HomeMy WebLinkAboutSCIMITAR #1 BLK 1 LT 4c Imi*tar
Block I
Lot 4
#051 � 132�05
Municipality of Anchorage
4.
Development Services Department
Building Safety Division
On-Sde Water and Wastewater Program, 4700 BragawSt.
P.O.Box196650 Anchorage.AK 99519-6650 Page 11 of 2
www.ci anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATERDISPOSAL SYSTEM ANDIOR WELL INSPECTIONREPORT
Permit Number. SWO50022 PID Number 051-132-05
144� HNSON
Wastewater System: E3 New Upgrade
Agj;2 CHUGACH PARK DRIVE
ABSORPTION FIELD
F""' Numbw of 11"M"11
69&M32 4
0 DW Ttimh 0 S1,6110- Tr*Xh 0 BW 13 MmINI 0012,41C
Soil Ra"
T,ttal Depth *m orq� qr�
LEGAL DESCRIPTION
2 GPDfF?
2.5 Ft.
13� Lot 8�.�
Dopin w p" tttm "m ong� wi,*,
or" deim bsr*M pqn
1 4 SCIMFTAM
Ft.
0.6 F1
To.noV ROVO ll�:
(318�* LVVft
15N 1W In
2 Ft.
30 Ft.
Well: El New Upgrade
G�Wllh
15
N�011,ml
3
D.Wsmi,��
5
Ft.
Ft
cwsvk� (�O*- A, 8. C)
TOW DOM. C11WOW
7� bbqvi� 11'"
Ppe Moittmi
PRIVATE
30 Ft. 1 220 Ft
JIM Fe
I" PVC
D�
BILL SULLIVAN
Do* DrdW SWCWWWLt,w,i
3111812005 1 180 Ft
lr�
GUARANTEED SERVICES
DM. �
I 101V2005
PWW " ;50 I
Ca" "09"' 7 G'�Ft
TANK
I GPMj
Ft.
SEPARATION DISTANCES
Septic [3 Holding 0 SX.E.P. 0 Other. ADVANTEX
TO
Front ��
Septic
Tank
Absorption
Field
Lift
staamoon
Holding
Tank
'ubldprtv&te
Sewer Line
��w
ANCHORAGETANK
cep�ly
I 1500 Ga
mm�
� a corrp�'
WON
+100'
+100'
STEEL
2
+100'
+100'
V
LIFT STATION
S.f.w.t.
+5!
+10'
Lot Lkw
+51
+10.
Turnp w* limii 0
'Punip aft � 0
Fop-
in
M
In.
+50,
+50,
P� Mw, & U."
E� IW� pwft�W bY
C~ Drw
RISING SON ELECTRIC
lt�
BENCH MARK
DelaWbw
GARAGE SLAS INSIDE DOOR
A.� E�&�
100 Ft
Inspections performed by: CHRISTOPHER WOOD Dates: 1' 10/5005
2"d 10/5005
Development Services Department Approval
Conditional Approval Date:
cHOMPHERR.WOOD 1
CE -10387
%
.. ......... ......
Reviewed and approved by: ��A Date: jAZ;e—;'
I
(R� �) I I
Permit No. SW050022
Page 2 of 2
Municipality of Anchorage
DEVELOPMENT SERVICES DEPARTMENT
ON—SITE WATER & WASTEWATER PROGRAM
4700 SOUTH BRAGAW STREET P.O. BOX 196650, ANCHORAGE, AK 99519-6650
On—Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: SClMlTAR#1 LOT 4 BLOCK 1
051-132-05
SWING TIES
1 C 1 29 5* 1 2 1.0'
I D 61.5'1 42.5
0 0 <D
ADVANTEX SCALE 10-4a'
1500 GALLON TANK
W/AX FILTER PO
8' 0 10
WELL
-0- HOUSEE131
TH1
D�fVEW AY.
0
TH2
'9'
0 - CLEANOUT
- WELL
- MONITOR TUBE ELEVATIONS
(NOT TO SCALE) /20/2006
S�
VA ARAGE ORIGINAL GROUND ENGINEER'S SEAL
ED ��L
VATION - 1001 LEVEL ATo 94.8
OF At `�k�
T I FILL TH-I ............. !��q
4
M MT -2
TANK �92.9
0. 0
1,500 GAL GRA Ej. . * * 87.9
.0.0
93.2 ADVANTEX OiRISTOPHER R. WOOD. -*&P-
3 C3 CE -10387
8 92.9 �J \92.3 8
92.3 BOTTOM OF T.H.
rq /- G q2,P'
ASBUILT SEWARD & ASSOCIATES 1JM 9TTRVFVTWr ral.—no
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
FOLLOWING DESCRIBED PROPERTY:
AND THAT NO FNCROAC4ENTS I XIST EXCEPT AS
INDICATED. IT IS THE 'RESPONSIBILITY OF THE
OWNER TO DETERMINE THE.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 CONSTRUCTION
OF FENCE LINES, OR FOR ESTA13LISHING BOUND-
ARY LINES.
SCALEt
DATE&
GRID: ......
.p . ...... 0
Ou-no Mak Ss�ad
0
FS: LS Ar
Aker.
BRA_W�N:
Z-5ing 6on Ciectric, Inc.
096 VoodLand Prive
[=-a-qLe Zver- A4 99577
(907) 622-6777
November 16, 2006
Guaranteed Services
Wayne Devore
Eagle River, AK 99577
Re: Unit Number I Lot 4 Block I Scimitar Subdivision
Dear Wayne:
The lift station at the above referenced property has been wired In accordance with NEC
and State/Local codes.
Thank you.
Sincerely,
xcr-�� 4, Nwr,��
--4�( d4a-� -A - >AAalr-�
Kevin S. Hornbuckle, Owner
Administrator License Number 1284
Specialty Contractor License Number 27285
04/05/2005 14:41 6882259 ULLIVAN
cerfifteb ;mritttng In
by
M 00. dbo
SULLIVAN WATER W '�LLS
P0.8=91021 C#PJC&*JrALASVA OUR' , ,
OWNeR 6 _#��
LEIAM
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PAGE 01/02
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SGS Environmental Services
200 W. Potter Drive
Anchorage. AK 99518
Tat: (907) 562-2343
f
Fax: (907) 581-5301
SGS Ref. M
1066844
Eagle River Englneedhg
Client PON:
Printed Daternme:
n1a
11/27/06 12:45
Client Name:
Project Name:
Scimitar Lot 4 Block I
collected DateMme:
11116= 16:15
Cnant Sample ID:
Scimitar Lot 4 Block I
Received DateMMe:
11117106 12:46
Matrix:
Drinking Water
Technical Director
Stephen Ede
PWSID
NIA
Released By: Bryan I Arnold
2006.11.27
1;5:uu;zz _Uw UU
Sample Remarks:
Ailowable
Prep Analysis
Results POL
UnIts
Me
Date Date Init
Parameter
Arsenic (A . a)
ND
ug/L
EPA200.8 10.0
EPA3532 10.0
Ila= w2lu TK
11117106 11117106 ALR
Nitrate (NO3)
2.20
0
V,9&
ODV100ml-
.
SM20 =B <1
I 1/17jo 11107M6 DT
Total Coliform
f I
a
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
ON-SiTE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Initial
Date Issued: Feb 07, 2005
Expiration Date: Feb 07, 2006
Permit Number: SWO50022 Parcel ID: 051-132-05
Legal Description: [SCIIAITARWI 'SU8DIVIS1`0N-6L-0bR-j COT'4
Design Engineer: 0848 Eagle River Engineering Services Site Address: 20212 CHUGACH PARK DRIVE
Owner Name: BRAD JOHNSON Lot Size: 43798 SO. FT.
Owner Address: 20212 CHUGACH PARK DRIVE Total Bedrooms: 4 Permit Bedrooms: 4
EAGLE RIVER. AK 99577 -
This permit Is for the construction of.
P� Disposal Field [?] Septic Tank E] Holding Tank F] 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 ( I BAAC80 ).
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 cJosed on the same day.
B. Covered, seated, and heated to prevent freezing.
5. The following special provisions.
THE UPPER SIX INCHES OF THE MOUND SYSTEM MUST CONSIST OF TOP SOIL AND THE MOUND MUST BE
VEGETATED SUFFICIENTLY TO PREVENT EROSION.
AIPCO A?QP4-r� V-JPJWL
r"rV131o'j TO Oessrjv r>%Is To wct-t doe4Tjov c#4^.V*e OV AvT Y
Received By -
,4t" /
Date: ?-/0!Z/c6
Issued B . Date: _-2 1-7 /m—
Oi/03/03 11:27 FAX 9073438437
____JM0AJ". USE ENFORCEMENT Q001
MunicipaUty of Anchoraige
Development Services Department
Building Safety Dmilon
On -Site Water and Wastewater Program
4700 South Bragaw St
P.O.BoxII96650 Anchorage,AK 9951"650-
www.cl.anchmge;ak.us
(907) 343-79D4
ON-SITE SEWERMELL PERmrr APPLICATION
FOR A SINGLE RkLY DWELLING
Parcel I.D. 0671 — 13a — 09 Permit Number SW
94d
Property owner(s) Day phone e(w�
Mailing address (1
Mailing address (2) cP&� 2-'. 0
V 2hVJ4,�wl
Rptdo _2z5_n � )
Legal description (Lot Block & Sub'd.) att-j_ 0 9-L L 11
Legal description (Section, Township& Range) 56-4 10 1 5- AJ t
Lot Size ---y-9. -
L'7L_Acresj15M
THIS APPLICATION IS FOR:
Number of Bedrooms 0, 4
i Sewer Only 11 Well Only, 11
Sewer and Well .9 Water Storage El
Sewer Upgrade 13
THIS PROPERTY CONTAINS,
Hot Tub Jacuzzi
Swimming Pool Water Softening Unit
13. 0
Therapy Pool 0
I certify that the above Information Is correct I further certify that thIs application Is being made for a
Single FamVDwellinUnd Is in accordance with applicable MunIclilial Codes.
