Loading...
HomeMy WebLinkAboutT15N R1W SEC 8 LT 160T15N RIW Sec 8 Lot 160 #051-154-01 �l Municipality of Anchorage ,:``_ '= ( Development Services Department Building Safety Division On -Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page I of www ci.anchorage ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number.07L 1 SO PID Number: _j—5� _5_ Name Gr TO �S A/1(,� Wastewater System: ❑New (Upgrade 05yo L a r ABSORPTION FIELD Pnone 8� NuiMer of Bedropma a Cl Deep Trench O SMIb. Trncn D Bed D Ma/M Dew S LEGAL DESCRIPTION Sod RehnpTOW D, D aie Depth h«peul 7scie GPDIFt� FI. BIMk LW suhdd^non 160 Depth w Vpe WMW hpn brprup �W) / FI. Gr" dayh penenn pppe f A! i = 1 TWimship I Ft" 1 section 2 Faa»dtl ewgho We GmWt M Loh 3 6 — FI. a/ FI. Well: El ❑ Upgrade rrevN Mnrn 10 N77q, s Dnu - Ines ?� Ft. FI Ci mcsoon tPro c&B.C) Ta 1 Usadro e/45 TWO a0l", fres P� MatenN prniar Date DNrd Stn,cW ••^iWar ./' �r Dne Militated� ^O7 FI � ({/_ H C lln Ywtd- Sal n arcp CsNaq,. •>.n] ANK GPM FL SEPARATION DISTANCES 6fSeptic ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Lift Holding ublio?nvate - ' From Tank Field Station Tank Sewer Line ^ �QGr wee . ^ NuOpryN Congnmsnls T sulre LIFT STATION LV Lme I g`I ` p L 'q �i(y /� Gr ieo l4e, i T s 3 r . .at« man n,� Pump a N N n Pump d» n 36 n n h aro MM n Eisq 'enWawn W - p Curtsn No, are nowt �� a.n rt Fleel is RwhaMs BENCH MARK LV:Wm «a Davip,an nn l T V po 'rl I ©DFI P, SO Er4needng 1"7-,-,20 Engineer's Stamp Inspections performed by: 1SBtMi & Birchwood Ln Rd Dates: Ctxgl*Alaska 99567 2nd Development Services Department Approval Conditional Approval Date: 07 * 00", •..., ,,, ,r DC ,4ik47y A %r1 rGView •1= 5tnziwxl a4 �1 « •• •••••••• .. t��FOA`e•»••�' Reviewed and approved by: iAi Date: _11/a/06 IRr pwe) ti + 4�lSSiO�'7 SIL PERMIT NO. SW0701 58 PACE 2 OF 4 Municipalit of Anchorage DEPARTMENT OF HEAH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 *Anchorage, Alaska 99519-6650 • Telephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 160, SECTION 8, T15N, R1W P.I.D. No. 051-154-01 K O r rI O K rn CRIB gRack NOA NO CRIB TO BE ABANDONED IED TO NEW :M. TO BE EN OWNER TMT =W HOUSE WELL LOT 1"77 HDPE NEW FAT S.T.1 I.D.S.F. BOX VALVES SCALE. `a, - 40' IL It11111ir ,.p{ *3 PERMIT No. SW070158 PACE 3 OF 4 Municipatit of Anchorage DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Ataska 99519-6650 • Tele hone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 160, SECTION 8, T15N, R1W P.I.D. N0. 051-154-01 TARIKA AVENUE -------------- s, LOT 2 WO CRIB ABANDONED H 1 A I ' W RADIU fry COMPRESSOR >.>.EXISTING GU GUAGC, AND AugY �+ CLASS C a WELL ai oaNf�pt+p CO CONTROL eos z rem 6 xrw IS00 24LON �+ CRIB TO BE ABANDONED NOPE SEPTIC TANK U NOT CONNECTED TO E STI 111111• WELL RADIUS N TTC NNECTE. TO BE • STI Ir�-"- - MOVE WYE" OWNLq L ROVES TO NEW MOUSE TMT Y N� m FA0 NEWALERTALL T ON o S.I.E.P.IANK LOT 1 m1 xrw Loss. C NE \ N\4j ♦rN 1 RUSHING VALVES MY A C\ \v ISO' RAOI S EOR EXISTING GLASS C WCLL SCALE: V - 60' LOT 177 EN ' SMP YN R/� N• •••N •NNgB•r �%' usf� PERMIT NO. SW0701 58 PACE 4 OF 4 Municipalit of Anchora e DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 •Anchorage, Alaska 99519-6650 • Te'lephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 160, SECTION 8, T15N, R1W P.I.D. NO. 051-154-01 GRADE r-- 98.9' INSULATION Gm —� NEW 1300 CAL.11 I `IY DISCHARGE PIPE 95.9 POLY. TANK ii MTI -100.0 MTI MTI=96.6'-J DIST. LINE -96.9' 95.6' 550 GALLON FAT ALBERT WITH PUMP ASSEMBLY AL GRADE I— _MT2= . m MT2=96.7= A GROUNDWATER AT 91.6- 88.6' B.O.H. CRADE=97.6' BOTTOM OF SAND=94.6' N. T. S. Dec 11 07 02:33p X942 Arlene St. u(>/. l Ancbora);e. AK. 49.102 Phone (907) 243-4721) Fax (907) 24.1-4730 MOA Atm: In.+p xtors 243-4730 p.1 Thio is concerning die home at 20816 Tarika (DLM W160 sm 8 T 15NRI W). The wiring orthis home, including the wiring of the well and septic boxes that are attached to the home tie all wired to NEC, and Anchoragc code. Rams I Iom Electric Inc. is I.icmed. Bonded and dasurcd to do wiring in Anchorage. Wasillu, Palmer, and the MamnuskaSusima Borough. If you need any other infontuuion please call tine office at the number above or Judy at 244-5419 'll,ank yon Judy Cishcr Banns Horn L'lectric dnc. MUNICIPALITY OFANCHORAGE Development Services Departments\ On -Site Water 8 Wastewater Program 4700 South Bragaw Street\ P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Jul 13, 2007 Expiration Date: Jul 12, 2008 Permit Number: SW070158 Parcel ID: 051-154-01 Legal Description: T1 5N R1 W SEC 8 LOT 160 Design Engineer: 0003 S & S ENGINEERING Site Address: 19911 OLD CRANBERRY Owner Name: CRAIG & SARAH PAULUS Lot Size: 108900 SO. FT. Owner Address: PO BOX 671261 Total Bedrooms: 4 Permit Bedrooms: 4 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. 71zo7%ask to b� r.,ovGc� CIGSer fo ha�nsG to cctiieve Correzf /v sic,pr/w Z /17 bne-- r Received By: Date:—? / f 3/O 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 ON-SITE SEPTIC/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. AC51- 1614-01 Property Mailing address PA � 61-11 0% 1 Site address ( PI I 0 ac'b �1�2VF1�(J' Legal description (Sub'd, Block & Lot) Lo I Legal description (Township, Section & Range) Lot Size jb3f LIM Sq. Ft. THIS APPLICATION IS FOR (®all that apply): Absorption Field Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ phone Code Number of Bedrooms T Code THIS APPLICATION IS AN: Initial Upgrade Renewal ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling a d -is n accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees Date of Payment: Receipt Number: (Rev. 11/05) Waiver Fees: Date of Payment: Receipt Number: ROBERT C. COWAN PEMILENGINEEnS (907)694.2979 !K&THAITHOMITY June 28, 2007 FAX(907)694.1211 MUNICIPALITY OF ANCHORAGE APPWNALS Development Services Department P.O. Box 196650 Anchorage, AK 99519 SEWERS WATER 1M EXTENS*w REFERENCE: Lot 160; Section 8; T15N; RIW; S.M. It is requested that you issue a permit to install a new I.D.S.F. septic system to serve SEWER& WATER the proposed four bedroom house on the referenced property. All other dwellings are NSPECTION to be removed from thisro e P P rt3'• A test hole was excavated and a percolation test performed. The approximate location of ENGIMEMNGSTGCMES the test hole is located on the attached site plan. At the time of excavation on 10/25/06 ANOTIEPOIITS water was found at 7 feet, and after monitoring ground water for seven days water was found at 6 feet. WELL NSPECTION We do not anticipate any adverse effects on neighboring wells, septic systems, reserve & FLOW TEST areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. SITE PLANS If you require additional information, please contact us. ROADDESIGN Sincerely, SO&TEST Robert A. Shafer, P.E. RAS/bjj PERCOLATION Enclosure TEST STA=LAIAL& MEC"am WSPEMNS ONSITE WASTEWATER EMSPOSALSTSTEM OESrN 17031 IIOIIT.I , r. ,, F • .:.. .. . •o •n • Ar = 60' I DESIGN SITE -PLAN ------------------ / OLD CRANBERRY DRIVE N 11314% 10s l 3WOH 3180"_•• 0 IFu 0 I I o A� o r nA r Inn r1 p ro O H+ spy I , a• I� °q > o�oosf M o 2 T^S Nm 0 IFu 0 I I o A� o j H+ spy I , cony °q > o�oosf z o I p A m O i Z �pj� '^ V1 tiZ > 8 I A o N ryy f K N ^ r +1 n W <>Ao Z o r `!� I" = 30' DESIGN SITE -PLAN SCAIc� W— o D W A_F8 I Ove r� OiONO0O �0. O o N N.O. V e` F„ w Sy�A vfZ-000 ����rm'1 to naffs ''�m �uu D 0 S 0', O T p kv ZOS�•�.' 0D i7 iO�p b o �+ z O"r m> rnN O s r d D SIN LG 0 C�7 DA : .:.. m �y col sniava 113M ,OSI �5 a �m �NN0 rn d'.' D RDx .;> z m N u --3 3WOH 31180H Z 000o n C-) 2: 0-D OtnomAD O .L . o A C/) xo me mac.. O� ..3 N !\V/ o DZ;o m2 0 r- i--� n rZ Z �/2 rc-)c .� D oc) vci �.� %S «^ b N� �.` mZ M 00 ZOn . Nm A�mO j m r �O Dw! Z r D ;uo>M7 - O on o w A� z y yFoo o.Am�Moo L J p�= A Cn Z sF000 ' 7 j N Hi D' z <r, m� D Z ,c w o C13 0N0 00 Z 40 �� o D;-40 3(70 S �vcn rNZ f \s t rrl r Xi Z4 0 o f zm rmV) r { Bio ��� ::E pit CA � D e N Performed rot. Municipality of Anchorage Development Services Department Building Safety Division +� On -Silo Water and Wastewater Program 4700 South Bragaw SI. P.O. Box 196650 Anchorage, AK 99519.6650 www. cLffP-qhQt!q ak.us (907) 343-7904 OF y ROBERT C. COWAN I C W. CE .8801 Iir? �+ �Soils�Lo�g -Percolation Test L._ .fit 0LIVS Date Performed: PERCOLATION RATE LI I PERC IIOLE DIAMETER (p •• TEST RUN BETWEEN .Z FT AND FT COMMENTS LOIL(- irf ,�& Zr SyWt> LAge PERroRMEDBY: s�. S {n1 (,,.rNY-.4iCrN�- 1 lz- CERTIrYTl1ATT111STESTWASI PERFORMED IN ACCORDANCE Willi ALL STATE AND MUNICIPAL UI LINES IN EFFECT ON TIIIS DATE. DATE: / /p j� ROBERT C. COWAN, P.E. CMLENGINEERS (907)694-2979 FAX(907)694.1211 INTERMITTANT DOSING SAND FILTER SPECIFICATIONS Lot 160; Section 8; T15N; RI W; S.M. am June 28, 2007 ,A�nLS GENERAL STATEMENT OF WORK SEWER&WMAIN The work and plans covered by these specifications consist of furnishing all labor, D(TE 101 materials, tools, transportation, and equipment necessary to complete an Intermittent Dosing Sand Filter system as described herein and on the attached drawings. �"CTM All work under this project shall comply with current Municipality of Anchorage (MOA) Regulations. The scope of this project includes the installation of a new I.D.S.F. septic system to serve ENGINEERINGSTUOIES the proposed four bedroom residence located on the referencedproperty. ANOREPORTS SITE INVESTIGATION WELL EST °N The Contractor must carefully examine the project documents, have full knowledge thereof, have investigated the site, and be satisfied with the conditions affecting the work. Conditions include, but are not limited to those bearing upon transportation, disposal, handling and storage of materials, availability of labor, water, electric power, roads, and SITE PLANS uncertainties of weather, physical conditions at the site including all underground utilities, the conformation and condition of the ground, the character of equipment and facilities needed preliminary to and during prosecution of the work. The Contractor must be satisfied „G,GDESIGN with the character, quality and quantity of surface and subsurface materials or obstacles to be encountered. Any failure by the Contractor to become acquainted with the available information will not relieve him/her from responsibility of performing the work as stated in these specifications and drawings. SOILTEST Location of utilities will be the contractor's responsibility. PERCOLATION TEST STRUMIRALa MECHANICAL NSPECRONS CNSITE WASTEWATER OISPOSKSYSTEM DESIGN Palle 2 Lot 108; Section 8; TiSN; R1W; S.M. June 28, 2007 SEPTIC TANK / LIFT STATION / AIR COMPRESSOR A. General The work under this section consists of the performance of all operations pertaining to furnishing and installing the septic tank/lift station, air compressor and piping to the sand filter. B. Materials 1. Tank a. Septic tank shall be a two compartment tank of at least the minimum size indicated on the drawings and MOA approved. b. First compartment shall have a separate 4" pump -out riser. The second compartment shall have a separate 4" pump -out riser. c. HDPE septic tanks are required to have a 4" monitoring pipe installed next to the tank extending to the bottom of the tank, a minimum of 2" direct burial insulation, and a maximum of 4 feet of cover. 2. Manhole Riser or Lift Station Tank a. An additional second compartment manhole riser shall be capable of being equipped with the following: A junction (Nems 4x) box or equal, bonded or attached to the pump basin. 2. UL listed electrical cord grips, installed in the J -box. b. An additional tank (M.O.A. approved) may be provided for the effluent pumping assembly and the items in (a.) above. 3. Effluent Pumping Assembly, Controls, Alarm & Piping a. Effluent pumping assembly shall be of approved materials, including the following: 1. A 110 volt or equal U.L. Listed effluent pump. Pape Lot 108; Section 8; T1SN; RiW; S.M. June 28. 2007 2. High-density PVC cylinder housing the pump, with level controls and screen, serving as a baffle to prevent the screen from clogging. 3. All piping shall be PVC or other non -corroding material. b. Pump controls and alarm system shall be an approved system with the following options consisting of; 1. Event counter 2. Elapsed time meter 3. Program timer 4. 10 watt heater 5. Remote alarm panel option with a minimum of 80 DB sound pressure at 24", operating temperature 30AC to 65AC, continuous sound to be located in the home. 6. Oil -tight visual alarm with push -to -silence feature. Automatic audio -alar reset. 7. 15 amp motor rated toggle switch, double pole, double throw with three positions; manual (man), automatic (auto) and center (off) (H.O.A.). 8. Nema 4x -rated, fiberglass, or equal, enclosure with hinged cover. 9. All controls to be installed as per manufacturer's recommendations. 10. Control panel to be installed on outside wall of home within sight of septic tank/lift station. c. Piping from the septic tank to the sand filter is to be 11/4" PVC schedule 40 solvent weld piping properly bedded as described in Materials Specifications and sloped to drain back to the lift station. Insulation board 2" thick and T wide centered over pipe is to be placed where soil cover is less than4' depth over pipe. Pape 4 Lot 100; Section 8; T15N; R1W; S.M. June 28, 2007 d. The airline from the house to the filter is to be HDPE insulated pipe 3/4"-2" SDR -11. The compressor will have a gauge (0-10 psi), a low pressure alarm, and be extended into the living area or garage for easy monitoring by home occupants. 4. Air Compressor a. Air compressor shall be a THOMAS LINEAR SERIES model number 5060-A or 5070V -A or M.O.A. approved equal. CONSTRUCTION SEQUENCE In order to insure proper installation, the system is recommended to be installed in the following order: I. Sewer line from house to tank H. Septic tank/lift station III. Sand filter IV. Leachfield bed (if required) V. Final grading CONSTRUCTION 1. Construction Instruments Contractor shall provide instruments such as transits, or levels, for establishing proper elevations and levelness of pipe or materials. 2. Pipe Laying All pipe shall be laid with material free of large or sharp rocks and organic matter. Each section of pipe shall be handled carefully and placed accurately. The spigot end shall be fully inserted pointing in the direction of flow and glued in place to make a water tight seal. Pape S Lot 108; Section 8; T1SN; R1 W; S.M. June 28, 2007 Each section of pipe shall be properly supported to insure true alignment and an invert which is smooth and free from roughness or irregularity. At all times, when work is not in progress, open ends of pipe and fittings shall be closed so that no undesirable substance will enter the end of the pipe or fittings. 3. Bedding of Pipe for Sewer Lines The pipe should be bedded with materials free of large or sharp rocks and organic matter, compacted. Native materials may be used as back fill material above the pipe, provided it is free of large rocks and organic matter. All lift stations shall be installed in accordance with the manufacturer's recommendations and standards. Electrical installation is to be in accordance with the National Electric Code (latest adopted edition) by a licensed electrical contractor, with M.O.A. inspection where required. If MOA inspection is not required, a licensed electrician is to provide a letter to the Engineer stating that the system meets or exceeds all applicable codes. 4. Excavation Excavate to proper depth to allow gravity flow, install tank level, tolerance 0.05 foot, on undisturbed or compacted classified sand fill material. Create a level sand surface over the tank and add 2" burial foam +35 PSI directly over tank. Mound unclassified soil over tank with a minimum of 2 feet of cover and anti -flotation weights that maybe required in areas of shallow ground water. 5. Connections All connections to be as per MOA requirements, PVC 3034 piping with Caulder or equivalent couplings for inlet riser pipes. All tank connections are to be completely water tight. Pape 8 Lot 108; Section 8; T15N; R1W; S.M. June 28, 2007 SAND FILTER The work under this section consists of the performance of all operations pertaining to furnishing and installing the sand filter. A. Materials 1. Sand Filter a. Liner (if required - not required for bottomless sand filter) - OSI Model LI or equivalent. 30 mil PVC cut and fabricated to provide water tight enclosure of filter sand volume. Seams to be permanent as per Manufacturer's recommendations. All connections, such as boot flanges, through sand filter to be permanently bonded to the liner. b. The Contractor shall provide a washed sand to meet ASTM C-33 Concrete Sand Specifications with the additional requirement that all but 1% of the materials passing the #100 sieve be removed. All sand shall be approved for use by the Municipality of Anchorage (M.O.A.). If the sample does not meet specifications, all sand will be removed and replaced. c. The Contractor shall be responsible for providing pea gravel that shall be a washed material containing no fines (0% passing the #100 sieve) and a maximum size of 1/4" diameter. d. The Contractor shall provide the manifold assembly. The manifold assembly shall be of approved materials with orifice shields and flushing assembly. All drilled holes to be cleaned of buns and pipes flushed, prior to assembly. Flushing valve to include riser to finish grade. Lateral distribution piping is to be laid level (@ t 0.05'). e. Top of the filter box to be insulated with 2" direct burial polystyrene insulation. f. The Contractor shall be responsible for providing filter fabric. g. Air coil in sand filter to be geoflow WF16-4-24 150 LF placed 6" above bottom of sand. Pape 7 Lot 108; Section 8; T1SN; R1W; S.M. June 28.2007 Construction of Sand Filter The sand filter construction is to follow procedures as outlined below, as applicable to this design. Pea gravel and filter sand are to be hand leveled to proper depth (tolerance within 0.05 feet) in filter, taking care not to allow mud or fine soil material into the filter or gravel layer. This would include any soil material picked up by excavation machinery buckets while loading specified material. The Contractor should estimate filter material volumes such that allowance is made for wastage of material in contact with the ground at site. The area over the sand filter to be finish graded with a minimum of 2 feet of cover and to prevent ponding of surface water runoff. Side slopes shall not exceed 3:1. The Engineer will reject any sand or pea gravel that does not meet specifications or is contaminated in transit or while handling. If such material is placed in the filter, all soil material maybe required to be removed and replaced with new material. CONTRACTOR / INSTALLER MUNICIPALITY OF ANCHORAGE ® Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-154-01 Legal description T15N R1 W SEC 8 LT 160 Site address 20816 TARIKA AVE Chugiak AK Current property owner(s) PAULUS Expiration Date: X The On -site system(s) is/are approved for 4 bedrooms Conditional approval for Comments or advisories: M bedrooms, with the following stipulations: Original Certificate Date: 12/29/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 05115401000 Complete legal description T15N R1 W SEC 8 LT 160 Location (site address) 20816 TARIKA AVE Current property owners) PAULUS CRAIG & SARAH 2. ON -SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone 376-7653 3. TYPE OF WATER SUPPLY: 0 Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: X Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel X Plastic ❑ Concrete ❑ Fiberglass Age 16 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: X AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On -site staff to verify the accuracy of the information provided. COSA Fee $ -90 Waiver Fee $ Date of Payment / Z�q�z?j Date of Payment COSA # 0 5C,2 S /y SC7 Waiver # COSA Application —June 2022 COSA Checklist Legal Description: T15N R1 W SEC 8 LT 160 Parcel ID: 05115401000 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system _ A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled unk Total depth unk ft Cased to unk ft ❑■ Sanitary seal is functioning correctly ❑■ Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 12/11 /23 Static water level at beginning of test 24.5 ft. Comments B. TANK DATA Measured operating fluid level in septic tank na* Date of pumping 12/29/23 ❑■ Required maintenance completed, if AWWTS Comments: *Premier Plastics w/IDSF D. ABSORPTION FIELD DATA Which system tested (date installed) 7/23/07 ❑■ ALL standpipes present per record drawing Total measured depth from grade 3•5 ft (max) Measured depth to pipe invert from grade ft (min) ■❑ N/A — pressurized field. ❑■ Per record drawings, field is insulated. ❑■ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies:2' Sand Liner Below E.D. Well production at time of test 5+ gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑■ No ❑■ Coliform bacteria is Negative Nitrate mg/L ❑■ Nitrate less than MRL (ND) Arsenic ug/L ❑■ Arsenic less than MRL (ND) Collected by NRim Eng. Date 12/11 /23 C. LIFT STATION ❑■ Required maintenance completed Age of lift station 16 years Lift station material plastic Comments: Adequacy test date 12/11 /23 Results g Pass Fluid depth prior to test 1 Water added 600 gal New fluid depth 2 in Elapsed time 30 min Final fluid depth 1 in in Absorption rate 600 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 3 Effective depth used 1 in Effective depth remaining 2 in in COSA Checklist June 2022 E. SEPARATION DISTANCES FrQm Private Well on Lot to: (Please enter distances If less than required or it community well on let) Septic TankiLift Station on Lot > 100' Community Sewer Man hol e1C leanou t > 100' �■ Yes if No ft ❑■ Yes if No ft Neighboring Tank �- 100' �■ Yes if No ft Private Sewer/Septic Line> 5' ■ Yes if No ft Absorption Field on Lot > 100' [E Yes if No ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50- ■❑Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Seaver Main > 75' ■QYes if No ft ■❑ Yes if No ft [J N{A — Served by Community Well (not on lot) or Public Water FromSeptic/Hold ing Tank and Absorption Fleld(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑■ Yes if No ft Surface Water > 100' ■❑ Yes if No ft Tank to Property Line > 5' �■ Yes if No ft Wells on Adjacent Lots: Field to Property Line > 1o' ❑■ Yes if No ft Private Wells> 100' ■© Yes if No � ft Water Main > 10' F■ Yes if No ft Community Wells > 200' ■❑ Yes if No ft Water Service Line > 10' ❑■ Yes if No ft F. ENGINEER'S COMMENTS If lank or field is under driveway comment below G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval GOdelines, indicates that the on -site water supply andlor wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in affect at the time of installation, unless noted otherwise. Name of Firm NorthRim Engineering Phone 94-70 8 Engineer's Printed Larne Steve Eng _ Date 12/19123 OF N 49 LE 10 �r Steve Eng.44 jr +,o CE-6256 _� Ns OSA Checklist June 2022 MUNICIPALITY OF ANCHORAGE ADVANCED 1\'AST'EWA7'ER'1'REA'I'MEN'I' SYSTEM MAINTENANCE: AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this _ ;(i Day of D e of 20 a .3, by and between Doc,y— S e(<< , 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: l . Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as 20816 Tarika Ave, Chugiak, AK 99567 IDSF located at (legal description) , -,91( %a f (' /q o(f. T15NR1 WSec8Lt160 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) ZP 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. _0 L It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). D P Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make ally necessary maintenance, repairs or permitted alterations to the system. 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) Pagel of 3 -71 Df Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. DL Owner acknowledges that the fine Ior failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. 0 f Owner agrees to grant the Municipality reasonable access to test and inspect the AWNUS. The Municipality will give at least 24-hour notice. D Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. _1 F O«aier 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. QOwner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The tern 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 I O\\"NER: $y, ram- I . (sig11111t1rc) brllc:�a7/a3 _(print 11,11110) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this 27 day of 1) ec 20a3,b)'_70(4 qla} Price NOTARY PUBLIC FOR ALASKA My Commission expires: ..see ¢- a3o 6 AMNICIPALITY: By: r (signature) (print name) (rev. 05/18/2018) Notary Public RON LANE State of Alaska EMyComm. Expires Sept. 23, 2026 Date: 1 Z 2 g �2,-j Title: Gt !' (L G— Page 3 of 3 O v 0 z m M M 0 v TARIKA AVENUE N 89'56'00" E 330.00' 50' BTr,- T RESERVATION / G 0 f 100 PROTECTIVE WELL RADIUS w w 0 1 0 NOTE: DUE TO SNOW & ICE COVER, SOME SURFACE LEVEL FEATURES ARE APPROXIMATE. SEE HOUSE DETALS I /SEPTIC PI <01 85.4' N 89'56'00" E 330.00' qP Lot 1 ! CANT 1.4 ■ 9.3, 1�9 � 2 STORY RESIDENCE w� 45 4 CANT 2.1' , 4.3' DECK HOUSE DETAIL Scale: 1'=30' 0 4 0 Lot 2 Lot 1 PLOT PLAN _ AS BUILT X SCALE 1" = 50' GRID N`N 0,':-1 Project No. 23-595/R1 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lan & Associates inc. c . (907) 522-6476 Phone 4 9 a��o (907) 522-4625 Fax �Q O A � p„ Professional Land Surveyors kenOlongsurvey.com �.....- ..,,9 p jonathanOlongsurvey.com WG."L'AN'G ryanOlangsurvey.comI hereby certify that I have surveyed the following described property: 4.T15N, R1W, SECTION 8, LOT 160Anchorage Recording District, Alaska, and that the Improvements situated thereon are within the properly Ilnes and do not encroach onto the property adjacent thereto, that Opo ` no Improvements on the property lying adjacent thereto encroach on the surveyed A�, f promises and that there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. 4Q —520� Dated this the 11� Day of at Anchorage, Alaska 00 FessloNA� �Q 0�40o��a It is the responsibility of the owner to determine the existence of any easements. AECC963 covenants, or restrictions which do not appear on the recorded subdivision plat.