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HomeMy WebLinkAboutKNIK HEIGHTS BLK J LT 5Kni,ek Heights Block J Lot 5 owl / � cay)C(,rvmed -rha+ �i 2. J 2-013 tank, , wa5 �JH�1PAlli`Y OF MUNICIPALITY OF ANCHORAGE ,„Nrnl On-Site Water &Wastewater Program `�,_<;k; Y • S�; '., PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 http://www.muni.org/onsite ` Lat !. Department 4'�CHOR p�E On-Site Wastewater Disposal System Permit Permit Number: OSP191189 Effective Date: 6/4/2019 Work Type: Septic Renewal Expiration Date: 6/3/2020 Tax Code Number: 01823224000 Site Legal Address: KNIK HEIGHTS BLK J LT 5 G:2936 Site Mailing Address: 13385 RIDGEWOOD CIR, Anchorage Owner: HIGGINS KENNETH P & CYNTHIA F Lot Size in Sq Ft: 21545 Design Engineer: NORTH RIM ENGINEERING Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field RI 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 proposed drainfield is not within the 30 foot radius of a test hole. A test hole shall be provided at time of construction to confirm separations to groundwater and impermeables, as well as the percolation rate. 7-day groundwater monitoring shall be provided. If the results require a design change, construction of the system shall stop pending on-site review and approval of a change order. Submit soils log with the inspection report, if not before. 2. Since the existing tank is connected downstream the AdvanTex, no further inspection of the existing tank's baffles is required. Received By: Date: 674( Issued By: 0 A Date: 4 il l• MUNICIPALITY OF ANCHORAGE • Development Services Department " -,r Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. C) '— 2-S7- qo?2— Property owner(s) .� ► " . ��= �� 2�2 C �2 Mailing address t- 2 5 W - le CT e J,- Site address Legal description (Sub'd., Block & Lot) 111 P _d Legal description (Township, Range & Section) Lot Size '24 Sq. Ft. Number of Bedrooms APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field Initial ❑ Single Family (SF) (w/wo ADU) Septic Tank [tom Upgrade ❑ Duplex (p) ❑ Holding Tank ❑ Renewal Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable unicipal t-o•es. 40-4 .gnature of pro...-. er !'=.,rized agent) Permit/Rush Fees: $145-00 Waiver Fees: Date of Payment: 5120 fg D(1 Date of Payment: Receipt Number: 05 R9 2_ I) Receipt Number: Permit No. QJ P 14 !1 7( Waiver No. it 10a .75 ckuutax fir G:1Development Services\Building Safety1On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc \bTI-SIN' ENGINEERING SteveEng.com Knik Hts Block J Lot 5 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is an existing 3-bedroom, single family home. The absorption trench is currently working. The owner wants to upgrade the system to a Category III Advantex. A design is submitted for a new trench& new Advantex. The neighboring lots are developed as indicated in the drawing. Previous test hole being used- no groundwater. A 9.5' deep trench will be excavated. The easements are located on the drawing and are not encroached upon. An additional test hole will be completed during construction, if required. A Category III application rate of 2 GPD/FT2. Trench Length= 225 FT2/6'x 2= 18.75'; 1 line @ 20'. No bedrock was encountered. A perk rate of 17 min/inch was used from previous soil test. Old trench will be connected via diverter valve inside Advantex. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications(AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Connect New Trench To Advantex. Install Valve To Previous Trench For Possible Later Use.Watertight couplings on inlet&outlet • 5' minimum between the tank and bed. 10' to property lines. • 2' of cover is required for trench+ 1 inch insulation board. • Solid pipe must be set on well compacted, stable soil • All cleanouts must extend to at least ground level • Trench to be placed level, minimum of 4' to groundwater, 6' to bedrock from drain-rock • Drain rock to be 1/2 inch to 2 %2 inch screened. Drain rock to be distributed uniformly throughout the trench. • Distribution pipe shall be 1.25" Schedule 40 PVC w/ 1/8"orifices @ 18"on center. • Force main shall be 1.25" Schedule 40 PVC, Force main burial to be 4' minimum. • Silt barrier(filter fabric)to be installed above the drain rock • Smeared trench sides must be raked or scarified before drain rock placement • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, PVC Schedule 40. • Sewer Service Line is minimum 2% slope • Septic Tank to be pumped every two years or when required • Insulation board shall be extruded direct burial polystyrene(Dow Styrofoam HI or equal) • Maintain minimum 10' separation between water line &wastewater system. ` r` ---.4Rt'��''9 R DESIGN NOTES: 1. Existing Trench Remains In Place. 2. Sewer Service Line minimum 2% slope. 3. Connect Existing Concrete Septic Tank Via Diverter Valve. Connect Advantex To Existing Tank Via Diverter Valve. 4. Lots Served by Private Water Wells. 5. No Conflicts Within 200'. Mark 100' Well Radius. 6. Check Condition Of Sewer Service Line— Replace If Necessary. 7. Depth Of New Trench © 9.5'. 8. Measure Separations Prior To Construction. 9. Test Hole During Construction To Verify Soil Conditions. Ridgewood Circle 3%/ lope Lot 4 Lot 1 — Septic Existing j Septic — Concrete cc- Tank H 0 3%/Slope / 'N a'/. lope C, \ 37JSlope I N--------Existing / N3 Trench 3 Barr) MT/Ch. CO t .CD 3% lope 10 _Diverter Valve To Existing Concrete Tank 3% /Slope �th 15 A GQ ion WE') ...„......,. ....''... eX 2s FI te.,01 v Q L.,..1" Pk R5 R100 CIuPOa Well o Well -- 10' Utility E•serpent 1 --'. ..--�°�� KNIK HEIGHTS 1" = 40' NOR THRI M ife...•'. 'f ENGINEERING * *$ BLOCK J LOT 5 DESIGN Po Box 770724 „ t LAYOUT Eagle River, Alaska 99577 S. ....C1-125.,..•hr WASTEWATER UPGRADE 907. 694. 7028 6/x/19 ADVANTEX UPGRADE 6/3/19 12 of 3 Foundation Cleanout 1 AX-20 Filter Pod30. — / AX20 POD MR—1 .Rim :.i• I7 ilDiverter Valve To Concrete Tank —1500 GALLON ,...../../- - �/L— /dymTa UFISMflON — . 5' Mounded Cover To Match Terrain likh.. A. a \ Monitor Tube CO 12' DESIGN NOTES: AdvGALLON a nTex ' 1. Depth of New Trenche is 9.5'. . 2. Advantex & Solid Pipe to be Placed on Compacted, • 3. ' Stable Soil, Free from Boulders. Filter Fabric �„:: . .• 3. Sewer Service Line is Minimum 2% Slope & 3' Cover. `= `'' ='=' P is r_4_. o_ip•.. 4. Water-Tight Couplings. •-: • f.:;*z -'''` 5. See Specification Sheet. ! ! e.z!=!ze;!= 6. All Work To Conform to Municipality of Anchorage (AMC) ! !`•`•`•`•`•` 6' ! !' ! ! ! != 9.5' Requirements & Specifications. .: i . . '- 117. Maintain 3' Cover Over Trench Or Insulate. ! 1-11'11= •4= -••'�=�_ `4-�` Drain Rock ••-•- -•. 8. Private Water Wells. . 1-1-110-11-1=1"- 9. :.:::.-1=1"9. Install Diverter Valve To Old Tank & New Trench. ! 1.!.-...4!4••:•.:1!: 10. Service Line 3' Cover Plus Insulate. Extra Insulation Under Driveway. 3' NORTHRIMt,�"` V., TRENCH END VIEW KNIK HEIGHTS ENGINEERING f : ':. ' E1 ADVANTEX PROFILE BL❑CK J L❑T 5 PO Box 770724 sa. • t Eagle River, Alaska 99577 % ct- ..•1, SEPTIC SYSTEM 907.694.7028 141 671/1-9 ' UPGRADE Date: 6/1/19 Pr°w n BY: SE ISc • Ob' i• = 5 ' I SHEET13 of 3 ^^ 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 2&ay of of 20 ,I,by and between pAN & � �,�ys ,herein t e"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 ,T1 &v ('L�� �, located at(legal description) ?� 3 co 5 RI 0),.ce o a c C ,\61e -61Acj0-00 ' 2. Maintenance,Repairs and Alterations. (Owner is required to read,understand and initial each 412t,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. „vii, 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). Jdij 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. , , 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: L BY: r�,//Li j- ,_,_46,_•• , as dit'If, t (signature) Date: 6 L 9 A I • ,�A �,, • . A _ (print name) MALT L ‘ • OF • • • •, r N ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoin: instrument was acknowledged before me this D day of Fita.A. , 20 J q,by __ _ _Id - I I 1 \\0111111/0 A: : ._ o .1 If, . .41'i, \ 0C/.10/ N•TA Y PUBLIC FOR ALASKA •••.... ... •:G �:` 2 My "smmission expires: /0-Z- )(1 � NOTARY *` *'pU . s4ii: OF•PS ' MUNICIPALITY: M lIIIIII\\\\� i By: 040-61 (signature) Date: 5/2-4// 9 Bebe()Ca -r0 GL (print name) Title: • (rev. 05/18/2018) Pagc 3 of 3 „,•+N`"p„,,„0„ MUNICIPALITY OF ANCHORAGE �p�cnt On-Site Water&Wastewater Program �'' 5�,. PO Box 196650 4700 Elmore Road _ •. Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 , � '” http://www.muni.orglonsite • 1 epartment On-Site Wastewater Disposal System Permit Permit Number: OSP171319 Effective Date: 11/1`X1'( Work Type: Septic Upgrade Expiration Date: 8 Tax Code Number: 01823224000 Site Legal Address: KNIK HEIGHTS BLK J LT 5 G:2936 Site Mailing Address: 13385 RIDGEWOOD CIR, Anchorage Owner: HIGGINS KENNETH P &CYNTHIA F Lot Size in Sq Ft: 21545 Design Engineer: NORTH RIM ENGINEERING Total Bedrooms: 3 This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ 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: The proposed drainfield is not within the 30 foot radius of a test hole. A test hole shall be litiprovided at time of construction to confirm separations to groundwater and impermeables, as well as the percolation rate. 7-day groundwater monitoring shall be provided. If the results require a design change, construction of the system shall stop pending on-site review and approval of a change order. Submit soils log with the inspection report, if not before. ---- // h7// 7 Received By: ' Date: Issued By: ( lit”, ^ ,( [16 C- Date: / I` i i 1 7 V 'MU 1,.H I C D P%•\ L N TY OF 4\ N VC/H • F \ k-,G E • Community Development Department ‘L21-,..77 ' � one: 907-343-7904 Development Services Division 907-343-7997 On-Site Water & Wastewater Program ON-SITE SEWERMIELL PERMIT APPLIC ac OI�I1 CT j Q Parcel I.D. ��0 r2,32^ 2 s g. ; Property owner(s) /716-(16Day phone I - 3 S3? Mailing address /S-31S ter e4v()ad e r Site address Legal description (Sub'd., Block & Lot) �/Wi/C /4717-j ,;7",_,c.,G Zr a -S Legal description (Township, Range & Section) Lot Size 26 69S Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field 710 Initial ❑ Single Family (SF) 7,/ (w/wo ADU) Septic Tank Upgrade ;n:' Holding Tank E Renewal Duplex (D) ❑ ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage E 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 o thorzed agent) Permit/Rush Fees: SIC) Waiver Fees: Date of Payment: lb Iola- Date of Payment: Receipt Number: 6/�C(0C1 ) Receipt Number: Permit No. 06pr3"f 3/q Waiver No. Permit App_9-1-12.doc 1\i2THIM NGINEERING SteveEng.com Steve Eng, PE, PH 907-694-7028 SteveEngPE@gmail.com Date: 10/13/17 Number of Pages: To: MOA On-Site Services Subject: Knik Hts 2 Block J Lot 5 Biocycle Upgrade An existing trench is functioning OK, however the owner wants to upgrade to a Category II Biocycle. A previous soil test is being used for design; no groundwater or bedrock indicated. The design calls for a new deep trench and Biocycle. The old trench will be connected via diverter valve. The entire subdivision is on private water wells and septic systems. The terrain slopes north slightly at the trench site. The system size is a single family at 3 bedrooms. Please review the wastewater system design for the existing 3 bedroom home. I have included design plans& specs, design guidelines, & soil tests. If there is need for additional information or clarification please give me a call. Thanks-Steve \bTf-RIM ENGINEERING SteveEng.com Knik Hts Block J Lot 5 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is an existing 3-bedroom, single family home. The absorption trench is currently working. The owner wants to upgrade the system to a Category II Biocycle. A design is submitted for a new trench & new Biocycle. The neighboring lots are developed as indicated in the drawing. Previous test hole being used- no groundwater. A 9.5' deep trench will be excavated. The easements are located on the drawing and are not encroached upon. An additional test hole will be completed during construction, if required. A Category II application rate of 2 GPD/FT2. Trench Length = 225 FT2/6'x 2 = 18.75'; 1 line @ 20'. No bedrock was encountered. A perk rate of 17 min/inch was used from previous soil test. Old trench will be connected via diverter valve inside Biocycle. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Connect New Trench To Biocycle. Install Valve To Previous Trench For Possible Later Use.Watertight couplings on inlet& outlet • 5' minimum between the tank and bed. 10' to property lines. • 2' of cover is required for trench + 1 inch insulation board. • Solid pipe must be set on well compacted, stable soil • All cleanouts must extend to at least ground level • Trench to be placed level, minimum of 4' to groundwater, 6' to bedrock from drain-rock • Drain rock to be V2 inch to 2 '/z inch screened. Drain rock to be distributed uniformly throughout the trench. • Distribution pipe shall be 1.25" Schedule 40 PVC w/ 1/8"orifices @ 27"on center. • Force main shall be 1.25" Schedule 40 PVC, Force main burial to be 4' minimum. • Silt barrier(filter fabric) to be installed above the drain rock • Smeared trench sides must be raked or scarified before drain rock placement • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, PVC Schedule 40. • Sewei• Service Line is minimum 2% slope • Septic Tank to be pumped every two years or when required • Insulation board shall be extruded direct burial polystyrene (Dow Styrofoam HI or equal) • Maintain minimum 10' separation between water line& wastewater system. r�. • A �� 4S 1! fi41se 0 +� 4 es, •• Lux. DESIGN NOTES: 1. Existing Trench Remains In Place. 2. Sewer Service Line minimum 2% slope. 3. Replace Septic Tank/Decommission Old Tank Per UPC. Connect Biocycle To Existing Trench. 4. Lots Served by Private Water Wells. 5. No Conflicts Within 200'. Mark 100' Well Radius. 6. Check Condition Of Sewer Service Line— Replace If Necessary. 7. Depth Of New Trench 0 9.5'. 8. Connect Old Trench Via Valve Inside Biocycle w/Line To Trench. 9. Test Hole During Construction To Verify Soil Conditions. Ridgewood Circle Decommission Old Septic Tank Per- UP//. toPe dLot4Lot 1 Septic New * SepticBiocycle sp Model 1500 0 liverter Valve 3% lope 40114 , 3% lope To Existing \ Trench 3%,Slope �1` N------.Existing / 3 Trench 3 Bdrr7 3%/Slope 3% Slope Well -- Well o R100--------- 10 Well - 10' Utility Easement --'•\ +°F` `'` KNIK HEIGHTS 1' = 40' NOR THRIM �P. ENGINEERING •*,4s• e*• BLOCK J LOT 5 DESIGN PO Box 770724 „� 't ' LAYOUT Eagle River Alaska 99577 ,, - WASTEWATER UPGRADE r. 907. 694. 7028 /f { � BIOCYCLE UPGRADE : T:o zf 3 i 1 iiverter Valve Valve & 1.25' PVC Discharge Line To Old Trench r 1.25' PVC Discharge Line To New Trench Influent I L BI❑CYCLE MODEL 1500 10.5' @ 1200 GALLONS 6' Mounded Cover To Match Terrain 8, T 1 \ Monitor Tube DESIGN NOTES: I 1, Depth of New Trenche is 9.5'. 2. Septic Tank & Solid Pipe to be Placed on Compacted, -',.•`- ."• 3. Stable Soil, Free from Boulders. Filter Fabric ---___,, 3. Sewer Service Line is Minimum 2% Slope & 3' Cover. ;;, ; T Th 4. Water-Tight Couplings. 0 iiiiiiiiiiii 5. See Specification Sheet. .• s, 6. All Work To Conform to Municipality of Anchorage (AMC) (s Oplea ••_ Requirements & Specifications. r:. .,:sup-.,'..... 