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T15N R1W SEC 18 LT 205-A
T1 N RIW 18 Lot 20 -A 051-232 -54 Permit Number: Tax Code Number: Work Type: On-Site Water & Wastewater System OSPl11106 05123254000 WellSeptic MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Initial Permit Effective Dates: July 20, 2011 to July 19, 2012 Design Engineer: SPURKLAND ENGINEERING Subdivision: T15N R1W SEC 18 Site Legal Address: T15N R1W SEC 18 LT 205-A G:1054 Owner/Address: WERRE ALMA PO BOX 873276 WASILLA AK 996873276 Permit Site Mailing Address: 18029 S BIRCHWOOD LOOP RD, Chugiak Lot Size in Sq Ft: 28622 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy Y Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: ' Date: Issued By: ~ /..~F~/'~~ Date: UNICIPALITY Community Development Department Development Services Division On-Site Water & Wastewater Program Mayor Dan Sullivan OF ANCHORAGE Phone:907-343-7904 Fax:907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. OBi Property owner(s) Mailing address Site address Day phone 77_3 ,AK,. :( Legal description (Sub'd., Block & Lot) I-'ISN' '~tid 5e~.. [~ IL.~ Legal description (Township, Range & Section) Lot Size ~-~,, G Z.'Z._ Sq. Ft. Number of Bedrooms THIS APPLICATION (~;;~ all that apply) IS FOR: Absorption Field ~ Septic Tank '1~ Holding Tank [] Privy [] Private Well J~, Water Storage [] THIS APPLICATION IS AN: Initial ~ Upgrade [] Renewal [] THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: I certify that the above information is correct. I further certify that this application is being made for/~)~a~3ingle~ ~ ,~',~7'~'''~'~'~a~ily Dwelling and is in accordance with applicable Municipal Codes. (~g11~¢'c~ property owner or authorized agent) / Permb/Rush Fees: ~'?;-,'- '" ,i~c:o "~ Waiver Fees: "~fT~ie of Payment: ~ ~i ~:!~'-' ~.,i Date of Payment: Receipt Number: ~..~:~.~ ~,¢,,~z \ Receipt Number: Permit No. ~¢~>'~'~.i \\ f (~-' Waiver No. G:\Building\On Site\Forms\Client Forms\Permit App_010411 .doc (Rev. 1/11 ) Environmental Consulting and Design SEPTIC SYSTEM DESIGN T15N R1W SEC 18 LOT 205A Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 June 14,2011 Subject: Septic System Installation Permit Ladies and Gentlemen: I am writing to request a permit to install a well and septic system for the above referenced property. The proposed system will serve a 4-bedroom single-family residence. The lot is undeveloped. Soil logs, design calculations, a site plan, design drawings and construction specifications are enclosed for your review. Design Calcs: No Groundwater observed to a depth of 9 feet below ground surface (5/24/2011) Soil Rating. From Testhole 5/17/2011 1.3 min/in = 4 gal per sq.ft/day No. of Bedrooms 4 Required Area per Bedroom: 150/4 =37.5 sq.ft. Total area required: 37.5 x 4 = 150 sq.ft. System: We are proposing an Advantex AWWTS with 1500 gallon tank, and a shallow trench absorption field. The absorption field will be 30 feet long and 5 feet wide and contain 0.5 feet (150 sq.ft. effective) of sewer rock. Soils: Three test holes were excavated on May 17th, 2011. See the attached soil logs. Ground water was monitored for through May 17, 2011. Ground water was not observed in test hole #3. Surface Water: A culvert is located under Spruce Crest Drive with its outfall located near the south east comer of the property. There is no defined drainage course after the culvert and no water was observed flowing out of the culvert on July 7th 2011, pictures are included. Several puddles were observed in the excavator track and uneven ground created during the excavation of test hole #2. It does not appear that they will dry up so during construction this area will be graded so that these depressions will not pond water. I have included pictures of the current conditions. Topography: The lot slopes to the north at approximately 1-5%. The proposed trench will be installed parallel to the contours of the site. There are no slopes greater than 25 % within 50 feet of the proposed drain field location. 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland~gci.net Environmental Consulting and Design i Waivers: None required. The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or concerns, please contact me at 279-3916. Sincerely, Lars Spurkland, P.E. Civil Engineer 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland~gci.net LDT ~ LDT 2 / ~ / / / / / SPRUCE CREST DRIVE L£T 205C I I I NOTE: THIS IS NOT A SURVEYED PI. AT. WELL ~c SEPTIC LOCATIONS TAKEN FROt, t ON-SITE WATER AND WASTE IfATER DEPARTMENT DOCUt, tENTATION. ALL LOCATIONS SHOWN ARE APPROXIt, tA TE. 50 I00 150 800 ~50 300 SCALE: l' = lO0 FT, SPURKLAND ENGINEERING 205 W 15TH. AVENUE ARCH. AK. 99501 (907) 279-$916 JERRY WERRE 18217 BIRCHWOOD LOOP RD., CHUG/AK, AK 99507 SEPTIC SYSTEM DESIGN DATE: JUNE 13, 2011 SHEET: 1/3 GRID: N19'1054 PERMIT # DSPIlIOXX PID# 051-232-54 T15NRIWS18L205ADl. flWG / ~ "' LDT 285C OH£ - SPRUCE CREST DRIVE INSTALL 4-BEDRO01~ SEPTIC SYSTEI~ I$00 GALLON ADVANTEX AWWTS / LENGTH 30 FEET WIDTH 5. O FE~ / ~AXI~U~ DEPTH I FOOT ROCK DEPTH 0.5 FEET ~' ~ ~w ~ ~s~ INSU~T/ON 2 INCHES COVER 2.0 FE~ ~ ~/~ ,. ..... ,~ LOCATIONS TAKEN FRO~ ON-SITE WATER AND WASTE WATER ~ ~? ~.~ APP~X/mATE. _ / 49th % ~.../. ........ .r+....rr..~ ..... ~.L~..~~ ............. ~ ~L~R~ SPURKLAN~ /,~ 25 O 25 50 75 ZOO 185 ]58 SCALE~ 1' = 50 F~ -,~g '~:..Lm~,,~j~ ~ SPURK~ND ENGINEERING T15N Rig SEC 18 LOT 205A SEPTIC SYSTEU DESIGN 205 W 15TH. AVENUE ARCH. AK. 99501 JERRY WERRE DATE: JUNE 13, 2011 (907) 279-~9~6 ~8217 BI~CHW~D LOOP ND., CHU6IA~ AK 99~6~ SHEET: ~/~ GNID: N~IOD4 PERMIT ~ DSP]]]OXX PID ~ 05~-~3~-54 T]SNR] ~S]SL~OSAD1.DWG 6" '~L.,~AP ADVANTEX 24-" , 2o % I INSULATED ELEV. = ,' .............................. I ~ El/.-- ' ,--, .~ . x ..~ ............ '.~ OPTIONAL -- ~1~ ~ S~ ~ ~ ~ ~ : 49th ~,~ ~,o~ ~1~ -.....~. ........ ~ ....... .,.....a..i ..... o~ ~ ~F~ ~ '7- ~ '/,'~ OVER THIS CONNECTION JL ~11~11.1~1.~~......... TO PRO. DE JJ ~~~SPURKLAND SHEER PRO~CTION- ~ ~ ., ~XmNO TO ~ ~ %~X No. C~-ZZS00 BRIDGE EX~VATION d .... ~/~"*.....,~ ~~--__~~ I~1 ~1 .... '%~¥~ 1500 GALLON ADVANTEX TANK 'l~_~~ BENCH MARK SPURKLAND ENGINEERING T15N ~1~ ~ ~OT 205~ SEPTIC SYSTEM DESIGN 203 ~15th Ave Amchopcge Ak 99501 JE~Y WE~E DATE, JUNE eS, ~7~-291~ ~Z~Z a/~HWO0a L~P NOAA ONUa/AK, AK ~Z SHEET, 3/~ OR~9, PERU/T ~ OSP~O~XXX PARCEL /~ ~ 0~-2~2-5~ T~5NR~WS~L205AataW~ To Advonf:ex Unif: Monitor I 1/4' Schedule 40 PVC- 3/16' Holes a ~ ~4 inches 5-Wide Trench: 5' Wide 20' L on9 1' Nox Depf:h 0,5' Sewer rock 2' Insulo f:ion 2' Cover 2ZO' T.H. ~ E.G. ELEK =XXX' Elev.=XXX ' Elev.=XXX ' NO SCALE Monitor Monitor // 2' Insulo t/on /I / / 2'+ Cover (m/n) ~--Silt 3orr/er o~ ?o Advonf:ex Un/f: 0,5 Ft oF Septic Rock EffecHve ND SCALE ~0.~ ELEK=XXX' NO GNOUNO ~TER OBSERVED BENCH WARK XXXXXXX , ASSUWED ELEVAHON 100 SPURKLAND ENGINEERING II 803 W15th Ave Anchorcge Ak 99501 T15N R1 · SEC 8 LOT 205A JERRY WERRE 18217 BII~CHWOOD LOOP DR., CHUG/AK, AK 9~$67 SEPTIC SYSTEM SCHEMATIC DATE: JUNE 30, 8011 SHEET, 4/4 ORID, N~/105,~ PERMIT If OSPI I IOXX PARCEL ID tf 051-232-54 TI5NRIWS8L205AD4. DWG Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.ci.anchora.qe,ak.us (907) 343-7904 Performed For: Legal Description: Soils Log - Percolation Test ITl W' 5~ [8 L~,jf 7_05 ~, Township, Range, Section: Slope Site Plan 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20- COMMENTS WAS GROUND WATER ENCOUNTERED? 'y~ $ IF YES, ^T ~AT DE~TH? o Depth to Water After p Monitoring? E Date: Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND PERC HOLE DIAMETER FT PERFORMED BY: I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Performed For: Legal Description: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www. ci.anchoraqe.ak.us (907) 343-7904 Soils Log - Percolation Test ~-~5 ~, Township, Range, Section: Slope Site Plan 2 3- 4- 5- 6- 7- 8- 9- 10- 11 12 13- 14- 15- 16- 17- 18- 19- 20- COMMENTS WAS GROUND WATER ENCOUNTERED? '~ ~..~ S IF YES, AT WHAT DEPTH? * t-- 5~ L ~ O Depth to Water After p Monitoring? E Date: Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETVVEEN FT AND FT PERFORMED BY: ] CERTIFY THAT THiS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Performed For: Legal Description: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.ci,anchoraqe,ak.us (907) 343-7904 Soils Log - Percolation Test Date P e rfo r me d :' '"~'~'~]]'- Loaf ~)~',,dt~ Township, Range, Section: Slope Site Plan 2- 3- 4- 5- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20- WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT DEPTH? '-- L O Depth to Water After p Monitoring? ~ E Date: Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE i,.,~ (minutes/inch) PERC HOLE DIAMETER ~ TEST RUN BETWEEN ~__ FT AND .3 FT PERFORMED BY: :~, ] ~ /Z H CERTIFY THAT THISTEST WAS PERFORMED IN ACCORDANO/E WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: d/~/Z~2,{ Performed For: Legal Description: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.ci.anchoraqe.ak.us (907) 343-7904 Soils Log - Percolation Test Date Pe~ormed: ~.0¢~'~ Township, Range, Section: Slope Site Plan 2- 3- 4- 5- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20- WAS GROUND WATER ENCOUNTERED? ~/¢5~ · S IF YES, AT VVHAT DEPTH? ~ i L O Depth to Water After P Monitoring? ~. ~ E Date: Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TEST RUN BETWEEN ~ FT AND ~ FT COMMENTS PERFORMED ~Y: /__..~,'~ ..~ ~,'~ ~' ) g'~. ~.i [ ~ 4,"~ ,.,/(~./;7_..~&. ~, CERTIFY THAT THIS TEST WAS PERFORMED N ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Environmental Consulting and Design SEPTIC SYSTEM DESIGN T15N R1W SEC 18 LOT 205A Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 July 26, 2011 Subject: Septic System Installation Ross Noffsinger: I have worked with Jerry Werre since 2005 where I was the inspecting engineer for the community septic system installed at Werre Subdivision. That system was approved by the ADEC and consisted of 2 elevated mound drain fields, an Advantex advanced wastewater treatment system and septic tanks for the 8 residences that the system currently serves. Jerry Werre is familiar with current septic system installation practices and ADEC standards. He is capable of meeting the installation requirements for septic system in the Municipality. He is the current owner of the property that he is developing, in addition he has installed and is familiar with all the components of the Advantex Advanced Wastewater Treatment System. If you have any questions or concerns, please contact me at 279-3916. Sincerely, /ars Spurkland Lars Spurkland, P.E. Civil Engineer ~0 203 West 15ta Avenue Suite 203, Anchorage, ~ 99501, Phone: 00~ 279-3916 Fax: (866) 354-1597, Lspur~and~gci.net MUNICIPALITY F ANCHORAGE ora; E[_a Development Services Department P' Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-232-54 1. GENERAL INFORMATION Complete legal description T15N R1W SEC 18 LOT 205-A Expiration Date: &- 2-`l —2C-_ Location (site address) 18029 SOUTH BIRCHWOD LOOP ROAD, CHUGIAK AK 99567 Current property owner(s) JAMES & KIMBERLY DICKENS Day phone Mailing address Real estate agent 18029 SOUTH BIRCHWOD LOOP ROAD, CHUGIAK AK 99567 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ 55 0 Waiver Fee $ Date of Payment 3 Date of Payment Receipt Number 3-c y 13 1 Receipt Number COSA # 0 S C a a 1 O R 3 Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE AK 99516 Engineer's Printed Name _CURTIS HUFFMAN, PE Date 3/11/2022 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the OF well and septic system. Therefore, any estimate of how long a system will function satisfactory AW�Q: for rent discrepancies exist can be given by First Water Consulting & encroachments, deficiencies or j g•• TH *�r curor future occupants p9ts or guarantee that no unseen enF� / • • • •� •—• • • • • • • ••• • • J� 6. DSD SIGNATURE • • • • • • . %j Curtis Huffman System #1 Approved for bedrooms t+t �Fc • CE 128991 .• ���.� Y pp �1'`�fF�•..4111/�2••FQ��r System ##2 Approved for bedrooms�``SSID Disapproved Conditional approval for bedrooms, with the following stipulations: ``l�i«((((rrrrrrr�i wQ - E = < VI/gsT_..V � ND m G �o hq o�- 41 ��1))))))11111") B Original Certificate Date:3—,2 `f— The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: T15N R1W SEC 18 LOT 205-A Parcel ID: 051-232-54 If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system A. WELL DATA ® Well log is filed with Onsite (or attached) Well production at time of test 1.52 gpm Date drilled 7/25/2011 Water storage tank volume NO gallons Total depth 180 ft (PER MOA DOCS) Well disinfected for coliform test? ❑ Yes ® No Cased to 44 ft (PER MOA DOCS) ® Coliform bacteria is Negative ® Sanitary seal is functioning correctly Nitrate mg/L ® Nitrate less than MRL (ND) ® Wires are properly protected Arsenic 7.22 ug/L ❑ Arsenic less than MRL (ND) Casing height (above ground) 18+ in. Collected by_ FW"cs Date of flow test for COSA 3/10/2022 Static water level at beginning of test 26 ft. Date of Sample: 3/10/2022 Comments WELL IS LINED WITH 4.5" SLEEVED TO 140'— SULLIVAN WATER WELLS 90 GPH B. TANK DATA Age of tank(s) 10.5 years Tank type/material SEPTIC / STEEL Measured operating fluid level in septic tank ® Standpipes/foundation cleanout per record drawing Date of pumping 7/30/2020 D. ABSORPTION FIELD DATA Which system tested (date installed) 8/29/2011 ® ALL standpipes present per record drawing Total measured depth from grade 2_9 ft (max) C. LIFT STATION ® Required maintenance completed* Age of lift station years Lift station material Comments: *SEE AX MAINTENANCE REPORT Adequacy test date 3/10/2022 Results M Pass For 4 bedrooms Fluid depth prior to test 0 in Measured depth to pipe invert from grade --- ft (min) Water added 600 gal ® N/A — pressurized field New depth 0 in ® Monitor tubes go to bottom of effective. If not, state Elapsed time <10 min depth into effective 0.55' ED PER MOA DOCS ®Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced gallons NES Comments/Deficiencies: ,,, E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' Water Service Line > 10' ® Yes Animal Containment > 50' ® Yes if No ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ®Yes _ if No ft ®Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water >' 100 _ ®Yes if No Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells >' 100 _ ®Yes if No Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ®.Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells >' 100 _ ®Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. rob *:. TM ;fir .. .... .......... . . Curtis Huffman >� CE 128991ti��� � 1 F�Z� OFESS 4N�`X` -UAW kk�NNd'�'e.'�`�o ft ft ft ft ft ft ft ft- 393 363 1: ■III ■ A■■ >A map No ■ ■ I: 1 i 0 INS ■ ■ a ■ an >_ I XM No ■ doll Moll va nTeio ;1' Field Maintenance Report Annual Inspection property ownerlrrnctcing N James Dickens Situ Address 18029 S. Rirchwool Loop Road, Chugiak AK 99567 AX Site ID r♦ County ID M Pod 1W AK -127371 I OSP111106 1 412390 Retrieve O&M Info gaily now R6CiM ratio Timer Settings: Perform Field Satmp :ng/Observations NTU (15:t NTUS) p -1 (6.5) DO (2-6) Currant Previous 2nd Compartment Odor of Sample Typical &j m -s ❑ Earthy ❑ Moldy Non -typical 'QSulf! ie ❑ Cabbage ❑ Decay oily film In PVu ( .]yes r9�, No Foam in tank (.] Yos I,u No Check Control Pane Reoir>: Amps Discharge Amps 11.E l!.1 Audible and visual ah imS OK Dlal tone ftelemotry a ily) 4 Yes No Inspect/Clean Purml - System Inspoot Risim/Ud ......... ........... Splice $ox ........ ...... ... j Float Cords .. . . . .. ........ Floats............ • ..... Pump ............ ........... BiotubO Filter . . ... ........... Blotube Pomp Vautt _ ......... . RocIrculating Splittol Valve...... . Comments ,AA- Signature - clean 4-Signature clean 111 10 slow ■R ■ on f ■■■ INS larw AnchorageTank 907-272-3543 operator Larry Betts Coranct Phone 907-351-0958 HM FAJL $ Data di Last Inapocuorl RTU123187 05/20/2020 Measure Sludge/Soutn SludcB Scum tat Compartment Current ( Previous Currant Previous 2nd Compartment Current Previous Current Previous Inspect/Clean AdvanTex Filter Odor: Normal ❑ Pungent Biomat: Normal ❑ Excossive Bridging/Ponding, _ None/Minor n Excessive Inspect/Clean discharge Pump System Inspttt Riser/Lid Splice Box Float cords X Inspect/Service Other System CoMponentS Inspect Clean Laterals/Oriflccs I% Pod Bottom Z Intake Vont Inspoot Clean Floats Y [ ' Purip z Inspect Glean Inspoot Clean Disinfection I;qulpm(nt ;z Dispersal Latorals/Orific9rIET --Fr 0b4ervations Additional Services Rendered L] Cleaned textile ahoGts? ❑ Replaced UV items? ❑ Roplaced/Used other Items? Parts Used. W F Warranty, B R Sillable (%/ appropriate selectim) W p Item Number Description Final/Safety Inspection �FiSV reinstalled 4 Manifold reconnected; flush valvas closed Summary/Recom me ndati ons ❑ Sy%em performing; no further action needed Cell for "rvice Lids bolted on control panel reactivated Tank needs pumping ❑ Other7 Gate Fax completed fornn to 1-866.384-7404 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATNIENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this Day of A/(Q,-r of 20 by and between ,S,ZZ-Q:13 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: I. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AW\.NITS), described as AN ADVANCED ADVANTEX SYSTEM located at (legal description) 1.� T15 R1W SEC18 LOT 205-A (18029 BIRCHWOOD LOOP ROAD) 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) Throu(J1101.1t the term ©f this Agreement, the Owner shall enter into a service ice agreen-ient with an AWWTS service and maintenance provider approved by the Municipality or the rn an u fact urer'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. 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 5400 to S600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page I of 3 4D Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. 4)3 Owner acknowledges that the ane for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. 5 Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. 513 Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. 5 Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: BY(signature) STATE OF ALASKA THIRD JUDICIAL DISTRICT (print name) ss. Date: -� Acv- °w)., The foregoing instrument was acknowledged before me this day of , NOT RY PUBLIC FOR ALASKA \�C, ?'so My Co mssion expires:-��_�;g`-rpgo�r•.ti% Tn MUNICIPALITY: Y - (signature) (print name) (rev. 05/18/2018) PUBLIC Got Date: -2 - ZZ Title: Page 3 of 3