HomeMy WebLinkAboutPOLLOCK HOMESTEAD BLK B LT 11Pollock
Homestead
Block B
Lot I I
#017-112-37
Municipality of Anchorage
• •. Development Services Department
Building Safety Division
i' Onsite Water & Wastewater Program, 4700 South Bragaw St. "T
t
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number. SWO30484 PID Number. 017-112-37
Name:
RYAN MATHIAS
Wastewater System: ■New ❑Upgrade
Address:
13120 LUPINE ROAD a ANCHORAGE, AK 99516
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 240-8430 4
O Deep Trench ■ Shallow Trench 0 Bed O Mound 000wr
LEGAL DESCRIPTION
s' "°ti4.0
TOW °'°" s
wo/se. rt
DWG.) rc
Block: Lot Subdivision:
B 11 POLLOCK HOMESTEAD
DWh to pipe kdtum fern or" q,edw
SEE DWG.
o,"W depth ke,wdh pip.
0.7
n rt
Township: Range: Section:
ns edd.d oems ergww grew:
Gvw wv :
_ — —
SEE DWG. rt
30 rt
WELL: ■ New ❑ Upgrade
Growl width:
5
Nunar of enc
1
Olelu.e eetween Ow.
—
pt
n
o w watbn prlwle. "C):
T.ld Depth:
Cowl 0 .drock
Told abarpaon arc
r+p. malerlat
PRIVATE
491 a
40 n
150 sa, rt
SCH40 PVC/D 3034/ F-810
asr:
ALPINE DRILLING
Dow "-d:
6/9420041
slaw wow kwwk
30
kwl n
G.E.G. Ltd./•••A+ HOMESERVICES
Dote kwee.d:
1/5-7/2004
n
YwS
pwrip Set AC
co.wg NdaM ADew rNound:
.5 cell
UNKNOWN rt
2 n
TANK
SEPARATION
DISTANCES
13Septic 0Holding ■S.T.E.P. ■Others
To
From
Septic
Tank
Abso Wn
n.%
Lin
Station
Holding
Tank
/PrNule
sew« Lin..
MOiM1l°al"•"
ANCHORAGE TANK
C P..4' in gouma:
1500
Well
100'+
1000+
100'+
—
25'+
STEEL
S o/ oampa w: 2
Surface Water••IDo'+
••too'+ ••too'+
—
—
LIFT STATION
Lal Una
5'+
10'+
5'+
—
—
s:. a eaeww:
1500/76
Monufaeb ..
ANCHORAGE TANK
Foundation
5'+
10'+
5'+
—
—
llnp M Wwl al:
iww 9L
Nish waw alum at
TIMER 13.5
I TIMER 13.5'
46" 24"
Curtain Drain
50'+
50'+
50'+
—
—
" rak" a Nadw:
ei`bkal wD"� pw%n,.d kr:
/20 OSI 05 HHF
M.O.A.
Remarks:
BENCH MARK
uWaaon end 0wanpu
TOP OF PUMP VAULT MANHOLE
*THIS IS AN ADVANTEX TREATMENT SYSTEM
**CURTAIN DRAIN OUTFALLS TO DRAINAGE DITCH
Nw wd ewe wn
1 q2.54
R
ALONG ROAD FILLED w/ DRAINROCK TO COVER SURFACE WATER.
cNciNcems aEAt
aoo60C
0 Qr,.
'....::.*.
*••A+ REPLACED ORENCO FIBERGLASS TANK W/ STEEL TANK IN THE WEEK OF 8/15-20/2004
Inspections G.E.G. LtD.
performed by: Dates: 1st 1/5/2004
. ..... ..
0
2nd 1/5/2004
D
3rd 1/7/2004
0 y fess.
X0*a
Development Services Department Approval
°•. E 7953 .. F`�p�
�d4p°a
Reviewed and approved by: Date: 2 -fl
ptw. 12/01)
P
��400000��
PERMITNUMBER: AS DRAWING PARCEL NUMBER:
SWO
SW030484 017-11 12-37
DRAINAGE DRCH
I / FlLLED w/ DRAINROCK
TH a I
NEW DRAINFIELC
NEW 1500 GALLON
ADVANTEK TANK
r
L
J NEW r
4 BEDROOM I
HOUSE
TH/z�
pqp
RABBIT CREEK—ROAD
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS t GENERAL CONTRACTORS
3701 F TLA ROAD. SUITE 101 • AWHORAGF. AK 09501 • PHONE (901)3111170 • FAX (007)518-5746
PREPARED FOR: PHONE NUMBER:
RYAN MATHIAS (907) 240-8430
LEGAL DESCRIPTION:
POLLOCK HOMESTEAD; LOT 11, BLOCK B
TYPE OF WORK:
AS -BUILT DRAWING OF NEW SEPTIC SYSTEM
C.J.G.
.E:
1" = 30•
E NUMBER:
2OF3
A
B
I
I
I
\
\
\
STI 35.50
45.28
MH1 40.65
51.71
MH2 44.50
56.73
MT1 33.60
68.15
MT2 42.84
92.69
RABBIT CREEK—ROAD
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS t GENERAL CONTRACTORS
3701 F TLA ROAD. SUITE 101 • AWHORAGF. AK 09501 • PHONE (901)3111170 • FAX (007)518-5746
PREPARED FOR: PHONE NUMBER:
RYAN MATHIAS (907) 240-8430
LEGAL DESCRIPTION:
POLLOCK HOMESTEAD; LOT 11, BLOCK B
TYPE OF WORK:
AS -BUILT DRAWING OF NEW SEPTIC SYSTEM
C.J.G.
.E:
1" = 30•
E NUMBER:
2OF3
PERMITNUMBER: AS -BUILT DRAWING PARCEL NUMBER:
SWO
SW030484 017-112-37
FINAL GRADE - TOP OF MANHOLE
0901-107 IR, 102.54 (AVG.)
TOP OF TANK94.53 \ 11
I I LL ■ I I ly I I /_TOP OF TAN
- 94.49 K
� �� ..RR11{l G44 1
ORIGINAL GRADE
O HIGHEST POINT
102.05
FINAL GRADE -
106.62 (AVG)
INSTALLED
BRACING AND
STAKING —
FABRIC
INVERT OF PIPE - 104.15 (AVG.) THE
TOP OF SANDRj'
DISTRIBUTION UNE IS 125 INCH PVC
INVERT OF PIPE
�
93.74
STEEL E
BOTTOM OF
TANK
TRENCH - 101.057
BOTTOM OF PUMP ' ,�'•
VAULT - 94.54 ORENCO PUMP
VAULT
BOTTOM OF
BOTTOM OF
TANK - 89.88
TANK - 89.61
ORIGINAL GRADE
O HIGHEST POINT
102.05
FINAL GRADE -
106.62 (AVG)
INSTALLED
BRACING AND
STAKING —
FABRIC
8/20/20(
e.11_% '.� DRAWN BY:
_ _.. __. - SCALE; E.W/C.,
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS 6 GENERAL CONTRACTORS 1
'j
3701 E T1AOR ROAD. SATE 101 • ANCHORAGE AR 00501 MO1F (007)3]1-01)0 • FM (001)5384246 N. •'S
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
RYAN MATHIAS (907) 240-8430 3 OF 3
LEGAL DESCRIPTION:
POLLOCK HOMESTEAD; LOT 11. BLOCK B
TYPE OF WORK:
PROFILE AS -BUILT DRAWING OF NEW SEPTIC SYSTEM
4";w5cms:�eev
• 0
INVERT OF PIPE - 104.15 (AVG.) THE
TOP OF SANDRj'
DISTRIBUTION UNE IS 125 INCH PVC
103.55 (AVG.):,/WITH
3 INCH HODS SPACED 10 INCHES
ON CENTER (30 HODS TOTAL)
BOTTOM OF
RELATIVE ELEVATION OF
TRENCH - 101.057
GROUNDWATER 98.80
RELATIVE ELEVATION OF BOTTOM
OF TEST HOLE - 94.05 —0
8/20/20(
e.11_% '.� DRAWN BY:
_ _.. __. - SCALE; E.W/C.,
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS 6 GENERAL CONTRACTORS 1
'j
3701 E T1AOR ROAD. SATE 101 • ANCHORAGE AR 00501 MO1F (007)3]1-01)0 • FM (001)5384246 N. •'S
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
RYAN MATHIAS (907) 240-8430 3 OF 3
LEGAL DESCRIPTION:
POLLOCK HOMESTEAD; LOT 11. BLOCK B
TYPE OF WORK:
PROFILE AS -BUILT DRAWING OF NEW SEPTIC SYSTEM
4";w5cms:�eev
• 0
. ,.