7. Maintain 3' Cover Over Trench Or Insulate, p. �'�' �' '�'' Drain Rock '=' '=••-'-INTI- 8. Private Water- Wells, :i 10.:• i_ i 9. Install Diverter Valve To Old & New Trench. '- !!=i Wi IPr ..1 .:t•:f0,01:1: 0 IP:0I: :• f: 3' - =�1--... TRENCH END VIEW KNIK HEIGHTS NORTHRIM � -� ENGINEERING fir' * ; BI❑CYCLE PROFILE BLOCK J LOT 5 77237 Bear Pow Circle4, Eagle River. Alaska 99577 . , ova -// SEPTIC SYSTEM 907.694.7D28 -',. /V gff7 ' UPGRADE Oh11/13/17 rm BrSE re: I, = 5 �t3 0 f 3 I SE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND ' .� IAP� V\ 44 lCN \A. THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this 15 Day of /ll p ve ri 6 er of 20 II, by and between '6),A,A a 415 \ ,mss herein the"OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." 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 &o y-i located at(legal description). n;1e, I-lek` ks e 1, 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 existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. 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. Alterations, 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 Municipality 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. I. 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. Amendment. 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: n e)kwe 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. 8. 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: ,j ../!/. l BY: ./1.14./Vii/;/2L, 1/' (signature) Date: /Qv/3-2))/7 A , . A, (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) The forego'n: instrument as acknowledged before me this l ay of c (cv 201-7 , ri044,, n - \\\\\1U11 Nlllll/ NOTARY�. IC FO ALASKA '•� My Commis expi e d.c . /d, owl g = 'NOTARY: PUBLIC:�,t` f��ii�gTFOF At-AS�P`� ///!!III 1110\\�� MUNICIPALITY: By: aC (signature) Date: \ j 15/.?o j 1 IZe Oeccs Ca,r ro (print name) Title: On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP131206 Tax Code Number: 01823224000 Work Type: Septic Permit Effective Dates: July 26, 2013 to July 26, 2014 Design Engineer: SPURKLAND ENGINEERING Subdivision: KNIK HEIGHTS Site Legal Address: KNIK HEIGHTS BLK J LT 5 G:2936 Owner/Address: HIGGINS KENNETH P & CYNTHIA F 4820 LEYDEN ROAD ANCHORAGE AK 995162957 Site Mailing Address: 13385 RIDGEWOOD CIR, Anchorage Lot Size in Sq Ft: 21545 Total Bedrooms: 3 This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Receiv Issued eABy:ji�:::_ Date: � 31 i B Date: O �2 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 1. D. 018-232-24 Property owner(s) KEN HIGGINS Day phone 345-8202 Mailing address Site address 13385 RIDGEWOOD CIR., ANCHORAGE, AK 99516 Legal description (Sub'd., Block & Lot) KNIK HEIGHTS BLOCK J LOT// Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: Date of Payment: (N all that apply) Receipt Number: Permit No. meG I ?-0(o Waiver No. Absorption Field ❑ Initial ❑ Single Family (SF) Q (w/wo ADU) Septic Tank El Upgrade E Duplex ❑ (D) Holding Tank F]Renewal El Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / 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 Permit/Rush Fees: A66' To^V, =L9 Waiver Fees: _ Date of Payment: :11 15113 Date of Payment: Receipt Number: n-Vq 30A Receipt Number: Permit No. meG I ?-0(o Waiver No. Permit App_9-1-12.doc Spars knd Emgomsefling Environmental Consulting and Design July 2°a, 2013 Municipality of Anchorage Development Services Department Building Services Division On-site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Subject: SEPTIC TANK PERMIT APPLICATION Knik Heights Block J Lot 5 Ladies and Gentlemen: We are submitting an application to upgrade the septic tank for this lot. The existing septic tank serving the above referenced property is 36 years old and the owner would like to replace it. The submittal consists of one (1) drawing showing the present improvements on the lot and the proposed improvements of the lot, of which only the septic tank is subject to this permit application. The installation of this septic tank will not prevent wells and septic systems from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses within 100 feet of the proposed septic tank location. The proposed septic tank will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or are in need of additional information please contact me at 279-3916. S� y, ft LarSs kland, P.E. 203 West 15o Avenue Suite 202, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng@gci.net RIDGEWOOD CIRCLE LOT 4 _FLOT Septic Area � �3 BDRM S.F.R. LOT 1 ABANDON EXLSTING \ SEPTIC TANK P£R MOA COL£ REQUIREMENTS IN K N I K HE ® ® BUICK J 25 0 25 50 75 100 125 150 f SCALE., 1' = 50 FT. NOTE. THIS IS NOT A SURVEYED PLAT. WELL & SEPTIC LOCATIONS TAKEN FROM ON-SITE WATER AND WASTE WATER D£PARTM£Nr DOCUMENTATION. ALL LOCATIONS SHOWN ARE APPROXIMATE. D11UBL£ 4 FEET CYIVER CLEANL7UTS Septic! Area GH TS si>J CUNN£CT£B 717 EXIST BRAINFIELB 1000 CALLUN SEPTIC TANK [7 raWBATIIIN CLEAAWT SPURKLAND 0 SPURKLAND ENGINEERING KNIK HEIGHTS BU J LOT 5 SEPTIC SYSTEM DESIGN 203 V 15TH. AVENUE ANCH. AK. 99501 KEN HIGGINS BATE, JULY 2, 2013 (907) 279-3916 11 13385 RIBGEVL717B CIR, ANCHURAGE, AK 99516 Sheer• 1111 aff m e.936 PERMIT # UPS131XXX PIB k 018-232-24 KNII(HEIGHTSBJLS.BVG MUNICIPALITY OF ANCHORAGE / 0 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION �� ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME /''� 0 EW ❑ ,�• UPGRADE M ILINGAYREESSS LEGAL DESCRIPTION LOCATION / NO. OF BEDROOMS Well Absorption area Dwelling / PERMIT N0. DISTANCE TO: doP �o- ! � ry U y _ 4. F- Q Manufacturer �— Material% No. of compartments w rn Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth y DISTANCE T0: Well Dwelling PERMIT NO. T,_ F Manufacturer Material Liquid capacity in gallons O DISTANCE TO: Well Foundation s Nearest lot lin �, o PERN4IT NO. Lu 2 w Z F'- z w No. of lines Length of each line ,. Total length of lilies 00 ,..) Trench width ` Fr� inches Distance between lines FTop rx a of tile to finish grade a !e_ Material beneath tile 4V g'e inches Total effective absorption area Length Width Depth PERMIT NO, w ce Q F- w a Type of crib Crib diameter Crib depth Total effective absorption area N DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. J W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER / o PIPE MATERIALS �y SOIL TEST RATING 40 INSTALLER REMARKS � OF 44t"� !� F �.7 n NS A, Earl D. Korynto 't� o �T J APPROVED DATE LEGAL a THE REQUIRED SIZE OF THE SOIL HBSORPTION SYSTEM IS� �� ��������� �� �� ����� ������� � THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFHCE OF THE GROUND HND THE BOTTOM OF THE EXCHVHTION (IN FEET) THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM I')EPTH OF GRHVEL BETWEEN THE OUTFHLL PIPE RND THE BOTTOM OF THE EXCHVHTION (IN FEET) ����� ������� ������� ����� ������ ������� �L~���� �������� ���~__�~� � PHCKHGE PLANT MAN` BE INSTHLLED AT THE PERMION SU8JECT TO THE FOLLOWING CONDITiONS� 1EITHEk' (::I CLASS I OR II NSF HPPRTVED PLANT MHY BE INSTHLLED 2H CONTINUOUS IF H MHINTENHNCE AGREEMENT IS NOT KEPT CURRENT YOU MH-? BE REQUIRED TO ENLARGE THE SOIL HBSORPTION SYSTEM HND/OR YOU MHY BE SUBJECT TO PROSECUTION ... .... ....... �����..... ��... ...... ��..... .......... ........ ����������� _g 1, C 0 ��IE-_ IE 1 R:;;:- IF:: T- A 1NG -HCKFILLING OF HNY SYSTEM WITHOUT F'11 P. -IFIL. INSPECTION HND BPPROYHL BY THIS DEPHR-Irl MENT WILL BE SUBJECT TO PROSECUTION MINIMUM DISTANCE BETWEPN H WELL HND HNY ON~SITE SEWAGE DISPOSHL SYSTEM IS : '].�0 FEET FOR (-I PR.TVFiTE WELL OR 200 FEl,-T FOP, A PUBLIC [1E.L WELL LOGS HR(::, REQUMED HtAD MUST B[::.' PETURNED TO T[AE DEPHRTMENT WITHIN ]0 DHYS OF THE WELL f"OMPLETION. OTHER REQUIREMENTS MHY HPPLY. SPECIFICHTION� HND CONSTRUCT�ON DIHGRHMS HRE HVHILHBLE TO INSUR� P�OPER INSTHLL�T��N IF I IF E.: I I E-, F ��� I CERTIFY THHT 1� I HM FHMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS HND WELLS RS SET 1:71DRTH BI.I� THE MUNICIPHLITY OF HNCHORHGE. 2� I WILL J. [A THLL THE SY�T�M �� HCC����NCE WITH THE CODES ]� � E�ST��� T�HT THE ON-S�T� ����� SY"T�� MHY REQUIRE ENI���EME�T IF THE RESIDENCE IS TO INCLUDE MORE TTIC-1N ] BEDROOMS. DHTE������-c���~.~_ VI0 -a--~=------------ z��--- V1 PA L C- 1 F" V`1 IL _- X ­ 11" P..? q*"7 0::::::II Ii u��l)::;;%- C'-ii� DEPHRTIlIENT ' HEHLTI, HND ENVIRONMENTHL OTECTION 825 '� STREET/ HNCHORFI GE, HK.1 L_ 11---- ���� ���~^����� 264~4720 ������ ��H.;:: - I 11 .5 11 PE�MIT NO ( 780027 ) HPPLICHNT ` F].41, C/O SOHIO- BOX 4�1]79 99509 272 11]5 LOCHTION LEYDEN RD LEGHL L5 GJ KNIK HTS SUB LUT SIZE 21480 SQUHRE FEET TYPE OF SOIL HBSORBTION SYSTEM IS� TRENCH MHXIMUM NUMBER OF BEDROOMS = '-':i SOIL RHTING (SQ FT/BR)� 200 THE REQUIRED SIZE OF THE SOIL HBSORPTION SYSTEM IS� �� ��������� �� �� ����� ������� � THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFHCE OF THE GROUND HND THE BOTTOM OF THE EXCHVHTION (IN FEET) THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM I')EPTH OF GRHVEL BETWEEN THE OUTFHLL PIPE RND THE BOTTOM OF THE EXCHVHTION (IN FEET) ����� ������� ������� ����� ������ ������� �L~���� �������� ���~__�~� � PHCKHGE PLANT MAN` BE INSTHLLED AT THE PERMION SU8JECT TO THE FOLLOWING CONDITiONS� 1EITHEk' (::I CLASS I OR II NSF HPPRTVED PLANT MHY BE INSTHLLED 2H CONTINUOUS IF H MHINTENHNCE AGREEMENT IS NOT KEPT CURRENT YOU MH-? BE REQUIRED TO ENLARGE THE SOIL HBSORPTION SYSTEM HND/OR YOU MHY BE SUBJECT TO PROSECUTION ... .... ....... �����..... ��... ...... ��..... .......... ........ ����������� _g 1, C 0 ��IE-_ IE 1 R:;;:- IF:: T- A 1NG -HCKFILLING OF HNY SYSTEM WITHOUT F'11 P. -IFIL. INSPECTION HND BPPROYHL BY THIS DEPHR-Irl MENT WILL BE SUBJECT TO PROSECUTION MINIMUM DISTANCE BETWEPN H WELL HND HNY ON~SITE SEWAGE DISPOSHL SYSTEM IS : '].�0 FEET FOR (-I PR.TVFiTE WELL OR 200 FEl,-T FOP, A PUBLIC [1E.L WELL LOGS HR(::, REQUMED HtAD MUST B[::.' PETURNED TO T[AE DEPHRTMENT WITHIN ]0 DHYS OF THE WELL f"OMPLETION. OTHER REQUIREMENTS MHY HPPLY. SPECIFICHTION� HND CONSTRUCT�ON DIHGRHMS HRE HVHILHBLE TO INSUR� P�OPER INSTHLL�T��N IF I IF E.: I I E-, F ��� I CERTIFY THHT 1� I HM FHMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS HND WELLS RS SET 1:71DRTH BI.I� THE MUNICIPHLITY OF HNCHORHGE. 2� I WILL J. [A THLL THE SY�T�M �� HCC����NCE WITH THE CODES ]� � E�ST��� T�HT THE ON-S�T� ����� SY"T�� MHY REQUIRE ENI���EME�T IF THE RESIDENCE IS TO INCLUDE MORE TTIC-1N ] BEDROOMS. DHTE������-c���~.~_ VI0 -a--~=------------ z��--- CONSULTING ENGINEERS AND SURVEYORS 2515 A ST., ANCHORAGE 99503 (907) 276-4245 October 19, 1977 Mr. James Schaden Re: Test Hole Log and Perculation Test Knik Heights Subdivision, Lot 5, Block J Our Work Order No. 77890 Dear Mr. Schaden: Attached herewith is the Test Hole Boring Log, Perculation Test results and our comments regarding soil conditions encountered on the subject lot. In accordance with your request, our investi- gation was conducted on October 5 and 6, 1977. A single test hole was placed on the lot as indicated on the ac e dafton sketch. This location is one of the lowest elevations on the lot. Drilling -was accomplished utilizing a mobile drill rig B-50 mounted on a track vehicle owned and oper- ated by Denali Drilling. The purpose of the investigation was to provide soil data for establishing the feasibility of on-site disposal of sanitary waste. The test hole was extended to a total depth of 16 feet below the existing ground surface. No Ot�Tw eTt-d� as encountered in the test hole. In addition, the soil near e ottom o-f—UhZ� stole was relatively drp� Pre- dominant soils were silty sands and gravels below the 7 foot level. After completion of the drilling operation, the test hole was backfilled and hand tamped to approximately the 12 foot level and filled wit—water. Approximately 24 hours later, the tes ha e was refilled with water tois he 6 fort level and a perculation tis ts7ff in accordance with the "Manual of Septic Tank Practice" of the U.S.P.H.S. Measured drop in the water level during the last 30 minutes of the test was 1.75 in v_h��for computed perculation rate of 17.1 minutes per incb._ If you have any questions hesitate to contact me. Attachments EDK/clr with regard to the above, please do not Very truly yours, Z �l. Kor nta Y GORDON D. UNWIN, P.E. LEO SCHEBEN, JR., P.E., L.S. EARL D. KORYNTA, RE. u- uj 7 7: M u o SOILS -CL I ENT_Zames Schaden PROJEC[xnik Heights Subd. Lot ELEV. TOP OF HOLE LOG BYe D. L. 5, Blk. J DATE -10/6/77 W. Q. NO 778.90 ui ui U. z a 0 0 . — --�- Peat(P 1 2 Wet Or anic, Sanay S— J -T —(OL) 2 — 3 3 4 _ el Silt (ML) — 4 5 5 --- -- 6 6 — — 7 7 Damp, Brown, Silty Sandy Gravel (GPI)-- 8 8 9 CoUbles �p 10 10 11 11 12 12 Damp, Brown Silty Grave y San (SM) 13 13 ess siit beiow 110 14 14 15 — 15 ------- Bottom of hole, no water to e - 16 16 17 - 17 ---- 18 - 18 s--- 19 - � 19 20------ 20 21 21 22 22 23 23 ' --- 24 1 24 1 a I I / / i °� O0 3v ., 00. —1 50' 05' 3o°E 209 97 to tt- 149 72 rj 01 w oll p l 23 a A kao o I o o 0 o t o I 01 �-n O IO S O° 5' -30 e- 0 J r (o0 0 I $ O3o -c 194 S3 I� ` n° 05 3o E- 1 5 00 I 01"P I % p p _I ._.--'--- - - �1•.----- - ,-- �- I X79 3o' D ice. �1;-0' �, � �kU�n�O�.._. � • � �Yc so* Z ~ SOC 0o E. �4 'oc Iso oo °zlb -o p, tn Al 0 0 Ib 258 91 _ 190 00 I loo 00 _. 109.92 w v ----- - - - - Soo 03 SO..C_ 65B 91 Tki ° Cry WATER WELL LOG FOSS DRILLING 1336 Ingra ,Street Anchorage$ Alaska 99501 WELL OWNS I d, &m e%6 C.h e., n USE OF WELL 4. e ) LOCATION SIZE OF CASING DEPTH OF HOLE . CASED TO I FT STATIC WATER LEVELi PTO YIELD.�LGAL.PER.MIN. WITH lot) FEET OF DRAWDOWN. REMARKS DATE COMPLETED -9 JLPUMP TO BE SET ATlv c i —t 0- -t _._.t0— �.t �t 0� 0- 0- 0- 0— .. t 0- -t — o- 0— ®at0- -t 0- -.t ®—t ._.et 0� �to� MUNICIPALITY OF ANCHORAGE ° DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPI30VAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# r()19 QA HAA# \� 1. GENERAL INFORMATION Complete legal description _L-�_�r B Y� J k"� k.-c.,I��s Location (site address or directions) t?�2 `.Saclti�i Property owner �s �c�-e iI Day phone Mailing address Lending agency Day phone Mailing address. Agent Day phone Sb (— D Ll 1L . Address r� ,�,�It� t1�0 D( Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water _ NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL.: / Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm _ I (n�i�O��t �1�vv kA .VSOn? o Phone Address Engineer's signature 6. D, S SIGNATURE ' Approved -for Disapproved. ��°��' ) bedrooms. Conditional approval for Additional Comments Date ,Y/yb bedrooms, with the following stipulations: Date The Municipality of Anchorage Department of Health and Hurnan Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the profusional engineer's work. •: ry; �4 -J••.t�•n'La bedrooms, with the following stipulations: Date The Municipality of Anchorage Department of Health and Hurnan Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the profusional engineer's work. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: —La' Parcel I.D. 1 A. Well Data f F Well type=: If A, B, or C, attach ADEC letter. ADEC water system number' Log present (Y/N) Date completed Y '> Driller < Total depth F' Cased to Casing height i Sanitary seal (Y/N)Wires properly p p y protected (Y/N) �. Date of test Static water level Well flow Pump levell FROM WELL LOG r� SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line WATER SAMPLE RESULTS: AT INSPECTION ; On adjacent lots f Public sewer manhole/cleanout !mlj Petroleum tank Coliform Nitrate Other bacteria Date of sample: 0 7. - et -3� Collected by: ,yam S. SEPTIC/HOLDING TANK DATA Date installed -2 t) ! f`_% Tank size &-e-A V Compartments Cleanouts (Y/N) �° Foundation cleanout (Y/N) lk-/ Depression (Y/N) High water alarm (Y/N) Alarm tested (Y/N) V$ r Date of pumping d f b _Pumper A01 of e } P - SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot On adjacent lots i �g �o Foundation .2 To property line lo Absorption field np _Water main/service line _ f Surface water/drainage C 72-026(3/93)' Front CONTINUED ON BACK PAGE rr� q / ,, Zn r, < f r - � r) - n g.p.m. g.p.m. r-1._1 - �� Y `7 .,,,, . t—r-1 V� Gi On adjacent lots "' ; On adjacent lots f Public sewer manhole/cleanout !mlj Petroleum tank Coliform Nitrate Other bacteria Date of sample: 0 7. - et -3� Collected by: ,yam S. SEPTIC/HOLDING TANK DATA Date installed -2 t) ! f`_% Tank size &-e-A V Compartments Cleanouts (Y/N) �° Foundation cleanout (Y/N) lk-/ Depression (Y/N) High water alarm (Y/N) Alarm tested (Y/N) V$ r Date of pumping d f b _Pumper A01 of e } P - SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot On adjacent lots i �g �o Foundation .2 To property line lo Absorption field np _Water main/service line _ f Surface water/drainage C 72-026(3/93)' Front CONTINUED ON BACK PAGE C. LIFT STATION N/ fA Date installed Size in gallons Vent (Y/N) High water alarm level _ "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested Surface water Date installed 0 `7`7 Soil rating (GPD/Ft') System type T etA;J1 0-(t Length ._� Width D ( Gravel thickness ( Total depth Total absorption area Cleanout present (Y/N) Depression over field (Y/N) 3 Date of adequacy test Results (pass/fail) / for Bedrooms Water level in absorption field before test `-) f . After test >?, Peroxide treatment (past 12 months) (Y/N) If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot , o' ' t On adjacent lots > /a" Property line > in To building foundation e �Tjo existing or abandoned system on lot On adjacent lots ' �tt� Cutbank � `h 0 M ir_ Water main/service line > t Surface water' Driveway, parking/vehicle storage area 1'D Curtain drain jo E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Engineer's Name I o n to Li J fl v Y K VA V_so4 Dates, HAA Fee $ Date of Payment - % 2 Receipt Number �� 4� 72-026 (3193)' Back Waiver Fee $ Date of Payment Receipt Number LEGAL: LOCATION: '��i P"IFC I=L- L. dLN VA 7_-i P .. 203 WEST 15TH. AVENUE SUITE 203 ANCHORAGE, ALASKA 99502-3904 (907) 279-3916 Fax (907)-276-6013 RESIDENTIAL WELL INSPECTION Lot 5 block J Knik Heights 4820 Leyden Drive OWNER: James Schaden TYPE OF WELL: Private, Single Family WELL LOG AVAILABLE: Yes INSTALLATION REQUIREMENTS MET:Yes WEL-L YIELD FROM WELL LOG: 7 Gallons per Minute PUMP YIELD FROM TEST: / 6.3 Gallons er_Minute WELL. YIELD FROM TEST: % More than b gallons per rninute� DATE OF INSPECTION: December 2, 1993 TEST PROCEDURE: Well was pumped at a constant rate while the drawdown was monitored with an acoustic probe. At -the beginning of the test water level was found at 194 feet below top of cas— ing. At a pumping rate of 6.3 gallons per minute the water level dropped to the pump intake in 28 minutes. A -total of 140 gallons were pumped. The well was allowed to recharge for 4 hours and then pumped again. 145 gallons were pumped before the pump shut off. TEST FOR E.COL.I AND TOTAL_ NITROGEN: Water was tested for E.Coli and total nitrogen on E.Coli 0. Total Nitrogen: 4.6 mg/l. Ma>a. allowable Total Nitrogen 10 mg/1. TEST RESULTS: This well meets the requirements of the Municipality of Anchorage. The Municipal requirement for well flow is 150 gal- lons. of water per bedroom per day. This well e>:ceed this requirement. The assessment of the condition of the well applies only to the conditions as of the day tested. The flow rate may change due to subsurface conditions that may not be observed from the surface, and changes in the land use and other factors that may impact the aquifer feeding the well. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 q Application Date _ r°'L.o 1. GENERAL INFORMATION 2. (a) Legal Description (include lot, block, subdivision, section, township, range) o_ T-, F3_�/ _ _�{� ht 1i L �, a 2%, Location (address or directions) (b) Applicant Name _'�-_SSJ���_ Telephone: Home Business Applicant Address q k.20 i�rGeo" (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ; Buyer ❑ ; Other ❑ (explain); (d) Lending InstitutionNru�-sbDrte EAr Telephoned Address C" s (e) Real Estate Company and Agent Address Telephone Mail the HAA to the following address TYPE OF RESIDENCE Single -Family Multi -Family ❑ Number of Eedrooms 3 3. WATER SUPPLY Other Individual Well Ix Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 11 84) 5. ENGINEERING FIRM PROVIDING wiSPECTIONS, TESTS, FILE SEARCH, DATt, AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm /J u� � Telephone <,76 "3 ?14 Address P,0 � /J Date 6. DHEP APPROV Approved for Q.� bedrooms y Approved X Disapproved Terms of Conditional Approval -f �.I r,� J Engineer's Seal r,. ... . e,. ,�• tJ,' '2225-E: (Q+'1 Jud 2S, tJ,I Condit CAUTION Date 61l,, The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 DEPT. OF IIEALTII ENVIRONMENTAL, PROTECTION UiV J9gw RECEIVED Legal Description: LOT_6 -_5 K I':N1K. 14-1G-f-irv-S s � 77, rF A 0-7 R 31 us A. WELL DATA Well Classification __ ' r If A, B, C, U. E.C. Approved (Y/N) Well Log Present (Y/N) — Date Completed — EL9 3•ffo Yield _ q� Total Depth —._ 79' _ Cased to 7k Depth of Grouting Static Water Level tqp- _ Pump Set At — Casing Height Above Ground 3 H'r Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot /IS _ ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole _ __ -- To Nearest Sewer Service Line o-n/Lot Water Sample Collected by (- S + — ; Date Water Sample Test Results o' �_ at, e�r 1 _ -�, Comments — B. SEPTIC/HOLDING TANK DATA Date Installed t ,���� Size I t71' No. of Compartments — r U%'0 Standpipes (Y/N) QNr- Air -tight Caps (Y/N) — Foundation Cleanout (Y/N) 1Li Depression over Tank (Y/N) _ Date Last Pumped Pumping/Maintenance Contract on File (Y, /N) ; for AYIA Holding Tank Fligh-Water Alarm (Y/N) -{yds Temporary Holding Tank Permit (Y/N) NA Separation Distances from Septic/Holding Tank: To Water -Supply Well _ 10 4s To Property Line To Water Main/Service Line —� Course Comments Page 1 of 2 72-026111/84) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata o20'o Type of System Design l R a NCR Date Installed `�/$0 /79- Length of Field 43 Width of Field &P Depth of Field I/ _1Z Gravel Bed Thickness Square Feet of Absorption Area Leo Q r`2. Standpipes Present (Y/N) ®1� Depression over Field (Y/N) Date of Last Adequacy Test 6)/0 qf / 8`116 Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well /l _n, To Property Line 140 To Building Foundation To Existing or Abandoned System on Lot No N On Adjoining Lots "5 D To Water Main/Service Line To Cutbank (if present) N O,0F� To Stream/Pond/Lake/or Major Drainage Course©� To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION NON a Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, or conformed to all OA and HAA guidelines in effect on the date of this inspection. Signed Date Company MOA No. Receipt No. 3 R 6 ('9 Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) Engineer's Seal 3 W. 15ih "C" SUITE 203 [MD) t; © OANCHORAGE, ALASKA 99501 CONSULTING ENGINEER TELEPHONE: 19071 279-3916 R E S I D E N T I A L W E L L I N S P E C T I O N LEGAL: LOT 5, 13LOCK J. KNIK HEIGHTS LOCATION: 4820 LEYDON DRIVE OWNER: JAMES SCHADEN TYPE OF WELL: SINGLE FAMILY WELL LOG AVAILABLE: YES INSTALLATION REQUIREMENTS MET: YES WELL YIELD FROM WELL LOG: 7 GALLONS PERMINUTE WELL YIELD FROM TEST: .6 GALLONS PEI? MINUTE PUMP YIELD: 6.5 GALLONS PER MINUTE DATE OF INSPECTION: JUNE 9, 1986 TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE OF 6.5 GALLONS PER MINUTE WHILE THE DRAWDOWN WAS MONITORED WITH AN ACOUSTIC PROBE. THE WELL, WAS PUMPED DRY. RECOVERY WAS THEN MONITORED FOR 40 MINUTES. STATIC WATER LEVEL WAS FOUND 190 FEET BELOW TOP OF CASING. AFTER PUMPING WELL DOWN TO 246 FEET PUMPING WAS STOPPED. AFTER 39 MINUTES THE WATEER LEVEL WAS AT 228 FEET. TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON JUNE 10, 1986. TEST WAS NEGATIVE• TEST RESULT: THIS WELL MEETS THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The Municipal requirement for well flow is 150 gallons of water per bedroom per 24 hours.Th:is, well surpasses this requirement. The assessment of the condition of this well applies only to the conditions as of this date. The flow rate of the well may change due to subsurface conditions that may not be observed from the surface,;- and, changes in Land use and other factors that may 'rrlp Lt �7e,--dQrlditions of the aquifer feeding the well. } 1. e, a +.,'• . �o. •2225-L =i ;fit; JUiJ` 2S, 1971 103 W. 15th "C" SUITE 203 � P44ANCHORAGE:,E L_F� ALASKA 99501 CONSULTING ENGINEER TELEPHONE: (907) 279-3915 S E P T I C S Y S T E M A D E Q U A C Y T E S T LEGAL: LOT 5, BLOCK J, KNIK HEIGHTS LOCATION: 4820 LEYDON DRIVE OWNER: LAMES SCIIADEN RESIDENCE: SINGLE FAMILY, THREE BEDROOMS WATER SYSTEM: ON SITE WELL SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: TANK: ESPINOSA CONCRETE TWO COMP, 1.000 GAL. ABSORPTION SYSTEM: TRENCH ABSORPTION AREA: 602 SQ. FT. SOIL RATING: 200 INSTALLATION DATE: MAY, 1977 DATE OF PUMPING: JUNE 10, 1986 DATE OF TEST: JUNE 9, 1986 TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND WITH 1.5 FEET OF COVER. 49 INCHES OF LIQUID. TRENCH WAS FOUND WITH 5 FEET OF COVER. 18 INCHES OF LIQUID IN SUMP. 100 GALLONS OF WATER WAS ADDED TO THE SUMP. THIS CAUSED THE WATER LEVEL TO RISE 3.5 INCHES. DURING THE NEXT HOUR THE WATER LEVEL DROPPED 3/4 INCHES, SHOWING AN INFILTRATION RATE OI' 20.7 GALLONS PER HOUR OR 496 PER DAY. TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the System. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requi- rements of the Municipality and State. pp _ �.�. n. 2225-E: f �i�, JUNE 25, 1971 Ii�s, ,r7'e1•