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Home My WebLink AboutEAGLEBROOK BLK 1 LT 4Eaglebrook Block 1 Lot 4 #017-121-20 Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP 171175 PID Number: 017-121-20 Dwelling: ❑ Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ❑ Upgrade Name: TARAS ILNITSKIY ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 6421 ANDOVER CIR, ANCH AK ❑ Other Phone Number of Bedrooms Soil Rating depth from original grade 4 4.0 GPD/SF JTotal +4.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade +5,0' Ft. Gravel depth beneath pipe 0.5' Ft. Subdivision Block Lot EAGLEBROOK BLK 1 LT 4 Fill added above original grade +7.5' Ft. Gravel length 60' Ft. Township Range Section Gravel width 5.0 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES 7o septic Sept Absorption Lift Station Holding Sewer. Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 300 Ft' 1.0 Ft. Well 1 QQ'+ 1 OQ'+ TANK El septic X S.T.E.P. [I Holding ❑ Other Manufacturer ANCH TANK Capacity 1500 Gal. I Surface Water 1001+ 1001+ Material ADVANETX AX -20 Number of compartments 2.0 Lot Line 10'+ 10'+ ( NA Foundation 10'+ 10'+ I LIFT STATION Manufacturer ANCH TANK PUMP BASIN Capacity 150 Gal, Curtain Drain UN 40' Pump on level at Pump off level at High water alarm at Remarks PRE-SET in. PRE-SET in. PRE-SET in. Pump make and model Electrical Inspections performed by PS20 MOA W1 HOUSE PIPE MATERIAL House to tank 3034 Tank to drainfield 3034 Installer MIKE ANDERSON,P.E. Drainfield 3034 CO/MT Inspector MIKE ANDERSON, P.E. BENCHMARK (Assumed elevation) 103.5 ft Inspection 15l 8-21-17 " 8-21-17 2 Location and description dates: GARAGE SLAB 3�c 4m COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp OF Ar -, � Conditional Approval: Date •• MICHAEL N. ANDERSON :c"= /o /0//V � CE -9 64 J?i? • • �;��..,.. Approved Date lwl Rt1{FSSta��"` Inspection Report_9-1-12.doc Permit No. OSP171175 Page 2 of 2 Municipality of Anchorage 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 Legal Description: EAGLEBROOK SUBDIVISION, BLK 1, LOT 4 PID No.: 017-121-20 MARK \ A B C01 TC01 10 10 TCO2 \ 36 �7 7 MT1 65\ 8� MT2\50 4 APPROX EXISTING CURTAIN DRAIN APPROX LIMITS OF MOUND TEST HOLE #1 BY OTHERS _ \ \ \ i • T1 �\ \I 1 RESERVE AREA, REBUILD EXISTING / \ \ \ TANK REMOVED ^ `\ 1 \ \ \ 1 \ \ TEST HOLE #2 BY OTHERS C01 626 T2 \ \ �" Col / TOPSOIL & SEEDED \ B / PUMP BASIN BENCH, 'SGA G� S B — — — — 1 00 GALLON FIBERGLAS TANK \� \ W ADVANTEX POD \ \ \ 100' WELL RADIUS — — — — �� ( \ DRIVEW / \ WE LANDS BOUNDRY I -- ASBUI�LT — / /�" 50' / SCAL€: _ MT1 MT2 OF0 �.�P�. ...........,�51�♦ Go, 4�. , ♦ C� ,o 7.5 ♦ MH PUMP BASIN FlNISH GRADE TOPSOIL & SEED 100 OG .� . 5 F] ER FABRIC & INSULATION FILL A • 49 TH •� • 105 105 •........ 104.5 ORO 98 �• , roos soDCALLON ��MICHAEL N. ANDERSON: / FIBERGLASS ADVAN7EX rtrz uxu 96AV OL . / ^ O E 4 69 All ♦ .% IV TOP OF EXISTING OLD IRAN ROCK SW ♦ �.��..9/25/20 .• ♦ .� 40 9 96.5 SEPTIC SECTION 93 ♦�♦............. •" \.�� N.T.S. WATER ® 98.6 9/8/05IIJT��.� 11 �� OWNER OF LAND: Taras Ilnitskiy ADDRESS: 6421 Andover Circle Anchorage, AK 99516 LEGAL DESCRIPTION Eaglebrook 131 L4 DATE: 9-7-17 PERMIT NUMBER: OSP171175 DATE OF ISSUE: 7-31-17 TAX IDENTIFICATION NUMBER 01712120000 Is well located at approved permit location: ®Yes ❑No Method of Drilling: ®air rotary ❑cable tool Depth of Well: 126' Casing Type: Steel Wall thickness .250 inches Diameter: 6 inches, depth 120 feet Liner type Static Water Level: 43 feet Recovery Rate 5 ® gpm gph Method of Testing Air Well Intake Opening Type: ® open end ❑open hole ❑ Screened Start feet Stopped ❑ Perforations Start feet Stopped Grout Type: Bentonite Volume: 50 lbs Depth: from 2 feet, to 42 feet Well Disinfected Upon Completion: ®yes ❑ no Method of Disinfection: Chlorine 50 PPM Comments: Bore Hole Data Depth From To 0 2 2 4 4 15 15 21 21 89 89 115 115 1 126 Casing Stickup Overburden Silty Sand & Gravel Wet Silty Sand & Gravel Tight Silt Sand & Gravel Silty Sand & Gravel w/ Clay Hardpan & Water Drillers Name: Cole Sullivan ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. Matsu Borough: Department of Environmental Conservation. Development Services DepartmentPhone: 907-343-7904 On -Site Water & Wastewater Section 1 11 U- Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: OSP 171175 Date of Issue: 07 - 31 -17 Parcel Identification Number: 01712120 Legal Description Block Lot Property Owner Name & Address: EAGLEBROOK BLK 1 LT 4 TARAS ILNITSKIY Pump Installation Date: 01 -30 -2018 IPump Intake Depth Below Top of Well Casing: 120 Pump Manufacturer's Name: Pentair Pump Model: 3nf152-8-p4 Pump Size: 1/2 _hp Pitless Adapter Burial Depth- 8 Pitless Adapter Manufacturer's Name: feet feet MARTINSON B-10XLF Pitless Adapter Installer: MIKE ANDERSON Well Disinfected Upon Completio? Yes 0 No Method of Disinfection: 0-ILvic—, Comments: Pump Installer Name: taras 11nitski Company: ( " Z Lkq V"r " , Mailing Address: 6421 Andover circle City: Anchorage State: ak -Zip: 99516 Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://w .muni.org/onsite On -Site Water & Wastewater System Permit Permit Number: OSP171175 Work Type: WellSeptic Renewal Tax Code Number: 01712120000 Site Legal Address: EAGLEBROOK BLK 1 LT 4 G:3138 Site Mailing Address: 6421 ANDOVER CIR, Anchorage Owner: ILNITSKIY TARAS Design Engineer: This permit is for the construction of: 2 Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy Effective Date Expiration Date Lot Size in Sq Ft: Total Bedrooms: Mcnr c ^ epartment 7/31/2017 7/31/2018 67663 D Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing VSIZE r_'JVY 7 �sk ZMA �Wa �Wr' I L Date: / Date: 7/314201? Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage Alaska 99519-6650 • (907)343-7904 • Fax(907)343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV151067 COSA#: Permit#:OSP171175 PID#: 017-121-20 Legal Description: Eaglebrook Block 1 Lot 4 Engineer: Mike N. Anderson Applicant: Taras Ilnitskiv Your request for a waiver of the required 50 feet horizontal separation from the absorption field to the curtain drain has been approved. The approved separation distance is 40.0 feet. In addition, your request for a waiver to provide Engineered Receiving Soil (ERS) in the absence of 2 feet of native unsaturated accepting soil has been approved. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ............................................................................... Waiver is Granted: X Waiver is not Granted: Date: 8 LO p Approved by: _ nt,Wl n OtA Ca-* g Name of Reviewer ............................................................................... **** VARIANCE/WAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE Community Development Department _� Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. D/_7 — /Z/ — 20 Property owner(s) Cyt I 0/ Mmilirlq addr�r �� %fnckor-01_ R4 dress Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Day phone 317—"/Z 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) Septic Tank Upgrade F-1Duplex (w/wo ADU) (D) ❑ Holding Tank El Renewal Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: A', I certify that the above information is correct. I further certify that this is in accordance with applicable MurAipal Codes./ of owner or authorized agent) Permit/Rush Fees: 4 "ey Date ot`��_ - Ib -11 Receipt Number: Permit No. nl5Ag111116 Permit App_9-1-12.doc Waiver Fees: 5 Date of Payment: T Receipt Number: U 2 �SFSIo Waiver No. QSj 1 b i 0 �1 July 27, 2017 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Renewal permit for well and septic Legal: EAGLEBROOK BLK I LT 4 To Whom it may concern: This is a request for a renewal for an old septic and well permit on the above referenced lot. Originally the a permit was approved for Garness Engineering but the system was not installed. Now a new owner is requesting a permit for development on the property therefore I'm submitting for a renewal of the old permit under my direction. The drawings have been updated for the new site plan with the only revision being the relocation of the well to the front of the lot. All of the septic design has remained the same as approved originally. The lot is flat and has no cut banks with slopes greater than 25 percent, see the drawing. This new system will not impact any of the neighboring properties due to the lot layout. Please call me if you have any questions. Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch. Ak 99516 Ph 727-8864 DESIGN CRITERIA: 3:1 SLOPE TOPSOIL AND SEEDING 4 BDRM X 150 = 600 GPD SOILS = 600/4.0 = 150 GPD 150 GA/5 = 30' (1) TRENCH +4.0' DEEP 0.5' EFFECTIVE 5.0' WIDE 30' LONG (T.H. BY CORWIN) ORG 20 OL 40 o SW l--1 GROUND WATER @ 1.33' 9-8-05 SEPTIC FIELD SECTION +4.0 TOP OF EXIST SYSTEM /—EXIkTING GRADE FILTER FABRIC &INSULATION & DRAIN ROCK 1.25"0 PIPE IOA SAND LD 1987 BED - C \ I \\ I I I I \ I I II PROPOSED DRAINAGE FIELD \ PROPERTY LINE I PROPOSED HOUSE PROPOSED ' GU CA, ' WELL r A O j1�R --- �� I I \\ \\ I \\\\ SMALL CREEK — ' 'EERFyOPo- RPgg1S ,-� Septic Design Prepared for TARAS ILNITSKY 40 PSE OF .40 q„ 4,s�♦ EAGLEBROOK, BLOCK 1, LOT •��• Anchorage, Alaska : 4 rH ... � ...:....... ... ........................ i.. .. Michael N. Anderson P.E. DATE: 7/26/2017 *.MICHAEL N. ANDERSON;i ♦0-•. 4601 NATRONA AVE DRAWN: DJR No. CE 9469 ��'�'•..iff/ ANCHORAGE, ALASKA 99516 ♦ r00 /�'• (907) 727-8864 /FAX: (907) 345-1391 SCALE: 1 "=200' �O,1jL_i•• 1 I I i � 110 _ EN ��Q,�S1SSYiP,E�N� Ilyl 1 �' B OLK1. LOT4 \\\ 11 NII 1 1 I I 1 -- 1 11 1 II EA LEBROOK01 I TRACT Al I 1 1 II 1 TH1 N1 1 1 IEAGLEBROOK $LOCK 1, LOT 2 I i i / EAGLEBROOK BLOCK 1, LOT 7 - /! / / / PROPERTY LINE APPROXIMATE'C' WETLANDS BOUNDARY GA 1 VA II II II DECOMMISSIONED UPER PC 0 0l T.H. BY BRUCE CORWIN, \ M PROPERTY LINE 1 IG\ �, P.E. fy�\. 1� (I 1 I� ml 1 1� NI II 11 x 1 � SURVEYOR TO STAKE 1 ALL PROPERTY LINES I I AND WELL RADIUS. r 1 ! I r ! 1 I 1 i I i i 1 i 1 1 II 1 I 1 EL 1 1 I 1 t \ \ \ � y HOUSE 1_ r Septic Design Prepared for TARAS ILNITSKY EAGLEBROOK, BLOCK 1, LOT Anchorage, Alaska \ M1'\ APPROXIMATE LOCATION OF CURTAIN DRAIN, OUT LET NOT LOCATED APPROXIMATE LOCATION i �OF MAN MADE POND \ \ \ \ \ r i \ \\ I SECONDARY SITE \ 4vp,,c . I I 1% PROPOSED 1,500 GALLON ADVANTEX TH#2 TANK AND POD \\ \ \ \ \ \\ �� PROPOSED WELL \\ 100' RADIUS 1 1 i _ , r r .PNOONE' r i � i Michael N. Anderson, P.E. DATE: 7/26/2017 4601 NATRONA AVE DRAWN: DJR ANCHORAGE, ALASKA 99516 (907) 727-8864 / FAX: (907) 345-1391 SCALE: 1"=50' 7'o ,�vvsor cr Ul .* OPINION OF COMPLIANCE ANCHORAGE GENERAL PERMIT 93 -10 -M4/11 -M4/12 -M4 File Number: POA -2017-365 Municipal Reference Number: Elmore Creek 17-A Permittee (LANDOWNER): Taras Ilnitskiy Expiration Date: October 31, 2020 Project Location: Eaglebrook Subdivision, Lot 4 Block 1; Andover Circle off Rabbit Creek Road Anchorage Wetland Management Plan Map #: 102 Wetland Unit #: 80 Wetlands Fill Amounts: </=.350 sq ft; -350 cyds Type II Work Description: Excavation and backfill for access driveway, utilities and single family home. All work will be performed in accordance with the attached plans submitted with application dated: July 7, 2017 The permittee will perform work in waters of the U.S. (wetlands) in accordance with the terms and conditions of the Anchorage General Permit, as specified below: Anchorage General Permit Conditions: GENERAL CONDITIONS OF THESE GENERAL PERMITS All activities identified and authorized by these GPs shall be consistent with the special conditions listed above, as well as the general conditions listed below. The Corps can also add site-specific special conditions to a GP verification, as applicable. Obtain GP verification prior to activity: No work shall be done under these GPs without first obtaining an Opinion of Compliance (OC) from the MOA Planning Division or General Permit Verification from the Corps. A copy of the Municipal building permit application and grade/fill permit application or Land Use permit application must be included with the GP application. Compensatory mitigation, if required, must be acquired before proceeding with authorized jurisdictional activities. Time limit: Verification under these GPs is valid until October 31, 2020, unless the GPs are modified, reissued or revoked. It is incumbent upon the applicant to remain informed of changes to the GPs. Taras Ilnitskiy Home POA -2017-365; Elmore Creek 17-A Mitigation: The activity must be designed and constructed to avoid and minimize adverse effects, both temporary and permanent, to waters of the U.S. to the maximum extent practicable at the project site. Mitigation in all its forms (avoiding, minimizing, rectifying, reducing, or compensating for resource losses) will be required to the extent necessary to ensure that the adverse effects to the aquatic environment are minimal. Compensatory mitigation will be required for all wetland losses greater than 0.1 -acre unless the District Commander determines in writing that either some other form of mitigation would be more environmentally appropriate or the adverse effects of the proposed activity are minimal, and provides a project specific waiver of this requirement. The applicant may seek this determination by written request to the Corps. The Corps' determination on compensatory mitigation will be returned, in writing, to the MOA Planning'`Division for inclusion into the OC. If applicable, compensatory mitigation must be completed prior to conducting work authorized under these GPs. Compensatory mitigation projects provided to offset losses of aquatic resources must comply with the applicable provisions of 33 CFR 332. MITIGATION NOT REQUIRED—Project fill covers < 0.1 acre Setback: Where there are wetlands along or around a stream or water body, the project shall include and maintain a non -disturbance setback, measured horizontally from the ordinary high water mark, as specified in Attachment A. Applicants shall contact the MOA Planning Division or Corps to obtain or confirm delineation of the setback. The setback extends only as far as the outer edge of the adjacent wetland boundary. Setbacks greater than 25 feet wide do not extend into non -wetlands. NO SETBACKS Buffer: The project shall include and maintain a non -disturbance buffer area, as specified in Attachment A. Applicants shall contact the MOA Planning Division or Corps to obtain or confirm delineation of the buffer. 3U, Delineation of project boundary: Project boundaries shall be staked, flagged or otherwise clearly delineated prior to the commencement of the authorized activity to prevent inadvertent encroachment of adjacent wetlands. Endangered Species: Activities authorized under these GPs must not adversely affect a federally listed threatened or endangered species, or destroy or adversely modify its designated critical habitat. Historic properties: No cultural resources shall be adversely affected by activities authorized by these GPs. If the permittee discovers any previously undiscovered archeological, paleontological, or historic resource, while conducting activities authorized by these GPs, the DC must be immediately notified by calling (800)'478-2712. The Corps will notify the Alaska State Historic Preservation Office of what has been have found. The Corps or the appropriate federal land manager will initiate the Federal and State coordination required to determine if the remains warrant a recovery effort or if the site is eligible for listing in the National Register of Historic Places. Inspection: The applicant shall allow the DE or their authorized representative(s) and/or a representative from the MOA Planning Division to inspect authorized work at anytime deemed necessary to assure that on-going and completed work is in compliance with the terms and conditions of these GPs. Transfer of General Permit: If the applicant sells or wishes to transfers the property associated with the authorized activity, the applicant must obtain the signature of the new property owner or lessee in the appropriate space on the verification/OC and submit a copy of that page to the MOA Planning Division and/or