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Home My WebLink AboutGREENBROOK BLK 2 LT 17Greenbrook Block 2 Lot 17 x#017-023-68 Municipality of Anchorage , Development Services Department Y t Building Safety Division On -Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 995196650 Page Of www.ci.anchorage.ak.us (907) 3437904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: Sk/ 253 PID Number: 0I - 023 - b $ Name: EoR(TE et6-Fl Wastewater System: El New 5rUpgrade Address: Boas A G•Aizvv CC2Uc- ABSORPTION FIELD Phone: Numberef Badrooms: Deep Tenon P.11c. Tlanrh ❑Bed ❑Mound ❑Mac. LEGAL DESCRIPTION 5°ilRagg: 5 OW Depth fromodgicalglade: GPD/Ft' Ft. Blod: Lot: Subdivision: Z I� GR.(EK RWK Depth to pipe bottom from original grade: oars Ft. Gravel depth beneath pipe: oo1.5 FL Township: Range: Section Fill added above original glade: GrovelLength.- C)—I Ft. aO Ft. • Well CC/RnL ❑New El Upgrad Gravel vMth: 5 Namherorlines: I Distance b=texen tines: e Ft. Ft. Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pip/e�Matenal: FL FL 1 5to Ft= ( (� CVC Sa. TO Dnllec Date Drilled: Stagc Water Level: FL InsWleo ��j1 [fool S('J'Or.(;Qp Date installed: ID u . Yield : Pump Sel of Casing Heigh Above Gmuntl: TANK GPM Ft. Ft. SEPARATION DISTANCES ❑ septic ❑ Holding R S.T.E.P. ❑ Other. To From Septic Tank Absorption Field Lift Station Holding Tank ubliclPrivate Sewer Line Mane as°rer i_ Ar1C�1or Ta {� Capacity: (;.1 [500 Well Material: .JT Number of Compartments: 2 Surface Water sW -loo +-too — LIFT STATION Lot Line aize: 4-S t• IO F ,� W" 15t�o Gal. Manufaauror e---� Afy.61x�, 21m 01 eNr—O Foundation +-51 +'tdt t LD •Pump an" level at: 32 in. "Pump ow level High wat,/,�aalarm at 7, '(O in. Elech icallnspeaionspetfmmedby: Curtain Drain — +. Pump Make -n M.d.l ` P;cn5lii Remadm: RS6 S-1 ft BENCH MARK e Qn 4o atin C«& C W"L d Location and Description: &o o SiAinj &Af S,' iou5t'. 9(e& Assumed Elevation: IDQ Ft. II Inspections performed by: Lars SDUA61WA Dates: ta' 101 o} ( 61 n9 \\` ,� OF' ,r 1l 2nd to/q O�'' _— . • tea )4 Development Services Department Approval? 49TH Conditional Approval Date: j p Lk?S E. SPUF KG1ND , Reviewed and approved by: 1 ate: f _ �- i o(�°F%`\S�;`„= I I LOT 16 I VACANT INSTALLED 4 -BEDROOM SEPTICSYSTEM I I V I ISOO ADVANTEX F££TTANK W/ AX20 POD & LIFT STATION / 20 LOT 2O I I V WIDTH 5 FEET TOTAL DEPTH 5 FEET / V ROCK DEPTH 2.5 FEET — — V COVER 2+NfEFTNcxEs� V I ; rH / 7 V TNI / / �7 V /17/ LOT 19 ,9T f L L / / - SW/NG77ES / F A A B 1 V T� P� / C 36 29.5 31.5 / ABANDONED EXISTING SYSTEM PER MOA CODE REOUIREM£NTS V / / v!// LOT 2 a v 1� 1 1 Ili 3 LOT 17 LOT I CF rte',. AN" 49th !'V ?'� �� ........ ................... LOT IS I �......:.: 25 0 25 50 75 100 125 150 I I •••••'•,1pR5$LU��•• SCALE, 1' = 50 FT. ')I'UKAI 15 . AVEN E I I GREENBROOK BLOCK 2 LOT 17 I I SEPTIC SYSTEM DESIGN 103 W AK. AVENUE DR. GEORGE SEIGFRIED DATE* OCT.15, 2007 (NCH. 7 9916 13035 ALGAR/N CIRCLE SHEET' 213 GRID: 2630 (907) 279-3916 � PERMIT N SVO70253 PID JI 017-023-68 GREENBROOKB2L17D2.DVG 5 -Wide Trench: 5' Wide 20' Long 5' Deep 25' Sewer r� 2' Insula tion 2' Cover 2' Insulation ELEV.= 98' Silt Barrier ELEV.= 95.5' 2.5 Ft of' Septic Rock Effective To Advantex Unit 1 1/4' Schedule 40 PVC 3/16' Holes at 18 inches Monitor 2' Cover (m1n) ELEV.= 101' NO SCALE ° ELEV.= 84' To Advantex Unit BENCH MARK BOTTOM SIDING EAST SIDE HOUSE ASSUMED ELEVATION 100' SPU203 W1 th ENGINEERING GREENBROOK BLOCK 2 LOT 17 SEPTIC SYSTEM ASBUILT 203 W15th Ave OR. GEORGE SEIGFRIED DATE: OCT. 25, 2007 Anchorage Ak 99501 13035 ALGARVN CIRCLE SHEET- 4/4 GRID1 2630 PERMIT I SWO700253 PARCEL ID 1 017-023-68 GREENBROOK82L 17D4. DWG _ MUNICIPALITYOFANCHOR4GE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 Permit Number: SW070253 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Legal Description: GREENBROOK BILK 2 LT 17 Design Engineer: 0007 SPURKLAND ENGINEERING Owner Name: GEORGE SEIGFRIED Owner Address: 13035 ALGARIN CIRCLE ANCHORAGE, AK 99516 - Date Issued: Sep 18, 2007 Expiration Date: Sep 17, 2008 Parcel ID: 017-023-68 Site Address: 013035 ALGARIN CIR Lot Size: 57402 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904(24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date: Issued By: C� N� Date: 1 Municipality of Anchorage z u{ * Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. _ IJ ('f 'aka - (.PO Property phone Mailing address_ 13035 81ggrin Ciroje Zip Code Site address 13035 Aj„n„ N -d'. Zip Code Legal description (Sub'd., Block & Lot) Greenhrook Block Z Loi j} Legal description (Township, Range & Section) Lot Size �, 409 Sq. Ft. THIS APPLICATION IS FOR (® all that apply) Absorption Field Septic Tank Holding Tank ❑ Privy El Private Well Water Storage Number of Bedrooms y THIS APPLICATION IS AN: Initial Upgrade Renewal I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Ot' :�r Waiver Fees: Date of Payment: Receipt Number: 9S� Receipt Number: (Rev. 11105) k0k, SPLIT almd Eimgome olmg Environmental Consulting and Design SEPTIC SYSTEM DESIGN Lot 17 Block 2 GreenBrook S/D Municipality of Anchorage May 23, 2007 Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 Subject: Septic System Permit Lot 17 Block 2 Green Brook S/D Ladies and Gentlemen: I am writing to request a permit for upgrading ofthe septic system for this property. The original system was installed in 1982. This system did not meet Health Authority Requirements in 1988 and a holding tank was installed at that time. Test holes excavated on the 9`h of May 2007 identified an area in the northwest comer ofthe property where an Advantex treatment system can be installed. The proposed system will serve a 4 -bedroom single-family residence. The lot is served by public water. Soils: Two test holes were excavated on May 9, 2007 under the supervision of Lars Spurkland. Generally speaking, the soils observed in test hole #I were dense silts unsuitable for the installation of aseptic system. In Test hole #2, a friable silt with rocks was observed between a depth of 2 and 11 feet. A percolation test was conducted at a depth of 4.5 feet and a percolation rate of 9.6 minutes to the inch was recorded. See the attached soil logs. Ground water was monitored from May 9'" through May 24`, 2007. Ground water was not encountered during excavation of the test holes nor during the ground water monitoring period. Test holes on the southern half ofthe property were conducted by Ted Moore of Flat Top Technical Services and conditions logged were similar to those encountered in test hole #1 Surface Water: A roadside drainage ditch along Algarin Drive, borders the property to the west, during break-up water is present in this ditch. The lot to the north has areas that are delineated as wetlands. Topography: The topography in the area of the septic system is generally flat. There are no man made or natural cut banks within 100 feet of the proposed septic system. The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or concerns, please contact me at 27-3916 Sincerely, LarsSpurkl d, P.E. 203 West 15o' Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng@gci.net sparM almd Enuhmewhmg Environmental Consulting and Design SEPTIC SYSTEM DESIGN GREEN BROOK BLK 2 LOT 17 Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 May 23, 2007 We are submitting an application for the upgrade of septic system for this lot. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable testholes are also enclosed. The septic system design is based on the following: No Ground Water Observered Use Advantex treatment system Soil Rating. From Testhole 05/9/07. 9.6 min/in = 5 gal per sq.ft/day Design Rate = 4 gal per sq. ft./day No. of Bedrooms 4 Required Area per Bedroom: 15014 =37.5 sq.ft. Total area required: 37.5 x 4 = 150 sqft Bottom Rock At 5 feet Top Rock At 2.5 feet Rock Depth 2.5 feet Total Bed Length 150 /5*.64 = 19.2 feet USE 20 FEET SYSTEM CONFIGURATION ADVANTEX W/ 5 -WIDE TRENCH TOTAL LENGTH 20 FT TOTAL WIDTH 5 FT TOTAL DEPTH 5 FT ROCK DEPTH 2.5 FT INSULATION 21N. COVER 2 FT (MIN) 203 West 15'h Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net I LOT 9 � � f rr II r l l r l / 1 / �I CD I ILOT 16 NN VACANT LOT 20 GA,�o'�. LOT 3 LOT 2 I LOT 19 SVP �l P LOT 17yePt�. III �Ar'en \ V / rr rrr LOT 1 LOT 18 — -- — — — -- — — — -- — - _ NOTES' ��•• �,•""',,,,•�� 1) SUBDIVISION SERVED BY COMMUNNY WATER.• '�P:••' �� Arcq J° 49th °•�� ...:..... .............. . /............ r f 'L S SPURKLAND ••♦ 50 0 50 100 150 200 250 1;$$I�•• 300 SCALE., 1' = 100 FT SPURKLAND ENGINEERING 203 W 15TH. AVENUE GREENBROOK BLOCK 2 LOT 17 SEPTIC SYSTEM DESIGN ANCH. AK. 9916 DR. GEORGE SE/GFR/ED DA TE- MAY 25, 2007 907 179-3916 13035 ALGAR/N CIRCLE SHEET 1 3 GRID: 2630 / PERMIT # SW070XXX PID # 016 -141 -XX 6REENBR17OKB2L17DI.DWG I I LOT 16 1 I VACANT INSTALL 4–BEDROOM SEPTIC SFTEM I v I 1500 ADVANTEX TANK W/ APO POD & LIFT STATION 20 FEET LOT 20 ' I V - _ - - _ WIDTHT 5 FEET TOTAL DEPTH 5 FEET / v ROCK DEPTH 2.5 FEET INSULATION 2 /NCWW _ — v1 COVER 2+ FEET V, TH , , v THI / / / LOT 19 V L L ,' v / / / Gne ccva 5 / ABANDON EXISTING SYSTEM PER / 11 M0A CODE REQUIREMENTS / �zQ4 re rot nt5w , / V l LOT 2 L17T 17 �� LOT 1 9 nOF M �•' �� 49th i /...()..a...-..-....�...' ........... LOT 18 1 1.... .. ..................... . I0. ,. LARS SPURKLAND 1�AV 1 1�✓,I, No, cE iisao � ti�i 25 0 25 50 75 100 125 150 1 I •••; t' ��•• SCALE 1' = 50 FT. I I 03 W � TH. A nu r L. I I GREENBROOK BLOCK 2 LOT 17 I I SEPTIC SYSTEM DESIGN 203 W 15TH. AVENUE ANCH. AK. 99501 DR. GEORGE SEIGFR/ED DA TE- MAY 25, 2007 1907) 279-3916 13035 ALGAR/N CIRCLE SHEET. 2/3 GRID: 2630 PERMIT # PID # GREEN5RO7KB2L17D2.DW6 L 9 THI* 15 0 6" JIM CAP 24" ADVANTEX AX20 POD INSULATED RISER is r. 6" Pump—OUT fi OPTIONAL SLIDE SECTION OF 6* PIPE OVER THIS CONNECTION TO PROVIDE SHEER PROTECTION— EXTEND TO BRIDGE EXCAVATION 12 SPURKLAND ENGINEERING 203 W15th Ave GREENBROOK BLOCK 2 LOT 17 SEPTIC SYSTEM DESIGN Anchorage Alk 9950 DR. GEORGE SEIGFRIED DATE, MAY 29, 2007 -u3z22lL— 13035 ALGARW CMUE SHEET, 314 GRID- 2630 PERMIT I SWO70OXX PARCEL ID I GREENDROOK8207D3.M r To Advantex Unit 1 1/4' Schedule 40 PVC 3/16' Holes at 18 inches Monitor 5-Wide Trench! O 5' Wide 20' Long 5' Beep 2.5' Sewer rock 2' Insula tion 2' Cover ON .. .......49th ..... .....I.... .. i NO SCALE ••........ 0• . 0 D�., LARRSSPURKLANAN �1�'p`; Monitor No C -11500 =: ON% it .......Unit 2 Cover lain) 2' Insulation Silt Barrier To Advantex 2,5 Ft of Septic Rock Effective NO SCALE SPU203 W1AND ENGINEERING 203 WAve GREENBROOK BLOCK 2 LOT 17 SEPTIC SYSTEM ASBUILT Anchorage ge Ak 99501 DR. GEORGE SEIGFRI£D DATE, MAY 30, 2007 13035 ALGARUN CIRCLE SHEET: 4/4 GRID: 2630 PERMIT I SWO70OXX PARCEL ID GRE£NBROOK82L17D4.DWG Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519£650 www.d.anchoraoe.ak. us (907) 343-7904 � Ylg�apeGGK� c�q TH Soils Log - Percolation Test ril Performed For: Dr. G4oaa6 S ie. fe"I Date Performed: Legal Description: Qr san 6ar•eola_ ZZ t;, t'} Township, Range, Section: g1 Depth 1 11 L I WAS GROUND WATER ENCOUNTERED? Nb 5 IF YES, AT WHAT DEPTH? "" L Depth to Water After O P Monitoring? E Date: PERCOLATION RATE i %U (mnutemneh) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS PERFORMED BY: L'AJ urFd I L ERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE ITH ALL STATE AND MUNICIPAL GUIDELI - IN EFFECT ON THIS DATE. DATE: 9J8_0 >~ Municipality of Anchoragei � NGIN Development Services Department ; `'' 49 Tfa 4 Building Safety Division / , .a,.r Onsite Water and Wastewater Program 4700 South Bragaw St. ' S-. FP P.O. Box 19665rage, AK 99519650 0 Anchorage, �•• LARS c. Sr'l.Ri � c^ yr ci.anchorace.akus (907)343-7904 11 (��D •5/ p•; t � f'ROf S51( Soils Log - Percolation Test Performed For. Dr. GEo Rtre 5iG6Frir. c> Date Peffomled: .S e 03r - Legal Description: GREEN BROOK BIK Z LT 7- Township, Range, Section: L4Z Depth ORkANtG Top Soi Sil�, Criwe. Some, sm-A �X. 5 17-1 1 8.0. H 18- 19 - WAS GROUND WATER Date Gross Time ENCOUNTERED? p Net Drop S IF YES, AT WHAT DEPTH? OK"', L Depth to Weber ARer tl O Monitoring? to P Dere: 5 3 if Reading Date Gross Time Net Time Depth to Water Net Drop $-11 0Min OK"', tl 30 %67/.Q to 3 %$ It 3/Y if 4,11 60 ;' -4 f " 3118" ff `1 99 10 ;h -4'/ " 3116" It It 10:1 tl I ). PERCOLATION RATE q,%p (mlMeerim;h) PERC HOLE DIAMETER TEST RUN BETWEEN 9.5 FT AND _FT COMMENTS M't rwakld PERFORMEDBY: LaCS :$4rW2nj I ERTIFY THAT THIS TESTW S PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES EFFECT ON THIS DATE. DATE: .51910-+ I MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION �. DA&TMENT OF HEALTH AND HUMAN SEFOES Environmental Health Division JUL 1 198a 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTIO Name 1;arr S/0 ann e/ DISTANCE!; Address - FROM TO SEPTIC ABSORPTIONS WELL 13035 /4/ qr/n Ct/t/e TANK FIELD WELL �]� I C J� ( G ; Phone(s) 3x5_'-776`5_ Permit No. 8C9009 y No. of Bedrooms ly LOT LINE L �V LEGAL DESCRIPTION Lot l Block e Subdiv ision - b~k FOUNDATION Qst yQl 9 .0^ f Township, Range, Section p SCC 26J �- _f2 �/ /,. 3W SI r/. AS -BUILT DIAGRAM (Show location of well, septic system, property lines, foundation, / J TANKS ® SEPTIC&gsr/NG) ® HOLDING Clyiew) - Manw.aurer ! 1 1 —0tj I Capacity m gallons ,encu& e 2000 Material V No. of Compartments - St4e/ ! TYPE OF SYSTEM Exaf.I� ❑ TRENCH ❑ BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom from Total depth from original grade original grade FT F Fill added above original grade Gravel depth beneath pipe FT ption area Distance between lines S8 FT Imes Soil rating Pipe material SD FT WELLS Csm nunrll ❑ PRIVATE ❑ OTHER (ldenlitV) classification (A,B,C) ., Total Depth cased to vA It - FT FT REMARKS: I-Iv(oCrn S�lectfYc�xfiw�/'. v(3umP" t�s/a!