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HomeMy WebLinkAboutT15N R1W SEC 18 LT 212 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201001 PID Number: 051-231-69 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade JOHN R. MITCHELL Site Address 19337 SPRUCE CREST DRIVE, CHUGIAK Phone Number of Bedrooms 4 LEGAL DESCRIPTION Subdivision Block Lot 212 Township Range Section 15N 1W 18 SEPARATION DISTANCES To Septic Absorption Holding Sewer C Tank Field Lift Station Tank Line Surface Water 1 550'+ 1 550'+ Lot Line 1 10'+ 1 10'+ 1 1 1 Foundation 1 10'+ 1 10'+ Remarks Original system decommissioned per code. Installer JRS Inspector FWC Inspection s, 1 1 /22/20 1 /23/2020 ,BSORPTION FIELD - ADVANTEX ❑ Deep Trench ® Wide Trench ❑ Bed ❑ Mound ❑ Other Dil Rating Total depth from original grade 2 GPD/SF 4 apth to pipe invert from original grade Gravel depth beneath pipe 2 Ft. 2 II added above original grade Gravel length VARIES 0.65 — 1.72 +/- Ft. 2 P, 25' 50 ravel width Beds: Number of Lines Distance between lines 5 Ft. Dtal absorption area Number of trenches Dist. between trenches 357 Ft2 2 6+ 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ® Other ADVANTEX Manufacturer Capacity ORENCO / ANCH. TANK 1500 Gal. Material Number of compartments NA I FIBERGLASS LIFT STATION Manufacturer Capacity ORENCO 1500 Gal. Alarm location Electrical installed by BASEMENT DRS ELECTRIC PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Drainfield 3034 CO/MT 3034 BENCH MARK (Assumed elevation) 100 ft Location and description dates: 2°d 3rd 4 t DOOR SILL ON-SITE WATER AND WASTEWATER SECTION APPROVAL Conditional Approval: Date Septic System Approved - Date 3©—ZD2c Note: this approval does not include well permit requirements. kr-,ev uoiuci rod *•TH • *��� .. .. .... ......... Curtis Huffman ?'c9 % CE 128991 1/25/2020. ltt,FuPR0FEWQ0 -I- kr-,vv I T15N R1 W SEC 18 LOT 212 PERMIT: OSP201001 Lot 211 SCALE, 1' = 30 z A—C=25,2' B—C=55,5' FCO A—D=35,1' B—D=60,3' A—E=45,9' B—E=66.8' A—F=48,0' B—F=68,5' A—G=52,9' B—G=52,4' A—H=62.2' S 89' 5';00"E 165.00' TH19-1 PID: 051-231-69 I 1 4BR RESERVE -�- 0 � I � 50' SURFACE WATER ASSUMED PATH MT CO O CO CV + MT H _ CO G E MT O S FACE WATER SPUTTER m DCO D DISSIPATES :;0NEW 1500 -GAL MH / DISAPPEARS 01 TANK & AX20 POD. m C MH C) m FCO I 45.7 CHANNELLED m RUNNING r SURFACE WATER e 46.0' 13 413R HO SE U' w F Cn (n AX20 POD 1500—GAL FAP ADVANTEX TANK CO GO B—H=62,9' SEPTIC SECTION A—I=65,6' SCALE: NTS B—I-64,7' T1 5N R1 W SEC 18 LOT 212 A—J=63,5' PREPARED FOR: B—J=80,1' JOHN R. MITCHELL 19337 SPRUCE CREST DR. CHUGIAK, AK 99567 FIRST WATER CONSULTING GO MT CO MT 95.05 FINAL GRADE 95.03 93.33 FILTER FABRIC ORIGINAL GRADE NSULATION & INSULATION TH19-1 1.5' oRG/OL SPLITTER 91.33 91.33 SEWER ROCK 89.33 89.33 SM/ap 93.50 CO MT FINAL GRADE CO MT 93.55 92.115 ORIGINAL GRADE FILTER FABRIC GRND.WTR. & INUSLATION O 10' .85 13' 12/28/19 0 90.85 BOH SEWER ROCK 79•. 88.85 88.85 RELATIVE ELEV. TO LOWER TRENCH SUPPORTISERVICES: OF AL�' vA F 5 qzz--V -9TH 13030 Sues Way SURVEY: Anchorage, Alaska 99516 DRAWN: (907)350-9566 SCALE: firstwaterAK©gmoil. com - 01/25/2020 b % (-.6rrtis Huffman KGL CE 128991 FWCS '01/25/202 1" = 30'OFESSIOIZ�' MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP201001 Work Type: Septic Upgrade Tax Code Number: 05123169000 Site Legal Address: T15N R1W SEC 18 LT 212 G:1055 Site Mailing Address: 19337 SPRUCE CREST DR, Chugiak Owner: MITCHELL JOHN R Design Engineer: FIRST WATER CONSULTING SERVICES This permit is for the construction of: Effective Date: Expiration Date Lot Size in Sq Ft Total Bedrooms: 1122120 �1»ent Is, Del) rtment 1/9/2020 1/8/2021 54450 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ 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 Received By: Issued By: Date: Date:✓6 4 PL AII(� MUMUF , UTY OF AHCHORQGE Development Services Department -3 Phone: 907-343-7904 On -Site Water & Wastewater Section - Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-231-69 Property owner(s) JOHN MITCHELL Day phone 9079525861 Mailing address PO BOX 770404 EAGLE RIVER, AK 99577 Site address 19337 SPRUCE CREST DRIVE, CHUGIAK, AK 99567 Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T1 5N R1 W SEC 18 LOT 212 Lot Size 54450 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field © Initial ❑ Single Family (SF) (w/wo AD U) Septic Tank ® Upgrade ® Duplex ❑ (D) Holding Tank ❑ Renewal ❑ 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. FWCS - Brent Western (Signature of property owner or authorized agent) Permit/Rush Fees: 546,Waiver Fees: Date of Payment: T/ I 1/Z Date of Payment: Receipt Number: d 1 L? b Receipt Number: Permit No. .Sp 1;26 1010 /Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc FIRST WATER CONSULTING 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com January 14, 2020 Municipalities of Anchorage On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: T15N R1W SEC 18 LOT 212 PHYSICAL: 19337 SPRUCE CREST DRIVE, CHUGIAK, AK 99567 The septic field has been found failed and encroaching groundwater and we request a septic permit to upgrade the system on the above referenced lot. We propose to install two shallow trenches with and Advantex system to serve the existing 4 -bedroom residence. The design is based on the recent test hole conducted on December 18, 2019. The slopes are moderate at 12-17% at the proposed upgrade location. The lot and area are served by private water and public water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. F I W 3 „�'si cr awia, LAT 6 WELL PER ADEC — WERRE S/D IS NOT A PUBLIC WATER SYSTEM STAKE WELL RADIUS PRIOR TO CONST. S 89 '00'E 165.00' 0 IBR RESERVE 50' SURFACE WATER ASSUMED SEPTIC =16 14+ l iIX7mX4% PATH Lot 211 N&-<6PES >25% W/IN 50' OF PROPOSED TRENCHES Lot 17 SURFACE WATER DISSIPATES OISAPPEARS SURFACE 48R 70'1 a CONNEK ORNO. 8.4' . 9.8' PIPE PORCH ON 31.2' DECK wELL� BLOCK GRAVEL RETAINING WALL 2 2 13�z5II Lot 1.25 Acres I N 1/2 SE 1/4 SW 1/4 NO WELLS W/IN 1 00'OF PROPOSED SYSTEM Lot 213 SPRUCE CREST DRIVE 9 00 165.00 Lot 16 16 Lot 15 I I PREPARED FOR: SUPPORT®SERVICES: F AZ JOHN R. MITCHELLMEN ��s� T15N R1 W SEC 18 LOT 212 1 WES * 9TH 19337 SPRUCE CREST DR., CHUGIAK, AK 99567 FIRST WATER CONSULTING DATE: 01/13/2020 rtis Huffman 13030 Sues Way SURVEY: KOCE 128991 wF Anchorage, Alaska 99516 o A DRAWN: FWCS '`�� 01/13/2020e (907)350-9566 SCALE: 1" = 60'ssto��' firstwaterAK©gmoil. corn i Lot 211 N&-<6PES >25% W/IN 50' OF PROPOSED TRENCHES Lot 17 SURFACE WATER DISSIPATES OISAPPEARS SURFACE 48R 70'1 a CONNEK ORNO. 8.4' . 9.8' PIPE PORCH ON 31.2' DECK wELL� BLOCK GRAVEL RETAINING WALL 2 2 13�z5II Lot 1.25 Acres I N 1/2 SE 1/4 SW 1/4 NO WELLS W/IN 1 00'OF PROPOSED SYSTEM Lot 213 SPRUCE CREST DRIVE 9 00 165.00 Lot 16 16 Lot 15 I I PREPARED FOR: SUPPORT®SERVICES: F AZ JOHN R. MITCHELLMEN ��s� T15N R1 W SEC 18 LOT 212 1 WES * 9TH 19337 SPRUCE CREST DR., CHUGIAK, AK 99567 FIRST WATER CONSULTING DATE: 01/13/2020 rtis Huffman 13030 Sues Way SURVEY: KOCE 128991 wF Anchorage, Alaska 99516 o A DRAWN: FWCS '`�� 01/13/2020e (907)350-9566 SCALE: 1" = 60'ssto��' firstwaterAK©gmoil. corn DESIGN CRITERIA: 600 GPD / 2 GPD/SF = 300 SF / 5'W = 60' LONG 60' L X 0.7 RF (2'E D) = 42'L INSTALL TWO TRENCHES 25'L X 5'W X 2'ED - 4' MAX FROM ORIGINAL GRADE, DECOMMISSION EXISTING SEPTIC TANK & INSTALL NEW 1500 GAL, ADVANTEX S,T, W/ AX -20 POD MAINTAINING 10'+ TO FOUNDATION, 5'+ TO FIELD & 501+ FROM WELLS, SURFACE WATER & SLOPES >25% WITH 4' OF COVER OVER TANK & 3' COVER OVER FILE OR INSULALTI❑N. S 89 5 '00"E 165.00' � n1 TH19-1 0 50' 4BR RESERVE D N1 SURFACE WATER ASSUMED N EXIST.ROACHES INSTALL 2 NEW TRENCHES � 25'L x 5'W x VED - 4'OG PATH te / TRENCH NISSI � � ROUND WA R1 �° n CO CO MT Et n '— � N N1 N 0 � .�I � N CO � O INSTALL 1500 -GAL TANK & AX20 POD. SPUTTER DCO Sl1t�CrACE WATER DISSIPATES O O \ O MH / DISAPPEARS O • DECOMMISSION EXIST. � ° O MH m c)� D SEPTIC TANK PER CODE 0 C m m C) 45.7 FCO CHANNELLED m r m 46.0 RUNNING SURFACE WATER -- N D rn r N 4BR HO SE U' O z w C Cn cn 00 46. .4 0 10"/ O C- Ln o o (A CONNEX DRNG. O 8.4' x 9.8' U' PIPE W O di PORCH ON 31.2' DECK _� WELL p O LOt 71 PREPARED FOR: SUPPORT®SERVICES: JOHN R. MITCHELL ���, OF 4Z�' 1k IIIII T15N R1 W SEC 18 LOT 212 9— TH 19337 SPRUCE CREST DR., CHUGIAK, AK 99567 FIRST WATER CONSULTING-' DATE: 01/13/2020 rtis Huffman 13030 Sues Way SURVEY: KGL CE 128991 Anchorage, Alaska 99516 DRAWN: FWCS 01/13/202e (907)350-9566 SCALE: 1" = so'gr '%onsslo p firstwaterAK®gmail. com Michael N. Anderson, P.E. Civil/Structural Engineering and Construction 4661 Natrona Ave. Anchorage, Alaska 99516 Phone 345-3377 Fax345-1391 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION:TI5N R1W SEC18 LOT 212 DEPTH FEET OG SOILS 1 { ORG/OL 2��; Depth to Water Net Dro 12/1.8/19 30 min 6" 2 9/16" 30 min 3 2 10/16" 30 min 6" 2 10/16" 4 5 =` f_=s J-.'- 6 7 SM/sp 8 y-♦ 1_' _ 9 10 12 J- = - 13 :== BOH 14 15 16 17 18 19 20 Municipality of Anchorage On-site Water and Wastewater FOR CODE COMPUANC �C OF QZO b ltibckenfuss, 01/0 7 :49TH MICHAEL N. ANDERSON. - No. CE 9469 12/27/.19 * ��ssioK�.ti PERFORMED FOR: JOHN MITCHELL TESTHOLE # 19-1 DATE PERFORMED: 12/18/2019 GROUND WATER ENCOUNTERED: YES IF YES, AT WHAT DEPTH: 11' DEPTH TO WATER AT MONITORING: 10' DATE: 12/26/19 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION Reading Date Gross Time Net Time Depth to Water Net Dro 12/1.8/19 30 min 6" 2 9/16" 30 min 6" 2 10/16" 30 min 6" 2 10/16" PERCOLATION RATE 12 (MIN / INCH) TEST RUN BEWTWEEN 4 & 5 FT PERC HOLE DIAMETER 6" PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16T" PERFORMED BY: FWCS / MNA - I MIKE N. ANDERSON CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 12/27/19 ~(/y~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ~ ~J , ~.~J~.'~r~ . ~ ~P~RADE NO. OF BEDROOMS DISTANCE TO: LW°tl/g/ I JAb~a~7 / Dwe~g~/ PE~7 Mot ' ~<Z Manufacturer ~ ~C No. of~partments ~ Liq. ca ac~ty in IF HOMEMADE: ~ gallons Inside length Width Liquid depth ~ ~ DISTANCE TO: Well DwelHng PERMIT NO. ~ No. of lines ~ Length~e~,,ine -- Total Io~f ,ines Tren~h Di~t.n~7~, lines  inches ~ ~ Top of ti~e t~ [in]sh grade - / ' Material beneath til~'~ ~ ~ . , ~al effective absorption area ~ ~ Type of cr~b Crib dim~eter Crib depth Total effective absorption area ~ Well Building foundation; Nearest )at Hne ~ DISTANCE TO: ~ OJass Depth Driller Distance [o ~ot dne PERMIT NO. ~ Building foundation Sewer line Septic tank Absorption area(si ~ DISTANCE TO: OTHER PIPE MATERIALS REMARKS 13 ( ~/78) I::~ F:q:::'l-. :[ C:FII"J T I_CIC:F:tT I ON L.E6FIL. :13 I'"1F:II"IF:I N S F:' [~'. U (:: E C I:;;: E S T L.O'[ "!"'~.'F:'f]!: Cfi:: SC(I:I,,.. FIB'ZORF'-!"IOI'.,I S'.~,'STEP1 ]:S: TF~:EI'.,ICH l'tl::~i:.:ill',tl,.ll'q NI...II',IEi:[EF['. 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THiS [:,Ei:F:'F:iF;:TI"IEi:I",tT I:::,UF4:[N~3 TI.-.IEi: 'T'H:I.S F'F~'.CII:::'[EFUf"'~,' lal'.JE:, THE: E:FtC:I.:::I::':[L.L. IIqG OF:' FIl',l"r' S'~'STE:I"I F!I'T'HOUT F:[NFII... ]:NSI::'EC:'T']:Ot",I F~I",!D F:IF:'I'::'ROVF:IL EIY DE[F'FII:;~THE:I",t'T I,.tlLI_. Ei:E :!!;l..J[~:..][[~(]]:"[' 'T'() ::L: !::'CII:;;~TH E:"r' "}'H[~: I"ll..II'.JII:::!Pt:::tLI I"'~" CIF F!I",IC:HCIF.'.'FI(3[~:. ;i~: Z IqlI..J.... II",I:i~;TF!L.L. THE S"r'STE!q :[1",t FIC:C:OI:~:DFINC:Ei: I.,.II'T'H THE (]:ODES. ::)~:: Z IJF,!DEF~:STF:IND THFff' THE OF,t-"SITE SE:b. IE[~'. S"r':E;'T'EI"I !'dFl"~" [;:E:(;~IJIf;~E [Nt_F:II:;~:(:~I~]"II~[I"JT IF THE S :[ GI",IE~:D: i::!i:::,F,i...,~,~ST Russell Oyster 694-2774 O & E ENG.NEERING & DEVELOi ,vlENT CO. Box 90, Davis St,, Eagle River, Alaska 99577 694-2774 or 688-2280 Performed for: Name: Mailing Address: Legal Description: /-- o7- -~/~. Depth (feet) SOIL LOG Earl Ellis 688-2280 Tel. No./°°0~- Soil Characteristics 1 6 7__ 8__ 9__ 10__ 11__ 12__ 13__ 14__ 15__ I PLOT PLAN PERC. TEST 16__ Ground Water Encountered: Yes L~No If yes, what depth Proposed Installation: Seepage Pit__ Drain Field__ Comments: 'formed by: Date: ~"'/'//~Z. [-: PLRNS MUNICIPALITY OF ANCHORAGE Development Services Department \ _ $ Phone: 907-343-7904 On -Site Water & Wastewater Section �'— Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-231-69 1. GENERAL INFORMATION Complete legal description T15N R1W SEC 18 LOT 212 Expiration Date: } (9 Location (site address) 19337 SPRUCE CREST DRIVE CHUGIAK AK 99567 Current property owner(s) JOHN R. MITCHELL Day phone Mailing address Real estate agent PO BOX 770404, EAGLE RIVER, AK 99577 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ oU Waiver Fee $ _ Date of Payment �a14 ��� Date of Payment Receipt Number $)q Receipt Number COSA # (35C96(09-1 Waiver # Distance: 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, 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 1/24/2020 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 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 & F6ff.S 6. DSD SIGNATURE System #1 Approved for Y_ bedrooms By: System #2 Approved for bedrooms Disapproved AW dW -49 • • • • Curtis Huff • • . • • Huffman ��� �'Fc •. CE 128991 ,•��`��� �� d'1��•• 1/24/2020�.���� PROFESSION�`� , Conditional approval for bedrooms, with the following stipulations: Original Certificate; Date: VVM1 r•_r` MINLJ -30-zd2-0 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: T15N R1W SEC 18 LOT 212 Parcel ID: 051-231-69 If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system _ A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 6/21/1982 Total depth 105 ft Cased to 105 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 1 211 812 01 9 Static water level at beginning of test 253 ft. Well production at time of test 1 gpm Comments B. TANK DATA – NEW TANK Age of tank(s) 0 years Tank type/material ADVANTEX / FIBERGLASS Measured operating fluid level in septic tank ® Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA – NEW FIELD Which system tested (date installed) 1/23/2020 ® ALL standpipes present per record drawing Total measured depth from grade 5_7 ft (max) Measured depth to pipe invert from grade 3.7 ft (min) ❑ N/A – pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective ® Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: Water storage tank volume 300 gallons Well disinfected for coliform test? ❑ Yes ® Nc ® Coliform bacteria is Negative Nitrate mg/L ® Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by FW`ES Date of Sample 12/18/2019 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date Results Z Pass For 4 bedrooms Fluid depth prior to test _ in Water added _ gal New depth —in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) N If yes, enter date Fwcs 'k E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No ft Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' Animal Containment > 50' ® Yes if No ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ft ft ft ft ft ❑ Yes if No 50'+ ft ® Yes if No Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No _ Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No —ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No —ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ❑ Yes if No 50'+ ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION / certify that l 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. �� —OF A Aw Aw ow Pee TH .. .. .... ..........� Curtis Huffman CE 128991 •��� '0lzROFESSO��®� ft ft MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENAINCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this 3 Day of January of 20 20 , by and between Jennifer Otero , 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 AN ADVANTEX SYSTEM located at (legal description) T1 5N R1 W SEC 18 LOT 212 (SITE: 19337 SPRUCE CREST DRIVE, CHUGIAK) 2. Maintenance. Repairs and Alterations. (Owner is required to read, understand and initial each section) Throughout the tern 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 i repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). r 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. Owner acknowledges that regular maintenance of an AW'VVTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Pagel of3 E Owner act°Wiedges that the runic' repairs fr ipalit orn the Manufacturer's Te Y may request records of Owner acicnOwled rep or maintenance and ges that the maintenance assesse ane for failing Provider. d in accordancen to maintain and re with AM IC 14.60.030. Pair an AWNk'-FS may be Owner agrees to grant the t A')'AN'TS• The i Mttrucipalit grant Y reasonable access to Owner test and inspect the pality will give at least 24- agrees that a hour notice. ny sale or transfer of title of the Certificate of On -Site S ystetns property will not occur without a Owner a Approval. new groes that the AW�VT by the S installation and maintenance requirements as Provided AWWTS vendor/installer and approved b P vided y the r of are the governing g maintain remote Monitoring and repair of the Owner's V Owner agrees to AWti�'s. AWWTS approval. ring of the AWWTS as required by the Terrri• The term of this gt Agreement shall be ' Munici ali n on the date of approval by the P ty to operate the installed system , or upon while the AWWTS is operationalr of title' and shall continue or until title is transferred.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 anway a the validity of the Agreement or an y Y ffect y 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 Lain. 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. Severabilitv. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 _OWNER: By, - I J'!�!. (signature) Date: z'7 �o ennifer Otero (print name) STATE OF ALASKA THIRD JUDICIAL DISTRICT ) ss. Jowl Loy- The foregoir int wnent was acknowledged before me this gay of 202 , by LS �,-1 1� S�c%er NOTARY PUBLIC FOR ALASKA B. EnoCh Snider NOTARY Ft1BUC - STATE OF ALASKA My Commission expires: 3///apa+MCamn*aionEvtftMarh13,20M Cw"is&i N=W19M012 MUNICIPALITY: Y: (signature) Date: _2j9'C7 (print name) Title: (rev. 05/18/2018) Page 3 of 3 J E L E C i R 6. C January 27, 2020 To whom it may concern, This is to confirm that the Advantex panel with all wiring per NEC was installed at 19337 Spruce Crest Dr. If you have any further questions feel free to contact me at 907-351-5163 Thank you, David R Stevenson Owner DRS Electric, LLC 18207 Stillwater Dr., Eagle River, AK 99577 907-351-5163 VA Lot 211 CA W O O O Lot 17 SEPTIC MAI TREATMEN' MF,,... 4.0' x 9.0• LANDING 45.7' 46.0• 1 STORY RESIDENCE WITH WALKOUT BASEMENT 46.1 • s O )0'A ) 8.4' x 9.8' rn CONNEX PORCH ON 31.2 DECK 'GRAVEL ' BLOCK RETAINING WALL 68.4' Lot 213 i� Lot 212 1.25 Acres SPRUCE CREST DRIVE I N 89'59'00"W 165.00' Lot 16 Lot 15 I I I PLOT PLAN AS BUILT _X_ SCALE _1___40=_ GRID _ NW 1055Project No. 19-706f_A2_ Lang & Associatesinc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 (907) 522-6476 Phone Professional Land 9(907) Surveyors 522-4625 Fax ken®longsurvey.com o->©� F a -S" Janathan0langsurvey.cam ..-I P QO I hereby certify that I have surveyed LOT 212, SECTION 18, T15N, the following described property: . per?: 49TH R1W, SEWARD MERIDIAN, ALASKA . *�a MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description T15N; RIW; Section 18; Lot 212 Location (site address or directions) 19337 Spruce Crest Chugiak, AK 99567 Property owner K~ Grose Mailing address 3402A Van~S Cird~e Day phone 0~ of state Rome, New York 13440 Lending agency Mailing address Day phone Agent Caroline StrCano/DON MCKENZIE R.,E.~ Day phone Address 13135 OLD GLENN HWY., S~ite 100, Eagl~ River AK 696-9033 696-0465 (h) Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 V TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: XXX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-02§ {Rev. 1/91) Front MOA #21 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. Phone Name of Firm 17034 Eagle R~e~p Date EngineeCs signature ~ " SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: /~,~ ~u~ Date _ ¢-- ¢' ~/"~ 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. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description:~,.-~:>'~' 'Z4'?----, ~:~e-(_.. ~ ~ ,.'~\~"~ ~--'\~' Parcel I.D. A, Well Data Well type ~¢'~q Log present (~1) Total depth \ Sanitary seal ~.~N) Date of test Static water level Well flow Pump leveM Cased to If A, B, or C, attach ADEC letter. ADEC water system number Lo--/.-\ ~ ~'"7--- Driller ::~.~,.~ Date completed ,'~c>~ '~ Casing height Wires properly protected (~JN) ~ FROM WELL LOG AT INSPECTION SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ~ ~-~ Absorption fie~d on lot \ o c. Public sewer main ~ ~ Sewer service line "Z~" \ ~ g.p.m. ; On adjacent lots ; On adjacent lots t, [3~ Public sewer manhole/cleanout ~-\/~ Petroleum tank WATER SAMPLE RESULTS: Coliform (~ Date of sample: L, ~ \ "1 ~cl ~ Nitrate Other bacteria ~-~ Collected by: B. SEPTIC/HOLDING TANK DATA Date installedI ~[ ~'~::5'7..~ Tank size Cleanouts Y~N) ~.~ Foundation cleanout {~) High water alarm (Y~)~ ~' Date of pumping L. ~ Z- \ --~t~ S & S ENGINEERING 17034 Eagle River Loep Roltd NO, Eagle River, Alaska 99577 \ ~::,~ O Compartments ~ Depression Alarm tested (WN) Pumper "~J.~.. ~..~_~-~S ~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot t.~ t~ To property tine \ c, ~ '¥ Surface water/drainage On adjacent lots Absorption field \ {s:~.~~¥' Foundation Water main/service line 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" level at_ High water alarm level _ ~es tested Meets MOA electrical codes (Y/N _,~ SEPA~OM LIFT STATION TO: Weir'on lot On adjacent lots Manufacturer Manhole/Access (Y/N) ~ ~Level at Surface water D. ABSORPTION FIELD DATA Date installed '7 -~ ~ ~ Length ~"~ ~t~ ~ Total absorption area _ Date of adequacy test ~.~yater level in absorption field before test '~\ Peroxide treatment (past 12 months) (Y~ ~c~,-~ ~->~ Soil rating (GPD/Ft Width "5 b. Gravel thickness Z~\ ~ ~ Cleanout present ,~N) t~, - 3...~--~ ~-¢~ Results~ail) '"'] ~ Total depth _ ,,~ Depression over field (Y,~ _ /'~ ~',>--~ for After test '-~ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot_ ~ c~c:>t ~ On adjacent lots ~ ~:> Property line To building foundation On adjacent lots '~ c, Sudace water ~- ~ ~ E.~Eurtain drain NGINEER'S CERTIFICATION Cutbank To existing or abandoned system on ~ l/~ Water main/service line Driveway, parking/vehicle storage area $ & S ENGINEEEING Signature . 17C3~ Engineer's Name Eagle Date Bedrooms inspection. HAA Fee $ / ~,,7~, ~ Date of Payment 72-026 (3/93)* Back Waiver Fee $ _ Date of Payment Receipt Number APPLF' \NT FILLS OUT UPPER HA ' ONLY PropcTty oWL,~ , ") Address '~ ~' ..... ~ [ z~ ~ -' ZIpCode- ~ '// . Realty Co. & A~Tki~ . ~ ~ ,..~ -- ,~ ~_ ~. ("~ Phone Legal Description ' /- /. ~ ~ , Type of Resl~nce ~ Single Family %~ ~ Multiple Family No. of Bedroo~ ~ ~ Other Water Supply ~lndlvidual ~ A~ACH WELL LOG. A wal Icg is required for all wells drilled since June 1975. ~ Community /~ L~ ~ /~. For wells drilled prior to that date, give well depth (attach Icg if available). ~ Public Utility ~ . ~ ~J. ~ Sewer Disposal .,; I ., .. / ~ NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Field Notes:.]~., /~ ~ ~), , .~ ~.,. ~ ,~ ,~ ) ~.~.~ ;~.,~ "' ~;', ¢ ~ ~' ~..' PF~T ':] ENVIJ; RECEIVED ( ~ ) APPROVED BEDROOM8 *CONDITIONS OF APPROVAL ( ) DISAP~OVED ( ) CONDITIONAL APPROVAL' Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received