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HomeMy WebLinkAboutPARK HILLS #1 BLK 2 LT 8MUNICIPALITY 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 hftp://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP221375 Work Type: SepticTank Upgrade Tax Code Number: 01714225000 Site Legal Address: PARK HILLS#1 BLK 2 LT 8 G:3037 Site Mailing Address: 14700 PARK HILLS CIR, Anchorage Owner: SHEPHERD TERRY LYNN & Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date: Expiration Date �»cnr Q j ; I■ J Depai-tnient Lot Size in Sq Ft: Total Bedrooms: 11/3/2022 11/3/2022 11/3/2023 52852 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ 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 �z�e-ive�-ap- P �-�'" ' TI S s v i- o 70 CEG Issued By: Date: Date: 11 Z -o- 2 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 017-142-25 Property owner(s) C/O ARM SEPTIC SERVICES Day phone 907-688-9433 Mailing address 14700 PARK HILLS CIRCLE *ANCHORAGE, AK Site address 14700 PARK HILLS CIRCLE *ANCHORAGE, AK Legal description (Sub'd., Block & Lot) PARK HILLS #1; BLOCK 2, LOT 8 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) R (w/wo ADU) Septic Tank ElUpgrade 0 Duplex ❑ (D) Holding Tank El 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 Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: ???- Date of Payment: M )1111-21?- Receipt Number: CD, Q�A Permit No. OS622 31� Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safetyl0n Site Water and Wastewater\Forms\Client FormsTermit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221375, Curtis Townsend, 11/03/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221375, Curtis Townsend, 11/03/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221375, Curtis Townsend, 11/03/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221375, Curtis Townsend, 11/03/22 MUNICIPALITY OF ANCHORAGE Z k �0 VA WN V Bic, rML61 VA10 1j 1H DIZA I HKAJyj N 31010 1 MOO" THIS MAINTENANCE,REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of thisay of & Ll of 20m-, by and between CIS herein the "OWNER," and the Municipality of I Anchor4ge, 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: Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as located at (legal description) 4;11SJU �-O+Z �10r-k=l (MODPac 4 11s AnJ) 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) CRL� Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. 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) Pagel of Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14,60*011* Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at leas, 24-hour notice. 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. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: �x (signature) Date: N� -(Print name) STATE OF ALASKA ss. THIRD JUDICIAL DISTRICT The foregoing. instrument was acknowledged before me this �'� day of dt-A)wo bo \/1 20Z2_,by::j�-y-%-j PUBLIC FOR ALASKA ission expires: A Z?Q SAMUEL GALICIA i1ERNANUEZ Notary Public State of Alaska MY Commission Expires Apr 15, 2024 MUNICIPALITY: By: (signature) Date: (print name) Title: (rev. 05/18/2018) Page 3 of 3 Municipality of Anchorage Page I of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ,._~(~ c~c~O~O I PID Number: O/r~ -/~--~,.~ Nam~.~,/~..~ /~j/,~/.~.~ ~ ~.~ Wastewater System: o New ~Upgrade ~d~ ~ ~ ~ ~ q~/~ ~ ABSORPTION FIELD Phone:~_~/ No. of Bedrooms:~ ~ Deep Trench ~ Shallow Trench ~Bed ~Mound~Other Total Depth from ori~in~l grCe:/ LEGAL DESCRIPTION so, Rating: ~ GPD/Sq. Ft. ~, S Lot: ~ Block: ~~/~~ Subd[v~ion: ~/~ Depth to pipe bo~om~from original grade: Ft. Gravel depth beneath~pipe Ft. Township: Range: ~ Section: Fill added above original grade: Gravel length: WELL: ~xt~Ti~New ~ Upgrade " Gravelwidth: ~t Numberoflines: Distan~b~eenlines: ~. I I ~/~ ~. Classification (~ate, A,B,C): Total Depth: ~sed To: Total absorption area~ ~ Pipe material: *~'~ Driller: '~ ~lied:~ St~ticWater Level: Installer: ~ &Ft, ~ ~VI~ Dat~ installedj,'[~ -- I1[10 -- Yield: ~t: ~Above Ground: Ft. I ~ ~,. TANK ~PARATION DISTANCES ~ ~Se~tio ~Ho~ing AS.T.~.P. TO S~ptic A~sorptio, L[~ Holding ,ubiic/Private Manufacturer: ~ %~ Capacity in gallo~s: From Tank Field Station Tank Sewer Lines ~ WelF {OO'~ IOO '~ ~O~ ~ ~/~ ~ ~ Material: ~7~ Number of Compa~ments: Surface water ~ t~' 10b ~* /0~'~ p/~ - LIFT STATION Lot ~ ~ Size in gallons: Manufacturer: Line ~ lO ~ '~ ~/~ ~ ~00 ~6~ "Pump on" level at: ~, ~ "Pump off" level at: ~ High water a~arm at: .o.n~tio. ~'~ ~0 '* :'~ ~/~ -- ~/2' I FA" I F~" ~ Pump Make & Model ~ Electrical inspections pe~ormed by: Remarks: ~ T~[S IS A ~EO~uc,ww~ BENCH MARK Location and Description: Inspections pedormed by: ~ ~,~. ~~ , ........... . ............ 7320 E~t ChiCHi. ~ ,~[ ,t[~ ...... '~i~.'. t4o. 9aoa Department of Heal~~approval J,~.~.3',.. ,, . ~...~ ~ ~ r~o ~-'" · Reviewed and approved by: Date:/2-/- ~ ~~ 72-013 (Rev. 9/91) MOA 25 PERMIT NUMBER: AS BUILT DIPlOid, WING PARCEL ID NUMBER: SW980301 ' 017-142-25 ¢ I00' FROM SURFACE PONDIt, IG~, <ii=~ \~ AS F~,GOED BY A RE~STERED~ ~ ~ ~ND SURV~OR, [ / ~ ~ ~ ~ ( BDRM tIOUSE/ / FILTER LOT 7, BLOCK 2 ~ ~ % PARK HfLLS ~t~ ~ C05 77 0 71 / x -- ~,,, ~ ' ' PHONE= (eOT) 3~7-6179/F~: (907) PARK ~ILLS SUBDIVISION ¢1, LOT 8, BLOCK 2 ,¢~ ;-"' 49:, .... : ........... , .... WPE OF WORK: DESIGN OF SEPTIC SYSTEM UPGRADE KATHY DAHLQUIST ~ 240-3458 ,- /g~ '(~¢"""'- 2'.~:--'"': ~' DATE: ID~WN BY: J oCALE: ' I PAGe: PERMIT SW9 8 0.,~0 NUMBER: 1 AS i BUILT DRAWING PARCEL 0 1 7-- ~B 142-25 NUMBER: IN~Afi~- ~ .~ ~ ....... ~ ~ PROM *CIRC*A~* ~{dl~t d~e ~ ~ i~e4 .*zf~w' ' : ~S~ WA~R AND WAS~WA~ CONS~TA~S, INC. PARK HILLS SUBDIVISION ~1, LOT 8, BLOCK 2 PROFILE AS-BUILT Of SEPTIC SYSTEM .'J **ep~re~ ear: PHONe NUMBER: KATHY DAHLQUIST 3ATE: O~WN r]Y: SCALE: 3 OF 3 { {/23/98 A,C,5, N.T,S. PA~[: RECEIVED -: ~OV 24 1998 .~ Munic paltry ot AncnOra9e :i:.'i :, ' ~ePt.::: Health & Human Services / ' ,'" :..<'Z ' ' ,*-,' " 5." _ · '~' ' · , : . . · WATER WELL REC'ORE~" ' - -'; STAT~ OF ALASKA . ~ · " DEPARTMENT OF NATURAL IRES~URE~J.-- · :. ;' Division of Geologicol ~ Geophysicol Surve~'s ._. .'LO~A?fON'GIr WI[LL (Plaaee-complete either ID. lb or lc.) A.D.L. NO,. ddre~'~ '. _ ~' / ~ ~ - . "-. ~'., ~£L~' LOG'?f' -: , .~;'., ... ',; --' . : . ~ . Feat 8elow 4. WELL DEPTH; (finaL) 5. OF COUPL~?ION; S. CASING: ~ Thr~ajSe~ ~-~ Watde~' Bockflllln~ Gravel pack ' " ' 'f";: ,,':-' ''" ' ' 5 Water Temperature o [] F [] C , MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW980301 Legal Description: PARK HILLS #1 BLK 2 LT 8 Design Engineer: 41 Owner Name: Dahlquist Owner Address: 14700 Park Hills Circle Anchorage, AK 99516-4245 Date Issued: Aug 13, 1998 Expiration Parcel ID: 017-142-25 Site Address: 014700 PARK HILLS ClR Lot Size: 52852 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] 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 engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. If DHHS is still in the sampling phase of system approval, a sampling contract shall be in place before the system is put into operation. This permit is for a recirculating septic tank with trickle filter in conjunction with an upflow filter (RUF) Received By: (~~.., ~'~ ' Alaska Water & Wastewater 7320 East Chester Heights Circle L Auchorage N Alaska 99504 Phone (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers July 28, 1998 Municipality of Anchorage Department of Health & Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic Upgrade for Lot 8, Block 2, Park Hills Subdivision #1 RECIRCULATING UPFLOW FILTER (RUF) SYSTEM To whom it may concern: 1. GENERAL: The existing 3 bedroom home is served by a private septic system and a private well. The existing septic system is surcharged and must be upgraded. As can be seen from the site plan, the location of the creek and the location of a cutbank limits the available area for a septic system upgrade. Given these site constraints, we are proposing to install the Recirculating Upflow Filter (RUF) system. 2. SOIL CONDITIONS: Two test holes were excavated on July 8, 1998 and a third test hole was excavated on July 15, 1998. In TH#l, the absorption rate was measured at a rate 10.4 minutes/inch on the upper bench and 120+ minutes/inch in the lower bench (see attached soil logs). One percolation test was performed in TH#2 between the depth of 5.0 feet to 5.5 feet. The absorption rate was measured at a rate of 120+ minute/inch. The SW material was visually rated as the same soil as in TH#1 between 2 feet and 4 feet. A percolation test was performed on TH#3 between the depth of 4.0 feet to 4.5 feet. The absorption rate was measured at 8 minutes/inch. 3, DRAINFIELD: The intent is to install a Recirculating Upflow Filter (RUF) system that will allow the use of a small drainfield in the area around the 30 foot radii of the test hole #2 and test hole #3. The size of the drainfield will be based upon the previously established criteria for the RUF systems, which dictates that soils percolating between 1 & 30 minutes/inch have an 2 allowable application rate of 4 gpd/ft , and soils percolating between 30 & 60 minutes/inch have an allowable application rate of 2 gpd/fi2. Given the perk rate of 10.4 minutes/inch in TH#1 and 8 minutes/inch in TH#3, the 4 gpd/ft2 application rate would apply. We are proposing to install a 5 foot wide drainfield that is 30 feet long and has an effective depth of 0.5 feet. This corresponds to an absorption area of 150 ft2, or an application rate of 3 gpd/ft2 (assuming 450 gpd total flow). Phge Two Lot 8; Block 2; Park Hills Subdivision #1 4. ORENCO PACKAGE SYSTEM: The STEP tank with the trickling and upflow filter will be manufactured by Anchorage Tank & Welding to meet the latest design criteria established by Orenco Systems, Inc. The point of contact at Anchorage Tank is Lowell McNutt. As with their standard STEP tank, it is equipped with a high water alarm per M.O.A requirements. 5. SURFACE WATER: There is a creek to the north/northwest of the proposed upgrade, which is greater than 100 feet away. 6. TOPOGRAPItY: The trench will be cut into the toe of a bank which has a slope of 50%+. As you can see from the attached topography site plan, there are no slope concerns below the trench area. 7. CLOSING: I am open to any suggestions from your department that would be an improvement to the proposed system. I am unaware of any negative impacts that tiffs installation would impose on adjacent wells, or septic systems. If you have any questions, please call us at 337-6179. Sincerel~ / ^, ~if JAG/gk ' ' '~' / / I i .~- ..... ~-" I_Ol' 7, BLOCK 2 /~ , ~ ~ i J, LOT 6, BI_OCK 2 "x / ~ ~ / il L ~ ~ X / ') I.OT 9,/BLOCK 2 '-. ~%'--.. ~ ~ I / ~ ~ t / /// ,, -,,..~_,~ ,, A~S~ WA~R AND WAS~WA~R ~ ., .~ ~ '~ IYPE OF WORK; PREPARED FOR: PHONE NUMBER: KATHY DAHLQUIST 240-~438 A.C.G. 1 = 100' 1 OF 5 ~,..-/~ONIT'~A. CI'OR IS RESPON$1BI.E FOR SOU~tFZ, ST FR~PERrF ~INE FLAGGED ~Y A REGISTERED ~ND SURe'OR PRIOR TO CONS I RUCllON. 2)THE CONI'RACTOR IS f,ESPONSIBLE~ F'DR CONTACTING THE ENGINEER PRIOR TO CONSTRUC'IION AND A~ER THE SURVEY WORK IS COMPLEq-ED 1-O ARRANGE A ~NDA'FORY SITE VISIT. EXI$11NG TO BE ABANDONED ---' - PROPERLY ABANDONED -PROPOSED 2000 GALLON RECIRCULATING SEPTIC -fAN)( (SEE PAGE 3 OF 5) LEOAL DESCRIPTION: TYPE OF WORK: DATE: IDf~WN PROPO:SED DRAINFIELD 30' LONG 8Y 5' WIDE DY 2.5' DEEP MAX. ON UPHILL SIDE W/ 1.5' OF SAND FILZER AND 0.5' OF SEWER DRAINROCK, (SEE PAGE 5 OF 5) SAMPLE F'ORT x --Pf,'.OPOS[-D UPFLOW FILIEf,t (SEE PAGE 4 01: 1.25 FNCN HDPE LINE SLOf DA I_lFl' STAI'ION FOR D~AINAGE LINE. NO LOW SPOTS WHICH WIlL ALL )V¢ WATER TO ~OI.LECT. ALL CONNECTIONS SHALL BE SFAINLESS SI'EEL WITIt STAI~,_ESS SlEEt_ LO1- 9,,~LOCK 2 ALASKA WATER AND WASTEWATER 7320 E. CHESTER HEIGHTS CIRCLE, /'¢,ICHORAGE, AK 99504- PHONE: (907) 337---6179/F,a.X: (907) 338-3246 &L DESCRIPTION: .... PARK t.~J. LS SUBDIVISION #1, LOT 8, BLOCK 2 E OF WORK: DESIGN OF SEPTIC SYSTEM UPGRADE ~ PHONE NUMBER: .... KATHY DAHLQUIST 240-3458 : I SOAI.E: I F AG E: I = 40' I I I ~Rd~NdPbfB~-~~_ ~ V~.f/~NX~P-~:~ III 1111111111"~ ........ ~,~ I~A~O~v¢,>/ ~, ~x,',~ ,%f~ ?:~ III 1111t11111 .J .... ~__=~4 ............. ~ ~ ~ III IIIIIIIIIL - (/IJfb~ I f~K ~N~RiCAfCP ~Ot~ 'h6 CO~U~d ~1111 II III ~(~" r~Am ?Af¢~ ~ ~1 ~1 ~ ,~ ~ ~ ~a~c4¢-.4~ co/~. ~ , ~ ~1~ r~ ¢ - "' {.k:&.~ ;;.;' ~?";." ~%:~.~ .......... :' ~ d , , ..,-,..., V ~EW ~ASKA WATER & WASTEWATER ~~' LEGAL DESCRIPTION'. PARK HILLS SUBDIVISION, LOT 8, BLOCK 2 '~: ....... :... PLAN AND PROFILE Of EECIRCU~TING SEPTIC TANK ,. PREPARED FOR: PHONE NUMBER: ~.% %¢ ~ CB47953 ..' g~ J,L.M. N.T.S. 3 OF 5 ~,oress~ ALASKA WATER & WASTEWATER PARK HILLS SUBDIVISION, LOT 8, BLOCK 2 ~.~.: .... :) ,./~.~ ............. ~PE OF WORK: P~N AND PROFILE OF UPFLOW FILTER .... g g~ .~ ...~ KATHY DAHLOUlST .40-~4~8 J.L.M. N.T.S. 4 OF 5 ~, otess~ CO o o dO L ....................... / ALASKA WATER & WASTEWATER ~ 9~ 5.~ 7320 E. CHE~E HEIG~S CIRCLE, ANCHO~GE, ~, g950~ ~ .... LECAL DESCRIPTION'. ..... ..... ~PE OF WORK: DETAIL OF P~N AND PROFILE or DRAINFIELD ~ e~i~,~ '~:'~,'s;7'"~ PREPARED FOR: PHONE HUMBER; ~% I' CE-7953 KATHY BAHLQUIST 240-3438 ~¢~ "' ~ " %% '".. , , .."' ~A-r~:7_25_98// ~w~ BY: SCALE: PAGE: ~;*e~ ' ...... - J.L.M. N.T.S. 5 or 5 ALASKA WATER & WASTEWATER " 7320 E. CHESTER HTS. CIRCLE * ~CHO~GE, AK. 9950~ ISOIL LOO - PERCO~TION TESTI .: ....... ~:~.~.I~.~..NI.~ PERFORMED FOR: KATHY DAHLQUISTU ~,'4~tjA~'~."~CLj~./...., DATE PERFORMED: 7/8/98 I I (f..O ~5~ TEST HOLE 2~,%o [. ,j SOIL C~SSIFICATIONS GC J W/ SM & LIGHT ~ SC G~VEL ~RY DENSE) DEPTH TO GROUNDWATER DATE 8 ~ ' & / 7.5' ' 7/8/98 Z~-. / 9~ ' -- .... I = I00' 11 ~ DATE READING CLOCK NET TIHE WATER LEVEL NET DROP TINE (HINUTES) READING (INCHES) 12~ 7/17/98 UPPER B[;NCH-PRESO ,KED OVERNIGH ~ PRIOR TO TE~TING 1 4:25 6" 13~ 2 4:55 _ 30 3 1/8" 2 7/8 5 ~:57 6" 1~ ~ 5:22 15-- 7/17/g~ LOWER BENCH-PRESC ~ED OVERNIGH~ · PRIOR TO TESTING 16-- 1 ~:20 6 1/8" ......... ~ ..... 4:5~__ ~o ~ 3/~" + ~/~ 17-- _ ............ ~ ~ 5:20 .~0 1~ PERCO~TION ~TEIO.4 · 120+(MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 20 m TEST RUN BETWEEN &0'3.5 FT. ~D 4.5-5.0 FT. COMHENTS: RECOMMEND USING AN INNOVAT~E (RUF) ~EM. PERFOBED BY A~SKA WATER A WASTEWATER I, ~ . ,~ , OERTI~ THAT THIS WAS PERFORB~ IA ACCORDANCE WITH ALL EI~TE AND BDNIClPAL ~GDIDELINES IN EFFECT ON THIS DATE. DATE: ~ ~ DEPTH TO GROUNDWATER DATE 8' 7/17/98 B' 7/24/98 ALASKA WATER & WASTEWATER [SOIL LOG - PERCO~TION TEST] 49 LEGAL DESCRIPTION: PARK HILLS SUBDMSION ~1, LOT 8, BLOCK 2 DATE PERFORMED: 7/8/98 , DEPTH .........TEST HOLE ~2 0o~o%o SW-vISUALLY o% ~°o~ SOIL C~SSIFICATIONS i1] ..... 2--~o~o%o RATED ~E SAME ~ ~o&o%o SOIL AS IN TH~I ~EE~,T~%? GW ORG ~% ~%~ ~ (APPROX. 10.~ I~G~ gL 4~o°o 0%°~ MIN/INCH) oo ~o ~o~ ~ gc OL sYs~,~ 6-- ~ ML ~ sc  DENSE ~ B.O.H. DEPTH TO DATE GROUNDWATER / t HOlM HOUSE -- ~ .... PI~)SE SEPTIC 8~ DRY ~ 7/8/g8 Z~ ........... .. -~ '~/ ~ I r'= Ioo' 11 --~ DATE READING CLOCK NET TIME ~ATER LEVEL NET DROP TIME (MINUTES) RE.lNG (INCHES) 12~ 7/17/g~ PRESOAK[ ) OVERNI~H · PRIOR TO 'ESTIN~ 1 4:15 6" 1 ~ -- 2 4:45 ~0 6" ~ 3 5:20 ]0 16-- 17-- 19~ PERCO~TION ~TE 120+ (HIN./INCH) PERC. HOLE DIA. 6 (INCHES) 20 I TEST RUN BETWEEN 5.0 AND 5.5 FT. COMMENTS: PERFOMED BY A~SKA WATER A WASTEWATER I, ~ . CERTI~ THAT THIS WAS PERFORMED I~ACCORDANCE WITH ALL ;TATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DEPTH TO DATE GROUNDWATER DRY 7/8/98 ~-- 7/17~98 DRY 7/24/9B ALASKA WATER & WASTEWATER PHONE (go7) 337-6179 * FAX (gO7) 338-3246 .' . Isolk LOG - PERCOLATION TESTI ~:" LEGAL DESCRIPTION: PARK HILLS SUBDMSION #1, LOT B, BLOCK 2 ' ' DATE PERFORMED: 7/15/98 ..... I I (feet) ~ TEST HOLE #5 ~:: '.',~ ~ SOIL CLASSIFICATIONS ~~~ ~J SP ,, ~ ,, SM ,~ OH /~ } t ~ DEPTH TO GROUNDWATER / , , ~,.. '1 I ~T~ DATE I ;~&i SEEPING ~ 10' 7/15/98 ..... : / L = O0 10-- ~T ; ~,- "' --T 11 -- Il ~ ~ DATE READING CLOCK NET TIME WATER LEVEL NET DROP 12 B.O.H. 7~]?/?~ _~?C. HO .~ ~A.~_ ~ ;~KE_D ~_H~I~..BRi~R TO TE~TING 1 4:21 6" 15-- 2 4:51 30 2 1/8" 3 7/8 3 5:53 5 5:24 15 16-- 17-- ! 19-- PERCO~TION RATE 8 (~IN./INCH) PERC. HO~ DIA. 6 (INCHES) 20 ~-- TEST RUN BETWEEN 4.0 ~, ANB 4.5 THIS WAS PERFORMED m~ ACCORDANCE WITH ALL {S~ATE AND MUNICIPAL GUIDELINES mN EFFECT ON THIS OATe. OATE: '~l~[~ DEPTH TO DATE GROUNDWATER SEEPING @ 10' 7/15/98 9" 7/24/98 FROM ; ALASKA [dATER 6 UASTE~ATER V Rick I~, ,$trom, Mayor PHONE NO. : 9073383246 Jul. 19 1998 12:3~5PM P7 MtmicipaliD of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Dear Homeowner/Prospective Buyer:. The on-site wa~tewater disposal system you are purchasing/installing is an "alternative" wastewatcr disposal system. This system, known as a "Re¢irculating/Upflow Filter Septic System", is undergoing testing within the Ivlunicipality of Anchorage under the Alternative System section of the Wastewater Disposal Regulations (AMC 15,65). There are certain r/sks involved with the ownership of one of these systems: 1. The technology used in tbJs system has been shown to be effective m other areas. The system is currently undergoing atwo year testing period in Anchorage under the guidance of the Depmhncnt of Health and Human Services (DHI-IS) and the State o£Alaska Department of Environmental Conservation (ADEC) to determine its effectiveness in a subarctic environment. 2. The system for this prop~ry received a vertical separation distance waiver from both State of Alaska and Anchorage Municipal Codes to ~round water. Th~* waiver was granted due to the system% expected performance w/thru thc site conditions on this property. I (we) certify that I (we) have read ~he above statements and am (are) aware of the risks outlined. I (we) also certify flint Il(we) am (are) in the process of purchasing (property legal description): (Purchaser Name) (Purchaser Name) ~ (Purchaser Signature) Notarize Here .... ¢~.~ C[ vi6¢i n{ Z. ~/~('l~ who is personally kno~ to me ~ ' ~hoS~ :ao~*:~y : proved on the basis of whose identity i proved o~ the 0ath/affir~ti0~ of , a credible wit~ass to be the signer of the above document, and he/she STATE OF ALASKA ..... ,.N?TARY PI.'~L!C Public My commission expires '7~- ~'~ FROM ,: ALASK~ WATER ~ WASTEWATER PHONE NO. : 90?5383246 Jul. 1S 1SS8 12:3~PM P6 PROPERTY OWNER AGR~F~M~....NT FOR ~ ~INTENANCE OF AN ON-SITE WASTEWATER DLqPO.qAL T~s agreement, da~ed 199__, is m~ac between the Mtmicipality of Ax~oragc Department of Hcalth aad Human Services fi)HI-IS) a~ thc prope~y owaer(s) of: TI~ agreement i.~ made for the purpose of mainminin§ an on-site wastewater flispozal system on the subject property. The property ovraers zgree to t~,e following: Submit to thc M-~{cipality of A~chorage, on an a~muo~ basis, an i~pection and operation statement from a regfste~ed professional engineer. This impecdon an~ . operation statement shall verify that the eag~neer has ~.~pected all effluent ~uct air pumps, timers, mad alarm.% and that any deficiencies have been repaired and tl~at the system is functioning as designed. (~gna~e) ~'' (Signature) (Printec~ Name) , ~$~¢ L. ~/~',~lc. who is personally known :o me wh~s~ ~an~it~ I pr~v~d ~n ~he ~a~h/a~fi~io~ of to be th~~E:'~°v~- document, and he/she a~~:~gned it. . ,.. ,~-~ ~ STATE OF ALASKA" :: ~ NOThRY PUbLiC ?:~ My commi~SiOn p  ~ .... MUNICIPALITY OF ANCHORAGE 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 ~NEW MAILI GADDRESS LOCATION NO. OF BEDROOMS~ DISTANCE TO: Well /OOg Absorption area 51 Dwelling ~1 PERMIT ~ ~Z Manufacturer Liq. cqpacity in gallon~ Inside length Width Liquid depth ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O ~ ~ Manufacturer Material Liquid capacity in gallons ~ Well Foundation ~ Ne.DISTANCE TO:of linesl/ Length ofJ~a~/line~ ~' Total lengthof lines/jt]~l~ Nearest lot lineTrench widt~J_.~/~linches ' PERM~ N~l'~g~Distance between lines ~ Top of tile to finish grade ~1 Material beneath tile~ Total effective absorption a~ ~ ¢ Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: j Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS AS~ aoaq SOIL TEST RATING INSTAELER . REMARKS APPROVED DATE LEGAL 72-013 (Rev. 3/78} Health and Environment~ .Protection Department 825'%_~ Street, Anchorage, AK. '~3:9501 264-4720 ~"' * * * HANDWRITTEN PERMIT * * * , WELL AND/OR ON-SITE SEWER PERMIT A~plicant: ~L~--~_ ~2~<~Mailing Address: n~cation: Phone Number: LEgal Description: ~>/'~ ',7_. (~.x~/ ~v/~L.Q~ LOt Size: T~pe of Soil Absorption System Is: Trench: ~ Drainfield: Seepage Bed': Holding Tank: M~ximum Number of Bedrooms: ,,,,,~ Soil Rating (sq. ft/br) The Required Size of the Soil Absorption System<~ DEPTH /0 LENGTH _~-~-l.~-- GRAVEL DEPTH ' ~ WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HO'L-D'I'-NG) TANK SIZE = /0~3 GALLONS * * P6rmit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of:residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * B&ckfilling of any system without final inspection and approval by this departmen- willl be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feed for'a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is~;25 feet and to a community sewer line is 75 feet. Well logs are required andl. must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER ~1~ 1 9 ~ 3 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set fcrth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 b~drooms. Signe~: ~-~&~~ ' Issued by: .,'~,~ ,'<--c--~-~6-~-7;-..~--c,c<3~/-~ ~p~licant Date: ¢-~-~Q - ~'L~ SWP/024 (1/81) ALASKA ~IROnm~nTAL CONTROL $¢01C~$, inc. I~nciineerinc] E, (~nuironmentol Studies PERCOLATION TEST DATA SHEET CLIENT .... ~{t:'r~ ~F~'~'t'C~J"~ . DATE L/q,,;l~ '~ AD. DRESS~_~'~i,'i'~ ~-k\\~ ~-~JJ[r~--'~L~)~bi-(''jr'~ ,~ k~Jr-~;;:~) ZIP CODE LEaL LOCATION TOTAL DEPTH OF HOLE ZONE TESTED _ Zr'7~' ft TO ft. ft READING # CLOCK TIME NET TIME DEPTH TO NET DROP RATE (min/in) DATUM FINAL PERCOLATION RATE PERFORMED BY 6xT~J~/~)/ (min/in) Best 33r;t Au~n,~. Sui,~-J*. AnJ~Jro¢. Alosk 99503 · (907) 276-1361 ,,, /[Z] SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION [] PERCOLATION TEST 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST i 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16- 17 18 19 20- COMMENTS SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN -- FT F CERTIFIED BY: ~~~ (minutes/inch) P~,R~ H~LI~5 g/ROLE O Found Rebar (~ Found Iron Pipe ~--~Elevation -~"Drainage Arrow It is the responsibility of the owner, prior to construction to verify proposed building location on Lot, Grade, and utility connections. I, the undersigned, hereby certify that, to my knowledge, no easements, Covenants or restrictions legally exist on this property which I have not revea'led to the surveyor of this tract. DATE I hereby tz~y '~p~,~a~vey was made by me or under my direct supervision and the property corners marked as indicated. DATE CONTRACTING ENGINEERS &ASSOC. 212 E. International Airport Road Anchorage, Alaska 99502 '.~q" ,--' _'"r Fo 2-z/53 F'ERMIT NO. DEF'RRTMENT OE "HERL. TH RN[:, EN',,,'IRONMENTRL "F'¢~OTEC:T! ON R;--._'5 "L'" STREET., RNE:HORRGE., RK. 99501 264-4720 ,:; 83:F14:--:7 > ]ET' RF'F'LIC:RNT HIGHLRND DESIGN INC SRR Bn::.:: --':±63: RNCHORRG LI-II-:FIT I ON I ..... - ..... .'L JIM RRMSTRONG LEGBL LSB2 F'RRK HILLS L. OT TYPE OF SOIL. RBSORPTION S'¢STEM IS: MRXIMUM NUMBER OF BEDROOMS = 3: SOIL RRT] THE REQUIRE[:, SIZE OF THE SOIL. BBSORPTION S'¢STE THE LENGTH [:'~MENS~ON ~5 THE LENGTH (~N THE DEPTH OF R TRENCH OR F'~T GROUND RND THE BOTTON OF THE EXCRVRT THE GRR'v'EL DEPTH ~5 THE H~N~MLIM RND THE BOTTOM OF THE EXCR', F~ON :,. 3:44-5743: SQLIRRE FEET' 264 THE TRENCH OR DRRINFIELD. THE SURFRCE OF THE EET). ~ --~._ BE'TP.IEEN THE OUTFRLL PIPE F'ERMIT RF'F'LICRNT HRS THE ~:E; 'El INFORM THIS DEF'RRTMENT DURING THE: INSTRLLRTION It4_PE_.TIuNz, OF Fltqt RDJRCENT TO THIS PROPERT'¢ RN[:, THE NUMBER F~F_ RESIDENCES. 'i'HFtT THE ~LLFF HILL SERVE. / / 'T' ~.-.~ ~--~ ":" "~" ':" Z ~"-~ ~ F" E F-" 'T ~ ~'-, ~" "~= ,,--" ~" ~-- ~RCI<FILLING OF RN'T' SYSTEM I. OUT FINRL. IN$PECTIO'q R'~[:, RPPRO,RL E:N' THIS CEPRRTMENT $,~ILL BE SUEL.IEC:'[/TCI F'ROSECLITION. MINIMUM DISTRNE:E E:ETHEEbf~ P.tELL RND RN'¢ ON-SITE SEI.4RGE DISF'OSRL $N'$TEM I9 t00 FEET FCR R F'RIVRTE I.qELL OR t~0 TO 200 FEET FROM R PUBLIC P.IELL [:'EF'ENDtNG UPON THE T'¢PE OF F'LIE:L~._P HELL MINIMUM DISTRNCE FROI'd']R F'RI',,,'RTE HELL TO R PRIVRTE SEHER LINE IS 25 FEEl" FIND TO R C:OMMLINIT'¢ $EHER' LINE IS 75 FEET. HELL LOGS RRE REQUIRED RND MUST E:E RETURNED TO THE DEPRRTMENT' HITH~N 3:0 DRYS OF THE &qELL COMPLETICIN. OTHER REQUIREMENTS MR'¢ RPPL'T'. $PECiFICR'TICINS RND CONSTRLtCTION DIRGRFIM$ RRE RVRILRBLE TO INSLtRE F'ROPER !NSTRLLRTtON. I C:ERTIF'¢ THRT 2L: I RM FRMILIFIR HITH THE RE-.--~JIF.".EMENTS; FOR ON-SITE 5EHERS RND WELLS RS SET FFIRTH E:'¢ THE MUNICIPRLIT"-r' OF FINCHORRGE. 2: I PJILL INSTFILL THE S,'¢STEM IN FtCCI]RDRNCE b~I"l"H THE CODES. 3:: I UN[:'ERSTRN[:, THRT THE ON-SITE ':';EPlER ""'?¢STEM MR"r' REL.]LIRE ENLRRGEMENT IF THE RES t F.:,EN_-:E I S REMO[."ELED TO ! NE:LLI[:,E MCIF.:E 'THRN 3: E:EDRI_'IL]I'dS. ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L Street, Anchorage, Alaska 99501 264,4720 -., SOILS LOG-- PERCOLATION TEST [] SOILS LOG [] PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: T~ .~ 1" ,-4 5 6 7 9 10 1 2 3 ~,~1 5-5.'5 ,' DATE PERFORMED: SLOPE SITE PLAN 11 12 13 14 15 16 17 18 19 20, COMMENTS ~ore ~CA¢~L WAS GROUND WATER ENCOUNTERED? , P IF YES. AT WHAT E ..DEPTH? 8, ~ ' Reading Date Gross ~r Net Depthto Net Time Time Water Drop PERCOLATION RATE , ~.,(-¢ TEST RUN BETWEEN 4//'z_ FT AND {minutes/inch) FT PERFORMED BY: CERTIFIED BY: DATE: f :"#19 12+ I ,.,' ,.: 14 J M L^~,~.^~, A$$ocIATF$ '' Soils Laboratory and Geotechnical Engineering ob,o. 82-347.03 Appr. JML Date 4/20/8; t SITE PLAN TRIAD ENGINEERING"' PARK HILLS SUBDIVISION #1 Anchorage, Alaska PLATE 1 8.2 :.14.3 13.0 R2 #6 ¢~-' - , 12.3 1lA LEGEND: BORING # DEPTH TO OBSERVED WATER ~'al[.l~l~R#?~ _ : r:'*$ul~dt'~ll{o~, '; , ' [~o~, BIo~K : lb. ' I/4qtrl. Section No. Townshlpa~ ~ngt '~ Meridian~ ' ' "'.:' . -..,~.;, .:: :,....:. ~-.' ,?u:;.k.~ ~ .---. , , .. ' ' .-~ ~" .A~ ~,-/~' ~::' ~ .'.'. ~o,_o,._~,~, '. '-.- ,o - ~-~-..:.*'~"'..~',,'"'~.'?~:-~*' ~'.~ ~*","~: ·" ' :- ' - ~ ~,. ~;. ~L~' *~.-~ z":::~.' ~:- ':' ':'::.'.::::"'?'~,qr ~':-:~', '"";:A~' :.' To~: ' ~.~. ,- ...... :...:.,:4~,~.-:':~'~-,:",> :~::,"-~... ' :" "" " ' ' u~","~"o, ~:~'"T~,::..:.;.~", :' ': ~'~ '.":: ." . :'.'~'~ ' -,".'-~L'' :7;. :~:~. '.' ;;::, '' · .. . ':: ' , ' ' ' : ~t:?'~: [ '?~"~'~i['.~? %; ;: "::~ ";' ':r ::~"":', -:~:~' I ~ ' '; ' Sit between? : - ft. and ' -' ~ ~t. '- :~'~ "':':~ ~-,::'':' ':-' - "~ .' ' ':; ' ' ' " ' - ' I j~<'>.;~::':-~.--: ~:~:: -.:.~q',~ '~. ..~' _.'~ .:.-: _': ' ,- 'L . la,S~OUTINS . Well ere'uted~ ::~;~:'-::-''."F,4. :~;'(:;:~" :"- ~ - ,.:, ~. , ~r ' ,, ~.' ' - ~ '. ~.. . , .~ ' ,::. ,.~ :~ ~/-~'-?'~ ',~. U :. -~:~:;.'~ ': ' '.- Z' . ': -,, · ;' · -, - ~ Subm, U ~' ~::.:~L~' .~ :.:".;;.. ,:~'..- :.: .... .:, ; -'."': ' · ' ~ · ' . - .- - .. '.:.~M':~,..;~::*>'_::~..:~'::~::.:'::~,'".' . ,:~' :~'. . :-:. ",, , . . · . . ".~ . . -. :, . :. _. ~::'>'~ '" '9 '*' ,'b ' ,'-;=. . .':., , ~ :,, -" , . - ' :. , . . - "~.;' ,~-~' ,'~. ~1~ ~ t1~ un~ ~l~d ~-~ f~ s' ra~o~f l~'~r~e fo f~e. best ~ my know e~e ~n~ bel e~ .... - . , '. · .-:: ...,,.. ~:' ,,::~ :~-..': . :.-, :...- .~. . ~. ? - . :.~-,- '.-:: .,... . _.: -.., ~'~-.(l~Z~i~:~;'/~'L:~'~'-);':.~,~::::'.· c~. e~.'~,~io~- ~'sf=fe ~ee,"~-~,m~,. cAff~Y~c.~to~' :' -','.. ':?'" .'~ ':" ' :.%. :' Municipality of Anchorage On -Site Water and Wastewater Program a (907) 343-7904 s , : E T r CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 017-142-25 1. GENERAL INFORMATION Expiration Date: ! —z © ?_ Z Complete legal description Park Hills #1 Block 2 Lot 8 Location (site address) 14700 Park Hills Cir. Anchorage, AK 99516 Current Property owner(s) Douglas & Donna Mills ____ Day phone Mailing address 14700 Park Hills Cir. Anchorage AK 99516 Real Estate Agent _ Day phone 2. TYPE OF DWELLING: M Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well M Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ WaiverNariance request for: 3 TYPE OF WASTEWATER DISPOSAL: Individual M Holding Tank ❑ Community ❑ Public Sewer ❑ Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ _550 Waiver Fee $ Date of Payment I?/121 Date of Payment Receipt Number o 501(G _ Receipt Number COSA # r�G 21 6Q 2Waiver # istance: 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING, INC. Phone 696-6111 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 9957.7_ Engineer's Printed Name _KENNETH M. DUFFUS _ Date Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future �+�\ occupants or can ArcTerra guarantee that no unseen r encroachments, deficiencies or discrepancies exist. - / OF -aL 1, 1 6. DSD SIGNATURE System #1 Approved for 3 System #2 Approved for Disapproved. Conditional approval for bedrooms. bedrooms. bedrooms, with the following stipulations: Ile ON-SITE WATER AND PROGRAM B _ Original Certificate Date: -I- ( —G. The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Septic System Advisory Well Flow Advisory COSA blue sheet 10-10-12.doc Nitrate Advisory Arsenic Advisory Other _Sf-evdo� v• i 0P"y 6C9V, �1_ a Legal Description: Park Hills #1 Block 2 Lot 8 Parcel ID: 017-142-25 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 9/22/83 Total depth 46 ft Cased to 46 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 16 in. Date of flow test for COSA 11/29/21 Static water level at beginning of test 27 ft. Comments B. TANK DATA Age of tank(s) 23 years Tank type/material Septic/Steel Measured operating fluid level in septic tank 42f1 IM Standpipes/foundation cleanout per record drawing Date of pumping 12/1/21 D. ABSORPTION FIELD DATA Which system tested (date installed)11/10/98 10 ALL standpipes present per record drawing Total measured depth from grade 3.5 ft (max) Measured depth to pipe invert from grade 3 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: COSA Checklist yellow sheet Well production at time of test 5.5 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No Coliform bacteria is Negative Nitrate 2.14 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L IS Arsenic less than MRL (ND) Collected by Arcterra Consulting Date of Sample 11/10/21 C. LIFT STATION kZ1 Required maintenance completed Age of lift station 23 years Lift station material Steel Comments: Adequacy test date 11/29/21 Results D Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 450 gal New depth 0 in Elapsed time 10 min Final fluid depth 0 in Absorption rate 450+ and 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' ® Yes if No Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No ft Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No ft Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' ft Water Main > 10' Animal Containment > 50' ® Yes if No ft ® Yes if No ft ft Water Service Line > 10' ® Yes if No ft Manure/Animal Excreta Storage > 100' comment below Community Sewer Main > 75' ® Yes if No ft ® Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ®Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Main > 10' ® Yes if No ft Communi y Wells > 200' ® Yes if No ft Water Service Line > 10' ® 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' Yes if No ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100' ® Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Surface Water > 100' ® Yes if No 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 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 Al Day of _Dg of 20 , by and between f herein the "OWNER," and the Municipality of 2cihor�g,,rein 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 Upflow Sand Filter located at (legal description) Park Hils #1 Slk 2 Lot 8-14700 Park Dills Circle, Anchorage 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or, the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. 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) Pagel of 3 c.. Owner acknowledges that the Municipality may request records of maintenance and �` repairs from the manufacturer's representative or maintenance provider. C4— Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new 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. CV, 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 OWNER: 1 ignature) Date: r< (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this 211 day of J�)Zremb, 2021-, by Vev o NOTARY PU LIC FOR ALASKA ;ary pu^" bl;c My Commission expires: 0: FONOTI te or Alaska [:VE:RNA�1- on Expires May 24, 2022 MUNICIPALITY. By: N (signature) 6L4-1 (print name) Date: 1-2-- 2 d 1 Z/ Title: (rev. 05/18/2018) Page 3 of 3 lv'UNICIPALITY--OF ANCHORAGE De,valopment Service- Deparl.rrieTit ` -Phone: 907-3437904 ._ din 81t.e Water & ' d- s� , veater Sectfori Fax: 907,3-.1-7997 Maintenance Log Owner _ � z`t' .�- Street Adtlr€��� Phar - — -- PID -Sludge levet -; _ins: ies Purnping: requiresAp_*�_Purnpincq Completed l � r i z1tation; .Pairrrp basket d am s rk r_ -Effluent filter cLaanec��,I_'L rag ,Control floats cleane " •PrGper float settings confirmed -Operation satisfactoq ° ,z -Dedicated efectrica1 a arm rircijit 7 _ -Addible and visas( alarm, jnside dvir ling :} I I I I syztern, OOP-1ap Ir~ -.round grater intr€rsle i at r°i r to tank conTYeotion Trctr.- d ; ri atr`usir_:;i around psFe� pt -in, -traticris y_e.�•Weep hol-r-grinctional -Polanholeice: Tian :)rlalD- Insulated 4rLrrope rly Secured - m f.'. -Ali manufacturer requ'r d insfActions and Maintenance complete ..-_.. ... .. --------- - ............... ........ -1 ........ ...... . ....... . ..........._.... Date of rnairltenancpL_2_A Company MUNICIPALITYRF ANCHORAGE �, •`" Development Pane:1;07-343-7904 Development Sev"res Department }`` : �3 �'9i' On -Site Vvater & Wastewater Section fax�f ��� Lift Sta#ioll='urttp Vault Maintenance Leath street A ddress ]'i�Ct Prone l,eg"al� esc,- t S L _ PID, -Sludge level inches -Pumping' required 4---lq -Purnping completed � y Lfella orte,-,. •P4rmp basket ciearted yf §, -Effluent filter cleaned -Control flo.-Its ctearted yje_� -Proper float settings confirmed OC)eration satisfactory -medicated lec rioal alarXr� circuit.,,.-t�,udibie and vi- ua alarm inside dwelling -Alarm system operation rtor no#.sf�.,t Ground water intrusion at riser totank connection _M .Groundk water intrusio;) amUnd Pipe per"etratians y f- -- Weep hole funs-bOnat -Manhole lid: Functional Insulated Pror Secured __ , Oibr, -Ali manufacturer required inspections and rnaintenan completed yew�,. np s.t�� �' �---.-.......... . ........ .....Woo s.......,.-.----..... _.. Technician 'Company signature SIMON JR's Septic Pumping and Excavation PO Box 773415 Eagle River, AK 99577-3415 Name / Address Doug Mills 14700 Park Hills Cir. Anchorage, AK 99516 Date Estimate # 12/16/2021 89 Signature Phone # E-mail 9076946454 jrsseptic@gmail.com Project Description Oty Rate Total Repair existing lift station, 7 hours at $225.00 for excavator/crew. Repair broken lines in lift station. Thaw and clean backflow preventer. Thaw line leaving lift station. 7 1 225.00 350.00 1,_575.00 350.00 Thank you for your business. Tota l $1,925.00 Signature Phone # E-mail 9076946454 jrsseptic@gmail.com 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 017-142~25~''' . 1. GENERAL INFORMATION Complete legal description Lot 8; Block 2; ParkHills Subdivision #1 Location (site address or directions) Anchorage, AK 14700 Park Hills Circle Property owner Mailing address Thomas Hennessy 14700 Park Hills Circle Day phone 349-5861 Anchorage, AK 99516 Lending agency Mailin. g address Day phone Agent Add ress Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: NOTE: XX Individual well Community well Public water If community well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. TYPE OF W~,STEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: XX Public sewer 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 Address EngineerS signature ALASKA WATER & W~STEWAT~.R CONSULTANTS, INC. IS TO BE PAID $ ~?~ ~°~¢ROM ESCROW ACCOUNT FOR ENGINEERING SERVICES PERFORMED. DHHS SIGNATURE .k/ Approved for ,~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments Date ./2. - /- ¢'r0' The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional eng Jneer registered in the State of Alaska. The DH HS 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 professional engJneeCs work. 72~325(Rev. 1/91) 8ack MOA~21 I~l:~r i ¥ CI~ ~OV 2 ~!. ]998 of Anchorage DEPArTmENT OF HEALTH & HUMAN 8E~Vl~cm~u~ o~ A~C~o~ Environmental 8e~ioes Division ~NVI~O~NT~S~VIC~S DI~ 8~ L Street, ~oom ~0~ · Anchorage, AI~sR~ gg~OJ * (gO7) 848-4744 Legal Description: Health Authority Approval Checklist A. WELL DATA Well type Log present~N) Total depth Sanitary seald~N) OI - If A, B, or c, attach ADEC letter. ADEC water system number Date completed Cased to Casing height (above ground) Wires properly protected ~-Y/N) Date of test Static water level Well production FROM WELL LOG AT INSPECTION WATER SAMPLE RESULTS: Coliform Date of sample: 8 g.p.m. 0,0-~ g.p.m. B. SEPTIC/HOLDING TANK DATA Date installed Foundation cleanout Date of Pumping /',J//~ Nitrate 1' ''~g mt/-/(._ Other bacteria ,~ /I//I/~9 Collected by: ~L~ Tank size / 5oo Number of Compartments c~ Cleanouts (~-.~N) Y~-~' Y~.S Depression (Y/I~ /'",.~0 High water alarm~(~N) ~ Pumper ~/~,, ~ Soil rating {(g.p.d.~t~ or fF/bdrm) Gravel thickness below pipe System type ~[/ID~5 O, ~' ' Total depth ~ ~/~-~ Depression over field (Y/N) }A. Jo For .bedrooms C. ABSORPTION FIELD DATA Date installed Length ~,6' Width Effective absorption area ] c'~© [~-- Monitoring Tube present ~1) Date of adequacy test ¢,J//~ -/'oE, uJ Results (Pass/Fail) Immediately after - gal. water added (in.): Fluid depth in absorption field before test (in.); (ins) Minutes later: Absorption rate = g.p.d. Fluid depth If yes, give date Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)* LIFT STATION Date installed Manhole/Access ~-N) High water alarm level at* Cycles tested ~//~ Size in gallons "Pump on" level at* ~,~ *Datum /%??~'~' ~ "Pump off" level at* ,f E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on Io'~. Absorption field on lot Public sewer main Sewer/septic service line On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station ~ SEPARATION DISTANCES FROM SEPTICP~I¢~II~ TANK ON LOTTO: Foundation ~ 'p Property line /0 ~ Absorption field ~ '/- Water main/service line /O '~ '/* Surface water/drainage /00 '~ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Surface water Curtain drain Building foundation ! 5 '~' Water main/service line /6 '~z leo' 4- Driveway, parking/vehicle storage area /o '-~ ~.,,. Wells on adjacent lots /o~ 'I ENGINEER'S CERTIFICATION · . ermined t riel ins c ions and review of Mumc,pal recoYds t~.,~a~_~ ~.~'.~,rn, are I cedi~ that I in confo~ance ith MOA H~ ideli Signature Date · , -~ '~ur ~o~~ ; HAAFee $ ~/~7-~ , ~ Date of Payment ]//~7~/~'~ Receipt Number ¢~ Waiver Fee $ = Date of Payment _ Receipt Number 72-026 (Rev. 3/96)* MUNICIPALITY OF ANCHORAGE DiV!SIC~N OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEAI~! AND ENVIRONMENTAL PROTECTION APPLICATION FOR H~ICH ALrfHORITY APPROVAL CEMfIFICATE 1. G~r~al Infor~nation Application Date (a) LeGal D~s~uiption (include lot~ block, Subdivision, section, township, range) Location' (add~ess o~, directions) (b) Applicants Name Applicants Address (c) Applicant is (check o~_~ne) Lending Institution Buyer ~; Othe~ ~ (explain); (d) Lendin~ Institution ~ Address Telephone (e) l~al Estate Co. & Agent Address Telephone 2. TYPe of l~sidence S ingle -Family Numbe~ of Bedrooms 3. Water Supply Multi-Family O~er (~s~i~) Individual ~%11 ~ Con,unity ~ Public ~ Note: If community v~ll system~ must have w~itten confirmation ~ ~e State ~p~nt of ~viro~ntal Con~rvation attesting to t~ legality ~d status. Is ~e ~11 adequate fo~ the n~r of ~ s~cified in this ~ ~) ~ 4. ~e Disposal Onsite~ ~blic ~ ~nity ~ Holding Ta~ ~ dis~sal system adequate f~ ~e n~ of ~ (~>N) Is the ~stewater [PaG~ 1 of 2] 2-15-84 The Municipality of Anchorage Departr~nt of Health and Environn~ntal P~otection dces not guarantee the continued satisfactory performance of the water supply and/or the wastewater disposal system° %his approval indicates that, as of the validation date shc~m abov~, based on t~ data and information furnished by an engineer registered in the State of Alaska, tJ~e water supply and wastewater disposal system is safe and func~ tional for the number of beclrcons and type of stmuctu~e indicated° (DHEP SEAL) 7. Mail. the HAA to the follcxd, ng address: /' KB2/d5/s [Page 2 of 2] 2-!5-84 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUIHORITY APPROVAL (BAA) CHECKLIST - FEBRUARY 1984 Well Classification Well Log Present (Y/N) Total Depth ~ Cased to Static Water Level l ~' Casing Height Above Ground Electrical Wiring in Conduit (y/N) Separation.Distances f~om Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot Public Sewer Line To Nearest C leanoat/Manhole D/A Water Sample Collected By L~ Water Sample Test Results Cc~,n-~nts i~uNIC:IPAUTY OF ANCHOIL, Ik(~- DEPT. OF HEALTH &. ENVIRONMENTAL pp, OTECTIOI~ If A, B, C~ C, DoE.C. Approved_(Y/N) Date Completed ~-/~'~5 ~' Depth of G~0uting ~/~ ~ ~t At ~' Sanit~y ~al on ~sing ~p~ession ~ound ~l~ead B. SEPTIC/HOLDING TANK DATA ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Se~r Service Line on LOt ; Date ~'~ ~ Date Installed ll' ZJ- Size 'IZ~O cc~J. No. of Ccmpa~tmsnts ~ Standpipes (Y/N) ~/~/ Air-tight Caps (Y~) ~f~5, Foundation Cleanout (Y~) ~p~ession ove~ Ta~ (Y~) ~) Date ~st P~d ~/~ P~ing~intenan~ ~n~a~ ~ File (Y~) ~/~ ; fo~ Holding Ta~ High-Wate~ Ala~ (Y~) 6%~/~ ~a~y Holdi~ Tank ~t (Y~) ~p~ation Distan~s ~ ~ptic~olding Ta~: To Water-SuPply ~11 /~0' To ~ilding F~ndation~ To ~o~ty Li~ /~ To Dis~sal Field To ~ter Main/~vi~ Li~ ~/~ To S~e~, Pond, ~e, ~ ~jor ~aina~ Cour + OO Conments [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD [I~TA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption A~ea Depression ove~ Field (Y/N) Results of Last Adequacy Test Length of Field ~' Depth of Field -~. ;. O' Gravel Bed Thickness ID' ~ ' Standpipes P~esent (Y/N) ~5 Date of Last Adequacy Test ~//~' Separation Distance from Absorption Field: To k%ter-Supply Well IO~ ./ To P~operty Line /O I To Building Foundation I~~ ~,~' To Existing or Abandoned System on Lot ~/A ; On~J'oining, Lots To Water Main/Service Line ~/~ To CutbaDJ~(if present) To St~eam/Pond/Lake/c~ Majo~ D~ainage Course + I To D~iveway, Pa~kin~ A~ea, o~ Vehicle Sto~age A~ea Co~ents D. LIFT STATION Date Installed Size in Gallons "Pum~ On" Level at High Water Alarm Level at Tested fo~ Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. Meets MOA Con~ents ** Check Permitted Bedroom Rating A~ainst HAA Bequest I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. [Pa~ 2 of 2] ' 2-15-84