HomeMy WebLinkAboutCHANDELLE ACRES LT 5Chandelle
Acres
Lot'5
#051-063-78
Municipality of Anchorage
Community Development Department Page 1 of 3
On-Site Water & Wastewater Program
4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907)343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP121392 PID Number: 051-063-78 ❑ New ■Upgrade
Name: JOHN & CYNTHIA RAMSEY
ABSORPTION FIELD
❑ Deep Trench ❑ Shallow Trench ■ Bed ❑ Mound
Address:
23730 IMMELMAN CIR. *ANCHORAGE, AK 99567
❑ Other
Phone: No. of Bedrooms:
SoII Rating:
Total Depth from original grade:
C/O AGENT 3
5.0 GPD/Sq. Ft.
2 ABOVE O.G. FL
LEGAL DESCRIPTION
Depth to pipe Invert from original grade:
Grovel depth beneath pipe:
SEE DWG. Ft.
0.65 Ft.
Subdivision: Block: Lot:
CHANDELLE ACRES — 5
FBI added above anginal grade:
Gravel length:
SEE DWG. F.
12 Ft.
township: — anger — ec Ion: —
Gravel width:
3eds Number of linea.
Distance between linea:
12 Ft.
2
5+
SEPARATION DISTANCES
Total absorption area:
Number7f trenches:
Diet. between trenches:
To
Septic Absorption Lift Holding public/Private
From Tank Field Station Tank Sewer Linea
144 SD. Ft.
—
—
FL
well
too'+
100'+
too'+
—
25'+
TANK ❑ Septic ■ S.T.E.P. OHolding ❑Other
Manufacturer.
capacity:
Surface Water
100'+
100'+
100'+
—
GREER
1500
Sol.
Lot Line
5'+
10'+
5'+
—
N/A
Material:
STEEL
Number of compartments:
2
Foundation
5'+
10'+
5'+
-
LIFT STATION
Curtain Drain
I NONE KNOWN
Manufacturer. Capacity:
GREER/QUANICS 1500 cal.
Remarks: OLD TANK WAS DECOMMISSIONED PER UPC.
rump on" level at:Pump
TIMER
off" level at:
TIMER
High water alarm at:
46"
THIS IS A QUANICS AEROCELL SYSTEM
Pump Make & Model:
Electrical Inspections performed by:
P—SE-41—T
PIPE MATERIAL
House to tank 03034 Tank to SCH40 (1 1/2")
droinfield
Installer
WILCO
Drainfield D3034 CO/MT D3034
Inspector GEG, Ltd.
BENCH MARK (Assumed elevation)
100.00 FL
Inspection
Location and Description:
Dates: 1st 11/28/12 2nd 11/28/12
3rd 11/28/12 4th 11/28/12
BOTTOM OF SIDING ® SW CORNER OF HOUSE.
Community Development Department Approval
ENO] EER9
�o
�� ..... qS�4
Conditional approval: Date:
..•
o
p* 0
ve o
.� .
o
Op y Gar ass:' Q�
Q CE
Approved: Date:aprofesslan000
°04000��0
Municipality of Anchorage
Community Development Department Page 1 of 3
On -Site Water & Wastewater Program
4700 Elmore St. a P.O. Box 196650 Anchorage, AK 99519-6650 a http://Www.muni.org/onsita • (907)343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP121392 PID Number: 051 —063-78 ❑ New ■ Upgrade
Name: JOHN & CYNTHIA RAMSEY
ABSORPTION FIELD
❑ Deep Trench ❑ Shallow Trench ■ Bed ❑ Mound
Address:
23730 IMMELMAN CIR. *ANCHORAGE, AK 99567
E]
E]Other
Phone: No. of Bedrooms:
Soil Rating:
Depth from original grace;
C/O AGENT 3
5.0 GPD/sq. n.
2 ABOVE O.G. Ft.
LEGAL DESCRIPTION
Depth to pipe Invert from original grade:
Grovel depth beneath pipe:
SEE DWG. EL
0.65 Ft.
Subdivision: Block: Lot:
CHANDELLE ACRES — 5
Fill added above original grade:
Gravel length:
SEE DWG. n.
12 Ft
owns Ip: _ anger — ec ion: —
Gravel width:
ae Number of linea
Distance between linea:
12 Ft.
2
5+ Ft.
SEPARATION DISTANCES
Total absorption area;Number
of trenches:
Dist. between trenches:
To
Septic Absorption Lift Holding Public/Private
From Tank Field Station Tank I Sewer Linea
1 44 SQ.n.
—
Ft
Well
100'+
too'+
100'+
—
25'+
TANK ❑ Septic ■ S.T.E.P. ElHolding ❑Other
Manufacturer:
Capacity: ,
Surface water
100'+
100'+
100'+
—
GREER
1500
Go[.
Lot Line
5'+
10'+
s•+
-
N/A
Material:
STEEL
Number of compartments:
2
Foundation
5'+
10'+
5'+
-
LIFT STATION
Curtain Drain
NONE KNOWN
Manufacturer. capacity:
GREER/QUANICS 1500 cal.
Remarks: OLD TANK WAS DECOMMISSIONED PER UPC.
"Pump on' level at:'Pump
TIMER
air level at:
TIMER
High water alarm at:
46"
THIS IS A QUANICS AEROCELL SYSTEM
Pump Make & Model:
Electrical Inspections pedommid by:
P—SE-41—T
PIPE MATERIAL
House to tank D3034 Tank to SCH40 (1 1/2")
drainfield
Installer
WILCO
Drainfield D3034 CO/MT D3034
Inspector GEG, Ltd.
BENCH MARK (Assumed elevation)
100.00 Ft
Inspection
Location and Dascription:
Dates: 1st 11/28/12 2nd 11/28/12
3rd 11/28/12 4th 11/28/12
BOTTOM OF SIDING @ SW CORNER OF HOUSE.
Community Development Department Approval
ENCH El"
ooOF o�pp
Conditional approval: Date:
JJ
/r -m/
0 ....:... .... . .... ...........0
Ve ge'!aje /L 1,., 6 -'9 0
Q y Gar ess.: 7
DO
CE 7 p�
Approved: Date: -f 31.34pod
Pro d,
p00000��o
PERMIT NUMBER: AS—BUILT DRAWING PARCEL ID NUMBER: I
OSP121392 051-063-78
r A —T—R-1
ST1
51.37
15.47
MH
54.02
23.79
MTI
72.76
46.69
MT2
82.21
58.16
MT3
86.37
59.27
MT4
77.24
47.64
COT
78.28
48.61
CO2
86.721
58.89
POD1
68.30
144.871
P002
70.21
47.24
CO3
75.89
51.77
I
tOV WELL RADIUS
I
1
GARAGE
EXISTING 3
BEDROOM
HOUSE
B
1 ING FCO
—
MH STI
POD1&2
CHANDELLE ACRES LOT 6
CO3 00
0MTI
THg1
MT T4
L
N
NE
N
/// �m 1
DRAINFIELD❑
/ I
1 GALLON
I \\
�fE'� TANK WITH
ST
SCALE:
/
iOUANICS AEROCELL
I \
/
1 CONTROLS
I \
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
3n1 E WWR ft . S M 101 • u HDRAC£, W sssm n W (907)337-31n . FM (907)333-34(0 xt:as�� ....9am.wn9tnenlM mm
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
JOHN & CYNTHIA RAMSEY C/0 AGENT 2 OF 3
LEGAL DESCRIPTION: DRAWN BY:
CHANDELLE ACRES LOT 5 1 PNB
OF WORK:
AS -BUILT DRAWING
2
\ l
LOT 3
I j
/
� f
I I LENIJIF( HEIGHTS
LOT 4 \
I I \
I \
VNIE HEIGHTS LOT 5
Rising Son Electric, Inc.
14916 Woodland Avenue
Eagle River, AK 99577
(907)622-6777
December 10, 2012
Garness Engineering Group, Ltd.
Attn: Sonja Blewett, Corporate Secretary/Treasurer
3701 E. Tudor Road, Suite #101
Anchorage, AK 99507
FAX(907)338-3246
Re: 23730 Immelman Circle — Chugiak, AK 99567
Dear Sonja:
The lift station at the above referenced address has been wir sd in accordance with
NEC and State/Local codes.
Thank you.
Sincerely,
pf
Kevin S. Hornbuckle, Owner
Administrator License Number 1284
Specialty Contractor License Number 27285
KSH/cmh
Cc: file
On -Site Wastewater Disposal 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: OSP121392
Tax Code Number: 05106378000
Work Type: Septic Upgrade
Permit Effective Dates: November 09, 2012 to November 09, 2013
Design Engineer: GARNESS ENGINEERING GROUP LTD
Subdivision: CHANDELLE ACRES
Site Legal Address: CHANDELLE ACRES LT 5 G:1460
Owner/Address: RAMSEY JOHN P & CYNTHIA O
23730 IMMELMAN CIR CHUGIAK AK 995675566
Site Mailing Address: 23730 IMMELMAN CIR, Chugiak Lot Size in Sq Ft: 40974
Total Bedrooms: 3
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank N Privy N 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
Community Development Department Phone: 907-343-7904
Development Services Fax: 907- 343-7997
On -Site Water & Wastewater Program
Mayor Dan Sullivan
On -Site Sewer/Well Permit Application
For A Single Family Dwelling
Parcel I.D. Q51— (.�)— -1
Property owner(s) JOHN & CYNTHIA RAMSEY Day phone C/0 AGENT
Mailing address 23730 IMMELMAN CIRCLE *CHUGIAK AK 99567
Site address 23730 IMMELMAN CIRCLE *CHUGIAK AK 99567
Legal description (Sub'd, Block & Lot) CHANDELLE ACRES LOT 5
Legal description (Township, Section & Range)
Lot Size Sq. Ft. Number of Bedrooms
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DEWELLING:
( Pall that apply)
Absorption Field
®
Initial El
Single Family (SF)
Septic Tank
®
Upgrade ®
(w/wo ADU)
HoldingTank
❑
Renewal ❑
Duplex (D)
❑
Multiple Dwellings
❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal codes.
GARNESS ENGINEERING GROUP, Ltd.
(Signature of property owner or authorized agent)
Permit/RushFees: Waiver Fees:
Date of Payment: Date of Payment:
Receipt Number:S7fDt� I"G Receipt Number:
Permit No. 0s e 1; 3R a Waiver No.
(Rev. 01/11)
2;4D't2
9eteHerzrEr 2012
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Rd.
P.O. Box 196650,
Anchorage, Ak 99519-6650
Ref: Proposed Septic Upgrade for Chandelle Acres Lot 5
To whom it may concern
The existing 3 bedroom house is served by a private well and septic system. The septic system is in a state
of failure and needs to be upgraded. We are proposing to install a Quarries Aerocell treatment system on
this property which includes the installation of a 1500 gallon S.T.E.P. tank and 12' by 12' bed type
drainfield. One test hole was excavated on the property. The drainfield will be designed around the 30
foot radius of this test hole. Comments regarding the design are summarized as follows:
1. SOILS: See the attached log which shows the soil classifications, groundwater monitoring, and the
percolation test results. Groundwater was encountered at 3 feet below grade; therefore, there is not 2 feet
of unsaturated receiving soil. We are proposing to use MOA filter sand to create a structural fill system so
as to provide 4 foot separation to groundwater. We noted that water was within 4 feet of the ground
surface in the existing trench drainfield in spite of the fact that the house has been vacant for a number of
months. In fact the liquid level in the trench rose significantly during seasonal high groundwater. In short,
the existing drainfield is seasonally surcharged in groundwater.
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system.
4. TOPOGRAPHY: As can be seen on the attached topography drawing the topography around the
drainfield slopes northwest to southeast at approximately 5%. In short, there are no slope concerns.
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.
M.S.
NOTE: Attached is a site plan drawing, a design drawing, one soil log, which are all part ofthe design package for
this septic system. (Contact G.E.G. Ltd for 7 page construction specification letter.)
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com
GAR]XSS ENQI?NEERING GROUP Ltd. p * : 4 �0
*p
CONSULTANTS 8GENERAL CONTRACTOR'.$. �...... ... ..... •••.........D
701 E. NWR ROI➢, SURE 101 • ANCIpR . M 9950) • MME (90])337-6179 • FIJI (907)338-3248 • WEBSITE: Ww.9amawn9lrne�in9.eam
PREPARED FOR: PHONE NUMBER: - - PAGE NUMBER: fey . .. ness.
;
JOHN & CYNTHIA RAMSEY C/O AGENT 1 OF 2 .13
LEGAL DESCRIPTION: DRAWN BY: Vo -
CHANDELLE ACRES; LOT 5 PNB Vdee
TYPE OF WORK: DATE: �40a ptofess'%O o'
SITE PLAN 10/8/12 �oO000�d
100' WELL RADIUS
C
ELLE
e
ES\\OT 8
(' // CHANb\LLE ACRES LOT 4
I/10
S
i
/
//
- - - - - - - - - - - ---
LENNIE HEIGHTS LOT 3 LENNIE-RETCFTTS LOT 2
00WFE I�
--�
RADIUS S j
/
`
/ ARS
CHANDELLE ACRES LOT 7
CHANDELLE ACRES TRACT
BEDR
OM
�/
HOMEOWNERS ASSOCIATION?X=
�E� HOU
IF.
0
PROPERTY
\
I(
\ I HEIGHTS)
LENNIE
� \ OT 1
NNIE HEIGHTS \ / /
\�
`--S
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//
L
L0O7T 4
AREA
CHANDRAOIiELLE ACRES, LOT 6
�O WFC—
o
/ ` '
�\
\ \ /
�
LENNIE HEIOHZS
LOT 5
EKLUTNff.� HEI HTS
STEWgRT AD (TION
�0 \
�I
W
EKLUTNA HPOF1TS
LOT/ .�
�}-619U4;LOT
EKLUTHEIGHTS
U
L0 17A -ADDITION
.TP,� �j
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1=1
,ADDITIONSTEWART
V
d
x
SARA
ll RAD'US�/ \\
3
EKLUTNA A96kS\
EKLUTI)IA HEFjIGHTS
STEA'ART-ADDITION\—
ST�WPRT ADDITION
LOT? I
I --I
DOIKL
EKLUTNA HEIGHTS
STEWART ADDITION
INA HUE;'
ST ARTDITION
>
EKLTITNA MEIGHTS
STEWART
0 q
ADDITION
LOT 16
loo. WEL�
U&
--��
LOT 4
EKLUTNA
EKLLgNA HEIGHTS \
EKLUTN HEIGHTS
HEIGHTS
STEWART ADDITION
ST ADDITION
Nr
STEWART
ADDITION
LOT 10 \
LOT/
LOT 15
SCALE:
I" = 100'
GAR]XSS ENQI?NEERING GROUP Ltd. p * : 4 �0
*p
CONSULTANTS 8GENERAL CONTRACTOR'.$. �...... ... ..... •••.........D
701 E. NWR ROI➢, SURE 101 • ANCIpR . M 9950) • MME (90])337-6179 • FIJI (907)338-3248 • WEBSITE: Ww.9amawn9lrne�in9.eam
PREPARED FOR: PHONE NUMBER: - - PAGE NUMBER: fey . .. ness.
;
JOHN & CYNTHIA RAMSEY C/O AGENT 1 OF 2 .13
LEGAL DESCRIPTION: DRAWN BY: Vo -
CHANDELLE ACRES; LOT 5 PNB Vdee
TYPE OF WORK: DATE: �40a ptofess'%O o'
SITE PLAN 10/8/12 �oO000�d
NUMBER OF BEDROOMS: 3
GALLONS PER DAY (GPD): 4,90+
PERCOLATION RATE/S: 5.21
PROPOSED APPLICATION RATE: 4.0 GPD/SQ
ALLOWABLE APPLICATION RATE: 5.0 GPD/SQ
MINIMUM DRAINFIELD SQ.FT.: 113 SQ FEET
MAXIMUM DEPTH OF EXCAVATION: 2 FEET
WIDTH: 12 FEET
LENGTH: 12 FEET
M.O.A. APPROVED SAND FILTER: 4 FEET
EFFECTIVE: 0.5 FEET
ACTUAL SO.FT.: 144 SQ FEET
LLITER THAT PERTAINS TO THIS DESIGN.
TO OBTAIN A COPY OF THE LETTER
CONTACT GEG. 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
I SHALL HAVE ALL PERTINENT
11 LOT LINES & EASEMENTS,
AND WELL RADII FLAGGED
BY A REGISTERED LAND
SURVEYOR PRIOR TO
CONSTRUCTION.
HAPPEN TO BE ALTERED
DURING ANY WORK IN THE
EASEMENTS THE OWNER
WILL BE RESPONSIBLE TO
CORRECT THE SLOPES BACK
TO 3:1.
CHANDELLE ACRES LOT 6
/
\a
\ EXISTING
100 WELL RADIUS
/
EXISTING 3
BEDROOM /
HOUSE /
/
INSTALL DBL C/0'S
AFTER DECK AREA IF
AS NOT AN EXISTING
MT CO ° EXISTING TANK 6
\.1T \\ MH ST DECOMMISSIONEDj'
MT
\. TH CO\/ UPS
sa \
Iv" 1 PROPOSED \
m �DRAINFIELO O \ ,
` PROPOSED 1500 \
l GALLON STEP TANK \
WITH QUANICS
1 AEROCELL CONTROLS I \
GARNESSCULEsE
NGINERINTRGROUP, Ltd.
3701 E ROAD,. 3WIE 101 . ANCXORIGE, NC 99E01 . F E (90]}33)_81]9 ° FAX (907)33 32M ° MEBSIIE; rw.9°ma°°n�h°°rin9w»m
PREPAREDRED FOR: PHONE NUMBER: PAGE NUMBER:
JOHN & CYNTHIA RAMSEY C/O AGENT 2 OF 2
LEGAL DESCRIPTION: DRAWN BY:
CHANDELLE ACRES LOT 5 PNB
OF WORK: DATE:
SEPTIC SYSTEM DESIGN UPGRADE 11/7/12
49
ENNIE\HE HTS LOT 3
1
rJ�
I /
{I /
A /
2E' \
LENNiE HEIGHTS
LOT 4\
HEIGHTS_ LOT 5
..A......
agam
GARNESS ENGINEERING GROUP, Ltd.
....CONSULTANTS S GENERAL CONTRACTORS
'01 E. NOOR ROAD, SURE 101 + ANCHORAGE, M. 99507 + PX E: (90)0-9179 + FM -9 38-3218 + W®EIIE: 9omesaengkroxi:
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: CHANDELLE ACRES LOT 5
PERFORMED FOR: JOHN & CYNTHIA RAMSEY nnTF- 10/10/12
DEPTH
(feet ORGANICS
1
PEAT
GM TO GW
TEST HOLE #1 (UPPER)
SOIL CLASSIFICATIONS
llmm�I
DATE
WEEPS 2'-14'
10/10/12
I.
im
3.5'
10/22/12
111111111
—
11,011191
6:35
30
0.25"
5.75"
3
6:35
—
6.00"
—
k'.
7:05
30
IIIIIIIII
5.75"
5
7:05
—
6.00"
—
X111!!1111
7:35
1 30
�i�.d
�
DEPTH TO
GROUNDWATER
DATE
WEEPS 2'-14'
10/10/12
3'
10/18/12
3.5'
10/22/12
6.00"
—
SEE ATTACHED SITE PLAN
DATE READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
10/22/12 1
6:05
—
6.00"
—
2
6:35
30
0.25"
5.75"
3
6:35
—
6.00"
—
4
7:05
30
0.25"
5.75"
5
7:05
—
6.00"
—
6
7:35
1 30
0.25"
5.75"
19� PERCOLATION RATE 5.21 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 2 FT. AND 3 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ® YES ❑ NO
SOILS LOGGED BY: ROB CAMPBELL PERCOLATION TEST PERFORMED BY: ROB CAMPBELL
COMMENTS: PERCOLATION RESULTS ARE WITHIN 1/16TH OF AN INCH
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS ERF RMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 2Ia
MUNICIPALITY OF ANCHORAGE
0 DEPARTMENT OF HEALTH & ENVIRONMENTAL PRO`J`ECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
PHONE
KNEW
_ 3
1:1 UPGRADE
MAILING ADDRESS
SR 227— N-1-10 G%7
LEGAL DESCRIPTION
CHAfU u Q
LOCATION
NO. OF BEDROOMS
U
DISTANCE TO:
Well
^/v'f j%Y Y E r
Absorption area
f
Dwelling r
5
PERMIT NO.
a zo g z,-?
Y
CLQ
~
Manufacturer ���� ^
jq
Material L
No. of compartments
cn
Liq. capacity in gallons
IF HOMEMADE:
1
Inside length_,
Width
Liquid depth
/000
Y
JAZ
DISTANCE TO:
Well
Dwelling
PERMIT NO.
Sz F
Manufacturer
Material
Liquid capacity in gallons
DISTANCE TO:
Well
zlv r
Foundation I
240t
Nearest lot line
5
PERMIT NO.
620 $2Z
=
/Vor
w
No. of lines
Length of eac IA �
Total lengt VWs
Trench width
Distance betweenfines
H
3
O inches
/V/A
FTop
of tile to finish grade/�
Material beneath tile
Total effective a sore on area
60 inches
yo
Length
Width
Depth
PERMIT NO.
w
C7
a H
Type of crib
Crib diamete
Crib depth
Total effective absorption
area
wa
w
�
Well
Building foundation
Nearest lot line
DISTANCE TO:
J
Clas�s� r.
Depth
Driller
Distance to lot line
PERMIT NO.
J
L��
w
Building foundation
Sewer line
Septic tank
Absorption area(s)
DISTANCE TO:
OTHER
PIPE MATERIALS � r
V 1/ L
SOIL TEST RATING
'L2
i
INSTALLER
REMARKS
JN
ON o��£nC
J
Co
io
r.
a.j
s
.�� ~a'�+'�w: �. via, „a.%g �. A►
APP VE p D TE LEGA ,
S:�G6PlI:E�!l9a
551, 1*01396X
/�lV i �LASI:A;,7?
72t0131(Rev. 3/78) v A ," --
MU" I C-- I F=F=IL- I -r-e C, F=- " " IE7. F4-4 FZ " Ci F_=
DEPARTMENT ' HEALTH AND ENVIRONMENTAL _,OTECTION
825 'L STREET.; ANCHORAGE, AK. 99501
E5 F= t^J f=
t4g=L-L 264-4720 - F; F=111= -
- " r-4 C)- LZ) " —:E; I -r 1= FR r-1 I
PERMIT NO. ( 820822 )
APPLICANT JOHN P RAMSEY SR 222 JUANITA LOOP 99677 349-4673
LOCATION
LEGAL L5 CHANDELLE ACRES LOT SIZE 999999 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ FT/BR)= 262
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
E> a F1' -r " = :B I- a N 13 -r " =-- :1- -1 :B 1:3 FR F=j 'EL L31 E: F= -r " = 4
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
FZ e: C---1 U I FR E-= L-31 'QEF T I I= -r F=l " F---- :E3 I 72"E: =-- 1 C3 10 C3 C3 F=4 L_ L_ (D " 5L
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
--- -rWID < � > F=IFZK=- FZE='r__lUlFRE[ >
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F=l'E:F;;_"Ml_r F=XF='lFRF=*_c=- E>E:r_-F=ME�l-=FZ _-3:1__- ::L So:B f:>
I CERTIFY THAT
1: 1 AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS As SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
3: 1 UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS.
SIGNED:
APPLICANT JOHN P RAMSEY
ISSUED BY ------ ------ --- V4. 0
rr;
oGpRRrrWWr OF WALTH AND ? tR iTAL PPOTSCTIaM
F#*2*XoV3E. AV, 990K
26#-4M
IT <�
nit
R�� mm Stze OF THE SCtL A8sawrtON S� srm tS.
THE STH DIPW4SIOM IS THE f.kl+lt'TH CIN FEE" OF THE TRENCH OR DRALWICZLO.:
THE owTH OF A TR f OR Pi T IS THE OISTfV CSE BET'S TW SUIWAM OF THE
OROUPO AM THE a0T rCW OF THE E}TION [ SET},
THOtE I5 M SET 1410TH FOR TRENCW L
` THE GFWVB- STH IS THE MINI" STH OF 0MVs*. sEn4sm THE JOUTFAUL PLpe
AND THE BOTTO" CF THC EMCMATt'O" {Edi FBEM
f t r . I cFw T� THE fI£SPO'�+fS t 8 tL I TY TO t�'1 Ti# LS O Th T t L1V� nic
1"srIAi-aTtON ti Crl(m 4F Aw _ MIFFIQ NT T4 MISPRr HE
TY fM T
t-� OF RES t S TMT THE fku.
Itl. im of Aw S'`esrEm W[Tmur Ffm IHI-PMTION AM PPPROVAL 8V MIS
VapmTMENT WILL 8E 'S[! T To PRosmff10K
"tA1I" DISTff" BETWEEN A WEU- AM MW Off -SITE SEWFM Df SYSTM IS
JUN FEET FOR A PRfVR E WELL OR IM TO 2" FEET FR)! it flUGL W ice_ OWOOING
T Tvw OF
FUR -1` WRJL
-_<
MINIMUM LINE IS 25 FEET FM
To R COMUNITV SEWER LEM IS 73 FSI.
weL.L Loos Fm REomwo Am mJSr eE RfTLwm TG THE Q :,mTiriEwr 1 imicf! 3a mvs
I _
CF DiE ma -L COMPLET Its!
r o REW IRF7' MrS rW APFLY. SPEC IF LCAT MS FM STi T -ION DIFAVbVIS ARE
rLomi€ To iiva.w PRavER msrAuArtok
_ r CERT LFV Tyr
L; I P f F M IL IAR H t Til THE REWLREMENTS FOR OX -S t TE SEWERS MW Wf .LS RS SET
FORTH BY T"E IC LPF9L I TY OF ft*14 )RFK3E.
i' 'z: I Nn -L imsraLA- THE SYSTETf Iii FccoRDAmx mum rm cwea
f l: f UM STFM TMT THE ON-SITC SES SYSTEM MY RMLAE XT IF THE,
iIf�G£ IS To i'i T1i 3
ICANT! Jt>f!f f',4*vqsE;
ISSUED BY--__��,-___-.__,. __�� SP#_ Vii"
�w
❑ SOILS LOG
MUNICIPALITY OF ANCHORAGE
ae DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION �N PERCOLATION
TEST
\„ 825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
!� GGlf'
PERFORMED FOR:C 1-4 /) ( l? DATE PERFORMED: V �'
LEGAL DESCRIPTION: L.m"JNs�
DEPTSLOPE SITE PLAN
H i 7 � ln.C`17�1 � �+
r�'Ia
3 �.
4 ��NQ`� SiL:TY U12skEL—
t
5
6
7 1.01
9 �l
MORE
ONES!
■■I■■'
■■II■
NONE
Date
Gross
Time
Net
Time
ONCE
■■I■■
■■I■■
■■I■■
■■I■■
Net
Drop
6-1(.0-13Z
10 C a�
WAS GROUND WATER j�� +—� L
11 � i y/ ENCOUNTERED?� `{ V O
P
12 E
IF YES, AT WHAT
13 DEPTH?
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
6-1(.0-13Z
5-6-
2
05P
? 8~
t
IS
I l) o-1 I
I uP1I
8
%.�
U Y11
I M
n A
f3
20I PERCOLATION RATE (minutes/inch) ,���
L_� Iy
TEST RUN BETWEEN 3 FT AND JZ FT
COMMENTS
PERFORMED BY:
72-008 (6/79)
CERTIFIED
DAT
NI
XPLORATION SUPPLY AND EQUIPMENT, INC.
x
8 DAILY DRILL SHIFT REPORT
c
0
� A S 3'& - 00-
;LIENT: DATE: 31 /Z
5,(x wis(O , ref-ey 5 Cr�ee
'ROJECT LOCATION: C--c`�" S �- t�R�Gl e I (e, A c�-�� ���
DRILL UNIT NO. / c/�t'r i�'J/J _f o� ► ,� J� ,G6/ /l J � �I ) J� I v
V SHIFT: DAY I NIGHT t
V O N APPR VED BY Q O
SCO FOREMAN J AU HORIZED EPRESE TATIVE
ROTARY
CORE
CASING
NUMBER
HOLE NO.
FROM
TO
FORMATION
FOOTAGE
FOOTAGE
FOOTAGE
SAMPLES
D
r�
C
Iq C v L err
to
6L 4-
40
v GU
`i yr
s t- f a r %g' a
TIME DISTRIBUTION
TRAVEL
ROTARY
CORE
SAMPLING REAMING
CASING
RIG MOVE
TOTAL HOURS
DOWN TIME (SPECIFY)
HOURS
STANDBY TIME (SPECIFY)
HOURS
EXTRA LABOR (SPECIFY)
HOURS
EXPENDABLES
ROTARY BITS USED:
TYPE: V %
SIZE: ��
SERIAL NO. 1
TYPE:
SIZE:
SERIAL NO.
CORE Bi T S USED:
TYPE:
SIZE:
SER141_ NO_
TYPE:
SIZE:
SERIAL NO.
REAMING SHELLS:
TYPE:
SIZE:
SERIAL NO.
CASING SHOES:
TYPE:
SIZE:
SERIAL NO.
DRILL MUD: TYPE: /hall e
NO. OF BAGS:
OTHER DRILL ADDITIVES: TYPE:
NO. OF LBS., BAGS, GALS:
START
STOP
TOTAL
DRILLER:
HELPER:
HELPER:
REMARKS:
A
{'v
N 1 6
J
r v1 ��-.- L
v
n ✓.
V O N APPR VED BY Q O
SCO FOREMAN J AU HORIZED EPRESE TATIVE
Time
APPLK NT FILLS
OUT UPPER HAI ONLY
Property Owner
b1 C 11� { 's 1(�
� jyl � Phone
Mailing Aodress Jk)
7*
Au (ak Zip Code 9 �1 ��7 30
Buyer -ok- Wx
Date
Inspector
Address :5 D, vO )e
Zip Code
Lending Institution ��'V
Fe cyn 'f2-> V') yl�
/
a2y L Ca!l to
Phone
Address
Zip Code
!f
Realty Co. & Agent �� �[/Q f� a rc) ey-6
( j) APPROVED BEDROOMS
Phone
Address
Zip Code
Legal Description L p E
Q v" 'e le
C ir'e 5 Pe -+e (T 5 e
Street Location
j f
Type of Residence
Date Sewer Installed
Well To Absorption Area
f'Single Family
❑ Multiple Family
No. of Bedrooms
r �,
❑ Other
i
Water pply
Individual
ATTACH WELL LOG. A well log is required for all wells drilled since June 1975.
❑ Community
For wells drilled prior to that date, give well depth (attach log if available).
❑ Public Utility
Sewer isposal
Individual
Year Individual Installed:��
❑ Public Utility
When Connected to Public Utility:
❑ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time
Time
Time
Time
Date
Date
Date
Date
Inspector
Inspector
Inspector
Inspector
Field Notes:
!f
( j) APPROVED BEDROOMS
'CONDITIONS OF APPROVAL
( ) DISAPPROVED
( ) CONDITIONAL APPPROkAL'
DATE
BY:
Soils Rating
Date Sewer Installed
Well To Absorption Area
Well Log Received
Septic Tank Size / U vC7
r �,
✓'
Well to Tank
72023 (3182)
D]
i��oF' LSt}" L'CrhS(ii�ilnl h -L
Municipality of Anchorage
On -Site Water & Wastewater Program
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 051-063-78 Expiration Date: 11-13-13
1. GENERAL INFORMATION
Complete legal description CHANDELLE ACRES S/D• LOT 5
Location (site address)
Current Property owner(s)
Mailing address
Real Estate Agent
23730 IMMELMAN CIRCLE, CHUGIAK, AK, 99567
FRED AMICANGOLI & KATHLEEN BROQUET Day phone
23730 IMMELMAN CIRCLE, CHUGIAK, AK, 99567
2. TYPE OF DWELLING:
0 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY:
Day phone
529-5695
TYPE OF WASTEWATER DISPOSAL:
Individual Well
0
Individual On-site
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
Received by: >/ _ Dater
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee
Date of Payment
Receipt Number
Waiver Fee $
Date of Payment
Receipt Number
COSA # ..2 14-- S 3 Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. i further verify that based on the
information obtained from the Municipality of Anchorage files and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd.
Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK, 99507
Engineer's Printed Name
Engineers Comments:
JEFFREY A. GARNESS, P.E.
In conducting this evaluation, GEG, Lb). attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
6. DSD SIGNATURE
I System #1 Approved for 3 bedrooms.
System #2 Approved for
Disapproved.
Conditional approval for
LN
bedrooms.
Phone 337-6179
Date '7 /3
4 I ............:: �D
(�..:......T
... .. Corn ..5::..
JA.
i
Ohs
7 53
bedrooms, with the following stipulations:
ON-SITE
WATER AND
WASTEWATER
PROGRAM
Original Certificate Date: Sy 13 _ / -3
The Mucipatity ol/A�TI ofage Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the repress atations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTCHMENTS:
COSA Checklist U/ Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
(Rev. 11105)
�O� n, dti D -L. c_oSA
If more than 1 septic system is on the lot:
COSA Checklist # _of_
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: CHANDELLE ACRES LOT 5
A. WELL DATA
Parcel ID: 051-063-78
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (YIN) YES
Date completed 12/5/82 Sanitary seal (YIN) YES Wires properly protected (YIN)
Total depth 90 ft. Cased to 90 ft. Casing height (above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test - 10/3/12
Static water level - ft. 46 ft.
Well production - g.p.m. 1.08 g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml. Nitrate 2.0 mg./L.
Arsenic: ND ug./L. Date of sample: 10/3/12
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEP/STEEL
Tank size 1500 gal. Number of Compartments E
Foundation cleanout (YIN) YES Depression over tank (YIN) NO
Collected by: GEG. Ltd.
Date installed 11/28/12
Cleanouts (YIN) YES
High water alarm (YIN) YES
Date of pumping NEW Pumper -
C. ABSORPTION FIELD DATA *BELOW FINAL GRADE
Date installed 11/28/12 Soil rating (g.p.ddit or '/bdrm 5_0 System type BED
Length 12 ft. Width 12 ft. Gravel below pipe 0.65 ft,
Total depth *3.42+ ft. Eff. absorption area 144 ft' Monitoring tube YES Depression over field NO
Date of adequacy test NEW Results (Pass/Fail) PASS For E bedrooms
Fluid depth in absorption field before test — in. Water added =gal. New depth =in.
Elapsed Time: — min. Final fluid depth = in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE If yes, give date
NOTE: TOPSOIL, VEGETATION AND 3:1 SLOPES CONFIRMED BY GEG, LTD. ON 8/7/2013.
D. LIFT STATION
Date installed 11/28/12 Size in gallons 1500 Manhole/Access (Y/N) YES
"Pump on" level at timer in. "Pump off' level at timer in. High water alarm level at 46° in.
Datum BOTTOM OF TANK Cycles tested NEW Meets alarm & circuit requirements? YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+
Absorption field on lot 100'+
Public sewer main N/A
Sewer /septic service line 25'+
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Holding tank N/A
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line
Building foundation 10'+ Water
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. 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.
Engineer's Printed Name JEFFREY A. GARNESS
Date Li /-7/13
(Rev. 11105)
Municipality of Anchorage
On -Site Water & Wastewater Program
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 051-063-78 Expiration Date: :3-/0 -!3
1. GENERAL INFORMATION
Complete legal description CHANDELLE ACRES LOT 5
Location (site address) 23730 IMMELMAN CIR. *ANCHORAGE AK
Current Property owner(s) JOHN & CYNTHIA RAMSEY Day phone C/O AGENT
Mailing address
Real Estate Agent
23730 IMMELMAN CIR. *ANCHORAGE, AK
VALESA LINNEAN W/KELLER WILLIAMS Day phone
2. TYPE OF DWELLING:
0 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY:
865-6440
TYPE OF WASTEWATER DISPOSAL:
Individual Well
0
Individual On-site
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
Received by: Date: 1,2112 2
COSA to be released to the engineer, unless otherwise requested by the engineer. /
COSA Fee $�##U(Y�(avrL
Date of Payment
Receipt Number
cosA # _D,6 0 1 55 3
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 files and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal' $
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd.
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system/
These conditions are outside the control of the evaluator of the system. Satisfactory tes
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report.by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
6. DSD SIGNATURE
System #1 Approved for bedrooms.
System #2 Approved for bedrooms.
Disapproved.
Conditional approval for 3 bedrooms, with the following
�? o -.
Phone
337-6179
Date i2 3 1z
4 T
..v*�
m! r A.
CE
Gar ess:
f1 179
The Municipality or Anchorage Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the represenatations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTCHMENTS:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Other
By: I !/� ` Original Certificate Date:l J Z
(Rev. "I"
If more than 1 septic system is on the lot:
COSA Checklist # _of_
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: CHANDELLE ACRES LOT 5
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# N/A
Date completed 12/5/82 Sanitary seal (YIN) YES
Total depth 90 ft. Cased to 90 ft.
FROM WELL LOG
Date of test
Static water level — ft.
Well production — g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml. Nitrate 2.0 mg./L.
Arsenic: ND ug./L. Date of sample: 10/3/12
B. SEPTICIHOLDING TANK DATA
Tank Type/Material STEP/STEEL
Tank size 1500 gal. Number of Compartments
Foundation cleanout (YIN) YES Depression over tank (YIN) NO
Date of pumping NEW Pumper —
C. ABSORPTION FIELD DATA *BELOW FINAL GRADE
Date installed 11/28/12 Soil rating (g.p.d./ft2or /bdrm 5.0 System type BED
Length 12 ft. Width 12 ft. Gravel below pipe 0.65 ft.
Total depth *3.42+ ft. Eff. absorption area 144 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test NEW Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test = in. Water added =gal. New depth =in.
Elapsed Time: — min. Final fluid depth — in. Absorption rate >= 450+ g.p.d,
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE If yes, give date
Parcel I D: 051-063-78
Well Log (YIN) YES
Wires properly protected (YIN) Y
Casing height (above ground) 12+ in.
AT INSPECTION
10/3/12
46 ft,
1.08 —9 P.M.
Collected by: GEC. Ltd.
Date installed 11/28/12
Cleanouts (YIN) YES
High water alarm (YIN) YES
D. LIFT STATION
Date installed 11/28/12 Size in gallons 1500 Manhole/Access (YIN) YES
"Pump on" level at timer in. "Pump off' level at timer in. High water alar level at 46" in.
Datum BOTTOM OF TANK Cyclestested NEW Meets alar & circuit requirements? YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots
Absorption field on lot 100 + On adjacent lots
Public sewer main
Sewer /septic service line 25'+
Public sewer manhole/cleanout N/A
Holding tank
Animal containment areas 50'+ Manurelanimal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehide storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this
date.
Engineers Printed Name JEFFREY A. GARNESS
Date l 2)3 )/ 2 -
(Rev.
(Rev. 11105)
Oplp�.cxm.+,.wo�
-a orNil�mumrv-
osr.azus cu rr[aecworur All FIT swvm
rt�
wfvu�[ss enoicroy rro aE vseo ra ver[aws..
uDRNoLEI-
cu A onMnrepue rotx¢ssvE sww nuprm ttx.
1
ABAVILi SURVEY l�iY
5U
/ ' HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY
OF THE FOLLOWING DESCRIBED PROPERTY
LOT 5, CHANDELLE ACRES
ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE
VISIBLE IMPROVEMENTS SIT DATED THEREON ARE WITHIN
THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS
E%IST OTHER THAN NOTED.
DATED AT ANCHORAGE,ALASKA THIS _15i_ DAY OF
DECEMBER 2012.
m 515.5
SGS Re£#
1124854001
Client Name
Gayness Engineering Group, Ltd
Project Name/4
Chandelle Acres L5
Client Sample ID
Chandelle Acres L5
,Matrix
Drinking Water
Printed Date/time
10/15/2012 11:06
Collected Date/Time
10/03/2012 14:00
Received Date/Time
10/03/2012 15:50
Technical Director
Stephen C. Ede
Sample Remarks:
Allowable
Prep Analysis
Parameter
Results
LOQ
Units
Method Container
ID
Limits
Date Date
[tit
Metals by ICP/MS
Arsenic
ND
5.00
ug/L
EP200.8
C
(<10)
10/08/12 10/09/12
SCL
Waters Department
Total NitrateiNitrite-N
2.00
0.100
mg/L
SM21 450ONO3-F
B
(<10)
10/09/12
CMA
Microbiology Laboratory
E. Coli
Negative
I
Mint,
SM2I 9223B
A
10/03/t2
DLC
Total Coliform
Negative
1
1 Want-
SM21 9223B
A
10/03/12
DLC
ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND
REPAIR AGREEMENT
MEMORANDUM OF UNDERSTANDING
BETWEEN MUNICIPALITY OFF AN HORAGE
AND Frei �' ��L�LtY1(2iL)t.+,
THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this
Day of (Detrm%e,_ of 20`d-, by and between �Ah rZe )(,, In Amz
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:
I. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality
grants permission -to Owner to utilize and operate an Advanced Wastewater
Treatment System (A W WTS), described as ucLj � C S located
at--� ; 11. ��j�� �� 5 Anchorage, Alaska.
2. Definitions.
A. Alteration. Any change to the design or function of an A W WTS 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 A W WTS 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 A W WTS that were included in
the original design which would allow the AW WTS to continue to
perform as designed.
G. 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 AW WTS, 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 0
($ U .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
A W W TS.
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 S 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 AWWTS.
B. 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: 7L,v c t A ye-ev
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 AW WTS is the governing professional guidelines for the construction,
maintenance and repair of the Owner's AW WTS.
7. Nonwaiver. The failure of either party at any time to enforce a provision of this
Memorandum ol'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 part thereafter to enforce each and every provision
hereof.
S. 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.
R. 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:
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. Severability. 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:
By r/ z-��'1 •(r �;i ,( By:
f < / i£ ✓G t..� < < < x. f/ �r Title:
Date: — —�' /. Date:
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT )
The foregoing instrument tyas acknowledged before me this day of
-t) .��11N1111itlUGVii.
n ,
NO ARY PUBLIC FOR ALASKA _
My Commission expires: 111 '1 _ 1L i.5
Filed for Record at Request oL•
AFTER RECORDING MAIL TO:
KATHLEEN BROQUET
10540 OUR ROAD
ANCHORAGE, AK
SPACE ABOVE THIS LINE FOR RECORDER'S USE
POWER OF ATTORNEY
(Special — Alaska)
KNOW ALL MEN BY THESE PRESENTS FREDERICK M. AMICANGIOLI, AN
UNMARRIED PERSON WHOSE ADDRESS IS 10540 Our Road, Anchorage, AK
99507 has made constituted and appointed, and by these presents does make constitute, and appoints
KATHLEEN A. BROQUET, AN UNMARRIED PERSON WHOSE ADDRESS IS 10540
OUR ROAD, ANCHORAGE,AK 99507 and lawful attorney for his/her and in his/her name, place and
stead, and for his/her use and benefit regarding the following described real property:
EXH A
GIVING and GRANTING unto his/her said attorney full power and authority to do and perform all and every act
and thing whatsoever requisite and necessary to be done in and about the premises, as fully to all intent and purposes
as he/she might or could do if personally present, including but not limited to contract, agree for, purchase, receive
and convey lands, tenement, hereditament, convey, mortgage, hypothecate, bargain, sell or sign any document for,
remise, and release. Also for his/her and in his/her name, and as his/her act and deed, to sign, seal, execute, deliver
and acknowledge such deeds, ]cases and assignment of leases, covenants, agreements, mortgages, hypothecations,
bil Is, bonds, notes, receipts, evidence of debt, releases and satisfactions of mortgage, judgment and other debts, and
such other instruments in writing, of whatsoever kind or nature, as may be necessary or proper in the premises
hereby ratifying and confirming all that his said attorney KATHLEEN A. BROQUET shall lawfully do or cause to
bedone by virt these presents. This Power of Attorney shall expire and terminate on: DECEMBER 31, 2013.
�1
FREDERICK M.AMICANGIOLI
STATE OF ALASKA
San JUDICIAL DISTRICT ,a— ^�
THIS IS TO CERTIFY that on this C,PifV�te.Y ry , 2012, before me the undersigned Notary Public,
personally appeared FREDERICK M. AMICANGIOLI_, known to me and to me known to be the
individual(s) described in and who executed the foregoing instrument and they acknowledged to me that they signed
the same freely and voluntarily for the uses and purposes therein set forth. _
WITNESS my hand and official seal.
(SEAL) Notary Public in and for ALASKA
i
commission expires:
Notary Public
K.SAETERN
State of Alaska
My Commission Expires May 18, 2015
EXHIBIT "A"
LEGAL DESCRIPTION
File No.: 01029-86825
Lot Five (5), CHANDELLE ACRES SUBDIVISION, according to the official plat thereof, fled under Plat
No. 79-190, in the records of the Anchorage Recording District, Third Judicial District, State of Alaska.
File No.: 01029-86825
AKC Exhibit A Legal Description Page 1 of 1