HomeMy WebLinkAboutLAKE RIDGE TERRACE BLK 6 LT 5Lokeridge Terrace
Lot iii
Block 6
#051-313-27
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP231240 PID Number: 051-313-27
Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ®Upgrade
Name
JOEL & DENALI GARCIA
ABSORPTION FIELD
'
❑ Deep Trench El Wide Trench El Bed ® Mound
Site Address
14950 TERRACE LANE, EAGLE RIVER
® Other ADVANTEX
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
2 GPD/SF
ABOVE ORIGINAL GRADE 2 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
2.58 Ft.
Gravel depth beneath pipe
0.58 Ft.
Subdivision Block Lot
LAKE RIDGE TERRACE 6 5
Fill added above original grade
VARIES 6.3 — 6.92 Ft.
Gravel length
20 Ft.
Township Range Section
Gravel width
15 Ft.
Beds: Number of Lines
3
Distance between lines
5 Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
300 Fe
NA
NA Ft.
Well
50'+
50'+
50'+
25'+
TANK ® Septic ❑ S.T.E.P. ❑ Holding ® Other ADVANTEX
Manufacturer
ORENCO / ANCH. TANK
Capacity
1500 Gal.
Surface Water
50'+
50'+
50'+
Material
EPDXY STEEL
Number of compartments
2
Lot Line
5'+
5'+
5'+
NA
Foundation
10'+
10'+
10'+
LIFT STATION — PUMP BASIN
Manufacturer
ORENCO
Capacity
75+ Gal.
Remarks DECOMMISSIONED EXISTING SYSTEM &
INSTALLED NEW ADVANTEX SEPTIC SYSTEM
Alarm location
FIRST FLOOR
Electrical installed by
CAPSTONE
Installer JRS
PIPE MATERIAL House to tank 3034 Tank to 3034
drainfield
Drainfield 3034 CO/MT 3034
Inspector FWC
BENCH MARK (Assumed elevation) 100 ft
Inspection 15` 9/27/2023 2nd 10/2/23
Location and description
3'd 10/2/23 0' 10/5/23
TOP OF MH
ON-SITE WATER AND WASTEWATER SECTION APPROVALOF
~'��! ' ' ' ....',ill
Conditional Approval: Date
PP
I '
No_ ..� if
TH
..• . .
Septic System
Approved
� Curtis Huffman :
�� �`9is.. CE 128991 .•�O.,W
Date /
IF • . 10/10/23 . •\\C Amw
llaw
0
pROFESSI0NP
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Note: this appy al does not include well permit requirements.
, ,wJ
PID:051-313-27PERMIT:OSP231240
FIRST WATER CONSULTING
LAKE RIDGE TERRACE B6, L5
N 89'40'W 200'
I
�10' UTILITY Lot 6
EASEMENT
LO
I
WOODEN FENCE
40.5'
�v ASPHALT
DRIVEWAY
5.1'x23.9
PORCH
N
2.Q'x24.3'
CANT >
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0
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WELL
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PLOT PLAN AS BUILT x SCALE 1' = 40' GRID NW 0653 Project No. 23-258/A2
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates, inc. (907) 522-6476 Phone
kenOlangaurvsy.com 4. OF `il
Professional Land Surveyors jonothanOlangsurvey.com �• l
troviaOlangsurvsy.com AL
! 4 'Lq `��
I hereby certify that I have surveyed the following described property:
LOT 5, BLOCK 6, LIKE RIDGE TERRACE SUBDIVISION (PLAT No. P-549)
Anchorage Recording District, Alaska, and that the Improvements situated thereon are
within the property lines and do not encroach onto the property adjacent thereto, that
no Improvements on the properly lying adjacent thereto encroach on the surveyed
premises and that there are no roadways, transmission lines or other visible
easements on said properly except as indicated hereon.
I; t)
Dated this the Day of at Anchorage, Alaska
If is the responsibility of the owner to determine the existence of any easements,
covenants, or restrictions which do not appear on the recorded subdivision plat.
*: 4STH '.
KENNETH G. LANG
No. I5202 ���A
`��pAa1�P����MW
11._ FSSak
State of Alaska AECC963
I
I
Lot 4
S 89'40'E 200'
10.2'x12.2' SHED
I
/WIRE FENCE
'
90w.5
Lot 5
30,000 S.F.
I
jf
�
92'x12.
. 1'
GREENHOUSE
WN
M1Q.0p
'
SEPTIC 1Q,b PIPES
C
�
z
I
MANHOLE
C
N
I
MANHOLES
4.O'x10.0'
TREATMENT POD BALCONY
I
\
N 89'40'W 200'
I
�10' UTILITY Lot 6
EASEMENT
LO
I
WOODEN FENCE
40.5'
�v ASPHALT
DRIVEWAY
5.1'x23.9
PORCH
N
2.Q'x24.3'
CANT >
U
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0
0
�
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WELL
LO W
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PLOT PLAN AS BUILT x SCALE 1' = 40' GRID NW 0653 Project No. 23-258/A2
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates, inc. (907) 522-6476 Phone
kenOlangaurvsy.com 4. OF `il
Professional Land Surveyors jonothanOlangsurvey.com �• l
troviaOlangsurvsy.com AL
! 4 'Lq `��
I hereby certify that I have surveyed the following described property:
LOT 5, BLOCK 6, LIKE RIDGE TERRACE SUBDIVISION (PLAT No. P-549)
Anchorage Recording District, Alaska, and that the Improvements situated thereon are
within the property lines and do not encroach onto the property adjacent thereto, that
no Improvements on the properly lying adjacent thereto encroach on the surveyed
premises and that there are no roadways, transmission lines or other visible
easements on said properly except as indicated hereon.
I; t)
Dated this the Day of at Anchorage, Alaska
If is the responsibility of the owner to determine the existence of any easements,
covenants, or restrictions which do not appear on the recorded subdivision plat.
*: 4STH '.
KENNETH G. LANG
No. I5202 ���A
`��pAa1�P����MW
11._ FSSak
State of Alaska AECC963
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: OSP231240
Work Type: Septic Upgrade
Tax Code Number: 05131327000
Site Legal Address: LAKE RIDGE TERRACE BLK 6 LT 5 G:0653
Site Mailing Address: 14950 TERRACE LN, Eagle River
Owner: GARCIA JOEL J & DENALI T
Design Engineer: FIRST WATER CONSULTING
This permit is for the construction of:
Effective Date:
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
,vicnt
`° S�
c
Department
8/31/2023
8/30/2024
31000
Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
i Special Provisions:
• A test hole is required prior to construction of the absorption field, in the location shown on the site plan, to
ofirm minimum separation to impermeable soil and seasonal high groundwater, as well as percolation
e. Construction may proceed at your own risk prior to 7 -day groundwater monitoring. If results require
�)�ratri
design change, construction shall stop pending approval of a change order. Please submit results with
the inspection report (or change order, if required).
may: _2 S 5LAec� +0 )' 0C'
Issued By:
8e -5,(5V1
J
Date:
Date:
.� JZ2 -2
4
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. 051-313-27
Property owner(s) JOEL & DENALI GARCIA Day phone
Mailing address 14950 TERRACE LANE, EAGLE RIVER, AK 99577
Site address 14950 TERRACE LANE, EAGLE RIVER, AK 99577
Legal description (Sub'd., Block & Lot) LAKE RIDGE TERRACE BLOCK 6, LOT 5
Legal description (Township, Range & Section)
Lot Size 31,000 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 �
(D) ElRenewal
Holding Tank
El
Renewal❑
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION
INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(SigriatUrE; af.property owner or authorized agent)
Permit/Rush Fees: 9
Date of Payment: I 4f to �
Receipt Number: 7- ( y (not
Permit No. o s P 2 3/ 2� o
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
0 G°-'*�- �
F�rs[ Water
�- - C O N S U L T I N G
S11PP0RiE PtdktllFeG
13030 Sues Way, Anchorage, AK 99516
907-350-9566 / firstwaterAK@gmail.com
September 19, 2023
Municipalities of Anchorage
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: SEPTIC SYSTEM UPGRADE PERMIT
LEGAL: LAKE RIDGE TERRACE BLOCK 6, LOT 5
After review of the site and area and conducting the testhole, an Advantex septic system will be
installed. Due to poor drainage, soils and other characteristics surface water has been determined
to encroach the previously permitted remove and replace conventional septic system. We
propose to remove encountered biomat material, excavate to native receiving soils, add Type II
material, followed by 2' MOA sand with 0.5' effective depth to 3'+ above currently observed
groundwater and at a minimum of 2' above grade — approximately maintaining the existing
elevations and integrity of the mound.
Due to the site and area as stated, the system is to be elevated to maintain increased horizontal
separations and to maintain the integrity of the mound with heavily vegetated and very moderate
slopes at the proposed upgrade location. The lot and area are served by private water. The
design will not impact any of the neighboring properties. Please contact us if you have any
questions.
Sincerely,
Curtis Huffman, P.E.
F�rsI��IWI��E�.
�I�!_J � V7.tI ERf WA51 E}VAIEA
,���'` SJPP[IRI s_p1ANNIHG
DESIGN CALLS:
4BR X 150 GPD = 600 GPD
600 GPD/2 GPD/SF = 300 SF SAS
300 SF / 15-W = 20 FT. MOUNDED BED
USE 1 BED - 20'(L) X 15'(W) X 0.5'(ED)
REMOVE ALL BIOMAT, ADD TYPE II, 2' MOA SAND & BOTTOM OF
SEWER ROCK ED IS TO BE 2' ABOVE ORIGINAL GRADE. APPEARS
EXISTING BED IS 4' ABOVE ORIGINAL GRADE.
NOTES: S�AIDE PROPERTY LINE &
I�
J
APPROX IDSF
FLAT SEPTIC LOCATION
FLAT O GEG SOILS SHOW 22 MIN / INCH
LARGE TREES WITH HEAVY
VEGETATION OF THIS
EXISTING MOUND. EXTENT OF
COVER IS APPROXIMATE EXISTI
ABSORPTION MOUND WILL BE
ABANDONED IN PLACE
GDS/
NO SLOPES >25% WITHIN 50'
OF PROPOSED FIELD.
LL RADII PRI❑R TO CONSTRUCTITN
/Lot 4 SURFACE WATER
IWITH GROUNDWATER AT V-3.5' S 89'4.0'E 000
NEW MOUNDED BED v
MUST MAINTAIN 6'+ Z
SEPARATION TO THE
ABANDONED BED. REMOVE
ANY SEWER ROCK WITHIN IN 6'
OF NEW BED &
REPLACE ANY BIOMATTED
MATERIAL & SEWER ROCK
OF THE OLD BED
WITH MOA SAND. INSTALL
MT ON EACH MOUND
CORNER. FINAL GRADE
SHALL HAVE 6'
OF TOPSOIL &
SEEDED/VEGETATED.
7
FLAT F
0
USE 45 LF OF 1.25' PVC
USE 1.5' SPACING
WITH j- HOLES
FLAT
TT
FqWATERSURWIRE FENCE
1 I
DACE WA1ER N U N
fV 41
FLAT 100 M
-EXISTING �hLLJ
ABSORPTION 3, U
BED
�10p
CyTop
FCO
QED .
197 .DT
MOUND OF
LL W
AX MOUND
I
SURVEY: KGL
/ tis Huffman wx
1
DRAWN: FWCS
1 9/19/23
MH DCO
FLAT
26.2'
MT MT
M
/
5' 2.5'
50' TO SURF
WATER
50' WELL RADIUS
MT *17.25'
C INSTALL NEW
NOW
AKE P TO CONST.
SURFACE
15' X 20' MOUND.
AX20 EPDXY TANK
Lot
5
WA TER
EXCAVATE TOMT
/ PUMP AS
N.
VV
NATIVE RECEIVING
8-135.
I
II & 2' MOA SAND °i
>t
71-123-1
NTH 0.5' ED.
10D' WELL
CE Wq SURFACE A
1 -0-5%
a I
'
WIEG SOILS SHOW 5TH GROUNDWATER IAT 6I NCH-7'.
NO WELLS WITHIN
100' OF PROPOS�D
SEPTIC SYSTEM
DESIGN BASED ON JITE ON
RECENT TH23-1.
N FENCE
40.5'
ASPHALT W
DRIVEWAY
WELL
.1
89'40'W 200'
Lot 6
FLAT
THIS IS A PARTIAL REMOVE ALL BIOMA ,
REPLACE WITH TYPE II, 2' MOA AND &
0,5' EFFECTIVE DEPTH.
APPROX
WELLOCATION 0
LAKE RIDGE TERRACE BLOCK 6, LOT 5 SUPPORT SERVICES:®®®®®
PREPARED FOR:
JOEL & DENALI GARCIA
14950 TERRACE LANE 1r* C� TH
EAGLE RIVER, AK 99577 / It
FIRST WATER CONSULTING
13030 SUES WAY
ANCHORAGE, AK 99516
907-350-9566 FirstWaterAK@gmail.com
DATE: 9/19/23
SURVEY: KGL
/ tis Huffman wx
1
DRAWN: FWCS
1 9/19/23
SCALE: 1" =40'
®FEssto��'
PAGE: 11 OF 2
REMOVE & REPLACE DESIGN DETAILS:
Go -1-15Z 1
INSTALL NEW 1500—GAL ANCHORED EPDXY STEEL AX20 TANK WITH PUMP BASIN. MAINTAIN 10'+
FROM FOUNDATION, 50' TO WELLS & SURFACE WATER, 5' TO FIELD & DECK SUPPORTS WITH 4' OF
COVER OR INSULATION. REMOVE ANY BIOMAT, ADD TYPE II, 2' MOA SAND AS REQUIRED / NEEDED &
INSTALL ONE 20'L x 15'W x 0.5'ED MOUND 2' ABOVE ORIGINAL GRADE OR HIGHER TO MATCH EXISTING
ED ELEVATION w/ INSULATION & 2'+ OF COVER MAINTAINING 50' TO WELLS / SURFACE WATER, 10'
TO LOT LINE,.... INSTALL PER AMC 15.65, 15.55, & MASS... TANK BEDDING, SEPARATIONS, MATERIALS,...
APPROX IDSF
FLAT SEPTIC LOCATION Lot ® SURFACE
FLAT J�OD GEG SOILS SHOW 22 MIN / INCH �}
WITH GROUNDWATER AT 1'-3.5' S 89`40'E00'
LARGE TREES WITH HEAVY
VEGETATION OF THIS
EXISTING MOUND. EXTENT OF
COVER IS APPROXIMATE. EXISTII
ABSORPTION MOUND WILL BE
ABANDONED IN PLACE.
USE 45 LF OF 1.25" PVC
USE 1.5' SPACING
WITH J" HOLES
FLAT
+\ SURFAC WATER Cfl
I
0 WIRE FENCE
9' DECK
.5
FLAT 2.2
S RFACE WATER N U N
N
FLAT W
EXISTING— ILJN I LL]
ABSORPTION 3 v U
BED
FLAT 197 TH ASS ED 10-N 1 O O _�
N �
�a -�0.0, J
EXTENT OF o a
MOUND FILL FCO
U) � a
POWE POLE
AX MOUND N
MH DCO FLAT 26.2'
�i
5T M M ®�®5' ® I 0 I
�MTIO ®IMT
15' X 20' MOUND.
EXCAVATE TO
F I NATIVE RECEIVING
F Noi c w ann TmF
o II & 2' MOA SAND
f, WITH 0.5' ED.
�50' TO SURF E WATER
rINSTALL NEW TAKE P TO CONST.
N
AX20 EPDXYXY A
TANK
;TEM W/ PUMP BAS N. Lot
8-13% ,
TH23-1
0-5%
Ln
o GEG SOILS SHOW 5 MIN / INCH
WITH GROUNDWATER AT 6-7'.
I
LAKE RIDGE TERRACE BLOCK 6, LOT 5
PREPARED FOR:
JOEL & DENALI GARCIA
14950 TERRACE LANE
EAGLE RIVER, AK 99577
FIRST WATER CONSULTING
13030 SUES WAY
ANCHORAGE, AK 99516
907-350-9566 FirstWaterAK@gmail.com
14\ 100' WELL
RADII
89°40'W 200'
FLAT
SUPPORTIIIISERVICES:
C.
DATE:
9/19/23
m
KGL
DRAWN:
FWCS
Z
o
• Q
2 OF 2
-00
L0
LIJ
{
O
N
O
NEW MOUNDED BED
O
MUST MAINTAIN 6'+
z
SEPARATION TO THE
ABANDONED BED. REMOVE
ANY SEWER ROCK WITHIN IN
6'
OF NEW BED &
REPLACE ANY BIOMATTED
MATERIAL & SEWER ROCK
--
OF THE OLD BED
WITH MOA SAND. INSTALL
MT ON EACH MOUND
CORNER. FINAL GRADE
SHALL HAVE 6"
OF TOPSOIL &
SEEDED/VEGETATED.
FLAT
USE 45 LF OF 1.25" PVC
USE 1.5' SPACING
WITH J" HOLES
FLAT
+\ SURFAC WATER Cfl
I
0 WIRE FENCE
9' DECK
.5
FLAT 2.2
S RFACE WATER N U N
N
FLAT W
EXISTING— ILJN I LL]
ABSORPTION 3 v U
BED
FLAT 197 TH ASS ED 10-N 1 O O _�
N �
�a -�0.0, J
EXTENT OF o a
MOUND FILL FCO
U) � a
POWE POLE
AX MOUND N
MH DCO FLAT 26.2'
�i
5T M M ®�®5' ® I 0 I
�MTIO ®IMT
15' X 20' MOUND.
EXCAVATE TO
F I NATIVE RECEIVING
F Noi c w ann TmF
o II & 2' MOA SAND
f, WITH 0.5' ED.
�50' TO SURF E WATER
rINSTALL NEW TAKE P TO CONST.
N
AX20 EPDXYXY A
TANK
;TEM W/ PUMP BAS N. Lot
8-13% ,
TH23-1
0-5%
Ln
o GEG SOILS SHOW 5 MIN / INCH
WITH GROUNDWATER AT 6-7'.
I
LAKE RIDGE TERRACE BLOCK 6, LOT 5
PREPARED FOR:
JOEL & DENALI GARCIA
14950 TERRACE LANE
EAGLE RIVER, AK 99577
FIRST WATER CONSULTING
13030 SUES WAY
ANCHORAGE, AK 99516
907-350-9566 FirstWaterAK@gmail.com
14\ 100' WELL
RADII
89°40'W 200'
FLAT
SUPPORTIIIISERVICES:
C.
DATE:
9/19/23
SURVEY:
KGL
DRAWN:
FWCS
SCALE:
1" =30'
PAGE:
2 OF 2
Lot 6
WOODEN
N '
E
N
50' WELL RADIUS
SURFACE WA7ER
SURFACE WA
® SOF®®
�I&
�* CATH*
` rtis Huffman wx
1 cP CE 128991
9/19/23
C
Frsl Water
S U L T I N G
W I I ER 11111 AS If vi AIF P.
'1. SUPPCR? 5 P1A6171176
13030 Sues Way - Anchorage, Alaska 99516
Tel. 907-350-9566 firstwaterAK@gmail.com
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: LAKE RIDGE TERRACE B6 L 5
DEPTH
FEET OG SOILS
<=:< ORG/OL
1
2
3
SM/GM
4
5
6
7
8
9
10
11
12
BOH
13
14
15
16
17
18
19
20
qt A
.-49 TM
• . '
Curtis Huffman :
CE 128991 ,• �`��
19/23 , . AIW
ll, pROFESS10 --F&
PERFORMED FOR: JOEL & DENALI GARCIA
TESTHOLE # 23-1 DATE PERFORMED: 9/12/23 1
GROUND WATER ENCOUNTERED: YES
IF YES, AT WHAT DEPTH: 5'
DEPTH TO WATER AT MONITORING: 4'
DATE: 9/19/23
SEE SITE PLAN FOR SLOPE & LOCATION
COMMENTS:
Damp perc bench.
VERIFY GROUNDWATER MT
AT TIME OF CONSTRUCTION
Reading Date Gross Net
Time Time
Depth to
Water
Net
Drop
9/13/23 30 min
6"
15/16"
30 min
6"
15/16"
30 min
6"
15/16"
PERCOLATION RATE 32_ (MIN / INCH)
TEST RUN BEWTWEEN 2 & 3 FT
PERC HOLE DIAMETER 6"
PRE-SOAKED PRIOR TO TEST & ALL READINGS TO
THE 1/16TH
PERFORMED BY: FWCS / FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT
ON THIS DATE. DATE: 9/19/2023
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE D REPAAGREEMENT, herein the "AGREEMENT" made and
entered into as of this {Day o of 20 , b and between
z\;y
,herein the "OWNER," and the Municipality of
Anchorage, herein thiA�l NICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as AN ADVANTEX SYSTEM
located at (legal description)
LAKE RIDGE TERRACE BLOCK 6, LOT 5
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The 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.
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 I 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.
` Owner 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
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the 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
STATE OF ALASKA )
ss.
THIRD JUDICIAL DISTRICT )
ThwCommission
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BY:AZ�l (signature)
(print name)
(rev. 05/18/2018)
Date: Z I 2
Title:
' Page 3 of 3
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9.2'x12.
GREENHOW
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Lot 4
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EASEMENT
6ALCONY
MANHOLE \
Lot 5
30,000 S.F.
Lot 6
PLOT PLAN AS BUILT —2L SCALE 1" = 4V GRID NW 0653 Project
No. 23-258/A1
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates, inc. (907) 522-6476 Phone
kenOlongsurvey.com
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Professional Land Surveyors lonathanolangaurvey.com
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I hereby certify that I have surveyed the following described properly:
I
LOT 5, BLOCK 6, LAKE RIDGE TERRACE SUBDIVISION (PLAT No. P-549)
Anchorage Recording District, Alaska, and that the improvements situated thereon aro
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easements on sold property
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Dated this the 2� Day of Juti� •Lo2`2- at Anchorage, Alaska
Dated
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covenants, or restrictions which do not appear on the recorded subdivision plat.
State of Alaska AECC963
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PLOT PLAN AS BUILT —2L SCALE 1" = 4V GRID NW 0653 Project
No. 23-258/A1
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates, inc. (907) 522-6476 Phone
kenOlongsurvey.com
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Professional Land Surveyors lonathanolangaurvey.com
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I hereby certify that I have surveyed the following described properly:
LOT 5, BLOCK 6, LAKE RIDGE TERRACE SUBDIVISION (PLAT No. P-549)
Anchorage Recording District, Alaska, and that the improvements situated thereon aro
%*' 48TH *O,
•
within the property lines and do not encroach onto the property adjacent thereto, that
no Improvements on the properly lying adjacent thereto encroach on the surveyed
� • • • • • • • •
premises and that there are no roadways, transmission lines or other visible
except as Indicated hereon.
�/ KENNETH G. LANG 'Qr
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easements on sold property
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Dated this the 2� Day of Juti� •Lo2`2- at Anchorage, Alaska
Dated
FOO, Z?�Li 'apSJQr'
It is the responsibility of the owner to determine the existence of any easements,\�\
covenants, or restrictions which do not appear on the recorded subdivision plat.
State of Alaska AECC963
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
MAI LING ADDRE~ ~p~.
LEGAL DESCRIPTION
LOCATION
Well
DISTANCE TO:
Manufacturer~ ~ ~g C'
Liq. capacity in gallons ~
/.~(~ ,r HOMEMADE:
DISTANCE TO: Well
Manufacturer
DISTANCE TO: Well
. Length of each line
No, of lines
Length Width
Type of crib Crib diameter
DISTANCE TO: Building foundation
Absorption area
Inside length
Dwelling
Foundation
Total length of lines
Material beneath tile
Depth
Dwelling
Mat e ria~l~ ~.~__~ /
W dth
OTHER
PIPE MATER I~_?
SOIL TEST RATING
INSTALLER
REMARKS
.~,PpH O N E [] NEW
~-~o~z~ ~ UPGRADE
Material
Nearest lot line
Trench width
inches
inches
NO. OF BED~.~O.O~MS
PERMIT NO.
No, of corck~rtments
Liquid depth
PERMIT NO.
Liquid capacity in gallons
PERMIT NO,
Distance between lines
Total effective absorption area
;21 ¢'O Z~ /
PERMIT NO,
Crib depth Total effective absorption area
Building foundation Nearest lot line
Driller Distance to lot line
Sewer line Septic tank
PERMIT NO,
Absorpt on area(s)
APPROVED
DATE LEGAL
/o .-
~MUNICIPALITY OF ANCHORAGEs=/
Department~f Health and Environmenta Protection
825 ~ Street, Anchorage, AK. 99501
264-4720
* * * HANDWRITTEN PERMIT * * *
WELL-~AND/OR ON-SITE SEWER PERMIT
Legal Description: C '--S S~ ~ ~& S+ '~ot Size:
Type of Soil ~sorption System Is:
Trench: ~ Drainfield: ~ Seepage Be~: ~ Holding Tank:
Maximum N~ber of Bedrooms: ~~Soil Rating(sq.ft/br)
The Required Size of the Soil ~sorption System Is:
DEPTH O LENGTH
GRAVEL DEPTH <~7 WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a 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 t~utfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTI~ TANK SIZE =~/~ALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection.and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31j 1 9 8 1 * * *
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the residence is remodeled to include more~that~bedrooms.
Applicant Date:
TO
Alaska Envirommen~l Control Services
1220 W. 25th Ave.
Anchorage, Alaska 99503
R
O
M
Department Of Health a~.
Environmental Protection
Les Buchholz
SUBJECT Lot 5, Block 6, Lakeridge 5'erraae SubdivisiOn DATE 11-24'80
MESSAGE
The gla~s s~mitted on 17 ~ov. 80 regarding the Rupprecht property
are satisfactory as an alternative system.
A Pe~'lit could be issued for a five b~room residence using a 1500
gal~nn septio ta~k and elevated absorption bed
REPLY
SIGNED DATE
Recli~orm ® 4S 471 SENDpARTPARTS3 WILLt ANDBE RETURNED3 WITH CARBONwiTH REPLy.INTACT - pcxy pAX (50 $~T$) 4~ 471
ALASKA I FIUIROFImenTA:L COFITROL $t RUICe$, IFIL
{~nciinecrinq 5 ~nuironm~nlG{ $1udies
MUNICIPALIT"~ OF ANCHORAGE
DERT. OF HEALTH &
ENVmoNt~[N~-^L P~:O'rEC'r~ON
November 2, 1981
NOV 6 lgS1
Donald K. Rupprecht
Box 1712 Blue Spruce
Eagle River, Alaska
99685
REC EIVED
Dear Mr. Rupprecht:
On October~31, 1981 I performed the final inspection for the
lift station and bed located at your property on Blue Spruce
drive. The job is substantialiy complete. The following
differrences are noted:
(1) Final grading has not been completed I was told that
because of the extreme wetness of the soil this would be
accomplished in the spring after break Upo At this time Dick
will move the excess soiling using most of it to improve the
road.
(2) Top soil has not been placed on the bed. I understand an
agreement has been made with Ed Walsh, you and Dick Wood to
escrow money to bring in top soil and spread it in the
spring.
(3) The idionator has been installed but has not been hooked
~o the system yet.
':(4) The electrical box that supplies the pump and alarm system
does not have a water tight cover on it. The cords plugged
into it should be secured to keep them from working loose.
(5) An alarm system has not been installed. Dick Woods has
informed me that this is on back order from Susitna and should
be in with in the next several weeks.
The system appears well installed and I see no major problems
with servicing. The culvert is large enough for a ladder to
placed for the bottom. I recommend to you that the lid to the
lift station be sprayed with urethane foam or blue styrofoam
placed over the lid to prevent the temperature from dropping
in the system. The lid for the system is the old manway lid
off. the multif!ow system° The lift station appears to be
tight. I see no evidence of excess water coming into the
system.
Once the discrepencies have been corrected the system should
give long service.
Sincerely yours:
ALASKA eFIUII Olqm nTAL COnTI OL $ 1 UIC1 $, IFIC.
I~ngineerin9 8 ~nuironment~J $ludi~s MUNICIPALITY OF ANCHORAGE
DEPT. OF p,~:ALTii &
ENVIRONMENTAL P2OTECTION
NOV 2, ! 'i980
Novembe'¢ 17, :1,980
MuniciPmlit~ o¢ Ar',cho~m6e
DePm'rtmerr~ o¢ Hemlth and Environmer, tml F:'~otection
825 I_. Street
Anoho~'m6e~ Ak. 99501 Attn~ M~, Les Buoholz
I ECEIVED
Demf' I..es ~
Enolosed m~e copies of soil test drmwin6s mhd sPeo:i, fiom-
tions for m alternative sewe~ s~stem tot M~,Don RuP~echt~
loomted on 17.1.~ E:lue SP~uoe~ Emile R~ve~ Ak. I_e~ml
diso~':i.~tion is lot ~
~.. blook. 6, Lmke~id~e 'fer~moe
Subdiv:[s:Lon. This is ~ePImoemer~f-~ZFfT~O~ sewe~
s~¢stem ir, strolled :i.n 19~5~
When we rmn our soil test on [)otobe~ 16, the water treble
wms mPProximmtel~ 2 teet below the 6~ound su~fmoe, ms ~ou
well know this subdivisior, is ext'remel~ wet, ms m
~esult o¢ Poe~ subdivisior, d~mir, mee. The existir, 6 seePmee
t~er',oh is omPmb:l.e o¢ tmk. in~; some wrater howevei'~ sho~tlu
m'¢ter mPP~oximmtel~ 10 to 15 emllor',s o¢ water' is Put into
the s~stem, sewm6e bubbles out on the e~ound in the
vmoinit~ o¢ the pl.l~lp PiPe. Theee'¢oee this s~mtem will have
to be mbmr',doned mn m new s,~stem instmlled. Beomuse of the
hieh wmte~ treble heine it onl~ 2 teet, we feel th;~t
mn mlternmt:i, ve s~stem would be indiomted ms m first step
uPe~mdir',~; thei~ sststem~ Howeve~ the uttimmte solution to
the P~oblem in thmt subdivision is to instmll P~oPe~.
d~minm6e Z have mmde the olient mwm~e o'~ this and
thmt she will wo'rk towmrds ~ettir',~ be'bte~
l'he instmllmt:Lon of the Smnuf'il chlorinator will insure
thmt :i.f the sewm6e does dm~li6ht from
the ~ro,..q",d wrater' from below the eround surfmoe thmt it will
not cremte m health hmzm'rd~ However, Z feel the soil ms
tested is omPmble o¢ mbso~bir,~ 'bhe ml~,o,.~F,t of sewage thmt we
hmve indiomted in ou~ desitin.
As th:i.s is or',e of the mu~'i-¢low rePlmoemer'r~, cases Z would
expect thmt the risk. mmr, m~ement ero,.,r,, for the Mur, iciPmlit-~
should be notified o¢ the design of the s~stem0
-®
GREI" -'", ANCHORAGE AREA BOR 'IH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK: J ".(]') ~'
FROM WELL -~' 'j I~-~'vlANUFACTURER //'~ _ MATERIAL ~--~'~'~¢'~ COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY (,/GfALLONS.
TILE DRAIN FIELD:
!
DISTANCE FROM WELL Y~/ FOUNDATION
NUMBER OF LINES
ABSORPTION AREA
DEPTH: TOP OF TILE TO FINISH GRADE
DISTANCE BETWEEN LINES
7~/~ ¢ SQ. FT. LENGTH OF EACH LINE
DEPTH OF FILTER
MATERIAL BENEATH TILE
?..~__ TOTAL LENGTHc.,~/~/
NEAREST LOT LINE c,~'0 OF L'NES
TRENCHWlDTH ~I~N. TOTALEFFECTIVE
/
IN. ABOVE TILE / IN.
WELL: , .' 0j¢~
TYPE 'D~
BUILDING
FOUNDATION
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST
LOT LINE ,
OTHER SOURCES
DISAPPROVED
NEAREST
SEWER LINE__
DEPTH.
SEPTIC SEEPAGE
TANK __ SYSTEM
REMARKS
DISTANCE FROM:
DISTANCES:
INSTALLED BY:
SEWER LINE DEPTH:
/D/~R~I OF SYSTEM
Received: Jul 6 2010 04:40pm
FROM : MEADOLI CREEK> DERMATOL .¢ PHONE NO. : 907 694 4773 Jul. 06 2010 05::36PM P4
LOG OF DRILLING by A O L
Gte;: .R ANCHORAge AREA BO! JGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
pERMIT NO.
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
INSTALLATION LOCATION ~ ' ~ [ ~, ~ ~ ~"' [ 2 ~ ~.m;' ~ ' ~ / --I~--~=' ' / ~ ~ ~L ~'
INSTALLATION Of' SEPTIC TANK ~ SEEPAGE PiT DRAI~ fl~D
SOIL TEST RESULT[ . 7~ NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED, BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
' 'W, --'"
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE Pit , DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK , SEEPAGE PIT . ~ , DRAIN FIELD
TO NEAREST LOT LINE.
DRAIN FIELD t~~ . ALSO CONSIDER AREA WELLS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
j,
/> /) o.
{~CENSED DESIGNER
CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GEE '~ER ANCHO AGE %REA B R U~ ORDINANC NO. 28-68 AND ABOVE
DESCrlbeD SYSTEM IS IN ACCORDANCE WITH SAID CODE %' ~ ~" ~'~ ' ~ thaTth,
Performed For
Leaal
This
"One test is worth a thousand opinions"
~xJl"~/~S~k ~ k Date Performed 7/7/?~
Oescrintion: Lot .~ Block~Subdivision ~gE~/~a~' ~~
Form Re~orts Soils Lo~ Percolation Test
r)eoth
Feet Soil Characteristics
Wa_$..GroUnd Water Encountered?.j'ot-l~¢e
If Yes, At what Depth?
· Reading· Date Gross Time Net Time Depth to H.20 Net Droo
-
, I i I '
Percolation Rate ?linute
Proposed Installation:· Seeoaoe Pit Drain Field
Deoth of Inlet Deoth To.~Bottom Of~it Or Trench
Pest Performed Rv o~M I/~)~(:~ Data Certified By:
NAME Of APPLICANT
GREATER ANCHOragE AREA Borough
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C"STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
PERMIT NO.
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
INSTALLATION OF: SEPTIC TANK ~ J~
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH ·
COMPLETION DATE ANTICIPATED
"7
SEEPAGE PIT ~ , DRAIN FIELD OTHER .
TO BE INSTALLED BY
NOTE.' THIS PERMIT iS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
DIAGRAM Ol= SYSTEM
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK~-
FOUNDATION TO SEEPAGE PIT DRAIN FIELD
lbo'
I00"
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVE/ BACKFILL
CONFORM TO BOROUGH ~:~,E~'~-L~TIONS REGARDING iNSTALLATION.
//
4
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE N~). 28~8 AND THAT THE ABOVE
_ i¥.//f'7,5 x . . .:
September 29, 1975
Mr. Rolf Strickland, Chief Sanitarian
Dept. of Env. Quality
Anchorage Municipality
3330 C Street
Anchorage, AK 99503
Subject: Lot 5 BlOck 6 Lake Ridge Terrace Subdivision
Dear Mr. Strickland:
We are in receipt of a revised plan for the on-site waste disposal
system on the subject lot. This revision is dated September 24,
1975. As long as the system is put in according to the plan and
a 4 foot seperation exists between the bottom of the discharge
pipe and the groundwater table we have no objection to this install-
ation this assumes that the system will be installed in natural
ground.
Yours truly,
Regional Environmental Supervisor
MUNICIPALITY OF ANCHORAGE
4
Development Services De artment
p p Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Parcel I.D. 051-313-27
Certificate of On -Site Systems Approval
Expiration Date: 1/13/2024
Legal description LAKE RIDGE TERRACE BLK 6 LT 5
Site address 14950 TERRACE LN
Current property owner(s) GARCIA JOEL J & DENALI T
XThe On-site system(s) is/are approved for 4 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
By: Original Certificate Date: 10/13/2023
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 Arsenic Advisory
Other
COSA Approval—June 2022
MUNICIPALITY OF ANCHORAGE
o
_ ea
Development Services Department
On -Site Water & Wastewater Section
Phone: 907-343-7904
Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 051-313-27
Complete legal description LAKE RIDGE TERRACE BLOCK 6, LOT 5
Location (site address) 14950 TERRACE LANE, EAGLE RIVER AK 99577
Current property owner(s) JOEL & DENALI GARCIA Day phone
2. ON-SITE SYSTEMS SIZED FOR 4 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: ® Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age NEW - 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 $_ % �l a Waiver Fee $
Date of Payment
COSA #_ 05c S (3 93
Date of Payment
Waiver #
COSA Application.doc
COSA Checklist 2022.docx
COSA Checklist
Legal Description: LAKE RIDGE TERRACE BLOCK 6, LOT 5 Parcel ID: 051-313-27
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 5/14/1975
Total depth 133 ft Cased to *UNKNOWN ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 12 in.
Date of flow test for COSA 3/4/2022
Static water level at beginning of test 112 ft.
Well production at time of test 6+ gpm
Water storage tank volume NA gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate 1.27 mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by Date 8/22/2023
Comments *Well log shows 133’ total depth with 6 5/8 ID casing to an unknown or unstated depth.
B. TANK DATA
Measured operating fluid level in septic tank NEW
Date of pumping NA – NEW SEPTIC TANK
Required maintenance completed, if AWWTS
Comments: NEW ADVANTEX SYSTEM
C. LIFT STATION
Required maintenance completed
Age of lift station NEW years
Lift station material PLASTIC
Comments: NEW AX WITH PUMP BASIN
D. ABSORPTION FIELD DATA
Which system tested (date installed) NEW SYSTEM
ALL standpipes present per record drawing
Total measured depth from grade 4.9 ft (max)
Measured depth to pipe invert from grade ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes (MT) go to bottom of effective (ED).
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) N
If yes, enter date
Adequacy test date NEW SYSTEM
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) 6 in
Effective depth used 0 in
Effective depth remaining 6 in
Comments/Deficiencies: Approximate total measured depths from existing grade.
COSA Checklist 2022.docx
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’
Yes if No *50+ ft
Neighboring Tank > 100’ Yes if No ft
Absorption Field on Lot > 100’ Yes if No *50+ ft
Neighboring Absorption Fields > 100’
Yes if No ft
Community Sewer Main > 75’ Yes if No ft
Community Sewer Manhole/Cleanout > 100’
Yes if No ft
Private Sewer/Septic Line > 25’ Yes if No ft
Holding Tank > 100’ Yes if No ft
Animal Containment > 50’ Yes if No ft
Manure/Animal Excreta Storage > 100’
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’ Yes if No ft
Tank to Property Line > 5’ Yes if No ft
Field to Property Line > 10’ Yes if No ft
Water Main > 10’ Yes if No ft
Water Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No *50+ ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No *50+ ft
Community Wells > 200’ Yes if No ft
If tank or field is under driveway comment below
F. ENGINEER’S COMMENTS
*MAY MEET CONVENTIONAL SEPARATIONS, BUT SYSTEM MEETS CATIII SEPARATION DISTANCE REQUIREMENTS.
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 FIRST WATER CONSULTING Phone 907-350-9566
Engineer’s Printed Name CURTIS HUFFMAN, PE Date 10/10/2023
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. The assessment of the condition of the well and septic
applies only to the conditions as of the day tested. The flow and absorption rates may change
due to subsurface conditions that may not be observed from the surface, changes in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the
system and maintenance. The operational life of all well and septic systems are subject to
these various and dynamic characteristics and are outside the control of the evaluator of the
well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by First Water Consulting &
10/10/23
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered int as of this Day of "/� of 20-13 , by and between
herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as AN ADVANTEX SYSTEM
located at (legal description)
LAKE RIDGE TERRACE BLOCK 6, LOT 5
2. Maintenance. Repairs and Alterations.
(Owner is required to read, understand and initial each section)
Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The 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.
- 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.
Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at Ieast 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.
- Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by. the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the 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: (signature)
SC-1-t04,4'(cn (print name)
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT )
The foregoing.instrument was acknowledged before
20q, by 004)
NOTAiW PUBL C FORS ' f
My Commission expires:' �h7
Date: e�- -4a-2—
me this ;�-%y of V o r- 0-
MUNICIPALITY:
By:ilMa,(signature)
(print name)
(rev. 05/18/2018)
M. E. ROBANCHO
Notary Public
State of Alaska
My Commission Expires Feb 5, 2025
Date: �0 /� 2
Title:
Page 3 of 3
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650
Anchorage, AK 99519-6650
www. muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D.
GENERAL INFORMATION
Complete legal description
Location (site address)
Current Prope~y owner(s)
COSA# 0,,_...,,,~ / O//
Expiration Date:
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing AddresS
Day phone
/_¢.. ,, p../,.,.,¢,., //'
Day phone
Day phone
i
Unless otherwise.,requested, COSA will be held by DSD for pickup.
NUMBER OF BEDROOMS: q
TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class
Public Water System
Well
TYPE OF WASTEWATER DISPOSAL:
[] Individual On-site []
[] Individual Holding Tank []
[] Community On-site []
[] Public Sewer []
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Phone
Name of Firm z"~.//'~"~.,,~
Address 2_~o /~-. ~,7/?~.
Engineer's Printed Name _,,,~.,~7-7/~/
DSD SIGNATURE
~ Approved for ~
Disapproved.
Conditional approval for
Date ¢~- ..~-/dP
bedrooms.
bedrooms, with the following stipulations:
· .... '..
WATER AND : ~
WASTEWATER ~ 5
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
X
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By:
Original Certificate Date:
(Rev. 11/05)
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Elmore Street
P.O. Box 196650
Anchorage, AK 99519-6650
www. muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description:
A. WELL DATA
Well type
Date completed
Total depth
IfA, B, or C provide PWSID #
Sanitary seal (Y/N)
Cased to
Parcel ID:
Well Log (Y/N)
Wires properly protected (Y/N)
Casing height (above. ground). [..~
Date of test / . ' t J~ AT INSPECTION
S,ta~c water level ~/~ ~ ff. '///" ft.
Wei c u on g.p.m, g.p.rn.
in,
B; SEPTIC/HOLDING TANK DATA
Tank Type/Material 5; ~'~ ¢~' Date installed.,
Tank siz~ ~ :~C~.gaL, Number of.Compartments % Cleanouts (Y/N)
Foun?a?~':~n.~J.~t(¥./N),':,,)(~5 Depression over tank (YlN) ~4/. Highwatera!arm(YlN)
Dat~rOf'~*-:~.;- ~-" ~.,~;~'~ Pumper ~'~.,~,)",~,~/
c.
Date f~il~ Ja-3/"~,~.~ Soil rating (g.p.d./~ Z$~ System ~pe
Length +'' 7~;:..~ fl. W~ ~ fl. Grovel below pipe
Total depth .~ ~. Eft. absorption ama ~ ~ Monitoring tube. ~t De~ession over,eld
Date of adequaw test ~- ~-/~ Results (Pass/Fail). ~ · For ~ ~drooms
Fluid depth in a~ption field before t~t 0 in. Water added l ~l. N~ dep~ 0 in.
Elaps~ Time:~ min. Finalflu~ depth. 0 in. Ab~rption rate >= + ~00 g.p.d.
Any rejuvenation treatm~t (p~t 12 mo.) (Y/N & ~pe) .... ~ ~ ~ If yes. giye date
--~ ,~NATER SAMPLE RESU.LTS:
· -Coliform ~ col0nies/100 mL Nitrate ~,'J-'mmg/L Other bacteria 4~ 'colonies/100 mL
Arsenic: ~, ~ uglL date of sample:i~'-,/~-?r__p Collected by:.
LIFT STATION
Date installed
/,,
"Pump on" level at ~'~'. in.
Datum
Size in gallons u,,J~,,,,,~ C-,-/~z~)Manhole/Access (Y/N) 7~
"Pump off" level at ~c/ in. High water alarm level at ~ ~43 ,,t in.
Cycles tested 4- ! ~:) Meets alarm & circuit requirements? /Ye-.5
E, SEPARATION DISTANCES
: SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot "* ~/~ '
Absorption field on lot -~ ! ~O ~
*Public sewer main ~ ~,~
Sewer/septic service line ~- ;2, ~ /
Animal containment areas ./../~:~ t
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout ~'~"~
Holding tank ~ ~/,,4 -
Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation ~ ~ ~ Property line .e, 5-
Water main +14~) ' water service line
· Wells on adjacent lots v. ,/~ /
Absorption field
Surface water
SEPARATION DISTANCE: FROM ABSORPTION FIELD ON LOT TO:
Property line '~/~
Water Service line
Curtain drain
Building foundation ~-/o
Surface water
Wells on adjacent lots
Water main ~/~ ·
Driveway, parking/vehicle storage 4. ~/~
Ge
COMMENTS
ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above, systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name
Date
COSA Fee $
Date of Payment
Receipt Number
Waiver Fee $
Date of Payment
Receipt Number
(Rev. 11/05)
Received~
Jul 6 2010 04:39pm
FROM : MEADOW CREEK> DERMATO
.f
PHONE NO. : 907 694 4773
Jul. E~6 2010 05:~5PM P2
F'i'i]~MIT AND CERTIF:£CATE
0~'
APF'ROF'R'f ATION
1 4?6
DONALD K RUPPRECHT '"
· . . . .;: '............ :.. ....., '.
~ERZ~ZAN ~
"f~E L, OCAT~ON DF THE WATER 5'.OUR6E Z~:'A DRILLED ~EL.L, f53 PEET DEEP'y ' .'
LOCATE~ WITHZN THE A~DVE:.bE~DRi~E~:'.;PARCEL OF PROPERTY ' "'
THE CONDZTZONZ 'TH~T"'::A'¢~;~';'.'¥' TO THIS' APF'ROPRIATZON ARE FOUND IN ATTACH-- '".:'.
HENT ~. ~T~8~Ei~")"~RE~'~-AND HA~E A PART HEREOF.
THE WATER ;~TF~TM iS ..
F .... ,~-~, GRANTED _~UBJECT TO THE PERTINENT STATUTORY
PROVt .... ON,. tN AE 46.~5, AND ADMINISTRATIVE REGULATION~
PAgE I
Parcel I.D. #
MU NIClPALITY OF ANCHORAGE aS~ O~ E~
DEPARTMENT OF HEALTH & HUMAN SERVI
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-8650 t~l 0 V'~"'0~-~00
(907) 343-4744
MUNICIPALITY OF ANCHORAGE
CERTIFICATE OF HEALTH AUTHORIT~-i~_VJB.0NMENTAL SERWC, F,q DIVlSI3,
APPROVAL FOR A SINGLE FAMILLY DWELEING ........
051-315-27
1. GENERAL INFORMATION
Complete legal description LAKERIDGE TERRACE SUBDIVISION: LOT 5. BLOCK 6.
Location (site address or directions) 14950 TERRACE LANE EAGLE RIVER. AK 99577
Property owner
Mailing address
Lending agency
Mailing address
DORTH EA RUPPERT
P-O- BOX 772421
Day phone
EAGLE RIVER. AK 99577
Day phone
(907) 696-2028
Agent Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OFWATER SUPPLY:
Individual well xxx
Community well
Public water
NOTE: If community weft system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site xxx
Holding Tank
Community on-site
Public sewer
NOTE: /f community wastewater system, provide wdtten confirmation from State ADEC
lng to the legality and status of system.
72-02~ (Rev 1/91) Fron MOA#21 Computer /ersion
Note: Alaska, Water and Wastewater Consultants, Inc,. shaft be paid $800.00 at,
or prior to, Closing for the engineering services proviaeo.
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 o)~ the information obtained from the Municipality of
Anchorage files and from my investigation and insp~,~tion, the on-site water supply and/or wastewater
disposal system is in compliance with all Municip/~l/~'nd State codes, ordinances, and regulations in effect
on the date of this inspection, i ,/~(
Name of Firm ALASKA WA'~¢ V~ ,TE-.WATE~R CONSULTANTS, INC. Phone (907) 337-6179
Address 6901 DEBARR RI~AD, S~JI/~/I ;~,~[~4CH~RAGE, ALASKA 99504 . /
Engineer's Signature ~,/'/'~/ :~.~ ~"-/ Date /'/'/
In conducting this evaluation, AWWC, Inc. ~tg~n~ ~d to pr"g"C'de a thorough, conscientious engineering analysis of the
system in accordance with ADEC and MOA DRH Guidelines & Regulations. The reported results described the
performance of the system under the conditions 7countered at the time of the test, and separation distances
measured to readily identifiable features. The operational life of afl wells and septic systems depend
on the local sails 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 ef the system. Satisfactory test results do not guarantee future performance ~,,~ , ~ /~..
of the system, nor do they guarantee that there are no hidden defects or encrcachments. ~-)}'"// //
AWWC, Inc. can therefore not provide any warranty for future estimate of how long the ~. '-~..'~ ¢U/ /~r. ~ '..'.~:~
system will continue to meet the operational requirements of the ADEC or MOA DHHS. ~ ~./..~ ':'~. .~. . .~. . . .t. .
The content of this report is for the sole benefit of the owner listed above. A~y ~ ..~/ ~.~..~
reliance upon or use of this report by any other person or pady is not author/zed, ~ ,//.//..., 7,..
nor will it confer any legal right whatsoever. ~ ~.¢ffr~ '_ A~,,~,~f'~ nes.s...' ~.
6. DHHS SIGNATURE ;,~, ". ..'
L.-"" Approved for L~ bedrooms 't~.~.~.~.~.~~'~'~' .............
Disapproved
Conditional approval for bedrooms, with the following stipulations:
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of
homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of
DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineeds work.
72-025 (Rev. 1/91) Back MOA #21 Computer Version
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVI
Environmental Services Division
825 %" Street, Rm 502 Anchorage, Alaska 995011(907)343~u7 ~pAll~...~,,~, ~ ~
Health Authority Approval Checklist N
Legal Description: LAKE RIDGE TERRACE S/D; LOT 5, BLK 6, Parcel I.D.:
051-513-27
A. WELL DATA
Well Type, PRIVATE
Log present (Y/N) ~ NO Date completed
Total depth 109.5'+ - Cased to 40'+
Sanitary seal (Y/N) YES
If A, B, or C, attach ADEC letter. ADEC water system number N/A
PRIOR TO 7/1975
Casing height (above ground). 12"+
Wires properly protected (Y/N) YES
Date of test
Static water level
Well production
FROM WELL LOG AT INSPECTION
...--' 9/12/00
..~y~?.~--- 109.5'
g.p.m. 6.0
g,p.m.
WATER SAMPLE RESULTS:
Coliform 0
Date of sample: 10/24/00
Nitrate
1.25 mq/L Other bacteria 0
Collected by: A.W.W.C., ~C.
B. SEPTIC/HOLDING TANK DATA
Date installed 10/,7,1/81 Tank size
Foundation cleanout (y/N) YES
1500 Number of Compartments 2 Cleanouts (Y/N)
Depression (y/N) NO High water alarm (Y/N) N/A
YES
Date of Pumping 9/12/00 Pumper SANITARY PUMPERS
C. ABSORPTION FIELD DATA
Date installed 10/51/81
Length *70'+ Width
*NOT GIVEN ON INSPECTION REPORT. MEASURED IN FIELD.
**SEE AT]ACHED LETTER DATED 10/31/2000.
o r ~-~"~ 280 System type BED
8oil
rating
(g.p.d./ft2
*25% Gravel thickness below p~pe *0.5' Total depth .3.0'-3.5'
Effective absorption ama 2190 SO.FT.
Date of adequacy test ** 10/23/2000
Fluid depth in absorption field before test (in.);
Fluid depth ** (ins).Minutes later:
Peroxide treatment (past 12 months) (Y/N)
72-026 (Rev. 3196)* Computer Version
Results [Pass/Fail) PASSED For
** Immediately after 930
** Absorption rate =
**YES If yes, give date
Monitoring Tube present (Y/N) YES Depression over field (y/N) NO
**4 Bedrooms
gal. water added (in.):
600+
9/22/2000
D. LIFT STATION
Date installed
Manhole/Access (Y/N) YES
High water alarm level at*
Cycles tested 3
10/51/81
Size in gallons.
"Pump on" level at* 34"
*Datum BO'FrOM OF TANK
UNKNOWN (,-HO0 GALLONS)
"Pump off" level at* 34"
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
~ 100'+
Septic/holding tank on lot
Absorption field on lot 100%
Public sewer main N/A
On adjacent lots 1 oo%
On adjacent lots 100%
Public sewer manhole/cleanout N/A
Sewer/septic service line 25'+
Lift station 100%
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation 5'+ Property line 5'+
Water main/service line 10% Surface water/drainage 100%
Absorption field
Wells on adjacent lots
5'+
100'+
SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+
Building foundation
Surface water
100'+
Curtain drain
NONE KNOWN
F. ENGINEER'S CE/R'
I certify that I h~/ve
of Municipal re¢ord;
with MOA HA~ guic
Signature ~
Engineer's Name
Date II/~
eld inspections and review
/stems are in conformance
this date,
v ~-
~JEFFREY A. GARNESS
10'+ Water main/service line 10'+
Driveway, parking/vehicle storage area 10'+
Wells on adjacent lots 10~+
~-7953 : ~
....'
......
Date of Payment
Receipt Number (¢¢.'Z//'c~
72-026 (Rev, 3/98)* Computer Version
Waiver Fee $
Date of Payment
Receipt Number
LAsICA WATER & WASTEwATER
:: -: CONSULTANTS, INC. :- :
October 31, 2000
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: Septic Adequacy Test and Health Authority Approval for
Lake Ridge Terrace Subdivision; Lot 5, Block 6,
To ~vhom it may concern:
The existing four bedroom house is served by a private well and septic system. On 9/12/2000, we
performed a well flow test and a septic adequacy test for the referenced property. During our site
visit we found a foundation cleanout, V,vo septic tank cleanouts, a' manhole for the lift station and
ftve cleanouts and five monitoring tubes for the mounded bed system. The monitoring tubes are
believed to be at the end of the drainfields and appeared to be sumps. Prior to adding ~vater to the
system it was noted that the liquid level in the monitoring tubes were 3/4 of inch lower than the
invert on average. Also, the monitoring tubes appeared to have some sludge in each sump. A
total of 1062 gallons of water was added to the monitoring tubes which caused the liquid levels
to rise from 1-3/4 of inch to 4-3/4 of inch in the sumps. The next day (1295 minutes later) the
monitoring tubes were checked and found the liquid level had dropped to within a I/2 inch of the
readings at the begirming of the test and also the liquid levels in all the sumps were below the
inverts.
The homeowner was made aware of our findings and inquired about cleaning the distributions
lines. Per our recommendation the homeowner contracted Old McDonald's Pumping to perform
the services. According to Mr. McDonald, the lines were jetted and 40 gallons of Septic Clear
was added to the sumps on 9/22/2000. Per the homeowners request, a second septic adequacy
test was to be performed a month after the lines were cleaned.
On 10/23/2000, a second adequacy test was performed. Prior to adding water to the system it ~vas
noted that the liquid level in the monitoring tubes were l of inch lower than the invert on
average. A total of 931 gallons of water xvas added to the monitoring tubes which caused the
liquid levels to rise fi'om 1-3/4 of inch to 2-1/4 of inch in the sumps. The next day (970 minutes
later) the monitoring tubes were checked and found the liquid level had dropped to within a 1/4
inch of the readings at the beginning of the test and also the liquid levels in ail the sumps were
below the inverts.. Based upon this data, it is concluded that the septic system meets the
requirements for a 4 bedroom residence and we request a Health Authority Approval be granted.
6901 DebmT Road, Suite 2B - Anchorage. AK 99504 - Ph: (907)337-6179 - Fax: (907)338-3246
if you have any q~u~l !~ons, please contact us at 337-6179. Thank you for your assistance.
Jeffrey 'ne .., M.S.
Presidd
690I Debau' Road. Suite 2B - Anchorage. AK 99504 - Ph: (907)337-6179 - Fax: (907)338-3246
Public Works Dept.
Fax:l-90?-?45-9825 Oct 19 2000
·
, ~ .~.- .~. ~ ~
12:23
P.01
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # ~)~-~
1. GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property owner ~'~
Mailing address
Lending agency
Marling address
Agent
Add ress
Day phone ~'J:~/~'- ,~,~-~,~
Day phone
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: -~
TYPE OF WATER SUPPLY:
Individual well ,~
Community well
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE:
If community wastewater system, provide written confirmation from State AD£C
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA #21
s),ueLu LUOO leUO!t!PPV
:suo!~elnd!~s 8uF~olloJ eH), H~F~ 'su~oo~peq
's~uoo~peq
Joj leAo~dde leUO!~!puoo
'peAo~ddes!Q
¢- JOt peAo~ddv
=IMn.LYN~)I$ SHHa
'9
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:/ZoT~ ~z~.~ (_~
A. WELL DATA
Parcel I.D.
Well type '"~.¢-¢g//~
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
If A, B, or C, attach ADEC letter.
ADEC water system number
Date complete~t Driller
Cased to !. '~ '.~ ~' Casing height
Wires properly protected (Y/N) V
FROM WELL LOG
Date of test ~-,///~/~5~'
Static water level
Well flow
Pump level
g.p.m.
SEPARATION DISTANCES FROM WELL TO:
Septic/~ tank on lot
Absorption field on lot
Public sewer main j~/~e
Sewer service line
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank /,~/'~
WATER SAM.?LE RESULTS:
Coliform
Date of sample:
Nitrate
Collected by:
Other bacteria
B. SEPTIC/Hi~I;BIN~TANK DATA
Date installed IOl'~'i/¢!
Cleanouts (Y/N) Y'
High water alarm (Y/N)
Date of pumping
Tank size I~
Foundation cleanout (Y/N)
¢,0.m, partments
Alarm tested (Y/N)
Pumper
SEPARATION DISTANCES FROM SEPTIC/14~-EHNG TANK TO:
Well(s) on lot IO~' On adjacent lots /'~-~
To property Fine ~ ~' ~ Absorption field
Surface water/drainage ~¢' ~
Foundation ~:::~ /
.Watermain/serviceFine /d~¢~
72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
Meets MOA electrical codes (Y/N)
"Pump on" level at
Manufacturer
Manhole/Access (Y/N)
~"7 ~ ~ "Pump off" level at
Cycles tested
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot /'Z~! On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date installed to[~l [~
Length '7 ¢~- Width
Total absorption area
Depression over field (Y/N)
Results (pass/fail)
Y
Peroxide treatment (past 12 months) (Y/N)
Soil rating ~O/~-~ System type
/
Gravel thickness // Total depth '~'
Cleanouts present (Y/N) ~"
Date of adequacy test ~/~'~?
for
.¢.~ ..u'~ If yes, give date
bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot / '~' -~' On adjacent lots I 5'~,:, 't~ Property line
To building foundation ~¢_2
On adjacent lots ,~ ~
Surface water
To existing or abandoned system on lot
Cutbank /(/¢-.¢~- Water main/service line
Driveway, parking/vehicle storage area
Curtain drain
E. ENGINEER'S CERTIFICATION
Signature
Engineer's Name
Date
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection,
David R. Dayto. P.E.
20210 Dona]ar St.
Chugiak, Alaska 99567
I ,' /~/¢/ / /
HAAFee$ /'7~ ,(~
Date of Payment ¢~'-,/&/¢ - (~ ~-'
Waiver Fee: $
Date of Payment
Receipt Number
---MUNICIPALITY OF ANCHORAGE*.
OF ~'~:~.FFI AND ENTIRu~,tEN~, PROI'ECTION
Date Received: _~S~_~[..5.}2_ l~J ................
Time
Date
N!sp ..........................
0:: I~.IuIVIDdAL SEWER AND WA].t',R FACILITIES
.,-~W,an,~.~ ]POI~ APPROVAL -r,
Lending I~}sti'{t{~tion Request: Alaska National Bank of the North
Mail. inc; Address: _.33_~01~__~__._S_t..r_e._.e_._%_,..__g_a_l___a__i_s_ ..... !_.I_~_:___ Phone: '278-4581
Larry Witaschek Phone: 688-3249
1698 Blue Spruce Lane 99567
3. ,'~' De~or~ 3'Pion Lot 5 Block 6 Lake Ridge Terrace Subdivision
~.~.ngl~ Family Residence: (x)
Mulbi. ple Fam:Lly Residence: ( )
' ~: Three
Number ).~. £~,edrooms:
Number - ~
o.,. Bedrooms
Well S'zste_m: Individunl Well (x)x Community/Public System ( )
Permit {~ Depth of Well 135'-- Well Log on File ( )
Construction~ Bacterial Analysi_s .............................
Sewage Disposal System: On-site System (x) Public Utility ( )
Permit # Installed 1976 Installer
· _ ...... _ facr~urer ....................................................
Septic Tank Size )~--
&,
Absorption Area Soils Rate Material
7~ Distances: Well to Septic Tank
to Sewer Line Nearest Lot line
to Nearest Lot Line
tO Absorption Area
Absorption Area
,Q : DeDartmenk of Health ane Env' ronmenLa'i Pro~ectlol
.' ~ i Rec~iest. for Approval[ of Indiv[.dual Sewer and Water Facilit'~.es
]i~{~al D~c_~}~i. en~ Lot 5 Block 6 Lake Ridge Terrace Subdivision
Depar tmen-~. Worksheet
rL ~ ~vlUNICIPALITY OF ANCHORAGE i:';,.~, i,
"~'~-L~cueSt~ for A reval of Individual Sewer and Water'~F~ci-lities
Mailing Address: ~ Phone
Realtor/Agent: -~le ~
~gle ,amily ~'esEaence: (~ Number of Bedrooms:
Multiple Family Residence:
( ) Number 6f Bedrooms:
Water Supply: *Individual Well ~) Public/Community System
If Individual Well, well depth /~ .
If, community System, name of system
( )
Sewage, Disposal System: On-site System ~ Public System ( )
If On-site System, date of installation: ___//~_~
*NOTE
A well log is required on ALL wells drilled since 6/75.
3/77