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Home My WebLink AboutNORTH WOODS UNIT 4 BLK 15 LT 5North Woods #4 Block 15 Lot 5 #051-064-08 Municipality of Anchorage V Development Services Department Building Safety Division On -Site Water and Wastewater Program. 4700 Elmore Road P.O. Box 196650 Anchorage. AK 99507 Page of www.d anchorage.sk us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SWO80207 PID Number. 051-064-08 Bill Becksfine Wastewater System: ❑ New ® Upgrade 23233 Green Garden Circle. Chugiak AK 99567 ABSORPTION FIELD Pl Manp.r of a•eoae. 4 O Deep TrMxll Id Shah. Tlercn 0 BW 0 Mann O Oe LEGAL DESCRIPTION sw Rao^9 250 lar Depa evnl alprlr 4ad. -AC1.o Gpcwe Ft. almkLot o.mi, p. loran nae al"wma. G<...l 08M lwwm pw Northwoods#4 -0.50 FL 0.5 Ft Tosrwft0 Rang. Sscaoe Fe .Oa•a Mww W" W Cr l&VM 2.0 Fl. 39 n. Well: ❑ New ❑ Upgrade Gr.wl.rae, rNmo«ar,.. 1 Dal"aa paaterlYr. NA 5 Ft. Ft CMwrabrl (PrrYal., A a. CI Taal Degn Cuss b Tae1 aoaagcn.r.. Rp. MMaMI AWWU NA FI. NA FI 195 Fe PVC 0� DM. Da Sw.: Waw L. lri Y Do*lnM"1•a NA NA I NA FT Dean Construction Dvmt 06!09109 Ywp WrpSaM uglMgqAeowGraaa CaNA TANK NA Gw NA FI. FL SEPARATION DISTANCES ❑ Septic ❑ Holding ® S.T.E.P. ❑ Other. To Septic Absorption Lift Holding udrJPmate " i°'•" tr From Tank Field Station Tank Sewer Une Anchorage Tank 1500 Gr MMaul IWmEa d Caw"suaa wa NA NA NA NA NA steel 2 suds w~ +100 ft +1008 +100 ft +100 ft LIFT STATION La LeM +10 ft +10 R +10 R +10 fl '. GM Anchorage Tank and Orenco 'Part/ on' Mwl M 'Pro ar r.a M Mpl «Ma aurin w Faadum +10 R + 10 R +10 fl +10 ft ;N 93.91 el 93.41 " OZrZ SID y�' NJ Pare Mala a Ma EYmiul xupx.ae F.rle W! by cM+..r Dr.n NA NA NA NA Orenco StD WAG Electric """"'BENCH MARK 7.500 pY Mdnr.pa Tra aepet fart iota Mvanba and M awron b AaV.fIM4 SIM Loraear.na D.auVl Orenco Pod to transfer effluent from DR station to sods absorption Bottom. right sill of mandoor. Garage 100.0 kvaoan aeW. Numaoue Inspedxtn UM Inspedion 0&09109. prase 4 estadlshed FL R. Godden Dates: 1" 05/18/09 En9lrweT'g Stamp \\,1 Inspections performed by: = ��O"F`�q ' •S i 2nd 05119/09 Department Approval �.► Q,t' 1 •••.Fy// Development Services y�• Conditional Approval Date:0. I. / •� •EN Reviewed and approved by: li%F P�Date: L " b ��EEE S0 i /+��,'•� Z ��o � � ZD L4 Ca O11 Q D Vii fDN+ZS I O oco 0 Zv z < 140!j v N N� 0 Z �gc;rn �pcN _ rt1 r- mo" x OAZ W O In 0 T1 ax 0 m Cz: O m zzmc> o z��n �v0 0 mAz p ^' 07, 0im0 \z 2 r rri M'�1 Z 0-10 Mcm 0r NZ 90 ^ Z-+ C pa Ovm� =`a D o yr ocDiczi 00 MD r D J zZ �� Dr- A m Z r r 'U ffl Z o . o X N N N .m 4 O C N N G M J)w W N ----- ; W rn m m0 O F M. to O N W WA (pd 0 A p • A 0 O Z Z N O07 K3 \ fM m N O O 1l -- WI) o A \ i•..� F0 • W W ,... •� D \ W D W D 0 O -i �N� !oJyy o��,��\\ ,,\,�t-��,,�'..�v�•�'�- �•r , v�O m(D7 MNv0 `., ni o0(Nm 0O + A• wD� I N�0 0 rZy ; wN�O N --< pv m va) o Z 0z (6'oDm v; v C n i�0m o AD AOCr M;un 0D zA r'Otio7 m vm 00 X O O C O cn �;V 0z KZ C3 O z0r, rn r� � �O Z Z (q pQ N _ Z.(p Z rn a NO —4r ..4 N m o Z ^'m0O �ZCO r Z O m 0i s (DIDr mmo m oiM vuW p 0 0 Z *mI 0 z0 mmo o rn m Ntoo rn Ln ED 4- p 0/, W/ Wm` •%mU X10oc zz z mv0 THETA Drawn by: FIGURE 2 SIVIG Environmental & Engineering LOT 5, BLOCK 15 Checked by: Project No: Contrail No: NORTHWOODS SUB NO.4 RE( rn A JN v K ,L'9Z l D M m A \ co .i7 o c o' \ m rn0 1 1 I 3 „00,00.06 S I 1WSlfSl nNJeY e$ 1 A "D 0 �- A A A V V\ V V A V A' 0 A- ,00'09 3„00,00.06 S 0 THETA Environmental & Engineering contract No: -+ -Dio o� OWN Z Ln z�vm v� CO c� zv 0 mm 14 � Cm 01 M Lnm n O a9 y 0;0 O z N ''t m N M� 74 N m W O> W ;0_ Ul A 2 N W Or N O) V U V O to N N A N tb N �I rn W W z00 \\ or ao of W rnzo W V A V OD r V W (I W WCo _. L4 tD N / OD O N W W "D 0 �- A A A V V\ V V A V A' 0 A- ,00'09 3„00,00.06 S 0 THETA Environmental & Engineering contract No: O X 3y, f N -+ -Dio o� OWN Z Ln z�vm v� CO c� zv 0 mm ;'(o Cm 01 M Lnm O -4 rt v 0;0 O z N ''t m M M� 74 N m W O X 3y, f N -+ —1 Z l7 off 9 '-' D tZ c 10 -4 C o-0 z�vm .. v zr C jC vo 0 o� Cm m z -4 rt (A 0;0 O z N ''t -n O Om M� 74 N m W O> W ;0_ Ul A 2 LOT 5, BLOCK 15 NORTHWOODS SUB NO.4 �N 0 X M M z S? 0 M z n M n r M n m a rn O o V ... W t N O O O N (A � w � C" N W A W O> W Ul A N W Or O) V U V O to N N A N tb N �I rn W W to or ao of W CA V W V A V OD O V W (I W WCo _. L4 tD L4 OD U OD O N W W W U <o b V N of W x ® o M v r- 0 v -Nrn i n ? v O 2 O A 'M M m '� c �A.. m A 0 n z rn v M Drawn by: SMG Checked by: REG FIGURE 1 Project No: 1tAG. ELECTRIC 1852 E. 57TI1 AVE, ANCHORAGE, AK 99507 Bill To Hill Ikckslmc RO Boy 671373 Chugial. AL• 99567 Invoice Date Invoice # 6!I(d21Mr) 322 P.O No Terms Project Due on rec ipt Quantity Description Rate Amount eleltrical winimllnit oI IRM septic Sl sleltl at 23233 Grven Oatden Cir. ruNidewe /� IaMr 851X) 5111 IX) 1 AtJ1�71aI 420I 42.181 Re 23233 Green Garden Cir Chugiuk. At.. 'PJ567 lo ehont it nen concent llle acpnc 1111 station a1 the Owe reterenced property h:u holn wined in uccortinwe I with NCC alnl stateAmal cukti. j Total 3552.t1u MA/Y—I8-200: 10:04 AM MARK. HANSEN P.E. 907 74E. 4721 P.01 ►.°. !o* 4313 Petmw. AK fPo4e-Nta •�++... w•. - ___ �-inInjp�O*SaadM.Mt 9/5/2008 Work Order: 08080 T & J Gravel Sales HC 31 Box 5080 B Wasilla, AK 99654 Fax: 746-2998 Project: Materials Testing Subject: Sieve Analysis, Filter Send Gentlemen: The following is the sieve analysis of the sand submitted on 912108 Sample Location: submitted Sample Identification: Filter Sand Sieve Passing MOA Spec. 1/z, 100% 3/8" 100% #4 100% 100 #10 73% #20 42% #40 19% #60 6% #100 1.7 % 0-2 #200 0.9% 0 - 1 The sample conforms to MOA specifications. If you have any questions, please do not hesitate to call. Sincerely, Mark Hansen Munlclpallty of Anchorage Development Services Department Building Safety Division y,. on -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 995196650 www.Inorglonsite (907) 343.7904 Soils Log - Percolation Test Performed For: Legal Description: BILL BECKSTINE DatePerformeo: oe/05/oa LTS 8U(l5 NORnnrooDS /a SUBDIVISION T~Ship, Range. Section: TEXT Slope Site Plan ORGANICS 1 _ rtU. SILTY SAND (SM) ORANGE SILTY SANDY GRAVEL (GM) VATH COBBLES AND BOULDERS. TAN 10— SILWY $ANDY GRAVEL (GM) ..1 BOH WITH SANDY GRAVEL WAS GROUND WATER ENCOUNTERED? YES e IF YES,AT WHAT DEPTH? 9.5 L Depth to WrterAMw 0 WrlttaF rtpT 6.3 R E Date. 08/16/08 ! M. 3910 R_ PERCOLATION RATE — (rNWWWh) PERC HOLE DIAMETER 6' TESTRUNBETWEEN — FT AND — FT COMMENTS See attached Meet for perculation dota. Ground *ater Monitoring, 09/15/08, 6.9 ft DNor grade. PERFORMEDBY: RONALD E. GODDEN I RONALD E. GODDEN CERTIFY THAT THISTESTWAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 08/18/08 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519.6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Sep 24, 2008 Expiration Date: Sep 24, 2009 Permit Number: SW080207 Parcel ID: 051-064-08 Legal Description: NORTH WOODS UNIT 4 BLK 15 LT 5 Design Engineer: 0072 THETA ENVIRONMENTAL ENGIN', Site Address: 023233 GREEN GARDEN CIR Owner Name: BILL BECKSTINE Lot Size: 24790 SO. FT. Owner Address: PO BOX 671373 Total Bedrooms: 4 Permit Bedrooms: 4 CHUGIAK , AK 99567 - This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be In accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3_ The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. A. Waiver WRO80066 allowing the absorption field to be oriented perpendicular to the contour lines. Received Issued By: Date: /O// B . Z'Inl'Date: w AS �4 _ Miuiicipahty, Of Anchorage 1 � S J 1:0. IG+x 1!MMliq •,lnchom+„c, .11a+k+ !kli l!)diral • 47(N) lilnurce Hwul Office: (!M17) 3M Ri(11 • IS+x: (!M)7) 3t3.8Y(M) Lllp://u�eu'.nuwLur� Mayor Mark Itegich Development Scr%iccs llcpartmcnl 9/24/2008 Ronald E. Codden, P.E. Theta Environmental & Engineering 660 Mancy Drive Wasilla, AK 99654 Subject: Waiver Request for Northwoods Unit 4; Block 15; Lot 5 Waiver Request WR#: 080066 Parcel ID # 051.064.08 Permit #SW080207 Dear Ronald E. Codden: went Department Your request for a waiver to orient the absorption field perpendicular to the topographic contour lines has been approved. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all code requirements for the absorption field orientation to the topographic contour lines be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. A lyJay" Crewdson, P.E. Civil Engineer On -Site Water & Wastewater Program Community, Security, Prosperity � Municipality of Anchorage `--1 Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, Alaska 99507 www.muni.org/onsite (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-064-08 Property owner(s) Bin Beckstine Day phone 696-2065 Mailing address P.O. Box 671373 Chugiak AK Site address Code 99567 Code Legal description (Sub'd., Block & Lot) Lot 5, Block 15 Northwoods # 4 Legal description (Township, Range & Section) Lot Size 24.790 Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field El Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms 4 THIS APPLICATION IS AN: Initial ❑ Upgrade (] Renewal ❑ certify that the above information is ect. I further certify that this application is being made for a Single Family DweI!IPPn049,�inAc dance with applicable Municipal Codes. - o ? T--S— (Signature of property owner or authorized agent) Permit/Rush Fees:' -/(00 Waiver Fees: Date of Payment: - /Q - Date of Payment: Receipt Number. 3 Receipt Number. 1/ 3 O I (Rev. 11/05) Theta Environmental & Engineering 660 Maney Drive Wasilla, Alaska 99654 (907) 242-0755 September 17, 2008 Ms. Deborah M. Wockenfuss On -Site Services Program MOA Dept of Health & Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Re: Lot 5, Block 15, North Woods #4 Subdivision, On -Site Wastewater Disposal System Permit Application, 4 Bedroom Single Family Dwelling In accordance with AMC 15.65.030, the following information is provided in support of an On-site Wastewater Disposal System Permit Application for the subject property: The subject property, at 23233Green Garden Circle in Chugiak, Alaska, currently has a 4 bedroom single family dwelling with public water (AWWU). The existing septic tank is an Anchorage Tank, steel, 1,250 -gallon double compartment tank. The soils absorption system is a bed. This application is for a 4 bedroom single- family dwelling. 2. Double M Construction and S &S Engineering (Robert Shafer) installed the original system in 1993. The owner noted that water was present in the drainfield and after examination, it was determined that the system had failed. The existing soils absorption system will be abandoned in-place by capping the line to the existing soils absorption system. 