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SOUTHPARK #1 BLK 3 LT 13
Municipality of Anchorage Page ] of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ¢..-.-.-~t./OY.~ [L~] PIDNumber: ~,¢3.~-- 43 ~1- 57 .a.~e: ~.¢~. ~.~ Wastewater System: ~ New ~Upgrade A~dress: ~,~ ~YO ~ C;~ ABSORPTION FIELD Phone:~ ' ~No. of Be~oms:~ DOeepmrench D Shallow Trench ~Bed DMoun~DOther Soil Rating: Total Depth from o~al grade: LEGAL DESCRIPTION GPD/Sq. Ft. LOt: j_~ Block:~ Sub~ion: ¢, )epth ,0 pipe bosom from original grade: Gravel d~eath pipe Township: I Ra,ge: ISectiOn: Fill added ab°va °rig'nmi grade: Ft. ~ength:-- ' Ft. WELL: D New ~ Upgrade ;ravelwidth: --~' Number of [ines: iDistancebe~.nlin~: Ft. OIs~ification (Private, A,B,C): Total Depth: Cased TO: Total absorption area:~ Pipe mater~al: Driller: Date Drilled: StaticWater Level: Installer: ~ Date installed: Ft. 'Yield:GPM IPump Set at: Ft. I~ing HeightAbOve GrOund:Ft. TANK SEPARATION DISTANCES ~ s~.t~¢ u ~o~din~ ~ S.~.~.~. TO Septic Absorption Lift Holding =ubllc/PrivateManufacturer: Capacity in gallons: Wel~ ~/~ Ma,e~ ~ ~;S~ Number of Com~.ments: Sudace LIFT STATION Lot Size in gallons:~ Manufacturer: "Pump o~' level at: High water alarm Foundation ~ Drain Remarks: BENCH ~ARK Inspections pe~ormed by: Depadment of Health and Human Se~ices approval '~:~' ''~ ~"~" 72-013 (Rev, 9/91 ) MOA 25 SU2FACE D2AINAO£ TOBBEN SPURKLAND P.E. 205 14/ 15TN. AVENUE ANCH. AK. 9950! [907) 279-:916 75 lO0 1~5 15~ 1~ = 5[I ET LOT 13, BI( 3 SOUTflPARK 162,10 BAUSH C/RC£E GEORGE AND GAYLE JONES SEPTIC SYSTEM AS BUILT DATE: JUNE 21, 2000 SHEET; 2/5 GRID: 5256 PE£MIT # 2V00144 PIP 11 020-051 57 £PKO313~,BI~6 T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Munic~alityofAnchorage Department ofHealthand Social Services 825 L S~e~ Anchorage, Alaska 99501 Subject: HAA Application Terralift Procedure Lot 13, Block 3 Southpark #1 PID 020-051-57 June 21, 2000 Gentlemen; The septic system serving this lot was tested on April 20, 2000 and failed. Prior to the test 10 inches ofponded effluent was observed in the beds. The addition of 250 gallons caused the observed water depth to increase to 19 inches and 21 inches. On May 24, 2000 the two beds were "Terra lifted" by Alaska Bio-Rem. Services, Jerry Leach. Two days later no ponded water was observed in the monitors. On June 6 the existing septic tank was replaced with a BioCycle unit and the effluent discharged to the drain fields. On June 21, 2000, 530 gallons of clean water was added to the drain fields. Prior to the test no ponded water was observed. The addition of the 530 gallons caused 6 inches of liquid to be observed in both monitors immediately. 3.5 hours later no water was observed in any of the monitors indicating that the drain fields are working satisfactory. Please issue a HAA for this property. Yours T. Spm'kland P.E. RECEIVED JUN 22 2000 ..... ~ M~.nlclpall{y ot.Ancl~orage..-, ....... uept. Health & Human Services MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jun 02, 2000 Expiration Date: Jun 02, 2001 Permit Number: SW000144 Legal Description: SOUTHPARK#1 BLK 3 LT 13 Design Engineer: 0007 Tobben Spurkland, PE Owner Name: George Jones Owner Address: 16240 Baugh Cir. Anchorage, AK 99516-4824 Parcel ID: 020-051-57 Site Address: 016240 BAUGH CIR Lot Size: 33628 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ~ Disposal Field [] SepticTank [] 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. THIS PERMIT IS TO REPLACE THE EXISTING SEPTIC TANK ON THIS PROPERTY WITH A BIOCYCLE TREATMENT SYSTEM. Received By: [,) ~ ~-~ Date: ~J~/J~ ~-~ Date: ~, To SPtO1RFd[ Ai%rD 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 13 BLOCK 3 SOUTH PARK #1 GEORGE JONES 16240 BAUGH CIRCLE Municipality of Anchorage Department of Health and Social Services 825 L Street Anchorage, Alaska 99501 May 18; 2000 We are submitting an application for the upgrade of the septic system for this lot. An HAg. inspection on April 20, 2000 revealedthatmorethan 10 inches of liquid were ponded in the absorption bed. Adding 250 gallons ofwater tothedrain field caused 19 inches of water to be observed in one monitor and 22 inches in a second. HAA approval would not be possible under these conditions. On May 2, 2000 three testholes were excavated on the lot. Suitable soil conditions for a replacement of the existing drain field could not be found. There is also a defined drainage along the south lot line that further restricts possibility to f'md suitable ground for a septic system. My client has been advised that he has two options. Install a holding tank or revitalize/reconstruct the existing absorption bed and install an advanced pre treatment system. A cursory analysis indicates that the cost of rebuilding the bed and installing a BioCycle will be in excess of $20,000. In addition the existing drive way and landscaping will probably be destroyed by the construction equipment, adding another $5-6,000 in repairs. Neither my client nor the DHSS favor the permanent installations of holding tanks. The most desirable solution would be to revitalize the absorption beds. This can be done with Hydrogen Peroxide, Acid treatment, or by Terra Lift. Due to the agitation caused by Hydrogen Peroxide, I do not believe this would be a good procedure. It is very likely that fines would be deposited in the bed and effectively plug the absorption area. I have witnessed several instances where the Terra Lift procedure effectively drained the bed. If both beds could be drain at this site, and pro treated and oxygenated effluent discharged to the ftrst bed, this bed may be able to absorb this effluent without a further generation of a bio mat. Even if a biomat is slowly formed, the second bed may be left idle for a long period, further "repairing" it self. If water start to pond in both beds, an acid treatment can be undertaken. The beds will be tested 30 days after the TerraLift treatment. I am submitting a site plan showing the installation of a BioCycle unit. Yours TOBBEN SPURKLAND P.E. 205 W 15TN. AVENUE ANCN. AK. 99501 (907) 279-5916 LOT 13, BI( 3 $OUTHPARK fi 16240 £AUGH CIRCLE GEORGE AND GAYLE JONES SEPTIC SYSTEM DESIGN DATE: APRIL 25, 2000 SHEET: 1/$ GI,~ID.· 5256/. PERN/T # £V$OYYY PLO # 0£0-051_-57 ,~Pk'f13131,PP/& 4-INCH INSULATION AIRCOMPRESSOR MIR SAND BACKFILL ~+ + _ 5'-£" MIN 6'-0" M3 BIOCYCLE 6000 4" PERF CO 0 co 0 ~ri EXISTING BEDS 2 X 10 X 40 DRAINFIELD IFT TOTAL DEPTH 0.5 FT EFFECHVE ROCK 4 FT COVER N~ SCALE I LEGEND: 1. PRIMARY TREATMENT, SEPTIC TANK 2. AERATION TANK 5. CLARIFICATION TANK 4. DISCHARGE TANK 5. SOIL ABSORPtiON TOBBEN SPURKZAND P.E. 203 W15th Ava Ak 99501 SI]U?H PARK #1 LL]? 13 BK PIZT£YCLE ~/ASTE ~/ATER SYSTEM WASTEWATER SYSTEk( SCHEMATIC DATE; MAY 19, 2000 SHEET: GRID: 5236 PERMIT # sw98xxx PIP # 020-05i 57 SPK031,33,,0 Munl:t~,allty ol Anchorage DEPARTMENT O~ -~EALTH & HUMAN SERVICES 825 "L" Street, A~mhorage, Alaska 99502-0650 SOILS LOG- PERCOLATION TEST L" ' ,(ENGINEER'S SEAL) DATE .E.PORMED: LE(~AI. DESCRIPTION: ~"&'~ ~*,~ I ~V~. ~ .~i~) o '[~.-~ ~A,A,v,Township, Range, Sect'on: SLOPE 8 10 11 12 13 14 15 16- 17- 18- 19- 20- WAS GROUND WATER ~J ! ENCOUNTERED? DEr'TH? E SiTE PLAN PERCOLATION RATE __ (m,nutes/inch) PERC HOLE DIAMETER __ T~ST RUN BETWEEN __ FTAND __ FT DISCLAIMFR: Rrnundwater c~diti~ns indicate~ are for the dates Past and future presence and/or depth of groundwater can not be shown only. predicted 'trom these obse~_v~cions. PERFORMED BY; ~ __ I CERTIFY THAT THIS TEST WAS PERFORMED IN 72-008 (Rev. 4/85) Munl;Ijc.all[y of Anchorage DEPARTMENT DJ: -~EALTH & HUMAN SERVICES 825 "L" Street, A~e:horage, Alaska 99502-0650 SOILS LOG- PERCOLATION TEST (ENGINEER'S SEAL) PERFORMED FOR: '~'~'~ ~*-~ ~ ~ V~'~5 DATE PERFORMED: LEGAl. DESCRIPTION: ~'-~ ~ I~, r~ ~ ~ ~oo~HPA~I~°wnsh~p' Range, Sect'on: ~ SLOPE 1 2 3 4 5 6 7 8 9 10 11 13 14 15 16 17 18 19 2O WAS GROUND WATER IF '/ES. AT WHAT D&PTH? pO SITE PLAN ri, Gross Net Depth to Net PERCOLATION RATE __ (mmu[es/mch) PERC HOLE OIAMETER DISCLAIMFR: Groundwater Past and future presence TCST RUN BETWEEN __ FTAND FT c~nditiens indicated are for the dates ~hown only. a;~d/or depth of groundwater can not be predicted ' trom these oose~,~aClons. PERFORMED BY: __ I "~. ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ' ACCORDANCE WITH ALL STATE AND MUNICIPAL GblL ELINES IN EFFECT ON THIS DAI'F. DATE: *~,,~ ~/ ~"~'~ 72-008 (Rev. 4/85) Munl.;)F'allty Gl Anchorage DEPARTMENT O~ '~EALTH & HUMAN SERVICES 825 "L" Street, Auchorage. Alaska 99502-0650 SOILS LOG- PERCOLATION TEST (ENGINEER'S SEAL) PERFORMED FOR: DATE PERFORMED: Township, Range, Section; SLOPE SITE PLAN t0 13- 15 16 17 18 19 20 WAS GROUND WATER ENCOUNTERED? E §e.c.l: 1o Waler AFter Dross Net Depth to Net Peading Date Time Time Water Drop PERCOLATION RATE )' ~ (m,nules/mch} PERC HOLE DIAMETER __ DISCLAIHFR~ GrnundwatRr Past and future presence TLST RUN BETWEEN FT AND __ FT candition~ indicated are for the dates shown only. and/or depth of groundwater can not be predicted 'trom these ouserv~,]~ns. PERFORMED BY; I , __ CERTIFY THAT THIS TEST WAS PERFORMED IN · ACCORDANCE WITH ALL STATE AND MUNICIPAL G[~tL ELINES IN EFFECT ON THIS DA'IF. DATE: '~4~. /t?/ ~ 72-008 (Rev. 4/85) PROPERTY OWNER AGREEMENT FOR TI~ MAINTENANCE OF AN ON-SITE WASTEWATER DISPOSAL SYSTEM This a~eement, dated '?/~ 5 /Z o.,_o ~ '109~% is made between the Municipality of Anchorage Department of Heal[h and Human Services (DHHS) and the property owner(s) of: This a~eement is made for the purpose of maintaining an on-site wastewater disposal system on the subject property: The property owners a~'ee to th, e following: Submit to the MunicipsJ/ty of Anchorage, on an annual basis, an inspection and operation statement from a registered professional engineer. This inspection and operation statement shall verify that the engineer has inspected all effluent and air pumps, timers, and alarms, md that any deficiencies have been repaired and that the system is functioning as designed. /~gnature) (Printed Name) ~ ~ /~ggnature) (Printed Name) ............................... N 3darize Here - State of ~1-~¢-~" On this 7--_~ day of ~'flv~-c-/ , ~.c~xe:~, ~o~q~ ~'~ ~S personally appeared befo_e~,[m~, ~ who is personally kno~ to me who~e identicy I proved on the basis of whose identit%, I provdd on the bath/affirmation of ~ ~ ~ ., a ~e witness to be the signer'of the above document, and he/she a dged that he/s e signed it ' ~C . My comm~ssSon expSres /'-~, MUNICIPALITY OF ANCHORAGE ,~-~'~, D£ ~'TMENT OF HEALTH AND HUMAN SER ~S ' .~, Environmental Health Division "~? 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES ~"/'~ '~,4 i"'~"~'~ '~ ~ SEPTIC ADSORPTION A~ ~ TANK FIELD WELL Phone(s)~ -]~ ~ g~ ("~ ~" Permitf)~O~%No./, ¢,': ~ NO of Bedrooms~ WELL .o, i'3 Subdivision .~dd,..,,g..¢ ,~ . %~ ¢~ix f'~ ,-~ FOUNDATION 2 ~ '30 Township, Range, Section %~-~ 'r ~ CkJ,¢--~ '~. '~.'~ ~- ~ I--~ AS-BUILTDIAGRA~tShowlocationofwe, l. sepdcsystem, p(opedylmes, loundaUon. driveway, water bodies, etc.) SE,~c U ~O~6 . ¢.. TYPE OF SYSTEM ~ TRENCH BED ~ W. DRAIN ~ OTHER ~o ~ ,,,~ 'D~pth to p~pe bottom from Total depth lrom original grade J, ~~ '~ ~ Total absorption are~ 4~ (D SO FT Distance between lines ~ FT U PRIVATE ~'OTHER (Identify) ~ REMARKS: ~,~'~ Health DepadmemApprovah ~-~ ~' ~ Date: '~'-~ 72-q!~3 (3/85) ENViRONr~*'~TAL'4 S.~T No.. ',~ ALASKA CONTROL SERVICE iNC. .~',~ ,_~,c-p~' /~//~-- 12oo West 33rd Avenue, Suite B CALCULATED BY. DATE ANCHORAGE, ALASKA 99503 CHECKED BY DATE (907) 561-5040 SCALE /V'T-~ ENVIRONMENTAL P,~OTECTION t]EC 201985 :.RECEIVED DEPAI::;;TMEI',I]" OF HEALTH AND ENVIRONMENTAL PROTECT IOIq 825 I... STREET, ANCHORAGE, AK 99501 264.~.4.720 'PERMIT NO." DATE ].,..~UED. 8,~t ,.JS,.~ ENGINEERED DESIGN 09 / 12185 APPL I CAN]": ADDRESS: CONTACT F'FIONE: MIKE F'RATT 1809.CINDY LEE: LANE ANCHOF!AGE ~ ~1":: 99504 562-5982 LEGAL ' '"c,', · -.. DE,.~L, RIF. SUBDIVISION.' SOUTHPARK ~2 LOT: 13 .~[..£,,1 IOII...,~ TOWNSHIP:. 11N RANGE: .;,W L. DT SIZE: ..,:,._~6,~8 (SQ,,FT. OR ACRe, S) LOCI ...... I cepti~'y that: 1.. I am t'ami].iar' w:[th the PequiPements fCIi' on-site seweps and wells as set ~'opth by the Municipality of Anc:hor'age (MOA) and L'he S~.ate ef Alaska. I will install the system in accopdanc:e with all MOA codes and r, egu]:ations, and in comp].iance with the design cpit(~pia of this pepmit. I will adhepe'to all MOA and State o¢ Alaska r'equipements for' the set back distances ~*om any existing well, wastewatep disposal system or' publ~.c sewera~je system on 't:.his ~r any adjacent op neapby lo'L. IF ,'.-~ I._IFT STA]"ION :IS INSTALI_.ED IN AN AREA DOVERED BY MOA ~.:UIL. DINb"I ' " CODES, THEN (]) AN EL. ECTF~ICAL PERMI] AND INSF'IEC-I-ION PLUS] BE OBTAINED; (2) AS,-BU]:Lf'S WI[,; h("[ tE APF'ROV~D W~F'-OU'I Ax ELECTRICAl. :[NSF'ECTION REF'ORT~ AND (3) FHE EL..ECTF~IL, AL WORK f'l[.)[:~'t" B~DJ]IxlE BY A LII]ENSED ELECTRICIAN, ' . SIGNED .¢~ ~~- ~ DATE: ~_~_~¢ AF'PLICAN]': MII<E PRATT MUNICIPAL ITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED LEGAL DESCRIPTION: DATE PERFORMED: PERCOLATION TEST 2 3 4 5 6 7 8 9 10 11 12 13- 14- 15- 16- 17- 18- 19- 20- SLOPE WASGROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? SITE PLAN O P E COMMENTS ,~,:1 .~ PERFORMED BY: ~ C~-~c~/ ff. PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN ~'~- FT AND ~'~ , FT ,, ~ CERTIFIED BY: ~ ~ DATE SOILS LOG MUNICIPAL ITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST TEST PERCOLATION LEGAL DESCRIPTION: ~L 2 G~ 3- 4- Cd 5- 7- 8- 9- SLOPE DATE PERFORMED: SITE PLAN 10- 11 13- 14- 15- 16 17 18 19 20 COMMENTS PERFORMED 72-008 (6/79) WAS GROUND WATER ENCOUNTERED? ~ SL O IF YES, AT WHAT ]~ DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop ~"-~ /o q~ ~ :z-,~° ~-' g HoC( ~ i ~- , / III~ ~'10 ~ ItGq t~ ~ PEROO AT'ON RATE TEST RUN BETWEEN /~.1/~_, FT AND (minutes/inch) FT DATE: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG -- PERCOLATION TEST PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: F-~- t\ 3- 4- 7- 13- 14 - 15- 16- 17- 18- 19- 20- COMMENTS ~o}{ I'S ~t ~l ,'~Lble SLOPE DATE PERFORMED: SITE PLAN WAS GROUND WATER ENCOUNTERED? ~ DEPTH? J 6'e~S · to IV '~ "-Gcoss~/' Net Depth to Net Reading Date Time Time Water Drop - I 4o~ PERCOLATION RATE TEST RuN BETWEEN 72-008 (6/79) · ALASKA [ IidlIgO[hm[ FITAL COF1TI OL Sel uiCeS, IIhC. SPECIFICATIONS FOR FIVE-WIDE ALTERNATIVE WASTEWATER TREATMENT SYSTEM - SOUTH PARK ADDITION #1 SUBDIVISION, BLOCK 3, LOT 13 1.0 GENERAL 1.1 THE DRAWINGS, 1 THRU 8, SHALL BE A PART OF THIS SPECIFICATION. 1.2 ALL MATERIALS AND WORKMANSHIP SHALL MEET THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE, DEPARTMENT OF ENVIRONMENTAL PROTECTION (DHEP), THE CONDITIONS OF THE PERMIT, AND ALL APPLICABLE RULES AND REGULATIONS CURRENTLY IN EFFECT. 1.3 ALL EXCAVATIONS AND DEPTHS ARE ADVISORY AND ARE TO BE VERIFIED OR MODIFIED IN THE FIELD BY A DHEP APPROVED INSPECTOR. 1.4 IT IS THE RESPONSIBILITY OF THE INSTALLER TO ADHERE TO APPROVED DESIGNS FOR INSTALLATION, TO MAINTAIN THE SPECIFIED SEPARATION DISTANCES, AND TO HAVE APPROPRIATE INSPECTIONS. 1.5 IF THE INSTALLATION IS NOT INSPECTED BY AN AECS ENGINEER, AECS WILL NOT BE RESPONSIBLE FOR THE DESIGN. 2.0 SEPTIC SYSTEM 2.1 THE SEPTIC TANK SHALL BE A UPC APPROVED TWO COMPARTMENT TANK, CONSTRUCTED OF 12 GAUGE STEEL WITH BITUMASTIC COATING, SET LEVEL ON UNDISTURBED SOIL, AND INSULATED WITH AN OVERLYING LAYER OF 2 INCH BURIAL TYPE POLYSTYRENE. 2.2 THE SEPTIC TANK AND ABSORPTION AREA SHALL BE A MINIMUM OF i00 FEET FROM PRIVATE WELLS OR BODY OF WATER, 150 FEET FROM CLASS C WELLS, AND 200 FEET FROM CLASS A OR B WELLS, UNLESS OTHERWISE SPECIFIED. LESS THAN THE REQUIRED SEPARATION DISTANCE MUST HAVE PRIOR APPROVAL OR WAIVER BY ALASKA DEPARTMENT OF' ENVIRONMENTAL CONSERVATION (ADEC). 2.3 2.4 THE SEPTIC TANK SHALL BE A MINIMUM OF 5 FEET FROM THE HOUSE FOUNDATION; AND A MINIMUM OF 5 FEET FROM THE ABSORPTION AREA. PIPING SHALL BE FITTED WITH A WATERTIGHT CALDER j COUPLING ON THE OUTLET AND INLET OF SEPTIC TANK. PIPING SHALL BE 4 INCH SOLID PVC ASTM D3034, OR CAST IRON, SLOPED A MINIMUM OF 1/4 INCH PER FOOT WITH A MINIMUM OF 4 FEET OF COVER. IF LESS THAN 4 FEET, PROVIDE 1 INCH OF DOW EXTRUDED BLUE POLYSTYRENE FOR EACH FOOT OF COVER LESS THAN 4 FEET. 1200 ~JCsl 33r~1 Aucnue, Suile [~ ,, Ancl~oro% Alos o 995o3 · [907) 561-5040 2.5 CLEANOUTS SHALL BE INSTALLED AS DESIGNATED AND CAPPED WITH AIR-TIGHT JIM CAPS (OR EQUIVALENT), AND EXTEND A MINIMUM OF 2 FEET ABOVE GROUND LEVEL. 3.0 DRAINFIELD SYSTEM ,/4.1 / 4.2 \4.3 3.1 IT IS CRUCIAL THAT CARE BE TAKEN IN CONSTRUCTION OF THE FIVE-WIDE TO ENSURE PLACEMENT INTO THE PROPER SOIL STRATUM FOR PROPER OPERATION OF THE SYSTEM. 3.2 THE GRAVEL FOR THE FIVE-WIDE SHALL BE 0.5 TO 2.5 INCH, SCREENED ROCK WITH LESS THAN 3% PASSING ~200 SIEVE RESIDUAL. ALL SUBSTITUTES MUST RAVE PRIOR APPROVAL BY DHEP. 3.3 THE BOTTOM OF THE EXCAVATION SHALL BE LEVEL AND RAKED WITH THE BACKHOE BLADE TO INSURE THAT THE BOTTOM HAS NOT BEEN COMPACTED DURING EXCAVATION. 3.4 THE DISTRIBUTION PIPE SHALL BE 4 INCH RIGID PVC WITH A MINIMUM CRUSH STRENGTH OF 1500 LBS. ALL PIPES SHALL. BE LAID LEVEL. 3.5 MONITOR STANDPIPES SHALL BE PLACED AS SHOWN IN THE DRAWINGS, AND SHALL BE RIGID PVC ASTM D-3034 OR, CAST IRON (4 INCH). THE SECTION BELOW GROUND LEVEL MAY BE EITHER DRILLED 0.5" HOLES ON THE 6 INCH CENTERS ON OPPOSITE SIDES OF THE PIPE OR A REGULAR SECTION OF PERFORATED DISTRIBUTION PIPE. EITHER MAY BE CLAMPED TO THE SOLID SECTION WITH A NO HUB COUPLING OR SOLVENT JOINT. A RUBBER RAIN CAP (JIM CAP OR EQUAL) SHALL BE PLACED ON THE TOP THE PIPE. 3.6 THE GRAVEL SHALL BE COVERED WITH A LAYER OF A NONWOVEN FABRIC (SUCH AS MIRAFAI, FIBRETEX 200 GRADE, POLY- FILTER X, OR EQUAL.). 3.7 IF INSULATION IS USED RATHER THAN MOUNDED BACKFILL, THE INSULATION SHALL BE DOW EXTRUDED BLUE STYROFOAM BOARD OF THE REQUIRED THICKNESS (1" PER FOOT OF SOIL LESS THAN 4 FEET). THE SOLID PIPE EXTENDING FROM THE SEPTIC TANK OUTLET TO DRAINFIELD SHALL HAVE 4 FEET OF COVER OR AN EQUIVALENT LAYER OF INSULATION TO PREVENT FREEZING OF THE LINE. 3.8 RECOMMEND THAT THE TOP OF THE ABSORPTION AREA SHOULD BE PLANTED WITH A WHITE CLOVER AND RED FESCUE MIX OR BLUEGRASS,~ CURTAIN DRAIN .... THE CURTAIN DRAIN DETAIL SHEETS SHALL BE CONSIDERED PART .... OF THIS SPECIFICATION. THE CURTAIN DRAIN, DRAIN PIPE, AND OUTFALL PIPE SHALL BE INSTALLED AT A GRADE OF NOT LESS THAN 0.45%. THE CURTAIN DRAIN SHALL BE HANDLED ACCORDING TO MANUFACTURERS INSTRUCTIONS. 4~.4 THE PIPE BETWEEN THE CURTAIN DRAIN AND THE OUTFALL PIPE SHALL CONSIST OF SB-2 PIPE. 4.5 BACKFILL AND COMPACT AS SOON AS POSSIBLE AS INSTALLATION PROCEEDS. 4.6 EXTEND THE FILL MATERIAL TO MINIMUM OF 6" ABOVE THE CURTAIN DRAIN. 4.7 THE CURTAIN DRAIN OUTFALL STRUCTURE SHALL NOT BE DIRECTLY EXPOSED TO THE ATMOSPHERE. REFER TO THE DETAILS FOR INSTALLATION. 4.8 THE OUTFALL PIPE SHALL CONSIST OF 8 FEET OF PERFORATED PVC OR PE PIPE. 4.9 THE 2" RIGID BLUE STYROFOAM BOARD INSULATION OR EQUAL SHALL BE LAID ON TOP OF THE OUTFALL PIPE. THE INSULATION SHALL BE 2 FEET WIDE AND EXTEND TO THE END OF THE PIPE. 4.10 THE CURTAIN DRAIN SHALL EXTEND A MINIMUM DEPTH OF 12' FEET INTO THE SOIL. IF SOILS ARE DISCONTINUOUS, AN AECS INSPECTOR SHALL ADJUST CURTAIN DRAIN DEPTH. 5.0 5.1 5.2 INSPECTIONS IF AECS DOES NOT INSPECT THE INSTALLATION OF THE SYSTEM, WE SHALL NOT BE RESPONSIBLE FOR ANY PART OF THIS DESIGN. THREE INSPECTIONS ARE REQUIRED: THE FIRST INSPECTIONS SHAL BE PERFORMED WHEN THE EXCAVATION FOR ABSORPTION AREA IS COMPLETE. THE SECOND INSPECTION SHALL BE PERFORMED PRIOR TO BACK- FILL OF THE SYSTEM, AFTER SEWER ROCK, LEACH LINES, AND SEPTIC TANK ARE INSTALLED. THE THIRD INSPECTION SHALL COVER THE INSTALLATION OF THE CURTAIN DRAIN AND BE PERFORMED AFTER EXCAVATION AND MATERIAL IS PLACED, BUT BEFORE ANY PART OF THE DRAIN IS BACKFILLED. AT THE CONTRACTORS OPTION, AECS CAN INSPECT PORTIONS OF THE THE DRAIN AS CONSTRUCTION PROGRESSES, AND AUTHORIZE BACKFILLING FOR EQUIPMENT ACCESS. ALASKA eiidlROFIFll{ FITAL COFITROL ~nclinecrincI $ ~nuiroDmeDtal Studies SI HUICI S, IFIC. Municipality of Anchorage 825 L. Street Anchorage, Ak. 99501 Attn: Steve Morris Dear Steve: ~0NIcIPAUrF Or ANCHo~$~ DEPT, OF HEALTH & September 6, 1985~NVl~ONM~NTA~ PROTECTIO~ $EP 6 1985 RECEIVED.' This is in regards to South Park Subdivision Addition No. 1, Block 3, Lot 13. Recently a curtain drain was installed on this lot. On 9/6/85 I observed that a 10-foot deep water monitor tube placed 17 feet do~ahill of the curtain drain was dry. Water can be seen running out of the oversize rocks covering the outlet of the curtain drain pipe. A diagram is attached showing the location of the monitor tube. If you have any questions please feel free to contact me at 561-5040. Sincerely, Approved by: Engineering Geologist 1200 [JJ~sl 33r(1 Auenug, Suite E~' J~nchoreq¢, Alaska 99503,{907) 561-50/40 POUCH 6-650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 TONY KNOWLES, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION August 24~ 1985 Mike Pratt 1809 Cindy Lee Lane Anchorage, Alaska 99507 Subject: Septic System, Lot 13 Block 3 Southpark Addition #1 Dear Mr. Pratt; Septic System/curtain drain design has been approved in concept by the Department of Health and Human Services (DHHS). Final approval of the system is contingent upon demonstration that the curtain drain can ef- fective!y lower ground water levels to four (4) feet below the proposed septic system. Final approval is contingent upon the following: 1) Ground water levels in the area of the proposed septic system must be monitored for a minimum of fourteen (14) days, with observations made at seven (7) and fourteen (14) days. If groundwater levels remain with- in four (4) feet of the bottom of system, groundwater monitoring shall continue until it can be shown that levels~have stabilized at a level four.(4) feet~below the system. 2) DHHS must be presented with a copy of the Right of Way permit issued by Public Works. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/pah TO AbASKA,EN, VIRON MENTAL C-~TROL ' ~ ~ SERVICES, INC. ' ~.200 W. 33rd Avenue Suite B · , ANCHORAGE, ALASKA 99503 (907) ~ ,.~/--$~; P'O Ob/~s ~ /-/o/7 RE: WE ARE SENDING YOU ~Attached [] Under separate cover via the following items: [] Shop drawings [] Prints ,,~ Plans [] Samples [] Specifications [] Copy of letter [] Change order [] COPIES DATE NO. DESCRIPTION THESE ARE TRANSMITTED as checked below: XFor approval [] For your use [] As requested [] For review and comment [] FOR BIDS DUE ~ Approved as submitted [] Approved as noted [] Returned for corrections [] 19 [] Resubmit [] Submit [] Return_ copies for approval copies for distribution corrected prints [] PRINTS RETURNED AFTER LOAN TO US COPY TO SIGNED: If enclosures are not as noted, kin~ly notify us at onc ALASKA EcFIUIF OFImeFITAL COFITI OL $1 BUICI $, August 20, 1985 Mike Pratt 1809 cindy Lee Lane Anchorage, Ak. 99507 Dear Mike: Here are the revised drawings for the curtain drain. Public Works and you will need a permit to work in the right of way. that time they will review the curtain drain outfall. I have included all of the DHS$ requested changes. Sincerely, PhD, PE I have talked to At ' . ALASKA ENVIRON~vlENTAL S,EET ~O. / O, CONTROL SERVICES, INC. ' 1200 West 33rd Avenue, Suite B CALCULATED 8Y · , ANCHORAGE, ALASKA 99503 CHECKED BY DATE (907) 561-5040 /,,~ ~ O ~ - : ..... ~.. ; ~ ~ :~..~',..~, ;x~-~ :....'~.°~X, : · , . , , .. . t C~ff ~,~ ,~i= ~l7 ~.~.LN . :v~ ,~~'~ ~ ~-"~ "~' ~ '~ ., ~ A~KA ENVIRONMENT.._ ~..; ~. CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503; ALASKA E NVIRONI'~._>,~TAL CONTROL SERVICES, INC. 1200 west 33rd Avenue. Suite B ~J',ICHORAGE. ALASKA 99503 (907) 56:[-5040 \ 'x \ ALASKA ENVIROi~J~IENTAL CONTROL SERVICES, INC. 1200 west 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 SCALE ALASKA ENVlRONI~TAL CONTROL SERVICe. ,lINC. 1200 West 33rd Avenue~ Suite B ANCHORAGE ALASKA 99503 (907) 561-5040 SHEETNO. ,'~ ~ OF ~ CALDULATEDBY Z~ CHECKED BY DATE DATE* ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 1200 West 33rd Avenue. Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 CHECKEO BY DATE SCALE PERPETUAL DRAINAGE USE EASEMENT THIS AGREEMENT ~, made this ~/~ dayo~f inaf~ter 1985, by and between William K. and Susan J. Jarvis, hu~e called party of the first part, and Max Oo Jensen or his assigns, hereinafter called party of the second part, WITNESSETH: That for and in consideration of the sum of ONE DOLLAR ($1.00) and other good and valuable consideration, the receipt whereof is hereby acknowledged, the party of the first part has this day bargained and sold, and by these presents, for itself, its executors, administrators, successors, and assigns, hereby grants, bargains, sells, conveys, transfers, and delivers unto party of the second part, its successors and assigns~ a drainage use easement with the right privilege, and authority to the party of the second part, its successors and assigns, for use as a locatiou for an underground curtain drsin, including the right to coastruct, operate, and maintain such improvemeats within said essement, described as follows; he, Southerly 20 feet of Lot 14, Block 3 of South.park Subdivision Addition No. 1 as shown on the attached Exhibit A. Together with the right to party of the second part, its successors and assigns, to maintain and to construct and operate; provided that no significant alteration of the existing contours and permanent vegetation (trees) occurs during construction. Any careless or unnecessary disturbance to the contours or the trees oa Lot 14, Block 3, by the party of the second part shall be re- stored by his own means and expense to the satisfaction of the party of the first part, additionally, reseeding of all disturbed areas shall be the responsibility ofthe party of the second part. Together with the rights; easements, privileges, and appurtenances in or to sg~d lands which may be requireg for the full enjoyment of the rights herein granted. IN WITNESS WHEREOF, emecuted this instrument as of the party of the first par~ has the day and year first above written. Susan J. Ja~ As tenants by the entirety. STATE OF ALASKA ) ) SS: THIRD JUDICIAL DISTRICT ) Before me, the undersigned, a Notary Public in and for the State of Alaska duly commissioned and sworn as such, this day personally appeared William K. and Susan J. Jarvis to me known and known to me to be the persons described in and who executedthe above instrument, and they acknowledged to me that they signed and sealed the same freely and voluntarily for the uses and purposes therein mentioned. Witness my hand and notarial seal thi~.~ day o ~,1985. Notary Public ~ and forthe State of Alaska. My commission expires: / / / MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROJECTION 825 L, Street, Anchorage, Alaska 99501 2644720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: '~E-) '''~'~ ~C~ ~/'' '~ LEGAL DESCRIPTION: ~-~- ~ ~ [~SOILS LOG TEST 2 3 4 5- 6- 8~ 19- 14 18 G reO'ct c~/ DATE PERFORMED: ~ ~ ~'~ ~'- I SLOPE WASGRO.NDWATER ~)e ~ [I ENCOUNTERED? . 'O: IF YES, AT WHAT DEPTH? ~ SITE PLAN J j Gross Net Depth to , Net .Reading' Date Time Time Water Drop ~ ,, i2:3~ /~ J~.~s~ ./0 PERCOLAT ON RATE. /'~ Iminutes/Jnch) DATE: EP 09/VS • f Municipality of Anchorage 1 On-Site Water&Wastewater Program • — (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 020-491-39 Expiration Date: �� O ZO 1. GENERAL INFORMATION Complete legal description SOUTHPARK S/D#1; BLOCK 3, LOT 13 Location (site address) 16240 BAUGH CIRCLE,ANCHORAGE,AK 99516 Current Property owner(s) JOHN-PEITER AND LYNDA TARBATH Day phone 382-1647 Mailing address 16240 BAUGH CIRCLE,ANCHORAGE,AK 99516 Real Estate Agent KALEB BRODERICK Day phone 229-6499 • 2. TYPE OF DWELLING: NI Single Family(w/wo ADU) Duplex (� Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: • Individual Well ❑ Individual On-site U Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System U Public Sewer ❑ WaiverNanancerequest for DRAINFIELD TO LOT LINE Distance: 5 FEET Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee$ 56D Waiver Fee$ g R 3 Date of Payment 512_1 I19 Date of Payment 5721 199 Receipt Number (.) 0/616 Receipt Number 0 .6/61(� COSA# 03 cf. 1 (7.3 Waiver# OS V 19 r 033 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are)safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP,Ltd. Phone 337-6179 Address 3701 E.TUDOR ROAD,SUITE 101 'ANCHORAGE,AK,99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date '/.7,J lig Engineer's Comments: In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septic system in accordance with the ,*\\\\111 guidelines and regulations established by the Municipality of Anchorage and industry pradices.The reported results describe the 4'''t 1, . condition of the sysfeMs on the date's of the evaluation.Separation distances were measured to readily identifiable features. �,c \\ .A( • Hidden defects or encroachments may exist that were not identified during the evaluation.The operational life of all wells and septic \�• •, ••Il••��'•.. (,T. systems depend on a variety of variables including,but not limited to,soil conditions,groundwater levels(that may fluctuate during i �••' t `i y v. the year),quality of construction(materials and workmanship),and the water usage of the family utilizing the system/s.These a'K�: 49 1 -...1\ ••• * 0� conditions can vary,and are outside the control of GEG.Satisfactory test results do not guarantee future performance of the ; m system's;therefore,GEG makes no warranty(express or implied)regarding the hAure performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the 0 ,, . • • or current systems fail.The content of this report is for the sole benefit of the person/party who retained GEG.Reliance upon the .*.(n fff ey,,k. Ga es s ,,�1 information provided in this report by any other person or party,including but not limited to subsequent property purchasers,is not `� I E-7953 I authorized.In short,GEG disavows any legal duty to anyone other than the person/party who paid for this report. , ri>'. i) ••:S�i 6. DSD SIGNATURE LICENS%IIiPROFESS\ �4. �/f #AECC884 �A\\\ JX/ System#1 Approved for 3 bedrooms. System#2 Approved for bedrooms. ``kkUll(((<f<<f" Disapproved. `• 4Y � ONS yt;' -;;--- ::-... n Conditional approval for bedrooms, with the following s io sQ�(.1gT ATF r " �l)T� RgN� ^ P C� )r fT1 ; C �GR�ti' R off': / ��s)))»));»)°)'D ' By: IM4 S" Original Certificate Date: (Q-3— 17 The Municipality or Anchorage Develop,emt Services Division(DSD)issues Certificates of On-Site Systems Approval(COSA)based only upon the represenafations 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. ATTCHMENTS: COSA Checklist O Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev.10/12112) COSA Checklist Legal Description: SOUTHPARK S/D#1; BLOCK 3, LOT 13 Parcel ID: 020491-39 If more than 1 septic system on lot: COSA Checklist# 1 of 1 Structure served by this system 1 A. WELL DATA • '• log is filed with Onsite (or attached) Well production at time of test .• Date drilled Water storage tank volum- gallons Total depth ft Well disinfect-• • coliform test? ❑Yes ❑ No Cased to ft I -• orm bacteria is Negative ❑Sanitary seal is functioning correctly Nitrate mg/L 0 Nitrate less than MRL (ND) 0 Wires are properly protected •'c ug/L 0 Arsenic less than MRL(ND) Casing height(above grou r• in. Collected by Date of flow to • OSA Date of Sample S - ' ater level at beginning of test ft. Comments CONNECTED TO PUBLIC WATER SYSTEM B. TANK DATA C. LIFT STATION Age of tank(s) X19 years 0 Required maintenance completed Tank type/material "K0.GA55 Age of lift station <19 years 0 Standpipes/foundation cleanout per record drawing Lift station material `. 5 Date of pumping SEE BIOCYCLE MAINTENANCE RECORDS Comments: THIS IS A BIOCYCLE TREATMENT SYSTEM SEE ATTACHED MAINTENANCE RECORDS D. ABSORPTION FIELD DATA DUAL BEDS(SPILLOVER) Which system tested(date installed) '°"1185 Adequacy test date 5/5/19 0 ALL standpipes present per record drawing Results ❑✓ Pass For 3 bedrooms AT Total measured depth from grade 3.5 ft(max) MTS Fluid depth prior to test *0 in Measured depth to pipe invert from grade 2.9 ft(min) Water added *798 gal 0 N/A—pressurized field New depth *2.5 in I� Monitor tubes go to bottom of drainfield. If not, state Elapsed time *5 min depth into effective ❑ Code-required soil cover over field ** Final fluid depth *0 in Absorption rate 450+ gpd ❑ System presoaked NONE • (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies:NEW MONITORING TUBES WERE INSTALLED BY WILCO EXCAVATING ON 5/7/2019 IN BOTH DRAINFIELDS. 'TESTED LOWER DRAINFIELD ONLY. UPPER DRAINFIELD LIQUID LEVELS WERE AT OR SLIGHTLY HIGHER IN ELEVATION THAN THE DISTRIBUTION LINES. UPPER DRAINFIELD 100%FULL. "UNKNOWN IF DRAINFIELDS HAVE INSULATION.CLEANOUT ON NORTH END OF WEST DRAINFIELD HAS ONLY 23.5"OVER TOP OF DISTRIBUTION LINE. MAJORITY OF DRIANFIELDS APPEAR TO HAVE 30+ INCHES OF COVER OVER TOP OF DISTRIBUTION LINES. NO FREEZING ISSUES PER OWNER(SEE ATTACHED STATEMENT). COSA Checklist yellow sheet E. SEPARATION DISTANCES CONNECTED TO PUBLIC WATER From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic - - Station on Lot> 100' Community Sewer Manhole/Cleanout> 1 i i' ❑Yes if No ft II -s if No ft Neighboring Tank> 100' II e ' o ft Private Se - :-• is Line>25' n Yes if No ft Absorption Field on Lot> 100' ❑Yes if No olding Tank> 100' [Nes if No ft Neighboring Absorption Fields> 100' Animal Con . ••- t> 50' ❑Yes if No ft •Yes if No ft Manure/Animal Excreta Storag- I�-t I" Co E ••- ewer Main>75' ❑Yes if No ft Yes • ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations> 10' ❑✓ Yes if No ft Surface Water> 100' ❑✓ Yes if No ft Property Line> 5' ['Yes if No ft Driveway/Parking> 0' ❑✓ Yes if No, comment Absorption Field > 5' ['Yes if No ft Wells on Adjacent Lots: Water Main > 10' ❑✓ Yes if No ft Private Wells> 100' []Yes if No ft Water Service Line> 10' Q Yes if No * ft Community Wells>200' ❑✓ Yes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ❑✓ Yes if No ft Driveway/Parking> 0' ✓❑Yes if No, comment **5 Property Line> 10' D Yes if No ft Wells on Adjacent Lots: Water Main > 10' • Q Yes if No ft Private Wells> 100' ❑✓ Yes if No ft Water Service Line> 10' ❑✓ Yes if No * ft Community Wells>200' D Yes if No ft Surface Water> 100' ❑✓ Yes if No ft F. ENGINEER'S COMMENTS •PER 2000 TOBBEN SPRUKLAND,P.E.DESIGN DRAWING,THE WATER LINE IS 10+FEET FROM DRAINFIELD AND BIOCYCLE. "REQUESTING 5 FOOT LOT LINE WAIVER.MOST EASTERN SEPTIC STANDPIPE(CLEANOUT/SUMP)FOR DRAINFIELD SCALES 7+FEET TO LOT LINE ON 2003 FRED WALATKA,RPLS AS-BUILT SURVEY.DRAINFIELD NEAR 25%SLOPE.NO INDICATION OF DAYLIGHTING EFFLUENT.DROPS-6 FEET IN ELEVATION AND FLATTENS AT DRIVEWAY.SEE ATTACHED PHOTOS. QQ600p�44 G. ENGINEER'S CERTIFICATION �� OF•... C�s4ti I certify that I have determined through field inspections and review ,SK-:-*-. - 1 4.- '•� Q of Municipal records that the above systems are in conformance with , : 4 9i "\ 7*00 MOA COSA guidelines in effect on this date. a ff, �� Garr ss: 0 P E-795 ,,p °Q‘' ...* _5/.COSA Checklist yellow sheet �4�OZa pro f essi0 0� #AECC884 �Opo 0 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 ��� Day of M of 20 1°1 ,by and between St o ,� 6, herein the"OWNER,"and the Municipality of J S m , R, p tY 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 operate an Advanced Wastewater Treatment System(AWWTS), described as g i o C. y(AQ.. located at(legal description) Sou_41-.c rt- "tel Z- 13 g7 2. Maintenance,Repairs and Alterations. (Owner is required to read, understand and initial each section) _..\ 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. A_ ,J 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 3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. S) Owner acknowledges that the fme for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. J� Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. 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. Owner 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 3 OWNER: By: 1 / �1� (signature) Date: 572. t 3 Cott" L5 Ct V print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) / The foregoing instrument was acknowledged before me this 19 day of /�'t 20/9,by 1. NOTARY PUBLI FOR ALAS gS1O~ My Commission expires: !/ -e 3J, j,Z _ : Nov ; 23 0: 2022 ' MUNICIPALITY: By: -%S. //p (signature) Date: a7 .3. (print name) Title: (rev. 05/18/2018) Page 3 of 3 \ G\�G 8142'0' O \ gpuGH 06 \ —6000 0 00 L�S� . co• R s ec,. D��'�/� J� o Sip4. co 'oma 0")� L9c. oOo •9 rte, dii/ ;;,, tib' SF Lot 14 Lot 12 ,; e /� ti�b� co X97_ o �� s �\ 1O7 ? 2.0 OH c?O `,acC R> n Z Conc.ret.wall—�\ 1 cl/ `9 NY •6'?/V O 1s-/ rVY 111111111 c(3' 7y `,, O t O ' `:' • •1 •� ' rys'C,f. LOT 13, Boardwalki\ '� \_ \ Ramp o \,- _.,k• m A. Wood fence-.. ...\- 1 -- - - - - --- -- - - 10' Utility Easement — — _-. N89°53'17"W 321.58 re,,,moi-'- /el.5` 25-/,/Wc'‘:-t.J AS-BUILT NO CORNERS SET THIS DATE Or 1 4 I hereby certify that I have performed a Mortgagee's inspection Q'` A( ' of the following described property: LOT 13_ BLOCK 3 _ • ,� + SOUTHPARK SUBDIVISION ADDITION No, 1 i (''• 49th j� .7 *� l. •* / Anchorage Recording District,Alaska.and that the £'!'3•• �P-•/•-1• ••• improvements situated thereon are within the property lines J(+, i-t-t . •• �lz and do not overlap or encroach on the property lying Vs jj+�' !j adjacent thereto,that no improvements on the property lying / •.'Elizabeth L. olotka:.f • S adjacent thereto encroach on the premises in question and rr- 40' #G'-‘,. •• 8036 - LS .• , . ,,,, that there are no roadways,transmission lines or other SCALE: 1 - g h RF . • • • ' • - visible easements on said property except as indicated ")? • •`.‘%' hereon. 4 1 0 Tssio$M-`� Dated at Anchorage.Alaska EASEMENTS OF RECORD,OTHER THAN + ��� this 9th day of MARCH ,1994. THOSE SHOWN ON THE RECORDED FB 19-3, pg 10-11 fJ -0 —1 C) FRED WALATKA&ASSOCIATES,L.L.C. PLAT ARE NOT SHOWN HEREON. Recert 6-20-00, 1-24-03 Engineers and Surveyors UNLESS OTHERWISE NOTED BEP, FB 02-5, pg 66 BE 907-248-1666 Municipality of Anchorage ,oenttt r‘ P.O. Box 196650 • 4700 Elmore Road ` Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-79971 )eparmien t http://www.muni.orq/Onsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV191033 COSA#: OSC191173 Permit#: PID#: 020-491-39 Legal Description: Southpark#1 BLk 3 Lot 13 Engineer: GEG Applicant: John-Peiter Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 5 feet. This waiver approval applies to the Existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. H The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non-objection have been received from the owner(s) of the affected adjacent property. (;i Adjacent properties are not affected by this waiver. Waiver is Granted: X Waiver is not Granted: Date: (0—. -1 9 Approved by: '—l 6 Name of Reviewer 3705 Arctic Blvd #313 Anchorage AK 99503 �lb) YCLEAlaska Email:crbioak@gmail.com A,/r:u..n•f\'!..•?n r.,V.:,emc m..,,, (907)274-0314 1st Quarter Inspection Report 2019 Homeowner Info Customer Name: J.P. and Lynda Tarbath Tank it: 81 Install Date:June 2000 Address: 16240 Baugh Circle Area: Potter Marsh Initial Inspection: Alarms Tested: Air g High Water A Battery Tested: Yes No n N/A (Please make sure alarm is on"normal", not"mute") Does system have a septic tank? No gl Yes ❑ (Recommend pumping tank every 2 years) Is System Lid Locked? Lid hardware in working order? Is there any noticeable odor? Yes Repaired ❑ Yes 71 Repaired ❑ Strong ❑ Mild ❑ None[Z1 System Inspection Inlet plumbing in working order? Solids pillow normal? Yes g Replaced ❑ Yes g Requires Pumping ❑ Are all aerators functioning? Any buildup of solids? Yes [71 Replaced ❑ Yes ❑ No [i Clarification return system operating? Any buildup of solids? Yes Adjusted ❑ Yes ❑ 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.) 7.5 4.0 8.76 Pump float operating? Alarm float functioning? Any buildup of solids? Yes 171 Replaced ri Yes { Replaced ❑ Yes ❑ No 171 Filter cleaned? Discharge line condition: Yes 171 N/A [1 Good / Replaced [] Comments: Has emalling or mailing of form been requested? I Inspected By: Chris Date: 03/21/2019 (contact office to request...) Yee El No 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING :Parcel I.D. OP-C~- 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Current Property owner(s) "~ Mailing address Lending agency Expiration Date: LoT t.C~'~ ~'..z-'-/ Day phone Day phone Mailing address Real Estate Agent Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. NUMBER OF BEDROOMS: ,~ TYPE OF WATER SUPPLY: ' Individual Well Individual Water Storage Community Class ~ Well Public Water System ~, ~., t.~L) TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer [] [] [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water Supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority 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 sample results. (Certificates may be reissued for a pedod 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 seal affixed hereto and as of the validation date shown below, I vedfy that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ' I; [. J,.C~.1 ~'~, ~., ~-'~c.t o.~ Address ~ ~ ~ I~ Engineer's Pdnted Name ~[~ ~ DSD SIGNATURE //' Approved for Z' Disapproved. Conditional approval for Phone. bedrooms. bedrooms, with the following stipulations: Date t J'z.c~ JC~ -~ Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X (Rev, 01/C2) Maintenance Agreements Supplemental Engineer's Report Other Odginal Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak.us (907) 343-7004 HEALTH AUTHORITY APPROVAL CHECKLIST Well type If A, B, or C provide PWSID # J Well Log (Y/N) Date completed Sanitary seal (Y/N) / Wires properly protected (Y/N) Total depth ~ .ft. Cased to ~,/ Casing height (above ground). .in. c.: .' FROM WELL LOG / AT INSPECTION Date °f te.st .T, ?., , /"/ . ~ Static water level ~ fl. : ~ lt. Well production ' ,/ g.p.m. ~ g.p.m. Coliform /~nies/100 mi. Nitrate mg./I. Other bacteria ' colonies/100 mi. Amenici f rng./I. Date of sample: Collected by: SEPTIC/HOLDING TANK DATA TenkTyp ater= Tanksize I/,eo gal. Number of Compartments /'~ (Y/N) ~ Depression over tank (Y/N) . . Foundation cleanout ! / Date of pumping I, I~, io~, Pumper Cleanouts (Y/N) ",/ High water alarm (Y/N) y C. ABSORPTION FIELD DATA Date installed Iq_~'.,~ Soil rating (g.p.d./ft~ or'Rz/bdem) ~ System type qo ~o Length ~ ~ ~ I o ff. Grovel ~1~ pi~ ~. ~ fl. Totaldepth ~_,~ lt. Eff. absorptlonarea~O~ Monitoring tube "// Date of adequacy test I / 1~ IO_'~, Results(Pass/Fail) Fluid depth in absorption field before test ~ in. Water added ¥$Ogal. Elapsed' Time: Jmin. Final fluid depth .'~'in. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (Y/N & type). ~i~ Depression over field I~! For ,,~ bedrooms New depth -~-'in. /9/p- [;) g.p.d. If yes, give date I,'''/ Eo LIFT STATION Date installed "Pump on' level at ~::) in. Datum "~o ~--~,v~ Size in gallons ! ~ ~ "Pump off' level at / ~ in. Cycles tested t.~ Manhole/Access (Y/N). y High water alarm level at t~. ~ in. Meets alarm & circuit requirements? y SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: / Septic tank/lift station on lot ~ On adjacent lots Absorption field on lot ,// On adjacent lots Public sewer main jJ Public sewer manhole/cleanout Sewer/septic service line Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ~-- [1/ Property line I ~ Absorption field Water main JO-C) Water service line ~-- -~ Surface water Wells on adjacent lots I~¢~. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line I ~) Building foundation '~) Water Service line ~. ,~ Surface water ~ ~ Curtain drain N J C) Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. EngineeKs Pdnted Name ~"~¢ ~ Date ', Water main. Driveway, parking/vehicle storage HAA F*ee $ Date of Payment Receipt Number (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number 27~ P. 02 Municipn]Jty of Anchorage D~tiopment Set. ices Depar~raent Building S~¢cy Dlvblon OR. Si~ Wirer ~d W~w~r PmS~' 4700 ~mpw P.O. B~ 19~50 ~chom~t, ~ 9g~194~0 PROPERTY OWNER AGREEMElV/' FOR THE MAINTEN~CE OF A_N ON-SITE WASTEWATER DISPOSAL SYSTEM / This al;recreant, dated //~.? ~ , is made bctwe.n th, M~icipEi~ of ~chor~e ~is agreement i8 made for ~e p~ose ofm~i~g ~ o~-site wutew~r ~spos~ system o~ ~c subject p~pc~y. , The propert7 owners agree to the following: Subrait to the Municipality of Anchorage, on an annu_.! basis, an i~spection and operation stateraent from a registered professional engineer. This inspection arid operation statement shall verify that the engineer has inspected all effluent and air pumps, timers, and alums, and that deficiencies have b~n repaired and that the systara is functioning as designed. (Printed Name) - (Printed Name) Thc Foregoin~ Instrument was acknowledged before me b Nota~ Public (Si~a~e). ~ot~'s p~n~ed My Co~ission ~xpi~s ~-/~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete'legal description LoT iS. /~ ~ '~ Location (site address or directions) Property owner Mailing address Lending agency ~ ~o ~ ~,;.,_ t,~,~ ~.~.,.~ Day phone Day phone Mailin. g address Agent ~--'~'~ ~'~- ~'~-~'~-'~ ~ Address "' Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: Day phone If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OFWASTEWATER DISPOSAL: NOTE: Individual on-site ~ Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOAB'/21 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. AddressEngineer's signature Phone Date DHHS SIGNATURE Ap.proved for ~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: The Municipality of Anchorage Department of'Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DH HS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Legal Description: k'- Municipality of Anchoragek'''/ Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us <I CEIVEI) dUN 22 2.000 (907) 343-4744 MUNICIPALITY OF ANCHORAGE '/Ip"'~NMENTAL SERVICES DIVI e ~ HEALTH AUTHORITY APPROVAL CHECKLIST A. WELL DATA Well type If A, B, or C provide PWSID # /~lt/Log Date completed Sanitary seal ___ /Wires properly protected Total depth __ ft Cased to ft //g~sing height (above ground) _ in. FROM WELL LOG / AT INSPECTION Date of test ^ c,,~J/-,~ 0 ~-- _ Static water level ~ft j,>.?/ ft Well production g.P.~/' __ g.p.m WATER SAMPLE RESULTS: / ...... Coliform colonies/100 ~te__ mg/I Other bacteria colonies/100 mi Date of sample: // Collected by: B. SEPTIC/~ Tank Type/Material "~1o Date installed /~//~/~ Tanksize /~LY~ gal Number of Compartments Cleanouts ~// Foundation cleanout ~" Depression over tank t~ High water alarm Date of pumping F//,~ Pumper tV/'/N- C. ABSORPTION FIELD DATA Date installed JO ~11- ~'.5 Soil rating (~ or ft2/bdrm) 1'7 z// System type Length r%~ ft Width I0 ft Gravel below pipe , .-~ ft Total depth ! ft Effective absorption area o°"/D fF Monitoring tube '"/ Depression over field Date of adequacy test &'//2//¢o Results (Pass/Fail) '~-~4L- For .~ bedrooms Fluid depth in absorption field before test ~/~-~ in Water added 6'L/~) gal. New depth ~ in. Elapsed Time: ~,~ra ;~2~ Tin Final fluid depth . ~_,~_~_- in Absorption rate >= ~D g.p.d. Any rejuvenation treatment (past 12 mo.)(Y/N & type) ~ /~,r¢,~/'J~J If yes, give date 72 026 (Rev. 01/00)* D. LIFT STATION Date installed Size in gallons lb. ool "Pump on" level at ~, in "Pump off" level at (5 in E. SEPARATION DISTANCES Manhole/Access High water alarm level at ~ in Meets alarm & circuit requirements . SEPARATION DISTANCES FROM WELL/(~ LOT TO: / Septic tank/lift station on lot /On adjacent lots / Absorption field on lot / On adjacent lots / Public sewer main J Public sewer manhole/cleanout /septic service line//'/' Holding tank Sewer SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation (~ ~/ Property line Water main / 00 ' Water service line Drainage 1 CO Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation ?, Surface water 1',40 ~-11~. Wells on adjacent lots Property line Water Service line Curtain drain F. COMMENTS Absorption field Surface water 100 ( Water main Driveway, parking/vehicle storage G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effe8t on this date. Engineer's Printed Name '~"'~lcb~,,~ S/~vc'Kt~ Date ~ ~(, ¢4~0 HAA Fee $ ,¢ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 01/00)* MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN;SERVICES Division of Environmental Services OmSite Services Section P.O. Box196650 Anchorage, Alaska .99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORI'F~' ' APPROVAL-FOR A SINGLE FAMILY DWELLING :ENERAL INFORMATION ~. Lo£-/.I.$, ,Blo¢~.$, ,SoO~par~ Subdivision ~I · -,,- ,Complete legal description ......... Location (site address or directions) 16240 Baulk ¢~.c~e Ancho~aqe, AK Property owner Wa.Z~ ~ Ma.~t~ He.~don... ' Day phone (h) 545-046'2 . ;?..,, (w) 56~-318S M~y Mailing add tess Lending agency · :Mailing address --~,~'. ~Agent Ch,~ Blake/ SLEEPER~'~E/,LTY Address 36240 Baugh Cir~ Anc[orag¢, AK 99516 800 E. Dimond Blvd. Suit¢3-~00 Day phone Day phone 344-2501 Anchorage, AK 99515 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ' ':'5'' -q 3. TYPE OF WATER SUPPLY: NOTE: TYPE OF WASTEWATER DISPOSAL: Individual on-site Individual well Community well Public water ~f community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. xxx NOTE: Holding tank ' Community on-site Public sewer - · · - If community wastewater system, provide written confirmation from State ADEC attesting to. the legality'and'statusof system. 72~)25 (Rev* 1/91) Front MOA #21 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 of this Health Authority Approval application shows that the on-site water supply and/or wa~stewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this ins~tion. Name of Firm . /~ ')/ Phone ;~_' ~--~'7 ,~ Address Engineer's signature ate ,-~ w DHHS SIGNATURE /~' Approved for ~'~ bedrooms. L Disapproved. bedrooms, with the following stipulations: __ Conditional approval for By: Additional Comments Date The Municipality of Anchomqe Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered iq the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissior,s in the professional engineer's work. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: /,.-eT /3 A. Well Data Well type ~--L/,A- ,,q~- ,~ Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test ,t~.../~ ,.~ ,~ouTR~,Y/~ Parcel I.D, I ~1~, or C, attach ADEC letter. ADEC water system number Date completed Driller Cased to Casing height Wires properly prot~ FROM WELL LO,~~I~PECTION Static water level Well flow ~ SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ~ o~ / ~ Absorption field on lot ~ C~L~ ~- g.p.m. .g.p.m. ; On adjacent lots ; On adjacent lots Public sewer main Sewer service line ~tank cWo~joEr~ SAM P LE R E S U LTS~...~~..~...~ Nitrate Dat~le..~ Collected by: Public sewer~ Other bacteria B. SEPTIC/I:IQI,,DING-TANK DATA Date installed Cleanouts~N) ~>'~ High water alarm (Y/~'~ Date of pumping ~-/~-~/ ~d~ Pumper /~?c _/Z~d~ SEPARATION DISTANCES FROM SEPTIC/I-J~EBtNG~'~NK TO: Well(s) on lot '~/°~"J~- On adjacent lots ~---/,~A £J/~ ~c~3 C/-- Foundation Tank size /(,.b (.'~O ~ (---- Compartments Foundation cleanou~Y~/N) ¥"~'-~ Depression Alarm tested (Y/N) ..-L,////','~ TO property line //O /¥~ Absorption field ,.~'~_,4_ Water main/service line /C) ~'?~- Surface water/drainage ~ ~ ~ I~T~I~ ~IVE~S~O~ o F ~*026(~)'F~t ~, /~O/+ ~o ~/~g ~u~ CONTINUED ON BACK PAGE C, LIFT STATION ,~o~J~ Date installed Size in gallons Wel D. ABSORPTION FIELD DATA Manufacturer ,~' Vent (Y/N) "Pump on" level at ~ "Pump off" Level at High water alarm level ,.~'~'~Cycles tested Meets MOA electrical codes (Y/N)._ ~ SEPARATION DIST. T. AN~M LIFT STATION TO: On adjacent lots Date installed Length Z~'O'/~' ' t Total absorption area Date of adequacy test Surface water /OI/I / ~-.~ Soil rating (GPD/Ft2) I?z~'Cd- Systemtype Width / ~ ' ~/o r Gravelthi~ness ~, ~ r Totaldepth ~ ~ Cleanout present) . ~S Depressbn over field (Y~ Water level in ab~tion field before test ~ Nter test Peroxide tmatment (past12 months) (Y/N) ~O~ /~O~ Ifyes, g~edate Bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot .-.'~)O/~C-.~ /~/~E~]~n adjacent lots ~"(--~',.~?~ 200 ~7~ Property line To building foundation / ('.~ /"~ To existing or abandoned system on lot /('.~ On adjacent lots ~-©/'/'- Cutbank_~.,~-~ ~ Water main/service line /0/'f-- Sur/ace water /0(~''¢- ~,~/~ '~ / Driveway, parking/vehicle storage area ~/'/'- Curtain drain Z~ ' ?O I,U~c~,m/?rE/jT- :;Y~'~o ~,¢o~£/~ ~,~-.'~ ~VE~&lo~.~ O.c' G,Zoc,,~,J~?'E,~ F~-o~4'l d-uw~.~/ A-, I.~/L~/,,~.J ~c'~7-f-'-~L.¢-, ~U,c_'7-/~/AJ /~/Z~//.J C~c~T~/ALL E. ENGINEER'S CERTIFICATION ~ce~fythat~havechecked~~~AandHAAgu~de~nesine~ect~nthed,~a~e~7~is~nspecti~n~~.. , , , :, Signature Date HAA Fee $ ~p~ ,/-42 Waiver Fee $ Date of Payment ~ .._ .~ ~ ?4/6 Date of Payment Receipt Numl~r / ~ Receipt Number. 72°028 (3/93)* Back MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SiTE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) ~o,~.~-d 1)¢¢n-~ ~D ~ ~ ~Loc~3 ~ ~c 3 T~l~~o Location (address or directions) A~)iCan~,Name ~l'~v~,, P~ Telephone: Home ~'~ ~ ~ Business Applicant Address: .~~°~, ~tNb'J LCE ~Nc ~ct~ ~K A~piicaflt'is (~hEc~'Sne)~ Len~'ing Institution ~; Owner/builder ~; Buyer ~; Other ~ (explain); (b) (c) (d) (e) Lending Instit'ution" Te[e Address: ' ' " Real Estate Company'and Agent Address (f) Telephone Mail the HAA. to the following addre~/ TYPE OF RESIDENCE Single-Family'' Multi-Family [] Number of Bedrooms Other WATER SUPPLY Individual Well [] Communit~-~ Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status·, ~, ~ ~ ~ SEWAGE DISPOSAL · Onsit Public [] Community [] Holding Tank [] Note: If community wall system, must have written confirmation from the State Department of Environmental Consarvation attesting to tho legality and status. Page 1 of 2 72-025 (11/84) ENGINEERING FIRM PROVIDIN~ ~NSPECTIONS, TESTS, FILE SEARCH, DA ~,.~ AND INFORMATION As certified by my seal affixed hereto and as of the validation date Shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 disposa~ system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm /~ ~ /,t ¢ Telephone ~--~' / ~ ~) Address / :2.0 o c,J. 3',~ ''-'f /z]rt ~-Ao,-~ ,,~ /~ ~ ¢. ~'~o ~ . Date /o .-z3- ~ ~" Approved for "~'~'/Z-~-' bedrooms b Approved 'K Disappr~ved¢ Terms of Conditional Approval Conditional 'CAUTION ' The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representation~ giyen in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state reqdir~ements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) ~/'~UNICIPALITY OF ANCHORAGE ~ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date - GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name ¢,~ [ K,G ~P-.h ~ Telephone: Home ,~,2- 5'~.- Business Applicant Address l¢c°~j ~.~r4~'l L(~. L./~f'de /~Nci~ /~,E. ' (c) Applicant is (check one): Lendi?g Institutidn []; Owner/builder ; Buyer []'; Other [] (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family ~/ Multi-Family [] Number of Bedrooms ~ Other WATER SUPPLY Individual Well [] Community~ Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite~ Public [] Community [] Holding Tank Note: If community well system, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status. 72-025 (1~/84) Page I of 2 ENGINEERiN~ FIRM PROVIDING ~PFCTIONS, TI=$T$, FIL~ SEARCH, DAT, ID INFOR~ATIOI\I As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm /~f ~C..¢ Telephone Address t%oO '~O 6 :~"6' 53 P~:~ tkbJc ~o~- Prig Date neer's Seal DHEP APPROVAL Approved for ,,':d~ ~¢(%~bedroomsby~¢.~¢-~ ..-/~' '-./'2'7¢¢--,.~,.~.- Date Ap~ved D~ved ~'~ ~ Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 · 72-025 (11/84) WELL DATA ation MUNICIPALITY OF ANCHORAGE (MOA) MUNICIPALITY OFI*.~r, tE, I:J~*.I~[ITHORITY APPROVAL (HAA) DEP'i' OF HEALTH · FEBRU^RY FNVIRONMENTAL PROTE~rI~.' - 264-4720 OEO t ~. 'Jg~5 Legal Description: RECEIVED Total Depth Static Water Level __ Casing Height Above Ground Electrical Wiring in Conduit (Y/N) ___ Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer [' Cleanout/Manhole Water Sample Collected Water Sample Comme ~'¢c. ~o_ffr.~¢& h'~Ec lc'He"' C;c~m,~n¢"~ __ ¢u~.'o,~(~ If A, B, C, D.E,C. Approved (Y/N) Date Completed Yield to Depth of Grouting Pump Set At Sanitary Seal on Casin Depression Aro (Y/N) ; On Adjoining Lots ; On.Lots To Nearest Public Se~ve~ To Nearest Sewer Service Line"o~...Lot ; Date B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes ~N) Depression over Tank (Y/~) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ~- ~oo To Property Line ~,O To Water Main/Service Line ~'7- /O Course ~,7- /00 Size ~ooo No. of Compartments Air-tight Caps ~N) Foundation Cleanout~/N) Date Last Pumped ; for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field ~,~' To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata / ~'¢ ~ ~ /'~ Date Installed /O -//- ~ ~- Width of Field /~ Square Feet of Absorption Area Depression over Field (Y/~_).~ Results of Last Adequacy Test Type of System Design Length of Field Depth of Field / Gravel Bed Thickness f/Z. ' Standpipes Present ~'~1) Date of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well ~"F 2.00 To Building Foundation Lot To Water Main/Service Line ~ q~ I O To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Property Line I O To Existing or Abandoned System on ; On Adjoining Lots ~ T- ,~ o To Cutbank (if present) ET 30 ~- I00 D. LIFT STATION Dimensions Manhole/Access (Y/N) "Pump On" Level at ~ "Pump Off" Level at High Water Alarm Level at ~ ~ ~...~.~('~ N)/¢~ Tested for / '"'Pump~...~nng Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) ~ ~'-~'~--. Comments~ ~ ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checke~, verified, or.conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~"~.c~ .,.~,~.,-~¢-~--~ Date __/) -- j~ - ~ "~ Company ~.-'/'//¢ ~'¢__~' / Receipt No. Date of Payment Amount: $ /_o ~"J'~3 Engineer's Seal Page 2 of 2 72 026 (11/84) · : .... ii !,,i, ' ,x DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA g9501 BILL SHEFFIELD, GOVERNOR Telephone: (907) Address: 274-2533 To Whom it May Concern: ~ ~.~~~. According,to records on file in this office the J~L~ Water System is in compliance with the State Drinking Water Regulations Sincerely, S Park 4'1 Block 3 Lot 13 The standpipes in the field are all 2729. When I first inspected the beds, there were no standpipes in place, only the T's where they would go, since they were just finishing it off. Later I went out to inspect the tank. By then~ they had put the standpipes in the field and backfilled. These standpipes, as well as the ones on the tank,.~were all 2729. I left a note on the tank telIing them to use 3034 on the tank and in the field, and telling what else was needed (cleanout between tank and field, etc.) I told Mike Pratt and Alan Ketter. Later I went out to see if things were fixed. They had replaced the tankwith 3034, and put the extra cleanout, and the strange thing is, I remember seeing that they had 3034 for the field ~.ipes, too. But now doing the HAA I see that the field standpipes are 2729. This is weird. I guess I didn't notice the pipes the last time, because I can't imagine them digging out 2729 pipes, replacing with 3034 for final inspection, and then replacing again with 2729. I guess it was my mistake, although in my mind the bright pink 3034 on those field standpipes is a clear memory. Obviously ! am going senile since my recent 28th birthday. At any rate, Mike Pratt says that will be no problem to replace those pipes in sp~ing; he said to just wYite it up as a conditional.