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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: .2 E] 0 -~ --~ ~-~ E] 0 rOE] I ~z ~o n ,--I- L~ 0 ~+ O1 0 I''tl Z .~ 0 2> -F Z Z P P P II 0 n o 0 "5 P ---I (/) p ,--I- 0 --q I-qO -Q 0 C d- ~0 0 < 0 ~t- 0 '-b fi) N 10/2~/2011 23:09 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) 0 u ~ U O 0 c~ 0 0 0 0 > 0 O~ 0 O- OLd ~ 0 U 0 0 0 Z m Z W LO .__1 ~--, ~-~ L~ Ld Z W W SBILS LBG - PERCBLATIBN TEST Per~orned For; Lee Coy 1 3 4 5 6 7 8 9 10 11 la 13 14 15 16 17 18 19 PO Pi 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) U I.- ¢- I.- U n n 0 o (..) 0 U I-- C > 0 0 0 ID' OL,J L,. ~' 0 o U o 0 O U W n ~ nx nx~ w ~V WU nx~ 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.