HomeMy WebLinkAboutSOUTHPOINTE BLK 3 LT 6$outhpointe
Lot 6
Block 3
#020- 311 -64
Municipality of Anchorage
On-Site Water and Wastewater Program - (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP161277 PID Number: 020-311-64
Dwelling: Z Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ® New El Upgrade
Name:
RYAN & BRIANNA TOLLEFSEN ABSORPTION FIELD
Address ❑ Deep Trench ® Shallow Trench ❑ Bed ❑ Mound
6458 SOUTHPOINTE DRIVE, ANCHORAGE
® Other ADVANTEX
Phone Number of Bedrooms Soil Rating Total depth from original grade
6 4 GPD/SF 3 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 1.9 Ft. 1.1 Ft.
SOUTHPOINTE 3 6 Fill added above original grade Gravel length
Township Range Section Var. 7.46' — 8.83 Ft. 48 Ft.
Gravel width Beds: Number of Lines Distance between lines
SEPARATION DISTANCES 5 Ft. -- -- Ft.
To Septic i Absorption Lift Station Holding i Sewer Total absorption area Number of trenches Dist. between trenches
From Tank Field Tank Line 275 Ft' 1 -- Ft.
Well 100+ 100'+ 100'+ NA 25'+ TANK ❑ Septic 0 S.T.E.P. [' Holding ❑ Other
Manufacturer Capacity
Surface Water 1001+ 100'+ 1001+ NA Anchorage Tank 3000 Gal.
Material Number of compartments
Lot Line 5'+ 10'+ 5'+ NA Steel 2
Foundation 5'+ 10'+ 5'+ NA NA _LIFT STATION
Manufacturer Capacity
Curtain Drain NA *501+ NA NA Anchorage Tank 3000 Gal.
Remarks *None knownPump on level at Pump off level at High water alarm at
.
Timer Act. 58 in. Timer Act. 29 in. 59 in.
Pump make and model ORENCO Electrical Inspections performed by
50GPM PF5005 N004424470 c-194140(
PIPE MATERIAL House to tank 3034 dra nreido 3034
Installer SANDERS & SANDERS -
Drainfield 3034 CO/MT 3034
Inspector ARCTERRA BENCH MARK (Assumed elevation) 100 ft
Inspection Location and description
dates: 1"9/7/17 2nd 9/7/17 Location and description
3rd 11/7/17 4th Edge of siding
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL AN.
�f'' A f`1
Conditional Approval: Date '!�`S�' ` ,6,i_
*i 9 Tl-i* y*
% KLNMF:'I'li N. I) ilr' li
� I G �t
1 '6x.y, 0 l/ G
Approv d J y t4
.., Date j-2 j 7 , \y�_,��
eer's Stamp
Inspection Report_9-1-12.doc
AS-BUILT SYSTEM DETAILS/SITE PLAN PID 020-311-64
S❑UTHP❑INTE BLOCK 3, LOT 6 PERMIT#I ❑SP161277
NEW 3K-GAL S.T. H44
-20 PODS (2003 PLAT)
io lir S
iiitiC
-E
cas o� .6 74'
• FCO
Cd
lV4
F
a.
711, ili
66606 TH16-3
Ili
SEp�
TH16-4
41.00.
•
0 40'
el
D. -AdTIC S: SEP
;OOOIIIIII::Ail
GRAPHICS SCALE
WELL® as SCALE: 1:40
A-C=15.0' 99.38 99,41
B-C=10.0' ORIGINAL GRADE
,,, I TWO 95,46
A-D=27.5' ; g PODS
oi-
B-D=16.5' TE um IO2,9 FINAL GRADE X04,2 f U
A-E=34.5, Ce I E'I�". 1. Ik�IF
B-E=15.5' ``NI ? FILTER FABRIC�a A9lIES
A-F=34.0' -1 3000 GAL - r —� 0.5'
via II ADVANTEX -I.1 :: Z� 93.5
B-F=15.0 a II TANK :II 94. 93.5
A-G=73.0' -R u u u d=1 .• ' ._' SEWER ROCK
B-G=57.0' 93.3: 93,9. '.`'___.,-'2,46 TRENCH (92.4E
A-H=74.5' 48'
B-H=59.0'
ABBREVIATIONS NO GRND, WATER
4.0.-41b.N6Mik Nik 8011 = BOTTOM OF TESTHOLE tk-' BOH C86.40
OF ,C� j \ CO = CLEANOUT
'ir <S. �6 1 MT = MONITORING TUBE SCALE! NTS PAGE 1 OF 1
,1
� `�_ w.r 0 PREPARED FOR'
RYAN & BRIANNA T❑LLEFSEN
/ P❑ BOX 243811 �R� ER��
* .4 * _- *4.100* Y //�i����►�\ `''_�Iii&�`` ; 907-242-6911 K 99524 + ," ��.'11„`
•�� r: , FIELD BOOKS COMPUTED: r
KE 'ii i". D '' ( N 1
CE-' _ / BOUNDARY: DRAWN: BMW > 1����.-.11,�1
/ wail' STAKING aiea�m: KMD \Will MIDIt�
. f /f/7. • !4!'r(JIl/I -
IL r� ASBUILr: JAG DATE 11/7/2017 : 1..,,.• ,
53I DWG. FILE GRID: '�Co o``�,I„�G �s
``_� MCAD FILE: JOB Na: R/V4`q SULT1 NO •�y6 L
72205 ADVANTEX 16-228 AK.99577'
/Volumes/ArcTerro Shared/Storage/WELL d: SEPTIC - Flled By Legal/Southpointe B3, L6/Southpolnte AX 68R ASB.dwg
04/13/2017 23:09 907-"5-'T1E1.:' ALPINE DRILLING PAGE 01x'01
Development Services Department
• •
Building Safety Division
4 !..I 41.0a4, •it
On-Site Waterb Wastewater Program
47oo Elmore Road .,« f• 11tib''
" , --• P,C, Bax 195e50 SRPITY•57 im0
Mark egroh Anchorage. AK 99507
MayorWww.nuni.0nan ite
(907)343-7904
{{Pump Installation Log41e + p
` i
Well Drilling Permit Number: SW_ Date of issue:
Parcel Jdentifcation Number:
01
� .�npe Owyer�'�awe& dre :
Legal c ptio 1 I c R f-T- i C(C L.
v4),p • X.' 1131 cCr
Pump Installation Date: jr7.01
Pump Intake Depth Below Top of Well Casing:�'(Lll feet
Pump Manufacturer's Name: 601.11(4:-)
Pump Model: G D J tJ "1
Pump Size ! 4. hp
Pitiess Adapter B riral Depth: ) /ft feet
PitlCS9 Adapter Manufacturer's Nstnte: it)
kitless Adapter Installer: P-1 f i
Well Disinfected upon Completion?4(Yes 0 No
Method of Disinfection:
Comments: 61- E F
Pump installer Name:
Aataow POW&7/eg Littlie
P.O. in 110496
Alleimise, AK 9951t4496
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
F till'
343 -1111
Alpine Drilling & Enterprises
Well Log
Permit Number: #SW 161277 Date of Issue: 9-29-17 Parcel Identification Number: 02031164000
Date Started: 5-2-17 Date Completed: 5-6-17 Is well located at approved permit location? x Yes ❑ No
Legal Description: South Pointe Block 3 Lot 6
Property Owner Name & Address: Ryan & Brianna Tolefsen Crown Pointe
PO Box 243811
Anchorage, Alaska 99524 3811
Borehole Data: Depth (ft) Method of Drilling x air rotary cable tool
Soil Type. Thickness &Water Strata From To
Casing type: steel
stick-up 0 2. Wall Thickness: .250 inches
gravelly cobble silt 2 Diameter: 6 inches Depth: 48 feet
Liner Type:
bedrock 4 407 Diameter: inches Depth: feet
Casing stickup above ground: 2 feet
Static water level (from ground level): 85 feet
H2O 130 135 Pumping level: 400 feet after
340 360
2-1 hours pumping 3 gpm
Recovery Rate: 3 gpm
Method of Testing: air lift
Well Intake Opening Type:
❑ Open End x Open Hole
❑ Screened Start feet Stopped feet
❑ Perforations Start feet Stopped feet
Grout Type: bentonite granules Volume: 7bgs
Depth: Start 0 feet Stopped 46 feet
WATER QUALITY A ITY TESTINGPump: Intake Depth feet
I Coliform N el Gai/l ppm Pump size hp Brand Name
Nitrates Co• -7 2- mg/L Well Disinfected Upon Completion?x Yes ❑ No
Arsenic_ -D ug/L Method of Disinfection: chlorine tablets
Comments:
Well Driller: Alpine Drilling&Enterprises
PD Box 110-196
Anchorage AK 99511
On -Site Water & Wastewater System Permit
MUNICIPALITY OFANCHORAGE
Development Services Department
On -Site Water &Wastewater Program
470OElmore Road, PO Box 196650
Anchorage, AKQQG19-SG5O
Telephone: (9O7)343-7SO4
Permit Number: OSP161277
Tux Code Number: 82031164000
Work Type: VVeUSeptio Initial
Permit Effective Dates: September 2S.2O18 to September 2Q.2U17
Design Engineer: ARC TERRA CONSULTING INC
Subdivision: SOUTHP0NTE
Site Legal Address: SOUTHPOINTE BLK 3 LT 6 G:3738
Owner/Address: TOLLEFGENRYAN &BRL4NNA
PO BOX 243811 ANCHORAGE AK 995243811
Site Mailing Address:
This permit is for the construction of:
Lot Size inSqFt:
Total Bedrooms:
i)epadoueut
175518
6
Y Disposal Field Y Septic Tank N Holding Tank N Privy Y Private Well N Water Storage
All construction must beinaccordance with:
1.The attached approved design.
2. All requirements specified inAnchorage Municipal code Chapters 15.55 and 15.66 and the State ofAlaska Wastewater
Disposal Regulations (1 8AAC72) and Drinking Water Regulations (I 8AAC80).
3.The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department atleast 2hours prior toeach inspection. Provide notification bycalling (8U7)343-7QO4(24houra).
4� From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A.Open and Close onthe same day.
B.Covered, sealed, and heated toprevent freezing.
Received By:
Issued By:
C�` �� � ~ ^~L�.-1��� o�� \ _�° ��\��i~ CAIN ^
MUNICIPALITY OF ANCHORAGE
Community Development Department
Development Services Division
On-Site Water & Wastewater Program
Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWER/VVELL PERMIT APPLICATION
020-311-64
Parcel I.D.
RYAN & BRIANNATOLLEFSEN
Property owner(s)
PO BOX 243811, ANCHORAGE, AK 99524
Day phone
907-242-6911
Mailing address
NHN SOUTHPOINTE RIDGE DRIVE, ANCHORAGE, AK 99516
Site address
SOUTHPOINTE BLOCK 3, LOT 6
Legal description (Sub'd., Block & Lot)
Legal description (Township, Range & Section)
175518 6
Lot Size Sq. Ft. Number of Bedrooms
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
([~ all that apply)
Absorption Field [~] Initial [~ Single Family (SF) [~]
(w/wo ADU)
Septic Tank r'~ Upgrade []
Duplex (D) []
Holding Tank [] Renewal []
Multiple Dwellings []
Privy [] (SF and/or D)
Private Well
Water Storage []
THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
~tur~perty owner or authorized agent)
Permit/Rush Fees:
Date of Payment: ~'-.~.~1 -/~
Re~ipt Number: O~ 0 ~ ~
Permit NO. ~/~/Z~
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
Permr~ App_9-1-12.doc
�,FtC`�ERR� fc
o
r"m
ARcTERIZA
-
CONSUETING, INC
212 E. 5151 Ave, Anchorage, AK. 99503
Office (907) 868-3791, Fax (907) 868-3793
TiNG
A' K. 9D511-�
September 6, 2017
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Well & Septic Permit — Southpointe Block 3, Lot 6
Due to the location of the septic stub, the location of the tank has changed. The
owner and contractor have requested a change order to go from two trenches to
one trench as the pervious permitted design. Please see attached modified
design. No other changes occur with this modification.
The property and adjacent lots are served by private water. There is no surface
water within 100' of the proposed system and there are no known curtain drains
within 50'. We do not expect there to be any adverse effect on adjacent lots by the
development of this system. If you have any questions, please contact me at 868-
3791 / FAX 868-3793.
Respectfully submitted,
A.rcT'erra Consulting, Inc.
e uffus, P.E.
Attachments: Wastewater Absorption System Details/Site Plan
20441 PTARMIGAN BLVD e EAGLE RIVER, AK 99577-8736 • PH (907) 868-3791 • FAX (907) 868-3793
A ¢T ERRA
CONSULTING~ INC
212 E. st
51 Ave, Anchorage, AK. 99503
Office (907) 868-3791, Fax (907) 868-3793
September 23, 2016
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Well & Septic Permit - Southpointe Block 3, Lot 6
The owner has requested we proceed forward to obtain a well and septic permit
for the proposed 6-bedroom house.
The general slope of this lot is from southeast to northwest at a grade of
approximately 18-23% over the septic area. On June 7, 2016 a testhole was
performed to investigate soils and groundwater. Also included is a copy of the
plat testhole TI-I44. The proposed system will serve the proposed 6-bedroom
house. We propose to install two 5'-wide shallow trenches with an Advantex
System. Groundwater was not encountered at excavation or at monitoring. The
reserve system with corresponding test holes are attached and shown.
The property and adjacent lots are served by private water. There is no surface
water within 100' of the proposed system and there are no known curtain drains
within 50'. We do not expect there to be any adverse effect on adjacent lots by the
development of this system. If you have any questions, please contact me at 868-
3791 / FAX 868-3793.
Respectfully submitted,
ArcTerra Consulting, Inc.
Attachments:
On-Site Sewer Application
Wastewater Absorption System Details/Site Plan
Soils Logs/Percolation Tests
20441 PTARMIGAN BLVD ° EAGLE RIVER, AK 99577-8736 · PH (907) 868-3791 ° FAX (907) 868-3793
°
N/ & 2 M-W1W"
H
PRIOR TO CONSTRUCTION THE SYSTEM, WELL RADII, PL/
EASEMENTS, REQUIRED SETBACKS, .. MUST BE STAKED,
NOTES'
1. INSTALL TWO AX -20 PODS WITH 3000 -GAL TANK
Scale: 1"= 100' 2. INSULATE TRENCH WITH 2" HD BURIAL FOAM,
PAGE 1 OF 3
3. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE
DESIGN DETAILS
6 BDRM X 150 GPD
= 980 GPD
900 GPD / 4 GPD
PER SQ. FT. (ADVANTEX
3Y8TEM)= 225 %Q. FT
(225 SF/ 5' WIDE
(1' GRAVEL) = 45 FT.
TRENCH
NO PUBLIC WELLS WITHIN 200' OF
USE 2 TRENCHES -
23' (L) X 5' (W) X 1'
[D / SEVER ROCK DEPTH)
PROPOSED SYSTEM.NO PRIVATE WELLS WITHIN 200' OF
EFFECTIVE DEPTH
IS 3' FROM EXISTING /
ORIGINAL GRAD[,
PROPOSED SYSTEM EXCEPT AS NOTED.
NO SEPTIC SYSTEMS WITHIN 200' OF
PROPOSED WELL EXCEPT AS NOTED.
NOTES'
1. INSTALL TWO AX -20 PODS WITH 3000 -GAL TANK
Scale: 1"= 100' 2. INSULATE TRENCH WITH 2" HD BURIAL FOAM,
PAGE 1 OF 3
3. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE
WASTEWATER DISPOSAL SYSTEM DETAILS
SOUTHPOINTE BLOCK 3, LOT 6
INSTALL 3K—GAL
& 2 AX -20 PODS
NO SLOPES >25% W/IN 50'
nr QDnPn��rn rTrI ThS
__1 eN) \
PRIOR TO CONSTRUCTION THE SYSTEM, WELL RADII, PL,
t
OF NkN EASEMENTS, REQUIRED SETBACKS, .. MUST BE STAKED,
A
PREPARED FOR1
RYAN & BRIANNA TOLLEFSEN CTER
PO BOX 243811
TH ANCHORAGE, AK 99524
907-242-6911
NNEUFFUS FIELD BOOKS COMPUTED:
L -7116 BOUNDARY. BOUNDARY DRAWN: BMW L<1
A4
AW STAKING* STAKING CHECKED* KMD
AOrDATE:* 09/06/17
r—S ASBUILT. JAG
DWG. FILE: GRID:
-228
ACAD FlLE: FILE JOB No.: 16 AK. 995
Aumes/ArcTerro Shored/Storage/WELL & SEPTIC —Filed By Legal/Southpointe 83, L6/Southpointe AX 6BR Design3.dwg
FUTURL.S. LOCATION
FOR ESERVE
H44
(2003 PLAT)
rn
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PROPOSED WELL
N
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7 �O
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Scale: N1\ �
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PAGE 2
AdvanTex
AX 20 SeriUs - Mode la tqltrete Return Line
3000-GAL S.T, ~/
TWFI AX-20 PI]DS
Inlet Riser/Ual
2" Dia.
Treatment System i, 9o" .i
:>---Discharge Filtrate
~--Min. 23" Dia.
Tank Opening
Top View
AdvanTex
Dia, Riser/Ud
ge Filtrate
t/8"/ft.)
Side View
Biotube® Pump
Package
]RENCD PACKAGE SYSTEM~ EndView
1, INSTALL 3000 GAL SEPTIC TANK ~// INTEGRATE]) A])VANTEX SYSTEM- TWO AX-PO PD])S
nR TANK ~/ILL BE SIZE]) PER ANCHORAGE TANK FOR A 6 B])RM RESI])ENCE,
2, INSULATE TANK, EXCEPT BELD~/ A])VANTEX PADS TO ALLn~/ HEAT TRANSFER,
3;,: NO AIR LINE REQUIRE]),
/Volume~/ArcTerra Shared/Storage/WELL z, SEF11(
SDUTHPDINTE BLrqCK
3, LOT G
Scale~ NTS
PAGE 3 DF 3
PREPARED FDR:
RYAN & BRIANNA TDLLEFSEN
PD BOX 243811
ANCHORAGE, AK 99524
907-242-6911
REiD BOOKS
BOUNDARY
STAKING
JAG
DS RLF~
~.~w~, BMW
cmrc~n: KMD
O^Te 09/19/16
GRID:,
^c~ nm FILE ~oe .~: 16-228
-- Rled By Legal/SouthpoJnte BS, L6/Southpolnte AX 6BR Des~gn2.dwg
CONSULTING, INC
212 E. 51st Ave, Anchorage, AK. 99503
Office (907) 868-3791, Fax (907) 868-3793
SOILS PERCOLATION TEST
Performed for: Ryan Tollefsen
Date Performed:
6/7/2016
Project:
Depth
(Feet)
10-
11-
12-
13-
14-
15-
16-
17-
18-
SOUTHPOINTE B3, L6
Org/OL
GM/SM - gp
B.O.H. - BEDROCK
HOLE PRESOAKED
PRIOR TO TEST
TEST HOLE # TH 16-1
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
Was Ground water encountered? NO
Depth to water after monitoring? DRY
What depth? NA
Date? 9/20/16
Reading Date Gross Net Depth of Net
Time Time Water Drop
1 6/8/16 h00 6"
2 1:30 30 min 3 1/16" 2 15/16'
3 * 1:31 6"
4 2:01 30 rain Y' Y'
5 * 2:02 6"
6 2:302 30 min 2 9/16" 2 15/16'
7
8
9
10
11
12
· Water Added
19-
20-
Percolation Rate 10.2 (min/in) Perc Hole Diameter. 6"
Test Run Between 5 feet and 6 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State
and Municipal guidelines in effect on this date.
ARc TERRA
CONSULTING~ INC
212E ~s~--
· ~ · ,~ve, Anchorage, AK. 99503
Office (907) 868-3791, Fax (907) 868-3793
SOILS PERCOLATION TEST
Performed for: Ryan Tollefsen
Date Performed: 9/13/2016
Project:
Depth
(Feet)
SOUTHPOINTE B3, L6
Org/OL
TEST HOLE # TH 16-3
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
5~
11-
12-
13-
14-
15-
16-
17-
18-
GM~M
B.O.H.- BEDROCK
HOLE PRESOAKED
PRIOR TO TEST
Was Ground water encountered? NO What depth? NA
Depth to water after monitoring? DRY Date? 9/20/16
Reading Date Gross Net Depth of Net
Time Time Water Drop
I 9/14/16 1:00 6"
2 1:30 30 min 2 8/16" 3 8/16"
3 * 1:31 6"
4 2:01 30 min 2 9/16" 3 7/16"
5 * 2:02 6"
6 2:302 30 rain 2 9/16" 3 7/16"
7
8
9
10
11
12
· Water Added
19-
20-
Percolation Rate 8.7 (min/in) Perc Hole Diameter, ,6"
Test Run Between 3 feet and 4~ feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State
and Municipal guidelines in effect on this date.
~ ! 4t~~ ~ CONSULTING, lNG
------%.4~s}~,~..¥~¢-~'Office (907) 868-3791, Fax (907) 868-3793
SOILS PERCOLATION TEST
Performed for: Ryan Tollefsen
Project: SOUTHPOINTE B3, L6
Depth
11-
12-
13-
14-
15-
16-
17-
18-
0rg/0L
GM/SM --gp/sp
B.O.H. - NO BEDROCK OBS.
Date Performed: 9/'13/2016
TEST HOLE # TH 16-4
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
Was Ground water encountered? NO D/hat depth? NA
Depth to water after monitoring? NO Date? 9/20/16
Reading Date Gross Net Depth to Net
Time Time Water Drop
1 9/14/16 1700 6"
2 1710 10 min 3 6/16" 2 10/16"
3 * I:11 6"
4 1721 lOmin 37/16" 29/16"
5 * 1722 6"
6 1732 10 min 3 8/16" 2 8/16"
7 * 1:33 6"
8 1:43 10 min 3 9/16" 2 7/16"
9 * 1:44 6"
10 1:54 10 min 3 8/16" 2 8/16"
11 * 1:55 6"
12 2:05 10 min 3 8/16" 2 8/16"
· Water Added
Percolation Rate 4 (min/in) Perc Hole Diameter 6"
Test Run Between .. 3 feet and __4 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State
and Municipal guidelines in effect on this date.
/PROJECT~#: .....
PERFORMEO FOR:
MUNIClFALITY OF ~ICHOEAGE
DEVELOPHENT SEEVICES DEPARTMENT/ON-SITE WATER ANO. W~TEWATER PROGRAM
/~700 SOUTH BRAGAW .STREET ANCHORAGE, AK 9,9519-6650
SOILS LOG -PERCOLATION TEST
LEGAL DESCRIPTION;
TEST HOLE
rite Seine urayel
SLOPE
DATE PERFOEHED:'
SITE
51212003
WAS GREATER
E~COL,etTEa~? . ,' No
Bed Rock IF YES, WHAT DEPT~?
~ 10.0' '
DEPTH OF WATER
AFTER
DATE:
S/1S/200)
~003
S
L
0
P
E
REAl)lNG DATE GR~S5 NET DEPTH TD NET
TI,HE TIME WATER
Start SiS . L..lt. 2:63"
I .. 1;/,~, 30 /*.'/S* 2.12' .
R~char~e ld, S ..
2 2:15 30 Z,.S"
Recharge 2:16
3 2:~c. 30 ~", 2' ,,,
PERC RATE: , ~ MI~,/INCH PERC. HC~ D;~t~reP.:' - .6"..
TEST RUN B~ 3.0 FT. AND /,.0 ,FT,
Test,Hole Pr..e. Soaked Prior to Test.
ADVANCED WASTEWATER TREA'IWIENT SYSTEM MAIN~I'ENANCE AND
REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHOILAGE
AND Ryan & Brianna Tolle[~en
THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this
herein thc "OWNER," and the Municipality of Anchorage, herein the
"MUNICIPALITY." In consideration of the ~rmtual covenants contained herein, the
parties to this Maintenance and Repair Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. Municipality grants permission to
Owner to utilize and operate an Advanced Wastewater Treatment System
(AWWTS), described as Advantex Treatment System AX 20
located at (legal description). __Southpointe Block 3, Lot 6 __
2. Definitions,
Alteration. Any change to the design or function of an AWWTS that includes the
installation or removal of any parts, cmnponents or pieces not h~cluded in the
origimd construction permit and design.
Certificate of On-Site Systems Approval (COSA). An approval by the
Municipality of existing water and wastewater disposal systems given at the time
of property sale and title transfer in accordance with Anchorage Municip'al Code
(hereinafter, "AMC") 15.65. These approvals certify that the systems are adequate
for the homes that they support and meet the codes d~at were in place at the time
of systenl construction.
Damage. Any man-made or natural change in a system that would inhibit the
system from performing as designed.
Maintenance and Repair. The scheduled and as needed replacement of existing
parts, components and pieces Of an AWWTS that were included in the original
design which would allow the AWWTS to contiuue to perfmm as designed.
Permit. An On-Site Wastewater Disposal Permit as required by AMC 15.65 to
construct and operate an AWWTS.
3. Term. The term of this Maintenance and Repair Agreement shall begin on tlne date
of approval by the Municipality to operate lhe installed system or issuance of a
COSA, and shall continue while the AWWTS is in use or is operational or until
the property is sold or title is transferred by the owner and a new COSA is issued
to the new owner or transferee of the property.
4. Alterations, Installation and Removal of Additional Equipment. Prior to
performing any alterations to an AWWTS, the owner agrees to obtain an On-site
Wastewater Disposal Permit from the Manielpality in accordance with AMC
15.65.
5. Maintenance and Repairs.
A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall
maintain their AWWTS in a satisfactory condition capable of producing treated
septic effluent in accordance with the equipment's approval for operation in the
Municipality. The owner shall enter into a service agreement with an AWWTS
sen, ice and maintenance provider approved by the municipality and the
manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it
shall be the responsibility of the Owner during the term of this Maintenance and
Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay
for any and all: (I) repair(s), (2) maintenance, (3) adjnstmant(s), (4) replacement
costs, and (5) inspection costs.
B. Owner agrees to comply with all applicable ordinance, laws, regulations, roles
and orders for the AWWTS.
C. Upon request by the Municipality, the owner agrees to provide the Municipality a
written schedule of routine maintenance and repairs which have been performed
on the system. When a record of maintenance is documented and maintained by
the system vendor, the owner agrees to allow the Municipality access to this
information.
D. Owner acknowledges that the frae for failing to maintain and repair an AWWTS
may be assessed in accordance with AMC 14.60 for improper discharge.
E. Owner agrees that only maintenance and repair personnel approved by the
Municipality will inspect and make any necessary maintenance, repairs or
permitted alterations to the system.
F. Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS upon 24 hours written notice.
G. Owner agrees that any sale or transfer of title of the property will not occur
without a new Certificate of On-Site Systems Approval.
H. Owner agrees that the AWWTS installation and maintenance requirements as
provided by the AWWTS vandur/installer and approved by the Municipality arc
the governing guidelines for the construction, maintenance and repair of the
Owner's AWWTS.
I. Owner agrees to provide and maintain a telephone connection to the AWWTS as
mquked by the AWWTS approval.
6. Nonwaiver. The failure of either party at any time to enforce a provision of tiffs
Maintenance and Repair Agreement shall in no way constitute a waiver of the
provisions, nor in any way affect the validity of the Maintenance and Repair
Agreement or any part hereof, or the right of such party thereafter to enforce each
and every provision hereof.
7. Amendment.
This Maintenance and Repair Agreement shall only be amended, modified or
changed by a writing, exccnted by authorized representatives of the parties, with
the same formality that this Maintenance and Repair Agreement was executed
with, and such writing shall be attached to Ihis Maintenance and Repair
Agreement as an amendment.
B~ For the purposes of any amendment modification or change to the terms and
conditions of this agreemenl, the only authorized representatives of the parties
are:
· b. Municipality: Director, Community Development or designated authority
C. Any attempt to amend, modify, or change this contract by citijet an unauthorizcd
representative or tmanthorized means shall be void.
8. Jurisdiction: Choice of Law. Any civil action axising from this Maintenance and
Repair Agreement shall be brought iu 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 Maintenance and Repair
Agreeinent,
3
9. Severability. Any provisions of this Maintenance and Repair Agreement decreed
invalid by a court of competent jurisdiction shall not invalidate the remahfing
provisions of' the Maintenance and Repair Agreement.
OWNER:
By: (sfgnature)
S'I55TE OF ALASKA )
) SS.
THIRD JUDICIAL DISTRIC~t' )
Date:
The foregoing instrument was acknowledged bel'ore me tiffS7 day of
MUNICIPALITY:
By:
;(print name)
Date: Title:
Sika�-�- •
OE By
OPT '(6
• Municipality of Anchorage
On-Site Water and Wastewater Program ail I
(907) 343-7904 SAFETY
Certificate of On-Site Systems Approval
Parcel I.D. 020-311-64 Expiration Date: 3 -a 0
1. GENERAL INFORMATION:
Complete legal description SOUTHPOINTE; BLOCK 3, LOT 6
Location (site address) 6458 Sothpoint Ridge*Anchorage,AK 99516
Current Property owner(s) Ryan Io(I65en Day phone 907-350-7483
Mailing address
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: 6
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ® Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
Received by: Date: /�//f`)
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ I ' 1 • -4 Waiver Fee $
Date of Payment 11/27(11 Date of Payment
Receipt Number (9? '133O Receipt Number
COSA# 17 ! 54J Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179
Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507
Engineer's Printed Name: Jeffrey A. Garness Date: t2/i /(Y"
Q0000000
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system o OF A 'Nin accordance with the guidelines and regulations established by the Municipality of Anchorage and o K\c..••• •4 .h
industry practices. The reported results describe the condition of the system/s on the date/s of the P.•' ` '• '110
�
evaluation. Separation distances were measured to readily identifiable features. Hidden defects or L( VIS
encroachments may exist that were not identified during the evaluation. The operational life of all wells Q A T'!' •�*VO
and septic systems depend upon a variety of variables, including but not limited to, soil conditions, ,
groundwater levels (that may fluctuate during the year), quality of construction (materials and 2VA
workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and
are outside the control of GEG. Satisfactory test results do not guarantee future performance of the / f e A. Go ness.
system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of oo • CE- S
the well or septic system. GEG makes no representation whether an alternative well or septic system Q 9' . �f 0".
can be installed on the property in the event either of the current systems fail to perform adequately in p e, . .(• c c
the future. The content of this report is for the sole benefit of the person/party that retained GEG to \\ Profess,oro\
perform the evaluation. Reliance upon the information provided in this report by any other person or ��OO000Oo
party (including subsequent property purchasers) is not authorized, nor will it confer any legal right
whatsoever.
#AECC884
6. DSD SIGNATURE
System #1 Approved for �o bedrooms
System #2 Approved for bedrooms
Disapproved
Conditional approval for bedrooms, with the followinSstip0liatTE G.
WATER AND '
t) WASTfZ
PROGRAM
•
-1/7-CC��l�•
/ Q
v.-J' /� Original Certificate Date: Z O ^tv
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 Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet 10-10-12.doc
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system
Certificate of On-Site Systems Approval Checklist
Legal Description: SOUTHPOINTE; BLOCK 3, LOT 6 Parcel ID: 020-311-64
A. WELL DATA WELL FLOW NOT TESTED BECAUSE WELL IS LESS THAN 2 YEARS OLD
Well type PRIVATE If A, B, or C provide PWSID# NIA Well Log (YIN) YES
Date completed 5/6/17 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 407 ft. Cased to 48 ft. Casing height (above ground) 18+ in.
FROM WELL LOG AT INSPECTION
Date of test 5/6/17
Static water level 85 ft. ft.
Well production 3 g.p.m. g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 ml. Nitrate 9.97 mg./L. Collected by: GEG, Ltd.
`f."'
4
Arsenic: <5.0 ug./L. Date of sample: 121V18
B. SEPTIC/HOLDING TANK DATA ADVANTEX
Tank Type/Material SEPTIC/STEEL Date installed 9/7/17
Tank size 3000 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES
Date of pumping - Pumper SEE ATTACHED ADVANTEX MAINTENANCE REPORT
C. ABSORPTION FIELD DATA 'BELOW EXISTING GRADE AT MONITORING TUBE
Date installed 9/7/17 Soil rating (Cp.d./ftr ft2/bdrm) 4.0 System type SHALLOW TRENCH
Length 48 ft. Width 5 ft. Gravel below pipe 1.1 ft.
Total depth 10.1+ ft. Eff. absorption area 275 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test - Results (Pass/Fail) PASS For 6 bedrooms
Fluid depth in absorption field before test 0 in. Water added - gal. New depth - in.
Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 900+ g.p.d.
Any rejuvenation treatment(past 12 mo.) (Y/N & type) NO If yes, give date -
-DRAINFIELD WAS NOT TESTED BECAUSE IT IS LESS THAN 2 YEARS OLD
-EAST MONITORING TUBE ONLY EXTENDS 7 INCHES BELOW THE INVERT OF THE DISTIBUTION LINE
-BOTH MONITORING TUBES WERE DRY ON 12/4/18
`ASSUMED VOLUME OF 2ND COMPARTMENT OF 3000 GALLON S.T.E.P.
**SEE ATTACHED MAINTENANCE LOG
D. LIFT STATION
Date installed 9/7/17 Size in gallons '1000 Manhole/Access (Y/N) YES
"Pump on" level at ** in. "Pump off' level at '" in. High water alarm level at in.
Datum Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 50'+ On adjacent lots 100'+
Absorption field on lot 50'+ On adjacent lots 100'+
Public sewer main 75'+ Public sewer manhole/cleanout 100'+
Sewer/septic service line 25'+ Holding tank 100'+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation '5' Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 50'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main 10'+
Water service line 10'+ Surface water 50'+ Driveway, parking/vehicle storage 3'
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
*MET CODE AT TIME OF INSTALLATION
.4, c OF .4 1,t1
G. ENGINEER'S CERTIFICATION 4,4,7\\>,.\.:::. • ••.
- 41 ►I *
l certify that I have determined through field inspections and :
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this �O Day of NoaeJJbe.( of 20 i`y' , by and between
4\fnANncm‘3 fV c c. s -j , 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 Ac / 4e
located at (legal description)
"J0v-k1n r)oivNA-0_, L-(p g 3
2. Maintenance,Repairs and Alterations.
Owner is required to read, understand and initial each section)
1_j )
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
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
Aph includes an annual maintenance fee(typically $400 to $600).
IV 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.
a. 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
±r2_ Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
0) Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
EA Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On-Site Systems Approval.
aOwner 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.
0' 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:
4 /
By: al/224 (signature) Date: f/-
4,1-47t, /`U/'d:ocy (print name)
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT )
The foregoin: instrument was acknowledged before me this 8 day, s ,
201$ , by is !�. S Co(e 611‘-4 STATE OF ALASKA
NOTARY PUBLIC ; .
4��!' ephanie S.Coleman '
N t ARY PUBLIC FOR ALASKA • Expires Sep.
29,2020
My Commission expires: Se.pi . 7 R,
MUNICIPALITY:i�
2�� -
(n- ( (signature) Date: (P
(print name) Title:
(rev. 05/18/2018) Page 3 of 3
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT • r 7 907-343-7904
On-Site Water and Wastewater Section Fax: 343-7997
www.muni.org/onsite
Nitrate Advisory
Certificate of On-Site Systems Approval # 0SC181545
Subdivision: SouthPointe, Block: 3, Lot: 6
A water sample revealed a nitrate concentration of 9.97 milligrams per liter (mg/L).
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Please see the attached "Nitrate Fact Sheet" for important
information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On-Site
Systems Approval.
Mailing Address: P.O. Box 196650 *Anchorage,Alaska 99519-6650 *www.muni.org
Nitrate Fact Sheet
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen,which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids,and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
Mailing Address: P.0.Box 196650*Anchorage,Alaska 99519-6650*www.muni.org
•-11-c.:" Municipality of Anchorage .. .
On-Site Water and Wastewater Program K � ,
(907) 343-7904 ��A l�I V
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 020-311-64 Expiration Date: .2- 2.219- 1 9
1. GENERAL INFORMATION
Complete legal description SOUTHPOINTE BLOCK 3, LOT 6
Location (site address) 6458 SOUTHPOINTE RIDGE DRIVE,ANCHORAGE,AK 99516
Current Property owner(s) RYAN &BRIANNA TOLLEFSEN Day phone
Mailing address PO BOX 243811,ANCHORAGE, AK 99524
Real Estate Agent Day phone
•Qg 10 i]
2. TYPE OF DWELLING: @ ICEIVi
9
® Single Family w/wo ADU) N t`KLL;1
111 Duplex ; .-,,,I "1;'--
1: Multiple Dwellings (Single Family and/or Duplex) c-,. a
3. NUMBER OF BEDROOMS: 6 'i o; 4'
TYPE OF WASTEWATER DISPOSAL:
4. TYPE OF WATER SUPPLY: Individual El
Individual Well ® Holding Tank ❑
Individual Water Storage ❑ Community ❑
Community Class Well . ❑ Public Sewer ❑
Public Water System ❑
WaiverNariance request for: Distance:
Received by: !1i� ' /%,/_`! Date: / - 5 ry
COSA to be released to the engineer,unless otherwis: r •••, led by the engineer.
COSA Fee $ i fl.('$ Waiver Fee $
Date of Payment 10-4-11? Date of Payment
Receipt Number CA(133D Receipt Number
COSA# Ooil 9'f 6 Waiver#
�Z1
5. STAT OF P• a N BY ENGINEER
As certified 6'y seal ix-. hereto and as of the validation date shown below, I verify that my investigation,
based on procebnis outline s 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 ARCTERRA CONSULTING,INC. Phone 868-3791
Address 20441 PTARMIGAN BLVD., EAGLE RIVER,AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date 11/22/2017
THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC...ASSOCIATED
WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. Engineer's Comments: This investigation was completed in compliance with
ADEC and MOA regulations. 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 inland use,
local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the
system. 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, ArcTerra can not give any estimate of how long a system will function
satisfactory for current or future occupants or can ArcTerra guarantee that no unseen +�'qs '�
encroachments,deficiencies or discrepancies exist. OF A
/ k r 9 TI I 9*
6. DSD SIGNATURE
FA
System #1 Approved for co bedrooms. ;�►
r� KENNETH M. l/' A. off
16
System #2 Approved for bedrooms. i'rr� tt 72z �
Disapproved. "co\xF• s1o ''
lk
Conditional approval for bedrooms, with the following stipulations:
- - ON-SITt j
tr
C WASTEWATWATEREAND R
PROGRAM �'-
- F sER\ri
. di/ Original Certificate Date: /1—,L 1 7
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 blue sheet 10-10-12-doc
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system _
Certificate of On-Site Systems Approval Checklist
Legal Description SOUTHPOINTE BLOCK 3 LOT 6 Parcel ID: 020-311-64
A. WELL DATA
Well type PRVT If A, B, or C provide PWSID# Well Log (YIN) Y
Date completed -(c.- j 7 Sanitary seal (YIN) Y Wires properly protected (YIN) Y
Total depth 1,107 ft. Cased to LIS ft. Casing height (above ground) - 24+ in.
FROM WELL LOG AT INSPECTION
Date of test -5--• - ( 7 --
Static water level Cir _— ft. ft.
Well production 3 g.p.m. .. g.p.m.
WATER SAMPLE RESULTS
Coliform NEG colonies/1 00 mL Nitrate 6.72 mg/L
Arsenic: ND ug/L Date of sample: 11/6/2017 Collected by: ARCTERRA
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC-ADVANTEX /STEEL Date installed 9/7/2017
Tank size 3000 gal. Number of Compartments 2 Cleanouts (YIN) Y
Foundation cleanout (Y/N) Y Depression over tank (YIN) N High water alarm (Y/N) Y
Date of pumping NA-NEW TANK Pumper
C. ABSORPTION FIELD DATA
Date installed 91712017 Soil rating (g.p.d./ft2 or ft2/bdrm)4.0 System type SHALLOW TRENCH
Length 48 ft. Width 5 ft Gravel below pipe 1.1 ft.
Total depth 10.46+ ft. (1116/17) Eff. absorption area 275 ft2 Monitoring tube Y Depression over field N
Date of adequacy test NA-NEW SYSTEM Results (Pass/Fail) For - bedrooms
Fluid depth in absorption field before test in. Water added gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= - g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN &type) N If yes, give date___-
D. LIFT STATION -ADVANTEX
Date installed 917117 Size in gallons 3000 Manhole/Access (YIN) Y
"Pump on" level at Timer Activated(58")in. "Pump off' level at Timer Activated(29")in. High water alarm level at 59 in,
Datum BOTTOM OF TANK Cycles tested 2 _ Meets alarm&circuit requirements? Y
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+ _
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main 75'+ Public sewer manhole/cleanout 100'+
Sewer/septic service line 25'+ Holding tank 100'+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 101+ Water main 10'+__
Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain 501+(NONE KNOWN) Wells on adjacent lots 100'+
F. COMMENTS
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
NILX
with MOA COSA guidelines in effect on this date. = Off; AL ,
Engineer's Printed Name KENNETH M.DUFFUS `2' �r(-
Date 11122/17 7'
COSA brown sheet_10-10-12.doc �/� � '
2j 71 6 W '. .`.
,
' 92 i 4".„,
f'��17/ :sslOV
•
• Municipality of Anchorage
•, fry _ � :°
► �_ Development Services Department sfoil '4^
Building Safety Division S A aTf
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
Nitrate Advisory
Certificate of On-Site Systems Approval # OSC171545
A Certificate of On-Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block 3, Lot 6 of
Southpointe subdivision. This inspection revealed a nitrate concentration of
6.72 milligrams per liter (mg/L) was reported for the property's well water
sample. The Environmental Protection Agency (EPA) has established a
maximum contaminant level (MCL) of 10.0 mg/L for public drinking water
systems. While private wells are not subject to this regulation, EPA
standards are based on existing health information and can therefore be used
to gauge the relative quality of water from private wells. Please see the
attached "Nitrate Fact Sheet" for important information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On-
Site Systems Approval.
Nitrate Fact Sheet
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble
in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass
rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is
in the form of ammonia or protein first, which through contact with oxygen and certain
bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from
wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also
result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or
three years, but is associated with a potentially fatal infant disease called
methemoglobinemia. In the digestive system of young children, nitrate converts to
nitrite, which can pass through the intestinal wall into the blood stream. There it
combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The
EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The
standard has been lowered from a previous level of 45 mg/L set by the US Public Health
Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and
other common home water treatment systems such as softening or iron filtration does not
readily remove nitrate. The best method for limiting nitrate in well water is source
control. This can include avoiding overdosing of fertilizer near the well and maintaining
good separation distances between septic tank leach fields and the well. A special anion
exchange filter that contains a media with a strong affinity for negatively charged ions in
water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical"
methods using a spectrophotometer to read the final color endpoint. Specific ion
electrodes also can be used to detect the activity of nitrate in water. This laboratory uses
several different wet chemical methods approved under the public water supply
laboratory certification program. They also have test kits available, which the laboratory
uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test
kit results against a certified analysis from the lab occasionally to verify the accuracy of
the kit. We recommend using a specially prepared bottle that has been rinsed in
hydrochloric acid for collecting samples.
ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND
REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE
AND Ryan & Brianna Tollefsen
THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this
o Day of e- e-121 pia of 20)6,by and between ryi+1,-t 10 ff ' t',
herein the"OWNER,"and the Municipality of Anchorage,herein the
"MUNICIPALITY." In consideration of the mutual covenants contained herein, the
parties to this Maintenance and Repair Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. Municipality grants permission to
Owner to utilize and operate an Advanced Wastewater Treatment System
(AWWTS), described as Advantex Treatment System AX 20
located at (legal description)._Southpointe Block 3, Lot 6
2.Definitions.
Alteration.Any change to the design or function of an AWWTS that includes the
installation or removal of any parts,components or pieces not included in the
original construction permit and design.
Certificate of On-Site Systems Approval (COSA).An approval by the
Municipality of existing water and wastewater disposal systems given at the time
of property sale and title transfer in accordance with Anchorage Municipal Code
(hereinafter, "AMC") 15.65. These approvals certify that the systems are adequate
for the homes that they support and meet the codes that were in place at the time
of system construction.
Damage. Any man-made or natural change in a system that would inhibit the
system from performing as designed.
Maintenance and Repair.The scheduled and as needed replacement of existing
parts,components and pieces of an AWWTS that were included in the original
design which would allow the AWWTS to continue to perform as designed.
Permit. An On-Site Wastewater Disposal Permit as required by AMC 15.65 to
construct and operate an AWWTS.
3.Term.The term of this Maintenance and Repair Agreement shall begin on the date
of approval by the Municipality to operate the installed system or issuance of a
COSA, and shall continue while the AWWTS is in use or is operational or until
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the property is sold or title is transferred by the owner and a new COSA is issued
to the new owner or transferee of the property.
4.Alterations,Installation and Removal of Additional Equipment.Prior to
performing any alterations to an AWWTS, the owner agrees to obtain an On-site
Wastewater Disposal Permit from the Municipality in accordance with AMC
15.65.
5.Maintenance and Repairs.
A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall
maintain their AWWTS in a satisfactory condition capable of producing treated
septic effluent in accordance with the equipment's approval for operation in the
Municipality.The owner shall enter into a service agreement with an AWWTS
service and maintenance provider approved by the municipality and the
manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it
shall be the responsibility of the Owner during the term of this Maintenance and
Repair Agreement, and any renewals thereof,at the owner's sole expense,to pay
for any and all: (1)repair(s),(2)maintenance, (3)adjustment(s),(4)replacement
costs,and(5)inspection costs.
B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules
and orders for the AWWTS.
C. Upon request by the Municipality, the owner agrees to provide the Municipality a
written schedule of routine maintenance and repairs which have been performed
on the system.When a record of maintenance is documented and maintained by
the system vendor,the owner agrees to allow the Municipality access to this
information.
D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS
may be assessed in accordance with AMC 14.60 for improper discharge.
E. Owner agrees that only maintenance and repair personnel approved by the
Municipality will inspect and make any necessary maintenance, repairs or
permitted alterations to the system.
F. Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS upon 24 hours written notice.
G. Owner agrees that any sale or transfer of title of the property will not occur
without a new Certificate of On-Site Systems Approval.
H. Owner agrees that the AWWTS installation and maintenance requirements as
provided by the AWWTS vendor/installer and approved by the Municipality are
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the governing guidelines for the construction, maintenance and repair of the
Owner's AWWTS.
I. Owner agrees to provide and maintain a telephone connection to the AWWTS as
required by the AWWTS approval.
6. Nonwaiver.The failure of either party at any time to enforce a provision of this
Maintenance and Repair Agreement shall in no way constitute a waiver of the
provisions, nor in any way affect the validity of the Maintenance and Repair
Agreement or any part hereof, or the right of such party thereafter to enforce each
and every provision hereof.
7.Amendment.
A. This Maintenance and Repair Agreement shall only be amended, modified or
changed by a writing, executed by authorized representatives of the parties, with
the same formality that this Maintenance and Repair Agreement was executed
with, and such writing shall be attached to this Maintenance and Repair
Agreement as an amendment.
B. For the purposes of any amendment modification or change to the terms and
conditions of this agreement, the only authorized representatives of the parties
are:
a. Owner: //Ay /ued-[-;.1
b. Municipality: Director,Community Development or designated authority
C. Any attempt to amend, modify,or change this contract by either an unauthorized
representative or unauthorized means shall be void.
8.Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and
Repair Agreement shall be brought in the Superior Court for the Third Judicial
District of the State of Alaska at Anchorage.The laws of the State of Alaska shall
govern the rights and obligations of the parties under this Maintenance and Repair
Agreement.
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9. Severability.Any provisions of this Maintenance and Repair Agreement decreed
invalid by a court of competent jurisdiction shall not invalidate the remaining
provisions of the Maintenance and Repair Agreement.
OWNER:
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STATE OF ALASKA )
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TTIIRD JUDICIAL DISTRICT)
Date: //' 7/jam-
The foregoing instrument was acknowledged before me this21 day of
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MUNICIPALITY: 1' " ••
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Date: j l 3.7 11 Title: .. (04.4"
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SOUTHPOINTE SUBDIVISION
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AS -BU I L T I HEREBY CERTIFY THAT I HAVE SURVEYED THE oisliiiikeir 10.0. te
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PROPERTY DEPICTED ABOVE AND THAT NO •4OF ,q 1
GASTALDI LAND ENCROACHMENTS EXIST EXCEPT AS INDICATED. ♦ "c0.......... �. QEctc -;SURVEYING, LLC R IS THE RESPONSIBILITY OF THE OWNER TO 1 •'`P•' �, '•�`, #. 2e.s
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JEFF A. GASTALDI, R.LS. DETERMINE THE EXISTENCE OF ANY EASEMENTS, a �; 4911'♦ '‘ # . 19.0' t
2000 E. DOWING RD., SUITE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT •. ' %