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LAKE RIDGE TERRACE BLK 10 LT 3
Lake Ridge Terrace Block 10 Lot 3 #051-323-17 5WOMITTAt Municipality of Anchorage Community Development Department Page of On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 - http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: 05P 121 034 PID Number: 051-323-1-+ ® New ❑ Upgrade Name: N00, WARREN ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bed [K Mound Address PQ GD)( 770P9 EAGIE A4C El Other Phone Number of Bedrooms Soil Rating A� Total d fro original de �` 3 IX,o GPD/SF 'f CP— Ft. LEGAL DESCRIPTION Depth to pipe invert from ori ' al gr de Q. $ �Ft. Gravel th be o pe �, J Ft. Subdivision Block Lot LAM RT. GE Terkuce 10 3 Fill added ab,6ve original rade � xf 2.5-34IFt.1 G71 length 30 Ft. Township Range Section Gravel wi 10 Ft. NqENer ines Distance between lines 1 5 Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches I From Tank Field Tank Line 300 Fe Ft. WellMM1 1�+ Iw+ /VA 1 �} TANK E] Septic [IS.T.E.P. ❑ Holding ® Other Manufacturer 13 TOCy(_LE Capacity 150() Gal. .NA Surface Waterf ' r n� (w �' NA A NA Material Ff13E.P CrLA55 Number of compartments I� Lot Line (Q`t 10'+ IVA NA NA Foundation1p'f 10'+ /\/A NA LIFT STATION Manufacturer — Capacity 1 cJ.00 Gal. Curtain Drain 20- ID'} /VA .NAUIOC Pump on level at Pump off level at High water alarm at Remarks I� i 44 2 S v-/7- in. in. in. Pump make and model kyE Electrical Inspections performed by MoA Installer PIPE MATERIAL Housetotank 3 Tankto �_ dreinfield $ch 40 Drainfield 50, LID COIMT Inspector LAR5 PORKLA D BENCHMARK (Assumed elevation) 100 ft Inspeciion m 1 % ID /2 f0 !Z Location and description 2n0 dates: 3'" 2 12. 4" TOP FOunos,T-Lon COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: DateOF.A<q 111 • s 1 .% _ d 4:0Z4914 v I fit SPURKLAND:�, ApprovedA4Date g / a 11 00 '10 I r�110'pROFES0 Inspection Repo _1-1-12.doc \ \ LOT 2 C� Wesel < 9 VACENT SWING TIES A B F. C.O. C 27' Z5' NO. MH. 37' 24' /> OF. MT. D 65' 53' LOT 5 OF. MT. £ 95.5' 82.5' e' LOT 3 B Well C A � u INSTALLED 3 -BEDROOM SEPTIC SYSTE ® B)OCYCL£ AWTS W/ BED LENGTH 30 FEET WIDTH JO FEET DEPTH I FEET MOA FILTER SAND 3 FEET ROCK DEPTH 0.5 FEET INSULATION 2 INCHES LOT 4 / sty � 5x _OT 4 lACENT HAROLD LOOP m3° sr IS NOT A SURVEYED PUT. WELL A• SEPTIC TAKEN FROM ON-SITE WATER AND WASTE WATEA T DOCUMENTAWIL ALL LOCATIONS SHOWN ARE 25 0 25 50 75 100 125 150 SCALE., 1' = 50 FT. 103 SPURKLAND 0 5PURKLANU LNGINLLN/NG I I � RIDGE TERRACE BLK 10 LOT 3 I IDA RECORD DRAWING ANCH AK 99501 HANK WARRENT£ JULY 25, 2012 (907) 279-3916 PO BOX 770848, EAGLE RIMER, AK 99577SHEET.• 2/3 GRID. NW555 PERMIT #OSP121039 PIB # 051-323-17 LRTBl0L3SC50ASB.BW6 4' MONITOR ASTM 3034 4' MONITOR ASTM 3034 G.O.H. ELEV.=79' FDIBIDDATION CLEAN OUT SLOPE FINISHED GRADE AWAY FROM TOP IN ALL DIRECTIONS DISCHARGE '.,q. 4' PVC INFLUENT ® O PPRI14ARY CHAMBER AERATION CHAMBER e o ® ® iv m CLARIFIER (DDISCHARGE CHAMBER TTOM X TANK ' BLUEBIIARD INSULATION SAND/GRAVEL BACKFILL MONITOR TUBE..: GENCH MARK TOP FOUNDATION ASSUMED ELEVATION 100' i .5t' �KLANI) LNGINEEK/NG I I LME RIDGE TERRACE BLIP 10 LOT 3 I I RECORD DRAWING 203 W 15TH. AVENUE HANK WARREN DATE.• JULY 25, 2012 907 2 9 39761 14213 HAROLD LOOP, EAGLE RIVER, AK 99577 SHEET. 1 3 GRID. NW553 PERMIT # 07121039 PID# 051-323-17 LRTBIOL3D3ASB,BWG i G.O.H. ELEV.=79' FDIBIDDATION CLEAN OUT SLOPE FINISHED GRADE AWAY FROM TOP IN ALL DIRECTIONS DISCHARGE '.,q. 4' PVC INFLUENT ® O PPRI14ARY CHAMBER AERATION CHAMBER e o ® ® iv m CLARIFIER (DDISCHARGE CHAMBER TTOM X TANK ' BLUEBIIARD INSULATION SAND/GRAVEL BACKFILL MONITOR TUBE..: GENCH MARK TOP FOUNDATION ASSUMED ELEVATION 100' i .5t' �KLANI) LNGINEEK/NG I I LME RIDGE TERRACE BLIP 10 LOT 3 I I RECORD DRAWING 203 W 15TH. AVENUE HANK WARREN DATE.• JULY 25, 2012 907 2 9 39761 14213 HAROLD LOOP, EAGLE RIVER, AK 99577 SHEET. 