HomeMy WebLinkAboutPREUSS #3 BLK 10 LT 7Preuss #3
Block 10
Lot 7
#050-571-55
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP211226 PID Number: 050-571-55
Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade
Name
THEODORE TREMBLAY
ABSORPTION FIELD - ADVANTEX
❑ Deep Trench ® Wide Trench ❑ Bed ❑ Mound
Site Address
20229 LUCAS AVE., EAGLE RIVER, AK
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
2 GPD/SF
5 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
1 Ft.
Gravel depth beneath pipe
4 Ft.
Subdivision Block Lot
PREUSS #3 10 7
Fill added above original grade
VARIES 1.5 - 1.9 Ft.
Gravel length
30 Ft.
Township Range Section
Gravel width
5 Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
300 Ft2
1
-- Ft.
Well
50'+
50'+
25'+
TANK M Septic ❑ S.T.E.P. ❑ Holding ® Other ADVANTEX
Manufacturer
GREER
Capacity
1500 Gal.
Surface Water
50'+
50'+
Material
HDPE
Number of compartments
2
Lot Line
10'+
10'+
NA
Foundation
101+
10'+
ILIFT STATION
Manufacturer
ORENCO
Capacity
1500 Gal.
Remarks DISTRIBUTION LINE FROM PUMP VAULT
& FIELD INSULATED. GM/SM SOILS 1-5'
Alarm location
BASEMENT
Electrical installed by
DRS ELECTRIC
Tank to
PIPE MATERIAL House to tank 3034 3034
Installer JRS
drainfield
Drainfield 3034 CO/MT 3034
Inspector FWC
BENCH MARK (Assumed elevation) 100 ft
Inspdection V1 6/30/21 6/30/21
Location and description
2nd
3`d 7/1/21 4'"
TOP OF PIER BLOCK
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
-=OF AJ
Conditional Approval: Date
i '•:t�,�,�
*: 49 7H ....�:*
Septic System
Approve
% �•,. Curtis Huffman
- i
.7_r
w- Date Z
�� cn91 . CE 128991 .•�c��/
s�F�•.
7/7/202t '•F*�'.:w
t11FOPROFESSION�'�
Note: this approval does not include well permit requirements.
kmuv U0JUL/ 10)
PERMIT: OSP211226
PID:
050-571-55
FP �
00
CANT
EXI STING 50' WELL
4
0
�-
0 413R
HOUSE RADIUS
N
UA
9.7'
38.0' B 14.0'
22.8'
INSTALLED
FCO DECK CONC
1500—GAL
TANK W/
OHDPE
AX -20 POD
cc)MH
O
C N
S
O
O
4BR RESERVE PAVED
D
<
O
OD/W
PUMP BASIN
E INSULATED
Z
O
z
MT MT
F
G
INSTALLED TRENCH
30'L X 5'W X4'ED —5'OG
TH21-1
DECOMMISSIONED
EXISTING SYSTEM
LOT 7
RI K 10
A—C=20.3'
FCO
MT MT
B—C-35.3'
—
9776 MH MH
—� !H 98.05 FINAL GRADE 96•�
A—D=26.7'
Ax20 POD
95.55
INSULATION rFILTER FABRIC ORIGINAL GRADE�-
TH21_1
/ do INSULATION
ORG/OL
B—D=37.8'
A—E=28.p6'
J92.133
4.20 4.29 5.55 95.55
SM/GM STRATA
SM/GM
B—E=37.8'
9
isoo—cAL
91 55 SEWER ROCK 91 55
FOUND
SHALLOWER
A
— F
= 4 0.9'
HDPE TANK
PUMP
BASIN
AT CONST.
INSTALLED
TRENCH -5' OG
B
— F
= 3 9.2'
GRND.WTR.
A—G=61.7'
SEPTIC SECTION
6/18/21
B—G=37.6'
SCALES NTS
13 '
BOH
53.55
PREUSS #3 BLOCK 10, LOT
PREPARED FOR:
THEODORE TREMBLAY
20229 LUCAS AVENUE
EAGLE RIVER, AK 99577
FIRST WATER CONSULTING
13030 Sues Way
Anchorage, Alaska 99516
(907)350-9566
firstwaterAK@gmail.com
7 SUPPORT$SERVICES: --_\\
F�OF A-L� ' .WRES dI
*�TH
C�
-�
DATE: 7/7/2021` 4mantis Huff
SURVEY: JLC , 4�, CE 128991
DRAWN: FWCS
SCALE: 1" = 3'6"2 d' 7/7/2021
PAGE: 1 OF 1 L (� \ 'SSI
o��'
MUNIGIPALITY OF ANCHORAGE
0n -Site Water & Vvastewater Program
PO Box 1966W 4700 Elnaxe Fuad
Anchorage, Alaska 9951$5550 Phone: (907) 343-79G4 FSX! (dpi] M1 -799f
hitoJ4mw mur%itr6mnsi1C
On -Site Wastewater Disposal System Permit
I'�rmi# Numbar: �Qr`F1 � FFA
Fork Type; Septic Upgrade
Tax Code Number: 0:5057155000
Site Legal Addremss: PR EUSS #3 BLS{ 10 LT 7 G'00,56
Site Mailing Address, 21 229 LUCAS AVE, Eagle River
0wnor- TREMBLAY THEODORF P II
Des Ign Engknew, FIRST WATER 1 O,ONSULTING
This permit is for the construction of;
Erfur.Llvu Data
Exp1r2tion Data:
Lot -Size in Sq Ft
Total 113e-irooms:
0�£nt
LJ:•I�•<I l�l 1714']]#
0V24f202_I
24)2022
22217
El Disposal Field ❑ Seco Tank ❑ Holding Tank ❑ PrivV ❑ Primate Wal l ❑ Vater Std rage
All-Gonsti uulRuli shall be iia a"uidai7ue will1.
1. The altached approved design.
2. All requ ire rnants specifiad in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (1 BAA -G72) :and Drinking Water Regulatlonis (1 BAAC80)
3. The wastewater code requires inspections during the installation. The engineer shell notlfy the Development
Servioes Departmant per AMC15-65- Provide noUriioatiorr by calling (90 7) 343-79D4 (24f7).
4. From Q old etr 15 to April 15, a Subsuffaoe soil absorption system u nd-er oonslruction during fraezi ng wad the r
shall be either:
a. Opened and Closed an �he some day, or
b. Coveired. Sealed, and heated to prevent freezing
Rec&ed B�
ISSued By:
Date -
date: i
6/2412021
4
MUNICIPALITY OF ANCHORAGE
Development Services Department -907 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 050-571-55
Property owner(s) THEODORE TREMBLAY Day phone
Mailina address 20229 LUCAS AVE., EAGLE RIVER, AK 99577
Site address 20229 LUCAS AVE., EAGLE RIVER, AK 99577
Legal description (Sub'd., Block & Lot) PREUSS #3 B10, L7
Legal description (Township, Range & Section)
Lot Size 22,217 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(N all that apply)
Absorption Field
R
Initial ❑
Single Family (SF) 0
(w/wo ADU)
Septic Tank
El
Upgrade Q
(D) El
Holding Tank
ElRenewal
ElDuplex
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.
nature of property owner or autnorizea agent)
Permit/Rush Fees: _5Q5 Waiver Fees:
Date of Payment: (�.12.1 Date of Payment:
Receipt Number: 901311 1 Receipt Number:
Permit No. 05t021 122.6 Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
13021 Montego Circle, Anchorage, AK 99516
907-350-9566 / FirstWaterAK@gmail.com
June 18, 2021
Municipalities of Anchorage
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: SEPTIC SYSTEM UPGRADE PERMIT
LEGAL: PREUSS #3 BLOCK 10, LOT 7
The existing septic field has been found failed and encroaching groundwater and the owners have requested
a septic permit to upgrade the system on the above referenced lot. We propose to install one shallow trench
with and Advantex system to serve the existing 4-bedroom residence. The design is based on the recent test
hole conducted on June 11, 2018.
The slopes are flat at the proposed upgrade location. The lot and area are served by private water and public
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
OSP211226, Deb Wockenfuss, 06/24/21
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP211226, Deb Wockenfuss, 06/24/21
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP211226, Deb Wockenfuss, 06/24/21
13030 Sues Way - Anchorage, Alaska 99516
Tel. 907-350-9566 firstwaterAK@gmail.com
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: PREUSS #3 B10, L7
PERFORMED BY: FWCS / FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT
ON THIS DATE. DATE: 6/18/2021
DEPTH
FEET OG
SOILS
1
ORG/OL
2
3
4
5
6
7
SM/GM
8
9
10
11
12
13
14
BOH
15
16
17
18
19
20
Reading Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
6/16/21 30 min 6 11/16
30 min 6 11/16
30 min 6 11/16
PERCOLATION RATE 44 (MIN / INCH)
TEST RUN BEWTWEEN 5 & 6 FT
PERC HOLE DIAMETER 6
PRE-SOAKED PRIOR TO TEST & ALL READINGS TO
THE 1/16TH.
