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T12N R3W SEC 27 LT 21
Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 1 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181185 PID Number: 018-092-24 Dwelling: ■❑ Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ❑t Upgrade Name: JESUS COUBERT ABSORPTION FIELD El Deep Trench El Shallow Trench X Bed EJ Mound Address 13741 Elmore ❑ Other Phone Number of Bedrooms Soil Rating depth from original grade 8i JTotal , (' GPD/SF 3 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2.5 Ft, Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot 21 Fill added above original grade 1.9 F1. Gravel length 25 Ft. Township Range Section 12N 3w 27 Gravel width Ft. Beds: Number of Lines 2 Distance between lines 6 Ft. SEPARATION DISTANCES .12 Toi Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From i Tank Field Tank Line 300 Ft2 - - Ft. Well} rjQ +50 _ __ i +25 TANK [9Septic ElS.T.E.P. ❑ Holding E]Other ADV4}v?t—:?r Manufacturer Anchorage tank Capacity 3000 Gal. Surface water+100 +100 -- -- Material Number of compartments Lot Line +10 +10 -- -- poly coated steel 3 NA Foundation +10 +10 __ -_ STATION ufacturer r1oFT Capacity _ Curtain Drain -- +50 -- I -- lift station - Gal. Remarkssystem upsized for 6 bedroom capacity Pump on level at - in. Pump off level at - in. High water alarm at - in. old tank and drainfield decomisioned on site per code requirements Pump make and model Electrical Inspections performed by Installer PIPE MATERIAL House to tank 3034 Tankto drainfield guaranteed services Drainfield3034 CO/MT3034 Inspector Charles balzarini BENCH MARK (Assumed elevation) 100 It Inspdeactiontes: 1" 7/31/18 8/2/18 Location and description 2"1 3" 8/8/18 a°, Top of Porch COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Q"fl' 'j a...:4 lot Conditional Approval: Date 7 ` ,• F., „' ' P' i C'QS , 4 . y 5kzver erV16e— i L ...... * _l— le. -- - _ ..... ......•. ll wi } cri i 1P_ect n ,nent 15. 7d .he cb tcf d- o ...... ........•...•..••.or ♦ a Qx, Baltarfnizro Approved lry - - Date /,9/I/e inspeciion mepon_a-_i-i z.00c _ 10'NON-PLATTED +' OFA Sl OVERHEAD POWER . •Ci . !q FROM POWER LINE. /�CEASEMENT 10' , .P . •• ��,k • *--49TH .* Q T 12N R3W SEC27 LOT 21 ,/ O OLD BED LOCATION(DEMOLISHED):, \ 0 h LLI OLD SEEPAGE PITS \ rA TH-1 K L CHARLES G1BALZARII NOT LOCATED DURING \ �+ F, 0E-13854 c� 0 0 CONSTRUCTION. \ +���TF�Fo -�7 '-P�� '� l� PROFESS\ .. `� � W � 12'x25'BED it \\\` 10, J i 10x20 RESERVE SITE \ I ,/ PERC PERC LOCATION REQUIRES AWWTS AND \ ADD'L SOILS EXPLORATION ` / i DRIVEWAY ti 1 CABLE,NOT �, •�. _ -------. , ORE I _ SWING TIES VANTEX SYSTEM POINT A B C DESC. B � \_ W/3000 GA r STEEL TANK& D 29.5 59.5 TANK MH �� (2)AX-20 FI TER PODS. E 79.82 70.88 MT 5 BR `•.\ `0 SIZED FOR 6 BEDROOMS )S F 26.56 46.8 MT HOME �,j_._ ._.,_., i 50�E�.L G 31.3 61.5 ATCO • F } I 'I ' H 31.5 63.2 ATCO �P•k I 67.2 57.2 CO O\Ne�L I \J5 1 75.4 62.7 CO l_ 5_, - ' H - -- BM •P ! � K 86.4 80 CO " ! \,iPOR, H I 0.\- " L 90 82.2 CO \, \ I p� ' I Y 970 LEGEND \, .0 i O CLEANOUT \ `L �:4 w0/� i • MONITOR TUBE / S TEST HOLE \...,DRIVEWAY �.' \ _ PLAN-SCALE: 1"=30' ONITOR TUBE BLUE BOARD INSULATION -+100.0'TOP OF PORCH FILTER FABRIC 94.6 _ FINISHED 96.9 TOP OF Li PODS TESTHOLE1LJ ,.COVER IIJ 92 7GRADE NOTE GROUNDWATER WAS NOT ENCOUNTERED DURING SOILS ORI„ EXPLORATION OR CONSTRUCTION BUT PROPERTY HAS A HISTORY iui •o OF HIGH GROUNDWATER 'I. 4,-;10.10.1.;..:01.:11.1 90.19INVERT 89.69 4"0 DISTRIBUTION PIPE 89.69 89.80 3000 GAL ADVANTEX TANK 0.5'EFFECTIVE SEWER ROCK NO GROUNDWATER 812118 80 7 SCHEMATIC PROFILE VIEW SHOWS ELEVATIONS OF INSPECTED ELEMENTS BUT DOES NOT DEPICT SYSTEM IN ITS ENTIRETY. SCHEMATIC ELEVATION-SCALE: NTS LEGAL DESCRIPTION:T12N R3W SEC 27 LOT 21 C&M ENGINEERING SERVICES OWNER:JESUS COUBERT DATE:08/07/18 I REV: 1 I DRAWN: CBI REF: 907-854-5558 SEPTIC RECORD DRAWING ���AL Pk Municipality of Anchorage jy� GINEER'S EArclo Development Services Department j*: N . *�� r. On-Site Water and Wastewater Section ,,, , ,,, 1 / rfi • 4700 Elmore St. _ P.O.Box 196650 Anchorage,AK 99519-6650 WWW.muni.org/onsite ./ (907)343-7904 / CHARLES G BALZARINI �++/F •. C•E•g385 4• �4��``�i Soils Log - Percolation Test Illi\PROFEssiok\-� \\\.. 6 - Performed For: JESUS COUBERT Date Performed: 8/3/18 Legal Description: T12N R3W SEC 27 LOT 21 Township,Range,Section: PERC TEST DURING CONSTRUCTION Slope Site Plan Depth COV5 j (,C f.iD.A./ (Feet) P 1�, I TOPSOIL 1- SM SILTY SAND 2 3- SW,SAND WITH SOME 4- GRAVEL 5- 6- 7- 8- WAS GROUND WATER 9- ENCOUNTERED? NO S 10- IF YES,AT WHAT DEPTH? L Depth to Water After o P 11- Monitoring? E 12- Date 13- 14- Reading Date Gross Time Net Time Depth to Water Net Drop 15- 1 8/3/18 6:35 0:00 o 0 16- 2 6:45 0:10 5-2/16 5-2/16 17- 3 6:46 0:00 0 0 18- 4 6:56 0:10 5-3/16 5-3/16 19- 5 6:57 0:00 0 0 20- 6 7:07 0:10 5-2/16 5-2/16 PERCOLATION RATE 3 (minutO$hnch) PERC HOLE DIAMETER 6 TEST RUN BETWEEN 3.5 FT AND 4.5 FT COMMENTS PERCOLATION TEST RESULTS ONLY.TEST RAN FOR 1+HOUR. PERFORMED BY: CHARLES BALZARINI I CHARLES BALZARINI CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 8/3/18 Frontier Surveys, LLC Project No: 18-328 Date:August 14th, 2018 NORTH Ordered By: Lisa Herrington Plat:N/A Grid:SW2936 Scale 1"=60' LOT 10I LOT 20 \ LOT 19 •• 1 i T BASIS OF BEARINGS-1— DRIVEWAY 1 — — — — 1 -- • N89°53'00"E 165.07 REC.4 • N89°53'00"E 165.10 MEAS.\ '' T12N R3W Section 27 LA Lot 21 ; z co ro 0 00 % 54,546 sq.ft.+/- •'F Q "' z 'J p Z 2 Story Wood Framed House • 2 I_•a+ Lo . w » F • Q LL 0. . .W O O N W W N Lu 1. LOT 11 gooet V{ N Z W i N W . m 8 .-----°*.-----°*1LT1} Q 8_0,e 0 .. _�SD 2 i w w R F \SSS I w Q Z w n u • O M tY1 01 C -- ~ \ 5\ \5T I Cm o O m N ''� M rrn M W m LOT 22 o W 0 C O O O —�},; i ! o o Oi. ASPHALT ti'GRAVEL O 0 J.:.'11,-,±c ` rrR O o O X I 3.4' •6.2' av 58.0 O O Z Z fop 18.2, 455 Z ID Z N`1-4 / i I 1 o g SEPTIC x W o © �I: I ' ` \S COVERS 1 4 , 2 Foo N 5 I I LOT 12 5 _•w o N 80.2 �,5.8' I,III t2 • o. U 0 GRAVEL WALKWAY �IIIIIIIIfv,f? ^ \ I OIrO0 if 18.6' Cte i / fn \ t!' ?..:.-c_ • m ASPHALT ,.GRAVE — 4 % / ��_ -� �° \ 50'PATENT ROADWAY ge g RESERVE \ US PATENT 1195190 • bk N89°53'00"E 165.07 REC. a 4 C. —.N89°54'14"W 164.88 MEAS. —— I O DRIVEWAY g 50'PATENT ROADWAY FF ' CCRESERVE I 4, ~l 1 I US PATENT 1205643 LOT 13 i I_ W LOT 52 � - r LOT 51 Legend: I i<• Electric Meter/Outside Power rco Telephone Pole LL Sign I� Xsy Gas Meter F4 Deck -0- Fence 0 Water Valve so Storm Drain S; Septic (W) Water Well (MB Mailbox —�— Over Hanging Power • Found Rebar General Notes: 1.This document is created for the purpose of a single property transaction and is subject to Federal Copyright Law. 2.Excepting for gross negligence,the liability for this survey shall not exceed the cost of preparing this survey. 