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HomeMy WebLinkAboutMOUNTAIN VALLEY ESTATES BLK 2 LT 9-� Municipality of Anchorage �.f Development Services Department Building Safety Division IN -' On -Site Water & Wastewater Program, 4700 Bragaw St. ; P.O. Box 196650 Anchorage, AK 99519-6650 www.cf.anchorage.ak.us (907) 343-7904 Page 1 of 3 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SWO80157 PID Number. 050-641--16 Name: STEVE HEINLE Wastewater System: ❑ New ■ Upgrade Address: 4432 BIRDSONG DRIVE * EAGLE RIVER, AK * 99577 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 230-9393 3 []Deep Trench ■ Shallow Trench O Bed O btound OOther LEGAL DESCRIPTION $oil Rating: 2.0 Total Depth from a"grode: GPD/sq. Ft. 2.5 MAX FL Block: Lot: Subdivision: 2 9 MOUNTAIN VALLEY EST Depth to pipe bottom from original grade: SEE DWG. Grovel depth beneath pipe; 0.57 Ft. FL Township: Range: Section: Fu added above rxfglnot grade: Grwd length: _ — SEE DWG. Ft. 45 F, WELL: ❑ New ❑ Upgrade Grad wkdth: 5 Nurnb,r of &we: 1 Distance bet.son linea: M Ft. Clomhcabon PeNvto. AAC : Total Dep - Cased To: (BEDNOCK) Total obeorptkxf ono: Pipe material: Fz - n. 225 so. FL 3034/ F-810/SCH 40 Static Water Level: Installer: GREY'S CONSTRUCTION iJol• instaad: 2/5-6/2009 OrNler: `��� Date tMlled: Ex`s rt. YINd: Pump Set At: Height Above arauna: TANK GPY Ft. Ft SEPARATION DISTANCES a Septic O Holding O S.T.E.P. Manufacturer. ca ga$orm 'aseptic Absorption Uft Holding ubk/Private From Tank Field Station Tank Sower Lkw, X` Well -too'+ 100'+ 100'+ - 25'+ Material; Number of Comportments: surface Water 100'+ 100'+ 100'+ — — LIFT STATION Lot Lina 5'+ SO'+ 70'+ — — Size In gal«,.: Manufacturer: 500 PREMIER PLASTICS Foundation 51+ 10'+ 70'+ - ` on level at: off level of: Hqh water ok,rm at: TIMER TIMER 46 Curtain Drain 20'+ 20'+ 20'+ — ` Pump Yoke k Yo": Electrical Mspecttane Wonnod by: P—TE-30—PLUS RISING SON ELECTRICAL Remarks: *THIS IS AN AEROCELL UNIT BENCH MARK Lmabon and Descrlptlon: OLD DRIANFIELD WAS ABANDONED IN PLACE TOP OF GARAGE SLAB NEXT TO MAN—DOOR THE MOUND IS TOPSOILED AND HAND SEEDED A•fwmed Elevot;on: 100.00 h Inspections performed by: GEG, Ltd. Dates: 9st 2/5/2009 FNG1 WS •Qom EAL 2nd 2/6/2009 ,. OF 1� 3rd 2/6/200.9 S �� Development Services Department Approval p � ?,��da 011111- 1 Conditional approval: Date: p... .... ... .. .... 0 •.J fr Gar ess: Q C ..A`�vvO� Reviewed and approved b Date: ,,-*Opp 44poap �o��°� rOfeS3jan Oo O0000��a -X t;,o to V EA6 i o r vv\ o, CHT „LLL +-o o\_ OLf pre \j e- J - CLQ 1/ly( CA T 11 Q ui:L� ZZ :aca4ew`, qqnics GARNESS ENGINEERING GROUP, Ltd AeroCell+. ENGINEERING SALES CONSULTING Alaska Authorized Dealer January 7, 2022 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Rd. P.O. Box 196650 Anchorage, AK 99519-6650 (907) 343-7904 Ref: Mountain Valley Estates; Block 2, Lot 9 (4432 Birdsong Drive, Eagle River, AK) Memo concerning converting CAT III AWWTS to CAT II AWWTS septic system To whom it may concern: The permitted septic system was installed on the referenced property in 2009, with a tank upgrade in 2016. The system was started up shortly after the 2009 installation. ARM Septic Services, LLC recently checked the monitorina tubes in the drainfield and found them to be dry. In order to simplify the operation and maintenance of the system, we are proposing that this unit be permanently configured as a CAT II system. Our justifications are as follows. The receiving soil has a percolation rate of 20 minutes per inch. Given this percolation rate, a 4.0 gpd/sq.ft. application rate is required for a Cat III system and a 2.0 gpd/sq.ft. application rate would be required for a Cat II system. There is 2+ foot of MOA filter sand below the drainrock in this drainfield. After the effluent passes through 2+ feet of MOA filter sand, the effluent should meet Cat III effluent quality levels. The residence on this property has a total of 3 -bedrooms, so 225 sq./ft. of absorption area is required for CAT II effluent (450 gpd / 2.0). The existing 2009 drainfield has 225 sq./ft. of absorption area. In short, the drainfield meets Cat If sizing requirement for 3 -bedrooms without the consideration of the sand filter. The Inspection Report shows a 2.0 gpd/sq.ft. application rate, so it should not need to be amended At this time, we request that your department approve a CAT II configuration to be used at the referenced property, Upon your concurrence, ARM Septic Service, LLC., will remove the actuator from the ball valve or leave the valve in the open position, and place a CAT II sticker on the control p4bel. P. E., M.S. 3701 East Tudor Road, Suite 101 ' Anchorage, Alaska 99507-1259 Phone: (907) 337-6179' Fax: (907) 338-3246' Website: www.garnessengineering.com Page 40 of 45 C. Remote monitoring. Category II and III systems that rely on mechanical devices and processes shall be monitored remotely by the equipment provider or other approved entity. Exception: AWWTS's already approved without remote monitoring. D. Accessibility. The design of a system shall include provisions to provide access to all components that require maintenance and repair or observation. E. Buoyancy forces. An AWWTS holding or treatment tank subject to buoyancy forces shall be anchored or ballasted as required to prevent flotation regardless of the liquid level in the tank. F. Frost protection. All system components shall be designed for protection from freezing and excessive heat loss that could detrimentally affect the system performance. G. Disposal field sizing. Wastewater disposal fields shall be sized according to the requirements of the following table: Table 6. AWWTS Effluent Application Rates Soil Percolation Rate (minutes/inch) AWWTS Category Application Rate (gallons/day/square foot) I - Trench I - Bed II III 1 -5 1.2 0.8 4 6 6-15 0.8 0.5 3 5 16-30 0.6 0.4 2 4 31 -60 0.45 0.3 1 2 61 -90 N/A N/A 0.5 1.0 90-120 N/A N/A 0.3 0.5 1. The above application rates for Category II and Category III systems are valid for systems using a discharge pump or timed dosage only. Category II and Category III systems using gravity feed without timed dosage shall be allowed fifty percent of the above application rates. 2. All categories must use a sand filter layer in gravel soils that have a percolation rate of less than one minute per inch. 4t Municipality of Anchorage Page J of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: .~(4.~ ~ ~0.-~,~"7 PID Number: ~' c//- i &' Address: No. of Bedrooms: .ho.¢qC._.~7q7 LEGAL DESCRIPTION Block: Subdlvlsion: Wastewater System: ~ New [] Upgrade ABSORPTION FIELD Deep Trench [] Shallow Trench [] Bed [] Moand Total Depth from orig~al grade:r-\ Township: Range: Section: Fill added above Cfi( Gravel width: Gravellength: WELL: Classification [] Upgrade Yield: Pump Set at: Distance between lines: )0~ Number °' 'ine~s:I .,.~O"Ft. Cased TO: Total absorption area: Ft. TANK SEPARATION DISTANCES TO Lift From Station Well- Surface Water Lot Line Foundation Curtain Drain Septic [] Holding [] S.T.E.P. Capacity in gallons: j ~O Number of Compartments: LIFT STATION Electrical Inspe Remarks: BENCH MARK Location and Description: 'T(~ I~"~ ~U~i Assumed Elevation: 00 17034 Eagle River Loop Road~.l~ Inspections performed by:.~. _.~,, ltlv.~.: Alask~ ~2S~Z. Dates: 1st 2nd Department of mea~anauuman ~erwces approva~ Reviewed and approved by: ~~J'~' Date: 72-013 (Rev. 9/91) MOA 25 PERMIT NO SW990327 PAGE 2 OF 3 Municip. aU%.. _y_..of' anchoraQe DEPARTPIENT OF HEALTHAND HUN[AN SERVICES ENVIRONNiENTAL SERVICES DIViSiON P.E. I}ox 195650 OhmchoPage, ataska 99519-6650~Tetephone: 343-4744 ON-SiTE WASTEWATER DISPOSAL SYSTEM AND/OR WELL [NSPECTION REPORT LEGAL LOT 9, BLOCK 2, MOUNTAIN VALLEY ESTATES P.I.D. NO. 050 641 16 LOT 8 ',~ '1 ~, ~ ] . ~ ENGINEER STAMp PERMIT NO 5W990327 Hu~icip. o~i~ oF Anchorage DEPARTMENT OF HEALTH AND HUh'fAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.D. Box 196650 eAnchoro, ge, AID. SRO, 99519-6650eTetephone~ 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 9, BLOCK 2, MOUNTAIN VALLEY ESTATES P.I.D. NO. 050--641-16 GRADE MT2 MT1 107.0' -ORIGINAL GRADE MT2=101.5 MT1 =103.5 GRADE ST1 ST2 CO1 OUTLET 101 NEW 1000 GAL. POLY. TANK 101.3' ENGI · GROUNDWATER AT 98.0' 89.0' B.O.H. ~ROM : DISOT~LL CONSTRUCTION FAX NO. : 1 90? 6960~15 Nov. 08 1999 OI:~4PM by SULLI VAN WATER WELLS P.O. BOX 670~'72. CHUGIAK. ALASKA 99597., TELEPHONE 988-2769 OWNER OF LAND ,~f$ OT~'L~ ~ LEGAL DESCRIPTION ~0 d~T~,~ PERMIT NUMBER ~ O~ate of issue O IS well located at approved pe~it location.'? ~s ~ No Method of Drilling: ~ota~ ~ cable tool Depth of well: ~ ~ Casing Type ~g ~ Wall Thinness ~ ~ inches Diameter ~// inches, depth ~ f~t Liner Type: Casing Stic~up A~ve Ground: ~ feet $tanc Water Level (from ground ~evel): ~ feet Pumping level: feet after hrs. pumping gpm R~over Rate: ~ gpm Method of Testing; ~/~ Well Intake Opening Type; ~ End ~ Open Hole ~ Sc~n~; Sta~ feet Stopped feet ~ Pedomtions ~ta~ feet Stop~d feet GroulType: ~O-~'T~ Volume Depth: from ~ ~eet, to -: - feet Pump Intake Depth: f~t Pump Size hp Brand Name Well Disinfected Upon Completion? ~s ~ No Mem~ of Disinfection: C~A~ . Comments: BORE HOLE DATA DEPTH D~IleFs Name ~ ~""'"'~- ' ATTENTION: It is the responsibirity of the prOperty owner to submit a copy of the well leg to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Congervation. MatSu Borough: Department of Environmental Conservation. Rising Son Electric P.O. Box 670687 Chugiak AK, 99567 (907) 688-6777 August 16, 2000 Re: Lift Station at Lot 9 I~lock 2 Mountain Valley Estates To Whom Zt May Concern: This letter is to certify that Rising Son Electric, Electrical Administrator license number 1;~84, Contractor license number 25396 has successfully completed the electrical connections in accordance with the N.E.C. for the lift station at the above referenced property. Should you have any questions, please do not hesitate to call me. Thank you. Sincerely, J(evin $. Hornbuckle Owner/Administrator KSH/cmh MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 995'19-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM /WATER SUPPLY PERMIT Initial Date Issued: Sep 09, 1999 Expiration Date: Sep 08, 2000 Permit Number: SW990327 Legal Description: MOUNTAIN VALLEY ESTATES BLK 2 LT 9 Design Engineer: 0003 S & S Engineering Owner Name: Carl Disotell Owner Address: PO Box 77210 Eagle River, AK 99577- ParcellD: 050-641-16 Site Address: Lot Size: 41516 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 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 ( 18AACS0 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 (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. 5. The following special previsions. 1.) THIS PERMIT ISSUED FOR THE CONSTRUCTION OF AN INTERMITTENT DOSING SAND FILTER WASTEWATER DISPOSAL SYSTEM. THE ATTACHED PROPERTY OWNER AGREEMENTS SHALL BECOME A PART OF THIS PERMIT PACKAGE. 2.) THE SAND USED IN THIS SYSTEM MUST BE A CLEAN COARSE SAND WITH 2% OR LESS PASSING THE #100 SIEVE AND 1% OR LESS PASSING THE #200 SIEVE. A SIEVE ANALYSIS MUST BE PROVIDED ON THE SAND USED OR OBTAINED FROM AN APPROVED SOURCE. Received By: ~"~ ~' ~--'""- Date: Date: ENGINEERING STUDIES ANDREPORTS WELL INSPECTION & FLOWTEST ROAODESIGN SOILTEST STRUCTURAL& MECHANICAL INSPECTIONS ROBERT C. COWAN, P.E, August 26, 1999 CIVIL ENGINEERS (907) 694-2979 F,a'X (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 9, Block 2, Mountain Valley Estates Subdivision It is requested that you issue a permit for a private well, and to install a septic system with an intcrmittant sand filter bed and 1000 gallon tank with a lift station to serve the proposed three bedroom dwelling on the referenced property. Two test holes were excavated on 8-13-99 and percolation tests were performed. The approximate location of the test holes are located on the attached site plan. Ground water was monitored as shown on the attached soils logs. Atter a week of monitoring the test holes water was found at 3 feet and 5-1/2 feet respectively as reflected on the soils logs attached. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. If you require additional information, please contact us. ~rt C. Cowan, P.E. ,~C/jhm Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER. ALASKA 99577 '1" = 100' SCALE SITE PLAN DESIGN / / / ~tAIH(I N.T.S. SCALE DESIGN DETAIL N,T.S.scALE PROFILE --' Oo-':DETAIL -- mC` --II -- ~111 II1=111--- ..~ . =11 = ~ - =T~II ~ ~ ~ '~ I1-~- ~ +~o~ Municipality ct Anchorage. DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST · EGAL D£SCRIPTION:~- ~'~/~ ownship, Range, Section: O//~ ~ /4 SLOPE : SiTE PLAN 1 2 3 4 5 6 7 8 9 10- 11 13- 14- 15- 16- 17 18 19 WAS GROUND WATER ENCOUNTERED? i F y ES, AT WH AT Q~ ~)/~'~/ IS DEPTH? pO E Monitoring;' ~ Bate: . Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE ~/ ~ (minutes/inch) PERC HOLE DIAMETER TEST R' N BETWEEN / FT AND ~- FT . ¢~"-~'t~ ~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STA'~ AND MUNICIPAL GU~~T ON THIS DATE. DATE: 7 10 12 20- SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT r7 o DEPTH? ' ~' : : / P E Monitoring? . /~' Oale~ '1 '~ross Net Depth to Net Reading ~'Q,3,~,~ Time Time Water Drop PERCOLATION RATE __ {mLnutes/inch) PERC HOLE DIAMETER -- TEST RUN BETWEEN __. FT AND FT COMMENTS PERFORMED BY: I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: U N MPAUTY F Development Services Department On -Site Water & Wastewater Section Parcel I.D. 050-641.16 Certificate of On -Site Systems Approval Expiration Date 1. GENERAL INFORMATION Complete legal description MOUNTAIN VALLEY ESTATES BLOCK 2, LOT 9 Location (site address) 4432 BRIDSONG DRIVE, EAGLE RIVER, AK 99577 Current property owner(s) TYSON KENNELL Phone: 907-343-7904 Fax: 907-343-7997 Day phone Mailing address 4432 BRIDSONG DRIVE, EAGLE RIVER, AK 99577 Real estate agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSAFee $ "I aJSQ �GOU ID"�I j Date of Payment g /aO� D Receipt Number. i 14 n 2 5 COSA# 05C 2 01 y 0�,) Waiver Fee $ Date of Payment Receipt Number 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 8/1/2020 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to `#AQit these various and dynamic characteristics and are outside the control of the evaluator of the P'� • •�^I�``� well and septic system. Therefore, any estimate of how long a system will function satisfactory gam•.. :1� ��� or for current or future occupants or guarantee that no unseen encroachments, deficiencies or J lli discrepancies exist can be given by First Water Consulting & FWCS 6. DSD SIGNATURE Curtis Huffman j System #1 Approved for bedrooms Curtis CE128991 Y pp �� srep-.$/1/2g2o•F: System #2 Approved for bedrooms 11\F�'°ROFESSO Disapproved Conditional approval for bedrooms, with the fol�`\\.�t,1�Eil�� O p y� \ .a PROG O� By: Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: MOUNTAIN VALLEY ESTATES BLOCK 2 LOT 9 Parcel ID: 050-641-16 If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system _ A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 6/24/1999 Total depth 69 ft Cased to 69 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 24+ in. Date of flow test for COSA 7/31/2020 Static water level at beginning of test 40 ft. Well production at time of test 2.6 gpm Comments B. TANK DATA Age of tank(s) 4 years Tank type/material SEPTIC / STEEL Measured operating fluid level in septic tank 49" ® Standpipes/foundation