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Home My WebLink AboutBIRCHWOOD LOOP LT 5Onsite File Bi*rchwood Loop 51�243�19 knuv uoiutr io/ Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181374 PID Number: 051-243-19 Dwelling: 0 Single Family (SF) ❑ with AD ❑ Duplex (D) ❑ Two Single Family Project: E New ,`] Upgrade Name Mathias Homes ABSORPTION FIELD F-1DeepTrench El Wide Trench El Bed 0 Mound Address ddress 1te S. Birchwood Loop Road ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 5.0 GPD/SFJ +2.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade +2,5 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot Birchwood Loop 5 Fill added above original grade S_.1 Ft. Gravel length 44.0 Ft. Township Range Section Gravel width 5.0 Ft. Beds: Number of Lines n/a Distance between lines n/a Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 128 Ft2 1 n/a Ft. Well 50'+ 50'+ 100'+ TANK N Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Advantex FAP Capacity 1500 Gal. Surface Water 50'+ 50'+ Material Number of compartments Lot Line 5'+ 10,+ NA Fiberglass 2 Foundation 10'+ 10,+ LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by Capstone PIPE MATERIAL House to tank 3034Tank to 3034 Installer drainfield Groundbreakers Drainfield 3034 co/MT 3034 Inspector Pannone Engineering BENCH MARK (Assumed elevation) 170 ft Inspection 15' 8/22/19 8/27/19 Location and description 3r° 2"' 4'h House Trim ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date ,�� OF ?C��,�� t� TH. e, ri .. Pnnnne ii Septic Syste 8-49 Approved pP Date �`®�' L, Note: this appro I does not include well permit requirements. knuv uoiutr io/ MANHOLE MANHOLE K:mm--j � 4Y)(�pv�0 2 co 00 y �:u u 0 m '-` 0 In Z��-'y Dp�O ZO2 --- i (A O O m 0 CO m z Z �z0 Z rr=t➢ O In z -1 �a D r 0 Z C7 m -4 m (nN C (n C!1 Z --1 OmDO�Otn-<;DOmDO arZD -oA z cnm,-MZ• X00-rnm r D (-)A 03 M. P, zm �ODi DNX mr*10r 0 !��zmrn0 Dx xcn -DQ 2=m- G�- O 0 0 DD OU'O�N� CCn px` O -1- r O Z7*00 m00� m N -ncn C�=�-�OZOm��DO N r -r CWj0 �`' O -im 0-00 m* 0 DO N OM m> z 0 X.i r-_ O GS 0 -i Z -+ r*m O 0 Om O D m m 4 a f a a 4 i ♦ f 4 � a @ f 4 f f a 6 f f 4 f 4 4 4 4 a t f a f 4 f f i 4 @ i/ t t O 10\ O D t / -1 ➢ f m Im 3 \ t 0 / A X' a a I � � a m o D / o^ < / mAN� m \ z> t y \ zoa \ m r cn V! ,. z \ m soffz TG- O�mzo«omn Az D n oxo, um 3s n (A \ om�o Cn{ ry��o mm i; '`1 Z iD--=� m��-a Goon 0 \/• ob \Nko aniz D zo i N;r F >/• `\,ma m�F='moo -I Ioo 13 / o ,moo xk C \ �S N7� \`\ Nv NOTES: PANNONE ENG SVC, LLC REVISIONS DATE RECORD DRAWING P.O. BOX 1807 PALMER, AK 99645 11/26/2019 PHONE 907 745-8200 FAX 907 745-8201 AP• SCALE BIRCHWOOD LOOP L5 :* 1" = 100, NO SITE: NHN SOUTH BIRCHWOOD LOOP P05i 243- 19 DRAWN JRL £seven anoAe JASON & RYAN MATHIAS CE 8149 PERMIT NO. PO BOX 110818 OSP181374 SITE PLAN SHE ANCHORAGE, AK 99511 2 OF 2 O O O r i Cn C I u) O to X Z D� ' \F,< p om F -D � D ' 1 12.0 0.5 , 2.0 \2.0 -4 m (nN C (n C!1 Z --1 OmDO�Otn-<;DOmDO arZD -oA z cnm,-MZ• X00-rnm r D (-)A 03 M. P, zm �ODi DNX mr*10r 0 !��zmrn0 Dx xcn -DQ 2=m- G�- O 0 0 DD OU'O�N� CCn px` O -1- r O Z7*00 m00� m N -ncn C�=�-�OZOm��DO N r -r CWj0 �`' O -im 0-00 m* 0 DO N OM m> z 0 X.i r-_ O GS 0 -i Z -+ r*m O 0 Om O D m m 4 a f a a 4 i ♦ f 4 � a @ f 4 f f a 6 f f 4 f 4 4 4 4 a t f a f 4 f f i 4 @ i/ t t O 10\ O D t / -1 ➢ f m Im 3 \ t 0 / A X' a a I � � a m o D / o^ < / mAN� m \ z> t y \ zoa \ m r cn V! ,. z \ m soffz TG- O�mzo«omn Az D n oxo, um 3s n (A \ om�o Cn{ ry��o mm i; '`1 Z iD--=� m��-a Goon 0 \/• ob \Nko aniz D zo i N;r F >/• `\,ma m�F='moo -I Ioo 13 / o ,moo xk C \ �S N7� \`\ Nv NOTES: PANNONE ENG SVC, LLC REVISIONS DATE RECORD DRAWING P.O. BOX 1807 PALMER, AK 99645 11/26/2019 PHONE 907 745-8200 FAX 907 745-8201 AP• SCALE BIRCHWOOD LOOP L5 :* 1" = 100, NO SITE: NHN SOUTH BIRCHWOOD LOOP P05i 243- 19 DRAWN JRL £seven anoAe JASON & RYAN MATHIAS CE 8149 PERMIT NO. PO BOX 110818 OSP181374 SITE PLAN SHE ANCHORAGE, AK 99511 2 OF 2 V -\! -P- CA CA C'l N N Ln O Cb Cn D N C...iA Cn c0 01 CO CA Cl CN CA v (o C'j m O N Cn C4 -+ -4 m (nN C (n C!1 Z --1 OmDO�Otn-<;DOmDO arZD -oA z cnm,-MZ• X00-rnm r D (-)A 03 M. P, zm �ODi DNX mr*10r 0 !