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Home My WebLink AboutFOREST RIDGE BLK 1 LT 11Forest Ridge Block 1 Lot I I #017-113-13 Municipality of Anchorage Development Services Department :. Building Safety Division — ; South Bragaw St j Onsite Water 8 Wastewater Program, 4700 P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.anchorage.ek.us (907) 343-7904 Page 1 of 3 Onsite Wastewater Disposal System and/or Well Inspection Report Permit Number. SWO10065 PID Number. 017-113-13 Name: JEFF HENDRIKSON Wastewater System: ■ New ❑ Upgrade 6171 ROSEWOOD DRIVE a ANCHORAGE. AK 99518 ABSORPTION FIELD Phone. No. of Bedrooms: (907) 565-4799 5 Deep Trench O Shallow Trench Mound Bed O Mou■Other o s LEGAL DESCRIPTION s" Ed`s 2.0 am/sq. FL Depot '`� 1.22 — 1 s3 R Lot: Block: Subdivision: Depth to pipe better, from 010 pose pawl depth beneath plpe 11 1 FOREST RIDGE 0.52 - 1.23 n 0.70 r< Township: Range: Section: FIN tided c•rM^el P••e o" wngtk - - — 1.5 - 2.5 In. 40 rt Gravel width; NuMer of Fes DYbnee b.t...n hese WELL: ■ New ❑ Upgrade 10 rt 2 5 rt CloeeMocoon Prwa* A&C 7otd Depth: cooed 7. Told absorption area: Flee Iri.terlet PRIVATE 1 73 n 73 rt 400+400 sm rt D 3034/F-Bto/SCH 40 PVC orwr: Dot. priced: store water Lew: 31 kw~. DENALI SEWER & DRAIN Dat. irrree.d: 6/7-13/01 ALPINE DRILLING 4/13/01 rt nee: wmp sd � corny "eight #be" t:fa.ra TANK 30 leu UNKNOWN n 2 Ft. SEPARATION DISTANCES ;Septic ;Holding ■S.TZP. 0Other To Septic Absorption Uft Holding blk/Prlyd. MVMi1ac0"r` ANCHORAGE TANK Cevedb in 9.cww 2000 From Tank Field Station Tank sew tk+w Well 100'+ 100'+ 100'+ — 25'+ tbma. STEEL le.ne. of ownpan•w� 2 Surface water 100'+ 100'+ 100'+ — — LIFT STATION Lot Line 5'+ 10'+ 5'+ - - lialwon su.2000 Cox NK ORENCO SYSTEMS ANCHORAGE T Foundation 5'+ 10'+ 5'+ - - m teed at: TIMER level eb TIMER mlin wet. dam - 45e rasp a Yodat eectrlor enpfem ••aon. perred W. Curtain Drain NONE KNOW RE ORENCmo M.O.A. Remarks: 'THIS IS AN ADVANTEX TREATMENT SYSTEM. BENCH MARK latatbe and Description BOTH PRIMARY AND ALTERNATE SITES WERE INSTALLED GARAGE FLOOR SLAB ON SOUTH SIDE. PER THE REQUEST OF THE HOMEOWNER. Dense ".orae 101.04 n ENGINEERS ll N "QOF �4°oou Inspections performed by: AWWC, INC. Dates: list 6/7/01 *�... .... ...... ° 2nd -4th 6/13/01 5th 8/27/01 :ere M .ss:.. OQ Department of Health and an Servic s approval 4�� •.• 7953 Ree �ievved and approved by: Date:1:2-17-0I n DOpOPr resa10� 0 4000 PERMIT NUAS-BUILT DRAWING PNUMBER: SW010065 065 -017 017-11 13-13 TH# / I I ' NEW 2000 GALLON RECIRCULATING SEPTIC TANK (ADVANTEX) 0 I B I 51 \ INSTALLED H� DIVERTER VALY I , MH 3 s NEW DRAII do /ZSEPTI'C sE TE NOTE: BOTH PRIMARY AND ALTERNATE SITES WERE INSTALLED PER HE REQUEST OF THE HOMEOWNER. NEW WELL 11/30/2001 F,grZ� , oNnwN er: 4. ALASKA WATER &. WASTEWATER c.J.c. CONSULTANTS, INC. wool ncoeoo cnen tl.TF 7N . AW.nFeOF eR *Q1M • R F (0071117(110 • FAX (907MAA.1746 PREPARM FOR: PHONE NUMBER: jrnL NUMB JEFF HENDRIKSON (907) 565-4799 1 2 OF 3 FOREST RIDGE SUBDIVISION: LOT 11, BLOCK 1 AS -BUILT DRAWING OF NEW WELL AND SEPTIC SYSTEM rn 93; E 7953 `F ............ c�Qv A 8 ST1 17.6 33.8 MH1 24.5 34.7 MH2 28.8 39.4 DV 33.4 36.9 MT1 31.4 25.1 MT2 31.9 25.1 MT3 37.2 43.1 MT4 41.8 50.4 MT5 69.3 58.5 MT6 .8 61.8 MT7 E772.5 68.9 MT8 75.5 73.8 rn 93; E 7953 `F ............ c�Qv PERMrrNUMBER: AS -BUILT DRAWING PARCEL- NUMBER: SW010065 017-113-13 SWO MOM -91J0* r-fOF OF MAwaf TOP OF HAMA - 99.05 9915 iK'MIG FLIER I/ PODS Gp OF fAIK At Olnff -"JO 51 h'H fCP OF IAll: Af NEf -95.8 ; NSW 2000 GAI.I.ON O U a 5S.E.P. TANK AINfI avER(�a� AfCLMff-963(s) NTRfofV" Af CUILEI.91" EM FINAL GRADE ORIGINAL GRADE ORIGINAL GRADE FINAL GRADE 99.0+ - 97.52-97.79 97.52-98.23 INSULATION 99.2+ NSULATION Mf Mf Q't 10.1 Q• BOTTOM OF WMa OF BOTTOM OF DILVNFIELD DISTRIBUTION LINES INVERT OF D2VNFIELD -95.97 -96.7 (AVG.) DWMBUInON ONES (A 9V96.30 (AVERAGE) - 97.00 (AVC.)RAD DATE 11/30/2001 Qgo�40 0 d,`� •}�., f14� DRAWN BY: ALASKA WATER & WASTEWATER C.J.G. ago%' y p SCALE CONSULTANTS, INC N.T.S.......... ' "' ""' "''� 6001 DFRARR ROAD. SURF 79 • ANCNORAGF. AK 00504 PNONF (WI)3374179FAX (007)319.3766 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: JEFF HENDRIKSON (907) 565-4799 3 OF 3 0 pp 953 .: 1 ��4i^''• �qoo� 4��dPFofesslo�°V �� LEGAL DESCRIPnON: FOREST RIDGE SUBDIVISION; LOT 11, BLOCK 1, TYPE OF WORK DRAWING OF SEPTIC SYSTEM UPGRADE PROFILE AS -BUILT az, bt'zz lNsyEC:,FrON.j?Ed opr 'MUNICIPALITY OF ANCHORAGE—' BUILDING SAFETY DIVISION 4700 SOUTH BRACAV STREET, ANCHORAGE, ALASKA i' 6PF.C770A5: Voice: (907) 343-8300 Far: (907)149-7777 ! INFORM471O11:• (907) 343-3211 � MAM ALCAN ELE=, ,JC PERlfr1'ALTlBEl'.: 01 -93,45 ' t. WIDDtt£ss: 5201 BISHOPS CASTLE CIIt , :DATE: 11/1'2001 S PHONE 01: 351-6141: , PHOA2 0?: A7: i 11 BLOCK. • 1 SUBDIPMION.• FORRLSTRllGE 9rrtfEA'IJ': GLE-,\7a T STAIION/PAPER FOLDED INELEC CABINET 4 FPE OFt+3: a3 #3. LSPEC770N: No non-compliance observed Cotrcaioru csscndal as cxpla:ncd Wow. �ararEn75:• Do tn•t conceal until re -inspected. ❑ C.O. alq,rovcd. 1411 rc-exmr ne at nett ImTcai n. ❑ C.C.O. aplKovcd (corm at below). M13 (Stonmwater) t : r P.eim;pec9:rt? �i] f I ' i 1 I !% -PEG70R: I } 1 + J DATE: Stonrwxrr teannad plaa's;+a. •xt site. 0 Stwnwalcr trea:mmt irnpla r.mtrd. I SitecM:t: dinat a Wnt4 b:ir.; a atro!led. ❑ bmtsalconca rrax bsles. kr tal�Jcomcl silt farts. ❑ Mer best msm„rm:nt pmaices or s!te'need:d. Sec a:tac,:ed derailed ootes _mmvirc. ❑ Falltxe to eo :p!y nmy reso!t in fires. Take w--'= cow. ❑ peirapea!on will be m:dc or.: — --- I ❑ Redimallow. — xt icer. to: Con:psry: I ID7IENCORILF 77ONSAREMWE,PMLSECriLLFORINSPE(MON xe3 DO NOT REMOVF- THIS A'077CE. , -- eriL-0f H031th anri HUMan_SP"1CW 825 OV Street - -—PO:8ex�9G669-Aasbera9s:Alacka9fl51 r - Rick Mystrom t np'IMwN.d.w+cPaage.aicus Mayor Permit Number. *SW 010 Date of Issue: 4-13-01 Parcel Identification Number. 017-113-13 Date Started: 4-13-01 Date Completed: 4-13-01 Is well located at approved permit location'? Yes -O No Legal Description:-.-.FugrestJ3idt7B Block llat 11 property owner Name & Addle+s: Jeffery D & Tanya Hennkson ..-5334 Bieheps4a6#e4kVk AriMaraae. Ak 99516 Borehole Data: Depth (ft) Method of Drilling ® air rotary cable too] Soil Type, Thickness & W�lerStrata From To Casing type: Sleet - stick-up _ -0 1 . Wald Thkjne.gr� inches _ 2 9 Diameter: 6 inches Depth: 73 feet organic & silt Liner Type: gravelly cobbly silt 9 67 'aches epi feet water sand & gravel 67 73 -bier: Casing stickup above ground: 2 feet Static water level (from ground level): 31 feet --Pumping1cveI-.M1eet g11er 4 hmirsVttmping3D+gpm Recovery Rate: 30+ gpm Method oUesBng: air_TM -'Vtlettitrtsikkc-t3prntttg�{><: .JZ Open End rJ Open Hole ❑ Screened Start feet Stopped feet -0rerforatium -Start zfbct -Scarped met -;rout Type: 9entonite�! 8 Volume: j rig Depth:Start 0 feet Stopped ± feet pimp: Intake Depth feet ' -Pomp Azc ftp Brand�ame well Disisfected-uren-C-ot%P et "?4Z xca O 1J Method of Disinfection: Clorine Tablets Comments: Well Driller. Alpine Drilling 8 Enterprises P O Box 110496 Anchorage AK 99511 Attention: The well drillershaltprev9dea'vell d thepropcay nu•rw nr flw wr{I h:!.n A,;1t, eh+1{ n�nvv{n s uwll Lr. to IM..n rlt nr 14"Ith !Z limmln Cnnnroc ontn Aove nr rmm�lMinn MUNICIPALITY OF ANCHORAGE 'f ,Q Development Services Department Iil''r�. On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial L (.1,61a/ ZPM 1411)/ Date Issued: Apr 13, 2001 Expiration Date: Apr 13, 2002 Permit Number: SWO10065 Parcel ID: 017-113-13 Legal Description: 'FOREST RIDGE SUBDIVISION BLOCK 1 LOT 11 , Design Engineer: 0041 AK Water & Wastewater Consultant Site Address: 5331 BISHOPS CASTLE CIRCLE Owner Name: JEFFERY D & TANYA L HENRIKSON Lot Size: 42806 SO. FT. Owner Address: 5331 BISHOPS CASTLE CIRCLE Total Bedrooms: 5 Permit Bedrooms: 5 ANCHORAGE . AK 995164266 This permit is for the construction of: Disposal Field Q✓ Septic Tank ❑ Holding Tank E] Privy Q✓ 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: 4/-13-19/ Date: 4 — /3 —0/ Municipality of Anchorage Development Services Department Building Safely Division OnSlte Water d Wastewater Program 4700 South Bragaw St P.O. Boz 196650 Anchorage, AK 99519-6650 www.d.anchorege.akus (907)343.7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-//3-/3 Permit Number S1,/010065' Property owneqs) JEFF HENfRIKSON Day phone 565-4799 Mailing address (1) 6171 ROSEWOOD DRIVE • ANCHORAGE. AK 995,18 :rm Meilingaddress (2) 5331 8154WOPS CASTLE CIRCLE zip Code 995lprt-4ZK Legal description (Section, Township & Range) N/A Lot Size 42.806 AmWSq.FL Number of Bedrooms 5 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well N Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ JacuzA ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. ALASKA WATER k WASTEWATER CONSULTANTS, INC. (Signature of property eownef or au"Ared ageni) Permit Fees: 5,1 i/yo • O O Date of Payment: V-5-0/ Receipt Number. R5g(o Waiver Fees* Date of Payment: Receipt Number. ALASKA WATER & WASTEWATER CONSULTANTS, INC. April 2, 2001 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Well and Septic Design for Lot 11, Block 1, Forest Ridge Subdivision To whom it may concern: The proposed 5 bedroom house will be served by a private well and septic system. Test holes were excavated on the property. The proposed septic system will be designed around the 30 foot radius of test hole #2. We are proposing that a 2000 gallon septic tank with the Advantex Treatment System and a lift station; and a pressurized bed type drainfield be installed. Comments regarding the proposed design are summarized as follows: 1. SOILS: Attached are logs which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that due to the overall appearance of the soils, an application rate of 2.0 gallons/day/ft2 should be used for the Advantex treatment system. 2. PRESSURIZED BED DESIGN: a. Percolation Rate: 20 minutes/inch b. Allowable Application Rate: 2.0 gallons/day/ft2 c. Number of Bedrooms: 5 d. Design Flow: 750 gallons per day e. Minimum Absorption Area: 375 ft2 f. Total Depth: 2 feet (maximum - at any point. remove all organics) g. Leveling Sand: 0.5 to 1.0 feet h. Effective Depth: 0.5 feet 1. Width: 10 feet j. Minimum Length: 40 feet long k. Effective absorption area = 400 ft2 Note: The distribution lines are to be 1-1/4 inch diameter schedule 40 pvc with 1/4 inch diameter holes spaced every 30 inches on center. Each lateral is to be 38 feet long and have 15 holes per lateral. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPHY: As can be seen on the attached topography site plan, the average topography of this property is a 5+/- percent running from approximately east to west; in short, there are no slope concerns. The trench is to be installed parallel to slope contours. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you for your assistance. P.E., M.S. NOTE. Attached is a site planta wing, a design drawing, a detail drawing, a topography site plan, two soils logs, and a �C page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com BIRCH TREE ESTATES S/D( BIRCH TREE ESTATES S/D I BIRCH TREE ESTATES S/D I BIRCH TEE BETE S S/D LOT 3LOT 35,2. BLOCK 1, LOT 33, BLOCK 1, LOT 34, BLOCK 1, --------�-O-QDiWEN-AMUE----------------------- ---------------i r------------ PROPOSED FOREST RIDGE S/D I 1 5 BEDROOM LOT 8. BLOCK 1, HOUSE �- I 1 EEppT�II �AREAG I I D 1 I TH�t i I I PROPOSED SEPTIC SYSTEM - (SEE DESIGN, PACE 2 OF 3) 100' WELL RADIUS FOREST RIDGE S/D LOT B, BLOCK ki FOREST RIDGE S/O LOT 12, BLOCK 1, •-1"FACANTD f'� M�� FOREST RIDGE S/D LOT 4, BLOCK 1„ j ALASKA WATER & WASTEWATER SGAIE J.L M. CONSULTANTS, INC. 6901 MARR ROAD, SUITE 20 - ANC M"IS AK "SOL • FIIONE (907)337'6179 • FAX 07U36J266 1" = 100 PREPARED FOR PHONE NUMBER: PAGE NUMBER:- JEFF UMBER:JEFF HENDRIKSON 565-4799 1 OF 4 7953 FOREST RIDCE SUBDIVISION; LOT 11, BLOCK 1, OF WORK: SITE PLAN FOR PROPOSED WELL AND SEPTIC SYSTEM RIDGE S/D BLOCK 1, I I I I I I I I I I I I INST. VALVE Sm \ I ' \y I I I I I I I _ I \wr 1 wrI I c l I I I II L—WMT I I I / X SEPTIC SYSTEM / I SETBACK FI / PROPOSED 2000 GALLON SEPTIC TANK WTTH ADVANTEX TREATMENT SYSTEM AND A UFT STATION. (SEE PACE 3 OF 4) 5 BED OM HOUSE :. I \ n4 4 SMT —PROPOSED DRAINFIELO. EXCAVATE \ A BED THAT IS 2 FEET DEEP MAX. \ BY 10 FEET WIDE BY 40 FEET LONG. ADD 0.5 TO 1 FOOT OF LEVELING SAND AND THAN 0.5 FEET OF CLEAN. WASHED SEWER DRAINROCK. (SEE DETAIL DRAWING. PACE 4 OF 4). mi ALASKA WATER & WAS TEANVATER CONSULTANTS, INC. om sinew men CFTC m • .Nfm rp " "sm • FM (007"374170 • FA% (00)13m -32L JEFF HENDRIKSON 1/2/2001 WN BY: J.LM. LE: 1"=30' 565-4799 1 2 OF 3 FOREST RIDGE SUBDIVISION; LOT 11. BLOCK 1. OF WORK: DESIGN OF PROPOSED WELL AND SEPTIC SYSTEM THE AX -10 PODS AdvanTex Treatment System P THEA SHALL BE PLUMBED AX Series - Mode la C9D AwANrF�c SO THAT THEY CAN Three (3) 34x48 Pods p.m slvn.• EACH BE ISOLATED. I TTODFILTTEERRK INLET el NOTE: THE BOARD INSULATION TO BE INSTALLED OVER THE SEPTIC TANK & 4' BEYOND ON ALL SIDES EXCEPT UNDER THE ADVANTEX FILTER. THIS WILL ALLOW FOR HEAT TO ESCAPE FROM TANK k RISE TO THE FILTER ABOVE IT. FINAL GRADE 2" INSULATION, 194' -THREE (3) AX -10 FILTERS CONNECTED TOGETHER. EASSA M M DR/AFIELD UFT STATION INLETQ ORENCO BIOTUBE 2000641M SCREENED 5SIP, " VAULT ` ENCO EFFLUENT PUMP DATE 9odp 4/2/2001 OF P� eis!� I DRAWN BY: op Af ALASKA `TATER & WASTRWATRR J.L.M.CONSULTANTS, INC. SCALEN.T.S. "6901 DEBARR ROAD. SUITE 28 • ANCHORAGE, AK 99504' FlIONE 07133 7-0179' FAK 907)33"246 REPAIRED FOR: PHONE NUMBER: PAGE NUMBER: JEFF HENDRIKSON (907) 565-4799 3 OF 4 FOREST RIDGE SUBDIVISION; LOT 11, BLOCK 1 DETAIL AND PROFILE OF ADVANTEX TREATMENT SYSTEM on- O %A a-, Ou-r�.�S Aa dA- 40 s-t�a- ;-►a ti LON FEET LANG U PgA1NN SITE ------------------------0 I I I I I I INSTALL DNERTER , O , VALVE IF ALTERNATEli ------------------------J SITE IS INSTALLED. --------- FROM ADVANTEXLt-1/4 INCH SCH. 40 PVC DISTRIBUTION LINES TREATMENT SYSTEM WITH 1/4 INCH DIA. HOLES SPACED 30 INCHES ON CENTER. 15 HOLES PER LATERAL. 30 HOLES TOTAL IN EACH BED. -7 PI tERJA1E SITE F ----------------------- ----------I o, I I I I I I I I INSTALL MONITORING ----------------------------------J TUBE (TYPICAL) 38 FEET LONG LATERAL GRADE FABRIC ADD 0.5 TO 1.0 FEET (61_1/4 INCH DIALIETER SCH. 40 PVC OF LEVELING SAND DISTRIBUTION LINES WITH 1/4 INCH DIAMETER HOLES SPACED 30 INCHES ON CENTER. 15 HOLES PER LATERAL - 30 HOLES TOTAL 10' WIDE DATE: A /n /nnnA NZ7_y7A 2 FEET DEEP MAXIMUM- AT ANY POINT ALASKA R'ATI:R & WASTENNIATER J.L.M. CONSULTANTS, INC. SCALE. O '� 6901 DESARR ROAD. SURE ire • ANCHORAGE. AK 90504 • PHONE 07)377-6179 • FAX 07)376-5246 N.T.S. Q REPAIRED FOR: PHONE NUMBER: PAGE NUMBER: O JEFF HENDRIKSON (907) 565-4799 4 OF 4 Q re GGrness- -GAL DESCRIPTION: QO ° C 7953 i) FOREST RIDGE SUBDIVISION; LOT 11, BLOCK 1, Nda rPE OF WORK: �44,•dp�o/esslo0a Ecom DETAIL AND PROFILE OF PROPOSED BED SYSTEM 1 MIN 1 AILASKA WATER & WASTEWATER CONSULTANTS, INC. 6901 DOM" Rw. SUFE 28 •ANCHORAGE AK •YOM • PHDNE (907)337-617Y *TAY:-(9Oi}T7B-U4- SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: FOREST RIDGE SUBDMSION; LOT 11, BLOCK 1 PERFORMED FOR: JEFF HENDRIKSON DATE: 3/16/2001 88 ORGANICS TEST HOLE 1 1 2—il w 1 i n 11 GM WITH SAND 3 4 5 71#111#1 SM LENSE IT ML 8 9 10 11 15 16 17 18 19 DEPTH TO GROUNDWATER DATE SEEPS o 3' & 4' 3/16/01 3.5' 3/21/01 2:51 — 6' — 2 3:21 30 5-1/2' 1/2' /.%1 3:21 i 6' — 4 3:51 11 1 5-5/8' 3/8' 5 3:51 — 6' — 6 • 0!4II1.1 5-5/8' 3/8' DEPTH TO GROUNDWATER DATE SEEPS o 3' & 4' 3/16/01 3.5' 3/21/01 2:51 — 6' — PROPOSED 5 BEDROOM DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 3/21/01 1 2:51 — 6' — 2 3:21 30 5-1/2' 1/2' 3 3:21 — 6' — 4 3:51 30 1 5-5/8' 3/8' 5 3:51 — 6' — 6 4:21 30 5-5/8' 3/8' PERCOLATION RATE 80 (MINANCH) PERC. HOLE DIA. 6' (INCHES) 20 1 TEST RUN BETWEEN 1.5 FT. AND 2.0 FT. COMMENTS: PERC—HOLE WAS PRE—SOAKED FOR 4+ HOURS PERFORMED BY ALASKA WATER do WASTEWATER I, JEFFREY A. C•ARNESS. CERTIFY THAT THLS/343fOPERFORMED l IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 4 /f I ALASKA WATER & WASTEWATER CONSULTANTS. INC. LEGAL DESCRIPTION: FOREST RIDGE SUBDMSION: LOT 11, BLOCK 1 PERFORMED FOR: JEFF HENDRIKSON DATE: 3/16/2001 ( eat) ===ORGANICS ITEST HOLE 2 IGROUNDWATERI DATE PROPOSED 5 BEDROOM HOUSE' _ L DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING CLASSIFICATIONS 3/21/01 1 2:50 rrSOIL 6' rGW 2 3:20 30 4' 2' 3 3:20 OR 6' r 4 jGPIIII11111MIL 30 4-1/2' 1-1/2' 1 3:50 r �lil'GM CIL/� 6 4:20 30 4-1/2' 1-1/2- • I j0 00 00, SWIIIIIIIIIMH rCH SM OHI I I GM WITH SAND SC IGROUNDWATERI DATE PROPOSED 5 BEDROOM HOUSE' _ L DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 3/21/01 1 2:50 — 6' — 2 3:20 30 4' 2' 3 3:20 — 6' 4 3:50 30 4-1/2' 1-1/2' 5 3:50 — 6' — 6 4:20 30 4-1/2' 1-1/2- 19 PERCOLATION RATE 20 (MINANCH) PERC. HOLE DIA. 6' (INCHES) 20 TEST RUN BETWEEN 2.5 FT. AND 3.0 FT. COMMENTS: PERC-HOLE WAS PRE-SOAKED FOR 4+ HOURS Wo e 5.5, r• 1� PERFORMED BY ALASKA WATER k WASTEWATER I. JEFFREY A. GARNESS, CERTIFY THAT THISIWAA PERFORMED I IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: o Z g a. 0 "'FOREST RIDGE SUBDIVISION' BLOCK 1 LOI IU oRAWNJ, ANDERSON cKD. R.A.S. I DATE8_15_94 ISHT. 1 OF 1 DESIGN CRITERIA: STRUCTURES, EASEMENTS, OR ENCROACHMENTS SHOWN ON THIS SITE PLAN ARE AS SHOWN ON AN AS -BUILT SURVEY DRAWN BY: GASTALDI LAND SURVEYING IT IS THE RESPONSIBILTIY OF THE CONTRACTOR TO VERIFY EASEMENTS, REQUIRED SEPARATION DISTANCES, AND PROPERTY LINES PRIOR TO CONSTRUCTION. 10' UnL ESUT I I •THJI I I • THjz I I LOT 9 LOT 10 I I flz ELL RADIUS I I I LOT 11 PROP. µ LL Gv` °•sem Ko CONTRACTOR IS REQUIRED TO OBTAIN UTILITY LOCATES PRIOR TO ANY EXCAVATION WORK. CLI nc ccrtt+ wr v.n. ,x xars.++, n wir sn[ cv:a+cus PERFORMED LEGAL DESC, P t 11, 2 It 11 3- 4- 5- 6- 7- 10- 11 45671011 12 13 14 15 1s 17 18 19 20 SLOPE SITE PLAN MANIC$ FkA T ( GA& GM- GRauEc — sFwo - src7 MuTUIE — VEPy WET. 3-20-93 a` ob- I a �. PERCOLATION RATE —J60— (minutevmcn) PERC HOLE DIAMETER TEST RUN BETWEEN 3 FT AND Y r FT COMMENTS S & S ENGINEERING PERFORMED BY: 17C34 liask pta� e vw qp�7� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH K*L9�ATFANDIMUNICf 1 GUIDELINES IN EFFECT ON THIS DATE. DATE: 72.008 (Rev. 4185) Y WAS WATER ENCOUNTERED? S IF YES, AT WHAT 'n L p DEPTH? E WAgE2 Depth to Wafer After AA-..—..w....l Monitoring? Daly 3-20-93 a` ob- I a �. PERCOLATION RATE —J60— (minutevmcn) PERC HOLE DIAMETER TEST RUN BETWEEN 3 FT AND Y r FT COMMENTS S & S ENGINEERING PERFORMED BY: 17C34 liask pta� e vw qp�7� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH K*L9�ATFANDIMUNICf 1 GUIDELINES IN EFFECT ON THIS DATE. DATE: 72.008 (Rev. 4185) Y +� O ...OFq to�•1E}1GIN .A9 :ti9$ is a� Municipality of Anchorage ^r �Z'• •'0"'«'�"' 1\C DEPARTMENT OF HEALTH & HUMAN SERVICES... ,`�in IAFE ,... (Tm�.. y 825 "L" Street, Anchorage, Alaska 99502 0650 :?t,R 4w,0 SOILS LOG — PERCOLATION TEST ria. 82 5•,.•�� PERFORMED FOR: J9C11NN 4J%i1LDERS /914c- :/; CV/L DATE PERFORMED: � 5 o�EO LaT /0 r 8uL 1 LEGAL DESCRIPTION: Pnz?gs-r �I D&E -11/1) Range, SectionRange. Section: 1 2 3 4 6 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Yi, — 1' WZ j 094A -KS snA. - sw%y C* -a / 4^'h -• SILty SA. oy G'/tM/t?C WITH Scala, G AIASY &W&- LErvs� (T'A— %w-ly Sh+ey 69w r.L Wru WASGROUND WATER ENCOUNTERED? IF VES, AT WHAT DEPTH? de—DeDU to Water Alter X—monitoring? �I SLOPE SITE PLAN ■■■■■■■■■■ 20 lul PERCOLATION RATE 11= (mmutes/mc��n++) PERC HOLE DIAMETER TEST RUN BETWEEN � FT AND —I.—FT COMMENTS S & S ENGINEERING PERFORMED BY:oop I � CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE W1S1k9 RITATEAiRfJVRLV97AL GUIDELINES IN EFFECT O THIS DATE. DATE: 72-M (Rev. 4/85) . . MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 017-113-13 1 Certificate of On -Site Systems Approval Expiration Date: (- — 1 �7 – 2 Q GENERAL INFORMATION Complete legal description FOREST RIDGE BLK 1 LT 11 Location (site address) 5201 Bishop's Castle Cir Current property owner(s) PLANTENGA Mailing address Real estate agent 2. TYPE OF DWELLING: 0. Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 Day phone 503.910-4878 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Q Private Septic Z Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5_60 , Date of Payment 10 IQ 0�� Receipt Number 0 6 0 71 IJ COSA # _ 05C22 10 7'3 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm NorthRim Eng. Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 2/10/22 OF ir jW 6. DSD SIGNATURE ♦� sem. . System #1 Approved for bedrooms System #2 Approved for bedrooms 2 Disapproved Conditional approval for bedrooms, with the following stipulations: Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of Onsite Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the Stale of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Septic System Advisory Well Flow Advisory COSA Ched-Aist blue sheer Nitrate Advisory Arsenic Advisory Other S fe 4-4&4 ,ed STQ21�a.►1(� Legal Description: FOREST RIDGE BLK 1 LT 11 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 4113/01 Total depth 73 ft Cased to 73 ft no Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 36 in. Date of flow test for COSA 2/11122 Static water level at beginning of test 31 ft. Comments B. TANK DATA Age of tank(s) 20.5 years Tank type/material . Stl Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping Note Advantex Maintenance D. ABSORPTION FIELD DATA 6/27/01 Which system tested (date installed) same ❑ ALL standpipes present per record drawing Total measured depth from grade 3 ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 017-113-13 Structure served by this system Well production at time of test 8+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L On Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by NRim Eng Date of Sample 2/11/22 C. LIFT STATION ❑ Required maintenance completed Age of lift station 20.5 years Lift station material Stl Comments: Adequacy test date 2/11122 Results [DPass For 5 bedrooms Fluid depth prior to test 1 in Water added 750 gal New depth 6 in Elapsed time 60 min Final fluid depth 1 in Absorption rate 750 gpd Any rejuvenation treatment (past 12 months) no If yes, enter date 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' [E] Yes Community Sewer Manhole/Cleanout > 100' 1 [0 Yes if No It [2 Yes if No ft Neighboring Tank > 10U V Yes if No ft Private SewerlSeptic Line > 25' Yes if No ft Absorption Field on Lot > 100' R] Yes if No ft Holding Tank> 100' Yes if No ft Neighboring Absorption Fields > 100' Q Yes if No It Water Main > 10' Animal Containment > 50' ['Yes if No ft Sa Yes if No ft Yes if No ft Water Service Line > 10' Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' Q Yes if No ft �J Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' [E] Yes if No ft Surface Water > 100' El Yes if No ft Property Line > 5' My Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' if No Yes if No ft Private Wells > 100' Q Yes if No It Water Main > 10' ft Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10' 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* Yes if No ft If absorption field is under driveway comment below Property Line > 10' Yes if No ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10* Yes if No ft Community Wells > 200' Q Yes if No ft Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION / certify that / 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. .49 Steve Eng CE -62W 07/06/2021 14:35 8686770 APLUS 394 615 r am III moseam son III onamon am BE III am 8 � Room e �a Field Maintenance Report Annual Inspe ,-tion PAGE 08 AnchorageTank 907-272-3543 Proparty 0wnarfn=king t Current oporator Currant Alex & Melissa Plani mga 2nd Compartment Larry Betts Previous Site Addreaa Prevlous Contact Phone 5201 Bishops Casty Circle, Anchorage AK 99516 (907) 743-0347 AX $ttw ID p County ID !1 Pod 0 RTU NIUL $ Detn 01 Lost InspeoUon AX -100086 SW970254 RTU 100066 11/04/2020 Retrieve O&M Info Dally now - Recirc ratio Timor settings: Perform Field Sampli hg/Observations NTU (1$:t NTlls) pH 16-9) DO (2-6) ,`? G,< Odor of Sample ` 7YPIC31 ❑ Musty A Earthy 0 Moldy Non -typical ❑ Sulfkh ❑ Cabbage 0 Decay oily flim in PVU C Yes A No Foam In tank Yes - No Ile Check Control Panels Recire Amps Discharge Amps Audible and visual alert is 210 Dial tone (telemetry oni -) L Yes �ND Inspect/Clean Pump !system Inspect Olean Riser/Lid ........... .........r(� Splice Box .......... ..... ...fJ� Roat Cords _ ..... _ .. _ . _ ... Floats.............. ......... Pump.............. .......... J Blotube Filter ....... ........... 8iotube Pump Vault .. . _ . _ .... Recirculating Splftter If,, luo....... 12 Signature _9-0 Measure Siudge/Scum Sludue Scum latcompartment Current Previous Currant Previous 2nd Compartment uMOV Previous Current Prevlous M " inspect/Clean AdvanUx Fitter Odor_ )ZNormal ❑ Pungent eiomat: —ONormal ❑ Excessive Brldging/Ponding: ONono/Minor ❑ Excessive Inspect/Clean Discharge Pump System Inspect Riser/Lid X Splice Box Float cords .+" Inspect/Service Other System Components In. -Peet Clean Late Bottom Pod Bottomm rrr---ttt Intake Vent Inspect Clean Floats Pump Inspect Clean Inspect Clo Disinfection EquipmentDispersal Lateralafdrifio� a( 1 Observations Additional Services Rendered ❑ Cleaned toxtilo sheets? ❑ Replaced UV Rams? ❑ Replaced/Used other items? Parts Used: W - Warranty, 8 - Billable (✓ appropriate selection) w R Item Number Description Final/S,afety inspection (RSV reinstalled /Manifold reconnected; flush valves closed Summary/Recommendations System performing; no further action needed ❑ Call for service bate Fax compi+efad farm to 1.1306-384-7404 lids bolted on Control panel reactivated ❑ Tank needs pumping ❑ other? k., Septic Tank Advisory Certificate of On -Site Systems Approval #OSC 221078 Subdivision: Forest Ridge B 1 lot 11 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this COSA / property is 20.5 years old. A leaking septic tank may be a source of contamination to the aquifer. Typical replacement costs range from $10,000 to $15,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of a 16 -year-old septic tank. Mailing Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTE MAINTENANCE AND REPAIR AGREEMENT I THIS MAINTENANCE AND REPAIR AGREEMENT, herein the -"AGREEMENT" made and entered into as of this --LS- Day of mAQ-c-14 of 20 ?-a, by and between 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: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as A SO \,/AV 1 EY - f!-- located at (legal description) FOIZE-ST iz1DC-1,;1 t3LK-I 40-FL1 5�- 01 53.StH �Q P�'- CA -, 7 L6 M GU o QLA G- 2. Maintenance, Repairs and Alterations. (Owner is required to read. understand and initial each section) SA— Throughout the term of this Aareement, the Owner shall enter into a service a,,reement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory w condition capable of perfori-ninor_1 as designed and producing treated septic of uent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). ,S-6— 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 C, failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Paye 1 of 3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider, Y-6 Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. S�E 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 Systerns Approval. S_-6 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. ,�E Owner agrees to maintain remote monitoring of the AWWTS as required by the A WWTS approval. 3. Term. The term of this Agreement shall be -in 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 I Agreement shall in no way constitute a waiver of the provisions, nor in any way affect Z__ I 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 Z-17 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, C, C� (rev. 05/18/2018) Paae 2 of 3 OWNER: By: `— (signature) Date: l 1 f0e �2- -nl name) v STATE OF A�A'�KA ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this _ f Nay of 161,4 t .-- !7 , 20yi, by C?e�rP - d -t?.» . STATE OF MARYLAND My Comm. E --ire, 5/.1J2'0- MUNICIPALITY: /.1/2'0 MUNICIPALITY: BY (signature) .(print name) (rev. 05/18/2018) Date: 3 — 15-- 2 C9 ZZ Title: Page 3 of 3 •e` Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 017-113-13 1. GENERAL INFORMATION Complete legal description FOREST RIDGE BLOCK 1 LOT 11 Expiration Date: to - 3-i 2 Location (site address) 5201 BISHOP'S CASTLE CIRCLE ANCHORAGE AK 99516 Current Property owner(s) GARY & CHRISTINA TARGAC Day phone Mailing address 5201 BISHOP'S CASTLE CIRCLE ANCHORAGE AK 99516 Real Estate Agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 5 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ® Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class —well 1-1Public Sewer ❑ Public Water System ❑ WaiverNariance request Received by: -.",&� COSA to be released to the engineer, COSA Fee $ 6-9(0 . Date of Payment SI2q I a Receipt Number 062 0 COSA#D.5 jl22i 11 Date: /N.�' by the engineer. Waiver Fee $ Date of Payment Receipt Number Waiver # 6. 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 ARCTERRA CONSULTING INC Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 5/2212018 ••• engmaers i-ammenrs: i ms investigation was commercial in compliance with ADEC and MOA regulations. 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 inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristes and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerm guarantee that no unseen _�_\ encroachments, deficiencies or discrepancies exist. - ` OF �,r�\ �Y � Sf7'11 6. DSD SIGNATURE _ %i4 System #1 Approved for bedrooms. / xEM1TETH D r e / System #2 Approved for _ bedrooms. 1 ss '4'i Disapproved. 1 \% .es \\i Conditional approval for bedrooms, with the following stipulations: Original Certificate Date: —7-22 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of Onsite 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 engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSTCNs1wL1P10.12.tlm If more than 1 septic system Is on the lot: COSA Checklist # of Structure served by this system _ Certificate of On -Site Systems Approval Checklist Legal Description: FOREST RIDGE BLOCK 1 LOT 11 _ parcel ID. 017-113-13 A. WELL DATA Well type PRVT If A. B, or C provide PWSID # _ Well Log (YIN) Y Date completed 411312001 Sanitary seal (YIN) Y Wires properly protected (YIN) Y Total depth 73 ft. Cased to 73 ft. Casing height (above ground) 36 in. FROM WELL LOG AT INSPECTION Date of test 4/13/2001 Static water level 31 ft. Well production 30 g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL NitrateHP-mg/L Arsenic: ND ug/L Date of sample: 5118122018 B. SEPTICIHOLDING TANK DATA 511812018 30 ft. 7 g.p.m. Collected by: ARCTERRA Tank Type/Material ADVANTEXISTEEL Date installed 612712001 Tank size 2000 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (YIN) Y Date of pumping 511712018 Pumper At HOME SERVICES IADVANTEX MAINTENANCE C. ABSORPTION FIELD DATA Date installed 6127/2001 Soil rating ( _Lid /ftr or�2.0 System type BED Length (West) 40140 (East) ft. Width 10110 ft. Gravel below pipe 0.7 ft. Total depth 2.8r ft. (measured 5/18/16) Eff. absorption area 400 1400 11Monitoring lube Y Depression over field N Date of adequacy test 5118118 Results (Pass/Fail) PASS For 5 bedrooms Fluid depth in absorption field before test 110.5 in. Water added 6001750 gal. New depth 1117 in. Elapsed Time: 1440 min. Final fluid depth 310.5 in. Absorption rate >= 750 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date D. LIFT STATION Date installed 8/272001 Size in gallons 2000 Manhole/Access (Y/N) Y "Pump on" level at TIMER in. "Pump off" level at TIMER in. High water alarm level at 45 in. Datum Bottom of Tank Cycles tested 2 Meets alarm & circuit requirements? Y E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank1lift station on lot 100'+ On adjacent lots Absorption field on lot 1001+ On adjacent lots Public sewer main 751+ Public sewer manhole/cleenout 100'+ Sewer /septic service line 251+ Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 1001+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10'+ Property line 5'+ Absorption field 5'+ Water main 101+ Water service line 10'+ Surfacewater 1004 Wells on adjacent lots 1001+ ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water 1001+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+ (NONE KNOWN) Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name KENNETH M. DUFFUS Date 5222018 CASA canary sheet_2t,15.dm - 'k 'k Ar �� OF ALS\ +4.9 TH 1' � A KENNen9r DowSgn Envelape ID: 5213006542A0416bADE3-6D2072DC49FB ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEENMUNICIPALITYOF ANCHORAGE AND Alex R plantenga THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this zD Day of July of 2018 , by and between Alex R ptantenga herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality giants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Adyantex AXIO located at (legal description). Forest Ridge Blk 1 Lot 11. 5201 Bishop's Castle. Anchorage 2. Definitions. 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. Certificate of On -Site Systems Approval (COSA). 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 Anchorage Municipal Code (hereinafter, "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 Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. 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. Permit. An On -Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AW WTS Do..Sgn Env lweID: 521a408542A04164-ADE3.6D2072DC49FB 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AW WTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations, Installation and Removal of Additional Equipment. Prior to performing any alterations to an AW WTS, the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall maintain their AW WTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AW WTS service and maintenance provider approved by the municipality and the manufacturer of the AW WTS for the entire term of the AW WTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any 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. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AW WTS C. Upon request by the Municipality, the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AW WTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AW WTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. Docu5i9n Envelope ID: 521340B542A04164-ADE3dD2072DG9FB H. Owner agrees that the AW WTS installation and maintenance requirements as provided by the AW WTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AW WTS. 1. Owner agrees to provide and maintain a telephone connection to the A W WTS as required by the AW WTS approval. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or chanced by a writing, execyted by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed with, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement, the only authorized representatives of the parties are: a. Owner: Al ez a pl antenga b. Municipality: Director, Community Development or designated authority C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair 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 Maintenance and Repair Agreement. DowSign Envelope In 52134OBS 42A0 164-A E3-6D2072DC49FB 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. 7OWNER: .y (signature) G¢ 2. I(,.� (printname) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT) Date: -1 2 EL"O"RI Public OLSON Alaska his My 16, 2036 The foregoing instrument was acknowledged before me this 2Q day of 20_�J,by -C 'Fic -i-- G/.. NOTARY PUBLIC FOR ALASKA My Commission expires: M4400 aT2O M MUNICIPALTTY: By: (signature) (print name) Date: 1 J — C iSTitle: 11 Municipality of Anchorage ' Development Services Department Building Safety Division V -tlr%,• On -Site Water BWastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK www.muni.org/onsrg/onsrie (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. t) I � -113'/3 COSA# D 1. GENERAL INFORMATION Expiration Date: /1— 3 — o ro Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address FOREST RIDGE SUBDMSION: LOT 11, BLOCK 1 5201 BISHOPS CASTLE CIRCLE • ANCHORAGE. AK 99516 JEFF HENDRICKSON Day phone 344-3532 5201 BISHOPS CASTLE CIRCLE 0 ANCHORAGE, AK 99516 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 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 Onsite 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 cerlified 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 (les 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. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 8 Z D Engineers Comments: In conducting this evaluation, GEG, Lt D. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines 8 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 identifiable features. The operational life of all wells and septic systems depend on the local sods 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 lost 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 sofe 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 57 bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other • N SIiE �•••'� • WATER AN WSpTEWpT�ER: PROG •: By: Original Certificate Date: S-3-06 IRr f�ARI ....PE ......... 13 .ess: -79P Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other • N SIiE �•••'� • WATER AN WSpTEWpT�ER: PROG •: By: Original Certificate Date: S-3-06 IRr f�ARI Municipality of Anchorage Development Services Department Buikflng Safety Division . Onsite Water 6 Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519 -MM www.muni.orglonske (907) 3437904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: FOREST RIDGE SUBDIVISION: LOT 11. BLOCK 1 Parcel ID: _0 /7- 113 - / 3 A. WELL DATA Well hype _iBNe7 If A, B. or C provide PWSID# N/A Date completed 4/13/2001 Sanitary seat (YM) YES Total depth 73 ft. Cased to 73 ft. FROM WELL LOG Date of test 4/13/2001 Static water level 31 R. Well production 30 9.p -m. WATER SAMPLE RESULTS: Web Log (Y/N) YES Wires property Proteded (Y/N) YES Casing height (above ground) 1 S+ in, AT INSPECTION 7/21/2006 27 ft. 5.12 g.p.m. Coliform _ 0 cotonles/100 ml. Nitrate _Nf2_mgA. Other bacteria_ 0 colonies/100 mi. Arsenic: NO ugA. Date of sample: 7/21/2008 C ilected by: GEG. Ltd. B. SEPTIC(HOLDING TANK DATA 'WILL BE PUMPED AS NEEDED UNDER ADVANTEX MAINTENANCE CONTRACT Tank Type/Matarlal _ AOVANTEX/STEEL Date installed 6/7-27/2001 Tank size 2000 gat. Number of Compartments 2 Cleanouts (Y/N) YES Foundation deanout (YM) YES Depression over tank (Y/N) NO High water alarm (YM) YES Date of pumping ' Pumper A+ HOME SERVICES C. ABSORPTION FIELD DATA 16SELOW EX Date installed 6/7-27/2001 Sop rating (g.p.dJfl t rr 2_0 System type BIS Length 40/40 ft. Width 10/10 ft. Gravel below pipe 0.70 ft, Total depth 2.83+ IL Elf. absorption area 400 400 ftr Monitoring tube YES Depression over field NO Date of adequacy test 7/21/2006 Results (Pass/Fall) PASS For 5 bedrooms Fluid depth in absorption field before test RY DRY in. Water added 760 gal. New depth4.5 4.5in. Elapsed Time: 324 min. . Final fluid depth DRY,/D in. Absorption rate >= 750+ g.pA. Any rejuvenation treatment (past 12 mo.) (Y/N 3 type) NONE KNOWN If yes, give date — D. LIFT STATION Date installed Size in gallons "Pump on" level at _in. "Pump ofP�t ---- 0.' High water alarm level at in. Cycles tested Meets alarm 8 circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/ldt station on lot 100'+ On adjacent kNs 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent kits 100'+ Public sewer manhole/cleanout N/A Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 50+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ 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. parkingtvehide storage 10'+ Curtain drain NONE KNOWN Wells on adjacent k is 100_+ F. COMMENTS G. ENGINEER'S I certily that I have determined through Held inspections and review of Municipal records that the above systems are In conformance with MCW COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. WNL Date a/i/°6 COSA Fee E c130. UU f l %5• cx) Date of Payment �31/0 (- Receipt Receipt Number 7 (nN. iI=) Waiver Fee E Date of Payment Receipt Number 98-29 FOREST RIDGE SUBDIVISION LOT 11, BLOCK 1 42,806 S.F. WOODHAVEN AVE. 0 n N 89048'11"E 166.03' 10' T. do E. ESMT. ------------------ I I I LOT 11 t I I I I I I I �y U) I 7`1 EXISTING e O 'I tNo I BUILDING (SEE MAL) s%.n• r*i in WELL w I ■ cl I I SEp% SISTE+ I - - .4 40' SEPTIC SETBACK Cb A3 4 42.-1v AS- GASTALDI LAND SURVEYING JEFF A. GASTALDI, R.L.S. 4726 WEST 88TH AVENUE ANCHORAGE, ALASKA 99502 PHONE 248-5454 GRID DATE 3137 10/1/2001 F.B. JOB NO. 01-07 FRS111 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 EASEMENT; COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT, UNDER NO CIRCUMSTANCES SHOULD ANY DATJ HEREON BE USED FOR CONSTRUCTION OR FO ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT, ALASKA NOTE: NO CORNERS SET THIS DATE. fA ri N W O O O O O O II 1 11=40' BUILDING DETAIL SCALE: 111=20' OF q i ,k 49111 •: A r ...............,....« Jeffery A. Gostoldl : o` t •., r LS -6091 .f �oa• o �p ••.....•••• `' a �tos$Iona%va '♦� ti t1***•