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HomeMy WebLinkAboutBLUEBERRY HILL BLK 4 LT 3Blueberry Hill
Block 4
Lot 3
#050-202-11
On -Site Water System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP111285
Tax Code Number: 05020211000
Work Type: Well Upgrade
Permit Effective Dates: October 12, 2011 to October 11, 2012
Design Engineer:
Subdivision: BLUEBERRY HILL
Site Legal Address: BLUEBERRY HILL BILK 4 LT 3 G:0058
Owner/Address: FORDHAM WILLIAM R & CONNIE S
21919 BARCLAY DRIVE EAGLE RIVER AK 995779516
Site Mailing Address: 21919 BARCLAY DR, Eagle River Lot Size in Sq Ft: 247420
Total Bedrooms: 3
This permit is for the construction of:
N Disposal Field N Septic Tank N Holding Tank N Privy N Private Well Y Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Date: M /'7 /
Date:l0 Z
MUNICIPALITY OF ANCHORAGE
Community Development Department .� Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
Mayor Dan Sullivan
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 65-0 ?-,0- i I ` 0t30 _
Property owner(s) W 6 LL I A ^ 'P,, -i- C.e-t-j iC- S. tf-b q A'**%Day phone 95 ` - SOCA Z -
Mailing address Z,I q 1 `1 J3A2C_t_AY bF2 a 1A4("cC ElvF"i ,, Ak 9577
Site address 5AM 6
Legal description (Sub'd., Block &Lot) LT 3 , �3 i 4 , ;zv +� �� � =�% Ia I ��- V •
Legal description (Township, Range & Section)
Lot Size ZO, 4Zo Sq. Ft. Number of Bedrooms
3
THIS APPLICATION IS FOR:
THIS APPLICATION IS AN:
(® all that apply)
Initial ❑
Absorption Field
❑
Septic Tank
❑
Upgrade
Holding Tank
❑
Renewal ❑
Privy
❑
Private Well
❑
Water Storage
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
I certify that the above information is correct. I further certify that this application is being made
for a Single Fiamily Dwelling and is in accordance with applicable Municipal Codes.
(S
J Com-,- _AA' --
property owner or authorized agent)
Permit/Rush Fees: Waiver Fees:
Date of Payment: i -1- + 1 G k III N Date of Payment:
Receipt Number: Receipt Number:
Permit No. `0 �) ` ` Waiver No.
GABuilding\On Site\Forms\Client Forms\Permit App 010411.doc (Rev. 1 /11)
%c -
O -N - - -
- - --------- -
-------- -----
Municipality of Anchorage
_ '
Development Services Department ``
_
Building Safety Division r
-
On -Site Water & Wastewater Program, 4700 South Bragaw St. - ,�;
, , , ,
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number. SW020205 PID Number. 050-202-12
Name:
BILL FORDHAM
Wastewater System: ■ New ❑ Upgrade
Y
6008 E. 12TH AVENUE APT 18 a ANCHORAGE, AK 99504
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 240-9398 3
0 Deep Trench ■ Shallow Trench 0 Bed 0Mound 00ther
LEGAL DESCRIPTION
Sol Rang:
3.0
Total Depur from or" 9a :
3.5
GPD/Sa n.
n
Block: lot: Subdivision:
Depth to pipe bottom from ongirwl gross.
Gravel d.pth Dena pipe:
4 3 & 4 BLUEBERRY HILLS
0.86 In.
0.62 R
Township: Range: Section:
nl em.e abaw original Poec
Gravel length:
- - -
1.46-1.76 In.
30 n
WELL: ■ New ❑ Upgrade
Grovel .win:
5
Number Of Errc
1
Dlelanae W ..n Knee:
-
n
n
Ckwiremuon Prk*.. &D.0 :
Tool Depth:card
To:
Total aboorptian ergo:
pipe ma1orW:
PRIVATE
338 n
40 n
eo. n 150
D 3034/ F-810/ SCH 40 PVC
DraMr.
Date pulled:
Slava wotor Laval:
YwtaNr:
OWNER INSTALL
Dote Wlawe4
8/1-5/2002
M—W DRILLING
7 26 02
33.85 n
Yleld:
Pomp Set At:
Coelng Haight Above Ground:
TANK
1.0 GPw
UNKNOWN n
2 n.
SEPARATION
DISTANCES
0Septic (3 Holding 0S.T.E.P. ■Othea
To
Septic
Absorption
Lift
Holding
Publle/Pdvats
1lwwlaatu .
ANCHORAGE TANK
Copedty In 2.11m :
1500
From
Tank
Field
station
Tank
SO~ unas
Wall
100'+
100'+
—
—
25'+
rat.wh FIBERGLASS
w 2
Surface water
100'+
100'+
—
—
—
LIFT STATION
Lot Una
5'+
10'+
—
—
—
Ste In gobs:
1500
hlanufoo ..
ANCHORAGE TANK ORENCO SYSTEMS
p M I a1:
-Pump off el wt:
Koh watts worm at
Foundation
50+
10'+
—
—
—
TIMER
TIMER
53"
pump Moe. ! Iba.b
a.ctrwa lrupreorr "Hmw br:
Curtain Drain
NONE KNOW
ORENCO%
6WNEf2
Remarks: *THIS IS AN ADVANTEX TREATMENT SYSTEM
BENCH MARK
lo0o4an and D.ecuptwn:
THE SYSTEM HAS BE OPERATING SINCE DECEMBER
TOP OF FINISHED FLOOR NEAR POINT "A"
OF 2002 WITH NO ADVERSE EFFECTS REGARDING THE
DISTRIBUTION LINE BEING A 1.25 INCH SCH 40 PVC
I
Awurrd EJ twin 106.02 rt
I
ENGINEERee I
GRAVITY FLOW LINE. THE HOMEOWNER IS AWARE OF HIS RESPONSIBILITY TO
oaoo�o 0
MAINTAIN THE SEPTIC SYSTEM. (VERBALLY APPROVED BY DAN ROTH ON 3/18/2003)
�•. y S��
ovov
AKWWC, INC.
Inspections performed by: Dates: 1st 8/1 /2002
• • 0�
p • • •: :..4.
2nd 8/2/2002
3rd 8/5/2002
QO ffr y arne
Development ervices Departallent Approval
�p �; .. E 9 ` �O
�4
T
4e • .. erre • �t`Ao
Opp°P,are„tanoo,
Reviewed and approved by Date:
(Rev. 12/01)
�4Oo0p
INUMBER: PARCEL ID NU
SW0 AS—BUILT DRAWING 1
SW020205 050-202-1212
ALTERNATE SITE -
TH/24L
2_5
NEW
A
B
ST1
12.0
33.4
POD
16.3
35.3
MH
21.7
39.4
MT1
22.3
21.0
MT2
41.0
47.0
ALTERNATE SITE -
TH/24L
2_5
NEW
NOTE: THE GRADE 35 FEED
OWNHILL FROM DRAINFIELD 1
LESS THAN 25 PERCENT.
OF SLOPE
NEW DRAINFIELD
\ .—r
IXISTINC •`�'•�`
\ GABION WALL
12/18/2003
00—
O
LL
.. •'.
4�
DRAWN BY:
ALASKA WATER & «'ASTI31VATER
p Ci.
a �� .•
.... V
�0
SCALE."
\
---^------^- ----- CONSULTANTS. INC. -�-�-------
1" = 50•
0 ...........
... .........
3701 F TIOOR ROAD SIIITF 101 • AWHu ,PA" AK 00107 • VI.O4F (0071X%7"70 • FAX (007MA-17n6
O
O
PREPARED FOR: PHONE NUMBER:
PACE NUMBER:
BILL FORDHAM (907) 240-9398
2 OF 3
Q f r
Gar ess-
LEGAL
DESCRIPTION:
oo� •' C
5 .•'•
BLUEBERRY HILL SUBDIVSION; LOTS 2 & 3, BLOCK 4,
0 �^�• •
4���40000���
FFG
• • • oov
TYPE OF WORK:
AS—BUILT DRAWING OF NEW WELL AND SEPTIC SYSTEM
NOTE: THE GRADE 35 FEED
OWNHILL FROM DRAINFIELD 1
LESS THAN 25 PERCENT.
OF SLOPE
NEW DRAINFIELD
\ .—r
IXISTINC •`�'•�`
\ GABION WALL
12/18/2003
00—
O
LL
.. •'.
4�
DRAWN BY:
ALASKA WATER & «'ASTI31VATER
p Ci.
a �� .•
.... V
�0
SCALE."
---^------^- ----- CONSULTANTS. INC. -�-�-------
1" = 50•
0 ...........
... .........
3701 F TIOOR ROAD SIIITF 101 • AWHu ,PA" AK 00107 • VI.O4F (0071X%7"70 • FAX (007MA-17n6
O
O
PREPARED FOR: PHONE NUMBER:
PACE NUMBER:
BILL FORDHAM (907) 240-9398
2 OF 3
Q f r
Gar ess-
LEGAL
DESCRIPTION:
oo� •' C
5 .•'•
BLUEBERRY HILL SUBDIVSION; LOTS 2 & 3, BLOCK 4,
0 �^�• •
4���40000���
FFG
• • • oov
TYPE OF WORK:
AS—BUILT DRAWING OF NEW WELL AND SEPTIC SYSTEM
IPEW020 05 AS -BUILT DRAWING PARGE<ID NUMBER:
SW020205 050-202-12
TOP OF ADVANTE% POD '
105.72 (AVG.)
FINAL GRADE
ATION 0 (AVC.)
ATONE
TOP OF
" 10'
PER RECOLLECTION OF AKWWC FIELD
TECHNICIAN, JODY MADS, BRACING AND
STAKING W/ VISOUEEN BARRIER ON DOWNHILL
SIDE OF DRAINFIELD WAS INSTALLED. � FILTER
Ile
TOP
D
02.54 (AVC.)-
VERBAL APPRUV BY VAN
/ ROTH ON 3/18/2003. FOR
GRAVITY FLOW SYSTEM USING
A PRESSURIZED LINE.
1 OF MANHOLE "
105.72 (AVG.)
)P OF TANK
101.24
OU'l m
AL GRADE "
5.48-105.78
INSLIATION
. INVERT OF PIPE — 103.18
(AVG.) THE DISTRIBUOON LINE
IS 125 INCH PVC W/ ] INCH
HOLES SPACED 11 INCHES ON
CENTER (30 HOLES TOTAL).
•BOTTOM OF TRENCH
" 100.51 (AVG.)
RELATIVE ELEVATION OF BOTTOM OF
TESTHOLE - 98.01 CrESIHOLE DRY)
ALASKA N'E'ATER & WASTE «'ATER
CONSULTANTS, INC.
3)01 F TUDOR POAD. SURF 101 • ANGHOPAGP. AK 00507 • MONF (907)537�170 • PAX (907)W-3746
PREPARED FOR: PHONE NUMBER:
BILL FORDHAM (907) 240-9398
LEGAL DESCRIPTION:
BLUEBERRY HILLS SUBDIVISION; LOT 2 & 3, BLOCK 4,
TYPE OF WORK:
PROFILE AS -BUILT DRAWING OF NEW SEPTIC SYSTEM
C.J.G.
LE:
i"=40'
3 OF 3
FROM :FIC,LLC FAX NO. :6220850 Aug. 11 2005 02:45PM P1
Jil
P . i
��.14916 VoodLand
LagLe Zver. A4 99577
(907)6:22-6777
August 11, 2005
Bill Fordham
21919 Barclay
Eagle River, AK 99577
Re: Lot 3 Block 4 Blueberry Hill Subdivision - 21919 Barclay - Eagle River, AK 99577
Dear Mr. Fordham:
The lift station at the above referenced property has been wired In accordance with NEC
and State/Local codes.
Thank you.
Kevin S. Hombuckie, Owner
Administrator License Number 1284
Specialty Contractor License Number 27285
M -W trilling, Inc.
P.O. Box 110378# Anchorage, AK 99511♦
•907-345-4000 • 907-345-3287 Fax•
Job No.: 02-146 Project No.: N/A Permit No. jW020205
Groundwater Well As -Built & Loi
♦ Nell owner. Fordham,. Bill ♦ Use of Well: Domestic
♦Legal Description: Blueberry Hill Block 4 Lot 2
Construction
♦Hole Depth: 338' ♦Casing Size: 6" ♦Cased To: 40' *Material.. A53Steel
♦ Drill Method: Air Rotary
Perf.
♦ lVell Completion- open end X Screen Perforated _ Method:
♦Screen/Perforotion description: None
♦Grout Notes: (1) Sack- No. 8 bentonite granules
• Nota: Grouted 6" to 38'
♦ Well Development: Method: Air surge Nota.
#Stade water level (SWL) 33.85' (above) (below) top of casing (T0Q-
♦ Weli'ield test at 1 gallons per minute (GPMl/gaBenaP&4wN (61r11) for 1 hours
with I W1. of drawdown (DD) from static level (SWL).
♦Method: Airlift
*Date of completion: 26 July 2002 —,-1, V
-_1,- -- ♦ Pump lnstad:
Depth In feet from
top of casing.
0 TO 2
Details of formations penet rat
Casing stickup
size ormaterial, color and hardness.
2
10
TO 10
TO 338
Fill ditch
Bedrock: black/gmy siltstone ar
illite, small water sea s insporadic
fractures throughout
TO
TO
TO
TO
TO
7EET,roonE
TO
TO
,�—(3eatlfied
TO
MUNICIPALITY OFANCHORAGE
Development Services Department
On -Site Water 8 Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ONSITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT
Initial
Permit Number: SW020205
0 d- /.•3a
V.la e /Z'-S6F"q
Date Issued: Jul 02, 2002
Expiration Date: Jul 02, 2003
Parcel ID: 050-202-12
Legal Description: BLUEBERRY HILL BLK 4 LT 2
Design Engineer: 0041 AK Water & Wastewater Consultarr Site Address:
Owner Name: Bili Fordham Lot Size: 178160 SO. FT.
Owner Address: 6008 E 12th Ave #8 Total Bedrooms: 3 Permit Bedrooms: 3
Anchorage , AK 99504 -
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.
