HomeMy WebLinkAboutELMORE #2 BLK 12 LT 2Imore lock 12 Lot 2 018-173 -31 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: _______________ Date of Issue: ____-____-____ Parcel Identification Number: ____-____-____ Legal Description Block Lot Property Owner Name & Address: Pump Installation Date: _____-_____-_____ Pump Intake Depth Below Top of Well Casing: __________ feet Pump Manufacturer’s Name: ___________________________ Pump Model: _____________________________________ Pump Size: ____________hp Pitless Adapter Burial Depth: _________ feet Pitless Adapter Manufacturer’s Name: _________________________ Pitless Adapter Installer: ____________________________ Well Disinfected Upon Completion? XX Yes No Method of Disinfection: _____________________________ Comments: Pump Installer Name: __________________________________ Company: ___________________________________________ Mailing Address: ______________________________________ City: ___________________ State: __________Zip: _________ Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: _______________ Date of Issue: ____-____-____ Parcel Identification Number: ____-____-____ Legal Description Block Lot Property Owner Name & Address: Pump Installation Date: _____-_____-_____ Pump Intake Depth Below Top of Well Casing: __________ feet Pump Manufacturer’s Name: ___________________________ Pump Model: _____________________________________ Pump Size: ____________hp Pitless Adapter Burial Depth: _________ feet Pitless Adapter Manufacturer’s Name: _________________________ Pitless Adapter Installer: ____________________________ Well Disinfected Upon Completion? XX Yes No Method of Disinfection: _____________________________ Comments: Pump Installer Name: __________________________________ Company: ___________________________________________ Mailing Address: ______________________________________ City: ___________________ State: __________Zip: _________ Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. Municipality of Anchorage Development Services Department Building Safety Division S A E On -Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Paget of 3 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: OSP111058 PID Number: 018.173-31 Name. Wastewater System: ❑ New ® Upgrade Becky Address: 4650 E 147th Avenue ABSORPTION FIELD Phone: Number of Bedrooms: ❑ Deep Trench ® Shallow Trench ❑ Bed ❑ Mound ❑ Other. Soil Rating: Total Depth from original grade: LEGAL DESCRIPTION 4 GPD/FF 6.8 Bottom of Ex. Ft. Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: 12 2 Elmore #2 +1.5 Fl. 0.5 Fl. Township: Range: Section: Fill added above original grade: Gravel Length: 4 Ft. 45 Ft. Well: [_1 New El Upgrade Gravel width: Number of lines: Distance between lines: 5 Ft. 1 Fl. Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material: Existing Private Ft. Ft. 225 Fe 3034 PVC Driller. Date Drilled: Static Water Level: Installer: Date Installed: Ft. Beek's Contracting Inc. 7/8/2011 Yield: JPump Set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES To From Septic Tank Absorption Field Lift Station Holding Tank Well 116.4 143.7 Size: 250 Get. Manufacturer. Orenco 1 Anchorage Surface Water 100+ 100+ Pump Make & Model P2005.1 Lot Line 63.2 31.1 Foundation 11.3 39.1 Curtain Drain NIA Remarks GARAGE FF ElOther: acity: 1500 G.I. nber of Compar 2 Tank High water alarm at: +45 in. 100.0 Ft. Engineer's Stamp Inspections performed by: PANNONE ENG. SVC, LLC Dates: 1St 7/8/2011 ������.►��1 2nd ....... 7/9/2011 �.�p�. ,♦♦ ,,,..q SN Development Services Department Approval �,•'' %♦i♦ Conditional Approval Date: i � 49TH ♦0 f.'8\ ... .............. ':Steven• R. Pannone.:�i Wftp No. CE 8149 ' ,zReviewed and approved by: �J IZ-1- Date:• I I a01 ♦ •�.. (Rev. 04/06) l; I ♦♦� •� '� ❑ Septic ❑ Holding ® S.T.E.P. Iblic/Private Sewer Line Manufacturer. Anchorage Tank 25+ Material: Steel wl AX20 POD and Aux. Pump Vault LIFT STATION Size: 250 Get. Manufacturer. Orenco 1 Anchorage Pump on" level at: +40 in. "Pump off" level at: +36 in. Pump Make & Model P2005.1 Electrical Inspections performed by: Micheal Green BENCH MARK GARAGE FF ElOther: acity: 1500 G.I. nber of Compar 2 Tank High water alarm at: +45 in. 100.0 Ft. Engineer's Stamp Inspections performed by: PANNONE ENG. SVC, LLC Dates: 1St 7/8/2011 ������.►��1 2nd ....... 7/9/2011 �.�p�. ,♦♦ ,,,..q SN Development Services Department Approval �,•'' %♦i♦ Conditional Approval Date: i � 49TH ♦0 f.'8\ ... .............. ':Steven• R. Pannone.:�i Wftp No. CE 8149 ' ,zReviewed and approved by: �J IZ-1- Date:• I I a01 ♦ •�.. (Rev. 04/06) l; I ♦♦� •� '� '" FC 24.6 14.6 i ' LOT UNDEVELOPED ~ L2 58.5 52.4 ,, ', NO WELLS OR SEPTICS M1 58.0 52.8 , . M2 94.0 94.0 :" ABANDONED PER COCE .: X'- ': ," A~;~E~I~ ~ ~' ADdUST LS/CO ELEVATION TO NEW ~ ,,' / ~b ~ ~ FINAL GRADE WHEN RESERVE IS ' / I ~ % -- INSTALLED AT A FUTURE DATE. WELL (E) ' NEW PRIMARY F EL; ~ %'P~"'~~6E W/NEW ADDN 55LFxO.5'EDxS'W +I'TD ~~~ X 4BR TO%AL , ,". / .' i J ~~ ~O FOD ~ AUX. PUMP VAULT / ' ' ~ ' ~ ~ [: 5'WX25LFX 0.5' ED NOTES: ~=~F A/?~' Date RECORD DRAWING P.0. BOX ]00217 ANCHORAGE, AK 99510 ~~ .... ~j. 7/]9/~ ELMORE ~2 BLOCK 12, LOT 2 ~ ~'~P:'~U~:~-~'~ 018-175-51 KENNETH RADACH ~¢~L CE 8149 .:~ PERMIT NO. 4650 EAST 147TH AVENUE ' '~ PLAN ANCHORAGE, AK 99516 ~0~9~.*¢ ....... ~-~ Sheet SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK WAS IN ACCORDANCE WITH THE ATFACHED SPECIFICATIONS. .3. SCOPE OF WORK: INSTALLED NEW 1500 GALLON S.T.E.P. TANK W/AX20 TREATMENT POD AND AUXILIARY PUMP VAULT, AND NEW SOIL ABSORPTION SYSTEM. 4. GROUNDWATER WAS OBSERVED AT .3 FEET BELOW EXISTING GRADE DURING EXCAVATION OF THE SOIL TEST HOLE. AN APPARENT WATER TABLE WAS NOT OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN ,3 FEET BELOW EXISTING GRADE. -INSULATION /1 ~" 0 PERF PIPE //-,vG" HOLES @ 24" O.C. // /- FILTER FABRIC 6" TOPSOIL-% I---5.0--~ // / ~DRAIN ROCK AND VEGETATION~ / I// / N 102,,2~L /_~__.. ~// -.."'g8.2, ~'%."..'2, SAND ¢ :/~%t'_..._ ~'~F~i!¢.:ii?F" -- 1 0 -- '" ' ' ' ; 97 2 · o, 415 T- ~:'.! 5.5;'¥:::.F:,?:.:'!':.~'i:'., .',:;i :~ ' -3.0 ~ i `3.5 :::.:'??,!;.~i ;.i.:~:.?,:.'.; '.:!:~::":/:~ 6~ GROUNDWATER -44]~ % %,.?L 5 8 8 ^T 3.o' -7.o [ --15.0 - SECTION ~3.5' .OA ~PE ,A LU ENGINEERED FILL uJ __~% ~- z XKo~::= r-INSULATION ~o~T · ~o ~ o -- 1 ~" ID PERF PIPE z ~ nTM ~ ~: J / /-- Y8" HOLES @ 24 O.C. :~ < JJ , : g7.2 8.T.E.P. TANK: ,~.~_1: :~., ,: ~:. ]/' '7:, ":>:~:'.~ ~ ~AND W/~20 POD i SEE 8EOTION & PA~METER8 ~5.5' MOA ~PE IIA ENGINEERED FILL PROFILE DESIGN PARAMETERS PRIMARY/RESERVE SEPTIO SYSTEM NO. BEDROOM: 4 (600 gpO) ABBREVIATIONS LEGEND TANK SIZE: 1500g S.T.E.P. OU OOPPER ~ W WATER LINE/ PERO RATE = 16-30 MPI DIP DUOTILE IRON PIPE WELL RADIUS SOIL RATING: 4 GPD/SF TH TEST HOLE AR~ RQD: 150 SF FO FOUNDATION CLEAN OUT ~ 88 NEW SEPTIO SYS. ~PE: WIDE TRENCH 0.5' E.D. T~ TANK CLEAN OUT NO. MIN LENGTH: 30 LF O~ CLEAN OUT NO. USED: M~ MONITOR TUBE NO. - R.I. RIGID INSU~TION 45 LF X 5' WIDE, 0.5' E.D., DCO DOUBLE CLEAN OUT 6.8' TD (BOSOM OF EXCAVATION) TOTAL AREA: 225 SF DV DIVERTER VALVE FS FLOW SPLICER NOTES: ____, ~ Dote ~ O~ A RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907)27~-82~ ~'~T~' ~'~Jl~ Soa,~ · ELMORE ~2 BLOCK 12, LOT 2~~ --~ ~~~3~7'~¥~'~ U~8-173-51 KENNETH RADACH ¢~,~]x CE 8149 2~ PERMIT NO. 4650 EAST 147TH AVENUE ~i~. .~ OSPlllO58 DESIGN DETAILS ANCHORAGE, AK 99516 ~t[?~z. ..... ,~ Sh~t - Municipality of Anchorage Community Development Department - Development Services Division Info and, Help: (907) 343-8211 INSPECTION: Voice: (907) 343-8300 Fax (907) 249-7777 Inspection Report- UGElec APPLICATION NO. E11-'1006 Subpermit of Master Permit; R 11-1021 Permit Type: Electrical ~0 minutes b4 for access. Requested by: s*61id ground-727.80-0-~ ' stullergj(~munkorg ~ of Project: E 4650'147TH AVE' Parcel: -018~733 i-000' Contacts '-Owner ~ RADACH KENNETH D & STEEN BECKY L Contractor (907)563-$249 SHELTON ELECTRIC CO INC "LR 1720 E 59TH AVE Inspector Comments: New SChedule Date:07/15/2011 ' Preference:AM, Inspection #: 130941 Date:_ &TOTSCJS~06 DNIIOV~INOD S,~B3~ PLAT NO, 69-96 SECOND ADDITION TO ELMORE SUBDIVISION LOT 2, BLOCK 12 86,920 S.F. E. 147TH AVENUE N 89°56'17"E 212,00'(R) N 89~55'41"E 211,35~M) ......... 10' X 16' SHED lO' UTIL ESMT. N 89e55'41"E 211.35'(C) N 89°56'17"E 212.00'(R) AS'BUILT ' ' " ' ' -- I HEREBY CERTIFY THAT I HAVE SURVEYED THE .... PROPERP( DEPICTED ABOVE AND THAT NO GAS'TALDI LAND ,ENCROACHMENTS EXIST EXCEPT AS INDICATED. SURVEYING, LLC IT IS THE RESPONSIBIUTY OF THE OWNER TO JEFF A. GASTALDI, R.LS. .DETERMINE THE EXISTENCE OF ANY EASEMENTS, 2000 E. DOWUNG RD., SUITE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT ANCHORAGE, ALASKA 99507 APPEAR ON THE RECORDED SUBDNISION PLAT. PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR ESTABESHING BOUNDARY OR FENCE ENES. 3036 7/20/2011 ' ' ' ANCHORAGE RECORDING DISTRICT, ALASKA F,B, JOB NO, NOTE: NO CORNERS SET THIS DATE. 11-01 SATE212P 1 "=40' LEGEND FOUND IRON PIPE · FOUND 5/8" REBAR x CALCULATED POINT, NOTHING FOUND OR SET (R) RECORD DIMENSION PER PLAT NO. 69-96 (M) MEASURED DIMENSION THIS SURVEY (C) CALCULATED DIMENSION PER PLAT NO. 69-96 Permit Number: OSP111058 Tax Code Number: 01817331000 Work Type: Septic Permit Effective Dates: June 17, 2011 On-Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 EImore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Upgrade to June 16, 2012 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: ELMORE #2 Site Legal Address: ELMORE #2 BLK 12 LT 2 G:3036 Owner/Address: R^D^CH KENNETH D & STEEN BECKY L 4650 EAST 147TH AVE ANCHORAGE AK 995164113 Site Mailing Address: 4650 E 147TH AVE, Anchorage Lot Size in Sq Ft: Total Bedrooms: 86920 4 This permit is for the construction of: Y Disposal Field Y SepticTank N Holding Tank N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. / Date: ' '~ tl Date: ~X:>~/ UNICIPALITY Community Development Department Development Services Division On-Site Water & Wastewater Program Mayor Dan Sullivan OF ANCHORAGE  Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0/~:5 Property owner(s) ,~'C'4/,¢'E'~'/-/¢¢¢/~/-/ / ~,27¢__J¢ y' ~r'~-~-,4,~ Day phone Mailing address Site address ¢---/G¢o ~.-r / c/ 7' ?' . ./-/ Legal description (Sub'd., Block & Lot),~'~/_./fc,~z? Legal description (Township, Range & Section) Lot Size ~(o) ~'7_0 Sq. Ft. Number of Bedrooms ~// THIS APPLICATION IS FOR: ((~ all that apply) Absorption Field [~ Septic Tank [~ Holding Tank [] Privy [] Private Well [] THIS APPLICATION IS AN: Initial ~ Upgrade ~ Renewal [] Water Storage [] THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: 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. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: Permit No. ~)~-~ Waiver Fees: Date of Payment: Receipt Number: Waiver No. G:\Building\On Site\Forms\Client Forms\Permit App_010411 .doc (Rev. 1/11 ) Pannone Engineering Services LLC Steven R. Pannone, Principal Re§istered Professional Engineer E-maih steve@panenRak.com June 10, 2011 Municipality of Anchorage Development Services Department On-Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: Elmore #2 Block 12, Lot 2 Septic System Permit Upgrade Request Ladies and Gentlemen: I am writing to request a permit to construct an upgraded septic system be issued for this property. The proposed systems will serve an existing three-bedroom house that is being expanded to four bedrooms. Currently the lot is developed. The lot is served by a private well. The existing trench is in failure and shall be decommissioned per code. The existing tank shall be decommissioned per code and a new S.T.E.P. tank installed. A new drain field will be installed west of the existing field and will be sized to handle a four-bedroom waste stream. The surrounding developed lots are served by private water systems. The private wells are located over 100 feet from the proposed soil absorption system. 1. Soils. A two test holes were excavated by Pannone Engineering Service in April of 2011. See the soil logs are attached. Ground water was monitored for seven days. Ground water was monitored to a depth of three feet (3') below ground level after the monitoring period. Bedrock was not encountered in the test hole. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 4 gallons/day/square feet should be used, using a mounded advanced wastewater treatment system with engineered fill to create the required separation distance from ground water. o Soil Absorption System Desi§n. a. See Sheet 2 of the design package 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and the existing drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The average topography in the area of the proposed septic system is approximately 0.5 to 1 percent based on the survey information in the area of the septic system. There are no steep slopes within the vicinity of the proposed drain field. 5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On-Site Department, the note will be removed and "Issued for Construction" drawings will be issued. Maiiina: ?~0~ Box 100217, Anchorasie~ A~< ~95t0~,0217 ~,.~.:; E';~s't 82m~ Ave, Cuite Telephone: (g07) 272-8218 FAX: (907) 272,-823J,. Page 2 of 2 6. Waiver Request for use of Engineered Receiving Soil (ERS). I am requesting a waiver to the 1992 Code to use the proposed Code Update Section of Engineered Receiving Soils (ERS). Below I will detail my request justifying the use of ERS: a. Two test holes were excavated, one at least 40 feet down gradient of the proposed location. The soils logs are attached. Ground water was monitored in both test holes. b. This design proposes to use two types of ERS. The base soils that will act as an interface between the existing soils and the soil absorption system (SAS) will be MoA Type II or Type IIA, which has a specified gradation per MASS. This interface will be approximately three and a half feet in depth and will be compacted to approximately 80 percent to allow free flow of the effluent through it into the native soil. The infiltration area was based on the soil type of the in-situ receiving soil as determined by a material analysis and by Table 8 of 18AAC72. We were unable to perform a percolation test due to the presence of ground water in the acceptable in-situ soil. A lab analysis was performed to determine the grain size distribution and material type. The analysis is attached to the design. A two foot thick filter sand layer will be placed over the MoA Type II material to act as an interface between the SAS and ERS. c. The SAS is sized assuming a percolation rate of the MoA type II material between 16 and 30 minutes per inch when compacted in place, which gives an application rate of 4 GPDSF. This will be the bottom area of the SAS. d. The system will protrude above the ground surface. The cover of the system will produce a mound, which will have at a minimum, three to one side slopes and six inches of organically rich soil to promote the growth of vegetation. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Attach ments: ?21aiNng: P~O~ Box 1002!7~ Anchora~.N, AK 99510~,0217 ~hysicsk 6s 5 East 82'~x~ Ay% Suite B6~ &~ ~ ', ",'~'~,, Te{ephone: (907} 272~8228 FAX; {907} 272-82i2 ~ LOT UNDEVELOPED . \ NO WELLS OR SEPTICS . yt', .:. EXISTING lO00g"' 'EAST 147TH AVENUE~ /" SEPTIC TAN.,'R -'-k · ABANDON PER CODE ~ ..' ~ ~ '"'. ~ o, dTiL,¥ EASE,,,,EN~', \ ,: EXISTING DRAIN, IELD-%X' ~' '~-/--/ -!  ~.~ ADJUST LS/CO ELEVATION TO NEW ,: ABANDON IN/PLAC. E FINAL GRADE WHEN RESERVE IS / /~ INSTALLED AT A FUTURE DATE. WF// rF~ ' /;; :::.. //MAX BURIAL IS 7.0' / LIMIT OF'FILL ~ ~"~ . ~-D,ECK --~ . .,,,~~ . ................. ~;~, X ~ .~¢~''~- (E) HOUSEW/NEWADDN '1 "~ 35,LFx_O,.5'EDxS'W, +I'TD ~ '~ ~ ~ 5 4BP TOTAL . .' / ,' 15x45 INFILTRATION AREA x ~ !iX,/'"x',~'1500gS.T.E.P-TANK(P) i \~ ' i ~ W/AX20 POD &: AUX. PUMP VAULT , ,,~ ,WELL(E) i 107.6, ,' ~__ RESERVE 4BP FIELD (P) ~ ' 5'W X 25LF X 0.5' ED WELL-SWCOR. 155 [WELL-NW COP. 163'i ×x / --1-~ i~ ~":::' NOTES: PANNONE ENG SVC, LLC zo~ O0NSTmUOT, 0N P.O. ~0X ~00~7 ~"C"0~, ~ ~S~0 ~ ...... V~$]~ ~/~'/~ ~"=50' KENNETH RADACH P~RMIT NO. 4650 EAST 147TH AVENUE .,~i~:.~.:~.. ~ osm~oss PLAN ANCHORAGE, AK 99516 ~l.t¢~;~ ...... .~%%.~ Sheet SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE A~rAOHED SPECIFICATIONS. 3. SCOPE OF WORK: INSTALL NEW 1500 GALLON S.T.E.P. TANK W/AX20 TREATMENT POD AND AUXILIARY PUMP VAULT, AND NEW SOIL ABSORPTION SYSTEM. 4. GROUNDWATER WAS OBSERVED AT 5 FEET BELOW EXISTING GRADE DURING EXCAVATION OF THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 5 FEET BELOW EXISTING GRADE, NOTIFY THE ENGINEER IMMEDIATELY.  ~INSULATION 1 ~" 0 PERF PIPE "HOLES © 24" O.C. ILTER FABRIC 6" TOPSOIL 5.0 DRAIN ROCK OBSERVED sP ~ , ENGINEERED FILL AT 3.0' -7.0 ' 1 5.0 SECTION ~ Z 2' SAND LW/~20 POD SEE SECTION & PA~METERS ~3.5' MOA ~PE IIA ENGINEERED FILL PROFILE DESIGN PARAMETERS PRIMARY/RESERVE SEPTIC SYSTEM A~ B R EVIATIO N S LEG E N D NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1500g S.T.E.P. CU COPPER --W. WATER LINE/ PERC RATE = 16-50 MPI DIP DUCTILE IRON PIPE WELL RADIUS SOIL RATING: 4 GPD/SF TH TEST HOLE AR~ RQD: 150 SF FC FOUNDATION CLEAN OUT ~ SS NEW SEPTIC SYS. ~PE: WIDE TRENCH 0.5' E.D. T~ TANK CLEAN OUT NO. MIN LENGTH: 30 LF C~ CLEAN OUT NO. USE: M~ MONITOR TUBE NO. R.I. RIGID INSU~TION 55 LF X 5' WIDE, 0.5' E.D., DCO DOUBLE CLEAN OUT 4.5' TD (BOSOM OF EXCAVATION) TOTAL AREA: 175 SF DV DIVERTER VALVE FS FLOW SPLICER FOR CONSTRUCTION P,O. BOX 100217 ANCHORAGE, AK 99510 ~.. ~.-~ SOILS LOG - PERCOLATION TEST TEST HOLE I SLOPE ' ~ 0',TI PLAN .................... -- , DiECK / X BOH X ~ '~~ ~ 4~R TOTAL 9 WAS GROUND WATER SLOPE 14 ~ , ENCOUNTERED? Y 15 ~ IF YES, AT WHAT ! TH ~6 ~1 DEPTH? -5-' X 17 ~ DEPTH TO WATER AFTER MONITORING? -3'- 18 ~ DATE: 5/3/11 I ~ ; WATER DATE PERFORMED: 4/21/11 R~DING ~ DATE CLOCK TIME NET TIME LEVEL NET DROP READING ~ NO PERC I 2 ~ 3 4 I 5 6 i COMM~N~S: Test hole exca~ated by ........................ . PERFORMED B~: Ste~e~ R. P~o~e, P.E. Z C~RT~ THA~ TH~S T~ST WAS P~R~ORMED ~N ACCORDANCE PHONE (907) 272-8218 FAX (907) 272-8211 Sca~ ELMORE ~2 BLOCK 12, LOT 2 o18-175-31 KENNETH RADACH '~teve~ERbl~nn°~e~ PERMIT NO. 4650 EAST 147TH AVENUE '¢~¢~. .:~ 0SPl11058 SOILS LOG ANCHORAGE, AK 99516 ~.¢~o~;~,o~F ~ Sh~t WATER CLOCK READING DATE NET TIME LEVEL NET DROP TIME READING 1 NO PERC 2 3 4 5 6 SOILS LOG - PERCOLATION TEST TEST HOLE 2 SLOPE / I \ ,7-% SlTEPLAN/y / WELL ~ 4/28/2011 EC 2 -- PT/GP ROCKY PEAT 3 MIXTURE ~ ~ ~Y 4/1812011 i SlL~ G~VEL 5~ ] %,[ %. ~~ (E) HOUSE W/NEWAE ~~i ~ ~ % k 4BR TOTAL lO ~ . [ , 100' OFFSET 12 : i / .............. i / I ' 13 ~ ~ ~ " ........ ' WAS GROUND WATER SLOPE ~4 ~ ENCOUNTERED? Y ~5 ~ IF YES, AT WHAT TH ~6 ~ DEPTH? ~-' X 17 ~ DEPTH TO WATER AFTER MONITORING? -1.7'- 18 DATE: 4/28/11 CLOCK WATER DATE PERFORMED: 4/18/11 R~DING DATE TIME NET TIME LEVEL NET DROP R~DING ~ NO PERC I 2 3 4 5 6 i COMM~N~S: Test Aote e~c~ated by ........................ . PBRFORMBD BY: Ste~e~ R. P~o~e, P.~. [ CBRT[~Y T~AT ~[S TBST WAS PBR~ORMBD IN ACCORDANCB W[~ A~ S~ATB AND MUN[C[PA~ GU]DD~N~S IN ~F~CT ON ~B DATg OF T~[S NOTES: FOR CONSTRUCTION P.O. BOX 102954 ANCHORAGE, AK 99510 ~ ~' '~ ~ ~,OU[ (~07) 272-8218 [~X (~07) 272-a211~'~'~"~m ~ "2'~  ' P.I.D. ~0~ ~2 B~OC~ ~2, ~OT 2 g~. ~........~..~........~ KENNETH RADACH~ ~~~. . PERMIT N0. SOILS LOG ANCHORAGE, AK 99516 l~i¢?~{s{~,~ Sheet CLOCK WATER READING DATE TIME NET TIME LEVEL NET DROP READING 1 NO PERC 2 3 4 5 6 ADVANTEX SYSTEM DESIGN ADVANTEX 24-" PASSIVE 4-" JIM CAP_~AX20.. POD~\ . INSULATEDRisER AUXILIARYPuMP \ VENT-~IAIR  BASIN .~ SLIDE SECTION "M[~ OF 6" PIPE OVER THIS CONNECTION '~u TO PROVIDE SHEER PROTECTION- 14' EXTEND TO BRIDGE EXCAVATION -'~1 i,, ~1 -- ~ ,, ~ 41 ~11 NOTES: PANNONE ENG SVC, LLC .~,..:,¢._ __..~:,~.'-'~ Dote ...... L ,~ 6/14/11 FOR CONSTRUCTION P.O, BOX 100217 ANCHORAGE, AK 99510 ,HO.E (907) 272-s~1~ tAX (9O7)272-S~11---.-"~%'""" ~. ~.~?~, Sco,e NTS ELMORE #2 BLOCK 12, LOT 2~, ~h~'~'P.~~~'':'-'?-n'n'Gr~'~ oIa-175-51 KENNETH RADACH~r~{%'*". CE 8149 -~-,~,'~' :ERM,T NO. 4650 [-AS-[ ~47TH AVENUE }~ ... ...' DESIGN DETAILS ANCHORAGE, AK 99516'~ Sheet 50F5 I US STD, SIEVE SIZE I US STD, SIEVE NUMBER I HYDROMETER r~ 1-1/2 3/4 3/8 I~4 #1~0 #~0, #40 #100 4_......~._.F._...~.~ ...F ..... ..... .~ ....... ....... ~ ..... I00 10 I O. I O, Ol O. 001 G~A[N ~IZE IN MILLIMEI~ COBBLES I SILT or CLAY SYMBOL SAMPLE SOURCE DEPTH (Feet) CLASSIFICATION ~ - - Groveiiy Sond (SP) Crow~heF Associates Port)cie Size Distr~butbn Piote Geotechnico) Engineering Services EimoFe S/D ~2, Dock 12, Lot 2 Anchoroge, AWsko m Fi)e No. Ponnone ) Dote April 2011 Job 04OO02 I I Total Dynamic Head (TDH), feet ~ 0 {.~ 0 0 0 0 0 C~ ~F~UNICIPALITY OF ANCHORAGE F~ Heal .~ and Environmental Protec, pn Fourth Floor West 825 L Street Anchorage, Alaska 99501 264-4720 INSPECTION REPORT ONiSITE SEWAGE DISPOSAL SYSTE~A SEPTIC TANK: D,STANCE C~'Jt FROM Wr'LL W INSIDE LENGTH MANUFACTURER ~ MATERIAL INSIDE WIDTH LIQUID DEPTH NUMBER OF --~"'['~'~ [ COMPARTMENTS LIQUID CAPACITY IO00GALLONS. _~ I , TOTAL LENGTH I DISTANCE FROM WELL FOUNDATION ~ O '~- ,NEAREST LOT LINE ~-'-~ OF LINE # of Lines I DISTANCE BETWEEN LINES Fd//~ TRENCt~ WIDTH3~ IN. TOTAL EFFECTIVE ABSORPTION AREA ,_"~'~ ~' SQ. PT. LENGTH OF EACtl LINE ~ t* DEPTtl OF' FILTER DEPTII: TOP OF TILE TO FIN'ISH GRADE ~r''0 MATERIAL BENEATI'{ TILE. I ..~'.N~. ABOVE TILE '~ IN. SEEPAGE PIT: DIAMETER OR WIDTH Log Crib Rings Crib Size: DIAMETER BUILDING FOUNDATION NEAREST LOT LINE LENGTH~, DEPTH DEPTH DISTANCE FROM: WELL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. Well Class: '~, Depth: Well Distance To: Lot Line Bldg: Sewer'~ine: Pipe Materials: # of Bedrooms: Installer: Remarks: ~e~ PERMIT NO. APPL I CANT LOCATION LEQRL r'lUN zc z F"RLIT~" OF FIf4CH,~RFIGE DEPARTMENT OF"*IERLTH AND EHVIRONMENTRL F'-SFECTION 825 'L' STREET, RNCHORRGE, AK. 264-472¢ 14ELL Rt4B, 13t4--5 I TE SEHEF; PERr'lI T i~a~ _n ( 778966 ) HRRVE~ EVRN~ 84¢ W iBTH 274-~66i E L2 B ~2 ELMORE SUB ~2 LOT SIZE 8692~ SQUARE FEET TYPE OF SOIL RBSORBTION SYSTEM IS: TRENCH 'MRXII'IUM NUblBER OF BEDROOMS SOIL RATING THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= -'1 ~ LENGTH= 28 GIq:RVEL DEPTH= 5 THE LENGTH DIMENSION IS THE LENGTH (IN FEET> OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET>. THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MININUM DEPTH OF GRAVEL BETHEEN THE OUTFRLL PIPE RHD THE BOTTOM OF THE EXCAVATION (IN FEET>. REQU I RED SEPT I C TRt4F.-. S I ~_E: 2[-'~014 GFILL¢'I'-,I$ PROF. RGE PLANT OPT I Ot-I 'R PRCKRGE PLANT f'IRY BE INSTALLED AT THE PERMITTEE"S OPTION SUBJECT TO .THE FOLLOWING CONDITIONS: i. EITHER A CLRSS I OR II NSF APPROVED PLANT MRY BE INSTALLED. 2. R CONTINUOUS MRINTEHRNCE AGREEMENT IS REQUIRED. IF R MAINTENANCE AGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SOIL ABSORPTION SYSTEM AND/OR YOU MAY BE SUBJECT TO PROSECUTION. TI40 ( 2 ;:, I t-,ISF'ECT I OI'-.IS PRE REQU I Iq:ED BACKFILLING OF ANY SYSTEM WITHOUT FINRL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. 'NINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEHRGE DISPOSRL. SYSTEM IS 100 FEET FOR R PRIVATE WELL OR 200 FEET FOR R PUBLIC WELL HELL LOGS PRE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DRYS OF THE WELL COMPLETION. OTHER REQUIREMENTS f'IRY APPLY. SPECIFICATIONS AND CONSTRUCTION DIRGRRNS PRE -AVAILABLE TO INSURE PROPER INSTALLATION. PERId I T E×P I RES DEOEI"IBEF4 2'1.. '1977 I CERTIFY THAT 'l: I Pr4 FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEN IH ACCORDANCE WITH THE CODES. ;~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. -- ~( .... j ...... v "'k' ' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEA,LTH AND ENVIRONMENTAL PROTECTION · Pouc~ B.6SO, An~orage, Alm~.a g9~2 276-2221 · SOILS LOG -- PERCOLATION TEST SOILS L°G ~ PERCOLATION .. TEST ole6~,~41c. D~-~ me.~t 2- 3- 4- .E IF YES, AT WHAT.· DEPTH? G;o~ Net Depth to Net Re~d'm~ Date TJm~ Time Wat~ Drop ' ' PERCOLATION RATE (minut~inch). 9 10 11- 12 13 14 15 16. 18' 19. 20-  . TEST RUN BETWEEN . FT AND ,, ,l~t'~, ~ ~--.ru~P~_~, ' ' ' _ -~.:------~--------. · . .~ 4o47-~. .. " ~ MUNICIPALITY OF ANCHORAGE ~ ID PERCO[.ATION -:- vEsT (Visual) · ~k DEPARTMENT OF HEALTH AND ENVIRONMENTAL p,,OTECTION ~ SOILS LOG - pERCOLATiON TEST PERFORMED FOR:~/~'I?VeW ~'[? ~Ve~/ ~V~ ~Fency LEGAL DESCRIPTION: et 2 Block 12 Elmore Subdivision Addition ~2 tE PLAN SLOPE Organic-Dark Brn (OL) Clayey-Gravels (GC) Sandy-Gravel Trace silt (GM) 9 WAS GROUND WATER 11 ¥~cll-Graded Gravel ENCOUNTERED? 12 ,F YES. AT W,AT DEPTH? -- . _ - Gross Net Depth to Net · 14 - Reading Date Time . Time Water Drop 15 16 Total Dep%h 17- 18 , (minut~linchJ 20 pERCOlATION RATE _ FT AND -- . FT TEST RUN 8E~EEN -- . PERFORMED BY._ SIL~RS EI;GII~RIIlG _CER . GREATER ANCtlORAGE AREA BORONS:' Department of Environmental q~ !lty 3330 "C" Street Anchorage, Alaska 99503 f',,) ~...OILS LOG - PEROLATION TEST Performed f?r.__~_.~ J~~, Date Performed Legal Description: ~ /~ ~'/~/.~ ~.~/~,~,__~ ~'~_~. This fom reports: Soils'log' ~ - Percolation test Depth Feet ]3- Was ground water encountered? If yes, at what depth? Reading Date Gross Time Percolation rate minute. · Proposed installat-16'n?' Seepage Pit Dupth of Inlet ...... · COlli'IEHTS: Net Time Depth to Water Drain Field Depth to 'b-ot-~- bT-pi t or trench Net Drop Performed Dy: By: EQ-040 (617~1) Date: ~pTtt 0~- I/t/ECL. IOq~ WM I C I P A L I TY ANCHORAGE Development Services Department . Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 018-173-31 1. GENERAL INFORMATION Complete legal description Elmore ##2 B12 L2 Location (site address) 4650 E 147th Ave. Current property owner(s) Becky Steen Mailing address Real estate agent 2. TYPE OF DWELLING: F-1 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Expiration Date: _ IO r1 J -Z/ Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic 0 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 $ 50 Date of Payment -7 Receipt Number 0� 29' SG COSA# 05C2-II'�)'30 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe 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 soil condition, ground water 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 this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. 6. DSD SIGNATURE —4, System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Date 260 2i_ Conditional approval for bedrooms, with the following stipulations:OF J ON-SITE f WATER AND ZI- O I;--. , TER PROGRAM 51 ,. _.. By: V%A- Original Certificate Date: 7-13 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 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSH Checklist Legal Description: Elmore #2 B12 L2 Parcel ID: 018-173-31 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA FE -1 Well log is filed with Onsite (or attached) Date drilled Total depth 109 ft Cased to 109 ft F14 Sanitary seal is functioning correctly lifflil Wires are properly protected Casing height (above ground) 30 in. Date of flow test for COSA 1-2"' Static water level at beginning of test 58.1 ft. Comments B. TANK DATA Age of tank(s) 10 years Tank type/material s' -11s:"' Measured operating fluid level in septic tank R Standpipes/foundation cleanout per record drawing Date of pumping ��0'-3/ P_ 1 °4- c' % /-. I D. ABSORPTION FIELD DATA Shallow Trench Which system tested (date installed) *112=I © ALL standpipes present per record drawing Total measured depth from grade 6.8 ft (max) Measured depth to pipe invert from grade) -5 ft (min) N N/A - pressurized field ❑Q Monitor tubes go to bottom of effective. If not, state depth into effective 0 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 Well production at time of test 1.2 gpm Water storage tank volume NSA gallons Well disinfected for coliform test? ❑ Yes F71 No ❑® Coliform bacteria is Negative Nitrate mg/L 0 Nitrate less than MRL (ND) Arsenic ug/L Ffflil Arsenic less than MRL (ND) Collected by PES Date of Sample 5126121 C. LIFT STATION Required maintenance completed Age of lift station 10 years Lift station material Steel Comments: Adequacy test date Results ❑✓ Pass For 4 bedrooms Fluid depth prior to test 0/0 in Water added 600 gal New depth 5/0 in Elapsed time 180 min Final fluid depth 0/0 in Absorption rate 600 gpd Any rejuvenation treatment (past 12 months) 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' El Yes Community Sewer Manhole/Cleanout > 100' Fv-J Yes if No ft FV1 Yes if No Neighboring Tank > 100' Z Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No Absorption Field on Lot > 100' Fv-1 Yes if No ft Holding Tank > 100' Yes if No Neighboring Absorption Fields > 100' Fv� Yes if No Water Main > 10' Animal Containment > 50' Yes if No Fv-1 Yes if No ft Fv Yes if No Water Service Line > 10' F/� Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' Yes if No ft 0 Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' El Yes if No ft Surface Water > 100' Q Yes if No Property Line > 5' Fv� Yes if No ft Wells on Adjacent Lots: C] Absorption Field > 5' F/I Yes if No ft Private Wells > 100' Fv� Yes if No Water Main > 10' [Q Yes if No ft Community Wells > 200' Fv Yes if No Water Service Line > 10' F/� 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' Q Yes if No ft If absorption field is under driveway comment below Property Line > 10' Q Yes if No ft Wells on Adjacent Lots: Water Main > 10' C] Yes if No ft Private Wells > 100' U Yes if No Water Service Line > 10' F/I Yes if No ft Community Wells > 200' R Yes if No Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION OF �qta, s� 1 certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with •' 49 TH MOA COSA guidelines in effect on this date. ............ fg5A1 ,.eV -!I P. Fcr.rcne [`ry i1'.• __ GI::.Il •jam_ s COSA Checklist yellow sheet ft ft ft ft ft ft ft ft ft ft I�✓ IC PALITY OF s°-4..:NCH0a _,kG 1 AyV;kNCED WASTEWATER TREA T MENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMI1NT" made and entered into as of this %4� Day of t'TL- ,,1? of 20,x? i , by and between "herein the "01� NER," and the iIIunicipality of Anchorage, herein the `�M�\ICIPALiTY", in accordance with Anchorage Municipal Code (AIvIC) 15.65365. 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 OWIler to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as `fl t G n r{ r-ce" , , ,, 4 d . located at (IegaI description) ?. Maintenance, Repairs and Alterations. (Owner is required to read; understand and initial each section) "I-hroughout the term of this Agreement, the Owner shall enter into a service. agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay foi• all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the _Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system. which could include sewage backup and costly repairs or drainfield replacement. (I-cv. 05l 18/2018) Page 1 of 3 f�_0-vvner acknowled<-es that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. �L .'LL_Owner acknowledges that the fine i�or failinato maintain and repair an A«rWTS may be assessed in accordance with AMC 14.60.030. ;, Owner agrees to ,rant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-I10ur notice. agrees that any sale or transfer oftitle ofthe property will not occur without: a new Certificate of On -Site Systems Approval. Owner agrees that the AWWI S installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by tine Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. 5'Ow11er agrees to maintain remote monitoring? of the AN\lWTS as required by the AWWTS approval. Terni. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Non -waiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a'waiver of the provisions, nor in any way affect the validity- of the Agreement or any part hereof, or tine 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 ofAny civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties Under this Ao reement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05f I W-2018) Page 2 of 3 OWNER: AI s` t k� (signature) Date: 7i Z j i Nymc I a'C,� i G� �r Ltf 114�C i�(print name) STATE OF ALASKA ) ss. THIRDJUDICIAL DISTRICT ) The foregoing instrument Was ackv vledffed before me this ( Z day of 'Tulq 20- I) t r-- y i-,wie6 catti��4'7J ov{rit 7 ��- ' ✓h^` � 3i }3��iif�L3r�'`i, 1i �: �*y�,.._m�,.a..,��'. - '�.. P"-`:k+�:���r XR�'IPUBLIC FOR ALASKA FoNG VAa Notary Publibli c ,E My Commission expires:State of Alaska My Commission Expires Jan 21, 2024 N.11 UNIC _(signature) Date: 7 —) S —2— (print name) Title: (retie. 05/18/20 18) Page 3 of 3 UO.- -4i -/UZI U • -_ i_ir,i_io 11 ;'r_I (1612212021 12:49 ) T}chorage Tank P IP i a ANN07 2V 371 Annual h,'pection =ror><'rty O,vn.�r••Tr.+r,a<rn� Kenneth Redac h & Becky Steen -- f --------d-- ------- ------- •----^--•--•-----------^----•------------_-•-._--- dmc 4650 E. 147th , %ve., Anci•,orape AK 09511; � F06 it A;:-'127 -13i 91: Time ~ oa e Insp Pra .~ MUNICIPALITY OF ANCHORAGe,,, ,, ~, DEPARTM, , OF HEALTH AND ENVIRONMEK l. PROTECTION 825 "L Street, Anchoraa~.. AlasKa 99501 __~ 264-4720 .~~ Date Received: ~#2: Time ,~.~ ~D% $3: Time Date ~L~_~f Date Insp ~/y~ .Insp February 3, 1978 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Security National Bank Mailing Address: Pouch 7-777 99510 Phone: 276-6800 2. Property Owner: Mailing Address: Harvey M. Evans Phone: 279-3757 Box 4-414 99509 3. Legal Description: Lot 2 Block 12 Elmore Subdivision #2 4: Single Family Residence: (x) Number of Bedrooms: Three Multiple Family Residence: ( ) Number of Bedrooms: Well System: Permit ~ Construction Individual Well (x) Community/Public System ( ) Depth of Well Well Log on File Bacterial Analysis (x) 6. Sewage Disposal System: On-site System (x) Public Utility ( ) Permit # U~O~ Installed 1977 Installer ~ Septic Tank Size /~)~ Manufacturer ~ Absorption Area ~'7~ Soils Rate i~-- Material 7. Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line ~ . Department of ~ealth and Enviro~ental Protection ~'~ 825 L Street, ~chorage, Alaska 264.-4~20 ~quest for Approval of Individual Sewer and Water-Facilities e Name of Buyer: Mailing Address: 3, Lending Institution: ~--~--,'/¥ /~-~',/ ~'~o'~ Mailing Address: /'~mtt~'~ ?- 777 e Se Phone: Phone: Realtor/Agent: Mai'ling Address: Phone: Legal Description: Street Location: Single Family Residence: Multiple Fam. ily-R~s~dence: Number of Bedrooms: Number of Bedrooms: 7. Water Supply: *Individual Well ~) Public/Community System ( ) If Individual Well, well depth /~? 'If Community System, name of system 8. Sewage Disposal System: *~n-site System ~) Public System ( ) If On-site System, date of installation:. /~?/F; *NOTE: A well log is required on ALL wells drilled since 6/75. ** If on-site sewer system is over two(2) years old, an adequacy .~est is required by this department. A fee of $25.00 must accompany each request before processing can be initiated. 3/77 /-Page Two' ' ' Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 2 Block 12 Elmore Subdivision %2 Comments: Affadavit Attached: ( ) Approved: ~approved: Department Worksheet: Letter Attached: ( ) Date: 2--P- '~ Date: RECEIPT FOR CERTIFIED MAIL~O¢ (plus postage) STREET AND Fi0. P.O., STAT~ AND ZiP CO~E ~V~R TO ADDI~E-S~E'-'ONLY ................................................... 'SO~- POSTMARK OR DATE ~ PS Fern NO INSURANCE COVERAGE PROVIDED-- Apr. 1971 38~ NOT F~ INTENNAT~ONAL MAIL