HomeMy WebLinkAboutKASILOF HILLS BLK 4 LT 12Kosilof Hill
lock 4
Lot 12
015-131
-2O
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program, 4700 EImore Road
P.O. Box 196650 Anchorage, AK 99507 Page ( of ~_~
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: ~ PO ~'~ o~r-[ PIDNumber:
U~: ~- ~ [ ~ ~ ~0 ~ q~ Wastewater System: ~ New U Upgrade
Phone: Number ~ ~rooms: ~ Deep Trench D Shallow Tren~ ~ B~ ~ Mound ~ther:
LEGAL DESCRIPTION so, Rating: ~ 0 GPD/Ft2''~ Ft.
Block: Lot: Subdivision: Depth to pipe bottom ~om original grade: Gravel depth beneath pipe:
Township: Range: Sedion: Fill added a~ve original gra~ -- ~ f Gravel Length:
Ft. ~ Ft.
Well: ~ New ~ Upgrade G,~ width: ~-~ ~ Ft. Number~of lines: ~ Distance~.be~een lines:Ft.
Class~tion (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Mateffak
Driller3 IV1"~ Date~ril.ed:/~/~tf StaticWater Love,:~ Ft. Installer:~/~,X-- J ~''O~ Date Instal
GPM '
Pump Set at: Casing Height Above Ground:
SEPARATION
DISTANCES
D Septic D Holding D S.T.E.P. ~~ Other:
T~To Septic Absorption Lift Holding }ublidPrivate Uanufa~urer: ~ Capacity:
From~
Tank Field Station Tank Sewer Line~ Gal.
Well /~ ~ /OJ~ ~. *0~ ': Number of Compa.ments:
Lot Line 2~ ~ ~ Size: Man~a~urer
"Pump on" level a~: ~ "Pump ~ level at: ~¢ High water ala~ at:
Cu,ain Drain ~ '/~, .~, Pump Make & Model Electri., I,~ections pe,o.ed by:
Lo~tion and Description:
~ Assumed Elevation:
Engineer's Stamp
Inspections performed by: {~ N D ~m ~ Dates: 1~t q~ - ~
Development Se~ices Depa~ment Approval
Fermit No. SW970581
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: 545-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: LOT 12, BLK 4 KASILOF HILLS S/D PID No.: 015-151-20
i~ ..... GRND. PiPE / ~' .. / ¢ ¢ LU I 1 Z \
FCO 10 65 99.6 9,3.6 // --
C02 63 80 98 92.4 /
TC01 64 81 98 /~T ~ /
~H 75 90 97.6 ~v' % /
305 99 52 103.4 BLK b / /
C04 100 52 105.4 /
C05 100 33 105.5 /
C06 101 95 1~ ~9.6~ / T~
C07 75 .~-'102.6 9~6~ ~E¢STING WELL RADIUS
~ 1~¢~se lOO.e ~/ ~ /
~ / '~ /
/ ~ /
SING
1,500 GALLON ~
N .T.S.
Oct 11 10 03:24p Michael Anderson
5625485 Pru d entia I Jack Whit eNi
907-345-1391 p.1
02:37:53 p.m. 10-08-2010 1 il
tN.~.PECTION REPORT
MUNICIPALITY OP ANCHOi~A(tE, E~IJILDIHG ~APETY r',,,~/.m<~:.:
3500 EAST TUDOR ROAD
OBSERVED ,
FAX NO.
:90? 345 0202
Sep. 20 2010 10:56AM
DEP.'.AR,T. MEN~ OF, NATURAL
Dr;v, ISION OF MINtNG,&"~
Pi
'. !?"~;,z'..-':-'; .:.;~,. -~...i
.'.~ :%> .~ ? .; ?
Rick Mystrom.
Mayor
Mmdcip T of Anchorage
Department of Health and Human Services
825 "k" Street
P.O. Box 196650 Anchorage. Alaska 99519-6650
http: wwv., cLanchorage.ak.us
343-4744
October 22, i998
F Atlee & Isabella M Dodge
PO Box 190409
Anchorage, Alaska 99519 0409
Subject: Lot 12 Block 4 Kasilof Hills Subdivision
Permit #SW970381, PID #015-131-20
The subject permit, issued October 22, 1997 bv this office for a
single family well and/or on-site wastewater system, has
expired as of October 22, 1998.
