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THE VILLAGES TR 9
The Villages Tr 9 #020-291-21 On-Site Water & Wastewater System Permit Permit Number: Tax Code Number: Work Type: OSP121402 02029121000 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: January 29, 2013 to January 29, 2014 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: THE VILLAGES Site LegalAddress: THE VILLAGES TR 9 G:3637 Owner/Address: HUEYAARON & JESSICA 10201 JACKPOT BAY CIRCLE ANCHORAGE AK 995150000 Site Mailing Address: Lot Size in Sq Ft: 142553 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 subsur[ace 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. Special Prows~on~~~Two supplemental test holes, one at 20 feet and the other at 40 feet down gradient from the drainfield ERS, shall be dug to verify the continuity of the accepting stratum's 2 foot minimum thickness. Results shall be submitted with the final inspection report. MUNICIPALITY OF ANCHORAGE Community Development Department Development Services Division On-Site Water & Wastewater Program Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/VVELL PERMIT APPLICATION Parcel I.D. 020-291-21 Property owner(s) Aaron & Jessica Huey Mailing address 10201 Jackpot Bay Cir, Anchorage, AK 99515 Day phone Site address Villages Scenic Parkway Legal description (Sub'd., Block & Lot) The Villages, TI" 9 Legal description (Township, Range & Section) Lot Size 142,553 Sq. Ft. Numberof Bedrooms 4 APPLICATION IS FOR: (J~ all that apply) Absorption Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage [] APPLICATION IS AN: TYPE OF DWELLING: Initial [] Single Family (SF) (w/wo ADU) Upgrade [] Duplex (D) Renewal [] Multiple Dwellings (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: Permit No. Waiver Fees: Date of Payment: Receipt Number: Waiver No. Permit App__- .., _.,.c ~ Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve .~. panengak.com Novemberl2, 2012 Municipality of Anchorage Development Services Department On-Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: The Villages, Tract 9 Septic System Permit Upgrade Request Ladies and Gentlemen: I am writing to request a permit to install a well and septic system be issued for this property. The proposed systems will serve a proposed four (4) bedroom house. Currently the lot is undeveloped. A new 1500g S.T.E.P. tank with AX20 Pod and Auxiliary pump vault will be installed. A new well will be installed. The surrounding developed lots are also served by private wells. There are no wells within 100 feet of this system. 1. Soils. A single test hole was excavated by Pannone Engineering Services in August of 2012, and the ground water monitored for seven days. The test hole monitor tube was dry after the seven day monitoring period. Bedrock was encountered in the test hole at 5.5' below existing grade. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 6 gallons/day,square feet should be used for a CAT III wastewater system, with engineered fill to obtain the required 6' clearance to bedrock (2' sand and 1.5' MoA type II). Soil Absorption System Design. a. See Sheet 2 of the design package. 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The existing topography slopes from north to south at approximately 25%-30% in the area of the proposed drain field. Fill will be placed before the system is installed to create an infiltration area of 25% or less for 50' below the drain field. 