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Home My WebLink AboutT15N R1W SEC 4 LT 19TI5N P, IW SEC 4 Lot 19 #051-072-16 Municipality of Anchorage Development Services Department ~: Building Safety Division .-%~' ~,: On-Site Water & Wastewater PrOgram, 4700 South Bragaw St. ;~ ~ P.O. Box 196650 Anchorage, AK 99519-6650 '~ ~ www.ci.anchorage.ak.us (907) 343-7904 On-Site Wastewater Disposal System and/or Well Inspection Report Page 1 of Permit Number: SW0¢0027 PID Number: 051 --072-- 1 6 TERRY FOREMAN Wastewater System: · New [] Upgrade 22150 DEER CIRCLE * CHUGIAK, AK. 99567 ABSORPTION FIELD Ph°ne:(907) 688-3807 4 'l::]Deep Trench r-IShallow Trench · Bed r'lMound mother* LEGAL DESCRIPTION ~,, .ou.: .~o, ~..~ ,,.,. o.~T,<. 2.0 ~D/s,. ~ 2.0 MAX 19 SEE DWG. ~ .58 Township: T15 Range: RIW SECTION 4 SEE DWG. F~ 30 F~ WELL: · New [] Upgrade Cr~e .i~: u.mber o, ,...: I""~. ~,,~... 12 ~ 6 PRIVATE 122 ,~ 122 ~ 560 so.~ D 3034/ F-810 SULLIVAN WATER WELLS ~/17/2004 68 ~. GEG, Ltd. 3 16-17/2004- 25 ~p, UNKNOWN ~. 2 ~ TANK SEPARATION DISTANCES ~so.t,= m Holdlng III S.T.E.p. [:3Other* Tank Reid Station Tank S.o.U.. ANCHORAGE TANK 1500 Well 100'+ 100'+ 100'+ -- 25% .~-~l: STEEL Number of cempurtment~: 2 Su,oee Water m0'+ mO'+ 100'+ - - LIFT STATION TIMER TIMER 46" Curtain Drain ' N~NE KNOW~ Pump Make & Model: I~leeirJcal Inspecflona performed b~. ~20 OS 05 HHF RISING SON Remarks: BENCH MARK · THIS IS A BOTTOMLESS INTERMITTENT TOP OF MANHOLE LID SAND FILTER 97.90 ~ OFFS? Inspecbons performed by:, GEG, Ltd. Dates 1st ~ ~' C~I_T ! '-..7~1 2nd 3/16/2004 'r ...... :": ')l~/' .............. 3rd 3/17 2004 '"~, .~'."/'~ ~'".~ ' / ~ '..U~;TTr ~/)/J,~, Garn,~ss..' . Development~Servi.ces Department Approval ~i~ ~". (.P,~v~i~e~ed and approved by'./~--- J..~.[N~,,.~,~ Date' '~l,o~l_~,-.,,.,z, "~;~'2;~ .......... GARNESS CONSULTANTS & G£NER~ CON~CTORS ~ ~une 22,2004 Municipality of Anchorage Development Service Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragraw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic System Installation for Lot 19; T15N, RIW, Section 4 (Bottomless Intermittent Sand Filter - ISF) To whom it may concern: The septic system on the referenced property was intalled on 3/16-17/2004. Elevation shots were taken at the bottom of the bed and found to be 93.30-94.46. Top of sand elevation shots were also taken and show to be 96.301 Based Upon these nUmberS there is 1.84-3.0 feet of sand. We are short of the 2+ feet of sand filter in,.o, ne localized area, but overall there is 2+ feet of sand. As can be seen on the attached detail drawing we still meet the 5¢ feet Separation distance to groundwater. If you haVe any questions feel fi'ee to contact us at 337-6179. Pre~en 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337'6179 * Fax: (907) 33823246 * Website: www.garnessenginering.com PERM,T N M8ER: AS-- BUILT DRAWING P 'DEL ,0 NUM6ER: SW040027 051-072-16 A 8 FCO 33.72 20.43 5T1 67.21 28.33 ST2 65.28 33.45 ! MR 65.01 34.56 ~ ~-~-- ~ ~ MT1 41,88 28.22 / MT2 45.67 57.06 / ~ MT3 16.04 43.02 ~ = MT4 20.56 48.98 ~ / N 1500 G~LON S.T.[.P. T~K // ALTERNATE ~/-- - / / ~ N~ BOWOMLESS WELb / / X ktf~/~' ~APPROXIMATE LOCATION / X / GLACIER ROAD NN~ //~z_// ?'~ 5/20/2004f ~.., ~ ~. , GARNESS ENGINEERING GROUR Lt . ~,~: R.A.L.~ ,' 4 T ~ '..Z ~ ...... ~OO,SO~tA,~e~,~C0~OtO"~ ~" = 40' ?.. :' F/. . .~ .... ~ .... :....~ ~[~, '.~ .....: ....... ." ~? A 8 FCO 33.72 20.43 5T1 67.21 28.33 ST2 65.28 33.45 J UH $5.01 34.56 MT1 41,88 28.22 MT2 45.67 37.06 MT3 16.04 43.02 MT4 20.56 48.98 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: TERRY & MICHELLE FOREMAN (907) 688-5807 2 OF 4 LEGAL DESCRIPTION: T15, R1W, SECTION 4; LOT 19, 'P(PE OF' WORK: AS-BUILT DRAWING OF WELL AND SEPTIC SYSTEM PERMIT NUMBER: swo4oo27 AS-BUILT DRAWING P^RCEL,D NUMBER: 051-072-16 FINAL GRADE ~ 96.97-97,37 ~NVERT OF SU.o~W ~500 GALLON i~ AT INL~ = 93.51 S.T.E.P. TANK TOP OF SAND : 9~.70-96.90 ' ;) ~ LINE = 96.68 (AVG.) ~1 ~AIR LINE = 94,76 = 93.50 - 9~.46 J, ' 12' WIDE ~~ ?:~ om~5/20/2004By: ' GARNESS ENGINEERING GROUP, Ltd. sc~: * t~:~ ~ ~ CONSULTANTS & GENE~ CON~C~RS T[~RY & MICHELL[ FOREMAN (gO7) 888-3807 3 OF 4 ' .:"'~ AS-BUILT DRAWING OF SEPTIC SYSTEM UPGRADE AS BUILT DRAWING SW040027 -- PARCEL ID NUMBER: 051-072-16 ELEVATION, 1 93.97 2 ' 94:25 3 94.46 4 93.55 5 93.18 6 92.90 ORIGINAL GRADES AT BOTTOM OF BED ELEVATION I TOP OF SAND = 96.30 30' /'1.84'+ OF SAND FILTER GAYNESS ENGINEERING GROUP, L{d} E'A.L. 5 '.. CONSULIAN~ ~ OEN~AL CONT~CTORS ~ :~ S~: PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ~..~ TERRY & MICHELLE FOREMAN (907) 688-3807 ~ Of ~ T15, RlW, SECTION 4; LOT 19 BOSOM OF BED ELEVATION AS-BUILT ELEVATION 1 93.97 2 94:25 5 94.4-6 4 93.55 5 95.18 6 92.90 Ol/Oi/i999 00:01 6882259 SULLIVAN PAGE 8i/81 dba SULLIVAN WATER ~LLS June 29, 2004 Gamess Engineering Group, Ltd. 3701 I~. Tudor Road, Suite 10i Anchorage, AK 99507 FAX #337-6179 Re: Lot 19 Section 4 T15 North RWFM 21851 GLacier Road, Eagle River, AK 99577 Dear Kelly: The lift station at the above referer~ced property has been wired in accordance with NEC and State/Local codes. Thank you. Sincerely, Kevin S. Hombuckle, Owner Administration License Number :1284 Specialty Contractor License Number 27285 MUNICIPALITY OF ANCHORAGE Deve/opment Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Date Issued: Mar 04, 2004 Expiration Date: Mar 04, 2005 Permit Number: SW040027 Legal Description: TI5N'~~i'~O~I~~ Design Engineer: 0041 AK Water & Wastewater Consultan~ Owner Name: TERRY AND MICHELLE FOREMAN Owner Address: P.O. BOX 770186 Total Bedrooms: 4 EAGLE RIVER, AK 99577-0186 Parcel ID: 051-072-16 Site Address: NHN GLACIER ROAD Lot Size: 108900 SQ. FT. Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage Ail construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify 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: /~,~ ~P'~ Date: Issued By: Date: Parcel I.D. Municipality of Anchorage Development SerVices Department Building Safety Division On-Site Water and Wastewater PrOgram 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/VVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING 0~'~ "~ Permit Number Property owner(s) TERI~' /llVO I'IICItI'-~.Z E F~lf£,~,~4/ Day phone Mailing address (1) ~0, O~X 770/8¢: Mailing address (2) NN~/ ~'/.,,~ ~'IE~ Legal description (Lot, Block & Sub'd.) Legal description (Section, TownshiP & Range) Lot Size l~)~ q~) THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Acre~ ?75'77- o184 Zip Code Number of Bedrooms [] Well OnlY [] [] Water Storage [] [] Jacuzzi [] [] Water Softening Unit [] I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of Property owner or authorized agent) Permit Fees: Date of Payment: Receipt Number: (Rev. 12/00) Waiver Fees; Date of Payment: Receipt Number: GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS ~ March 1, 2004 Municipality of Anchorage Development Service Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragraw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Proposed Well and Septic System for Lot 19; T15N, RIW, Section 4 (Bottomless Intermittent Sand Filter - ISF) To whom it may concern: A proposed 4 bedroom house is to be built on the referenced property and is to be served by a private well and septic system. The proposed well is to be drilled in the area shown on the attached site plan and design drawings. We are proposing that a 1500 gallon S.T.E.P. tank and a bottomless Intermittent Sand Filter (ISF) system be installed. Comments regarding the design are summarized as follows: 1. GENERAL: Two test holes were excavated on the property to determine an area suitable for a septic system. Due to the high groundwater in the area, and poor soils, it is our opinion that a bottomless ISF system is the most economical option. 2. SOILS: Attached are logs which shows the soil classifications, groundwater monitoring, and the percolation test results. After 7+ days of groundwater monitoring, water was found to be at 6 feet in TH#1 and at 8 feet in TH#2. We are going to assume a high groundwater level of 4 feet during the spring, based on groundwater readings taken from the neighboring property. The percolation tests for both test holes were performed between the depth of 2.5 feet to 3.0 feet and the rates were 60 minutes/inch. 3. DRAINFIELD DESIGN: Bottomless Intermittent Sand Filter (ISF) a. Percolation Rate: 60 minutes/inch b. Allowable Application Rate: 2.0 gallons/day/ft2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day 2 e. Minimum Absorption Area: 300 ft f. Effective Depth below pressure pipes: 2.5+ inches g. Width: 12 feet 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessenginering.com h. Length: 30 feet. i. Effective absorption area: 360 ft2 J. Air Supply: Thom, as Industtie,,s, Model S070, "Anchorag,e, Tank". k. Air SUpply Line: Wasteflow emitterline, 1/2 inch I.D, Anchorage Tank". 1. Sand Material: In accordance with M.O.A. latest standards m. Pea Gravel: 100% passing 3/8" sieve, less than 20% passing the 1/4" sieve, and less than 1% passing the #8 sieve· We are proposing to excavate down to a depth of 2 feet (maximum - remove all organics), place a minimum of 6 inches of sand, install the air supply line, and cover it with 1.5 feet of sand. On top of the sand, we will place 6 inches of 3/8 inch pea gravel, with the pressure laterals midway in the layer. We will use a conventional lift station (Anchorage Tank), equipped with a programmable timer so that flow can be intermittently dosed to the ISF. 4. SURFACE WATERS: There is no surface water within a 100 foot of the the proposed septic system upgrade. 5. TOPOGRAPItY: As can be seen on the attached topography site plan, there are no slope concelTlS. 6. MATERIALS AND CONSTRUCTION PRACTICES: The materials used, and the construction practices will comply with DSD's "Intermittent Sand Filter Design, Installation & Maintenance Manual". The contractor should read this document prior to construction. Copies are available at the On-site Water & Wastewater program (4700 South Bragraw) 7. CLOSING: I am open to any suggestions from your department, which would be an improvement to the proposed design. ! am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179. Thank you for your assistance. Sincerely, JeffreyA. Gamess, P.E.,M.S. President 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www. garnessenginering.com T15N R1W SEC 4- LT 15 T15N R1W SEC 4 LT 18 T15N R1W SEC ~. LT 1~- ~-- SMALL STRE. A~ (APPROXIMATE LOCA'I~ON) T15N R1W SEC ~ LT 13 ALTERNA'R PROPOSED SEPTrC SYSTEM (SEE DESIGN, PAGE 2 OF LOT 20E~; PEG S/D PROPOSED 4 BEDROOM GLACIER ROAD T15N RIW SEC ~. LT 26 WELL PANORAMIC PLUS LT25A 1.25 INCH HDPE PIPE, SLOPE SO 'FHAT ~ THERE IS DRAINAGE OF THE UNE TO THE FIELD, OR THE S.T.E.P. PROPOSED BOTTOMLESS INTERMITTENT SAND (ISF) SYSTEM. EXCAVATE A BED THAT 15 2 FEET DEEP MAXIMUM BY 12 FEET WIDE BY 30 FE~T lONG. ADD 2+ FEET OF M.O,A. APPROVED ,~D RLTER NqD THEN 0.5 FEET OF PEA GRAVEL. (SEE; PAGE 3 OF 3 FOR CONSTRUCTION DETAIL AND 1500 CAM.ON S.T.E,P. TANK INSTALLED W~H THE INTERMITTENT DOSING T~MER CONTROLS. AIR UNE/ NR COMP/RESSOR (SEE / / 20' R.O,W. EASEMENT -4 NOTES: \ \ \ L FOUNDATION CLEANOUT WELL / / %) THE AIR COMPRESSOR SHALL BE LOCATED WOI-IIH THE OARAGE OR THE B~EMENT. THE CONTP, AOTOR SHALL PROVIDE A 0--10 PS PRESSURE GAUGE AT A LOCA~ON WHICH IS READILY ACCESSIBLE FROM W~HIN THE HOUSE. NO~ A 30 PSI GAUGE WILL NOT WORK, 2,) THE AIR COMPRESSOR SHALL BE A ~HOMAS INDUSI~iES MODEL 5070; AS SuPPuED BY ANCHORAGE TANK. 'n-IH AIR LINE sHALL BE 1/2 INCH DIA. HDPE (1 PIECE), INSULATED WrTH i/2 INCH FOAM WRAP (RS VALUE), INSIDE A 2 INCH SCH 40 PVC JACKET. THE ENE SHALL BE BURIED TO A MINIMUM DEPI~ OF' 3 FEET. 3.:!_,_~.E ,C.O_NTROL PANEL FOR THE B.T.E.P: TANK SHALL BE INSTALLEI) wITH AN AU~a~UAL ~NmcATOR ON ME OUTSIDE or THE HOUSE. GLACIER DATE: 5/ /2oo, DRAWN BY: GARNESS ENGINEERING GROUP, Ltd J.L.M. ~ ~ CONSULTANTS & GENERAL CONTRACTORS SCALE: PREPARED FOR: PHONE NUMBER: PAGE NUMBER: TERRY & MICHELLE FOREMAN 688-5807 2 OF T15N, R1W, SECTION 4; LOT 19 DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM ROAD ,5/4' DIA, SCH 40 PVC r'~NRLINE COIL SPACED AT APPROX. 2 LATERALS ,'HO~ SHID FEET, ORENCO "WASTEFLOW' TYPE · .... / ......................... '-x ORE,OO o,~,o,,,>._ /Z..u.'~.o_,._?.o__.o_.,,,.. PR~S,.,RE \ / OPPL,ED .,' A',,ONOR.,GE 'r.,,,,<. t ! /?, , , , , , , , , , , , , ,~,-,~; ! ; '"-- ~ ,.., ~. ...... ~~G~T~I,.B.E~AT ~--I_N.S~i'__,A~.__ F.L_Y~_.(~_D FLUSHING VALVES WITH~ (DRILL 1/4. INCH DIA, HOLES) PLAN VIEW 6" ~*,w= n~ -,,' - 3/~-" PVC LATERALS (TYp. 6~7 /'--FILTER FABRIC OVER GRAVEL W]3]'t THE PVC ? - / MT / PEA GRAVEL LATERALS BURRED MrDWAY IN /-- ~-JNAL GRADE APPROVED SAND FILTERJL / ._: r~/ 12 ' -,-o. o,= ~D PROFILE VIEW GARNESS ENGINEER~ Ltd J.L.M. TERRY AND MICHELLE FOREMAN (907) 688-5807 T15N, R1W, SECTION 4; LOT 19 DETAIL OF BOTTOMLESS INTERMITTENT SAND FILTER (ISF) GARNESS ENGiNEERiNG GROUP, Ltd. m~*m~~ CONSULTANTS & GENERAL CONTRACTORS ~m~ 3701 E' T~3~ R~' SUITE 101 * '~NCNOR~E' NC ~07 * ~40NE: (907)337-111'/~ ' FAX: (~37)3~ * ~ W~~ 1 ......... '' I' '/Y ........... ISOIL,, LOG - PERCO~TION TESTI LEGAL DESCRrP~ON: TiSN, RlW, SEC~ON 4; LOT 19 PERFORMED FOR: ~RRY ~ MICHEL~ FOREM~ DATE:,, 2/13/2o0~ q~ t. q .* .~ DEPTH ~ (f ORGANICS ITEST HOLE S I IFIOATIONS SITE P~N ~ ~ 1 '= 100' GM CL GC 0L *~// ~ ~ SW MH SP CH // 7~1 FI l~lt~ ~D S~LT - DEPTH TO : ~:~]~~~~ VERY TIGHT GROUNDWATER DATE ............. t ...................... N~- ...... ~-- ............. ~ ................... ~_ DRY 2/1 ~/0~ N / 7.5' 2/14/04 x / ~.o' 2/~z/o4 G~CIER RO~ 10 6.0' 2/25/04 -- -- ~----- 11 DATE RE~DING CLOCK NET TINE WATER LEVEL NET DROP TIHE (HINUTES) RE~DING (INCHES) ~ 2 ~/~ 4/04 ~ ~ 500 - 6. _ 2 1530 30 ~ 5-1/2" 1/2" 13 3 1530 - 4 ~6oo 3o _ 5-~/2" ~/2" 14 5 1600 - 6- _ 15 6 16~0 30 5-1/2" 1/2" 16 17 18 19 PERCOLATION RATE 60 (NIN,/INCH) PERC, HOLE DIA. 6 (INCHES TEST RUN BETWEEN 2.5 FT. AND 3.0 FT. 20 A FOUR HOUR PRESOAK WAS PERFORHED: I YES ~ NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORHED BY: JODY MAUS CONNENTS: PERFORMED BY AK~C, INC. I, JEFFR~ A[ GARNESS, CE~I~ THAT THIS W~ ~EEFORMED IN ACCORDANcE WITH ALL ~ATE AND ~UN!ClPAL GoiDEEI~ES IN EFFECT ON THIS DATE: ~]l RNESS ENGiNEERinG GROUP, Ltd .~/ff]&~..'"' 5 d ~"-.~ PERFORMED FOR: TERRY ~ ,IOHELLE rORE~ DATE: 2/i~/2004 ~,-"~ ',~ ......... ~PT.~: ITEST HOLE ¢2I e~~ Ol SSIFICATIONS SITE P~N /~ .... GW ~ ORG 1"=100' 6 ~ GH/SH/HL ~ SC / ~. X, ~PROPOSEDX TI HIXTURE OF ~ ~ ~ WELL ~m GRAVEL, SAND, ~ ~'~ N~ ~ ~lr~ DEPTH TO GROUNDWATER DATE ............. t ...................... N~- ...... T-- DRY 2/~/o~ t~ // 9.0' 2/14/04 "~ /~ - -- S.O' 2/17/04 G~CIER EOAD 11 DATE READING CLOCK NET TIME WATER LEVEL NET DROP TiME (M~NUTES) READING (iNCHES) 16 17 18 19 PERCOLATION RATE 60 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES TEST RUN BETWEEN 2~5 FT. AND 5.0 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: I YES ~ NO SOILS LOGGED BY: dODY MAUS PERCOLATION TEST PERFORMED BY: JODY ~AUS COMMENTS: PERFORMED BY AKWWC, INC. I, JEFm~ A. ~ARNESS, CERTI~ THAT THIS ~ pERFORmED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEUNES IN EE~OT ON TRiS DATE~ ~Jl Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program .-- 4700 Elmore Road P.O, Box 196650 Anchorage, AK 99519-6650 j' ~~_~¢_~ www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEHs APPROVAL FOR A SINGLE FAHILY DWELLING Parcel I.D. 051-072-16 1. GENERAL INFORMATION Expiration Date: -~2/c~ ~ ////! Complete legaldescription T15N, RIW, SEC 4-, LOT 19 Location (site address) 21851 GLACIER VISTA ROAD *CHUGIAK, AK 99567 Current Property owner(s) TERRY & MICHELLE FOREMAN Day phone 688-5807 Mailing address 21851 GLACIER VISTA ROAD *CHUGIAK, AK 99567 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 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 On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATE.r~ENT OF !NSPECT!ON BY ENGINEER As certified by my sea/affixed hereto and as o? the validation date shown be/ow, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Gu/defines for this application, shows ~.~ ~ ~ ~;~ .... t ,,,~~n-~,~ water su~lv. , , and/or~-,~,~,~,~,~,~' .... ~ ~,~,~. ~,~,~,,,~,,o,~. is {~),~, .... safe, fu~fiona~ .... , and adequate for the number of bedrooms and type of structure indicated herein. ! furt,Ser veriPy that based on the on-site water supply and/or wastewater disposal system is(are) in compliance wit.~ afl applicable Municipal and State codes, ordinances, and regulations in effect at t,ffe time of instaflation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 537-6179 Address 5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date Engineer's Comments: In conducting this evaluation, G£G, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described 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 soils condition, groundwater 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of t,ffis report by any other person or party is not authorizad, nor will it confer any legal right whatsoever. 5, DSD SIGNATURE ~/'""~ Approved for bedrooms. Disapproved. Conditional approval for ,'~.. sen!c AC.V!S~JF~, Septic System Advisory Well F/ow Advisory l~',.~,~ ,"~.uv~',fl~" ~/ /// / / ,/ // , .~ ~ Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: ~/~,>/~/"/~ / (Rev, 11105) Bo CERTIFICATE Legal Description: WELL DATA Well type PRIVATE Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 OF ON-SITE SYSTEMS APPROVAL CHECKLIST T15N, RIW, SEC 4, LOT 19 Date completed 3/17/04- Total depth 122 ft. Date of test Static water level 68 Well production 25 WATER SAMPLE RESULTS: Coliform 0 colonies/100 mi. Arsenic: ND ug./L. SEPTIC/HOLDING TANK DATA If A, B, or C provide PWSID# N/A Sanitary seal (Y/N) -Y Cased to 122 ft. FROM WELL LOG 3/17/04 g.p.m. Parcel ID: 051-072-1 6 YES YES 18+ in. Nitrate 0.692 mg./L. Date of sample: 3/25/11 Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION 3/34-/11 71 .ft. 7.31 g.p.m. Tank Type/Material Tank size 1500 gal. Foundation cleanout (Y/N) YES Date of pumping 3/11/11 ABSORPTION FIELD DATA Date installed 5//16-17/04 Length 30 .ft. Total depth '2.91 STEP/STEEL Collected by: GEG, Ltd. Date installed 3/16-17/04- Cleanouts (Y/N) YES High water alarm (Y/N) YES JR'S PUMPING System type BED Gravel below pipe 0.58 Number of Compartments 2 Depression over tank (Y/N) NO Pumper [*BELOW EXISTING GRADEI Soil rating (g.p.d,/ft2o~ 2,0 Width 12 ft. ft, Eft. absorption area 360 ft2 Monitoring tube YES Date of adequacy test 3/24-/11 Results (Pass/Fail) PASS Fluid depth in absorption field before test **2.5 in. Water added 695 gal. ****2.25. Elapsed Time: 1135 min. Final fluid depth m. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date **MONITORING TUBES HAVE JIM CAPS ON BOTTOM AND PROBABLY TRAPPING LIQUID. ***FILLED TO TOP OF DISTRIBUTION LINES. ****HOME WAS OCCUPIED AND SYSTEM USED OVERNIGHT. SYSTEM ABSORBED PROBABLY MORE THAN 800 GALLONS. Depression over field NO For 4- bedrooms New depti~**5'5in. 6OO+ g.p.d. D. LIFT STATION Date installed 3/16-17`/04 Size in gallons 1500 "Pump on" level at TIMER in. "Pump off" level atTIMER in. Datum BOTTOM OF TANK Cycles tested 3 E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot 100'+ Public sewer main N,/A Sewer/septic service line 25'+ Animal containment areas 50'+ 100'+ Manhole/Access (Y/N) YES High water alarm level at 46 Meets alarm & circuit requirements? YES ¸in. On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout Holding tank N,/A Manure/animal excrete storage areas N/A 100'+ Building foundation Water main Wells on adjacent lots SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 5'+ Property line 5'+ N,/A Water service line. 10'+ 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Absorption l~ield 5'+ Surface water. 100'+ Property line 10'+ Building foundation, 10'+ Water service line 10'+ Surface water 100'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ COMMENTS Water main N,/A Driveway, parking/vehicle storage 10'+ 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 JEFFREY A. GARNESS Date COSA Fee $ Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT TN ~ · MEMORANDUM OF L, DERSTANDING THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this herein the "OWNER." and the Municipality of Anchorage. herein the "MUNICIPALITY." In consideration of the mutual covemmts contained herein, the pagies to this Memorandum of Understanding agree as 'follows: 1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS). described as ~ 5 ~ located at T)5/~-,J.~,f~..,...~,5.: Anchorage, Alaska. 2. Definitions. A. Alteration. Any change to the design or fhnction of an AWWTS that Includes the installation or removal of any pmqs, components or pieces not included in the original construction permit and design. Prior to per:t:brming any alterations to an AWWTS the owner must obtain a Wastewatcr Disposal System Construction Permit fi'om the Municipality B, (ertificate of On-Site Systems Approval. An approval by thc Municipalit) of existing water and wastewater disposal systems given at the time of prope%, sale and title transfer in accordance with AMC 15.65. t'hese approvals ce,:ti!? that the systems are adequate for the homes that they support and meet thc codes that were in place at the time of s~stom construction. Damage, Any man-nmde or natural change in a system that x,xould inhibit the system from pertbrm:ing as designe& D. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS ~o continue to perform as designed. E. Permit (Construction) An On-Site Wastewater l)isposal System Construction Permit as defined by AMC 15.65. F,, Permit (Operating) An Advanced Wastewater Treatment System Operating Permit. An annual pem~it, issued b> the Municipality, thru allows the Owner to operate an AWWTS. upon meeting all the requirements of this agreement, the conditions of Operating Permit, the requirements of the On-Site Wastewater System Construction Permit and all relevan~ provisions of AMC 15.65 ()whet shall pay to Munic:ipality an annual fee of ~) ($_,~,00), payable on or belk:)re tine issuance of the operating permit and annually thereaficr. 'Tine annual ibc is duc on or bcfi:)rc thc anniversa0 dale of thc approval by thc MUnicipalilv of~ ~ ~., , re.la} ed s~ stem. 4. Terns. The term of this Memorandum of Understanding shall be tbr the l iJ~ o f the AW Wi 'Ii'he term begins on the date of appro:'at by the Municipali!;, of the installed sF stem and shall continue ~;~,hile the AWWTS system is in t~se or operaiionat ~r until the properly is sold or title is transtkrred by owner and a new certificate of On-Site approval is issued to the new owner or trans'~bree of the property. 5. Alterations~ Installation and Removal of Additiona! Equipment. Owner agrees not to make any alterations, removal of parts or additions to thc AWWTS without a Construction Permit from the Municipality. 6. Maintenance and ~, A. Throughout the term of this Memorandum of Understanding. the Owner shall maintain AWWTS in good repair. In addition, it shall be the responsibility of the Owner during the term ot' t his Memorandum o f Understanding, and any extensions or renewals thereoi', at the owner's sole expense, to pay for any and alt: (1) repair(s), (2) maintenance, (3) a4iustment(s), (4) replacement costs, and (5) inspection costs. f:urther, Owner agrees to comply will all applicable ordinance, laws. regulations. rules and orders tbr the AWWTS. B. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the Owner's A WWTS Operating Permit 'I'his schedule shall be submitted to the Municipality annually upon the renewal of the permit. Thc schcdutc o~' maintenance and repair conlained in the Owner's AWWTS C. Owacr acknowledges that the fine schedule lbr thiling to maintain and repair an A~"WTS are codified in AM( 14.60. Municipality x:vill inspect and make an.,.' nc.c.~ssat' '"' "' 'y maintenance, repairs or permitted alteranc ns to the system. E. Owner agrees to grant the Municipality reasonable access to test and inspect the A ,'~ IS upon 24 hours written notice. F. Owner agrees tlnat any sale or transtar oftitte of the property will not occur without a new ('emficate' of (.)n-S~te" Systems Approval. G. Owner agrees that the relevant provisions of the standm'd specification guidebook tbr AWWTS is the governing r" ' , p ofess~onal guidelines tbr the construction, maintenance and repair of the Owner' s A W WTS. 7. Nonwaive[. I he tklilure of either part),' at any time to en:N)rce a provision of this Memorandum of Understanding shall in no way constitme ~ waiver of the provisions, nor in any .... way ef~cl the validity of the Memorandum of Understanding~ or any part hereoL or the right of such party thereafter to enfbrce each and every provision hereof, 8. Amendment. A~ This Memorandum of Understanding shall only be amended, modified or changed by a writing~ executed by amhorized representatives <)I' the parties, with thc same fi>rmality of this Memorandum of Understanding was executed and such writing shall be attached to this Mcmorandtm~ of [~ndcrstanding as an amendment. B. For thc purposes of any amendment modification or change 1o the terms and conditions of this contract;, the only au honzed ~epmscntat~vcs of the parties are: ()wrier: A n c h o rag e: P urc has i n,g~ 0 ffi c er Any attcmpt to amend, modii?', or change this contract b) either an unauthorized representative or unau:thorized means shall be void. 9. Jurisdiction: Choice of Law. An5,' civil action arising fi'om this Memorandum of [Jnderstanding shall be brought in the Superior Court For the Third Judicial District of the State of Alaska at Anchorage. The laws :~" · - ~_t the State of Alaska shall govern the rights and obligations of the parties under this Memorandum of [)nderstanding. l O. Severabilitv.= Any provisions of this Memorandum of Understanding decreed invalid by a court ct competent jurisdiction shall not invalidate the remaining provisions of the Memorandum of Un.derstanding. OWNER: Date: ........ Mt NICIPALI I Y: By' Title: Date: STATE OF AI.ASKA Till RI) JUDI(.171A L DI SIRICI' The forego' 20/[., by N(. I AR5 My Commi ) instrument '~,as acknowledged bef~¥;~ DN.thisc-~5~day o sion cxpircs: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak, us (907) 343-7904 Parcel I.D. 1. CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING o51-o72-16 O&drO GENERAL INFORMATION Expiration Date: Complete legal descripfion T15, RIW, SECTION 4, LOT 19, Location (site address or directions) GLACIER ROAB * OHUGIAK, AK. 99577 TERRY & MICHELLE FOREMAN Day phone 688-3807 22150 DEER CIRCLE * CHUGIAK, AK. 99567 Day phone Day phone Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address Un/ess otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4- 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 (HA,&) based only upon the representations given in paragraph 4 by an independent professional engineer registered in the State of Alaska, Certificates of Health Authority Approval are required for the treb~(~' of btle (except between spouses) for properties served by a single-family on-s~te wastewater disposal and/di water supply system. DSD also issues HAAs upon request to homeowners. Cedificates 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 samples. (Cedificates 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 watei- system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engines~ work. o 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 Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS. P.E. Engineer's Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysis ef the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported result~ described 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 soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being set'zed by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee futura performance of the system, nor do they guarantee that there ara no hidden defects or encroachments. GEG, Ltd. can therafora not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any ether person or party is not authorized, nor will it confer any legal right whatsoever. Phone 337-6179 5. DSD SIGNATURE Approved for bedrooms. Disapproved. t~ Conditional approval for ~ bedrooms, with the fllowing stipulations: At the time of title transfer, the new property owner shall sign the attached maintenance agreement which shall be returned to~ this office before an unconditional approval is issued. . ~ ~ ~ . . Attachments: ' H~ Checklist ~ Manitenan~ Agreemems : Septic System Adviso~ Supplemental Engineer s ~o~ , PR~n Well Flow Adviso~ Other . By~ ,~ ~ 3~_ ~t ~g~ Original Ce.ifi~te Date: (Rev. 12101) Size in gallonS __ n. "Puml M~ Hi Meets alarm sewer main pUblic sewer Propedyline o Surface water se~lce Building foundation Water main Surface water Driveway, Wells on ame that the above sYstems are/n ~ in effect on this date. Waiver Fee $ Date of Payment Receipt Number ASBUILT - SEWARD & ASSOCIATES ] HEREBY CERTIFY .THAT I HAVE SURVEYED THE SCALE: , FOLLOWING DESCRIBED PROPERTY; / ~"~'~ ~<~T/~_r~-~, ~..~..~/-~ ..,-:.,..~- DATE: x ~ - AND TH'AT NO ENCROACHMENTS EXIST ExCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE ~'¢ OWNE~ TO DETERMINE THE EXISTENCE OF ANy GRID: ~,, EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONstRUcTiON OF FENCE LINESI OR FOR ESTABLISHING BOUND- DRAWN: ARY LINES. LAND SURVEYING 694-0829~ x,j~ .' /~ .. u.4_~~ , 07j19-04 12:47PM FROM-CT&E ESI, SGS ENV SERVICES §D7561530] T-127 P.02/03 F-27§ _. SGS SGS Ref.# Client Name Project Name/# Client Sample ID Matria 1044033001 Gamess Engineering Group, Ltd. Lot 19, T15N, R1W, Section 4 Lot 19, T15N, RIW, Section 4 Drinking Water Sample Remarks: All Dates/Times are Alask: [Standard Time Printed Date/Time !07/15/2004 16:22 Collected Date/Time 07/12/2004 6:40 Received Date/Time 107/12/20,~¢ 13:08 Technlcal Dire~ St~f. Ede ReaulL~ PQL Units Method Allo~,able Pr~p Analysis Container ID Lin!its Date Date Init Waters Depart~ent Ni~a~-N 0.342 0.100 mg/L EPA 300.0 B (<=I~) 07/12/04 3JB Microbiology Laboratory Total Coliform col/100mL SM20 9222B A (<=1~ 07/12/04 DKC