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NORTH SLOPE #2 BLK 4 LT 9B
North Slope #2 Block 4 Lot 9B #050-511-09 Municipality of Anchorage • Development Services Department t Building Safety Division Onsite Water 8 Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.anchorage.ak.us (907) 343-7go4 On -Site Wastewater Disposal System and/or Well Inspection Report Paye 1 of 3 Nome; Permit Number. SW040376 PID Number. 050-511-09 RAYMOND BAILEY Wastewater System: ■ New ❑Upgrade Address: .NHfq KUPARUK AVENUE a EAGLE RIVER, AK.99577 ABSORPTION FIELD (907) 622-4088 No. of Bedrooms: ¢ O Oeep Trench O SAullow Trench Deed Mound ■ Other - LEGAL DESCRIPTION Saa eepw, r t>.Pe r� «tea: BI«M: Loa 1.25 vD/sa n ••3.0(MAX.) n' Subdivision: D.ppi b Pip. bonorn een, a 96 NORTH SLOPE #2SEE DWG. Fa treMc a� e.Pu swwan pDa` 0.5+ Towmhip; — Ronge: — Section: — FMI .ea.M Wow p,,M„, gn M R GaN WVh: n SEE DWG. FL 50 rL WELL: ■ New ❑ Upgrade Ge M .tmm a I'll, Oiaenc. w..«, pM cw.iti.eme P,;,a 10 . n 2 5 w saT . raa D.pne Cows To: R PRIVATE 116 L 116 °� ma. d o.Mw R. ebl w ar.a 500 SD. R D 5034/ $CH 40 PVC/ SCH 40 Dot. Drw.M: Sleee war l.va: Mtwn SULLIVAN WATER WELLS 4/28/03 87 RPC EXCAVATION OoaMw nae: rt 1779/04-10/l/04 P,rmp sa N: co.:.v Mwgnt App.. t:re„ne: 10 anti UNKNOWN R 2 it TANK SEPARATION DISTANCES I17Septic oHalding ■s.r.E.P.• O Other To Septic Absorption Lift Holding /Prtwt. ;EANCHORACE coo ity N eoMor,.; rmm Tank Field stotion Tank s..« tM.. TANK 1500 Well too'+ 100'+ 100'+ — 25'+ NiwneirLY COATED STEEL 2 Surface Water 100'+ 100'+ 100'+ LIFT STATION Lot Line 5'+ 10'+ 5'+ _ _ s"' M, e.4° * .tp.VtpptYr.n 1500 61 ANCHORAGE TANK NCO SYSTEMS Foundation 5'+ 104 5'+ _ _ °A t"" •t' a' t..a a: wyn "ECO et: TIMER 30.25 TIMER 20.25 46" 34.75 Curtain Drain 50'+ 50'+ 50'+ _ _ ^""P Y0Y' • : rrputoa ewo«tw,. P.rt.rm.e tr. /20 OSI OS HHF RISING SON ELECTRIC Remarks: BENCH MARK *THIS IS AN ADVANTEX TREATMENT SYSTEM ane O BOTTOM OF TANK IN ST1 ••2.0 FEET OF M.O.A. APPROVED SAND FILTER ADDE. ,..rd Eoabp_ 90.12 n ENW WER'3 SEAL 4 Inspections performed by: GEG, Ltd. Dates: 1st 9/29/20Da 0 �• �o' 2nd 9.L/200a �....... Q D 3rd 10/1 /2004 y Gorn ss: .. oQ� Development ervices Department Approval 04p� f E- °o Reviewed and approved by: Date:- PERMfT NUMBER: PARCEL ID NUMBER; SW040376 AS -BUILT DRAWING 050-511-09 0 / / ORAJNFIELD . e.- SN TH11 ALTERNATE SrTE FCO 1.82 18.77 CO 25.28 24.66 STI 61.54 52.46 MH1 69.05 58.13 MH2 73.40 92 .02 MTI 63.75 45.31 2 64.11 47.99 3 104.59 84.11 MT4 105.56 86.37 DATE: 10/14/2004 000 0 DRAWN BY: UP, Ltd. GARNESS ENGINEERING GRO R.A.L. CONSULTANTS L GENERAL CONTRACTORS SCALE: 3701 F TUDOR ROAD. SURE 101 - ANCHORAGF AR 00507 - PWONF (907)5374170 - FAX (90))538-3?46 1. = ...... ... 'REPARED FOR: 40'.......... RAYMOND BAILEY PHONE NUMBER: PACE NUMBER: 9 (907) 622-40882 .... ... . ........ . ...... 04 EGAL DESCRIPTION: Car ss.: NORTH SLOPE SUBDIVISION #2; LOT 98, BLOCK 4, 5 AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE 0 ass% to- Irr L* NEW WELL CURTAIN CO2 DPAN Col NEW 1500 CO \fCO GALLON ADVANTEX TREATMENT SYSTEM TH12 NEW / / ORAJNFIELD . e.- SN TH11 ALTERNATE SrTE FCO 1.82 18.77 CO 25.28 24.66 STI 61.54 52.46 MH1 69.05 58.13 MH2 73.40 92 .02 MTI 63.75 45.31 2 64.11 47.99 3 104.59 84.11 MT4 105.56 86.37 DATE: 10/14/2004 000 0 DRAWN BY: UP, Ltd. GARNESS ENGINEERING GRO R.A.L. CONSULTANTS L GENERAL CONTRACTORS SCALE: 3701 F TUDOR ROAD. SURE 101 - ANCHORAGF AR 00507 - PWONF (907)5374170 - FAX (90))538-3?46 1. = ...... ... 'REPARED FOR: 40'.......... RAYMOND BAILEY PHONE NUMBER: PACE NUMBER: 9 (907) 622-40882 .... ... . ........ . ...... 04 EGAL DESCRIPTION: Car ss.: NORTH SLOPE SUBDIVISION #2; LOT 98, BLOCK 4, 5 AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE 0 ass% PERMIT "UMBER: AS -BUILT DRAWING PARCEL ID NUMBER: SW040376 050-511-09 TOP OF MANHOLE FINAL GRADE TOP OF ADVANTEX POD 99.54 (AVG). 99.28-98.95 99.58 (AVG.) TOP OF MANHOLE 99.54 (AVG.) INSULATION TOP OF TANK 94.99 , 1 INVERT OF 1500GALLON PIPE - 94.38 STEEL ADVANTEX TANK T'. TOP OF SAND FILTER 100.00 FINAL GRADE 102.84-103.18 INSULATION P OF TANK - 95.05 INVERT OF PIPE - 91.3 BOTTOM OF/ ORENCO PUMP MANHOLE - 91.31- VAULT ER FABRIC Z102IGRADE 101.0 101.00 MAX, BOTTOM OF / (�-�_10•� BED OM OF -/ 1 L/ INVERT OF DISTRIBUTION LINE - 100.50 (AVC). THE DISTRIBUTION LINES ARE 1.25 INCH PVC WITH 1/4 INCH DIAMETER HOLES RELATIVE ELEVATION OF SPACED 38 INCHES ON CENTER (15 HOLES RELATIVE ELEVATION OF GROUNDWATER IN TEST HOLE . 95.00 PER LATERAL/30 HOLES TOTAL), GROUNDWATER IN TEST HOLE - 95.00 RELATIVE ELEVATION OF RELATIVE ELEVATION OF BOTTOM OF TEST HOLE O 91.00 BOTTOM OF TEST HOLE O 89.00 DATE: 10/14/2004 c of 3131314 DRAWN BY: Op .( ....... . 5,�0 GARNESS ENGINEERING GROUP Ltd. R.A.L. �I CONSULTANTS A GENERAL CONTRACTORS �.�.� SCALE: A i . !} '•� 3701 F TUDOR ROAD. SUITE 101 • ANCHORAGE. AR 00507 • FNONF (00))]31-0110 • FAx l001)335SRA 1 O 40' ..... .... '. '''''"' 1REPAREO FOR: PHONE NUMBER: PAGE NUMBER: RAYMOND BAILEY (907) 622-4088 2 OF 3 ;: �A ' EGAL DESCRIPTION: NORTH SLOPE SUBDIVISION #2; LOT 9B, BLOCK 4, YPE OF WORK: PROFILE AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE Rising Son Uectric. Inc. 0916 \Voodland Drive Cagle River. Al!� 99577 (907) 622-6777 . , � • N October 21, 2004 To whom it may concern: Re: #2 Lt 9 B Blk 4 North Slope Subdivision The lift station at the above referenced property has been wired in accordance with NEC and State/Local codes. Thank you. Sincerely„, Kevin . Hornbuckle, Owner Administration License Number 1284 Specialty Contractor License Number 27285 Too'd HLS'OT VO/TZ/OT LLL9 ZZ9 Zoe •7u] M141�I3 uos �.w-T—.^'�r�nTJR's,^/M•�+rt+l..^+��.+^•�v+�.N!'�.,^...T^•.'.'•,.,�.�.�'^.�'►V-lt�.'f-w�..+nv«..�_. I ..-M1..-rv-...�.��Y;-.•+•r-.�.Y'^'1^.-�. ._.' ....�-�. Certf f teb �rftting Rog DOC CO. dba SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 TELEPHONE 688-2750 OWNER OF LAND: R� DR lLt N BORE HOLE ADDRESS: F LEGAL DESCRIPTION: A CA T Ii J 4 -4 PC �• k ,3,- 4 ro Qui I DATE: 6S1n� PERMIT NUMBER:'10 Date of Issue • .._.j,AXIDENTIFICATIONNUMBER:'Q�_ - 1ii - 40 f_ Is well located at approved permit location?. 6)> s 'j No Method of Drilling: �r rotary �:.I cable tool Depth of well: ^� Casing Type .STS El- Wall Thickness . 10 inches Diameter _[2inches, depth feet I Liner Type:�JJ�L - Casing Stickup Above Ground: C�' feet Static Water Level: feet Recover Rate:--/ gpm Method of Testing: & Well Intake Opening Type: �n end U open hole Screened; Start feet -Stopped feet. U Perforations - Startfeet�Stgpped feet Grout Type: 4C: r4af' d Volume % S-4 4a.3 Depth: from feet, to d feet I Well Disinfected Upon Completion?"s U No 4 Method of Disinfection: Fm TO t I I-Ar'.a f. Sri L& JO OJC431oe4c•.) Ct JYA"/a 4--J '= Cad 'L e Sbac ni, J /J4 It/0 �-A^d 6,t 4_j, 4. CG.ay BansO f i Yi I -• C�'�t I c A- J ee i ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservation. MUNICIPALITY OFANCHORAGE Development Services Department On -Site Wafer 6 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Permit Number: SW040376 Legal DescriptionSNORTH SLOPE #2 BLK —4 LT '9B Design Engineer: 0855 Gamess Engineering Group, LTD Owner Name: RAYMOND BAILEY Owner Address: 30671 KUPARUK AVE EAGLE RIVER. AK 99577 - Date Issued: Sep 03, 2004 Expiration Date: Sep 03, 2005 Parcel ID: 050-511-09 Site Address: Lot Size: 43260 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 0 This permit is for the construction of. ❑,/ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specked 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: Date: Issued BY Date: Municipality of Anchorage :,'�;'1Pj 'Iiia;•. •. ,,,,,.. r.. 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'Ve-v•,6 �S w oc�o3�6) Parcel I.D. 05o" 511"� � Permit Numbet StA 1 1-3 0 Property owner(s) RAYMOND BAILEY Day phone 240-8430 �Mailng address (1) P.O. BOX 772594 • EAGLE RIVER. AK. M9ni g address (2) � 1 nC11 r k Aue_ m< Zip Code 99577 Legal description (Lot, Block & Sub'd.) NORTH SLOPE SUBDNISION N2: LOT 9B. BLOCK 4. Legal description (Section, Township & Range) Lot Size 43, Acres/Sq.Ft. Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only N Well Only ❑ Sewer and Well ❑ 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. GARNESS ENGINEERING GROUP, Ltd. Permit Fees: Waiver Fees* Date of Payment: Date of Payment: Receipt Number. Receipt Number. GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS August 27, 2004 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Proposed Septic System for North Slope Subdivision #2; Lot 9B, Block 4, To whom it may concern: The 4 bedroom house is under construction and was previously permitted for a well and septic system that was designed by S&S engineering. The well was drilled under this permit and the owner has now retained G.E.G. to redesign the system using Advantex- technology. We are proposing that a 1500 gallon Advantex Treatment System and a pressurized 5 -wide trench type drainfield be installed in the vicinity of the S&S Engineering test holes. The drainfield will be designed around the 30 foot radii of these test holes. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. We are proposing to use an average application rate of 1.25 gallons/day/ft2 should be used. 2. BED DESIGN: a. Percolation Rate: 5.5 & 80 minutes/inch (soils vissualy rated to be 60 min./inch) b. Proposed Application Rate: 1.25 gallons/day/R2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 480 ft2 f. Total Depth: 3 feet (maximum) g. M.O.A. Approved Sand Filter: 2.0 feet h. Effective Depth: 0.5 feet (minimum) i. Width: 10 feet j. Minimum Length: 50 feet long k. Effective absorption area = 300 fiZ Note: The distribution lines are to be 1.25 inch PVC with %4 inch diameter holes spaced 38 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507 Ph: (907) 337-6179' Fax: (907) 338-3246' Website: gemessengineering.com inches on center(15 holes per lateral/30 holes total). 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPHY: As can be seen on the attached design, the average slope in the area is where the proposed drainfield 5 to 10 percent slope running northeast to southwest. Approximately 15 feet down hill from the proposed drainfield, the slope increases to a 15 to 20 percent. In short, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact Jody Maus at 337-6179. Thank you for your assistance. / n .E., M.S. NOTE: A site plan drawing, a design drawing, two detail drawings, two soil logs, and a 5 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' Website: gamessengineering.com LOT 10. BLOCK 4: NORTH SLOPE S/D /2 (VST) \`\ I IAIo \`\ AVENUE \ LOT 11-A. BLOCK 4; NORTH SLOPE S/D /2 CVAGANT) \ ` EXISTING WELL\\ LOT 12, BLOCK 4; NORTH SLOPE S/O #2 (FIELD VERIFY) \� TERNAT SITFji EXISTING 4 BEDROOM TN12 HOUSE LOT B, BLOCK 4; / •`.�>,, NORTH SLOPE S/D /2 \ TH 1 LkU I I - pgRU `, PROPOSED SEPTIC SYSTEM A (SEE DESIGN PAGE 2 OF 4) \\ \ \FNUF LOT 18. BLOCK 4; NORTH SLOPE S/D 12 I>cl V LOT 9. BLOCK 4; NORTH SLOPE S/D /2 (VACANT) GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS 6 GENERAL CONTRACTORS LOT 7, BLOCK 4; NORTH SLOPE S/D /2 vr LOT IB. BLOCK 4; NORTH SLOPE S/D /2 DATE:���•::::Y z, RBYA.L004 L IO .... DRA N L 9S( SIJ SCALE: ;•'pl.:4� •.-9 s ....:. '[IT .. .. I" = 100• PREPARED FOR PHONE NUMBER: FAUL NUMULK: RAYMOND BAILEY 622-4088 1 OF 4 NORTH SLOPE SUBDIVISION #2; LOT 9—B, BLOCK 4 OF WORK: SITE PLAN FOR PEOPOSED SEPTIC SYSTEM OUTFALL (APPROXIMATE LOCATION) NO WATER RUNNING ON 8/24/2004 NOTE: THE CONTRACTOR SHALL HAVE THE EAST LOT LINE AND THE WELL RADIUS FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO \ \ J0• CONSTRUCTION. NEW \ I/ WELL \ \ \ INSTALL FOUNDATION CLEANOUT / 1ti -• NEW 1500 GALLON ADVAHTEX TREATMENT / SYSTEM W/ PUMP \\ VAULT (SEE DETAIL \ \ PACE 4 OF 4) r \ h CO2 DRAIN col 1 � 1 / J3• \ ...'.� •moi ALTERNATE GFfNl \� 11 —PROPOSED DRAINFIELD. EXCAVATE A BED THAT IS 3 FEET DEEP MAXIMUM BY 10 FEET WIDE BY 50 FEET LONG. ADD 2 FEET OF M.OA. APPROVED SAND FILTER AND THAN 0.5 FEET OF EFFECTIVE. THE DISTRIBUTION LINES ARE TO BE 1.25 INCH PVC WITH 1/4 INCH DIAMETER HOLES SPACED 38 INCHES ON CENTER 15 HOLES PER LATERAL/30 HOLES TOTAL (SEE DETAIL 0' PAGE 3 OF 4 - 8/27/2004 V•! DRAWN BY: GARNESS ENGINEERING GROUP, Ltd. R.A.L. O% ' �I o e � ` 4 `7e SCALE: CONSULTANTS& GENERAL CONTRACTORS 11" — 40r 0........... • •• •••••• ••.... J]01 E TUDOR ROAD, SOTF 101 • ANCHORAGF. AK 00507 • P ONF J00])33].01]0 • FAX (007)33R3TL6 .. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: RAYMOND BAILEY 622-4055 2 OF 4 •, y . mes r NORTH SLOPE SUBDIVISION #2: LOT 9B. BLOCK 4. 0" '•d.. OF WORK:Prolesslo�" DESIGN OF PROPOSED SEPTIC SYSTEM X0440000 ----------- I I I 10• I t I OUT L-------------------------- -------------------------- ------------------------ ----------------------- - t I, I I TT --- �---------------- Mr- — I I 'LTHE DISTRIBUTION LINES ARE TO BE 1.25 INCH PVC WITH 1/4 INCH DIAMETER HOLES SPACED 38 INCHES TANK ON CENTER (15 HOLES PER LATERAL/30 HOLES TOTAL). -FINAL GRADE (TOP SOIL AND RESEED PER M.OA CODE.) FABRIC MAXIMUM I— To' DATE: 8/27/2004 DRAWN BY: R.A.L. GARNESS ENGINEERING GROUP, Ltd. Ste: CONSULTANTS d GENERAL CONTRACTORS 'r 40, 701 F IMMPOAD SURF 101 • ANC.ORAGF. AK 00507 • FNONF (007)357-0170 • FAX (007)516JTL6 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: RAYMOND BAILEY 622-4055 3 OF 4 NORTH SLOPE SUBDIVISION #2; LOT 98, BLOCK L OF WORK: DESIGN OF PROPOSED SEPTIC SYSTEM L.i -T,T4 THE DISTRIBUTION LINES ARE TO BE 1.25 INCH PVC WITH 1/4 INCH DIAMETER HOLES SPACED 38 INCHES ON CENTER (15 HOLES PER LATERAL/30 HOLES TOTAL). r.......... y A. forness —7 53 .. eV5 AdvanTex Treatment System AX Series - Mode la One (1) 40x96 Pod AND 1 2' INSLXATION INLET 4. INLE 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 h RISE TO THE FILTER ABOVE R. AX20 ORENCO BIOTUBE SCREENED 7ADVANT�EXTANK 500ON VAULT 11/r PUMP 8/27/20C DRAWN BY: R.A.L. GARNESS ENGINEERING GROUP, Ltd. SCALE: CONSULTANTS& GENERAL CONTRACTORS N.T.S. 3701 F. TLOOR ROAD, SUITE 101 • ANCMORAGF. AK 00507 • M F (907)317 6179 • FAX (007WIA-VL6 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: RAYMOND BAILEY (907) 622-4088 4 OF 4 LEGAL DESCRIPTION: NORTH SLOPE SUBDIVISION #2; LOT9B. BLOCK 4. TYPE OF WORK: DETAIL DRAWING OF PROPOSED ADVANTEX TREATMENT SYSTEM ED DRAINFIELD TO DRAIN FIELD I ORENCO PUMP VAULT ... P • • GOfO SS,• o — 3 Q � '• SAG Aug -23-2004 02:40pm From-IIailBozes.Etc.e2206 I +907-696-3297 MuiiMpAlly tit AlIblletdUa beveloontfil WAmt bebarlrrlehl bul64nd Shcely blvlsrm 1.? On -Silo Water and Wdste baler Program 4700 soblli brdgt* SL b.0. boa (86650 Anohoiage. AIC 89519.6650 ymb.d.dncfioraae.ak.Us (907)343.7904 Bolls Ldg - PeNboklloti f6sl 'eriomred roe -g_= //jt ,/ go, besalplion: Z -or g6 : /JLOL/G 4: N011-r7l St.E beplh 01Z6*,V(Gs (Feet) i T-405 P.003/004 F-402 ... r ,% GINEER• C 4, '•�=tr�r .: ............' •� ROBERT C. COWAN J �C j CE - 8801 ; s bele Pell ormed:Z/7- !JL T/f / site Plan WAS GROUND WATER kNCOUkTERET1t �O s- Itrtts.Arw4lArbE'T11T L N beach I ik I Aha 0 e on8a.6,yT dd R _ bele. C� ()Z t Nadlnd bale Cross time Net Time beplh 6waler Ne brop AoA✓. !O O/ U d 5�y 30 o 5%z,r 4.2.: D O 0 - O E 30 3c 5-3 r' PthCOU11014 PATE EX/ ( e*�4FERCr10LEpI MIER l?" tbSthlhtbHfvEklI�CT 0t) or Ily: At)cNA4c. Zt- Gtg4L IN ACCORDANCE WITH ALL STATE AN' Rtll r tltAT tI11S TESTWAS bATE. bATE: Aug -23-2004 02:41pm From-klailBozes,Etc.e2206 +907-696-3297 T-405 P.004/004 F-402 Muulelp ply ti! Atidiump bevelopnleiil teivlces bebdrlydehl 6u0dlnd Shcely blvlslan on -Site Water and Wdsla.4aler program A700 Sa1rB1 brdgdw St. :`.O, box 19665o Androiage, Ak 99519.6650 tivww.d. dnrJ+vaaa.ak.eT (9071343-7904 Srsils Lbd - Velbolstlotl test •do,med For, � I LC�•9 , albesatplion: V 07L �f �� Depth Q26.4,SlGS 6m bale WAS GRoul7b WATER- t"CoUNTEREOT s {T7—O Ih YES•AT WHAT bcprNT '� L -� - 1 beplb bvv;le, Ah.1 i `o o �2�IZmo� balr.LT- gy: II_ IG IFI Accon AN fmT C. COWAN CE -8801 heading bale Gross Tima tial Tints Depth b Wale, Nfl brop soA ✓ /O O/ 0 0 � � I�Z" i 30 O 1 PERCOLA7101 BATE t2.S PEAC110.twnrrcrtn 1� ttst lal.1t) 9ttweEN - '5-- PT Aub _�i,T r /- - mrirV MAT t111S TEST WAS -IISbAre.. BATE: oY wMSOR a.o�n e �$ �n ^�cn ��V � q��ftl S♦ v 2 ;Sch Roos"' �o'�.•••� 'T'�♦1 CP ♦ oR"'C-":8 O S 0 0 0, 0 �'',b •. i� • I � y A i e �icY gun ♦, \ `f►�� ' V MUNICIPALITY OF ANCHORAGE Development Services Department Onsite Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM /WATER SUPPLY PERMIT Initial Permit Number: SW030425 Legal Description: f4ORTKS1[OPE3t2 BLK=4tT=9B' Date Issued: Oct 09, 2003 Expiration Date: Oct 08, 2004 Parcel ID: 050-511-09 Design Engineer: 0003 S & S Engineering Site Address: Owner Name: Ray Bailey Lot Size: 43260 SO. FT. Owner Address: PO Box 772594 Total Bedrooms: 4 Permit Bedrooms: 4 Eagle River. AK 99577 - This permit is for the construction of: ❑✓ Disposal Field ❑Q Septic Tank ❑ Holding Tank ❑ Privy Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By. Date: /0 /7Q 40 3 Issued By. Al vv Date: �' 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.enchorage. ak.us (907)343-7904 ON-SITE SEWER/VVELL PERMIT APPLICATIO11i FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-5-11-09 Permit Number SW C36gZr Property owners) /ta��, Day phone &Z2— ef08f Mailing address (1) PO //°X 77.25957 - Mailing address (2) �L Zip Code 99577 Legal description (Lot, Block & Sub'd.) Lof gB, Bloch , it/o-K JLi�C zl Z Legal description (Section, Township & Range) L1_ // Lot Size 3, 260 Acr /S .Ft. Number of Bedrooms `T_ THIS APPLICATION IS FOR: 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,P'5�hily Dwelling and is in accordance with applicable Municipal Codes. of property owner or authorized agent) Permit Fees: sl G �� Waiver Fees: Date of Payment: iC 03 Date of Payment: Receipt Number: (Rev. 12'CO) 15 x P P'61 - 2% 4— 174 � Receipt Number: MUNICIPALITY OF ANCHORAGE Development Services Department Onsite Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM ) WATER SUPPLY PERMIT Initial Permit Number: SW020441 Legal Description: NORTH SLOPE #2 BLK 4 LT 9B Design Engineer: 0003 S & S Engineering Owner Name: Ray Bailey Owner Address: PO Box 772594 Eagle River. AK 99577 - Date Issued: Oct 29, 2002 Expiration Date: Oct 29, 2003 Parcel ID: 050-511-09 Site Address: Lot Size: 43260 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of. ❑✓ Disposal Field R✓ Septic Tank ❑ Holding Tank ❑ 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: /c/7// z. Date: 102?loa Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0 tv —511— Oct Permit Number SW 02 0 4 4 / Property owner(s) R A Y 13,41 L If, y Day phone 6,);t " Y0 SS' Mailing address (1) P. O. 8 X i7 a S-2 y Mailing address (2) EOfc-1-4— ReyO.4, 1 4X '/ Zip Code qc!-r77 Legal description (Lot, Block & Sub'd.) Lot (�9, 2leel `4 A& sbPG 2 Legal description (Section, Township & Range) Lot Size �3� a6 AcreSq.Ft. Number of Bedrooms q THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well 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. & S ENGINEERING 1 17034 Eayb River Loop Road No. 204 (Signature of property owner or authorized agent) Permit Fees: t S"S-O. "O Waiver Fees: Date of Payment: 10 /7- V/0 Z Date of Payment: Receipt Number: o a 7 3 a 7 Receipt Number: (Rev. 12100) S& October 23, 2002 nOBERTC. COWAN, P.E. ROBERT A. SHAFER, P.E. CIVIL ENGINEERS (907)694-2979 FAX(907)694.1211 W,LTMALnH+ry MUNICIPALITY OF ANCHORAGE APPROVALS Development Services Department P.O. Box 196650 Anchorage, AK 99519 SEWER►WATER MAMEXTENS*M REFERENCE: Lot 9B, Block 4, North Slope fel SEWER& WATER It is requested that you issue a permit to install a well and a septic system to serve the PSPECTION proposed four bedroom dwelling on the referenced propperty. 714AL Sc W a a LT^'L re rpe 'rA4o&44 15 V'0 OL G1JCCN &' r44 .4 - 7&4 -?-f~ 2s /3R+PL144 Nu -t4 �OtiNQY/IOn/• Two test holes were excavated and percolation tests performed. The approximate locations ENf°"EE STS of the test holes are located on the attached sitelan. At the time of excavation 10/01/02 ANOREPORIS P ), water was not found. After seven days of monitoring, ground water was found at 6 feet. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve "E"E&noWTEST areas or drainage patterns by the installation of the proposed septic s stem. The construction of this system will not prevent any future development on any of the adjacent properties. SITEPLANS If you require additional information, please contact us. Sincerely, ROADDESION fR�� �N� Obert C. Cowan, P.E. 500.1E5T RCC/bjj Enclosure PERCOLAMN ' TEST STRIACTLNMA WCIIMOM NSPECTIONS • ONSITE WASTEWATER D6POSALSISTEAI DEHIDN 17094 NORTH EAGLE RNER LOOP t SURE 204 • EAGLE RIVER, ALASKA 99577 .t t"- %i�'r =03 I�? e..�p A tLOL� 2'?i3 ,11`'%�•4 ' / fad= / / U O ( ( z c/o MSW obi MEom z,omro � N 5 / b0♦Oy � p�1� / ops J W I) O / Dy1. ` .x v/ o�9 / % a. V/ N / \ /QryOlJayy�>I.1lli/N• N • • dNlar / ... o J� U �, ��jeaE,osp 2 / ;z 040 PV�� / H o �St�NG GR / C2 z u O / LLJ v ^ cr / 02 W WW w UQN Ql~.. \\�� a / C1 W a V) 6 W / E- \ VI z v� v) 010 0 OROCL 0 3 m C7�uo C"-,0 of U Y w LS1 > Z W r i4.F g'Am' W .�.vLL> IL�1 o� ACL P I....i 1 / J Pn_ w Q1 p'POP W L)W U' O /� / o�� n I+JWpZ Ll Wz�LLI VO4 0IM NVId-3115 I NJIS30 I or = OF A!" MU111cipollly of Af1th&;jyd Cjfr0 GINEER' 8 E/ bevelopmchl tetvices beparlmetll bugling d IelyWas blvise*at on On-Slle 4700rSouthbr9gawSt. Plogram P.O. box 196650 Anchorage, Ak 99519-6650 Is ROBERT C. COWAN ww (907) 343-7904k L7 fC. - 8801 IIf�F� Salts Lt1d - VeFbolatla11'test Pedormed roe: // ��,j 1 �G /^�% ,/ balo Performed: /{J Legal Desalpllorl: -V Ra : /.SLOG/G 4 ; NO/t rw 5cclk- "�2• %/V Depth �/�ilf�N/GS 2- bale Gross Time Ilel Tlme .•. 14opf brop d- 5 S 7 O 0 oe -- 9- • • wA5 GRDUIID WATER tficomitnErn /V a 00 S 10- r IPYES.ATVJIIAfbEPtel7 L ��- 5" berth to water Altai0 E I,tonlloilnR7&3' 12• beleZ 13- 6,31e, 3 ' Tran F— heading bale Gross Time Ilel Tlme Depth to Water 14opf brop S O 0 oe -- 3a a S7 - err 3 OO 5" 3fl 30 6,31e, 3 ' PERCOIAtIO11RAlt _25V 1"-mesexhl FERC I IDLE DIAMETER ibsthUTbbtktll• l Pt AND —I't CoLII.Ithts hEhrohllEb bY: M 1 GHAd L �t CL -ARE. CERTlrY TIIAT 11115 TEST WAS Pthr01161ED IH ACCORDANCE WITH ALLSTATE ANO 1AUNICIbAL GUIDELINES IN EFFECT ON TI IIS bATE. BATE: i Performed For: 11- Legal Llegal bescrlption: �r beplll (reel) pl1GAl�/GS 6ftl Muldcipal►ty tit Alidwk;ige bevelopmetll Setvices beparlmetll bugding Safely blvfslon On -Silo Water end Waslewaler Program 4700 South bragaw St. P.O. box 19665o Anchorage, Ak 995196650 W%�.clBUj (907)343-7904 Stills Lbg - Pett:olatlott test WAS GROIIIID WAIER ND ENCOtIIITERED7 e IPYEs.ATvvNAlbEPt11T booth to Water Ahel AIon110,601, E bale: heading bale Gross lime Nel Tllne Depth to Water Nei Drop oEroA✓ /O O/ 0 O G IIZ" 4✓ O O rl .- 30 30 I ' ° S• 0 O 1 ,- -30 2D S• S" PEACOIAIIOFIRAIE ",,'7�I�"Ae~) iEsthUlhLtwEEll- -5- tT AND PERG11GlED1AMEIER C42- 11EhFOhl4Eb bY: II'J tL i' *yt' J CA,A-yLt l 1�7 f G7"a`� CERTIFY MAT 1111S TEST N1AS PEMORh1Eb IN AC CD )ANCE WITH ALL STATE AND MUNICIPAL CUID'ELINES IN EFFECT ON MIS bAlE. bAIE: I S & S\ ROBERTC.COWAN, PE. piieep 111G t10BERTA. SHAFER, P.E. CIVIL ENGINEERS (907)694-2979 SEWERS WATER FAX (907) 694-1211 INTERMITTANT DOSING SAND FILTER SPECIFICATIONS T1,AUR"a`TM W Lot 9B, Block 4, North Slope Subdivision #2 October 23, 2002 GENERAL STATEMENT OF WORK SEWERS WATER MWExTENSONS The work and plans covered by these specifications consist of furnishing all labor, materials, tools, transportation, and equipment necessary to complete an Intermittent Dosing Sand Filter system as described herein and on the attached drawings. BEWER6 WATER - SWECT" All work under this project shall comply with current Municipality of Anchorage (MOA) Regulations. `WR `Bf1D A 4 Bedroom House 600 GPD Bottomless Sand Filter and absorption area (360 S.F. required) Sand filter to be constructed on accepting soil With all organics removed. (bottomless only.) ' WEtLtrKCTKW • FLOW TEST SITE INVESTIGATION The Contractor must carefully examine the project documents, have full knowledge thereof, SITEPLAM have investigated the site, and be satisfied with the conditions affecting the work. Conditions include, but are not limited to those bearing upon transportation, disposal, handling and storage of materials, availability of labor, water, electric power, roads, and ra noESaN uncertainties of weather, physical conditions at the site including all underground utilities, the conformation and condition of the ground, the character of equipment and facilities needed preliminary to and during prosecution of the work. The Contractor must be satisfied SOUEST with the character, quality and quantity of surface and subsurface materials or obstacles to be encountered. Any failure by the Contractor to become acquainted with the available information will not relieve him/her from responsibility of performing the work as stated in these specifications and drawings. PERCUATKM TEST Location of utilities will be the contractor's responsibility. s1RucTUTAaa EcawArx NSPECTIOfA ONSITE WASTEWATER O6POSALSYSTEM OES*N 17034 NORTH EAGLE RIVER LOOP 4 SURE 204 • EAGLE RIVER. ALASKA 99577 Page 2 Lot 9B, Block 4, North Slope S/D 02 October 20, 2002 SEPTIC TANK / LIFT STATION /AIR COMPRESSOR A. General The work under this section consists of the performance of all operations pertaining to furnishing and installing the septic tank/lift station, air compressor and piping to the sand filter. B. Materials 1. Tank a. Septic tank shall be a two compartment tank of at least the minimum size indicated on the drawings and MOA approved. b. First compartment shall have a separate 4" pump -out riser. The second compartment shall have a separate 4" pump -out riser. 2. Manhole Riser or Lift Station Tank a. An additional second compartment manhole riser shall be capable of being equipped with the following: 1. A junction (Nema 4x) box or equal, bonded or attached to the pump basin. 2. UL listed electrical cord grips, installed in the J -box. b. An additional tank (M.O.A. approved) may be provided for the effluent pumping assembly and the items in (a.) above. 3. Effluent Pumping Assembly, Controls, Alarm & Piping a. Effluent pumping assembly shall be of approved materials, including the following: 1. A 110 volt or equal U.L. Listed effluent pump. 2. High-density PVC cylinder housing the pump, with level controls and screen, serving as a baffle to prevent the screen from clogging. Page 7 Lot 8B, Block 1, North Slope SID 92 October 20, 2002 3. All piping shall be PVC or other non -corroding material. b. Pump controls and alarm system shall be an approved system with the following options consisting of: 1. Event counter 2. Elapsed time meter 3. Program timer 4. 10 watt heater 5. Remote alarm panel option with a minimum of 80 DB sound pressure at 24", operating temperature 30AC to 65AC, continuous sound to be located in the home. 6. Oil -tight visual alarm with push -to -silence feature. Automatic audio -alarm reset. 7. 15 amp motor rated toggle switch, double pole, double throw with three positions; manual (man), automatic (auto) and center (off) (II.O.A.). 8. Nerna. 4x -rated, fiberglass, or equal, enclosure with hinged cover. 9. All controls to be installed as per manufacturer's recommendations. 10. Control panel to be installed on outside wall of home within sight of septic tank/lift station. c. Piping from the septic tank to the sand filter is to be 1 1/4" PVC schedule 40 solvent weld piping properly bedded as described in Materials Specifications and sloped to drain back to the lift station. Insulation board 2" thick and 2' wide centered over pipe is to be placed where soil cover is less than 4' depth over pipe. d. The air line from the house to the filter is to be HDPE arctic insulated pipe 3/4"-2" SDR - 11. The compressor will have a gauge (0-10 psi) and be installed in a heated area, crawl space, or garage. Page 4 Lot 9B, Block 4, North Slope SID 02 October 23, 2002 4. Air Compressor a. Air compressor shall be a THOMAS LINEAR SERIES model number 5060-A or 507OV-A or M.O.A. approved equal. CONSTRUCTION SEQUENCE In order to insure proper installation, the system is recommended to be installed in the following order: I. Sewer line from house to tank II. Septic tank/lift station III. Sand filter IV. Leachfield bed (if required) V. Final grading CONSTRUCTION 1. Construction Instruments Contractor shall provide instruments such as transits, or levels, for establishing proper elevations and levelness of pipe or materials. 2. Pipe Laying All pipe shall be laid with material free of large or sharp rocks and organic matter. Each section of pipe shall be handled carefully and placed accurately. The spigot end shall be fully inserted pointing in the direction of flow and glued in place to make a water tight seal. Each section of pipe shall be properly supported to insure true alignment and an invert which is smooth and free from roughness or irregularity. At all times, when work is not in progress, open ends of pipe and fittings shall be closed so that no undesirable substance will enter the end of the pipe or fittings. Pages Lot 8B, Block 4, North Slope SID i2 October 23, 2002 3. Bedding of Pipe for Sewer Lines The pipe should be bedded with materials free of large or sharp rocks and organic matter, compacted. Native materials may be used as back fill material above the pipe, provided it is free of large rocks and organic matter. All lift stations shall be installed in accordance with the manufacturees recommendations and standards. Electrical installation is to be in accordance with the National Electric Code (latest adopted edition) by a licensed electrical contractor, with M.O.A. inspection where required. If MOA inspection is not required, a licensed electrician is to provide a letter to the Engineer stating that the system meets or exceeds all applicable codes. 4. Excavation Excavate to proper depth to allow gravity flow, install tank level, tolerance 0.05 foot, on undisturbed or compacted classified sand fill material. Create a level sand surface over the tank and add 2" burial foam +35 PSI directly over tank. Mound unclassified soil over tank with a minimum of 2 feet of cover and anti -flotation weights that may be required in areas of shallow ground water. 5. Connections All connections to be as per MOA requirements, PVC 3034 piping with Caulder or equivalent couplings for inlet riser pipes. All tank connections are to be completely water tight. SAND FILTER The work under this section consists of the performance of all operations pertaining to furnishing and installing the sand filter. A. Materials 1. Sand Filter a. Liner (if required - not required for bottomless sand filter) - OSI Model LI or equivalent. 30 mil PVC cut and fabricated to provide water tight enclosure of filter sand volume. Seams to be permanent as per Manufacturer's recommendations. All connections, such as boot flanges, through sand filter to be permanently bonded to the liner. Page 9 Lot 9B, Block 4, North Slope SID 02 October 27, 2002 b. The Contractor shall provide a washed sand to meet ASTM C-33 Concrete Sand Specifications with the additional requirement that all but 1% of the materials passing the #100 sieve be removed. All sand shall be approved for use by the Municipality of Anchorage (M.O.A.). If the sample does not meet specifications, all sand will be removed and replaced. c. The Contractor shall be responsible for providing pea gravel that shall be a washed material containing no fines (0% passing the #100 sieve) and a maximum size of 1/4" diameter. d. The Contractor shall provide the manifold assembly. The manifold assembly shall be of approved materials with orifice shields and flushing assembly. All drilled holes to be cleaned of buns and pipes flushed, prior to assembly. Flushing valve to include riser to finish grade. Lateral distribution piping is to be laid level (@ t 0.05'). e. Side walls and top of the filter box to be insulated with 2" direct burial polystyrene insulation. f. The Contractor shall be responsible for providing filter fabric. g. Air coil in sand filter to be geoflow WF164-24 150 LF placed 6" above bottom of sand. Construction of Sand Filter The sand filter construction is to follow procedures as outlined below, as applicable to this design. Pea gravel and filter sand are to be hand leveled to proper depth (tolerance within 0.05 feet) in filter, taking care not to allow mud or fine soil material into the filter or gravel layer. This would include any soil material picked up by excavation machinery buckets while loading specified material. The Contractor should estimate filter material volumes such that allowance is made for wastage of material in contact with the ground at site. The area over the sand filter to be finish graded with a minimum of 2 feet of cover and to prevent ponding of surface water run off. Side slopes shall not exceed 3:1. The Engineer will reject any sand or pea gravel that does not meet specifications or is contaminated in transit or while handling. If such material is placed in the filter, all soil material may be required to be removed and replaced with new material. CONTRACTOR/INSTALLER MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050-511-09-000 Expiration Date: Legal description NORTH SLOPE #2 BLK 4 LT 9B Site address 30671 KUPARUK AVE Eagle River AK 99577 Current property owner(s) GERONDALE JACOB REVOCABLE LIVI X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for Comments or advisories: 0 6/9/2024 bedrooms, with the following stipulations: Original Certificate Date: 12/7/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval—June 2022 PUgUHMPAUTY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. - 050-511-09 Complete legal description North Slope #2 Block 4 Lot 9B Location (site address) 30671 Kuparuk Ave, Eagle River, AK 99577 Current property owner(s) Jacob Gerondale Living Trust Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: 0 Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ®❑ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel 0 Plastic ❑ Concrete ❑ Fiberglass Age 19 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑® AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $-9 5-0 Waiver Fee $ Date of Payment /��7 Date of Payment COSA # 05C 2-3 I L- 6 I Waiver # COSA Application—June 2022 North Slope #2 Block 4 Lot 9B 050-511-09 0.775 Forge Engineering 11/08/23 N/A N/A N/A Benjamin Schiller, P.E. (907) 522-7773 To: Page: 27 of 37 2023-06-26 19:56:18 GMT 19073086608 From: Wes Anderson 48.9 053 some 4 an 1111 Jones 119 man on of man 111 8 5 IN IN Is are 5. a 1111 a 9. ■ [`. Field Maintenance ReportAnchorage%n Annual Inspection 907-272-3543 Property Dw .v;'/Twkhlg N Operator 71 Jake Gerondale A+ Home Services Tech `<t4 A({(A(056 I �GaYIIaEt Pno(�9. ._ 30671 Kuparuk Avenue, Eagle River AK 99577 (907} 903-4113 j RX >nv dp.J ourSYfDa PntlN Roll BNLN Data of last II2sPectFon AX 104379 -- _jSW04037E 1203794 R'1 X103465 081291202?- ^ Retrieve O&M info Measure Sludge/Scum Daily fPaw_,.,_. Mudge Scrum . — i st compartment Current Previous Current Previous Recite ratio Timer.. ettangs. 2nd Compartment � Current.^� Previous Current Previous Inspect/Clean AdvanTex F€€ter.... Inspect clean Cow-, Normal lu Pungent LateralstC7afiaas ] fq Perform Field Sampling/Observations _ Biomak nformal L , Excessive Pod Bottom u (tsNTUT. pH { a} oD (z-s) h i Badging/Flondang None/Minor C' Exces5wo Intake Ve v. Inspect/Clean Discharge Dump System Odor of Snmpisn Inspect Inspect clean _, �t ,l J Typical l"'+;" tv?uaty Earthy Maidy �7 Riser/Gid Floats IE ! I 6pGeeOox. Pomp Non-typical �.'ul,tlfide Cabbage _Dar-ay Oily Tilm in Paid 's °n'! No Most cords ._, Foam in tank 4j Yes vlNo Inspect/Service Other System Components Inspect Clean Inspect Clean Check Control Panel Disinfection Esuipmant F1 I 1 Dispersal LateraWOrlfices iF Recw Amps pischarge Amps Additional Services Rendered Audible and. visual alarms QK t-_,I Qleaned Willie sheeT8? Ej Replaced uv items? Dial tone {telemetry only) �N yes -INo. L_]Rep7acatlfUsed other Items? harts Used: W = Warranty, 8 = Billable (/ appropriate selection) Inspect/Clean Pump System IN B Item Number Description Mspect Clean r— t Riser/Lid __ �_ .� ____.............,,...... SphCV BOX n,_ Floats ...:...,_. � .� Final/Safety Inspection Pnrnp_. ,............ .. .... Lti� �`l rRsurcrinstIt� _ [=.J Udo bolted or; Biotub©v Filter..., . E".; ts, Manifold roconnectedt final,.valves closed :L„ Control panel react dated -..... Seettabe Pump vault ....... �' !. f SummarydRecsmmendatlens Recirculating Splitter Valve. ... ... (r,? ', L."J System p rdformingi no further action needed Tank needs pumping L� Call#gr sorvico [j Other? Signatur+air Z/1' r"f -r — -___. _ _ __ __..._', ate Fax completed form to: 11-866-384--7404; MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this -3c, Day of _ of 20 Z S, by and between _A k s• t (co , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as ynnt ex located at (legal description) -North Slope 42 Rlock 4 T,nr 9B 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand aro initial each section) Throughout the term of this Agree n?,,:�t i -: Owner shall enter into a service agreement U with an AW WTS service and mair:.v i e : a:-ovider approved by the Municipality or the manufacturer's representative. T1:c A :a .VTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. �Lr It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). `.,- l -r Owner agrees that only maintenance and repair personnel approved by the Municipality 0 or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. L TOwner acknowledges that regular maintenance of an AW WTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 n f C� K Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. KT Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. �r Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 247 -hour notice. ` Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the goveming guidelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until tide is transferred, 4. Nonwaiver. The failure of the Munici.,36 i , MY time to enforce a provision of this Agreement shall in no way constitiiic a ,,f the provisions, nor in any way affect the validity of the Agreement or any part hoof, or the right of the Municipality thereafter to enforce every provision hereof. S. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction. Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shalt govem the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By: (signature) Date: —30 t004 2 3 Tc.,,(print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this .Z,.k day of /t/e:ve.�bc✓ 20 2 j' , by _ c;" W; I&c l "Official Seal" NOTARYTUBLIC FOR ALASKA �•-•� My Commission expires: o6/7_4r,./ZNotary Public a-- q- (�. —" 7 B. Wilson State of Alaska ia; s) Date: 03 ane) Title: 1 e�jrlp/ (rev. 05/18/2018) Page of 6A • Municipality of Anchorage On -Site Water and Wastewater Program n (907)343-7904 $, STY Certificate of On -Site Systems Approval Parcel I.D. 050-511-09 Expiration Date: -13 1. GENERAL INFORMATION Complete legal description North Slope #2 BIk4 U913 Location (site address) 30671 Kuparuk Ave., Eagle River AK. 99577 Current Property owner(s) Christian & Mary Meyers Day phone Mailing address P.O. Box 770910 Eagle River Ak. 99577 Real Estate Agent 2. TYPE OF DWELLING: Q Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual ID Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee Date of Payment Receipt Number COSA # O s (�-- 121 �Z o W Date: Waiver Fee $ _ Date of Payment Receipt Number, Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Address Phone X71;1 - SC3 1 B Engineer's Printed Name 5i-CAleAA tp_ Vag-mnn:° Date 6. DSD SIGNATURE System #1 Approved for _�_, bedrooms System #2 Approved for bedrooms Disapproved I ziol q Conditional approval for bedrooms, with the following stipulations: By: Original Certificate Date:/ O _2 3"! 2— Theici lily of orage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Septic System Advisory Well Flow Advisory CASA blue sheet r - %, c Nitrate Advisory Arsenic Advisory Other Pannone Engineering Services uc Steven R. Pannone, Principal Registered Professional Engineer E-mail: stevegrianen¢ak.com October 22, 2012 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street Anchorage, Alaska 99519 Subject: North Slope #2 Blk4 Lt9B Revision to COSA Approval Ladies and Gentlemen: I am writing to request that the COSA approval for this property be revised from three bedrooms to four bedrooms. The system was approved for four bedrooms in 2008. PES tested the system in August of 2012. We introduced 484 gallons over a 110 minute period. The water levels in the field were dry when we started the test and remained dry during the entire test. Using the procedure established by Lee Reid, P.E. report "test of Insitu Septic Systems" one can plot the absorption rate verses time on a log scale to obtain the daily absorption rate. When plotted on this scale one can easily see that the required 600 gallons will be absorbed in less than 140 minutes, well below the required 1440 minutes. The actual absorption rate was measured to be 4.4 gallons per minute (136 minutes to absorb 600 gallons). Therefore I request the system be approved for four bedrooms. By granting this approval, the health and safety of this lot or the surrounding lots will not be compromised. Please call if you have any questions. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Attachments: Revised COSA Paper Work Mailing: P.O. Rax 3.00217, Anchorage, AK 99590-023.7 Physical: 332 1/2 East (Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Municipality of Development Servic Building Safety Division On -Site Water and 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 FOR A SINGLE FAMILY DWELLING Parcel I.D. oro-cis-oq COSA # O`JQ PILi0% Expiration Date:— J— / 1. GENERAL INFORMATION Complete legal description North Slope #a BIk4 LtgB Location (site address) :to671KuparukAve, Eagle RiverAk ggrn Current Property owner(s) Christian & Mary Meyers Day phone Mailing address Lending agency Mailing address Real Estate Agent P.O. Box77ogio Eagle River Ak. ggm Day phone Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of 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 sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 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 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 Pannone Engineering Services, LLC Phone 272-8228 Address P.O. Box 3.0023.7, Anchorage AK 49S3.o Engineer's Printed Name _Steven R. Pannone P.E. Date/0 Q'© { Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. ., '„%Vkjj, The operational life of all wells and septic systems depend on the local soil condition, ground water �����OF q� ��♦♦ levels that may fluctuate during the year, and the water usage of the family being served by the system. P,.................. 1♦♦ These conditions are outside the control of the evaluator of this system. All systems eventually fail and Ce '•'� satisfactory test results do not guarantee future performance of the system, nor do they guarantee that ° r c-. ♦♦j there are no hidden defects or encroachments. PES can therefore not provide any warranty for future 00.....N•••• •• •••• • •• ••�•••••� performance nor give any estimate of how long the system will continue to meet the opemtional 0i requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed 5 Steven R Pan none; above. Any reliance upon or use of this report by any other person or parry is not authorized nor will it ♦1♦ s'•. N o. CE 8149 confer any legal right whatsoever. ♦j . 01 5. DSD SIGNATURE ♦♦�����OOO���;��.•�� Approved for bedrooms. LZ Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: xv Original Certificate Date: 0 (Rev. 711 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 Legal Description: North Slope #2 Blk4 Lt9B Parcel ID: oro-cll-og A. WELL DATA Well type Private Date completed 4,/28/200-4 Total depth iib ft. Date of test Static water level Well production If A, B, or C provide PWSID # Sanitary seal (YIN) Y_ Cased to iib ft. FROM WELL LOG 4/28/2o03 WATER SAMPLE RESULTS: Coliform _&kl) colonies/100 mL ft. 9 -P.M. Nitrate 17.53'ng/L Well Log (Y/N) Wires properly protected (YIN) Y Casing height (above ground) 25 in. AT INSPECTION 8/2;/2022 ft. 4.4 g.p.m. Arsenic: 4. ug/I Date of sample: �� I� Collected by: 1C, B. SEPTIC/HOLDING TANK DATA Tank Type/Material Steel Date installed 10/1/2oo4 Tank size iroo gal. Number of Compartments 2 Cleanouts (Y/N) Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) Y Date of pumping 8/28/202.2 Pumper JRs Pumping C. ABSORPTION FIELD DATA Date installed 10/1/2012 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.25 apd/sf System type Bed* Length 5o ft. Width ft. Gravel below pipe o.s ft. Total depth 3 ft. Eff. absorption area 500 ft2 Monitoring tube Y Depression over field N Date of adequacy test 8/22/2012 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test o in. Water added48 gal. New deptho in. Elapsed Time:lio min. Final fluid depth o in. Absorption rate >= 4ro+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed iohho% "Pump on" level ato3 2S** in. Datum BottomofTank E. SEPARATION DISTANCES Size in gallons 25oo Manhole/Access (Y/N) "Pump off' level at 20.25** in. High water alarm level at 4,6 in. Cycles tested 2 Meets alarm & circuit requirements? Y SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot ioo+ Absorption field on lot ioo+ Public sewer main 75+ Sewer /septic service line 25+ Animal containment areas -ioo+ On adjacent lots ioo+ On adjacent lots ioo+ Public sewer manhole/cleanout ioo+ Holding tank ioo+ Manure/animal excrete storage areas Zoo+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line -5± Absorption field s+ Water main 20+ Water service line zo+ Surface water 200+ Wells on adjacent lots ioo+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line io+ Building foundation 2o+ Water main 20+ Water Service line io+ Surface water ioo+ Driveway, parking/vehicle storage io+ Curtain drain 5o+ Wells on adjacent lots Zoo+ F. COMMENTS G. ENGINEER'S CERTIFICATION l certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone, P.E. Date 1n %2d ?0 K COSA Fee $ Z tCi p Waiver Fee $ _ Date of Payment Q l J 112L Lb!?�= Date of Payment Receipt Number ® 3y So I� Receipt Number (Rev. 11105) usc-\aL%gt o M ren R. Pann, No. CE 8149 G ASBUILT SEWARD &ASSOCIATES LANA SURVEYING 69 I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE - FOLLOWING DESCRIBED PROPERTY OF AI � DATL= .... . R AND THAT NO ENCROACHMENTS E3CIST EXC6� AS t INDICATED. IT IS THE RESPONSIBILITY OF THE � ; ` :` rH� OWNER TO DETERMINE THE EXISTENCE OF ANY GRID " •_•�• EASEMENTS, COVENANTS, OR RESTRICTIONS a' WHICH DO NOT APPEAR ON THE RECORDED SU BDIT -� VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD �� o ��a n�t4 awor FB f/ ! 4 5.'. LS—� s m ANY DATA HEREON BE USED FOR CONSTRUCTION OFFENCE LINES, OR FOR ESTABLISHING BOUND— ARYDRAWN., LINES,r� , FROM - T -409 P.001/005 F -T56 ADVANCED WAMWATER TREATMENT SVSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN MUNICIPALITY OF ANCHORAGE AND_�acob Gerat,slole THIS MEMORANDUM Or UNDERSTANDING made and entered into as of this 5 Dayof�O 4o6er of2il-Llibyand between Jamb Gara�cl�tC. herein the "OWNER., and the Municipality of Anchorage, herein the "MUNTCIPALITY" In consideration of the mutual covenants contained herein, the panics to this Memorandum of 7 Tndetstanding agree as follows: I. ADVANCED WASTEWATER TREATMENT SYSTBMS. Municipality grants permission to Owner tm utilize and opcmte an Advanced Wastewater Treatment System (AWWTS),described as_(3t 034111Tex locuted at /L%M-CH SLvPE ZIU< tj,_ 4-4Y yQ , Anchorage, Alaska. 2. Definitions. A. Alterution. Any change to rhe design or function of an AW WTS that Includes the installation or removal of any pans, components or pieces not included in the. original construction permit and design. Prior to performing any alterations to an AW WTS the owner must obtain a Wastewaicr Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65. 9. Certificate of Onsite Systems A,pprovaL 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 AMC 15.65. FROM- T-409 P.002A05 F-756 These approvals certify that dte systems are adequate for the homes that they support and meet the codes that were in place at die time. of system construction. C. Dalnuge. Any man-made or natural change in a system that would inhibit the system from performing as designed, D. Maintenance and Repair. The scheduled and as needed replacement or existing paras, components and pieces of an AWWTS that werc included in the original design which would allow the AW WTS to continue to perform as designed. B. Permit (Construction) An On -Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. P. Permit (Operating) AnAdvnnccdWastewater Treatment System Operating permit. An annual permit, issued by the Municipality, that allows the Owner to operate an AW WTS, upon meeting all the tcquiromenls of this agreement, the conditions of Opurating Permit, the requirements of the On -She Wastewater System Construction Permit and all relevant provisions of AMC 15.65 I Fee. Owner shall pay to Municipality an annual fee of"'2.tF4O— ($ D .00), payable on or before the issuance orthe operating permit and annually dwreafter. The annual fee is due on or before the anniversary date of the approval by the Municipality of installed system. 4. Term. The farm of this Memorandum of Undernnnding shall be for the life of tlic AW WTS. FROM- T-409 P.003/005 F-750 The term begins an the date of approval by the Municipatity orthc installed system and shall continue while the A W WTS system is in use or operational or until the property is sold or title is transferred by owner and a new certiFcate of on -Site approval is issued to the new owner or transferee of the property. 5. Allcrattvos.lnslatla(jon ylid Removal of Additions) Equipment, Owner agrees not to make any alterations, removal of pans or additions to the AW WTS without a Construction Permit from the Municipality. 6. Mainlennncc and Repairs. A. Throughout the term orthis Memorandum of Understanding, the Owner shall maintain A WWTS in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memomudum of Understanding, and any extensions or renewals thereof, at die owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) impecdan costs. Further, Owner agrees to compiv will all applicable ordinance, laws, regulations, rules and orders for the AW WTS. 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 AW WTS Operadng 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 A W WTS Operating Permit is: qS ('�GtrJ� KED C. Owner acknowledges that the fine schedule for failing to maintnin and repair an AWWT5 are codified in AMC 14.60. FROM- T-409 P. 004/005 F-756 D. Owner agrees that only maintenance, repair personnel certified 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 inspucl the AW WTS upon 24 hours written notice. P. 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 AW WTS is the guveming professional guidelines for the aonstmorion, maintenance and repair of the Owner's A W WTS. 7. Nonwatver. 'lhc failure of tither parry 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 effect the validity of the Memorandum of Understanding or any part hereof, or the right of such parry thareafierto enforce each and every provision hereof. S. Ame dt�}u tilt. A_ This Memorandum of Understanding shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same rbnnality of this Memorandum of Understanding was executed and such writing shall be attached to this Memorandum of Understanding as an amendment. B. for the purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized rcptesentatives of the parties arc: FROM - T-400 P.005/005 F-755 Owner: Jgr_cb Anchorage: Purgjm • i er C. Any attempt to amend, modify, or change this contract by either an unauthorized represemative or unauthorized menns shall be void. 9.3nrisdiction: Choice of Law Any civil action arising from this Memorandum of Understanding shall he brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The taws of the Stoic of Alaska shall govern the rights and ubligatioas of the parties under this Memorandum of Understanding. 10. Severability. Any provisions of this Memorandum of Understanding dccrpcd invalid by a court ofcompetent jurisdiction shall not invalidate the rcmaining provisions of the Mernoraodum of Understanding. ;Yate. �— STATE OF ALASKA THIRD JUDICIAL DISTRICT The by M MCIPALITY: By. Title: Date: ss. I before me this J day of NOTARY PpWiC FOWAVASKA My Commisy,ton expires: s � I day yiyo3 ��'°' �rh,� ........ p5'at�y� \ Municipality of Anchorage o i !�7��!jpppj}��j777yyy�� Developmont Services Department = `; Building Safety Division ;. On -Site Water & Wastewater Program 4700 Bragaw Street L) P.O. Box 196650/� �✓� v Anchorage. AK 99519-6650 l ' www.muni.org/onsiteonsite ' (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. m - 51 �- COSA# 1. GENERAL INFORMATION Expiration Date: I D -.2 - O g Complete legal description NORTH SLOPE SUBDIVISION #2• LOT 96 BLOCK 4 Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address 30671 KUPARUK AVENUE • EAGLE RIVER AK • 99577 RAYMOND BAILEY Day phone 622-4088 30671 KUPARUK AVENUE • EAGLE RIVER, AK • 99577 Day phone EVA LOKEN Day phone 689-6479 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site N 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 Oh -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 Engineers Printed Name JEFFREY A. GARNESS. P.E. Date 24a ? /fl 7? 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 & 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 ofall 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 solo 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 V_ bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineers Reort Other 711 / ag'�cq``o�v 0 jDro tesslo" '400o��tU,r'!r Y %\``\` P��ZOF,gN'crS �G . •� •� O'er J`�:• ••ON-SITE.•••��c_ WATER AND ; m- WASTEWATER PROGRAM ' o• • • �` BY Original Certificate Date: -7-,2-9-os )Rev 11/05) 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 Legal Description: NORTH SLOPE SUBDIVISION #2; LOT 9B, BLOCK 4 Parcel ID: 0 6'0 �0 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (YIN) YES Date completed 4/28/2003 Sanitary seal (YIN) YES Wires property protected (YIN) YES Total!depth 116 ft. Cased to 116 ft. Casing height (above ground) I x+ in. FROM WELL LOG AT INSPECTION Date of test 4/28/2003 7/11/2008 Static water level 87 ft. 89 ft• Weil production 10 g.p.m. 5.8 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mt. Nitrate 0.648 mg./L. Other bacteria 0_colonies/100 ml. Arsenic: 0 ug./L. Date of sample: 7/2/2008 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material ADVANTEX/STEEL Date installed 9/29-10/l/2004 Tank size 1500 gal. Number of Compartments 2 Cleanouts (YIN) YES Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) YES Date of pumping AS REQUIRED Pumper A+ HOME SERVICES C. ABSORPTION FIELD DATA BELOW EXISTING GRAME Date installed 9/29-10/1/2004 Soil rating .p.d./ 'or ft'/bdrm)11.25 System type TRENCH Length 50 ft. Width 10 ft. Gravel below pipe 0.5 ft. Total depth'2.25-3.25 ft. Eff. absorption area 500 ft' Monitoring tube YES Depression over field NO Date of adequacy test 7/11/2008 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test DRY in. Water added6� 00 gal. New depth DRY in. Elapsed Time: 0 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 - D. LIFT STATION •MAINTAINENCE INSPECTIONS PERFORMED BY ANCHORAGE TANK. Date installed 9/29-10/1/04 Size in gallons 1500 Manhole/Access (Y/N) YES TIME TIMER/ 46/ "Pump on" level at 30.25 in. "Pump oft" level at 20.25 in. High water alarm level at 34.775 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 N/A Sewer /septic service line 25'+ Public sewer manhole/cleanout N/A Holding tank N/A 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 * T %� review of Municipal records that the above systems are in 0 """' .99. ' . conformance with MOA COSA guidelines in effect on this Vol date.......... ...:... J re G ess: Engineer's Printed Name JEFFREY A. GARNESS QQ �, CE -7953 e� Date :7.12 110 e•.71Z1�V8co`�o i COSA Fee Waiver Fee $ Date of Payment as Date of Payment Receipt Number _ �h i Receipt Number (Rev. 11105) ASBUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: AND THAT NO ENCROACHMENTS EXIST ExctP7 AS INDICATED. IT IS THE _ RESPONSIMLITY OF THE OWNER TO DETERMINE THS EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONsrRUCTION OFFENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. SCALEi iii//O � oma\\\t1 pF A DATE. .'dkp .•• 'fL GRID .. ..... f t Dro M..L !r o.d FB f •. ts- 910 � a D AWN: SCS ReLM 1083169001 Client Name Gamcss Engineering Group, Ltd. Project Name/N North Slope #2 L9B B4 Client Sample ID North Slope #2 L9B B4 Matrix Drinking Water P1% SID 0 All Dates/Times are Alaska Standard Time Printed DatdFime 07/10/2008 13:42 Collected Date/Time 07/02/2008 9:30 Received Date/Time 07/02/2008 12:20 Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis pwamnn Results PQL Units Method Container ID Limits Date Date Init Metals by ICP/MS EP200.8 Arsenic ND 5.00 Waters Department NRB Total Nitratc/Nitritc-N 0.648 0.100 Microbiology Laboratory (<10) Colony Count 0 Total Coliform 0 Fecal Coliform 0 ug/L EP200.8 C (<10) 07/07/08 07/09/08 NRB mg/L SM20450ONO3-F B (<10) 07/03/08 1DZ coV100mL SN1209222B A (<200) col/100mL SM209222B A (<I) coV100mL S%1209222B A (<I) 07/02/08 DLC 07/02/08 DLC 07/02/08 DLC ■ ■ ■'■ From:ANCH TANK & WELDING INC 277 3715 ■ wn ■■ ■0 JL1L-18-2008 10:068 FROM: wee ■■ ■ ■■ wool ■ on ■ ■iii anummu■ ■ now Field Maintenance Report Inspection 07/18/2008 10:23 11421 P.001/001 70:16663847434 P:Sr1 101 391 ■■■ ■ no was ■ am ■ an ■ ■ =o AnchorageTank & Welding, Inc. 907-272-3543 Reties O&M Into Duey flow — It.0-v ratio Tkner senrgs Recirc Off Cycle Time -12.7/min Recire on Cycle Time . 0.5/min Perform Field Sampl'ntg/Obsert ations I" V Sit tnus) I pct W% I DO R�1 I Ill J t Odur of Sample. _/ Tip" umusty Erisrt+y ❑Mph' Nnn.tYv" ❑Sumde pGbb490 ❑DaeaY aiv nim n pvu LYas c3mo seen In tank ❑ Y.a c4fr- Cheek Control Panel Pecko Amps D'sdho9e Amps Ray & Marsha Bailey 1 G.0 sn. oar... 30671 Kuparuk Avenue, Eagle River, AK 99577 907.622-4088 axs..roa C'. "o• .da arv.nn_• sha> o+. AX -104379 050-511.09 203794 RTU103465 1012512004 Reties O&M Into Duey flow — It.0-v ratio Tkner senrgs Recirc Off Cycle Time -12.7/min Recire on Cycle Time . 0.5/min Perform Field Sampl'ntg/Obsert ations I" V Sit tnus) I pct W% I DO R�1 I Ill J t Odur of Sample. _/ Tip" umusty Erisrt+y ❑Mph' Nnn.tYv" ❑Sumde pGbb490 ❑DaeaY aiv nim n pvu LYas c3mo seen In tank ❑ Y.a c4fr- Cheek Control Panel Pecko Amps D'sdho9e Amps 1;t--3 1 G.0 P.e.iew Audlele and vlail siorme VrOK pmvleus Dial ton.p i"Mrry oM1 ❑res All. Inspeet/Clreen Pump System Sum mary/Rcoomtnondaliona tnOPW Clem IUaer/lie .................... L� C� Sir" [112x .... ...... .......... Float cord*...................P" pleats ....................... ❑ el Pump ........................❑ 13, a;ealbeputs.................. ❑ 11'1 B&Mbe Pump vau t ............ ❑ LJ elating 5plinervaW....... Rdra ❑ M Canments Measure Sludpa/Scum sk.a.. scum ._.A. 112 Compa.tm...l Current PreMeua Cunem L P.e.iew and Companm.nt Current pmvleus Cunom Previous InspeWClean AdvanTea Fitter Odor. LC�j �N'-nat" ❑pNgam Biomet t�tvorn�ra_l�6> � ❑EXCOSSNe andglrlgrPdndhF L4*5*❑Exca,o" Inapect/Clasn Discharge Pump Syatem kar�p�ae�ct IttaaNUd Lsplco sox Cr1..1 Flom mrda 131 Inspect/Service Other System Components Irneoact Gaon Clsln'm4on EQuiprmm ❑ U cbt.xval" _ - btspect Clean lat.reld"ora ❑ a -,Pod Bottom ❑ Ur ke Intavent �,' 13 kepect dun Floats ❑ C Pump ❑ 3opT leact Clean Dispersal ImerwaorMoas ❑ ❑ Additional Services Rendered ❑ Geanea taw" ahaawp ❑neple"d Warm? n Floplaood/Used other Ham? Flnat/Satety Inspection ❑ RSV ralradas.d ❑ Udo boned on C-1 MaNlom racanrret94 aped Yswee ekMed n COr t Dl parol reset urea Sum mary/Rcoomtnondaliona ❑1leatmenl syslamkpsrlannimy ❑Gallia aM'ide no "her aoapn mo«.an 11Tars. asvda pur^Wrg n odes. Eianatu7 . _ Date -7-/-of ra: completed form to 1-866-384-7404 Page 1 of 1 Sonja Garness From: apw@gci.net on behalf of Jim Sullivan [apw@gci.netj Sent: Monday, July 21, 2008 6:59 PM To: Sonja Garness Subject: 1-964 North Slope Sonja I extended well casing on this property, It is 18" above grade with MOA seal and conduit Thanks Jim Sullivan, CPI Arctic Pump & Well, Inc. PO Box 770197 Eagle River, AK 99577 (907) 688-2510 (907) 258-2510 (907) 745-2510 7/22/2008 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.d.anchorage.ek.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D. 650 _ 51 �_ 09 HAA# _ MD 159 1. GENERAL INFORMATION Expiration Date: :z Z� 0 Jr Complete legal description NORTH SLOPE SUBDMSION J9. LOT 9B BLOCK 4 Individual Water Storage ❑ Individual Holding tank Location (site address or directions) 30671 KUPARUK AVENUE • EAGLE RIVER AK 99577 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address RAYMOND BAILEY Dayphone 622-4088 P.O. BOX 772594 + EAGLE RIVER AK 99577 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 Day phone Day phone 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Welt ❑ 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 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. Address 3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE, AK 99507 Engineers 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 d 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 softs 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 tight whatsoever. 5. DSD SIGNATURE Approved for 4 bedrooms. Disapproved. Conditional approval for Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Phone 337-6179 Date 110)055- bedrooms, 0 oS bedrooms, with the following stipulations: Maintenance Agreements Supplemental Engineers Report Other gy 'e.�% 1� po-L u Original Certificate Date: ta... 12Jo,f Municipality of Anchorage ' Development Services Department Building Safety Division e' Onsite Water & Wastewater Program : • " 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-650 www.cl.anahorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: NORTH SLOPE SUBDIVISION ft LOT 98 BLOCK 4.- Parcel ID: 050-511-09 A. WELL DATA Well hype PRIVATE If A. B, or C provide PWSID# N/A Well Log (YM) YES Date completed 4/28/2003 Sanitary seat (YM) YES Wires property protected (YIN) YES Total depth 116 ft. Cased to 116 ft. Casing height (above ground) 18+ in. FROM WELL LOG AT INSPECTION Date of test 4/28/2003 Static water level 87 Well production 10 g,p,m, g.p.m. WATER SAMPLE RESULTS: ColBorm 0 cotonies/100 ml. Nitrate 0.59 mgA. Other bacteria 0 colonies/100 rrd. Arsenic: N/A mgJL. Date of sample: 3/31/2004 Collectedby:GEG. LtD. _ B. SEPTIC/HOLDING TANK DATA TankTypeJMaterial 3/16' POLY COATED STEEL Date Installed 9/29-10/1/2004 Tank size 1500 gat, Number of Compartments 2 Cleanouts (YM) YES Foundation cleanout (YIN) YES Depression over tank (YM) NO High water alarm (YM) YES Date of pumping NEIN Pumper C. ABSORPTION FIELD DATA Date installed 9/29-10/11/04 Soil rating ft.p.d fthbdrm)1.25 System type TRENCH Length 50 ft. Width 10 ft. Gravel below pipe 0.5 ft. Total depth 02.6"Aaft. Eft. absorption area520 rt' Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pasa/Fall) - For 4 bedrooms Fluid depth in absorption field before test = in. Water added =gad. New depth =1n. Elapsed Tana: = min. Final fluid depth = in. Absorption rate >_ - g.p.d. Any rejuvenaUon treatment (past 12 mo.) (YM & type) - If yes, give date - D. LIFT STATION Date installed /29-10//1/04 Size in gallons 1500 Manhole/Access (Y/N) YES "Pump on" level at 19—.250. "Pump off" level at20._Y5jn. High water alarm level at 34 75 in. Datum BOTTOM OF TANK Cycles tested NEW Meets alarm & circuit requirements? '� E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankA)ft station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service Une 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTICIHOLDING 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: Party line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkinghrehicle storage 10'+ Curtain drain 50+ Wells on adjacent lots 10(y+ F. COMMENTS G. ENGINEER'S CERTIFICATION 1 car* that 1 have determined through field inspections and review of Municipal records that the above Systems ere In conformance with MOA HAA guidelines in effect on this date. J Engineer's Printed N JEFFREY A. GARNESS Date HAA Fee S % 60 Waiver Fee S Date of Payment Date of Payment Receipt Number I Receipt Number Mov. 12101) 4- 6-05: 5:27PMt �CS RcLM 1051705003 tient Name Garness Engineering Group, Ltd. 'roleetName/# Various ;Gent Sample iD N Slope S/D #2 Lot 9B Blk 4 4atrlx Drinking Water ample Remarks: :907 5616301 All Datesffimes are Alaska Standard Time Printed Date/Time 04/06/2005 8S7 Corrected Date/l2me 03/31/2005 1725 Received Datefrlme 04/01/2005 10:17 Technical Director Stephen C. Ede ■ 4/ 6 Allowable Ptep Analysis l`ame`r Results PQL Units Mabod CootainerID tlmits Datc Date 41it raters Department Nitrate -N 0.590 0.100 Licrobiolocty Laboratory Total Coliform 0 mg/L EPA 300.0 B (o—)0) 04/01/05 CAM col/IOOmL SM209222B A (<-l) 04/01/05 TIF APR -18-2005 06:58 AM RAVENWOOD 907 742 3260 P.02/02 KVr: eek Ave. I hereby certifyy dw IRhavee &urveyid the focowing'deaWbed , / _ �.�k � OF At'a'hl s ia.t 3L T ItFN ditE, 1�iid; ;` ,y' "•y'�•l:i-'i, Atuhonge Recoedfnd Ptetlm. Alaska, ind Net the Improve- . centssituat" erc wA an are wYhin.tlle property fines and'do npt a_ m.rfap of erxso.ch on the psopVM 4 g edlacent thereto, that. . „ N no Icprover ear on property. iyk�t ad►etettt thereto encroach Ono the preerias in 9u'en°n Ord tfwt there ae no roadways, i - eranamiwion une.or other visible eaernenb on said property . a . t, eecept a b,dlcated heteoer. k. f:O. EE:S• '' � Dated at Fiek River, Aleeka i .•.t+; t 'r:' • this /� 2T of. ROBERT CJOHNSON ey trt,.�.^.�► SCACIi:Amps redYand.SurveyorNS_RBO-LS _ Box 77-04%;1Emgle•River, Alaska 9"77 • Phonr(907jd94,�343 ,