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HomeMy WebLinkAboutDANIEL LT 1 Daniel 5/ c? L1 APEL -# O51 09Z 50 000 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION. REPORT Permit Number: OSP221312 PID Number: 05109250000 Dwelling: Q Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New Upgrade Name RUSH FRANCES ABSORPTION FIELD ❑ Deep Trench t❑ Wide Trench ❑ Bed ❑ Mound Site Address 20961 S BIRCHWOOD LOOP RD ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 764-2222 4 6 GPD/SF 1.5 Fi LEGAL DESCRIPTION Depth to pipe invert from original grade 1.1 Ft. Gravel depth beneath pipe 0.5 FI Subdivision DANIELLT 1 Block Lot Fill added above original grade 1.2 - Ft. Gravel length 21 Ft iTownship Range Section Gravel tividlh 5 Ft. Beds; Number of Lines - Distance between lines - Ft SEPARATION DISTANCES To Septic AbsorptionI Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank f=ield Yank Line_ 105 Ft` 1 Ft t Well 501+ 50'+ na na i :25'+ TANK N Sep tic ❑ S.T.E.P. ❑ HoldingX Other Manufacturer ADVA(�TEX FAP Capacity 1500 Gal Surface Water '� 00'+ 10r'+ na na Material Number of compartments Lot Line 101+ ' 101+ na I na NA P Istc 2 Foundation 10,+ 0'-}- na na LIFT STATION Manufacturer Capacity Remarks field, Tank, Lines Insulated Anchorage Tank 200 Gal Concrete Ballast Around FAP Alarm location Pest @ House Electrical installed by Rising Son Installer PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield ARS Drainfield D3034 COMT D3034 Inspector North Rim Eng. BENCH MARK (Assumed elevation) 100 ft Inspdectiosn i,,6/27123 zed 6/2$123 Location and description 1 Std 6130123 41" Door Landing ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: I. OF '�q ��� Date •tl : ` 49 TH t f♦ Steve Er% i Septic System Approved L (� �� IcE-6256Sp �if0/9 / 2 Date 2 2p z Note, this approval does not include well permit requirements. o � D d < rTl Z zq rn Z vODT rn �X m ZN cp v 3 r N D Sy to :7j ` N N V ^ vJ N W CD, ? 1,D N'•, � fTl o� � fTl D d < 0 fU N O U1 1-1 Qn C DF970z dzod t0 M X n = Fl Q n FT'l < Frl M 3 h I ,� (D<-3- , U, Ul ��-5 0 fU N O U1 1-1 Qn O n C t0 W* W* r0 Q n � N �o W 3 � � Q c-� r n � s � d a z O O :5 N - S ;-: O - Q Q_ F— mH r � W m ZY I 3 h I N d ,� (D<-3- , U, Ul ��-5 fU N O U1 �: Qn O n C — F— W* W* r0 Q n � s �o N d C:) V)~ Q -1 Q Q p V� Qn O n C rF o Q° I� q C:) (7 O O � N � < < 0 0 3 � � Q c-� r n � s � O O :5 N - S ;-: O - Q Q_ W ZY N O5—_ �Q 4_r DECK NORTH BIRCHWOOD LOOP NORTH BIRCHWOOD LOOP ARCTIC PUMP Be WELL INC. Jim "Nuffivq. rfl H- 7019-7 Well Dpcornmissloning Log Daniel B%ek: Un.: t R socrinn Lol; on-- wu)!r U'.Ya! waicer I'l-c-, ram ccin-nd cantrartar ;ccf rminr re u el I dc-camm i"kxri n Name: AM Sullivan Coln; nn�e ,3rq1icp;rtp& W,.1,11.! b.[:] I."X,iDn: LiSt 111C SPICC bdl— to pK-idt a urth. �ilperty sim»ujgae rwinwi.^A i=—;: Nnr-b Arrn,4 [Voscruralc s,0z,,tF.- distin;k, G, t*411 wV1I O-wa, U41 tht drn.illg :Mote Jtcsw•aaticdi�smn�lnll�ruswc:ldrcatci:torp:rm�nrntsir.�ctmr.cr::�r-np_rvoxnrrs. (V)M MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP221312 Work Type: Septic Upgrade Tax Code Number: 05109250000 Site Legal Address: DANIEL LT 1 G:1357 Site Mailing Address: 20961 S BIRCHWOOD LOOP RD, Chugiak Owner: RUSH FRANCES NELL Design Engineer: NORTH RIM ENGINEERING This permit is for the construction of: Effective Date: Expiration Date o�'"e+n' '1P U � n DeI)artine nt Lot Size in Sq Ft: Total Bedrooms: 8/25/2022 8/25/2023 31996 0 Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: • The extra well on the lot is to be decommissioned prior to IR approval. Received B) Issued By: Date: 8/25/22 Date: ? ZSz Z 4 MUNICIPALITY OF ANCHORAGE L Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTICIWELL PERMIT APPLICATION Parcel I.D. 05109250 Property owner(s) RUSH FRANCES Mailing address 20961 S BIRCHWOOD LOOP RD Site address same Day phone 764-2222 Legal description (Sub'd., Block & Lot) DAN IELLT 1 Legal description (Township, Range & Section) Lot Size 31,996 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field R Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank El Upgrade El El (D) Holding Tank El Renewal Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Cod 6 (Signature of property owner or authorized agent) Permit/Rush Fees: 4 J � 5 Date of Payment: V51;0.2,17 Receipt Number: —66 7y gb Permit No. 05f -)a1312_ Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc SteveEng.com Daniel Lot 1 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is an existing 4-bedroom, single family home. The septic system is failing. The owner wants to upgrade the system to a Category III Advantex. A design is submitted for a new trench & new Advantex. The neighboring lots are developed as indicated in the drawing. Previous test hole being used- attached. A 1.5  deep trench will be excavated. The easements are located on the drawing and are not encroached upon. A Category III application rate of 6 GPD/FT². Trench Length = 100 FT²/5 = 20; 1 line @ 20, 5 wide. Neighbor wells are indicated, slopes are flat. The system is sized from previous soil test. No conflict to neighboring lots by this upgrade. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations.  Connect new trench to new 1500 Gallon Advantex w/1 AX-20 Filter Pod.  Watertight couplings on inlet & outlet  5 minimum between the tank and trench. 10  to property lines.  3 of cover is required for trench or add insulation board.  Solid pipe must be set on well compacted, stable soil  4 of cover or insulation is required for tank; an equivalent of 1  insulation for 1 foot soil cover. Tank & solid pipe must be set on well compacted, stable soil.  4 diameter cleanouts with airtight caps are required 1  to 4 from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10 from the tank positioned to provide cleanout access towards the tank and towards the absorption field.  All cleanouts must extend to at least ground level.  In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron.  Trench to be placed level, minimum of 2 to groundwater.  Drain rock to be ½ inch to 2 inch screened. Drain rock to be distributed uniformly throughout the trench.  Silt barrier (filter fabric) to be installed above the drain rock  Smeared trench sides must be raked or scarified before drain rock placement  Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, PVC Schedule 40.  Sewer Service Line is minimum 2% slope  Septic Tank to be pumped every two years or when required Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221312, Deb Wockenfuss, 08/25/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221312, Deb Wockenfuss, 08/25/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221312, Deb Wockenfuss, 08/25/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221312, Deb Wockenfuss, 08/25/22 NORTH BIRCHWOOD LOOP 13, yo ° SHANEA.HOLT :'`o�� LS8914 rxFsswvno.r ANauFuvrF�FxrsxsxEavAxEFrrFrAxEnrcw rRF C'v owA�xoExccnxoAsol n/FalroE nnssuxvn. �Onp�Fefil°N1 �c� WxnlF°ElWS PVAIY/xb Qi'nuxunARnEsa°x°M°nF°nx[EiS THE n/FQ44,ii1�'Nc5E0YRF0R rN5 KEGF L4:1lI(i'NSr rl'iJi1;Ne 5'E0F?.:4LY r0Y!J%YAYf' C0vFUCISUFTYF.EN' pJSONG SJNUIiuNcSANDftiATiEOLCTUXESAYL4roN JSFMJIISlY715 Nrof rO nE EAARAroN7SE0JEePH/R0EFliRSUSLKMEuOf1rt•Hs rFNPoOA0rYSfY,wIIUtIrfO0rR'fEA:NVaSME.GSERNARw'0OI/CG�Kol11ID EN ANYPAMGSHOWNNEMONIAYBEA,RvATIC$. rI'r4(Nba1P's1MNYaAS/0AaTJ1REvW0r4CvERTINcUATRT.NwSOEI S'IXEE, NNnCIotEP'IrSNYSJONONJEFNCu.N•0sr:EYiSuNA6EroR0vEFo¢CaET6A1s3C'TwE7LPnr./IAEE Si ASBU/LT SURVEY 111=30' NO CORNERS SET TliL GATE 1 HEREBY CERTIFY THAT 1 HAVE PERFORMED ASURVEY OF THEFOLLOWING DESCRIBED PROPERTY LOT l 0,1PAEL SUR. (AAr82-19 ) ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXSTOTHER THAN NOTED. DATEDATANCHORAGE,ALASKA THIS Y.i DAYOF M tl 2022 xxru'/�w�_rvw. ,NCTU2Y.FA!' e`.'S01 :33.92 F8221-2? Fnasn / MUNICIPALITY OF ANCHORAGE /0 I r - DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ► , a ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 .i __: ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAMEP ONE ❑NEW Je /r I aDD &'&.3a 3J UPGRADE MAILING ADDRESS /t ^, 0 k 3 9 / "A// //U� /)/ - 7 / LEGAL DESCRIPTII/ l/1) /vim l� vr� G C�� !�/ L- / Di,wui _ LOCATIO /- NO.OF BEDROOMS /t/,a ,/rau/a-00 -19c We ll,32 ( bsorption`rea /2_, Dwelling / ÷ PERMIT NO. DISTANCE TO: �/ �J Uy — a Z ManufacturerMaterial No.of compartments � W aA( ( 7//UG-- w Liq.capacit �in_gallons Inside length Width Liquid depth zgiIF HOMEMADE: a y DISTANCE TO: Well Al Dwelling PERMIT NO. JAZ I�FQ- Manufacturer Material Liquid capacity in gallons 0 Well Foundation Nearest lot line PERMIT NO. J= DISTANCE TO: Lu LL z No.of lines Leng eac l }2 Total length of lines Trench width Distance between lines F—¢ T inches <1... Top of tile to finish grade Material beneath tile Total effective absorption area cc p inches Length26 /../... Width/5- 1„�. Depth //� r`Lil 2/4/0<fERMIT wX% Type of crib Crib diameter Crib depth _ Total effective absorption area �r>p w WeIIJ�J .� Buildfegn�atiln Nearest lot line, f 'Z DISTANCE TO: `/ // lir: J Class . ...___k �Ds ` �L Driller Distance to lot line PERMIT NO. J �j � /V w DISTANCE TO: Building foundation Sewer line Septic tank Absorption areafs) OTHER ` PIPE MATERIALS l( V,`el _ C( G W eS-S-- d/eratz__ roe �� OV SOIL TEST RATING Q a,b INSTALLER J . 7 REMARKS OF4( 11, I w.. .......,a Ak c t t,• =ir• 'iy/L . ' i,..4 - ...ft" gJ�, ,4 Robert A. ` `ff `Cmoa,�o d LS ' Sha it 1 �.'r s G. Ae No. 1457-:� a ,-'s> I _ I t tLI,�FC,:,S\(P.r.'o I / --__________I J Ln6 9 .,i 8/eC//to 0 .Coo App._ A•P-OV•• D//A``TE LEGAL 0' , 'c.,ARE RIVER_ ALASKA 'gel;Zj 2-813 (Rev.3/78) PH. 694-2979 MUFAICIr~FIII__ IlF�e OF- FINICA-P--- DEPARTMENT . HEALTH AND ENVIRONMENTAL . AOTECTION ^ 7/ u 825 'L' STREET, ANCHORAGE, HK99501 264-4720 ID r-4_�� 1 --FE Sc E L-4 E F: ILI F•Ci F:Fi VD E F"E IF:IA I -I- PERM I T I-PERMIT NO. ( 821084 ) APPLICANT JERRY JUDD PO BOX ]9 CHUGIAK 688-]0]5 LOCATION LEGAL L1 DHNNIEL LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS : DRHINFIELD MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ FT/BR)= 85 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS : CEP-TI-1= �' !Ti 1___Er41_TiTH= 27:fe: �F:FiVEI__ EYEF"TI-1= :1_ THE LENGTH DIMENSION IS THE LENGTH ( IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION ( IN FEET) THE TR:EINI1-1 WIC.T1-1 ][ 1:17, :1_� �IDID F-EET THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION ( IN FEET). IRE��UIF:EID �EF"TIC: TRINIK � I2== iLIDIEICI CiFil___LONIS; PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE ___ TWO ( 2-1* -:. Ilr-42-:TIOr.VE, FIFIlE R:EIDUIIREIC. --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTIM MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTHLLHTIM P-ER:MIT E:-..:F. I1F:E� �E1.1-:EMEP.: �:1_" :1_�1�� I CERTlFY THHT 1 : I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE 2 : I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODEa ]: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INflLIDE 10RE THAN ] BEDROOMS. SIGNED : __-4� _��� HPPL��HNT J�� YkJUDD / / ISSUED BY -x" ��^�71/4 DATE ' =/ ' 2/e2-- v4. 0 itttg rite Air ,, //:, ;' - EXCAVATION ROBERT A.SHAFER jj� ‘ WORK CIVIL ENGINEER �, ? 694.2979 tl: k October 20, 1982 E4C'LE RIVE R.AQP wP 5 MUNICIPALITY OF ANCHORAGE DFPT C- ' o. Mr. Jerry Judd ENVIR-.;,.;.._r,..... 2tfION P.O. Box 39 Chugiak, Alaska 99567 L 2 ,7 1982 Dear Mr. Judd, RECEIVED Reference: Lot 1; Daniels Subdivision A sewer system adequacy test could not be performed on the system located on this property, as you requested. The septic tank was located, and through pumping of the tank, we were able to verify the capacity of approximately 1,000 gallons. At our request, you excavated the area beyond the septic tank and located an old log crib. Our inspection revealed that the log crib was completely full of water and appeared to be approximately 3 feet into the water table. Further use of this crib is prohibited. At your request, a soil test was taken and a permit was obtained from the Municipality for you to upgrade the system. The seepage bed required by Permit 821084 should be constructed immediately. When you are ready for the on-site inspection to be performed on this system, you are to notify this office. We will provide the inspections and file a report with the Municipality. If we may be of further service, please do not hesitate to contact us. Sincerely, / 7/,;/14, IR/,./ROBERT A. SHAFER, P.E. R>AS/iga /cc: Municipality of Anchorage Environmental Health Department SRB 196X EAGLE RIVER,ALASKA SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ❑ PERCOLATION --..t.(1 TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST r/ PERFORMED FOR: ��/e��i CZ o,0 DATE PERFORMED: ? --7f-2 LEGAL DESCRIPTION: 1— D 14 .7 7 .. SLOP SITE PLAN DEPTH ' u 11 ey 6L(_ C- •1 i F'L t-1-?'-- I �� ,4 \T 2 ti ' Si 3 - , n 4 - � ( 9- (....... . 5 - d7 T ( nk S.‘"7 (.� 6 - �1 at (X �-pJ 1 f 7 - c` 1 fit'! c - 8� - ��l N o e y ( <-/--/tco3 9 • 9 - 1 10 - 1 1 - WAS GROUND WATER '-e"/ S ENCOUNTERED? L 0 —_, _ 12 - • PE _______Th__IF YES,AT WHAT /^L 1 I ��- —� 1 13 - � �+`AVIrt DEPTH? l .� 1 14 -• �°;' a e• 4 � Gross Net Depth to Net +� Beading Date Time Time Water Drop 15 - t * 0 44:4‘;),. i, 1 'foe 'a, ,.. e J ti 16 - , `'. Robert A. Sh: .r : '�sfl 'J.1 ''y No. 145?-E ,''/ j 17 - Itt ti)a'6., �l'd 18 - t�t?+�0�� , �7 r 19 - rr 20 - // / PERCOLATION RATE Fes' / f- (minutes/inch) /VI w • ^� � TEST RN BEjiGVEEN FT •N / FT COMMENTS ( : C /- �/ ( a- PERFORMED BY: - ssco 99 :nItia //19 // DATE:/19 OC' — OC7CERTIFIED Bim' yC., 1 Pio 2979 72-008 (6/79) APPLICT FILLS OUT UPPER HAL ONLY Property Owner' �,.��� l ..\J� Phone Maili!F Address '�� '< < ,. _/ -1, Zip Code 1Q GP0 MS-- Buyer 72; , , ,, _, . v Address l Zip Code Lending Institution Phone Address I G/ J / Zip Code Realty Co. &Agent Phone Address Zip Code Legal Description '— /1}/a,„ JJ Street Location /// )144,_ _ 7Z,--1 .„64, ,4..e e>X. � ii._...k l' Type of Residence Single Family , ❑ Multiple Family No.of Bedrooms ❑ Other Water Supply .©Vndividual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑ Community For wells drilled prior to that date, give well depth(attach log if available). ❑ Public Utility Sewer Disposal Individual Year Individual Installed: ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE:THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time t Time x�C! o `IC/0 __ ctft0/ La.p Date Date Date Date 1C-al.