HomeMy WebLinkAboutPARADISE VALLEY BLK 9 LT 25, 26Paradise Valley
Block 9
Lot 25
#020-422-14
MUNICIPALITY OF ANCHORAGE
V11-
1
Development Services Department wPhone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Parcel I.D. 020-422-14
Certificate of On -Site Systems Approval
Expiration Date: 9/2/23
Legal description PARADISE VALLEY BLK 9 LT 25, 26
Site address 6015 BULGARIA DR
Current property owner(s) WALLETTE JANA DEANN &ROBERT MICHAEL
X The On-site system(s) is/are approved for 4 bedrooms
Conditional approval for
Comments or advisories:
bedrooms, with the following stipulations:
By Original Certificate Date: 6/2/23
9
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 A\i-iHO GE
Development Services Department -s
Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 0 20-422-14
Complete legal description PARADISE VALLEY; BLOCK 9, LOT 25 & 26
Location (site address) 6015 BULGARIA DRIVE *ANCHORAGE, AK
Current property owner(s) MIKE & JANA WALLETTE
2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS
Day phone 632-8886
3. TYPE OF WATER SUPPLY: 0 Private Well ❑ Private Well serving 2 dwelling units
❑ Priv_ate Well serving 3+ dwelling units ❑ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete 0 Fiberglass
Age 13+ - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS X 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 $ .5 5 0
Date of Payment Sf23�23
COSA#
Waiver Fee $
Date of Payment
Waiver #
COSAApplication—June 2022
—A
COSA Checklist
I Legal Description. PARADISE VALLEY; BLOCK 9, LOT 25 & 26 Parcel ID: 020-422-14
If more than I well and/or septic system on lot, provide separate checklist. Structure served by this system _
A. WELL DATA
El Well log is filed with Onsite (or attached) Well production at time of test 4.3+
.: - - gpm
Date drilled 1978M Total depth 69.6+ ft Water storage tank volume N/A gallons
Cased to UNK ft Well disinfected for coliform test? M Yes No
On Sanitary seal is functioning correctly Eldoliform bacteria is Negative
Wires are properly protected Nitrate mg/L El Nitrate less than MRL (ND)
Casing height (above ground) 12+ in. Arsenic ug/L E,] -'Arsenic less than MRL (ND)
Date of flow test for COSA 5/11/2023 Collected by GARNESS ENGINEERING GROUP
Static water level at beginning of test 68.2 ft. Date 5/9/2023
Comments WELL HEAD HAS 3 BOLTS; IT IS RECOMMENDED ADDITIONAL BOLTS BE ADDED TO ATTACH THE WELL HEAD TO THE CASING
B. TANK DATA
Measured operating fluid level in septic tank
Date of pumping
X Required maintenance completed, if AWWTS
Comments: *SEE ATTACHED MAINTENANCE
D. ABSORPTION FIELD DATA
Which system tested (date installed) 1991
IN ALL standpipes present per record drawing
Total measured depth from grade 5.6 ft (max)
Measured depth to pipe invert from grade ft (min)
ME N/A - pressurized field.
[1 Per record drawings, field is insulated.
RE Monitor tubes go to bottom of effective.
If not, state depth into effective
❑ Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced - gallons date
Any rejuvenation treatment (past 12 months)
If yes, enter date -
1910 CYC LF—
C. LIFT STATION
MR Required maintenance completed
Age of lift station 14 years
Lift station material FIBERGLASS
Comments:
Adequacy test date 5/11/2023
Results [C Pass
Fluid depth prior to test 0.75 in
Water added 766 gal Ji
New fluid depth 4.25 in
Elapsed time 120
min
Final fluid depth 1.5 in
Absorption rate 600+ gpd
FIELD STATUS - POST RECOVERY vii
Effective depth
h (pe ngs, 12 in
Effective depth sed A—'�'6 In
eF
Effective dept aining 7-7-a in
V, 1 1 2,3
T,
Comments/Deficiencies: DRAINFIELD IS ADJACENT TO SLOPES >25% - NO DAYLIGHTING WAS OBSERVED
BOTTOM OF MT1 = 97.93 & BOTTOM OF MT2 = 97.72. MT1 WAS USED FOR TEST
COSA Checklist -June 2022
V'1 �ed
I J t
E. SEPARATION DISTANCES / 12-3
From Private Well on Lot to: (P ter to c if less than required or if community well on lot)
Septic Tank/Lift Station on L > 100' Community Sewer Manhole/Cleanout > 100'
Yes if No - + ftp ❑Q Yes if No ft
r
Neighboring Tank > 100' no Yes if No ft I Private Sewer/Septic Line > 25' Yes if No ft
Absorption Field on Lot >100' . es if No * + ft Holding Tank > 100' Yes if No ft
Neighboring Absorption Fields T60 _ -'``` ms```s Animal Containment > 50' Q■ Yes if No ft
Yes if No ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ME Yes if No ft QYes 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
Building Foundations > 10'
Tank to Property Line > 5'
Field to Property Line > 10'
M Yes if No ft
n Yes if No ft
❑� Yes if No ft
Surface Water > 100'
Wells on Adjacent Lots:
Private Wells > 100'
3n rouired)
es if No
Yes if No *
64
Water Main > 10' Q Yes if No ft Community Wells > 200' s--if-No ft
Water Service Line > 10' Yes if No ft If tank or field is under drivew y comment below
0/a
°F. EN 1NEER'jCGMMENTS
); 6TIC TANK IS ADJACENT TO DRIVEWAY. ROCKS INSTALLED TO PROTECT TANK FROM TRAFFIC
THERE IS NO FOUNDATION CLEANOUT THAT WAS LOCATED BY GEG. SEE ATTACHED PHOTO OF
POTENTIAL CLEANOUT IN CRAWLSPACE
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 Gamess Engineering Group, LTD. (GEG) Phone 907-337-6179
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 and septic systems depend
upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate
during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing
the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not
guarantee future performance of the systems; therefore, GEG makes no warranty (express or implied) regarding
the future performance of the well or septic system. GEG makes no representation whether an alternative well
or septic system 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 party
(including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever.
COSA Checklist—June 2022
......... .. ............. ..
...... .........
Q� _J A. Gar ss:
C —795-15•
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UCENSEprofession \
MECC884
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 /7—' Day of Noy of 20 2 3 by and between
1�,�LAOVA-1! iopi Wherein 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:
I. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as Q'�,-&y c J�N Wov CN-czq ;2- '� r7- w a -VZ S �S ; + 0 UCL3
located at (legal description)
L-ZLA,L.-2G f Lz6 FE,�
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 8400 to $600).
Owner agrees that only maintenance and repair personnel approved by the Municipality
P 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) Pagel of 3
AAOwner 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 constriction, maintenance and repair of the Owner's AWWTS.
Owner agrees to maintain remote monitoring of the AWWTS as required by the
5-96 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 AIaska 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. 0511812018) Page 2 of 3
OWNER:
p
By: Jc r t. ignature) Date: S I 2 3
A +ar�oalnO;DIN i jgz6 (rtoasnl(printname)
STATE OF ALASKA )
ss.
THIRD JUDICIAL DISTRICT 1
The foregoin instrument was acknowledged before me this day of
20 ?a2 , by may(„mIMae,; Au4r;
UBLIC FOR ALASKA
sion expires:
MUNICIPALITY:
By: /tet/ 4 (signature)
(rev. 05/18/2018)
NOTARY PUBLIC
SALLY V. MARINUCCI
STATE OF ALASKA
My Commission Expires Oct. 28, 2025
Date: y y
(print name) Title:
Page 3 of 3
E[':I�YC�17E
1st Inspection Report 2023
3705 Arctic Blvd #313
Anchorage AK 99503
Email: crbioak@gmail.com
(907) 274-0314
Homeowner Info
Customer Name: Mike and Jana Wallette Tank#: 244 Install Date: Oct. 2010
Address: 6015 Bulgaria Dr.
Initial Inspection:
Area: Rabbit Creek-Goldenview
Alarms Tested: Air IVI High Water 1�1 Battery Tested: Yes ❑ No ❑ N/A
(Please make sure alarm is on "normal", not "mute")
Does system have a septic tank ? No W1 Yes ❑ (Recommend pumping tank every 2 years)
Is System Lid Locked? Lid hardware in working order? Is there any noticeable odor?
Yes 171 Repaired ❑ Yes ❑ Repaired ❑ Strong[] Mild ❑ None [VI
Inlet plumbing in working order?
Yes 171 Replaced ❑
Are all aerators functioning?
Yes �] Replaced ❑
Clarification return system operating?
Yes Fv� Adjusted ❑
pH Reading:
(pH of 6-8 is ideal)
7.8
Pump float operating?
Yes 171 Replaced ❑
System Inspection
Dissolved Oxygen PPM
(2-5 is ideal)
3.2
Alarm float functioning?
Yes [V1 Replaced ❑
Solids pillow normal?
Yes 171 Requires Pumping ❑
Any buildup of solids?
Yes ❑ No
Any buildup of solids?
Yes ❑ No FvJ
Turbidity of discharge (in FTU)
(Under 35 FTU is considered compliant.)
7.85
Any buildup of solids?
Yes ❑ No [YI
Filter cleaned? Discharge line condition:
Yes [YJ N/A ❑ Good Replaced ❑
Comments:
Chris/Abi Date: 03/22/23 inspected d B : Has emailing or mailing of form been requested?
p Y (contact office to request...) Yes No
Municipality of Anchorage *+:~:
Development Services Department ~
Building Safety Division ~ ~
On-Site Water and Wastewater Program, 4700 EImore St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page of
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: -~l, qOqC)'ZO~ PID Number: OZO- ~Z~- i~
Name: D~ ~3 ~ ~ Wastewater System: D New ~ Upgrade
A
AddreSs:Phone: 'PO ~¢0~ 1~ 55q ~ nC~ OrC}~e(of Bedrooms: ~ ABSORPTION FIELD
~ Deep Trench ~ Shallow Trench ~ Bed ~ Mound ~ Other:
Soil Rating: Total Depth from original grade:
LEGAL DESCRIPTION ~,, ~.
Block: Lot: . -- Subdivision: Depth to pipe bottom from original grade:
~ 'Zs P~r~&,s6 '¢~ t~y Gravel depth beneath pipe:
Ft. Ft.
Township: Range: Section: Fill added above odginal grade: Gravel Length:
Ft. Ft.
Well: ~;5~,~ ~ New ~ Upgrade G .... Iwidth: Ft. Numberoffines: Distancebe~eenlines:Ft.
Classification (Pdva~A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material:
Ft. Ft. Ft2
Driller: Bate Ddlled: Static Water Level: Installer: Date Installed:
Yield: GPM Pump Set at: Ft. Casing Height Above Ground:
.~. TANK
SEPARAIION BISIANOES D Septic D Holding D S.T.E.P. ~"Other:
T~ Septic Absorption Lift Holding 'ublio/Private Manufacturer: C~a~ AL~b, Capacity:
Tank Field Station Tank Sewer Line 6~ Gal.
Well ~'~ Material: F ;~t"~ Number °f C°mpadment'4
SuCace Water ~i
{ LIFT STATION
: Size: Manufacturer:
~ "Pump 9n" level at: "Pump o~' level at: in, High water alarm at:
Pump Make & Model
Curia'" Drain ~{z / X ~,y~ Ele't"'llnspecti°nspe"°rmedby;
Remarks:
~,;.~,~) ~.¢_ ~} L;(.~ .3~;0.,~ A~;~,Ao,. [ocationand BENCHMARK
~ Assumed Elevation:
Ft.
Inspections performed by: 0~5 A ~ ~[, Dates: 1st 10j2¢ Oq ~ ~--'- '''X'
~ r ' %': ~ ~;'? :¢~: '
Development Se~ices Depa~ment Approval - ~ ..... . .....
. . ~Q ¢.~ .
Conditional Approval Date: ',..~
Reviewed and approved by: ( te:~- ~- t/' d'O~'F l~'x~/~:
LBT £7 /
VACENT
/
/
LDT ~6
/
/
ABANDONED EXISTING SEPTIC
TANK '~ UFT STATION PER
CODE REOUIREYENTS
LDT
YACENT
$-BDRM
HOUSE
~ ~ '" .-. -.. / LDT 14
SWING TIES /
I C 43.0' 62.
INSTALLED BIOCYCL£ ATS TANK.
CONNECTED TO EXISTING BED
INSULATED PIPING
UNDERNEATH DRIVEWAY
%
%
NOTE: THIS IS NOT A SURVEYED PLAT. WELL & SEPTIC I
LOCATIONS TAKEN FROM ON-SITE WATER AND WASTE WATER[
DEPART~tENT flOCUYENTATION. ALL LOCATIONS SHOWN ARE
APPROXIMATE.
,"--.--~.~ ~
25 O 25 5~ 75 I8~ 125 15§
SCALE: 1' = 50 FT.
SPURKLAND ENGINEERING
205 P/ 15TN. A VENUE
ANCH. AK. 9950!
(9OX,) 279-$916
PARADISE VALLEY BLOCK 9 LOT 25
DAVE ENGLAND
6015 BULGARIA DRIVE
SEPTIC SYSTEM ASBUILT
DATE: NO K 20, 2009
SHEET: 1/2 GRID: $558
PERMIT # Piti # 028-422-14 ParodiseVolleyBgL25Dl. dw9
INSTALL FOUND~ATIllN CLEAN OUT ~
SLOPE FINISHED GRADE AVAY
I .,/"F~nM TOP IN ALL ~IRECTIONS
6' MIN
L ~ ~- ~ PPRIMARY CHAM~ER
~ ~ ~ ~ ~ ~AERATION CHAM~ER
: ' J ~BISCHA~GE CHAMBE~
' ' F~:":'"~':":'":'z':~":'~:~'~':'~'i~'~-o ~' s~:/a~VEt ~t~r~:~:
LEVELING
CBMPACTE~
INS TALL A TION
Z EXCAVATE~ A 1~' x lB' x lB' DEEP HOLE FOR ~IBCYCLE SYSTE~
~ PLACE~ A ~INI~U~ Of ~' ~ O~ GRAVEL FOR LEVELING COURSE IN THE ~BTTBM OF THE EXCAVATION
COMPACT ~ REQUIRE~
~ PLACE 4 SHEETS BF ~' x 8' x 8' ~IRECT ~URIAL RIGI9 INSULATION BN TOP BF CBMPACTE~ LEVELING COURSE
TB PROTECT ~BTTBM OF FI~ERGLA%% TAN~ TAKE EXTRA CARE TB ASSURE THAT INSULATION COURSE I~ LEVEL
IN ALL DIRECTIONS,
~. ~ACKFILL AROUND TANK UP TB INVERT BF ~' INFLUENT AN9 1-1/4' EFFLUENT LINES ~ITH FREE-FLOWING NSF
MATERIAL F~EE BF LA~GE STONES BR 3BUL~ER~
XgNB/a~ VEL ~CKFILL
: '.':'...'"' i .
' CBNNECTE~ ~ EXISTING LINE
~r~ '.-" .'"4~
:
....
SPURK~ND ENGINEERING P~JDISE VArY B~ $ ZT 25 SEPTIC SYSTEg ASBUILT
203 · ISTH. AVENUE
ANCH. AK. ~950~ DAVE ENG~ND DATE: NOK 20, 2009
~07) 27~-~9~6 60~5 BULGARIA DRIVE SHEET: 1/2 GRID:
PERMIT g S~090~04 PZ~ g 0~0-4~-14
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343.7904
ON-SiTE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Oct 07, 2009
Expiration Date: Oct 07, 2010
Permit Number: SW090204
Legal Description: PARADISE VALLEY BLK 9 LOT 25
Design Engineer: 0007 SPURKLAND ENGINEERING
Owner Name: DAVE ENGLAND
Owner Address: PO BOX 100554
ANCHORAGE, A 99516-
Parcel iD: 020-422-14
Site Address: 6015 BULGARIA DRIVE
Lot Size: 0 SQ. FT.
Total Bedrooms: 0 Permit Bedrooms: 4
This permit is for the construction of;
[] D sposal Fie d [] Sept cTank [] Ho di.gTank [] Pri,,y
[] 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.
Municipality 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 SEVVER/~NELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
ParcelI.D. OZO- I~.'~- I~{
Property owner(si D^vr~ <~,~ J~ ,,~ Day phone
Mailing address J~O ~o,,,. l~55~l~nc~r~&.~ ZipCode
Siteaddress ~I5 Bu/fari~ Dci~e:A.~[orD,;
AK ZipCode
Legal description {Sub'd., Block & Lot) Pq~tS~ V~llt/ BlkS Lo{2B
Legal description {Township, Range & Section)
Lot Size .Sq. Ft. Number of Bedrooms
THIS APPLICATION IS FOR ([] all that apply): , THIS APPLICATION IS AN:
Absorption Field [] Initial
Septic Tank [] Upgrade
Holding Tank [] Renewal
Privy []
Private Well []
Water Storage []
[]
[]
[]
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees:
Date of Payment:
Receipt Number.
(Rev. 11/05)
Waiver Fees:
Date of Payment:
Receipt Number.
Environmental Consulting and Design
I
Municipality of Anchorage
Development Services Depanmem
Building Services Division
On-site Water and Wastewater Program
4700 Elmore Road
P.O. Box 196650 Anchorage, AK 99519-6650
I
September 15, 2009
SEPTIC SYSTEM UPGRADE PERMIT APPLICATION
PARADISE VALLEY BLK 9 LT 25
Ladies and Gentlcnnen:
We are submitting an application to upgrade the septic system at the above referenced properly. Thc existing
septic system consists ora 1000 gallon septic tank, a 500 gallon lift station tank, and a 32 foot by 24 foot
wide sub surface absorption bed. The system currently is approved for two bed rooms. Thc owners would
like to upgrade the system to serve a four bed residence. An adequacy test was performed on the bed on
August 21a, 2009 and the absorption bed was found capable of disposing of more than 600 gallons per day.
With the installation ora BioCyclc ATS tank, the absorption area required per bed room would be reduced
from 375 sq. fl. to 75 sq. ft.
The submittal consists of two (2) drawings showing the present improvements on the lot and the proposed
improvements of the lot, of which only the septic tank is subject to this permit application.
There are no wells within one hundred feet of Ihe proposed replacement site. The installation of this septic
tank will not prevent wells and septic systems from being installed on the adjacent Iota. There are no
developed or natural surface / sub surface drainage courses within 100 feet of the proposed septic tank
location. The proposed septic tank will not change the general slope of thc area. Ponding and/or
concentration of surface runoff will not result from this installation.
If you have any questions or are in need of addilional information please contact me at 279-3916.
Sincerely,
203 West 15~h Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (907) 276-6013, SpurklandEng~gci.net
/
/
LOT ~7 ~
\
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\
./
rANK ~ I. gT STA~4 PER
LOT 2~
B~OCYCLE
TO ~NG
LOT 24
VACENT
LAm~.~. J
SCALE, 1' = 50 FL
SPURKLAND ENGINEERING
203 W 15Ttt. AVENUE
ANCH. AK. 99501
?AR.~ISE VALLEY BLOCK 9 LOT 25
DAVE ENGLAND
6015 BULGARIA ORIV£
SEPTIC SYSTEM DESIGN
DATE: SEPT. 15, 2009
SHEET: 1/2 GRID: 3538
PERMIT Il PID Il 020-488-14 PoradiseValleyBgL25Dl. dw9
/NS/ALL FDUND. DAT/D/V O.L"AH DUT m~
INS I'AL L A TI£N
,t, £XC,4VAT£ A lO' x Iff' x Iff' ~EEP I~I.E FOR ~IOEY~£ SYSTEt~
£ PLACE A MINIMLI~ 17f' 4' SAND OR I~AVLrL ~ LEVELING COUR2E Ill THE E~7TI27H 17F THE EXEAVATZLT~
'~ PLACE 4 $1~'~T$ OF ~' x 8' x ~' B1R~CT ~.~IAL RIGID INSULATION BN TOP OF COMPACTED L£VELI~VG ~S~
TO PROTE£T ~OTTON IT FI;~GLAS$ TALC. TA~E £XTRA ~ TO ASSUA~ THAT ]NSULATJZ~V ~SE IS LEVEL
1N ALL BI~ECTII~
4. ~ACKFILL A~D TA~ UP TI? B~£T Df' 4' IMrLUENT A~D 1-1/4' ~7'FLUE~T LINES VITH ~RL'~-~LBIVTNG I~
MdTERIAL FREE ~- LARGE $TgN[$ L~ ~DUtI~SR£
SPURKLAND ENGINEERING
203 IV 15TM. AVENUE
ANCH. AK. 99501
(~0~) ~-~
PERMIT # SVOgOXX
PARABISE VALLEY BLK 9 LT 25
DAVE ENGLAND
6015 BULGARIA DRIVE
II SEPTIC SYSTEW DESIGN
DATE: SEPT. IS, 2009
SHEET: 1/2 GRID: 3,538
PID # 0£0-4£B-14
Paradise Vatley~M.c~D3~
Environmental Consulting and Design
Single Family On-site Wastewater Disposal System
Construction and Material Specifications
Subject Property: PARADISE VALLEY BLOCK 9 LOT 25
Date:
September 15, 2009
General:
e
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6.
7.
The owner shall contract with a contractor to perform the work outlined in these
specifications and plans in accordance with the attached MOA permit. There Is not
contractual arrangement between the contractor and the Engfneer. The Engineer shall be
the owner's representative and will inspect the work to document the contractors
activities. Final acceptance of the contractors work rests with the owner and the hlOA.
The scope of the project includes the procurement and installation of a new BioO/de ATS
tank at the location depicted on the attached site plan drawings. The BioCycle ATS tank
shall be connected to the existing drain field. Two-inch thick, 40 psi, direct bury board
foam shall be installed directly over all piping beneath the driveway.
Construction shall be in accordance with the approved site plan and design drawings and
any special provisions noted on the Municipal well and/or septic permit. All materials,
components, workmanship and construction practices shall comply with the f, lunicipa[ity of
Anchorage's latest ordinances regarding wells and septic systems, as well as MOA,
Development Services Department, On-site Water and Wastewater Program (DSD)
policies.
The contractor Is responsible for obtaining all underground utility locates, layout of the
proposed system, and verifying and maintaining all required separation distances to lot
lines, surface water, wells, steep slopes, etc.
The property owner shall be responsible for final grading any depressions formed from
settlement of backfill material. The property owner Is also responsible for vegetation of all
areas disturbed by septic system installation activities.
Contractors installing wastewater disposal systems must be certified to do so by the MOA
DSD, On-site Water Wastewater Program. Property owners installing their own systems
must receive advanced approval from I~IOA DSD prior to system installation activities.
The contractor shall ensure that ALL materials being used are in compliance with the most
current guidelines established by the Municipality of Anchorage. Refer to 'Standards and
Specifications for Component Parts and Materials Used in the Construction of On-site
Wastewater Disposal Systems~, Dated December 2000, as provided by MOA DSD, On-site
Water and Wastewater Program.
SepUc Tank Installation:
The tank shall be level and sufficiently bedded to prevent settling of shifting of the tank.
The sewer service line from the house to the tank shall have a minimum slope of 2%
unless prior approval is obtained from the engineer.
203 ',Vest 15 Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci. net
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7.
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10.
11.
12.
~nspections:
1.
2.
3.
4.
Environmental Consulting and Design
I
The Inlet and outlet lines from the tank shall be bedded in drain rock or the soil shall be
sufficiently compacted to prevent future settlement of the soil.
Septic tank inlets, outlets and cleanouts shall be fitted with water tight couplings.
A cleanout shall be installed 1 to ,i feet from the foundation.
Post tank cleanouts shall be installed per MOA requirements. Does not apply to
pressurized lines.
In areas with high ground water, the septic tank shall be sufficiently anchored to resist
buoyancy forces when there is not adequate soil cover to resist uplift force. The
contractor shall refer to the engineer for direction regarding this matter.
The tank backfill shall be graded sufficiently to ensure positive drainage away from the
tank.
All holding tank and lift stations shall have an audible and visible alarm inside the
residence being served.
All lift stations shall be wired in compliance with all MOA guidelines and the Uniform
Electrical Cede. A municipal electrical permit and inspections must be obtained where
required by the HOA.
The contractor shall verify that the septic tank/lift station is a minimum of 100 feet from
any residential water well, 150' from any class 'C' well and 200 feet from any community
water wells. Additional separation distances must also be maintained.
The contractor shall remove or abandon the existing tank in compliance with the Uniform
Plumbing Code.
A minimum of one inspection is required by the Municipality of Anchorage. This inspection
must be conducted under the supervision of a Professional Engineer licensed to practice in
the State of Alaska.
The inspection must be conducted after the placement of the Biocycle ATS tank,
distribution lines, stand pipes, cleanouts, and insulation, but before the placement of any
baddill.
The contractor shall provide a legible copy of all field notes relating to system layout and
construction to the engineer for the use in preparing the record drawings.
The contractor shall coordinate all inspections with the Engineer. A minimum of 24 hours
notice is required prior to the start of construction. If necessary, a preconstruction
meeting will be held on-site.
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci.net
Municipality of Anchorage Page I of ~
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: ~-~/ (-I I~i)'~:>L~-~ PID Number: O~2'C) -- ~ ~ ~
:~ Wastewater System: D New ~U
Name: ~C~~ ~_~ pgrade
Address=~,. ~. '~O~ t t It ~ ABSORPTION FIELD
Phone: lNo. of~ooms: D Deep Trench D Shallow Trench DBed ~Mound DOther
LEGAL DESCRIPTION sci, Rating: ~ Total Depth from original grade:
~~ GPD/Sq. Ft. ~
Lot: Block: .~ Subdivision: ~ Depth to pipe bottom from original grade: Gravel depth beneath pipe
Township: J Range: Section: ~ Fill added above original grade: Gravel length:
WELL: D New ~ Upgrade Gravel ~: ~ ~/ Number of lines: Dislance belween lines:
Classification (Private, A,B,C): T~tal Depth: Cased To: Total absorption area: Pipe material:
Driller: Date Drilled: Static Water Level: Installer: ~ Date installed: ,
Yield:~P~ Pump Set at: Ft. Casing Height Above Ground:Ft. J TANK
SEPARATION DISTANCES g Septic g Holding g S.T.E.P.
To Septic Absorption Lift Holding 3ublic/Private Manufacturer: ~apacity in gaJJoRs:
From Tank Field Station Tank Sewer Lines
Material: Number of Compartments:
well IO'~ J ~0 Ii 0
Surface
w~t~ ~ ~ ~ LIFT STATION
Lot Size in gallons: Manufacturer: ~
Foundation ~ L~0 J ~ [ "Pump on"~level at: "Pump off",~ ~level at: High water~alarm ~t:
Cudain ~
~J~ ~Z ~ F~ Location and Description: ~ ~_~ ~CO~'
~ ~4~ Assumed Elevation: ~C~ ~,
ENGINEER'S SEAL
,ns,eotions performed by: ~ Dates: ,st "~ia ~: ~~t~z~
Department of Heal~Huma~vices approval ~'' =. '
~~ / /
Reviewedandapprovedb~~~Datef~/f~/ :~..~ ~
/~ ~
72-013 (1/91) MOA 25
/
/
/ \
/
\
\ \
~FI STA TIDN
~ + 500 GAL --
\. + llf?£NCll/
/
~ 100
£CALD 1~ = 50 FE
lOOO GAL SEPHC
__ TBM Top
GARAGE SLAB
ELEV. I00.00/
M£MIID£ /
/
99,1/
/
/
/
,
1.50
TI1BBEN SPURKLAND P,E,
203 W 15TH. AVENUE
ANCH, AK. 99501
(gOT) 279-.q916
LDTS p4 & p6 ~9LL1CK 9
PAfeADIS£ t/ALLEY
SEPTIC SYSTEM AS BUILT
DATE. BECEMBER lP,, 1991
SHEET, 213 fiRID, 3538
Septic Tank Outlet ~ 95+-
LiFt Station inb'et ~ 923
508 GAL
STEP TANK
SOLIg HEADER
~-- Monitor Tube
1/8' HI1LES ~ 6 £-£ ~
PLAN VIEW
T
12' OF Septic rock
12' ± SANg LAYER
2 Ff OVER OLg fRENCH
/,fin. 3 Ft oF Cover
~'11
ELEV, 10,2..5-103.5
ELEV, 9B.O
ELEV, 96,7
~ 18/10/91 EtEV. 93.7
Bottom Df ged 101.50
EXIS~ GROUND
~TEI'B:BEN SPURKLAN~
6751 ~d, gI_~BN13 ]~LVD, II
J ANCH. AK, t9502-3904 II
NO TE~
PLACE A NINIMUN OF T~/O FEET OF SAND
IN THE EXISTING T£EN£H
LOTS 25/25 BLOCK 9 PARABISE=~ SEPTIC SYS'TEM /NS BUILT
~)ATE, DEC. 18 1991
EUGENE 6ERUW
6015 ~ULfiARIA SHEET~ 3/3 GRI~, 3538
INSPECTION REPORT
MUNICIPALITY OF ANCHORAGE, BUILDING SAFETY DIVISION
3500 EAST TUDOR ROAD
INSPECTIONS (907) 563-3464 INFORMATION (907) 786-8211
REC
DEC
D M~la!aipal
ept, Health
NAME '.-~ ?,.- I ' . / PERMIT NO r , 0
' ( -'~ ' / PHONE
OTC// - ' BEOCK / SUBDIV, //"'(~ ,< /i '
FOUNDAflON -"~ ELEC. SERVIC~ ~ ~ PLBG.
