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Home My WebLink AboutROBINDALE LT 8Robindal Lot 8 #051-053-03 Municipality of Anchorage :?' Development Services Department ~ ...... Building Safety Division On-Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.cLanchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW000157 PID Number: 051-053-03 Lars ~teYens WastewaterSystem: [] New [] Upgrade 900 Merill Field Drive ABSOitPTION FIELD Pbe~e: Number of Bedroo. ns: ~ Ra~ng: Total Dep~ Item oeiginal grade: LEGAL DESCRIPTION 0.8 c,,~e 4.0 8 Robtndale 2.0 F,. 2.16 1.2 F,.80 Well: [] New [] Upgrade c.~,~: 5.0 Ft.Number ofli~,es:l Distanc~ between lineS:FL Private 186 F~ 186 F~ 571+ Fe D3034 & F810 SULLIVAN 8/23/2000 162 FL ~...,,, e-~. ~ ~/~,, ~ 8 2 FL TANK SEPARATION DISTANCES I~ Septic [] Holding [] S.T.E.P. [] Other: Fmm~~ Septic Absorption Lift Holding Public/Private Manufac[urer: Capaoty: Tank Field Station Tank Sewer Line Anchorage Tank 1000 w., 100'+ 100'+ NA NA 2s'* Steel 2 ~,~,~w,~, 100'+ 100'+ NA NA X~/ LIFT STATION · ,~u., 5'+ 10'+ NA NA ~°: '~"""'"~' F~,~.~ 5'+ 10'+ NA NA 'Pump on' leve~ at: 'Pump off' mve~ at: I H~gh warm CurtainOmin NA '50'+ NA NA / ~ PumpMake&Model EJectr~allnspec~msperfoemedby: · none known BENCH MARK Top of Foundation 100 FL Eng!ne~q ~Stamp Inspections performed by: KND En.qineerin.q Dates: 1st 8121/2000 ~',~*[~9~'~'H,,:,d,.~.;, ~ll[..~ 2"~ 8123/2000 ' ~' . Reviewed and appr°ved bY: ~ Date: AS-BUILT SYSTEM DETAILS/SITE PLAN Permit SV000157 RFIBINDALE SUB LVIT 8 PID#051-053-03 B-C=36,9' ... PREPARED FOR: . · LARS STEVENSON ......... z ............................... : ...... ~ ANCHORA6E. AK. 99501 ~v~'.~ ............ ~ ~ S~m JOHNSON m~mtO:KMo 20441 PTARMIGAN BLVD. --~~ o~ ~m: ~ NWl 561 ...~...~.~.~...~.........:..~.:~v::.v.v.....v.v..~..~.:..~v~v~..v.v.v......~....v. ...........-..........,........ '"'"11 'c~':O001.DWG ~"" 0001 ("07~696-6111/FAX (907)696-8111 by P,O. BOX 670272, CHUGIAK, AIJ~KA 99567 · T~LEPHON~ ~88o2769 OWNER oF LAND //~{ ~"rEo x~'~J ~' a~,.j i~ORE HOLE nATA ................... ~ ...... /'~ ,,J C, ~4. DEPTH ADDRESS P PERMIT NUMBER 000 ! 5~te of Issue~-~ T~ INDENTIFICATION NUMBER ~-~- Is well Io~ted at approv~ pe ~No Casing Ty~ ~Wall Thickness Diameter ~ // inches, depth./~ f~t Line, Type: C~sing Stickup ~ve Ground; ~' f~t 8~tic Wa~r Level (from ground level): ~ ~ ~ 2 feet Pumping level; ~et after hm. pumping .gpm R~ver Rate: ~ gpm Methed of Testing:. Well Intake Opening T~: ~ End ~ Open Hole ~ Scr~ned; Star feet Stop~ feet ~ Perorations Sta~ . ~j Stop~d feet Grout T~: R~,~ ~olume Depth: from '~ ~e~to ~ feet Pump In~ke ~pth: PumpSize ~p Brand Name~ Well Dislnfected Upon Completion? ~ ~ No Meth~ ~ Dislnfe~ion: ~/~[ ~ ~ ' Commenb: ATTENTION: It i~ the ~esponsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Coneervafion. MatSu Borough: Department of Environmental Conservation. T0/T0 39~d N~AI-~ Gg~BB9 T0:~0 BGGT/TO/[O ~ ~ ENGINEE~NG, INC. ~ ~..' ~ ... ~'~. 20441 PTA~IGAN BLVD. i~L4~~.., ~.~.