HomeMy WebLinkAboutUS SURVEY 3042 LT 84A T10N R2E SEC 19U
3042
Lot 84
075-132
-51
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) 3437904
No. af Bedrooml:
4
PermR Numben SW020169
NATHAN WORKS
Address:
U.S. 3042, LOTS 84A &: 84B;
Phone:
(907) 783-1027
LEGAL DESCRIPTION
- 84A &: 84B U.S. 3042
..O
Page 1 of 3
On-Site Wastewater Disposal System and/or Well Inspection Report
PID Numben O75--132--51
Wastewater System: · New [] Upgrade
ABSORPTION FIELD
{3Deep Trench r"lShollol Trench IIBed rtMound
WELL: · New [] Upgrade
PRIVATE 320 ~ 320
5 ~,~/s~ ~. *'1,48 ~.
SEE DWG ~. 0.58 ~
SEE DWG ~. 20 ~.
10 r~ 3 ~
200 se,~D 3034/ F-810 / SCH. 40 PVC.
HEFTY DRILUNG 6/20/02 15 ~ DON CONRAD 7/15/02
25 ~ UNKNOWN .. 2.0 .. TANK
SEPARATION DISTANCES
To Septic ~bmorpt]on Uft HoMing
Tank ~ld St~Uon Tank .~,,~ U-- ANCHORAGE TANK 1500
100'+ 100'+ 100'+ - 25% STEEL 2
SuHace Water 100'+ 100'+ 100'+ --
Lot Une *** 4'+ 7'+ 5'-4- --
Foundation 5°+ 10'+ 5'+ -
LIFT STATION
1500IANCHORAGE TANK/ORENCO SYSTEMS
TIMER TIMER 46
OR[NCO AURORA ELECTRIC
BENCH MARK
TOP OF ELECTICAL OU'i~-r BOX NORTH SIDE OF CABIN
Curta;n Dmln NOiNE KNOWq
Remarks:
*THIS IS AN ADVANTEX TREATMENT SYSTEM
**FROM HIGHEST O.0. TO TOP OF SAND
*** WR020025
TOP OF ADVAN'EX MANHOLE = 99.03
Inspections performed by: AKWWC, INC. Dates: 1st 7/15/2002
2nd 7/15/2002
3rd 7/16/2002
Development Services Department/~pproval o
Rl~.v}ez~w~dandapprovedby.~~/ ~- ~f'~/'~Date: ~
pERMiT NUUS[R:
SW020189
AS-BUILT DRAWING
A B
MT1 49.49 56.85
MT2 50.92 50.75
MT3 45.55 4:5.15
MT4 41.095 49.5
IdH1 18.65 58.9
MH2 25.98 45.1
POD 15.09 57.95
CO 12.9,5 57.55
FCO 5.61 29.89
DRNNFIELD
3 BEDROOM
HOUSE
/
1500 GALLON ADVANTEX
/ ~ TREATMENT SYSTEM
/ ~
~T 840
\
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
PRE. PARED FOR: pHONE NUMBER:
NATHAN WORKS (907) 783-1027
U.S. 5042, LOTS 84A &: 84B;
AS-BUILT DRAWING OF NEW SEPTIC SYSTEM
o8/ol/o2
DRAWN BY:
B.S.G.
SCALE:
1" = 30'
PAGE NUMBER:
2OF5
PARCEL ID NUMBER:
075-152-51
N
LOT 84C
US e:UR~t' 3042
(NO
\
I
~ ~uM~ AS-BUILT DRAWING ~' ~uM~:
SW020169 075-152-51
TOP OF ADVAN'TEX POD
.......... ,,~m....-..~.~..,?.: ~.,~ex,~ '~o TO-"',~
,, L ~ ~lNSUt~'no~
,
ORENCO PUMP
VAULT
TOP OF SAND - 100.0g
CROUNDWA~ -- 93.66
R~ ~A~0N OF
OF ~ HO~ ~ g1~6
ALASICA_ WATER & WASTEWATER
CONSULTANTS, INC.
PREPARED FOR: PHONE NUMBER:
NATHAN WORKS (907) 785-1027
U.S. 3042, LOTS 84A & 84B;
PROFILE AS-BUILT DRAWING OF SEPTIC SYSTEM
os/~2/o2
DRAWN BY:
B.S.G.
SCALE.:
N.T.S.
PA:3[ NUMBER:
30F5
BOTTOM OF BiO - 98.59 (AV~.)
AL~RORA ELECTRIC, INC.
1118 East 70th Ave.
Anchorage, AK 99518
(907) 349-2100 Fax (907) 868-2294
CUSTOMER#: 03010
INVOICE#: 127013
INVOICE DATE: 07/22J02
DUE DATE: 08/21102
BILL TO:
Nathan Works
PO Box 63
Girdwood, AK 99587
LOCATION: 03010
Works, Nathan
PO Box 63
Girdwood. AK 99587
WORK ORDER NUMBER: 010942
YOUR REFERENCE NUMBER:
DESCRIPTION QUANTITY
R£0U[ST: Wtre In septic systems
RESOLUTION: Hung panel for sewer system and tied In wires for syste~.
suppl i ed.
LABOR
Rhoades, James M 7.50 hrs
PRICE AM6UNT
Customer had all materials
60.0000 450.00
TOTAL LABOR: 450.00
TOTAL: 450.00
f1EFTY DRILLING
3540 AKULA, DR(V[
ARCHORAGE, AK 995`C ,
(907) 345.0593 ;'I\;•e
LOCATION Or wtLL IPIep1 l..►lete ollla, 1.. l► a le.)
Papeah !Athletes Lel 1 clock Ik7 1/4 alto. $•colon
:14 -Fol
. ole TANCII AMC DIRECTION IRON 0040 INT[hS[CTIONS
Iffeal Address fee Atom of Noll Location IP�CJ I•G.X.
S. WCLL Lea L.1 Veto•
staffer
A.
I •I$, MATER WELL CONTRACTOR'S CCATIFICATIONI 4
Thi qll oda IrllLlo_Ireget ay )9116dletlea Pod late repel N 1,e. N IM bell 4
Ra la9no
Net �aa We..CoM
Aoii.1 \y;a�` i...•.. •/i.l•[J'7I^-__-1.d11
\ tlpNt
WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geological a Geophysical Survey$
0,I11161 reran me..S
Iv, Te9nlktrN� MAga •E� Ylrlliu
3. OWNER Or WILL-
4-me
ILL
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❑Aster 04#11ed' [3/0,84 [3Olhu6
?.UstiA Cam soGy 0 PvbID.!aply 0 Indwsper
[3 Irrigation [3 Rechvl8 0 Caw.ulcol
• O Tssrwetl 0Olhorl
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at...- I4� It. Death welsh) be./f1.
1, to. Ostlh vu Sllclvp, fl,
7, FINISH OF MILLI
Tyraf b���,. Op.a16r,
so Videsh $1841 Length:
See be1Y0e0 to. a1N f J1.
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10. STATIC •A4X LEM � 6.� •�
o Above of Ej Oelaw land'esrfece Pei8
EgalracRl Olkd:
11 • PUNPINO LCYEL ►alas, lead oNton$ $Ad YIELD
fl, e1br��Nt. I9.PIes 1•hm.
...11. grief bre. PVNaine���t.r.a,
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�• iuiili� Na wie.Hilia •— � `•�••�•••�'� ��•�� Dale; : 'Ef � 1 A{.
room OF•I/we 111/8II , 1
•���.Ccap? 0111e1b.11 wNIT[•UaL 0001, 11UN •Orlll•e, Canoe, -4984101• Mae
200 •d Nwor56t0T 2:0/90/80 L822 1`9L Los 33Nt*M.LNIRILI 3.131H3A
MUNICIPALITY OF ANCHORAGE
Development Sen/ices Department
On-Site Water & Wa$lewater Program
4700 South Bragaw Street
P.O. Bo~ 196650, Anchorage, AK 99519-6650
(907) 343~7904
ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Renewal
Date Issued: Jun 13, 2002
Expiration Date: Jun 13, 2003
Permit Number: SW020169
Legal Description: US SURVEY 3042 LT 84AT10N R2.E SEC 19
Design Engineer: 0041 AK Water & Wastewater Consultan'
Owner Name: NATHAN WORKS
Owner Address: PO BOX 63
GIRDWOOD, AK 99587-
Parcel ID: 075-132-51
Site Address:
Lot Size: 9257 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Privy
[] Private Well
[] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. Ail requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastawater 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.
