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HomeMy WebLinkAboutFOREST RIDGE BLK 2 LT 18I 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 N,~,: ,.~-~ ~,~ ~ ~ F< r Wastewater System: ~New. D Upgrade PnO~:~/~. Z~'~. No. of ms: ~D~pTmnch ~ ShallowTmnch ~ Bed ~ Mound ~ Other WEL~ ~New ~ Upgrade omw~w~: ~ ~ / ' , ':,;SEPARATION DISTANCES ~ptic ~Holding ~S.T.~P. Remarks: ~qc~ ~,~'"~ ~-/ BENCH MARK / / ENGINEER~ S~L Depadment of Health and Human Se~ices approval Reviewed and approved by: Date: ff-24- ~ ~ ~'"'~~~:'~ · Permit No. -- Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 19665g Anchorage, Naska 99519-665g Telephone: 345-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: Forrest Ridge lot 18 BIk 2 PID No.: 01711281 All welts AIl w e11.~ 4 House Orivewoy ~ Loco[ion $~NG TIES A-C = 362' B-C = 80.5' A-D = 22.5' B-D = 54.5' Approx Rodlus I~ - TEST HOLE · - MONITOR TUBE o - SEWER CLEANOUT ~- - WELL :-- L'[ACHRELD EASEMENT Scale 1"=50' 11/6/98 E~ SEAl. ~¢. O.F....A. L ~,'~ ~,TATI ~)~ ALA~Y~ DEI~.Rt~I~IT OI~ MATUI~U. Imm~URC~ DmZ: f;een R ~, ~ . MUNICIPALITY OF ANCHORAGE DEPART~NT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L~ STREET, ROOM 502 /~NCHORAGE, ~J.J%SKA 99519-6650 PAGE I OF ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PEP. MIT PERMIT NUMBER: SW980216 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES OWNER NAME:MOORE GARY W & OWNER ADDRESS:5346 ~ANi"rELL AVE ANCHORAGE, ALASKA 99516 DATE ISSUED: 7/02/98 EXPIRATION DATE: 7/02/99 PARCEL ID:01711281 LEGAL DESCRIPTION: FOREST RIDGE BLK 2 LT 18 LOT SIZE: 34990 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TAAIK / WELL SYSTEM ALL CONSTRUCTIONMUST 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 SJ_4%SKA WASTEWATER DISPOSAL REuuhATIONS (18AAC72) ~ DRINKING WATER REuuLATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DH/{S 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 TOAPRIL 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 A~D HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. 1 SPECIAL PROVISIONS: RECEIVED BY ~~~~/~ ~~ DATE: DATE: Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax July 1, 1998 Dan Roth On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re' Forest Ridge Lot ! 8 BIk 2 Permit Application request for information Dear Mr. Roth: Due to the topography and elevation of this lot, we feel that it is not representative of the remainder ofthe subdivision in regards to water table fluctuation. The subject lot is much higher in elevation, and is located on a hill with steep slopes to the West, Southwest, and North. The month of June 1998 was also noted as being one of the wettest months with the most rainfall in recent history, and it is our opinion that the traditional seasonal high water tables of May have carried over into the month of June during which time we monitored the water table. In summary, it is felt that the groundwater table is not subject to extreme fluctuations that are common on surrounding lots and that the water level observed is the high level for the water table of the subject lot. In addition, the utilization of the Biocycle System is beneficial by treating the effluent before release to the subsurface disposal system. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. \1997~98-037-~q~B Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax June 15, 1998 Jim Cross, P.E. Manager, On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re~ Forest Ridge Lot 18 BIk 2 Narrative & Permit Application Dear Mr. Cross: The proposed well and septic system will utilize a Biocycle Treatment System to decrease the required absorption area for the proposed 4 bedroom residence. The system is located on a hill and will require a variance of separation distance of 50 feet to 35 feet to the change in slope of +25% to the West and Southwest. The system will have 6 feet of ground cover to utilize the soil strata below this level, and to avoid a clayey silty layer from 4-6'. It is our opinion that effluent will not daylight from the slope which is subject to the variance. The surrounding lots ofthe area have high groundwater and many systems utilize intermittent sand filters. These surrounding lots are lower than the subject lot, and the higher elevation on this lot allow the use of a deep trench due to the groundwater depth of 15 feet. There are existing monitor tubes to the Northeast of the proposed system, in a lower part of the lot that show groundwater at 7' below ground surface. If the system were moved to the remaining area ofthe lot, this high groundwater table will limit the system design in this area and possibly place it in unusable soil. The Biocycle System will reduce the area required to a 67' trench, and will allow both primary and reserve systems to be placed in the higher elevations of the lot. The trench will be located 10' from the lotline common to lot 17. This will provide the required +10' separation to existing bed type septic system. All wells including all adjacent wells are +100' to any component of the wastewater disposal system. Reserve area on the subject lot is adequate, as shown on the site plan. Surface drainage is not expected to be of concern due to the topography of the site. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. [1997~98-037-NAR.DOC ~I TEST HOLE · - MONITOR TUBE o - SEWER CLEANOUT · -~- - WELL EASEMENT --- PROPOSED LEACHF~ELD i,~- EXISTING LEACHFIELD -NO SURFACE WATER · NO KNOWN CURTAIN DRAINS Biocycle System Prop House Locotion. All w?lls ? 'MT No Soil Log I% / Existing Bed System / ~ Approx We Rodius EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 10421 YEW Drive E. gle River, Al,aka 99677 [RES Projecl Number: 9~037 CA~ File Nome: 98-037.dw~ WELL/SEPTIC SITE PLAN Foresl Ridge Lot 18 BIk 2 CLIENT: Hogmeier CONTRACTOR: Hogmeier Consl. 1%40' 6/15/98 MJN /e~ I I00'~ Prop Eagle River Engineering Services Louis Butera, P.E. · P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax LEGAL: A. I. 2. 3. 4. $. 6. 7. $. 9. B. 1. SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM Forest Ridge Lot 18 BIk 2 6/15/98 GENERAL The well and septic plan are for a single family residence only. The drawing and or site plan shall be a part of this specification. All materials and workmanship shall meet the Anchorage Department Of ltealth and State Department of Environmental Conservation requirements. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. ~- It is the responsibility of the owner to obtain all necessary permits or easements and to I adjacent multi-family wells. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. Any remaining open test hole excavations shall be filled. SEPT1C TANK/LIFT STATION Septic tank and lift station shall be a 1,500 gallon Bioeycle type unit approved for four bedroom capacity with Meyers MFA0 pump and level controls capable of providing a 50 gallon effluent dose, with high water alarm mounted in the home. Biocycle supplier is Pegasus Engineering at 283-9003. 2. Receipt from MOA Building Safety stating the lift station was wired to applicable codes to be supplied to Engineer upon completion of work. C. TRENCH I. The trench is to follow the natural land contour to maintain uniform total depth of the trench bottom. 2. The bottom of the trench shall be level, plus or minus !.5". 3. The total depth ofthe trench excavation is not to exceed I I' at any point. 4. The effluent line within the trench shall be laid level within 0.03'. 5. The trench gravel is to be covered with typar fabric material. 6. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed over the leachfield. 7. The area over the trench is to be fnlsh graded to prevent ponding of surface water runoff. 8. The septic tank and Icachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTll = I I' GRAVEL DEPTH = 5' under pipe, 2" over pipe TRENCH LENGTtl = 67' TRENCH WIDTll = 3' SOIL RATING = 0.45 GPD/ft2 BEDROOM CAPACITY = 4 SEPTIC TANK -- Biocycle System Twenty-four (24) hours notice required for all inspections. \ 1997~98-037-spec.doc EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99577 (907) 694-5195 ERES Project No.: 98-037 Calculated By: LB Date: 6/15/98 Legal: Forest Ridge Lot 18 BIk 2 Single Family 4 Bedroom Dwelling TEST HOLE Deep Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom Percolation rate Wastewater application rate Required absorption area Trench width (W) Gravel depth (D) 600 gallons 24 minutes per Inch 0.45 gallons per day per square foot 1333 square feet 3 feet 5 feet Required length = Required absorption area / 2 1 D Required length = 1333 I 2 Biocycle Reduction Factor = 0,5 Adjustedlength = 67 feet Total Excavation Depth = 11,0 feet / 5 Note: Soil rating raised to match surrounding soil data 98-037-cal.xls 12:03 PM6/15/98 RUSH G 3` Munieipality of Anehoraore r On -Site Water and Wastewater Program (907) 343-7904 5 F E T Y Certificate of On -Site Systems Approval Parcel I. D.017-112-81 Expiration Date: 1. GENERAL INFORMATION: Complete legal description FOREST RIDGE; BLOCK 2, LOT 18 Location (site address) 5346 Manytell Avenue *Anchorage AK 441-1433 Current Property owner(s) Rob & Kim Weingart Day phone Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ $880 Waiver Fee $ Date of Payment Receipt Number Date of Payment Receipt Number COSA # OSC211121 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: Garness Engineering Group Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: ZI In conducting this evaluation. GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSDiSIGNATURE � System #1 Approved for J bedrooms 11 System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, .c 1 TIS : Y .......... ......... ess: t/ CE -7953 �e • •tel red f ofess%n ' ��`a G j • • .\ F, o `\ o #AECC884 Y Y OFON-SITE WATER AND WASTE V'ATER with the folfbv g s 1�It RAwl � . Original Certificate Date: L?— / q — ?-% 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist Legal Description: FOREST RDIGE; BLOCK 2, LOT 18 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA © Well log is filed with Onsite (or attached) Date drilled 9/13/98 Total depth 103 ft Cased to 103 ft ® Sanitary seal is functioning correctly FE -1 Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 3/9/21 Static water level at beginning of test 33 ft. Comments B. TANK DATA Age of tank(s) 16 years Tank type/material SEPI CSTEE Measured operating fluid level in septic tank 52 FM -1 Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA Parcel ID: 017-112-81 Structure served by this system Well production at time of test 7.8 gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes R Nc ® Coliform bacteria is Negative Nitrate 1.04 mg/L ❑ Nitrate less than MRL (ND) Arsenic ND ug/L ❑ Arsenic less than MRL (ND) Collected by GEG Date of Sample 3115/21 C. LIFT STATION 0 Required maintenance completed Age of lift station 22.5 years Lift station material FIBEFGIASS Comments: BIOCYCLE Which system tested (date installed) 'o/3o/se Adequacy test date 3/9/2021 ® ALL standpipes present per record drawing Results QPass For **5 bedrooms Total measured depth from grade 12.9 ft (max) Fluid depth prior to test 11 in Measured depth to pipe invert from grade ft (min) Water added 825 gal © N/A — pressurized field New depth 22 in ® Monitor tubes go to bottom of effective. If not, state 120 depth into effective Elapsed time min © Code -required soil cover over field Final fluid depth 16 in X System presoaked Absorption rate 750+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NO date of test) Gallons introduced *2019 gallons If yes, enter date N/A Comments/Deficiencies: PRE-SOAKED ON 318/27 "SEE JUSTIFICATION LETTER IN REGARDS TO SIZE AND SOIL RATING - 2005 TRENCH HAD 18' OF LIQUID ON 3/77/21 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 Community Sewer Manhole/Cleanout > 100' Cv Yes if No ft 7✓ Yes if No Neighboring Tank > 100' F Yes if No ft Private Sewer/Septic Line > 25' EZ] Yes if No Absorption Field on Lot > 100' 0✓ Yes if No ft Holding Tank > 100' ❑✓ Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' Yes if No 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0 Yes if No ft F,/TI Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' F'� Yes if No ft Surface Water > 100' ft ft ft ft ft Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No ft Private Wells > 100' Q Yes if No Water Main > 10' ❑✓ Yes if No ft Community Wells > 200' Yes if No Water Service Line > 10' P/1 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' [Z] 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' Yes if No ft Private Wells > 100' [✓ Yes if No Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' Yes if No Surface Water > 100' F71 Yes if No ft F. ENGINEER'S COMMENTS "ASSUMED BASED ON WELL LOCATION - SEE MOA INSPECTION REPORT. WEST MONITORING TUBE FOR THE 1998 TRENCH IS NOT SHOWN ON AS -BUILT, BUT IS PRESENT AND CONFIRMED TO BE FUNCTIONAL. G. ENGINEER'S CERTIFICATION / certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet #AECC884 ft ft ft ft r a� •NJ 119 1 March 18th, 2021 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref Forest Ridge; Block 2, Lot 18 — 5 Bedroom Approval To whom it may concern, The subject lot has a BioCycle AWWTS installed on that is preceded by 1250 -gallon septic tank. The primary and secondary treatment system is sized, and approved by the MOA, for five bedrooms. There is a 1998 deep trench (5.2 feet effective) on the property that has a total absorption area of 696 sq.ft. The 1998 drainfield was originally designed for a conventional septic system and was based on a percolation rate of 24 min/inch. A 24 min/inch soil has an application rate of 2 gpd/sq.ft. when receiving effluent from a CAT II AWWTS. The existing home has five bedrooms, which corresponds to a design flow of 750 gpd. The minimum drainfield size, based upon a 2 gpd/sq.ft. soil application rate, is 375 sq.ft. The 1998 trench has 696 sq.ft of absorption area, so it is adequately size to handle 750 gpd. The subject 1998 trench was pre-soaked with 2019 gallons on 3/8/21 and passed and adequacy test for 5 -bedrooms on 3/9/21. If you have any questions, please contact meat 337-6179. Thank you for your assistance. Sincerely, Jeff�V- A. Gam- ess) P.E., M.S. ....... . a reyAS ., ¢�`6> CE -7953 � Cited � �� tl�l�lia®j;. `k� 31 z( 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Website: www.garnessengineering.com 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 ythis � �1 Day of Mjecd-t of 20.2-1 , by and between �c1 ,herein the OWNER, and the Municipality of Anchorage, herein the "M ICIPALITY", 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: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as 2. located at (legal descrintion) (Owner is required to read, understand and initial each section) Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adiustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). wner 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. U ' Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 AA -Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. Owner acknowledges that the tine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. 4t --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 Municipalitv 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 By: I signature) Date: 1v (print name) STATE OF ALASKA THIRD JUDICIAL DISTRICT The foregoing 2p , by - NOTARY Nly Comrr. )1ti ss. ,�dbe. re etl.s�day f WOW/ M ,IC F ALA KA � /I expires: Notary Pubiic ROWER►A KEHA State of Alaska Commission No' 2109946 - 20mmission �a..:___ —06 1'IJNICIPALITY: By: (signature) Date: 3 ^� (print name) Title: (rev. 05/18/2018) Page 3 of 3 3705 Arctic Blvd #313 Anchorage AK 99503 Email: crbioak@gmail.com (907) 274-0314 4th Quarter Inspection Report 1 Homeowner Info Customer Name: Rob and Kim Weingart Tank#: 51 Install Date: Oct. 1998 Address: 5346 Manytell Ave. Area Lower DeArmoun-Buffalo Initial Inspection: Alarms Tested: Air FVJ High Water [�J Battery Tested: Yes ❑ No ❑ N/A (Please make sure alarm is on "normal", not "mute") Does system have a septic tank ? No ❑ Yes Z (Recommend pumping tank every 2 years) Is System Lid Locked? Lid hardware in working order? Is there any noticeable odor? Yes Z Repaired ❑ Yes FV1 Repaired ❑ Strong ❑ Mild ❑ None System Inspection Inlet plumbing in working order? Solids pillow normal? Yes [� Replaced ❑ Yes C✓] Requires Pumping ❑ a .;��„� � �y�'" x„•::b �. �;� a z a - s "„ � ..s t 3"w�";.�.� 1,,� ��rv" zm �i r�..x .� :f � �' ,:,� Are all aerators functioning? Any buildup of solids? Yes 0 Replaced ❑ Yes ❑ No [� ..._..,..:w,s.�-�x`°;.e..`r,:„,':;�.,�,�,��,_. Vii•` � ���,.c-,�.���`��^,���x„ a%r�"�' a: �,'�...r � �i ar;.'�t :a x��..�,�:'�s� ,x.._$i,a�.; �s�r.N�`,``�%��.��.�'�'„h ',:r�a.,k �"�"�����x r��� Clarification return system operating? Any buildup of solids? Yes 0 Adjusted ❑ Yes ❑ No Effl:Uen6«�eCJ����i�eJ�ulkz�xt� `s•"��� �� � a txdr 'r* x 7 x Tr"e fx�'w�gkcz h ��i;� n�?�s � �' y� r r„� �' �x z aiy�'��' x pH Reading: Dissolved Oxygen PPM Turbidity of discharge (in FTU) (pH of 6-8 is ideal) (2-5 is ideal) (Under 35 FTU is considered compliant.) 7.0 3.5 5.14 '�.iv:�y:, Ir <. .�F�: ,. s;,�, '"'"^��a��-� r�s x�� '-'H'`�.r �'�„� ``�,`�,✓�a ss 3��.� ��-�e ��a`s'1v1��.'„:' �r�, '�� �.a'�'';.,. „� �L,�s ����,...`,�+�za�`��,.. Pump float operating? Alarm float functioning? Any buildup of solids? Yes [✓ Replaced ❑ Yes Z Replaced ❑ Yes ❑ NoFVJ Filter cleaned? Discharge line condition: Yes [] N/A ❑ Good Replaced ❑ Comments: Inspected By: Chris Date: 11/23/2020 Has emailing or mailing of form been requested? (contact office to request...) Yes ❑ No Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 'L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: 2 3- 4 5- 6' 7- 8- 10- 11- 12 t3 14 15 16 17 18 20- DATE PE.FORMEO: COMMENTS Township. Range, Section: SLOPE WASGROUNDWATER ENCOUNTERED? SITE PLAN S IF YES. AT WHAT (~ DEPTH? /4./,,~ P E Moni~ring? I ~ ~ Oat~ _~ --/I- Reading Date Time Time Water D~op I ~-~ /(,'r~ ~1 PERCOLATION RATE -- TEST RUN BETWEEN -~..Z.~ (mmutes~mch) PERC HOLE DIAMETER ~" // 7' '{'- FTAND ~" J" FT PEB.ORMED BY: ~--.rC' ~'~' . ~~ CERT,FV T.AT TH,S TEST WAS PEB~ORMEO.N ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE; 72-008 (Rev. 4/65) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# , (~)/~/I ~-.~/ NAA# 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address 'Lending agen~:y. Mailing addres, s Agent ~ Day phone Day phone Address Unless otherwise requested, HAA will be. held for pickup. 2. NUMBER OF BEDROOMS: /"/ 3. TYPE OF.WATER SUPPLY: · ~' ',~" Ir~dividual well .... :.Community well ~: Public water " NOTE: If community·well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. 4....;3~t'EE OF WASTEWATER DISPOSAL: · . _ Indivi~,~lc~lte' ' -' 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. 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 d~te of this inspection. Name of Firm ~ .~ ,-.. Engineer's signature Phone Date //-/?°7oc S,O.ATU. Approved for ' OU Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: t Additional Comments Date, /'7.'q'98 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 Indepenc[ent professional engineer registered in the State of Alaska. The DHHS does this es a courtesy to purchasers of homes and their lending institutions in orderto 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. Legal Description: A, WELL DATA Wall type Log present (Y/N) ~/~-$ Total depth Saniten/seal (Y/N) RECEIVED DEC 0 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SER)~w o~ ANCHO~e Environmental Services Division a~VL~OI~N~.Sf.~V~:S 825 L Street, Room 502 · Anchorage, Alaska 99501 ° (907) 343-4744 · Health Authority Approval Checklist If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to Casing height (above ground) ~ ~' ' Wires propedy protected (Y/N) Date of test Static water level Well production FROM WELL LOG $-I~-q~ g.p.m. AT INSPECTION g.p.m. WATER SAMPLE RESULTS: Coliform Date of semple: B. SEPq~4OL-'OtN~ TANK DATA Date installed I~ -~ -(7,~Tank size Foundation cleanout (Y/N) /Y~,~ Nitrate ~,/~' /~' Other bacteria Collected by: I..C'c,'~ ~,,,/Number of Compartments / Date of Pumping Depression (y/N) ~ aaa.outs(y/N) High water alarm (Y/N) ~' Ce ABSORPTION FIELD DATA Date installed /~-3c~ -?~' - length ~ Y~' Width ~ ' Gravel micknass below pipe Effective a~sor~on ama ~'~ / )' Monitoring Tube present (Y/N) Date of adequacy test - z,f/'/~ - Results (Pass/Fall) ~/,'~ Fluid depth In absorption field before test (in.); due bepth /V'/t (ir=) Mi.utes late~. /~/,~ Peroxide treatment (past 12 months) (y/N) Sollmting ~orfta/l:)drm)~,¥,C' Systemtype ~::~,,~. ~:- ~, Total depth II. · Depression over field (Y/N) For ~4;/'/~ bedrooms Immediately after ~l,//l~gal. water added (in.): Absorption rate = ,,4//~f q-p.d. . y., ~e date 72-026 (Rev. 3f96)* D. UFT sTATION~ Data installed Et Manhole/Access (Y/N) High water alarm level at* Cycles tasted SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ~-/~ ~ ' Absorption field on lot ~-/~'~ Public sewer main Sewer/septic sen/ice line */,~c~ · Size in gallons "Pump on" level at* *Datum · 'Pump off' level at* On adjacent lots '~' / ~'P On adjacent lots ~/~' ' Public sewer manhole/cleanout Uft station + SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~' ;2~ ' Property line ~ ~' / Absorption field Water main/service line -F.?¢~ ' Surface water/drainage +'/¢~¢~ ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Surface watsr Curtain drain Wells on adjacent lots I I~ ' Building foundation / ~ ' Water main/sewice line Driveway, parking/vehicle storage area + Wells on adjacent lots + /~o · ENGINEER'S CERTIFICATION I certify that I have determined thru field fnspec~ons and rm4ew of Municipal reco~.]~e~.are Date of Payment ./,c~/..~ 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number