5. The following special provisions.
This Permit is for Lot 2 and Lot 3 but is listed under the PID for Lot 2 only
Received By:
Issued By:
Date: 7-2 —d9
Date: 2 02
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
tj S (907) 343-7904
F`
ON-SITE SEWER/WELL PERMIT APPLICATION p( `iaws' A
FOR A SINGLE FAMILY DWELLING (SSwe
S„aw=e-
Parcel I.D. ASID Permit Number stano205
Property owner(s) BILL FORDHAM Day phone 740-9398
Mailing address (1) 6 ong? E Ai lee -d
Mailing address (2) L�k e1) rcta 44
Zip Code 9 !?S-0
Legal description (Lot, Block & Sub'd.) __ LOTS 9 & 3. BLOCK 4• PLUEF3FRRY H11 IS ai BDIyISION
Legal description (Section, Township & Range) N/A
e-'3 c.a
Lot Size-2e{7e1aD + 179/611) Acre Sq.Ft. Number of Bedrooms 3
THIS APPLICATION IS FOR:
Sewer Only ❑ Well Only ❑
Sewer and Well Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
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.
ALASKA WATER & WASTEWATER CONSULTANTS INC.
agent)
Permit Fees: 00 50 Waiver Fees
Z
Date of Payment: to'28 -02 Z/1/t) �4ate of Payment:
22001 �2D$�
Receipt Number: Receipt Number.
ALASKA WATER & WASTEWATER
"„•.•.z.... •�—,.�...-.-�.s.—'� CONSULTANTS. INC...•..m.^.w."W,....�,.•."..'""W'm"'"'°"""'""'"
June 28, 2002
Municipality of Anchorage
Development Service Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
Ref: Proposed Well and Septic System for Lots 2 & 3, Block 4; Blueberry Hill Subdivision
ADVANTEXT" TREATMENT SYSTEM
To whom it may concern:
1. GENERAL: The proposed 3 bedroom home will be served by a private well and septic
system. Two test holes were excavated on the property. We are proposing to design the septic
system around the 30 foot radii of these test holes. Due to the shallow bedrock, the limited
amount of receiving soils, and the steep slopes, we are proposing to use an Advantex treatment
system and a 5 -wide trench type drainfield. The well is to be located in the area shown on the site
plan and design drawing.
2. SOILS: See the attached log, which shows the soil classifications, groundwater monitoring,
and the percolation test results.
3. DRAINFIF.LD APPLICATION RATE: The intent is to install an Advantex Treatment
System that will allow the use of a small drainfield in the area around the 30 foot radii of the test
holes. A percolation test was performed in each test hole between the depths of 4.0 to 4.5 feet
and found the rates ranged from 3.3 to 5 minute/inch. The Advantex system has received class III
approval and we are going to conservatively assume an application rate of 3.0 GPD/FT'.
4. TRENCH DESIGN:
a. Percolation Rate: 3.3 & 5 minutes/inch
b. Proposed Application Rate: 3.0 gallons/day/ft2
c. Number of Bedrooms: 3
d. Design Flow: 450 gallons per day
e. Minimum Absorption Area: 150 ft2
f. Total Depth: 3.5 feet (max.)
g. M.O.A. Approved Sand Filter Depth: 2+ feet
6901 Debarr Road, Suite 2B — Anchorage, AK 99504 — Ph: (907)337-6179 — Fax: (907)338-3246
h. Effective Depth: 0.5 feet
i. Width: 5 feet
j. Minimum Length: 30 feet long
k. Effective absorption area: 150 ft2
5.ORENCO PACKAGE SYSTEM: The STEP tank with the Advantex Treatment System will
be manufactured by Anchorage Tank & Welding to meet the latest design criteria established by
Orenco Systems, Inc. The point of contact at Anchorage Tank is Lowell McNutt. As with their
standard STEP tank, it is equipped with a high water alarm per M.O.A. requirements.
6. SURFACE RATER: There is no surface water within 100 feet of the proposed septic
system upgrade.
7. TOPOGRAPHY: the homeowner has excavated a pad on the property. The test holes were
dug at original grade and the area uphill of the test holes was excavated and placed on the
downhill side of the test holes. The homeowner has created a flat area 25 feet south of test hole
41. The proposed drainfield is to be placed on the same contour line as the test holes and the
homeowner will excavate and fill until no slope exceeds 25 percent grade 35 feet from the
drainfield. We request that the required 50 feet setback to a cutbank be waived to 35 feet. Given
the porosity of the soils and the high level of effluent treatment from the Advantex system, it is
our opinion that there is little risk with the granting of this waiver. We are also recommending
that a geofabric and seeding be layed down on the cutbank for stabilization.
8. CLOSING: I am open to any suggestions from your department that would be an
improvement to the proposed system. I am unaware of any negative impacts that this installation
would impose on adjacent wells, or septic systems. If you have any questions, please call us at
337-6179.
M.S.
NOTE: Attached is a site plan drawing, a design drawing, an Advantex detail, a trench detail,
two soil logs, and a 7 page construction specification letter which are all part of the design
package for this septic system.
6901 Debarr Road, Suite 2B — Anchorage, AK 99504 — Ph: (907)337-6179 — Fax: (907)338-3246
BLUEBERRY HILL S/D;
LOT 2, BLOCK 4,
ALTERNATE SITE. WILL
REQUIRE FILL TO BE
PLACED DOWNHILL TO
A17TH12 J ��
EXISTING
CUTBANK
BLUEBERRY HILL S/D;
LOT 3, BLOCK 4,
• PROPOSED SEPTIC SYSTEM
(SEE DESIGN PACE 2 OF 4)
/ 3 BEDROOM
---
HOUSE
I I
\ I I
STH/1 \ I
BLUEBERRY HILL S/D;/�---
LOT 3. BLOCK 2.
DATE:
6/28/2002
� I DRAWN BY:
Al AS 1170'ER & «'ASTENVIVI LR SCALE: C.J.G.
r.a
".1.0
.•.W...v CONSULTANTS. INC.
"` - _"_'�—"....•. 1" = loo,
PAPP POI SviTF TP • ANCNOPAGF AN 00"4 • FNONF (V0111D.600 • FAY (007MS.374M1
PREPARED FOR PHONE NUMBER: PAGE NUMBER:
BILL FORDHAM 240-9398 1 OF 4
_EGAL DESCRIPTION:
BLUEBERRY HILLS SUBDIVISION. LOT 2 & 3, BLOCK 4,
SITE PLAN FOR PROPOSED WELL AND SEPTIC SYSTEM LOCATION
-_ . BARC�9 Y pR�Vf
....... .. .. ... ........
.. . ... .. ........
v A. Go ess.:
E 7953Ne
e,
PROPOSED DRAINFIELD. EXCAVATE A
TRENCH THAT IS 3.5 FEET DEEP MAXIMUM
BELOW THE TOP OF THE NATURAL ORGANIC
LAYER BY 5 FEET WIDE BY 30 FEET LONG.
ADD 2 FEET OF M.OA. APPROVED SAND
FILTER THEN 0.5 FEET OF CLEAN. WASHED
SEWER DRAINROCK. THE DISTRIBUTION UNE
IS TO BE 1 J' PVC PIPE WITH J' HOLES
SPACED EVERY it INCHES ON CENTER (30
HOLES TOTAL). (SEE DETAIL. PAGE 4 OF 4)
ALTERNATE SITE /
TH12
0
iaK
FILL SHALL BE PLACED SO AS TO
CREATE A 35' SEPARATION DISTANCE
BETWEEN THE NEW DRAINFIELD AND
ANY SLOPES GREATER THAN 25%
NOTE: DEPENDING ON THE HOUSE ELEVATION,
lHE LIFT STATION MAY NOT BE REQUIRED. IF
IS NOT REQUIRED, THEN THE DRAINFIELD
TO BE A GRAVITY FLOW TRENCH.
