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TRAILS END BLK 3 LT 5
t ode am mm Oro Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211114 PID Number: 015-191-36 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name STEVE KELLY & DAPHNE HALL ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench R Bed ❑ Mound Site Address 11371 COBRA STREET ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 3 GPD/SF +0.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade +1.0 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot TRAILS END 3 5 Fill added above original grade VARIES 3.5+ Ft. Gravel length 15 Ft. Township Range Section Gravel width 15 Ft. Beds: Number of Lines 3 Distance between lines 5 Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 225 Ftz -- -- Ft. Well -- 50'+ 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Gal. Surface Water -- 50'+EXISTING Material Number of compartments Lot Line -- 5'+ NA Foundation -- 10'+ LIFT STATION Manufacturer Capacity Gal. Remarks DECOMMISSIONED EXISTING FIELD, SEALED LEAKING LID OF EXISTING TANK W/ BENTONITE. GRND. WTR. -1.8' OG Alarm location Electrical installed by PIPE MATERIAL House to tank 3034 Tank to 3034 Installer JRS drainfield Drainfield 3034 CO/MT 3034 Inspector FWC BENCH MARK (Assumed elevation) 100 ft Inspection1�' 5/19/2021 5/19/21 Location and description dates: 2.a 3`° 5/20/21 4`° TOP OF AX L I D ON-SITE WATER AND WASTEWATER SECTION APPROVAL r OF �l ,r 1 • Conditional Approval: Date �r�Q ' . ts�l�� % • Curtis Huffman. 1� �F�; • CE 128991 •• �`��� Septic System Approve w� Date —2—S -2 �� vsl,�R• 6/16/202J.- %\q!.r OPROF ESSI�N OF�SS Note: this approval does not include well permit requirements. 1\ kRev uoiueri u/ 30.0' � APPROX. 50 WELL RADII I N 89 59'30"E 189.44' 1 1 5' UTILITY EAS NT R=10 ►� W PROTECTIV RADIUS MT E 28.2' B MT S• F ASPHALT DRIVEWAY 100' o s- MT RADIUS GRND. b O w WTR. No MONITORED C MT O N 2021 ORIGINAL ELD DECOMMI ZONED EXTENT n M OF MOUND D W TH1-ENG 12.0' o 2013 O D N o4BR N FCO o LS INSTALLED K O ^' 007 RESIDENCE MT \ 15' x 15' MOUND m O O W N / SEALED LEAKING O O ;0 EXISTING UD W/ BENTONITE 41. 14.0' TANK LS POD APPROX. LOC 0 Ss AX -20 OF BERM / SWALE O > O rn o 22.2' A < Z COVERED DECK J LOT 5 M EliEl 22,733 S.F. S 89 59'30"W 189.54' w Q TR,41L STREET DRAINAGE DITCH A -C=80,3' SEPTIC SECTION SCALE, NTS B—C=59,4' MT MT 2013 A—D=82.5. 106.66 TOPSOIL 1os.52 ENG TH1 FCO 311 SLOPE TYPE 15' X 15' BED /MOUND 1' ORG/OL B—D=48.7' /� A—E=96.5' IR MH AX20 POD MH MH FABRIC & INSULATION SID B—E=59.3' 103.8 6` OF SEWER ROCK 103.83 — i ORIGINAL 103.33 A—F-94.7 GRADE 10283 2.5' MOA SAND TOP OF GRND.WM. SAND O 7' B — F = 6 9.0' EXISTING STEEL 100.83 5/25/13 1500—GAL ADVANTEX PUMP 5/7/21 BOTTOM TANK & LS BASIN GROUND WATER NO GRND. WATER OF MOA MONITORED OBSERVED IN BOTTOM OF SAND 10' AT. -1.8' FROM 101.03 BED AT INSTALL & BOH TANK INSPECTED & GRADE IN RECENTLY MEASURED AT 2i IN MT* 9283 LEAKING UD INSTALLED MT* OBSERVATION PIPE SEALED W/ BENTONITE TRAILS END BLOCK 3, LOT 5 SUPPORT®SERVICES: FPREPARED FOR:WES w�� OF �% , STEVE KELLY & DAPHNE HALL �� �7 11371 COBRA STREET ,� 9 TH * * 0, ANCHORAGE, AK 99507 k� FIRST WATER CONSULTING 13030 Sues Way DATE: 6/16/2021 rtis Huffman ,�i Y SURVEY: KGL 10 r CE 128991 14� Af Anchorage, Alaska 99516 DRAWN: FWCS6/16/2021 A ar (907)350-9566 SCALE: 1" = 30'VA sslolz�' firstwaterAK©gmail.com PAGE: 1 of 1 MORTGAGE SURVEY _X_ SCALE _ 1 30'_ GRID __SW 2641N Project No. Associates, 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lail & A s s o c i a t e s inc.- (907) 522-6476 Phone ' (907) 522-4625 Fax �F COpp4 Professional Land Surveyors ken®iangsurvey.com o ,� O jonothan®langsurvey.com S Q I hereby certify that I have surveyed the following described property: LOT 5, BLOCK 3, TRAILS END SUBDIVISION (PLAT No. P-604) Anchorage Recording District, Alaska, and that this Mortgage Location Survey is a representation of the conditions that were found on the date the survey was performed. This survey does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained hereon shall not be used to establish any fence, structure, or other improvements. Dated this the Day of Day _ __' at Anchorage, Alaska �_ � ''� �- � It Is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. ?* 49!-H y*l KENN H tNG' .LS-5202. 40�R�FFSSIONA%- �?oo AECC963 MUM IPAUTY OF ANCHORAGE On -Sita Water & wasta%yater Program PO Box 196zW 4700 Elmore Roed Anchorage, Alaska Ml phone_ CW) 34;�-7W For. t9 ) 343.7 97 htlO:+!www. rnunior*mMe On -Site Wastewater Disposal System Permit Permit Number; O P211114 Work Typa- Septic Upgrade T;%y rrkr o Nt,mho-r- n1 r.1111 non Site Legal' Address. TRAILS E=ND BL 3 LT 5 C=2641 Site Mailing Addr-ess: 11371 COBRA ST, Anchorage UW1 M. KE=LLY b I E_VE= & 0 es I gri En g inee r: FI RST WATER CON5ULT1 NC Th Es perm it i s fQr th a constru ction of; Eyffe4; ve Date: Expiration Date, tititi e n r CAW� 4}rf r r. Dopa r jMW"r Lot S lae In Sq rt; Taal Bedrooms. 412M-021 4Wr2.022 22735 0 Dl. po tai Field ❑ 0ep1ii. Trac i k ❑ I IvIk1i i iy Tai ik ❑ Privy ❑ m ivate Well D VVa tei 3 EUi dy v All construction shall be In acoerdance with; 1. The attached apprawed design, 2. Ail requirements specif-ed in Anchorage Mkanicipal code Chapterr, 15.55 and 15.65 and the State of Alaska Wastewater Disposal Ra3gulations (18AAG72) and Drinking Water Regulatlons (18AAC80) _ The wastewater code requires inspections during the installation_ The engineer shall notify the Developrnent Services Department per AMC 15.65_ Provide notification by calling (007) 343-7904 (24R). 4. From October 15 to Aprll 15, a sa bsurface soil absorption system under construction during kaazing vwea"r shall he either-. a. Opened and Closed on the same day, or b. Covered, sealed. and heated to preaentzing "ctal Provisions - 1. Seven day ground water monitoring is to be completed prior comtruction_ Please submit stamped Dnd Ogne•d resvIts wwlth the As-bullt Inspectlon Report_ If the results require a design change, construc4ion of the system will stop pending 0n -Site review and approval. 2. The tank is to be invastigab&d to determine if there is groundwater Intrusion and repaired if necessary. Raceivad 133 Issued Ey: 4/27/2021 Data'. Date:' I r 4 ON-SITE SEPTIC/VVELL PERMIT APPLICATION Parcel I.D. 015-191-36 Property owner(s) STEVE KELLY & DAPHNE HALL Day phone Mailing address 11371 COBRA STREET, ANCHORAGE, AK 99507 Site address 11371 COBRA STREET, ANCHORAGE, AK 99507 Legal description (Sub'd., Block & Lot) TRAILS END B3 L5 Legal description (Township, Range & Section) Lot Size 22,733 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field rx-1 Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank ElUpgrade Z El (D) Holding Tank El Renewal ❑ Renewal Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Jr `� 5 Waiver Fees: Date of Payment: ' Z( Receipt Number: 1120 C�Z3�r Permit No. ()S9 a) Date of Payment: Receipt Number: Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com April 26, 2021 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: TRAILS END BLOCK 3, LOT 5 The property owner has requested we obtain a permit to upgrade the failed absorption trench of the above referenced lot. We propose to install a mound as shown on the attached design to serve the existing 4-bedroom residence. The design is based on MOA record documents (soils, groundwater monitoring, ). An additional testhole will be performed the middle of May 2021 to confirm soils and groundwater. The proposed mound will have total absorption area roughly one-third larger and 1 higher in elevation than the original absorption field, which will be completely decommissioned. The slopes are moderate at 5-8% at the proposed upgrade location. The lot and area are served by private water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211114, Deb Wockenfuss, 04/27/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211114, Deb Wockenfuss, 04/27/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211114, Deb Wockenfuss, 04/27/21 A,A lInsfir-wry r' Municipality of Anchorage -;,. "`'uJu�: On -Site Water and Wastewater Program • (907) 343-7904}' Page ON-SITE WASTEWATER INSPECTION REPORT DEC 17 Z0115 Permit Number: OSP/3117 2- PID Number: 0/55/ 71 36'6cc Dwelling: PSingle Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project?�qNew ❑ Upgrade Name: ABSORPTION FIELD El Deep Trench '7`lI Shallow Trench El Bed El Mound Address (� �0 L�(F2 / 4 3��r' ❑ Other Phone' y 7070? Number of Bedroomp Soil Rating 5 Total depth from original grade 3.00 ,3.55— 0? GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Q • Ft. Gravel depth beneath pipe (0- ^� [— Ft. Subdivisior /�— ����� S Block Lot 3 Fill added above original grade 2 t Gravel length 36 ( Township Range Section Ft. Ft. Gravel width Ft. Beds: Number of Lines — Distance between lines — Ft. SEPARATION DISTANCES ToESepticAbsorption Field Lift Station Holding Tank Sewer Line Total absorption area Number of trenches � Dist. between trenches From 150 Fe — Ft. Well Q/ 6� ` / TANK ❑ Septic ❑ S.T.E.P. ❑ Holding 1l Other ✓ Manufacturer _ 2, /%J (/139 X-15 ��(�l/l Capacity S Q Gal. ( S aG / urface Water 5�� C ['�� `' Material Number of compartments J �J Lot Line IQ ¢ NA Foundation/d i f 6 A) 't- LIFT STATION Manufacturer Capaci� _ ' Gal. Curtain Drain r l%6 U� v�� Remarks � , t iL�vE� J"l� '�JO _ /�L 1/ Pump on level at 3 (�: Pump off level at y 6-, - High vra er alarm at ' 6 in. in. in. Pump make d model Electrical Inspections performed by PIPE MATERIAL House to tank P V G Tank to � f 4(3 Installer CAf-iS drainfield Pig7 Drainfield_Sp CO/MT d� BENCHMARK (Assumed elevation) /SCS ft Inspector ��/L(:—=,A j Inspection���-- dates: l 62 � 2nd -- Location and description aro 6 2� / 4in COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineers Stamp Conditional Approval: Date CiC r �I �O LIT ' n [ tad 1 Vl ! tyl J .L� "--"! [+'6'OG4s9 nvr: on. r�o.�: ,.., as, •s 51G�9 ?f a ,.� �y//f,/S'�( 1 \ — � CGJr ,rCVlc�sr_�ea =, t , W. Eng A Approved Date If15172C00n KepOfi_y-I-"I 2.000 G7R7 IQ2m It eG@ �dq q... eeem mWwa / § 2 z- /{ f 2 / §_ / /�� 23® f ) G //\ 7 c o �a 2 2 G �\ wm* � C -P 0 X -P @ m (- -P c d Cl- > 7 � * \\ a« cc co I >> ! W� � ze :, 0 G w 2 � ; S p 2 L - m i 4 LO g u) / 4 c ;a G» f % #; / / d Qk 41 /LLJ G� I C: b « ±« oj ,ƒ /' y : � ( L ± 4' . g o c 0 m 2 � . \ ! (§j S: / ( ( 6 z 00 _ ! G 3 0 w § u ) w u� Lk_ \ } E )_ \ o ) w { J \ 0 \ \ j ] ... r n \ \ « s 7 � \ 4' cai � \ � § ) OJ g 0, Ln 00 / W \ 75 j § — m41 \ q - \ ---- ) \ \¥ k as- � ) !� a.Q \ } 0i9 K $mi 41 § R .. \ � j 0 G w 2 � ; S p 2 L - m i 4 LO 2 u) / 4 c ;a G» #; / / d J� A Z G G» #; «' Qk 2� /LLJ G� .92 C: b « ±« /' y : � A ; May 21, 2014 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 5, Block 3, Trails End Subdivision Well Decommissioning Waiver Dear Onsite Services Engineer: The existing well on Lot 5, Block 3, Trails End Subdivision was decommissioned on October 18, 2013. Work was completed by Cat's Eye Excavating under the supervision of Dave Harper of Alpine Drilling. The well was exposed to 8' below grade where the casing was removed. The casing was then backfilled with a mixture of onsite silty sand and cement slurry to the bottom of the well. The top 4' of the casing was filled with concrete and the entire excavated area was then covered with a 1' layer of additional concrete. The excavated area was then backfilled to grade. The process to decommission the well is not totally in compliance with Section 15.55.060 Section L of the Water Well Code, but the methodology used insures shallow surface water or other contaminants will not encroach into the abandoned well casing and find its way to the aquifer. We hereby request a waiver be issued allowing the decommissioning of the well in manner described above. Sincerely, N� Imo-"-.� E. Michael E. Anderson, P.E. P� 49th •°. MICHAEL E. ANDERSON NO. CE -4381 4 AGREED: ,.,t� David Harper, Alpine Drilling 01/31/2014 19:10 907-345-0202 ALPINE DRILLING PAGE 02/02 Municipality of Anchorage Community Development Department On -Site Water and Wastewater Program 4700 Elmore St. - P.O, Box 196650 Anchorage, AK 99519-6650 • http;//wvvw.muri.org/onsite • (907) 343-7904 Well Decommissioning Log Legal Address: Subdivision Trails End Block 3 Lot 5 T R Section Lot On-s@e Water & Wastewater Program certified contractor performing the well decommissioning: Name: David Harper/Cory Gove signature: t Company: Alpine Drilling/Cat's Eye Well decommissioning data 10-18-13 Method ofdeoommissioning: AMC. 15.55,060Ll &.❑ b. El C. Location: Use the space below to provide a drawing of the property showing the following Berns; -- • North arrow • Decommissioned well, • Other water wells on the property, • Two separate swing -lie distances for each well shown on the drawing, Note: The swing -lie distances shall be measured from either permanent structures or the property corners. The area surrounding the casing was excavated to 8' below grade. The casing was then cut off. A mixture of on site silty sand and cement was injected into the well casing to the entire depth. The top 4' of casing was filled with concrete. A second lift of concrete 1' deep was then placed over the excavated area. The excavated area was then backfilled. G:SCommunity DevelopmenttDevelopment ServlceslBultdtng SafWOn Site Water and WastewaterlFormsk0lent Forne\W@II Decommisionirg form.doo Certified Drilliniq Log I lip- BILL 8. COLE DOC CO dba �9 ULLIVAN WATER WELLS OWNER OF LAND: Foster's Fine Finishes ADDRESS: PO box 3511 Palmer, AK 99645 LEGAL DESCRIPTION Trails End Blk 3 Lot 5 DATE: 10/25/13 PERMIT NUMBER: 131172 DATE OF ISSUE: $/5/13 TAX IDENTIFICATION NUMBER 01519136000 Is well located at approved permit location: ® Yes ❑ No Method of Drilling: Fair rotary ❑ cable tool Depth of Well: 240 Casing Type: Steel Wall thickness ,250 Inches Diameter: 6 Liner type None Inches, depth 104 feet Static Water Level: 13 feet Recovery Rate 5 [ gpm ❑ gph Method of Testing Air Well Intake Opening Type: ❑ open end Z open hole Screened Start feet Stopped ❑ Perforations Start feet Stopped Grout Type: Granular Bentonite Volume: 50 lbs Depth: from 0 feet, to 42 feet Well Disinfected Upon Completion: 0 yes ❑ no Method of Disinfection: Chlorine 50 ppm Comments: R ♦r l r _ r� !'�71 4 1: r Bore Hole Data Depth From To 0 2 Stickup Overburden Silty Sand and Gravel (tight) Sand Silty Sand and Gravel Hardpan Bedrock(broken) Bedrock Drillers Name: Bill Sullivan ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. Matsu Borough: Department of Environmental Conservation. Municipality of Anchorage Community Development Department On -Site Water & Wastewater Program 4700 Elmore St. P.O. Box 196650 Anchorage, AK 99507-6650 www.m.uni.org/onsite (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW 131172 Date of Issue 8-5-13 Parcel Identification Number: 01519136000 Legal Description Trails End Lot 5 Block 3 Pump Installation Date: 7-18-14 Pump Intake Depth Below Top of Well Casing: Pump manufacturer's Name: Goulds Pump Model: 7GS07412-C Pump Size: 3/4 Pitless Adapter Burial Depth: 10 Pitless Adapter Installer: Cats Eye Disinfected Upon Completion? ® yes Method of Disinfection: Chlorine 50 PPM Comments: Pitless Manufacturer: Martinson 230 Property Owner Name & Address Gary Foster- PO BOX 3511 Palmer, AK 99645 feet hp feet Pump Installers Name: Chad Cross and Cole Sullivan —Sullivan Water Wells Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Well Disinfected Upon Completion? On -Site Water & Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP131172 Tax Code Number: 01519136000 Work Type: WellSeptic Permit Effective Dates: August 05, 2013 Design Engineer: NORTH RIM Subdivision: TRAILS END to August 05, 2014 Site Legal Address: TRAILS END BILK 3 LT 5 G:2641 of —2. Lf,. f5 //'0Z Owner/Address: FOSTER GARY L DBA FOSTER's FINE FINISHES PO BOX 3511 PALMER AK 996453511 Site Mailing Address: Lot Size in Sq Ft: Total Bedrooms: 22733 4 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy Y Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: 1. The existing well is to be decommissioned prior to Inspection Report approval. Special Provisions: 2. The berm is to be in place prior to Inspection Report approval. 