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EAGLEBROOK #1 BLK 2 LT 4
Eaglebrook #1 Block 2 Lot 4 #017-121-56 Municipality . tty1 of Anchorage �' 1_ Development Services Department :Mg Building Safety Division hi On -Site Water and Wastewater Program. 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page www.d.anchorage.ak.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SW 010IS`I PID Number 011-- Ill - S of Name 1 Tocf� Co'New Wastewater System: IS Upgrade Addre.. 6212 A241e-e, ABSORPTION FIELD Plan Pant' el e.aon.. e l 0 Dew Trench O Shallow Trench XS., 0 Mand 0 Onur LEGAL DESCRIPTION Sal Rating 1 GpThre Tow °e°° na"°"n°grade (/ r Fl. aladh Lot NOM IopMeatom front 2 `1 £a lc 1C"•d""Y°^ ,It �r V K F 1 ongeue brad. ' Ft. Grant d.Wl Mn.M Tigre O o . 1 FI Taanalup Range • 6.Nan Fu added .1100w Oniplal grade (— 2_ Ft. Grant WV, 15 Ft. Well:Derma £1; .,n ❑ New • Upgrade Cave I O FI. Number a Inn 2 Demme we. b. 5 Ft CI.Fenolnn (Pante) 8. CI Taal ppm Fl. Cased to FI Total .Dwpeon area 15o Fe Tice hinnyr�1' rk . ktb 40 Mr Dele Dated Static Wen Lent FL aaWler DEAn ConS1 . Tile muased /110/09+.ng Veld GPMFI. Romp Set et CWert Mow Ground FL TANK SEPARATION DISTANCES ❑ septic ❑ Holding ❑ S.T.E.P. giOtner. To Fran Septic Tank Absorption Ldt Station Holding Tank ueaciPnvate Sewer Une Maetaa""r Dip Cycle eapaur cal / Gs WN ltd, M1Field Ivy+ rpDit' 4/rt -2.5 4 SF} Mateo. IFt /GSS OC/. suraoeWalr tO+T 1Wr+ foo+ ,444 LIFT STATION La lea IDti. ID' 'y ID F 1 NIA s.. `/ Mandwue FouM.eon �'' IJr�' S I. NJi .Pump On' 2.5 m pump olr was MO��CI`• yyit m Sgn *Per Nen Sl 25 m Curtain Cron AIA /`/IA A/1• WA / P Maxea Mode eyt., E IaicS ln.Maan. Wormed by l� I; Remarks ow 513TEr1 AI3g1JDONEO P&P-. BENCH MARK plop Lot?€ RE441g61sieiVrs Louuon end pwptgn Grit Acme's. VOor LaDAN. , Awned Elevation Nor}I7 Silt Grip, 00 FL / �+ � Inspections performed by: 1.� JPun ,NIy1nQ Dates: 1M 1 dBlo1 Engineers Stamp ��\\\\��� r �K �F' `AA�S�l11 � c. G' .9 /. art . C'UP•KIAND. to � . (11500V` i /// 2"d ty 810} Development Services Department Approval Conditional Approval Date: Reviewed and approved by: .Ji .. / Date: g --2- 0 INSTALLED 4—BEDROOM SEPTIC STSTEM BOCYCLE TANK W/ 10' X 15' BED LENGTH 15 FEET WIDTH 10 FEET TOTAL DEPTH 4 FEET FILTER SAND 2.1 FEET ROCK DEPTH .9 FEET INSULATION 2 INCHES COVER 2 FEET (MIN) ABANDOThISTINC TANK & DRAIN nap PER MOA CODE REQUIREMENTS ALEA DRIVE / SNTNC TILS A B C 73.5 40.4 0 79.2 117.7 Septfcc C Area 3B 0 0, 3 Bo i lar _. 49th W Egta AAS ,5Ant! EEK W�' R ORAItUGE .'R ;LARS 1 LR2KLAND 15' CR *f• • •. No. CE -1'" co co 2 25 0 25 50 75 100 125 150 SCALE! 1' = 50 FT. SPURKLANO ENGINEERING 203 W 15TH. AVENUE ANCH. Alt'. 99501 (907) 279-3916 EAGLE BROOK BLOCK 2 LOT 4 TODD COL VER 6212 AZALEA DRIVE SEPTIC SYSTEM AS -BUILT DATE: JULY 26, 2007 SHEET: 2/3 GRID: 3138 PERMIT # SV070154 PID # 017-121-56 EAGLE BROOKB2L4D2.DV6 4' MONITOR ASTM 30.74 -\1/4 GRADE TO DRAIN GEOTEXTILE E 116.71 BACK FILL �i �ryi -2/44:///4/////44:4-41101.444e, � '��e$ �iii . iii ��if»3. . re• VI• veto:, -1B. 5 WASHED SEVER ROCK ° 2-1/2' MINUS •:: {LEY.=1l.LB'" •...•..: /ILTER SAND' Y6' • .. . I5' FLEY.`111.7. STANDARD BED NTS INSTALLATION FOLMDDAIION CLEAN OUT SLOPE FINISHCD &ADC AVAY FREE TOP IN ALL DIRECTIONS N20=106.2' 4' PVC INFLUENT 0 PPRIMARY CHAMBER m AERATION CH4MB£R GCLARIFI£R mDISCHARGE CHAMBER B.O.H.=1027' 8'-0' BLLCBO4RD INSULATION 4' SAND/GRAVEL LEVELING COURSE, CYMPACT£D L EXCAVATE A 10' x 10' x 10' DEEP HOLE FOR BTOCYCLE SYSTEM 2 PLACE A MINIMUM OF 4' SAND OR GRAVEL FLAT LEVELING COURSE IN THE BOTTOM OF THE EXCAVATION COMPACT AS REQUIRED 3 PLACE 4 SHEETS O. 2' x 8' x 2' DIRECT BURIAL RIGID INSULATION ON TO° Or COMPACTED LEVELING COURSE TO PROTECT BOTTOM 6 FIBERGLASS TANK. TAKE EXTRA CARE TO ASSLAPE THAT INSULATION COURSE IS LEVEL IN ALL DIRECTIONS 4. BACKFILL AROUND TAMP IP TO INVERT or 4' TMZLCNT AND 1-1/4' EFFLUENT LINES VITH FRCS-FLOVING NSF MATERIAL FREE OF LARGO STONES OR BOULDERS 15' SAND/GRAVEL BACKFILL :LYS ter. '• ►e- I I1 -AT.aT-LTL1.0 'mica LT--. T-till' a ag _.Ia.I IaWa. s'. Ia 'a.. a.w 0a • 4 •• 49th •• LARS PURKLAND MONITOR TUBE• BENCH MARK GARAGE ACCESS DOOR LANDING NORTH SIDE GARAGE ASSUMED ELEVATION =100' SPURKLAND ENGINEERING 203 W 15TH. AVENUE ANCH. AK. 99501 (907) 279-3916 No. CE -11500 �" ••..��u off'•'' �.: ,.=5 : ". EAGLE BROOK BLOCK 2 LOT 2 6212 AZALEA DRIVE TODD COLVER SEPTIC SYSTEM AS -BUILT DATE: JULY 26, 2007 SHEET: 3/3 GRID: 3138 PERMIT >t 51/070154 PID k 017-121-56 EAGLEBRO7KB2L 4D3BIODVG MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage. AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW070154 Legal Description: EAGLEBROOK #1 BLK 2 LT 4 Design Engineer: 0007 SPURKLAND ENGINEERING Owner Name: TODD COLVER Owner Address: 6212 AZALEA DR ANCHORAGE , AK 99516-4331 Date Issued: Jul 11, 2007 Expiration Date: Jul 10, 2008 Parcel ID: 017-121-56 Site Address: 006220 ANDOVER CIR Lot Size: 85736 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit Is for the construction of: Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date. -7-410 7— Issued By. Date: %/ 11 /n% Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcell.D. nlq•�o�l'Slo Property owner(s) Todd Colver Day