A new permit must be obtained from this office for a well
and/or on-site wastewater system NOT installed by the
expiration date.
If you have drilled the well, a well log must be sent to
this office for documentation of the installation and to
close the permit.
If a licensed Professional Engineer has inspected the
installation of the on-site wastewater system, the original
as-built inspection report must be sent to this office for
review, approval and documentation. All inspection reports
must be submitted within 30 days of construction completion.
When applying for a new permit, the fees are: $320.00 for an
on-site wastewater permit; $120.00 for a well permit and
$440.00 for a combined on-site wastewater and well permit.
If you?have any questions, please call this office at 343-4744.
S nc?ely, /
J~'m. es Cross, P.E.
P~ogram Hanager
0n-sS~e ServSces
enc: Copy of Permit
cc: KND Engineering
PAGE 1 OF 2
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL /%/qD WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW970381
DESIGN ENGINEER:KND ENGINEERING
OWNER N/MME:DODGE F ATLEE & ISABELLA M
OWNER ADDRESS:P.O. BOX 190409
ANCHORAGE, ALASKA 99519
DATE ISSUED:10/22/97
EXPIRATION DATE:10/22/98
PARCEL ID:01513120
LEGAL DESCRIPTION:
KASILOF HILLS BLK
4 LT 12
LOT SIZE: 48994 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PEP, HIT: 4
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
4.
THE ATTACHED APPROVED DESIGN.
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) .
THE ENGINEER MUST NOTIFY DNHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744~ ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT)
FROM OCTOBER ].5 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
THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
THIS PERMIT IS ISSUED FOR THE CONSTRUCTION OF AN INNOVATIVE
RECIRCULATING UPFLOW FILTER SYSTEM. AS A CONDITION OF TNIS
PERMIT~ THE OWNER SHALL ~LAKE ARRANGEMENTS FOR THE SYSTEM TO
BE SftMPLED ONCE A MONTH FOR A MAXIMUM OF 12 CONSECUTIVE
MONTHS AFTER BEING PUT IN USE. THE ATTACHED PROPERTY OWNER
AGREEMENTS BECOME~ A/PART OF THIS PE RMIT PACKAGE.
ISSUED BY:~'''~/ /' 7~
~.ND ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907)696-6111/FAX (907)696-8111
September 9, 1997
Municipality of Anchorage
Dept. of Health & Human Services
On-Site Services Section
P. O. Box 196650
Anchorage, Alaska 99519-6650
Subject: Kasilof Hills S/D Lot 12, Block 4 - Permit for Innovative On-Site System & Well
On August 8, 1997, five testholes were excavated on the above lot. The results are attached.
After careful consideration of the development of this lot we are proposing to install a re-
circulating trickling filter septic tank in conjunction with an upfiow filter. We feel that this is
necessitated due to the shallow bedrock in the area as well as the potential for contamination
within the bedrock layers at lower elevations. In conjunction with this system we are also
installing a field in excess of estimated capacity for the discharge field. The reserve field area is
also illustrated on the site plan. We have designed these fields as single shallow trenches to
serve the proposed 4 bedroom dwelling.
This lot is served by individual well. There are no sewer systems that will encroach into the
proposed well site and there are no public or private wells within 200' of the proposed septic
site except as noted. There are also no known curtain drains within 50' or any surface water
within 100'. The installation will have no adverse effect on neighboring lots. The lot has slopes
in excess of 25% in the southeast corner with the remainder of the slopes being less than 25%.
There are several flatter areas which are being proposed for use of the installation of the septic
system. There is no standing water or drainage problems in the area.
We have designed the system utilizing the top soils strata. Computations for soil absorption
was based on the rate of 20 minutes an inch. Based on the above we are requesting that a
permit be issued for the sewer system and well.
If you have any questions about this application, please contaRvw, e.at.fi96-6111/FAX 696-8111.
'~'~*~r~tH y OF ANCHO~A~i~
Respectfully submitted,
KND Engineering 8~P 0~ ]~?
Kenneth M. Duff~s, P.E.
attachments: On-Site Well and Sewer Application
Wastewater Absorption System Details/Site Plan w/attachments
Soils Logs (2)
I IJl
VAC&N I
%Y%ILH IOlZTAII %/%]1t
HILl X %78 IBT 1P, 1~1 iICI<
LIII lA
WELL
I[11
~ I lZl I /3
o. o
V ~[-Y~N I
IL1F L;
SFP I lC
I)ESIGN gElATI S
4 BIJI~H X 150 (;PI) 600 (;PLO
600 GPD/4,0 OPE PLI~ %0. I l, 150 %(~ I 1
~50/%' · 0.0 BF) (0.5' G~AVITI ) : 300 I I. I RENCH
USL SH5LLUW rRENCII 5' WI]}F X 4/' JL1NG X~ UIEEP
IoEet depih oF sysEc, m i5 ],O' f'r'om nr-igineL gr-o~
IoEet der)Lb of' 9r'avet b(Xc}w dlsLr'ibuL;or~ pipe
NIII
INSUI &FE ALi I INI g, XYSII H CF]NI)EINI Nfg, II(ENO1 AN1) 16NE
W1 IH R' ~1~ BURiAl I~JAH.
CIINTRACI[JR WIN LNSU[~E N~XIHUH ;~Z g UPi tNIII SEP]]C I~NI(.
~I)I}IFIBN~I i ILL WII [ BI Al)liED IlVl Iq ~YXIEH Ill 6CII11 V~
M]N, 3' UBVFN 11 REDUII~[
INS]ALL SPRAY UNF]IINAE lIN UPFI []W I II II N BHX AND UIJV[
MIN, IHICKNESS Ht ~" ALIING Ali E1UIS~DE PHI~TH]NS F]F IlIL NIX,
I)l~l PAR[ 8
All EF I}OOGE
I}IIOGI F /'dill AJRCIqAI T SI:RVICES
I)11, I?[JX 100409
I<NI} IiNGINEEelN6
;~(]44I I~ rARMi(~AN I?LV])
FA(,I I I~JVEl~, ~1<, 99577
(901)GgG GIN/lax (9[]7)GUG 811]
WASTEWATER SYSTE' ]3E-TA LS?SI-I-E PLAN
I<ASILBF HILLS S?D LBT 12, BL[3CI< 4
[_BT lA
LB]' 2A
LBT 9
LOT 5
LBT 6
LBT 5
LBT 7
/
I
/
/
LBT 13
LBT 11
,~ CBN-I'I3URS
PREPARE]} FEIR:
ATLEE DBDGE
I1E]DGE F ATLEE AIRCRAFT SERVICES
Is. EL 8BX 190409
ANCIIBRAGE, ALASKA 99516
KN1) ENGINEERING
20441 PTARHIGAN BLV]J
EAGLE RIVER, AI<~ 99577
(907)6S6 6111/Fo, x (907)696
DATE: 8/30/97 DR~WlNG fl
SCAI_E~ t' - 100' 97077-S~
PERFORMED FOR:
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
(FEET)
1
3
4
5
7
8
10
12
13
14
17
18
2O
w', .o ~.;~.:,%. ..... ~. · ·
DATE PERFORMED:
Township, Range, Section:
SLOPE
WAS GROUND WATER .,/
ENCOUNTERED?
S
IF YES, AT WHAT /~//~ L
DEPTH? r,,, pO
E
SITE PLAN
Deplh to Water Alter
Monitoring',)
Gross Net Depth to Net
ReadingDate Time Time Water Drop
/ ¢-5.?? /0 ¢ z.I ~ i_., ,,
~/, ~" I0 'S~ ~ ~ "
~ /~; ~ ~ /~ ...W ~" ~"
PERCOLATION RATE _
TEST RUN BETWEEN _
~ ~ tm]nutes/mch) PERC HOLE DIAMETER
~' FTANO 7 FT
ACCORDANCE WITH ALL STA~E AND MUN~PAL GUIDELINES IN EFFECT ON~ //THIS DATE. DATE: ~2,/~ h?