OF SLOPE
-PROPOSED 4 BEDROOM FIBERGLASS
ADVANTEX TREATMENT SYSTEM AND A
UFT STATION (SEE NOTE)
(SEE DETAIL. PACE 3 OF 4).
'ED
\
\ \\ DRft;v4r `\ i
EXISTING CABIMI WALL �� ``.•�.� //
DATE: Q,opQiDOpQ
Ill lltll6/28/2002 0
i 1 DRAWN BY: v l..
AIASICA «TATER & «TASTI:«'ATI:R
SCALE:
INC.._ ...,.. F X(........._._.. 1 — 50 Q °.:.. .. F. P,
e•�^' pp SdCF CPAD SilrtAN; T9 • CNCwOPAf.F. AK 00504 • OwONF 100)pL0
Je9 • FAX (007I338.5746 — O
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: Q
BILL FORDHAM (907) 240-9398 2 Of 4
ness. Q
LEGAL DESCRIPTION: oOQ �. E 7953 00�
BLUEBERRY HILL SUBDIVSION; LOTS 2 & 3, BLOCK 4, ya0
TYPE OF WORK: 44 ^vy x`'o�
DESIGN OF PROPOSED WELL AND SEPTIC SYSTEM LOCATION ��� I oop��
NOTE JIM CROSS,
P.E. PAS THE
ADVANTEX MANUAL
AdvanTex" Treatment System
000
AX20 -Mode l a
40x94Pod
NYL
6'
6' PVC PIMP—OUI
C".Vl
6' PJC COUPLING
CLUED TO TANK
c".2)
SLIDE SECIION
OF r PPE
OVER THIS C0NNECTKIN
TO PROVIDE
SHEER PROTECTION -
EXTEND 70
BRIDGE EXCAVATION
1
� e
3 BEDROOM
FIBERGLASS
ADVANTEX.TANK
t "
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
BILL FORDHAM (907) 240-9396
AL DESCRIPTION:
BLUEBERRY HILL SUBDIVISION; LOTS 2 & 3, BLOCK 4
E OF WORK:
DETAIL DRAWING OF ADVANTEX TREATMENT SYSTEM
C.J.G.
N.T.S.
NUMBER:
3 OF 4
F��
SCREENED
VAULT
EFFLUENT
PUMP
THE DISTRIBUTION UNE IS TO BE
1 J' PVC PIPE WITH J' HOLES
SPACED EVERY 11 INCHES ON
CENTER (30 HOLES TOTAL)
MT
�r-----------------------------
pl
O.I
MT----------------- ---------�
30 fff r LONG
NOTE: THE FINAL GRADE
35 FEET WEST FROM THE
TRENCH MUST BE GRADE
AND FILLED TO LESS
THAN A 25 PERCENT
SLOPE.
FINAL GRADE
DISTRIBUTION UNE IS TO BE 1 J'
PVC PIPE WITH J' HOLES SPACED
EVERY 2 FEET ON CENTER
ORIGINAL GRADE—\iCOVER / NATURAL SLOPE
INSTALL BRACING AS NEEDED
ALASKA «TAITR & «'AS7'I:«TATI:R SCALE: C.J.G.
......_ .... CONSULTANTS. INC..._.._ N.T.S.
♦.�. �'cAR9 RAAt S:IITC 7R • AN!NMAr,' AA 0050!. • P..(.NR (0071117.6179 • FAX (0071114-771.6
PREPARED FOR: PHONE NUMBER: PACE NUMBER:
BILL FORDHAM (907) 240-9398 4 OF 4
BLUEBERRY HILLS SUBDIVISION; LOT 2 & 3, BLOCK 4,
OF WORK:
DETAIL FOR PROPOSED SEPTIC SYSTEM
OF EFFECTIVE
• 2.0'+ OF MOA
APPROVED SAND
FILTER
NOTE: THE BOTTOM OF THE
SEWER ROCK WILL BE 6'+
FEET ABOVE BEDROCK.
.. ... ..... ........
y A. GOrn ss.
E
ALASKA LR & NVASTLNVAI'LR
....- .._..-.......... CONSULTANTS- INC..._.._._-._...,
SOIL LOG — PERCOLATION TEST
LEGAL DESCRIPTION: BLUEBERRY HILL SUBDIVISION: LOT 2 & 3, BLOCK 4,
PERFORMED FOR: BILL FORDHAM DATE: 6/11/2002
DEPTH - - --
(IeetORGANICS ITEST HOLE 1
1
I'll.
II
71
8
BEDROCK
9-
1011 10-
11
12-
13-
14-
15-
16-
17
21314151617
18
SOIL CLASSIFICATIONS
DATE
DRY
6/11/2002
GW
6/13/2002
DRY
ORG
' : •
GP
6_.-____---
III 11
ML
2
GM
10
' ///,
CL
GC
8:45
'ILII
OL
-
SW
4
I
MH
�� '•
SPS/%%/
5
CH
1;1"t
SM
-
i'
OH
X060
SC
4'
2-
DEPTH TO
GROUNDWATER
DATE
DRY
6/11/2002
DRY
6/13/2002
DRY
6/24/2002
--8:35---
---
PROPOSED SEPTIC SYSTEM
(SEE DESIGN PAGE 2 OF 3)
TOE OF SLOPE
c Z�-
TH12
IE
- /
TH/1
I �
EXISTING 1 \�
CUTBANK 1 PROPOSED�.._
1\3 BEDROOM
HOUSE
SITE PLAN
1"=100'
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
6/13/2002
1 --
--8:35---
---
6_.-____---
2
8:45
10
4'
2"
3
8:45
-
6"
-
4
8:55
10
4'
2'
5
8:55
-
6'
-
6
9:05
10
4'
2-
7
9:05
-
6"
-
8
9:15
10
4'
2"
9
9:15
-
6"
-
— ---
10
10
4
2"
_9:25_
-- 9:2.5
__.
-
— —
11--
_1
12
9:35
10
4-
2'
19� PERCOLATION RATE 5 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 4.0 FT. AND 4.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO
SOILS LOGGED BY: CALEB GALL PERCOLATION TEST PERFORMED BY: CALEB GALL
COMMENTS:
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE:
DATE
GROUNDWATER
(MINUTES)
READING
(INCHES)
6/13/2002
Qoo6�pp0
_ _DRY
6/24/2002
6"
-
AEASKA
NN ATER & NVASTENVATER
�
.. _..,...._..u.....,
---
_ ....._......._,_,. CONSULTANTS INC.."_.,�...._._._..�..-..._..........
-
n n
....... . . .... ...
6901 OEBMF
ROAD, SURE 2B • ANC110RAGE, M. 99501
• Pn0NE�907 }}]-6179 • fAx: 907 }39-]b6 • •E9LiE: or".c.eom
..........