3. The property generally slopes from southeast to northwest but has numerous compound slopes. It appears some leveling was accomplished when the lot was developed and fill was observed in the percolation holes, but not the actual test hole. There is a 10- foot cut bank to the west along the lot line with Lot 4, but does not affect the proposed onsite system. A 10 -foot cut bank exists along the north lot line. The lot slopes are indicated on the plan view of the plan set. The location of the soils test and percolation tests were in native soils. The test hole accomplished by Theta Engineering is indicated on the plan view of the plan set. 4. The area, where the replacement soils absorption system is proposed is located along the east side of the lot. 5. The new system will be a Category III system consisting of an add-on lifts station and an Advantex AX -20 pod. The existing 1,250 gallon septic tank will be removed and a new Anchorage Tank steel 1,500 -gallon septic tank with the Advantex pod will be installed and connected to the existing A pump vault will be added after the podttank to collect the treated effluent from the pod and pump the Page 1 of 3 9117=08 Noftwoods*4-UB 154L-dstine-Mun1SASPermitLU.doc effluent to the wide trench where it will be further treated and disposed of in the soils absorption field. Buoyancy restraint calculations will be provided to the installer. 6. The Advantex AX -20 pod is an approved system, manufactured by Orenco and Anchorage Tank. The engineer has specified this system and further specifies that it will be constructed, installed and operated in accordance with the manufacturers specifications, instructions, and requirements. The engineer will verify the various required inverts and provide that information with the as built. 7. The soils found during the soils test were silt (ML), silty sand (SM) and gravel and Gravelly Sandy Silt (GM). Ground water was observed in the test holes, and in subsequent monitoring. This information is provided in the soils logs, attached. The new system will be installed near Test Hole # 1. 8. Percolation tests were performed in the GM and the percolation rates were 14.7 and 22.7 minutes per inch. The design application rate will be 0.6 GPD/SF or 250 sq ft/bedroom. Since the dwelling has 4 bedrooms, the total required absorption area would be 1,000 sq ft. 9. The GM layer extends from 25 feet below grade to the bottom of the test hole at 10.5 feet below grade. Ground water was observed in the test hole at 9.5 feet below grade on 8/5/08 and further observed at 6.3 feet below grade on 8/16/08. Due to the time of the year, an additional 2.0 feet was added to the ground water level for an adjusted level of 4.3 feet below grade. Another ground water monitoring event occurred 09/15/08 and the ground water was observed to be 6.9 feet below grade. Due to the time of the year, an additional 1.0 feet was added to the ground water level for an adjusted level of 5.9 feet below grade. Since the bottom of the system must be 4.0 feet above ground water and 6.0 feet above bedrock or an impermeable layer, the top of the soils absorption system will be at 1.9 feet below grade. The existing silt and fill will be removed and replaced with filter sand to provide a level trench bottom. This will satisfy the ground water separation requirement. See Soils Log 1. 10.The system will be a wide trench. The Advantex system is a Category III system and allows an application rate of 4-gaVday/sq ft. The bottom of the trench will be 0.5 feet below the distribution pipe. 4 br x 150 gpd/br = 600 gal/day, 600 gpd/4.0 gpd/sq ft requires a minimum of 120 sq ft of absorption area. Then 120 sq ft / 5 ft = 24.0 ft of trench. 11.There will be a single 5 -wide trench and will be at least 34.0 feet long. This will provide for a total of at least 180 sq ft of absorption area. This will allow the bottom of the system to be at least 6 feet above an impermeable layer or bedrock and at least 4 feet above seasonally high ground water. 12.A waiver for placing a wide trench perpendicular to the slope is required. The location selected is the only place on the lot where a separation distance of 50 feet from a cut bank can be obtained. Further, it is doubtful that a replacement system can be installed anywhere on the lot, other than the location Page 2 of 3 8/172008 NoAhwoods#44.5815-Becks6n"uniSASPermftUr.doc selected, due to the cut banks. However, there is a 2% slope, which will run in the same direction as the trench. While this slope is slight, it is a 2 ft drop over 100 ft. Since the trench is 34 feet long, the drop is expected to be 0.68 feet. Since the elevation of the bottom of the trench is expected to be 1.9 feet, at the test hole, the bottom of the trench probably can not daylight. However precautions have been taken to prevent this from occurring, just in case. The sides of the trench will be lined with visqueen from well below grade, at the SM/filter sand interface to above the top of the sewer rock. Further, filter sand will be used to level the area above the GM to again ensure that day lighting will not occur. Therefore, I recommend this waiver be granted. 13.There are no known wells on the adjacent lots. AWWU Public Water serves the subdivision. There are on-site absorption systems on the adjacent lots. It does not appear the system on this property will prevent development of the adjacent lots or the installation of replacement systems on the adjacent lots. 14.The owner has signed the Advanced Wastewater Treatment Maintenance and Repair Agreement MOU and the original is attached. 15.The owner reserves the right to not install the system until on or about October 15 to have the ground water monitored at the actual seasonal ground water table high. If the ground water allows the installation of the soils absorption system at a lower elevation below grade, the design will be modified to reflect the new elevation and a ground water monitoring event will be documented and submitted by the engineer. Based upon the data and drawings attached, I recommend a permit for this wastewater system be granted. If there are any questions, please feel free to contact me at (907) 242-0755. Enclosures: Soils Log, Test Hole # 1 with attached percolation data Figure 1, Overall Plan View Figure 2, SAS Details MOA AWWTS MOU Agreement s�OF11 ZA In, Page 3 of 3 9117/2008 Northwoods#415B 15-8eckstine-MuNSASPerm Mr.doc Municipality of Anchorage Development Services Department Building Safety Division a,1 On -Ste Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 995736650 www mun org/omile (907) 3437904 Soils Log - Percolation Test Performed For: 80.1 BECKSDNE Date Legal Description: LTS BLI(IS NORDMWDS /4 SUBDIVISION Township, Range, Section: TEXT " 1_ Y- S- WAs GRW ND WATER ORGANICS FILL SILTY SAND (SM) ORANGE 4- .: YES 5_-< BON WITH SANDY GRAVEL SILTY SANDY GRAVEL (ON) 6 WITH COBBLES AND BOULDERS. TAN 6- 9.5 L Depth to f WatwAer 7- Nbri torYtp? 6.3 ft E SEEP a- . •,,. -3L-09/OSL/O��B� WAs GRW ND WATER SILTY WrDY GRAVEL (GM) ENCOUNTERED? YES BON WITH SANDY GRAVEL 6 F YES,AT WHAT DEPTH? 9.5 L Depth to f WatwAer 0 Nbri torYtp? 6.3 ft E Date: 08/16/08 -� d id ■ l ■ r -I _- • A W., "p -M. --I PERCOLATION RATE - pr4WWWh) PERC H CLE DIAMETER 6' TESTRUNBETWEEN - FT AND - FT COMMENTS See ctto hod Meet Ia pamutalion dato. Lound water Monitoring, 09/15/08, 6.9 ft Delo. grade. PERFORMEDBY: RONALD E. GODDEN I RONALD E. GODOEN CERTIFY THAT THISTEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATES 08/16/08 Theta Environmental & Engineering Percolation Data Location: Lot S. Bk 15 Northwood # 4 Subdivision 1-5B15Northwoods#4-Beckstine-Pero Data-TH 1-V1.xls 9/15/2008 Pen: Test # 1 P-1 Reading Date Gross Time Net Time Depth of Water Start ft Depth Of Water Stop ft Net Drop ft 0 8/5/2008 2:02 PM 0 1 0.65 1 0 1 0 1 8/5/2008 2:32 PM 300.65 0.7 0.47 0.18 2 8/5/2008 3:02 PM 30 0.651 0.47 1 0.18 3 8/5/2008 3:32 PM 30 1 0.47 1 0.18 4 Percolation Rate: 0.18 ft = lin/30 min = 0.07 in/min= 14.7 min/in Test run between 3.0 ft and 3.5 ft. Per; Hole Diameter = 0.5 ft. 1-5B15Northwoods#4-Beckstine-Pero Data-TH 1-V1.xls 9/15/2008 Pero Test # 2 P-2 Reading Date Gross Time Net Time Depth of Water Start ft Depth Of Water stop ft Net Drop ft 0 8/5/2008 2:03 PM 0 1 0.7 1 0 1 0 1 8/5/2008 2:33 PM 30 0.7 0.59 1 0.11 2 8/5/2008 3:03 PM 30 0.7 0.59 1 0.11 3 8/5/2008 3:33 PM 30 0.59 0.11 4 Percolation Rate: 0.11 ft = 1.32 in/30 min = 0.04 in/min= 22.7 min/in Test run between 3.5 ft and 4.0 ft. Perc Hole Diameter = 0.5 ft. 1-5B15Northwoods#4-Beckstine-Pero Data-TH 1-V1.xls 9/15/2008 1 I X9Z l 3„00,00.06 S I v A�Ln �N IINS3 ,un ,Sl n J,., M v /pZ A X M M z 0 M z A 0 A r M ® - - 0 0 O m -_Co zv v mm M ,Z£ o _ v A _ -v 0 c m F ro 0 z m m m C c-) 0 0 .0. .. m Z 0 rq M Z� �n Cu z 0 ,� - - 4� on z C co - Z` O= N V \ c 0• N m m -- z \ V A S O I O o0 1. a \ 4 1\ N i m 71 r i \ z \ v \ c \ mzv \\ 6 v /pZ A X M M z 0 M z A 0 A r M 0 I A0, A �. �. � A �. • ,00.08 3 .,00,00.06 S D 0Ila I wo*oq-4 40 Z'p -rt 0io\4 mom oD tvi Zl , D O aOrC00 z- ;, O C .. 0=10 "'4z mm -V CD voomZm '`��` cm 0 f ,q ( 0 ;0 m2 OC 0tN J� 0 '�% -0;0�r •W % m gzN /�+� ' OL'4x ;Vzi 0 ra 2 2 X ® - - 0 0 O m -_Co zv v mm M n o _ v _ -v 0 0 I A0, A �. �. � A �. • ,00.08 3 .,00,00.06 S D 0Ila I wo*oq-4 40 Z'p -rt 0io\4 mom oD tvi Zl , D O aOrC00 z- ;, O C .. 0=10 "'4z mm -V CD voomZm '`��` cm 0 f ,q ( 0 ;0 m2 OC 0tN J� 0 '�% -0;0�r •W % m gzN /�+� ' OL'4x ;Vzi 0 ra 2 2 X ® • O 0 O m r, 0 v M n o ;um v 0 c m F ro ^CD M m C c-) 0 .0. .. m Z 0 rq THETA Drawn by: Environmental & Engineering LOT 5, BLOCK 15 SMG NORTHWOODS SUB NO.4 Checked by: cO""" REG FIGURE 1 Project No: Y 0zZ 0 r req Zom z;m0Fo r o zV) Nm X r,0, o. zo 0po-i'iz vo Z pZ0cop -m C0 0 o F) rn c OomZO 0 oz x v cmc ' v 0 m zNE^ =^n X00 v� Qo EEA C: —i> = o v v D� r D v 0j f Z _0C �zN 4 a r*i pOCr0 C: rn -c-I m N mCg 0mv+v r O� � �r 0;u VM �xO F m Ln ? 1 E: O N O DO _4 O o Z z A I mz (7 O = p O 1 M p w Z �n A A ��-1o m I C.) o o A Z 0 Z am A M 0 p O 1 -0 E7 Z m z =o A ��-1o m -, Opo * rn Z x r 0 Z am THETA Environmental & Engineering Contract No: r" � Qe ;W QOM C N G O 0 'O r p N 0 �vm z0r- <mz �� rn . I I rn T rn +F .O� z :'n� c ,: If -If -0 ZI h w _— �W O O L A O LOT 5, BLOCK 15 NORTHWOODS SUB NO.4 C] 61 I i O D 0 Q7 DOn CN ;z0 0 A 1.1 Drawn by: SMG Checked by: REG FIGURE 2 Project No: C i mo z 0 z 0 I I rn T rn +F .O� z :'n� c ,: If -If -0 ZI h w _— �W O O L A O LOT 5, BLOCK 15 NORTHWOODS SUB NO.4 C] 61 I i O D 0 Q7 DOn CN ;z0 0 A 1.1 Drawn by: SMG Checked by: REG FIGURE 2 Project No: C i mo z 0 z 0 ZI h w _— �W O O L A O LOT 5, BLOCK 15 NORTHWOODS SUB NO.4 C] 61 I i O D 0 Q7 DOn CN ;z0 0 A 1.1 Drawn by: SMG Checked by: REG FIGURE 2 Project No: C i mo z 0 z 0 LOT 5, BLOCK 15 NORTHWOODS SUB NO.4 C] 61 I i O D 0 Q7 DOn CN ;z0 0 A 1.1 Drawn by: SMG Checked by: REG FIGURE 2 Project No: C i mo z 0 z 0 ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN MUNICIPALITY OF ANCHORAGE AND William B. Beckstine THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this 19th Day of Sept. of 2008 , by and between William B. Beckstine herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Memorandum of Understanding agree as follows: I. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AW WTS), described as Advantex located at Northwoods # 4, Block 15, Lot 5 Anchorage, Alaska. 2. Definitions. A. 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. Prior to performing any alterations to an AW WTS the owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65. B. Certificate of on -Site Systems Approval. 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 AMC 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. C. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. D. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AW WTS that were included in the original design which would allow the AW WTS to continue to perform as designed. E. Permit (Construction) An On -Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. F. Permit (Operating) An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that allows the Owner to operate an AW WTS, upon meeting all the requirements of this agreement, the conditions of Operating Permit, the requirements of the On -Site Wastewater System Construction Permit and all relevant provisions of AMC 15.65 3. Fee. Owner shall pay to Municipality an annual fee of Zero ($ 00.00), payable on or before the issuance of the operating permit and annually thereafter. The annual fee is due on or before the anniversary date of the approval by the Municipality of installed system. 4. JLrM. The term of this Memorandum of Understanding shall be for the life of the A W WTS. The term begins on the date of approval by the Municipality of the installed system and shall continue while the AWWTS system is in use or operational or until the property is sold or title is transferred by owner and a new certificate of On -Site approval is issued to the new owner or transferee of the property. S. Alterations, Installation and Removal of Additional F.guinment. Owner agrees not to make any alterations, removal of parts or additions to the AW WTS without a Construction Permit from the Municipality. 6. Maintenance and Repairs. A. Throughout the term ofthis Memorandum of Understanding, the Owner shall maintain AW WTS in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the owner's sole expense, to pay for any and all: (I ) repair(s), (2) maintenance, (3) adjustmcnt(s), (4) replacement costs, and (5) inspection costs. Further, Owner agrees to comply will all applicable ordinance, laws, regulations, rules and orders for the A W WTS. B. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the Owner's AW WTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's AW WTS Operating Permit is: Biannual C. Owner acknowledges that the fine schedule for failing to maintain and repair an AW WTS are codified in AMC 14.60. D. Owner agrees that only maintenance, repair personnel certified by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. E. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. F. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. G. Owner agrees that the relevant provisions of the standard specification guidebook for AW WTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's AW WTS. 7. Nonwaiver. The failure of either party at any time to enforce a provision of this Memorandum of Understanding shall in no way constitute a waiver of the provisions, nor in any way effect the validity of the Memorandum of Understanding or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 8. Amendment. A. This Memorandum of Understanding shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality ofthis Memorandum of Understanding was executed and such writing shall be attached to this Memorandum of Understanding as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized representatives of the parties are: Owner: William B. Beckstine Anchorage: Purchasing Officer C. Any attempt to amend, modify, or change this contract by either an unaudroriied representative or unauthorized means shall be void. 9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of Understanding 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 govcm the rights and obligations of the parties under this Memorandum of Understanding. 10. Severability. Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum of Understanding. ONN ER - MUNICIPALITY: BY:7t !.:� QpPJ By: Date: P Title: Date: STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowled ed before me this 3day of5> Q. 20.Lk, by X l l i C' e �( "k "A'c�I ,e NOTARY PUBLIC FORA ILASK My Commission expires: -U13 (Hev. 9/91) MOA 25 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: c1,-34-rnznf�" PID Number: 04510�rr'� D� Name. II � Wastewater System: ew El Upgrade w �:/ ABSORPTION FIELD Phone No. of B rooms: ❑ Deep Trench ❑ Shallow Trench Xged ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: G' Total Depth from original grad GPD/S . Ft. Lot: Block: �/.- , II,�Su�bdiivvisicon: i� crs t WOGS(,7aj Depth to pipe bottom from original r de: e Ft. Gravel depth beneath pipe �e 6•S Ft. Township: Range: - Section: Fill added above original grade;., Gravel length: Ft. Ft. WELL: ❑ New ❑ Upgrade Gravel width: Ft. Numbe flines: Distant/gnbetWeenlines: W I Ft. Classification (Private,A,B,C): k Total Depth: Cased To: Total absorption area Pipe material: ��LU -?4w Ft. Ft. SQ. Ft. ;%O Driller: Date Drilled: Static Water Level: Installer: Date installed: Ft. (r "1 Yield: Pump Set at: Casing Height Above Ground: TAN K GPM Ft. Ft. SEPARATION DISTANCES eptichjE,� ❑ Holding ❑ S.T.E.P. To From Septic Tank Absorption Field Lift Station Holding Tank Public/Private Sewer Lines Manufacturer: �4 Capacity in gallons: 17.,!570 Well �%6A ,7 7byt (/'N .,..� �- n� I� /T✓ Mate ia� I: Grp Numbero ompartments: Surface Surface Water 160 (6D'-(- — LIFT STATION Liot l;�'( Ip t4 / r Size in gallons: Manufacturer: Foundation 12j ' / _4 ✓ ,-- "Pump on" level "Pump off" level at: High water alarm at: Curtain f �V (, Purr<5Fake & Model Electrical Inspections performed by: Drain Remarks: BENCH MARK L aryl Description:ctJ Assumed Elevation: p ENGjNg[P;,s,S,,9AL y� A 7i 4 k. S & S ENGINEERING nA Inspections performed b 7034 Eagle River Loop Road, No. Oates: 1st -1-1-7-- a ys� �cTu a 2nd Department of He `Ith Ind d Hu Services a r va w. 2 Reviewed and approved by: Date: 6 -U13 (Hev. 9/91) MOA 25 Permit No. SW430054 Page 2 of 2 Municipality of Anchorage 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 �Jy l VVJV111 UVI1. vii iv, owl u n i >, wi riv "u-001 Ob4 CO1 CO2 MT1 MT2 CO3 FINAL G] NEW 93.2' 1250 GAL 93.0' S.T. N.T.S. NEW 1250 GAL SEPTIC ♦ 86.2' NO WATER FOUND 4 BDRM HOUSE FOUNDATION TBM B A FCO A B 11.0 40.0 C01 14.7 43.5 CO2 20.7 48.5 CO 22.7 50.0 CO 24.0 51.0 CO3 16.4 63.8 C04 64.5 109.0 MT1 36.0 72.0 1" = 40' MT2 53.6 102.5 72-013 A (Rev. 9/91) MOA 25 BED 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 PERMIT NUMBER:SW930054 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:DOUBLE M CONSTRUCTION OWNER ADDRESS:P.O. BOX 670095 CHUGIAK, AK 99567 PARCEL ID:05106408 PAGE 1 OF 1 DATE ISSUED: 4/07/93 EXPIRATION DATE: 4/07/94 LEGAL DESCRIPTION: NORTH WOODS UNIT IV BLK 15 LT 5 LOT SIZE: 24790 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION 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 (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 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: RECEIVED BY: ISSUED BY: c DATE: DATE:4 7 l h. M ROBERT SHAFER, P E ROGER SHAFER, P E. f --Z-9793 CIVIL ENGINEERS (907)694-2979 FAX 694-1211 HEALTH AUTHORITY Municipality of Anchorage APPROVALS DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street Anchorage, AK 99519-6650 SEWER & WATER MAIN EXTENSIONS REFERENCE: North Woods Subdivision Addition #IV, Block 15, Lot 5 SEWER & WATER INSPECTION We request you issue a permit to install a septic system to serve the proposed 4 bedroom house on the referenced property. ENGINEERING STUDIES Two test holes were excavated and percolation tests performed AND REPORTS on the property. The approximate location of the test holes are located on the attached site plan. This property is served by a Community Water System. There WELL INSPECTION are no community well protective radii which encroach upon the &FLOW TEST property. As can be seen from the site plan this lot has enough area for another future septic upgrade. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. SITE PLANS If you have any questions, or require_ additional information for your review, please contact us. Sincerely, ROAD DESIGN ...... Roger J. Shaf r, P.E. SOIL TEST /RLS/LSU/lsu PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 i 40' S/TE PLAN O z A o E V� y O O O � � O O z A o 0 y E V� y O O Oyu O � � O O z A o °o �o y m 0 0 � b 1 0 a .,. y3 a a Oyu O � � O z A o °o �o y m 0 m = C- IZ • '79 i� `�9 ® m A s Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR:OVCSVE. (..--t7�s� DATE PERFORMED: 3 LEGAL DESCRIPTION.t:±T7 �VL- k45 {�p(?f{'�1ipp SI.� NTnShlp, Range, Section: COMMENTS SLOPE WAS GROUND WATER ENCOUNTERED? 0 � S IF YES, AT WHAT j^�'� A L DEPTH? P E Depth to Water Aft Monitoring?_ Dater ■■■■ENO .■■� MEMO►!,"! ■■■■■■o NNE 10111100 Reading Date Gross Time Net Time 2 �/ U 3 4 5 6 7 =a 8 D "� 9 10 12 13 14 Z:oo 15 S 16 17 18 19 20 COMMENTS SLOPE WAS GROUND WATER ENCOUNTERED? 0 � S IF YES, AT WHAT j^�'� A L DEPTH? P E Depth to Water Aft Monitoring?_ Dater ■■■■ENO .■■� MEMO►!,"! ■■■■■■o NNE 10111100 Reading Date Gross Time Net Time Depth to Water Net Drop 3 Z:oo 'Its S 3 PERCOLATION RATE +�y"., l (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN J FT AND --A— FT - S & S ER1taINEERING r_ _� PERFORMED BY: g� Qk� qq�r'' CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITFfAP[eSTA�"�E�`A*ftISIICTPAL GUIDELINES IN EFFECT ON T IS DATE. DATE: 72-008 (Rev. 4/85) on Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR:VaA) a6't.-(-- l tv+�NS`T`. Ci�"�j�' DATE LEGAL DESCRIPTION��"! Q71.IG-�6' t�-� oevc4� \ oo�ShIp Range, Section: COMMENTS SLOPE WAS GROUND WATER DEPTH 6 0 C>^� 1't£ -+C s 2 0 �O DEPTH? 3 E 4 / tt✓1 5 6- 5"5- 7 8-6 9- 10 10 - 11 it � 12 J {1 ` 1j01'l 13- 314151617 14- 15- 16- 17 18 19 20 COMMENTS SLOPE WAS GROUND WATER Net Time ENCOUNTERED? 0 C>^� 1't£ -+C s IF YES, AT WHAT A L AA- 0 DEPTH? P E t Depth to Water g-rq'\A Monitoring? _`y Date: �l SITE PLAN Reading Date Gross Time Net Time Depth to Water Net Drop C>^� 1't£ -+C t Zi/Js /'C'� i M 5"5- to PERCOLATION RATE 1" (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 72 FT AND A FT PERFORMED BY: Sr&5 ENGINEERING I � CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE W1470AII IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) Bogle River; Alaska 99577 • Municipality of Anchorage Ute On -Site Water and Wastewater Program (907) 343-7904 s A F E T Y CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-064-08 Expiration Date: 7 ao�a 1. GENERAL INFORMATION,+ Complete legal description NorthWoodsY#4 Block 15 Lot 5 Location (site address) 23233 Green Garden Cir. Chuiak, AK, 99567 Current Property owner(s) Mathew Budin Day phone Mailing address Real Estate Agent 23233 Green Garden Cir. Chuiak. AK. 99567 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑D.uplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System WaiverNariance request for: Received by: 4 Day phone TYPE OF WASTEWATER DISPOSAL: Individual Holding Tank ❑ Community ❑ Public Sewer ❑ COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ J 50 Date of Payment Receipt Number C7 COSA# 06C;)_ a Date: Waiver Fee $ Date of Payment Receipt Number Waiver # Distance: 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING, INC. Phone 696-6111 Address 20441 PTARMIGAN_ BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M._DUFFUS_ Date Engineer's Comments; This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future �a�\ occupants or can ArcTerra guarantee that no unseen OF .l Ilk encroachments, deficiencies or discrepancies exist. O �, ` �< 11 6. DSD SIGNATURE C__� System #1 Approved for '7 bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: 11kk (((((((((( - - .`y\`, -4 OF A&;( �, ``-c `� pN-s► ( C V �--WASE--R-AND eco WAST4-V`,fATER �FN_T_'_SERv�� ))))111 Original Certificate Date: -- The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist _ X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory _ Other COSA blue sheet -10-10-12 doc Legal Description: COSA Checklist Northwoods #4 Block 15 lot 5 If more than 1 septic system on lot: COSA Checklist # ELL DATA ❑ Well to d with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Comments B. TANK DATA Age of tank(s) 12 years Tank type/material Step/Steel Measured operating fluid level in septic tank LN.. Standpipes/foundation cleanout per record drawing Date of pumping *Advantex D. ABSORPTION FIELD DATA Which system tested (date installed) ■❑ ALL standpipes present per record drawing Total measured depth from grade 3.5 ft (max) Measured depth to pipe invert from grade 3 ft (min) ❑ N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective 0 Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 051-064-08 of Structure served by this system Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ Nc ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Ar ug/L ❑ Arsenic less than MRL (ND) Collected by-'%!!% Date of Sample C. LIFT STATION Required maintenance completed Age of lift station 12 years Lift station material Steel Comments Adequacy test date 4/22/21 Results ❑✓ Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 600 gal New depth 5 in Elapsed time 10 min Final fluid depth 0 in Absorption rate 600+ gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES rivate Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift n Lot > 100' if No Community Sewer Manhole/Cleanout > 100' Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' ❑ Yes i ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No ft Tank > 100' ❑ Yes if No ft Neighboring Absorption Fields > 100' if No Animal Contain 0' ❑ Yes if No ft ❑ Yes if No ft Water Main > 10' ® Yes if No Manure/Animal Excreta Storage Community Sewer Main > 75' ❑ Yes if No ft ❑ Yes i ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: ® Yes Absorption Field > 5' ® Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' ® Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' 0 Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet 09/17/2020 04:56 8686770 APLUS 364 935 ■■1■ ■ ■■mg ■■■■ no ■ ■ ■ ■■ rl 1■ ■ an ■o■ ■ ■ ■ Room ■ 1■g ■ ■on■ ■gn■ on ■ R ■o■ !► van77ea ® Field Maintenance Report Annual Insm ction PAGE 01 gnome 8 ■ ■ l� q AnchorageTank 907-272-3543 Propmty OwnerlReckin9 x, - Current 6, ... Splice Box ........ ...... OpurMar Float Cords ....... ......... Matt & Elise Budin Floats ............ .......... Previous Larry Betts Previous saemdmn Biotube Pump Vault .......... COMM ft.. 23233 Green Gard n Circle, Chugiak AK 99567 (907) 688-8688 "ska to x County Ip x POC x aTv MNL x Dula at LSM ln,p Ian AX -121159 SW080207 407446 RT11115769 04/28/2019 Retrieve O&M Into Darty now Recirc ntio_ Timer Settings: Call ahead - lock A gate Perform Field Samp Ing/Observatlons MU(15 =NTU s) [ i(g'g) D0(2'6) Odor of Sampl Typical Mug e ❑ Earthy Moldy Non -typical Suit le ❑ Cabba ge ❑ Decay oily Rim In U ] Yes Foam In tank ] Yes o Check Control Pam R6circ Amps Discharge Amps Audible and visual al me OK Dial tone (telemetry ( tM Yes ❑ No Inspect/Clean Pum System Inspect Risar/Lid ......... .......... Current 6, ... Splice Box ........ ...... �/I Float Cords ....... ......... . Floats ............ .......... Previous Pump ............ ... ....... Previous aiotubex Filter ..... ........... Biotube Pump Vault .......... - Roeirculating Spline Valve... - ... Comments Signature .. 6371M Measure Sludge/Scum RlvdaP Scum tat Compartment Current 6, Previous �/I Previous 2nd Compartment Current Previous ECu�jnt Previous Inspect/Clean AdvanTex Filter Odor:kNono/Minor ortnal ❑ PungentI Biomet:rr aa! ❑Excessive Bridging/Ponding: ❑ Excessive Inspect/Clean Dlacharge Pump System Inspect Rlsedud Splice Box Float Cords Inspect/Servlce Other System Components Ins��p---epppct Clean aI� �/I Podd Bottom 1//LIQ Bottom P /',7(A� Intake Vont —1 Inspect Clean Floats �/I Pump YJ /',7(A� Inspect Clean Inspect Clean Disinfection Equipment Dispersal Laterala/Orifices Observations I f - Additional Services Rendered ❑ Cleaned textile sheets? ❑ Replaced W Items? ❑ ReplacodAhed other items? Parts Used: W s Warranty, B = Billable (✓ appropriate selection) W B Item Number Deserlpticn Fln ! afety Inspection RSV reinstalled Manifold reconnected; gush valvae closed Summary/ReCotmmendatione Q System performing; no further action needed ❑ Cell for service Data '^ Fax completed form to 1-866-384-7404 I!( CoBolton on Dnotrol parol reactivated ❑ Tank needs pumping ❑ other? 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 �;/ 1—kDayof � l G- of 20 �( by and between // lr�Cc�CG�e%'�¢v��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 2 3 2 3 3 located at (legal description) 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. c- , Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. 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: (signature) By: `�v "�`�� nature) (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) Date: S_A_1 012/ The foregoing instrument was acknowledged before me this �,- day of atj,, 20 0by Nta4ine- Anne(or_ NOTARY PUBLIC FOR ALASK ?' z • NOTARY ; m •. My Commission expires: 4 � , MUNICIPALITY• /1 n signature kJi C C ,r.CArr,90 (print name) (rev. 05/18/2018) Title: Page 3 of 3 GARDEN CIRCLE r --15' T&E EASEMENT i I Lot 8 Lot 6 Lot 7 U« MORTGAGE SURVEY X SCALE 1" = 30' GRID SW 1233 Project No. 20–XXX/61 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, 1 n C . (907) 522-6476 Phone �4Q�oop (907) 522-4625 Fax ¢4 C QQ Professional Land Surveyors kenOlongsurvey.com O A L �p Jonathan *Ion gsu rvey.com I hereby certify that I have surveyed the following described property: LOT 5, BLOCK 15, NORTH WOODS SUBDIVISION UNIT IV (Plat No. 83-333) Anchorage Recording District, Alaska, and that this Mortgage Location Survey is a representation of the conditions that were found on the date the survey was performed. This survey does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained hereon shall not be used to establish any fence, structure, or other Improvements. Dated this the v0i'\ Day of — , 'i 2' -I , 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. �* 49THW -7*� 'A KENNETH G. o Nva 40��SSl0NAL �a AECC963 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 i Parcell.D.# HAA# R 1. GENERAL INFORMATION Complete legal description Lot 5; BtOA 15; Norah wood6 #4 Location (site address or directions) Property owner Doub.E?e "M" Con3tnucti-on Day phone 688-3113 Mailing address P.O. Box 670095 Chugiak, AK 99567 Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well Community well XXX Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Autnonty 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 ordertosatisfy 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 #21 S & S ENGIN Phone Name of Firm 17034 Ea iv* 0oP goad No. 2oA Address Ea Date 2 3 Engineer's signature A f 1 4 Vin m ` S t hr.0 � a xs as +ea �1, •y0awpn •• .sen.. na'y.t. 1457•% (Y a ��'ll"'w441=pw,R v 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Autnonty 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 ordertosatisfy 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 #21 Municipality of Anchorage .. Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: I� �o �` �r'arcel I.D. cv5 10 6��a� A. Well Data Well type c � rl 013, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed Total depth Sanitary seal (Y/N) Cased to Wires 7_10n Casing height d (Y/N) WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Collected by: Other bacteria Date installed /'lTank sizeclean( /IZ��O ��L-Compartments Z Cleanout (Y N) -Foundation clea/N) Depression (Y High water alarm (Y) V Alarm tested (Y/N)- Date of pumping j�j �1A �I" +l-) V__ Pumper O 1 4 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: t � Well(s) on lot _ NIS On adjacent lots Foundation 1 2 To property line 10 -1- Absorption field Surface water/drainage 1 CO I'k- 1� Water main/service line _1b 72-026 (3/93)' Front CONTINUED ON BACK PAGE FROM WELL LOG AT INSPECTION �z 0 Date of test z O G z� Static water level y Well flow ZZ g•p•m• g.p.m. m -P. A 44,i5 -00 N Pump levell r11 -0 o 0 SEPARATION DISTANCES OM WELL TO: o m Septic/holding tank on lot %e a— ; On adjacent lots Absorption field on lot On adjacent lots ' Public sewer main Public sewer manhole/cleanout Sewer service line r r Petroleum tank t_J 0 C_ WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Collected by: Other bacteria Date installed /'lTank sizeclean( /IZ��O ��L-Compartments Z Cleanout (Y N) -Foundation clea/N) Depression (Y High water alarm (Y) V Alarm tested (Y/N)- Date of pumping j�j �1A �I" +l-) V__ Pumper O 1 4 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: t � Well(s) on lot _ NIS On adjacent lots Foundation 1 2 To property line 10 -1- Absorption field Surface water/drainage 1 CO I'k- 1� Water main/service line _1b 72-026 (3/93)' Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE Well on lot D. ABSORPTION FIELD DATA FT STATION TO: On adjacent lots Manufacturer (Y/N) "Pump off" Level at Cycles tested Surface water Date installed Soil rating (GPD/Ft2) & System type P-261-2 Length Sy Width -7,6 Gravel thickness 6.15 Total depth Total absorption area I Cleanout present&l) Depression over field (Y�I 1t:j— Results ass/fail �� for Bedrooms Date of adequacy test �.d (P ) Water level in absorption field before test After test Peroxide treatment (past 12 months) /) If yes, give date• SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 10 On adjacent lots 7iOd -4� Property line To building foundation 11D!1--1 To existing or abandoned system on lot �-) On adjacent lots :&y �'h Cutbank 0 0T1 J�' Water main/service line Surface water OD 1 4-- Driveway, parking/vehicle storage area 50 Curtain drain t30" E. ENGINEER'S CERTIFICATION I certify that 1 have checked, verified, or conformed to all MOA and NAA guidelines in effect on the date of this inspection. �x r Signature Engineer's IN VEERING 1703 agle River Loop Road No. Date E le HAA Fee $ � OD c ( Date of Payment f— — g3 Receipt Number ;Z60-7 Z p7T % 72.026 (3/93)` Back Waiver Fee $ Date of Payment Receipt Number