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HomeMy WebLinkAboutTRAILS END BLK 3 LT 6Trails End Block 3 Lot 6 #015-191-45 Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Number: Q.SPI31253 PID Number: d1.5–/g/-41S Page / of 3 Dwelling: Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project New ❑ Upgrade Name: GAR /cam S / !rZ ABSORPTION FIELD Address ❑ Deep TrenchShallow Trench [:1 Bed El Mound A G . BDx 35/l , AAc.,.r��ee. r,.,.�__ Phone Number of Bedrooms l5 560 Soil Rating Total depth from original grade GPD/SFj G Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneathpipe Subdivision _ Block Lot/ / S Ft. v S FL /`S ,Eh/b 6 , Township Range Section Fill added above original grade Gravel length / Z Q , Ft. Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES `- _ Ft. Ft To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line �(J' - Ftp � — Ft. Well 6V �1/ a6j (f/ !d0 �,F. _ zs' f TANK ❑ Septic ❑ S.T.E.P. ❑ Holding Other Manuf ct�urf / Capacity by /�QQ Surface Wl ��i oO r (� Gal. Material Number of compartments oU, Lot Line O r f A6 !f. r NA F5 155(r 1 2 Foundation S l0 '7' . �6 LIFT STATION Manufacturer Capacity Curtain Drain — — 114Irl i (34* F r44Ik, /,®6 Gal. Remarks A &VAV!56z _ 9 69 Pump on level at Pump off level at water alarm at jHIgh y Q in. - Pump make and model ElectAcal Inspections performed by b✓gnlT� S�N4�d /� insfaiter �PIPEMATERIAL HousetotankPl/Cz H40I dranSZ5ZS Drainfield SSC(-( f Inspector BEr.NCH MARK (Assumed elevation) Q G ft Inspection t° / /3 !� /� Location and description d f 0 (.j tJd770 dates: 0 Z� J 3d 2° ( e COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineers "Stamp Conditional Approval: Date t` s Approved 0.e4vL(/I, Date r 1- 7 - i q InenorNnn [Jenn.i O_1 � .l..r g tj 3 R 3 9 » & g 2 y c w 2 y 2 t:j a 2 9 ■ ■f// \ < ( 2 9 E .! /W\ ;\ ® / 2 p ED 0 <� 2 c f R . 2 y S 2 ro % BRO»7RAVENUE §K Z \ mwmrX) (A) 2wGR t,� 2 2 ,02 CD \p \§ N ■| ||| :3/ \%® §/ �m®n o |2 [ k�\ | & P _ .ay. ( » \ \ \\\\ \ \ ` / ^^ » m g \ & .�. a / % j m .. k G e a m / R ? @ \ / 3 � \ J & / \00 ik (A ( ° ® I /ro ID mm ( {{ 0 °' y w � && ({ _ . / ro [��� G c » \ « \ mm / » )$ \ - w » . = m .| 2 \ y & .« c z 0 \ ` & . 2 § 9 0 e ( » D a e } \ \rD 0 \ { \ F— < ; j�( D } } g �=G \ � /}/2 ® 3 /J / :5 � / Z\ ` tV)( n C- a I \ ( p g (+ I ;� S❑ILS L❑ ENGINEERING Performed For: Gary Foster - PERC❑LATI❑N TEST Date Performed) 7/31/13 Legal Description; Trails End B3 L6 DEPTH (FEET) Organic Fill & Overburden SP Silty Sand W/Gravel TA Locations See Attached Design Previous Monitor Used For Groundwater Groundwater? No Depth Water Depth After Monitorino,7' Date: 6/12/14- 6/20/14 # Date Gross Time Net Time Depth Net Drop 1 7/31 0 -- 7" -- 2 7/31 10 10 min, 12° 5" 3 7/31 12 -- 7' -- 4 7/31 22 10 min. 12° 5" 5 7/31 25 -- 7' -- 6 7/31 35 10 min, 128 5" 7 7/31 37 -- 7- -- 8 7/31 47 10 min, 12" 5" 9 7/31 50 -- 7" -- 10 7/31 60 10 min. 12" 5" 21 - Percolation Rate 2 min,/inch Perc Hole Diameter 6" Test Run Between 2' and 3' Comments PrPsnaked. Measured to nearest 1/10th inch. Performed By NorthRim Eng, I CERTIFY THAT THIS TEST WAS Performed in Accordance with All S ate/Municipal Guidelines in Effect ON THIS DATE. DATE: 7/31/13 NORTHR/M *:49Ili . * TESTH❑LE LOG T, H, 1 ENGINEERING PO Box 770724 e Eagle River. Alaska 99577 907.694.7026` g�y►� GE❑TECHNICAL i1 6/20/14 lir. Vannoy Electric 12014 231 E. Forest Ave Wasilla AK, 99654 N Anchorage: 907-569-3333 Valley: 907-357-3383 ." Fax: 907-357-0173 Friday, November 07, 2014 Reference: L6 B3 Trails End Subdivision Foster's Fine Finishes 11363 Browder Ave. Anchorage, AK To: Whom it may concern, Vannoy Electric installed the wiring and control box for the Advantix lift station system. The lift station was wired to code and approved by the Municipality of Anchorage electrical inspectors. The inspection # 310717 was done on 7/28/14. Thank you, Chris Apthorp Vannoy Electric Authorized Representative Vannoy Electric I Substance Abuse Agreement I Certified Drilling Log , OC CO d6a BILL % ROLE �ULLIVAN WATER WELLS s P.O. Box 670269, Chugiak, AK 99567 688-2759 OWNER OF LAND: Foster's Fine Finishes ADDRESS: PO Box 3511 Palmer, AK 99645 Bore Hole Data Depth From To LEGAL DESCRIPTION Trails End Elk 3 Lot 6 DATE: 10/30/13 0 2 PERMIT NUMBER: 131253 DATE OF ISSUE: 8/23/13 TAX IDENTIFICATION NUMBER 1519145000 Is well located at approved permit location: N Yes ❑ No Method of Drilling: Nair rotary ❑ cable tool Depth of Well: 240 Casing Type: Steel Wall thickness ,250 inches Diameter: 6 inches, depth 84 feet Liner type 4.5 in PVC 200ft perforated 2 5 5 12 12 65 65 142 142 168 168 175 175 190 Static Water Level: flowing feet Recovery Rate 8 N gpm ❑ gph Method of Testing Air Well Intake Opening Type: ❑ open end N open hole ElScreened Start feet Stopped ❑ Perforations Start feet Stopped Grout Type: Granular Bentonite Volume: 50 lbs Depth: from 0 feet, to 20 feet 190 210 210 218 218 230 230 240 Well Disinfected Upon Completion: N yes ❑ no Method of Disinfection: Chlorine 50 nom Comments: Stickup Overburden Silty Sand and Gravel Silty sand & gravel w/ clay Bedrock brown broken Bedrock gray Bedrock yellow Bedrock brown Bedrock dark brown broken Bedrock gray Bedrock gray w/ quarts & fractured Water Bedrock gray Drillers Name: Cole Sullivan 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. Municipality of Anchorage: Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www,muni.org/onsite (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW 131253 Date of Issue 8/23/13 Parcel Identification Number: 1519145000 Legal Description Property Owner Name & Address Trails End blk 5 lot 6 Foster's Fine Finishes PO Box 3511 Palmer, AK 99645 Pump Installation Date: 11/4/13 Pump Intake Depth Below Top of Well Casing: 212 Pump manufacturer's Name: Goulds Pump Model: 7SB074712CL Pump Size: 3/4 Pitless Adapter Burial Depth: 30 Pitless Adapter Installer: Sullivan Water Wells — Cole Sullivan — Chad Cross Well Disinfected Upon Completion? ® Yes ❑ No Method of Disinfection: Comments: Pump Installers Name: Sullivan Water Wells — Cole Sullivan — Chad Cross feet hp feet Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. 9 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: OSP131253 Tax Code Number: 01519145000 Work Type: WellSeptic Permit Effective Dates: August 23, 2013 to August 23, 2014 Design Engineer: NORTH RIM ENGINEERING Subdivision: TRAILS END Site Legal Address: TRAILS END BILK 3 LT 6 G:2641 Owner/Address: FOSTER GARY L DBA FOSTER'S FINE FINISHES PO BOX 3511 PALMER AK 996453511 Site Mailing Address: This permit is for the construction of: Y Disposal Field Y Septic Tank /©,2-q. 13 d- //-,00 Lot Size in Sq Ft: 22800 Total Bedrooms: 4 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. Special Provisions: Percolation Testing: Additional testing shall be completed such that the entire drainfield is within 30 feet of a percolation test. Test results shall be submitted with the final inspection report. z -as -w CDi AWWTS CAdvmAAP_xN a.v.A ro-vZsni Ak AWv, geld. •�-1'�0.,� � If'ou v.d In?a e r uv.o,n : � irr : �.. J1e � rt a W i��\; I iiia a,�a;� Aila. S � tv\rt ,ra , llc L&'11 k .LTf, V%4%1 ' \_a ae.4 ; Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 hftp:/Iwww.muni.org/0nsite Development Services Division On -Site Water and Wastewater Program went S a Department **** VARIANCE/WAIVER REVIEW **** Waiver#: OSP131254 COSA#: Permit#:OSP131253 PID#: 015-191-45 Legal Description: Trails End, Block 3. Lot 6 Engineer: North Rim Engineering Applicant: Gary Foster Your request for a waiver of the required 100 feet horizontal separation from the septic system to the surface water has been approved. The approved separation distance is 50.0 feet. This waiver approval applies to the proposed septic system only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ..................................................................... 0 a . . . . . . . . Waiver is Granted: X Waiver is not Granted: Date: g a3 l3 Approved l �de Name of Reviewer ..............................................................................1 Rec#: 005673 Amount: $800.00 Date Paid: 8/5/2013 **** VARIANCE/WAIVER REVIEW **** MUNICIPALITY OF CC*— Community Development Department Development Services Division On -Site Water & Wastewater Program Parcel I.D. 015 - Property owner(s) Mailing address _ Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWERIWELL PERMIT APPLICATION 9! - '? 5U . PCF, Day phone 3 IS— S6o f ? ?151�s Site address fro' der e Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) Lot Size ZZ, POO Sq. Ft. Number of Bedrooms _ V APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field N1 Initial Single Family (SF) Septic Tank W Upgrade ❑ (w/wo ADU) Holding Tank ❑ Renewal ❑ Duplex (D) ❑ Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: < lracc. ('JCAV_ JLC J y �+ Distance:, I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature or auttyafized agent) Permit/Rush Fees: 5307 a 06 _ Waiver Fees: Date of Payment: C& Date of Payment:5 ! 7j Receipt Number: b'S�" Receipt Number: U b'S(o12) Permit No. os Vol 1> ash, Waiver No. O'pPjl �;S i a!5�4— Permit App_9-1-12.doc C 01 k. (�TH21M ` N, INEERING zs-, Trails End S/D, Block 3, Lot 6 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is a new 4 -bedroom, single family home. Some of the neighboring lots are not yet developed. These lots are small and are served by private water wells. Surface water exists on Trail Street and a waiver was previously approved. The configuration is very tight and for this reason the absorption bed runs parallel to the 5% slope. This should not be of vital concern with the small 20' advantex drainfield. The Orenco Systems, AdvanTex Treatment System will be utilized. This system requires a 1500 gallon processing tank/lift station and 1-AX20 filter pod. A Category III System drain field will allow an application rate of 6 GPD/FT2. This allows a 5' x 20' bed. Adequate separation to groundwater will be maintained. A new sewer service line & foundation cleanout shall be installed. No adverse impacts are expected from development. The neighboring subdivision lots are similarly developed, some are vacant. Water wells are depicted on the drawing. The easements are located on the drawing and are not encroached upon. Soil tests revealed silty sandy soil. An existing monitor tube was used in conjunction with the soils test. No bedrock was encountered or groundwater was encountered. A berm will be constructed- see waiver. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations, Orenco Systems AdvanTex Treatment System Design/Installation Manuals, Anchorage Tank & Welding requirements. • Installation by an Authorized AdvanTex Installer only; approval issued by Orenco Systems & Anchorage Tank & Welding, Inc. • 1500 gallon, two compartment AdvanTex processing tank, 1-AX20 filter w/50 gpm pump, VeriComm Monitoring System & Mode la standard package per AdvanTex Treatment System Manual. • Watertight couplings on inlet & outlet. • 5' minimum between the tank and bed. 10' minimum to property lines. • 3 feet of cover or insulation is required for bed; an equivalent of 1" insulation for 1' soil cover. • Tank & solid pipe must be set on well compacted, stable soil. • 4 inch diameter cleanouts with airtight caps are required 1' to 4' from foundation wall, prior to any 90 degree bend in 4 inch line, prior to the processing tank. • All cleanouts must extend to at least ground level • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron • Trench to be placed level, minimum of 4' to groundwater, 6' to bedrock. • Drain rock to be 1/2" to 2 %' screened. Drain rock to be distributed uniformly throughout the bed. Perforated pipe to be installed level with perforations down. c0 CzINEERING Trails End S/D, Block 3, Lot 6 • Silt barrier (filter fabric) to be installed above the drain rock • Smeared bed bottom must be raked or scarified before drain rock placement. • The finish grade must be mounded to promote drainage over the bed • Insulation must be placed over any pipe installed under driveways or parking areas. AdvanTex Treatment System and absorption bed shall not be located under driving or parking areas. Schedule 40 PVC (1") to run from Advantex Lift Station to field. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope • Maintenance agreement for the AdvanTex Treatment System is required for approval. • Insulation board shall be extruded direct burial polystyrene (Dow Styrofoam HI or equal) �CR I� ENGINEERING MEMO Date: 8/3/13 To: MOA On -Site Services Steve Eng, PE, PH P.O. Box 770724, Eagle River AK 99577 (907) 694-7028 tel northrimeng@aol.com Number of Pages: % Subject: Trails End S/D, Block 3, Lot 6 Septic System Design, Waiver Request & Well Siting A new house and wastewater system are planned for the subject lot. A previous monitor tube showed no water to 13'- a soil test was completed at this site which exhibited favorable soil. The neighbor lots are small with development as shown in the drawing. The design calls for a conventional septic system & private sewer lines. Private water wells serve the area lots and are shown in drawings. A new water well is also proposed. A surface water drainage exists along Trail Street to the south. This requires a waiver request- attached. We plan on constructing a berm to mitigate the effects of this surface drainage. Please review the wastewater system design for the single family home. I have included design plans & specs, design guidelines, & soil tests. If there is need for additional information or clarification please give me a call. Thanks -Steve RTP I�- ENGINEERING MEMO Steve Eng, PE, PH (907) 694-7028 tel NorthRimEng@aol.com Date: 8/3/13 To: MOA On -Site Services Subject: Trails End S/D, Block 3, Lot 6 WAIVER REQUEST Number of Pages: 2 The subject site has a small surface water drainage along Trail Street. This requires a waiver request. Lot 6 did not exhibit any water in the test hole monitor. We are following the State of Alaska (SOA) Memorandum on waivers, dated January 3, 1985. We have scored the system based on this State Memo. However the Memo further advises that measures can be taken to mitigate contamination. Point totals are not high, but we are mitigating the close proximity to surface water by building a protective berm. The waiver request to the runoff flow in Trail Street is to 50' for the absorption trench and 68' for the Septic Tank. The required separation is 100'. By constructing a surface berm along with the natural topography we will meet the basic intent of the 100' separation requirement. After consultation with your office, we will request a waiver according to the State of Alaska (SOA) Memorandum on waivers, dated January 3, 1985. This Memorandum utilizes a procedure to award point values for geological conditions at the site and makes recommendations based on these point values. Geological: Test holes in the area demonstrate silty gravels and sands. A monitor tube previously completed on-site indicate the top 13' to be free of water. Surface runoff exists along Trail Street on the south of the property. Water Table: No water was encountered in the test hole/monitor tube. The distance from the bottom of the leach field to the highest water table is 5.5'. Water level is assumed to be deeper than 13' from Test Hole 1. This gives a point total of 0.7. ENGINEERING MEMO 2. Soil Sorbtion: The soil tests indicate the soil is silty sand. The average of silt and sand equals a point total of 3.0. 3. Permeability: There is a point value for silty sand. This yields a point total of 1.7. 4. Water Table Gradient: The slope of the gradient most likely parallels the surface slope @ 5%. However the property slopes toward the southwest rather than directly south to the stream. Normally the gradient slopes toward the surface water, but it is close to neutral due to the direction of flow. This yields a value of 2.5. 5. Horizontal Separation: The horizontal separation is 50' to the absorption trench & 68' to the Advantex Tank. This yields a value of 1. The total point total = 0.7 + 3 + 1.7 + 2.5 + 1= 8_9 This point total has a value that states "contamination is unlikely from bacteria, but possible from chemicals or virus". However the SOA Memorandum places special emphasis on "mitigating" factors. We feel that the advanced wastewater system will allow a deviation in this case from the required separation. It is likely that this road runoff drainage already contains bacteria which is usual for a surface water. To further mitigate any damage we are constructing a berm, which along with the natural topography will require over 100' for any surface effluent to engage the surface water. We request the waiver due to the above argument. If there is need for additional information or clarification please give me a call. 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O p d "F a Cn 4.> C5 J L l7 W H O Z M 0 0 N �I Q � N Q 0 J W Q U E N N � F— J W a LLJ w oZ zw S❑ILS LOG - PERC❑LATI❑N TEST ENGINEERING Performed For: Gary Foster Date Performed: 7/31/13 Legal Description: Trails End B3 L6 DEPTH (FEET) 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10 - 11 - 12 - 13 - 14 - 15 - 16 - 17 - 18 - 19 - 20 - 21 - Organic Fill & Overburden SP Silty Sand W/Gravel T,H, Location: See Attached Design Previous Monitor Used For Groundwater Groundwater? No Depth Water Depth After Monitorino,None Dat( # Date Gross Time Net Time Depth Net Drop 1 7/31 0 -- 7" -- 2 7/31 10 10 min. 12' S" 3 7/31 12 -- 7° -- 4 7/31 22 10 min, 12" 5" 5 7/31 25 -- 7° -- 6 7/31 1 35 10 min. 12" 5" 7 7/31 37 -- 7" -- 8 7/31 47 10 min. 12° 5" 9 7/31 50 -- 7" -- 10 7/31 60 10 min. 12" 5" Percolation Rate 2 min,/inch Perc Hole Diameter 6" Test Run Between 2' and 3' Comments; Pr(—oakPd. MPas,urPd to Performed By NorthRim Eng, Performed in Accordance with F EN THIS DATE. DATE: 7/31/13 NORTHRIM * 49Iti ENGINEERING �•••��-•; CERTIFY THAT THIS TEST WAS to/Municipal Guidelines in Effect f ❑LE LOG IT. H. 1 GE❑TECHNICAL Date: 1/13 " Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I. D. 015-191-45 1. GENERAL INFORMATION Complete legal description Trails End Block 3 Lot 6 Expiration Date: Z l8 Location (site address) Browder Avenue, Anchorage, AK Current Property owner(s) Foster Day phone 315-5601 Mailing address PO Box 3511 Palmer AK 99645 Real Estate Agent Builder Day phone 315-5601 2. TYPE OF DWELLING: SUBMITTAL ® Single Family (w/wo ADU ) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) OCT 2®)� 3. NUMBER OF BEDROOMS: 4 `.'° 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class C Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Received by: G>��� v" I Date: 1� COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ C, C, • &O Date of Payment 1011410 Cvb_ Receipt Number 0+5 2 -co' Date: Date of Receipt Number. COSA# O`,C.-IH 1,542- 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 NorthRim Engineering Phone 694-7025 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 10/14/2014 6. DSD SIGNATUREi— J� System #1 Approved for bedrooms. L, System #2 Approved for bedrooms. C, r�f req Disapproved. Conditional approval for bedrooms, with the following stipulations: By: poe.-f- Original Certificate Date: The Municipality of Anchorage Devlopment 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 9-1-12 dm 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: % -? /L S 67 J.0 'S3 L >,�' Parcel ID: © 15 - l ?/- 4"-15- A. l.S A. WELL DATA Well type l If A, B, or C provide PWSID # Well Log (Y/N) Date completed d d f 3 Sanitary seal (Y/N) Wires properly protected (YIN) T Total depth24�4 ft. Cased to _?�Lft. t Casing height (above ground) 2�in. FROM WELL LOG Date of test Q /S Static water level 1C/OGy�q ft. Well production g.p,m, WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate l mg/L Arsenic ND. ug/L Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material b &A& Tank size 150 gal. Number of Compartments 2 Foundation Cleanout (Y/N) (YmJ) Date of pumping Pumper AT INSPECTION ft. g.p.m. Collected by: zt , "&i Date installed 3 / Cleanouts (Y/N) Y I gh :"dater alarm (YriN) C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft2 or ft2/bdrm) �_ System type r ra„� a � Length 00 ft. Width S ft. Gravel below pipe O_ S ft. Total depth 3 ft. Eff. absorption area440 ft2 Monitoring tube 4— Depression over field Date of adequacy test A/Fw Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Elapsed Time: - min. Final fluid depth Any rejuvenation treatment (past 12 mo.) (YIN & type) Water added gal. New depth in. _ in. Absorption rate >= g.p.d. If yes, give date D. LIFT STATION Date installed 611311V Size in gallons 1,14 "Pump on" level at in. "Pump off" level at 2d� in. Datum 6 a tto.n . Cycles tested 3 Manhole/Access (YIN) High water alarm level at in. Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 140 `4F On adjacent lots /DO /f Absorption field on lot /00 't On adjacent lots r/) d `1' Public sewer main A/fJ Public sewer manhole/cleanout d14 Sewer /septic service line Z S Holding tank N A Animal containment areas SO f Manurelanimal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation .S f Property line F Absorption field 5 - Water Water main A /A Water service line Al r� Surface water IdQ or Wells on adjacent lots /DO 'f ABSORPTION FIELD ON LOT TO: Property line �0 i Water Service line /z� i Building foundation A2 r �t- Surface water UO r Curtain drain 41A— Wells on adjacent lots F. COM11irlENTS Water main /U Driveway, parking/vehicle storage '?'10 `F )r WA r/Ei2 - wiT# BEreRvt TRit 051- d IS f -f NC -E >'/o o' G. ENGINEER'S CERTIFICATION l certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Date fall l COSA brown sheet_10-10-12.doc �II � II I� LOT 7 I N 89'59'30"E 190.00' — 5' UTILITY EASEMENT / x-10' CEA EASEMENT SEjTIC PIPES _ LOT 6 / 31.2 ` 22,800 S.F. 'u / o z0' 2 STORY MANHOLES / o RESIDENCE TREATMENT POD m M IJ 0 I u G 26.2' N n R= PRpiECT S 89'5W30"W 190.00' TRAIL \STREET PLOT PLAN AS BUILT X SCALE 1" = 30' GRID SW 2641 I I 3.0 c . ICE! 2.0'..: 4 DHALT'_ DRIVEWAY. O o G N v 22.0' I*I 25.2' CANT WELL Project No. N I 13-135 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone o00�0 Registered Land Surveyors (907) 522-4625 Fax —oOFAo//pOH kerMangsurvey.com / jonothan®langsurvey.com po`` .•• •`q�0o I hereby certify that I have surveyed the following d#escribed property: 0%P ' VT LOT 6 AnchorageBLOCK Recording TDistrict, Alaska, and END that hateLAT he Improvements situated thereon are P -6049TH within the property lines and do not encroach onto the property adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visibleQ............."' .."•'•' ' easements on said property except as indicated hereon. QO c KENNETH G. LANG , LS -5202 Dated this the Day of at Anchorage, Alaska OQ�`c� '•, yoQ A Oo It is the responsibility of the owner to determine the existence of any easements, D���FESSION4 covenants, or restrictions which do not appear on the recorded subdivision plat. �04000� ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND �^'t�k�l�C�t�'y�1J THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into asof this Day of r /iy of 20 /� by and betweenZ./"k;y *X4 -d) 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). lrai(s Era, L6 g3 2. Definitions. 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. 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 AW WTS that were included in the original design which would allow the AW WTS to continue to perform as designed. Permit. An On -Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AW WTS. 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 Eauivment. Prior to performing any alterations to an AW WTS, 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 A W WTS 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 AW WTS service and maintenance provider approved by the municipality and the manufacturer of the AW WTS for the entire term of the AW WTS. 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 AW WTS. 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 AW WTS may be assessed in accordance with AMC 14.60 for improper discharge. E. 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 A W WTS 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. Nonwaiver. 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. B. 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: b. Municipality: Director, Community Development 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. O' �R: By: IIJDate: &-J//- (signature) /y %�(, j1� l�� ��if}A%�•3 1print name) STATE OF XW.4 OPA"- J ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this h day of. % 20,[ , by A Sof M ` 1mrn& 4 rMy Com PUBLIC FOs iSiGt/7G! � r goo OFFICIAL SEAL My Commission expires: SHERRY M. HOUGH ' NOTARY PUBLIC NO, 29790 STATE OF LOUISIANA PARISH OF RICHLAND My Commission is for Life MUNI(C�IPALIT �J r�I�-Y: A D By: �-v (signature) Date: 1I /$ / nah /AJoc kM;At!a (print name) Title: C6