0
---
SOIL LOG
- PERCOLATION TEST
—
LEGAL
DESCRIPTION: BLUEBERRY HILL SUBOMSION: LOT 2 Qi 3, BLOCK 4,
O P e r y am SSS O
PERFORMED
FOR: BILL FOROHAM
DATE6/11/2002
oh9 —795 p0�
DEPTH
----
----- ORGANICS
TEST HOLE #21
n444a p,0Ils-iOn0\�,�0
p0p0�0�66
1
-=--
6
6 1 el
SOIL CLASSIFICATIONS
3"
2
i
�I I
7
9:20
J i
'1 -o GW--- - ORG
PROPOSED SEPTIC SYSTEM
3
'i J
f GP 1 1 1 1 1 1 ML
(SEE DESIGN PAGE 2 OF 3)
10
-
�i
rt UI GM '/%/ CL
4
_ 1
'S�/.i� GC ' i ' I ', OL
TOE OF SLOPE
Lw
vrV�V-
0 0. SWMH
---
—
6
1 GM
• �'•'• SP / CHTHII
11
6'
-
SM OH
12
9:50
10
3"
3"
`\
7
.,
;Ili;DEPTH
TO
I -
I
I
8
:I I V
Exlrnr+clb
DRY �/l 1/2002CUTBANK
1 PROPOSED
r I wl
DRY6/ 13/2002
\3 BEDROOM
HOUSE
9
K
BEDROCK
SITE PLAN
"-100'
1
10
Hon-
DATE READING CLOCK NET TIME
WATER LEVEL NET DROP
tt
12
13
3 9:00
6--
4 _9:10 10
14
5 9:10
. -_
15
16
17
18
19
PERCOLATION RATE 3.3 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 4.0 FT. AND 4.5
FT.
20
A FOUR HOUR PRESOAK WAS PERFORMED: 0 YES F-1NO
SOILS
LOGGED BY: CALEB GALL PERCOLATION TEST PERFORMED BY:
CALEB GALL
COMMENTS:
BY AKWWC, INC. 1,
JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE
PERFORMED
WITH ALL
STATE AND MUNICIPAL
GUIDELINES IN EFFECT ON THIS DATE:
DATE
GROUNDWATER
(MINUTES)
READING
(INCHES)
6/13/2002
1
_ _DRY
6/24/2002
TIME
(MINUTES)
READING
(INCHES)
6/13/2002
1
8:50
-
6"
-
— —
—2.
10
3"
3"
—
—
—9:00—
---
-----
---_- ----
—
—
3 '
---3" _---
--- -----
-
- —
----
6
9:20
10
3"
3"
7
9:20
8
9
9:30
9:30
10
-
3"
5"
3"
-
10
9:40
10
3"
3"
9:40
-
11
6'
-
12
9:50
10
3"
3"
'M -03-2002 17[07 S&S ENGINEERING 907 694 1211 P.02/02
Ay
EASEMENT AGREEMENT
The undersigned, in consideration of mutual agreement set forth below, grant, convey and affirm
the following easement, effective this 3rd day of May, 2002, and agree to the conditions and restrictions as
follows:
1, William Fordham, hereinafter referred to as grantor, owner of certain real property herein after
referred to as "Lou 2; Block 4; Blueberry Hill Subdivision". According to the official plat thereof flied in
the records of ANCHORAGE RECORDING DISTRICT, Third Judicial District, State of Alaska, do hereby
grant to William Fordham, hereinafter referred to as the grantee, as owner of certain real property
hereinafter referred to as "Lot 3; Block 4; Blueberry Hill Subdivision" according to the official plat thereof
Met][ in the records of ANCHORAGE RECORDING DISTRICT, Third Judicial District, State of Alaska. I
An easement for the on-site wastewater disposal system to be placed on Lot 2; Block 4; Blueberry Hill
Subdivision, as shown on the attached site plan, together with right to maintain the on-site wastewater
disposal system to include reasonable egress and ingress for pumping the septic tank and maintenance of the
absorption area. The easement to be effective upon the signing of this agreement by the parties.
1. It Is understood and agreed that sewer service to Lot 3; Block 4; Blueberry Hill Subdivision is to
be provided by connection beginning on Lot 2 and extending onto Lot 3; Block 4. It is further
agreed that the cost of maintenance of the Inplace sewer lines shall be bom by the grantee.
2. There shall be no charge for the use of the on-site wastewater disposal facilities so long as this
casement Is in affect unless a charge Is arranged between the parties of their heir or assigns or
successors In interest by separate written agreement.
3. Grantor makes no warranty as to the adequacy of the wastewater disposal system and shall not be
liable for any damages caused by the system failing to work adequately.
4. The grantor further covenant and agrees that the grantee shall have full, free and uninterrupted use
of said easement for reasonable domestic use as long as such use does not create an unreasonable,
adverse impact upon the grantor.
5. Failure to make use of the on-site wastewater disposal system herein described shall not be deemed
abandonment of the said easement.
6. The grantee further agree to bear all cost, if any, for the operation, [maintenance and/or
abandonment of the on-site wastewater disposal system and/or easement.
7. This easement from grantor to grantee shall be binding upon the inure to the benefit of the parties
hereto, their bele, legal representative, successors and assigns, and shall run with the land.
Crrattior' /la, •'� S �t� Grantee. \ C pv I t ` T �Ot1�
r�
tLi
A 1, � If A, � (J�— x1'ioa �
J
? Wall ,Fo`rrdham(Lot2) 6AjQI,`3.ltd—N0�^ William Fordham (Lot3) (ou�s� fe4etirt.^
ytd swornto before me this %�>� day of 2002 for William Fordham.
i e-4 t rissitbnexpires &IB1OZ
otary Public
C CP
TOTRL P.02
Certificate of On -Site Systems Approval
Parcel I. D. 050-202-11
Legal description BLUEBERRY HILL BLK 4 LT 3
Site address 21919 BARCLAY DR
Expiration Date:
Current property owner(s) BRASHEAR DAPHNE L & STEPHEN W
7/23/2025
X The On-site system(s) is/are approved for 3 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
By: Original Certificate Date: 8/6/2024
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory X
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
COSA ApprovaIjune 2022
MUNICIPALITY OF ANCHORAGE R05H
Development Services DepartmentPhone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 050-202-11
Complete legal description BLUEBERRY HILL BLOCK 4 LOT 3
Location (site address) 21919 BARCLAY DRIVE, EAGLE RIVER, AK 99577
Current property owner(s) STEPHEN & DAPHNE BRASHEAR_ Day phone
2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS
3. TYPE OF WATER SUPPLY: N Private Well r-1 Private Well serving 2 dwelling units
F-1 Private Well serving 3+ dwelling units R Community Well or Public
F-1 Water Storage
4. TYPE OF WASTEWATER DISPOSAL: Z Private Septic F-1 Private Septic serving 2 dwelling units
R Holding Tank r_1 Community Septic or Public Sewer
5. SEPTIC TANK: F-1 Steel E] Plastic E] Concrete Z Fiberglass
Age 22 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: Z AWWTS F-1 Bed F] Deep Trench Z Wide Trench n Seepage Pit
Waiver request for:
Expedited review requested: R
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $--550
1-4
V150
Waiver Fee $
Date of Payment
! 3/ZZ-02_
/
Date of Payment
f
COSA # Qc-) c 2LA 1-2 7 � Waiver #
COSA Application.doc
COSA Checklist.docx
COSA Checklist
Legal Description: BLUEBERRY HILL BLOCK 4 LOT 3 Parcel ID: 050-201-11
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled 7/26/2002 Total depth 338 ft
Cased to 40 ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 18 in.
Date of flow test for COSA 7/23/24
Static water level at beginning of test 190 ft.
Well production at time of test 0.24 gpm
Water storage tank volume 1000 gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by Date 7/23/24
Comments __________________________________________________________________________________
B. TANK DATA
Measured operating fluid level in septic tank NA
Date of pumping *NA
Required maintenance completed, if AWWTS
Comments: *ADVANTEX MAINT REPORT
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 8/5/2002
ALL standpipes present per record drawing
Total measured depth from existing grade 3.6 ft (max)
Measured depth to pipe invert from grade ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes (MT) go to bottom of effective. (ED)
If not, state depth into effective
Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months) N
If yes, enter date
Adequacy test date 7/23/24
Results Pass
Fluid depth prior to test 0 in
Water added 450 gal
New fluid depth 1 in
Elapsed time <10 min
Final fluid depth 0 in
Absorption rate 450 gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) 7.4 in (MOA 0.62’ED)
Effective depth used 0 in (Final Fluid Depth)
Effective depth (ED) remaining 7.4 in
Comments/Deficiencies: Approximate total measured depths from existing grade. ED per measurements, visual observations & MOA
docs ED appears approximate. Per MOA request all lift station data was removed from this COSA checklist and per MOA record documents,
this is an approved gravity Advantex septic system with no field cleanouts.
COSA Checklist.docx
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Absorption Field on Lot > 100’ Yes if No ft
Neighboring Absorption Fields > 100’
Yes if No ft
Community Sewer Main > 75’ Yes if No ft
Community Sewer Manhole/Cleanout > 100’
Yes if No ft
Private Sewer/Septic Line > 25’ Yes if No ft
Holding Tank > 100’ Yes if No ft
Animal Containment > 50’ Yes if No ft
Manure/Animal Excreta Storage > 100’
Yes if No ft
N/A – Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10’ Yes if No *5+ ft
Tank to Property Line > 5’ Yes if No ft
Field to Property Line > 10’ Yes if No **0 ft
Water Main > 10’ Yes if No ft
Water Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No ft
If tank or field is under driveway comment below
F. ENGINEER’S COMMENTS
*TANK IS 5’+ TO FOUNDATION PER CODE AT TIME OF INSTALL. **TRENCH ACROSS PROPERTY LINE WITH
PREVIOUSLY GRANTED EASEMENT – SEE MOA FILE. FUNDATION CLEANOUT INSIDE.
G. CERTIFICATION & 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, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Engineer’s Printed Name CURTIS HUFFMAN, PE Date 7/29/24
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. The assessment of the condition of the well and septic
applies only to the conditions as of the day tested. The flow and absorption rates may change
due to subsurface conditions that may not be observed from the surface, changes in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the
system and maintenance. The operational life of all well and septic systems are subject to
these various and dynamic characteristics and are outside the control of the evaluator of the
well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by First Water Consulting &
7/29/24
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
-g", 907-343-7904
"N
On -Site Water and Wastewater Section r Fax: 343-7997
www.muni.org/onsite
Well Water Advisory
Certificate of On -Site Systems Approval # OSC241274
Subdivision: Blueberry Hill, Block: 4, Lot: 3
This well's productivity was determined to be .24 gallons per minute. The minimum
well productivity required under (AMC 15.55) for a 3 -bedroom residence is .31
gallons per minute or 150 gallons per day per bedroom. Although the well
production does not meet this requirement, water storage has been provided to
meet minimum code requirements.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
0810112024 08:48 Anchorage Tank
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21919 Barclay Drive, Eagle River AK 95577
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Perform Field Sampling/Olasorvatlous
NTU (16 a NTUs)
pM (6-9)
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Clean
Rlser/l-id ............. . .. „ .
Ynd Compartm*nt
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TYph%w Iu* ❑ Earthy ❑ moldy
Nan -"Irl ❑ SLOW$ ❑ Cabb"t I1 DaceY
city film In PVD ❑ Yee NNa
Poam In tank ❑ Y" N No
0heek Contra] Panel
ReclrctAmps pischaW Amps
Aredlble and visual slarms 0 OK
Dial tan* (talemetrY Only) 1Yba ❑ Ma
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Rlser/l-id ............. . .. „ .
Ynd Compartm*nt
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Float Cords .............. . ... .
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Fkaa#s........................
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Pump ...............« ......I
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907-272-3543
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(907) 6876543
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❑
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pisinfrctlon EqulprrMnt ❑ Dwporerl Lateraleldllikes ❑ ❑
obeervatlpn4
Addid6nel Fervltso hands
❑ Cleaned tsottlia sheath ❑ R ptnoad UV Moms?
❑ Repleo*WV"d other Items?
Pa,rta Usodl W . Warranty, B a Billable Of aPProPrlate Wee lonj
W B harm Numbw Dewiptlon
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RSV i*lnsWl*d fSLlds bolted an
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#ummary/Recommendatlans
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MUNICIPALITY OF ANCI-10RA(VE
ADVANCED WASTEWATER TRE ATNIE NT SYSTEM
MAINTENANCE ANDRE PAIR AGREEMENT
TI -ITS MAINTENANCE AND REPAIR AGREEMENT. herein the "A(iREEMENT" made and
entered into as of this 15�bay of -TC11 %J of 20,) by and between
herein the "OWNER," and the Municipality of
Anchorage., herein the ICIPALITY-, in accordance with Anchorage Municipal Code
(AMC) 15-65.365. In consideration of thv mutual covenuras contained herein, the parties to this
Agreement agree as follows:
1. Advanced 'Wastewater Treatment Systems The Mui-deipality grants pen-nission to the
Owner to utilize and operate an Advanced Wastewater "Treatment System, (AWWTS),
described as AN ADVANTEX SYSTEM
located at (legal description)
BLUEBERRY HILL BLOCK 4, LOT 3
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
.96 Throughout the term of this Agreement, the Owner shall enter into aservice agreement
with an AWW7S service and inaintenance 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, adiustment(s), replacement costs, and inspection costs. 'chis
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,
W
repairs or permitted alterations to the system.
Owner acknowledges that regular maintenance of an AWVv'TS reduces the potential
failure of the system, which could include sewage backup and costly repairs OT drain-rield
replacement.
(rev, 05/18/2018) Page 1 of 3
Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
Owner acicnowledges that the fine for failing, to maintain and repair an AWWTS may be
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 ol'this Agreement shall begin on the (late of approval by the
Municipality to operate the installed system, or upon transfer of title, and shalt continue
while the AWWTS is operational or until title is transferred.
4. Nortwaiver. Tlie 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 agM0111011L by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall he
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. I'he 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
STATE OF ALASKA
THIRD RITDICIAL DISTRICT
The foregoiaginstrumteras as ackno
20A, by _ lip Pf ,
NOTARY PUBLIC FUR
Mly Commission expires:
>nature) Date:
nt name)
ged before. me thij�day of -Play
S14ARON G, CRUZ
A Notary Public
f State of Alaska
011,XMy commission Expires Sep 1, 2024
MUNICIPALITY:
By: (signature) Date: Ll
(Print name) Title:
(rev. 05/18/2018) Page 3 of 3
2024- 021413- 0
KRecording District aoi Anchorage
08/09/2024 12:44 PM rase i of a ccc
Recording District:
Returnto: S'-�Q p e w. 6ntskeute-
6
q r 6. S�. , she /0 0 , # ?-&*
Akic4ae-a3e, Ak q`iSo 1
THIS COVER SHEET HAS BEEN ADDED TO
THIS DOCUMENT TO PROVIDE SPACE FOR
THE RECORDING DATA. THIS COVER
SHEET APPEARS AS THE FIRST PAGE OF
THE DOCUMENT IN THE OFFICIAL PUBLIC
RECORD,
DO NOT DETACH
May 8, 2018
PROPERTY EASEMENT
The undersigned grant, convey, and affirm the following easement, effective this 9 A day of
August 2024, and agree to the conditions and restrictions as follows:
I, Stephen W. Brashear, and I, Daphne L. Brashear, hereinafter referred to as grantor, am the
owner of certain real property hereinafter referred to as "Lot 2; Block 4; Blueberry Hill
Subdivision", according to the official plat thereof filed in the records of ANCHORAGE
RECORDING DISTRICT, Third Judicial District, State of Alaska, and do hereby grant to the
owners, hereinafter referred to as grantee, of certain real property hereinafter referred to as "Lot
3; Block 4; Blueberry Hill Subdivision", according to the official plat thereof filed in the records
of ANCHORAGE RECORDING DISTRICT, Third Judicial District, State of Alaska, an
easement for the on-site wastewater disposal system to be placed on Lot 2, Block 4, Blueberry
Hill Subdivision, as shown on the attached as -built drawing, together with right to maintain the
on-site wastewater disposal system to include reasonable egress and ingress for pumping the
septic tank, maintenance of the septic tank and absorption area (the leach field), and installation
of a new septic system in an alternative location if it becomes necessary due to a failure of the
original septic system. The easement will be effective upon the signing of this agreement by the
grantor with the following terms and conditions.
1. There shall be no charge for the use of the on-site wastewater disposal facilities so long
as this easement is in effect unless a charge is arranged and agreed upon between the
parties or their heirs or assigns or successors in interest by a separate written agreement.
2. The grantor makes no warranty as to the adequacy of the wastewater disposal system and
shall not be liable for any damages resulting from the system failing to function
adequately.
3. The grantor further covenants and agrees that the grantee shall have full, free, and
uninterrupted use of said easement for reasonable domestic use as long as such use does
not create an unreasonable adverse impact on the grantor.
Id,1411tlIIIIGIVIVI!dlPlllV�;;d'IIIIIN�VIVI;IIIuIV
Page 10l d
301-2014-021413-0
4. Failure to make use of the on-site wastewater disposal system herein described shall not
be deemed abandonment of the said easement.
5. The grantee shall bear all costs, if any, for the operation, maintenance, and/or
abandonment of the on-site wastewater disposal system and/or easement.
6. This easement from grantor to grantee shall be binding upon the inure to the benefit of
the parties hereto, their heirs, legal representative, successors and assigns, and shall run
with the land.
Grantor:
A14
Stephen W. Brashear Daphne L. Brashear
State of Ala aka
Judicial District (or County of
(or Municipality of
Subscribed and sworn to me on this 9 day of PU 2024 before me, the
undersigned personally appeared: Stephen W. Brashear and aphne L. Brashear known to me to
be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged that
he/she/they executed the same for the purposes therein contained.
f �IiIIIII:U!II'dIIII�IIIRll9'pllllll'' IIIIlPnllll lllnln
Page a of a
aoi— zona— oziaia—o
SW020205 AS—BUILT PARCEL050ID NUMBER:
a50-ao2-�12
ST1 12.0 33.4
POD
16.3
35.3
MH
21.7
39.4
MT1
22.3
21.0
MT2
41.0
1 47.0
ALTERNATE SATE j
TH12�
2_6
NEW 1500 CALLON ADVANTEX✓/
TREATMENT SYSTEM
NOTE: THE GRADE 35 FEED
DOWNHILL FROM DRAINF"IELD 1
LESS THAN 25 PERCENT,
TOE OF SLOPE
NEW DRA1NFIELD
\I
� S
1
WELe .tA.t 1�ti V.
EXISTING ••.��, Q,•,,.,
CABION WALL
R `—
CIIIIIIf�1611111�11'IIIlIIIIIPI IIIIII�IIiIIRI!pllll
Page 4 0l d
301-202<-021<13-0
GATE:
12/18/2003
DRAWN 8Y:
MASIU iiATN"R&♦ASTIJ'A ATER
5701 F TUOnR conn Su1TF 101 • Ay^HrRAr,c AK 400.07 • Pw(wF @
SSE,
(ag71S17.-6170 FAX (001)tlA•lAh
PREPARED FOR: PHONE NUMBER:
PAGE NUMBER:
O
D
BILI. FORDHAM
....
(907 240-9308
)
2 OF 3
f r
C
Ger ess� �
5 4.p
LEGAL, VESCRIPTION:
BLUEBERRY HILL SUBDIVSION; LOTS 2 & 3, BLOCK 4,
OD's
Ode 'Cr(y
TYPE OF WORK:
AS—SUILT DRAWING OF NEW WELL AND SEPTIC SYSTEM
CIIIIIIf�1611111�11'IIIlIIIIIPI IIIIII�IIiIIRI!pllll
Page 4 0l d
301-202<-021<13-0
United States of America
State of Alaska I J,
THIS IS TO CERTIFY that the foregoing is a full, true and correct
copy of the document as it appears in the records and files of my office.
IN THE WITNESS WHEREOF, I have hereunto set my hand
and have affixed my official seal at Anchorage, Alaska,
this q �-�' day of
By Vy
Rec r -Z
zoo
If more than 7 septic system is on the lot:
COSA Checklist # _of _
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: Blueberry Hill S/D; Block 4, Lot 3 Parcel ID: 051-202-11
A. WELL DATA
Well type Private If A, B, or C provide PWSID # - Well Log (Y/N) Yes
Date completed 7/26/2002 Sanitary seal (Y/N) YeS Wires properly protected (Y/ -N) Yes
Total depth 338 ft. Cased to 40 ft. Casing height (above ground) 18+ in.
FROM WELL LOG AT INSPECTION
Date of test 7/26/2002 10/29/2015
Static water level 33.85 ft 206 ft
Well production 1.0 g.p.m.. "0'10 g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mL Nitrate alk mg/L
Arsenic fi.)D ug/L Date of sample: 10/29/2015 Collected by: AK RICIN Engineering
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEP/FiberglassDate installed 8/1-5/2002
Tank size 1500 gal Number of Compartments 2 Cleanouts (Y/NYes
Foundation cleanout (Y/N)**Y Depression over tank (Y/N) NO High water alarm (YM) Yes
Date of pumping - Pumper See attached maintenance report
C. ABSORPTION FIELD DATA _
8/1-5/2002 x z 3.0 Shallow Trench
Date installed Soil rating (g.p.d./ft or ft /bdrm) System type
4� 30 -- a w'dtn 5 ft Grave I baow e
I i 0.5 ft
qI
Total "" ft
Dat,, #adeq.,.. te99
Fluiao� ptlq in abssrptio
�'��' • . JM aMn��
Any rejA�tieatfj
i p p
pbsorption area 150 . fe Monitoring tube Yes Depression over field NO
015 Results (Pass/,Fail) Pass For 3 bedrooms
1 before test Dry in. Water added 4 50 gal. New depth' Dry in.
�® Final fluid depth Dry in. Absorption rate >= 450+ g.p.d.
iast 12 mo.) (YIN & type) None Known If yes, give date _
D. LIFT STATION
Date installed 8/1=5/2002
"Pump on" level at Timer in.
Datum Bottom of tank
E. SEPARATION DISTANCES
WELL ON LOT TO:
Size in gallons 1500+
"Pump off" level at Timer in.
Cycles tested See attached
Septic tank/lift station on lot 100'+
Absorption field on lot 100'+
Public sewer main 75'+
Sewer /septic service line 25'+
Animal containment areas 50'+
SEPTIC/HOLDING TANK ON LOT TO:
Manhole/Access (YIN) Yes
High water alarm level at 53 in.
Meets alarm & circuit requirements? Yes
On adjacent lots 1001+
On adjacent lots 100'+
Public sewer manhole/cleanout 100'+
Holding tank 10'+
Manure/animal excrete storage areas 100'+
Building foundation Property line 5 + Absorption field 51+
Water main 101+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
Property line *** 0. Building foundation 104
Water Service line 10'+
Curtain drain None Known
Surface water 1004
Wells on adjacent lots 100'+
Water main 10'+
Driveway, parking/vehicle storage .10'+
F. COMMENTS
*1000 gallon storage tank inside garage. **Inside house. ***Easement was
granted for trench to cross property line. Filed in MOA records.
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA C SA guidelines, in effecfon this date.
Engineer's Printed Name1 e�t �2
Date It1g�.a©lti
COSA brown sheet 10-10-12.doc
Municipality of Anchorage
' Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
Water Well Advisory
Certificate of On -Site Systems Approval (COSA) # OSC151620
During a recent COSA on-site inspection and test of the potable water
supply well on Block 4, Lot 3 of Blueberry Hill subdivision, the well's
productivity was determined to be 0.1 gallons per minute. The minimum
well productivity required by this Department (AMC 15.55) for a 3 -bedroom
residence is 0.31 gallons per minute. Restriction of non-critical water uses
such as washing cars and watering lawns and gardens may be required.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
Municipality of Anchorage
• Development Services Department
Building Safety Division 5 E r
On -Site Water & Wastewater Program
4700 Elmore Road
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
ii
Cos
Parcel I.D. 050-202-W
1. GENERAL INFORMATION
Expiration Date:
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing' -address
BLUEBERRY HILL; BLOCK 4 LOT 3
21919 BARCLAY DRIVE *EAGLE RIVER, AK 9957
WILLIAM & CONNIE FORDHAM Day phone 952-5002
21919 BARCLAY DRIVE *EAGLE RIVER, AK 9957
Day phone
DAR WALDEN W/ KELLER WILLIAMS Day phone
865-6500
101 W BENSON BLVD # 503 *ANCHORAGE AK 99503
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
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
El
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 samples. (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
Address
GARNESS ENGINEERING GROUP, Ltd.
3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described 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 soils condition, groundwater 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 the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
Phone 337-6179
Date 10 43 If
Conditional approval for bedrooms, with the following stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Nitrate Advisory Other
By:—
(Rev.
y:(Rev. 11/05)
UF,��� ,
�N-SITE c` .
• 1t'ATER AND : 'R'
WASTEWATER
%PROGRAM -
Original Certificate Date: l ( ")— l — //
'• .Je fr A.
ss.=
O9� '• E 795
�pf�,. �•.Ic��3�it..
bpi
��
04�a Pr o f e s s!ov\o;zg�o
Conditional approval for bedrooms, with the following stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Nitrate Advisory Other
By:—
(Rev.
y:(Rev. 11/05)
UF,��� ,
�N-SITE c` .
• 1t'ATER AND : 'R'
WASTEWATER
%PROGRAM -
Original Certificate Date: l ( ")— l — //
Municipality of Anchorage
Development Services Department °<
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: BLUEBERRY HILL; BLOCK 4, LOT 3
A. WELL DATA *1000 GALLONS OF WATER
STORAGE IN RESIDENCE.
Parcel ID: 050-202-12
Well type PRIVATE If A, B, or C provide PWSID# N A Well Log (Y/N) YES
Date completed 7/26/02 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 338 ft. Cased to 40 ft. Casing height (above ground) 18+ in.
FROM WELL LOG
Date of test 7/26/02
Static water level 33.85 ft.
Well production
WATER SAMPLE RESULTS:
1.0
g.p.m.
AT INSPECTION
9/30/11
166 ft.
*0.07 g.p.m.
Coliform 0 colonies/100 ml. Nitrate ND mg./L. Collected by: GEG, Ltd.
Arsenic: NQ Date of sample: 10/3/11
B. SEPTIC/HOLDING TANK DATA *C/O IN CRAWLSPACE
Tank Type/Material STEP/FIBERGLASS . I Date installed 8/1-5/02
Tank size 1500 gal Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) *YES Depression over tank (Y/N) NO High water alarm (Y/N) YES
Date of pumping Pumper
C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE
Date installed 8/1-5/02 Soil rating (g.p.d./ftzor /bdrm 3.0 System type TRENCH
Length
30 ft. Width 5 ft. Gravel below pipe 0.62 ft.
Total depth *3.08 ft. Eff. absorption area 150 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test 10/7/11 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 0 in. Water added 500 gal. New depth 0 in.
Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date —
D. LIFT STATION *SEE MAINTENANCE REPORT
Date installed 8/1-5/02 Size in gallons 1500
"Pump on" level at TIMER in. "Pump off" level atTIMER in.
Datum BOTTOM OF TANK
E. SEPARATION DISTANCES
Manhole/Access (Y/N) YES
High water alarm level at 53" in.
Cycles tested * Meets alarm & circuit requirements? YES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
100'+
Absorption field on lot
100'+
Public sewer main
N/A
Sewer /septic service line
25'+
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Holding tank . N/A
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation
5'+
Property line 5'+ Absorption field
5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line -A
0'
Building foundation
10'+
Water main N/A
Water service line
10'+
Surface water
100'+
Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION v �F ..........
certify that 1 have determined through field inspections and 4 TH •.7*
review of Municipal records that the above systems are in �' • ' • • ' ' ' • • . ' • . . . • .. . . . . . . . .
conformance with MOA COSA guidelines in effect on this
..... ....................
date. O Gar ss. -
Engineer's Printed Name JEFFREY A. GARNESS 009 E-795 epi
Date 1 h, 40��professio�oo�
COSA Fee S `L 6
Date of Payment /U//g!'/
Receipt Number a 4;^A3 2
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
ASBUI1_T
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
FOLLOWING DESCRIBED PROPERTY,
AND THAT NO ENCROACHME'N'TS EXIST EXCEPT AS
INDICATED. IT IS THE RESPONSIBILITY OF THE
OWNER TO DETERMINE THE EXISTENCE OF ANY
EASEMENTS, COVENANTS, OR RVITRICTIONS
WHICH DO NOT APPEAR ON THE RECORDED SUBDI—
VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD
ANY DATA HEREON BE USED FOR CON:+TRUCTION
i OF FENCE LINES, OR FOR ESTABLISHING BOUND-
ARY LINES.
SEMARD & ASSOCIATES LAND SURVEYING 694-01
SCALE:
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