1 3 GRID. NW553 PERMIT # 07121039 PID# 051-323-17 LRTBIOL3D3ASB,BWG SpuMand Engomemamg Environmental Consulting and Design SEPTIC SYSTEM INSTALLATION Municipality of Anchorage July 27, 2012 Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 Subject: Septic System Installation- Ground Water Levels Lake Ridge Terrace Block 10 Lot 3 Ladies and Gentlemen: The ground water depth at test hole #1 was checked on July 10, 2012. It was observed at 7 feet below the ground surface. The test hole was excavated on March 9th, 2012 and ground water was observed at 12 feet below ground surface. Water was also observed at 3 feet below ground surface on April 1801, 2012. This reading does not represent seasonal high ground water because the ground water monitor was being influenced surface water intrusion from rapid melting of the snow pack. Per conservation with Jay Crewdson and Jeff Poet on July 10th, 2012, it was decided that the maximum excavation depth of the drain field would be based upon the July 10th, 2012 ground water reading. The bottom of the drain field was installed 6.3 feet above the ground water level on July 10th, 2012. Three feet of filter sand was installed beneath the sewer rock to ensure sufficient ground water separation. 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 OWNER OF LAND i�i _- tj Ar BORE HOLE DATA ADDRESS: LEGAL DESCRIPTION: i� DATE: ef PERMIT NUMBER. '21 Cfi LF Date of Issue—if - TAX IDENTIFICATION NUMBER: _ Is well located at approved permit location? L1lis O No Method of Drilling: ,[> air rotary ❑cable tool Depth of well: Casing Type Wall Thickness inches Diameter f inches, depth feet Liner Type: <' Casing Stickup Above Ground: feet Static Water Level U-. feet e Recover Rate: n u g n � 3 Method of Testing: ." f'I Well Intake Opening Type: Ll open end wopen hole ❑ Screened; Start -feet Stopped - feet ❑ Perforations Startfeet Stopped ; Grout Type: �- X. Volume feet Depth: from feet, to " feet Well Disinfected Upon Completion? O=Y6s' ❑ No Method of Disinfection: Comments: DEPTH From To t q � n � 3 t_�' `=Fj a e jo ,-..S J 'Y a3 r� • - -�.€»mom Driller's Name a zsta A _= ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage. Department of Health & Human Services and/or, Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservation. ARCTIC PUMP & WELL INC. Jim Sullivan Box 770197 f' Eagle Rivet' AIC 99577 am a sync (907) 688-2510 (907)258-2510 (907) 745-2510 anw V26.11 Pump Installation Log Well Drilling Permit Number: OSP121039 Parcel Identification Number: 05132317000 Date Of Issue: 4/20/2012 Legal Description LAKE RIDGE TERRACE B10 Property Owner Name Address: L3 Hank Warren Lot: 3 PO BX 770848 Block: 10 Eagle River AK 99577 Pump Installaion Date: Pump Intake Depth Below Top of Well Casing: Pump Manufacturer's Name Pump Model: Pump Size: Pitless Adapter Burial Depth: Pitless Adapter Manufacturer's Name Pitless Adapter Installer: Well Disinfected Upon Completion? Method of Disinfection: Com ments: PumpinstallerName: Arctic Pump & Well, Inc. Thursday, March 21, 2013 7/5/2012 367 Feet Franklin 10JS t S4 -2W 230 1 10 Feet S-50 u/k Yes Chlorine SGS ReE# 1130611001 Client Name Warren, Henry Project Name/# 14213 Harold Loop - Well Client Sample ID 14213 Harold Loop - Well Matrix Drinking Water Printed Date/Time Collected Date/Time Received Date/Time Technical Director 04/10/2013 10:41 02/18/2013 8:00 02/18/2013 12:10 Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Microbiology Laboratory E. Coli Negative 1 100mL SM21 9223B A 02/18/13 LCE Total Coliform Negative 1 100mL SM21 9223B A 02/18/13 LCE SGS ReE# 1130611002 Client Name Warren, Henry Project Name/# 14213 Harold Loop - Well Client Sample ID 14213 Harold Loop - Well Matrix Drinking Water Sample Remarks: Printed Date/time Collected Date rime Received Date/Time Technical Director 04/10/2013 10:41 03/28/2013 8:00 03/28/2013 12:20 Stephen C. Ede Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 Waters Department Total Nitrate/Nitrite-N ND 0.100 ug/L EP200.8 B (<10) mg/L SM214500NO3-F C (<10) 04/01/13 04/01/13 ACF 04/02/13 AYC On -Site Water & Wastewater System Permit 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 Permit Number: OSP121039 Tax Code Number: 05132317000 Work Type: Welseptic Initial Permit Effective Dates: April 20, 2012 to April 20, 2013 Design Engineer: SPURKLAND ENGINEERING Subdivision: LAKE RIDGE TERRACE Site Legal Address: LAKE RIDGE TERRACE BILK 10 LT 3 G:0553 Owner/Address: WARREN HENRY N PO BOX 770848 EAGLE RIVER AK 995770848 Site Mailing Address: Lot Size in Sq Ft: 22662 Total Bedrooms: 3 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. S] Received Issued By: 1-2- Issued -2 MUNICIPALITY OF ANCHORAGE Community Development Department < Development Services Division On -Site Water & Wastewater Program Mayor Dan Sullivan ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 051.323 — Phone: 907-343-7904 Fax: 907-343-7997 Propertyowner(s) NAhk WARPC- /V Day phone Mailing address PO BO-/ 77999 �_AwL�_ IZ;ve,.,AK `tg5TT Site address 14213 k Aaojo L ,�pl F_L�q lL [Lives., AV. `1`( 571 Legal description (Sub'd., Block & Lot) LRk< Rtac e Tia -ex -c. 31bC I) LT 3 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (® all that apply Absorption Field l Initial -0 +� Septic Tank 7� Upgrade ❑ Holding Tank ❑ Renewal ❑ Privy ❑ Private Well Water Storage ❑ 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 Single Family Dwelling and is in accordance with applicable Municipal Codes. of property owner or authorized agent) Permit/Rush Fees:�JD~ aoo Date of Payment: 3b -F-11 a, ceb� Receipt Number: D)-10')jtS� Permit No. rpSe Ica-Ib3S Waiver Fees: Date of Payment: Receipt Number: Waiver No. GABuilding\On SiteTorms\Client FormsTennit App_010411.doc (Rev. 1/11) Environmental Consulting and Design SEPTIC SYSTEM DESIGN Lake Ridge Terrace Block 10 Lot 3 Municipality of Anchorage March 27, 2012 Development Services Department Revised April 19, 2012 On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 Subject: Septic System Installation Permit 14213 Harold Loop Ladies and Gentlemen: I am writing to request a well and septic system installation permit for the above referenced property. The lot is currently undeveloped. The proposed system will serve a 2 -bedroom single- family residence. Soil logs, design calculations, a site plan, design drawings and construction specifications are enclosed for your review. Design Calcs: Groundwater observed to a depth of 12 feet below ground surface (3/9/12). Groundwater observed at a depth of 3 feet below ground surface. (3/18/12) Soil Rating. From Testhole 3/9/12 17.1 min/in = 2 gal per sq.ft/day 30 min/in = 2 gal per sq.ft/day No. of Bedrooms 3 Required Area per Bedroom: 15012 =75 sq.ft. Total area required: 75 x 3 = 225 sqft System: We are proposing a BioCycle AWWTS followed by a mounded bed absorption field. The absorption field will be 30 feet long and 10 feet wide and contain 0.5 feet (300 sq.ft. effective) of sewer rock. Two feet of MOA filter sand will be placed in the bottom of the excavation. Soils: Test holes were excavated on March 0, 2012. See the attached soil logs. Ground water Monitoring will continue through April 18`y', 2012. Groundwater observed at a depth of 3 feet below ground surface. (3118/12) Surface Water: There are no surface waters within one hundred feet of the proposed septic 203 West &h Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net SpwNsimd Enghmse ing Environmental Consulting and Design system upgrade. Topography: The ground level slopes down towards the west at less than 5% grade Waivers: None 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, IIlI lILars Spurkland, P.E. Civil Engineer 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gcinet SPLITMand Engonc efing Environmental Consulting and Design SEPTIC SYSTEM DESIGN Lake Ridge Terrace Block 10 Lot 3 Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 Subject: Ladies and Gentlemen: Proposed Well Location 14213 Harold Loop April 19, 2012 Lake Ridge Terrace subdivision has a history of low/ no producing wells. The proposed well location was selected because this area of the property is more likely to produce a viable well than other locations. The 100 foot well radius will impact portions of Lot 2 Block 10 and Lot 2 Block 9 Lake Ridge Terrace Subdivision. Lot 2 Block 10 is owned by Hank Warren, the developer of Lot 3, and he has no objections to the proposed impact. The well radius would extend approximately 20 feet into west half of Lot 2 Block 9. This would impact approximately 620 square feet of area that is not already impacted by other well radii. Based upon the existing septic system as -built and an assumed position of the existing well, approximately 5000 square feet exists that is outside of well radii. A portion of this area appears to be used as driveway, but it appears that potential septic upgrade sites exist along the north property line and west of the existing shop. Further investigation would be required to confirm that these areas are suitable for the operation of an onsite wastewater disposal system. If you have any questions or concerns, please contact me at 279-3916. Sincerely, L S,�w, Lars Spurkland, P.E. Civil Engineer 203 West 150i Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci net LOT 2 / VAC£NT / �w Lor s / ` ` J / LOT I LOT 3 LOT 4 \ 1\ cawEmman xm ® I HAROLD LOOP ` Lor 2 G eLOT 4 �o I I PA NT I Lars III I LOT 3 \ I I I — — — — — — — — — ------------------ 20' UIS LsrT — — — — NOTE: THIS IS NOT A SURVEYED PGT. WELL R SEPTIC LOCATIONS TAKEN FROM ON—SIX WATER AND WAST£ WATER DEPARTMENT DOCUMENTATION. ALL LOCATKMLS SHOWN ARE APPROAMMATE. 