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HomeMy WebLinkAboutT15N R2W SEC 25 LT 129CT15N, R2W, Section 25 Lot 29-C #051-312-35 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page Of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221450 PID Number: 051-312-35 Dwelling: P1 Single Family (SF) R with ADU R Duplex (D) El Two Single Family Project: El New P1 Upgrade Name Robert Hahn ABSORPTION FIELD Site Address El Deep Trench [:] Wide Trench ®Bed W1 Mound 15443 Husky St. Eagle River 1 0 Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 2.0 GPD/SFI 4.7 Ft, LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 2.18 Ft. 0.25 Ft. 129C Fill added above original grade Gravel length Township Range Section 1.17-1.27 Ft. 32 Ft. 15 2 25 Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 13 Ft. 5 2.4 Ft. To„ Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist- between trenches From Tank Field on Tank Line 416 Ft2 Ft. Well 100+ Septic El S.T.E.P. 171 Holding El Other i Manuf Capacity Surface Water Gal, 100+ Mat Material Number of compartments Lot LineNA 10+ Foundation 10+ E LIFT STATIONManufacturer Ca 'ty Remarks Gal, Tank exvosed during bed installation, no holes seen. Alarm location Electrical installed b Air compressor and pump alarm tested and working. PIPE MATERIAL House totank Tank to Installer drainfield D3 ' 0 - 34 Northern Excavation Drainfield D3034 CO/MT D3034 Inspector Areterra Consulting BENCH MARK (Assumed elevation) 100 ft InspectionLocation and description dates.- 11/16/22 2"' 11/16/22 Yd 11/16/22 4`11/18/22 Bottom of Shed Roof ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp (OF Conditional Approval: Date 49M KENNETH[ 0 s a Septic System CE 7 Approved' Date ib__0�7 Note: this approval does not include well permit requiremen s. (Rev 05_/0_2/18) AS—BUILT SYSTEM DETAILS/SITE PLAN Permit ❑SP221450 T15N R2W SEC 25 LOT 129C PID# 051-312-35 I �SH HED i I � s r � D B / MT MTF K rri ry D F n fel = X �c COs H O � G C V) H 3 MT Frl o� Z! EXISTING AIR r� CUMPRESSUR a / ¢I �I A / \ SND Sf'p U. LV rel c I of pi , N� �I �I SCALEi 1' = 30' a a A -C=82.7' A -H=111.8' .. B -C=78,3' B -H=106.0 9a 91 95,00 q A -D=86.5' A -I=112.7' B-D=75Ij .0 B -I=105.7 o PLYWOOD FINISHED GRADE r P'O v A -E=110.2' A -J=113.8 VISBUEEN HARRIER ❑RIGINAL GRADE 93,73 FILTER FABRIC 34 a B -E=106.3 B -J=105.5 A 91,8 A -F=114.0' A -K=114.0` y EA GRAVEL 91.30 B -F=104.3 B -K=104.8 A -G=110.9' F B -G-106.7 SAND FILTER A DISTRIBUTION LINES 91.55 a 13� BOTTOM OF SAN 89.0 IR LINE $9,5 4 ■ lk SCALEr NTS 41 Aw OF At ..- � 1 PREPARED FOR: gCTER m ROBERT HAHN 228 PYRRA ROAD JO' Nyk 4 TH * FORD CITY, PA, 16226-0000 a a FIELD BOOKS COMPUTED: a � A ; x N _ 1B •• BOUNDARY: N ZA DRAWN: KSD Z o F STING CHECKED:N A CHECKED: KMD a �° I.•.�i�q�,r Aseui�T. JLS DATE: �2 �3 22 S$YO�y� ■ �a� DWG. FILE: GRID: NW0653 •�eR' c ACAD FILE: FILE JOB No.: 22167 AK. 3I - "6 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: OSP221450 Work Type: Septic Upgrade Tax Code Number: 05131235000 Site Legal Address: T1 5N R2W SEC 25 LT 129C G:0653 Site Mailing Address: 15443 HUSKY ST, Eagle River Owner: HAHN ROBERT J & FRANCES Design Engineer: ARC TERRA CONSULTING INC This permit is for the construction of: Effective Date: Expiration Date Lot Size in Sq Ft Total Bedrooms: 11 /14/2022 11/14/2023 Q Disposal Field ❑ 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 Special Provisions: 1. MOA requires that an air gauge and alarm be installed on the air compressor. 2. The steel tank is 22 years. Per Policy W.05 Standard of Care Regarding the Inspection of Steel Septic Tanks, the tank should be exposed and inspected for holes at the time of construction to replace a failed drainfield. -. .4 +-(-) X rr_�Y-ro� Cons, Date: Issued By: Date: II /y Z- M MUNICIPALITY OF ANCHORAGE Development Services Department %' Phone: 907-343-7904 On -Site Water & Wastewater Section --� Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-312-35 Property owner(s) Robert Hahn Day phone Mailing address 228 Pyrra Rd. Ford City, PA 16226 Site address 15443 Huskv St. EaLle River Legal description (Sub'd., Block & Lot) Lot 129C Legal description (Township, Range & Section) T15N R2W Sec 25 Lot Size 30,000 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field X❑ Initial ❑ Single Family (SF) ❑X (w/wo AD U) Septic Tank p ❑ Upgrade ❑X (D) ❑ Holding Tank ❑ Renewal ElDuplex 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. Dea Duffus (Signature of property owner or authorized agent) Permit/Rush Fees: 616 - Date of Payment: /D/a pl a Receipt Number: 00L/ / 56 Permit No. Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221450, Deb Wockenfuss, 11/14/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221450, Deb Wockenfuss, 11/14/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221450, Deb Wockenfuss, 11/14/22 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 f Day of of 20_ZZ, by and between A --. herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65365. 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 Intermittent Sand Filter located at (legal description) T15N R2VV Sec 25 Lot 1290, 15433 Husky St, ChAtgtak- 4tk,9 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) hroughout the teen 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. t shall be.the responsibility of the Owner during the teen of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically S400 to 5600). ner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative wilt inspect and make any necessary maintenance, repairs or permitted alterations to the system. A�vner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfieid replacement. Page 1 of 3 (rev. 05/18."2018) _, caner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. inner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. .4�-caner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. /6 � wner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. caner 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. �Iner a`rees 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. S. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent _jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05118."2018) Page 2 of 3 ONVNER: By- (sionature) DaIe (print name) STATE- OF ., t 'r='A } � SS TI IIRD JUDICIAL DISTRICT ) The foregoing 1 •t merit was ac �-- o?wledged before me titin Slav Of tV ?Q)Ji by 1 l Commonwealth of Pennsylvania - Nc�ar� Seel V. Dawn Zimmerman, Notary Puolic 0"1-A Y PUBLIC FO rC�if: fC 1115 `1IU�"�� Armstrong County MV C 11111ission expire.. My commission expires November3.2028 Commission number 1185534 member, Pennsylvania Association e1 t4ota^es ,MUNICIPALITY: Ry: – G ��- I� r' Ale".�ir�cti----'Z�l�natttrcl i (print name} t � ; { Y Y z F (rev. 05'14 101h) C)nte.�j– =— title "" ^"' ^'"^^ '~^ "^""~'" WA Pred ta 4t cent 4hef0p�Lo ca -Aii ii AM J. WA Pred ta 4t cent 4hef0p�Lo ca -Aii ii AM Municipality of Anchorage Poge 1 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 545-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SWO00151 PID Number: 051 --512--55 Name:NiCK AND ROBYN SCALES WastewaterSystem: [] New · Upgrade Address: 15445 HUSKY ST. EAGLE RIVER, AK 99577 ABSORPTION FIELD No. of Bedrooms: eh°ne:(907) 696--5259 4 IDDeep Trench DShallow Trench mBed nMound BOther* LEGAL DESCRIPTION .2.0 o.o/s.. ~ 1.8 - 2.5** 129-0 - - (+)0.74 - (+)0.04 F~ 0.27 Township: 15N Ronge: 2W Section: 25 Fill added above odginal grade:Gnrvel length: 3 ~ 30 WELL: [] New [] Upgrade/,,.,''/''''''- °~v"' ''dth: 12 F~ Number of lines:6 IDi~en~ baleen lin":2 R. ~1 ~60 sQ. ~ D 3054/ F-810/SCH 40 PVC ~ DENALI SEWER AND D~IN 6/15/00 - 6/19/00 ~,. ~,. TANK SEPA~TION DISTANCES ~ Septic ~ Holding · S.T.E.P. -rom Tonk Reid St=Uon m=nk S.w.~ u~.. ANCHORAGE TANK 1500 Well 100'+ 100% 100% -- 25% STEEL 2 s~ ~oo'+ ~oo'+ ~oo'+ - - LIFT STATION Water Line ~500 ANCHORAGE TANK~ORENCO SYSTEMS Foundation 5'+ 10'+ 5'+ -- -- 42" 46" Droin - NONE KNOWN 20 OSl 05 HHF ALCAN ELECTRIC I I Remarks: *BO~OMLESS ]NTERMI~ENT SAND FILTER. BENCH MARK · * 2.27' OF MOA APPROVED SAND FILTER BELOW TOP OF MANHOLE LID TOTAL DEPTH. Inspections pe*rmed by:. AWWC, INC. Dates: 1st 6/15/00¢~ .,/ , ,~,~ 3rd 6/~5/00 .~,~ ~...~ ~....~ 5th 6/~9/00 ~..' (~-7953 ..."~ Depa~ment of Health and Human Se~ices approval ~?~.~ ...~ .......... · Reviewed and approved by:~~ ~, ~ Ddte:~- ~' Oe ~ ~ ~ ~ PERMIT NUMBER: AS BUII T DP WING PARCEL ID NUMBER SWO00151 ' 051-512-55 % % A B ' % k~ ST1 58.8 48.5 ~ k ST2 42.4 56.0 ~ ~ ~H 43.e 5S.O ~ % ~T~ ~2.5 ~.2 ~ % MT~ 5~.3 S~.~ % MT5 87.9 112.2 ~ MT4 89.5 109.6 I I~O~ ,~,~ ~ I / AIR LINE ., .........,..,.... ,.../ ¢¢//. /¢-~ ~ ",~, '-- ~ ~ ~ . I~R~NT ~D AIR COMPRESSOR~ / ~ S.T.E,P. T~K / / / I ,ATE: AI~ASI~ WATER & WASTEW~FER ~.~.w. ~ ..~ PREPPED FOE: PHONE NUMBER: PAGE HUMBER: NICK ~ ROBYN SCALES (907) 696-5259 2 OF ~ ~ ~ T15N, E2W, SEC 25, LOT 129C, ~4 '"'. ."" ~E Of WORK: ~rOfess~O~ AS-BUILT OF SEPTIC SYSTEM UPGRADE (BOTTOMLESS ISF) PERMIT NUMBER: AS BUILT DRAWING PARCEL ID NUMBER: SW000151 - 051-312-35 FIg~I. 6RAPE - /--NgNHOte tip -' 9~,'/4 / 98,~, - 98.? / - NBW I COO T~S~P' 97,~7~ ~} -- blN~5 ~ 98 24 , / / ; ;;;:' OmWN6/26/2000By: ~&~'j'l''~'~¢ CFi f/' }~, AI,&SB WATER & WASTEWATER K.D.W. ~ 7////~ NICK & ROBY. SCALES (907) 696-3239 3 OF 3 ,~ [¢p¢~A~/ "}~ T15N, R2W, SECTION 25, LOT 1290 ..'" PROFILE AS-BUILT OF SEPIIC SYSTEM UPGRADE (BOITOMLESS ISF) 06/01/~00 THU 16:25 FAX 907 762 3149 JACK ~¥~II'[~ REAL ESTATE ent ~ty: /~.l. aaka Water & ~I/as~:ewateP Consu; 907 338 3246; Jun.1 -0o 14:S1; PROPERTY OWNER MAINTENANCE AGi~EEMENT ON-SITE WAiT~WATER DISPOSAL SYSTEM ~]002 Page 2/2 This agreement, d~re4 ~/~ 200~ is made between the MunicipaLity of Anchorage Department of H~alth ami Human ~vcic~s (DH3IS) and the property owner(s) of ~ agreement is made for the purpose of maintaining an on-site wastewater disposal system on me subject property. The prol:,er~ owner(a) agree to ~e fo}lowing: Tho property owner(s) will have an annual inspeedon of the system performed by a registered professional engineer. This inspection shalt verify that ail effluent and air pgml~, timers, and alarms are functioning as flesign~. Any ~lefieiencies shall be correete~l and ~e engineer's statement that the sysmm is i'uncfioning as designed s~ll b~ fried annually with the DHHS. Property Own~ (Notarize Here) Sent By: Alaska WateF & WastewateP Consu; 907 338 3246; dun-27-O0 9:43; Page 2/2 Alcan Electrical Engineering, [nc. 6670 A~c~ic Spur Rd. Anchorage, Alaska 99515 Fax Cover Sheet DATE: June 27, 2000 TIME: 8:50 AM TO: AVVVVC HONE: 337-6179 ,Jenny FAX; 338-3248 FROM: AIc..a~ Electrlc PHONE: 563-3787 8kipp Brlngmann FAX: 562-6286 T15N, R2W, $ec.25, Lot 129C (15443 Husky St.) RECEIVED 000 MUnicipality of Anchorage Dept. Health & Human Services In regards to the sewage lift station that Alcan connected at th~ above mentioned location. All electrical work performed by Alcan was done to 1999 National ]Electrical Code, (NEC) standards. If you have any questions please contact me. Thank you! Number of pages including ~over sheet: 1 [/[ 'd lgLB'ON 0[~10313 NVOI¥ ~¥g~:6 ooog'~'Nnp MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box '196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jun 07, 2000 Expiration Date: Jun 07, 2001 Permit Number: SW000151 Legal Description: T15N R2W SEC 25 LT 129C Design Engineer: 0041 AK Water & Wastewater Consulta Owner Name: Rick & Robin Scales OwnerAddress: 15443 Husky St. Eagle River, AK 99577- ParcellD: 051-312-35 Site Address: 015443 HUSKY ST Lot Size: 30000 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] SepticTank [] 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 (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. Date: ~,~-- 700 Date: -~-7- O O ALASKA i,¥ATER & WASTEWATER May 31, 1999 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Sewer Upgrade for Lot 129C, Section 25, T15N, R2W (Bottomless Intermittent Sand Filter-ISF) To whom it may concern: The existing 4 bedroom house is served by a private well and septic system. The existing septic system consists of a 1250 gallon septic tank and deep trench type drainfield. The existing drainfield is surcharged and must be upgraded prior to sale of the house. We are proposing that a 1250 gallon S.T.E.P. tank and a innovative Bottomless Intermittent Sand Filter (ISF) system be installed. Comments regarding the proposed upgrade are summarized as follows: 1. GENERAL: A test holes was excavated north of the existing septic system to determine an area suitable for a septic system upgrade. Groundwater was encountered in the test hole and is believed to be shallow in the area. Given the limited area around the testhole, the setbacks from the existing septic system, and the contours of the property; it is our opinion that a Bottomless Intermittent Sand Filter (ISF) system is the most viable option. 2. SOILS: Attached is a log ~vhich show the soil classifications, groundwater monitoring, and the pemolation test results. The soils below the organics are a GM/SM material to a depth of 2.0 feet an then transition to a GP/SP material (very compact) to a depth of 8.0 feet (bottom of test hole). Groundwater was found at 6.0 feet excavation and on 5/30/00, the monitoring tube was checked and found water to be at 4 feet, 8 inches. A percolation test was performed between the depth of 2.0 feet to 2.5 feet which had a percolation rate of 7 minute/inch. It is our opinion that due to the overall appearance of the soils, a application rate of 2.0 gallons/day/sq.ft, should apply for the proposed bottomless intermittent sand filter system. 3. DRAINFIELD DESIGN: Bottomless Intermittent Sand Filter (IFS) a. Percolation Rate: 7 minute/inch b. Allowable Application Rate: 2.0 gallon/day/ft2 c. NumberofBedrooms: 4 6901 Debarr PPad,, Suite 2B ~ AncI~orage, AK ~ 99504 ~ (907) 337-6179 ~ Jrax (907) 338-3246 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 300 ft2 f. Effective Depth below pressure pipes: 2.5+ g. Effective Depth: 2.5+ inches h. Width: 12 ft. i. Length: 30 ft. k. Effective absorption area = 360 ft2 j. Air Supply: Thomas Industries, Model 5070, "Anchorage Tank". k. Air Supply Line: "Wasteflow" emitterline, 1/2 inch I.D, "Anchorage Tank". 1. Sand material: In accordance with M.O.A. latest standards m. Pea Graves: 100% passing 3/8" sieve, less than 20% passing the 1/4" sieve, and less than 1% passing~ IJge #8 s~eve.' We are proposing ~ exca~vate down tOd depth of 2 feet (maximum- remove all oreanics), place a minimum of 3'g'inches of sand, install the air supply linc, and cover it with 18 inches of sand. On top of the sand, we will place 6 inches of 3/8 inch pea gravel, with the pressure laterals midway in the layer. We will use a conventional lift station (Anchorage Tank), equipped with a programmable timer so that flow can be intermittently dosed to the ISF. 4. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic upgrade. 5. TOPOGRAPHY: As can be seen on the attached design, we are proposing to install the bottomless ISF on a generally flat area near the base of a slope that is less than 25 percent; in short there are no slope concerns. 6. MATERIALS AND CONSTRUCTION PRACTICES: The materials used, and the construction practices will comply with DHHS' "Intermittent Sand Filter Design, Installation & Maintenance Manual". The contractor should read this document prior to construction. Copies are available at the Municipal Onsite Services office (5th floor, 9th & L St.) 7. CLOSING: I am open to any suggestions from your department, which would be an improvement to the proposed design. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank ~o~ for your assistance. Presittdnt I ~ NOTE: Attached is a site plan drawing, a design drawing, a detail drawing, a soils logs, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road,, Suite 2B N Anchorage, AK ~ 99504 - (907) 337-6179 ~ Fax (907) 338-3246 J I L I ' ALMDALE AVENUE ".. l- / ~ .... .......... ~ I r-........ ~ ......... / ...... II ~ II I / .10o' WELL RA~USL I \\ LOT 125A Il] 7,// '1 ' ' X \ l{ JOD'/ WELL RADIUS II ~ I \ \ t / I I j \ \ Il /', , i ~j\ \'' LOT'~124Bf~7~--'' // J \ J / // \ I\ [ / ~)1 --- \ LOT125B I ,I I ~-/Z. ~\\ ~'. [~100' WELL RADIUS I LOT 123 I ' j / J ' , J 7 LENISTING X~XISTING \, I MI I "~'-~1 LO]- 129B ,100' WELL RAOlU$~ II (/)I I I I \ ,q-, I x. / I ~ I __ _~,J ~:- ....................... t SEE SAW AVENUE 5/51/2000 ,_¢-.- ,~ OF ~:~ ~.....;' '..~ W I'ER & TEWAIZR .. EICK & ROBIN SCALES (907) 696-5239 1 OF 3 ~9~ .... ;~r~ T15N, R2W, SEC 25, LOT 129C, iJ,~r"C,,~ .. SITE P~NFOR SEPTIC SYSTEM UPGRADE (BOTTOMLESS ISF) NOTES: THE AIR COMPRESSOR SHALL BE LOCATEO WITHIN THE BASEMENT OR THE GARAGE. THE CONTRACTOR SHALL PROVIDE A 0-10 PSI PRESSUR GAUGE AT A LOCATION WHICH IS READILY ACCESSIBLE FROM WITHIN THE HOUSE. NOTE: A 50 PSi GAUGE WILL NOT WORK. THE AIR COMPRESSOR SHALL BE A THOMAS INDUSTRIES MODEL 5070, AS SUPPLIED BY ANCHORAGE TANK. THE AIR UNE SHALL BE 1/2 INCH D~ HDPE (1 PIECE), INSIDE A 2 INCH SCH.40 PVC JACKET. THE LiNE SHALL BE BURIEO TO A MINIMUM DEPTH OF 3 FEET. THE GONTROL PANEL FOR THE $.T.E.P. TANK SHALL BE INSTALLED OUTSIDE RESIDENCE WITH AN AUDIBLE/'V1SUAL INDICATOR INSIDE THE HOUSE. DRIVEWAY NOTE: THE CONTRACTOR SHALL HAVE ALL THE 100 FOOT WELL RADII SHOWN FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION, ~ PROPOSED BO1TOMLESS INTERMITFENT SAND FILER. EXCAVATE A BED THAT IS ~ 2 FEET DEEP MAXIMUM. (REMOVE ALL ORGANICS) BY 12 FEET WIDE BY 30 ~ FEET LONG. SEE ATrACHED DETAIL AND PROFILE (PAGE ,.3 Of 5) FOR ~ CONSTRUCTION DETAILS AND \ PROPOSED 1500 GALLON S.T,E.P, EXISTING C"7'-r LAT _~,D / 4- BEDROOM HOUSE EXISTING SEPTIC TANK TO BE ABANDONED AIR (SEE NOTES) / / / / ~ / INSULATED / AIR LINE (SEE NOTES) / / / ALASKA VATER & WASTEWATER :~: ~-~ CONSULTANTS, lNG. DATE: MT CO 5/5 /2ooo DRAWN BY: J,L.M, SCALE: 1" = 30' FOR: PHONE NUMBER: PAGE NUMBER: RICK &: ROBIN SCALES (907) 696-5259 2 OF LEGAL DESCRIPTION: T15N, R2W, SEC 25, LOT 129C, OF WORK: DESIGN FOR SEPTIC SYSTEM UPGRADE (BOTTOMLESS ISF) MT EXISTING DRAINFIELD TO BE ABANDONED COMPLETELY PLAN VIEW ~ Pb~O~ ~P D/4" PV6 LA~5 (~,4)~ ~ ~ 5~~ ~Fl~ ~l~ J.L.M. ~ ~/ "..~ ~ ~S~ WATER & WASTEWATER s~: CONSULTANTS, INO, ~ ...... PREPPED FO~: PHONE NUMBER: PAGE NUMBER:~].~.~ DETAIL OV BOTTOMLESS INTERMITTENT $ANV VILTKR (ISV) ALASKA WATER & WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 2B * ANCHO~GE, AK. 99504 PHONE (907) 357-6179 * FAX (907) 358-3246 [SOIL LOG - PERCOLATION TEST[ LEGAL DESCRIPTION: PERFORMED FOR: DATE PERFORMED: T15N, R2W, SECTION 25, LOT 129C, RICK &: ROSIN SCALES 5/m/oo ORGANICS I TEST HOLE #1 I GM/SM GP/SP HARD DIGGING SOIL CLASSIFICATIONS ORG NL CL OL NH CH OH SC DEPTH TO DATE GROUNDWATER 6' 5/19/00 4'-8" 5/30/00 SITE 3 BEDROOM SEPTIC BOUSE SYSTm LOT 129B .'100' WELL RADIUS~I DATE READING CLOCK NET TIME WATER LEVEL NET DROP TINE (NINUTES) READING (INCHES) IPERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING ,5/19/00 1 1:52 6" 2 2:22 50 2:22 1 7/8" 4 1/8" 4 2:52 30 1 3/4" 4 1/4" 5 2:52 6 3:22 30 1 3/4" 4 1/4" PERCOLATION RATE 7.0 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 2.0 FT, AND 2.5 FT. COMMENTS: PERFORMED BY ALASKA WATER &: WASTEWATER. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFOJ~k~D IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON DATE: '~ ~'~' ~ ~ MUNICIPALITY OF ANCHORAGE Zi ~. DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION I 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT [] UPGRADE LEGAL DESCRIPTION ~ ~ Material ~ No. of compartments ~ ~ ~ DISTANCE TO: Well'[r~(/~ Dwelling PERMIT NO. O Z ~ Manufacturer Material Liquid capacity in gallons ~ ¢ Well Foundation t Nearest lot line ~ ( : PERMIT NO~ Nm~ DISTANCE TO:. ~+0~ ~U~5 Distance~t~e~lines . Z No, of lin~ Length of each lin~ TotaJ length of~f Trench width ~ --"~ ¢ ~ incheslnChes ~ ~ ~ Top of tile to finish grade Material beneath tile , iLength ,, /~ Width Depth PERM[TNO. ~ ~ Type of Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ DIST~Cfi TO: Buildln~ foundation Se~or lino Septic tank ~ t ~ Absorption PIPE MATERIALS APPROVE · ATE LEGAL 72-013 - ' DEPARTMENT '' HEALTH AND EN'./IRONMENTAL' ~Z, TECTION ~,~.~, TYPE OF SOIL HE.>uRBTIEN _.,=.TEM IS: TRENCH MR~.~II',ILIM NUMBER ElF BEDROOMS = 4 SGIL RATING .... Q FT,-'BR)= THE RE~UIRED SIZE OF THE =.OIL MBSORFTILN =,~.¢TEM ~ ~¢~ I~d. E:.EF'TH= 12 LEFI~3-FH= 49 13 F: Fl'./i L B, EF'TH= THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIEL. D. THE DEPTH OF 8 TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET), SEPT I E: TR~-JF; S I ZE= 1250 PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PF~OPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILt_ SERVE. TPJm3 (2) I r4SPEm3TIE~S R~:E~ ~:E[;4~.LIZ ~E[:' BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL. SYSTEM IS i00 FEET FOR A PRIVATE WELU OR i50 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELl_. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERF11 T E,'-~-:F' I I~ES DEE:EF1BER -?:1. 1978 I CERTIFY TI-IRT t: I 8M FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF RNCHORAGE. 2: I WILL INSTALL. THE SYSTEM IN ACCORDANCE WITH THE CODES. 3:: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RES I[~EN,~MODELE~,~:LUDE MORE THAN 4 BEDROOMS. RF'PL I CANT HARRY MRCKEY ,.,. O 8. E GE(- ~ECHNICAL 8- DEVELJ'PMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell O~$ter 694-2774 SOIL LOG Soils [:t Foundations Perfo~ed for: Name: ///~/~' Hatltng Address: ~,~'. Legal Description: ~'~ /~~ Depth (feet) Sot1 Characteristics Earl Ellis Land Developmerit Tel. No. 5 11 15 Ground Water Encountered: Yes No~ If yes, what depth__ Proposed Installation: Seepage Pit: Drain Field__ Comments: Performed by: Date: Well Log: 'Lot 129 C, ~To.dd Subdivision 'Sa~ $owfel. ~ Eale River, Alaska' 99577 Drilled bM: Harry A. ,Mackey Owners: Log: , Triple M~Cabinet and Floorcove~ing ' ~illiam ~ndI Michele ~riggs ,0-7 feet,-, gravely sand to cl~y 8-~8 feet,-,clay more to a hardpan i~8~43 feet,-~targe boulder ,43~h9 feet,- Gravel, clay and a~little ~t~r ~9~61 feet,-,Sand, gravel ,clay' ,6~ , feet - ,Water - 5 gal min.'or, more~' Cased to 70 feet and drilled~to'9~, ?0~95 feet,- Course sand, clay to grave~i, ROBERT C. JOHNSON Registered Land Surveyor P. O, Box 456 EAGLE RIVER, ALASKA 99577 2I April 1972 Mr~Rolf Strickland DEQ- GAAB Subject's Soils andWater info f0r~_~_BLM L~t l£9~Sectton~.R~ WATER~ Lot~140 adjacent on the south has 55' well at ½ GPM. Lot~,128 adjacent~,on the west i's cna 15' hill and has 77' well at 1GPM.~ Lo$i. 142 located 330' west and in.the ne~t: tier of lots south has 123' well at 15 GPM~ Lot 129 located'330' west~ has 109' well at~2 GPM. Lot'129 has a 125' well w~i~ has never been~used or'developed to d~te~ ~ellinE~ onL'ot~i40 adjacent on south h~s septic~tan~ and'100', of dr~i~ til~..(a~out 1 year old) ~elling'on Lot!~i28 adjacent on west has septic tan~' and seepage pit: now in 5%H~,year off'use and~is situatedi~s~lty till containingi~ lenses of'sandy gravel~ The other adjoining lots h~ve no d~velop~ent on the~at this time~, SOILS~: A 5~' te 25' deep by 600' lone'cut for the Glen~Hyyo is located~ 500' southeast of~Eot:I29 and is a gravelly till ~*~th sandy lenses and~ pockets quit'e similar toH~ cuts Iocated¼mile south as reported i'n'i971 for theLake Ridge Terrace Subd. project~ A ~' d~ep ~y 40' long road~cut is located 230' north of Lot~*129 and exposes sand and gravel under 30" oftopsoil~ A 10' deep by'J00' lon~!i~hru'cut located 350' northwest of 'Lot~',129 exposes sandy gravel and was used tb surface sor~e of'the local st~eetso Lot~i29 has no excavati'ons on it'o Lo~;,129and~adjoining~iBLM Lot~ are located on a hill which is excess/o~50' in height andwhich slpoes off on the north~ eas~, and west° i. 694-2543 or 694-9210 Certificate of On -Site Systems Approval Parcel I.D. 051-312-35 Legal description TI 5N R2W SEC 25 LT 129C Site address 15443 Husky St Eagle River Current property owner(s) Robert and Frances Hahn Expiration Date: 7 1 ?O Z 3 The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: c Original Certificate Date: 1/17/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory_ Absorption Field Advisory Nitrate Advisory Tank Age Advisory X Arsenic Advisory Other COSA ApprovMjune 2022 HUHMPA UTY OF AHC HO FRA GCE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 051-312-35 Complete legal description T15N R2W See 25 Lot 129C Location (site address) 15443 Husky St. Eagle River, AK Current property owner(s) Robert Hahn 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: © Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ® Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ✓❑ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: © Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 22 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: © AWWTS © Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ �-�O 1� Waiver Fee $ Date of Payment I �1 �'�a C,� Date of Payment COSA # �5c22 5s` Waiver # COSA Application June 2022 Legal Description: T15N R2W See 25 Lot 129C Parcel ID: 051-312-35 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 1/1986 _Total depth 400 ft Cased to 40+ ft ✓❑ Sanitary seal is functioning correctly F/I Wires are properly protected Casing height (above ground) 20 in. Date of flow test for COSA 9/28/22 Static water level at beginning of test 40 ft. Comments B. TANK DATA Measured operating fluid level in septic tank 42" Date of pumping 12/5/22 0 Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed)New 11/16/22 © ALL standpipes present per record drawing Total measured depth from grade 3.6 ft (max) Measured depth to pipe invert from grade ft (min) FX -1 N/A — pressurized field. ❑ Per record drawings, field is insulated. ® Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) Text .If yes, enter date Comments/Deficiencies: COSA Checklist June 2022 Well production at time of test 0.22 gpm Water storage tank volume 1000 gallons Well disinfected for coliform test? ❑ Yes ✓❑ No 0 Coliform bacteria is Negative Nitrate 1.54 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑./ Arsenic less than MRL (ND) Collected by Areterra Date 9/28/22 C. LIFT STATION 0 Required maintenance completed Age of lift station 22 years Lift station material Steel Comments: Adequacy test date Results ❑ Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' R] Yes if No ft 0 Yes if No ft Neighboring Tank > 100' Q Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Absorption Field on Lot > 100' ✓❑ Yes if No ft Holding Tank > 100' Q Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ❑.! Yes if No ft R Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' [2]Yes if No ft 0 Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' 0 Yes if No ft Tank to Property Line > 5' © Yes if No ft Field to Property Line > 10' n Yes if No ft Water Main > 10' [✓1 Yes if No ft Water Service Line > 10' R Yes if No ft F. ENGINEER'S COMMENTS Wells on Adjacent Lots: Private Wells > 100' Community Wells > 200' Q Yes if No ft ® Yes if No ft If tank or field is under driveway comment below G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Areterra Consulting Phone (907)-696-6111 Engineer's Printed Name Kenneth Duffus Date Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can Arclerra guarantee that no unseen encroachments, deficiencies or discrepancies exist COSA Checklist June 2022 www.muni.org/onsite Septic Tank Advisory Certificate of On -Site Systems Approval # OSC221557 Subdivision: Block: , Lot: T15N R2W Sec 25 Lot 129C The septic tank for this property is 22 years old. The average life for a steel septic tank is 20 years. Typical replacement costs range from $7,000 to $11,000. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like. Madmg Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www mum org �xn,.. r s,_., r... ._ Well Nater Advisory Certificate of On -Site Systems Approval # OSC221557 T15N R2W Sec 25 Lot 129C This well's productivity was determined to be 0.22 gallons per minute. The minimum well productivity required under (AMC 15.55) for a 4 -bedroom residence is 0.41 gallons per minute or 150 gallons per day per bedroom. Although the well production does not meet this requirement, water storage has been provided to meet minimum code requirements. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. 77 777, ,Mailing Address P O box 196650 *xAnchorage, Alaska 99519 6650 *www mum org % 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 *c_� 3 Day of of 20 a e., by and between Kra �Q� 1 J -0>r -2 ek , 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), descri-bed as Intermittent Sand Filter located at (legal description) T15N R2W Sec 25 Lot 129C, 15433 Husky St, Chugiak 2. Maintenance. Repairs and Alterations. (Owner is required to read, understand and initial each section) L Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. J L 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). J L 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. c' Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) 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 fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14,60.030. WAC Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. �- Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. �L 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. J�—Owner agrees to maintain remote monitoring of the AWWTS as required by the .' AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By 61--6t`t�hl (signature) Date: 1a )1 a 1�a (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this day of 20j.?,- by d� NO ARY BLIC fOR ALASKA F , . PaNk My Commission expires: 05--7,�, -&1j, MUNICIPALITY:-- By: (signature) t J a -'n $ �O L.i� /',.. f3 (print name) Date: t 1 Z 3 Title: (rev. 05/18/2018) Page 3 of 3 WNER: By: R(signature) Date: 2. 2G2Z C_in G, , G, (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this day of W 20��4NOTAR ?k �>r le a PUBLIC FOR ALASKA uoIt Al-A, My Commission expires: S fa Doi..I&xIM MUNICIPALITY.- By: UNICIPALITY:By: (signature) (print name) Date: Title: (C---tiril (rev. 05/18/2018) Page 3 of 3 Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING 051-312-55 1. GENERAL INFORMATION Complete legaldescription T15N. R2W. SEC 25: LOT 129-C Location (site address or directions) 154,45 HUSKY ST. EAGLE RIVER. AK 99577 Property owner NICK AND ROBYN SCAI ES Mailing address 15445 HUSKY ST. EAGLE RIVER. AK 99577 Lending agency Day phone Mailing address Agent MANNY ESCABEDO w/PRUDENTIAL JACK WHITE Day phone (907) 227-5259 Address 5~01 "O" STREET. SUITE 200 ANCHORAGE. AK 99505 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4- 3, TYPE OF WATER SUPPLY: Individual well xxx Community well Public water NOTE: If community well system, provide wdtten confirmation from State ADEC attest- ing to the legality and status of system. Day phone (907) 696-5239 4. 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 lng to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 Computer Version Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $3570.00 at, or prior to, closing for the engineering services provided. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspe,cfion, the on-site water supply and/or wastewater disposal system is in compliance with all MunicipaJ ~,hd State codes, ordinances, and regulations in effect on the date of this inspection. .fi'fi//I Name of Firm ALASKA W~ V~ ~'F~/'~TE~R CONSULTANTS, INC. Phone (907) 337-617_9 . / , / Address 6901 DEBARR p,0AD. ~[U~ ~B~/,/~NCHbRAGE, ALASKA 99504 , /' _._ Engineer's Signature ~"~/~/t~/JF'__ ~~~/ Date ~/~-~/~ -- system in accordance with ADEC and Md/A fi)HI~ ' Guidelines & Regulations. The reported results described the pedormanca of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of ~ the evaluator of the system. Satisfactory test results do not guarantee future performance ~'.~ ~v of the system, nor do they guarantee that there are no hidden defscts or encroachmsnts, .~,.~%~:~" // / J~'/"/.~.~.~.~l~, AWWC, Inc. can therefore not provide any warran~y for future estimate of how long the ~'~ ~'" /~ system ~11 continue to meet the operational requirements of the ADEC or MOA DHHS. ~. ~. :./...l..~/t////ff.(~.~ ~. '..,. . . . .~, The content of this report is for the sole benefit of the owner li'sted above. Any ~J~ / reliance upe, or uss of this report by any other person or pa y is ,ot authorized, nor will it confer any legal right whatsoever. ~ '~ ; ~. ef~re~//A. 6. DHHS SIGNATURE q~,-~,, ... ... ~ .,'~,. .. .......... · I/" Approved for ~ bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: There are nitrates present. It is su~eested that periodic testin~ be performed to insure the wells continued suitability. Current nitrate concentration is 5.34 mt/1. EPA maximum concentration is 10.0 mt/1. More information on nitrates is available from the On-site Services Program, DHHS, 343-4744. By: Date II The Municipality of Anchorage Depadment 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 cedain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a cedificate is issued, The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72~)25 (Rev. 1/91) Back MOA//'21 Computer Version Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICL~N Environmental Services Division 825 "L" Street, Rm 502 Anchorage, Alaska 99501 (907) Health Authority Approval Checklist Legal Description: T15N, R2W, SEC 25; LOT 129-C Parcel I.D.: 051-312-35 A. WELL DATA Well Type PRIVATE Log present (Y/N) Date completed Total depth. 400' Cased to 40'+ Sanitary seal (Y/N) YES IfA, B, or C, attach ADEC letter. ADEC water system number YES 1/86 Casing height (above ground) 2' Wires properly protected (Y/N) YES Date of test Static water level 25' Well production 3.75 WATER SAMPLE RESULTS: Coliform 0 Date of sample: 5/30/2000 B. SEPTIC/HOLDING TANK DATA Date installed 6/15/2000 Foundation cleanout (Y/N) Date of Pumping. NEW C. ABSORPTION FIELD DATA Date installed FROM WELL LOG ~/56 AT INSPECTION 5/~ ~/2ooo 13.5' ~ g.p.m. *0.26 g.p.m. ~ · 1000 GALLON NSF APPROVED PLASTIC STORAGE TANK _~ Nitrate 5.34 mq/L Other bacteria 0 ~ Collected by: A.W.W.C., INC. [ Tank size 1500 YES** Pumper - ***2.27' OF MOA APPROVED SAND FILTER BELOW TOTAL DEPTH. 6/15/oo - 6/19/oo Soil rating (g.p.d./ft2 orft2/bdrm) Number of Compartments 2 Cleanouts (Y/N) Depression (Y/N) NO High water alarm (Y/N) YES **INSIDE FOUNDATION 2 System type BOTTOMLESS ISF Length 30' Width 12' Gravel thickness below pipe 0.27 Total depth ***2.43 - 3.13 Effective abSorption araa 360 SQ. FT. Monitoring Tube present (YIN) YES Depression over field (Y/N) NO Date of adequacy test NEW Results (Pass/Fail) For ~ Fluid depth in absorpt!0n field before test (in.~dded (in.}: __ · r~atment (past 12 monthS) (Y/N) If yes, give date : 72-028 (Rev. 3/96)* Computer Version D. LIFT STATION Date installed Manhole/Access (Y/N). High water alarm level at* Cycles tested 6/15/00 - 6/19/00 Size in gallons YES ."Pump on" level at* 42" 46" NEW *Datum BOTI'OM OF TANK 1500 "Pump off' level at* 42" E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line. 100'+ 100% N/A 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Lift station 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5'+ Property line 5'+ Absorption field Water main/service line 10'+ Surface watefldrainage 100% SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property line 10% Building foundation 10'+ Wells on adjacent lots 100% Water main/service line Surface water 100% Driveway, parking/vehicle storage area 1 o'+ Curtain draiI NONE KNOWN Wells on adjacent Iots~ ...... Icertifythatl h~ve of Municipal ~co~¢e ~ove[systems are in confo~ance Signature Engineefs ~~~ A, GARNESS Date. HAA Fee $ ,-~© ,OO Date of Payment ~?~ -7/c-~) Receipt Number b [~/o ~_~-r._~) 72-026 (Rev. 3/96)* Cornputer Vemion Waiver Fee $ Date of Payment Receipt Number. MUNICIPALITY OF ANCHORAGE MEMORANDUM WATER WELL ADVISORY HEALTH AUTHORITY APPROVAL NO. 0~)0 ~2,,"~/ During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Lot ~~~_~ Block ~ of 7~/~-A/j~ Z~/; ~C,~'Subdivision, the well's productivity was determined to be ~,~ L gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a ~ bedroom residence is O.~__/ gallons per minute. Although the subject well currently~cacas ~ minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies ~f the subject Health Authority Approval. ' .~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Service~ Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEAl]TH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 0',.~] ~/~-- ~'-q NAA# 1. GENERAL INFORMATION Lot 129C; Sec 25i T15N; R2W Complete legal description Location (site address or directions) 15443 Husky Street Eagle River, AK 99577 Pro '~d~:b~er'i "'~±ck ~ Robin Scales , p y, · : ; , Day phone 696-3239 i~1~iling.address' ':l~Z~3 Husky Drive Eagle River, AK 99577 Lending ag'ency· ' ' Day phone · "~il~lalli~g a~dress-. Agent. " Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 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 xxx Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm $ & $ ENGINEERING Phone 17034 Eagle River Leop Road No. 204 Address Eagle River, AJaska 99577 Engineer'ssgnature ~//'~¢'¢~? ~.-~,.,,_- Date 7/~'/~/? DHHS SIGNATURE · ~ Approved for Disapproved. __ Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments 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 D H HS does this as a courtesy to purchasers of homes and their lending institutions in orderto 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. 72~25(Rev, 1/91) Back MOA~I MUNICIPALITY OF ANCHORAGE ~i~ONMmTA~ S~VlC~S OIVlSION Municipality of Anchorage JUL 2 9 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 3~4[~4~ E I V 825 L Street, Room 502 · Anchorage, Alaska 99501 ° (907) 34 Health Authority Approval Checklist Legal Description: ~.-~' t'z-~ C5 $cc.~.~}~t~l,.J) [~_~ Parcel I.D.: O.~ / .- 31 3- -'5 5- A. WELL DATA Well type ~,\V,~'~- If A, B, or C, attach ADEC letter. ADEC water system number Date completed ¢" I, ct q ~' Log present~_Y.)N) ~ 'To 4o~' , ,V,~,~ "r~ 7~'a " Total depth c~ ~ , ~O.J~,,~ Cased to 7~ ~ Casing height (above ground) Sanitary seal Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform 0 Y FROM WELL LOG Wires properly protected~/N) AT INSPECTION ~7- I-~7 Date of sample: "~/-~.'~/~ ~' B. SEPTIC/HOLDING TANK DATA Date installed ~ ~'~ ~ Tank size Nitrate /o,? 7 .g.p.m; ,Z, ,'Z-~z '"~//... Other bacteria Collected by: 5 '~ ~ ~{-~_~'. Number of Compartments ~ Cleanouts (~AI) ~zS5 Foundation cleanout (?O ~'~0 Depression (Y~I,~ ~ High water alarm (Y/N) DateofPu, rnp.}'~;::' ~[~t'~ Pumper ~"'.-l~, eO~',~ ~ C. ABSORPTI'~N:FIELD DATA'~ . ~,~. 5. Datei~stailed--:~' ~ ......... .. [~Soilrating (g.p.d./ff~or~. /~ System~pe Length . ~ ~ ' Width ' '~ Gravel thickness below pipe Total depth Effective absorption area '"~ ~ Monitoring Tube present~N)~ Depression over field (Y~ Date of adequacy test "~" I ~ ~ 7 ResultS/Fail) /~ ~ For Fluid depth in absorption field before test (in.); ~ '~ ~ Immediately afte~ gal. water added (in.): Fluid dept~ ~ ~/~ ~ (ins) Minutes later: ~ ~ Absorption rate = ~ 0 o & _g.p.d. Peroxide treatment (past 12 months) (Y~ ~P~ /~ If yes, give date bedrooms 72-026 (Rev. 3/96)* ~ 3 'j'1 ~OI2 /~a,,J D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at* ~p off" level at* High water alarm level at* _,....-~ *Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT 'TO: Septic/holding tank on lot ~ o c> On adjacent lots Absorption field on lot \o ~ On adjacent lots Public sewer main ¢ [ A' Public sewer manhole/cleanout Sewer/septic service line .~.~- k ,~ Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~' ~' '~ Property line __ \ o \ ~ Absorption field~ Water main/service line ~,F) t, ¥ Surface water/drainage Icc, ~ ~ _ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line Surface water Curtain drain ~ Building foundation Io Water main/service line ~' ~" Driveway, parking/vehicle storage area Wells on adjacent lots ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal recorc ~"~,~ ~l~F. stems are in conformance with MOA HAA auidelines in effect on this date. Date _ _ HAA Fee $ ~'~ D~ '/~(~ Date of Payment Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* July 18, 1997 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 129C, P.c. ll~n: ~ubd?A:'~cn Water Storage System Inspection Dear Onsite SerVices Engineer: On July 17, 1997, we visited the house located on Lot 129C l~llin3 Subdiaiai~a to inspect the type and capacity of the potable water storage system. The inspection was prompted by the homeowner who requested the inspection be completed to assure the system is in compliance with Ordinance No. 96- 98(S), Section C concerning water storage facility specifications. The storage system consists of two 250 gallon custom made aluminum storage tanks with varying dimensions. The exterior of the tanks is covered with 2" of white foam insulation. One tank is free standing on the furnace room floor. The other is above resting on the floor joists and built entirely inside the wall. Tank No. 1 is approximately 81" high by 42" wide and 16" deep. A sight glass is installed to allow inspection of the water level. Tank No. 2 is approximately 115" long by 24" high and 26" wide with a riser on top to accommodate the float switch and inlet and outlet piping. Tank No. 2 is above Tank No. 1. It is separated by a 2" X 10" floor joist and connected by copper pipe. The storage system is filled from the top tank. A 3/4" copper air vent extends from the storage system through an outside wall and also serves as an overflow. A Smith Aqua Air V-200 Goulds Pressure Tank with a capacity of 40 gallons feeds the house. Water is transferred to the pressure tank from the storage tanks with a transfer pump. The water storage system was installed by Todds Plumbing of Eagle River. The overall condition of the water storage system is good with no detectable leaks. Water was delivered to the site by Pure Glacier Bottled water and injected in to the storage system. The system had been previously drained. 487 gallons of water was pumped at a rate of 10 gallons per minute. The site glass in the upper tank indicated 4" of caPacity remaining. This would indicate the system will hold a volume in excess of 500 gallons, is therefore in compliance with the Municipal Ordinance, ~.'.' Sincerely, Michael E. Anderson, P.E. SEWER&WATER INSPECTION ENGINEERING STUDIES ~uNO REPORTS WELL INSPECTION & FLOWTEST ROADDESIGN 801LTEST STRUCTURAL& MECHANICAL INSPECTIONS ROBERTC. COWAN, P,E. ROBERTA. SHAFER, P.E. WELL RECOVERY TEST DATA CiViL ENGINEERS (907) 694-2979 FAX (907) 694-1211 CLIENT: WELL LOCATION (legal): L-%~..~ TEST DATE: WELL DEPTH: ~ ~. W~LL DRILLER: CASING DEPTH: TEST PROCEDURE: 1) Draw water down to pump. 2) Shut pump off 15-60 min. -record time -record meter reading 3) Turn pump on. Drawdown. 4) Shut pump off. -record time -record meter reading 6) Calculate gaL/min, recovery. TEST DATA: START TIME: MISC DATA: I ( Casing Height: Sanitary Seal? Wires in Conduit? Grading O.K.? Pump Depth: Samples Taken? ~"~.~ Date: t,"/,. '. ~,~ STATIC WATER LEVEL: ,~... I TR,AL II PUMP II TIME II METER II I ON ---- -"- ~o.L~ 2 ON % OFF 3 o~ ~ ~ ~ OFF %~ ~ ~ OFF 4 ON OFF OFF 5 ON OFF RESULTS: WELL CURRENTLY PRODUCES: ~ I D, (~ ~PH FLOW RATE NOT GUARANTEED--SUBSEQUENT VARIATIONS CAN OCCUR. 17034 NORTH EAGLE RIVER LOOP . SUITE 204 . EAGLE RIVER, ALASKA 99577 ,7 DATE RECEIVED ~ ' INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE MUNICIPALITY OF ANCHORAGE DEPT. OF I!~,:',LTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTioi~NVIRONMENT/\L  825 LStreet-Anchorage, Alaska 99,01 FEB 6 1981 ENVIRONMENTAL SANITATION DIVISION T ,..hoo. 2B.-.,20 .RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete ~equests will not be proce~ed. Please allow ten (10) days for processing. 1. ROPERTY WNER . ~ . P ONE ~ROPERTY RESIDENT (if different from above) ~ 2. ~ - ' PHONE ILING ADDRESS ~ . LEGAL DESCRIPTION 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One ~ Four ~' SINGLE FAMILY [] Two ~-~ Five [] MULTIPLE FAMILY [] Three [] Six [] Other 7. WATER SUPPLY ~ * ATTACH WELL LOG. A well log is required for all wells drilled INDIVIDUAL* [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** ~Oi,'~00 YEAR ON-SITE SYS'IJEM WAS INSTALLED. [] PUBLIC UTILITY ~ .~.~6.c~T V 'LzP'~" j~c~ ~ THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTI LITY Conl]ectioo Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTENI PERMIT NUMBER [] I NDIVI DUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY i~) Connection Verified INSTALLER []Septic Tank or [] Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TO: Septic/Holding Tan~; Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line ^PPROVEDFOR BEDROOMS / [] CONDITIONAL APPROVAL {letter must accompany cert[ficatel [~ DISAPPROVED 72-010 (Rev. 6/79) ,¢,/; MUNICIPALITY OF ANCHORAGE DEPT. OF I EALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIo~NVIRONMENTAL p;:dLT{£CTION/~ 825 L Street - Anchorage, Alaska 99501 FEB 5 197 ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES PROPERTY RESIDENT (If different from above~- PHONE , PHONE 2. BUYER ~ ~ ~' . 5. LEGAL DESCRIPTION STREET'O.E' NUMBER OF BEDROOM B. TYPE OF RESIDENCE [] One ~OOM~Four [~INGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six [] Other WATER S PPLY 7. ~ INDIVIDUAL~ [] COMMUNITY [] PUBLIC UTI LITY 8. SEWAGE DISPOSAL SYSTEM [~ INDiVIDUAL/ON-SiTE** * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) I J ~t~J~ ~'ln · L~/~ Z .L~. ~ **If individual/on-site, give installation date /~'?~ If system is over two (2) years old an adequacy test is required [] PUBLIC UTI LITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR I NSP ECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS '~ SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO '~ FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY ~ INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER '~INDIVIDUAL/ON -SITE DATE INSTALLED [~PUBLIC UTILITY Connection Verified C~ _ ~-~3- INSTALLER ~]Septic Tank or []Holding Tanki ~ ~ ,~ Size: I ~,(,~(~"~ If Tank is homemade SOILS RATING give dimensions: I TYPE OF TANK MANUFACTURER 4. DISTANCESwELL TO: Septic/Holdingl ~ ~).1 Tank Absorption\ I ~kIArea~' Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS [~ APPROVED FOR. ,z~ BEDROOMS [] CONDITIONAL APPROVAL (letter must a/c~mpany certificate) LEGAL DESCRIPTION 72-010 (Rev. 3/78) DTI002496 ALAS KA LOT 124E LOT 124A N00*07'50')E (N00°16'15"E NOO"17'19"E 100.78' (N00°17'30" 101.00) R) ._ 80MM HUSKY STREET (SAN BOWFEL AVE) ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: BLM LOT 129C T12N R2W Sec25 S.M. AK PLAT 72-131 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shouh any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DATE; SCALE; E-MAIL; NOV 22, 2022 1 »=40' schullerOak.net 2 2 -1 1 1 DRAIN BY: ICHECKED BY, GRID NUMBER: BOOK/PA7;E JLS NW0653 220365 LOT 129B FND ALUMINUM MONUMENT FND 5/8" REBAR S"v OF 4N, L A 1v Z_d 0 1 V 49TH ?A ?A ?A ?A .. ...................... i. ..J, HN L. SCHULLER.: 0 T 1Q_1 r)A r).q q ew O.W.04p, 0 1831 Talkeetna Street k�' -.jk. Z1, Z2,.. • Anchorage, Alaska 99508 �® lfessiono\ (907) 227-1455 office (907) 274-4992 fax