BOND BEAM, ~ ~ ELEC. ROUGHJ~?,ti/-~.~' GAS TEMp·ROUGH
FRAMING ~ ,_ELEC. FINAL ..... ~" GAS
INSULATION ~ ~ OTHER ~ MECHANICAL
SHEETROCK '~., ~:, MECH. FINAL
STRUCT. FINAL ~ ~ FIR~FINAL ~ ?EBG, FINAL ~
OTHER ~ ZONING ~ OTHER
~'~O NONCOMPLIANCE OBSERVED ~ CORRECTIONS ESSENTIAL AS
EXPLAINED BELOW
[] WILL REEXAMINE AT NEXT INSPECTION [] DO NOT CONCEAL UNTIL REINSPECTED
COMMENTS
INSPECTOR 'D~TE
WHEN CORRECTIONS ARE MADE, PLEASE CALL FOR INSPECTION__
84~002 (Rev. 11/87)
DO NOT REMOVE THIS NOTICE
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW910359
DESIGN ENGINEER:TOBBEN SPURKLAND, P.E.
OWNER NAME:GEROW EUGENE JR &
OWNER ADDRESS:P.O. BOX 111185
ANCHORAGE, ALASKA 99511
DATE ISSUED:il/06/91
EXPIRATION DATE:il/06/92
PARCEL ID:02042203
LEGAL DESCRIPTION: ~PARADISE VALLEY BLK 9 LT 25
LOT SIZE: 29985 (SQ. FT.)
NUMBER OF BEDROOMS: 2 THIS PERMIT: 2
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED BY: ~/
F~F":iE....-.~[:~-~' F' ,,. E~ ,,.
15th, Avenue~ SuRe 20~
ANCHDRAGE~ ALASKA 99501
(907) 279-3716
LOTS
25
SEPTIC SYSTEM DESISN
26 BLOCK ? PARAg!BE
EUBENE BEROW
?ALLEY
Ground War. er at 6
Use. Pressurized Bed
Sc)i]. Rating. From i:est October 3~ 199:[
18 rain/in = .4 {:]al/min
Required Ar..?a per Bedreom:
Number e~ Bedrooms 2
Bed Area 750 sq,,<t.,
PRESSURIZED BED
TOTAL LENGTH
TOTAL WIDTH
TOTAL AREA
TOTAL DEPTH
ROCK DEPTH
52 FT.
24 FT.
768 SO.FT.
5 FT.
I FT.
5 FT.
SEPTIC TANK 1000 BAL. EXISTINS
LIFT STATION 500 GAL
ABANDON EXISTING SYSTEM:
PLACE A MIN. OF 2 FT OF SAND OVER
EXISTING TRENCH
The installation o,~ this sept:i.c sy?,tem will not pr-event wells
-From boa installed on the adjace~!t lots.,
There are no developed or natur~l ~ur~:ace / sub sur+ace drainage
courses on this (::)r '!':he ad.:iacent lots.
The preposed septic system will not change the general s].epe
· khe area, F)ond:i. ng ar)d/or concentration o~ SUmr~,ace runo~¥ will not
r'esult Yrom this :i. nstal].ation,.
\\\
~3
TRACT
ALL ADJ[IINING
LDTS A£E VACANT
GREEN BELT RESERVE
,"'"..,,.~..,.~
$0 O .50 I0~ 150 £~ £$0 300
SCALE: 1~ = 100 FT,
N:TE,
TFIBBEN SPURKLAND P.E.
;:>03 W 15TH. AVENUE
ANCH. AK. 99501
LOTS eE~ e8 BLOCK
PARADISE VALLEY
SEPTIC SYSTEM I)ESIGN
DATE, NDVEMBER 1, 1991
SHEET, 1/3 GRJ]), 3538
/
/
50O ~AL LIFr/~TA~IQN --
END EXIST. TRENCH
1000 6AL SEPTIC
-- TaN TDP
GAraGE SLAB /
ELEV. 100.00/
-- PI~£P£..VED £4 X 3£
25 ~
ENB EXIS[. TRENCH
TOP Oy FEET OF DRIVEl,lAY
lO0 125 150
SCALE: 1' = SO FT.
TFIBBEN SPURKLAN]? P,E. II
203 W 15TH. AVENUE
II
(~NCH, AK, 99501
(907) 279-~916
LL]T£ ~ ~ ~ BLD£K 9
PARADISE VALLEY
J J SEPTIC SYSTEM DESIGN
DATE, NDVEM.~ER L 1991
SHEET, 2/'3 GRID, SSS8
50D GAL
STEP I'ANK
] I/R' PVC --
$OLIBNEABER
3 Ft o? Cover
Fill
ELEV,
£X15~ GRDUNB
1£' o£ Septic rock
12' ~- .~AND LAYER
REPLACE ALL ORGANIC MATERIAL
~ott~D£ ~ed
1~1.$~
ELEV' 97.7
ELEV. 96.7
IO/ID/9I ELEV. 93.7
ND
PLACE A MINIMUM DF TIrO FEET DF SAND
IN THE EXISTING TRENCH
TD]]?EN SPURKLAN]? P,E,
6751 W, DIHDN]~
ANCH, AK, 9950B-3904
(907) 248-5095
LilTS 25/2~ ~LI1CK 9 PA£A$ISE
EUGENE DE£DV
6015 BULGARIA
SEPTIC SYSTEM DESIGN
DATD NOV, 4 199~
SHEET, 3/3 GRI]D~ 3538
Municipalily of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCRIPTION: ~'~
1
7
8
9
DATE PERF'ORMED:~: J'O' O I
-'~.l.t,~,¢~b/¢~.k/Township, Range, Section: '~'J~rLN, ~_*~ LL./. ~2~>( II
SLOPE SITE PLAN
10.
11
12
13-
14-
15
16
17
18
19
2O
WAS GROUND WATER
ENCOUNTERED?
S
IFYES, ATWHAT ~2 I/Z~ 0L
DEPTH? p
E
I]epth lo Water Alter ~"
Monitoring? Date: /
Reading Date Gross Net Depth to Net
Time Time Water Drop
io, ~, ~.,~1I~ ~ ~ c~ -- 1'7 ~'~
I&;o '6 '~ o ~'~'~//i 7
PERCOLATION RATE /,~-~ (minutes/inch) PERC HOLE DIAMETER
COMMENTS
PERFORMED BY; ~ 4c: L,f..>z'~Z~ I ir ¢ c~C~.~- ' CERTIFY THAT THIS TEST WAS PERFORMED IN
AOCORDANCEWITHALLSTATEANDMUNICIPALGUIDEUNESINEFFE~TONTHISDATE.' DATE: ~ Y, /~'//
72-008 (Rev. 4185)
203 ~!STH, AVE, SUITE 206
ANCHORAGE, ALASKA 99501
SPECIFICATIONS FOR SEPTIC SYSTEM INSTALLATION
LOT 25/26 BLOCK 9 SEC 11 TllN RSW
1.0 GENERAL_
1,, il. Owner is Eugene Gerow,: ~,01,,. Bti]igaria Drive~
Alask,=.~ 99511.6. Postal Address: P.O~ Box 11~185
99511.
Anchorage
Anchora.c]e
1.,2 Engineer is tine person or entity Inired by the Owner
inspect this project. The Engineer must be recognized by the
Municipal :i. ty O~ Anchorage, Department o¥ Heal. th and Human
Servi c ~..-.., s ,,
1,,3 Contractor :Ls 'I:'.he person or ent:i, ty hired by the Owner
· bo :i. nsta].l 'l::his project. The Contractor must be recognized
by the Municipality o~ Armhorage~ Department o~ J-)~alth and
Human Serv:Lces~
~. ~ zI. ITII*]~ Dra;~3. ngs,~ sleets t 'J:]hrc:)L~gh .3~ shal'! be part o¥ 'L'.h3. s
spec :L f .5. cat i on ~
t~5 Ali. materials and worl.::manship shall meet the
ments of the Mun:ic':ipal:i. ty c,,.~ Anchorage,., Department c)~ Health
and Human Services~ the c:c.,nd:i, tions o~ the permit, and all
applicable rules and re~;!uI~aticJns cLirrent!y in effect,,
1,,ff. All excavat:Lon depths are adv sory, and are to be
V~:~r]il f J. ed ~:~nd may be modi iF :~ ed 3. J'] tl"J(~? f ie]. d by the Engineer.
1.7 ]:t :Ls the responsiJ]i].ity of the Owner or the Contractor
to.~ adhere 'kc) the approved design~ to verify that the speci-
f:Led separat:Lon distances are me'L:~ and that the reqL~ired
1.8 The Contractor or the Owner shall report, to the. Engi-
neer any obserw:~,d condit:i, on which would put the sept:it
.......,~"-.~.~t....m i'n violation of State or Nun:i.c:ipa]. regular, it)ns,,
2.0 SEPTIC TANK
2.:!. If there :Ls an ~'~).'.5.~,?~.iJ")g s~.~F.'-tic tanl.::~ 3. t. may be used :L-F
.5, t fl'te:e(a*t:s]~ thai capa(:ity r"(ei, qLt~ r~F:~mel']t roi" ~he residence,, The
tank ~ ....~ be - water
.... h,::t.,. I :). nspected by th¢~ Engineer ~ and i ts
.,:..°. ~:~":' A net~, septic tank sl]al:. ~ bn. ............. one qCabr'.5. (::ated 1:)5' o,.i t h,-..=r.
,C:~pec i {: .5. c at i on s .l:: or sept i
Lo'(:: .~'"5/'"(-:-. E',I oc:k 9 Paradi se V~=~]. Iey
Anchorage Tank and Welding of by Greet Tank
The septic tank shalt I:)e a UPC-approved two-compartment
tank~ constructed o.F 12 gauge,~ er bett. er~ steel ~,~i'hh
mast:fo cc)ating,, The tank shall be set level on undisturbed
sc)il.The tank shall be cevered ~,~:i. th the equivalent o~ ~our
-~ e e'!:. o'f
2.3 The septic 'hank shall be installed a minimum o-F ~:i, ve
-feet fr,,~m the ht~use ~(oundation and a mini;hum o.F ~:i. ve Yeet
-From t. he absorpt:i.(:'.)n area.
2.4 The septic i:ank shall be a m:i. nimum e~: 100 ;feet ~:rom any
well serving a s~ng].e residence; t00 ~eet. ~:rc~m any bc~dy
t,,,ai::er~ creel<s or dra:i, nage dit. ches ~.~d. th ~].o~ing ~,~a'Eer; 150
· Feet ~rom Class "C" wells, and 200 .Feet ~rem Class A or
Class B v~e!ls.
2~5 Ali. pipe connectic:,ns to the 'hank shall be mechanical
wa'hertight calder couplings. Clean(~uts shall be install, ed
as de*s'.i, gnated and capped with air-tight rain caps. Clean ....
(DI.U~:.~:~ ~[~h~:~].l extel'lQ a rain:[mum (:)~ ].2 inches ab(~ve ~J. na]. gr(]und
eleva'L::[on, Provisions shall be made ~c~r" landscaping and
:i. mpc)r'tation i.F topsoi ]..
2.6 L.:i..Ft stat:i, on shall be as manu.,Factur"ed by Anchorage Tank
and Welding~ or as prc~vided by Acreage Systems
3.0 ABSORPTION FIELD
3,,1 Gravel used :i.n 'hhe absorption .Field sha].l be 0.5 'he) ?,.5
inch screened rocl.::~ with less than 3% passing the h. le~ 200
3,,2 Sand~ used ¥or leveling or" ,Fc~r ~il'hering~ shall have an
e.Fee(::tive gra:i.n s'.i. ze bet~4eert N.~,, 4() sieve and Nc),, 18 sieve~
Llni.Formity coe~.Fic:i, ent slna!l be ].ess than 4. Not mer"e than
5% by weight shall, pass the No,, 2(}0 sieve,,
3,,3 .4-:i. nch per,Zorated pipe shall be ASTM F8:t. 0,, For pres-.-
sure distribt,tt.i, on, pipe shall be Schedule 40 PVC or ABS.
Solid 4--,:i. nch pipe shall be Cast Iron c:~r ASTM D3034,,
3.5 Monitor standp:i_pes shall be installed as shown. 'That
sec:tion c'.).~ the p:i. pe pene~:rat:i, ng the gravel shall be per-fo-
rated~ eli:her by dr:i. 1].~ng 0.5" holes tin 6-inch centers or by
jo:i, nin~ a sec'!:.ion (::)'F F"810 per~Forated pi].e to a so!id sect~.op,
c:~.f pipe~
3,.6 Geotextile shall be Mira~i :!.40.
3.7 Insulation shall be extruded direct burial polystyrene,,
Do,.~ Chemical S'hyro.Foam HI 4-'.}~
Gpeci~i(:::ations ¥or ?.;epti. c: system installation
25/26 Bloc/.:: 9 Paradise Valley
- ",a 20% '=' ~ ' -
'~,', ":",","/ sand and more th ............. l~.t. All
measLu~ed []y VO].LUn~.,
3,,9 Grass seed shall, be F..c.:.l~,.t,.,,.~ b].tu:~orass~
organic matt [~r ,,
qL,¢.tnt i t J. ~?--: are
4.0
I NSTALLAT tON
4. 1 Locate al l underground ut:i. 1 :i. ties,~ property ]. i nes
Ct.t'Et;r'62 dF'iV6)~'Jatys,¢ ex~stiRg or- proposed ~ater (.~el].s,~ water
wa~,~s¥ f~;Lll,"~6tC:(-:;.) atrid .~5t:.tb stzr{'z¢lc:e dr"ainage -fac:i. 1:i.t:i. es~ lal.::es,~
i:)(:)nds,¢ ,~nd all (:rLher {acil'iti(~:,s req..~r:i, ng separatic)rl dis-
t.~iu"l[:eE(~ -fI'"(:]fR 'l:he proposed septic syst. em. Not,:i.-fy O~ner or
Engineer (::)'¢ any observed possibl(-~, con~].i ct.
4,, 2 Stake al ignment, o.f system v,d. th fflarkeF's ~h(]wJ.n(::] thE~
prot¢~(:'~'.:i, ve d:i.~t, atlqCe~; .~rc]m ~,,~e].].~: and ~,,.~tt.e~- bc)c:J:i, es.
zl..3 Establish an el. eva'Lion benchmark,, This BM sba!! be
easily ident:i,¢ial]le,, si:?;d:ile and permanent. An arbitrary
4,,4 Instal], t, het. anl< as sl'~(:)~r~ c)n the (:]r'a~]:i,m,;.]s. Record the
:i. nlet and out].et (.::~],eva~.J.C)lqS oe tl'l~ tank. Tank s!'~a, ll be
F)].ac:ed c)n undisturbed nat:i, ve so:i.]..
4.5 Excavate t:he ab~:~orption ~ield. Batttom o'f excavation
shal], be level and scar:i,-[ied. I~ sidev~alls smears~ they
sba1! also be scar-i.{ied,, Recor"d elevatic)n 0.¢
rn:i. ddle and end o-f trench. Record eleva(ion (::)~ each
and c::e:,nte~ point o'~ bed,, Cor'}str"uctior'~ equipment shall,
operate on the ~:!.ocir c,.F the excavation. Cr'v mater:i.a:, com-
~(-"P¢',d by the operai:iorl o-f the ror'~structJor~ eouipment sl'~a],].
1::) a ....... ~".: .....
removed and replaced ~:i. th uncompacted I~a'Leria].s.
4.6 F'lace the rock to the depth spec:i-{ied. Do not contami-
nat. e r"c)cl.:: ~i'Lh na'~J, ve ~'~a(:er:i.a].s or spoils ~t.-om the
-~:.:i. on. Level the rock st.ir~tcm ("t ..... 1") beeere insi:al].ir'lg tl'1~a
p e r ~ o r a't':, ed p i p e,
4~7 Install the dj. st.l'"J, bu. tJ. ot] pipe. Record the elevat:i, on
(~3i:~(::h.jQJ. f~t. f::or presst.ire system so!vent t..t~e].d t.h~
4,,8 Cover" 't:.l"te dist. ribL~tic)n pipe ~,~it.h rock~ and cover the
c~>[(::a~vat:i, or') with ~]:]ecyLext~].e be-Fore l:)ac::[::.[:i.).],J.n(~ ~.nd placing
middle and end (::)'~: i:rench,, Record the {inish ground e].(¢va .....
t:i. on at each c:or"ner ~tnd a't:: the m:i.c]p(:)i~qt o'{: 't:.h~ bed.
4,, 10 F'urnish a copy (;:)'~ atl survey notes 'E(:) the Engineer.
5.0
INSPECTIONS
5,, 1 A m:i.n:i, mum o~f three inspections are requJ, red~ 'The
~.rst inspection ~,,~ilt be o.~ the open excavation,, At t.h~s
t ~.m~:~ '[]l']e ~¢(]:i. ]. c]C:)l-ld:i, tion~s ~:i. 1 i be observed and compared to
the de~igr~ assumptions,, Grc)Lu']d
o-F bedrock ~,,d.].l be
The ~secclr~d :i. nspect J. c)n
s.~andp:i.i::les,~ distr:[but:ior~ pip~.n~!,~ tank(s) and other
The th:i. rcl inspect.:[ori w:i.].l be a.[t. er comp].e)t:ion o~: the ~orl.::~
Any cle-Ficiencies ~il]. be noted and the Contractor ['lcr~:.ified.
Such de~:i, ciencies shall be co, fretted ~,~J.'!:hJ.n -l':.(~n days,~
:[ I"~spe(::t i on c)r c er'I: :i..~ i c at i Ol"l by an licensed electrician,
Submit pi."'c,c:)'e (::)~ inspection or certi-ffLc:atic)n to the Engineer,,
5,,3 Submit (:::atalog data c]'~ al~ met:hah:ica], equipment~
5,,4 Not.:i.~y Enginemr at ].east 24 hours ~.n advance o~ be(lin-
,':?rave). ~
~...,VI~NICIPALITY OF ANCHORAGE %__L
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
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION
DISTANCE TO'
o ~ .
~ Z Manufacturer
~ Liq. capacity in gallons ~ ~ u~,~c~A~
~ 0 OD .............. :
~,.~ [ DISTANCE TO' Well~
O~ ~ I Manufacturer
~ I ~ ~"~
~ · ~ I No. of lines ~ I Length of each line
Top of tile tO finish grade
Length Width
~ ~ I Tgpe of crib [ Crib diameter
I DISTA~Cfi TO:
~ IClass I Dept~
~ I BuUding foundation
~ I DISTANCE TO:
Absorption area~.~ l Materi~T~ ~Dwelling
I nside~n~t~ W dth
Dwelling
OTHER
PIPE MATERIALS
SOl L TEST RA~ING
INSTALLER
REMARKS
FoundationO
Material
Nearest lot lilac) [
Trench wid}hl ·
-T~nehes
Total length of lines
Material bene~t~ tiqe
~-inches
Depth
PHONE ~r'N EW
~ Tq-Z.~ql mOPGRADE
NO. OF BEDROOMS3
PERMIT No. q ~0:5.5 0
No. of compartmer~_~
Liquid depth
PERMIT NO.
Liquid capacity in gallons
PERMIT NO. q~)350
Distance between li~s/ ~
Total effective.~on area
PERMIT NO.
Crib depth Total effective absorption area
Building foundation Nearest lot line
Driller Distance to lot line
Sewer line
Septic tank
~--~ ~, 100
PERM,T N~/$O :3 EO
Absorption area(s)
pro-?
/.
/
!
!
72-013 (Rev. 3/~I'8~ ' ~/
DATE LEGAL
,, fl .... NF O'OHN SUDDCK-. '"'* LRIIS';Ft¢: DRIVE 9¢¢~Ft'~ 27~-754:t
LOCRI"ION 8ULGRRIR DRIVE ~%' O~
· ':,5 LOT =,IZE 29~¢~F~ '~QI tRRE FEET
LEGRL L.m~ 8L~ PRRRDISE VRLLE9 SUBD '-- -
, .~F~= OF =,UIL RB..~U;.ETIDN _q~'STEM lei: TRENCH
MA~4IMUVI NUMBER OF BEDROOHS =
=,UtL
' II ' _ ,,z'- , F "-'"- ' IS:
THE REC4_IRED CgIZE OF' THE
~,,~.'~' LENGTH I:)IMEr4=,.,.ON' '"~ ~' I'-=, TIlE '-'~' .,IN F~:.,;T.) OF ,,-,~ TRENCH
THE DEPTH OF R TRENCH OR PIT !G THE DIGTRNCE BETHEEN TIIE GURFRCE OF THE
GROUND RND THE BOTTOM DP THE D'4CRVRTION (IN FEET).
THERE IS NO SET WIDTH FOR TR~ZNCt'IE%.
TIIE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRYEL. DETHEEN THE OUTFRLL PIPE
RND TIlE 8OTTOM OF THE D~CRVRTION (IN FEET).
PERMIT RPPLICRNT HRS 'TI-IE RESPONSIBILIT'..," TO INFORM THIS [:,EPRRTMENT DURING THE
INSTRLLRTtON INSPECTIO;~S OF FIN'./ WELLS RDJFICENT TO THIS PROPERT'¢ FIND THE
NUf,IBER OF RESIDENCES THFIT THE WELL WILL SERVE.
E:RCKFILL. IN6 OF RN¥ S%'~STE~fi H]THOUT F[NRL ~NGPECTION RND RPPROVRL B~,' THIS
DEPFII;:TMENT WILL. DE SUD.3'EO~ 'TO PROSECUTION.
MINIfIUr'I DISTRNCE DETWEEN R WELL f'JND RNN' ON"'SITE GEt4RGE DISPOSRL S'dSTEM
I~J8 FEET FOR R PRIVFITE WELL; OR
~..~,,_, TO ~O~4. _ FEET,~'r"""~,'~,.,,, F~ ,~'.~,~'r'" *~'"~. WELL ~EP~,',[,~NG UPON THE T?F'E OF o, ,~,, ~'r" ~",,
NELL LOGS RRE REQUIRED RND MUST E:E RETURNED TO THE DEPRRTMENT WITHIN
~,. ~"IE WELL L:CMPLET~N.
OTHER RELqUIREMIZNT'.S f'll-l"*" FIPF'L',". 5F'ECIF~CRTION5 FIND CONSTRUCTION DIRGRI3H5 FIRE
RVFIILRBL. E TO INSURE PROPER INSTRLLRTION.
I ..... :=,,.. IF.,. THFFF
~" ~ ~'" I ,c' ~. ~',r: ' ~- .:,Et4L~R:,FhND HELLS 13~ SET
-. ,,=:4LIR~M~.,I,~ FOR ON"'z, ITE ~ ~ ~ ' ~
"f,, ,tLIl .'., ,,I~
· 1' t FIM ~ ~"' '~"
I C I ~ 1 ,.,. I T ~ OF RNC ',,J ~ , aE,
FU,-. f, l , I ,~ fl,J, ~
2: I ,,.'"'.(~ I,-~:,TF,~.:.*'~ ' ' TIlE "'"-'~,~: , EM IN ,~C68,..D¢' 'm :N,_.~¢": NITtl THE CODES.
- ~' ~. ~,~F~t-'r¢¢ ENLR~Ef'IENT.~. THE
2:: ~ U,-,,.E,.._.TRN[ T,I,.,T THE
V3. 2
October 12, 1977 R&M No. 751248
Mr. John Suddsuk
22 Loussac Drive
Anchorage, Alaska 99503
Subject: Soil Investigation for S~nitary Sewer System, I~t 25, Block 9,
Paradise Valley Subdivision, Anchorage, Alaska
Dear Mr. Suddsuk:
At the request of Ms. Anita Bates on October 10, 1977, we conducted a
subsurface soils investigation near the middle of the south boundary of
the subject lot. The test hole was drilled as close as possible to the
lot boundary and is approximately 20 feet south of the approximate
middle of the south boundary of the lot. The investigation complied
with those procedures required by the Municipality of Anchorage, Depart-
ment of Health and Environmental Protection.
This investigation, which was accomplished on October il, 1977, consisted
of a test hole drilled to a depth of 20.0 feet below the existing ground
surface. The test hole was sited according to your instructions and its
location is shown in attached Drawing A-01. Drilling was accomplished
with a rotary drill rig using continuous-flight solid-stem auger with an
outside diameter of 6.0 inches. A sample was taken at the depth shown
on the soils log in Drawing A-01. The sample will be held in storage at
our lab for approximately six months. In addition, all material brought
to the surface by the augers was continuously monitored by an experienced
engineering geologist.
The topography at the drilling site is generally steeply-sloping to the
south. At the time of the investigation the lot had original vegetation
consisting of birch, alder, mountain ash, and spruce. The top of the
test hole was located on fill material approximately 0.5 feet below
original ground surface.
The soils encountered in the test hole are shown in the test hole log in
Drawing A-01. The symbols used in Drawing A-01 are explained in Drawings
B-01 and B-02. This log displays specific conditions encountered at the
test location. However, subsurface conditions may vary.in other parts
of the lot without any apparent surficiat evidence of the change.
Groundwater was encountered in the test hole at a depth of 12.0 feet.
Bedrock was not encountered. At the time the hole was drilled, seasonal
frost was not present and permafrost was not encountered.
An offset hole was drilled fo~ the purpose of performing a percolation
test. The hole was drilled to a depth of 10 feet and offset from Test
Hole No. 1 a distance of 5 feet. Soils encountered in the offset hole
were similar to those encountered in Test Hole No. 1. The percolation
test was performed~ within the offset hole at the depth shown in the
attached Table 1. 'All depths were measured from the top of the hole.
The data in Table 1 show average infiltration from the depths indicated
to the bottom of the hole. The measured percolation rate was 1.~0
minutes per inch.
We appreciate this opportunity to be of service to you. Please contact
us if you have any questions concerning this letter of if we can be of
additional servicel
Very truly yours,
R & M CONSULTANTS, INC.
Michael Mitchell, Jr.
Senior Geologist
i
Jim McCaslin Brown, Ph.D.
Head, Earth Science Department
MMjr/JMB/gld
Attact~nents: Drawings A-01, B-01, B-02; Table 1
LOCATION SIiETCIt
Lot 25, Block 9, Paradise Valley
Subdivision, Anchorage, Alaska
Distances shown are approximate
and have not been measured by
surveying methods.
%lot to Scale.
12.0'
TEST HOLE NO. 1
Scale: 1"=3'
10-11-77
FILL-SILT
SkNDY SILT TO' SILTY
SA!~D, BOTtl ~';ITIt SO~3
GRA~E~ L (SH-~)
Bro~mn,
.0.0'
0.5'
SILTY SA3ID
G PeAVE n (SM)
Brown, ~'~et
--12.0'
20.0'?.D.
Gro~mdwater %~as encountered at a
depth of 12 feet~
This log depicts'subsurface soils
observed within the tes~t hole at
the location '~howo.
See Drawings B-01 find B-02 for ..
~xplanation of syh. t)olsl '
LOCATIO.~I SKETCII k~lD TEST
ItOLE LOG
l.fR. JO}I~l SUDDSUK
h3 lCq IORAGE, AL~ KA
Na751248
TIME
TABLE NO. 1
PERCOLATION TEST
~ohn Suddsuk
Offset Hole No. 1
October 11, 1977
ELAPSED
TIME
INCHES
R&M No. 751248
DROP IN INCHES
10:50
10:51
10:52
10:53
10:54
10:55
10:56
10:57
10:58
10:59
11:00
11:05
11:10
11:15
11:20
11:30
11:40
11:50
0
1
2
3
4
5
6
7
8
9
10
15
20
25
30
4O
5O
60
16.5
28.0
34.0
40.0
44.5
48.0
51.25
54.0
57.0
60.0
61.5
68.0
70.0
72.5
73.0
75.0
76.0
76.25
0.0
11.5
6.0
6.0
4.5
3.5
3.25
2.75
3.0
3.0
1.5
6.5
2.0
2.5
0.5
2.0
1.0
0.25
59.75 Inches Total Drop
1.00 Minutes per Inch
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. O- ~,O - t-i ~. 2.
'1. GENERAL INFORMATION~
Complete legal description
LoCation (site address)
Current Property owner(s)
Mailing address
Lending agency
COSA'#~
Expiration Date:
Day phone
Day phone
Mailing address
Real Estate Agent . r2~ J--~-,~,~- Day phone
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup.
NUMBER OF BEDROOMS: z~
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
[ I
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 System's 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.
Name of. Firm,
Address, ~0~ ~', i5
E ngin eer s Printed Na me
5. DSD SIGNATURE
'~'"' Approved for
Disapproved..
bedrooms.
Phone
Conditional approval for
bedrooms, with the following stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well .Flow Advisory
Nitrate Advisory
X
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date:
(Rev, 11/05)
Municipality of Anchorage
DevelOpment Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Elmore Road
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 Pr;'
Date completed
Total depth ~ ;FG ft.
Date-of test
Static water level
Well production
lie,/ BIK q'Lof z5 Parcel ID: OZO-- YZZ.- 1~
/
IfA, B, or C provide PWSID #~
"S~fiit~ry seal (Y/N) Y
Cased to '7 ~ ft.~
FROM WELL LOG
~ ~o~ 9.p.m.
Well Log (Y/N) /%/'
Wires properly protected (Y/N)
Casing height (above ground)
AT INSPECTION
ft.
g.p.m.
Y
7_. ¥ in.
WATER SAMPLE RESULTS:
· Coliform /V'~o colonies/100 mL' Nitrate 0.~,15 mg/L
Arsenic: /v'r',) ug/L date of sample: ~//,~/I I
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material 8,~ C wl~. / ~'~ q/"-~
/ ~ /
Tank size.. II~00. gal. Number of Compartments
Foundation cleanout (Y/N) '~
Date of pumping N'~,td
C. ABsORpTION FIELD DATA
Depression over tank (Y/N) ~
Pumper -"'-
ft.' Width '7..W ff.
Collected by: L^r~
Water added [O0Ogal.
Date installed I=]Z·~,/
~_ooq,
Cleanouts (Y/N) /vJ~,~ k~, ~e
High water alarm (Y/N)
Date installed
Length 3~
Total depth ,.~ ft. Eft. absorption area '"~'Go° ~ Monitoring tube
Date of adequacy test ~iZll Zoo~ Results (Pass/Fail) J7¢~55
' I
Fluid depth in absorption field before test (~ in.
Elapsed Time: 15 min.. Final fluid depth j~
Any rejuvenation treatment (past i2 mo.) (Y/N & type)
. in. Absorption rate >=
/V~o~. (~vtO~o~ If yes, give date
System type ~'e<[
Gravel below pipe ~ ft.
Depression over field (V'
For ~ bedrooms
New depth ,5 in.
~,CO g.p.d.
D. LIFT STATION
Date installed
"Pump on" level at '7.5 in.
Datum
E, SEPARATION DISTANCES
Size in gallons
"PumP off" level at Wi/Kin.
Cycles tested
Manhole/Access (Y/N) "3/
High water alarm level at ?_7. I/~ in.
Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on lot IOO -I-
Public sewer main
Sewer/septic service line ~ ~.5 +.
Animal containment areas 50 ~
On adjacent lots !(30
On adjacent lots i(3o t'
Public sewer manhole/cleanout
Holding tank /V/~
Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation .~ '4- Property line 5 '~' Absorption field
JOe
Water main A//A
Wells on adjacent lots
Water service line tO t+ Surface water ! OO ~-
SEPARATION DISTANCE FROMABSORPTION FIELD ON LOT TO:
Property line ~/O ~4.- Building foundation
Water Service line lO Li. Surface water IoO
Curtain drain 50 ~+ ~A/,o,) Wells on adjacent lots
Water main /~'//~
Driveway, parking/vehicle storage
F, COMMENTS
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. / ~.~..~N~
..,: . . .
Engineer's Printed Name L AP,5 "~u¢- ~vlc~'
, ·, ,
COSA Fee $
Date of Payment
Receipt Number
Waiver Fee $
Date of Payment
.Receipt Number
(Rev. 4/10)
<~
' ~ ~s k
t ~
I ~
I
/
II t ~
~ I
- ~ S7 14' 50" E. 227.2~ ~
, ,. ~ ~,,, ~ ~ ~
ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND
REPAIR AGREEMENT
MEMORANDUM OF UNDERSTANDING
BETWEEN MUNICIPALITY OF ANCHORAGE
THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this
{'~r Dayof ['e~[uar7 of20ij ., by and between ~c,~0~ ~
herein the "OWNER," and the Municipality of Anchorage, herein the
"MUNICIPALITY." In consideration of the mutual covenants contained herein, the
parties to this Memorandum of Understanding agree as follows:
1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality
grants permission to Owner to utilize and operate an Advanced Wastewater
Treatment System (AWWTS), described as Bio CvcJt AT$ located
at P^e^cl{$~ [/~lh2t Bl~..fi L.T 7-5 ,Anchorage, Alaska.
2. Definitions.
A. Alteration. Any change to the design or function of an AWWTS that
Includes the installation or removal of any parts, components or pieces not
included in the original construction permit and design. Prior to
performing any alterations to an AWWTS the owner must obtain a
Wastewater Disposal System Construction Permit from the Municipality
pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65.
B. Certificate of On-Site Systems Approval. An approval by the
Municipality of existing water and wastewater disposal systems given at
the time of property sale and title transfer in accordance with AMC 15.65.
The term l~gi.. ~ abe ~ o'r apD"oval t-,y t~ Mu~i~iU' ot'~ i.~aJ kxt s,, <cra and
~.t~ o~6m~, whik thc &W'~: ['S s~"stcm is in usc o~ o-~l'io~l <>~ unfii, ~}~c p~-,,',-~.,, is
A. I ~o~u~ ~ ~ of ~5 ~kn~dum of Undt~ta~rlng. ~¢ ~..~'ncr
&W'~,-I'S a~ '~ilk~ ~ AMC ~4,~0
[his ~m~~ ~'L~8 ~i (~:y ~ a~ ~~ ~r ~
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
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
GENERAL INFORMATION
Complete legal description
Location (site address or directions)
'~/.~.~ ~.~-~o' ! ~ Day phone
Property
owner
Mailing address ~. O. ~>~ !~ ~/2;~"
Lending .................... agency Day Ph0nb
Mailing address.
Agent !~/
Address
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.
4. TYPE OF WASTEWATER DISPOSAL:
NOTE:
72-025 (Rev. 1/91) Front MOA #21
Individual on-site
Holding tank
Community on-site
Public sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
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 furtherverifythat based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
NameofFirm /o~-~'¢--¢n C0ck-c~~/'~ ~'~[-~- Phone ~¢~--~ ~
Address ~O ~ U~ ~-~
Engineer's signature ~- -~~
/
Date
DHHS SIGNATURE
//~ Approved for ~_
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments ,~~ ~
Date / ,~~
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 engineer's work.
72-025 (Rev, 1/91) Back MOA ~21
Legal Description:
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
~g£~(~/~ ~0~-----------------~4 ~/./t~ Parcel I.D. 0~9 '~
A. WELL DATA
Well type '~.
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
If A, B, or C, attach ADEC letter.
Date completed
Cased to ~ ~-O
FROM WELL LOG
Date of test
Static water level
Well flow
Pump level
ADEC water system number
I ~ ~'/~-~ Driller
Casing height
Wires properly protected (Y/N)
g.p.m.
AT INSPECTIONMuNiCiPALiTY OF ANCHORAGE
._~2.~-~- i~'~ i L~q~ONMENTAL SERVICES DIVISION
7.~ DEC 11 1991
t 'E EiVED
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot 140 ~-
Public sewer main
Sewer service line /~
; On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Petroleum tank
90 '±
WATER SAMPLE RESULTS:
Coliform /~¢0 Nitrate
Date of sample: v~ (~'~t J ~ ~ [
I~, ~ ¢ Other bacteria
Collected by: '1 "~' ~
B. SEPTIC/HOLDING TANK DATA
Date installed ~/~L'~/~'~c~ Tank size /(~-¢~-~ Compartments
Cleanouts (Y/N) ~.) b'L(~ Foundation cleanout (Y/N) / Depression (Y/N)
High water alarm (Y/N) J~/'/,~ Alarm tested (Y/N)
Date of pumping , ~//~ Z-/~/' Pumper A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot /LO '~
To propertyline ' c~)
Surface water/drainage
On adjacent lots ~ /(J~ Foundation ~r~
Absorption field ~ 0 '_L Water main/service line ..~. 5
72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE
C. LIFT STATION
Vent (Y/N) y "Pump on" level at
High water alarm level
Meets MOA electrical codes (Y/N)
Manufacturer
Manhole/Access (Y/N)
-¢2-~ "Pump off" level at
Cycles tested ~/~
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot I J 0 --- On adjacent lots
Surface water
D, ABSORPTION FIELD DATA
Date installed I~ 0 v/ ¢0'-0I
Length .~ 2- Width
Total absorption area
Depression over field (Y/N) I'~
Results (pass/fail)
Peroxide treatment (past 12 months) (Y/N)
Soil rating
Gravel thickness
~ d ~,/P ~.1.,I/5.'~ System type KO u~ vt. o(~
/,,,~ Total depth 2--~
Cleanouts present (Y/N) ~-/ ( ' ,:~. t,44 ¢¢t4.-t ' ~4.~,~
Date of adequacy test ["//~'~
~ bedrooms
for
If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Wellonlot I //0 '~-~ On adjacent lots ~ /¢-~) Propertyline
To building foundation C,~(~'~ ''"'~ To existing or abandoned system on
/
On adjacent lots ~ t'U~g~ Cutbank~ I ¢_~ Water main/service line
Surface water i"r",,~/~ Driveway, parking/vehicle storage area
Curtain drain h///~\
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
HAA Fee $ / ?P
Date of Payment
.eoe pt Number
72-026 (Rev. 3/91) Back MOA21
Waiver Fee: $
Date of Payment
Receipt Number
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
D,v,s,oN OF E.WRO.MENTA' SE.V,C S
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL ~' j ~')~) _
OF ON-SITE SEWER AND WATER FACILITY
264-4~44
Application Date
GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Description (include lot, block, subdivision, section, township, range)
(b)
Location (address or directions)
Property Owner
Mailing Address
(c) Lending Institution
,
Telephone: Home
Telephone
Business
Mailing Address
(d) Real Estate Company and Agent
Address ~,~,.~'¢[ iiC. ~l /
Telephone ~
(e) Mail the HAA to the followinq address: or: Check here~ if hold for pick up.
List contact person and day phone number below.
TYPE OF RESIDENCE
Single-Family [~
Number of Bedrooms
WATER SUPPLY
Individual Well~ Community [] Public
[]
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsite~ Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page I of 2 72-025 trey 8/861 Front
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
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 shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
i ectio
the date of this n~.cuoJ~. ~~
Name of Firm Telephone
Engineer's Seal
DHHS APPROVAL
Approved for -~
Approved ~
Disapproved Cpnditional
Date
Terms of Conditional Approval
CAUTION
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
engineer's work.
Page 2 of 2 72-025 IRev 8/86) Back
l~/,,,,,,,~,:, i ~,~'~.,~,~ ~}~ · MUNICIPALITY OF ANCHORAGE (MOA) "'¥~"':~'4 ~,~ ~ ", '~'/~':'~TH AUTHORITY APPROVAL (NAA)
~ - ' '~"'~' ~/~, '~' CHECKLIST - FEBRUARY 1984
91987 264-4720
Legal Description:
DATA
Well Classification
Well Log Present (Y/N)
Total Depth ~ 7~,
'~_~-,-.~ If A, B, C, D.E.C. Approved (Y/N)
N Date Completed ,/~ '~'~ Yield
Cased to -~ 7~, Depth of Grouting
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot I ~_.~
To Nearest Edge of Absorption Field on Lot I O~'
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
Comments
~,~ f,~ I~, To Nearest Public Sewer
1~4. O ~*'~ To Nearest Sewer Service Line on Lot
~', .¢,~ ;Date
B. SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes (Y/N) O ~tr ~
Depression over Tank (Y/N)
Size 1 ~'~ No. of Compartments ~
Air-tight Cap~ (Y/N) ~ Foundation Cleanout (Y/N) I N~I D~ '~,~
}'"~[ Date Last Pumped --.~/c~/'~7
Pumping/Maintenance Contract on File (Y/N) f'¢/',~ ; for
Holding Tank High-Water Alarm (Y/N) /'~//'~' ~ Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well
To Property Line
To Water Main/Service Line
Course
Comments
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Page 1 of 2
72-026(~1/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absorption Area
Depression over Field (Y/N) t~
Results of Last Adequacy Test
Separation Distance from Absorption Field:
Type of System Design
Length of Field /z~ ~
Date of Last Adequacy Test
To Water-Supply Well
To Building Foundation
Lot
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
Depth of Field
Gravel Bed Thickness
Standpipes Present (Y/N)
To Property Line ~, ~1~
To Existing or Abandoned System on
; On Adjoining Lots __['~,J c)r,~
To Cutbank (if present)
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify t~t I have checked, verifie,¢, or conformed to all MOA and HAA g uidelines in effect on the date of this inspection.
Signed -~~ Date ~e-/_--4 /0t/'~¢'"7
?
Company MOA No.
/oo /
Receipt No.
Date of Payment
Amount: $
Page 2 of 2
72-026 (11/84)
Engineer's Seal
'- ~ ~ - ~ ANCHORAGE ALASKA 99501
CONSULTING ENGINEER TELEPHONE: (9071 279-3916
RESIDENTIAL WELL
INSPECTION
LEGAL:
LOCATION:
LOT 25 & 26, BLOCK 9, PARADISE VALLEY
6015 BULGARIA
OWNER:
TYPE OF WELL:
WELL LOG AVAILABLE:
JOHN SUDDOCK
SINGLE FAMILY
NO
INSTALLATION REQUIREMENTS MET: YES
PUMP YIELD:
7 GALLONS PER MINUTE
DATE OF INSPECTION:
MARCH 9, 1987
TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE OF 7
GALLONS PER MINUTE WHILE THE DRAWDOWN WAS
MONITORED WITH AN ACOUSTIC PROBE. THE WELL
WAS PUMPED TILL THE DRAWDOWN STABILIZED. STATIC WATER LEVEL WAS
FOUND AT 71 FEET BELOW TOP OF CASING. WHEN PUMPED AT 7 GALLONS
PER MINUTE THE PUMP CYCLED WITH THE WATER LEVEL FLUCTUATING
BETWEEN 73 AND 76 FEET. RECOVERY WAS INSTANTANEOUSLY.
TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA
MARCH 3, 1987. TEST WAS NEGATIVE.
ON
The Municipal requirement for well flow is 150 gallons of water
per bedroom per 24 hours.This well surpasses this requirement.
The assessment of the condition of this well applies only to the
conditions as of this date. The flow rate of the well may change
due to subsurface conditions that may not be observed from the
surface, and changes in land use and other factors that may
impact the conditions of the aquifer feeding the well.
TEST RESULT: THIS WELL MEETS THE REQUIREMENTS OF THE
MUNICIPALITY OF ANCHORAGE.
' ~ ~ ~ ~ .~ ANCHORAGE, ALASKA 99501
CONSULTING ENGINEER TELEPHONE (907 279-3916
SEPTIC SYSTEM ADEQUACY TEST
LEGAL:
LOCATION:
OWNER:
RESIDENCE:
LOT 25 & 26, BLOCK 9, PARADISE VALLEY
6015 BULGARIA DRIVE
JOHN SUDDOCK
SINGLE FAMILY, THREE BEDROOMS. VACANT SINCE
DECEMBER 1~86.
WELL: PRIVATE, ON SITE
.
-SEPTIC SYSTEM: FROM MUNICIPAL' RECORDS: ~:~'° '
TANK: GREER STEEL, TWO COMP. 1~0~ GAL~:':- '?
ABSORPTION SYSTEM: TRENCH ~:
ABS0RP. TION AREA: SQ.
SOIL ATING: 155
INSTALLATI~ n~. ~,~,~ ~n~o
· ~,,, . JUl,[ 2,~. 19 I ....
DATE OF PUMPING: MARCH 1't 198'7 ROTO-ROOTER
DATE OF TEST: MARCH 18, 1987
TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND
WITH THREE FEET OF COVER AND 49 INCHES OF LIQUID.
CLEANOUT AND SUMP TO TRENCH WERE NOT VISIBLE AND HAD TO BE
LOCATED AND EXTENDED. SUMP WAS FOUND BLOCKED WITH DIRT AT THE
-TEE. A MONITORING TUBE WAS INSTALLED NEXT TO SUMP· TOTAL GRAVEL
DEPTH IS 42 INCHES. ON MARCH 9, 9 INCHES OF LIQUID WAS MEASURED
IN THE MONITORING TUBE. 700 GALLONS OF CLEAN WATER WAS ADDED TO
THE TRENCH. THIS CAUSED A WATER DEPTH OF 18 INCHES TO BE MEASUREO
IN THE MONITORING TUBE. ON MARCH 16 THE LIQUID LEVEL IN THE SUMP
WAS 11 INCHES. 1000 GALLONS OF WATER WAS ADDED TO THE TRENCH.
THIS CAUSED THE WATER LEVEL TO RISE 15 INCHES WITHOUT FLOW BACK
INTO THE TANK. WITHIN THREE HOURS THE WATER LEVEL DROPPED TO 21
INCHES. THE NEXT MORNING THE WATER LEVEL WAS STILL 21 INCHES.
ANOTHER 1050 GALLONS WERE ADDED TO THE TRENCH, THIS CAUSED THE
LEVEL TO RISE TO 37 INCHES. ( 65 GALLONS PER INCH ) AFTER 4 HOURS
THE LEVEL DROPPED 3 INCHES. AFTER 18 HOURS THE LEVEL HAD DROPPED
7 INCHES. DURING THE FIRST 4 HOURS APPROXIMATELY 195 GALLONS HAD
BEEN ABSORBED, DURING THE 18 HOURS 455 GALLONS.
TEST RESULT:
THIS SYSTEM MEETS THE CODE REQUIREMENTs OF
THE MUNICIPALITY OF ANCHORAGE.
The operational life of all septic systems depends on the local
soil conditions, groundwater levels that may fluctuate during the
year, and the water usage of the family being served by the
system. These conditions are outside the control of the evaluator
of this septic system. We can therefore not give any estimate of'
how long the system will continue to meet the operational requi-
rements of the Municipality and State.
'i M DEPT OF HEALTH &
UNICIPALITY OF ANCHORAGE ' '~%-"-,;ECTION
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTE~¥~'~)NMENTAL
JAN 2 2, 1979
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720 RECEIVED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
I
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) davs for processing.
1. PROPERTY OWNER ! I PHONE
work
Suddock, John g.J .~4~Z~.~.~
home
MAI LING ADDRESS
2222 Loussac Drive, Anchorage, Alaska
PROPERTY RESIDENT (If different from above) PHONE
Suddock, John E. : 344-9853
2. BUYER PHONE
Suddock, John E. 344-9853
MAILING ADDRESS
2222 Loussac Drive, Anchorage, Alaska
3, LENDING INSTITUTION I PHONE
Peoples Bank & Trust Co.I 279-7511
MAILING ADDRESS
Pouch 7-007, Anchorage, Alaska 99510
4. REALTOR/AGENT I PHONE
I
N/A
MAILING ADDRESS
5. LEGALDESCRIPTION
Lots 25 & 26, Block 9, Paradise Valley Subdivision
STREETLOCATION [
___~N Bulgaria Drive, Anchorage~ Alaska
6. TYPE OF RESIDENCE
[P~ SINGLE FAMILY
[] MULTIPLE FAMILY
7, WATER SUPPLY [] INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTILITY
8. SEWAGE DISPOSAL SYSTEM
[] INDIVIDUAL/ON-SITE*;
[] PUBLIC UTILITY
NUMBER OF BEDROOMS
[] One [] Four
[] Two [] Five
[] Three [] Six
[] Other
* ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled/p~rior to that date, give well
depth (attach log if available.) fll5 I l'),~
**If individual/on-site, give installation date
If system is over two (2) years old an adequacy test is required
by this Department.
NOTE: THE INSPECTION FEE MUSTIACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIA:TED,