50 0 50 100 150 200 250 300 SCALD 1' = 100 FT SPORKIAND ENGINEERING LAKE RIDGE TERRACE BLK 10 LOT 3 SEPTIC SYSTEM DESIGN 203 W XTH. AVENUEANCH. HANK WARREN DATE.- MARCH 27, 2012 (907) 7 99501 90TJ Y39-3916 I PO 60X 770640, EAGLC RIVER, AR 55J77 .SHEEP: 7/J GR/O: NWJJJ PERMIT #OSP1210XX PID # 051-323-17 LRTB10L3SCI00,DWG \ \ LOT 2 -� mel \ � � 9� VAC£NT F LOT 5 j __ J / ♦ F 0 \ " PROPOSED OT 3 LOT 4 / INSTALL 3 -BEDROOM SEPTIC SYSTEM © BIOCYCLE AWTS W/ BED LENGTH 30 FEET �` s £SERVE ARFA WIDTH 10 FEET DEPTH 1 FEET F MOA FILTER SAND 2 FEET ROCK DEPTH 0.5 FEET INSULATION 2 INCHES sxmc~sr COVER 2 FEET HAROLD LOOP 1 Y I Wel LOT 4 ���� OF %vj��'1.1 VACENT moo'•' NOTE. THIS IS NOT A SURVEYED PLAT. WELL k SEPTIC 49th LOCATIONS TAKEN FROM ON -S17£ WATER AND WASTE WATER DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE f ,off? APPROXIMATE. x°Q`° "-- • ARS • ................... SPURKLANO•: NO. CE -11500 'tib 25 0 25 50 75 i00 125 150 ��..•••..��'q lf;l.1^'�k��� SCALD I' = 50 FT DRAWING REVISED 4/18/2012 SPURKLAND ENGINEERING LAKE RIDGE TERRACE BLK 10 LOT 3 SEPTIC SYSTEM DESIGN 203 W 157H. AVENUE HANK WARREN DATE. MARCH 27, 2012 ANCH. AK. 99501 (907) 279-3916 PO BOX 770848, EAGLE RIVER, AK 99577 SHEET.- 2/3 GRID: NW553 PERMIT # 17SPI21OXX PID # 051-323-17 LRTB10L3SC100,DVG T.H. ELEV.= 4' MWMR ASrN 3034 fLfV.= 3 I COVER 2 fLEV.= .:2' MA &7ii SNO . --BED � NTS BISMOW 14��9 FoulBurrla cLEAx Gur ALAE FOIShEB GRAK AWAY FFROY MP M ALL BIRECTOBNS �1 0 4' PVC MPLOENT M PPRIM9RY aNi WR AD AERTION CMAWR iy oamigER H ®DISCHARGE CNANBER ,BOrfiW IF MAK ='�'-P' BLI.iBIWRO BI a4nUY INSTALLATION 1. EXCAVATE A 10' x 10' x 10' DEEP hME OR BIIICYCLE SYSTEM. 2. PLACE A MINIMUM DF 4' SAND LIR GRAVEL FOR LEVELING COURSE IN THE BOTTOM L7F THE EXCAVATION COMPACT AS REQUIRED. x PLACE 4 SHEETS OF 2' x 8' x 2' DIRECT BURIAL RIGID INSULATION ON TOP OF COMPACTED LEVELING COURSE TO PROTECT BOTTOM LIF FIBERGLASS TANK. TAKE EXTRA CARE TO ASSURE THAT INSULATION COURSE IS LEVEL IN ALL DIRECTIONS 4. BACKFILL AROUND TANK UP TO INVERT OF 4' INFLUENT AND 1-1/4' EFFLUENT LINES WITH FREE-FLOWING NSF MATERIAL FREE IF LARGE STLWES OR BOULDERS. SAND/GRAVEL BACKFILL MMlri7R TUBE DRAWING REVISED I SPUNKLANU LNGINWeING I,UE RIDGE TERRACE ELK 10 LOT 3 11SEPTIC SYSTEM DESIGN I 203 Wdd11K5TH. AQV�ENUE HANK WARREN DATE. MARCH 27, 2012 INY9B -0 I I 14Pi3 HAMULO LVVr, GAOL[ MIVCH', AN VYDYY bHttY. 7/1 bNIH: NWd'JS I PERMIT # OSPI2XXXX PIN 051-323-17 LRTB10L3D3.DWG ' Municipality of Anchorage Development Services Department e Building Safety Division / �A, a' / �r On -Site Water and Wastewater Program _ 49TH ; , • 4700 Elmore Road ' P.O. Box 196650 Anchorage, AK 99507 0 • • • • . ' S www.ci.anchoraae.ak.us LA• SPURKLAND.Fw (sol) 343-7904 /t �� • 11500 Soils Log - Percolation Test iitFp `'tJP� Performed For: Hank WarrenA Date Performed: Mar�R��204•t� Legal Description: Lake Ridge Terrace Blk 10 Lot 3 Township, Range, Section: T04` Depth 1/2/111 QRGaN�CS - /// Silh w/ Saa,¢ Sw.-+ei Gi (Mt, (, A) 10- 11- 12- 13- 14- 15- 1 a WAS GROUND WATER ENCOUNTERED? Yes 5 IF YES, AT WHAT DEPTH? 12' L Depth to Water After I o P Monitoring? � E Date: i$ 2017, Reading Date Gross Time Net Time Depth to Water Net Drop 3/9/12 1:45 PM 0 MIN 10.5625" 8.4375" 3/9/12 2:15 PM 30 MIN 10.375' 2.125" 8.625" 3/9/12 2:45 PM 60 MIN 10.5" 1.75' 8.75' 3/9/12 3:15 PM 90 MIN 1.75' PERCOLATION RATE 17.1 (minutWnch) PERC HOLE DIAMETER 6 TEST RUN BETWEEN 0.5 FT AND 1.5 FT COMMENTS PRE-SOAKED PERFORMED BY: Lars SpUrkland I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAtIOUrDELINES IN EFFECT ON THIS DATE. DATE: 3/16/2012 Municipality of Anchorage Date r I Development Services Department Depth to Water �P �•'^ Building Safety Division On -Site Water and Wastewater Program 3/9/12 •t 0 MIN 11" 4700 Elmore Road 9.4375' • ' 2:14 PM 30 MIN P.O. Box 196650 Anchorage, AK 99507 1.5625' • . N_J www.ci.anchoraae.ak.us (907) 343-7904 It Soils Log - Percolation Test +�I Performed For: Hank Warren Date Performed: Legal Description: Lake Ridge Terrace Blk 10 Lot 3 Township, Range, Section: 11- 12- 13- 14- 15- 16- 17- 18- 19 - COMMENTS PRE-SOAKED WAS GROUND WATER ENCOUNTERED? Yes 5 IF YES, AT WHAT DEPTH? 12' L Depth to Water Atter o I P Monitoring? I E Date: y !43 ZDtZ 1 6�. rye .SPURKLAND: 10 11500/ Site Plan Reading Date Gross Time Net Time Depth to Water Net Drop 3/9/12 1:44 PM 0 MIN 11" 9.4375' 3/9/12 2:14 PM 30 MIN 10.8125" 1.5625' 9.75' 3/9/12 2:44 PM 60 MIN 11.25' 1.0625' 10.75' 3/9/12 3:14PM 90 MIN 1.0" PERCOLATION RATE 30 tmin"1 A ch) PERC HOLE DIAMETER 6 TEST RUN BETWEEN 3 FT AND 4 FT PERFORMED BY: Lars Spurkland I 7Z�L�'2 1j�j ty�IAVbL- —CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPA6.libl INES IN EFFECT ON THIS DATE. DATE: 3/16/2012 Municipality of Anchorage Development Services Department ,'E.PF Q .1 11 Building Safety Division a Q•' • •. t� y�r On -Site Water and Wastewater Program / �' •% r 4700 Elmore Road 049 r/ P.O. Box 196650 Anchorage, AK 99507 :....... ... ...... www.ci.anchoraae.ak.us ( . (907) 343-7904 E. SPURKLAND... Soils Log - Percolation Test �� 11500 Performed For. Hank Warren Legal Description: Lake Ridge Terrace Blk 10 Lot 3 TW17 1 ORGAN %LS S;1E w( erre 5a."� Cm L) �;row'j Slit) 6cl PRE-SOAKED WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water Atter Monitoring? Date: Date Performed: Township, Range, Section: No s _ L 0 P E Site Plan Reading Date Gross Time Net Time Depth to Water Net Drop 3/9/12 1:46 PM 0 MIN 9.5" 8.3125" 3/9/12 2:16 PM 30 MIN 9.4375' 1.1875" 8.25" 319/12 2:46 PM 60 MIN 9.5' 1.1875" 8.375" 3/9/12 3:16PM 90 MIN 1.125" PERCOLATION RATE 30 (minutesfinch) PERC HOLE DIAMETER 6 TEST RUN BETWEEN 1 FT AND 2 FT PERFORMED BY: Lars Spurkland I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GW LINES IN EFFECT ON THIS DATE. DATE: 3/1 612 01 2 AhAk Umrr[ kind C �go�c�c�rro�g Environmental Consulting and Design Single Family On-site Wastewater Disposal System Construction and Material Specifications Subject Property: LAKE RIDGE TERRACE BLOCK 10 LOT 3 Date: March 27, 2012; Revised 4/19/2012 General: 1. The owner shall contract with a contractor to perform the work outlined in these specifications and plans in accordance with the attached MOA permit. There is not contractual arrangement between the contractor and the Engineer. The Engineer shall be the owner's representative and will inspect the work to document the contractors activities. Final acceptance of the contractors work rests with the owner and the MOA. 2. The scope of the project includes the procurement and installation of a 3 -bedroom on- site wastewater disposal system at the location depicted on the attached site plan drawings. The scope of the work also includes the installation of a new Biocycle tank, a drainfield comprised of a mounded bed 10 feet wide x 30 -feet long, 1 foot deep, with 2.0 foot MOR filter sand and 0.5 feet of septic rock below the distribution piping. The location of the drain field is shown on the attached site plan drawings. The maximum depth of the field will be 1 foot below the existing ground surface. A minimum of two feet of cover is required over the drain field. In addition to the required earthen cover, 2 -inch thick, 40 psi, direct bury board foam shall be installed directly over all piping beneath the driveway and over the drain field. 3. Construction shall be in accordance with the approved site plan and design drawings and any special provisions noted on the Municipal well and/or septic permit. All materials, components, workmanship and construction practices shall comply with the Municipality of Anchorage's latest ordinances regarding wells and septic systems, as well as MOA, Development Services Department, On-site Water and Wastewater Program (DSD) policies. 4. The contractor is responsible for obtaining all underground utility locates, layout of the proposed system, and verifying and maintaining all required separation distances to lot lines, surface water, wells, steep slopes, etc. S. The property owner shall be responsible for final grading any depressions formed from settlement of backfill material. The property owner is also responsible for vegetation of all areas disturbed by septic system installation activities. 6. Contractors installing wastewater disposal systems must be certified to do so by the MOA DSD, On-site Water Wastewater Program. Property owners installing their own systems must receive advanced approval from MOA DSD prior to system installation activities. 7. The contractor shall ensure that ALL materials being used are in compliance with the most current guidelines established by the Municipality of Anchorage. Refer to "Standards and Specifications for Component Parts and Materials Used in the 203 West 150i Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net '&& SpaMalmd EIMU'R umhNo Environmental Consulting and Design Construction of On-site Wastewater Disposal Systems", Dated December 2000, as provided by MOA DSD, On-site Water and Wastewater Program. Septic Tank Installation: 1. The tank shall be level and sufficiently bedded to prevent settling of shifting of the tank. 2. The sewer service line from the house to the tank shall have a minimum slope of 2% unless prior approval is obtained from the engineer. 3. The inlet and outlet lines from the tank shall be bedded in drainrock or the soil shall be sufficiently compacted to prevent future settlement of the soil. 4. Septic tank inlets, outlets and cleanouts shall be fitted with water tight couplings. S. A cleanout shall be installed 1 to 4 feet from the foundation. 6. Post tank cleanouts shall be installed per MOA requirements. Does not apply to pressurized lines. 7. In areas with high ground water, the septic tank shall be sufficiently anchored to resist buoyancy forces when there is not adequate soil cover to resist uplift force. The contractor shall refer to the engineer for direction regarding this matter. 8. The tank backfill shall be graded sufficiently to ensure positive drainage away from the tank. 9. All holding tank and lift stations shall have an audible and visible alarm inside the residence being served. 10. All lift stations shall be wired in compliance with all MOA guidelines and the Uniform Electrical Code. A municipal electrical permit and inspections must be obtained where required by the MOA. 11. The contractor shall verify that the septictank/lift station is a minimum of 100 feet from any residential water well, 150' from any class'C' well and 200 feet from any community water wells. Additional separation distances must also be maintained. 12. The contractor shall remove or abandon the existing tank in compliance with the Uniform Plumbing Code. Drain field Construction: 1. The drain field shall be excavated to the dimensions outlined in the design drawings. If any discrepancies are noted, contact the engineer immediately for clarification. 2. The drain field shall be installed parallel to slope contours. 3. The bottom of the drain field shall be within 2" of level. If the sidewalls or bottom of the excavation become smeared, they must be raked or scarified prior to the placement of filter sand or drain rock. 4. The drain field must be a minimum of 5 feet from the test hole excavation. S. Distribution pipe is to be installed level with perforations facing downward, atop a level bed of drain field rock. Septic rock shall then be placed atop the distribution piping to provide a minimum of 2" of cover, level across the entire width and length of the trench, above the piping. 203 West 15`h Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net _ SPUTMand Eimgo'ROBA[mg Environmental Consulting and Design 6. A silt barrier must be installed at between the final drain rock and the native soil backfill. The silt barrier shall cover the entire drain rock surface. 7. Monitor tubes must be 4" in diameter, installed in the locations depicted on the design drawings, and extend a minimum of 12" above final grade. The portion of the monitoring tube below the distribution piping must be perforated and the portion above the drain rock shall be solid. S. Backfill over the final gravel layer must not be less than 2 feet. Insulation must be installed when the backfill depth is less that 3 feet. 9. Drain field back fill shall be mounded to prevent depressions from forming due to subsequent settlement of backfill material. 10. The contractor shall verify that the drain field is a minimum of 100 feet from any residential water well, 150' from any class'C' well and 200 feet from any community water wells. Additional separation distances must also be maintained. Inspections: 1. A minimum of two inspections are required by the Municipality of Anchorage. These inspections must be conducted under the supervision of a Professional Engineer licensed to practice in the State of Alaska. 2. The first inspection must be conducted after the excavation of the drain field and before the placement of any gravel. The septic tank may be set in place, but may not be backfilled. 3. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, stand pipes, cleanouts, and insulation, but before the placement of any backfill. 4. The contractor shall provide a legible copy of all field notes relating to system layout and construction to the engineer for the use in preparing the record drawings. S. The contractor shall coordinate all inspections with the Engineer. A minimum of 24 hours notice is required prior to the start of construction. If necessary, a preconstruction meeting will be held on-site. 203 West 15`h Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN MUNICIPALITY OF ANCHORAGE AND H1;;1 V 111, tV 1Z1? ✓ N THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this f� Day of 141'R I L, of 201�Z, by and between NC --N EK &f, Wq IZJ / l 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 UL k—E located at �r) K,F�� �� TC l�%�/ E l 18 �r J� Anchorage, Alaska. 2. Definitions. A. Alteration. Any change to the design or function of an AW WTS that Includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Prior to performing any alterations to an AW WTS 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 ZEZD(J�V'" ($ 0.00), payable on or before the issuance of the operating permit and annually thereafter. The annual fee is due on or before the anniversary date of the approval by the Municipality of installed system. 4. Term. The term of this Memorandum of Understanding shall be for the life of the AWWTS. The term begins on the date of approval by the Municipality of the installed system and shall continue while the AWWTS system is in use or operational or until the property is sold or title is transferred by owner and a new certificate of On -Site approval is issued to the new owner or transferee of the property. 5. Alterations. Installation and Removal of Additional Equipment. Owner agrees not to make any alterations, removal of parts or additions to the AWWTS without a Construction Permit from the Municipality. 6. Maintenance and Repairs A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AWWTS in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further, Owner agrees to comply will all applicable ordinance, laws, regulations, rules and orders for the 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: / Kt IVyA L L- �- C. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. D. Owner agrees that only maintenance, repair personnel certified by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. E. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. F. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. G. Owner agrees that the relevant provisions of the standard specification guidebook for AW WTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's AW WTS. 7. Nonwaiver. The failure of either party at any time to enforce a provision of this Memorandum of Understanding shall in no way constitute a waiver of the provisions, nor in any way effect the validity of the Memorandum of Understanding or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 8. Amendment. A. This Memorandum of Understanding shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality of this Memorandum of Understanding was executed and such writing shall be attached to this Memorandum of Understanding as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized representatives of the parties are: Owner: H r-- N R C N, (O A fZ l;�l, hl 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: By: Date: Z STATE OF ALASKA THIRD JUDICIAL DISTRICT MUNICIPALITY: By: Title: Date: ss. The foregoing instrument was acknowledged before me this l6 day of A Pc ; 20N by Hfnn rr' NOTARY PUBLIC FOR ALA My Commission expires: 6 u 20 L Notary Public LESLIE ANDREE State of Alaska My Commission Expires Aug. 11, 2014 ARCTIC PUMP & WELL INC. Jim Sullivan, CPI ss�pn �n PO Box 770197 ams s r Eagle River, AK 99577 (907) 688-2510 (907)258-2510 anw(a), ci.net Pump Installation Log Well Drilling Permit Number: SW Parcel Identification Number: Date of Issue: Arctic Pump & Well, Inc. Page 1 of I Legal Description:Lake Ridge Ter Property Owner Name & Address: Lot:3 Hank Warren B1ock:10 PO Bx 770848 Fna-p River AK 99577 Pump Installation Date: 9/2/2010 Pump Intake Depth Below Top of Well Casing: Feet Pump Manufacturer's Name: Pump Model: Pump Size: hp Pitless Adapter Burial Depth: feet Pitless Adapter Manufacturer's Name: Pitless Adapter Installer: Well Disinfected Upon Completion? Yes Method of Disinfection: Chlorine Comments: Well permanently decommissioned by procedurel5.55.060L.c. Pump Installer Name: Arctic Pump & Well, Inc. Arctic Pump & Well, Inc. Page 1 of I MUNICIPALITY OF ANCHORAGE a Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 051-323-17 Certificate of On -Site Systems Approval Expiration Date: 7/4/23 Legal description LAKE RIDGE TERRACE BLK 10 LT 3 Site address 14213 HAROLD LOOP Current property owner(s) WARREN WILLIAM R X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for Comments or advisories: bedrooms, with the following stipulations: By: Original Certificate Date: 4/4/23 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 _ANCHORAGE If Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section 'J Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 051-323-17 Complete legal description Lake Ridge Terrace Block 10 Lot 3 Location (site address) 14213 Harold Loop Current property owner(s) Bill Warren 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: M 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: ❑ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 11 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ 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. COSAAppUcalion June 2022 COSA Checklist_June 2022 COSA Checklist Legal Description: Parcel ID: 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 Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test 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 Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank Date of pumping Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade 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 Adequacy test date Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in Comments/Deficiencies: COSA Checklist_June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F.ENGINEER’S COMMENTS 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 Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. 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E 0 w I U- l0 cy)I ,donor, 0 AMP" 0 0 lk U -i ;0,01 Mc) " (DO a L— 75 LL (D V) 10% LL (3) LL 0 ry, r) • AW AMW MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of thisDay ofPof 20 _Za, , by and between P i ha -d TcaCS , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an tAdvanced Wastewater Treatment System (AWWTS), described as 1 v C.1 located at (legal description) 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) '117 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. 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). -- 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 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. M Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. L 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) Date: 201,492 3 �rAEZ Tl'c,�, (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before 20 by, i' 11i hiy.1 ftvi i= . rr5 NOTARY PUBLIC FOR ALASKA My Commission expires: 17-wl MUNICIPALITY: me this'Z,'�'day of By: lbzlC% _ (signature) (print name) NOTARY PUBLIC KATELYN CHRISTENSEN STATE OF ALASKA My Commission Expires December 04, 2024 - Date: Y Title: (rev. 05/18/2018) Page 3 of 3 Inspection Report 3705 Arctic Blvd #313 Anchorage AK 99503 Email: crbioak@gmail.com (907) 274-0314 Homeowner Info Initial Inspection: System Inspection Customer Name:Tank #: Install Date: Is System Lid Locked? Inlet plumbing in working order? Are all aerators functioning? Pump float operating? Date: Filter cleaned?Discharge line condition: Alarm float functioning?Any buildup of solids? Clarification return system operating? pH Reading: (pH of 6-8 is ideal) Dissolved Oxygen PPM (2-5 is ideal) Turbidity of discharge (in FTU) (Under 35 FTU is considered compliant.) Solids pillow normal? Any buildup of solids? Any buildup of solids? Lid hardware in working order?Is there any noticeable odor? Alarms Tested: Air High Water Does system have a septic tank ? Battery Tested:Yes No Yes Yes Yes Good Replaced Yes Yes Yes Yes Yes Yes Strong Mild None No Yes Yes Repaired Replaced Replaced Replaced Replaced No Adjusted Requires Pumping No No Yes Repaired N/A Primary Chamber Aeration Chamber Clarification Chamber Effluent testing result Discharge Chamber Yes Comments: Inspected By: N/A (Recommend pumping tank every 2 years) (Please make sure alarm is on "normal", not "mute") Address:Area: Has emailing or mailing of form been requested? (contact office to request...)Yes No