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HomeMy WebLinkAboutROCKHILL BLK 2 LT 6Rockhill Block 2 Lot 6 #015-362-11 Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://Www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP141400 PID Number: 015-362-11 ❑ New ❑✓ Upgrade David & Melinda Skieens 6531 Shale Circle Rockhill 4 2 6 10 From Septic Tank Absorption Field Lilt Station Holding Tank Sewer Line Well 100+ 100+ N/A N/A N/A Surface Water 100+ 100+ NA N/A Lot Line 50.3 19 NA N/A NA Foundation 78.6 101.2 NA N/A Curtain Drain 50+ 50+ NA N/A Remarks 3SORPTION FIELD ❑✓ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other iI Rating Total depth from original grade 1 2 GI=DlsF 11.5Ft. pth to pipe invert from original grade Gravel depth beneath pipe 5.5 Ft, 6 Ft. added above original grade Gravel length 0 Ft. 45 Ft. rvel width Beds: Number of Lines Distance between lines 3 Ft. NIA N/A Ft. al absorption area Number of trenches Dist. between trenches 540 Ft2 1 NA Ft K 0 Septic ❑ S.T.E.P. ❑ Holdinq ❑ Other IlFrIll on level at make Steel at 0 Installer PIPE MATERIAL Housetotank 3034 drain'FZ 3034 - JRs Septic Pumping LLC Drainfield 3034 CO/MT 3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 98ft Inspection , - Location and description dates: is 9124/14 Zed 9125/14 s" 9/25/15 e NE corner of house by foundation cleanout COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL I Engineer's Stamp Approval: Approved Date r/+{ IQj"CE 81 DateNk DRAIN FIELD (E) _ _ 33LF x 3•W x 6.0'ED x 11.57D EXPANDED TO ACCOMMODATE 4BR ABBOTT ROAD_-_ -- - ------ �ADDED 1 2L x 3'W x 6.0'ED x 17.5'TD-- -�_ TOTAL: 45LF x 3'W x 6.0' ED x 1 1 .5'TO _ --" -- 10' T&E EASEMENT-- - -M i TH 1 (E. R. ENGINEERING) - - 1000g SEPTIC TANK (E) m - FC3 REMOVED PER CODE '/ INSTALLED 1250g SEPTIC_- - -- - TANK IN PLACE - D"'Dco �� - � RESERVE 4BR DRAIN FIELD (P) Tz (// 45LF x 3'W x 6.0' ED x 115TD DRIVEWAYT T1 A - - 107.1: FC 4BR HOUSE (E) 1073 ,--- - --- _.\ M M M e cs WELL (E) I\ WELL (E) / 3 \ 3 WELL (E) - 7--w 3 j ' SHALE CIR. - A 1 B FC 7.2 30.9 T1 80.5 90.2 T2 89.7 100.1 DCO 91.4 102.2 M2 128.7 140.6 M3 144.2 156.9 FC3 141.8 155.1 NOTES: - PAMONE ENG SVC LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211�y �. OF p ill ,r �(�• l_r4511 TH ... .. . . . ........ Steven 'R. 'Pannone' IPS.� ] ••. �� f� �� 111 �� OFESSID� \\ �� Date 3/06/2015 RECORD DRAWING Scale ROCKHILL, BLOCK 2, LOT 6015-362-11 DAVID & MELINDA SKIEENS 6531 SHALE CIRCLE ANCHORAGE, AK 99507 P.I.D. NO PERMIT NO. OSP131005 PLAN Sh'ettF2 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS, 2. SCOPE OF WORK: INSTALLED NEW 1250g SEPTIC TANK AND EXPANDED SOIL ABSORPTION SYSTEM TO ACCOMMODATE 4BR. 3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 19 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. NO APPARENT WATER TABLE WAS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 17.5 FEET BELOW EXISTING GRADE. - FILTER FABRIC 4" PERF PIPE 15 DRAIN ROCK 6" ABOVE PIPE INVOR 5{ .5 -3 0.5 i RESERVE FIELD (P) EL. 86.0 DRAIN ROCK 6.0 SECTION DM Ir EL. 80.0 FILTER FABRIC 3.0 3.0 7 5 4" PERF PIPE DRAIN ROCK 6" ABOVE PIPE IN z` 72.0 19 m w 1- J ¢O O O w0 0 O O¢ ¢ w ro¢ O w O J W Z Z IiU U UOU � U U EL 92.8 EL 91.5 88.5 REMOVED 1000g SEPTIC TANK (E) EL. 86.0 EL. 87.7 INSTALLED 1250g SEPTIC TANK IN PLAC PROFILE DRAIN ROCK EL 80.0 ABBREVIATIONS DESIGN PARAMETERS DESIGN PARAMETERS cu COPPER PRIMARY RESERVE DIP DUCTILE IRON PIPE NO. BEDROOM: 4 (600 gpd) NO. BEDROOM: 4 (600 gpd) TH TEST HOLE TANK SIZE: 12509 TANK SIZE: 12509 FC FOUNDATION CLEAN OUT PERC RATE = 2 MPI PERC RATE = 2 MPI T# TANK CLEAN OUT N0. SOIL RATING: 1.2 GPD/SF SOIL RATING: 1.2 GPD/SF C# CLEAN OUT NO. AREA ROD: 500 SF AREA ROD: 500 SF M# MONITOR TUBE NO. SYS. TYPE: DEEP TRENCH 6.0' E.D. SYS. TYPE: DEEP TRENCH 6.0' E.D. R. 1. RIGID INSULATION MIN LENGTH: 41.7 LF MIN LENGTH: 41.7 LF DCO DOUBLE CLEAN OUT OV DIVERTER VALVE USED: USE: FS FLOW SPLITTER 33LF x 3'W x 6'ED x 11.5'TD (E) 45LF x 3'W x 6'ED x 11.5'TD BFG BELOW FINISH GRADE ADD 12 LF X3'W x 6.0' E.D -x 11.5'TD TOTAL AREA: 540 SF OG ORIGINAL GRADE TOTAL AREA: 540 SF FG FINISH GRADE TS&V TOPSOIL & VEGETATE -- (E) EXISTING P PROPOSED NOTES: P�NOl\P� ENG SVC, LLC ,�'"ate RECORD DRAWING .