~ ER, SOILS PERCOLATION TEST ~er~o~ ~or: Lars Stevenson Date ~er~ormed:~~~' Project: Roblndale Lot 8 TEST HOLE # 0o-1 Perc Depth (Feet) 4- 5- 6- 7- 9- 10-- 11- 12- 13- 14-- 15- 16- 17- 18- SEE ATrACHED SITE PLAN FOR HOLE LOCATION Org-black , Depth to water after monitoring? NA Date? NA Bottom of trench Reading Date Gross Net Depth to Net Time Time Water Drop 1 8/21/00 1:00 - 6" 2 1:30 30mtn 3 10/16" 2 6/16" 3 * 1:31 - 6" 4 2:01 30 rain 3 12/16" 2 4/16" 5 ' * 2:02 - 6" 6 2:32 30 mtn 3 12/16" 2 4/16" · Water Added 19- 20- HOLE PRESOAKED PRIOR TO TEST Percolation Rate · 13.3 (min/iri) Perc Hole Diameter Test Run Between 4 feet and 5 feet 6,t I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Date Issued: Jun 09, 2000 Expiration Date: Jun 09, 2001 Permit Number: SW000157 Legal Description: ROBINDALE LT 8 Design Engineer: 0070 KND Engineering Owner Name: cJo KND Engineering Owner Address: 20441 Ptarmigan Blvd, Eagle River, AK 99577- Parcel ID: 051-053-03 Site Address: Lot Size: 19074 SQ, FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: Disposa Field [] SepticTank C1 Holding Tank CI Privy [] Private Well F'~ water storage Ail 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 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. ~51'i13~1~ f(~ll0Wing special provisions? I'ZAT THE TIME OF CONSTRUCTI0~ ~;I~E ENGINEER SHALL' PERFORM AN ADDITIONAL PERCOLATION TEST" ~, 'i' IN THE VACINrI~ OF THE PROPOSED ABSORPTION TRENCH IN ACCORDANCE WITH AMC 15.65 (30 : ',.. , MINUTE READINGS). Received By: ~~ Issued By: ~-t~4J"~/- Date: Date: .~' ~ ?- ~)~ 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 May 24, 2000 Municipality of Anchorage Dept. of Health & Human Services On-Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: New sewer & well petmit- Robindale Subdivision Lot 8 Gentlemen: The owner has requested we proceed forward to obtain a well and septic permit on the subject lot. On April 4, 2000 we dug two testholes for the proposed system. The results of these tests are attached. The general slope of this lot is from south to north at a grade of approximately 2 - 5%. We have designed our system utilizing the eastern testhole we excavated for the 3- bedroom house, which is proposed for this lot. The lot will be served by an individual well. We propose to install a 5' wide shallow trench. Water was not encountered during the excavation. Water was encountered during monitoring at 8.5' and 9'. There are no public or private wells within 200' of our proposed system location except as noted. There is no surface water within 100' of the proposed system and there are no known curtain drains within 50'. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, ]I(ix~) Engineering Kenneth M. Duffus, P.E. attachments: On-Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Logs/Percolation Tests WEL'L /ASTE /ATER DISPOSAL ROBINDALE SUB LOT 8 SYSTEM DETAILS/SITE PLAN PROPOSED ~VE '0 RiO0,O0 9 SEPTIC 'H #0~1 / \ MT SEPTIC C0~ SEPTIC SEPTIC 13 PREPARED FOR, LARS ~T£VENSDN 900 MERRILL FIELD DRIVE ANCHORAGE, AK 99501 fiELD BOOKS eou,e~m~. SEWARD s~ SEWARD ~e~_T: SEWARD ~ ~ 00001 ~,Aw~:. JAS ~ KMD 5/12/00 NW1561 00001 Sc~lie, 1'= 100' PAGE 1 OF E~ ]]~~ ?,NGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (g07)696-6111t/FAX (g07)696-6111 DESIGN DETAILS 3 BDRM X 150 GPO = 450 GPO 450 GPD/O.B opn PER SQ. FT. = 562.5 SQ, FT (562.5/¢59) X 0.70(RF) ¢2.0' GRAVEL) = 7B.75 FT. TRENCH USE I TRENCH 79'(L) X 5'(W) X Tot=[ depth o¢ system Is 4.0' ?rom orlgtn=t 9r=de. Tot=t depth o¢ or=vet betow dlstrlbu'tlon plpe Is NOTES. 1. USE 1000 GALLrtN SEPTIC TANK. IF REQUIREI). INSULATE TANK IF <4' COVER. ~. INSULATE TRENCHES VITH ~° HI) BURIAL FOAM.. 3. CDNTRACTnR ;/ILL ENSURE NAXlNUN aX SLOPE INTO SEPTIC TANK. 4. ADDITIONAL FILL ~/ILL I)E ADDED OVER SYSTEM TO ACHIEVE HIN. 3' COVER IF REQUIRED. 