HomeMy WebLinkAboutAUDUBON HILLS #1 BLK 3 LT 1Audubon Hills
#1
Block 3
Lot 1
#015-231-60
Municipality of Anchorage I
Development Services Department ,
\�
Building Safety Division
On-Site Water and Wastewater Program, 4700 Elmore St.
P.O. Box 196650 Anchorage, AK 99519.6650 Page of
www.ci.anchorage sk.us (907) 343.7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SW PID Number: 015-231-40
Nanks R-ssel ker,..4z
Wastewater System: ElNew Z Upgrade
A°Nau
2450 AJ.46, Drive
ABSORPTION FIELD
Phone NunibN of Bedouins'
4
O D«p rr.ixll D Snenaw TlerNil KBeO O MWn° D other
LEGAL DESCRIPTION
Sea Rating
150
701M D1PM am orlprw grade
GPDIFta
z.S Ft.
Bloc Lot ( SuDanaon .r
�1
Depth to ppe boom ear, Nuwnl grade
Gr"dWh beneath ppe
3 AUa teen ;11
FI.
0.5 Ft
T~mp Range Seaham
FII aeeae above anpnot pa°e
Gravol Length
I �2 FI.
2o FI.
Well: Ex1S •A ❑New C] Upgrade
Wavol Waal
t0
Nuiroer al Ines
2
DmaneMMvarl knee
5
Ft.
Fi
cnsrbubon lPn«tor, XB cp
Total Depth
cow 10
Total absorption area
Pipe materia
Ft.
Ft
Zoo Fir
5C1h 40
Grow
Dale DNNO
Slaba Wath LeVN
InsiolIN',L
Dale a1 712W
Fi
Rao -'[ 0--d.IL
E 23 08
nolo
Pump SN at
r
cane Heght Aimee Ground
TANK
GPM
FI.
FL
SEPARATION DISTANCES
0 Septic O Holding ❑ S.T.E.P. CI Other.
To
Septic
Absorption
Lift
Holding
ubbtlPtivate
mi ad1 or
Twwl;
cspay
From
Tank
Field
Station
Tank
Sewer LineAnchor
Get Z
we
too,
I00 {
1
�•S i
mal«al
Stec
Hamber al Dom«rb«nls
I
Surlac waterloo'(.
\00`}
LIFT STATION f
%1 1
s
t
n
180wo,
Lot L,«
5 +
104
Gel
FWrMatian
t
t
'Perry on, Ievol at
'Pump oN' pvN N
High enter alarm at
5 �
� D �
N
in
N.
Cunrn Onn
N.D.
N•O•
Pump make d ModelEls
knspecams parlorme7 by
Ramarka
BENCH MARK
Lwobw and D..puan
wmw Ejorou.
l0UFI.
Inspections performed by: L�la..f�w�[Y SbDates: 1a' t3 z3 08
OF.
�:
Development Services Department Approval
_l a
.....
'
Conditional Approval Date:
l Gi f 1150- :C>`
t�vF1SeJ
Reviewed and approved b ' Dale:
IRs area)
i------------------------ -
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I I
112' 26.5' C
I J 10.0. 5 14.5' RESfRVL $,
1 K 36' 11' ARU
I III I
1 N5TAt1UD 1150 OAIEON S17W TANK TH —0
DMAVAND I=AV BED I
LDNDTH 10 FELT, WN 10 W
I I AWAU[D 43 FELT RUER SAND 11 I
BO(TOY ROCK O Z5 fW RaOW GS
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25 0 25 50 75 100 125 150
SCALE, I' = 50 FT.
LARS
ISPURKLAND ENGINEERING OT 1 BLOCK 3 AUTUBON HILLS I I SEPTIC SYSTEM ASBUILT
203 W 15TH. AVENUE DATE: OCT. 20, 200E
ANCN. AK. 99501 RUSSEL KOONTZ
,,,,,,, „„& I r AUDUBON DRIVE SHEET 2/3 GRID: 2739
PERMIT #SW060117 PID # 015-231-60 Audubon Hills B3L12.dwg
TEST ROLE
,
soma=-
��������
,
w��1�i 1, lwmm
MWI M? TUBE
BIOCYCLE 6000
1250 GAL SEPTIC TAW
•
tnap-�,rw rpill.
1M7M TUBE
I '
SANB/GRAVEL BADTILL
0
1150 GIL SEPTIC TANK
W
49th �^1 0:
SPURKLAND ENGINEERING AUDUBON HILLS BLOCK 3 LOT I SEPTIC SYSTEM ASBU/LT
103 W 15TH. AVENUE 11350 AUDUBON HILLS OR/VE DATE. OCT. 20, 1008
(NCH. AK. 99501
(907) 279-3916 11 RUSSEL KOONTZ SHEET- 3/3 GRID: 1739
PERMIT # SV080117 PID k 015-231-60 6VhVl073DV6
MUNICIPALITY OF ANCHORAGE 9-22. 05?
Development Services Department P 3
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Jul 08, 2008
Expiration Date: Jul 08, 2009
Permit Number: SWO80117 Parcel ID: 015-231-60
Legal Description: Audubon Hills #1 Block 3 Lot 1
Design Engineer: 0007 SPURKLAND ENGINEERING Site Address: 12350 Audubon Drive
Owner Name: RUSSELL KOONTZ Lot Size: 44636 SQ. FT.
Owner Address: 12450 AUDUBON DRIVE Total Bedrooms: 4 Permit Bedrooms: 4
ANCHORAGE, AK 99516 -
This permit is for the construction of:
Z Disposal Field ❑ 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.
Issued By.
Date: * Og
Date: 7 -q
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.orglonsite
(907) 343-7904
ON-SITE SEPTIC/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. n 5 '0131- lot)
Propertyowner(s) t4s5eton}z. Dayphone aaci-lltP�P
Mailing address Zip Code
Site address (A; SO Au,1,46nn Drive Zip Code `1'i510
Legal description (Sub'd, Block & Lot) A A.1 6r` wills 1�1oc,k �S Lo4 2
Legal description (Township, Section & Range)
Lot Size 40, ID�� _Sq. Ft.
THIS APPLICATION IS FOR (®all that apply):
Absorption Field
Septic Tank
❑
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage
❑
Number of Bedrooms I
THIS APPLICATION IS AN:
Initial
❑
Upgrade
29:
Renewal
❑
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)
PermiURush Fees: lQD Waiver Fees:
Date of PaymentA//)/p.. al� Date of Payment:
Receipt Number: b 5D / Receipt Number:
(Rev. 11/05)
Environmental Consulting and Design
SEPTIC SYSTEM DESIGN
AUDUBON HILLS BLOCK 3 LAT I
Municipality of Anchorage September 12, 2006
Development Services Department
On Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, Alaska 99519
Subject: Septic System Permit
Audubon hills Block 3 Lot 1
Ladies and Gentlemen:
1 am writing to request a permit for the replacement of the absorption field serving this property. The existing4 bedroom
home is served by a private well and septic system. The final inspection report was never approved because the
absorption field may be periodically inundated with ground water. In order to bring this system in to compliance with
current code, the bed must be raised four feet and re -constructed.
Soils: A soil log was included with the original permit application (Permit Number. SW 030447). The attached copy
indicates One and a half feet of organics followed by 5.5 feet of dense brown sand w/ gravel. From a depth of 7 to 12.5
feet a dense silt was present. Water was encountered during the excavation at a depth of 12.5 feet. The total depth of the
test hole was 12.5 feet. Ground water monitoring over the last two years indicated that the seasonal high ground water is
at 6.5 feet below the ground surface (4/22102 7 feet, 5/3/05 6.5 feet, 7/21/06 7.5 feet).
Surface Water: There is a drainage ditch along Audubon Drive. Flow was observed in the ditch on July 21, 2006.
The drain field and Bio cycle tank are over 100 feet from the observed water.
Topography: The average topography in the area of the septic system slopes to the west at less than 10 %. The area
of the drain field is level.
The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent
lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of
surface runoff will not result from this installation.
If you have any questions or suggestions that may improve the proposed system, please contact me at 279-3916.
Sincerely, /
Spurkl rid, P.E.
Civil Engineer
203 West 15'" Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (907) 276-6013, SpurklandEng@gcLnet
`- Environmental Consulting and Design
L SEPTIC SYSTEM DESIGN
Audubon !fills Block 3 Lot 1
Municipality of Anchorage June 24, 2008
Development Services Department
On Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, Alaska 99519
Subject: Septic Permit Revisions
Audubon Bills Block 3 Lot I
Ladies and Gentlemen:
The following revisions are being submitted to the original septic permit application for Audubon hills Block 3 Lot 1.
Per meeting with Dan Roth, approval has been granted to install a 1250 gallon tank prior to the Biocycle unit. The
existing bed will be excavated. Ground water was measured at 6.5 feet below the existing ground surface on May 51h,
2005. This is assumed to be the seasonal high for groundwater. A minimum of 4 feet of vertical separation between the
bottom of the drain field and seasonal high ground water will be maintained with the addition of MOA approved filter
sand. (4+feet). Maintaining four feet of vertical separation from the base of the drain field and ground wateralongwith
a highly clarified effluent a will ensure that ground water quality is maintained and that public health is protected.
If you have any questions or concerns, please contact me at 279-3916.
Sincerely,
L sP
Lars Spurkland, P.E.
Civil Engineer
203 Nest 15'" Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (907) 276-6013, SpurklandEng!a`gci.net
F-- - - - - - - - - - - - - - - - - - - - - - -- -
-------------- •�—
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Test Hole 9/25/06
I EA $/
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� NSTALL 1250 GALLON SCPIIC TANK
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I LENGTH 20 FELT. W7 0 CECT I
INSTALL I ftCr !ITER SAND -
BOTTOM ROCK O 2.5 RET BELOW 0.1 I 1
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No. CE-II500.'�'��
25 0 25 50 75 100 125 150 • ••• •
SCALE? I' = 50 FT. astir,
.... i••�
SPURKLAND ENGINEERING OT 1 BLOCK 3 AUTUBON HILLS SEPTIC SYSTEM DESIGN
203 If 15TH. AVENUE DATE. JUNE l9, ?007
ANCH. AK. 99501 RUSSEL KOONT7
/vn7) 97o -.role I r AUDUBON DRIVE SHEET- 2/3 GRID: 2739
PERMIT 11SW060XX PID k 015-231-60 Audubon Hills B3L12.dwg
I' WNW
ASTM 3031
GRAD£ TO MAIN AIRCOMPRUSOR
GEDT£XTIL£ _�11
-17
=,MCK 3, ,UR LyrS
AC71VAI£D SLUDGE
20• 1150 GAL. SEPTIC TANK
STANDARD BED BIOCYCLE 6000
NTS
MNITOR Tue£
20'
!s
1-1/I' SCIiCDL[£ 10 PVC V/ 3/8' FCd£S P 30'
TOP AND BOTTOM
LF2
1_I:e
MN17 7 TUBE
1250 GAL SEPTIC TAW
�.�POF
(E ,.......•, .,���i
�t ,,49th ° •��
i"
LARS SPURKLAND••
(fLut�
•�� �•' No. CE-It500 �'t ��C �
SAND/GRAVCL BACKFILL �`.r�;'•.,_ _,irtr_i
X'UMALAIVU LNGINLLNNNG I I AUDUBON HILLS BLOCK 3 LOT ApppBO�T BLOCK LpT L��SEPTIC SYSTEM SHEMAT/CSYSTEM SHEMAT/C
203 W 15TH. AVENUE 12350 AUDUBON HILLS DR/V£ DATE.• JUN£ 19, 2007
(NCH. AK. 99501 RUSSEL KOONTZ SHEET. 3/3 GRID: 2739
j907) 279-3916
PERMIT # SV030XX PID # XX GVW1073BVG
BioCycle Alaska, Inc.
Lars Spurkland, P.E.
Spurkland Engineering
203 W. 150'Ave
Anchorage, AK 99501
Re: BioCycle Wastewater Treatment System at
Dear Lars:
aerated wastewater treatment systems
October 11, 2006
Regarding our recent conversation, I am providing you the following information on the
BioCycle system you requested.
Volume of Discharge Chamber: The BioCycle discharge chamber has a working
volume of 470 gallons. The dimensions of the chamber are as follows: diameter = 4 feet
and height is 5 feet.
Effluent Filter: BioCycle uses a Sim -Tech filter that contains a stainless screen and a
600 micron filter sock. We have used this filter for several years and found it to be very
effective and reliable. We perform maintenance on each BioCycle system every three
months and change the 600 micron filter sock as part of the maintenance procedure. We
have never experienced any problems with this filter. Enclosed please find some
manufacturer's literature for the Sim -Tech filter.
Discharge Controls: We use a SJE Rhombus "Vertical Master" pump control for our
discharge pump. The dosing volume with this pump control averages approximately 50
gallons. We can exchange the "Vertical Master" out for a timer on the pump if the 50
gallon discharge volume is not what you need.
Regards,
BioCycle Alaska, Inc.
6A -S r&A Al�
Gus Andress, President
1504 W. 47'' Ave, Unit B 907-563-1646 office
Anchorage, AK 99503 907-3986574 cell
biocyclealaska@,alaska.net
I
sTF-100 FEATURES
STF-100A2
F.IFR SCREEN
t 7n I.
EF W CRATFJ RF TA'
2)G/. STA -KESS STEEL TYK347 le a ..i
N,1N 00?)N Es
75
A
A-
—f
1
_
l__: A
A r SOUR WELC UTA?V
73 571 1 1
TE0
1
r—+ 17 121
_a
1
225-51 I
W4' KIT FCR
l.___J
i.
MESS KA Qv
V
aW 1GM
30
so
3422 qle
!27En
1
I
FLYER01Ert0. c-jT,"
r Km
8r Low maintenance
t• Easy to install and service
t• Economical
C Extends life of drain field
4- Improves effluent quality
i• The last line of defense before the laterals
fi Vortex scrubbing action helps keep filter
clean providing maximum maintenance
intervals
i Uses a S.S. filter screen with .062
diameter holes
t• Provides a 69.52 sq. in. or 41% open
area which allows the filter to pass 83.8
GPM at 1 PSI
4 Assures quality effluent with lower TSS
levels, keeping pressurized systems
functioning at 100% efficiency
+• Low head loss .5002 R or .21 PSI
6 Flow rate with clean screen 120,672 GPD
@ 1 PSI
Z• Flow rate with 95% plugged screen
114,912 GPD @ 1.8 PSI
G Job ready with 2' schedule 80 union
and tailpiece attached (STF-100)
Field assemble does not include union
or tailpiece (STF-100A2)
<• Use optional filter socks to filter smaller
particles
Order part No. STF-100
STF-100A2
CAD detail drawing available in DXF faunal
RELATED PRODUCTS
STF-104-600M page 14
STF-104-150190M page 14
STF-104TN page 14
STF-101 page 14
STF-101A page 14
STF-107page 14
STF-102 page 14
STF-FC page 14
STF-150page 14
U.S. Patent • 5.885,452 STF-1038page 14
Canada Patent 8 2.237,751 STF-105 page 14
Toll Free 888-9933290 Office 231-582.1020 Fax 231-582-7324 EmilaimtedT@freeway.net Web www.simtecnfilter.dom PAGE
N
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^„
Sem �b�
Municipality of Anchorage ? '
Development Services Department
Building Safety DM31on
On-Site Water and Wastewater Program, 4700 S. Bragaw SL
P.O. Box 196650 Anchorage, AK 99519-6650 Page I of 3
www.d.anchorage.skus (907) 343.7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number.
4 0W IF/ PID Number. /r - - bo
-
1 7
Wastewater System: CdNew ❑ Upgrade
Adae.e D o
ABSORPTION FIELD
Pone
I
Fn.ew a s
D Deep Twch D Sneno.e Tew d *f d Q M.W D Omer
LEGAL DESCRIPTION
°""'"v
TOM Dpneomaporped..
F
B�orx la
--A,>
6'bM
_A-X b 1� �,..
Deph to Ma Doran fan eelpfer Grade:
FI.
Fa added eDo"e alpfW V•d•.
Greel mpe, Duran P"^
V FI
Gr"Lente:
TenNq Rhee
Samom
Ft.
120 Ft.
Well:o.wnad
[ New
E] Upgrade
10
Mmwrfnee
omerceeenweewe
Ft.
15 F
er",11can PMMs. A a, ct
Tar Depeu
eeeed la
7"Own so n "a
P"Maal.l.
7
✓
o Ft.
FL
Oto Fl
S k I/o f
Meer
I L
Data Drre
Slrkwrr Lea
frt~
D 1006
Doe futrled
Q%23�o
11-17--04
O FL
Y,W 2 n Puegarr
3—TQ
DeeeyIM1fMADeeGfa.ea
TANK
GPM Be,
Ft.
K
SEPARATION
DISTANCES
❑ Septic ❑ Holding ❑ S.T.E.P. Mother.
7o
Septic
Absorption
Lift
Holding
PuWkJPdvat
Mera,[ AW.
Cap"
From
Tank
Field
Station
Tank
SewerUne
/ ODG.1
vn"
Ij)tjP10
)t:
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MrrW:
/'i G
Nu Ofc rlmeme'
13a
13O
LIFT STATION
La L""
rJ5
rJ'
//o D•O Gr
/p d` r_LF
;75Pomp
.Pump elr te«el f{yFeu
ala
10
\ 0W-UAh
canto DramPump
N�o
N�o
Mefe a Moet
EMaixalf"p.abeuP.M W
iL
rd
R.mrf.
K Tto 1 "G 14
BENCH MARK
Loumn said Dewpom:
'14 in `i o tA S lbtisl
Asr Erreuon
in 0
100 �
'as,
edoea eA
Inspections by:
I-AIZS ST VJZVkAHDates: 1" 123,10y
'
performed
2n4 9R o
21 e
a3 7'borL`�
Develop
nt Services epartment Ap royals'
tr.aa ,p
R 'wed d by: Date:'
L
Sem �b�
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OD + 21.3'
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ARfAI
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TOH SPURKLAND ..
N0. -2225 ••.••• ti, i
25 0 25 50 75 107 125 150
SCAL& P = 50 FT.
1
I lUWt.N 5FUKKLAIVU r.L.I r
OT I BLOCK 3 AUTUBON HILLSII SEPTIC SYSTEM ASSUILT
203. K.Th! AVENUE RUSSEL KOONTZ DATE, SEPT. 30, 2004
/oml 9>•o_rolR
ANCHAK. 9950E AUDUBON DRIVE SHEET.' 2/3 CRID: 2739
PERMIT �SVO30447 PID if 015-231-60IPERMIT PIB 015-231-60 ABH03012BVGG
b
4' PMMF
ASTM X34
CRAW TO ARAN
BACK FAL
� 2p'
STANDARD B£B
NTS E
24' MV
v.=94r
A = 935' I Q m
= 92.3' I %n
Dotter+ Testwe
ELEV. = 87'
TIILNDDATIIN aEAN OUT
SLLPL' MIMED GRADE AVAY
FROM TLP N ALL DIRECT W
AµI $
DISCHARGE
"101��
—1 1
4' PVC NLLENT
tD PPRIWY CMWBER
m ACRATMV CHAMBER
0 CLARXER
GDISLHARW CHAMBER
BOTTOM OF TANK
�2' BLLCBWB NSLCATILW
INSTALLATION
L EXCAVATE A 10' x 10' x 10' A2P WE M =CYCLE SYSTEM
E FLAX A AW" Or 4' SAND LR &RAM PLR LEVELNG CaRSE N 17C BOTTLW tlr THE EXAVATM
CDWACT AS RrWJREA
3 PLAX 4 SHEETS CF ' x B' x 2' DIRECT ARIAL RIGID WMATAN W TLP Lr 0WACTED LEVELIAG CH.P.RSE
AI PROTECT BOTTW X MEMASS TAN- TAKE EXTRA CARE TO ASSLR£ THAT NSLLATM GMSC IS LEVEL
N ALL DIRECTIOVS
4. X47£R LL AUND AWLLARW S PS R MUMS,
4' 2LCNT AND 1-1/4' ETELLCNT LDES VITH TREE-nDVW W
20' IOYIICR r SWARAM BACKrILL
1' SL7CDLC£ 40 PVC V- 3/16' M - P
TCP AND 00TTAV
h
0
V-.
- z
T08BfN STH. AVENUE
P.E. LOT 1 BLOCK 3 AUTUBON HLUS SEPTIC SYSTEM SH£MAAC
203. AK.
AVENUE AUTUGON DRIVE DATE SEPT. 30, 2004
(NCH. AK. 99501 907 179-3916 I I RUSS£L KOONTZ SHEET • 3/3 GRID: 2739
PERMIT # SV030447 PID # 015-231-60 AAtiaaWVG
Rick Mystrom
Mayor
Municipality of Anchorage
Department of Health and Human Services
825 V Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
http.rlwww. d anchorage. ek. us
Permit Number: #SW 040461 Date of Issue: 10-28-04 Parcel Identification Number: 015-231-60
Date Started: 11-12-04 Date Completed: 11-15-04 Is well located at approved permit location? ® Yes ❑ No
Legal Description: Audubon Hills #1 Blk 3 Lt 1
Property Owner Name & Address: Russel/Koontz
PO Box 221125
Anchorage. Alaska 9952JL
Borehole Data: Depth (ft)
Soil Type, Thickness & Water Strata from To
Method of Drilling ®air rotary ❑ cablC tool
Casing type: steel
stick-up 0 2
Wall Thickness:.250 inches
organics 2 5
silt 5 8
Diameter: ¢ inches Depth: 40 feet
Liner Type: Leel
gravelly silt 8 42
silly water sand &gravel 42 50
Diameter: 4 inches Depth: 47 feet
Casing stickup above ground: 2 feet
Static water level (from ground level): 0 feet
Pumping level: 40 feet after
50 hours pumping 32 bpm
Recovery Rate: 32 gpm
Method of Testing:tp tmn
Well Intake Opening Type:
❑ Open End ® Open Hole
® Screened Start 45 feet Stopped 50 feet
❑ Perforations Start feet Stopped feet
Grout Type: bentonite Yranules Volume: 1
Depth: Start!2 feet Stopped ? feet
Pump: Intake Depth feet
Pump size hp Brand Name
Well Disinfected Upon Completion? ® Yes ❑ No
Method of Disinfection: chlorine tablets
Comments: 6 inch caring pulled bank to 30 feet from 40
feet after installing; 50 feet of 4 inch casing and cement
graded as it was pulled Otte bag of bentonite chips
installed from 40 feet to 44 feet cement grount installed
until it surfaced outside the 6 inch casing. Well was kept
drawn down by pumping until the cement haul regired time
to set up. A. 100 slut &'; screen was installed from 45 feet
to 50 feet.
Well Driller. Alpine Drilling & Enterprises
PO Box 110496
Anchorage Alaska 99511
Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water 8 Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WATER SUPPLY PERMIT
Renewal
Date Issued: Oct 28, 2004
Expiration Date: Oct 28, 2005
Permit Number: SW040461 Parcel ID: 015-231.60
Legal Description: "Audubon Hills #1 Block 3 Lot 1
Design Engineer: 0007 Tobben Spurkland, PE Site Address: 12350 Audubon Drive
Owner Name: Russel Koontz Lot Size: 44636 SO. FT.
Owner Address: PO Box 221125 Total Bedrooms: 4 Permit Bedrooms: 4
Anchorage . AK 99521 -
This permit is for the construction of:
❑ Disposal Field ❑ 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:
Issued By: Date: v A 8 o
Municipality of Anchorage
\ Development Services Department
Building Safety Division` 74
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ek.us
(907) 343-7904
ON-SITE SEWERIWELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. ptS- 2 3 I -Cao Permit Number SW
Property owner(s) 9�5 5 c ( Ic00ar7 Day phone 07-17- //6
Mailing address PO. 30c ZZ /f Z5 Zip Code
Site address Zip Code
Legal description (Lot, Block & Sub'd.) _ Le r I 6/ k 3
Legal description (Section, Township & Range) /L3Sn //}ut�u%oN D2.
Lot Size 636 Acres/� Number of Bedrooms y
THIS APPLICATION IS FOR:
Sewer Only ❑ Well Only ❑
Sewer and Well ET" 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/Rush Fees: / as.'" Waiver Fees:
Date of Payment: /0At3 boy Date of Payment:
Receipt Number: , %o / Yokl� Receipt Number:
(Rev. 09/04) —�T�
T.SPURKLAND PE.
203 W 15th. Avenue, Suite 203
ANCHORAGE, ALASKA 99501
(907)279-3916
Fax (907)-276-6013
SEPTIC SYSTEM DESIGN
LOT 1 BLOCK 3 AUDUBON HILLS
Municipality of Anchorage
Development Services Department
On Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, Alaska 99519
October 15, 2003
We are submitting an application for the installation of a well and septic system for this lot The
submittal consists of three (3) drawings showing the present improvements on the lot and the
adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the well and
septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system,
(sheet 3/3). Soil logs and percolation tests of applicable test holes are also enclosed. The septic
system design is based on the following:
Groundwater at 6 Ft.
Use Standard Bed with BioCycle
Soil Rating. From Testhole 04/15/02.
2 min/'m - 4 gal per sq.ft/day
No. of Bedrooms 4
Required Area per Bedroom: 15014 -37.50 sq.ft.
Total area required: 3750 x 4 —150 sgft
Bottom Rock At 2 feet
Top Rock At 2.5 feet
Rock Depth 0.5 feet
Minimum Total Bed Length 150 /10 - 15
USE 20 FT
SYSTEM CONFIGURATION
BIOCYCLE
STANDARD BED
TOTAL LENGTH
20
FT
TOTAL WIDTH
10
FT
TOTAL DEPTH
3
FT
FILTER SAND
12INCILES
ROCK DEPTH
0.5
FT
COVER
3
FT
The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent
lots.
There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots.
The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface
runoff will not result from this installation.
1 �l
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(NCH. AK 99
907 279-39/616
RUSS£L KOONTZ
U
ADUBON ORIV£
DAT£: OCT 9, 2003
SH££T.13 GRID2739• :
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PERMIT IISV030XXX PID # 015-231-77
ABH03011.DVG
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OT 1 BLOCK 3 AUTUBON HILLS I I S£PT/C SYSTEM DESIGN
103. K. 9 AVENUE RUSS£L KOON77 DATE: OCT. 9, 1003
ANCIL AK. 99501 AUDUBON DRIVE SHEET. 213 GRID: 1739
L9n7) 979-3916
I PERMIT ASV030XXX PID k 015-231-77 ABH03012.DVG
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Mayor ,llark Begich
Altulicipali4r of Anchorage
P.O. Ikn I N4N) a Anchorage, Alaska Vt519-GG50 * Tdtphunc (1X)7) 333-&301 * rax 1'.X17) 343.6(X)
47W nmgaw Strut 0 Anchorage, Alaska V&)"s
wim.mmti.org
September 9, 2004
Russell Koontz
P.O. Box 221125
Anchorage, AK 99521
Iluildincr Safety, Division
Subject: On -Site Water and/or Wastewater Permit.
Permit Number: SW030447
Legal Description: Audubon Hills #1 Block 3 Lot 1
Dear Mr. Koontz:
tpt tlp
p �<
p O
2'
An On -Site Water/Wastewater Permit, number SW030447, issued by this office for a single-family
system, will expire on October 20, 2004 This permit was valid for 365 calendar days.
If this was a well permit and the well has been drilled, a well log must be sent to this office for
documentation of the installation and to close the permit.
If this permit was for a wastewater disposal system, an original as -built inspection report must be sent to
this office for review, approval and documentation. This as -built inspection report must be signed by
the licensed Professional Engineer who inspected the installation of the system. As -built inspection
reports are required to be submitted within 30 days of the completion of the system.
If no system was installed under this permit, and you are still planning to install a well or wastewater
disposal system, a new permit must be obtained from this office. A new permit for a second year may
be issued for a fee of $115.00 if the renewal application is received on or before the expiration date of
the original permit.
When applying for anew permit, the fees are: $460.00 for a wastewater permit and $175.00 for a well
permit.
If you have any questions, please call this office at 343-790.1.
Sincerely,
Dan el J. Rot
Program Manager
On -Site Water and Wastewater Program
Enc: Copy of permit
Community, Security, Prosperity
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 ) WATER SUPPLY PERMIT
Initial
Permit Number: SW030447
Legal Description:tAudubon Hills #1 Block 3 Lot 11
Date Issued: Oct 21, 2003
Expiration Date: Oct 20, 2004
Parcel ID: 015-231-60
Design Engineer: 0007 Tobben Spurkland, PE Site Address: 12350 Audubon Drive
Owner Name: Russel Koontz Lot Size: 44636 SQ. FT.
Owner Address: PO Box 221125 Total Bedrooms: 4 Permit Bedrooms: 4
Anchorage , AK 99521 -
This permit is for the construction of.
Q Disposal Field ❑✓ 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.
Issued By.
Date: (� x-3103
Date: 1UZ1 G
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.sk.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015— 9°5 1 — (9 O Permit Number SW03644 %
Property
k.e
Mailing address (1) 7 0 .3oX 2.02.1126
Day phone Aq q_ 1 I to iv
Mailing address (2) Zip Code
Legal description (Lot, Block & Sub'd.) LOT I. BP- 3 AuTNlols" 14,11 !>4-I
Legal description (Section, Township & Range) 1 o231;1n A1) d t)1,)ny\ 'Dy(.
Lot Size y U 1 (0310 Acres Sq.Ft. . Number of Bedrooms y
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.
(Signature of property owner or authorized ag t)
Permit Fees: 5 0 aiver Fees:
Date of Payment: I C A/0-371 ate of Payment:
Receipt Number: �� `� Receipt Number:
(Rev. 12100)
n .SFS rELfi`lM P.E.
203 W 15th. Avenue, Suite 203
ANCHORAGE, ALASKA 99501
(907)279-3916
Fax (907)-276-6013
SEPTIC SYSTEM DESIGN
LOT 1 BLOCK 3 AUDUBON HILLS
Municipality of Anchorage
Development Services Department
On Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, Alaska 99519
October 15, 2003
We are submitting an application for the installation of a well and septic system for this lot. The
submittal consists of three (3) drawings showing the present improvements on the lot and the
adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the well and
septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system,
(sheet 3/3). Soil logs and percolation tests of applicable test holes are also enclosed. The septic
system design is based on the following:
Groundwater at 6 Ft.
Use Standard Bed with BioCycle
Soil Rating. From Testhole 04/15/02.
2 min/in - 4 gal per sq.ft/day
No. of Bedrooms 4
Required Area per Bedroom: 150/4 -37.50 sq.ft.
Total area required: 37.50 x 4 - 150 sqft
Bottom Rock At 2 feet
Top Rock At 2.5 feet
Rock Depth 0.5 feet
Minimum Total Bed Length 150 /10 - 15
USE 20 FT
SYSTEM CONFIGURATION
BIOCYCLE
STANDARD BED
TOTALLENGTH I
20
FT
TOTAL WIDTH
10
FT
TOTAL DEPTH
3
FT
FILTER SAND
12
INCITES
ROCK DEPTH
0.5
FT
COVER
3
FT
The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent
lots.
There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots.
The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface
runoff will not result from this installation.
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SEPTIC SYSTEM DESIGN
203TH. AVENUE
(NCH.. AK.K.99501
RUSSEL KOON77
AUDUBON DRIVE
DATE. OCT. 9, 2003
SHEET • 1/3 GRID: 2739
907 179-3916
PERMIT # SV030XXX PID K 015-231-77
ABH0301LDVG
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OT 1 BLOCK 3 AUTUBON HILLS SEPTIC SYSTEM DESIGN
203 W 15TH. AVENUE RUSSfL KOONTZ DATE: OCT. 9, 2003
ANCH. AK. 99501 AUDUBON DRIVE SHEET: 2/3 GRID. 2739
/oml ��o_m�a
PERMIT #SV030XXX PID # 015-231-77 ABHO3012.DV6
TDuvDDartw aEav DUT
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ASTN 3RT4
GRADE TO DPAIN SLLPr fVd VED aADr AWAY
6' MIN FROI TDP DV ACL DIRCCTOILS
GE'OIEXTILC _ 24. �
BACK iTLL 31 /!-1/ PVC Blsa RGE
—�
WADED SEVER RDCK i 4' PVC DifZLCNT
NIMLC t� m m PPRIWY CHAMBER
. ` - • .:-•• •:. �« x� 0AERATMV CIDWBER F1T� 51110' t2A = %, n 2� m ® i CLAROER 4RGr CHAMBER
6DISC
STANDARD BEDTTOK X TANG
NTS
a
BLLEBDARD DNSCLATIIN
INSTALLATION
1 EXCAVATE A 10• x 10' x !0' DEEP NXE FOP BIDCYCLE SYSTEM
2 PLACE A NDd" X 4' SAND OP OPAVEL FOP LEVELDC CO.RSr !N TIE BUTTER Or TIC CXCAVAUN
CDMPACT AS REDUIRED
3 PLACE I SLEETS O. 2' x D' x 2' DIRECT BLRIAL RIGID DLS'ILATZW OV TIP X 0WACTED LEVnDC CDCRSr
TD PRlTIFCT BOTTOI O• FIBERQASS TAM. TAKE EXTRA CARE 70 ASSLRE PAT WELATMV CORSE IS LEVEL
DV ALL DIRECID)MS
4. BACXFRL AROAYD TAN; LP TO INVERT Ir 4' MLEHT AND 1-1/I' EMLENT LPET WITH FREE-FLDVD4G NSF
M4TER/AL FREE Or LARGE SUES OP FOLDERS
2D• C-1 /— MWTOP TUBE
SAMD/6RAVEL BACKFILL
15'
1' SCIEDC.EE 40 PVC V/ 3/16' NLLES P 30'
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RID .32739 I
IPERMIT O SV030XX PID B 015-231-77 ABHMIMWGif SV030XX PID B 015-231-77 A TSDWG
Municipality of AnchorageGINEERSSEAL) SLC
r
Development Services Department
Building Sa!ey Division »fi4r+s-�.1a..'„-,w-aoowaafi'
a.
On -Site Water and Wastewater Program
■ 4700 South Bragaw SI.
P.O. Box 196650 Anchorage. AK 99519.6650 • W
9 A` T k n. 6.: vrL.a:xl . W 4
w.ci anchorace ak.us S
.w ct.== < 8 NVQ'=
(907)343-7904
Soils Log - Percolation Test
Performed For: V SS GL V_0QN77 Dale Performed: 4115)02
Legal Desorption: LOT 1 1:w_ -5 A Ij in Q,oNTownship, Range. Section:
Depth
� /// � OQF�AN1t5
1 0/ U
y” y
3. 0 - svr Ct
'0 O Vy /
e. 9a( IQt AJ�
,cI,A7c: v 411.40 Z.
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tx"s �
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$alb
to-
12,/?—
M L
it-
Flonitoring?
P e M /Lo�.a/
12-
2
K
13-
13-
OOTTO Vl 0 1-
I,
No�>✓
1;-
;7-
1�-
zo-
CC`.! ;IExTS
YEAS GROUND YrATER
E.`:CCUYiEFED'+
5
to
IF YES. AT W1'AT DEPTH?
12,/?—
Depth to Y!aW After
Flonitoring?
E
Data: '4/ILlo r.
I Reding I Date I Gross Time I Nel Time 10epth Io Water I Pie! Drcp
PEReCLATICHRATE _y{_l—xe.rrt F-ACHC!Em.IMR
TEST FUNSEVIEEH_ZEFT ANDFT
%_P.FCRacD BY. 1 . S 1 1. S CERTIFY THAT THIS TEST E5771."S
PE?POR:: ED IN ACCORDANCE VATH ALL STATE AND 1.!U?I:CIPAL GUIDELINES IN EFFECT ON T'r.IS DATE DATE: 2f-1 O
Municipality of Anchorage
Development Services Department
• +� Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 190850 Anchorage, AK 995198650
www.ci.anchorage.ak.us
(907)343-7904
ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET
Legal description: AVDVBON HILLS #1 SUBDMAION BLOCK 3 LOT 1
The attached paperwork has been reviewed and Is being returned for the following reasons:
❑ Original signature or stamp missing on
❑ Calculation error in design. _
® Additional soils information needed. DOES ML SOIL PERC FASTER THAN 120
MINtrrES/IN" yaf
❑ Water monitoring results inadequate. _
❑ Discrepancy in information submitted.
❑ Topographic information missing or Inadequate.
❑ Incomplete; missing
❑ Incomplete; missing
❑ Additional adequacy test information needed. _
❑ Water sample unacceptable. _
❑ Measured/proposed distances/dimensions missing. _
❑ Locations of all soils, percolation and water monitoring tests not shown. _
® Proposed system too deep for soils information submitted. SYSTEM TOO DEEP FOR WATER
❑ Well log required.
❑ Omission in narrative.
❑ Insufficient fill over tank or field._
❑ Other.
Name of reviewer: DARN Date: 10/15/03
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
BioCycle
AGREEMENT
ALASKA GUARANTEE AND MAINTENANCE
Barcen: RttszcUKoont And: Bint),cicAlaska (lYcCcr_,p=y)
PUB 221125 43630 Snwi` ST.' Xoad
Anchorage, AK 99522-1125 Kenai, AK 99611
907-283-90031283.8118 fax
email: biocccl�-nl:n.3:aflakuka.mm
Legal: Ll B3 Audubon SID
THE COMPALNY'SLL%BILITY UNDER THIS WARILLNTY IS LLUITED. PLEASE READAND UNDERSTAND THE
CONDITIONS APPEARING HEREIN.
A OVERLLL WARRANTY
The Company warms to repair or replace, free of charge, the fiberglass tank or piping component therein of the BioCycle system,
which has failed due to defective manufacture, for a period of five (5) years from the date of installation of the BioCycle system with
the exception of the air blower, discharge pump and electrical control panel which are covered under separate marufacmra's limited
one year warramy. The warranty on the Unk and piping is valid provided the Customer adheres to all of the terms and conditions set
out in this Agreement and the Customer continues to participate in the Company's maintenance program as set out below, This
Warranty does not apply if the BioCycle system or any part thereof has been damaged by accident, abuse, misuse, neglect, fire, force
majcure, or has been damaged by modifications, alterations or aaachmrnU made by, ce other acts of, the Customer, or if the plumbing
fixtures are not installed in compliance with local codes ordinance; or if due to defect/ in workmanship in the installation or the
BioCycle system or any part thereof, if not installed by the Company.
Other than ander exceptional clrcumCancet, all warramy service Requests will be scheduled for service within twenty-four (24) hours
of the Customer's all for service.
B MUTATION OF LIABILITY
A BioCycle system or any part thereof claimed to be defective shall be held until inspected by an authorized representative of the
Company and, upon hi0w specific instructions, a BioCycle system or any part thereof found to be defective will be repaired or
replaced at the discretion of thc Company. THE LIABILITY OF TIIE COMPANY, ITS OFFICERS, DIRECTORS, AGENTS AND
SERVE\TS AND ITS AF MATES AND THEIR RESPECTIVE OFFICERS, DIRECTORS, AGENTS A\'D SERVANTS TO THE
CUSTOMER WITH RESPECT TO THE SALE AND INSTALLATION OF A BIOCYCLE SYSTEM SHALL BE LIMITED TO
REPAIR OR REPLACEMENT AS PROVIDED HEREIN TO A MAXIMUM OF 711E PURCHASE PRICE OF THE RELEVANT
SYSTEM AND DOES NO INCLUDED ANY COST OF REMOVAL OR REINSTALLATION OR CONSEQUENTIAL
DAMAGES OF ANY KIND.
THE COMPANY, ITS OFFICERS, DIRECTORS, AGENTS AND SERVE\TS AND ITS AFFILIATES AND THEIR
RESPECTIVE OFFICERS, DIRECTORS, AGENTS AND SERVANTS SHALL NOT BE LIABLE FOR PERSONAL INJURIES
OR DEATI I TO ANY PERSON OR FOR ANY LOSS, DA.AMAGE. LIABILITY, CLAIM, OR EXPENSE OF A\'Y KIND OR
NATURE HI IETI IER TO 11 IE SYSTEM, THE CUSTOMER. OR ANY OTHER PROPERTY, CAUSED OR CONTRIBUTED TO,
DIRECTLY OR MIREC rLY. DY TIIE OR'\ERSIIIP, DEUVERY. OPER,%TION, INSTALLATION, OR POSSESSION OF
THE SYSTEM, BY MME SYSTEM OR ANY INADEQUACY THEREOF FOR ANY PURPOSE OR ANY DEFICIENCY OR
DEFECT THEREIN, THE USE OR MAINTENANCE THEREOF, ANY REPAIRS, SERVICING OR ADJUSTMENTS THERETO,
OR ANY INTERRUPTION OR LOSS OF SERVICE OR USE THEREOF OR ANY LOSS OF BUSINESS, OR BY ANY OTHER
CAUSE OR REASON WHATSOEVER OR HOWSOEVER CAUSED, CONSEQUENTIAL OR NOT, INCLUDING THE
NEGLIGENCE OR DEFAULT OF THE COMPANY, AS ALL SUCH RISKS AS BETWEEN TIIE COMPANY AND THE
CUSTOMER ARE TO BE BORNE BY THE CUSTOMER THE CUSTOMER AGREES TO INDEMNIFY AND SAVE
HARMLESS TUE COMPANY, ITS DIRECTORS, OFFICERS, EMPLOYEES, AGENTS, SUCESSORS AND ASIGNS FROM
ANY COST, EXPENSE, CLAIM, ACTION, LIABILITY OR SLIT ARISING FROM DIRECT OR INDIRECT DAMAGE T'O
PERSONS OR PROPERTY RESULTING FROM THE OPERATION OF TIIE BIOCYCLE SYSTEM OR FROM THE BIOCYCLE
SYSTEM BEING OUT OF SERVICE FOR REPAIR OR bIALNTENA E.
C DISCLU\IER OF WAILANTIES
THIS WARRANTY IS IN SUBSTITUTION FOR DAMAGES TO WHICH TUE CUSTOMER MIGHT OTHERWISE BE
ENTITLED AT LAW OR IN EQUITY AND, IN PARTICULAR, IN LIEU OF AN ACTION FOR FUNDA.\MENTAL BREACH OF
CONTRACT, THE CUSTOMER WILL BE MOUND BY THE PROVISIONS OF THIS WARRANTY. THE WARRANTY SET
FORTH ABOVE IS EXCLUSIVE AND IN LIEU OF ALL OTHER WARRANTIES, AGREEMENTS, REPRESENTATIONS OR
CONDITIONS OF THE COMPANY WHETHER WRITTEN, ORAL. COLLATERAL. STATUTORY, IPMLIED OR OTHERWISE
AND THE COMPANY SHALL NOT BY VIRTUE OF HAVING SOLD THE SYSTEM BE DEEMED TO HAVE MADE ANY
OTHER WARRANTY, AGREEMENT, REPRESENTATION OR CONDITION WHATSOEVER.
ONGOING MAI\TEN,LNCE
1. ONGOING MAINTENANCE is a requirement of the state of Alaska, Department of Environmental Conservation and the
Municipality of Anchorage and shall be performed by the Company on a quarterly basis (once each 3 months) beginning from
the due of itwallation of the System and continuing throughout the life of the System, and where necessary, the Company
agrees to perform the following maintenance tasks:
a Adjust the air intake in the clarification chunba (every 3 months}
b. Clean the inside of the clarifiatim and discharge chambers (every 6 months)
C. Replenish the supply of chlorine tablets, if chlorination of effluent is being performed (every 3 torahs}
d Check the aeration pump, discharge pump, electrical rystcm (every 3 months).
C. File a copy of the kaimem ore Report with the Department of F.nvironmemu Conservation State of Alaska, or my
other local regulatory agemy laving jurisdiction ova the cru tau wldcL tLu S)steni is u::alkd
L Ona every Wee (3) months the filter in the air Wma will be change,:.
2. In the event the Customer requests the Company to perform maintenance to the system other then that speed in D.1. above or
where the Customer requests work to be performed which is not a put of the above guarantee, the Customer shall pay the
Company's reasonable additional changes for the work done as; well at for any associated equipment and or supplies.
Additionally, the Customer shall pay the Company's reasonable charges where the need for work is a resuh of the Customer's
failure to ensure compliance with the operating instructions, from loading the system in excess of the design Dow for the
installation, or where the problem is the result of force majeure (Le. earthquake, food, lightning, lend slip, or Dom persons not
authorized by the Company interfering with the system in any way, or a a result of the Customer failing to comply with this
AVr&m:m.
3. Commencing at the end of ane (1) year from the date of this comma, the Customer agrees to participate in BioCycle's ongoing
maintenance program, as; nqu'red by ADEC, and agrees to pay for such maimenvtce services at in annual rate of Wn which
shall be invoiced to the Customer by the Company at or about each anniversary date of this Agreement, with annual renewals of
the muintenuwa contract deemed to be automatic The Company shall be emitled to &her the annual service chuge from time to
time a refected in the incase in the rational cost of living index
4. In recognition of the Company's need to provide regulates with the assurance that repair and m aintenimm services will continue
uninterrupted, it is a condition of this ask that the Customer.
AL Allow the Company and its authorized Agents and Dealers to access the property for the purpose of inspecting
maintaining and/or repairing the BioCycle system
b. Replenish disinfectant materials as ate required
c. Check all components for evidence of corrosion and cleem repair or replace components u required unless mused by
accident. abuse, misuse, neglect fee, fora majuere, or unless damaged my modifications. alterations or attachments
made by, or other acts of, the Customer which have of been authorized by the Company, or unless "used by the BioCycle
system or any pan thereof not being installed or operated in accordance with the instructions supplied by the Company,
or unless "used by the facility's plumbing fixtures not being installed in compliance with applicable local codes
or ordinances, or unless due to defects in workmanship in the installation of he BioCycle system or any put thereof: if not
installed by the Company.
d He a copy of du Quarterly %Unt.duuue Repan wi4s ADEC.
E CHLORINE WALNINO
1. Due to the risk and danger involved in the mixing of different chlorine compounds, the Customer hereby agrees to refrain from
adding chlorine compounds of any kind directly to the BioCycle system
2. The Customer is also advised against ming and/or discharging compounds to the system, such as; chlorine, drain cleaners,
usccti id.::, I;WJu 4 me.:Ziuiwi4 cit: in amounts 9W wuuld be Lu nd'ul to the syst:m ad caws,; it lu c:ax: fun timi ng in a
normal matter.
F ADDITIONAL WORK
If the Customer requests the Company to perform work on the BioCyclo system other than that specified in D above, ore where the
Customer asks for work to be performed which is not a par of the above mairtenana scheddde, the Customer dull pay the
Company's additional charges for the work done and fa any associated materials The costs associated with any laboratory analysis
to support or maintain the permit are also the responsibility of the Customer The Customer shall also pay the Company's additional
charges for work done and materials supplied pursuam to the above mainteneoe wbere the need for work and the materials is as a
result of the Customer's failure to ensure compliance with any operating instructions or conditions of this Agreement or is as a result
of the DioCycle system being required to bear a work load which exceeds is rated operating capacity or where the problem is as; a
result of earthquake• fee, flood, rout, lightning tempest and ship, or fiom pastas not authorized by the Company imerfering with
the the BioCycle system in any way.
Cuttoma's Sigruture
Due:_
tv
Company Representative
Date:C,A-`-tby d�5
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99507
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015-231-60 COSA # QSC `a 12-2-3
Expiration Date: /0 _L51— L2
1. GENERAL INFORMATION
Complete legal description AUDUBON HILLS #1 BLOCK 3 LOT 1
Location (site address) 12350 AUDUBON DR., ANCHORAGE, AK 99516
Current Property owner(s) MICHEAL SCHILD Day phone
Mailing address.
Lending agency Day phone
Mailing address
Real Estate Agent KAREN CISMOSKI Day phone 242-1761
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual Well ❑r
Individual Water Storage ❑
Community Class Well ❑
Public Water System ❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
F
Individual Holding Tank
❑
Community On-site
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water 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 Spurkland Enginneering
Address 203 W. 15th Ave., Ste 202, Anchorage, AK 99501
Engineer's Printed Name Lars Spurkland
5. DSD SIGNATURE
1� Approved for bedrooms.
Disapproved.
Phone 279-3916
Date JULY 10, 2012
s gyp.• ''!r' rt
� • 49 it
C, SPURKLAND�
to
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: 7-16 —/j—
(Rev, 11105)
Municipality of Anchorage
• Development Services Department x ,
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 995IM650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: ✓9uoizoon NICEST 13Lk 3 LT 1 ParcellD: OIS-231-GU
A. WELL DATA
Well type ILVI If A, B, or C provide PWSID #= Well Log (YM) y
Oq Sanitary seal (Y/N) Y Wires properly protected (Y/N)
Date completed—,, U17 y
Total depth 5O ft. Cased to 40 ft. Casing height (above ground) 2y in.
Date of test
Static water level
Well production
FROM WELL LOG
II, tzjoq
ARTE5TA�y ft.
3Z
WATER SAMPLE RESULTS:
Coliform NF -G• colonies/100 mL Nitrate 5.56 mg/L
Arsenic: .ND ug/L date of sample: b !t Zo)z
B. SEPTIC/HOLDING TANK DATA
AT INSPECTION
6120
ARTE5IAN ft.
3,9 g.p.m.
Collected by: Anson !"1ox u55
Tank Type/Material XCADVAr.E IANKISTEEJ 51DC*,LN J&3P742155 Date installed
Tank size 120'0 al. Number of Compartments Zjq Cleanouts (Y/N) y
Foundation cleanout (Y/N) Depression over tank (Y/N) High water alarm (YIN) i
Date of pumping ho nwAOLE
A6MEM6 T
C. ABSORPTION FIELD DATA
Pumper B!2WLLE AIkSKA
Date installed 0$ Soil rating ((p.d./ or fe/bdrm) j ibD
System type BED
Length 20 ft. Width 10 ft. Gravel below pipe 0.5 ft.
Total depth 5 I ft. Eff. absorption area 100 ft2 Monitoring tube'_ Depression over field IN/
Date of adequacy test 620 12 Results (Pass/Fail) ?A65 For y bedrooms
—Plaid depttrirrabsarptionifield before test r2z--i..--Water-addedz:�! gal.— "yew depth ( in '
Elapsed Time: Itp min. Final fluid depth l in. Absorption rate >= 600 g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) IVO If yes, give date "-
D. LIFTSTATION
Date installed Z3 oy Size in gallons IbOf? Manhole/Access (Ym) Y
"Pump on" level at 25 in. "Pump off' level at 44,5 in. High water alarm level at Z2•5 in.
Datum Twp TAnI- Cycles tested 3t Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot IDD'+ On adjacent lots Ic01+
Absorption field on lot loo+ On adjacent lots lupi+
Public sewer main 25 + Public sewer manhole/deanout RA
Sewer /septic service line 25 �+ Holding tank NA
Animal containment areas 50+ (N,D,) Manure/animal excrete storage areas Ifs' + U1,D,
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5i+ Property line 5+ Absorption field 51+
�
Water main NA Water service line IO + Surface water IDD r+ ( N,
Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line jO i+ Building foundation lo+ Water main NA
i
Water Service lineblrl + Surface water IODt+ (AI.O, Driveway, parkingNehide storage 10 +
Curtain drain a+ l N,ol Wells on adjacent lots 1001+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
certify that I have determined through field inspections and
review of Municipal records that the above systems are in 4�
conformance with MOA COSA guidelines in effect on this date.
lt� 11'. / PUii LANb'�
Engineer's Printed Name LABS JiaM-Avnf)110
DateIIZN��F�
I�
COSA Fee $ Waiver Fee $
Date of Payment7���G �l o� Date of Payment
/icr-o
�ipiNumUer 2L----ReceipfNumbe—r (Rev. 4110) -
Municipality of Anchorage Q�` `Pr`
P.O. Box 196650 •4700 Elmore Road a
Anchorage. Alaska 99519-6650 • (907) 343-7904 • Fax !9071343-7997 Depurtmnt
hftp://Www.muni.org/Onsite
Development Services Division
On -Site Water and Wastewater Program
**** VARIANCE/WAIVER REVIEW ****
Waiver#: OSPI21179 COSA#:OSC121257 Permit#:
PID#: 015-235-02
Legal Description: Audubon Hills, Block 2. Lot 6A
Engineer: Anderson Engineering
Applicant: Capitol Constructors, LLC
Your request for a waiver of the required 100 feet horizontal separation from the septic tank to
the private well has been approved. The approved separation distance is 94.0 feet.
This waiver approval applies to the existing septic tank only. Any future upgrade to the on-site
wastewater disposal system will require all separation distances be met or another approval from
this department.
❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this
waiver.
❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected
adjacent property.
® Adjacent properties are not affected by this waiver.
KNOW ..... ........... ..... ............ ........... .......... ........... ......W...
Waiver is Granted: X Waiver is not Granted:
Date: /a Approved lyy�Jy�10
Name of Reviewer
................................................................................
Rec#: 08056G Amount: $1,050.00 Date Paid: 7/6/2012
**** VARIANCEIWAIVER REVIEW ****
Municipality of Anchorage s
Community Development Department
Development Services Division
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
Nitrate Advisory
Certificate of On -Site Systems Approval # 121273
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block 3, Lot 1 of
Audubon Hills #1 subdivision. This inspection revealed a nitrate
concentration of 5.56 milligrams per liter (mg/L) was reported for the
property's well water sample. The Environmental Protection Agency (EPA)
has established a maximum contaminant level (MCL) of 10.0 mg/L for
public drinking water systems. While private wells are not subject to this
regulation, EPA standards are based on existing health information and can
therefore be used to gauge the relative quality of water from private wells.
Please see the attached "Nitrate Fact Sheet" for important information
regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
/�SrJ\�L3:�L:F.`y 113P:1S� _ ►.3'I. M Dlulu IM►M_ A • _ : ►I I
REPAIR AGREEMENT
MEMORANDUM OF UNDERSTANDING
BETWEEN MUNICIPALITY OF ANCHORAGE
AND ZA0k J A(M6 2kvnt/t,
THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this
7 Day of JOLJ _ of 20 t 2, by and between McVV j Jft(nyt— 7(es(Q
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 (AW WTS), described as 6 1 ocq Et`c' located
at ADD J ti'tt LS t3L-aek 3 tat'" 1 Anchorage, Alaska.
2. Definitions.
A. Alteration. Any change to the design or function of anAW WTS 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 AW WTS that were included in
the original design which would allow the AW WTS 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 AW WTS, 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
-2-c Rc>
($-70 .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 AW WTS 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 AW WTS without a
Construction Permit from the Municipality.
6. Maintenance and Repairs.
A. Throughout the term of this Memorandum of Understanding, the Owner shall
maintain AW WTS 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 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 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 AW WTS
Operating Permit is: AOd Jet"
C. Owner acknowledges that the fine schedule for failing to maintain and repair an
AW WTS 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
AWWTS upon 24 hours written notice.
F. Owner agrees that any sale or transfer of title of the property will not occur
without a new Certificate of On -Site Systems Approval.
G. Owner agrees that the relevant provisions of the standard specification guidebook
for 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,
nor 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: 7mcc � q(pdS 1.,f-
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:
MUNICIPALITY:
By: y:
Title:
Date: 7 rdiL_ Date:
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT )
The foregoing instrum t was knowledged before me this 1 day of ( U
201a , by �P�'l.n l �C�IMS
c i
S:NARY
OF ALASKA
NOTARY P LIC FOR ALASKA PUBLIC `�My Comrnission expires: R-a0'1Cnifer AdamsMsion apl" 9,aO SSV .
BioCycle Alaska
4971 Thompson Drive
Homer, AK 99603
226-2476 office 399-0331 cell
Email: biocyclealaska@gci.net
Customer
Michael and Chrisie Schild
12350 Audubon Drive
Anchorage, AK 99516
307-679-0506
907-752-1127
1st Qtr Maintenance 2012
BioCycle Location
Huffman
Install Date: September -10
Tank #: 170
MAINTENANCE DESCRIPTION
COMMENTS
l i
PRIMARY CHAMBER SCUM LEVEL t O� HIGH
AERATION CHAMBER & AERATION SYSTEM .
BLOWER SIZE 60, 80, 120 L/MLN
AERATION PRESSURE �qj�,—{IIGH LOW
NOISE LEVEL OK HIGH
GENERAL CONDITION '.'Ok POOR
SYSTEM: AIR LEAKS OK LEAKS
AIR DIFFUSER/AIR SUPPLY ~OK: POOR
MIXED LIQUOR CONDITION ODOR ;' �NO; YES
This chamber was cleaned to
CLARIFICATION CHAMBER
prevent build-up of solids. This
SLUDGE ACCUM IN HOPPER LOW HIGH
procedure is performed every 6
CLARITY OF EFFLUENT , CLEAR FAIR CLOUDY
months.
�v
Discharge chamber was pumped
DISCHARGE CHAMBER , -
down and cleaned with a shop
DISCHARGE PUMP OPERATING "(ES, NO
vac to remove all settled solids.
l
ALARMS CHECKED AND OPERATINCf---
AIR/POWER YE§, NO
HIGH WATER �, YES i NO
1 st Qtr 2012 Maintenance was performed today
! 1
BY: LARRY BETTS DATE: ,
BioCycle Alaska
4971 Thompson Drive
Homer, AK 99603
226-2476 office 399-0331 cell
Email: biocyclealaska@gci.net
12350 Audubon Drive
Anchorage. AK 99516
127
3rd Qtr Maintenance 2011
BioCycle Location
Huffman
Install Date: September -10
Tank #: 170
MAINTENANCE DESCRIPTION
COMMENTS
PRIMARY CHAMBER SCUM LEVEL OK HIGH
AERATION CHAMBER & AERATION SYSTEF
BLOWER SIZE0 120 L/MIN
AERATION PRESSURE &,- HIGH LOW
NOISE LEVEL OK -1 HIGH
GENERAL CONDITION 60POOR
SYSTEM: AIR LEAKS t,�yS.< LEAKS
AIR DIFFUSER/AIR SUPPLY b,,i POOR
MIXED LIQUOR CONDITION ODOR �q YES
CLARIFICATION CHAMBER
SLUDGE ACCUM IN HOPPER ,LOW HIGI4
CLARITY OF EFFLUENT ICLEAR AIR CLOUDY
DISCHARGE CHAMBER
`j
DISCHARGE PUMP OPERATING IYES NO
ALARMS CHECKED AND OPERATING
AIR/POWER ES NO
HIGH WATER 'S__) NO
3rd Qtr 2011 Maintenance was performed today
tt
BY: LARRY BETTS DATE: V� ♦i
SioCycle Alaska
4971 Thompson Drive
Homer, AK 99603
226-2476 office 399-0331 cell
Email: biocyclealaska@gci.net
2350 Audubon Drive
,nchoraae. AK 99516
762-1127
4th Qtr Maintenance 2011
BioCycle Location
Huffman
Install Date: September -10
Tank #: 170
MAINTENANCE DESCRIPTION
i
COMMENTS
PRIMARY CHAMBER SCUM LEVEL OIC HIGH
AERATION CHAMBER & AERATION SYSTEM
BLOWER SIZE r6O.
80 120 DMIN
AERATION PRESSURE O '
HIGH LOW
NOISELEVEL 'O -
HIGH
GENERAL CONDITION
POOR
-
SYSTEM: AIR LEAKS ,¢K
LEAKS
AIR DIFFUSER/AIR SUPPLY OK
POOR
MIXED LIQUOR CONDITION ODOR --NQS
YES
This chamber was cleaned to
CLARIFICATION CHAMBER
prevent build-up of solids. This
SLUDGE ACCUM IN HOPPER. LOW)
HIGH
procedure is performed every 6
CLARIFY OF EFFLUENT .CLE
FAIR CLOUDY
months.
Discharge chamber was pumped
DISCHARGE CHAMBER
down and cleaned with a shop
DISCI -LARGE PUMP OPERATING Y -
NO
vac to remove all settled solids.
ALARMS CHECKED AND OPERATING
�--1
AIR/POWER ESY
NO
HIGH WATER YE
NO
4th Qtr 2011 Maintenance was performed today
BY: LARRY BETTS DATE:
Tract B
Z
0
4
c�
0
Lot 2
HUFFMAN ROAD —
PLOT PLAN AS BUILT X SCALE 1" = 50' GRID SW 2739 Project No.
11-006
Lang & Associates, InC. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049
(907) 522-6476 Phone o�oopp�0
Registered Land Surveyors (907) 522-4625 Fax OFA
kglanglsOalaska.net / jclangisOalasko.netQ0 ... • • • ,9sQoo
I hereby certify that I have surveyed the following described property: QQ� TH • • �)
Lot 1, Block 3, AUDOBON HILLS (Plat No. 77-307) 49_
Anchorage Recording District, Alaska, and that the improvements situated thereon are ' .:...........E ..............
within the property lines and do not encroach onto the property adjacent thereto, that Q
no improvements on the property lying adjacent thereto encroach on the surveyed
premises and that there are no roadways, transmission lines or other visible
easements on sold property except as indicated hereon.OQO0
Dated this the -Ji4' Day of Jk,uu,nn.� Zoll , at Anchorage, Alaska 4pNz
It is the responsibility of the owner to determine the existence of any easements, ��
covenants, or restrictions which do not appear on the recorded subdivision plat.
<ENNETI�i �..�G •� o
+ P-5202
A''•(•Z.11l • •'�ro�Ga
12j"CSSIONAI- �
i
SGS Ref.#
1110100001
Client Name
Anderson Engineering
Project Name/#
Audubon Hills No. 1 Lot 1, B 3
Client Sample ID
Audubon Hills No. I Lot 1, B 3
Matrix
Drinking Water
PWSID
0
Printed Date/Time
01/06/2011 16:58
Collected Date/Time
01/03/2011 12:00
Received Date/Time
01/04/2011 8:20
Technical Director
Stephen C. Ede
Sample Remarks:
Allowable
Prep Analysis
Parameter
Results
LOQ Units
Method Container ID
Limits
Date Date
Init
Metals by ICP/MS
Arsenic
5.00 U
5.00 ug/L
EP200.8
C
(<10)
01/04/11 01/05/11
NRB
Waters Department
Total Nitrate/Nitrite-N
6.12
0.100 mg/L
SM20 450ONO3-F
B
(<10)
01/05/11
AYC
Microbiology Laboratory
E. Coli
Negative
1 100mL
SM20 9223B
A
01/04/11
DLC
Total Coliform
Negative
1 100mL
SM20 9223B
A
01/04/11
DLC
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343.7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. _0 1S- 2 '31 - (n U HAA # Ci 6� 0 6 4A
Expiration Date: . _�3 - 2 g - O co
1. GENERAL INFORMATION
Complete legal description A,4. .bon 13V- 3 LL I
Location (site address or directions)
Current Propertyowner(s) R4SSGI koou�Z Day phonexVI -Ilbb
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
P. 0. 0 ox 22.112 S
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: '\
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage ❑
Community Class Well ❑
Public Water System ❑
Day phone
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual On-site (�
Individual Holding tank ❑
Community On-site ❑
Public Sewer ❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.)
Certificates are valid for one year for properties served by Class A or B wells or a public water system. The
Municipality of Anchorage is not responsible for errors or omissions in the professional 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 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
Address
Engineer's Printed Name
Phone .719-391 b
Date I2 12'bS
SO
g TH�
5. DSD SIGNATURE :70BE 1SFURCLQ;JO;' '
Approved for bedrooms. �IJ' CE 222;
Disapproved.' rssa.ms •cv
x Conditional approval for !_ bedrooms, with the following stipulation.
$5000.00 to be escrowed for septic upgrade. Money not to be released
until this office Rives final approval.
Additional Comments
Attachments:
HAA Checklist X Maintenance Agreements
Septic System Advisory Supplemental Engineer's Report
Well Flow Advisory Other
By: L/� V Original Certificate Date:
(R...O=)
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: Au du Don Qk 3 Loi 1 Parcel ID: O fs -2 3 / -49 O
A. WELL DATA'
Well typerr (,p c If A. B, or C provide PWSID # =
Date completed itIZ oy Sanitary seal (Y/N) Y
Total depth SO ft. Cased to 4D ft.
FROM WELL LOG
Date of test 11- 12 - O 9
Static water level "A,rl.cs;.wt.
Well production 37- g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 mi. Nitrate &r- mg./I.
Arsenic: mg./I. Date of sample: A40i
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Q14I4
Tank size 11100 gal. / Number of Compartments AL
r
Foupdation cleanout (Y/N) Y Depression over lank (Y/N) N
Date of pumping 1•-Y)]e' ,
Pumper / —
Well Log (Y/N) 7
Wires properly protected (Y/N) Y
Casing height (above ground) 'Ly in.
AT INSPECTION
NES �o+sL. ft.
NEW C.,J g.p.m.
Other bacteria _colonies/100 ml.
Collected by: 15 "A h Ic
A
Date installed
Cleanouts(Y/N) Y
High water alarm (Y/N) _
C. ABSORPTION FIELD DATA 11
Date installed g 2 ON Soil rating (g.p.d./ft2 or ft2lbdrm) "i_0 System type Bc1
Length 1.0 ft. Width 10 ft. Gravel below pipe 0.5 ft.
Total depth 4 ft. Eff. absorption area 1GQ_ft2 Monitoring tube 7 Depression over field 1✓
Date of adequacy test Neki Results (Pass/Fail)
Fluid depth in absorption field before lest = in. Water added= gat.
Elapsed Time: =min. Final fluid depth = in. Absorption rate >=
For — bedrooms
New depth= in.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date
g.p.d.
D. LIFT STATION
Date installed 4 23 o y
'Pump on" level at in.
Datum t•'1oR T . k
E. SEPARATION DISTANCES
Size in gallons APOt)
'Pump off level at 99.Sin.
j
Cycles tested M e..:
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tanknift station on lot 1051
Absorption field on lot *15r
Public sewer main i 100'
Sewer /septic service line %25 r
Manhole/Access (YIN)
Y
High water alarm level at (ZL1 Lin.
Meets alarm & circuit requirements? Y
On adjacent lots *?Icb'
On adjacent lots _ >100,
Public sewer manhole/cleanout ) 100
Holding tank
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation )10 r Property line > 101 Absorption field i
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
Nitrate Advisory
Certificate of On -Site Systems Approval # 050648
During a recent Certificate of On -Site Systems Approval inspection and test
of the potable water supply well on Block 3, Lot 1 of Audobon Hills #1
subdivision, a nitrate concentration of 5.5 milligrams per liter (mg/L) was
reported for the property's water well sample. The Environmental
Protection Agency (EPA) has established a maximum contaminant level
(MCL) of 10.0 mg/L for public drinking water systems. While private well
are not subject to this regulation, EPA standards are based on existing health
information and can therefore be used to gauge the relative quality of water
from private wells. Please see the attached "Nitrate Fact Sheet" for
important information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
7
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AUDUBON DRIVE
P � P
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a
SGS Ref. M
Client Name:
Project Name:
Client Sample ID:
Matrix:
PWSID
1058303
Jennifer Koontz
12350 Audobon Drive
12350 Audobon Drive
Drinking Water
SGS Environmental Services Inc
200 W. Potter Drive
Anchorage, AK 99518
Tel: (907) 562-2343
Fax: (907) 561-5301
All datesttimes are Alaska Standard Time
Printed Daterrime: 12127105 14:30
Collected Daterrime: 12/22/05 12:05
Received Daterrime: 12/22/05 13,36
Technica;;;H Steppphen Ede _
Releasevf��
Sample Remarks:
Allowable
Prep
Analysis
Parameter
Results POL
Units Method Limits
Date
Date Init
Bacteria
0 OB, W/O Coli
92228
1222/05
12/22/05 dpt
Nitrate
5.51 0.10
mg/kg EPA 300.0 10.00
1222105
12/22/05 jc
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 SUBMITTAL COMMENT SHEET
To: bben Spurkland
Legal description: Audubon Hills #1 Block3 Lot 1
The attached paperwork has been reviewed and is being returned for the following reasons:
❑ Original signature or stamp missing on —
❑ Calculation error in design.
❑ Additional soils information needed.
❑ Water monitoring results inadequate.
❑ Discrepancy in information submitted.
❑ Topographic information missing or inadequate.
❑ Incomplete; missing
❑ Incomplete; missing
❑ Additional adequacy test information needed.
❑ Water sample unacceptable. _
❑ Measured/proposed distances/dimensions missing.
❑ Locations of all soils, percolation and water monitoring tests not shown.
❑ Proposed system too deep for soils information submitted.
❑ Well log required.
❑ Omission in narrative.
❑ Insufficient fill over tank or field. -
0 Other. Found absorption field Inundated with water
Name of reviewer. Jeff
Date: 5/3/2005
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
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4152 ' Active Address N
6261 Preliminary Address (Subject to Change) SW W 64
® Public Road
d..
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Anchorage Area Atlas reference number: 320
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