M.nicipality of Anchorage
Development Services Department
Building S~'ety Division
On-Site Water and Wa.~ewaler Program
4700 Bragaw SLeet
P.O. Box 196~50 Anchorage, AK 99519-6650
www.ci.ancherage.ak.us
(907) 343-7904
Waiver Review Worksheet
WRt/: WR020025 PlD~: 076-t32-5'1 I-La~: ,,
Date Received: ~d23/01
Legal Descdption: US Sewer 3042 Lot 84A TION R2E Section 19
Engineer. Jeffrey A. Gameee P~
~laeka Water & Wastewater Consultente. Inc.
Applicant: Nathan Works
Permit~: swo2ol~
Waiver Requested: 6 feet from the north orooerW line and 3 feet from the weet Drooertv line to the
omoo~ed eeotl¢ evetem.
Criteria: Geology Points:
A. Water Table
.B. Soil Seq~tion
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
Waiver la Granted: f Waiver Is not Granted:
LlstCondifionaorReesonsforebove: c:~E~ ,~,~c(-e,~ ~L,~:*,~-~'~
Municipality of Anchorage
George P. Wuerch, Mayor
Building Safcty Dix~sion
P.O. Box 196650 * 4700 S. Bragaw Strcct
Anchorage, Alaska 99519-6650 · (907) 3~-8301
htt p://www.el.anchoragc.ak.us
6/13/2002
JeffGamess
Alaska Water Wastewater Consultants
Subject:
Waiver Request for US Survey 3042 Lot 84A TION R2E Section 19
Waiver Request #WR020025
Parcel ID #075-132-51
~epartment o~
Public Works
Dear Jeff Garness:
Your request for a waiver of the required 10 feet horizontal separation from the
absorption field to property line has been approved. The approved separation distances
are 5 feet from the north property line and 3 feet from the west property line to the
proposed septic system.
This waiver approval applies to the absorption field to property line separation only. Any
future upgrade to the on-site wastewater disposal system will require all separation
distances be met or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
oe; dall
~' VOn-~i~;'g"~a~; & Wastewater Program
Municipality of Anchorage
Development Sen/ices 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
Permit Number SW
Property owner(s)
Mailing address (1)
Mailing address (2)
Legal description (Lot, Block & Sub'd.) ~-~
Legal description (Section, Township & Range)
LotSize~..~'~ .-~-'~ AcreslSq. Ft.
THIS APPLICATION IS FOR:
Sewer Only []
Sewer and Well "~
.[]
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub []
Swimming Pool []
Therapy Pool []
Day phone
Zip Code
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.
( roperty owner or authorized agent)
Permit Fees:
Date of Payment:
Receipt Number:
(Rev. 12/00)
Date of Payment:
Receipt Number:
MUNICIPALITY OF ANCHORAGE
Development Services Department
On.Site Water & Wastewater Program
4700 South Bregaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Initial
Date Issued: Jun 14, 2001
Expiration Date: Jun 14, 2002
Permit Number: SW010189 Parcel ID: 075-132-51
Legal Description: US SURVEY 3042 LT 84AT10N R2E SEC 19
Design Engineer: 0041 AK Water & Wastewater Consultant Site Address:
Owner Name: NATHAN WORKS Lot Size: 9257 SQ. FT,
Owner Address: PO BOX 63 Total Bedrooms: 4 Permit Bedrooms: 4
GIRDWOOD, AK 99587-
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Privy
[] Private Well
[] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. Ail requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By: ,~~~
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 South Bragaw SL
P.O. Box 11)6650 Anchorage, AK 99519-6650
www.d.anchorage.ak.us
(9O7) 343-79O4
O
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR ~, SINGLE FAMILY DWELLING
Parcel I.D.
Permit Number
Property owner(s) NATHAN WORKS
Day phone 783-1027
Mailing address(I) P.O, BOX 63 GIRDWOOD, ALASKA 99587
Mailing address (2)
Zip Code
Legal desc~'Iption (Lot, Block& Sub'd.) U.S. SURVEY 3042: LOTS 84A & 848
Legaldescflptlon(Section, Townshlp&Range) TlOAl R2£ ~ECTIO,M ~
Lot Slze C~-F7 Acms/Sq. Ft. Number of Bedrooms
THIS APPUCATION IS FOR:
Sewer Only ~]
Sewer and Well
Sewer Upgrade []
4
THIS PROPERTY CONTAINS:
Hot Tub [~]
Swimming Pool
Therapy Pool []
Well Only
Water Storage
Jac~r/'~!