/elf in line 51 bei�o+ a t?n lydrn /4476r }j &VI' e e 74(uc't Scale: Ili ,=,W j f - Inspections Performed by: {arrsrf So'Il «&corpixw/ I-rmcAi. Float sef f5ka o Teel, 9'61cr -fa frf Fr ax(aI'm C 2W be(ow AP nk Date: 77, ndy 29 /966 -J .T / Municipal and State guidelines in effect an Health Department Approval: to cattily that This inspection was performed a� ccording to all / I , f THWIRiRE F. MOORE CE - 3,589 V'q Dater+�+i ® Fro,°ession�, MUNICIPALITY OF ANCHORAGE Department of Health & Human Services 825 L Street, Anchorage, Alaska 99501 343-4720 ON - SITE HOLDINB TANK PERMIT Permit Number: 888094 Upgrade Date Issued: 06/24/88 Owner Name: LARRY SPANNAGEL Owner Address: 13035 ALBARIN CIRCLE ANCHORAGE, AK 99516 Parcel Id: 017-023-68 Lot Legal: Subdivision: Section: 26 Township: 12N Range: 3W Lot Size 57402 (sq.ft! or acres) Max Bedrooms: This Permit: 4 Total Capacity: 4 HOLDING TANK: Minimum Tank Size: 2,500 gallons, A high water installed on the tank and connected to the residence" Depth tank < 4,0 feet requires insulation over tank. Day Phone: 345-7705 alarm must be to top of holding HOLDING TANK TO BE INSTALLED PER ENGR'G SPECS IN LINE WITH EXIST ING TRENCH"DEPT. WILL REQUIRE CONFIRMATION BY ENGR THAT SYSTEM AJO IS FUNCTIONING ACCORDING TO SPECS. CONFIRMATION MUST BE GIVEN BETWEEN SEPTEMBER 1 AND 30, 1988" - CALL DHHS TO REPORT INSPECTION AT 343-4744 OR 343~4681" PUBLIC WATER PROVIDED TO THIS LOT" I CERTIFY THAT: 1" I am familiar,with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2" 1 will install the system in accordance with all MOA codes and regulations, and in compliance ith th d i criteria [ this it w e design es cr er a o s perm " 3. 3 will adhere to all MOA and State of Alaska requirements for the set hack distances from any existing well' wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4^ I understand that this permit is valid for a maximum of 4 bedrooms" I also understand that the capacity of the total system is 4 bedrooms and any enlargement will require an additional permit" Sig�ed: DATE: �~�'� .. ,� ��, �'�� ~� �r (Owner) LARRY SPANNAGEL � Issued By: DATE: -A�� CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. 14530 ECHO ST. PH: (907) 345-1355 ANCHORAGE, ALASKA 99516 June 22, 1988 M.O.A. Dep't. of Health and Human Services P. 0. Bos 196650 Anchorage, Ak 99519 Attn: Susan Oswalt RE: Septic System Upgrade - Lot 17, Block 2, Greenbrook S/D Dear Ms. Oswalt: As we discussed on June 9th, the following information is offered in support of our application for a permit to upgrade the wastewater disposal system on the subject lot by adding a holding tank at the downstream end of the existing trench system. The permit for the existing 4 bedroom system, which was issued in October, 1982, utilized a soil rating of 165 square feet per bedroom, based on perc test data submitted in 1981 by Alaska Testlab at the time of the original subdivision development. While their perc test procedures are not clearly spelled out, it appears that this rate was determined on the basis of a 16 foot deep bore hole filled with water, and thus bears little relationship to rates measured by currently approved procedures. Based on observations at the time of construction, the engineer supervising the installation of the trench increased it's size to correspond to a soil rating of approximately 250 square feet per bedroom. I conducted an adequacy test of the system on June 2nd of this year, and found the trench to have a surge capacity of slightly over 300 gallons, and an absorption rate approximately adequate for a two bedroom residence only. A repeat of the adequacy test on June 21 produced an identical absorption rate, indicating that soil tightness rather than seasonal groundwater is the factor causing the diminished capacity. The family reports that they have never experienced backups with normal usage. I then arranged to have two test holes dug to verify the absence of groundwater and determine the feasibility of upgrading the system. Test hole # 1 was located near the southwest corner of the lot in a location topographically similar to that around the existing trench. Below the surficial peat and loam, a uniform light gray, dense, dry silt extended to the bottom of the hole at 16 feet. No sign of water table was observed then or when rechecked on June 20. A second test hole was excavated in a slightly lower location where the ground surface was dipping towards a less well drained area. The same friable gray silt was encountered to a depth of 11 feet, where it was underlain by silty sand and pockets of cleaner sand. Slow water seeps were observed in the sand stratum, and on June 20 the water level in the monitor tube stood at 14.4 feet below ground surface. A perc test conducted between 10 an eet deep !n t e Erie a gray silt stratum showed a perc rate of approximately 240 minutes per inch with a 12 inch head, which is considerably slower than the minimum rate legally allowed for a soil absorption upgrade. Elsewhere on this lot the soils appear to be similar to those encountered in Test hole #1, while a nearly continuously flowing drainage ditch along the back of the lot precludes an upgrade anywhere along the east side. Based on surficial evidence, soils in the northwest corner of the lot are no better than in the southwest corner. Thus, no conventional upgrade of — the soil absorption system is possible. ` Since the owners report that the existing soil absorption system has never caused them any problems, and it appears to be capable of continuing to operate in a safe manner, I propose the non -conventional solution of leaving the existing system in place and installing a 2000 gallon holding tank beyond the end of the trench, with a small bump in the line to ensure that wastewater first flows into the trench. Thus, the holding tank will only receive effluent which is in excess of the capacity of the trench to handle. �o This will result in the holding tank requiring much less frequent pumping 71 than a conventional holding tank installation. cH Coupled with the existing septic tant,3—M gallons of holding tank storage capacity will be obtained..-A-h1gh water alarm will be installed as y, specified in the ordinance,-alTwing 1200 gallons of additional storage after the alarm is sounded. The proposed location adjacent to the driveway will fy¢- allow ready access for pumping, and make any possible failure visually OV apparent. There is no chance that future residents will allow effluent to be discharged onto the ground surface, since the configuration of the lot is such that effluent would back up into the house before it could surface. However secure, watertight caps will also be placed on all cleanouts. Please give me a call if you have any questions. I trust that you will agree that this is an appropriate solution for an unusual circumstance. Sincerely, Ted Moore, P.E. 1-07- 19 (VACANT) 9O Flattop Technical Serve I4530 Echo Street Anchorage, Alaska 9957r OT l6 VACANT L.G. T. 1, i -ERUTIHG � TRENCH / 4 =Pr.c Jam,, tt TRNk f \� I P &0o f44, AaM pR1vE&,Ar sf' /- O T /8 (VACAIY r) exicriK6 H CsaR�r Ho�t,E $(,OP+= EVALUATION THrS /,Or L{ 6FK=03 }LLY L, SVEL WITH A G614fLE sLaPE SE Oa THE DR10G64-4N1e Ttiu 1+R0S A L.GSl wttL DRAINED ARC -A —�� u bf c U/a�c w•� OF A % it 20a def :,�;•49TH' 6 ...................... .. : THEODORE R MOORE •• A CE -3589 ,•`w~a► s •. .• t,�q � f � Lor 2 0 NO NEAR r8Y � l�EVELG PME Ni / 2 1.GT t 'o j1 i LOT- 17, r3 /-OC rT 2 GREEh13f?OOK SID SITE PLAN DATE; 61ef/89 0LvM 3Y: r" NOTE; THIS if ND'r A SuRV�SeC PLAT. ALL LOCA7 ARE APPROXi"Are Lot 17, Block 2, Greenbrook S/D 13035 Algarin Circle Holding Tank Installation Specifications All construction materials and practices shall conform with M.O.A requirements. A Municipally approved 2000 gallon holding tank is to be installed in the location shown on the site plan. The line supplying effluent to the holding tank shall be connected to the end of the perforated pipe in the existing trench. A one inch "bump" shall be constructed in the line leading to the holding tank to ensure that effluent passes into the holding tank only when the existing trench is full. The existing trench monitor tube is to be remain in place. An audible and visual alarm shall be mounted in the garage at a location designated by the owner. This alarm shall be set to go off when 800 gallons of effluent has collected in the holding tank, leaving 1200 gallons of reserve. All cleanout and monitor tubes shall be equipped with watertight caps. attop Technical Services s I Awa 14530 Echo Streef Anch Ar •• ,'�,• v 4 e � Municip.1gyoncR6�ge5 111� ; DEPARTMENT OF HEALTH &HUMAN SERVICES "L" ®49 .........:... 825 Street, Anchorage, Alaska 99502-0650 0,,, !�g^!� SOILS LOG — PERCOLATION TEST 4 THEODORE F. MOORE CE 3589 opq o®a' T !7R # ! . - • PERFORMED FOR: L.,Q *—a4 a ptgg NV -tb; $S•11a,®0 DATE PERFORMED:_ LEGAL DESCRIPTION: 1,17. B2•E?p bI'ac�Fc` Township, Range, Section: DEPTH ipi- SLOPE SITE PLAN 1 1 S n sw ea ' 400,. 2 3 4 5 6 7 tj1_ 1,Tq q oly Srlf 8 dry, goose 9 10 WAS GROUND WATER ENCOUNTERED? IY 11 S IF YES, AT WHAT L 12'DEPTH? P A +lentB OT EisV E 13 Depth to Water After Ile rt A o of - Monitoring? Dale: 6Y20�6& 14- 15- 16-- 41516 8.11 17 18 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop M07 Cee eCrenc ;0 srmddte &EaAeica/ 1o(1� ee77/ Ja TEjt ,ye 2 PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER T1{ #/ TEST RUN RUN BETWEEN FT AND FT COMMENTS PPK M07 Cee eCrenc ;0 srmddte &EaAeica/ 1o(1� ee77/ Ja TEjt ,ye 2 PERFORMED BY: F14(64P S reAhn4a/ Seraecy -3,10+e /*'P . CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 6F�•� IBB 72-008 (Rev. 4/85) PERFORMED LEGAL DESCR DEPT a•S 2 3 4 5- 6 7 8 9 10- 11 SP 12 13- 14- 15-- 16- 17- 18- 191 314,516171819 20 *ttop Technical Services • 14530 Echo Street Anchorage, Alaska 99516 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST T. N. #P Pt Sr -f S'py,otj. loam P12 1,74P Devi. Self densCj friablt, Sh suy..saho4 w• FF..� rey,t M WAS GROUND WATER ENCOUNTERED? OF Al i °. .......................... . THEODORE F. MOORE P ,PA.° P. C`r_ - 3589 m'`A 4F DATE PERFORMED:_ 6161& Range, Section: bLUPL I IF YES, AT WHAT L DEPTH? S+G- ipetw O P E Depth to Water Alter Monitoring? r'f" Date: 6/20"M SITE Net Timetime Depth to Net Water Drop 3 : S2 28 1/1 Y : / 26 7/6 tReadingDateGross Y SB 2s v JPERCOLATION RATE ;—>(minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN f0.0 FT AND c/.O FT COMMENTS SP S'l'-bIAu/rt /,a>F [OCe/!/^en"oC q'1 02f fff fj Bn G� tuKf PERFORMED BY: F� %Cobntl Seocr 1 CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: _6121 /" 72-008 (Rev. 4/85) C"r04nif efe✓ of T.N. # 3'-v'fAan of T.M ikr anr•<. e4cc11;n7 repk'c MUNICIPALITY OF ANCHORAGE DEPARNT OF HEALTH & ENVIRONMENTAL PROTECTION *0 ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE NEW MF: 67 9�s I ❑ UPGRADE MAI LING ADDRESS�•. y� -SR o -_3 6,02 LEGAL DESCRIPTION > J� CST /Z.. LOCATION // // NO. OF BEDR'OOrS O Absorpti area DISTANCE TO: W L( Dwelling �T,,j`VO.nnggPERMI 4j1 y QManufacturer ~ -hl G �� L Materg � L CJ No, of. compl so V Liq. cap aci in gallons IF HOMEMADE: Inside length �0 Width Liquid depth �a2 DISTANCE TO: Well Dwelling PERMIT NO. SZFQ- Manufacturer Material Liquid capacity in gallons G DISTANCE TO: Well �g.(-j Found�tyon p'i Nearest to line PERMIT WT j LL Z W No. of lines Length of a ch Ia Total lengthof li es Trench width .Distance between lines P '3-0 inches Q H Top of tile to finish grader� 7 f Material beneath the F Total effect ve absorption area 2 al Length Width Depth PERMIT NO. C7 a F W �• Type of crib Crib diameter Crib depth Total effective absorption area w DISTANCE TO: Well- Building foundation Nearest lot line J Class Depth I Driller Distance to lot line PERMIT NO. J W DISTANCE TO: Building found 1 on Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SO3L SOIL TEST RATING 16 5 r' INSTALLER REMARKS e �ff✓L 1A1'Sn �� 7 CO'✓Lf� q, 0.,2225 E i RFs • N APPROVED DATE LEGAL �� i�:�8 G -c T /7If k- 2 eev�j,, 72-013 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE Department Health and Environmenta rotection 8251:0 Street., Anchorage,. AK.' 05.01 f 264-4720 Permit # # #HANDWRITTEN PERMIT # # # /O�RO�N-STTE SEWER : PERMIT / Applicant: % �i�nA p e e /Afailing Address.: SQ 7 600 l% Location.: -Phone. Number: Legal Description-:mm� Lost Size:.: Type of :Soil Absorption:System Is: Trench-: Drainfield: 'Seepage Bed: Holding Tank: Maximum Number of Bedrooms: Soil Rating(sq.ft/br) / $ She:Required S,ijze of-the:Soil Absorption System Is:' DEPTH.l � .LENGTH. `T 2L .'GRAVEL DEPTH::. I<P WIDTH_. The length.dimension is the length(in feet) of the trenchor_drainfield' The depth of::a trench .or pit is the distance.between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of..gravel 'between the outfall pipe and the bottom of the excavation(in feet). # REQUIRED SEPTIC(HOLDING) TANK SIZE := U .GALLONS # # Permit applicant has the responsibility to inform this department_during:the installation inspections of any wells adjacent to.this property and the number of residences that the well will.serve. # # # TWO(2) IN"SPECTIONS ARE REQUIRED # # # Backfilling of any system without-finalinspection and approval by this department will:.be_subject.to prosecution. Minimum.distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well _depending upon the type ofpublic well. Minimum distance from a private well to a private sewer line is 25 feet and to -a community sewer line is 75 feet. Well logs are required and:must be returned to this: department within 30 days of the.well completion. Other requirements may apply. Specifications and construction diagrams .are available to insure proper.,installation. # # # PERM.IT EXPIRES DECEMBER 31, 1 9 3.2 # # # _I certify that (1) .I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2)_.I will install the system in accordance with codes. (3) ILlicant and that the on-site sewer system may require enlargement if eence is remodeled to include more that Icfbe ooms. Signed: Issued by: p Date: la/- 740" SWP/024(1/81) 4040'•0"St,eet •gnchorage, April 17, 1981 W.O. #A19708 Second and Fourth Anchorage Limited Partnership 4611 Business Park Blvd. Anchorage, Alaska 99503 Attention: Mr. Les Pace Re: Subsurface Investigation for Suitability of On -Site Sewage Disposal,'Lot 4, Block 1; Lot 2, Block 2; Lot 3, Block 2; Lot 8, Block 2; Lot 9, Block 2; Lot 10, Block 2; Lot 17, Block 2; Lot 19, Block 2; Lot 26, Block 2; Lot 3, Block 4; .