HomeMy WebLinkAboutELMORE #2 BLK 8 LT 12 Municipality of Anchora[ e 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 Na~: ~To~ ~~ Wastewater System: D New ~Upgrade ,~,,,,: ~ u ABSORPTION FIELD ,,o.: I,o;.~.oom.: DDeepTrenc~ ~Sha,owTrench XSed ~Mound ~Olher SEPARATION DISTANCES m s~p~c ~ Ho~a s,,,~, ~o ~o , ~o LIFT STATION Water ~ ~ ~ ~ Line q~ I ~ I Remarks: BENCH MARK ENGI~E~B'~ SEAL Inspections performed by: ~ ~ Dates: 1st ~/~ ~, .~ ~. Deparlmenl ot Health and Human Se~ices approval ~((~,,',. c~'~"~ ,...,~ --' O£NCl4 BOITOI~ $101NG NO. C£-2225 P5 50 75 SCALE, I' = 50 FI. 1,25 150 IIOBBEN SPURKLAND P.E. 20J W ISTH. AVENUE ANCN. Al(. 9950l PERNII # $W980£9£ II ~,'LMOI?A' LT 12 BLK 8 460t £ASI t45/r£10N JIM STOW PlD # 018-17~-$4 II sEPtiC srsrEu AS ooItr OATE: OCr. 9/t998 SH~ET: 2/J GRID: 3036 ELEO81£P. DWG 4-INCH INSULATION § X $7.$ DRAIN£1ELD $ FT TOTAL DEPTH 2 FT FILTER SAND 0.5 FT EFFECTIVE ROCK 2 FT COVER 2" INSULATION AIRCOI~PRESSOR -- ': ,-'-' BIOcYCLE ,ooo JlOBBEN SPURKLAND P.E. J j 4nchoro~e ~k 99501 27B-.~BTE PENMI~ ~ 5~980292 ~ 2' INSUUrION FILTER SAND GROUNDWATER NO SCALE 96. I 95.6 93. 6 LEGEND: 2. $. 4. 5. ELMDRE BLDCK 8 LD? 12 B1OCYCLE b'ASfE ~/ATER SYSTEM PRIMARY TREATMENT, SEPTIC TANK AERATION TANK >. ~:.'~]. CLARIFICATION TANK :; '. . DISCHARGE TANK , . ' SOIL ABSORPTION BENCH MARK: BOTTOM SIDING DA~E: /]OC~. 9, 1998 SHEE~: 5/~ GRID: ~0~6 PiP # 018-172-$4 ELEOB123. DWG blOV-- 1 FR1' 8 : 15 RE~ EIVED {VOV 2 4 1998 MunlclpaJlly o! Anchoringe Dept. Health & Human Sarvlces MUNICIPALITY OF ANCHORAGE Deparfment of Health and Human Sen~ices On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage. AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Aug 11, 1998 Expiration Date: Aug 11, 1999 Permit Number:. SW980292 Legal Description: ELMORE#2 BLK 8 LT 1"}., Design Engineer:. 7 '~0 Lt.~U {:~ ,~,~ Owner Name: James Stow OwnerAddress: PO BOX 112323 Anchorage, AK 99511-2323 Parcel ID: 018-172-,.~. Site Address: 014401 TETON PL Lot Size: 40280 SQ. FT. Total Bedrooms: 2 Permit Bedrooms: 2 This permit is for the construction of; [] Disposal Field 1-~ Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and Ihe State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either:. A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. ~his.pemll{ is for a Biocycle system / . .. A'minimum distance of 100 horizontal feet shall be maintained betWeen the subject trench and the subject well and well on Lot 7, block 7. The maximum depth of the bottom of the system shall be one foot below existing grade (after excavation of organic ~materiats and importation of sand liner). The orientation of the trench may be adjusted to fit the trench betWeen the well radii. Received By: ~~~ Date: ~?' ! ''[''' ~'~"- Issued By: 4~ Date: ~" l f'~ 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 9950 I (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 1 BLOCK 8 ELMORE JIM STOW 4601 E 145TI1. AVE. Municipality of Anchorage Department of Health and Social Services 8201 Street Anchorage, Alaska 99501 June 13, 1998 August 7, 1998 We are submitting an application for the installation of a septic system upgrade for this lot. The existing system has failed, partly due to high groundwater conditions. On June 8, 1998 several locations on the lot were probed, showing that groundwater was as shallow as 2 feet in places. One location was found where groundwater was located at 6.5 feet. This area is limited in extend, and encroached upon by two wells. A pre treatment unit is the best solution under the present circumstances, and Mr. Stow wants to install a BioCycle. He is familiar with this system, a BioCycle is installed on one oftbe adjacent lots. The existing residence is a 2- bedroom single family structure, however a three bedroom system is desirable. The horizontal distance between the well on this lot and the well on lot 7 is 235 feet, 2 feet more or less, less thun is required for the placement of a standard 5-wide three bedroom absorption field. We request to use a 5.5 feet wide trench to eliminate encroaching on the wells. The Site was revisited on July 23, 1998. The testhole was dry to 8 feet below ground surface. Since the first sitevisit substantial regrading of the road ditches had occurred. The ditches along the south and west property line were dry, but the ditch across E 145TH had water running. It can safely be assumed that all ditches will have running water during breakup and after heavy precipitation. A standard septic system complying with AMC Chapter 15.65 cun not be installed on this lot. A holding tank or an approved pre-treatment unit are the only options available to the owner. A holding tank is not desirable. All three approved pre-treatment units will under normal use and maintenance meet EPA's secondary treatment standard. We suggest the installation ofa BioCycle because of the cost and the amount of maintenance and warranty provided by the supplier. This submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests ofapplicable testholes are also enclosed. The septic system design is based on the following: Ground Water at 5 ft. Use 5.5 ft Wide Trench with BioCycle 6000 Soil Rating. From Testholes June 8, 1998 3 min/in = 2.4 gal per sq.ft/day No. of Bedrooms 3 Required Area per Bedroom: 150/2.4 -- 62.5 sq.ft. Total area required: 62.5 x 3 = 187.5 sqft Top Rock At I feet 24" of filter sand Rock Depth 0.5 feet · Total Trench Length 187.5/5.5 = 34.0ft. SYSTEM CONFIGURATION 5.5 WIDE TRENCH TOTAL LENGTH 34.0 FT TOTAL WIDTH 5.5 FT TOTAL DEPTH 3 FT FILTER SAND 2 FT ROCK DEPTtt 0.5 FT COVER 2 FT INSULATION 2 IN. BIOCYCLE 6000 PRE TREATMENT UNIT The installation of this septic system will not prevent wells from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoffwill not result from this installation. o ~o ~oo ,~ SCALE,'. 1'\= I" LOT I LOT £ LOT 12 IVeL ITOBBEN SPUNK/AND P.E. 203 W 15TH. AVENUE ANCH. At(. 99501 (9OX) PEI~NIT # $1ggBooXX PID # EZMORE LT 12 BLK 8 4601 EAST 145/TETON JIM STOP/ SEPTIC SYSTEI~ DESICN DATE: JUNE 9, 1998 SHEET: I/5 C£1O: J056 yy ELEOSI£LD~/G I~ISTALL ~IOCYCLE INSTALL 5 X 145TH, AVENUE SPURKLAND NO. CE-EZE5 50 z-'o SCALE: I' = 50 FT. 1~5 158 IOBBEN SPURKLANO 205 P~ 15TH. AVENUE ANCH, AR 99501 (~07) ~Zg-Sg,e PERMI[ # swg$ooxx II PID # El, MORE LT 12 BLK 8 4601 EAST 145/TETON dlld STOP/ 01B-17~-34 SEPTIC SYSTEId DESIGN DATE: JUNE 9, 1998 SHEET: 2/3 GRID: JO J6 ELEQ~I22.D~/G 4-INCH INSULATION SAND ~ACK£1LL -- * $'-~' ktlN B'-O* ~3 *i j /~ Am BIOCYC: E 6000 t-ti4 eve ~r/~ t/a' t~ot£s ar Jo' 5 X 57.5 DRAINFIELD J FT TOTAL DEPTH 2 FT FILTER SAND 0.5 FT EFFECTIVE ROCK 2 Fl' COVER 2' INSULATION ~;o~,o~o~oo%~o~o-o_o ,, , .... ..... ~ ...... i ' ~ ~6~ ' ' ' ~ ~ SILT BARRIER ~ EILTER SAND ~ROUNOW4~ER NO SCALE LEGEND: I. PRIIdARY TREAT/WENT, SEPTIC TANK 2. AERATION TANK J. CLARIFICATION TANK 4. D/SCHA£CE TANK 5. SOIL ABSORPTION I'OBBEN SPURKLAND P.E. J J 203 Wl5fh Ave Anchoraae Ak 99501 279-5.9'/6 PERMIT # SW98XXX ELMOPE BLDCK 8 LET 8IOCYCLE VASTE VATER SYSTEM 018-172-34 WASTEWAT££ SYSTEW $CH£WAT/¢ DATE: JUNE 16, 1998 SHEEn SIS GRID: SOS6 ELEOSl£3.DV6 PERFORMED FOR: LEGAL DESCRIP~'ION: 1 2 3 4 5 6~ 7- 8 10- 11- 12 13 14 15 16. 17- 18- 19- 20- COMMENTS Munlclpaflty Df Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Archorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST OP-.G/~C, ltC5 ~ ]_.11.~ ~v2.~.Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT ~t (~ DEPTH? p E De,th to Water After t_~ ~ ~,~.~,,/~,-~( Monitoring? ,~,,,~ Dire: SITE PLAN Gross Net Depth to Net eading ,~ ..~.~ ~,o~ ~ -.~ ~. _ m ~ lO ~ ~ ~ ~//~ Io -'~ ~ ~ - PERCOLATION RATE ,.~ (mmutes/,nch) PERC HOLE DIAMETER ~.~ TEST RUN BETWEEN 'r~ FTAND ...~..~ F T PERFORMED BY: ~'7, ,~ , I ~'~'"~ '"~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~'~ ~/~t~-~ 72-008 (Rev. 4/85) DEPT. OF ENVIilONMENTAL CONSERVATION TONY KNOWI. E,$, OOVERNOR DIVISION OF ENVIRONMENTAL ltEALTH DRINKING WATER and WA,'iTEWATER PROGRAM 555 CORDOVA STREET ANCHORAGE, AK 99501 ht t p://www.sta t e.ak.us/d ec/h on~e/ht m Telephone: (907) 269-7519 Fax: (907) 269-7650 June 29, 1998 Mr. Tobben Spurkland 203W. 15'hAve.,#203 Anchorage, Alaska 99501 Re: Waiver Request for Lot ! 2, Block 8, Elmore ADEC # 982 I-WW-175-276 Dear Mr. Spurkland: I have reviewed your informatior for relocating an on-lot ~vastewater disposal system for Lot 12, Block 8, Elmore. Based upon th, information provided your proposal to meet site concerns and allow for a safe development can be accomplished, if the following items are able to be meet: 1. Install the Biocycle 650 as you proposed. 2. Install the field with e ~.ninimum of 4 feet betweer the bottom ofthe drainrock layer and any water level found on the site. 3. Using the 5-feet by 37.5 foot trench, align to minimize any encroachment into the wells around the area. This approval does not imply the granting of additional authorizations, nor obligate any state, federal, or local regulatory body to grant required authorizations. State Drinking Water and Wastewater Regulations require fees for plan reviews for waivers. The attached billing is for your requested review. Thank you for your cooperation: z:d coordination with this Department. If you have any questions, please do not hesitate ',o contact me. Respectfully, William R. Rieth, P.E. Environmental Engineer WRR/cf Enclosures: As Stated AUG-05-98 WED 12:51 PM ADEO DRINK WAT/SOL WASTE FAX NO. 907 269 7655 P. 05 TONY KNOWLE$, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION FAXED DIVISION OF ENVIRO~N~IENTAL HEALTH DILhNKING WATER and WASTEWATER PROGRAM 555 CORDOVA STREET ANCHORAGE, AK 99501 htto://www.stat¢.ak.us/dec/home/him August 4, 1998 Mr. Tobben Spurkland, P.E.' 203 W. 15~ Ave., #203 Anc. horage, Alaska 99501 Re: Lot 12, Block 8, Elmore ADEC # 982 I-WW-175-276 Telephone: (907) 269-7519 Fax: (907) 269-7650 RECEIVED AUG 5 199B Munic~pahty um ~,,~no~age Dept. Health & Human Services Dear Mr. 5purkland: As you are aware, there was a meeting WedneMay, July 29 between the Department staffand Municipality staff. The meeting was. held, in part, to discuss you~ project on Lot 12, Block 8, Elmore. I issued you a letter concerning the above project on June 29, 1998 (see attachment concem~rig the'placement ufa field on the lot). Since that time, some changes in ditching have occurred. Further review of the design, in light of the recent changes, has confirmed the