Corps, along with appropriate documentation of the Taras 11nitskiy Home 2 POA -2017-365; Elmore Creek 17-A . transaction. All information must basubmitted within 3Odays ofthe property transfer to . validate the transfer pfthe {SP authorization tothe new party. ' � modified by any other Federal, `State, `orlocal governmental authorization, amVdifioationofthe GPs, MOA Planning Division's Opinion of Compliance, and any verification by the Corps to perform activities under these GPs may need tobeobtained. ' Use of multiple general permits, including Nationwide Permits: The use of more than one GP or Nationwide Permit (NWP) for a single and complete project is prohibited, except when the acreagelossof waters of the United States authorized by the GPs and/or NWPs does not exceed the loss of more than one acre of wetlands. Project site restrictions and design criteria: 1. For Residential developments, the aggregate total loss of waters of the United States authorized by GP -1 993-1 0-M4 shall not exceed one acre. For residential subdivisions, the aggregate total loss of waters of United this GP cannot exceed one acre. This includes any loss ofwaters ofthe United States associated with development ofindividual subdivision lots. 2. ErosioDCon1nd: Prior tothe initiation ofany fill discharge authorized inaccordance with GP- 18Q3-12-K84'the Permittee shall install 'erosion control measures along the perimeter of all work areas to preventthdisplacement or erosionof fill material outside the authorized work areas. The erosion control measures shall remain in place and be maintained until all authorized work is completed and the work areas are stabilized. Immediately after completion of the final grading of the land surface, all slopes, land surfaces, and filled areas shall be stabilized using sod, degradable mats, barriers, or a combination of similar stabilizing materials to prevent erosion. 3. Fill Material: Only clean fill material shal | be used for this project. The fill material shall be free from items such as trash, debris, automotive parts, asphalt, construction rnatsha|a, concrete blocks with exposed reinforcement baand soils contaminated with any toxic substance, intoxic amounts ihaccordance with Section SO7ofthe Clean Water Act. 4 Within GOdays ofcompletion ofthe work authorizedb this permit, the Permittee shall complete haattached "Ge|f-{|ertifica1ionStatement cf Compliance" form (Attachment D), QEthe attached "As -Built Certification By Professional Engineer" form (Attachment E),and submit hto the Corps. These are further described below. Statement ofCompliance: | the event that the completed work deviatesinany manner from the authorized work, the Permittee shall describe the deviations between the work authorized uythis permitand the work as constructed on the "Self -Certification Statement of Compliance" form. The description of any deviations on the "Self -Certification Statement of Compliance" form does not constitute approval of any deviations by the Corps. As -Built Certification: Within 8Ddays of completionofthe work authorized bvthis permit, the Permittee shall submit as -built drawings mfthe authorized work and a completed "As -Built Certification ByProfessional Engineer" form tothe Corps. The as - built dnswingmahmUbeaignad and sealed byaregistered professional engineer and include the following: a. Amlan view drawing of the location of the authorized work footprint, as shown on the permit drawings, with transparent overlay of the work as constructed in the same scale as the permit drawings on 81/2 -inch by 11 -inch sheets or PDF. The plan view drawing should show all "earth disturbance," including wetland impacts and water management structures. TaraHome P()A-2017-365'Elmore Creek l7 -A 3 b. A|ist of any deviations between the work authorized by this permit and the work as constructed. In the event that the completed work deviates, inany manner, from the `authorized work, describe on the attached" CertificationBy Professional Engineer" form the deviations between the work authorized by this permit and the work aoconstructed. Clearly indicate onthe as -built drawings any deviations that have been listed. Please note that the depiction and/or description ofany deviations onthe drawings and/or "Ao-Bui|t Certification ByProfessional EnQineer"'fonndoes not constitute approval ofany deviations by the Corps. . c. Include the Department of the Army permit number on all sheets submitted. 1. Time Limit. GP authorization of this project expires on: October 31, 2020. If you need more time to complete the authorized activity, submit a request for extension under these GPs to the Municipal Planning Department prior to the expiration date. You may not continue work beyond the expiration date until receiving notification to that effect from the Municipal Planning Department or the Corps Regulatory Branch. Note: Permiteeshould allow a/least one month forprocessing mfextension requests. 2. Setback Where there are wetlands along around a stream or waterbody, the project shall include and maintain a non -disturbance setback, measured horizontally from the ordinary high water mark. The setback extends only as far as the outer edge of the adjacent wetland boundary. Setbacks greater than 25 feet wide do not extend into non -wetlands. For previously unplatted residential subdivisions, the setback area shall be tracted out, rather than being included in individual lots. . � 6` ^ �fnom streams that are neither onadnjmouonoruuddabove and. defined 1 Other Approvals Required Before Starting Work. You must not disturb wetlands for this project until you have obtained all applicable Municipal and State approvals required for the work. These approvals may include, but are not limited to:Munkog& of Anchorage: El Land Use Permit ` El .ClearingEl Grading ~& Fill PermitEl Right -of -Way Permit El Building Permit Flood Hazard PermitEl Preliminary Plat Approval 17 Subdivision Agreement El Utility Agreement(s) FI Rezoning Approval 2 Stormwater Treatment Plan n Parks Right -of -Entry Permit El ` Wastewater Disposal ' LJ Urban Design Commission 171 Geotechnical Commission Alaska Department of Environmental Conservation: FI Stormwater Treatment Plan 0 Wastewater Disposal [I Soil Remediation Plan ' . If any of these—or other—approvals result in a change to the attached plans, you must provide a description of the change and a revised plan(s) to either Municipal Planning Department Staff or the Corps Regulatory Branch, and may not proceed with the project until the change is authorized. Turas llnitskiy Home 4 P()A-20l7-365'Elmore Creek I7 -A 4. Offset Unavoidable Impacts. Tooffset the unavoidable adverse impacts of the project to the aquatic environment, the pnnndeo Ey Mitigation not required; fill less than 0.1 aoma LJMitigation required; fill greater than U1acres; ` Limits onWork Area. You must not conduct any ofthe following activities inwetlands or vmatedbodieebeyond the approved projectfootprint ( in any other avoidance area identified above) during either construction oroperation o(the pnoject/fani|dy: > Discharge of fill material (even temporarily), including stockpiles; or, ' > Excavation and aideoaeUng/bockfU|ing;or, > Mechanized bndcleahnU;or, > Operation, orservicing ofequipment. 5 �mnatn��d�n�un�f� You runoff ^ employ measures to preclude minimize both erosion and the transport of sediment, pollutants, and solid waste beyond the approved project footprint. These measures shall include, but are not limited to: El Phasing of Site Preparation (to minimize the extent ofexposed aci/);El Silt Fence; � Reroute Offsite Runoff around Disturbed Soils (e.g., � Mulching (e.g., d chips,straw, gravel); Matting (e.g., jute, straw, coir); Sheeting for Stockpiles,'p"'m"x o;; E] Check Dams in Ditches/Drainageways (e.g., hay bales, sand bags, gravel berms); M Surface Roughening (to slow runoff down slope); El Terracing of Slopes; El Sediment Trap(s); El Temporary Sediment Basin; 'Storm Drain Inlet Protection (e.g., hay bales, sand bags, and gravel ben -n) Outlet Filtering/Stabilization for Construction Dewatering; Onsite petroleum spill/leak response equipment and supplies and provision for their proper disposal . G. Contaminated Soil. |fcontaminated soils are discovered during construction, you must immediately cease all work inthe vicinity cfthe contamination, contact the Alaska Department cf Environmental Conservation for instructions, and defer any further activity until you receive ADEC approval tucontinue. 