Loading...
HomeMy WebLinkAboutROSEBUD HILLS BLK 1 LT 3Rosebud Hills Block 1 Lot 3 #017-381-38 Permit Nuraber., 9SINI-- Date firf Issue: - Pareei .Aden if cation Nmuber- - D a#e Date Started. '-2-21 Date Completed: -3-21 Is -.,v.ell locatod at approved, p(,-rtn4t Tocatiojf? x Yesrj No LegalPtscription: Rosebud Hills Block -1 Lot 3 Propikwiy Owner Name Ik Adidres,�- Ana Metfot 5501 Ridgeview Drive Anchorage. Alaska 99516 Borehole Dnta: Depth (ft) Sc't1'P,rpc., Thickness &%,ater Strati: From To Ex'winq weh, 23S bedrod 231S 32,,� IvIetbod af Drilling -x air ratary *1e tool Casing type, steel Wall Thickness:,250 inclics Diameter: 6 iiichts Dentla: -9 ff'.0. Diameter- inches Lk--pth: __ feet Casiog qtIckup above ground- -.1, , feet Statie Nvater level (fi-om zrotmd level ): 1.53 im Pumping leve): 32.5 feet after 2 hours puroping L- gpm Recovery Rate, 15 )ni data of Testing: ±1Y �li Well LI Opening T., yr te Open End < Open 1401e F! ",:recncd. Start - feet Stopped feet El Pcr(orations feet &opped._ fc-(A G rout. TV Volume: pump. Intake Depth feet Parnp sizz _ hp 13rat4d *Name _ —I Well DisiivItcled Upon Completioe Xlethod al'Pisinfecdon: chforine NU -4-s comments; Well DrMer, ,'.Ypins.-.Drd1Mg & E'nterprises MiyllingAdcbes-v Anchorage, AIaska 9951.1 -.- - I .17,j,jT-j-j-'.j,-t -- .LII �i -1 :� 0 %{,,7GE ,,'E.',/E,0 Municipality of Anchorage Page of 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: Sid q5 © l & 2 PID Number: 0917 — 3P 1— 38 Name:. Wastewater System: VNew El Upgrade MF_i—LoTi �a Address: 1'Z ABSORPTION FIELD Phone: No. of BedrooLl ms: L7 beep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: ©a(- Total Depth from original grade: d / GPD/Sq. Ft. Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe 6. � U l 3 IB V� I ��!DE: 30 5 Ft. Ft. Township: Range: Section: Fill added above original grade: Gravel length: 1&0 Ft. 0 — Ft. WELL: I�lew ❑Upgrade Gravel width: 1,3 Number of lines: Distance between lines: /115 Ft. Ft. o2 Classification (Private, A,B,C): Total Depth: I Cased To: Total absorption area: Pipe material: _ / 3 CT's% 31 e 3 LI e P-1 l0 T if a-6 Ft. 1 23 P, Ft. SQ. Ft. Driller: Date Drilled: Static Water Level: de- IJLO, Ftm 6, i �t� led: ` 22 M116 Installer: DateYM Yield: Pump Set at: Casing Height Above Ground: TANK / f/2_ GPM 3e -No Sn Ft. Ft. SEPARATION DISTANCES Ig'Septic ❑ Holding ❑ S:T.E.P. TO Septic Absorption lift Holding Public/Private Manufacturer: ^� 1�' 7 & 1-4`t Capacity in gallons: P Y 9 5 O From Tank Field Station Tank Sewer Lines /–TN 1 1 I Material:/ Number of Compartments: Well �'3 w t /q71 !j 4e e/J Q_ SurfaceLIFT STATION Water rq Jo t LotSize Line S r in gallons: Manufacturer: "Pump on" level at: "Pump off" level at: High water alarm at: Foundation \, I Y - Curtain�, J Pump Make 6 Model Electrical Inspections performed by: Drain I �l Remarks: 5'tt" , P"BENCH MARK 'r ) Location and Description: r 'c%i l7 i1 - OL int. C .�) ✓(� V/' ' p Ut-e-r-�C�c Assumed Elevation: /}o tj ao_ ENGINEER'S SEAL Inspections performed by: S Dates: 1st �//q6 2nd Department of Heal and Hu an Services approval Reviewed and approved by: T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Robert Robertson Municipality of Anchorage Department of Health and Social Services 820 I Street Anchorage, Alaska 99501 Subject: "Pink Sheet" Lot 3 Rosebud Hills S/D Septic System As Built Gentlemen; The As Built drawings for this system have been redrawn in response to your "Pink Sheet" dated 8/27/96 All elevations are shown 2. Monitor elevations are shown 3. By subtracting the given elevations of the bottom of the trenches from the given elevation of the invert of the distribution piped a total gravel depth of 6.7 feet can be arrived at. 4. The splitter valve has been called out for clarity 5. Swingties to the well and to the southwest property corner have ben provided. Yours T. Spurkland P.E. P. . 1 1 1 1 I PRIMARY SYSTEM I 1 I 25 0 25 0 75 100 125 150 E swlNGTIES. SCAL I ` = 50 F% I G AC 183 FT .����tttV, BC 134 1 CONBARY SYSTEM AD 196 ♦♦♦♦P� ••O•••%A�... BD 152.5 I = ���,.• '•.,•��� D AE 226 •, BE 193 I s 3 ;' •; 49th AF 182 ... % ..... ............ . I F C BF 144 {'ii''.a+',',', 10 AG 209 %. .. ..�...S ......% .......:...... BG 188 I �. �:••TOBBE SPURKLAND•: •� vi No, CE-22 AV tipk]FESSI�N�O♦ I I 1 I I IBL-NCIH MARK B Well I 14 ROAR �— BENCH MARK �— TOP OF WELL CASING -ASSUMED ELEV 10-00-FT TOBBEN SPURKLAND P.E. LOT 3 BLOCK I ROSEBUD HILLS SID SEPTIC SYSTEM AS BUILT 203 W 15TH. AVENUE PETE MILLOT DATE: JULY 07, 1996 ANCH. AK. 99501 5501 R/OGEVIEWEVIfW DRIVE SHEET: 2/3 GRID: 2837 P.N. S+x. `?SoltD2 t"'lD of?-3$1�3� Clean Out 1 Monitor Clean Out IE 94.2 87.5 Standard Trenches - 1.5' Wide 50' L ong 10' Deep 6,5' Sewer rock 3' Co ver NO SCALE Clean Ou 0 Qu 3 0 v � 0 1250 gal Septic tank Clean Z 200 FLOW SPLITTER IVU JGMEE BENCH MARK, TOP OF WELL CASING ASSUMED ELFV, 100,00 TUBBEN SPURKLAND P.E.SEPTIC SYSTEM AS BUILT zo3 wlstr, Ave LOT 3 BLOCK 1 ROSEBUD Anchorage A99sO1 PETE MIL L17TT DATE: ,JULY 07, 1996 5501 RIDGEVIEW DRIVE SHEET; 3/3 GRID 2837 tp,N. SW 4750 16 -PlD vrl ^ 381 Clean Clean Out Standard trenches- 1,5' Wide 50' L ong 10' Deep 6,5' Sewer rock 3' Co ver 1 Monitor Clean Out Clean Ru NO SCALE Cleanouts I rMonitor �� 98t — S O c cs a, U s s 0 q 0 � 1250 gal Septic tank Z P00 FLOW , 00% IF -11 Mira �tn�Ti- ngnI i � iuii n iii i u l l IE 94.51 I 140 /••`Y..•►•••1Ia1II/11I..•••..••.••.•.•.......1...•�.1...•••......•❖•.Y.�••.••..•••.11..•..1...••...❖❖•...�./11�.��.1.•••.-Y.•.••-•....•••..1.❖1......BURN .Y.•....Y1 .......❖❖�.Y.•.Y•1.�.•�.1.•••.Y..I11; 87.5 . Septic Pock / gal. septic.I NO SCALE _UENCH MARK_ I OF WELL CASINC-- ASSUNEV 100,00 4. TOBBEN SPURKLAND RE. L 17 T 3 BL 17CK I ROSEBUD 5/1) S PTIC SYSTEM AS BUILT 203 W15th Ave PETE MILLOTT DATE; JUL r 0/ 1996 Anchorage • 99501 / • / /� • 1 i WATER WELL RECORD STATE OF ALASKA DEPARTMENTOF NATURAL RESOURES Division of Geological a Geophysical Surveys Drilling Permit No. LOCATION OF WELL (Please complete either lo, ib or Ic.) A.D.L. No. Ic.l Borough Subdivision Lot Block'gtrs. Section No. Township N ❑ Range E ❑ Meridian AN /of—of_of— S❑ W❑ 17-11INTERSECTIONS DIST��� 3. OWNER OF WELL: ��ECTION����D S Addresses/}: ' �`��J,,J////// Street Address and Area of Well Location 2. WELL LOG _ Feet Below Surface 4. WELL DEPTH: (final) 3. DATE OF COMPLETION ? r4 — — - Material Type Top Bottom -s -+eft. O6 3 g. Cable tool ❑ Rotary ❑ Driven ❑ Dug ❑ Auger ❑ Jetted ❑ Bored ❑ Other: 7. USE: Domestic ❑ Public Supply ❑ Industry ❑ Irrigation ❑ Recharge ❑ commerical ❑ Test Well ❑ other: �p�./ - •r/ ��� b S. CASING: [] Threaded CR Welded diam. 6 In. to ft. Depth Weight / 7 Ibs./ft. diam. in. to ft. Depth Stickup ft. G G/G vIS-6— 57 2o 7 91/4, e- c70 r 9. FINISH OF WELL: d' a2 Type: olomtter: Slot/Meth Size: Length: Set between ft. and ft. Backfilling gravel pack 10. STATIC WATER LEVEL:��ft. fd Above or ❑ Below land surface Dots Equipment used: I I . PUMPING LEVEL below land surface and YIELD -ft. after hrs. pumping 9 -P.M. VUL 199 a33 ft. after bra. pumping79. p.m. UIl11;jpaj i Of 12.GROUTING We11 Grouted: El Yes No 8c MfftllRfl Material: ❑ Neat Cement -C] Other: 13. PUMP: (if available) HP Length of Drop Pipe ft. capacity g.P.m. ❑ Subm. ❑ Jet ❑ Centriflcol ❑ Other �---------------- 14. REMARKS: 1>8-ldj �/c-fes,- �! 16. WATER WELL CONTRACTORS CERTIFICATION: 13: Wafer Temperature ❑ F ❑ C _° Th;s well was drilled under my jurisdiction and this report is true to the best of my knowledge and belief; S� r L2_r_!l� t c1N I/ Dt r l/• yg�1:3 'J � V Regitered business Name Contract License Number ..Signed:-$= Date: Authorize Rear gen tolive Form O2-WWR (11/81) Copy Distribution: WHITE -State OGGS, PINK -Driller, CANARY -Customer TO F R 0 M (R�% 4S 472 SEND PARTS I AND 3 INTACT - POLY PAK (50 SETS) 4P472 PART 'A EMIR AF 1219TUMM WITM UPEY. PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW950162 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:MELLOTT MILTON M & OWNER ADDRESS:5501 RIDGEVIEW DR ANCHORAGE, AK 99516 PARCEL ID:01738138 LEGAL DESCRIPTION: ROSEBUD HILLS BLK 1 LT 3 LOT SIZE: 52883 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 7/15/95 EXPIRATION DATE: 7/15/96 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 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED P ISSUED BY: /6�'/ 3/cam DATE: '-7/t 2 l 3- DATE:- DATE % 1r 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 3, BLOCK I ROSEBUD S/D it M1c DN PETE MILLOTT No Ground Water or Impervious Layer to 16 ft. Use Standard Trench Soil Rating. From test 5/2/95 12 min/in = 0.8 GAL/SQ.FT.DAY Material is silt Use.6 gal per sq.ft/day No. of Bedrooms 4 Required Area per Bedroom: 150/.6 = 250 sq.ft.. Total area required: 4 x 250 = 1000 sq. ft. Ground Elevation at Absorption Field 4 feet below planned finished floor Testhole Total Depth 16 Less 6 10 Less 3 feet cover 7 Use 6.5 Length of Trench 1000/2x6.5=77 [feet] Use two trenches, each 40 feet SYSTEM CONFIGURATION STANDARD TRENCH TOTAL LENGTH 80 FT. l(7�o lr TOTAL WIDTH 2 FT. TOTAL DEPTH 10 FT. ROCK DEPTH 6.5 FT. COVER 3 FT. �D I SEPTIC TANK 1250 GAL. INSTALL BULL -RUN DIVERSION VALVE'��'� The installation of this septic system will not prevent wells from be installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. pg.' 0 1 01 ?.� C- 00IX Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST 1'ft --W PERFORMED FOR:_ LEGAL DESCRIPTION: 1 2 3 4 5 6 a 17 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS 5c Na -',,4 " Nn to (ENG, INEER S SEAL) L 1 DATE PERE, mEDq Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? _ Depth to Water After Monitoring? Date: SITE PLAN Reading Date Gross Time Net Time Depth to Water Net Drop :'3� /V;" 187B I 9 w; !O Z/g r'lP_� 55 ly �s )o /0 C, 11'2 ''/e (o 12 `/z I1� PERCOLATION RATE L2 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN G /I FT AND 7 FT PERFORMED BY: I Y S CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) 1� (ENGINEER'S SEAL) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650f SOILS LOG — PERCOLATION TEST " t/ PERFORMED L• � FOR , !e ' `I y �' DATE PERFORMED,.- LEGAL ERFORMED:LEGAL DESCRIPTION: LU' 1 -6 3 Township, Range, Section: LLS SLOPE SITE PLAN 1 2 3 4 5 l6 7 8 9 10 11 12 13 14 15 16 n 18 19 20 COMMENTS j�rle. WAS GROUND WATER %,,A D ENCOUNTERED? _ S IF YES, AT WHAT L O DEPTH? P E Depth to Water After a Monitoring? Date: Reading Date Gross Time Net Time Depth to Water Net Drop & •ao s s `< b q: 2- - S PERCOLATION RATE � (minutes/inch) PERC HOLE DIAMETER i TEST RUN BE WEEN FT AND 6, , FT / l 1/1 r4 e3 _ c>L+ (/N lei lci A -P - M4 -t i'S-L tit, Y-��t, � L Le c PERFORMED BY: I [ ' S CERTIFY TH T THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - IrT- LaT --— I 3 1 L17T 4 I 1 1 1 1 LOT 1 LOT 1 VACANT I VACANT I C I � I 1 I I III I I � 1 I J I III I I C 1 1 1 0 I I Well 1 1 1 I II III I I — 1 1 I I RIDGEVI_W DRIVE C I �o V I S O �1 0 � I 1 �s Well VACANT 1 •.• OF q�♦ 1 ., •............. 4 qS♦i AF • 49th •' car 1 o L17T 2 50 0 50 100 150 200 250 300 SCALE. I' = 100 FT TO EN SPURKLAND�� ♦� F�F� .,,� ,. •'° Fri TOBBEN SPURKLAND P.E. LOT 3 BLOCK I ROSEBUD HILLS SID SEPTIC SYSTEM DESIGN 203 W 15TH. AVENUE H«704 DATE: JULY 1, 1995 ANCH. AK. 99501 PETE ,__ ___ __._ 5501 RIDGEVIVIEW EW DRIVE SHEET: 1/3 GRID: 2837 - -- -- -- --N------ I I _ 1 1 I I PRIMARY SYSTEM 1 I 1 I 25 0 25 0 75 l00 125 150 SCAL - 1" = 50 FT ONDARY SYSTEM � I I 1 © I I I 1250 GAL, SEP LIC LK I I I I I , .' 49- 7BIfN SPURKLA ��CrJ�•�• No, CE -2225 - - ••♦����s�FESSl��. <t4 TOBBEN SPURKLAND P.E. LOT 3 BUCK I ROSEBUD HILLS SID SEPTIC SYSTEM DESIGN 203 W 15TH. AVENUE Ml�.>DATE: JULY 1, 1995 ANCH. AK. 99501 ,ID __ „_„ 5550101 RIDMILLOT GEVIEW DRIVE SHEET: 2/3 GRID: 2837 40 0 T Monitor Clean Uu Clean l7ut v Standard Trenches- j _° _ Q a f 2' Wide A o 0 40' Long / a 10' Deep 14 V 6.5' Sewer rock 3' Cover 1 _ '� 1250 gal Septic tank 1 � i i Monitor Clean Out DIVERTER VALVE B LL-RUN Clean Ou�t��-� %� l/ /(/ Pyr I v S NV SCALE Mira fi 140 6,5 rt of Septic Rock Cleanouts 4" Topsoil � 3' Cover NO SCALE Monitor - Exist, Ground 4' Mn Cover over Tank 1250 gal, septic tank BENCH MARK, ASSUMED ELEV, 100,00 TOBBEN SPURKLAND P.E. LOT 3 BLOCK 1 ROSEBUD SID SEPTIC SYSTEM AS BUILT 203 W15th AveDATE: LUL Y 1, 1995 Anchora e Ak 99501 P�IPELE MILTLr I'll 9 5501 RIDGEVIEV DRIVE SHEET 313 ARID: 2837 - - - - - - - - N I 1 i I I PRIMARY SYSTEM I I I I 25 0 25 0 75 100 125 150 SCAL - 1' - 50 FT. CONIIARY SYSTEM © I I 1 I © I 1 I 1250 GAL. SEPTIC TA K I „ I I OF q ��p# .�.••�� , 4' :G,,° y� ' *# I ,'•: I ;� 4 th ..................... 00 • , iWdll ........... .................. ..'....i TUB EN SPURKLA D C ✓� S• O. CE-2225 ••••�_AW .............••• ����i�FESSIO �••� _ _ TOBBEN SPURKLAND P.E. LOT 3 BLOCK I ROSEBUD HILLS SID SEPTIC SYSTEM DESIGN 203 W 15TH. AVENUE PETE MILLOT DATE: JULY 1, 1995 ANCH. AK. 99501 5501 RIDGEVIEWEVIEW DRIVE SHEET: 2/3 GRID: 2837 40 El - Monitor Clean Ou Clean Out Standard Trenches, P' Vide 40' L ong 10' Deep 14 6.5' Sewer rock 3' Co ver solid pipe cross connect Monitor Clean Out Clean Out NV SCALE Cleanouts 4" Topsoil 3' Cover Mira Fi 140 6,5 Ft of Septic Rock O c n, U cb 10 q 0 1850 gal Septic tank DIVER TER VAL VE BULL -RU�V Monitor. - Exist. Ground 4' Min Co ver over ank IP5O gal, septic tank NV SCALE BENCH MARK, ASSUMED ELEV. 100.00 TOBBEN SPURKLAND P.E. LUT 3 BUCK 1 R17SEBUD 91D SEPTIC SYSTEM AS BUILT 203 W15th Ave DATE. LULY 1, 1995 Anchorage Ak 99501 PETE MILLOTT SHEET 3/3 GRID: ?837 .. 5,501 RIDGEVIEW DRIVE `Y 5' 1 '� RECEIVED OCT 131995 Municipality of Anchorage Dept. Health & Human Services � � x:34 ofo. ev✓ et% e,$ y 7`TF-rd aro•o/•>7,i� / ham® �P"-// ooa 71119'1 . nhr _ ✓) r> !tea �P {tk } 3 ? s�lOw ,�J� y. `V :��/ `�j ° <i���4� c�J'ftrG�2 �n���s' �Lia� �� �s�J=i�v�i�� �✓���� 2 cl LC �✓-'tf�-� "X7 �% i✓c�Jr->L�/ / �a sJ:tiei-z Co-rs�<o.2//�z-G�j c�,���./�f C�dv /s�'v���� t C/1v/W/-(- C171-'� 7_/I�/Yi 2 P�Yi7� �j� `,��. ✓� ,Or/ -.mil <e�U-( �4r�'It�,/ 4 /� r � /v � ve s✓ J�!> l e)X 74 z 1� e6;rje1j ,U Monitor Z 9,7,` 5r` Clean Ou Clean Ott41�( `3,Isi g3,81 Standard Trenches 1.5' Wide 50' L ong 10' Deep `* 6.5' Sewer rock 3' -Cover _ I/k—s I % ir6 %f Monitor 1 87, T; Clean Ou Clean Out_43 93,40 NO SCALE lYir2 98f IE 94.2 87.5 LQ Gr?,A SPLITTER IE94.2 87.5 gl, 9,5 z 0 a a, v s - -\7�1250 gal Septic tank jI �-- Z 200 FLOW SPLITTER 99f lir 94.26--11 1 LE 94.51 1250 SEPTIC TANK 81f u NO SCALE lalw "11-7 BENCH MARK. TOP OF WELL CASING ASSUMED ELEV. 100,00 TDBBEN SPURKLAND P.E. LOT 3 BLOCK 1 ROSEBUD SID SEPTIC SYSTEM AS BUILT 203 W15th Ave 11 PETE MILL17TT DATE' JULY 07, 1996 AnchAnchorage Ak o, 99501 5501 RI06EVIEW DRIVE SHEET1 3/,3 GRID 2$,37 aea coo qq T M co Tov --L oq� TO U ro i 3(j Co mro- It 6;- 7 s ?- 2 ¢¢a aao Z bQo z Co 2 Al re /n�') i -A %'/1/h ca ,� 6') g- oml-- e/e v Za el-ev -- 0, 3--" 717)` Q S`Jv6 �s/gam i d44�0-jj /"6- / 19, 4, '7// f'fp4 I , 6, gs" / c le -&7001v �/ Wes Y_ 11,111,01te 4w, �`�vr�•�•l��t✓ �r��.� � d'�r�� �-%r�r��r��; vh his � �!do�f -f���� C�;��' �/�/ i?s 6'P Y ../�1,± T/G 19/� `�a!_'� 3![..•' GQ t'; r'C,.�''-Wfr�J Acl��✓re t / 13 Q S`Jv6 �s/gam i d44�0-jj /"6- / 19, 4, '7// f'fp4 I , 6, gs" / c le -&7001v �/ Wes Y_ 11,111,01te 4w, �`�vr�•�•l��t✓ �r��.� � d'�r�� �-%r�r��r��; vh his � �!do�f -f���� C�;��' �/�/ i?s 6'P Y ../�1,± T/G 19/� `�a!_'� 3![..•' GQ t'; r'C,.�''-Wfr�J /-/a / cx %- 1 4 ate./c,1 �t'G/�LJ rm� moo ; o 171,200,11 Al / ,dam .res, a v / 4AO' - a, -)d 17 d /,®IVB Ail- Ji 4dvo &�o- L�. ����-�1 ,��� �- � /vim s��r��//��.� �� ��,� ♦_�;=�u�`����'� f C� Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 0 Anchorage, Alaska 99519-6650 * Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: J � 7 C jy2 PID Number: 0/7-- -�Pj' "1 Name: Wastewater System: L1 NeW ❑ Upgrade M,t-t_vTi —o Address: - - 2- ABSORPTION FIELD - �, � Phone: No. of Bedrooms: QlDeep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: ©,(� Total Depth from original grade: /o/. GPD/S .Ft. Lot_ Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe 6. _> _5 3� S Ft. Ft. Township: Range: Section: Fill added above original grade: Gravel length: t / &0 U — Ft. Ft. ! WELL: gllew ❑ Upgrade Gravel width: -5 Number of lines: Distance between lines: i /_ Ft 62 Ft. Classification (Private, A,B,C): Total Depth: "-• Cased To: Total absorption area: "J Pipe material: _ 7J0 � q e ✓Pr T � 3 Ft. �3 Ft. / 0-0 SC. Ft. Driller: �u,vt Lr ✓t l�z Date Drilled:Static g ^ JL' 7 Water Level: Ij Ft. Installer: S eG Date i tal Ied: /v Z 2/ — 2 Yield: Pump Set at: Casing Height Above Ground: TANK / '/Z GPM (3o't-ro: Ft.> Ft. SEPARATION DISTANCES O}Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines I AN(_ 14f T / N) /0�2-50 Welt, t f Material: / /J Number of Compartments: 3 Ll/ 1� 7 Surface Water jy � � LIFT STATION LotSize in gallons: Manufacturer: Line Foundation"Pump ►y ; on" level at: "Pump off" level at: High water alarm at: Curtain1 Pump Make & Model Electrical Inspections performed by: Drain N BENCH MARK Remarks: / Location and Description: f t Lj Assumed Elevation: <<u " I Fr ~ ENGINEER'S SEAL F� `'s a14�> DaTE.�. Inspections performed by: 2nd Department of Health and Human Services approval Reviewed and approved by: Date: 72-013 (Rev. 9/911 MOA 25 L _ -1 1 I I I I I I I PRIMARY SYSTEM I 1 25 0 25 0 75 100 125 150 I SCAL : 1" = 50 FT �ONDARY SYSTEM i ��P-��... ........ �`♦. •. I � �0• • 49th �. ' •Jo �.....s......... ........... T BEN SPUR �•'_�� No. CE-z22s ••'�� FES ++++••• I I I I I IBEhff MARK I I Well I X — TOBBEN SPURKLAND P.E. [[LOT 3 BLOCK I ROSEBUD HILLS SID 203 W 15TH. AVENUE P£7f MILLOT ANCH. AK. 99501 rq!17\ 170_701e 5501 RIDGEVIEW DRIVE M BENCH MARK TOP OF WELL CASING _ .As ELEv Inn.nn rT. SEPTIC SYSTEM AS BUILT DATE: JULY 07, 1996 SHEET: 2/3 GRID: 2837 I Clean Clean Out Standard Trenches- 1.5' Wide 50' L ong YV, 10' Deep 6,5' Sewer rock 3' Co ver u Clean Out Clean NO SCALE Cleanouts Monitor I ME - "1 MR a, �a 5 0 q XD - 1250 o -1250 gal Septic tank — Z 200 FLOW DIVD? TER 310N KINI Lu -11-11 -11 71 11 II II II -11 -11-71 if II 11-1'-71 'll 11'r11- II 'll -II 11 If 11 11 11=41-11_ 11-' fCllffll �Il�rIIIIIIIIIIIIII�IIIIIIIIII��II�IIpI1.IIII��I1�IImII�I1Sll�rll1 IIIIIIIIII� IIwll l�"'� Ir� II -11 11 11 II 11 -II II 11 -11"11 II 11 II II II II II -II II 1 IE 94.5187.5 I oF SepticRock NO SCALEj 'OENCH MARK, TOP OF WELL CASING ASSUMED ELE V. 100.00 IUBBENSPUR A.nchorage Ak 95D01 LOT 3 BLOCK ROSEBUD S/ SEPTIC Sy PET_ .ILLOTT DATE: JUL Y 07, 1996 5`- --___..- DRIVE SHEET: 3/3 GRID: 2537 310N �� ' ---yah fa:� January 10, 1986 TO: Permit Applicant i . gy 1 P.C. 8CX 6650 ANCHORAGE, ALASKA 99502-0650 ((907') 264-4111 ro, Y doa c=s. r ,a DEPARTMENT OF HEALTH & HUMAN SERVICES Subject: Permit # 850338 Lot 3 Block 1 Rosebud Hills Subdivision A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1985. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit 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(three part form) must be sent to this office for review and approval,and for documentation. If there are any further questions, please call this office at 264-4720. Sincerely, w a,-t� Susan E. Oswalt Program Manager On-site Services SEO/ljw enc: Copy of Permit M P P4 1 C_:� I IL_][ -F' -V IJ 0=-- 04 9 -,R C_ " WE ' DEPARTMENT O qEALTH AND ENVIRONMENTAL [ lTECTION ~ 825 L STREET, ANCHORAGE, AK 995n1 ' PERMIT NO: DATE JSSUBD: APPLICANT: ADDRESS: ("'OkITAC"T' PHONE - 850338 06/29/85 M. MELLOTT 15251 SNOWFLAKE DR. ANCHORAGE, AK 99516 243-2633 LEGAL DESCRIP: SUBDIVISION: ROSEBUD HILLS LOT: 3 BLOCK: 1 SECTION: 27 TOWNSHIP: 12N RANGE- 3W LOT SIZE: 1.214A (SQ^FT. OR ACRE'S) ` MAX BEDROOMS: 4 Listed below are the options available to you in designing your septic system. Choose theoption that best fits your site. "T-����K^A c_- II -A ��E:-. 110 w~ 13 F:Zo4][�.11 DEPTH TO PIPE BOTTOM (FT.) 4.0 4.0 4.0 GRAVEL DEPTH (FT.) 5"0 0.5 3°5 TOTAL DEPTH (FT.) 9.0 4.5 7^5 GRAVEL WIDTH (FT.) 2.5 26.0 5"0 GRAVEL LENGTH (FT.) 82.0' 50.0 97.0 ** GRAVEL VOLUME (CU. YDS. 41°13 48.2 71.9 ' (GALS) TANK SIZE 1,250"0 ** 1,250"0 ** 1,250"0 ** SOIL RATING (SQ.FT./BR) 205 213 225 ** GRAVEL LENGTH > 75 FT. REQUIRES MULTIPLE RUNS (NOT EXCEEDING 75 FT. EACH) ** 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 theMunicipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria o[ this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maximum of 4 bedrooms and any enlargement will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING (.',ODES,' THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. SIGNED ISGUED BY I ' / . DATE. - DA f E. ATE:DATE: • 501 LS LOU Gross Time Net Time / ..IUNICIPALITY OF ANCHORAGE PERCOLATION 11 14 131310 DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST a ' \ 825 L. Street, Anchorage, Alaska 99501 264-4720 `- / SOILS LOG — PERCOLATION TEST PERFORMED FOR: �P / r" le /i / I DATE PERFORMED: LEGAL DESCRIPTION: L01 ' r vock 1 '-poze-6J 1x1115 5U L!V I6lon DEPTH SLOPE SITE PLAN (FEET)JL 1U1 2 Orr -1c. S;1+ (OL) tl Al4 5 6 y 7 - 7 3 aale.�� 10 11 12 13 14 5 0F A a\ 16 i �►�4�.•••.•t•9 AV, 7% 17 :49—TX* 18 G•••N • Ralph B. Ie 19 f •.••CE -I9 -- WAS GROUND WATER S 0 ENCOUNTERED? L O P IF YES, AT WHAT E DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop 11 14 131310 x/14/85 30 Mtn f T�� 1%(S 3a mtn 15 �Ilnl( `i%lror •. ••l Cb J 15 �� 7 >. . I Ar 20 �� prof�sslo� 00 n PERCOLATION RATE / C20 (minutes/inch) G 10 8-R• TEST RUN BETWEEN ._lSt== FT AND 7'10 FT COMMEN PERFORMED BY: JEFF ?ETERS(:)Q CERTIFIED B • 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. 017-381-38 1. GENERAL INFORMATION Expiration Date: Complete legal description Rosebud Hills, Block 1, Lot 3 Location (site address) 5501 Ridgeview Drive Anchorage, AK Current property owner(s) Ana Mellot Trust Day phone (907) 240-8384 Mailing address 5501 Ridgeview Drive, Anchorage, AK 99516 Real estate agent Wendy Stevens 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone (907) 240-4029 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic Q Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ Waiver Fee $ Date of Payment y U 2 1 Date of Payment Receipt Number. Q 3 Z (o Receipt Number COSA # D. 2 i ff)t�r) Waiver # Distance: 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone (907) 522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Benjamin Schiller Date 2/3/2021 0FAd:9��1 �* TH 6. DSD SIGNATURE �• • "• • • rj System #1 Approved for bedrooms "',.......... — �.. Benjam(n.,Schiller System #2 Approved for bedrooms % 41 CE 12592 Disapproved � Conditional approval for bedrooms, with the following stipulations: o�(Y 0F,4A,'_,-,, WATER AND J WAST' V'ATER o NT SER\J\G�-1�``\ By: J / Original Certificate Date: 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 engineer's work. 7. ATTACHMENTS: COSA Checklist X Septic System Advisory Well Flow Advisory COSA Checklist blue sheet Nitrate Advisory Arsenic Advisory Other Scp�-Lc'01"(,o V11_/ • Legal Description: Rosebud Hills, Block 1, Lot 3 If more than 1 septic system on lot: COSA Checklist # A. WELL DATA FOR Well log is filed with Onsite (or attached) Date drilled 8/31/95 Total depth 326* ft Cased to 238 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) '18 in. Date of flow test for COSA 1/3/21* Parcel ID: 017-381-38 of Structure served by this system Well production at time of test 1.5* gpm Water storage tank volume None gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by FORGE ENGINEERING Date of Sample 1/26/21 Static water level at beginning of test 153* ft Comments Well deepened on 1/3/21 from 238' to 326'. Well production from log after deepening. Well disinfected after positive coliform sample. B. TANK DATA Age of tank(s) 24 years Tank type/material , Septic/Steel Measured operating fluid level in septic tank 50.5" ❑ Standpipes/foundation cleanout per record drawing Date of pumping 1/29/21 A+ Home Services D. ABSORPTION FIELD DATA Deep Trench Which system tested (date installed) 6/22/96 ❑ ALL standpipes present per record drawing Total measured depth from grade 11/9 ft (max) Measured depth to pipe invert from grade 5.5/3.6 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective 5.5/5.3 FOR 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 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Septic System is gravity flow. Adequacy test date 10/29/20 Results Q✓ Pass For 4 bedrooms Fluid depth prior to test 22/6.5 in Water added 600 gal New depth 39.5/19 in Elapsed time 1440 min Final fluid depth 20.5/6 in Absorption rate >600 gpd Any rejuvenation treatment (past 12 months) NO 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 M Yes if No Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' F,_,� Yes if No Absorption Field on Lot > 100' Rl Yes if No ft Holding Tank > 100' R Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' 0 Yes if No F-11 Yes if No ft if No ft Community Wells > 200' Yes if No Surface Water > 100' ✓® Manure/Animal Excreta Storage > 100' if No. Community Sewer Main > 75' [D Yes if No ft Fv_J Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' F-11 Yes if No ft Surface Water > 100' ft ft ft ft 1i R Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' F11 Yes if No ft Private Wells > 100' 0 Yes if No. Water Main > 10' Fl Yes if No ft Community Wells > 200' ❑✓ Yes if No. Water Service Line > 10' [D 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' U Yes if No ft If absorption field is under driveway comment below Property Line > 10' F/1 Yes if No ft Wells on Adjacent Lots: Water Main > 10' F/I Yes if No ft Private Wells > 100' Yes if No ;j, Water Service Line > 10' F-9 Yes if No ft Community Wells > 200' Yes if No Surface Water > 100' ✓® Yes if No. ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATIONUF1���� I certify that 1 have determined through field inspections and review co • ;y �� of Municipal records that the above systems are in conformance with � TH ' MOA COSA guidelines in effect on this date. ' ' ' r Be01 nja niSchiller CE 12592 �'fl�c • . 2/3/21 . • '�G�s COSA Checklist yellow sheet M ft i10 ft Septic 'Tank Advisory Certificate of On -Site Systems Approval # OSC211040 Subdivision: Rosebud Hills Block:1, Lot: 3 The septic tank for this property is 24 years old. The average life for a steel septic tank is 20 years. Typical replacement costs range from $7,000 to $11,000. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like. Ma�hng Address P O Bax 196650 *Anchorage, Alaska 99519 6650 *www muni org • Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 S I I I I I Certificate of On -Site Systems Approval Parcell.D, 017-381-38 1. GENERAL INFORMATION Complete legal description ROSEBUD HILLS BLK 1 LT 3 Expiration Date: Location (site address) 5501 RIDGEVIEW DR ANCHORAGE AK 99516 Current Property owner(s) MILTON MELLOTT Mailing address Real Estate Agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well (] Individual (] Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: NONE Distance: Received by. Z" Date: e 2 V ( g COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $rJ, , Waiver Fee $ A�6/ Date of Payment 1 1:5— C %b5 Date of Payment Receipt Number 'qoo) Receipt Number COSA # 0�r 16102-11 Waiver # 6. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm SPURKLAND ENGINEERING Phone 279-3916 Address 203 W. 15TH AVE.,STE.202A, ANCHORAGE, AK 99501 Engineer's Printed Name 7-Ae_ a,-, -e Date Zai Junt.ecc•., 6. DSD SIGNATURE System #1 Approved for /� bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: i By: L Original Certificate Dater 4 The Municipalityf chorage 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 engineer's work. 7: ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Y Other COSA blue sheet f ! .. If more than 1 septic system is on the lot: COSA Checklist # -L_of 1 Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: ROSEBUD HILLS BILK 1 LT 3 A. WELL DATA Well type PRIVATE Date completed 8/31/95 Total depth 238 ft. Date of test Static water level Well production If A, B, or C provide PWSID #- Sanitary seal (YIN) Y Cased to 238 ft. FROM WELL LOG 8/31/95 118 1.5 Parcel ID: 017-381-38 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 24+ in. AT INSPECTION 8/19/14 152 0.54 ft. g. p. m. WATER SAMPLE RESULTS: Coliform IYP colonies/100 mL Nitrate �/N!D mg/L Arsenic JL ug/L Date of sample: `lj i f //;2 9 ///Collected by: ANSON MOXNESS B. SEPTICIHOLDING TANK DATA Tank T e/Material SEPTIC/STEEL 6/21/96 Type/Material Date installed Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Date of pumping 8/7/14 C. ABSORPTION FIELD DATA Depression over tank (Y/N) N High water alarm (Y/N) N Pumper MCDONALDS PUMPING Date installed 6/22/96 Soil rating (g.p.d./e or ftz/bdrm) 0.6 System type TRENCH Length 100 ft. Width 1.5 ft. Gravel below pipe 6.5 ft. Total depth 10 ft. Eff. absorption area 1300 ft2 Monitoring tube Y Depression over field N Date of adequacy test 8/19/14 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 3/19 in. Water added 1200 gal. New depth 46/42 in. Elapsed Time: 90 min. Final fluid depth 30/36 in. Absorption rate >= 600 g p d Any rejuvenation treatment (past 12 mo.) (Y/N & type) -- If yes, give date - D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons_ Manhole/Access (Y/N) in. "Pump off' level at in. High water alarm level at in. E. SEPARATION DISTANCES WELL ON LOT TO: Cycles tested Septic tank/lift station on lot 1001+ Absorption field on lot 100'+ Public sewer main NA Sewer /septic service line 25'+ Animal containment areas 50+ Meets alarm & circuit requirements? On adjacent lots 100'+ On adjacent lots 100+ Public sewer manhole/cleanout NA Holding tank NA Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Water main NA Water service line 104 Wells on adjacent lots 1004 ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 101+ Water Service line 10+ Surface water 100'+(N.O.) Curtain drain 50'+ (N.O') Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION i certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name T4 tooCco-ti F. Date Lcu—W Zoos' COSA brown sheet_10-10-12.doc Absorption field 51+ Surface water 100+ Water main NA Driveway, parking/vehide storage 10' Pu°°9 'Agile Bpg,�000 p600E9 Yy �r :. T"EODOR: T, L600RE Municipality of Anchorage J"f Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # 151024 During a recent COSA on-site inspection and test of the potable water supply well on Block 1, Lot 3 of Rosebud Hills subdivision, the well's productivity was determined to be 0.54 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 4 -bedroom residence is 0.41 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. N. H Vol hereby Brod$ that a survey of tai._ ...__. Block -- _ Subdivision was a ,e. the tmprava-menu Sid rated thereon are within the prp[ietty Firs and Jo not overlap or encroach an the property lying adjacent thereto_ that no improvements 0�1 property lying adjacent thereto encroach on the premises in ^Juesaoa and that there are no roadways, €retlssnis,=.ion lines or other Asible easempids on said Property except as indicated hereon. it is tae "as -P lisib/ihiy of the awoef to determars the exlc eoce of any easements, 'ovenanes, Or resit?r dons which do not appear on the recorded subdivision Jia€. Under no circumstances should an,, data hereon be used for C)"Mrtse?iOn or !ar estabAshing boundary or fence tines. (r �• :3ated at AnrhnCaga..4laska, this _ .� �'...---- _._ day of tq- !''ONSYRUCTING E44GENE"S, 1601 Buddy Werner fir. Xneharage,Alaska M6-2000 r _