5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage~ AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-82tl Page 2 of 2 that the review is complete and that there are no further comments is received from MoA On-Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Attachments -Soils Log -Septic System Design Maili~g: P.O. Box 100217, Anchorage,/~K 99510~-0217 Physk:~h 332 East Ma[]or Ave, Anchorage, AK 9950:t Telephone: (907) 272-8218 FAX: (907) 272-821I :"I- RACT;9 il 80.5 i~ 128.9 z Z 1500g S.T.E.P. w/AX20 POD TANK (P~ AND AUX LIARY PUMP VAULT RESERVE DRAIN FIELD (P) 20LF X 5'W X 0.5'ED X +0.5'TD W/2' SAND & 1.5' + MOA TYPE FIL_ gJM7 E~_.""¢, ¢ILL SLOP'~ .,,. TH-1 (~'"~-~" ~ '/ ~.~, , .. . .I .: .. RETA NING WALL LOCATION .~ r: ! (RESERVE FIELD) ' ' ,,' ,, I ', , : · ' ' . - JDRAN F.E, LD (P) , / .,RETAINING WALLLOCATION..ff / - : ] '" /' :" ' .20LFX5WXO.SEDX+O.5'TD (PRIMARTFIELD) : ] ~ . / ,' ,: /' /W/2'SAND& 1.5' :t: MOA TYPE II FILL :/ 1 ! : : LIMIT OF FILL : ; ~ : · , ' ' f. .: ; : .' ¢ , FOR ........ ,...,,~,,~ P.O. BOX 100217 ANCHOI~AGE, AK 99510 ~HO~ (907) 27~-821~ FAX (907) 27~-a~11 ~ '-:- ~..'a~.l:l-I ~'~'..r~ ~--5{} THF VILLAGES, TRACT 9 .~. ~..'.Y.Y.Y.Y.Y.Y.Y.Y~....~.....¥~.. ~ o2o-29~-21 AARON & JESSICA HUE¥ ~, ~ CE 8'149 ~' 0SP~2~402 ~o~o~ OACKPOT RAY C~RCLa ~, ~.. .~f~ __ PLAN ANCHORAGE, AK 995~ 5 '{[~?~'~;~;;~.~-~'~'~-'~.~ Sheet SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS, 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS, ..3. SCOPE OF WORK: INSTALL NEW 15009 S.T.E.P. TANK WITH AX20 POD, AUXILIARY PUMP VAULT, AND SOIL ABSORPTION SYSTEM, INSTALL WELL. 4. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 5,5 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE, IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 5.5 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. RIGID INSULATIO.~. ----..____ FILTER FABRIC 1 Y~" 0 PERF PIPE Ya" HOLES @ 24" O.C,~ 2'.0/ RESERVE fIELD /-~ ~ _ ' ~ ~o SECTION ~ nLTER FABRIC -/~ . 9~ ~ ~ ~ ~///~1 ~" ~ PERF PIPE n --I I ~ ~ ~ PROFILE ~o POD DESIGN PARAMETERS cu COP~E~ PRIMARY/RESERVE SEPTIC SYSTEM DIP DUCTILE IRON PIPE NO. BEDROOM: 4 (600 gpd) TH TEST HOLE U~O~N~ TANK SIZE: 15009 S.T.E.P. FC FOUNDATION CLEAN OUT W/AX20 POD T~ TANK CLEAN OUT NO. W- WATER LINE/ PERC RATE = <I MPI WELL RADIUS SOIL RATING: 6.0 GPD/SF C~ CLEAN OUT NO. AREA RQD: 100 SF M~ MONITOR TUBE NO. ~ SS ~ NEW SEPTIC SYS. ~PE: WIDE TRENCH 0.5' E.D. R.I. RIGID INSU~TION MIN LENGTH: 20 LF DCO DOUBLE CLaN OUT DV DIVERTER VALVE USE: FS FLOW SPLICER 20 LF X 5' WIDE, 0.5' E.D., +0.5' TD BFG BELOW FINISH GRADE WITH 2' SAND, OG ORIGINAL GRADE AND 1.5' · MOA ~PE II FILL FO FINISH GRADE TOTAL AR~: 100.0 SF TS~V TOPSOIL & VEGETATE ~ 12/4/2012 FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 ~ ..... ';~0~' Stole ~ NTS THE VILLAGES, TRACT 9 ~ ~~. .... Bteven R. Panno~e AARON ~ JESSICA HUEY~'~L~%,. CE 8149 ...~...~ ~ERMIT NO. 10201 JACKPOT BAY CIRCLE DESIGN DETAILS ANCHORAGE, AK 99515'~ SOILS LOG - PERCOLATION TEST TEST HOLE 1 SLOPE ' ~3"~ ; / SITE~ PLAN ~ ; ,'~ ;' ,: ~ , , · ./..'~ :, . / :' ~ / . ~ ~ ." ,, ~__ ~ T 1 " / WAS GROUND WATER SLOPE 14 -- ENCOUNTERED? N 15 -- IF YES, AT WHAT TH DEPTH? --.--' X 17 -- DEPTH TO WATER A~ER MONITORING? 18 DATE: 9~/20~ 2 ~ 8/30/12 8:02 5.47 2 8:05 3 MIN 11.47 6 (DRY) PERO~TION ~TE <1 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN B~EEN 4 ~AND 5 COMMENTS: Test hole excavated by ~ANNONE ENO]NEaRING. ~ec hole w~s p~eso~cd. PERFORMED BY: Steven R. P~none~ P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL G~DLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: P~O~ ~G ~C, ~ ~, 12/4/2012 FOR CONSTRUCTION P.0. B0X 102954 ANCHORAGE. AK 99510 THE VILLAOES, TRACT 9 ~ ~~. ~ ~20-29~-2~ AARON ~ JESSICA HUEY ~ ~' CE 8149 · ~ ~ERB~T NO. 10201 JACKPOT BAY CIRCLE ~i~'A Sheet SOILS LOG ANCHORAGE, AK 99515 READING DATE CLOCK WATER TIME NET TIME LEVEL NET DROP READING I 8/30/12 8:02 5.47 2 8:05 3 MIN 11.47 6 (DRY) 3 4 5 6 ADVANTEX DESIGN ADVANTEX 24" 4" JIM CAPx~A,X20 POD~ INSUlt, TED AUXILIARY PASSIVEAiR .~ \ ~ RISER, PUMP \ VENT-~ ~, ~ J~ ~ BASIN OVER THIS CONNECTION TO PROVIDE SHEER PROTECTION- ~4' EXTEND TO BRIDGE EXCAVATION ro~ ¢ONS~UOT, ON P.O. BOX ~00~7 ~NOHORAO~, AK PHONE (~07) 272-8218 THE VILLAGES, TRACT 9 g ~%;...,. o2o-291-2, AARON ~ JESSICA HUEYfi~ ~". CE 8149 .~'*~ 'ERMIT NO. 10201 JACKPOT BAY CIRCLE *~i~:. '~9~ ~SP121402 SITE SECTION ANCHORAGE, AK 99515 ~i;m~ .... ~ Sh~t MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 020-291 1. GENERAL INFORMATION Complete legal description THE VILLAGES TRACT 9 Expiration Date °i r3 -Z©Zc? Location (site address) 19463 VILLAGES SCENIC PARKWAY, ANCHORAGE, AK 99516 Current property owner(s) MAX & LISA RABINOWITZ Day phone Mailing address Real estate agent PO BOX 1162, GIRDWOOD, AK 99587 2. TYPE OF DWELLING: ® `Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Private Well Water Storage Community Well Public Water System 4 Day phone TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Holding Tank ❑ ❑ Community ❑ ❑ Public Sewer ❑ Waiver request for: Distance: I. Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Ll ! of -5b Waiver Fee $ Date of Payment �o�iio� Date of Payment Receipt Number Receipt Number COSA # S[ -z1'26 Waiver # COVID-19 2519- USM ""T APPLIED 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 5121/2020 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 well and septic system. Therefore, any estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & Fks 6. DSD SIGNATURE System #1 Approved for A bedrooms System #2 Approved for bedrooms Disapproved y::..Vw.......... Curtis Huffman CE 128991 Conditional approval for bedrooms, with the following_ stipulations: `�llry J� ON-SITE �.r. Original Certificate Date: -2d 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: THE VILLAGES TRACT 9 Parcel ID: 020-291-21 If more than 1 septic system on lot: COSA Checklist # _of A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 8/17/2013 Total depth 246 ft Cased to 46 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 5/19/2020 Static water level at beginning of test 49 ft. Well production at time of test 3.2 gpm Comments B. TANK DATA Age of tank(s) 6 years Tank type/material ADVANTEX / STEEL Measured operating fluid level in septic tank ® Standpipes/foundation cleanout per record drawing Date of pumping * D. ABSORPTION FIELD DATA Which system tested (date installed) 7/27/2014 ® ALL standpipes present per record drawing Total measured depth from grade 3_8 ft (max) Measured depth to pipe invert from grade _ft (min) ® N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective Structure served by this system Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 1.29 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by WES Date of Sample 5/19/2020 C. LIFT STATION ® Required maintenance completed Age of lift station 6 years Lift station material STEEL Comments: *See Advantex maintenance report. Adequacy test date 5/19/20 Results 0 Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 600 gal New depth 3 in Elapsed time <5 min ® Code -required soil cover over field Final fluid depth 0 in El System presoaked Absorption rate 600+ and (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 FkS 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 ft 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' Surface Water > 100' ® 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' ft ft ft ft M ® Yes if No ft 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 ���®1•!®��®`� I certify that I have determined through field inspections and review ' • �'���� of Municipal records that the above systems are in conformance ®®aj�4' • . �-� �; with MOA COSA guidelines in effect on this date. *; •-49TH •, Ar ., ..... Curtis Huffman M��G��lF9•.C5/26/2Q1.*�\\�A w ft 10 061"01r 2020 19: 41 8686 770 . 05128!2020 15:35 Anil orage Tank ®Moss oil IN mo a PaloX11 Ila o oil APLUS TA.X'$07 277 3715 376 724 5 a a a a Mansil ME me am 11 a a 111 a Willn , O Field aWftna"C'O RISPO' Annual. ns ecticn ��--� fns a,oc,urtl rw,,,or :,rkl„�,. Larry Betts Max Rebinavvitz 19463 Villaces :er do Parkway. Anchorage AK ^9516 ;.:x�nt;� I'D ¢ vna a F1'RJ r1lln_ n AX Q"'1D” RTU128006 AX -133G53 pSP 121401 4175,74 Retrieua O&M Ink patty rlcw_•_ — ROgircrhti0— — Timor 9Cltirgs; This for a. CO! A Home Is for Si e PQrform Field Sr,, 132lin9l0139eruation5 111 U 0 5 =- 1,17, pH (3 9) CO t2 51 Y inspect Clean OtIar Of, lsvmple 1 Typical j luct}• _Farlhy �'Pe, oldy Nen•elCicai ?! ultid? [(.t?hr�lge !Oechy Oily tilnl in l*VI,l ( yea c F.)aro at i6np D Yes I-1 MO Chgcic CantrOI � Ml Xzi Aodre Amps Dk Char,e Anes �• RSV rrinsto!{t;d ........ ............ EigWhe•�Fil4,nr, ...-....�.--. Auditzle andviq� I hlorms ZOK 111 fin! tnr:^ (intern, ry nniy) L7 Yea No Inspoot/Clsim � imp SyStM C.Ivn I_at:`ralsJOfriCns f� Y inspect Clean Riv-0,id ..... ........... 1 y+l ItO,n tdemthnr aencrilytinn Splice Sox . . .. ............... Float CordS ... .. , . .. • . • . , ...71 Flo*t3........ .............. Xzi ' RIME �• RSV rrinsto!{t;d ........ ............ EigWhe•�Fil4,nr, ...-....�.--. I !" Blowbo,Rump' }'A ...,........ RcCirr :sting S titter Volva....... av�mttriar3r1�700+�m1m0!tdatFoet s c9Jilments -- Slgrt2Vture_,-- - Measure gludgedacum PAGE 01 P.001 tool AnchcrageTank 907-2272-3543 c(Nttct Fn^Rm (907)555-5555 Cotc of !.oat Inrp^t5rn, 09103/2019 Sludge Scum .^ _ _ -• ---- - --- --- — --- • -- — } 1?t Comsarimerrt C•ur? ;t`4 . Rr.vious Currer;t Previous 2nd Ccmpartr;tent C !rrent prcvious Cu r.,111, Pre;•iou? InspactfC160rt .i7sdw)n ,ex Filter Odor: i rJormai U Rungent F.7inmat: l Norrnai c,;casaivn tLridgir!glPondirig: I N4ne`Mi?oY [—'l EtCess!vr Inspenct Glean "Discharge pump $vstem lnspec'. Rlserl sd 1 spllCc nOl; ,J.r �tOat C6`I•Yi9 !7 1e9apecttSarvice tither SYSteM compomemz In*pec! Wan Diaintectirn 6qulpiMl)t J y -j ai"pe k.IhSt'YVatio', t Acldii:ional ServiCO[1 Rende:rPd Inipcot C.Ivn I_at:`ralsJOfriCns f� Y pad ecttnrte intakr• Vent if insp2;a, Ctean Final,;. ?ur!iv Irt^•pect Cieor plat C,rterals/4ritsces� Cleansd t^xt91e yFlPcts7 Rr^placed LIV ilernfl? 1 R:a�lacedlUsed o1ht;Y itetn.7 taat'ts i. Sad:l4r a Wuraljty, B = 3(llablc (Ve appropriate S1lCctic n) y+l ItO,n tdemthnr aencrilytinn F;naG'8efet�f In�pobtiblt RSV rrinsto!{t;d ids t KrLetl cn {�]° Pv1.ni`ofa r<cbnrteatedi tlusr, vHivas cfp9 G Canirol pen el rc>:Lllw{taa av�mttriar3r1�700+�m1m0!tdatFoet s C:1 System Verrurntirig; no further Galan n* tlo0 C: 1pnk r1 rn Purrpirr n C,Ill tar sC VICO' [_ C)It:er9 •„�,�.� '•— .�"�' Calc— �1 C ►�3 Fax cemp patted tares to I-866-38&4 404 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANC1 AND Rt?PAflt AGRF,EM.ENT, herein the "AGREEMENT" made and entered into as of this c�' ay of�c'll of 2QD , by and between a>1 �l/ 2-1 he✓✓rein the "O)ANER," 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 Wasteivater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater'. reatment Sy -tem (AWWTS), ADVANTEX SYSTEM described.rSX1S1zt.xaa 1 ap. located at (legal description) 2. Maintenance, Repairs and Alterations. I F,,i,,ir,(,(quired to read, understand and initial each section) tit 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 he maintained in a. satisfactory condition capable of performing as designed and producing treated septic effluent in �t accordance with the equipment's approval for operation in the Municipality. t 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). ?caner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, h repairs or permitted alterations to the system. ')�vncr acknowledges that regular maintenance of an AWWTS reduces the potential failure oI'the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Pagel of3 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 AW -\NITS may be 'I V , ssessed in accordance. with AMC 14.60.030. agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The 1v11-unicipality 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 ficate of On -Site Systems Approval. agrees that the AVNMTTS installation and maintenance requirements as provided by the AWNVTS vendor/installer and approved by the Municipality are the governing ✓'•f i � e guidelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AW VVTS as required by the AWAVTS approval. 3. Terri. 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 AW-WTS 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 signature) Date:15 /-L,7 Z0Zo )rint name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing iinstjj�nent was acknowledged before me this a9day of w , 20 ZO, by 7it �+'2 may' off,' \o011I!IJlllll�/ NOTARY PUBLIC FOR ALASKA 3� : ��� 4P . 'r My Commission expires: / 02 `� %p2 _ NOV. 23 in. 022 4F 5�4� 2 ' c 0 F A � MUNICIPALITY: By' v..,► QL4(sigliature) Date: l�/'� �2-40 (print name) Title: (rev. 05/18/2018) Page 3 of 3 RS_LIS ° EPLAWS MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On-Site Systems Approval Parcel I.D. 020-291-21 Expiration Date: j3 -1? 1. GENERAL INFORMATION Complete legal description The Villages Tract 9 Location (site address) 19463 Villages Scenic Parkway Current property owner(s) Aaron & Jessica Huey Day phone Mailing address Same Real estate agent Day phone 2. TYPE OF DWELLING: Q Single Family(w/wo ADU) RUSH ❑ Duplex ❑ Multiple Dwellings (Single Family and/orr Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic El Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ gg0 Waiver Fee $ Date of Payment 51/0/19 Date of Payment Receipt Number 1i 2 Receipt Number COSA# OSCietLaof 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system.All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty for future performance,nor can we estimate remaining life of the system.The content of this report is for the sole benefit of the owner fisted above. Name of Firm Pannone Engineering Services Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 �' Engineer's Printed Name Steven R. Pannone P.E. Date �) •49 311 �� f _.€.0, ........ 6. DSD SIGNATURE ... \ '• •r♦ /u_ System#1 Approved for L% bedrooms ••Mewl -. -anrione iitoSystem#2 Approved for bedrooms CE 8149 .; r Disapproved Conditional approval for bedrooms, with the following stipulations: ```�C�Qpa lTY(pF61r6'ir -S�rE c'� ►0 WASTE' ND m WA rPlio rn ,0 Alt? o`� i))1)»)t1)11 \ 1 n . �f t _ By: (� t`—{ ✓`'l Original Certificate Date: / The Municipality of Anchorage Development Services Division (DSD)issues Certificates of On-Site Systems Approval(COSA)based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklst o!ue sheet COSA Checklist Legal Description: The Villages Tract 9 Parcel ID: 020-291-21 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system 1 A. WELL DATA CI Well log is filed with Onsite (or attached) Well production at time of test 3.0 gpm Date drilled 8/17/13 Water storage tank volume n/a gallons Total depth 246 ft Well disinfected for coliform test? ❑Yes ID No Cased to 45.5 ft Coliform bacteria is Negative ❑■ Sanitary seal is functioning correctly Nitrate 3.72 mg/L ❑ Nitrate less than MRL (ND) ❑� Wires are properly protected Arsenic ug/L ■❑Arsenic less than MRL(ND) Casing height(above ground) 18+ in. Collected by PES Date of flow test for COSA 4/29119 Date of Sample 4,'23h19 Static water level at beginning of test 35.2 ft. Comments B. TANK DATA C. LIFT STATION Age of tank(s) 5 years 11 Required maintenance completed Tank type/material * Age of lift station 5 years Measured operating fluid level in septic tank * Lift station material F'0e'g?s 0 Standpipes/foundation cleanout per record drawing Comments: Advantex/Steel Date of pumping D. ABSORPTION FIELD DATA Shallow Trench Which system tested (date installed) 7/27/14 Adequacy test date 4/29/19 El ALL standpipes present per record drawing Results ❑✓ Pass For 4 bedrooms Total measured depth from grade 4.0 ft(max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade ft(min) Water added 600 gal M N/A—pressurized field New depth 0 in I Monitor tubes go to bottom of effective. If not, state Elapsed time 240 min depth into effective ft Code-required soil cover over field Final fluid depth 0 in ❑ Absorption rate <600 gpd System presoaked (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) n/a date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet 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' Community Sewer Manhole/Cleanout> 100' 0 Yes if No ft ❑✓ Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line>25' Ti Yes if No ft Absorption Field on Lot> 100' 0 Yes if No ft Holding Tank> 100' 0 Yes if No ft Neighboring Absorption Fields > 100' Animal Containment> 50' 0✓ Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0 Yes if No ft 0✓ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0✓ Yes if No ft Surface Water> 100' Q Yes if No ft Property Line> 5' El Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0✓ Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' 0✓ Yes if No ft Community Wells> 200' 0 Yes if No ft Water Service Line > 10' 0 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' Q✓ Yes if No ft If absorption field is under driveway comment below Property Line> 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' ✓0 Yes if No ft Private Wells> 100' El Yes if No ft Water Service Line > 10' 0 Yes if No ft Community Wells >200' 0✓ Yes if No ft Surface Water> 100' ✓0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION �v1. ,��OF ALq 9 . p,\Q... .sk.ti I certify that I have determined through field inspections and review AfeCo: •:9 T.1 of Municipal records that the above systems are in conformance with *•• 4* -I •*10 MOA COSA guidelines in effect on this date. (/J (� / • • . •��V 0 lip' " ,. COSA Checklist yellow sheet I\ , 1 1 1 �NetghOor's I Oriva ay 1 ■ ` c t N 89'57'57"E ---- , \ 1 255.93' i • 1 1 i 1 l I l spe I 1 :Smut 0-0 1 1 aoo 1 ri ,obm •N+'' 11 l ., 1 k c / I ` • l \ ''.-';, Iall :Si ti 1'' WellC'e Ti / I 1 • 1 e t i11 1.1. :,/Jzr 7Z0' I ry.. 1 zol'Ib losz' I 1 1 2nd Story t." o cr ;„: 17---------i;::.T 1 I O.ck &I r r 4.R bleon Out 2nd Story I1 Er i Or lis � � Deck 1 N I ��)Stood Pipes IV it 1 tr I nv Pump Vault I Z. I I .. access Z 1 0 ` 8 4 ,r , W I i 7� p I 0ron Field £ I Vents a I 1 t 1 ________________.________\ I 3 1 0 N TRACT 9 S \ l g 4 8 Si 0 4 I W1 i 'I tea. 50.o' e 1 II I I I\ 1 I , . I 1 N 89'55'27"W - - — — `I '1 199. 83' • • TRACT 15A \ i .,. . -... I NOTES 1. Recertification: ?�°F.' k Farpolnt Land 5ervices, LLC LEGEND ��.sP••' 4,_•S9'## SUEE.VCYING. MAPPING, LAND PLANNING. GIS • Monument '�.• ® Se Pt lc Vent tk• 49TH /\ •,*y �,ry 1131 E.76th Ave.,5urte 101 Anchorage,Alaska 99518 ../ FarporntAe..com•(907)522.7770•Survey@farporntak.com (O�-0Ekc.Meter ,Or'',..,,-.--,''HkE/�!4t RECERTIFICATION AS•UUII.T SURVEY OF: EXCLUSION NOTES:II is the owners responsibility to determine til EIec.Translormer )/;,ri9, Tract 9,The Villages the odstence of any easements,covenants,or restrictions which 0 IP Tekrom Pedesis] I 4.y0.;MIC L J.HORl.E,'� do not appear on the Plat used for this survey.NOTE:Under no +c• •.0 Plat No.77-106 �_ (4'..%.,......LS.531 .•5��� Anchorage,Alaska or for the eoobIi.on hould UI prop ttyheImeeon be used for construction lk 0Oi;SSOt111\/. s ne poperlY lines. MthnePREPAWeiser O0.0EN No DATE' SCALE: IcoraNG. Mehnfr W¢ixr Group \\\ANC' May 14,2019 1--60' R4R 3SSOMIOlown Noce 19159 OMWN:IOIECXED GOD No: Ira100r/PAGf IAnchnra5e•Ar 99507 1D I ME SW3637 147/13 ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND Max J.Rabinowitz THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this 9th Day of MaY of 2019 , by and between Max J.Rabinowitz herein the"OWNER,"and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement 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 located at(legal description). See attached Exhibit A 2. Definitions. 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. Certificate of On-Site Systems Approval(COSA). 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 Anchorage Municipal Code(hereinafter,"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. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. 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. Permit. An On-Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations,Installation and Removal of Additional Equipment. Prior to performing any alterations to an AWWTS,the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement,the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement,and any 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. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AWWTS. C. Upon request by the Municipality,the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. C. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance,repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice, G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. H. 