9/ra/i3 cd 'ezr afiV 1 10-w u�_d jekyyn / (TL/ P W Com"` -l t S (t Y C, c� 4� %- • 11r-1 'v !� t en C ✓' if- 6-13 cd, sdt'a. Received Issued By 4 Municipality of Ancho P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 hftp://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program mens S �o F E r y Department **** VARIANCEIWAIVER REVIEW **** Waiver#: SP131173 COSA#: PID#: 015-191-36 Legal Description: Trails End B3 L5 Engineer: North Rim Engineering Applicant: Gary Foster Permit#: OSP131172 Your request for a waiver of the required 100 feet horizontal separation from the absorption field to the surface water has been approved. The approved separation distance is 75.0 feet. In addition, the tank to surface water separation is approved to be 55.0 feet. This waiver approval applies to the proposed absorption field and tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ............................................................................... Waiver is Granted: X Waiver is not Granted: Date: Approved by: Name of Reviewo( ........................................................... •.................. Rec#: 045940 Amount: $800.00 Date Paid: 6128113 **** VARIANCEIWAIVER REVIEW **** MUNICIPALITY O Community Development Department Development Services Division - On -Site Water & Wastewater Program Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/ WELL PERMIT APPLICATION Parcel 1. D. G ( 5- !`ll— 3 6 Property owner(s) _%ark Ems �zr Day phone 3 1 S - 5011 Mailing address `� 6o'y/ :5 5", 0 - ? Site address Legal description (Sub'd., Block & Lot) 3 C. 4 3 L S Legal description (Township, Range & Section) Lot Sized z, 733 Sq. Ft. Number of Bedrooms APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field Initial 1E51 �❑ Single Family (SF) �a (`^1wo ADU) Septic Tank [ Upgrade Duplex (D) ❑ Holding Tank E]Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well Water Storage f ❑ n Distance: --7-9' I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. property owner or agent) Permit/Rush Fees: S3U dCX3 Waiver Fees: 8� r Date of Payment: (0 0(l i Date of Payment: (o�a$ (L3 Receipt Number. GqtTCj qO Receipt Number: Permit No. ©S'e 1311-)a Permit App_9-1-12.doc Waiver No. OSP 13 i I '_?a ENGINEERING IZ M MEMO Steve Eng, PE, PH P.O. Box 770724, Eagle River AK 99577 (907) 694-7028 tel northrimeng@aol.com Date: 6/27/13 Number of Pages: To: MOA On -Site Services Subject: Trails End S/D, Block 3, Lot 5 Advantex Design & Well Siting A new house and wastewater system are planned for the subject lot. A previous test hole (by others) showed poorly graded sands below organics. A high groundwater table is present. A perk test was conducted at the site of the previous test hole. The design calls for an elevated trench, new Advantex Cat III, Lift Station, & private sewer lines. Private water wells serve the area lots and are shown in drawings. A new water well is also proposed. Please review the wastewater system design for the single family home. I have included design plans & specs, design guidelines, & soil tests. If there is need for additional information or clarification please give me a call. Thanks -Steve �iC�TI- IZM ENGINEERING MEMO Steve Eng, PE, PH (907) 694-7028 tel NorthRimEng@aol.com Date: 8/3/13 To: MOA On -Site Services Subject: Trails End S/D, Block 3, Lot 5 WAIVER REQUEST Number of Pages: 2 The subject site has high groundwater and a small surface water drainage along Trail Street. Due to these difficult site conditions we are designing the Advantex system. We are following the State of Alaska (SOA) Memorandum on waivers, dated January 3, 1985. We have scored the system based on this State Memo. However the Memo further advises that measures can be taken to mitigate contamination. For this reason we are using the Advantex; even though point totals are not high, the Advantex system provides a superior quality effluent. Neighboring lots are successfully using the Advantex for treatment. The waiver request to the runoff flow in Trail Street is to 75' for the absorption trench and 55' for the Advantex Tank. The required separation is 100'. By constructing a surface berm along with the natural topography we will meet the basic intent of the 100' separation requirement. After consultation with your office, we will request a waiver according to the State of Alaska (SOA) Memorandum on waivers, dated January 3, 1985. This Memorandum utilizes a procedure to award point values for geological conditions at the site and makes recommendations based on these point values. Geological: No well log was discovered for geological information. Test holes previously completed on-site indicate the top 10' to be clean sandy gravel. Measurements of lake level and water level within the well were completed to determine gradient. 1. Water Table: The distance from the bottom of the leach field to the highest water table is 4'. Water level is assumed to be that monitored from Test Hole 1. This gives a point total of 0.5. MIIRT� IL ENGINEERING MEMO 2. Soil Sorbtion: The soil tests indicate the soil is silty sand. The average of silt and sand equals a point total of 3.0. 3. Permeability: There is a point value for silty sand. This yields a point total of 1.7. 4. Water Table Gradient: The slope of the gradient most likely parallels the surface slope @ 5%. However the property slopes toward the southwest rather than directly south to the stream. Normally the gradient slopes toward the surface water, but it is close to neutral due to the direction of flow. This yields a value of 2.5. 5. Horizontal Separation: The horizontal separation is 75' to the absorption trench & 55' to the Advantex Tank. This yields a value of 2. The total point total = 0.5 + 3 + 1.7 + 2.5 + 2 = 9_7 This point total has a value that states "contamination is unlikely from bacteria, but possible from chemicals or virus". However the SOA Memorandum places special emphasis on "mitigating" factors. We feel that the advanced wastewater system will allow a deviation in this case from the required separation. It is likely that this road runoff drainage already contains bacteria which is usual for a surface water. To further mitigate any damage we are constructing a berm, which along with the natural topography will require over 100' for any surface effluent to engage the surface water. We request the waiver due to the above argument. If there is need for additional information or clarification please give me a call. Thanks -Steve GO --laI Block 3 Lot 5, Trails End S/D Nor[hRim Engineering SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is a new single family home with 4 bedrooms. High groundwater exists in the area. Neighbor lots have been successfully developed using the "Advantex" advanced wastewater system. The Orenco Systems, AdvanTex Treatment System will be utilized. This system requires a 1500 gallon processing tank/lift station and 1-AX20 filter pod. A Category III System drain field will be utilized, which will allow an application rate of 5 GPD/FT2. This allows a 5' x 30' bed. The bed will have a 2 foot thick sand liner beneath the drain rock. Adequate separation to groundwater will be maintained by elevating the entire system. A new sewer service line & foundation cleanout shall be installed. No adverse impacts are expected from development. The neighboring subdivision lots are similarly developed, some are vacant. Water wells are depicted on the drawing. Lot 6 to the east is undeveloped. Soil tests found typical soil for this area; sandy soil with high water table. The soil test/monitor was completed by another engineer, however a shallow perk test was recently completed at this site. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations, Orenco Systems AdvanTex Treatment System Design/Installation Manuals, Anchorage Tank & Welding requirements. • Installation by an Authorized AdvanTex Installer only; approval issued by Orenco Systems & Anchorage Tank & Welding, Inc. • 1500 gallon, two compartment AdvanTex processing tank, 1-AX20 filter w/50 gpm pump, VeriComm Monitoring System & Mode la standard package per AdvanTex Treatment System Manual. • Watertight couplings on inlet & outlet. • 5 foot minimum between the tank and bed. 10 foot minimum to property lines. • 3 feet of cover or insulation is required for trench; an equivalent of 1" insulation for one foot soil cover. • Tank & solid pipe must be set on well compacted, stable soil. • 2' Sand Liner to be from approved MOA vendor such as "Central Paving" in Wasilla. • 4 inch diameter cleanouts with airtight caps are required 1 to 4 feet from foundation wall, prior to any 90 degree bend in 4 inch line, prior to the processing tank. • All cleanouts must extend to at least ground level • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron • Trench to be placed level, minimum of 4 feet to groundwater, 6 feet to bedrock from drain -rock • Drain rock to be %2 inch to 2 '/2 inch screened. Drain rock to be distributed uniformly throughout the trench. • Perforated pipe to be installed level with perforations down • Silt barrier (filter fabric) to be installed above the drain rock • Smeared trench sides must be raked or scarified before drain rock placement • Backfill over drain rock must not be less than 36" or insulation required • The finish grade must be mounded to promote drainage over the bed • Insulation must be placed over any pipe installed under driveways or parking areas. Block 3 Lot 5, Trails End S/D CO *I NorthRim Engineering AdvanTex Treatment System and absorption bed shall not be located under driving or parking areas. • Schedule 40 PVC (1 inch) to run from Advantex Lift Station to field. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope • Maintenance agreement for the AdvanTex Treatment System is required for approval. • Insulation board shall be extruded direct burial polystyrene (Dow Styrofoam HI or equal) LLI F -- O z z 0 (n W in co &�( N M a I[) 0 4M z o H \H o > N II u o W z LLJ Q o > M JW 1� pq cz X G W dS � J J w x 3 3 wLLJ z ~ > z a 0 > Q W Q J Q Q � �: :04 p Coif Q \ Ln � 0 � ~ Q W c L � Pa > J g }' J O W I N NE L m c� u N d L C5 Y co co H u ca 0, X -P o c � J i co N 0 x p �.0 /I N N -� z u N 0:1i�0 3 C5 C4---W O O al u V N Yo Ll N vj O p N Q 3: a d ih in L O UI o i O o Q Ul p" O 3 f U-)jv.�: u Y r-1 L fv i � I J 6 @ 0 I O a j 0 Ll I. L f L7 N x m Cl m + r o 3 s C5 o a 0 L� Coif Q \ Ln � 0 � ~ Q W z Q � Pa > J Q J 3 W L m c� Y co co H U Q o � J Wz r -i Q z W H x W 0 � ~ Q W z Q � Pa > J Q 3 THF NmIINEE S❑ILS LOG - PERC❑LATI❑N TEST Date Performed: 7/31/13 Performed For: Gary Foster Legal Descriptions Trails End B3 L5 DEPTH (FEET) 9 - 10 - 11 - 12 - 13 - 14 - 15 - 16 - 17 - 18 - 19 - 20 - Organic Fill & Overburden SP Silty Sand W/Gravel TR Locations See Attached Design Previous Monitor Used For Groundwater Groundwater? Yes Depth 8' Water Depth After Monitorinq,7' Date: 5/25/13 # Date Gross Time Net Time Depth Net Drop 1 7/31 0 -- 7" 2 7/31 10 14 min. 8" 1" 3 7/31 12 -- 7" -- 4 7/31 22 14 min. 8" 1" 5 7/31 25 -- 7" -- 6 7/31 35 14 min. 8" 1" 7 7/31 37 -- 7" -- 8 7/31 47 14 min, 8" 1" 9 7/31 50 -- 7" -- 10 7/31 60 14 min. 8" 1" 21 - Percolation Rate 14 min./inch Perc Hole Diameter 6" Test Run Between 2' and 3' Comments: PrPsnaked. MeaSUred to nearest 1/16th inch. Performed By NnrthRlm Eng, I CERTIFY THAT THIS TEST WAS Performed in Accordance with All State/Municipal Guidelines in Effect ON THIS DATE, DATE: 7/31/13 NOR THRIM ENGINEERING PO Box 770724 Eagle River, Alaska 99577 907.694.7028 two C" .• •. a-aro� TESTH❑LE LOG GE❑TECHNICAL IT. H, 1 7/31/13 11 UH C�GDA=L0TY OF Z�\ H C H 0 EE Development Services Department = Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-191-36-000 Expiration Date: 5/18/2024 Legal description TRAILS END BLK 3 LT 5 Site address 11371 COBRA ST Anchorage AK 99507 Current property owner(s) DOMENICO LISA J &MACDONELL ELIZABETH S X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 1/19/2024 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 Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA ApprovaLJune 2022 Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-191-36 Complete legal description TRAILS END BLOCK 3, LOT 5 Location (site address) 11371 COBRA STREET, ANCHORAGE, AK 99507 Current property owner(s) LISA DOMENICO & ELIZABETH MACDONELL Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 10 -See advisory if steel older than 20 years 6. ABSORPTION FIELD: ® AWWTS ® Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ 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 Application.doc COSA Checklist.docx COSA Checklist Legal Description: TRAILS END BLOCK 3, LOT 5 Parcel ID: 015-191-36 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 10/25/2013 Total depth 240 ft Cased to 104 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 1/11/2024 Static water level at beginning of test 21 ft. Well production at time of test 4.3 gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 3.16 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 1/11/2024 Comments B. TANK DATA Measured operating fluid level in septic tank * Date of pumping MAINT REPORT 5/18/2023 Required maintenance completed, if AWWTS Comments: *SEE AX MAINT REPORT …. C. LIFT STATION Required maintenance completed Age of lift station 10 years Lift station material PLASTIC Comments: AX PUMP BASIN D. ABSORPTION FIELD DATA Which system tested (date installed) 5/20/2021 ALL standpipes present per record drawing Total measured depth from grade 3.2 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 1/11/2024 Results Pass Fluid depth prior to test 0 in Water added 600 gal New fluid depth 1 in Elapsed time <5 min Final fluid depth 0 in Absorption rate 600 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 6 in (MOA 6” ED) Effective depth used 0 in (Final Fluid Depth) Effective depth (ED) remaining 6 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots, visual observations, MOA record documents & ED appears approximate at 0.5’ or 6”. 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 *50+ ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No *50+ 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 ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No *50+ ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No *50+ ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS *MAY MEET CONVENTIONAL SEPARATIONS, BUT SYSTEM MEETS CATIII SEPARATION DISTANCE REQUIREMENTS. EXISTING BERM APPEARS TO BE IN PLACE TO DIRECT POTENTIAL SURFACE FLOW AWAY FROM SEPTIC SYSTEM. ELEVATED DECK DRIVEN SUPPORT APPEARS TO BE APPROXIMATELY 3.4’ FROM EXISITING 2013 AX SEPTIC TANK. 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 1/18/2024 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 & 1/18/24 To: Page: 07 of 10 2023-05-18 23:39:37 GMT 19073086608 454 969 ■on ■nea■ a nen a ■ ■■n ■ no name .. ■n■ ■ on Nunn ■ n a ■ an mile 4 Field Report . a. i. Annualf. i From: Wes Anderson AnchorageTank 907-272-3543 Property owoernrecking # Inspect operater Lisa Domenico & Liz MacDonell DO (2.6) A+ Home Services Tech Sno Address �7. Contact. Phone 11371 Cobra Street, Anchorage AK 99507 Intake Vent (503) 975-8099 AX Site 108 County IDR Pod# RTU 41JUL#: nate of Last Inspection AX=133149 OSP131172 417874 RTU128586 07114/2022 Retrieve O&M Info Daily flow Reciro ratio Timer settings: Perform Field Sampling/Observations Inspect NTU (I 5_ pH (6.9) DO (2.6) tst Companmant. :NTUa) IV, E �7. Current Odor of Sample Intake Vent Typical ,Musty ❑ Earthy r, Moldy Non -typical Ef Sulfide f,_'. Cabbage ❑ Decay Oily film in. PVtl L,yes SN, Foam in tank Yes NN,... Check Control Panel Current Previous m Amps Discharge Amps Splice Box "^, i¢Racirc I I •. [ . Audible and visual alarms VLJ ON Dial tone (telemetry only) "&Yes F_-.1 No Inspect/Clean Pump System Inspect Clean ,. Riser/Lid ..... ..., ..... _ Splice Box ......... - Float Cords.. .. ............ .. - Floats ,_.......... .. ........... Pump ....... _ , . ;moi Blotubor Filter.... ' Biotube Pump Vault ......... , , . Recirculating Splitter Valve..... , .... Comments Measure Sludge/Scum Siudae scum InspectfClean AdvanTex Filter Inspect Clean Odor, _ j Pungent Laterals{Onfices :. tst Companmant. Current. Previous Current Previous Intake Vent [> Inspect/Clean Discharge Pump System 2nd Compartment Currant Previous Current Previous Splice Box "^, Pump.. - —. ice, 77 InspectfClean AdvanTex Filter Observations Additional Services Rendered .fel Cleaned textile sheets? [_ Replaced UV items? Replaced/Used other items? Parts Usedt W = Warranty, B = Billable iv/ appropriate selection) W B Item Number Description Final/Safety Inspection RSVrelnatalled Lids bolted on Manifold reconnected, flush valves closed Control panel reactivated Summary/Recommendations System performing; no further action needed ❑ Tank needs pumping Call for service 0 Other? Signature C' ''f.„".' -v -'•`v _ ,. Data L.7,7.+,;, Fax completed form to 1-866-384-7404 Inspect Clean Odor, _ j Pungent Laterals{Onfices :. ��,,'' ��N""ormal Biomat: L Normal '`] Excessive Pod Bottom jy BndginglPonding:''&,NonefMmor f -Excessive !I!I!I Intake Vent [> Inspect/Clean Discharge Pump System Inspect _ Inspect Clean Riser/Lid Floats . Splice Box "^, Pump.. - —. ice, Float cords„ .Inspect/Service Other System Components In*sspact Clean Inspect Crean Disinfection Equipment t - �, Dispersal Laterals/Orifices—S-1 rt - Observations Additional Services Rendered .fel Cleaned textile sheets? [_ Replaced UV items? Replaced/Used other items? Parts Usedt W = Warranty, B = Billable iv/ appropriate selection) W B Item Number Description Final/Safety Inspection RSVrelnatalled Lids bolted on Manifold reconnected, flush valves closed Control panel reactivated Summary/Recommendations System performing; no further action needed ❑ Tank needs pumping Call for service 0 Other? Signature C' ''f.„".' -v -'•`v _ ,. Data L.7,7.+,;, Fax completed form to 1-866-384-7404 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 EZ' Day of Jan char of 20�, by and between ✓a Cah h e (.� l ✓a , 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 located at (legal description) AN ADVANTEX SYSTEM TRAILS END BLOCK 3, LOT 5 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) b-FffThroughout the term of this Agreement, the Owner shall enter into a service agreement 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 D-11, accordance with the equipment's approval for operation in the Municipality. ( )L( It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. J Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Pagel of 3 �Lj Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. KITOwner acknowledges that the fine for failing to maintain and repair an AWWTS may be ssessed 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. n V Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing idelines for the construction, maintenance and repair of the Owner's AWWTS. %i�cOwner 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: By. signature) Date: J (print name) T T STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this Zoday of Tll-%, t-,ry 202,% by 1&9 $� awn T�c� a„al Loral¢ L2ca,+� Trac, NOTARY P LIC FOR ALA ICA NOTARY PUBLIC My Comn 'ssion expires: d/ o/ �2 tea% KEN GARCIA STATE OF ALASKA MY COMMISSION EXPIRES JANUARY 01, 2027 `IN / (signature) (print name) (rev. 05/18/2018) Date:6 Title: Page 3 of 3 MUNIMPAUTY OF ANCHORAGE �-7 Development Services DepartmentPhone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-191-36 Expiration Date:-Auer(V 2C)G1 1. GENERAL INFORMATION Complete legal description TRAILS END BLOCK 3, LOT 5 Location (site address) 11371 COBRA STREET, ANCHORAGE, AK 99507 Current property owner(s) STEVE KELLY & DAPHNE HALL Day phone Mailing address Real estate agent 11371 COBRA STREET, ANCHORAGE, AK 99507 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Date of Payment Receipt Number COSA# Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE 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 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 & FW[..5 6. DSD SIGNATURE System #1 Approved for System #2 Approved for Disapproved Conditional approval for I-( bedrooms bedrooms r�+ Date 6117/2021 bedrooms, with the following stipulations: `TY OF,�ii��` ON oma'% -21,, �� WATER AND r m -- Z5F2V'A�:; 1_F7�'CATER �. 0Z�l PR.OQr- J r�r^ By: Original Certificate Date:�� The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: TRAILS END BLOCK 3 LOT 5 Parcel ID: 015-191-36 If more than 1 septic system on lot: COSA Checklist # _of — Structure served by this system _ A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 10/25/2013 Total depth 240 ft Cased to 104 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 24+ in. Date of flow test for COSA 4/19/2021 Static water level at beginning of test 25 ft. B. TANK DATA Age of tank(s) 8 years Tank type/material ADVANTEX / STEEL Measured operating fluid level in septic tank * ® Standpipes/foundation cleanout per record drawing Date of pumping 8/13/2020 D. ABSORPTION FIELD DATA – NEW FIELD Which system tested (date installed) NA – NEW FIELD ® ALL standpipes present per record drawing Total measured depth from grade 3.2 ft (max) Measured depth to pipe invert from grade ft (min) ® N/A – pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective Well production at time of test 4.5 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ® Nc ® Coliform bacteria is Negative Nitrate 3.57 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by FK Date of Sample 4/19/2021 C. LIFT STATION – AX PUMP BASIN ® Required maintenance completed Age of lift station 8 years Lift station material PLASTIC Comments: *SEE MAINTENANCE REPORT Adequacy test date NEW FIELD Results ❑ Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min ® Code -required soil cover over field wi INsuLTATION Final fluid depth in ❑ System presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced gallons FWFS Comments/Deficiencies: E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No _ ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ® Yes if No ® Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) ft ft ft ft ft Building Foundations > 10' ® Yes if No ft Surface Water > 100' ❑ Yes if No *50 ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: ® Yes Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No _ ft Private Wells > 100' ® Yes if No _ ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ❑ Yes if No *50 ft F. ENGINEER'S COMMENTS *ADVANTEX SYSTEM 50'+ TO PRIVATE WELLS & SURFACE WATER. G. ENGINEER'S CERTIFICATION l certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. tf� TH •' • .... ....t..�.`.�.. • Curtis Huffman ` CE 128991 .• �``�i Development Services Department On -Site Water & Wastewater Section Parcel I.D. 015-191-36 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description TRAILS END BLOCK 3, LOT 5 Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: D ao 1 Location (site address) 11371 COBRA STREET, ANCHORAGE, AK Current property owner(s) STEVE KELLY & DAPHNE HALL Day phone Mailing address 11371 COBRA STREET, ANCHORAGE, AK 99507 Real estate agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Receipt Number ( 0 Receipt Number 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $�%0 ( cot 1 � 17) 01U /h 1_� Date of Payment 5/% /.20.QyDate Waiver Fee $ of Payment Receipt Number ( 0 Receipt Number COSA # t)s G Z.1 12 l C\ Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY ANCHORAGE AK 99516 Engineer's Printed Name CURTIS HUFFMAN PE Date 4/26/2021 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 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 & FWIS 6. DSD SIGNATURE System #1 Approved for System #2 Approved for Disapproved Conditional approval for q bedrooms bedrooms 0J� TH � . .. ......... .M �� . •.�...:. Curtis Huffman CE 128991 -4/26121- PROFESS10Nt�� bedrooms, with the following stipulations: Se �A-i c .s � � ���/t+�c�z �� t ©S� -21(1 1 ` i - -Vo b� cc Nv _o I e_.. -4f±,. an A d---,Q� C) �;�. 10-k- C -S -butt{ SV�,Yw b� + i( ��llltt(r A V(( ON-SITE WA ,. ;,ATER z PROGF\AM Z-02,1 By: �1 C(! C. rUL ,�' SERV ��rtif tate Date: 5 (© ;Wa 1�11� The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist Legal Description: TRAILS END BLOCK 3, LOT 5 Parcel ID: 015-191-36 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 10/25/2013 Total depth 240 ft Cased to 104 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 24+ in. Date of flow test for COSA 4/19/2021 Static water level at beginning of test 25 ft. Well production at time of test 4.5 gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 3.57 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date of Sample 4/19/2021 Comments B. TANK DATA Age of tank(s) 8 years Tank type/material ADVANTEX / STEEL Measured operating fluid level in septic tank * Standpipes/foundation cleanout per record drawing Date of pumping 8/13/2020 C. LIFT STATION – AX PUMP BASIN Required maintenance completed Age of lift station 8 years Lift station material PLASTIC Comments: *SEE MAINTENANCE REPORT D. ABSORPTION FIELD DATA – NEW FIELD PENDING Which system tested (date installed) NA ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Code-required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Adequacy test date NEW FIELD PENDING Results Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) N If yes, enter date Comments/Deficiencies: E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100’ Yes if No 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 From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Property Line > 5’ Yes if No ft Absorption Field > 5’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No *50 ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10’ Yes if No ft Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No *50 ft If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No F. ENGINEER’S COMMENTS *ADVANTEX SYSTEM 50’+ TO PRIVATE WELLS & SURFACE WATER. 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 COSA guidelines in effect on this date. 4/26/21 08/13/2020 17:28 8686770 APLUS PAGE 03 367 936 OI ■■■■■O°.o moons ■n■ ONE ■ SOUSE 8 1■■ ■ on MOOSE ■ ■ no ■■■ ON ■ ■ ■ m■■ ■ ■■■■ ■mm■■■■■ ■ ■ ■O■■ ■■ tet; 4� rfTe,e ce Field Maintenance Report Annual Inspti (ction Proporty 0w erarocklnz Steve Kelly & Dap ie Hall opucnnr Larry Betts AnchorageTank 907-272-3543 Jl:p wdd.sas pl W9) DO (2-6I r77 2 Cnrrtect PBeno 11371 Cobra Stree Anchorage AK 99507 Previous Curent (603) 361-2478 Ax Sko in x eoumy to ♦ Pod x RTU MNL x 0816 of Lost tn8pecnon AX -133149 OSP131172 417874 RTU128586 06/05/2019 Retrieve O&M InfoI Measure Sludge/Scum Daily flow Sludge scum Reclm ratio Timor settings! Perform Field Samp.l t9/Observations NTU (IS t NTUS) pl W9) DO (2-6I r77 2 Odor of Sample Typical �I Must7 71 Earthy ❑Moldy Non-typical /'y/C�J, Sulfld ElCabbage ❑ Decay Oily Rim in Pvu [_ Yes No Foam in tank [_ Yes No Check Control Panel Recim Amps Discharge Am a Audible and visual akin .s 4OK clometry art ):>Dial tan Yea ❑ No Inspect/Clean Pump. iystem Inspect Riaer/Lid ........... Splice Box .......... ......... Float Cords ......... ......... Floats .............. ..... .. Pump.............. ........ elotubo6 Filter ....... ........ Biotube Pump Vault .. ......... Recirculating Splitter Vi vs....... Comments Signature Clean W, 1St Compertmont Cur l Previous Current Previous Intl ampartmcnt Current\ Previous Curent Previous Inspect/Clean AdvanTex Filter Odor: Normal ❑ Pungent .lomat: Normal ❑ Excessive Bridging/Ponding: None/Minor ❑Excessive Inspect/Clean Discharge Pump System Inspect ltl Splice Box Float cords Inspect/Service Other System Components Inspect Clean Laterals/Orificas Pod Bottom , Intake vent VI Inspect Cl Floats yJ Pump Inspect Clean Inspect Clean Disinfection Equipment Dispersal Latarals/Orifice, Observations Additional Services Rendered ❑ Cleaned textile sheets? ❑ Replaced UV items? ❑ Roplaced/Used other atoms? Parts Used: W = Warranty, B = Billable (✓ appropriate selection) W B Item Number Description Final/Safety Inspection ,;"SV reinstalled anTold reconnected; flush valves closed S mmary/Recommendations ❑ System perfomling; no further action neodod ❑ Cell for service Lida hoped on Control panel reactivated ❑Tank need. pumping ❑ Other? Fax completed form to i -a66 -S$4-7404 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCEAND REPAIR AGREEMENT, herein the "AGREEMENT" made and /y entered into as of this ' I Day of % }1 PY of 20al, by and between L Sa �o w c. ,I 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 (AW WTS), described as located at (legal description) AN ADVANTEX SYSTEM TRAILS END BLOCK 3, LOT 5 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AW WTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AW WTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 4�-- Owner acknowledges that the Municipality may request records of maintenance and 1 repairs from the manufacturer's representative or maintenance provider. T Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be V 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. Li V/ Owner agrees that any sale or transfer of title of the property will not occur without a new n Certificate of On -Site Systems Approval. �4yI Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of QWNER- By: (signature) Date: '51-4-2, -z I STATE OF ALASKA THIRD JUDICIAL DISTRICT The.fbregoing-,i�strument was acknowledged before me this 17 20, by Ai)Ui, liolik 4"V NOTARY PUBLIC FOR ALASKA My Commission expires: MUNICIPALITY: By: -(&GCLQ— &A _(signature R&-' C Cc�- ea-,crd( (print name) day of /I Date: Title: (rev. 05/18/22018) Page 3 of 3 ESCROW HOLDBACK AGREEMENT In Reference To: Conditional COSA for 11371 Cobra St Anchorage, Ak 99516 Agreement between Steve Kelly & Daphne Hall/ Lisa Domenico & Elizabeth S MacDonell Property Address: 11371 Cobra Street Anchorage, Ak 99516 Amount withheld: $18,750.00 The undersigned parties authorize Keller Williams Alaska Group to escrow funds at 1.5X’s the highest bid from Michael Anderson, P.E., in the amount of $18,750.00. Funds will be held from the sellers, Steve Kelly and Daphne Hall. For the purpose of: New leach field installation Work to be performed by: JR’S Septic Pumping and Excavation No funds will be dispersed until full MOA approval. Upon MOA approval and issuance of COSA for above property, Keller Williams Alaska Group shall pay invoices for the above-mentioned work. The remainder of excess funds shall be returned to the Seller that funded the escrow account. The work must be completed no later than June 01, 2021. If you have any questions regarding this matter, please feel free to contact me direct at 907-865-6500 or email paddybcoan@gmail.com . The undersigned parties hereby jointly and severally indemnify and hold Keller Williams Alaska Group harmless from and against all costs, damages, judgments, attorneys’ fees, expenses or obligations of every kind and descriptions which, in good faith, it may incur or suffer in connection with this escrow holdback. Dated: ____________________ Sellers ___________________________ Buyers ____________________________ READ AND APPROVED BY: Broker _________________________________________ DLJL6LJQ 9HULILHG: 92)65)B4-AA77-481C-8929-B3B(61B5BAA8DocuSign Envelope ID: 220DD393-3C13-42CE-B3FA-5BAFBE17E983 5/7/2021 | 9:31 AM AKDT 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com April 26, 2021 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: CONDITIONAL COSA LEGAL: TRAILS END BLOCK 3, LOT 5 The pending permitted 4-bedroom septic field upgrade has been impeded due to weight restrictions, pending groundwater monitoring and other factors. We are therefore requesting a Conditional COSA at this time and will proceed with the upgrade once conditions allow. The system has been working for the occupants and granting of this Conditional COSA will not impact any of the neighboring properties or pose a public health risk. Attached are the construction bids and escrow letter for the pending installation. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. EPLFFI'iS MUNICIPALITY OF ANCHORAGE (A- Development Services Department \—" "` Phone: 907-343-7904 On Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On-Site Systems Approval n Parcel I.D. 015 191 36 Expiration Date: C)—(7— �1 1. GENERAL INFORMATION Complete legal description Trails End Block 3 Lot 5 Location (site address) 11371 COBRA KING Current property owner(s) KAREN Day phone Mailing address Real estate agent Day phone 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex Li Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic U Water Storage n Holding Tank ❑ Community Well Fl Community ❑ Public Water System Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 550 Waiver Fee $ Date of Payment to Rot 19 Date of Payment Receipt Number 05-120D Receipt Number COSA# Q SC I t (2(q 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 C&M ENGINEERING Phone 8545558 Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Date 6/5/2019 ......... r*: 49TMI � •.* / 6. DSD SIGNATURE g f•'•.' System #1 Approved for Al bedrooms / ' • • ''u 1 r CHARLES G BALZARINI • System #2 Approved for bedrooms � F�•. CE-13854 Ale Disapproved �ikk4'eo. OFESS10-p� Conditional approval for bedrooms, with the following stipulations: y1Y OF�rq (6? 0 i ON-SITE WATER AND ; WASTEWATER 1 'PROGRAM may. iv;lir cER\jk ')l)J))))1111111 By: Original Certificate Date: (o —17-1 q The Municipality of Anchorage Development Services Division(DSD) issues Certificates of On-Site Systems Approval(COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist Legal Description: Trails End Block 3 Lot 5 Parcel ID: 015 191 36 If more than 1 septic system on lot: COSA Checklist# 1 of 1 Structure served by this system 1 A. WELL DATA 0 Well log is filed with Onsite (or attached) Well production at time of test +4.1 gpm Date drilled 10/25/13 Water storage tank volume na gallons Total depth 240 ft Well disinfected for coliform test? ❑ Yes ❑■ No Cased to 104 ft i1❑ Coliform bacteria is Negative El Sanitary seal is functioning correctly Nitrate 3.77 mg/L ❑ Nitrate less than MRL(ND) ❑Wires are properly protected Arsenic ug/L 0 Arsenic less than MRL (ND) Casing height(above ground) 24 in. Collected by C&M Engineering Date of flow test for COSA 6/4/19 Date of Sample 6-11"I q Static water level at beginning of test 13 ft. Comments B. TANK DATA C. LIFT STATION Age of tank(s) 6 years ❑■ Required maintenance completed Tank type/material Adv Age of lift station 6 years ❑ Standpipes/foundation cleanout per record drawing Lift station material Stl Date of pumping See Advantex Svc. Record Comments: Tank is Advantex/Steel D. ABSORPTION FIELD DATA 5x30x0.5 shallow trench Which system tested (date installed) 70/25/13 Adequacy test date 6/4/19 ❑■ ALL standpipes present per record drawing Results lEPass For 4 bedrooms Total measured depth from grade 3 ft(max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade ft(min) Water added 600 gal El N/A—pressurized field New depth 6 in [' Monitor tubes go to bottom of drainfield. If not, state Elapsed time <1440 min depth into effective ❑■ Code-required soil cover over field Final fluid depth 0 in El System presoaked Absorption rate 600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) no date of test) Gallons introduced na gallons If yes, enter date na Comments/Deficiencies:home was not vacant prior to test.Leachfield Montitor Tube Repaired COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot> 100' Community Sewer Manhole/Cleanout> 100' 0 Yes if No ft 0 Yes if No ft Neighboring Tank > 100' QYes if No ft Private Sewer/Septic Line > 25' QYes if No ft Absorption Field on Lot > 100' QYes if No ft Holding Tank> 100' QYes if No ft Neighboring Absorption Fields > 100' Animal Containment> 50' 0 Yes if No ft 4❑Yes if No ft Manure/Animal Excreta Storage> 100' Community Sewer Main > 75' 0 Yes if No ft LI Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water> 100' 0 Yes if No 55 ft Property Line > 5' QYes if No ft Driveway/Parking >0' 0 Yes if No, comment Absorption Field > 5' QYes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells> 100' QYes if No ft Water Service Line > 10' 0 Yes if No ft Community Wells >200' DYes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 0 Yes if No ft Driveway/Parking > 0' 0 Yes if No, comment Property Line> 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' EYes if No ft Private Wells > 100' 0 Yes if No ft Water Service Line > 10' 0 Yes if No ft Community Wells > 200' ['Yes if No ft Surface Water> 100' 0 Yes if No 75 ft F. ENGINEER'S COMMENTS Waiver on file for reduced separation dist from septic to surface water. new code would not require this waiver. no surface water observed at time of inspection. G. ENGINEER'S CERTIFICATION ��PF ALArkk 1 certify that I have determined through field inspections and review /�'�Q:• of Municipal records that the above systems are in conformance with *"49 TH *�l4 MOA COSA guidelines in effect on this date. 6/7/2019 / •••j ••••• r ..2.,.y... j r6 CHARLES G BALZARINI v ��1ici• CE 13854 ••c.*Age "ki 0pROFESSION'-. COSA Checklist yellow sheet `�\��>>� DocuSign Envelope ID:9ED41 C76-A150-4F74-AA1A-6813695F797B 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 6 Day of June of 20 19 ,by and between Daphne Hall and Steve Kelly , 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 ADVANTEX located at(legal description) TRAILS END LOT 5 BLOCK 3 2. Maintenance,Repairs and Alterations. ,DS DS(Owner is required to read,understand and initial each section) OA" Throughout the term of this Agreement,the Owner shall enter into a service agreement 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 DS DS accordance with the equipment's approval for operation in the Municipality. R- L % 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 DS DS includes an annual maintenance fee(typically$400 to $600). Nk- S Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, __DSDS repairs or permitted alterations to the system. V� S. " Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system,which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 DocuSign Envelope ID:9ED41076-A150-4F74-AA1 A-6813695F797B c—DS DS PR 4 Owner acknowledges that the Municipality may request records of maintenance and DS , —DS repairs from the manufacturer's representative or maintenance provider. CO - S Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be DS SDS assessed in accordance with AMC 14.60.030. Olk S4 Owner agrees to grant the Municipality reasonable access to test and inspect the DS DS AWWTS. The Municipality will give at least 24-hour notice. Of S ' Owner agrees that any sale or transfer of title of the property will not occur without a new DSDs Certificate of On-Site Systems Approval. [ P Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing SDS DS guidelines for the construction,maintenance and repair of the Owner's AWWTS. PN- FS 4 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: B : ! (signature) Date: (0//2h9 (print name)3/04V/16/11 s+.eoh Piv loll (A-1-4-1-1 _41 __.. .., STATE OF AtitSIM ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this /2-day of Atte 1,017 , 20 1 , by jta t.t. L) 2(wrd I-4-a((.c. -. 4 _/ / /1 0% _ �TA'ir :LIC FO' ALASKA �''"••'�'JED IA I4AL�ui•orubh 7 ►d Commission expires: Fe&raeuy q, 2.07.--2- ,, '` .