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Home My WebLink AboutPTARMIGAN LT 3Ptarmigan Lot 067-$ ! ! -04 Municipality of Anchorage . Page "' DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ,~c::~4~/~(_~ O~-~) PID Number: ~-- Name: ~As~/~ ~, /~C~, Wastewater System: ~New ~ Upgrade Address: ~9~ - ~.~ ~BeepTrench ~ShallowTre.ch ~Bed UMo~nO UOther Total Depth from original grade: LEGAL DESCRIPTION soilRating: /, ~ GPD/Sq. Ft. Lot:~ Block: Subdiv~ion: Depth to pipe heroin from original grade: Gravel depth beneath pipe Township: Range: I Section: Fill added above orig~l grade: Gravel length: v,,5 Ft. ~7 Ft. ~ Gravel width: Number of lines: Distance be~n lines: WELL: New Upg rude Classification (Private, A.B.C): Total Depth: Cased To: Total absorption area: Pipe material: Date installed:/ Date DrilJed: Static Water Level: Instal]er: n Pump Set at: Casing Height Above Ground: SEPARATION DISTANCES ~Septic U Holding C S.T.E.P. TO Septic Abso~tion L,. Holding ~,Private Ma~ ~ Cap.ci~ingailo~s: From Tank F~eld Station Tank Sewer Unes SuVaco Water ~/~ ~ ¢ W/~ L! FT STATION . / " ' ~ High water alarm at: Foundation ~t Io ~/~ "Pump on' level at: ~t Cu~ain Drain //~ / ~ Pu~Electrical Inspections pedormed by: Remarks: BENCH MARK Location and Description: I Assumed Elevation: EN~JNEERZS~SE~ 2nd Depadment of Healt~and Human.~ices approval Rewewed and approved by: Date: ~ /~ Permit No. 2 Page ' 2 of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 545-474-4 On-Site Wastewater Disposal System and/or Well Inspection Report Legal DescripUon: LOT 3 PTARMIGAN P,~RMIGAN BLVD _ EASEMENT 40' FHI TANK 89'55'45" W ELEVATIDNS (NBT TB SCALE) (N 89'55'5E' E DRIOINAL GROUND LEVEL AT~ 9B,O 176.60') PID No.: SWING TIES A-C = 19P,3' B-C = 82,4' A-I) = 174.5~ B-D = 68,9' 82.509 · - MONITOR TUBE o - SEWER CLEANOUT -,)- - WELL EASEMENT LEACHFIELD NO SURFACE WATER NO KNOWN CURTAIN DRAINS SCALE 1"=60' 8/16/96 ENGINEER'S SEAL ~,- OF AL ~ ~<,k¢.. ............. .d ~,~ ?~.:" 4-9 TH ~ ~ ~.... ...'~ M-W DRILLING, Inc. 110378 · 1033~ Otd SewanJ Highway ANCHO~E, ~ 99511 DRIWNG ~eJt O~Aer__ ~4ATtK R,¥1P ~.~/~ PAGE 1 of 2 ~ ~W¢IDO~ESTIC ... :f.,~ion (~ki.w.¢.,.¢ ,~: Tow"a.4~, ~ge-, ,~,~ ~ l~o'~; o~ ,~..,,tcm.~e ~,;',', roar] LOT 3, PTARMIGAN EAGLE RIVER, ALASKA Well pumping test at Depth in feet from A TO 2 2 TO 6 -=_&__TO 18 18 _TO. 34 34_' 5i~ of casing 6" ~epth ol I-IoIe 250 ~eet ~ed~ 250.72 ~eet Static wa~ l~el !R~. (~'.. · ow) ~d su~a~. F~h ~ we~ (~k one) o~ ~d ( X ~ ( ); ~e~ 1 ,'~' r: ~ .... ,. ?q ?: v :.. ,-' ,. WELL LOG ~-~ ~to,-~a~om ~n~rat~, ~ of ma~ial, eol~ ~d h~em PFFFIII h COBBLEY ¢,.~E,~?SD'."T.'J¢, COBBLEY Oept, Health & Human Services %1'" ' ', ,"'~J~ ' i "¢ ,- :~. ,9', '. '. ' ~-7 *~ ,% ~f-;' ~,;~, '~¢'~",' .-'.-' '. · - Cl~Y: 6R[Y. S~LTY, 6RAVELL~ ..... ); 81 TO 120 120 _TO 136 . 136 TO 140 ... _~J~_TO. i58 ._=_158_~) 166. _==lEG_TO. 3_55 GRAVEL: SILTY, COBBLE¥ SILT; COBBLEY GRAVEL: SILTY SILT: SOME GRAVEL GRAVEL: SILTY CLAY, 5TICK¥.~ SILTY I~i~=W DRILLING, inc. P_O_ B~x ~ 10378 · llkgSO Oki .'~ewa~d Highway ANCHO~GE. ~S~ ~511 PAGE 2 of 2 ~iLUNG ~ Townsl~Jp, l~e, ~ection~ ~f ~own; or d~stance m.~n ~oad-- ..... Fgze o~ easing. b-'tM~e water l~el ._., ~ee~, ( ) ~i~ WeE ~p~g Date ~ 178/PO lgq 194 ~ 201 __...~.LTO e12 )$ penetrated, size oi materi~l, coIor and hardness GRAtfELL Y DAMP RECEtVED '- - CLAY ~ BOTTOM I ~ CUSTOMIER MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF 1 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW960230 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES OWNER NAME:KIEHL CYRIL & LOIS OWNER ADDRESS:2020 MULDOON ROAD ANCHORAGE, ALASKA 99504 DATE ISSUED: 8/01/96 EXPIRATION DATE: 8/01/97 PARCEL ID:05036236 LEGAL DESCRIPTION: PTARMIGAN LT 3 LOT SIZE: 43560 (SQ. FT. NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (iSAAC80) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY: DATE: Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax July 22, 1996 Jim Cross, P.E. Manager, On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Ptarmigan, Lot 3 Narrative & Permit Application Dear Mr. Cross: The proposed well and septic system will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are large, allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30' distance. 3. Reserve space is adequate, due to absorption capacity. 4. Drainage will not be affected and is not a major consideration in our design. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. _) \ 1996\96-063A-NAR.DOC ~SEPTIC ' I I t ~ ~ ~ 241.1 __, 15~UTILITY EASEMENT__ \ \ ~ ~ o ~/ .~ - , LBT 3 ~ L~T 4 / / IS~.4 NO D~LOPMENT ~ - TEST HOLE · - MONITOR TUBE o - SEWER CL~NOUT ~ - WELL NO SURFACE WATER ~SEMENT NO KNOWN CURTAIN DRAINS PROPOSED L~CHFIELD I- EXISTING LEACHFIELD WELL/SEPTiC SITE PLAN LEGAL: PTARMIGAN LOT 5 CONTRACTOR: ( N A ~..~9 TH ~ EACLE RIVER, A~ 99577 ~ ~o~ss~o~ (907) 694-5195 FAX: (907) 694-3297 z SEPTIC +100' 89'35'56" (94.10) 15', UTILITY __ THI PROP HSE Z LE]T N 89'35'56" E IE]T 4 176.66 159.~t NO DEVELOPMENT NO SURFACE WATER NO KNOWN CURTAIN DRAINS [] - TEST HOLE · - MONITOR TUBE o - SEWER CLEANOUT ~ - WELL EASEMENT --'- PROPOSED LEACHFIELD ~- EXISTING LEACHFIELD WELL/SEPTIC SITE PLAN LEGAL: PTARMIGAN LOT 5 OWNER: KIF'HL CONTRACTOR: ~/ JOB# 96-065 DATE: 7//19/961 SCALE 1" = 60' A EAGLE RZVER ENGZNEERfNG SERVICES P.O. Bex 773294 EAGLE RIVER, AtE. 99577 (907) 694-5195 FAX: (907) 694-3297 SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: Ptarmigan, Lot 3 07/19/96 GENERAL 1. The well and septic plan are for a single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. 9. Any remaining open test hole excavations shall be filled. SEPTIC TANK 1. Septic tank shall be MOA approved, 1,250 gallons minimum. Set for gravity flow to leachfield elevation, and insulate with 2' soil cover minimum. 2. 3. 4. 5. 6. TRENCH The trench is to be located in position shown on plan.. The bottom of the trench shall be level, plus or minus 1.5". The total depth of the trench excavation is not to exceed 10.5' at any point. The effluent line within the trench shall be laid level within 0.03'. The trench gravel is to be covered with typar fabric material. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed over the leachfield. 7. The area over the trench is to be finish graded to prevent ponding of surface water runoff. 8. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH = 10.5' GRAVEL DEPTH = 7' under pipe, 2" over pipe TRENCH LENGTH = 36' TRENCH WIDTH -- 3' SOIL RATING = 1.2 GPD/ft2 BEDROOM CAPACITY = 4 SEPTIC TANK = 1,250 gallons minimum Twenty-four (24) hours notice required for all inspections. \1996\96-063a-spc.doc Municipality at Anchorage DEPARTMENT OF' HEALTH & HUMAN SERVICES 825 "L" Street. Anchorage. Alaska 99502-0650 SOILS LOG -- pERCOLATION TEST '1--,-// 'E~AL OESCRm'nO~: /- ..~ /C~7~/~-,,?~ 5~ Townsmp. Range. Section: SLOPE I I I I I I WAS GROUNO WATER ENCOUNTERED? J il.ill I I1~ Ill II L ' J ~ PERCOLATION RATE 4, ?%/..,.$ (m,nutesnncn) PERC HOLE OIAMETER TEST RUN 8E~E~ 7.~.~ ..... /, *' , THAT T~I$ TEST WAS PERFORMED IN Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0550 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: ~"/~- ~// DATE PERFORMED: Township, Range, Section: 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16- 17 18 20. COMMENTS SLOPE WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT nL DEPTH? p E Oepth Io Waler After/ Moniloring? c~',"..) Oat,- ?-.Z2 -~ SITE PLAN Reading Date Time Net Time Depth to Water Net Drop Z. ?//~ PERCOLATION RATE TEST RUN BETWEEN (m~nutesnncn) PERC HOLE DIAMETER __ FTAND ?'J-- FT PERFORMED BY: ";-¢/'Q -"-~-~ ~-:-::; ¢.':, :¢ -'-'-': '~ I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAl ~lJlfl~l IhJc:q I,M ¢'¢:¢¢¢'T ,~ Tu~e mATe ~ATC. ~:~ ' ,')- ',~._ ">~.¢ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMEO FOR: LEGAL DESCRIPTION: ¢'"~f'~'"~'"~ L. ~ ~ 5 6 7 8 9 10 1I 12 13. 14 15 16 17 18 2O +'/V' ' COMMENTS DATE PERFORMED: Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTER ED? S L IF YES, AT WHAT O DEPTH? p E Depllt t0 Water Alter / Monitoring? ,c9~ "-~ Dale: ~-'~ Reading Date Gross Net Depth to Net Time Time Water Drop f~ ~_ - .4 ~,., . ~.__.~,z -- / ~-/?-~'~' .~-,' ~7 ~7 ~I/~" PERCOLATION RATE /' ~" (mmutes/mch) PERC HOLE DIAMETER TEST RUN BETWEEN ~7 FT AND ~ FT PERFORMED BY: .z'~_'..C_';z~¢..,- I , ,-' - ..... - ,~ CERTIFY THAT THIS TEST WAS PERFORMED IN EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99577 (907) 694-5195 ERES Project No.: 96-063 Calculated By: LB Date: 7/19/96 Legal: PTARMIGAN LOT 3 Single Family 4 Bedroom Dwelling TEST HOLE 2 Deep Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = 600 gallons Percolation rate = 2 minutes per inch Wastewater application rate = 1.2 gallons per day per square foot Required absorption area = 500 square feet Trench width (W) = 3 feet Gravel depth (D) = 7 feet Required length = Required absorption area / 2 / D Required length = 500 / 2 Required length = 36 feet Total Excavation Depth = 10.5 feet / 7 SINGLE FAMILY ON-SITE WORKSHEET ERRS PROJECT NUMBER: 96-063 LEGAL DESCRIPTION: PTARMIGAN LOT 3 NUMBER OF BEDROOMS: 4 WATER USE PER BEDROOM: 150 PERCOLATION RATE: 2 DEPTH TO GROUNDWATER: 16.5 DEPTH TO IMPERMEABLE LAYER: 16.5 ANTICIPATED DEPTH OF COVER: 3.5 MOUND OR BED SYSTEM CALCULATED BY: LB WASTEWATER APPLICATION RATE: ABSORPTION AREA REQUIREMENT: MINIMUM BED LENGTH 12 FEET WIDE BED 15 FEET WIDE BED TRENCH SYSTEM WASTEWATER APPLICATION RATE: ABSORPTION AREA REQUIREMENT: SHALLOW TRENCH OPTIONS 5 FEET WIDE TRENCH GALLONS MINUTES PER INCH FEET FEET USABLE SOIL STRATA FEET TOTAL USABLE DEPTH: USABLE SOIL STRATA DEPTH: 0.8 GAL/SQ.FT 750 SQ.FT 10.5 7 63 FEET 50 FEET 1.2 500 GAL/SQ.FT SQ.FT DEEP TRENCH OPTIONS 3 FEET WIDE TRENCH DESIGN SPECIFICS FIELD SYSTEM: GRAVEL DEPTH: TRENCH OR BED WIDTH: LENGTH: TOTAL EXCAVATION DEPTH: D (B=BED, S=SHALLOWTRENCH & D=DEEP TRENCH) 7 FEET 3 FEET 36 FEET 10.5 FEET EFFECTIVE REQUIRED TRENCH EFFECTIVE REQUIRED TRENCH DEPTH (FT) ENGTH (FT) DEPTH (FT) ENGTH (FT) 1 88 4 63 2 70 4,5 56 2.5 64 5 50 3 58 5.5 45 3.5 54 6 42 4 50 7 36 8 NA 9 NA MUNICIPALITY OF ANCHORAGE Development Services Department 5 r % Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 020-042-67 Certificate of On -Site Systems Approval Expiration Date: �S-^ I Ll _ Z o zZ 1. GENERAL INFORMATION Complete legal description PTARMIGAN ROOST BLK 1 LT 3 Location (site address) 16100 Wind Song Dr Current property owner(s) KABLE JOHN Mailing address Real estate agent _. Cher 2. TYPE OF DWELLING: Fx_1 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 830-2211 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic 0 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 $5 `SO Waiver Fee $ Date of Payment Date of Payment Receipt Number Receipt Number COSA # O s C - ZZ 10 y GJ 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 NorthRim Eng. Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 2/10/22 �Q�EOAl F,�yIt �f s * 49 Mi* ' 6. DSD SIGNATURE t• WEA sbw Enq ".. System #1 Approved for bedrooms ♦♦� CE -LOM System #2 Approved for bedrooms h. __ /` 10 / 2Y Disapproved Conditional approval for bedrooms, with the following stipulations: OF N1 P EFt Z z—SRO -- B Original Certificate Date: 2 7 i�ZZ 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 engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA ereddst blue sheet Legal Description: PTARMIGAN ROOST BLK 1 LT 3 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 4/3/98 Total depth 305 ft Cased to 38* ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 45 in. Date of flow test for COSA 1/28/22 Static water level at beginning of test 31 ft. Comments * Into Bedrock B. TANK DATA Age of tank(s) 23 years Tank type/material plStc Measured operating fluid level in septic tank na ❑ Standpipes/foundation cleanout per record drawing Date of pumping na D. ABSORPTION FIELD DATA 9/4/98 Parcel ID: 020-042-67 Structure served by this system Well production at time of test 5+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by NRimEng Date of Sample 1/28/22 C. LIFT STATION ❑ Required maintenance completed Age of lift station 23 years Lift station material pIStc Comments: BIOcycle Which system tested (date installed) same Adequacy test date 1128/22 ❑ ALL standpipes present per record drawing Results ❑✓ Pass For 4 bedrooms Total measured depth from grade 4.5 ft (max) Fluid depth prior to test 3 in Measured depth to pipe invert from grade 4 ft (min) Water added 600 gal ❑ N/A — pressurized field New depth 6 in ❑ Monitor tubes go to bottom of effective. If not, state depth into effective OR Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Elapsed time 30 min Final fluid depth 3 in Absorption rate 600 gpd Any rejuvenation treatment (past 12 months) no If yes, enter date 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' S Yes Community Sewer Manhole/Cleanout > 100' 2] Yes if No ft rV1 Yes if No ft Neighboring Tank> 100' Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Absorption Field on Lot> 100' Q Yes if No ft Holding Tank > 100' Q Yes if No ft Neighboring Absorption Fields > 100' ft Private Wells > 100' Animal Containment > 50' Q Yes if No ft Q Yes if No ft if Noft Community Well > -muni S — 260' Q Yes if No ft Manure/Animal Excreta Storage > 100' El Community Sewer Main > 75' [D Yes if No ft Q Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' S Yes if No ft Surface Water> 100' El Yes if No ft Property Line > 5' El Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q Yes if No ft Private Wells > 100' Q Yes if No ft Water Main > 10' Q Yes if Noft Community Well > -muni S — 260' Q Yes if No ft Water Service Line > 10' El 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' E -Yes if Na ft If absorption field is under driveway comment below Property Line > 10' Q Yes if No ft Wells on Adjacent Lots: Water Main > 10' Q Yes if No ft Private Wells > 100' Q Yes ' if No ft Water Service Line ?: 10* Yes if No ft Community Wells > 200' Q Yes if No ft Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION / 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. COSA Checklist yellow sheet OF --"% P�� orc, Q: Steve Eng ~ 4,J , Ikk Ux CE -62W X0 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 Zhu Day of "A-1 of 20_Z,2�_, by and between t.�G4.,�►et �, , 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 BIOCYC! F located at (legal description) 2. Maintenance, ReDairs 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). X25 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. 2& 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 4'5 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. `713 Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. 42 Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. 2 Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term 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 Latin. 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: / ~r Y (signature) Date: Z- Z- zc)ZZ Z. CL,, (print name) STATE OF ALASKA THIRD JUDICIAL DISTRICT The foregoing instrument as 204;�aby 2 i�, Y-4 . NOTARY PUBLIC-FO� My Commission expires: ss. edged before me thisrQ day of d , li, - -t , '; f! State ofWaska SKA NOTARY PUBLIC S Miriam Beckford My Commisslcn ExpI es pec.1G, 2G25. MUNICIPALITY: 'r BY °'� w (signature) Date: ` 1 `1 Z. (print name) Title: (rev. 05/18/2018) Page 3 of 3 ✓/ V✓ lllt.l- 1J.- 11✓y✓ Anchorage AK 99503 Email: crbioak@gmail.com (907)274-0314 Homeowner Info Customer Name: Ward and Meghan Kable Tank#: 45 Install Date: Sept. 2002 Address: 16100 Windsong Area: Rabbit View-Goldenview Initial Inspection: Alarms Tested: Air V High Water Battery Tested: Yes ❑ No ❑ N/A (Please make sure alarm is on "normal", not "mute") Does system have a septic tank ? No V Yes ❑ (Recommend pumping tank every 2 years) Is System Lid Locked? Lid hardware in working order? Is there any noticeable odor? Yes Repaired ❑ Yes [ Repaired ❑ Strong ❑ Mild None ❑ System Inspection .. r�1-1� L.,t�el`y3.. G'T,."''� y ) S-.�",�. ; ��'� .�,�} K:a �� Fh "'' t 13 �'i`v*i-'h 1 u'* 4'... t °>� `.t•. �.. F, yam`- ��.n.�� ,h . Fu+'�' �, .i, y Inlet plumbing in working order? Solids pillow normal? Yes [ Replaced ❑ Yes [ Requires Pumping ❑ Ara�onxCh�rn, W� �K�✓Z�S+��A �f t�� ars ua"se4 tS'�� €� 4 �t � � }1 4 SAN C�� ** ; 4 }i� ix � sS� � # ?N l y,-. "c � f _.Ti ;fifiv.V. ': ,"'"'?:.�t 4� ': S ''�'�..E�'E.' 4 .fit" "tt i �x."r ?"'` + 'i � ^�' �'5^' � 1^'�'v-„^� fi" +3.' vu.... �' �'� ;p f 1�"•. .' � �"y �.s y } : � � '�"� 1- i`"x: "Y�. ..5. �s ....t.. r�az a. .....:. �{..:wY�m .�sdh`��'�:.e'r*.'vvxw..-, �aw-.'a w�a4l„"a`a�l��""'}'asi�x.,..ai?�i✓vw:��tvwaew.mm...2t+.a. r-.:.. �.,% � ;z.:.. �. ..v.. w(..c.da....sxw.rs +.... ., ._+........F�a».a."M'S�+aGhM1.b. u.muwu'..N`..re,.6 .,nev..S. ,.....Y'a _.ar L. ..>��afiL_-sS Are all aerators functioning? Any buildup of solids? Yes ❑ Replaced [� � Yes ❑ No [� Clarification return system operating? Any buildup of solids? Yes] Adjusted ❑ Yes ❑ No FVJ � "'E j�(� aP ""..1:.: ��r� � ��2y� ��" Y! F, "'i" 'eei? '�:z ""d �#", t:«� L.'elv�`'�tf'y�� b �..'. _e"„e� .5.�' .2t,Y�t'.+s"?.�.�'zYo-"`-£.tP„�” .k' t£4 'k� �"•'.. fnz�Yx'`wiid�'e�',K.�.�'��u'G`sir.'"niter:.r.,.eu.��'+✓.�E'v��'�.:w�"3"��9Y§s�w..P�:t�5.F-F`Y.U,-,....�:`v�i"'.4^��64��,.�"�'��w��.si ti.t,��.�^..^a.:u�i«.�,v�..r .��'w":;.u::Y'c.....:.v'X. LraxL�.x.:n.,.s�'c...c�.a.nr.`��,...w.fk`.i'�.c�..,h+: �F...,.3,<�ru� Sv�i"'+y'�}i�-�'•��Ci".4vxYa�fi„� pH Reading: Dissolved Oxygen PPM Turbidity of discharge (in FTU) (pH of 6-8 is ideal) (2-5 is ideal) (Under 35 FTU is considered compliant.) 7.0 3.5 6.29 .+.- s..w.:.,fi }c.✓AN�uat:,+�R:.,.w..,Em:a."'k.".xk�ry.'�L^.2'�.a3a.u�.m.<A+a-s......d2�u ra`;F.a..4.�E.,w.t.�.«e- 3c.'.vh.X�x�ti�-..3.,�.x•,..�„�7�v^`' .3�''�.L.., „�..0 S.aa..+,w,.. sMXu..w�Ek:^,e� v Pump float operating? Alarm float functioning? Any buildup of solids? Yes V Replaced ❑ Yes A Replaced ❑ Yes ❑ No FVJ Filter cleaned? Discharge line condition: Yes FY71 N/A ❑ Good _ Replaced Comments: Has emailing or mailing of form been requested? Inspected By: Chris Date: 12/29/2021 (contact office to request...) Yes No Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and 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 FOR A SINGLE FAMILY DWELLING Parcel I.D. 067-311-04 COSA# 0%¢-.~ i\i Expiration Date: /0 -2/- J// GENERAL INFORMATION Complete legal description Ptarmi§anf LOT 3 Location (site address) 20510 Ptarmigan Blvd, EAGLE RIVER, AK 99577 Current Property owner(s) Mark Ramp Mailing address same Day phone 351-9971 Lending agency Mailing address Day phone Real Estate Agent owner ,~ Mailing Address un/e~ss'°'therwige requested, COSA will be held by DSD for pickup. NUMBER OF 'BEDROOMS: 4 'TYPE OF WATER SuPPLy: Individual Well [] IndividUal Water Storage [] Community Class ~ Well [] Public Water System Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank Community On-site Public Sewer E] 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, Junctional 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. ,r"' Name of Firm NorthRim Engineering Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 7/20/2011 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 septi~%s~ems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. DSD SIGNATURE ~~~ ~ Approved for ~ bedrooms, u Cond,t,onal approval for bedrooms, w,th the foHow, ng st,pulat,~~;:i Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X · ~,~v,:. · ..... '. O.-SlTE ~ ; WASTEWATER : _: Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: (Rev. 11105) ./ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 1966~50 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Ptarmigan, LOT 3 A. WE'LL* DATA Well type PIU~ATE IfA, B, or C provide PWSID # Date completed 8~5,/96, Sanitary seal (Y/N) __ Total depth 250 ff. Cased to 250 ff. FROM WELL LOG g.p.m. Date of test 8/1~6 Static water level 180.3 Well production 15+ WATER SAMPLE RESULTS: Parcel ID: 067-311-04 Well Log (Y/N) _Y Wires properly protected (Y/N) Y Casing height (above ground) 24+ in. AT INSPECTION ?/1s/2ml 181.6 ft. 8+ g.p.m. Coliform NEC colonies/100mL Nitrate <MRL .mg/L Arsenic: 1.0 .mg/I Date of sampte: 7./15/2011 Collected by: NRim Eng. B, SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 8/12/'96 Tank size 1250 gal. Number of Compartments 2_ Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) _N High water alarm (Y/N) N Date of pumping 10/14/10 Pumper Sanita,-TPmnpers C. ABSORPTION FIELD DATA Date installed 8/12/96 Soil rating (g.p.d./~ or ~/bdrm) 1.2 System type .peep Tzench Length 37 ft. Width --3 ff. Gravel below pipe 7__ft. Total depth 12.5 ft. Eft. absorption area 528 fi2 Monitoring tube Y Depression over field _N Date of adequacy test 7/15/11 Fluid depth in absorption field before test Elapsed Time: 60 min. Final fluid depth Results (Pass/Fail) Pass For 4__ bedrooms ~ in. Water added 600 gal. New depth 5~ 45 in. Absorption rate >= 600+ g.p.d. in, Any rejuvenation treatment (past 12 mo.) (Y/N & type) N__lf yes, give date -- D. LIFT STATION Date installed na Size in gallons na "Pump on" level at na in. "Pump off" level at na Datum na CycleS tested na E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on.lot :tOO'+ Public sewer main NA Sewer/septic service line 25'+ Animal containment areas 100'+ Manhole/Access (Y/N) n_.~a High water alarm level at na in. Meets alarm & circuit requirements? n._~a in. On adjacent lots 100'+ On adjacent lots :t00'+ Public sewer manhole/cleanout NA Holding tank :tOO'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 10'+ Absorption field~ Surface water :tO0'+ Building foundation 5'+ ,Water main NA Wells on adjacent lots :tOO'+ Property line :tO'+ Water service line SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Water main NA Driveway; parking/vehicle storage 10'+ Property line :tO'+ Water SerVice Ii:ne 10'+ Curtain drain (None~ao~) COMMENTS Building foundation 10'+ Surface water ~00'+ Wells on adjacent lots 100'+ 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. Enginee?s Printed Name Sfeve Eng Date 7/21/2011 COSA Fee $490.00 Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number ,I PTARHIGAN :BLV[I b >-15.6 S 89'35'45" W I HEREBY CERTIFY THAT I HAVE SURVEYED TIlE FOLLOWING PROPERTY: PTARMIGAN 5URDM,5]ON LOT 5 AND TINT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS TRIg RESPONSIBILITY OF THE O~NER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS. COVENANTS. OR RESTRICTIONS ~HICH DO NOT APPEAR ON THE RECORDED SUBDMSION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUNDARY LINES. 82.50' LBT 3 N 89'35'56" E 176.60' EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 10421 VFW Drive Eagle River, Alaska ~9577 PTARMIGAN SUBDV. LOT 3 ASBUfLT SURVEY GRID: SW 56 19/23/95 MJN , [ /,o! ERES Project Number: 96-063 SCALE: CADD File Nome: 96-063AB f%50'