RightFax
1/19/2004 7:06 PAGE 1/1 RightFax
Inspection Report
Municipality of Anchorage, Building Safety Division
4700 South Bragaw
INSPECTION: VOICE 343.6300 INSPECTION:FAX (907)249.7777 INFO: 343.7962
Name
Address
Legal
Subdivision
Comments or Directions
Dave
15340 POLLOCK DR
BKBLT11
POLLOCK HOMESTEAD
Permit 04-7075
Phone 727-0972
622-6777
Inspection Date 1/19/2004 PM
Inspection Ratro Electrical Rsinspsction N
\0 NO NONCOMPLIANCE OBSERVED
❑ CORRECTIONS ESSENTIAL AS EXPLAINED BELOW
❑ WILL RE-EXAMINE AT NEXT ❑ LSO NOT CONCEAL UNTIL REINSPECTION
INSPECTION
COMMENTS: (for inspector use only)
i L(c
Inspector �' � � � .Data• / �— ` OL/
Municipality of Anchorage
Department of Health and Human Services
825 OV Street
P.O. Box 196650 Anchorage, Alaska 995IM5o
Rick Mystrom httpl/www.d.arichorage.ak.us
Mayor
Permit Number. #SW 030484 Date of Issue:11 19-03 Parcel Identification Number. 017-112-37
Date Started: 6-9-04 Date Completed: 9-10-04 Is well located at approved permit location? ® Yes ❑ No
Legal Description: Pollock Homestead Block B Lot 11
Property Owner Name &Address: Ryan Mathias
13120 Lupine Road
Anchorage. Alaska 99516
Borehole Data:
Soil Type, Thickness do Water Strata
Stick up
-gravelly silt -
Bedrock
Depth (ft) Method of Drilling ® air rotary ❑ cable tool
From To
Casing type: steel
0 2 Wall Thickness: ,250 inches
2 36 --Diameter: B inches Dcpth�40 feet _
36 491 Liner Type:
Diameter: inches Depth: feet
Casing stickup above ground:,? feet
Static water level (from ground level): 30 feet
Pumping level: 491 feet after
2-4 hours pumping 5 gpm
Recovery Rate: 5 gpm
Method of Testing: Atlift
Weil Intake Opening Type:
❑ Open End ❑ Open Hole
❑ Screened Start feet Stopped feet
❑ Perforations Start feet Stopped feet
Grout Type: hLnjonjje.L8 Volume:
Depth: Start 0 feet Stopped 10+ feet
Pump: Intake Depth feet
PUMD size hp Brand Natne
Well Disinfected Upon Completion? ® Yes ❑ No
Method of Disinfection: chlorine table1S
Comments:
Well Driller. Alpine Drilling B Enterprises
PO Box 110496
Anchorage Alaska 99511
Attention: The well driller shall provide a well log to thero Owner ` J= •, - �.... LL . T. p
petty within 30 days of completion and the property
1 G16q-
MUNICIPALITYOFANCHORAGE
Development Services Department 1 V
On -Site Water d Wastewater Program ^ m
4700 South Bragaw Street t1✓
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904 l _
ON-SITE WASTEWATER DISPOSAL SYSTEM ) WATER SUPPLY PERMIT
Initial
Date Issued: Nov 19, 2003
Permit Number: SW030484
Expiration Date: Nov 18, 2004
Parcel ID: 017-112-37
Legal Description; Pollock Homestead Block B Lot I I I
Design Engineer: 0041 AK Water & Wastewater Consultant Site Address: Unknown
Owner Name: Ryan Mathias Lot Size: 20312 SO. FT.
Owner Address: 13120 Lupine Road Total Bedrooms: 4 Permit Bedrooms: 4
Anchorage . AK 99516 -
This permit is for the construction of.
❑,/ Disposal Field [?] Septic Tank E] Holding Tank [3 Privy Q✓ Private Well E] 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:
Date: i' �%
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 SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. �,1' Z 1 Permit Number Sw0YQ 8'¢
Property owners) RYAN MATHIAS Day phone 240-8430
Mailing address (1) 13120 LUPINE ROAD • ANCHORAGE. AK
Mailing address (2)
Zip Code 99516
Legal description (Lot, Block & Sub'd.) LOT 11, BLOCK B: POLLOCK HOMESTEAD SBDIVISION
Legal description (Section, Township & Range) N/A
Lot Size 10 1 14 Z Acre Sq.Ft
THIS APPLICATION IS FOR:
Number of Bedrooms 4
Sewer Only ❑ Well Only ❑
Sewer and Well 0 Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal codes.
ALASKA WATER & WASTEWATER CONSULTANTS, INC.
Permit Fees: t <; (�—O Waiver Fees*
Date of Payment 1 � L /Date of Payment
u1111 i
Receipt Number. I `1�'_ Receipt Number.,
ALASKA WATER F& WASTEWATER
CONSULTANTS, INC.
November 10, 2003
Municipality of Anchorage
Development Service Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
Ref: Proposed Well and Septic System for Lot 11, Block B; Pollock Homestead Subdivision
ADVANTEXT"t TREATMENT SYSTEM
To whom it may concern:
1. GENERAL: The proposed 4 bedroom home will be served by a private well and septic
system. Three test holes were excavated on the property. We are proposing to design the septic
system around the 30 foot radii of test hole #1 & #3. Due to the limited amount of receiving soils
and high groundwater we are proposing to use an Advantex treatment system with a pump vault
and a pressurized 5 -wide trench type drainfield. The well is to be located in the area shown on
the site plan and design drawing.
2. SOILS: See the attached log, which shows the soil classifications, groundwater monitoring,
and the percolation test results.
3. DRAINFIELD APPLICATION RATE: The intent is to install an Advantex Treatment
System that will allow the use of a small drainfield in the area around the 30 foot radii of the test
holes. The Advantex system has received class III approval and we are going to assume an
application rate of 4.0 GPD/FT2.
4. PRESSURIZED 5 -WIDE DESIGN:
a. Percolation Rate: <1 & 6.7 minutes/inch
b. Proposed Application Rate: 4.0 gallons/day/tie
e. Number of Bedrooms: 4
d. Design Flow: 600 gallons per day
e. Minimum Absorption Area: 150 fl2
f. Total Depth: 1.0 feet (max. limited to the removal of organics)
g. M.O.A. Approved Sand Filter Depth: 2.5+ feet
h. Effective Depth: 0.5 feet
i. Width: 5 feet
j. Minimum Length: 30 feet long
k. Effective absorption area: 150 ft2
3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507
Ph: (907)337-6179' Fax: (907)338-3246 0 Websitc: akwwc.com
5.ORENCO PACKAGE SYSTEM: The STEP tank with the Advantex Treatment System will
be manufactured by Anchorage Tank &: Welding to meet the latest design criteria established by
Orenco Systems, Inc. The point of contact at Anchorage Tank is Lowell McNutt. As with their
standard STEP tank, it is equipped with a high water alarm per M.O.A requirements.