cleanout per record drawing Date of pumping 5/6/2020 — PER MAINT. REPORT D. ABSORPTION FIELD DATA Which system tested (date installed) 2/6/2009 ® ALL standpipes present per record drawing Total measured depth from grade 3_6 ft (max) Measured depth to pipe invert from grade ft (min) ® N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate ll .2Fmg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by FW`ES Date of Sample 7/31/2020 C. LIFT STATION —AEROCELL UNIT ® Required maintenance completed Age of lift station 11 years Lift station material PLASTIC Comments: SEE ATTACHED MAINT. REPORT Adequacy test date 7/31/2020 Results M Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 600 gal New depth 6 in Elapsed time 10 min ® Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 450 and (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced gallons FWES Comments/Deficiencies: t=. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No 5'+ Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ® Yes if No ® Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No 5'+ ft Surface Water > 100' ® Yes if No _ Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: ® Yes Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No _ Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No . Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No —ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that 1 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. Ape ..• .... ....�...... ' Curtis Huffman ¢� ��c •. CE 128991 �pROFESSI4NP\'���� ft ft ft ft ft ft ft ft DigiSign Verified: 277691E1-9071-4C09-AF56-EE815AF6AF61 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this 21 Day of August of 20 20 , by and between Daniel Kozak , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as AEROCELL UNIT located at (legal description) MOUNTAIN VALLEY ESTATES BLOCK 2, LOT 9 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) Throughout the term of this Agreement, the Owner shall enter into a service agreement NZ with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 DigiSign Verified: 277691E1-9071-4C09-AF56-EE815AF6AF61 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. Owner acknowledges that the fine for failing to maintain and repair an AWWTS maybe assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing _ guidelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 DigiSign Verified: 277691E1-9071-4C09-AF56-EE815AF6AF61 OWNER: By: (signature) Date: Daniel Kozak (print name) STATE OF AL*� aY� ) �� ) ss 08-04-2020 THM3� � ) The foregoing instrument was acknowledged before me this 11 day of A U-.0 20 '21;', by ­Da1\i-e-A V -d k --) n y\�,*LEy DA&,, l//1 OTARy + L)20105215NZ NOTARY PUBLIC FOR J -W 44 My Commission expires: MUNICIPALIT _(signature) (print name) Date: 2 � —zv Title: (rev. 05/18/2018) Page 3 of 3 ARM Septic Services, LLC Maintenance Checklist: Advanced Treatment SystemS ,�w TI 11E Operational Checklist: Advanced Treatment System Legal Description: Street Address: LA`t 374- Service provided on gate:a Time: t Service provided by Company, _ `—� c,,� employee: [sae of last service. i v c.�J �a By: You Other: 1. 1"ype of Aerocell Treatment System Cat 11 -AeroCell Treatment System Cat III -AeroCell Treatment System 2. Conditions at media filter: ' .' Unacceptable a Evaluate presence of odor within 10 ft of perimeter of system: one Mild ._i Strong } Chemical — Sour ID, Source of odor: if present: fj 3. Manhole Risers and Pipe Caps: Acceptable Unacceptable a Cover's intact acs""Yes No f b. Method of securing cover ( r t C insulation present on all Inds?--+?�'�es _ No c�� -57�Kr+ iCiS-5 d. Any plumbing leaks or water intrusion _Yes �o 5� ick �1 C�Ur� C!" e Surface waterlinfiltration into components: L- Yes N -No k _ 4. Venting/Air supply: '`?Acceptable `__' Unacceptable a All supply unit operating properl� Yes � No b. Venting appears operable. 2 Yes LNo 5. Media surface: "`Acceptable j Unacceptable a. Biomat on surface. -Z S– es No b. Uniform spray pattern. E"5 es tJ No d. Ponding inion media. Yes No e Plugging/clogging of nozzles. i_? Yes No f. Media appears to be settling. >-<--Yes L No g. Appropriate maintenance performed. %N res '� No h Pest activity at surface. Yes �No 6. Etflaent quality aEffluent odor after passing through media filter !�' None 0.lild Strong b. Effluent color after passing through media filter: ;Clear Brown Black i 24738 Chugiak Drive *Chugiak, AK 99567 office/fax: (907) 688-9433 Emait: ARMServicesAK@outtook.com (PAGE 1 of 3) ARM Septic Services, LLC 7. Tasks for recirculating/discharge flows: Acceptable Unacceptable a. If applicable. Jandy valve functioning: � Yes �j No L N/A b. If applicable. Jandy Valve basin dry: L�'Yes L! No ' N/A c. Cleaned collection system in Aerocell unit: Li Yes V No '"-Not Necessary d. Design recirculation ratio: 80 : 20 e. Actual recirculation ratio (Estimated): Yes i i No g. 8. Pump System: acceptable Li Unacceptable a. Control panel in Auto: es Li No b. Timer settings IFS Panel (No Override timer): Yes ON: OFF L. 'oo' — Override ON: Z ..(jet, ^ Override OFF:C% " c. Floats in correct placement. L7Yes r� No d. Floats working properly pies !` No e. High water alarm operational �-,c'Yes L_ No f High water alarm count: 3 g Pump run counts: h Pump run time: i. Effluent Filter serviced: Yes lu No j. 'Tank lids secured after inspection: RYes r No k. Weep hole functional: des LJ No f �— 9. Primary Tank: `Acceptable JUnacceptable a Sludge and scum level checked: rl ❑ Yes i� 7 No i / b Sludge/Scum levels: 1st:_Q 2nd: (� 3rd: _N N/A r 1•� 1, ; 1 Z C Tank needs to be pumped. Yes No d itvater softener backwash discharging on system?'—'Yes ArNo e How many people live on the system?: f. Tank lids/caps secured after inspection Yes i i No g. Last Date Tank pumped::�'+r� 10. Drainfield: a. Type of Drainfield (circle one): Bed <Wde r Deep Trench b. Design Effective depth: 7 inchestee c. Checked Liquid Levels in Drainfield: %Yes No MT#1 Liquid Level: __ Inches MT#2 Liquid Level: Inches MT#3 Liquid Level: Inches MT#4 Liquid Level:. Inches d. Is there any surfacing effluent?: D Yes > to 24738 Chugiak Drive ;Chugiak, AK 99567 office/fax: (907) 688.9433 Email: ARMServicesAK@outtook.com (PAGE 2 o 3) ARM Septic Services, LLC 11. Is the remote monitoring st s m functioning? Y .� 9 • (if no, describe in comments) a. Type of Monitoring system: 12. Does this system receive an advisory notice/warning? (if so, describe in comments) ��.:� es _� NO 13. Is the system in satisfactory condition/pass inspection? (if no, describe in comments) es NO— Other O Other Comments: A1G{�� � 1 Service Provider: (e ci^TDate: 24738 Chugiak Drive `Chugiak, AK 99567 office/fax: (907) 688-9433 Email• ARMServicesAKCouttook. corn (PAGE 3of3) Parcel I.D. 050-641-16 Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 · www.ci.anchorage.ak.us ' (907) 343-4744 ' CERTIFICATE OF HEALT~'~AOTFI©R'ITY~'APPR~¥AL ~7~.~' c~t~{,'..-:~v-~'~.~ FOR A SINGLE FAMILY DWELLING. Expiration Date: GENERAL· INFORMATION Com~i~ie Ieg~i"description Lot ~'o~ation (site address or directions) 9, Block 2, Mountain Valley Estates NHN Birdsong Drive Current Property owner(s) Carl Diso tell Mailing address PO Box 770210, Eagle River, Lending agency D~y phone AK 99577 694-5797 Day phone Mailing address Real Estate Agent Mailing Address Day phone Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: ' 3. TYPE OF WATER SUPPLY: Individual Well ' Individual Water Storage Community Class. Well Public Water System TYPE OF WASTEWATER DISPOSAL: [] ' Individual On-site [] · Individual Holding Tar~k [] . Community On-site [] Public Sewer [] [] [] The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates 0f Health Authority Approval are required for the tcansfer of title (except between spouses) on properties served by a single (amily omsi!e wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. Certificates of Health Authority 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 less than 30 days old. 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. 72-025 (Rev. 01/00)' 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 Health Authority Approval Guidelines for the Health Authority Approval application show 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 site water supply and/or wastewater disposal system is in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. S & S ENGINEERING Name of Firm .17034 Eagle River L~p Road N0~204 Eagle River, Alaska Engineer's Printed Name P, obe~:t Cowart Phone Date Approved for' ,,~. bedrooms· ,..:, DisaPproved. Conditional approval for __ bedr;ooms with the following stipulations. 6. DHHS SIGNATURE Additional Comments Attachments: HAA Checklist Septic SystemAdvisory Well Flew Advisory X Maintenance Agreements Supplemental Engineer's Report Other Expiration Date: Original Certificate Date: Reissue Date: 75-025 (Rev. 01/00)* Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak.us ~,ECEIVEI~ AUG 17 2000 MUNICIPAL[~ OF ANCHORAGE (907) 343-4744 ,vII~C)NMENTAg SERVICES DIVISJ' Legal Description: HEALTH AUTHORITY APPROVAL CHECKLIST ~¢ z ,,~,~. ~.-'~ lIe~ 2~:/- If A, B, or C provide PWSID # Sanitary seal Y Casedto /~'~' ft A. WELL DATA Well type/,) Date co2pleted Total depth ~' '~ ft FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS: ft g.p.m Parcel I.D.: Well Log J./7'¢ ~'' Wires properly protected ~ Casing height (above ground) ~dp in. AT INSPECTION g.p.m Coliform O colonies/100 mi Nitrate '~) mg/I Other bacteria '~' colonies/100 mi Date of sample: ~//~/ m 0 Collected by: ~¢ // B. SEPTIC/HOLDING TA~DATA Tank Type/Material ~ ~ - ~/~ Date installed Tank size/~ ~ · gal Number of Compa~ments Depression ate of p~mping~ ~ ~ ~ ~/ Cleanouts ~ 'FoUndation cleanou over tank High water alarm D Pumper ~~ O. ABSORPTION FIELD DATA ~'~/~/([~ ~ Date installed ~/~ Soil rating (g.p.d./ft2 or ff2/bdrm) J. 2~ System type ~, ~, ~, F Length ~ ft Width /~ ff Gravel belowpipe Total depth ~ Effeotive absorption area~Off2 Monitoring tube.~ /. Date of adequaoy test Results (Pass/Fail) Fluid depth~ in absorption field before test ~/~ in Water added ~/~ gal. New dep~/~'~ in. m,. ,n Any rejuvenation treatment (past 12 mo.) (Y/N & type). ~ If yes. give date / ' -- ~',"o Depression over field /V ~ For .~ bedrooms 72-026 (Rev. 01/00)* LIFT STATION Pump on level ai ///~' in Datum E. SEPARATION DISTANCES Size in gallons //cle s tested Manhole/Access/.~_ High water alarm level at 0'~-~--~'- in Meets alarm & circuit requirements .J/ ! Public sewer manhole/cleanout SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot J¢~/.~Z On adjacent lots Absorption field on lot /~P r?z- On adjacent lots Public sewer main ~/~- Sewer/septic service line '2~.¢- r/~ Holding tank SEPARATION DISTANCES FROM SEPTIC/~hNGr~-ANK ON LOT TO: Building foundation <¢~ / Property line 2~'~ ~/- Water main /'u)//1~- Water service line //0 Drainage .-"~:::E-~ /~L Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ~-~ 0 (~ Building foundation -'~ '¢ / Water Service line ./?) /-/ Surface water /'/_x:P /TL. Curtain drain ..¢~0 r '/-- Wells on adjacent lots Absorption field Surface water Water main /~////'i- Driveway, parking/vehicle storage ,~7_2 (/- F. COMMENTS G. ENGINEER'S CERTIFICATION I ri . . . ce t fy that f have determined through field Ins~lQu~abO review of Municipal records that the above sys?g~ conformance with MOA HAA guidelines in effebt on this date. Engineer's Printed Name ~r / ~ ~/~ Date HAA Fee $ '¢~ cs'7~ Date of Payment ~',// Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 01/00)*