HomeMy WebLinkAboutFOX HILL BLK 2 LT 5Fox Hill
Block 2
Lot 5
#051-073-14
u
Municipality of Anchorage Page 1 of 3
Development Services Department
Onsite Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 995196650 '
www ci anchorage ak.us (907) 3437904 '
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. SWO40254
PID Number. 051-073-111
rtat r
Rand Hamilton
Wastewater System: New
Ad
21800 Woodcliff Dr. Chu iak. AK 99567
ABSORPTION FIELD
P1me
""0a a1Bsba""'
Raised Bed
349-0991
Five 5
LEGAL DESCRIPTION
Sd R.ap
Tar Dept avn onanr voce
1.5 ci,(we
.5 Ft.
BIoaL Lat SuE swi
Dsgn b pye Oollan hprtt wqw led.
Cn dem eatratn pipe
2 5
Fox Hill
0 Ft.
.5 FL
TO-WW Rope
SxJ :
Fe added eCo.e onarW pec•
r•wat LNVM
3-5 Ft.
50 Ft.
Well: New
Ge.at.nam
15
to •limo
3
Dlatuceeatreen
1 5
Ft.
FL
cwatM1raean tPm.t•, A B, C).
Tar Depot
Coed n
Tar oo.vpt m err
Pp. Atatoai
Private
123
Ft. 123 FL
750 Fle
ASTM 3034 PVC
D~
Sullivan Water Wells 17/29/04
Date DN
Swim water Le.r
68
Ystauer
WrR Services
Date Yutrlr.
1 9/26-29/04
FL
YWc
Puny set ot.
c.V A C."
TANK
30 nm
Ft.
2 Ft
SEPARATION DISTANCES
Advantex Treatment System
To
Septic
AEsorption
Lift
Holding
lubiwPitivate
' or
'T^
From
Tank
Field
Station
Tank
sewerune
Anchorage Tank
1 2,000
wr
>100'
>100'
N/A
N/A
>25'
Steel
Two (2� j�
solace Wrr
>100'
>100'
N/A
N/A
LIFT STATION
Law
>5'
>10'
N/A
N/A
Sao
.auw
Ca,
Fa.natan
>5'
>10'
N/A
N/A
•P"'4 b.atr
•P""p°'r ""°'r
RpP erx elatmr
in
b
in.
>20'
>2D'
pi r Awe& AbOet
Er bwemvq pwf.,.�.d by
Cutan orate
Ed's Electric
Gravi ow m 'iter o Absorption Bed.
BENCH MARK
Loran atn i
Concrete Upper Deck Support. Third From
South.
'Aormed Ebvrrm.
100.0 FL
Engineer's Stamp
f',414
9:h.. ��••�
;.fir,
Inspectors performed by: AH
dates: 1" 9/26/04
i rx�CX
ot VNAE. RS04 1
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Department of Health and Humatin Services approval
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Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 Bragaw Street Anchorage, AK. 99519-6655 - 343-79D4
On -Site Wastewater Disposal System or Well Inspection Report
Permit No.: SW040254
u I�
ADVANTEX
TANK
Page 3 of 3
PID No. 051-073-11
PROFILE AS -BUILT
Scale: NONE
77.2
+ 49th
ANXRSQI
"fifteb-Lttl�
by
Doc Co. %a
SULLIVAN WATER WELLS
Ro. BOX 670272, CNUGIAK, AMSKA 99567
OWNER OF
F94
DATE: �t &
PERWMIf NL*Aa 1 ate of LesE,e - -G�i
TAX OJEty MCAS117N 941AMER: -aO�-
is "I W48d at approved twit kxaWn? i0g a No
Method of trolling: &9fMtWY i.t cable coot
Depth of,+ 1r 3 -
Cas+o9 TYOB �l7wan Tt1iClmeSs - ---' d 5' inches
tinerType: -
04ing Stickup Above Ground: gL - -
StafiC Water Levu s, few
MmmFtate- qPM
Moat -re 1414- ..
TMI
't4-
TMI Intake Opening TYpe:�r>en and U open hole
sc+�ertsd: sea=t teat stupl� teat
s�� siert --ftp
�� '►�`°pped
nepttr.from to &60
YMI Dish ed Upon Cornpiofian- 4PK-, QM
Commenim
D
UTE"ON: it is the responsibility of the property owner to submit a COPY of the well log to the proper authority. Muroc"I
-if AnchornOW Depertmw* of Hem ,& Duman Sevvtcea and ar Department of Environmental Conservation. MetSu Bcrougl
3epartment of Environmental Conse"tkm.
EDS ELECTRIC INC 907 2272 4590 11!07!05 07:38pm P. 001
ED'S ELECTRIC INC.
