HomeMy WebLinkAboutMOUNTAIN VALLEY ESTATES #1 BLK 4 LT 6Mountain
Volley Estates
#1
Block 4
Lot 6
#050-661-18
Municipality of Anchorage
Development Services Department {
Building Safety Division
Onsite Water and Wastewater Program, 4700 Elmore Road
P.O. Box 196650 Anchorage, AK 99507 Page ( Of y
wwwci.anchorage.ak.us (907)343.7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SWO80107 PID Number: 050-661-18
Name JERRY KOETJE
Wastewater System: ❑✓ New ❑ Upgrade
bran
314STAYSHEECIRCLE ANCHORAGE, AK 99504
ABSORPTION FIELD
Phone 929-8088 NO W d Babcoms 4
DOW Tnr.rl t] Shallow Trench 0 Bea 0 10 a I D S. F 0 other
LEGAL DESCRIPTION
Sou Rama
2.0
7081 Own horn ongnai pace
2
GPDN12
FI.
Bbck4 Lot Summuarl
DWh to p" bmanl horn engnal grata
Gr" dWh beneelh Pea
MODNTNN VALLEYES7ATE311
0.3 ABOVE O.G. FI
0.3 PEA GRAVEL -2 SAND FILTER Ft
Tovmshp Rarge SeMn
Fd •mac above ongnal pace
Gravel L enPh
3.2 Fl.
36 Ft.
Well21 New E] U rade
' pg
G,aYel andh
Narnba ak,w
or.tarYx between Mlas
10 Fn.
4
2 Ft
Cl6ssdfataal (P wale A a. C)
Taw Depth
Cased a
Toot ab "M area
PVe Melanal
PRIVATE
7-40 Ft.
IqZ FI
360 Ft:
I ASTM D3034 SCH. 40
Or~
S'LL I VA a
Dale Draw
% -"7 S
Slate: were, L"
2-7 '
hutaaer
DOUG GRAY
Owe inetaiw
9.18-2008
L -L
—O
FI
Y.0
Pump sen n
220
Cenq Negh1 Aoove Groom
TANK
GPM
FI.
Z FL
SEPARATION DISTANCES
0 Septic ❑ Holding ❑ S.T.E.P. ❑ Other.
To
Septic
Absorption
Lin
Holding
utguPmate
C.P�y
From
Tank
Field
Station
Tank
Sewer Line
PREMIERPLASTICS
1300 Gat
Mater.,
Nu W d Carnpatinads
We
101'
112'
111'
25'+
HDPE
2
swiace wale,
100'+
100'+
100'+
LIFT STATION
u.
ZZ -
LN
72'
30'
67'
550 Gel
PREMIER PLASTICS
'Pump on. Tavel M
'Pump otf ie e N
Hon waler awn at
FD"'da"p^
39'
47'
48'
e,
38
1
144
Cutin Oren
NONE
KNOWN
Pump Make 8 Model
Elecprul inspechons Warned by
R"n'rl,'i
BENCHMARK
hL T
Coulon"Deiw plon
01 AJ T/7GL F d / C
BOTTOM OF SIDING AT POINT -A'
I
awnwd Nveteal
{ FLL
.'i, 100 Ft
` SO Englneedng
E P
Inspections performed by: 15861 i Birchwood to. Rd. Dates: 1" 9-18-2008
Chuglak• Alaska 99567 2nd 9-19-2008
AVea��Pj.••"«••�s.� r
'; ati
Develo me Se ices DetApproval
* tot,
Conditional Ap roval ��' Date: _% _-0 9
Or
L�%✓_✓
l C � �(`rl�n � /YS
�•I" open :• shot• = ..
,J,'• No. 1437-E
Reviewed by: 3" 0
�t C "POFE-, 10O
and approved Date:
�'�%.,XX
tan arae)
PERMIT NO. SW080107 PACE 2 OF 4
Municipality of Anchorage
DEVELOPMENT SERVICES DEPARTMENT - BUILDING SAFETY DIVISION
ON-SITE WATER AND WASTEWATER PROGRAM, 4700 BRAGAW STREET
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: (907) 343-7904 • www.ci.anchorage.ak.us
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL LOT 6,BLOCK 4,MOUNTAIN VALLEY EST. #1 P.I.D. NO. 050-661-18
SWO80107
ALT SITE DESIGN
BY GARNESS FV1-FV4
AEROCELL UNIT
1//4 TH3A
TH2♦ MT2
NEW I.D. S.F.
NEW 550 GALLON
TH1♦ MT1 FAT ALBERT EH
S.T.E.P. TANK
PRESSURIZED MH NEW 1300 GALLON
. 1K"b PVC ST12s •TMT HOPE SEPTIC ITANKH
t`
CONTROL BOX /
• t
T
A FCO AIR COMPRESSOR,
-GUAGE & ALARM
INSTALLED IN 6rm"BE
a Offal 0NSFHfENT
0
. "OUSE
OM
4
k
100' EXISTING WELL RADIUS
-LOCATION OF
DRAINAGE DITCH
--_— —
-----
V 40•
-r�c1+
r �,. •.
••
•oSoAA•iho}p: ••�}•%
IN� 1457-1
100' WELL RADIUS :; •.,� ,.•'•C���
LOT 7 t,,, •.»...•. -.
PERMIT No. SWO80107
PACE 3 OF 4
Municipality of Anchorage
DEVELOPMENT SERVICES DEPARTMENT - BUILDING SAFETY DIVISION
ON-SITE WATER AND WASTEWATER PROGRAM, 4700 BRAGAW STREET
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone (907) 343-7904 • www.ci.onchorage.ak.us
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL LOT 6,8LOCK 4,MOUNTAIN VALLEY EST. #1 P.I.O. No. 050-661-18
LOT 7
LOT 5
i
I
wo 8010
ORION
I
` I
I
BVSGiRCSS
ACROC[LL UNIT
SEPTIC I
i
. THSA
THiw MT
C pREn
I
NEW I.D.S.E.
I
I
' NEIN 550 GALLON
I
TMIA MTI IAT ALRCRI CH
S.TE.P. TANK
I
W
PRESSURIZ[D YH NEW HGO GALLON
1%-0 PVC EH
I
STI IMT NDVCI SEPTIC I,5A
LOT 8 I
I
:. CONTROL RO[�
In I
I
TRM
I
Co AIR COMPRESSOR,
GLACE f ALARM
z...
INSTALLED IN wommm,
� '
-I
era w $A S EPA E T
I
0
3 I
I
C I
o I
I
I�
1
I
100' EXISTING WELL RADIV
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I
I
LOCATION OF
DRAINAGE DITCH
--_ --------------------
_______ __________ ___________________UNDEVELOPED
I
LOT 9 I
' " B0
00
1' WELL IT OILS
�'� 1�. !
£a
I
LOT 7
c,�t;.•........`,'sr�r
J.. 1'1
. R•
v S,
Na. 1457-I •.��'i
BLOCK 5 I
I
BLOCK 4
1
•' �Aut
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i
PERMIT No. SWO80107
PAGE 4 OF 4
Municipality of Anchorage
DEVELOPMENT SERVICES DEPARTMENT - BUILDING SAFETY DIVISION
ON-SITE WATER AND WASTEWATER PROGRAM, 4700 BRAGAW STREET
P.B. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone (907) 343-7904 • www.cLanchorage.ok.us
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL LOT 6,8LOCK 4,MOUNTAIN VALLEY EST. #1 P.I.D. NO.
INSULATION
86.4
MT1= 93.7'
FINAL GRADE
r- 89.3'
NEW 1300 GAL.
FIDPE TANK
MTl
MTI =90.5
DIST.
1411061
050-661-1
CONDUIT
DISCHARGE PIPE
86.1' �
550 GALLON FAT ALBERT
WITH PUMP ASSF.AfDily
FINAL GRADE A1T2 NIT2=93.7'
INSULATION /-ORIGINAL GRADE
.M CUM
r MR m �LNo
A
GROUNDWATER AT 84.0'
75.5' B.O.H.
I- AIT2=90.5'
BOTTOM OF SAND=88.5'
N T.S.
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Pr'eporod by
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r'LAlI P'LAMrs a L.UI SURVETS p7E; ---
IT IS THE RESPUM&BIUEY OF DIE gUILIIEF IMT vroNrA. !-Nit^ 'rli IMI,v DIJSE IMvkUVIMIINTS ABOVE GROUND AND LASIBLE WLL be
CONSTRUCTION, TO VCPIFY PROPOSED DUILOINO C.NAIIf ILLI AIIK ItM•\WN rrNL%S, RELLW. SLPTIC. C.ICANOUT11. SIOCWALIt S. ORIMIWAY .
TO FINISICO GRADE AND UTILITY MNNEr TIONS AMU ;L, LCILNNINL FI,:, &RC. SI4QYYN IN fNLIN APPRGXIMATF LOUAIIOFI. ONLY SNOW
THE C)CISTENCC Of ANY CASCMCNTS. G)VLNANTS DM RCSTRIf.TON� yr PFr VENT ]IUME IMRw UVk4cN 1Z PREM LACING SEW ANO LOCATLO.
111"Ie" DO N T APPEAR ON TN9 RECORDED SURGIIAS",M FLA I. q I31 JC
UMOfP NO fS!NMMTTANCES SNMNI. AN A$ SL'LT RC :1^,EO ML IIF)SDat RIM %w rm ESTASUSNMC ROLNOARY OR MICE UKS.
THE "VEYOR TAMr? RES'ONSBIUrY NCR TNr Mn1Al DA.YSACllf. ON:Y AMD ASq Alis IINANCm. UABNIY ONLY FOR MC COST Or Tile SURVEY.
LISTED OISTAMLLS PREVAIL OWN SI.ALINf, REPFODLN;ThIN MAV CAUSr e"OM'i IN SCALE.
TO'd d£b:ZT 60-90-ueC
04/06/2009 16:45 9076941211 SNSENGINEERING
r
/
PAGE 02/07
SGS Retd
1090065001
0.100 mg/L. SNJ20 450ONO3-F
B
Client Name
S & S Engineering
Printed Date/Fime
01/21/2009 9:31
Project Namem
Mt. Valley Estate 01; B4 L6
Collected Datc/rtme
01/07/2009 12:00
Client Sample ID
111t. Valley Estate NI; B4 L6
Received DatefTime
01/07/2009 14:40
\(atria
Drinking Water
Technical Director
Stephen C. Ede
rm SID
O
eoi/IOOmL SM209222B
A
Sample Remarks
Sample 1D revised per Client request -
Allowable Rep Analysis
Pan.•oeter Reeulrs PQL units Method Conw4w tD Lent ate am init
Metals by ICB/MS
Arsenic A'D 5.00 ualL 6200.8 C (<10)
Waters Department
Total NitrataNitrite-N
0.165
0.100 mg/L. SNJ20 450ONO3-F
B
(<10)
Microbielogy Laboratory
Colony Count
0
col/100mI, SM20922213
A
(a00)
Total Coliform
0
Cot/IOOmL SM21092=1
A
(<I)
Fecal Coliform
0
eoi/IOOmL SM209222B
A
(<I)
01/12/09 01/13/09 SCL
01/15109 JDZ
01/07/09 DLC
Ol/07/09 DLC
01/07/09 DLC
Jan 08 09 09:34a Sullivan Water Wells
907 688 2759 p.1
CC'erritieb oritting og
by
Docco.a�
SULLIVAN WATER WELLS
P.O. BOX 670272, CHUGIAK, ALASKA 99567 -TELEPHONE 688-2759
OWNEROFLAND: Jt leje`l Aj0F7
ADDRESS:
LEGAL DESCRIPTION:
Cr -T .x* / t3`ic Lo-�
DATE: 7 1 '3' A 4
PERMIT NUtv1BER:v kw� Z O — Cate cf Issue -l- a - Dy
TAXIDENTIFICATIONNUMBER: 25 -y&i - IF
Is well located at appm,/ed�PDrmit local'or.? 4e< J No
Method of Drilling:i63'a r rotary U cable tool
Depth of well: _a go
Casing Type 511ML Wall Thickness inches
Diameter_ inches, depth. !Da feet
Liner Type: ND.d=
Casing Stickup Above Ground: cZ• feet
Static Water Level: �� feet
Recover Rate: I gpm
Method of Testing: Ap,
Well Intake Opening Type: :1 open end en hole
UScreened; Start_( fee: Stopped feet
erforations Start 110 I� StoppedI_�c�,,''11feet
a �N'
Grout Type: /3.. t� % vj7d !:Vclume
Death: from D feet, tofeet
Well D'sinfected Upon Completion? des O No
Method of Disinfection: ChLm..•I't� ";z P/M
Comments:
CAY4,it, V ri <-A_ Jr0
,,)) WC%
_1'410114..1 i CaB/, C_r
_114-40102,J ff ca, L
_Yr/. f<AiaS
�CQ�oL�
13 01j.4.✓
Dril:Vs Name CptE S �Ltr.1
ATTENTION: It Is the respons`bil:ty of the property owner to submit a copy of the well log to the proper authority. Municipality
of Anchorage: Department of Health & I luman Services and/or Department o: Environmental Cermervation. Matsu Borough:
Department of Environmental Conservation.
Arctic Pump & Well Inc.
Jim Sullivan, CPI
PO Box 770197
IMI"M MW Eagle River, AK 99577
YW { Im X (907) 688-2510
(907)258-2510
(907)745-2510
apwncF i.net
Pump Installation Log
Well Drilling Permit Number: SW080107
Parcel Identification Number: 050-661-18
Date of Issue: 8-6-08
Legal Description:Mountain Valley
Property Owner Name & Address:
est#1
Jerry Koetje
Lot•.6
3148 Tayshee circic
fel --L.A
enrh^OP AV 00511.1
Pump Installation Date: 11-24-08
Pump Intake Depth Below Top of Well Casing:220 Feet
Pump Manufacturer's Name: Dempster
Pump Mode1:MBF2-75-52
Pump Size:3/4 hp
Pitless Adapter Burial Depth: 10 feet
Pitless Adapter Manufacturer's Name:Martinson
Pitless Adapter Installer: Grey construction.
Well Disinfected Upon Completion? Yes
Method of Disinfection: Chlorine
Comments:
Pump Installer Name:
Arctic Pump & Well, Inc.
Arctic Pump & Well, Inc.
Page I of /
01/08/2009 10:56 9076941211 SNSENGINEERING PAGE 02/02
Jan 07 09 03:47p R C Electrical Samir He 3388333 p•1
Q._. Afr$ mlffow• td[aaS7YV a.r+..Mfmf w
AC ELECTRICAL
P.O. SOX 1422966
ANCHORAGE, AK 99504.2296
(907) 632-1629
TC:
Ta r S CCS 41GIgC'i'flnQ
+o is C94 --12-4,L
'EC RIA L 0103
I-Vork Order/invoice
�
ncn±i:C]�iP. ,
YW{N evFw fv
CJf!Uww W:�f+Ni.
1
($aArwoRK ❑conTnACT ❑exrra
65 -�i 45
LO �
6 10� OJ/17An AIrC'
�+.au MR
auu .iv
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�l>c�r cf, r 1 c� a Ic a
L 6 Ih Vpllira 1 t✓ C'1t'ciric
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TOTAL LABOR
QT`/'
I �l cif rCc. ".•lin i'irz(�� ' o •. .9573
I
i
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L S
I�
.I
TOTAL MATERIALS:
i
S ,
TOTAL
LAeoa i
^w+T'.w=ww». vy w.�ww{�^+rww•d+•wo..wrndrY wwa
I _ �G� 1 � / /" / , / •G ( V J
Irr....'C
TOTAL
MATERIALS
_.. _
I
Thank Yo u!
TAX
I i
TOTAL
I i
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
ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT
Initial
Permit Number: SWO80107
Date Issued: Aug 06, 2008
Expiration Date: Aug 06, 2009
Parcel ID: 050-661-18
Legal Description: MOUNTAIN VALLEY ESTATES #1 BLOCK 4 LOT 6
Design Engineer: 0003 S 8, S ENGINEERING Site Address: NHN BIRDSONG DRIVE
Owner Name: JERRY KOETJE Lot Size: 70200 SO. FT.
Owner Address: 3148 TAYSHEE CIRCLE Total Bedrooms: 4 Permit Bedrooms: 4
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,LThe following special provisions' .
A. REDESIGNED SYSTEM
Received
Issued
By: Date: 8/4�?g
Date: dy
B
Municipality of Anchorage
• --1 Development Services Department ,?
Building Safety Division ;
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage. Alaska 99516650
www.muni.org/onsite /j 961,5 (
C
(907)343-7904 gefml 0d6WT
O90/O7
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcell.D. 96z) -gyp /-a
Property owner(s) J11
Mailing address 0/
Site address 39.:R,7 ,d i,Ird 5
Legal description (Sub'd., Block & Lot)
Legal description (Township, Range 8 becuonf
SSP %�,l e. Day phone L 2/"' go o
F (C i'• AM Zip Code `7%40q
Lot Size q64 PID Sq. Ft. Number of Bedrooms
T 4/
THIS APPLICATION IS FOR (� all that apply):
Absorption Field
r
THIS APPLICATIO ISf N:
Initial LYQJI f N
Septic Tank
ffi
Upgrade // ❑
Holding Tank
❑
Renewal ❑
Privy
❑
Private Well
❑
Water Storage
❑
I certify that the above information Is' torr t. I further certify that this application is being made for a
Single Family Dwelling and is inlaccordaXce with applicable Municipal Codes.
(Signature of property owner r orized agent)
Permit/Rush Fees: Waiver Fees:
Date of Payment: Date of Payment:
Receipt Number. Receipt Number.
(Rev. 11105)
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Municipality of Anchorage
Development Services Department
Building Safety Division
• i¢• On -Site Water and Wastewater Program
4700 South Bragaw SL
P.O. Box 196650 Anchorage, AK 99519-6650
www.d.anchorane ak ua
(907) 343-7904
OF A(
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GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS S GENERAL CONTRACTORS.
June 23, 2008
Municipality of Anchorage
Development Service Department
On -Site Water& Wastewater Program
4700 Bragaw Street
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907)343-7904
Attention: Deb Wockenfuss
Ref: On -Site Sewer Commetns for Mountain Valley Estates #1; Lot 6, Block 4,
The following is a list of your comments and our response regarding a permit for the proposed septic
system for the referenced property:
I. The cover letter does not state than an Advanced Wastewater System is being used. — The cover
letter states that we are using a Quanics Aerocell System which is an advanced wastewater
system. In the future we will note on the cover sheet that we are proposing to use an advanced
wastewater system and then state which advanced wastewate r system we are proposing to use.
2. Based on the construction method, a french drain may be considered surface water. The system
may be to close to surface water. — A site visit was performed at the end of May and found water
running from the uphill lot northwest of the referenced property into the french drain. The
manhole for the french drain was taken off and found the water running north, away from the
proposed septic system. It is not believed that the water runs between the transition in the grade
on the french drain and the manhole locate southwest of the referenced property. However, a
revised design drawing is attached which shows the proposed septic system will be constructed
100 feet from the centerline of the french drain. It is our understanding that the policy in the past,
that french drains and curtain drain have been considered to be the same. Based upon the
regulations a curtain/french drain is required to be 50 feet uphill from a proposed drainfield. If the
regulations or policy of your department has changed, please issue an official memo. It is very
difficult to design system with changing policies.