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. I. Owner agrees to provide and maintain a telephone connection to the AWWTS as required by the AWWTS approval. 6. Non giver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof,or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed with,and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. 13. For the purposes of any amendment modification or change to the terms and conditions of this agreement,the only authorized representatives of the parties are: a. Owner: Max J. Rabinowitz b. Municipality: Director. Community De elopment or designated authority C. Any attempt to amend, modify,or change this contract by either an unauthorized representative or unauthorized means shall be void. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair 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 Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNER: By: --. (signature) Date: c ! S / Max J.Rabinowitz (print name) STATE OF ALASKA ) )ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this 9 day of May 20 19 by. MaxrJ.Rabinowitz TOT, Y PUBLIC FOR A A ' A lState of Alaska a My.Commission ex�i NOTARY RI-131.1c t Charity Wilkinson My Commission FmItes Feb 25,2023 MUNICIPALITY: By: 1 (signature) Date: 571 SIA (print name) Title: 95/26;2018 11:91 8686770 APLUS PAGE 94 * 318 849 m 1w I ill ■ NM III ■ ■■ IR 11111 me ■■ ■ ■■ 111 1 1 ■■ 1 11 1■ 1 i rer ■ IR 1■ I III ■11■ ■ RIR ■ 1111■ RIR A`dvalnTexe Field Maintenance Report Anchorac eTanlc Annual Inspection 907-272-354'3 Proporty Owner/rreakinp N OPeretor -- —� Aaron&Jessica Huey Larry Betts - Site Aggress Contact Phone -- 19463 Villages Scenic Parkway,Anchorage AK 99516 (907)555.5555 AY alta ID d County ID': Ped x RTU HAIL 6 Date of Last Ira:cection AX-133053 0SP121401 J 417574 RTU128006 07/21/2017 -_ Retrieve O&M Info Measure Sludge/Scum Daily flow Sludge Scum 1st Compartment Current _� Previous Current ;Previous Resin ratio Cry/ Timer settings: 2nd Compartment Current Previous Current Previous Inspect/Clean AdvanTex Filter InaroOCt Cl'.in Odor: Normal ❑Pungent laterals/Orifice:; c Perform Field Sampling/Observations G� Blomat: V1 Normal ❑Excessive Pod Bottom 171 NTU(15±NTUa) pH(6-6) DO(2-6) BridgIng/Ponding: None/Minor ❑Excessive Intake Vent r (,Cr bInspect/Clean Discharge Pump System Odor of Sample Inspect Inspect Cleini Riser/Lid Z Floats (2r Typical !Musty ;_,Earthy ❑Moldy �' /-f r ' Non typical Sulfide Cabb e ❑Decay Splice Box Pump a� 1_2I y Oily film In PVU '-1 Yes 0 No Float cords Foam In tank :j VINO Inspect/Service Other System Components Inspect Clean In:;peect Clean Check Control Panel Disinfection Equipment yJ Dispersal Laterals/0ririct�s,a ,...47-1Rcclrc Amps Discharge Amps Observations / Additional Services Rendered ❑Cleaned textile shoots? ❑Replaced UV Items'' pa..Ad.,. Audible and visual alarms 1 ❑OK Replaced/Used other items? Dial tone(telemetry only) ❑Yes ❑No , Parts Used:W=Warranty,B=Billable(✓appropriate selection) '\fi5.1/4 Inspect/Clean Pump System w 13 Item NumberDescription Inspect Clean - -- Riser/Lid rl-,.,,1,/ -- Spike Box )/_ -- -- Float Cords I✓/ Floats / r r Final/Safety inspection Pump JJ 7 RSV reinstalled r7Uds bolted on Biotube"Filter ..V /� ZeMsnlfold reconnected;flush valves closed c.omrol panel reactivated Biotube Pump Vault Y I/ Summary/Recommendations / Recirculating Splitter Valve Stem performing;no further action needed ❑Tank needs pumping ❑Call forservice ❑Other? Comments __ _--- Signature Datei, Fax completed form to 1-866-384-7404