(Signature of property owner or authorized agent)
Permit Fees: Waiver Fees: -
DateofPaymant; DaleofPsymeht
Receipt Number. Receipt Number
(Rev. 12MO)
Eagle ]River Engineering Services
Christopher R. Wood, P.E.
10421 VFW RD. Suite 201 (907) 694-5195 tel
Eagle River, AK 99577 (907) 694�3297 fax
February 3, 2005
Dan Roth
Manager, On -Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re: Scimitar# I Lot 4 Block I
Narrative & Permit Application
Dear Mr. Roth:
Eagle River Engineering Services (ERES) has been contracted to design a well and septic system
at the above referenced property. The proposed septic system and well will have very limited
impact on adjacent properties for the following reasons:
I . The surrounding lots are all large, allowing sufficient room for septic sites.
2. Immediate neighboring septic systems are all +20'distance from the proposed new
septic system, and no private wells are within 100' of the new system.
3. This permit is for a new well and septic system.
4. Drainage will not be affected and is not a major consideration in our design.
Two test holes indicated that the underlying soil in the area for the septic system is comprised of
two feet gravelly sand underlain by tighter GM material to a depth of 12 feet. Water was present,
and therefore the septic system will require a lift station and bed configuration. The water table
was monitored after very heavy rains, and probably indicate the worst case scenario for water
table information. The owner has opted to utilize Advantex systems to reduce the size of the
mounded leach bed, and to ensure a longer useful life leachfield. The owner might install the
replacement leachfield at the time of original construction also. This work will not affect the
reserve septic areas on adjacent lots. If you have any questions please call our office at 694-
5195.
Sincerely,
EAGLE RIVER ENGTNEEMG SERVICES
Christopher R. Wood, P.E.
Principal
V003%04-113SEPTICNARRATIVEMOC
ltivu% %I �.# Qv I L-04 %.Y-I:o I wif�i
REVISED LOT
3&4 "�'SEPTIC +30 lv� +
LAYOUT ��WCLL +100 lb
MAPrM 11 A
.%
N,
00, VcLL
PAMA
bm ADVAN
\I IAW
W/AX �k CA
ru BASIN
too* Wm
PAM
6 a +30—
Pwc
's%salm +30
C) WELL +100 ... ....
WELL
L=TKM
*M&L t&W AtwANtEx
I bM n.OH T� LOCA710"
LTM POO
F"MW
M-7-ALZ"
PADKM
Im 2
REPLACEMEKT
A, em
SEP
CAR
I W WELL PAMIS —mDcr0oFmmG wLLL
WERTER VALVE
TM HOLE
LoNnto ?Me Nola.
SEWER CLEM OUT
+ WELL 1. 140 P40WO CURM4 DRAM
EASEMENT 2. HO XNOW SWACe M
"W= LEAcm racm
COINVEWAY I'm DORM WML
WELL/SEPTIC SITE PLAN
OF oV
LEGAL: scimrrAR SUE3D. #1 LOTS 3&4. BLK 1
OWNER: BRAD JOHNSON
CONTRACTOR: GUARANTEED SERVICES
10
JOB# 04-112 DATE: 01/31 05 1 SCALE 1"= 60' � T
00
EAGLE RIVER ElVGrNEERrNG SERVICES k;,CMf in vwo'o'm'
T, - Cr -1038 of
10421 VFW RD. SUITE 201 7
EAGLE RIVER, AK. 99577 -
A (907) 694-51,95 FAX. (907) 69,
r�� (—Nl--� 1�1
'*'�SEPTIC +30
WELL +100
.i% vo�
-P
411-�IGO' WELL tK
RADIUS
\4
PROPOSED
WELL
LEGEND:
--
100' WELL RADIUS
DfVERTER VALVE
TEST HOLE
L40NITOR TUBE
SEWER CLEAN OUT
+ -
WELL
-
EASEMENT
PROPOSED LEACH FIELD
DRIVEWAY
'po. 0
'po
�:oo
40,
pi
A\�
1.25' HOPE
IPE
H I
//7<
NOTES:
1. NO KNOWN CURTAIN DRAINS
2. NO KNOWN SURFACE H20
100'
RADIL
WELL
SCALE: I"- So'
100' WELL
wlUS
+3D—
WELL/SEPTIC SITE PLAN
OF
LEGAL: SCIMITAR SUBD. #1 LOT 4, GLK 1 1p"N
OWNER: BRAD JOHNSON
jw T
CONTRACTOR: GUARANTEED SERVICES H
... . .. . . ....