3. Missing the Alt'IVTS Maintenance Agreement. — The owner of the property has been notified that
he must go to your department and sign the AW WTS Maintenance Agreement.
4. /s there an excessing slope located on the roadway. — The driveway is uphill from the proposed
septic system and does not impact the septic are in anyway. This should not be a concern with
your department since it is uphill from the septic system.
5. Please note the slope of the driveway. — This is not a concern with your department since it is
uphill from the septic system. However the owner is aware that the driveway can only be a 10
percent slAe.
have any kue#tions, please contact us at 337-6179. Thank you for your assistance.
M.S.
3701 E. Tudor Road, Suite 101 ' Anchorage, AK 99507-1259
Ph: (907) 337-6179' Fax: (907) 338-3246' Website: www.gamcasengincering.com
GARNESS ENGINEERING GROUP, Ltd.
-= - -- -- CONSULTANTS & GENERAL CONTRACTORS +>, r x
April 21, 2007
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907)343-7904
Ref: Proposed Well and Septic System for Mountain Valley Estates #1; Lot 6, Block 4,
To whom it may concern:
The proposed 4 bedroom house is to be served by a private well and septic system. We are proposing to
install a 1500 gallon S.T.E.P. tank and a dual 5 -wide trench type drainfield. Two test holes were
excavated on the property. The drainfield will be designed around the 30 foot radius of these test holes.
Comments regarding the design are summarized as follows:
1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the
percolation test results.
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE. WATERS: There are no surface waters within 100 feet of the proposed septic system.
4. TOPOGRAPHY: As can be seen on the attached design drawing the average topography below the
drainfield is a 15-20 percent slope running approximately west to east.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems.
If you have an;Auestions, please contact us at 337-6179. Thank you for your assistance.
P.E., M.S.
ached is a site plan drawing, a design drawing, one soil log, which are all part of the design package for
system. (Contact G.E.G. Lid. for 7 page construction specification letter.)
3701 E. Tudor Road, Suite 101 ' Anchorage, AK 99507-1259
Ph: (907) 337-6179' Fax: (907) 338-3246 • Websitc: www.gamesscngineering.com
i
100' WELL RADIUS I
If
MdUNTAIN VALLEY ESTATES /1,1 \ �/
LOT 7, BLOCKS I I ---MOUNTAIN VALLEY ESTATES /1,
Of LOT 5. BLOCK 4
� I �
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WATER RUNNING INTO I I 0
FRENCH DRAIN I I Q
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I I /' TM/Z PROPOSED SEPTIC
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MOUNTAIN VALLEY ESTATES /1, I I TH/1
LOT S. BLOCK 5
/ / I PROPOSED
4 B ROOM HOUSE
I \ s PROPOSED 1D0'
c IUS
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MOUNTAIN VALLEY ESTATES /1. \I I •:�3.;1.`=' /
LOT 9. BLOCK 5 I,T,
,�• MOUNTAIN VALLEY ESTATES /1,
I - LOT 7, BLOCK 4
1 1
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GARNESS ENGINEERING GROUP, Ltd. p*�
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Al L TI0011 IIbD. fU1[ 101 YLN014Y.L Nf N]0) htlL 90»}1)-1170 • IY
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: O••• ••..... ..
JERRY KOETJE 929-8088 1 OF 4 O e ';i Y Gor ss.:
LEGAL DESCRIPTION: DRAWN BY: p v CE -7953 ; •\��
MOUNTAIN VALLEY ESTATES #1, LOT 6, BLOCK 4 K.D.M. poi '•••f ssl '
TYPE OF WORK: DATE: Pr ofesalo opo
SITE PLAN FOR PROPOSED SEPTIC SYSTEM DESIGN 4/21/2008
(RBY. 01N5)
URFACE WATER RUNNING
FROM UPHILL INTO
iI FRENCH DRAIN
ENCH DRAIN MANHOLE
I
I'
PF
1,_--HINCI
I I PROP
I DRAIN
II JM by VALVE
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650i ROCELL
L-100 F04
FRENCH DRAI
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II
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LETTER THAT PERTAINS TO THIS DESIGN.
TO OBTAIN A COPY OF THE LETTER
CONTACT CEG. BY PROCEEDING FORWARD
WITH THIS INSTALLATION, THE ENGINEER,
WELL DRILLER, CONTRACTOR AND
PROPERTY OWNER AGREE THAT THEY
HAVE READ THESE SPECIFICATIONS AND
AGREE TO ACCEPT THE TERMS AND
MOUNTAIN VALLEY EST, LOT S. BLOCK 4
IT LOCATION OF CHANGE
7F FRENCH DRAIN
moi' I CO
In., . 15-20%
,.ALTERNATE SITE
l
I I 11-705
TH11 i
II
W u 1s-70%
PROPOSED
4 BEDROOM
MC
OUSE
F
NUMBER OF BEDROOMS: 4
GALLONS PER DAY (CPD): 600
PERCOLATION RATE/S: S MIN./INCH
PROPOSED APPLICATION RATE: 3.0
MINIMUM DRAINFIELD SO.FT.: 2D0
DRAINFIELD DESIGN:
MAXIMUM DEPTH: 2.5 FEET
MOTH: S FEET
LENGTH: 40 FEET
M.OA APPROVED SAND FILTER: 2.5 FEET
EFFECTIVE: 0.5
REDUCTION FACTOR: N/A
ACTUAL SO.FT.: 200
NOTE: THE CONTRACTOR SHALL HAVE
THE NORTH & WEST LOT LINES AND THE
100 FOOT SETBACK TO THE FRENCH
DRAIN FLAGGED BY A REGISTERED LAND
SURVEYOR PRIOR TO CONSTRICTION.
-rrturu u Mw N,Vu Lu .p
\GALLON S.T.E.P. TANK WITH AEROCELL
CONTROLS. PANEL AND FLOATS.
100' OFFSF DRAINAGE LINE
PROPOSED 100' WELL RADIUS I
APPROXIMATE LOCAT10� EXISTING
DRAINAGE NEE —,
ER RUNNING INTO \ /
FRENCH DRAIN
MOUNTAIN VALLEY EST, LOT 7, BLOCK 4
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS i GENERAL CONTRACTORS
]101 C TIOLM VOID. ll 1101 • ,lC1 OWIL YI M ? • A (901)] y) li • IY (007)m. " � COLIC w�.P�timn
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
JERRY KOETJE 929-8088 2 OF 4
LEGAL DESCRIPTION: DRAWN BY:
MOUNTAIN VALLEY ESTATES #1, BLOCK 4, LOT 6 K.D.M.
