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BROADWATER HEIGHTS BLK 3 LT 26
Broadwater Heights Block Lot 26 3 #050-081-66 -•�t 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 wWw.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: 6 "M 1'9 PID Number: _Q_ SQ_091-9 ` e lef►L Qe�h -tS Wastewater System: ❑New U rade Y p9 Ad-ess a s ' ,( SORPTION FIELD Plans q � I 1 NumDsr d Ba 0o .s- �] F//�/^�/e 0 DseP Trench o Snalpr Trovan ❑Bed 0 Mound m al»r /yam LEGAL DESCRIPTION BPa Rai.V OGPDIFIt Toul D.pn frm dryn,iry � 0 . FI. Blodt. Ld� /' mann Fe DWM to PPS txxtm can W.Q pWe aavN dei G Sl ,pipe 6 3 s. s + Lave Ft TPv mp Ranpe. Seuan Fa added aoove m91" 7+d• 5 Gr" Lergln t •FI. FI. Well: ❑ New ❑ Upgrade GrevN andn: Numoar Ins, D $Ia W Inas Ft. Ft CIa,aA�ulan(Prnala. A B \ TOM Depen. Grid W. Tda wso"wt r.a L Pasts .M F,5 t C FI. FI 3�0 Ft° Draw. Data Dm Stabc WSW Lev sl � Dale 1`010 d. /v �_O Ft. X a / CLJ Ywd mp Sat M . M /1pPve &r TANK GPM Ft. Ft. SEPARATION DISTANCES (Septic ❑ Holding ❑ S.T.E.P. ❑ Other. To From Se tic nk Absorption Field Lift Station Holding Tank ubhUPnvate Sewer line Yp1•` . / %Cm QS x' 'y Q Gai. WWI 1 1 I r, Male W Nyle dco wan «u \//L�� 7 OBJ Sul.x weer .r. �y}� I.U-1- � 1 •/- LIFT STATION WL" ' 1 t Fpuraman \ / �� 1 'Pump On' »vM M q 'Pump oM W V n N�pn wales alam al in n g n. Cvlrn avn Pump Maka 8 Moo{d L�Q4 EI napadana pr•o by 1Cj1tL�a ���ELCCW44L Remerka X► • s 1, of C Lorir BENCH MARK T ate b �o Lo 1.. a D.a Paan. l rI c S Z_ e , va A, L»valron. ( O Ft. S A S ENGINEERING Engineers Stamp Inspections performed by: 117034hole Rlvar Lees Ra.d. No.liWs: 1" Eagle River, Alaska 99577 2 nd 6x -07 ...•• Development Services Department Approval Conditional Approval Date: „O A. abde, • 1611. 1444�/ Reviewed and approved by: ate: IRev W/06t v,P�R A PERMIT No. SW070118 PAGE 2 OF 3 Municipalityof 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 26, BLOCK 3, BROADWATER HEIGHTS P.I.D. NO. 050-081-66 v � < 9a� I I CJS _,A , I EXISTING 4 BEDROOM O HOUSE O M Y{� I NEC MHA CAL ROOM l" I CI c \ I f I � MH CONTROL BOX I �I m I NEW 550 GALLON FAT ALBERT S.T.E.P. TANK ST2 T M g I I N s S PCO AT' N r'i I NEW 1300 GALLON AT MTl ° I rI HOPE SEPTIC TANK Z MT2 FVI-FV8 I I I I I I NEW I.D.S.F. \ � � SCALE. V - I I 100' WELL RADIUS I I E 1P I I 4w f+ LOT 271. A.&ew I SEPTIC c AREA T4aaf I F/ PERMIT N0. SWO701 1 8 PAGE 3 OF 3 Municipalityof Anchora e DEPARTMENT OF HEATH AND HURAN 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 26, BLOCK 3, BROADWATER HEIGHTS P.I.D. No. 050-081-66 FINAL GRADE � 97.4' INSULATION 93.8' I NEW 1300 GAL. POLY. TANK MTI= MT2- MTl -98.4 J MT2=98.4' DIST. UNE -98.7' 93.5' 97 550 GALLON FAT ALBERT WITH PUMP Ac¢ .110Y L GRADE DISCHARGE PIPE GRADE w ung "MAJ "_wo. W: ':70.11 OF SAND=98.4 A N. T. S. NO GROUNDWATER FOUND 92.4' B.O.H.EI NGUaW %f 1 mAd, I4a4 A 13 C F 0 22.5 22.0'— ST1 22.0 — 35.5 T2 25.5 — 37.5 MT 21.0 — 39.5 MH 31.0 — 37.0 FV_ T 734.5 40.0 — FV8 21.0 34.5 — MT1 20.0 34.0 — MT2 21.5 52.5 — 93.5' 97 550 GALLON FAT ALBERT WITH PUMP Ac¢ .110Y L GRADE DISCHARGE PIPE GRADE w ung "MAJ "_wo. W: ':70.11 OF SAND=98.4 A N. T. S. NO GROUNDWATER FOUND 92.4' B.O.H.EI NGUaW %f 1 mAd, I4a4 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-0650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW070118 Legal Description: BROADWATER HEIGHTS BLK 3 LT 26 Design Engineer: 0003 S & S ENGINEERING Owner Name: JERRY DETHLEFS Owner Address: 12202 SWEETWATER CIRCLE EAGLE RIVER. AK 99577-7932 Date Issued: Jun 20, 2007 Expiration Date: Jun 19, 2008 Parcel ID: 050-081-66 Site Address: 012202 SWEETWATER CIR Lot Size: 48499 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 4 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. -THE UPPER SIX INCHES OF THE MOUND SYSTEM MUST CONSIST OF TOP SOIL AND THE MOUND MUST BE VEGETATED SUFFICIENTLY TO PREVENT EROSION. ANY EXCAVATED CONTAMINATED MATERIAL BURIED ONSITE AND MUST ALSO HAVE UPPER SIX INCHES OF TOP SOIL AND BE VEGETATED SUFFICIENTLY TO PREVENT EROSION. -NEED TO SUBMIT MAINTENANCE AGREEMENT WITH INSPECTION REPORT. Received Issued Date: Date: Municipality of Anchorage Development Services Department Building Safety Division �- � r 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. 