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Home My WebLink AboutSAND LAKE #2 BLK 1 LT 30� [�� . Inspection Report_14'12.jyEE 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: OSP151116 PID Number: 011-132-46 ❑ New ✓❑ Upgrade Name: Denny Patella & Abigail Stolz ABSORPTION FIELD ❑ Deep Trench ❑✓ Shallow Trench ❑ Bed ❑ Mound Address 8031 Wilcox Street ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade - 4 6GPD/SF - 4Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.5 Ft. Gravel depth beneath pipe 0.5Ft. Subdivision Block Lot Sand Lake #2 1 3 Fill added above original grade 0 Ft. Gravel length 20 Ft. Township Range Section - - Gravel width 5Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES - To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 100 Fe 1 N/AFL Well 112.3 109 124.2 NIA NA TANK ❑ Septic El S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank / Orenco Capacity I 15000a1. Surface water 100+ 100+ 100+ N/A Material Steel Number of compartments - 2 Lot Line 17.2 7.4 20.0 NIA NA Foundation 8.6 19.86 22.7 N/A LIFT STATION. - Manufacturer - Orenco Capacity - 5000a1. Curtain Drain N/A N/A N/A N/A Pump on level at Pump off level at High water alarm at Remarks Installed Advantex- 40 in. 36 in. 45 in. Pump make and model - Electrical Inspections performed by P2005 MoA Building Safety PIPE MATERIAL House to tank 3034 Tank to 3034 dmintield Installer - - A+ Home Services Drainfield (E) CO1MT (E) Inspector Pannone Engineering Services BENCHMARK (Assumed elevation) 100ft Inspection, - 1' 27JUL15 2w 28JUL15 Location and description - - dates: Threshold rear door 3`° 4,h COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date even E *Pgnnope Approved Dates n CE 1AW Inspection Report_14'12.jyEE 1 PzI 19 FC 6.0 Ti 12.5 T2 19.5 AUX 24.4 PUMP MTI 19.6 MT2 38.3 - CLASS \ ABANDONED DRAIN FIELD PER CODE p -o 20.2 23.8 8 - - 7 27.2 36.1 48.6 \ 2 \� PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510A�q\sllt PHONE (907) 272-8218 FAX (907) 272-8211Sc' ii 23 % .... .... .. .... / .. . ., .. ... / Steven . Pannone 9F.•, CE 8149 >tFoOEESSoNP SS �� Date 0�/2s/ts _ Ie 50' P.I.D. NO 011-132-46 _____ t\\ ABANDONED SEPTIC. TANK PER CODE \ -__~\_-- INSTALLED TANK _ 15008 ADVANTEX % -'�- --------------- W/ AX20 POD "--------_ ------ I� w i INSTALLED DRAIN FIELD 20LW F x 5.0' x 0.5ED, 4.0' TO r \� �'\ U)o 3 SIR SFD t ti TN \ 22 X O — i•� _ _ V f� 21 SS "C`4/ELL------ -- SEPTIARE a __----- l ... CJ CLASS "C" WELL I— / ! \ F-1 — I ! 5 1 1J ISEAREA ! r IWELL�/ - j, %j 20 .fl/ if /l !'tiL — — J r / of J 19 FC 6.0 Ti 12.5 T2 19.5 AUX 24.4 PUMP MTI 19.6 MT2 38.3 - CLASS \ \ \ p -o 20.2 23.8 8 - - 7 27.2 36.1 48.6 "C" WELL NOTES: PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510A�q\sllt PHONE (907) 272-8218 FAX (907) 272-8211Sc' % .... .... .. .... / .. . ., .. ... / Steven . Pannone 9F.•, CE 8149 >tFoOEESSoNP SS �� Date 0�/2s/ts RECORD DRAWING Ie 50' P.I.D. NO 011-132-46 - SAND LAKE #2 31 L3 DENNY PATELLA 8031 WILCOX ST ANCHORAGE, AK 99502 PERMIT NO. OSPI51116 DRAWN . JRL PLAN Sheet 2 OF 3 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. ALL WORK WAS IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: ABANDONED SEPTIC TANK (E) AND DRAIN FIELD (E) PER CODE. INSTALLED ADVANTEX 1500g SEPTIC TANK W/ AX20 POD (P) AND NEW SOIL ABSORPTION SYSTEM. 4. GROUNDWATER WAS NOT OBSERVED TO A DEPTH OF 15.0' AS EVIDENCED BY THE SOIL TEST HOLE. AN APPARENT WATER TABLE WAS NOT OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 15.0 FEET BELOW EXISTING GRADE. FILTER F DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1500g (P) PERC RATE - 1.86 MPI SOIL RATING: 6.0 GPD/SF AREA ROD: 100 SF - SYS. TYPE: WIDE TRENCH 0.50' E.D. MIN SIZE: 20 LF 1.25"0 PIPE 5' O.C. TYPICAL W/ 0.125" DRILLED HOLES 18" O.C. (P) DRAIN ROCK _T_ a j SECTION 1500g ADVANTEX TANK (P) PROFILE LEGEND --- WATER LINE/ WELL RADIUS USED: 20.0' LONG X 5.0' WIDE, 0.50' E.D., 4.0' TD TOTAL AREA: 100.0 SF NOTES: PAMONE ENG RECORD DRAWING P.O. BOX 100217 ANCHO -_ PHONE (907) 272-8218 FA DRAWN DESIGN NOTES NEW SEPTIC SVC, LLC 1GE, AK 99510 (907) 272-8211 SAND LAKE #2 B1 L3 DENNY PATELLA 8031 WILCOX ST ANCHORAGE, AK 99502 ABBREVIATIONS CU w 1.25'0 PIPE 5' O.C. TYPICAL. 4 m= W/ 0.125" DRILLED HOLES r N FOUNDATION CLEAN OUT 18" O.C. (P) z TANK CLEAN OUT NO. C# r PROCK 6"ABOVE G - I PIPEIPET INV z RIGID INSULATION DCO rFILTER FABRIC � PROFILE LEGEND --- WATER LINE/ WELL RADIUS USED: 20.0' LONG X 5.0' WIDE, 0.50' E.D., 4.0' TD TOTAL AREA: 100.0 SF NOTES: PAMONE ENG RECORD DRAWING P.O. BOX 100217 ANCHO -_ PHONE (907) 272-8218 FA DRAWN DESIGN NOTES NEW SEPTIC SVC, LLC 1GE, AK 99510 (907) 272-8211 SAND LAKE #2 B1 L3 DENNY PATELLA 8031 WILCOX ST ANCHORAGE, AK 99502 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. 1. 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 AND VEGETATE E EXISTING P PROPOSED 07/28/15 TH "'W. P.I.D. NO 1-132-4 Steven Pannone PERMIT NO. IP CE 8149 \4 � OSPI51116 �l lFFfQ ' • • ,� Sheet ill �O�ssio�P 3 OF 3 THE STATE 01ALASKA Steve Pannone, P.E. 611" ER'dOR BILL GdALKER Pannone Engineering Services P.O. Box 10-0217 Anchorage, Alaska 99510-0217 Department of Environmental Conservation Division of Water Wastewater Discharge Authorization Program 555 Cordova Street Anchorage, AK 99501 Main: (907)269-7519 Fax: (907)334-2415 August 5, 2015 Re: Anchorage -Sand Lake 4 2, Block 1, Lots 3 & 4 -Waiver of Separation distances to the Field and the new Septic Tank Effluent Pump (STEP)-ADEC Plan Tracking Number 25212 Dear Mr. Pannone, On August 5, 2015 the Department received an engineering plan submittal for the waiver of separation distances to the drain field and the STEP tank, a Secondary Treatment Unit with an AX 20 Pod. The source well is reported to be an established Class C well that has been registered. It may require work to protect the well head. The well head must be protected and must still retaining it's sanitary seals. Please confirm this information with the completion of the project. The waiver requested to the soil absorption field is a reduction from 150 feet to 109.0 feet. The engineer has provided information and recommended this reduction. The information does indicate that this waiver would still be protective of public health. The waiver requested to the STEP Tank is a reduction from 150 feet to 111. l feet. Again the engineer has provided information and recommended this reduction. The information does riot indicate that this waiver would still be protective of public health. Should in the future these waivers requested by the engineer be found that the site conditions endanger public health or are a public health concern, these waivers may be rescinded. This approval does not imply the granting of additional authorizations nor obligate any state, federal or local regulatory body to grant required authorizations. Any person who disagrees with this decision may request an adjudicatory hearing in accordance with 18 AAC 15.195- 18 AAC 15.340 or an informal review by the Division Director in arcordance with 18 AAC 15.185. Informal review requests must be delivered to the Division Director, 410 Willoughby Avenue, Suite 303, P.O. Box 111800, Juneau, Alaska 99801, within 15 days of receiving the decision. Guidance information on the informal review process may be found at http://www.dec.state.ak.us/commish/Review- Guidance.htm. Adjudicatory hearings requests must be delivered to the Commissioner of the Department of Environmental Conservation, 410 Willoughby Avenue, Suite 303, P.O. Box 111800, Juneau, Alaska 99801, within 30 days of the decision. If a hearing is not requested within 30 days, the right to appeal is waived. Thank you for your cooperation. If you have any questions please do not hesitate to contact me at 269- 7519. Respectfully, William R. Rieth, P.E. Environmental Engineer 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: OSP151116 Tax Code Number: 01113246000 Work Type: Septic Upgrade Permit Effective Dates: June 26, 2015 to June 25, 2016 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: SAND LAKE #2 Site Legal Address: SAND LAKE #2 BILK 1 LT 3 G:2224 Owner/Address: PATELLA DENNY F & STOLZ ABIGAIL 8031 WILCOX STREET ANCHORAGE AK 995024151 Site Mailing Address: 8031 WILCOX ST, Anchorage Lot Size in Sq Ft: 6750 Total Bedrooms: i3'y 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. -*Cvd-}rfV;SkS �-° 42 40LAV(LI) IaP�rDvw�S. Received B, Issued By: 5 MUNICIPALITY OF AN Community Development Department Development Services Division On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT Parcel I.D. 011-132-46 MAY O §hqp 9 343-7904 Fa 9 343-7997 13,37 .ti Property owner(s) Denny Patella Day phone None Available Mailing address 8031 Wilcox St, Anchorage, AK 99502 Site address 8031 Wilcox St, Anchorage, AK 99502 Legal description (Sub'd., Block & Lot) SAND LAKE #2, B1 L3 Legal description (Township, Range & Section) 6750 Ca Lot Size Sq. Ft. Number of Bedr ms-� APPLICATION IS FOR: APPLICATION IS AN: TYP"F DWELLING: (® all that apply) Absorption Field RInitial F-1 Single Family (SF) 19 (w/wo ADU) Septic Tank ❑X Upgrade ❑X Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: c�l� LSC 8 Nt-Y Tank and drainfield separation from Class "C" well on adjoining lot Distance:115' pqr- *..'Arve2APP I certify that the above information is correct. I further certify that this is in accordance with '20®Y 8 applicable Municipal Codes. of property owner or autnonzeo agent) Permit/Rush Fees: r'1 Date of Payment: Receipt Number: nZ 31, It N Permit No. 05fet' J I I I �P Permit App__.:- :L:c Waiver Fees: Date of Payment: Receipt Number: Waiver No. Pannone Engineering ServiceS LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve(c@oanengak.com Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road P. 0. Box 196650 Anchorage, Alaska 99519 Subject: SAND LAKE #2, 131 L3 Septic System Permit Request Ladies and Gentlemen: $¢r Co i I am writing to request a permit to install a new ptic t ink, N property. The proposed system will serve a prop sed °' developed. The proposed system will utilize a 15 Og STEP tank 6 May 2015 n field be issued for this m house. Currently the lot is NTEX). The surrounding developed lots are served by a combination of private wells and-Class'"C'-w1e ls. There are no wells on the surrounding lots within 100 feet of this system. The Class "C" well that serves this lot is 116.8' away from the proposed tank and 119.9' from the proposed field. A waiver request has been submitted to the Alaska Department of Environmental Conservation to waive the separation distance. 1. Soils. A test hole was performed by Pannone Engineering in April of 2015. Groundwater was monitored for seven days. Ground water was not encountered in either test hole after the seven day monitoring period. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 6 gallons/day/square feet should be used for the proposed Category III 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 existing topography slopes from the northwest to the southeast at approximately 4%. 5. 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 Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 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. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 o - s �t i - " 4 N av V) I— i (n N 0 x o CJ! 0 U q J LJLLJ 55 "C`w€LL- _---"_- CLASS "C" W\4- EPT 100 ELL �^ rz p� >x NOTES: PANNONE ENG SVC, LLC . QF Q/�\\i\ 07/(/15 Dote FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 ��"' "'qS�� PHONE (907) 272-8218 FAX (907) 272-8211 /rg�P �y+` Scale *• *�1 r'=50' ... .... .... . ..... P.I.D. NO SAND LAKE #2 31 L3 ........ 011-132-46 DENNY PATELLA Ste ven'R.'Pann orae PERMIT N0. DRAWN JRL PF.•. CE 8149 of PERMIT o 8031 WILCOX ST 0" - PLAN ANCHORAGE, AK 99502 +��1�f0 oFESs : Sheet 4 \\ (V - 1 ----------- -- 24 ABANDON GRAIN .�• FIELO (E) PER CODE 2 23 ABANDON SEPTIC -_ "___JWSTALL ISOOg ADVANTEX L� � TANK (E) PER �06E TANK W� AX20 POD (P) - "�""'-------= DRAINFIECO (P) I �l 20LF x 5.0'W x 0.5'ED, 4.0" TO (1 3 6R SFS TR 22 3`� l ;: 4 21 - -�/ SEPTIC � l 11 1 AREA WELL � � \ ` r�_ —, I � � /•'� _. I C F 5 WELL WELL/ ZO � oo. o 8 � 7 CLASS "'C" WELL If 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. ALL WORK WILL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: ABANDON SEPTIC TANK (E) AND DRAIN FIELD (E) PER CODE. INSTALL ADVANTEX 1500g SEPTIC TANK W/ AX20 POD (P) AND NEW SOIL ABSORPTION SYSTEM. 4. GROUNDWATER WAS NOT OBSERVED TO A DEPTH OF 15.0' AS EVIDENCED BY THE SOIL TEST HOLE. AN APPARENT WATER TABLE WAS NOT OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 15.0 FEET BELOW EXISTING GRADE. FILTER FAB 00.0 0.5 SM -7.0 SM -15.0 BOH 'o 0 DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1500g (P) PERC RATE = 1.86 MPI SOIL RATING: 6.0 GPD/SF AREA ROD: 100 SF SYS. TYPE: WIDE TRENCH 0.50' E.D. MIN. SIZE: 20 LF 1.25"0 PIPE 5' O.C. TYPICAL W/ 0.125" DRILLED. HOLES 18" O.C. (P) ROCK. iSECTION m m .�.1125 0 0,1 PIPE 5' O.C. TYPICAL W/ o s W/ 0.125" GRILLED HOLES F � 18" O.C. (P) O O DRAIN ROCK 6' ABOVE O PIPE INV E 100.0' n I f -FILTER FABRIC PpA2(l DRAIN ROCK LL mo�L T 15009 ADVANTEX- 20.0 TANK (P) PROFILE USED: 20.0' LONG X 5.0' WIDE, 0.50' E.D., 4.0' TO TOTAL AREA: 100.0 SF LEGEND — WATER LINE/ WELL RADIUS NEW SEPTIC 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. 1. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BEG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE - TS&V TOPSOIL AND VEGETATE E EXISTING P PROPOSED NOTES: PAMONE ENG SVC, Date LLC �� QF Q(,\`l, 07/ 15 R CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 J ��'' "'qS �) PHONE (907) 272-8218 FAX (907) 272-8211 %g�p �y') Scale ..... .. ... P.I.D. NO SAND LAKE #2 31 L3 ......... . .... .... �ot1—lsz—al DENNY PATELLA Steven. E2814onom � '�n�e/ PERMIT NO. DRAWN JRL �. // OSP151116 8031 WILCOX ST + DESIGN NOTES ANCHORAGE, AK 99502t�1��Fp a.....�... Sheet 2 OF 4 ADVANTEX TANK SYSTEM WITH AX20 POD DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 15008 (P) PERC RATE = 1.86 MPI SOIL RATING: 6.0 GPD/SF AREA ROD: 100 SF SYS. TYPE: WIDE TRENCH 0.50' E.D. MIN SIZE: 20 LF USED: 20.0' LONG X 5.0' WIDE, 0.50' E.D., 3.5' TD TOTAL AREA: 100.0 SF LEGEND --- WATER LINE/ WELL RADIUS NEW SEPTIC NOTES: PAMONE ENG SVC, LLC CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 SAND LAKE #2 B1 L3 DRAWN JRL DENNY PATELLA 8031 WILCOX ST DESIGN NOTES ANCHORAGE, AK 99502 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 BFC BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL AND VEGETATE E EXISTING P PROPOSED • ~�'Q.041. 107/06/15 NTS .... ... . . ........ P.I.D. NO Steven R. Pannone CE 8149��/ 'll`fpy?OFESSIONP�' \\\\\s 11-132-41 PERMIT N0. OSP151116 Sheet 3 OF 4 TEST HOLE 1 SOILS LOG - PERCOLATION TEST OR TOPSOIL SLOPE �y SITE PLAN III 1--_--------,,, II 2 3 TEST ------- HOLE 4 SM SILTY SANDS \ - 5 \M a i 5 J TH �* 6 �. \ 7 \ �� 6 --- \ ---------V_ --- 11 SM FINE SAND/ M\ ;\ 1 _ +/ SANDY-SILT 1 12 13 WAS GROUND WATER SLOPE 14 ENCOUNTERED? N 15 IF YES, AT WHAT TH 1 BOH DEPTH? -0-' X DATE PERFORMED: 04/29/15 DEPTH TO WATER AFTER MONITORING? - DRY - DATE: 05/06/15 WATER READING DATE aTIMEK NETTIME LEVEL NETDROP ATE READING 1 04/29115 0921 4.295" 2 09'.31 10MIN 11.205 6.91 1447 3 09.32 4.295" 4 0942 IDMIN 10.070 5.775 1.731 5 0944 4.295" 6 09:54 10MIN 9.745 5.450 1.834 7 0955 4.295" 6 1005 10MIN 9.705 5410 1.846 9 1006 4.295" 10 1016 10MIN 9.665 5370 1.862 11 10.17 4.295" 12 10:27 10MIN 9661 5.366 t.863 PERCOLATION RATE 5 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 3.5 FT AND 4.5 FT COMMENTS: Test hole excavated by Pannone Engineering Svc. Test Hole was presoaked before perc test. PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: LLC_��Date FOR CONSTRUCTION P P.O. B �i02�954 ANCHORAGE, ONE ENG CK 9951100 r '(��F.A�,'gS �� 06/25/15 PHONE (907) 272-8218 FAX (907) 272-8211 %g�P !y�� Scale NTS ... :. - ... . :.. P.I.D. NO SAND LAKE #2 B1 L3 .. .. .. .. 1-132-46 DENNY PATELLA Steven Pannone'% PERMIT No. DRAWN JRL ' 9 CE 8149 \�� OSP151116 8031 WILCOX ST f _ SOILS LOG ANCHORAGE, AK 99502 ,�ItF9� o.....ePc' Sheet �� S9 4 OF 4 FH E STATE Department of Environmental Conservation ALASKA Division of Water Wastewater Discharge Authorization Program 555 Cordova Street (_ ERhO 1 LL `,':ALS;ER Anchorage, AK 99501 Main: (907)269-7519 Fax: (907)334-2415 May 12, 2015 Steve Pannone, P.E. Pannone Engineering Services P.O. Box 10-0217 Anchorage, Alaska 99510-0217 Re: Anchorage -Sand Lake # 2, Block 1, Lots 3 & 4 -Waiver of Separation distances to the Field and the new Septic Tank Effluent Pump (STEP)-ADEC Plan Tracking Number 25212 Dear Mr. Pannone, On May 12, 2015 the Department received an engineering plan submittal for the waiver of separation distances to the drain field and the STEP tank, a Secondary Treatment Unit with an AX 20 Pod. The source well is reported to be an established Class C well that has been registered. The well head must be protected and must still retaining it's sanitary seals. Please confirm this information with the completion of the project. The waiver requested to the soil absorption field is a reduction from 150 feet to 119.9 feet. The engineer has provided information and recommended this reduction. The information does indicate that this waiver would still be protective of public health. The waiver requested to the STEP Tank is a reduction from 150 feet to 14 6. 