��zmrn0 Dx xcn -DQ 2=m- G�- O 0 0 DD OU'O�N� CCn px` O -1- r O Z7*00 m00� m N -ncn C�=�-�OZOm��DO N r -r CWj0 �`' O -im 0-00 m* 0 DO N OM m> z 0 X.i r-_ O GS 0 -i Z -+ r*m O 0 Om O D m m 4 a f a a 4 i ♦ f 4 � a @ f 4 f f a 6 f f 4 f 4 4 4 4 a t f a f 4 f f i 4 @ i/ t t O 10\ O D t / -1 ➢ f m Im 3 \ t 0 / A X' a a I � � a m o D / o^ < / mAN� m \ z> t y \ zoa \ m r cn V! ,. z \ m soffz TG- O�mzo«omn Az D n oxo, um 3s n (A \ om�o Cn{ ry��o mm i; '`1 Z iD--=� m��-a Goon 0 \/• ob \Nko aniz D zo i N;r F >/• `\,ma m�F='moo -I Ioo 13 / o ,moo xk C \ �S N7� \`\ Nv NOTES: PANNONE ENG SVC, LLC REVISIONS DATE RECORD DRAWING P.O. BOX 1807 PALMER, AK 99645 11/26/2019 PHONE 907 745-8200 FAX 907 745-8201 AP• SCALE BIRCHWOOD LOOP L5 :* 1" = 100, NO SITE: NHN SOUTH BIRCHWOOD LOOP P05i 243- 19 DRAWN JRL £seven anoAe JASON & RYAN MATHIAS CE 8149 PERMIT NO. PO BOX 110818 OSP181374 SITE PLAN SHE ANCHORAGE, AK 99511 2 OF 2 Development Services Department Building Safety Division On -Site Water Wastewater Program 4700 Elmore Poad P.O. Box 196650 Mark Begich Anchorage, AK 99507 s F Y Mayor www.muni.org/onsite (907)343-7904 Pump Installation L® Well Drilling Permit Number: SW Date of Issue: Parcel Identification Number: Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Water & Wastewater System Permit Permit Number: OSP181374 Work Type: WellSeptic Initial Tax Code Number: 05124319000 Site Legal Address: BIRCHWOOD LOOP LT 5 G:0954 Site Mailing Address: Owner: MATHIAS JASON 50% & Design Engineer: PANNONE ENGINEERING SERVICES Thi -§.-Permit is for the construction of: Q Disposal Field✓❑ Septic Tank ❑ Holding Tank ❑ Privy Effective Date Expiration Date Lot Size in Sq Ft: Total Bedrooms: 10/23/2018 10/23/2019 122484 Q Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: 1. Prior to IR approval, submit a well decommissioning log for the existing well. 2. The septic system design is only valid if there is 2' of native peat. 57/2.2//q CD #( ma✓eG! Received By: Date /'0/3/b g, Issued By: Date: 4 E PANS 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. 051-243-19 Property owner(s) RYAN & JASON MATHIAS Day phone Mailing address PO BOX 110818 Site address NHN BIRCHWOOD LOOP Legal description (Sub'd., Block & Lot) BIRCHWOOD LOOP L5 Legal description (Township, Range & Section) Lot Size 122,484 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑X Initial Single Family (SF) ❑X (w/wo ADU) Septic Tank ❑X Upgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well 0 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. (Signature of property owner or authorized agent) Permit/Rush Fees: d 78(.( Waiver Fees: Date of Payment: I O/I('/i& Date of Payment: Receipt Number: O7645 7) Receipt Number: Permit No. 05P`3)3f- Waiver No. Permit App_:.'•:�.,:c: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE CONIPLJANCE Pannone Engineering Services LLc OSP181374,Deb lhbcerrfuss, 10,30/: Steven R. Pannone, Principal Registered Professional Engineer E-mail:steve@panengak.com 19 October 2018 Subject: BIRCHWOOD LOOP L5 Initial Septic System Permit Request Design Narrative This is a design narrative to issue a permit to install an initial septic system for this property.The system will serve a proposed four(4) bedroom house.The system will utilize a new 1500g ADVANTEX tank w/AX-20 Pod and ERS drain field. This lot will be and the lot to the North and East are served by private wells.The lots to the south and east are currently undeveloped. There are no wells within 100'of the proposed septic system. 