IYPE OF WORK: °ATE' REVISED
PROPOSED DESIGN FOR SEPTIC SYSTEM 6/23/200E
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DATE: RAWN BY: ..-. -
4/23/2008 K.D.M.
GAL DESCRIPTION: a _ .�. _ .. �4�1 .. . • • • •
MOUNTAIN VALLEY EST. #1, LOT 6. BLOCK 4 . e y A. C mess: 0
TYPE OF WORK: GARNESS ENGINEERING GROUP, Ltd.
DESIGN OF QUANICS AEROCELL SYSTEM GCNSULTANTS60EKERALCONTFACFOF9 p0 +ffZ3/�S'Y�Q�
ve. a •nn er �w 1s1 ron.e[. t wror wm MI mw.n/rw pmt rtr »r . vrt:...�•�y+w�.
PREPARED FOR: D��P�ofesel°�Oo�
PHONE NUMBER: AGE: O04Op��op
JERRY KOETJE 929-8088 4 OF 4
lcm
MOYNAA .CAA 11
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2.5' MAX
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GARNLSS ENGINLLRING GROUP, Ltd. pe
CONSULTANTS 3 GENERAL CONTRACTORS """ .. . . """...... •
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PREPARED FOR: PHONE NUMBER: PAGE NUMBER: A. GOFf1E$S;•
JERRY KOETJE 929-8088 3 OF 4 Q v
LEGAL DESCRiPUON: DRAWN BY: OQ r 53 FFG
MOUNTAIN VALLEY ESTATES #1. LOT 6. BLOCK 4 K.D.M.
TYPE OF WORK: DATE: O0p000��60
PROFILE DRAWING OF SEPTIC DESIGN 4/21/2008
006 0
OF •. Cq°�44
GARI�ESS ENGINEERING GROUP, Ltd. oP. S�ooOo�
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• CONSULTANTS S GENERAL CONTRACTORS 9
3701 E T1000 ROM. S E 101 • AkV" 4 M 9W97 • 91gb[: (07)M7-6179 • Fw 907 32" • M[B50L 9mrrrq+rrYy. • • • • • • • • • • • • • • • • •.O
SOIL LOG - PERCOLATION TEST q„ 0
LEGAL DESCRIPTION: MOUNTAIN VALLEY ESTATES 1, BLOCK 4, LOT 6 P • e A. Gar ess.:
PERFORMED FOR: JERRY KOETJE DATE: 8/13/2007 °v CE
e'•� jz/ 428�cgv
(feet) »» ORGANICS ��00000V�oo
TEST HOLE 2
ON
SOIL CLASSIFICATIONS
2
GW ____ ORG
3 GP ---- ML
TM/2 PROP
GM TO SM GM CL
A SYSTEM
4 w/LENSES OF ML GC OL U TM/I
°C >°9 o SW MH
5
"�'• SP CIA
Z 5'-6' SM i i OH
HEAVY SEEP Sc ♦BEDROOM HOUSE
7
11
12
13
14
15
16
17
18
9
PERCOLATION RATE 5 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
1
TEST RUN BETWEEN 5 FT. AND 5.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: E YES [3 NO
SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: KYLE MAUS
COMMENTS:
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WA P FORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: LI 0 y
DEPTH TO
DATE
GROUNDWATER
8/14/2007
6.83 8/20/2007
8
B.U.l I.
9
10
8
B.U.l I.
9
10
o:
SCALE:
1• - 200•
DATE READING CLOCK NET TIME WATER LEVEL NET DROP
TIME (MINUTES) READING (INCHES)
8/14 2007 1 3:40 - 6" -
2 4:10 30 0" 6"
3 4:10 - 6" -
4 4:40 30 0" 6"
5 4:40 - 6" -
6 5:10 30 0" 6"
DEPTH TO
GROUNDWATER
DATE
DOQO�
o OF ��pp
8/14/2007
7.5
8/20/2007
8/14/2007
I
P
GARNLSS
ENGINEERING GROUP, Ltd.
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CONSULTANTS& GENERAL CONTRACTORS•�•••-•-•--_-•"-••-.....,..-••
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10I • wlc"ONCAL w NX7 (W7)437-6179 • IA< s°) -]3.6 • MSMsnL psn.�q:»..y.om•
4 BEDROOM HOUSE
o:
SOIL LOG — PERCOLATION TEST
LEGAL DESCRIPTION:
MOUNTAIN VALLEY ESTATES 11, BLOCK 4, LOT 6
P J If A. G ness: �O
PERFORMED FOR:
JERRY KOETJE DATE: 8 13 2007
°m� ' LC}EjZI Q,04* P�Oa
DEPTH
0"
4p°d'OrOfsss, 0\
(feet) »»
ORGANICS ITEST HOLE 1
�040000��
1 7_77=
6"
—
0
SOIL CLASSIFICATIONS
5:11
2
0"
SCALE:
m
GW .c_c ORG
3
GP MIL
1 • � 100'
GM CL
4
GC OL
GM TO SM °. °°° o SW MH
5
w/LENSES OF ML '::•.: SP CH
SM OH
6
SC
6 — 7
7
HEAVY SEEP
8
9
ti.O.N.
10
11
12
13
14
15
16
17
18
PERCOLATION RATE 5 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
19
TEST RUN BETWEEN 5 FT. AND 5.5
FT.
20
A FOUR HOUR PRESOAK WAS PERFORMED: N
YES ❑ NO
SOILS LOGGED
BY: JODY MAUS PERCOLATION TEST PERFORMED BY: KYLE MAUS
COMMENTS:
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WA P
FORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: ` Z.
6
DEPTH TO
GROUNDWATER
DATE
7.8
8/14/2007
7.5
8/20/2007
8/14/2007
I
3:41
N
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
�TM/Z
PROPOSED SEPTIC
8/14/2007
I
3:41
N
U TH/1
—
2
PROPOSED
30
0"
4 BEDROOM HOUSE
o:
3
4:11
0
6"
—
c�
4
4:41
z
0"
6"
0
5
4:41
—
6"
—
0
6
5:11
�
0"
SCALE:
m
1 • � 100'
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
8/14/2007
1
3:41
—
6"
—
2
4:11
30
0"
6"
3
4:11
—
6"
—
4
4:41
30
0"
6"
5
4:41
—
6"
—
6
5:11
30
0"
6"
Municipality of Anchorage 5 6 7 8 g � ,
.i_ On-Site Water&Wastewater Program ti ;e.. .,_ >a'
(907)343-7904 +"�a:;` , 5 G r E T Y
s -o
Q.