-_:- - P.O. BOX 210767
ANCHORAGE, AK 99521
NOVEMBER 4, 2005
TO WHOM IT MAY CONCERN:
SUBJ: SEPTIC LIFT STATION, BLK 5 - SUB. FOXHILL,
2180 WOOD CLIFF DRIVE, PETERS CREEK
ANCHORAGE
(907)272-4591
Fax: (907) 272-4590
ED'S ELECTRIC, INC. INSTALLED CONTROL PANEL AND FINAL
TERMINATIONS ON SUBJECT PROJECT TO THE CODE REQUIREMENTS
OF THE NATIONAL ELECTRICAL CODE AND THE MUNINCIPALITY OF
ANCHORAGE.
NOTE: UNDERGROUND WIRING INSTALLED BY OTHER'S
THANK YOU,
DWAYNE R BRUNS
ED'S ELECTRIC, INC.
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519.6650
(907) 343-7904
17p
29 100
oil
ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Initial
Date Issued: Jul 12, 2004
Expiration Date: Jul 12, 2005
Permit Number: SW040264 Parcel ID: 051-073-a
Legal Description: tFOX HILLSUBDIVISION BLOCK 2 LOT 5 r
Design Engineer: 0014 Anderson Engineering
Owner Name: WT. SERVICES, LLP
Owner Address: 21800 WOODCLIFF DRIVE
ANCHORAGE, AK 99518 -
Site Address: 21800 WOODCLIFF DRIVE
Lot Size: 40000 SO. FT.
Total Bedrooms: 5 Permit Bedrooms: 5
This permit Is for the construction of.
❑✓ Disposal Field Q✓ Septic Tank ❑ Holding Tank [] Privy 0 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.
Date:
Issued By. 1J l Date: r z �o y
Municipality of Anchorage
• Development Services Department
Building Safety Division
Onsite 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
u �-0=13-11
Parcel I.D. 1
Number SW
Property owner(s) W T Services, LLP Day phone 242.0684
Mailing address (1) 431 E. 4P Avenue Anchoraae AK99503
a." address (2) 2180D ltlk&te ! ,11U&_f_ Zip Code
Legal description (Lot, Block & Sub'd.) - Lot 5. Block 2. Fox Hill Subdivision
Legal description (Section, Township & Range)
Lot Size qy, pop Acr /Sq.Ft.
THIS APPLICATION IS FOR:
Number of Bedrooms Five (5)
Sewer Only ❑ Well Only ❑
Sewer and Well ® Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit Fees:
Date of Payment
Receipt Number.
(Rev. 12/00)
Waiver Fees:
Date of Payment:
Receipt Number.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-9779 rFAY►
June 29, 2004
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 5, Block 2, Fox Hills Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer.
The owner of Lot 5, Block 2, Fox Hills Subdivision intends to construct a new five -
bedroom home on the lot. We are therefore requesting a permit be issued for the
construction of a new well and septic system to serve the home. The attached Site
Plan and backup documentation identify the location and configuration of the new well,
septic system and alternate site and the parameters used in the design. Also identified
on the plans are the location of the surface drainage, test holes and the wells and
septic systems on the surrounding lots. Drainage arrows and spot elevations are
shown indicating the current drainage patterns. The drainage patterns will be
maintained after construction.
The test holes placed on this lot revealed silty gravel with some sand. The percolation
rate in the upper layers ranged from 29 minutes to 40 minutes per inch. No
groundwater was noted in any of the test holes and none was noted during the
monitoring period. Previous experience in the area, however, indicates groundwater
and surface water is present during periods of heavy runoff. We are therefore
proposing to place a five -bedroom Advantex Treatment System. The terrain of the lot is
such that gravity flow from the filter to the absorption bed is possible. The absorption
bed will be 50' long x 15' wide along with 2" of insulation and 2' of fill to prevent frost
penetration and freezing. All organics will be removed to the underlying silty gravel and
replaced with drainfield rock. The bed will be constructed at the existing ground level. A
berm will be constructed up hill from the bed to prevent surface water intrusion into the
area.
Lot 5, Block 2, Fox Hills
June 29, 2004
Page Two
The ground surface on the lot slopes as shown on the site plan from east to west at
varying slopes. The absorption bed will be constructed parallel with the slope as much
as possible in conformance with Municipal requirements. All components of the new
septic system will be constructed a minimum of 100' from any surface water and 100'
from the well on this and adjacent lots.
If the system is constructed in accordance with our design the following statements
apply:
1. The system, if constructed as designed, will have no adverse impact on the wells
in the area or those to be constructed in the future.
2. The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
3. The system, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
4. The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,
Michael E. Anderson, P.E.
Attachments
49th /\
MICHAEL E ANDERSON
111 No. CE -4381 j
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N 0092'05'W 134.32
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NOTE; THE Ba= U15LUTKIN TO BE
INSTALL^. OYER THE SEPTIC TANK & 4'
BEYOND CN ALL SDES EXCEPT UNDER
THE AZ ANYEX fiTER. THIS WILL ALLOW
FOR HEAT TO UE FROM TANK Q
•
FUSE TO THE FILTER ABCVS R.
NUL CRNEl 6, juwCAP
r An
r A@
AdvanTex" Treatment System
AX20-Mode la
`JTZ—_ww
40x94Pod
(If Necessary)
i INLET
OPTIONAL
II: t
SAE SL'Tr.N
ort'PVC I,I'
O+rx tm CDNNLOm
VDroE
SHM pRCTE= ,- ' lftfg BEDROOM l I I '
CrMfo TO
FlBERGLASS'TANK �;� i�:•
02DCE CKMAWN!,
SYSTEM SECTION
NOT TO SCALE
NOTE: SYSTEM MUST BE PLACED IN STRICT CONFORMANCE WITH
MANUFACTURER'S RECOMMENDATIONS.
E.
PROPOSED CFWNFlELD
0
LOT 5, BLOCK 2, FOX HILL SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Five Bedroom House Shallow Bed System
Pere. Rate: 29 MinAnch Five Bedroom Advantex Treatment System
Application Rate: 1.5 GPD/SF
5 Bedrooms X 150 GPD/2 GPD/1.5 GPD/SF (Application Rate) = 500 SF Absorption Area
500 SF/15 SF (VYldth) - 33.3 LF Bed Length
THEREFORE: Construct a 50' Long x 15' Wide Shallow Bed as Shown Below.
Place Distribution Piping at Original Ground Surface. Provide 2' of Insulation
and T of Cover Over Bed. Maintain 100' Separation From All Wells in the Area.
Natural Backfill \ 11
2' Insulation 6 2'
.5� I O O O FIV
\ ' rs
5' Dreinfield Rods 4' PVC
Underying GM
r
2.5' 5' S' 2.5'
r l r r
r
NOTE: Remove Existing Organics to Underlying Silty Gravel. Replace With Drainfield Rods.
Construct Berm Around Bed to Prevent Surface Runoff From Entering Area.
TYPICAL BED SECTION
(NO SCALE)
NOTE: Grade Area Surrounding Bed to Drain Away.
Minimum 6' Separation From Bedrock. i
Minimum 4' Separation From Groundwater. i
Minimum 100' Separation From Wells in the Area. i
Minimum 100' Separation From Surface Water or Streams..'
Minimum 10' Separation From Water Service Line.
AIM
Michael E. Anderson
No. CE4381 f
OF At
P•
49� F`V
...& .....
• .. Municipality of Anchorage �(
Development Services Department P r SINK
4700 South Bragaw Street Anchorage, AK 99519-6650 6 `�'•
SOILS LOG -PERCOLATION TEST #It4��F,
PERFORMED FOR: 7Y 1SVIL'Fh (— '
DATE PERFORM
LEGAL DESCRIPTION: OX)U Township Range Section:
DEPTH I• SLOPE. SITE
1
2
3
4
41-
6
7
8
9
10
it
12
13
14
15
16
17
18
19
20
COMMENTS
T V r-1.
22 -
NEL !. ANCERSON
a-4361
pAp it tt10�1�:
1: Ito /tri /v41-
1 WAS GROUND WATER ' A
Ww /Inay ENCOUNTERED (y
S
L o
IF YES, AT WHAT
Mss! I tJ VADEPTH? OP
A-�AS e,
Depth to Wier Aha
Nonitming7 Brie
bo .
®O®®®!
PERCOLATION RATE -i1 (minute inch) PERC HOLE DIAMETER
TESTRUNBETWEEN 5-5"ry
FTAND -5' FT
PERFORMED BY:. Aw-'w" bi I -CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE �" 3
PERCOLATION RATE -i1 (minute inch) PERC HOLE DIAMETER
TESTRUNBETWEEN 5-5"ry
FTAND -5' FT
PERFORMED BY:. Aw-'w" bi I -CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE �" 3
• OF A i
*; 49i)I fti +
• Municipality of Anchorage I�+-K R�-+• •J
d + : WCHAEL [. ANEERSCN : 0
Development Services Department �� CE - 4381
4700 South Bragaw Street Anchorage, AK 99519-6650 IIsr�19.•� •����
SOILS LOG - PERCOLATION TEST 1 FD
Vii. �
PERFORMED FOR: IV /� T 15',C7XV1CrS �/'�� DATE PERFORMED: / Zob S�
LEGAL DESCRIPTION: 7 {i Z rOX I l L.Li Township, Range, Section:
DEv SLOPE SITE PLAN
(FEET)
2 i
41 IGS -
66I."'"
d2t1~�
7
84_ 1
9-
AA/Ni L L
10
"I �^1S WAS GROUND WATER
ENCOUNTERED?
tb_ IF YES, AT WHAT
pue, M�. DEPTH?
12
.
Depen n wain Ma No
13
Monitoring? M/Ai�.t�
14
15
16
17
19
20
COMMENTS tet•✓'�'S� x
\�h
F
PERCOLATION RATE 2% (minutevinnch)PERC HOLE DIAMETER
TEST RUN BETWEEN FT ANO SFT
r
PERFORMED BY:. CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE r C
dF w; —
r1.. IN..) •.• .
Municipality of Anchorage . : C.k rA •, 4 r
Development Services Department 1. 0.
E. ANDIMSON; i
4700 South Bragaw Street Anchorage, AK 99519-6650 �� ciJ'., CE -4381 ... •'�:=
SOILS LOG - PERCOLATION TEST ��+,+F� PROFFSStBN ����
It TA x%
PERFORMED FOR:JV II 1 t7YtW �tw!/ . r/' DATE PERFORMED: t
0
LEGAL DESCRIPTION:.Y7_ 1- F?>• Alm .Lt�5D Township, Range. Section:
DEPTH SLOPE. SITE PLAN
(FEET) Jar a
1 1( _
Qfi
2 6m
3 L
Lo
a' /
5
6
wwo
9
t r
+~M1r
ry •.
' C /
1 O WAS GROUND WATER
ENCOUNTERED?
11 S /
IF YES. AT WHAT L
O
DEPTH?
12 E p' iD
13 Depth Ic Water Met13-
lilooittring7 Ott
14 Reading Date Gross Net Depth to Net
Time Time Water Drop
15 .
16-
17-
187
67718.
79 '
20
•. PERCOLATION RATE (minutevimh) PERC MOLE DIAMETER ,
(TEST RUN BETWEEN 11 FT AIN�D FT
COMMENTS C G' � t'V/ :7t1 C� �-i,. flnwt VI•W IAO g•7ste-L rtn'•S0 U%,.
2 hY'S4/b
PERFORMED BY:. TI • ' ' ,�•%''I� 1 _I ^^' CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE
or At 11k,1
0 1`.` • ,,,w, •SLI,
' 491H f� ;•
• Municipality of Anchorage a +�' MICHAEL [. ANDERSON � V IV
Development Services Department �I%� CE -4381 +��!
4700 So SOILS LOG StreetPERCOLATIONtg 6650
PERCOLATION EST ,�1�;• PgOFE55�0�����
PERFORMED FOR: 6{Z�(�GJ �,„t- DATE PERFORMED:__
LEGAL DESCRIPTION: L- . LI, �`p=�—{ -ILL 5/p!> Township, Range, Section:
1
2
3
4
�5
6
7
g
9
10
11
12
13
14
15
16
17
1a
19
20
O�
GMx
J* -µs
Te' -
,,%w(sri•
WAS GROUND WATER
ENCOUNTERED? N 0
IF YES, AT WHAT
DEPTH?
OepN b wYa Ma
111000winq? Date
SITE PLAN
PERCOLATION RATE (Minutminch) PERC HOLE DIAMETER
.
TEST RUN BETWEEN i.S FT AND- 5:5 FT
COMMENTS G"-', 'ar'I Wy C.d
PERFORMED BY:. 1 f'I' CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE_ DATE 30
owj�
OF-Mm��
PERCOLATION RATE (Minutminch) PERC HOLE DIAMETER
.
TEST RUN BETWEEN i.S FT AND- 5:5 FT
COMMENTS G"-', 'ar'I Wy C.d
PERFORMED BY:. 1 f'I' CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE_ DATE 30
Municipality of Anchorage
E On -Site Water and Wastewater Program
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 051-073-14
1. GENERAL INFORMATION
Complete legal description Fox Hill Block 2 Lot 5
Expiration Date: 6 g / 3
Location (site address) 21800 Woodctiff Drive, Peters Creek, AK
Current Property owner(s) Whah-Wills, Anelia & Whah, Marv- Day phone 244-3355
Mailing address same
Real Estate Agent Birch Lake Realty Day phone 244-3355
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 5
4. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
❑
Community Class C Well
❑
Public Water System .
❑
TYPE OF WASTEWATER DISPOSAL:
Individual
Holding Tank
❑
Community
❑
Public Sewer
❑
Received by: - ' Date:
COSA to be released to the engineer, unles✓othemise requested by the engineer.
COSA Fee $ Z40D
Date of Payment 210510
Receipt Number 006q(o 3
COSA # 05C131 b 5 (D
Date:
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 Firm NorthRim Engineering Phone 694-7028
Address PO Box 770724, Eagle River
Engineer's Printed Name Steve Eng Date
Conditional approval for bedrooms, with the following
By: fi Original Certificate Date:
The Municipality of Anchorage Devlopment 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
Septic System Advisory
Well Flow Advisory
COSA blue sheet_9-1-12.doc
X Nitrate-�dvsbrx->
Arsenic Advisory
Other
Y
�' E•� . Qp.f "' 3
6. DSD SIGNATURE
X System #1 Approved for bedrooms.�a.
System #2 Approved for bedrooms.
t,
Disapproved.
Conditional approval for bedrooms, with the following
By: fi Original Certificate Date:
The Municipality of Anchorage Devlopment 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
Septic System Advisory
Well Flow Advisory
COSA blue sheet_9-1-12.doc
X Nitrate-�dvsbrx->
Arsenic Advisory
Other
If more than I septic system !son the lot
COSA_Checklist# of
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description:. rQ) �L-1144 13.2 /S Parcel ID: OSI— 073- [+�
A. WELL DATA
Well type �_ If A, B, or C provide PWSID # Well Log (YIN)_
Date completed 2 d Sanitary seal (YJN) Wires properly protected (YIN)
Total depthL;3 ftCasedao /Z3 fL Casing height (above ground) 2 in.
FROM WELL LOG
Date of test 7
Z221o;(
Static water. level '5�& ft
Well production 30 9 -P.M.
WATER SAMPLE RESULTS:
AT INSPECTION
70 ft
O.P.M.
Coliform ..,0 colonies1100 mL r Nitrate Z• 2 mg/L
Arsenic /,
r .ug/L Date of sample: / Collected by:rL
B. SEPTIC/HOLDING TANK DATA p
Tank.Type/Material
Tank size2d!� gal. Number of Compartments Z
Date installed
Cleanouts (YIN)
Foundation cleanout (Y/N)� Depression over tank (YIN)//. �. High water alarm (Y/N)
Date of pumping L ' � ' Pumper oe!jm eL
C. ABSORPTION FIELD DATA
Date installed _X� Soil rating (g.p.d.lfe or fe/bdrm) System type _ 41.i. 22Fsd
Length so ft. Width S it Gravel below pipe Q S ft.
se
Total depth 6/' ft Eff. absorption area fh . Monitoring tube Y Depression over field
Date of adequacy test 1 aJ d f 5 3 Results (Pass/Fail)s s (- For bedrooms
Fluid depth in absorption field before test _� in. Water added gal. New deptl-CO in.
Elapsed Time: _Y o min. Final fluid depth 0 in. Absorption rate >= 750 g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date
D. LIFT STATION ill A
Date installed
"Pump cW level at in.
Datum
E. SEPARATION DISTANCES
WELL ON LOT TO:
Size ln.gallons ManholelAccess (Yll
`Pump ofr level at in. High water alarm level at in.
Cycles tested Meets alarm &'circuit requirements?
Septic tankliift station on lot /dG i1 On adjacent lots -
Absorption field on lot /00 't` On adjacent lots
Public sewer main _AIM Public sewer manholeldeanout
Sewer /septic service line J(- 'C Holding tank AM
Animal containment areas /d o f Manure/animal excrete storage areas /00 f
SEPTICIHOLDING TANK ON LOT TO:
Building foundation s t Property line lD Absorption field Z�L`
Water main f> r Water service line O fi Surface water 6Q
�f
Wells on adjacent lots
ABSORPTION FIELD ON LOT TO:
property line / (S �f Building foundation ele Water main
Water Service line �49 r Surface water /Od Driveway, parkins/vehide storage a t
Curtain drain VAIX Wells on adjacent lots /00
F. COMMENTS
G. ENGINEER'S CERTIFICATION
l certify that 1 have determined through .rreld inspections and
review of Municipal records that the above systems are In
conformance with MOA COSA guidelines in effect on this date.
Engineers Printed
/Name
Date
conA brown sheel_10-10A2.doc
IAT 5 BLOCK 2 HAS 40,000.00 6(LtT.
4
,. 16.74'43"
231.19
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2800803
CIIPVE A31US US lDIGM TMQENT
DELTA R
0330 Vandaard Drlre, sufw 203
dnchorade, Alaake opd09
Drawn b .Y
Field Book
CI R{]{'S{' SB0.00' 161.dJ'I aLle16'
(809) 652-0050
DFIB
218
'ERT 7/14/06
I hereby cerWy fret . property da.crlbad hereon bit been .ur.ayva
D r LL my dLecOen, ane mat ma tmprmemenU tlluataa merepn
OF A4 144
RANDY HAMILTON
J'A1 gS�11
ate
11/16/05
Scale
1" = 40•
Legal Descriptio
anMark
.nn.mfulon
11¢or or Omer euementa m .afa preperV except a .howo.I
Grid
ASBUILT
Lot 5 Hlock2
en41"•° . °^ey n4. Inc.
1458
2800803
pox BILL
0330 Vandaard Drlre, sufw 203
dnchorade, Alaake opd09
Drawn b .Y
Field Book
SUDDMSION .
