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HomeMy WebLinkAboutRABBIT CREEK VIEW & HEIGHTS BLK 11H LT 11ARabbit Creek View & Heights Block 11H Lot 11A #020-581-65 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 Page I of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: sw090115 PID Number: 020-581-65 Name: AARON BORK Wastewater System: [] New [] Upgrade Address: 8001 NORTHWIND AVE. UNIT A ANCHORAGE AK.99504 ABSORPTION FIELD Phone: Number of Bedrooms: 306-9535 3 [] DeepTrench [] Shallow Trench [] Bed [] Mound [] Other: Soil Rating: Total Depth from original grade: LEGAL DESCRIPTION 0.6 GPD/Ft2 6.0' Ft. Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: 11H 1 lA RABBIT CREEK HEIGHTS 1.7-1.8' Ft. 4.2-4.3' Ft. Township: Range: Section: Fill added above original grade: Gravel Length: 0.8-1.9' Ft. 39.0' & 38.0' (77.0' TOTAL) Et. Gravel width: Number of lines: Distance between ~lines: Well: [] New [] Upgrade 5.0' Ft. 2 10.0+ Ft, Classification (Private. A. B, C): Total Depth: Cased to: Total absorption area: Pipe Material: PRIVATE 326.0' Ft. 177.0' Ft. 770.0 Ft2~ ASTM D3034/F810PVC Driller: Date Drilled: Static Water Level: Installer: Date Installed: ALPINE DRILLING 7/20/09 71.0' Ft. A+ HOME SERVICES 7/24/2009 Yield: I Pump Set at: I Casing Height Above Ground: 2.0 GPMI 315.0' Ft.I 2.0'+ Ft. TANK SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other: ~To Septic Absorption Lift Holding ~ublic/Private Manufacturer: Capacity: From ~ Tank Field Station Tank Sewer Line ANCHORAGE TANK 1000 Gal. Material: Number of Compartments: we, 100.0'+ 100.0'+ ............................ 25.0'+ STEEL 2 Surface Water 100.0'+ 100.0'+ ............................ ~ Size: Manufacturer:LIFT STATION Lot Line 5.0'4- 10.0'+ ............................ N/A Gal, "Pump on" level at: "Pump off' level at: in, High water alarm at: Foundation 5.0'+ 10.0'+ ........................... in. in, Pump Make & Model Electrical Inspections performed by: Curtain Drain .............. NONE KNOWN .............. Remarks: BENCH MARK Location and Description: NOTCH IN TREE Assumed Elevation: 100.0 Ft. Inspections performed by: ,~' ,~..,Y g/,~¢t,'V//.~','f-D~ate~s: 1et 7/24/2009 · -~,/nd 7/24/2009 Development Services Department Approval ~'~/ ,.,~:-u _~'~'~, ".."*:'¢~'. Reviewed and approved by: ,~. //j~./~,, e: ~- ~ *-/O (Rev. 04/06) ' ,/ PERMIT NO SW090115 PAGE 2 OF 3 ~lunicip~Lity o¢ Anchorage DEVELOPMENT SERVICES DEPARTMENT - BUILDING SAFETY DIVISION ON-SITE WATER AND WASTEWATER PROGRAM, /-+700 BRAGAW STREET P,D, Box 196650 ·Anchoroge~ ALosko 99519-6650 ·Tetephone', (907) 343-7904 ·www,ci,onchor~9e,ak,us ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL, RABBIT CREEK HEIGHTS BLK 11H LT 11A P.z.$. xo. 020-581-65 LOT 14 LOT 15 ~ ~ LOT ? 10' 10' UTILITY ESMT. lO' UTILITY ESMT. 10' UTILITY ESMT. 10' UTILITY ESMT. 10' UTILITY ESMT. I NO PRIVATE WELLS I WITHIN 100'+, NO NEW SHALLOW L_ COMMUNITY WELLS WITHIN 200'+ OF TRENCHES MT.5 ........ SEPTIC SITE T4 , ".4/~/'~"~i",.,.t;~_ 0= .' TaM(NOTCH IN TREE) LOT 1 ' / / PERMIT NO. SW09011 5 PAGE 3 OF 3 MunicipeLity ©F Anchor~o, ge DEVELOPMENT SERVICES DEPARTMENT - BUILDING SAFETY DIVISION ON-SITE WATER AND WASTEWATER PROGRAM, ATO0 BRAGAW STREET P.D. :Box 196650 I Anchoroge, ALasko 99519-6650 ·TeLephone: (907) 343-7904 ·www.ci.onchoroge.ok.us ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL RABBIT CREEK HEIGHTS ELK 11H LT11A P.I.D. NO. 020-581-65 ST1 ST2 jGRADE 105.5' NAL GRADE ...fi2" INSU ~ .................................................... ~F TANK , NEW 1000 2' INLET 101.4'/ GALLON '~OUTL~ 101. CO1 SEPTC TANK 102.0' MT2RCR03BMTI.~CO1 = 96.4' II II I1~ co~ -- 97.5' H~AL GRADE ./ --1L]II.F__iiP 2'' INSULATION ORIGINAL GRADE I II SR J I~1co3 -- 93.9' = 9~.~' Jl~ === = a9.~' ~ '~-==l = a9.~' NO · WATER FOUND 83.6' B.0.H. A B C FCO 1 6.5' 7.5' _ ST1 67.0' 49.0' 68.0' ST2 68.5' 49.5' 66.5' DEL1 69.5' 49.5' 66.5' DEL2 69.5' 49.5' 66.0' C01 - 80.5' 85.0' MT1 - 78.0' 80.5' C02 95.5' 72.0' 84.0' MT2 95.5' 75.5' 85.5' COS - 92.5' 95.5' MT5 - 94.5' 98.0' C04 112.0' 90.5' 102.0' MT2 114.0' 92.0' 105.5' FS - 75.5' 80.5' Municipality of Anchorage Development Services Department Building Safely Division On-Site Waler and Waslewaler Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsile (907) 343-7904 Performed For: 4- 5- 6- 7- 8- 9- 10- 13- t6- 17- 18- 20- Soils _L.~g - Percolation Test COMMENTS Dale Performed: Township, Range. Section: PERFORMED BY: PERFORMEDIN ACCOF Sile Plan WAS GROUND WATER E~COU.~ERED? tF YES, AT WHAT DEPTH? Depth to Water After Monitoring? Dale: ..~ Dale Gross Time Nel Time Deplh lo Water Net Drop PERCOLATION RATE TEST RUN BETWEEN AND PERC HOLE DIAMETER FT CERTIFY THAT THIS TEST WAS FECT ON 1' HIS DATE. DATE: r FROH :Alpi~-,~ Dr'illi~-,3 FAX NO. :907 ~45 0202 Oet. 27 2009 Oi:05F'H PI Alpine Drilling & Enterprises Well Log Permit Number: #SW090115 Date of Issue: 7-20-09 Parcel Identification Number: 020-5_81-65 Date Started: &2-09 Date Cmnpleted: 8-3.09 ls well located at approved permit location? x Yes [] No Legal Description: Rabbit Creek Heights Blip' 11H Lot 1 IA Property Owner Name & Address: Aaron Bork Borehole Data: Soil Type, Thickness & Water Strata From To Stick-up 0 2 Gravel fill 2 4 (h~ganics & silt 4 5 gravelly silt 5 29 silt 29 35 gravelly silt 35 67 silt), gq'ca,el 67 109 gravelly silt 109 171 weathered rock 171 ] 77 bedrock t 77 326 8007 Northwind Ave, Unit A Alaska 99504 Depth (f0 Method of Drilling x air rotary [] cable tool Casing type: Wall Thickness: .2.~_5 inches Diameter: _6 inches Depth: 177 feet Liner Type: ~ Diameter: ..... inches Depth: feet Casing stiekup above ground: 2 fe-~t Static water level (from groand level): ?j_/feet Pumping level: 326.feet after ~ hours pumping _2. gpm Recovery Rate: ___ gpm Method of Testing: .air Well Intake Opening Type: [] Open End x Open Hole [] Screened Stm-t .., feet [] Perforations Start __ feet Grout Type: b__entonite granules Stopped ~ feet Stopped ~ feet Volume: 2 bgs Pump: Intake Depth ~ feet Pump size ~ hp Brand Name Well Disinfected Upon Completion? x Yes [~] No Method of Disinfection: chlorine tablets Comments: Well Driller: Atp#ze Drilling & Enterprises PO Box 110496 Anchorage AK 99511 Mark Begich Mayor Development Services Deportment Building SofeW Division On-Site Water & Wostewoter Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.rauni,orq/onsi?¢ (907) 343-7904 Pump Installation Log Well Drilling Permit Number: SW Date of Issue: Parcel Identification Number: Replacement Only: YES NO Legal Description Lot l lA, Block l lH, Rabbit Creek Heights Property Owner Name & Address: Aaron Bork Pump Installation Date: 4/12/2010 Pump Intake Depth Below Top of Well Casing: 315 feet Pump Manufacturer's Name: Myers Pump Model: 8GPM Pump Size 1 hp Pitless Adapter Burial Depth: 12 feet Pitless Adapter Manufacturer's Name: Maas Pitless Adapter Installer: Aarow Pump Well Disinfected Upon Completion? [] Yes [] No Method of Disinfection: Recirc Comments: Pump Installer Name: Aarow Pump & Well Service LLC PO Box l10496,Anchorage, AK. 99511 (907) 346- 9355 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. N B9 ~-0~ ~-4" E 100,07 10' UTILITY EASEMENT I I I o o 0.H. 0E£K 7 GRAVEL ~/E L LO/ PARKING Z 0 Z O O ~ O NOTE: PLAT NO. 200~-91 REFERS T0 AN EASCHENT ALONG THE CAST SIDC OF LOT 11 A, WHICH IS NOT NOT DEDICATED ON SAID PLAT AND THEREFORE NOT SHOW HEREON. PAINE ROAD FINAL STRUCTURE AS-BUILT AS-BUILT SURVEY 1" = 30' GRID 3341 THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES OR FENCEL]NES. ~:ASEMENTS OF R~:CORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HER~:ON.(UNLESS INDICATED) NOTE: ANY FENCELINES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LINES OR LOCATE STRUCTURES. ANY PAVING SHOWN MAY BE APPROXIMATE DUE TQ SNOW CONDITIONS. I HEREBY CERTIFY THAT I HAVE PERFORMED A MORTGAGEE'S INSPECTION OF THE FOLLOWING DESCRIBED PROPERTY. LOT 11 A, BLOCK 11 H, RABBIT CREEK HEIGHTS SUB. ANCHORAGE RECORDING DISTRICT, ALASKA AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NQ VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED, DATED AT ANCHORAGE, ALASKA THIS 27TH DAY OF JULY 2010 HOLT LA-ND SURVEYING -- TEL. 345-5513 11059, FB 136-66,138-16 MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: Jul 20, 2009 Expiration Date: Jul 20, 2010 Permit Number: SW090115 Parcel ID: 020-581-65 Legal Description: RABBIT CREEK HEIGHTS BLK 11H LT 11A Design Engineer: 0003 S & S ENGINEERING Site Address: NHN PAINE RD Owner Name: AARON BORK Lot Size: 19702 SQ. FT. Owner Address: 8001 NORTHWIND AVE, UNIT A Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE, A 99504- This permit is for the construction of: [] DisposalField [] SepticTank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. Ail requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Parcel I,D. Mnnicipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, Alaska 99507 www. muni.orglonsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Property owner(s) Aaron Bork Mailing address 8OOl Northwind Ave. Unit A, Anchorage Ak. Site address Day phone 306-9535 Zip Code 99504 Zip Code Legal description (Sub'd., Block & Lot) Rabbit Creek Heights, Block 11H, Lot 11A Legal description (Township, Range & Section) Lot Size /ti: 7~- Sq. Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR ([~ all that apply): Absorption Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage [-] THIS APPLICATION IS AN: Initial [] Upgrade [] Renewal [] Date of Payment: Receipt Number. (Rev, 11/05) I .certify that the above in'correct. I further certify that this application is being made for a Single Family Dw~applicable Municipal Codes. (Signature of pro~thofized agent) Pe~miURush Fe~s: .5720 V-Z.~) Waiver Fees: Date o, .a,ment: ~_~-/~,.~ (,m,j Receipt Number:. July g, 2009, 2009 ROBERT C. COWAN . CIVIL ENGINEERING PH: 907-694-2979 FAX: 907-694-1211 MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot I lA, Block 1 IH, Rabbit Creek Heights Subdivision it is requested that you issue a permit to install a nexv xvell and a new shallmv trench septic system to serve thc proposed three bedroom house on thc referenced property. A test hole was excavated and a percolation test performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation (6/22/2009) water was not found. After seven days of monitoring, ground water was not found. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system 4411 not prevent any future development on any ofthe adjacent properties. Sincf~e~ Enclosure lfyou require additional information, please contact us. 15861 S. Birchwood Loop Road - C. huglak, Alaska 99567 LegM Descflpflon: 3o 8 9. 15- 16- 17, 18- 20, Municipality o! Anchorage ~~ e~-~--~ Developmenl Services Depadment On-Site Wa~er ~nd Wasl~afer Pr~m P.O. Box ' 96650 An.orage. AK 99519.6650 (907) 343-7g~ Soi~og - Percolation Test / I ~//Z.?TC~ ' ~'~ * Sile Plan Slope / / / / · / / COMMENTS PERC HOlE DIAMETER T EST RUN BETWEEN -- AND F T PERrORMED BY: CERIIFY TIIAT THiS TEST WAS ECT ON IHI$ DATE. DATE; ROBERT C. COWAN . CrV1L ENGINEERING PH: 907-694-2979 FAX: g07.~94-1211 ON-SITE WASTE~VATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot I lA; Block 1 IH; Rabbit Creek tleights S/D July 8, 2009 GENERAL: The scope of this project includes the installation of new well and new shallow septic trenches to serve the proposed three bedroom residence located on the referenced property. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherxvise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. Contractors installing wastewater disposal systems must be certified by the Municipal Development Services Department or ADEC if required, for system installations. O~ers installing their o~ systems must also receive prior approval from the respective agency. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. All HDPE septic tanks are required to have a 4" monitoring pipe installed next to the tank extending to the bottom of the tank. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 15861 S, Birchwood Loop Road - C~ hugiak, Alaska 99567 Page 2 Lot tlA; Block ¶IH; Rabbit Creek Heights Subdivision July 8, 2009, 2009 All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Septic tanks installed with less than 4 fi. of cover shall be insulated. All tlDPE septic tanks are required to be covered with a minimum of 2" direct burial insulation, and a maximum of 4 feet of cover. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 fi. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCII/DRA1NFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom ofthe excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before grovel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The Page 3 Lot 11A; Block 1tH; Rabbit Creek Heights Subdivision July 8, 2009, 2009 finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials arc approved for use in septic system installations in the Municipality of Anchorage: Type &Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (tIDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mimfi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (server rock) shall be 0.5"-2.5" screened grovel with less than 3% passing the//200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. INSPECTIONS: Page 4 Lot 1tA; Block tlH; Rabbit Creek Heights Subdivision July 8, 2009, 2009 Typically them will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any grovel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, grovel, distribution lines, standpipes, cleanouts, and insulation, but before the placement ofany other backfill. 3. The final inspection is to occur upon final grading ofthe property. Often there vdll be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre- construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR / INSTALLER Municipality of Anchorage G c On -Site Water and Wastewater Program (907) 343-7904 5 3 F E T Y` c Certificate of On -Site Systems Approval Parcel I.D. 020-581-55 Expiration Date: 1. GENERAL INFORMATION: Complete legal description RABBIT CREEK VIEW AND HEIGHTS; BLOCK 11H LOT 1A Location (site address) 16925 Nickleen Street *Anchorage Current Property owner(s) Saniea Livingston Day phone Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3- 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 550 Waiver Fee $ Date of Payment `Z-2_ Z -2- 2 - Receipt Receipt Number. G a 4% Z COSA# (DSCa� 1 10 Q Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Gamess Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and��. industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or� '� • . • • • • { • encroachments may exist that were not identified during the evaluation. The operational life of all wells ` : •'_u) and septic systems depend upon a variety of variables, including but not limited to, soil conditions, I groundwater levels (that may fluctuate during the year), quality of construction (materials and r;" r workmanship), and the water usage of the family utilizing the systems. These conditions can vary, and j-."""""•."" " " "'""'. """" are outside the control of GEG. Satisfactory test results do not guarnrdee fuiuie peiformance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of ;;j . • • • • • • • ... • • • • • • • • • • the well or septic system. GEG makes no representation whether an alternative well or septic system ;. can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or u lr,``�•: �'� '� `'�' party (including subsequent property purchasers) is not authorized, nor will it confer any legal right 6. DSU SIGNATURE System #1 Approved for bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms, with the J �i #AECC884 p ff Yf pF ing r F VVAST.�: AND m' J9)�/ SFRVIC�SV�`� i Original Certificate Date: 3 _Z a 1T�'^ The Municipality of Anchorage Development Services Division (DSD) issues Certificates of Onsite Systems Approval (COSA) based only upon the representations given In paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA ChecklistNitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other 10% Legal Description: RABBIT CREEK VIEW AND HEIGHTS; BLOCK 11H, LOT 1A ParcelID: 020-581-55 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Well production at time of test **6.5+ gpm Date drilled 19901?I Water storage tank volume N/A gallons Total depth *72 ft Well disinfected for coliform test? ❑ Yes ❑ No Cased to UNKNOWN ft ❑ Coliform bacteria is Negative ❑ Sanitary seal is functioning correctly Nitrate mg/L ❑ Nitrate less than MRL (ND) ❑ Wires are properly protected Arsenic ug/L ❑ Arsenic less than MRL (ND) Casing height (above ground) 18+ in. Collected by GEG, LTD. Date of flow test for COSA 2/15/22 Date of Sample 1112J22 Static water level at beginning of test ** ft. Comments *PER ANCHORAGE WELL AND PUMP SERVICE **ARTESIAN WELL WITH PACKER 0 i iSu B. TANK DATA Age of tank(s) 3 years Tank type/material STEEL Measured operating fluid level in septic tank ❑.Standpipes/foundation cleanout per record drawing Date of pumping C.required T STATION maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA DUAL 5' WIDE TRENCH - 'SOUTH/NORTH Which system tested (date installed) 316119 Adequacy test date 2/15/22 ❑ ALL standpipes present per record drawing Results QPass For 3 bedrooms Total measured depth from grade 3.83 ft (max) * Fluid depth prior to test 0/0 in Measured depth to pipe invert from grade **2.66 ft (min) * Water added 309/309 gal ❑ N/A — pressurized field `New ❑ Monitor tubes go to bottom of effective. If not, state depth 0/2 in depth into effective 5- Elapsed time 115 min ❑ Code -required soil cover over field ` Final fluid depth 0/0 in ❑ System presoaked Absorption rate 450+ and (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NONE date of fest) Gallons introduced 2757 gallons If yes, enter date N/A Comments/Deficiencies: '•2• of INSULATION OVER BOTH TRENCHES "PRE-SOAK PERFORMED SAME DAY AS ADEQUACY TEST COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100'Community Q Yes *50'+ Sewer Manhole/Cleanout > 100' ❑ Yes if No ft [Q Yes if No ft Neighboring Tank > 100' M Yes if No ft Private Sewer/Septic Line > 25' M Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No *50'+ ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' ft Water Service Line > 10' Animal Containment > 50'[]✓ Yes if No ft 0 Yes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Manure/Animal Excreta Storage > 100' if No Community Sewer Main > 75' M,, Yes if No ft M Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' ❑ Yes if No *50'+ ft Property Line > 5' Q Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q Yes if No ft Private Wells > 100' ❑ Yes if No *50'+ ft Water Main > 10' 0 Yes if No ft Community Wells > 200'✓Q Yes if No ft Water Service Line > 10' 0 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 21 Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' ❑ Yes if No *50'+ ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' ❑ Yes if No *50'+ ft F. ENGINEER'S COMMENTS *ADVANCED WASTE WATER TREATMENT SYSTEM. **PER INSPECTION REPORT. SOUTH TRENCH DISTRIBUTION LINE IS OUT OF LEVEL BY APPROXIMATELY 3 G. 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. COSA Checklist yellow sheet o OF .q�%� ooh. 4 —Th D p... ...... .......... . ...... �O13 _J Gayness.: C 7j• 53 •c O V o �ofessio� o #AECC884 4N�OOpOoa 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 V--^— Day of jVj ftof 20 i%?, by and between —-4 I9 26-[2k the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) I5.65.365. 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 � � q 2. � l C f ( '(' � �� f located at (legal description) ?A?i-F C V I EOA/ t H 6-` i .5 LOT I A &Lk- l l N 2. Maintenance, Renairs and AIterations. (Owner is required to read, understand and initial each section) mAJ 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. 2 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. �_ (1 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. Q�66, Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. L�JU< 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. i Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. 'rhe 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. Severabilitv. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By: I xll'i I �"�`�< � (signature) Date: (print name) STATE OF ALASKA ) I OPAI,SKA t)FrlrtALss�et' NOTARY P'i1�3. IC �. THIRD JUDICIAL DISTRICT ) _ The foregoing instrument was acknowledged before m5this o- day of —NgTARY PUBLIC FOR ALASKA A_ M Commission expires: INGTARY PUBLIC -STATF Or; ALASKA r REINA Z, STREHL OFFICIAL Si AL MUNICIPALITY: ? By: (signature) Date: (print name) Title: (rev. 05/18/2018) Page 3 of 3 0312112022 10:58 Anchorage Tank 03/21/2022 09:56 8686770 - . , --1 ru rul Sul 40C ltftfK s� 1 '. TAK}907 277 3715 P.0011001 APLUS PAGE 01 tFA�}9Q? �1? 3•!i5 P-0011001 443 913 ' X amMIR 0 am min so , poll lob 4 a an I! .x i am a Iku's"adre-V RW Mabftmne ROW Unscheduled Ron Reed sltoAeu�lta '-.....- 16925 Nloklee 1 Street, Anchorage AK 99!"16 NXSMIDa 146638 P0 724� DIRPalchur Com 'nents sorer 03/09/21122 12.00 AM r❑ne — M please do CO RA h3POMn, Nome is empty but VID012. 06 Ron Rotd H you neeG access, Need 'eAof( to GEG ASAP.., "MCAVOS'S tf RNR Condition L M,,nde by vatic ommo Moni►oriny system 0 Malo lry Otfam-- ,ormv 09Othor,. � ...... _ Site condition at ;21118 of ooll r Aterm 0 Tank Over►lo%, `! Odr. (-1 sevratie Backup U other Field satnplfngla flonreilons L�Neeyy�an, D�iNQtrrcaRntu►ry 1VTia (16 a Nf Ua� PH 00 (2-8) Odor orf Aompla. YYWaeI L'3E"Y CMalery 1 Non-ty01cat �9uHide CebbaQe [�pQyy, Conditions of site Aran An , Yrs L Ke Tnnic Liquk/ Leval 1.1 Norrnet f) Nlph ~ tj La Pump Cto017rrtollanj V Yea 0 Nn CRCuk 51805Vt P,e(*e........ f TRPp--Lz.pq r❑-� ON r�PChnlpe..... C ] Tripprd g On '011 GOl1UOu • • •. .j TrippedOn C oil VOOV "ATR V Boatel. 0 RpVllnsG}n_} OncurrmtNhe 00n91 Riehl r tW thrAnp ihn �nmtuifl►n ittiuta -0erripu>g Eta ind ;atW Gy dtp yarrow 011111 Md LRDo. InputsPower (Qrann LED) "hip a AnchorageTank 907-272-354.3 0SMArs ­ -­----------•— .._ Larry Betts .... — roan! vt'm (907}830-2687 x711 ANL A Ata ai LsticapomA, RTU139291 01/100020 Cauto of Maif fnctlon: o Moch.11ca► QPr000alo Rcrlatxd _ t l �Y� 71 � .•...-. �l i/ALJ). M ! .- A SOMI®e Rdndefud; - - --� , grts Used; W n Wa. anly,, B a minabie I- Nalanl llotfolt►tinIx 10 N1hur uUen n0ed,.ti EA'JdWonal apvfca RSW,.d Fb 1Vftf 1`V Insp®Mion, Lido bchrd o1T mm Ab of 11Rmflgo44 comment _- Qvurot Panel maativstinyP Y" No — .. —•_. ) CIMIR Breskorm per' On -f Ottii oD1*0r,ArRal i on : ort cantra►a; ��{',`�' Tlma 1113110 ► Tr„!sl-nme To►otThe a�---- rj Orr} Fox Completed %rm to 1-136'6-384-7404 on ANCHORAGE WELL & PUMP SERVICE, INC. D _ 7640 KING STREET ANCHORAGE, AK 99518 PH, 907-243-0740 Bill To: RON REED 16925 NICKLEEN STREET ANCHORAGE, AK 99516 USA Invoice Invoice #: 20221249 Ship To: RON REED 16925 NICKLEEN STREET ANCHORAGE, AK 99516 USA SALESPERSON YOUR NO. SHIP VIA COL I PPD SHIP DATE TERMS DATE PG. TYLER S RIDGWAY 33346 Net 10 2/8/2022 1 TY. ITEM NO. DESCRIPTION PRICEI DISC % EXTENDED TX. PRICE 1 Service Call SITE VISIT TO ASSESS ENGINEER REQUIREMENTS FOR SALE OF PROPERTY 1 Field Service 01/31/22 - Check system. Well head $198.00 $198.00 completely frozen. Camera down cordoated tube. Found water leaking into tube - possibly from well head. Contacted excavator to thaw ground and well head to allow access. Notified customer and engineer of findings. Depth of well is 72'. 1 ST5-Tyler Service Tech 1 ST2-Mark Service Tech 1 CAMERA WELL CAMERA $400.00 $400.00 1 Field Service 02/07/22 - Return to site, check system. Run $495.00 $495.00 well pump to drag static water level down. Extend pump and power wires. Install casing upgrade with necessary components. Install I artisian packer and spire units. Test system - i ok. NOTE AWPS will return to site to fill in depression I! with gravel after Arctic Terra picks up ground thawing equipment. 3 ST5-Tyler Service Tech 3 ST2-Mark Service Tech 1 WLC-ALM-952806fWTCC-E 6" ALUMINUM WELL CAP $70.00 $70.00 MIDWEST 1 FIT-PVC-BSH-1.25X1 BUSHING -1.25"X1" PVC SCHEDULE 80 $6.00 $6.00 1 Electrical 1" X SLIP PLASTIC ADAPTER $8.00 $8.00 2 PARTS: 1" CARLON PVC PIPE $8.00 $16.00 3 ESP-SPK-4-SP4C 4 -Wire Plastic Splice/Repair Kit $16.00 $48.00 1 WPK-WLB-935638/6X4 FLOWING ARTESIAN WELL PACKER $1,265.00 $1,265.00 We appreciate your business. Thank you! SALE AMT.FREIGHT SALES TAX TOTAL AMT. PAID TODAY BALANCE DUE