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ROLLING HILLS ESTATES BLK B LT 6
Rolling Hills Estates Block B Lot 6 #011-072-13 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program. 4700 Bragaw St. P.O. Box 196650 Anchorage. AK 99519-6650 Page of www.ci.anchorage.sk.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: Sw D(o0 t9\ PID Number: Ott —0'42=— f * Conrzk S1265 Wastewater System: [3 New XUpgrade "*V"F lalb B ' Dr. ABSORPTION FIELD Prong RMnbr o BeOvane 9 Kp p T...n O lit b Trw,a, o Bee O MaW O omen LEGAL DESCRIPTION am .n (.� Tar Dpneomapawareae 13 cvorF1' F.. Bract (3 LN &DMw.un L7 Ro\\1n m �S DWM b pt» !,,Mon ll m W"wa h, Gres OPM pwwrn pp 3 F6 FI TPW.MV R/q. SMon Fi aOME tlove agvW p.M &r L&Vh 1—� Fl. l00 Fr. Well: /Jf �//5 tNew [:3Upgrade O. r nrn 5 Hweawawwa Dnwa»a«..w wwa `-I`1ri R. Fi Cia.aayro (Pr W. AJ Q Taw D. in Galeal" Tar mliwawri M P" Www Fl. I Fl JLVJ FIS r SID D.'eler Dre Drr.a Swc Waw Levi ll r Dezn Cons Dale MMu -4 Ft 1; oro Tea Pw.p sr M Cewlp Haat eop Gr TAN K GPM Fl. F! SEPARATION DISTANCES ❑ Septic ❑ Holding ❑ S.T.E.P. ❑ Other To I Septic Absorption Lift Holding lublwjPnvate From Tank Field Station Tank Sewer Line Gal waI 100+ '� � 25 1 •7 Wim..Numaw a Colapenmen. Su"wrw At D. " LIFT STATION LN KI Gr qIM FOutiron • Ioi + —" -P.P M. Y.rr 'Puny aF ivmr Hy.-alw awmM n n C~Dnn V No.1 e. _' ,_ Pu Make a Moor Eim r mi Myaalorw pwwmea q Re s BENCH MARK LPCelan n0 D.wplgn NW CornCn Dec\C A...�neo w.alun MID FI a Inspections performed by: L'3C5 St+vr{Llar`� Dates: 1 Db `S*nl00Q 1XIWI OF At 11 2 � II Ola Development Services Department Approval' E P�'•......., S If i SAI. * *. Conditional Approval Date: 49TH / k. LAAS E. FURKI ND ✓ 11500 Reviewed "] 1 �°FiC, SIGN"� and approved by: _ Date: (An r S o WlOel SAND LAKE SCHOOL SITE (VACENT) INSTALLED 4 -BEDROOM SEPTIC SYSTEM TANK EXPOSED .4 FOUND INTACTED LENGTH 60 FEET WIDTH 5 FEET DEPTH 13 FEET ROCK3-fEf7— — — COVER 10 FEET I I � A H Lrm C N.D49.0' \ BA DONED EXIST/ 01 I H o ses 9xs T NCH PER CO E 1 A REOU/RfMfN IS I 1 I -¢- Well Septic 1 I Area I 1 I e TANK EXP f4• MD IN GOOD COLOT 6 I I I� I Sep Ic!)-¢ Well 1 I rAre OF I I I I LO 1 1 I •. :. 49th• -----J I----------------- I _,.. X 10' W f� - - - �. ' l SPURKLIu1D•�••= C, 25 0 25 50 75 100 125 150 - - - - SCALEt 1' = 50 FT. h�.`.�_n:3���� Ifpu'w 0n0 TH. tng'ne8nnAVENUE LS I I LOT 6 BLOCK B ROLLING HILESTATE I I SEPTIC SYSTEM ASBU/LT ANCH 203. AK. K. 99501 CONRAD SP/LS DATE.• AUGUST 8. 2006 (907) 279-3916 7216 BAILEY DRIVE SHEET. 2/3 GRID: 2126 PERMIT # SVO60191 PID # 011-072-13IPERMIT PID 011-072-13 RdMngHillsEstL6BB2.dwgg O O O p 1250 gal Septic tank o Verified Size and Integrity z _a Shallow Trench z 0 5' Wide a 60' Long 3 13' Deep 3' Sewer rock 10' + Cover P49th %n i...................... ..:t..... �. �. •LAOS SPURKLAND I�ep :, No. CE-11300 NO SCALE Monitor Cleanout 10' + Cover Elev.= 99.0' Bev.= 88.4' Silt Barrier Elev.= 85.3' 3.0 Ft of Septic Rock Effective 1250 gal. septic tank NO SCALE Bench Mark NW Comer Deck Assumed Elevation 100' SPURKLAND ENGINEERING LOT 6 BLK B ROLLING HILLS ESTATE SEPTIC SYSTEM SCHEMATIC 203 WISth Ave Anchorage Ak 99501 CONRAD SPILS DATE, AUGUST 3, 2006 P799-3916-3916 7216 BAILEY DRAT SHEETi 3/3 GRID, 2124 PERMIT f SWO60191 PARCEL ID / 011-072-13 Ro1lingHi11sEs116B82.dwg MUNICIPALITY OFANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SWO60191 Legal Description: ROLLING HILLS ESTATES BLK B LT 6 Design Engineer: 0007 SPURKLAND ENGINEERING Owner Name: CONRAD SPILS Owner Address: 7216 BAILEY DRIVE ANCHORAGE. AK 99502 - Date Issued: Jul 03, 2006 Expiration Date: Jul 03, 2007 Parcel ID: 011-072-13 Site Address: 007216 BAILEY DR Lot Size: 26200 SQ. FT. Total Bedrooms: 4 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 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: Date: r k d 6 Date: 7 Municipality of Anchorage Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519650 www.muni.orglonsite (907)343-7904 ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. oil -oqd- 1 :� Property owners) Conrad Spils Day phone 248-3889 Mailing address 7216 Bailey Drive, Anchorage, AK Zip Code 99502 Site address 7216 Bailey Drive, Anchorage, AK Zip Code 99502 Legal description (Sub'd., Block & Lot) Rolling Hills Estates Block B Lot 6 Legal description (Township, Range & Section) Lot Size ' b , P-Ct) Sq. Ft. Number of Bedrooms 4 THIS APPLICATION IS FOR IS all that apply): THIS APPLICATION IS AN: Absorption Field 0 Initial ❑ Septic Tank ❑ Upgrade El Holding Tank ❑ Renewal ❑ Privy ❑ Private Well ❑ Water Storage ❑ certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of proberty owner or authorized agent) Permit/Rush Fees: yeD oc Waiver Fees: Date of Payment 61b 46� Receipt Number. 0823-f.1 (Rev. 11/05) Date of Payment Receipt Number. Environmental Consulting and Design SEPTIC SYSTEM DESIGN Lot 6 Block B Rolling Hills Estates Municipality of Anchorage June 27, 2006 Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 Subject: Test hole Depth Rolling hills Estates Lot 6 Block B Ladies and Gentlemen: I am writing to request a permit t for the construction of a new septic system for this property. The single family four bedroom residence contains a full basement and the plumbing exits the house 10 feet below grade. On May 30th, 20061 witnessed the excavation of a test hole. Below the organics to a depth of 18 feet silty sand was encountered. I am requesting that we be permitted to install a 5 - wide trench with the bottom of rock at a depth 13 feet below the ground surface. Well logs from the surrounding properties do not indicate any bed rock or impermeable layers to a depth of greater than 100 feet. A test hole excavated on this property in 1978 to a depth of 20 feet did not encounter impervious layers. Waiving the requirement that the bottom of the drain field be 6 feet above the maximum test hole depth will not affect future development of the surrounding properties or impact ground water quality. If you have any questions or concerns, please contact me at 279=3916. Sincerely, Lars Spurk�and, P.E. Civil Engineer 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng@gci.net h SpuNwd EngWoflimg Environmental Consulting and Design SEPTIC SYSTEM DESIGN LOT 6 BLOCK B ROLLING HILLS ESTATE SID Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 June 26,2006 We are submitting an application for the installation upgrade of the septic system for this lot. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 113), the proposed improvements of the lot, of which only the septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable tcstholes are also enclosed. The septic system design is based on the following: No Ground Water Encountered. Use 5 -wide with 2 feet of rock Soil Rating. From Testhole 05/16/05. 2.5 min, m= 1.2 gal per sq.fVday No. of Bedrooms 4 Required Area per Bedroom: 150/1.2 =125 sq.ft. Total area required: 125 x 4 = 500 sgft Bottom Rock At -12 Feet Top Rock At -10 Feet Rock Depth 3 Feet Trench Length: 500/5•.58= 58 Feet USE 60 FEET SYSTEM CONFIGURATION 1250 Gallon Steel Tank TOTAL LENGTH 60 FT TOTAL WIDTH 5 FT TOTAL DEPTH 13 FT ROCK DEPTH 3 FT COVER 8 FT The installation of this septic system will not prevent wells and septic systems from being 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. 203 West 15t° Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng@gci.net SAND LAKE SCHOOL SITE (VACENT) I BLN B I I'I I III LOT 3 I I LOT 4 I I I I ROL L ING HIL L S ES TA TES 50 0 50 100 150 PW 250 369 SCALEr I' = 100 FT. won Ril I BLE, I I LOT 6 C 0 C 0,4t i .. 49th _ SPURKIAND SPURKLAND ENGINEERING LOT 6 BLOCK B ROLLING HILLS ESTATE I I SEPTIC SYSTEM DESIGN I 103 W 15TH. AVENUE CONRAO SPILS DATE: JUNE ?6, 2006 ANCH. AK. 99501 7116 BA/L£Y DR/Vf SHEET. 1/3 GRID: 2124 ' PERMIT #SV060XXX PID 1I 016 -141 -XX K0urngnnr5c54c0DDJ-WW9 I ` T2 Ril I BLE, I I LOT 6 C 0 C 0,4t i .. 49th _ SPURKIAND SPURKLAND ENGINEERING LOT 6 BLOCK B ROLLING HILLS ESTATE I I SEPTIC SYSTEM DESIGN I 103 W 15TH. AVENUE CONRAO SPILS DATE: JUNE ?6, 2006 ANCH. AK. 99501 7116 BA/L£Y DR/Vf SHEET. 1/3 GRID: 2124 ' PERMIT #SV060XXX PID 1I 016 -141 -XX K0urngnnr5c54c0DDJ-WW9 I SAND LAKE SCHOOL SITE (VACENT) INSTALL 4 -BEDROOM SEPTIC SYSTEM V£RIny EXISTING TANK SIZE AND INTEGRITY LENGTH 60 FEET WIDTH 5 MET DEPTH 13 FEET COVER 10 FEET I I I I 1tvEt 1 N EXISTING 1 x - H PER CODE 1 OUIREMENTS I ell, I I CArealc I I VERMY EXSITIN6 NK SIZE AND INT£ lTT LOT 6 N T I I l� I Are re Well �I I I I I � I I I I I I I I I I I LO I I I JI L - - - - - - - - - - - - - - - - -- L_ ' gr A-R-rc [51? — — — 25 -- 0 25 50 75 100 125 150 — — — — - SCALEt 1' = 50 FT. fC,« «49th LAP LA URKLAND Spurk/ond Engineering LOT 6 BLOCK B ROLLfNC HILLS ESTATE SEPTIC SYSTEM DESIGN I P3 W 15TH AVENUEH DATE.• JUNE 26, 2006 ANCH. AK. 99501 CONRAD SPILS Inn7l 97o -:ora 7116 BA/L£Y DRIVE SHEET. GRID: 2l2s q PID # Shallow Trench NV SCALE Sit t Ba 3.0 ft of Septic Rock Effective 203 N15th Ave Anchorage Ak 99501 PERMIT I M90OXX 5' Wide 60' Long 13' Deep 3' Sewer rock 10' Cover Monitor Cleanout 10' Cover NS SCALE 0 Z 3 1250 gal Septic tank Verify Size and Integrity o a 49th W i........„ ....... ...... ......h. Q6 L S SPURKLAND�• f'• No. CE -11500 1250 gat septic tank 9' LOT 6 BLK B ROLLING HILLS ESTATE I ( SEPTIC SYSTEM SCHEMATIC CONRAD SPILS DATES JUNE 26, 2006 7216 RAW AW SHEETi 3/3 GRIDS 2124 PARCEL ID ,/ XX Municipality of Anchorage Development Services Department Building Safety DMslon on -Site Water and Wastewater Program 1700 South Brag" St. P.O. Box 196650 Andwrage. AK 995IM50 www d anchorage BXUS (907) 343-7904 `Soils Log - Percolation Test Performed For. '�Conr$ 115 Date Performed: Legal Desalp0on: (oT % Blk [3 Rol o!j4 Il;lk fSrW L Township. Range. Section: _ WAS GROUND WATER Date ENCOUNTERED? Net Time Depth to Water a IF YES, AT WHAT DEPTH? L O DepmbWnWAMr ..� P alonmoeav?----��E Dara: 4pf _ { 5115 N ' .(ENGINEER'S SEAL) is Pp i9 �MeNM.e.A'eMe.• ''v K • GF't.'?.+J 7 fn's Reading Date Gross Time Net Time Depth to Water Net Drop 5 30 o(o 1010 0 rn in 9 =/ " 5115 N it, (00.130 10 II 0 lh Y S3/'/J1 n 10:23 206^ 103/8" !o I/8 I, b 1 33 30Th;.. 10 3 a 91/4 II 6 5/4 1) 10143 4D m; OIL 10:53 50 '„ i0'la "I LE! .03 61) m? PERCOLATION RATE L r !!) (�) TEST RUN BETN£EN q FT AND 1; FT PERFORMED BY: IONcJ V1 I CERTIFYTHATTHISTES W PERFORMED IN ACCORDANCE W H ALLSTATE AND MUNICIPAL GUIDE 11 S IN EFFECT ON THIS DATE. DATE: MAO k)�_4-1 re_v 4UNICIPALITY OF ANCHORAGE / a DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION ' e 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 \ ON-SITE SEWAGE DISPOSAL_ SYSTEM AND/OR WELL INSPECTION REPORT NAME V PHONE �zz NEW 1_l.A i�Tn�_V C) � Q— -- L �'- �7 I U ❑ UPGRADE MAILING ADDRESS () LEGAL DESCRIPTION LOCATION (5)CIO 1 NO. OF BEDROOMS DISTANCE TO: Well Absorption area Dwelling PERMIT NO. 6 1-2 I- Manufacturer C\ ':>li \ `•Il'aT1C Material No. of compartments to Lin. capacity in gallons -L Ise) 1I IF HOMEMADE: Inside length K) Width V Liquid depth +� I�jj t-1— �02 DISTANCE TO: Well Dwelling PERMIT NO. = Z h Manufacturer Material Liquid capacity in gallons wz DISTANCE TO: Well A-�()�� Foundation �� � Nearest lot line 'oZi� PERMIT NO. (� L 6b J LL Z F -2w No. of lines �77 _ i� Length of each_ fie -a I -I' -- �J _1'r Total length of lines 1() �� Trench ryidiI J lc� inches Dist qce between lines �f�N71 Nj)()e), �. ncH Top of tile to finish grade Material beneath tile, -I Total effective absorption area O 1 finches je _L—_(1 -- Length Width De Depth PERMIT NO. w G a H wa Type of crib Crib i me er : Crib depth Total effective absorption area DISTANCE TO: Well Building foundation Nearest lot line lass Depth Driller Distance to lot line PERMIT NO, W DISTANCE TO: Building foundation Sewer line Septic tank Ahsorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER k' REMARKS TY tIUN \�_ yr rr �rntn _- — _ �'7 t�tlf 1)1rv6'- to A_ V.) S APPROVED �- DATE LEGAL 72-013 (Rev. 3/78P „1_W DRILLING, INC. 5- A DRILLING LOG Well Owner t•1. Tdotttli.: Use of Well 172ni. Location (address of: Township, Range, Section, if known; or distance main road 1.w (; Uuck U 11,0111111”liJ.).lu 1"n1lCten Size of casing ' nep th of Hole 1.U£; ieet Cased to 7.0 7 —8—feet Static water level it. (above) . a(1�Si�wt) land surface. Finish of well (check one) open end Screen ( ); Perforated ( ). Describe screen or perforatio i Well pumping test ar .i (t gallons per (If6tif) (minute) for__1._—h0urs with_ 1 t� ft• of drawdown from static level. .. Date of completion WELL LOG Depth In feet from ground surface Give details of formations penetrated, size of material, color and hardness (' TO 9 C:tr.Jtt • a;t i,cktt t TO 3 (h tnti.t•c TO 20 hn� td C1V 0 It) TO 35Bund TO O5 r, TO 7'i1.1iabd. ' . TO (Y/ 1 % TO I (iii TO TO -To— TO— TO— TO— TO— Gt•ridu-aa :Gia. of .\ :�•, pq ra 0" V41_10 T -1 FT 5" IX 14 R&� to v"lKvh"pqjLU PERMIT NO. ( 780175 ) 8PPLICHNT 7217 BHlLEY 24] Z78��-�-.~ /L �. � ^��^�'�� ����u«\ LOC8TION BH)LEY ST . LEGHL L6 BE: ROLLING HlL|S EST LOT SIZE 26600 SQUARE FEET TYPE OF SOIL RBSORGTION SYSTEM IS: TRENCH % \»\\ MHXlMUM NUMBER OF BEDROOMS = 4 SOIL RATING !SQ THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: |7 164 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRGINFIELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND RND THE ROTTOM OF`THE EXCAVATION (IN FEET). THERE IS NO SET WlDTH FDR TRENCHES THE GR8VEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE HND THE BOTTOM OF THE EXCHVOTION (IN FEET). ' FRIEVulhi 1E 140CA 55 FF F> -r �c v n �'Filh4H l< 41.1 1: it! EE — J Ad 55 two 1T a 001 ".. I.. IJ I y 110,; '-ERM lT HPFLICANT HMS THE RESPOHSI8ILlTY TO INFORM THlS 0EP04TMENT DURING THE INSTALLATION INSPECTONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THRT THE WB -L WILL SERVE. 1 p"IFT < 1 ho A X PATRIFOFIC! 1- 3: 0503 FIFO& fQFFCAk 6 A I&PEE" BACKFILLING OF ANY SYSTEM WITHOUT FINAL. INSPECTION RND RPPROVHL BY THIS DEPARTMENT WILL BE SU8J[CT TU PROSECUTION. F>E!FZPl 1:-F ETNKF> X &V�53 FT L; Em Pi E�i: E�:�: �' ����� LY" SOILS LOG MUNICIPALITY OF ANCHORAGE 04-15D DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST Pouch 6050, Anchorage, Alaska 99602 276.2221 SOILS LOG - PERCOLATION TEST PERFORMED FOR:, V1141 yi l CA- DATE PERFORMED: LEGAL DESCRIPTION:_I.-(7T to D_ts g_.;'•:Y. 78 Date OftG A till L bV-i {_q )3UY$:l;;,E NI, Not Time r,4 OL UVGANht SILT nr, A v 2- ✓ J O , ° ' • 'p O O R LY G'P A'ta 11 r�) 3- u u„ o twt. o I e,,`T' L.et v!/ 11 - , NL.AS1IC_iry 4- -5 V r ENCOUNTERED? O 12 - t ct 5 37 5 Y g_.;'•:Y. 78 Date ML INortGrc,Nhr. SIt s Lev• PI_gsriclT</ Ir Not Time Depth to Water Ir 9- A v I No PLA9SY 11--i'1"y , IICt�IVIjIn 0 01LA-TAN 11v 6 0 v 10- 11 - ;2x-, WAS GROUND WATER S N U L r ENCOUNTERED? O 12 - t ct P L 37 5 Y IF YES, AT WHAT DEPTH? 13� 14 - e, 16- 1 Np I= NES 17- 18- 19- 20 8-19-20 r� t.T.Nh,h; SITE PLAN I, I, IL, 1 LI 0 I tt.Q I 1 too", , Reading Date Gross Time Not Time Depth to Water Net Drop t LLz— tt.Q I 1 too", , Reading Date Gross Time Not Time Depth to Water Net Drop t LLz— O _ © ;2x-, 1 t� _ �l 3L) ,0 37 5 Y 10 _AU -- 1.0 o PERCOLATION RATE_ 5 —(minutes/inch) TEST RUN BETWEEN FT AND FT PERFORMED BY:__1l.t'A_L,A _+A_C),* CERTIFIED BY: Y n I ,n L... MUNICIPALITY NCH® Development Services Department P P Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 011-072-13 1. GENERAL INFORMATION Expiration Date: IR " ` - Z d Z? Complete legal description ROLLING HILLS ESTATES BLOCK B, LOT 6 Location (site address) 7216 BAILEY DRIVE, ANCHORAGE, AK 99516 Current property owner(s) TRACY HIGHTOWER Day phone Mailing address Real estate agent 7216 BAILEY DRIVE, ANCHORAGE, AK 99516 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5-50 Date of Payment `4—ZR "2.,z Receipt Number Sl -0?-c/ y COSA # 05 G22) I < r5 Date: Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY,_ ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 4/27/2022 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to �~ OF A these various and dynamic characteristics and are outside the control of the evaluator of the •�f(i '``4 well and septic system. Therefore, any estimate of how long a system will function satisfactory �rg�Q: • • . ' for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & FW C5 ' 0 *' TH • �'* / . .. ........ 6. DSD SIGNATURE �•'. •"• "'....' (� Curtis Huffman System #1 Approved for / bedrooms �f �Fc�•, CE 128991���� System #2 Approved for bedrooms }�iilFVPROF SstO���� Disapproved Conditional approval for bedrooms, with the following stipulations: �cctcf WATER AND 'J))))111111 ))1 , By: Original Certificate Date: l '2-6Z2. 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: ROLLING HILLS ESTATES BLOCK B, LOT 6 Parcel ID: 011-072-13 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 4/28/1978 Total depth 108 ft Cased to 107.6 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 4/19/22 Static water level at beginning of test 78 ft. Comments B. TANK DATA Age of tank(s) *44 years Tank type/material SEPTIC / FIBERGLASS* Measured operating fluid level in septic tank *47" ® Standpipes/foundation cleanout per record drawing Date of pumping 4/19/22 D. ABSORPTION FIELD DATA Which system tested (date installed) 7/17/2006 ® ALL standpipes present per record drawing Total measured depth from grade 15.5 ft (max) Measured depth to pipe invert from grade 12.7 ft (min) ❑ N/A — pressurized field Structure served by this system _ Well production at time of test 5+ gpm Water storage tank volume NA 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 FES OUTSIDE SPIGOT Date of Sample 4/19/2022 C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: *SHALLOW ST/FIELD DCO/FIELD CO. c -r nr_G Adequacy test date 4/19/2022 Results 0 Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 620 gal New depth 11 in ® Monitor tubes go to bottom of effective. If not, state depth into effective MOA IR TED —SHOWS 2.8'ED* Elapsed time <1200 min ®Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: MT/CO AT END GRADE. ELEVATIONS SHOW WITHIN 0.2' OF THE MOA IR 3'ED NES 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' ® Yes if No Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' Water Service Line > 10' ® Yes Animal Containment > 50' ® Yes if No ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ®Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No Water Main > 10' ® Yes if No. ft Community Wells > 200' ® Yes if No Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l 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. low All TH Curtis Huffman • i T$ �'F� •. CE 128991 A, PRO* * 'S N�`�'-•— ft ft ft ft ft ft ft ft ,09 Fig 9'69 r ,00'06 L 11 „00,00.06 N z....'.. sasodmd uold—}old jo; jo 'scull Apadoid 6w4sllgD}sa jo; O-K—I-L6 •fa2j •6d/qd 'bZLZ •PIJD Hdb :48 pa>10040 votz,-1—goon :Japjo �JoM 'uol}onj}suoo uo} pasn aq uoaJay 0}0p AUD pinoys saouolswnojlo ou japul} -;old uolslnlpgns papjooau ay} uo joaddo jou op 4DlyM s6uhlo} 0�— :alooS Lgb—d :load 82lN �8 uMDaO 90OZ '9Z O.'..'..' AOM—}o—}y6IJ .10 suol}ole;sau 's}uouano0 's}uawasoa ,(uo ;o aoua}slxa gZgg-Lgc, :XD3 20966 D>iSDIV 'a ojoyouy pow otomy ay} aulw�a}ap o} }Iilglsuodsa� s�auMo a41 sl 11 :3iON ANVNOISflIOX3 Sa�� s3 S'��H 6ui��ci� :aUO a 10 �DAa f10 UOSUa S2 L6Z9-Z99 4d OOZ j. S P I 8 8 M O-V$,:Iaa4 aouaj buoyJan0 Ja1oM pa}ou uoy; gay;o ;slxa s}uawyaowaua ou puo saull Aliadad ay} uly}vn ago uoa�ay; pa}on}Is s;uawanojdwl ay; sagl}�ao 6ulMoJp sly} uo uMoys so Aliadold t t l 8 ���18 9 S�MNION3-S�1�NN1��d-S2�O.l3A2inS NOil�(1�11SN0� �8 oNd� llaM 1041 puo t�� a}aiouoD :, >, (S) adldpuD}S ol;daS ay} ;o AaAJnS lools64d o pa}onpuoo soy HD3INVI :NOLLVOIALLN30 A mns llo4dsV.......:::: :uol}dl�osa0 106a1 ci _ :pua6alI SIJJ04 ADr:!g pajapip =a 'NVId 101d V SV 39(1 NOd 03WIOON 38 Ol ION SI JNIMVNO SIHl :31ON I I I mine-sd ,09 Fig 9'69 r ,00'06 L 11 „00,00.06 N z....'.. ....'.'....'.....'....... ..:.. o.............'..'........ ........... .. C4 O.'..'..' ..................'... N O........... ..'.'..... ....'.'..•. .... ..... Cw O O .1-1: ....•.. ... ................. ' m 110128 J ' W � r` 4- 0. \4\ Z z�� W 0 8'1V,4 3snOH 911IISIX3 41 Z'9 -V ,00'0L L 3 „00,69. ois (any adidbo8) (any JSLZ) anuany puZL JSaM z o O O C O C O M- 0 CD m 3 CD O W O L 10-1 cQ �ouolssalo��� ?c a�1 0zo s� sVj o� : uaul}}o Val //_j .J ..:...... 16 ..` MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D.# d 11 — 0-7 - /3 v _ HAA�L cc 1. GENERAL INFORMATION Complete legal description Lot 61 Block B, Rolling Hills Estates S/D gej Location (site address or directions) 7216 Bailey Drive AnrhoragP. AK l?roperty owner .`Stephen Herold _Day phone "Mailing address ,''.PO fox 327, Dutch Harbor, AK 99569 .1 ;Lending agency,- - City Mortgage nnThomas Day phone 263-0764 Mailing address '121: W. Fireweed, Suite 121, Anchorage, AK 99503 Agent _ Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4N 3. TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Ray.1/91) From MOAN21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate forthe number of bedrooms and type of structure indicated herein. I furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on- site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. 5 & S ENGINEERING G �y _ �g 7y Name of Firm 17034 Snglo,���a 1eo« Phone Eagle River, Alaska 99577 Address Engineer's signature Date /o 6. DHHS SIGNATURE ✓ Approved for Disapproved. a Fd uR bedrooms. Conditional approval for Additional Comments UITIC OF y ROBERT C. COWAN `o y CE -8801 y bedrooms, with the following stipulations: Date I?- z �1 - % 9 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-0251Re AM) Beck MOAV21 Municipality of Anchorage pUG p 1999 DEPARTMENT OF HEALTH & HUMAN SERVICES of nN Environmental Services Division M0NIGPA�ttA19ERV 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 39"�sw� Health Authority Approval Checklist Legal Description: Z --c7 ?ioCK e01 -1-/A11- S'ParcelI.D.: QST 10 A. WELL DATA Well type If f ✓ % If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) �L -' Date completed !t 12e1.7:,5 / / n Total depth_ 1 � / _ Cased to Casing height (above ground) Sanitary seal (Y/N) 7 Com__ Wires properly protected!/ I) ea _ FROM WELL LOG AT INSPECTION Date of test Static water level ( /V 4< <--"�:�_8 -` Well production _ / 9 _3 g.p.m. _— .304- —9.p.m. WATER SAMPLE RESULTS: Coliform Nitrate C • 5 Other bacteria 0 X17 — Date of sample:.. 9 Collected by: _�fh✓2- S & S ENGINEERING B. SEPTIC/HOLDING TANK DATA 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 Date installed _/� 8 ��Tank size 1 �GNumber of Compartments 2 Cleanoutsa)_V5 Foundation cleanout �) _ 7 es Depression (Y40 ASO High water alarm (Y/N) _ -04 Date of Pumping/ Pumper_ C. AB13ORPTION FIELD DATA Date installed-}��%/ _ Soil rating (g sddtt' or 2/bdrm System type / 96 f / Length _ ✓ 1- Width_ Gravel thickness below pipe w Total depth_ Effective absorption area Monitoring Tube present&)/ 65 Depression over field efo AVD Date of adequacy test _ Results (Pass/reoa) For _k-OL12 bedrooms i I / u Fluid depth in absorption field before test (in.); 2 2-rr Immediately afterz2o-(gal. water added (in.): / v Fluid depth `»' (ins) Minutes later: Absorption rate g.p.d. Peroxide treatment (past 12 months) (Y/N),& NE MOWN If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed nv /+ Size in Manhole/Access (Y/N) High water alarm level at* Cycles E. SEPARATION DISTANCES on" level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: "Pump off" level at* Septic/holding tank on lot /00 'f` On adjacent lots 1001-,4- Absorption yQ1'f"Absorption field on lot /epo //- On adjacent lots /OU /�- Public sewer main Al A Public sewer manhole/cleanout Al ZA- Sewer /septic service line ) /'f Lift station /V IIA - SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation moi/ Property line Absorption field Water main/service line /0 f Surface water/drainage / % Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line /0 7� Building foundation /0 /� Water main/service line 49/71- Surface 9fSurface water //7o /f Driveway, parking/vehicle storage area /0 /7` - Curtain drain NOAle— 1KN e/Pd /J Wells on adjacent lots /d0 i-�- F. ENGINEER'S CERTIFICATION 1 certify that I have determined thru field inspections and review of Municipal record., et(�NtDo9� Mems are in conformance with MOA HAA guidelines in effect on this date. yP,•+ : Signature �-�•+�-� Ny�� e 1 /+ ,,/eeM�1 11 1 •,pNMY,(�w�y, Engineer's Name �l d 9 f�-2 % C . `- a w,f ✓ y <„< , f� �;��Y iy9-A ROBERT C COWAN I� Date HAA Fee $ )a Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY ANCHORAGE • '� DEPARTMENT OF HEALTH &HUMAN SERVICES �r Division of Environmental Services' On -Site Services Section - P.O. Box 196650 Anchorage;' Alaska • 99519-6650 -- r• 343-4744•ui4';iti^t1,.. _. CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 01 0 3 HAA If IA W" t 1. GENERAL INFORMATION / C 1 Complete legal description m 3 �� 13 �a �� jyya %�; !d1 (alitr_ SIU Location (site address or directions) 7:211 Property owner _� l� . _ _ �9K4 2es Day phone 2'i 3 - 3 70 _ Mailing address Lending agency G7 �Ac� �t' C)de-1 Day phone Mailing address ('o D 1 L - O ✓ Agent lti Nva �dr�iv, Day phone Address ;z0j C,S(„�v� Unless otherwise requested, HAA will lllbe held for pickup. 2. NUMBER OF BEDROOMS: —� 3. TYPE OF WATER SUPPLY: Individual well —� Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site — Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADF-C attesting to the legality and status of system. 72-025(Rev. 1/91) .Front MOA 421 2A Vow A098 (l6R'ABU) SdRZd -�aoM s, eau!6ue !euo!ssaloid aql ui suo!ss!wo jo saoaaa aol a!q!suodsaa IOU el e6eaogouy to Alped!o!unw eqi •panesi si aleoippeo a ajolaq elep az leue ao suo!loadeul lonpuoo IOU OP SHHCl to se9Ao!dw3 •sluawaa!nbaa alels pue !eaepal upped A}s!les olaap.)o ui suo!lnl!lsul bu!pual magi pue sawoq to siesepind of Asapnoo a se sigl seop SHHG eql TMse!y;o WIS sql ui paaelsiBei jeau!6ua !euoisseloid luepuedeoul ue Aq anoge g gdeAcued ul u9n16 suo!leluesaadaa aql uodn A!uo paseq saleol;!pap !enoaddy ; Alpogjny ylleaH sonss! (SHH°) seolnaaS uewnH pue ylleaH to luawpedaa a6eaoyouy jo Alpad!o!unW eqi :suoile!ndils 6uimo!!oj aql ql!m 'swooapaq •swooipaq sluawwOO !euoll!Ppy ao� !enoadde !euoll!puoo''- •panojddes!° aol panoaddy P: 3anIVNDIS SHHO 9 k _ y �.�vr� � aanleu6!s s,�aau!6u3 id vn q 9 /x z ssaappb' lbs -b ouogd �� l%f �'�lA 5 14 jj67 wa!d1oaw3N •uo!loedsui sigl to alep eU1 uo loajja ui suo!le!n6aa pue 'seoueu!po 'sepoo alelS pue led!o!unW Ile 4l!m eouei!dwoo ui s! walsAs !esods!p aalemalsvm ao/pue A!ddns aaleM el!s-uo a41 'uo!loadsui pue uo!l36!lsanW Auk woal pue sal!} 96eaoyouy to Al!!ed!o!unyq aql woal pau!elgo uo!lewao;ui aq1 uo paseq leglAI!JaAaa4pn;1 •uiejeq poleo!pui ainlonalslo 9dA1 pue swooapaq;o aegwnu 9q1 aol alenbape pu3 !euo!lounl'ales s! waleAs !3sods!p aalennalsem io/pue Alddns aejLam ails-uo eql legl smogs uo!1eo!ldde !enoaddy A1!ao4lny ylleaH s!43 10 u01136118anu! Aw 3343 AluaA I 'Mo!aq umogs alep uo!lep!!eA ag110 se pue olaaaq pax!lle leas Aw Aq pa!1!pao sy 833NION3 AS N01103dSNl d0 1N3W31t/1S 'S u 4 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: --JDT6 RV- 13 Parcel I.D. o t l 0 72 15 Rot_I_.INC� t-FtLt_s A. WELL DATA Well type _R F•5 If A, B, or C, attach ADEC letter. ADEC water system number N/A Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump level Date completed y1?817B _ Driller H Cased to FROM WELL LOG r} ZR � 7_6 / `c3 Casing height Wires properly protected (Y/N) AT INSPECTION G'�il ill g.p.m. �� , t�� g.p.m. j�e 'Cfc �I SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot IDS ; On adjacent lots I l70 Absorption field on lot On adjacent lots 1 &0 + Public sewer main N/6 Public sewer manhole/cleanout Public sewer service line — N//& Petroleum tank N/.A. WATER SAMPLE RESULTS: Coliform — Nitrate rr —�� _ Other bacteria CI Date of sample: II z.' el I Collected by: r) - _,�- B. SEPTIC/HOt:DTNG TANK DATA Date installed 7/UJ 7,6 Tank size i 0 Compartments 2 Cleanouts (Y/N) Foundation cleanout (Y/N) )' Depression (Y/N) High water alarm (Y/N) 17.4 Alarm tested (Y/N) Date of pumping r�9, Ayte,n. �eas Pao( SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well (s) on lot On adjacent lots Foundation To property line 60 i' Absorption field I D Water main/service line b0 Y Surface water/drainage N/k 72-026 (Rev. 3/91)Front MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION N/ Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at "Pump off' level at High water alarm level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed - '/'f/7A Soil rating )9) System type i 2�NGN Length 105 Width Gravel thickness Total depth Total absorption area 7dro Cleanouts present (Y/N) i Depression over field (Y/N) N Date of adequacy test "41191 Results (pass/fail) t�aS5 for bedrooms Peroxide treatment (pas( 12 months) (Y/N) If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 115 On adjacent lots 1 00 f Property line e20 To building foundation To existing or abandoned system on lot NZA On adjacent lots 70 Cutbank NSA Water main/service line 50 t Surface water N/A Driveway, parking/vehicle storage area 75 ± Curtain drain ni E. ENGINEER'S CERTIFICATION 1 certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature n r Engineer's Name 1 0b be v( JpU.1 �a Date HAA Fee $ ��-®' Waiver Fee: $ Date of Payment </� t sI Date of Payment Receipt Number o�l �V Receipt Number 72-026 (Rev. 3/91) Back MOA 21 � LEGAL: LOCATION: OWNER: RESIDENCE: WELL: �^ L.,.- oO�h F""= 1E.� 675lN^011ON0BLVD, ANCHORAGE, ALASKA 99502-JY04 (907) 248-5095 SEPTIC SYSTEM ADEQUACY TEST Lot 6, Rlrck P Rolling Hills Estate 7216 8ailey Drive Ril] Rompa Single Family, 4 Hied rnoms Privat�, On Site SEPTIC SYSTEM: FROM MUNICIPAl- RECORDS: 4 Bedroom Systmm TAN�: Sunset Plastic 1250 Gal. Two Comparts. ABSORPTION SYSTEM: Trench ADSORPTION AREA: 780 Sq" Ft. SOIL RATING: 191 INSTALLATION DATE; 7/11/78 DATE OF LAST PUMPING: Anch^ Cess Pool June 17, 1991 DATE OF TEST: June 11, 1971 TEST PROCEDURE: System was inspected and measured. Tank was found with 9 feet of cover and with a liquid level of 52 inches. Trench clean out was 10 deep and dry" Trench monitor tube was 14.5 feet deep with 34 inches of water -.600 gallons of clean water was added to the trench while the water levels in the tank and the monitor tube werw monitored. The water level in the tank rose 3 inches, while the level in the monitor. rose 15 inChes" Six hours after adding the water the level in the monitor had dropped 10 inches, indicating that 400 gallons of water had heen absorbed" TEST RESULT: This system meets the code requirements of 1' the Hea]th and Social Services Department of the Municipality of Anchnrage. NOTE The operatinnal life of all septic systems depends on the lnral soil conditinns, groundwater levels that may floctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long this system will funrtion ti f t ry for current or future occupants. ' �5 -:- L..,_ e-1 lf�ll ID lf=" .. E7- 6751 1,1. 7-Q5iW. 0N00BLVD^ AUC80KNG/ALASKA YY502-J904 (Y07>248-505 RESIDENTIAL WELL INSPECTION LEGAL: |ot 6 R.toct B Rolling Hills Estate LOCATION: 721/, Bailey Drive OWNER: 1 -Dill Rompa TYPE OF WELL: Private, Single Family WELL LOG AVAILABLE: Yes INSTALLATION REQUIREMENTS MET:Yes WELL_ YIELD FROM WELL_ LOG: 18 Gallons per Minute PUMP YIELD FROM TEST: DATE OF INSPECTION: 5^5 Gallons per Minute June 11 1991 TEST PROCEDURE: Well was pumped at a constant rate while the drawdown was monitored with an acoustic prob�. At the beginning nf the test water level was found at 81 feet below top of casing. At a pumping rate of 5,5 gallons per minute the water level dropped 1 foot to 82 feet, A total of 600 gallons were pumped, TEST FOR E.COLI AND TOTAL NITROGEN: Water was tested for F,Coli and total nitrogen un June 12, 1991 E.Coli O. Total Nitrogen 1.3 mg/l^ Max. allowable Tota] Nitrogen 10 mg/l. TEST RESULTS: This wel] meets the requirements of the ^ Municipality of Anchorage" THIS WELL WILL PRODVCE`MORE THAN 3GALLONS PER MINUTE FOR MORE THAN F15URHOURS The Muniripal requiremenL fnr well flow is 150 gallons of water per bedroom per day. This well exceed this requirement. The assessment of the condition of the well applies nnly to the conditions as of the day tested. The flow rate may change due to suhsurfrAce concjitipns that may not be nb�erved from the svrface, and c.hanges in the land use and other factors t ha t in 4 a c t t aquifer feeding the well. AV ' w^°~I'— i , Il' Tob - CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING �nooanronv 5633 0 STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 LL �T ANALYSIS REPORT BY SAMPLE for WORKorder# 35124 Date Report Printed: JUN 12 91 @ 15:55 Client Sample ID:POTABLE WATER L6 BE ROLLING HILLS PWSID :UA Collected JUN 11 91 @ 11:00 his. Received JUN 11 91 @ 16:40 his. Preserved with :AS REQUIRED Analysis Completed :JUN 12 91 Laboratory Supervisor STE HEN C. E�DE,/ Released By Chemlab Ref It: 912652 Lab Smpl ID: 1 Matrix: WATER Parameter Tested ------------ NITIIATE-N Sample ROUTINE SAMPLE COLLECTED BY: T. SPURKLAND. Remarks: Client Name :TOBBEN SPURKLAND, P.E. Client Acct :TOBBENS BPO # PO It NONE RECEIVED Req It Ordered By Send Reports to: 1)TOBBEN SPURKLAND, P.E. 2) Result Units Method ---------------------------------- 1.3 mg/l EPA 353.2 Allowable Limits 10 --_.-.._:._ 1 ...... _.=..=.e.-=...._`==-..o....=.-i--=.--........--_.-,.-,.--..- Tests Performed ' See Special Instructions Above UA -Unavailable ND= None Detected See Sample Remarks Above NA= Not Analyzed LT -Less Than, GT -Greater Than `Sk_o I�t1»� .h.r i;3onm - - MUNICIPALITY OF AN F16VA91- i DEP�.'ZSF HFAti l - Lc„I r Ir!'.I IISOim ANC, OR!"GI ENVIRONMENTAL P�J)iFCTION [)/�t i .I AH IVIS d f or HL/ -6'. I I t v) (iiMM tlTAL PROTECTION /r/ - _ e.. I Stet . Anclm :.�.: A Il ka 9A!i(11: 8 I NOV 2 8 197 ,: IALc.i\C,i Nfckf{11,,, �. DIVISIONKw� - - I lefnt,re2f>G.4, o RECEIVED i I OIILS' FOR API ROVAI )F 0MT)It!!1)UAL VVAI fR AI\ID SEWER I ACIl I11FS ....... _ .. __ --------- i - Of RF.f TIONS: ( iii ll. tc r R on r• 1. 1 ne,emplote mel rose sill not he Pr ocessed, P[ ease a Il ow ten( i0) clays for Pi occ ;ine. 243 3708 7216 Bailey D7 Anch., AK ...�rrl iflr: eM Lor.t ar <evel PIrOPJ E.__ mixXXXXXymm 1{. Same as Above 1 Alaska Mutual Savings Bank 1v �\�At��L^�1 _ X274 3561 -- PO Box 1120 Anch., AK n/a Lot 6 Block-_ B Rollin Hills Estates I 721b Bailey Dr YI XX - - NUMBrIi Or BRUBOOrbi� - 0 one CN Four III Over__- - SINGLE FAMILY ❑ Two El Five f .I MLJLrlPI, l FAM. 11. ( ❑-:Three - Cl SIv - KX INUIVIDLJAL' ATTACIi WELL LOG. A ,well log 4 required for all weIN dlll,rd C7 Com miliml Y- - sine tnc 1976, For vvcl(sdrilled prim to that date, Clive well -. .) f'LIh L.iC I_,Thf_IT`r' depth imlarn ink if avai Wile.l. - - - - - - ----------- ..__. ..m . 8. ,r l.LtvAGf LL.!t,,t\I-:,1..tChj _...._J___ ...,. �-___.. _.—__—..------- "11: indiv dwil!on-sl te, qive installn [ion disto.- 4-1[0-6 -- - i ,_____'"Irindivdwil!on-site,giveinstalln[iondlte-_4-1[0-6--.:i f sv ten; is over two j2) years old an axle mM test A required - 1._:I ,PUL'LIC U-fILLI'Y b/ this Uepsrtment. NO'Vl." 1 HI- INSt E.0 UOfJ FEE MUST ACCOMPANY FAMI RI.OUEST BEFORE -PROCESSING CAN DE Iii,n IAYED. - - !zc!o(.>nal 72010 (l;ev. 3/78) '1ITIS SIDE I-GP. OFFICIAL. USE ONLY uAle t:Lct:n7cD - II'•1SPC:C'I-ION; ili`QINTft75N'fS fl" II IxL - - ----- TI'P r3 ')A TF, IJAIi l - ---� �----""---- - - - INSPECTGR---------------� IN51'ECTOR - IfJSPECTOR 1.1YP•EOPRESIDENC17 NUMBER OF BEDROOM —�- D SINGLE FAMILY ❑ ONE CJ THREE_ O FIVE 7 01-HER ❑ MULTIPLE FAMILY LJ TWO CJ FOUR I-] SIX 2. IVA'(ER SUPPLY I°Ell lvllT nluf.nuerc ❑ INDIVIDUAL DEPTH OF WELL. ❑ COMMUNITY —-- --- DALE DRILLf_D ❑ PUBLIC UTILITY - Connection Verified___-_-- LOG RECEIVIZD 3. SEWAGE DISPOSAL SYSTEM - PEF nalT NUM 3ER -_.- �- CDINDIVIDUAUON SITE -DAmEms7Al-Leo -- - --- ---- ------------ ❑PUBLIC UTILITY Connection Verified_ _ INSTP.LLER� El Sept�ic1Tank or ❑ Holdinq Tank Tank is hotnemade 7,OI I_S RATING give dimensions: TYPE Of" TANK MANUFACTUR R TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Se otic/Holdin< Tank Abson tion Area 1 J � Sewer Line Neares[ I_o[ Line WELL T0: A6501"1)11011 Area IO nowest LU( Line ~5. I__{J APPROVED FOR _'4'"' - __ BEDROOMS CON DI-i ZONAL. APPROVAL (letter nntst accompany certificate) C,7 DISAPPROVED ---- _ UAIII� --FiV� it�) _ -f^-� � L[GAI. DFSCilIP'FION - - II 72010 (l;ev. 3/78)