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HomeMy WebLinkAboutFOREST RIDGE BLK 2 LT 16Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page of ON -SITE WASTEWATER INSPECTION REPORT Permit Number:.OSP241079 PID Number: 017-112-83 Dwelling: Z Single Family (SF) n with ADU n Duplex (D) FI Two Single Family Project: n New Z Upgrade Name ANTHONY & TIFFINEY FRENCH ABSORPTION FIELD n Deep Trench n Wide Trench E Bed El Mound Site Address 15151 OXFORD BLUFF CIR, ANCHORAGE El Other Phone Number of Bedrooms Soil Rating Total depth from original grade 1 4 2 GPD/SF 1 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 0.5 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot FOREST RIDGE 2 16 Fill added above original grade VARIES 1.9-1.95 Ft. Gravel length 20 Ft. Township Range Section Gravel width 15 Ft. Beds: Number of Lines 3 Distance between lines 5 Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer i I Total absorption area Number of trenches Dist. between trenches Lift Station From Tank Field Tank Line 300 F t2 Ft. Well 50'+ 50'+ 1 25'+ TANK lZ Septic 0 S.T.E.P. El Holding El Other ADVANTEX Manufacturer EXISTING Capacity Gal. Surface Water 50'+ 50'+ Material Number of compartments I Lot Line 5 5'+ NA Foundation 10'+ 10'+ 1 LIFT STATION Manufacturer EXISTING Capacity Gal. Remarks FIELD INSULATED & NEW VALVE TO EACH BED. Alarm location Electrical installed by Tan PIPE MATERIAL House to tank 3034 drainfkieldto 3034 Installer PCN .... .... ..... Drainfield 3034 CO/MT 3034 Inspector FWC BENCH MARK (Assumed elevation) 100 ft Inspectes:tion 1" 2 5/20/24 nd 5/20/24 da Location and description 3 d 5/21/24 4 1h 5/22/24 ITOP OF NEW VALVE LID ON -SITE WATER AND WASTEWATER SECTION APPROVAL or— A Conditional Approval: Date TM .... .... . ......... Septic System0 Approved - .. .. ... ........ Curds Huffman ig,,* CE128991 Date .6/6/24 PROFESSO'� Note: this approval does not include well permit requirements. --0- NN, (Rev 05/02/18) PID:017-112-83 PERMIT:OSP241079 FIRST WATER CONSULTING FOREST RIDGE BLOCK 2, LOT 16 c-0-Im i r-D0� O m-+(1)m �cnEz Xmrn `rl Om=Z �` 0 =a°� C/) iU m�'z° =0 �m� y mn r zz=0 m Om0 -Crnmm' 4-0 C7 M o 0 --i I I �� C)°zMm � s0 _►� sad a X r�- p6� ova � � V7 rn r Q CD to WO Z5�� iU < T Cr cfl n. e ` �,N`� 30 N� :. ,. 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Y D m o to V 0 a) 00 m-- o CD Qo 3 ° -� / N • rn • -TI° 00 v00 CD o00 cn J- 00 00 CL CD 00 CD o -0 CD O CD 0 ` <y • ae-1• �/ -D•I oET ETmaD �. n� � 20 • : ��� 00 MUNICIPALITY OF ANCHORAGE ,111€-„t. On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 r i hftp://www.muni.org/onsite DC1)aI-tIII ent On -Site Wastewater Disposal System Permit Permit Number: OSP241079 Effective Date: 5/13/2024 Work Type: Septic Upgrade Expiration Date: 5/13/2025 Tax Code Number: 01711283000 Site Legal Address: FOREST RIDGE BLK 2 LT 16 G:3137 Site Mailing Address: 15151 OXFORD BLUFF CIR, Anchorage Owner: FRENCH ANTHONY & TIFFINEY Lot Size in Sq Ft: 41969 Design Engineer: FIRST WATER CONSULTING Total Bedrooms: 4 This permit is for the construction of: Q Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: S S C-- Date: Issued By: tL Date: 2 MUNICIPALITY OF ANCHORAGE Development Services Department a ' Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON -SITE SEPTICM/ELL PERMIT APPLICATION Parcel I.D. 017-112-83 Property owner(s) ANTHONY & TIFFINEY FRENCH Day phone Mailing address 15151 OXFORD BLUFF CIRCLE, ANCHORAGE, AK 99516 Site address 15151 OXFORD BLUFF CIRCLE, ANCHORAGE, AK 99516 Legal description (Sub'd., Block & Lot) FOREST RIDGE BLOCK 2, LOT 16 Legal description (Township, Range & Section) Lot Size 41,969 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field E] Initial ❑ Single Family (SF) x❑ Septic Tank ❑ Upgrade (w/wo ADU) Holding Tank ElRenewal ElDuplex (D) ❑ Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 9 �- Waiver Fees: Date of Payment: 2 y Date of Payment: Receipt Number: Permit No. Z C( I b J Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewate r\Forms\C lie nt Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! May 6, 2024 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: FOREST RIDGE BLOCK 2, LOT 16 The existing septic field has been found failed and per the owner a new absorption field will be installed to upgrade the existing septic system on the above referenced lot. We propose to basically install a duplicate absorption field of the existing 2006 field with the existing Advantex system to serve the 4-bedroom residence per the attached design. The design is based on the test hole #2 conducted in the fall of 2005 by Mike N. Anderson, PE. Groundwater was observed at test hole monitoring on 11/25/2005 at 5.5’. The bottom of this Advantex treated effluent absorption bed will be 4.5’ above the monitored groundwater per these record drawings / test hole. The slopes are moderate at 0-3% at the proposed upgrade location. The lot and area are served by private water with no known private wells within 50’ of the proposed septic system. Based on visual observations and review of available information, the design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241079, Curtis Townsend, 05/13/24 FIRST WATER CONSULTING FOREST RIDGE BLOCK 2, LOT 16 DESIGN CALCS: NO WELLS WITHIN 100' OF PROPOSED SEPTIC TANK NO SLOPES >25% WITHIN 35' OF PROPOSED AX FIELD. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241079, Curtis Townsend, 05/13/24 FIRST WATER CONSULTING DESIGN DETAILS: FOREST RIDGE BLOCK 2, LOT 16 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241079, Curtis Townsend, 05/13/24 Municipality of Anchorage Page 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: ~,)' eff'ffr'Ol~P~ PIDNumber: OI'7 I1~.~_ N.me: ¢,.,O~-O~ q E, UILDF_.I~.~ ,TIOC.,. Wastewater System: I~New D Upgrade 15t51 c~Fo~D ~LLIFtc C.4,qCLg_ ABSORPTION FIELD WELL: '~New D Upgrade Gravel width: Number Of lines: S ~ Ff~ 4.,G Ff. Dal Dr lied: Slahc Water Level: Installer: Da e In$1alled: TANK SEPARATION DISTANCES ~ Septic i'1 Holding ~ S.T.E.P. su,a~e ~C~Yc: - LIFT STATION Remarks: ~',~}"~(:~'X ~3~"' Lp,~_C, Ch, PSD BENCH MARK Department of Health.at~d Humao.Ser'vices approval Reviewed and approved bj~-----~~~ Date: OXFORD BLUFF GIR. O Sa FOREST— RIDGE SUBDIVISION zr2 LOT 16 , $LOCK 2 ! 41, q to q s . F• ...fit. O ... ;a • ff �'fNi " AL ST•k'UCTt)E' RA s - SuiL•.¢ � T " i �t�'.••' ' ;• •;9 weuqsv�� P or A f 714 • too ii M• ,Y 94ot6�- 'F'io�ot�I�za� s�.cc►or,� �-a' (� � .:... n�cs� .. .. ., . 66 lt�.S Sw; �IIL r t �'rc+Ti Allan W. M Itt <v j 8 s 39 . �!/ '._. I f t % .� Y / I �FVC x 3 Q+ bb t o # �.., No. 4977-E is &Ft AVEL q pRIVE ti Sk II C -tJ D►� CtjV = 41 3. 1 3t? S',s' (cu g, �OfJ�� � -���QQ�� z:x53 L. a T'E� Vlou_-# z F. ` P. CA MT- - N © V)15 Lai W rr44 rt,) top' Ot S---P ,r1t. IFIELO \ tTtt t 0 1 mac° ti. fc�bFt of WELL O. GASTALDI LAND SURVEYING Jeff A. Gastaidi, R.L.S. 4726 West 88th Ave. Anchorage, Alaska 99502 PHONE 248-5454 GRID DATE 3137 1 9-za-g4 F. S. - I JOB NO. 94 -13 1►tJC�t M.K. u- I hereby certify that I have surveyed the property depicted above and that no encroachments exist except as indicated. It is the responsibility of the owner to determine the existence of any easements, covenants or restrictions which do not appear on the recorded subdivision plat. Under no circumstances should any data hereon be used for construction or for establishing boundary or fence lines. ANCHORAGE RECORDING DISTRICT, ALASKA O M EM57Wv $U1L1>1N& o�tb�aw- 1s 7 ,f 116 C-�Ut7 it2.Z8 1SG N rfla� TLX FENCE (APX•) z.xs2 t� WELL FP•CANT• i0 Li STATiO�J N 89 * 4B ' 37 "E 169, GREENPO I NT Z rlt �4�'t61lp►N.&LAWii CL}— 4 /� • sl{Jfi �w FAsriG �k ;op FES514 � iQ.S' S�trJt=1Q %�►'R.®�.si�.'�''�r Top f�ROlxn� �FJL% PtpE ea to!•3Pi 9g,O 13514.bq Ss Ioz.3z '>7-7 ? j-3L Sz 107-.10 97 y 29.30 La¢t gB.s6 97-7 Z9.3a 1`'``T. 17-1,13 419,s i16•Z7 hATZ Iz0.03 11q.1. Itb.Z$ face'3 t21.'L7 1%9.4 Ili Z3 kTy IZ1.46 I19.S Its ZZ WELL. Io3,9a Ipi. b W 32� W s --.------ 1 O' T EV E E EL EC . E S MT. i 270. 38' AVENUE O M �4 R�3 0 oc W ILI INSPECTION REPORT MUNICIPALITY OF ANCHORAGE, BUILD!NG SAFETY DWISION 3500 'EAST TUDOR ROAD · INFORMATION (907) 786-8211 NSPECTIONS (907) 563-3464 NDATION - BEAM __ FRAMING -- INSULATION -- )CK FINAL )THER ~ ri NO NONCOMPLIANCE OBSERVED g ELEC.$ERVICE _ [::~ PLBG. ROUGH~ g ELEC. ROUGH . GAS TEMP. -- rlrl ELEC. FiNAL- [~ GAS ~THER ~/,~ ./f/~,.i/ MECHANICAL -- - ri _~- ~,,,~,~F ~c..~,.~- . ~ FIRE FINAL - ~ PLBG. FINAL- .. ZONING ~ ~ OTHER- ~ CORRECTIONS ESSENTIAL AS EXPLAINED BELOW COMMENTS ~ DATE t/ / ' N WHE~. CORRECT,ON$ ARE ~AOE. pLE*SE CALL FO. INS.EC'.O - DO HOT REMOVE THIS HOTI~ ~ (Re~. 11,'117) . LOCATION OF WELL ., ' 14 · SUeOIVISION . LOT BLO~ LOCATION/SKETCH: DEPTHS MEASURED FROM:l'lcasing top r'lground surface STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES ., DIVISION OF WATER WATER WELL RECORD WELL OWNER: BOREHOLE DATA: Material Type and Color Depth From To WELL DEPTII: / DATE OF COMPLETION Dept[', of hole: .~ ~ ft Depth of casing: /~ 't '~---1 7 ' /~7~/ I-l ground surface DEPTI. I TO sTATIc WATER LEVEL: ./-/~7 It below I-q~op ?f casing Date: ~ / 7 / ~C~' METHOD OF DRILLING: I~,alr rotary I-] cable tool n other USE OFWELL: I-~:domestic I"1 irrigation [] monitor D public supply [] other. CASING STICK-UP: ..~ ft. Diam: ~, In. to/2'clt Casing type: ,_%"'~'~. ,~"~/ ~,. in. tO _Z~__C~t WELL INTAKE oPENING TYPE: [] open end [] screened /[]~pedorated [~Lopen hole Depths of openings: /~;'/ to /(:~'~ ft SCREEN TYPE: Diam: In. SlotiMesh Size: Length: It GRAVEL PACK TYPE: Volume used: Depth to top: GROUT TYPE: Volume: Depth: l,rom It to. It DEVELOPMENT METHOD: Duration: PUMPING LEVEL AND YIELD: ~?'~ It after ,,,~r/' hfs pumping ,. ~---"gpm PUMP INTAKE DEPTlt~ tt Ilorsepower: __ WELL DISINFECTED UPON COMPLETION? [~'.YES r-I NO CONTRACTOR INFORMATION: Regi§t~dx/., _Business Hame ' Signature of Authorized Respres~ative REMARKS: PLEASE MAIL WHITE COPY OF LOG TO: DNRIDIVlSION OF WATER PO BOX 772116 EAGLE RIVER AK 99577-2116 PAGE I OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HTSVL~N SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW940164 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:TAYLOR WILLIAM F III & TAMI D OWNER ADDRESS:lS151 OXFORD BLUFF CIR ANCHORAGE, AK 99516 DATE ISSUED: 6/02/94 EXPIRATION DATE: 6/02/95 PARCEL ID:01711283 LEGAL DESCRIPTION: FOREST RIDGE BLK 2 LT ~6 LOT SIZE: 41969 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CON'£KUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ~r~CHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (~8AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DH/{S AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) 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: BA~EDi6~ii~'::~S'%-ED'JSOIL' RATING' OF' X 6 "MIN/IN' PERC,- THE BASAL'AREA-:OF TI{E:BED MUST BE 750 SQ.-FT~-THE-MAXIMUM WIDTH I~2:~SFT.~X. 50-FT.. ~/'//,,~ il/'7 ...................... '; RECEIVED BY: ""'//--~~// ,~ DATE: / /; Murfitt Company_ CONSULTING ENGINEERS & TESTING 13810 Venues Way * Anchor~, Alaska 99515 · Teleph~e (907) 345.2737 · FAX (907) 345-3264 Municipality of Anchorage Department of Health and Human Services 825 L Street ' P.O. Box 196650 July 21, 1993 ATTENTION: Mr. John Smith, P.E. RE: Well and Septic System Permit Request Lot 16, Block 2 Forest Ridge Anchorage, Alaska Colony Builders, Inc. Our Job 93-213.09 Dear Mr. Smith: Attached is the design documentation submittal for well and septic system permit approval for the referenced residential lot. :The proposed design is for a three bedroom, single family dwelling for Colony Builders, Inc. of Anch. orage. Note that we have proposed relocation of the well on Lot 16, Block 2 from the Plated well location due to site limitations for the construction of mound systems. There appears to be no conflict with surrounding septic installations with the proposed relocation. Based on our review and testing we do not fore see any adverse effects on surrounding properties by the installation of Ihis proposed system. We therefore request that you approve this relocation. We are concerned, however, that previous percolation testing excavations at this particular site may have adversely disturbed the soils. In this regard, we have attempted to locate the new systems in areas which may have not have been disturbed. This can only be confirmed when the actual site construction inspections are performed and accordingly, the bed area may have to be increased to accommodate previous site disturbance. We look forward to a favorable review. Please call, however, if you have any questions. Yours truly, A.W. Murfitt Company ATTACHMENTS: Soils Test and Percolation Test results. Soil Grainsize Analyses. Site Plan and Section. Municipality of Anchorage DEPAnTMENT OF HEALTH & HUMAN SERVJ~~.~ 825 L Street. Anchorage. Alaska g9502.-~6~0. SOILS LOG -- PERCOLATION ' PERFORMED FOR:. LEGAl. DESCRIPTION:.. 3 4 5 :6 7 8 9- 10- I1 DATE PERFORMED: Township, Range. Section: ~F ~/ Tr2.1~ 13. ~tr/..3.~3 / 14 18- 19- 20- ENCOUNTERED? IF YES, AT WHAT GL E Depth Io Water Alter . ~. Joflilotln§? ~ DII~ ~ Reading Dete Cross Net Depth to Net Time Time (/jG.~~ W.rer 4"~ Crop ~,h~ '~ " /~ '1~ 0 ~, S~ 0 " ~/.,o,( /o /~,~ PERCOLATION RATE _ / (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN . 0.~ FTAND /-'/. FT (~0~'11( .' /tO b~J~.JJ) LW. MURFITr COMPANY (~ · ConsultinE Ensineers & Testing ACCORDANCE WIT H ALL STAIE AND MUNICIPAL GUIDELINES IN EFFE~90~d ~1~1][. CATE: . G/'~ ~/~ 72 ~8 ~flev 4,85) PERFORMED FOR: LEGAL DESCRIPTION: 4 5~' 6- 7- g- 13, 14 15 16 17 18 19 20 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN 825"L"SIr . _ _ eet, Anchorage, Alaska 99502~650 SOILS LOG -- PERCO~TION .~. 0Jfl7~?_. ~'/- '7..7~/ ENCOUNTERED? IF YES, AT WHAT DEPTH? Oeplh Io Water AJler ,~' -) Monitoring? ~"~.. ~ tllll IIII PERCOLAIlON RATE ~ (minutes/inch) PERC HOLE DIAMETER ~// TEST RUN BETWEEN 1.3 FTAND ~,~ FT : , , ' ' ~/~ . I ~~~YTHAT THISTE~T WAS PERFORMED IN . _ 13~10 Venus Way 72.~8 (ney 4,85) (~7) 345-2737 · (;;RAIN. SIZE DISTRIBUTION TEST REPORT 90 __ 80 I 70__ 60 40 __ 30 I 20__ 10 0 200 100 % -I- .3 ' ' 0.0 0.0 10.0 GRAVEL 20.8 .33.6 1.0 O.1 GRAIN SIZE - mm % SAND 60.2 5.3.6 0.01 SILT CLAY 19.O 12.8 I:1 LL PI D85 D60 DSO 16.41 0,77 0,51 15,85 3°02 1.60 0,394 0,0989 DIO cc:I Cu MATERIAL DESCRIPTION · SILTY SAND with GPJ~VEL, MOISTURE: 24.6~ · SILTY SAND with GRAVEL, MOISTURE: 9.7~ Project No.: 93-213.09 Project: Forest Ridge Subdlvlslon Colony Bldrs, · Locotion: Lot 16, Perc Test 1 - 2 · Locotlon: Lot 16, Perc Test 2 2 . Dote. June 28, 1995 USCS I AASHT0 SM A-l-b SM A-l-b Remorks: Second set of perc tests for Lot 16. Figure No. Permlt'No. Page ~ o! ~ Municipality of Anchorage 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 LegalDescription: LOTIG.,{~ Fo'R,C:51 ~lO~.E PID No.: Permit No. Page ,,~' of ~' Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O, Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-SUe Waslewaler Disposal System and/or Welt Inspection Reporl Legal Description: LoT IG ~'o EsT' I::'&E' I ¥'DIA, L~Er~ TU~,E PID No.: PLAN MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this 3 Day of Ty^e of 20 2Y , by and between r` L G' 6 Q N A o N , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: I. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as located at (legal description) AN ADVANTEX SYSTEM FOREST RIDGE BLOCK 2, LOT 16 2. Maintenance, Repairs and .alterations. (Owner is required to read, understand and initial each section) 5ce Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. Ga It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). ECL Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Pagel of 3 56( Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. 6 Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. fCt_ Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. f ct Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. EGG Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality arc the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. IF CC Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent ,jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 (61 nxnure) Date, print name STATE 0FALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The fore-oinu, 111SM1111CIlt was ockuo before mcthis � dovo 2U��� b '[} --- --- UU 41 N-,fv Commission expires: OTA u v ��`�L�/__� (siuoa(u/u) Date: � (rcr,05/|A/20|A} Puuc3of3 MUNICIPALITY OF ANCHORAGE Development Services Department / Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 017-112-83 Certificate of On -Site Systems Approval Expiration Date: 5/1/2025 Legal description FOREST RIDGE BLK 2 LT 16 Site address 15151 OXFORD BLUFF CIR Anchorage AK Current property owner(s) FRENCH X The On -site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: New owners to call Anchorage Tank to schedule pumping of the septic tank once they move in. Original Certificate Date: 6/12/2024 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA ApprovaLJune 2022 1. GENERAL INFORMATION Parcel I.D. 017-112-83 Complete legal description FOREST RIDGE BLOCK 2, LOT 16 Location (site address) 15151 OXFORD BLUFF CIRCLE, ANCHORAGE, AK 99516 Current property owner(s) ANTHONY & TIFFINEY FRENCH _Day phone 2. ON -SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: Z Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: E Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: E Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age - See advisory if steel older than 20 years 6. ABSORPTION FIELD: M AWWTS Z Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On -site staff to verify the accuracy of the information provided. COSA Fee $ 2- GO Date of Payment -5- 3i 2t COSA# 05C29 / 16 �'( Waiver Fee $ Date of Payment Waiver # COSA Application.doc COSA Checklist.docx COSA Checklist Legal Description: FOREST RIDGE BLOCK 2, LOT 16 Parcel ID: 017-112-83 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 6/7/1994 Total depth 388 ft Cased to 120 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 5/1/24 Static water level at beginning of test 40 ft. Well production at time of test 2.2 gpm Water storage tank volume NA 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 5/1/2024 Comments B. TANK DATA Measured operating fluid level in septic tank NA Date of pumping ADVANTEX SYSTEM – SEE REPORT Required maintenance completed, if AWWTS Comments: NEW MAINT REPORT JUNE 2024 C. LIFT STATION Required maintenance completed Age of lift station 18 years Lift station material PLASTIC Comments: ADVANTEX SYSTEM D. ABSORPTION FIELD DATA Which system tested (date installed) NA - NEW FIELD ALL standpipes present per record drawing Total measured depth from grade 2.95 ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective (ED). If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date NA – NEW FIELD Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – NA / NEW FIELD – NOT TESTED Effective depth (per record drawings) 6 in (MOA 0.5’ ED) Effective depth used 0 in Effective depth (ED) remaining 6 in Comments/Deficiencies: Approximate total measured depths from existing grade. COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No *50+ ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No *50+ ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No *5+ ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No *50+ ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No *50+ ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS *MAY MEET CONVENTIONAL SEPARATIONS, BUT SYSTEM MEETS CATIII SEPARATION DISTANCE REQUIREMENTS. G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 6/6/2024 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 6/6/24 IR Page: 20 of 29 2024-06-08 00:25:29 GMT 19073086608 From: Wes Anderson 481 325 min ■■ ■ all ■■ ■ ■a■ on Sato■ ■ use ■■SOS most■■ ■ ■tons ■ m■■ m■■ j�varowe Field Maintenance Report Annual Inspection Pmpanyowmr(aed&9# Tony French 15151Oxford Bluff Circle, Anchorage AK 99516 m# Pod# AX-107393 SW060W1 206819 Retrieve O&M Into Daly Now Recife ratio _ Thar aWnga Pwrrerm Fhdd SarrolinglObservations NTUs)= r!! Odor of SamPle Typical ❑ Musty Earthy ❑ Moldy Nontypical ❑ SuHidf ❑ Cabbage ❑ Decay Oily aim In PVu mYes o Foam in tank ❑ Yes No Check Control Panel Fieckc Amps Discharge Amp Audible and visual alarms LYOK Did tone (telemetry only) Elyse ❑ No inspectlCiean Pump System Im Peet Clean RisarRid ..................... Splice Box .................... post Cords ............... .... Floats........................ Pump........................ Biotubee Filter ................. Biotube Pump Vault ............ Recirculating Spli ter Valve...... . Comments Measure Sludge/Scum iia an ■on ■ = El INS ■ ■ wall AnchorageTank 907-272-3543 A+ Home Services Tech Caned Phone (907)230-4306 oeoe of Lark irmpeeaW 06/28/2023 Sludge scum 1st Compertrnem current Previous Cii urrent Previous L} 1 2nd Compartment Current Previous Current Previous InspecUClean Odor. l'i Onne Biomat: orm: Bridging/Ponding: Norre/ InspectlClean Discharge Ins pycr Riser/Lirl l,I Splice Box Roat cords La]-,Y! Irtspect (Service ON, Sy Disinfection Equipment Additional Services Randall ❑ Cleaned textile sheets? ❑ Replaced/Used other ftmel. Parts used: W = warranty, B = w S hem Number /Safety Inspection RSV reinstalled Manifold reconnected;+. ❑ system pertormirg: no D Call fqr service i In C ❑PUrgeM Laterals/orifices ❑Excessive Pod Bottom Excenshre I Intake Vent I System 1 Floats Pump f Cponents / DlEpersal laterels(Orifices ❑ Replaced UV Items? Is (✓ appropriate selection) Description Li a bolted on o f/mrol panel reactivated !=. T' needs pumping Other'1 _ Fax completed form to '° .;(~ MUNICIPALITY_ _. OFANCHORAGE . ...... ;..~ - .'~ ' :-' !::?~': ...... DEPARTMENT OF HEALTH & HUMAN SERVICES ::~ ' ~ .. .... ':: .... =::. . ~,.. , :.Division bf Environmental Services :.... . .....:~..,: . ""-? '~; ...... :- -'c- .... , ..... , on-Site Serv ces Section '-' ' , .~ ..~..,. :,...,,, ....... ' . i . ~. :. ~i~ ' · ......... . ........ :'" J ' ~. ,: '~';; -/"' .:' . , ...~';,1., ' , ' ~ .....:': ' ...c ...... CERTIFICATE OF HEALTH AUTHORITY ~ APPROVALFORASINGLEFAMILYDWELLING .. ~::: :.~.: _. 1, OENEI~L'INFORMATION :~'?~.-~'2~_ ..... *~.~H:. ~" "*' ,..,. ~ '.:. I ....... ';Complete I~:Jal d~riptlon '.b~"lG'.~l~ '~ ~'~ . ~ ~O "Location (site'ad~re~ 0r dlr~l~fi~)' '~1~ 'i ~ '- ~o~ '~ G '~:1~- k~m ~ [K?''qqs~''''' """ " .... '" '" ,-' 0 ~, '~ . '- -Z~, ~'L ...... ' -~-~ ~ ~'~ ~ Pro~.~wn~. ~'~'~Ul~q.~, Day phone~ Malling address ...... '-~ Lending agen~ ~ :,x ~.. ~ '~:: · ...... ~ Day phone Mailing addre~ ..... -* ~"" ''~ - ~"~ ~ , ...... '" '" Agent : ' .......... ~ "~ Dayphone ~'~ '-.' ~.'Addr~ ...... ' ' . .'. Unl~ othe~l~ r~u~t~,'H~ will ~ held for pickup. ~: ':'~.:::::41;~,;/:~.~-::k~':~':":' '"-" '-"--. ._.3 :' Indwldu~l w~ll ~ ~ .... '- '- ' ' ........... ........ ...... NOT~. . If communl~ well s~tem,.provide wd~en confi~atlon from S~te ADEC a~est- ' ', ','. lng t~ the I~ali~ and s~atus of s~,m "{' ~.~'., .~...; .. ~' ,. ~o~munl~on-slte ~ ~':; ............. ,- ~-" ?:.,- ' ............ "'- · ...... ~ '~ . ..... Pubhc sewer{_~ ~ ......... ...~.. · ....... .-' · ..... " ' :;'" ;-"-""' '"":"" - "~ ''" ' '":"'': ..... - .... ;'.:_.:'2'~: '- ' / I - 5., STATEMENT. OF INSPECTION BY ENGINEER - . ' - '. S'~.-". i '~:~ '.'.".;?.ii:?: *; :' ' . As certifi,,,, by my seal ~ffixed hereto and as of the vahdatton date show[~ below, I venfy that my Investigatioh of this Health Authority Approval application shows that the on-site water supply and/or Wasi~-W~-ter d sposal system is'safe~ fu~ctional and.adequate for th~ numbe'r of t~r~oms .-'. and type of structu~'e lndica~l h~rein. I further veri~ that based on the Information obtained from.. · - the Municipality of Anchorage files and from my inves.ti_,qation and inspection, the o_nL.~ite. water.. supply and/or wastewater disposal system is in compliance wit.h all Municip. al and,State.cedes,, ~' ordinances, and reg[dations in' effect on the'date of this Inspectmn. ' · ~ ~ .~ . c "-'- "-'-,'._-.' Add : ~" ~ * C ~' ' ' ~":" ]"' ' ' '~= " '"' ~' " " ' ' ' 1 '~ ..~*."-'"' · . ':, ..; .- ;:-, v :-.' .:: :-ConditiOn;d approVal .for:~ ............ ', be~rooms.:i~ th t~e f(~llow ng :stipulati6ns: . .;...]-.. . . . . ... .. ~, .... ,:--~.. .-.-~ : .."~ ... . ,:. _. .... j .' ,~ , Addiflonel ~omment~ ~-~ ..:'..;*';..';.,'.'.'...'.'-,..~:.Z~",**',¥-'*.L.L~:~. '.:-_: ...... '~. - "-- '[ '-' ' ' ':-'::" '" : ; "*'~"~' '" '" '" The Municipality of Anchorage Department of Health and Human Services (DHHS) I~ues Heal~ ~uffiort. ty. Approval Certificates based only upon the representations given in · profe~ional engi ,nee[.registered I.n .the ~ste of Alaska. The DHHS does this as a courtesy to purchasers of homes - .. and ~ir I~t. i~g I~s~**utio~3s in:o ,rd. er to ~tisfy certain federal and ~tate ~'~.l~.. ~j~f D~ H~..~_.S_~' .......... 'nn:tt .- ssonsln~ mfes~ona en neev'$work., .~ !,il , ~ ........ D, . .. .... responsible for errors or om P g ..... , .... ., ........ ............. Municipality of Anchorage ; , Department of Health and Human Services , HEALTH AUTHORITY APPROVAL CHECKLIST LegalDescrlption: LI~ /~Z. I~'~,Ec~T-~I~..' ParcelI.D. O I"'(11 A. Well Data Well type '1~1 [/'~'~ If A, B, or C, attach ADEC letter. ADEC water system number Log present {y/N) L{~--.~_> Date completed (-,,[71¢[~ Driller ~L-~)(N~ Total depth ~ ~::~ ~'f.- Cased to . i 7-.(3 Et Casing height Sanitary seal (Y/N) ~'-~'~ Wires properly protected (Y/N) ~{ ~:::~ Date of test Static water level Well flow Pump level1 FROM WELL LOG ~o ~ AT INSPECTION g.p.m. .g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 1.0"( Absorption field on lot %~<3 .~' ~'~ Public sewer main Sewer service line ; On adjacent lots + I~3Q ~+-.- ; On adjacent lots '[' ~%~ ~- Public sewer manhole/cleanout I~ ! ~, Petroleum tank I~0t~ WATER SAMPLE RESULTS: Coliform (::3 Date of sample: C~"L-~.~°~ Nitrate _ O. [0 Other bacteria ~' Collected by: B. SEPTIC/HOLDING TANK DATA Cleanouts {Y/N) ~'E:~' Foundation cleanout (Y/N) ~---~ High water alarm {Y/N) L{ ~:_~ Alarm tested (Y/N) Date of pumping ' ~.~ Pumper SEPARATION DISTAI~ES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot I 0 ~ ~c.. On adjacent lots -t.- t {3 0 ~* To property line ~-~. ~ Sudace water/drainage Compa~ments "TL0 0 Depression {Y/N) Foundation Water main/service line ~2-m6 (~3)' F~t CONTINUED ON BACK PAGE C. UFT STATION Size in gallons 'L.S c3 Vent (Y/N) ~ E~, 'Pump on' level at High water alarm level Meets MOA electrical codes (Y/N) t~:...~ SEPARATION DISTANCE FROM LIFT STATION TO: Well or~ lot [0t~. ~ t~'+... D. ABSORPTION FIELD DATA Date installed ..~ ~-iI c{, ~ Length "1 ~, ~ac.. Width Total absorption area I [~ ~ o Date of adequacy test k} ~.~,/ Water level in absorption field before test On adjacent lots" 4-..3.[30 ~ Soil rating (GPD/FF) ~ O. ~ GraveJ thickness O .~ ~"~c_,' Cleanout present (Y/N) Results (pass/fail) Manufacturer ~I~ Cj::)! ManholelAccess (Y/N) k~ ~'~ . .'Pump off' Level at _ Cycles tested ,System type Total depth '2),.~ ~'~. Depression over field (Y/N) ~ 0 for Bedrooms After test Peroxide treatment (past 12 months) (Y/N) .If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ~, raj:3 ,.~ On adjacent lots ~ t ~ ~ Property line To building foundafion I~.~ ~-'. To exisfing or abandoned system on .lot ~ 0 kJ"L On adjacent lots -.{.- ~.~ o ~ Cutbank IO"bl~':C- Water main/service line Suffase water ~ h3~c= Driveway, parking/vehicle storage area +' 2.Cn3 ~-{~ , Curtain drain ~ E. ENGINEER'S CERTIFICATION I ca.fy that l have checked, veri§ed, or conformed to ali MOA and ~:.n~--'...~'~,~"f~tt~e date of this inspection. D.,eo,, a en, R, pt Number 72-026 (3/93)' Back Waiver Fee $ -' 'l ' ' Date of Payment Receipt Number