GROUND WATER ENCOUNTERED: YES
IF YES, AT WHAT DEPTH: 11
DEPTH TO WATER AT MONITORING: 11
DATE: 6/18/21
TESTHOLE # 21-1 DATE PERFORMED: 6/11/2021
SEE SITE PLAN FOR SLOPE & LOCATION
COMMENTS:
VERIFY GROUNDWATER MT
AT TIME OF CONSTRUCTION
PERFORMED FOR: THEODORE TREMBLAY
6/18/21
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP211226, Deb Wockenfuss, 06/24/21
MUNICIPALITY OF ANC140RAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered i�� o as of this ✓ 4 Day of J ✓1 t of 20.E 1 , by and between
herein the "OWNER," and the Municipality of
r ri
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
PREUSS #3 BLOCK 10. LOT 7
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 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.
—TT- It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Pagel of 3
Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
`tt Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
+ 1 Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
Tr Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
'It 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.
ITF 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. Severabilitv. 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: 24
�u4 r x100
l� O�0 ✓� �. vY `" `�j �c (print name)
STATE OF ALASKA )
ss.
THIRD JUDICIAL DISTRICT )
The foregoing instrument was acknowledged before
20'% , by "j% Pia 610 Ye— UZ 4
NOTARY PUBLOC FORA A, KA
My Commission expires: I I ?.Lf
MUNICIPALITY:
me this2p-i�d ly of ,
BY:L44&6�1�(signature)
(print name)
r�NTOTARY
OF ALASKA
PUBLIC -�:�;ra Lauda , t
pN Carir�ksslon G � �" - -
Date: 2 `i Z
Title:
(rev. 05/18/2018) Page 3 of 3
.~, ~ MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
/
PHONE / E:~EW
LEGAL DESCRIPTION
LOCATI~'~~d~
T I Well
DISTANCE TO: ,¢'-, '}
/Manufacturer.~__ --
DISTANCE TO' Well ._
Manufacturer ~
Well ~
DISTANCE TO: I ~ ~
NO. of li~s LeBg~of each line
Top of tile to finish gri~e z
I Typo of~ Cri~meter
I
~ Depth
Building fo:~d~n
OTHER
PIPE M..~E.~IA LS
SOIL TEST RATING
REMARKS
Absorption area
Inside le ngt h~,.~
Dwelling
Dwelling
JWidth ~
NO. OF BEDROOMS
No. of {:~,~par tments
Liquid depth
PERMIT NO,
Material _ Liquid cap~acity in gallons
Foundation :~._ '~O Nearest lot lin~j~(fO PERMIT NO.
Total length c~i~ j Trench ~ffzh~ ~% Distan~
Material beneath tile Total effectivdabsorption area
D~ PERMIT NO.
Crib de% I Tot~, effec¢~~
Building foundati~ Nearest lot line
Driller 1 Distance to lot line PERMIT
Sewer line . ~ J Septic tank ~ ~ I Absorption area~s)
DATE
LEGAL
PERMIT NO.
8PPLICBNT
LOCATION
LEGBL
THOMRS E. QUINLRN
LUCRS
L? Bi8 PRUESS #5
PO BOX i434 ER
LOT SIZE
TYPE OF SOIL RBSORBTION SYSTEM IS: TRENCH
221~0 SQURRE FEET
MRXIMUM NUMBER OF BEDROOMS = ~ SOIL RRTING (SQ FT?BR)= 285
THE REQUIRED SI[~,OF~,OIL RE:SORPTION~_~YSTEM IS:
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIEL. D.
THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE
GROUND RND THE BOTTOM OF THE E×CRVRTION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIF'E
RND THE BOTTOM OF THE EXCRVRTION (IN FEET).
RE[:. SEPT I C Tfl J"-~[--':.' _...5_"; I ZE= ±~Z~E~3 ,]R~._[_C,?-.l~-?.