JOB#04-113 I DATE: 01/31/05 1 SCALE 1 50' 0. 0
i o" — —1 ** �� 4" .
0, J-soo
EAGLE RIVER ENGINEERING SERVICES 0 QiRISTOPHER R WOOE -
'p CE -1038'7 Aw
-A'Ar
10421 VFW RD. SUITE 201 <t;Am
EAGLE RIVER, AK. 99577 kFESSIO0
A
(907) 694-5195 FAX. (907) 694-3297
m
Eagle 'kaiver Engineering '�_,ervices
10421 Vr-W RD Suite 201 Christopher R. Wood, Px. (907) 694-5195 tel
Eagle RiVer, AK 99577-3294 (907) 694-3297 fax
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM — MOA CERTIFIED INSTALLER
LEGAL: Scimitar #1 Lot 4 Blk I
Februnry3,2005
A. GENERAL
1. Ile replacement septic plan is for a 4 bedroom single family residence only.
2. The drawing and or site plan shall be a part of this specification.
3. All materials and workmanship shall meet the Anchorage Department of Health and State Department
of Environmental Conservation requirements.
4. All soil tests are advisory to the design and are to be verificif or modified in the field by the engineer.
5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet
Municipality of Anchorage, Department of Environmental Conservation requirements.
6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any
adjacent multi -family wells. A licensed surveyor should locate any utility easements and exact 100'
radius from the existing and neighboring on-site wells.
7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer
approval.
8. Any remaining open test holc excavations shall be filled and monitor tube removed.
B. ADVENTEX SYSTEM AND SEPTIC TANK
I . Septic tank shall be a fiberglass 1500 -gallon tank capacity of MOA approved construction for use with
Advantcx system. Install as per current manufacturers recommendations for conditions in Alaska.
2. Install one AX -20 filter pod over septic tank capable of treating 600 gallons per day of waste flow.
3. Install Orenco 24" pump basin PB -2496 outside septic tank, with OSI pump model P30-05 and
controls to allow 23 gallon dosing of septic leachfield. Set pump float to 13.5" above pump, timer for I
minute dosc time. Controls to be installed to MOA code by licensed electrician familiar with OSI
applications. Controls to include a dedicated phone line and web based monitoring system.
A municipal inspection report or receipt from a licensed electrician shall be provided to the engineer
verifying lift station wiring to all applicable codes.
C. BED
I . Ile bed is to follow the natural land contour to maintain uniform total depth of the bed bottom.
2. T1c bottom of the bed shall be level, plus or minus 1.5".
3. The depth below grade of the gravel layer is not to exceed 2.91 as measured at the monitor tube.
4. Coarse Sand shall be utilized where necessary to build up the bed to grade if deep topsoil is
encountered and excavated.
1
5. 1be effluent lines (3) arc to be 11" PVC lines with 1/8" holes drilled 12" OC within the Icachrield,
placed facedown, or up with orifice shields placed over holes. Line from tankto field is to be 1-1/4"
IlDPE.
6. Ile bed gravel is to be covered with typar fabric material.
Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed
overthebcd. Mounded side slopes not to exceed 3:1.
8. Ile septic tank and leachrield must not be closer than 100' to any existing private well, 1W to any
I Class "C" well, or 200 feet to any community well.
U003\04-11313cd-lift- spec.doc
SPECIFICATIONS FOR ('..'SITE SEPTIC SYSTEM — MOA CERIED INSTALLER
LEGAL: Scimitar 01 W 4 Hlk I
February3,2005
Continued:
RECOMMENDED LEACHFIELD DIMENSIONS:
BOTTOM OF GRAVEL LAYER - 2.9' Below Grade at monitor tube
GRAVEL THICKNESS= 6" under pipe, 2" over pipe
BEDLENGTH— 30' BED WIDTTI - 151
SOIL RATING = 2 GPD/115 BEDROOM CAPACITY = 4
�SEPTICTANK- 1,500 Gal tank for use w/Advantex system and pump basin
EFFLUENT PIPE = I" PVC with 1/8" holes oriented down, or up with orifice shields spaced at 12" OC.
Twenty-four (24) hours notice required for all Inspections.
\2003\04-113Bcd-lift- spcc.doc
(04�
EAGLE RIVER
ENGINEERING SERVICES
P.O. Box 773294
Eagle River, Alaska 99577
(907) 694-5195
ERES Project No.: 04-113
Calculated By: CW
Date: 1/31/2005
Legal: Scimitar Sub #1 Lot 4 Black I
Single Family 4 Bedroom Dwelling
Bad Subsurface Wastewater Disposal Field
Water use at 150 gallons per bedroom =
Percolation rate -
Wastewater application rate -
Required absorption area =
Bed width (W) =
Gravel depth (D) =
TEST HOLE I
600 gallons
30 minutes per Inch
2 gallons per day per square foot
300 square feet
15 feet
0.5 feet
Required length - Required absorption area / Bed width
Required length - 300 1 15
Required length - 20 feet
Total Excavation Depth = 30 feet
2.61
04-113—bedCalc 0:01 PM113112005
QE I
'IE RS
I Municipality of Anchorage —V
NEER'S
10 Development Services Department 49)
Building Safety Division
On -Site Water and Wastewater Program
47M South Br2gaw St. - t-;�44
P.O. Box 196M Anchorage. AK 99519-6650 CHRISTOPHER R
.wmw.cf,anchoraQe ak-u CE -i
(907) 343-7904 X
Soils Log - Percolation Test
Performeil For. Date Performed:
I - 7,/3 W�,�
Legal Description: .5" el Township. Range. Section: 7- 1 �0 R 16)
Slope Site Plan
F -F -r -F-1 I I I -T -li i i r—T—r-i
Depth
11
12-
13-
14-
is-
16-
17-
18-
19 -
COMMENTS
I
Ir
FCCA-W) 01"fIffl-c-
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WAS GROUND WATER
T7(�flr ENCOUNTERED? NA 5
I Z
B0 rlor/� IF iES. AT WHAT DEPTH? 7
Depth to Water After P
M�Koring? 4 -'9 E
Dole: )QzQj5/0
Reading
Date
Gross rime
Net Time
Depth to Water
Net Drop
-77..
-el e�
el
50
e� r/,-
-r/.
� f P`LK� MULE. DIAMETER
TEST RUN BETWEEN -5:/ FT AND O�- FT
PERFORMED BY:
CERTIFY T14AT THIS TEST
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
_10LAI
I Municipality of Anchorage 1.) 'UN
Devefopment Services Department
Building Safety Division
On -Site Water and wastewater Program
4700 South Bragaw SL I I CHRISTOPHER R. WOOD
P.O. Box 196650 Anchorage. AK 9951"650 %
,-www cf.anchorage sk.0 CE -10387 Z
(907) 343-79G4
SS
Solis Log - Percolation Test.
Performed For. RPA b -xin) t1Aj!;,ne-) Date Performed: `7
Legal Description: 5;(-T Ll Township, Range. Section: T 15 t,,.) r
14 - - I
FDepthl
91z0Lj#j Tv
F1 -:'q �w - 4 0
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0
7-
8 -
WfAf RAM IMM
WAS GROUND WATER
0
ENCOUNTERED? tj
IFIFES. ATWHAT DEPTH? L
Depth to Water After 0
P
15-
is-
17-
18-
19-
Date: —
PERCHOLEDIAMETER 411
TESTRUNSETWEEN FT AND FT
COMMENTS
PERFORMEDPY: If ff P7-_ C, 1010 L) C H Pj- Sr, t,\10,-)� CERTIFY THAT THIS TEST WAS
') C?>
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: IL
WfAf RAM IMM
PERCHOLEDIAMETER 411
TESTRUNSETWEEN FT AND FT
COMMENTS
PERFORMEDPY: If ff P7-_ C, 1010 L) C H Pj- Sr, t,\10,-)� CERTIFY THAT THIS TEST WAS
') C?>
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: IL
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Certificate of On -Site Systems Approval
Parcel I.D. 051-132-05
Legal description SCIMITAR #1 BLK
Site address 20212 Chugach Park Dr
Current property owner(s) Craft
Expiration Date:
1 LT 4
X The On-site system(s) is/are approved for 4 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
Original Certificate Date: 1 / 31 Za'L 3
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
systems) 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
MUNICIPALITY OF ANCHORAGE
Development Services Department f 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. 051 132 05
Complete legal description SCIMITAR#1 BLOCK 1 LOT 4
Location (site address) 20212 Chugach Park Drive
Current property owner(s) Craft
2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS
Day phone
3. TYPE OF WATER SUPPLY: ❑■ 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: X Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: X Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age 18 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for: NONE
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 $ J Jy
Date of Payment
COSA # �35C i
a6(v
Waiver Fee $
Date of Payment
Waiver #
COSA Application_June 2022
COSA Checklist_June 2022
COSA Checklist
Legal Description: Parcel ID:
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled Total depth ft
Cased to ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Well production at time of test gpm
Water storage tank volume gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date
Comments __________________________________________________________________________________
B. TANK DATA
Measured operating fluid level in septic tank
Date of pumping
Required maintenance completed, if AWWTS
Comments:
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed)
ALL standpipes present per record drawing
Total measured depth from grade ft (max)
Measured depth to pipe invert from grade ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes go to bottom of effective.
