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HomeMy WebLinkAboutVALLEY VIEW TERRACE BLK 2 LT 13 'r ' Municipality of Anchorage Page / of '?' DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: -'~. ~'~tgO~'C~ PIDNumber: O'.'SF).' L~-~-~ Name: .... Wastewater System: D New /~pgrade Address: %> O i5(?~ ~40 ~¢~, 2 ABSORPTION FIELD ~ Deep Trench ~hallow~rench ~Bed ~ Mound ~Other I Total Depth from original grade: LEGAL DESCRIPTION S°itRatino: i, ~ GPDISq~F4~ Lot: Block: SubdP ~ ;on: Deplh to pipe boltom ~rom original grade: Gravel depth beneath pipe ' Ft ~ O Ft WELL: ~ New ~ Upgrade Gravel width: ~ Number of lines:i 1°isunce baween ~ines:~.~' Classification (Private, A.B.C): Torsi Depth: Cased TO: Total absorption ar ~a: ' Pipe material: ~riller: Date Drilled: SlaVic Water Level: Installer: Date installed: , ~ SEPARATION DISTANCES ~ Septic ~ Holding ~S.T.E.P. s,~o~ LIFT STATION Water Remarks: BENCH MARK ~/¢ XpL°cati°n and Dosm 'pti°n: ¢ " r. :~ ,,,, .. , Inspections performed by: ~ Dates: ¢ ~t ~ *" ~-¢,~ ,.. Department of Health and Human Services approval << '... c~ ; " Reviewed and approved by~~ ~, ~Date:~.'/~¢... "'~,~, '' ~';;. .. .... ~ 72 (}13 fRev 91911 MOA 25 1" FF ! ~BI°CYcLE C Nell ABSORPTION TRENCH AB~NOON SWING TIES: AC 29 FT BC 55 ! BD 76 k BENCH 14ARK:; WINDOW SILL ASSUt/ED ELEVATION: IO0. O0 FT 1-OBBEfl PURl(LAND P.E. 205 W ISTH, AVENUE ARCH. AK. 99501 (907) 279-5916 II VALLEY VIE TERRACE LOT I$ BLOCK 2 TOM LORD SEPtiC SYSTEM AS.BUILT DATE: MARCH 51, 1999 SHEET: 2/5 GRID: SW16~ PERMIT # S~/990020 PID II 050-35£-18 VVTO?I32, DF/G 4-INCH INSULATION AI£OOWP£ESSOR I-I/4 PVC WITH ~/8" HOLES AT .30" 5 X 50 DRAINFIELD $ FT TOTAL DEPTH ! FT EFFECtiVE ROCK 5 FT COVER I05.$~ 99. J -°I 6" MIN SAND BACKFILL 5'-2" 6'-0" M5 + 4 4 + + + : BIOCYCLE 6000 SILT BARRIER ND SCALE LEGEND: 1. PRIMARY TREATMENT, SEPTIC TANK 2. AERATION TANK i CLARIFICATION TANK 4, DISCHARGE TANK $. SOIL ABSORPTION BENCH MARK: WINDOW SILL ASSUI~ED ELEVATION I00.00 FT TOBBEN SPURKLAND P.E. 205 W15th Ave Ak 99501 VALLEY VfE / LOT I3 BLD£K 3ID£YCLE ~/ASTE ~/ATER SYSTEM WASTEWATER SYSTEkt SCHEtffATIC DATE: MARCH $I, 1999 SHEET: GRID: PEBMIT # S~/9900~0 PJD # 050 35£-18 VVTO£I33, DI/6 RECEIVED APR 6 1999 Oept. Health & Human Serv Rive:c/ AK C,a,.oel Eie{hrlo }~J, Sed Lhe Bio=Cs~c:ie }.o©ahed ak Val!e2' View Tixis ~io CycJ. e was winced pe~; the 1996 National Sleoh:lea] Code~ lilt you have a~ly questJ, ons please qlve. 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 (9O7) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Mar 02, 1999 Expiration Date: Mar 01,2000 Permit Number: SW990020 Legal Description: VALLEY VIEW TERRACE BLK 2 LT 13 Design Engineer: 0007 Tobben Spurkland, PE Owner Name: TOM LORD Owner Address: PO BOX 140882 ANCHORAGE , AK 99514-0882 Parcel ID: 050-352-18 Site Address: 023603 LOWER TERRACE ST Lot Size: 47916 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] 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 ( t 8AAC72 ) and Drinking Water Regulations ( 18AA080 ). 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. 5. The following special provisions. THE ATTACHED PROPERTY OWNER MAINTENANCE AGREEMENT SHALL BECOME A PART OF THE PERMIT. Issued By: .. Date: 7 -2 - 7~ 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 RECEIVED ,lAN 13 1999 MUNICIPALITY OF ANCML~A(~E ENVIRONMENTAL SERVICES DIVISION SEPTIC SYSTEM DESIGN LOT 13 BLOCK 2 VALLEY VIEW TERRACE TOM LORD Municipality of Anchorage Department of Health and Social Services 820 1 Street Anchorage, Alaska 99501 December 23, 1998 We are submitting an application for an upgrade of the septic system for this lot. Tim submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable testholes are also enclosed. The septic system design is based on the following: Groundwater at 8 ft. Limited area available for standm'd septic system USE BIOCYCLE Soil Rating. From Testholes dated 12/01/98 9 rain/in = 0.8 x 2=1.6 gal per sq.ft/day No. of Bedrooms 3 Required Area per Bedroom: 150/1.6 =93.75sq.ft. Total area required; 93.75 x 3 - 281.25 sqft Use Standard 5-wide with 12 inches of rock Required Length: 281' 0.87/5 = 48.9 ft SYSTEM CONFIGURATION STANDARD 5-WIDE TRENCH TOTAL LENGTH 50 FT TOTAL WIDTH 5 FT TOTAL DEPTH 3 FT ROCK DEPTH 1 FT COVER 3 FT BIOCYCLE 6000 TANK The installation of this septic system will not prevent wells fi'om being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area, Ponding and/or concentratioo of surface runoff will not result from this installation. / ~k Nell / I! N 14 ! ! / / 250 300 TOBBEN SPURKLAND P.E. 205 W 15TH. AVENUE ANCH. AK. 9950! (907) 279-$916 VALLEY VIEW TERRA£E lOT 15 EI_OCK 2 TOI/ LORD SEPTIC SYSTEM DESIGN DATE: DEC. 22, ~998 SHEET: I/,~ GRID: SWI6~ PEr'NIT # SF/FgOOXX Piti ti 050-35~-18 VVfOZI3I,flk/5 Well 49±h 3PURKLAND No. c£-2825 Well / lOO 185 I50 FZ / ! ! TOBBEN SPURI(LAND P.E. 205 W 15TN. AVENUE ANCH. At(. 99501 (907) 279-5916 VALLEY VIEf~ TERRACE LOT 15 BLOC/( 2 TOM LOf~D SEPTIC SYSTEM DESIGN DATE: DEC. 22, 1998 SHEET: 2/5 GRID.. SW16~ PEr, MIT # 21~9980,¥X PID # 050 75~° 18 VV?O~12~.DL./5 4-INCH INSULATION AIRCOWPRESSOR M/N SAND BACKFILL 5'-2' IdlN 6'-0" ~tAX BIOCYCLE 6000 AIR LINES I-1/4 PVC WITH liB" HOLES AT 5 X 50 DRAINFIELD $ FT TOTAL DEPTH 1 FT EFFECTIVE ROCK $ FT COVER ~ t NO ££ALE j PRIMARY TREATMENT, SEPTIC TANK 2. AERATION TANK 5. CLARIFICATION TANK 4, DISCHARGE TANK 5. SOIL ABSORPTION TOBEEN SPURKLAND P,E. 205 Wl51h Ave Ak 99501 VALLEY LDT I3~ BLOCK B1ZT£YCLE WASTE WATE~ SYSTEM WASTEV/ATER SYSTEW SCHEWAT/C DATE: DEC. 22, 1998 SHEET: GRID: PER'MIT # SW9900XX PID # 050-35£-18 VVTO~133, D~6 PERFORMED FOR: Munt i.c'ality of Anchorage DEPARTMENT O: "~EALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG .- PERCOLATION TEST (ENGINEER'S SEAL) DATE PERFORMED: ~"~'/I l~& Township, Range, Section: 10- 11 13 HoLd 14 15 16 17 18 19 20 SLOPE WAS GROUND WATER ~! 7 ENCOUNTERED? IF YES, AT WHAT ~0~., t ~ DEPTH? ~ E Oeplh Io Walcr A/ler I f4mlilorir~g? 7 Dale: SITE PLAN DISCLAIMER: grnundwater Past and future presence ' from these oJ~.sorva~]ons. PERFORMED BY: I ACCORDANCE WITH ALL STATE AND MUNICIPAL G[ I£ ELINES IN EFFECT ON THIS DATr[ 72-008 (Rev. 4/85) PERCOLATION RATE __ (m~nules/mch) PERCHOLE DIAMETER __ TEST RUN BETWEEN FT AND FT nonditinn~ indicated are for the dates and/or depth of groundwater can not be shown only. predictPd .-- CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: Munlcil:ality of Anchorage DEPARTMENT OF ~EALTH & HUMAN SERVICES 825 "L" Street, A~mhorage, Alaska 99502-0650 SOILS LOG- PERCOLATION TEST PERFORMED FOR; "L c~ Lo~D DATE PERFORMED: LEGAL DESCRIPTION:..Lo~L Id i ~K ~L- 1 10- 12 13 14 15 16 17 18 19 20- Township, Range, Section: SLOPE SITE PLAN GROUND WATER E 'iCOUNTER ED? s IF YES, ATWHAT i1~ t ~ E /=./~/_ Time Time Water Drop f->o "~ - g __8~ ~o 2 ~o 5'lz P . ~COLATION RATE ~ (m.'~ 'es/inch) PERC HOLE DIAMETER ~ ~ I ~l ST RUN BETWEEN ~ FT Af,D ~//~ FT DISCLAIHER: Groundwater t.o_~ditions indicate.,: are for the dates shown only. Past and future presence ~,nd/or depth of gro'.~ndwater can not be predicted from t,ese o~s~e,~vatlons. PERFORMED BY: I CERTIFY TRAdA}r'THIS TEST WAS ACCORDANCE WITH ALL STATE AND MUNICIPAL GUII.ELINES IN EFFECT ON THIS DATE DATE: _ 72-008 (Rev. 4/85) PERFORMED IN PROPERTY OWNER AGREEMENT FOR TI~ MAINTENANCE OF AN ON-SITE WASTEWATER DISPOSAL SYSTEM This agreement, dated 199 , is made between the Municipality of Anchorage Department of Health and Human Services (DHHS) and the property owner(s) of: This agreement is made for the purpose of maintaining an on-site wastewater disposal system on the subject property. The property owners agree to th, e following: Submit to the Municipality of Anchorage, on an annual basis, an inspection and operation statement from a registered professional engineer. This inspection and operation statement shah verify that the engineer has inspected all effluent and air pumps, timers, and alarms, and that any deficiencies have been repaired and that the system is functioning as designed. (Signature) (Signature) (Printed Name) (Printed Name) .............................. Notarize Here ........................................... State of A'[6i %ldr~ On this ],.'-)- day of /~, TJ~_w'~,~rt.~ i '~'r'~. personally appeared before me, who is personally known to me ~>~whose identity I proved on tile basis of __ whose identity I proved on the bath/affirmation of , a credible witness to be the signer~i he/she ackn~:dged that he/sbe si(n~/d it. ~ / ) Notary, Public / ' ' , commission ~pires G~-~TER ANCHORAGE AREA BOROI' ~H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 N°· 757 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING NAME. ~/~/'~/'%'~-~' ~ ~ ADDRESS SEPTIC TANK: DISTANCE FROM WELl ~:,~" LIQUID CAPACITY //~"~:/~) GALLONS. NUMBER OF MATERIAL ~- COMPARTMENTS / .~-~7~ ~'.,~',, Z,,-*/~/~/-:-~:-,¢z-/~r~ ~',/~/ LIQUID INSIDE LENGTH ~ INSIDE WIDTH ,,'~ DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS ~/ OUTSIDE DIAMETER ~ OR WIDTH LINING MATERIAL //r'~' ~t/r-'~'¢,~' .~,-~//' DISTANCE FROM WELL /~ NEAREST LOT LINE ~ ~2 ~z, TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) , LENGTH ~ , DEPTH BUILDING FOUNDATION ~ ~) SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELl NUMBER OF LINES ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE FOUNDATION ~',~ / . NEAREST LOT LINE DISTANCE BETWEEN LINES /~//~ TRENCH WIDTH SQ, FT. LENGTH OF EACH LINE TOTAL LENGTH , OF LINES IN, TOTAL EFFECTIVE .DEPTH OF FILTER MATERIAL BENEATH TILE ~ IN. ABOVE TILE WELL: ~ .. ~///~ ~.~.*~.~,_~):.,.~-> ¢¢,/,-'~',;-z, DISTANCE FROM WATER TYPE ~¢/z~:~ , DEPTH ~ Z)~ , BUILDING FOUNDATION. /~ / SAMPLE ~ NEAREST NEAREST SEPTIC SEEPAGE ~ / OTHER LOT LINE ~¢ / ~ , SEWER LINE. /~ /~ ,TANK ~ ~ / , SYSTEM , CESSPO01/~/~ , SOURCES/~ DISTANCES: DIAGRAM OF SYSTEM DATE :~/ / APPROVED GREA'I ,-~R ANCHORAGE AREA BOR(...,LIGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6-6E0 ANCHORAGE, ALASKA 99502 TELEPHONE 279-8686 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT NAME Of APPLICANT /~-/)/~]~¢- /~ ¢'~ MAILING ADDRESSf/'/~/~'" ~.¢//7 ~///,~/ PHONE INSTALLATION LOCATION ~ ~/~ ,~ TYPE AND SIZE OF FACILITY TO BE SERVED ~ ~/~)~ ~f~///~ /~/Z~ ~/ ~ / ' FINANCED THROUGH TO BE INSTALLED B SOIL TEST rESUltS ~/~' NOTE: THI~ PERMit I~ NOT VALID WITHOUT ~OIL COMPLETION DATE ANTICIPATED ./'~ ~/ FINAL INSPECTION= 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUSJECT TO PROSECUTION. ./~ ~ TYPE ~'~?~/E~::~-~~ SEEPAGE AREA SIZE '~-~¢~-~ TYPE ~.~//&/,.~L/ SEPTIC TANK SIZE MINIMUM DISTANCES, REQUIREMENTS WELL TO SEPTIC TANK ~-~ ~ , SEEPAGE PIT , CAST IRON INTO AND OUT Of SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET[NTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT fitted WITH AIRTIGHT REMOVABLE CAPS. GRAVEL SACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION, OR LICENSED DESIGNER BIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-08 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE, ':'ATE d t A, PL,OANT'S SI NAT"RE '/ IEATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT 327 EAGLE STREET ANCHORAGE, ALASKA 99501 Depth Fee~ -- C-- Location Sketch Was Geound Wate~ Encounte~ed?_.~ Reading Date G~oss Time Net Time Depth To H20 P~oposod Instal~Seepage Pit__ k D~ain Field Depth Of Inlet Depth To Bot"~'o~ ~f-~it Or Trench ..... Net Drop Data Cem~ified By:...~_~f~/~>~.~ .... PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM !502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW950258 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:LORD THOMAS J & JULIAN A OWNER ADDRESS:P.O. BOX 140882 ANCHORAGE, AK 99514 DATE ISSUED: 8/31/95 EXPIRATION DATE: 8/31/96 PARCEL ID:05035218 LEGAL DESCRIPTION: VALLEY VIEW TERRACE BLK 2 LT 13 LOT SIZE: 47916 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: WELL SYSTEM 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 (iSAACS0) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ./2 ~7 / ,Z-:~t~ Gl o,~[~ DATE: I S SUED BY: ~;?~'~/-g-~// ~- - ...... DATE: / r r t 41" fi P b 10 r 11, SULL-I'l-AiN 'IAVA'IFUR. WELLS P.O. BOX 670272, CHMAK, ALASKA 89567 - TELUIH-OINE 688-2759 OWNER OF LAND 4t,D I - ------2- DEPYH? M' N ADDRESS to ,=.-t I ( L -E.Vf: Ll 011- r. LEGAL DESCRIFf DATE - Started E,,. de(j A S PER J-Pl' PERIMITNUMMER -AS RUND OF FOWMAIJON: C. Froni---L�--Fi. to– F fldc From-- Ft. F,,. From--Tt, to­ MISCL. YNFORMAIION: 17 RECEIVED SEP 211995 Municipality of Anchorage Dept. Hesilth &Human Services 1 -0 From t. to From[o-:- From. t«.-.*. From to From Ft. — ----- �tn From t. to f( , From t. to i F i. From From-- Ft. F,,. From--Tt, to­ MISCL. YNFORMAIION: 17 RECEIVED SEP 211995 Municipality of Anchorage Dept. Hesilth &Human Services Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 050-352-18 Legal description Certificate of On -Site Systems Approval j „/ /-?- Expiration Dat�- 2--4'2-023--' Valley View Terrace Block 2 Lot 13 Site address 23603 Lower Terrace St Current property owner(s) Lord Thomas X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: By: Original Certificate Date: 11-4-22 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 Arsenic Advisory Other COSA Approval—June 2022 M U HMPALITY OF ANCHORAGE A 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. 05035218000 Complete legal description VALLEY VIEW TERRACEBLK 2 LT 13 Location (site address) 23603 LOWER TERRACE ST Current property owner(s) LORD THOMAS Day phone 717-9632 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 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: 0 Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete Q Fiberglass Age 24 yrs _ 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 $ Date of Payment COSA # () S L Z Z- i S Z Waiver Fee $ Date of Payment Waiver # COSA Applicabon_June 2022 COSA Checklist Legal Description: VALLEY VIEW TERRACE B2 L13 Parcel ID: 05035218000 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 9/95 Total depth 200 ft Cased to 30.5 * ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 9/26/22 Static water level at beginning of test 54 ft. Comments * Seated in Bedrock B. TANK DATA Measured operating fluid level in septic tank Date of pumping 6/27/23 ❑ Required maintenance completed, if AWWTS Comments: * Biocycle D. ABSORPTION FIELD DATA Which system tested (date installed) 3/30/99 ❑ ALL standpipes present per record drawing Total measured depth from grade 4.5 ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. no 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) If yes, enter date Comments/Deficiencies: COSA Checklist June 2022 Well production at time of test 2+ gpm Water storage tank volume0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 0.229 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by NRimEng Date 6/8/23 C. LIFT STATION ❑ Required maintenance completed Age of lift station 24 years Lift station material fbrgls Comments: Adequacy test date 9/26/22 Results ❑ Pass Fluid depth prior to test 0 in Water added 450 gal New fluid depth 0 in Elapsed time 30 min Final fluid depth 0 in Absorption rate 450 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 12 in Effective depth used 0 in Effective depth remaining 12 in 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' tgYes if No ft M Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' Yes if No ft Absorption Field on Lot > 100' Yes if No It Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' nE Yes if No ft nm Yes if No ft Manure/Animal Excreta. Storage > 100' Community Sewer Maiin> 75' FE]Yes if No ft R Yes if No It F1 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' FR] Yes if No ft Surface Water > 100' Yes if No ft Tank to Property Line > 5' n Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' no Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' Water Service Line > 10' F. ENGINEER'S COMMENTS Fol Yes if No ft [E Yes if No ft Community Wells > 200' R] 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 Cerfificate 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 Finn NorthRim Engineering Phone 694-7028 Engineer's Printed Name Steve Eng Date COSA Checklist June 2022 9120/22 OF 44 4444 Steve Eng CE -62W -Vw 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 Day of jokj of 2043 , by and between J soh t6m,5 S�,Cj rev 1'1-Zn5cY1, herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as % j C Y' G u.— located at (legal descriptio Q5 U Q3 Luuo`� e r'rzL,-c 5S [-,SIS Q,' re � %� IL Lt �(5 -7-7 ?. 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 AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This 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. gOwner acknowledges that regular maintenance of an AWWTS reduces the potential O 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. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. QOwner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided 1�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. 9/1 FOwner 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: r 3 sLgnatu I re) Date: / 02 �lti��rne5 �/ N Gn�rint name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this day of JtIL , 20,n, by Jofemi a S}lEcc EY UA�/Sa ✓ NOTARY PUBLIC FOR ALASKA My Commission expires: MUNICIPALITY: �y By: (signature) (L� S T 0 `v ^' S 1�0(print name) VaKal baiw STATE OF ALASM Noun lobllc 0 eu cto.a cWWh6a,1z2051 om E0ft0My= Date: - // Z X 2 3 Title: C— ( (/l C_ Page 3 of 3 COSA Checklist Legal Description: VALLEY VIEW TERRACEBLK 2 LT 13 Parcel ID: 05035218000 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 9195 Total depth 200 ft Cased to 30.5 * ft �■ Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 9/26/22 Static water level at beginning of test 54 ft. Comments * Seated in Bedrock B. TANK DATA Measured operating fluid level in septic tank Date of pumping NA 9 Required maintenance completed, if AWWTS Comments: * Biocycle D. ABSORPTION FIELD DATA Which system tested (date installed) 3/30/99 9 ALL standpipes present per record drawing Total measured depth from grade 4.5 ft (max) Measured depth to pipe invert from grade ft (min) N 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) If yes, enter date Comments/Deficiencies: Well production at time of test 2+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes 0■ No 0 Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L ❑■ Arsenic less than MRL (ND) Collected by NRimEng Date 9/26/22 C. LIFT STATION X Required maintenance completed Age of lift station 23 years Lift station material fbrgls Comments: Adequacy test date 9/26/22 Results 9 Pass Fluid depth prior to test 0 in Water added 450 gal New fluid depth 0 in Elapsed time 30 min Final fluid depth 0 in Absorption rate 450 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 12 in Effective depth used 0 in Effective depth remaining 12 in COSA Checklist June 2022 -1-14 t S G H L L / S C'N (S 8,r F -,t/ /-- 15 T10( t L4-�- /-/ I -r ' PL (/-,., 1-on�ti,� i10„ SCALE: 1 "= 50' Lot 12 LOT 13 ,11pp� 8504V R N60o36' \�R T 719 _0 \SFT / Shed o Well Planter (typ) Septic vent Conc. Block Ret. wall (typ) Planter Wood Ret. wall (typ) - —� Se',otc ink h � � C'hprryp��`\99? a% bodr�� `3� �'gssr s Lot 14 � ,�F ' �F; • S qL�! o4 rr �� • d 49th ;9 4"' i� 4f, 000 : Elizabeth L. Walatka .� ® sr�i • 8036 - LSAR , • �e�� o ®� OFEss1otw- AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection in accordance with ASPLS Standards of the following described property: LOT 13 BLOCK 2 VALLEY VIEW TERRACE SUBDIVISION Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 20th day of OCTOBER, 2022. EASEMENTS OF RECORD, OTHER THAN FRED WALATKA & ASSOCIATES, L.L.C. THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON BE Engineers and Surveyors UNLESS OTHERWISE NOTED. FB 22-4, pg 15-17 907-248-1666 This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to establish any fence, structure or other improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product. w 3705 Arctic Blvd #313 Anchorage AK 99503 Email: crbioak@gmail.com (907) 274-0314 Homeowner Info Customer Name: Tom Lord Tank#: 64 Install Date: March 19% Address: Lower Terrace Street Area. Eagle River Initial Inspection: Alarms Tested: Air [�J High Water �] Battery Tested: Yes ❑ No ❑ N/A (Please make sure alarm is on "normal", not "mute") Does system have a septic tank ? No 0 Yes ❑ (Recommend pumping tank every 2 years) Is System Lid Locked? Lid hardware in working order? Is there any noticeable odor? Yes 0 Repaired ❑ Yes Z Repaired ❑ Strong ❑ Mild ❑ None 0 System Inspection Inlet plumbing in working order? Solids pillow normal? Yes F Replaced ❑ Yes [4 Requires Pumping ❑ Are all aerators functioning? Any buildup of solids? Yes 0 Replaced ❑ Yes ❑ No ❑�] �....� "uy�� � ,,.;,� s-.✓�n�". .. .,=�3 ��,r "�.s" w'`''„,:u w�":�-....�-��r'� �c�� �,' u..�^��, r^�.`^�."Y .c Ss��� T.a..� w �° �����#`�o,�. Glar�fia {�-i � .U'�ha .•{* ., ;�-- �. �.�? � ^�zsFn..,,,.,. '�� ,. %„�.: "y, a �, ���'�:�s'�"",�,, =�' z�. r. ��. � "`i�,,, �� z .'��"�4�.z".��' ��? �' ,�'��r� .� ;;�, Clarification return system operating? Any buildup of solids? Yes 0 Adjusted ❑ Yes ❑ No [✓] pH Reading: Dissolved Oxygen PPM Turbidity of discharge (in FTU) (pH of 6-8 is ideal) (2-5 is ideal) (Under 35 FTU is considered compliant.) 1. 3.5 2.11 .lxtan'!ux'S,�mcvaiJ9'.'3`�+'naR;..aae Pump float operating? Alarm float functioning? Any buildup of solids? Yes [V1 Replaced ❑ Yes Z Replaced ❑ Yes ❑ NoFVJ Filter cleaned? Discharge line condition: Yes [VI N/A ❑ Good Replaced ❑ Comments: Has emailing or mailing of form been requested? Yes ❑ No Inspected By: Chris Date: 6-23-2022 (contact office to request...)