6. SURFACE NVATER: There are no surface water within 100+ feet of the proposed septic
system.
7. TOPOGRAPHY: As can be seen on the attached topography site plan the area around the
proposed drainfield is relatively flat. In short, there are no slope concerns.
8. CLOSING: I am open to any suggestions from your department that would be an
improvement to the proposed system. I am unaware of any negative impacts that this installation
would impose on adjacent wells, or septic systems. If you have any questions, please call us at
337-6179. I n
P.E.1 M.S.
NOTE: Attached is a site plan drawing, a design drawing, an Advantex detail, a trench detail,
three soil logs, and a 7 page construction specification letter which are all part of the design
package for this septic system.
3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507
Ph: (907)337-6179' Fax: (907)338-3246' Websitc: akwwc.com
I
LOT 6, BLOCK B �
/ I\\PpLLOCK HOMESTEAD S/D 1
I / I
// • 1 1
�F''— LOT -9. BLOCK B 1
/ POLLOCK HOM STEAD I
� `-SEPTIC\ I
j 1 I LOT 4, BLOCK A'' JJ �+
LOT 3, BLOCK A I I� POLLOCK HOMESIF��I ���` ��\\ I y1pLDINO
POLLOCK HOMESTEAD i I I �\`_--- • �\ \j PROPOSED AN
lc�PTIC 4 BEDROOM
/A,R� 1 / i I ,nn• wF11 aATnlsJl HOUSE
I \ WW ALTERNATE SPIE
ice, 1 I�EPTIC i \\ I
ARS 1 \ �� \ n+J3 i� LOT 3, BLOCK 2 �\
LOT 2, BLOCK A I / \\ FYI ' �� PoLLOCK HOMESTEAD \
POLLOCK HOMESTEAD I L04 S, BLOCK A
PoLLOCK HOMESTEAD
y ABANDONED
TH/WI �THJp I WELL
TMJ PROPOSED SEPTIC SYSTEM
I \\ I TMJ --__ (SEE DESIGN PACE 2 OF 4)
I \� • i - -'E--
EXISTIG
LOT 1, BLOCK A I ��-� bG `� CLASS NC-
POLLOCK HOMESTEAD I I LOT 6, BLOCK A WELL
i I POLLOCK
HOMESTEAD '
12 I ALTERNATE SITE
I `�VACANT�
I I►�PIl 1 \ /
ws�4�- PROPOSED
_�'- / �� 4 BEDROOM
HOUSE
RABBIT CREEK ROAD__ `"
-------- �
PROPOSED WELL
LOT 1A, BLOCK 1
POLLOCK HOMESTEAD
LOT 18, BLOCK 1
POLLOCK HOMESTEAD
LOT 2. BLOCK 1
POLLOCK HOMESTEAD
11/10/2003 •_. OF
�• i t/ �. _ DRAWN BY: ��>�� •� +)��il
ALASKA NVATKR & «'ASTBNVATKRJ.L.M. :`c., '4 S7*'
CONSULTANTS, INC. 5
..... ..... ... ......
H F TUDOR ROAD. SIIITF 101 • AWAGF. AR 99507 • FNONF (907)331-6179 • FAX (9W153A•3746 1 — loo,
i
.PARED FOR PHONE NUMBER: PAGE NUMBER:
RYAN MATHIAS 240-8430 1 OF 4 i• If me s.
AL DESCRIPTION: ++��r D • 79553
LOTS 10 AND 11, BLOCK B; POLLOCK HOMESTEAD SUBDIVISION +;4,1
'E OF WORK:1+)+;is�..�o TQ99i0n-�'�+
SITE PLAN FOR PROPOSED WELL AND SEPTIC SYSTEM LOCATION
PROPOSED GRAINFIELD. EXCAVATE A TRENCH
THAT IS 1 FEET DEEP MAXIMUM BY 5 FEET
WIDE BY 30 FEET LONG. REMOVE ALL
ORGANICS THEN ADD 2.5♦ FEET OF M.OA
APPROVED SAND FILTER AND THEN ADD 0.5
FEET OF CLEAN, WASHED SEWER DRAINROCK.
THE OISTRIBUTIOIN LINE IS TO BE 1.25 INCH
PVC PIPE WITH 1/4 INCH HOLES DRILLED
EVERY 10 INCHES ON CENTER, 30 HOLES
TOTAL (SEE DETAIL DRAWING, PACE 4 OF 4) /
THl3
PROPOSED 1500
(SEGALLON ADVANTEX /SYSTEM.t/\——t
ED AI DRAWIING+rtPAGE 3 OF 4.) r——oral
MNJL------J II
-STALL �J
FOUNDATION T(!1t, rl
I
RABBIT CREEK ROA
PROPOSED
4 BEDROOM
HOUSE
TH/2'I'{�
AND EAST LOT LINES FLAGGED BY A REGISTEF
LAND SURVEYOR PRIOR TO CONSTRUCTION.
/ 11/10/20
DRAWN BY:
ALASKA WATER & WASTE RTATER J.L.M.
CONSULTANTS, INC. I SCALE:
1" = 307
3701 F. TLOOR ROAD. SIIITF IOi • ANGNORAGF. Ac 00507 • PHONF (007)337--70 • FAX (007)33A-3746
PREPARED FOR: PHONE NUMBER: PACE NUMBER:
RYAN MATHIAS (907) 240-8430 2 OF 4
LEGAL DESCRIPTION:
POLLOCK HOMESTEAD SUBDIVISION; LOT 11. BLOCK B
TYPE OF WORK:
DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM
i'�
SITE
1/C�-7Q-93 k)
NOTE: JIM CROSS,
P.E. HAS THE
AwANra MANUAL
AdvanTe)( Treatment System
AX20 -Mode 1a
_ _ _ _ 40x94Pod =�
41016
a1i
•
�1
UFT
NOTE: THE BOARD INSULATION TO BE
INSTALLED OVER THE SEPTIC TANK & 4•
BEYOND ON ALL SIDES EXCEPT UNDER
THE ADVANTEX FILTER. THIS WILL ALLOW
FOR HEAT TO ESCAPE FROM TANK k
RISE TO THE FILTER ABOVE IT.
6• dM CAP
FINAL GRADE (TYP-2)
6' Pvc i
6• PVC
CLUED
INWAAAKC
mmm
TO PROPOSED DRAINFIELD
b NCH
IIIS"TED
1WMBeSE
INLET_�j
4�
!
ORENCO
-----------------
---
BIOTUBE
PTIONA
I
SCREENED
VAULT
SLIDE SECTION
OF 6• PIPE
OVER THIS CONNECTION ..
PROWDE 4 BEDROOM
SHEER PRROOTECTION-
EXTEND TO FIBERGLASS TANK : j
E�FFElL1EONT
PUMP
ORRICE EXCAVATION
�I II
i
-
DATE:
11/10/2003
DRAWN BY:
-- -- ,
ALASKA NATER & WASTEWATER
J.L.M.
SCALE:
N.T.S.
CONSULTANTS, INC.
5701 E )UDM ROAD. SIPTE 10- • ANCNMAOF. AK 00507 • PMNF (901)137-61M •FAX (00))318-3)46
p 4 .. . .............
�-' •' •
TM
Q
PREPARED FOR: PHONE NUMBER:
PAGE NUMBER:
RYAN MATHIAS (907) 240-8430
3 OF 4
Q P .,. If y
mess
LEGAL DESCRIPTION:
Q�O J CE -7953
POLLOCK HOMESTEAD SUBDIVISION; LOT 11, BLOCK B
N�ro feeelooc�o
TYPE OF WORK:
DETAIL DRAWING OF ADVANTEX TREATMENT UNIT
O000
30 FEET LONG-�
r------------- -----------------------�1
I MT O I'
SIJ
S FEET
WIDE
L OMT_ _- --
I
-------------rr =— J
-jj-
INSTALL VISOUEEN
BARRIER AROUND
PERIMETER OF TREN(
INSTALL BRACING AND
STAKING AS NEEDED -
ORIGINAL
V DEEP MAXIMUM
(REMOVE ALL ORGANICS)
FROM PUMP VAULT
-THE DISTRIBUTION LINE IS TO BE 1.25 INCH SCH
40 PVC WITH 1/4 INCH HOLES FACING DOWN
EVERY 10 INCHES ON CENTER (30 HOLES TOTAL).
AL GRADE
INSULATION
—FILTER FABRIC
2.5+' -FEET `OF A.OA.`" .
,. •APPROVED SAND FILTER'
FEET
FEET OF EFFECTIVE
AS
GRADE
-THE DISTRIBUTION LINE IS TO BE 1.23
INCH SCH. 40 PVC WITH j INCH DIAMETER
HOLES SPACED 10 INCHES ON CENTER.
11/10/2003
DRAWN BY:
ALASKA WATER & WASTLRTATKR SCALE. J.L.M.
CONSULTANTS, INC.
3701 F TI1D0 POAD. SUITE 101 • ANCNORAC.F. Arc 99507 • PNONF (907)357- 179 • FAX (907)33.3746 N.T.S.
IREPARED FOR: PHONE NUMBER: PAGE NUMBER:
RYAN MATHIAS 240-8430 4 OF 4
.EGAL DESCRIPTION:
POLLOCK HOMESTEAD SUBDIVISION; LOT 11. BLOCK B
WE OF WORK:
DETAIL DRAWING OF PRESSURIZED TRENCH
mvF
n
5'-7-
_ o
0
5'-3'
6/21/2002
74'
4/29/2003
-_
_,_ -,..4.......
ALASKA
–
VVA a'�R R SVASTE«'ATKR
2
101 • NIC110R1GC. M 99507 • P1 L- 907W7-6179 • rM: 901 336-3246 • wmsOC M..a
30
3701 L TUDOR
ROAD. SUITE
3
SOIL FO—G— PERCOLATION TEST
000 '.
LEGAL
DESCRIPTION:
POLLOCK HOMESTEAD SUBDIVISION: LOT 11, BLOCK B f1 A. es5.- O
4
RICK RIDS 6/12/2002 �04� '•. C 7953 ;'`1�
PERFORMED
FOR:
DATE:
'
DEPTH
(1ee1)
5
0 °.° • ..... �o°v
44��40efesslo o
–
6'
–
TEST HOLE 1
6
1:42
ORGANICS
1 1 2'
4 1 2'
SOIL CLASSIFICATIONS I
y
z
GM/SM o;°:o> GW = ORG
3
iT1
` L LOT 10, BLOCK 8
: 7Z•c GP ML POLLOOCK HOMESTEAD I i
SM°IU GM CIL of
4-1
GC OL
�'>�"•
•
GP GRAVEL .> o SW MH cYil '
5
..
LENSE , .. SP CH �j'
! SM OH a�
6
SC
GM
7
DEPTH TO DATE i 42 '1
I�
8
B.o.u.
9
SITE PLAN
I 1"-100'
10
DATE READING CLOCK NET TIME WATER LEVEL NET DROP
11
12
13
14
15
16
17
18
PERCOLATION RATE 6.7 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
19
TEST RUN BETWEEN 1.5 FT. AND 2.5 FT.
20
A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO
SOILS
LOGGED
BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: ZACHARIAH CALL
COMMENTS:
'TEST HOLE DRY ON 10/17/2003 AND ON 10/31/2003. 1
A.W.W.C., INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS W SA1 P�� FORMED IN ACCORDANCE
PERFORMED
BY
WITH ALL
STATE
AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: _ H o
GROUNDWATER
5'-7-
s/tz/zooz
5'-3'
6/21/2002
74'
4/29/2003
•66'
5/6/2003
TIME
(MINUTES)
READING
(INCHES)
6/13/2002
1
12:12
–
6�
–
2
12:42
30
1 1 2'
4 1 2'
3
12:42
–
6'
–
4
t:12
30
1 1 2'
4 1 2'
5
1:12
–
6'
–
6
1:42
30
1 1 2'
4 1 2'
ALASKA NVAT.KR & WASTENVATKR
CONSULTANTS, INC.
1 L TWOR ftZ. SUfft 101 • AW.HOPAOL AC 09507 - PHOW-- (907)337-6172• N- (907)3w-32" • W03smek..c.w.n
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: POLLOCK HOMESTEAD SUBDMSION; LOT 11, BLOCK 8 OQ •'.J a Go e55.,
PERFORMED FOR: RICK RIOS DATE: 6/12/2002 OQ� i —79
DEPTHQOQ°Ov Pio 1 e ee;0�edoc
(fee ) ORGANICS TEST HOLE #2 �00000��
1
1
1
1
1
1
1
1
1
DEPTH TO
GROUNDWATER
DATE
DRY
-
9'-3-
6/21/2002
33-
uawi
11'
Nir
I''1'�'II
���//
2
�y
;17YYSi
WIN
WON&,
4 3/4"
DEPTH TO
GROUNDWATER
DATE
DRY
6/12/2002
9'-3-
6/21/2002
33-
4/29/2003
11'
0/31/200
1,1 I
LOT 10, BLOCK 8 �
POLLOCK HOMESTEAD /
TH 3
0 /
1 1
1
1 �
SITE PLAN
1-.100'
DATE READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
6/13/2002 1
12:13
—
6-
—
2
12:43
30
4 3/4"
1 1/4-
3
12:43
—
6-
—
4
1:13
30
5-
1-
5
1:13
—
6-
—
6
1:43
30
5-
1-
19 PERCOLATION RATE 30 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 5.0 FT. AND 6.0 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO
SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: ZACHARIAH GALL
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WA P RFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: u
ALASKA «'ATLR & A'VASTK«'ATKR
CONSULTANTS. INC. 4.;... ,•• .L .��.... ...: O
1JUIL LUU — rLKL:UL.AIIUN ItJIIQ��. G
LEGAL DESCRIPTION: POLLOCK HOMESTEAD SUBDIVISION; LOT 11, BLOCK B. OO •p '.J 6Off1 ss.•
PERFORMED FOR: MATT LEDERHOSS DATE: 4/29/2003 QO 953
DEPTH ____
(feet) === :ORGANICS TEST HOLE 3 4����0000���00
7
8
9
10
11
12
13
14
15
16
17
DEPTH TO
GROUNDWATER
• ° o
SOIL CLASSIFICATIONS
4/29/2003
2
.00°
5.0'
10/17/03
5.0'
0:°°o 0
SP/SW GW ---
ORG
2.5 FT.
�•°°°o
•� °°o°
n .:+s% GP I
ML
3
.:.°e°°
SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: SUSAN
6 — 4
0' 6'
e°o°
1 W GM
CL
•o.°o
•'
TH 3
CERTIFY THAT THIS
4
• 4°
GC
OL
0' 6'
/� /o O
SW
TH/1
—
—
MH
5
'• • t SP
CH
I
• SM
OH
IL
6
SC
7
8
9
10
11
12
13
14
15
16
17
DEPTH TO
GROUNDWATER
DATE
5.0'
4/29/2003
37'
5/6/2003
5.0'
10/17/03
5.0'
10/31/03
DATE
READING CLOCK NET TIME
TIME (MINUTES)
WATER LEVEL NET DROP
READING (INCHES)
4/29/03
1 — —
`
LOT 10, BLOCK B
2 — 4
0' 6'
POLLOCK HOMESTEAD
i
2.5 FT.
4 — 4
0' 6'
A FOUR HOUR PRESOAK WAS PERFORMED:
5 — —
6' —
SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: SUSAN
6 — 4
0' 6'
UI
I,
6' —
8 — 4
TH 3
CERTIFY THAT THIS
9 — —
6' —
0
a,
i
i
0' 6'
/� /o O
TH/1
—
—
1
THT
I
IL
I �
SITE PLAN
1"-100'
DATE
READING CLOCK NET TIME
TIME (MINUTES)
WATER LEVEL NET DROP
READING (INCHES)
4/29/03
1 — —
6' —
6 (INCHES)
2 — 4
0' 6'
3 — —
6' —
2.5 FT.
4 — 4
0' 6'
A FOUR HOUR PRESOAK WAS PERFORMED:
5 — —
6' —
SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: SUSAN
6 — 4
0' 6'
7 — —
6' —
8 — 4
0' 6-
CERTIFY THAT THIS
9 — —
6' —
WITH ALL STATE AND MUNICIPAL
10 — 4
0' 6'
/� /o O
19
I
I
PERCOLATION RATE
<1 (MIN./INCH)
PERC. HOLE DIA.
6 (INCHES)
TEST RUN BETWEEN
1.5 FT. AND
2.5 FT.
20 _fly—JII
A FOUR HOUR PRESOAK WAS PERFORMED:
❑ YES N NO
SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: SUSAN
OSWALT
COMMENTS:
PERFORMED BY AKWWC, INC. 1,
JEFFREY A. GARNESS,
CERTIFY THAT THIS
WAS PE FORMED IN
ACCORDANCE
WITH ALL STATE AND MUNICIPAL
GUIDELINES IN EFFECT
ON THIS DATE:
/� /o O
Municipality of Anchorage .41 4111
On -Site Water & Wastewater Program I se
in-'—�`
;LLQ(907) 343-7904
OEC 6 2013
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 017-112-37 Expiration Date: J `�
1. GENERAL INFORMATION
Complete legal description POLLOCK HOMESTEAD; BLOCK B, LOT 11
Location (site address)
Current Property owner(s)
Mailing address
Real Estate Agent
2. TYPE OF DWELLING:
15340 POLLOCK DRIVE, ANCHORAGE, AK, 99516
JONATHON & MINDI SINCLAIR Day phone
15340 POLLOCK DRIVE, ANCHORAGE, AK, 99516
762-4603
HEATHER DAMASSIOTIS W/ KELLER WILLIAMS Day phone 865-6433
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
E
Individual On-site
0
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ I Waiver Fee $
Date of Payment �� �21�� Date of Payment
Receipt Number 6(..%(o rn Receipt Number
COSA# C�J�1�Ji��J� 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. 1 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 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK, 99507
Engineer's Printed Name
Engineers Comments:
JEFFREY A. GARNESS, P.E.
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADES 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 this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
6. DSD SIGNATURE
System #1 Approved for
System #2 Approved for
Disapproved.
Conditional approval for
bedrooms.
bedrooms.
bedrooms, with the following
337-6179
Date C-ZjN o
® , • iffAm
VCE -795)
i 21J�` .1sT o
Er. ;
Pro f e ssio�000
Y tOF Wo f/,
tic
ON-SITE
WATER AND
WASTEWATER
�.� PROGRAM
Original Certificate Date:
The Munfc6Yty 6r rage Develop, emt Services Division (DSD) issues Certifibates of On -Site Systems Approval (COSA) based only
upon the represenatations 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. ATTCHMENTS:
COSA Checklist
Septic System Advisory
Well Flow Advisory
ra<„ vnsi
Nitrate Advisory
Arsenic Advisory
Other
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: POLLOCK HOMESTEAD; BLOCK B, LOT 11 Parcel ID: 017-112-37
A. WELL DATA *BEDROCK ® 36
Well type PRIVATE If A, B, or C provide PWSID# N/A
Date completed 6/9/2004 Sanitary seal (Y/N) YES
Total depth 491 ft. Cased to *40 ft.
FROM WELL LOG
Date of test 6/9/2004
Static water level 30 ft.
Well Log (Y/N) YES
Wires properly protected (Y/N) YES
Casing height (above ground) 16+ in.
AT INSPECTION
11/22/2013
Well production 0.5 g,p,m, 1.01 g.p,m,
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml. Nitrate /'J(:) mg./L. Collected by: GEG, Ltd.
Arsenic: N Q ug./L. Date of sample: 11/22/2013
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material S.T.E.P./STEEL
Tank size 1500 gal. Number of Compartments 2
Date installed 1/5/2004
Cleanouts (Y/N)
YES
Foundation cleanout (Y/N) YES Depression over tank (YIN) NO High water alarm (Y/N) YES
Date of pumping 5Cc i.n50a,e , Pumper A+ HOME SERVICES
C. ABSORPTION FIELD DATA BELOW EXISTING GRADE
Date installed 1/5/2009 Soil rating .p.d./ or ft/bdrm) 4_0 System type
TRENCH
Length 30 ft. Width 5 ft. Gravel below pipe 0.6 ft.
Total depth *3.2-3.9 ft. Eff. absorption area 150 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test 11/22/2013 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test DRY in. Water added 625 gal. New depth DRY in.
Elapsed Time: min. Final fluid depth DRY in. Absorption rate >= 600+ g,p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date
NOTE: TRENCH WAS INSULATED. 24" SOIL COVER SATISFIED.
D. LIFT STATION
Date installed 1/5/2004
TIMER/
"Pump on" level at 13.5 in.
BOTTOM OF TANK/
Datum BOTTOM OF BASKET
E. SEPARATION DISTANCES
*SEE ATTACHED MAINTENANCE INSPECTION REPORT.
Size in gallons 1500/76 Manhole/Access (Y/N) YES
TIMER/ 46/
"Pump off' level at 13.5 in. High water alarm level at 24 in.
Cycles tested * Meets alarm & circuit requirements? YES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+
Absorption field on lot 100'+
Public sewer main N/A
Sewer /septic service line 25'+
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Holding tank
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain 50'+ Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
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 Printedame JEFFREY A. GARNESS
Date t', -/y %l3
(Rev. 11105)
of
CE-
4z,fk. �3l,
prof
From:ANCH TANK & WELDING INC
05/20/2013 07:42 3686770
277 3715
APLUS
12/03/2013 13:39
#773 P.001/001
PAGE 05
206 456
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15340 Pollack Drive, Anchorage AK 99516 -
Blatuber Filter .... .."'-_I.....
907-555-5555
Ax Site IDs
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Pod ft
AW ANL a
Asia of Inst Impaction
AX -103943
SW030484
202555
RTU102416
06/17/2012
Retrieve O&M Into
Dally flow
eecim ratio
Timer settinge:
Perform Field Sampling/Observations
NTU US t N�TyUs) pH (6.81 DO (2 5-6,
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r�
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K
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Clean
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studies
I St 0ompeont/r
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2nd Cumpareht
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ist
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.
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Clean
Measure Sludge/Scum
studies
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Inspect/Service other System Components
Inspect Clean Inspect Clean
plolntection Equipment [I ❑ Olapaotal Latemle/Drlacae ❑ ❑
Obseivallona
Additional Services, Rendered
❑ Cleaned textile sheets? ❑ Rapieoed UV items?
❑ Reploeed/Uaed other items?
Parts Used: W = Warranty, B = Billable (,/ appropriate selection)
W B /tam Number Doscrlptlon
Final/Safety Insdoection
�0RSv reinstalled rLlds boned on �
ManHeld reconnected; flush valves closed klto,it.l PAPA] reactivated
Summary/Re commendatlona
X_-qystam performing; no further Action needed E)lank needs pumping
❑ call for seNiae ❑ Other?
Fax completed form to 1.866-584.7404
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
BETWEEN MUNICIPALITY OF ANCHORAGE
AND Quce W (i� r
THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this
Day of �of 20, by and between
herein the "OWNER," and the Municipality of Anchorage, herein the
"MUNICIPALITY." In consideration of the mutual covenants contained herein, the
parties to this Maintenance and Repair Agreement 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 (legal description).
2. Definitions.
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.
Certificate of On -Site Systems Approval (COSA). An approval by the
Municipality of existing water and wastewater disposal systems given at
the time of property sale and title transfer in accordance with Anchorage
Municipal Code (hereinafter, "AMC") 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 man-made or natural change in a system that would inhibit
the system from performing as designed.
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.
Permit. An On -Site Wastewater Disposal Permit as required by AMC
15.65 to construct and operate an AWWTS.
3. Term. The term of this Maintenance and Repair Agreement shall begin on the
date of approval by the Municipality to operate the installed system or issuance of a
COSA, and shall continue while the AWWTS is in use or is operational or until the
property is sold or title is transferred by the owner and a new COSA is issued to the
new owner or transferee of the property.
4. Alterations, Installation and Removal of Additional Equipment. Prior to
performing any alterations to an AWWTS, the owner agrees to obtain an On-site
Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65.
5. Maintenance and Repairs.
A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall
maintain their AWWTS in a satisfactory condition capable of producing treated
septic effluent in accordance with the equipment's approval for operation in the
Municipality. The owner shall enter into a service aereement with an AWWTS
service and maintenance provider approved by the municipality and the
manufacturer of the AWWTS for the entire term of the AWWTS In addition, it
shall be the responsibility of the Owner during the term of this Maintenance and
Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay
for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement
costs, and (5) inspection costs.
B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules
and orders for the AWWTS.
C. Upon request by the Municipality, the owner agrees to provide the Municipality a
written schedule of routine maintenance and repairs which have been performed
on the system. When a record of maintenance is documented and maintained by
the system vendor, the owner agrees to allow the Municipality access to this
information.
D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS
may be assessed in accordance with AMC 14.60 for improper discharge.
E. Owner agrees that only maintenance and repair personnel approved by the
Municipality will inspect and make any necessary maintenance, repairs or
permitted alterations to the system.
F. Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS upon 24 hours written notice.
G. Owner agrees that any sale or transfer of title of the property will not occur
without a new Certificate of On -Site Systems Approval.
H. Owner agrees that the AWWTS installation and maintenance requirements as
provided by the AWWTS vendor/installer and approved by the Municipality are
the governing guidelines for the construction, maintenance and repair of the
Owner's AWWTS.
6. Nonwaiver. The failure of either parry at any time to enforce a provision of this
Maintenance and Repair Agreement shall in no way constitute a waiver of the
provisions, nor in any way affect the validity of the Maintenance and Repair
Agreement or any part hereof, or the right of such party thereafter to enforce each and
every provision hereof.
7. Amendment.
A. This Maintenance and Repair Agreement shall only be amended, modified or
changed by a writing, executed by authorized representatives of the parties, with
the same formality that this Maintenance and Repair Agreement was executed
with, and such writing shall be attached to this Maintenance and Repair
Agreement as an amendment.
B. For the purposes of any amendment modification or change to the terms and
conditions of this agreement, the only authorized representatives of the parties
are:
a. Owner:
b. Municif
C. Any attempt to amend, modify, or change this contract by either an unauthorized
representative or unauthorized means shall be void.
8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance
and Repair 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 Maintenance and Repair
Agreement.
9. Severability. Any provisions of this Maintenance and Repair Agreement decreed
invalid by a court of competent jurisdiction shall not invalidate the remaining
provisions of the Maintenance and Repair Agreement.
OWNER:
1`
By: LLC L (signature) Date:
r
(print name)
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT )
The foregoing instrument was acknowledged before me this 11, day of
20a, by 10,�
r
NOTARY P IC MRALASKA
My Commission expires:: '1 �,-
MUNICIPALITY:
name)
Date:
Title:
Municipality of Anchorage
Development Services Department
:• -
p
Building Safety Division
On -Site Water t: Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519.6650
www.muni.org/onsite P
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
nr1 ,1
Parcell.D. (��}–I��–�� COSA# l)o?s1� may_
1. GENERAL INFORMATION Expiration Date:—/ I –1
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
POLLOCK HOMESTEAD: BLOCK B. LOT 11_
15340 POLLOCK DRIVE *ANCHORAGE, AK 99516
CHUCK & CHRISTY CLEMENT Day phone 360-2715
15340 POLLOCK DRIVE *ANCHORAGE AK 99516
Day phone
TAMI TAYLOR W/ PRUDENTIAL Day phone 244-3504
3801 CENTERPOINT DR 11200 *ANCHORAGE -AK 99503
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual Well
N
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
0
Individual Holding tank
❑
Community On-site
❑
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. 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 riles 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 Finn GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179
Address 3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 135 OS
Engineers Comments:
In conducting this evaluation, GEG, LID. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines 8 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 detects 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 this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
✓ Approved for __q_ bedrooms.
Disapproved.
Conditional approval for bedrooms, with the flowing stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By. G(/, 8� Original Certificate Date:
(R. 11105)
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
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
0
T,
Legal Description: POLLOCK HOMESTEAD BLOCK B, LOT 11 Parcel ID: Q%7- / /2' 37
A. WELL DATA
Well type PRNATE If A, B, or C provide PWSID# N/A
Date completed 6/9/04 Sanitary seal (Y/N) YES
Total depth 491 ft. Cased to 40 ft.
FROM WELL LOG
Date of test 6/9/04
Static water level 30 ft.
Well production 0.5 9.p -m.
WATER SAMPLE RESULTS:
Well Log (Y/N) YES
Wires properly protected (Y/N) YES
Casing height (above ground) 18+ in.
AT INSPECTION
7/23/09
25 ft,
1.4 g.p.m.
0
Coliform 0 colonies/100 ml. Nitrate ND mg./L.
Other bacteria 0 colonies/100 ml.
Arsenic: ND ug./L. Date of sample: 7/23/09 Collected by: GEG Ltd.
B. SEPTIC/HOLDING TANK DATA JADVANTEX SYSTEM
Tank Type/Material STEP/STEEL Date installed 1/5/04
Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (YIN) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES
Date of pumping 6/17/09 Pumper A+ HOME SERVICES
C. ABSORPTION FIELD DATA FOELOW EXISTING GRADE
Date Installed 1/5/09 Soil rating (g.p.dJft'o /bd 4_0 System type TRENCH
Length 30 ft. Width 5 ft. Gravel below pipe 0.6 ft.
Total depth •3.08+ ft. Eff. absorption area 150 ft' Monitoring tube YES Depression over field NO
Date of adequacy test 7/23/09 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test 0 in. Water added 600 gal. New depth 0 In.
Elapsed Time: 0 min. Final fluid depth 0 in. • Absorption rate >= 600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date —
D. LIFT STATION 'INSPECTED BY A+ HOME SERVICES
DURING MAINTENANCE INSPECTION
Date installed 1/5/04 Size in gallons 1500/76 Manhole/Access (Y/N) YES
"Pump on" level atTiMER 13.5 in. "Pump off" level at TIMER 13.5 in. High water alarm level at 46/24 in.
Datum BOTTOM OF TANK Cycles tested ' Meets alarm & circuit requirements? YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main
Sewer /septic service line 25'+
Animal containment areas 50'+
Public sewer manhole/cleanout N/A
Holding tank N/A
Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service tine t0'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10,+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain 50'+ Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION AF
I certify that l have determined through held inspections and
........... .
...............
review of Municipal records that the above systems are in Q
conformance with MOA COSA guidelines in effect on this Q
date.Q of r y A. Garness�
Engineer's Printed Name JEFFREY A. GARNESS�Q CE -79 3 Cpl
Date�'' �qoo
04°d Pro f s $slot\
��00000��
COSAFee S L4C1b SSL
Date of Payments t)
Receipt Number 09 5 Y 8 3
(Rev. 11105)
Waiver Fee $
Date of Payment
Receipt Number
146 183
awn on on ■■a■ an ■1a■ one MR as ■o ■
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WanTexa Field Maintenance Report AnchorageTank & Welding, Inro
Unscheduled 907-272-3543
Prey O .a.m ng s
Om®O®®m®
OP~ .
Charles & Kristy Clement
Pow
(Green LED)
Mike Blakeslee
sm Adeno
Gama Peer.
15340 Pollock Drive, Anchorage AK 99516
(907) 360-2715
A%amce
camry DP
Pod•
RfV WLP
omatrlk.PMla.
103943
SW030484
202555
RTU702418
06/082009
Dispatcher Comments
Data 06/102009 Time: 12:00 AM
Replace discharge pump.
Notification of site condition
❑ Made by VerlComms Monttorkq system
❑ Mads by Nomeowrrr
❑ Other
Site condition at time of call
❑ Alarm ❑ Tank Overflow
❑ Oda ❑ Sewage Backup
❑ Outer
Field SamplingfObsenations
❑Necesary ❑Not naaassry
Ntu tis s NTUs) FN (6-11) 1 DO a$)
Odor of Sample.
typical ❑Musty ❑Earthy ❑Moldy
Non -typical ❑Sulfide ❑Cabbage ❑Decay
Conditions at site
Alam On ❑ Yea ❑ No
(ll yes alarm type )
Tank Liquid Level ❑ Normal ❑ Nigh ❑ hew
Pump Operational? ❑Yu ONO
Group Breakers
R,dre........ ❑ Tripped ❑ On ❑ Oil
Dechargs..... ❑ Tripped ❑ On ❑ Oe
Controls ...... ❑ Tripped ❑ On ❑ Off
VOOMs ATRTU Board: (Ir applicable)
Document the panel status by shading the appropriate
Inputs and outputs as indicated by the yollow and red LEDs.
Inputs
Om®O®®m®
OwtpLft
Pow
(Green LED)
❑ On ❑ On ❑ Flsshkg
Cause of Malfunction:❑ Modianical ❑Process -Related
Part Used: W . Warranty. 8. Billable (V appropriate selection)
Notes/Final Recommendations:
❑ System peaorming; no
action needed
❑Additional service needed
FlnaVSafety Inspection:
Uds boned on7 ❑ Yes
Of damaged, comment
Cordml Panel reacgvated7 ❑ Yes
Orcutt Breaken:
❑ No
❑ NO
Realms ❑ On ❑ Oe 0isdwnw.. ❑ On ❑ of Co ,u [:)On ❑ On
Time at Stta Trawl Tine Total Time
signatuie
I Pete Time
Fax completed form to 1-866-384-7404
rav-20-2M es:39R FROM:
70:16663847404 P:616
1D1519
new ■■ ■ BEEN E on ■ ■ on E IN Muslim SEE
3
See so a man sommumm amuse to See
FsW Maheam of Report
Inspection
Anch�geTank & Welding, Inc.
807-272-3543
rwewy dem
Charlet & Krinty demand
Crean
❑
15310 PoAodc Drive, Andnwe, AK 88516
(907) 360-2715
uc ewDl
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AX•103943
017-112,37
202555
R7U102418
0211612005
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Rodrc on Cyde Time - O.5/min
per/erm Field ■reptir■4be0r9*11"
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let compav rent Qmet
is"
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❑cararoe - m amen
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reawwo.rd.. ar.n wvea 610"0
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S .— Date
Fax completed form to 1-886-784-7404
OCT -1-2093 12:0W FROM: TO:18663847404 P:4,6
laws ■i■■ i■■i■■■■■■■■ ■
soni ■ ■■■ ■■ ■ .■■
Field Maintenance Report
Inspection
Charles 8 Kri* Clement
112 520
■ ■ ■■
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■ ■■■■■ �
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AnchorageTank & Welding, Inc.
1 907-272-3543
3
15 0 Pollock Drive -Anchorage AK 99516 v T9 07) 360-2715
uwro. l;w.r ro. eae. rrtV.na.s h.r•w Dal.
AX -103943 SW03J 84 202555 RTU102418 OS/202DC8
Retrieve 03M Info
Daily low .
Rrxhrc ratty _... •--
Tlm.r s rninfis:
Recirc Ott Cycle Tie -17.5/min
Recirc On Cycle Time - 0.5/min
Perform Field Samplingl0b"mations
Nru(lazNTW)
pretaat
DORS I
",�
M..0y rUQW
Non-typicel ❑suMdo
❑Cebbpe (70eeey
Odoror Sample.
❑purro.rd
TypiWl ❑PAVIty
",�
M..0y rUQW
Non-typicel ❑suMdo
❑Cebbpe (70eeey
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room In unk I.lvee ,L7.,N/c
Cheek Control Panel
w
r near. a,ap.
or.uwroa wmp•
rk
PAWlb& and Msuul:lama
Ia1oK
Dial tom (telemetry only?
?_lyes V.No
Inspect/Clean Pump System
krep0e, Clean
11"I/Lad ....................,��
apku Dua.................... r
Fled Cane ...................
F,oats........................
rump ....................... L' Las
awtub0e Flta.................r l—'7•,
Blolube Potts Wulf............ 1.1 FR
Iledroulatep splllluflku.e....... r:
canment.Q:¢I �,��
Measure Sludge/Scum
Inspect/Claan Advan7ex Fitter
Odor, 1
❑purro.rd
alomat lie"
r-3 eesatw
swonmwwh w ❑Nonan
lot Cempennhenl
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w
1D
rk
and compare
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previous
current
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Inspect/Claan Advan7ex Fitter
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r-3 eesatw
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bsped Clean knpeot dean
dMamem I I L7 obpersaltabrala/Orfilm I I O
Addhlo Services Rendered
I leatae .hoots? O Replaced UV Mme?
i other Mmol
Fnattgotety Inspectionweloorw
SlanatuajY- Data 9 _
Fax completed form to 1-668-384-7404
Cl uds brand en
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❑Coneolpu.lreaNWated
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❑ Ga ter Sam"
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❑Lok rosda ph.hrWrhp
SlanatuajY- Data 9 _
Fax completed form to 1-668-384-7404
JUN -8-2039 10:34a FROM:
TO:186631347404 P:V6
144350
M ■,,s ■ son ■ son ■ ■ s t ■ ■ as ■ i
tm as ■ an ONE s ■ as ■ ■ ■ ■ ■■
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[00vanTema Rdd Maktenwce Report AnchorageTank & Welding, Ina
Annual Inspection 907-272-3543
n.p•vr o,.�dr,,.a.y•
cfi"
a.� - -
Charlea 6 Kristy Clement
kM*A vwd ❑
Mike BIa*eslee
armr.
��.�..
15340 PDnodt Drive, Andmrape AK 84516
(907) 360.2715
m modO..lr
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SV403 84
1=1=05
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� ns a NILlq pr16-pr DD a�
natal of Sable
?ypk:d ❑maty mrw" ❑Hoary
wn+m" ❑Bruno. ❑cabbepe ❑Decay
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kalpact aeon
Cas-fud ....................
Bolt Dar ...................
F" cora .................
Itbat....................... pol
A
.........................
S&C40 a I3rr.................
W�.
Mot "Vardt ............ 1
coma+ama _�. v iSCharq C(
Measure SbAdye/6eum
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Calf Cpmpartntwrt // Prow(ka C rmm pmol u.
2MCamprM.nr t?..d p I"a :: v erb�e
MapeoVCtean A&MTet FDter
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Inspect
ntaarnad I$
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bapect
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❑PA%w d.U..d ac e. Bens?
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Fax Completed form to 1-866.384-7404
(cD�� 400%
Municipality of Anchorage
0
Development Services Department
'.,.. .,
Building Safety Division
'
On -Site Water 8 Wastewater Program
❑
4700 South Bragaw St.
❑
P.O. Box 196650 Anchorage. AK 99519.6650
❑
www.ci.enchorage.ak.us
❑
(907)343-7904
❑
CERTIFICATE OF HEALTH AUTHORITY APPROVAL A
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 017-112-37' HAA# 194 OUI(o
1. GENERAL INFORMATION Expiration Date: / 1—.2 3
Complete legal description
Location (site address or directi
Current Property owner(s) RYAN MATHIAS Day phone 240-8430
Mailing address 13120 LUPINE ROAD • ANCHORAGE. AK. 99516
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing address
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well
0
Individual On-site
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given In paragraph 4 by an Independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority
Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may
be reissued with new water 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. 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 onsite water supply and/or wastewater disposal system is(are) safe, functional and adequate
for the number of bedrooms and type of structure Indicated herein. 1 further verify that based on the
Information obtained from the Municipality of Anchorage riles and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system Ware) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Finn GARNESS ENGINEERING GROUP, Ltd.
Address 3701 E. TUDOR ROAD, SURE 101 • ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineers Comments:
In conducting this evaluation, GEG, Ltd. attempted to provide a thorough,
conscientious engineering analysis of the system In accordance with ADEC and MOA
DSD Guidelines 6 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 this report by any
other person or party is not authorized, nor will It confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for bedrooms.
Phone 337-6179
Date 13 Z3 nt
Disapproved.
R Conditional approval for 4 bedrooms, with the filowing stipulations:
At the time of title transfer the new property Pr ah ll Aign rh fir shad
maintenance agreement which shall he rPtvrnPd fin rhi ff"oh Fora ^
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
1/ Manitenance Agreements
Supplemental Engineers Reort
Other
Original Certificate Date: 42' 3-0
tI-
By:
(Rw. 11/01)
Municipality of Anchorage
' Development Services Department
Building Safety Division
Onsite Water & Wastewater Program
4700 South Bragaw, St.
P.O. Box 196650 Anchorage, AK 995196650
www.d.anchorage.ek.us
(907) 343.7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Desariptlon:POLLOCK HOMESTEAD SUBDIVISION* LOT 11. BLOCK B. Parcel ID: 017-112-37
A. WELL DATA *CASED TO BEDROCK
Well type MOTE If A, B, or C provide PWSID# N/A
Date completed 6/9/2004 Sanitary seal (YM) YES
Total depth 491 ft. Cased to •36 ft.
FROM WELL LOG
Date of test 6/9/2004
Static water level 30 ft.
Well production •5 —
g -p.m -
WATER SAMPLE RESULTS:
Well Log (Y/N) YES
Wires properly protected (Y/N) YES
Casing height (above ground) 16+ in.
AT INSPECTION
ft.
g.p.m.
Coliform 0 oolonies/100 ml. Nitrate 0.1 mgA. Other bacteria 1 colonies/100 ml.
Arsenic: N/A mgA. Date of sample: 8/2/2004 Collected by: GEG. LtD.
B. SEPTICIHOLDING TANK DATA
Tank Type/Material STEEL Date installed 1/5/2004
Tank sae 1500 gal. Number of Compartments 2 Cteanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES
Data of pumping NEW Pumper —
C. ABSORPTION FIELD DATA
Date Installed 1/s/2004 Soil rating .p.d r ft1bbdrn) 4_0
Length 30 ft. Wkfth 5 ft.
System type TRENCH
Gravel below pipe O.6 ft.
Total depth •3.04 ft. Eft. absorption area 150 ft' Monitoring tube YES Depression over field NO
Date of adequacy test — Results (Pass/Fall) — For 4 roorTC
Fluid depth in absorption field before test = in,—...T17kA New depth =in.
Elapsed Time: = min.
kr. Absorption rate > — g.p.d.
(past 12 mo.) (YIN & type) — If yes, give date —
D. LIFT STATION
Date installed 1/5/2004
TIMER/
"Pump on' level at 13.5 in.
Datum B.O.H.
E. SEPARATION DISTANCES
Size in gallons 1500/76 ManholelAccess (YIN) YES
TIMER/46/24 in.
'Pump oft level at _ in. High water alarm level at
Cycles tested NEW Meets alarm & circuit requirements? YES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAtft station on lot 100'+
Absorption field on lot 100'+
Public sewer main N/A
Sewer /septic service line 25'+
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Holding tank N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water •100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water •100'+ Driveway, parking/vehide storage 10'+
Curtain drain 50'+ Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
1 cantly that I have deterruned through Held Inspections and
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineers Printed N me JEFFREY A. GARNESS •
Date fit 23 Gr}' dp�ot.
HAA Fee E So } 125 � Waiver Fee $
Date of Payment Date of Payment
Receipt Number o5717.1 Receipt Number
(wv. taro+)
08/23/2004 11:12 9072432081
SCALE.
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FRED WALATKA & ASSO
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N Bre° 4-I'ZI" E 1 41,5'7-
Recert $ 20-04;*! :
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A"UILT NO CORNERS SET THIS DATE
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SEMENTS OF RECORD. OTHER THAN Fd o 4 -¢j
KXE SHOWN THE AT ARE NOT SOHOWN HEREON,
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PAGE 01
8z 39a-/
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1 hereby certify that I have performed a Mortgagees Inspection
Of the folkmving described property; Lo T I
BLoGK 13 Pcr—t..0ck
t E-.•"rE L
n• 5CG6 CIV 1610N
is Anchorage Recording Precinct. Alaska. and that the
inlPro ements situated thereon are within the property lines and
f10 not overlap or encroach on the property lying adjacent
thereto. that no •Improvements on property lying adjacent thereto
r 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•
Dated at Anchorage. Alaska
this �0 fh day of
FRED WALATKA d ASSOCIATES
BE l907) 248.1686 Engineers and Surveyors
