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Home My WebLink AboutT15N R1W SEC 5 LT 86Onsite File T15N RIW SEC 5 Lot 86 The 2' piped sand f ilter is to remain for all COSA approvals. James “Jay” Crewdson, P.E Email: CELLC.1@outlook.com Cell/Text: (907) 280‐9493 PO Box 671389 ● 18368 Amonson Road ● Chugiak, Alaska 99567 September 10, 2024 Municipality of Anchorage On‐site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99519‐6650 Attention: Deb Wockenfuss Reference: T15N R1W S15 Lot 86 Existing Crib (seepage pit) Crib Documentation and Minimum Required Absorption Area Crib Documentation Liner Material: perforated steel Liner Size:46‐inch (3.83‐feet) diameter x 72‐inch (6.0‐feet) tall Effective Depth: 6‐feet Total Depth: 6.8‐feet Insulation:4‐inch thick above crib Gravel Width: 3‐feet (outside of steel crib liner) Outer Diameter: 3.83‐feet + (2 x 3‐feet) = 9.83‐feet Outer Circumference: 3.14 x 9.83‐feet = 30.88‐feet Absorption Area: 30.88 x 6 = 185‐sf Minimum Required Absorption Area Soils Percolation Rate: 1.5‐mpi Application Rate: 50‐gpd/sf (BioBarrier AWWTS) Bedrooms:4 Min. Required Area: (150x4)/50=12‐sf Please feel free to contact me for more discussion. Thanks James “Jay” Crewdson, P.E. swom" 1 1 A1 Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181050 PID Number: 051-081-28 Dwelling: 0 Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New 0 Upgrade Name: Atkins Jeppsen 20217 Trust ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 21625 Scenic Dr., Chugiak, AK 99567 ❑ Other Phone Numb er of Bedrooms Soil Rating Total depth from original grade 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot 86 Fill added above original grade Ft. Gravel length Ft. Township Range Section 15N 1W 5 Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding ;Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well 50+* 50+* 23** TANK ❑■ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer BioBarrier-Infiltrator Tanks Capacity 540 and 1530 Gal. Surface Water 50+* 50+* Material HDPE Number of compartments 3 Lot Line 5+ 10+ NA Foundation5.6*** 10+ LIFT STATION Manufacturer Capacity Gal. ( Curtain Drain None Known Remarks *BioBarrier 0.5-N w/remote monitoring Pump on level at in. Pump off level at in. High water alarm at in. ** see waiver ***outside of foundation soil bearing prism Pump make and model Electrical Inspections performed by Soils perc test for existing crib: 1.5-mpi PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 Installer ARM Services Drainfield CO/MT Inspector Crewdson Engineering LLC BENCH MARK (Assumed elevation) 100 ft Inspdection 15' 6-16-18 6-29-18 Location and description 2nd SO 411, Bottom of siding at "A" (see record drawing) COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Lj s L S Conditional Approval: Date i0).-* •'� +�/ /TH* •,,pr i* ' 4 •� / ames A. Crewdson•: j C1 1527 Approved�cr1. Date a d 1 i\�PROFES _/� .r � I h'i S 5 542;,1 w b e i i A-i;,xkd ALLC # 112279 Inspection Report_9-1-12.doc L' c kiiT v-1a.J _11 �U,� rtT�L172(L�l / fj' I11�L1 11Q�N Yec�lli,cZ1%t' /,t 11c��CV Ccc�din lJtt�fVe�s SWING TIES (feet), C1 C2 C3 C4 M1 M2 M3 DC DC -FM A 29.31 13.89 14.71 23.50 17.00 11.22 8.42 23.41 B 50.96 62.93 77.52 79.86 59.38 66.59 75.81 50.21 34.66 C 3.66 WELL — f. 25'. WELL' RADIUS GARAGE 8, 1 E U I BR ADU i I �,�O'WELL i RADIUS DECK ----------------- > 3 BR SFH M z 01. M DRIVEWAY W M rp+ BOTTOM OF HOUSE SIDING ASSUME 100' ELEV Mi C,2EG INLET ELEV-J Infiltrator IM -540 INV 97.48' SEPTICTANK PETERS CREEK--- 1<11ETERS CREEK 0SETBACK LOT 86 UNNAMED CREE C1 C4 CRIB TH1 0 M1 \---UNNAMED CREEK ri M2 C 50' SETBACK C C2 M B1 5 � 'ED SF B2 ORIENTED 45*± FROM VERTICAL (BENCH MARK) A F STAND PIPE ORIENTED 45*:t FROM VERTICAL ioBarrier 0.5-N SEPTIC TREATMENT SYSTEM USING INFILTRATOR IM -540 AND IM -1530 TANKS 50' PATENT ROW RESERVE -PLAN SCALE: 1"=307 M2 ELEV /99.4' M3 FG 99.5' TOT ELEV (BOTH TANKS) 98.00, 0 Infiltrator IM -1530 OUTLET ELEV-/ SEPTIC TANK INV 97.31' NOTES 1. 4" FOAM BOARD INSULATION PLACED ABOVE BOTH TANKS AND ALL.PIPES NOT TO SCALE T15N, R1 W, Section 5, Lot 86 Septic System Inspection Report Record Drawing Plan and Profil& Civil & Environmental Engineering Prepared for: Mike Atkins Date: 10-22-18 PO Box 671389 Chugiak AK 99567 . celic.1@outlook.COM Permit: OSP181050 Page: 2 of 2 Cellfrexi: 907-280-9493 - Fax: 907-688-2295 ALL INFORMATION SHOWN 014 THIS DOCUMENT IS THE PROPERTY OF CREWDSON ENGINEERING, LLC AND SHALL NOT BE USED FOR ENGINEERING OR CONSTRUCTION PURPOSES WITHOUT WRITTEN PERMISSION FROM CREWDSON ENGINEERING. LLC LEGEND (E) existing B# - blower BR -BEDROOM C# - cleanout DC - double cleanout ED - effective depth EG - existing ground ELEV - elevation FIG - finish grade FM -force main IAW - in accordance with INV - invert M# - manhole SF - sand filter TOT - top of tank .... .. aoaaaaaaa . ... ........... . ames A. Crewdson CI1527 � ALLIC #112279 ALLC #112279 Municipality of Anchorage Development Services Department yy Building Safety Division G' is3: ri • • • ; On -Site Water and Wastewater Program D S 4700 Elmore Road Q : • . • • • • • P.O. Box 196650 Anchorage, AK 99507 ®49 ,lames A. Crewdson: �Q www.ci.anchorage.ak.us Q (907) 343-7904 �� C11�527 ` •'��® Soils Log - Percolation Test\��ROFESS\®NP "® D Performed For: M 1 j 11 Date Performed: Legal Description: / / 5 %(J ��CS^ C�� Township, Range, Section: Slope Site Plan Depth (Feet) SEE DESIGN SEE DESIGN L), 5 ' UV w 'I� , to 3- 4- 5- so0, 6- 7- 8 - WAS GROUND WATER 9_1 ENCOUNTERED? 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20 - COMMENTS S IF YES, AT WHAT DEPTH? L 0 Depth to Water After p Monitoring? E Date: I I I SEE DESIGN I I I I Perc hole presoaked Reading Date Gross Time (2et Ti FedDepth to Water Net Drop i� PERCOLATION RATE S (minutesrinch) PERC HOLE DIAMETER U TEST RUN BETWEEN �FT AND j FT (� �y /� Y A In /. /) -_ l . t r T, c _.7 n �. gin • �.. r-' : �� n �A' — R �.1 a, V4/I PERFORMED BY: Crewdson Engineering LLC i James Crewdson CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Municipality of Anchorage s , P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Section * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV181089 COSA#: Permit#:OSP181050 PID#: 051-081-28 Legal Description: T15N R1 W Section 5 Lot 86 Engineer: Crewdson Engineering Applicant: Atkins Jeppsen 20217 Trust Your request for a waiver of the required 25 feet horizontal separation from the sewer service line to the private well has been approved. The approved separation distance is 23.0 feet. See engineer's waiver request for justifications This waiver approval applies to the existing sewer service line only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. .......................... a 0 0 0 M M 0 a a a 0 M ......... ■ ............ a M t t t ...... a 0 M t .. ■ 1 Waiver is Granted: X Waiver is not Granted: Date: c 0 Approved C. rUtr pp by: Name of Reviewer **** VARIAN C E/WAIVER REVIEW **** Crewdson Engineering,_ LLC �c> Civil & Environmental Engineering October 22, 2018 Onsite Reviewer Municipality of Anchorage On-site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99519-6650 Reference: T15N, R1W, Section 5, Lot 86 Well to Private Sewer Line Separation 23 -Foot Waiver Request osv . $10$ i i� Z15 ,?R, j 10A -0c 9,",t pq 'Z 5 5 G James "Jay" Crewdson, P.E. Email: CELLC.1@outlook.com Cell/Text: (907) 280-9493 Fax: (907) 688-2295 The existing private sewer line was found to be less than the required 25 -feet from the well where it exits the building. Mitigating factors: 1. This is an existing condition that has no known problems related to the reduced well separation distance. 2. Topography between the well and private sewer line is such that any overflow from the private sewer line would not flow towards the well. 3. The private sewer line was replaced/revised during the recent septic system upgrade to improve its freeze protection and is in excellent condition. 