need to retah~ the four feet beneath the drain rock. Wi~ wells in close proximity that axe drawing water from leas · than i 50 feet and a failed septic ~,stem on this log the use of the Biocyele 6000 effluent you have recommended is a logical provide the form of treatment. You show cover of three feet in your propoged design; with insulation, a reduction to two feet of cover is allowed by State · regulation listed 15 AAC .7.2.025C0)(3). I suggest, that you again approach, the Municipality with a plan that does not require a vertical separation, distance waiver for the development on Lot 12, Block 8, Elmore Subdivision. Please see Ms. Meat wig the Municipality to continue your project as.. she will have copies of this corresi~ondenee. Respectfully. William IL Rieth, P.E. Environmental Engineer WR. RJcf Enclosures: As Stated cc** lq$. lVl. e&J:~ lqOl~ . PROPERTY OWNER AGREEMENT FOR THE I~NANCE OF AN ON-SITE WASTEWATER DISPOSAL SYSTEM This a~eement, dated /"/PS' 199.~., is made between the Municipality of Anchorage Department of :tealth and Human Services (DHHS) and the property owner(s) of: This a~eement is made for lhe purpose of maintaining an on-site wastewater disposal system on the subject property. The property, owners a~'ee to tl],e following: Submit to the Municipali .ty of Anchorage, on an annual basis, an inspection and operation statement from a registered professional engineer. This inspection and operation statement shall verify that the engineer has inspected all effluent and air pumps, timers, and alarms, '.nd that any deficiencies have been repaired and that the system is functioning as desk.ed. (Signature) (Printed Name) (Printed Name) .............................. Notarize Here ~TUUZ ................................. State of On this day of personally appeared before me, -- who is personally know~ to me __ whose identi:v ! proved on the basf. s of __whose identi~y I proved on the bath/affirmation of , a credible witness to be the signer of the aboy~ ~ocument, and he/she a.:knowledged that he/she signed Notary Public My commission expires BioCycle ALASKA WASTEWATER TREATMENT SYSTEMS GUARANT~g. AND MAINTENANCE AGREEMENT And: BioCycle AI.-tska (The Company} 2440 £. Tudor Road. $te. 162 Anchorage. Alaxka 09507-1185 (907) 283-900M(007) 2R.1.8 ! Ig Fa< A. G UA _R..~a. NTE F: Thc Company Jnara~tecs to Kpair or mplac ~?te 0fcharge any pans of the $v$ em ta dllrlnS repair ar teplaccntent duc to defect,va ' a. ~imin five O) yea~$ of this Ag rcmcnt, except for ~ recta in thc aeration pump. tho d scharge pump and thc eleculcal cireuit~, for whh h thc Ix'rind of ~ ~nB, shall I~ one (I) ~esr. . b. ~(I mhcr than umlc* exccpfiop II eircumslanc¢s, tM ~mpany shall rcs~nd within ~ ~casonahlc time o~ ~e MAINTENANCE a. Adjuq thc air intake in the ¢larilication chamber c. Replcnilh the iupply Of chlorine tablets, Ifchlorination ofeffiucnt ~ being ~ffo~ed. e. File a copy Pt the Malntcn~cc Report wi~ ~e ~p~nl Of [nvlronmefllal Consolation. S~ or Alaska. or any outer local (cgula~o agent)' ha*ingjufl~dlction ~'er ~e e~a In which elk Sys~m Is installed ' [ ~CC Cve~' ~e (3) months ~e filler fit tho alt blo~r will be changed. 2. In ~; went the Cu~omer ~qne;u the ~mp~y to ~etfo~ main~=nan~ to lh* system o~r than ~a~ s~cifi~d In R I. a~vt or Company a ~nublc add; ;anal ch~gcs ~o ,,~ ~o~ done ~ ~1 a, fo* ~y a;mclat=d aquipment ~d e~ supplies. Addilie~allv the Cu;m~r *ha;I pay thc Company's ~a~o ~btc sh~e~ whom th; nc{d for a'o~k i~ a ~sult of~ Customer'a fa;lure ~ en~u~ compli~te ~}ith Ih: operating instmctionq. ~ .m ;ending the I}.llem ~n ;xce~ of~e &sign ~ow fo; lhe In~allation. nr where ~e J Camm;acing at tire em] of one (I) year fr.~m the dar= of this conm~ct, the Custo~ agw~ lo panicipale in ~i~ycle s o~gnlnl C. CIILORINE WARNING ~ ~. GRFf'~.~R ANCHORAGE AREA 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM PHONE '3"¢d" 007,2 .AME t'?--m~ ~'YOU~ MA,L,NOADDRESS ?.©. 8ox LOCAT,ON'I i '*' U'/S LEGALDESCR'PT'ON RIIc ' (mor¢ SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH MANUFACTURER ~, ~ ~ ~-'-' MATERIAL /' INSIDE WIDTH ~ LIQUID DEPTH z NUMBER OF · COMPARTMENTS f LIQUID CAPACITY/~(~GALLON$. TILE DRAIN FIELD= FOUNDATION ~7 NEAREST LOT LINE.~ DISTANCE FROMWELL NUMBER OF LINES / DISTANCE BETWEEN LINES )t['/b - TRENCH WIDTHi~''v'v''~''~''~ N ABSORPTION AREA ~'~'"'~ SQ. FT. LENGTH OF EACH LINE /~'~,f ~' 4 ) DEPTHOF FILTER ~7~.~1N DEPTH; TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE , ABOVE TOTAL ,ENOTH. - OF L,NES //x..,, = ?~" TOTAL EFFECTIVE ~ILE _~IN. DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION , LOT LINE , SEWER LINE , TANK . SYSTEM CESSPOOL APPROVED , OTHER SOURCES DISAPPROVED DISTANCES: INSTALLED SEWER LINE DEPTH: LOT SLOPE: REMARKS: ~ DIAGRAM OF SYSTEM O ,.,,TALL*T,O. LOGAT'O" [/W"~ ¢ '""S''~ FINANCED THROUGH TO BE INSTALLED BY NOTes THIS pI~RMIT IS NOT VALID WITHOUT ~OIL FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL, QUALITY AUTHORITY WILL, BE SUBJECT TO PROSECUTION. searle TANK s~zE ~ O"O C:~ - TTPE _ ~ SEE.AGE AnEA slz~ . wrr ' DIAGRAM OF SYSTEM MINIMUM DISTANCES. REQUIREMENTS .EpT,CTANK~.g-' 'T''~''-- ~, .~. WELL TO SE,'r;C TANK ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK ~)RAIN FIELD -SEEPAGE PIT o DRAIN FIELB CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28*68 AND THAT THE ABOVE E0-016(3-75) GARY PLAYER VENTURES CONSULTING GEOLOGIST SOX 476-M, STAR ROUTE A · ANCI-IORAGE, ALASKA 99507 · PHONI'~ 344-7075 SOILS LOG Performed for Legal Description .DePth (feet) --2- 0~5 S.oil_ Description -16- -18- -20- Total Depth ],.~'" Was groundwater enco~utered Depth to bedrock ~~-0 feet in C~/~ ? ~t depth IOf~ ? How determined LAS~ ? Respectfully submitted, Gary F. Player Consulting Geologist DA~LY DRiLLiNG LOG PENN JERSEY DRILLING CO. 2833 Eazt T2nd Avenue ow~£R OF m'm'D..--..ii.L'...2J.".'2~'::-~-~.~ .................................... a~oRrss ............ :".:~.:_~2;L.12~ 2'.i..2.'....~.?~.~.~;'-27-~2.7 ......... w£L~._s,TE.._..?.!.L'..!i.~.Z'.:_.2.._!~?.L.!.i..Li:i..~ ................... D A TE_~ T A RTED ..._. ~.: [ .: ~ :..~......?..~ .~,.....'],..?...-. ?.. ................................................. o ATr,--r,.~ ............ ?;.f .~....?.!:....!?.!'.'. ................................. Anch~rare, Alask~ 99502 34~-2612 DEPTH OF WELL. ............. ~ ................................................................. STATIC LEVEl, OF WATER tUT ......................................................... DRAW DOWN FT .......................................................................................... GALS. PER HR.. .................. :....~.:..:....:../..~ ........................................................... ~-~:.~ . ·* .., KIND OF CASING ............................................................................................... KIND OF FORMATION: FROM ......................... l~r. TO....~ .................... 1~ .................................... FROM.......'. .................. FT. TO...--..; .................. 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MISc~ INFORMA~ON: FROM .......................... FT. TO........v ............... FT ....................................... FROM ......................... FT. TO ........................ FT ......................................... FROM .......................... FT. TO ....................... FT ......................................... FROM ......................... FT. TO ....................... FT ........................................ FROM .......................... FT. TO ......................... FT ....................................... FROM .......................... FT. TO .......................... FT ....................................... FROM ......................... FT. TO ......................... FT ........................................ FROM .......................... FT. TO ........................ FT ..................................... FROM ......................... FT. TO ....................... FT ........................................ I~OM .......................... FT. TO ......................... FT ........................................ FROM. ......................... FT. TO ........................ FT ........................................ I~OM ........................ FT. TO ....................... FT .................................... I 0 ~0 3C 2~2.C'0 41,ZIgsq ~'t. RIVERTON 212.00 41,293 sq '~f. ,; AVE. S 89°50'47"w- 1338,. 9.4 212 O0 2 ~ 2.0C --_ N$9o56'I7"E __ - 0 212.00 2~2 O0 212 O0 2~ 2 A.CHOR^ DEPARTME[ ~F HEALTH AND ENVIRONMEN1 PROTECTION 825 ~L Street, Anchorage, Alaska' -99501 279-2511, ext. 224 or 225 Date Received: April 14, 1977 #1: Time ;/~.~f~ ~D9. ~2: Time #3: Time Date L/-;~.~Q ~o Date Date Insp ,('~¢.m~,[~ Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institution Request: Peoples Bank and Trust Mailing Address: Pouch 7-007 99510 Phone: 279-7511/242 Phone: 344-0077 home Property Owner: James/Romona Stow Mailing Address: Box 10222 Klatt Station 99502 278-1912 his w 344-1413 her w Lot 12 Block 8 Elmore Royalty Subdivision 3. Legal Description: 4: Single Family Residence: (xk Multiple Family Residence: ( ) Number of Bedrooms: Number of Bedrooms: 5. Well System: Public/Community System: ( ) Individual Well: (x~ m ® Construction ,,'~2~ ~'~ Sewage Disposal System: On-site System Permit ~ / Installed 1977 82 Well Log on File (x~ a'./?, Bacterial Analysis (/ Public Utility ( ) Installer Septic Tank Size /0~0 J Manufacturer ~ Absorption Area ~Soils Rate /~-~ Material / Distances: Well to Septic Tank /OF9-7~ to Absorption Area./~ to Sewer Line ~ I1~, Nearest Lot line ~ Absorption Area to Nearest Lot Line ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L Street, Anchorage, Alaska 99501 279-2511, ext. 224, 225 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: VA 2. Property Owner: JA~fES & RO%IONA STOW Mailing Address: BOX 10222 KIATr STATION 3. Name of Buyer: JA~S & RO~DNA STOW Mailing Address: BOX 10222 KLATr STATION 4. Name of Lending Institution: Mailing Address: 5. Name of Realtor or Agent: ' J. A. MCDITI'~,R EEALTY' Mailing Address: 6. Legal Description: Location: FHA CONV ~ Day Phone: HOHE P}DNE 344-0077 278-1912 _ or344~] 41~__~ Day Phone: Phone: 279-7511 EXT 242 JONAS ARNBRISTAR 3400 IfF. VI~[}lli%~____Phone: 279-2589 [Dr 12 BLk. 8 Elmore RoYalty Subdivision ,7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation SINai-. FAXKLY RESIDENCE No. Bdrms. 3 .Individual "~ SEPTIC Individua~ (on-site) IQ'7'7 '/2.003(3~6) Page Two . · '-' Departmen~'of Health and Environmental Protection ~' 'Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 12 Block 8 Elmore Royalty Subdivision' Comments: Affadavit Attached: ' (') Approved: Disapproved: Letter Attached: ( Date: Date: Department Worksheet: 8 9 1p �7 O r. • r� Municipality of Anchor ' e o <E • e 2017 On-Site Water and Wastewater Progr.m ��N 6 (907) 343-79045 .r r Y Cu \ Certificate of On-Site Systems Approve 6 e Parcel I.D. 018-172-45 Expiration Date: --( ^1 7 1. GENERAL INFORMATION Complete legal description Elmore #2, Block 8, Lot 12 Location (site address) 4601 E. 145th Avenue Anchorage, AK 99516 Current Property owner(s) Matthew & Casey Randall Day phone 632-4538 Mailing address 4601 E. 145th Avenue Anchorage, AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: Single Family (w/wo ADU) El Duplex El Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: —AinarW0 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for. Distance: t Received by. . g�j �+<4•klb ti J I Ia w A + Dater / /-4 COSA to be releasedto a engineer,unless oise requested by th.eff eer. Li1r it /2/; 1i26r W21)&14 COSA Fee $ 62-to — Waiver Fee $ Date of Payment C, I Ito ti 1 Date of Payment Receipt Number 0(.0 Receipt Number COSA# d5C1.1 t 24L' 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 Anderson Engineering Phone 522'7773 Address PO Box 240773, Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 6/16/2017 A et •S � '' .�.; •.'I ate tc Crj: 6. DSD SIGNATURE Cdr ' 49Th .•�- v rJ°ro°v4 •i°°�'''o '•� �• System #1 Approved for bedrooms ; 0 •MICHAE! ANDERSON System #2 Approved for bedrooms � c�so Cc-4381 �� 4 ,e; ° C-!G'-i 7 °�•s Disapproved #p, Fp°..0,•.0. 418 PROFE5S\D���a`'° Conditional approval for bedrooms, with the following stipuralifibi4r,'�'`�" ON SITE WATER AND r- R, WASTEWATER -� PRC`J„'R,'i Y'i LL(// By: Original Certificate Date: 6,-2/ / The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet_E c 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: Elmore #2, Block 8, Lot 2 Parcel ID: 018-172-45 A. WELL DATA Well type Private If A, B. or C provide PWSID # Well Log(YIN) Y Date completed 7/25/05 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 1 72 ft. Cased to 1 72 ft. Casing height(above ground) >18 in. FROM WELL LOG AT INSPECTION Date of test 7/25/05 4/22/16 Static water level 60 ft. 63.58 ft. Well production 20 g.p.m. 7.6 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate .886 mg/L Arsenic ND ug/L Date of sample: 5/30/17 Collected by: And. Engineering B. SEPTIC/HOLDING TANK DATA Tank Type/Material Biocycle/Fiberglass Date installed 9/8/98 Tank size 1 ,600 gal. Number of Compartments 4 Cleanouts (YIN) Y Foundation cleanout(YIN) Y Depression over tank (Y/N) N High water alarm (Y/N) Y Date of pumping Pumper Biocycle Maintenance - See Records C. ABSORPTION FIELD DATA Date installed 9/9/98 Soil rating (g.p.d./ft2 or ft2lbdrm) 2.4 GPD/SF System type 5' Wide Length 34 ft. Width 5.5 ft. Gravel below pipe 5 ft. Total depth 4.4 5 ft. Eff. absorption area 1 87 ft2 Monitoring tube Y Depression over field N Date of adequacy test 4/22/1 6 Results (Pass/Fail) Pass For 2 bedrooms Fluid depth in absorption field before test 0 in. Water added 300 gal. New depth 0 in. Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 300 g p d N Any rejuvenation treatment (past 12 mo.)(Y/N & type) If yes, give date D. LIFT STATION Date installed 9!8198 Size in gallons 1 ,600 Manhole/Access(YIN) "Pump on" level at 25 in. "Pump off"level at 44.5 in. High water alarm level at 22.5 in. Datum Bottom of Tank Cycles tested 3 Meets alarm&circuit requirements? Y E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot X100' On adjacent lots >100' Absorption field on lot 100' On adjacent lots >100' Public sewer main >75' Public sewer manhole/cleanout >100' Sewer/septic service line >25' Holding tank >75' Animal containment areas _ >50' Manure/animal excrete storage areas 100' SEPTIC/HOLDING TANK ON LOT TO: >5' >5' >5' Building foundation Property line Absorption field Water main X10 Water service line >1 Surface water >1 00 Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line > Building foundation > Water main > 10' Water Service line >1 Surface water 0' >100 Driveway, parking/vehicle storage > Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION 4. / certify that I have determined through field inspections and �41 • '`�'���' • review of Municipal records that the above systems are in .� •• 49TH •• �I conformance with MOA COSA guidelines in effect on this date. y:....:,;.,1".. .... F_L .P--42 a.•• Michael E. Anderson, P.E. �•••••••,•- • - Engineer's Printed Name �" ,:•MICHAEL E. ANDERSON 6/16/2017 d0 CE-4381 Date #i re�''.• ./1 -(.7%, ,,,4•- •• (.7 �� COSA brown sheet 10-10-12.doc ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNIIPALITY OF ANCHORAGE AND t.L./1'c( el-4.A THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this /L' Day of 'u of 20 177 by and between 7j.v;c( 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 grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Biocycle Treatment System located at (legal description). Lot 12, Block 8, Elmore No. 2 Subdivision 2. Definitions. Alteration. Any change to the design or function of an AWWTS 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 AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On-Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 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 AWWTS 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 AWWTS, 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 AWWTS 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 AWWTS H. 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. 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 changed by a writing, executed 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: �n.✓,tt a 64 LA..r c.- 2 A,.I :,V..., - 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. ;axil.. service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. 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: (I) 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 AWWTS. 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 AWWTS 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 AWWTS 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. 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. 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. OWNER: By: (signature) Date: 4/— i (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT The foregoing instrument was acknowledged before me thisII L) day of 20 13, by Did .wry �C _ NOTARY PYY PP...0 C FOR AL SKA soM ko : . My Commission expires: Li-�6 /WI q 4 s r: itelett.d .- 40,, • , MUNICIPALI • 1 t �^ (signature) Date: -2_i ^1 7 (print name) Title: