Loading...
HomeMy WebLinkAboutSUSITNA VIEW ESTATES BLK 1 LT 2ub r\a, U LIJLo 3A02:�—Oc�-a.5 &C)C.�cLL gt__t,s4,m Municipality of Anchorage age 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)5yZZC' PID Number: ePW Z'57 Name: �7Rv i /t(O c.72�//0k Wastewater System: ❑ New il2l Upgrade AddreN ip'o FC&jd0S1q ABSORPTION FIELD Phone: No. of Bedrooms: ❑ Deep Trench 71 Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: 40 Total DeSlrom original grade: GP/Sq. . Ft Lot: Block: /gubdivision:// JU$ 4j Depth to pipe bottomfromAriginal grade: �'�' Gravel depth beneath pipe G Z C R e'_.' &r.T Ft. Ft. Township: Range: Section: Fill added above oiginal grade: Z—L Gravel length: Zy 1 sa 7- Ft. Ft. WELL ❑ New ❑ Upgrade Gravel width: 5 Numb? lines: Distance between lines • Ft. Ft. Classification (Private, A,B,C): Total Depth: I Cased To: Total absorption area: Pipe material: Ft. Ft. 136 SQ. Ft. Driller: Date Drilled: Static water Level: Installers, I/ W LL! ��J Date installed:.p� r✓J qJ Ft. Yield: Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES ❑Septic ❑Holding I''S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: �C> From Tank Field Station Tank Sewer Lines ,-- Material: Number of Compartments: Well-� t 5 Surface LIFT STATION Water Lot Size in gallons: Manufacturer: Line Foundation "Pump o IeveJ. �� � "Pump ojbl�vel t: �G/A�yl L� High wateralyfm at: 6 `97 - Curtain Pump Make & Modd�e.111�1 Electrical IrsP tions performed by: Drain BENCH MARK Remarks: ?� 0/OC cStw GL Location and Descripti co V, Ou C! lT/G ��•� c�i�i//y /y r � �e/ Assumed Elevation: Ft {I� /y � rOt vl J/'r"VQ.IVC 1(4��/4':/ C//l�C✓j ��fl ENGINEER'S SEAL 14 � Veal) c�vriy�rel� ss�ti ms y ,A/c/� � 9T �� •• o coamooao Inspections performed by: (ma5-'4JoL'&?rPDat�es: 1st Z3 9� 8 L� 9� 2nd �oeeeo semseooseoe• The lore A. Johnson e Department of Health ntPHuman "ices approval /�-A CE51J1 e�w� by: / Date:lvp Reviewed and approved PrES`V5 - 72-013 (Rev. 9/91) MOA 25 A 3 CO#I 5,6 !A4 CO#2 16,5 48,3 PIOCYCLI; 23.2 51.7 NOT: AU, MSA UMMM5 DJ's IN Mf. 10' Gas Line basement 31RCH A PIRCH 3 OMr#I 57 469 000#I 24,9 44,6 21V 231 47 CO#5 19,1 43,5 CO#4 159 15 CO#5 42,5 19,5 Mr#2 20.6 11 Mr#3 372 14.4 31RCH 3 50,8 I Old Mr �CO#5 Mr#�3 31pCN 3 M42 `CO#q Old CO 31�CH A _ P7 CK Neuse A � CO# I °CO#2 *310CYCLr PROJECT 51.0AN Uf 6kAV D • E L. cr gw II1I�IIII �A�I1CESIGNEC: EAJ CATE: 7-6-45l�'�CHECKED' -SCALE t-40l9�. FILE NAME SHEET TITLE A53UIKr KLAN VIEW 8-30-95 95893-50 1/2 c0#4& I52 5 58,5 57.5' Fill - a 3' min C i -2 min ��- - • 1.8oa oa °c°�°cco °oma opo a°o�00000 } -6" min 5' Trench Detail Scale 1/4" = 1 1001 100' Nmse C0#2 CO#5 95,8' Top TM#1 100' (5111) 68' 923' 92' Inlet Outlet Well 13iocycle CO#5 171V & Old MT 65,2' 65.2' OM#2: 24" PVCN(A) 68,03' OM#5, 1511 131pCN(13) 65551 PROJECT DRAWN _ DRF APPROVE@ r DESIGNED: TAJ CAIS: )--CO/W/JCHECKEDSCALE: 1-40 llll(IIF`( TITLE FILE NAME SHEET P513Ull-fVVIONU NT5 8-30-95 95893—t�, 2/2 FROM Alaska Engineers SEP.20.1995 2:25 PM P 2 ,`.y .1111}111:: X.t•Al...l.l'; �1� :.�f.11.:111".'.�.:.. +itli.1"1111)ii :i111'1:I'Y 1:1i1.'J!s1:7r7 ofr •1. t =t•' " ltdif Ij 11:,71!111: .•}b: lil'..i i;' .N y..... _;.. 1F S;9�s: c.:dG: �: :;:.'-.. �.: JC :�A'��tu'.•.a�.: .. .. .., w. .. �. i ..... ..... ...I A. .....,. �........ ._ _ .... tl. F.. ... _....... ........ ._. ... ... ... I:r'`'1"1'•. r,.JFt.:'rxr.t, r;�ur�1� '' !.I, 1. c.. tfr'ri.,. ,r1,; 1:�, •Ir' Fed ofofifaL' i UT*"."," 1, L.t.iGF; : l a r, f-1 L:till 2i' N, :f N"; 1, I " yn or IN;11fr:7(nr}: 110 i ON1.!Ini'; .fAokA; " •!. 1: r: iy"1 idh$, i tid:i:",1'.'I: :;I�eFi. "1'.I I!ti:I F•:; C,1 :; X101 n:, r•: v: �: I": •: 1: I�I,1 171.1 IIrT 11\!:•:.;1, owl 11, , L?!'•:' `,.:;:'i 1:11 4 e,- ;—r -r 1. &- t RECEIVED SEp 201995 Municipality of, ,'Cholage Dept. Health & Human Services I h!'. I, I • .. 111 t•: 1ilt NIIT. rt: 14: :. 711 I 14 OT I. r'1: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT NUMBER:SW950226 DESIGN ENGINEER:CRITERIUM ALASKA ENGINEERS OWNER NAME:SLOAN GARY OWNER ADDRESS:17100 FEODOSIA DR ANCHORAGE, AK 99516 PARCEL ID:02009125 LEGAL DESCRIPTION: SUSITNA VIEW ESTATES ELK 1 LT 2 LOT SIZE: 28209 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 2 �Iz3/�qJ (UPGRADE) PERMIT c7.t� DATE ISSUED: 8/17/95' EXPIRATION DATE: 8/17/96 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 343-4744 ( 24 HOURS ) (NOT 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 INTEGRITY OF THE EXISTING PIPE TO BE REUSED FROM THE TANK TO THE FIELD SHALL BE VERIFIED. — �iocy[LFi ur+�'c Sc't try �LRGrz UK '� l4 UKP Sam Wnp Sd»< Corvowz OIC �I �. SLen �NS7YK(ANG V.U. TO OLP SYS. %LST/N4 ��ti 4o &F T�^c+�cN n>oT CGFia C THIS Z/MEQ LrrvE M"'"` a10cyGoe. �� ppdp6se"n FE�O NaS N07 YE7 36EN IIFRIFiFA Fc✓t Z ret, 1 z, 3, 0- pI�fv p /S C,V ' o - of // P(�- vv-�- v Aj-tA-i- /V&-T!!C-- t 7Z- C-O�� '� /vi-IaLC ylp 17�s�.c� r Gf LII�Ia� / J L/N. Lem t , /"- ., Munk pality of Ancho&age }! �.: Department of Health and Human Services N 825 "L' Street Rick Mystrom, P.O. Box 196650 Anchorage, Alaska 99519-6650 Mayor 343-4744 August 18, 1995 Ted Johnson, P.E. Criterium Alaska Engineers PO Box111790 Anchorage, Alaska 99511 1790 Subject: Waiver Request for Lot 2 BLock 1 Susitna View Estates Waiver Request #WR950036, PID #020-091-25 Iwo "Y) aa(� Dear Mr. Johnson: 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 septic tank of 50 feet the leachfield from the well of 60 feet and 5 foot to the property line. This waiver approval applies to the existing septic well separation only. Any future upgrade to either require all separation distances be met or another from this department. Si rely, Robert W. Robinson Civil Engineer On-site Services RWR/ljm system to will approval MUNICIPALITY OF ANCHORAG J Department of Health and Human $ rvices On-site Services Section Waiver Review Worksheet I WR# ( al90,2,(pn j PID# 020-091-25 HA# Permit Date Received: July 31, 1995 Legal Description: Lot 2 Block 1 Susitna View Estates Subdivision Engineer: Ted Johnson P E Criterium Alaska Engineers PO Box 111790 Anchorage Alaska 99511 1790 Applicant: Gary Sloan Waiver Requested: Private well to the septic tank of 50 feet; and leachfield of 60 feet 9hw �S �0/ //n4 u,aloe h Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability 1 �CCCCffff D. Water Table Gradient/ E. Horizontal Separation C4f TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: Waiver is NOT Gtr List Conditions or Reasons for above: /_ o ./ /n..._ ,.� _ .1/ .�_� � urL� �� ,•ions/�-`� Date: Rec #: #01151/1921 By: Name � o ame o Amount: $ 920.00 anted: ewer Date Paid: 7-31-95 • Municipality of Anchorage ,��� Department of Health and Human. Services dhFj Rick Mystrom, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 August 18, 1995 Ted Johnson, P.E. Criterium Alaska Engineers PO Box111790 Anchorage, Alaska 99511 1790 Subject: Waiver Request for Lot 2 BLock 1 Susitna View Estates Waiver Request #WR950036, PID #020-091-25 Dear Mr. Johnson: 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 septic tank of 50 feet the leachfield from the well of 60 feet and 5 foot to the property line. 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. Si rely, �c� Robert W. Robinson Civil Engineer On-site Services RWR/ljm a g � ka ALASK`AEIGII E E R S ,tszf< AV, July 28, 1995 Mr. James Cross, P.E., Program Manager On -Site Services, Water Quality Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519-6650 P.O. BOX 111790 ANCHORAGE AK 9 951 1-1 79 0 TEL 907 349-1003 IN AK 800 478-1003 FAX 907 344-9936 RECF!`'r� 'vL 3 1 N, 6 Municip 'ye Dept. Health a, IIin GGc' services Reference: Separation Waivers for On -Site Septic System Upgrade, Lot 2 Block 1, Susitna View Estates (17 100 Feodosia Drive), Anchorage, AK, CAE Job #95893 Dear Mr. Cross: We are requesting two separation waivers on the above -referenced on-site upgrade. The first waiver requested is a variance of the distance from the well to the septic tank. We are requesting that the Biocycle system we are installing be permitted 50 feet away from the well head on the opposite side of the residence: (See attached plan review.) As can be seen from the profile, the tank will be downhill from the well. The well head is at an elevation of approximately 104 feet and the top of the Biocycle tank will be approximately 96 feet. We are also planing to install an impermeable permalon boot around the Biocycle tank. This boot will prevent any leakage from the tank extending beyond the immediate proximity of the tank itself. The permalon boot will form an impermeable barrier between the tank and the surrounding soils. The well log on record for the well shows that the aquifer for the well is some 242 feet below the surface. Bedrock starts at 47 feet below the surface. This indicates that there are 195 feet of bedrock between the upper level soils and the aquifer. In addition, the ground slopes at a 52% slope on the downhill side of the Biocycle tank. Should there be any escapement from the tank, it will most surely fall in a downward direction away from the well head. r The second waiver we are requesting is a separation waiver between the drainfield and an intermittent stream to the north of the field. The extent of the drainfield will be approximately 60 feet away from the stream. The stream is timing downhill, generally from the east of the site to the west side of the site. The drainfield is placed on a bench on slopes that also run east to west. It is highly unlikely that any effluent from the drainfield would work towards the stream. Both the stream and the drainfield are roughly at the same elevation or the same place on a side hill. The slopes of the side hill are generally from the east to the west of slopes, generally between 25% and 50%. The site also slopes gently to I south at about 3%. As can be seen from the soil logs submitted, the soils below the drainfield are silty sands turning int( gravely silt that is highly compacted some 6 feet below the drainfield. These highly compacted grave REGISTERED PROFESSIONAL ENGINEERS BUILDING INSPECTIONS INVESTIGATIVE ENGINEEITIGATION SUPORTING ,[ / 1�S11 d �` J� CJc>, �..,\ V ✓v-' CONSTRUCTION MANAGEMENT Mr. James Cross, P.E. July 28, 1995, Page 2 silts are relatively impermeable. The gradient of these materials seem to be going downhill also, which would suggest that any effluent from the field would be going down the hill parallel to the stream. We would also suggest that the effluent from the Biocycle system is a treated effluent, which will not jeopardize contamination of the stream. We respectfully request that you grant these waivers and issuethepermit for this system to alleviate the condition of the failed system on this site. As we indicated in our original application we are prepared to immediately install this system to alleviate this problem. Thank you again for your attention to these matters. TAJ/jbj/Enclosures W WAAL; 5U5tfMA V0W VrAIK5. VX#Z, BI.M#I 5OL5 Fare Kate - Ib a>h/.t A ApphcAft tie - 4D aV/ 5K 450 av/ (4D GI's/5F) - 5r /12,.7 t 10' G*s Ltd Kwoo t n - �acaeci t'LAM VFW P; l , 1 95893-111 1/3 I 644- . Trench Detcll Scale 1/4" - 1' I ,r f 100' <50 P r-- J. -961 �. Wel 90' aR feAHdo #I f#A Nda #2 c2 r9m 95883-12 2/3 T N mm 1o*offti �• •eeeooi �eseueoeeoo A Johnson ; Q 5191 •��\� O -' Nm Pn* id i_ f PROJWT 91 om tram ME t'LM VFW OP qd9 FIX NAW INwr W93 -i13 t - 3/3 3 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR:'- DATE ��/ DATE LEGAL DESCRIPTION: ` � i SrJJ/ OZ:4township, Range, Section: (FEET) 2 5�� 13ror H J�clnd 3- food 4- 5 s\.l ar'x°h C wa'le-l�y S "H 6 511.1 SLOPE 10 WAS GROUND WATER (j,,,� ENCOUNTERED? .� 11 s IF YES, AT WHAT 2 L 12 DEPTH? T P E 13 Depth to Waier After Monitoring? Date: 14 15 16 17 18 19 20 COMMENTS Reading Date Gross Time Net Time Depth to Water Net Drop q•'�6 /.•04 Z/4 /o iY/o/j/c /O T' 14 1(.114 2 Z /0 //: DU /U /'//- / sG 6 n PERCOLATION RATE - (m1r1WeS1mch) PERC HOLE DIAMETER TEST RUN BETWEEN vj> FT AND Z FT PERFORMED BY: Jdl4g5a Lt 1 /71eo'�16 /G 14• VC)14 - YCLFRTIFY THAT THIS EST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE 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 FOR: < 5549-y /._S.D l%% DATE PERFC r LEGAL DESCRIPTION: L Z/ 8,1 JIJ.S, (//t=4J Township, Range, Section: 1-1 SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20• COMMENTS (/rOlUh CJ�✓vl� :JAHr� WAS GROUND WATER /b ENCOUNTERED? /Y IF YES, AT WHAT DEPTH?: _ Depth to Water After Monitoring? Dale: i Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE tminWeSr,nch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT PERFORMED BY: do"UZq I / ,�' V �4��ER71FY THAT T IS EST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: �✓'�� 72-008 (Rev. 4/85) . l July 18, 1995 Mr. James Cross, P.E., Program Manager On -Site Services, Water Quality Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519-6650 P.O. BOX 111790 ANCHORAGE AK 99511-1790 TEL 907349-1003 IN AK 800 478-1003 FAX 907344-9936 Reference: On -Site Septic System Upgrade, Lot 2 Block 1 Susitna View Estates (17100 Feodosia Drive) Anchorage, AK, CAE Job #95893 Dear Mr. Cross: Enclosed are the drawings outlining the upgrades we are proposing for the failed on-site system on the above -referenced lot. You will note that this upgrade incorporates a biocycle aerated wastewater treatment system. Because of this innovative system,', we are recommending that waivers be granted for the well separation distance, proximity of the drainfield to steep slopes, and proximity of the drainfield to surface waters. We have incorporated provision for protecting the potable water supply by encasing the biocycle treatment system within an impervious enclosure. The tank will be enclosed in an impervious boot, which will protect the tank and its insulation from the surrounding backfill, as well as contain any contaminants within the boot. In addition, the well is a deep well some 252' deep, bedrock starting at 47' below the surface. We believe the installed impervious boot, as well as the naturally impervious bedrock, will adequately protect the water supply. in addition to the biocycle being within the 100' well radius, a small portion of the drainfield will also be within that radius. The drainfield will encroach 4' into the radius; however, the elevation of the drainfield is some 30' below the elevation of the well head. The alternative to placing the drainfield within this radius would be to encroach further on the setback from the top of the nearby slope. There is an intermittent stream to the north of the drainfield. This stream is some 60' from the drainfield. We are of the opinion that the surface waters will be adequately protected, as the effluent from the biocycle system is effectively a treated effluent. The effective size of the drainfield has been reduced by 507o. This reduction is reasonable because of treated effluent. We recognize that this design deviates in many instances from regularly accepted standards. We are a of the opinion, however, that this is the type of installation that the biocycle is ideally suited f REGISTERED PROFESSIONAL ENGINEERS BUILDING INSPECTIONS INVESTIGATIVE ENGINEERING LITIGATION SUPPORT CONSTRUCTION MANAGEMENT ; RC i` ALASI�lwEGINEERS �f s'! ✓,�� y � � ^ �' :; l July 18, 1995 Mr. James Cross, P.E., Program Manager On -Site Services, Water Quality Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519-6650 P.O. BOX 111790 ANCHORAGE AK 99511-1790 TEL 907349-1003 IN AK 800 478-1003 FAX 907344-9936 Reference: On -Site Septic System Upgrade, Lot 2 Block 1 Susitna View Estates (17100 Feodosia Drive) Anchorage, AK, CAE Job #95893 Dear Mr. Cross: Enclosed are the drawings outlining the upgrades we are proposing for the failed on-site system on the above -referenced lot. You will note that this upgrade incorporates a biocycle aerated wastewater treatment system. Because of this innovative system,', we are recommending that waivers be granted for the well separation distance, proximity of the drainfield to steep slopes, and proximity of the drainfield to surface waters. We have incorporated provision for protecting the potable water supply by encasing the biocycle treatment system within an impervious enclosure. The tank will be enclosed in an impervious boot, which will protect the tank and its insulation from the surrounding backfill, as well as contain any contaminants within the boot. In addition, the well is a deep well some 252' deep, bedrock starting at 47' below the surface. We believe the installed impervious boot, as well as the naturally impervious bedrock, will adequately protect the water supply. in addition to the biocycle being within the 100' well radius, a small portion of the drainfield will also be within that radius. The drainfield will encroach 4' into the radius; however, the elevation of the drainfield is some 30' below the elevation of the well head. The alternative to placing the drainfield within this radius would be to encroach further on the setback from the top of the nearby slope. There is an intermittent stream to the north of the drainfield. This stream is some 60' from the drainfield. We are of the opinion that the surface waters will be adequately protected, as the effluent from the biocycle system is effectively a treated effluent. The effective size of the drainfield has been reduced by 507o. This reduction is reasonable because of treated effluent. We recognize that this design deviates in many instances from regularly accepted standards. We are a of the opinion, however, that this is the type of installation that the biocycle is ideally suited f REGISTERED PROFESSIONAL ENGINEERS BUILDING INSPECTIONS INVESTIGATIVE ENGINEERING LITIGATION SUPPORT CONSTRUCTION MANAGEMENT Mr. James Cross, P.E. July 18, 1995, Page 2 Therefore, we request that you approve this permit application and issue a permit for the installation of this system. We do request that you give this your immediate attention, as we are trying to accomplish the installation of this system prior to August 5th for the safety of the occupants of the residence. In order to meet the schedule, we should have the permit to hand by July 31st, to start construction of this system. We appreciate very much your cooperation, and if you have any questions, please do not hesitate to contact us. TAJ/jbj/Enclosures C I. 5U%MVZWf5rAt5,Wr#2,VM#1 500 Fore Pik P- l mml-rA ApOkmNm oo OB aV1 T 450 aV/ (OB aV/ 50 -4626 5f 50X reAwUm for Pbq& -- 282 5F 10, Cm WO vaimpt PLMVEW PA Fork Hk tA 0 go*:* 0 'In Df. Imp pipe r� fai FUN" 9589.3-11 1/3 WeR Ham 6p, pipe u Mm011k "UMP" m i.� MN1%WNli,6 #1 • Nev Pra" V* (21' + n') � 295 5P �W�wl � 1ENGN� � j MM ii t4 saw" 3/3 f 31k7III / U O 6 J _ vh,1 0Y0 U 651...._ i 64'- 49 1aetNola #� , PWFU � 1 GV v,G —IF 09 0 60 5,L-, U {7— p (0 JAW � f b y (� f �Q\� �[%(✓�c7'U� 7730 ��OW ✓GN G✓1 �C�l ull �1 CG/G X4'=r� 98' _ - 100' (51) t96' r--' wa 90' .�- rp.,.*'" 3a fejt Hole #2 p'y; * _M71 • -c. >Go nose," Vol'i...:' A. Jehnson DEPOWX 7AJ .,DAM 7-1 Qo ..� ciEO= . SC. - 1-10 FUHuE "L'T 95893-12 .. 2/3 min min min Trench Detail Scale 1/4° = 9' TeA Ade 44 FT7.RIiT?: 5 *: 49UL .••.••••o•••••• Theodore A. Johnson CE5191 -L-_____..___�. y VV r ..-9 , Wel 901 feet Me #2 98893-12 2/3 WA,, 5U5fTiJAVM5fAT.5, Wr#2, ft.M#I 5OL5 More Gate op 9b mW40 ApOtsM n Kato -- 4D (v/ 5K 450 aV ( SFA AV/ 5F) ► 062,55F 10' Gas LV0 4A nim t 5LOM Lra Ate oma fsi,w _ +�► :-z _ + cg;w" �gWC2a , �______.__ _. _�.___ 1� ;.� .-_..__. PLM VEW l 95893-111 1/3 1 k ( , 3 k'r Well Owner J;an �+tu ^1U � `' I,ocat�oa � (addreu�>M1ot. Tova � r 61 if Size of cuing r'� n„pth ot: 4ex;r.' t2 >. statio.water levet `tt �Pert0rtii 'ImDesaibe afxeen or petforat Wen pumpLYg'test at all h`�of dralddoan.iroal;�taUcri, �` Dote "ot,completio++ ""�t •);]nir`F] 2. Depth Yn feet from;' .F, ` x ;,` ground �urfaf�a` ;��" ,,,c50Iv 47 M 9 � r✓ C � pi ?.�.b � {{` a} TV kA TniyliU1 A TO 5; i .•:ft" TSO\ ,TO TO ao R en � s DRILUNO,, tne. 1310C Intfrtutlorul Airport Road , 07)12744611 .' %GE,t ALASKA 99509 WNO LOO ' ` Ux of prat hom )tion, ii I�OWnj. or f 'UnCe main Y'J8r] . re R en P.O. BOX 111790 ANCHORAGE AK 99511-1790 TEL 907349-1003 INAK 800478-1003 FAX 907344-9936 August 11, 1995 Mr. James Cross, P.E., Program Manager On -Site Services, Water Quality Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519-6650 Reference: Supplemental Information For On -Site Septic System Upgrade, Lot 2 Block 1 Susitna View Estates (17100 Feodosia Drive), Anchorage, AK, CAE Job #95893 Dear Mr. Cross: At our meeting yesterday, at the site of the septic system, you requested five pieces of additional information. They are: 1. Detail of energy dissipater. 2. Calculations showing sufficient pipe was available to accept the volume of discharge from the Biocycle System. 3. Either evidence of the well head being upgraded, or a note on the permit that it must be upgraded. 4. Specifications for the low head UL listed pump to go in the Biocycle. 5. An executed Disclosure Form signed by the purchaser. We are enclosing detail of the energy dissipater, calculations showing the volume available in the pipe from the energy dissipater through the drainfield, and a cut sheet on the Zoeller 53 Mighty Mite effluent pump as well as a Myers ME40. Both are UL listed. We have contacted Arctic Pump and Well Service to extend the well casing and to correct other deficiencies at the well head. We have been advised these deficiencies have been corrected. We are also enclosing an executed Disclosure Form, executed by the purchaser, Kathy Bishue. We respectfully request that you issue the permit, so that we may proceed with the installation of the system. The information provided with this letter adequately addresses the five issues you raised at our on-site meeting and should satisfy your concerns. REGISTERED PROFESSIONAL ENGINEERS BUILDING INSPECTIONS INVESTIGATIVE ENGINEERING LITIGATION SUPPORT CONSTRUCTION MANAGEMENT WE AV OR �v AL S K "ASESi, AGI NEERS 01 P.O. BOX 111790 ANCHORAGE AK 99511-1790 TEL 907349-1003 INAK 800478-1003 FAX 907344-9936 August 11, 1995 Mr. James Cross, P.E., Program Manager On -Site Services, Water Quality Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519-6650 Reference: Supplemental Information For On -Site Septic System Upgrade, Lot 2 Block 1 Susitna View Estates (17100 Feodosia Drive), Anchorage, AK, CAE Job #95893 Dear Mr. Cross: At our meeting yesterday, at the site of the septic system, you requested five pieces of additional information. They are: 1. Detail of energy dissipater. 2. Calculations showing sufficient pipe was available to accept the volume of discharge from the Biocycle System. 3. Either evidence of the well head being upgraded, or a note on the permit that it must be upgraded. 4. Specifications for the low head UL listed pump to go in the Biocycle. 5. An executed Disclosure Form signed by the purchaser. We are enclosing detail of the energy dissipater, calculations showing the volume available in the pipe from the energy dissipater through the drainfield, and a cut sheet on the Zoeller 53 Mighty Mite effluent pump as well as a Myers ME40. Both are UL listed. We have contacted Arctic Pump and Well Service to extend the well casing and to correct other deficiencies at the well head. We have been advised these deficiencies have been corrected. We are also enclosing an executed Disclosure Form, executed by the purchaser, Kathy Bishue. We respectfully request that you issue the permit, so that we may proceed with the installation of the system. The information provided with this letter adequately addresses the five issues you raised at our on-site meeting and should satisfy your concerns. REGISTERED PROFESSIONAL ENGINEERS BUILDING INSPECTIONS INVESTIGATIVE ENGINEERING LITIGATION SUPPORT CONSTRUCTION MANAGEMENT WE Mr. James Cross, P.E. August 11, 1995, Page 2 If you have any further questions or concerns, please do not hesitate to contact us. Sincerely, Theodore A. Johnson, P.E., L.S. Principal TAJ/jbjBnclosures M] v CRITELARsUNG, baE E R S. Project Name_ Number Designed by �7�aa-1a, Date P.O. A ANCHORAGE 90 K 99511-1790 Checked by Date TEL 907 349-1003 Sheet 7 800 478.1003 (IN ALASKA) Of t A Ir I G � c-yc I" CRI JAELAKSLE"61E E R S Project Name/�lG// Number g3 T Deed#�y z l7� Date P.O. BOX 111790 Checked b Date ANCHORAGE AK 99511-1790. -. Y TEL 907 349-1003 Sheet —L of 800 478-1003 (IN ALASKA) QUAL/TY PUMP9 SINCE /939 „ Productinformation presented here reflects conditions at time of publication. Consult factory regarding discrepancies or inconsistencies. ZJ9Z_ZZZJ_ff 3280 Old Millers Lane P.O. Box 16347 • Louisville, Kentucky 40216 (502) 778-2731 • FAX (502) 774-3624 COMPARE THESE FEATURES • Non -clogging vortex impeller. • Float operated, submersible (NEMA 6) 2 pole mechanical switch. • UL -listed 3 -wire cord and plug. 9 ft. standard for automatic. 15 ft, standard for non -automatic. • Cast iron or bronze motor and pump housing. No sheet metal parts to rust or corrode. • Cast iron or bronze switch case • Glass filled polypropylene base and strainer plate. • Engineered, glass -filled impeller with metal insert. • Stainless steel screws and switch arm. • Model "55" stainless steel guard and handle. • No screens to clog. • Water tight neoprene "❑" ring between motor and pump housing. • Automatic reset thermal overload protection. • Oil filled motor—hermetically sealed. • Entire unit pressure tested after assembly. • Carbon and ceramic shaft seal. • Maximum temperature for effluent or dewatering -1300F. - 540C. • Passes 1/2" solids (sphere). • 11/2" NPT discharge. • RPM 1550, 60 cycles. • On point -71/21. • Off point -3". • Major width -101/4'. • Height -93/4': COMPLETELY SUBMERSIBLE HERMETICALLY SEALED Watertight—dust tight. Permanently oiled bearings. VARIABLE LEVEL CONTROL SYSTEMS AVAILABLE Zff1Z_Z1* Tff� 3280 Old Millers Lane P.O. Box 16347 • Louisville, Kentucky 40216 (502) 778-2731 • FAX (502) 774-3624 !o Manufacturers of ... QZIWITY POMF9 SNCE 1939 w FM0493 © 0289 ! Supersedes 0486 \r`tY a,J`1.J 1939 Ofhy 1989 vJ P VE Y "53" Cast Iron Series "55 Bronze Series MIGHTY -MATE" DEWATERING OR EFFLUENT PUMP SUBMERSIBLE PASSES 1/2" SOLIDS 11/2" NPT DISCHARGE MODELS AVAILABLE MPM WIER suwa /M MfXSN. SS wage Pump Mfg. Assoc. MA Specification Numbers Serle: NSC 4425 Series NSB 4415 • Automatic or Non -Automatic • "53"-.3 HP, 115V or 230V • "55"-.3 HP, 115V only •Canadian Standards Assoc. SP • ® Approval available LISTED • N53 available packaged with Piggyback Mercury Float Switch. AUG -16-95 WED 09;19 ALYESKA PUMP & EQUIPMENT FAX N0, 3445072 ME40 4/in HP Effluent va i Irrctin VJu�,er Fttmps ti•j:»l L p —, 30 e., 4. TONE ME40 59=5 SP£L1IENT PUW5 ARE y ONE QP THS MOSRET TODAY T 11 UP FL PUMPS ON THE MAR von,s impellel, r systems Lind ln ho ma and eiY true utre for today' ' .,.,,_,,.•.,� mhA Edth isonnstruated q( PURAf3LE MPc'ClR WILL DELI4ER MANY YEARS OF RELIABLE . 'V'CH Qil-lilu1Gd ^irar for marlmum heat AssiH�rti�n and conl:rntOus bcaling �edlr,a moi0* s Crverlr>-rr'_ rot t,, eltrninales starllllg xw;tcncs auu rP1aY; wP.tcll are prone to frill. YgAR5 of TXE MESO 1S DESIGNEI} £OR MANq MASNTSNA.NCE PREE OpBRATION ■ pusit!vr. seClirlg, 141j,:k connect Snnl and Switch Cords Lu. lire ni wCp19 t! serr ce is ev r necoMiry. a r'!ala tesfrd, V71aa a.u;Jt.,, tlo laS maa unum rmovJ draw doompAitomadCwdalsonlv.; Only the n1¢neal 4........— like cast iet9 01 g0 �c esin the nal le1r, fl ent tOr many e ,,rinlsffte.van - e MEll-MrdeCna'*;u1 tlotlt �tritc Ortlr.. pcinualrar nixtormur inforrnation,al �al!yourr vtyeis ,iisiriCutor tur:1ry of the My�rx Pa15!aAd. Olt -10 Sr, Ps olfiaa a1419iw8 ADVANTAGES By 17ESI" h�Ip,MMUM D INC- EPFICIE14CYOV1DES . E,)rlcsed design for h!gh eltial 0 p' P" Fonar M L:liminaies powwWty of jcn•nmin. and VoJnte, w PC(ss�s a n1U 14 inr..h solid, ■ Oric.(iriaI p.rtormanae. rte ,Cal [I�d a l[wear o0wrn l:ry replacing $RODUCT CAPABILITIES 1 InloTnitlar.i li4 • Malare!a�'[:wlDaia 4ilO hP.,^;0r rcr- :Ludcrf Dora. o:>ur:.a II l i5'/r?IG. l LS a:nS6 l ph M14 i �v7 •Ia:Is. y T :� CIC TY:�n: P.:iNf CA!+-aYluU. pY. aa, e�—. e�vclliG Gra"1 in•fl"-aN ^I JtSc:rsilY i R �E,} rcm 1 1n. 24 M:n. St�ltl'.O rJ1y51mP1"T 9d :n_n J pup{ax ImC-°�le:'NNeRin4 i N4 SET '--� `VlOnem�n 1 4 AtIIha RonbDpI ✓ul�r. --1 11 , NiErtV,- c..+w�:Cvm' to ar aV it Ns rL"C �1w:1:uricalShaa S!++:s wr1»nn na: u,c 1 UrAF;2E 2jN4VA710N ME6s'S 'f720N P. 02 AUG -16-95 WED 09:19 ALYESKA PUMP & EQUIPMENT FAX N0, 3445072 4 -1 10WER a roux cows M.vA (1:ickconnw't Wcc(91tight ROH naazsvn;pgYYpnlN'ir jj IttL^tijbgrQ IT'Arr11m:�? lur .u;'u anal ppe:ation. .( 1} able. repldCCGplg Ltirn `. ptvmP exte;,nr, I A F �JEUIIT.NoRPlLOaM ; Mj,'L`$IA2IICA7. LOT i Sw1TCH / I I �j��§r cangle v UMVI? HOUSING cast irms for etldent .'" trcir—civ. ov"TIOMSWITCH But -in. to olotocl o9olnrt a✓whx�ri ,xmdllia^5. 4/30 HP MOTOR Cw rpm. 40 HZ i15 or 73(N. sirq: PROPERTY OWNER AGREEMENT -=FOR THE MAINTENANCE OF AN ON-SITE WASTEWATER DISPOSAL 44 SYSTEM This agreement, dated 199, is made between the Municipality of Anchorage Department of Health and Human Services (DHHS) and the property owner(s) of: , / , i l _ I >1 This agreement is made for the purpose of maintaining an on-site wastewater disposal system on the subject property. The property 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 of Anchorage, on an annual basis, an inspection and operation statement from a registered professional engineer. This inspection and operation statement shall verify, that the engineer has inspected all effluent and air pumps, timers, and alarms, and' hat any deficiencies have been repaired and that the system is functioning as designed. ignature) a50D Judicial District ) State of) ss. (Signature) (Printed Name) On this day personally appeared before me to be the individual, or individuals descrito me known instrubed in and who executed the within and foregoing signe�ent, and acknowledge that free and voluntary act and deed, for the uses and purposes thereon mentionedthe same • Given under my hand and official seal this 14,qday of- Lr US'T 19 oS (Signature of Notary) n1Af n O'A1r-1 L (Printed Name of Notary) Notary Pu lic in and for the State of Mmicipi ity of Anchorage Department of Health and Human Services A825' ' Street Rick Mystrom, P.O. Box 196650 Anchorage, Alaska 99519-6650 Mayor Dear Prospective Homeowner: The property you are interested in purchasing has an "alternative" wastewater disposal system. This system, known as a "Biocycle Aerated Wastewater Treatment System", is undergoing testing within the Municipality of Anchorage under the Alternative System section of the Wastewater Disposal Regulations (AMC 15.65). There are certain risks involved with the ownership of one of these systems: 1. This system has been shown to be effective in other areas. The system is currently undergoing two year testing period in Anchorage under the guidance of the Department of Health and Human Services (DHHS) and the State of Alaska Department of Enviromnental Conservation (ADEC) to determine its effectiveness in a subarctic environment. Testing results on systems installed in 1994 have been very encouraging. Copies of initial test results are available from the DHHS. 2. The Biocycle system has not been tested and approved by the National Sanitation Foundation (NSF). Currently, Anchorage Municipal Code for Wastewater Disposal Regulations requires proprietary equipment to have NSF approval. This approval or changes to the Wastewater Disposal Regulations through Municipal Assembly action will be necessary prior to this system being approved as a standard system. 3. The "Biocycle" system has received vertical separation distance waivers from both State of Alaska and Anchorage Municipal Codes to both ground water and bedrock. These waivers were granted clue to the system's expected performance within the site conditions on this property. If the test results do not support these waivers, modification or replacement of this system may be required. 4. If this system fails to meet the 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) other wastewater disposal system that meets Municipality of Anchorage requirements. The cost of any conversions required to meet code requirements will be the responsibility of the homeowner at the time of conversion. I (we) certify that I (we) have read the above statements and an (are) aware of the risks outlined. I (we) also certify that I (we) an (are) in the process of purchasing (property legal description): 2�E (Purchaser Name) (Purchas Signature) Here 3co Judicial District ) State of Oq(Q�n ) ss. (Purchaser Name) (Purchaser Signature) On this day personally appeared before me n, , b US�) o e. , to me known to be the individual, or individuals described in and who executed the within and foregoing instrument, and acknowledge that 2a " signed the same as YiQ- free and voluntary act and deed, for the uses and purposes therein mentioned. Given under my hand and official seal this i b day of 006U5T '191957 (Signature of Notary) mUOA UODA & LL (Printed Name of Notary) 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSA,. SYSTEM NAME—���-�.�, L%�"u MAIL[ �F�jESS e ik�J ",(LEGAL IMS- LOCATION LEGAL DESCRIPTION SEPTIC TANK DISTANCE �- FROM WELL �� MANUFACTURERS=� MATERIAL INSIDE LENGTH 4� INSIDE WIDTH LIQUID DEPTH PHONE 3 -1 "' 72t41 �_A C' i-V�C,j.C4 l - V NUMBE-R-OF— COMPARTMENTS LIQUID CAPACITYZ�_GALLONS. TILE DRAIN FIELD: / TOTAL LENGTH J� DISTANCE FROM WELL / FOUNDATION NEAREST LOT LINE rTT% r OF LINES NUMBER OF LINES f DISTANCE BETWEEN LINES TRENCH WIDTHS IN. TOTAL EFFECTIVE ABSORPTION AREA �� SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE _MATERIAL BENEATH TILE �IN. ABOVE TILE IN. WELL: J l TYPE —� BUILDING FOUNDATION CESSPOOL CONSTRUCTION DEPTH DISTANCE FROM: NEAREST NEAREST SEPTIC�T_--SEEPAGE LOT LINE , SEWER LINE , TANK_S�_, SYSTEM , OTHER SOURCES APPROVED DISAPPROVED DISTANCES: INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE REMARKS: Form EQ -032 REMARKS DIAGRAM OF SYSTEM G.A.A.B. N C DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION G( 2510 E. TUDOR RD., ANCHORAGE, Atm. 99507 ov 276-2221 arq WELL Fllf-dGY 10W I T F= F=B-4EF_ F;�' F'EF_ F:!rq Z F PERMIT NO. C 75181 ) APPLICANT. YENNEY'S CONSTRUCTION 9100 LAKE OTIS 349-:242 LOCATION FREDOSIA DRIVE LEGAL L*#l= SUSITNAy� VIEW ESTATES LOT SIZE 28209 SQUARE FEET Uta L_e, 4- a ( )uc L + %" SELF'SO, ILiS TYPE OF SOIL ABSORBTIGN SYSTEM IS: TRENP'H MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ FT/BR)= 125 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: 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 I5 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). F?l_=:C4 ._.l I F?EGti 'F=F'T 11C: -rn"F< _ I 3101DI_t 13Fil_ L��®1 8' BACF:FILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON—SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 GAYS OF THE WELL COMPLETION. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F`EF?Ih1 I T ti.PPFFL._ Z L�)- F= C) F? rJt-.FE YEFeF? F= F?1C)lM I E!Sk—eE I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR GN—SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON—SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE y R DELED TO INCLUDE MO E THAN 3 BEDROOMS. S � (�� _ SIGNED:-- ________-- APPLICA�T YEF dEY S C td T CTION / ISSUED BY 1 Ivo '1� ,tip eonaE¢uction �Jzit fair "One test is worth a thousand opinions" 2204 Cleveland Anchorage, Alaska 99503' Performed For Jim Sloan�� _Date Performed 5/7/76 , Legal Description: Lot�Block � _Subdivisinni7Gj pw ,s._.tes This Form Renorts ,Soils Lon yes _ Percolation Test_ Depth 2 it Char 4— 6— Sandy Gravels (GP) 8— (6% Silt Size) 10 — 12- 14, 16- 18- 20— Gravelly 6-18- 20— Gravelly Silt (ML) Sandy Gravels (GP) Bottom of test hole i c s Was Ground Water Encountered? NO If Yes, At what. Depth? Readinq I Date I Gross Time MU� U 0 Net Time I Depth to H2O I Net Drop Percolation Rate Minute Proposed Installation: Seenaae Pit Drain Field Deoth of Inlet Depth To Bottom Of Pit Or Trench rnMMENT$: 125 square feet drainage arregs�irP_ oar. Par^^" -- ea No bedrock encountered. To Whom It May Concern; November 17,1980 Yenney's Construction Co. and I mistakenly indicated to the Municipality of Anchorage the actual legal description of where the septic system was placed. Presently your records show that Lot 1 Blk. 2 Susitna View Est. But the actual legal description is Lot 2 Block 1 Susitna View Estates. The lot is located on Feodosia Drive. Please correct your records accordingly. Thank Y u j3Ocjes SloanE. 12th orage, Ak. 99510 �1 M -W DRILLING, Inc. 4 P. O. Box 4-1224 • 1310C International Airport Road (907) 274-4611 ANCHORAGE, ALASKA 99509 DRILLING LOG Well Owner -i' < ` ''=,a,' Use of Well Dcm Location (address of: Township, Range, Section, if known; or distance main road r. 1!,. ,> ;ex nr. Vic -v,. Fstatr < Size of casing J' Depth of Hole—_222--feet Cased to l ' feet Static water level ft. (above) (below) land surface. Finish of well (check one) open end Screen ( ); Perforated ( ). Describe screen or perforation '"n: %"` Well pumping test at gallons per (hotlt) (minute) for hours with ] `;n' ` ft. of drawdown from static level. Date of completio* 170 Depth in feet from ground surface IO TO r i TO TO TO --TO- O TO- TO TO TO WELL LOG Give details of formations penetrated, size of material, color and hardness C:�xsirc Si:ic:kt:l� ;eclrock: r.:rr,y r.rnui,t:on ,, v. -')Ater snr.,hs in fr..ci:ury sorni� NWVA Certified Contractor �.� No'Y. 314 �F 97,3' 3 —CONTRACTOR Parcel I.D. 020-091-25 Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION JUN s 8 Gi-etchen $tulle, Expiration Date: ' I Complete legal description SUSitna View Est. Block 1, Lot 2 Location (site address) 17100 Feodosia Dr. Current Property owner(s) Michael & Kathleen Lacey Day phone _ Mailing address 17100 Feodosia Dr. Anchorage, AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings'(Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for:, COSA to be released to the COSA Fee $ DA69 Date of Payment (0112//05 Receipt Number COSA# o5cr�za�9 Waiver Fee $ _ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. _ Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 6/16/2015 *; 49 TH ... .... . 6. DSD SIGNATURE Steve .R..Pa.nn..... _AZSystem #1 Approved for bedrooms �/ � •, CE -8149 System #2 Approved for bedrooms (+til, / M AW .....ot�V'e Disapproved` Conditional approval for bedrooms, with the following stipulations: By: r Original Certificate Date: The M 1cipa' orage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the r ass chtions given in paragraph 5 by an independent. professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet ° :, c If more than 1 septic system is on the lot: COSA Checklist # + of 1 Structure served by this system I Certificate of On -Site Systems Approval Checklist ti Legal Description: Susitna View Est. Block 1, Lot 2 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 5/27/1976 Sanitary seal (Y/N) Y Total depth 252 'ft. Cased to 5 1. 1 ft FROM WELL LOG Date of test 5/27/976 Static water level 20 ft. Well production 10 9 - p.m - WATER SAMPLE RESULTS: Coliform Neg colonies/100 mL Nitrate ND mg/L Arsenic ND ug/L Date of sample: 6/3/2015 B. SEPTIC/HOLDING TANK DATA Tank Type/Material BIOCycle/Fiberg lass Parcel ID: 020-091-25 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 12+ in. AT INSPECTION - 6/3/2015 85 ff. 3.2+ g.p.m. Collected by: PES Date installed 8/23/1995 I Tank size 1,500 gal Number of Compartments .4 - Cleanouts (Y/N) Y Foundation cleanout (YIN) Y—_ Depression over tank (Y/N) N_ High water alarm (YIN) Y Date of pumping 5/26/2015 Pumper BioCycle Alaska, C. ABSORPTION FIELD DATA Date installed 8/23/1995 Soil rating (g.p.d.W or ft2/bdrm) 4.0 GPD/SF System type Shallow Trench Length 27 ft. Width 5 ft. Gravel below pipe 1 ft. Total depth 3'3 ft. Eff. absorption area 135 ft2 Monitoring tube Y Depression over field N Date of adequacy test 6/3/2015 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth 1 in. Elapsed Time: 150 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) No If yes, give date r, D. LIFTSTATION Date installed 8/23/1995 Size in gallons 1,5.00 "Pump, on" level at 9069 in. `Pump off" level at 89.10 in. Datum Bottom of Tank Cycles tested Unknown* Manhole/Access (Y/N) Y High water alarm level at 9097 in � Meets alarm & circuit requirements? yES> E. SEPARATION DISTANCES WELL ON LOTTO: Septic tank /lift station on lot 50** On adjacent lots 100+ Absorption field on lot 100+ On adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout 100+ ' Sewer /septic service line 25+ Holding tank 100+ Animal containment areas: 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Absorption field 5+ Waterman 10+ Water service fine 10+ Surface water 100+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: - -- Property line 0 Building foundation 10+ Water main .10+ Water Service line 10+ Surface water 60 Driveway, parking/vehicle storage 10+ Curtain -drain 50+ Wells on adjacent lots 100+ F. COMMENTS *Tested by BioGycle Alaska; **Waivers on file WR#950036 ***See attached lot line waiver request G. ENGINEER'S CERTIFICATION I certify that I 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. Engineer's Printed Name Steven R. Pannone 6/16/2015CE-+s14� Date is •. COSA canary sheet 2-6-15.doc Pannone Engineering Services «c Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve(aDnanengak.com June 23, 2015 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P O Box 196650 Anchorage, Alaska 99519-6650 Subject: Susitna View Est. B1, L2 Lot Line Waiver Amendment Waiver No. WR950036 Ladies and Gentlemen: Waivers. We request a modification to Waiver No. WR950036 from five feet (5') to zero feet (0') to the lot line. The 1976 absorption field was placed across the lot line onto lot 1. Granting this waiver is not likely to affect the health and safety of this lot or the surrounding lots now or in the future. See attached easement and survey as -built. If you have any questions or concerns, please contact me at 907.272.8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 3M8a visoao3.A -T- 0 0£'LL 1,tZ,£Oa00 N f "`-1 'n4s3 nlnun :W ,00'991 1.2.0.00 N 0 II f L'6Z f � • h � 3 ZZ p' • t' S _1NYJ ,B_9 'n4s3 nlnun :W ,00'991 1.2.0.00 N 0 II 8Or Z R 0�. Q ? Z Z 0 Q Z M N �W =09uw F Vlp� € m 3m= ¢ h U 0 0 2 0 m z O O H omW U�O fZZJ V = K Qrixl O <� K z OW NK p� yOj O K 00WE3jF0zo ez Z m} gyp' Z W _ x+10 ���.� O m Z O gabt00% mim a Z mWW� J C 100. n agon ��m \ m c� m o >Wo o Z M Q N it W= x P n N t7 f � • h � ,�. p' • t' 8Or Z R 0�. Q ? Z Z 0 Q Z M N �W =09uw F Vlp� € m 3m= ¢ h U 0 0 2 0 m z O O H omW U�O fZZJ V = K Qrixl O <� K z OW NK p� yOj O K 00WE3jF0zo ez Z m} gyp' Z W _ x+10 ���.� O m Z O gabt00% mim a Z mWW� J C 100. n agon ��m \ m c� m o >Wo o Z M Q N it W= x P n N t7 BioEycle Alaska 3705 Arctic Ave. #313 Anchorage AK 99503 (907)274-0314 E-mail: crbioak@gmail.com Box 111224 orage, AK 99511 2nd Quarter Maintenance 2015 Physical: 17100 Feodosia Dr MAINTENANCE DESCRIPTION COMMENTS- PRIMARY CHAMBER SCUM LEVEL HIGH BE SURE YOUR ALARM IS AERATION CHAMBER & AERATION SYSTEM BLOWER SIZE 60 ® 120 L/MIN ALWAYS ON "NORMAL" NOT ON AERATION PRESSURE HIGH LOW "MUTE" NOISE LEVEL HIGH GENERAL CONDITION POOR SYSTEM: AIR LEAKS LEAKS AIR DIFFUSER/AIR SUPPLY C65 POOR MIXED LIQUOR CONDITION ODOR YES CLARIFICATION CHAMBER SLUDGE ACCUM IN HOPPER LO HIGH CLARITY OF EFFLUENT FAIR CLOUDY DISCHARGE CHAMBER DISCHARGE PUMP OPERATING NO - r✓ eX rock ALARMS CHECKED AND OPERATING AIR/POWER 6 NO �V2r4t HIGH WATER NO C I st Quarter Maintenance performed by: BY: LARRY BETTS (862-7434/CHRIS 331-7978) DATE: ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND Oh�i�IL jZ7SCL /90�) bot- b�do THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this 10 Day of JV r16— of 20 15, by and between herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as l G Csy SK's- �� °( 1 �'7 oy Fc o �� si a• Z>r � UuuU�� located at (legal description). W 1/2 , ,6loce— 1, stls,4naz_ Vr'r_'4) �Slz r Su6d�iSZJn 2. Definitions. Alteration. Any change to the design or function of an AW WTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On -Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code (hereinafter, "AMC") 15.65. These approvals certify that service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AWWTS. C. Upon request by the Municipality, the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an A W WTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNER: By: (signature) Date: evS� (print name) 10 _IU&C 2015 STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT The foregoing instrument was acknowledged before me this —W day of t V ti 20 1G, by )4Vf . P,NF :A - 44 "6A -6N1 . n11 NotaryPobiie NOTARY PUB I OR ALASKATHEEINE A A'$� RSON MyCommisRi expires: My Commission Expires Oee 7.2017 MUNICIPALITY: By: (signature) Date: name) Title: �v Document Title: Grantor: /'4 C L-,�,v 1 Grantee: 1\4,-.C, Le. -- i Recording District: A c i10 /'c, - Property Description: S e --C, , - , After Recording Return to: 2015-027984-0A s Recording District 301 ANCHORAGE K A 06/26/2015 02:00 PM Page 1 of 2 I I�IIIIII 111111 IIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIII) !III 4 �n 6, 44 1 r=te � 'Q 0:1__113 r e I o c le. I %+ o? Lai )00 11 THIS COVER SHEET HAS BEEN ADDED TO THIS DOCUMENT TO PROVIDE SPACE FOR THE RECORDING DATA. THIS COVER SHEET APPEARS AS THE FIRST PAGE OF THE DOCUMENT IN THE OFFICIAL PUBLIC RECORD. Au;ust 19, 2010 DO NOT DETACH PERPETUAL WASTEWATER ABSORPTION EASEMENT This easement is made by Michael A. Lacey and Kathleen A. Lacey, whose address is 17100 Feodosia Drive, Anchorage, Alaska, 99516, hereinafter referred to as "Owner(s)". This Easement shall become effective on the date it is recorded, shall run with the land, and shall inure to and be for the benefit of all future owners of the subject real properties. Recitals WHEREAS, Owner(s) is the owner of the following described real properties: Lot One (1), Block One (1) and Lot Two (2), Block One (1), SUSITNA VIEW ESTATES SUBDIVISION, according to Plat No. 70-287, Records of the Anchorage Recording District, Third Judicial District, State of Alaska; WHEREAS, a portion of the wastewater absorptions system for the benefit of Lot Two (2) presently encroaches upon a portion of Lot One (1) and, WHEREAS, Owner(s) herein desire to provide for the perpetual utilization of the wastewater absorption system, NOW THEREFORE, for the reasons stated above Owner(s) declares as follows: An easement is hereby created on Lot One (1), more particularly described above, to accommodate the wastewater absorption system which extends onto Lot One (1) ten (10) feet and starts twenty (20) feet west of the northeast corner of Lot One (1) and runs one hundred thirty (130) feet parallel to the property line on Lot One (1) and shall provide for maintenance and operation of said wastewater absorption system. Said easement shall remain in full force and effect for so long as said wastewater absorption system is utilized for the benefit of Lot Two ((2). �P 1 Dated: / �I � d I S ,J // . /M J,..v ' Michael A. Lacey -D Kathleen STATE OF ALASKA ) THIRD JUDICIAL DISTRICT :ss. / he foregoin$ Perpetual Wastewater Absorption Easement was acknowledged before me this / day of _,AAAC., 2015, by Michael A. Lacey and Kathleen A. Lacey. Notary Public in and for 2 1 9 My commission expires: �1f�'AIIbI�N�i�IiNII�IIr��If�Nllll�ll��ld'�N'�all��lliall�'I�I 2015-027984-0 • lvIunicipality of Anchorage , ,, Department of Health and Human Services Rick Mystrom, 825 " L' Street Mayor P.O. Box 196650 Anchorage, Alaska 99519.6650 343-4744 August 18, 1995 Ted Johnson, P.E. Criterium Alaska Engineers PO Boxl11790 Anchorage, Alaska 99511 1790 Subject: Waiver Request for Lot 2 Block 1 Susitna View Estates Waiver Request #WR950036, PSD #020-091-25 Dear Mr. Johnson: 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 d'stance(s) are a private well to the septic tank of 50 feet)%%ag leachfield from Private and foot to the property line. 0e+j_ ppf 60 feet . Scav�'gfe +vier This waiver appy applie the e fisting septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Si rely, Robert W. Robinson Civil Engineer On-site Services RWR/ljm 05- MUNICIPALITY OF ANCHORAGE ' " • DEPARTMENT (W HEALTH &HUMAN SERVICES Division of Environmental Services %F' • _'- On -Site Services Section. ' P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Location (site address or directions)_/ Prooertvr'owner ; f�o4�r Day phone /�¢� �/Rtot�l� CJ�Y gaddress'P,i�O'/'rs";Q 19agency `i Day phone � yti j �lr�7 i�):i r 145[ �h9/kcc�S 3 ;3 �0 s //l q �GtGNAvG —Day phone 4:�G'f{5 ss x , o� Pus , �a,r -s t •-T ,, N ;_ ,91of Y otherwise requested, HAA will be held for pickup.,, "i"=,+ d s eel r P P s :•-1i =< OF BEDROOMS:`- - .ER �.;r OF WATER SUPPLY ` �Indiv ual well i Ax Community well y, )tai , Publicwater c R. "►f community well system, provide written confirmation from State ADEC a ing to the legality and status of system. '` ' OF WASTEWATER DISPOSAL: Individual on-site ,' rye 13, � yti ` f'y nfirmation from StateADEC... , :•-1i , ', 1)� ik a,f61f d{ t - YYt w, h II+ S ,4 5 STATEMENT OF INSPECTIONiBYI ENGINEER ,)*{ {" 6 u� rbt is t h etvalidation date shown below, I verify that my a 5 of th As cert)f{ed by,my seal affoced hefeto and _ ter supply val ,a lIcation shows that the on-site wa pp y investigation of this Health AutholltY APpr, - Pp'1 and adequate for the number of bedrooms na and/or wastewatter disposal system is safe, functio _ 9 and type of structure indicated herein I f1 111 urthervenfythat based on the information obtained from ;2( yP c.p. =4U;; 44 1; ,w"Tr X'; ,u + <" - in esti ation.and inspection, the on-site water ra a files and from'my y 9 the Muhrckpalrtyof Ancho 9 #, s, t ,4 i {x r" supply and/or wastewater°disposal system is rn compliance with all Municipal and State codes, a x { ordinances'and"regulations in effect on the date of this inspection.,' �(�(y/� '. i G -Gr ItGc�S t Phone Name of Firm •" i1j Address • `^i< A' f- a _; } ys , '�, ,ift Date t , Engineer's signature )5�i��°��{ I! ��OF 9", i 51 ` '.;, .. .a ���♦1����Lw`��. _. 1 I , { ; Theodore A Johnson CE51 'PSOFEt SS�w,• 6. ` DHHS FSIGNATl1RE y>nl t;.� 7AProved for z --j`� i" DlSapproVed. }��i`, jM1+l3i`i sC 1 sn L' Conditional approval fort '� — bedrooms, "With the following stipulations; Additional Comments �� r /j'lr9 /N/�6>v/�rc1 07 ' v, „n, + By: CAUTION t } The Municipality of Anchorage Department pf Health and Human Seniices (DHHS) issues Health Authority Approval Certificates based only upon the `representatlo`ns given in paragraph 5 above by an independent professional engineer registered in the State of Alaska; The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy c�rtain federal and state requirements. Employees of DHHS do not conduct inspection analyze data before a cQitificate�i�hissuI. ed The Municipality of Anchorage is not responsible for errors or omissions m iheprofessional engineePs work 1, kk ifeiw�Y>9�Ss,ri,id 72-025(Rw-1/91) Back MOA I✓tl/y v i -.i 1�. :1 ,F g i#`.�#��s '4� k,.S:,. t RECEIVED Municipality of Anchorage 7 1995 DEPARTMENT OF HEALTH & HUMAN SERVICES SEP Environmental Services Division municipality of Anchor 825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907)[34pMR641th & Human Seli§ /Health Authority Approval Checklist Legal Description:�o�Z7��lel��Sz R Ur i Parcel I.D.: 020'09/'7-67 A. WELL DATA Well type iUli / ' If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed / tay /tel Tom/ Total depth 2J�L— Cased to 5/ • °J Casing height (above ground) Sanitary seal (Y/N) FROM WELL LOG Date of test / s Static water level Well production g.p.m. WATER SAMPLE RESULTS: Wires properly protected (YIN) Coliform ��]]( Nitrate ©, (G /�A Date of sample: L) 9 I; Collected by: AT INSPECTION /25� ++ 4Y z3,//q9S i �9�kloycc/ ai W04Je) 9 -P -111 - Other bacteria 0 B. SEPTIC/HOLDING TANK DATA Date installedTank size /&ENumber of Compartments Cleanouts (oYJ/I�� Foundation cleanout (YIN) ( Depression (YIN) High water alarm (Y/N) r Date of Pumping (f�(1 Pumper tt C. ABSORPTION FI—EL-D�DATA e / } / Date installed-, ' Z3/ '!r ' Soil rating (g.p.d./fr2 or ft'/bdrm) 40 System type'+MA4J /yc�l4 Length za Width Jr Gravel thickness below pipe w Total depth Effective absorption area _ Monitoring Tube present(Y/N)� Depression over field (Y/N) /v Date of adequacy test ' Results (Pass/Fail) 6/4 For _Nk bedrooms Fluid depth in absorption field before test (in.); —r Immediately after_ gal. water added (in.): Fluid depth A— Minutes later: (in.) Absorption rate = g.p.d. Peroxide treatment (past 12 months) (Y/N) If yes, give date D. LIFT STATION Date installed��d Size in gallons /d<?'u� Manhole/Access (YIN) 7 "Pump on" level at* gD 69 "Pump off' level at* CJ l High water alarm level at* 96 CLI *Datum Cycles tested 1(lCCeI/k b-Aefab IV E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 5-9 ; On adjacent lots /DO + Absorption field on lot _�/ O 1/i/ 6W �lU�/ On adjacent lots leo f Public sewer main WA Public sewer manhole/cleanout —NA t Sewer /septic service line Jb Lift station 0 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: r q� Foundation' 23 • Z Property line b Absorption field �Z✓ 60' Water main/service line Surface water/drainage 1&k_ Wells on adjacent lots /00-(- SEPARATION ODf SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation / 3Z Water maitt/service line i Surface water SO Driveway, parking/vehicle storage area lz f Curtain drain N/A% Wells on adjacent lots l06 ¢- F. ENGINEER'S CERTIFICATION I certify that 1 have determined thru field inspections and review of1funicipal in conformance 15Y OA 11/1,4gu'delines in effect on this date. Signatur Engineer's Name TU ave_ /�. �dlGte�y PGs i Date,tid�v �oj�l5 HAA Fee $ ZCD6. 06 Waiver Fee $ Date of Payment I -" `y" Date of Payment Receipt Number b) Rev. 8/95 OSS: haa,wk,doc Receipt Number 71II:S/CMu'�,. items are oo.e.e ,,���^P l rr�(1 o oesoosoeo0, e1NMMNeO% reAJohnson CE 5191 :.w`" PROpwry OWNER AGREEMENT TOR THE MAINTENANCE OF AN16 ON -SI'Z'E WASTEWATER DISPOSAL SYS'T'EM -I his agreement, dated 199_, is made between the Municipality of Anchorage Department of Health and Human Services (MIS) and the property owner(s) of:/ 1 , o/._L / -<- -4. //,,.r.a �� �e7• This agreement is made for the purpose of maintaining an on-site wastewater disposal system on the subject properly. The properly Owners agree to lire following: Allow the Municipality of Anchorage the perpetual tight of entry to the property during normal working hours, to allow for effluent sampling or evaluating the general slate of repair or function of the system. Submil to the Municipality of Anchorage, on an annual basis, an inspection and operation sbdcnsent from a registered professional engineer. 'I ills 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. t ign�alure) . (Signature) 3pD judicial District ) ss. Stale of II �2`�iicl ) (Printed Name) On tills day personally appeared before me 4,�a,4fileen 1h'511D'I(9C-- .to me known to be the Individual, or Individuals described In and who executed the within and foregoing Instru(^ent, and acknowledge that `JZ_ signed the some as Ise.{,' free and voluntary act and deed, for the uses and purposes therein mentioned. Given under my hand and official seal this Itor"dayof fifKIJST ,182�. (Signature of Notary) "Pero of22uti)ELL- (Printed Name of Notary) Notary Pu Ilc In and for the Stale of Residanl al - Fypltes My Corrrmiss on ExpiAdyao 9gT avuraemnasreras Mtuiicipa]iLy of Anchorage Department of Health and Human Services 01** 825"L" Stre ll rscv. Alyslmm, P.O. Box 196650 Anchorage, Alaska 99519-6650 Alayo, Isar Prospective HOnncowner. -1 he properly you are interested in purchasing has an "Ntemative" wastewater disposal system. Ibis system, known as a "BIOCYCle Aerated Wastewater Treatment System", is undergoing testing within the Municipality of Anchorage under the Alternative System section of file W aslewaler Disposal Regulations (AMC 15.05). 'I here ere certain risks involved with tine ownership of One (if (hese systems: I. 71his system Inas been shown to be effective ill other areas. The systean is currently undergoing a Iwo year testing Period In Anchorage under the guidance of the Department of Headband Hamar Services (DI IHS) mall die Site of Alaska Department of Bnvironmenlal Couservatiuu (ADBC) to detennine its effectiveness in a subarctic envtmm lent. Testing results on systems installed in 1994 have been very encouraging. COPies of initial test results are available from Use DI11Is. 2. '1 lie Biucycle system has not been tested laidapproved by the National Sanitation Foundation (NSF). Currently, Anchorage Municipal Code for Wastewater Disposal Regulations requires proprietary equipment to have NSF approval. This approval or changes In Ibe Wastewater Disposal Regulations Ihaugh Municipal Assembly action will tse necessary prior in Ilhis system being approved ars a slandmd system. g, 1 be "Biocycle" system has received venial separation distance waivers front ixeh Slate of Alaska and Anchorage Muricilad Cates to holh ground water ;old bedruck. 91nese waivers were galled due to Ilse syslcui s expected perfunuance within the site conditions on this papery. If the test results du not support these waivers, altaf icalion or replacement of this SYstenr may be required. 4. 11 this system hills to meet the requirements set for tl to become a slandald axle :grpwved wastewater (lisposal system, it may have to be rcnmvcd and replaced by either It holding Iznik in (if Possible) other wastewater disIlOA system that meals Municipality of Anchorage requirentenls. 'Hie cost of any conversions required kr nscet Cale requirenlenls will be the responsibility Of the homeowner it file lime of conversion - 1 (We) Celli fy thal I (we) have read the above statements aul ,all (are) aware of the risks Outlined. 1 (we) also Ccnify Ihal 1 (we) an (are) in the process of Purchasing (property legal description): (Purchaser Nmne) (Purchaser Name) (Purdase'Slgualure) (Purchmer Signature) Ilere JPL) Judicial District ) ) ss. Stale ofi�IC4`sk� I On this day personally appeared before me fY�l6)�P�,r4 �` �JUSa`1rJ e. ,to me known to be the Individual, or Individuals described in and who executed the within and foregoing Instrument, and acknowledge that I - signed the some as hQI— free and voluntary act and deed, for tile uses and purposes therein mentioned. Given under my hand and olfklal sealthis I(odayof Ii(]cso5f- ,1995-- Ili/,f (Signature of Notary) q ' 14-0_1 AiAx c L (Printed Name of Nolery) Not Public in and for the State af` Re tolerates V Phee My commission Expires My August t9. teslontggi amu pu��mas 5. LEGAL DESCRIPTION 4.,? -2 SvS fnii+,Z_si4 f4 DATERECEIVED • - INSPECTION APPOINTMENTS TIME TIME TIME ❑ One ❑ Four ❑ Other SINGLE FAMILY DATE DATE l DATE INSPECTOR INSPECTOR INSPECTOR n since June 1975. For wells drilled prior to that dat ,give well MUNICIPALITY OF ANCHUKAUL MUNICIPALITY OF ANCHORAGE DEPT. OF H-ALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROT EMPMONMENTAL PIUIECTION 825 L Street - Anchorage, Alaska 99501 • NOb' 17 1980 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DI RECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER G S /0 PHONE 3 sus ao r: MAI LI NG ADD ESS S Gf/JDO yc �. �lG 4Sa % PROPERTY RESIDENT (If different from above) PHONE B.S/R 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION 11 ia, rcft oic7 it PHONE -2 o66s MAILINGADD RE: R/ G 4. REALTOR/AGENT JJ PHONE MAI LI NGADDRESS,,�- SD! 5. LEGAL DESCRIPTION 4.,? -2 SvS fnii+,Z_si4 f4 STREET LOCATION Jam' 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS ❑ One ❑ Four ❑ Other SINGLE FAMILY ,Z9 Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY 91 INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that dat ,give well ❑ PUBLIC UTILITY depth (attach log if available.) ,j,? 8. SEWAGE DISPOSAL SYSTEM - ,® INDIVIDUAL/ON-SITE** 49W YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY CJk \G"lC NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) () -rJ ITYa THIS SIDE FOR OFFICIAL USE ONLY '- 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ six 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMITNUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS a]--APPROVEDFORBEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE Jl--a-b-, BY Qc � 72-010 ( Rev. 6/79) A f K :1 <- ED cl ul V e� n f- 1" Go ED A