4. The private sewer line exits the building under a slab -on -grade, near interior walls that would make it very difficult to move. Given the mitigating factors shown above, we believe there is minimal risk involved with the existing 23 -foot separation distance and request a waiver be granted allowing it to remain in its present location. Please feel free to contact m if you have any questions. J mes "Jay" Crewdson, P.E. OF W000 James A. Crewdson �� • 011527 ••i OW �1 ZROFESSIONP-►� ALLC, l I PO Box 671389 • 18368 Amonson Road * Chugiak, Alaska 99567 LOT 78 1 LOT 77 ■ 1 LOT 76 O 0) N M LOT 85 zo 0 0 0 0 LOT 94 0 C5 C5 z 0 wo wa i N 0 0 CO l– U 2 In C7 g p W Ln D 54.1 24.3'– �W ih C9 QM v Cr o W C� V6 _24.3' ), WEST 330.07' LOT 86 2 SEPTIC STANDPIPES (4 TOTAL) N FX�Sr•�NG .3� 32 8 &0 SF05, ELECTRIC PEDESTAL SEPTIC LID SEPTIC BOX SEPTIC LID OSF6 1 S °ss ss° °ss SS co N 154.3' coo m 50' RIGHT OF WAY RESERVATION o n `I PER MISC. BOOK 219 PAGE 11 LO I I WEST 330.13' LOT 93 LOT 87 LOT 92 OF 49TH*** NOTE: Q THIS DRAWING SHALL NOT BE MODIFIED FOR USE AS A PLOT PLAN WITHOUT THE EXPRESSED D '. ' "' """"' """' WRITTEN CONSENT OF LCG LANTECH. ) 9 •. STEVEN CALLAG AN LEGEND: O L 12'3�4,/�g •' t� Q .. Asphalt%J SJ�� SEPTIC STANDPIPE SSO d a d WATER WELL ® Concrete �44rOfessiond\ Overhang ��O;O000� FENCE —X—X— Wood Deck PARCEL NO. 051-081-28-00 ADDRESS: 21625 SCENIC DRIVE, CHUGIAK, AK 250 H Street LEGAL Anchorage, Alaska 99501 DESCRIPTION: LOT 86, SECTION 5, AS -BUILT Survey Department TOWNSHIP 15 NORTH, SURVEY CERTIFICATION: LCGLANTECH, INC HAS CONDUCTED A PHYSICAL -"" - Phone: 562-5291 SURVEY OF THE PROPERTY AS SHOWN ON THIS DRAWING AND CERTIFIES RANGE 1 WEST, SEWARD MERIDIAN THAT THE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE Mainline PROPERTY LINES AND NO ENCROACHMENTS EXIST OTHER THAN NOTED. .Inc Phone: 243-8985 DRAWN DATE: 7/3/2018 WORK ORDER: 18078 EXCLUSIONARY NOTE: IT IS THE OWNERS' RESPONSIBILITYTO DETERMINE AECC 668 THE EXISTENCE OF ANY EASEMENTS, COVENANTS, RESTRICTIONS OR DRAWN BY: MH PLAT: RIGHT-OF-WAY TAKINGS WHICH DO NOT APPEAR ON THE RECORDED CHECKED BY: SC GRID: NW1457 SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION, FOR ESTABLISHING PROPERTY ORDERED BY: MIKE ATKINS SCALE: 1" = 40' FB/PG: 809/44-45 LINES, OR FOR PLOT -PLAN PURPOSES. +.to "�O MUNICIPALITY OF ANCHORAGE ,,»enc On-Site Water&Wastewater Program .o 5`',, PO Box 196650 4700 Elmore Road '� - 11 ct Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 http://www.muni.org/onsite --irel_fai I)cpartinent 4NcNO_RpV*" On-Site Wastewater Disposal System Permit Permit Number: OSP181050 Effective Date: 4/24/2018 Work Type: Septic Upgrade Expiration Date: 4/24/2019 Tax Code Number: 05108128000 Site Legal Address: T15N R1 W SEC 5 LT 86 G:1457 Site Mailing Address: 21625 SCENIC DR, Chugiak Owner: ATKINS JEPPSEN 20217 TRUST Lot Size in Sq Ft: 108900 Design Engineer: CREWDSON ENGINEERING, LLC Total Bedrooms: 4 This permit is for the construction of: El Disposal Field 0 Septic Tank ❑ Holding Tank 0 Privy ❑ Private Well 0 Water Storage All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Ipiew tt Special Provisions: 1. This system is being tested for Advanced Wastewater Treatment System approval. If it does not meet requirements, it may need to be replaced. 2. The crib is to be documented. A percolation test is required. i Received By: `! Date: S Issued By: /� / •- _ Date: � MUNICIPALITY OF ANCHORAGE Community Development Department 4 I = :� Phone: 907- _ •I Development Services Division Fax: •s ••tf On-Site Water & Wastewater Program ti ION A ON-SITE SEWER/WELL PERMIT APPLICATION a APR 11 2018 ; tea. Parcel I.D. C61— O / -.,2 c. j { 5 Property owner(s) /I;k . d 1 k►,� y�is'� . i ppb N Day phone ' Mailing address 02l t,o2C—SC vt ;c_ 4Jl^: L-fv.V x k .�k ' qq Site address Sa.ln� Legal description 77 CA/ R/14) 1 gZ1? Legal description (Township, Range & Section) Lot Size /()&g,0i) Sq. Ft. Number of Bedrooms - `i APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field Initial ❑ Single Family (SF) J (� (w/wo ADU) Septic Tank Y-=�, Upgrade Duplex (D) Holding Tank ElRenewal ❑ ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable, unicipal Codes. (Signa 4e of property owner or authorized agent) Permit/Rush Fees: '‘S-6 Waiver Fees: Date of Payment: k-13 - • Date of Payment: Receipt Number: Qt{ 1,0(tuG Receipt Number: Permit No. DJb Waiver No. Permit App_9-1-12.doc Crewdson Engineering,_LLC QMJames "Jay" Crewdson, P.E. Email: CELLC.1@outlook.com Cell/Text: (907) 280-9493 Fax: (907) 688-2295 Civil&Environmental Engineering April 11, 2018 Onsite Reviewer Municipality of Anchorage On-site Water&Wastewater Program 4700 Elmore Road Anchorage, AK 99519-6650 Reference: T15N, R1W,Section 5, Lot 86 Septic System Upgrade Design Narrative The owner of the subject property would like to replace the undocumented functioning septic system. The 4-bedroom home utilizes water saving "low flow" toilets, faucets and appliances and is eligible for a reduced design flow in accordance with the AMC 15.65,210.D.2 Exception. As such,the design uses 125- gpd/bedroom times 4-bedrooms (3-bedroom home, 1-bedroom ADU) for a total daily design flow of 500 gallons. The septic system will use a BioMicrobics, Inc. BioBarrier 0.5-N Membrane BioReactor (MBR) sewage treatment system. The effluent produced by the MBR will be discharged into the existing crib drainfield, which will be verified for adequate size while it's exposed to attach the new effluent pipe. Soils "Test Pit 2" (attached)indicates 100-sf/bedroom soils,which for the MBR requires an application rate of 50-gpd/sf. The required minimum drain size is calculated to be (500-gpd)/(50-gpd/sf)= 10 square feet of absorption area. The project also includes replacement of the force main from the garage/ADU to the septic system. Please feel f ree to contact me if you have any questions. James "Jay" Crewdson, P.E. „ � •s..1? I 'ames A. Crewdson . 4%� tr OFESS\IY \\\�� — . L 114.) — PO Box 671389 • 18368 Amonson Road • Chugiak,Alaska 99567 i \ ' 11 \ \ p i€/;?s, 11 ill I � M I \ \ XI PLAN \ PETERS CREEK rn I SCALE: 1"=30' sc.---50'SETBACK m I D WELL 100'WELL RADIUS- I \ m ETERS CREEK I •&R(E)FORCE MAIN k<1300' 00'SETBACK APPROX.LOCATION E)CRIB,PERFORM SOILS GARAGE& \ PERCOLATION TEST TO VERIFY \ 1 BR ADU SIZE IS IAW BB 0.5-N APPROVAL, I \ RESULTS SHALL BE SUBMITTED WITH THE FINAL INSPECTION DECK REMOV REPORT. (E)ST tl 44. • . . I . • 0 • P)BioBarrier 0,5-N UNNAMED CREEK / ili W/SAND FILTER 50'SETBACK I • 3 BR SFH 1 • / 10' P)BioBarrier I DRIVEWAY BLOWER(2 TYP) (E)ELECTRICAL p}BioBarrierMETERBASE CONTROL I • • / PANELSNNAMED CREEK / 00'SETBACK \ / 50'PATENT ROW RESERVE \ \ NOTES 1. All components shall be installed IAW MOA,DES and BMI requirement's. LEGEND MBR-Membrane Bioreactor 2. Construction requires Level 1 and Level 2 DES certified contractors. (E) existing MD-Mixing Device Level 1 contractors complete all required excavation,backfill,and (P) proposed MOA-Munic.of Anch. placement/installation of tanks and external piping. ABO-Above Bottom Of MPI-minute per inch Level 2 contractors install all required septic treatment equipment, ADU-accessory dwelling unit MT-monitor tube coordinate with the electrical sub-contractor and complete the BMI AMC-Anchorage Municipal Code MWL-Maximum Water Level required system startup procedure. BB-BioBarrier MBR OWL-Operating Water Level 3. Level 1 and Level 2 contractors shall be MOA certified installers. BGL-below ground level R&R-remove&replace 4. The septic tanks shall be installed IAW the attached BMI-BloMicrobics Inc. SF-square foot "Infiltrator IM-Series Tank Installation Manual",and BR-bedroom SFH-single family home "Infiltrator IM-Series Tank Buoyancy Control Guidance" CO-cleanout SNDF-Sand Filter 5. The minimum allowable drain size shall be based on a flow rate of DC-double CO ST-Septic Tank 150 gallons/day/bedroom. DES-Denali Environmental Supply TU-Treatment Unit EG-existing ground W/-with FC-foundation CO FG-finish grade GRW-groundwater CPEP-Corrugated Polyetheylene Pipe IAW-in accordance with OvienkoningineetalLiC T15N, R1 W, Section 5, Lot 86 t,.XV .di* F, Septic Upgrade Design %*.. ;� *#i ...,4•141•44 , r` jc_____71,0 s A.Crewdson . .F s Prepared for: �� • C11527 ••�4• iv' °"'tII`Et"`onmen'l B"�'ee"'4 Mike Atkins and Krista Jepsen Date: 4-23-18 jk,4,11:d3;/ F,;. OBox671389ChugiakAK99567 • celic.1@outlook.com Permit: OSP181050 p Page: 1 of 2 i\‘NNs.. `�4" Cell/Text:907-280-9493 • Fax:907-688-2295 N_L INFORMATION MOWN ON THIS DOCUMENT IS THE PROPERTY OF CREWDSON ENGINEEREA3.LLC MD SHALL NOT SE USED FOR ALLC#112279 ENGINEERING OR CONSTRUCTION PURPOSES WITHOUT WRITTEN PERMSSSON mROUCREWDSON ENGINEERING.LLC 24"0 HDPE RISER&LIDVENT OUTLET INSULATED(3 TYP) \ 4"0 PVC 4" PVC \_—, OPEN END — 1- INLET/BAFFLE EFFLUENT LINE ,_-11 I— DES SNDF _' Ir 11- 4"0 PVC 72"MAX ABO TU / 6"0 PVC I('I—� IIII II' h ai!I i. I24"MIN • INDEPENDENT Il.l�ll II- I FLOAT STAND _ Iiiimie • I�II j_ I PARTITION 1 4- ii: BB I SEE DETAIL P1 \ 1,, ! i �.II. �l 547" SaniTEE 45" 47" BB MD \ MWL 38'• .0 I I OWL 1. 16.•�I-I 1 tsirl I Itt II .. I I --.11—.11-11-1111—.11-11-11-11—u L a—u—u—cru—..,—.—u—n—u—u—n—a—..—n—a—u--vr��r r.l CONNECT TO //� (E)CRIB SETTLING ZONE TREATMENT ZONE SEE NOTE 7 Infiltrator® IM-540 TANK Infiltrator® IM-1530 TANK NOTES TABLE 1.BioBarrier®SUBSURFACE DRAIN 1. COMPONENTS AND EQUIPMENT SHALL BE IAW THE MOA"STANDARDS AND SOIL PERCOLATION RATE DRAINAGE RATE SPECIFICATIONS FOR COMPONENT PARTS AND MATERIALS USED IN (MIN/IN) (GPD/SF) CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS" 1-5 50 2. COMPONENTS AND EQUIPMENT SHALL BE IAW THE MOA BioBarrier®0.5-N 6-15 23 APPROVAL REQUIREMENTS 16-30 14 3. BioMicrobics®EQUIPMENT SHALL BE INSTALLED IAW BioMicrobics® 31--60 6 INSTALLATION REQUIREMENTS 60-120 3 4. Infiltrator®COMPONENTS SHALL BE INSTALLED IAW"Infiltrator IM-Series Septic 120-240 1.7 Tank General Installation Instructions"and "Infiltrator IM-Series Tank Buoyancy NOTE Control Guidance" 1. SIZE AND CONSTRUCT NEW DRAINFIELDS 5. THE CONTRACTOR SHALL ACQUIRE ALL BioMicrobics®, Infiltrator®AND Denali IAW AMC 15.65.010 WIDE TRENCH AND Environmental Supply(DES)COMPONENTS DIRECTLY FROM DES UNLESS AMC 15.65.210.D2b WIDE TRENCHES USING EXPRESS PRIOR WRITTEN APPROVAL HAS BEEN ISSUED TO THE TABLE 1 DRAINAGE RATES CONTRACTOR 6. IF REQUIRED,THE SAND FILTER LENGTH SHALL PROVIDE 2-FEET EFFLUENT TRAVEL DISTANCE PRIOR TO DISCHARGING TO GROUNDWATER AND 3-FEET PRIOR TO DISCHARGING ABOVE AN IMPERMEABLE BARRIER 7. VERIFY(E)CRIB IS IAW TABLE 1 SIZE REQUIREMENTS FOR 1-5 MPI SOILS E 4"O—C REMOVE 2"0� HIGHLIGHTED (3 TYP) 34"38 AREA 1--36" III ■ % 12" DETAIL P1 SCALE:NTS PARTITION HOLES &CUTOUTS NOTE 1. PARTITION 1 IS MODIFIED IAW THIS DETAIL AND PROVIDED BY DES T15N, R1 W, Section 5, Lot 86 V\ ....6.