7. Endangered Species. The activity must not jeopardize the continued existence ofothreatened mr endangered species, as identified under the Endangered Species Act, nor endanger the critical habitat cdsuch species. Tozas llnitskiy Home 5 pOA-2017-365' Elmore Creek 17-A Special Conditions, as required by the Watershed Management Services (WMS) of the Municipality of Anchorage: No additional conditions recommended. Special Conditions, as required by the Planning Division of the Municipality of Anchorage: No special conditions are required by the MOA Planning Division. Special Conditions, as required by the Corps of Engineers: PCN Not Required Your signature be w, as permittee, confirms that you accept and agree to comply with the terms and conditions ofAnchorage General Permit 93-10-M4 as supplemented in this document. SIG Owner --7 DATE PRINT T� Owner DATE Opinion of Compliance The signature below confirms the Municipality of Anchorage's opinion that the project described above meets the terms and conditions of Anchorage General Permit 93-10-M3. c4a v,-xa SIGN Thede To ish, Senior Planner DATE PRINT Thede Tobish, Senior Planner Taras Ilnitskiy Home POA -2017-365; Elmore Creek 17-A TE on When the work authorized by the Anchorage General Permit is still in existence at the time the property is transferred the terms and conditions ofthe permit will continue tobebinding onthe new owmer(a)ofthe property. Tovalidate the transfer ofthe permit and the associated liabilities associated with compliance with its terms and conditions have the transferee sign and date be/ow. (TRANSFEREE) (DATE) Attachments: Final Project Plans (sheets X2 , dated July 7, 2017) Taras llnitskiy 80mc POA-20l7-365;Elmore Creek 17-A P ,e"Nly 7 &7Vh 200--345,FlrnokCK AA \ s OF GRAPHIC SCALE: t Inch = 40 Feet LEGEND Ieoggr .. egwrsr: / SPOT ELEVATION � yg��Af 20 0 20 40 $0 DRAINAGE DIRECTION 0\"�realoxw a e1Scale Le al Deecrl tion BOBBYR BURNETT srerzolT 1 - as i D.r.Dy a.rtly wat eD. Prap•,t. a..."d D.raaa D.. D..a .y.e 2861 Carriage Drive Grid PLOT PIAN LOT 4, BLOCK ,� ar.m�•� w m d1r 11i1naanE wdo vet om 4 SW 3138 D r Pr o•emaal•.1t be.d r... Anekarage, Alaska 99507 EAGLEBROOK SUBD ION rt l rOP• P r as cD on the P• 7 1tW o •cent IDarato vNxa th.M.° •Down.°TDN 1• (9 0T) 950-5541 Drawn Dy Weld Hook PLAT 78-158 pmP�� a w•ar•Pert� (rlaa ad)alaat lDsr.io a ... D oa tk. BFB �.. •r otD•�leuem.al. w• Ja.r. a roaawZ , Uaa.mlaal.a .a . ProwrU .:e.Pt .Da.a. LOT SQUARE FOOTAGE 67,663 S.F. LOT COVERAGE 04.57% ' 20 DRAINAGE & WALKWAY EASEMENT T at E AS M N — — '� \ \\ HOUSE DETAIL 464. N— N.T.S. , i �� °y $m —'N40—a � Sr m\ , 1° �• .zs , VW—ELL o�x ;\Z ONE STORY WOOD FRAME e°l- \' \ �'bE�NF'A.. I p um HOME v 1910 7.5 ",. :.:a / .. .. , p• F.G.F. ELEV. 802.0 e ° p rye / 0 1950 SEPTIC 4, 1 mpry� 0°ry 0pryp \ m — al m "oe NZO 1;10 \ s OF GRAPHIC SCALE: t Inch = 40 Feet LEGEND Ieoggr .. egwrsr: / SPOT ELEVATION � yg��Af 20 0 20 40 $0 DRAINAGE DIRECTION 0\"�realoxw a e1Scale Le al Deecrl tion BOBBYR BURNETT srerzolT 1 - as i D.r.Dy a.rtly wat eD. Prap•,t. a..."d D.raaa D.. D..a .y.e 2861 Carriage Drive Grid PLOT PIAN LOT 4, BLOCK ,� ar.m�•� w m d1r 11i1naanE wdo vet om 4 SW 3138 D r Pr o•emaal•.1t be.d r... Anekarage, Alaska 99507 EAGLEBROOK SUBD ION rt l rOP• P r as cD on the P• 7 1tW o •cent IDarato vNxa th.M.° •Down.°TDN 1• (9 0T) 950-5541 Drawn Dy Weld Hook PLAT 78-158 pmP�� a w•ar•Pert� (rlaa ad)alaat lDsr.io a ... D oa tk. BFB �.. •r otD•�leuem.al. w• Ja.r. a roaawZ , Uaa.mlaal.a .a . ProwrU .:e.Pt .Da.a. On -Site Water & Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP151189 Tax Code Number: 01712120000 Work Type: WellSeptic Upgrade Permit Effective Dates: July 21, 2015 to July 20, 2016 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: EAGLEBROOK Site Legal Address: EAGLEBROOK BLK 1 LT 4G:3138 Owner/Address: LAIRD GLYN D & SHERI C 12930 ADMIRALTY PLACE ANCHORAGE AK 995153724 Site Mailing Address: 6421 Andover CIR, Anchorage This permit is forthe construction of: Y Disposal Field Y Septic Tank N Holding Tank Lot Size in Sq Ft: 67663 Total Bedrooms: 4 N Privy Y Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By Municipality of Anchorage Ment S 1p F Z rG J v y epartment **** VARIANCE/WAIVER REVIEW **** Waiver#: OSVI61067 COSA#:. Permit#:OSP151189 PID#:017-121-20 Legal Description: Eaole Brook, Block 1. Lot 4 Engineer. Garness Engineering Group - - Applicant: Glyn Laird Your request for a`waiver of the required 50 feet horizontal separation from the absorption field to the curtain drain has been approved. The approved separation distance is 40.0 feet. This waiver approval applies to the proposed absorption field only. Any futureupgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department: ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. Adjacent properties are not affected by this waiver. ....................■.................... ................... ................... Waiver is Granted: X Waiver is not Granted: Date: Approved by Name of Reviewer •............. •........■.■■................•................................r MUNICIPALITY OF Com unity Development Department Development Services On -Site Water & Wastewater Program Mayor Dan Sullivan ANCHORAGE On -Site Sewer/Well Permit Application lk Single Family Dwelling Parcel I.D. U ITTAL JUN 18 2015 Gcetchc� Stulle: Phone:907-343-7904 Fax: 907- 343-7997 Property owner(s) GLYN LAIRD Day phone 227-6558 Mailing address 12930 ADMIRALTY PLACE *ANCHORAGE AK 99515 Site address 6421 NHN ANDOVER CIRCLE *ANCHORAGE, AK Legal description (Sub'd, Block & Lot) EAGLE BROOK; BLOCK 1, LOT 4 Legal description (Township, Section & Range) Lot Size Sq.Ft. Number of Bedrooms 4 APPLICATION IS FOR: Initial (all that apply) Upgrade Absorption Field Renewal Septic Tank Multiple Dwellings Holding Tank ❑ Privy ❑ Private Well Water Storage ❑ APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: TYPE OF DEWELLING: Single Family (SF) (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) Distance: 40 FEET I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: (D` l a l(7 Receipt Number:0:506-1199 � a)1,2 ! L) U Permit No. 5 06-1 L0pp 9 Waiver Fees: 0 Date of Payment: W1 V a `( Receipt Number: ? /-2 Waiver No. 0�(o C(01 - (Rev. 01/11) GARNESS ENGINEERING GROUP, Ltd oe CIVIL & ENVIRONMENTAL ENGINEERS --- g July 20, 2015 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic System Upgrade & Initial Well for Eaglebrook; Block 1, Lot 4 To whom it may concern: Currently there is no house on the subject property. The existing bed type drainfield was installed in 1987. After it was installed it was determined that it is encroaching upon groundwater. The land remains undeveloped and the septic system has never been used. After discussions with Deb Wockenfuss in your office, it was agreed that utilization of an Engineered Receiving Soils (ERS) would be acceptable to your department. We are proposing to install a Quanics Aerocell treatment system (CAT III) utilize a 650 aerocell pod, a 1500 gallon S.T.E.P. tank, and a Quanics panel/controls. We are proposing to excavate to the top of gravel in the existing bed (approximately 4 feet deep), import 8 feet of MOA approved sand (to create a separation of 5 feet to groundwater), and build a 30 foot long, five -wide mounded trench. The existing septic tank shall be decommissioned per UPC. Comments regarding the design are summarized as follows: 1. SOILS: There is not 2 feet of unsaturated soils in the area of the drainfield. We are proposing to excavate down to 4 feet and build up with engineered fill, which in this case will be MOA filter sand. This will require a variance to the existing code. See the design drawing for construction specifications. See the attached 2005 logs performed by GEG which show groundwater at 16 inches below grade. Also, see the attached 1987 log which shows the classification by Bruce Cowin, P.E. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There was ponding in the road ditch 100'+ away from the existing drainfield, and a manmade pond approximately 30 feet away from the existing drainfield to the east. 4. TOPOGRAPHY: The general topography around the drainfield is relatively flat. 5. WAIVER: We are requesting a waiver to the existing curtain drain of 40 feet. We are also requesting a variance to providing a sieve of the saturated soil. Justification for the waivers is as follows. - The existing drainfield is approximately 30 feet away from curtain drain & we are creating a greater separation distance. - Based upon our groundwater readings, it is unlikely that the curtain drain is even 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337.6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com Page 2 of 2 functional. - We will be using CAT III treatment, resulting in a significant reduction in BOD, TSS, and fecal coliform levels. -Soil was visually rated at 150FT21bedroom by Bruce Cowin, P.E. The existing drainfield has a total absorption area of 1140 FT2. -Once the liquid passes through the Quanics treatment system and the imported sand, the water will be dispersed through the drainrock of the oversized 1140 FT bed and absorbed into the underlying soil. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. a /1 P.E., M.S. 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507.1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www. garnessengineering.com NUMBER OF BEDROOMS: 4 GALLONS PER DAY (GPD): 600 PERCOLATION RATE/S: P1 MIN/INCH PROPOSED APPLICATION RATE: 4 (CAT III) MINIMUM DRAINFIELD SQ.FT.: 150 FT° FPROPOSED ENGINEERED FILL MAXIMUM DEPTH OF EXCAVATION: TO TOP OF ROCK IN EXISTING BED (APPROXIMATE 4 FEET) WIDTH: 5 FEET LENGTH: 30 FEET M.O.A. APPROVED SAND FILTER: APPROXIMATELY 8 FEET EFFECTIVE: 0.5 FEET ACTUAL SO.FT.: 150 Fr NOTE: THE CONTRACTOR SHALL HAVE THE EAST & SOUTH LOT LINES, AND ALL WELL RADII FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. LETTER THAT PERTAINS TO THIS DESIGN. TO OBTAIN A COPY OF THE LETTER CONTACT DEG. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND EXISTING CURTAIN DRAIN; SEE PAGE 19 OF 53 IN MOA RECORDS FOR LOT 3 & 4. OUTLET PIPE COULD NOT BE LOCATED PROPOSED 5'X30' DRAINFIELD TO BE BUILT ABOVE EXISTING DRAINFIELD PROPOSED 1500 GALLON STEP TANK WITH QUANICS AEROCELL CONTROL/PANEL OLD TANK TO BE 5H#' DECOMMISSIONED PER UPC PROPOSED 650 AEROCELL POD TO BE SET ON TOP OF MOUND APPROXIMATE LOCATION OF 1987 T.H. BY BRUCE J. CORWIN P.E. EXISTING BED IN ACCORDANCE WITH AMC15.65.113B THE CONTRACTOR AND THE ENGINEER SHALL MEET ON—SITE PRIOR TO CONSTRUCTION T.H. #2 EAGLEBROOK S/D LOT 3, BLOCK 1 LOCATION POND 0 GARNESS ENGINEERING GROUP, Ltd :,�: _ae CIVIL & ENVIRONMENTAL ENGINEERS-_.. vis.. 3701 E. TU" ROAD. SUM 101 • PHCHOfNLE. M 99507 • PMNF firm 'I1 A174 • Fav 10n 1v 1t,Icxnv ...................r...n...... PREPARED FOR: PHONE NUMBER: PAGE NUMBER: GLYN LAIRD (907 227-6558 1 OF 5 LEGAL DESCRIPTION: DRAWN BY: EAGLEBROOK; BLOCK 1, LOT 4 D.J.G. TYPE OF WORK: DATE: SEPTIC SYSTEM DESIGN UPGRADE 05/29/2015 _1 EXISTING CURTAIN DRAIN; SEE PAGE 19 OF 53 IN MOA RECORDS FOR LOT 3 & 4. OUTLET PIPE COULD NOT BE LOCATED PROPOSED 5'X30' DRAINFIELD TO BE BUILT ABOVE EXISTING DRAINFIELD PROPOSED 1500 GALLON STEP TANK WITH QUANICS AEROCELL CONTROL/PANEL OLD TANK TO BE 5H#' DECOMMISSIONED PER UPC PROPOSED 650 AEROCELL POD TO BE SET ON TOP OF MOUND APPROXIMATE LOCATION OF 1987 T.H. BY BRUCE J. CORWIN P.E. EXISTING BED IN ACCORDANCE WITH AMC15.65.113B THE CONTRACTOR AND THE ENGINEER SHALL MEET ON—SITE PRIOR TO CONSTRUCTION T.H. #2 EAGLEBROOK S/D LOT 3, BLOCK 1 LOCATION POND 0 GARNESS ENGINEERING GROUP, Ltd :,�: _ae CIVIL & ENVIRONMENTAL ENGINEERS-_.. vis.. 3701 E. TU" ROAD. SUM 101 • PHCHOfNLE. M 99507 • PMNF firm 'I1 A174 • Fav 10n 1v 1t,Icxnv ...................r...n...... PREPARED FOR: PHONE NUMBER: PAGE NUMBER: GLYN LAIRD (907 227-6558 1 OF 5 LEGAL DESCRIPTION: DRAWN BY: EAGLEBROOK; BLOCK 1, LOT 4 D.J.G. TYPE OF WORK: DATE: SEPTIC SYSTEM DESIGN UPGRADE 05/29/2015 EAGLEBROOK S/D TRACT A-1 (VACANT) EAGLEBROOK S/D LOT 2, BLOCK i 1 r A-/ 1 1 \ \\ 1 1 \ \ 1 1 — 1 1 1 1 1 1 POTENTIAL HOME SITE AND 1 I DRIVEWAY; OWNER WILL BE 1 1 RESPONSIBLE FOR WORKING 1 1 WITH THE MUNICIPALITY FOR ANY PERMITS REQUIRED TO 1 CONSTRUCT IN WETLANDS V I ILI EAGLEBROOK S/D LOT 3, BLOCK 1 CSEPnC '1 1 1 1 SEPTIC PUMPER ACCESS TO 1 1 THE SEPTIC TANK IS AN 1 1 IMPORTANT FUNCTION OF THE 1 1 DRIVEWAY 1 1 I II i p5enen / � 1 1 I I \\ PN00�jER OR Z i I EAGLEBROOK S/D I LOT 1, BLOCK 2 I EAGLDI I / 1 1 EAGLEBROOK S/D �RPTTIIC LOT I/ 1 1 LOT 2, BLOCK 2 Tic AREA EAGLEBROOK S/D 11 11 LOT 3A, BLOCK 2 GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS - 3'!01 E. HOOP POW. SUITE 101 • AHCHOPAGE. N( 99507 ' PHOHE (9071 337-8119 • F. (9071 339111. • Y MM- ... �....w../wm PREPARED FOR: GLYN LAIRD LEGAL DESCRIPTION: BDIVISION; BLOCK 1. LOT 4 TYPE OF WORK: k 100 SCALE SEPTIC DEISN UPGRADE PAGE NUMBER: 6558 2 OF 5 DRAWN BY: D.J.G. DATE: 7/20/2015 f M6O E.SSI 1 1 11 1 t 1 1 1 1 1 E7 WETLAND BOUNDARIES ARE APPROXIMATE; BASED UPON MOA MAPPING EAGLEBROOK S/D TRACT A-1 (VACANT) , Q oz I I EAGLEBROOK S/DI I I LOT 36, BLOCK L� I / I i I I I i I EAGLEBROOK S/D LOT 2, BLOCK 1 1 1 1 1 EAGLEBROOKS/D 1 1 LOT 3A, BLOCK 2 1 1 1 1 1 1 1 1 1 1 1fill EAGLEBROOK S/D LOT 2, BLOCK 2 N I 1 [SEPTIC 1 SCALI AREA = i EAGLES/D LOT 3,, BLOCK 1 RETIC EAGLEBROOK S/D LOT 1, BLOCK 2 SIC GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS = M01 E. lUOOR ROPD. SUn 101 • ONCHOMOE. M 99507 . P90xE (BOT ilJ-atm • . lonT �, u • rvcxnc. ,.—.............i.... :PARED FOR: PHONE NBER: PAGE NUMBER: GLYN LAIRD (907)2UM27-6558 3 OF 5 AL DESCRIPTION: DRAWN BY: EAGLEBROOK SUBDIVISION; BLOCK 1, LOT 4 D.J.G. E OF WORK: DATE: 100 SCALE WETLAND MAPPING 7/20/2 1 1 , 1 1 1 1 , >f STANDARD TANK CONFIGURATION NOTE: A 1500 CALLON S.T.E.P. TANK IS TO BE USED FOR A 3 OR a BEDROOM SYSTEM. NUIL: FLOAT LEVELS ARE FROM BOTTOM OF PUMP. (g) IS FROM BOTTOM OF TANK. 1. THE TANK, FLANGE GASKET, AND BLOTS/NUTSIWASHERS FOR FLANGE ARE SUPPLIED BY GREER TANK. 2. THE INSULATED RISERILID, BOLT ON FLANGE, PUMP, FLOATS, INTERNAL PIPING, GROMMETS, CONTROL PANEL, AND AEROCELL UNIT ARE SUPPLIED BY GARNESS ENGINEERING, THE ALASKA STATEWIDE DISTRIBUTOR FOR QUANICS INC. 3. ALL OTHER EXTERNAL COMPONENTS SUCH AS PIPING, FITTINGS, WIRING, INSULATION, ETC., SHALL BE SUPPLIED BY THE CONTRACTOR. ELECTRICAL WIRE/S (SUPPLIED BY CONTRACTOR). �e SEE INSTALLATION MANUAL FOR SPECIFICATIONS-<- f TANK NOTES: . GEG RECOMMENDS ALL PIPE PENTRATIONS/JOINTS AND RISER CONNECTION ASSOCIATED WITH A TANK THAT WILL BE SUBMERGED IN GROUNDWATER BE ENCASED IN BENTONITE CHIPS. . IF GROUNDWATER IS ENCOUNTERED, THE CONTRACTOR SHALL INSURE THAT SOIL COVER AND/OR BALLASTING IS PROVIDED AS NECESSARY TO OVERCOME BUOYANCY FORCES. O 4" CLEANOUT A 24" INSULATED LID SIM/TECH PRESSURE FILTER LISTED SPLICE BOX WITH 7 / WITH 5 CORD CONNECTORS I 1/ 2" UL LISTED LB BOX 24" RISER. TOP 4 FEET INSULATED WITH 2 INCHES URETHANE WITH TOPCOAT - PVC CONDUIT FOR ELECTRICAL CONNECTIONS (FLOATS & PUMP) - 2" OF INSULATION OVER TANK IS RECOMMENDED ON ALL INSTALLATION REGARDLESS OF BURIAL DEPTH 1500 GALLON S.T.E.P. TANK SUPPLIED BY GREER TANK 10 GAUGE. RATED FOR 10' BURIAL BAFFLE (SEALED) - WELDED AROUND ENTIRE PERIMETER - QUANICS CUSTOM CONTROL PANEL WITH SENSAPHONE AND ACTUATOR CONTROLS 4" BY 4' WIDE RIGID INSULATION CENTERED OVER PIPES HIGH WATER FLOAT TIMER OVERRIDE FLOAT JANDY VALVE FLOAT QUANICS AEROCELL CAT. III QUANICS AEROCELL SYSTEM CATEGORY 111 CONFIGURATION (3 TO 4 BEDROOM SYSTEMS) o J LL oZ w } a J a O w a QUANICS AEROCELL 650 TREATMENT MODULE WITH INTERNAL DIVIDER WALL AND CLEANOUTS 2" DISCHARGE LINE .25" SUPPLY LINE RECIRCULATION LINE LEVEL CUTOFF FLOAT (ON/OFF) GOULDS PE51M FROM ALASKA PUMP OR EQUIVALENT (SUPPLIED BY GARNESS ENG.) PUMP PLATFORM 4° VISUAL PORT 4" BY 4' WIDE RIGID INSULATION CENTERED Il OVER PIPE - - DISCHARGE LINE BUSHING TO DRAINFIELD- INSULATED JANDY VALVE BASIN. DRAINFIELD. SEE APPROVED ENGINEERED DESIGN DRAWING NOTE: ALL PIPE IS TO BE SCHEDULE 40 PVC ALL NOTED OTHERWISE. NOTE: ALL PIPING FROM S.T.E.P TANK TO AEROCELL MODULE SHALL BE PLACED ON SUITABLE BEDDING MATERIAL THAT IS MECHANICALLY COMPACTED. ALL LINES SHALL BE GRADED SO THAT THEY WILL DRAIN AFTER EACH PUMP CYCLE AND WILL NOT RETAIN ANY STANDING WATER. Ln ZI m� O Z Z. N LU. x a ¢ o 0 to w 2m Z Z. LU. F•�I Fa"� W w �g V) OW 0 Q'x In V J E Z$ wm J W Z O o: ;V Y _ a U O V1 In Q _ L) w O �O �- D m tt W �UW � M1J OJ 3w LLO o� f VESSM-0�14 1*emi,aiiyA7fl:9g0 n DEPARTMENT OF HEALTH E HUMAN SERVICES 825 'L' Street, Anchorage, Alaska 99502-0550 SOILS LOG ® PERCOLATION TEST :r�:• � J� l PERFORMED FOR: r� �•+!? '�r1 �� _ DATE PERFORMED.==,. LEGAL DESCRI 4 _5 6 3C� ® 7 11 12 +2 14 16- 16. 17- 18- 19_ ___....,_20 - 1 5fl WAS GROUND WATER ENCOUNTERED] 4RA S IF YES, AT WHAT I L 0 DEPTH? P E (! plh to Yta12F.ilei r,r e'r mmwnngz „, - ..PERCOLATION HATE iminules/inch) PERC HOLE OIA AE1 ER TEST RUN BETWEEIN FT AND FT COMMENTS-.3r,�r r: tx ;;x r_-v::s I wyl. •J '^rt _ td _. 1 { ! ._ ..� , x.01.7 !YY`•l�1'3.'Lf=.. 'll.:,�L4 r�'.•�.%�,�G ltr� n PERFOPMFoBY: ACCORDANCE WITH ALL STATE AND MUNICIPAL C 72-008 (Rev. 4785) 5. AAS PERFORMED IN rr �.t. IS NEFFEC-O/N THIS DATE. DATE GARNESS ENGINEERING GROUP, Ltd. -- --�-. ,- "CONSULTANTS& GEN ERAL CONTRACTORS: 101 E MOOR ROAD, SME 101 • ANCHORAGE, M. 99607 • PHONE (007)M7-6179 •FAX: (907)33a-320 • WFB+IIE: gameeeenginearin SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: EAGLEBROOK SUBDIVISION. LOT 4. BLOCK 1. PERFORMED FOR: GLYN LAIRD DEPTH (feet) 1 2--455;;;;4 ORGANICS/LOAM 6 7 8GM 9 10 B.O.H. 11 12- 13- 14- 15- 15- 17 21314151617 18 TEST HOLE #11 SOIL CLASSIFICATIONS GW ORG ai GPML GM CL GC OL 8°0 o SW MH SP CH SM ' � "OH Sc DEPTH TO GROUNDWATER DATE 8.5' 8/30/2005 1.33' 9/8/2005 19� PERCOLATION RATE (MIN./INCH) PERC. HOLE DIA. (INCHES) TEST RUN BETWEEN FT. AND FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ❑ NO SOILS LOGGED BY: KELLY HEITSTUMEN PERCOLATION TEST PERFORMED BY: COMMENTS: PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS P RF MED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: _ I O' MiTrrrmr 19� PERCOLATION RATE (MIN./INCH) PERC. HOLE DIA. (INCHES) TEST RUN BETWEEN FT. AND FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ❑ NO SOILS LOGGED BY: KELLY HEITSTUMEN PERCOLATION TEST PERFORMED BY: COMMENTS: PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS P RF MED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: _ I O' 0 GARNESS ENGINEERING GROUP, Lt T*pyo CONSULTANTS & GENERAL CONTRACTORS - � - __: - 3701 E. TUDOR FOLD, SUITE 101 • MCHOB E, M. 99507.- PHONE: (907)337-8179 - FM: (907)338-3Y46 WEBSITE: 9a n9heedn9 . ).. t ... .. .............. ....0 SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: EAGLEBROOK SUBDIVISION, LOT 4, BLOCK 1, •.J. fry A. G rness,- PERFORMED FOR: GLYNN LAIRD DATE: 8 30 2005 CE (�� ea' G'� Z y7.°Ao ( eetj TEST HOLE 2 4 �0�r°Ooeelo o' 55 ORGANICS/LOAM SOIL CLASSIFICATIONS 11 GIN ORG �i 3 _ e+k GP1111111111 ML GM CL 11 `1 4 — GC OL N 1 ` `1 TH#1 �. °° o°° o SW MH 5 ': -'• : SP CH SM � � i OH �' 1' ` 11 1 6 SIC 1 11 I 1, 1 TH#2 7 GM 1 1 1 11 I 8 11 1 `,�� ,I1 TH#3 ', 11 1 9 SCALE: 1' = 100' - 10 - 71 12 B.O.H. 13- 14- 15- 16- 17- 18- 19- 3 14 15 16 17 18 19 PERCOLATION RATE 120+ (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 4.0 FT. AND 4.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: E YES ❑ NO SOILS LOGGED BY: KELLY HEITSTUMEN PERCOLATION TEST PERFORMED BY: BENNY MAUS COMMENTS: PERFORMED BY GEG, Ltd, I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PFRFO MED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: r1 l j vs DEPTH TO GROUNDWATER DATE g' 8/30/2005 3.5 9/8/2005 9/22/205 1 3:30 - DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 9/22/205 1 3:30 - 6" - 2 4:D0 30 6" 0" OP 'TECHNICAL CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. PH: (907) 345-1355 May 4, 1988 Mary Foot 5800 Kalgin Drive Anchorage, AK 99516 Dear Ms. Foot: 14530 ECHO ST. ANCHORAGE, ALASKA 99516 Per your request, I have done some follow-up investigation of the of the water table conditions on Lot 4, Block 1, Eaglebrook S/D during breakup. When I first looked at the lot on April 12, I found no water in the septic tank or absorption field standpipes, and the water level in the monitor tube near the protective curtain drain appeared to conform at that time with the required 4 foot vertical separation. When I returned to the lot on April 30, I found new caps cemented onto the absorption field standpipes. I had to cut a couple of these off to perform my inspection. I then measured 11 inches of water in the cleanout pipe at the north end of the field, and 4 inches of water in the monitor tube near the middle of the field. Thus, it appears that the monitor tube does not extend to the bottom of the gravel in the absorption field as it is supposed to, and that the groundwater had risen to approximately 18 inches above the bottom of the field. The septic tank had completely filled with groundwater. The curtain drain monitor tube now had 35" of water in it. I discussed this situation with the excavator who had installed the system, and was told that they had discovered and repaired a blockage in the main curtain drain which is designed to drain the entire property. They expected the situation would improve within a few days. I returned on May 3 and discovered that the septic tank and field had apparently been pumped, as there was now only 2 inches of water in the cleanout pipe at the north end of the field, and the tank had only 15 inches of water in it. The curtain drain monitor tube now had 36 inches of water, indicating to me that the ambient groundwater level had not been reduced. You asked for my opinion on whether the system was in compliance with Municipal requirements, and also whether I felt the lot with the present wastewater disposal system would be a safe investment. Based on the observations I have made, I must respond in the negative to both questions. It is possible that measurements could be made at other times of the year which would not indicate a groundwater problem, but I would expect similar groundwater problems each during breakup. Please give me a call if you have further questions. Sincerely, cc. Acreage Systems, Inc. Corwin and Associates, Inc. MUNICIPALITY OF ANCHORAGE DE rATMENT OF HEALTH AND HUMAN SETA. ,ES 6� Environmental Health Division J 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES FROM SEPTIC TANK ABSORPTION FIELD WELL Address Phone(s)�] � Permit No. �y No of eedrooms WELL s+� L.r` I li �1 t� I ' LOT LINE � 001 LEGAL DESCRIPTION Lot Block Subdivision ® g j ro 66®m Al[/ b6^! FOUNDATION _ _ ----.._ C�_ I /i n IV ® 11l C lY\ _-----_-... —__.� _ Township, Range, Section 4r' AS -BUILT DIAGRAM (Show location of well, septic system, property lines, foundation, _.-_...._..._.� .. driveway, water bodies, etc.) TANKS - - SEPTIC ❑ BOLDING Manu lacture Capacity in gallons `] �`'(� Material No. of Compartments CCaO:>�11C7I�1- — - TYPE OF SYSTEM <dJ ❑ TRENCH U'-19ED ❑ W. ®RAIN [I OTHER _ _ Depth to pipe bottom from original grade I 1 otal depth from original grade O - /fig p, U m FT 02 0 FTI fill added above original grade Gravel depth beneath pipe It -0 FT — - - d� - -- Gravel IengRr 7 FT Gravel width FT Total absorption area Q SQ FT Distance between Imes j _ FT --- Number of Imes So I ratml g SQ FT Pipe material A617&30,54 Installer Date Installed -- -- - -- - ELLS 1 ❑ ryPRIVATE El OTHER (Identlfv) m _ �._ , -__. Classdicauon Tota Depth Cased to FT FT nstallel Date Installed. - -- `---- -- --'-- REMARKS: °9 ! a a /y// ,,,gp ,, ®per dg er_y-. 10L' err CiLN ® 171,6%k tf;0JI SCale: XT3, - Inspections Perforr®9��gcf by ENGINEERS SEAL ._rte% 1r ® [.{ J e 0..r S ._ a/ );,,qJ t, V fzl • SC'°°_ tom- ' Date: IL '1g I cantly that Ihis ijnspeclinn was performed according to all y Municipal and State guidelines in effect on this date: r Flea9tty Department Approval: Dale. _46 ��,�� Elf To Mw TV R 11; 1-110 TOO w0w Go 0- DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, AK 9950l 264-4720 URS9~10 :R V TEE W IT! ki M TAN IT" El 14 41 1.1 PERMIT NO: 87(1)37 ENGINEERED DESIGN DATE ISSUED: 03/26/87 AM. ICHt4T: JACK WHITE INC. / ACREAGE SYSTEMS ADDRESS: 601 E.NORTHERN LIGHTS BLVD. ANCHQRA8E, AK 99503 CONTACT PHONE: 276-6552 LEGAL DESCR1P: SUBDIVISION: EAGLE BROOK LOT: 4 BLOCK: 1 SECTION: 35 TOWNGHIP: 12N RANGE: 39W LOT SIZE: 68868 (SQ.FT, OR ACRES) 1. 1 am familiar with the requirements for wells as set forth by the Municipality of Anchorage (MOA) and the State of, Alaska. 2. I will 1nsta11 the system in accordance with all MOA codes and regulations, and in complianc0 with the design criteria of this permit. �. l will adhere 1 C al] MOA and State of Alacka requirements or the set back distances from any existing weli, wastewater disposal system or public sewerage system on Lhis or any adjacent or nearby lot. IF A L. IM STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDIN8 C010131, THEN (1) 14 ELECTRlCAL PERMIT AND INSPECTION MUST BE (2) AS-BUILTS W]LL NOT BE APPRUVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3> THE ELECTRICAL WORk MUST BE DONE BY A LlCENSED ELPAZ! RlCIAN. DATE 4_ 7-4-19 ~,�� , ��him , � '� � ^r / � / /�� ^��,�� ^�� ~�� *��x*n�Y�,�/ ��~� ^�� '.'- ~. �`~�� // '~ 7-;i A w~;;,~~ 'ej�� S r,4P- ®Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG ® PERCOLATION 'LEST "IEN _INEER'S SEAL), ,f t 6 P PERFORMED FOR: 4 _�z! ...t � `t• _DATE PERFORMED'.' 6gP.l�a� LEGAL DESCRIPTION: �d."/d. r Township, Range, Section: � D PTH to I I _+ t9 SLOPE SITE PLAN LJ ) �4J l 4 ® CA 5 6 0 7 V 9 o �o 11 12 31415 13- 14- 15 16 17 18- 19- 20— COMMENTS 81920COMMENTS WAS GROUND WATER ENCOUNTERED? t r S IF YES, AT WHAT g 1 L DEPTH? I O P E Depth to Water After t Monitoring? � Date:/ A-f4�87 im Be Date Gross Net Depth to Net Time Time Water p PERCOLATION RATE .._._ (minutes/inch) PERC MOLE DIAMETER f TEST RUN BETWEE — FT AND w PERFORMED BY: IQ/ CERTIFY THV TH TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES N EFFEC THIS DATE. DATE: 72-008 (Rev. 4/85) 4 ®F I bRr��vl�0u ro i -o I ® e; a Prop tk Arta Raved, bov" vdn,i W ah j raP1aco �s1krr� !Velpo �evs� recap flay SC -.r>PF(� Off/-Clle? P/oP `/zj d((eC'17 ti •g �" �, '� �• i�.g, „� f �f:., , r tom, tjr,,,^,� MMI, Typ. Defoll S lope to drain —Backfill, 3' minimum ,,Perforated 4" PVC pipe® N.T. S. To Septic Tonk $® �® Clean sad fil I Is gravel, "N Undisturbed Boll Cil®N A®A Notes: N.T. S. I. Grade area to divert surface water away from mound. 2. Four bedroom system. 3. Imported Bond fill roted of 150 sf/br. 4. Sep+rc +ank +o be f,250 gql. turn. l� . %EF Deep by, B.J.C. Drown by, LM. Dote Dram: 3/27/97 Checked by: D.J. Urvin LOT 4 .8Z oCk /, EAGGF(32ook 5'619,0. AC2EA 67E 5;V5AF"5 PreMed by "CH , &LAM S, a:soclatee, inc. It07) W -«a M LA) ATE r- /tel0w lion Lor 4 13LK I EA&�-69EOOK Bao c MON IT tq® Ipf�-Sen-9- 4 4 4 1 C u STA 1 ht D EA I ty ® MOKIT®2 PIPE le.i +er Mon i •}ored 1 s -a LA%m+e r ct+ / -7'-6" Below G mde- i "TEM CATION PLAN LOT BLOCK SUBDIVISION SECTION/ TOWNSHIP/ RAPoOE C 1 SCALE, NOTE f�• .Ve. �`• -.,i_ THE ACCURACY OF LOCATION OF EXISTING PROPERTY CORNERS, WELLS, AND SEPTIC C •, _'� DRAWN BY, SYSTEMS INDICATED IS NOT EXACT. Tf, DIMENSIONS INDICATED HAVE BEEN C"oNORTH cc'� >-+�--jGO1%sDETERMINED BY USE OF CLOTH TAPE AND NOT BY SURVEYING TECHNIQUES. c 1. Corwin PREPARED FOR U , CC ---5283 �. s 4•d. ��`�Sotf� J�� >: Ing: �r�q%ora•. .... DATE°�/Z�/8% SHEET of . ,, °. _ F� 1 P(z-opoSED ¢AtNA&C Sou D eA I N_ UN mr-ro¢ �EO� P I PE" EN D I 41, FIE PIPE Zo �'CPNK vl I �1 ^ p o � `GUQ.TIN OZA1ty SLOPE 4" PFr-F PIPE \ tf�onl+or `O pipe Peo PosE I}ovsa GUdaTX+l Dentu ILooT 3 SLK LOT. BL K I �uF-TKIki De Irl DDoT �SEW R SYSTEM LOCATION PLAN LOT BLOCK SUBDIVISION SECTION/TOWN SHI P/RANGE SCALES NOTEa l ®9 TH£ ACCURACY OF LOCATION OF EXISTING PROPERTY CORNERS, YELLS, AND SEPTIC RAWN BYSYSTEMS INDICATED IS NOT EXACT. � . S� DIMEN31ONS INDICATED NORTH HAVE BEEN 9 DETERMINED BY USE OF CLOTH TAPE AND NOT BY SURVEYING TECHNIQUES. ,® Br c J. Corwin m ,�L.h bta� o PREPARED FOR, CE -5211ry3 ,®P�>� i (µ�(pJ�J(p �. m� is !Air ®® ROFESb%` ;-�,�'- A DATE, C? -7 7 SHEET OF RUSH, MMMCPAUTY OF ANCHORAGE `�1 (g •aa2 Development Services Department ', Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 017-121-20 1. GENERAL INFORMATION Expiration Date: Complete legal description EAGLEBROOK BLK 1 LT 4 Location (site address) 6421 ANDOVER CIR, ANCH AK Current property owner(s) TARAS ILNITSKIY Day phone Mailing address SAME Real estate agent Day phone 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well [j 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 $ C060 ,, V t (p Date of Payment _ jb=q� 2_0 Receipt Number oo 4o 2 1 COSA # OSG20153 L f Waiver Fee $ Date of Payment Receipt Number Waiver # 6. 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 Flies 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 MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 10-5-20 6. DSD SIGNATURE V System #1 Approved for 4 bedrooms System 42 Approved for _ bedrooms Disapproved Conditional approval for bedrooms, ,41�4r`i dq x' • MICHACL N. ANDLRSON,."Ir CE 94 with the following stipulatio�t�\dam` By. &f Oew l ze Original Certificate Date: 10/_1 f " 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. T. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Charklisl blue sheet COSA Checklist Legal Description: EAGLEBROOK BLK 1 LT 4 Parcel ID: 017-121-20 If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system _ A. WELL DATA ❑EI Well log is filed with Onsite (or attached) Date drilled 9/7/17 Total depth 126 ft Cased to 126 ft ❑� Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 25"+ in. Date of flow test for COSA 10)14120 Static water level at beginning of test 22.3 ft. Comments IZM10:I.11r73IF_1 Age oftank(s) 2017 years Tank type/material Measured operating fluid level in septic tank NEW X Standpipes/foundation cleanout per record drawing Date of pumping ' Advantex, fiberglass D. ABSORPTION FIELD DATA Advantex Which system tested (date installed) 8/21/17"7 X ALL standpipes present per record drawing Total measured depth from grade 3 ft (max) Measured depth to pipe invert from grade ft (min) ❑NI N/A –pressurized field ❑E Monitor tubes go to bottom of effective. If not, state depth into effective Well production at time of test 5+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes K No ❑01 Coliform bacteria is Negative Nitrate mg/L Q Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by MNA Date of Sample C. LIFT STATION 9/25/20 ❑0 Required maintenance completed Age of lift station 3 years Lift station material PVC Comments: new system installed in 2017 Adequacy test date 10/2120 Results Q✓ Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 600+ gal New depth 1 in Elapsed time 1440 min fi❑ Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 600+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) — date of test)If yes, enter date 0 Gallons introduced gallons — Comm ents/Deficiencies: COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 0 Yes Community Sewer Manhole/Cleanout > 100' v❑ Yes if No _ ft M Yes if No _ ft Neighboring Tank > 100' 0 Yes if No _ ft Private Sewer/Septic Line > 25' E] Yes if No _ ft Absorption Field on Lot > 100' v❑ Yes if No _ ft Holding Tank > 100' 0 Yes if No _ ft Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' 0 Yes if No ft ❑ Yes if No ft if No _ _ Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Yes if No _ ft M Yes if No _ ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No _ ft Surface Water > 100' ❑✓ Yes if No _ ft Property Line > 5' 0 Yes if No _ ft Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No _ ft Private Wells > 100' Yes if No _ ft Water Main > 10' 0 Yes if No _ ft Community Wells > 200' Yes if No _ ft Water Service Line > 10' 0 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' v❑ Yes if No _ ft If absorption field is under driveway comment below Property Line > 10' v0 Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No _ ft Private Wells > 100' Yes if No _ ft Water Service Line > 10' 0 Yes if No _ ft Community Wells > 200' Yes if No _ ft Surface Water > 100' 0 Yes if No _ ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that / 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 l�TN.. /. • *Aa MiCHAR N. AicDLRS(;PJ : �r CE 94 9 05/27/2020 15:42 8686770 ■■ ■■N■ Noun0 Sam ■ ■ FIN on an soon APLUS 372 461 ■ ■�■■■■ no on AvanTex Field Maintenance Report Annual Inspe(tion Proper,, Ownerllnrrking r Teras Ilnitskiy alto md"re - 6421 Andover Drive, o,nchorage AK 99516 A% Sha ID r County ID a Pea r AX -143885 OSP171175 427827 Retrieve O&M Info Daily flow - 1166M ratio Timer settings: Perform Field Samlall ig/Observations NTN (15 s NTUe) pi (6.9) DO (2.6) 1 .7 b Odor of Sample 1jpical Must ❑Earthy ❑Moldy Non -typical 7 sulfas ❑ Cabbage ❑ Decay Oily film In PVU (- yea O Foam in tank '., Yes No Check Control Pane Roclm Amps Discharge Amps �0-y Il. `7 Audible and visual ata me OK ,,, Dial tone ftelematry" ly) ❑ Yea I(I /// No inspect/Clean Pum.I System Current Pmvlous Inspect Pre 2nd Compartment Rlser/lld ......... ....... Provlous Currem Prc Splice Box ........ ....... Float Corrie ....... ........ Floats.. .......... ... ... .. Pump ............. .........:: 'f'i Slotube Fitter.. BioNbe Pump Vault: ......... Recirculating Splittrn delve....... Comments Signature—.. -- Clean PAGE 13 ■N ■N■ ■ ■ ■ ■ an s ■ a AnchorageTank 907-272-3543 OM..r Larry Betts Concoct Pnon. (907)555-5555 RTU VAAL r Dote m Laffi Inspection RTU135545 07/23/2019 Measure Sludge/scum Ce.A-- Scum 1st Compartment Current Pmvlous Current Pre 2nd Compartment Current Provlous Currem Prc Inspect/Clean AdvanTex Filter Odor: V Normal ❑ Pungent I Dlomat: Normal ❑ Excessive Bridging/Ponding: f NonaMllnor ❑Excessive Inspect/Clean Discharge Pump System Inspect ld 1Z Splice SB Splice Box Float cords I ct/Service Other System Components Moue Vlous Inspect Cliireya111n Laterals/Onficr•s Pad Bottom Intake vcm Inspect ect l C��e777akkttn Floats Pump Pump Hsps inspect Clean Inspect Clean Disinfection Equipment rC Dispersal Lsteralsffinfices Observations .. Additional Services Rendered ❑ Cleaned textile sheets? ❑ Replaced UV Items, ❑ Replaced/UsW other Items? Parts Used: W = Warranty, B = Billable (✓ appropriate selection) ... .. .. u.....nnr Dnserlotlon FIn91(Safety, Inspection RSV MIstalled Manlfeld mconnected; Hush volvea closed Summary/Recommendations ❑ System performing; no further action needed ❑ Call for service Date Fax completed form to 1-866-384-7404 �yLids bolted on ILI Control panel reactivated []Tank needs pumping ❑ Other? , 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_�� Day of of 20-10, by and between 76-L�u- D 05C." , herein the "OWNER," and the Municipality of Anchorage, herein the "Mb`NTICIPALITY", 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 A®y'a\ CN t` E A {1Chp. aq , f�'Y- located at (legal description) 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 teen of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically 5400 to S600). 1 V l,l 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. tn!- 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 Cit) Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. AiOwner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. `h� V D 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 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: CTI Q-JlVkAN-00--4�(print name) STATE OF ALASKA ) } ss. THIRD JUDICIAL DISTRICT } The foregoininstrument was acknowledged before me this at�day of QcVo btc' , 20_X, by ur�t MCS FARY PUBLIC FOR ALASKA Commission expires: Ct 7 aL� MUNICIPALITY• By: (signature) (rev. 05/18/2018) HART 0 TAR n UBL��,tr OF P�-P� Expires' Datej o- g-20 (print name) Title: Page 3 of 3 MUNICIPALITY OF ANCHORAGE Department of Health & Human Services s DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel l.D.# �Qtp-�2l-a HAA #_® 0R',az� 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision section,,township, range) l' E '6' L E-bc Location (address or directions) (b) Property owner ALAE AGF SYS—1 F MS T-W,.Telephone : (home) Business 34 5 -z 1Z2 Mailing Address (c) Lending Institution Telephone N.�A Mailing Address (d) Real Estate Company and Agent Address l' Telephone (e) Mail the HAA to the following address: (or check here'�4 if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single -Family Number of bedrooms 4 3. WATER SUPPLY Individual Well X Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 • �.ff TRIM a •' As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm C<"v> i ti+ 4 A <coc. Telephone 577-1.3 Address Jif_E PIIQLD #7(15" A'�� Date .e, Engineer's Seal 6. DHHS APPROVAL p -11- q Approved for bedrooms by Z« _�� Date //�—If / Approved Disapproved Conditional Terms of Conditional Approval 7777 A CAU�TIONf ..>, s �.r.;, , ..,t. � �. ,r i.,�..d,. ` G„ The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Bev. 7/88) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) ® MUNI( � fft6pproval (HAA) rNvutolvM= a F _s tF AY 1994 343-4744 ¢-ti i�" 2 s.� 1989 Legal Description: A. WELL DATA RECEIVED Well Classification _ Z -LV -4 Tg___ -_ If A, B, C, D.E.C. Approved (Y/N) _ Well Log Present (Y/N) _y__ _—Date Completed __4e_i_._ Yield Total Depth- /_~ t Cased to _L33-'_ Depth of Grouting_ Static Water Level 7Z' ___ __ Pump Set At 1.S/__ Casing Height Above Ground_ _ Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) _Y� _-_ Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot _._ — ; On Adjoining Lots p Ca( To Nearest Edge of Absorption Field on Lot _� ; On Adjoining Lots _.7 /CrO To Nearest Public Sewer Line _. L/- -._ To Nearest Public Sewer Cleanout/Manhole N /)_ To Nearest Sewer Service Line on Lot __�50 Water Sample Collected by / L27fFt9 SdqPeSvf�___ ; Date Water Sample Test Results ST/SE=r? rr Comments % [ c.-,1_ LJr ! I B. SEPTIC/HOLDING TANK DATA Date Installed 411 _Size /-5-0 No. of Compartments Z Standpipes (Y/N) Y Air -tight Caps (Y/N) —Foundation Cleanout (Y/N) Depression over Tank (Y/N) -AL _ _._ Date Last Pumped ✓ Pumping/Maintenance Contact on File (Y/N) ; for Holding Tank High -Water Alarm (Y/N) _. Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well - _ _ To Building Foundation To Property Line To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course Comments -5 -,)-f /e,� - L /le o 72-026 (Rev. 7/66) Front Page 1 of 2 •0 Vf- Soils Rating in Absorption Strata - %�_ —Type of System Design Date Installed �� — Length of Field',__ Width of Field Z4 ' _ Depth of Field Gravel Bed Thickness -,— Square Feet of Absortion Area /, Os' . s 1 -_ Statndpipes Present (Y/N) _ V Depression over Field (Y/N) N Date of Last Adequacy Testes 5�'� 1y�✓tr (�Jrc+ Results of Last Adequacy Test _LI=7757 ___-- SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well G®° _� To Property Line --3(2-° _ To Building Foundation To Existing or Abandoned System on Lot On Adjoining Lots To Water Main/Service Line SG To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course __r—Y-M To Driveway, Parking Area, or Vehicle Storage Area Comments =.. ��d� fL_ % �/s I i —& ver use � D. LIFT STATION Date Installed _ Size in Gallons "Pump On" Level at High Water Alarm Level at _. Tested for Meets MOA Electrical Codes (Y/N) Comments **Check Per it ed Bedre I certify th I ave chec inspectio f Signed Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) ing Against HAA Request" rified, or conformed to all MOA and Receipt No.7 Receipt No. Date of Payment _. Waiver Fee: $ _ Amount: $ " _ Date of Payment 72-028 (Rev. 7/88) Back Page 2 of 2 Pumping Cycles during Adequacy Test. elln in effect on the date of this M 5 k �Engineer's Seal z@,a I v Y6 _,