AUG 0 20)U
a.
cx
CERTIFICATE OF ON-SITE SYSTEMS AP '41` AL „ „ti
68L9 �
Parcel I.D. 050-661-18 Expiration Date: ) 1 �S 1
1. GENERAL INFORMATION
Complete legal description MOUNTAIN VALLEY ESTATES#1; BLOCK 4, LOT 6
Location (site address) 3827 BIRDSONG DRIVE, EAGLE RIVER,AK 99577
Current Property owner(s) SCOTT&KRISTIN BOZARTH Day phone 764-1362/764-1342
Mailing address 3827 BIRDSONG DRIVE, EAGLE RIVER,AK 99577
Real Estate Agent KATIE LIKKEL Day phone 313-7929
2. TYPE OF DWELLING:
▪ Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well • Individual On-site
Individual Water Storage ❑ Individual Holding tank 0
Community Class Well ❑ Community On-site ❑
Public Water System ❑ Public Sewer 0
WaiverNariance request for N/A Distance: -tf
Received by: Date: e/ /5 / / t
COSA to be released to the engineer,unless otherwise requested by the engineer.
COSA Fee$ 0 Waiver Fee$
Date of Payment g 10I\e Date of Payment
Receipt Number N Receipt Number
COSA# 6E- g I 1 o� Waiver#
•
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the
information obtained from the Municipality of Anchorage files and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are)in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP,Ltd. Phone 337-6179
Address 3701 E.TUDOR ROAD,SUITE 101 *ANCHORAGE,AK,99507 ) f
Engineer's Printed Name JEFFREY A. GARNESS,P.E. Date v/g l r'
Engineer's Comments:
In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septic system in accordance with the ������\
guidelines and regulations established by the Municipality of Anchorage and industry practices.The reported results describe the ♦♦♦• OFA l'%4�,
condition of the system/s on the date/s of the evaluation.Separation distances were measured to readily identifiable features ♦ P .•••{
....... h�
Hidden defects or encroachments may exist that were not identified during the evaluation.The operational life of all wells and septic - C •••• ; v ♦♦
systems depend on a variety of variables including,but not limited to,soil conditions,groundwater levels(that may fluctuate during ♦ 1 •••
the year),quality of construction(materials and workmanship),and the water usage of the family utilizing the system/s.These m * \ •;* ♦ •
conditions can vary,and are outside the confrol of GEG.Satisfactory test results do not guarantee future performance of the 4-9 i
system's;therefore,GEG makes no warranty(express or implied)regarding the future performance of the well or septic system.
GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the /, ...i
current systems fail.The content of this report is for the sole benefit of the person/party who retained GEG.Reliance upon the o♦♦.... e ie i A` mes�
information provided in this report by any other person or party,including but not limited to subsequent property purchasers,is not ♦ r �--�
authorized.In short,GEG disavows any legal duty to anyone other than the person/party who paid for this report. ! / C 7)G;.a
3
6. DSD SIGNATURE �� pR0 S4♦♦
LICENSE �,1""���
1( System#1 Approved for 7 bedrooms. #LICEN 84
System#2 Approved for bedrooms. wvi4`i.' ,.
Disapproved. 0/V. ��
�grFS/TF �.
Conditional approval for bedrooms,with the following stipula : R,q
itto c.
frOn 41-
FP
-144•
�C.
•
By: Original Certificate Date: 5Z —( S t4
The Municipality or Anchorage Deve!op,emt Services Division(DSD)issues Certificates of On-Site Systems Approval(COSA)based only
upon the represenatations 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. ATTCHMENTS:
COSA Checklist Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
(Rev.10/12/12)
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system
Certificate of On-Site Systems Approval Checklist
Legal Description: MOUNTAIN VALLEY ESTATES#1; BLOCK 4, LOT 6 Parcel ID: 050-661-18
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed 7/9/2008 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 240 ft. Cased to 182 ft. Casing height (above ground) 24+ in.
FROM WELL LOG AT INSPECTION
Date of test 7/9/2008 7/17/2018
Static water level 27 ft. 29 ft.
Well production 4 g.p.m. 3.3 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG. colonies/100 ml. Nitrate 0.293 mg./L. Collected by: GEG, Ltd.
Arsenic: <5 ug./L. Date of sample: 7/18/2018
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/PREMIER PLASTIC Date installed 9/18-19/2008
Tank size 1300 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 6)) I'& Pumper -M ES244I S) L L 1r
C. ABSORPTION FIELD DATA BELOW EXISITNG GRADE
Date installed 9/18-19/2008 Soil rating kp.d./ orft2/bdrm)"2.0 System type **I.D.S.F.
Length 36 ft. Width 10 ft. Gravel below pipe 0.3 ft.
Total depth *2.7-2.9 ft. Eff. absorption area 360 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test *7/17-18/2018 Results(Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test *0 in. Water added 1,005 gal. New depth *0 in.
Elapsed Time: 0 min. Final fluid depth *0 in. Absorption rate >= 600+ g.p.d.
Any rejuvenation treatment(past 12 mo.) (Y/N &type) NONE KNOWN If yes, give date -
*NOTE: HOUSE VACANT MORE THAN 60 DAYS.ADDED 1,478 GALLONS TO DRAINFIELD ON 7/17/2018 AND AN ADDITIONALLY
1,005 GALLONS ON 7/18/2018.ADDED WATER TO NORTH MONITORING TUBE AND MONITORING LIQUID LEVELS IN SOUTH
MONITORING TUBE. FLUID DEPTH IN SOUTH MONITORING TUBE REMAINED DRY THROUGHOUT TEST AND NORTH
MONITORING TUBE WAS DRY WITHIN 7 MINUTES AFTER WATER HAD STOPPED FROM BEING ADDED.
*PER INSPECTION REPORT AND PREVIOUS COSA. **SEE ATTACHEL MAINTENANCE
D. LIFT STATION LOG PERFORMED BY CERTIFIED SERVICE PROVIDER. ***PER ELECTRICIAN REPORT.
Date installed 9/18 19/2008 Size in gallons *550 Manhole/Access (Y/N) YES
"Pump on" level at *44 in. "Pump off' level at *38 in. High water alarm level at *44 in.
Datum *BOTTOM OF TANK Cycles tested ** Meets alarm & circuit requirements? ***YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main 75'+ Public sewer manhole/cleanout 100'+
Sewer/septic service line *25'+ (WITH CAVEAT) Holding tank 75'+
Animal containment areas 50'+ Manure/animal excrete storage areas _ 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 10'+ Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main 104
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE Wells on adjacent lots 100'+
1.*j.'T1.•► IC' 0
F. COMMENTS
*FOUND 4"STANDPIPE NEXT TO WELL-SEE ATTACHED PHOTO. GEG CONSULTANT,JODY MAUS,WENT INTO
GARAGE AND DID NOT OBSERVE ANY WATER OR SEWER SERVICES INSIDE GARAGE.4"STANDPIPE? P41"(
er' BE FOR GARAGE FOUNDATION DRAIN?)
017
..lookss• i�11
� _ OF. !••
G. ENGINEER'S CERTIFICATION .41 ..••"•'• •..•..�•,
4/ •4• i\ I.. * ,i
I certify that I have determined through field inspections and ,�• •
review of Municipal records that the above systems are in l� •
conformance with MOA COSA guidelines in effect on this "� V
date. ••r • •
• 0: - A. •rness.:
Engineers Printe N me JEFFREY A. GARNESS �jJ' •.,.•...C• • .i.•..,..t 1°10.•4•
�*41 N
Date • - ROF S\C •►•
LICENSE ,''IIiti "`***4
#AECC884
(Rev. 10/12/12)
`.1 .. ' . .!• •( -l:1:€-t i:. i%• '1': t i a`t"f,'I •1)I ,• 'L ..... . �1 ..
1". !: t •. ..l h .q*) t. ii•.:. i, , ... ;,,'.t. Nt, ).)•-•1 i- afi:'tl• 'v('1. ,,%. _
1,•
• Intermittent Dosing Sand Filter
Maintenance Log
Owner hi i`:>14i l 7c' c..-}VA Street Address 39 (2);r A %�
Phone, —134Legal Desc Mo'ir -cin VakIk. ' CCWec PID ,, •
Septic Tank: k cLK
, 9 Cr 0 e
•Sludge level 11 _inches -Pumping: requiredIt •Pumping completed ..rlc�
Absorption Field:
'Liquid level ___V_inches 'Flushing valves per approved design -nc:
-All flushing valves opened. distribution lines flushed, and flushing valves closed Cp no
Lift station:
•Pump basket cleaned •, e no •Biotube effluent filter cleaned . no
•
'Timer float setting I inches •High level float setting4l inches 'Reference point104A o ,.._
'Pump on a _____seconds - •'Pump off_4. __minutes J ,#,;r
•
"Cumulative lifetime cycles N j _ •Cumulative run time-_.•.!� i ._..hours
'Operation satisfactory kir_no
Air System:
.Air pump filter cleaned ves._.,1 i "Air pressure _S psi
-Date of latest install or rebuild g _-_•Air system operationsatisfact not satista_ctory
Alarm System: .r- (14 04)
'Dedicated electrical circuit no '•Audible and visual alarm inside dwellng t '_ s
o
.Float setting Lf CIinches 'Alarm system operation sfa not satisfactory
Comments: ] 4„,f5 ivf oft0,-) bti`. f'ic . put • Pfellu't
v)4 4 Lttcnptt u1 ta?'S f pc4st4 `t
.. ..s,.r.., ,...u't"'//yw,, ,1!.c .. . .)t ? (”
t/A
Q .1 'inSWOr 'Veto :;nim al .rM ,n tt4 , q Ll 1 . "Itis JA e Qc c 0
box 10
'`I'' ' . . L er 4.N4trievl i foe s.51 Foi- t; .fJkj et-fru.jop.•. ..
Maintenance Provider:
Technician NARA.4 su,A4kte- ._._.__..
Date of maintenance 31 .,.
fc StriAtt.S
Company e
Signature .__ _...A,-----'. _.. _ __, Date `uhf
7,11
in,F Ma ntirnanrP I no 04r131.1 rirx•.
GARNESS ENGINEERING GROUP, Ltd
---°==--= •- - ENGINEERING SALES-CONSULTING
Certificate of Onsite Systems Approval
Home Owner Questionnaire
owner SSair K . f.304,nz mStreet Address • 8 2-1 lei)sOr4( t) 12. - . ' 7- '
955 �;1
Phone
1. Has a closing date been set? 9. Do you have any of the following?
111-'4i:es (Date: ro 4-4It-a❑ No 0 Arsenic Removal System
2. Number of rooms in the dwelling(s)that meet 0 Nitrate Removal System
the definition of bedroom `i 0 Sediment Filter
3. Onsite systems on the lot: 0 Water Softener
Er Well Dr-Septic 0 Water Storage Tank
4. Are you aware of any idle/abandoned well or ❑ Well Pump Protector
septic system? 0 Grinder pump prior to septic tank
❑ Yes No 10. Onsite system accessibility:
5. Are you aware of any septic systems or 0 Locked fences
modifications to a septic systems that
have been 0 Dogsin the and
done without State or MOA approval? 11. Has your drainfield been rejuvenated in the last
❑ Yes ❑-'l�lotwo years?
6. Is the home vacant? 0 Chemical Treatment(Date )
• Yes 0 No
�, ,,,,�� /B
0 Terralifting(Date )
Date of vacancy: ❑ Other(Date )
7. Has th ouse been terized?
Yes L� O C9 No
. Have either of the following occurred: 12. How many people occupied the home during the
❑ Well stopped producing water majority of the time you owned it?
❑ Septic system backup 13.How many wells are on the lot? ..
Details: l�
. 610 511%3 6 bPcSE AU&oSr 10
ru Zo/€ •
0 SE ffAS Nor B ".S FoQvY,Rt�
u.JIN' RrZeD ��T Hc,T -71,0: •
—. /�:_i_5<rgli_______
/-• fn Dae: /3 dui o�
1
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 O Day of At4. vtcit of 20 (8 , by and between
J f x,455 °�.
cw4y �f i{'�7,ny Lti55� , 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 Allyn'Uri V4//7 Esh)ec # / L ` ?V z tlk.
located at(legal description)
3827 I3i&kali D/'. E49k £ivvef, At: Vic 77 n/,
2. Maintenance,Repairs and Alterations.
(Owner is required to read. understand and initial each section)
.iThroughout the term of this Agreement,the Owner shall enter into a service agreement
_0(
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).
--1/1Owner agrees that only maintenance and repair personnel approved by the Municipality
g.
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
IR
failure of the system.which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Page 1 of 3
•
•
J IWC Owner acknowledges that the Municipality may request records of maintenance and
[((�''`�f repairs from the manufacturer's representative or maintenance provider.
_yikJ Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
IOwner agrees to grant the Municipality reasonable access to test and inspect the
�
1 / �� AWWTS. The Municipality will give at least 24-hour notice.4
Owner agrees that any sale or transfer of title of the property will not occur without a new
iD� Certificate of On-Site Systems Approval.
sOwner 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.