� OF A�\``l 3/06/2015 P.O. BOX 100217 ANCHORAGE, AK 99510 � ......' :9S ot 1 PHONE (907) 272-8218 FAX (907) 272-8211 Scale 49 T NTS P. P.I. %•• t.. •••• ID.N0 ROCKHILL, BLOCK 2, LOT 6 �C-.., / 015-362-11 DAVID & MELINDA SKIEENS / Steven R. Pannone PERMIT NO. PF,•_ CE 8149�� 0SP131008 6531 SHALE CIRCLE c�J�.p J Sheet DESIGN DETAILS ANCHORAGE, AK 99507 '1 �Fp' PL On -Site Wastewater Disposal 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: OSP141400 Tax Code Number: 01536211000 Work Type: Septic Renewal Permit Effective Dates: September 19, 2014 to September 19, 2015 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: ROCKHILL Site Legal Address: ROCKHILL BLK 2 LT 6 G2438 Owner/Address: SKIEENS DAVID J & MELINDA L 6531 SHALE CIR ANCHORAGE AK 995076762 Site Mailing Address: 6531 SHALE CIR, Anchorage Lot Size in Sq Ft: 46725 Total Bedrooms: 4 This permit is for the construction of Y Disposal Field Y Septic Tank N Holding Tank N Privy N 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 gllqpolq MUNICIPALITY OF ANCHORAGE . Almmunity Development Department Phone: JaMM6"@ Development Services Division Fax: On -Site Water & Wastewater Program SEP 12 2014 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-362-11 Property owner(s) David & Melinda Skieens Day phone?JZ, t3 t j Mailing address 6531 Shale Cir., Anchorage, AK 99507 Site address 6531 Shale Cir Legal description (Sub'd., Block & Lot) Rockhill, Block 2, Lot 6 Legal description (Township, Range & Section) Lot Size 46,725 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) FX Absorption Field 1Z Initial El Single Family (SF) (w/wo ADU) Septic Tank ❑X Upgrade Duplex (D) ❑ Holding Tank ❑ Renewal �. Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE ( WAIVER REQUEST FOR: Distance: I certify that the above information is correct. 1 further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent} Permit/Rush Fees: 40 GAwrA-e Waiver Fees: Date of Payment: Date of Payment: Receipt Number: Receipt Number: Permit No. Ono 1914(t)o Waiver No. Permtt App_:- :LIC.., On -Site Wastewater Disposal 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: OSP131008 Tax Code Number: 01536211000 Work Type: Septic Upgrade Permit Effective Dates: February 14, 2013 to February 14, 2014 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: ROCKHILL Site Legal Address: ROCKHILL BLK 2 LT 6 G:2438 Owner/Address: SKIEENS DAVID J & MELINDA L 6531 SHALE CIR ANCHORAGE AK 995076762 Site Mailing Address: 6531 SHALE CIR, Anchorage This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank Lot Size in Sq Ft: 46725 Total Bedrooms: 4 N Privy N 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 Issued By MUNICIPALITY OF ANCHORAGE Community Development Department 16 Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I. D. 015-362-11 Property owner(s) David & Melinda Skieens Day phone Mailing address 6531 Shale Cir., Anchorage, AK 99507 Site address 6531 Shale Cir Legal description (Sub'd., Block & Lot) Rockhill, Block 2, Lot 6 Legal description (Township, Range & Section) Lot Size 46,725 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field Q Initial ❑ Single Family (SF) Q (w/wo ADU) Septic Tank ❑X Upgrade nX Duplex (D) ElHolding Tank ElRenewal ElMultiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Waiver Fees: Date of Payment: ;1 Wyk Date of Payment: Receipt Number: /&P 1i& ;L Receipt Number: Permit No. 10SP/.3//919 Waiver No. Permit App_-'-:. :_'.,:c, Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panenzak.com January 31, 2013 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: Rockhill, Block 2, Lot 6 Septic System Permit Upgrade Request Ladies and Gentlemen: I am writing to request a permit to upgrade the septic system be issued for this property. The proposed systems will serve an existing four (4) bedroom house. Currently the lot is developed. The existing drain field is designed for a three (3) bedroom house and is operating adequately for a three bedroom house. The homeowner is upgrading to a four (4) bedroom house and wishes to upgrade the septic system to accommodate this. The existing 1000g septic tank and will be abandoned per code, and a new 1250g tank will be installed. The drain field will be expanded to accommodate four bedrooms. This lot is served by a private well that is located over 100 feet from this system. The surrounding lots are also served by private wells. There are no wells within 100 feet of this system. 1. Soils. A single test hole was excavated by Eagle River Engineering in July of 2002, and the ground water monitored for seven days. Groundwater was not observed in the hole monitor tube after the seven day monitoring period. Bedrock was not encountered in the test hole. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 1.2 gallons/day/square feet should be used for a conventional wastewater system. 2. Soil Absorption System Design. a. See Sheet 2 of the design package. 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The topography slopes from northwest to southeast at approximately 25% in the area of the proposed drain field. There are no steep slopes in the area. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, Alt 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 S. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Attachments -Soils Log -Septic System Design Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor Ave, Anchorage, AK 99501. Telephone: (907) 272-8218 FAX: (907) 272-5211 DRAIN FIELD (E) 33LF x 3'W x 6.0'ED x 11.5'TD EXPAND TO ACCOMMODATE 4BR (P) ADD 12LF x 3'W x 6.0'ED x 11.5'TD ABBOTT ROAD__ TOTAL ------ .45LF x 3'W 6.0' ED x 11. 5'_TD 10' T&E EASEMENT TH-1 (E.R. ENGINEERING) 10008 SEPTIC TANK (E) -0 ABANDON PER CODE - - ------- INSTALL 1250g SEPTIC TANK (P) �/ ..... . RESERVE 4BR DRAIN FIELD (P) 45LF x 3'W x 6.0' ED x 11.5'TD DRIVEWAY 107.7 4 BR HOUSE (E) w ,1086M N\ Al ------ Z WELL (E) WELL (E) WELL (E) \N W� SHALE CIR. NOTES: PAMONE ENG SVC, LLC Date ON �4 OF Al,,q FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 � ly� - .1 ...... 0, 2/8/2013 PHONE (907) 272-8218 FAX (907) 272-8211 ...... . ... P.I.D. NO ROCKHILL, BLOCK 2, LOT 6 Steven 015-362-11 e DAVID & MELINDA SKIEENS PERMIT NO" 6531SHALE CIRCLE 63% CE2l 49 Ospi 31008 Shet PLAN ANCHORAGE, AK 99507 1eOF 2 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 2. SCOPE OF WORK: INSTALL NEW 1250g SEPTIC TANK AND EXPAND SOIL ABSORPTION SYSTEM TO ACCOMMODATE 4BR. 3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 20 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 17.5 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATLY. FILTER DRAIN ROCK 6" ABOVE PIPE SECTION 0.5 DRAIN ROCK 3.0 Q w z� 0 p o v wo v o w m r m z o� FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# 1iU U V o D U U o f ABANDON 10009 SEPTIC TANK (E) INSTALL 12508 SEPTIC TANK (P) PROFILE DESIGN PARAMETERS PRIMARY NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1250g PERC RATE = 2 MPI SOIL RATING: 1.2 GPD/SF AREA ROD: 500 SF SYS. TYPE: DEEP TRENCH 6.0' E.D MIN LENGTH: 41.7 LF OR -3 RESERVE FIELD (P) 6.0 SP 3.0 FILTER FABRIC LL 4" PERF PIPE DRAIN ROCK 6" ABOVE PIPE INV -19u12.0 °�- o m o o zz o zz 2 W 1J `0 U z U DESIGN PARAMETERS RESERVE NO. BEDROOM: 4 (600 gpd) TANK SIZE: 12508 PERC RATE = 2 MPI SOIL RATING: 1.2 GPD/SF AREA ROD: 500 SF SYS. TYPE: DEEP TRENCH 6.0' E.D MIN LENGTH: 41.7 LF USE: USE: 33LF x 3'W x 6'ED x 11.5'TD (E) 45LF x 3'W x 6'ED x 11.5'TD ADD 12 LF X 3'W x 6.0' E.D x 11.5'TD TOTAL AREA: 540 SF TOTAL AREA: 540 SF NOTES: PANNONE EKG SVC, LLC CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 ROCKHILL BLOCK 2, LOT 6 DAVID & MELINDA SKIEENS 6531 SHALE CIRCLE DESIGN DETAILS ANCHORAGE, AK 99507 ROCK ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL & VEGETATE Date OF K,C kl 2/8/2013 ,t� Scale '49LF / NTS P.I.D. NO 015-362-11 Steven R. Pannone ;/ PERMIT N0. 9 . CE 8149 , Sheet 2 OF 2 U Municipality of Anchorage • r+ Development Services Department i��y: Building Safety Division On -Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 of 2 . www.cianchorage.ak.us (907) 743.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SW020254 PID Number. 