050 = AI- 10 ze / // Property owner(s) (�lG'ry ;� D e fA /e_ fC Day phone 6�P4 7o. Mailing Site address Legal description (Sub'd, Block & Lot) Legal description (Township, Section & Range) Lot Size qqq Sq. Ft. Code Number of Bedrooms T Code THIS APPLICATION IS FOR (®all that apply): THIS APPLICATION IS AN: Absorption Field ® Initial ❑ Septic Tank Upgrade 14 Holding Tank ❑ Renewal ❑ Privy ❑ S Private Well ❑ • ' Water Storage ❑ I certify that theove in mation is correct. I further certify that this application is being made for a Municipal Codes. Single Faymil nd is in accordance with applicable . S J "L7n,!J,/ It'P//n owner or authorized agent) Permit/Rush Fees: y Waiver Fees: Date of Payment: D Date of Payment: Receipt Number: o0,60 Receipt Number: (Rev. 11/05) ROBERT C. COWAN . CIVIL ENGINEERING June 21, 2 PH: 907.894-2979 FAX: 907.894.1211 "E"R AUTHORn MUNICIPALITY OF ANCHORAGE AMWNA S Development Services Department P.O. Box 196650 Anchorage, AK 99519 EEY/ERBWATER M EXTENSS)NS REFERENCE: Lot 26; Block 3; Broadwater Heights -SEWERSWATER We excavated five test holes on thereferencedproperty in order to find suitable soils PISPEDT" to upgrade the failed septic system serving the home. During excavation we encountered bedrock at one to two feet in each location. The only viable option for upgrading the septic system and still maintain adequate separation from bedrock is to EIKJNEER&4ST"3 place the innovative absorption field over the existing system. ANOREPORTS Our design calls for extensive fill in order to maintain a 25% slope for a minimum of 35 feet (see page three of design dated 6-14-07.) To maintain less than 25% slope for WELLSISPECTION a distance in excess of 35 feet would require an unreasonable amount of fill. As you /FLOWTEST can see by the cross section provided with this design there is no potential for effluent to leach out Is slope. SREPLAM Si rely, SOl1EST PERCOLATON TEST STROCTOMLS MECKWCAL S4PECTIONS ONSITE WASTEWATER DGPMk SYSTEM DESIGN A/ /RobA-IS'hafer, P.E. 15861 S. Birchwood Loop Road - Chuglak, Alaska 99567 DATE: April 7, 2004 '4t MUNICIPALITY OF ANCHORAGE B4. Building Safety Division a MEMORANDUM TO: On - Site Services Program FR s oss, P.E. ger, On -Site Water Wastewater Program SUBJ: Slope setbacks from >25% In situations where slope conditions will not allow a wastewater disposal field to be located 50 feet horizontally up gradient from a change in slope to greater than 25%, as required in AMC 15.65.060A.1.b the following requirements apply. (As allowed by AMC 15.65.030.G) 1. A point shall be determined two and one half feet above the invert of the distribution piping of the septic field at the field's closest point to the slope greater than 25%. 2. A line shall be drawn from this point and perpendicular to the distribution piping at a down slope of 25% in the direction towards the slope greater than 25%. 3. The intersection of this hypothetical line and the actual slope shall be a minimum of 35 feet horizontally from the point established in #1. 4. This 35 foot horizontal separation shall be the minimum allowed between a disposal field and a slope of greater than 25%. If a property has a wastewater disposal system that was constructed prior to 1986 and the absorption field encroaches a change in slope greater than 25%, an upgrade of the failed system may be approved In the same location If the following applies: 1. No other location exists on the property to construct an upgrade drain field with proper separations. 2. The engineer field verifies that no effluent ever surfaced on the slope surface. 3. The engineer maximizes the separation from the field to the slope as much as possible. HEALTH AL fIgRTY APPRCVAIS SEWER& WATER LWNEXTENSIONS SEWER&WATER INSPECTION MCC& RINGSTUDIES ANOREPORTS WELL NSPECTM &FLOW TEST SITE MANS ROAD DESIGN SOL TEST // PERCOLATION TEST STTa1CfURAL1 MECHANICAL INSPECTIONS CNSM WASTEWATER CISP06ALSYSTEAI DESIGN nOBERTC. COWAN, P.E. nOBERTA. SHAFER PE. CIVILENGINEERS (907)694-2979 FAX(907)694-1211 June 14,2007 MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 26; Block 3; Broadwater Heights Subdivision It is requested that you issue a permit to install an I.D.S.F. septic system upgrade to serve the existing four bedroom dwelling on the referenced property. The existing field is in failure, and the only location to place the upgrade is over the existing system. A test hole was excavated and a percolation test performed. At the time of excavation 8/8/78, ground water was not found. After monitoring, no ground water was found. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve 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. If you Enclosure information: please contact us. .E. 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U J v.v r -6,aD LIAS (S W, SIEVE Wr 07o SizE Rcr.. ,r -/ �._ fs_. — i:J 5L I 7 9 � 3¢ I feG zo 4 �j t3 i 47_ I foo I I I vA.v I j?o 9 •? '� :? h C G � y c 5 r ZAl vi 47. o � � o l 11 � ::v � ;. y o �� � :7 0 ^, c dtd�''�• is„••;t�2'o '. � � \ � \ \ � \ � � � N ^� `� 42w-`'1 w�:••� ems' .��•. • .r•r. ��•_.w_—._ ....IY I�r.••..r�•YT F!`�� ••M...M�n�`;_-.•-^•at ��! S& REALTNAUTIIORTY APPROVALS SEWER & WATER MAM EXTENSIONS SEWER& WATER INSPECTION ENGINEERING STUDIES ANOREPORTS WELL INSPECTION & FLOW TEST SITED ANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALS'STEM DESIGN ROBERT C. COWAN, P.E. CML ENGINEERS (907)694.2979 FAX(907)694-1211 INTERhIITTANT DOSING SAND FILTER SPECIFICATIONS Lot 26, Block 3, Broadwater Heights Subdivision June 14, 2007 GENERAL STATEMENT OF WORK The work and plans covered by these specifications consist of furnishing all labor, materials, tools, transportation, and equipment necessary to complete an Intermittent Dosing Sand Filter system as described herein and on the attached drawings. 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 1300 gallon HDPE septic tank, a new 550 gallon fat albeit S.T.E.P. tank, and an I.D.S.F. septic system to serve the existing four bedroom residence located on the referenced property. SITE INVESTIGATION 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 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 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. Location of utilities will be the contractor's responsibility. Page 2 Lot 26, Block J, Broadwater Heights Subdivision June 14, 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 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. HDPE septic tanks are required to have a 4" monitoring pipe installed next to the tank extending to the bottom of the tank. 2. Manhole Riser or Lift Station Tank a. An additional second compartment manhole riser shall be capable of being equipped with the following: 1. A junction (Nema 4x) box or equal, bonded or attached to the pump basin. 2. UL listed electrical cord grips, installed in the J -box. MR 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. Page 3 Lot 26, Block 3, Broadwater Heights Subdivision June 14, 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 wattheater 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 -alarm 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 1 1/4" 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 2' wide centered over pipe is to be placed where soil cover is less than 4' depth over pipe. Page 4 Lot 26, Block 9, Broadwater Heights Subdivision June 14,2007 d. The airline from the house to the filter is to be HDPE arctic insulated pipe 3/4"-2" SDR - 11. The compressor will have a gauge (0-10 psi) and�e extended intotl�a living area or garage for easy monitoring by home occupants. Q n 61° Wire d T h rou' Lt Sp? 5701130 Seirler aZrcrw" 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 M. 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. Page S Lot 26, Block 3, Broadwater Heights subdivision June 14, 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 may be 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 6 Lot 20, Block 3, Broadwater Heights Subdivision June 14,2007 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 aand 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 burrs 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. Sidewalis and 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 WF164-24 150 LF placed 6" above bottom of sand. Page 7 Lot 26, Block 3, Broadwater Heights Subdivision June 14,2007 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 may be required to be removed and replaced with new material. CONTRACTOR/ INSTALLER ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN YUNICIPALITUF ANCIIORAGF AND V(4 LrVtD,. lJC'T1-1 EFS THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this �� Day of 5WO of 2094, by and betweenh6(f(� herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Memorandum of Understanding agree as follows: 1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Q 5 • t located at 2. Definitions. Anchorage, Alaska. 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 -�?Oaj) (S�.00), payable on or before the issuance of the operating pen -nit 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 nrAW &I The terns 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 snake any alterations, removal of parts or additions to the AWWTS without a Construction Permit from the Municipality. 6. Maintenance and Repairs. A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AWWTS in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further, Owner agrees to comply will all applicable ordinance, laws, regulations, rules and orders for the AWWTS. B. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the Owner's AWWTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's AWWTS Operating Permit is: 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 aerees 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 AWWTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's AWWTS. 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 Memorandutn 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: .[�[ r ,(a'ah 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: yser z,cs(.c' f► • j��r� By: / Title: � Date: L[�,w%Q� Date: STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The f regoin trument was acknowledged before me this flay of�, 20Q� by rARYPUB ICALA��A,t�Nt� Commission expires: �! v' Pilo 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 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: S&S ENGINEERING Legal description: BROADWATER HTS BLOCK 3 LOT 26 ®Permit []C.O.S.A. []Inspection Report The attached paperwork has been reviewed and is being returned for the following reasons: 19 II 1. -NEED TO SUBMIT MAINTENANCE AGREEMENT 2. -NEED JUSTIFICATION FOR SEPTIC ABSORPTION FIELD IN SAME LOCATION, MUNICIPAL MEMO SUBJECT SLOPE SETBACKS FROM >25%, DATED APRIL 7, 2004 Name of reviewer: JOE Date: June 20, 2007 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK \\ } MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I� ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE L!NEW ❑ UPGRADE MAILING ADDRESS y,/ 31 k/v 'C. /G LEGAL DESCRIPTION G oAa 4,e- h2sh S LOCATION e Q NO. OF BEDROOMS Uy DISTANCE TO: Well Absorption area Dwelling 74D / PERMIT NO. /GOO E Q Manufacturer AN� Maternal sleelZ No. of compartr nit N&rd Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth b y _10Z DISTANCE TO: Well Dwelling PERMIT NO. 2? F Manufacturer Material Liquid capacity in gallons 0 w= DISTANCE TO: Well r �O Foundatio t Q Nearest lot line / b PEHMIT NO QQ J I.L. Z 2 W ~ H p No. of lines L n th o ach line _ Top of rile to finish grade s Total length of inrt Trench width Q Inches Material beneath filaTotal Inches Distance between ones r effective abso hon area O� w V Length Width Depth PEHMIT NO. d F- W LL Type of crib Crib diameter Crib depth Total effective absorption area W DISTANCE TO: Well Building foundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS P w SOI L TEST RATING %S INSTALLER s r REMARKS Rovil DES' 6 w L Q APPROVED DATE LEGAL n4- Ps 7 7 72.617 (Rev. 31781 mUN I C I PHL. I TY OF nr4CHOo-CnOE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 'L' STREET, ANCHORAGE, Ah. 99501 264-4720 WELL F=l NE> C:l I TE SEWER PERrl I T ,PERMIT NO.-- 781000 ) APPLICANT JIM STARR GEN DEL EAGLE RIVER. 694 3786 LOCATION SWEETWATER, ._, • LEGAL L26 B3 BROFDtJATER HTS �• - LOT'SIZE 48250 SQUARE FEET TYPE OF SOIL 'ABSORBTION "SYSTEM' IS:` DRAINFIELD. %QS AfQ.wo maT""'l MAXIMUM NUMBER OF BEDROOMS,.- 3 SOIL RATING,(50FT/BP..)S�o'� THE REQUIRED SIZE OF THE SOIL ABSORPTION EYf3TEM IS: C7EPTH= , LEfVGTH= -sem (3F;Z" 'EL_ ,DEPTH= THE LENGTH DIMENSION,IS THE LENGTH CIN FEET)iOF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR -'FIT I5 THE DISTANCE'BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF.'THE EXCAVATION CIN FEET). THE TREr-dCH W I E>TH I S .mss. OOC� l FEET THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). REQU I RE17 SEF TIC , TFiMK . SIZE= : - o 34@ GAL_L_OrJS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF,ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT)'THE WELL WILL SERVE. i --- TWC? C 2 ] I MSPECT I Oro ' FfRE RECZ. U I REO --- EACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT -TO -PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY 014 -SITE SEWAGE DISPOSAL SYSTEM.IS 100 FEET FOR A PRIVATE WELL; OR 1. _ 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELl� WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO-THE-DEPARTMENT_WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER. REQUIREMENTS MAY APPLY. `SPECIFICATIONS'ANST .UCTION DIAGRAMS ARE AVAILABLE TO INSURE PROBER•INSTALLATION.- 9 PERMIT EXP I RES [7ECF�f'i yO.R I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENT OP, 64 JE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH ^THE CODES. 3: I UNDERSTAND•THAT,`THE 014 -SITE SEWER SYSTEM MAY REQUIRE EtJLARGEMENT•,IF".,THE RESIDENCE IS REMODELED TO•INCLUDE MORE THAN'•3 BEDROOMS. „ _1} I rz_ /110VNO � �✓ SIGNED APPLICANT JIM STARR S ere Sive ISSUED BY�--------------DATE ������ _-- V3.2 (, f%L.0 .✓O. LoCA/��/�oN L_Z`, 4 -3 ACI An Q AT k7 2- PC -le -H75 OSEc OW/J4XRS LoCAT/Oy MAP) h SHEET ._L O%Z 144 Lcr Ov V 815178 pAre Noce LOct.�p CL/c„7' S��g Fi"-0JECT 0Co7'11 CLA_://�/cnTioN �`Cr .SA/yPLt /N�o¢MAT/ON �" PEAT ept) *A --ti: N L +j n ''* ry F. Carth'mz:t /ofz —rNr✓ Zoe Z - GRAS s.."Plx Q 4 / Sig V6 krr ReT. Afs.J . /. GRAvcLLr s.L-rS A, D I i .. �.9`' CAMP WN.ct� O/O[.iub, . 3 i� y Rnw �Cacr. 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U,J 1J.vr 4,LrD CLASS (Sw) $/EVE S.zE hT ReT• cJo 2�=r V% i _P_AfSJ „ i 4 3 bG '• —¢ 4 � I 2 /oo lob vA •�9 I Ro 9 moo — No 0 u w A ad d \ > \ \ um, tu X- w Am� \ 0 \ \ \ \ / / \ \ � � � z z LU w U LL. 0 kx a \ \ \ \ / / \ \ � � � z LU uj UA z Qix \ \ \ \ / / \ \ � � � � 000066660,60,0* i \ /\ \ \ \ \ \ \ \ \ 0 C4 a 2: w 0 Cd w 0 CA L6 0 ce w 0 09 L6 0 Ix w 0 w w 0 Cd L6 0 cc w / / \ \ � � � � � d � \\ 0* 0 o o o o 0, /\ \ /� ��\� C4 0 0 z 00 99 rg 0 X 0 Cd 0 w w 0 cc w 0 W. La. 0 w L& :K L6 0 % 6. Ix L� ed L6 z — J Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.d SO — O 81— 6 Co 1. GENERAL INFORMATION COSA # h q Expiration Date: 0 g ^ Q 7 Complete legal description Lot 26; Block 3; Broadwater Heights Subdivision Location (site address) 12202 Sweetwater Cir. Eagle River, AK 9957 Current Property owners) Jerry a Cindy Dethtefs Day phone 6949273 Mailing address same Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site IZI Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers 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 s a s Engineering Phone 694-2979 Address 15861 S. Birchwood Loop Rd. Chugiak, AK 99567 Engineer's Printed Name (� 0 4,fA T C. CC, w nFni Date 7 OF 5. DSD SIGNATURE fo, -A i ROBERT C. COWAN P ti CE -8801 ✓ Approved for 4 bedrooms. si Disapproved. Il,��f�hic5tyc� Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory X_ Other By: �.�,/ Ax Original Certificate Date: —07 (Rw 11A5) Municipality of Anchorage • '� Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsde (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: L -RC- FSwcx F f amftLt? %c_ 14Ts Parcel ID:O So -off l - L C A. WELL DATA Well type - VgTt7 Date completed -1 ic/-16 Total depthft. If A, B, or C provide PWSID # Sanitary seal &) -AS Cased to j_—Oft. M bat<iL FROM WELL LOG Date of test 10 1-76 Static water level 37t 100 ft. Well production '3 •0 g.p.m WATER SAMPLE RESULTS: Coliform O( colonies/100 mL Nitrate 6 G mg/L Arsenic: ug/L date of sample: , _540 Well Log&) J) �4^ Wires properly protected 0) Casing height (above ground) P LT(I,� inn. AT INSPECTION JCTTIIONN 5 U q r ft. (.` g.p.m. Other bacteria O colonies/100 i il. Collected by: '_->s5; 1`n�lA,t�Qy1)� B. SEPTICIHOLDING TANK DATA Tank Type/Material S 6PrI L ( Dale installed (V ZZ O Tank size 1 Wgal. Number of Compartments Cleanouts (�ID!) �jlcg Foundation cleanout&) -*6 Depression over tank (Y®_Q High water alarm 01S A2O Dale of pumping A)6uW 3Pumper C. ABSORPTION FIELD DATA Date installed Soil rating g.p.d./fe r ft2/bdrm) ZO System type rLZ p'� r r Length 010 ft. Width ft. Gravel below pipe 0.915 ft. Total depth N_0 ft. Eff. absorption area Monitoring tube E� Depression over field lUo Dale of adequacy test Trt01 Results (Pass/Fail) For -4 -bedrooms Fluid depth in absorption field before lest = in. Water added= gal. New depth= in. Elapsed Time: — min. Final fluid depth = in. Absorption rate >= — g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date — D. LIFT STATION Date installed '''�a 'Pump on' level at Ain. Datum Tx5TiOry) E. SEPARATION DISTANCES Size in gallons Manhole/Access©J) I m 'Pump off" level at in. High water alarm level at glRi' in. Cycles tested Meets alarm & circuit requirements? tl Eg SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot C. Absorption field on lot Public sewer main AJIR t Sewer /septic service line .? 5 -I Animal containment areas SC d -- r On adjacent lots / 0e) 'I- ! On adjacent lots /00 -11- Public sewer manhole%leanout Holding tank wt, r Manure/animal excrete storage areas too + SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 1 Building foundation t 4- Property line <4- Absorption field $ ! I Water main 62.101 Water service line /L9 = Surface water Wells on adjacent lots l of + SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: r Property line 321 2 Building foundation /— Water main A) !4 1r Water Service line 4- Surfacewater %Z19 r 4- Driveway, parking/vehicle storage 10 4-- Curtain r- Curtain drain 1►VAX- Wells on adjacent lots _ /00 t F. COMMENTS *- 11 J)ca t S 19 rT wC-(L. , u-) t IzCS R•r2Y TN FT -9 1 S 04 "'brry-t_iNfT►�L! C- t S P2bPMLy Padf Ir�TLr D t.017-' ~1V (TC4Z4V4 G. ENGINEER'S CMI 1 1 ATION MILK) 1:40CE- 4.&%tiZ.;&Lva ,_ I certify that I have determined through field inspections and • _ •• review of Municipal records that the above systems are in c� ; conformance with MOA COSA guidelines in effect on this date. •, k.:`iP- ''''' Engineer's Printed Name Y? 0 g Cd wA-- Date -7 Q /a -7 i iroserr c COWAN o� C:.8801 r%:..,.• . �. COSA Fee $ 5 Waiver Fee $ Date of Payment /� �� Date of Payment Receipt Number wtp 1 12n Receipt Number (Rev. 11/05) 'N •i ,K n , ^t .r �Y\0 . L or/wsd ? t W�IK {W ` itli Y 1 1 1 y Ih Alt aR w✓ t i _ 1 i 1 ^fry C o,N, I ' L off Q fir or kir / h:a�•S.r.�J {��J.•F.J 7-7-'p 7. AS -BUILT 1 hereby certify that I have surveyed the following described property: II- e, 2iilee-k 3 P/i cLsa use %er i'^ /'/-t Slit c� Anchorage Recording Precinct, Alaska, and that the improve- ments situated thereon are within the property lines and do not overlap or encroach on the property lymg adjacent thereto, that no improvements on property IvtnR adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Eagle River, Alaska this =day of t-L-� ri.+z 19 ROBERT C. JOHNSON SCALE: Registered Land Surveyor No. 880 -LS 1•'O/ Box 77.0456, Eagle River, Alaska 99577 Phone (907) 6942543 S a Sl ROBERT C. COWAN . ..rn�eRmG CIVIL ENGINEERING � / _U y 11,2UU1 PH: 907.094-2979 / FAX: 907-694.1211 1EALTHAUTNORrY MUNICIPALTfY OF ANCHORAGE APPflOdd S Development Services Department P.O. Box 196650 Anchorage, AK 99519 SEWERS WATER - 1A NE%TEf8g11S REFERENCE: Lot 26; Block 3; Broadwater Heights During installation of the septic on the above referenced property, all excavated -SEWER&WATER contaminated soils were buried on site. WSPECRCN The well is in a pit near the parking area, and cannot be raised due to the chance it may be hit by vehicles. E11GNEEPAW STLC43 ANOREPORTS There are no immanent health hazards posed by either of these issues. Request you issue the Certificate of On -Site Systems Approval immediately. WELLNSPECT" SRDWTEST Sincerel , arePLANs 11,/ZR r . Sha er, P.E. L11 ROAD DESIGN $OLLIEST PERCOLATION TEST STR UMALa MECKANrAL NSPECTIONS ONSIIE WASTEWATER DGP06ALSYSTEM DESIGN 15861 S. Birchwood loop Road - Chuglak, Alaska 99567 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 # 070234 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 26 of Broadwater Heights subdivision. This inspection revealed a nitrate concentration of 6.02 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. 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 99519.0850 www.cl.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Bob Cowan Legal description: Broadwater Helohts Block 3 Lot 26 E]Permit ®C.O.SJL ElInspection Report The attached paperwork has been reviewed and is being returned for the following reasons: 1. What was done with contaminated soils from old system? 2. Is it a health issue to raise well casing above grade ? Name of reviewer: M Date: July 13. 2007 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK ! /MUNICIPALITY OF ANCHORAGE NL; ,._�Atlif+ FANCtICIMOt O DEPARTMENT OF HEALTH & HUMAN SERVICES Etr✓ Nrdt lERVICtS DIVISIO,y Division of Environmental Services Div \ On -Site Services Section 6 1997 P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 RECEIVED CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 01. - CA 1 - HAA tt 1. GENERAL INFORMATION Complete legal description Lot 26; Block 3; Broadwater Heights Location. (site address or directions) - 12202 Sweetwater circle t- Eagle River AR Property owner Dr. Richard GregoryDay phone 694-9809 Mailing address" -.12202 Sweetwater Eagle River 99577 Lending agency Day phone yMailing address -'1 Agent Virginia Kohfield/ Remax of Eagle River Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 v 3. TYPE OF WATER SUPPLY: Individual well R:IX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site xxx Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. \ 72-0251Rw. 1N11 Front MOAR21 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & S ENGINEERINGphone G cl'! - D. cr 17034 Eagle River Loop Road o. Address Eagle River, Alaska -99 Engineer's signature 6. DHHS SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for Additional Comments M ItITIr Date $ / 1 r / 9 7 F j0 \n ROD Rr C COWAN yc �[E'_8801f si f t��r,i.�f^. ►iSSt� bedrooms, with the following stipulations: Date Vg Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate Is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. n -M m«. iAn Beck MOAN21 MUNICIPALITY OF ANCryOMGt Municipality of Anchorage ENVIRONMENTAL SERVICES DMS DEPARTMENT OF HEALTH & HUMAN SERVICEAUG 2 6 Environmental Services Division 1997 825 L Street, Room 502 • Anchorage, Alaska 99501 • (90R 23 IAA [ ( V L C D Health Authority Approval Checklist 11CC Legal Description: LIDITVp '0W(-3 epr--00!-ID rSF_¢Parcel I.D.: A. WELL DATY i Well type _1_// 14 If A, B, or C, attach ADEC letter. ADEC water system number Log present`Ynv) Date completed 9 -Io-76 Total depth D� Cased to I Ara 016PP,0tvr-Casing height (above ground) ONE, Sanitary sea(Q)N) FROM WELL LOCI Date of test 9 -10-7f Static water level 3�b ' t w yo Well production �• ES'f g.p.m. WATER SAMPLE RESULTS: Wires properly protected N I) AT INSPECTION &-7-9 Coliform Nitrate -2, l/ Other bacteria Z� Date of sample: 8 - S" % Collected by: S & S ENGINEERING B. SEPTICIHOLDING TANK DATA EMU River, Aloka "5V Data installed V -k 8-'%c1 Tank size :<PVwJ Number of Compartments -Z— Cleanou'1 Y♦�1)� Foundation cleanout(�I) — Depression (YQ High water alarm (YM) � Date of Pt$rtiptng , Pumper -TX-. C. ABSORPTION FIELD DATA Data Installed `' t 8 -W :Soil rating rm System type vim: �G, Length -i1' Width '!5�'— Gravel thidmess below pipe 0,5-' Tatai depth Effective absorption area S Monitoring Tube present )N)* Depression over field (YZ0 Date of adequacy test f-747 Resultdjjj;)Feil) For bedrooms ti N Fluid depth in absorption Held before test (in.); Immediately after-6egal. water added (in.): o Fluid depth O y (ins) Minutes later: — ' Absorption rate = g.p.d. Percodde treatment (past 12 months) (1Q As �J e, � r!od if yes, give data 72-026 (Rev. 3/98)' D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm E. SEPARATION DISTANCES 'Datum Size in gallons "Pump off" level at' SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot On adjacent lots ,Ou Absorption field on lot tU On adjacent Its Icy..) II 1 I Public sewer main Y Public sewer manhde/deanoul 11 Sewer /septic service line Lift station tt SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5i % Property line 10 %1- Absorption field 2 1 PEI= //`^� At—.rA)4r Water maintservice line /D Surface wateddrainage 100 1r Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line % 1 Building foundation 10 (j Water main/service line 10 14 - Surface water /t7 a I+ Driveway, parkingNehicie storage area Sj I Curtain drain r3 J A- I4>'tbyd eJ Wells on adjacent lots 100 i �- F. ENGINEER'S CERTIFICATION I certify fhaf I have determined thru field inspections and review of Municipal recd hq ms are in conJbrmance with M define In effect on this date. y'� .0 •` �., S� Signature /*� Engineer's Name ►i I B t,2; v uA.� RCW'C Cavin Date a S �N 7 '�l\ C'E - Qe01 dw HAA Fee Date of Pe Receipt Ni 72-026 (Rev. 3/913)' Waiver Fee S Date of Payment Receipt Number 050 0 1 (o MUNICIPALITY OF ANCHORAGEfNI �NMfNT� OrAN, DEPARTMENT DIVIS ON OF ENVIRONMENTAL SERVI ES ES ✓(/N v��fSo/V/410N CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL 91987 444 OF ON-SITE SEWER AND WATER FACILITY R C� 264. C NA Application Date 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Descc iption (include lot, block, subdivision, section, township, range) Location (address �/oorrd�directions) / n (b) Property Owner(TAdZA Telephone: Home t¢ s' , p Business Mailing Address (c) Lending Institution �A���`� �"�`� Telephone Mailing Address (d) Real Estate Company and Agent Address /� y $ Telephone [/�/ y 47 � (e) Mail the HAA to the followina address: or. Check here If hold for pick up. List contact person and day phone number below. S & S ENGINEERING Eagle rver Loop Road No. 204 /'. ' ✓ /� .//y/� Fate River. Alafia 94577 2. TYPE OF RESIDENCE Si ngle-Family X Number of Bedrooms - 3 3. WATER SUPPLY Individual Well Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 77-025 01" B,BBf Fronf +Jae iae,e ney) Seo -u i •, Z {o Z abed 'lliom s,jaau16ua leuo!ssalaad all ui suo!ss!wo jo slam jol alq!suodsai lou s! a6ejoyouV {o Al!led!o!unpy ayl •panssi s! alewpliao a aiolaq elep azAleue io suolloadsui lonpuoo lou op SHHO {o saaAoldw3 sluawaiinbai alels pue lejapal ule{iao Als!les of japio u! suognllsu! 6u!pual rayl pue sawoy to siaseyoind of Asaunoo a se slyl saop SHHO ayl'elselV to ale1S ayl u! paials!6ai iaaulbua leuolssalad luapuadapu! ue Aq anoge S 4dej6eied ul uaA16 suo!leluasaidai ayl uodn Aluo paseq saleo!1!uao lenaddy Al!joylny ylleal l sanss! (SHH(3) sa3!Ajas uewnH pue 411eaH to IuawliedaO 06eioyouV to Al!led!o!unVj all ojjdo e Sq`%^ 1 roll ,xvvs .y v" NOI1f1Vo _C -V it WN RINK lenaddV Ieuog!puoO {o swial leuo!1!puoO panaddes!O / panaddV Aq swoapaq 77 �� V7tV Jo{ panaddV a Cil IVVAOHddV SHHa area DJPPV vuc -VN PeOH C1001 JOAIM 01893 MLI 2 _ euoydalal JNIM33NION3 S 8 S wnj {o aweN •uo!loadsu! s!yl 7o elep ayl uo 13aga ui suo!leln6ai pue'saoueu!pio'sapoo ale1S pue ledlo!unVq Ile yl!m a3ue!Idwoo ui si walsAs lesods!p jalemalsem jo/pue Alddns Jalem al!s-uo eyl 'uoyoadsui pue uo!le6ps9nul Aw wal pue sal!{ a6eioyouV to Al!led!o!unVy ayl wal pau!elgo uo!lewiolu, all uo paseq leli A1laA jalunl I •u!ajay palempu! ainlonjls {o edAl pue swoapaq to iagwnu ayl iol alenbape pue leuo!loun{'ayes so walsAs lesods!p ialemalsem io/pue Alddns ialem el!s-uo ay11ey1 SMOyS lenaddV Al!joy1nV ylleaH s!yl to uo!le6!lsanu! Aw leyt AluaA I'molaq UMOyS aWP uo11ep1leA all {o se pue olaJay pax!{{e leas Aw Aq pa!{!ljao sV P1 NOI1VWdOdNI CNV V1VC'HOHV3S 3lld'S1S31'SNOIlO3dSN1 ONICIAOdd WUId E)NIH33NIJN3 'S n r'1 MUNICIPALITY OF ANCHORAGE (MO•.,' MLINIMALITY Of AN04024WALTH AUTHORITY APPROVAL (HAA) DEPT. OF HEALTH & CHECKLIST - FEBRUARY 1984 E{.ry)RONMENTAL PROTECTION 2844720 )dUN 2 91987 Legal Description: A. WELL DATA RECEIVED Well Classification �'� If A. B, C, D.E.C. Approved (Y/N) Well Log Present (VN) Date Completed 41'(0-78 Yield 3.1 6110--1 Total Depth S 8D ' Cased toA Depth of Grouting I Static Water Level 13 Pump Set At JAL Casing Height Above Ground S I C N Electrical Wiring in Conduit (Y/N) Sandary ea on as ng (Od ) Depression Around Wellhead (Y[P4(_ PIT Separation Distances from Well: To Septic/Uokkmg Tank on Lot li ; On Adjoining Lots I Ps L-1' To Nearest Edge of Absorption Field on Fot 1 t�v I -t ; On Adjoining Lots 14 - To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by S t^�'� : Date �-1t'- 87 Water Sample Test Results Comments tY /.fm Ma� to •..i��� 1. SEPTIC/149EUM TANK DATA i.V Date Installed 6-10--M Size 1 4RE0 No. of Compartments Standpipes &N) Air -tight Caps&lr/N) Foundation Cleanout MN) o � Depression over Tank (Y16? 'Date Last Pumped lo' Pumping/Maintenance Contract on File (Y/N) A; for Holding Tank High -Water Alarm (Y/N) rJ)ATemporary Holding Tank Permit (Y/N) P Separation Distances from Septic/Woking Tank: 1 To Water -Supply Well ( e %=L 14- To Building Foundation 1 � To Property Line I o -Y To Disposal Field S 1 To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course P D 0 Comments •r !U�S L�fsS+'1sot� Yyr'4?1 aG' Z�G3'1 OLZ Page 1 of 2 72-026(11184( C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata (���i31� Type of System Design Gi Date Installed r Length of Field B? Width of Field S 1 Depth of Field Gravel Bed Thickness o, S Square Feet of Absorption Area sStandpipes Present MN)°d Depression over Field (YDate of Last Adequacy Test lo-�L3 -$7 r �• Results of Last Adequacy Test ��'r1s 3$:L Separation Distance from Absorption Field: To Water -Supply Well oy 14L To Property Line -Lc=> - r To Building Foundation Lot r? To Water Main/Service Line 1+ To Existing or Abandoned System on On Adjoining Lots ;01 — To Cutbank (if present) 1JoP-) To Stream/Pond/Lake/or Major Drainage Course tJo "t✓ 1 To Driveway, Parking Area, or Vehicle Storage Area So Comments ' ::C I D. LIFT STATION Date Installed Size in Gallons Dimensions Manhole/Access (Y/N) "Pump On" Level at 'Pump Off' Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA " Check Permitted Bedroom Rating Against HAA Request •' Icertify that Ihave checked, verified. orconformedtoa� and AA guidelines in effect on the date of this inspection. Signedl��ENGINEERING 1e CIA • Comp - Rlwe• Masks 99577 MOA No. Receipt No. (e 00 0 O hrs�r --vi •• Date of Payment 6'Z1�6�% i Gj : F �•�'S/r- Amount: $ p moi^: ice) �. .. .............r. Rebon A. S ,,W �T � Page 2 of 2 , ���•,� No. 1,074 n-ozs (11,84) HEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FEDERAL TAX ID M 92.0040440 NIALYSIS REPOPT BY SAMPLE CIIent PC# : VERBAL Peq a: Client Scpl ID: L26 B3 BROAD WATEP.HTS Sa�:cIe kecra JUit 17 87 Oreeredey Serc Reports To: S 8 S ENGINEEPING i7U34 EAGLE P.IVEP LCOP PD.. #204 EAGLE Pi' ER. Ah. 4YE?i Specht rOUPIliE5AMPLECOLLECTED6-16-879 1620 H3S BY P.P. if5'ruct: CheMIMP.et e: 6611 Para^eterTeztee ------------------- h1TRATE-h Sa^noIe RXI INE SAMPLE: Lab Smpl ID: 1 Matrix: Water Result/Units -- 4.2 - 1--------- Pe^arkS: klALY3iS COhf�LETED:b-ld-87 a � LaboratcrySuoervisor: Stephen C. Ede I Tests Pertormea + See Speclai InstructiorsAbove ND= Ncne Detectea •* See Samitle P.emarks Above liA= Not Analyzed LT=Less Than, GT=Greater Than Wort. UrC?C 1 cilent Account 3:ISE;;JP Late P.epert Printed: JUN 2a61; 's 17:Ui peleasen ez : sct,&iE�l ReportsAccree442 AtIowacle Methoe Llmlts ---------------------------- lU 5. LEGAL DESCRIPTION Loi zi. [316, k. 3 S D " DATE RECEIVED INSPECTION APPOINTMENTS NUMBER OF,SEDROOMS TIME ❑ One ❑ Four ❑ Other TIME TIME / I ')5 Three ❑ Six 7. WATER SUPPLY DATE ' ATTACH WELL LOG. A well log is required for all wells drilled DATE DATE ❑ PUBLIC UTILITY depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM INSPECTOR 119-11 YEAR ON-SITE SYSTEM WAS INSTALLED. INSPECTOR INSPECTOR NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. NCHOPAGE DEPT. OF 1`.ALTiI & MUNICIPALITY OF ANCHORAGE EM/IROP JEr.TAL tLXLCrION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION + 825 L Street • Anchorage, Alaska 88501 APR 2 g 1980 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 R E C E I V E D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER J -amt% 0. S-fwrr PHONE 69y-3'18 MAILING ADDRESS p SR 2 box '73y1 lc 1�1 uc� �I�Ac EA 19511 PROPERTY RESIDENT (It of tferent trom above) PHONE 2. fB�fUYER YA,.it ' Wcnjok (iAst tr PHONE Z�i3 -1�4� MAILING ADDRESS 1e511 Linc1tn �nL D/evt. Avtr.60rA y�lRt� �1°ISOZ 3. LENDING INSTITUTION A(A:IkA VA SA 11 S PHONE .�-Ici -3SICi MAILING ADDRESS bol w. 5'� A,r,d.,,l.� Alalka g9sot 4. REALTOR/AGENT I Fce., AI Lindrt YRi cr PHONE b`1�-a91i MAILING ADDRESS Ariltt<r Ra.� k=a le. 2.vc�r A(AckA 995-17 5. LEGAL DESCRIPTION Loi zi. [316, k. 3 S D STREET LOCATION S w s.0s.sl.er'Af Cli'C�L 6. TYPE OF RESIDENCE NUMBER OF,SEDROOMS ❑ One ❑ Four ❑ Other SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY ')5 Three ❑ Six 7. WATER SUPPLY �. INDIVIDUAL' ' ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM K INDIVIDUAL/ON-SITE" 119-11 YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLICUTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) 72010 (Rev. 6/79) M THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE l� SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE Efi THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY L^ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL y DATE DRILLED LOG RECEIVED 40 Gr eQ 3.SEWAGE DISPOSAL SYSTEM 17INDIVIDUAUON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER OW�� SOILS RATING optic Tank or ❑ Holding Tank Size: /&VO If Tank is homemade give dimensions: TYPEOFT9NK sT,ec! MANUFACTURER ,4A tA4 7WA"6 TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELLTO: SeptmlHoldmg Tank (JDIf Absorption Area /00 Sewer Line Nearest Lot Line Oji' Absorption Area to nearest Lot Line 5. COMMENTS C APPROVED FOR 3 BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE 2 % Ar" 8D BY 72010 (Rev. 6/79) M �v ry ri 0 -14 S 60 ol f "' I cc u