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HomeMy WebLinkAboutSIEFKER #3 TR 4B Municipality of Anchorage '~ Page ! 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: S ~///~TD-'~ 'Dc?") PID Number: ~/~-- Z~/-~ ~ N~.: HA~Lo ~ ~/~-'~ WastewaterSystem: ~ew ~Upgrade Address: ~b¢/ ~'t2' ~ ABSORPTION FIELD Phone: Ne. of Bed,s: ~eep Trench ~ Shallow Trench D Bed D Mound D Other r DESCRIPTION sci, .a,in~: Total Depth from original~rade:.7 LEGAL /~ ~/Sq. Ft. Lot: Block: Subdiv~ion: Depth to pipe bo;lorn from original grade: Gravel depth beneath pipe Township: I Range: ~ Section: Fill added above original grade: Gravel length: ~ .~ I ~ ~, ~ ~. I I ~ .t. I '~ .t. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Driller: Date Drilled: SlaticWalerLevel: Installer: Date insl~lled' Yield: GPM Pump Set at: Ft. Oaring Height Above Ground:Ft. TAN K SEPARATION DISTANCES ~ Septic ~ Holding ~.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: Fro~ Tank ~ield Station Ta.k Sewer Li.es ~/OCy~ ~ ~ SudaCewater ~ ~qoW LIFT STATION Lot / .. i size in gallons: ~ Manufacturer: ~ump Mak* & Mod~l Electrical Inspocfions parformed b~: H ~ q~ BENCH MARK Remarks: Assumed Elevation: ~ · . : , Inspoctions porformod by: ~ Datos: ~s~ ~ ·~'-~ ..................., Department of Health~Hum~rvices approval ':,~. ,' .... . . 72-013 (Rev. 9/91) MOA 25 I ?£AC T 4A _.._ FOk/ING SPRING UNDER DRIVE~ - 4> ~5 50 ! 75 IOO 125 150 SCALE: )1 dO FT. TI~ACT 42 VA£ANT ~ #4 40 Ff. LONG 7 F[ TOTAL DEPTH ~EV~L -- 5~ T~ZE~-~OCK 3 FT, COVER CLE~ REVISED: NOV. 30, 1995 ¢H,4~ LEWGfH-OF--DRAINFIELD FR04t 20 FT TO 50 FI-. TOBBEN SPURKLAND P.E. II II 205 W 15TH, AVENUE ANCH. AK, 99501 (907~ 279-3916 TRACT 4B S/EFEER SJD DALE AND JANET HARLOW $641 CLEO AVENUE SEPTIC SYSTEM AS BUILT DATE: JUNE 23, 1996 SHEET: 2/$ GRID: 2735 20 FT 1-I/4" PYC Schedule 50 3(/16" Holes ~ 18" S TANDA/~fl T£ENCH ~IO£ YCL E TREATMENT PLANT 3 Ff. of Cover 1-i/2" Dischorge -- /-- 4" Topsoil ,J ,o~o~o~o~o~0~2~o~o~ooo~o~o~o 1-1/2" DisfibufionMirafiPiPe140 ~/ 60" Sewer Rock ....... BACKFILL AND LEVEL YtlTH SAND BIOCYCLE PLANT Idyers Pump IdE40 4~10 HP BENCH )~fARKL: BOTTOid SIDING' TOBBEN SPURKLAND P.E, 203 W 15TH. AVENUE ~gNC~I AK. 99501 OZ)' 279-39i6 II BIOCYCLE AERATED TREATMENT PLANT TRACT 4B, SIEFI<ER~5 564i CLEO AVENUE SEPTIC SYSTEM AS BUILT DATE: NOV. i5, i995 SHEET; 5/5 GRID: 2755 ~ 40 FT ~ i-l/4" PVC Schedule SO J ~~ 5/16" Holes @ 18" S TANBA£B T£ENCH © ~IDC YCL £ T~EA ?MENT PLANT Ft. of Cover i-1/2" Discharge -- lObS 0 0~0 0 0 0 0 0 0 0 0 0 0000000 0 0 00 0 0 0 0 0 %,,7 1-1/2" Oisfibufion Pipe Idirofi 140 60" Sewer Rock £EVIS£D, NOR 30~ ]995 £HAiVOE LDVSTH DF T£ENCH F£DM £$ F T TI? 50 F T, 4fl / F, iNSTAl I TOBBEN SPU£KLAND P.E. 203 W 15TH. AVENUE IANCH AK. 99501 (90~)' 279-3916 BIOCYCLE PLANT l~yers Pump IdE40 4/10 HP BENCH ~tARK; BACKFILL AND LEVEL WITH SAND 94,0 TOP WELL CASING BIOCYCLE AERATED TREATMENT PLANT TRACT 4B, SIEFKER //5 $64! CLEO AVENUE SEPtiC SYSTEA,I AS BUILT DATE: JUNE 23, 1996 SHEET; 5/3 GRID: 2735 5O 0 5o fCAL 150 200 ~00 FL I~/]NG £P£IiVG /-£ 4: 300 Veil PWSIi~ £139B8 TOBBEN SPURKLAND P.E. II 203 W 15TH. AVENUE II ANCH. AK. 99501 (907~ 279-~916 TRACT 4B $IEFI(ER DALE AND JANET HARLOW 564i CLEO AVENUE SEPTIC SYSTEM DESIGN DATE: NOV. 13, 1995 SHEET: I/$ GRID: 2755 t0 ~ FDWN6 SP~/N5 50 ~ 75 SCALE; i~ 50 FZ ! // LATE UIiIDE~ DRIVEl ® #4 1~5 VA CA/V [ 49~h }BEN SPURKLAND No, cE 2225 £L ED ~N~xiVUE / D~AIH F/ELD 20 FT, LZ]HE 7 Fl' TflTAL DEPTH 3 FL CBVE¢ . TOBBEN SPURKLAND P.E. I~ 203 W 15TH. AVENUE II ANCH. AK. 99501 /c~)7~ 279-3916 TRACT 4B SI£FKER S/I) DALE AND JANET HARLOW 5641 CLEO AVENUE SEPTIC SYSTEM DESIGN DATE: OCl-. 24, 1995 SHEET: 2/5 GRID: 2755 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE ~ASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW950397 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:HARLOW JANET L OWNER ADDRESS:3641 CLEO AVE ANCHORAGE, AK. 99516 PAGE 1 OF - 3 -qe DATE ISSUED:il/30/95 EXPIRATION DATE:il/30/96 PARCEL ID:01528164 LEGAL DESCRIPTION: SIEFKER #3 TR 4B LOT SIZE: 45066 (SQ. PT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM 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 (iSAACS0) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (MOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: 1.THE WASTEWATER DISPOSAL SYSTEM INSTALLED UNDER THIS PERMIT IS AN ALTERNATIVE SYSTEM UNDERGOING EVALUATION WITHIN THE MUNICIPALITY OF ANCHORAGE. 2.THE MINIMUM LENGTH OF THE TRENCH MUST BE 50 FEET. 3.IF THE EVALUATION OF THE WELL TO LEACHFIELD WAIVER PAGE 2 OF 2 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 THE WELL MUST BE RELOCATED 9UTSIDE THE 100 FT. RECEIVED BY: · ISSUED BY: / REQUEST DOES NOT MEET MINIMUM REQUIREMENTS FOR APPROVAL. SETBACK. ~ FOI¥ING SPRING £5 T£A£f 4]2 N ££ALE; I LATE UNDE£ D£IVEI 113 P£LZPOSED BIO£Y£LE T£EATME~ 75 lOO 125 50 FF ?£A£? 4S VA£AN? 150 :'~/""~'""'~:,,~_X, ~#4 DPODED D£AIN FIELD I ' ,~ I ~ 50FL LONG ~ ~ I/ 7 FT TOTAL DEPTH ~ 3 F~ CDVE~ ~LE~U~ ~EVISED: NO~ 50, ~995 F~ON 20 FT TO 50 F~ TOBBEN SPURKLAND P.E. I J II 205 W 15TH. AVENUE ANCH. AK. 99501 (907~ 279-~1 § TRACT 4B SIEFI(ER S/D DALE AND JANET HARLOW .3641 CLEO AVENUE SEPTIC SYSTEM DESIGN DATE: OCT, 24, 1995 SHEET: 2/5 GRID: 2755 1-I/4" PVC Schedule Ho/es @ 18" 5' ?ANBAI~B ?£ENCH ?[Z7£ Y£L E T~EA ?HEN? PLANT 5 Fi. of Cover 1-I/2" Dischorge -- /-- 4" Topsoil ooooo Pipe /ffirofi 140 60" Sewer Rock B£ViSEfl: NLTI/ 30, i995 CHAN6E LEN6?H DF ~£ENCH BACKFILL AND LEVEL W/TN SAND BIOCYCLE PLANT /dyers Pump lifE40 4~10 NP BENCH MARKL: BOTTO~I SIDING ITOBBEN SPURKLAND P.E. . . 279-59~6 BIOCYCLE AERATED TREATMENT PLANT TRACT 4B, SIEFKER //5 56,t ! CLEO A VENUE SEPTIC SYSTEM AS BU/LT DATE: NOV. 15, 1995 SHEET: 5/50RID: 2755 PROPERTY OWNER AGREEMENT FOR THE MAINTENANCE OF AN ON-SITE WASTEWATER DISPOSAL SYSTEM This agreement, dated ~//~4'), // 199-.2.57is made between the Municipality of Anchor. age DeI>¢~:.m~ent of Hcahh and I-Iuman Services (DHHS) and the property owner(s) This agreement is made for the purpose of maintaining an on-site wastewater disposal system on the subject property. The p,'Ol)erty owners agree to the following: Allow the Municipality of Anchorage the perpetual right of entry to the property during normal working hours, to allow for effluent sampling or evaluating the general state of repair or function of the system. Submit to the Municipality o,: Anchorage, on an annual basis, an inspection and operation statement fi'om ,'t registered professiomtl engineer. This inspection and operation statement shall verify that the engineer has inspected all effluent and air pumps, timers, and alarms, and that any deficiencies have been repaired and that the system is functioning as designed. '.~ i Si~!,:ttm'c) (Signature) (Printed Name) (Printed Name) CRIBED AND SWORN to before me a Notary Public he State Of Alaska on the ~(~ day of November, Nota~0tariz~14ere) Public in a~l for the State of Alaska. My Commission Expires: ~/~ STAT[ OF ALAS~ 1995.ab Rick Mystrom, Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P,O. Box 196550 Anchorage, Alaska 99519-6650 Dear Homeowner/Prospective Buyer: The on-site wastewater disposal you are interested itl purchasing is mi "alternative" wastewater dispos,d system. This system, known as a "Biocycle Aerated Wastewater Treatment Syste~n", is undergoing testing within file Municipality of Anchorage under the Alternative System section of file Wastewater Disposfl Regulations (AMC 15.65). There are certain risks involved with file ownership of one of fllese systems: Tlds system has been shown to be effective itl other areas. Tile system is cmTently undergoing a two year testing period in Anchorage under the guidance of the Department of Health and Human Services (DHHS) and tile State of Alaska Department of Enviromnental Conservadou (ADEC) to determine its effectiveness itl a subamtic envirolanent. Testing results on systems installed itl i994 have been vel3, encouraging. Copies of initial test results are available from the DHHS. The Biocycle syste~n has not been tested ,'md approved by file National Sanitation Foundation (NSF). Cun:endy, Anchorage Municipal Code for Wastewater Disposal Regulations requires proprietary equipment to have NSF approval. This approval or changes to the Wastewater Disposal Regulations dlrough Municipal Assembly action will be necessary prior to this system being approved as a standard system. The "Biocycle" system for fl~is property may have received vertical separation distance waivers fi'om bo/h State of Alaska and Anchorage Municip~d Codes to both ground water and bedrock. These waivers were granted clue to the system's expected performance wifllin ll~e site conditions on flits property. If the test results do uot support fllese waivers, modification or replacement of this system may be required. If tllis system fails to meet tile requirements set for it to become a standard, code approved wastewater disposal system, it may have to be removed and replaced by either a holding tank or (if possible) olher wastewater disposal system that meets Municipality of Anchorage requirements. The cost of rmy couversious required to meet code requirements will be the responsibility of the homeowner at the time of conversion. I (we) ceriify lhat I (we) have read the above statetnents and am (are) aware of the risks outlined. I (we) '~_)als°~-cerdfY~./that I (w~>mn~ ~ ~ (are)~il)tile process of purcbasing~roperty leg~ description)~: ~ (Purchaser Name) (~(Purchaser~am~ (Purchaser Signature) ch ~ u~ ( ' · Signature) ~CRIB~D AND ~B~ORN ~o before me a Noear7 Notarize Here Publ~ ~ for ~he S~age of AZaska on Lhe . . day__Anchorage, AZaska. N~Pu~c ~n anf for Che S~Lo ~f Alaska. My Commission Expires:~/~/97 T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Municipality of Anchorage Division of Environmental Health Department of Health and Social Services 820 1 Street Anchorage, Alaska 99501 Subject: Septic System Upgrade Tract 4B Siefker S/D October 24, 1995 MUNICIPAL[fy OF ANCHOP, AGk ~I"/VIRONMENTAL SI~RV/CE$ DIVISION OCT 24 1~5 Gentlemen; This lot was developed with a 5-bedroom residence in 1968. At that time an undocumented septic system was installed. Per the present owner a concrete block septic tank was installed together with a log crib and a trench. The system has failed and must be replaced. In 1991 the firm of Besse, Epps and Potts conducted a soil investigation on the lot and recommended that bed be installed in the north east section of the property. This recommendation was not followed. Additional soil work was conducted on Oct. 20, 1995. Several testholes and percolation holes were excavated. In general a plastic dense silt was found with a course sand at 12 and 14 feet. A heavy water flow was observed in the sand. Several attempts to perc the silt failed with percolation rates much greater than 120 minutes per inch. The only soil that will perc was the sand and the loam immediately below the organic layer. This loam layer may be 2 feet thick. Tract 4A, the adjoining prope~V to the west, was developed in 1994. The soil log fi'om this property shows a course sand fi'om 4 to 18 feet with water at 14. Jim Williams did the soil work on this lot. I found the location of one of the 1991 testholes. My interpretation of the soil is more conservative than BEP. ! attempted a perc at three feet at this location, but found an unacceptable perc rate ' I see three possibilities for this lot. 1. Holding tank. 2. Bottomless sand filter with sand to the top of the onsite sand at 12 feet. A monitor was installed in this hole to mouitor the elevation of the groundwater. Proper separation to groundwater can be obtained with a finer grained sand than the filtersand. 3. A BioCycle with discharge directly under the organics. Discharge to wetlands is becoming common and is a recommended practice. According to "Small Flows" nitrate removal is accomplished with no discernable disadvantages. This property is being sold and both the old and new owners are anxious to have this matter resolved. Please review and comment. Yours d--- FDI¥ING SPRING I 25 0 25 50 ~¢v?~,~,~ £CALE; ! 1 Ti?ACT 4B I 1~5 Ti?ACT 4~ VACANT J~/ 49~h I50 BBEN SPURKLAND No. CE-2225 CLEO AVENUE TOBBEN SPURKLAND P.E, 205 W 15TH. AVENUE (j Il ANCH, AK, 99501 (~07) 279-3916 TRACT 4B S/EF/EER-S/D DALE AND JANET HARLOW 36,11 CLEO AVENUE J [ SEPTIC SYSTEM DESIGN DATE: OCT, 24, 1995 SHEET: 2/3 GRID: 2735 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST (ENGINEER'S SEAL) PERFORMED FOR: I.~.'~,Z~[,__ ~_.. :~AIP--LO d_2 LEGAL DESCRIPTION:~ 1 2 3 4 5 6 7 8 9 10-- 11 12 13 14 15 16 17 18 19 2O DATE PERFORMED: IOl'Z'Oi~.5 WAS GROUND WATER ENCOUNTERED? Township, Range, Section: SITE PLAN SLOPE S IF YES, AT WHAT iDt oL DEPTH? PE Depth ,,~ Water ^lief Monito, mg? Date: Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN (m':~ tes/inch) PERC HOLE DIAMETER FT AND _ FT PERFORMED BY: . ,. CERTIFY THAT TIllS TEST WAS PERFORMED IN ' ACCORDANCE WtTH ALL STATE AND MUNiCiPAL GUiDELiNES iN EFFECT ON THiS DATE. DATE; 72-008 (Rev. 4/85) I Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchor,age, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST (ENGINEER'S SEAL) LEGAL DESCRIPTION:~,.~ ~ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Township, Range, Section: SLOPE WASGROUND WATER ENCOUNTERED7 8 IF YES, AT WHAT ~ OL DEPTH? /f'~-.' p E Deplh to Waler Afier Moniloring? flale: __ SITE PLAN Reading Date Gross Net Depth to Net Time Tima Water Drop (minutes/inch) PERC HOLE DIAMETER FT AND __ FT PERFORMED BY: T'~, .~ I .'~ -~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACOORDANCE WITH ALL STATE AND MUNiCiPAL GUiDELiNES tN EFFECT ON THIS DATE. DATE: Ot~ ,~..L/)lq~~-' 72'008 (Rev. 4/85) .' Municipality of Anchorage: ' .' ~;~ DEPARTMENT:OF HEALTH & HUMAN SERVICES 825 "L" SIreet;~Anchorage, Alaska 99502-0650 SOILS LOG¥~ PERCOLATION TEST i:;:... ::,: ::: .. :WAS GROUND WATER ENCOUNTERED? ':IF: YES, AT WHAT ~,: DEPTH? . Oeplh to Water Alter // Momtorlno? . !O,E ,Y'~ __ DATE PERFORMED:, Township. Range. Section: SLOPE Time /-~, SITE PLAN Net Depth lo Time Water ,,, ?~" ,, Net F tEN~4~E?'S SE*LI Municipality ot Anchorage ~ ~ ?% I%'"'..'~' '- ~' ~:. DEPARTMENT OF HEALTH & HUMAN SERVICES [~ ' ~ ~':"'~ ~ '~ ~ 825 ,,L,, Street, Anchorage, Alaska 99502'0650 ~ sores LO~ -- P~RCOLAT~ON T~S~ . .. ~ SITE PLAN  Township, Rang~ _FOAL DESCRIPTION: SLOPE 1 3 4 $ 9 WAS GROUND WATER lo ENCOUNTERED? ' - S 11 IF YES, AT WHAT O _..---- ---'"' _P OEPTH? E 12 ___~_. ~ Dep h to Water Alter ,z~' ~ ~ ~ ~ I 13 Monitoring,,) ..~ Oa 15 19 20 PERCOLATION RATE, _L,,/(/-1/ , tm~nutes/tnch) PERC HOLE DtAMETER N BETWEEN (3, B~...~,T AND ----.~ ~ ' FT '"'-------'-- ~[[~.., r3,.~. ~-~--- CERTIFY THAT THIS TEST WAS pERFORMED IN 72~8 {Rev. 4/~) T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Municipality of Anchorage Division of Environmental Health Department of Health and Social Services 820 1 Street Anchorage, Alaska 99501 Subject: Up Grade Permit P1N 015-281-104 Tract 4B Siefker #3 November 15, 1995 Gentlemen; The propm~y located on Tract 4B Siefker #3 is being sold. The septic system serving the 5-bedroom residence does not meet Municipal Requirements and must be replaced. A BioCycle treatment plant is suggested. The attached submittal shows the cmrfiguration of the proposed waste water disposal system. This system can be installed at this time, or the new owner of the property may elect to wait till next yem'. The existing system is not causing sewage to back up or surfacing on the ground. An installation approval fi'om the Health Department is the only item preventing this transaction to close. The buyers have vacated their present residence and will move to this location as soon as a permit has been obtained. Please expedite the review of this application. Yours Tobben Spurkland P.E. 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN TRACT 4B SIEFKER DALE HARLOW No acceptable soil on north ½ of lot. Testholes #1, #2, and #3 showed ground water at 10 and 12 feet and non percable soil fi'om 0 to 12 feet. Testhole #4 showed no groundwater or impervious layer from 0 to 13 feet. Testhole showed dense sand throughout. Percolation Rate: 6 minutes per inch Drainfield within 100 feet radius of well. Recommend installation of BioCycle Package Treatment Plant Wastewater discharge rate 4 gallons per sq. Ft. Requh'ed area: 5 x 150/4 = 187.5 sq. Ft. Use Standard Trench: 20 ft long, 5 feet of effective rock depth. A = 200 sq. Ft. Maximum separation to existing well. 80 feet. Apply for well waiver. Verify integrity and effective volnlne of existing septic tank. Replace baffles as required The installation of this waste water disposal system will not prevent wells fi'om be installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. Municip ty of Anchor-ague Department of Health and Human Services 825 "L" Street Rick Mystrom, Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4?44 December 1, 1995 Tobben Spurkland, P.E. 203 West 15th Avenue %203 Anchorage, Alaska 99501 Subject: Waiver Request for Tract 4B Siefker Subdivision #3 Waiver Request ~WR950065, PID #015-281-64, SW950397 Dear Mr. Spurkland: Your request for waiver(s) of the required 100 foot horizontal separation of a septic system to a private well has been approved. The approved separation distance(s) are a private well to-the leachfield of 80 feet and a lot line water of 0 feet to the south. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincer~y, Robert W. Robinson Civil Engineer On-site Services RWR/ljm MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet Permit WR# WR950065 PID# 015-281-64 HA# Date Received: November 22, 1995 Legal Description: Tract 4B Siefker #3 Engineer: Tobben Spurkland, P.E. 203 West 15th Avenue #203, Anchoraqe, Alaska 99501 Applicant: Janet Harlow Waiver Requested: Waiver request of a private well on lot to the new leachfield of ~ feet; and 0 to the south lot line. Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability ~,~ D. Water Table Gradient E. Horizontal Separation TOTAL: / ~ / 2. Special Conditions: ~ 3. Other: Waiver is Granted: Waiver is NOT Granted: List Conditions or Reasons for above: ~/~/-/~ ~'// ~ Name of Reviewer Rec #: #01495/4173 Amount: $ 920.00 Date Paid: Nov 22, 1995 ~ 0£1 0£ 'l I ~r') T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 MUNICIPALITY ~Jt: ANCI-~Ut,~t: ~NVIRONM~Ni~L ,~RVIC~8 DIVI$10N Municipality of Anchorage Division of Environmental Health Department of Health and Social Services 820 I Street Anchorage, Alaska 99501 November 15, 1995 Stlbject: Gentlemen; REQUEST FOR WAIVER OF SEPARATION DISTANCES FOR PRIVATE WELL TO DRAINFIELD TRACT 4B SIEFKER #3 We are submitting a request fol' waivers from the separation distances stated itl Title 18, Alaska Administrative Code, Chapter 80.020. The existing septic system on this lot was installed in 1965. No documentatinn of the septic system exist, except the owners statement that the system consist ora home made concrete tank and a log crib. The home contains 5 bedrooms. The septic tank is approximately 95 feet from the well, which meet the separation requirements in effect in 1965. The log crib is ]note than 100 feet fi'om the well, but has failed and will be abandoned. The only suitable location fo]' a soil absorption system is along the south lot line. The well serving this lot is located approximately 82 feet fi'om the south lot line. With the drain field located with no sepm'ation to the lot line, a separation of approximately 85 feet can be maintained to the well. No well log exist for this property, however logs fi'om adjacent properties show water at 100 feet or more with static levels at 50 feet more or less. All well logs shows impervious layers of various thicknesses. Tile discharge fi'om the proposed BioCycle treatment plant qualifies as secondm3, treated effluent. The possibility that the effluent will contaminate the well is practibly non-existent. The ]es]hole at the disposal field location showed a silty sand to a depth of 13 feet. The effluent will be filtered through a minimum of 6 feet of fine grained soil. Any pathogen will be trapped by the soil. Due to the absence of suspended solids in the effluent, and the presence of oxygen, clogging and progressive failure of the drainfield will not happen. Sm'facing of effluent is therefore not a concern. A water quality sampling of the well water on showed Undetectable Nitrates and no bacteria. The granting of this waiver is justified as follows: The required separation distance of 100 feet are arbitrary and cannot be supported through technical or scientific 1 arguments. Common sense will support the idea that a minimmn separation distance is both prudent and desirable. Common sense will also support the view that if 100 feet is safe, so is 99, and 98. A separation distance of 100 feet will probably prevent septic system effluent contaminatiou in 99.999% of all cases. There have been recorded instances where a well have been contaminated by septic system effluent. In all cases this have happened where the ground consist of fi'actured bedrock or hardpan that will channel effluent into streams. Contamination may also occur if the subsurface soil consist of clean gravel or rock deposit with no sand or fines. When the subsurface soil consist of a mixture of gravel, sand and fine materials, the septic system effluent is effectively filtered and rendered harmless in a rely short distance. Both tile ADEC and the Municipal Health Department recognizes the filtering ability of sandy material by actively supporting and promoting the installation of a 2-foot sand filter as a superior alternative to the standard soil absorption systems. So confident are the two agencies of tile filtering capabilities of the sand filter that they have reduced the required separation distance to groundwater and bedrock by 50% and 33% when the sand filter is used. The total well depth of this well is 89 feet, with a static water level at 30 feet. Assuming that the effluent fi'om the drainfield can travel through the soil and reach the open end of the well casing a travel distance of more than 120 feet would be required. This distance is 60 times greater than the 2 feet of filter sand in the recommended sand filter. The conclusion must therefore be that contamination of the well is not possible because of the location of the septic system. Yours Tobben Spurkland P.E. Gentlemen; M-W DRILLING, INC. Well Owner Location DRILLING LOG Use of Well (address of: Township, Range, Section, if known; or distance main road Size of cas~ng Static water level. Screen ( Depth of Hole. ft. (above) ); Perforated ( feet Cased to feet (below) land surface. Finish of well (cheek one) ). Describe screen or perforation Well pumping test at gallons per (hour) of drawdown from static level. Date of completion : .: 7 5 open end ( (minute) for hours with WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness ,Zasinc 2~ick::~ ); ft. TO. .TO TO TO - TO TO .TO. TO TO .TO - TO .TO_ TO TO TO.. Org,~.mic s Ce~i'ificate. No's. 814 & 973 2 -- STATE WATER WELL RECORD STATE OF &LASKA DEPARTMENT OF NATURAL RESOuREs D~vision al Geological & Geophysical Surveys 4. WELL 0EPTH: (flnalJ J 5 DATE OF COMPLETION []Cable fool lO. STAtiC WATE. LEVEL: Equlpm.nf used: 12.GROUTING Well 13/oulea: MaIiHaI: [~ Neat ..,, ..... ¢_ 3 2 z= ~t-~'/_/p.<, ~o~.,o. ~,° .... ~u~o., 15. water Temperature ____a L--~ F ~ C WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological a Geophysical Surveys · ' '~ ' Drilling Permil No, LOCATION OF WELL (Pleoee complete either la~ lb or lc,) la "orouqh Ib"~'I I/4qtrs. Section No. TownshiPNL--} Range Er--} Meridian ~J DISTANCE AND glRECTION FRO~ ROAD INTERSECTIONS ~, OWNER OF WELL: All~ Gonsioros~ 2. WELL LOG Feet Below ' ' Surface 4, WELL DEPTH; (final) 5. DATE OF COMPLETION ,~?.zvel-~/20 20 gpm 10~ 107 d,.~. . .- . . 9, FINISH OF WELL: Type: Diameter: 8lot/Mesh Size: Length:. Set between ft. and ft. '" '"' '- ' ' , ." II, PUMPING LEVEL below land ~urfaoe and YIELD ' ' .... ":~UNiCIPALITY.'OF'>AN':HO~G~ 12.SHOUTING - Well Grouted: ~ Yea ~No 13, PUMP: (if available) HP ' U~i"'~ ~"; Length of Drop Pipe ~ ft. ~apacily J~ g.p.m. 16. WATER WELL CONTRACTOR'S CERTIFJCATION= I~. Wotsr TemperGture _ o ~ F ~ C Registered Business Name Contracl Llc~ns~ 'Number ~ ~ Authorized RepresenteHve / ' static i~'~L (belowj i~l surt~,e. Finish of well Give, del,lib o! formations F~etr~ted. size of material, color and ~ CT&E gef.~ ClieI:~ Sample ID L4B $IEFKEE Cl~en~ N~t~la TO~EN SPUR~5 P.E, ~;ORK O~'der 19~2~ O%-der~d Dy Prin~ed Dat~ 1%/I0/95 ~D ~:17 hrs, PWS I D UA CT&E Environmental Services Inc. Laboratory Division ~z~`~``~"~`~J~``~;~`~.~`~`~,J~a~;~.~;~r~tt~t~~t~t~~ , · '~'~': Laboratory Analysis Report WATER Technical $irec~or STEPHEM C. EDE Sample R~%l/arks~ SD3~,PLE COD~ECTED Vhavai'_abl ~ 200 W. Potter Drive, Al~choraoo, AK 99518-1605 -, Tel: {907) 562-2343 Fax; (907) 581.530! cA,I/I~'I~,I~.,tDhlTAI !~AC, ILI¥ [~$ IN ALASKA. CALIFORNIA, ;LOR:OA. ,:,,LINOIS. MARYLAS~D, MICHIGAN, MISSOURI, ¢',~W JEF~S~,Y, OHIO, WES[ V RG :' ���5678970, ® Municipality of anchorage On -Site Water and Wastewater Program (907) 343-7904 s A E T V << ti 68L95�J Certificate of On -Site Systems Approval 0z < Ad Parcel I.D. 015-281-64 Expiration Date: 2, q—t 1. GENERAL INFORMATION: Complete legal description Siefker#3; Tract 46 Location (site address) 3641 Cleo Avenue *Anchorage, AK 99516 Current Property owner(s) William & Rose Phillips Day phone 907-529-7350 Mailing address Real Estate Agent 3641 Cleo Avenue *Anchorage, AK 99516 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. 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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Gayness Date: IZ In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system 1__1"0F in accordance with the guidelines and regulations established by the Municipality of Anchorage and o �•.• "' •. XSN industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or O� encroachments may exist that were not identified during the evaluation. The operational life of all we coll � � and septic systems depend upon a variety of variables, including but not limited to, soil ndition %• • • • • .. • I - • • • • • • • • • . • • • groundwater levels (that may fluctuate during the year), quality of construction (materials an workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, an 0..... .. . ....... are outside the control of GEG. Satisfactory test results do not guarantee future performance of the ••Je Ir A. Car ess.: system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of v49 _ �, 9 the well or septic system. GEG makes no representation whether an alternative well or septic system s c O can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to 4 Po;essio"ON ro perform the evaluation. Reliance upon the information provided in this report by any other person or ����� *% party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE System #1 Approved for bedrooms OF11( �41% System #2 Approved for bedrooms Disapproved Ott -SITE `9G� T AND Conditional approval for bedrooms, with the fJowing�i i i . ER O ✓ o WA Conditional 1 1 �A '1 J Dt�l 1\7 A 1 e� �N7- SEPN _11\\ ��` Original Certificate Date: l��f 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 Septic System Advisory Well Flow Advisory COSA blue sheet 10-10-12.doc Nitrate Advisory Arsenic Advisory Other •.. Legal Description: Siefker #3; Tract 413 If more than 1 septic system on lot: COSA Checklist # A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 1965? Total depth *89 ft Cased to unknown ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 8/30/19 Parcel ID: 015-281-64 of Structure served by this system Well production at time of test 6+ gpm Water storage tank volume n/a gallons Well disinfected for coliform test? ❑ Yes FOR Nc ❑ Coliform bacteria is Ne Ive Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Yrsenic less than MRL (ND) Collected by GEG, LTD Date of Sample 8129119 Static water level at beginning of test 38.9 ft. Comments *Per Tobben Spurkland. P.E. Waiver request dated 11/15/95 B. TANK DATA Age of tank(s) 23 years Tank type/material $TEP/FRP Measured operating fluid level in septic tank Unknown ❑ Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA BIOCYCLE Which system tested (date installed) 1996 ❑ ALL standpipes present per record drawing Total measured depth from grade *7.3 ft (max) Measured depth to pipe invert from grade - ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective 3.5' ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced n/a gallons Comments/Deficiencies: 'At MT COSA Checklist yellow sheet C. LIFT STATION ❑ Required maintenance completed Age of lift station 23 years Lift station material FRP Comments: BIOCYCLE Adequacy test date 8/30/19 Results ❑✓ Pass For 4 bedrooms Fluid depth prior to test 15 in Water added 1045 gal New depth 20 in Elapsed time 120 min Final fluid depth 16 Jn Absorption rate 600+ gpd Any rejuvenation treatment (past 12 months) If yes, enter date n/a no 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' 0 Yes if No Community Sewer Manhole/Cleanout > 100' 0 Yes if No ft Yes if No ft Neighboring Tank > 100' Q Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No ***80ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' Q✓ Yes if No ft R Yes if No ft ft If septic tank is under driveway comment below *Assumed Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑r 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' 0 Yes if No ft Surface Water > 100' ❑r Yes if No ft Property Line > 5' r❑ Yes if No ft Wells on Adjacent Lots: 0 Yes Absorption Field > 5' El Yes if No ft Private Wells > 100' ❑ Yes if No ft Water Main > 10'. r❑ Yes if No ft Community Wells > 200' ✓0 Yes if No ft Water Service Line > 10' ❑r 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' ❑r 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' 0 Yes if No ft Private Wells > 100' ❑ Yes if No ft Water Service Line > 10' 0 Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' r❑ Yes if No ft F. ENGINEER'S COMMENTS *Assumed **See attached letter dated 9/7/19 ***WR#950065 G. ENGINEER'S CERTIFICATION _o OF q I certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance withi .77 MOA COSA guidelines in effect on this date. .. 9 H �............. .... QO ' .J f _ Gorne O 9; CE 79 Opoe^e-.,��t2 �.q�cAoG COSA Checklist yellow sheet 40 a pro f e ss'1o0oo #AECC884 0��00000� TREATMENT POD— Z Tract 4A 10.1'x16.1' ------------- 0 0 Tract 3 EAST 150.00' N. CLEO AVENUE —r ---------- I 0I O O1(D ENCROACHMENT EASEMENT 2870, PG. 48) Tract 4C 10.2' ENCROACHMENT 4.0'x10.0' LEAN-TO 1 —1--10.0'x10.0' GREENHOUSE ,�—SEFnc PIPES 1 _L ----------- PLOT PLAN AS BUILT JL SCALE 1" = 50' GRID SW 2735 Project No 19-251/A1 Associates, 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & H S S O C i a t e S y info (907) 522-6476 Phone (907) 522-4625 Fax QoQOQ�p��O Professional Land Surveyors kenolongsurvey.com v OF A Jonathan®langsurvey.com �P'`� I hereby certify that I have surveyed the following described property: Tract 4B, SIEFKER SUBDIVISION No. 3 (PLAT No. 72-173) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed promises and that there are no roadways, transmission lines or other visible easements on sold property except as indicated hereon. Dated this the , Day of at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. 49TH y*l .............. .. . ........... KENN ' s' ' LAN Ar Vp 4 . LS -5209. • o :�soG 40����SSIONN- �o AECC963 GARNESS ENGINEERING GROUP, Ltd _-- - -- ---- - ENGINEERING o SALES- CONSULTING September 7, 2019 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road PO Box 196650 Anchorage, Alaska 99519-6650 Re: Siefker Subdivision #3, Tract 4B — 3641 Cleo Ave, Anchorage, Alaska To whom it may concern: The septic system on the subject property consists of a BioCycle treatment system and a drainfield that were both installed in 1996. During our recent work to obtain a COSA for the well and septic system, we attempted to confirm the separation distance between the drainfield on the subject lot and drinking water wells on adjacent properties. We searched for the private well that is believed to be on Siefker #3, Tract 5, Lot 2 but were unable to find it. Per the record drawing for the drainfield on Siefker #3, Tract 413, the well of concern on Siefker #3, Tract 5, L2 is 100 feet away. In short, we were unable to verify this separation distance. Furthermore, based upon our review of the MOA records, it is believed that the following lots are served by a private (formerly Class C) well located on Siefker #3, Tract 5, Lot 10: 1. Siefker #3, Tract 5, L3 2. Siefker #3, Tract 5, L4 3. Siefker #3, Tract 5, L5 We could find no well logs on file at the MOA for any of these lots, so it is believed that they are sill connected to the subject "community" well on Siefker #3, Tract 5, L10. If this is correct, there are no potential encroachment concerns regarding the drainfield on Siefker #3, Tract 4B. Please call or email if you have any questions. Pres 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com 3705 Arctic Blvd #313 acE-Alaska Anchorage AK 99503 &, IN" sY.,�ms ��, Email: crbioak@gmail.com (907) 274-0314 3rd Quarter Inspection Report 2019 Homeowner Info Customer Name: Bill and Rose Phillips Tank#: 13 Install Date: June 1996 Address: 3641 Cleo Area Huffman Initial Inspection: Alarms Tested: Air [J High Water 0 Battery Tested: Yes A No ❑ N/A ❑ (Please make sure alarm is on "normal", not "mute") Does system have a septic tank ? No A Yes ❑ (Recommend pumping tank every 2 years) Is System Lid Locked? Lid hardware in working order? Is there any noticeable odor? Yes 21 Repaired ❑ Yes [� Repaired ❑ Strong ❑ Mild ❑ None 21 System Inspection Inlet plumbing in working order? Solids pillow normal? Yes [� Replaced ❑ Yes A Requires Pumping ❑ Aeration 7hamber: Are all aerators functioning? Any buildup of solids? Yes [✓] Replaced ❑ Yes ❑ No 21 Clarifi�n Chamber Clarification return system operating? Any buildup of solids? Yes 0 Adjusted ❑ Yes ❑ No [v� u. ntAestin ,:.esul pH Reading: Dissolved Oxygen PPM Turbidity of discharge (in FTU) (pH of 6-8 is ideal) (2-5 is ideal) (Under 35 FTU is considered compliant.) 6.8 2.9 15.9 Pump float operating? Alarm float functioning? Any buildup of solids? Yes 0 Replaced ❑ Yes A Replaced ❑ Yes A No ❑ Filter cleaned? Discharge line condition: Yes N/A ❑ Good © Replaced ❑ Comments: Ins Chris : Inspected B p Y Date: 08/22/19 Has emailing or mailing of form been requested? (contact office to request...) Yes No 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 f Z Day of of 20 `i , by and between 01;y,4-1'5 8o,-C;C-l-- , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as r3 i o <.vc !e located at (legal description) q23 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) =�3 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). e.a< 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. C... 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 C r Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. ,i3. 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. C: 3, Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. c,g, 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. c,B, Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By: _ (signature) ��i�escc� (print name) STATE OF ALASKA THIRD JUDICIAL DISTRICT The forego' m tru 20 la, by �r S Date: Z ss. ed before me this Waay of &&M, IC FOR ALASKA expires: Plog,21.7ov MUNICIPALITY: By: fiku 19(signature) ke- be CC G. Gr ro / /(print name) Notary Public M. SERA TUINIUA State of Make My Commission Expires Feb. 3, 2021 Date: !� Title: (rev. 05/18/2018) Page 3 of 3 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 APPROVAL FOR A SINGLE FAMILY DWELLING JUL 08 1996 1. GENERAL INFORMATION Complete legal description 7'/2- RECEIVED Location (site address or directions) Property owner Mailing address Lending agency Mailing address Day phone Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: '"/' TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer lng to the legality and status of system. / If community well system, provide written confirmation from State ADEC attest- 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 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my invest(g'ati~)n of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functionaland adequate for the number of bedrooms and type Of structure indicated herein. I furtherverifythat based on the information obtained from the Municipality of Anchorage flies 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. Engineer's signature ~ ~~-~,-c~'¢¢% Date -7/?//'1 ~' DHHS SIGNATURE /'~ Approved for ~ bedrooms. Disapproved. / Conditional approval for bedrooms, with the following stiPulations: A, dditional Comments Date 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 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 satisfl/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 engineer's work. 72'025 {Rev. 1/91) Back MOA i¢21 Legal Description: Municipality of Anchorage ~ut~tc~Pattn,08 DEPARTMENT OF HEALTH & HUMAN SERVICES~N'VIRoN~EmaLSE Environmental Services Division 825"L" Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist RECEIVED 015- A. WELL DATA Well type Log present (Y/N) Total depth If A, B. or C, attach ADEC letter. ADEC water system number /~ Date completed / ¢/'{¢ .~¢ ~ . )' L//O t Cased to ~/7/0 I Casing height (above ground) Sanitary seal (Y/N) ¢ ......... % --' , FROM WELL LOG Date of test ¢~,")3 Static water level Well production WATER SAMPLE RESULTS: Coliform Date installed __ g.p.m. t>91 Wires properly prbtected (Y/N) 'Y/ AT INSPECTION Foundation cleanout (Y/N) Date of Pumping ~//tctv Nitrate N Collected by: ~ 5, / Tank size 1¢ C'fi)" Number of Compartments /'-/ Cleanouts (Y/N) . "'/ Depression (Y/N) Iq High water alarm (Y/N) 7 Pumper ~t//~4 g.p.m, Y C. ABSORPTION FIELD DATA Date installed Length 17/~ t Width Soilrating (g.p.d./ft2orfl2/bdrm) /. {.a Systemtype_T~?~[~/J4 Gravel thickness below pipe ~- ~ Total depth '7 t Effective absorption area /7/t90 Monitoring Tube present(Y/N) 'x/ Depression over field (Y/N) tx,t/ Date of adequacy test /Y//)~ Results (Pass/Fail) "~ For ,,Z/ bedrooms Fluid depth in absorption field before test (in.); P~t//tq- Immediately after /~gal. water added (in.): ~/ Fluid depth ~'/ (ins.) Minutes later: ~ Absorption rate = ~ g.p.d. Peroxide treatment (past 12 months) (Y/N) J If yes, give date / AI s USA Federal Credit Union July 17~ 1996 Robert W. Robinson Municipality of Anchorage Department of Health and Human Services 825 "L" Street Anchorage AK 99519 RE: Tract dB Siefker Subdivision 3 Alaska USA no. 9177221 Health Authority Certificate for septic system Dear Mr. Robinson: This letter is provided as a follow-up to our conversation this morning regarding the bedroom count at the above referenced property. The house has originally had five bedrooms. The present owners, Mr. and Mrs. Phillips, have removed the closet from one of the bedrooms and converted it to an office. The house now has four bedrooms. Thank you for your assistance in this matter. at 786-%709 if you have any questions. sinc~ ~ .____/ ~ement Officer Please call me Re. Box 196613 · Anchorage, Alaska 99519-6613 Member Service Center: 1-800-525-9094 · TDD/Hearing Impaired: 1-800-742-7084 · Administrative Offiees: 907-563-4567 T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Municipality of Anchorage Department of Health and Social Services 820 1 Street Anchorage, Alaska 99501 Subject: SW950397 PID 015-281-64 Tract4B Siefker#3 July 7, 1996 Gentlemen; Transmitted are the As Built and an HAA for this property. The owner has converted one of the original bedrooms into an office, making this a four bedroom house. The As Built and the HAA reflect this. A water sample was collected on July 8, 1996. The results will be forwarded when received. Yours CT&E Environmental Services Inc. La b o r a t ory [3 i v i $i o n ~p~F~j~i~/a~p~r~p"~p~.jjjjjJ~jjjj~j~Jjj~~ Laboratory Analysis Report CT&E Ref,# Client Sample ID Matrix WSIO 962748,96274800'2 Siefker S/D 3 TR 48 Drinking Water Collected Date 07/08/96 Technical Director: Stephen C, E(te Released By Sample Remarks: Total Coliform Results OC Qual 0.100 u 0 Units Method ALlowable Prep Analysis Limits Date oato O,iO0 mg/L ~PA 353.2 0 co[/lOOmL $H18 9222B 07/09/96 EMB 07/08/96 TAV U · Undetected LT - Le~s than GT - Greater thm~ P - Secondary Dilution d ' Be[ow the calibratio~ ran 200W Potter Drive, Anchorage, AK 99B18-1606 -- Tel: (907) $62-2343 Fax: (907) 561-6301 3180 Peger Road, Fairbanks, AK 99709-6471 -- Tel: (907) 474-8656 Fax: (907) 474-9685 ENVIRONMENTAL FACILITIES IN ALASKA, CALIFORNIA, FLORIDA, ILLINOIS, MARYLAND, MICHIGAN, MISSOURI, NEW JERSEY, OHIO, WEST VIRGINIA The attached paperwork has been reviewed and is being returned for the following reason(s): Discrepancy in legal description and/or owner name. Discrepancy in number of bedrooms. Signature and/or stamp missing on .~S~9~.measured ~d!.stances to.. sewers/Hells,..~cur~ain,d~ains'~' .... -.: and streams within~200 feet of proposed system. Replacement disposal site not shown and/or tested. _Calculation error ~in design._ ., .~ .~ .... _ ......... ............ . ..... ... .... Show locations of all soils, percolation or water table tests. Proposed system too deep for soil :test ~ubmitted. ' Topographic information missing or inadequate. ;. 7~ ~M~-~ Narrative missing or inadequate. ~ ~ ~.e~--~ --/,l~ .... -~ Additional soil/perc test needed.~3~~ ~ ~ '~ '~ Sand filter requirements not satisf~~~~~ .... Water monitoring results missing or~~beca~~' Incomplete; missing ~~ ~~ ~/~ ~ · -- ~ ~ / / Well~og requiFea: · Water sample unacceptable because Other ~7~ ~ ~ ~ ~~ '~ MUNICIPALITY OF ANCHORAGE Department of Health & Human Services On-Site Sewer/Well Permit Application NOTE:Applicati .....tbefilledoulcornpleleJy i SINGLE FAMILY DWELLING Property Owner Name ~.~. ~.~~t ~ L, Mailing Address t/,~' /''~' /J "¢q/~'/¢~5' "~'(' ~- Legal Description *~r~ 4 ~ Lot Slock Section ./,- Lot Size -?-Q/~.-,:.'-:' ~.~L~/.z3 .~.~-s-/s(~ F, Number of Bedrooms: .-_~" ~',~ Day Phone Zip Code Township Subdivision MiiNiC~i~AbTY OF Inspections will be conducted by: ENVIRCsNMENTAL SE]~VICES DiViSiON ;'"" Approved Engineering Firm ! 6 199! Municipality (permit fee included~ Does your house contain any of the following: Hot Tub, SwimmingPooI, TherapyPooi, Jacuzzi, I~ECEJVED or Water Softener Unit? /~,' If yes, which one? This application is for: Sewer Only "~ Sewer and Well __ Sewer Upgrede 'Well Only I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and in accordance with applicable Municipal codes. Fees: 72-o12 (Rev 10186) Property Owner/Well Driller Receipt # ~ ~--~ ~ :~ Permit # TRACT 4B, SIEFI(ER SUBDV. The lot ~s located north o6 Hil[f'man Road at the corner off Cleo Street and AvJon Street. The lot ~s 150 feet in w~dth and 300 feet in [en~'th. Except for the ~rea around the home f~he property ~s wooded. The home was hi, lit in 1965. The septic system ~s made of' n concrete block septJc t~nk, pet' the owner, the d%mens~ions are 5'x6'xS' At the time of' hook tlk~ of t:he proposed drainf'ield I wil] uncovep to verify the condi, ti. on and size, The drainff~eLd i.s a 1o~ a'rib septaa'e pit, The pit ~s in failure, The slope is a'entle and is toward the northwest, There a~e no d~ainage probl, ems as Cleo i.s dikched to drain properly. Avion is not exbended north of Cleo, thereCore Avion Street d~ains west on Cleo ri~ht-o¢-way, The property next door, Tract. 4A. is vacant and is undeveloped. This proposal will. have no impach, on Tuact 4A, Tract 4C is also vacant and heavily wooded, Thus there is no impac[ on adjacent propert i em. The proposal is to construct a 38 x 68 foot bed. This desio~n will ha-ye the ]east impact, and provide ample room for replacement sio~hts f~r the future if and when needed. Drai. nae'e is not an issue since the property eenaral )v ~ra;ina Norl hwe~::t, The home ~ s 5 bedroom therefore 750 sc!, t'?., of dr'ainae'e area i.s necessary. The 4 ndJcate zl0 rain/inch. I used O, 3 e;pd per' sq. l't , aDp] :i cat i on rate an~] added 50 sq, [t, to [he ~ross ar~a ma[~in~' I~e drainage area a00 sq, ft, The new drainage area is in excess 120 fi, from the existing' on si. he we].]., Test [lo[e n~tnlt~er 2 was much the same aa test. hole number I except ~hat a ~'rave] wa bearin~ st~aha was found at 1l,~) feet, I have been monibor:in~' water tab.la since July 13 and hhe water table has maintained a Level of 101 inches below ~'round surface. I have set the bed four feet below o~round surface and will be o~reater than four feet above the ~,ater table, Dale R, Merrell, P,E, Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 13 14 15 16 17 18 19 2O Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER /~ )~, -~j~__ ENCOUNTERED? s L IF YES, AT WHAT O DEPTH? p E §eplh to Waler Alt~r // a Monitoring? / ~-~ 2'~ Oale: "//*'~/4' Gross Net Depth to Net Reading Date Time Time Water Drop .~.-q_.;' ~./,~.¢ o o ¢~ ~, _~ ~ ¢, ~ /~ /% ¢ ¢ ~ ~// PERCOLATION RATE TEST RUN BETWEEN __ (m,nutes/~nch) PERC HOLE DIAMETER PT AND COMMENTS PERFORMED BY: '-~1~¢ ~/~'r¢'~'(( , ~I~- ~4~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED EOR:'~-~'~_~ 1 2 3 4 5 6 7 8 9 lO 11 12 13 14 15 16 17 18 19 20 (ENGINEER'S SEAL) . DATE PERFORMED: Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? s IF YES, AT WHAT ~, L DEPTH? 1~ ~ O P E Monitoring? Reading Date Gross Net Depth/:o Net Time Time Wa1:er Drop PERCOLATION RATE __ TEST RUN BETWEEN __ (minutes/tach) PERC HOLE DIAMETER __ FT AND __. FT PERFORMED BY: ~-~ ~ I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~'~/~--~ 1 12-008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 'L' Street, Anchor.age, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 lO 11 12 13 14 15 16 17 18 19. 20- ¢ J'~'~, ~-~ WAS GROUND WATER ~ ,~ ,r... ,~_ ~,.(..? ENCOUNTERED? IF YES, AT WHAT DEPTH? I ~ (ENGINEER'S S'EAL) : DATE P ER FOR'IViEDi Township, Range, Section; SLOPE SITE PLAN ~enito, ,rig? _ ~ Dale: Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE COMMENTS . ~*~f~ '~.2~.'¢',~ TEST RUN BETWEEN (minulestinch) PERC HOLE DIAMETER FT AND ~. FT PERFORMED BY: %~' ~ -- I .. ~f -~ CERTIFY THAT TI-ilS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNiCiPAL GUiDELiNES iN EFFECT ON THiS DATE. DATE: 72-008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchor.age, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 2 6 9 10 11 12 13 14 15 16 17 18 19- 20 WAS GROUND WATER ENCOUNTERED? ENGINEER'S SEAL) DATE PERPORMED, ' q Township, Range, Section: SLOPE SITE PLAN IF YES, AT WHAT DEPTH? lei),, ,0 Water After / /~/~/~j . hlonilorJng? ~ Oate: Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE __ COMMENTS ~ (~ ---~..~ y..i~...TEST RUN BETWEEN (minutes/inch) PERC HOLE DIAMETER FT AND __ FT PERFORMED ~3Y: _ ~'"'~.-~ __ I r .'~- '~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WiTH ALL STATE AND MUNiCiPAL GUIDELINES iN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) FOR: Municipalily of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST __ DATE PERFOItMED: SCRIPTION: ~ ~ ~ ~--~ra. ~ Townsh,p, Range, Section. WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? OePlh Io Wller Alter // Reading Date SLOPE (ENGINEER'S SEAL)' SITE PLAN s Time /.5 Time Depth 13 Water Net L~tOD PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG-. PERCOLATION TEST ~o~ COMMENTS (ENGINEER'S SEAL) · DATE "ER*ORMED: Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED;) s IF YES, ATWHAT ~L DEPTH? p E Depth to Waler Aflerl ~onitorino? ~L_~___ Dale: Reading Date Gross Net Depth 4,e ,,~,. Net Time Time Water ~.~.~ Drop PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER / ' CERTIFYATI~AT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUiDELiNES iN EFFECT ON THiS DATE. DATE: 72-008 (Rev. 4/85) PERCOLTION TEST DATA FORM Percolation Test Location YZ2.~*r 4-~ Test hole number ?/o./ Depth to bottom of hole. /3 / inches. Diameter of hole 5~t/ inches. Depth, inches 0 '-~ /2 'j Percolation test by Date of test Soil text [y' -/3 ~ q'/ Time Time Measurement Drop in water Percolation rote Remarks Interval (Min) Inches level Minutes per inch inches