1. Soils. One test hole was performed on the property in the area of the proposed system by Garness in December 2016 and PES confirmed soil profile and percolation test in a new test hole performed on 09OCT2018. Ground water was not observed to a depth of 3.0' below the surface after water monitoring in GEG TH6. Bedrock was not encountered in the test hole to 13.5. Based on the results of the percolation test,a sieve analysis and overall soils appearance, an application rate of 5.0 GPD/SF was used for a CATIII AWWTS wastewater system in the area of the test hole. The ERS mound will be constructed of classified fill or screened peat. Screened peat has an accepted percolation rate in the 1- 5mpi range(Water,Air,and Soil Pollution 69: 165-177, 1993). 2. Soil Absorption System Design. a. See Sheet 1 of the design package. 3. Surface Water:There is no surface water within 50 feet of the proposed septic tank and drain field(AWWTS). 4. Topography: The existing topography on the lot generally slopes from southeast to the northwest. The proposed field is to be installed in a slope of 10%-15%and there are no steep slopes in the area of the proposed system. 5. Drawing Markings:The Drawings are marked"For MoA Review Only".When written notification that the review is complete and that there are no further comments is received from MoA On-Site Department,the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of this or the surrounding lots. If you have any questions or concerns, please contact me at 272-8218. Sincerely, • Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-82.11 DESIGN PARAMETERS —w — WATER LINE / PRIMARY/RESERVE SEPTIC SYSTEM WELL RADIUS NO. BEDROOM: 4(600 gpd) TANK SIZE: 1500g I ADVANTEX d PERC RATE: USE 6-15 MPI' (P) SOIL RATING: 5.0 GPD/ SF AREA ROD: � u �l�l'--- 120 SF CO SYS. TYPE: ERS WIDE TRENCH �Y HORIZONTAL CONVEY. FS MIN LENGTH: 50LFx 10'W MOA TYPE II MT 40LFx5'W SEWER ROCK TRUE I}ORTH USE (SEE DETAIL THIS SHEET): / SCREENED PEAT 133CY AROUND MOA a m m \a m a a YI a m a al TYPE II / \ 50' STREAM SETBACK (AWWTS) ` f MOAII 50LFx10'Wx2.0'E.D., 2.0'TD I SAND 2'E.D., 0.0'TD /` FIELD 40LFx5'Wx0.5'ED,+2.0'TD O / \( TH LEG( TOTAL AREA: 120SF SIDEWALL MOA TYPE II / w —w — WATER LINE / WELL RADIUS — SS — Ss — NEW SEPTIC ABBREVIATIONS TH TEST HOLE (P) PROPOSED (E) EXISTING CO CLEAN OUT NO. FC FOUNDATION CLEANOUT FS FLOW SPLITTER MT MONITOR TUBE NO. TYP TYPICAL cO"3t I L — ' — — — \ -WELL P \ / Lot 6 ! \ 87,774 sf / 41 \ FIELD: 4DLF.5.0 W.O.n.D..+2.0 T.D. W/2.0 SAND ERS: SDLF.IO'W.2.O'E.D..Z.O'T.D. (MOA TYPE II) m m m a m m m a W/ 2- R.I, AND MTa k CO, AT ENDS OF FIELD m m m m OI y m 3:1 SIDE SLOPES ON MOUND WITH CLASSIFIED FILL OR, m a m a O a m (y SCREENED PEAT. TS&V MOUND / (SEE MOUND DETAIL THIS SHEET)� m m a m m1 m m m m m/ \ m R cFfl ARFAfNI 1 YT BASED ON AWWTS^CADIZ AND / MLoI 4 m m m m e l m m N£1LAN0 AND STR AM 1 a m LOCATION BASED UPON m \1 I I a m SURVLY DATA B S4 ( 1 m o m a m Ym 11 1 1 i m m a --0 \o b m m m m m a a / 11 I am qo mmm pml0 mma�a�WELLIEI 3 o aim m m m \ / IIIILORS TYPE IIA CLASSIFIED FILL N I Y o I -------------r MOUND DETAIL SCALE: 1"=10' SAND MOA TYPE II 6.0- 1-10.0 0.0 O p M0114- M N o� N II ZN Z00 O Q U - Q W 2 n a a. In Do DO rn rn CD 0 0 0 nN N N N \ \ \ \ Q m N O N 0 0 0 0 x � � cr O I \ / O p J sea / \r.' , / -i L0 'A UD 0— Lf I T 1 A A rZco TANK (P) W/ A%-20 POD m = Q — / FC BEFORE TANK / / Y! / ¢ O O 00 OJ z O Q 1 DRAINAGE EFFEMORA� \ Y >,' /' Z d O m \WELL P .., , ' F 1 / / W oN 0 % Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181374, Deb Wockenfuss, 10/30/18 NOTES & SPECIAL PROVISIONS: 1.- SCOPE AND SPECIFICATIONS: 1.1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE WATER RATE DATE NET TIME LEVEL NET DROP (MPI) READING TEST HOLE 2 2 MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND 1 O PER PEAT MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS AND AND IN 2 OR 6 ACCORDANCE WITH AMC 15.65 AND 15.55. O 04 O Zorn 1.2. SCOPE OF WORK: INSTALL NEW 15008 ADVANTEX TANK W/ AX -20 POD, AND SOIL ABSORPTION 3 oz0 0 a�Z SYSTEM. INSTALL WELL Z Jz 1.3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 2.0 FEET BELOW EXISTING GRADE AS 4 H_-__ EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE 0 EXCAVATIONS LESS THAN 8.0 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. 5 ML GRAY SILT 1.4. STRUCTURES DEPICTED ON THE SITE PLAN ARE BASED UPON ONE OF THE FOLLOWING: CONCEPTUAL PLOT PLAN DEVELOPED BY OWNER; A PLOT PLAN DEVELOPED BY RLS; OR A SURVEY AS—BUILT. 6 2. CONSTRUCTION SPECIFICATIONS: 2.1. ALL EXCAVATION DEPTHS ARE ADVISORY. THEY ARE TO BE VERIFIED AND MAY BE MODIFIED BY THE ENGINEER IF ACTUAL FIELD CONDITIONS VARY FROM THOSE USED TO PREPARE THE DESIGN 2.2. EXCAVATE THE DRAIN FIELD. BOTTOM OF EXCAVATION SHALL BE LEVEL AND SCARIFIED. RECORD ELEVATIONS AT BEGINNING, MIDDLE AND END OF TRENCH BOTTOM. CONSTRUCTION EQUIPMENT SHALL NOT OPERATE ON THE FLOOR OF THE EXCAVATION. ANY MATERIAL COMPACTED BY THE OPERATION OF THE CONSTRUCTION EQUIPMENT SHALL BE REMOVED AND REPLACED WITH UNCOMPACTED MATERIAL. 2.3. PLACE THE SEWER ROCK TO THE SPECIFIED DEPTHS. DO NOT CONTAMINATE SEWER ROCK WITH NATIVE MATERIAL OR SPOILS FROM EXCAVATION. LEVEL ROCK SURFACE TO ±1" PRIOR TO INSTALLING THE PERFORATED PIPE. 2.4. ALL PIPE SHALL BE PVC CONFORMING TO ASTM D3034 OR ENGINEER APPROVED EQUAL. MINIMUM SOIL COVER SHALL BE 3 FEET OVER THE PIPE AND 4 FEET OVER THE SEPTIC TANK. ONE INCH OF INSULATION MAY BE SUBSTITUTED FOR 1 FOOT OF SOIL COVER. 2.5. ALL INSULATION SHALL BE 2" THICK DOW HI -40 INSULBOARD OR ENGINEER APPROVED EQUAL. CENTER INSULBOARD WIDTH OVER SEPTIC TANK OR LINES. 2.6. GEOTEXTILE SHALL BE MIRAFI 140S OR ENGINEER APPROVED EQUAL. LAP ALL JOINTS 2 FEET MINIMUM. 2.7. COVER THE DISTRIBUTION PIPE WITH A MINIMUM OF 2" OF SEWER ROCK AND COVER WITH GEOTEXTILE BEFORE PLACING INSULATION AND BACKFILL. 2.8. MATERIAL USED AS FILL SHALL BE CLEAN AND FREE OF ORGANICS, TRASH AND CONSTRUCTION DEBRIS. 2.9. SLOPE ALL FILL MATERIAL TO DRAIN AT 2% MINIMUM SLOPE AND 3:1 MAXIMUM SLOPE AND IN SUCH A MANNER THAT PONDING AT OR NEAR THE DRAIN FIELD DOES NOT OCCUR, THE FILL SHALL BE LEFT AT 6" HIGHER THAN SHOWN TO ALLOW FOR SETTLEMENT. SEED SURFACE AFTER COMPLETING INSTALLATION AS PER MOA CODE. 2.10. RECORD THE FINISH GROUND ELEVATION OVER THE BEGINNING, MIDDLE AND END OF SYSTEM. 2.11. MAINTAIN 5' SEPARATION BETWEEN PERCOLATION HOLE AND THE DRAIN FIELD TRENCH. 2.12. EXPOSE, PUMP AND FILL LOG DISPOSAL CRIB OR CONCRETE TANK WITH SOIL TO ABANDON LAW WITH MOA CODE IF NEEDED. 3. CONTRACTOR RESPONSIBILITIES: 3.1. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION AND SEPTIC LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK. 3.2. THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE ATTACHED. 3.3. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES, 3.4. THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING AND LOCATES SHALL BE IN PLACE PRIOR TO NOTIFYING THE ENGINEER. 3.5. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE CONDITIONS/LIMITATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN. 3.6. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED—LINE AS—BUILT DRAWINGS TO THE ENGINEER. THE RED—LINES SHALL INCLUDE PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND TANK ELEVATIONS. 3.7. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF EXCAVATION, TOP OF PIPE WITH CLEAN—OUTS AND MONITOR TUBES INSTALLED, INSTALLED TANK AND FINAL GRADING. 4. THE CONTRACTOR SHALL SIGN THE FOLLOWING: I CERTIFY THAT ALL WORK WAS PERFORMED IN ACCORDANCE WITH THE APPEND PERMIT, AND ANY AND ALL CHANGE ORDERS, AND THAT THE AS—BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS CONSTRUCTED. CONTRACTOR: BY: TITLE: DATE: 8 9 10 11 12 13 SOILS LOG GO 73*( READING WATER RATE DATE NET TIME LEVEL NET DROP (MPI) READING 1 . _I 0 = . L17 2 3�:I—DoCD 3 O PER 4 _J�z —Q s m<_ 6 0=-00j O � Q WAS GROUND WATER SOIL TEST RESULTS/ANALYSIS ENCOUNTERED? N PERCOLATION RATE NO PERC (ERS) IF YES, AT WHAT DEPTH? —NA—' DEPTH TO WATER AFTER MONITORING? — 2.0 — DATE' 13MAY2019 COMMENTS: Test hole excavated by MATHIAS HOMES. PERFORMED BY: Joseph Lawendowski. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. DATE PERFORMED: 20NOV2007 CW TH#5 06MAY2019 PES CONFIRMED SOILS & H2O MONITORING D0 O I M N N C) ZD N Z O I- a O Q Q �N W N _� �O w :� V)n aw. v) 00 rn rn i \\\ N N O N N O O 0= w w ON V�� mcN m 0— . _I 0 = . L17 .Q^ 3�:I—DoCD Nix007Doy O o L7 C) _J�z —Q Zz� W¢� m<_ W��q 0=-00j O � Q O 04 O Zorn ) Cf) 00 am oz0 0 a�Z m=Q Q Z Jz � W I-_ F0 J Z O W J 0 LLJ O LJ oO' Zo O Jz H_-__ 0 cn GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS - 3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE. AK 99507' PHONE (907)337-6179- FAX (907) 338-3248' MBSRE: w gameas"nglM d g.c SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: T15N, R1 W, SECTION 19, LOT 4 - PROPOSED MATHIAS SUBDIVISION PERFORMED FOR: RYAN MATHIAS DATE: 12/6/2016 DEPTMR ORGANICS feet 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 GM & ML CL OR ML VISUALLY RATED IMPERMEABLE TEST HOLE #6 SOIL CLASSIFICATIONS DEPTH TO GROUNDWATER DATE DRY 113191 ��% NNN • ,�• �. II��I��I RERW MZRA 2 3:10 30 5-3/8" DEPTH TO GROUNDWATER DATE DRY 12/6/2016 8' 12/13/2016 3' 5/11/2017 6" - 5� Pci N SCALE: 1"=100' DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 12/7/2016 1 2:40 - 6" - 2 3:10 30 5-3/8" 5/8" 3 3:10 - 6" - 4 3:40 30 5-3/8" 5/8" 5 3:40 - 6" - 6 4:10 30 5-3/8" 5/8" 19 PERCOLATION RATE 48 (MIN./INCH) PERC. HOLE DIA. 6 TEST RUN BETWEEN 3 FT. AND 4 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: E YES ❑ NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: ERIK WIDGER/J.L.M. COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PEVFORtAED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: (INCHES) IJ:•ct vTW RU, SUITE 201 ^ - 7. _ -'C. ".:L_ ,.....CT. :..x577 .. (9:-)7) da .rig F.A.. (907) 604-1297 .�, S('1LS LOG - P RC/LAT! '; ,. Tt-. __ i `. • _. . PFqFOR1.1FD ;-np. n iri�i Tf'l1/tlJ 'e'i `.4 . ,Ah - ._ -- —DATE PERFORMEC i! t "77 •tom q ��ems` ► LEGAL 4ESCRIPT!ON: 1.15N Ply/ ccr +r. g....7.7- —— ...... TOWNSHIP RANGE SECTION 1154. R1W. SEC. 1g c- I DEPTH (FEET) __ _ 5 li: saL�NtN(3T TO SOALI� 1 1 1 1 I if.a r — °-1 is .'s,;' r 0 ... I;r....;Ii....‘ill a : :. i i _.. 1 . ..; ,::..1 -,:—It.•,' '1..u.,r , ./-1.," i r ! I f H:! f 1 40— I 1_ .ii:.C.. ,SELL-0/41A 1 _._.. __ --- ......_... t 1s--1 I ! I ��- FERC TEST RFc a Tc i ` In_L=iiifiiVu DATE 1GF O. 'i1i ETaiEl x�."."r_ • 1 ,r^Tl l ^�.Ell: "� _ _ .. Ia -t 1 -- !I 1 I i--r—�--. i-'--_. - i___ __ a - i--- . �— -• — . _ Ii I ;_�� I_... ! 1 -I- •I-- i { ! , I 1--_-_I._ 1 ._ 1 -I .— • _. .-1 1 — --- _ PERGOLA TON RATE= rArmytron.A — I _ __i r'W.-A C.v.n.r.+r a4iLytF4ki — I A N'1 ._ 'n1.{f.fEA1TC• SOI. 1,47.,13:..::. ; .4 • .r CHrif QPHF-RJ/Qn0 _ L /4' ES. CI•IRISTr?ruF.R wenn THAT THIS 1T:ST WAY P!r-n' r En bNl. uirnlfrlAA` �.`.I„r.. - � , +�••,-,� i.•i .•',C;t;(}FsUAtdC;t WITH .411 �:I'a7C Eur•IE3 IN LI-Hier ON THIS DR 1E, 11Tr ' ___ _,ice . MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR C: AGREEMENT, herein the "AGREEMENT" made and enteredintoas off� this ,, -1 Day of a'toi„ of 20 /8 , by and between m -1L5 to �-iic , 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 Ankic, located at(legal description) /01— cc g741(...00d /o f St)b. 2. Maintenance,Repairs and Alterations. (Owner is required to read, understand and initial each section) 'Pot-- 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). 11.44. Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, n repairs or permitted alterations to the system. 12 n` 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 974l Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. ./h Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. `A Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. ik Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. VAAA 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 OWNS (signature) Date: /0/4/8 /C1 r/1 Ma 1 Irl/ (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The peoin g • strument was acknowledged before me this(U day of20% by / /45 nottuurrrrrr,_ MOF N�T,° RY PUB FOR ALA'KA • OTAR y'• My Commission expires: , - c)• G rt�111JOF)�111P �� MUNICIPALITY: By: ,) A /_, (signature) Date: /006 Deb (,c b�ki,ncg s (print name) Title: (rev. 05/18/2018) Page 3 of 3 Wheaton Water Well, Inc. 1190 N. Wasilla-Fishhook Road Wasilla, AK 99654 (907)376-2041 Name: Ryan Mathias Address: 13120 Lupine Road City: Anchorage State: AK Zip Code: 99516 Well Site: T 15N, R 1 W, Sig Additional: Permit # OSP 171369 Yell Depth: Below Ground: Above Ground: 262 ft. f! From: 260 ft. 0 2 ft. 9 12 "al/Min: 2 17 tatic Level: top of casin 41 rasing: 46' of 6" ID Steel 44 Diner Pipe: creened: 'erforated: grouted: B Depth: evelop. Method: Ai se of Well: Residential rilIing Method: Rotary Ise.: Well disinfected with c: chlorine 50 ppm none Lot: 5 Block: To: 67 220 ft. silt, gravel 12 68 none 83 41 84 none hard packed sand, silt 67 94 ntonit 98 20' + 167 84 196 evelop. Method: Ai se of Well: Residential rilIing Method: Rotary Ise.: Well disinfected with c: chlorine 50 ppm none Lot: 5 Block: To: Formation: 9 silt, gravel 12 wood/muck, silt 17 topsoil 41 silt, gravel 44 hard packed sand, silt 67 sandstone 68 coal 83 sandstone 84 coal 94 sandstone 98 damp sandstone (1 gpm) 167 sandstone 196 soft brown shale (1 gpm) 262 sandstone Liner pipe is set from 42 ft. to 262 ft. and perforated. ate Drilled: 12-15-2017 Driller: Ben Mattson The well was pumped 5' off the bottom with 100% draw down for 2 hours and recovered at 2 gpm. „N,`_'' `''"0F MUNICIPALITY OF ANCHORAGE mens On-Site Water&Wastewater Program �0 5,� PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997• http://www.muni.org/onsite I)rryartni(•nt 9NCMO0.' On-Site Water System Permit Permit Number: OSP171369 Effective Date: 12/13/2017 Work Type: Well Initial Expiration Date: 12/13/2018 Tax Code Number: 05124309000 Site Legal Address: T15N R1W SEC 19 LT 4 REM G:0954 Site Mailing Address: 17620 S BIRCHWOOD LOOP RD, Chugiak Owner: MATHIAS JASON 50% & Lot Size in Sq Ft: 790745 Design Engineer: Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy El 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: When well testing is complete, the well driller shall place an approved sanitary seal on the well head and no pitless adapter or pump shall be installed until an approved wastewater disposal system has been constructed. i.� Received By: _ A(--< 1v i.Cp Date: /3 3// Issued By: � , i,_ z ,= Date: /Z---/ 7 MUNICIPALITY OF ANCHORAGE 41 Community Development Department r-] Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On-Site Water &Wastewater Program ON-SITE SEWER/VVELL PERMIT APPLICATION Parcel I.D. 65/ L/3 - cel /� g �7 Property owner(s) yGuvt �_14S Day phone yo es1.3p Mailing address Po &?c /(O(�i� (; i 4v ci A/� ! i5 Site address / 76a D 5 Xi J- w�c�k'// ,/�9 Legal description (Sub'd., Block & Lot) .gbh /cT �[ Legal description (Township, Range & Section) 77d4 4 S , / / Lot Size / -Ft Number of Bedrooms ,S Pro A Li- 5 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (EI all that apply) Absorption Field ❑ Initial 1)E1' Single Family (SF) (w/wo ADU) Septic Tank ❑ Upgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal ❑ 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. Signature of property owner or - thorized agent) Permit/Rush Fees: 2(5-p0 Waiver Fees: Date of Payment: 0-113(17 -C .c,. Date of Payment: Receipt Number: 21 (F1 Receipt Number: Permit No. OSPI'i-aoct Waiver No. Permit App_9-1-12.doc , ♦•, p _, 1`I.0,T SURVEYED . ,,,O, .9� i� 0 LCC. • /''' /kK\ / / ?,(i)poa Wsai( &A \ , ,'( / ./< /// Cli,/0 ., ,,, .. / ♦,♦ pt _r eoc(e . 7.,.\i,,(.___ ----- • I I ♦,♦ 1 ♦. PROPOSED 100' • \\\\ '\ ♦.♦ ' WELL RADIUS/)\'. ♦ � G. ; ivc-i! \ \ ♦♦ / t�� / Lsj ,.-` • / y , 1 • c ' --- _�= a�, / ` C" / 16,000+ SQ.FT. / SEPTIC RESERVE AREA . \ .. , .•\ N / ♦ Lot4 of / • ., Qo eP. „), d� -s... 494'S ' 7,,<\,.1//1/1,.\\-.. / , de-,,,z, ._ t.,c,' ,,-c\, ,( ,\- \ , ‹<\ . ,. „ ' , , ., \ \.\ / /01, i ...... , „c\,_ \,.., CD / 5 \I.,,N O II • � � o�Q �� / MUNICIPALITY OF ANCHORAGE Development Services Department u g_ Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-243-19 1. GENERAL INFORMATION Expiration Date: 20 Complete legal description Birchwood Loop L5 Location (site address) 17900 S. Birchwood Loop Road Current property owner(s) Mathias Homes Day phone Mailing address Real estate agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic E Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 95 Waiver Fee $ Date of Payment 11116-119 Date of Payment Receipt Number 70 Receipt Number COSA # 1915766 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe 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 soil condition, ground water 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 this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. Phone (907) 745-8200 Date l q//11q OF A 6. DSD SIGNATURE System #1 Approved for bedrooms stave i Panrione �F CE 8149 4�i System #2 Approved for bedrooms �� sl`• �w,, Disapproved Conditional approval for bedrooms, with the following OF,q��i�� Oil -SITE WAT' AND PRO(-, AM pq QS //vt�JJ�as )1111}}ill,\ By: Original Certificate Date: Z The Municipality of Anchors 41velopment 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 Checklist blue sheet Legal Description: Birchwood Loop L5 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 12/15117 Total depth 262 ft Cased to 46 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 12/15/17 Static water level at beginning of test ** ft. Comments ** top of casing, not artesian B. TANK DATA Age of tank(s) 0 years Tank type/material Measured operating fluid level in septic tank n/a ❑ Standpipes/foundation cleanout per record drawing Date of pumping n/a D. ABSORPTION FIELD DATA Mound t Parcel ID: 051-243-19 Structure served by this system 1 Well production at time of test 2.0 gpm Water storage tank volume n/a gallons Well disinfected for coliform test? ❑ Yes El No ❑ Coliform bacteria is Negative Nitrate 0.266 mg/L ❑ Nitrate less than MRL (ND) Arsenic 17.549 ug/L ❑ Arsenic less than MRL (ND) Collected by Pannone Engineering Services Date of Sample 11118t19 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Which system tested (date installed) 8/27/19 Adequacy test date n/a - ❑ ALL standpipes present per record drawing Results ❑✓ Pass For 4 bedrooms Total measured depth from grade 3.0 ft (max) Fluid depth prior to test in Measured depth to pipe invert from grade 2.6 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: 'Rigid insulation over field COSA Checklist yellow sheet Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Q✓ Yes Community Sewer Manhole/Cleanout > 100' Q Yes if No ft 7 Yes if No Neighboring Tank > 100' FV -1 Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' M Yes if No ft Holding Tank > 100' F/� Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' ✓/ Yes if No M✓ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' M✓ Yes if No ft 0 Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' El Yes if No ft Surface Water > 100' ft ft ft ft ft CQ Yes if No ��ft Property Line > 5' Q✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' ✓0 Yes if No Water Main > 10' ✓v Yes if No ft Corhmunity Wells > 200' 0 Yes if No. Water Service Line > 10' C]✓, Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' Yes if No Water Service Line > 10' P/ Yes if No ft Community Wells > 200' 0 Yes if No Surface Water > 100' [, Yes if No 0+ ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. /? COSA Checklist yellow sheet ��YF OF AlVis' • _ `e�.�.r� •R. •Fan�lne� ft ft ft ft DEVELOPMENT SERVICES DEPARTMENT f � On -Site water and wastewater Section www.muni.org/onsite Arsenic Advisory Certificate of On -Site Systems Approval # OSC191555 Subdivision: Birchwood Loop, Block: , Lot: 5 907-343-7904 Fax: 343-7997 A water sample revealed an arsenic concentration of 17.55 micrograms per liter (ug/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. 11111-1111 -g-, nchorag�Aask� 99519 6650'��i►i�rW muni"org> Y � ��g�` AND _ vqy iVi.€ E 'L'F _0 THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this 1; , ,Day of _ ; ; of 20 by and between herein the "OWNER," and the Municipality of Anchorage, herein the "IVMNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as located at (legal description). 2. Definitions. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On -Site Systems approval (COSA). 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 Anchorage Municipal Code (hereinafter, "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. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of emsting parts, components and pieces of an. AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On -Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. AIterations. Installation and Removal of Additional Equipment. Prior to performing any alterations to an AWWTS, the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any 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. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AWWTS. C. Upon request by the Municipality, the owner agrees to provide the _Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Ivlunicipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. H. 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. F. Owner agrees to provide and maintain a telephone connection to the AWWTS as required by the AWWTS approval. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendmexrt. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed with, and such -writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement, the only authorized representatives of the parties are: a. Owner: b. Municipality: Director. Community Development or designated authority C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. S. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair 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 Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNER.--- By: '`' %�,!'1 �'% = `� (signature) Date: Z- r , (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this - day of 20 < by ' j"� L .t <. L a -��•- Ft.l: ti(!.` L�7 - NOTARY PUBLIC FOR ALASKANote- Pubuc My Commission expires: /(r f'1 �-- v �' �}% E ANOR� cs'rAsa�; MUNICIPALITY: By: (signature) (print name) Date: / �Z-' 6,_ Title: