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WOODBOURNE BLK 1 LT 6
Woodbourne #015-351-12 Municipality of Anchorage ,.r Development Services Department Building Safety DiWsion ... *. Onsite Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.d.anchorage.sk.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: 0'"50 ZS t PID Number: 1 31; % 1, Z Neme: Wastewater System: New ❑ Upgrade Melrose! �\ w o Z ABSO TION FIELD Ptho,he:D� K ' `-) MerAera Bebowna:3 V-+� ❑DNa Tleldt Shdbx Trantli F Bed [3 Mount! ❑otlrer. LEGAL DESCRIPTION sal Ramp: (.t Told Deptt from orginal Weals:1 t3 r GPDIFt' Ft. Bbdc Leh � Sub9viabn: �LA,(�OIVI Depth to pipe bman ham odanel wad.: Brawl depth beneath pipe: WGiTD Q�nw(1�N L7 Ft. to" Ft. TaNnehlp: Range: secdm: Fa added above original grad. Gmrel Length: 13 r FL ``LO Ft. Well: �J New ❑ Upgrade G.(0'� Ft. 2 o Ines: Distance mbwxlhFt. '�� Ft. 0sufficalion (Private, A B, C): ToW Depth: Cased "':Total abaohption area Pipe Material: ?#L(L, rt� TE l�S Ft. 16t Fi 200 C' FP '� Drax Date Drilled: StarkWieyts, Level: Installer Den InNalled: lRde lot 4 �r FL C, 1- C InewPunp S + sal aL Caehp Heightft wG, : TANK GPra 119 F.71 Ft. SEPARATION DISTANCES ❑Septic [I Holding ❑S.T.E.P. Other: To Septic Absorption LIR Holding ubgdPdvate b: From Tank Field Station Tank Sewer Lim 4&0tLE '1OCCA Gal. YM ed * to& I IVLr A- K&- Material: Nhanbar d Cmparrnenn: Surarewaler too'\- l001' t (to'+- NIA Lot Lha ((.lo` �Ii7' "ILS Gel. LLIFTSTATION W. 6tc"C.LF- Fandedm ('� %.3 \� lt'1it25^ "Pump m' level at Turnp orr level r:. idg water alamh al S In. Me, In h. Pwnp Maks a Model Electrical InspaWW,q performed by: Cu in Dram hj -L'�bY� �-l4Zt'a1L. R°rnan° BENCH MARK c Y[t1K \.tst+w�cb �x Lamdm and salptlm: -1" of CMv- vrAIJ- ea vatim: e s w C3'(l W eyL 'O'er t [X� FL It (aSr b"9 0'N SUCH %'LxL• C-OVItL LNSi"�U.M4�\�! Engmeei's - ". ek . Inspections performed by: lb'oo t T Li%o Dates: 1" 161 IS 65- Y i 2nd I F'r'l-H, :D-,i , Developme t Services Department Approval '10453 Reviewed and approved by: ate: 44 r� ♦ QFr (ave. tvm) a. ,, +'" 1'G LOT 6 BLOCK 1 WOODBOURNE CREEK EASEMENT CREEK EASEMENT / AS BUILT SWING TIES A B IFCCI 18.3'120.31 S 24.5 21.6 T1 34.7 31.6 T .6 48.7 INSTALLED NEW BIOCYCLE 7 LINSTALLED EW DISCHARG LINES 5' APART UNDEVELOPED TEST HOLE LOT 49.1 �Sa ;:1. LT.n/ ..._....... Dote: . 86THARD r WOODBOURNE LOT6 BLOCK 1; 11/30/04 10463 WELL AND SEPTIC sFqun: AS BUILT 3 8 FILENAME: WSWOODBOURNE LOT 6.DWG BIOCYCLE INSTALLATION ��NsEXPOSE TOP OF 1_JLI6" ABOVE TANK GRADE GRADE (97.8) I DISCHARGE (93.5•) INFLUENT — (94.0') 4"3034 PVC o e BOTTOM OF TANK 89.3) 4" NFS LEVELING H-8' DIAMETER —1 4 SHEETS OF COURSE 2'X8' BLUEBOARO INSULATION NOTES 1. ELEVATIONS FROM SW HOUSE CORNER, TOP OF CMU WALL, ASSUMED 100' INSTALLED DRAINFIELD BIOCYCLE UNIT 12.6' TO FOUNDATION MONITOR TUBE 1 NOTE:. ASSUMED ELEV. ON SW CORNER OF HOUSE, TOP OF CMU WALL - 100 FT GROUND SURFACE AT GROUND SURFACE AT MTI. (97.9') ---,_ MTI. (96.0') —,, i-]" DIA PERF PVC. SPACE A" HOLES EVERY 18 INCHES. CAPPED ENDS, �-- MONITOR TUBE 2 MT 2 BOTTOM (90.4') 4" RIGID BOARD INSULATION, STAGGERED JOINTS; -FILTER FABRIC MT 1 BOTTOM -SEWER ROCK (92.5'-93.0') (91.4') 3' S' 3' 1' SAND (91.5'-92.5') 1-1/4" DIA PERFORATED PVC PIPE. (93.0') TP BOTTOM ........... (87.0') +.• � �+^� ORAINFIELO SECTION �--s c„ F--'' ys p� A AS BUILT .�.IZZ - NTS N Dote: TODD . eETwzRo •, WOODBOUFiNE LOT 6 BLOCK 1 11/30/04 �. 104£3 WELL AND SEPTIC Figure: .....s . AS BIALT 4 v"�O ms , FILENAME: WSWOODBOURNE LOT 6.OWG Nov-16-04 09:17A p.O2 FROM : ALPINE DRILLING _ FAX NO. :907 345 0202 Nom. 14 2W3 07:04PM pi Municipality of Anchorage Department of Health and Human Services P.O. Box 196650 ti25.L. 6treet > *ajry+.w.da ee.At!! 0457x6650 Permit Number. #SW 030261 Date of Issue: 7-16 03 Parcd Identification Number: 15,?51_1 Lesal DescriptioDate Started: n: Date Comytwd: 1x1.-03 is well located at e�oved permit lomtion? ® Yes No W—Lot 8 Property OWoer Name k Address:Bethard� r 1 2440 Dennis Way Anohora Alaska 995f5 Borehole Data: Depth (ft) Method of D Soil Type, ThkJme" & Wader Stan from To s�llag ®alt rotary ❑cable tool slide-up 0 �°S jypC �l 2 ww Thlcimess: �Q hlches organics 6 an 2 3 Diamcer. Alaches Depth: MI feet gravelly ax 3 78 Liner Type- sandy silt 78 85 Diameter inches Depth: feet 30y gravel 85 102 Casing sdcitnp above ground: g feet gravelly alk 102 160 Static water kvel.(A m ground level): H hot bedrock160 184 PumpingkVeL..Uvetlafter T hours pun4ft ¢ Xpm Recovery Sato.4 tpm Method of Testing: !lClld Well Intake Opening Typc ® Open End ❑ Open Hole ❑ 3cremed Start feet stopped fear ❑ Parioratlons Start feet Surpped feet Grout Type: benronLe # 8 Volume: ]bg Depth I Stan 0 feet Stopped 2 feet Pamp: Intake Depth feet P,%mP size Brand Mune WoII Disinfected Upon Compictiont ® Yes ❑ No Method of Disinfectlow' Cott U.. Well OrMer. A4*m Driffing 6 Enterprtsos PO Boor 110496 Anchorage Alaska 99511 Atteatioa: The well driller shall provide a well We to the property owner Whhin 30 days of completion and the property ... ..- . .a....... •.w. ..e.0 ..__vi . ....a Vim... .l VV.." • •... ._. n_—_s_., d.L f. ♦n .__._ .! ... �.•p... filov 39 04 05:55p 907-561,-4255 P.1 i page of I MsPECTlONREPORT ! MUNICMALITY OF ANCHORAGE — BUILDING SAFETY DIVISION 4700 SOUTH BRAGAW STREET, ANCHORAGE, ALASKA i MPEC770AW. Voicc (997) 3434309 Fax. (997j 249-7777: MFORMA770N (9" 343-7962 imAm.. S'�\e\4on'Ueckr:r. MRAU vex:03-laW ! wnnxass: 11"1 (DO t�ooa�pourwe �r Di 11 /19 /oq PHONE #J: S1o3.3a4q MONSNz Lim Lo BLOCK: 1 SUBDIVISION Woo 0Q P A e COAMMMM. 27PEOF INSPEC770N:1eC�krlca\ NoaasaoonptimacaLa�cd. [] Do nd ooaml until m®prctalL Z]Go. appund ❑ c000utiom""JA ogpGc.a (aommahbolo.) Lama boo.. Wall:oanu®u. udnwutbepo.ti®. [XJII ]VTS: R mpwd=7 ff arvirvj Jc Jrwrlr. Jura JNWJJUr. MUNICIPALITY OFANCHORAGE ID -1 —0-5 1 1 , 730a1nq e Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM f WATER SUPPLY PERMIT Initial Permit Number: SW030251 Legal Description. VJ16oatro�iock i Lot 6'. Design Engineer: 0019 Flattop Technical Services Owner Name: Todd Bethard Owner Address: 2440 Dennis Way Anchorage , AK 99515 - Date Issued: Jul 15, 2003 Expiration Date: Jul 14, 2004 Parcel ID: 015-351-12 Site Address: 11760 Woodbourne Drive Lot Size: 103578 SO. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy 0 Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: 7 Is"' 2 orJ3 Date: I Municipality of Anchorage • •. Development Services Department , Building Safety Division i On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 611S&51112e Permit Number SW 03025'1 Property owner(s) T000 DlEr* " &&g huff Day phone 104 4VN U41 Mailing address (1) Wyo pl;r1N11 www_ Mailing address (2) ANw! 0AAA bR ot%c_ Zip Code '[9 S i S Legal description (Lot, Block & Sub'd.) Lor 6 GL.af- 1 we+o0ou rLN 6 5�+.6, Legal description (Section, Township & Range) Lot Size Z.41 4CA S Acres/Sq.Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ® Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub 13 Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized Permit Fees: Waiver Fees: Date of Payment: Receipt Number: (Rev. 12/00) Date of Payment: Receipt Number. c Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 S. Bragaw Street Anchorage, Alaska 99519 Submitted by: Todd Bethard, P.E. 907-644-2049 Please find enclosed an application for the installation of a well and septic system for Lot 6 Block 1 Woodbourne Subdivision. This application consists of three figures: 1. Existing conditions of Lot 6, Block 1 and adjacent parcels 2. Proposed improvements to Lot 6, Block 1 3. Septic system details and sections 4. Appendices (soil logs and recommendations) Design of the system was based on the following design criteria: Type of system: Soil percolation rate: Soil rating: Required area / bedroom: Number of bedrooms: Total area required: System configuration: Filter sand depth: Rock depth: Notes: Biocycle with drainfield 1 minute / inch 3 gallons / day / square foot (conservative) 150 square feet / bedroom 4 bedrooms 200 square feet 20 feet long by 10 feet wide by 2 feet deep 1 foot 0.5 feet Lot size is sufficient for standard trench system located else where on the lot. Reduced impact to surrounding and improved treatment was desired by homeowner due. The creek is approximately 135 feet from the test hole and runs just inside the north property line. Test hole was excavated by Flattop Technical Services on May 21, 2003. Minor seeps were found at 6 feet, and a static water level was observed at 8 feet in the monitor tube. The well will be located on the south east corner of the lot. Both the Biocycle unit and the absorption field will be located over 100 feet from the proposed well, and over 250 feet from the adjacent existing well. The adjacent undeveloped lot will not be adversely impacted by the proposed location. The system will not impact drainage on the lot. The excavation area will be graded to prevent ponding. Attachments: 1. Percolation Test Report !" " ODD S. i' 2. Surrounding Property Documentation 10463 M� WELL LOT 2 BLOCK 1 LOT 6 BLOCK 1 WOODBOURNE 01535112 TEST HOLE SEPTIC SED HOUSE TEST HOLE J UNDEVELOPED WOODBOURNE DRIVE TODD B. BETHARD 10463 WELL 01535109 LOT 4 BLOCK 1 WELL 01535110 LOT 5 BLOCK 1 01535111 WELL 1 inch 100 feet Date: WOODBOURNE LLOT�6 BLOCK 1 06/16/03 WELL AND SE 11v Fl9un: PERMIT APPUCATM 2 )BOURNE LOT 6.DWG CREEK EASEMENT 4 R TEST HOLE In UNDEVELOPED LOT 49TH TODD B. BEI 10463 LOT 6 BLOCK 1 WOODBOURNE CREEK EASEMENT PROPOSED SEPTIC LOCATION PROPOSED HOUSE LOCATION REPLACEMENT IELD /I I , PROPOSED WELL TEST,HOLE Dote: )ODBOUFNE LOT6 BLOCK 1 06/16/03 WELL AND SEPTIC Fguro: PERMIT APPLICATION 3 URNE LOT 6.DWG SIOCYCLE INSTALLATION EXPOSE 6" ABOVE 4' MAX INFLUENT -L- 4' L4" 3034 4" NFS LEVELING COURSE 2 TODD B. SO ,. 10463 I:Nil'vN �8' DIAMETER —I BIOCYCLE LEGEND 1. PRIMARY AERATION 2. SECONDARY AERATION 3. CLARIFICATION 4. DISCHARGE DISCHARGE i r J Q ~ yC1 � > W O S 4 SHEETS OF 2'X8' BLUEBOARD INSULATION 10' TO FOUNDATION 5 MONITOR TUBE INSTALLATION NOTES 1. EXCAVATE 10'%10'X10' HOLE FOR SIOCYCLE INSTALLATION 2. PLACE 4" NFS LEVELING COURSE. COMPACT. 3. PLACE 2'%8'X2" BLUEBOARD INSULATION. STAGGER JOINTS AND ENSURE LEVEL IN ALL DIRECTIONS. 4. BACKFILL TO INVERT OF 4" INFLUENT LINE AND 1 J" EFFLUENT LINE WITH NFS FREE OF LARGE STONES PROPOSED NEW DRAINFIELD UNIT EXISTING GROUND SURFACE PROPOSED GROUND SURFACE APPROXIMATE ELEVATION GRADE TO DRAIN 2' UNCLASSIFIED BACKFILL , MAXIMUM EXCAVATION ro DEPTH 2.5' 2.5' S' 2.5' WATER TABLE ON MAY 28, 2003 /A\ DRAINFIELD SECTION 1-J" DIA PERF PVC. SPACE &- HOLES EVERY 16 INCHES. CAP ENDS MONITOR TUBE." 4"MONITOR TUBE 3034 4" RIGID BOARD INSULATION, STAGGER JOINTS -FILTER FABRIC i" SEWER ROCK ' FILTER SAND 1-1/4" DIA PERFORATED PVC PIPE. SPACE 3/16" HOLES EVERY 18 INCHES. PLACE APPROX. 6" BGS IN CLEAN GRAVEL LAYER. CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. 14530 ECHO ST. PH: (907) 345.1355 June 1, 2003 ANCHORAGE, ALASKA 99516 Todd Bethard 2440 Dennis Way Anchorage, AK 99515 Dear Todd: Per your request, on May 211 conducted a soils test to assess the feasibility of constructing a wastewater disposal system off the northwest side of your proposed house on Lot 6, Block I of Woodbourne S/D. A site plan and a test hole log with perc test data are enclosed. Several strata of densely compacted gravels with variable silt content were encountered in the test hole. These were interspersed with other strata of tight silt. Small water seeps were observed at a depth of 6 feet and major seeps at a depth of 9 feet. A week after the test hole was dug a stabilized groundwater level of 8.0 feet was observed in the monitor tube that we put into the test pit before backfilling. Because this spring's breakup has been particularly mild, a shallower seasonal high water table could be observed in other years. I conducted a percolation test in the uppermost stratum of clean sandy gravel, at which location I measured the percolation rate to be one minute per inch. This translates into a soil application rate of 1.2 gpd/sq. ft., so for a 4 -bedroom residence (600 gpd) the required absorption area would be 500 square feet. Due to the shallow groundwater table, the only feasible conventional soil absorption system would be a 5 -foot wide drainfield. Thus, the necessary length would be 100 feet, which could be accomplished by two 50 -foot drainfields as illustrated on the site plan. The bottoms of the drainfields will have to be very shallow (approximately 1.5 feet below ground level), so it is not clear whether this system can be constructed without using a lift station. Because 5 -foot wide drainfields are designed to absorb downwards through their bottoms, they have a greater propensity for premature failure than trench type systems. Although it is not required by Municipal code, I usually recommend the placement of 12 inches of coarse washed filter sand under the sewer gravel in this type of system. I believe this sand should facilitate the absorption of septic tank effluent into the native soil and thus enhance the longevity of the system. The depth to groundwater appears to be a couple of feet greater in the test hole dug by Tobben Spurkland a couple of years ago. This should allow the construction of a trench type system at that site, although it will definitely also require the installation of a lift station. Assuming the soils between I and 5 feet deep in that test hole also perc at a rate of less than 5 minutes per inch, a 63 -foot long trench with 4 feet of effective sewer gravel would be appropriate for a 4 -bedroom residence. On the site plan I have also shown how this could be configured. Please feel free to give me a call if you wish to discuss any of this, and I would be happy to review any final design plans you come up with a no additional cost. I will enclose an invoice reflecting my standard engineering fee for this phase of the work which I have now completed. Sincerely, Ted Moore, P.E. ___________________________________________________ _J J / LITTLE CAMPBELL CREEK J LOT 6, BLOCK 1 WOODBOURNE SID 2 PARALLEL 50 -FOOT LONG x 5 -FOOT WIDE DRAINFIELDS 126"ALLON SEPTIC TANK 5V T.H. #1 ------ ----- ------ , ---------- PI ------------ REPLACEMENT DRAINFIELDS------- 1500 -GALLON STEP TANK m. mpe +. xi st%CA ' �nnao....l..••!!H!'s ar ✓,.e ............. "m THEODORE F. A40ORE C»-3589 [ 7 63 -FOOT LONG SOIL ABS. TRENCH w. 4.0' EFF. GRAVEL EPURKLUND TEST MXE REPLACEMENT TRENCH LOT7 PROPOSED BLOCK 1 WELL SITE (VACANT) R 100' WELL i R 100' WOODSOURNE DRIVE_ _ _ _ _ _ _ _ _ LOT 6, BLOCK 1, WOODI PROPOSED WELL AND SE SITE PLAN FLATTOP TECHNICAL SERVICES LOT 3 LOT 414530 ECHO STREET BLOCK 2 BLOCK 2 , -' ANCHORAGE, ALASKA 99516 (VACANT) _ _ _ _ _ _ _ NOTE: THIS IS NOT A SURVEYEI LOT 5 BLOCK 1 FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 TEST HOLE # 1 SOILS LOG -PERCOLATION TEST LEGAL DESCRIPTION: Lot 8 Block 1 Woodbourne S/D DATE PERFORMED: May 21 2003 - - PERFORMED FOR: Todd Bethard SLOPE DEPTH (teat) PL 1 SM Reddish sandy loam 2 5 6 9 10 11 18 19 GP Clean brown sandy gravel Hard digging GM Gray silty gravel Dense, hard digging ML Gray silt Small water seep in gravel lens GM Sandy silty gravel Dense +Major water seeps ML Gray gravelly silt Dense B.H. Depth to Groundwater I Dale IIM ��•��QQ y'", ,rya 49TH ;.., A! : THEODORE F. MOORED °.fi `'r,�•.. CE -35134 • ,'; SITE PLAN K 33 T.H. #1 52 122 aPSD T HOLE 46 137 , 0% V Date Reading Clock Time Net Time (minutes) Peroometer Reading Net Drop (inches) 5/21 12" Presoak 273/8 12" esoak 7 314 Start #1 12:41:25 12:46:25 18 5 318 23 8 #2 12:51:50 5 183/8 5 318 water #3 20 lul PERCOLATION RATE 1 (minutesfinch) PERC HOLE DIAMETER 6" TEST RUN BETWEEN 2-5 FT AND 3.0 FT COMMENTS: Sourkland test hole monitor tube had water 0 10' - 2" below around level on 5/29103 PERFORMED BY FLATTOP TECHNICAL SERVICES. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: JQI-07-03 04:19P Permit Counter 907 343 8250 P.01 20 ZZ 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.cl.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: TODD B. BETHARD Legal description: WOODBVRNE SUBDIVISION BLOCK 1 LOT 6 u •'C� `AY:'rty � 5 A ! T V The attached paperwork has been reviewed and Is being returned for the following reasons: ® Original signature or stamp missing on SIGNATURE MISSING ON THE APPLICATION RM 'SA-birr ❑ Calculation error in design. _ ❑ Additional soils information needed. _ ❑ Water monitoring results inadequate. _ ❑ Discrepancy in information submitted. _ ® Topographic information missing or Inadequate. PLEASE SHOW SLOPES ON SITE PLAN OF A 1076 MAXIMUM SLOPE. S"'ge v'ef#LQ&.KrCTL6p ^u n - *%4#*o � Utviz..'r SwaW14 &%01* ® Incomplete; missing PROPERTY OWNER MAINTENANCE AGREEMENT ❑ Incomplete; missing _ Qabuy SLbO Q vv<u,N i ❑ Additional adequacy test Information needed. _ ❑ Water sample unacceptable. ® _ Measured/proposed distances/dimensions missing. MrSSIN 1§1W4W4e9 , s t4wol oN ❑ Locations of all soils, percolation and water monitoring tests not shown. u ❑ Proposed system too deep for soils information submitted. _ ❑ Well log required. _ ❑ Omission in narrative. _ ❑ Insufficient fill over tank or field._ ® Other. WHAT WILL THE TOTAL DEPTH OF THE BOTTOM OF THE BEDS BE FROM Name of reviewer: DAN t1i6BYCST I.r68NrT Sttrv.IN Date: /6 23!03 S�TtOV CN*4.+..6>p &A r Please supply the necessary Information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN MUNICIPALITY OF ANCHORAGE ANDTedd t3tltiwrd av►d l�►ob►nRciC101 THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this day of fud� 1 S 20 04 by and between itbin I iek- 1 fDdd 62%;'Tierein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties 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 located at Woodbmeme, [alio l3kacl4 Anchorage, Alaska. 2. Definitions. A. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Prior to performing any alterations to an AWWTS the owner must obtain a Wastewater Disposal System Construction Permit from!the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65 B. Certificate of On -Site Systems Approval. An approval by the Municipality of existing water and wastewater disposalsystems given at the time of property sale and title transfer in accordance with AMC Pagel of 5 15.65. These approvals certify that, the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. '"'Damage. •Any coati-made'br natural ehatige in a system that°woutd inhibit the system from performing as designed. 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 to continue, to perform as designed. E. 'Permit (Construction). An. On -Site Wastewater Disposal, System Construction Permit as defined. by AMC 15.65. ` F. Permit (Operating). -An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that - , allows the Owner to operate an AWWTS, upon meeting all requirements of this agreement, the conditions of the Operating: Permit, the.. requirements of the On -Site Wastewater System Construction Permit and all relevant provisions of AMC 15.65. L. 3. Fee. Owner shall pay to Municipality an annual fee of (5j.00), payable on or before the issuance of the operating permit and annually thereafter. The annual fee is due on or before the anniversary date of the approval by the Municipality of installed s.stem. Paye 2 of 4. Term. The tern of this Memorandumof Understanding shall be for the life of the AWWTS. The term begins on the date of approval by the Municipality of the installed system and shall continue while the AWWTS system is in use or operational or until the property is sold or title is transferred by owner anti -a new certificate of on site approval is issued.to the - new owner or transferee of the property. 5. Alterations, Installation and Removal of Additional Equipment. Owner agrees not to make any alterations, removal of parts or additions to the AWWTS without a Construction Permit from the Municipality. 6. NII intenance and Repairs. A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AIWWTS in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the ownei s sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further, owner agrees to comply with all applicable ordinances, laws, regulations, rules and orders for 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 AWWTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's AWWTS Operating Permit is: Page 3 of 5 C. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. D. Owner agrees that only maintenance, repair personnel certified by the -Municipality will inspect and make any iiecessmy maint,,nance,;, z;pairt,�er_ permitted alterations to the systems. E. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. F. Owner agrees that any sale or transfer of title of the property will not_ occur without a new Certificate of On -Site Systems Approval. G. Owner agrees that the relevant provisions of the standard specification' guidebook for AWWTS 'is the governing professional guidelines for the construction, maintenance and repair of the Owner's AWWTS. 7. Nonwaiver. The failure of either party at any time to enforce a provision of this Memorandum of Understanding shall in no way constitute a waiver of the provisions, nor in any way affect the validity of this Memorandum of Understanding or'any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 8. Amendment. A. This Memorandum of Understanding shall only be amended, modified or changed by a writine. executed by authorized representatives of the parties, with the same formality as this Memorandum of Understanding was executed and such writing shall be attached to this Memorandum of Understanding as an amendment. Pige 4 of r e B. For the purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized representatives of the parties are: Owner:, . _ ?,d, Q,!1,b PD0A &-k4� Anchorage: Purchasin Officer , C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of Understanding 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 Memorandum of Understanding. 10. Severability. Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum. of Understanding. OWNER: Date: ]&,151200-5 STATE OF ALASKA TWTRD u,nTCI.AT DISTRICT MUNICIPALITY: By: _ Title: Date: ss. [oreso' instrument was acknowledged before me this �Sy f 20(1' by the ��oti of be if of u ic% 991Eo rage. I'^� arh- A(/gi,� NOTARY PUBLIC FOk ALASKA Page 5 of 5 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 s " ` r www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: TODD B. BETHARD Legal description: WOODBURNE SUBDIVISION BLOCK 1 LOT 6 The attached paperwork has been reviewed and Is being returned for the following reasons: ® Original signature or stamp missing on ; IGNATVRE MISSING ON THE APPLICATION FORM ❑ Calculation error in design. ❑ Additional soils information needed. ❑ Water monitoring results inadequate: Discrepancy in information submitted: _ ® Topographic information missing or inadequate. PLEASE SHOW SLOPES ON SITE PLAN OF A 10% MAXIMUM SLOPE_ ® Incomplete; missing PROPERTY OWNER MAINTENANCE AGREEMENT ❑ Incomplete; missing ❑ Additional adequacy test information needed. ❑ Water sample unacceptable. _ ® Measured/proposed distances/dimensions missing. MISSING ❑ Locations of all soils, percolation and water monitoring tests not shown. ❑ Proposed system too deep for soils information submitted ❑ Well log required. _ ❑ Omission in narrative. _ ❑ Insufficient fill over tank or field ® Other. WHAT WILL THE TOTAL DEPTH OF THE BOTTOM OF THE BEDS BE FROM i ORI6INAL GRADE AT THE DEEPEST POINT?? Name of reviewer. DAN Date: 6/23/03 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK Municipality of Anchorage •� Development Services Department Building Safety Division ep On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. A1SS5112- Permit Number SW Property owner(s) TODD r39T*A9X Day phone 90'+ 644 1441 Mailing address (1) 1AIA6 gitJNll wva{ Mailing address (2) 60040rW40E *A_ Zip Code 19 S 1 S Legal description (Lot, Block & Sub'd.) LAT 4 GLKX- 1 W&►Ot30u.rt4+6 Sv.b Legal descriptionn�SS'oi, Township & Range) Sly l 1-I ��L['Jnnd k () (lr � 1 Lot Size Zc'!� Acres/ q.FL' Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ® Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub 0 Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: @ �7 511� Waiver Fees: _ Date of Payment: (0l 1 CL 1 0 P) Date of Payment: Receipt Number. O'3�� S �o r �� Receipt Numbs . (Rev. 12100) T— Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 S. Bragaw Street Anchorage, Alaska 99519 Submitted by.- Todd y:Todd Bethard, P.E. 907-644-2049 Please find enclosed an application for the installation of a well and septic system for Lot 6 Block 1 Woodbourne Subdivision. This application consists of three figures: 1. Existing conditions of Lot 6, Block 1 and adjacent parcels 2. Proposed improvements to Lot 6, Block 1 3. Septic system details and sections 4. Appendices (soil logs and recommendations) Design of the system was based on the following design criteria: Type of system: Soil percolation rate: Soil rating: Required area / bedroom: Number of bedrooms: Total area required: System configuration: Filter sand depth: Rock depth: Notes: Biocycle with drainfield 1 minute / inch 3 gallons / day / square foot (conservative) 150 square feet/ bedroom 4 bedrooms 200 square feet 20 feet long by 10 feet wide by 2 feet deep 1 foot 0.5 feet Lot size is sufficient for standard trench system located else where on the lot. Reduced impact to surrounding and improved treatment was desired by homeowner due. The creek is approximately 135 feet from the test hole and runs just inside the north property line. Test hole was excavated by Flattop Technical Services on May 21, 2003. Minor seeps were found at 6 feet, and a static water level was observed at 8 feet in the monitor tube. The well will be located on the south east comer of the lot. Both the Biocycle unit and the absorption field will be located over 100 feet from the proposed well, and over 250 feet from the adjacent existing well. The adjacent undeveloped lot will not be adversely impacted by the proposed location. The system will not impact drainage on the lot. The excavation area will be graded to prevent ponding. Attachments: 1. Percolation Test Report 2. Surrounding Property Documentation 01535109 WELL LOT 4 BLOCK 1 WELL 01535110 LOT 2 BLOCK 1 LOT 6 BLOCK 1 WOODBOURNE LOT 5 BLOCK 1 01535112 PROPOSED SEPTIC 01535111 r—PROPOSED HOUSE TEST HOLE WELL TEST HOLE UNDEVELOPED WOODBOURNE DRIVE WELL 1 inch = 100 feet ^^i• r T 4g�..1�:��% Dole: WOODBOU M LOT 6 BLOCK 1 06/16/03 TODD D. EETHAt20 10403 WELL AND SEPTIC Figure: PERMIT APPLICATION •.o. 2 ��'ESSIOtkt;�,y'" FILENAME: WSWOODBOURNE LOT 6.DWG CREEK EASEMENT TEST HOLE UNDEVELOPED LOT LOT 6 BLOCK 1 WOODBOURNE CREEK EASEMENT PROPOSED SEPTIC LOCATION REPLACEMENT FIELD PROPOSED HOUSE LOCATION PROPOSED WELL TEST HOLE TODD B. EETHAM) ti W L076 BOCK 1 06/16/03 10463 + a WELL AND SEPTIC Fgum: �lo� PERMIT APPLICATION 3 FILENAME:WSWOODBOURNE LOT 6.DWG 4' MAX INFLUENT L 4" 3034 4' NFS LEVELING COURSE BIDCYCLE INSTALLATION RIF - EXPOSE 6' ABOVE i GRADE wimilvia 1-8' DIAMETER — BIOCYCLE LEGEND 1. PRIMARY AERATION 2. SECONDARY AERATION 3. CLARIFICATION 4. DISCHARGE DISCHARGE Z 4 SHEETS OF 2'X8' SLUEBOARD INSULATION INSTALLATION NOTES 1. EXCAVATE 10'XIO'X10' HOLE FOR BIOCYCLE INSTALLATION 2. PLACE 4" NFS LEVELING COURSE. COMPACT. 3. PLACE 2'XB'X2" BLUEBOARD INSULATION, STAGGER JOINTS AND ENSURE LEVEL IN ALL DIRECTIONS. 4. BACKFILL TO INVERT OF 4" INFLUENT LINE AND 1 J" EFFLUENT LINE PATH NFS FREE OF LARGE STONES PROPOSED NEW DRAINFIELD BIOCYCLE UNIT MONITOR TUBE EXISTING GROUND SURFACE PROPOSED GROUND SURFACE APPROXIMATE ELEVATION GRADE TO DRAIN 2' UNCLASSIFIED BACKFILL io \ J � 2.6' S' a 2 R 0 z a WATER TABLE a T ON MAY 28, 2003 A DRAINFIELD SECTION NTS 1-j" DIA PERF PVC. SPACE a- HOLES EVERY, 18 INCHES. CAP ENDS MONITOR TUBE.. 4'MONITOR TUBE 3034 4" RIGID BOARD INSULATION, STAGGER JOINTS -FILTER FABRIC i" SEWER ROCK I' FILTER SAND 1-1/4" DIA PERFORATED PVC PIPE. SPACE 3/16" HOLES EVERY 18 INCHES. PLACE APPROX. 6" BGS IN CLEAN GRAVEL LAYER. CIVn. & ENYMONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. PH: (907) 345-1355 June 1, 2003 Todd Bethard 2440 Dennis Way Anchorage, AK 99515 Dear Todd: 14530 ECHO ST. ANCHORAGE, ALASKA 99516 Per your request, on May 211 conducted a soils test to assess the feasibility of constructing a wastewater disposal system off the northwest side of your proposed house on Lot 6, Block I of Woodbourne S/D. A site plan and a test hole log with perc test data are enclosed. Several strata of densely compacted gravels with variable silt content were encountered in the test hole. These were interspersed with other strata of tight silt. Small water seeps were observed at a depth of 6 feet and major seepsAt a depth of 9 feet. A week after the test hole was dug a stabilized groundwater level of 8.0 feet was observed in the monitor tube that we put into the test pit before backfilling. Because this spring's breakup has been particularly mild, a shallower seasonal high water table could be observed in other years. I conducted a percolation test in the uppermost stratum of clean sandy gravel, at which location I measured the percolation rate to be one minute per inch. This translates into a soil application rate of 1.2 gpd/sq. ft., so for a 4 -bedroom residence (600 gpd) the required absorption area would be 500 square feet. Due to the shallow groundwater table, the only feasible conventional soil absorption system would be a 5 -foot wide drainfield. Thus, the necessary length would be 100 feet, which could be accomplished by two 50 -foot drainfields as illustrated on the site plan. The bottoms of the drainfields will have to be very shallow (approximately 1.5 feet below ground level), so it is not clear whether this system can be constructed without using a lift station. Because 5 -foot wide drainfields are designed to absorb downwards through their bottoms, they have a greater propensity for premature failure than trench type systems. Although it is not required by Municipal code, I usually recommend the placement of 12 inches of coarse washed filter sand under the sewer gravel in this type of system. I believe this sand should facilitate the absorption of septic tank effluent into the native soil and thus enhance the longevity of the system. The depth to groundwater appears to be a couple of feet greater in the test hole dug by Tobben Spurkland a couple of years ago. This should allow the construction of a trench type system at that site, although it will definitely also require the installation of a lift station. Assuming the soils between 1 and 5 feet deep in that test hole also perc at a rate of less than 5 minutes per inch, a 63 -foot long trench with 4 feet of effective sewer gravel would be appropriate for a 4 -bedroom residence. On the site plan I have also shown how this could be configured. Please feel free to give me a call if you wish to discuss any of this, and I would be happy to review any final design plans you come up with a no additional cost. I will enclose an invoice reflecting my standard engineering fee for this phase of the work which I have now completed. Sincerely, Ted Moore, P.E. ------------------ LITTLE CAMPBELL CREEK , LOT 6, BLOCK 1 WOODBOURNE SID 2 PARALLEL 50 -FOOT LONG x S -FOOT WIDE DRAINFIELDS 1250 -GALLON SEPTIC TANK 50' T.H. #1 -- - - - -- REPLACEMENT DRAINFIELDS- _ _ _ - ,r LOT 7` PI BLOCK 1 W (VACANT) WOODBOURNE DRIVE LOT 3 BLOCK 2 (VACANT) - 1500 -GALLON STEP TANK fe.`a.2�V••MH.•�. aft �. a ; 49TH THEODORE F. A60ORE CE - 3589 LOT 4 BLOCK 2 , R 100' LOT 5 BLOCK 1 i 63 -FOOT LONG SOIL ABS. TRENCH w. 4.0' EFF. GRAVEL 'ROP. -BDRM IOUSE 63' r -. B9' TTnTKHOLE REPLACEMENT TRENCH )SED SITE R 100' LOT 4 BLOCK 2 , R 100' LOT 5 BLOCK 1 i FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 TEST HOLE # 1 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: Lot 6, Block 1 Woodbourne S/D DATE PERFORMED: May 21 2003 PERFORMED FOR: Todd Retard DEPTH SLOPE (feet) PL 1 SM Reddish sandy loam 2 GP Clean brown sandy gravel 3 Hard digging 6 7 8 17 18 GM Gray silty gravel Dense, hard digging ML Gray sift Small water seep in gravel lens GM Sandy silty gravel Dense -Major water seeps •N••••••••••.: THEODORE F. 1lOORE CE -3589 .�` r. 4 SITE PLAN ML Gray gravelly silt Depth to Groundwater Date Dense ma 1 sees 8.0' 5/21/03 0% Ma'or sees 9.0' 521103 LO E + B.H. Water 0 8.0' 529/03 Date Reading Clock Time Net Time (minutes) Percometer Reading Net Drop (Inches) 521 12" Presoak 27318 12" Resoak 273/4 Start #1 12:41:25 12:46:25 5 18 53/8 3318 #2 12:51:50 5 18 53/8 Add water 33/8 #3 20 UPERCOLATION RATE 1 (minuleafinch) PERC HOLE DIAMETER fi" TEST RUN BETWEEN 25 FT AND 3.0 FT COMMENTS: SDurkland test hole monitor tube had water 0 10' - 2" below ground level on 529/03 PERFORMED BY FLATTOP TECHNICAL SERVICES. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Lot 02 Lot 02 4' Create PDF file from pages ® to r28 PwIn M0. •y' elan• _ h7e A a MunloIpeMy of Anchonropp0 DEPARTYENYO0HEALTHANDHUNAN99VICO ENYIRONNENTAL sERVIC54 DIVIe1ON P.O. sox 178860 Anohoro7a,AiY9kaee61Pa8dtt T#bphel»:146.4744 On4q% Wastewater Disposal system end/or Well InapecDon Report LOT 2 i - - -1-- .. Lf,'RLE11•d01 Zy 6 TIES M tl 11I ei1R'N�i�ila � E I kwon 1Y1>CI I ;V�YMIIM.•R rw 1 �Awnw. w>n fJiM lri Page ®of 28 Powered by LaserFiche WebLink v5.01: Registered to City of Anchorage of 28 Page 1 of 1 http://0nsite.ci.anchorage.ak.us/scripts/LFWebLink.exelweblinkldefault2.htm?doc=37488... 6/11/2003 Lot 05 L'f NunldpalMyy of Ancharspa Pe1a Z of 4 bEPARTNENT HPJtHANDHUNANSGRV=5 EMRONNENTALSERVICU D"ION PAL SOK 998650-Axp6OMS16 AN 893IM50.34341" ' �.GIteW99t9tiva[a�016pDaa15Yst9morNfaAMI9pBCttortRaport P9rmlt Number SWON236 PID No. 015451-11 Page 2 of 2 t :9 :..PLAN . • _ • .. .acne 1• ■e6• �.' �. Wage FL -777 of 10 Powered by LaserFiche WebLink v5.01: Registered to City of Anchorage http://onsite.ci.anchorage.ak.ustscriptsILF W ebLink.exelweblinkldefault2.htm?doc=56273... 6/11/2003 EMIP Lim 1i=FrEMKSM 12M I..tmkam ErMSTWAi [ m IMMEIEME t :9 :..PLAN . • _ • .. .acne 1• ■e6• �.' �. Wage FL -777 of 10 Powered by LaserFiche WebLink v5.01: Registered to City of Anchorage http://onsite.ci.anchorage.ak.ustscriptsILF W ebLink.exelweblinkldefault2.htm?doc=56273... 6/11/2003 ' Lot 04 PramitMe. -191 g3pf" P.yo E a, d Municipality of Anchorage DEPARTMENT Of HEALTH AND.,HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.D. Box 198330 a AnohoMoe, Alaska 08318.6030 • Telephone. 348-47" on -Site Wastewater Disposal System andtar Wall Inspection Repart �i. JDYYerlpSlarx 49u, erZ—l� 1AJAC V%We 61E'- --- AIDNa,• 41'�3tlla r. .... _ ..�_(_ _ .`..T-.,.._0...1..__1. .�. tet...... i.. l....,_.. ... .. t Powered by LaserFiche WebLink v5.01: Registered to City of Anchorage Page 2 of 2 http://onsite.ci.anchorage.ak.uslscriptsILF WebLink.exelweblinkldefault2.htm?doc=37489... 6/11/2003 Powered by LaserFiche WebLink v5.01: Registered to City of Anchorage Page 2 of 2 http://onsite.ci.anchorage.ak.uslscriptsILF WebLink.exelweblinkldefault2.htm?doc=37489... 6/11/2003 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. O t`o 1. GENERALINFORMATION �r -P, u> -D HAA # M ot961� Expiration Date:T�als�s. Complete legal description _ LCT b Location (site address or -directions) 0(oO Current Propertyown6r(e) i�0t+a-to ��"N ��4 Day phone Mailing address. 11�+o Wba o w�-c'G x Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well . 0 Individual Water Storage ❑ Community Class '" Well ❑ Public Water System ° ❑ Day phone- Day hone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to* homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the 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 -Tav n 13t mAluw i 1- Phone U%" 20ql Address 2S Z -5 C S1 Pn�cH- AY- S�ig't; 3 Engineer's Printed Name TOo 0 +fir'r*AfL43 5. DSD SIGNATURE Approved for bedrooms. Q.o`' Disapproved. Conditional approval for 3_ bedrooms, with the following stipulations: The upper six inches of the mound rtdspewatsr disposal system shall consist of too top soil and be vegetated to prevent erosion Money to be placed in PArrnw for the amount of 1.5 times the high bid from a minimum of 3 certified contractors. Money in escrow shall not be released until this office has a van final approyaL e.wor -s all be completed no later than 6/15/2005. Additional Comments ttttt ON-SITE rN TIMIrMANU Attachments: WASTEWATER HAA Checklist X Maintenance AgreeV PROGRAM Septic System Advisory Supplemental Engined Well Flow Advisory Other By: / \a�� 0 . , VMn ut 0 Original Certificate Date: i /a/,�•, _ (Rov. OV02) Municipality of Anchorage • Development Services Department «' !� Building Safety Division S. ,„ On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorageak. us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L -T CO QW� 2 -"DEV V^v'"JE Parcel ID: OZ'S 3S tt'Z A. WELL DATA Well type wdw, If A, B, or C provide PWSID # _ Well Log (YIN) Date completed to( "1(0-3 Sanitary seal (YIN) �A Wires properly protected (YIN) Total depth t K ft. Cased to 1(a ft. Casing height (above ground) Zy" in. FROM WELL LOG AT INSPECTION kw,k Date of test Static water level y"+- ft• ft' Well production S 9.p.m: og.p.m. WATER SAMPLE RESULTS: Coliform �V colonies/100 mi. Nitrateo•t3 mg./1. Other bacteriacolonies/100 mi. Arsenic: 4 NnW L Mg./I. Date of sample: t i ra Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Fig`+ Date installed Iol l`1 (°3 Tank size 2g� - gal. Number of Compartments `1 Cleanouts (YIN) ti Foundation cleanout (YIN) �J_ Depression over tank (YIN) l� High water alarm (YIN) `1 G_ Date of pumping z ! :A1 Pumper 1v1, C. ABSORPTION FIELD DATA nstalled tO r ftZlbdrm) Date i 20 Soil rating t_Z System type Length 20 ft. Width ft. Gravel below pipe ° ft. Total.depth e 3 ft. fff. absorption area 2 ftp Monitoring tube "A Depression over field N Date of adequacy test '4t5 . Results (Pass/Fail) P Fora bedrooms Fluid depth in absorption field before test © in. Water added— gal. New depth 'b in. Elapsed Time: jmin, Final fluid depth O in. Absorption rate >_ 0C) 9 P•d Any rejuvenation treatment (past 12 mo.) (YIN & type) E, c N( V If yes, give date Date installed to 1 tK 1 03 Size in gallons tow "Pump on" level at`L5 in. Pump off' level at I -L in. Datum Wra-A 0 V*v"— Cycles tested y E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot tom* Absorption field on lot ko o t Public sewer main N JA Sewer /septic service line tau+ Manhole/Access (Y/N) Y High water alarm level at `(S Meets alarm & circuit requirements? y On adjacent lots toot On adjacent lots 100I.- Public oo r Public sewer manhole/cleanout v Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation �' Property line Cnto' Absorption field i Water main V h Water service line S3 Surface water too. Wells on adjacent lots iWr SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line `1� Building foundation Water main N 4 �5 s Water Service line (01-4 Surface water toot Driveway, parking/vehicle storage Curtain drain N Or Wells on adjacent lots (001 - F. COMMENTS G. ENGINEER'S CERTIFICATION�� �C A. I certify that 1 have determined through field inspections and } review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name �pO° l3erytin r� bs It Date tt(TLlst HAA Fee $ 57 j0/ ,// _ Date of Payment l 2.2 0`f' Receipt Number 0607 (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number Todd Bethard Attn: Mr. Todd Bethard 11760 Woodbourne Dr Anchorage, AK 99516 907-868-5083 Fax: 907-6442022 Client Sample ID: 11760 Wood Bourne Client Project: MOA Water Advisory Location: Sample Matrix: Drinking Water COC #: PWS#: Comments: Analytica International, Inc. 5761 Silverado Way, Unit N Anchorage, AK 99518 Phone: 907-258-2155 Fax: 907-258-6634 Report Date: 11/19/2004 Receipt Date: 11/12/2004 Sample Date: 11/12/2004 Sample Time: 3:00:OOPM Collected By: MCL Method Flag Definitions: MRL = Method Reporting Limit MCL = Maximum Contaminant Limit B = Present also in Method Blank H = Exceeds Regulatory Limit M = MatrixInterference J= Estimated Value D = Lost to Dilution *• = RL higher than MCL; target not detected Sample Comment: Lab#: A0411143-OIA Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 0-NO3E/4500-NO3E (Aqueous) - Nitrate + Nitrite Test was conducted by: Analytica - Anchorage Nitrate asN 0.130 mg/L 0.10 10 4500-NO3E 11/17/200411/17/2004 AJ Lab#: A0411143-OIB Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst Arsenic Well Water I Test was conducted by: Analytica - Nairbanks <MRL ug/L 2.5 SO 11/18/200411/19/2004 NA Reported by: Amber Hammontree, Laboratory Project Manager Page 1 of 2 DRINKING WATER ANALYSIS REPORT FOR COLIFORM BACTERIA Todd Bethard Date Received: 11/12/04 Time Received: 15:45 Date Analyzed: 11/12/04 Time Analyzed: 16:00 11760 Woodbourne Date Reported: 11/19/04 Time Reported: 16:00 Anchorage, AK 99516 Comments Phone Number: S = Satisfactory Fax Number: U = Unsatisfactory POS = Positive Test Result Collected by: TB NO = None Detected Sample Type: Routine TNTC = Too Numerous To Count (>200 Colonies) CG = Confluent Growth Method of Analysis: Membrane Filtration (SM 9222 B) HSM = Heavy Sediment Masking, Results May Not Be Reliable TLIT = Sample Age >30 Hours, Too Long In Transit R = Resample Required Comments: NT = No Test * # Colonies/100 ml "' # Colonies/ml Sample Sample Total* E. Coli* Other' HPC* Date Time Coliform Bacteria Result Lab# Location Comments 11/12/04 15:00 ND NT ND NT AX7472 11760 Woodboume satisfactory Amber Hammontree, Project Manager 11119104 Ana"ca International, Inc Anchorage, AK o o o —n �pn`• mRb0 mm�p Ib ap' m °ninonpPp�yRg m [l7 m np mPom p m n o pi vmpytf��. �c d� no pm rtrt�'{^yngp� cF g/�, Ci �m p0.PP PP'"min& OP�CyW <7 ^ Avf; dm -Mme• �qm �►�•( O or Orr a w e,,°.+ Gb»mmpm Ne� y Sb a m o a°a bsm° `a rrz ae.n oma H un Pmn! btipP men' on 6' P amo��a a e O .00 ap Sm m C p e• :s R 7 q m "Fr mm e,a p. m ° a m o ° n^Oa ma mop tii�'°i '°Q�m°'°rytPD n °_m ° pP m 0. Cm^ R mein p. tv n 0 Gp nip y P.°q ..]G n.m t7y ,N6 rn mP yPo�re e` xP &:Cao `+°tr em.m C mb O P O gr a p° P p m C w p q p F m ^ m a o m m� o CJ O II 4W bet ' • 9�e64 5 aa', s � a p •:0 , co Iw'• 1 N• m: '�� WOJ am or 11 tz U770 0 N� 026442 i / i cn 14,