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Home My WebLink AboutSKYWAY PARK ESTATES BLK 3 LT 3Skyway Park Estates Block 3 Lot 3 #019-141-23 Inspection Rep6rt_1-1-12.doc Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://wvvw.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP131012 PID Number: 019-141-23 (] New ❑ Upgrade Name: ABSORPTION FIELD Matthew and Linsdey Jolly ❑ Deep Trench ❑✓ Shallow Trench ❑ Bed ❑ Mound Address 9122 Dewberry Street Anchorage, AK 99502 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 1.0 GPD/SF 5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 1 Ft. Gravel depth beneath pipe 4.OFt. Subdivision Block Lot Skyway Park Estates 3 3 Fill added above original grade 1.6-2 Ft, Gravel length 60 Ft. Township Range Section Gravel width 5Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 600 Ftp I One Ft. Well >100' >100' N/A N/A >25, TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank/Orenco Capacity 1,500G'j. - Surface water >100' >100' NIA N/A NA Material Steel Number of compartments Two _ Lot Line >5' >10' N/A N/A -- Foundation -- >5' >10' N/A N/A LIFT STATION _ Manufacturer Capacity Gal. Curtain Drain None Noted Pump on level at Pump off level at High water alarm at Remarks Advantex Treatment System with Gravity Flow. in. n. in. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank D3034 drainfield Tank to D3034 Installer Red Dog Excavation Drainfleld HDPE CO/MT D3034 Inspector MEA BENCH MARK (Assumed elevation) 100.0 ft Inspection.r 1 5/1/13 5/1/13 Location and description dates: 2•a Garage Slab. 3" 10/4/13 4'" COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL ::gi etijlimp, ��•��.OF • A4 440 Conditional Approval: Date Si,`Q;•'' S R 49TH .7 j... ...e .. .... �R>0 �NIICf1AEL E. ANDERSON • �? 0 CE • 4381 Approved Date Inspection Rep6rt_1-1-12.doc 0 rn (Y1 z� w m � of K 'n < ❑ Q W p� U � U :n Z W �Ce) 0 L W ❑ M 0 co O O r V W 0 Q m N U) W W U Oo ONO of 5LW Q m Qr Z n � n Q O V ,00'OOZ 3„00,00.00 N a \m” j \ O y v2 72 3 I ,00'OOZ 3„0£,10.00 N 0 133diS vend t- ri J H pq 0 ,Ol ------- __-1wS3_lun -----------� I m� I - �o F iv ro fo N I V m Ul a I = I I I � I x E o I a \m” j \ O y v2 72 3 I ,00'OOZ 3„0£,10.00 N 0 133diS vend t- ri J H pq 0 Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit No.: OSP131012 Existing Grade — 95.6— 91.6—/ Page 3 of 3 19LLISx111MBEA&W 98.2 Finished Grade Drain Field Rock 60' Trench 79.6' a x r 91.6 II Groundwater @ 86.6' 9-14-12 U 98.4 — Existing Grade 95.6 PROFILE AS -BUILT ' Scale: NONE .i 49 ,. _ th AEL E. ANDERSON No. CE -4381 t!xtttlnrta 1 unici sport - ElecFin Alpine Drilling & Enterprises Well Log Permit Number- #SZY13t012 Date of Issue: 2-28-13 Parcel Identification t�[ttmber:-04914?2 000 Date Started: 5-21-13 Date Completed: 5-22-13 7s well located at approved permit location:`? x Yes ❑;' No Legal Description; Skyway Park Estates Black 3 Lot 3 Property Owner Name & Address: Jolly Matthew Troy & Lindsay Lee 9122 Dewberry St fl»rh.vrh.r.n iiT-11, nnc^ . Borehole Data: Soil Type; Thickness & Water Strata Depth (b) From To Method of Drillingi x air rotary ❑eagle tool Casing type. steel Stick-up 0 1.5 Wall Thickness:.250 inches Organics trod sill br 511tbr gravelly sill wet hr 1.5 3 5 3 S 18 Diameter: S inches Depth: 43 feet Liner Type. Diameter: _inches Depth: _ feet Casing stickup above ground: 1.5 feet sift grey as 23 Static water level (from ground level):.9'_feet gravelly sih 23 42 Pumping level: 40 feet atter silty ivatersand chi gravel42 43 2 hours pumping 12 gpm Recovery Rate: 12 gpm Method of Testing*: airlt' i Well Intake 0pmting Type: x Open End El Open Hole Screened Start __ feet Stopped feet El Perforations Start feet Stopped feet Groat Type: hgntotategrcmules Volume: I& De the Start 0 feet- Slo d z feet Pump: Intake Depth_ feet Pump size __ lip Brand Name Well Disinfected Upon Completion? xYes F]No h. t5a ofDisinfeedon: chf0rneta6%ta- Comments: Well Driller: Engine Drilling & Enterprises PO' 13ax 110496 I' - Rnc1wrageAK9931J Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road r4,�..`o z. -01y P.O. Box 196650 Mark Segich Anchorage, AK 99507 Mayor www.muni.orc/onsite (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW 131012 Date of Issue: 2128113 Parcel Identification Number: 01914123000 Legal DescriptionProperty Owner Name & Address: Block 3, Lot 3 Skyway Park Estates Jolly Matthew Troy & Lindsey Leel Colony Builders 9122 Dewberry St: Anchorage, AK 99502 Pump Installation Date: 7110/13 Pump Intake Depth Below Top of Well Casing: 42 Pump Manufacturer's Name: Goulds Pump Model: 10SBO5422C Pump Size 1/2 hp Pitless Adapter Burial Depth: N/A feet Pitless Adapter Manufacturer's Name: NIA Pitless Adapter Installer: N/A Well Disinfected Upon Completion? 7 Yes ❑ No Method of Disinfection: Chlorine Tablets Comments: Pump Installer Name: Aarow Pump & Well Service, LLC P.O. Box 110496 Anchorage, AK 99511-0496 feet Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. 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: OSP131012 Tax Code Number: 01914123000 Work Type: WellSeptic Initial Permit Effective Dates: February 28, 2013 to February 28, 2014 Design Engineer: ANDERSON ENGINEERING Subdivision: SKYWAY PARK ESTATES Site Legal Address: SKYWAY PARK ESTATES BILK 3 LT 3 G:2729 Owner/Address: JOLLY MATTHEW TROY & LINDSEY LEE 9122 DEWBERRY ST ANCHORAGE AK 995025541 Site Mailing Address: 11841 PUMA ST, Anchorage This permit is for the construction of: ,',�gtial.F N Holding Tank Lot Size in Sq Ft: 59960 Total Bedrooms: 4 N Privy N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By: MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 019-141-23 Property owner(s) Troy Jolly and Lindsey Lee Day phone Mailing address 9122 Dewberry Street Anchorage, AK 99502 Site address 11841 Puma Street Anchorage, AK Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) Skyway Park Estates, Block 3, Lot 3 Lot Size 59,960 Sq. Ft. Number of Bedrooms Four (4) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial FXI Single Family (SF) ❑X Septic Tank ❑X Upgrade ❑ (w/wo ADU) Holding Tank ❑ Renewal ❑ Duplex (D) ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well Water Storage ❑ 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 pr owner o� d agent) Permit/Rush Fees: to Waiver Fees: Date of Payment: ,�2 ho 13 Date of Payment: Receipt Number: fJ� 6-Ae'e Receipt Number: Permit No. P13160Rn Waiver No. 0(5P13/013 well Permit App_> ::-'.,:c- ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773: 677-7766 (FAX) February 5, 2013 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 3, Block 3, Skyway Park Estates Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 3, Block 3, Skyway Park Estates Subdivision intends to construct a four-bedroom home on the lot. We are therefore requesting a permit be issued for a well and septic system to sere the new home. The soils on the lot absorb water at very slow rates and make it difficult to place a conventional septic system. We therefore propose to place an Advantex Treatment System on the lot to provide the most effective treatment of the septic effluent prior to discharge into the surrounding soil strata. The location of the absorption system is shown on the attached Site Plan. Drainage patterns are also shown on the plan and will not be modified as a result of the proposed construction. Two test holes were placed on the lot in August of last year. Groundwater was found at a depth of 12' below the surface. The percolation rate in the materials encountered was 60 minutes per inch. Our design provides for the bottom of the absorption trench to be at 5' below the ground surface. We are therefore proposing to place a four- bedroom Advantex Treatment System. The absorption trench will be 60' long x 5' wide x 4' effective depth. The distribution line in the trench will be placed at 1' below the existing ground level to take advantage of the looser soils near the surface. 3' of fill will be placed above the trench and 4' over the septic tank to meet Municipal Code and prevent freezing. Grading will be completed over the completed septic system and landscaping completed to insure positive drainage away from the finished area. The ground surface of the lot slopes from the east to the west at a 1% slope. The trench will be constructed parallel with the contours of the slope as much as possible in conformance with Municipal requirements. All components of the new septic system will be constructed a minimum of 100' from the well proposed for this lot. No conflicts exist between the proposed well and septic system and those in the area. Lot 3, Block 3, Skyway Park Estates Subdivision February 5, 2013 Page Two If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, W1,1"t a--, Michael E. Anderson, P.E. Attachments .°•• 49th••••'' eA� MICHAEL E. ANDERSON I � I r i � r � , r r r � r I i I i r i OLD KIATT ROAD ------------ / -- - ----------- --- ---- I WMI , wal 2/ / I r 1 \ `\ �\ � , p ®xelP \\ 4 / \ i I <Y\J , r , H r W Wr ______________________________________ ______ d' ___________________________________ ________ r__________________________________ (n II 5 \\\ OFrA/ -'� �rWall I 1 Existing ................. 1♦♦ / Wall •.....? ----------------- 49th _. '• ♦ \ / ♦?MICHAEL E. AN➢ERSON t ♦♦�f�'., NOS CE -4381 , � AREA M A P - ♦f♦�,pRpFES„pN�� SCALE 1" = 100' .00'OOZ 3..00.00.00 N ,UU UU6 J„U£:JU.UU N O ro 133a1s wind LOT 3, BLOCK 3, SKYWAY PARK ESTATES SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS Four Bedroom Home 5' Wide Trench System Perc. Rate: 60 Min./Inch Advantex Treatment System Application Rate: 1.0 GPD/SF AX -20 Filter Pod 500 Gallon Add On Lift Station 4' Drainfield Rock 4 Bedrooms * 150 GPD/Bedroom = 600 SF Absorption Area 600 SF/1.0 GPD/SF/5 SF (Width) *.5 (Red. Factor 60 LF Trench Length THEREFORE: Construct a 60' Long x 5' Wide x 4' Effective Depth Absorption Trench. Flow Line Elevation in Trench to be 1' Below Original Ground Surface. Total Depth to be 5' Below Existing Ground. Provide 3' Cover Over Absorption Trench and 4' Cover Over Septic Tank. 3' Min. Natural Backfill Ci Geotextile Fabric 6"1 1 ,o 1" Perforated PVC (Holes Down) 3/16" Holes @ 2.0' Spacing Drainfield Rock 5' TYPICAL 5' WIDE TRENCH SECTION (NO SCALE) •�.P�E NOTE: Grade Area Over Trench to Drain Away. py Minimum 6' Separation From Bedrock. 49th Minimum 4' Separation From Groundwater.$0;. Minimum 100' Separation From Private Wells in the Area. �a: MICHAEL E. ANDERSON Minimum 100' Separation From Surface Water or Streams: �� .,, No. CE -4381 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650 DEPTH (feet) 1 - 2- 3 - J 6 - 7 - 8- 9 - 10- 11- 12- 13 15 16 17 18 1 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: LOT 3, BLOCK 3, SKYWAY PARK ESTATES SUBDIVISION PERFORMED FOR: COLONY BUILDERS DATE: 81112012 PROJECT NO.: PARCEL ID#: TECHNICIAN: J. BERKRAM TEST HOLE # 1 OB/OG SLOPE SILTY SAND/SILT m SM/ML a z BOH T DEPTHS 12' WAS GROUND WATER ENCOUNTERED? YES IF YES @ WHA DEPTH OF WATER AFTER MO DATE OF MO SEE SITE PLAN 49th MICHAEL E ANDERSON NITORING: 9/14/2012 GROSS TIME (INCH NET TIME DEPTH To NET DROP DATE READING (MINUTES) (MINUTES) WATER (INCHES) ES) 10/6/11 TEST HOLE PRESOAKED PRIOR TO TESTING: 1 10:15 2.13" 2 10:45 30 2.75" .62" 3 10:46 2.25" 4 11:16 30 2,75^ .50" 5 11:17 2.50" 6 11:147 30 3.00" .50" PERCOLATION RATE: 60 (MIN/INCH) PERC. HOLE DIA. 8 (INCHES) TEST RUN BETWEEN: 3.OFT. and 4.0 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY VETECH ENGINEERING TECHNICAL SERVICE. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: PERCOLATION RATE: 60 (MIN/INCH) PERC. HOLE DIA. 8 (INCHES) TEST RUN BETWEEN: 3.OFT. and 4.0 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY VETECH ENGINEERING TECHNICAL SERVICE. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650 DEPTH (feet) 1 - 2 3 4 5 6 7 8 9- 10- 11- 1 1 1 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: LOT 3, BLOCK 3, SKYWAY PARK ESTATES SUBDIVISION PERFORMED FOR: COLONY BUILDERS DATE: 81112012 PROJECT No.: PARCEL ID#: TECHNICIAN: J. BERKRAM TEST HOLE # 2 OB/OG SILTY SAND/SILT SM/ML 17 BOH 18 19 SLOPE SEE SITE PLAN 49th MICHAEL E. ANDERSON WAS GROUND WATER ENCOUNTERED? YES GROSS TIME (MINUTES) IF YES Q WHAT DEPTH? 12' S 10/6/11 DEPTH OF WATER AFTER MONITORING: 1p O I% 12:04 1.25" DATE OF MONITORING: 9/14/2012 P 12:34 30 1.875" E DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) 10/6/11 TEST HOLE PRESOAKED PRIOR TO TESTING: 1 12:04 1.25" 2 12:34 30 1.875" .625" 3 12:35 1.125" 4 1:05 30 1.75" .625" 5 1:06 1.25' 6 1:36 30 1.875' .625' PERCOLATION RATE: 60 (MINANCH) PERC. HOLE DIA. 8 (INCHES) TEST RUN BETWEEN: 3.5 FT. and 4.5 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. T EST PERFORMED BY VETECH ENGINEERING TECHNICAL SERVICE. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: Page I of 2 Watershed Management HOME PROGRAMS W—FS 111,111 --olill 1 11 1 Nxmm� Ba- k —IoGaL(e�ry Wetland Mapping Municipality of Anchorage Wettands Data Lmate an oddm,, , V. -Y% llttp:/Iww'A"ane-horagestorm-%vater-cora/maP,html?webmap--Obe2O8al5ao04aldaa6138Sf26,,, 2/21/20rtlo' 13 ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEENCIPA IT F ANCHORAGE AND . r 1, �6tt�{ THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this Day of _ rLtartn of 20 (5, by and between 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: L ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater gDvti..,rv�T�r Treatment System (AWWTS), described as $ysva+✓t located at St<yIrlA!/ rA.ML CSnWL,-S SLcCA- �� , Anchorage, Alaska. 2. Definitions. r 3 A. Alteration. Any change to the design or function of an AWWTS that Includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Prior to performing any alterations to an AWWTS the owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AMC') 15.65. B. Certiflcate of On -Site Systems Approval. An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with AMC 15.65. 1 These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. C. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. D. Maintenance and Repair, The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. E. Permit (Construction) An On -Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. F. Permit (Operating) An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that allows the Owner to operate an AWWTS, upon meeting all the requirements of this agreement, the conditions of Operating Permit, the requirements of the On -Site Wastewater System Construction Permit and all relevant provisions of AMC 15.65 3. Fee. Owner shall pay to Municipality an annual fee of D'jCF— ($ 6 .00), payable an 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 Construction Permit from the Municipality. 6. Maintenance and Repairs. A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AWWTS in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further. Owner agrees to comply will all applicable ordinance, laws, regulations, rules and orders for the AWWTS. B. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the Owner's AWWTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's AWWTS Operating Permit is: C. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. D. Owner agrees that only maintenance, repair personnel certified by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. E. Owner 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 AWWTS. 7. Nonwaiver. The failure of either party at any time to enforce a provision of this Memorandum of Understanding shall in no way constitute a waiver of the provisions, nor in any way effect the validity of the Memorandum of Understanding or any part hereof, or the right of such party thereafter to enforce each and every provision hereof: 8. Amendment. A. This 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:-� Anchorage: Purchasing Officer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of Understanding shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Memorandum of Understanding. 10. Severability. Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum of Understanding. OWNER: MUNICIPALITY: By: By: Titles Date:�� Date: STATE OF ALASKA ) ss: THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me thisday of. 202,�, by n 4:::1 NOTA1Zi rCCFOR ALASKA My Co sion expires: 4 pv- /-11� "7 - Notary Public Y. STUDSTILL - - State of Alaska My Commission Expires Nov 17, 2014 COSA Checklist Legal Description: SKYWAY PARK ESTATES BLOCK 3, LOT 3 Parcel ID: 019-141-23 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 5/22/2013 Total depth 43 ft Cased to 43 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 2/18/2021 Static water level at beginning of test 12 ft. Well production at time of test 4+ gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic 5.55 ug/L Arsenic less than MRL (ND) Collected by Date of Sample 2/18/2021 Comments __________________________________________________________________________________ B. TANK DATA Age of tank(s) 7 years Tank type/material ADVANTEX / STEEL Measured operating fluid level in septic tank SEE MAINT. Standpipes/foundation cleanout per record drawing Date of pumping 5/6/2020 C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: SEE ATTACHED MAINT. REPORT D. ABSORPTION FIELD DATA Which system tested (date installed) 5/1/2013 ALL standpipes present per record drawing Total measured depth from grade 7 ft (max) Measured depth to pipe invert from grade 3 ft (min) N/A – pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Code-required soil cover over field W/ INSULATION System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Adequacy test date 2/18/2021 Results Pass For 4 bedrooms Fluid depth prior to test 39 in Water added 650 gal New depth 46 in Elapsed time 1410 min Final fluid depth 39 in Absorption rate 600 gpd Any rejuvenation treatment (past 12 months) N If yes, enter date Comments/Deficiencies: Operating in the top 1’ of the 4’ ED. 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 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 From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Property Line > 5’ Yes if No ft Absorption Field > 5’ 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 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 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 If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No F. ENGINEER’S COMMENTS G. ENGINEER’S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. 3/1/21 P us hfl o Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 019-141-23 1. GENERAL INFORMATION Expiration Date: —1 Complete legal description Skyway Park Estates, Block 3, Lot 3 Location (site address) 11841 Puma Street Anchorage, AFC Current Property owner(s) Matthew & Lindsey Jolly Day phone Mailing address 9122 Dewberry Street Anchorage, AF< 99502 Real Estate Agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Four 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual El Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System I-1 Public Sewer F-1 WaiverNariance request for:, Received by: �� `y Date: COSA to be released i%the engineer, unless otherwise requested by the engineer. COSA Fee $ R5 Waiver Fee $ Date of Payment 66J>"/�3 Date of Payment Receipt Number G F60- 6 Receipt Number COSA# "q 61316f6 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. Name of Firm Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Phone 522-7773 _ Date 10/5/2013 OF At to ®� n ° 49TH ; 6. DSD SIGNATURE ii.qp?: __AZ System #1 Approved for bedrooms 01—. •°°•t•°-. ° +Ip' MICHAEL E AERSON°°� & System #2 Approved for bedrooms s% 'CE - 435: Disapproved ®+®f� pROFE S w Conditional approval for bedrooms, with the followirib By,_ Original Certificate Date:/ V '" < The Icip yp 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. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet_! .! 1 If more than 1 septic system is on the lot: COSA Checklist # of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Skyway Park Estates, Block 3, Lot 3 A. WELL DATA Parcel ID: 019-141-23 Well type Private If A, B, or C provide PWSID # Well Log (Y/N) Y Date completed 5/22/13 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 43 ft. Cased to 43 ft. Casing height (above ground) >18 in. FROM WELL LOG AT INSPECTION Date of test 5/22/13 Static water level 9 ft. Well production 12 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate N/D mg/L Arsenic N/D ug/L Date of sample: 7/30/13 B. SEPTIC/HOLDING TANK DATA Tank Type/Material AdvanteX/Steel Tank size 1,500 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Date of pumping New Const. Pumper C. ABSORPTION FIELD DATA ft. 011iIIIIIIIIIIII Collected by: Anderson Engrg. Date installed 5/1/13 Cleanouts (Y/N) High water alarm (Y/N) Y IF Date installed 5/1/13 Soil rating (g.p.d./ft2 or ftz/bdrm) 1.0 GPD/SF System type 5' Wide Trench Length 60 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 6.6.7 ft. Eff. absorption area 600 fe Monitoring tube Y Depression over field N Date of adequacy test New Const. Results (Pass/Fail) For _bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) __--- "Pump on" level at in. ,Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: >100' > 100 On adjacent lois Septic tank/lift station on lot > 100' >100' On adjacent lots Absorption field on lot N/A N/A Public sewer manhole/cleanout — Public sewer main N/A >25' Holding tank Sewer /septic service line -- > 100' >50' Manurelanimal excrete storage areas Animal containment areas SEPTICIHOLDING TANK ON LOT TO: >5 >5' >51 Property line Absorption field Building foundation > 0, >100' > 10' Water service line Surface water Water main Wells on adjacent lots > 100' ABSORPTION FIELD ON LOT TO: N/A >10, >10' Water main Building foundation Property line , > 1 0' > 100' Driveway, parking/vehicle storage > 10 Water Service line Surface water None Noted >100' Curtain drain Wells on adjacent lots F. COMMENTS Advantex Treatment System with Gravity Flow to G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Michael E. Anderson, P.E. Engineer's Printed Name 10/5/2013 Date COSA brown sheel_10-10-12.doc Trench. p, - MICHAEL E. ANDERS^N JJ. • 0-`4381 0 Z cnQ W AirN 0 . 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