( : ° s `f *common son MUNICIPALITY: By—`. - (signature) Date: (o —/ `e-/ 9 (print name) Title: FIR/Gly/'2G11'i E_IG: 09 86:=0677n APL_Is PAGE 82 mi UI I IN ■ 1111111f ■ 3414 ■■ ■■ !i ■■11 ■ e III I i ■ ■ ■ ■ III I ■ ■■ ■ >• j = ■■■ w■ I ■ ■■ III I ■■ ■■ I ■ mu ; `.AdvarfT?x® Field Maintenance Report Annual Inspection AnchorageTank 907--272-3543 r I nmPerty Ownerr'Froekhg^ A Opamtor I Karen King Larry Betts .SIte Addmrnn Genteel PM>no 11371 Cobra Street, Anchorage AK 99507 (907)529-5611 AX Site ID% County ID t Pod 4 RTU RJUL Y bete of Lasi trrnpaction LAX-133149 OSP131172 417874 RTU128586 06/12/2018 Retrieve O&M Info Measure Sludge/Scum _ a Daily flow - Sludge Scum RacirC ratio 1st Compartment Current P ious Current Previous Timer settings: ------- 2nd -`2nd Compartment Current Previous Current Previous Inspect/Clean AdvanTex Filter Inspect Clean Perform Field Sampling/Observations Odor: ,Normal n Pungent Laterals/orifices f� Blomat: Normal J ExCesalve Pod Bottom _• [NTU(1S±WA) pH(6-9) DO(2-6) Bridging/Ponding; I V C/.'' - ns/Minor 'Excessive intake Vent .�' ' Inspect/Clean Discharge Pump System Odor of Sample Inspect !nopect Cle;,n Typical <I Musty ❑Earthy ]Moldy Riser/Lid Floats 4I. Non-typical ]Sulfide 0Cabbage ❑DecaySpiiceBox Pump I_ Oily film In PVU E Yes NO Float Cords Foam In tank ❑Yes o Inspect/$ervice Other System Components Inspect Clean inspect Gran Check Control Panel Disinfection Equipment Dispersal Laterals/Orifices,�- Recirc Amps Discharge Amps L_._1 3 -`7 Observations - f Additional Services Rendered Audible and visual alarms OK ❑Cleaned textile sheets? L:Replaced UV item:so Dial tone(telemetry only) ❑Yes ( No ❑Replaced/Used other items? Parts Used:W=Warranty,B=Billable(✓appropriate selection) Inspect/Clean Pump System W s Item Number oesoriptior Inspect Clean - - — — Riaer/Lid _ --N Splice Box -- Float Cords , Floats N Final/Safety Inspection Pump RSV reinstalled Lids bolted on Biotubee Filter Mold reconnected:flush valves closed ontrol panel reactivated Blotube Pump Vault Summary/Recommendations Recirculating Splitter ValveAAti tom performing:no further action needed ❑Tank needs pumping ❑Call for service C Other? _ Comments z 17o -- -. Signature f! Date (ley 11 _. Fax completed form to 1-866-384-7404 Municipality of Anchorage • On -Site Water and Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APP Parcel I.D. 015-191-36 Expiration Da 1. GENERAL INFORMATION Complete legal description Trails End Block 3 Lot 5 Location (site address) 11371 Cobra St Anchorage AK Current Property owner(s) Nugent Properties LLC Day phone 355-4722 Mailing address 4237 E Meridian Loop Wasilla Real Estate Agent Nugent Day phone 355-4722 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 Individual Water Storage ❑ Holding Tank ❑ Community Class C Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Received by: / Gla— Date: COSA to be released to the engineer, unless othAise requested by the engineer COSA Fee $ Ln— / Date of Payment i2-11%-11,!5 Receipt Number op>98-1 t Date of Payment Receipt Number. COSA# ora CA.610 (P Waiver 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm _NorthRim Engineering Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 12/16/2015 6. DSD SIGNATURE System #1 Approved for System #2 Approved for Disapproved. Conditional approval for _ yA (.Sd bedrooms. bedrooms. bedrooms, with the following stipulations. I/ i By: ryl,v, Original Certificate Date: )_12__/(S The Municipality of Anchorage Devlopment Services Division (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Cohcti �,,CL,4 COSA blue sheet 9-1-02dac If more than t septic system is on the lot: COSA Checklist # of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: 7?lc- _% gdb 163 4s Parcel lD615-/g1- 3,C A. WELL DATA Well type P If A, B, or C provide PWSID # Well Log (Y/N) Date completed /d 25 Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth 2410 it. Cased to /f.6/ -ft. Casing height (above ground) in. FROM. WELL LOG AT INSPECTION�£� Date of test. 2 Static water level Z3 ft. Well production S g.p.m. WATER SAA (IpLE RESULTS: Coliform d colonies/100 mL Nitrate NQ mg/L Arsenic —P�� ug/L Date of sample: (ani /S g.p.m. Collected by: 45: B. SEPTIC/HOLDING TANK DATA Tank Type/Material/0 AJ7W--z / /rG Date installed-/ Tank size LE-0-11gal. Number of Compartments Z Cleanouts (Y/N) y/ Foundation cleanout (Y/N) Depression over tank (Y/N) Al High water alarm (YIN) Date of pumping A/ Pumper C. ABSORPTION FIELD DATA 4Z—Z5//3 Soil ratingSft��1l Date installed (g.p:d./ftZ or ft2/bdrm) � System type % �ZcAIC Length G ft. Width - _ ft. Gravel below pipe JI.S ft. Total depthd�,,� ft. Eff. absorption area 1,50 ft2 Monitoring tube y Depression over field Date of adequacy, test _�/& 1 Results (Pass/Fail) . T For bedrooms Fluid depth in absorption field before test in. Water added gal._ Ng4depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed "Pump on level at XC in. Datum B07To� E. SEPARATION DISTANCES Size in gall ns "Pump ofr level in. Cycles tested Manhole/Access (YIN) Y High water alarm level at, 0 in. Meets alarm & circuit requirements? WELL ON LOT TO: Septic tank/lift station on lot /!�Q �f On adjacent lots Absorption field on lot O Q, 'f On adjacent lots ;/ad,ff. Public sewer main / Q Q / f Public sewer manhole/cleanout _ Id 0 r Sewer /septic service t line Z S f Holding tank led 4 r* Animal containment areas rf Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation Jr f Property line Absorption field h f 1r Water main /� 6 f' Water service line /a r 'F Surface water 5S- rt Wells on adjacent lots 60 rf ABSORPTION FIELD ON LOT TO: r Property line rf Building foundation / Q G Water main � r Water -Service line' �` Surface water Driveway, parking/vehicle storage '� Curtain drain 4 s6 Wells on adjacent lots ./&a 'f F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certf€y.gP*-J=ftreve, 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 cS1r25(/E ek) Date /off COSA yellow sheet_2-6-16.doc 10 Im D j1 rC Iz C rri ASPHALTDRIVEWAY W N Z ro 2 STORY Z { 12 RESIDENCE _ COVERED DECI F0I � I I �LOT4 ---- � I L "E 169.44' _ —) f� F- ' 5' UTILITY EASEMENT / 10' CEA EASEMENT of 0 SEPTIC PIPES I I IOC LOT 5 22,733 S.F. I I o S MANHOLES o TREATMENT POD I I rnl 107.7 CA 1 ' STREAM TRAIL STREET ri PLOT PLAN AS BUILT X SCALE 1" = 30' GRID SW 2641 Project No. 15-191/At Lang & Associates Inc, 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 (907) 522-6476 Phone Registered Land Surveyors (907) 522-4625 Fax �p ker0angsurvey.com / jonothan®tangsurvey.com �—1 F A °�4 I hereby certify that 1 have surveyed the following described property: LOT 5 BLOCK 3, TRAILS END SUBDIVISION (PLATP-604) �QC7, p Anchorage Recording District, Alaska, and that the Improvements situated thereon are 49TH within the properly lines and do not encroach onto the property adjacent thereto, that no Improvements an the property lying adjacent thereto encroach an the surveyed l promises and that there are no roadways, transmission lines or other visible 4`t easements on sold property except as Indicated hereon. KENNETH G. • .aG Q LS -5202 V- easements this the Day of A: ori.• 5 , of Anchorage, Alaska ' It Is the responsibility of the owner to determine the existence of any easements, Q�tsSIONAw oar covenants, or restrictions which do not appear on the recorded subdivision plat. °DOOooa RESIDENTIAL MORTGAGE, LLC NMLS #167729 January 11, 2016 RE: Lot 5, Block 3, Trails End Subd. 11371 Cobra Street, Anchorage, AK 99516 To Whom It May Concern, This letter confirms that Residential Mortgage will withhold funds in the amount of $2550 from the seller's proceeds for the following items to be completed when the weather permits: -repair the existing berm and regrade the surface downslope along the berm to promote surface drainage to flow downslope along the berm. The work is to be completed no later than July 1, 2016 and evidence from the Municipality of Anchorage that the work has been inspected and approved is to be provided before any funds are released. Sincerely, Steve Aldrich Executive Vice President 100 Calais Dr Suite 100 Anchorage, Alaska 99503 907-222-8800 www.ResidentialMtg.com