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ROLLING HILLS VIEW ESTATES BLK 2 LT 2
P-01 ling Hills View Estates Block 2 Lot 2 #050-322-02 Douglas T. Kenley, P.E. 9806 E. Northstar Circle, Palmer, Alaska 99645 (907) 746-1073 July 25, 2012 Municipality of Anchorage On -Site Services 4700 South Bragaw Anchorage, Alaska Re: Bruce Davis, Owner Rolling Hills View Estates S/D, Block 2, Lot 2 19139 Upper Skyline Eagle River, Alaska 99577 ENGINEER'S AS -BUILT REPORT FOR DRAIN FIELD MAINTENANCE Subject Background: The existing septic system, constructed in 1986, failed an adequacy test on June 24, 2012. A permit, #OSP121178, was issued to the homeowner on July 5, 2012, to have Northern Excavation & Construction perform maintenance on the leach field by replacing the drain rock, thereby removing the accumulated biomass. The leach field is a deep trench, 30 inches wide and 37 feet long, with an effective depth of 6 feet. The trench lies in an east -west orientation near the southern end of the property. As the original percolation test was performed at a depth of 14 feet below grade and bottom of trench was believed to be 10 feet below grade, there was a desire to confirm that there was at least 6 feet of permeable soils beneath the bottom of the trench as required by the permit. The MOA required that an inspection be performed by the engineer or his representative of the bottom of the trench after the septic rock was removed and again after the new sewer rock, drain pipe, and fabric had been installed. Jeff Poet at MOA was also present for inspection of the bottom of the trench. Report: During excavation of the existing septic rock it was noted that the bottom of the existing trench was approximately two feet lower than necessary, when providing a 2% slope in the drain pipe from the tank. It was, therefore, feasible to raise the bottom of the trench 2 feet, maintain the required cover over the trench, and still achieve a full 6 feet of separation between the bottom of trench and impermeable soil or bedrock. After removal of the existing septic rock, and while the trench was open, surrounding soils of a representative type encountered from four feet to ten feet below grade were utilized to fill the bottom 2 feet of the trench in order to raise the elevation of the bottom of the trench. A rod was then driven to establish refusal and to confirm a 6 foot depth of soil below the new bottom of trench. Septic rock was then used to fill the trench to the 6 foot effective depth. Leach piping, filter fabric, cleanouts and monitor tubes were then installed. As the work was fully open, a few improvements were made including a cleanout at the east end of the drain field, a double -Wye cleanout between the septic tank and the drain field, cleanouts at both ends of the leach field, and a monitor tube at the west end of the drain field. Also, the lengh of the trench was extended 3 feet to the east. Rolling Hills View Estates S/D, Block 2, Lot 2 July 25, 2012 Page -2- Progress of new sewer rock and pipe installation was observed after the bottom of the trench was established and the following elevations were taken utilizing Northern Excavation's transit: Reference Point (Top of east end of block wall, due south of end of drain field) 12.40'=100.00' Bottom of trench 99.65' Bottom of pipe 105.65 Top of sewer rock 106.25' Finish grade (Start of drain field) 109.50' Finish grade (End of drain field) 110.80' If you have any questions regarding this installation, please call me at (907) 746-1073 or 243- 5372. Sincerely, ,( O "t, Douglas T. Kenley, P.E. PE #8176 On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP121178 Tax Code Number: 05032202000 Work Type: Septic Upgrade Permit Effective Dates: July 16, 2012 to July 16, 2013 Design Engineer: DOUGLAS T KENLEY Subdivision: ROLLING HILLS VIEW ESTATES Site Legal Address: ROLLING HILLS VIEW ESTATES BILK 2 LT 2 G:0254 Owner/Address: DAVIS BRUCE & KATHY L 19139 UPPER SLYLINE DR EAGLE RIVER AK 995772653 Site Mailing Address: 19139 UPPER SKYLINE DR, Eagle River This permit is for the construction of: Y Disposal Field N Septic Tank N Holding Tank N Privy %�/7// Z /161n Lot Size in Sq Ft: 46173 Total Bedrooms: 3 N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: INSPECTIONS: The open excavation for the drainfield shall be inspected by On-site prior to placement of drain rock. Special Provisions: A driven rod shall be used to verify six foot vertical separation from the bottom of the drainfield to bedrock. Results shall be submitted with the final inspection report. Received Issued By MUNICIPALITY OF ANCHORAGE 01 Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program Mayor Dan Sullivan ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. _ 01 - ?� – ook _ Q Property owners) 4 65� D y phone Mailing address P nY /- C r S� Site address d7 Legal description (Sub'd., Bloc & Lot) es Legal description (Township, Range & Section) o IiAl > 5 S Lot Size L C700 Sq. Ft. Number of Bedrooms _ THIS APPLICATION IS FOR: (0 all that apply) Absorption Field Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION IS AN: Initial Upgrade �❑/ ,(.n Renewal ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: I certify that the above infor ation is correct. I further certify that this application is being made for a Single Family Dwj and.is: rf acc rdance with applicable Municipal Codes. ,Otr (Signature of Wiperty o r authorized agent) Permit/Rush Fees: JIBI— Waiver Fees: Date of Payment: Date of Payment: Receipt Number: C--�I_fSbX G C h�_ Receipt Number: Permit No. c5fla wl g Waiver No. GAl3ui1ding\0n Site\Forms\Client Forms%Permit App_010411.doc (Rev. 1/11) 06/29/2012 13:37 6960214 REMAX EAGLE RIVER Bruce Davis 18506 Upper McCrary Eagle River, Alaska 99577 June 29, 2012 Municipality of Anchorage Building Safety Division Attention: Jay Crewdson Reference. Residential Property of Bruce Davis Rolling Hills View Estates Subdivision, Lot 2, Block 2 Gentlemen, I have a situation with my septic system for which I am requesting consideration. I would like to perform maintenance to my drain field by replacing the existing rock, scraping the side walls of the trench when doing so and replace with new rock. For background, the septic system for my above listed single family residence was installed in 1985. My father-in-law was the builder and I have lived in the house up until relatively recently.. The house is located. on Upper Skyline Drive in Eagle River, a location known for relatively low producing wells and lots of evidence of bedrock in close proximity to the surface of the ground. My lot specifically has exposed bedroom extensively at the North end of the lot and the bedrock appears to dive down deep at the South end of the lot as there is no appearance of it at the drive entrance which is considerably lower in elevation. There is a natural bench to terrain, flowing East West that has a pattern that ties to Lot 1 to the East of my lot. Reviewing the septic records and looking at the terrain o€the land the soils from these two lots are closely related. The lot to the West, has a much higher predominance of exposedd bedrock, seemingly throughout the lot and the natural bench dissipates quickly before entering that property. Lot 1 was developed at about the same time as my property. Lot 3 was developed much later. 1 am presenting this information to assist in understanding the overall picture of the Iay of the land. The wells and septic systems around my property have all been Tully developed to the standards required by MOA at the time each permit was issued. The land slopes considerably in the area. As I am in the midst of now selling my property, I had an Adequacy Test performed on the septic system last week. Due to the low producing well, it took nearly all day to induce all the required water. We did not achieve passing results. There is flow, h just isn't satisfactory. Lot I had an Adequacy Test in 2003 and did achieve passing results. Both lots utilized the same soils absorption rates in the engineering of the systems for the drain fields. Both systems apparently used a visual means of determining absorption rates as that apparently was the accepted practice during that time. I work with soils in my work and have a pretty good understanding that a person that is well experienced can PAGE 02/03 06/25!2012 13:37 6960214 REMAX EAC --E RIVER PAGE 03/03 deduce what types of soils can perform to certain. requirements. I also understand our collective migration these days to desire measurable means to make determinations. So my first avenue for achieving an acceptable Adequacy result is to bring in a contractor to perform the'feralift method which injects high pressured air a foot on each side of the trench. This method blows perforations through the trench wall into the drain rock. The reality is that it could be considered a maintenance method to a drain field as the drain field builds up a biomass over time between the two dissimilar fields of the overall leach field. In reviewing alternative processes, it was mentioned that another possibility was to remove the existing drain rock and replace with new drain rock. Such a method, seems to me, would invite a more thorough method of performing the maintenance function of cleaning up the biomass. However, in exploring the MOA bureaucratic processes for this, there is no MOA procedure for allowing such a process. Typically, when there isn't a process, there is default to the nearest process that exists. In this case, that defaults my situation into getting caught up in most of the actions for what is required for a new system. That becomes cost prohibitive, and the reality is, this would no longer be maintenance. Some of the differences are that in 1885 the percolation tests were done visually, today there done different. There could be new engineering involved. Anyway, it appears that all of the procedures would simply discourage me from doing what I believe is a more thorough method of addressing the necessary maintenance to my system. This effectively causes me to wonder why common sense managed to get away again. Thus, I am asking the MOA to not require the application of new requirements but to allow me to remove and replace the drain rock and clean up the accumulated biomass as a maintenance function to my drain field, realizing that the original permit was imtended for a system that would serve for the life of the house. Certainly, we should be allowed to do maintenance and :repairs to ubat we have cur hard earned money invested in. If I can do the Teralift method as a maintenance function, it only seems reasonable that I should be. able to do this method as a maintenance function as well. Both my drain field and the drain field on Lot I have proven their functionality for many years, there has never been any indication of effluent seeping out of the surface of the ground. My own Adequacy test almost passed and the reality is that the 450 gallons of water with a low producing well, is way above the actual usage of the system. due to the fact that the well isn't capable of producing that much water. My request is for MOA to simply allow me to perform the maintenance on a system that has already proven to effectively operate for 25 years. Attached is indication from the engineer that has been involved with the Adequacy test that this request has been reviewed and there is concurrence from him with the requested action being appropriate in this application. Sincere , Bruce Davis 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 NAME PHONE EW rZ 0�, r,- a El UPGRADE MAILING ADDRESS -- . 'c> 25' LEGAL DESCRIPTION •� 1.•, -V ,. LOCATION „�., n NO. OF BEDROOMS � 2 Well a Absorption area, Dwelling o "+' PERMIT NO. U DISTANCE TO: �� C:G54r� Y n~. Q w l.- Manufacturer � � n Material No. of compartmental„ U) Li . capacity in gallons IF HOMEMADE: Inside length Width ---. Liquid depth C>,aL=, �—. Y Jzz DISTANCE TO: Well Dwelling PERMIT NO. = z F Manufacturer Material Liquid capacity in gallons Well 1 Foul ion I Nearest lox line PER IT NO. V = DISTANCE TO: y, I �' 7✓(�3 v J Z No. of lines Length of eac line Total len th ofilines Trench width Distanckbb een lines W `'� % © inches N h Top of tile to finish grade 1 Material beneath the - ` Z, Total effective bs rpyip�i area inches Length Width Depth PERMIT NO. w Q F Type of crib Crib diameter Crib depth Total effective absorption area as LM LU U) Well Building foundation Nearest lot line DISTANCE TO: e th Driller Distance to lot line PERMIT NO. JCI J W Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO: OTHER PIPE' rMATERIALS D l Vc, M SOILTESTRATINC�_ i i y'�/ Pill - `.' w INSTALLER SC_ -O' -V REMARKS • OF A1,, %j ° AP C- % 34— lee ,< • u ar++• •; yq berf R. Shafer ww No. 1457•EAV (1ti ways wew��.O,° 44 112,101WEERINO APPROVED �j - DATE LEGAL ;.a ti LE � IVE•R• ALASKA 19577 // PH. 694- 376 7 Z /� i A i 8� 2 6Fc, W a a a a0 0 0 a a 9 O w z w .G e i c75? F U 6Fc, W a a a a0 0 0 a a 9 O w z w 6Fc, W a a a a0 0 0 a a 9 O w z ^ /~ � . ' ���X Ell 1: 1:1 K 1.. 1: W V" . M F17 M INI M 1-1 oil 141 not W� DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ' 825 1 AK 99501 264 4720 oil HNJ --- 10 1: W M M W ET! 141 too HAJ HEE I.. I.. FA K lot 1-1 X -T*' PERMIT NO: 850036 DATE ISSUED: 02/12/85 APPLICANT: BRUCE & KATHY DAVIS ADDRESS: P,O, BOX 772653 ANCHORAGE, AK 99577 CONTACT PHONE: 688_3275 LEGAL DESCRIP: SUBDIVISION: ROLLING HILLS VIEuy^ALOT: 2 BLOCK: 2 SECTI�N: 6 TOWNSHIP: 12N RANGE: R3W LOT SIZE: 46000 (SQ,FT^ OR ACRES) ' MAX BEDROOMS: 3 ^ ^ Listedbelow are the options available to you in designing your septic system. Choose the optio t b t your, site. �~..... ..... _~ ~ ...... ^-~~~..... �~~.�~�_��'~ If���][�� DEPTH TO PIPE BOTTOM (FT" 4,0 4.0� 4"0 GRAVEL DEPTH (F 0 0.5 3.5 TOTAL DEPTH (FT.) 10,0"/ / 4"5 7`5 / GRAVEL WIDTH (FT.) 2^5 17.0 5"0 GRAVEL LEN8TH (FT.) 32,O 34.0 41 0 GRAVEL VOLUME (CU"YDS.) 19.3 21"5 30.4 TANK SIZE (GALS) 1,000'0 ** 1,O00,0 ** 1�000�0 ** SOIL RATING <SQ.FT,/BR) \ 125 / 125 125 *� TANK MUST HAVE AT LEAS ENTS I certi�y that: 1. I am {amiliar, with the requirements �or on�site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2, I will install the system in accordance with all MOA codes and regulationin "and in compliance with the design cyiLear, ia of this permit" 3. I will adhere to all MOA and State of Alaska requirements ��r the set back distances from any existing well, wastewater disposal system or public sewerage i5ystem on this or any or nearby* lot. 4" I understand that this permit is valid for a maximum of 3 bedrpoms any enlargement will require an additional permit, ' IF A LIFT STATIONIS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODE�, THEN (11 AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS`BUILTS WILL NOT BE APPROVED WIT EL�CTRICAL` INSPECTION REPORT; AND <3) THE ELECTRICAL WORK MUST BE A LICENSED ELECTRICIAN. SIGNEDDATE: _~~~..... ..... ~~ ANLI � ISSU�D B DATE: .... ..... ..... ���_..... ... . ..... ..... ..... ..... ..... ..... �_..... ..... ..... � - ~ ~ v �������������� �� ���������� ./^ DEPARTMENT OF HEALTH AND ENVIRGMENTAL PROTECTION . 825 L STREET, ANCHORAGE, AK 99501 ` 264-4720 4Z) RVI --- jEs :1: Q- PEE $Ej PEE Qj PEE If4t tic QAJ ITE O.� IF::::,, IF-'Q'! o-T '.E -T, " PERMIT NO: 840956 oATE 1/26/84 APPLICANT: BRUCE bAVIS ADDRESS: P O BOX 772653 EAGLE AK 99577 CONTACT PHONE: 562-540 ` LEGAL DESCRIP: SUBDIVISION: ROLLING HILLS VIEW E LOT: 2 BLOCK: 2 SECTION: 6 TOWNSHIP: 14N RANGE: 1W LOT SIZE: 46000 (SQ^FT" OR ACRES) MAX BEDROOMS; 3 . Listed below are the options aveableto you in designing your septi� systc�.'m" Choose theoption that best fits your site. ������.�������������������.�������� "T FR! PEE two 1:1 h 11 ��REH:: ID IR 01%][ A 11 DEPTH TO PIPE BOTTOM (FT.) 4"0 4"0 4.0 GRAVEL DEPTH (FT^) � 6"0 0.5 3,5 TOTAL DEPTH (FT.10"0 5 7.5 GRAVEL WIDTH (FT^) 2"5 17,0 5,O / GRAVEL LENGTH (FT,) 32"0 34.0 41"0 GRAVEL VOLUME MILK YDS") 19.3 21.5 TANK SIZE (C-iALS) 1,000,0 ** 1v000,O ** SOIL RATING (SQ"FT"/BR) 125 125 125 ' ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS ~..... .... ~-�--��-� ' I certify that: 1" I am familiar with the requirements for on-site sewers and wells as set, forth by the Municipality cH, Anchorage <10A) and the State o� Alaska" 2" I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3^ I will adhere to all MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disppsal system or public 'ewerage system c1n this or any adjacent or nearby lot" 4" I understand that this permit is valid for aolf 3 bedrooms and any enlargement wiIl require an additional permit" ' IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INWIFE CTION MUST BE OBTAINED; (2) AS~GUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUS E BY A. LICENSED ELECTRICIAN^ SIGNED DATE: ... ..... ..... .... -_..... ~ APP��CANT: BRUCE6�AVIS y- ISSUED BY DATE: 6 /8,f _..... �... ..... .... ..... -...... �..... ..... �� � / I*" SOILS LOG MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264.4720 SOILS LOG -PERCOLATION TEST PERFORMED FOR: bielutC;' Tjho S DATE PERFORMED: /'1 xr- `3:903 LEGAL DESCRIPTION: �� C.� i�� f4d, " i �'� y'" SLOPE SITE PLAN DEPTH (FEET) 1-2. ivn S rlly 5.),n 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS F PERFORMED BY: 72-008 !6/791 ..L_ 1 f®° v/, I rAA e,<� oit,a&.A gy-XVRA aIca, n wed j ir"t'04 ��W�IN.■ CSIII1■ MEN MORE ON ENNE MEMO 0000 0000 WAS GROUND WATER + po L ENCOUNTERED? O P E IF YES, AT WHAT DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop F� PERCOLATION RATE, ;.TEST RUN BETWEEN 4 %)/ AnJ-ci FT AND 04 ����f��MI��/.. A I=41111 NEW11L v (minutes/inch) FT DATE: .r-5 �rtyj -: MuniciDality of Anchorage Location (site address) Development Services Department Building Safety Division Current Property owner(s) On -Site Water and Wastewater Program Mailing address 4700 Elmore Road Lending agency P.O. Box 196650 Mailing address Anchorage, AK 99507 Real Estate Agent www.muni.org/onsite Mailing Address (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING p50 Parcell.D. X322-02 1. GENERAL INFORMATION COSA# 0 G e la1310 Expiration Date: /6 — 3 d —1�2_ Complete legal description Rolling Hills View Estates Sit), Block 2, Lot 2 Location (site address) 19139 Upper Skyline Drive, Eagle River, Alaska Current Property owner(s) Bruce and Kathy Davis Day phone 351-9700 Mailing address 18600 Upper McCrary Road, Eagle River, Alaska 99577 Lending agency VA Day phone Mailing address Community Class Well Real Estate Agent Audrey Mason, ReMax of Eagle River Day phone 6223344 Mailing Address 11525 Old Seward Highway, Eagle River, Alaska 99577 Unless otherwise requested, COSA will be held by DSD for pickup 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ✓❑ Individual On-site 0 Individual 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 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 -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 sample results. (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, 1 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 Douglas T. Kenley, P.E. Address 9606 E. Northstar Circle, Palmer, AK 99645 Engineer's Printed Name S. DSD SI NATURE Approved for Disapproved. Douglas T. Kenley Conditional approval for bedrooms_ Phone (907) 746-1073 Date -717 S -A -L_ bedrooms, with the followin COSA Checklist X Arsenic Advisory Septic System Advisory Well Flow Advisory Nitrate Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: 7-30-1-2- (R., -30'!(Rev. IM5) Municipality of Anchorage Development Services Department Building Safety Division Onsite 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 CHECKLIST Legal Description: Rottlng Hills View Estates SID, Bock 2, Lot 2 Parcel ID: 050-322-02 A. WELL DATA Well type P" ata If A, B, or C provide PWSID # _ Date completed 5131185 Sanitary seal (Y/N) Y Total depth 125 ft. Cased to FROM WELL LOG Date of test 5/31/85 Static water level 115 ft Well production 3 g.p.m. WATER SAMPLE RESULTS: Coliform Negativecolonies/100mL Nitrate 8.1 mg/L Arsenic: Negative ug/L date of sample: 6/25/12 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1000 gal. Number of Compartments 2 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 45 in. AT INSPECTION 6124/12 25.9 ft 2.3 g.p.m. Collected by: F. Kenley Date installed 7/12/85 Cleanouts (Y/N) Y Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alar (Y/N) NIA Date of pumping 7/14/2012 Pumper JRs Pumping C. ABSORPTION FIELD DATA Date installed 711612012` Soil rating (g.p.d./ft2 or ff/bdr) 125 System type . Trench Length 40` ft. Width 2.5 ft. Gravel below pipe 6" ft. Total depth 10 ft. Eff. absorption area 444 ft2 Monitoring tube Y Depression over field N Date of adequacy test 6/24/12" Results (PaWFail) P** For 3 bedrooms Fluid depth in absorption field before test _ in. Water added_ gal. New depth_ in. Elapsed Time: _ min. Final fluid depth _ in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date D. LIFT STATION Date installed "Pump on" level at _ in. E. SEPARATION DISTANCES Size in gallons "Pump off level Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 120+ ft. Absorption field on lot 150+ ft. _ Public sewer main Wo. Sewer /septic service line A M ft. Animal containment areas 50+ ft. ManhoWAccess (Y" Meets alarm $ circuit requirements? On adjacent lots On adjacent lots 100+ ft. 100+ ft. Public sewer manhole/cleanout N/A Holding tank N/A Manure/animal excrete storage areas 100+ ft. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ ft. Property line 10+ It. Absorption field 5+ ft. Water main N/A Water service line 10+ ft. Surface water 100+ft. Wells on adjacent lots 100+11- SEPARATION 00+ft. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10+ ft. Building foundation 10+ ft- Water main N/A Water Service line 10+ ft• Surface water 100+ ft. Driveway, rhin y pa givehlcle storage 5+ ft. Curtain drain None Known Wells on adjacent lots 100+ ft. 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 COSH guidelines in effect on this date. Engineers printed Name Douglas T. Kenley P.E. Date COSA Fee Data of Payment Jo Receipt Number (Rev. 4/10) Waiver Fee $ _ Date of Payment Receipt Number in. Municipality of Anchorage s` 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 # 121310 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 2, Lot 2 of Rolling Hills View Est. subdivision. This inspection revealed a nitrate concentration of 8.1 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. Douglas r. Kenley RE. 8176 9806 E Northstar Circle, Palmer, Alaska 99645 (907) 746-1076 WELL AND SEPTIC ADEQUACY TEST Legal: Rolling Hills View Estates S/D. Block 2 Lot 2 Address: 19139 Upper Skyline Drive, Eagle River, AK Applicant: Bruce Davis Phone: 351-9700/C Work Order M 12112 Date of Test: 24 -Jun -12 Tank Level (in.) 50 System Data: Tank Volume (gallons): 1,000 Absorption System: Trench Number of Bedrooms: 3 Absorption Required (150 gal X #bedrooms) 450 Depth of well (ft.): 125 Depth of Casing (ft.): 3 Static Water Level (ft.): 29.9 Height of Casing (inches above ground): 58 Time Net Time (min.) Meter Reading ) Incremental Volume (gal.) Total (gal.) Flow (gpm) Well Level {ft Delta Well Level (ft.) Monitor #1 Comments Tube Level in.) 12:31 - 88471 - - - 29.9 - 33 12:44 13 88488 17 17 1.3 33.9 0.0 33-118 12:51 7 88496 8 25 1.1 36.5 33-1/8 1:01 10 88508 12 37 1.2 36.2 -0.1 33-1/2 1:11 10 88520 12 49 1.2 43.6 0.0 33-1/4 111 10 88532 12 61 1.2 44.8 33-3/8 1:31 10 88546 14 75 1.4 47.9 33-3/8 1:51 20 88580 34 109 1.7 61.8 0.0 36 2:11 20 88613 33 142 1.7 -- 0.0 36-1/2 3:09 58 88655 42 184 0.7 - 0.0 37-1/8 3:47 38 88714 59 243 1.6 79.4 76 4:09 22 88730 1 16 259 0.7 1 - 0.2 - 4:31 22 88752 22 281 1.0 82.3 0.0 59-1/8 6:28 117 88853 101 382 0.9 - 59 64-5/8 66-3/8 9:03 53.2 69 9:36 128 88951 98 480 1 0.8 70-1/8 10:12 1 1 1 1 1 68-1/2 System Passed X System Failed Additional Comments: The X on the "system passed" is for the well only. The well produced 281 gallons in 4 hours for an average GPM of 1.2. The septic system had maintenance work done on 7/16/2012. Adequacy test was not required for the work that was done at that time -Just an Engineer's letter acknowledging that it had been inspected. Jul 26 12 09:43a Heinz Frey i 2082552615 n v o 0 n N zoo 66. CU 14C. w li�lT'f„tr,5 �`YZ4 f.pG:E Zoe.e�. --�I 19 i ? ' 1 (00' SI�Yt-intG tom, 2t`� -7 _z 7 I 7” rn N AS -BUILT I hereby certify that I have surveyed the following described property; LOT -_Z. P—OLLItA4z 1-\1 LLS y;r Kt ESTAEi=r 1 ' w'W 4i ota� �1 lLA hi, Anchorage Recording Precinct, Alaska, and that the improve- ments situated thereon are within the Property lines and do not overlap or encroach on the property lymg adjacent thereto, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Eagle River, Alaska this i'-1 --T"-A day of 8Lo'ya -tzti L 19 ROBERT CaJOHNSON `l. �;t SCALE: Registered Land Surveyor No.`I380-LS 1" — y o Box 77-0456, Eagle River, Alaska 99577 Phone (907) 694254.' „ l V r MUNICIPALITY OF ANCHORAGE A/1UNIaPAuil' of AN010RAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION•. DEPT. o HEALTH & iA DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date �- /%- 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, sect', n, township, range) �f 2 fit..-M� � �• �L.t.1 0..) Lm. 1..15 � Locatio (address or directions) (b) Applicant Name&(JLk�, i%�I 5 Telephone: Home �g�nn� �!�= Business Applicant Address T (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder Buyer ❑ ; Other ❑ (explain); 4 3. 4. (d) Lending Institution Address (e) Real Estate Company and Agent — Address Telephone _ (f) MeWthe HAA to the following address: Telephone TYPE OF RESIDENCE Single -Family Multi -Family ❑ Other Number of Bedrooms 3 WATER SUPPLY Individual Well Community ❑ Public 13 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL I Onsite g Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11184) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regullations in effect on the date of this inspection. Name of FirmTelephone Address $ `� ,(fig pl;f�t� er —. /J /� (/ ZIVE ,tl"pp6iY+Y+•.yyV((yLy ttR1 �5. e(:,r:dry //7 i✓7 a Date -------Ts-. �` a O ... ..ar+e+e. •+�a' '0 rr Ra . $ober) A. Shafer i •. No. 1457•0 J 1*yep •��h B..oaH•.a Q��i� 6. DHEP APPR4rOL Approved fo�'v bed Approved C Terms of Conditional Approval room (�� Date isapproved Cond' conal CAUTION 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 i professional engineer's work. Page 2 of 2 � �ANICIPAUT"OF A MUNICIPALITY OF ANCHORAGE (MOA) oEPr. or H�&Ali t'< HEALTH AUTHORITY APPROVAL (HAAy T'1�i^Cl i;- ''1T;`,L Pi: lrCiiO J CHECKLIST - FEBRUARY 1984 1, 264-4720 1 Legal -Description: A. WELL DATA Well Classification If A, B, C, D.E.C. Approved (Y/N) Well Log Present &) Date Completed 'qS 3% "8C__ Yield ,%� �P� ✓ Total Depth 0-5 Cased to l5 Depth of Grouting Static Water Level Pump Set At i t Casing Height Above Ground �✓�� Sanitary Seal on Casing (SDN) Electrical Wiring in Conduit/N) Separation Distances from Well Depression Around Wellhead (Y/dO To Septic/We4diriTTank on Lot _\ 2--c> t ; On Adjoining Lots To Nearest Edge of Absorption Field pn Lot On Adjoining Lots To Nearest Public Sewer Line A To Nearest Public Sewer f Cleanout/Manhole +� To Nearest Sewer Service Line on Lot Water Sample Collected by S 5 6:4�&LN) � ; Date " { e 9 Water Sample Test Results , Comments A- B. SEPTIC/F TANK DATA Date Installed I -S3-e67 Size (L-_N=n:�> No. of Compartments Z StandpipesWN) Air -tight Caps6%) Foundation Cleanoul::O5/N) Depression over Tank (YW Date Last Pumped Pumping/Maintenance Contract on File (Y/N) — ; for a A Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) N Separation Distances from Septic4l6le444a-Tank: 1 l To Water -Supply Well 1 ZD t- To Building Foundation To Property Line 11=� IA' To Disposal Field Sl To Water Main/Service L'n� C t� 14- To Stream, Pond, Lake, or Major Drainage Course 1! Comments Page 1 of 2 Q� C. ABSORPTION FIELD DATA 3x iA� Soils Rating in Absorption Strata il, Type of System Design 'T�czW Date Installed Length of Field �Zr Width of Field �� Depth of Field L� Gravel Bed Thickness Square Feet of Absorption Area y �Standpipes Present(ON) Depression over Field (Ya> I Date of Last Adequacy Test { W Results of Last Adequacy Test eS {A Separation Distance from Absorption Field %+ ` I To Water -Supply Well To Property Line Lfl 4 - To Building Foundation // �� �" To Existing or Abandoned System on Lot a /M ; On Adjoining Lots To Water Main/Service Line Lfl (k To Cutbank (if present) L'b: To Stream/Pond/Lake/or Major Drainage Course l/A. To Driveway, Parking Area, or Vehicle Storage Area 4+4=> ,�_ Comments D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at _ "Pump Off' Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed a & g EmalwanwoDate /O -Z3- ear 1UUX CompAb^ DIVER, ALASKA MOA No. SSaa3 Receipt No.o +p "�r/ ya.ass nr Date of Payment 6a/23��� ,vv,.� ,a,05'!� Amount: $ `/S•y� ,� Page 2 of 2 72-026 (11/84) =g 'CHEMICAL & GEuLOGICAL LABORATORIES �F ALASKA, INC. TELEPHONE (807) 562-2343--- _ -ANCHORAGE NJDUSTRIAL'CENTER-- ,.,,,, 5633 B Street Drinking Water Analysis Report for Total Coliform Bacteria a TO BE COMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY WATER SYSTEM: Mt(e) See h on back Analysis shows this Water SAMPLE to be: I.D. NO. rtr Satisfactory 7 5 (] Unsatisfactory Water System Nona Phone No. 5213 -Tx ❑ Sample too long in transit; sample should npt be over 30 hours old at examination to Meiling Addrep/� indicate reliable results. Please send new /iii L erp • 474q sample via special delivery mail. city sten Zip Code SAMPLE DATE: Me. Day yaw SAMPLE TYPE: {-Routine O Check Sample (for routine sample With lab ref. no. t Ttreatdaf O Special Purpose eWater SAMPLE Time Collected NO. LOCATION Collected By I I L Z 13 2 d or -w. t2 r� z 3 41 I 5 Date Received'�� " �f Time Received / SOO Analytical Method: O Fermentation Tube D Membrane Filter Lab Ref. No. Result' Analyst 00 - e`1 C713' _ I I m L I m U m ED *No. of colonies/too ml. a No. of Posiow Ponioin. 06.1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD A". 1668 READ INSTRUCTIONS Membrane Filter. Direct Count CollformHooml Verification -LTO BGS Final Membrane Filter Results Collform/100ml BEFORE g- /3 EC Reported By Oats Time: i Sd a a.m. p.m. COLLECTING SAMPLE_ TNTC = Too Numerous To Count _ E PO L, - ri 6-650 ANCHORAGE, ALASKA 99502-0650 (907)264-4111 TONY KNOWLE& MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Permit #: 840956 January 31, 1985 TO: Permit Applicant SUBJECT: Tot 2 Block 2 Rolling Hills View E Subdivision A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1984. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system, the original as -built inspection report and the yellow copy must be sent to this office for review and approval, and for documentation. if there are any further questions, please call this office at 264-4720. Sincerely, Keith E. Bandt, Supe visor Environmental Engineering Program KEB/ljw enc: Copy of Permit SWP/057