°-Sa I Lt.1.3. Inspector Inspector Inspect9z Inspector N(a4I . Field Notes: v. "4 C.t O Ld 4 c",,,,...,. c-4-44-del � + MUNICIPALITY OF AN ORAGE �"�' S(l) DFPT C- ;" IT.! P. �PI '` ENVIR'J.Jt,'_t,.A_ , A.) -C-TION v4,, CCT 201982 RECEIVED_ ( ) APPROVED BEDROOMS / -CONDITIONS OF�APPROVAL ( ) DISAPPROVED ce4-.0C— �I�JIV" ""—���VJ'WPP ( _CONDITIONAL APPROVAL* DATE it `.6, p z--- BY: _BY: c2 ( Q Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Well to Tank Septic Tank Size 72-023(3B2) /} c ' ���!�Y�cY UU r w z;646R5*. JAL ` J -kt,cWi297 LiL CLID )44t_ ( < (ci j2 . °C.cS u.. L-t44A0 --r.L atart, /0-0-+2040 /ta<-.2,mk 21- -,LL L) - z , . i L6,1 : �.f� c. L�.� norr ,. G-- • ,. J4 9 ,/ A9• MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 051-092-50 Certificate of On -Site Systems Approval Expiration Date: 0z `-f Legal description DAN I EL LT 1 Site address 20961 S BIRCHWOOD LOOP RD Chugiak AK Current property owner(s) RUSH X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 05109250000 Complete legal description DAN IELLT 1 Location (site address) 20961 S BIRCHWOOD LOOP RD Current property owners) RUSH FRANCES NELL 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone 764-2222 3. TYPE OF WATER SUPPLY: X Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: FE -1 Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑■ Plastic ❑ Concrete ❑ Fiberglass Age new - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench 0 Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ Zg0 Waiver Fee $ Date of Payment /, /2?� Date of Payment COSA # 05C_2:-3)360 Waiver # COSA Application—June 2022 COSA Checklist Legal Description: DANIEL LT 1 Parcel ID: 05109250000 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled unk Total depth unk ft Cased to unk ft 0 Sanitary seal is functioning correctly 0 Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 6/27/23 Static water level at beginning of test 11 ft. Comments Well On East Decommissioned B. TANK DATA Measured operating fluid level in septic tank na Date of pumping new 0 Required maintenance completed, if AWWTS Comments: new D. ABSORPTION FIELD DATA Which system tested (date installed) 6/30/23 Q ALL standpipes present per record drawing Total measured depth from grade 2.7 ft (max) Measured depth to pipe invert from grade 2.2 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. 0 Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Well production at time of test 3+ gpm Water storage tank volume0 gallons Well disinfected for coliform test? ❑ Yes ❑■ No 0 Coliform bacteria is Negative Nitrate 0.251 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L E]Arsenic less than MRL (ND) Collected by NRimEng Date 8/4/23 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 8/4/23 Results Q Pass Fluid depth prior to test 0 Water added gal New fluid depth in Elapsed time min Final fluid depth in in Absorption rate gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 6 Effective depth used 0 in Effective depth remaining 6 in Comments/Deficiencies: New Advantex FAP & New wide trench Insulation Board Over Field COSA Checklist June 2022 in E. SEPARATION DISTANCE From Private Well on Lot to: (Please enter distances if less than required or it community well on lot) Septic TankiLift Station on Lot > 100' >50 Community Sewer fulanhole/Cleanout �, 100' Yes if No ft Q Yes if No ft Neight�oring Tank > 100' ■❑ Yes if No ft Private 8ewerl eptic Liege > 5' ■❑ Yes if No ft Absorption Field en Lat> 100' ❑Yes if No >50 ft Holding Tank> 100' ■❑Yes if No- ft Neighboring Absorption Fields > 100' Animal Containment > 50' g Yes if No ft ■❑ Yes if No ft ManurelAnimal Excreta Storage > 100' Community Sewer Main > 75' ❑■ Yes if No ft 7■ Yes if No ❑ N/A — Served by Community W -all (not on lot) or Public Water From S epticfHold ing Tani€ and Absorptian Fields) an Lot to: (Please enter distances if less than required) Building Foundations > 10' ■❑ Yes if No ft Surface ti!'4fater > 100'■❑ Yes if No _ Tank to Property Line > 5' ■❑ Yes if No ft Wells on Adjacent Lots; Field to Property Line > 10` ■❑ Yes if No ft Private We > 100' ❑■ Yes if No _ Water Main > 10' ■❑ Yes if No ft Community Wells > 200`■❑ Yes if No _ Water Service Line > 10' ■❑ Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENT ft ft ft ft G. C'E R'I'IFIC:A'I'ION & .9TA'i'EME:NT OF INSPECTION TIO BY E:NCA NEER As certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply andlor wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulation.9 in effect at the time of installation, unless noted otherwise. Narine of Firnl North Rim Engineering Phone 694-7028 Engineer's Printed Dame Steve Eng Date 9}15123 ArAW r S�r�I o ' c Steve Eng AV GOSA Checklist June 2022 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this 32"' Day of Ocrob62. of 20_Z_5_, by and between D Ay16 . Ci►su 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 pp operate an Advanced Wastewater Treatment System (AWWTS), described as rA�/ p r �t located at (legal description) J)A1Jt6L V—M 1 2. Maintenance. Repairs and Alterations. (Owner is required to read, understand and initial each section) DC Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, 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. (rev. 05/18/2018) Page 1 of Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. DC- Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be Dc— assessed in accordance with AMC 14.60.030. Dc - Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. �C- Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. PLI 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. DLOwner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of OWNER: BY: (signature) Date: S X2.3 Qq5l,� (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this ab day of ('kTOB Q_ , 20 23, byp�D �\jTH q NOTARY LIC FOR ALASKA t : •,, NO� OO . Z ,,;My Commission expires: 1, MUNICIPALITY: By: (signature) FiwQ (print name) �a0c OF AL P5 �CN Date: Title: C I vi L tib'/,,,, ` (L - (rev. 05/18/2018) Page 3 of 3 NORTH BIRCHWOOD LOOP \ o \ imnna RAIL�I�CE �\�� OF q jq�;4p CO '49 r SHANE A. HOLT...' p LS -6914 0` Q�a o �Arofessiona� foJ o ��DDOoo�� THESURVEYDATA AND MEASUREMENTS HEREONAREPREPARED FOR THE OWNER OFRECORDAS OF THEDATE OF THIS SURVEY. ANYUSE OF THIS DRAW/NO BY THIRD PART/ES IS PROHIBITED UNLESS WRITTEN PERMISSION IS PROVIDED. GRID NW 1357 THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EASEMENTS OF RECORD OR OTHER RIGHTS OF WAY, OR ANY ENTITY NOT ON THE RECORD PLAT ARE NOT SHOWN HEREON, UNLESS NOTED. NOTE: FENCELINES THAT MAYAPPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAYBE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. AS-BU/LTSURVEY I" =301 NO CORNERS SET THIS DATE K1 HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY L0T1 DANIEL SUB (PLAT 82-19) ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE,ALASKA THIS 26- DAY OF l(1LY -2023 HOLT LAND SURAEYING 9309 GROVER DRII/E ANCHORAGE,AK 99507 15392 FB 221-22 232-58 223-8615