72-008 (Rev, 4/85)
Municipality o! Anchorage
DFPARTMENT OF FIEALTFt & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
6
7
8
9
10
'11
12
13
14
15
16
17
19-
20-
SLOPE
WAS GROUND WATER
ENCOUNTERED?
IF YES, ATWHAT /~/~ ~
DEPTH? pO
E
Depth to Waler Alter
h~onitoring? 0 Dale:
SITE PLAN
J I
Gross Net Depth to Net
Reading Date Time Time Water Drop
---. (mmuleszmch) PERC HOLE DIAMETER __
PERCOLATION RATE
COMMENTS
TEST RUN BETWEEN FT AND
, / [
F1
ACCORDANCE WITH ALL STATE AND MUNICIPAL
Municipality of Anchorage
Department of He~2a~!,Lh,, satnr~tHuman Services
RickMystrom, P.O. Box 196650 Anchorage, Alaska 99519-6650
Mayor hltp:h'www.ci.anchorage.ak.us
Dear Homeowner/Prospective Buyer:
The on-site wastewater disposal system you arc purchasing/installing is an "alternative" wastewater
disposal system. This system, known as a "Recirculating/Upfiow Filter Septic System", is undergoh~g
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 die ownership of one of these
systems:
7tm technology used in this system has been shown to be effective in other areas. The system is
currently undergoing a two year testing period in 3mchorage under the guidance of the Department
of Health and Human Services (DHHS) and the State of Alaska Department of Environmental
Conservation (ADEC) to detennh~e its effectiveness in a snbarctic environment.
The system for this property may have received vertical separation distance waivers from both
State of Alaska and Anchorage Mmficipal Codes to both ground water and bedrock. These
waivers were granted due to the system's expected performance within the site conditions on this
property. Ifthetest results do not support these waivers, modification or replacement ofthis
system may be required.
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 Mmficipality of Anchorage requirements.
The cost of any conversions ~equired 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 mn (are) aware of the risks outlined. I (we)
also certify, that I (we) am (are) in the process of purchasing (property legal description):
(Purchaser 'Name)
(Purchaser Signature)
(Purchaser Name)
(Purchaser Signature)
PROPERTY OWNER AGREEMENT
FOR THE MAINTENANCE OF AN
ON-SITE WASTEWATER DISPOSAL
SYSTEM
This agreement, dated tS~P~ff/- 1997--, is made between the Municipality of
Anchorage Department of Health and Human Services (DHHS and the property
owner(s) of:
This agreement is made for the purpose of maintaining an on-s~te 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 that any deficiencies have been repaffed and that the
system is functioning as designed.
(Signature)
(Signature)
(Printed Name)
(Printed Name)
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www. muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015-131-20
1. GENE~L INFoRMATIoN
Complete legal description
Expiration Date: [- / / - j//
KASILOF HILLS BLOCK 4f LOT 12
Location (site address) 10400 KASILOF BLVD. ANCHORAGE, AK 99507
Current Property owner(s) ATLEE & ISABELLA DODGE
Day phone
Mailing address
PO BOX 111355, ANCHORAGE, AK 99511
Lending~ency
Dayphone
Mailing address
Real Estate Agent Day phone
Mailing Address 6643 BRAYTON DRWE, ANCHORAGE,. AK 99507
Unless otherwise requested, COSA will be held by DSM for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class __
Public Water System
Well
TYPE OF WASTEWATER DISPOSAL:
[] Individual On-site []
[] Individual Holding Tank []
[] Community On-site []
[] Public Sewer []
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSM also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. 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 inspect~, ~the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Munid~)~.~. State codes,
ordinahces, and regulations in effect at the time of installation. " ..~' [~. ,~
~;,.~ of Firm ARCTERRA CONSULTING, INC. Phone 868-3792
Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date 10/08/2010
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 dudng 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,
AmTerra can not give any estimate of how long a
system will function satisfactory for current or future
occupants or can ArcTerra guarantee that no unseen
encroachments, deficiencies or discrepancies exist.
5. DSD SIGNATURE
~,, JApproved for L../..
Disapproved.
bedrooms.
Conditional approval for
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory ~
Nitrate Advisory
bedrooms, with the following stipulations:
,:5 :!'f
0N-SITE
: WASTEWATER
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date:
A=
M cipaHty of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www. muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Well' LOg(Y/N):X
Parcel ID: 01~-131-20
Legal Description: KASILOF HILLS BLOCK 4, LOT 12
WELL DATA
Well,type ~.TE 'E A, B;?or C pr~i~e, PWSID #
Date Completed 4-22-1998
Total depth 305 ft.
Wires properly protected (Y/N) Y
Casing height (above ground) 24 in.
Sanitary seal (Y/N) Y
Cased' to 22 ff.
AT INSPECTION
22
FROM WELL LOG
Date of test 4-22-1998
Static water level 6 ft.
Well production 4 g.p.m.
0.94
Collected by:. ArcTerra
WATER SAMPLE RESULTS:
Coliform NEG colonies/100mLNitrate 0.15 mg/L
Arsenic: ND mg/I Date of sample: 08/30/2010
B. SEPTIC/HOLDING TANK DATA
' Tank Type/Material'STi[P/Steel
Date installed 09/1_998 Tank size 1500 gal.
g.p.m.
Number of Compartments _2 Cleanouts (Y/N) Y'Foundation cleanout (Y/N) y Depression over tank (Y/N) __N
High water alarm (Y/N) ¥ Date of pumping O8/28/2010 Pumper Azotmd The Clock Pumping;
C. ABSORPTION FIELD DATA
Date installed 9/'1_998 Soil rating (glp.d./ft2 or ft2/bdrm) 4.0 System type Upflow Filter - Shallow Treach
Length 40 ff. Width --5 ft. Gravel below pipe 0.5 ft. Total depth 3.93 ft. (measured 8/30/10)
Eft.. absorption area 200 ~ Monitoring tube Y
Date of adequacy test 08/30/2010
Fluid depth in absorption.field before test 0__ in.
Depression over field __N
Results (Pass/Fail) PASS For ~ bedrooms
Water added 600 gal. New depth 0 in.
Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N___lf yes, giVe date --
D. LIFT STATION
Date installed 9~_998 Size in gallons 1500 Manhole/Access (Y/N)~
"Pump on" level at 30 in. "Pump off' level at 20 in. High water alarm level at 36 in.
Datum Bottom of Tank Cycles tested 2 Meets alarm & circuit requirements? _Y.
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+
Absorption field on lot ~:00'+
PUblic sewer main 75'+
Sewer/septic service iine 25'+
Animal containment areas 50'+
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout 100'+
Holding tank 100+
Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+
Water main 10'+ Water service line 10'+
Wells on adjacent lots 100'+
Property line 10'+ Building foundation 10'+
Water Service line 10'+ Surface water 100'+
Curtain drain 50'+ {None ~owa)
F. COMMENTS
Absorption field 5'+
Surface water 100'+
10'+
Vacant absorption systea~ surcharged with 1500+ ~allons prior to per~ormln~ adecl~ev test.
C .T CAT O.
I certify that I have determined through field inspections and ~~~'
review of Municipal reCOrds that the above systems are in ~~ ~
COSA Fee $490.00 + $294 Rush Fee
Date of Payment 10/08/2010
Receipt Number
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Water main 10'+
Driveway, parking/vehicle storage
Wells on adjacent lots 100'+
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www. ci. anchorage, ak. us
(907) 343-7904
Water Well Advisory
Certificate of On-Site Systems Approval (COSA) # 101242
During a recent COSA on-site inspection and test of the potable water
supply well on Block 4, Lot 12 of Kasilof Hills subdivision, the well's
productivity was determined to be 0.94 gallons per minute. The minimum
well~productiv~t-y-requircd_bythis Department (AMC15.~5) for a 4-bedroom
residence is 0.41 gallons per minute. Although the subject well currently
exceeds this minimum requirement, all parties concerned are advised that the
production capacity of the well may fluctuate. Restriction of non-critical
water uses such as washing cars and watering lawns and gardens may be
required.
This advisory must be attached to all copies of the subject Certificate of On-
Site Systems Approval.
1104,501001
ArcTen'a Elagineering mid Surveying
Kasilof Hills L 12,B4
Ka'silof'Flills L 12,B4
Drhlldna Water
Printed Date/Time
Collected Date/Time
Received Date/Thne
Tech nic :il Director
09/03/2010 16:34
08/30/2010 11:4,5
08/30/2010 14:09
Stephen C. Ede
;ample Remarks:
Allowable Pr~p Atmlysi$
bOQ
Llni'[s
Me~hod
Co~tt~',ner ID LitIaits Date Datv lni'[
~tal~ by Ic~/~lS
Ars¢nie
ND
5.00
ug/L
EP200.8
C (<10)
08/31/10 09/01/10 'NI~
Total N'itrate/Nitrit¢2N
0,150
0.100
mg/L
SM20 4500NO34F B
(<10)
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ANCHORAGE RECORDING DISTRICT
UTILITY
ESMT
WELL®
ASBUILT OF:
KASILOF HILLS SUBDIVISION
LOT 12 BLK 4 PLAT 66-96 SHT 2 OF 2
SURVEY CERTIFICATION: I, John L. Schuller, have conducted a
physical survey of this property as shown on this drawing and that the
improvements situated thereon are within the property lines and no
enehroachments exist other that noted.
EXCLUSION NOTES: It is the owners responsibility to determine the
existence of any easements, covenants, or restrictions which do not
appear on the recorded subdivision plat. Under no circumstance should
any information on this drawing be used for construction of fences,
structures, improvements, or for establishing boundary lines.
WORK ORDER NUMBER: IDA'rE: ISOALE: IE-~4AIL:
IAU¢ 11, 2010 I 1"=40'
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· JOHN' L. SCHULLER.-' .-N ~
". LS-10408 ..'
,~ '.. . ." ~,>q ~/
1881 Talkeetna Street
Anchorage, Alaska 99508
(907) ~7-1455 office
(907) 274-499g fax
ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND
REPAIR AGREEMENT
MEMORANDUM OF UNDERSTANDING
BETWEEN MUNICIPALITY OF ANCHORAGE
AND
THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this
/ / Day of (~ ~ "]t:O J~ (//of 20 / Q 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 Memorandum of Understanding 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 ~/o -F/ot.~ r't' /-/-'e//'located
2. Definitions.
Anchorage, Alaska.
A. Alteration. Any change to the design or function of an AWWTS 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 AWWTS 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 AWWTS that were included in
the original design which would allow the AWWTS 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 AWWTS, 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 ~ ~---' Y ~
($ Q) .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. Term. The term of this Memorandum of Understanding shall be for the life of the
AWWTS.
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.
5. Alterations~ Installation and Removal of Additional Equipment. Owner agrees
not to make any alterations, removal of parts or additions to the AWWTS without a
Construction Permit from the Municipality.
6. Maintenance and Repairs.
A. Throughout the term of this Memorandum of Understanding, the Owner shall
maintain AWWTS 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: (1) repair(s), (2)
maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs.
Further, Owner agrees to comply will all applicable ordinance, laws, regulations,
rules and orders for the AWWTS.
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 AWWTS 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 AWWTS
Operating Permit is:
C. Owner acknowledges that the fine schedule for failing to maintain and repair an
AWWTS 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 AWWTS is the governing professional guidelines for the construction,
maintenance and repair of the Owner's AWWTS.
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 of this 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:
Anchorage: Purchasing Officer
C. Any attempt to amend, modify, or change this contract by either an
unauthorized 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 govern the rights and
obligations of the parties under this Memorandum of Understanding.
10. Severabilit~. 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.
Date:
MUNICIPALITY:
By:
Title:
Date:
STATE OF ALASKA )
) SS.
THIRD JUDICIAL DISTRICT ) ~.~
The foregoing instrument was acknowledged before me this ~ day of
20 Iii,by C~'lFt '~{'E~h6¢
N0~ARY PUBLIC YOR AL~ eve':.
M, ~ommission expires: ~ ~ ·