HomeMy WebLinkAboutTERI #2 TR D3Teri
Tract
050- 75 !
-43
Wasilla, AK 99654
(907)376-2041
Name:
Shane & Kristina Brown
Address:
3821 Harca St
City:
Eagle River State:
AK Zip Code: 99577
Well Site:
Teri #2 Tr D3
tot/Block:
Additional:
Well Depth:
121 ft.
From:
To: Formation:
0
23 sand/gravel/silt
Below Ground:
119 ft.
23
57 silt/gravel/cobble
Above Ground:
2 ft.
57
62 damp silty gravel
Gal/Min:
15
62
72 dry grave/silt
72
77 wet silt/gravel
Static Level:
84,
77
81 gravel/water
81
86 damp silt/gravel
Casing:
121ft. of 6 in. x .25 in. steel
86
87 gravel/water silty87
90 damp silt/gravel
Liner Pipe:
N/A
90
113 damp silt/cobble
113
121 gravel/water
Screened:
N/A
Perforated:
N/A
Grouted:
Yes
Depth:
N/A
f WATER QUALITY TESTING
I Coliform _-IU.1)_____ CoV100ML
Develop. Method:
Air
?Nitrates . 6a
Arsenic _ -31
Use of Well:
Residential
Drilling Method:
Rotary
Misc:
Other:
Chlorinated
The well was pumped 5' off the bottom with 100% draw down for 2 hours and recovered at 15 .
Date Drilled:
5/21/2020 Driller: Ben Mattson
(907) ••
r • IInstallation• 1;
Well Drilling Permit Number: SW OSP201124 Date of Issue: 05/19/2020
Parcel Identification Number: 050-751-43-000
Legal Description Property Owner Name & Address:
Teri #2 Tract D3 Shane Brown
3831 Harca St
Eagle River, AK 99577
I Pump Installation Date: 05/24/2020
Pump Intake Depth Below Top of Well Casing: 115 feet
Pump Manufacturer's Name: Meyers
Pump Model: 3NFL72-12-P4-01
Pump Size 3/4 hp
Pitless Adapter Burial Depth: 8'6" feet
Pitless Adapter Manufacturer's Name: Campbell
I Pitless Adapter Installer: unknown
IWell Disinfected Upon Completion? ✓❑ Yes ❑ No
Method of Disinfection: chlorine
I Comments:
Pump Installer Name: Wheaton Water Well, Inc.
1190 N. Wasilla-Fishhook Road
Wasilla, AK 99654
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
Development Services Department
Building Safety Division
GE BV
On -Site Water & Wastewater Program <a
4700 Elmore Road z
P.O. Box 196650
Mark Begich
Anchorage, AK 99507 s r E T Y
Mayor
www.muni.org/onsite
(907) ••
r • IInstallation• 1;
Well Drilling Permit Number: SW OSP201124 Date of Issue: 05/19/2020
Parcel Identification Number: 050-751-43-000
Legal Description Property Owner Name & Address:
Teri #2 Tract D3 Shane Brown
3831 Harca St
Eagle River, AK 99577
I Pump Installation Date: 05/24/2020
Pump Intake Depth Below Top of Well Casing: 115 feet
Pump Manufacturer's Name: Meyers
Pump Model: 3NFL72-12-P4-01
Pump Size 3/4 hp
Pitless Adapter Burial Depth: 8'6" feet
Pitless Adapter Manufacturer's Name: Campbell
I Pitless Adapter Installer: unknown
IWell Disinfected Upon Completion? ✓❑ Yes ❑ No
Method of Disinfection: chlorine
I Comments:
Pump Installer Name: Wheaton Water Well, Inc.
1190 N. Wasilla-Fishhook Road
Wasilla, AK 99654
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT s ''d 907-343-7904
On -Site Water and Wastewater Section Fax: 343-7997
www.muni.org/onsite
Well Decommissioning Lo
Legal Address:
Subdivision Teri #2 Block Lot D3
-i- 14N R 1E Section 33 Lot na.t D3
On-site Water & Wastewater Section certified contractor performing the well decommissloni
Name:
Brian Wille Signature:
Company:
Wheaton Water Well, Inc.
Well decommissioning date 05/20/2020 Method of decommissioning: AMC 15.55.0601-1 a. ❑ b. ❑ C. 3
Location: Use the space below to provide a drawing of the property showing the following items:
• North arrow
• Decommissioned well location
• Location of other water wells on the property
Two separate swing -tie distances for each well shown on the drawing
Note: The swing -tie distances shall be measured from either permanent structures or the property corners.
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MUNICIPALITY OF ANCHORAGE
n,enc
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
{t� I-6650 Phone: (907) 343-7904 Fax: (907) 343-7997Anchoraee, Alaska 99519
http://www.muni.org/onsite
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On -Site Water System Permit
Permit Number: OSP201124 Effective Date:
5/19/2020
Work Type: Well Upgrade Expiration Date:
5/19/2021
Tax Code Number:
Site Legal Address: TERI #2 TR D3 G:0704
Site Mailing Address: 3831 HARCA ST, Eagle River
Owner: BROWN SHANE E & KRISTINA L Lot Size in Sq Ft: 88363
Design Engineer: Total Bedrooms:
4
This permit is for the construction of:
❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy I] Private Well
❑ 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
Special Provisions:
The existing well is not allowed to be subsurface (pit well). If it is not decommissioned, it must be brought
above grade and protected with bollards or similar.
To close this permit please submit:
1. Well Log
2. Pump Install Log
3. Water sample results
4. Well Decommissioning Log
Received By: �� c�yL( �/lGt Date: 5 Z C�
issued By: �,(J Date: �� 0
Development Services Department \ rl Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. C50 -- r1,`� ( ` `T
Property owner(s)(� hay _' .? kr) e,' 17 h>j 6 1���� yl Day phone b114 -ob IJ Z
Mailing address �3 X 3 J I Likk 22 S j2i✓C
Site address 39'31 J--OJ1fGL
Legal description (Sub'd., Block & Lot) (�,e � ; -k Z T kac;i D�
Legal description (Township, Range & Section)
Lot Size ?8.3( 3 Sq. Ft. Number of Bedrooms
APPLICATION IS FOR: APPLICATION IS AN:
TYPE OF DWELLING:
(Z all that apply)
Absorption Field ❑ Initial ❑
Single Family (SF)
(w/wo ADU)
Septic Tank ElUpgrade
Duplex (D)
❑
Holding Tank ElRenewal ❑
Multiple Dwellings
❑
Privy ❑
(SF and/or D)
Private Well �]
Water Storage ❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that
this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
0
Permit/Rush Fees: Z? Waiver Fees:
Date of Payment: /1 '117- 0 2- 0 Date of Payment:
Receipt Number: ZS ( 3)r,?— Receipt Number:
Permit No. S �20 0 Z� Waiver No.
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ANCHORikGr RECORDING DISTRICT
.ASBLI!3'OF:
TERI SUBDIVISION, ADD. 2
S /J- 9 0 W
Municipality of Anchorage
Development Services Department
Building Safety Division ~
On-Site Water and Wastewater Program, 4700 S. Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page of
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: OSP101185 PID Number: 050-751-43
Name:
.IAMF,~ D. ,~MITH Wastewater System: [] New [] Upgrade
Address:
3831 HARCA ST.. EAGLE RIVER. AK 09577 ABSORPTION FIELD
Phone: Number of Bedrooms:
4 [] Deep Trench i-I Shallow Trench [] Bed [] Mound [] Other: ADVANTEX
LEGAL DESCRIPTION Soil Rating: Total Depth from original grade:
2.0 GPD/Ft2 10 Ft.
Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe:
TRACT D 3 TERI #2 4 Ft. 6.0
Township: Range: Section: Fill added above original grade: Gravel Length:
2.49 - 3.2 Ft. 35 Ft.
Well: [] New [] Upgrade Grave~ width: Number of lines: Distance between lines:
3 Ft. 1 -- Ft.
Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material:
Private-Existing Ft. Ft. 420 Ft2 D3034
Driller: Date Drilled: Static Water Level: Installer: Date Installed:
Ft. A+ 10/18/2010
Yield: GPM Pump Set at: Ft. Casing Height Above Ground:
Ft. TANK
SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other:
T~ To Septic Absorption Lift Holding ~ublic/Private Manufacturer: Capacity:
Tank Field Station Tank Sewer Line Anchorage Tank 1500 GaL
Material: Number of Compartments:
we, 100'+ 100'+ 100'+ NA 25'+
Steel 2
k .
Surface Water 100'+ 100'+ 100'+ NA ~ / LIFT STATION
Lot Line 5t't- * 2'+ 5'+ NA/~ Size: Manufacturer:
1500 Gal. Orenco - Anchorage Tank
Foundation 5*+ 10*-F 5'+ NA "Pump on" level at: "Pump off' level at: in. High water alarm at:
TIMER in. ACTIVATED 46" in.
Curtain Drain NA ** 50'+ NA NA Pump Make & Model Electrical Inspections performed by:
Franklin 2445040 l17-1/2hp MOA
Remarks:
· WR#OSP101186 **None known. Previously existing BENCH MARK
Location and Description:
septic tank was removed and decommissioned per UPC. Back door sill
Assumed Elevation:
