HomeMy WebLinkAboutGREEN FOREST #1 BLK 3 LT 1Green Forest Block 3 Lot 1 #018-011-18 Jun 17 Z- 011, 4p 4;'�chvra9E) `s',r ,i1; -6, Hi.;rnp bar �U,V p -, .�.q`, �;;I�..u6�c: '�rs.sr2'd` ':^. ,f'c'i:.�c'`�t°1�2'C. �i'��f'"'i✓,'�? arJ� j �4, 470 uimor : kcac' P.O. Rox 391-6650 Mark 5 giclt Mayor ivv;w.anur_ _i.or ,lor � Pump Installation Log Well Drilling Permit Number; S NV_.____ Date Of tissue: P areel IdentificatIcrrr ,`umber: 01$7 011- Legal Descripti©u ..�� Pr( crtyOwner Name & Address: Pump ljlstdki tion Dale: �L � `s^ Pump btake Depth Below Tfjp f i''r,� eV �':a ina: � C1 feet. Pump Manufacturer's `dame: ' `kt Pump Model: {� 3'ucop ° izc t/It hP I'Mess Adapier• Burial Depth-, JeL, £tet }'itless Adapter Man u6cttit er's Name: Pitic:s .Adaptt:r .[rastallt.r: i Well Disinlec>ed Uport Ccmaplcdua Ll�;T 3'e", ,_ o Method of Disinfection: Coininants: fi. tz j Punip in`ttaller Na mc: V.U_)Yl.t�` r , r Attention: ? tit P-Xac< irstalier s�t� yl provide a Pump ins-itktion log to rhe DSD within 31) daye Ofpump installaro5_. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 On-Site Wastewater Disposal System and/or Well Inspection Report Page 1 of 3 Permit Number. SW050270 Name PID Number, 018-011-18 DUANE FRIDLEY Wastewater System: 0 New Address: ■ Upgrade 12517 SNOWBIRD DRIVE • ANCHORAGE, AK 99516 Phone: ABSORPTION FIELD No. of Bedrooms: (907) 265-9147 3 O Deep Trench O Shollow Trench ■ Bed OMound O Other LEGAL DESCRIPTION Se° Ro4i : Tq D.cu Tram ",Wase. 2 0 Lot: Block: GPD/4 rL 3.0 Subdivision: pi" bo Inwn n 1 3 GREEN FOREST o.pu � °"9l"°' °'o0i c.eti e.qn tKhvoln 29 Township:.59 — Range: — Section: .41 R 0 R rsl eeaw eeew ^•IF per.: — crawl km°tn: 0.63 T< 22/18 rL WELL: cnw .an 10 17 Nw p• 1 `�` w.we. e•..m rw. 0 New 0 Upgrade ( we.c1: Cow Ta n. 4 N/q rL WE�1 �•n rL n.•.ww„ ewo/ Tata a p� ,,,�� 270 so. rt D 3034/ F-810 ExtSj\NG aN• Dom: Slalk: Moor Level: naaN„• r„m:q• p K Dela Mahe: n GEG. Ltd 9/27-29/2005 ceM° height ftGrano: rL rL TANK SEPARATION DISTANCES aseptic 0Holding 0S.T.E.P. To ■Other• Septic Absorption Lift NYank brK/Pdvate YendacAN C.P" b aslant - From Tank Field Station Yank z.... tkwa ANCHORAGE TANK 1500 Well 100'+ 100'+ 100'+ — 25'+ STEEL NwM•r of °°""°""""'. Surface Water 100'+ 100'+ 100'+ —2 — LIFT STATION Lot Line 5'+ et'+ 5'+ _ _ s"• ~ e01vj' ue„doe,e,: 1500 Foundation 5'+ 10'+ 5'+ m 1w W at. ANCHORAGE TANK ORENCO SYSTEMS vwp of Mewl _ _ x N°n eolr sW. TIMER TIMER Curtin Drain NONE KNOWN P'"°° Mp a e' E"' In.o•clena pMarmM 46" er /20 OSI 05 HHF M.O.A. Remarks: *I' LOT UNE WAIVER GRANTED WITH PERMIT. BENCH MARK "THIS IS AN ADVANTEX TREATMENT SYSTEM. L« one SOUTH END OF SILL ON MANDOOR OF GARAGE OLD SEPTIC TANK WAS COMPLETELY -• ABANDONED PER UPC. a•,,,,•e E •w wn; , 100.00 r ENGINEER•$ 060 O. GEG Inspections performed by: INC. OGj. H , Dates: 1st 9 27 2005 0 °9 * 2nd 9 28 2005 �........ 0 3rd 9/29/2005 "'_`. f ..A. Q .... ss!• approval 4 795 :oma Reviewed and approved b /A\r �0 e `F" by: (Ft-.T2/a0) „ 0"'t, �tla9/strnK / ed����0 �Eoo PERMIT NUMBER: SW050270 AS -BUILT DRAWING PARCEL ID NUMBER: r 018-011-18 f ST1 53.83 22.59 D81.1 59.50 31.42 D81-2 59.42 32.73 DBL3 56.69 39.75 DBL4 56.12 40.77 FD 59.31 34.78 COI 41.36 61.95 CO2 46.11 62.86 CO3 50.41 64.71 C04 55.59 66.09 C05 61.47 37.91 MT1 1 41.61 47.95 MT2 157.74 60.65 MH 60.36 24.61 I I 1 1 OLD DRAINFIELD WAS - NOT CONNECTED. CO! WAS INSTALLED ON / LINE TO OLD SYSTEM / / I / 1 ABANDONED IN PLACE FOR FUTURE USE 4 DELI `� / BL2NEW 1500 GALLON ADVANTE% TANK V W �O)S n CKUNG FILTER LAT 2. BLOCK 3: 1 `INSTALLED ROW GREEN FOREST S/D NEW DRAINFTELO DIVERTER 1 I I I 1 I I I 1 1 L 1 100' WELL RADIUS - � GAIZNESS ENGINEERING ��GROUPTORS_ Ltd CONSULTANTS & GENERAL Val c n sn.o, sort jai . moow 4 r ssnti• . woK (uo�yn-s�io . ru (cnvs�nw • s.ssrt:...,p.. m„ . PREPARED FOR: PHONE NUMBER: PAGE NUMBER: DUANE FRIDLEY 265-9147 2 OF 3 GREEN FOREST TWE OF WORK: AS BUILT PA0 IRa. O1pA LOT 1. BLOCK OF SEPTIC UPGRADE B.F.M. 10/12/2005 PERMIT NUMBER: AS—BUILT DRA 11 11r� PEEL ID NUMBER: SWO50270 018-011-18 TOP OF MANHOLE FINAL GRADE . TOP OF ADVANTEX POD - 96.76 (AVG). 96.97 , - 96.63 (AVG.)--\ INVERT OF PIP I 1500 GALLON STEEL I 92.34 ADVANTEX TANK GRADE — 94.02 INSULATION TOP OF SAND - 90.39 — ELEVATION OF :.�•i�i�PY'::.1%v. GROUND WATER i;'ti'.,µv ✓ - 82.85 BOTTOM OF BED - 88.31 RELATIVE ELEVATION OF BOTTOM OF TESTHOLE 80.39 INVERT OF DISTRIBUTION UNE - 90.98 z� L • iR GARNESS ENGINEER ING� GROUP, Ltd. CONSULTANTS & GENERALRS PM C TCM LIMO. iC[ 101. me o m 00!01 . P cwyo") ," • rY (.01I1Y-.V4 . A91L' w.gv.r.wywryyan PREPARED FOR: PHONE NUMBER: PAGE NUMBER: DUANE FRIDLEY 265-9147 3 OF 3 LEGAL DESCRIPTION:DRAWN BY: GREEN FOREST S/D; LOT 1. BLOCK 3. Z.T.G. TYPE OF WORK: DATE: AS BUILT PACKAGE OF SEPTIC UPGRADE 10/12/2 IRn. 01MI ORIGINAL GRADE I 93.39 O HIGHEST POINT FILTER FABRIC P ey A, arness. CE 795 q � SFO P.O. Bot 196650 • Anchorage, Alaska 99519-6650 • Telephone (907) 3'1-3.8301 • Fax (907) 343.8200 4700 Bragaw Street • \nchoragc, Alaska 99507 Nvux :muni.org Mayor Mark Begich Building Safety Division 11/29/2005 Garness Engineering Group 3701 East Tudor Road, Suite 101 Anchorage, Alaska 99507 Subject: Waiver Request for Green Forest Subdivision, Block 3, Lot 1 Waiver Request #WR050104 Parcel ID #018-011-18 HAM 050555 and Permit # SW050270 Dear Mr. Garness, 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 1.0 foot. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another; approval from this department. If there are any further; concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, ze_"�11111 Julie Makela, P.E. Civil Engineer On -Site Water & Wastewater Program Community, Security, Prosperity Municipality of Anchorage Development Services Department • Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Waiver Review Worksheet WR#: WR050104 PID#: 018-011-18 HA#: HAA050555 Date Received: 8/5/2005 Legal Description: Green Forest Subdivision, Block 3, Lot 1 Engineer: Garness Engineering Group 3701 East Tudor Road, Suite 101 Anchorage, Alaska 99507 Applicant: Duane Fridley Waiver Requested: 1 foot between property line and absorption field Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Permit#: SW050270 Points: ■■E0Nff0EEEEEo00MM000E00EMM0R0aE0ff0ENn000aE0NEN00KNnXR0000a0E000ffM0X0XXEW0EEE0s1 Waiver is Granted: Waiver is not Granted. List Conditions or Reasons for above: Date: _(� ����0� By: Name of Reviewer ■■���e������as��������������������a0a00EMUUEEMMMMMMMMUM0M00MMMMMMMMMMMMMMMMo001 �/5/ dm5 Rec#: 71948 Amount: $175.00 Date Paid:11912912W& GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORSm July 27, 2005 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Lot Line Waiver Request for Green Forest Subdivision, Lot 1, Block 3, To whom it may concern: We request that your department issue a 1 -foot lot line waiver from the south property line to the proposed drainfield. I am 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 '.E., M.S. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507 Ph: (907) 337-6179' Fax: (907) 338-3246' Website: gamessengincering.com From +19078308507 Thu Sep 29 20:26:07 2005 Page 1 of 1 INSPECTION REPORT MUNICIPALITY OF ANCHORAGE, BUILDING SAFETY DIVISION 4700 SOUTH BRAGAW INSPECTION INFORMATION &HELP: 343-7962 INSPECTION: VOICE 343-8300 INSPECTION: FAX (907)249-7777 www.muni.org/BSD/Inspections.cfm NAME: Kevin PERMIT#: 05-9321 COMPANY: Rising Son Electric INSPECT DATE: 9/30/2005 PM PHONE #: 250-1100 PHONE #: PHONE #: ADDRESS: 12517 SNOWBIRD DR LOT 1 BLOCK 3 SUBDIVISION: GREEN FOREST GRID #: SW2833 COMMENTS or DIRECTIONS TYPE OF INSPECTION: Rotro Electrical COMMENTS: (FOR INSPECTOR USE ONLY) �LCLT��4� C� PRINTED NAME � DATE: MUNICIPALITY OF ANCHORAGE Development Services Department 1b On -Site Water 8 Wastewater Program l U 4700 South Bragaw Street p p- D P.O. Box 196650, Anchorage, AK 99519-6650 1 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Aug 09, 2005 Expiration Date: Aug 09, 2006 Permit Number: SWO50270 Parcel ID: 018-011-18 Legal Description: GREEN FOREST BLK 3 LT 1 Design Engineer: 0855 Garness Engineering Group, LTD Site Address: 012517 SNOWBIRD DR Owner Name: DUANE FRIDLEY Lot Size: 20920 SO. FT. Owner Address: 12517 SNOWBIRD DR Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE. AK 99516-2607 This permit is for the construction of: ❑V Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. a.) Well is located in utility easement. Letter(s) on non -objection shall be submitted with the On -Site Wastewater Disposal System Inspection Report. 9/15/d005 owat(\ 6%()"� C-aV-A "N. (C)'(\ t.tJ�\ cC�t1.LkS -�S C�ca� . E\•cnc�a_Jt.oc� a.os-� �cco�h . �lM 912910 -041/ Qt/kORAItiF1F-1.b TR►tP►}7o/D BF 7o SMY /ti6e,OD DF_S16aS FPOM SFrw1DEs To J9 5014 S. YA-0P FILTER &S0AnDED Received By. Date: p -_)l"0 RMX1[9 _.. MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Aug 09, 2005 Expiration Date: Aug 09, 2006 Permit Number: SWO50270 Parcel ID: 018-011-18 Legal Description: GREEN FOREST BLK 3 LT 1 Design Engineer: 0855 Gamess Engineering Group, LTD Site Address: 012517 SNOWBIRD DR Owner Name: DUANE FRIDLEY Lot Size: 20920 SO. FT. Owner Address: 12517 SNOWBIRD DR Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE. AK 99516-2607 This permit is for the construction of: ❑,/ Disposal Field ❑D Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. a.) Well is located in utility easement. Letter(s) on non -objection shall be submitted with the On -Site Wastewater Disposal System Inspection Report. Received By: Issued By: Date: (F--)/-0 �— Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. or� -tot 1- 1,9 Permit Number Property owner(S) DUANE FRIDLEY c/o ANITA BATES w/ COLDWELL BANKER Day phone 265-9147 Mailing address (1) 2525 'C' STREET • ANCHORAGE. AK Mailing address (2) Legal description (Lot, Block & Sub'd.) LOT 1 BLOCK 3• GREEN FOREST SUBDIVISION Legal description (Section, Township & Range) _LI/A Lot Size o �' V' Acre q.Ft Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only [,J Well Only ❑ Sewer and Well ❑' Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ certify that the above information is correct. I further certify that this application is being made fora Single Family Dwelling and is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. Permit Fees: 4w -co Date of Payment: 121151067 Receipt Number: 1141 49 Waiver Fees* I IS - i3y Date of Payment: Receipt Number: Lt94� GARNESS ENGINEERING GROUP, Ltd. w-- CONSULTANTS & GENERAL CONTRACTORS July 27, 2005 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 ReL Proposed Septic System Upgrade for Green Forest Subdivision; Lot 1, Block 3, To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The drainfield is currently in the state of failure and needs to be upgraded. We are proposing to install a new 1500 gallon S.T.E.P. Tank, a MOA approved recirculating trickling filter sized for 3 bedrooms, and a 5 -wide trench type drainfield. Four (4) test holes where excavated on the property. The drainfield will be designed around the 30 foot radius of test hole #4. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPHY: As can be seen on the attached design drawing the average topography in the area of the propsed drainfield is a 1-5 percent slope running approximately south-east to north-west. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any ff iestions, please contact us at 337-6179. Thank you for your assistance. P.E., M.S. NOTE: Attached is a site plan drawing, a design drawing, one soil log, which are all part of the design package for this septic system. (Contact G.E.C. Ltd. for 7 page construction specification letter.) 3701 E. Tudor Road, Suite 101 ' Anchorage, AK 99507 Ph: (907) 337-6179' Fax: (907) 338-3246' Website: gamessengineering.com T12N R3W SEC29 / T12N R3W SEC29 PARCEL 2 / PARCEL 4C N (NO CONCERN) --- 1' - loo,rF�— i/ \ p-100—F-RA°IIm I I I GREEN FOREST 5/D 6. BLOCK 2;' 1 \\\ 1 LOT 1' BLOCK 2; / GREEN FOREST 5/0 / (NO CONCERN) , LOT 2. BLOCK 2; 'k GREEN FOREST S/D LOT 5. BLOCK 2; / \� i/ 1 LOT 20. BLOCK 2: I I lF GREEN FOREST S/D ---� HORTH N HILLS2I I PAND SEWEERR+R I ;I II LOT 3A, UNIT 1; �' Q II J GREEN FOREST S/D /� NC I I II �\ 3 BEDROOM HOUSE I I II Fes' LLI SEPTIC ISTING �TH�1 % I I m \� \ SYSTE LOT 21. BLOCK 2; I {J2 NORTH NN HILLS DI _ _ NORTH S/D WA �I UBLIC �2 \ PAND SEWER I �SEPTC ' � \ � AREEAA w \\ r\\` PRS /i TH/4 \\ I LOT 2. BLOCK 3; T•\ /\ GREEN FOREST S/D ��---� LOT 22. BLOCK 2: ---- HUFFMANN HILLS I _--,�-----I I NORTH S/D /2 I r �— \ PUBLIC WATER I LOT 4, BLOCK 3;' \\ w / AND SEWER i I GREEN FOREST S/D LOT 3. BLOCK 3: � (VACANT) ; 1 GREEN FOREST S/D f I I GARNESS ENGINEERING GROUP, Lt'-'.*'?: :�*�0 CONSULTANTS & GENERAL CONTRACTORS 1 C TAO11 IGD, 1111[ 101 � MOIOIWL N( NIOf � FICK -�1T � IVt N � X42 �w asn. PREPARED FOR: IPHONE NUMBER: PAGE NUMBER: •• •••• m ••. DUANE FRIDLEY c/o AGENT 265-9147 1 OF 3 '•, A. amass: j9 LEGAL DESCRIPTION: DRAWN BY: OQ�� CE- 53J :� • GREEN FOREST SUBDIVISION: LOT 1. BLOCK 3 J.N.T./R.A.L. COQ e ' •�7�"? /' 4-e TWE OF WORK: DATE' 00000�es�6rofesso 00 SITE PLAN FOR PROPOSED SEPTIC SYSTEM UPGRADE 7/27/2005 (Rw.OIM5) NUMBER OF BEDROOMS:3 GALLONS PER DAY (GPD): 140 PERCOLATION RATE/S: 60 MIN./INCH PROPOSED APPLICATION RATE:1 MINIMUM GRAINFIELD SO.FT.: 450 DRAINFIELD DESIGN: MAXIMUM DEPTH:5 FEET WIDTH: 5 FEET LENGTH:53 FEET M,OA APPROVED SAND FILTER: N/A EFFECTIVE:3 FEET REDUCTION FACTOR: 0.58 ACTUAL SO.FT.: 456 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 NOTE: THE CONTRACTOR SHALL HAVE THE SOUTH LOT UNE AND ALL WELL RADI SHOWN FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. I PROPOSED THJ3� M.O.A. APPROVED / RECIRCULATING TRICKLING FILTER (SIZED FOR 3 STH/1 BEDROOMS) PROPOSED 1500 GALLON '+ TH/2 S.T.E.P. TANK (NO LOG) O EXISTING ORAINFIELD TO REMAIN FOR POSSIBLE �u�+ �Q FUTURE USE INSTALL FLOW 1 L SEPETIIC� SPLITTER TH/4 ��� PROPOSED DRAINFIELDS INSTALL FOUNDATION /1 LOT 2. BLOCK 3: I EXISTING GREEN FOREST S/D SEPTIC TANK TO SALE: BE COMPLETELY ABANOOND 1' 40 I 1 WELL RADIUS � J GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS I L 1c Ro w SM 101 • MIDO E. r "W? • n (40W I" • F" 0011 M1 ". ..w,a....wy.wMwa.. tEPARED FOR: PHONE NUMBER: PACE NUMBER: DUANE FRIDLEY c/o AGENT 265-9147 2 OF 3 GAL DESCRIPTION: DRAWN BY: GREEN FOREST SUBDIVISION; LOT 1, BLOCK 3 J.N.T./R.A.L. PE OF WORK: DATE: DESIGN FOR PROPOSED SEPTIC SYSTEM UPGRADE 7/27/2005 (RW.01A)5I W 0 WELL INSTALLPU FLOW ` ,� FROM MOA I SPUTTER Ir APPROVED RECIRCULATING TRICKLING FILTER — — — —, Col L------–——L"— ------� GRADE S' MAX. S' —410 GARNESS ENGINEERING�GTORS GROUP, Ltd. 0 ;? . 9 ......... Mt IL T FMO. Mei 101 • NSMORCL MI FO:M[ (007)0.T1 -01T • FM (001)110 " � RH914 meow• PREPARED FOR: PHONE NUMBER: PACE NUMBER .•• .••• .......•.... DUANE FRIDLEY c/o AGENT 265-9147 3 OF 3 Q y '• Gomess. ` LEGAL DESCRIPTION: DRAWN BY: GREEN FOREST SUBDIVISION: LOT 11 BLOCK 3 J.N.T./R.A.L. OQo� '�J2$fo�ood TYPE OF WORK: OATS O�dP�o Fssslonogo PROFILE FOR PROPOSED DRAINFIELD 7/27/2005 �OOoo��o 1Re. F1N51 GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS LEGAL DESCRIPTION: PERFORMED FOR: DEPTH DATE GREEN FOREST SUBDMSION; LOT 1, DUANE FRIDLEY BLOCK 3 DA (feet) yan____ m TEST HOLE F11 SOIL CLASSIFICATIONS as ym ORGANICS 2 yyyy i 6 GW ORG f tc: v GP ML 3 sas�ai+ aanm mllwllGM CL GC OL q °° •°° : SW MH 5 . t SP CH SM OH 6 SC �I11111111® 0 11 B.o.rl. 12- 13- 14- 15- 16- 17- 18- 19— SEE 213141516171819 DEPTH TO GROUNDWATER DATE DRY 7/14/2005 SEE SITE PLAN FOR LOCATION OF TEST HOLE DATE IREADING I CT MEK I (MINUTE) NET TIME I WATER READING LEVELI (INCHES) F PERCOLATION RATE <120 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 4.5 FT. AND 5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: JORDAN TROISI COMMENTS: 'PERC HOLE WAS FILLED WITH 10' OF WATER FOR A PRESOAK. AFTER 4 HOURS THE WATER LEVEL DID NOT DROP. PERFORMED BY GEC, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS P RFDRMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS 3701 L noon aow. WTE io, ..no OPACt. M. ouW) 07 an-e1n . F": coy -32" • .cev�E: ,.•....y...,. SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: GREEN FOREST SUBDMSION: LOT 1, BLOCK 3, PERFORMED FOR: OUAANE FRIDLEY DATI DEPTH ---- WATER LEVEL READING (reet) TEST HOLE SOIL CLASSIFICATIONS 2 ON FOR L� vN= ---- c o; GW ---- ORG GP ML GM CL 4 GC OL °4 600 00( SW MH 5 • SP CH SM OH 8 - SC 7 8 9 10 11 12 13 14 15 18 17 18 IGROUNDWATERI DATE SEE SITE PLAN FOR LOCATION OF TEST HOLE DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) ON FOR L� vN= 19 I I PERCOLATION RATE _ (MIN./INCH) PERC. HOLE DIA. — (INCHES) —jJI—JIB TEST RUN BETWEEN FT. AND FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: O YES ONO SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: — PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PEWORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: Eg Sir GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS E GENERAL CONTRACTORS SOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: GREEN FOREST SUBDIVISION; LOT 1, BLOCK PERFORMED FOR: DUANE FRIDLEY DEP (reet ORGANICS TEST HOLE 4 t SM 2- 4- 5— SM/GM a5SM/GM 6- 7- 8- 9- 10- 11 7891011 ML 12 13-10 14- 15- 16- 17- 18--1 415161718 • CLOCK TIME - • WATER LEVEL READING mm 7/20/2005 1 2:04 •. 6' • IIIII1111 2:34 IIII!11 5 1/2* �//moi 3 2:34 — 6' — 4 3:04 IIIIIIIII 1 5 1/2- 1/2' 5 3:04 — 6' ISl�lli 6 Y/�B. • f: �ffi 38' DEPTH TO DATE GROUNDWATER DRY 7/19/2005 DRY 7 28 2005 SEE SITE PLAN FOR LOCATION OF TEST HOLE DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 7/20/2005 1 2:04 — 6' — 2 2:34 30 5 1/2* 1/2' 3 2:34 — 6' — 4 3:04 30 1 5 1/2- 1/2' 5 3:04 — 6' — 6 3:34 30 558' 38' 19� PERCOLATION RATE 60 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 4.5 FT. AND 5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: SUSAN OSWALD PERCOLATION TEST PERFORMED BY: JORDAN TROISI COMMENTS: PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WA$ PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 7 7 r GRE. :R ANCHORAGE AREA BOF 'IGH C � Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ADDRESS PHONE j ii r %:;: /'i>=' Sit ✓i// h,.-���'l3 - %S�" LOCATION/✓ 7 i%/>'"✓ /%"%%%Y %' / LEGAL DESCRIPTION_=i % �" ✓/ /! _':i:/j i "t! SEPTIC TANK: DISTANCE NUMBER OF FROM WELL MANUFACTURER -!'%' _ MATERIAL COMPARTMENTS, INSIDE LENGTH _ INSIDE WIDTH LIQUID DEPTH _LIQUID CAPACITY - / GALLONS. SEEPAGE PIT: NUMBER OF PITS =.,�� DIAMETER OR WIDTH_LENGTH=. DEPTH LINING MATERIAL <' %'%%-`! CRIB SIZE: DIAMETER L DEPTH DISTANCE FROM: WELL_.__--',`! ' / TOTAL EFFECTIVE BUILDING FOUNDATION_' NEAREST LOT LINE­��-9 ABSORPTION AREA (WALL AREA) 2 SQ. FT. ADDITIONAL ABSORPTION'i WELL: i -_� . - _3--,— - , TYPE � �r — CONSTRUCTION — � /� �- sfDEPTH_ �!'�� f DISTANCE FROM: BUILDING NEAREST / f NEAREST i SEPTIC SEEPAGE FOUNDATION LOT LINE SEWER LINE'' �, TANK! SYSTEM " CESSPOOL,,z//%%'/�� OTHER SOURCES --- APPROVED DISAPPROVED REMARKS �'/ �.%- —�"v i�% — -Y'✓ -r— DISTANCES:r�%`"� ' INSTALLED BY: ! T r„ PIPE MATERIAL: v LOT SLOPE: h REMARKS: DIAGRAM OF SYSTEM r DATE '% /_ _ APPROVED G.A.A.B Form No. EQ -031 GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 '•C•• STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274.4561 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO. NAME OF APPLICANT ✓%!fl��y/-'i/ / MAILING ADDRESS L (k��HONE = INSTALLATION LOCATION //y l' % i /���'z%l� LEGAL DESCRIPTION /-��� /-n��i- �� �/P :"/� / Zlr-� (%_.__✓_� r- INSTALLATION OF: SEPTIC TANK SEEPAGE PIT , DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH TO BE INSTALLED BY ✓/ f ��-I `i SOIL TEST RESULTS/, -Z� NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE TYPE ��}' SEEPAGE AREA SIZE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK -� FOUNDATION TO SEEPAGE PIT DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK SEEPAGE PIT DRAIN FIELD Z� TO NEAREST LOT LINE. WELL TO SEPTIC TANK SEEPAGE PIT , DRAIN FIELD ALSO CONSIDER AREA WELLS, WATER MAIN TO SEPTIC TANK � SEEPAGE PIT DRAIN FIELD / i SEPTIC TAN K,�_, SEEPAGE PIT - DRAIN FIELDI�__L�// , TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNER TYPE DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE SIGNATURE APPLICANT'S J C ��� / l �:�� \_(]4•Q-1 %L __ . _ � i a /J��i�I� /_ it G�- •�Jl� r � i I � I i ic- 7— I I i' f i � "i i i �_:''I� i 9f =�� r _�:� L/f kyr-�F-`• I 1 - I , i r i I I l l l I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE SIGNATURE APPLICANT'S J C ��� / l �:�� \_(]4•Q-1 %L __ GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY Case 11 3330 "C" Street ANCHORAGE, ALASKA 99503 Performed For�, %,.z,< ;✓, «z_�_ __ Dated Performed Legal Description: 1-0041,j Bl ock =3 ,Subdi vi si on C%>r - - t This Form Reports Soils Log :X ^_ _— Percolation Test - Soil Test Must Be Logged To 4' Below Proposed Seepage System m — Depth Feet Soil Characteristics 1— 2- 3- 4- 5.- 6.- 7.- 8— —4- 5.-- 6.-7.e8— c.. �� y - y rcr a -p 9.-- L 1 .-- 10-- 1 3 -- 14 -- Was -- 14- -Was Ground Water Encountered? 1)U If Yes, At What Depth?___ Reading Date Gross Time I Net Time Depth to 1-I20 Net Drop rct k-L),a(1 ivn Ra t,r_ III I1IU Ce Proposed Instal_lation: Seepage Pit Drain Field Depth of Inlet _ ___Depth to Qottomof Pit or Trend--_ COMMENTS: Test Performed BY Certified BY: T.H.I. 10-4-74 �N Silt some sand & organics(ML) Silty Sands (SM) .o Silt some sand & gravel (M) o i •: Sand some gravel & silt (SP—SM) 0�: 0 Sanhy silt with some gravel (SM—ML) ro. ' 'o NO WATER TABLE 0.0' t.01 2.0' 3.5' 6.0' 9.0' NOTE: Test Hole Excavation with tractor—mounted backhoe. M DON HUMIAN PROPERTY LOG OF TEST HOLE ANCHORAGE, ALASI:A R Engineering & Geological Consultants Inc. ANCHORAGE FAIRBANKS ALASKA JUNEAU DATE 10-4-74 IscALE III-2'�DWN BY BH I CHKD BY MED I PROJ. NO®_462090 LDWo NO. A-01 / E Municipality of Anchorage °too On -Site Water and Wastewater Program <" (907)343-7904 SAf ETY Certificate of On -Site Systems Approval / Parcel I.D. 018-011-18 Expiration Date: ` —/ -7^ ZZ 1. GENERAL INFORMATION: Complete legal description GREEN FOREST #1; BLOCK 3, LOT 1 Location (site address) 12540 Northern Raven *Anchorage Current Property owner(s) David Slama Mailing address Real Estate Agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 907-301-1974 Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ 575o Waiver Fee $ Date of Payment (Q '" (3rZ ? Date of Payment Receipt Number D of Z Receipt Number COSA # 1 5C-� �2 1 a Waiver # N 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. Name of Firm: Gamess Engineerinq Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: /12:2-- In 'y In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of theleN evaluation. Separation distances were measured to readily identifiable features. Hidden defects or `� encroachments may exist that were not identified during the evaluation. The operational Iffe of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and G workmanship),and the water usage of the family utilizing the s stem/s. These conditions can vary, and ; ' . •' • "' • ...... ' 9 Y 9 Y rY, � ... ...• ...� are outside the control of GEG. Satisfactory test results do not guarantee future performance of the �9 systems; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system V1 r -y (=crne.s•, can be installed on the property in the event either of the current systems fail to perform adequately in (i� CE- 755 the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or oG party (including subsequent property purchasers) is not authorized, nor will it confer any legal right _o whatsoever. #AECC884 6. DSD � IGNATURE System #1 Approved for —3 bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: 12 Original Certificate Date: �— ZZ 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. 7. ATTACHMENTS: COSA Checklist _ Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other �OF'rr���i J ON-SITE =� WATER AND O WASTE-v`,!ATER o G PROGKAM F JJJJJ)�)S)E�l�l\\1 Legal Description: GREEN FOREST #1; BLOCK 3, LOT 1 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 1974(?) Total depth *84.5+ ft Cased to UNKNOWN ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 5126/22 Static water level at beginning of test 79.3 ft. Comments *PER GEG WELL FLOW TEST IflnIF_ k'IAVYTA 1 Age of tank(s) 17 years Tank type/material STEEL Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping SEE ATTACHED MAINTENANCE D. ABSORPTION FIELD DATA BED Which system tested (date installed) 9125105 ❑ ALL standpipes present per record drawing Total measured depth from grade '2.91 ft (max) Measured depth to pipe invert from grade *2.33 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective Parcel ID: 018-011-18 Structure served by this system _ Well production at time of test 5.5+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? F1Yes Nc HWcoliform bacteria is Negative Nitrate 0.10 30mg/L ❑ Nitrate less than MRL (ND) Arsenic I56 ug/L [:]Arsenic less than MRL (ND) Collected by GEG, LTD. Date of Sample 5/26122 C. LIFT STATION ® Required maintenance completed Age of lift station 17 years Lift station material STEEL Comments: ADVANTEX Adequacy test date 5126122 Results ❑✓ Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 677 gal New depth 5 in Elapsed time 120 min ❑ Code -required soil cover over field Final fluid depth 2 in ❑ System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NONE date of test) BN/A Gallons introduced N/A gallons If yes, enter date Comments/Deficiencies: 'DRAINFIELD INSULATED "MT1 NON-FUNCTIONAL NO SEPTIC PIPES FOUND FOR 1974 LOG CRIB d>/t, M1 COSA Chedc6st yellow sheet 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' 0 Yes *50'+ Community Sewer Manhole/Cleanout > 100' ❑ Yes if No ft F 7, Yes if No ft Neighboring Tank > 100' R Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No *50'+ ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' 0 Yes if No ft [I Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0 Yes if No ft n Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No **5'+ ft Surface Water > 100' ❑ Yes if No *50'ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Yes Absorption Field > 5' 0 Yes if No ft Private Wells > 100' ❑ Yes if No *50'+ ft Water Main > 10' 0✓ Yes if No ft Community Wells > 200' 2] Yes if No ft 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' 0 Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No ***1 ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100' ❑ Yes if No *50'+ ft Water Service Line > 10' Yes if No ft Community Wells > 200' [] Yes if No ft Surface Water> 100' ❑ Yes if No *50'+ ft F. ENGINEER'S COMMENTS *AWWTS **MET CODE AT TIME OF INSTALL ***WR#050104 CONDITION OF 1974 LOG CRIB IS UNKNOWN AND DISTANCE FROM SEPTIC TANK TO OLD LOG CRIB IS UNKNOWN. G. ENGINEER'S CERTIFICATION o��oC�000 0 I certify that 1 have determined through field inspections and review oo �Q of Municipal records that the above systems are in conformance with C� T H MOA COSA guidelines in effect on this date. * , ; , , , , �„ :l , , , , , , , , , , , ; , *, .0 "(�� �, ' J U CE— •' ev COSA Checklist yellow sheet�4e° Ar o f e s sio�GN #AECCa84 ��0�40�Ocy Sonia Blewett From: david slama <drslama@hotmail.com> Sent: Monday, May 23, 2022 11:37 AM To: Sona ewe Cc: Brian Broderick Subject: Re: 12540 Northern Raven Attachments: image001 jpg; image002.png; image003jpg; 12450 Northern Raven 2022 Inspection.pdf; IMG_0069 jpg ffually patched that hole a week ago. I got a fiberglass bondo kit. It came out pretty good. I painted it a matching reen. You can clearly tell a patch was done but it's strong and there's no more opening. Sent from my Whone On May 23, 2022, at 11:02 AM, Sonja Blewett <Sonja@garnessenginee ring.com> wrote: Hello, please see email below from maintenance provider.... Sonja From: Tom Varney <tom@anchoragetank.com> Sent: Monday, May 23, 2022 10:49 AM To: Sonja Blewett <Sonja@garnessengineering.com> Subject: RE: 12540 Northern Raven Good morning, Please see the attached inspection dated May 11. Also, Larry noted a small chunk missing from the pod lid. This really ought to be replaced since it is open to the inside of the pod, rather than just on the lip under the lid. _ From: Sonja Blewett <Son!a@garnessengineering.com> Sent: Monday, May 23, 2022 10:40 AM To: Tom Varney <tom@anchoragetank.com> Subject: 12540 Northern Raven Hello! Do you have maintenance report for 12540 Northern Raven? Owner is David Slama. Thanks! Sincerely, Sonja Blewett Corporate Secretarvareasurer Arsenic Advisory Certificate of On -Site Systems Approval # OSC221281 Subdivision: Green Forest #1, Block, 3 Lot 1 A water sample revealed an arsenic concentration of 15.5 micrograms per liter (ug/L). 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. Mailing Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org bay.12.2022 03:56 PM A+ 907S6S6770 S 422 915 X110 no OR ann®or up exam go an on nomma 11 *vanTeW Field Maintenance Ite ert Annual Inspection I on 1111 lip F III is 11 IN Ion AUK P 3/13 Minor m nchorsgeTank 907-272-3543 FroDerty 0wnorMmklna 0 Inspoct operator Provlous David & April Varna Previous Larry Betts artment Slia Addrast Previoue Pump........................ coMeot Phone 12540 Northern Raven Drive, Anchorage AK 99516 inopoot j Biotube Pump Vault ............ (907) 301-1974 AX Silo 10 q Counly 100 Pod M Float cords ❑ RTU 8NL p Inspec;�,Service Other System Components onto of Last impaction AX -106327 SWO50270 206535 RTU138935 06/21/2021 Retrieve OW Into Dally flovi Reclrc ratio Timer eettinge: (` al_ Perform Field Sampling/Obsorvations NM (15 x NTUA) pH (6-9) DO (2.6) S--'0 (0 iV Odor of Sample Typical Musty ❑ Earthy ❑ Moldy Non-typioolSuifldo ❑Cabbago ❑Dooay oilyflim In P U Owe WNo Foam in tank ❑ You V No Check Control Panel Reoiro Amps Discharge Amps Audible and visual alarrns ZOK Dial ton tetemotry oni ZYeo ❑ No Inspect/Clean Pump System Comments Signature Cloan IVieasur7 sludge/Scum Sludge Scum let Comdartment Inspoct Riser/Lid ..................... Provlous SpliceBox ................... Previous Float Cords ................... artment Floats ........................ Previoue Pump........................ Previous Blotubo° Flitar................. inopoot j Biotube Pump Vault ............ Riser/ d ❑ Recirculating SpiltterValve ....... Comments Signature Cloan IVieasur7 sludge/Scum Sludge Scum let Comdartment AdvanTex Fitter Current p�� Provlous urrent Previous 2nd Com artment Current Previoue urront Previous 1 Inspect/Clean AdvanTex Fitter inspect Clean Odor 17 Normal ❑ Pungont toralo/Orificos t� Blomaj: 0Normal ❑Ex0000hro P dBottom Bridg)ng/Ponding: ZNono/Mtnor ❑Excossivo in ake vent ID InspectClean Discharge Pump System inopoot j Inapoot Cloan Riser/ d ❑ Ft ats ❑ ❑ Spllco�Box ❑P1 mp ❑ r Float cords ❑ Inspec;�,Service Other System Components Inspect Cloan Disinfection Equipment Dispersal Inspect Clean L tarals/Ornlces Obsoryatlons Additioal Services Rendered ❑ Clo nod toxtllo ahoote? [] R locod UV {too? m ❑ ne , wed/Usod other Items? Parts Used, W . Warranty, B ■ Billable W appropriate s leotion) W 10 nom Number A000rlotlon ety Inspection rolnstallod reconnected; flush vaivos closad ❑ sysitem performing; no further action needed ❑ Call for service _ bolted on rat panel roactivatOd needs pumping �'- ��!11Data _)-1-11, — Fax completed form to 1.866-584.7404 i 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 23rd Day of May of 20 22 , by and between Anthony J Rotello , herein the "OWNER," and the Municipality of Anchomoe, 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 pernussion to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Advantex Septic located at (legal description) 12540 Northern Raven Drive, Anchorage, AK 99516 2. Maintenance, Repairs and Alterations. (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 AVt,`WTS 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 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. Owner acknowledges that regular maintenance of an AWIAnfS reduces the potential failure of the system, which could include sewage backup and costly repairs or dranfield replacement. (rev. 05/18/2018) Page 1 of 3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. Owner acknowledges that the fire for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Owner agrees to grwit the Municipality reasonable access to test and inspect the A)rN7S. The Municipality will give at least 24-hour notice. ONAmer agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. 6� 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. 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 Thud 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 of3 OWNER: By: D?t/r1�%��c�� (signature) Date: Gs�a�ae�aa (print name) T - STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing nstrument was acl5nowledged before me this -71 day of MoV 202, by 1- t l NOTARY UBLI FOR ALASKA My Commission expires: 2� STATL OPAL.451U Naury➢u6tic s. K Boni• C. NO.: 320330005 '� Commi�i £apyn: Wr3or-O_6 1➢'1li l<1C1CA• • t l L : By: ' tom--- (signature) (print naive) (rev. 05/18/2018) Date: Title: Page 3 of 3 !� Municipality of Anchorage On -Site Water & Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel l.D. 018-011-18 Expiration Date: 9—/7—/3 1. GENERAL INFORMATION Complete legal description GREEN FOREST: BLOCK 3, LOT 1 Location (site address) Current Property owner(s) Mailing address Real Estate Agent 2. TYPE OF DWELLING: 12517 SNOWBIRD DRIVE *ANCHORAGE, AK MATTHEW & CARRIE SETIAN Day phone 222-1359 12517 SNOWBIRD DRIVE *ANCHORAGE, AK Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: Day phone TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site E Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ Received by COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ + O Date of Payment 5-1 f 3 h 3 G� Receipt Number ©80 1 & COSA # 05iif I3 11z Date: Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 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 GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date i_� 13 Engineer's Comments: o n f,A i�r{IJV Rrasr 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, 0006�op4�4 o! OF and separation distances measured to readily identifiable 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. 9 These conditions are outside the control of the evaluator of the system. Satisfactory test . . . . . . . . . . . . . . . .1 results do not guarantee future performance of the system, nor do they guarantee that Q 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 " " " ......... A. G operational requirements of the ADEC or MOA DSD. The content of this report is forQA e ey rness, 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 confer any legal right whatsoever V y C -i-. 3 e; p �4 sysrP' • 5l r� 1 .�c��O 6. DSD SIGNATURE �4° prof ess!00lz§ �O0000�� I/System #1 Approved for 3 bedrooms. ,®��t® System #2 Approved for bedrooms. ``° pP� M Disapproved.�� ON-SITE =f WATER AND Conditional approval for bedrooms, with the following stipulations: y )WASTEWATER t:� ' vt o n f,A i�r{IJV Rrasr Original Certificate Date: The M61fic441ityorAnchorage Develop, emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatations 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. 7. ATTCHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory (Rev. 11105) Nitrate Advisory Arsenic Advisory Other If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: GREEN FOREST; BLOCK 3, LOT 1 Parcel ID: 018-011-18 A. WELL DATA *PER GEG INSPECTION **PER SURROUNDING WELL LOGS Well type PRIVATE If A. B, or C provide PWSID# N/A Well Log (YIN) NO Date completed PRE -1974 Sanitary seal (YIN) YES Wireserl ro p p y protected (YIN) YES Total depth *84+ ft. Cased to **40+ ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test NO WELL LOG 3/30/13 Static water level 7 ft. 81 ft. Well production 15i 9,p -m. 4.56 —9-P M. WATER SAMPLE RESULTS: Coliforms colonies/100 ml. Nitrate mg./L. Collected by: GFG. I td, Arsenic: ug./L. Dateofsample: 5.1,1113 B. SEPTIC/HOLDING TANK DATA ADVANTEX SYSTEM Tank Type/Material STEP/STEEL Date installed 9/27-29/05 Tank size 1500 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES Date of pumping C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE Date installed 9/27-29/05 Soil rating (g.p.d./ftlbrjjjbdrm 2.0 Length 22 & 18 ft, Total depth` o ! w ft. Width 10 & 17 ft. ADVANTEX SYSTEM System type BED Gravel below pipe 0.59 ft. Eff. absorption area 270 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 3/30/13 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 600 gal. New depth 1 in. Elapsed Time: 160 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date - BED IS INSULATED D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump ofr level High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent Absorption field on lot 100'+ Public sewer main — N/A Sewer /septic service line 25'+ On adjacent lots 00'+ .9 Public sewer manholetcleanout N/A Holding tank Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 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 *1' Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkingtvehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *WAIVER WAS GRANTED WITH PERMIT G. ENGINEER'S CERTIFICATION I certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSH guidelines in effect on this date. Engineer's Prin7d Name JEFFREY A. GARNESS Date _ � 1113 (Rev. 11/05) OF q Municipality of Anchorage Community Development Department h a- Development Services 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 Arsenic Advisory Certificate of On -Site Systems Approval # 131180 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 3, Lot 1 of Green Forest Subdivision. This inspection revealed an arsenic concentration of 23.1 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 - CiteCvQtPmQ Annrnvnl, „�....,...., rr-...__ 05/31/2012 07:32 8686770 APLUS PAGE 01 M won gnomon ■m ■ 190821so ONE �8 ■: some Mp iii. OEM on 1 ■ on ■Iron■ on o S *ivanTexe MEN MaInteeamw Boport 4nchorageTank & Welding, Inc. Annual Inspection [lflb nen ^t Ai PeseYrnmwlllaaunea Matt 8 Gerrie Satan aMAtM Mike Blakeslee 12517 Snowbird Drive, Ancho 0aA1ie�P� rego AK 89516 (907) 222-1369 exeema Pad t RN MLt Dw cord eupraa an AX 106327 SVY060270 2118535 RTU106347 09116(2071 �rfl�a Padmmoo Timerasmngu Perrmnt Fbdd SempllnP/Obsersadlons NVU p5 a" PN (a'PI DO (>!� osar r �srpla 7h*W ❑Musty ❑Earthy ❑Mo* Nen-yptm ❑ftMde ❑Cetrbepe ❑Darcy onyaMrMFW ❑Yes (--)Flo Foam kr teak ❑Yea No Cbeck CoMml P7mal Rsolm Amps Matltvga Amps atudlth and vMwd mq Dial mne tMiemeby w*4 �Yp ONO Inupeor/taean Pomp System Clean SavoBox.. M ................. Pmrm .................. Bkmbsa Filer ................. l� Bhmbe Pump l/auk ......... RadmuMgng aPllkar Vahra....... �J Caerekerds RlesaeW Sludtelsem . sed.. ae.... In Canpadmem CUMM Pmkus COMMA Prwhow _ 2nd Co"rbum Cunem PMW&= I Currom Pmdem Inepaowelean Aaranux Flyer >n C . Odor: Namkd ❑Pungent LMbw b/Oddem mama@ ❑@meeias Pod BeMe�n BddginglPmkdbw NoleNlnor ❑Emawlw W-kovem Im1PeeHC101to Disabargd Pump System min" Te_ Ina ROM SPlae tkdt y� Pump f / Floal cards ��-ry-i� bwpoct/Sonrlt6 Other System C&mponettte t H Oldnfactlon Epulpmen nye DNpeienl I.eNralal�esa yr Obwvavana s AddNtetml Urviaan ltertda/ed ❑Chened leslle ahaeta7 ❑ Replaced UV WM? / ❑ Rowace Ahad abler Rems4 - Porta Used W e Wnrrany, B c Wdge (./ appmpdwa seWW* W t - nus Nwnaar naaariolow FfRs BeTetjrltwpaadlen RBV robtabdad a eat Wan 6-onadd noonroeted; flush V11V'" dosed Petrel peal maatloetad %mmary/RaeemMondotlon ❑enMn Perrmrnegi no furpor aclon needed []Tank needs pumping . ❑C41 for mwke ❑OakeYl FaX Completed form to 1408-884»7+404 Municipality of Anchorage FOREST Development Services Department 1. BLOCK 3 Building Safety Division Individual On-site On -Site Water & Wastewater Program Location (site address or directions) 4700 South Bragaw SL SNOWBIRD DRIVE P.O. Box 196650 Anchorage, AK 99519-6650 Community Class Well www.ci.anchorage.ak.us Community On-site (907) 343-7904 Public Water System CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. Q9 /'? HAA# 1. GENERAL INFORMATION Expiration Date: Complete legal description GREEN FOREST SUBDMSION: LOT 1. BLOCK 3 Individual On-site Location (site address or directions) 12517 SNOWBIRD DRIVE • ANCHORAGE. AK 99516 Current Property owner(s) DUANE FRIDLEY Day phone . Mailing address Lending agency Mailing address Real Estate Agent Mailing address c/o ANITA BATES w/ COLDWELL BANKER FORTUNE Day phone ANITA BATES w/ COLDWELL BANKER FORTUNE Day phone 2525 'C' STREET • ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 265-9147 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 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 Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority 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 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 Health Authority 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 (les 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 GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 i 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 lest, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwaterlevels 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 test 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 confer any legal right whatsoever. 5. DSD SIGNATURE Approved for _Z2_ bedrooms. Disapproved. Conditional approval for bedrooms, with the Phone 337-6179 Date /Zlilot WATER AND /1llOU II I IGI I W. HAA Checklist_ Septic System Advisory Well Flow Advisory (Rw. IZVI) Maintenance Agreements Supplemental Engineer's Report Other Municipality of Anchorage Development Services Department � .r Building Safety Division On -Site water & wastewater Program 47W South Sragew St. P.O. Box 108850 Anchorage, AK 99519.8650 wwwAanctwrageAk us (907)343.7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: GREEN FOREST S/D: LOT 1. BLOCK 3 Parcel ID: 018-011-18 A. WELL DATA Well" PMVAh If A, B, or C provide PWSID# N/A Well Log (YIN) NO Date completed PRE 1974 Sanitary seal (Y/N) YES Wires property protected (YM) YES Total depth 82+ ft. Cased to 40+ ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 7/8/2005 Static water level ft. 79 fl, Well production g,p,m. 4.92 g,p,m_ WATER SAMPLE RESULTS: COMM= 0 colonies/100 mi. Nitrate 0.1 mgA. Other bacteria <2 colonies/100 ml. Arsenic: N/A mg,/L, Date of sample: 10/5/05 Collected by: GEG. LtD. B. SEPTIC/HOLDING TANK DATA TREATMENT Tank Type/Material STEEL- Date Installed 9/27-29/2005 Tank size 1500 gal. Number of Compartments 2 Cteanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (YM) NO High water alarm (YIN) YES Date of pumping NEW Pumper _ C. ABSORPTION FIELD DATA ENIMENIAllym Date installed 9/27-29/2005 Soo rating jj.p.d ft%dnn) 2_0 System We BED Length 22/18 ft. Width 10/17 ft. Gravel below pipe 0.59 ft, Total depth 03.4-3.6 ft. Eft. absorption area 270 ft= Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fal) rooms Fluid depLabsorptlon field before test _ in. Wate _gal. New depth _in. Elapsed : _ min. apth _ in. Absorptlon rate � g.p.d. n. treatment (past 12 mo.) (Y/N 3 type) If yes, give date D. LIFT STATION Date Installed 9/27-29/05 Size in gallons 1500 "Pump on" level at TIMEJn. Datum BOTTOM OF TANK E. SEPARATION DISTANCES 'Pump otf" level at>7�n. Manhole/Access (YIN) YES High water alarm level at 46 In. Cycles tested NEW Meets alarm & circuit requirements? YES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/ltfi station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/deanout N/A Holding tank N/A 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 we 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ■1' Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkinglvehide storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION i certify that I have detemdned through field inspections and * '! review of Municipal reowds that the above systems are in conformance with MOA HAA guidelines in effect on this date. ............. y Ing: Engineer's Printed Name JEFFREY A CARNESS CE -7953 •' Date /O /21 /bS o'�dP�of.■dW`d�c HAA Fee S Li ` 0 - Date of Payment to -o< Receipt Number 75 724 (Rev. 1201) Waiver Fee E Date of Payment Receipt Number pR=_�-� pOXE 33.211 N 79 5p1 XO / 60 o OF A "I0 �PS V1 oU! 49ZH*a ............................... CODE or DRIVEWAY I LOT ,I o SHANE A. HOLT: !, LS -6914 L ..... THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SNOW AM CONFLICTS BETNEEN EXISTING STRUCTURES AND PUTTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES OR FENCEUNES EASEMENTS OF RECORD. OTHER THAN THOSE SHONN ON THE RECORDED PLAT, ARE NOT SHOWN HEREOWWWESS INDICATED) NOTE ANY FENCELINES SHONN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LINES OR LOCATE STRUCTURES. ANY PAVING SHONN MAY BE APPROU "TE DUE TO SNOW CONDITIONS. ASBULT SURVEY (NO CORNERS SET THIS DATE( 1'RSO I HEREBY CERTIFYTHIAT 1 NAVE PERFORMED A MORTGAGE" INSPECTION OF THE FOLLOW NG DESCRIBED PROPERTY. LOT 1, BLOCK S, GREEN FOREST MIT NO.1 ANCHORAGE RECORD94 IDSTRXC , ALASKA AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WTHIN THE PROPERTY MES AND NO VISIBLE ENCROACHMENTS EMT OTHER THAN NOTED. DATEDATANCHORAGE,AIASKATMSOTH� N DAYOF_OCTOBER 7005 HOLTLANDSURVEYO 911W. 817410,40 TEL NS5517 Municipality of Anchorage ,� + j 1!q 16. IeKbLI •.yH•Ior,4a.WeL, }I!•t l!uaWl•-471K1Ii.n. J, •� •. � Unrq QKlrl ai:NiWll • fn, !s' 1.,• y111A � i .- ... 1 IJ diaiC�❑ Ingr//w,.x.nunilnT �,(�_i 3fdy4)rAlurkK-gich i>.n'elopmaltSen9ccancpartrticnt Ir'Paruncnr November 9, 2003 Duane Fridley 12517 Snowbird Drive Anchorage, AK 99516 Dear Mr. Fridley: REi Eaeroaeismentt Water WeU Block 3, Lot 1, Green Forest pl Subdivision, Grid 2833 The Right or Way Division has reviewed a request for a letter of nonobjection to an existing water well, which encroaches 3 fees Into a 104001 utility eascmcat on the east aide of the pmpcmy. On the as -built survey dated October 6, 2003, submitted with the request, the pMitioner has shown the existing water Wall This letter Of nonobjoction Is Issued with stipulations, and by wing it the petitioner is agreeing to The following: I. Municipality of Anchorage (MOA) will be hold harmless, now arvl forever, for any damages or injury to any person as a result of the encroachments. 2. All applicable codes and regulations will be observed and maintained within the easement. 3. This letter Of non -objection will in no way preclude MOA from full use and eriioymnt of its rights within any portion of the easement. 4. Additional and extraordinary costs hwurred during any (utute requited construction, repair or reconstruction of MOA improvements to accommodate any or all of the encrtarchmrnu sbai be paid by the property owner. 3. Obtain kltery of nonobjection from the following utilities: Anchorage Water & Wastewater Utility ® Alaska Communications Systems ® Chugach Electric Asaeciatlon, Inc. [] Matanuska Telephone Atsociation ❑ Matanuska bkctric Association, Inc. ® Enstar Natural Gas Compuny ❑ Municipal Light & Power ® GCI Cable of Alaska ❑ Byeoom (G•Irdwood Cable TV) All Icuers of non -objection should be retained in your permanent files. if you have any questions, pleau call me at 343.8033. Sincerely, CAl ick La.— Right of Way Supervisor Concur Property Owner(s) Comnutnity, Secrtrity, Prosperity r���w••••r1',�,oUOa�N�../.wn;,, M..,�,.,, f..r ire! G / r,:Ilv.bv NOV 12,2005 09:17A 9073383246 I e6rd 100000-000-000 page 2 No dEZt60 S00Z'8Z AON ■� ENCROACHMENT PERMIT 1203-29A G-2833 EN05064 018-011-18 This permit is between Chugach Electric Association, Inc., an Alaska non-profit electric cooperative, (herein "Chugach"), whose address is P. O.Box 196300, Anchorage, Alaska 99519 and Duane R. Fridley, (herein "Permittee"), whose address is 12517 Snowbird Drive, Anchorage, AK 99516. 1. Easement. Chugach is the grantee or user of an easement for the construction and maintenance of electrical facilities, as follows: Dedicated by the plat of the subdivision known as Green Forest Subdivision, according to Plat Number 66-134, recorded on the 30th day of September 1966, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, Described in that certain written instrument recorded on the 4th day of August 1952, in Volume 76, Page 276, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, Described in that certain written instrument recorded on the 30th day of June 1958, in Easement Book 3, Page 348, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, (herein "Easement") which pertains to the following described real property: The South Thirty Feet (S 30') of the East Ten Feet (E 10') of Lot One (1), Block Three (3), Green Forest Subdivision, according to Plat Number 66-134, recorded on the 30th day of j September 1966, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, Permittee acknowledges the validity of the Easement. Permittee warrants and represents that Permittee is the owner of the fee simple interest in the land subject to the Easement and the following described real property to which the Easement is adjacent: Page 1 of 4 Lot One (1), Block Three (3), Green Forest Subdivision, according to P1atNumber 66-134, recorded on the 30th day of September 1966, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, (herein "Parcel"). 1. Encroachment. Permittee has purchased or constructed the following improvements on or within the real property subject to said Easement: A well that encroaches approximately Three Feet (3') into said Easement for a distance of approximately One Foot (1'), (herein "Encroachment"). 3. Permit. Chugach hereby authorizes Permittee to continue the existence of the Encroachment in its location subject to the covenants set forth in this permit. 4. Indemnification. Permittee shall indemnify and hold Chugach harmless from any claims for personal injury, property damage or other loss arising in any way from the continuation of the encroachment. 5. No Expansion or Increase. Permittee shall not in any way expand or increase the extent to which the Encroachment occupies any of the real property encumbered by the Easement without the prior written consent of Chugach. Chugach has no obligation to provide such consent. 6. No Interest in Real Estate Acquired. Permittee hereby acknowledges that the Encroachment and any additions thereto, even if in violation of this permit, has not and shall not in the future give rise to any interest or estate in the real property subject to the Easement or any other real property. Without in any way limiting the foregoing, Permittee acknowledges that the Encroachment is not adverse to any interest of Chugach and its continuation is entirely with the permission of Chugach for purposes of the common law doctrine of adverse possession. This permit creates no interest in the real property subject to the easement. 7. Modification of Utility Facilities. If the electric utility facilities located within the Easement are upgraded, added to, replaced or reconstructed, Permittee shall pay that portion of Chugach's total costs for such modification which is reasonably attributable to accommodating or preserving the Encroachment. If such payment is not made within thirty (3 0) days of written demand for same, Chugach may terminate this permit in accordance with paragraph 9, below. 8. Covenants Runnine with the Land. The obligations of the Permittee arising from this permit shall be covenants running with the land which shall burden the Parcel and the Permittee's interest in the land subject to the Easement and shall benefit the Easement. Encroachment Permit - Page 2 of 4 9. Termination. Chugach may terminate this permit after the giving of thirty (30) days written notice of such termination if: a. The Encroachment is enlarged, increased or extended within the real property affected by the Easement. b. The Encroachment is damaged by any means to an extent of more than thirty percent (30%) of its replacement cost at the time of destruction. C. Permittee fails to make the payment described in paragraph 7, above. 10. Term. This permit shall, if not sooner terminated by Chugach, expire forty (40) years from the date hereof. 11. Entire Agreement. This written permit constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all other prior or contemporaneous agreements, oral or written, between the parties. No modifications, amendments, deletions, additions or alterations of the permit shall be effective unless in writing and signed by all of the parties hereto. CHUGACH ELECTRIC ASSOCIATION, INC. By: 14— lelIA- Edward M. Jenkipp, .E., Director, Engineering SeKices Division Date: /0 — Z / - o S PERMITTEE Ora Date: 9?-2.5-2-GbS Encroachment Permit - Page 3 of 4 STATE OF ALASKA ) ) ss: THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this day of At,, r t' -s k— 2005, by PRINT PERMITTEES(S) cko'^; Notary Public in and for the State of Alaska ON My commission expires•J "/ 7 Q 0 0'7 STATE OF ALASKA ) ) ss: THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this 2 A <,�- day of 04o � w 2005, by EAt il d'A M. J P.,, k Director, Engineering Services Division of Chugach Electric Association, Inc., an Alaska corporation, on behalf of the corpo 'on. Notary Public in and for the State of Al ska My commission expires:o fiff.f / _ AFTER RECORDING RETURN TO: Chugach Electric Association, Inc. P.O. Boa 196300 Anchorage, Alaska 99519-6300 Encroachment Permit - Page 4 of 4 n August 15, 2005 Duane Fridley Gamess Engineering Group, Ltd. 3701 E. Tudor Road, Suite 101 Anchorage, Alaska 99507 n ACS Alaska Communications Systems ACS has no objection to the encroachment of the well into a platted easement located on Lot 1, Block 3, Green Forest Subdivision as depicted on the as -built drawing submitted. Acceptance and use of this letter of non -objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: 1. ACS will be held harmless, now and forever, for any damages or injury to any person or property as a result of this encroachment. 2. Any ACS facility damaged or destroyed as a result of this encroachment will be repaired at no cost to ACS. 3. Any costs incurred by ACS for special construction necessitated by this encroachment will be bome by the property owner. 4. All applicable safety code regulations will be observed and maintained. 5. This letter of non -objection will in no way preclude ACS from full use and enjoyment of its rights within any portion of its right-of-way. Sincerely, 4Gregc d, Foreman Outside Plant Engineering ACCEPTANCE: 4t' DATE: A4ryl /0/2/lOs- KO.Po + DrMLECOSP.Enp,reWfpw=RRESFOwONoeECT~ Fa Sbd DOC 600 Telephone Avenue Anchorage, Alaska 99503-6091 tel 907.564.1000 www.acsalaska.com 11110005 -Aug -22 i■ %M 11:49 AM MOA Building Safety 9073438214 ANCHORAGE WATER & WASTEWATER UTILITY "A New Standard of Excellence" Owned by the Munidpalidy of Anchorage Gayness Engineering Group 3701 E Tudor, Suite 101 Anchorage, AK 99507 Engineering Division Anchorage 3000 Arctic Boulevard Anchorage, Alaska 99503-3898 au.aaap city fax 907.562.0824 http://www.awwu.biz 2002 Mark Begich, Mayor August 22, 2005 Re: Green Forest, Block 3, Lot 1 (Grid 2833) Encroachment into Easement Dear Property Owner: The Anchorage Water & Wastewater Utility received your request for a letter addressing AWWU's position regarding the existing well that encroaches into a utility easement that parallels the south east property line. An as -built drawing with well location and easements was submitted with the request. AWWU water and sanitary sewer mains are not available to the referenced lot. AWWU is not using the utility easement and has no objection to the encroachment. If you have any questions, please call me at 343-8009 or the AWWU Planning Section at 564-2739. Sincerely, Hallie Stewart Engineering Technician Voted Best Tasting Water In America -1998 U.S. Conference of Mayors 1/1 August 12, 2005 Mr. Duane Fridley c/o Gamess Engineering Group Ltd. Mr. Jeffrey Gamess 3701 East Tudor Road, Suite 101 Anchorage, Alaska 99507 Re: Letter of Non -Objection Grid: 2833 To whom it may concern: ENSTAR Natural Gas Company A DIVISION OFSEMCO ENERGY Engineering Department 401 E. International Airport Road P. O. Boz 190288 Anchorage, Aluka 99519-0288 (907)334-7743 FAX (907) 562-0053 ENSTAR Natural Gas Company has no objection to a well encroachment into the Ten Feet (10 ft) utility easement East boundary of Lot 1, Block 3, Green Forest Unit No. 1 Subdivision, according to Plat 66-134, located within the NE 1/4, Section 29, Township 12 North, Range 3 West, Records of the Anchorage Recording District, Third Judicial District, State of Alaska. Acceptance and use of this letter of nonobjection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: • ENSTAR will be held harmless, now and forever for any damages or injury to any person or property as a result of this encroachment. • Any ENSTAR facility damaged or destroyed, as a result of this encroachment will be repaired at no cost to ENSTAR. • Any costs incurred by ENSTAR for special construction necessitated by this encroachment will be home by the property owner. • All applicable safety code regulations will be observed and maintained. • This letter of nonobjection will in no way preclude ENSTAR from full use and enjoyment of its rights within any portion of its right-of-way. Sincerely, �%���JJJ Andrew Frailer Right -of -Way Assistant ENSTAR Natural Gas Company cc: File Doug 1'J 05 02:21p ■ ■ fn % August 19, 2005 Duane Fridley Home Owners 12517 Snowbird Drive Chugiak, Alaska 99516 Dear Duane Fridley, p.I Subject to your agreement to indemnify the company as set forth below, GCI Cable Inc. of Alaska has no objection to the well encroaching into the 10' Utility Easment 3' on the Southeast property line of Lot 1, and Block 3, Green Forest Subdivision. Known as (12517 Snowbird Drive. Anchorage, Alaska 99516), in city grid # NW2833 This letter of non -objection in no way precludes GCI Cable from full use and enjoyment of any rights it may have within any portion of the utility easement and or the right-of- way, including unlimited access for servicing its facilities. Also any additional and extraordinary costs incurred during any future required construction, repair or reconstruction of GCI's facilities to accommodate any or all of the encroachments shall be paid by the property owner. By signing below, you agree to indemnify and hold GCI Cable harmless, now and forever, for any damage, costs, expense (including reasonable attorney's fees), liabilities and injury to any person or property occurring as a result of the encroachment. Please indicate your acceptance by signing and returning this letter to myself at the address below. If not signed and returned to GCI within 30 days of issuance this letter of non-obicetion becomes void for all intents and pumoses Sincerely, Rob Hansen CAD Operater Level 1 E -Mail- RHANSFNI(a�GCI.COM Office # (907) 868-6769 Fax # (907) 868-8580 J"ZJV- Ar Acceptance signature B -ZS -7W5' Date 5151 Fairbanks Street • Anchorage, Alaska 99503 • 907 / 868-5600