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HomeMy WebLinkAboutT12N R3W SEC 33 LT 241 E2Onsite File T12N R3W Section 33 Lot 241 E2 #018-322-17 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191513 PID Number: 018-322-17 Dwelling: ❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑ Upgrade Name Carlos C. Carillo Living Trust ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 15500 Old Seward Hwy. Anchorage, AK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 6.0 GPD1SF 5.6 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 5.1 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot 241 E1/2 Fill added above original grade 0.0 Ft. Gravel length 26 Ft. Township Range Section 12N 3W 33 Gravel width 5 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 130 Ft2 1 FL Well >50' >50' N/A N/A >25 TANK ❑ Septic [:1 S.T.E.P. ❑ Holding p Other Manufacturer Orenco/ Advantex F.A.P. Capacity 1,500 Gal. Surface Water >50' >50' N/A N/A Material Fiberglass Number of compartments 2 Lot Line >5' >10' N/A N/A NA Foundation >10' 0' > 1 0' N/A N/A LIFT STATION Manufacturer Capacity Gal. Remarks Septic is adequately sized for 4 bedrooms. Alarm location Inside home, near NW corner. 1 Electrical installed by Power Lighting & Control LLC PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 Installer Denali Exavating Drainfield D3034 Co/MTD3034 Inspector J. Williams BENCH MARK (Assumed elevation) 100 ft Inspec2�dion 151 12/17/19 12/18/19 Location and description dates: r Threshold of back door. 34'h ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp ®®�� OF Conditional Approval: Date ��P,>>•°°'' .aS�® ....ra ...9th ... .. ..... �..... ..........................nu..............� �� �geMICHAEL E. ANDERSONl�_ � ®� fes:• No. CE-4381 Se tic S stem p y J n ApprovedDate�10pF F,•.,,.�`v27/Zo ,..•'��� Note: ���'IS' this approval does not include well permit requirements. Rev (Rev 05/02/18) T12N R3W SEC. 33, LOT 241 EAST 2 PERMIT # OSP191513 LOT k` 7 / La PAN ESTATES LOT 3J �r 50' RADIUS PIPE FOR ' ELECTRICAL /^\ INSPECTION /� 100' RADIUS ® l \ EXISTING WELL B ' ! \2C \ \\\ MH � yO PID #018-322-17 I r ! � 1 `-~ — O'.ACCESS ESMT E2 K 32, PG 208) 1,500 GALLON AMM NTEX TANK MH -� ! FXP TANK. - '�TH1® 2C 21 ® SHED, MT 1 L®\1AIr:ll CARFORTI 26' LONG x 5' WIDE x.5' , EFFECTIVE DEPTH I t "AES SORPTION TRENCHr MT2C0z ! \ \-M-AINTAIhl,12' SEPARATION \ EXISTING r�® ��FRONhOLD TRENCH. � \ EG ITRENEH_ ALTERNATE SITE. \\ -AB Q N C N_P AG \ EXI- ~NG TANK EILL'Et&, y \ TABAN_DONED-IN, PCA'E TOW OF-8LU.EF LOT 241 W2 r / ~a 1 1 It ENGINEERING .' • 49th MICHAEL E. ANDERSON No. CE -4381 `QF1/13/20 .''•....•• ®®� °ROFESSIt®®d PLAN AS -BUILT 0 50 100 kON ME �M NM FEET 111=50' 50' RADIUS 100' RADIUS \ A_ 2j01 I 3.4 •.M —MF42-- ,53:05 — 48:45... ti 53:2 PLAN AS -BUILT 0 50 100 kON ME �M NM FEET 111=50' 50' RADIUS 100' RADIUS \ A_ 2j01 50.8 3.4 •.M —MF42-- ,53:05 — 48:45... 2 Z 53:2 --51,q, �C01 5I 7 -75Z.2 MTI 54:0` ''54.-4 CO2 55-j-, MT2 57.0 75,I ELECT. 18.8x` 5.9 LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT EI - ELECTRIC INSPECTION MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE T12 N R3W SEC. 33, LOT 241 EAST 2 PERMIT # OSP191513 P I D #018-322-17 0�- 0 73 95.8 ORIGINAL/FINAL GRADE 90.7 D RAINFIELD ROCK 90.2 MOA APPROVED FILTER SAND 8.2 26' - NO GROUNDWATER 10/22/19 81.8 PROFILE AS -BUILT ENGINEE0.I NG (NO SCALE) 88.2 90.7 90.2 .11l CllC Municipality of Anchorage llepar[ment P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Section * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV201004 COSA#: Permit#:OSP191513 PID#: 018-322-17 Legal Description: T1 2N RM Section 33 Lot 241 E2 Engineer: Forge Engineering Applicant: Carlos C. Carrillo Living Trust Your request for a waiver of the required. 12.0 feet horizontal separation from the new absorption field to the existing absorption field has been approved. The approved separation distance is 6.0 feet. See engineer's waiver request for justifications. This waiver approval applies to the existing absorption fields only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ............................................... ■ ............................. ■ 1 Waiver is Granted: X Waiver is not Granted: Date: Idwo Approved by:��Jutou Name of Reviewer ............................................... ■ ............................. ■ 1 **** VARIAN C E/WAIVER REVIEW **** c)sv a01 d 6L - *)a 5 Ped 1/2tl20z E N G I N E E R I N G PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) January 17, 2020 MOA Development Services Department On -Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: T12N R3W SEC 33 Lot 241 E2 —15500 Old Seward Highway Absorption Trench to Absorption Trench Waiver Dear On -Site Services Engineer: The existing trench on the subject property was not clearly documented and impossible to accurately locate in the field. The end of the new trench is now placed approximately 6.7' from the old trench. A waiver is therefore required since we can't meet the 12' or twice the effective depth of the absorption trench requirement. Underlying soils on the lot are primarily clean gravel with varying amounts of sand based on test holes completed in the past. Absorption rates are typically under 5 minutes per inch. Very little horizontal migration of effluent is expected and absorption should be in a downward direction. In addition, the new system is an Advantex Category III Treatment System. We request a waiver be issued allowing the existing absorption trench to remain at the location shown. Sincerely, Michael E. Anderson, P.E. Lot 2 Cn M � N �-- M co co M Z W W 0 l.— r— N U c0 NT W O O 0 0 00 O O 0U) N 1- 0 N 0*9 GOLD PAN ESTATES Lot 3 N8905615211E (R) N8904615711E (M) 165.01 (R & M) a; N 0 Carport ;0.9 Goo .O Cc, •O Septic tank oa Septic vent (typ) Well Window well (typ) o 00 2 Story Frame House with Basement Top of Bluff a o EN 8486T I a) I 0 w LEGEND (n 11 I (� M (R) Record per Plat No. 74-29 (Gold Pan Estates) �Q o I (R1) Record per Record of Survey (Potter Point Game Refuge) o m (R2) Record per Plat No. 2006-57 (BIRD TLC Subd.) N (R3) Computed per BLM plat of Section 33 dated 1-25-1968 j (M) Measured �,A l ,q N, Ora va �� Van encroaches 0.2't Shed Carport E 1/2 LOT 241, SECTION 33, T12N, R3W, S.M., AK 165.08(R3&M) BASIS of BEARINGS N89°57'36"W (R1) POTTER POINT GAME REFUGE N m SCALE: 1"= 50' O 0O Cn OCD ``�� ch M 4%p,OF ,q W W �,�P•• ••S , 00 o m 49th O00O ... .. O o 0 O O 0 •• •• Z C/) / 4,'A izabeth L. Walatka �� • • 8036 - LS • • FAff C)YOFESSIONPA- �� RECERTIFIED 1-15-20&00 AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection in accordance with ASPLS Standards of the following described property: E 1/2 LOT 241, SECTION 33, T12N, R3W, S.M., AK Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 11th day of October , 2019. EASEMENTS OF RECORD, OTHER THAN FRED WALATKA & ASSOCIATES, L.L.C. THOSE SHOWN ON THE RECORDED FB 20-2, pg 2 Engineers and Surveyors 907-248-1666 PLAT ARE NOT SHOWN HEREON FB 19-8, pg 21-22 BE g y UNLESS OTHERWISE NOTED. This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to establish any fence. structure or other improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product. 12-/17/17 (a.i 5----ALfTy MUNICIPALITY OF ANCHORAGE /Z/s'/9 On-Site Water&Wastewater Program �e �`t i ''Aye% PO Box 196650 4700 Elmore Road 4. 1 «,.r4.i•1 , 1 Anchorage,Alaska 99519-6850 Phone:(907)343-7904 Fax:(907)343-7997 ...t:;. :• http://www.muni.org/onsite Q'- 4 a CI • .C40110.61. L I: tmeut On-Site Wastewater Disposal System Permit Permit Number: OSP191513 Effective Date: 12/16/2019 Work Type: Septic Upgrade Expiration Date: 12/15/2020 Tax Code Number: 01832217000 Site Legal Address: T12N R3W SEC 33 LT 241 E2 G:3134 Site Mailing Address: 15500 OLD SEWARD HWY, Anchorage Owner: CARRILLO CARLOS C LIVING TRUST Lot Size in Sq Ft: 54450 Design Engineer: FORGE ENGINEERING Total Bedrooms: 4 This permit is for the construction of: El Disposal Field Q 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 Received By: ()tet ll%Udit+ 4( ;4-1 /21/q i. (�j Date: �(q Issued By: 410;14.4 „i______ Date: /2----7/ 7/f EPL4AJiS MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On-Site Water& Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 018-322-17 Property owner(s) Carillo Carlos C Living Trust Day phone 301-5141 Mailing address 11401 Old Seward Highway Anchorage, AK 99515 Site address 15500 Old Seward Highway Anchorage, AK Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T12N R3W Section 33, Lot 241 E1/2 Lot Size 54,450 Sq. Ft. Number of Bedroom ' APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: IN all that apply) Absorption Field U Initial ❑ Single Family (SF) [ (w/wo ADU) Septic Tank ❑X Upgrade X Duplex (D) [ Holding Tank ❑ Renewal [ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well U Water Storage [ THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR: Well to Septic System Distance: 75' I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. -rvL„ILI, E._04A-r9-1 (Signature of property owner or authorized agent) Permit/Rush Fees: 595 Waiver Fees: 0 20 Date of Payment: /i 1/thq Date of Payment: ii l j '/iq Receipt Number: 001,5( b Receipt Number: Permit No. P/9/6i; Waiver No. 05 V I9 loge/ Permit App_:-:•::..:c PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) December 10, 2019 MOA Development Services Department On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: T12N R3W Section 33 Lot 241 E1/2 – 15500 Old Seward Highway Septic System Design Dear On-Site Services Engineer: The owner of the above lot intends to replace the existing failed septic system on the property with a new four-bedroom Advantex Treatment System. We are submitting this design and permit application for the construction of a new septic system. The attached site plan identifies the location of existing wells in the area, the existing septic system and the proposed septic location. No waivers are required as the new system will be constructed more than 50’ from all wells in the area. The ground surface on the lot slopes to the southwest at grades greater than 25% more than 35’from the area of the septic system placement. The absorption trench has been designed to meet the steep slope requirements of the Municipal Code. Contours are shown on the site plan showing the grade and direction of flow. Storm water drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Additional percolation tests will be required during construction of the absorption trenches to verify the subsurface soils are consistent with our design. We request a provision be added to the permit requiring these tests. Please refer to the attached test hole log and plan and profile sheet for the septic design. If this design is followed no adverse impacts will occur to adjacent properties. Sincerely, Michael E. Anderson, PE 12/10/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191513, Deb Wockenfuss, 12/16/19 115 110 12 0 10050 0 FEET 1"=50'3-BDRM H O M E NOTE: NO SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. CONFLICTS WITH WELLS OR SEPTIC SYSTEMS HAVE BEEN ADDRESSED. CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND TH1 T12N R3W SEC. 33, LOT 241 EAST 2 12/16/19 TOP OF BLUFF CARPORT SHED 20' ACCESS ESMT (BK 32, PG 208) EXISTING WELL EXISTING WELL 1,500 GALLON ADVANTEX TANK w/AX-20 POD. 50' RADIUS 50' RADIUS 100' RADIUS 100' RADIUS DECOMMISSION EXISTING SEPTIC TANK PER M.O.A. CODE. 25' LONG x 5' WIDE x .5' EFFECTIVE DEPTH ABSORPTION TRENCH. MAINTAIN 12' SEPARATION FROM OLD TRENCH. MH MH ALTERNATE SITE. DECOMMISSION EXISTING ABSORPTION TRENCH. REMOVE ABOVEGROUND PIPE CO 2CO 2CO CO MT Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191513, Deb Wockenfuss, 12/16/19 T12N R 3W SECTION 33, LOT 241 EAST 1/2 DESIGN FACTORS: SYSTEM REQUIREMENTS: 750 GPD PEAK FLOW PERK RATE: <1 MIN/IN APPLICATION RATE: 6.0 GPD/SF 5' WIDE TRENCH SYSTEM 1,500-GALLON STEEL ADVANTEX TANK w/AX-20 POD 2' MOA APPROVED SAND TYPICAL TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY 750 GPD / 6.0 GPD/SF /5' WIDE * 1.0 (RED. FACTOR) = 25 LF TRENCH REQUIRED (25 LF SPECIFIED) 12/16/19 4" PERFORATED PVC (HOLES DOWN) 5' 6" 4' 2' BOTTOM OF TRENCH: 5' BELOW GRADE FLOW LINE ELEVATION: 4.5' BELOW GRADE TOP OF TRENCH: .5' ABOVE GRADE 6" 6" DRAINFIELD ROCK MO.A.APPROVED SAND GEOTEXTILE FABRIC Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191513, Deb Wockenfuss, 12/16/19 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE 1 SLOPE SLOPE SITE PLAN DATE READING GROSS TIME (minutes) NET TIME (minutes) DEPTH to WATER NET DROP TEST HOLE PRESOAKED PRIOR TO TESTING: PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) T12N R3W SEC33 L241 E2 10/15/19 L. Tidwell DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING: IF YES @ WHAT DEPTH? - .22 6 3 4 018-322-17 CLIENT 10:46 10/15 1 2 3 4 5 6 136 - 142 OB Professional Engineers Stamp: 12/11/19 0:55 No None 10/22/19 3"- SANDY GRAVEL GP 6" 10:49 1:01 6" 10:52 1:05 6" 10:53 1:18 6" 10:58 1:15 6" 10:59 1:19 6" 136 - 142 136 - 142 136 - 142 136 - 142 136 - 142 Very sandy material. digging went fast. walls of hole stood until about 13' then began to sluff off. Sand liner required. percolation test measurements BOTTOM OF HOLE taken to the 1/16th inch increment. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191513, Deb Wockenfuss, 12/16/19 LOT 2 2 U) C0 C0 Z M CO CZ4 (Y) CY) cvi CY) co C,e) Z LU W 0 m L0 (0 P: 7-N 0(0"'T W (::) C) wo 0 C:) C:) Cf) C*q W I- 0 t- 17 GO Well c' Window well (typ) ® N N Carport Septic vents 21.9 0 00 LEGEND (R) Record per Plat No. 74-29 (Gold Pan Estates) (R1) Record per Record of Survey (Potter Point Game Refuge) (R2) Record per Plat No. 2006-57 (BIRD TLC Subd.) (R3) Computed per BLM plat of Section 33 dated 1-25-1968 (M) Measured =4 ---,-,Top of Bluff *41 OF A 00 -57 v49th 00 00- 05 CD 0 0 a 0 40 .0 coco 00 CO lizabeth L. Walatka 00 0 E 1/2 LOT 241, SECTION 33, T12N, R3W, S.M., AK LS UJ III < 8036 0 E0 "OF-Esslosm- \Y C) C:) 0 0 c) CD C:) 0 z U) 0 _J 165.08 (R3 & M) BASIS of BEARINGS N89057'36"W (Rl) POTTER POINT GAME REFUGE EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. UNLESS OTHERWISE NOTED FB 19-8, pg 21-22 AS -BUILT NO CORNERS SET TMS DATE I hereby certify that I have performed a Mortgagee's inspection of the following described property: E 1/2 LOT 241, SECTION 33, T12N, R3W, S.M., AK Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 11th day of October 2019. FRED WALATKA & ASSOCIATES, L.L.C. BE 907-248-1666 Engineers and Surveyors z LJJ W CR W I- 0 0 LD PAN ESTATES < co 0�, Iwo LOT 3 W co 0 �e 0 r) 0 N8905615211E (R) N8904615711E (M) 165.01 (R &M) .0 Carport 9- 0 3� 0 2 Story Frame House with Basement Or N.,t;7Shed GO Well c' Window well (typ) ® N N Carport Septic vents 21.9 0 00 LEGEND (R) Record per Plat No. 74-29 (Gold Pan Estates) (R1) Record per Record of Survey (Potter Point Game Refuge) (R2) Record per Plat No. 2006-57 (BIRD TLC Subd.) (R3) Computed per BLM plat of Section 33 dated 1-25-1968 (M) Measured =4 ---,-,Top of Bluff *41 OF A 00 -57 v49th 00 00- 05 CD 0 0 a 0 40 .0 coco 00 CO lizabeth L. Walatka 00 0 E 1/2 LOT 241, SECTION 33, T12N, R3W, S.M., AK LS UJ III < 8036 0 E0 "OF-Esslosm- \Y C) C:) 0 0 c) CD C:) 0 z U) 0 _J 165.08 (R3 & M) BASIS of BEARINGS N89057'36"W (Rl) POTTER POINT GAME REFUGE EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. UNLESS OTHERWISE NOTED FB 19-8, pg 21-22 AS -BUILT NO CORNERS SET TMS DATE I hereby certify that I have performed a Mortgagee's inspection of the following described property: E 1/2 LOT 241, SECTION 33, T12N, R3W, S.M., AK Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 11th day of October 2019. FRED WALATKA & ASSOCIATES, L.L.C. BE 907-248-1666 Engineers and Surveyors t ~-% MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION £NVlRONMEN'rAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT MAILING ADDRESS LEGAL DESCRIPTION ] Well ~ Absorption area Dwelling PERMIT NO. ~ G ~ee~ MateriaS }~ r No. of compartmenX Liq. ca~cl,,m.__l.~acit~ogal Ions IF HOMEmDE; I nsid~l?~,.[~ Width Liquid depth ~ ~ Z DISTANCE TO: OZ ~ ManufacturerI Material Liquid capacity in gallons Well ~e Fou.dation ~ ~ Nearest lot ]ine PERMIT NO. ~ DISTANCE TO: ~ No. of lines Length of eac Total length o~ lines Trench width ~ Distance berceuses Top of tile to fi.ish gr.d. ~:t.ri~l beneath tile ~b~r~n area O j z ~ginches Total effectiv Length. Width Depth PERMIT NO. ~ ~ Type of c~b Crib diameter Crib depth Total effective absorption area ~ Wel] Building foundation Nearest lot line ~ DISTANCE TO: ~ ~s ~ . . ~ Depth Driller Distance to lot line PERMITNO. ~ DISTANCE TO: BuUdin, foundation S.w.r line Septic tank OTHER PIPE MATER'A~ SOILTESTRATING ~ ¢ ,// APPROVED DATE L~GAL 72-013 3/78) F'EF:H I 'l" I'-,!O. .'~IF F L .t. _..rfl',l. -I'IH LCICFIT ! ON OLC, ?,EI.,.IFIR[:v'~rFiIE:E: t T C:!:;~:K ~ : '.: ._ =: ~SCIIL. F~:FFI'!Nb (::E;I:i:! , [, IL ..- ...... FIFK:<IklLIH '~UHLEF.. OF EF[')F'-FIM'.:; ::~: ..... ' '"'":'~:" ..... TI'IE L.E:NGTH [:' I MEN5; Z ON I S~; THE L.EIqEFFH ,:: :[ [",! FIEE?' ) OF '!'HE TF:E:NC:H O1:,~'. DI:;'.F:I ! !",If I E~L..D. THE DEF'TH OF FI TRENCH O1:;;: PiT I:5 'THE [X[S"I'FfNCE~ BET[,.IEE~:N "FHE SL.IRFF~CE OF' THE: GF:OL!ND F4N[:' THE E:OTTOM OF' 'I"I"'I[E EE',:<CFI',,,'FI"I'~EIN ,::IN FEET). THF2F?.E I9; NO E;E:T [q:[DTH FOR THE: GF'.FIVI~EL. BFZFI"H Z:E: THE P'IZNIHUH [)E:PTH Of FIN[) THE BOTTOM Of fi'HIE ET,:',',C:F[',,,'F:IT!ON (!N FEET). F}{E ~G:[ IL...~ ][; ~:~'.: EE [::Z:" :~J:; ~; ~::::~ ~"' 3!:: C: -'~"' ~::::~ PfCF'.I'"IZT RE:'F'LZCFINT Hf:l~; THE FzEZ6F'ON~E;ZE)ZL.!-FY ]:N:FJ'f'tqLL.FITiON ZNE;PEZE:TION~; OF F:If',!M I.,.!ELL.~; 1:~[).SFIC:FZi",IT "f'O -Fl.'IZOd; F'F'.OPEF:T'~" I::!!",~[) TH[E f'4WHE:EiF: OF' F~rE:~;ZDENC:E~5 THFIT THE l.,.l~k.L ., : IE.i'l ,TTHq rr' I::'llqFtl._. '!..4'SF'~EC:TTF'fl'.,I FIN[:, ,.fF.. L TI..Ii:E'; 'fEFi::f::F:'i!..I_Ti"~C~ I::l[:' I::IN"/ c' , ...... ... . ~ .... E',"i" E:,I:EPI:~F::THENT H Z I..L F.?,I.E :~;IJD..:fEC:T TO F'F: ': '~;[::" T ]': N. CEF:TII::¥ THFFF 2204 C ?ye]and AncBorage, -~.le-~~-h 99503' -' Date ?erformed 8-18-78 formed ~Or Tim Foster ,~l Oescription: Lot 241 Block Subdlvisinn s form Renorts Soils Loq ~e~ Percolation Test E 1/2 Lot 241 sec 33 ~S 12N ~ enth eet Soil Characteristics Pea~ ~ Bromish Sllt ~ Brown Sandy Gravel Bottom Of Test Hole Ground Water Encountered? N~o Yes, At what. Depth? <eadinq Date !ate Grnss Time /{et Time Depth .... Ilinute <:olation ' Drain Field Frnposed lost~ion: Seenaoe Pit Perth of Inlet Depth '[o Bottom Of Pit Or :~ENTS: 85S~.~t. drain~re~re4~eT bedroom. to H20 Net Dron Trench Performed By ,i~P~au~.-~ .... Data Certified B~': CTL __~ Date: 8-18-78 ' o~1 C.N,LI, fod~p. ..... ~,ppzox,. TOp. OF Bill Foster Realty ..~.~ -- 7839 El/2 BLM Lot 241, SW 1/4 Sec. 33 T12N, R3W, S.M. **s ~.o~ o. August 22, 1978A.~ ,.~T ,.~ ,~- *.c.o,^~. ^~^s~*.~..s 1st ~.~ o, Septemberw8 SCALE Woo P 5 LA]' / C PA, TY OF ANC.ORAGE :,, ' .... DEPARTMENT OF HEALTH & ENV RONMENTALPROTECTION ;' :: ':' ' 'i'Tf©b i~t~;(/ I Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FAGIHTIESi DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 2. BUYER MAILING ADDRESS 3. LENDING INSTITUTION MAI LING ADDR ESS PHONE PHONE PHONE PHONE 5. LEGAL DESCRIPTION ,, , ~ ,~ ~ ~ / /// '~ -- ~ 6~ TYPE OF RESIDENCE NUMBER OF BEDROOMS'  S INGLE FAMILY [] MULTIPLE FAMILY 7. WATER SUPPLY ..J~C-- INDIVIDUAL* [] COMMUNITY [] PUBLIC UTI LITY [] One [] Four [] Other__ [] Two [] Five Three [] Six * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975, For wells drilled prior to that date, give well depth (attach log if available,) 8. SEWAGE DISPOSAL SYSTEM ~ iNDiViDUAL/ON.SiTE.~ [] PUBLIC UTI LITY If ~nd~v~dual/on-site, give installation date . If system is over two (2) years old an adequacy test is required by this Department, NOTE: THE INSPECTION FEE MUST ACCOIVIPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE NSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [~Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line S, COMMENTS C PP.ovED Z¢ BEDROOMS [] CONDITIONAL APPBOVAL {letter must accompany certificatel ~'"~DISAP~BOV ED DATE BY (Title) LEGAL DESCRIPTION 72-010 (Rev, 3/78) MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT,herein the "AGREEMENT" made and entered into as of this Day of DCttW.Lt-v- of 20 tek , by and between C7 lkv-L2 �t a , 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: I. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System(AWWTS), described as Advantex Treatment System located at(legal description) T12N R3W SECTION 33 LOT 241 E2- 15500 Old Seward Highway 2. Maintenance,Repairs and Alterations. (Owner is required to read, understand and initial each section) Q Throughout the term of this Agreement.the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance,adjustment(s),replacement costs,and inspection costs. This includes an annual maintenance fee(typically $400 to$600). ',,Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. e.-Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system,which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. (� '^ • wner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. wner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. {." Owner agrees that any sale or transfer of title of the property will not occur without a new eCertificate of On-Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. e Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system,or upon transfer of title,and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions,nor in any way affect the validity of the Agreement or any part hereof,or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By: . ' (signature) Date:/c1' 69,,,,LL, (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) lck The foregoing instrument was acknowledged before me this 1 ' day of 20 \PI, by Q J\ S CavriI1D '� e ; • , �, OFFICIAL SEAL 0 ARY BLIC FOR ALASKA NOTARY PUBLIC State of Alaska Commition expires. -0. a 4 I �� 4 t• JAMIELYN K.AMIDON 4 sr My Commission Expires Jan.26,2020 ) "Iry VVV VVV VVVVVVVVVV V VV VV VVI* MUNI IPALITY: By: hit ,( - (signature) Date: tz4z/jq print name) Title: (rev. 05/18/2018) Page 3 of 3