100 Pt.
Engineer's Stamp
~, ~./ "~t~
Inspections performed by: ArcTerra Dates: 1st 10/18/2010 ~ ..*;/4 0 ~. :~.__..~..~ __~.~
2® 10/18/2010
Development Services Department Approval ~~.,s,/~
,//,/ ' ' ' ~"'" ~ ~"~
,.~v. ,:/Go>Reviewed and approved by: ./,,--'--"-" -_--/' //'-/. )-/~C~ Date:/0-2 7-/O
AS-BUILT SYSTEM DETAILS/SITE PLAN Permit OSPlOl185
TERI fi2 TRACT D3 PID~ 050-751-43
~ 4.2'
~ ~ _~ SCALE~ 1'
~^-c=s5,o' ~
~B-C-17,5 '
~, A-D=31,O FIN^L GRADE
~B-D=30,5' = ' ' I
~A- E = 57,5' ~ ..~ ~ ~ w~
I
~ i SEWER R~CK
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~ ~. ./~....~ ~ND~BOUNDARY ~': BMW
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~~~ ,~ mm: FILE ~ No.: 10-160 · AK. 99577
I
' 1500 GAL ~ . -~-
/
18/26/2018 10: 4i 9078683793
OCT-8?-80J. 0 ¢~¢~:~0 From:
PAGE 02/02
Permit Number:
Tax Code Number:
Work Type:
On-Site Wastewater Disposal System
OSP101185
05075143000
Septic
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
Upgrade
Permit Effective Dates: September 17, 2010 to September 17, 2011
Design Engineer: ARC TERRA CONSULTING INC
Subdivision: TERI #2
Site Legal Address: TERI #2 TR D3 G:0704
Owner/Address: SMITH JAMES D
PO BOX 36 LENGBY MN 566510036
Permit
Site Mailing Address: 3831 HARCA ST, Eagle River
Lot Size in Sq Ft: 88363
Total Bedrooms: 4
This permit is for the construction of:
Y Disposal Field Y SepticTank 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.
Special Provisions: The trench must maintain 7' separation from sonatubes. The asbuilt is to
show sonatube location.
Received By:. Date:
Issued By:
Date:
Municipality of Anchorage
P.O. Box 196650 · 4700 Elmore Road
Anchorage, Alaska 99519-6650 · (907) 343-7904 · Fax (907) 343-7997
http:l/www.muni.or,q/Onsite
Development Services Department
On-Site Water and Wastewater Pro.qram
VARIANCE/WAIVER REVIEW
Waiver/C: OSP101186 COSA#:
PID#: 050-751-43
Legal Description: Teri #2 Tract D3
Engineer: ArcTerra
Permit: OSP101185
Applicant: James D. Smith
Your request for a waiver of the required 10 feet horizontal separation from the absorption field
to the property line has been approved. The approved separation distance is 2.0 feet. A waiver
from an excessive slope is approved to 35 feet. A third waiver is approved to allow the field to
be 7 feet to the deck sonotube.
This waiver approval applies to the proposed 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.
Waiver is Granted: X
Waiver is not Granted:
Name of Reviewer
Rec~: 04565C Amount: ,$200.00 Date Paid: 913110
**** VARIANCE/WAIVER REVIEW ****
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
vvww.muni.org/onsite
(907) 343-7904
ON-SITE SEVVER/VVELL PERMIT APPLICATION
v,,.,'.,..- Of PlOIl 6 FORA SINGLE FAMILY DVVELLING
Parcel I.D. 050-751-43
Property owner(s). JAMES D. SMITH
Mailing address PO BOX 36 LENGBY, MN
Site address 3831 HARCA STREET, EAGLE RIVER
Legal description (Sub'd., Block & Lot) TERI #/TRACT D3
Legal description (Township, Range & Section)
Lot Size 88,363 Sq. Ft.
Day phone
Zip Code 56651
Zip Code 99577
Number of Bedrooms 4
THIS APPLICATION IS FOR ([~ all that apply):
Absorption Field []
Septic Tank []
Holding Tank []
Privy []
Private Well []
Water Storage []
THIS APPLICATION IS AN:
Initial []
Upgrade []
Renewal []
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
ARCTERRA
(Signature of property owner or authorized agent)
Permit/Rush Fees:
Date of Payment:
Receipt Number:
(Rev. 11/05)
Waiver Fees:
Date of Payment:
Receipt Number:
September 3, 2010
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Septic Upgrade & Waivers - Teri Subdivision #2, Tract D3
The owner has requested we proceed forward to obtain a septic permit to
upgrade and replace the existing septic system for the subject lot. Due to the
limited area for the proposed upgrade and existing characteristics of the lot, a lot
line waiver to 2' of property line is requested along with waivers to slopes in
excess of 25%. Please see attached profile slope drawing per MOA April 7, 2004
Slope Setback Memo.
On August 27, 2010 a testhole was performed for the proposed system. The
results of this test are attached. The portion of this lot where the septic upgrade is
to be installed has slopes of 0-1% with slopes in excess of 25% along the western
portion of the property.
We have designed our system utilizing the testhole we excavated for the 4-
bedroom house. The lot is served by an individual well located in the central
portion of the lot. We propose to install a 2' wide deep trench with an Advantex
Treatment System. Water was not encountered during the excavation or
monitoring.
There are no public or private wells within 200' of our proposed system location
except as noted. There is no surface water within 100' of the proposed system
and there are no known curtain drains within 50'. We do not expect there to be
any adverse effect on adjacent lots by the development of this system.
September 3, 2010
Teri #2, Tract D3
Page 2 of 2
If you have any questions, please contact me at 868-3792/FAX 868-3793.
Respectfully submitted,
ArcTerra Consulting, Inc.
Attachments:
On-Site Sewer Application
Wastewater Absorption System Details/Site Plan
Soils Log/Percolation Test
Owner/Contractor Specs
20441 PTARMIGAN BLVD · EAGLE RIVER, AK 99577-8736 · PH (907) 868-3791 · FAX (907) 868-3793
:'~- ~ .~,~.~r .~ 212E. SlStAve, Anchorage,AK-99503
""~';;~,°°~"2k~,,, ; X~?~,flOffice'~;° ,"~ -- (907)868-3791, Fax (907)868-3793
September 14, 2010
Deb Wockenfuss
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Teri Subdivision Add. No. 2 Tract D-3 - Foundation Separation
Per your permit review, we are requesting along with the slope and lot-line
waivers that a ?'waiver to foundation (sono tube) be granted at this time.
Construction of the absorption field in the consolidated GM silty soils would
have no direct impact upon the sono tubes of the covered deck. The absorption
system will be over 10' from the main house foundation.
Due to the limited septic upgrade area, the submitted design is attended to
maximize the available area. The minimum required length with 6' of effective is
25'. As noted on the design, the designed length is notably longer.
If you have any questions, please contact me at 868-3792 / FAX 868-3793.
Respectfully submitted,
ArcTerra Consulting, Inc.
/ELL a WASTEWATER DISPOSAL SYSTEM gETAILS/SITE PLAN
TERI SUBD, ADD NO,2, TRACT D-3
NO PUBLIC WELLS WITHIN ~00' OF
PROPOSED SYSTEM,
NO PRIVATE WELLS WITHIN ~00' OF
PROPOSEB SYSTEM EXCEPT AS NDTEB.
ND SEPTIC SYSTEMS WITHIN ~00' OF
PROPOSED WELL EXCEPT AS NOTED.
Scc[e~ 1"= 100'
PAGE 1 OF 4
i' I
COUPUIED:
DR^W.: BMW
C~EC~D= KMD
D^TF.: 9/3/10
SD: SE704
~ .o..' 10--160
^c~ eta FILE
A~ILT: SCHULLER
ST,~Ne STAKING
FIELD BOOKS
SOUND^RY= BOUNDARY
PREPARED FOR:
JAMES D SMITH
PO BOX 36
LENGBY, MN 56651
907-242-5494
DESIGN DETAILS
4 BORN X 150 GPO = 800 GPO
6>00 GPO/2 GPO PER SQ. FT, (ADVANTEX SYSTEM)= 300 SQ, FT
(300 SF / ;2 x 8' GRAVEL) = ;25 FT, TRENCH
USE i TRENCH - 40' (L) X ;2' (6/) X 6.O'(D)
To~aL dep-th o? system is 10' max ?rom original grade,
Total depth o? gravel below dis~cribu~ion pipe is 6,0' ,
NOTES:
CONTRACTOR TO A3ANDON EXISTING SEPTIC TANK AND
DRAIN FIELD,
INSULATE TRENCHES 6/ITH ;2' HI) BURIAL FOAM,
3, CONTRACTOR 6/ILL ENSURE MAXIMUM ;27. SLOPE INTO SEPTIC TANK,
4, ADDITIONAL FILL 6/ILL BE ADDED OVER SYSTEM TO ACH[EVE
MIN, 3' COVER IF REQUIRED.
5. CONTRACTOR 6/ILL ENSURE ALL SEPARATIONS TO ADJACENT
6/ELLS & SEPTICS, EASEMENTS, & OTHER SETBACK REQUIREMENTS.
WASTEWaTER DISPBSAL SYSTEM SETAILS
TERI SUBD, ADD NB,2, TRACT D-3
PREPARED FDR:
JAMES D SMITH
PO BDX 36
LENGBY, NN 56651
907-842-5494
FIELD BOOKS ~Pu~:
e~ND~Y: BOUNDARY ~^~= BMW
~Nm STAKING ~E~: KMD
~ILT: SCHULLER
^c~ e~ FILE
9/.3/10
SE704
No.: 10--160
SccLe: 1#: 30'
PAGE 8 OF 4
AdvanTex Treatment System
AX 20 Seri~s - Mode la
Inlet Riser/Lid
2" Dia. Vent
AdvanTex
90'~
inlet ~p~-'~~ LAdvanTex Filter
Top View
Filtrate Return Line
z~--Discharge Filtrate
~--Min. 23" Dia.
Tank Opening
30" Dia. Riser/Lid
Side View
Biotube® Pump
Package
Discharge Filtrate
nRENCE] PACKAGE SYSTEM:
1/8"/ft.)
LI
End View
1, INSTALL 1500 GAL SEPTIC TANK ~// INTEGRATE]] ADVANTEX SYSTEM-
BR TANK WILL BE SIZED PER ANCHFIRAGE TANK FFIR A 4 BDRM RESIDENCE,
2, INSULATE TANK, EXCEPT BELOW ADVANTEX PADS TFI ALLBW HEAT TRANSFER,
3, NB AIR LINE REQUIRED,
PREPARED FOR:
JAMES ]]SMITH
PD DBX 36
LENGBY, MN 56651
907-848-5494
FIELD BOOKS
80UND^RY: BOUNDARY
STAK,NO: STAKING
^S~U~LT: SCHULLER
D~. RLE:
^CAD ~t~: FILE
~Server~Storage~WELL & SEPTIC - Filed By Legal~Teri Subdivision~Tract D-3~dwg¥OO44As-B.dw,
Recirculating
Splitter. .
Valve (RSV) with
Quick Disconnect
ScaLe: NTS
PAGE 3 DF 4
WASTEWATER DISP~ISAL TRENCH DETAILS
TERI SUB]D, ADD NO,2, TRACT I)-3
CLEAN DUT
-4' MONITDRING 4' MONITORING~
TUBE TUBE
FROM SEPTIC ~ ·~_ ~o~
TANK ' ~ 4' PERFORATED DISTRIBUTIDN LINE
40'
PLAN VIEW DEEP TRENCH DETAILS
SCALE, NTS
TRENCH SECTION ~. ~...~__ ~:~:,: .........
~= ~
,
NDTE~ BDTTDH DF SEWER DRAINRDCK ~uS ~:~ 6,0' s[~[~ ~OCK
MUST BE 4+ FEET ABDVE R~
GRaUNDVATER AND ~+ FEET ABOVE R~
~EDRQCK. ~ ~ :~
~: X~ SCALE~ NTS
2.0'
' 35.0' -
PROFILE SECTION
~~~ PAGE 4 DF 4
~_ SCALE: 1 "= 1 O'
PO BOX 36
,oo s
~~~ ~: SE70~
~\Server\Storage\WELL & SEPTIC - Filed by Legal\Terl subdivlslon~Trac{ D-3\dwg\10044As-B.dwg
: ~ st
:..~. ~ .~,~..~ ~?,~ 212 E. 51 Ave, Anchorage, AK. 99503
'--6~%~, *~:~¢~ Office (907) S68-3791, Fax (907) 868-3793
Performed for: Don Smith
SOILS PERCOLATION TEST
Date Performed:
0s/25/20~0
Project:
Depth
Teri S/D #2 Tract D3
ORG/OL
TEST HOLE # TH 10-1
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
3-
4-
5-
6-
7-
8-
9-
10-
11-
12-
13-
14-
15-
16-
17-
18-
19-
20-
GM w/boulders to 2'
B.O.H.
HOLE PRESOAKED
PRIOR TO TESTING
Was Ground water encountered? NO What depth? NA
Depth to water after monitoring? DRY Date? 9/3/10
Reading Date Gross Net Depth to Net
Time Time Water Drop
1 8/27/10 1:00 - 6,, _
2 1:30 30 min 4 8/16" 1 8/16"
3 * 1:30 - 6"
4 2:00 30 min 4 8/16" 1 8/16"
5 * 2:00 6"
6 2:30 30 min 4 9/16" 1 7/16"
7
8
9
10
11
12
· Water Added
Percolation Rate 21 (min/in) Perc Hole Diameter 6"
Test Run Between 4.5 feet and 5.5 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State
and Municipal guidelines in effect on this date.
ANCHORAGE AREA BO"" SH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDF LENGTFI
_ MANUFACTURER/,'~27]'-¢ )¢?~¢('E¢',1¢
NUMBER OF
. MATERIAL("~C:rI(/?~(~ ¢~/~¢/~, COMPARTMENTS
~'; ~ __ INSIDE WIDTH~.~'; ~ __LIQUID DEPTH ~--- LIQUID CAPACITY // (~ ~)'-~ GALLONS.
SEEPAGE PIT:
NUMBER OF PITS
ADDITIONAL ABSORPTION
DIAMETER_ OR WIDTH ]~-; LENGTH 1'_'~', DEPTFI
CRiB SIZE: DIAMETER DEPTH~CZ__ DISTANCE FROM: WELL
· ~ TOTAL EFFECTIVE
., NEAREST LOT LINE ~,O . ABSORPTION AREA (WALL AREA) '~ ~
_SQ. FT.
WELL.:
TYPE
CONSTRUCTION DEPTH
DISTANCE FROM:
BUILDING
FOUNOATION _
NEAREST NF-AREST SEPTIC
LOT LINE SEWER LINE TANK
SEEPAGE
SYSTEM
CESSPOOL _, OTHER SOURCES
APPROVED __ DISAPPROVED__
· REMARKS
DISTANCES:
INSTALLED BY: (~/'~'X]~?/~-~(~'
LOT SI_OPE:
Form NO, EQ-031
DIAGRAM OF SYSTEM
~'Oc{ W da TIOkI
GREATER ANCHORAGE AREA BOROUGH
PERM I T
825 ¢' ¢-;TREET, ANCHORFIGE, FIK. DF t.
141r.:':~ I_ b. F"IE fr~.'l""l :E "~"
( ;:'00:,~57 )
fIPPL I CRl'4'f'
L. OCRT l ON
IIFIRVEY PUL.LEN
I IRRCR STREET
PO BO)( 96:1.
LOT SIZE
694 '20~.~0
%OURP. E FEET
MINIMUI'I DiS'I'RNCE BETI4EEN R NELL RND RNY ON'-SITL" SENRGE I)ISPO2;RL SYSTEM IS;,
~.00 I-EET FOR R PRIVRTE 14ELL¢ OR
ft. 50 TO 288 FEIi;T FROM R PUBLIC: WELL DEPENDING UPON THE TYPE OF PUI~LIC 14ELL.
~4ELL. LOGS; RRE REL;4UIP, ED RND MUST BE I;~ETURNED TO THE DEPRI~TMENT 14ITl liN ]~0 DRYS
THE 14ELI. COMPLETION,
o"rIIER RIZ~]L.IIREMENTS MRY RPPL,Y. SPECIFICRTIONS RND CON~;TRUCTION DII-IGRFIMS fIRE
I'/YRILFIBLE 1'0 INSURE PROF'ER INS;TKILLRTION,
2'.
& L DRILLING COMPANY
BOX 97, EAGLE RIVER, ALASKA 99577 · TELEPHONE6f14-2588
OWNER OF LAND
ADDRESS /)a
LEGAL I)ESCRII'TION~_
DATE - Started
PERMIT NUMBER
DEP'FIt OF WELL / -/,5' r-~)-,
STA'rlC LEVEL OF WATER F'F.
DRAW DOWN FT. -~ 7)
GALS. PER ltR .~ o
KIND OF CASING ~ ~ ~9 ~)
/ /d?
KIND OF FORMATION:
Fromm? ' ·
Ft. to- '-) Ft.
From -~ ' Ft. to .'~ ~ Ft.
From ,( ,',-~Ft. to_ l, if_Ft. ~z~j.~6o~?~4,x ,f Ih'om
From /,.i~Ft, to_ / 6?~'Ft.. _~7 d ~Y i' ~qS?t~4~k, XI ~iom
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MISCL INFORMATION:
DRILLER'S NAME '
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
vvww.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 050-751-43
COSA # f--" / (;/Z (¢ 7
ExpirationDate: /'- -- ¢,~ '~-- //
GENERAL INFORMATION
Complete legal description TERI #2 TRACT D3
Location (site address) 3831 HARCA ST., EAGLE RIVER, AK 99577
Gurrent Property owner(s) TAMES D. SMITH
Mailing address PO BOX 36 LENGBY, MN 56651-0036
Lending agency
Mailing address
Real Estate Agent
Mailing Address
Un/ess otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
Day phone
TYPE OF WATER sUPPLY:
Individual Well',
Individual Water Storage
Community Class ~ Well
Public Water System
Day phone
Day phone
TYPE OF WASTEWATER DISPOSAL:
[] Individual On-site []
[] Individual Holding Tank []
[] Community On-site []
[] Public Sewer []
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm ARCTERRA CONSULTING, INC. Phone 868-3792
Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577
Engineer's Printed Name KENNETH M. DUFFLTS Date 10/2~/2010
Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The
assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow
and absorptiOn rates may change due to subsurface conditions that may not be observed from the surface,
changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the
water usage of the family being served by the system. The operational life of all well and septic systems are
subject to these various and dynamic characteristics and are outside the control of the
evaluator of the well and septic system. Therefore,
ArcTerra can not give any estimate of how long a
system will function satisfactory for current or future
occupants or can ArcTerra guarantee that no unseen
encroachments, deficiencies or discrepancies exist.
DSD SIGNATURE
~'"'~'~ Approved for
Disapproved.
bedrooms.
Conditional approval for
bedrooms, with the following stipulations:
~.: ON-SITE
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
X
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
(Rev. 11/05) ~C~
Original Certificate Date:
Municipality of Anchorage
Development Services. Departme nt
Building Safety Division
On-Site Water & Wa~tewater Program
4700 Bragaw Street
P.O. BOX 196650
Anchorage, AK 99519-6650
www. muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal' Description: TERI #2 TRACT D3
Parcel ID:
A. WELk .DATA
Total depth 173 ft.
(Y/N)_Y
Cased to 173 .ff.
FROM WELL LOG
173
Date of test
Static water level 112
Well production 14
WATER SAMPLE RESULTS:
Coliform NE(; colonies/100mL Nitrate
Amenic: ND .mg/I Date of sample: 10/0~/201_0
g.p.m.
Casing height (above ground) 12+ in.
AT INSPECTION
67 ff.
~93+ g.p.m.
C=
*'15.2 mg/L
Collected by:. ArcTerta
Tank Type/MateriaI. S~St-eel Date installed 10,//8/2010 Tank size 1500 gal.
Number of Compartments _2 Cleanouts (Y/N) _ Foundation cleanOut (Y/N),Y_ Depression over tank (Y/N) __N
High water alarm (Y/N) ¥ Date of pumping .NA - New Tank Pum per
ABSORPTION ,FIELD DATA
Date installed 10//8/20~0 Soil rating (g.p.d./ft2 or ft2/bdrm) 2.0 System type A(hra~tex-Deep Trench
Length 35 ff. · Width --3 ff. ". Gravel below pipe 6__ft. Total depth 12.49 ff. (Measured 10/22/10)
Eft. absorption area 420 ft2 Monitoring tube Y
Date of adequacy test NA - New System
Fluid depth in absorption'field before test -_ in.
Depression over field N
Results (Pass/Fail) Pass For 4 bedrooms
Water added - gal. New depth - in.
Elapsed Time: -- min. Final,,fluid depth - . in. Absorption rate >= _- g,p.d.
Any. rejuvenation treatment '(past 12 mo.) (Y/N & type) -__ff yes, give date
D. LIFT STATION
Date installed 10/18~0 Size in gallons 1500 Manhole/Access (Y/N)Y
"Pump on" level at Timer Activated in. "Pump ofF' level at Timer Act. in. High water alarm level at 46in.
Datum Bottom of Tank Cycles tested 2__ Meets alarm & cimuit requirements? Y
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on.lot 100'+
Absorption field on lot :tOO'+
Public sewer main 75"+
Sewer/septic ~rVice. line 25%
Animal containment areas 50'+
On adjacent lots 100'+
On adjacent lots 100'+
Public seWer manhole/cleanout ,,, 100'+
Holding tank.,
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 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
F=
SEPARATION DISTANCE FROMABSORPTION FIELD ON LOT TO:
Property line 2% WV#OSP101186 Building foundation
Water Service line 10'+ Surface water 100'+
Curtain drain 50'+ {None Known)
COMMENTS
10'+
Water main 10'+
Driveway, parking/vehicle storage 10'+
Wells on adjacent lots 100'+
*MOA well records don, t seem to raz~eh what was shown on the well ca? ~h~ was replaeed wi~h a
seal (9-30-86, 67' SLW,~80' Casing~ 75' pwmp & 10 GPM). Point of Use RO system i~nlled in kitchen_
**Cas'rog vei-i~led - see atlached AAROW letter.
G. ENGINEER'S CERTIFICATIO'N
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name KENNETH M. DUFFUS
Date 10/25/2010
COSA Fee $250.00
Date of Payment /
Receipt Number O
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
Nitrate Advisory
Certificate of On-Site Systems Approval # 101267
A Certificate of On-Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block , Lot
of Teri#2 Tract D3 subdivision. This inspection revealed a nitrate
concentration of 15.2 milligrams per liter (mg/L) was reported for the
property's well water sample. The Environmental Protection Agency (EPA)
has established a maximum contaminant level (MCL) of 10.0 mg/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.
Please see the attached "Nitrate Fact Sheet" for important information
regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On-
Site Systems Approval.
Aarow Pump & Well Service LLC
(907)346-9355
Inspection Report
3831 Harca St.
Camera well to 50'. No entrance of surface water was found, no perforations of any kind. Well is
on a slope and we couldn't see any evidence of surface water going around the outside of casing.
Brian R. Wille
Aarow Pump & Well Service
LOT
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DECK/
CARPORT
GRAVEL
D/W
WELL
ENTRy
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CARPORT
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TRACT D-3
ENTRy
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ANCHORAGE RECORDING DISTRICT
ASBUILT OF:
TERI SUBDIVISION, ADD. 2
TRACT D-3 PLAT 80-172 GRID SE 704
SURVEY CERTIFICATION: I, John L. Schuller, have conducted a
physical survey o£this property as shown on this drawing and that the
improvements situated thereon are within the property lines and no
enchroachments exist other that noted.
EXCLUSION NOTES: It is the owners responsibility to determine the
existence of any easements, covenants, or restrictions which do not
appear on the recorded subdivision plat. Under no circumstance should
any information on this drawing be used for construction of fences,
structures, improvements, or for establishing boundary lines.
WORK ORDER NUMBER: IOA~: ISCAU~: IE-MAlU
IOCT 2~, 2o~o I ~"=4o'
I
1 O--044 I°"*~ "Y: I°"~°KE° "Yt°"'° """"E": I
~1-= FND BRASS CAP MONUMENT
(~) = FND 5/8" REBAR
92.00'
(S34'36' 35"~
7RAC~
,.~,~.L LAND P~g')
183~ Talkee~na Stvee~
Anchorage, Maska 99508
(90?) 227-1455 office
(90?) 2?4-4992 fax
ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND
REPAIR AGREEMENT
MEMORANDUM OF UNDERSTANDING
BETWEEN MUNICIPALITY OF ANCHORAGE
AND
THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this
,,~_. ~' Day of f__) C-~, of20/~, by and between
herein the "OWNER," and the Municipality of Anchorage, herein the
"MUNICIPALITY." In consideration of the mutual covenants contained herein, the
parties to this Memorandum of Understanding agree as follows:
1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality
grants permission to Owner to utilize and operate an Advanced Wastewater
Treatment System (AWWTS), described as /q ~//c/& ~, ~/t.~,._/ located
A. Alteration. Any change to the design or function of an AWWTS that
Includes the installation or removal of any parts, components or pieces not
included in the original construction permit and design. Prior to
performing any alterations to an AWWTS the owner must obtain a
Wastewater Disposal System Construction Permit from the Municipality
pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65.
B. Certificate of On-Site Systems Approval. An approval by the
Municipality of existing water and wastewater disposal systems given at
the time of property sale and title transfer in accordance with AMC 15.65.
at ,~//~z _/ ~ ?.. ~,~ ~-/L ~f~ ? , Anchorage, Alaska.
2. Definitions.
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 (Construction) An On-Site Wastewater Disposal System
Construction Permit as defined by AMC 15.65.
Permit (Operating) An Advanced Wastewater Treatment System
Operating Permit. An annual permit, issued by the Municipality, that
allows the Owner to operate an AWWTS, upon meeting all the
requirements of this agreement, the conditions of Operating Permit, the
requirements of the On-Site Wastewater System Construction Permit and
3. Fee.
($ ~ .00), payable on or before the issuance of the operating permit and annually
thereafter. The annual fee is due on or before the anniversary date of the approval by the
Municipality of installed system.
4. Term. The term of this Memorandum of Understanding shall be for the life of the
AWWTS.
all relevant provisions of AMC 15.65
Owner shall pay to Municipality an annual fee of
The temq begins on the date of approval by the Municipality of the installed system and
shall continue while the AWWTS system is in use or operational or until the property is
sold or title is transferred by owner and a new certificate of On-Site approval is issued to
the new owner or transferee of the property.
5. Alterations, Installation and Removal of Additional Equipment. Owner agrees
not to make any alterations, removal of parts or additions to the AWWTS without a
Construction Permit from the Municipality.
6. Maintenance and Repairs.
A. Throughout the term of this Memorandum of Understanding, the Owner shall
maintain AWWTS in good repair. In addition, it shall be the responsibility of the
Owner during the term of this Memorandum of Understanding, and any extensions or
renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2)
maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs.
Further, Owner agrees to comply will all applicable ordinance, laws, regulations,
rules and orders for the AWWTS.
B. Owner agrees to provide the Municipality a written schedule of routine
maintenance and repairs which have been performed on the system pursuant to the
terms and conditions contained in the Owner's AWWTS Operating Permit. This
schedule shall be submitted to the Municipality annually upon the renewal of the
permit. The schedule of maintenance and repair contained in the Owner's AWWTS
Operating Permit is: N,,/e~ v' l
/
/
C. Owner acknowledges that the fine schedule for failing to maintain and repair an
AWWTS are codified in AMC 14.60.
D. Owner agrees that only maintenance, repair personnel certified by the
Municipality will inspect and make any necessary maintenance, repairs or permitted
alterations to the system.
E. Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS upon 24 hours written notice.
F. Owner agrees that any sale or transfer of title of the property will not occur
without a new Certificate of On-Site Systems Approval.
G. Owner agrees that the relevant provisions of the standard specification guidebook
for AWWTS is the governing professional guidelines for the construction,
maintenance and repair of the Owner's AWWTS.
7. Nonwaiver. The failure of either party at any time to enforce a provision of this
Memorandum of Understanding shall in no way constitute a waiver of the provisions,
nor in any way effect the validity of the Memorandum of Understanding or any part
hereof, or the right of such party thereafter to enforce each and every provision
hereof.
8. Amendment.
A. This Memorandum of Understanding shall only be amended, modified or changed
by a writing, executed by authorized representatives of the parties, with the same
formality of this Memorandum of Understanding was executed and such writing shall
be attached to this Memorandum of Understanding as an amendment.
B. For the purposes of any amendment modification or change to the terms and
conditions of this contract, the only authorized representatives of the parties are:
Anchorage: Purchasing Officer
C. Any attempt to amend, modify, or change this contract by either an
unauthorized representative or unauthorized means shall be void.
9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of
Understanding shall be brought in the Superior Court for the Third Judicial District of the
State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and
obligations of the parties under this Memorandum of Understanding.
10. Severabili ,ty. Any provisions of this Memorandum of Understanding decreed
invalid by a court of competent jurisdiction shall not invalidate the remaining provisions
of the Memorandum of Understanding.
OWNER: MUNICIPALITY:
By: By:
Title:
Date: Date:
STATE OF ALASKA )
) SS.
THIRD JUDICIAL DISTRICT )
The forego~ing instrument~.~s acknowledged before me thlsoZ:": day of
.,-/ ~, ,, .:-- ~
I/.. ,,, :
x'J~TA~V~BLIC FOR ~A/L~SKA
My Com~ion expires',.~J¢: g;~' '/Ct ~'~: