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HomeMy WebLinkAboutRIVER VIEW ESTATES BLK 5 LT 10Phone: Municipality of Anchorage '-'---(.~ page 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: ~__.~L~-/~~0 ~' PlDNumber: OejO'- No. of B~ooms: LEGAL DESCRIPTION Township Range Sechon: WELL: ~ New ~ Upgrade Classification (Private, A,B,C): Total Deplh Cased To: Driller: Date Drill .d: Static Waler Level: SEPARATION DISTANCES From Well Surface Water Lot Line Curtain Drain Remarks: of _~ Wastewater System: ~'New CJ Upgrade ABSORPTION FIELD [Z] Deep Trench ~ShallowTrench [] Bed [] Mound []Other Soil Rating: ~, ¢ GPD/Sq. Ft. 0epth to pipe bott~,m from obginal grade: Fill added above original grade: ,~2 '~'¢ Ft. Gravel width: ;~)~ Ft. Tofal Depth from original grade: Gravel depth beneath pipe O. Gravel length: Number of lines: Distance between hnes Pipe material: Total absorption area: ~v//.~. ~-~k~eb~[¢_ z¢D r~.,~:~) SO. FL Date installed: ~/ ~ / ] TANK [] Septic [] Holding [] S.T.E.P. Ldt I Holding IPublic/Priv&le Manufacturer: [ Capacity in gallons: [ I i Ma e iai: I Number of Compa/tmenls:  '~ ' LIFT STATION / S zen gallons: Manu/acture~:_ , Pump Make & Model Electrical Inspections performed by: BENCH MARK Inspections performed by ~ -¢:;' - ENGINEER'S SEAL Department of Health and Human Services approval P, eviewed and approved ",' "~' ~ ~_~/~'-~.--~ Date: 10/?/~,2 25 ~5 ?OTAL DEP / CF~iERL LEN~ CTIVE N f50 75 S ALE: l" 50 FT. I I 7t 2 £r rTH 50.0 ?OCKDEPTH ~5 \ £T 1£5 TOBBEN SPURKLAND P.E. 205 W 15TH. AVENUE ANCH. AK, 99501 (907) 279-$916 LO]' lO BLOCK 5 RIVERVIE~f £STATES MICNELSOHN AND DAUGNfE£ SEPtiC SYSTEM AS BUILT DATE: SEPT. 15, 1997 SHEET,' 2/5 ORID: SW55: ti SW970252 PI]) tt 050-792-25 £V£O51O£,Pk/6 AlP, LINES BIOCYCLE 6000 4-INCH INSULATION I-I/4 PVC WITH i/8" HOLES AT JO' ~ 0 5 X 50.0 DRAINFIELD 2 FT TOTAL DEPTH ,5 FT EFFECTIVE ROCK ~ 3 FT COVER 97.5 i**~'"~'"~'"~'"~'"~'"~'"~""~lll ,,,--, -* ~ ~ ~ ~ ~ -' -- - JI ~LI I--~11 I--~11 I-~11 I~IZL--~LLI-~JJ- L~I~I_~LI Izl I I'--' '11 I--I I I~1,, 0 0 0 O 0~0 ~ oCoOoOoOoGoOoGo O000~UOwO~o L£CEND; 1, PR/MARY TREATMENT, SEPTIC TAN/( 2. AERATION TANK 5. CLARIFICATION TANK 4. DISCHARGE TANK 5. SOIL ABSORPTION REVISED AUS, £0~ 1997 70BBEN SPURKLAND P.E. 203 W15fh Ave Anchoroqe Ak 99501 279-.39 ¥6 R[YERVIE}~~ ESTAT£, BL067( 5, LOT 10 BIOCYCLE WASTE WATER SYSTE~I MICHELSOHN AND DAUGHTER II WASTE .rE SYSTEMSCHEWAflC I I DATE: SEPT. iS, i997 I PE?¢M/? II SW970252 PIP # 050-792-25 M,,W DRILLING, Inc, P.O. 8ox 11¢)378 · 10330 Old Sowa~ J ¼ighway (907) 349-8535 ANCHORAGE, ALASKA 99511 F',. E1 1 DRILLING LOG LoeatioA (address oL 'rownshig, Range, Section, if known; or distance main to,ct__.. ,. f,©q'~] N ~ SLze of casings_5" .._Depth of Hole_lB3 Static water lew~.30 Screen ( ); Perforat~ ( D~cribe screen or perforation Well pumping test at 5 ~ga~oni pet of drawdown from static level, Date of completion feet Cased to. 33~ 8 ___feet ibelaw) land surface. Finish o~ well (check One) ). open end ( X,' ); ~'~) (minute) for 1 hours witl~ 1 00% + ~t. AS BUILT NOTES: WELL DRY GROUTED WITH 1 SACK BENTONITE GRiANULES Depth in feet from WELL LOG grou.nd surface 0 TO 2 Give d.0.t~,.ils et formations penetrated, size of material, color and hardness CA~ING STZCK UP 2 TO__3() 3O .TO~__tl2 __17.2. TO 176 176 TO_..A8 BOULDER G~VEL: GREY BROWN..~. COBBLEY~_ SIL_TY_~f_~A[qDY~ ......... ~ RRD~: GREY BT,ACK ,qTr,~mQN~TF,~_CiOMMON ~AQ~URIN~ WITH WHITE LENSES: 3 GPH _~BOVE: VE, Iq3_t~ACT. URED; --~ 9~X.B.ELVIz LH~FJLA Df 140' WATER .... TO_ TO _TO .TO - TO TO TO · R.E { E-!.V ED .......... .................................. 4~,4u n ic; pa I ity. ef-A~cn o}:aga__i_ ._ Dept. Health &Hurnan Services -' ~ct 'O:'~- certh~-' .. ~ 9'~o ...... r 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN RECEIVED MUnicipality of Anchor De~t. Health & Hurn~,, o-~g.O RIVERVIEW ESTATE, BLOCK 5, LOT 10 Municipality of Anchorage Department of Health and Social Services 820 1 Street Anchorage, Alaska 99501 August20,1997 We are submitting a revised application for the installation of a well and septic system for this lot. The original submittal used the soil below 4 feet as the accepting soil. This revised submittal will utilize the gravelly sand between .5 and 4 feet as the receiving soils. This material was perc'd at a rate of less than 1 rain per inch, but the material at 5 feet will satisfy the requirement for filtering. The submittal consists oftln'ee (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the well and septic system are subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable testholes are also enclosed. The septic system design is based on the following: Ground Water ~ 7 ft during breakup Use 5-Wide Trench with .5 feet of rock Use BioCycle Treatment Plant Soil Rating. <1 rain/in 2.4 gal per sq.ft/day No. of Bedrooms 4 Required Area per Bedroom: 150/2.4 = 62.5 sq.ft.. Length of 5-wide trench per bedroom: 62.5/5 = 12.5 Total Length of Trench: 12.5 x 4 = 50 ft SYSTEM CONFIGURATION 5-WIDE STANDARD TRENCH TOTAL LENGTH 50 FT TOTAL WIDTH 5 FT TOTAL DEPTH 2 FT ROCK DEPTH 0.5 FT COVER 3 FT BIOCYCLE The installation of this septic system will not prevent wells from being installed on the adjaceut lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. £$AL£' I" I?0 FL Lot 1: Lot ? 300- Lot 9 ( LOT 10 BLOCK 5 RIVERVIEI~ Eb'TAT2,'S MI£H£I$OHN ~ OAUGHT£R TOBBEN SPURKLAND P.E. 05 W 15TH, AVENUE ,ICH. AK. 99501 Z) 279-5916 Lo~' / f~ev,'sed; Aug, LO~, I997 SEPTIC SYSTEM DESIGN DATE: JULY 16, 1997 SHEET: 1/3 GRID: '[? Ii PiP 11 £VEOSiO/,DWG ~BBEN SPU£1(LAND P.E. W ISTH. AVENUE AK. 99501 279-5916 II 125  REVISED AUG. 20, 1~99Z~ WELL LOCATION SIZE OF D.F. LOT 10 ~£OO]( 5 £JV£RVJEt~ ~TAT£S [[ SEPTICDATE.. JuLySYSTEM16, DES/ON1997 kflCHELSOHN AND DAUOHTE£ SHEET; 2/5 GRID: SW551 T # PIP # £VEOSiO2, DF/5 4-INCH INSUIA TION i A IRCO~iP£ESSO£ 8" ~IN SAND BACKFILL 5'-2" MIN 6'-0" ~AX ~ BIOCYCLE 6000 1-1/4 PVO ~f/ITH I/8" HOLES AT 5 X 50.0 DRAINFIELD 2 FT TOTAL DEPTH .5 FT EFFECTIVE ROCK 5 FT COVER ~ SILT EARRIER ND £CALE LEGEND; 1, PR/NARY TREATtdENT, SEPtiC TANK 2. AERATION TANK 5, CLARIFICA TlOfl TANK 4, DISCHARGE TANK 5, SOIL ABSORPtiON £EV[SED AUd, £$~ ]997 'gBBEN SPURKLAND P.E. ~3 WlSth Ave · horacle Ak 99501 -59¥6_. RIVERVIEfl~ ESTAT£, BLOCK 5, LOT 10 BIOCYCLE WASTE WATER SYSTE~ kilDHELSOHN AND DAUGHTER WASTEWATER SYSTEkf SCHEMATIC DATE: JULY 16, 1997 SHEET: 5/5 GRID: SW552 PERFORMED FOR: LEGAL DESCRIPTION: 2 3 4 7 8 ~3 14 15 20 Munlcipallty ol Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L_" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST (ENGINEER'S S~AL) DATE PERFORMED: DISCLA[FLFR: fi~JJ~J~ater Past and Future presence from these obs~r~y~tlons. PERFORMED BY: _ _ Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT 0 DEPTH? p E 8eplh Io Water Alter t~0nil0ring? D3le; SITE PLAN Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE 1EST RUN BETWEEN ... c~ondZJ,~ons in~Li_cated are for theJate5 shown on.]},. and/o~ depth of 9roundwater can not be predicted ~¢-- ~'~ CERTIFY THA'r THIS TEST WAS PERFORMED IN PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 1966S0, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW970232 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:JENT JOHN N & OWNER ADDRESS:NHN RIVER PARK DRIVE CHUGIAK, ALASKA 99567 DATE ISSUED: 7/31/97 EXPIRATION DATE: 7/31/98 PARCEL ID:05079225 LEGAL DESCRIPTION: RIVER VIEW ESTATES BLK 5 LT 10 LOT SIZE: 40323 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL 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 343-4744 ( 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~ RECEIVED BY.~ ISSUED BY: 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-39t6 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN RIVERVIEW ESTATE, BLOCK 5, LOT 10 Municipality of Anchorage Department of Health and Social Services 820 1 Street Anchorage, Alaska 99501 July 16, 1997 We are submitting an application for the installation of a well and septic system for this lot. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the well and septic system are subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable testholes are also enclosed. The septic system design is based on the following: Ground Water ~ 7 ft during breakup Use 5-Wide Trench with 2 feet of rock Use BioCycle Treatment Plant Soil Rating. 20 min/in: 1.2 gal per sq.fl/day No. of Bedrooms 3 Required Area per Bedroom: 150/I.2 - 125 sq.ft.. Reduction Factor for 2 feet of Rock: 0.7 Length of 5-wide trench per bedroom: 125 x .7/5 = 17.5 fl Total Lengtb of Trench: 17.5 x 3 = 52.5 ft SYSTEM CONFIGURATION 5-WIDE STANDARD TRENCH TOTAL LENGTH 52.5 FT TOTAL WIDTH 5 FT TOTAL DEPTH 3 FT ROCK DEPTH 2 FT COVER 3 FT B1OCYCLE Tbe installation of this septic system will not prevent wells fi'om being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. MUNICt?ALITY OE ANCHORAG[: EHVIRONMENIAL SERVICES DIVISION JUL 1 6 1997 RECEIVED Municipality of Anchorage DEPARTMENT OF !qEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG --. PERCOLATION TEST PERFORMED FOR: LEGAL O E SC R i p T, O N: ~,~ t ~/~ ~'~_.',~ (ENGINEER'S SEAL) ~-, ¢"~"~ / 'Township, Range, Section: 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O LoT' SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? 08fib Io Waler Reading Time Time PERCOLATION RATE ~-,:~ (m,nules/mch) PERC HOLE OlAMETER ~L~ II TES] RUN BETWEEN ~ ~ FTAND- ~ ~-FT Net Drop -] DISCkAIt'UTJZ~__Grnu]zd~]zLte~r~iorks irLcLt~ate_d am~e for~he_~$hown o~Lly. Past and future presence and/or depth of groundwater can not be predicted ~~ ,. -~ CERTIFY TMA[ THIS TEST WAS PERFORMED iN 72-008 (Rev. 4/85) N 150 TOBBEfl SPURI(LAflD P.E, 205 14/ ISTH. AVENUE ANCH. AK. 99501 (907) 279-3916 J J LOT 10 BLOCK 5 RIVERVIE~f ES2'4TES' MICHELSOHN AND DAUGHTER SEPTIC SYSTEkt DESIGN DATE: JULY 16, 1997 SHEET; 2/5 OR/D: S~55 ?E£HIT if P/I) ii £VEOSIOZDI,/E V4O/ttV f Lot 9 S£4LE; !' lOO FL i I ® 1 LI~? /2 Lot 1.3 Loi' 11 VACANT % ~ '~ ' VACANT M~ _ ' ~ Lot ,-,~,..... ,~...:>... ,,:: ~, ........ .~ ......... .~.,.....~ 203 W 18TH. ~VE~UE :'~ZO I]£OCE 5 £IVE£VIEfl' Eb']'zl]~5~ ~YSTEM DESIGN YlCHELSOHN ~ DAUGHTEP ~ SHEET: 1/3 GRID: SY10352 P£,P>'IIT tl PIG ti __ ~ __~ AI£COk(PRESSOR 5'-2" MIN ~ £10CYCLE 6000 4-INCH INSULATION UTO I-1/4 PYC V/ITH 1/8" HOLES .AT 50" 5 X 52,5 DRAIN?IELD 5 FT TOTAL DEPTH 2 FT EFFECTIVE ROCK 3 FT COVER 0 0 0 ~ ~ © 0 0 0 O O ~ ~ cOoO00 0 O O 0 0 ~_~ ~ 0 O 0O 0 0 O O O (2 ,~ _ .... 0~0 O~O~O~O~C}~, LEGEND; 1. PRltdARY TREATtdENT, SEPTIC TANK 2. AERATION TANK $. CLARIF/CA TlON TANK 4. DISCHARGE TANK 5. SOIL ABSORPTION ?OBBEN SPURKLAND P.E. RIVERVIEfl: ES~ ' vz I~ 'ATE, BLOCK 5, LOT 10 ~ SYSTEM SCHEMATIC J A~c~ho~Ele~ Ak 99501 II BIOCyC~E WASTE WATER SYSTE~ Il DATE: JULY 16, 1997 I~ ./CH. SOHNANDDAUGHTER ~GR/D,. MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 050-792-25 Certificate of On -Site Systems Approval Expiration Date: October 29, 2022 Legal description RIVER VIEW ESTATES BLK 5 LT 10 Site address 21200 RIVER PARK DRIVE, EAGLE RIVER, AK 99577 Current property owner(s) DAVID & KONI THIEDE X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: By: CL K-1:1�& Original Certificate Date: ,July 29, 2022 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA ApprovaUune 2022 MUHUFAUTY OF AHCHO RAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. #050-792-25 Complete legal description Lot 10, Bk 5, Riverview Estates Location (site address) 21200 River Park Drive, eagie River, AK 99577 Current property owner(s) David Thiede Day phone (907) 306-5302 2. ON-SITE SYSTEMS SIZED FOR.4 BEDROOMS 3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ® Fiberglass Age 2 5 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ® Wide Trench ❑ Seepage Pit Waiver request for: Distance: Expedited review requested: 0 By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 55-1) Gk 0�3 Date of Payment i I2Lfla I XM3��I Waiver Fee $ Date of Payment COSA # Qs C Z%_ 13 S 2 Waiver # a7i3-7 5 COSA Applica6on_June 2022 COSA Checklist Legal Description: Lot 10, Bk 5, Riverview Estates Parcel ID: #050-792-25 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 812 7btal depth 1 83 ft Cased to� 7 _ R ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA _7119122 Static water level at beginning of test 5 5 _ Lft. Comments B. TANK DATA Measured operating fluid level in septic tank Date of pumping ® Required maintenance completed, if AWWTS Comments: 1600 Galion Biocvcle Tarik D. ABSORPTION FIELD DATA Which system tested (date installed) 8/2697 ® ALL standpipes present per record drawing Total measured depth from grade �ft (max) - V -4"Q Measured depth to pipe invert from grade ft (min) ® N/A — pressurized field. ❑ Per record drawings, field is insulated. ® Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) None Known If yes, enter date Comments/Deficiencies: COSA Checklist June 2022 Well production at time of test 4 _0 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes [INc ® Coliform bacteria is Negative Nitrate mg/L ® Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by Pinard Eagirieerirng Date 6/29/22 C. LIFT STATION ® Required maintenance completed Age of lift station 2 5 years Lift station material Fi berg ('a_ss Comments: Adequacy test date 7/19/22 Results ® Pass Fluid depth prior to test 0 in Water added 6QD__ gal New fluid depth 2 in Elapsed time J_51L min Final fluid depth 0 in Absorption rate600+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 6 in Effective depth used 2 in Effective depth remaining 4 in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' ®Yes if No ft ®Yes if No ft Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No ft Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' K]Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' K] Yes if No ft ®Nes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ®Yes if No ft ®Yes if No ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No Tank to Property Line > 5' ® Yes Field to Property Line > 10' ® Yes Water Main > 10' ® Yes Water Service Line > 10' ® Yes F. ENGINEER'S COMMENTS if No ft Wells on Adjacent Lots: if No ft Private Wells > 100' if No ft if No ft Community Wells > 200' ® Yes if No ® Yes if No If tank or field is under driveway comment below ft ft ft ft G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. NameofFirm Pinard Engineering Phone (907) 232-1347 Engineer's Printed Name Paul E Pinard Date 7/27/22 OF A � f�(�U @, tl ... G Paul E. Pir'aaa.rd CCl rI•� O _ _ g COSA Checklist June 2022 bd(oo E -Alaska '4dvancaa Wastnw Systa ms `"�^� 2nd Quarter Inspection Report 2022 Homeowner Info Customer Name: Dave and Koni Thiede Address: 21200 Riverpark Dr. Eagle River 3705 Arctic Blvd #313 Anchorage AK 99503 Email: crbioak@gmail.com (907) 274-0314 Tank#: 33 Install Date: Aug. 1997 Area Highland Initial Inspection: Alarms Tested: Air 0 High water 0 Battery Tested: Yes ❑ No ❑ N/A (Please make sure alarm is on "normal', not "mute") Does system have a septic tank ? No 0 Yes ❑ (Recommend pumping tank every 2 years) Is System Lid Locked? Lid hardware in working order? Is there any noticeable odor? Yes Repaired ❑ Yes [ Repaired ❑ Strong ❑ Mild ❑ None [� System Inspection Inlet plumbing in working order? Solids pillow normal? Yes 0 Replaced ❑ Yes A Requires Pumping ❑ Aeration Chamber �----------- - ------------- J— — Are all aerators functioning? Any buildup of solids? Yes [VI Replaced ❑ Yes ❑ No ❑ Clarification Chamber Clarification return system operating? Any buildup of solids? Yes 0 Adjusted ❑ Yes ❑ No r Effluent testing result pH Reading: Dissolved Oxygen PPM Turbidity of discharge (in FTU) (pH of 6-8 is ideal) (2-5 is ideal) (Under 35 FTU is considered compliant.) 7.0 3.5 7.22 Discharge Chamber Pump float operating? Alarm float functioning? Any buildup of solids? Yes 0 Replaced ❑ Yes A Replaced ❑ Yes ❑ No A Filter cleaned? Discharge line condition: Yes N/A ❑ Good —V1 Replaced ❑ Comments: Insected B Y : Chris p Date: 06/23/2022 Has emailing or mailing of form been requested? Yes (contact office to request...) No ❑ LOCATION: Lot 10, Bk 5, Riverview Estates DRILLER: M -W Drilling DATE WELL COMPLETED: 8/12/97 WELL DEPTH: 183' STATIC WATER LEVEL (top of casing): 55.6' PINARD ENGINEERING P.O. Box 871347 Wasilla, AK 99687 (907) 357-ENGR (3647) WELL FLOW TEST JOB NUMBER: 22-143 DATE OF TEST: 7/19/22 FIELD STAFF: P.J. Pinard Time Elapsed Time Minutes Static Water Level Flow Rate m Cumulative Gallons Pumped Remarks 2:00 PM - 55.6' 4.0 - Start Test - Meter 79380 2:15 15 4.0 60 79440 2:30 30 67.0' 4.0 120 79500 2:45 45 4.0 180 79560 3:00 60 75.3' 4.0 240 79620 3:15 75 4.0 300 79680 3:30 90 79.0' 4.0 360 79740 3:45 105 4.0 420 79800 4:00 120 83.5' 4.0 480 79860 4:15 135 4.0 540 79920 4:30 150 88.4' 4.0 600 79980 4:45 165 4.0 660 80040 5:00 180 90.1' - 720 Stop Test - 80100 RECOVERY 1 5:25 PM 1 25 1 69.8' 1 All well protection features are satisfactory. Average Flow Rate: 4.0 gpm Comments: DURING THIS TEST, TIS WATER SUPPLY WELL WAS CAPABLE OF PRODUCING 4.0 GPM. THIS TEST DOES NOT CONSTITUTE A WARRANTY OR GUARANTEE THAT THE WATER SUPPLY SYSTEM WILL CONTINUE TO FUNCTION AND PRODUCE AT THIS RATE. Reviewed by: Paul Pinard rP Date: 7/23/22 P.O. Box 871347 Wasilla, AK 99687 (907) 357-ENGR (3647) ADEQUACY TEST LOCATION: Lot 10, Bk 5, Riverview Estates APPLICANT: David Thiede 2120 River Park Drive Eagle River, Alaska 99577 SEPTIC TANK TYPESIZE: Fiberglass/Biocycle Treatment Unit, per MOA Records ABSORPTION SYSTEM: 5 Wide Shallow Trench, per MOA Records DAILY FLOW: 4 BEDROOMS x 150 GAL/BR = 600 Gallons TEST DATA EN I JOB NUMBER: 22-143 DATE OF TEST: 7/19/22 FIELD STAFF: PJ Pinard NUMBER OF BEDROOMS: 4 SCUM: SLUDGE: NEEDS TO BE PUMPED: Yes No CURRENTLY IN USE: Yes XX No Time Flow Rate Volume Cumulative Volume Septic Tank Septic Tank Soil Absorption System Comments pM (GPM) (GALs) (GALs) Liquid Level A Level Monitor Tube 1* A SAS Level Monitor Tube 2* A SAS Level 2:00 4.0 - - 0.0' - Start Flow — Meter 79380 2:15 4.0 60 60 0.0' 0.0' 79440 2:30 4.0 60 120 0.1' 0.1' 79500 2:45 4.0 60 180 0.1' 0.0' 79560 3:00 4.0 60 240 0.2' 0.1' 79620 3:15 4.0 60 300 0.2' 0.0' 79680 3:30 4.0 60 360 0.2' 0.0' 79740 4:00 4.0 120 480 0.2' 0.0' 79860 4:30 - 120 600 0.2' 0.0' Stop Test - 79980 RECOVERY Date Time ST MT SAS MT 7/19 5:20 PM 0.07-0.2' *ALL MEASUREMENTS IN FT. TEST: PASSED XXX FAILED COMMENTS: System was found to be operating satisfactorily. There was no measurable liquid in the SAS MT prior to beginning the test. With the addition of 600 gallons (the design daily flow), the level rose to 0.21. A recovery measurement, taken 50 minutes after stopping the test flow, showed satisfactory absorption with a return to the starting level. Reviewed by: Paul Pinard I Date: 7/23/22 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 ZR Day of c����� of 20 ZZ, by and between L ,.herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as ('OrVC] located at (legal description) tyer View E5t"a+e-5 Q 5 L 10 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) Al 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. 09 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). LIAZ 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. AR Owner acknowledges that regular maintenance of an AWWTS reduces thepotential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 V6 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. AR Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Ae Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. U R Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. AP 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. JOS Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a_provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By (signature) Date: *6YA . (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) 29411122 The foregoing instrument was acknowledged before me this -,9 day of , 202, by X02 q&4,r; uLP 2 NO RY PU IC FOR ALASKA •ptARY•'•. as• e. r My Commission expires: %1a (ptV <� MUNICIPALITY: �.p By: /6 i� (signature) (print name) f'lJB •. �?F C* Date: Title: (rev. 05/18/2018) Page 3 of 3 Parcel I.D. # 1. MUNICIPALITY OF ANCHORAGE D[:PARTMEN'I- 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 "GENERAL INFORMATION Complete legal description Property owner Mailing address Lending agency Mailing address Agent Address H,'~., .~,~.~-~,,~1 8: pe.,.~),~,¢-' Day phone · Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well NOTE: Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer tf 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 STATEIVlENT 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. NameofFirm I,*)~-~-.~ ~q¢:? ~'J'~ Phone.. ¢~-7~-~//~ Address Engineer's signature DHHS SIGNATURE ~ ~' Approved for Disapproved. Conditional approval for . bedrooms. bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesyto purchasers of homes and their lending institutions in order to satisfy certain federal and state req uirements. 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 ' ~NMEN'I'AL StiRVICEs DIVIS;. ~unieipaHty o~ Anchorage DEPARTMENT OF HEALTH & HUMAN SERVI ~,~. C E I V J~ D Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist Legal Description: 'J~L,/~- ~'~J~,V(L/ 15E~,~,Tt",'TL~"7 Parcel I.D.: A. WELL DATA Well type Log present (Y/N) '~/ Total depth .] Sanitary seal (Y/N) Date of test Static water level Well production If A, S, or C, attach ADEC letter. ADEC water system number Date completed ~'~//fi/2~/¢ ~ Cased to '9 '~ f~'~ FROM WELL LOG g.p.m. Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION Y g.p.m. WATER SAMPLE RESULTS: Coliform Date of sample: B. Nitrate ~ ~,'~ Other bacteria Collected by: Date installed b 7 Tank size /~-¢¢~;' Number of Compartments Cleanouts (Y/N) . Foundation cleanout (Y/N) '~/ Depression (Y/N) H High water alarm (Y/N) Date of Pumping h~//~ Pumper C. ABSORPTION FIELD DATA Date installed ¢"/-4,/~ ? Soil rating (g.p.d./fF e~ Length .~. ¢..) r ¢. t Width ~ Gravel thickness below pipe Effective absorption area ,~ ,~'~) J~/ r... , Monitoring Tube present (Y/N) Date of adequacy test ~///~ Results (Pass/Fail) Fluid depth in absorption field before test (in.); J immediately after Fluid depth ~'~ (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) 2.- /"/ System type '~ -- O, ~ Total depth · Depression over field (Y/N) For ¢,¢¢ bedrooms ,~gal. water added (in.): Absorption rate : / g.p.d. If yes, give date 72-026 (Rev. 3/96)* D. t LIFT STATION Date installed ~//¢'/z.-/,¢~ 7 Manhole/Access (Y/N) / High water alarm level at* Size in gallons "Pump on" level at* r.~ d~ 'Datum '~,,~/~ ~ Cycles tested "Pump off" level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: 1 Septic/holding tank on lot Absorption field on tot Public sewer main Sewer/septic service line On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~ Property line /~ ~ Water main/service line .>~o'~ Surtace water/drainage ~/O SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line &CO ~ Surface water I~'l Curtain drain 1"41 Building foundation Absorption field Wells on adjacent lots F. ENGINEER'S CERTIFICATION Water main/service line Driveway, parking/vehicle storage area Wells on adjacent lots /~ ?~-'~-~ I certify that I have determined thru field inspections and review of Municipal records that the abOve systems are in conformance with MOA HAA guidelines in effect on this date. Signature Engineer's Name Date HAAFee $ '~ (~ ' ~ Date of Payment /~ 'z'~//~/'~7 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number