If not, state depth into effective
Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months)
If yes, enter date
Adequacy test date
Results Pass
Fluid depth prior to test in
Water added gal
New fluid depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) in
Effective depth used in
Effective depth remaining in
Comments/Deficiencies:
COSA Checklist_June 2022
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Absorption Field on Lot > 100’ Yes if No ft
Neighboring Absorption Fields > 100’
Yes if No ft
Community Sewer Main > 75’ Yes if No ft
Community Sewer Manhole/Cleanout > 100’
Yes if No ft
Private Sewer/Septic Line > 25’ Yes if No ft
Holding Tank > 100’ Yes if No ft
Animal Containment > 50’ Yes if No ft
Manure/Animal Excreta Storage > 100’
Yes if No ft
N/A – Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10’ Yes if No ft
Tank to Property Line > 5’ Yes if No ft
Field to Property Line > 10’ Yes if No ft
Water Main > 10’ Yes if No ft
Water Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No ft
If tank or field is under driveway comment below
F.ENGINEER’S COMMENTS
G.CERTIFICATION & 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, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm Phone
Engineer’s Printed Name Date
C&M ENGINEERING
CHARLES BALZARINI, PE 1/05/23
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 0 Day of J?W tA4 f jl of 20�25 by and between
Lv lti. 12 . Forneletsvrt 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 ADVANTEX
located at (legal description)
SCIMITAR#1 BLOCK 1 LOT
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS 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.
10 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).
LCA Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Rid' Owner acknowledges that regular maintenance of an AWWTS 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
LflA Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
L/0 Owner acknowledges that the fine for failing to maintain and repair an AW WTS maybe
assessed in accordance with AMC 14.60.030.
1 A Owner agrees to grant the Municipality reasonable access to test and inspect the
AW WTS. The Municipality will give at least 24-hour notice.
L Rt4 Owner agrees that any sale or transfer of title of the property will not occur without anew
Certificate of On -Site Systems Approval.
/914 Owner agrees that the AW WTS installation and maintenance requirements as provided
by the AW WTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AW WTS.
_4_YZA Owner agrees to maintain remote monitoring of the AW WTS 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 AW WTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. 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 shall govern 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
OWNER:
By: 1� _ (signature) Date: ! !0 Z 6 �3
�., le ,e, de ,-s un (print name)
STATE OF ALASKA )
ss.
THIRD JUDICIAL DISTRICT )
The foregoing instrument was acknowledged before me this 1D day ofV�i/ti ,
2oa.� , by STATE OF ALASKA
NOTARY PUBLIC �h
NOTARY PUBLk FOR ALASKA , r Jenie R. Sta. Maria
My Commission expires: _ - �°Z `r ; My CwniWw EJ#re�
MUNICIPALITY:
By: ��(� d— (signature)
(print name)
Date: 13 2 02 3
Title: C,1,.. i! 1 �Z
(rev. 05/18/2018) Page 3 of 3
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
BETWEEN MUNICIPALITY OF ANCHORAGE
AND Joshua Craft
THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this
15 Day of September of 20 16, by and between Joshua Craft
herein the "OWNER," and the Municipality of Anchorage, herein the
"MUNICIPALITY." In consideration of the mutual covenants contained herein, the
parties to this Maintenance and Repair Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. Municipality grants permission to
Owner to utilize and operate an Advanced Wastewater Treatment System
(AWWTS), described as
AdvanTex
located at (legal description).
Lot 4, Block 1, Scimitar #1
2. Definitions.
Alteration. Any change to the design or function of an AW WTS that
includes the installation or removal of any parts, components or pieces not
included in the original construction permit and design.
Certificate of On -Site Systems Approval (COSA). An approval by the
Municipality of existing water and wastewater disposal systems given at
the time of property sale and title transfer in accordance with Anchorage
Municipal Code (hereinafter, "AMC') 15.65. These approvals certify that
the systems are adequate for the homes that they support and meet the
codes that were in place at the time of system construction.
Damage. Any man-made or natural change in a system that would inhibit
the system from performing as designed.
Maintenance and Repair. The scheduled and as needed replacement of
existing parts, components and pieces of an AWWTS that were included
in the original design which would allow the AWWTS to continue to
perform as designed.
Permit. An On -Site Wastewater Disposal Permit as required by AMC
15.65 to construct and operate an AWWTS.
3. Term. The term of this Maintenance and Repair Agreement shall begin on the
date of approval by the Municipality to operate the installed system or issuance of a
COSA, and shall continue while the AWWTS is in use or is operational or until the
property is sold or title is transferred by the owner and a new COSA is issued to the
new owner or transferee of the property.
4. Alterations, Installation and Removal of Additional Equipment. Prior to
performing any alterations to an AWWTS, the owner agrees to obtain an On-site
Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65.
5. Maintenance and Repairs.
A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall
maintain their AWWTS in a satisfactory condition capable of producing treated
septic effluent in accordance with the equipment's approval for operation in the
Municipality. The owner shall enter into a service agreement with an AWWTS
service and maintenance provider approved by the municipality and the
manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it
shall be the responsibility of the Owner during the term of this Maintenance and
Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay
for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement
costs, and (5) inspection costs.
B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules
and orders for the AWWTS.
C. Upon request by the Municipality, the owner agrees to provide the Municipality a
written schedule of routine maintenance and repairs which have been performed
on the system. When a record of maintenance is documented and maintained by
the system vendor, the owner agrees to allow the Municipality access to this
information.
D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS
may be assessed in accordance with AMC 14.60 for improper discharge.
E. Owner agrees that only maintenance and repair personnel approved by the
Municipality will inspect and make any necessary maintenance, repairs or
permitted alterations to the system.
F. Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS upon 24 hours written notice.
G. Owner agrees that any sale or transfer of title of the property will not occur
without a new Certificate of On -Site Systems Approval.
H. Owner agrees that the AWWTS installation and maintenance requirements as
provided by the AWWTS vendor/installer and approved by the Municipality are
the governing guidelines for the construction, maintenance and repair of the
Owner's AWWTS.
I. Owner agrees to provide and maintain a telephone connection to the AWWTS as
required by the AWWTS approval.
6. Nonwaiver. The failure of either party at any time to enforce a provision of this
Maintenance and Repair Agreement shall in no way constitute a waiver of the
provisions, nor in any way affect the validity of the Maintenance and Repair
Agreement or any part hereof, or the right of such parry thereafter to enforce each and
every provision hereof.
7. Amendment.
A. This Maintenance and Repair Agreement shall only be amended, modified or
changed by a writing, executed by authorized representatives of the parties, with
the same formality that this Maintenance and Repair Agreement was executed
with, and such writing shall be attached to this Maintenance and Repair
Agreement as an amendment.
B. For the purposes of any amendment modification or change to the terms and
conditions of this agreement, the only authorized representatives of the parties
are:
a. Owner: Joshua Craft
b. Municipality: Director, Community Development or designated authority
C. Any attempt to amend, modify, or change this contract by either an unauthorized
representative or unauthorized means shall be void.
8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance
and Repair Agreement shall be brought in the Superior Court for the Third Judicial
District of the State of Alaska at Anchorage. The laws of the State of Alaska shall
govern the rights and obligations of the parties under this Maintenance and Repair
Agreement.
9. Severability. Any provisions of this Maintenance and Repair Agreement decreed
invalid by a court of competent jurisdiction shall not invalidate the remaining
provisions of the Maintenance and Repair Agreement.
OW7_(signature)
R:
By:
Josh a Craft (print name)
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT )
The foregoing instrument was acknowledged before me this
201 V , by 13 I -es wroA e -n pey*-p
�In��itN4-l-l.vn07�,
NOTARY PftOt FOR ALASKA
, K
My Commission expires: 14' 1 u(s.
MUNICIPALITY:
By: (signature)
Date: 09/15/16
1i day of
�N\ QP G E4 111i
mid apTgq�,
86G
Date:
name) Title:
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
r www.muni.orglonsite
. JR (907) 343-7904
CERTIFICATE OF ON-SITE SYSTEms APPROVAL
FOR A SINGLE FAMILY DWELLING
44?.-�7 , ,
Parcell.D. 091-13A-65- COSA # 01121)qO5
Expiration Date: 2 17-,g
/0;7
1. GENERAL INFORMATION
Complete legal description 5CrM174R. LOT- 14
Location (site address) Zo?-17- c"_jAeA_aj+ P"r- hk -
Current Property owner(s) B(�+b J-0 H*-k$cP� — Day phone
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
ZyJ34 &��IrQe- erviiiik Pa4b 467A 41C 7?5'77
Unless otherwise requested, COSA will be held by DSD for pickup.
Day phone
Day phone
3,0 1 - (' ? Ll 7
2. NUMBER OF BEDROOMS:
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
El
Public Water System
Public Sewer
El
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
bile (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 CerVficate 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 - EA&IC IZXJtR &W�r44-ZR7A).< Phone
Address login VFjj AA. :5t4.rr&- se I e,+et4,&akX4X c)4y!;-77
Engineer's Printed Name 4�kr!C7ypW R. WCIW� Date 1) /27/0 /6
I
5. DSD SIGNATURE
V' Approved for LA bedrooms.
— Disapproved.
— Conditional approval for _ bedrooms, %vith the folic
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineers Report
Other
B, &'4 Original Ce rtificateDate:
(Ft*�. 11105)
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Ske Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-W5O
www.muni.orglonsite
(907) 343-7904
CERTIFICATE OF ON-SiTE SYSTEms APPROVAL CHECKLIST
Legal Description: ScInU17AA 0- 1 13 1 L Y Parcel I D: 051 - 1'32 -05
A. WELL DATA
Weil type f�K%147'0- If A, B, or C provide PWSID #
Dale completed -L11V1Z0PV Sanitary seal
Total depth Zk—ft- Cased to.:&7- 0 ft.
FROM WELL LOG
Date of test 3hphooi-
Static water level ft.
Well production g -p -m -
WATER SAMPLE RESULTS:
Well Log 6�N) 1.46r.$
Wires properly protected&) Yk-,5
Casing height (above ground) Z 4/ n.
AT INSPECTION
,V/,+
'V/f
'V 14 . g.p.m.
Coliform _-�---colonles/100 ml- Nitrate �. d, mg/L Other bacteria 0 colonies/100 ml -
Arsenic: mg/l Date of sample: 10-6-106 Collected by: C�a rl 6gl7tat'll);
B. SEPTICIHOLDING TANK DATA
Tank Type/Material .14wc* r4wrc Date Installed lb IV 5' IZ4,v
Tank size I gal. Number of Compartments -Z-- Cleanouts (ON) V65
Foundation c3eanout &N) Yf-5 Depression over tank (Y& A"> High water alarrr" AW y6r�s
Date of pumping ,v 14 Pumper 'y Z4
C. ABSORP71ON FIELD DATA
Date Installed -LQhL4E1:vvrSoiI rating (g.p.d./ft' or Ft;bd v v '*2- system type Aby4-Aiex istc-t>
Length 312 ft. Width ft. Gravel below pipe o' ft.
Total depth 415- ft. Eff. absorption area Yaft? Monitoring tube -N/&L'J� Depression over field AJ 0
Date of adequacy test Al /4 Results (Pass/Fail) P.+Sf For Z/ bedrooms
Fluid depth in absorption field before test C' In. Water added 0 gal. New depth_g2_ in.
Elapsed Time: Q min. Final fluid depth 0 in. Absorption rate >= 460 g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) AJ14- If yes, give date Al A
4-
D. 4dM8'r*1rIe ! - Re-c-1,rc"6if-on P"MR kA,,�,J
Date installed 10/5/C�00-15 Size In gallons 1900 ManholelAccess ON) � e.�
*Pump on*level at in. OPump off' level at 15— in. High water alarm level at 10 in.
Datum TOO Of n Cycles tested AOAO, MP(,-) Meets alarm & circuit requirements?ye5
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankilift station on lot 4 1&,o I
Absorption field on
Public sewer main
t + too
+ 10,0 "
On adjacent lots 4 1 Ly
On adjacent lots -t- 100
Public sewer manhole/cleanout +I V�J
Sewer /septic service line - 4' Z- S' Holding tank 4 wo
Animal containment areas 4 1&90 Manurelanimal excrete storage areas
SEPARATION DISTANCES FROM SEPTICIH0691N TANKONLOTTO:
Building foundation +5 Property line + 5 Absorption field 4- 5
Water main + lot Water service line Surface water
Wells on adjacent lots I- too
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line Building foundation '1-149 Water main
r I
Water Service line 4-10 Surfacewater +/00 Driveway. parking/vehicle storage + 10
Curtain drain + TO I
+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
Wells on adjacent lots -+ too I
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name 6 49r57UP*6* ?- W01�1>
Date 11 ZZ -;X /0 e
COSA Fee $ 7' e-2)
Date of Payment /6 t,
Receipt Number
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
Eagle River Engineering Services
Christopher R. Wood, P.E.
10421 VFW RD. Suite 201 (907) 694-5195 tel
lEagle River, AK 99577 (907) 694-3297 fax
November 29, 2006
Deb Wockenfuss
Review Engineer, On-Sitc Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re: Scimitar #1 Lot 4 Block 1
COSA Test Hole clarification letter
Dear Ms. Wockenfuss:
This memorandum is to clarify the location of the deep test hole on Lot 4 of Scimitar #1 Block
1, as noted on COSA Review Comment sheet item #1. It was noticed that the test hole
identification Ws were transposed on our soil logs. Please see attached soil logs with the correct
Ws. Hopefully this clarifies the test hole identification question and any confusion this may have
caused.
We have addressed all comment items, and they have been corrected on the attached Inspection
Report forms. Please let us know if you require additional information to assist the approval
process.
If you have any questions please call our office at 694-5195.
Sincerely,
EAGLE RIVER ENGR,;EE4TNG SERVICES
OWK /c�–/—
Christopher R. Wood , P.E.
Principal
\2003\04-113TEST)IOLEMEMO.DOC