--- .F Agkkk BioBarrier 0.5-N *" A • ' 1' .•*lel DETAILS A `avigu. - Prepared for: ,r#1<F' a e'C11527 Crewdson A. •��' °�'I&g"Mtlf'"e1dEngineering Mike Atkins and Krista Jepsen Date: 4-23-18 ��lict,;_��?j:l$07_,:.' '0 Box 671389 Chugiak AK 99567 • cellc.1©outlook.com Permit: OSP181050 Page: 2 of 2 l\��"`=��a Cell/Text 907-280-9493 • Fax:907-688-2295 ALL INFORMATION SHOWN ON TWA DOCUMENT tS THE PROPERTY OF CREYNSON ENGINEERING LLC AND SHALL NOT BE USED FOR ALLC#112279 ENGINEERING OR CONSTRUCTION PURPOSES WITHOUT WRITTEN PERMISSION GROGCREWDSON ENGINEERING.LLC ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND Krista J ,ps-ef) THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this le5" Day of 14 f ri' 1 of 20 IA ,by and between Kr1 i{Ctp p v, herein the"OWNER,"and the Municipality of Anchorage,herein the 1' "MUNICIPALITY." In consideration of the mutual covenants contained herein,the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),described as BioBarrier 0.5-N located at(legal description). T15N, R1W, Section 5, Lot 86 2. Definitions. 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. Certificate of On-Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code(hereinafter, "AMC") 15.65.These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. 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. Permit. An On-Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations,Installation and Removal of Additional Equipment. Prior to performing any alterations to an AWWTS,the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement,the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition,it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement,and any renewals thereof, at the owner's sole expense,to pay for any and all: (1)repair(s),(2)maintenance,(3)adjustment(s), (4)replacement costs, and(5)inspection costs. B. Owner agrees to comply with all applicable ordinance, laws,regulations, rules and orders for.the AWWTS. C. Upon request by the Municipality,the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor,the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance,repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test andinspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. H. 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. I. Owner agrees to provide and maintain a telephone connection to the AWWTS as required by the AWWTS approval. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions,nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof,or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing,executed by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed with, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement,the only authorized representatives of the parties arc: a. Owner: current owner b. Municipality: Director.Community Development or designated authority C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall he brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNET;;,: 4,6671- By: k l 1 5--/a. J JpS-er1 (signature) Date: LI I S 1 S 15.1a jeto pS- r) (print name) STATE OF ALASKA ) ) ss. TIIIRD JUDICIAL DISTRICT ) ,�+t The f regoin_ instrume t was acknowledged before me this lb day of ri I, 20/b , by ir%5►, _ -e1, ' "V'_ �0 ,, _ 1 Notary Public NO ��' PUB O' i ASKA I MATTHEW JONES State of Alaska My rommissiI Aires: c/o3/tZ2J l My commission Expires Feb.3,2021 MUNICIPALITY: By: ,b ./ (signature) Date: y/v'/is Deb ( dLke nc:A 5 (print name) Title: t Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 0 Fax (907) 343-7997 http://www.mun i.org/Onsite Development Services Division On -Site Water and Wastewater Program mens s r v Department **** VARIANCE/WAIVER REVIEW **** Waiver#: OSP141166 COSA#: PID#:051-081-28 Legal Description: T16N R1W SEC 5 LT 86 Engineer: Garness Engineering Group Applicant: Joshua Jeppsen Permit#: OSPI41145 Your request for a waiver of the required 100 feet horizontal separation from the absorption field to the surface water has been approved. The approved separation distance is 70.0 feet. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this varr►maA ❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ................................................•.............................1 Waiver is Granted: X Waiver is not Granted: Date: Approved b . Name of Reviewer .............................................................................. I.. GARNESS ENGINEERING GROUP Ltd Ad......I 7ea�sxrcx srs r» , .. :: CIVIL & ENVIRONMENTAL ENGINEERS. .... GROUP.) Ltd May 30, 2014 Municipality of Anchorage F 19 Development Service Department ^ ►�� On -Site Water & Wastewater Program ""�' ° ° • of 4700 Elmore Road Anchorage, AK 99507 Ref: Waiver Request/Amendment Drainfield to Surface Water for T15N, R1W, Sec 5, Lot 86; To whom it may concern: 6 5wLZ? A septic tank permit was issued (OSP141145). During the flagging of the creek setback it was discovered that the creek (Peters Creek) had eroded towards the drainfield. There is already an existing waiver in place (WR#88-066) from the drainfield to the creek for 95 feet. The property owner indicated that erosion of the creek bank has resulted in the creek bank moving progressively closer to the septic system over the last seven (7) years. The separation distance between the creek and the drainfield is now a little over 70 feet. We are requesting for an amendment to the existing waiver and/or issuance of a new waiver for a distance of 70 feet. In order to mitigate this, we are proposing to install a berm(s) so that surfacing effluent would have a travel path of greater than 100 feet to the creek. The drainfield is in a highly visible and vegetated area. If effluent were ever to overflow, it would be recognized quickly and corrected. We are unaware of any adverse impacts this waiver would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. 05Pt(46tS(o 413 :7. 1.4e) QC.Z114 0175D -C) 3701 East Tudor Road, Suite 101 `Anchorage, Alaska 99507-1259 Phone: (907) 337-6179' Fax: (907) 338-3246 ` Website: www.garressengineering.com I EXISTING WELL R,po I p`� �p0 � NOTE: BERM TO BE AT MINIMUM 24" HIGH AND 6' AT BASE. THE BERM IS TO BE GRADED SO THAT THERE IS POSITIVE DRAINAGE AND SO THAT NO WATER CAN POND. MUST BE TOPSOILED AND VEGETATED AFTER CONSTRUCTION. MT HAD 4.5" OF LIQUID `1 LEVEL ON 5/30/201`, INSTALL DOUBLE CLEANOUTS I OLD SEPTIC TANK TO � REMOVED AND REPLACED WITH A NEW 1000 GALLON PROPOSED SEPTIC TANK. GARAGE EXISTING 3 BEDROOM HOUSE / I SCALE: 1 40 PROPOSED BERM- INSI� SO THAT IN THE EVENT OVERFLOWING EFFLUENT, TH TRAVEL DISTANCE FROM ANY PORTION OF THE SEPTIC SYSTEM IS GREATER THAN 100 FEET TO CREEK. DDITIONAL BERMS TO BE STALLED AS REQUIRED TO C TE A DISTANCE GREATER THAN 100 FEET, APP,20X{l:TE LOCATION ,-6F PETERS CREEK EXISTIN DRA_;IELDS / --- - L% 50 FOOT PATENT ROW RESERVE 'a 30 FOOT PATENT ROW RESERVE GARNESS ENGINEERING GROUP, Lid CIVIL & ENVIRONMENTAL ENGINEERS 3701 E. MOOR RO'D, SVIM 101 • A HO . M 99507 • PHONE (907) 337-8179 • FM (907) 338-3245 • WE n vgomweeng[roerngso � OE PREPARED FOR: PHONE NUMBER: PAGE NUMBER: KRISTA JEPPSEN 801-259-2118 1 OF 1 to LEGAL DESCRIPTION: T15N, RiW, SECTION 5, LOT 86 TYPE OF WORK: WAIVER AMENDMENT J.L.M. 4 Ell ffffy A.—aeness.1 CE— 953 5%o f!!�•' 4aC'� PROF!lifE'SS�ION®i��' I'llnlwLs Ir -E) A I A AC A/r_. 1 /lr -7-T 1,7 L/V L-/t/V/V/L-r V/ LV/ / / I -vh f /'-j (EAST 330 07°� TO WNSHIP 15 NORTH RANGE i WEST SECTION 5 GOVERNMENT LOT 66 rXX WELL SEPTIC VENT RECORD DATA 4.49-R l' Osv CONCRETE b n s!mrc THIS 15 A RECERTIFICATION OF AN A5—BUILT SURVEY PERFORMED IN JUNE 1989 (MLA JOB89-106). W k— C� TWO STORY PRAMe HOU5E �SHEO ------ 50' PATENT RIGHT-OF-WAY RESERVE 330. /1nI )r-C)A/A Ar-A/r / n / V -- - kytL-rt/vly/L/v/ L_L/I L r_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _------ 4.49 -RL _____ r�•p r •• G RY D. KOVJA%.. yS ® �5 8856(�a s. r tt0-- 25 50 75 100 --Piursl�`___ , SCALE fcCUYV%C CK UND AS? c;t(;IvF s rA�f 11940 BUSINESS BLVD,. (11fE 205 EAGLE RIVER, ALASI:.