8 feet. Agaiq the engineer has provided information and recommended this reduction. The informati does -4Fie*in ' to that this waiver would still be protective of public health. f W R Should in the future these waivers requested by the engineer be found that the site conditions endanger public health or are a public health concern, these waivers may be rescinded. This approval does not imply the granting of additional authorizations nor obligate any state, federal or local regulatory body to grant required authorizations. Any person who disagrees with this decision may request an adjudicatory hearing in accordance with 18 AAC 15.195- 18 AAC 15.340 or an informal review by the Division Director in accordance with 18 AAC 15.185. Informal review requests must be delivered to the Division Director, 410 Willoughby Avenue, Suite 303, P.O. Box 111800, Juneau, Alaska 99801, within 15 days of receiving the decision. Guidance information on the informal review process may be found at http://www.dec.state.ak.us/commish/Review- Guidance.htm. Adjudicatory hearings requests must be delivered tc the Commissioner of the Department of Environmental Conservation, 410 Willoughby Avenue, Suite 303, P.O. Box 111800, Juneau, Alaska 99801, within 30 days of the decision. If a hearing is not requested within 30 days, the right to appeal is waived. Thank you for your cooperation. If you have any questions please do not hesitate to contact me at 269- 7519. Respectfully, 17) William R. Rieth, P.E. Environmental Engineer MUNICIPALITY OF ANCHORAGE t DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL. ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE al{3 — q8V NEW ❑UPGRADE MAILING ADDRESS A 0, 610o LEGAL DESCRIPTION Lai LOCATION NO. OF BEDROOMS 3 t) DISTANCE TO: Well Absorption area. Dwelling PERMIT NO. _Y a 2Q Manufacturer { • _ _ Mater' No. of compartments y Liq. capacity in gallons !7 ®Q IF HOMEMADE: Inside length Width Liquid depth 0 Y J0 DISTANCE TO: Well Dwelling PERMIT NO. I ? F Manufacturer - Material Liquid capacity in gallons D w=. DISTANCE TO:�. Well Foundation Nearest to n PERM�V Jul l �oZ6� j LL Z F Z w No. of linest Length o a h I;,ne Total length of lines Trench th /� 07. inches Distance between lines M D Top of tile to finish grade �( / Material beneath tile inches Totalabsorption area w (7 Length Width Depth PERMIT NO. i F wa Type of crib Crib diameter Crib depth Total effective absorption area W DISTANCE TO: Well Building foundation Nearest lot line J- J Class Depth Driller Distance to lot line 7 PERM T'7,8-0,) ,8 -0,( w 3 DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOILTEST RATING CYC) INSTALLER REMARKS OU APPROVED 1 DATE LEGAL 7 -/q -W — 72-013 (Rev. 3/78) r 11_16 18 I Ir IT �e • CA F= F=9 44 ED V4 CA F~ Fl C% EE ° DEPARTMENT RL"I HND ENVIFiNNENTAI AW : IO REET: �_W/ -79 5 5 -7 . 264-4720 NJEL_L_ FAIl'AE• CAr'.6 IN I _ EE _°E_03E=F Z F°6=F:`1^1 I T PERMIT NO. C 780261 ) 40;o3U 'APPLICANT R:OSEANNE SHOEMAKER PO BOX ._:101.: 243 484r,14bdill LOCATION 8324 ENDICOTT LEGAL L23 SANDLAKE SLIE' #2 LOT SIZE 6750 _QUARE FEET TYPE OF SOIL ABSORBT I ON SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = _ `OIL RATING &SO FT/BR )= 240 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM I=: E_•��, e.��= " L_ =7P'l(3T6-J= 'tfy F-F=F _E=r_ i- THE LENGTH DIMENSION IS THE LENGTH +:IN FEET? OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT L, THE DI_.TANCE BETWEEN THE SURFACEOFTHE GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIt'IUM DEPTH OF GRAVEL BETWEEN THE OUTFFILL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). T F=6 6'-J k f I _ , LEA CD C J 'w PERMIT APPLICANT HAS THE RES6;'ONSIBILITY TO INFORM THIS: DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL. SERVE. --- -IF NJCA • I V4I°F°EF=_T I ®oI J-° f? FQ En 6= E=CALe I F_6=E• � — BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL; OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC: WELL. WELL LOGS: ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAB'S OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATION_, AND CONSTRUCTION DIAGRAMS: ARE AVAILABLE TO INSURE PROPER INSTALLATION. I F°6= e C•6=®_ E=rlEAEF' 11LAL a' I CERTIFY THAT 1: I HM FAMILIAR.. WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS _,ET FORTH BY THE MUNICIPALITY OF ANCHORAGE 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS/QEMODELED TO INCLUDE MORE THAN I BEDROOMS. SIGNED ICANT ROSEANNE I_. '-+_,I".EC BT_ -- 7_`"--"_ =-t------DA•rE__57"_.:f__;7 $_ V-: 4I MUNICIPALITY Or ANCHORAGE Depart f Health and Environmental ction SOILS LOG PERCOLATION TEST 78-11 Performed for Rose Ann Schoemaker Date Performed 4-20 & 21-78 Legal Description Lot 23 Sand Lake Subdivision No. 2 n 10 6 14 16 0- 1' - Muskeg, organics 1- 5' - Silty, sandy soil, some gravel SP -SM 200 square feet per bedroom 5-16' - Silty sand and silt interbeds - SM 250 square feet per bedroom Aberage square feet per bedroom - visual - 236 Total Depth = 16' No gxovndwater encountered Date Net Time Depth Net Drop 4/21/78 -0- - 1.75 in. -0- 20 min. - 3.0 in. 1.25 160 min. -10.0 in. 8.25 Percolation Rate 19.4 _minute s/inch Performed By___��,� nCHAMPION DRILLING COMPANY, INC. 0 STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION CONSTRUCTION AND OPERATION CERTIFICATE for PUBLIC WATER SYSTEMS A. APPROVAL TO CONSTRUCT G Plans for the construction or modification of L e � � r 61'e -k Qa hSLA 9,2 �LIts- J q public water system located in�& , Alaska, submitted in accordance with 18 AAC 80.100 by have been reviewed and are El approved. ❑ conditionally approved (see attached conditions)., BY TITLE - DATE If construction has not started within two years of the approval date, this certificate is void and new plans and specifications must be submittedforreview and approval before construction. B: APPROVED CHANGE ORDERS Change (contract order no. or descriptive reference) _ Approved by - Date C. APPROVAL TO OPERATE The "APPROVAL TO OPERATE" section must be completed and signed by the Department before any water is made available to the public. p The construction of the Q �� "'� -�2 public water system was completed on (date). The system is hereby granted interim approval to operate for 90 days following the completion date. - BY TITLE DATE As -built plans submitted during the interim approvalperiod, or an inspection by the Department, has confirmed the system was constructed according to the approved plans. The system is hereby granted final approval to operate. By TITLE DATE DISTRIBUTION,: 1. WHITE - ENGINEER (Complete Section C). 2. YELLOW - WATER SYSTEM FILE (complete Section C) 18-0487 (Rev. 11185) - - - A GOLDENROD ENGINEMUNFBORQUGH (complete (complete on C) A) MUNICIPALITY C) j Development Services Department �`'�� p p �== = Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I. D. 011-132-46 1. GENERAL INFORMATION Complete legal description SAND LAKE #2 BLOCK 1, LOT 3 Expiration Date: Y` 2-S-- Z D Z t/ Location (site address) 8031 WILCOX STREET, ANCHORAGE, AK 99502 Current property owner(s) OLIVIA THOMPSON & WALKER HARRIS Day phone Mailing address Real estate agent 8031 WILCOX STREET, ANCHORAGE, AK 99502 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ® Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 550 Date of Payment V'2,9 - Z -7— Receipt —Receipt Number S / 9 Z 7-3 COSA # Dom? ? 1) 67 Date: Waiver Fee $ Date of Payment Receipt Number Waiver # Distance: 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name _CURTIS HUFFMAN, PE Date 4/27/2022 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the •�f(i '�Q well and septic system. Therefore, any estimate of how long a system will function satisfactory/g�Q; •' • . !f9 }� for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting &% * " 9 TH FWC5 0 .. ....... 6. DSD SIGNATURE Curtis Huffman / I` System #1 Approved for bedrooms �� F��s •. CE 128991 •.`��`i� System #2 Approved for bedrooms �liltFOPROF S ONP��' Disapproved Conditional approval for bedrooms, with the folloXi Ig �fi (&Wf� ns: `P��Y OF A (t-, ti, ON-SITE WATER AND 1111)1IV. By E—WAOriginal Certificate Date: 5___ _ Zv 2Z The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: SAND LAKE #2 BLOCK 1, LOT 3 Parcel ID: 011-132-46 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA PRIVATE (C") ON ADJ LOT ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Comments B. TANK DATA Age of tank(s) 7 years Tank type/material ADVANTEX / STEEL* Measured operating fluid level in septic tank M Standpipes/foundation cleanout per record drawing Date of pumping 6/10/21* D. ABSORPTION FIELD DATA Structure served by this system _ Well production at time of test 2 gpm (FYI = FLOW) Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 2.31 mg/L E]Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by FES OUTSIDE SPIGOT Date of Sample 4/25/2022 C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: *SEE AX MAINT REPORT — NEW 5/2022. Which system tested (date installed) 7/28/2015 Adequacy test date 4/25122 ® ALL standpipes present per record drawing Results E Pass For 4 bedrooms Total measured depth from grade 4.1 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade _ft (min) Water added 600 gal ® N/A — pressurized field New depth 3 in ® Monitor tubes go to bottom of effective. If not, state depth into effective MOA IR 0.5' Elapsed time <1300 min ®Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) Gallons introduced gallons If yes, enter date NE Comments/Deficiencies: ; E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No Community Sewer Manhole/Cleanout > 100' M Yes if No ft M Yes if No ft Neighboring Tank > 100' M Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No ft Absorption Field on Lot > 100' M Yes if No ft Holding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' Water Service Line > 10' M Yes Animal Containment > 50' ® Yes if No ft M Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ®Yes — if No ft ®Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No *8+ ft Surface Water > 100' ® Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells >' 100 _ ®Yes if No ft Water Main > 10' M Yes. if No ft Community Wells > 200' ® Yes if No ft Water Service Line > 10' M Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells >' 100 _ ®Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS *MET MOA CODE AT INSTALL. ADEC WAIVERS TO ADJ. CLASS "C" PRIVATE WELL — CURRENTLY DO NOT APPLY PER MOA / ADEC CODES. G. ENGINEER'S CERTIFICATION / certify that / 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. -44 �Ik! or- • _ •.fir ....t... f Curtis Huffman ' �� Fc•. CE 128991 .•�cc`�� `sl�,Q'•S15120�2•'�� 391 801 Il 11111 it 0 on Milo 11 0 111 1 on ONES ff li 0 a all 0 ORRIN No noil 1:! FieldMaintenance AnchiorageTank Annual inspe, otion 0n7_070_QIZA 3 PmPrty pvrnerararking x Current Operator t T �� • v Ryan & Olivia I-lerril 2nd Compartment Larry Bets Previous $its Address Pri vious 8031 Wilcox Street, Anchorage AK 99502 Contact Phony CIn Floats 907-555-5555 nx 8an rn u�ffso y rQ x Pod 0RTU kfta� Oats of Leat IrmpWfon AX -137220 P151116 421239 7 04/30/2020 Retrieve O&M Info Daily flow Reclrc ratio_ Timer settings; Perform Field Sampe vi'Observaticns NTU (15:t NTUs)ph (g.g) DO (2-6) i Odor of Sample Typical XJ Musty ❑ Earthy ❑ WHY, Non -typical 4 Sulfid, ❑ Cabbage ❑ Decay Oily Film in PVu [ 'Yes No Foam in tank .Yes No Check Control Panel Reclrc Amps Discharge Amps fly. 1. ) DIP 3 Audible and visual aian is VOK Dial tona (telemetry onl •i ❑ Yes 0 No Inspect/Clean Pump ; i ystem inspect Clean Rlser/Lld ........... .... Splice Box . . . . ..... ......... Float Cords ......... . . ...... . Floats .............. ........ /716. Pump.............. .. Biotubol Filter . . . . . . . ....... . . (7i Blotube Pump Vault .. ......... TT Rdolrculating Splittor V9 ve....... Commentrg Slanature Measure Sludge/Scum Sludge 1AtCompartment Current Previous ❑ Excessive Previous 2nd Compartment current Previous FCCur-rent Pri vious InspectitWeen AdvanTex Filter Odor; (Z Normal ! ❑ Pungorrt Biomat: fM Normal ❑ Excessive Bridging/Ponding: None/Minor ❑ Excessive Inspect/Clean Discharge Pump System Inspect Riser/6itl Splice Box Float cords CIn InspectlService other System Components Inspect Clean Inspect Clean Disinfection Equipmeent f[� Disparaal Lateraistorifices !£J Observations N f (f f Additional Services Rendered ❑ Claanod textile sheats? ❑ Repiaard UV items? ❑ Replacad/Us9d other items? Parts Used: W = Warranty, B . Billable (,r appropriate selection) W B Item Number Deseriptlon Final/Safety Inspection RSV reinstalled Manifold reconnected; flush valves closed SummarylRecommen dations F—J system performing; no further action needed ❑ Call for servirre Data Fax completed form to 1-866-384-7404 r Lids bolted on Control panel macuvatad ❑ Tank needs primping ❑ Other? Inspect Clean laterals/Orifices �1 Pod Bottom J]�" intak* Vent Inspect CIn Floats r�'.'tl Pump � S InspectlService other System Components Inspect Clean Inspect Clean Disinfection Equipmeent f[� Disparaal Lateraistorifices !£J Observations N f (f f Additional Services Rendered ❑ Claanod textile sheats? ❑ Repiaard UV items? ❑ Replacad/Us9d other items? Parts Used: W = Warranty, B . Billable (,r appropriate selection) W B Item Number Deseriptlon Final/Safety Inspection RSV reinstalled Manifold reconnected; flush valves closed SummarylRecommen dations F—J system performing; no further action needed ❑ Call for servirre Data Fax completed form to 1-866-384-7404 r Lids bolted on Control panel macuvatad ❑ Tank needs primping ❑ Other? MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this ZZZ. — Day of _ of 20 �by and between (N J l � / a ^A o 4 , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as AN ADVANCED ADVANTEX SYSTEM located at (legal description) SAND LAKE #2 BLOCK 1, LOT 3 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) ' Throughout the term of this Agreement, the Owner shall enter intoa service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 ltLG, Owner acknowledges that the Municipality may request records of maintenance and 1 repairs from the manufacturer's representative or maintenance provider. tl"L Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be (j assessed in accordance with AMC 14.60.030. tom`- Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. yiOwner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing �j guidelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the _ AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until.title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER- By: WNER: By:' ` v V --(signature) w ` I U-�AA- G. Ccs. -SO n (print name) STATE OF ALASKA ) ss. TIURD JUDICIAL DISTRICT ) Date: S 1 b -,? -a— The The foregoing instrument was acknowledged before me this ANy of 0.sj 20 ,by W !LV GA 5 c n T -41� ASKA S ofA1twka My i sco res: NOTARYPUBLIC Sha: ifa Hay... . MUNICIPALITY: (signature) (print name) Date: -S — ` ! - Z02 2 - Title: Title: (rev. 05/18/2018) Page 3 of 3 • PG • Municipality of Anchorage � On-Site Water and Wastewater Program a a� (907) 343-7904 SA ETY CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 011-132-46 Expiration Date: t1-1 1. GENERAL INFORMATION Complete legal description SAND LAKE#2 BLOCK 1,LOT 3 Location (site address) 8031 WILCOX STREET,ANCHORAGE,AK 99502 Current Property owner(s) ERIN & KYLE GILPIN Day phone Mailing address 5431 W 82"D AVENUE,ANCHORAGE,AK 99502 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class C Well ® Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: Received by: Date: /N 9 COSA to be released to th- =-• nee,,. less otherwise requested by the engineer. COSA Fee $ 5gLi Waiver Fee $ Date of Payment f X/171/6 Date of Payment Receipt Number a3g. // Receipt Number COSA# O I<1/((4 / 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 ANDERSON CONSTRUCTION & ENGINEERING Phone 345-3377 Address 4640 SHOSHONI DRIVE,ANCHORAGE,AK 99516 Engineer's Printed Name MICHAEL N.ANDERSON,PE Date 12/12/2018 smr °°o o e .�.. t. s1,0 of sJ• •• o t .!1 • A v ft's ° S �� Y Y p %f ° 4 9_._. xt� °o°o.o o•I•.•'� 6. DSD SIGNATURE P' ° '•° �a •oo°.oa L( MICHAEL �ElhiacRSD�Tte°� ;�� System #1 Approved for bedrooms. Fit CE System #2 Approved for bedrooms. �'tt< p °••••tt •°� Vff OF(SS Disapproved. �`y.ts,0 ..; meq Conditional approval for bedrooms, with the following stipulations: Av . 4J WATERSITE rn �/ASTFANDR • WATE PROGRAM o . By: v‘-• Original Certificate Date: 1— 1 `I -� 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 • •t-. • t If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system , Certificate of On-Site Systems Approval Checklist Legal Description: SAND LAKE#2 BLOCK 1,LOT 3 Parcel ID: 011-132-46 A. WELL DATA Well type Private("C") If A, B, or C provide PWSID# Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production _ g.p.m. g.p.m. WATER SAMPLE RESULTS: p Coliform Ole S colonies/100 mL Nitrate 5.--. C( mg/L Arsenic: ►`) ug/L Date of sample: 12/12/2018 Collected by: F.W.C.S B. SEPTIC/HOLDING TANK DATA Tank Type/Material ADVANTEX/STEEL Date installed 7/27/2015 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) Y Date of pumping 7/7/2018 Pumper A+SERVICES/ANCHORAGE TANK -MAINT. C. ABSORPTION FIELD DATA Date installed 7/28/2015 Soil rating (g.p.d./ft2 or ft2/bdrm) 6 System type SHALLOW TRENCH Length 20 ft. Width 5 ft. Gravel below pipe 0.5 ft. Total depth _4.2 ft. (Measured 12/12/18) Eff. absorption area 100 ft2 Monitoring tube Y Depression over field N Date of adequacy test 12/12/2018 Results (Pass/Fail) PASS For 4_bedrooms Fluid depth in absorption field before test 0 in. Water added _ 600 gal. New depth 4 in. Elapsed Time: 210 min. Final fluid depth 0 in. Absorption rate >= 600 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N _ If yes, give date D. LIFT STATION Date installed 7/27/2015 Size in gallons 250 Manhole/Access (Y/N) Y "Pump on" level at 40 in. "Pump off' level at 36 in. High water alarm level at 45 in. Datum BOTTOM OF TANK Cycles tested 2 Meets alarm&circuit requirements? Y E. SEPARATION DISTANCES WELL ON LOT TO: - NO WELL ON LOT Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 8.6'(PER MOA IR) Property line 10'+ Absorption field 5'+ Water main 10'+ Water service line 101+ Surface water 100'+ Wells on adjacent lots 112'-ADEC WAIVER TO CLASS C (PER MOA IR) ABSORPTION FIELD ON LOT TO: Property line 7.4' (PER MOA IR) Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 101+ Curtain drain 50'+(None Known) Wells on adjacent lots 109'+•ADEC WAIVER TO CLASS C(PER MOA IR) F. COMMENTS Vacant system presoaked per code prior to testing. G. ENGINEER'S CERTIFICATION �� OF 4!4`1%1 • I certify that I have determined through field inspections and , "?•• •:7 (1 review of Municipal records that the above systems are in / 49TH ;-Cr /� conformance with MOA COSA guidelines in effect on this date. •••• •• ? : �S a Engineer's Printed Name MICHAEL N.ANDERSON.PE / .MICHAEL 4,t .+.tERSON: r��:•• CE9 69 Date 1211212018 EF4(�(t • • 1 .. .., l� . COSA canary sheet_2-6-15.doc MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT i i f r—\, 907-343-7904 On Site Water and Wastewater Section ` Fax: 343-7997 } www.muni.org/onsite Nitrate Advisory Certificate of On-Site Systems Approval # OSC181642 Subdivision: Sand Lake #2 , Block: 1, Lot: 3 A water sample revealed a nitrate concentration of 5.89 milligrams per liter (mg/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. Mailing Address:P.O.Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org • Municipality of Anchorage = A s4 a On -Site Water and Wastewater Program (907) 343-7904 s Certificate of On -Site Systems Approval Parcel I.D. 011-132-46 1. GENERAL INFORMATION Expiration Date:l / ` 7 Complete legal description Sand Lake #2, Block 1, Lot 3 Location (site address) 8031 Wilcox St. Current Property owner(s) Denny Patella & Abigail StOlz Day phone Mailing address 8031 Wilcox St. Anchorage, AK 99502 Real Estate Agent 2. TYPE OF DWELLING: Fx] Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: # y 4. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class 'C' Well 0 Public Water System ❑ WaiverNadance Received by: Day phone TYPE OF WASTEWATER DISPOSAL: Individual Holding Tank ❑ Community ❑ Public Sewer ❑ COSA to be released to t4 erp6ineer, unless otherwise requested by the engineer. COSA Fee $ 'D'i - y%60� Date of Payment Receipt Number 05�ZZG COSA# 0'5C-15ND3 Date: 2 I -? 261 5 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 Ofin-Site, Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) s6fe; .fungtional 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 andlor 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 athorough, 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 not guarantee 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 Engirfering-Services LLC Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SI NATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Phone (907) 272-8218 Date 7/31/2015A1'i } "ft.06*4dra:,_, ift�•. CE -8749 �{ Conditional approval for bedrooms, with the following stipulations: OFAti; . By: / r Original Certific:atP Date: .q / % - /,. ' Th2ity chorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) basedonly upon he 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 r - If more than 1 septic system is on the tot: COSA Checklist # I of f + Structure served by this system I Certificate of On -Site Systems Approval Checklist Legal Description: Sand Lake #2, Block 1, Lot 3 A. WELL DATA Well type Class 'C' Date completed Total depth ft. Date of test Static water level Well production Parcel ID: 011-132-46 If A, B, or C provide PWSID # Well Log (YIN) Sanitary seal (Y/N) _ Wires properly protected (Y/N) Cased to ft. FROM WELL LOG IN _ 9•p -m. WATER SAMPLE RESULTS: Coliform Nleb colonies/100 mL Nitrate D mg/L Arsenic . 6.81 ug/L Date of sample: 02/10/15 B. SEPTICIHOLDING TANK DATA Tank Type/Material AdvanteX/Steel Tank size 1,500 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Date of pumping New Pumper N/A Casing height (above ground) in. AT INSPECTION FIN ..- Collected by: PIES Date installed 7/2742015 Cleanouts(YIN) Y High water alarm (Y/N) Y C. ABSORPTION FIELD DATA Date installed 712812015 Soil rating (g.p.d./ft2 or ft2/bdrm) 6 GPD/SF System type Shallow Trench Length 20 ft. Width 5 ft. Gravel below pipe 0,5 ft Total depth 4 ft. Eft. absorption area 100- ft2 Monitoring tube Y Depression over field N Date of adequacy test New Results (Pass/Fail) Pass For S l bedrooms Fluid depth in absorption field before test New in. Water added New gal. New depth New im , Elapsed Time: New min. Final fluid depth New in. Absorption rate >= �06 9-p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed 7/27/2015 Size in gallons 250 "Pump on" level at 40 in. "Pump off' level at 36 Datum Bottom of Tank Cycles tested New Manhole/Access (Y/N) Y in. High water alarm level at 45 in. Meets alarm & circuit requirements'? Yes E. SEPARATION DISTANCES WEtt_ ON LOT TO: Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer /septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOTTO: Building foundation 5+ Property line 5+ Absorption field 5+ Water main 10+ Water service line : 10+ Surface water 100+ Wells on adjacent lots 112* ABSORPTION FIELD ON LOT TO: 1W -7, 7 10+ 10+ Property line Building foundation Water main Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage11 0+ Curtain drain 50+ Wells on Adjacent lots 109* F. COMMENTS *DEC Waiver on File 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 Steven R. Pannone Date 7/31/2015 COSA canary sheet_2-6-15.doc r -a:-.CE-8149 .Sk 30' 30' NOTE: Distances are 21.5' Dirt ") Drive 6 N 13.3' !1.4' �- ro 4.1 Patio Ornamental Brick Retaining Wall LOT 2 2—Level Wood Frame Residence on Concrete Block Foundation measured to the wood trim. LOT 4 LOT 23 0 4 LOT 3 BLOCK 1 Man Hole N w Treatment o 0 2.0' Pod o o LOT 22 -Vent 0 tn ui Wood Porch Clean Out & Stairs (Typ.) I hereby certify that an accurate survey of the following described property: SAND LAKE SUBDIVISION NO. 2 (P-176) LOT 3, BLOCK 1 was made on July 28. 2015 and that the improvements 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 29th day of July 2015. LOT 21 SCALE 1 " = 20' 0' 10' 20' 40' G.i N rn F - w w 2 rn Municipality of Anchorage Ment S O" P Z t' S L Q ry epartment **** VARIANCE/WAIVER REVIEW **** Waiver#: osv161092 COSA#: osc16J! 03 Permit#: oso161116 PID#:011-132-46 Legal Description: Sand Lake #2 B-1 L-3 Engineer: P Applicant: Derinv & Abigail Patella Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 7.0 feet. This waiver approval Applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. Z Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. ❑ Adjacent properties are not affected by this waiver. • uP�l ��rl.��• a Y�r�� a ��l��l i'f• u��l�.��Y��u Waiver is Granted: X Waiver is not Granted: Date: 7S"�� Approved by: •�r1��■ ul��i�� a �F••��r�il��l �� u■ �.�+iia »��l�t��a •�� Pannone Engineering Services «c Steven R. Pannone, Principal Registered Professional Engineer L4 It5 „A E-mail: steve@panengak.com J (VSO Z15" Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P O Box 196650 Anchorage, Alaska 99519-6650 Subject: SAND LAKE #2 B1 L3 Lot Line Waiver Request Ladies and Gentlemen: August 3, 2015 - 0SV1-5Ia92' We request a waiver to seven feet (7') to the lot -line. The planned field and tank had to be re -oriented during installation due to unforeseen obstacles. Lot line letter of no issue from the owner of Lot 22 has been obtained. Granting this waiver is not likely to affect the health and safety of this lot or the surrounding lots now or in the future. If you have any questions or concerns, please contact me at 907.272.8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Andre Spinelli From: Juli Webster <Juli@panengak.com> Sent: Monday, August 17, 2015 1:15 PM To: andre@spinellhomes.com Subject: Please printout this page, sign and return to me today plez Importance: High Sand Lake #2 BS, L3 8031 Wilcox Street The neighbor is Spinell Homes, Inc 1900 W Northern Lights Blvd, #200 Anchorage, AK 995017 I, the owner of the above property, understand that the septic system on 8031 Wilcox Street (Sand Lake #2 B1, L3) has a septic system (installed in 2015) located with 7.4 feet of the adjoining lot. le understand that the Municipal Code requires the septic system to be place a minimum of 10 feet from the lot -line and that the Owners are applying for a waiver to 7.4 feet. I understand granting this waiver will not affect our ability to install future upgrades to our septic system, por will granting this waiver affect the use of our property in anyway. Therefore, I do not object to the issuance of this waiver. 0/7/5 Spinell 1�5k� COKPILNICA"IONS it aska:nmmu��: atmrs.:nm August 5, 2015 Denny Patella & Abigail Stolz 8031 Wilcox Street Anchorage, Alaska 99502 Alaska Communications has no abjection to the drain field monitoring tube 2.4 feet into the 10' Utility Easement located along the eastern boundary of Lot 3, Block 1 of Sand Lake #2 Subdivision, otherwise known as 8031 Wilcox Street as depicted on the drawing submitted by Pannone Engineering Services LLC, Acceptance, (your signature below), and use of this letter of non -objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: 1. Alaska Communications will be held harmless, now and forever, for any damages or injury to any person or property as a result of this encroachment 2. Any Alaska Communications facility damaged or destroyed as a result of this encroachment will be repaired at no cost to Alaska Communtcations. 3. Any costs incurred by Alaska Communications for special construction necessitated by this encroachment will be bome by the property owner. 4. All applicable safety code regulations will be observed and maintained. 5. This letter of non -objection will in no way preclude Alaska Communications from full use and enjoyment of its rights within any portion of this easement s. Alaska Conanunica8ons is under no obligation to restore any structure damaged as a result of Alaska Communications full use and enjoyment of its rights within any portion of easements or right-of-ways. Plsase:rIgn below, retain this form:for youruse and return a signed,copybaek to AFaaka Communieaf}one. Foreman MS#t4 600 Telephone Ave. Anchorage, AK 99503 ACCEPTANCE SIGNATURE: DATE: Ey1Cat ;Cl Grid SWC 2131 POWBONG ALASKA'S FO URE August 14, 2015 Denny F. Patella and Abigail Stolz 8031 Wilcox Street Anchorage, Alaska 99502 Subject: Encroachment Permit Request for Drain Field Monitoring Tube Lot 3, Block 1, Sand Lake Subdivision.No. 2' NW'/s of Section 10, TUN, R4W, S.M., Alaska EN15026, Chid 2224, MOA ID #011-13246 Dear Mr. Patella and Ms. Stolz: Enclosed is the Encroachment Permit as requested for the drain field and monitoring tube on the east side of the above referenced property. Please review the Encroachment Permit. Ifthe conditions are agreeable, please sign the document where indicated, have your signatures properly notarized and return the document to this office for full execution and recordation. If convenient, you may sign the document before a notary in our Land Services Department at Chugach. Chugach will have this document recorded. If you would like a conformed copy of the recorded document, please include $2.00 for the State Recorders' fee. The check should be made payable to Chugach Electric Association, Inc, A self-addressed, stamped envelope is enclosed for the return ofthe signed and notarized Encroachment Permit and the conformed copy fee, ifyou want a conformed copy. All work within the easement areas must be in compliance with the enclosed copy of Chugach's Electrical Facility Clearance Requirements. Also enclosed for your use and information is the 811 Alaska Dag Line utility locate call center card, and Chugach's *%at Is an Easement? handout. If you have any questions, please call me at 762-4646. Sincerely, 1 Claudia Roberts Right -of -Way Agent III Enclosures Chugach Electric AssociDlion, Inc. 5601 Elxlw Cow P.O Box '96MG Aa&nM9e. Afusin 995!9,6300 • 1907) 5634494 fa:• f9071562-0027 , JSC01478-74W v.�n:: huyachefeclJc.ccm • iNc�hclwyc;chekch%c ccm 120410B Grid 2224 EN15026 011-132-46 ENCROACHMENT PERMIT This permit is between Chugach Electric Association, Inc, an Alaska non-profit electric cooperative, (herein "Chugach"), whose address is P. O. Box 196300, Anchorage, Alaska 99519 andDenny F. Patella and Abigail Stolz (herein "Permittee"), whose address is 8031 Wilcox Street, Anchorage, Alaska 99502. I . Easement. Chugach is the grantee or user of an easement for the construction and maintenance of electrical facilities, as follows: Described in that certain written instrument recorded on the 110' day of March 1952, in Volume 69 at Page 105, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, (herein "Easement") which pertains to the following described real property: The East Ten Feet (E10') of Lot Three (3), Block One (1), Sand Lake Subdivision No. 2 according to Plat Number P-176, filed on the 26h day of April 1950, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska. Permittee acknowledges the validity of the Easement. Permittee warrants and represents that Permittee is the owner of the fee simple interest in the land subject to the Easement and the following described real property to which the Easement is adjacent: Lot Three (3), Block One (1), Sand Lake Subdivision No. 2 according to Plat Number P- 176, filed on the 26a' day of April 1950, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, (herein "Parcel'). 2. Encroachment. Permittee has proposed to construct the following improvements on or within the real property subject to said Easement: Encroachment Permit -Page 1 of 4 A septic drain field and monitoring tube that encroaches approximately Three Feet (4') into the west side said Easement for a distance of approximately Five Peet (5'), (herein "Encroachment"). 3. Permit. Chugach hereby authorizes Permittee to construct and continue the existence of the Encroachment in its existing location subject to the covenants set.forth in this permit. 4. Indemnification. Permittee shall indemnify and hold Chugach harmless from any claims for personal injury, property damage or other loss arising in any way from the continuation of the Encroachment. 5. No Expansion or Increase. Permittee shall not in any way expand or increase the extent to which the Encroachment occupies any of the real property encumbered by the Easement without the prior written consent of Chugach. Chugach has no obligation to provide such consent, 6. No interest in Real Estate Acquired. Permittee hereby acknowledges that the Encroachment and any additions thereto, even if in violation of this permit, has not and shall not in the future give rise to any interest or estate in the real property subject to the Easement or any other real property. Without in any way limiting the foregoing, Permittee acknowledges that the Encroachment is not adverse to any interest of Chugach and its continuation is entirely with the permission of Chugach for purposes of the common law doctrine of adverse possession. This permit creates no interest in the real property subject to the easement. 7. Modification of Utility Facilities. If the electric utility facilities located within the Easement are upgraded, added to, replaced or reconstructed, Permittee shall pay that portion of Chugach's total costs for such modification which is reasonably attributable to accommodating or preserving the Encroachment. If such payment is not made within thirty (3 0) days of written demand for same, Chugach may terminate this permit in accordance with paragraph 9, below. 8. Covenants Running with the Land. The obligations offhePetmitteearising from this permit shall be covenants running with the land which shall burden the Parcel and the Permittee's interest in the land subject to the Easement and shall benefit the Easement. 9. Termination. Chugach may terminate this permit after the giving of thirty (30) days written notice of such termination if: a. The Encroachment is enlarged, increased or extended within the real property affected by the Easpinent. " b. The Encroachment is damaged by any means to an extent of more than thirtypercent (30%) of its replacement cost at the time of destruction. Enemaehmeat Permit - Page 2 of 4 C. Permittee fails to make the payment described in paragraph 7, above. 10. Term. This permit shall, if not sooner terminated by Chugach, expire forty (40) years from the date hereof. 11. Entire Agreement. This written permit constitutes the entire agreement between the �f patties with respect to the subject matter hereof and supersedes all other prior or contemporanepu8 agreements, oral orwritten, between theparties. No modifications, amendments, deletions, add!f Q-* or alterations of the permit shall be effective unless in writing and signed by all ofthe parti@s h CHUGACH ELECTRIC ASSOCIATION, INC. PERAUTTEE By: BY��i LiuLcuua'::' Shelly Schmitt, Senior Manager Denny F. Patella Distribution Engineering Oki Date: G f? • eI4 t G2t JtLuU-4 C Abigail Stolz e18 -17,2a15 Encroachment Permit - Page 3 of 4 STATE OF ALASKA ) ) ss: THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this r&ay of H Armes 2015, by tA'ihArgsy.�o (PRINT NAME(S) OF PERSON(S) SIGNING DOCUMENT) Notary Public ALYSSA C. WILKERSON Stall of Alaska Mycommisslon EapinYMay 31, 2018 STATE OF ALASKA } } ss: THIRD JUDICIAL DISTRICT } ary Public in and for the State of Alaska commission expires•. MAj S 1 � 6 R The foregoing instrument was acknowledged before me this day of ,2015, by Senior Manager, Distribution Engineering of Chugach Electric Association, Inc., an Alaska corporation, on behalf of the corporation. Notary Public in and for the State of Alaska My commission expires: AFTER RECORDING RETURN TO: Chugach Electric Association, Inc. P.O. Box 196300 Anchorage, Alaska 99519-6306 Atta: Land Services Department Encroachment Permit - Page 4 of 4 August 14, 2015 Denny Patella &Abigail Stolz 8031 Wilcox Street Anchorage, Alaska 99502 Dear Denny Patella & Abigail Stolz: Subject to your agreement to indemnify the company as set forth below, GCI Communication Corp has no objection to the drain field monitoring tube encroaching into the utility casement at Lot 3, Block 1, Sand Lake #2, also known as 8031 Wilcox Street, city grid 2224. This letter of non -objection in no way precludes GCI Communication Corp from full use and enjoyment of any rights it may have within any portion of ttre utility easement and or the right-of-way, including unlimited access for servicing its facilities. Alsoany additional and extraordinary costs incurred during any future required construction, repair or reconstruction of GCI's facilities to accommodate any or all of the encroachments shall be paid by the property owner. By signing below, you agree to indemnify and hold GCI Communication Corp harmless, now and forever, for any damage, costs, expense (including reasonable attorney's fees), liabilities and injury to any person or property occurring as a result of tate encroachment. Please indicate your acceptance by signing and returning this letter to me at the address below. Sincerely, Markus Kofoid DSP Design Engineer GCI Communication Corp 5151 Fairbanks St. Anchorage, AIC 99503 907-868-6168 Office 907-868-8580 Fax Acceptances �(L1t11S tL C 006 17 Date Gvflguv_s-f ii.Pice_ u°%9r�� YO f '. f 'Q�1�cY ` i ¢Ou�•iB,✓/vn�1 , ~ r Date i0 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the. representations given in paragraph 5 above by an indepenoent t professional engineer registered in the State of Alaska. The DHHSdoes this asacourtesy topurchasers ofhomes and their lending institutions in orderto satisfy certain federal and state requirements: Employees of DHHS do not x conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not > responsible for errors or omissions in the professional engineer's work., f, rCr. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L67- 3 &A I SMt) LAKE S/D Parcel I.D. I!I/,�2 A. Well Data t Well type CLASS G If A, B, or C, attach AD C letter. ADEC water system number A21 -FA- /ZO Log present (Y/N) completed Driller Total depth Cased to Casing height Sanitary seal (Y/N) FROM WELL LOG Date of test Static water level Wires properly protected (Y/N) AT INSPECTION Well flow g.p.m. g.p.m. Pump levell SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot On adjacent lots Absorption field on lot /ZU ; On adjacent lots _ Public sewer main Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: Date of by: bacteria B. SEPTIC/Hft "TANK DATA Date installed r �� Tank size %l XX) GAC— Compartments l Cleanouts&N) Y(�C Foundation cleanout (Y6 jl . _ Depression (Y&V High water alar (yo A16 Alarm tested (YIN) :: /dA Date of pumping /0 1/ /J/ 7 3 "Pumper P6JA .l _<�W&,Z_g Z)yU1N 5W1c6__ SEPARATION DISTANCES FROM SEPTIC449E-BfNG-TANK TO: GLASS L/ Well(s) on lot Mfic On adjacent lots Z �-t"" Foundation :S-+- To S-a- To property line j) t Absorption field_.5- Water main/service line DC7 /�f— Surface water/drainage kz /dam 72-M(SM)•From CONTINUED ON BACK PAGE n o � m pa rM G ® y °z B. SEPTIC/Hft "TANK DATA Date installed r �� Tank size %l XX) GAC— Compartments l Cleanouts&N) Y(�C Foundation cleanout (Y6 jl . _ Depression (Y&V High water alar (yo A16 Alarm tested (YIN) :: /dA Date of pumping /0 1/ /J/ 7 3 "Pumper P6JA .l _<�W&,Z_g Z)yU1N 5W1c6__ SEPARATION DISTANCES FROM SEPTIC449E-BfNG-TANK TO: GLASS L/ Well(s) on lot Mfic On adjacent lots Z �-t"" Foundation :S-+- To S-a- To property line j) t Absorption field_.5- Water main/service line DC7 /�f— Surface water/drainage kz /dam 72-M(SM)•From CONTINUED ON BACK PAGE C. LIFT STATION /V D N L / Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROySTATION TO: at Well on to/ On adjacent lots Surface water -�� iS��EN?-\ D. ABSORPTION FIELD DATA L�� pr<1 Co% Z3 13 0< i 5,0"D t(t[(Lr- SO #I Ai00U0 FtiK t Date installed 7/1419 P Soil rating (GPD/Ft2) Z�/�� System type Length 42 , r-7Width < 3Z It Gravel thickness r Totaldepth �2 Total absorption area ! Cleanout present6N) $ Depression over field (Y&d ✓Ub Date of adequacy test 2%0/ 74— Resu pas ail) /qys fora'r'!� Bedrooms Water level in absorption field before test 6OX-7 Aftertest AdE 2 Peroxide treatment (past 12 months) (Y/N) if yes, give date eM SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot X�WL�' On adjacent lots /00 �-- Property line 3/ s� To building foundation /60r 14-/ To existing or abandoned system on lot V NJ On adjacent lots Z Cutbank f% 6 /'%CI '-Water maintservice line `0 f� Surfacewater �lil% ��— Driveway, parkingtvehicle storage area /0 r� Curtain drain AA1,J9 KA-&J,'U E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to Signature S & S ENGINEERI < 17034 Eagle River ad tVa Engineers Name e:..__ .,_ Date HAA Fee $ 9CO. Date of Payment 3 1 1 Receipt Number 67 r�Zjl 72-028 (3193)' Bads and HAA guidelines in effect on the date of this inspection. Waiver Fee $ Date of Payment _ Receipt Number_ bawl A. 56*4" N& 1074 ,q:�;n?F05prt'InfI�I'II DECLAit ON OF EASEMENT FOR SEPTIC SYSTEM WHEREAS, John Wilber (hereinafter Wilber) and Ned A. Sparks (hereinafter Sparks), are the owners in fee of Lots 3 and 23, Block 1, Sand Lake Subdivision #2, according to the official plat thereof, filed under Plat Number P-176, Records of the Anchorage Recording District, Third Judicial District, State of Alaska --- commonly known as: 8031 Wilcox Drive, Anchorage, Alaska 99507; and WHEREAS, there exists partially on Lot 23 a septic system and related apparatus owned by Wilber and Sparks, which presently serves Lot 3; and WHEREAS, Wilber and Sparks desire to assure the continuity of septic service to Lot 3. NOW, THEREFORE, Wilber and Sparks declare and covenant as follows: 1. There is hereby established and reserved, for the benefit of Lot 31 Block 1, Sand Lake Subdivision #2, according to Plat P-176, Records of the Anchorage Recording District, State of Alaska, an easement for the use and maintenance of the presently existing septic system which is located partially on Lot 23 and which services the property on Lot 3. 2. Said Lot 3 septic system is located on Lot 23. The within established easement is intended to provide reasonable access in, to, and around the presently existing system, as well as any portion thereof, which is located on Lot 23 and is serving Lot 3. The purpose of said easement is for the use and maintenance of any said septic system. 3. The said easement shall run with the land and shall be binding upon the owners of Lot 23, for so long as the Lot 23 septic system, or any necessary replacement thereof, is needed for the habitation of Lot 3. DATED this �WM]ay of ri�-3 , 1994 ohn Will r Ned A. Sparks akl4 / 0j STATE OF ALASKA ) 6 ) THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY than on this ,?,q4qq day of Fe , 1994, before me, the undersigned Notary Public duly commissioned and sworn, personally appeared John Wilber, known to me and to me known to be the person named in and who executed the foregoing; and he acknowledged to me that he signed the same freely and voluntarily for the uses therein stated. WITNESS my hand and official seal. 1915-195- a y Public in andr for Alaska My commission expires .t' STATE OF ALASKA ' THIRD JUDICIAL DISTRICT THIS IS TO CERTIFY than on this Ze:-hday of rE/ , 1994, before me, the unders wd,�]o�a,gyPublic duly commissioned and sworn, personally appeared A. Sparks, known to me and to me known to be the person named in and who executed the foregoing; and he acknowledged to me that he signed the same freely and voluntarily for the uses therein stated. WITNESS my hand and official seal. o lea y Public in an ford! Alaska My comms io expire�� s Return to: T � ,iyV��y� J Y I'. S & S Engineering, 17034 North Eagle River Loo Ste. 204, r '�s,�;4+ hf Eagle Rier, Alaska 99577 9 p e • MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 3 Block 1 Sand Lake Subdivision #2 (b) Location (address or directions) Applicant Name John Wilber Telephone: Home 243-4846 Applicant Address 8031 Wilcox Anchorage, Alaska 99502 Business (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder Ek Buyer ❑ ; Other ❑ (explain); (d) Lending Institution National Bank of Alaska Telephone 272-5551 Address i Ruth Labar, 301 W. Northern Lights Boulevard, 99503 (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single -Family UxMulti-Family❑ Other Number of Bedrooms two (2) 3. WATER SUPPLY Individual Well ❑ Communityf$x Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite &3t Public ❑ Community ❑ Holding Tank O . Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) 5. ENGINEERING FIRM PROVIDIR INSPECTIONS, TESTS, FILE SEARCH, DNA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Nameof Firm Quadra Engineering, Inc. Telephone Address Date Engineer's Seal This department has received written confirmation from the engineer regarding the Conditional Approval of March 21, 1956. The corrections have been accomplished and an inspection has been completed by the engineer. The subject property meets with Municipal standards and is now approved. 6. DHEP APPROVAL Approved for two (2) bedrooms by a September 18, 1986 Approved XXXXXXX Disapproved Terms of Conditional Approval Conditional CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/04) r MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 A. WELL DATA MUJ411-IPALITY OF ANCHORMol DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION RECEIVED Legal Description: 402' 3 BLe eW / s.9No e'.A.ro- Sven 2 savor Apy Tufty f2 N. R 4 W Well Classification C If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Al Date Completed 196.S Yield /o Gf'il1 Total Depth 135' Cased to /Oo'F Depth of Grouting "14rm Static Water Level 840 Pump Set At //N' Casing Height Above Ground ?40 Sanitary -Seal on Casing (Y/N) Y Electrical Wiring in Conduit (Y/N) 14 Depression Around,Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot I ; On Adjoining Lots To Nearest Edge'of Absorption Field on Lot jam/ ; On Adjoining Lots 7 To Nearest Public Sewer Line A&A6E fi✓ AREA To Nearest piibijc Sewer Cleanout/Manhole AVA To Nearest Sewer Service Line on Lot .v�A Water Sample Collected by QdADIZA - M°FADDIEP4 ;Date Zhialme. Water Sample Test Results SATO? PACT`O V Comments 4-ASSumpruo&t nur-rm SoiL5 **-ro BE SBRIEO rM CoAlmyez-wNE0! FRosr Goes eur e= d�ouva B. SEPTIC/HOLDING TANK DATA Date Installed Size of Compartments Standpipes (Y/N) Air -tight Caps (Y/N) }r Foundation Cleanout (Y/N) V Depression over Tank (Y/N) N Date Last Pumped Pumping/Maintenance Contract on File (Y/N) Y ; for Holding Tank High -Water Alarm (Y/N) N1A Temporary Holding Tank Permit (Y/N) Al Separation Distances from Septic/Holding Tank: To Water -Supply Well To Building Foundation .S To Property Line �yi To Disposal Field $ To Water Main/Service Line G S To Stream, Pond, Lake, or Major Drainage -Course t SZo' FRdm SAM IN LAKE Comments Pagel of 2 72-026(11/64) 0 C. ABSORPTION FIELD DATA 11 Soils Rating in Absorption Strata 22 S Type of System Design P f T Date Installed lq65 Length of Field Width of Field Alo AS BUILT DE7-4115 OWA11ABLE Depth of Field Gravel Bed Thickness Square Feet of Absorption Area Standpipes Present(Y/N) N Depression over Field (Y/N) N Date of Last Adequacy Test3�8(e Results of Last Adequacy Test PASSED Separation Distance from Absorption Field: To Water -Supply Well IZOr To Property Line /8 To Building Foundation 11 To Existing or Abandoned System on Lot NON E ; On Adjoining Lots S 3 To Water Main/Service Line b71 To Cutbarik (if present) NOT pea5je r - To Stream/Pond/Lake/or Major Drainage Course t 520 FZOM SAAIn LAKE To Driveway, Parking Area, or Vehicle Storage Area ` 94 Comments .A9602 PTION L7P4 RAS DE QEQ UIXED GQR t"4,kO 7MfAl Z BEDROOMS I- ON ADSAQSr4T LoT-- W 1 TH /N 761 -Na Lob RVA/LABLEOe/ sUBTE'cT ProPek'Ty D, LIFT STATIO14 ;%VI14 Date Installed Size in Gallons "Pump On" Level at — High Water Alarm Level at Tested for Electrical Codes (YIN) — Dimensions Manhole/Access (Y/N) — 'Pump Off" Level at Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** Icertify that I have checked, /verified, orconformed toall MO d a HQAguidelines ineffect onthe date ofthisinspection. Signed 1�f Date 3 l9i Company A140A0 6IJ6.6G MOA No. Receipt No. In IV) Date of Payment ?pKE �F.:q4gi�l c/ V Amount: $ yI:'•• •••s,��a� Engineer's Seal Page 2 of 2 72-026 (11/84) el E. Anderson. 4381= E REQUEST FOR APPROVAL INDIVIDUAL SEWAGE AND NATER (Fill out i riplica 'Name of person of propertyt Number -of. -bedrooms in house,. 5. Waten.Analysis: „ &10/ 302", /--.I or a. Bacteria], b. Detergent ti,- 6. Weil data: (D a. Type Y b. Depth c. Casing Size d. Distance from well to closest existing or propose 1. Sewer line -2. Septic tank &Zd ,_/4a 3. Seepage Area =W_KZaQ' 4. Cesspool' S. Property Line 6. Other sources of possible contamination, i.e., creeks, lakes,, houses, barn, drainage ditch, etc. fr`` Z7Sewage disposal system. 1{ a. Age of system b. Septic tank capacity in gallons 1' C. Name of septic tank manufactur@r A -LZ f 1. .If khome made" show diagram on reverse side of this form. d: Disposal field or size and 1. Distance toroe r p p rry� line / .,/ to house foundation r e, Percolation Test results f. Percolation Test performed by Use the reverse.side of this form to show diagram. Diagram should include he following information: property lines; -well location, house location, ~aseptic tank location, disposal area location, location of percolation test, an� direction of ground slope. e 9. The Ilmformation on this form is true and correct to the best of my knowledge. S gn ure of Applicant Date Signe —� TO BE FILLED OUT By HEALTH DEPARTMENT PERSONNEL ElLoThe above described sanitary facilities are hereby approved, subject to the ?ol�owin g conditionsc Conditions: 7 The above described sanitary facilities are disapproved for the following reasons• Signature o � is :. Date }•j : x.: Approval is valid for one year following the date of approval. CPJ:cw