5. CONTRACTOR TD EXCAVATE TANK AN]) VERIFY INTEGRITY. K WASTE~,/ATER DISPBSAL RBBINDALE SUB LBT 8 3 BD #00-1 (D 1000 CB 1 F1 ~ci( Esm SYSTEM BETAILS 0 MT CB % PREPAREB FOR' LARS STEVENSON 900 HERRILL FIELD ANCHBRA6E, AK. 99501 REI.D BOOKS seu.o,~. SEWARD m~,~,,~. ~ SEWARD ~ KMD ~ SEWARD o~m 5/12/00 ~ ~ N~561 0OOO1 00001 Scare, 1'= 80' PAGE 2 DF E ]~~ ENGINEERING 20441 PTARMIGAN BLVD. EAGI,F. RIVER, AK 99577-8736 ~ ~ ENGINEE~NG 20~1 ~IGAN BL~. SOILS PERCOLATION ~ST Perfo~ed for: Lars Stevenson Date Perfo~:~ Project: Robindale Lot 8 TEST HOLE # 0o-1 Depth (Feet) ORG- black SEE ATTACHED SITE PLAN FOR HOLE LOCATION SM/GM - loose/reed dense, red/brown w/cobbles to 6' Was Ground water encountered? NO Depth to water after monitoring? 9' What depth? NA Date? 05/18/00 14- 15- 16- 17- 18- SM--increasing density w/depth B.O.H. Reading Date Gross Net Depth to Net Time Time Water Drop 1 4/4/00 1:00 7" 2 1:10 10 rain 6 8/16" 8/16" 3 * 1:11 7" 4 1:21 10 rain 6 8/16" 8/16" 5 1:21 6 8/16' 6 1:31 10 rain 6" 8/16" 7 1:31 6" 8 1:41 10 rain 5 8/16" 8/16' 9 1:41 5 8/16" 10 1:51 10 min 5 1/16' 7/16" 11 1'.51 5 1/16" 12 2:01 10 rain 4 10/16" 7/16" · Water Added 19~ 20- HOLE PRESOAKED PRIOR TO TEST Percolation Rate 22.86 (min/in) Perc Hole Diameter Test Run Between 3.5 feet and 4.5 feet 6~ I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. · [~J[~ L~ ENGINEERING EAGLE ~R, AK 995~-8736 SOILS PERCOLATION tEST Perfo~ed fon Lars Stevenson ~ate Performed:~~ Project: Roblndale Lot 8 .TEST HOLE # 00-2 14- 15- 16- 17- 18- Depth ORG - rootmat black SM/GM -w/sandy silt SM--increasing density w/depth B.O.H. SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Ground water encountered? NO What depth? NA Depth to water after monitoring? 8.5' Date? 05/18/00 Reading Date Gross Net Depth to Net Time Time Water Drop 1 4/4/00 2:00 7" 2 2:10 10rain 512/16' 14/16" 3 2:10 5 12/16" 4 2:20 10 rain 4 14/16' 14/16" 5 2:20 4 14/16" 6 2.'30 10 rain 4 1/16" 13/16" 7 * 2:31 7" 8 2:41 10 rain 6 1/16" 15/16" 9 2:41 6 1/16" 10 2:51 10 min 5 3/16" 14/16" 11 2:51 5 3/16" 12 3:01 10 min 4 5/16" 14/16" · Water Added 19- 20- HOLE PRESOAKED PRIOR TO TEST IPercolation Rate 11.43 (min/in) Perc Hole Diameter . Test Run Between $ feet and 4 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street , P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. O51-053-03 GENERAL INFORMATION Complete legal description Lot 8, Location (site address) . 241 co Robindaie COSA# O~--_~. ~ \\ .~:~(,,o Expiration Date: ./~ ,~2_ ~ -// Subdivision Rambler Road Chugiak~ Alaska 99567 Current Property owner(s) Mailing address Lending agency Mailing address Debbie & Jerry Silva Day phone(907) 688-1026 24100 Rambler Road Chugiak~ Alaska 99567 Day phone Real Estate Agent ' Mailing Address '~' 3801 Centerpoint · Dr., Unless. otherwise requested,: COSA will be held by DSD for pickup. NUMBER OF BEDROOMS:, ., _3 Barb Huntley/Prudential Dayphone(907) 227-5228 Suite 200 Anchorage, AK 995O3 TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well [] Individual On-site [] Individual Water Storage [] Individual Holding Tank [] Community Class .... Well [] Community On-site [] Public Water System [] Public Sewer [-I 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 propedies 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 Address PO Box 871 Engineer's Printed Name Paul E. Pinard Engineering Pinard, P.E. 5. 