PERMIT RPPLICRNT HRS TFIE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING TFIE
INSTALLRTION INSPECTIONS OF RNY WELLS RDJRCENT TO THIS PROPERTY RND THE
NUMBER OF RESIDENCES THRT THE WELL WILL SERVE.
-FPIC) <2) I ~4L~F'EE:T/C,)4S RP.E REC~)UIRE[)
BflCKFILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION 8ND RPPROVRL BY THIS
DEPRRTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTRNCE BETWEEN R WELL RND RNY ON-SITE SEWRGE DISPOSRL SYSTEM IS
ia8 FEET FOR R PRIVRTE WELL~ OR
±50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELi ....
OTHER REQUIREMENTS WRY RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS PRE
TO INSURE PROPER INSTRLLRTION.
F'EF~:I'-I I T EXP I F~'ES L~.ECEI'-IE:ER ."!::-.-1 ..
I CERTIFY THRT
i: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET
FORTH BY THE MUNICIPRLITY OF RNCHORRGE.
2: I WILL INS'FRLL. THE SYSTEM IN RCCORDRNCE WITH THE CODES.
i~: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM WRY REQUIRE ENLRRGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THRN ~ BEDROOMS.
RPPL I C:RNT
O ~- E GEO~¥.,:CHNICAL ~' DEVELOPMENT CO.
R:ssell Oyster
694-2774
Soils ~' Foundations
Box 90, Davis St,, Eagle River, Alaska 99577
694-2774 or 688-2280
Earl Ellis
SOIL LOG
Land Development
Performed for: Name: /')~J_ / ~.xo.~ ~ (~f2(~Ud~// Tel No.
Depth (feet) Soll Characteristtc~
~ _ / . i
15 . . .~.) ~.~_~D 4~-~~:~ "'~--.
~.- , ~' .~- ~ . ~
Ground Water Encountered: Yes ~o__ If yes, what depth
Proposed Installation~ Seepage Pi~ Drain Field
Co~ents:
Date:
CASE ~."
Performed For /3Z '11
uega.,, u ......... /~ .........
Depth '
........ [~ ................... ': ...... Location Sketch
l,.1, j'_~u,~//
3~~!--/- Z& O c~.~ t
'/~'
0% ' ~ - ' , . .. ~' -.
xe~d J.r g Date ,* ,.~ ·
_, ,~-~oss 'lime 5ie'r ¢:u,e Depth To H20 Net Drop
1{' �'tl h, ., kk2, ` � y,.. ,.ti r{i' {Ps�y �1�.,,�• fie] � ...�.., `e.vr ,,u � ... ��1T I'„i I ••_,a �ft 9 ,�^ h�J, � � �' y^...
. �. � <.,-.F U � � `ir� C L� d��i) �.ea �i � s � � � — �i'^'�� H � �.9 �A � •�C �. i� t_ �ssA F -
Development Services Department
On -Site Water & Wastewater Section
Parcel I. D. 050-571-55
Certificate of On -Site Systems Approval
1. GENERAL INFORMATION
Complete legal description PREUSS #3 BLOCK 10, LOT 7
Expiration Date
Location (site address) 20229 LUCAS AVENUE, EAGLE RIVER, AK 99577
Phone: 907-343-7904
Fax: 907-343-7997
d -j 7-z
Current property owner(s) THEODORE P. TREMBLAY II Day phone
Mailing address
Real estate agent
20229 LUCAS AVENUE. EAGLE RIVER, AK 99577
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 $ 25_.5Q Waiver Fee $
Date of Payment 7/_ /, 1 Date of Payment
Receipt Number 21102-5 Receipt Number
COSA # 05 G Z 113,66 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 6/30/2021
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 g�Q: • • • •,9 ���
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by First Water Consulting & FIAN ' * • 9TH ......*
6. DSD SIGNATURECurtis Huffman
System #1 Approved for bedrooms ���'6' . CE128991
System #2 Approved for bedrooms l�,F�PROFESS10Nt�
Disapproved
Conditional approval for bedrooms, with the following stipulations:
`\````l4F�cc c ANC/y6,
/y �, 6,1,,
10,UEN
B 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
COSA Checklist
Legal Description: PREUSS #3 BLOCK 10 LOT 7 Parcel ID: 050-571-55
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) Water storage tank volume gallons
Date drilled 1972 – PER MOA DOCS* Well disinfected for coliform test? ❑ Yes ® No
*Total depth 100 ft ® Coliform bacteria is Negative
*Cased to 100 ft Nitrate 8.49 mg/L [:]Nitrate less than MRL (ND)
® Sanitary seal is functioning correctly Arsenic ug/L ® Arsenic less than MRL (ND)
® Wires are properly protected
Casing height (above ground) 18+ in. Collected by F
ES
Date of flow test for COSA 5/13/2021
Static water level at beginning of test 77 ft. Date of Sample 6/23/2021
Well production at time of test 4.7 gpm
Comments WELL CASING INSPECTED & VERIFIED IN 2012 PER MOA DOCS.
B. TANK DATA – NEW TANK -
Age of tank(s) 0 years
Tank type/material ADVANTEX / HDPE
Measured operating fluid level in septic tank
® Standpipes/foundation cleanout per record drawing
Date of pumping
D. ABSORPTION FIELD DATA – NEW FIELD
Which system tested (date installed) 6/30/2021
® ALL standpipes present per record drawing
Total measured depth from grade 6.9 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
C. LIFT STATION – NEW PUMP VAULT
® Required maintenance completed
Age of lift station 0 years
Lift station material
Comments:
Adequacy test date - NA NEW SYSTEM
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 W/ INSULATION 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
NES
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
Community Sewer Manhole/Cleanout > 100'
❑ Yes
if No *50+ ft
® Yes
if No ft
Neighboring Tank > 100' ® Yes
if No ft
Private Sewer/Septic Line > 25' ® Yes
if No ft
Absorption Field on Lot > 100' ❑ Yes
if No *50+ ft
Holding Tank > 100' ® Yes
if No ft
Neighboring Absorption Fields > 100'
Private Wells > 100'
Animal Containment > 50' ® Yes
if No ft
® Yes
if No ft
ft
Community Wells > 200'
® Yes if No ft
Water Service Line > 10'
Manure/Animal Excreta Storage > 100'
if No
Community Sewer Main > 75' ® Yes
if No ft
® 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
Surface Water > 100'
® Yes if No ft
Property Line > 5'
® Yes
if No
ft
Wells on Adjacent Lots:
Private Wells > 100' ® Yes if No ft
Absorption Field > 5'
® Yes
if No
ft
Private Wells > 100'
❑ Yes if No *50+ 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
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.
Awl
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�.. Curtis Huffman
FOCE
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LOT 7 BLOCK 10 PLAT 7.1-91
N89°50'45"W 124.01' '
(N89°59'00"W x 12x4_.Z__ai—x—x—x1
10' UTILITY ESMT
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LOT 7 BLOCK 10 PLAT 7.1-91
N89°50'45"W 124.01' '
(N89°59'00"W x 12x4_.Z__ai—x—x—x1
10' UTILITY ESMT
WELL
PAVED
D/W
S89°50'48"W 123.98'
(N89`59'00"W 124.05' R)
SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a
physical survey of this property as shown on this drawing and that the
improvements situated hereon are within the property lines and no
enchroachments exist other than noted. Under no circumstance should
any information on this draMng be used for construction of fences;
structures, improvements, or for establishing boundary lines.
EXCLUSION NOTES: It is the owners responsibility to detennine
the existence of any easements, covenants, or restrictions which
do not appear on the recorded subdivision plat.
JULY 3, 2021 1"=30' 1 schullercak.n
21-069-2 ORAS`' BY: CHECKED BY GRID NUMBER: BOOK/PA
JLS NW0056 210215
LUCAS AVE.
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JOHN L. SCHULLER. o
LS -10408
�,°fessiona� �a
yo�D
LAND
1831 2alkeetna Street
Anchorage, Alaska 99508
(907) 227-1455 office
(907) 274-4992 fax
CONC
DECK
LANDING C
80.0'
EXISTING
HOUSE
38.0'
(V nj
DECK
0 SEPTIC
SYSTEM
SEPTIC a
VEN T
(typ)
LOT 7
BLK 10
WELL
PAVED
D/W
S89°50'48"W 123.98'
(N89`59'00"W 124.05' R)
SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a
physical survey of this property as shown on this drawing and that the
improvements situated hereon are within the property lines and no
enchroachments exist other than noted. Under no circumstance should
any information on this draMng be used for construction of fences;
structures, improvements, or for establishing boundary lines.
EXCLUSION NOTES: It is the owners responsibility to detennine
the existence of any easements, covenants, or restrictions which
do not appear on the recorded subdivision plat.
JULY 3, 2021 1"=30' 1 schullercak.n
21-069-2 ORAS`' BY: CHECKED BY GRID NUMBER: BOOK/PA
JLS NW0056 210215
LUCAS AVE.
r
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M
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49TH
,.......... ...� ..
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JOHN L. SCHULLER. o
LS -10408
�,°fessiona� �a
yo�D
LAND
1831 2alkeetna Street
Anchorage, Alaska 99508
(907) 227-1455 office
(907) 274-4992 fax
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC 211366
Subdivision: Press #3 Block 19 Lot 7
A water sample revealed a nitrate concentration of 8.49 milligrams per liter (mg/Q.
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 murn org
ammumErm
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.
� Mai(�ng Address P O Box 196650 * Anchorage,�Alaska 99519 66504*��www murn org
M'111CIPALITY OF ANCHORAGE
L ! NX
L11
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this Day of �,)a— of 20 -211 , by and between
_ 3V t °' '�� ' , 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 AN ADVANTEX SYSTEM
located at (legal description)
PREUSS #3 BLOCK 10, LOT 7
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 AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
accordance with the equipment's approval for operation in the Municipality.
It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Page 1 of 3
Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
_)km Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
m N Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
114 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:
By:(signature) Date:
,]olc�tG�f.[ (print name)
STATE OF ALASKA )
} ss.
THIRD JUDICIAL DISTRICT )
Th oregoiin Inst�urx�e�nt was a owled ed efore me this day of_, vo
2 Ki EJB j �,
-qpm�LTYpOFFICIAL SEAL
TARYPUBLIC FO A S . AOSA KA1.A•DE LA CRUZ
ASKAOARUBItC•STATE Of ALASKAMy Commission expires: y Comm. Expires October 91.2022
MUNICIPALI'T'Y:
sy—h.. ( {signature)
{print name)
Date:...7,..r I. �.(
Title:
(rev. 05/18/2018) Page 3 of 3
�— Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program$
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99507
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 050-571-55 COSA # o�C NaVAO D -
Expiration Date: 2 _-z—/3
1. GENERAL INFORMATION
Complete legal description Preuss Subdivision No. 3, Block 10, Lot 7
Location (site address)
20229 Lucas Avenue Eagle River, AK 99577
Current Property owner(s) Thomas E. Quinlan
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
20229 Lucas Avenue Eagle River, AK 99577
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: Three (3)
3. TYPE OF WATER SUPPLY:
Individual Well
✓❑
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
Day phone
Day phone
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
❑✓
Individual Holding Tank
❑
Community On-site
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm Anderson Engineering
Phone 522-7773
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E. Date a/27/2012
a �P• "
Is
5. DSD SIGNATURE
_Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
X Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
X Other
By: Original Certificate Date: 2
(ReeIV05)
Municipality of Anchorage
�• '� Development Services Department
r•
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Lot 7, Block 10, Preuss Subdivision No. 3 Parcel ID: 050-571-55
A. WELL DATA
Well type Private If A. B, or C provide PWSID # _ Well Log (YIN) N
Date completed 1972 Sanitary seal (YIN) Y Wires properly protected (YIN) Y
Total depth 100 ft. Cased to 100 ft. Casing height (above ground) >18 in.
FROM WELL LOG AT INSPECTION
Date of test 6/5/2012
Static water level ft. 55 ft.
Well production 9-p m. 5.4 g.p.m.
WATER SAMPLE RESULTS:
7.c17
Coliform 0 colonies/100 mL Nitrate *A; mg/L
Arsenic: N/DD mg/I Date of sample: 7/10112 Collected by: J. Berkram
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel Date installed 8/31/79
Tank size 1,000 gal. Number of Compartments 2 Cleanouts (YIN) Y
Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (YIN) �y
Date of pumping 6/1/2012 Pumper JRs Pumping
C. ABSORPTION FIELD DATA
Date installed 8131/79 Soil rating (g.p.d./ftz or ftzlbdrm) 285 SP/BDRM System type Deep Trench
Length 88 ft. Width 3-4 ft. Gravel below pipe 7 ft.
Total depth 13 ft. Eff. absorption area 1.232 ftz Monitoring tube Y Depression over field N
Date of adequacy test 6/5/2012 Results (Pass/Fail) Pass For 3 bedrooms
Fluid depth in absorption field before test 73 in. Water added 450 gal. New depth 80 in.
Elapsed Time: 1.440 min. Final fluid depth 73 in. Absorption rate >= 450 g.p.d
Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date
D. LIFT STATION
Date installed Size in gallons
"Pump on" level at_ in. "Pump off' level at _ in.
Datum Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Manhole/Access(Y/N)
High water alarm level at
Meets alarm & circuit requirements?
Septic tank/lift station on lot >100'
On adjacent lots >100'
Absorption field on lot >100'
On adjacent lots >100'
Public sewer main N/A
Public sewer manhole/cleanout
Sewer /septic service line >25'
Holding tank N/A
Animal containment areas >50'
Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >5' Property line >5_
Absorption field >5'
Water main NIA _ Water service line
>10' Surface water >100'
Wells on adjacent lots >100'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line >10' Building foundation >10' Water main NIA
Water Service line '10' Surface water >100' Driveway, parking/vehicle storage >26
Curtain drain None Noted Wells on adjacent lots >10a
F. COMMENTS' Information Regarding Absorption System Taken From Municipal Files. Well Casing Verified Greater Than
40' Deep with no Perforations by Aarow Well and Pump.
in.
G. ENGINEER'S CERTIFICATION
SPS;•- "-
Aw . •- Y y�
l certify that l 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 m
Engineer's Printed Name Michael E. Anderson, P.E.
a'�f,� C:E*4381
Date 8/31/2012
�fIN. ®Ppprrt51Q�`���
COSA Fee $ Ll q O —
Date of Payment g l I I i a c
Receipt Number
(Rev. 11105)
D`,-c-l)lyoa
Waiver Fee $ _
Date of Payment
Receipt Number
ASBUII.T
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
SCALE; ,
FOLLOWING DESCRIBED PROPERTYz
/L 30
o9Ei/SStr'd?GLUi/ cd3Co/7�!%/O —
AND THAT NO ENCROAGAHMENfS EXIST EXCEPT AS
_
DATL;
INDICATED. IT IS THE RESPONSIBILITY OF THE
AN
GRID=
EASEMENTS, COVENANTS, OR RESTRICTIONS
WHICH DO NOT APPEAR ON THE RECORDED SUBDI-
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FB:
ANY DATA HEREON BE USED FOR CONSTRUCTION
_
d
ARY LINES.
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11
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ASBUII.T
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
SCALE; ,
FOLLOWING DESCRIBED PROPERTYz
/L 30
o9Ei/SStr'd?GLUi/ cd3Co/7�!%/O —
AND THAT NO ENCROAGAHMENfS EXIST EXCEPT AS
_
DATL;
INDICATED. IT IS THE RESPONSIBILITY OF THE
OWNER TO DETERMINE THE EXISTENCE OF ANY
GRID=
EASEMENTS, COVENANTS, OR RESTRICTIONS
WHICH DO NOT APPEAR ON THE RECORDED SUBDI-
VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD
FB:
ANY DATA HEREON BE USED FOR CONSTRUCTION
OF FENCE LINES, OR FOR ESTABLISHING BOUND-
ARY LINES.
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AAROW PUMP & WER SERVICE, LLC
P.O. Box 110496
Anchorage, AK 99511
Office: (907) 346-9355 • Fax (907) 345-0202
Eagle River: (907) 622-9335
CUSTOMER
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No. 9519
JOB SITE
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INVOICE (DATE
liy�
WELL DEPTH
/CEJ
SWL ,
Nev
CHLORINATED
PUMP DEPTH
SALESPERSON//s
J-. �iJGT r run
QUANTITY
DESCRIPTION
0.v PRICE
AMOUNT
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LABOR
HOURS
RATE
AMOUNT
TOTAL MATERIAL
TOTAL LABOR
y�o
WORK ORDERED BY
DATE COMP.
TOTAL
LABOR
PAY THIS AMOUNT
y1®
00
Thank You
SIGNATURE
(I Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that if above work is not paid for in 90 days I agree to allow Aarow,
Pump & Well Service, L.L.C. the right to remove unpaid for equipment and charge for labor already performed & labor to remove unpaid for equipment.)
TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE.
SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS.
Municipality of Anchorage s
o -f �
Community Development Department
Development Services Division
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 # 121402
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block 10, Lot 7 of
Preuss #3 subdivision. This inspection revealed a nitrate concentration of
7.97 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.