,j 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
•
OWNER:
•
.. i.._,;. / (signature) Date: 2 )(33( o2o
Ll II. A S A er .. (print name)
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT )
The foregoing instniment was acknowledged before me this 3 day of AVOLJ SI- •
20A, by QJ(\ Q9 UUSS\ 4-1(X0$1.x) Uus51
NOTARY UBLIC Vii'' ALASKA NOTARY PUBLIC
My Commission expires: Q4(21-1 -OZU STATE
Z OF ALASKA
MY EPIEB Juis 27.2020
MUNICIPALITY:
By: ( (/t/ (signature) Date:
g-� 5--fie
(print name) Title:
(rev. 05/18/2018) Page 3 of 3
Parcel I.D. 050-661-18
Municipality of Anchor e S�' � ZJIJ
On -Site Water and Wastewater Progr ,,.3
(907)343-7904 N
Certificate of On -Site Systems Ap
1. GENERAL INFORMATION
Expiration Date: I ^ 6--17
Complete legal description Mountain Valley Estates #1. Block 4, Lot 6.
Location (site address) 3827 Birdsong Drive
Current Property owner(s) Jerry & Vikki Koetje Day phone
Mailing address 3827 Birdsong Drive. Eagle River, AK. 99577
Real Estate Agent Day phone
2. TYPE OF DWELLING:
Fx1 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex) _
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Q
Individual
R
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
WaiverNadance
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 526
Date of Payment W"Illk
Receipt Number ?3018C7
COSA# 05C161t/Z
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 Cerfificate of On -Si Systems prove[ Guidelines for this application, shows that the on-site water supply and/or wastewater
disposal system is (are) sa fGnctional d adequate for the number of bedrooms and type of structure indicated herein. I further verify that
based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply
and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at
the time of installation.
In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test,
and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil
condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions
are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future
performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed
above: -
Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218
Address P.O. Box 100217, Anchorage Ak. 99510
Engineer's Printed Name Steven R Pannone
6. DSD SIGNATURE
System #1 Approved for _�__ bedrooms
System #2 Approved for bedrooms
Disapproved
Date 9/28/2016
M-.��.>>1
s
r�AW
,.....C,
/r���e CE -8149
Conditional approval for bedrooms, with the following stipulations:
By: Q v �_ �c(/L%�Gt Original Certificate Date:
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of pn-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.
-A
7. ATTACHMENTS:
COSA Checklist
Septic System Advisory
Well Flow Advisory
COSAbluesheet f ., c
X Nitrate Advisory
Arsenic Advisory
Other • } �� A r.
If more than t septic system is on the lot:
COSA Checklist # 1 of i
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: Mountain Valley Estates #1. Block 4, Lot 6. Parcel 0: 050-136149
A. WELL DATA
Well type Private If A; B, or C provide PWSID #
Date completed 79/2008 Sanitary seal (YIN) Y
Total depth 240 ft. Cased to 182 ft.
FROM: WELL LOG
Date of test 7/9/2008
Static water level 27 ft.
Well production 4 9 -p.m.
WATER SAMPLE RESULTS:
Coliform 'NEG colonies/100 mL Nitrate ND mg/L
Arsenic ND ug/L Date of sample: 9/8/16
Well Log (Y/N) Y
Wires properly protected (Y/N) Y
Casing height (above ground) 18# in.
AT INSPECTION
7/2112016
29.4
3.5 9 -P.M.
Collected by. PES
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/HDPE Date installed 9/18/2008
Tank size 1300• ' gal. Number of Compartments 2 Cleanouts (Y/N) Y "
Foundation cleanout (Y/N)-.Y Depression over tank (YIN) N High water alarm (Y/N) N
Date of pumping 7/28/16 Pumper JR'S Ptamping
�. ABSORPTION. FIELD WA
9/18/2008 2 2.0 g.p.d./SF I SE
Date installed Soil rating (g.p.d./ft or ft2/bdrm) System type
_Length 36 ft, Width 10 ft. Gravel below piper 0.3 ft.
Total depth 45 ft. Eff, absorption area 360 ftz Monitoring tube Y Depression over field N
Date of ade Q uacY ;r test 7/21/2016 Results (Pass/Fail) Pass For 4 bedrooms
--�— - —
Fluid depth in absorption field before test 0 1n. Water added 625 gal. New depth 0 in:
Elapsed Time; 80 min. Final fluid depth 0 in. Absorption rate >= 600+g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) No If yes, give date
D. LIFT STATION
Date installed 9/182008 Size in gallons 550 Manhole/Access (Y/N) Y
"Pump on" level at 44 in. "Pump off" level at 38 in. High water alarm level at 48
Datum .Bottom of Tank Cycles tested 2 Meets alarm &circuit requirements? Yes
E. SEPARATION DISTANCES
WELL -ON LOTTO:
Septic tanknift station on lot 00+ On adjacent lots $00+
Absorption Feld on lot 100+ On adjacent lots 100+
Public sewer main 75+ Public sewer manhole/cleanout 100+
Sewer /septic service line 25+ Holding tank 100+
Animal containment areas 50+ Manure/animal excrete storage areas 100+
SEPTIC/HOLDING TANK ON -LOT TO:
Building foundation 5+ Property line 5+ Absorption field 5+
Water main 10+ Water service line 10+ Surface water 100+
Wells on adjacent lots 100+
ABSORPTION FIELD ON LOTTO:
Property line 10+ Building foundation 10+ Water main i 0+
Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+
Curtain drain 50+ Wells on adjacent lots 100+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
F 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.
Engineer's Printed Name Steven Patgoe
Date 9/28/2016
COSA canary sheet_2-6-15.doc
I
ASSUILT SEYIA&D & ASSOCIATES LAND SURVEYING 694-0829
I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE.
FOLLOWING DESCRIBED PROPERTY- a OF At e
AND THAT NO ENCROACHMENTS EXIST EXCEI l AS %q
INDICATED. IT IS THE RESPONSIBILITY OF THE �" " i `" 4. }may
OWNER TO DETERMINE THE E:
tISTENCE OF ANY
EASEMENTS, COVENANTS, OR RESTRICTIONS _ 'r• X56 �
WHICH DO NOT APPEAR ON THE RECORDED SUBDI-
VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD Fid
ANY DATA HEREON BE USED FOR'CONSTRUCTIOIN ��"- - ; `' •�" `
OF FENCE LINES, OR FOR ESTABLISHING BOUND- 'w'r;y
ARY LINES DRAWN ' �y Asx g n -