3.All measurements/setbacks are to the visual/apparent building footprint. 0 30 60 120 4.Dimensions to property lines are plus/minus O.lft. �� Feet `` `\x•\\5\\11111 t 1 This survey complies with ASPLS Mortgage Location Standards.The survey represents visible improvements and ti 0 F , 111 conditions at the time of the survey.This document does not constitute a boundary survey and is subject to any .4 //I inaccuracies that a subsequent boundary survey may reveal.It is the responsibility of the Owner to determine .�P•' `r4. i/ the existence of any easements,covenants,or restrictions which do not appear on the record plat.Under no Lj ' •'••. //, circumstances should this document be used for construction or for establishing a boundary or fence line. *: 49TH '.* , As-Built Survey of: • P • ---7._...aT12N R3W Section 27, Lot 21 FREDERIC W. NER •' tr' I,Frederic Wagner,hereby certify that this Mortgage Inspection Survey was performed by me,or '2�^6, • No. •L.S.•9946• •' 1/4, .7 under mydirect supervision on August 14th,2018. �/� •`rte 8/15/2018 • p _ g ff 1 AR • - • ' ,o,„-,...-- Frontier Frontier Surveys, LLC FRONTIER 1 f t I SSIIONA``... 650 W.58th Ave.Suite E Anchorage,Alaska 99518 41• Surve - ti� 907.460.1686-info@frontiersurveys.com C► . . PROFESSIONAL SEAL www.frontiersurveys.com 8 A 2018-038281-0 L Recording Dist: 301 - Anchorage A S 10/9/2018 10:23 AM Pages: 1 of 4 K A 1203-27C Grid 2936 EN 18024 018-092-24 This pen -nit is between Chugach Electric Association, Inc., an Alaska non-profit electric cooperative, (herein "Chugach"), whose address is P. O. Box 196300, Anchorage, Alaska 99519 and Jesus Gerardo Cedillo COLibert (herein "Pen-nittec"), whose address is 619 Flaghoist Lane, Houston,Texas, 77079-2552. 1. Easement. Chugach is the grantee or user of an casement for the construction and maintenance of electrical facilities, as follows: Described in that certain written instrument recorded on the 3rd day of March 1958, in Book E-3, Page 173, on file in the office of the District Recorder, Anchorage Recording District, Third Judicial District, Seward Meridian, Alaska, (herein "Easement") which pertains to the fallowing described real property: Twenty Foot (20') wide casement centered on the Chugach overhead powerline crossing Lot Twenty -One (21) in Section 27, Township 12 North, Range 3 West, Seward Meridian, Anchorage Recording District, Third Judicial District, State of Alaska. Permittee acknowledges the validity of the Easement. Permittee warrants and represents that Permittee is the owner of the fee simple interest in the land subject to the Easement and the following described real property to which the Easement is adjacent: Lot Twenty -One (2 1) in Section 27, Township 12 North, Range 3 West, Seward Meridian, Anchorage Recording District, Third Judicial District, State of Alaska. (herein "Parcel") 2. Encroachment. Permittee has constructed or purchased the following improvements on or within the real property subject to said Easement: A septic cleanout pipe that encroaches approximately Two Feet (2') into the west side of said Easement for a distance of approximately One Foot (I') in width, Encroachment Permit - Page I of 4 eRecorded Document (herein, "Encroachment"). 3. Permit. Chugach hereby authorizes Permittee to continue the existence of the Encroachment in its existing location subject to the covenants set forth in this pert -nit. 4. Indemnification. Pennittee shall indemnify and hold Chugach harmless from any claims for personal injury, property damage or other loss arising in any way from the continuation of the Encroachment. S. No Expansion or Increase. Peimittee shall not in any way expand or increase the extent to which the Encroachment occupies any of the real property encumbered by the Easement without the prior written consent of Chugach. Chugach has no obligation to provide such consent. 6. No Interest in Real Estate Acquired. Permittee hereby acknowledges that the Encroachment and any additions thereto, even if in violation of this permit, has not and shall not in the future give rise to any interest or estate in the real property subject to the Easement or any other real property. Without in any way limiting the foregoing, Permittee acknowledges that the Encroachment is not adverse to any interest of Chugach and its continuation is entirely with the permission of Chugach for purposes of the common law doctrine of adverse possession. This permit creates no interest in the real property subject to the easement. 7. Modification of Utili!y Facilities. If the electric utility facilities located within the Easement are upgraded, added to, replaced or reconstructed, Permittee shall pay that portion of Chugach's total costs for such modification which is reasonably attributable to accommodating or preserving the Encroachment. If such payment is not made within thirty (30) days of written demand for same, Chugach may terminate this pen -nit in accordance with paragraph 9, below. 8. Covenants Rurming with the Land. The obligations of the Permittee arising from this pen -nit shall be covenants running with the land which shall burden the Parcel and the Pert-nittee's interest in the land subject to the Easement and shall benefit the Easement. 9. Termination. Chugach may terminate this permit after the giving of thirty (30) days written notice of such termination if. a. The Encroachment is enlarged, increased or extended within the real property affected by the Easement. b. The Encroachment is damaged by any means to an extent of more than thirty percent (30%) of its replacement cost at the time of destruction. C. Permittee fails to make the payment described in paragraph 7, above. 