HomeMy WebLinkAboutAUDUBON HILLS BLK 2 LT 3Audubon Hill Block Lot 3 #015-231-53 - Municipality of Anchorage Development Services Department Building Safety Division ' On -Site Water & Wastewater Program, 4700 Bragaw St. - P.O. Box 196650 Anchorage, AK 99519-6650 www.cLanchorage.ak.us (907) 343-7904 Page 1 or 3 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW0601 11 PID Number- 015-231-53 Name: WADE lACEY Wastewater System: ❑ New M Upgrade Address: 12341 AUDOBON CIRCLE *ANCHORAGE, AK 99516 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 345--4870 4 0 Deep Trench ❑ Shallow Trench 13 Bed 0 bound O Other LEGAL DESCRIPTION Sal 1`10": 1.5 Total Dopth from orlglnal grad!• - 1.87 �' �� GPO/Sq. Ft. Block: Lot, Subdivision: Depth to p:po bottom from orighwt grodo: Gravel dopth Wooeth pipe: 2 3 AUDOBON HILLS 1.41 FL 0.5 PL Township: flange: Section: FTC added oboes odgln& oroM: Grav-A bnath: — — — SEE DWG. rL 28 m WELL: ❑ New ❑ Upgrade Gravel nldtlt: 15 Nombor of Immo: 3 Ddtance botrao� Ona!: 5 rL FL Goaa+ficot.on PrTvola, A.e,C : Total bop Cooed To: Total abaorptlon °roo: Pipe matc": t^, st. 420 so. D 3034/ F-810 inttonx GEG Doto lmtow: 7/15-17/08 Dridor. lJ Data DrirWd: Static Waw La, -m: R TANK Yhra: Pump Sat At: co.ing Height Above Ground: r, PITY n. Ft. SEPARATION DISTANCES ❑ Septic ° Holding 19 S.T.E.P, M Other* To Septic Absorption Uft Holding ublk/Prfirota uO O1{1f°r' GREER cOpOC� �' ofom- 1500 From Tank Field Station Tank Sorror Lhwii Well 100 1 + 100'+ — — 25'+ fdoierbl: STEEL Numbor of comportmonto. 2 Surface Water 100'+ 100'+ — — — LIFT STATION Lot Lane 5'+ 10'+ — — Silo to gotrono: 1500 monufoetwor. QUANICS Foundation 5'+ 10'+ — — — 'Pump on brei d: Pump off lover at: High crater ¢tarn at 1 TIMER TIMER 44" Pump 6 cho LFtdcdor: Ekclricol "poctlono podormod br• Curtain Drain�EE NONE KNOWN p—TE--30—PLUS M.O.A. Remarks. -OLD TANK AND DRAINFIELD WAS PUMPED, CRUSHED BENCH MARK Ux on orb Dexrlptim AND COMPLETELY ABANDONED NW CORNER OF BOTTOM WHITE STEP *THIS IS A QUANICS AEROCELL SYSTEM ON REAR STAIRS Assumed Elovotwn: 1 00.00 Inspections performed by: GEGr Ltd. Dates: 1St 7/15/08 ENGINEE"SEAL �aQoo 2nd 7/16/08 C:zr�� �bd� 3rd 7/17/08 Development Services Department Approval ........ D Conditional approval: Date: :, j' f ness, y A. G CE -7953 t� 4Qn�mr•'..$�f$r0�$.• �A�� Reviewed and approved by: - Date: 0, (Rev. 4/0) �4eaP�oresslor°4� �4Og4�QQQ Co in V e rs i o n + ern e. CAT '3U 4-a o` CAT JE Q uan t c 5 S r 4em Q,�PrvVecl 8/2y/z020 — T � d f I II 111' OR- GARNESS ENGINEERINGUP, Ltd Jar xC H ENGINEERING, SALES > CONSULTING Alaska Autharized Dealer June 30, 2020 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Rd. P.O. Box 196650 Anchorage, AK 99519-6650 (907) 343-7904 Ref: Audubon Hills S/D; Block 2, Lot 3 (12341 Audubon Circle, Anchorage, AK) Memo concerning converting CAT III AWWTS to CAT 11 AWWTS septic system To whom it may concern: The permitted septic system was installed on the referenced property in 2008 and started up shortly after the installation. ARM Septic Services LLC recenity checked the monitoring tubes in the drainfield and found them to be dry. In order to simplify the operation and maintenance of the system, we are proposing that this unit be permanently configured as a CAT II system. Our justifications are as follows: The receiving soil has a percolation rate of 30 minutes per inch. Given this percolation rate, a 2.0 gpd/sq.ft. application rate is required for a Cat II system. There is 2 foot of MOA filter sand below the drainrock in this drainfield. The residence on this property has a total of 4 bedrooms, so 300 sq./ft. of absorption area is required for CAT II effluent (600 gpd / 2.0). The existing 2008 drainfield has 420 sq./ft, of absorption area. In short, the drainfield meets the Cat II sizing requirements. At this time, we request that your department approve a CAT 11 configuration to be used at the referenced property. Upon your concurrence, we will have ARM Septic Service, LLC., go to the property, remove the actuator from the ball valve or leave the valve in the open position, and have them place a CAT II sticker on the control panel. STnrcerelyj s, 9.E., M. S. 3701 East Tudor Road, Suite 101 *Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineedng.com  Municipality of Anchorage Development Services Department (' .u. ngSa,e D,v s,on On-Site Water & Wastewater Program, 4700 Bragaw St. .... P.O. Box 196650 Anchorage, AK 99519-6650 ~ www.ci.anchorage.ak.us (907) 343-7904 Page 1 of On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW08011 1 Pla Number. 015--231 --53 WADE LACEY Wastewater System: r'] New · Upgrade 12341 AUDOBON CIRCLE *ANCHORAGE, AK 9951~ ABSORPTION FIELD Phone: NO. of Bedrooms: (907) 345-4870 4 ri Deep Trench ri Shallow Trench · Bed I-IMound E3Other LEGAL DESCRIPTION ~" "~: '"' ~ ~,'~"~o~ -"~-'-~ ~""'e', 1.5 c.~/s, ~. , .,~, 2 3 AUDOBON HILLS 1.41 n_ 0.5 - - - SEE DWG. ,. 28 I WELL: ~ New 1-1 Upgrade 15 ~ 3 5 ~. .. 420 SO. fL D 3034/ F-810 n. GE(; 15-17/08 ,, ,, TANK SEPARATION DISTANCES ~s.~t~ a.o,d~n~ .S.T.~.P. .Other* ?~,.~TaI Septic Absorpt;on Uft Hold;rig'ub~c/P~v~h 14.~lec~-.c. C~pec,t-/ i. Tank F~eld Station Tank S..., u,,.. GREER 1500 we, 100'+ 100'+ - - 25'+ STEEL 2 S.,a:e Wat,r 100'+ 100'+ - - - LIFT STATION Lot Line 5'+ 10'+ - - - 1500I QUANICS Foundation 5'+ 10'+ -- -- -- TIMER TIMER 44" Curtaln Drain NONE KNOWN P-TE-30-PLUS M.O.A. I I Remarks:OLD TANK AND DRNNFIELD WAS PUMPED, CRUSHED BENCH MARK AND COMPLETELY ABANDONED NW CORNER OF BO'FrOM WHITE STEP eTHIS IS A QUANICS AEROCELL SYSTEM ON REAR STAIRS 100.00 Inspections performed by: GEG, Ltd. Dates: 1st 7/15/08 2nd 7/16/08 3rd 7/17/08 · -...... ~),, Development Services Department Approval ' ~?:i:'.z. ~9.[: ~ Conditional approval: Date: ,~ ¢ ...d~f, v0 ~." C[-7953 .-" Rgviewed and approved by:~ Dote:~ SWO80111 - 015-251-53 ~ _ CO 60.40 39,52 / N~ ~8' ST1 107,60 99,06 ~ ~ ~ ~ .... ~ ~ MH 109.35 103.56'/ ~ ~ ~ ~ / ~ POD1 134.60 124.83 / // / / ~ .0~2 ~3s.~s ~=7.0~ / /~ co~ / / ~ 132.39 123.96 / N~ 1500 ~ON FD 133.69 125.80 ' // / / r J /I ~ ..... "~u0 - 9 GARNESS ENGINEERING GROUP, Ltd. ~l~.:...... .].{.it.. ~...: .... WADE ~CEY~ 345-4870] 2 OF 3 ~ ASBUILT DRAWING 7/29/08 {Rev 01~) NUM.R: AS-BUILT DRAWING SWO80111 I PA~C[L ID NUMD£R: I 015-251-55 I TOP OF TANK INLEt m IN~ERT OF BUNG INLET TOP Glr TANK - 92.88 OUTLET - 9.1.45 1500 GAJ..LON $.T.£.P TANi 10 OAUC£, RATED FOR 10' BURIAl. DEPTH FABRIC ORIGINAL GRAgE -- HIGHEST POINT 105.09 15' WIDE: RELATIVE EL_rVATION OF BOTIOM OF TEST HOLE - 89.09(H20 0 92.59) DISTRIBUllON UNE m 101.72 (AVC.) Bo'rroM OF' BED m 90.22 IYP)r OF WORK: PRFILK DRAWING (Rev 01/O5) GARNESS ENGINEI~RING GROUP, Ltd. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: AUDOBON HILLS; BLOCK 2, LOT 5 ~*E P.N.B 7~28/2008 Inspection l-leporl: Municipality of Anchorage, Building Safety Division 4700 Elmore Road INFO & HELP (907) 343-8211 INSPECTION: VOICE (907) 343-8300' FAX (907)249-7777' www.muni.org Name Company Address Grid Subdivision Work Description Permit Technician Comments or Directions Kevin Rising Son Electric 12341 AUDUBON DR SW2739 AUDUBON HILLS Permit # 08-8614 Inspection Date 12-Sep-2008 AM Phone 250-1100 907 6226777 LOT 3 BK2 TR n/a LIFT STATION ELECTRIC CONNECTION . WAGAR, KATHLEEN D. Lift Station Electical Inspection Type Electrical:Retro Electrical Comments (for inspector use only) Inspector Michael N. Anderson, P.E. Civil/Structural Engineering & Construction 4661 Natrona Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 June 25, 2010 Municipalities of Anchomge Departments ofllealth and Iluman Services P.O. Box 196650 Anchorage, Alaska99519-6650 Fax 249-7847 Re: Audobon llills, Blk 2 Lot 3, Max burial depth To Whom it may concern: This letter is in reference to the burial depth for the septic tank on the above lot. An analysis was performed for the 1,500 gallon buried tank. Loads were developed using AWWA M 11 criteria set forth in chapter 6. The tank was modeled using finite elements and the SAP2000 analysis package. The model assumed thin shell elements matching the 10 gage wall thickness (0.1345 inches), and the tank dimensions are 4'4" in diameter and 12%0" long. Loads were developed assuming an 8.2 ft burial depth with the tank being above the water table. No internal baffle was modeled so the stresses reported by the analysis are conservative. Soil loading was applied to the top quadrant of the tank. Restraints were applied to the bottom quadrant of the tank. The analysis assumes the tank is empty and above the water table. The maximum stress from the analysis is 15,570 psi. The maximum allowable stress is 18,010 psi. The tank wall strength is adequate for the burial condition. Speaking with Lorri Grainawi from the Steel Tank Institute (STI) located in at, 944 Donata Court Lake Zurich~.~~(as also determined that the stresses on the steel tank are adequate for the given depth. I~c~.~a~e anyAubtt~ffff~t~i~se call me at 727-8864. MUNICIPALITY OF ANCHORAGE Development Services Department On. Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jul 08, 2008 Expiration Date: Jul 08, 2009 Permit Number: SW080111 Legal Description: AUDUBON HILLS BLK 2 LT 3 Design Engineer: 0855 GARNESS ENGINEERING GROU~ Owner Name: WADE LACEY Owner Address: 12341 AUDUBON CIR ANCHORAGE, AK 99516- Parcel ID: 015-231-53 Site Address: 012341 AUDUBON DR Lot Size: 50549 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. Ail requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Municipality of Anchorage Development Services Department Building Safely Division On-Site Water & Wastewater Program 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERHIT /~,PPLICATION FOR A SINGLE FAHILY DWELLING Parcel I.D. Property owner(s) WADE LACEY Day phone 345-4870 Mailing address Site address 12341AUDUNBON CIRCLE * ANCHORAGE. AK Zip Code cjc~516 Legal description (Sub'd, Block & Lot) ~,UDUBON HILLS. BLOCK 2. LOT 3 Legal description (Township. Section & Range) Lot Size t~O ~ ~t"~ Sq. Ft. Number of Bedrooms 4 THIS APPLICATION IS FOR ( [] all that apply): Absorption Field Septic Tank Holding Tank Privy Private Well [] Water Storage [] THIS APPLICATION IS AN: [] Initial [] [] Upgrade [] Renewal [] 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. GARNESS ENGINEERING CROUP~ Ltd. Permit/Rush Fees: Date of Payment: Receipt Number; (Rev. 11/05) Waiver Fees: Date of Payment: Receipt Number: GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS July 2, 2008 Municipality of Anchorage Development Service Department On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907) 343-7904 Ref: Proposed Septic System Upgrade for Audubon llills; Lot 3, Block 2, To whom it may concern: The existing 4 bedroom house is served by a private well and septic system. The septic system is in a state of failure and needs to be upgraded. We are proposing to install a 1500 gallon S.T.E.P. tank with Quanics controls/floats, an Aerocell 650 pod and a bed type drainfield. One test hole was excavated on the property. The drainfield will be designed around the 30 foot radius ofthis test hole. Comments regarding the design are summarized as follows: I. SOILS: See the attached logs which show the soil classifications, groundwater monitoring, and the percolation test results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There are no surface waters within 100 feet ofthe proposed septic system. 4. TOPOGRAPilY: As can be seen on the attached design drawing the average topography within 50 feet of the proposed drainfield is relatively flat. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. Pres,af?tl/ "-' ~t 'hOis ~ , ~.d~,a~ ,i~ gt ~. afider Sj gp'la dg ; ac': 'nn~ gt 'J; : :o ~o i$~ ~ ;gi~t cWa[~t ',Cohn adtet car! J part oft lie des ir, pa clare for 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259 Ph: (907) 3374179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com / / ~ I , TRACT A-2 \ I /V ' ~UDU~O~ ~s; ~ ~ ~ ..o.~c .~----~ ~ // · 7-- -~ I ~e~. ~~3;~ i 'h ._ / ~X.. [ / ~~ / AUDUBON H~LLS ~ ~ ~ .... K~ ..... OP~S -~'~ /~ ~ '~ '~, B~BLOCK ~0T2. LOT 6AA~N~ S~ ~ ~' ~ /' I ~ I I GARNESS ENGINEERING GROUP, Lt(I.. .... ~.~.~ · ~"~ e~"~e~o~ ........... AUDUBON HILLS; BLOCK 2, LOT 5 K.D.M. / PERCOLATION RATg/S: 30 MIN./INCH ~ ~ J~--- .ROPOBEB *opuc, nO..~T~: ,.S / ~ ~N~: 28 ~ TO BE COMP~LY TO 08TNN A CO~ OF ~E ~ER / / ~ / i v / /~~0 CONSTRUCTION. OARNESS ENGINEERING GROUP, Ltd. PROPOSED SEPTIC SYSTEM DESIGN UPGRADE 7/I/2008 GAllNESS ENG INEEI1 ING GI1OUP, Lt¢l. ISOIL LOG - PERCO~TION TESIJ 'i"',~ LEGAL DESCRIPTION: AUDOBON HI~; BLOCK 2, LOT 3 PERFORMED FOR: W~E ~C~ DATE: 6/10/2008 feet) ORGANICS JTEST HOLE ~lJ ML .__._ GW ====: ORG GM CL GC OL J~  ~ % ,.SW MH SP CH SM OH SC DEPTH TO DATE ~GEOUNDW~TER ~DY SIL~ DRY 6/10/08 G~L, DAMP SM OR GU 10.5' 6/17/08 10 J 1" - 1~' 11 DATE READING CLOCK NET TIHE WATER LEVEL NET DROP TIME (HINUTES) READING (INCHES) s/1 s/200s ~ ~:20 - s" - 1 2 2 5:50 50 5" 1 15 5 5:50 - 6- - 4 4:20 50 5' 1' 14 5 4:20 - 6- - 6 4:50 50 15 16 17 18 PERCOLATION RATE 50 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 19 TEST RUN BETWEEN 2.5 FT. AND 5.5 FT. 2 A FOUR HOUR PRESOAK WAS PERFORMED: I YES D NO SOILS LOGGED BY:. SU~N OSWALT PERCOLATION TEST PERFORMED BY: ~LE MAUS COMMENTS' PERFORMED BY GEG, Ltd. I, JEFFR~ A. GARNESS, CERTI~ T~T THIS WAS ~ER~RMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: DEPTH TO DATE GROUNDWATER DRY 6/10/08 10.5' 6/17/08 ~31SXS 99300B3Y SOINVnO JO NOI$30 ~ XOOgB '~ 109 'SlllH NOBnOnY ~oo~/~/z I ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN MUNICIPALITY OF ANCIIORAGE TtlIS MEMORANDUM OF UNDERSTANDING made and entered into as of this ~ Dayof ~-/~tt of20Vk, by and between ,'t~d ~Z~.t.C/ , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Memorandum of Understanding 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/ft,~/? Ix/ CE [-~C~(s(~( located 2. Definitions. A. 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. Prior to performing any alterations to an AWWTS thc owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65. B. Certificate of On-Site Systems Approval. An approval by the Municipality of existing water and wastewatcr disposal systems given at the time of property sale and title transfer in accordance with 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. C. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. D. 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. E. Permit (Construction) An On-Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. F. Permit (Operating) An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that allows the Owner to operate an AWWTS, upon meeting all the requirements of this agreement, the conditions of Operating Permit, the requirements of the On-Site Wastewater System Construction Permit and all relevant provisions of AMC 15.65 3. Fee. Owner shall pay to Municipality an annual fee of ($_.~_.00), payable on or before the issuance of the operating permit and annually / thereafter. The annual fee is due on or before the anniversary date of the approval by the Municipaliiy of installed system. 4. Term. The term of this Memorandum of Understanding shall be for the life of the AWWTS. The term begins on the date of approval by the Municipality of the installed system and shall continue while the AWWTS system is in use or operational or until the property is sold or title is transferred by owner and a new certificate of On-Site approval is issued to the new owner or transferee of the property. 5. Alteratlons~ Installation and Removal of Additional Eqnipment. Owner agrees not to make any alterations, removal of parts or additions to the AWWTS without a Construction Permit from the Municipality. 6. Maintenance and Repairs. A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AWWTS in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the oxvner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further, Owner agrees to comply will all applicable ordinance, laws, regulations, rules and orders for the AWWTS. B. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the Owner's AWWTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's AWWTS Operating Permit is: L~L-~ ,~'~,Cl C. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. D. Owner agrees that only maintenance, repair personnel certified by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. E. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. F. Owner agrees that any sale or transfer of title of the properly will not occur without a new Certificate of On-Site Systems Approval. G. Owner agrees that the relevant provisions ofthe standard specification guidebook for AWWTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's AWWTS. 7. Nonwaiver. The failure ofeither party at any time to enforce a provision of this Memorandum of Understanding shall in no way constitute a xvaiver of the provisions, nor in any way effect the validity of the Memorandum of Understanding or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 8. Amendment. A. This Memorandum of Understanding shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality or'his Memorandum of Understanding was executed and such writing shall be attached to this .Memorandum of Understanding as an amendment. B. For the purpo~s ofany amendment modification or change to the terms and conditions of this contract, the ~nly authorized representatives ofthe parties are: Owner: ~[~./~1' Anchorage: Purchasin~ Officer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of Understanding 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 Memorandum of Understanding. 10. Severabilitv. Any provisions ofthis Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum of Understanding. OWNER: MIYNICIPALITY: Title: Date: ~O~..% 3,/ ,-2 o o r~ Date: STATE OF ALASKA ) THIRD JUDICIAL DISTRICT ) The~ foregoinginstrument vt,as acknowledged before me this'~ day of C~t/J ¢[ , 20_0_~,by -[X_)a~.~_( I~p~5 ,the ©bO/'~.)~,-/ . / NOTj{RY PUBLIC FOR AL3j;SI~A / -, 4,~, ".~...~.t~ ~ omm,ss,on ×p,res: ,.,".;*. :..o .. f~'~'~ MUNICIPALITY OF ANCHORAGE f~ 't DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE I ~PGRADE MAILING ADDRESS LEGAL DESCRIPTION LOCATION DISTANCE TO; ~,~& IAt~s°rpt'°n area Manufacturer DISTANCE TO: Manufacturer IF HOMEMADE: Well D,STANCE / OD ' '/-- , of tile to finish Inside length Dwelling Foundation Total ,eng Material beneath tile Depth Dwelling Material Width Material Trench- widt hv I ~:~,~ NO. OF BED~OOM$ PERMIT. NO. No. of compartments Liquid depth PERMIT NO. Liquid capacity in gallons T°ta' eR ect ~Ve~b~r~.~narea PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller D~stance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS/ SOIL TEST RATING APPHOVED · DATE LEGAL  ! -~UNICIPALITY OF ANCHORAGE · DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ,~" [] UPGRADE  z Manuf~turer ' Material ~: ~ T~ of tile ,o finisk grade 4 Material ~neath ,tie 6~I m Well Building f~ndation Nearest lot line ~ DISTANCE TO: OTHER / PiPE MATERIALS 501L TEST RATING 72-013 {Rev. 3/78) ~ ~EPRRTMENT ~ HERLTH AN~ ENVIRONMENTRL ~OTECTIOI~ /.~ 825 'L' ~TREET, ANCHORROE, AK. ~Sel ' A COPY MU$T BE ODTAZNED FEOH THE F%LES - DATA NOT AYAZLABLE %N THE COMPUTEE - DEPARTMENT,O,~ .RLTH AND ENVIRONMENTAL I'..~ ECTION / ~-~ ~ 825 L STREET, ANCHORAGE, AK. 99501 .... ~ /~ ..... ~ PERMIT NO. ( 780552 ') ~ ~ APPLICANT BOB TIEDE SPA BOX 4-22D ~44 8964 LOCRTIOH AUDUBON CIRCLE ' LEGAL L~ B2 AUDUBON HILLS S/D LOT SI~E 54450 SQUARE FEET TYPE OF SOIL 8BSORBTION SYSTEM IS: TRENCH .~" MAXIMUM NUMBER OF BEDROOMS = 4 ~' ' ,SOIL RATING (SQ FT?BR)= ~.~O- THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= 12 LENGTH= 9~. 6 GRAVEL DEPTH'= THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT I5 THE DISTANCE BETWEEN THE SURFACE OF T~ GROUND AND THE BOTTON OF THE EXCAVATION <IN FEET). THERE IS NO SET ~H FOR TRENCHES. DEPTH.IS THE MINIHUH DEPTH OF GRAVEL BETWEEN ~HE.O~FRLL~PIPE THE GRAVEL AND THE BOTTOH OF THE EXCAVATION (IN FEET). ' ' : ' REQU IRED SEPT I C TANK S I ZE= 2258 6R'LLOr4S PERMIT RPPLICRHT HAS THE RESPONSIBILIT~ TO INFORM THIS DEPARTMENT CDURING THE INSTALLATION INSPECTIONS OF 8N~ WELLS RDJRCEHT TO THIS PROPERT~ AND THE NUblBER OF RESIDENCES THAT ~HE WELL WILL SERVE. ', ------ <2> ZN PEOTZON BACKFILLING OF ANY S~STEM WITHOUT FIHRL INSPECTION AND APPROVAL B~ THIS DEPARTMENT WILL BE :SUBJEOT TO PROSECUTIOH. HINIMUH DISTANCE BETWEEN R WELL AND ANY OH-SITE SEWAGE DISPOSAL SYSTEM IS iO~ FEET FOR R pRIVATE WELL~ OR 15~ TO 28~ FEET FROM R PUBLIC WELL DEPENDING UPON THE T~PE OF PUBLIC WELL. WELL LO~ ARE REQUIRED RHD MUST BE RETURNED ~0 THE DEPARTMENT WITHIN ~ OF THE WELL COMPLETION. '' OTHER REQUIREMENTS MR~ RPPL~.. -' SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER-INSTRLLRTIOH. PERrIIT EXPIRES DECErIBER ~ 1978 I CERTIFY THAT l: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND/WELLS RS~ET,~ F, ORTH BY THE MUt~ICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN RCCORDAHCE WITH THE CODES. ~ '~: .I UNDERSTAND-'.THRT THE ON-SITE SEWER SYSTEM MAY REQUIRE EHLRRGEMEHT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. SI GNED: ~~_~_~__~_~.*. .......... -__ APPLICANT BOB TIEDE ISSUED DATF V3. 2 o .: ', - ' 'DEI%']R [MrrlT/"',; I IEI1LTH fIND E~IV IP, ON;'II~NT~L/' ~'~OTECTION ~ ~..~5 "r.' 5IRIZET, IRhlCtlORROE,, RI(. 14ELL_ PF='- r~l-1 3- T PIZZa'lIT I';0. ( 7003.47 ) APPLICANT LOCRTION LEORL DOD TIEDE RUDODRN LRNE L 3 D ~ RUDODRN IIILLS SUO LOT $1ZC HIt,'IHL:H DISTP,;JC." D~TWEFN Fi HELL FLUID l~O FEET FOR 13 I"RIVf'ITIZ I.,',"LL~ OR 1.58 TO ~8~] FrD. T FRO:'1 fl PUDLIC 14CLL D,"PrI',~DII','O UrO,~l THr' T','r[: OF PUDI. IC NELL. 14FLL LO05 P, RLT. D. EQUIRED P, ND MUST DF_ r.F_.TURI'~',"'D TO TII~ DF_.PFIRTMF_I'JT WITIIIN ,~OF Tllt~ WF. LL COMPLETIOtL OTIIER r<EQUIr.,"'HEIIT5 HA',' I'IPPL%', 5PECIFICFITION5 13ND CONSTRUC:TIO;i DIFIORRM5 P,V,qlLP, DL~ TO I,~JSURE PROPlJR INSTP,: LFITIO~:. I CF_.,~TIr",' TII,'-iT 1: I r,M Ff:HILIP, R HITII TILE. Rro. uIP. EHF_t~T5 for O;~-SITE 5r'l.~P.5 P, iqD 14.'-LL5 IL5 5IT FORTii D',' Tllr' MUh~ICIDFILITY OF F1NCIIOD. fIO,C. -": I 141LL INSTr, LL TII," 55'STIZH Itl 13CCORDI3~C.E WITII TII.'- OODF-5. s _ .............. P,,PI'L I CI3t~T [}OD T IIZDF V3. DAILY DRILLING LOG PENN JERSEY .DRILLING CO. Z833 E~st 7Znd Avenue Anchorage, Ahska 99502 DE'TI! OF ~,VELL. .................... [..~ .................................................................... STATI0 LEVEL OF WATER DRAW DOWN FT ................................................................................................ :.. o~.,. ~:,~{~.: .................. .'.~..0.......~.,.~.l~l .......... CJ.~r_~ ...................... KIND OF FORMATION: ~,o,, ........ C' ...... ~. ~o.....:3-. ........... ~....'~c~.'..~c~.~..~ .......... ~Ko.~t......:.,~ ........... FT. TO........!..~ ......... FT...C../~.tl....:i.~! 0., .... rKo.~ ........................ FT. To ............... ~ ........ FT...~.L~.!:..I .............. ~,o.,, ......... !.-~. ...... ~. ~o......:.-.2~'i ......... ~.....ql..~.¥ ..................... ~.o.,, ..~"1 ...... FT. ~o ........ 3..0. ......... ,-r...6:~.~;~:.t,.c..!..%l FROM ....................... FT. TO ............................................. ~.: ............. ~,o.,,.....~0 ......... ~. ~o ....... ~.3 ......... ~..~.l.0.¥:~.~j~'.e.~ ~,o,~t........~l.'-] ...... FT. TO......,~'.~ ......... ~..C,L)V..;,.~:me,.. ~o.~ ..................... FT. TO ......................... ~r........~-~-k~-~ .............. ~-,o.,,.....-)-~ ..... rt. TL.6'f/.......:.FT.C'.:..~[~,!~ I ~,o.,,.......Sg ......... ~.,o.....~.....~..~.~.t...~..~!.~ ,Ko.,,... ......... ,~,o.,, .......................... ~. ?o.......I.L~.........~_~.C..'....9.i~.....~: P~ FEOM ......................... FT. TO .......................... FT ......................................... FROM ......................... FT. TO .......................... FT ....................................... FR 0.~! ......................... FT. TO ......................... l~r ...................................... FROM ......................... FT. TO .......................... FT ......................................... FROM ......................... FT. TO ......................... FT ........................................ FRO.~! ....................... FT. TO ......................... FT ......................................... FROM ......................... FT. TO .......................... FT ......................................... FROM ......................... FT. TO .......................... FT ......................................... FROM ......................... FT. TO .......................... FT ......................................... ; F t,.:c'.~ r.e. ex- PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 5 7 8 g ~I0 11 12 13 14 15 16 17 18 19- 20- COMMENTS [] SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6650, Ancho~, AJad~ca 99502 276-222! .~SOILS LOG -- PERCOLATION TEST DATE PERFORMED:, SLOPE -~"/PERCO LATION TEST ENCOUNTERED? O SITE PLAN P IF YES, AT WHAT E DEPTH? Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE ~ ~'~ (minutes/inch) TEST RUN BETWEEN ~'~'" FT AND 5'0 FT PERFORMED BY: ~'~ ~"'~ 5 ~ CERTIFIED BY: 72-008 (7/76) MUNICIPALITY OF ANCHORAGE i 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. 015-231-53-000 Expiration Date: Legal description AUDUBON HILLS BLK 2 LT 3 Site address 12341 AUDUBON CIR Anchorage AK 99516 10/21/2025 Current property owner(s) LACEY WADE C REVOCABLE TRUSTLACEY WADE C / TRUSTEE X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for Comments or advisories: a bedrooms, with the following stipulations: Original Certificate Date: 11/7/2024 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. 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. 015-231-53 Complete legal description AUDUBON HILLS BLOCK 2 LOT 3 Location (site address) 12341 AUDUBON CIRCLE, ANCHORAGE, AK 99516 Current property owner(s) LACEY WADE C REVOCABLE TRUST Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: ® 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: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 16 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ® AWWTS ® Bed ❑ Deep Trench ❑ 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 $ 550 Waiver Fee $ _ Date of Payment A I/2 `i Date of Payment COSA # Waiver # COSA Application.doc COSA Checklist.docx COSA Checklist Legal Description: AUDUBON HILLS BLOCK 2 LOT 3 Parcel ID: 015-231-53 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 5/20/1978 Total depth 113 ft Cased to 31+ ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 10/24/24 Static water level at beginning of test 21 ft. Well production at time of test 5+ gpm Water storage tank volume None gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 0.248 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 10/23/2024 Comments B. TANK DATA Measured operating fluid level in septic tank *NA Date of pumping 10/21/24 Required maintenance completed, if AWWTS Comments: *FLOATS/TIMER – SEE QUANICS MAINT C. LIFT STATION Required maintenance completed* Age of lift station 16 years Lift station material Steel Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 7/17/08 ALL standpipes present per record drawing Total measured depth from grade 4.4 ft (max) Measured depth to pipe invert from grade 3.6 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective (ED). 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 2000 gallons 10/23/24 date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 10/24/24 Results Pass Fluid depth prior to test 0 in Water added 860 gal New fluid depth 2 in Elapsed time 20 min Final fluid depth 0 in Absorption rate 600 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 6 in (MOA 0.5’ ED) Effective depth used 0 in (Final Fluid Depth) Effective depth (ED) remaining 6 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots, visual observations, MOA records & appears approximate. COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No *50+ ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No *50+ ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No *5+ ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No *50+ ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No *50+ ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS *MAY MEET CONVENTIONAL SEPARATIONS, BUT SYSTEM MEETS CATII/III SEPARATION DISTANCE REQUIREMENTS. G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 10/29/2024 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 10/29/24 ARM Septic Services_ LLC Maintenance Checklist: Advanced Treatment System Operational Checklist: Advanced Treatment System Legal Description: Street Address: 1134-`i f Ldobor, c_,\rCjf Service provided on: Date: - 50'- Z Time: ADN EA Itf Hf�Jl. WN— AWati.m. Service provided by: Company:" [Km Technician: C5 L")C."Y7 1IJW01, Date of last service: � ^ Z7- � By:Y Other: 1. Type of Aerocell Treatment System: �I Cat 11-AeroCell Treatment System ❑ Cat III -AeroCell Treatment System 2. Conditions at media filter: Aftceptable ❑ Unacceptable a. Evaluate presence of odor within 10 ft of perimeter of system: rik?gone ❑ Mild ❑ Strong ❑ Chemical ❑ Sour b. Source of odor, if present: A) 4C 3. Manhole Risers and Pipe Caps: Acceptable ❑ Unacceptable a. Cover/s intact: l4?�es ❑ No b. Method of securing cover: 'gC.lt/,� c. Insulation present on all lids? ` Yes ❑ No d. Any plumbing leaks or water intrusion: ❑ Yes [Itno e. Surface water/infiltration into components: ❑ Yes S 1No 4. Venting/Air supply: 'Wcceptable ❑ Unacceptable a. Air supply unit operating properly, 5Pes ❑ No b. Venting appears operable. �es ❑ No 5. Media surface: �lAcceptable ❑ Unacceptable a. Biomat on surface. ❑ Yes b. Uniform spray pattern. i Yes d. Ponding in/on media. ❑ Yes e. Plugging/clogging of nozzles. ❑ Yes f. Media appears to be settling. ❑ Yes g. Appropriate maintenance performed. Yes h. Pest activity at surface. ❑ Yes 6. Effluent quality a. Effluent odor after passing through media filter: b. Effluent color after passing through media filter: L� • *one ❑ Mild ❑ Strong Clear ❑ Brown ❑ Black 17933 Old Glenn Highway *Chugiak, AK 99567 office/fax: (907) 688-9433 Email: ARMServicesAK@outlook.com (PAGE 1 of 3) ARM Septic Services, LLC 7. Tasks for recirculating/discharge flows: " A ptable ❑ Unacceptable a. If applicable, Jandy valve functioning: ❑ Yes El No NN/A b. If applicable, Jandy Valve basin dry: ❑ Yes ❑ No M/A c. Cleaned collection system in Aerocell unit: ❑ Yes ❑ No [ I of Necessary d. Design recirculation ratio: 80 : 20 e. Actual recirculation ratio (Estimated): : 2� 8. Pump System: L fcceptable ❑Unacceptable a Control panel in Auto: L91 Yes ❑ No b. Timer settings IFS Panel (No Override timer): ❑ Yes ON: - OFF: _17- e. - Override ON: Ie - Override OFF: ❑ N/A c. Floats in correct placement: 'KrYes ❑ No d. Floats working properly: ®'Yes No e. High water alarm operational: C; -Yes No f. High water alarm count: g. Pump Run Counts: h. Pump Run Time: In 4� I. Float Error Counts: LIN/A j. Total Override Counts:_ WN/A k. Effluent Filter serviced: WYes ❑ No I. Tank lids secured after inspection: WYes No m. Weep hole functional: r 'es No 9. Primary Tankceptable ❑Unacceptable a. Sludge and scum level checked: ❑ Yes YNo b. Sludge/Scum levels: 1st:90�_ 2nd: 3rd: N/A C Tank needs to be pumped: ❑ Yes & No d. Water softener backwash discharging on system? ❑ Yes ❑ No e. How many people live on the system?: . vkc-Ai- f Tank lids/caps secured after inspection: I�Jles ❑ No g Last Date Tank pumped: _ 'I - i 10. Drainfield: a. Type of Drainfield (circle one): Bed 5 -wide Deep Trench b. Design Effective depth: c ' s/feet c. Checked Liquid Levels in Drainfield:YYes ❑ No MT#1 Liquid Level: V Inches MT#2 Liquid Level: Inches MT#3 Liquid Level: Inches MT#4 Liquid Level: Inches d. Is there any surfacing effluent?: ❑ Yes No 17933 Old Glenn Highway *Chugiak, AK 99567 office/fax: (907) 688-9433 Email: ARMServicesAKCoutlook.com (PAGE 2 of 3) ARM Septic Services, LLC 11. Is the remote monitoring syst m functioning? (if no, describe in comments) &'Yes ❑ No a. Type of Monitoring syst( b. Phone line working? ❑ Yes ❑ No ❑ N/A 12. Does this system receive an advisory notice/warning? (if so, describe in comments) UYes VNo 13. Is the system in satisfactory condition/pass inspection? (if no, describe in comments) �es ❑ No Other Comments: Le�k,A r'\�nlwlfor ker ,�X_S 5eal�8. C'.'1r\-tC4ej 61-zu f, LJ N(r in) , V rc Pj- QTS t'-JU r In VJ , A -f J',,.L e. /? % Service Provider: Date: ® %L 17933 0[cwtenn Highway *Chugiak, AK 99567 office/fax: (907) 688-9433 Email: ARMServicesAK@outlook.com (PAGE 3 of 3) : Municipality.Of Anchorage ,;, ....,. Development .SerVices Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O, Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite · (907) 343-7904 C_.ERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGL 'FAI'41LY DWELLING Parcel I.D. 015-231-53 1. GENERAL INFORMATION COSA# 0,.~ O /0 / I / Expiration Date: / 0 "' / ~-/ ~' Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address AUDUBON HILLS S/D; BLOCK 2, LOT 3 12341 AUDUBON CIRCLE * ANCHORAGE, AK * 99516 WADE LACEY 12341 AUDUBON CIRCLE Day phone ANCHORAGE, AK * 99516 Day phone 345-4870 Day phone Unless otherwise requested, COSA Will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well · ' Individual On-site · Individual Water Storage [] ¢ Individual Holding tank [] Community Class .Well F-I, Community On-site [] Public Water System [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for propedies served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my sea/a~xed hereto and as of the "~" va,/dadon .d~e shown belowo 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 th~ ~ i~ ,~ information obtained from the Municipality of Anchorage files and from my investigation and inspe~i~ni~ tt¢~i on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 557-6179 Address 5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date Engineer's Comments: · In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD G~idelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the COntrol of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that · there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not au!horized, nor will it confer any legal right whatsoever. DSD SIGNATURE Approved for /-~ Disapproved. Conditional approval for bedrooms. ~ : WATER AND : m: ..~ ,, WASTEWATER .: _: ~ ,.. PROGRAM ..' ~ .~.,o~,,-.. .. x,,.~ bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory ~tru~e Advisory (Rev. 11/05) Arsenic Advisow Maintenance Agreements Supplemental Engineer's Report' Other Original Certificate Date: '.-~-' i;z -/0 CERTIFICATE Legal Description: WELL DATA Well type PRIVATE MuniciPality of Anchorage Development.Services Department Building Safety Division On-Site Water & Wastewater 'Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni,org/onsite (907) 343-7904 OF 0N-SITE SYSTEHS AUDUBON HILLS S/D; BLOCK 2, *PER AAROW PUMP AND WELL If A, B, or C provide PWSID# N/A Date completed 5/20/1978 Sanitary seal (Y/N) YES Total depth 113 ft. Cased'to ~1/'+ ft. FROM WELL LOG Date of test 5/20/1978 Static water level 53 ft. Well production 20+ g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mi. Nitrate 2.36 mg./L. Arsenic: ND ug./L. Date of sample: 6/28/2010 SEPTIC/HOLDING TANK DATA Tank Type/Material S.T.E.P./STEEL Tank size 1500 gal. Number of Compartments 2. Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping 6/28/2010 Pumper. ABSORPTION FIELD DATA ~*BELOW .EXISTING, GRADEI Date installed 7/15-17/08 Soil rating ~or ft2/bdrm) ** 1.5 Length 28 ff. Width 15 .fi. Total depth *4.0-4.4 ft. Eft, absorption area 420 ft2 Monitoring tube YES Date of adequacy test NEW Results (Pass/Fail) PASS Fluid depth in absorption field before test - in. Elapsed Time: - min. Final fluid depth - Any rejuvenation treatment(past 12 mo.) (Y/N & type) **ADVANCED TREATMENT SYSTEM (QUANICS) APPROVAL CHECKLIST LOT 3 Parcel ID: (~ INSPECTION. SEE ATTACHED. Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 6/28/2010 31 ft. 5.2+ g.p.m. Other'bacteria 0 colonies/100 mi. Collected by: GE(:; Ltd. Date installed 7/15-17/2008 Cleanouts (Y/N) YES High water alarm (Y/N) N/A MCDONALDS PUMPING System type **BED Gravel below pipe 0.5 ft. Depression over field NO For - bed~'ooms Water added - gal. New depth - in. in. Absorption rate >= - g.p.d. NONE KNOWN If yes, give date - D. LIFT STATION Date installed "Pump on" level at in. Size in gallons Manhole/Access (Y/~N) .._-- ''Pump off'~ High water alarm level at Cycles tested. Meets alarm & circuit requirements~ SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ ~ A.bs~orptron field on lot 100'+ Public sewer main N/A Sewe'r/septic service line 25'+ Animal containment areas 50'+ in. On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout Holding tank N/A Manure/animal excrete storage areas N/A 100'+ Building foundation Water main Wells on adjacent lots SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 5'+ Property line 5'+ N/A Water service line. 10'+ 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Absorption field Surface water. 5'+ 100'+ Property line 10'+ Building foundation 10'+ Water service line 10'+ Surface water 100'+ Curtain drain NONE KNOWN Wells on adjacent lots, 100'+ COMMENTS Water main N/A Driveway, parking/vehicle storage 10'+ G. ENGINEER'S CERTIFICATION I certify that I have determined ~through field inspections and review of ~nicipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Prin~ted Name JEFFREY A. GARNESS Date .7/~//°/ COSA Fee $ Date of Payment ReCeipt Number (Rev:' 11/05) Waiver Fee $ Date of Payment Receipt Number PLAT NO. 77-307 AUDUBON HILLS SUBDIVISION LOT 3, BLOCK 2 50,549 S.F. L---94.' AUDUBON CIRCLE .% 87.74' SEPTIC SYSTEM WELL Z 1"=40' BUILDING DETAIL SCALE: 1'"-20' AS-B U I L T , HEREBY CERTIFY THAT , HAVE SURVEYED THE PROPERTY BEPIOTEB ABOVE AND THAT NO GASTALDI IANB ENCROACHMENTS EXIST EXCEPT AS INDIOATED. SURVEYING, LLC It IS THE RESPONSIBILITY OF THE OWNER TO JEFF A. GASTALDI, R.I..S.DETERMINE THE EXISTENCE OF ANY EASEMENTS, 2000 E. BOWLINe RD., SUITE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT :ANCHORAGE, ALASKA 99507 APPEAR ON THE RECORDED SUBDIVISION PLAT. PHONE 248-54-54. UNDER NO CIRCUMSTANCES SHOULD ANY DATA GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR 2739 6/15/2010 'ESTABUSHING BOUNDARY OR FENCE UNES. ANCHORAGE RECORDING DISTRICT, ALASKA FoB. JOB NO, 10-04- AHS32 NOTE: NO CORNERS SET TH IS DATE. Aarow Pump & Well Service, LLC P.O. Box 110496 Anchorage, AK 99511 Office: (907) 346-9355 - Fax (907) 333-8976 Eagle River: (907) 622-9335 N_0 '08715, CUSTOMER JOB SITE L~_~/ ' J L J QUAN~ DESCRIPTION PRICE AMOUNT ~BOR HOURS RATE AMOUNT TOTAL MATERIAL TOTAL ~BOR WORK ORDERED BY~ DATE COMP. TOTAL I ~BOR PAY THIS AMOUNT ~ ~ Thank You SIGNATURE (I Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that if above work is not paid for in 90 days I agree to allow Aarow Pump & Well Service, LLC, the right to remove unpaid for equipment and charge for labor already performed & labor to remove unpaid for equipment.) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE, SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. QuanicsXM/AeroCellTM Advance Wastewater Treatment Routine Maintenance Service Report 2008 Report date: April 29, 2009 Unit #: Legal Description: Street: Home owners name(s): Home owner mailing address: City, State, Zip: Start-up date of unit: Service contract current: Service contract ending date: 43 Audubon Hills BLK2 LT3 .12341 Audubon Hills Wade & Barbara Lace¥ 12341 Audubon Hills Anchorage, AK 99516 8/06/08 Yes 8/06/09 Date(s) of Routine Service: 8/06/08, 10/24/08 Dates of repairs/non-routine service dates: none noted during 2008 to April 29, 2009. This report is to inform you that your QuanicsXM/AeroCellTM advanced wastewater treatment system is working within normal parameters. The following items were noted during routine service: Tiiners adjusted: No Auto dialer working (phone line connected with phone service): Yes Orifices cleaned: orifices not clogged - cleaning not necessary Pumping needed: No Floats adjusted: No Drain field levels: Good, all dry Filter cleaned: filter condition good - cleaning not necessary QuanicsTM/AeroCellTM Service Provider: EMM Technical Services LLC. P.O. Box 672235 Chugiak, AK 99567 Phone/Fax 907-688-0395 Cell 907.351.7042/907.223.0555 Thank you, Jody Maus Note: Copies of Service Report will be made available to the Municipality of Anchorage Development Services Department On-Site Water & Wastewater Program upon request. · -' [ DATE RECEIVED "' INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE //, DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECt~CIPAUTY OF 825 L Street - Anchorage, All~,ka 9~54)1 DEPT. OF HEALTH & (~ ENVIRONMENTAL PROTECTION ENVIRONMENTAL SANITATION DIVISION Telephone 2644720 MAR g 1981 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SE~ DIRECTIONS: Complete all parts on page 1. Incomplete requests wiU not be processed. Please allow ten (10) days for processing. 1' PROPERTY OWNE~__~.,/,./.1~. ~.~.,J PHONE ' ' MAILING ADDRESS PROPERTY RESIDENT Ill different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION I PHONE MAILING ADDRESS J 4. REALTOR/AGENT j PHONE I MAILING ADDRESS i S. LEGAL DESCRIPTION STREET LOCATION Z ~.~ · I ' 6. TYPEOF RESIDENCE NUMBER OF~BEDROOMS ~' SINGLE FAMILY I--1 One ~' Four [] Other .r--I Two ~ Five ~ MULTIPLE FAMILY ~ Three ~ Six 7. WATER SU~LY ~3 INDIVIDUAL' I--I COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISFO~AL · A'I-rACH WELL LOG. A well log is required for all wells drilled - since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) ,~ INDIVIDUAL/ON.SITE" [] PUBLIC UTILITY / ,~'~-~ YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72.OLO (Rev, 6/79) ._-~ - THIS SIDE FOR OFFICIAL USE oNLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS I'--1 SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY * - * [] INDIVIDUAL DEPTH OF WELL [~ COMMUNITY )ATE DRILLED I--] PUBLIC UTILITY Connection. Verified. LOG RECEIVED 3. SEWAGE DISPOSAL. SYSTEM PERMIT NUMBER [] INDIVIDUA~L/ON -SITE "* . DATE INSTALLED []PUBL,c UT,L'TY 7 Connection Verified iNSTALLER I-'lSepticTank or [--IHold[ngTank ~_~--o If Tank is homemade Size: SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO= S~p,,ci.olUine ,.., JAb,orp,o. Area JS.~., L,., iNca,s, Lot L,ne Absorption Area to nearest Lot Line 5. COMMENTS ~PPROVED FOR ~'~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) r-I DISAPPROVED 72-010 {Rev. 6/79) · MUNICIPALITY OF ANCHORAGE ,MUNICIPALITY OF ANCHORAGE  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIONDEPt. G~ H~ALTH & 825 L Street · Anchorage. Alaska 99501 , ~IRONMZNTAL P~O;[~ION ENVIRONMENTAL ENGINEERING DIVISION ~0V 2 ? 1978 - Telephone 2~720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND DIRECTIONS: Complete ell parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PRO~EI~TY OWNER MAILING ADDRESS /~ /~ T ' PROPE~[~ RESIDENT {If different from ebon) IPHONE ~ gUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION MAILING ADDRESS 4. REALTOR/AGENT MAILING ADDRESS PHONE PHONE JPHONE 5. LEGAL DESCRIPTION c_ & ;- 115 STREF. T LOCATION 6. T~PE OF ~ESIDENCE NUMBER OF BEDROOM5 .~INGLE FAMILY ~ One ~ Four ~ Two ~ Five ~ ' MULTIPLE FAMILY ~ Three ' ~ Six [] Other T. WATER SUPPLY ~ INDIVIDUAL' I-'1 COMMUNITY [] PUBLIC UTI LITY 8. SEWAGE DISPOSAl. SYSTEM '-~ N DIVI DUA L/O N.SITE°° i'-I PUBLIC UTILITY · ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drille~l..~.~ to that date, give well depth (attach log if available.) f/~ ° e.l,f individual/on-site, gtve instal at on date "~"%J'~,.t ici '3 ~'. If system is over two {2) years old an adequacy t~st is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) -~ '-'~' "i THIS SIDE FOR OFFICIAL USE ONLY /~, -. DATE FtECEIVEO INSPECTION APPOINTMENTS · : TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR 1..TYPE OF RESIDENCE NUMBER OF nEDROOMS ONE ["1 THREE r-I FIVE [] OTHER SINGLE FAMILY [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX 'ERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY }ATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified iNSTALLER ?Sep_tic~,.~nk or I'--IHoldingTank ""~_ ~ ~ize/.~-,~ ~ IfTankishomemade SOILSRATING live dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA M AT E R IA L~..~,~ 4. DISTANCES Sept.clHolclmg Tank IAb$orption Area Sewer Line I Nearest Lot Line WELLTO: I I Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR f/ BEDROOMS r'-I CONDITIONAL APPROVAL (letter mu*t accompany certificate} [] DISAPPROVED DATE BY {Title) LEGAL DESCRIPTIONX (. 72-010 (Rev. 3178)