No preview available
HomeMy WebLinkAboutKENO HILLS BLK 1 LT 2Keno Hills Block 1 Lot 2 #020-171-09 _ Municipality of Anchorage H . Development Services Department . µ• Building Safety Division - On -Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page I of 3 www.cl.anchorage.ak.us (907) 343.7904 ON-SITEWASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTIONREPORT 15 W OOL PS 0;0-171 -tq Permit Number. PID Number: _ Nsnn' • / 1 ' T Wastewater System: M New ❑Upgrade F ABSORPTION FIELD Pro Nmf of asoo: q C3 DP Tcn p tlw TMth O Bso O MOM l0O- 1 LEGAL DESCRIPTION Sort Raong TONT Dspm grant: from Mq,kW �? • GPDrFIt FI. 1110* I La: ^ S."Vism: /�// ( �C D m N ppe W"M g" W: G,* N Mph berwathjlimps: + 4- vll Ili S Q6A�7C. •gyp FI. r7l .7 :/n 1Y/ Ft 7o ,Pkp: Range: sawon: FJ ossa Move omPmtl psM: /' { (�I • FL Grey L*Vh: O Ft. Well: New rade ❑ Upgrade GravN wM: p Inst. o sm ",~iims ( j FL •—( FL CNhGoon (PnM . &'C): TOM Dwm: 116 cacti N: +4 TOW sbworpaon we" Pres kA�/elMar: r Ft. 1 Ft. Dv(/l/ FT •/ Dnnsm . Dets DNNe SHOO War« L hsblNr 6); Dau hFWrM Fl / C(?I% / L/C I /O/7 T_t^lG V mala: P 5*1 al: ca.mg 1Nghl APC,.'G."wno: TAN K GPM FI. p( Ft. SEPARATION DISTANCES W Septic []Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Litt Holding lubliriPmate Me feme1f'r P • t O From Tank Field Station Tank Sewer Line (' / ✓ G j Gr. ww 1 a0' Cb' 1311 aft MalMal. H PF Hymppr or DaroarvmMl.. 14 e- STATION$YfNCIwaIM LoLira 121'. S6 f I �LIFT s NJV/ v,Q 5il C 5 Fawkaoon O L 7 L y6(1 �D ( 'Pump an Nvsl al (—// •Pump oK NvN al. 3 S Hrgn waist Parr (1/ 1:96 b. N in. CwNin Drain ^ �IIL' PPmW Makes MOMI V El mapKOMa pangrrNe Dy' l � r Uvircs G„f.r�G Rsma-F Fail- fittwor SET BENCH MARK 106 of mvE4e . Lou ana D•ompoan. , Of F '4 n,quown. IOD FL P. S ENGINEERING r Engineer's Stamp Inspections performed by: 7034 Eaale River Lear, Qa.A No. •':gle River, Alaska 99577 2na'a a4-06 Development Services Department Approval f % Conditional Approval Date: •� w- ••• n s A. Vmdw W 44W4 Reviewed and approved by: Date, — O" O (Rev sine) i �•A n J / r PERMIT NO. SW050425 PACE 2 OF 3 Municipalityof Anchorage DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Bax 196650 • Anchorage, Ataska 99519-6650 • Telephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 2, BLOCK 1, KENO HILLS S/D P.I.D. NO. 020-171-09 10' UTILITY EASEMENT 50' SECTION LINE EASEMENT ------------Ft=ppm------�-------------------------------- + �\ S .. MTsr i YTS \ f \ \ THN2 n 1 1 MTI1 MT3 I �\ VALVE \ NEW 5 0 CA NEW GALLON \ EAT ALBERT ALBERT S.T.E.P. TANK p MN TMT3 TB4 NEW 1300 GALLON Tx T1 HDPE SEPTIC TANK TMTI • 1 ECO COMPRESSORS AND CUAGES IN GARAGE Y hTY) 04 Cb �yy • - ..� SCALE: A � SO' *fi*. 100' WELL RADIUS "• A. Sahmilw - - - - - - - - - - UTI E 10 UTILITY EASEMENT ' PERMIT No. SWO50425 PAGE 3 OF 3 Municipalityof Anchora e DEPARTMENT OF HEATH 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 LEGAL LOT 2, BLOCK 1, KENO HILLS S/D P.I.D. No. 020-171-09 INSULATION 83.3' I NEW 1300 GAL. POLY. TANK DIST. LINE -82.7' GRADE 85.8' 83.0' 83.4' 83. 550 GALLON FAT ALBERT WITH PUMP ASSEMBLY GRADE „-, „_,_ urzx.0 .n,..l n'.muxt two A BOTTOM OF SAND=80.2' GROUNDWATER AT 78.2' H. T. S. 72.2' B.O.H. r.RAnrIncvTH C DISCHARGE PIPE ORIGINAL GRADE MTI85.9 82.5 MT2 86.0 82.0 MT3 1 86.1 82.2 MT4 1 84.8 1 82.2 MTS 1 84.6 82.1 A. If►ia I Y7J S& May 2, 2007 ROBERT C. COWAN . CIVIL ENGINEERING PH: 907.694-2979 FAX: 907.694.1211 IEATI/AIINppTY APPIIOWN3 MUNICIPALITY OF ANCHORAGE Development Services Department SEWEREWATER P.O. Box 196650 WNE)MM1ONS Anchorage, AK 99519 REFERENCE: Lot 2; Block 1; Keno Hills Subdivision INSPECIgNIER NHN Bluebell During the design orientation of the sand filter on this property alders, shrubbery, and dense vegetation caused us to misinterpret the slope of the ground, therefore at the ENaNEERP.asitms A401W"Ts time of construction, the sand filter was rotated to better fit with the established contours. WELLNSPECTION The large sand filter (three times the normal size) was determined to have a longer life EELOWTEST by dividing the filter into three separate distributing zones. Therefore an Orenco distributing valve was installed to feed a manifold with three separate zones, each zone being equivalent to a standard sand filter. This allowed the pump to be a WEPW6 standard size (approximately 30 gpm) with each zone being dosed through the distributing valve each time the pump comes on. „o„ODES„ In order to provide air to each of the three zones, three separate air lines and compressors were provided. Each zone has approx 150 feet of air line distribution within the sand filter. All zones receive continuous air supply through the compressors. Each compressor has its own gauge and can be monitored by the SOMESi homeowner. This design change was discussed with the permitting authority prior to construction PERI:«A TO" and verbally a roved. TEST Since y, STRuclwaa lAEawAca .aPECTIow .Shafer, P.E. RA Its ONSITE' WASTEWATER 06POSALSMIEM 0ES10N 15861 S. Birchwood Loop Road - Chuglak, Alaska 99567 FROM : Rpr 23 07 09:38& PHIM NO. : Apr. 22 2007 05:53AM P2 p.l Pump Installation LogR. u.1 �j KUM DATE: AMM GOODtAUC �s __ . L7 � 'r V � Pit1uM Mlaptor Masat&emnr•e Nene: (va w 1jC i � �^ � � i� *d"SA41*plsr'www1icr: )Dr;A5 51C-% i • �` �• • 5• b rP PLOP TYPE ;*s 00 for Mao> 11P6 TT.. • r�� nes✓' p �� Y rola' aah Y,r 1 anme'u: ,w. 240 w - 101 C. (r .�cOM usre a. � es Ts. , A CAM "wc, r r. C• `�`y .�, i wTdac CMAWAa Tr (:Dun lvl{ 1 T. - erd ure. F. `7 T. tub ` well was disinfected upon completion. method: calcium hypochlorite. FROM : PHONE NO. Mar 17 06 09:86a Hills I 1 WrrIJUn __� '�J`rhwhip _Rr 6V1(k!1<».e om',%(fnom top of casin Matcrial: T)w. ('O!4r h' wvN1K1d. 1ttn! stickup 0 drt & gravel clay & rock sand & gravel coarse gravel wARtle 1h20 silty day & rock silty fine gravel w/6ttle h20 bedrock Mar. 13 2007 09:27AM P3 P.1 Well Log n:aimya,anv { 1(nM ' Aulwvv0 •w. \.m A 4trn 216701 Ransom Ridge Anchorage. Ak. 99516 2 B 14 14. 3? 15 4006, 1'.nipMnv1.03 : 16 .:006 +� Bill Wilkinson $:COPn tH nr •• 'ri tJ '�. al �i w• Drill:n.- mctltod: IX l .4tr rtK:k.v. 1 I Cilhi: ttwl. Utlw•r ••►Yv�r�il/•'r� +u'riv. IX IIh.n+va tt;, Ixht l i 17vIKII ul hdr. `°kt� :1. ('ufh.l• xtKkup: 2•, • It <'.wu.kryl,c:5leel Il:wkrtr*a ;2510 Inclk• l'n:inp diantet.v• S. Inchcy Iu.u,Y depth: 54 , 1: furor l!qw:,,,,,- Iliuuiam r. - hwitt+t IkpciT _,n I Xuttk Mata (fraw wp of csdrq Y .34 it M)03..' 16.2W6 lruoq+ing level & y:u:J: feet alicr Nktr+m gp,t t Rvkoway nuc: -.._ 6 .1q.nt. Al�vhtwl ork'Yuny ,airlift A+clryn,w•nt ntrJud: iiU(,�'__ I.htrndm[,•L10(1[. 37 41 N'cl11ma1valknini gpc:1 l t1ptT wTJ.I X)Upcn hula Ud yr li. $nrrcJ - n 41 50 __� !'.+•Ibruad:luvr�.. ..... 1.CLyhwJ. -• n i 50 551 I say .._._.__...n.slnr� _._n N(Stw...., .......... i _...... 51 166 (ittwd Iv'M' bentonite Volunw_ lkpilq fmm g. ovr1,d vrf Oe . 111- 20 R 11inip Inr.Ikc tk7Th:._ .. , — li 1 Pump atn): fps Isuut<I ntanw:, � „I: nn"M� 7 - I ^ uj° rcl! J InInI Intl uiam cunipktiI; 1 X) t)rilt.r Cann,teas.• Jirelhinwrw................ ......... a.. ............................ . t 1+Y88e.40.be!I.tfiN.U?t3.at.deptlis.of_52:t.Z5.'. K�g_140' fora ictal of 6 9P.n):.. ........ .............. ..... .... .... %xvn driu%er lruutr, Johany,.Kay...... ............ ........................ .. Conpun>retnc:....!s�hY. llllrifj,.,lnC._..... . _.. ............................ M:ti:ini.acklnv:...3$40 Akula Dr. .._....................................... I I 1,IY. Anchorage Statc:.jh%ip 99516 i I I'rksac ntnuher: 1 , 907 /) 34345 . 0593 faX3454700 I U,il!aawteivaoc. // frl'-"1 Municipality of Anchorage Development Services Department Building Safety Division On-.4lte Wow and Waatowsur%6mkm 4700 Sotuh Hrayw St. P.O. Hoa 1%650 Andxm%.c. AK 99519.6650 W W WIn1m i.o(rjpnRiW IM 343-71*1 attention: PropeKy owner 3nall provide a well log to the )6D within 60 days of well completion. Perm!: cumber-SV1/050425 I :hucorl«t e: Nov 08 '2005.. ) PsrnellJcm41nionVmnhec�jQ_',_�j]„'. ... i b v M lot atvd aitm tt vcd Mriu l kwcmonY ( Y1 Yctc to 1 )Ko 04-19-2007 12:37 HUGHES ELECTRIC 907-376-6098 Hughes Electric 4701 E. Bogard Rd. Bay #2 Wasilla, AK. 99654 (907) 376-6097 (907) 376-6098 Fax Mailing Address 231 N. Anna St. Palmer, AK. 99645 To Whom it may concern, I Greg Hughes owner of Hughes Electric, Electrical Administrator # 1496, am writing to inform you that we wired a lift station at Lot 2 Block 1 Keno Hills. All work was done correctly to NEC. If you have any questions please don't hesitate to call. (907) 376-6097 Thank ) PAGES MUNICIPALITY OFANCHORAGE 3 _ e ` /� 0'0 Development Services Department On -Site Water 6 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Permit Number. SWO50425 Legal Description: KENO HILLS BLK 1 LT 2 Date Issued: Nov 08, 2005 Expiration Date: Nov 08, 2006 Parcel ID: 020-171-09 Design Engineer: 0003 S & S Engineering Site Address: 005941 BLUEBELL DR Owner Name: BILL WILKINSON Lot Size: 113256 SO. FT. Owner Address: 16701 RANSOM RIDGE Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE. AK 99516 - This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well p Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specked 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. THE UPPER SIX INCHES OF THE SYSTEM MUST CONSIST OF TOP SOIL AND THE MOUND MUST BE VEGETATED SUFFICIENTLY TO PREVENT EROSION. 8.L S -/"{, sa e,,( !tom wi // ' i/--* . 4-01'4t <ll 5 it r li t . Vr jd c- a- 7Z—'I'cr `+ v rnV- w; It 6•c. Lf0 ja 1, iia jet,( G"e3 0.2 Received By. Issued By. FAPLW�pp_��* Date: �/ o Mthilcipality otAnchorage • �- bevelopment Services Department •''• Building Safety Division •; On -Site Water and Wastewater Program ' 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. _ Con- 19.1- nq Permit Number SW Property owner(s)_ Q %1k W 1 t IOSCh 11 Day phone Z � ? - 5-�-'} 3 Mailing address ±- --01 {Z11NSG h\ i t nC (— l A Zip Code 51 Site address .__SQLiI (31u��4�1KpCode Legal description (Lot, Block & Sub'd.) l-6 Legal description (Section, Township & Range) Lot SizeI l�Jr Acres q.Ft. THIS APPLICATION IS FOR: Number of Bedrooms A Sewer Only ❑ Well Only ❑ Sewer and Well ,� Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimmirtg Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above Information Is correct. Single Family DweIIIna and s in accordance_ further certify that this application is being made for a h applicable Municipal Codes. (Signature of property owner or authorized agent) S i 3 DMN[[RING No. 201 Permit/Rush Fees: Date of Payment: oA Waiver Fees: Date of Payment: Receipt Number: 7439 (Rev. 09/04) � _ 2q 4L% Receipt Number: lsAth S& NEALTHARHGRRY APPROVALS SEWER a WATER 1ANNEXtENSIONS SEWER& WATER PNsmcnoN ENGINEETSNGSTUMES ANDREPORTS WELL INSPECTION & RAW TEST SITE PLANS 0 PERCOLATION TEST STRUCTU AL & MEOW4CAL INSPECTIONS ON WE WASTEWATER DISPOSALSYSTEM DESIGN ROBER7 C. COWAN, P.E. CML ENGINEERS (907) 694.2979 July 20, 2005 FAX(907)694-1211 MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 2, Block 1, Keno Hills S/D It is requested that you Issue a permit to Install a Well & septic system (Intermittent Dosing Sand Filter trench) to serve the proposed 4 bedroom house on the referenced property. A test hole was excavated and a percolation test was performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation on 7/03/75 water was not found. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. If you require Cowan, P.E. information, please contact us. 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER ALASKA 99577 ��. V ,��, • t �J iy�i�p •�, poi O .'., �Ci �be�QQP L3. i I m ' \ O �Wg I 4 SOW I I I rc_l` I I I 0m0a3 �l •\ r 1 v^l'\ =I � ♦� I v! 014 WI �I n WOOW V 11 oI O ; I w ol '0 1 I JI ,�/ •� j , n j/ w I W MI O I /- k -1 .-. I� I• I �DIf —� i ] _ Ja , I 1 I I 3oe 1 •--� Up W to ' J X11 1� ovi i- - c I IF, I �- C IsIm �= oNp' E--- CL V) .-r C7 p I CL 0 Op0 I I wi i r I F I I m I N ION^ I I I I I n L II I N I I I C/) u f.. I 1 I I I I W mJQ I n n 1 I I I CI (~ 1 I 1 La epwn« U I H 1 I ULj I'aG1 1 1 ��l t r �d�av � UJ Z W 3 0J loiyl ,mx_I lo�ol Q LO O N 0 �I IgFYI 'suoi ^Wa" ►.r 0 NONtO I jjCol I<�u1 NVId-3115 NOIS30 109 = 3emd | N>20-- 'S ""J" ' of .um I I� £� �i U / X. R Z� \�¥\[ \ �/ / ( | I, C,4 \ } )�� ) /M c ^ ul!° . ) \\ ; ��,U�§ Cl) - /22fI( m S 4 2 - E § �up , O y a ,� ® )| ■ �` � � |■ ! - eR G ■ E ® &` L \ E§/f al w � | / , | _ � )!/; � q � | < \ §|§} ! - 00 \ ( \ ` Z 3emd | N>20-- 'S ""J" Municipality of Anchorage Development Services Department Building Safety Division +.t On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Www clanchorage sk.us (907) 343.7904 Soils Log - Percolation Test Performed For: TALL 1 ueso/u .t /� Dale Perk Legal Description: Gd i 2,1 'i Lr— 1 4 v Mites t� ownship, Range, Section: Depth — C124 2- Date Gross Time 3- - Net Drop 4 N�,, 5 6- -7- e7 1: 0c)r#n 7- 8- 6 !°° rp�� ->'o $ tlg4 MIN 10- 10 :. c,d EI 11- 13- COMMENTS WAS GROUNDWATER ENCOUNTERED? �b S IF YES, AT WHAT DEPTH? L Depth to Water After D Monaoring?o, P E Date: b Z? O$ 0141. a'n EA�ar . 1 wt ao C; r ed: O $ Site Plan Reading Date Gross Time Net Time Depth to Water Net Drop 1: 0c)r#n !°° rp�� ->'o $ tlg4 MIN 5"01q fLl3/grr rr 6'-31 ( �� N/ !� 'r 60 TEST RUN BETWEEN_ FT AND, MULL UVIMETER (7 " PERFORMED BY: IL I C TIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL ST E AND MUNICIPAL I ELINES 1 ECT ON THIS DATE. DATE: 1 00/1 PJGi ROBERT C. COWAN, P.E. CML ENGINEERS (907)6942979 FAX(907)694-1211 INTERMITTANT DOSING SAND FILTER SPECIFICATIONS Lot 2, Block 1, Deno Hills Subdivision IEALTNAUf1gRITY Ao�wA1s July 20, 2005 GENERAL STATEMENT OF WORK VER uNEMMIONS The work and plans covered by these specifications consist of furnishing all labor, materials, tools, transportation, and equipment necessary to complete an Intermittent Dosing Sand Filter system as described herein and on the attached drawings. SEWE.C,,o "`WA,'r" All work under this project shall comply with current Municipality of Anchorage (MOA) Regulations. 4 Bedroom House 600 GPD woRESUNGSTU roRRTS OES Use 20' x 60' Bottomless Sand Filter and absorption area (1200 S.F. required) Sand filter to be constructed on accepting soil with all organics removed. (bottomless only.) i�TESTCTON SITE INVESTIGATION The Contractor must carefully examine the project documents, have full knowledge thereof, WE PLANS have investigated the site, and be satisfied with the conditions affecting the work. Conditions include, but are not limited to those bearing upon transportation, disposal, handling and storage of materials, availability of labor, water, electric power, roads, and uncertainties of weather, physical conditions at the site including all underground utilities, ROAOOESIGN the conformation and condition of the ground, the character of equipment and facilities needed preliminary to and during prosecution of the work. The Contractor must be satisfied with the character, quality and quantity of surface and subsurface materials or obstacles to SOILTEST be encountered. Any failure by the Contractor to become acquainted with the available information will not relieve him/her from responsibility of performing the work as stated in these specifications and drawings. PERCOLATION Location of utilities will be the contractor's responsibility. TEST STRUCTURAL& MECHANIC& 9APECTIOIS ONSITE WASTEWATER OISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RNER LOOP • SUITE 204 • EAGLE RIVER ALASKA 99577 Pape 2 Lot 2, Block 1, Keno Hills 5!D July 20, 2003 SEPTIC TANK / LIFT STATION / AIR COMPRESSOR A. General The work under this section consists of the performance of all operations pertaining to furnishing and installing the septic tank/lift station, air compressor and piping to the sand filter. B. Materials 1. Tank a. Septic tank shall be a two compartment tank of at least the minimum size indicated on the drawings and MOA approved. b. First compartment shall have a separate 4" pump -out riser. The second compartment shall have a separate 4" pump -out riser. 2. Manhole Riser or Lift Station Tank a. An additional second compartment manhole riser shall be capable of being equipped with the following: A junction (Nema 4x) box or equal, bonded or attached to the pump basin. 2. UL listed electrical cord grips, installed in the J -box. Qat b. An additional tank (M.O.A. approved) may be provided for the effluent pumping assembly and the items in (a.) above. 3. Effluent Pumping Assembly, Controls, Alarm & Piping a. Effluent pumping assembly shall be of approved materials, including the following: 1. A 110 volt or equal U.L. Listed effluent pump. 2. High-density PVC cylinder housing the pump, with level controls and screen, serving as a baffle to prevent the screen from clogging. Page a Lot 2, Block 1, Keno Hills SID July 20, 2003 3. All piping shall be PVC or other non -corroding material. b. Pump controls and alarm system shall be an approved system with the following options consisting of. 1. Event counter 2. Elapsed time meter 3. Program timer 4. 10 watt heater 5. Remote alarm panel option with a minimum of 80 DB sound pressure at 24", operating temperature 30AC to 65AC, continuous sound to be located in the home. 6. Oil -tight visual alarm with push -to -silence feature. Automatic audio -alarm reset. 7. 15 amp motor rated toggle switch, double pole, double throw with three positions; manual (man), automatic (auto) and center (off) (H.O.A.). 8. Nema 4x -rated, fiberglass, or equal, enclosure with hinged cover. 9. All controls to be installed as per manufacturer's recommendations. 10. Control panel to be installed on outside wall of home within sight of septic tank/lift station. c. Piping from the septic tank to the sand filter is to be 1 1/4" PVC schedule 40 solvent weld piping properly bedded as described in Materials Specifications and sloped to drain back to the lift station. Insulation board 2" thick and 2' wide centered over pipe is to be placed where soil cover is less than 4' depth over pipe. d. The airline from the house to the filter is to be HDPE arctic insulated pipe 3/4"-2" SDR - 11. The compressor will have a gauge (0-10 psi) and be extended into the living area or garage for easy monitoring by home occupants. 4. Air Compressor Pape,t Lot 2, Block 1, Keno Hills SID July 20, 2005 a. Air compressor shall be a Ttloms LINEAR SERIES model number 5060-A or 5070V -A or M.O.A. approved equal. CONSTRUCTION SEQUENCE In order to insure proper installation, the system is recommended to be installed in the following order: I. Sewer line from house to tank 11. Septic tank/lift station III. Sand filter W. Leachfield bed (if required) V. Final grading CONSTRUCTION 1. Construction Instruments Contractor shall provide instruments such as transits, or levels, for establishing proper elevations and levelness of pipe or materials. 2. Pipe Laying All pipe shall be laid with material free of large or sharp rocks and organic matter. Each section of pipe shall be handled carefully and placed accurately. The spigot end shall be fully inserted pointing in the direction of flow and glued in place to make a water tight seal. Each section of pipe shall be properly supported to insure true alignment and an invert which is smooth and free from roughness or irregularity. At all times, when work is not in progress, open ends of pipe and fittings shall be closed so that no undesirable substance will enter the end of the pipe or fittings. 3. Bedding of Pipe for Sewer Lines Page 5 Lot 2, Block 1, Keno Hills SID July 20, 2005 The pipe should be bedded with materials free of large or sharp rocks and organic matter, compacted. Native materials may be used as back fill material above the pipe, provided it is free of large rocks and organic matter. All lift stations shall be installed in accordance with the manufacturer's recommendations and standards. Electrical installation is to be in accordance with the National Electric Code (latest adopted edition) by a licensed electrical contractor, with M.O.A. inspection where required. If MOA inspection is not required, a licensed electrician is to provide a letter to the Engineer stating that the system meets or exceeds all applicable codes. 4. Excavation Excavate to proper depth to allow gravity flow, install tank level, tolerance 0.05 foot, on undisturbed or compacted classified sand fill material. Create a level sand surface over the tank and add 2" burial foam +35 PSI directly over tank. Mound unclassified soil over tank with a minimum of 2 feet of cover and anti -flotation weights that may be required in areas of shallow ground water. 5. Connections All connections to be as per MOA requirements, PVC 3034 piping with Caulder or equivalent couplings for inlet riser pipes. All tank connections are to be completely water tight. Page 6 Lot 2, Block 1, Keno Hills SID July 20, 2005 SAND FILTER The work under this section consists of the performance of all operations pertaining to furnishing and installing the sand filter. A. Materials 1. Sand Filter a. Liner (if required - not required for bottomless sand filter) - OSI Model LI or equivalent. 30 mil PVC cut and fabricated to provide water tight enclosure of filter sand volume. Seams to be permanent as per Manufacturer's recommendations. All connections, such as boot flanges, through sand filter to be permanently bonded to the liner. b. The Contractor shall provide a washed sand to meet ASTM C-33 Concrete Sand Specifications with the additional requirement that all but 1% of the materials passing the #100 sieve be removed. All sand shall be approved for use by the Municipality of Anchorage (M.O.A.). If the sample does not meet specifications, all sand will be removed and replaced. c. The Contractor shall be responsible for providing pea gravel that shall be a washed material containing no fines (0% passing the #100 sieve) and a maximum size of 1/4" diameter. d. The Contractor shall provide the manifold assembly. The manifold assembly shall be of approved materials with orifice shields and flushing assembly. All drilled holes to be cleaned of burrs and pipes flushed, prior to assembly. Flushing valve to include riser to finish grade. Lateral distribution piping is to be laid level (@ t 0.05'). e. Sidewalls and top of the filter box to be insulated with 2" direct burial polystyrene insulation. f. The Contractor shall be responsible for providing filter fabric. g. Air coil in sand filter to be geoflow WF164-24 150 LF placed 6" above bottom of sand. Page 7 Lot 2, Block 1, Keno Hills SID July 20, 2004 Construction of Sand Filter The sand filter construction is to follow procedures as outlined below, as applicable to this design. Pea gravel and filter sand are to be hand leveled to proper depth (tolerance within 0.05 feet) in filter, taking care not to allow mud or fine soil material into the filter or gravel layer. This would include any soil material picked up by excavation machinery buckets while loading specified material. The Contractor should estimate filter material volumes such that allowance is made for wastage of material in contact with the ground at site. The area over the sand filter to be finish graded with a minimum of 2 feet of cover and to prevent ponding of surface water runoff. Side slopes shall not exceed 3:1. The Engineer will reject any sand or pea gravel that does not meet specifications or is contaminated in transit or while handling. If such material is placed in the filter, all soil material maybe required to be removed and replaced with new material. CONTRACTOR/INSTALLER ,, ,, ,GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3330 •'C•' STREET ANCHORAGE, ALASKA 99503 tm)I)) TELEPHONE 274-4561 411 - APPLICATION AND PERMIT NAME OF APPLICANT IrA I )EfioWs MAILING ADDRESS �`5`� -57 /YGL. l . PHONE INSTALLATION LOCATION / %� / LEGAL DESCRIPTION /0 r•C Y/A/� � INSTALLATION OF: SEPTIC TANK �j / SEEPAGE PITS %� DRAIN FIELD OTHER , TYPE AND SIZE OF FACILITY TO BE SERVED {� IO�� �"` FINANCED THROUGH SOIL TEST RESULTS TO BE INSTALLED BY NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIR D. B CKFILLING DEPARTMENT OF ENVIRONMENTAL QUALITY, THOR TY WILL BI SEPTIC TANK SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS v FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT D AIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK , SEEPAGE PIT JAITO NEAREST LOT LINE.''rn�WELL I TO SEPTIC TANK 420 SEEPAG ITDRAIN FIELDS O CONSID WATER MAIN TO SEPTIC TANK /,J r SEEPAGE PIT , DRAIN FIELD i SEPTIC TANK, SEEPAGE PIT , DR N FIELD , TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G,A.A.B. OR LICENSED DESIG ER .` SIZE WITHOUT FINAL INSPECTION BY THE SCUTION. TYPE DIAGRAM OF SYSTEM 7,5-- V /K I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. ~AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID. CODE. DATE 7i 0 / APPLICANT'S SIGNATURE .^.m Nn Fn -M [ .r% GRER ANCf I BOk4w4IJGH�1 # '} DEPARTMENT OF J NVIRONMENTAL QUALITY • gllMl No. _ + " l4e 33 ST T A ORAALASKA 99503,, ON 274-45 -45 61 F lv°: / 1 O YK1• SEWAGE DISPOS — XPPLICATION AND PERMIT NAME OF APPLICANT INSTALLATION LOCATION MAILING DDR®S _ 1 S --%dr' LEGAL DESCRIPTION �+ / INSTALLATION OF: .SEPTIC TANK SEEPAGE PIT DRAIN FIELD OTHE�e %7~ TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH n %) . TO BE INSTALLEDBY SOIL TEST RESULTS GLV 4#f t 7-3- 7S NOTEi THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL. INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK. SIZE MINIMUM DISTANCES, REQUIREMENTS s % FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT DRAIN FIE SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK SEEPAGE PIT DRA TO NEAREST LOT LINE. WELL TO SEPTIC TANK �- SEEPAGE PIT _ DRAIN FIELD ALSO CONSIDI WATER MAIN TO SEPTIC TANK �. SEEPAGE I DRAIN FIEL SEPTIC TANK,SEEPAGE PIT-=2=DRAT TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CR EXCAVATION 5 FEET INTO UNDISTURBED SOIL, �. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TA FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING G.A.A.B. OR LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF DESCRIBED SYSTEM IS INn4CCOrD-ANCE WITH SAID CODE. DATE`IBAPPLICANT'S SIGNATURE FORM NO. EQ -016 SEEPAGE AREA SIZE TYPE � s DIAGRAM OF SYSTEM 7 . ANCHORAGE FAIRBANKS ' T� CONSULTANTS, INC. JUNEAU e. 249 EAST 51ST AVENUE • P.O. BOX 6087 • ANCHORAGE, ALASKA 99503 • TELEPHONE 907-279-0483 • TELEX 090-35415 July 3, 1975 Ray Jeffers 1557 H Street Anchorage, Alaska R & M No. 562054 RE: Test Hole and Soil Log Report for Sanitary System Lot 2, Block 1, Kino Hills Subdivision Dear Mr. Jeffers: We are submitting herewith the test boring results and our comments regarding soil conditions encountered at the subject site. This investigation was performed in accordance with your request of June 28, 1975, and those procedures outlined in a letter dated December 19, 1974 by Mr. Rolf Strickland of the Greater Anchorage Area Borough Department of Environmental Quality. A single test hole was put down within the Lot 2 area for the purpose of defining general subsurface soil conditions for the proposed sanitary system. Excavation was accomplished with an auger type drilling rig and the test hole was extended to a total depth of 20.0 feet below the ground surface. The final log prepared for the test hole has been included in Drawing A-01. Ground water was not encountered in the test hole. We appreciate being given this opportunity to be of service to you:. Should you have any questions with regard to the above, please do not hesitate to contact us. Very truly yours,,.. R & M CONSULTANTS, INC. 0 James W. Rooney Vice President JWR/WED/sc Enclosure xc: GAAB T.H.-1 7-2-75 0.0'" ORGANICS TAN SANDY SILT 1.0' .v SANDY SILT w/TRACE TO SOME GRAVEL (ML) . 11.4' 00 Ko .. 0. - - . OA 0 7�0 00 0' AA/:D• SILTY GRAVELLY SAND Very Tight (SM) D 0doo 20.0' TD NO WATER TABLE' Log Represents Lot 2 Block 1 Kino Hills Subdivision Jeffers Property Log of Test Hole Anchorage, Alaska Consultants Inc. ANCH0RA6E FAIRBANKS ALASKA - JUNEAU - --- nn•rF 7—'2-75 SCAt-E 1^=3�� OWN 8Y [,�tEj� ,. CHKQ SY WED PRoo. No.562054 Qwa NO -A-01 I acri� /G 1 Municipality of Anchorage 111; 'Ol B" • Development Services Department r• _ Building Safety Division On -Site Water and Wastewater Program ` 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 0-10 — 7/— 07 COSA# 0103 Expiration Date: " f — D R 1. GENERAL INFORMATION. Complete legal description Lot 2; Block 1; Keno Hills Subdivision Location (site address) 5937 Blueben Current Property owner(s) Steve Rhodes Day phone 441-1247 Mailing address 175DO Mountainside Dr. Anchorage, AK Lending agency Day phone Mailing address Real Estate Agent Kevin Taylor Day phone 273-7223 Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site ID Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ 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 Onsite 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. DSD 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 engineers 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 Onsite 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 S 8 S Engineering Phone 694-2979 Address 15861 S. Birchwood Engineer's Printed Name Chugiak, AK 99567 Date %7,)r, /0 or- �,••L•1 'ROIERt C COWAN 5. DSD SIGNATURE a Approved for bedrooms. 1tt�1£v r,= Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: (Rev. 1M) ;1 Municipality of Anchorage Development Services Department Building Safety Division – •--: On-Site' Water & Wastewater Program 4700 Bragaw Street P.O. Box 188650 Anchorage, AK 995188650 www.muni.orgionske (907) 343-7804 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: LAYrt i�tor� ��A41 iParcel ID:7/- 0 9 A. WELL DATA We" typAwtIX­ If A, B, or C provide PWSID #= Well Loe) YES Date completed 3 iblOb Sanitary sea(2�N) '&S Wires properly protecte<@Nq (ES Total de ''� r r ) /9 depth Cased to St ft. Casing height (above ground t In. FROM WELL LOG AT INSPECTION Date of test to Static water level 3 r ft, ►� ft. Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform D coloniesl1l10 mL Nitrate Q ng/L Otter t>actaria © colonies/100 mL Arsenic: 6` r r mgA Date of sample: IiHDl Collected by. S4 :w?f�ll(iFiL'Q►/lJ(s B. SEPTICIHOLDING TANK DATA Tank Type/MaterW ")rme- % Date installed 2 /rpt Tank size 1300 gal. Number of Compartments � Cl..tem 7 E V, Foundation cleanou(5% M Depression over lank High water alarm (Y® _&Io Date of pumping Pumper t u t As o u, C. ABSORPTION�FIE�LDATA Date installed /24/Ob Soil rati (g.p.d. fe/bdrm) O. S System type Length ft. Width V?O ft. Gravel below pipe Total depth y_y ft. Eff. absorption area tIDOfP Monitoring tube Depression over field Date of adequacy test u 2*9t*v) Results (Pass/Fed) For _q_ bedrooms Fluid depth in absorption field before test = in. Water added= gal. New depth= in. Elapsed Time: = min. Final fluid depth — in. Absorption rate >= I g,p-d, Any rejuvenation treatment (past 12 mo.) (01 type) iUo If yes, give date D. LIFT STATION - Date installed 2 Qb Size in gallons `Pump on' level at 'n in. 'Pump ofr level at ,!E in. Daturnf l� Cycles tested 2 E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAtt station on lot j t_ Absorption field on lot Public sewer main Sewer /septic service line 1-1- 1 Animal containment areas ManholelAccesso) High water alarm level at in. Meets alarm & circuit requirements? Y to s On adjacent lots to© + t On adjacent lots 100 r Public sewer manhole/cleanout A3 A Holding tank 1 Manure/animal excrete storage areas 1�b SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: I 1 i Building foundation {D Properly line S It Absorption field 5 ? Water main _ JA Water service line I© r4 -j Surface water t Wells on adjacent lots Kid t SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: r t Property line Re Building foundation Water main Water Service line t Surface water Ifb + Driveway, perkingivehicle storage } 1 Curtain drain &1QIUE MUV Wells on adjacent lots leo 4 F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field 'inspections and review of Municipal records t e above systems are in conformance with MOA CO guide ne in fie o his d . Engineers Printed Name Date 81211707 COSA Fee $D r Waiver Fee $ Date of Payment a(� fit Receipt (Rev. 11/05) Date of Payment Receipt Number A. a1/e 1404 SCS ROEM Client Name Project Name/# Client Sample ID Matrix PWSID Sample Remarks: 1076206001 S & S Engineering L2; BI; Keno Hills L2; B1; Keno Hills Drinking Water If All DatesfTimes are Alaska Standard Time Printed Date/time 12/10/2007 8:32 Collected Date/time 11/26/2007 13:20 Received Date/rime 11262007 13:35 Technical Director Stephen C. Ede Allowable Prep Analysis Parameter Results PQL Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 1127/0712/06/07 TK Waters Department Total Nitratc/Nitritc-N ND 0.100 Microbiology Laboratory Total Coliform 0 mg/L SN1204500NO3-P B (<I0) coV100mL SN1209222D A (<I) 1127/07 LCP 1126/07 SDP ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN MUNICIPALITY OF ANCHORAGE AND Smye LANs LANG � KJ/ltsreAl LANA o THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this � Day of DE c6 me6A of 20,Qj, by and between s1m w o, hsiasr_,,J ZA jC o� 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 -�CDS F located at_KCNo Nlt-t-S GI LZ Anchorage, Alaska. 2. Definitions. 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 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 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 7—c I< 0 ($ O .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 Fauipment. 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 AWNVTS 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: Yell Rt- C. LC. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. t 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. T'onwvaiver. 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: 0%vner: SHANE -1KT/RSTEN 1-.41J6 ,4, ,0 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 orLaw. 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. Severabilitv. 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. OWNER: BY /Y/ l Date: /'i I/( A-4 STATE OF ALASKA THIRD JUDICIAL DISTRICT The foregoing instrument 20 -OL by MUNICIPALITY: By: Title: Date: ) ss. before me this // day of . the _C)49 rf NOTARY PUBLIC FOR ALASKA My Commission expires:1 0 l V • 1 Municipality of Anchorage 0 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 Parcel I.D. CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING 020.171-09 1. GENERAL INFORMATION COSA# 1)2oIat Expiration Date: 9-/0"O % Complete legal description Lot 2: Block 1: Keno Hills Subdivision Location (site address) Bluebell Current Property owner(s) Bill Wilkson Day phone 242-5443 Mailing address 16701 Ransom Ridge Anchorage, AK 99516 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well❑ ❑� Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ 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. DSD 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 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 S a s Engineering Address 15861 S. Birchwood Loop Rd. Eagle . AK 9 6 Engineer's Printed Name 5. DSD SIGNATURE Approved for __ Lj bedrooms. Disapproved. Phone 694-2979 Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Q��� �� /� Original Certificate Date: r j 0 D 7 (Rev IIM) Municipality 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 Legal Description: -T�ttYX �'1 KrM F1111S Parcel ID: 02D A. WELL DATA Well type�lUffrc Date completed J3_4/04 Total depth ALft. If A. B, or C provide PWSID # = Well Log N) - YfS Sanitary seal) A-5 Wires properly protecte (i Cased to 5 Casing height (above ground) >'0� rt in. FROM WELL LOG Date of test 3 Static water level /: ;q ft. 6 Well production 6-() g.p.m. WATER SAMPLE RESULTS: Coliform 'colonies/I00 mL Nitrate •6�-'mgx /L Arsenic: 10150111- date of sample: VL716 9 AT INSPECTION �lY ft. g.p.m. Other bacteria 0 colonies/100 mL Collected by: '54-S rt4/KA521/v4 B. SEPTIC/HOLDING TANK DATA '(� Tank Type/Material �Lifl fC D 1 E Date installed a Lig Oiv Tank size 1300 gal. Number of Compartments Cleanout) Foundation cleanout (1 /) Lm ()01-bprreession over tank (10High water alarm Date of pumping — A) 5 -P mu per C. ABSORPTION FIELD DATA Date installed oR dl!i Soil ratingg.p.d./ft2 r ft2/bdrm) �• System type )ASF � r i Length_ ft. Width ft. Gravel below pipe D. 5 ft. tt II -t ,.1� Total depth y_7 ft. Eff. absorption area 17/1rL2 Monitoring tube 7�> Depression over field Date of adequacy test —NEW �rt/T57�1+1- Results (Pass/Fall) For 1- bedrooms Fluid depth in absorption field before test — in. Water added= gal. New depth= in. Elapsed Time: = min. Final fluid depth — in. Absorption rate >= I g.p.d. Any rejuvenation treatment (past 12 mo.) (Y& type) If yes, give date — D. LIFT STATION Date installed a 1 `Pump on' level at . in. Datum ?"rDTTOy41 E. SEPARATION DISTANCES Size in gallons S SO Manhole/Acces©N) 7 �S "Pump off" level at _3!� in. High water alarm level at in. Cycles tested oC Meets alarm & circuit requirements? AES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank lift station on lot Absorption field on lot :Zm Public sewer main A-) IM_ Sewer /septic service line (?25 r+ Animal containment areas '50I -f On adjacent lots On adjacent lots ICS 14 10014- Public 001+ Public sewer manhole/cleanout — A-) lid Holding tank I Manure/animal excrete storage areas /OO + SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: / S Building foundation /0 r Property line S t Absorption field Water main 1 Water service line IO!'- — Surface water Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: 1 ' Property line 56 Building foundation � Water main N n I ' DIf Water Service line /Q 'f Surface water ICO Driveway, parking/vehicle storage �_ I Curtain drain A7n KN -'f'" Wells on adjacent lots /► F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that I have determined review of Municipal records th, conformance with MOA COSA,4c Engineers Printed Date h field inspections and above syVeyns afe, in COSA Fee $------------ _ c Date of Payment Receipt Number n� - (Rev. 11105) 15 :2-01 6 Waiver Fee $ Date of Payment Receipt Number ANALYTICA GROUP S&S Engineering Atm: Tami / Yoshi 17034 Eagle River Loop Rd. Eagle River, AK 99577 907-694-2979 Fax: 907-694-1211 Client Sample ID: Lot 2, Block 1 Sampling Location: Keno Hills S/D Client Project: none Sample Matrix: Aqueous COC #: YN PWS#: Residual Chlorine: Comments: Lab#: A0704197.OIA Analytica International, Inc. 4307 Arctic Blvd. Anchorage, AK 99503 Phone: 907-258-2155 Fax:907-258-6634 Report Date: 4/25/2007 Receipt Date: 4/17/2007 Sample Date: 4/17/2007 Sample Time: 2:35:OOPM Collected By: YN Flat Definitions: MRL - Method Reporting Limit MCL - Maximum Contaminant Limit B - Present also in Method Blank 11- Exceeds Regulatory Limit M - Matrix Interference J— Estimated Value D - Lost to Dilution •• - RL higher than MCL; target not detected TNC — Too Numerous to Count - result rejected CF - Confluent Growth - result rejected TCNG - Turbid Culture No Growth - rejected Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 92228 (Aqueous) - Membrane Filtration MF Test was conducted by: Analytica - Anchorage Bacteria, Other <MRL CFU/IOOmL 1.0 4/17/2007 4/17/2007 PL Total Coliform <MRL CFU/IOOmL 1.0 Lab#: A0704197-OID 4/17/2007 4/17/2007 PL Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 4500-NO3E (Aqueous) - Nitrate Test was conducted by: Analytica - Anchorage Nitrate as N 0.625 mg/L 0.10 10 4/20/2007 4/20/2007 AJ Lab#: A0704197 -OIC Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 00.8/200.8 (Aqueous) - Family Well Water I Arsenic 0.597 ug/L 0.15 Reported by: Claire Toon, Page 1 of 1 Laboratory Project Manager was 10 200.8 4/24/2007 4/25/2007 KB E HUI•I : , 1 1 I .LN 2.60 ACRES II2S.T1' PHONE NO. : ✓EFFEIPS SUED• MANHOLES 10' ='rrr II AiE' M' ENTS A LOT 1 N 90'00'00'E 437.27' — — -- —Av ---- — — — --� LOT a Mar. 04 2007 06:11(41.1 N2 I 1 LOT 1 I BLUEI9ECC ; I l X60' BUILDING SETBACK UNE SEPTIC CLEANOUTS ,ry .y �d 10 i� - 2.0' % 22.3' 5m] ►LOT P1Alt AS BUILT Z. SCALE 1 ,5'alop 3438 prolod No. 05-150 Lnnq ASSDolat9s Inc. 11500 Daryl Avenue, Anchorage, AIael.a 99515-5049 (aO •522-11478—Phens, trod l.gnd Sury yore (907 522-4625 Fax A El I haw survcyod the foaowtna dosolbed properly: KENO HIUS SUBDMSION (PUT 71-150) . : I DI*W# Ak w, and that to Improwmtnto tRuoted thereon an Ona and de hot ensvoaoh onto the property odjaesnt thereto, that the property Mng polaasltt Mtrsto snorocoh on the surveyed Dere ors no roadways, trvns"%Wton tines or other vlslble ;roperty except as InMooted heroen. ' ' _ Do► of..,, ���,.� 1 �.R1. r of MoMraot, Nada goof tht .wrier k det In't #0 txIdents or .qqrr�momsnty, rens whish do not appear on the eerded wbdMelon plat. ONE STOV t WOOD FWWE RESIDENCE WITH FULL Sk"NEN HOUSE DETAIL SCALE: 14 — 30' Municipality of Anchorage .. Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196850 Anchorage, AK 99519-8850 www.cl.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Bob Schafer Legal description: keno Hills Block 1 Lot 2 The attached paperwork has been reviewed and is being returned for the following reasons: 1. Well Pump Log 2. Maintenance Agreement from buyer 3. Bed turned 90% from permit 4. Fill in water results on Checklist 5. Foundation cleanout needed 6. High water alarm needed for lift station 7. Slope of bed not 3 to 1 8. Are there alarms on air pumps i 9. Fat Albert is buried too deep Name of reviewer: lgff Date: May 9, 2007 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK