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Home My WebLink AboutBIRCH TREE ESTATES BLK 1 LT 33 Municipality of Anchorage Development Services Department Building Safety Division On-S~te Water and Waslewater Program, 4700 S. Bragaw St. P.O, Box 196650 Anchorage, AK 99519-6650 Page www, ci,anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT , , PID Number: Wastewater.System: [] New [] Upgrade E CC. LEGAL DESCRIPTION ABSORPTION FIELD r'l Deep Ttenc.~ 1-1 Shaltow Trenc~ ~ed r't Mou,~ Well: [~New [] Upgrade C ass ~ c.~',~n ~Pt,va,e A 8 C) I Total Oeoth ~ Clsed to ,e,~ J P~mp Set ~t. J Cas,~ ~ht ~ ~. SEPARATION DISTANCES Tc Absorption Septic Tank Field L3~ L,re Lift Holding Station Tank 6,0 ! I r'l Septic r'] Holding [] S.T.E.P. Public/Private Manufac~u~m' TANK LIFT STATION lt,,oOG,, ! BENCH MARK loc)°--~ ,: Inspections performed by: T ~ Dates: 1" ~ ~/~'~/' Development[Services ~upartment Approval . and approved by: ~ Da[e: ~/'~,/0:~ 2&tS $CALE~ I' = $0 FT, / 49t:h SPURKL&HD No. II BIRCH TREE ESTATE LOT $$ BLOCK I TO~( BUTCHER II GRID: $057 SEPTIC SYSTEI~I AS BUILT DATE: JULY 15, 205 SHEET:2/3 PERMIT # SVfl£fl4£7 PID # 017-I41-05 ETEO1338.flVG r'"Z76~IEII4TIZlV ~£AN BUT I15~ 3034 ' ' ' " ~ ~ ~ ~ ,"' ~: ~'~' ·., :... ,:.. ~.s ~ ~ ~ ~r$ · , ~4 T~ IN2 T~L L ~ TIDN ~ o / F~~.~ ~ :.; :'_x~ ~' '"'' rOaaEX SPURK~NO P.E. LOT 33 BLOCK I BIRCH T~E E~ATE SEPTIC SYSTEM SHENATIC 20~ W I6TX. AVENUE BATE: JULY 13, ANCH. AK. 99501 TON BUCHER .(907) 279-3916 SHE~: 3/3 GRID: 3037 PERHIT ~ 2-Mfl~f14E7 PI~ ~ 017-141-05 BTEflI32.BIO Jul 13 03 10:35p Tom Butcher 34S-1631 p.l Rick Mystrom Mayor Municipality of Anchorage Department of Healt..~, and Human Services B25'L Street P.O. Box 195650 Anchorage. Alaska 99519-6650 h:t~:/!~.~;.ct,anc~orage ak us Permit Number: ~SW 020427 Date oflssue: 10.21.02 Parcel Identification Number: 017.141.05 Date S/aria.al: 4-29-03 Date Completed: 4-30-03 Is ~vell located at approved permit location? [] Yes [] No Legal Description: Birch Tree Estates BLK 1 Lt 33 Property Ownee Name & Address: Thomas Butcher 1120 E Huffman #663 Anchorage, Alaska 995~5 Borehole Data: Depth (ft) Method of Drilling [] air rota~ I-'] cable tool Soil Type, Thickness & Water Strata From To Casing type: steel sEc, k-up 0 2 silty gravel fill 2 7 graveily silt 7 35 cobbly gravelly silt 35 ~8 cobbly gra ve!ly silt w~ldrs 88 120 sandy sill 120 123 wator sand & gravel 123 126 sandy silt 126 130 Wall Thickness: ,.,25Q inches Diameter: _6 inches Depth:/26 feet Liner Type: ~ Diameter:. , inches Depth: feet Casing stickup above ground: 2 feet Static water level (.from ground level): 92 feet Pumping level: 126 feet after 2 hours pumping_7 gpm ReeoveD' Rate: _7 },'pm Method of Testing: .air li~ Well Intake Opening Type: [] Open End I-30pe~ Hole [] Screened Start feet Stopped feet [] Perforations Start feet Stopped~ feet Grout Type: bentonite grarmles Volume: I bg Depth: Start 0 feet Stopped .?.9 feet .Pump: intake Depth__ feet Pump size., hp Brand Narae __ Well Disinfected Upon Completion? [] Yes [] No Method of Disinfection: chlorine tablets Commen~: Well Driller: A/pine Drilling & Enterprises PO Box ~ 10496 Anchoroge Alaska 99511 Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property ~u! )0 0:3 0%~42p Tom Butcher ~5-1~;~1 p.! Oul 09 03 08:~Ip Tom l~utoher ~45-163! p. % zor.. .7.~ ~zoat, t #3: .~ C.O. ~l~mvad. ,-..r'" COMMENTS: [ ,o ~_ o; i.e~.."'..... I'( ,'~:. , ..,, ?,.:. ~ ~,~.,. ,c ~.~ ~.C..' / ; ' I?Y$1)I~ CT O R: 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 WASTEVVATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: Oct 21, 2002 Expiration Date: Oct 21,2003 Permit Number: SW020427 Legal Description: BIRCH TREE ESTATES BLK I LT 33 Design Engineer: 0007 Tobben Spurkland, PE Owner Name: thomas butcher Owner Address: 1120 e huffman #663 anchorage, AK 99515- Parcel ID: 017-141-05 Site Address: 005151 WOODHAVEN AVE Lot Size: 27159 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 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. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P,O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak,us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING ¢arce!LD. 0l'¢- /¥1- 05- Permit Number Sw0Zo4. Z7 Property owner(s) fvlailing address (1) Mailing address (2), Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range} ,-or Si~e.. Z"7, 'Y'/ THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROP[::RTY CONTAINS: HotTub Swimming Pool Therapy Pool Day phone ~q -,,~¢ ~ 7 Acres/Sq. Ft. Zip Code . ~:~ ~' 17 Number of Bedrooms [] Well Only Water Storage [] Jacuzzi' [] Water Softening Unit 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 aut,h~ized agent) Permit Fees: ~ Da,e of Paymen',: Receip: Number: ~"~ ~ 86 (Rev. 12;00) Waiver Fees: Date of Payment: ~Receipt Number: T.$PUP JAND P.E. 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 33 BLOCK 1 BIRCH TREE ESTATE Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 October 16, 2002 We are submitting an application for the installation of a well and septic system for this lot. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet I/3), the proposed improvements oftbe lot, of which only the well and septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable test holes are also enclosed. The septic system design is based on the following: Groundwater at 6 Ft. Use Standard Bed with BioCycle Soil Rating. From Testhole 08/26/02. 7 rain/in = 3 gal per sq.ft/day No. of Bedrooms 3 Required Area per Bedroom: 150/3 = 50 sq.ft. Total area required: 50 x 3 = 150 sclft Excavate 3 ft Filtersand 1 fi Effective Rock 0.5 2" Insulation 2' Cover. Triangular Shaped Bed: 20' x 10' Survey Well Radia. This is a nominal lot for development and can only be developed with a category II waste disposal system. The well locations on lots 32 and 33 were located with respect to the lot lines. The creek along the north property line is intermittent and is not aligned with the property line. The creek bed is located inside of lot 24, 5 to ! 0 feet north of the lot 33. The test hole was excavated on Aug, 26, 2002. Ground water was observed at 8 feet, with a water surface at 6.5 feet on Sept. 12, and at 6 feet on October 10 and October 15, 2002. The well serving this lot will be located 15 feet south of the northwest comer ofthe lot. Both the original absorption field and the replacement will be located 5 feet bom the proposed BioCycle and 100 feet from the proposed well. All well radia will be permanently marked prior to installation of the waste water disposal system. The installation ofthis septic system will not prevent wells and septic systems from being installed on the adjacent lots. The proposed septic system will not change the general slope of the area. Pond ing and/or concentration of surface runoff will not result from this installation. 49th I T 9 vACANT BLOCK 1 BLOCK P [OBBEN SPURKLANO P.E. 203 i~I I5TH. AVENUE ANCH. AK. 99501 (907) 279-$9~6 II BIRCH TREE ESTATE LOT $$ BLOCK I TO~ BUTCHER SEPTIC SYSTEM DESIGN DATE: OCT. 16,2002 SHEET: I/$ GRID: 3037 PERMIT II SWO2OXXX PIB # 017-I41-xx BIEOI331.BVG 3,1 33.96 RIO0.O0 SCALE, 1' = $0 FT. 49~:h ~PI,,IRKLAN]) No. TSTR; ;4~'ENUE ANCI(. AK. 99.50I (907) 279-3916 II BIRCH TREE ESTATE LOT 33 BLOCK I TOt~ BUTCHER II GRID: 3037 SEPTIC SYSTEM DESIGN DATE: OCT. IE, 2002 SHEET:2/$ PERRIY #$VOSflXXX PID # O17-141-xx BTEOI332.flVG I ~S INST~LL~ HON _ "~ . ~: ..:~. , , ~ ~ ~ .... o TOBBEK 5PURK~NO P.E. ~T 33 BLOCK I B$CH ~ff gSl~ SCPnC s~rEu SHEUAnC ANCO. AK. 99~I TO~ BUCHER DATE: ~T. 16, 2~2 (907) 279-3916 SHE~: 3/3 ~lO: 3037 PERH~T ~ S-VO~OXXX P~ ff 0]7-]4]- Pe",a~e~ For: Legal De$cril)l~¢n: 8-.-" ~ - 9- 10- 13- 16- 17- Municipality of Anchorage Development Services Department Building Safety Division On-Sile Water and Wastewaler Program 4700 Soulh Dragaw St. P.O. Box 196650 Anchorage, AK 99519-66.50 .www.ci.anchora.qe.ak.us (907) 343-7904 · > ,.' (ENGINEER'S SE~? Soils Log - Percolation Test -,~ ,, ,.:~"~.'~" "'--" '?'-' { "~ I~:~Ct.A "~p_..[~[ff"rownship, Range, Section: Slo0e ~ ~ ~ ~ Site Ptan WAS GROUNOWATER ENCOUNTERED? IF YES. A? WHAT DEPTH? Depth to Water A~tet Monitoring? Reading Dale Gross Time Nel Time Del)Ih to VVate, ~'1,~~ ~:~~o~. ~'1~ I ~'1~ ~Z° ~:,~ ~o ~ ~ I 3 "/,u I. PERCO~TION ~TE 7 I~u~e~c~) PERC HOLE DIAMETER 7EST RUNSE~EEN ~ , FT AND ~ FT ~E~FORMEDBY. ~-"".....,~ I "~ ;'~ CERTIFY THAT TH~S TEST W~.$ =E ~-'CRMED ~,1 ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON TH S DATE. DATE. ~/~.~/~1 ~_. 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 —(�( Parcel I.D. 017-141-05 Expiration Date: 1. GENERAL INFORMATION Complete legal description BIRCH TREE ESTATES BLOCK 1, LOT 33 -- Location (site address) 5151 WOODHAVEN AVENUE,ANCHORAGE,AK 99516 Current property owner(s) ROBERT WAGNER&LAURA HINES Day phone Mailing address 5151 WOODHAVEN AVENUE, ANCHORAGE, AK 9951-6 Real estate agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Private Septic Private Well ® Holding Tank (l Water Storage ❑ Community ❑ Community Well n Public Sewer ❑ Public Water System fl Waiver request for: Distance: Received by: Date: COSA to be released to the engineer. unless otherwise requested by the engineer. COSA Fee $ 550. O0 _ Waiver Fee $ Date of Payment ;1 1c2 1 (.°1 Date of Payment Receipt Number 0 I I -.1t Receipt Number -COSA# OS C 1°([ 0r _ 1 Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On-Site staff may visit the site to verify the information submitted. Name of Firm ANDERSON CONSTRUCTION& ENGINEERING Phone 345-3377 Address 4640 SHOSHONI DRIVE,ANCHORAGE,AK 99516 Engineer's Printed Name MICHAEL N. ANDERSON,PE Date 3/9/2019 -:4 9 L '• -pito 6. DSD SIGNATURE System #1 Approved for _- bedrooms MI AEE N. ANDERSON =r' CE 9 9 •:<..,vr System #2 Approved for bedrooms i/4% • Disapproved tp ti Conditional approval for bedrooms, with the following stipulations: �� ON—SITE G WATER ANAT 4;. ER Q 4 r 4 PROGRAM �QWASTEWSCRv�C��O / By: —411 - Original Certificate Date: 3 �S !� q The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X - Nitrate Advisory Septic System Advisory - Arsenic Advisory Well Flow Advisory - Other COSA Checklst Cue sheet COSA Checklist Legal Description: BIRCH TREE ESTATES BLOCK 1, LOT 33 Parcel ID: 017-141-05 If more than 1 septic system on lot: COSA Checklist#_of_ Structure served by this system A. WELL DATA ® Well log is filed with Onsite (or attached) Well production at time of test 3.75 gpm Date drilled 4/30/2003 Water storage tank volume NA gallons Total depth 130 ft Well disinfected for coliform test? ❑ Yes ® No Cased to 126 ft ® Coliform bacteria is Negative ® Sanitary seal is functioning correctly Nitrate.. mg/L [Nitrate less than MRL (ND) ® Wires are properly protected Arsenic .._ ug/L Arsenic less than MRL (ND) Casing height (above ground) 18+ in. Collected by FWCS Date of flow test for COSA 3/8/2019 Date of Sample 3/7/2019 Static water level at beginning of test 95 ft. Comments B. TANK DATA—6/9/2003— 1600-GAL BIOCYCLE C. LIFT STATION Age of tank(s) 16_years ❑ Required maintenance completed Tank type/material FIBERGLASS Age of lift station _years Measured operating fluid level in septic tank * Lift station material ® Standpipes/foundation cleanout per record drawing Comments: Date of pumping *See attached Quarterly Reports D. ABSORPTION FIELD DATA—20'L x 7.5'W x 0.5'ED —3 GPD/SF = 150 SF Which system tested (date installed) 6/9/2003 Adequacy test date 3/8/2019 ® ALL standpipes present per record drawing Results El Pass For 3 bedrooms Total measured depth from grade 3.7 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade ft (min) Water added 450 gal ® N/A—pressurized field New depth 6__ in ® Monitor tubes go to bottom of effective. If not, state Elapsed time 110 min depth into effective Final fluid depth 0 in ® Code-required soil cover over field ❑ System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) Gallons introduced _ gallons If yes, enter date Comments/Deficiencies: FCO inside house COSA Checklist yellow PRVT W&S copy 3.docx 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' Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No ft Neighboring Tank > 100' ® Yes if No _ ft Private Sewer/Septic Line > 25' ® Yes if No ft Absorption Field on Lot> 100' ® Yes if No ft Holding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' Z Yes if No ft ® Yes if No _ _ ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Wells on Adjacent Lots: Property Line > 5' ® Yes if No ft Private Wells > 100' ® Yes if No ft Absorption Field > 5' ® Yes if No ft Water Main > 10' ® Yes if No ft Water Service Line > 10' Community Wells > 200' ® Yes if No ft ® Yes if No ft Surface Water > 100' If septic tank is under driveway comment below ® Yes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No -_ ft If absorption field is under driveway comment below **Property Line > 10' ® Yes if No ft Wells on Adjacent Lots: Water Main > 10' Z Yes if No ft Private Wells > 100' ® Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Surface Water> 100' ® Yes if No ft F. ENGINEER'S COMMENTS 4,c: CSF t1 s,,i It G. ENGINEER'S CERTIFICATION �'`Q:•'• ..,,,,A_::••:Ss4-�I't I certify that I have determined through field inspections and review r' t S`T of Municipal records that the above systems are in conformance d° �%�'�V:° ° ° .. ,� with MOA COSA guidelines in effect on this date. �. • • .. `i i. i .1.:12.,•• MICHAEL N. ANDLRSCN :,".- ' i' �•.. C[ 9169 •'.c'j COSA Checklist yellow PRVT W&S copy 3.docx 1 ' 17 •(.:,• )N,:' ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND O S"l.✓a z) THIS MAINTENANCE AND REPAIR AGREEMENT made and enteredrinto as of this 5 Day of WtVA (k. of 20(Ct, by and between 4 05k.t/4 r2-0(3-01 - herein U(3-P1 -herein the"OWNER,"and the Municipality of Anchorage,herein the "MUNICIPALITY."In consideration of the mutual covenants contained herein,the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems.Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),described as BIOCYCLE located at(legal description). 5151 WOODIIAVEN AVENUE,ANCHORAGE, AK 99516—BIRCH TREE ESTATES LOT 33, BLOCK 1 2. Definitions. Alteration.Any change to the design or function of an AWWTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On-Site Systems Approval(COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code (hereinafter, "AMC") 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage.Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair.The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On-Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AWWTS is in use or is operational or until 1 the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations,Installation and Removal of Additional Equipment.Prior to performing any alterations to an AWWTS,the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement,the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition,it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense,to pay for any and all: (1)repair(s), (2)maintenance, (3) adjustment(s),(4)replacement costs,and(5) inspection costs. B. Owner agrees to comply with all applicable ordinance,laws,regulations,rules and orders for the AWWTS. C. Upon request by the Municipality, the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. H. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are 2 the governing guidelines for the construction,maintenance and repair of the Owner's AWWTS. I. Owner agrees to provide and maintain a telephone connection to the AWWTS as required by the AWWTS approval. 6. Nonwaiver.The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions,nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended,modified or changed by a writing, executed by authorized representatives of the parties,with the same formality that this Maintenance and Repair Agreement was executed with,and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement,the only authorized representatives of the parties are: a. Owner: b. Municipality: Director, Community Development or designated authority C.Any attempt to amend,modify,or change this contract by either an unauthorized representative or unauthorized means shall be void. 8.Jurisdiction: Choice of Law.Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability.Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. 3 OWNER: By: ► l ,r- (sign.. ) OVA- 2..tJ62— (print --(print name) STATE OF ALASKA ) )ss. THIRD JUDICIAL DISTRICT) Date: The foregoing instrument was acknowledged before me this day of 20 11,by.. zumt- 1/1. OFFICIAL SEAL ► < STATE OF ALASKA MICHELLE WEBB i;. ► f. i NOTARY PUBLIC FOR ALASKA NOTARY PUBLIC-_.-_ _,. • • My Commission expires: 41, / MUNICIPALITY: By: .� (signature) (print name) Date: Title: 4 ✓/V✓ tal .al�. L1Y4 .i✓a✓ bkCCD6 .EAIaskaAnchorage AK 99503 t� ,�m� Email: crbioak@gmail.com (907) 274-0314 4th Quarter Inspection Report 2018 Homeowner Info Customer Name: Laura Hines Tank#: 155 Install Date: June 2003 Address: 5151 Woodhaven Area Lower DeArmoun/Buffalo Initial Inspection: Alarms Tested: Air High Water 71 Battery Tested: Yes ❑ No n N/A U (Please make sure alarm is on "normal", not"mute") Does system have a septic tank ? No [71 Yes n (Recommend pumping tank every 2 years) Is System Lid Locked? Lid hardware in working order? Is there any noticeable odor? Yes Zvi Repaired n Yes Repaired n Strong ❑ Mild ❑ None 1 System Inspection Inlet plumbing in working order? Solids pillow normal? Yes Replaced ❑ Yes [71 Requires Pumping ❑ re—ra. Chamber. Are all aerators functioning? Any buildup of solids? Yes L✓ Replaced ❑ Yes ❑ No 171 Clarification return system operating? Any buildup of solids? Yes [✓ Adjusted n Yes g No pH Reading: Dissolved Oxygen PPM Turbidity of discharge (in FTU) (pH of 6-8 is ideal) (2-5 is ideal) (Under 35 FTU is considered compliant.) 6.9 3.7 28.7 Pump float operating? Alarm float functioning? Any buildup of solids? Yes 171 Replaced n Yes 71 Replaced n Yes n No Filter cleaned? Discharge line condition: Yes 1Z1 N/A ❑ Good Replaced n Comments: Adjusted air switch, please put alarm switch back on normal Has emailing or mailing of form been requested? Yes n No Inspected By: Chris Date: 12/02/18 (contact office to request...)