'DSo SIGNATURE ~ Approved for ' .3 Disapproved... COnditional approval for Phone(907) 357-3647 Wasiiia, Alaska 99687 Date bedrooms. bedrooms, with the following stipulations: By: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: (Rev. 11/'O5) Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343:7904 CERTIFICATE.OF ON-SITE SYSTEMS APPROVAL CHECKLIST Lot 8, Robindaie Subdivision IfA, B, or c provide PWSID # Sanitary seal (Y/N) ~'.. Cased to 186 ft. FROM WELL LOG 8/2)/00 162 ft. 8 g.p.m. Nitrate 3.25 mg/L Legal Description: A. '.WELL DATA Well type Date completed 8/.2-3/00 Total dePth 1 80 ff. Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL 'Parcel ID: 051-053-03 Well Log (Y/N) ~ Wires properly protected (Y/N) Casing height (abov(~ ground) AT INSPECTION 9/22/11 16/,. 8 5.3 ' g.p.m. Collectedby: Pinard Arsenic: ND ug/L date of sample:9/1-3/~11 B, SEPTIC/HOLDING TANK DATA. Tank Type/Material Sep%ic/S%eel Tank size 1 000 gal. Number of Compartments 2 Foundation cleanout (Y/N) ~ Depression over tank (Y/N) N Date of pumping. 8/29/11 Pumper JRs Pumping C, ABSORPTION FI:ELD DATA Date installed 8/21/00 Soil rating (g.p.d./ff2 o~:lrn) 0.8 Length 80 ft. Width § ft. Total depth ~ ft. Eft. absorption area .6_7_Lft2 Monitoring tube ~ Date of adequacy test 0/22/11 Results (Pass/Fail) Pass Fluid depth in absorption field before test 1/+ in. Water added~80 gal. 16 in. Engineering Date installed 8/21/00 Cleanouts (Y/N) ~ High water alarm (Y/N) NA System type Trench Gravel below pipe. 2.1 6 ~' Depression over field ]~ Elapsed Time: J4.DD min. Final fluid depth ~ in. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (Y/N & type) Nc.-.c For .3 bedrooms New depth22 in; /~50+ g.p.d. If yes, give date De LIFT STATION I~A Date installed "Pump on" level at ~ in. Datum :E. SEPARATION DISTANCES Size in gallons "Pump off" level at~ Cycles tested in. SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift ~tation on lot 1 O0 ~ + Absorption field on lot 1 O0 ~ + ~Public sewer main '75 ~ + Sewer/septic service line 25 = + Animal;containment areas 50 ~ + Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? in. On adjadent lots 1 O0 ~ + On adjacent lots 100 ~ .+ Public sewer manhole/deanout 100 ~ + Holding tank '1 O0 ~ + Manure/animal excrete storage areas 1 O0 ~ + SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 57 ~- ' Property line § r ~ + AbSorption field, Water main ]~A Water service line ' 1 0 ~ + Sui'race water 1 O0 ~ + Wells on adjacent lots 1 O0 ~ -I- · SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property. line :~1,0'! + Building foundation 10 ~+ Water main Water Service line ~10 ! + Surface water * '1~OO~''+ Driveway, parking/vehicle storage 10 ~ + Curtain drain None [a=oem Wells on adjacent lots 100 ' + Fi COMMENTS G. ENGINEER'S CERTIFliCATION conformance wfth MOA COSA guidelines in effect on this date. ~....-----a~ ~.~~~.~ ..... _ · I::ng,neersi~nntedName Paul E. Pinal-d, P.:E. "~'~e~"m'~'~ : 'Z~ ~ ..... --~. ~ --=-~ ~_ -. ~,,~.~.~,~_. .... COSA Fee $ 4_~G~ ~ -.--- Waiver Fee $ Date of Payment ReCeipt Number (Rev. 4/10) Date of Pa, yment Receipt Number ~m~ ~ RAMBLER ROAD ~ ~a~ ~ 889° 57~ 30"W 132.00' · ~ I~-~ o LOT 7 ~ ~-~ LOT 9 - ~tS~NG ~ ~ HOUSE 41.0 ~ / , , " ~ ~0' HIlL .... 0 0 .- N8g" 57' 3~E 132.00' mr ~ SUR~Y ~E S~BOLS ~ ~ ~ ~T 0 FOUND ~ PLOT P~S ~ LOT SUR~ NO~: IT IS ~E ~SlB~ ~ ~E BUt~ OR O~ PRI~ ~ ~Y ~O~ IM~O~ TO ~NI~0 ~E ~0 U~U~ ~N/C~S ~O TO D~INE ETC., ARE ~ IN ~E ~ ~ ~Y [A~, ~AN~ 0R RES~I~S MAY ~T ~; IMPRO~M~ ~ B~NG ~N ~o L~. SURLY ~RCAnON ~ ee Prepared by ~o~,~ ~ ........... Robert E. Johns, Jr. & Assoc. ,=~~==, _~:.-:~~ Professional Land Surve~rs '~"= ~' ~~~~""t ~" ~ 09/02/11 RE ~WL ~- ~--- ~-- ' ' ' ' ' ' ' 'ei~,,,.,~.~ ~e~ ROBIN DALE LOT 8 42.8 ~! Ex,s~NO q HOUSE 41.0 40~ 10' UTIL. ESMT. ' ,.. ~ O 0 PINARD ENGINEERING P.O. Box 871347 Wasilla, AK 99687 (907) 357-ENGR (3647) ADEQUACY TEST LOCATION: Lot 8, Robindale Subdivision APPLICANT: Debbie & Jerry Silva 24100 Rambler Road Chugiak, Alaska 99567 SEPTIC TANK TYPE/SIZE: Steel/1000 Gallons, per MOA Records ABSORPTION SYSTEM: Shallow Trench, per MOA Records DAILY FLOW: 3 BEDROOMS x 150 GAL/BR = 450 Gallons JOB NUMBER: 11-302 DATE OF TEST: 9/22/11 FIELD STAFF: PJ Pinard NUMBER OF BEDROOMS: 3 SCUM: 0.0' SLUDGE: 0.0' NEEDS TO BE PUMPED: Yes CURRENTLY IN USE: Yes XX No XX No TEST DATA Time Flow Volume Cumulative Septic Tank Septic Soil Absorption System Comments Rate Volume Tank PM (GPM) (GALs) (GALs) Liquid Level A Level Monitor A SAS Monitor b SAS * Tube 1 * Level Tube 2* Level 12:35 5.3 4.0' 1.2' Start Flow- Meter 215070 12:50 5.3 80 80 4.1' 0.1' 1.3' 0.1' 215150 1:05 5.3 80 160 4.1' 0.0' 1.4' 0.1' 215230 1:20 5.3 80 240 4.1' 0.0' 1.5' 0.1' 215310 1:35 5.3 80 320 4.1' 0.0' 1.6' 0.1' 215390 1:50 5.3 80 400 4.1' 0.0' 1.7' 0.1' 215470 2:05 80 480 4.1' 0.0' 1.8' 0.1' Stop Test - 215550 RECOVERY Date Time ST MT SAS MT 9/22 3:40 4.0'/-0.1' 1.6'/-0.2' PM 9/22 7:15 1.27-0.4' PM *ALL MEASUREMENTS IN FT. TEST: PASSED XXX FAILED COMMENTS: System appears to be operating satisfactorily. There was 1.2' of measurable liquid in the SAS MT prior to beginning the test. With the addition of 480 gallons to the system (more than the design design daily flow), the level rose 0.6' in the MT. Recovery measurements showed satisfactory absorption, with a return to the starting level in about 5 hours. Reviewed by: Paul Pinard ~'~l/J( Date: 9/23111 PINARD ENGINEERING P.O. Box 871347 Wasilla, AK 99687 (907) 357-ENGR (3647) WELL FLOW TEST LOCATION: Lot 8, Robindale Subdivision JOB NUMBER: 11-302 DRILLER: Sullivan Water Wells DATE OF TEST: 9/22/1'1 DATE WELL COMPLETED: 8/23/00 FIELD STAFF: PJ Pinard WELL DEPTH: 186' STATIC WATER LEVEL (top of casing): 164.8' Elapsed Static Flow Cumulative Time Time Water Rate Gallons Remarks (Minutes) Level (gpm) Pumped 11:45 AM .... 164.8' 5.3 --- Start Test - Meter 214800 12:00 PM 15 165.1' 5.3 80 214880 12:15 30 165.1' 5.3 160 214960 12:30 45 165.1' 5.3 240 215040 12:45 60 165.1' 5.3 320 215120 1:00 75 165.1' 5.3 400 215200 1:15 90 165.1' 5.3 480 215280 1:30 105 165.1' 5.3 560 215360 1:45 120 165.1' 5.3 640 215440 2:00 135 165.1' 5.3 720 215520 2:15 150 165.1' 5.3 800 215600 2:30 165 165.1' 5.3 880 215680 2:45 180 165.1' 5.3 960 215760 3:00 195 165.1' 5.3 1040 215840 3:15 210 165.1' 5.3 1120 215920 3:30 225 165.1' 5.3 1200 216000 3:45 240 165.1' - 1280 Stop Test 216080 RECOVERY 3:50 5 164.8' All well protection features are adequate. Average Flow Rate: 5.3 gpm Comments: DURING THIS TEST, THIS WATER SUPPLY WELL WAS CAPABLE OF PRODUCING 5.3 GPM. THIS TEST DOES NOT CONSTITUTE A WARRANTY OR GUARANTEE THAT THE WATER SUPPLY SYSTEM WILL CONTINUE TO FUNCTION AND PRODUCE AT THIS RATE. Reviewed by: Date: Paul Pinard ~"~'~ 9/23/11 SGS Reft# 1114422001 Client Name Pinard Engineering Printed Date/Time 09/20/2011 8:07 Project Name/# Kitchen Sink; Lot 8, Robindale Collected Date/Time 09/13/2011 13:30 Client Sample ID Kitchen Sink; Lot 8, Robindale Received Datefl'ime 09/13/2011 14:17 Matrix Drinking Water Technical Director Stelahen C. Ede Saml~le Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals b~r ICP/MS Hardness as CaCO3 234 5.00 mg/L SM20 2340B C 09/14/11 09/15/11 NRB Waters Department Total Nitrate/Nitrite-N 3.25 0.100 mg/L SM20 4500NO3-F B 09/15/11 AYC Microbiology Laboratory E. Coli Negative 1 100mL SM20 9223B A 09/13/11 CR Total Coliform Negative 1 100mL SM20 9223B A 09/13/11 CR Private Individual Analysis Alkalinity 150 10.0 mg~L SM20 2320B D 09/14/I 1 ATJ Aluminum ND 20.0 ug/L EP200.8 C 09/14/11 09/15/11 NRB Antimony ND 1.00 ug/L EP200.8 C (<6) 09/14/11 09/15/11 NRB Barium 8.52 3.00 ug/L EP200.8 C (<2000) 09/14/11 09/15/11 NRB Cadmium ND 0.500 ug/L EP200.8 C (<5) 09/14/11 09/15/11 NRB Calcium 42300 500 ug/L EP200.8 C 09/14/11 09/15/11 NRB Chloride 36.3 0.100 mg/L EPA 300.0 D (<250) 09/13/11 09/14/11 SDP Chromium 2.98 2.00 ug/L EP200.8 C (<100) 09/14/11 09/15/11 NRB CO3 Alkalinity ND 10.0 mg/L SM20 2320B D 09/14/11 ATJ Conductivity 462 1.00 umhos/cm SM20 2510B D 09/14/11 ATJ Copper 256 1.00 ug/L EP200.8 C (<1300) 09/14/11 09/15/11 NRB Fluoride ND 0.100 mg/L EPA 300.0 D (<2) 09/13/11 09/14/11 SDP HCO3 Alkalinity 150 10.0 mg/L SM20 2320B D 09/14/11 ATJ Iron ND 250 ug/L EP200.8 C (<300) 09/14/11 09/15/11 NRB Lead 2.58 0.200 ug/L EP200.8 C (<15) 09/14/11 09/15/11 NRB SGS Ref.# 1114422001 Client Name Pinard Engineering Printed Date/Time 09/20/2011 8:07 Project Name/# Kitchen Sink; Lot 8, Robindale Collected Date/Time 09/13/2011 13:30 Client Sample ID Kitchen Sink; Lot 8, Robindale Received Date/Time 09/13/2011 14:17 Matrix Drinking Water Technical Director Stel~hen C. Ede Allowable Prop Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Private Individual Analysis Magnesium 31200 50.0 ug/L EP200.8 C 09/14/11 09/15/11 NRB Manganese 1.41 1.00 ug/L EP200.8 C (<50) 09/14/11 09/15/11 NRB Nickel 2.81 2.00 ug/L EP200.8 C (<100) 09/14/11 09/15/11 NRB OH Alkalinity ND 10.0 mg/L SM20 2320B D 09/14/11 ATJ pH 7.90 0.100 pHunits SM20 4500-H B D (6.5-8.5) 09/14/11 ATJ Selenium ND 5.00 ug/L EP200.8 C (<50) 09/14/11 09/15/11 NRB Silver ND 1.00 ug/L EP200.8 C (<100) 09/14/11 09/15/11 NRB Sodium 4260 500 ug/L EP200.8 C (<250000) 09/14/11 09/15/11 NRB Sulfate 23.9 0.100 mg/L EPA 300.0 D (<250) 09/13/11 09/14/11 SDP Total Dissolved Solids 252 10.0 mg/L SM20 2540C D (<500) 09/16/11 ATJ Zinc 346 5.00 ug/L EP200.8 C (<5000) 09/14/11 09/15/11 NRB Arsenic ND 5.00 ug/L EP200.8 C (<10) 09/14/11 09/15/11 NRB Thallium ND 1.00 ug/L EP200.8 C (<2) 09/14/11 09/15/11 NRB JKs Pumping PO Box 773415 Eagle River. AK 99577 (907) 694-6454 Billing Info.rmati°n _ Debbie & Jerry Silva 24100 Rambler Road Chugiak. AK 99567 (907) 688-1026 Job Site Information Debb~e 24100 Rambler Road Job Deecriplton: P.O. Number, Terms: Salesrep: Map Book: Cross Streets: Job Comments~ 1250g Service Agreement Number: 034043 Order Date: 08-Aug-2011 Service Date: 29-Aug-2011 Technician: Dave & Jeremiah Net 30 Tax %: 0 Kar[~a Job Type: Repeat Map Gr~: 16 Robinson Road Last Serv *08110/2010' 1000g S/S = 4 this day Chugiak, AK 99567 (907) 688-1026 g07-276-6000 Additional Location Comments: Diagram House at the T- end of Robinson Road, straight ahead Lot 8 on Taxi Book #'s are on mailbox at start of DW Septic ~ back of home Sewice Type Oty Septic Sew 1000K 1 s ~liaorarn~17~i11 bmp Price Each Tax? $185.00 No Gallons Planned: 1250 Hose Length: Double Tank: :-", Pump System: ~ Baffles Outlet:. _~ .... Extension Actual NonTaxable Total Estimated Charge~ $185.00 AclualCl~arge~ :' ~ / Customer agrees to the terms and conditions shown. THIS IS A BINDING AGREEMENT. Taxable Total Tax Total Grand Total $O.00 $0.00 $18500 · . epreee.tat~ve ..,-~ ,/' Date Signature and.T~ ~ Cu~r~ ~ / '~' ~ ~.' , ,~, , , ~?. , , / . ~ .~ ~' . / .'I/ · '/.~' ~-, ~t..'~'~ r.,~ . , ~ ? ~t~ ~y JRs ~mpi~ Date Fo~ ~ur ~d~ ~n~nmnm ~ a~: ~. V~ and MaWr Ca~ p~men~ o~r ~ p~ne. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. BOx 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FoR A SINGLE FAMILY DWELLING ParcelI.D. 051-053-03 GENERAL INFORMATION Complete legal description p, obindale Lot 8 Location (site address or directions) HA,Ag Expiration Date: 24100Rambler 'Rd. Chugiak:.AK 99567 Current Property owner(s) .-Tony Vargo Mailing address .~nme as above Lending agency Day phone 227-R.~93 Day phone Mailing address Real Estate Agent Ronnie King Day phone 68R-2276 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 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 Health Authority Approval (HAA) based only upon the representations ~given in paragraph 4 by an independent professional civil engineer-registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority 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. STATEMENT OF INSPECTION BY ENGINEER . As certified by my seal affixed hereto and ~s of the validation 'date shown below, I verify ,that my investigation, based on procedures outlined in the Health Authority 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 KND ENGINEERING= Inc, Phone (.907) 6§6-1;111 Address 20441 Ptarmigan Blvd.= Eagle River.. AK 99~;77 Engineer's Printed Name Kenneth M. Duffus Date 04/0.~/04 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 in land 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 and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, KND can not give any estimate of how long a system will function satisfactory for current or future occupants or can KND guarantee that no unseen encroachments, deficiencies or discrepancies exist. DSD SIGNATURE ~ Approved for ~ Disapproved. Conditional approval for bedrooms, with the following stipulations: bedrooms. Attachmenis: HAA Checklist Septic System Advisory Well Flow Advisory .= ; WASTEWATER: -: '... 'PROGRAM ..' · .. · -~,, ~, ·.. . . .' <.~,,--..~ Maintenance Agreements Supplemental Engineers Report Other Original Certificate Date: Legal De~ ,Municipality of AnChorage DeVelOpment Services Departmenl ' ' :~i Buiidir~g Safe[y Division ' on-site water & Wastewater Program · 4700 South Bragaw ;St. P.O. B°X:196650. Anchorage, AK 99519-6650 ' . www.ci.anchorage.ak.us i(907) 343-7904 ' HEALTH AUTHORITY APPROVAL'-'CHEcK~JsT ription:~ 'ROBINDAL~ LOT-8' Parcel ID: iO51 -053-03 A. WELL DATA ' Well;,type private Ifa, B, or C pm~ide PWSlD completed_.~ -'.San tary seal I.-" ' . ': Total: depth . 18{]; ft. ' cased to' ;"'186 . We'll Log (Y/N) Y Wires pro,p~'l~~ I~rotected (Y/N)..Y Casing heig,ht:(above ground) Z ' AT INSPECTION · '03/24/04~;i,t' Static w;teJr level Well production g.p.m. WATER SAMPLE RESULTS: ~ ~ : ':i 'i '- Coil rm !0 Colonies/100'mI.Nitrale :'4.4 :mg./I.Other~bacteria. 0 col0nles/10o .. : Collected by;~,:KND Engineering '.B.: SEPTIC/HOLDING TANK DATA ' i' : ;' !il' Tank t TyP~)Material ~ SEPTIC/S'J:'EE~J-;~ Da~, ih'stalled 8 / 2 1 / 0 0 - Tank size i 000 gal. Number of Compartments~ Ceanouts (Y/N~Y ~' . .', ' : ": · · Foun~at,opJc!eanout (WN) Y ~Depr. e,s. sion:9,.ve[ tank (Y/N).N i High.water'alhi-~: (Y/N)'N Date!,nstalled 8/;)1/7.000 Soil ratinn '~'~nd/ft2orft2/bdrm~'0 8 ' S,,~ter~'~,~,.,.~ ~,~:~,,~u Length..80. ft.W,dth.5 .t. '.!'. :: ' ' . .~, ~..Gravelbelowppe 2.16 ft. Total dept.,h J4_, ft. Eft. absorption.are:~.571~ 'f!2 Monit6ring t~? Date of ade,.quacy test '3/23/04 FOr .3._ bedrooms Fluid depth '~n absorption field befor~'testZl,in' ':. Water added 450'gal ! ': New depth ~ R in Elapsed. T~me:~ 1440 .... ,m n. . F~nal flu d depth 19.8 ~n," Absorot on_ rate >= 450+ g.p.d. Any rejuvenation, ..... treatment (past 12 mo); (WIV & type)' ........ ~N ' ~' If yes..give date LIFT STATION · :. Date installed "Pump' on" level at in. Datum. SEPARATION DISTANCEs Size in gallons : "Pump off" level at' . Cycles tested Manhole/Access (Y/N). in. High water alarm level at Meets alarm & circuit requirements? in. SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 1'00'+ On adjacent lots 1 0 0' + On adjacent lots 1 0 0'+ Public sewer main 75'+ Public sewer manhole/cleanout Sewer/septic service line ZS'+ Holding tank I 0 0 ' + SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Water main 1 0'+ Wells on adjacent lots '100'+ . .Property line 5 ' + Water service line 1 0 ' + SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ 1 0'+ ' 100,+ Building foundation Absorption field 5 ' + Surface water I 0 O' + Water main I O' + Water Service line 10'+ Curtain drain 50'+ COMMENTS Surface water 1 0 0' + Driveway, parking/vehicle storage Wells on adjacent lots I 0 0 ' +, Absorption ·field operating in upper half. · 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 HAA guidelines in effect on this date. Engineer's Printed Name Kenneth M; DuffUs Date 4/05/04 10'+ HAA Fee $430.00 Date of Payment Receipt Number (Rev.'l~01) ' Waiver Fee $ Date of Payment ReceiPt Number ~' :'.,7't 0.'8 t~C.E, ~.~:¥':?:,; "'"" ' .... ' ~ .l. :he~'eby.,¢ertlfY, tl~at J' ' .thereofi"are,withln' the ~roperty lih'~s !'ox, e/lap Ori~'nE£oach ,. no, impro~rh~nts , n the l~remtses in uestxon 'and' tl:iat' there ar,~m ¢"r:,a : i q'ansmxsslon except as md~cated.hereon.,~, ... ; . ,..., · ,.,,: , :~ -.., · Dated at Ea~Ie River.' Alaqka ., ~ ~ ';;", ~ .-' :."-'i:.'~" .... " thLs ! ~L'7'~ ~da); Of '- '..'. ::/'~.t.~., f~ .... '..'. ' .~ ~,_; :,'-?,= r4- .. SCALE:':':, '.:i' .' 1" -= :;,~,~ .~.: ' L · _Box'77-0456;'Ea'gle Riv&r,:^laska 99577 ' , ', . : ' · . Phdne(907} 694-2543 " ,' ,~.: 04-02-04 12:13P~ FR0~CT&E ESI, SGS ENV SERVICES 9075615301 T-898 P.02/02 F-269 SGS Ref.# 1041522001 Client Name KND Engineering Project Name/# Robindalc Lot 8 Client Sample ID Robindale Lot 8 Matrix Drinking Waler All Dates/Times are Alaska Standard Time Printed Date/Time 04/02/2004 11:24 Collected Date/Time 03/30/2004 14:30 Received Date/Time 03/30/2004 15:40 Technical Director Stephen C. Ede Released BI' Sample Remarks: Allowable Prep Analysis Parameter Results PQL Units Method Container ID Limits Date Date Init Waters Department Nitrate-N 4.40 0.100 mg/L EPa. 300.0 B (<=lO) 03/30/04 JJB Microbiology Laborato~3/ Total Coliform col/100mL SMI8 9222B A (<=1) 03/30/04 DKC