-Lot 4, Block 4; Lot 6, Block 4; Lot 12, Block 4; Lot 13, Block 4; Lot 14, Block 4, Greenbrook Subdivision Dear Mr. Pace: During :larch and April of 1981, we drilled a 15 foot boring on each of the above lots and placed a perforated, 3/4 inch PVC pipe in each hole so that the water table could be monitored over a period of time and a percolation test run in the hole. The holes were drilled using a Nodwell mounted, Mobile.B50 drill rig owned and operated by Denali Drilling, Inc. The drilling was supervised and the test holes logged by Mr. Ted Krupka, senior technician, and Mr. O.M. $atch, geologist with Alaska Testlab. After the holes were drilled, our technician returned on several occasions and checked the water level in each of the test holes. After a period of time the holes were saturated, left to stand overnight, saturated again and a percolation test run. The percolation test was run by monitoring the drop in the water table elevation at 10 minute intervals for a minimum of one hour. The percolation rate listed in this report was computed using the slowest 20 minutes of that percolation test. Included with this report is a test hole location sketch for each lot and a log of the boring placed on each lot. The results of this exploration are described as follows: Lot 4, Block 1 The water table elevation measured in the test hole at this site remained fairly constant at about 12 feet. The percolation rate measured on April 15 was 6.0 minutes/inch. Because of the need to keep the system shallow and the high silt content, we recommend a more conservative design percolation rate of 10.0 minutes/inch. rate was 5.2 Onutes/inch, however, we remmend�a design rate of 10`.0 minutes/inch. Since the seasonal water level is quite high, we recommend a mounded disposal system so sufficient separation is achieved. Lot 10, Block 2 The test hole was located in the southwest corner of the lot, and we recommend that the.sewage disposal system be placed in this area. The water level is quite near the surface towards the front of the lot. The water level while drilling on April 8 was 9.0 feet, then was found at about 12 feet over the next few days. On April 14, the percolation rate was measured at 2.5 minutes/inch. We recommend that a more conservative rate of 10.0 minutes/inch be used, due to the silty nature of the upper soils. The system should -be placed as high as possible, in the upper 8 to .10 feet, to avoid conflicts with the seasonal high water, mounding may be necessary for insulation. Lot 17, Block 2 No ground water was encountered while drilling on this lot on April 8, or when checked again April 9 and April 16. The measured percolation rate was 5.4 minutes/inch, however, we recommend a more conservative design rate of 10.0 minutes/inch because of the siltier nature of the soils. Lot 19, Block 2 No water table was observed in the 16 foot test hole while drilling on April 8, or on April 9. The percolation rate was measured at 8.9 minutes/inch, however, we recommend a more conservative design rate of 10.0 minutes/inch because of the silty nature of the soils. The system should be placed as high as possible, as high seasonal water levels were found in the immediate area. Lot 26, Block 2 The test hole no water was The measured was drilled near the center of the lot Observed. The test hole was also found percolation rate was 6.2 minutes/inch. Lot 3, Block4� \ No water was observed in on April 8, but was at 12 percolation rate was 14.6 should be kept as high as April 8, and dry April 9. the test hole at this site while drilling .5 feet the following day. The measured minutes/inch. The disposal system Possible to avoid conflicts with the ___Pth i- Fro_ == 0.0 1.0 1.0 2.0 2.0 16.0 Bottom of Test. Hole. Frost Line: Free Water Level: Date7•yp09 Logged by: ;710. at, Lesorl Brown Peat, Pty tion F-4, Brown Silt, --- ML, moist, stiff, F-4, Brown Gravel,NP Stiff, NP,3 m�y SandY Silt mum' ML, moist Set 3/4« ' and to monitorperforate water d Ptab�epe tO run perc test elevation Re commended Design Perc RateeS/inch, 10.0 minutes/inch. 16.0 Feet 1.0 Foot 4/8/81 - None Observed 4/9/81 _ None Observed 4/16/81 - None Observed • • -t• • Municipality of Anchorage °A On-Site Water and Wastewater Program v I r (907) 343-7904 SAFETY Certificate of On-Site Systems Approval Parcel I.D. 017-023-68 Expiration Date: 5��8 1. GENERAL INFORMATION Complete legal description Greenbrook, Block 2, LotI7 Location (site address) 13035 Algarin Cir. Current Property owner(s) Paul & Melinda Ashner Day phone Mailing address 13035 Algarin Cir. Anchorage, AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class 'A' Well Q Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: , I/ -1�` / Date: 5/9/c2r)i?— COSA to be released to the engineer, unless otherwise requested by th gineer. COSA Fee $ 526, Waiver Fee $ Date of Payment 41/26[/ Date of Payment Receipt Number 3 Y I5' Receipt Number COSA# 635C-r?//4/(/ 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 listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven I. Pannone Date 4/24/2017 %OF .cS ; *: 49 - /0MO" • *y 6. DSD SIGNATURE •• ••' V System #1 Approved for t_( ,bedrooms • .Steven . Pannone • or--- .•. CE-6149 System #2 Approved for bedrooms 9s••• Disapproved �'k OFESSOlk\-- 1" \NN�`i` Conditional approval for bedrooms, with the following stipulations: By: ��n � Original Certificate Date: 5/07 The Municipality of Anchorage velopment Services Division (DSO) 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 blue sheet_f - If more than 1 septic system is on the lot: COSA Checklist# 1 of Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: Greenbrook, Block 2, LotI7 Parcel ID: 017-023-68 A. WELL DATA Well type Class 'A' If A, B. or C provide PWSID # 21 0346 Well Log (YIN) Date completed Sanitary seal (YIN) Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: Collected by. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Advantex/Steel Date installed 10/4/2007 Tank size 1 ,500 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (YIN) Y Date of pumping N/A Pumper None C. ABSORPTION FIELD DATA Date installed 10/4/2007 Soil rating (g p.d./ft2 or ft2/bdrm) 5 GPD/SF System type Shallow Trench Length 20 ft Width 5 ft Gravel below pipe 2.5 ft. Total depth 3.7* ft. Eff absorption area 1 56 ft2 Monitoring tube Y Depression over field N Date of adequacy test 9/23/2016 Results (Pass/Fail) Pass For 4 bedrooms 0* ` U.00 0* Fluid depth in absorption field before test in Water addedgal. New depth in. Elapsed Time: 310 min. Final fluid depth 0* in. Absorption rate >= 600+ g.p.d. No Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date D. LIFT STATION 950 Date installed 10/4/2007 Size in gallons-1751'1°1491' Manhole/Access (Y/N) Y 9 (..GA�n� "Pump on" level at "� y�. "Pump off' level at ' ' 36 in. High water alarm level at -- (1S in.pe' Bottom of Tank 5 ` f° Datum Cycles tested Meets alarm &circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Absorption field 5+ Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 200+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+ Curtain drain 50+ Wells on adjacent lots 200+ F. COMMENTS *Monitor tube appears to be 20" too shallow. G. ENGINEER'S CERTIFICATION �� OF ,4 t1 AN-4. Si. I certify that I have determined through field inspections and .• �)� .•..kl �� review of Municipal records that the above systems are in f it?..' • • 11 /`‘11.1...'* •, conformance with MOA COSA guidelines in effect on this date. !01•• � ��•- Engineer's Printed Name Steven Pan none ":Sleveri�. Pannone . fro CE-8149 Date 4/24/2017 ��}iqs•, / t� sv. COSA canary sheet_2-6-15.doc ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this r) Day of 41,4i 1 of 20 /7, by and between PCS in i,T, a Slt 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: I. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as 4aCvx located at(legal description). J 7 Ba 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 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. 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: 'Pa/:c-�' ,l `r1 C of ag 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 AIaska 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. By: /Y ,u cP2 O , (signature) Date: y1/4-0/i 7 P C C f h'1 f u AJ374-¢ hvjj(print name) STATE OF ALASKA ) )SS. THIRD JUDICIAL DISTRICT ) The foregoin l instrument was acknowledged before me this 2Uday of ft-Orr#j''d� 2017 , by 0, Sh . • 4 • P(kUL.\ �h►' x. d �`-- I-Aka VAL NOT IP ' be I OR ALASKA * :`' My Co issio expires: J U.x'& 2-%J•1 2::) II \>>•. ,. a •'` ' ems ....••• MUNICIPALITY: BY: �� (signature) (/7��7 (print name) Date: LTttle: Municipality of Anchorage Development Services Department $F'V Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 01-1-023-- toB COSA # 8C C3fZ� Expiration Date: ( C,17 1. GENERAL INFORMATION Complete legal description Greer Jroob 9Z L I T Location (site address) 13035 A I4Gri `i c 2 Current Property owner(s) _lif, 6$ e6rgp se j t<li ej Day phone Mailing address 13035/{ �ayri.� Circe t Anr_6Q ave 4k 9 15((o Lending agency Mailing address Day phone Real Estate Agent ..81- &i.5 i.5 Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: �( 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. 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 504r 1A3nA �r15+�Qeti nk Address 203 W, 15t" A fe,. /lnc6rcX 4! .A KYj5D1 Engineer's Printed Name LAf� Saur-12AGvtc' 5. DSD SIGNATURE E/ Approved for Disapproved. bedrooms. Phone 277-371(o Date IZ ao o" OF, A i� l CO. i :4TH �. �t ... i ..1.........• LAPS E. SPURKLANDy 3 .fes P .12200� Conditional approval for bedrooms, with the following stipulations: Attachments COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: (1/fid/ , —Original Certificate Date: — 08 (Rev. 11105) Municipality of Anchorage e Development Services Department Building Safety Division On Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: green 6roc L B1k Z LA IT Parcel ID: 43 6S A. WELLDATA P,61.- VJoJCA. Well type — If A, B, or C provide PWSID # = Well Log (Y/N) — Date completed = Sanitary seal (Y/N) — Wires properly protected (YIN) Total depth — ft. Cased to — ft. Casing height (above ground) — in. FROM WELL LOG AT INSPECTION Date of test — Static water level ft. ft. Well production g.p.m. — g.p.m. WATER SAMPLE RESULTS: Coliform s colonies/100 mL Nitrate — mg/L Other bacteria _ colonies/100 mL Arsenic: _ mgll Date of sample: — Collected by: B. SEPTIC/HOLDING TANK DATA j Tank Type/Material nc6 m 1 n S el Date installed 104k_+ Tank size 15M gal. J Number of Compartments Z Cleanouts (YIN) Y Foundation cleanout (Y/N) _�L Depression over tank (YIN) /V High water alarm (Y/N) / Date of pumping NP a1 Pumper NQk/ C. ABSORPTION FIELD DATA Date installed 401 10 0 Soil rating (g.p.d./ft' or ft /bdrm) -5 System type 5 -W,J e - Length 20 ft. Width 5 ft. Gravel below pipe 'Z 15 ft. Total depth -5 ---ft. Eft. absorption area �ftz Monitoring tube -)L Depression over field `V Date of adequacy test Al r.Nl Results (Pass/Fail) New) For Awbedrooms Fluid depth in absorption field before test AJf MJ in. Water added-)C,4gal. New depth M4 in. Elapsed Time: 164 min. Final fluid depth I V_VJ in. Absorption rate >= Nt W g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N@aN1 If yes, give date N t NI D. LIFT STATION Date installed 10 0 "Pump on" level at -SP- in. Datum Aur holt R.i m E. SEPARATION DISTANCES Size in gallons 1500 "Pump off" level at 11 in. Manhole/Access (YIN) T High water alarm level at Yv Cycles tested 14-1 Meets alarm & circuit requirements? Yes SEPARATION DISTANCES FROM WELL ON LOT TO: p4w," WJu Septic tankilift station on lot Absorption field on Public sewer main Sewer /septic service line Animal containment areas On adjacent lots '— On adjacent lots Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: 1 Building foundation f 5 Property line + 101 Absorption field +5 I r r Water main +10 Water service line +10 Surface water + 100 1 Wells on adjacent lots + 7150 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10"t Water Service line 10 1+ Curtaindrain NoAe,Obw,/"� F. COMMENTS: G. ENGINEER'S CERTIFICATION I Building foundation 10 4 Surfacewater 100 1-- t Wells on adjacent lots 2W t 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. Engineer's Printed Name LArs SO4r DateITIO-' COSA Fee $ 030 Date of Payment_7 Receipt Number I03U3g SIG✓ (Rev. 11105) c Water main ID 1F r Driveway, parking/vehicle storage 10 '1' Waiver Fee $ Date of Payment Receipt Number 49TH' m'. LARS E. SPURK ND;� 11 00' i i1 �F:.It,��o�.•cLC�C?.� D M N M W 0 a a� � > 50,08G SYstem N I O / J / O 00s89a- Y � .W c V G_ 00'99 3AO,Olo90N N' M -3'70810 obigo CY " I 2i 9�a'YJ • �' Y VJ . � 4 5 Qz a M ❑r a o w W K 2 b OU ir O � O O U J W J Q Qz F W ❑ ❑ Z Uw O ❑ w W K 2 b OU ir z 0 O �I O U U 0 O z W J Q W N it w a N f U) w a MUNICIPALITY OF ANCHORAGE • _ Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I. D. # D / 7 r D x3 — G 7 HAA # 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) l.of 17 , [dock, 2, 6-re"6rooir S/z Location (address or directions) 13o3S Accrin Grcle (b) Property owner Aarry Seunn5ye/ Telephone : (home) ?yr- 7705- Business Mailing Address IWS- AV!_arl., Grcte., _c ha ori �¢h 9g5-' 6 (c) Lending Institution .Sea lScf 60n1or Telephone Mailing Address P.O. Pox 61Y103, Sea Me , Wetrh,7y17 9BrZY (d) Real Estate Company and Agent i?e /•yux eMeerfi<r — Caiay Lbu l$4 ?owfw /ie nda, Address 26-oo Cor d0um S'i-, At"t 99500 Telephone 276 - 276i (e) Mail the HAA to the following address: (or check here ®, if hold for pick up.) List contact person and day phone number below: h'rucre 3 V15-- 2. s-- 2. TYPE OF RESIDENCE Single -Family 91 Number of bedrooms H 3. WATER SUPPLY Individual Well ❑ Community % Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site g1 Public ❑ Community ❑ Holding Tank 72-025(Rey.7/Ee) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional .and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Flatly TecGr r �u / Setvr cb Telephone 3yS- i 34'S Address 111,5'30 ECiro V /f/+ cAo/ 7f, /}h 995'1 Date SeyAem b NOTE; ThC u-netlYcca.,<er d �r`notu! s ys tem rt a hl brig cu,kh Yz 14e, e,_&j; � Cu�aC,A ber y huncll<d by e Soil✓ absore/rwi �nu+cb� aAc,( -1ht r'eMar.,dv by fl+e holdi,7 /a,7 /r. Nufi,; y v� I*e hold, )Aan!* wru be htCtlf�t✓%J riCi'e.rr�y /Jtr'toGil OJ h�'� 6. DHHS APPROVAL Approved for 64 bedrooms by Approved X Disapproved Terms of Conditional Approval O A44 4. .. °..... ....... . iHeODORE F, n1GORE j � 0,o.% CE -35£39 J wA7 Encdyt es.$eal �4, den, resd Conditional CAUTION Date ,7- /;5-Fil ., .. The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections oranalyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors oromissions in the professional engineer's work. 72-025 (Rev. 7188) Back Page 2 of 2 CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE E. MOORE, P.E. 14530 ECHO ST. PH: (907) 345-1355 ANCHORAGE pTA`��p %516 September .11, 1988 MUNICIPALITY dE ANCI CJAAC,E DEPT, OF HEALTH & ENVIRONMENTAL PROTECTION M.O.A. Dept, of Health and Human Services SEP 121988 P.O. Box 6-650 Anchorage, AK 99519 RECEIVED Attn: Susan Oswalt RE: Lot 17, Block 2, Greenbrook S/D - Holding Tank Installation Dear IVIS. Oswalt: As agreed, on September 8 1 reinspected the holding tank installation on the subject property to assess performance of the hybrid system after several months of operation. On the date of my inspection the monitor tube from Test Hole #I (dug prior to the holding tank installations still indicated no groundwater within 16 feet of ground surface. The holding tank, itself, was bone dry, indicating it had not yet received any overflow from the soil absorption trench. The fluid level in the trench was 77 inches below ground level, as compared to 58 inches below ground level on June 2, when I conducted the original adequacy test. Based on these observations, it is my conclusion that the hybrid system is functioning according to design, and has saved the owner the necessity of pumping the holding tank several times already. Accordingly, I am enclosing a new HAA blue sheet for reissue of approval without conditions. Please feel free to give me a call if you have any questions. Sincerely, J -c Ted Moore, P.E. 0 0 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISI N OF CERTIFICATE OF INSPECTION OPECTION FOR ENVIRONMENTAL EALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application DateX" ('y I. /988 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Q. (3(bCkC �� 6rfen Smack Location (address or directions) (b) Property Owner {arra MMAn aq?/ Telephone: Home 3YS-77oS Business Mailing Address ccrin Circ/e �./}nC1Wnzr/Q,. Ak 9,95-1,r- (c) 9S7,r-(c) Lending Institution Sect Piirrh '34nfr Telephone Mailing Address P.O. OOx G3y(o3 SBxffte GC/or�ii �y 98rZy (d) Real Estate Company and Agent ✓�� Mux Pioptrhv — Care! poaftir¢ Address 2d'007 tornfow SA y /tinc�torat�� g9.9a3 Telephone rr.,c (e) Mail the HAA to the following address: or: Check here 5r, if hold for pick up. List contact person and day phone number below. -rgr( t-roo'e 3%S--136-3' 2. TYPE OF RESIDENCE Single -Family Number of Bedrooms 3. WATER SUPPLY Individual Well ❑ Community® Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL — HybrrrW- Syt%r," Onsite ® Public ❑ Community ❑ Holding Tank Note: If communitywell system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (Rev 8/86) Front 0 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Flu14100 TeChnicc' Ser-✓;ta Telephone 3 `1S-l3ss Address !'1530 Echo Sl� .. Iirt�G�r�� A� 9�S f6 V Dated (988 Aare; The cr.•e kw«1-er Sy.0 A" it a Ayhrid� '/i Ae c.&r�m catp4t6Ay Gtnc>; %tie Y-eina+nder b, PAe /V,7 h. P",01"7 v *e he(dryi f be necm-,Saryl dctr"7f C,f huh denanex. 4/.�•9,unskly he,:!;r Aa�m�� r fife Sar/ =6,-a,?1=n irendi� OF At� reg * 49L.... I . j`�., Engineer's Seal ® : THEODORE F. MOORE ; Q CE = 8589 mow` B 6. DHHS APPROVAL y Approved for ` (/) bedrooms b Date Conditional Termso Conditional Approval ,V 12-7l63 CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 _ 72-025 fnev e+as) Back •MUNICIPALITY MUNICIPALITY OF ANCHORAGE OF ANCHORAGE • ENVI l . r _ ENVIRONMENTAL SERVICES DIVISION ONMENTALEALTH pROTECTION LJ>J} MUNICIPALITY OF ANHORAGE (MOA) HEALTH AUTHORITY A13PROVAL (HAA) - 1 1988 1988 CHECKLIST - FEBRUARY 1984 RECEIVED 264-4744 RECEIVED Legal Description: tnof tZ g/odr 2, �'teCn �jrook' S /D A. WELL DATA Well Classification a14 If A, B, C, D.E.C. Approved (Y/N) Y Well Log Present (Y/N) bate Completed Yield Total Depth Cased to Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot On Adjoining Lots To Nearest Edge of Absorption Field on Lot On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by Date Water Sample Test Results Comments ro Ona / o,erAkccr,/% cLfiuc rio{ SS B. EPTIC/HOLDING TANK DATA CS) 11/8/82 (S) 12&Vf°"/ S) Z Date Installedd) 6IM/BB Size eOOO o/ No. of Compartments Standpipes (Y/N) v Air-tight Caps (Y/N) Y Foundation Cleanout (Y/N) Y Depression over Tank (Y/N) N Date Last Pumped Pumping/Maintenance Contract on File (Y/N) AGR, for twA. Holding Tank High-Water Alarm (Y/N) Y Temporary Holding Tank Permit (Y/N) Y Separation Distances from Septic/Holding Tank: To Water -Supply Well > 200To Building Foundation 2S'L (H) YL To Property Line W 20 �N� 15' To Disposal Field &H) f 2 To Water Main/Service Line > 231 To Stream, Pond, Lake, or Major Drainage Course > 100 r Comments Ina /ank inSfac!/e-,-t fv waec!6e wbt� e2fe red tKGeeds french Cct�cL�,. Page 1 of 2 72-026 (Rev. 8/86) Front • 0 C. ABSORPTION FIELD DATA Per c[!-6010 Soils Rating in Absorption Strata 26-0 47(18a lr Type of System Design ?rent/) Date Installed tl /61'82 Length of Field 6 ?' bel -V C. o, !t Width of Field 26, Depth of Field IV, Gravel Bed Thickness Square Feet of Absorption Area 992 Standpipes Present (Y/N) Y Depression over Field (Y/N) H Date of Last Adequacy Test 6/2/68 Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well 7 20Yi' To Property Line JS'� To Building Foundation yO� To Existing or Abandoned System on Lot N.A. On Adjoining Lots >30 1 To Water Main/Service Line 7 to To Cutbank (if present) N.A. To Stream/Pond/Lake/or Major Drainage Course 5 too To Driveway, Parking Area, or Vehicle Storage Area 271 Comments Y bedrOOM etde4;?0Lc9C,, aeehieveeC /find Coir Lrnaitcg o0� tr>!icb t ha(diy Aalk D. LIFT STATION NA Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments — Dimensions Manhole/Access (WN) "Pump Off" Level at Vent (Y/N) ** Check Permitted Bedroom Rating Against HAA Request ** Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed � - .F A"C, Date 7/ //A9 Company fnhMw Teal+ Sc cr MOA No. 86 Receipt No. -� Date of Payment Amount: $� " Page 2 of 2 72-026 (Rev 8/86) Back ...'-UHL F. My ,DpC CE -3589 Enginebr's Seal USE� STEVE COWPER, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 563-6775 3501 C STREET. SUITE 1334 ANCHORAGE, ALASKA 99503 DATE: Z7-� PWSID #: To Whom It May Concern: According to the records on file in this office, the 6_re vNNDf�o S-"'Qc�-u--_--_-_-..._____ Water System is in compliance with the State of Alaska Drinkinq (.later Regulations. Sincerely. Ronald S. Klein Environmental Field Officer RSK:sa MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date 12/23/35 (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 17, Block 2, Greenbrook Subdivision Location (address or directions) 13035 Algarin Circle (b) Applicants Name Lav4rence & Linda S anna el Tele p 345-7705 276-1655 p 9 hone - Home Business Applicants Address 13035 Algarin Circle, Anchorage, Alaska (c) Applicant is (check one) Lending Institution ; Owner/builder ! 1 ; Buyer ; Other [::I (explain); (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: 2. Type of Residence Single -Family' Number of Bedrooms 3. Water Supply Individual Well El Multi -Family four Other (describ Community Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal OnsiteF7, 7 Public Community Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental ConEWrvation attesting to the legality and status. [Page 1 of 2] 5. Engineering Firm Providing Inspections, Tests File Search Data and Information As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 Naanicipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm A. W. Purfitt Company Telephone 349-7531 8010 Kin Date December 23, 1985 6. DHEP Approval Approved forl"Ocs— &(r4� bedrooms AK 99518 (ENCINEER SEAL) Approved _y_ Disapproved Terms of Conditional Approval CAUTION e � t,io ' 6 .z AHnn W. IAr In Na. 497-E °p„n` ,-q' nor":.SSkI1�` Conditional THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/DI8 [Page 2 of 2] 7-19-84 MUNICIPALITY OF ANCHORAGE (MOA) 98619 Z 330 HEALTH AUTHORITY APPROVAL (HAA) NOIJ-D3106d 1VJN3VyN00AN3 CHECKLIST - FEBRUARY 1984 IIV 'S liNV d A '!dp Legal Description: Lot 17, Block 2, A. 6ELL DATA N/ Nb io nddarNnW Greenbrook Subdivision Well Classification If A, B, or C, D.E.C. Approved(Y/N) Well Log Present (Y/N) Date Completed Yiel Total Depth Cased to Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) Separation Distances frau Well: To Septic/Holding Tank on Lot On Adjoining Lots To Nearest Edge of Absorption Field on Lot ; On Adjoining Lots_ To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected By Date Water Sample Test Results B. SEPTIC/HOLDING TANK DATA Date Installed 1982 Size 1250 pal No. of Catrpartments two Standpipes (Y/N) Yes Air -tight Caps (Y/N) Yes Foundation Cleanout (YIN) Yes Depression over Tank (Y/N) No Date Last Pumped 7-27-85 Pumping/Maintenance- Contract on File (Y/N) 1)do ; for N/A Holding Tank High -Water Alarm (Y/N) No Temporary Holding Tank Permit (YIN) No Separation Distances from Septic/Holding Tank: To Water -Supply rtbil N/A To Building Foundation To Property Line 10' To Disposal Field _ To Water Main/ServiLine 20To Stream, Pond, Lake, or Major Drainage M Course NIA Comments [Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 165 (permit) Type of System Design Trench Date Installed 11/8/82 Length of Field 62' Width of Field 2 1/2' Depth of Field 8' Gravel Bed Thickness 8' Square Feet of Absorption Area 992 Standpipes Present (YIN) Yes Depression over Field (YM) No Date of Last Adequacy Test 12/20/85 Results of Last Adequacy lest Satisfactor Separation Distance from Absorption Field: To Water -Supply Well N/A To Property Line 10' To Building Foundation 40' To Existing or Abandoned System on Lot N/A ; On Adjoining Lots undeveloped lots on each side To Water Main/Service Line 20' To Cutbank(if present) N/A To Stream/Pond/Lake/or Major Drainage Course N/A To Driveway, Parking Area, or Vehicle Storage Area 35' Cc mnents 600 gallons of water into system on days 1 and 2. Water levels returned starting (static) level. System adequate D. LIFT STATION N/A Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes(YM) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (YM) Pumping Cycles during Adequacy 'lest. meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. Signed Date / Z AS- Company A. W. h,urfitt Company MOA No. STA -015 KB1/d5/s [Page 2 of 21 2-15-84 7— Time APPLL4$NT FILLS OUT UPPER HA ONLY Time Property Owner -'i-' ,`. 1: , , ( -1, �y i Phone r _ _ i (... Mailing Address Zip Code Inspector Buyer Inspector Inspector Address Zip Code - Lending Institution &2l'1 :.f:f'j._,� Phone .fes Address �1L,,ji ; FT-Yi�i -d Zip Code ( ) DISAPPROVED Realty Co. & Agent ( ( CONDITIONAL APPROVAL' Phone Address Ii .-'; ? ';! Zip Code Legal Description - B _ Soils Rating Date Sewer Installed Street Location Well To Absorption Area Well Log Received 14 Type of Residence Well to Tank O'Single Family ❑ Multiple Family No. of Bedrooms ❑ Other Water Supply r❑ JEiclividual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. Community For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Sewer Isposal Individual Year Individual Installed:�� ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 7— Time Time Time Time Date Date Date Pate Inspector Inspector Inspector Inspector Field Notes: &2l'1 :.f:f'j._,� .fes APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ( CONDITIONAL APPROVAL' DATE B Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received 14 Well to Tank Septic Tank Size 72 023 (3/82)