HomeMy WebLinkAboutROSEBERRY PARK ESTATES BLK 1 LT 3RO
b try Park
Estates
Block I
Lo1'
#050-315-28
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program, 4700 Elmore Road
P.O. Box 196650 Anchorage, AK 99507 Page / of,--~
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: O ..~-~/[(0 ~O' Pig Number:
Address: ~ 0 ~7 7 2¢~[, ~ ~ ABSORPTION FIELD
Pho~e:~ ¢~__~ ~SS Number of Bedrooms~ ~eep Trench ~ Shallow Trench ~ B~ ~ Mo~d ~ Other:
LEeAL DESOR~PT~O" Soil Rating: X ~ G"D/Ft' T°talDepthfr°m°doi"~lorad~ ~ Ft.
Block: Lot:~ /'0~~ p~ Depth to pipe bottom from original grade:~; g Ft. Gravel depth beneath pipe: Ft.
Well: ~ New U Upgrade Gravol width: % Ft.Ft
Classifi~tion (Pri~e, A. B. C):¢ Total Depth: ~ Cased to: Total
t0¢'~¢ ~ Z~OFt ¢~ Ft absorption area:
Driller: __ __ Date Dril[e¢ * ' StaticWate/Level' ' Installer: 7¢0
~e : ] Pump Set at: Casing Height ~ove Ground:
SEPARATION
DISTANCES
~Septic ~ Holding ~ S.T.E,P. ~ Other:
Tank Field Station Tank Sewer Line ~ ~ ~O ~ Gat.
Well /~O~ /~0'* -- -- :~ ~ ~ Materia,~ Number of ~a.ments:
S ufiace Water /~ 0 '~ /~0~ - ~ ~ LIFT S~ATI05
Foundation ~ ~ ~ -- "Pump oW level at: ~' ,eve, at:/ in, High water ala~ at:
Cudain Drain ~ ~ ~ ~ Pump Make & Model~ Electd~l Insp~ns pedormed by:
Remarks:
BENCH MARK
: Lo~tion and Descript~
Assumed Elevation:
Inspections pedormed by: /Uf~ ~(~ /~¢)' Dates: 1st
2®
Development ad.ices Depa~ment Approval
Conditional Approval Date:
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Pump Lu~zller
AWPS, INC.
PAGE
01/01
Well Log
Permit Number: OSP 141080 Date of Issue ra~2o'vl Parcel Identification Number:
[)ate Started: $1912011 [)ate Completed: 6/10t2011 Is well located at approved permit location'?
Property Description ROSEBERRY PARK Lot 3 Block I Section: Town:
Property ()whet Name & Address:
"Borehole Data: '
Soil fypc, Thickness & Water Strata
Casing Stickup
Overburden
Silt Sand Gravel
Hardpan
Sand Gravel Clay Dense
Brown i~,drock
Gray Bedrock
Gray & White Bedrock
Gray Bedrock
Gray & White Bedrock
Gray Bedrock
Dark Gray Bedrock
Green Bedrock
Gray Bedrock
Gray & White Bedrock
Water Sample Results:
Arsenic:
Nitrates
'lotal Colifbnn Bacteria
Other bacteria:
05031528000
X Yes !No
Range:
MICHAEL QUINN CONSTRUCTION
PO BOX 772641 EAGLE RIVER, AK 99577
Depth
From To
Method of Drilling :x i air rotary cable tool
Casing type:
Wall thickness 0.2s inches
Diameter 6 inches Total: 64 feet
Liner type:
Diameter inches Depth: t~et
Casing stick2up above ground: 2 feet
0 2
2 4
4 15
15 39
39 59
59 71
71 105
105 t08
108 160
160 164
164 247
247 269
269 304
304 331
331 340
rog/1
ct) ionies/100m L
Static Water Level(t~om top of casing)
Pumping Level: (~et after
~ hours pumping gpm
Recovery Rate 2 gpm
Method of Testing: Test Pump
Well Intake Opening Type
i Open End X Open ttole
Screened Start t~et
i ! PeHbrations Start feet
39 t;2ci
Stopped feet
Stopped fket
Grout Type: Bentonite dry granular Volume: 100 Pounds
Depth 44 Start 0 feet Stopped 44 63et
Pump Intake Depth: feet
Pump size: HP brand name
Well disinfected upon Completion? x Yes No
Method of disinfection CHLORINE SO PPM
Comments: WELL RECOVERY IS AFTER HYDRO-FRAC
i Well Driller:
:Cole Sullivan
Sullivan Water Wells
P.O. Box 670272
Chugiak, AK 99567
col/100mL (907) 6811-275'1t
210
On-Site Water & Wastewater 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: OSPl11080
Tax Code Number: 05031528000
Work Type: WellSeptic Initial
Permit Effective Dates: June 06, 2011 to June 05, 2012
Design Engineer: NORTH RIM ENGINEERING
Subdivision: ROSEBERRY PARK ESTATES
Site Legal Address: ROSEBERRY PARK ESTATES BLK 1 LT
Owner/Address: MICHAEL QUINN CONSTRUCTION INC
PO BOX 772641 EAGLE RIVER AK 995772641
3 G:0154
Site Mailing Address: 18618 OUTLOOK CIR, Eagle River
Lot Size in Sq Ft: 47617
Total Bedrooms: 5
This permit is for the construction of:
Y Disposal Field Y SepticTank N Holding Tank N Privy Y 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.
Received By: ~-"~'~, Date:
Issued By: ~;-~ ~/~ Date: ~/~,
Community Development Department
Development Services Division
On-Site Water & Wastewater Program
UNICIPALITY OF ANCHORAGE
Phone: 907-343-7904
Fax: 907-343-7997
Mayor Dan Sullivan
ON-SITE SEWERNVELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. ~) 5'~'"' ~' ] 5 - ~-~ oc~
Property owner(s) //~, f~ (~J r ~ '~
Mailing address ,? Go ~ o ~' ~ 71
¢'fff /
Site address ~_~..jf fo o t?... ~__.., ~ ~ (~
Legal description (Sub'd., Block & Lot) /~,~ ~ ~¢7 ~
Legal description (Township, Range & Section)
Lot Siz~ ~q. Ft. Number of Bedrooms
THIS APPLICATION IS FOR:
([~ all that apply)
Absorption Field ~
Septic Tank ~
Holding Tank []
Privy []
Private Well /~
Water Storage []
Day phone
THIS APPLICATION IS AN:
Initial ~
Upgrade []
Renewal []
THIS
APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
I 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 oCpr~y owner or authorized agent)
PSi;mit/Rush Fees:
Date of Payment:
Receipt Number:
Permit No. i~.1: ~':~ '::'~
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
G:\Building\On Site\Forms\Client Forms\Permit App_010411 .doc (Rev. 1111 )
MEMO
Steve Eng, PE, PH
P.O. Box 770724, Eagle River AK 99577
(907) 694-7028 tel
northrimeng@aol.com
Date: 6/6/11
Number of Pages:
To: Debby Wockenfuss
MOA On-Site
Subject: Roseberry Park Estates, Block 1 Lot 3
5/27/11 Comments, Septic System Design
Debby:
The following replies to your 5/27/11 comment sheet:
1. Property lines were checked & redrawn.
2. Engineers cover letter herewith.
3. Neighboring properties are undeveloped, or no development within 200 feet of the proposed
wastewater site.
4. New signatures included.
5. 4 foot effective depth to the invert of the pipe.
The subject property has ~mostly undeveloped neighboring properties, with no other
conflicts. Large lots are present in the subdivision with no conflict. The lot is level at the front
and slopes to the south.
Please review the wastewater system design & well location for the proposed single family home.
I have included design plans & specs, design guidelines, & soil tests. If there is need for
additional information or clarification please give me a call.
Thanks-Steve___. ..............
Roseberry Park Estates, Block 1, Lot 3
SPECIFICATIONS & DESIGN GUIDELINES
Wastewater System Sizing: This is a new 5-bedroom, single family home. This is a new
subdivision and most of the neighboring lots are not yet developed. These lots are large
and are served by public water. No adverse impacts are expected from development. No
conflicts to the other lots will take place by this septic system construction. The
easements are located on the drawing and are not encroached upon. Soil tests revealed
sandy soil with low silt. An application rate of 1.2 GPD/FT2 with 0.5 reduction factor for
utilizing a 5' wide trench. Trench Length = 625 FT2/5 'x .5 reduction factor = 63'; 1 line
~ 63'. No bedrock was encountered or groundwater was encountered.
Specification Requirements: All components and work must comply with the
Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water
Regulations and Wastewater Regulations.
· Two compartment, 1500 gallon septic tank. Watertight couplings on inlet & outlet.
· 5' minimum between the tank and bed. 10' to property lines.
· 3' of cover or insulation is required for trench; an equivalent of 1" insulation for each
foot soil cover.
· Tank & solid pipe must be set on well compacted, stable soil.
· 4 inch diameter cleanouts with airtight caps are required 1' to 4' from foundation
wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two
adjacent opposing cleanouts between the tank and the absorption field, not more than
10' from the tank positioned to provide cleanout access towards the tank and towards
the absorption field.
· All cleanouts must extend to at least ground level.
· In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron.
· Trench to be placed level, minimum of 4' to groundwater, 6' to bedrock from drain-
rock.
· Drain rock to be ½ inch to 2 ½ inch screened. Drain rock to be distributed uniformly
throughout the trench.
· Perforated pipe to be installed level with perforations down.
· Silt barrier (filter fabric) to be installed above the drain rock.
· Smeared trench sides must be raked or scarified before drain rock placement.
· Backfill over drain rock must not be less than 36".
· The finish grade must be mounded to promote drainage over the trench.
· Insulation must be placed over any pipe installed under driveways or parking areas.
· Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789,
ABS ASTM D2661,
· Sewer Service Line is minimum 2% slope.
· Septic Tank to be pumped every two years or when required.
· Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal)
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SBILS LBG - PERCBLATIBN TEST
Per~orned For; Lee Coy
1
3
4
5
6
7
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9
10
11
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13
14
15
16
17
18
19
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DEPTH
(FEET)
_ .
Organic
SP/GW
Sand w/
Water
Groundwater Observed;@ 15'
Depth To Water AFter Monitorin9: 14,5'
Date oF Monitor: 11/23/03 & 5/i/04
Dc~e Gross Time Ne~c Time Depth Ne~c Drop!
4/2! 0 5"
4/P1 1 1 min, 6" 1"
4/81 3 4,5"
4/81 5 1 min, 5,5" 1"
4/al 7 -- 4,, __
4/21 8 1 min, 5" 1"
Percolation Rate; 1 min,/inch
Pre-Soak Seeped Away In Under
Perc Ho~e Diameter = 6H
Test Run Between 3' and 4'
10 Minutes
PerFormed in Accordance with AIl State/Municipa[ Guidetines in ECFect tk
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WATER SUPPLY PERMIT
Initial
Date Issued: Sep 29, 2009
Expiration Date: Sep 29, 2010
Permit Number: SW090190
Legal Description: ROSEBERRY PARK ESTATES BLK 1 LOT 3
Design Engineer: 0838 NORTH RIM ENGINEERING
Owner Name: MIKE QUINN
Owner Address: PO BOX 771641
EAGLE RIVER, A 99577-
Parcel ID: 050-315-28
Site Address: OUTLOOK CIRCLE
Lot Size: 63000 SQ. FT.
Total Bedrooms: 0 Permit Bedrooms: 4
This_ permit is for the construction of:
E~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 B~~~;~ ~/(//'~~~¢'''~ ~'
Date:
Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Road
P,O. Box 196650
Anchorage, Alaska 99507
www. muni.org/onsite
(907) 343-7904
ON-SITE SEWER/VVELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D.
Property owner(s) ~/' ~("~- L/"~,_, (,1 -%
Mailing address ~ (::~. ,~'¢,< '7'"~---2~'/T/'/
Site address ~,.~ '(-fo ~ ~-~ O-~,,'e'/~
Legal description (Sub'd., Block & Lot)/~0.5¢-~¢-~a~ /~.r' ~L
Legal description (Township, Range & Section)
Lot Size ~/. ~'/'~'O~-~... Sq. Ft. Number of Bedrooms
Day phone
Zip Code
Zip Code
THIS APPLICATION IS FOR ([~] all that apply):
Absorption Field
Septic Tank
Holding Tank
Privy
Private Well
Water Storage
THIS APPLICATION IS AN:
Initial ~
Upgrade []
Renewal []
I 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 property owner or autt75ri~d agent)
Permit/Rush Fees:
Date of Payment:
Receipt Number:
(Rev. 11/05)
Waiver Fees:
Date of Payment:
Receipt Number:
I L~?~INEERING
NodhRim Engineering
PO Box 770724
Eagle River. AK 99577
907-694o7028
September 22, 2009
MOA On-Site Water & Wastewater Program
4700 Bragaw St
Anchorage, AK 99519
RE: Roscberry Park Estates, Block 1, Lot 3
Water Well Permit & Septic System Permit
The referenced property is undeveloped as are the neighboring properties. There is no
water or wastewater development within 200 feet of the proposed water well site. The lot
slope drops offto south of the lot. The likely location for the future wastewater system is
at the test hole location on the drawing.
Please review the well location for the single family home. If there is need for additional
information or clarification please give me a call.
Sincerely,
Design Enclosures
Roseberry Park Estates, Block I, Lot 3
SPECIFICATIONS & DESIGN GUIDEI,INES
Wastewater System Sizing: This is a new 4-bedroom, single family home. This is a new
subdivision and most of the neighboring lots are not yet developed. These lots are large
and are served by public water. No adverse impacts are expected from development. No
conflicts to the other lots will take place by this septic system construction. The
easements are located on the drawing and are not encroached upon. Soil tests revealed
sandy soil with Iow silt. An application rate of 1.2 GPD/FT~ with 0.5 reduction factor for
utilizing a 5' wide trench. Trench Length = 500 FTV5'x .5 reduction factor -- 50'; I line
(~ 50'. No bedrock was encountered or groundwater was encountered.
Specification Requirements: All components and work must comply with the
Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water
Regulations and Wastewater Regulations.
· Two compartment, 1250 gallon septic tank. Watertight couplings on inlet & outlet.
· 5' minimum between the tank and bed. 10' to property lines.
· 3' of cover or insulation is required for trench; an equivalent of 1" insulation for each
foot soil cover.
· Tank & solid pipe must be set on well compacted, stable soil.
· 4 inch diameter cleanouts with airtight caps are required 1' to 4' from foundation
wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two
adjacent opposing cleanouts between the tank and the absorption field, not more than
10' from the tank positioned to provide cleanout access towards the tank and towards
the absorption field.
· All cleanouts must extend to at least ground level.
· In solid pipe runs, ASTM D-3034 may be used in lieu ofcast iron.
· Trench to be placed level, minimum of 4' to groundwater, 6' to bedrock from drain-
rock.
· Drain rock to be ~ inch to 2 ~ inch scrccncd. Drain rock to bc distributed uniformly
throughout thc trench.
· Perforated pipe to be installed level with perforations down.
· Silt barrier (filter fabric) to be installed above the drain rock.
· Smeared trench sides must be raked or scarified before drain rock placement.
· Backfill over drain rock must not be less than 36".
· The finish grade must be mounded to promote drainage over the trench.
· Insulation must be placed over any pipe installed under driveways or parking areas.
· Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789,
ABS ASTM D2661,
· Sewer Service Line is minimum 2% slope.
· Septic Tank to be pumped every two years or when required.
· Insulation board to be extruded direct burial polystyrene (Dow Styrofoam Itl/equal)
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SOILS LBG - PERCOLATION TEST
PerForMed For: Lee Coy
DEPTH
(FEET)
9- 0.-':"
15- '' '
19 -
20 -
Organic
SP/G~
Send w/
Grcvet
Groundwoter Observed: ~ 15'
Depth To ~oter AFter Monitor ng 14,5'
Dote oF Monitor: 11/83/03 & 5/1/04
D(zi;e Gross Tine Nei: Tine Dept;h Ne't Drop
4/21 0 -- 5, --
4/21 1 1 nln. 6' 1'
4/21 3 -- 4.5' --
4/21 5 1 Min. 5.5' 1'
4/81 7 -- 4' --
4/21 8 1 nih. 5' 1'
Percototion Rote, 1 Min./inch
Pre-Sock Seeped Awoy In Under
Perc Hote Diometer = 6'
Test Run Between 3' ond 4'
10 Minutes
PerForMed in Accordonce with Att Stote/Municipot Guidetlnes in EFFect
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www. muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 050-315-28
COSA # O~Q~
Expiration Date:
GENERAL INFORMATION
Complete legal description Roseberry Park Block 1 Lot 3
Location (site address) 15515 Outlook Circle, F,a§le River, AK 99577
Current Property owner(s) OuLrm, Md<e
Mailing address same
Lending agency
Mailing address
Real Estate Agent Dee Quinn
- Mailing Address RE/MAX, Eagle River
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 6
Day phone 694-4955
Day phone
Day phone 694-4955
TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class ~
Public Water System
Well
TYPE OF WASTEWATER DISPOSAL:
[] Individual On-site []
[] Individual Holding Tank []
[] Community On-site []
[] 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, 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 NorthRim Engineering Phone 694-7028
Address PO Box 770724, Eagle River
Engineer's Printed Name Steve Eng Date 10/2~/2011
Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. 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 inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the
water usage of the family being served by the system. The operational life of all well an~,~e~§qg~:~s are
subject to these various and dynamic characteristics and are outside the control of the
evaluator of the well and sept c system ,~,'~..~3
DSD SIGNATURE ~ "~~"'"
~/ Approved for G bedrooms :{;~5~:%
....
Conditional approval for bedrooms, w~th the following sbpulabons:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
X
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By:~~o~/~
(Rev. 11/05)
Original Certificate Date: / O - ~ '7'- 1/
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www. muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Well Log (Y/N).~' 7
Sanitary seal (Y/N) Y
Cased to
FROM WELL LOG
6/lo/11
39
mg/L
Legal Description: Roseberr~ Pa~k Block 1 Lot 3
A. WELL DATA - Public Water
Well type P If A, B, or C provide PWSID #
Date completed 6/'/0/1_1
Total depth 340 ft. 64 ft.
Date of test
Static water level ft.
Well production 2 g.p.m.
WATER SAMPLE RESULTS:
Coliform Pass colonies/100mL Nitrate <IV[EL
Arsenic: 1.1_8 a~/1 mg/I Date of sample: 8/24/11
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel Date installed 7/14/11
Parcel ID: 050-315-28
Wires properly protected (Y/N) _
Casing height (above ground) 2a. in.
AT INSPECTION
new
g.p.m.
Collected by: NRim Eng
Tank size 2000 gal.
Number of Compartments 2_ Cleanouts (Y/N) Y_ Foundation cleanout (Y/N) ___ Depression over tank (Y/N) N
High water alarm (Y/N) N Date of pumping new Pumper
C. ABSORPTION FIELD DATA
Date installed 7/14/11 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 System type Trench
Length 76 ft. Width .5 ft. Gravel below pipe 4 ft. Total depth 7._~5 ft.
Eft. absorption area 760 ~ Monitoring tube Y Depression over field N
Date of adequacy test NFW
Fluid depth in absorption field before test~
Elapsed Time: na min. Final fluid depth
Results (Pass/Fail) Pass For ~ bedrooms
na in. Water added na gal. New depth na
na in. Absorption rate >= n_~a g.p.d.
in.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N__lf yes, give date --
D. LIFT STATION
Date installed na
"Pump on" level at na in.
Datum na
E. SEPARATION DISTANCES
Size in gallons na
"Pump off" level at na
Cycles tested na
in.
Manhole/Access (Y/N) na
High water alarm level at na , in.
Meets alarm & circuit requirements? na
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100+
Absorption field on lot 100+
Public sewer main NA
Sewer/septic service line 25+
Animal containment areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation .5'+ Property line 1_0'+
Water main NA` Water service line 10'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
On adjacent lots 100+
On adjacent lots 100+
Public sewer manhole/cleanout INA,
Holding tank
Manure/animal excrete storage areas 100'+
Absorption field 5'+
Surface water 100'+
Water main
Driveway, parking/vehicle storage
10'+
Property line 10'+ Building foundation 10'+
Water Service line 2.5'+ Surface water 100'+
Curtain drain Wa Wells on adjacent lots 100'+
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 COSA guidelines in effect on this date.
Engineer's Printed Name Steve
Date 10/2Z/2ml
COSA Fee ~
Date of Payment
Receipt Number
(Rev, 11/05)
Waiver Fee $
Date of Payment
Receipt Number
ANALYTICA
GROUP
NorthRim Eng
Attn: Steve Eng
17237 Bear Paw Circle
Eagle River, AK 99577
907-694-7028
Fax: 907-694-7026
Client Sample ID: ERlSg'/g go{JestS:
Sampling Location: /8~f~ O~,ot~c,~*c~
Client Project: E~8glg ~[o~
Sample Matrix: Drinking Water
COC ~:
PWSg:
Residual Chlorine:
Comments:
SP-Analytica, Inc.-Anchorage
4307 Arctic Blvd.
Anchorage, AK 99503
Phone: 907-258-2155
Fax: 907-258-6634
Report Date: 9/7/2011
Receipt Date: 8/24/2011
Sample Date: 8/24/2011
Sample Time: 10:00:00AM
Collected By: SE
Flag Definitions:
MRL -- Method Reporting Limit
MCL = Maximum Contaminant Limit
B = Present also in Method Blank
H = Exceeds Regulatory Limit
M = Matrix Interference
J = Estimated Value
D = Lost to Dilution
** = RL higher than MCL; target not detected
TNC = Too Numerous to Count - result rejected
CF = Confluent Growth - result rejected
TCNG = Turbid Culture No Growth - rejected
Labg: A1108364-01A
Analysis Method Prep Prep Analysis
Parameter Result Units Flags MRL MCL Method Date Date Analyst
4500-NO3E (Aqueous) - Nitrate+Nitrite pres Test was conducted by: Analytica - Anchorage
Nitrate-Nitrite as Nitrogen <MRL mg/L 0.10 10 8/31/2011 8/31/2011 MC
Lab#: A1108364-0 lB
Analysis Method Prep Prep Analysis
Parameter Result Units Flags MRL MCL Method Date Date Analyst
9223B-PA (Aqueous) - Coliforms in DW
E. Coli Pass PASS/FAIL 1.0
Total Coliform Pass PASS/FAIL 1.0
Lab#: A1108364-01C
Test was conducted by: Analytica - Anchorage
1 8/24/2011 8/24/2011 KM
1 8/24/2011 8/24/2011 KM
Analysis Method Prep Prep Analysis
Parameter Result Units Flags MRL MCL Method Date Date Analyst
200.8/200.8 (Aqueous) - Family Well Water I
Arsenic 1.18 ug/L
0.15
Test was conducted by: Analytica - Thornton
10 200.8 9/1/2011 9/1/2011 RM
Page 3 of 3
HOUSE DETAILS
SCALE: 1"=20'
1.5'x4.1' CANT-
COVERED POR(
2-STORY RESIDENCE
0,2~
3.8'x6.5' CONCRETE
10'x12' BALC(
_ J
0
_J
o
OUTLOOK CIRCLE
?--
PLOT PLAN
S 89'23'20"E 244.52'
EASEMENT
0
CLEANOUTS
LOT :3
47,617 S.F.
~ _ ~ ~ N 89'01'45"E~244.40'
I
LOT 8 I LOT 7
I
I
LOT 4
AS BUILT X SCALE 1" = 40' GRID NW 154 Project No. 11-076/ol
Lo n g (907) 522-6476
Registered Lond Surveyors (907) 522-4625
kenOIongsurvey.com / JonathonOlangsurvey.com
& Associates, inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-;3049
Phone
Fax
I hereby certify that I have surveyed the following described properly:
LOT 5, BLOCK 1, ROSEBERRY PARK SUBD, (Plat 2005-155)
Anchorage Recording District, Alaska, and that fha Improvements situated thereon ore
within fha property lines and do not encroach onto fha properly adjacent thereto, that
no improvements on fha properly lying adjacent thereto encroach on fha surveyed
premises and fhaf there are no roadways, transmission Ilnes or other visible
easements on said property except as Indicated hereon.
Dated this the Day of , , at Anchorage,
Alaska
If is the responsibility of the owner fo determine the existence of any easements,
cnvennnf.~, or re.~fricfinn.~ which do not onnenr on fha recorded .~uhdivi.~ion Gini.