HomeMy WebLinkAboutNORTH WOODS UNIT 3 BLK 11 LT 1Northwoods #3 Block 11 Lot 1 #051-732-05 Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SV/980/ y0 PID Number: 0.5_1 - 73d -oS Name: 7�IC 7" d�+ASCo. El Wastewater System: 9New Upgrade Address: P.O. goX '770//0 CA&I 2rvER 99577 ABSORPTION FIELD Phone: No. of Bedrooms: [� ❑Deep Trench ❑Shallow Trench K Bed gMOUnd ❑Other LEGAL DESCRIPTION Soil Rating: 1�1 0 Total De th from original grade: cf • GPD/S . Ft. Lot: Block: Subdivision:Depth 15R7,� r 3 to pipe bottom from original grade: "r 0. S Ft. Gravel depth beneath pipe 0. '/ Ft. Township: ..— Range: — Section: — Fill added above original grade: H• 8 Gravel length: 0 Ft. C:2 Ft. WELL: El New ❑Upgrade Gravel width: y�g NumberLgflines: Distance between lines: J £S Ft. (J Ft. Classification (Private, A,B,C): Total Dep Cased To: Total absorption res: Pnip a material: L/ COMAA cc.c/ Ft. Ft. i� 3 O SQ. Ft. r V C SCII 7 0 Driller: Date Drilled: Static Water Level: Installer: Date installed: 9 Ft. Yield: Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES .2 Septic ❑ Holding D4 S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer:��]] Capacity in gallons: From Tank Field Station Tank Sewer Lines �M /C/C Q Welh K /tf /1 H ,ij /j Material: o Number of Compartments: Surface Water /610/ r /00 f d0 � LIFT STATION Lot Line / 3 9 / C� 0 / S Size in allons: �/ A Manufacturer: ©RC-.Al C0 Foundation / /0 J 'Pump on" level at: /V "Pump off" level at: High water alarm at: I 3a 1/ 1 y,//� 7 Curtain Drain / dowc 49w,41I Pump Make & Model DOS/ OS/!fI Electrical Inspections performed by: 96.4 6V Y �1 j Sts' CLtrC. c es/7. Remarks: 8011-om tESS BENCH MARK SYST"- /�/ �.. /7r Location and Description: M = Tor L, FT 37A7/cul, 3 ,r Ali? Ljltic SULArc� A14 PLAC15%ias C V If-30311 ,i4iE Assumed Elevation: /o E v R P R oTEcTi o.y � ........ k: f �` tXSENGINEERING A i t 77034 Eagle River Loo Road N -9-98�Inspections performed by: 9%: 1st 9 .F- A, d5Ka " 2nd 9-/o-98 , 9OURT c. CQ 'AwN. ........�.. �4 Department of Health and Human Services approval (�CE-889d,tM1���\�'�i �� Reviewed and approved by: Date: 72-013 (Rev. 9/91) MOA 25 PERMIT NO. SW9801 40 PAGE 2 OF 3 DEPARTMENT ANDhHUM-AN SERVICES ENVIRONMENTAL SERVICES DIVISION RI, Box 196650 •Anchorage, Alaska 99519-6650 • Telephone; 343-4744 ON—SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 1, BLOCK 11, NORTH WOODS #3 P.I.D. NO. 051-732-05 LOT 2 RAMSE�SUBD. NEWLOT 1 4 BR HOUSE I GRAVEL IDRIV 3/4" AIR LINE A B TO SAND FILTER FCO LIFT THA Z ` .` o STI STATION (LS) NEW MTt MT2 1300 GAL. A — POLY TANK TH ALT i I I F MT4 LSITEJ �MT3 TH KEY BOX 15' UTILITY ESMT. / SHELTERING SPRUCE AVE. LOT 1 I FILTERaq&J& = 40' Epw�En® f'sTrgt��ig� I el A' + °r. 0. ROBERT C. COWAN. i `? CE - 3801+`<� ter+ PERMIT NO. SW9801 40 PAGE 3 OF 3 Municipalit of Anchore DEPARTMENT OF HEATH AND HUa AN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 •Anchorage, Alaska 99519-6650 • Tele hone) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 1, BLOCK 11, NORTH WOODS #3 P.I.D. NO. 051-732-05 GRADE 99.2' INSULATION 96.9' NEW 1300 GAL. POLY. TANK 7Z 96.6' N.T.S. MT1=103.5' MTI MT4 FINAL GRADE MT2 MT3 MT2=103.8' MT4=103.4' MT3=104.1' ORIGINAL GRADE INSULATION M GRAVEL WRWw / AIR LNE MT1=100.6'MT2=100.6' MT4=100.6' MT3=100.8' BOTTOM OF SAND=98.6' DIST. LINE=101.0' N.T.S. GROUNDWATER AT 95.6' 87.6' H.O.H. N. T. S. m w 70 m rill m n o -o r m - m o Ln O = O O o < C) 0 o �_ o o —< z m m n C-)< a E n c N .. O DC o m L ® O O O y 0 CD ip N O m 9 o 3a Cn o N ➢ N N ' o m v. -0 O OO C O �. c0 O' K O m n �- O• N N r o rco a m N t m n o -o r m - m o Ln O = O O o < m y un, o z m m n C-)< x E n c N .O O DC o m L ® O O (C O y 0 CD ip N O m 9 co 0 N ➢ N N < O OO C O �. c0 O' K O m n �- O• N N r o a m N t f Q �o o tw)- � - N 0 50 o z m .�^ z N n O cnZ N e. O DC A 0 Z CD m 9 co 0 MOV -18-98 WED 15:28 HEAVENLY LIGHTS ELECT CO 373 3894 P.01 QQ������M,,j���,, ��, �Q'���-[�'�q/7,�� gmdnf 491 _VVi _0llow Street • Witsilla, Alaska 99654 Phone# (907) 373-3893 • Pax# 373-3894 PROPERTY OWNER AGREEMENT FOR THE MAINTENANCE OF AN ON-SITE WASTEWATER DISPOSAL �g SYSTEM This agreement, datedN�.199$, is made between the Municipality of Anchorage Department of Health and Human Services (DHHS) and the property owner(s) of. // This agreement is made for the purpose of maintaining an on-site wastewater disposal system on the subject property. The property owners agree to the following: Submit to the Municipality of Anchorage, on an annual basis, an inspection and operation statement from a registered professional engineer. This inspection and operation statement shall verify that the engineer has inspected all effluent and air pumps, timers, and alarms, and that any deficiencies have been repaired and that the system is functioning as designed. (Signature) (Signature) (Printed Name) (Notarize Here) Subscribed and sworn to before MO this Xday of All Notary Pubic My Commission Fxoires < (Printed Name) 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 PERMIT PERMIT NUMBER:SW980140 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:NORTHWOODS INC OWNER ADDRESS:3111 C STREET, #555 ANCHORAGE, ALASKA 99503 PARCEL ID:05173205 LEGAL DESCRIPTION: NORTH WOODS UNIT III BLK 11 LT 1 LOT SIZE: 26495 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 6/01/98 EXPIRATION DATE: 6/01/99 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THIS PERMIT IS ISSUED FOR THE CONSTRUCTION OF AN ALTERNATIVE INTERMITTENT DOSING SAND FILTER ATER SYSTEM. THE ATTACHED PROPERTY OWNER AGRE NT TO HAVE THE SYSTEM CHECKED ANNUALLY BY A PROFESSION NGINEE SHALL BE A PART OF THIS PERMIT PACKAGE. RECEIVED BY: -.4eZ J� I DATE: - I�WE��DATE: 2 !' HEALTHAUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN s&S� Sin eRinq May 19, 1998 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 1; Block 11; North Woods Subdivision Unit 3 ROBERT C. COWAN, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 Request you issue a permit to construct a Bottomless Intermittent Sand Filter System on the referenced property. This system will include a 1500 gallon STEP tank and will be adequate to serve the proposed four bedroom home. The construction of the wastewater disposal system will not adversely effect the adjacent properties. The construction will be in accordance with the attached drawings sheets 1 - 4. This home will be connected to an existing key box on the Municipal Public Water System. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. 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DESIGN 09.1 1 Ot7Z ' gw Q \X o s ^O ti �asO z -zW 90 C U� MM V' h� p0N 0trj.= �z w I - 0 .W z 000 C9�Ky]� xo o? � tz C y C 4 O C U� V' h� p0N �z r P-3 t�7 DETAIL O M 0 x 0 b NN N.T.S. PROFILE DETAIL SCALE —I OC DO�i+ III IIIlillll mW IIIIIIIII Wm . �N .vm a IIIIIIIIiI Jo ;A $ �»-C iIIII IIII nm N"my �be y—IIII=1I�II III=F_I M�ba •» —III— p ��m IIIIIIIIIIII '�� > m\� IIIIIIIIIII HA N� — llii b e ps oG i;� a gym-. E r r, wNN rig l J FH os \ 'r'mo ON "o Vl � yy O O d N �a d a no Q �JJ N y m® I o a ►may I��H.... i' � on C�^/� Oy mo z � n —III—III —III—II �z"�'n III—III— O FCXA III—I 'U rpl z II—III 2 �+aow " x r _III= I z Cc�'n'a ty II—III— ti� � � ,~� �-�� : _• III�IIIIII -�ez �` r�r• p's. s"•.;S`>Z�� 1=III= n m . • s>� �IIIIII m �r p IIIIiII 00co -n IIIIII MW n0 w V Y � `.i• 1•. �' Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: �DATE PERFORMED: LEGAL DESCRIPTION: L 1 X1 3 DD be, Township, Range, Section: EPhH SLOPE SITE PLAN Uvrx� 2 4 `—�-- 0 ��rr 5- 6- 7 67 8- 9- 10- 11 0 11 12 13 14 15 16 17 18 19 20 5� S (5:- ouk $tots. WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT ' L DEPTH? O e P Depth to Water After Monitoring? C� Date: i B G PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER (� TEST RUN BETWEEN % FT AND - FT COMMENTS L'©ti %' ©✓ab NErD RI S & S ENGINEERINGNG PERFORMED BY: — N River Loop ea,..,.� naw 2 �"'� CERTIFY THAT THIS TEST WAS PERFORMED IN 117W4 Ea�g 4tr�� 9q ACCORDANCE WIT�:d9:IL NX%A'%bY`NRJNIqq��CIPA7777 L GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) S& May 20, 1998 ROBERT C. COWAN, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTHAUTHORITY BOTTOMLESS INTERMITTENT SAND FILTER SPECIFICATIONS APPROVALS Lot 1, Block 11, North Woods Subdivision, Unit III SEWER&WATER GENERAL STATEMENT OF WORK MAIN EXTENSIONS The work covered by these specifications and the plans consist of furnishing all labor, materials, tools, transportation, and equipment necessary to complete an intermittent sand filter SEWER&WATER system as described herein and on the attached drawings. INSPECTION All work under this project shall comply with the latest edition and addendum to all applicable codes, ordinances and standards including Municipality of Anchorage -Dept. of Health and ENGINEERING STUDIES Human Services (MOA)-(DHHS) septic installation guidelines and On -Site Waste Water AND REPORTS Disposal Systems permits. 4 Bedroom single family home = 600 GPD WELL INSPECTION Use 2.0 GPD/SF for polished effluent &FLOW TEST 300 S.F. required 36'X 10' sand filter and absorption area Sand filter to be constructed on accepting soil SITE PLANS SITE INVESTIGATION ROAD DESIGN The Contractor who proposes to complete this project must carefully examine the project documents, have full knowledge thereof, have investigated the site, and be satisfied with the conditions affecting the work. Conditions include, but are not limited to those bearing upon SOILTEST transportation, disposal, handling and storage of materials, availability of labor, water, electric power, roads, and uncertainties of weather, physical conditions at the site including all underground utilities, the conformation and condition of the ground, the character of equipment PERCOLATION and facilities needed preliminary to and during prosecution of the work. The Contractor must TEST be satisfied with the character, quality and quantity of surface and subsurface materials or obstacles to be encountered insofar as this information is reasonably ascertainable from an inspection of the site, including all prior exploratory work, as well as from information STRUCTURAL& presented by the plans and specifications made a part of this project. Any failure by the MECHANICAL INSPECTIONS Contractor to become acquainted with the available information will not relieve him/her from responsibility for performing the work as stated in these specifications and drawings. ON SITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 Page 2 Lot 1, Block 11 North Woods Subdivision, Unit III May 20, 1998 Location of utilities will be the contractor's responsibility. At least forty-eight (48) hours prior to commencing work, the Contractor shall contract all local utility companies to obtain underground utility locates. The Contractor shall exert due care to prevent damage to utilities. Should a utility be damaged, the Contractor shall notify the utility company and shall have repaired at his own expense any damage resulting from failure of the Contractor to request an underground utility locate or to exert due care. If any utility company determines that a utility has to be temporarily raised, lowered, moved, guyed, shored, braced or otherwise protected during construction, it shall be done at the expense of the Contractor to the satisfaction of the utility company. INSPECTIONS Typically, there will be a minimum of four (4) inspections required during the installation of the waste water disposal system. These inspections will occur as follow: Inspection of work in progress may be made by the Engineer and MOA-DHHS at any time. The following schedule of required inspections is to be adhered to. Twenty-four (24) hours notice is required prior to each inspection. Inspections can only be arranged during weekdays and during normal working hours. The following inspection schedule is to be strictly adhered to: Septic tank/lift station is in place, but not backfilled. Sewer piping from building to tank is complete and properly bedded. Sand filter location is excavated and prepared for filter construction. 2. Engineer to be notified with Contractor's schedule during actual construction of the sand filter to allow spot inspection during construction. Any deviation from reported schedule is to be reported to the Engineer. 3. Final inspection of the sand filter with all pressure piping in place, but prior to placement of cover material. Test pressure piping to ensure adequate flow and pressure, (requires completion of lift station wiring and piping prior to this inspection). 4. Inspection of final grading and adequate cover. The Owner shall contract with the Contractor to perform the work outlined in these specifications, plans and in accordance with the attached MOA permit. There will be no contractual arrangement existing between the Contractor and S&S Engineering. S&S Engineering shall be the Owners' representative and will inspect the work as stated above to document the Contractor's activities. Final acceptance of the Contractor's work rests with the Owner and the MOA. 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 Page 3 Lot 1, Block 11 North Woods Subdivision, Unit III May 20, 1998 responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. All landscaping, fences, sidewalks, paving, driveways, utility markers and other improvements, removed to facilitate the Contractor's operations shall be fully restored to their original condition and location by the Contractor unless otherwise directed by the Engineer. Items damaged by the Contractor during removal, storage, or restoration, shall be repaired or replaced in kind by the Contractor. This work shall be considered incidental to the project. MINIMUM MATERIAL SPECIFICATIONS 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated oli Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes ASTM D2241 Yes Yes ASTM D2239-74 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 water tight couplings (Caulder, Fernco, or equal). SEPTIC TANK/LIFT STATION A. General The work under this section consists of the performance of all operations pertaining to furnishing and installing the septic tank/lift station and piping to the sand filter. Page 4 Lot 1, Block 11 North Woods Subdivision, Unit III May 20, 1998 B. Materials Tank for Lift Systems a. Septic tank shall be a 1500 gallon two compartment tank specifically for use with Orenco Systems, Inc. patented lift station assembly Orenco No. 4200, or approved equal. b. The tanks shall be designed for adequate burial depth as required by MOA and State regulations. The design or analysis shall be in accordance with accepted engineering practice and local regulatory agencies. c. In areas with high ground water, the tank shall be adequately weighted or anchored to prevent flotation if the tank is pumped. 2. Risers a. First compartment shall have a separate 4" pump out riser. The second compartment shall have a separate 4" pump out riser. b. An additional second compartment manhole riser shall extend above surface grade, shall have a minimum nominal diameter of 24", and shall be capable of being equipped with the following: 1. A junction (Nema 4x) box or equal, bonded or attached to the riser. 2. UL listed electrical cord grips, installed in the J -box. c. A lid - shall be furnished with the riser. It shall be constructed to meet H-10 loading requirements and have a latching mechanism. d. Riser installation - each riser shall be sealed or welded to the top of the tank in such a manner as to prevent infiltration of ground water. e. Lid insulation - 4" rigid extruded polystyrene shall be placed inside and attached to the lid. f. Riser insulation - 2" sprayed shop applied urethane on circumference of riser with 46465 Tnemec coating. Page 5 Lot 1, Block 11 North Woods Subdivision, Unit III May 20, 1998 3. Effluent Pumping Assembly a. Effluent pumping assembly shall be Orenco systems (TM) Mode120- OSI-05-HHF series, or approved equal consisting of the following: 1. 1/2 H.P. 110/120 volt or equal U.L. Listed effluent pump. 2. Screened pump vault (U.S. patent No. 4439323) 59" deep, 3/16" thick high-density PVC cylinder houses the pump, level controls and screen and serves as a baffle to prevent the screen from clogging. 3. Fifteen 1 1/2" diameter holes are drilled in the vault at a level that places them at about the midway point of the depth in the septic tank. 4. Flap check: Allows the vault to drain when removing the tank. Screen: 15" diameter cylinder of high-density polyethylene 1/8" mesh. 5. All piping shall be PVC or other non -corroding material. b. Pump controls and alarm system shall be Orenco systems SICTETMRO 110 volt with the following options consisting of: 1. Event counter 2. Elapsed time meter 3. Program timer 4. 10 watt heater 5. Remote alarm panel option with a minimum of 80 DB sound pressure at 24", operating temperature 30°C to 65°C, continuous sound to be located inside the home. 6. Oil -tight visual alarm with push -to -silence feature. Automatic audio -alarm reset. 7. 15 amp motor rated toggle switch, double pole, double throw with three positions; manual (man), automatic (auto) and center (off) (H.O.A.). Page 6 Lot 1, Block 11 North Woods Subdivision, Unit III May 20, 1998 8. Nema 4x -rated, fiberglass, or equal, enclosure with hinged cover. 9. All controls to be installed as per manufacturer's recommendations. 10. Control panel to be installed on outside wall of home within sight of septic tank/lift station. c. Piping from the septic tank to the sand filter is to be 1 1/4" PVC schedule 40 solvent weld piping properly bedded and sloped to drain back to the septic tank. Insulation board 2" thick and 2' wide centered over pipe is to be placed where soil cover is less than 4' depth over pipe. CONSTRUCTION SEQUENCE In order to ensure proper installation, the system is to be installed in the following order: 1. Sewer line from house to tank 2. Septic tank/lift station 3. Sand filter 4. Final grading CONSTRUCTION Pipe Grade and Alignment Variance of individual pipe sections from established line and grade shall not be greater than 0.05 feet, providing that such variance does not result in a level or reverse sloping invert. During the progress of the work, the Contractor shall provide instruments such as transits, or levels, for transferring grades from offset hubs or other construction guides from the control points and bench marks provided to the Contractor by the Engineer. The Contractor shall provide qualified personnel to use such instruments and who shall have the duty and responsibility for placing and maintaining such construction guides. 2. Pipe Laying All pipe shall be laid with Class C bedding, free of large stones and organic matter. Page 7 Lot 1, Block 11 North Woods Subdivision, Unit III May 20, 1998 Each section of pipe shall be handled carefully and placed accurately, the spigot end shall be fully inserted pointing in the direction of flow and glued in place to make a water tight seal. Each section of pipe shall be properly supported to ensure true alignment and an invert which is smooth and free from roughness or irregularity. At all times, when work is not in progress, open ends of pipe and fittings shall be securely and satisfactorily closed so that no undesirable substance will enter the end of the pipe or fittings. 3. Bedding of Pipe for Sewer Lines The pipe should be bedded with Class C bedding materials, compacted to 95%. Native materials may be used as back fill material above the pipe, provided it is free of large stones and organic matter to a point one (1) foot above the top of the pipe. All pumping services shall be installed in accordance with the manufacturer's recommendations and standards. Electrical installation is to be to code by a licensed electrical contractor, with Municipality inspection where required. If MOA inspection is not required, a licensed electrician is to provide a letter to the Engineer stating that the system meets or exceeds all applicable codes. 4. Tank Installation Excavate to proper depth to allow gravity flow, install tank level, tolerance 0.1 foot, end to end, on undisturbed or compacted to 95% classified sand fill material. Line excavated tank pit walls with 2" +35 PSI burial foam full depth of tank. Back fill between tank and foam and compact in a manner to prevent damage to tank surface coating. Create a level sand surface over the tank and add 2" burial foam +35 PSI directly over tank. Mound unclassified soil over tank location to a depth of 2' above finished grade to allow positive drainage away from tank and counteract buoyancy. 5. Connections All connections to be as per MOA-DHHS and UPS requirements PVC 3034 piping with Caulder or equivalent couplings for inlet riser pipes. All tank connections are to be completely water tight. Page 8 Lot 1, Block 11 North Woods Subdivision, Unit III May 20, 1998 SAND FILTER The work under this section consists of materials and construction/installation of the sand filter. A. Materials The Contractor shall provide a washed sand to meet ASTM C-33 Concrete Sand Specifications with the additional requirement that all but 1 % of the materials passing the #100 sieve be removed. A sample may be taken from the sand bed during construction for purposes of quality control. If the sample does not meet specifications, all sand will be removed and replaced. 2. The Contractor shall provide pea gravel that shall be a washed material containing no fines (0% passing the #100 sieve) and a maximum size of 1/4" diameter. 3. The Contractor shall provide round rock that shall be washed gravel with rounded edges, well graded with maximum diameter of 1/2". 4. The Contractor shall provide the manifold assembly. The manifold assembly shall be the Orenco Model SFM 1036 or equivalent with orifice shields and flushing assembly. All drilled holes to be cleaned of burrs and pipes flushed, prior to assembly. Flushing valve to include riser to +12" above finish grade with extension handle provided to operate globe valve from the ground surface. 5. Side walls and top of the filter box to be insulated with 2" direct burial polystyrene insulation and be inside the plywood box. 6. The Contractor shall provide the filter fabric. 7. The linear air diffuser line and compressor are available from Orenco, no model number available. The feed line from the house to the filter is HDPE arctic insulated pipe 3/4"-2" SDR -11 Maskell-Robbins or equivalent. The compressor will have a gauge (0-10 psi) and be installed in a heated area, crawl space, or garage. B. Construction of Sand Filter The sand filter construction is to follow procedures as outlined in the Orenco Installation Manual as applicable to this design. Rock, pea gravel and filter sand are to be hand leveled to proper depth (tolerance within 0.05 feet) in filter, taking care not to allow mud or fine soil material into the filter or rock layers. This would include any soil material picked up by excavation machinery buckets Page 9 Lot 1, Block 11 North Woods Subdivision, Unit III May 20, 1998 while loading specified material. The Contractor should estimate filter material volumes such that allowance is made for wastage of material in contact with the ground at site. Work on the sand filter may be suspended at the Engineer's discretion due to inclement weather conditions, such as rainfall. The sand filter and material stockpiles will be completely covered by a tarp over night during construction until finished. Filter internal construction should be accomplished in one (1) day's time. The area over the sand filter to be finish graded with a minimum of 2 feet of cover and to prevent ponding of surface water run off. Side slopes shall not exceed 3:1. Six inches of top soil and seed are required over the entire sand filter when the side slopes approach 3:1, or at the discretion of the M.O.A. The Engineer will reject any sand, round rock or pea gravel that does not meet specifications or is contaminated in transit or while handling. If such material is placed in the filter, all soil material may be required to be removed and replaced with new material. CONTRACTORANSTALLER MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051 732 05 1. GENERAL INFORMATION Expiration Date:.7— I _2 Complete legal description NorthWoods#3 Block 11 Lot 1 Location (site address) 21940 Voyles Current property owner(s) Charter, Pritts Mailing address Real estate agent 2. TYPE OF DWELLING: E Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 412.50I(COVID-19) Date of Payment 1/ 30 Receipt Number QP U b COSA # OSC201697 Waiver Fee $ 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 C&M ENGINEERING Phone 8545558 Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Date 12/5/2020 OF A1q �1 -2 0 "o, * •49 TH *��l 6. DSD SIGNATURE '"' System #1 Approved for bedrooms rr • CHARLES G BALZARItaf System #2 Approved for bedrooms r�`���s.•. CE -13854 .�� W DisapprovedlTFl�\PROF• ' - t�N�,���-���- Conditional approval for bedrooms, with the following stipulations: � p I c, I-Cco-v a4 et4j"rj 4V kv-,ie✓' �'ar� f' V��� read MR �P►� TC(t�r.lt6lP� To C't7v1G{(�t (rtndt �\ S t r1CP/'i'vt ! e S S { / s V`P di p� ms's.` ,�'`1 � i" (. t4 ! c� yr ~Jt�LCUYttif N' R-1 O v1 S x— S+J",;R r V_tj9 'ice ._i �Gi S 6 c'm 4-o pprr-y a 1�aS� 2 l% - z,s a v'®tet; t, opt - �r�b s� t Original Certificate Date: 1'2,�: - Z The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site 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 Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue'sheet Legal Description: NORTHWOODS#3 BLOCK 11 LOT 1 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Comments public water B. TANK DATA Age of tank(s) 22 years Tank type/material septic /plastic Measured operating fluid level in septic tank na/lift ❑ Standpipes/foundation cleanout per record drawing Date of pumping 12/23/20 D. ABSORPTION FIELD DATA IDSFS Which system tested (date installed) 1998 ❑ ALL standpipes present per record drawing Total measured depth from grade 3.5 ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field Al Monitor tubes go to bottom of effective. If not, state depth into effective Parcel ID: 051 732 05 Structure served by this system 1 Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by _ Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station 22 years Lift station material plastic Comments: not on timed dosage Adequacy test date 11127/20 Results ❑✓ Pass For 3 bedrooms Fluid depth prior to test; 0 in Water added 450 gal New depth 2 in Elapsed time 15 min ❑ Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) Gallons introduced 500 gallons If yes, enter date Comments/Deficiencies: FLUSHING VALVES NOT LOCATED. NOT INSTALLED PER PREVIOUS REPORT. presoak volume per 15.65.060 Ma. ii 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' 0✓ Yes if No Community Sewer Manhole/Cleanout > 100' Q Yes if No ft M Yes if No ft Neighboring Tank > 100' F/71 Yes if No ft Private Sewer/Septic Line > 25' 1✓ Yes if No ft Absorption Field on Lot > 100' F Yes if No ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' ❑✓ Yes if No ft 0 Yes if No ft if No ft F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ✓0 Yes if No ft Z Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑✓ Yes if No ft Surface Water > 100' 0✓ Yes if No ft Property Line > 5' 0✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' P Yes if No ft Private Wells > 100' Yes if No. Water Main > 10' ✓0 Yes if No ft Community Wells > 200' 0✓ Yes if No 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' 0✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' Yes if No Water Service Line > 10' 0✓ Yes if No ft Community Wells > 200' 0✓ Yes if No Surface Water > 100'✓0 Yes if No ft F. ENGINEER'S COMMENTS BUYER NEEDS TO GET SEPTIC SYSTEM ON ROUTINE MAINTENENCE CONTRACT. G. ENGINEER'S CERTIFICATION 1 certify that l 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. 12/20/20 COSA Checklist yellow sheet CSG. OF: A1,4 49 TM.. •:.��� A . .... CHARLIE G BALZARINI ��i��F�• CE -13854 k,hlF0PROFESSIONP -� ft ft ft ft Ph: 907-85 -5558 Municipality of Anchorage Onsite Water & Wastewater Program 4700 Elmore Rd Anchorage, Ak 99507 RE: Requested Conditional COSA for Northwoods#3 Block 11 Lot 1 Dear Reviewer, The above referenced system is served by a IDSF system which was installed in 1998. The system was inspected and tested and found to be functional. The following items have been noted in the course of inspection, testing, and maintenance: ® The home was vacant at the time of testing. The absorption field was presoaked in accordance with 15.65.060 B5a. ii. "The gallons of water equal to the volume of the drainfield below the distribution pipe invert multiplied by 0.4". Calculated as follows: 18x20xO.4*7.5 = 1080. 1080x0.4= 432 gallons. Because there is no clear guidance offered in regards to IDSF systems, we. have interpreted the drainfield depth to be the depth of gravel below the distribution pipe (0.4'). The sand filter material is excluded from this volume because it is functionally similar to the accepting soils. Maintenance was recently performed on the system. The maintenance provider made repairs to the electrical system and installed a new air pump. ® The maintenance provider identified additional items that required repair or were suggested to be repaired: o The air pressure gauge is not functional. — We recommend that the gauge be replaced at the new owner's discretion. o Flushing valves were not located in the drainfield. — The system has a history of approval without flushing valves. Because of the age of the system and its history of function without them, we recommend approval of the COSA. The owner should consider having them installed in the future. o The lift station control panel does not provide timed dosage. — The system has a history of COSA approval with the same configuration. We recommend that the COSA be approved with the panel in its current configuration. The owner should consider having the panel upgraded when electrical repairs are made. o During electrical repairs required by the maintenance provider, the maintenance provider found that the wires in the lift station junction box were corroded. The wire for the high water alarm was damaged during the repairs. An electrician indicated that the repairs could not be made without trenching. o The maintenance provider indicated that modifications may have been made to the pump control panel. We noted that the pump control switch does not appear to be original to the panel. A new toggle switch was installed and appears to have been professionally installed, labeled, and adequate. Writing on the inside of the panel indicates this work was completed before the previous COSA was approved and no apparent safety hazards were observed. We recommend that the panel be allowed to remain in service. We are requesting that a conditional COSA be issued with the requirement that the lift station electrical be repaired no later than July 1, 2021. The repairs will include replacing the damaged wiring and ensuring functionality of the alarm system and functionality of the system. The bid value times 1.5 has been set aside for the repairs. The 1.5 factor should cover any code or functionality issues likely to be discovered by the electrician during the repair. The engineer will verify completion of the repairs and operation of the system prior to requesting final COSA approval. The MOA may require that they inspect the completed repairs prior to issuance of the final COSA approval. The conditional COSA is justified because repairs are difficult to make in the winter and the issues do not represent a substantial risk to health, safety, or the environment. There is always some risk that the lift station pump could fail and the system would backup due to a lack of high water alarm. This risk is mitigated by the recent maintenance, and the relatively short time that the system will be used prior to repairs being completed. The high water alarm wiring has been disabled so there is not an immediate risk to life safety. Assessing electrical systems is outside the scope of Civil Engineering, however with the exception of the high water alarm, the remainder of the lift station wiring appears to be consistent with many that we have observed. The engineer notes that the condition of the wiring has likely persisted for years and is something that is not required to be inspected as a part of routine maintenance. The proactive efforts by the maintenance provider will result in the improved long-term function of the system. Thank you for your time in reviewing this permit request. Please do not hesitate to contact me at 907-854-5558 or by email cgbalzarini(a),gmail.com with any questions or concerns. Sincerely, Charles Balzarini, PE 1� of .4[��'�l 11/20/20 ,v� • �s�9��! �: � TH •.fir .. . .. ... r • • �HARLES G BALZARIMI ��� �Fc •.. CE -13854 .• �`�i ��/srF9�''••...••'F,\\ A ���F� pROFESs40NP4,,� January 22, 2021 TO: MOA --Tim Eklund 3350 Midtoyvn Place Anchorage, AIS 99503 Phone: (907) 865-4700 Fax: (907)865-4750 w-,"i:remaxdyiiamicproperties.com Reference: Escrow HOldback for completion of work on septic wires to be run in spring for 21940 Voyles Blvd. Chugiak, Ak. 99567 AKA: North Woods #3, Lot 1,Block 11. Re/Max Dynamic Properties agree to hold escrow funds per bid from 907 Electric for wiring installation on Septic system and agrees that no funds what -so -ever will be released until the MOA onsite has issued full approval for work to be done. One and a half times the bid will be held. anner Each Office Independently Owned and Operated Proposal ADDRESS Charles Balzarini ARM Septic Services, LLC 17933 Old Glenn Highway Chugiak, AK 99567 (907) 688-9433 ARMServicesAK@outlook.com www.ARMSigrvicesAK.com PROPOSAL # 1715 DATE 01/04/2021 Labor 2 165.00 330.00 Labor to replace existing wire nuts with waterproof wire nuts, replace waterproof cord grips in junction box, repair junction box lid, install air blower, and other miscellaneous repairs to lift station junction box. Actual labor charge may be higher or lower depending on site conditions. Please note: A licensed electrician may need to be contracted in the event that the above repairs do not remedy the problem, or if additional electrical issues are encountered. Additional costs may be necessary to complete the repairs. materials 1 35.00 35.00 Waterproof wire nuts, watertight cord grips, screws, etc. Job Matedals:Air Blower 1 685.00 685.00 Air Blower By signing below, the client agrees to the proposed work, terms, TOTAL 1 and price. The client has also read and signed the "Residential Addendum A" and agrees to the terms. The client acknowledges that ARM Services, LLC has the right to lien this property. Accepted By Accepted Date ARM Services, LLC $ ,050.00 Charles Blzarini 2404 12/30/2020 ARM Septic Services, LLC 17933 Old Glenn Highway Chugiak, AK 99567 (907) 688-9433 ARMServicesAK@outlook.com www.ARMServicesAK.com $500.00 Site Work IDSF Maintenance/Checklist inspection 21940 Voyles A 3.75% interest charge will apply to all invoice over 30 days late. 12/30/2020 Due on receipt BALANCE DUE ARM Septic Services, LLC 500.00 OWNER: By: (signature) Date: 1 oL 0 2 (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL, DISTRICT ) The foregoing instrument was acknowledged before me this j� day of 20 2(, by T UBLIC F0 ASKA NOTARY PUgUC My Commission expires: l d zfs JERRY MW— 6y TE MY COMMISSION EXPIRES COCT• 07, 2024 MUNICIPALITY: By: (signature) (print name) Date: 1-7-2 / Title: ir+� ��7' K Zt by J✓�fTY xL( a Z 1n Y i r�ik 9• yy§) ?x Intermittent Dosing Sand Filter Owner c/o Charles Balzerini Street Address 21940 Voyles Blvd. Phone 854-5558 Legal Desc. Northwoods Unit 3; 611, L1 PID Septic Tank: -Sludge level 6" inches -Pumping: required yes o -Pumping completed yes-@ Absorption Field: -Liquid level Dry inches Flushing valves per approved design yes -All flushing valves opened, distribution lines flushed, and flushing valves closed yes n Lift station: -Pump basket cleaned e no •Biotube effluent filter cleaned 3e no -Timer float setting 34 inches -High level float setting 45.5 inches -Reference point Bottom of Tank -Pump on N/A . seconds -Pump off NIA,- minutes -Cumulative lifetime cycles N/A- -Cumulative run time -operation satisfactoryes o Air ay§tem. -Air pump filter cleaned yes -Date of latest install or rebuild NEW Alarm System: (Unknown) -Dedicated electrical circuit `desj� -Float setting 45.5 inches NIA .. hours -Air pressure 3 psi (See final note) -Air system operation satisfactory not satisfactory -Audible and visual alarm inside dwelling e no -Alarm system operation satisfactory of satisfacto Comments: -Flushing valves could not be found. Recommend owner or contrtictor excavate to find valves. If valves are not found and flushed as designed, system will have ................................ .............................................................................................. issues in the future. "Existing panel appears to be a timer panel that was modified to be on -demand instead of a "dosing" panel. Panel appears to no longer be .................................................................................................................................... a UL listed or approved panel due to modifications. Panel no longer meets requirements of a timed dosing panel as required for an "Intermittent Dosing" system. ............................................................................................................... -Alarm is non-functional at this time. Wires at the lift station J -box are badly corroded. Recommend replacement of electrical from lift station to house, and .............. ................................................... ............................................................................................... installation of a UL listed timer panel. ................... Note: Recommend a new air gauge is installed at the blower. ................................................................................... Maintenance Provider: Technician Nathaniel Kurka Date of maintenance 12/22/20 Company ARM Septic Services frd Signature Date InSF MaintPngnce I.on 040313 dnc For: Audrey Mason sold007@yahoo.com 12242 W Skyline Or Eagle River, AK tel://907-360-3237 *SEPTIC SYSTEM WIRING: -Aquire a municipal permit. -Once a trench has been established between the septic tank in the control box, provide and install new wiring in the trench. -Terminate wiring as required on each end. -Ensure proper operation is required. *Septic wiring access boxes need to be free from any septic debris. EXCAVATION: -SMG Landscapes Inc to provide a proper trench for the wiring. -Backfilling when complete. *This is an estimated cost based on previous projects. *Scheduling/Weather requirements: We are currently scheduling 2-3 weeks out from approval of the estimate. -A 30 degree minimum outside temperature is necessary for any exterior work. This may affect scheduling. *NOTES' -Does'not include repair.to any landscaping or fencing structure. *NOT INCLUDED:,,. -Digging/trenching, After_hours work=. b *907 Electric provfdes a 1 -year warranty on,all labor and materials supplied. This estimate does not include anything outside the above scope of work. Any additional work required or material needed will be billed separately as T+M. *907 Electric reserves the right to re -quote the project should any unforeseen obstacles or conditions arise on past due a 1/2 16805 Farm Ave. Suite 300 Eagle River, AK 99577 info@907electricak.com www.907electricak.com 907-887-9473 Estimate Estimate No: 1447 Date: 01/22/2021 1 $1,125.00 $1,125.00 1 $1,200.00 $1,200.00 - Estimate 1447 - 01/22/2021 Payment Details A 50% deposit of $1,162.50 is required by 02/01/2021. Invoice2go CO Subtotal $2,325.00 Total $2,325.00 Deposit due 02/01/2021 $1,162.50 Rising ®n Electric Services LLC 36784 Eklutna Lake Road I Chugiak, Alaska 99567 (907) 622-6777 RECIPIENT: Audrey Mason Remax of Eagle River SERVICE ADDRESS: 21940 Voyles Dr Chugiak, AK 99567 Sent on Jan 22, 2021 jbox septic septic j box 1 $110.00 $110.00* 12X wire 12X wire 440 $0.25 $110.00* Wire Nuts (waterproof) Waterproof Wire Nuts 11 $2.00 $22.00* Trencher rental fee Trencher rental fee 1 $400.00 $400.00* Conduit 1" PVC 1" PVC Conduit 4 $9.00 $36.00* Liquid Tight 3/4" 3/4" liquid tight 7 $4.00 $28.00* grounding bushing 3/4" 3/4" grounding bushing 1 $7.00 $7.00* PVC FA 3/4" PVC FA 3/4" 1 $2.00 $2.00* Liquid tight 3/4" connector 3/4" Liquid Tight Connector 2 $6.00 $12.00* Best Guess This is our best guess at a worst case scenario. Most of our jobs come in at less but occasionally a job may come in more. If we start the job and encounter a problem, we will let you know immediately. If you have questions about this estimate please feel free to call Dakota at 622- 6777. Thank you Due upon receipt Invoices are due upon receipt unless prior arrangement has been made. All past due accounts will be charged 1.5% monthly interest fee and a $25 second billing charge. 1 of 2 pages Rising n Electric Services t Vk,� LLC 36784 Eklutna Lake Road Chugiak, Alaska 99567 (907) 622-6777 * Non-taxable This quote is valid for the next 30 days, after which values may be subject to change. 2 of 2 pages Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 r CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-732050 Expiration Date: 1. GENERAL INFORMATION Complete legal description Northwoods #3 Block 11 Lot 1 Location (site address) 21940 VOYLES BLVD Peters Creek, AK Current Property owner(s) BURKHART Day phone 244-1930 Mailing address same Real Estate Agent Cindy Wilson Day phone 244-1930 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: Individual Well ❑ Individual Water Storage ❑ Community Class C Well ❑ Public Water System TYPE OF WASTEWATER DISPOSAL: Individual Holding Tank ❑ Community ❑ Public Sewer ❑ Received byDate: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Date of Payment Receipt Number nod COSA #_ DSC1�jI5�J� 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 NorthRim Engineering Phone 694-7028 Address PO Box 770724 Emile River Engineer's Printed Name Steve Eng Date 10/21/2013 ,sem 6. DSD SIGNATURE System #1 Approved for bedrooms. System #2 Approved for bedrooms. n Disapproved. ti. Conditional approval for bedrooms, with the following stipulations' By: 1z Original Certificate Date: The Municipality of Anchorage Devlopment Services Division (DSD) Issues Certificates of On -Site 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 Checklist Septic System Advisory Well Flow Advisory COSA blue sheet 9-1-12.doc X Nitrate Advisory Arsenic Advisory Other If more than 1 septic system is on the lot: . COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: &OOC di"Od-S' � 3 $ /Z 141 Parcel ID:QS�- 732 05 A. WELL DATAM4 - PO LIG Wyq775r� Well type If A, B, or C provide PWSID # Date completed Sanitary seal (Y/N)_ Total depth ft. Cased to ft. FROM WELL LOG Date of test Static water level ft, Well production g,p,m. WATER SAMPLE RESULTS: Well Log (YIN) Wires properly protected (Y/N) Casing height (above ground) in. AT INSPECTION Coliform colonles/100 mL Nitrate mg/L Arsenic ug/L Date of sample: Collected by: ft. B. SEPTIC/HOLDING TANK DATA Tank Type/Material 7ESP-4• /��GJf rr✓ Date installed o 9- Tank size 1300. gal. Number of Compartments _Z Cieanouts (Y/N) Foundation cleanout (Y/N) 4—, Depression over tank (Y/N) High water alarm (Y/N)-' Date of pumping `7 Pumper J—/?' C. ABSORPTION FIELD DATA Date installed 7//0/'?* Soil rating (g.p.d./ftz or ft2/bdrm) 2 System type Z65F Length _ 20 ft. Width A? ft. Gravel below pipe Total depth 3 ft. Eff. absorption area 36d ft2 Monitoring tube 4- Depression over field Al Date of adequacy test -7/3013 Results (Pass/Fail) For .3 bedrooms Fluid depth in absorption field before test d in. Water added 4-1 SO gal. New depth 3 in. Elapsed Time: CO min. Final fluid depth O in. GAbsorption rate >= � g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type)%/C : If yes, give date D. LIFT STATION Date installed O "Pump on' level at "/Of in. Datum 7 aP E. SEPARATION DISTANCES WELL ON LOT TO: IM Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service line Animal containment areas Size in gallons 150 Manhole/Access (Y/N) "Pump off" level at SS in. High water alarm level at in. Cycles tested Meets alarm & circuit requirements? I On adjacent lots On adjacent lots Public sewer manhoWcleanout Holding tank Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation S'f Property line /a t Absorption field Water main '� Water service line /d 'r`. Surface water Wells on adjacent lots Q 't ABSORPTION FIELD ON LOT TO: Property line 4Q 'f Building foundation /0 Water main /D f Water Service line %Q �f Surface water /Ori '� Driveway, parking/vehicle storage Curtain drain VNI^_ Wells on adjacent lots �f F. COMMENTS /I 4VW y X 47-T_S 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. Engineer's Printed Name S Date COSA brown sheet -10 -10 -12 -doe MUNICIPALITY OF ANCHORAGE • Community Development Department • On -Site Water & Wastewater Program P: 907-343-7904 • F: 907-343-7997 • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.inuni.org Owner Phone Legal Septic Tank: Intermittent Dosing Sand Filter Maintenance Log Street Address Z L/0 V6y1CS 19U -e— Chua5ch PID -Sludge level inches -Pumping: requiredes no •Pumping completed es no Absorption Field: -Liquid level inches 1>) Oh2 OVto�T�b25 Ne Vales 1n jmf c% k%0'0 - q _� -Flushing valves per approved design ygLgo -All flushing valves opened, distribution lines flushed, and flushing valves closed Lift station: -Pump basket cleanedes no •Biotube effluent filter cleaned es no -Timer float setting_inches -High level float setting_inches -Reference point -Pump on seconds -Pump off minutes SiQnJec- on o�s- 5 oIZ- •Cumulative lifetime cycles -Cumulative run time hours -Operation satisfactory es no Air System: -Air pump filter cleaned es no -Air pressure``psi -Date of latest install or rebuild IQ ®cfi A013 _ -Air system operation satisfactory not satisfactory Alarm System: -Dedicated electrical circuit es no -Audible and visual alarm inside dwelling ygL no -Float setting inches -Alarm system operation satisfactory not satisfactory Comments: ............ %) �.s.....5. 5 .....hGS........... n...c!...G>r....�...2........ Technician %c,<T:N e lc"�S Company _ � -?- 5 Se cy\ ces Signature ivar maintenance L0q_u4us1s.a0c Date of maintenance v& B Date LOT 2 RAMSEY SUBD. TRACT A ONE-STORY RESIDENCE X DOG IPEN r FENCECMNNK-. x I � FENCE Le�x� x - 1 15' URLnY EASEMEN— T I 26 LOT,4S F. CANT. ASPF1ACT OR"Y , �. SHELTERING SPRUCE AVENUE a) O C r rrlD v PLOT PLAN _ AS BUILT X SCALE 1" - 40' GRID NW 1459 Project No. L13 -203A1 Lang & Associates, Inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 907) 522-6476 Phone 00040 Registered Land Surveyors 907) 522-4625 Fax ooOF oppp ken�longsurvey.com / jonathan0angsurvey.com G��� ••,A. 9V4� I hereby certify that I have surveyed the following described property: oo`Q;•' %� LOT 1 BLOCK 11 NORTH WOODS #3 (PLAT # 83-068) �1(ij; 9QQ Anchorage Recording District, Alaska, and that the Improvements situated thereon are o A9 r 0 within the property lines and do not encroach onto the property adjacent therefo, that i...., no Improvements on the properly lying adjacent thereto encroach on the surveyed FA 1 premises and that there are no roadways, transmission lines or other visible ' t"j0 FIAtI C, LANG easements on said property except as indicated hereon. Q `Z. ' LS -9944 Dated this the Day of 6G (G�,�t� , ' at Anchorage, Alas a Q�Q4 �'• �C)(.-r J vO p It Is the responsibility of the owner to determine the existence of any easements, Q�Ra�ssIONAF-�o< covenants, or restrictions which do not appear on the recorded subdivision plat. pp0040o�a Municipality of Anchorage Development Services Department "GE Building Safety Division On-Site Water and Wastewater Program ` 4700 South Bragaw St: P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D.0SSI'-�3�-0$` HAA # (llI 333 "� ;"` Expiration Date: — C S r 7 �� 1 GENERAL INFORMATION C6mplete.legaldeseripti"bn _Lot i; Block 11; Ngrthwoods S/D #3 ' Locafion (site addres'or''lirections) " 21940 Voyles Blvd., Chugiak,AK Handled by Country Realty 'Current Property owner(s) Veteran's Administration Day phone688-8500 •Mailing address Nand Stably @ Country Realty, P.O. Box 671923 Chugiak N Lending agency Day phone. Mailing address Real Estate Agent Country Realty Day phone 688-8500 Mailing Address _ P.O. Box 671923, Chuaiak AK 99567 Unless otherwise requested, HAA will be held by DSD for pickup. �ir�G,iJ G i J �o 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well L] Community On-site ❑ Public Water System ® Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority 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 Health Authority 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 SSS Engineering Phone 694-2979 Address 17034 North Eagle River Loop, Suite 204, E.R. AK 99577 Engineer's Printed Name Robert C. Cowan Date _7— 2 —2004 N ROBERT C. COWAN E Q 5. DSD SIGNATURE "ems CE -8801 , \ , I/ Approved forbedrooms. 4 e,44 "�•_.. C`vJ aysa FNc�s�i��F,� Disapproved.Aays+a Conditional approval for bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory. Supplemental Engineer's Report Well Flow Advisory Other By7 Original Certificate Date: vy (Rev. 01/02) munlelpanty of Anchorage ^ � . .w�.. .... CSevelopmen#Services �epartment� _A�°z Building Safety"DMsloh­ c 'r On Site Water &"wa"steJJater Program r g ws x Y outS ., cor, ncra noggeak ,Pc us ,u� HEALTH AUTHOR1TYAPPROVAL CHECKLIST _ trip ion. -43P OS 1 7 Z OS arcel ID °tis1-.u'2.M'.![.zrr'tr Cic �/4 L cJIf A B dr C provide PWSTD'# Weil Log (Y11 „w; mZ" „ ^,a rr,. Pea anI ary sea ares properly protected ( )` ase o ' ft L�g ""f Casing eig t veground) in. xta� 6G PECTION �s iter evel t. ft auction ` g.p.m. "g.p.m, �Li�§' olonies/100 ml. Nitrate mg:7t"' "° " O�ie�iacteria colonies/1b0 inl mg /I Date of sample Collected by i i ', cr'w„" )�a`rsY. rota"` d tan^'. ater0 1 11 mAy.etC4,1 Date installed 1�©p gal. al Number of Compartments 2 CleanoutsN) Ve(I .a m a+ax&.44'�h^`9t�"kS"£."wt}'Ct'c.� n c 6anout N) Depression over tank (Y/� vvv High water alarm �mping C Pumperp' /.�PrvrOMMI M0'f: �'-.t5 %ikWWk�$LS "¢s5�!y=5vMXF'�XC-si`F2MwLF�±"reJs. %Gti.?FF",W..vnM'+%+M aeoe Me /0 Soilrating PA' or ftz/bdrm) z System type'Aoiha.+e n„a r -j' J oft Width 1 $ t ft Gravel below pipet- �dvsftn Eff. absorption area `3%6 ft' Monitoring tube AS Depression over field �o � �.. equacy test,6 ,5 O Results (Pass/Fail For �✓ bedrooms iin a sorpfion ie a ore test d to Water addedgal. New depth,_ in; me min Final fluid depth © m Absorption rate > S g p d R�a�`'?�"..a�S'u on line records above systems are Water main Driveway, parking/vehicle storage 0 CE =8801 RAMSEY SUBD., TRACT A S 89054'24"E 118.36' (M) S 89°54'!0"E 117.99 (R` I 3 y2, I i o ys� I � 1 I I*1 C 0 - D Z D Z I O I 1 D. I 1 C7�C� 1 1 I m mo%rm I =mro mgm N z D l m m \ I� 4 z 15.9' /z.fi' z i Ix z m $ x 8g ° Z <n i (i 2 4.0' .ZI P N .mm O W loo 47.4 a c m Q I N �m s 1 1 gOoN r m ASPHALT DRIVE I 1 A m O P VI v 25.3 v I Ig � v O 00 r l r �A ZI 00 I D DI D ym I m ml I m ml �1 0 1 p 0 X -X N O z i I 9 X X X W _ 15' UTILITY EASEMENT , ' .00 02O Oy . °'P N 90°00'00"E 98,59' (M) BASIS 98,62 (R) SHELTERING SPRUCE AVENUE czr 512 o00 0-7 z p Q.m vmo 000 z 0� F y m m� n� 5. m m QCL O C Ali m O a 6 N O== ,: Q'•-•.• `�:r�J.;�j,9''♦ Q 1 r lb QD U Q' O N O Y. t° N Q M O1 •�1y/ .� m z rTi o " yo' w �n v �' ••1 . + 0 NS Q> Q'I ,nQK-Oo=4/s..•.• :N•O �' rY aE CD J MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES Cec;c?.�2CJ b Division of Environmental Services CUD On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 051-732-05 HAA # 1. GENERAL INFORMATION Complete legal description Lot 11 Block 11, Northwoods #3 Location (site address or directions) Voyles & Sheltering Spruce Property owner �' t,�, C �� ���� (�`- Day phone Mailing address Lending agency Day phone Mailing address Agent Target Realty/Dick Brown Day phone 694-2388 Address PO Box 774627, Eag]P River, AK 99577 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well Community well Public water XXX 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: XXX Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA e21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & S ENGINEERING Phone — 9 7Cj 17034 Engle River Loop Road No. 204 Address Engineer's signature 6. DHHS SIGNATURE J Approved for 0 bedrooms. Disapproved. Conditional approval for Additional Comments By: C Date 1 / --s- / 2 cl Op �a P �1sol % . J bedrooms, with the following stipulations: Date 2.1& C? 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-=(Ray.1/91) Back MOAM21 D. LIFT STATION C 011 a �V " P ✓3 Fs' � J Date installed / I C Size in gallons _ of Manhole/Access/N) V #-J "Pump on" level at* a High water alarm level at* y "Datum t3v 7- r ° m Cycles tested E. SEPARATION DISTANCES PuAL1 L W4 -7 -!;✓0, SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer /seDge-le—rvice line On adjacent adjacent lots / 57.0 "Pump off" level at* 3 x Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: � r i Foundation )o Property line 3C, Absorption field 10 Water main/service line 10 f Surface water/drainage 0 0 Wells on adjacent lots ) 0 0 4 - SEPARATION DISTANCE,FROMABSORPTION FIELD ON LOTTO: 1. 1 Property line a 0 Building foundation a y Water main/service line 1 Surface water i o 0 + Curtain drain N0144- K Now n4 F. ENGINEER'S CERTIFICATION Driveway, parking/vehicle storage area aO , Wells on adjacent lots / D 0 J- / certify that I have determined thru field inspections and review of Municipal in conformance wi h &40A_HAA gui lines in effect on this date. Signature WJ Z ✓R—� Engineer's Name C- e 0 Date a `� HAA Fee $ 3 6Z ' c� Date of Payment AN Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number RCIBnT G,,COWAN IQ ��i,'•� CE - 8801 U are 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 Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal systerri 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 fites 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 Slate codes, ordinances, and regulations in effect at the time of installation. Name of Firm S & S Engineering Phone 694-2979 Address 17034 N. Eagle River Loop RD. Eagle River, AK Engineer's Printed Name Robert C. Cowan Date - OF w ROBERT C. COWAN4 5. DSD SIGNATURE hlt+cls CE -8801 : pp 3 bedrooms., It � Approved for Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist • • X Septic System Advisory Well Flow Advisory Maintenance Agreements SUpplementai Engineer's Report Other By:i Original Certificate Date: .5 Z' 02 (R« 12M) Municipality of Anchorage •., • Development Services Department • Building Safety Division ` sa ser On-Sfte water & Wastewater Program 4700 South Bregaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.d.endwrage.ak.us (907)343-7904 _... _...... .1Jct-r TN AUTHORITY APPROVAL CHECKLIST Legal Description: c_Ic.) NO��'F! vJtx� S 3 Panel ID: C51 3Z 0'' A. WELL DATA3LlC,/A-Liwu Well type _ If A, B. or C provide PWSID # _ Well Log (YM) Date completed _ Sanitary seal (YIN) _ Wires property protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) n. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RE LTS: Coliform onies/100 ml. Nitrate mgA. er bacteria oolonies/100 mi. Date of sample: Collected by: B. SEPTICIHOLDING TANK DATA Tank Type/Material Date installed` �� . Fie Tank site' 50D gal. Number of Compartments � Cleanouts (Y/N) Y Foundation cleanout j(Y//Nl I�p J Depression over tank (YIN) I High water alarm (Y/N) Date of pumping S Pumper C. ABSORPTION FIELD DATA, 1tn�� Date insWiled Soil ratan p.d./ft= ftr/bdrm) f% System type r✓aF d ^ P Length `to ft. Width to ft. Gravel below pipe Z' s:A- J ft. Total depth —3— ft. Eff. absorption area 3�&fI2 Monitor*be - Depression over field Date of adequacy test Jr d Results (PasslFaitFor bedrooms .I Fluid depth in absorption field before test in. Water added�'gal.. New depth in. x Elapsed Time: min. Final fluid depth in. I Absorption rate >= '� 5Z� , g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN &type) e\ if yes, give date -� D. LIFT STATION Date installed 1 Size in gallons "Pump on* level at -r v in. `'Pump off" level at 326n. m. Datu" r4cydes tested 1,04- E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON Septic tank/lift station on lot Absorption field on lot Public sewer main Manhole/Access ('YIN) Y_ High water alarm level at !14 in. Meets alarm & circuit requirements? TO EA t, l r: / i W LJ On adjacent lots On adjacent lots Public sewer me Sewer /septic service line 4 Holding tank _ SEPARATION DISTANCES FROM SEPnCAiQkUfkG TANK ON LOT TO: ' f J Building foundation 1 Property line 16 Absorption field *7 'f' r r , Water main I -� ` Water service line "f Surface water / Co -A- Wells on adjacent lots _r SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ('0 , + Building foundation 10 )1 Water main j C, r '� I Water Service line - 10 1+ Surface water 102 T Driveway, parkingivehicie storage Curtain drain &4(- IZ-AJow Wells on adjacent lots 292:2f+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and q ` review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name 1766 4A C . Ccw4o' Date S- /16 /0 -z- HAA y �- !� HAA Fee $ � / •�• Date of Payment r- / 16 r'O L Receipt Number 01 9 t L r (Rev. 12/00) , Waiver Fee $ Date of Payment Receipt Number w 1 m O RAMSEY SUBD., TRACT A N S 89054141 118.36' (M) 5 89`54-IWE IIT.99 (R) 2 r z o0 d= enc 5.-m ,SO = O A N -r N O Q'w cr 2-00 CC0 91 iongo ^�a3 p n 9 v�too0 IFa 30 e•� Xm 1 3RAYCL DRIVE j 1 1 O I P I rn 13 N I H l -- — — —— N s- ---- s 15' UTILITY EASEMENT .DG �Zr-0 'f I AVENUE C I m N " • 30,00,00,E 98.59, BASIS 98.62 (R) SHELTERING SPRUCE 2 O :9 rn O N Cl 2 mX3 O z z r z o0 3C1vooZZ 0o v,o�. 0 rs `10 900 enc 5.-m ,SO = O A N -r _mem•• Q'w cr 2-00 CC0 91 iongo ^�a3 p �'— Zin v�too0 IFa m Q C•' �O O &L 2 O :9 rn O N Cl 2 mX3 O z z s 2 O :9 rn O N Cl 2 mX3 O z z