(809) 652-0050
DFIB
218
I hereby cerWy fret . property da.crlbad hereon bit been .ur.ayva
D r LL my dLecOen, ane mat ma tmprmemenU tlluataa merepn
OF A4 144
eme,
will to me property Ree. end de vc! a lap r e¢r....h m the
• er °
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parry Iywd •aLr.¢e mercer uNe.. ame..d...brwn. net no
me property ly6nd edl.cevt macaw anoro.ch on me
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11d°ra/ailrrel��0
Reproductlou to.,cau.a
-
ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND
REPAIR AGREEMENT
MEMORANDUM OF UNDERSTANDING
BETWEEN MUNICIPALITY OF ANCORAGE
AND 57-40 "1
THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this
Day of M A -RC. Yl of 20 l3 , by and between 5TCu f�
herein the "OWNER," and the Municipality of Anchorage, herein the
"MUNICIPALITY." In consideration of the mutual covenants contained herein, the
parties to this Memorandum of Understanding agree as follows:
1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality
grants permission to Owner to utilize and operate an Advanced Wastewater
Treatment System (AWWTS), described as APVA-N %" located
at Ls- 6� OZ fo u H 1 LL Anchorage, Alaska.
2. Definitions.
A. Alteration. Any change to the design or function of an AWWTS that
Includes the installation or removal of any parts, components or pieces not
included in the original construction permit and design. Prior to
performing any alterations to an AWWTS the owner must obtain a
Wastewater Disposal System Construction Permit from the Municipality
pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65.
B. Certificate of On -Site Systems Approval. An approval by the
Municipality of existing water and wastewater disposal systems given at
the time of property sale and title transfer in accordance with 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.
C. Damage. 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 of
existing parts, components and pieces of an AWWTS that were included in
the original design which would allow the AWWTS to continue to
perform as designed.
E. Permit (Construction) An On -Site Wastewater Disposal System
Construction Permit as defined by AMC 15.65.
F. Permit (Operating) An Advanced Wastewater Treatment System
Operating Permit. An annual permit, issued by the Municipality, that
allows the Owner to operate an AWWTS, upon meeting all the
requirements of this agreement, the conditions of Operating Permit, the
requirements of the On -Site Wastewater System Construction Permit and
all relevant provisions of AMC 15.65
3. Fee. Owner shall pay to Municipality an annual fee of
($_.00), payable on or before the issuance of the operating permit and annually
thereafter. The annual fee is due on or before the anniversary date of the approval by the
Municipality of installed system.
4. Term. The term of this Memorandum of Understanding shall be for the life of the
AWWTS.
The term begins on the date of approval by the Municipality of the installed system and
shall continue while the AWWTS system is in use or operational or until the property is
sold or title is transferred by owner and a new certificate of On -Site approval is issued to
the new owner or transferee of the property.
5. Alterations. Installation and Removal of Additional Equipment. Owner agrees
not to make any alterations, removal of parts or additions to the AWWTS without a
Construction Permit from the Municipality.
6. Maintenance and Repairs.
A. Throughout the term of this Memorandum of Understanding, the Owner shall
maintain AWWTS in good repair. In addition, it shall be the responsibility of the
Owner during the term of this Memorandum of Understanding, and any extensions or
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.
Further, Owner agrees to comply will all applicable ordinance, laws, regulations,
rules and orders for the AWWTS.
B. Owner agrees to provide the Municipality a written schedule of routine
maintenance and repairs which have been performed on the system pursuant to the
terms and conditions contained in the Owner's AWWTS Operating Permit. This
schedule shall be submitted to the Municipality annually upon the renewal of the
permit. The schedule of maintenance and repair contained in the Owner's AWWTS
Operating Permit is: AtJIJOi (-
C. Owner acknowledges that the fine schedule for failing to maintain and repair an
AWWTS are codified in AMC 14.60.
D. Owner agrees that only maintenance, repair personnel certified by the
Municipality will inspect and make any necessary maintenance, repairs or permitted
alterations to the system.
E. Owner agrees to grant the Municipality reasonable access to test and inspect the
AW WTS upon 24 hours written notice.
F. Owner agrees that any sale or transfer of title of the property will not occur
without a new Certificate of On -Site Systems Approval.
G. Owner agrees that the relevant provisions of the standard specification guidebook
for AW WTS is the governing professional guidelines for the construction,
maintenance and repair of the Owner's AW WTS.
7. Nonwaiver. The failure of either party at any time to enforce a provision of this
Memorandum of Understanding shall in no way constitute a waiver of the provisions,
not in any way effect the validity of the Memorandum of Understanding or any part
hereof, or the right of such party thereafter to enforce each and every provision
hereof.
8. Amendment.
A. This Memorandum of Understanding shall only be amended, modified or changed
by a writing, executed by authorized representatives of the parties, with the same
formality 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 representatives of the parties are:
Owner: "-)TEu Ctj S TL
Anchorage: Purchasing Officer
C. Any attempt to amend, modify, or change this contract by either an
unauthorized representative or unauthorized means shall be void.
9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of
Understanding shall be brought in the Superior Court for the Third Judicial District of the
State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and
obligations of the parties under this Memorandum of Understanding.
10. Severability. Any provisions of this Memorandum of Understanding decreed
invalid by a court of competent jurisdiction shall not invalidate the remaining provisions
of the Memorandum of Understanding.
OWNER:
By:
Date: 3 %3
STATE OF ALASKA
THIRD JUDICIAL DISTRICT
MUNICIPALITY:
By:
Title:
Date:
ss.
The foregoing instrument was acknjwleded before me this' 4`day oid1 h2 e./Li
ol,,
ARY PUBLIC FOR AL
y Commission expires: �S `/ / A��ICT•,�
Parcel I.D.
Municipality of Anchorage
Development Services Department
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
051-073.14
1. GENERAL INFORMATION
COSA # 0 0 3 7.2.
Expiration Date: r — 2. 1 O 7
Complete legal description Lot s, Block 2, Fox Hill subdivision
Location (site address) 21800woodaiR Drive Chugiak, AK 99567
Current Property owner(S) Randy Hamilton Day phone 349.0991
Mailing address 21800 Woodcliff Drive Chuglak. AK 99567
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup
2. NUMBER OF BEDROOMS:
Five (5)
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Q
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 Anderson Engineering
Address P. O. Boz 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E.
5. DSD SIGNATURE
Phone 522.7773
Date 12f1912006
✓ Approved for bedrooms. *1.
4�%,p"� S'tt
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: (�� Original Certificate Date:
r/
(R. 11.05)
Municipality of Anchorage
Development Services Department
Building Safety Division : • (��_
Onsite Water and Wastewater Program s ,
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519.6650
www.muni.org/onslte
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 051-073 14 f COSA # Q (d 0 3 7
Expiration Date:
1. GENERAL INFORMATION
Complete legal description Lot 5, Block 2, Fox Hill Subdivision
Location (site address) 21800 Woodcliff Drive Chuglak, AK 99567
Current Property owner(s) Randy Hamilton Day phone 349.0991
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
21800 Wooddiff Drive Chuglak, AK 99567
Unless otherwise requested, COSA will be held by DSD forpickup.
2. NUMBER OF BEDROOMS: Five (5(
Day phone
Day phone
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-registeredln.theStateafAUaska—Certificates of�On.SReSystems Approvalare required for -the transfer -0f
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 Onsite Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm Anderson Engineering Phone 522-7773
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E.Date 811=006'
0
L #Musm
5. DSD SIGNATURE
ff Approved for S bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Attachments:
COSA Checklist X Arsenic Advisory
--- Septic System Advisory -- --- - - Maintenance Agreements - -- - —
Well Flow Advisory Supplemental Engineer's Report
Nitrate Advisory Other
By. IAZ /<D Original Certificate Date:
(R. 1IMS)
Municipality of Anchorage
• Development Services Department J.
Building Safety Division
Onsite Water & Wastewater Program •
4700 Bragew Street
P.O. Box 196650
Anchorage, AK 9951946650
www.muni.wg/onsRe
(907) 943-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
i
Legal Description: tat 5. Block 2, Foot Hill Subdivision Parcel ID: 051.073.1Q -
A. WELL DATA
wen type P its
Date completed 7/29104
Total depth 123 R
Date of lest
Static water level
K A, B, or C provide PWSID 0 _
Sanitary seal (YM) V
Cased to 123 it.
FROM WELL LOO
789/04
68 ft.
Well production 30
WATER SAMPLE RESULTS:
CdUarm 0 colonies/100 mL
Arsenic: wD mgfl
B. SEPTIC(HOLDING TANK DATA
9 -
p.m -
Nitrate .832 mg/L
Date of samples 6127/06
Tank Typ&UaterW Advamex/Stsel
Tank size Z000 gal. Number of Compartment 2
Foundation cleanout (YIN) Y Depression over tank (YIN) N
Date of pumping New Consbuctlon Pumper
Wen Log (YM) Y
I
Wires property pnrtected (YM) Y
Gating height (above ground) 124 in.
AT INSPECTION
I
ft �
I
g.p.m.
Other bacteria 0 colonies/10D mL
Collected by: J. Anderson
i
Date installed gr=2004
Cleanout (YIN) Y
High water alarm (YM) Y
C. ABSORPTION FIELD DATA
Date installed g/28-26104 Soo rating (g.p.d/e or 1t°Ibdrm)1.5 GPD/SF System type Shallow Bed
Length 50 R Width 15 R Gravel below pipe .5'ft.