015-362.11 HMna DAVE & MEL INDA SKIFFNS Wastewater System; ®New ❑Upgrade P.O.. BOX 232163, ANCHORAGE, AK 99523 ABSORPTION FIELD Pharr. N,..er a eaaaoma ° D"0 T • a o 5"'"° r'" ° a loadO Mound O omr 346-2048 3 LEGAL DESCRIPTION ScWIts"° TaalD.pM"mMpnMpraea 1.2 GpoF" 11.5' Fl. Baa Lar S�awi DSFM to Poa eom.m r:'. oign•i Ora" cmat aaorn e " V W 2 6 ROCKHILL 5.5' P. 6' FI To. p HMq. soot Fa Mnw rle.a wgnw WMN CrMN Lwgm. T12N R3W SEC. 14 0 Ft. 33' Ft. GrMM wqm rFnw«. Well: [3 New ❑ I Diauc.Upgrade 3' Ft. NIAat...l inFI.F cias ftawe, (1,"M•. A e. Cr Taal Own cased 0 Two aasorppon area P'q "otea NOT IN Ft. FI 396 Fir ASTM 3034, FBI Dollar DMF orate sinK Waits LM MIMW Doe wua.e' Ft MIDNIGHT SUN EX. 811212002 vwa I Pump SM M I Car" wqv Aaar. crw.la TANK DPM FL Fl SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P To Septic Absorption Lift Holding ouoll Mnvate L�i otn From Tank Field Station Tank sewer Line ANCHORAGETANK '1,1400,411 w ""r +100' +100' NIA NIA STEEL s,nMrwoff +100' +100' NIA NIA La L.r +10' +10' NIA NIA Fw w NIA NIA NIA NIA c/IMn a.n NIA NIA NIA NIA PMvb LIFT STATION Sw MMMacrur ❑ Other. D 1000 DM Hamar a caroMlm«as 2 NIA cM 'Pump W IMrM M 'Pump aT IMM M I Hpn wMar Man. at n M n Pump Mrd a Moats ela Mspaeoma pelwm by BENCH MARK L• &VI Daaayuan. SW LOT CORNER REBAR. Inspections performed by: E.R.E.S Dates: 1' 8112/2002 2nd 811312002 Development Services Department Approval Reviewed and approved by: Date: of/ tr/d7. lam 1Z%) II Nwmaa Er ~ 80.76 Ft Engineer's Stamp OF AC2 0 Z491H*�'�S�QO . 1r • LOUIS A. Butera �r / 0 ti CE4736 2/27/2001 1:56 PM FROM: Fax TO: 6225195 PAGE: 002 OF 002 .,� Municipality of Anchorage AW Department of Health and Human Services 825'L7 Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Rick Mystnxrt httpJ&~.cf.ancharage.ak.us Mayor Permit Number: WSW 020254 Date of Issue: 7-3 Parcel Identification Number: 015,362-11 Date Started: 10-4-02 Date Completed: 107-02 Is well located at approved permit location? ® Yes ® No Legal Description: Rockhill Blk 2 Lot¢ Property Owner Name & Address: Dave & Melinda Skleens PO Box 232163 Anchone e, Alaska 99523 Borehole Data: Depth (ft) Method of Drilling ® air rotary ❑ cable toot Soil Type, Micknen do Water Strata From To Casing type: sjqXj stick-up 0 2 Wall Thickness: 2A inches organics & sit 2 3 Diameter. ¢ inches Depth: 270 feet silty sandy gravel 3 27 Liner Type: gravelly silt 27 35 Diameter: inches Depth: feet silty gravel 35 Casing stickup above ground: 2 feet gravelly sandy silt 55 63 Static water level (from ground level): feet Pumping level:_L7Q,feet after gravelly st7t 63 162 9 hours pumping 4 gpm gravelly sandy silt H2O 162 174 Recovery Rate: 4 gpm gravelly silt 174 263 Method of Testing: "l" bedrock 263 300 Well Intake Opening Type: ❑ Open End ❑ Open Hole ❑ Screened Start §1 feet Stopped 67 feet ® Perforations Start 10 feet Stopped 174 feet Grout Type: bentonite granules Volume: l! bsrs Depth: Start 0 feet Stopped? feet Pump: Intake Depth feet Pum size hp Brand Name Well Disinfected Upon Completion? ® Yes ❑ No Method of Disinfection: chlorine tablets Comments: Well Driller: Alpine Drilling & Enterprises PO Box 110496 Anchorage Alaska 99511 Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property .... . ...1 _. to I Nt ..1..11 ... .M. . —1$1. . .t . P•... a ♦• . .. n. _. ... :•1.•. rA J.. r. . .t..•_ . MUNICIPALITYOFANCHORAGE p , Development Services Department On -Site Water& Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Date Issued: Jul 30, 2002 Expiration Date: Jul 30, 2003 Permit Number: SW020254 Parcel ID: 015-362-11 Legal Description: ROCKHILL BLK 2 LT 6 Design Engineer: 0024 Eagle River Engineering Services Site Address: 006531 SHALE CIR Owner Name: Dave & Melinda Skieens Lot Size: 46725 SQ. FT. Owner Address: PO Box 232163 Total Bedrooms: 3 Permit Bedrooms: 3 Anchorage . AK 99523 - This permit is for the construction of: ❑✓ Disposal Field 0 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: -7/ 31 /71 Date: 7/30/0 z Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 015 —3&;;� —11 Permit NumberSWO2025¢ Property owner(s) (yc0e Day phone Sy O — 134 f Mailing address (1) Po (lox a 3a I (P 3 Mailing address (2)G�tb�Q-� Q,) Zip Code OI C Sa3 Legal description (Lot, Block & Sub'd.) L-0 - 6 Legal description (Section, Township & Range) Lot Size y(p ?a� S Acres/Sq_FL Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only Sewer and Well 12 Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 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 prop ,y owner or authorized agent) Permit Fees: ITT0 • '"O Date of Payment: Receipt Number: Waiver Fees: 3I�5/°Z L_% DatacfPayrnent 02 32L G J f5 Receipt Number. Eagle River Engineering Services Louis Butcra, P.E. P.O. Box 773294 Eagle River, AK 99577-3294 July 22, 2002 Jim Cross, P.E. Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Rockhill, Lot 6, Block 2 Narrative & Permit Application Dear Mr. Cross: (907) 694-5195 tel (907) 694-3297 fax The proposed septic upgrade/well and septic system will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are large, allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30' distance. Reserve space is adequate, due to absorption capacity. 4. Drainage will not be affected and is not a major consideration in our design. This system is being installed on a 25% sloped area on the lot and has a large depth of cover to accommodate gravity feed from the proposed house location. We may have to adjust the gravel depth/trench length to accommodate gravity flow. If this is necessary we will call in for any modification approval prior to construction. If you have any questions please call our office at 694-5195 Sincerely, Louis Butera, P.E. \2002\02-024 SrPitcNARRATIVEMOC 5 HSE / 501.0' 1 ABBOTT ROAD S89'59'22"E 320.00' 10' TELEPHONE AND ELECTRIC EASEMENT T 0 CP R100.0' n I NO WELLS +100 LOT LOT 6 NO SURFACE WATER NO KNOWN CURTAIN DRAINS r /- / I Rll OQ Q� NO SEPTI: SYSTEMS �~ Ip [HSE 0.0' CD�,� R100.0' V NO WEDS ♦100' 7 APPROX. LOCATION OF SEPTIC SYSTEM ® - TEST HOLE • - MONITOR TUBE 0 - SEWER CLEAN OUT - WELL - - EASEMENT PROPOSED LEACH FIELD - EXISTING LEACH FIELD [-^=7 - DRIVEWAY WELL/SEPTIC SITE PLAN LEGAL: LOT 6, BLOCK 2 ROCKHILL SUBDIVISION OWNER: SKIEENS CONTRACTOR: NA JOB# 02-024WS DATE: 7/22/02 1 SCALE 1 " = 50' EACLE RIVER ENGINEERING SERVICES AP.O. Boz 773294 EACLE RIVER, AK. 99577 (907) 694-5195 FAX. • (907) 694-3297 OF A4 II' , � 'Z * : 49 TH .. ............. i1 • . LOUIS A. BUTERA •W i 5 CE -6736_ INSULATEW/!' SLUESCARD UNDER DRIVEWAY. Z MIN SOIL COVER. LOT LOT 6 NO SURFACE WATER NO KNOWN CURTAIN DRAINS r /- / I Rll OQ Q� NO SEPTI: SYSTEMS �~ Ip [HSE 0.0' CD�,� R100.0' V NO WEDS ♦100' 7 APPROX. LOCATION OF SEPTIC SYSTEM ® - TEST HOLE • - MONITOR TUBE 0 - SEWER CLEAN OUT - WELL - - EASEMENT PROPOSED LEACH FIELD - EXISTING LEACH FIELD [-^=7 - DRIVEWAY WELL/SEPTIC SITE PLAN LEGAL: LOT 6, BLOCK 2 ROCKHILL SUBDIVISION OWNER: SKIEENS CONTRACTOR: NA JOB# 02-024WS DATE: 7/22/02 1 SCALE 1 " = 50' EACLE RIVER ENGINEERING SERVICES AP.O. Boz 773294 EACLE RIVER, AK. 99577 (907) 694-5195 FAX. • (907) 694-3297 OF A4 II' , � 'Z * : 49 TH .. ............. i1 • . LOUIS A. BUTERA •W i 5 CE -6736_ Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 Eagle River, AK 99577-3294 (907) 694-5195 tel (907) 694-3297 fax SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: Rockhill, Lot 6, Block 2 July 22, 2002 A. GENERAL 1. The well and septic plan are for a single family residence only. 2. The drawing and or site plan shall be apart of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. S. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi- family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. 9. Any remaining open test hole excavations shall be filled and monitor pipes removed. B. SEPTIC TANK and SEWER PIPING 1. The sewer piping from the house shall be 4" PVC 3034 laid at 2% grade maximum - 1% minimum and insulated where it is under driving surface with 4" of burial foam, 2' wide centered over piping. 2. Septic tank shall be minimum of 1,000 gallon tank of MOA approved construction, insulated or place with 4' of soil cover. C. TRENCH 1. The trench is to follow the natural land contour along slope to maintain uniform total depth of the trench bottom. 2. The bottom of the open trench excavation shall be level, plus or minus 1.5" prior to placing gravel. 3. The total depth of the trench excavation is not to exceed 13' at any point in relation to natural ground surface. 4. The 6' of effective depth sewer gravel and effluent pipe is to be covered with typar fabric material. S. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed over the leachfield. 6. The area over the trench is to be finish graded to prevent ponding of surface water runoff. 7. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH = 13' GRAVEL DEPTH = 6' under pipe, 2" over pipe TRENCH LENGTH = 31' TRENCH WIDTH = Y or bucket width. SOIL RATING= 1.2 GPD/112 BEDROOM CAPACITY= 3 SEPTIC TANK = 1000 minimum 2 inspections required - Twenty-four (24) hours notice required for all inspections. \2002NO2-024Trench- spcc.doc EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99577 (907)694-5195 ERES Project No.: 02-024 Calculated By: LB Date: 7/22/2002 Legal: Rockhill, Lot 6, Block 2 Single Family 3 Bedroom Dwelling Deep Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = Percolation rate = Wastewater application rate = Required absorption area = Trench width (W) = Gravel depth (D) = TEST HOLE 1 450 gallons 2.0 minutes per inch 1.2 gallons per day per square foot 375 square feet 3 feet 6 feet Required length = Required absorption area / 2 / D Required length = 375 / 2 / 6 Required length = 31 feet Total Excavation Depth = 13.0 feet SINGLE FAMILY ON-SITE WORKSHEET ERES PROJECT NUMBER: 02-024 CALCULATED BY: LEGAL DESCRIPTION: Rockhill, Lot 6, Block 2 NUMBER OF BEDROOMS: 3 WATER USE PER BEDROOM: 150 PERCOLATION RATE: 2.0 DEPTH TO GROUNDWATER: 19 DEPTH TO IMPERMEABLE LAYER: 19 ANTICIPATED DEPTH OF COVER: 7 MOUND OR BED SYSTEM WASTEWATER APPLICATION RATE: ABSORPTION AREA REQUIREMENT: MINIMUM BED LENGTH 12 FEET WIDE BED 15 FEET WIDE BED LB GALLONS MINUTES PER INCH FEET FEET USABLE SOIL STRATA FEET TOTAL USABLE DEPTH: USABLE SOIL STRATA DEPTH: 0.8 GAUSQ.FT 563 SQ.FT TRENCH SYSTEM WASTEWATER APPLICATION RATE: ABSORPTION AREA REQUIREMENT: SHALLOW TRENCH OPTIONS 5 FEET WIDE TRENCH EFFECTIVE REQUIREDTRENCH DEPTH (FT) LENGTH (FT) 1 66 2 53 2.5 48 3 44 3.5 40 4 38 DESIGN SPECIFICS FIELD SYSTEM: GRAVEL DEPTH: TRENCH OR BED WIDTH: LENGTH: TOTAL EXCAVATION DEPTH: 47 FEET 38 FEET 1.2 GAUSQ.FT 375 SQ.FT 13 6 DEEP TRENCH OPTIONS 3 FEET WIDE TRENCH EFFECTIVE REQUIRED TRENCH DEPTH (FT) LENGTH (FT) 4 47 4.5 42 5 38 5.5 34 6 31 7 NA 8 NA 9 NA 10 NA D (B -BED. S=SHALLOW TRENCH & D=DEEP TRENCH) 6 FEET 3 FEET 31 FEET 13.0 FEET Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Boz 196650 Anchorage. AK 99519-6650 www cl anchorane ak Us (907) 343-7904 Soils Log - Percolation Test Performed For. Dave & Melinda Skieens Legal Description: Rockhill, Lot 6, Block 2 r�i 1 e 0r'nnI(- Tspsoil t 5- 6-Io7G` 7-- 8- 10-11 11-r Send vv;fh &rive 12- i.� 7 H;96 Sn / content i 13- 14- '. 15- 16-;. ' 17- 18- 9• o r •• r 10 20- COMMENTS Lout A Buten CE47M Date Performed: 7/122002 Township, Range. Section: T12N. R3W. SEC. 14 Slope Site Plan 1 'r v1• r r 1 WAS GROUNDWATER I Date ENCOUNTERED? No Depth to Water s IF YES. AT WHAT DEPTH? L Depth to Water After O Monitoring? D4Y E Dates 7-19-0� ree Reading Date Gross Time Net Time Depth to Water Net Drop Soak 1 7/12/02 I I: sO. 27 2 7/12/02 12:00.27 10in; n 3 7/12/02 12:ol.2o 6=�° 4 7/12/02 12:11.20 10 min 6�'iisa S 14 5 7/12/02 11:12:00 6 7112/02 12: 2.00 /0rnin (r- (icy s r6rr PERCOLATION RATE 2.0 (M. 0,11 M1 PERC HOLE DIAMETER 6" TEST RUN BETWEEN 6' FT AND 7- FT PERFORMED BY: Eagle River Engineering I --YCERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 071VS/2002 .2i n� E 8V • Municipality of Anchorage On -Site Water and Wastewater Program a (907) 343-7904 s a r E T Y CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Dec ;Za / a.o 2 t - Parcel I.D. 0.15-362-11__ __ _ Expiration Date: _ 1. GENERAL INFORMATION Complete legal description Rockhill Block 2_Lot_6 Location (site address) 6531 Shale Cir. _Anchorage. AK Current Property owner(s) Rodney Weeks Mailing address Real Estate Agent 6531 Shale Cir._ Anchorage,_ 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone __ Day phone ____ 3. NUMBER OF BEDROOMS: 4 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ® Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class _ Well ❑ Public Sewer ❑ Public Water System ❑ Waiver/Variance request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by.the engineer. COSA Fee $ 6-670 Date of Payment Z� _ Receipt Number ty COSA # OsG 2-112- 11 a 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. Name of Firm ARCTERRA CONSULTING, INC._. Phone 696-6111 Address _20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS. Date�_�__._ 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 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, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen ,� o a encroachments, deficiencies or discrepancies exist. L-^� ` ft Ti - 6. i- /\ 6. DSDSIGNATURE \// System #1 Approved for bedrooms. System #2 Approved for bedrooms. Disapproved. KENNETH 11. u RJ r "16 f 7 Conditional approval for bedrooms, with the following stipulations: �J , i v� rr r .Z - 4,0 J ---�ao — B -J-ems I�wZc��� Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist _ X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other __ COSA blue sheet -10-10-12 doc 18 Rock barrier along driveway to prevent vehicle access over tank and field Parcel I.D. 015-362-11 BMITTA ?4£ 3U Municipality of Anch age f On -Site Water and Wastewater Pro ram A�� O ?�15 r (907) 343-7904 Gretchen Stupe ° Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description Location (site address) Rockhill, Block 2, Lot 6 6531 Shale Cir. Expiration Date: 11-17-1,5- 6531 !"f7 f.J Current Property owner(s) David & Melinda SkleenS Day phone Mailing address 6531 Shale Cir. Anchorage, AK 99507 Real Estate Agent 2. TYPE OF DWELLING: FxFl Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Fx] Individual F] Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for:, Received by: z Date: i is COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ �J2%' Waiver Fee $ Date of Payment $ l'�(i5 Date of Payment Receipt NumberCi Jr?'J+a�t!'l Receipt Number COSA# ©SC���"i b'� 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. - In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate 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 system. All systems eventually fail and satisfactory test results do notguarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Bax 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Date 7121/2015 Conditional approval for bedrooms, with the following stipulations: OF.a;; WATER AND By: � 9 M1—c� `— Original Certificate Date: 3— 17— /S7_ The ici➢ahty An rage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) basedonly 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 COSA blue sheet 7 ., .. If more than 1 septic system is on the lot: COSA Checklist #? of 1 Structure served by this system I Certificate of On -Site Systems Approval Checklist Legal Description: Rockhill, Block 2, Lot 6 - Parcel ID: 015-362-14 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 10/7/2002 Sanitary seal (YIN) Y Total depth 300 ft Cased to 270 ft. Date of test FROM WELL LOG 10/7/2002 Static water level unknown ft Well production 4 g.p.m. Well Log (Y/N) Y Wires properly protected (Y/N) Y - Casing height (above ground) 16+ in. AT INSPECTION 7/20/2015 108 ft. 4.4+ 9--p-m. WATER SAMPLE RESULTS: Coliform Neg colonies/100 mL Nitrate ND mg/L Arsenic ND ug/L Date of sample: 07/27/15 Collected by: Pn B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,250 gal. Number of Compartments 2 Foundation cleanout (Y/N) Date of pumping New Y Depression over tank (Y/N) N Pumper N/A Date installed 9/242015 Cleanouts(Y/N) Y High water alarm (Y/N) N C. ABSORPTION FIEL"ATA Date installed 9/25/2014 Soil rating (g.p.d./f:2 or ft2/bdrm) 1.2 GPD/SF System type Deep Trench Length 45 ft. Width 3 ft. Gravel below pipe 6 ft. Total depth" 1 ft- Eff absorption 461 540 fe Monitoring tube Y �Vepm, ssion over field N Date of adequacy test New Results (Pass/Fail) Pass For 2 bedrooms Fluid depth in absorption field before test NeW in. Water added New gal. New depth New in Elapsed Time: New min. Final fluid depth New in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons _ in. "Pump off" level at Cycles tested _ Manhole/Access (Y/N) in. High water alarm level at in. Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ On adjacent lots 100+ Absorption field on lot 100+ On adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout 100+ Sewer /septic service line 25+ Holding tank 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Absorption field 5+ . Water main 10+ Water service line 10+ Surface water 100+ Wells: on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line .10+ Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION ( 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 Steven R. Pannone Date 7/21/201.5 COSA canary sheet 2.6-15.doc ABBOTT ROAD 0 U) 0 LO NOTE: Dimensions are measured to the wood trim. I hereby certify that an accurate survey of the following described property: ROCKHILL SUBDIVISION (97-37) LOT 6, BLOCK 2 was made on August 6, 2015 and that the improvement: situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Easements other than those shown on the record plat may not appear on this drawing. Anchorage Alaska, this 11th day of August 2015, 1 SCALE: 1"=40' 0' 20' 40' 80' Municipality of Anchorage O • Development Services Department s Building Safety Division On -Site Water and Wastewater Program ` 5 A F ET Y a 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 Parcel I.D. HAA # 4 © 0 7 3 - Expiration Date: _ ro — 3 " O 4 1. GENERAL INFORMATION Complete legal description J-.6 orv. Location (site address or directions) 'e 4- Current Property owners) Day phone Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF -BEDROOMS: 3 3. 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 ❑ 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. Municipality of Anch6rage Development SerVice'sDepartmient A Z Iii, a[X building Safety Division 'On -Site Water & Wastewater Program S A F E T Y 4700 South Brag6w'St. P.O.: Box 196650 Anchorage,"AK ;99519-6650 www.ci.an6h6'r6ge.ak.us (907) 343�17904 HEALTH AUTHORITY CHECKLIST Legal Description: Ldp- 4, ,,Parcel ID: A. WELL DATA Well type If A, B, or !C provide PWSI D # We'll Log (Y/N Date completed Sanitary seal (Y/N), X Wires properly protected (Y/N):! Total depth ;0,0 ft. Cased to 1'.7;'0 -ft. j Casing height (above ground) 1n.. FROM WELL LOG AT INSPECTION Date of test Static water level P.M. Well production g.p.m. 91 i. WATER SAMPLE RESULTS: � Coliform colo:nies/1 00 ml. Nitrate kfat-mg'./l. Other bacteria'colonies/100 mi. Arsenic: :Dateofsample mg./I. h :Collected by: B. SEPTIC/HOLDING TANK DATA: Tank Type/Material ;;x -e e- Date installed Tank size &)Pl) gal Number of Compartments i Cleanouts (Y/N)11. Foundation cleanout (Y/N) y Depres'sion over tank (Y/N) High water alarm (Y/N �,W Z_ 1-Y Pumper Mrd 'klt. Date of pumping HoLje_ i4 -f -e- ---vl;i 1 3-4-1. C. ABSORPTION FIELD,DATA Date installed Soil ratin fe/bdrm) /,a System type 1_�be.A7 Width 3 ft. Gravel below pipe Length 3 31 'ft. ft.! Total depth Eff. absorption area 39,/ ft2 Monitoring tube'Y Depression 8ver,fieid' Date of adequacy test /V40f Results (Pass/Fail) 1: For 'bedrooms' Fluid depth in absorption field before test 0 in. Water added 0 gal. New depth_ ' in. Elapsed Time: --Min. Final fluid depth ---in. Absorption rate >= g.p.d.� Any rejuvenation treatment (past 12, mo.) (Y/N & type) 11 If yes, give date Ln P ABBOTT ROAD R CZ o S89'59'22"E 320.00' 10' TELEPHONE AND ELECTRIC EASEMENT 58.9. LOT 6 C9 •i C e�' r•' ..'. o 25.2• •4•' , yCRAVEL •... '.: Z f $ ENTRY' A. • �• 1e .%4. FIREPLACE . CANT. 6? a d --'uSE ` 2ND—STY qO� 9+ CANT. Q' 7 �0000pp0o LEGEND: oa OF A.Cgo4 ... 0 DO�Q •S,��Q GRAVEL DRIVEWAY R=50.00' *� 49TH .y* 0 L=46.5%' SEPTIC STANDPIPES O L�� ...........................�'�— .:.... SHALE wEu_ OQ LOUIS A. ........................... BUTERA�O CIRCLE QQ�s�e�P� LS 9338 •C3 X=:' 444��00000�� SCALE. DATE: BY: L. BU TERA & ASSOCIATES A SB UI L T SURVEY 1•=5o' 03/01/04 BJR P.O. Box 773294 10421 VFW Drive Eagle River, Alaska 99577 LEGAL: LBUTERA Project No: 02-024 (907) 696-7375 FAX. (907) 622-5195 LOT 6, BLOCK 2 ROCKHILL SUED. CADD File Name: 02-024AB I hereby certify that I have surveyed the following described propertyi LOT 6, BLK, 2, R13CKHILL SURD. Anchorage Recording Precinct, Alaska, and that no encroachments exist except as Indicated. It Is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. Under no circumstances any data hereon be used for construction of fence lines, or for establishing boundary lines. 3- 2-04;10:53AM; ;907 51115301 * 2/ 3 SCS Rera 1040971001 Client Name Lou Butera & Assoc. Project Name//! Rock Hill, L6, B2 Client Sample ID Rock Hill, L6, B2 Matrix Drinking Water PWSID 0 Sample Remarks: All Dates/Times are Alaska Standard Time Printed Date/Time 03/02/2004 7:50 Collected Date/Time 02/26/2004 18:30 Received Date/Time 02/27/2004 8:20 Technical Director Stephen Q Ede Released By Parameter Results pQL Units Method Container ID Allowable Prep Analysis Limits Date Date ]nit Waters Department Nitrate -N Microbiology Laboratory Total Coliform 0.100 U 9 OB, No Coli 0.100 mg/L EPA 300.0 B (<-10) coV100mL SM189222B A (<-1) 0227/04 JJB 0227/04 DKC