phone 440-7040 Mailing address 6212 Azalea Drive, Anchorage, AK Zip Code 99516 Site address 6212 Azalea Drive Zip Code Legal description (Sub'd., Block & Lot) Eagle Brook S/D Block 2 Lot 4 Legal description (Township, Range & Section) Lot Size 851 Z' o Sq. Ft. Number of Bedrooms 4 THIS APPLICATION IS FOR (0 all that apply): THIS APPLICATION IS AN: Absorption Field 0 Initial 0 Septic Tank 0 Upgrade 0 Holding Tank 0 Renewal 0 Privy 0 Private Well 0 Water Storage 0 certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. S (Signature of Property owner or authorized agent) Permit/Rush Fees: giro r Waiver Fees: Date of Payment:/ / U_I itc) Date of Payment: Receipt Number. "I/ Eft Receipt Number: (Rev. 11/05) Si ?J.:4 Sparff0aad C ngfin caroms ,' I Environmental Consulting and Design SEPTIC SYSTEM DESIGN Eagle Brook S/D Block 2 Lot 4 Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 Subject: Septic Permit Eagle Brook S/D Block 2 Lot 4 Ladies and Gentlemen: July 5, 2007 1 am writing to request a permit for the construction of a new septic system for this property. The proposed system will serve a 3 -bedroom single-family residence. The original septic system was installed in 1985 and has failed. An existing well on the property provides water to the house. Soils: A test hole was excavated on June 19'1%2007. See the attached soil logs. Ground water was monitored through June 27th, 2007. Ground water was measured at a depth of 9.5 feet below ground surface. Surface Water: There is a Creek easement along the south property line. The proposed septic system will be greater than 100 feet form the nearest water. Topography: The topography in the vicinity of the proposed drain field is Oat. A cut bank has been excavated for the house. Minimum separation distances between the drain field and this cut bank will be maintained. The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent Tots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or concerns, please contact me at 279-3916. Sincerely, te--AAP /11°11/t Lars Spurkland, P.E. Civil Engineer 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland`ragci.net 7.t.A, _1 i.A.)-\ts= Spurr'kUand C ngDneeeing Environmental Consulting and Design 1 SEPTIC SYSTEM DESIGN EAGLE BROOK BLK 2 LOT 4 Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 June26,2007 We are submitting an application for the upgrade of septic system for this lot. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil Togs and percolation tests of applicable testholes are also enclosed. The septic system design is based on the following: Groundwater at 9.5 Ft. Use BioCycle treatment system Soil Rating. From Testholc 6/19/07. <I min/in = Filter sand Req'd Design Rate = 4 gal per sq.ft/day No. of Bedrooms 4 Required Area per Bedroom: 150/ 4 =37.5 sq.ft. Total area required: 37.5 x 4 = 150 sqft Bottom Excavation Top Filter Sand Rock Depth Bed Width Total Bed Length at 5 feet at 3 feet at 0.5 feet 10 feet 150/10= 15 feet SYSTEM CONFIGURATION BIOCYCLE TANK TOTAL LENGTH TOTAL WIDTII TOTAL DEPTH FILTER SAND ROCK DEPTII INSULATION COVER 15 FT 10 FT 5 FT 2.0 FT 0.5 FT 2 IN. 2 FT (MIN) 203 West 156 Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net TRACT A-1 4 1 11 - CRf 16 _ YS E T[_ —T �— SU SCREENING 6yENT lI 1 J 2i 1 50 0 50 100 150 200 SCALES 1' = 100 FT. 250 300 S -1 0 3A 3B � GV- cr_401-�_I 0 B P 49fh 'to l'�••� y= Y` • ..�.1....fl . i• P • LAR, SPURKLAND No. CE -11500 :�• I. I'� fl%S SPURKLANO ENGINEERING 203 W 15TH. AVENUE ANCH. AK. 99501 (907) 279-3916 EAGLE BROOK BLOCK 2 LOT 4 TODD COLVER 6212 AZALEA DRIVE SEPTIC SYSTEM DESIGN DATE:: JUNE 23, 2007 SHEET. 1/3 GRID: 3138 PERMIT # SV070XXX PID /1 EAGLE BRSOKB2L4D1.DVG J 5 INSTALL 4 -BEDROOM SEPTIC SYSTEM BIOCYCL£ TANK W/ 10' X 15' BED LENGTH 15 1717 WIDTH 10 1117 TOTAL DEPTH 5 FEET FILTER SAND 2 (FET ROCK DEPTH .5 FEET INSULATION 2 INCHES COVER 2 FEET (MIN) i i ji i Septic y Area �/ i i \ i • \ \ i .•••• i i i C/ I k\ * I...• A&NDON [X751fNC TANK A ILDRAIN ALiD P£R YOA CODF REOUMEMEN/S �yEL Septic cArea 3B S 2 o V Oct 4C1)� B •4*S%W %* )‘(..)\--. f' 49t�Jhp' �% •`4 _ �. DRAINAGE _ , 1 LARS • SPURKLAND I _ _ — ZS• CREEK . _ _���' No E-ttSoo n so 75 100 125 150 1,' II t" :• SCALE' ]' = 50 FT. • SPURKLAND ENGINEERING 203 W 15111. AVENUE ANCH. AK. 99501 (907) 279-3916 EAGLE BROOK BLOCK 2 LOT 4 TODD COLVER 6212 AZALEA DRIVE SEPTIC SYSTEM DES/GN DATE: JUNE 23, 2007 SHEET. 2/3 GRID: 3138 PERMIT 1/ PID 11 EAGLE BROOKB2L9D2D1/6 4' M(N1TOR ASTM 3031 GRADE TO DRAIN GCOTEXTILE 1 • • "'arm S/NO. 1!' 15' — STANDARD BED Mrs FOLNDDATI N CLEAN air SLOPE FINISIEP GRADE AVAY FROM TOP IN ALL DIRECTIONS 4' PVC IAFLLCNT 0 PPRINARY CHAMBER 0 AERATION CHAMBER 0 CLARIFIER ®DISCHARGE CHAMBER 8'-0' 12' BLTEBOARD INSLLATILW 4 SAN D/GRAVEL LEVELING COURSE, COMPACTED INSTALLATION L EXCAVATE A 10' x 10' x 10' DEEP I,RE FOR BIOCYCLE SYSTEM 2. PLACE A NINIMON OF 4' SAND OR GRAVEL FDR LEVELING CURSE P1 THE BOTTOM OF THE EXCAVATION C0E'ACT AS REQUIRED 3 PLACE 4 SHEETS OF 2'x8' x 2' DIRECT BURIAL RIGID INSOLATION ON TO' IF COMPACTED LEVELING CURSE TO PROTECT BOTTOM OF FIBERGLASS TAMC. TAKE EXTRA CARE TO ASSURE THAT INSULATION COARSE IS LEVEL IN ALL DIRECTIONS 4. BACKFILL AROLND TANK LP TO INVERT OF 4' IFLLCNT AND 1-1/4' EFFLLCNT LIES WITH FREE-FLOVING NSF MATERIAL FREE OF LARGE STONES LR BOLL:CRS SPURKLAND ENGINEERING 203 W 15TH. AVENUE ANCH. AK. 99501 (907) 279-3916 EAGLE BROOK BLOCK 2 LOT 2 6212 AZALEA DRIVE MEGAN CL4NCEY SEPTIC SYSTEM SH£MATIC DATE: JUNE 29, 2007 SHEET: 3/3 GRID: 3138 PERMIT 11 Sw070XX P1D # XX EAGLEBROOKB2L4D3BIODVC Performed For. Legal Desaiption: 1 2- 3- 4 - Depth (Feet) //1/L -A ' • 9.: Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw Si. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci erd+Orage_ak.us (907) 343-7904 Soils Log - Percolation Test ra�1 C0!tiER £1, le brtok Blk 2 to 4 Slope ORGANICS Sad 43 Gnat \ •I n 5- rTrtwt 4 S;\4 6 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20- 6fl wI5;kt tenses SIR , harp WAS GROUND WATER ENCOUNTERED? IF YES. AT WHAT DEPTH? DOPA. b Wier Mot Monaodng? of mill •fi l 149 • 7H 9 !,, ?X%'if .LAAPSC'.S%1C<LAND. i Q•. 115:0 V•i il) ••. ••�' Pii0FES51G�P� \10-7- 6.\\`•• 0-7' Date Performed: Township, Range, Section: Yes IO 9.5 D Dien: (0 /1 1•I0} 6 L 0 P E Site Plan Reading Date Gross Time Net rine Depth to Water Net Drop PERCOLATION RATE C. prrwAinl PERC HOLE DIAMETER TEST RUN BETWEEN 3.5 FT AND H.5 FT COMMENTS Pec 61.9 f 114. 5 4;.,.., to Dept. 11n ;nr1v� . Pfawe� Pry < 3)'L stile kA en KH Tole( c PERFORMED BY: LIN .S i.Ahrscl\\ I /ow --CeCERTIFY THAT THIS TES PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE /1 07- SptrrkUSSd Engline©rSSng Environmental Consulting and Design Single Family On-site Wastewater Disposal System Construction and Material Specifications Subject Property: Eagle Brook S/D B2 L4 Date: June 29, 2007 General: 1. The owner shall contract with a contractor to perform the work outlined in these specifications and plans in accordance with the attached MOA permit. There is not contractual arrangement between the contractor and the Engineer. The Engineer shall be the owner's representative and will Inspect the work to document the contractors activities. Final acceptance of the contractors work rests with the owner and the MOA. 2. The scope of the project includes the procurement and Installation of a 4 -bedroom on- site wastewater disposal system at the location depicted on the attached site plan drawings. The scope of the work also includes the installation of a new BioCycle tank, a drainfield comprised of 1 bed, 10 -feet wide x 150 -feet long, 5 feet deep, with 2 feet filters sand and 1 foot of septic rock below the distribution piping. The location of the drain field is shown on the attached site plan drawings. The total depth of the field will be 5 feet below the existing ground surface. All components of the proposed septic system must be constructed a minimum of 100 feet from any surface water or water wells in the area. A minimum of two feet of cover is required over the drain field. In addition to the required earthen cover, 2 -inch thick, 40 psi, direct bury board foam shall be installed directly over all piping beneath the driveway and over the drain field. 3. Construction shall be in accordance with the approved site plan and design drawings and any special provisions noted on the Municipal well and/or septic permit. All materials, components, workmanship and construction practices shall comply with the Munidpality of Anchorage's latest ordinances regarding wells and septic systems, as well as MOA, Development Services Department, On-site Water and Wastewater Program (DSD) policies. 4. The contractor is responsible for obtaining all underground utility locates, layout of the proposed system, and verifying and maintaining all required separation distances to lot lines, surface water, wells, steep slopes, etc. 5. The property owner shall be responsible for final grading any depressions formed from settlement of backfill material. The property owner is also responsible for vegetation of all areas disturbed by septic system installation activities. 6. Contractors installing wastewater disposal systems must be certified to do so by the MOA DSD, On-site Water Wastewater Program. Property owners installing their own systems must receive advanced approval from MOA DSD prior to system Installation activities. 7. The contractor shall ensure that ALL materials being used are In compliance with the most current guidelines established by the Municipality of Anchorage. Refer to "Standards and Specifications for Component Parts and Materials Used in the 203 West 156 Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net 4.17111111e,. TTA Spry Enufin eectog Mend Environmental Consulting and Design 1 Construction of On-site Wastewater Disposal Systems", Dated December 2000, as provided by MOA DSD, On-site Water and Wastewater Program. Septic Tank Installation: 1. The tank shall be level and sufficiently bedded to prevent settling of shifting of the tank. 2. The sewer service line from the house to the tank shall have a minimum slope of 2% unless prior approval Is obtained from the engineer. 3. The Inlet and outlet lines from the tank shall be bedded In drainrock or the soil shall be sufficiently compacted to prevent future settlement of the soil. 4. Septic tank inlets, outlets and deanouts shall be fitted with water tight couplings. 5. A cleanout shall be Installed 1 to 4 feet from the foundation. 6. Post tank deanouts shall be installed per MOA requirements. Does not apply to pressurized lines. 7. In areas with high ground water, the septic tank shall be sufficiently anchored to resist buoyancy forces when there is not adequate soil cover to resist uplift force. The contractor shall refer to the engineer for direction regarding this matter. 8. The tank backfill shall be graded sufficiently to ensure positive drainage away from the tank. 9. All holding tank and lift stations shall have an audible and visible alarm inside the residence being served. 10. All lift stations shall be wired in compliance with all MOA guidelines and the Uniform Electrical Code. A munidpal electrical permit and inspections must be obtained where required by the MOA. 11. The contractor shall verify that the septictank/lift station is a minimum of 100 feet from any residential water well, 150' from any class 'C' well and 200 feet from any community water wells. Additional separation distances must also be maintained. 12. The contractor shall remove or abandon the existing tank in compliance with the Unform Plumbing Code. Drainfield Construction: 1. The drainfield shall be excavated to the dimensions outlined In the design drawings. If any discrepancies are noted, contact the engineer Immediately for clarification. 2. The drainfield shall be installed parallel to slope contours. 3. The bottom of the drainfield shall be within 2" of level. If the sidewails or bottom of the excavation become smeared, they must be raked or scarified prior to the placement of filter sand or drainrock. 4. The drainfield must be a minimum of 5 feet from the test hole excavation. 5. Distribution pipe is to be installed level with perforations facing downward, atop a level bed of drainfield rock. Septic rock shall then be placed atop the distribution piping to provide a minimum of 2" of cover, level across the entire width and length of the trench, above the piping. 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland`ragci.net Sparrldand Engfineell1n l's"— Environmental Consulting and Design v1'Z,�1" I i J 6. A silt barrier must be installed at between the final drain rock and the native soil backfill. The silt barrier shall cover the entire drain rock surface. 7. Monitor tubes must be 4" in diameter, installed in the locations depicted on the design drawings, and extend a minimum of 12" above final grade. The portion of the monitoring tube below the septic rock must be perforated and the portion above the drain rock shall be solid. 8. Backfill over the final gravel layer must not be less than 2 feet. Insulation must be installed when the backfill depth Is less that 3 feet. 9. Drain field back fill shall be mounded to prevent depressions from forming due to subsequent settlement of backfill material. 10. The contractor shall verify that the drain field is a minimum of 100 feet from any residential water well, 150' from any class 'C' well and 200 feet from any community water wells. Additional separation distances must also be maintained. Inspections: 1. A minimum of two Inspections are required by the Munidpality of Anchorage. These inspections must be conducted under the supervision of a Professional Engineer licensed to practice in the State of Alaska. 2. The first inspection must be conducted after the excavation of the drain field and before the placement of any gravel. The septic tank may be set in place, but may not be backfilled. 3. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, stand pipes, cleanouts, and insulation, but before the placement of any backfill. 4. The contractor shall provide a legible copy of all field notes relating to system layout and construction to the engineer for the use in preparing the record drawings. 5. The contractor shall coordinate all inspections with the Engineer. A minimum of 24 hours notice is required prior to the start of construction. If necessary, a preconstruction meeting will be held on-site. 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN MUNICIPALITY OF ANCHORAGE AND TO 1Colt¢,.. THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this _ Day of of 20_, by and between 'TAA Can.. herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Memorandum of Understanding agree as follows: 1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as BI0 CYCLE at 6211 Azat6A EAG -LE Bacot< 5/p BIoctc L toT4 2. Definitions. • located , Anchorage, Alaska. A. Alteration. Any change to the design or function of an AWWTS that Includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Prior to performing any alterations to an AWWTS the owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65. B. Certificate of On -Site Systems Approval. An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with AMC 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. C. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. D. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. E. Permit (Construction) An On-Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. F. Permit (Operating) An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that allows the Owner to operate an AWWTS, upon meeting all the requirements of this agreement, the conditions of Operating Permit, the requirements of the On-Site Wastewater System Construction Permit and all relevant provisions of AMC 15.65 ,,( 3. Fee. Owner shall pay to Municipality an annual fee of Y� (S f6 .00), payable on or before the issuance of the operating permit and annually thereafter. The annual fee is due on or before the anniversary date of the approval by the Municipality of installed system. 4. Term. The term of this Memorandum of Understanding shall be for the life of the AWWTS. The term begins on the date of approval by the Municipality of the installed system and shall continue while the AWWTS system is in use or operational or until the property is sold or title is transferred by owner and a new certificate of On -Site approval is issued to the new owner or transferee of the property. 5. Alterations, Installation and Removal of Additional Equipment. Owner agrees not to make any alterations, removal of parts or additions to the AWWTS without a Construction Permit from the Municipality. 6. Maintenance and Repairs. A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AWWTS in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further, Owner agrees to comply will all applicable ordinance, laws, regulations, rules and orders for the A W WTS. 13. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the Owner's AWWTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's AWWTS Operating Permit is: Q4 CAC ly C. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. D. Owner agrees that only maintenance, repair personnel certified by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. E. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. F. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. G. Owner agrees that the relevant provisions of the standard specification guidebook for AWWTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's AWWTS. 7. Nonwaiver. The failure of either party at any time to enforce a provision of this Memorandum of Understanding shall in no way constitute a waiver of the provisions, nor in any way effect the validity of the Memorandum of Understanding or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 8. Amendment. A. This Memorandum of Understanding shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality of this Memorandum of Understanding was executed and such writing shall be attached to this Memorandum of Understanding as an amendment. 13. For the purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized representatives of the parties are: Owner: Iowa 7. Anchorage: Purchasing Officer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of Understanding 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 Memorandum of Understanding. 10. Severahility. Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum of Understanding. OWNER: MUNICIPALITY: Date: 7-/0-0 7 STATE OF ALASKA THIRD JUDICIAL DISTRICT By: Title: Date: ) ss. The foregoing instrument was acknowledged before 2001 , by TDO 8 Cm/►'e�2 me this/° day o�� �_ � \9ll 711ii�i / \ �;.. A ic) NOTARY PUBLIC FOR AL SCA w/) b1y Commission Expires !Ail:. i OTARY My Commission expires.--0e0beti 3, 2008 � : :,PiJBLIC; z Nance Address MUNICIPALITY OF ANCHORAGE DEI ATMENT OF HEALTH AND HUMAN SER. ,cS Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT D. I)a c ( Lir' I g©> f to 1AciZ21P6 IJ Phonets) Permit No.No. of Bedrooms 6��- 4/0 186'063 5 3 LEGAL DESCRIPTION Subdivision B12,0614.. ,.. FAGFOUNDATION /-3 AS -BUILT DIAGRAM (Show !oeallon 01 well, septic system. property lines, lou ndallon, dnvewaylwater bodies, etc.) [Block Township, flange, Section WELL DISTANCES SEPTIC TANK ABSORPTION FIELD 150 WELL LOT LINE > 35 V 7 25 1._L'N,1.,. TANKS < SEPTIC Manufacturer CI HOLDING Capacity in gallons Material GrM No. of Compartments TYPE OF SYSTEM ❑ TRENCH ❑ BED ❑ W. DRAIN ❑ OTHER Depth 10 pipe bottom from onglnal grade 3 Fill added above original grade FT FT Total depth from original grade Gravel depth beneath pipe Gravel length Total absorption area 4L3a FT SO FT Gravel width Distance between 'lines FT FT FT FT Number of lines Soil rating Pipe material I �_.SQ FT Agrwf A Installer Date Installe`j �lvc.K "I;Ac 14.0 t t7li 5 1 Li PRIVATE Classdicahon (A,B C) WELLS r' L1 OTHER (Identify) Total Depth Cased to FT FT Install( Date Installed. REMARKS: le .— Scale: Inspections Performed by: Date. I 010 be -14 . k- _ certify that this inspection was periermed according to all Municipal and Slate guidelines in effect on this dale. health Department Approval: Date ! -sq- ENGINEER'S SEAL CT I IFGAIWL. ICIcV C3FG DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, AK 99501 264-4720 ���131: FE: !BEE IPJEE �[1'.1 '11- ERMIT NO: 850638 /ATE ISSUED: 09/30/85 IPPLICANT: TODD B" COLVER a:DRESSo BOX 16 LAKERIDGE DR. EAGLE RIVER, AK 99577 �ONTACT PHONE: 688-4811 EGAL DE8CRIP: SUBDIVISIONx EAGLE BROOK SECTION: 35 TOWNSHIP: 12N DT SIZE: 2A (SQ.FT. DR ACRES) |AX BEDROOMS: 4 LOT: 4 RANGE: 3W BLUCK: NA Tisted below are the options.available to you in designing your septic ystem" Choose the option that best fits your site. EPTH TO PIPE BOTTOM (FT.) 4"0 4.0 4"0 /RAVEL DEPTH (FT") 3.5 0"5 2"5 OTAL DEPTH (FT") 7"5 4~5 6.5 RAVEL WIDTH (FT.) 2.5 21"0 5"0 RAVEL !.ENGTH (FT.) 80.0 ** 40"0 72,0 /RAVEL VOLUME (CU.YDS") 29.7 31"2 40"0 ANK SIZE (GALS) 1,250.0 ** 1,250.0 ** 1,250°0 ** QIL RATING (SQ^FT"/BR) 140 140 • 140 ** GRAVEL LENGTH > 75 FT, REQUIRES MULTIPLE RUNS (NOT EXCEEDING 75 FT. EACH) ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS certify that: 1. I am familiar with the requirements for on-site sewers and wells as set Corti-) by the Municipality of Anchorage (MOA) and the State of Alaska. 2" I will install thesystem in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit" 3^ I will adhere to all MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. I understand that this permit is valid for a maximum of 4 bedrooms and any enlargement will require an additional permit, F A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, TiEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS |ILL NOT 0E APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE lECTRICAL WOR[ MUST BE DONE BY A LICENSED ELECTRICIAN. v IIGNED }PPLICANT: TO) SSUED BY = DATE: (o t / DATE: gy-c, � -orac5 January 10, 1986 TO: Permit Applicant Subject: P.O. BOX 6650 ANCHORAGE, ALASKA 99502-0650 907) 264-4111 7CNY x,';OWLES. DEPARTMENT OF HEALTH 8 HUMAN SERVICES Permit 4 850638 Lot 4 Eagle Brook Subdivision A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1985. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a. private engineer inspected the installation of the on-site sewer system the original as -built inspection report(three part form) must be sent to this office for review and approval,and for documentation. If there are any further questions, please call this office at 264-4720. Sincerely, Susan E. Oswalt Program Manager On-site Services SEO/ljw enc: Copy of Permit MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: /CI de/ CuJiter- LEGAL DESCRIPTION: DEPTH (FEET) Brow DATE PERFORMED: 0e4ANICS 7-, g A NI> A g 0-A al - 13- 14 - 15 16 - 17 - 5;114/ et,&tot 18 - 19 - a. ..: 22 b". E ,. , ........ .D',.;:. ?j, Oa 20 - COMMENTS L 0 CA/10 1.4 6 F 9 t ,J PERFORMED BY: 72-008 (6/79) SLOPE WAS GROUND VVATER \/ ENCOUNTERED? IF YES, AT WHAT DEPTH? XSOILS LOG 0 PERCOLATION TEST T 1 AN, R3 t.V./ SITE PLAN s L0 E 101 Reading Date Gross Time Not Time Depth to Water Net Drop NIUNIC/PAL/Ty V/RONA4E.F HEAL NrAL -)a N L,m,40:2 PRo 4 • 1996 RECEivrD PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN g.C.T 4bI.E ET AND FT CERTIFIED BY: DATE:4'- / 4 X\ SOILS LOG CIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHOR DEPT. OF HEALTH & DEPARTMENT OF HEALTH AND ENVIRONMENTEWM41:: •NOTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST APR 9 19c" PERFORMED FOR: / ol're //i/ /jRECEIVER DATE PERFORMED: ye',/i LEGAL DESCRIPTION: Lot 9 / 0— 35 Ti 2,1•1 Lid SLOPE 1 2 - 3 - 4 - 5 - 6 - 7 - • ps I/ Sa / ee4 (G. -s ep/ tearther-A-,. 8 - 9 - 10 — 11 — 12 — 13 14 — V 117 sq -d, 6-r-4 freli CC; V' se 4 f 15 19 — leo oeoee o_oeee. raty, 16 - 17 — „ "`"r-' 18 _ ("lz • 20 — Nd.4 2 2 2 5 — JUNE 2i, 19/1 WAS GROUND VVATER ENCOUNTERED? IF YES, ATWHAT DEPTH? /e.-Cisee") L / /3 E SITE PLAN Reading Date Gross Time Net Time Depth to Water Net Drop PEFiCO-borT-1E+fg IRATE TEST RUN BETWEEN COMMENTS teS± 1.10. •-e., / . / Ye> (minutes/inch) FT AND FT iee c c • d 4 ; IC% 2 7 PERFORMED BY: •612‘1 , CERTIFIED BY: rs DATE: gliik/tf,5 72-008 (6/79) 1 V.9 r� el 1 Jd 1wN D L® • Pkoofi S c.'SAN1 14 °"'.del vv, `� �wlroi !t/fokr.14./ .411. r.P ;4 ee®715 : 1-1) ie erg°.0 1 ...: .'®:tc.isi g; // ete..44; pti —?-04 64.5, qg REQ 1;VED `is //'7 ao.,4 atof`• DIT = IE°Ir TiLIBM 1201 RRIROM ST. 99515 ANCHORAGE, ALASKA 344-7714 SIX INCH WATER WELL DRILLED- -OUT TO THE DEPTH OF 158 p.. DRILLED AT THE RATE OF 123.00 PER FOOT. PROPERTY OWNER at. Toa Coo ve t 488-4811 OJT LOCATION OF WELL SITE Lt. Li Banc)... S. Faf-In , V' jJ6%o..), tP DRILLER WELL LOG: 0----23' g.taveL wtLth 25% clay mateta.L. 23---68' Coatoe gtaveL. 15% clay.. Be-tnJe Clau o a.L Ramaait t Dtttt n.a WA tk.o. 68--122' ka tdpan. R cemented q ta.ve.L. Sevetat oma.LL bow(.deAo. 122-158' Wet gtaveL lath .th n a-teao oand. good wa.teJt bea4Lig q.taveL, however, ./.tam 157 .to 158 A. good qu,a.Lt ty. wate t ohawdng 15 FlR. Wate t .tecove ty, back up..ta w.W n. 55 ft of. .the outface. 3/4 ho44e oubrneiti hie. pump ohouJd be 4n4talled .ten../.t O.4 bottom.. To.ta.L coot af D42/Ung: 823.00 pet /,t X 158 {,t: 1t634.00 13634.00 COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF 13634.00 THANK YOU VERY MUCH. DATE October 16th, 1985 BERNIE CLAUS OF RAMPART DRILLING WORKS SERVICE CHARGE 0 F 1'/ % PER MONTH WILL BE ASSESSED ON PAST DUE ACCOUN 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 1.5. Parcel l.D. -011-7111-75(0 COSA # (Y 02161 Expiration Date: l ! - / - U.7 PIS. • .,... .. 1. 'GENERAL INFORMATION Completelegal,descrip ion c2Iebrcok $1. BleAct L.+ 1 Location (site.address) ' 6211 ,4 4L2 Drhvp :Current Property owrier(s) %a I Col ve& Day phone 1i10 -k040 Mailing address (oll2 Az7.1e� Drive_ i to cLoraie 1 AK 9151b rg a d d Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Q Individual On-site ❑ Individual Holding tank ❑ Community On-site ❑ Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) In compliance with all applicable Municipal and State codes, ordinances and regulations in effect at the time of installation. Name of Firrn SFrOanX E inceriny Address 2133 W. Gil" 6le, 2031 AncllorA�ej AK 99501 Engineer's Printed Name Lars .1).1.:121 'Anc\ 5. DSD SIGNATURE i/ Approved for Disapproved. Conditional approval for Lf bedrooms. Phone 279.39fb bedrooms, with the following stipulations: llltoIZYOP��irr •Rce.. • M04;;;-_ Additional Comments ON-SITE tt rIt WATERGAND • m- : WASTEWATER :, = lii PKURAM Ft,,;;,..... �% • �rk*-01\�� 'ina.1))))))))j Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other (Rev. 11/05) Original Certificate Date: 49-• 1 - 0 7 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Ell l iN izok *1 ¶3W 4 C0{ Z A. WELL DATA Well type &tnke. If A, B, or C provide PWSID # Date completed 1011405 Sanitary seal (Y/N) Total depth 150 ft. Cased to ) 40 ft. FROM WELL LOG Date of test 101495 Static water level 55 ft. Well production 15 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate Ma mg/L • 01+1) �f ITIp-t Arsenic: ND ug/L date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material lir, Y.. Fibaybs5 Tank size ILDD gal. Number of Compartments 4 Foundation cleanout (Y/N) y Depression over tank (Y/N) /✓ Date of pumping gem/ Pumper Parcel ID: 0I1- 121-56 Well Log (YIN) Y Wires properly protected (Y/N) V Casing height (above ground) +21 in. AT INSPECTION 91/010- -t8 ft. 5.S g.p.m. Other bacteria JO colonies/100 mL Collected by: Ltao 9' Date installed 1,1+7 1 Cleanouts (Y/N) M�«Iek Jlttoe High water alarm (Y/N) Y C. ABSORPTION FIELD DATA Date installed ijie)o4 Soil rating or ft2/bdrm) 1 Length 15 ft. Width ID ft. System type 84.D Gravel below pipe 6.9 ft. Total depth S ft. Eff. absorption area 150 ft2 Monitoring tube Y Date of adequacy test Alt& Results (Pass/Fail) — Fluid depth in absorption field before test = in. Water added= gal. Elapsed Time: min. Final fluid depth = in. Any rejuvenation treatment (past 12 mo.) (YIN & type) Depression over field N For bedrooms Absorption rate >= New depth= in. g.p.d. If yes, give date — D. LIFT STATION Date installed ell °i 'Pump on" level at 25 in. Datum Ta? a fEe15 Size in gallons (60o 'Pump off level at /HY& in. Cycles tested /I4yI E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 1081- Manhole/Access (Y/N) High water alarm level at 2L 2 j Meets alarm & circuit requirements? 1 On adjacent lots Absorption field on lot 100 + On adjacent lots Public sewer main NIA Sewer /septic service line SO + Holding tank IOo in. loo + Public sewer manhole/cleanout N/q NIA Animal containment areas SD + Manure/animal excrete storage areas 100.1- SEPARATION oo + SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation cIt Water main ►o+ Property line 5+ Absorption field 5+ Water service line 10 + Surface water 100't Wells on adjacent lots 1001 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10 Building foundation 10r+ Water Service line 50'4 Surface water 100 + Curtain drain 14St. Welts on adjacent lots 100 + F. COMMENTS Water main 10 + Driveway, parkingNehicle storage 0'+ 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. Engineer's Printed Name LW'S SpurR�d�111.4,101, Date r .,• . 491d In_ 1.• ..// ?UBKLA'D:LICJ j FELS1 J.' s COSA Fee $ Date of Payment 1\i_ `,01 Receipt Number `V1 V1 (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number SCS Ref.N Client Name Project Name/II Client Sample 11) Matrix PWSID 1073445001 Tobbcn Spurkland P.G. Eagle Brook 13214 Eagle Brook 13214 Drinking Water 0 All Dates/Times are Alaska Standard Time ' Printed Date/Time 07/24/2007 8:12 Collected Date/time Received Date/Time Technical Director 07/17/2007 15:30 07/18/2007 15:35 Stephen C. Ede Sample Remarks: Parameter Results PQL Allonahle Prep Analysis Units Method Container ID Limits Date Date Init Waters Department Total Nitratc/Nitritc-N ND Microbiology Laboratory Total Coliform 0 0.100 mg/L SM204500NO3-F B (<101 07/20/07 JDS col/IOOml. SM209222B A (<1) 07/18/07 SDP SG$ SCS Refit Client Name Project Name/# Client Sample ID Matrix PWSID 1071475001 Tobben Spurkland P.E. Eagle Brook B2 L4 Eagle Brook B2 L4 Drinking Watcr 0 All Dates/Times are Alaska Standard Time Printed Date/Time Collected Date/Time Received Date/time Technical Director 04/30/2007 8:58 04/102007 15:35 04/10/2007 16:12 Stephen C. Ede Sample Remarks: Parameter Results PQL Allowable Prep Analysis Units Method Container ID Limits Date Date !nit Metals by ICP/M3 Arsenic :raters Department ND Total Nitrate/Nitrite-N 0.108 Microbiology Laboratory Total Coliform 0 5.00 ug/L EP200.8 0.100 mg/L EPA 353.2 co1/100mL SM20 922211 C (<10) 04/18/07 0428/07 TIC B (<10) 04/12/07 .IDS A (<1) 04/10/07 DPT SEA TURN SUED. LOT 14 pule LOT 16 o 01-1 Septic Ter* eco , 44.0 '? 2 Story Frame House 3. N00°04'54"W 428.69 i owe" 0' Tele. & Elec. Ea 1 n 185 Wood fence— ood ret. wall n 5 Window OH prytna9eEaseme+t/ 1 25 CteaNtaInt. Centered 0t r, �— a— EaSen'ent 5o screentn9 '' 1' fete• &Stec 1475eA422eE 186,07 O EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. �abbtt Cts/ Via/ Fb 07-6, pg 1-2 0 O LOT 3 SCALE: 1"= 40' O F Ac�s l II • *: 49TH :9 ? ..?. /1„: Fred2Sa ��'�q.• No. 3255-S i 111 kitp�E\iaiai)•�, AS -BUILT NO CORNERS SET THIS DATE BE 1 hereby certify that I have performed a Mortgagee's Inspection of the following described property: LOT 4. BLOCK 2. EAOLEBROOK SUBDIVISION, ADDITION No.1 Anenorage Neeoramg rreunet, AmsKa, ane mat the Improvements situated thereon are within the property Anes and do hot overlap or encroach on the property tying adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the premises in question and that there ore no roadways, transmission Anes or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 24th day of JULY .2007 FRED WALATKA & ASSOCIATES Engineers and Surveyors (907-248-1666) gab— /.3 es MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application DateDec_ .23/ ! Q S 6 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) Lo r iC 2— (a) (a) Legal Description (include lot, block, subdivision, section, township, range)) Becz,mk LOT 4, ATE, -13 Pao S.E.L. 3�,'T1 .Nf R3U& Location (address or directions) CPY`es.0 �0. t1S (b) Property Owner TODD GULV1^QL.. Telephone: Home 688- 448I/ Business Mailing Address 12>O) I (cl, LA K E IR I DF, •E TP. EJ (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent kl O T V E Address Telephone (e) Mail the HAA to the following address: or: Check here if hold for pick up. List contact person and day phone number below. (. SP 0 12.LANki\ 2. TYPE OF RESIDENCE Single -Family Number of Bedrooms 3. WATER SUPPLY Individual Well pSC Community 0 Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public 0 Community 0 Holding Tank 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 f Rev 8/861 Front 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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. 1 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 Address Date 203u/irt5LG, Telephone A7 - 34l� e_23iRte 6. DHHS APPROVAL Approved for 74711'r.'C3)bedrooms by Approved Disapproved A CF0!1(� q� e ° e1 ;. * : ^ r H A 4,> • A. 2225-E c)-1% .°� tl • JUNE 25. 1971 ,�;;•',;i •P"Nzjoo Engineer's Seal -4. /o -s .. Date yZ 3/—B!i Conditional Terms of Conditional Approval CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates 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. Page 2 of 2 72-025 (Rev 8/861 Back pEs<hQq° , MUNICIPALITY OF ANCHORAGE' (MOA) /� f n /Y 9. \�'O� ;�J®r „HEALTH AUTHORITY APPROVAL (HAA) t 6Z,n fyi .4�( (_DLA r, V J� ct c� `� CHECKLIST 64-4720UARY 1984 q L I /,„ P , 04 ^ V �� Legal Description: �7 V./ eAc6L,e Ba e,oY., St•Sea, 56 t,_ afi 2 ,up A. WELL DATA Well Classification -R j~. If A, B, C, D.E.C. Approved (Y/N) Ws/rat Well Log Present (Y/N) /- Date Completed ID lit, ib g s Yield 15 C Ptt-( Total Depth 5 a Cased to 1 6 a Depth of Grouting N (? N C Static Water Level 55 Pump Set At 1 46 Casing Height Above Ground e" T Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) J Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot 1014 On Adjoining Lots 1 c To Nearest Edge of Absorption Field on Lot 16O ; On Adjoining Lots To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments NON 4 To Nearest Public Sewer To Nearest Sewer Service Line on Lot > ; Date o � t� �.cY B. SEPTIC/HOLDING TANK DATA Date Installed t °/!°rl Pit- Size ""' No. of Compartments --r- 0b Standpipes (Y/N) y Air -tight Caps (Y/N) Foundation Cleanout (Y/N) 7' Depression over Tank (Y/N) ril Date Last Pumped - N mr: Iv Pumping/Maintenance Contract on File (Y/N) WA _ ; for N/4 Holding Tank High -Water Alarm (Y/N) INVA Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well 1 0 4 To Building Foundation 1.3 To Property Line >AS To Disposal Field 50 f To Water Main/Service Line ,> to -0 Course To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 70_119a/ 1 vue\ C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 1/£5-/a s Width of Field)) Type of System Design Length of Field Depth of Field 2ENc;N log, B Gravel Bed Thickness .5 Square Feet of Absorption Area p Standpipes Present (Y/N) Depression over Field (Y/N) N Date of Last (Adequacy Test NI me Results of Last Adequacy Test N/ANm AV Separation Distance from Absorption Field: To Water -Supply Well t 5 0 To Property Line _ .2e55 To Building Foundation 6c. + To Existing or Abandoned System on Lot i\l c;/' To Water Main/Service Line '> /0 To Cutbank (if present) `3c To Stream/Pond/Lake/or Major Drainage Course > / To Driveway, Parking Area, or Vehicle Storage Area > / Comments • On Adjoining Lots D. LIFT STATION Date Installed 14i4g Dimensions Y. Size in Gallons 50 Z% Manhole/Access (Y/N) / ,/ i4 "Pump On" Level at _ la "Pump Off" Level at y High Water Alarm Level at y,, Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Y Comments '° Check Permitted Bedroom Rating Against HAA Request'" I certify that I have checked, venfi •., or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed it , /' Date i 72s Company MOA No Receipt No. alat �C// Date of Payment// Z2-/-2 3� 16 (1'/ Amount: $ , irr) Page 2 of 2 72-026 (11/84) e •g *® 49 !J P.00(111400 000000.0•009 o N. 2225-E °: p( • Jt pt 2t U 7& Engineer's Seal