Total depth 4± fL ERsbaorptlon area 600 fl Monitoring tube Y Depression aver Belt N
Date of adequacy test New Corot. Result (Pass/Fan) For _ bedrooms
Fluid depth in absorption field before test in. Water added gal. New depth in.
EtpsW Time: min. Final fluid depth in. Absorption rite >= g.p.d.
Any rejuvenation treatment (past V mo.) (Y/N 6 type) If yea, give date '
D. LIFT STATION
Date installed Size in gallons
Manhda/Aecesa (y/N)
'Pump on' level at _ in. 'Pump or level at _
in. High water alarm level at in.
Datum Cycles tested
Meeb alarm b mast ragtri warn O7
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/ltit station on lot >1W
On adjacent lots >1011'
Absorption field on lot >11111'
On adjacent kxs >iw
Public sewer main WA
Public sewer manhoWdeanout N/A
Sewer /septic service line >2'
Holding tank WA
Animal containment areas None
Manure/animal excrete storage areas Nam
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
Building foundation >5 Property One >S
Absorption field >1g'
Water main >10' Water service One
>1p Surface water >1W
Wells on adjacent lots >1W
SEPARATION DISTANCE FROM ABSORPTION FIELD
ON LOT TO:
Property Ona >1t1' Building foundation
>1g' Water main >IV
Water Service One >1t1' Surface water >1W Driveway, park6oWdde awrsge >25'
Curtain drain None Noted Wells on adjacent k>ta
>tllll'
F. COMMENTS: Gravity Flow From Advantex Filler w Absorption
Bed.
O. ENGINEER'S CERTIFICATIONGj`'
l cedl0y Mat / have determinedthrough field inspedlorrs and 'to[49th
review of Municipal nroords that the above systems are inconformance with MOA COSA guidelines in effect on this date. c ammoroEngineer's Printed Name Michael E. Anderson, P.E. 0Date a/11/2mh,a ss0
asssrar
COSA Fee $ t�4. `n
Date of Payment P) • 11-0 C9
Receipt Number F?44V I T_
(Rev. I IM)
Walver Fee S
Date of Payment
Receipt Number
N
SEPTIC
DELTA
I RADIUS LFNGTH TANGENT
VENTS
1 24-24-04-1380.00-
1 161.83' 1 8216'
000
I
O
Lr)
O O
II
O
0SEPTIC
CV
C1 VENTS
'C1
O
O
O
Z
SEPTIC
VENTS
LOT b BLOCK 2 HAS 40.000.00 SQ.FT.
11
N 77-36#46" W 3
20' ORAJNA
OF ESOT
SEPTIC
VENTS
6V) O
N 76.14,43 , W
231,19
101
7
r � _
7
WELL /
CURVE TABLE
CURVE
DELTA
I RADIUS LFNGTH TANGENT
C7
1 24-24-04-1380.00-
1 161.83' 1 8216'
RANDY HAMILTON
9330 Vanguard
me
61 /
I
I
GRAPHIC SCALE, 1 Inch " 40 fret
40 10 6 10 n 40 so
11/18/05 1 1" = 40'
ing, Inc. 1458 2800893
Suite
09507203 Drawn by Field Boc
0 DHB 218
I hereby certify that the property described hereon has been surveyed
by me, or at my direction, and that the improvements situated thereon
are within the property lines and do not overlap or encroach on the
property lying adjacent thereto unless otherwise shown. That no
improvements on the property lying adjacent thereto encroach on the
premises in question and that there are no roadways, transmission
lines or other easements on said property except a shown.
It is the responsibility of the owner or builder, prior to construction,
to verify proposed building grade relative to finish grade and utility
connections and to determine the existence of any easements, covenants,
or restrictions which do not appear on the recorded subdivision plat.
Listed distances prevail over scaling.
Reproduction may cause distortion.
Lot 5 1 Block2 I
FOX HILL
SUBDIVISION .
I
II
4
GRAPHIC SCALE, 1 Inch " 40 fret
40 10 6 10 n 40 so
11/18/05 1 1" = 40'
ing, Inc. 1458 2800893
Suite
09507203 Drawn by Field Boc
0 DHB 218
I hereby certify that the property described hereon has been surveyed
by me, or at my direction, and that the improvements situated thereon
are within the property lines and do not overlap or encroach on the
property lying adjacent thereto unless otherwise shown. That no
improvements on the property lying adjacent thereto encroach on the
premises in question and that there are no roadways, transmission
lines or other easements on said property except a shown.
It is the responsibility of the owner or builder, prior to construction,
to verify proposed building grade relative to finish grade and utility
connections and to determine the existence of any easements, covenants,
or restrictions which do not appear on the recorded subdivision plat.
Listed distances prevail over scaling.
Reproduction may cause distortion.
Lot 5 1 Block2 I
FOX HILL
SUBDIVISION .