% JIJ577 (907) 694-4199 "IELD WORK DATE: 6-15-05 PARTY CHIEF: DIA )RAWN DATE! 6-17-05 IIRAWN BY: JC I hereby certify that I hove, or someone under my supervision has, inspected the property describer) as: GOVERNMENT LOT 86, SECTION 5 TOWNSHIP 15 NORTH, FfANGE 1 WEST SEWARD MERIDIAN, ALASKA Anchorage Recording District The improvements situated thereon are within the property lines and do not encroach or overlap onto adjacent properties, nor do any improvements from adjacent properties encroach or overlap onto this property• except as indicated hereon. Na lot corners have been set. The property dimensions been are tram the record plat and are not necessarily as we may have measured. .The improvemal locotions are approximole and have been determined only to the extent that enables as to determine if there ore any eneroochmenle onto or off of lila lot. Orafling and reproduction may produce graphic inconsistencies; therefore scaling should not be otteornled to determine unshown dimensions. This drawing is not adequate far addilionol construction or far determining the exact Incalion of property lines. Only easements from the recorded subdivision plot noted above are shown hereon and It is the responsibility of the owner to determine if uny other cosecants, cnvennnte. ar restrictions exist. 0McClintock Land Associates, lac. (IAA) 2005 This doeume at is copyrighted and is authorized to be used for onereal property transaction or praiser only. Any copy is to be considered unautho Nxed unless it bears an original surveyor's signature (usually in blue ink) or o slump showing recorder's office data. Copyright restrictions (but not re—use restrictions) ore waived if this document hes been officially recar,.d. trading institutions may also nmke additional copies for their own records. Liability to MLA is limited to fees received far this project. FIELD BOOK: 106-22 PLOT SCALE: 1"-50' GRID: NW 1457 OWG NAME: A005-183 JOB NO: 05-183 Ln � W 5f li , e e ). 4.49-R l' Osv CONCRETE b n s!mrc THIS 15 A RECERTIFICATION OF AN A5—BUILT SURVEY PERFORMED IN JUNE 1989 (MLA JOB89-106). W k— C� TWO STORY PRAMe HOU5E �SHEO ------ 50' PATENT RIGHT-OF-WAY RESERVE 330. /1nI )r-C)A/A Ar-A/r / n / V -- - kytL-rt/vly/L/v/ L_L/I L r_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _------ 4.49 -RL _____ r�•p r •• G RY D. KOVJA%.. yS ® �5 8856(�a s. r tt0-- 25 50 75 100 --Piursl�`___ , SCALE fcCUYV%C CK UND AS? c;t(;IvF s rA�f 11940 BUSINESS BLVD,. (11fE 205 EAGLE RIVER, ALASI:.% JIJ577 (907) 694-4199 "IELD WORK DATE: 6-15-05 PARTY CHIEF: DIA )RAWN DATE! 6-17-05 IIRAWN BY: JC I hereby certify that I hove, or someone under my supervision has, inspected the property describer) as: GOVERNMENT LOT 86, SECTION 5 TOWNSHIP 15 NORTH, FfANGE 1 WEST SEWARD MERIDIAN, ALASKA Anchorage Recording District The improvements situated thereon are within the property lines and do not encroach or overlap onto adjacent properties, nor do any improvements from adjacent properties encroach or overlap onto this property• except as indicated hereon. Na lot corners have been set. The property dimensions been are tram the record plat and are not necessarily as we may have measured. .The improvemal locotions are approximole and have been determined only to the extent that enables as to determine if there ore any eneroochmenle onto or off of lila lot. Orafling and reproduction may produce graphic inconsistencies; therefore scaling should not be otteornled to determine unshown dimensions. This drawing is not adequate far addilionol construction or far determining the exact Incalion of property lines. Only easements from the recorded subdivision plot noted above are shown hereon and It is the responsibility of the owner to determine if uny other cosecants, cnvennnte. ar restrictions exist. 0McClintock Land Associates, lac. (IAA) 2005 This doeume at is copyrighted and is authorized to be used for onereal property transaction or praiser only. Any copy is to be considered unautho Nxed unless it bears an original surveyor's signature (usually in blue ink) or o slump showing recorder's office data. Copyright restrictions (but not re—use restrictions) ore waived if this document hes been officially recar,.d. trading institutions may also nmke additional copies for their own records. Liability to MLA is limited to fees received far this project. FIELD BOOK: 106-22 PLOT SCALE: 1"-50' GRID: NW 1457 OWG NAME: A005-183 JOB NO: 05-183 On -Site Water and/or Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141145 Tax Code Number: 05108128000 Work Type: SepticTank Upgrade Permit Effective Dates: May 29, 2014 to May 29, 2015 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: T15N RlW SEC 5 Site Legal Address: T15N R1 W SEC 5 LT 86 GA457 Owner/Address: JEPPSEN JOSHUA 50% & DAHL KRISTA 50% 21625 SCENIC DR CHUGIAK AK 995670000 Site Mailing Address: 21625 SCENIC DR, Chugiak Lot Size in Sq Ft: 108900 Total Bedrooms: 3 This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By MUNICIPALITY OF Community Development Department Development Services On -Site Water & Wastewater Program Parcel I.D. 051-081-28 ANCHORAGE Phone: 907-343-7904 Fax: 907- 343-7997 Mayor Dan Sullivan On -Site SewerMell Permit Application ? ► / < A For A Single Family Dwelling v `' Property owner(s) KRISTA JEPPSEN Day phone 801-259-2118 Mailing address 21625 SCENIC DRIVE *CHUGIAK, AK 99567 Site address 21625 SCENIC DRIVE *CHUGIAK, AK 99567 Legal description (Sub'd, Block & Lot) T15N, R1 W, SEC 5, LOT 86 Legal description (Township, Section & Range) Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: ( Mall that apply) Absorption Field ❑ Initial ❑ Single Family (SF) Upgrade ® (w/wo ADU) Septic Tank ® Renewal ❑ Duplex (D) ❑ Holding Tank ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: Distance: — I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) PermittRush Fees: i �gqq, Waiver Fees: Date of Payment: 51a9 f��lqDate of Payment: Receipt Number: (JaZc2l/(Jl7 Receipt Number: Permit No. - Q 5PARIL16 Waiver No. (Rev. 01/11) GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS. May 27, 2014 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Rd. P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Proposed Septic Tank Upgrade for T15N, R1 W, SECS, LOT 86; To whom it may concern: The existing three (3) bedroom house on the referenced property is served by a private well and septic system. Per a pumping company and the owner the septic tank is failed and needs to be upgrades'. We are proposing to decommission the existing septic tank per UPC and replace it with a new 1000 gallon septic tank. We are unaware of any adverse impacts this installation may have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. Sincerely, A P.E., M.S. 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com C UW, L10. MV A O PAUL JYLUNUAIIUN LETTER THAT PERTAINS TO THIS DESIGN. TO OBTAIN A COPY OF THE LETTER CONTACT GEG. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND I CONDITIONS OUTLINED. EXISTING HOUSE NOTE: THE CONTRACTOR SHALL HAVE THE NORTH & WEST LOT LINES, ALL WELL RADII, & THE 100' SETBACK FROM PETERS CREEK FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO r'ONCTRI ICTION IEXISTING DRAINFIELDS APPROXIMATE LOCATION OF PETERS CREEK - 1111 `EXISTING DB DBLOW SPUTTER INSTALL L C/ 0'S / OLD SEPTIC TANK TO BE REMOVED AND REPLACED WITH A NEW 1000 GALLON - SEPTIC TANK. - - 50 FOOT PATENT ROW RESERVE 30 FOOT PATENT ROW RESERVE GARNESS ENGINEERING GROUP, Ltd" " mmmx waw CIVIL & ENVIRONMENTAL ENGINEERS W01 E. MU ROOD, SUOE 101 * lWORORgGE. PIC 99507 • R E (907) 331-81M • FM (907) 338-3948 • WEBSRE: wW pmewn Il Omg=m M ..... PREPARED FOR: PHONE NUMBER: PAGE NUMBER: F KRISTA JEPPSEN 801-259-2118 1 OF 1 LEGAL DESCRIPTION: DRAWN BY: •�� T15, R1W, SECS, LOT 86 PNB �1 TYPE OF WORK: DATE: ♦ SEPTIC TANK UPGRADE DESIGN 5/27/14 1� MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99507 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME - P�7HO7�NE KNEW ❑UPGRADE MAILING DDR lI L. _/w Cc, IRI'OoZ' LEGAL DESCRIPTION Lvv M, s4a� t'- r LOCATION NO. OF BEDROOMS W I Absorption area Dwelling PERMIT 91 1197 �JZ v O DISTANCE TO: C� Y F Z Manufacturer Materia No. of comport ents w Liq. capacCp gallons )) IF HOMEMADE: Inside length Width Liquid depth ❑ Y JDZ DISTANCE TO: Well Dwelling PERMIT NO. = z Manufacturer Material Liquid capacity in gallons ❑ Well Foundation Nearest lot line PERMIT NO. w= DISTANCE TO: J w z HZ w — No. of lines t� Le gth of each line (� (,j (.3 , Total) n hof lines 1 ( Trench dth inches Distance bet!�Y�errlirrs ( 7—� K F Top of rile to grade / ! Material beneath rile Total erff5t0,—absorption area ❑ _finish ' inches Length, Width Depth PERMIT NO. w C7 C( F Type of crib Crib diameter Crib depth Total effective absorption area W° w - Well Building foundation Nearest lot line DISTANCE TO: J Class Depth Driller Distance to lot line PERMIT NO. J w Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO: OTHER PIPE MATERIALS / SOI L TEST RATI /66 INSTALLER 6 _ RE ARKS 'u'L ` 69/-� fad. f II / Z- L P F `L 'I— QC PPRO E DATE LEGAL -7 Ili 7 72-M3 (Rev. 3/78) - L/ �x fl-_ I i�! ^ -DEPARTMENT 0' AEOLTH AND 925 /LSTREET H�C , 264-472KK ~ / Al k=7 L.L,11 K! 9 E" .9—��S: _T ' 9- LE PERMIT NO. � ( 780189 ) �+^ APPLICANT JERRY L WALKER GEN. DEL EAGLE RIVER 694 3348 LOCATION NORTH BlRCHWOOD LOOP LEGAL L86 SECT.5 T15N R1W SW LOT SIZE 108900 SQUARE FEET .TYPE OF SOIL HBSnRRTION SYSTEM IS: DRHINFIFL . 4/0 77e M05T ST -AY OUT 0F(pm�4.�u�*� ,1|��XI|'|UM 14UMBEF� OF BEDROOMS = ] SOIL RATING (SQFTi1�'R)�� 1'm0 p&mf� ' THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: REawnawb //VSv4.4'r/4/o_ gvtTH Srl(Zopo" cQ ��-�= �� -�� 05 � THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHlNFIELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). 1 1-1 ETE 1- Fit EF A4 cl 14 01 X K117- 1-1 1: nw 25' pol fRo nza F17 E7 k=_ _T THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET) �1EE��111:_- �101010,f _1�� PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. --- ?1- 9411 cm �:2: -u KKEH-, FP.!E=G_uLJ:KKEElT> --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL RE SUBJECT TO PROSECUTION. ^ MINIMUM DISTHNCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL; DR � 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. T'S050-1171- I CERTIFY THAT 1: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS. 5IGNED:_ ___________ ||M"L1[ JERRY L WALKER « (/ ISSUED BY_ __ DHTE_ Ze__-_ VI.2 a ATF GREATER A14CU0RAGL AREA BOROUGH DEPARTMENT OF ENV tRONMF11TAL QUAL TTY Case 3330 "C" Street ANCHORAGE, ALASKA 99503 Performed For ��f- ostfj it Dated Performed Legal Description: Lot 8(,=63-aEic na Sid#ori awn i, (5a 2_ I Jnr s•M• This Form Reports Soils Log_ ` Percolation Test I Soil Test Must Be Logged To 4' Below Proposed Seepage System3y DFeetiTTc5+PSoil Characteristics UJ�G ��' �:' `U tick o.s.•� i<. !s•., .. .,-r�3a.. C) - •c F: K�: t�.h 'S.I;B I�rc 'rvi{P .�;i r; ;nn• • FRS: v 'ni- 1'0 • t'S1" �'•v Gross Time Net Time �4' �p Depth t ( FN e.� Fr ` • l\\ �Gi:? Y.�ack or�ac.,� �;. CSI.- - y ,i NN17 tlf1 L brn Sd /9 PI�w San...: c',bl^1 (1-06) •ti:— tvdt iareded WJ!d1.5,(,Y,Iei S so.. ;A.. �'7W16% .d. 4 Vim• ` weic✓ t -d' -c . _ _ OS' J CD A �/SZrF -- - - Was Ground Water Encountered? Yes s I �016 If Yes, At What Depth? lP F ll Reading Oate Gross Time Net Time �4' �p Depth t ( FN e.� Fr ` • l\\ �Gi:? y ,i NN17 MEN on M■■■■■� MIN Reading Oate Gross Time Net Time �4' �p Depth t ( FN e.� Fr ` • l\\ �Gi:? y ,i NN17 Percolation Rate Mi nul:n Proposed IristallTtion: Seepage Pit Drain Field X Depth of Inlet-- I' _ Depth to Bottom 67t—Pit or Trenc .0014MENTS:-.�c�2! .��Ilo4, cP,z�sal �',rld r<<"„ -.r ,,. i�.;� ��,1 ..r:�,l b___h hal, U,;I„- f; E,i,' S•'+. �, .�„ �i 1'vc-( i„ Irl _2 'T,U of Ilc,..l. a1 1' - AH Ir ,. i” ' Gwi: - /,,i 13 Test Performed BY_,0,•L)r� Ii, 1,N •� ,.•< Date Certi Picd BY:L December 29, 1978 $780189 Jerry L. Walker Gameral Delivery Eagle River, Alaska 99577 Subject: T15N R1W Section 5 Lot 86 A permit issued by this department for well and/or sewer system has expired. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal ordinance. if you have drilled the well, a well log should be sent to this department to document the installation date. if there are any further questions, please contact this office at 264-4720. Sincerely, Les N. Buchholz, R.S. Senior Environmental Specialist LNB/ljw enc: copy of permit EsEER"00-1— Q IR:1, ��%%1L__ ��'12� THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD- THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND HND THE BOTTOM OF THE EXCAVATION (IN FEET). �� '�� THE GRAVEL DEPTH IS THEE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE HND THE BOTTOM OF THE EXCAVATION (IN FEET). F&AE015 cowlEEK-1- X N0 TFIVAK PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. 1- 00 K3 c lot :1 �� E�� BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL B; THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION, MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM I- 100 FEET FOR H PRIVATE WELL, OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 70 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. I CERTIFY THA -1 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS FET FDRTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH TUE CODES. I: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS. SIGNED ISSUED �� DEPARTMENT O'\EHLTH AND ENVIRONMENTAL F TECTIOm 825 /L' STREET/ ANCHORAGE, AK 9950-L ' 264-4720 �sms EA �� .... ... 1�� I� PERMIT NO. ( 780189 ) 8PPLICHNTGEN. DEL EAGLE RIVER 694 7548 LOCATION NORTH BIRcHWODD iO0P FEET LEGAL L86 SECT.5 T15N RtW SW LOT SIZE 108900 SQUHRE AV re � /m� " 0-/r /00 ��^r*l TYPE OF SOIL HBSORBTION SYSTEM IS: DRHINFIELD ~ , 0 MAXIMUM NyMGER OF BEDROOMS = 7 SOIL RATING (SQ FT/BR)- 100 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM _A4AR IS: EsEER"00-1— Q IR:1, ��%%1L__ ��'12� THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD- THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND HND THE BOTTOM OF THE EXCAVATION (IN FEET). �� '�� THE GRAVEL DEPTH IS THEE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE HND THE BOTTOM OF THE EXCAVATION (IN FEET). F&AE015 cowlEEK-1- X N0 TFIVAK PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. 1- 00 K3 c lot :1 �� E�� BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL B; THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION, MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM I- 100 FEET FOR H PRIVATE WELL, OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 70 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. I CERTIFY THA -1 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS FET FDRTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH TUE CODES. I: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS. SIGNED ISSUED ' GRLr+iER ANCHORA(?C AREA BOROU(,.'� DEPARTI.1ENT OF ENURONMIF(ITAL QUALITY Case fl 3330 "C" Strect ANCHORAGE, ALASKA 99503 erforrred For Rs Fr +jle��Dated Performed--a/-2_1h' egal Description: Lot 2I hr s,M• his Form Reports Soils Log_ Percolation Test T - Soil Test Must Be Logged To h' Below Proposed Seepage System3y Feet Tes'fp�� 2 Soil Characteristics VJ4e ;7jv fo -:L 1 :Fri, bl- SP tl rSr [- 'UYM Shc9�r w $J++.; f,'h1-4 hrr, to Usc 10L -� Was Ground Water If Yes, At What Encountered?_-)___ t Depth? l� i� tl I 1 a a loe to � I a Reading Date Gross Time Net Time Depth t,,,, t�t%Ai e`14r1 D R+ ° 1 ata i; I 11�TP � I I 1 a a loe to � I a Reading Date Gross Time Net Time Depth t,,,, t�t%Ai e`14r1 D R+ ° 1 ata i; I 11�TP ,rcotacion +:ar.e Minute Proposed Installation: Seepage Pit Drain Field Depth of Inlet _ Depth to E3o.ttom oY Pit or Trench r' MMENTS: ,a! .S 11a1low AsPasal { Irl Yr ✓ ..1 {his <{aai .;r:✓, I b,ii h 1 it v + �rr i1'Fr � A r n� st Performed BY �),,/ ,r� - .�1�=>. l:al�-c��l-•t_ _Date Certified BY: Date: 1. til r-4 < 00 to 00 0 Y < 00 00 C7 - w IN 'o w > 0 w 0 w LL0 0 < 00 00 C7 - w IN z 0 0 0 z 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 0 0 0 0 0 0 0 0 0 0 0 z 0 . . . . . . . . • . . 0 0 0 0 O 0 0 O 0 0 O O O z 0 ix ix 94 wgaWwa Ww4w. Z z 0 Municipality of Anchorage Department of Health and Human Services dh Tom Fine, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 October 25, 1988 Lou Butera, P.E. Eagle River Engineering Services PO Box 773294 Eagle River, Alaska 99577 Subject: Waiver Request for T15N R1W Section 5 Lot 86 Waiver Request #WR88-066 Dear Mr. Butera: Your request for waiver of the required 100 foot separation of a septic leachfield to a surface water has been approved. The approved separation distance is 95 feet. This waiver approval applies to the existing septic system to the surface water only. Any future upgrade to the septic system will require all separation distances be met or another apporval from this department. Sincerely, � &� )_/ % wv Daniel J. Roth Civil Engineer On-site Services DJR/ljw EAGLE RIVER ENGINEERING SERVICES Lou Butera, P.E. P.O. Box 773294 Eagle River, Alaska 99577 Telephone (907) 694-5195 September 20, 1988 Mr. Daniel J. Roth Civil Engineer On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519-6650 RE: Lot 86 T15N R1W Sec. 5 Dear Mr. Roth: MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION OCT 31988 RECEIVED On behalf of my client, Mr. Ralph Winterrowd, I am applying for a waiver of horizontal separation distance, septic leachfield to surface water, to 95' distance. This waiver is to allow Health Approval of well and septic systems. The subject septic system was installed in 1979 with inspections by the Municipality of Anchorage. Our measurements show a distance of 95-98' to the extreme edge of a bend in Peters Creek. It appears that the bank has eroded to create this distance. The owner is taking steps to control erosion and it was determined that a waiver would be preferable to adding fill to the site which would essentially accomplish the same result. Ground slope between septic system and creek is essentially zero or flat. There is dense vegetation and high grass with an uneven furrowed type ground surface. Any surface leakage of effluent would most likely be trapped in the immediate area and percolate into the porous soil. Surface seepage would also be noticed as the septic system is immediately adjacent to the home. Subsurface soil characteristics of the area are gravel type soil (GW). The ground water table is measured at 4.25' below the bottom of the septic system or 6' below ground surface with measurements taken in April and September. Septic and well have passed an adequacy test. If there are any questions regarding this matter, please do not hesitate to contact me at 694-5195. Sincerely, Zi��.r� Louis Butera, P.E. ir��.�'�S -7101 3011 LAB/bjr EAGLE RIVER ENGINEERING SERVICES P. 0. Box 773294 EAGLE RIVER, ALASKA 99577 Phone 694-5195 )00 FmwC l 11 GN M 0111). JOB Lf 96 T/sN RIW Sec S SHEET NO. I OF CALCULATED BY L,,( /3 DATE %laO /fa' CHECKED BY DATE ItNT I? I? I,- r - CD O CY) CD (1) X LL o co ♦ ^ o LL V � d Q O i U z Q oo� LL ol —.0 � U a) � z o� a U /� 06 co L c E o (D U) 00 Rf L- Q- Q0 - U) Q Q U) U) U) N _0 O N cu U LO N O N r O ai cu C O N 0- x x W O O O C6 N 1 00 O LO O 0 a) U ti LO rn Q 00 m J LO U U Q� W z W z U V- LO c r - O Ly Q U) U u) N a) a) � M a) J U) rwn V O LU J W 2E U) z Y Q U) ti N (D N z W U) d w 3 U) z Y F- 0 O tf a) 0- 0 O D- c U X E O A NT N O N co O a) L) %6- 0 0 OO CL 0 -0 a 3 _Q u) 'v cA � L CCO C 7 p t co tm E �-- O Fes. a0) m O 0 L O O 0 v 0 C 'u1 N as a ` C Q a -0 E Cl)0 0 N O N Q ,N a -- � ,C N 0 -— � .V (n (nO •3 a) a .N z a N j = O O C ca a) C L CL CL Q cn Vcn m O N O X a) U iC +' C/) O L O 4-- 4+, -0 m o cn Cl? N E'a Q ' > 0 Q o O O O cn — N u) .> 0 W 0 (1) 0 U) O O o U O Q a) 41 ca U_ � v_) - O N N Q Q Q` � al w O n N � L - v L P— U Q H O U= m 0 s c aNi t a V y a Q a a N N d Q) C 00 WA z O Q O LLz QJ W z w 0 a� cB ,all C O .2- L) U (n O ca 0) a) N C_ 0 r� a� a� LL a� C� v 1 a) a) LL CO 0 U � � LO C _ a) N U) co C 3 U O W >+ N CL U C• C m ® C V C C O •C cm U O a) O UQ) fl >N Q H .0 N O a_ 0 cu = 0) +U) :3V Licm Q. 0 ❑ ❑a) O C a) a U Y IL V cnEl;C •L N cn IL0)VQ'/ U) T�T V/ L (D W I VI O -OU) W O —_ (n I- s a) ❑ O � Nc®v d�, a W o CL 0. 7 ❑M C. OO / co z o- Oa. cn o mss+ E O ❑ ❑Z ❑ Q Q C L N a w® 3 Cl) N C/) > >, ElO >, WW ~ H LL R ami N Y (1) z 0CL "+ Q O o I a W W O LL O H d = d L) j w w a) A CL a a) U)i U H H Q M O � Q > N a) O X >% th d ui c0 W O m 0 a� a� LL a� C� v 1 a) a) LL CO 0 COSA Checklist NEW.docx COSA Checklist Legal Description: T15N R1W SEC 5 LOT 86 Parcel ID: 051-081-28 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 6/2/1981 Total depth 223 ft Cased to UNKNOWN ASSUME 40’ ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 9/5/24 Static water level at beginning of test 4 ft. Well production at time of test 5 gpm Water storage tank volume None gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic 8.71 ug/L Arsenic less than MRL (ND) Collected by Date 9/5/24 Comments Static was visible at 4’ at test & well was in a small enclosure with a light bulb for heat. B. TANK DATA Measured operating fluid level in septic tank *NA Date of pumping *SEE MAINT REPORT Required maintenance completed, if AWWTS Comments: *MAINTENCE OF BIO BARRIER BY ARM C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: __________________ D. ABSORPTION FIELD DATA Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade 6.8 ft (max) Measured depth to pipe invert from grade 3.7 ft (min) N/A – pressurized field. Per record drawings, field is insulated.* Monitor tubes (MT) go to bottom of effective (ED). If not, state depth into effective *3.5’ 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) N If yes, enter date Adequacy test date 9/5/2024 Results Pass Fluid depth prior to test 21 in Water added 600 gal New fluid depth 28 in Elapsed time 90 min Final fluid depth 21 in (+ 30” ED missing) Absorption rate 600 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 72 in (MOA 6’ ED)* Effective depth used 51 in (Missing ED + Final Fluid Depth) Effective depth (ED) remaining 21 in Comments/Deficiencies: Approximate total measured depths from existing grade. *Per crib documentation & ED per elevation measurements of the bottom of crib and the cleanout invert just prior to crib with 2.5’ or 30” of ED missing – not measurable. COSA Checklist NEW.docx 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’ Yes if No *50+ ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No *50+ ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No **23 ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft 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 ***5.6 ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No *5+ ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No *50+ ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No *50+ ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS *MAY MEET CONVENTIONAL SEPARATIONS, BUT SYSTEM MEETS CATIII SEPARATION DISTANCE REQUIREMENTS. **WAIVER OSV181089 – ADU TO SEPTIC SERVICE LINE. ***Per inspection report – outside soil bearing prism. 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. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 9/19/2024 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. 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 in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. 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, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 09/19/24 BETI-fi r R WATER. BETTER DENAI,I FNVIR� ORLD. • Chugiak, A 99567 1`IMENTAL SI_TPPL y FIE r D jNj�p� Phone: 907-280-9493 -E-mail: cell 18368 Amonson Rd. BioBarrierglVl CTjON &SERVIc.1@outlook.cbm BR S REPORT ystems CE INSTALLA �... Instal lation Ad UTHORIZED SERA U -_.. CE P _ R WIDER�.._,..,�. Ot�uer Name �^ Nalilc't �f' ..__._ Mail qd_...... � caress n S �:�(rcctVct Cih ... 1 Mail Address Y � CEJ I G� (% -rStatr , Phone e-mail Fay (Phone�"ba �3 3 Fa, r1i e-mail INSTALLATION INFOR111ATInN .. -._._ _ Model No. COMPONENT BLOWER Blower Brand and Size FUNCTION Serial No. "- Date of Installation ........._ . .. .......... Z -V (93 PROCEDURE OPERATION :Open ONVer housing check to confirm that blower is running (be ;sure blower is ON and sho«s ON in the BB panel. INTAKE FILTER iRemove wtng nut from intake ;assemble on blower, remove all €debris from filter element. Put CONTROL PANEL AUDIO & VISUAL ;Place control panelinto MANUAL FUNCTION jMODE then turn the blower OFF. ;See "Manual Mode" directions in jsenue manual for proper execution of this task. REACTION BEING AERATED CHAMBER SOLIDS ' KMON AL koBarrier over system and check to be sure vigorous boiling is ocurring (unless panel indicates the system is in LTRP mode). Cheek Solids RemoN al procedure in Whe Service, Manual. Date of last pump -out RESULT . ... . . ....... .. ` Ll C&T Cjv Authentisign ID: DFFE63AA-1D75-EF11-991A-002246299C60 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 17th Day of September of 2024 _, by and between Makellie Hanofee , 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 BIO -BARRIER located at (legal description) T1 5N R1 W SEC 5 LOT 86 2. Maintenance. Repairs and Alterations. M (,Owner is required to read, understand and initial each section) Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This M includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. NOwner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Pagel of 3 Authentisign ID: DFFE63AA-1D75-EF11-991A-002246299C60 M1Owner acknowledges that the Municipality may request records of maintenance and M� repairs from the manufacturer's representative or maintenance provider. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the RAWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new MKCertificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing R guidelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 N bA W O CIS b bA 7 c ' J—, u ani U L V0 �+ F- F -i N 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/onsitef" R� � S � (907) 343-7904 ; ��I CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. O51— M 1- ,'2 g COSA# n Q 1. GENERAL INFORMATION Expiration Date: _ — "! ' O 7 Complete legal description T15N R1 W SECTION 5 LOT 86 Location (site address) 21625 SCENIC DRIVE * CHUGIAK. AK 99567 Current Property owner(s) SUZAN BOWEN Day phone 688-5351 Mailing address P.O. BOX 671103 • CHUGIAK AK 99567 Lending agency Day phone Mailing address Real Estate Agent LAVERNE PETTIGEN w/ DYNAMIC Day phone 622-7163 Mailing address 3111 'C' STREET * ANCHORAGE AK 99503 Unless otherwise requested, COSA will be held by DSD /or pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ii. Individual On-site 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 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 samples. (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 seat 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 riles and from my investigation and able Municipal ct the al on-site water supply and/or wastewater disposal system is(are) in compliance with all app P and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SURE 101 " ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily idontifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory lost results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will it confor any legal right whatsoever. 5. DSD SIGNATURE V Approved for 3 bedrooms. Phone 337-6179 Date 0 . G.. j Disapproved. Conditional approval for bedrooms, with the flowing stipulations: ON-SITE WATER AND WASTEWATER PROGRAM Attachments: COSA Checklist Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Reort Nitrate Advisory Other By: (/ �,� �� Original Certificate Date: (RW.7LOS) Municipality of Anchorage Development Services Department �J Building Safety Division On -Site Water & Wastewater Program 4700 8ragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.orglonsfte (907)343.7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: T15N. 111% SECTION 5 LOT 86 Parcel ID: 0S/ -0F/ -.Z$ A. WELL DATA Well type MNATE If A, B, or C provide PWSID# N/A Date completed 6/2/1981 Sanitary seal (Y/N) YES Total depth 223 ft. Cased to 40'+ ft. FROM WELL LOG Date of test 6/2/1981 Static water level 50 ft. Well production 5 g,p,m, WATER SAMPLE RESULTS: Coliform _0 oolonies/100 mi. Arsenic: 10.4 ugJL. B. SEPTICIHOLDING TANK DATA Nitrate N4_mg./L. Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12"+ in. AT INSPECTION 10/31/2006 52 ft. 2 g.p.m. Other bacteria 0 oolonies/100 ml. Date of sample: 6/14/2007 Collected by: GEG Ltd. *INSIDE CRAWLSPACE Tank Type/Materiai - SEPTIC/STEEL Date installed 7/11/1979 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation deanout (Y/N) "YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 8/16/2006 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA Data installed 7/11/1979 Soil rating (g•p•dJR'or t )fir 100 System type TRENCH Length 78 ft. Width 5 ft. Gravel below pipe 0.5 ft. Total depth *179-4.58& Eff. absorption area 300 to Monitoring tube YES Depression over field NO Date of adequacy test 10/31/2006 Results (Pass/Fail) PASS For 3 bade Fluid depth in absorption field before test i in. Water added 473 gal, New depth 7_5 in. Elapsed Time: 290 min. Final fluid depth 3_5 In. Absorption rate >= 450+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) TERRAUFTED If yes, give date9 30 2006 sy:;,4" w0.4 p1z., 0,4 */110/07 Il; V C) j 't i /N/n1 "S #AI "' A 1 I PLT -1-1 I L 7 L/ V L_ IL I V/Vrt_r V I L.L/I // I (EAST 11A nly•1 I TOWNSH/P 15 NORTH RANGE 1 WEST SECT/ON 5 W , �sc W . GOVERNMENT LOT 86 3 ' O L 1,, W O , 2 N 2 , M O , O XX z ' shoo ar r� 9A6• � FC;FNT) t WELL 05, SEPTIC VENT XX XX) RECORD DATA Osv THIS IS A RECERTIFICATION Ow OF AN AS -BUILT SURVEY PERFORMED IN JUNE 1989 ON (MLA JOB 89-106). neo 6rozr 9 FiPMfe Hou5e ---I}-- O- - - - - - - - - - - - - - - - - - - - - - SHGD lel lel n 50- PATENT RIGHT-OF-WAY RESERVE -rh / V ♦r% I r C) I IUJ L 7> rrL1A IA �r—A r1'rI /1r v 1 t7v L_ VI%IVMC—I vl L.vl LTJ 0 � r --------------------------- . ---------------------- ' AS—B 1TI T ••��\\ \ , has. inspectI her 01y c "edfriithetpropertyvdescrib ddasne under my aupervtaion .,c OF A p, , •- S P;.••" :�$ GOVERNMENT LOT 86, SECTION 5 1 , 0 TOWNSHIP 15 NORTH, RANGE 1 WEST 4 ,•, SEWARD MERIDIAN, ALASKA wyl•� Anchorage Recording District GARY D. KOWAL ��Bp6,-58oS:�la 0 25 50 75 100 SCALE 11CCUNhOCK LAND ASSOCIATES, JANM 11940 BUSINESS BLVD. SUITE 205 EAGLE RIVER. ALASKA 99577 (907) 694-4499 1ELD WORK DATE: 6-15-05 PARTY CHEF: OM 1RAWN DATE; 6-17-05 DRAWN BY: JC The improverxnts situated thereon are Within the property lines and do not encroach or overlap onto odjacent properties, nor do any ieprovemenls from adjacent properties encroach or overlap onto this property, except as indicated hereon. No let oalnems haft been asp. The properly dimension,plot end he $h0en are Irc01 the record approsisola erolhere�0 sslly 0s lgralneEOOnlrv1 e011 ssusilent Tthat irobhesnua locatelgnOro if Ihen era ssy aacraaclwnoc anlo 01 off Of IM lot. Dropping ono reprodwilm Idrs oo nnslhan IOirnsians-c. las this Mdrawing cls innolhOuld adequate beoratpd[jIleft.llantl essernlsiIr a IM for recordeorasuba vides ply the Iacted above a,a shown here" and Itonly Is IM nrirrlcllosspansi011lly al the boner 10 0410101100 It say other easseenls, covenants, or m exist. CIIcCIlatcca land Assaciatss. Inc. (LLA) 2005 This Oecueenl 11 cepyrighled Ind is authorised to be used to, on, net properly transaction Of Prefect Only. Any copy Is 10 04 ceaclderod unauthorized unless It boon an ori Incl sarveyar's signature lus"lll' In 111" Ina) ar a stamp $having recorder's aft co data. Copyright rostrlcil I"I (but Out royale reslrlell"s) oro "lead 11 this document has been 0111101e11y recorded. Lending Institution my alga mate bdditla dI Copies to, Iheir den records. Liability to LLA R limited to loss received for Ihlg project. FIELD BOOK: 106-22 PLOT SCALE: 1-.5W CR10: NW 1457 OWC NAME: A805-183 JOB N0: 05-183 D. LIFT STATION Date installed "Pump on" level at n. E. SEPARATION DISTANCES Size in gallons Manhole/Access�(Y/N"Pump off" leve High water alar in. Cycles tested Meets alar & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/Ilft station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water e95' Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS WAVIER G. ENGINEER'S CERTIFICATION I car* that I have determined through field inspections and fig. review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Print -d Name JEFFREY A GARNESS °q / Date COSA Fee c if y) •Uv 4. 175 K ()S H Waiver Fee $ Date of Payment Z� U % Date of Payment Receipt Number l f -15 Receipt Number (Rev. 1 V06) Municipality of Anchorage ,..�_ Development Services Department j 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 Arsenic Advisory Certificate of On -Site Systems Approval # 070227 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 86 T15N R1 W Section 5 of Subdivision. This inspection revealed an arsenic concentration of 10.4 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. • MUNICIPALITY OF ANCHORAGE�� DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section On P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# - q9 HAA# _'2Q� 1. GENERAL INFORMATION Complete legal description Lot 86 T15N R1W Section 5 Location (site address or directions) 21625 Scenic Drive, Chugiak Property owner Ralph Winterrowd Day phone 269-7000 Mailing address 6901 F- rnidor, Snita 7 Anchorages AK 99507 Lending agency NSA Day phone Mailing address Agent NSA Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well x Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site X Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rey. 1/91) From MOA 421 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Eagle River Engineering Services Phone 694-5195 Address P.O. Box 773294, Engineer's signature 6. DHHS SIGNATURE P\ Approved for Disapproved. Conditional approval for Additional Comments River, AK 99577 bedrooms. Date ii1,31%_,_ bedrooms, with the following stipulations: By: Date/W��7 SEEM 11110 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 courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7M25(Rev. 1/91) Rack MOA921 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: 407- SL 1-151-1 2/W S6G5 Parcel I.D. A. WELL DATA Well type P2/V11TAC If A, B, or C, attach ADEC letter. ADEC water system number N1A Log present (Y/N) Datecompleted06-11OZ-A) Drillers W/L.LIf}Mi Total depth 223 Casedto 7� 7 �T Casing height Sanitary seal (Y/N) Y6 Is Wires properly protected (Y/N) yE5 FROM WELL LOG AT INSPECTION Date of test U(o�0?�S'102/92 Static water level U / Q(l1T 2EL/D AQC_D Well flow 15.0 g,p.m. 2' g.p.m. Pump level UNKNOWN ON&NOW&Z SEPARATION DISTANCES FROM WELL TO: Septic/hotdh"nk on lot %DD —;On adjacent lots /UD Absorption field on lot ; On adjacent lots zoo / Public sewer main NJA Public sewer manhole/cleanout /VIA Sewer service line f %S Petroleum tank NOAIC /f?A4126N7 WATER SAMPLE RESULTS: / Coliform Nitrate D'/ L Other bacteria Date of sample: �p�2!'122Collected by: E /J6/NEE./2 B. SEPTIC/FI860ING TANK DATA Date installed X999 Tank size /000 Compartments 2 Cleanouts (Y/N) %/&�: S Foundation cleanout (Y/N) YES Depression (Y/N) I'VO High water alarm (Y/N) Alarm tested (Y/N) N1,4 Date of pumping , /off 9 2 Pumper SEPARATION DISTANCES FROM SEPTIC/HeEMG TANK TO: We] I(s) on lot zoo/ On adjacent lots t ZOO Foundation To property line t /0 Absorption field Surface water/drainage 4- Water main/service line 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y. Manufacturer Manhole/Access SEPARATION DISTANCE FROM LIFT STATION TO: Well D. ABSORPTION FIELD DATA On adjacent lots -- "Pump off' level at Cycles tested Surface water _ Date installed —J�i% Soil rating /00 System type i Length 7tf Width s � G/' r�avel thickness � Total depth � Total absorption area 3 � ��d iP Cleanouts present (Y/N) y Depression over field (Y/N) Date of adequacy test /1/0�,/2 2 -- Results (pass/fail) zQA SS for 3 Peroxide treatment (past 12 months) (Y/N) _ U.1A If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /00 ¢ —On Property line To building foundation To existing or abandoned system on lot bedrooms 7� /U v On adjacent lots x_30 ' Cutbank N //1 Water-main/service line Z10 ' WAivIC,Q Surface water 95 5 Driveway, parking/vehicle storage area /01 Curtain drain E. ENGINEER'S CERTIFICATION I certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. �en((ees'r � brR Signature Engineer's Name Date N, OFFSSIO�� ?� HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/91)Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number L;'JNICif''F.LIT1' O. P.'idCF!O.^.AGE h\I.J MUNICIPALITY OF ANCHORAGE • t Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES MW 343-4744 ECI IVES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # OSR 081 2 o HAA # �A 20, - C��(Ll 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 86 T15N R1W Sec.5 Location (address or directions) Scenic St. Chu iak (b) Property owner Ralph Winterrowd Telephone: (home) n/a Business 248-4485 Mailing Address 6311 DeBarr Rd Suite L -2B Anchorage Alaska 99504 (c) Lending Institution Mailing Address (d) Real Estate Company and Agent Address Telephone Telephone (e) Mail the HAA to the following address: (or check here ❑, if hold for pick up.) List contact person and day phone number below: nick -up by engineer 694-5195 2. TYPE OF RESIDENCE Single -Family IR Number of bedrooms 3 3. WATER SUPPLY Individual Welles Community Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site 7 Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 Move (een. 'ABU) szo-ze ' AOM s,Aaauibue leuo!ssa;oid agl ui suolss!wo ao saoaaa jo; alg!suodsai lou sl e6eaogouV;o Al!led!o!unw agl •panssi sl aleo!;!liao a aao;aq elep az/leue io suo!loadsu! lonpuoolou Op SHHa;o sea (oldw3 •sluawaa!nbai elels pug leaapal u!eliao Alsiles of aapio u! suo!lnipsu! 6u1pual a!agl pug sawog;o siasegoind of (salinoo a se s!gl saop SHHQ agl'PNsglV;o alelS agl u! p9aals!6ai Aaaul6ualeuo!ssa;o.)dluapuedepu!ue(ganoge9ydea6eiedu!uOA!6suo!leluasaadaaagluodnllluopasugpaleo!llin lenoaddV Ll!aoglnV glleaH sonss! (SHHCD sao!naaS uewnH pug g11e9H;o luawliedap abejogouV;o Alllgdlo!unw agl NOIIf1VO lenoaddV leuo!l!pgoO;o swaal leuo!i!puoO panoaddes!Q panoaddV Z_��"" alet]!q swooapaq S,ao; panoaddV 7 1VAOHddV SHHQ '9 F.P 886T 'ST '.zagwaAON alga LL566 12TV '.zaAtg aT6a8 66zELL xog 'o'd ssaappV 56T5-669 auogdalal saOtA.zaS butzaaur6ag aGAtd OT62g Wald;O aweN ,uo!loadsui s!gl;o alep agl uo loal;a ui suo!lelnbgA pue'saoueu!pio'sapoo ale1S Pug led!o!unw Ile gl!M aoue!ldwoo ui s! walsAs !esods!p aaleMalseM aoLpue Alddns aaleM ells-uo agl 'uo!loadsu! Pug uo!le61isanu! (w woe; pug sal!; a6eaogouV ;o jlled!o!unVq agl woe; paulelgo uo!;ewao;u! 9141 uo paseq legl A;!jaA aaglin; I •u!ojag paleo!pui ainlonjls;o ad (l pug swoojpaq;o jegwnu agl ao; alenbepe pug leuo!;oun; 'a;es si walsls lesods!p aaleMalseM JO/pue (lddns aaleM al!s-uo aql legl sMogs lenoaddV (l!aoglnV gileaH s!ql;ouo!le6!isanu!AwleglA;!aanl'MolaquMogsalgpuo!lgp!jenalll;o se Pug ola1agpax!;;g!gasAwAgpaippeosV NOIIVWHOdNI ONV VIVO'HOHV3S 3'lld'SIS3.L'SNOII33dSNl ONIMAOHd WHId JNI833NIEM 'S A. WELL DATA of �H alth Y OFANCHORl (H (MOA) F HEAITHI�alfh Authority Approval (HAA) i EN' NTA PROTCHIMKLIST -FEBRUARY 1984 343-4744 Legal Description: I of eLp T75/? RECOVED Well Classification 7 n la -16 If A, B, C, D.E.C. Approved (Y/N) n A Well Log Present (Y/N) _ Date Completed iR �a �� Yield Total Depth-�V 5 Cased to Depth of Grouting iL HCl_ Static Water Level 4-d Pump Set At ILI0 / / Casing Height Above Ground `% Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) To Septic/Holding Tank on Lot 001 ; On Adjoining Lots J -/0O/ To Nearest Edge of Absorption Field on Lot 100 ; On Adjoining Lots f /00 r To Nearest Public Sewer Line 11-1 az To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot 1i' X5' Water Sample Collected by Date yew/ ?y Water Sample Test Results Co/ r yo rn-, z , /1 d-rc'_L L 0' 1 M 9/& Comment: B. SEPTIC/HOLDING TANK DATA Date Installed IM Size/U �_No. of Compartments Standpipes (Y/N) �-Air-tight /Caps (Y/N) Foundation Cleanout (Y/N) Depression over Tank (Y/N) % Date Last Pumped . «W is Pumping/Maintenance Contact on File (Y/N) ) ; for C( - Holding Tank High -Water Alarm (Y/N) P -I((- Temporary Holding Tank Permit (Y/N) u - SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well i()(Ji To Building Foundation �f To Property Line + la, To Disposal Field F1 To Water Main/Service Line /01 To Stream, Pond, Lake or Major Drainage Course 00 l Comment: 72-026 (Rev. vae) From Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata /oo 4' ,,e Type of System Design fie_ d Date Installed /q 77 Length of Field RG r Width of Field 3 Depth of Field ftw a2. O Gravel Bed Thickness 6 _ Square Feet of Absortion Area 3 3 P Statndpipes Present (Y/N) Y Depression over Field (Y/N) Al Date of Last Adequacy Test /a 788 Results of Last Adequacy Test 5'Q-k�4 p?' -0! SEPARATION DISTANCE FROM ABSORPTION FIELD To Water -Supply Well — /00 To Property Line -}/o r To Building Foundation /O To Existing or Abandoned System on Lot 730 ; On Adjoining Lots ' 30' To Water Main/Service Line -/0 To Cutback (if present) "14 To Stream, Pond, Lake, or Major Drainage Course a;r//Xj To Driveway, Parking Area, or Vehicle Storage Area f/O Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access(Y/N) "Check Permitted Bedroom Rating Against HAA Request" "Pump Off" Level at Vent(Y/N) Pumping Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Company Date /�/ry F� ( Engineer's Seal MOA No.�6S Receipt No. p 'Y Receipt No Date of Payment 111f > id Amount: $ 17J. 00 Waiver Fee: $ Date of Payment 72-026 (Rm 7/66) Back Page 2 of 2 l" ICIPALITY OF ANS DEPT. OF W, MUNICIPALITY OF ANCHORAGE (mokViIGNM€NiAi HEALTH AUTHORITY APPROVAL (HAA) 11 26 1985 CHECKLIST - FEBRUARY 1984 264-4720 {nom E V Legal Description: Sem A. WELL DATA v. Well Classification Pr' I'q �-C If A, B, C, D.E.C. Approved (Y/N) NIA Well Log Present (Y/N) !z Date Completed GL`e�&'� Yield Total Depth a 3 Cased to iZ + Depth of Grouting 4114 Static Water Level f 3 r AAI„ `" ! Pump Set At Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: l To Septic/Holding Tank on Lot Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) On Adjoining Lots -I,- To Nearest Edge of Absorption Field on Lot �; On Adjoining Lots �� o To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole 419 e_ To Nearest Sewer Service Line on Lot a 5 t Water Sample Collected by J'nsi^e er Date Water Sample Test Results Sa f'r FG -4, Comments B. SEPTIC/HOLDING TANK DATA Date Installed 7� 7 S Size 1pyD G" / No. of Compartments 'Z Standpipes (Y/N) y C`e) Air -tight Caps (Y/N) Foundation Cleanout (Y/N) Al Depression over Tank (Y/N) y Date Last Pumped 8� /Z8S' Pumping/Maintenance Contract on File (Y/N) ; for _L//4 Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) 1V14 Separation Distances from Septic/Holding Tank: To Water -Supply Well joe lU To Property Line To Building Foundation To Disposal Field 'k/ To To Water Main/Service Line /U * To Stream, Pond, Lake, or Major Drainage Course 400 4e *,f, Creep Comments Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Type of System Design Date Installed —,/ 2 7'i Length of Field i Width of Field 5 Depth of Field a / Gravel Bed Thickness G Square Feet of Absorption Area �9� Standpipes Present (Y/N) Yo 6e 1hr✓r,11,W Depression over Field (Y/N) !1J %>, Foy( e,. j Date of Last Adequacy Test i9 �; 2 a i9dl Results of Last Adequacy Test -S• f•stje��.,., Separation Distance from Absorption Field: J To Water -Supply Well Zoe To Property Line To Building Foundation i To Existing or Abandoned System on Lot %)d On Adjoining Lots 3"-1- To Water Main/Service Line To Cutbank (if present) llt4p e_ To Stream/Pond/Lake/or Major Drainage Course ZUv / % /e To Driveway, Parking Area, or Vehicle Storage Area 7 - Comments D. LIFT STATION N� Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access(Y/N) 'Pump Off' Level at Vent(Y/N) Pumping Cycles during Adequacy Test, Meets MOA '" Check Permitted Bedroom Rating Against HAA Request " I certify that I havvee chheecke_d,,verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. SignedY �z'��26 Date SV •7 �/f s' Company z MOA No. _ST- r a 6S - Receipt No.aw/�l OF Date of Payment ao ' �� s� Amount: $ Uri) Engineer's Seal 01 ��,9nn.la navequ EausEav'f.a�a6v-�a• Page 2 of 2 72-026 111/841 fnUls A. Rurf,p•'V - - °? 6Y -6 - MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 8/21/85 1. GENERAL INFORMATION - (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name ' anna Knhl Pr Telephone: Home 688-3099 Business 688-3999 Applicant Address P n Rnx 269 (hugi ak Alaska 99567 (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ❑ ; Buyer❑:; Other (explain); (d) Lending Institution r;+j Mnrt,gage Telephone 694-3504 Address -i3'2 Ricar� Alaska�,77 (e) Real Estate Company and Agent M2Tiq.nna Knhl er Address p D $fix 7FG Chllaiak Alaska A��67 Telephone SRRAgG (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single -Family ® Multi -Family ❑ Other Number of Bedrooms 3 3. WATER SUPPLY Individual Welles Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite,a Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 01;04) Page 1 of 2 - FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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 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. Name of Firm Geri a #W fn Et(a EEauv.Ga�flVICi G -- Telephone F�an¢ Address EAGLE RIVER, AK 99577 Date ��a) � S- QnA RIA, Q 0. ®OX 773294 'two water samples taken were unsatisfactory after chlorine treat- ment of the well the 3rd periodic check samples of sample was satisfactory. I would suggest in the future. A.. Bu:era ' o ta Sb! 6. DHEP APPROVA Approved for bedrooms byxeate Approved Disapproved Conditiona Terms of Conditional Approval CAUTION Engineer's Seal 7® The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2