10. Tenn. This pennit shall, if not sooner terminated by Chugach, expire forty (40) years from the date hereof. Encroachment Permit - Page 2 of 4 2 of 4 eRecorded Document 2018-038281-0 11. Entire Agreement. This written permit constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all other prior or contemporaneous agreements, oral or written, between the parties. No modifications, amendments, deletions, additions or alterations of the pen -nit shall be effective unless in writing and signed by all of the parties hereto. CHUGACH ELECTRIC ASSOCIATION, INC. By:_ShALS6�VkAttt? Shelly Schmitt, §enior Manager Distribution Engineering Date:— Encroachment Permit - Page 3 of 4 3 of 4 eRecorded Document 2018-038281-0 STATE OF TEXAS ss: COUNTY OF RQrYj5 The foregoing instrument was acknowledged before me this day ofO RM 2018, by Jesus Gerardo Cedillo Coubert. CHELSEA DeLEON Notary Public, State of Texas 'My Comm. Expires 02.15-2021 Notary 10 131006724 STATE OF ALASKA ) ss: THIRD JUDICIAL DISTRICT Notary ublic in and for the State of Texas My commission expires- 07-11512D2A The foregoing instrument was acknowledged before me this e;AA, — day of b e. T- 2018, by 6)e- I 14 5� W'i it— Senior Manager, Distribution Engineering & Chugach Electric Association, Inc., an Alaska corporation, on behalf of the corporation. STATE OF ALASKA Notary Public in and for the State of Alaska NOTARY PUBLICMy commission expires: e3'/VZ-02'Q Stephen L. Howe 0 .My Commission Exp +11Z,?- - I I AFTER RECORDING RETURN TO: Chugach Electric Association, Inc. P.O. Box 196300 Atichorage, Alaska 99519-6300 Encroachment Permit - Page 4 of 4 4 of 4 eRecorded Document 2018-038281-0 Municipality ®f Anchorage •ter„ �: : ra, Uc�1j i P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 e Fax (907) 343-7997 http://www.muni.orq/Onsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW *** Waiver#: OSV181070 COSA#: Permit#: OSP181185 PID#: 018-092-24 Legal Description: T12N R3W Sec 27 Lot 21 Engineer: CM Engineering Applicant: Your request to have greater cover over the tank than the published approved cover has been approved. See the engineer's letter and calculation for the justification. This waiver approval applies to the existing tank only. • Waiver is Granted: X Waiver is not Granted: Date: q/.0//8- Approved by: / 6ar... .rte! Name of ,fewer **** VARIANCE/WAIVER REVIEW **** C&M ENGINEERING SERVICES Ph:907-854-5558 Municipality of Anchorage Onsite Water&Wastewater Program 4700 Elmore Rd Anchorage, Ak 99507 RE: Septic System replacement for T12N R3W SEC 27 LOT 21 Dear Ms Wockenfuss, This letter is to follow up on comments generated by the change order request and installation of the system at the above referenced property. Upon additional inspection of the property, it was found that the system may encroach within 10' of the overhead powerline. We noted that the power poles are significantly out of plumb, so various interpretations are possible. Measuring between the pole centers would show that the system does not encroach. We measured from the line itself and determined that second after tank cleanout may encroach 0.2' into the easement. The leachfield and other components were found not to encroach. A letter of non- objection has been requested from Chugach Electric. During a follow up visit, it was found that the final burial depth of the tank slightly exceeds the tank rating. It should be noted that the advantex pods and riser reduce the soil load on the tank significantly. Additionally, the over depth material is topsoil which has a significantly lower unit weight than compacted material. We've attached calculations showing the tank is capable of withstanding the actual burial depth at this site. The tank calculations are conservative and intended only for this specific application. The new bed location encroaches on the seepage pits as shown on the hand drawn records. During construction, the seepage pits were not found. It is believed that they were not located as shown. It is also possible that they were removed or filled. The department has asked for justification of a cross slope waiver for the drainfield. During construction, it was found that the slope at the bed location varied from the contours shown on the plan. The"cross" slope of the bed was found to be less than 0.5% and the system was installed appropriately for the actual topography. Thank you for your time and consideration while reviewing these issues. Please do not hesitate to contact me at 907-854-5558 or by email cgbalzarinigmail.com with any questions, concerns, or if you need additional information. Sincerely, Charles Balzarini, PE Legal Description:T12 N R3W SEC 27 LOT21 A 3000 gallon steel septic tank was installed at the property and the rated burial depth was exceed during final grading.The depth of the tank is recorded at 6.5',which exceeds. the 6'rated burial depth. The 3000 gallon anchorage tank currently approved by the MOA has been approved based on a finite element analysis performed by others which uses soil loading calculated byAWWA M11 equatio 6-2. The MOA approved calculations show an applied soil load of 759 psf based on a high unit weight of soil. Since a re-calculation of tank capacity would require structural review and significant effort,we are proposing to demonstrate that the site specific soil loading does not exceed the 759 psf shown in the approved calculations. He:= 80in= 6.667.ft Max Cover over Tank(this exceeds our measured 6.5') Nand 115 Ibf Unit Weight of Soil.Published unit weights of sandy material ft3 vary wildly.Based on our experience 115 pcf is a safe assumption for the unit weight of this material. "'topsoil 85 Ibf Unit Weight of loose Top Soil ft 3 sand + • topsoil _ 112 75 pro ooned wei ht of soil soil 16.167. -6.667) 6.667 ) ft3 P weight Bc := 751n width of tank Ltank 15ft= 180.in length of tank Hc Cc :=c = 1.067 Embankment Coefficient Bc We Cc'Noi1.13c2 =4.698 x 103. Ibf Dead Load per foot ft w Pressure:= - = 751.667.psf Uniform Distributed Dead Load Bc Approved calc was for 759 psf,so 752 is ok Check that Advantex Pods result in a lower weight than equivalent volume of soil Vpod := 91 in•40in.31 in=65.301.ft3 Volume of a AX-20 pod Wpoddry•= 400Ibf published dry weight of a AX-20 pod Wpodfull • Wpoddry+ Vpod 64 Ibf =4.579 x 103•Ibf 64 pcf is assumed for the ft3 density of liquid effluent l'pod — Wpodfull _70.125•Ibf unit weight of a pod full of water Vpod ft3 The(2)pods installed direly over the tank aleviate a significant weight of soil on the tank,in addition to the volume of soil dispaced by the 2'riser.These values are difficult to quantify using AVWVA M11 6-2,but by inspection,they significantly reduce the loading on the tank. Based on these calculations,we can be assured that the tank is structurally adequate for the burial depth at this location. �?�i ;i� .', '-a• �4 B / ..0 Pei' '49,-;" C'--431V4 ,.44. afb .,1/7/,x. ' 7 31fi -R,,k_ �,,,'''ff.y �. MUNICIPALITY OF ANCHORAGE mrti�/.2/i: 30M 7 \ On-Site Water&Wastewater Program ,o S0; • mor ,at PO Box 196650 4700 Elmore Road ` i. . Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 httpalwww.muni.orglonsite r'° ,r. / Dchartmcnt 4kcHOX P' On-Site Wastewater Disposal System Permit Permit Number: OSP181185 Effective Date: 7/30/2018 Work Type: Septic Upgrade Expiration Date: 7/30/2019 Tax Code Number: 01809224000 Site Legal Address: T12N R3W SEC 27 LT 21 G:2936 Site Mailing Address: 13741 ELMORE RD, Anchorage Owner: COUBERT JESUS GERARDO CEDILLO Lot Size in Sq Ft: 54450 Design Engineer: C & M Engineering Total Bedrooms: 5 This permit is for the construction of: El Disposal Field E Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: 1. The Engineer needs to do an additional test hole prior to the construction of the septic field. Construction may proceed at your own risk before the 7 day water monitoring is complete. Please submit stamped and signed results with the As-built Inspection Report. If the results require a design change, construction of the system will stop pending On-Site review and approval. 2. If the percolation rate is less than 1 min/in. 2' of MOA sand is required or a sieve analysis completed to determine soil type. I / 7 /-.W/(g Received By: Date: /// Issued By: /,ii/G'L/ �,_�� Date: X. 0 MUNICIPALITY OF ANCHORAGE Development Services Department it Phone: 907-343-7904 On-Site Water & Wastewater Section — Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 018-092-24 Property owner(s) JESUS COUBERT Day phone 632-3469 Mailing address 13741 ELMORE Site address 13741 ELMORE Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T12N R3W SEC 27 LOT 21 Lot Size 54,450 Sq. Ft. Number of Bedrooms 5 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field 0 Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank 0 Upgrade Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy n (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: NONE Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: -N' T" Waiver Fees: Date of Payment: 7110 [I? Date of Payment: Receipt Number:conip Receipt Number: Permit No.O Pigji& Waiver No. G\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc -7)k- Cc(C €P1Cn Ex fed Munidpality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181185,Deb Wxkenfuss,07/3CY- C&M ENGINEERING SERVICES Ph:907-854-5558 Municipality of Anchorage Onsite Water&Wastewater Program 4700 Elmore Rd Anchorage, Ak 99507 RE: Proposed Septic System replacement for T12N R3W SEC 27 LOT 21 Dear Reviewer, The above referenced property is currently served by an older, failed 5 bedroom septic system. The owner would like to replace it with a new septic system. We are proposing to install a new septic tank, and a new drain field. The old tank will be decommissioned per moa requirements. Our review of available documentation and field investigation show that this project will not adversely impact any nearby Wells, Wastewaterdisposal systems, replacement disposal sites, or drainage flowing onto and off of the subject property. Due to the historic high groundwater and history of failed systems on this property, we are proposing to install a new advantex system. The lot is served by a private well and the proposed septic system will be installed outside of the well's protective radius. Included with this letter is a permit application and design package, including plans, specifications, calculations, and a soil log. Thank you for your time in reviewing this permit request. Please do not hesitate to contact me at 907-854- 5558 or by email cgbalzarini gmail.com with any questions or concerns. Sincerely, Charles Balzarini, PE -�_ R1nr C jI • ,�, - patA., • ewater T 12N R3W pEC27 LOT 20 T 12N R3W SEC27 LOT 19 ! ,..1t'^• FOR 9 i. •I: ANCE i k /�cop.0SP181185. `w- - ...,•T \ ` / %*: 49TH " *`/ I ; /0 ••. .• f LEGEND / / 1 V I r O CLEANOUT \ ••• • ••• %•• ••• %/ \ CHARLES G BALZARIM • MONITOR TUBE \ % r ' Q- Ale 1C0'NEIGHBOR NG ;' O F GE-13854 ' ki WELL RACIUS %' • ® TEST HOLE �i T4' • ••7/27/18.•;t°*� ' l 0PROFESS\O ' . 0.5% ,i/SLOPE INDICATORf`\```tt DEMOLISH EXIS G •� BED SYSTEM OLD TREGCH // \, ,i LQZRTION i .—r.--. --'- SEPTIC AREA III 1 �EAIaCt8F7ERISTING STEP TANK 1.------____:1:11 PER MOA I - REQUIREMENTS QT 12N R3W SEC27 LOT 21 0 ILI TH-1 i' • I OLD HOME _ . a ! ` ` �',. p O OLD�yEP'T !LOCATION _ OLD$ QNS TN R3W SEC27 LOT 22 L--_ I „ LU 10'x20'BED c / PROPOSED TESTHOLE % /' 10'x20'RESERVE 'N/' ,Ni / _— ADVANTEX SYSTEM ---- / SITE .��;� � W/2500 GAL TANK 8 �l ,07 (2)AX-30 FILTER POW- �'N. // ORIVI=WAv NEW HOUNDATION`` ,' % ,\'\ �\ / CLEALOUTI / •\ / / ;' -- I \ / ./ I,x; I \ i i : 3 \5 BR \ \iI / ./. / HOME \ `� \ 1 `\ROT------...7- J / \ 411 \ ` 50 iE��.. ! 1 %\ f 4 '.. % 5�V1� — 4 sl \ p0@� % i I I \ / V \\N.,....... / 1 f N. ! Jj \\\ '� < /N. I \\ ' ) �..�'.— -� is \ -- -- -4 a - \ \ /I `\ N. DRIVEWAY ,• \ •--.—.-- — — -N / �'N.NOTES: 50'ROW \ Y \ 11 / 1.THE PROPOSED SEPTIC SYSTEM IS GREATER THAN: 50'FROM ANY PRIVATE WELLS \ OVERHEAD 200'FROM ANY PUBLIC WELLS \ ELECTRIC ; 100'FROM ANY SURFACE WATER \\ ! 50'FROM ANY STEEP SLOPES ..•N-. . 10'TO ANY PROPERTY LINE OR FOUNDATION f%- • 5'TO ANY TEST HOLES ' EXCEPT WHERE SHOWN _.-----50.ROW - SCALE:1” =40' LEGAL DESCRIPTION:T12NR3W SEC27 LOT 21 C&M ENGINEERING SERVICES OWNER:JESUS COUBERT I DATE: 07/12/18 I REV: 0 DRAWN:CBI REF: 907-854-5558 SITE PLAN REVIEWED FOR CODE COMPUE OSP181185,Deb VLbckenfuss,0: C&M ENGINEERING SERVICES 907-854-5558 Septic Design Calculations Residence: T12N R3W SEC 27 LOT 21 RESIDENCE/LOT INFO number of bedrooms 5 br Water usage/bedroom 150 gpd/br Water Usage 750 gpd DRAINFIELD system type: AWWTS, CAT III type: BED Application Rate 6 gpd/sqft required absorption area 125 sqft trench width (W) 10 ft gravel depth (D) 0.5 ft below distribution pipe Min Required Length: 12.5 ft Total Excavation Depth: 3 ft Cover: 3 ft Insulation: 2" blueboard Use Length: 20 ft Effluent Pipe: 4"ASTM 3034 Design Summary System type: BED Tank: 2500 gal New Drainfield: 10'x20'x0.5' W'xL'xD' BED absorption area: 300 sqft Calc By: CGB Date: 7/16/2018 41.44 k AtbW * *err y411110r-- 400, CHARLES G BALZARINI` 111 0/#1Fc CE13854 �SIFA� `��C'\i kt\ PROFESS\O niapality of Anchorage er and Wastewater 4; �E COMPLIANCE Municipality of Anchorage /% 6' r N = 0(.111 - erfuss 07/30': • Development Services Department / On-Site Water and Wastewater Section • • ••• • c Age 4700 Elmore St. • %r f •_ P.O. Box 196650 Anchorage,AK 99519 6650 ••• • � •• .•••••• • www.muni.org/onsite / (907)343-7904 CHARLES G BALZARI• •T �'F �•• CE-13854 • `/ e / G'i+• Soils Log - Percolation Test 1111\pROFESSIONP`��=� Performed For: JESUS Date Performed: 7/3/18 Legal Description: T12N R3W SEC 27 LOT 21 Township, Range, Section: _ Slope Site Plan 1C • Depth (Feet) TOPSOIL 1-I 2- SM SILTY SAND 3 SW,SAND WITH SOME 4- GRAVEL 5-� 6-I •7- 8- WAS GROUND WATER 9- ENCOUNTERED? NO S ' 10- IF YES,AT WHAT DEPTH? NONE Depth to Water After 11- Monitoring? NONE E 12- BOH Date: 7/10/18 13- 14- Reading Date Gross Time Net Time Depth to Water Net Drop 15- 1 7/10/18 12:23 0 0 0 2 12:29 0:06 6" 16- ' 6• 17- 3 12:30 0 0 0 4 12:37 0:07 6" 6" 18- 19- 5 12:38 0 0 0 20- 6 12:45 0:07 6" 6" • PERCOLATION RATE 1.2 (minutes/inch) PERC HOLE DIAMETER 3 TEST RUN BETWEEN 3.5 A'- FT AND 4,5 FT COMMENTS LAST 6 READINGS SHOWN,TEST RUN FOR 1+ HOURS,MEASUREMENTS TO THE 1/16" PERFORMED BY: CHARLES BALZARINI I CHARLES BALZARINI CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 7/12/18 "A� NORTH Scale 1 = 30 Legend: Frontier Surveys, LLC Project No: 18-117 Date: April 11th, 2018 I Ordered By: Stephanie Olendorff I Plat: P-664 I Grid: N/A I LOT 10 LOT 11 LOT 12 LOT 13 z O Z N O . w J L�� •• cn I� wLL L 'O O ' w w N a U O 0rA 0 Nz .;1 M a I I LOT 20 DRIVEWAY BASIS OF BEARINGS— — �— N89° 53' 00" E 165.07 REC. o N89" 53' 00" E 165.10 M EAS. I M I rn 00 r- 00 � Irl ~I Z LU SEWER MAN HOLE I al a cn \SZ $� (S-1 Z) ($'S� -s-x °U �J Ln \51 �I kk Q oN / �I I a 0 :•: z N O Y ' w J 00 J .• _ LU Q.� _ s. w O O !.' w w N cn a U O a}.01PZ O ..J O N r •4v . .:' •• O LLI • 4C o�" \ I \!�F``�9 O) 00 I\ U I ° I5.8' 80.z I L, I GRAVEL WALKWAY �' \ 18.6' .ASPHALT''.;;;` GRAVEL, \ 3 50' PATENT ROADWAY RESERVE US PATENT 1195190 LOT 19 LOT 22 N89 53 00 E 165.07 RLC. T N890 54' 14"W 164.88 77S., DRIVEWAY a T rc _ I a 0 LOT 52 rK,N Electric Meter/Outside Power c -O, Telephone Pole II -a Sign Gas Meter ® Deck Fence Water valve S; Sewer c/o ;W; Water Well MB Mailbox —OHP—Over Hanging Power 0 a x 0 I a x 0 sD Storm Drain • Found Rebar 50' PATENT ROADWAY RESERVE US PATENT 1205643 LOT 51 General Notes: 1. This document is created for the purpose of a single property transaction and is subject to Federal Copyright Law. 2. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. 3. All measurements/setbacks are to the visual/apparent building footprint. 0 30 60 120 4. Dimensions to property lines are plus/minus 0.1ft. Feet OF At 49T*H ...... .................... 4-1 ................ .........� FREDERIC W. NER r —NO. L.S.-9946 0 4/11/2018 :JF 1r �Fo o9 1 ` pRoFEs ...51 OA` l N PROFESSIONAL SEAL This survey complies with ASPLS Mortgage Location Standards. The survey represents visible improvements and conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may reveal. It is the responsibility of the Owner to determine the existence of any easements, covenants, or restrictions which do not appear on the record plat. Under no circumstances should this document be used for construction or for establishing a boundary or fence line. As -Built Survey of: Lot 3, Block 2 Gateway Subdivision I, Frederic Wagner, hereby certify that this Mortgage Inspection Survey was performed by me, or under my direct supervision on April 10th, 2018. Frontier Surveys, LLC FRONTIER* 650 W. 58th Ave. Suite E Anchorage, Alaska 99518 Sure S*t* 907.460.1686 - info@frontiersurveys.com www.frontiersurveys.com WQ lG� GAS STUB $� WQ I W � n1 w �DJ ', GARAGE DRAIN IIJ W •:. :• I. M O M M O W 0 Ln I O "ASPHALT. W °:'. GRAVEL O ° O y6.2' : z C Z / O I 3.4 ° 58.0 o Z \ 10 18 2' � O O Z a 0 :•: z N O Y ' w J 00 J .• _ LU Q.� _ s. w O O !.' w w N cn a U O a}.01PZ O ..J O N r •4v . .:' •• O LLI • 4C o�" \ I \!�F``�9 O) 00 I\ U I ° I5.8' 80.z I L, I GRAVEL WALKWAY �' \ 18.6' .ASPHALT''.;;;` GRAVEL, \ 3 50' PATENT ROADWAY RESERVE US PATENT 1195190 LOT 19 LOT 22 N89 53 00 E 165.07 RLC. T N890 54' 14"W 164.88 77S., DRIVEWAY a T rc _ I a 0 LOT 52 rK,N Electric Meter/Outside Power c -O, Telephone Pole II -a Sign Gas Meter ® Deck Fence Water valve S; Sewer c/o ;W; Water Well MB Mailbox —OHP—Over Hanging Power 0 a x 0 I a x 0 sD Storm Drain • Found Rebar 50' PATENT ROADWAY RESERVE US PATENT 1205643 LOT 51 General Notes: 1. This document is created for the purpose of a single property transaction and is subject to Federal Copyright Law. 2. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. 3. All measurements/setbacks are to the visual/apparent building footprint. 0 30 60 120 4. Dimensions to property lines are plus/minus 0.1ft. Feet OF At 49T*H ...... .................... 4-1 ................ .........� FREDERIC W. NER r —NO. L.S.-9946 0 4/11/2018 :JF 1r �Fo o9 1 ` pRoFEs ...51 OA` l N PROFESSIONAL SEAL This survey complies with ASPLS Mortgage Location Standards. The survey represents visible improvements and conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may reveal. It is the responsibility of the Owner to determine the existence of any easements, covenants, or restrictions which do not appear on the record plat. Under no circumstances should this document be used for construction or for establishing a boundary or fence line. As -Built Survey of: Lot 3, Block 2 Gateway Subdivision I, Frederic Wagner, hereby certify that this Mortgage Inspection Survey was performed by me, or under my direct supervision on April 10th, 2018. Frontier Surveys, LLC FRONTIER* 650 W. 58th Ave. Suite E Anchorage, Alaska 99518 Sure S*t* 907.460.1686 - info@frontiersurveys.com www.frontiersurveys.com ROBERTSHAFER, P.£ ROGERSHAFER CIVIL ENGINEERS (90;') 694.2979 Nove~b~q. 25, 19~)0 FAX 694.1211 SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN $OJLTEST PERCOLATION TEST George g bLLIMreE Bo6t~c P. O. Bo~ 4-138 Aneho~ge, A2~ 99509 REFERENCE~ Lot 21; 3gc. ~7, TI2N, R~, S.~. D~ M~. g ~r6. W~ ~v~ ~mp~ the i ...... ' ....... · rg{~ to ~g DEC' ~ d~d S~pt~b~ 19, 199~ ~ah~. wit~n.t~ L~ 4~ t~ the ~t~ sy~t~ ~ r~re approve. Th¢~ ~e 6~g.for a f&ow t~t and ~t~ ' ~yst~ approv~ the w~ ~64ng wi~ ng~ to be ~tended a ~ of I ~t. above ground and the pit around the w~ h~d m~t be f~ in. We wi~ ~o need to l~pe~ the ~t~ ~mpon~ ~t~n th~ ho~g. Thg ~o~ ~so~ed w~h approving th~ ~t~ syst~ are a~ 1. Extend w~l~ ~asing $175.00 2. Fi~in w~l~pit $$00.00 3. We~l Flow Tut $200.00 4. ~at~r Samples 80.00 5. ~ Sy~t~prov~ R~qu~t ~0.00 ~905.00 Ene~o~eA platte find an invoice for our ~¢¢tvie~ to date and an invoice from Twee~ Ex~av~tlng for the ~ep~e ~y~t~ Z~on. Sine~V, ROGER J. SHAFER RJS/gm ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204. DEPT. OF ENVIRONMENTAL CONSERVATION STEVE COWPER, GOVERNOR ANCHORAGE WESTERN DISTRICT OFFICE 3601 C,STREET, SUITE 322 ANCHORAGE, ALASKA 99503 !~ " 563-6775 September 19, 1990 ~.Ir. Robert A. Shafer S & S Engineering 17034 Eagle River Loop, Suite 204 Eagle River, Alaska 99577 SUBJECT: Lot 21, Sect. 27, T12N, R3W, S.M., Anchorage (9121-DA-028) (9121-FA-014) Dear Mr. sharer: The Department has reviewed your August 21, 1990 letter on the subject property waste disposal system and has the following comments: 0 The separation between the Class "C" well and private sewer on the 3 bedroom home is less than the regulatory required minimum distance of 75 ft. The Department m~y allow a var.lance ~T-t~s se~ ~ ~hC cond-i-~h~elthe.r~. P? (~oly~thylene) welded pipe ?r, restraine~ joint ductile 1to, pipe %,_be used within 75 ft. radius of the well.j~If not, ~a o~al waiver re'quest must be su~tted in accordance with 18 AAC 72.021. Your report indicates a maximum anticipated groundwater elevation 5 ft. below exiting grade. We request your reasoning on this determination. The Department ~eels that addit__iqnal monitoring of the water table is necessar~oweve~'~we may allow~ 6T~T--~-~n ~,or this]mOnitoring if the bottom of \the bed is set at a level (+) 1 {t. above original Igr~a?e~(-'-lVlso, the sand liner must be extended an ~additfonal 2 ftt_~to compensate for tile elevation q_J~se of the bed_~ Lot 21, Sect. 27, T12N, Page 2 September 19, 1990 R3W, S .[4. ~deter[nination is m. ade that the bed ~'-~o~ ed, a ~ully pressurized distribution ~,,~-~ 7[ ~_~q~uzrea to be lnstalled._~/-~is is needed.to provide eqWal distri%~-ti]roughout the dralnfield to avoid potential overloading and leakage to the ground surface. J Please provide information on the extent and age of the existing fill on the property as shown in tbe top layer of the two soil logs. The water system will require approval prior to giving approval on the waste disposal system. Please provide a flow test and water quality samples from the well. If you have any questions, please contact me at our Anchorage Western District Office at 563-6775. ~,'IP L: p f Sincerely, b[ichael p. Lewis, P.E. Environmental Engineer HEALTH AUTHORITY APPROVALS SEWER & WATER MAiN EXTENSIONS SEWER & WATER INSPECTION ENGINEESJNGSTUOIES ANDREPORTS WELL INSPECTION & PLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL It'ISPECTIONS ROSERT SHAFER, P,E, ROGER SHAFEJ'I August 21, 1990 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 State of Alaska DEPARTMENT OF ENVIRONMENTAL CONSERVATION $601 C Street Suite $22 Anchorage, Alasha 99503 REFERENCE: Lot 21, Sec. 27, TI2N, RSW, S.M. Anchorage, Alaska Request you issue approval to upgrade the on-site wastewater disposal system serving the t. wo Single fo~li~y r~blden¢~s on the referenced property. The w211 s~rvZng the referenced property was drilled prior to 1965. There is no log or record. The two or/ginally documented septic systems w~re installed in 1973. The £eachfie~d serving the house on the south portion of the property was upgraded in 1982. During t~s past y~ar the property owners experienced problems with th~ sep~c syst~ s~rving th~ so~her~y hous~ du~ to groundwat~ i~usion. ~h~n soil6 t~ts w~ perfo~d to upgrad~ t~s sep~c syst~ ~ ~s d~in~ t~ both s~st~s wer~ wlt~n groun~t~. Thus, a comp~t~ upgrad~ to both syst~s is proposed. A~ch~d for your revi~ ar~ th~ following docents: I. A sil~ plan to a I" equa~ ~00' sca~ showing th~ ~ng w~& ~ s~p~c lotions for thz r~fer~nced and a~ surroundlng prop~s. 2. A sil~ p~an to a 'I" equ~s 50' s~l~ showing the proposed upgrad~ and d~ign ~te)~a. $. A cross-section d~tail of the proposed leaehfi~d bed. 4. Two soils logs performed in the area of the proposed ~eachfi~d. 5. A list of mater/als spe~fic~ons taken from the D.E.C. Installers Reference Manual. 6. A copy of the Munl~pal file with inspection reports for the ~xisting systems. ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 Pc~g~. Two Lot 21; S¢¢. 27, TI2N, RSW, S.M. Anchorage, A~as ka Augu6t 21, 1990 If yo~ /~ve any qu~tions, review, p~ea~ contact us. or if you r~q~re additiona~ ~nformation for ~our Munlcipalily of Anchorage ~ L Street, Anchorage, Alaska 99502-0650 L~L DESCRm~O~:~ ~t Township, Range, 7 8 10 Jr", WAS GROUND WATER ENCOUNTERED? IF YES, ATWHAT ~ I~ O 11 12 DEPTH? P E 13. Ospth Io Waist Aller, I Mort orino?. ~ -Dais: 14 Reading Date Gross Net Depth to Net 15 Water Drop 20. PERCOLATION RATE .. (minutes/inch} PERC HOLE DIAMETER PERFORMED ny: $ & 5 ENGINEEEING ~ ~ -- - : 17034 Eagle River Loop Road No. 20~ ~ ~ CERTIFY THAT THiS TEST W S PERFORMED Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street. Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATEiP~ IRM~ LEGAL DESCRIPTION:· ~ "~.--I 12 13 14 15 20- Township, Range, Sectior~T~-Z.~..~ , ~__ SLOPE · SITE'PLAN ENCOUNTERED? IF YES, AT WHAT DEPTH? Oeplh Io Water After MonlierlnO? ~ Date: Reading Date Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER __ TEST RUN BETWEE.N ~ FT AND .FT $&$ENGINEERING f/ // ~ ~ PERFORMED BY' --A*-- · -. I J/J~'"'~ '"'- ~ · I 3rtre'~%'a~)le~~ '~,~/ CERTIFY THAT T~'S TEST W~AS PERFORMED IN 72'008 (Rev. 4,85) />'/ // / NAME MUNICIPAI_ITY OF ANCHORAGE DEPARTMENT OF HEAl.TH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 625 LStreet-Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAl. SYSTEIVI AND/OR WELl_ INSPECTION REPORT F~--ONE MAILING ADDRESS LEGAL DESCRIPTION LOCATION I Well t I Absorpdon area I Dwelling DISTANCE TO: OE~O Material IIOMEMADE: Inside length Wi~d~il DISTANCE TO: Well Dwellin9 Well DISTANCE TO: Top of tile to finish grad,~ Length Width Total lengtg of lines Maierial Nearest lot line NO, OF BEDROOMS PERMIT NO. PERMIT NO. Liquid capacity in gallons PER iT NO. Total effectiveabsorptio area PERMIT NO, OTHER PIPE MATERIALS SOiL TEST RATING i NSTA ~tL~-E R~-- ~f'j APPROVED 72-(~13 (R'ev, 3/78) DATE LEGAL F'ERMIT NO. RPPLICFINT GEORGE C BOSTER LOCRTION LEGBL T:t2NR3:N S27 T"r'PE OF: SOIL FIBSORPTION S"r'STEM DEPRRTMENT OF HEFILTH END ENVIRONMENTBL PROTEBTION 825 "L' STREET., 8NCHORBGE., BK. ~3f-4--S] l: TE SE[qEE~ F'ERI'd I T' 0::L2 L. OT SIZE L'~9999'_a SQURRE FEET IS: 'FRENCH 11"~(3 ,- ..... . MFI,'..,:IMLIM N.MBER OF E:EB, ROOMS SOIL RHTiN= (S6~ FT,,'BR)= 1~.., ~ '~O~z THE RE;~ IRED _,I~E OF THE _,OIL FIBSORPTION =,¢=,TEfl Z .... ~ '¢ ~ ¢~ TNE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRFIINFIEL[:,. THE DEPTH OF' R TRENCH OR PIT I9 THE DISTRNC:E BETHEEN THE SURFACE OF THE GROUND FINE, THE BOTTOM OF THE EXCFP,,'FITION (IN FEET). THERE IS NO SET 14IDTH FOR ]"RENCHEg. 'THE GRFIVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETNEEN THE OUTFRLL PIPE RN[:, THE BOTTOM OF THE E',:'(CIg,/RTION (IN FEET). PERMIT FIF'F'LICFINT HFIS TI-tE RE-,PUNzlEILIT¥ TO INFC~M THIS [:,EPBRI'MENT DURING THE IN-.THLLHTIuN IN=,FECTIuN~ OF RN'¢ NELLS FIDJBCENT 'ro THIS PROPERT'¢ RN[:, ]"HE '~ ~, '- r' ',% ,~ ,:,,, NLli',IBER. OF RE_I[EN_E_ THBT THE NELL NILL .~ER E. T ~.._llEi .:' ;=:" '~ ~ II'-.I:--L--=PECT .'[ e]ll'-45 I=~E:E F~.' E L--~. Ell 1 F~.E[ BFIuF. FILLING OF FIN¥ S'¢L:;TEM .t4I'I'HOUT FINFIL II'.4SF'ERTICd'4 FIND RPPROVRL B'~' THIS [:,EF'FIRTMENT NILL BE _,UE, JECT TO PRL]SE]L TION. MINIMLIM DISTFINCE BETNEEN R NELL FIhID RNY ON-SITE SEHFIGE DISPOSFIL S'¢S-I"EM IS 1OO FEET FOR FI PRIVFITE 14ELL OR 15E~ TO 200 FEET FROM FI PUBLIC NELL DEPENDING LIPON THE T"r'PE OF PUBLIC NELL MINIMUH DIS'¥FINCE FROM FI PRIVRTE NELL TO FI PRIVFI'TE SENEF.: LINE IS 25 FEET RI,ID TO R COi'4MUNI]"'¢ SENER LINE IS 75 FEET. OTHER REQUIREMENTS MFI¥ RPPL'¢. SPECIFICRTIONS FIND CONSTRUCTION DIFIGRFIMS RRE B',/RILI=IBLE TO INSURE PROPER INSTFILLFITION. F'EF~:I-1 ][ T E~-::P Z F-.'E $ [-=.ECEI'-IBEF-." -----=:1~. I CER]'IF¥ THR]" 2[.: IRM FRMILIRR NITFI THE RE6~UIREi',IENTS FOR ON-SITE SENERS RND klELLS FIS SET FORTH 8~-' THE MUNICIPFILIT'¢ OF FINCFIOR. FIGE. 2: I NILL INSTRLL THE S'¢STEM IN 8CCORDFINCE NITH THE CODES. 3: I UNE, ERSTFIND THFIT THE ON-SITE SENER S'.r'STEM MR'¢ REQUIRE ENLRRGEi',IENT IF THE RESIC, ENCE IS REMODELED TO INCLUDE i',IORE THRN 5 BEDR'OOi',IS. S, IGNE[: :-BPPLIC~4T GEBI~:QE L: BOST:~.- -- ~ ...... ,FITE_ 0 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anci~orage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST [~ SOILS LOG [] PERCOLATION TEST LEGAL DESCRIPTION: 1 2 3- 4 6 7 9 10 "---~41 12 13 14 15 16- 17- 18- 19- 20- SLOPE E:~-F~od ,~F .RC, LE' SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop ~,~;,; U;' ,,,/~.~ ,_. ,.¢ ...,,- . PERCOLATION RATE {minutes/inch) COMMENTS PERFORMED BY: 72-008 (6/79) TEST RUN BETWEEN FT AND FT Gr 'R ANCHORAGE AREA BORO~ DurAflTMENT OF ENVIRONMENTAL QUALI,, 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING NAME ~'~.'w~ ~'z?-~ ~)' ~:~:' ~ f '~Z~-~z~' _ADDRESS ·~'/)~l~ '/~ ~/~ ~ LOCATION /~~'.4/ ,~,W~-~ ~ LEGAL DESCRIPTION SEPTIC TANK: ./,,/,.), ~z.- ~ /_~;~-'- COMPARTMENTS __ LIQUID LIQUID CAPACITY //':-'~'~ .__ GALLONS. INSIDE LENGTH. INSIOE WIDTH -- DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS LINING MATERIAL NEAREST LOT LINE OUTSIDE DIAMETER // OR WIDTH --' . LEN TH ., DEPTH '-- . DISTANCE FROM WELL f/~.~--'~g~-;~ BUILDING FOUNDATIOJ~/~'~'~'~'~,,~'' TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. TILE DRAIN FIELD: TOIAL LENGTH DISTANCE PROM WELL FOUNDATION NEAREST LOI LINE , OF LINES NUMBEr OF LINES TANcE BETwEeN .trENcH WIDTH --- .... IN. TOTAL EFEEcnvE ABS SQ. FT. LENGTH OF EACH LINE_ DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEArH TILE }N. ABOVE TILE WELL: ~ ~,~-~',e~ DISTANCE FROM WATER TYPE-'~/-~-'~/'~'~ DEPTH , BUILDING FOUNDATION. SAMPLE ~ , NEAREST ~ NEAREST ~ SEPTIC ~ SEEPAGE ---- OTHER LOT LINE ., SEWER LINE . TANK SYSTEM__ , CESSPOOL -- , SOURCES ~-- DIAGRAM OF SYSTEM G.AAR GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. SEWAGE DISPOSAL SYSTEM -- APPLICATION AND Pt~RMIT INSTALLATION OF: SEPTIC TAI'IK :SEEPAGE PI , DRA~IN FIELD ., OTHER MINIMUM DISTANCES, [~EQUIREMENTS FOUNDA'rlON TO SEEPAGE PIT WeLL l'O SEPTIC TANK ~.~ SEEPAGE PIt . CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS GRAVEL BACKFILL CONFORM TO BOROUGH REG LATIONS REGARDING INSTALLATION. OR LICENSED DESIGNER AREA SIZE TYPE I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA E~OROUGH ORDINANCE NO, 28-68 AND THAT THE ABOVE DESCRI D SYSTEM 15 IN ACCORDANCE WITH SAID CODE. GREATER ANCHORAGE AREA BOROUGH SEWAG£ DISPOSAL SYSTE~ ~ APPLICATION AND P£RMI~" DRAIN FIELD _ DRAIN FIELD I CERTfFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGe AREA BOROUGH ORDINANCE NO. 28-68 ANd THAT THE ABOVE DESCRIBE SYSTEM IS IN ACCORDANCE WITH SAID CODE. G"" '~R ANCHORAGE AREA BORG' b,.?~RTMENT OF ENVIRONMENTAL QUAL,, ¥ 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECIlON REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: NUMBER OF DISTANCE FROM WELl ~'~ _MATERIAL .~-"'~'-~'~ _COMPARTMENTS ~ LIQUID CAPACITY ~"~'~-~,~'~ _GALLONS. INSIDE LENGTH -- .__INSIDE WIDTH -- _DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: ,~---~-.-~/:.-~-~/'J"~ NUMBER OF PITS ~ ~.~f~,~?~-. OUTSIDE DIAMETER _OR WIDTH LENGTH__ , DEPTH LINING MATERIAL '~'~) ~¢~ DISTANCE FROM WELL__ ..,~/e/~, NEAREST LOT LINE ~ ~ ~ ~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~ SQ. FT. · BUILDING FOUNDATION~t¢~/ TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELL .~IJNDA-TJ~HN~. NEAREST LOT LINE ., OF LINES NUMBER OF LIN ANCE BETWEEN UNES '~_ TRENCH WIDTH ~-~ ,~-~"~ IN. TOTAL EFFECTIVE ABSORPTIO AREA SQ. FT. LENGTH OF EACH LINE ~ ~- - ~ ~/ DEPTEE TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE __IN. ABOVE TILE. WELL: ,~' ,,, 4,~:/./.,.~ - ,,,~,>..~,.~, ,~, ,-,~,,~- .~,-~-- - ,,.~./.~.,~:.z,, ~ TYPE~/_~__ DEPTH ~ / DISTANCE FROM WATER _,BUILDING FOUNDATION. / _SAMPLE ~/~, NEAREST LOT LINE /~ ~ NEAREST SEPTIC SEWER LiNE _, TANK~ ~ SEEPAGE / OTHER · , SYSTEM //~ CESSPOOL//~ , SOURC~/~ DIAGRAM OF SYSTEM DISTANCES: APPROVED. G,A.A.B. August 20. 1973 i~ir. alld i,~rs. George ~ox 4-138 A~,lchora,(je, Alaska C. Boster On-site sewer and water system serving Lot 21, Soc. 27, 'F12N, Dear iqr. and Mrs. )~oster: Eliclo~ud i)lease find a copy of th~: Si:ate of Alaska Supply Code w~ich ~.~s in effect at th(: tt~e you obtained your sower IJer),~its from this department. Sections 251 and 265 deal with well construction and well distance requirem~;nts to se~.~age disposal systems. Sincerely, C.S. iqcKechnie, E~)vironmental Control Officer CSt,I/ko Enclosures Cord14(o)ia C 0_5 • '� Municipality of Anchorage U On -Site Water and Wastewater Program (907) 343-7904 s a v o r Certificate of On -Site Systems Approval 12/711 a Parcel I.D. (q04i� firl�1�7_1�1�13•I7�i►_�ii[�P.l /Qirtu/ Expiration Dat . Complete legal description T 1 ,;X.0 l:� -3&t1 7 :� _7 LZJ f r,;2 7 Location (site address) P-1 E Current Property owner(s) 1 r?y� ``���� Day phone Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: [9 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual Jcj Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: 0 Received by- Date: , l COSA to be r o the engineer, unless otherwise requested by the engineer. COSA Fee $ Waiver Fee $ Date of Payment (a Date of Payment Receipt Number G%(,99 t,l Receipt Number COSA # C[ S t I Waiver # conk. f2 -7q y�71io 01.00ID 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. .rUJr� ive, `? SSS Sia Name of Firm C..� -rPhone Address�� Perry,d oL An- sewer -,erVtcc ltne a/i4h1n -61e- Engineer's Printed Name �i-l/4�F-�S t�f1'M-L %je iuhr�t ed Date 6. DSD SIGNATURE __X_ System #1 Approved for -,6_ bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, 64 f✓ • • t • ° • "e 1 s s ��� t ARLES G BALZARINI r ).��F��• G� 13854 ' � r 4 with the following s�i1:t'se�,-�' - a EnGrrxcc_`'in'1e�if Perry,d oL An- sewer -,erVtcc ltne a/i4h1n -61e- eGtSeMen j- l rs %je iuhr�t ed �0 0it 51 e- bV ae. ON-SITE �. `A/ATER AND ��� l..yll U ly✓t. / t tai 1/'rW 'i i Yl,�dTEv-lIATt_n -� PROGRAM By: 1 lj(/ — Original Certificate Date: g The Municipality of Anchorag Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet_r '- . c If more than 1 septic system is on the lot: COSA Checklist# 1 of1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: T ( >-N Rt ) 5 2 7 t'' 1 Parcel ID: 015 •O.IA'4 A. WELL DATA Well type fry✓c % If A, B, or C provide PWSID# Well Log (Y&4410 Date completed� Oc l'73 Sanitary seal ON)/e5 Wires properly protectedetN)) 5 Total depth J 0 ft. Cased to 1-6,--4 ft. Casing height (above ground) -t)-u in. FROM WELL LOG AT INSPECTION t1 Date of test tt< V / 5 Static water level thNK ft. "l-'6� ft. Well production U�ke` g.p.m. .4 ".) g.p.m. WATER SAMPLE RESULTS: Coliform -���' colonies/100 mL Nitrate Ai h mg/L Arsenic f" ug/L Date of sample: 7/b/1', Collected by: CA-likete5 13N- 441 ''' B. SEPTIC/HOLDING TANK DATA ,� / Tank Type/Material A.�VANsF Tt^)( � EEL Date installed A 115 Tank size 210Q-7 gal. Number of Compartments 3 Cleanoutsdx Yo 5 Foundation cleanout&N)/F., Depression over tank(YID.40/0 High water alarm(1NN) Y��S Date of pumping /tit it Pumper iv/n C. ABSORPTION FIELD DATA Date installed 84MS Soil rating (g.p.d./ft2.43Piiikaik - O System type 3�' Length _aide p I ,S ft. Width IA- ft. Gravel below pipe 49-5 ft. Total depth 4...7 ft. Eff. absorption are- pa'''. a''. vv ft2 Monitoring tube ` Depression over field NO • Date of adequacy test A//f} -NES Results C/Fail) PA 9$ For d tedrooms Fluid depth in absorption field before test_ _in. Water added_ gal. New depth _in. Elapsed Time:_ _ min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) /O If yes, give date/t//+¢ D. LIFT STATION Date installed 'J' LST Size in gallons Manhole/Access (Y/N) "Pump on" level at ' in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm &circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot .'+ 50 On adjacent lots ♦ tc70 Absorption field on lot 4 50 On adjacent lots .4 100 Public sewer main '4 too Public sewer manhole/cleanout '+' too Sewer/septic service line 4 .15 Holding tank 't tOh`) Animal containment areas 4-100 Manure/animal excrete storage areas -f 1c1:7 SEPTIC/HOLDING TANK ON LOT TO: Building foundation 4 10 Property line 4 10 Absorption field "410 Water main .} 1,0 Water service line 410 Surface water .4 106 Wells on adjacent lots ESC) ABSORPTION FIELD ON LOT TO: Property line + 10 Building foundation •f l 0 Water main "f IC) Water Service line +10 Surface water .fico Driveway, parking/vehicle storage 4142 Curtain drain + G Wells on adjacent lots-t IV • F. COMMENTS G. ENGINEER'S CERTIFICATION ",etc CIF A� \,k I certify that I have determined through field inspections and yA. ? ••• ' •'7 �—�� review of Municipal records that the above systems are in /�'CVi '9 I, conformance with MOA COSA guidelines in effect on this date. >,*:• 4 "' TH �••* f/ Engineer's Printed Name m5 P�"'-2�'gt • • • • • • • • • Date U' 5 + 46 • • • • ` : . • /4 - -LES G BALZARINI �% `�`;PROFESSIONr--4," COSA canary sheet_2-6-15.doc MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the"AGREEMENT" made and entered into as of this S Day of 3.m.,/ of 20 1'' , by and between Zy't 1 ?1 OZT V/d}g-.KL.4(—i ,herein the"OWNER,"and the Municipality of Anchorage,herein the"MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein,the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as ADVANTEX located at(legal description) T12N R3W SEC 27 LOT 21 2. Maintenance,Repairs and Alterations. (Owner is required to read,understand and initial each section) Throughout the term of this Agreement,the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in ccordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all gira ,� repair(s),maintenance, adjustment(s),replacement costs,and inspection costs. This includes an annual maintenance fee(typically$400 to$600). `, I Owner agrees that only maintenance and repair personnel approved by the Municipality VW or the manufacturer's representative will inspect and make any necessary maintenance, re.:Ifs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential 1'Ifailure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of3 Owner acknowledges that the Municipality may request records of maintenance and ,,,_______ repairs from the manufacturer's representative or maintenance provider. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. ywner agrees to grant the Municipality reasonable access to test and inspect the " AWWTS. The Municipality will give at least 24-hour notice. ...1 ---- Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. / -4----caner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction,maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system,or upon transfer of title,and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions,nor in any way affect the validity of the Agreement or any part hereof,or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of3 1 OWNER By: //�' / (signature) Date: -Q-S-- TK,-..r Qc,t �\\\\\\U 01111//1J///// I B,9` f J 4-KL4/✓8 (print name) �ommyno.1-.0, :�A �: STATE OF ALASKA ) ! NOTARY *_ *`• PUBLIC :e,` THIRD JUDICIAL DISTRICT • ) 13!:1!.?.(?;ti°yR`��\\ odao//jOIIFIIINA�\Li \\\\ The foregoi instrument was acknowledged before me this 7� y f 1�} 20 Ib,by Debv0.124n Voi.4,-,.._..i/,. ., / i A NOTARY / BL/ FOR ALASKA My Commission -xpires: 202/ ify_Z6 MUNICIPALITY: By: (signature) Date: (print name) Title: (rev. 05/18/2018) Page 3 of 3 OWNER: I By: wI. i L (signature) Date: Q"-i '1 yS - ?p � \\II) \?(A�1 RVC` (print name) �����\�` 113Jo! j/i `a X01;'of i;;d.6!i STATE OF ALASKA ) =,f1.. AIIVIONI• DI'ISfld ** THIRD JUDICIAL DISTRICT )ss �44,!.!.•,0o,;t,0,46' .- iiij� ,.{ uKi1\\\ l_j The foregoing in�strument was acknowledged before me this_' 6 0 U , 204,by A) r, , ' ih (Anutte ill.'! 'Al ,J / NOTARY 't.BLI 'OR ALASKA My Commission e pires: Q MUNICIPALITY: By:---,QOZt) / - / signature) Date: C7�� 7:) C Pn' ,- 1) .UD h (print name) Title: (rev. 05/18/2018) Page 3 of 3