF THIS SURVEY. ANY USEOF THIS DRAWING BY THIRD PARTIES IS PROHIBITED UNLESS WRITTEN PERMISSION IS PROVIDED. THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOD/ ANY CONFLICTS BETNEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS NOT TO SE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES- EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOYN HEREON ( UNLESS INDICATED) NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAYING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHONN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNON ANDVOR ICE. YARD LIGHT • SEWER SYSTEM PIPE —__ STONE WALL AS-BUILTSURVEY 1" =30' NO CORNERS SET THIS DATE I HEREBY CERTIFY THA T I HA VE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT10 BLOCK4 ROCKHILL SUB. (PLAT81-143) A NCHORA GE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENT S SITUATED THEREON ARE WITHIN THE PROPERTYLINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED ATANCHORAGE,ALASKA THIS 19 TH DAYOF FEBRUARY , 2025 16210 240-36 HOLT LAND SURVEYING 9309 GROVER DRIVE ANCHORAGE,AK 99507 223-8615 Parcel I,D. # 1. GENERAL INFORMATION Complete legal description CERTIFICATE OF HEALTH AUTHORITY , APPROVAI~ FOR"A SINGLE FAMILYDWEi~LIi~o 015-063±~9 Location ;(site address or directions) Property o~er uailin'g'add'~:ess C/o Colony Builders Lending agency Mai'iing ~ddress ' Address NHN Main Tree Drive Anchorage, AK ..... 'Day phone 2340 Loren Circle Day phone Day phone Unless otherwise requested, HAA will be held for pickup. 4 NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: xx 244-6233 Anchorage AK If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. > XX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 {Rev. 1/91) Front MOA #21 ' i nv~Sti ordinances, and regulations in effect on the date Name Of Firm "~ASKA WATER & WJII~TE~I~ Address - " Engineer's signature Alaska Water & INSPECTION BY~ ENGINEER my ppiicatisr~"~hows that thb omsite water supply po~,l system is Safe, functional and adequate for the nUmber Of bedrooms and tyPe of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal .system is in compliance with all Municipal and State codes, inspection. Phone Wastewater Consultant, Shall be PAID $ or prior to, closing for the Engineering Services Provided. Date ~/~' ~.///~ ~ DHHS SIGNATURE Approved for ~O~- Disapproved. Conditional approval for bedrooms. bedrooms, with thee following stipulations: 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 courtesyto PUmhasers 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 engineeCs work. 72-O25(Rev. 1/91] Back MOA~ZI Well'tYpe Total ~lepth Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform ~ Date of sample: ~//~/~ B. SEPTIC/HOLDING TANK DATA Date installed ~'/~ Tank size Foundation cleanout(~¥N) Date of P, u~ping C. ABSORPTION FIELD ~;:?"FROM":: c~. WELL:?'i:~'~' :::;;": '::':':LOG ': ~'::J': "~:i'-.'. INSPECTION ~ ' ' ' g.p.m. Cased t0 ' '/' ~ Casing height (above ground) ,/S g.p.m. Nitrate · /~ /~j~ Collected by: /~ -~'~--~ Number of Compartments c~ Cleanouts (Y/N) Depression High'water al~m ':' ' Width Date of adequacy test Results (Pass/Fail) Fluid depth in absorption field Fluid depth Peroxide :treatme · If ) date 72-026 (Rev. 3/96)* Property line Surface water Curtain drain SEPAR~:~i°N' i~'ISTAI~'~s FROM WELL ON LOT ~0::" :' ' ' Septic/holding tank on lot / / Z-// ~' On adjacent lots /~3 ''/- ,Abs0rPti~n f~eld on I~t',' '. ' : /~' ~ On adjacent lots /~ ..'."~;:L~ ~, ~.,~ ,',:{,v, ~ / · . ' , ' ,, , - . - Public sewer main'' ' ~ Public sewer manhole/cteanout Lift station . SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~ ~ Prope~y line ~ ~ Absorption field Water main/se~ice line ~ ~ Sudace wateddrainage /~ ~ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: ~ ~ Building foundation ~ ~ Water main/se~ice line / /~ + Driveway, parking/vehicle storage area Wells on adjacent lots F. ENGINEER'S CERTIFICATION signature L.-~-~'f/~//~J~. ~ :,,Engineer,s Na~ef, ~,J~~ '~ Date HAAI Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* ~"ple Remarks: ~o~aL Coliform 0 02t~9/99 KAP · L91~ LOOI.I.G Z£-6Z -I '0~1 (£'bl-I~ DT1001464 %