HomeMy WebLinkAboutTHE TABLELANDS BLK 7 LT 4The Tablelands
Block 7
Lot 4
#051-801-36
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 Page 1 of 3
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SW050154 PID Number: 051-801-36
Name: JOHN THOMSOM
Wastewater System: ■ New ElUpgrade
Address:
ABSORPTION FIELD
17343 SANTA MARIA DRIVE * EAGLE RIVER, AK 99577
Phone: No. of Bedrooms:
(907) 240-2020 4
❑Deep Trench ❑Shallow Trench ❑Bed ❑Mound ■Other
LEGAL DESCRIPTION
Soil Rating: 2 O GPD/Sq.
SEETotal Depth from original grade:
Ft.
Block: Lot: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe:
7 4 TABLELAND S/D
SEE DWG. Ft.
0.5+ Ft
Township: Range: Section:
— — —
Fill added above original grade:
Grovel length:
30
SEE DWG. Ft.
Grovel width:
Number of linea:
Distance between linea:
WELL: ■ New ElUpgrade
10 Ft.
1
— Ft.
Classification (Private, A9,C): Total Depth: Cased To:(BmRaCK)
Total absorption area:
Pipe material:
D 3034/ F-810
Q Ft. Ft.
300 SQ. Ft.
Installer.
GREEN GENERAL
Date installed:
11/9/2005
Driller. '\ ' to Drilled: Static Water Level:
�P
TANK
Yield: �� \ Casing Height Above Ground:
V
GPM Ft Ft.
SEPARATION DISTANCES
❑ Septic ❑ Holding ❑ S.T.E.P. ■ Other*
To
Septic
Absorption
Lift
Holding
Public/Private
Manufacturer.
GREER / ZABEL TECH
Capacity in gallons:
1500
From
Tank
Field
Station
Tank
Sewer unee
Material:
STEEL
Number of compartments:
Well
—
—
—
—
—
2
Surface Water
100'+
100'+
100'+
—
—
LIFT STATION
Lot Line
5'+
10'+
5'+
—
—
Size In gallons:
1500
Manufacturer.
GREER ZABEL TECH
'Pump on' level at-
ump off level at,
High water alarm at:
Foundation
5'+
10'+
5'+
—
—
TIMER
TIMER
1 45"
Pump Make do Model:
Bectrical Inspections performed by.
Curtain Drain
NONE KNOWN
P—TE-30 PLUS
RISING SON
Remarks: *THIS IS A ZABEL AEROCELL (SCAT) SYSTEM
BENCH MARK
Location and Description:
BENCH MARK 1: TOP OF MANHOLE
BENCH MARK 2: BOTTOM OF SIDING NEAR POINT B
Assumed Eevation:
BM1:97.01 Ft. BM2: 102.3 Ft.
ENGINEER'SSL
0600 I �4
�ec
GEG, Ltd.Inspections performed by: Dates: 1st "x8/2005 I
.�
2nd 7/9/2005
3rd 11/9/2005
Qom_/ . . ......................�
QO J�I rE A. G rness.
Development Services_D partment Approval
4�9: f f� ci 53 0oQ
4 �c
Z/
Reviewed and approved by _ zz —�Date:T 3 - 1
44ere �
Op° r0fesSiOV4
(Rev. 12/01) 1�QDDOpO�
PERMIT NUMBER:
SW050154
A
ST1
29.31
0.56
ST2
35.42
16.58
MH1
38.85
16.20
MH2
47.01
35.58
uH3
48.76
3a.03
COl
43.11
32.27
MTl
43.96
33.00
CO2
45.74
32.68
MT2
50.19
35.89
CO3
67.68
52.57
MT3
64.35
59.48
C04
70.32
62.87
MT4
68.76
60.28
SP
50.41
39.98
AS -BUILT DRAWING
G1, /
APPROXIMATE LOCATION /
J / OF WATER SERVICE
/
UNE -\//
MEL
AEROCELL
/ PROPOSED
1500 GALLON /
/ S.T.E.P. TANK co
/
/ =n
//.
Z, F
r• -
F � ,
PARCEL ID NUMBER:
051-801-36
r Box
THOS
DRNNFIELD
L-4• INSULATION. 4'
WIDE OVER UNE. FROM
TANK TO AEROCELL
UNIT
LOT S. BLOCK 7:
TABLELANDS S/D
1VACANT)
SITE
GARNESS ENGINEERING GROUP, Ltd. p; 4
CONSULTANTS& GENERAL CONTRACTORS Q'••"'"""
M L wca0 low cart 101 • /eomlur. M 0 -0 0011aa-01n • M
PREPARED FOR PHONE NUMBER: PAGE NUMBER: .• ••• ••••• •••••••:••.
JOHN THOMSON 240-2020 2 OF 3 DO P ' ey amess:
LEGAL DESCRIPTION:
DRAWN BY:CE-795 .`�
TABLELAND S/D; LOT 41 BLOCK 7. B.F.M.
TYPE OF WORK: DATE' �04poofesslo�
AS—BUILT FOR NEW SEPTIC SYSTEM 12/15/2005
(R".01m)
PERMrTNUMBER: PARCEL ID NUMBER:
SW0 AS -BUILT DRAWING I
SW050154 051-801-36
TOP OF
FILTER -
TOP OF TANK
AT INLET - 91.76
INVERT OF BUNG
AT INLET - 91.16
1.51 'MAX.
D 4' FROM
VAL GRADE
FINAL GRADE -
99.69 -101.15 -
FINAL GRADE - 98.06 TOP OF MANHOLE - 97.01
ST1 SM MH
TOP OF TANK
/ AT OUTLET - 91.76
N 1500 GALLO
S.T.E.P. TANK
2'
TOPSOIL AND SEEDING TO BE I
FILTER DONE IN SPRING OF 2006 ,
R OF DISTRIBUTION
UNE - 97.13
OF SYSTEM - 94.36
L-L--�—RELATIVE ELEVATION OF BOTTOM
OF TEST HOLE 81.56
GARNESS ENGINEERING GROUP, Ltd. *
CONSULTANTS E GENERAL CONTRACTORS �""'
=I L 11Aa ICN• Ort tot • YogNL M ••ert) • woK W1NJ 1" • W (90*) " • p w.^•�w/�r•I
PREPARED FOR PHONE NUMBER: PAGE NUMBER:
JOHN THOMSON 907-240-2020 3 OF 3 QOQ om'
LEGAL DESCRIPOON: DRAWN BY:
TABLELAND S/D; LOT 4, BLOCK 7, B.F.M. 0
TYPE OF WORK:
AS -BUILT FOR PROFILE DRAWING 12/15/2005
t". 01105)
ORIGINAL GRADE
- 96.06
.••••• mess::
79
�16fl5«4�c
•a Dec 15 05 11:40a p.1
•
■ • Dec 15 2005 11s3GRM HP LASERJET FAX 622-6777
`` , Rising Son 6.lecEric. Inc.
l; Oo. 6 Voodland Drive
�� •� �/ 9agLe River, AV, 99577
(907)622-6777
ro
December 15, 2005
C &T Construction
John Thomson
17343 Santa Maria
Eagle River, AK 99577
FAX #696-5072
Re: Lot 4 Block 7 Tableland Subdivision
Dear]ohn:
The lift station at the above referenced property has been wired In accordance with NEC
and State/Local codes.
Thank you.
Sincerely,
P,a , p-
Kevin 5. Hornbuckie, Owner
Administrator License Number 1284
Specialty Contractor License Number 27285
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water d Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
l610f) 3pM
5 pm
Date Issued: Jun 02, 2005
Expiration Date: Jun 02, 2006
Permit Number: SWO50154 Parcel ID: 051-801-36
Legal Description: THE TABLELANDS SUBDIVISION BLOCK 7 LOT 4
Design Engineer: 0855 Gamess Engineering Group, LTD Site Address: NHN WHISPERING BIRCH DRIVE
Owner Name: JOHN THOMSON Lot Size: 40920 SQ. FT.
Owner Address: NHN FALLOW CIRCLE Total Bedrooms: Permit Bedrooms: Ty
CHUGIAK , AK 99567 -
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.
5. The following special provisions.
a.) The upper six inches of the mound absorption field shall consist of topsoil and be vegetated sufficiently to prevent
erosion.
-7/4 20
�4*%noA
A"%A�Swc�.. '.17,doo5 o.Wc o.A. _%n
1/q,-tD5
16<50I
bc.a
S,o V11 -SPO\
Received By.
Issued By.
Date: 6131US'
Municipality of Anchorage •.
• '� Development Services Department
/ Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. (— ?01 _moo Permit Number
Property owner(s) JOHN THOMSON _ Day phone 240-2020
Mailing address (1) 17343 SANTA MARIA DRIVE • EAGLE RIVER, AK.
Mailingaddr86s (2) N R* J Fh t I0 Cl r -C c "-6— Zip Code 99577
Legal description (Lot, Block & Sub'd.) LOT 4, BLOCK 7; TABLELANDS SUBDIVISION
Legal description (Section, Township & Range) N/A
Lot Size yo.qgD Acres 11 Number of Bedrooms
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
❑
certify that the above information is correct. I further certify that this application is being made fora
Single Family Dwelling and is in accordance with applicable Municipal codes.
GARNESS ENGINEERING GROUP, Ltd.
Permit Fees: gl� q1 c ' �0
Date of Payment:
Receipt Number: I =515 _ e0)I
Waiver Fees*
Date of Payment:
Receipt Number:
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
June 30, 2005
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907)343-7904
Ref: Proposed Septic System for Tableland Subdivision; Lot 4, Block 7,
To whom it may concern:
Your department issued a permit for a 3 bedroom septic sytem on the referenced property (SW050154). The
owner requested that we re -design his septic system to accommodate 4 bedrooms. The length of the drainfield
is the only change that is made in this design. Comments regarding the design are summarized as follows:
1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the
percolation test results.
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system.
4. TOPOGRAPHY: As can be seen on the attached design drawing the average area around the proposed
dminfields is relatively flat. In short, there are no slope concerns.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If
please contact us at 337-6179. Thank you for your assistance.
, M.S.
NOTE: Attached is a site plan drawing, a design drawing, one soil log, which are all part of the design package for
this septic system. (Contact G.E.G. Ltd. for 7 page construction specification letter.)
3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507
Ph: (907) 337-6179' Fax: (907) 338-3246' Website: gamessengineering.com
LOT 4. BLACK 8;
LOT 8. BLACK 8; TABLELANDS S/D
LOT ETABLELANDS Nin
TABLELANDS
ABLLANDS/D — — — _ _ _.
LAT 7. BLOCK 8; (VACAN» �
TABLELANDS S/D
Lor e. BLOCK e: (VACANT)
TABLELANDS S/D
Nom»
i
ABLEIANDS S/D
NAC0
LOT 2. BLOCK 7.
TABLELANDS S/D
HATE CVACANT)iSITE
TH S LOT 3. BLOCK 7:
TABLELANDS S/D
TH/ ,i (NO CONCERN)
1. BLOCK 7
TABLELANDS SA
r
PROPOSED SEPTIC /
PROPOSED
SYSTEM
OFD 261CN• /
4 BEDROOM
HOUSE LOT S. BLACK 7; j
\�\(ApL�XON) TABLELANDSs/D
I / /
TABABLEIANDS S/D % / Q
(VACANT) % 4Z-
LOT
ZLOT 8. BLACK 7: \� /
LOT 7. BLACK
TABLELANDS S/D \
(NO CONCERN) � � � / /
TABLELANDSbin
D
) / O4/ /
NOTE: ALL PROPERTIES SHOWN
WILL BE SERVED BY PUBLIC N
WATER. /
GARNESS ENGINEERING GROUP, Ltd. Bo, : :�„
CONSULTANTS & GENERAL CONTRACTORS
PREPARED FOR: PHONE NUMBER: PACE NUMBER (/ �•-�
JOHN THOMSON (907) 240-2020 1 OF 3 Q0 '• 1 y a ese.
TABLELAND SUBDIVISION: LOT 4. BLOCK 7. R.A.L.
E OF WORK DATEREVISEI
SITE PLAN FOR PROPOSED SEPTIC SYSTEM 6/30/2C
(Rev. 0105)
OF BEDROOMS:4
PER DAY (OPD): 600
DON RATE/S: <1 MIN./INCH
D APPLICATION RATE: 2.0
DRAINFIEID SO.FT.: 300
Yvx*IP_L`11
WELL DRILLER. CONTRACTOR AND
PROPERTY OWNER AGREE THAT THEY
HAVE READ THESE SPECIFICATIONS AND
AGREE TO ACCEPT THE TERMS AND
i
AIIMUM DEPTH:1.5 FEET A
' 64 FEET Op`
.OA APPROVED SAND FILTER.,2 FEET/A KEY BOI
FFECTIVE:*0.5 FEETEDUCTION FACTOR: N/A A V
CTU& SO.FT.: 320 `CI`
WATER SEERVOCE
ALTERNATE SITE
/ 1SOOPROPOSG ED /NDA APPROVED
S.T.E.P. TANK -,,,/TRICKLING RECIRCULATING
/ / / TM/S
FILTE
(StZED
ALL 4 /
� /
FOUNDATION / /�
/ CLEANOUT `* rb
/ PROPOSED
\
F,9 \
\o4l
\F
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
L 1OMM bh \IR 101 • MOOMOL MI MIO/ • OIOY[ QO1III1- IM • M[ 0049&�W" • MMllp �.Iw�m"OwwV4�
JOHN THOMSON 907 240-2020 1 2 OF 3
LEGAL DESCRIPTION: DRAWN BY.
TABLELAND SUBDIVISION; LOT 4, BLOCK 7, R.A.L.
TYPE OF WORK: DATE
SITE PLAN FOR PROPOSED SEPTIC SYSTEM 6/30/2C
(11".01M5)
(SEE DETAIL
PAGE 3 OF 3)
LOT S. BLOCK 7;
TABLELANDS
(VACANT)
FROM MOA APPROVED
RECIRCULATING TRICKLE
FILTER SYSTEM -
I F O
CO
OUT
FINAL
PLYWOOD BRACING
W/ VISOUEEN BARRIE
INSULATION
BRIG FILTER
I•—s'—�l
-PLYWOOD BRACING
W/ VISOUEEN BARRIER
GRADE
GARNESS ENGINEERING GROUP, Ltd. p: ' •'-:y
CONSULTANTS i GENERAL CONTRACTORS..........
......... . .
1 L N AWA 11M 101 • NOOWM MI OMOI 1101[ (OOY)3A-1111 M CWPA "
PREPARED FOR: PHONE NUMBER: PACE NUM ... ••••••••••
JOHN THOMSON 907 240-2020 3 OF 3 Q a ':Je f A. mess. -
LEGAL DESCRIPTION: AWN BY: QO�i Edi
TABLELAND SUBDIVISION; LOT 4, BLOCK 7, R.A.L. �e, 7�cJ�q$'''�oo
TYPE OF WORK:
DA'REVI5ED ���OPro
p 1101
DETAIL FOR PROPOSED DRAINFIELD 6/30/2005
(11«.0105)
GARNESS
ENGINEERING
CONSULTANTS
10i • AIOOMM ML
GROUP, Ltd.
E GENERAL CONTRACTORS
In • N • WOOL- ,srrgYMgem.
.oQ�pF ��oop
a►",' ••• .......
1 ■DI . 7UR
1/29/04
SOIL LOG
- PERCOLATION TEST
4'
LEGAL DESCRIPTION'
TABLELANDS SUBDMSION; LOT 4, BLOCK 7,
OQ •.J fre OTe34.�
C
QO
•q`�.
—753DEPT14
PERFORMED FOR:
JOHN THOMSON
DATE: 1/21/2004
�' j
0•
6•
O��DO°Oo�o��
=Z:
(feet) =___
ORGANICS
TEST HOLE 4
1
4
4:44
30
0•
LOAM
SOIL CLASSIFICATIONS
5
2
—
6•
6
5:14
30
3
6•
a t GP ML
GM CL
/
q
GC OL
.•°.° SW MH
TH#5
5
• •'• : SP CH
TH#4
.RAMSM : OH
6
SC
7
SM/ML
w/ SOME
e
GRAVEL
N:.`�.Y.
9
SITE PLAN
1'100'
10
it
12
13
14
B.O.H.
15-
5
16
16-
17-
17
18
18-
PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
19
t9
TEST RUN BETWEEN 1.5 FT. AND 2.0
FT.
20
A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO
SOILS LOGGED
BY: JODY MAUS PERCOLATION TEST PERFORMED BY:
RICK LYON
COMMENTS:
*MAY BE INFLUENCED BY SNOW MELT RUNNING INTO BENCH.
GEG. Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED
IN ACCORDANCE
PERFORMED BY
WITH ALL STATE
AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE:
DEPTH TO
GROUNDWATER
DATE
SEEP O 13.5'
1/21/04
•10�
1/29/04
12.5'
4/6/04
4'
5/10/2005
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
5 18 2005
1
3:44
—
6'
2
4:14
30
0•
6•
3
4:14
—
6•
4
4:44
30
0•
6�
5
4:44
—
6•
6
5:14
30
0�
6•
o�o60ppp0o
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS 6 GENERAL CONTRACTORS 9*
701 L ROM. ELITE 101 • NKNORME. N DOW7 • RQL (07)M?—R179 • FA - i0) —]3N • RFHLTL ,mr•••gwwp.c•m
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: TABLELANDS SUBDIVISION; LOT 4, BLOCK 7, DO o f rey Garness.
PERFORMED FOR: JOHN THOMSON DATE: 1/21/2004 �O CE -7953 ;'`4`
DEPTH
�44�0 Pofeso 0000
(reef) ORGANICS TEST HOLE 5 �pppoo��
LOAM SOIL CLASSIFICATIONS f
2 o= GW ---- ORG
3 r:+ GP ML
GM CL
4 GC OL
°• •0 o SW MH ,/� �� TH#5
5• : SP CH fi �� TH 4
SM OH
6 SC
7 SM/MLDEPTH TO DATE
1�
w/ SOME
8 DRY 1/21/04
GRAVEL
9 SITE PLAN
10
' � 1'
%
11
12
13
14--1 1111
B.O.1I.
15
16
17
18
19 PERCOLATION RATE 30 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 4.5 FT. AND 5.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO
SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: RICK LYON
COMMENTS: *MAY BE INFLUENCED BY SNOW MELT RUNNING INTO BENCH.
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WA P RFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE:
GROUNDWATER
•10.5' 1/29/04
13.5 4 8 04
4.0, S/1e/dam � 100'
DATE READING CLOCK NET TIME WATER LEVEL NET DROP
TIME (MINUTES) READING (INCHES)
1/22/2004
1
14:16
—
6"
—
2
14:46
30
5'
1'
3
14:46
—
6'
—
4
15:16
30
5"
1"
5
15:16
—
6'
—
6
15:46
30
5'
1'
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
May 25, 2005
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 South Bmgaw Street
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907)343-7904
Ref: Proposed Septic System for Tableland Subdivision; Lot 4, Block 7,
To whom it may concern:
Your department issued a permit for the referenced property on 4/23/2004. The permit expired on 4/232005.
On 5/102005 we took a groundwater reading in test hole #4, and found the liquid level at 4 feet below original
grade. We have redesigned the septic system and are proposing that a new 1500 gallon S.T.E.P. tank, a MOA
approved recirculating trickling filter (sized for 3 bedrooms), and a 5 -wide trench type drainfeld be installed.
Due to high groundwater we also propose that 2 feet of MOA approved sand filter be installed. The drainfield
will be designed around the 30 foot radius of test hole #4. Comments regarding the design are summarized as
follows:
1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the
percolation test results.
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system.
4. TOPOGRAPHY: As can be seen on the attached design drawing the average area around the proposed
drainfields is relatively flat. In short, there are no slope concerns.
We are unaware ofjjiny adverse impacts this installation would have on adjacent wells or septic systems. If
you have any quer ns, please contact us at 337-6179. Thank you for your assistance.
P.E., M.S.
NOTE: Attached is a site plan drawing, a design drawing, one soil log, which are all part of the design package for
this septic system. (Contact G.E.C. Ltd. for 7 page construction specification letter.)
3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507
Ph: (907) 337-6179' Fax: (907) 338-3246' Website: gamessengineering.com
LAT 4. BLOCK 8:
LOT S• BLOCK 8: TABLELANDS /D
LOT 8. BLACK 8; TABLELANDS S/D (VAC_ _ _ —
TABLELANDS S/D (VACANT) /'
LOT 7. BLOCK 8; (VAUNT)
TABLELANDS S/D
�i
LOT 8. BLOCK 8: NAUNO �
TABLELANDS S/D
(VACANT)
AT 9, BLACK 8:
i'
TABLELANDS
LOT Z. BLOCK 7:
TABLELANDS S/D
TLRNATE NANn
SITE
TMs LAT J, BLOCK 7;
TABLELANDS S/D
TH/ ,, ; ; (NO CONCERN)
1. BLOCK 7:
TABLELANDS S/D
r i (VACANT) /
PROPOSED SEPLIC /
SYSTEM (SEE DESIGN.PROPOSED /
3 BEDROOM PAGE 2 OF 2) /
Fq HOUSE LOT S. BLOCK 7; /
\/O TION) %jOCATABLELANDS S/D
��\ C //''I
\ LAT S. BLOCK 7: / Q
TABLELANDS S/D / Q- i
(VACAN)
LOT 8. BLOCK 7:
LAT 7. BLOCK 7;
TABLELANDS CONCERN) \��� // TABLELANDS S/D
WILL BE PRO
RVEDEBYEPUBLICWN /� (VACANT)
(N)
WATER.
GARNESS ENGINEERING GROUP, Ltd.,pG�: y'
CONSULTANTS& GENERAL CONTRACTORS �••••.• •• •••• •••• ......••••••
5101 L TIWI1 b10. /IA[ 101 MOIOIUOL Mf pA0) ROK - IN • fUt M �OCIC w� a
PREPARED FOR: PHONE NUMBER: PAGE NUMBER ••• •• •• •••••••
JOHN THOMSON (907) 240-2020 1 OF 3A .• e f A. mess.-
LEGAL DESCRIPTION: DRAWN BY: QOD°v+ 79 •• G
TABLELAND SUBDIVISION: LOT 4. BLOCK 7. R.A.L
TYPE OF WORK IOATLREVISED
(R".01.05)
NUMBER OF BEDROOMS 3
GALLONS PER DAY (GPD): 450
PERCOLATION RATES: <1 MIN./INCH
PROPOSED APPLICATION RATE: 2.0
MINIMUM DRAINFIELD SO.FT.: 225
LETTER THAT PERTAINS TO THIS DESIGN.
TO OBTAIN A COPY OF THE LETTER
CONTACT GEG. BY PROCEEDING FORWARD
WITH THIS INSTALLATION. THE ENGINEER,
WELL DRILLER. CONTRACTOR AND
PROPERTY OWNER AGREE THAT THEY
HAVE READ THESE SPECIFICATIONS AND
AGREE TO ACCEPT THE TERMS AND
i
MJWMUM uLYIm"'"I
WIDTH:5 FEET P
M.0 AAAPPROVED SAND FILTER: 2 FEET \9EFFE0.5 FEET
REDUCTION FACTOR: N/A
ACTWL SO.R.: 250 7
WATER
/ SERVICE
LINE
BOX
C\\ALTERNATE SITE
/ ZI SOOR GALLON /MOA APPROVED y�
STEP. TANK RECTRICKLIIRCULM.UFlLTER
(SIZED FOR 3 /
BEDROOMS)
/ INSTALL
FOUNDATION
/ CLEANOUT
y't
PROPOSED
DRAINFIELD
(SEE DETAIL
PACE 3 OF 3)
�. LOT 5. BLOCK 7:
TABLELANDS S/D
.r: •i.SY.•' (VACANT)
Jt-
Fq< \
Cp
GARNESS ENGINEERING GROUP, Ltd.p '?•'
CONSULTANTS & GENERAL CONTRACTORS Q'
L TIOM1 MMl lIIR 101 • Mna1ML MI /MOT • 111ML 001AWL �IM • PA (90/)3A CM M1M10 w#.�M�
PREPARED FOR: PHONE NUMBER: PACE NUMBER:
JOHN THOMSON (907) 240-2020 2 OF 3 29 '
TABLELAND SUBDIVISION; LOT 4, BLOCK 7, R.A.L.
E OF WORK: a -m -TUM
SITE PLAN FOR PROPOSED SEPTIC SYSTEM 5/25/2(
(Rm.Olft)
V
.................
A. Gamess.:
FROM MOA APPROVED
RECIRCULATING TRICKLE
FILTER SYSTEM —
O
CO
OMT II
J
50.
FINAL GRADE MT CO
2' INSULATION
PLYWOOD BRACING
W/ VISOUEEN BARRIER T4 ABRIC FILTER
PLYWOOD BRACING
w/ VISOUEEN BARRIER
1.5'
1 5.
GRADE
GARNESS ENGINEERINGGROUP, Ltd. ••T,
CONSULTANTS & GENERAL CONTRACTORS........
1 L TCM WA Wft 101 • "C OWAL M M!O) ACK 00Y)WAlln • W (607)�", IIWR: w,#^ r, O •
PREPARED FOR PHONE NUMBER: PAGE NUMBER: •• •••••• ••
JOHN THOMSON (907) 240-2020 3 OY A. nese
e �
LEGAL DESCRIPnON: DRAWN BY: O ai E-795
7 ,r
TABLELAND SUBDIVISION; LOT 4, BLOCKI, R.A.L 004 a�.ti �oo�
TYPE OF WORK: a REVISED °jDrofesst0e
DETAIL FOR PROPOSED DRAINFIELD 5/25/2005 04000
(Rw. 01005)
GARNESS ENGINEERING GROUP, Ltd. 0,
CONSULTANTS & GENERAL CONTRACTORS A . 4 e
N1 ?"A kM 101 • M OOVAL M 09W - F Q - IN - /M: . ...... • ...
•• • • • • • ............ •
SOIL LOG — PERCOLATION TEST
LEGAL DESCRIPTION: TABLELANDS SUBDIVISION; LOT 4, BLOCK 7, QO 9 '.� f y mess:
•E-7953
PERFORMED FOR: JOHN THOAISON DATE:_!/21/2004 QQ%a car
^•
(feet ____ ORGANICS TEST HOLE 4 PTtielyp
���Oo/o�a�o
1 ----
LOAM SOIL CLASSIFICATIONS
2 �•
b o GW =__= ORG
3 a4,
+. GP ML
GM
4 GCOCL
OL
e •°•°• SWMH TH#S
5 '••. SPCH TH#4
SM OH
6 Sc
7 SM/MLGROUNDWATER DATE
DEPTH TO
.:
W/ SOME
e SEEP O 13.5' 1/21/04
010' 1/29/04
GRAVEL ri..
9 12.5' 4/8/04 SITE PLAN
10 4' 5/10/2005 1'f 100'
11
12
13
14
B.O.fI.
15
16
17
18
19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 1.5 FT. AND 2.0 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO
SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: RICK LYON
COMMENTS: •MAY BE INFLUENCED BY SNOW MELT RUNNING INTO BENCH.
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS ERF RMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 2 r J -
DATE READING CLOCK NET TIME WATER LEVEL NET DROP
TIME (MINUTES) READING (INCHES)
5/18/2005
1
3:44
-
6'
-
2
4:14
30
0�
6'
3
4:14
-
6'
-
4
4:44
30
0•
6'
5
4:44
-
6•
-
6
5:14
30
0•
6'
•
� PGE B`
•,
1"-r Municipality of Anchorage
K.:iOn-Site
Z
Onn-Site Water and Wass tewwater Program a� �;�j��i
(907) 343-7904s n ETY
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 051-801-36 Expiration Date: 1 -
1. GENERAL INFORMATION
Complete legal description THE TABLELANDS BLOCK 7,LOT 4
Location (site address) 23605 FALLOW CIRCLE,CHUGIAK,AK 99567
Current Property owner(s) JAMES R & TRACY L GLYNN Day phone
Mailing address 1127 SE TURNBULL ST.,COLLEGE PLACE,WA 99324
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well _ Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class _Well ❑ Community ❑
Public Water System ® Public Sewer ❑
WaiverNariance request for: Distance:
Received by: -- Date:
Date: 4/9//�
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ G 2 ( Waiver Fee $
Date of Payment 'a - 2 - \ S Date of Payment
Receipt Number0�KDN Receipt Number
COSA# sDC- Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm ANDERSON CONSTRUCTION & ENGINEERING Phone 345-3377
Address 4640 SHOSHONI DRIVE,ANCHORAGE,AK 99516
Engineer's Printed Name MICHAEL N.ANDERSON,PE Date 08/02/2018
ja�.�1 ,,371,`
J I f
,:r4-;°.•‘ ',e„y'i}
7H ,� ° �•
6�.
6. DSD SIGNATURE F
1 rL:,•: Avh��5i✓r�,e Q::,e
?e� System #1 Approved for I-I bedrooms. s'o e=;°,,%,.c}Acr 9.
c,;;;;.-System#2 Approved for bedrooms. << e j;. ,,
cr
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
ON-SITE .
WATER AND .
WASTEWATER o
PROGRAM a;
00,
BY Original Certificate Date: ¶r R -1 ?
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet10-10-72.doc
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system
Certificate of On-Site Systems Approval Checklist
Legal Description: THE TABLELANDS BLOCK 7,LOT 4 Parcel ID: 051-801-36
A. WELL DATA - PUBLIC WATER
Well type If A, B, or C provide PWSID# Well Log (YIN) —
Date completed Sanitary seal (Y/N)__ Wires properly protected (Y/N)
Total depth ft. Cased to ft. Casing height(above ground) in.
FROM WELL LOG AT INSPECTION
Date of test
Static water level ft. ft.
Well production — g.p.m. g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 mL Nitrate_ mg/L
Arsenic: _ ug/L Date of sample: Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC I STEEL Date installed 1119/2005
Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N)
Date of pumping /maintenance Pumper ARM SERVICES
C. ABSORPTION FIELD DATA
Date installed 11/9/2005 Soil rating (g.p.d./ft2 or ft2/bdrm) 2.0 System type MOUND 1 BED
Length 30 ft. Width 10 ft. Gravel below pipe 0.5+ ft.
Total depth 3.4 ft. (Measured 8/1/18) Eff. absorption area 300 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 8/1/2018 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test 0 in. Water added 600 gal. New depth 1 in.
Elapsed Time: 20 min. Final fluid depth 0 in. Absorption rate >= 600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N &type) N If yes, give date
D. LIFT STATION
Date installed 11/912005 Size in gallons 1500 _Manhole/Access (Y/N) Y
"Pump on" level at TIMER in. "Pump off' level at TIMER in. High water alarm level at 45 in.
Datum BOTTOM OF TANK Cycles tested 2 Meets alarm&circuit requirements?Y
E. SEPARATION DISTANCES
WELL ON LOT TO: - NA/ PUBLIC WATER
Septic tank/lift station on lot On adjacent lots
Absorption field on lot On adjacent lots
Public sewer main Public sewer manhole/cleanout
Sewer/septic service line Holding tank
Animal containment areas Manure/animal excrete storage areas
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 10' Property line 10'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 200'+
ABSORPTION FIELD ON LOT TO:
Property line 10' Building foundation 10'+ Water main 10'+
Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain 50'+(None Known) Wells on adjacent lots 200'+
F. COMMENTS
Vacant field presoaked per code prior to testing.
G. ENGINEER'S CERTIFICATIONOF At
I certify that / have determined through field inspections and .:''gyp:•'• ••71.s. '
review of Municipal records that the above systems are in j •'• ` •'may s1
• 49TH
conformance with MOA COSA guidelines in effect •
on this date. •�r d�
Engineer's Printed Name MICHAEL N.ANDERSON,PE /•
•• MICHAEL N. ANDERSON .".' g'
Date 08/0212018 � .•. C j� 69 ••,��
COSA canary sheet_2-6-15.doc
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 r% Day of P\‘..)1LY c of 20 is~'_,by and between
CAA 04,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
located at(legal description)
0-3(00C— JN `l C3 C',r L\ e C •
.
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.
c-tTeIt 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).
�Z- 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.
W----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 3
Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On-Site Systems Approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction,maintenance and repair of the Owner's AWWTS.
_ Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system,or upon transfer of title,and shall continue
while the AWWTS is operational or until 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 3
ARM Ser\ ices. II('
Maintenance Checklist:Advanced Treatment System I
c) -1 Ali ,1
Operational Checklist Advanced Treatment System cwt`'""'1 "I'„m,=.�
Legal Description:TM., liriktedCakil-S + Q7- 1- Li
Street Address: /(:;iO--V Il: C-IP+ - - -
Service provided on Date4 13-W4 i 3Time
Service provided by Company APA1ilif Employee OA`f 0 A dilv‘
t)ate of last service _l, oo� __ _ By You Other
1 Type of Aerocell Treatmepcstem:
��//Cat II-AeroCell Treatment System
-:-. Cat Ill-Aer ell Treatment System
2.Conditions at media filter: .Acceptable Unacceptable
a I-valu a presence of odor within 10 ft of perimeter of system
None Milo - Strong . Chemical . .Sod!
b Source of odor if present ,A”/
3. Manhole Risers and Pipe Cap . !Acceptable Unacceptable
a Covens intact es . ...No J�
h Method of securing cover 'St1C±..sE /A /3 1+'-/f
c Any plumbing leaks or water intrusion —Yes -14 No
d Surface water/infiltration into components . YesYNo
4.Venting/Air supply: -/'Acceptable . Un9eceptable
a Air supply unit operating properlly//V Yes - Nc
b Venting appears o erable " Yes No tw i�'`���`a L i6 fr`�
N, te.l ( [ttN s/$ijl
5.Media surface: `_ Acceptable .._ Unacceptable
r
P P
a Biomat on surface '.Y s ._.No
b Uniform spray pattern Yes ._Ny
d Ponding in/on media . YesNo
e Pluggingrclogging of nozzles Yes Nq7
f Media appears to be settling Y r No
g Appropriate maintenance performed es Nom
h Pest activity at surface __ Yes VQo
6.Effluent quality
a Effluent odor after passing through media filter _... __ Mid Strong
b Effluent color after passing through media filter Clear ._.Brown .__: Black
24738 Chugiak Drive'Chugiak, AK 99567
Ph: 19071 317-9433 office/fax: (907) 688-9433 Email: ARMSeivicesAK(ioutlook.com PAGt 1
11111P-
ARM Services, 1.1-C
7. Tasks for recirculating/discharge flows: acceptable Unacceptable
a If applicable. Dandy valve functioning _Yes to N/A
b If applicable Jandy Valve basin dry ;.._Yes NoY/1�A
c Cleaned collection system in Aerocele unit ..... Yes No .- Not Necessary
d Design recirculation ratio 80 : 20
e. Actual recirculate ratio (Estimated): ;8O : p�prat� L
,� '� EXTRAS: ��1� T�
8. Pump System: LYAcceptable .Unaccept le
a Control panel in Auto. es No -Remote monitoring working?:
b Timer settings — —
-Phone line working?_—__- _ N/A
ON ).M+A._.. OFF I ✓
Override ON �M i n- Overnde OF`F/ 6 M A V/QG I
c Floats in correct placement .Yes _ No
d High water alarm operational ,Yes No
e High water alarm count--------
I Pump run time 3DDLO87- n
g Pump run counts i ? 3t_./'t�
h Effluent Filter serviced ` No
i Tank lids secured after inspection Y I_ No
l Weep hole functional 1/Yes No
9 Primary Tank Zptable ._.Unacceptable / i
9
v� ,�"'I°4 l
Sludge and scum level checked __Yes ��
b lank needs to be pumped Y _, No
c Tank lids/caps secured after inspection .— Yes No
10.Drainfield
a. Type of Drainfield(circle one) 5-wide Deep Trench
b. Design Effective depth (;:it. _feet
c. Checked Liquid Levels in Drainfield _�.Yes No
MT#1 Liquid Level A et Inches
MT#2 Liquid Level 6 R 7 Inches
MT#3 liquid Level Indies
MT#4 Liquid Level _" //Inches
d. Is there any surfacing effluent Yes VNO
Other Comments:
Service Provider:A " " 1..0 f t L (IA(.C_g Date: S/9/I D
r- r
Distributor: U`iuf %S 6-41,11r-e-trt, J
24738 Chugiak Drive 'Chugiak, AK 99567
Ph: (907) 317-9433 office/fax: (907) 688-9433 Email: ARMServicesAK®outlook.com PAGE 2
OWNER:
v1 (signature) Date: g /m /15')
r A Q..(a . C-\R.2V (print name)
STATE OF ALASKA )
)ss.
THIRD JUDICIAL DISTRICT )
The foregoillg instrument was acknowledged before me this '4 ay of A r -
2018 ,by ico.kii S (Xcx-
r r blr c) NOTARY PUBLIC
NOWY ItJBLIC FOR ALASKA TIFFANY BLANCHARD
My ntin.mission expires: ( -1.=S- 2-02.1 STATE OF ALASKA
A MY COMM.EXPIRES MARCH 28,2021
MUNICIPALITY:
By: _ (signature) Date:
(print name) Title:_
(rev. 05/18/2018) Page 3 of 3
Municipality of Anchorage
Development Services Department
Building Safety Division
Onsite Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.cl.anchorage.ak.us
(907) 343-7904
Cndl
'O
v� CERTIFICATE OF HEALTH AUTHORITY APPROVAL IQ�
FOR A SINGLE FAMILY DWELLING
Parcel I.D. _L_�,1�— &Q/ R�:� — HAA# 05C&3'4
1. GENERAL INFORMATION Expiration Date: to /i 5/a
Complete legal descriptionTABLELAnNDS 5/U* LUUI a ULUUK/i
Location (site address or directions) -3(005 Fa I.f m n�
p (,f'VL):Q' K 9951o74
Current Property owner(s) JOHN THOMSON Day phone (907) 240-2020
Mailing address
Lending agency
Mailing address
Real Estate Agent
17343 SANTA MARIA DRIVE • EAGLE RIVER, AK 99577
Day phone
EVA LOKEN w/PRUDENTIAL VISTA Day phone (907) 689-6476
Mailing address 16635 CENTERFIELD DRIVE • EAGLE RIVER. AK 99577
Unless otherwise requested, HAA will be held by DSD for pickup. CONDITIONAL HAA
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual Well
❑
Individual Water Storage
❑
Community Class Well
❑
Public Water System
E
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 samples. (Certificates may be reissued for a period of up to one year with valid
water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water
system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's
work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, 1 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
Address
GARNESS ENGINEERING GROUP, Ltd.
3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name
Engineer's Comments:
JEFFREY A. GARNESS, P.E.
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for bedrooms.
Phone
337-6179
Date i -?- h b10 S
OF
X=1 IQ
9 �*
y-e—yorn ess:
CE -795
p5 SAN
ZD .fr0fessioo°aoG
Disapproved.
Conditional approval for bedrooms, with the fllowing stipulations:
Money to placed in escrow for the amount of 1.5 times the attached cost estimate for
placement of six (6) inches of top soil and sufficient vegetation of the mound
absorption bed. Money in escrow shall not be released until thiG affire has given
final approval. The work shall be completed no later than June 15, 200`:;(+ �
g
c
t x"L,5 G ems.•
fs
�` N sir •: _
Attachments: �l ��,r;AND
COSA Checklist_ Arsenic Advisory 5r�
Septic System Advisory Manitenance Agreements �� +• , GRA
Well Flow Advisory Supplemental Engineer's Reort ��J��'.' • • `•�Q�,��,���
Nitrate Advisory Other �JJJ�/S}�j1���}
By: Original Certificate Date:
(Rev. 12/01)
Municipality of Anchorage
•.
•1', Development Services Department
Bonding Safety Division
On.Stte Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 995196650
www.ci.ancf orage.ak.us
(907)343.7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: TABLELANDS S/D: LOT 4. BLOCK 7. Parcel ID: 051-801-36
A. WELL DATA
Well typera MX
Total depth
PUBLIC WATER
If A, B, or C provide PWSIDN _ Won
Sanitary seat
to ft.
FROM WELL LOG
Date of test
Static water level ft.
Well production g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 ml. Nitrate
property protected (Y/N)
Casing height (above ground) in.
AT INSPECTION
of sample: Collected by:
ft.
-9-P.M.
S. SEPTICIHOLDING TANK DATA THIS IS A ZABEL AEROCELL (SCAT) SYSTEM
Tank Type/Material GREER / STEEL Date installed 11/9/2005
Tank size 1500 gal. Number of Compartments 2 Cleanouts (YM) YES
Foundation cleanout (YM) YES Depression over tank (YIN) NO High water alarm (YM) YES
Date of pumping NEW Pumper
C. ABSORPTION FIELD DATA
,�
Data installed 11/9/2005 Solt rating OE> ftlbdnn) 2_0 System type BED / MOUND
Length 30 ft. Width 10 ft. Gravel below pipe 0.5+ ft.
Total depth 0&13-4.69 ft. Eft. absorption area 300 ft' Monftoring tube YES Depression over field NO
Date of adequacy test NEW Results (Pas&'Fall) PASS For 4 bedrooms
Fluid depth in absorption field before test = in. Water added =gal. New depth =in.
Elapsed Time: = min. Final fluid depth = in. Absorption rate >- 600+ g,p.d.
Any rejuvenation treatment (past 12 mo.) (YM & type) NONE KNOWN If yes, give date -
D. LIFT STATION
Date installed 11 /9/2005
Size in gallons 1500
Manhole/Access (Y/N)
YES
"Pump on" level at TIMERin.
"Pump off, level at TIME n.
High water alar level at
*2 45 in.
Datum BOTTOM OF TANK Cydes tested NEW Meets alar & circuit requirements? YES
E. SEPARATION DISTANCES PUBLIC WATER
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot On adjacent lots
Absorption field on lot
Public sewer main
Sewer /septic service
On
sewer manhole/deanout
Holding tank
areas Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
Building foundation 5'+ Property Ane 5+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 200'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main 10'+
Water service line 10'+ Surface water 100'+ Driveway, parkinglvehide storage 10'+
Curtain drain NONE KNOWN Welts on adjacent lots 200'+
F. COMMENTS
TO BE TOP SOILED AND
G. ENGINEER'S CERTIFICATION
I car* that I have determined through field inspections and
review of Municipal records that the above systems ars in
conformance with MOA COSA guidelines in effect on this
date.
Engineer's Printed NJEFFREY A. GARNESS
Date 1-t/167
�
COSA Fee s .1 + WE Waiver Fee $
Date of Payment w-o,� Date of Payment
Receipt Number -1 ti U ai � Receipt Number
(rw. 17)01)
F.Ec-Dec.21
i
■
2005111:25AMM Garness Ensineerina Group, Ltd. NO -1370 P. 1P. el
••1 ly
1.1
Dec•21. 2005 11:26AM Garness Ensineerina Group, Ltd•" G'No.1370 P. 2
121
MWARD & ASSOCIATES LAND SURVEYING 694-0829
1 HEREBY CERTIFY -THAT 1 HAVE SURVEYED THE SCALEs,.
FOLLOWING DESCRIBED PROPEHTYt �'T� +• QF A %
J 'Elw�ld4S�u�C. yeq. 7 DATE, ` P(�....... �.Q3`�/
AND THAT NO ENCR04 4ENTS 61ST EXCEPT A5
INDICATED. IT IS THE RESPONSIDILITY OF THE
OWNER TO DETERMINE THE EXISTENCE OF ANY GRID:••
.... t
EASEMENTS, COVENANTS, OR RESTRICTIONS i
WHICH DO NOT APPEAR ON THE REcORDEb SU8O1- �� •. w.. M.h s«a i
VISION PLAT. UNDER NO CIRCUMSTANCES SHOUI�Felolwvl
44v is 6918 •
ANY DATA HEREON BE USED FOR CONSTRUCTION- �1
OF PENCE LINES, OR FOR ESTABLISHING BOUND- A�+kslarul�'�.
BOUND-
ARY LINES. �>•erwsw
ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND
REPAIR AGREEMENT
MEMORANDUM OF UNDERSTANDING
BETWEEN MUNICIPALITY OF ANCHORAGE
AND , \(% Go 1.1 Ck
THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this
,2qDay of,
herein the "OWNER," and the Municipality of Anchorage, herein the
"MUNICIPALITY." In consideration of the mutual covenants contained herein, the
parties to this Memorandum of Understanding agree as follows:
1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality
grants permission to Owner to utilize and operate an Advanced Wastewater
Treatment System (AWWTS), described as eh n located
at
2. Definitions.
A. Alteration. Any change to the design or function of an AWWTS that
Includes the installation or removal of any parts, components or pieces not
included in the original construction permit and design. Prior to
performing any alterations to an AWWTS the owner must obtain a
Wastewater Disposal System Construction Permit from the Municipality
pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65.
B. Certificate of On -Site Systems Approval. An approval by the
Municipality of existing water and wastewater disposal systems given at
the time of property sale and title transfer in accordance with AMC 15.65.
These approvals certify that the systems are adequate for the homes that
they support and meet the codes that were in place at the time of system
construction.
C. Damage. Any man-made or natural change in a system that would inhibit
the system from performing as designed.
D. Maintenance and Repair. The scheduled and as needed replacement of
existing parts, components and pieces of an AWWTS that were included in
the original design which would allow the AWWTS to continue to
perform as designed.
E. Permit (Construction) An On -Site Wastewater Disposal System
Construction Permit as defined by AMC 15.65.
F. Permit (Operating) An Advanced Wastewater Treatment System
Operating Permit. An annual permit, issued by the Municipality, that
allows the Owner to operate an AWWTS, upon meeting all the
requirements of this agreement, the conditions of Operating Permit, the
requirements of the On -Site Wastewater System Construction Permit and
all relevant provisions of AMC 15.65
3. Fee. Owner shall pay to Municipality an annual fee of
($--.00), payable on or before the issuance of the operating permit and annually
thereafter. The annual fee is due on or before the anniversary date of the approval by the
Municipality of installed system.
4. Term. The term of this Memorandum of Understanding shall be for the life of the
AWWTS.
The term begins on the date of approval by the Municipality of the installed system and
shall continue while the AWWTS system is in use or operational or until the property is
sold or title is transferred by owner and a new certificate of On -Site approval is issued to
the new owner or transferee of the property.
5. Alterations, Installation and Removal of Additional Equipment. Owner agrees
not to make any alterations, removal of parts or additions to the AWWTS without a
Construction Permit from the Municipality.
6. Maintenance and Repairs.
A. Throughout the term of this Memorandum of Understanding, the Owner shall
maintain AWWTS in good repair. In addition, it shall be the responsibility of the
Owner during the term of this Memorandum of Understanding, and any extensions or
renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2)
maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs.
Further, Owner agrees to comply will all applicable ordinance, laws, regulations,
rules and orders for the AWNVTS.
B. Owner agrees to provide the Municipality a written schedule of routine
maintenance and repairs which have been performed on the system pursuant to the
terms and conditions contained in the Owner's AWWTS Operating Permit. This
schedule shall be submitted to the Municipality annually upon the renewal of the
permit. The schedule of maintenance and repair contained in the Owner's AWWTS
Operating Permit is:
C. Owner acknowledges that the fine schedule for failing to maintain and repair an
AWWTS are codified in AMC 14.60.
D. Owner agrees that only maintenance, repair personnel certified by the
Municipality will inspect and make any necessary maintenance, repairs or permitted
alterations to the system.
E. Owner agrees to grant the Municipality reasonable access to test and inspect the
AW WTS upon 24 hours written notice.
F. Owner agrees that any sale or transfer of title of the property will not occur
without a new Certificate of On -Site Systems Approval.
G. Owner agrees that the relevant provisions of the standard specification guidebook
for AW WTS is the governing professional guidelines for the construction,
maintenance and repair of the Owner's AW WTS.
7. Nonwaiver. The failure of either party at any time to enforce a provision of this
Memorandum of Understanding shall in noway 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:
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 I.aw. 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.
STATE OF ALASKA
THIRD JUDICIAL DISTRICT
MUNICIPALITY:
By:
Title: —
Date:
) ss.
The foregoing instrument was acknowledged before me this V day of &I,
20_, by -S1Cilh - �T �IL1Q , the Tf):%C)4.ra. j nr t:�"
NO RY P BLIC FORA ('A,S)' ����j�\? ,I ; ;1 /0Y oo
My Commission expires:
PUBLIC
Ala A USA
Mortgage Company
01109106
RE: Mortgage Loan
C&T Construction to Glynn
Loan # 9699856
23605 Fallow Circle
Chugiak AK 99567
Lot 4 Block 7 Tablelands
To whom it may concern,
Upon closing, we will be escrowing for 4520.25, 1 '/z tunes
proposed bid from Land -tech, for soil, hydroseed, and labor,
to cover drain field mounds on above referenced property. A
copy of the bid is attached.
Sincerely,
Diane Perez
Senior Loan Processor
Alaska USA Mortgage
Alaska USA Mortgage Company, LLC
P.O. Box 196850 - Anchorage. Alaska 99519-6850 • 907.563-3033 - Fax: 907.261.14n1 •www .i..c..... .,r .--- ---
199-1 E00/200 d 010-1 99ye19Z oaea11on YSn 21selY-void 6041 90-80-utr
J2a-12-2000 12+OI Froe-
USA
Federal Credit Union
January 12, 2006
MOA
Attn: Julie Makelo
Re: 23605 Fallow Circle
Chugiak. AK 99567
T-024 P.001/001 F-849
In regards to the subject properly, the money shall be held In escrow until
such time as a final unconditional Certificate of On -Site Systems Approval
Is issued by the On -Site Water & Wastewater Program
Thank You.
Dunkin
Mortgage Closing Manager
P.O. Box 196613 • Anchorage, Aavka M19-8613 • Admi&traWve Offim: 907.2775577' WWWJ 3$c3Use.or9
Member Service Center. M Anehoraga: 563++587 Long DlsWnce Too Free: 1.800.629.8094 - TOD/Hearing Impaired: 1.800-742.7084
OZO-d Z00/Z00'd 821-1 WE 192 Healtoh Vsn e:1selY-a01d Emil 90 -21 -ver
Jan 09 06 12:2Bp
Dec 23 OS 01131p
load -tech
20919 Elsie Place
Chuglak, Ak.
99567
SCOTT JRHISCH
I ~1ADDRESS I
JORNTHOMSON
17143 SANTA MAIUA CR
EAGLE RJVTdt AK 99577
1-907-668-0552 p.1
PROPOSAL
DATE ESTIMATE NO.
1rn=3 115
p.I
L99-1 600/600'd OLS -1 9996191 61121Jon YSO 11sely-moll 5011 90-80-otf
P.O. Na.
TERNS
DUE DATE
RE'
FOS
PROJECT
Due m mcdpl
11 MODS
TTEPJ
DESCRIPTION
QTY
COST
TOTAL
H7DROSEED
INCLUDES SOLJtYDROSEED AND LABOR PER SO FT. 1AT
2.400
0A9
1.176.00
W7 TABLELAND SUB,COVBR DRAIN MEW MOUNDS
HYDROSEM
INCLUDES SOIL.HYOROSMD AND LABOR PER SQ. 1T: LOT
1.730
0.49
I.M.50
T.BLK 7 TABLELANDS SUB. COVER DRAIN FIELD MOUNDS
TOPSO4 AT$ -17.110 PERYD.HYDRO tst.12 SQ FT.
Total J4 o13eo
L99-1 600/600'd OLS -1 9996191 61121Jon YSO 11sely-moll 5011 90-80-otf
Municipality of Anchorage
Development Services Department
• Building Safety Division *A1
On-Site Water and Wastewater Program4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET
To: harness Engineering Group
Legal description: The Tablelands Subdivision, Block 7. Lot 4
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._
® Other. d)1�rNeed maintenance agreement signed by buyer. 2.) Need one (1) cost estimate
1_-J ---- :__ __- ---a._ C__ 4-- --:1 -.d---,J:-.. ......-.J .....a--.. 7 % K1- 4 1 -tea-- J: ---
Name of reviewer: Julie Makelo. P.E.
Date: 12/22/2005
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK