HomeMy WebLinkAboutMICHAELS RIDGE LT 1Miochel's Ridge
Lot 1
#017-113-15
- " 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: S V10e) O `z) 4 PID Number: O 17 — B I --ARL-LT—
R /.TName:
Name:
Wastewater System: ❑ New ❑ Upgrade
Address: ^� -
ABSORPTION FIELD
e�Q
Phone:
No. of Bedrooms:
p Deep Trench ❑ Shallow Trench lK eed o Mound ❑ Other
LEGAL DESCRIPTION
Soil Rating: Ll
Total Depth from original 7e.
PD/ FI.
Lot: Block: Subdivision:
Depth to pipe bonom from original grade
Gravel depth beneath pipe _
n. F1
Mi 7< Rift Q.
a� 5 Ft
Township:
Range:
Section:
Fill added above original grade:
Gravel length: n
Ft
(i Ft
WELL: XNew ❑ Upgrade
Gravel wl0ln:
1 O
Number of lines:
DM1t+nta beMeln linos"
Ft
Ft
Classification (Private. A.B.C): Total Depth: Cased To:
Total absorption Pipe material: II,,
$+ `CrZ'4 D P ✓ (—
PP-WAarea;
--sCICFt. Ft.
1] Ft. T
Driller: Date Drilled: Slat K water LavN:
Installer. Date Installed: r7/�
4o ale 7 7
LPrt"4 1b -4 -001FL
.i's
Pump Set at: Casing Height no:
nerd:_ Above Grpu
15 GPM PpOd Ft. Ft.
TANK
SEPARATION
DISTANCES
p4 Septic ❑Holding ❑S.T.E.P.
To
Septic
AWIPtlon
Lm
Holding
blklPmate
Manufacturer.
AtAf-v+ I A v-A%L
Capacity In gall` ns:
From
Taft
Field
station
Tent
sewer Lift,
Material:
Number of Compartments:
Well
4�
Ib0
17-0
—
It b
k-��
Surface
rfa e N
N �c
N1b
LIFT STATION
WateLoto
c
4y
is
35
Size In gallons:
t
Manufacturer. 910 C Y C L 1=
Line
-
e0
"Pump on" Isvelat.
'Pump l yarl at:
High w 'rrn at:
YT-
Foundation
CurtainAt
10
I
Nib
N
Pump Make a Mods)
E-yk
I Electrical Inspections Performed by:
M V µ
Drain
O
BENCH MARK
Remarks:
Location and Description:
•cM
/
r4 .PLGs. t.I
1 tl e�
Assumed Elevation:
►vo r.
ENGINEER'S SEAL
I S Dates: 1s
�j
Inspections performed by:
a
.J,• ....
2nd ao
Tc ,. _•..a
Department of Health and Human Services approval
Reviewed and approved by: Date:
77-013(R. 9190 MOA 25
363f0
1000 GAL *PrIC TANK ` SANG TIES I \
61pCYCL£ o, f AB\ 18.0 fT I \
\ 1 1 \ !OkJ B£Q; AC 16.0 1
TOTA{} Of AH J rr BC 1 JO.5
\ , ElL lfp SANGp 2 TTrf AD \ JI.O 1
\ \
SEW
ROC
k 0.5 r BD 1 31 5 1
1 \ 1 coVE J Ir
AC \54.5
\
1 N 1 I BE \ns
#1 , C
r TO
1 I \
\N
\ \ \ ♦\ �\ i
1
25 0 \ 25 50 1 751 100 \ !25 150 I 1
SCALE; l' = 50 { T.OF
I 1
' : ��P.••" ........i••., �1� \I \363.00 1 ,
49th: • \ 1 1
TOB LN SPURKLAND : i
•-C,��..• NO. CE -2225 �Sl^1�
MARK:
ELEV.
\ X:
I/nml o�e_zafa TOBBEN SPURKLAND P.E. I I AIICIIEL'S RIDGE' SID LUT I I I SEPTIC SYSTEM AS BUILT I
203 W 15TH. AVENUE SEC 32 T/2N R3W DATE. • OCT 11, 2000
ANCIl. AK. 99501 MICH£LSOIIN AND DAUGHTER SHEET. • 2/3 GRID: 3137
PERMIT # SW000345 PID # 017-112-13 MICHRII2.DWG
AIRCOMPRESSOR
BIOCYCLE 6000
BENCH MARK:
TOP FOUNDATION
ASSUMED REV. 100.00 I7
1.
2.
J.
4.
5.
INV. 93.30
1000 GAL. SEPTIC TANK
PRIMARY TREATMENT, SEPTIC TANK
AERATION TANK
CLARIFICATION TANK
DISCHARGE TANK
SOIL ABSORPTION
ITOBSEN SPURKLAND P.E.I I LOT 1 MICHEL'S RIDGE SID I I SEPTIC SYSTEM SCHEMATIC
203 W15Ih Ave GOLDEN VIEW DRIVE DATE: OCT. 11, 2000
Anchorage Ak 99501
nvn_rnic MICHELSOHN AND DAUGHTER SHEET.3/3 GRID: 3137
PERMIT 0 SV000345
From
ALPINE DRILL 907 3450202.
Mayor
Oct.10.2000 04:15 RM
Municipality of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 198050 Anchorage, Alaska 99519-6850
http-INmw d.anchorage.ak.us
WE
Permit Number: #SW 000345 Dale of Issue: 8-31-00 Parcel Identification Number: 017-112-13
Dale Started: 10-4-00 Date Completed: 10-4-00 Is well located at approved permit location? ® Yes ❑ No
Leal Description: Michaels Ridge Lot 1
Property (honer Name & Address: Michelsohn & Daughter Cons Inc.
750 W Dimond Blvd.
Anchorage. Ak 99515
Borehole Data:
Depth (ft)
Method of Drilling ® air rotary ❑ cable tool
Soil Type, 7hickncss R Watt? Strata
From
To
Casing type: stool
slick -up
0
2
Wall Thickness: ,025 inches
sandy gravel fill
2
5
Diameter: f inches Depth: 9944 feet
organics & silt
5
8
Liner Type:
gravelly silt
8
12
Diameter: itches Depth: feet
'
Casing stickup above ground: 2 feet
silly cobbly gravel!
12
21
Static water level (from ground level): L5 feet
cobbly gravelly silt
21
65
Pumping level: 94 feet after
sandy gavelly silt
65
81
2 hours pumping 15 gpnt
silty sandy gravel H2O
81
92
Recovery Rate: 75 gpm
water sand & gravel
92
94
Method of Testing: gtlifj
\'Veli Intake Opening'l)(pe:
0 Open End ❑ Open Hole
❑ Screened Start feet Stopped feet
❑ Perforations Start lbct Stopped fat
RECEIVED
f ilrout Type: (3entonite # 8 Volume: >�
Depth: Start 0 feet Stopped ± fat
Pump: Intake Depth feet
OCT 12 2000
Municipality of Anchorage
Pump size hp Brand Name
`
Dept. Health ✓£Human Services
Well Disinfected Upon Completion? ® Yes ❑ No
Method of Disinfection: Clorine Tablets
Comments:
Well Driller: Alpine Drilling & Enterprises
P 0 Box 110496
Anchorage AK 99511
y
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On -Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 3434744
ONSITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Initial
Date Issued: Aug 31, 2000
Expiration Date: Aug 31, 2001
Permit Number: SW000345 Parcel ID: 017-112-13 '
Legal Description: T12N R3W SEC 34 NE4NE4SE4SE4 PTN PARCEL 4 (1*elzca o
Design Engineer: 0007 Tobben Spurkland, PE Site Address:
Q i
Owner Name: Michelsohn & Daughter Construction, Inc. Lot Size: 65233 SO. FT.
Owner Address: 750 W. Dimond Blvd. Total Bedrooms: 6 Permit Bedrooms: 6
Anchorage , AK 99515 -
This permit is for the construction of:
F,/ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each Inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Date: C--3 1—u6
Date: 9-31-00
1.6T.PMMAND P.E.
203 W 15th. Avenue, Suite 203
ANCHORAGE, ALASKA 99501
(907)279-3916
Fax (907)-276-6013
SEPTIC SYSTEM DESIGN
LOT 1 MICHELS RIDGE S/D
MICHELSOHN AND DAUGHTER
Municipality of Anchorage
Department of Health and Social Services
820 I Street
Anchorage, Alaska 99501
August 14, 2000
We are submitting an application for the installation of a well and waste water disposal system for
this lot. The submittal consists of three (3) drawings showing the present improvements on the lot
and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the
well and waste disposal systems are subject to this permit application, (sheet 2/3), and a schematic
of the waste disposal system, (sheet 3/3). Soil logs and percolation tests of applicable testholes are
also enclosed. The septic system design is based on the following :
No Ground Water to 12 Ft.
Use BioCycle
Soil Rating. From Testhole 04/17/00
Percolation Rate <I min/inch
Use Sand Filter
Soil Application Rate 4 gal / sq ft
No. of Bedrooms 6
Required Area per Bedroom: 15014 - 37.5 sq.ft.
Total area required: 37.5 x 6 = 225 sgft
Use 10x23 bed Area 230 sq ft
SYSTEM CONFIGURATION
BIOCYCLE
1000 GAL SEPTIC TANK
STANDARD BED
TOTAL LENGTH 23 FT
TOTAL WIDTH 10 FT
TOTALDEPTH I 3 FT
SAND FILTER 2 FT
ROCK DEPTH 0.5 FT
COVER 3 FT
The installation of this well and waste water disposal system system will not prevent development of the adjacent
lots.
There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots.
The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface
runoff will not result from this installation.
36.00
LOT Il�
LOT �! ` ` I I I LOT?'
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LOT it I 1 \ �\ \�l `� �; �� \\� LOT 2
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- 49th s 0
5.
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i r.Lu.. I LOT 4
TOBI N SPURKLAND
V
♦1c�j,s:, No. CE-2225
50 0 50 100 150 200 250 300
SCALE: 1' = 100 FT.
TOBB£N SPURKLAND P.E. AlICIIBL'S RIDGE SID LOY' 1 SEPTIC SYSTEM DESIGN
103 W 15TH. AVENUE SEC 32 T12N R3W DATE. AUG. 15, 2000
ANCH. AK. 99501 MICHELS01%N AND DAUGHTER SHEET. 1/3 GRID. 3137
/nml o7n_zarc
I PERMIT N SWOOYYY PID k YY MICHRIILDVG
\ \ \
1 I 363.10
�\ \
I 1
\
1
\
1 c 1 \ \
11010 GSL S&77C TANK1�1
\ \
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407A( DOTH 3 Yi7
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COD'£R \3 fl \
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to
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\ \ I I
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2s 0 2s so \ 75loo \I i25 i 150 I 11
SCALE.- I1 = 50 fT. I
...... q(�qh�
.. •Y •`��� \36300 I
L-� - -
49th !v \ 1
ma=y TD zN $PURKLIIND ate,
10,62.• No. CE -2225 ft p
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TOBB£N SPURKLAND P.EI I I I MICHEL'S RIDGE SSD LOT I SEPTIC SYSTEM DESIGN I
203 W 15TH. AVENUE SEC 32 T12N R3W DATE: AUG. 15, 2000
ANCH. AK. 99501 MICHELS5WN AND DAUGHTER SHEET. • 2/3 GRID: 3137
/nn7l nm_zn.c
PERMIT k SWOOYYY PID k YY MICHRII2.DWG
/UVV VM'. JLI /IV IMI...
BIOCYCLE 6000
4. th t° •��
i...
_ . 0 .....•- C LEGEND:
;....,
0 _N WURK�AND !
o. cc-zzzs 1. PRIMARY TREATMENT, SEPTIC TANK
a+•... .... .....�'� �:� 2. AERATION TANK
J. CLARIFICATION TANK
4. DISCHARGE TANK
5. SOIL ABSORPTION
ITOBBEN SPURKLAND P.E.I I LOT 1 MICHEL'S RIDGE SID I I SEPTIC SYSTEM SCHEMATIC I
203 W151h Ave GOLDEN VIEW DRIVE DATE' AUG. 14, 2000
Anchors a Ak 99501
` Me MICHFLSOHN AND DAUGHTER SHEET- 3/3 GRID: 3137
PERMIT a SVOOOXXX PID k XX
PERFORMED
LEGAL DESCC
✓E
1 po
!p
2
on
Munl;lrallty of Anchorage
DEPARTMENT OF nEALTH 6 HUMAN SERVICES
825 "L" Street, Allt:horage. Alaska 99502.0650
SOILS LOG — PERCOLATION TEST
.(ENGINEER'S SEAL)
f -w t _ fr ✓ DATE PERFORMED:- � .�/»��•
F= y, N k LI, N 1
E�, SE LiTownship. Range, Section: �t 3 ZI 12N, a 3 vL/
O.L9Q t'I.t L � r
GrAJLr, BCPU." G 5
� 1 1
3 t I
t •' Grab Sp.IwnD le
G^,,,Lcn a 1xi.
s
r
6 T Y
t
7 "
8
N
10
11
12
13
pr •a
14
_1}re)
1S
eV'I1lfsh..
T 7-
17
1�1
Is
-
19
WASGROUNDWATER —�
ENCOUNTERED?
S
L
IF YES. AT WHAT 0
DEPTH? P
E
cqt to Wav Aller
MaeilMlaa7 /0 OIIC
20 -j I '
uPERCOLATION RATE /I Immulevmth) )ERC HOLE DIAMETER
TLST RUN BETWEEN FT AND .—A FT
DISCLAIMER- GrnunflwatPr r^ndit-inne, indi ratan are for the dates shown Only.
Past and future presence and/or depth of grotndwater can not be predicted
from these ODser,V,a L,UnS. !�
PERFORMED BY: _..J S —_ I I • S CERTIFY THAT THIS 1T/EST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUI: ELINES IN EFFECT ON THIS OAT r. DATE: -,g 7 "Bfl
72.008 (Rev. 4/85)
f.
PERFORMED FOR:
LEGAI, DESCRIPTI
11
744 'Z
Munl:lrat(ly of Anchorage
DEPARTMENT 00: •IEALTH & HUMAN SERVICES
625 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
.. (ENGINEER'S SEAL)
DATE PERFORMED:—,V— I7-6.0
Township Range. Section: S�ct ?j2 1 12M, 23LO
r+= IITF DI AN
S cwt rX
s �r
GT -k tr stele
12
13
ea :•.�:
14
17
Cr.,,
V
WAS GROUND WATER A,O
ENCOUNTERED? 1`
s
L
IF YES, AT WHAT O
Dir°TH? P
E
at�.F.10 Water Alter It� y
Molilorinp7 � One:
Groh Nel Depth 10 Net
Veedinp Dote Time Time Weser OroO
19 U
-
20 PERCOLATION RATE 4 ( (minutevinth) PERC HOLE DIAMETER
I
TLST RUN BETWEEN L FT AND /() FT
DISCLAIMER• GrnnndwAtpr rnndi inns indirAtPd are for the dates shown Only.
Past and future presence and/or depth of grotndwater can not be predicted
rom these o erva n .
PERFORMED BY; PJ' __ 1 1, . _ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GtK ELINES IN EFFECT ON THIS DA117. DATE:
72-009 (Rev. 4/65)
6 3 -/ OF A4.
li
I ?ENGINEER'S SEAL)
a .0
..; Y
Munlclrallly of Anchor a .—• • F _, ) �•
DEPARTMENT OF nEALTH 6 HU $E0VRq2P2-;i01Qk
f
825 "L" Street, Alrt:horage, Alaska . �• ;
SOILS LOG — PERCOLAT)N1k`S;•,••,..✓'r.
°`IjpRDc
�/
G� ��St� ,) mob' �•"' DATE PERFORMED: bI117/V
PERFORMED FOR:
Township, Range, Section:
LEGAL DESCRIPTION: SLOPE SITE PLAN
13
14
is •
As
/ I
16,
17F+•••
s •;
18
19 �Q
p2rn� �1 C y
`'A -G r•, ve_/ C
S AAA W %.,. Lt4 G "' ULA- (
SP -
Ce.iLe_ SntiJY
J
N�'arc",r
(-iyD
�tiavR�T `
0 A41,
•` per^' .:,%, *',
r ............... �I
•C. -Y
bcr C; ual�nd • � �';�
CE -2223 :^Y
�'Rn ^cCi ` ti•
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Cloth to Wrler Aller
monitoring? silt:
1s•Z
20 -� LLa �`s1 b
PERCOLATION RATE (mmu1B/meh) FERC HOLE DIAMETER
TEST RUN BETWEEN FT AND FT
D I S C L A I KLLt--G=-LL!1 frnnndwatn Cr ' a{ • p a aro far the datoe shown Only.
Past and future presence and/or depth of groundwater can not be predicted
d
Yom e s e 0 ser 1( a n 5 CERTIFY THAT THIS TEST WAS PERFORMED IN
PERFORMED BY: J — 1
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIC ELINES IN EFFECT ON THIS DATE. DATE:
,, 14
72.006 (RN. 4/851
AUG -31-40 THU QQ;22 AM TOPPER SPURKLAHD 276601E P.01
PROPER'T'Y OWNER AGREEMENT
TOR TTM MAINTENANCE OF AN
' ON-SITE WASTEWATER DISPOSAL
SYSTEM
0:2000
This agreement, dated 8 ?, ?99-_, is made between the Municipality of
Anchorage Department of flealth and Human Services (DHHS) rind the property
owcer(s) of.
Loi' 1 11bbE
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 en;incer. lois inspection and
operation statement shall verify that the engineer has inspected at effluent and air
pumps, timers, and alarms, ind that any deficiencies have been repaired and that the
System is Moctioaing as designed.
(Signature)
uG-fn�C' �0�Qr
(Printed Name) (Printed Name)
----------------------- N .�.arize Here
State of /41AS,i_) On this -, day of , QQ(�
'P CGI m/iyx S w- pe-sonally appeared before We.
_cam who is personally known to me
whose idanci.y I proved on the basis of
whose identi:z I provdd on the bath/affirmation of
a credible witness
to be the signer of the %yr document, and ha/aha acknowledged that he/she signed it.�
`\SPP •C;fgc��
Q•• OTA4 •p ar Publ c
�m•� _ e _ < •Z= Hy commission expires �_D!
e �
PROPERTY OWNER AGREEMENT
FOR THE MAINTENANCE OF AN
ON-SITE WASTEWATER DISPOSAL
SYSTEM
This agreement, dated_Fe�oruAryIJ4r 2001, is made between the Municipality of
Anchorage Department of Health and Human Services (DHHS) and the property
owner(s) of.
Lo{- f mlchReL's Ridge
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, ind that any deficiencies have been repaired and that the
system is functioning as designed.
13utl.der
l ture)
`t P.uL ftl�te.l�t;Lst�i-�w�'S'at.
rcl�ohoLaokP4 I;LA4teraD st uc.
(Printed Name)
?ropo,s11cD Buyer
�r Oj
(Srggnnature)
MAuREEr, Jpf{til5-tea
��%ert 3o�tys�-alU
(Printed Name)
-------------------------------N::arize Here ----------r----------------------------
State of _ALASKA On this Al day of _ z mg OCA
pe-sonally appeared before me,
)_ who
whos
whose identi':l
is personally known to
e identity I proved on
to be the signer of
me
the
the
basis of (D�tEA7r$j
bath/affirmation of
a credible witness
acknowle that he/she signed
signed it.
'tel �iilP, .fry
otary Public
sion expires
Municipality of Anchorage
Development Services Department
Building Safety Division
Onsite Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage. AK 99519-6650
www.muni.orglonsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS
FOR A SINGLE FAMILY DWELLING /�, ,,� 1
Parcel I.D. O ' 13- 15 COSA# r V"la
1. GENERAL INFORMATION Expiration Date: _I P_ — / � " d a
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
MICHAEL'S RIDGE SUBDMSION: LOT 1
14800 GOLDENVIEW DR. • ANCHORAGE. AK 99516
ROBERT & MAUREEN JOHNSTON Dayphone 348-8311
c/o RAL INSPECTION SERVICES
Day phone
Unless otherwise requested, COSA will be heldby DSD for pickup.
2. NUMBER OF BEDROOMS: 'A 5 $ e'gsT`VA &'%ua Fo, Ge•400.v�S
3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well
N
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
Individual On-site
Individual Holding tank
❑
Community On-site
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems
Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may
be reissued with new water samples. (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 Finn CARNESS ENGINEERING GROUP, Ltd. Phone
Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, UD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily Idontifiable features. The operational life of all wells and
septic systems depend on the local soils condition, 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 the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the solo benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party Is not authorized, nor will It confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
337-6179
Date g'="/cL,
Conditional approval for bedrooms, with the flowing stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Reort
Nitrate Advisory Other
ON-SITE
WATERANU
WASTEWATER
PROGRAM '
SENDS,\\\
//��/JJl)1)111111
Original Certificate Date: — OG
Municipality of Anchorage
Development Services Department
Building Safely Division
On,Sbe Water 6 Wastewater Pmgram
4710 Bregaw Street
P.O. Bou 1966M
Anchorage, AK 995196650
www.murmi.org/onabe
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: MICHAEL'S RIDGE SUBDIVISION, LOT 1 Parcel IDD/ 7 3 /5-
A. WELL DATA
Well type PWAM If A, B, or C provide PWSID# N/A
Date completed 10/4/2000 Santry peal (YM)YES
Total depth 94 ft. Cased to 94 ft.
FROM WELL LOO
Date of test 10/4/2000
Static water level 35 ft.
Well production 15 O.P.M.
WATER SAMPLE RESULTS:
Web Log (YM) YES
Wires property protected (YM) YES
Casing height (above ground) 18+ 1n,
AT INSPECTION
7/27/2006
34 ft.
4.3 g.p.m.
Colborm _ Q_ colonies/100 ml. Nitrate r vu mg.IL. Other bacteria cdonies/100 ml.
Arsenic: _&D,_ugJL. Date of sample: 7/25/200a Collected by: GEG. Ltd.
B. SEPTIC(HOLDINO TANK DATA
Tank Type/Material SEPnCA=L + BIOCYCLE Date installed 9/25/2000
Tank size 1000 + BIOCYCLE gal. Number of Compartments 2244 Cleanouts (YM) YES
Foundation cleanout (YM) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES
Date of pumping 7/27/2006 Pumper McDONALD'S PUMPING
C. ABSORPTION FIELD DATA
Date installed 9/25/2000 Soil rating Cq.p.d ftlbdnn) 4
Length 22 ft. Width 10 ft.
System type BED
Gravel below pipe 0.5 ft.
Total depth 4.96 ft. Eft. absorption area 220 fe Monitoring tube YES Depression over field NO
Date of adequacy test 7/27/2006 Results (Pass/Fab) PASS For 6 bedrooms
Fluid depth in absorption field before test DRY in. Water added 915 pal. New depth 01n.
Elapsed Time: 0 min. Final fluid depth DRY In. Absorption rate >= 900+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yea, give date
D. LIFT STATION
Date Installed X25/2000 Size in gallons 1600 Manhole/A=M (YIN) YES
"Pump on" level at 30.0 in. •Pump otf level at 13.51n. High water alarm level at 40.5
Datum BOTTOM OF TANK Cycles tested 3 Meets alarm ti circuit requirements? YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAift station on lot 100'+ On adjacent lots 1000+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main N/A
Sewer /septic service line 25'+
Public sewer manholeldeanout N/A
Holding tank N/A
Animal containment areas 50'+ Manure/animal excrete storage areas 1000+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 1001+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parkinghrehide storage 0'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
*BIOCYCLE MAINTENIWCED IN JUNE - NEW BLOWER INSTALLED 6/16/2008 fSEE MATCHED RECORDS)
G. ENGINEER'S CERTIFICATION
I certify that I have detemrined through held inspections and 1 ! 7*
review of Municipal records that the above systems are in •...."' .. ' ' ' . """•"'
conformance with MOA COSH gu/deUnes in effect an this
date. Y .......
A. massa
Engineer's Printed a JEFFREY A GARNESS �fy 79
Date `b ! z o 6 •' 1��i�
COSA Fee, 1-130. 00
Date of Payment 9 1 X /01
Receipt Number
(Wv. tiros)
Waiver Fee $
Date of Payment
Receipt Number
SGS Ret#
1064143001
Client Name
Garness Engineering Group, Ltd.
Project Name/N
14800 N. Golden View
Client Sample ID
Ltl Michael's Ridge
Matrix
Drinking Water
Sample Remarks:
All Dates/rimes are Alaska Standard Time
Printed Date/time 08/032006 8:07
Collected Dale rime 07/25/2006 9:08
Received Date rime 07/25/2006 10:15
Technical Director Stephen C. Ede
Allowable
Prcp Analysis
Parameter
Results
PQL
Units Method
ContainalD
Limits
Date Date
Wit
Metals by ICP/MS
Arsenic
ND
5.00
ug/L EP200.8
C
(<10)
07/26/06 07/31/06
Nil
Waters Department
Nitmtc•N
ND
0.100
mg/L EPA 353.2
D
(<10)
0725/06
ALR
Microbiology Laboratory
Total Coliform
0
col/IOOmL SM209222B
A
(<1)
0725/06
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ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND
REPAIR AGREEMENT
MEMORANDUM OF UNDERSTANDING
BETWEEN,AIVNICIPALIIX OF ANCHORAGE
j
AND }-1-01Z lY Un? -
THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this
day of of 20MI, by and between i• HA 'PyVtkn7Z-
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 (AW WTS), described as located
at Anchorage, Alaska.
1000 6motlj Vitt
2. Definitions.
A. Alteration. Any change to the design or function of an AW WTS 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 AW WTS 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.
These approvals certify that the systems are adequate for the homes that
they support and meet the codes that were in place at the time of system
construction.
C. Damage. Any man-made or natural change in a system that would inhibit
the system from performing as designed.
D. Maintenance and Repair. The scheduled and as needed replacement of
existing parts, components and pieces of an AW WTS that were included in
the original design which would allow the AW WTS to continue to
perform as designed.
E. Permit (Construction) An On -Site Wastewater Disposal System
Construction Permit as defined by AMC 15.65.
F. Permit (Operating) An Advanced Wastewater Treatment System
Operating Permit. An annual permit, issued by the Municipality, that
allows the Owner to operate an AW WTS, upon meeting all the
requirements of this agreement, the conditions of Operating Permit, the
requirements of the On -Site Wastewater System Construction Permit and
all relevant provisions of AMC 15.65
3. Fee. Owner shall pay to Municipality an annual fee of 222.0
($,K-00), payable on or before the issuance of the operating permit and annually
thereafter. The annual fee is due on or before the anniversary date of the approval by the
Municipality of installed system.
4. Term. The term of this Memorandum of Understanding shall be for the life of the
A W WTS.
The term begins on the date of approval by the Municipality of the installed system and
shall continue while the AW WTS system is in use or operational or until the property is
sold or title is transferred by owner and a new certificate of On -Site approval is issued to
the new owner or transferee of the property.
5. Alterations, Installation and Removal of Additional Equipment. Owner agrees
not to make any alterations, removal of parts or additions to the AW WTS without a
Construction Permit from the Municipality.
6. Maintenance and Repairs.
A. Throughout the term of this Memorandum of Understanding, the Owner shall
maintain AW WTS in good repair. In addition, it shall be the responsibility of the
Owner during the term of this Memorandum of Understanding, and any extensions or
renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2)
maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs.
Further, Owner agrees to comply will all applicable ordinance, laws, regulations,
rules and orders for the AW WTS.
B. Owner agrees to provide the Municipality a written schedule of routine
maintenance and repairs which have been performed on the system pursuant to the
terms and conditions contained in the Owner's AW WTS Operating Permit. This
schedule shall be submitted to the Municipality annually upon the renewal of the
permit. The schedule of maintenance and repair contained in the Owner's AW WTS
Operating Permit is:
C. Owner acknowledges that the fine schedule for failing to maintain and repair an
AW WTS are codified in AMC 14.60.
D. Owner agrees that only maintenance, repair personnel certified by the
Municipality will inspect and make any necessary maintenance, repairs or permitted
alterations to the system.
E. Owner agrees to grant the Municipality reasonable access to test and inspect the
AW WTS upon 24 hours written notice.
F. Owner agrees that any sale or transfer of title of the property will not occur
without a new Certificate of On -Site Systems Approval.
G. Owner agrees that the relevant provisions of the standard specification guidebook
for AWWTS is the governing professional guidelines for the construction,
maintenance and repair of the Owner's AW\VTS.
7. Nonwaiver. The failure of either party at any time to enforce a provision of this
Memorandum of Understanding shall in no way constitute a waiver of the provisions,
nor in any way effect the validity of the Memorandum of Understanding or any part
hereof, or the right of such party thereafter to enforce each and every provision
hereof.
8. Amendment.
A. This Memorandum of Understanding shall only be amended, modified or changed
by a writing, executed by authorized representatives of the parties, with the same
formality of this Memorandum of Understanding was executed and such writing shall
be attached to this Memorandum of Understanding as an amendment.
B. For the purposes of any amendment modification or change to the terms and
conditions of this contract, the only authorized representatives of the parties are:
Owner:
Anchorage: Purchasing Office
C. Any attempt to amend, modify, or change this contract by either an
unauthorized representative or unauthorized means shall be void.
9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of
Understanding shall be brought in the Superior Court for the Third Judicial District of the
State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and
obligations of the parties under this Memorandum of Understanding.
10. Severability. Any provisions of this Memorandum of Understanding decreed
invalid by a court of competent jurisdiction shall not invalidate the remaining provisions
of the Memorandum of Understanding.
STATE OF ALASKA
THIRD JUDICIAL DISTRICT
M11 TCIPALITY:
By:
Title:
Date:
) ss.
The forego �n� instrument was acknowledged before me this L day of ,
20 , by' #` q&'mica the fiWM--k— of
(JYj2De,y 14 , on behalf of the Municipality of Anchorage.It
rARY PUBLIC FOR
Commission expires:
Municipality of Anchorage
W.5-1-0A,
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw SL
P.O. Box 196650 Anchorage, AK 89519.6650
ww v.cl.anchorage.ak.us
(907) 343.7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D.. d17-1 15 _ HAAS HP D / o / 71
Expiration Date: A - L- b
1. GENERAL INFORMATiON
Complete legal description µ' e.Ire,As ,"e! a g. !l° 1
Location (site address or directions) l rl %�* •+ vi a v -
Current Property owner(s),?ad- M—ful,els,-LH Dayphone f7aA-3-r,7.i
Mailing address
Lending agency Day phone'
Mailing address
Real Estate Agent Day phone
Mailing Address
Unless olhortivlse requested. HAA rill be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
1911*
individual On-site
IT
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (OSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paregrzph 5 by an Independent professional cMl
engineer registered in the State or Alaska. Certificates cf Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single family cn-site wzstevreter disposal endlor ureter
supply system. DSD elso issues HAAs upon request to homecvners. Certificates of Health Authority Approval ere
valid for 90 days from the date of Issue fcr properties served by a private or Class C well end may be reissued with
new water sample results less than 30 days cid. (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 Munic!pzlity or Anchorage Is not respcnsible fcr errors or emissions 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 verily 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, l further verify that based on Lhe information obtained from the
Municipality of Anchorage fides 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 r,G
� fOjJhGN �pvLaKW E Phone %9-IS17
Address3 lV �eSLlr aZD
Engineer's Printed Name •i OW -e H s'nvrlClaucQ Dat:
1'r' x rp.i ; ENGINEER'S;; .
r, • .. ��Srph1P •�.
5. DSD SIGNATURE
_ZSApproved for _G bedrooms.
Disapproved. `
Conditional approval for bedrooms• with the following stipulations:
Additional Comments
Attachments:
HAA Checklist X
Septic System Advisory
Well Flow Advisory
ONSITE
PROGRAM
Maintenance Agreements
Supplemental Engineer's Report
Other
By: W. Original Certificate Date:
vt"Azoo,
MunicipaUty of Anchorage : ,•• •.,,
Development Services Department ._
BuiMV Safety Division ...
on -Site water & wastewater Program
470D South Brapaw Sl.
P.O. Box 198850 Ancharape. AK 99519.8850
www.cl.anchorape.ak.us
(907)343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Lepel Description: HiC,l,e1S ;dC Lot I ParcallD: (ia.-IS
A. WELL DATA
Wan type K A, B. or C provide PWSID 0 -t/6 Wed Lop (YIN)
Date Completed! /0 ( Sanitary seal (YIN) �` Wires properly protected (YIN) _
Total depth 4q R. C83edlo_V_fL C=Nhelpht(above Wound) _LIn.
FROM WELL LOO AT INSPECTION
Date of lest 14 /v I
static water level 3 e R. R•
Well production 1 >; p.p m. 9 -
p.m -WATER SAMPLE RESULTS:
Cdiform _0_,coloniasl100 ml. Nitrate R9, _m9 -A. Oder bacteria 4 ooloniesl100 ml.
Data of sample:
y2 a Collected by 7-S
B. SEPTICIHOLDING TANK DATA
Tank TypelMaterial AM (k b ` Z' k Date Installed
Tank size lbd)O gel. Number of Compartments Cteanouts (YIN)
Foundation cleanout (YIN) Depression over tank (YIN) High water alarm (YIN)
Date of pumping _ NVA Pumper I`*/A
C. ABSORPTION FIELD DATA
Date installed �17%Soil rating (g•p•dJV or Rtlbdrm) System type �c
Length Width 1 C R. Gravel below pipe O. 3 R.
Total depth R. Eff. absorption area A�O R' Moniforing tube Daprassion over flat P%
Data of adequacy test M/14 Results (Pass/Fall) ✓ For ✓bedrooms
Fluid depth In absorption field before test '✓In. New depth�in.
Elapsed Time: ✓ min. Final fluid depth ✓in. Absorption rate >= ^� g.p.d.
Any rejuvenation treatment (pest 12 mo.) (YIN d type) If yes, give date
D. LIFT STATION
Date Installed q > / Size ingallons /bety MaMoWAccess (YIN)
'Pump oR' level aty �% n. Koh water alarm level at .2 A XL in.
Cycles tested ✓ Mesio Sturm a circuit rovinmsnts4 �
'Pump on' level atMin.
Datum /
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAift station an lot I I IS On adjacent bis i / D -b
Absorption field on lot ISO On adjstxnI loll too
Public sewer main , N/P. Pubile sewer manhole/cleanout IS41s
sewer /septic aervica l ne It tP Holding tank N,/Af
SEPARATION DISTANCES FROM SEPTICINOLDING TANK ON LOT TO:
Building foundation 16 Property line AQ Absorption field .fib
Water main N/^ Water service line i t; O • Surface water N l O
Wells on adjacent lots 1 1 Vo ,
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line BuBdtnp blWation to & Water main N%.
Water service line Surface water N 10 Driw.wy. part lrg/vehide storage 5!7
Curtain drain µlo Wells on agecent W >
F. COMMENTS
HAA Fee$ 3da.00
Date of Payment qjW&I
Receipt Number 5WITA 16S
(Rev. 12100)
Waiver Fee S
Date of Payment
Receipt Number
'.�:
G. ENGINEER'SCF.RTIFICATION
�"�':'� W
I cot* at I have detemAwd through field krspectloru and
th
r* f• : ,�07tt j•1 44
N., �..NY�.• 1.1
review of Munk(pal records that the above systems are in
v...
,
conformance with MOA HAA guidelfnes Az eRed on this date.
c'� N
1 J kl
cndN
04
Engineers Printed Name e A K
.,�
Date
HAA Fee$ 3da.00
Date of Payment qjW&I
Receipt Number 5WITA 16S
(Rev. 12100)
Waiver Fee S
Date of Payment
Receipt Number
APR -29-01 16:10 Mt -
CUE Ret. tr:
Client Name,
Project Mama:
Cliar4 Sample ID:
Matrix -
ME Environmental Services Inc.
Laboratory Division
1012171001
Tobben SpurWnd
Na
Lot 1 Michet's Ridge
Drinitin0 "later
200 W. Potter Drive
Anchcragc. AK 99-1e
Tei: (907) 562.2343
Fax: (907) 5GI.5301
Client PON:
Pi Wed Datefrlme:
CcF,ected Datefnmc:
Received Oatcnime:
Technica! DireVer.
7-112 PAI/02 F-164
13/21
04'19.'01 16:00
04.27r01 18:00
0427101 0.8:45
Stethen Ede
Mewable Prep Anaiysm
Parameter Results PDL Units Method Umits Date Date Irot
Total Celdcrm (MF)
D C0111 00 ml SM92229
0427!01 SKW
Nitrate 0.6U 0.5 "k EPA300 10.0 6427101 SCL