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.
ALASKA WATER &: WASTEWATER CONSULTANTS, INC.
(Signature of property ownor or outhorizod ngont)
Permit Fees: ~-~t..~
Date of Payment:
Receipt Number.
Waiver Fees:
Date of Payment:
Receipt Number.
ALASIG WATER & WASTEWATER
CONSULTANTS, INC.
May 15, 2002
Municipality of Anchorage
Development Service Department
Building Safety Division
On-Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
Reft Revision to Design for Septic System for Lots 84A & 84B; U.S. Survey 3042
ADVANTEXTM TREATMENT SYSTEM
To whom it may concern:
1. GENERAL: A well and septic permit was issued on June 14, 2001, for the referenced
property (Permit #SW010189). We are proposing to change the septic system from a Bottomless
Intermittent Sand Filter (ISF) to an Advantex Treatment System. The following are the design
revisions. The proposed 3 bedroom home will be served by a private well and septic system. The
homeowner would like the septic system designed for a 4 bedroom residence. Two test holes
were excavated on the proper~y. We are proposing to design the septic system around the 30 foot
radii of these test holes. Due to the shallow groundwater and the limited area for a septic system,
we are proposing to use an Advantex treatment system and a pressurized bed type drainfield. The
proposed well is to be located in the area shown on the site plan and design drawing.
2. SOILS: See the attached log, which shows the soil classifications, groundwater monitoring,
and the percolation test results.
3. DRAINFIELD APPLICATION RATE: The intent is to install an Advantex Treatment
System that will allow the use of a small drainfield in the area around the 30 foot radii of the test
holes. Percolation tests were performed in each test hole between the depths of 3.5 to 4.0 feet and
found the percolation rate to be 12.6 and 53.3 minute/inch. Given the percolation rate for test
hole #I, the allowable application rate for Advantex effluent is 5.0 GPD/FTz. Regardless, we are
going to conservatively assume an application rate of 2.0 GPD/FT2. We are providing 2+ feet
separation distance to groundwater.
4. TRENCII DESIGN:
a. Percolation Rate: 12.6 & 53.3 minutes/inch
b. Allowable Application Rate: 2.0 gallons/day/ft2
c. Number of Bedrooms: 4
6901 Dcbarr Road, Suite 2B ~ Anchorage, AK 99504 ~ Ph: (907)337-6179 - Fax: (907)338-3246
d. Design Flow: 600 gallons per day
e. Minimum Absorption Area: 300 ft2
f. Total Depth: 3.0 feet (max.)
g. M.O.A. Approved Leveling Sand: 1.5 feet
h. Effective Depth: 0.5 feet
i. Width: 15 feet
j. Minimum Length: 20 feet long
k. Effective absorption area: 300 ft2
S. ORENCO PACKAGE SYSTEM: The STEP tank with the Advantex Treatment System will
be manufactured by Anchorage Tank & Welding to meet the latest design criteria established by
Orenco Systems, Inc. The point of contact at Anchorage Tank is Lowell McNutt. As with their
standard STEP tank, it is equipped with a high water alarm per M.O.A requirements.
6. SURFACE WATER: There is no surface water within 100 feet of the proposed septic
system upgrade.
7. TOPOGRAPHY: The average topography where the proposed drainfield is to be installed is
a 10~ percent slope running from approximately noah/northeast to south/southwest. In short,
there are no slope concerns.
8. LOT LINE WAIVER: We request that a 5 foot line waiver from the north property line and
a 3 feet lot line waiver from the west property line to the proposed septic system. We are
unaware of any adverse effects on the adjacent properties with the granting of this waiver.
9. CLOSING: I am open to any suggestions from your department that would be an
improvement to the proposed system. I am unaware ofany negative impacts that this installation
would impose on adjacent wells, or septic systems. Ifyou have any questions, please call us at
337-6179. ///
S'm~e, r4~ly,- Z/
NOTE: Attached is a site plan drawing, a design drawing, an Advantex detail, a bed detail, two
soil logs, and a 7page construction specification letter which are all part of the design package
for this septic system.
6901 Debarr Road, Suite 2B ~ Anchorage, AK 99504 ~ Ph: (907)337-6179 ~ Fax: (907)338-3246
LOT 82
US SURV['Y 3042
US SURVEY 3042
PROPOSED SEPT1C SYST[ ,4.- ~.
($r'~' DESIGN. P~E 2 OF 4) ~'' S'"'~TE~.
LOT83
(NO ~
PROPOSED
3 BEDROOM
/ ~ DS[ HO[.DtNO /
va aunvr., o~.~,~ / ~ INSPEC33ON REPORT ~ /
/ / ,.
DATE.: R£VIS[D
,,~ . 5/~512oo2
,__~.. , ..,~,~
ALAS]~ X;WrER & WASTEWATER , J.LM. ~'z~-)Y"';Lg'/H"~'"' '"~,
. CONSULTANTS. INC. ~t.:. -,, ,
PR~ FOR PHONE NUMBS; P~E NUM~:
~.:~.. ............ :....~
NATHAN WORKS (907) 783-1027 10g 4
U.S. SURVEY ~042; LOTS 84A & 84B
SITE P~N FOR PROPOSED SEPTIC SYSTEM
PROPOSED 4 BEDROOM FIBERG~I~S
ADVANT~X TREA1uD, n' ~ WITH
A UFT STA'nON
(SEl~ DETNL, PAGE 3 OF 4
!
!
/
ii
I
/
INSTNJ.
FOUNDATION
LOT 840 ~
~ US SURVI~' .,.x042
\
\
LOT 84£
US SURVEY .9042
ALASKA WATER & WASTE'~,~TER
CONSULTANTS, INC.
PR/PARED FOR: PHONE NUMBER:
NATHAN WORKS (907) 785-1027
U.S. SURVEY 3042; LOTS B4A &: 84B
DESIGN OF PROPOSED SEPTIC SYSTEM (ADVANTEX SYSTEM)
\
US SURV['Y ~042 ~
\
\
NOTE: ~E CO~OR UU~ ~ ~E
FO~OWlNG ~MS SU~D BY A
REGi~ILRED ~D SU~OR PRIOR TO
~ CON~RUC~ON:
1. THE NO~ ~D WE~ PROPE~ UNES.
2. ~E 100' WE~ ~IUS ~OU LOT 84E,
US SU~ ~042.
5. ~E PROPOSED WE~ LO~ON ~D
~E PROPOSED 100 FOOT WE~ ~US.
t ~ ~/ /
~/~/~oo= ?~t. ~%}{~
NOTE: JIM CRO~$.~
p. Ir H~5 THE I
AdvanTex' Treatment System '~''''
AX20 - Mode la :o -
40x94Pod
TO PROPOSED DRNNFIEM)
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
NATHAN WORKS (907) 783-1027
U.S. SURVEY 5042; LOTS 84A & 84B
5/~5/2oo2
DRAWN BY:
J.L.M.
N.T.S.
PAGE NUMB[3~:
50F4
DETAIL OF ADVANTEX TEATMENT SYSTEM WITH LIFT STATION
20 tt~ LONG
18 t"E["'r LONG LK/I~N.S
11~Nll~E D~STPJBU310N UNE~ ARE TO
.25 INCH $CH 40 PVC WITH 1/4
CH DLAMET~ HOL~ SPACE{) 22
INCHE~O. C=',r~ O0 HOL[S
P~ LA'r~,~/~O HO~S ~.).
I
I
I · F'~OM ACVANTEX SYSTEM
AND UFT STA~ION,
/--THE DIS~RtBU110N UN[S ARE TO
/ 1.25 INCH $CH 40 PVC t~ 1/4
MONffORING 1U9£.--~ / INCH Ol,U4Lit. i~ HOLE~ SpACrn
~ / INCH~ON C~ (10 ~
~ M.O.A.
APPROVI~ I.~NG SAND--
ALASKA WATER & ' STEWA'I'ER
CONSULTANTS. INC.
PREPARED FOR: PHONE NUMBER:
NATHAN WORKS (907) 785-1027
IFGN. ~ESCRIPT~ON:
U.So SURVEY 5042; LOTS 84A &: 84EI
'PIPE OF' WORK:
DETAIL OF PROPOSED RED
15 t~.[ ~IDK
5/15/2002
J.LM.
N.T.S.
40F4
ALASKA WATER & WASTEWATBR CONSULTANTS, INC.
PHONE (907) `3,37-6179 * Ir.~((907) 338-,3246
· J SOIL LOG - PERCOLATION TEST J
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE PERFORMED:
U.S. SURVEY 3042. LOTS 84A AND 84B
TOM AND BARBARA SWEAT
7/22/2000
I TEST HOLE JJl I
9-- B.O.H.
10--
11--
12--
SOIL CLASSIFICATIONS
~Gw .~ ORG
~ GP ~ IlL
GC OL
~ o~ ~w MH
..:~ ,., SP CH
t~ ]~ SM OH
~;~ ~sc
DEPTH TO DATE
GROUNDWATER
8.5' 7/22/00
6.7' 7/30/00
"JSITE PLAN "-~C~a,/w. ~
I r = ~oo' I ' "~'~_c,,¥ ,~z ·
7/30/00 PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING
13--
14--
15--
16--
1 8:13 ~ 6'
2 8:43 30 3 5/8" 2 3/8'
3 8:43 -- 6'
4 9:13 30 3 5/8" 2 3/8"
5 9:13 6"
6 9:43 30 3 5/8' 2 3/8"
17--
18--
19--
20
PERCOLATION RATE
TEST RUN BETWEEN
12.6 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
3.5 FT. AND 4.0 FT.
COMMENTS:
PERFORMED.BY'ALASKA WATER & WASTEWATER. I, JEFFREY A. GARNESS, CERTIFY THAT THIS
WAS PER~O~¥~I~ IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON
DATE: ~6 I~.f/O0
ALASKA WATER &: WASTEWATER CONSULTANTS, 1NC.
6901 DEBARR ROAD, SUITE 28 * ANCHORAGE. AK. 99504 PHONE (907) 357-6179 * FAX (907) 338-3246
ISOIL LOG - PERCOLATION T£STI
LEGAL DESCRIPTION: U.S. SURVEY 30~,2, LOTS 84A AND 84B
PERFORMED FOR: TOM AND BARBARA SWEAT
DATE PERFORMED: 7/22/00
..... ORG,~J~ICS
ITEST HOLE #21
2-- ; ; SOIL CLASSIFICATIONS ~ ''
~ ..... '"[SITE PLANI
, · ..... ..<~.., GW ..... ORG I I' = I00' I - 7"~'~lc~
4- , , ~ ~ ~c ~ OL
~-- ~ ~'~ SP ~ CH
GROUNDWATER ~'~
'5.75' 7/29/00
9~
TIME (MIN~ES) RE.lNG (INCHES)
7/~0/00 PERC. HO~ W~ PRESO~ED 4+ HOURS PRIOR TO TE~NG
13~ 1 8:12
2 8:42 30 5 7/16' 9/16"
14m .3 8:42 -- 6'
4 9:12 30 5 7/16" 9/16'
15~
5 9:12 -- 6'
16~ 6 9:42 ;30 5 7/16' 9/16'
19 ~ PERCOLATION RATE '5;3.3 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
20 TEST RUN BETWEEN 3.5 FT. AND 4.0 FT.
COMMENTS: 'BENCH WAS DUG ON 7/22/00 (WATER AT 5.5), FIELD TECHNICAN RAN PERKS ON
7/30/2000. PERK IS IN SATURATED SOIL, MAKING IT CONSERVATIVE.
PERFORMED BY ALASKA WATER & WASTEWATER. I, JEFFREY A. GARNESS, CERTIFY THAT THIS
WAS PERF(~MJED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL CUIDEUNES IN EFFECT ON
DATE: ~IZ'/OO
Sent:By: Alaska Water & Wastewater Consu; 907 338 3246; Aug-25-O0 7:49; Page 2
PROPERTY OWNER MAINTENANCE AGREEMENT
ON-SITE WASTEWATER DISPOSAL SYSTEM
This agreement, dated ~ - 7.2_- ~ ,200/, is made between the Municipality of
Anchorage Department of Health and Human Services (DHHS) and the property owner(s) of
This agreement is made for the purpose of maintaining an on-site wastewater disposal system
on the subject property.
The property owner(s) agree to the following:
The property owner(s) will have an annual inspection of the system performed by a registered
professional engineer. This inspection shall verify that all effluent and air pumps, timers, and
alarms are functioning as designed· Any deficiencies shall be corrected and the engineer's
statement that the system is functioning as designed shall be filed annually with the DHHS.
__.,Owner Name
Property Owner Name
· (Notarize Here)
State of _~.~
.ludicial D~strict ~ SS.
On this ~ day of
year o~OOJ , before me, t~¢ undersigned notary
pu~personally appe:tred:
~J),/~ ~IO~O~C~ Icnowa to mc to be
· c person(s) whose name(s) is/are subscribed to thc
within instrument and acknowledged that he/she/they
executed the same for the purposes therein
contained.
~[tness whereof. I hereunto sxet~my
band
and
'~'~otaD' ~blic {*igaa{ur¢~
June 12, 2001 2:43 PM
From: akglrdwood
Fax #:(907)7831027
Page 2 of 4
B O3863PG069b
DEED OF EASEMENT
Om~tor Nsd,.m Works. Om~or. of Lin 4 Houento~ Mine Road, 0 ~'~i, Alulm
995r/, h~eby ~.,~1:s lo Grantee. Nathan Wedcs e~'Co~ 4 Ho~mlo~ Mk~e Ro~d, Gb'dv,~M, Ala.~a 995~7, a
emsifl me~t ~ nq~o~ lo the ?llov, b~ desc~bed p'qx'rV: .........................................................................................
Lot ~4A U.S. Su~'cy 3042. A,'tcho~ie Recording DL~,rict. Slate o{'Als~ka
P~.-c~: 2 - D~min~flt I~
Lo~ [4B U.S, Sm'~y 3042. Anc~o~ge i{p:o~ding Db~cf, ~ of Alu~
~TATE OF ALASKA
THIRD JUI~CAL DISTRICT
~ f~ego~g instnm~e~ was ~cimowled~ed before me
200l,by NATHAN WOP~,
12- thy or June,
My Cemmt~ ~/D,',2.~:)q ................................
........ June 12, 20~1..2:4;~ PM ........ From:akglrdwood ........ Fax.#:(90?}TS~1027 ........ Page 3~G~4 .......................................
BKO3863P~0699
,/
/
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tO"~ &~t. 2. ~H[ 1~' WELL flAl~bS FROM'LOT"" / ...........................
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.~'Zi~'.'.'..: ................ ,":'","T'~'~-"':':'":':':'::::'.':'::' ~ - ............. ~..,t t~; ........................
~~2~;~'~'~s~'~J~'~'.'~ x:2'~T':'" ~:~'~ ~:i. ~' :'.'.':'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.':.'.'.'.'.
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......... ~ ~ ............................................................................................. ~% .......... .:.,.. ~ ..........................
i~q ~LJRVFy 3042: LOTS A & B
DESIGN OF 'SEPTIC 5Y~[M (ISr)
June t2, 2001 2:43 PM
03999!
From: akglrdwood Fax #: (907)7831027 Page 4 of 4
~ J, I~ Pm ~z: 38 ............................ i~'~'§'~'~'~"~'d"~'Y~"O' ..............................
/'~" REO'UESIED BY
AHCI'IORAGE.
RECOR[:)X~C., eISTR~CT'"'~,C.~'"',r~'~/;~2.~-"7/_~,'</,< ~/~','~Y~ - ............................ ; .........................................................
06/0~/2~00
S07-348oBS3!
We~OwueF Michael Polzin
PAGE
L4x.~tlo~ (ed~m of: Township, l~nge, Sec+Jori. If known; or di~ttnce main rol~
U.s. ~ 30~2 ~c 84F
S~o o! c~inf~ 6" nepth of Hol, 383 feat Cued to 352 feet
8~Ue wlter level 18.7 fL (~ '. ~elow) lind surface. Fiflbh o! well (check one) open end ( X
Seree~ ( .); PAr!orAted ( . .,).,
l:~uc~b~ scr~n or.~ ' ~/~
We~ pump~f test at ~0 .. ~ ~t ~ur)
of ~swdo~ ~ i~tlc b~L )~
H.: '~ '
D*p~ In 2~t from
~o~d
(minute) for
WELt LOG
Oiv~ de~aih of formations penetrated, eize of material, color and hArdneu
);
2. TO &
6. TO12_
12TO 25 ,
___2.f_zo los
1~ TO
2~5TO 255
, 255 ~O, 2?6
,,,
336~O 3~6
3~6'ro 352
Crevel fi11
Ravel: silk/dirty, ~;acerbe~L,~ - umldn't cleanup.
Fractured bedrock
~efl~ock: ~ev black, stltetone az~ilite, ~,~te~ ~ ~-=ac~es
I--CUSTOMER
Municipality of Anchorage .'
DeveloPment serVices Department
· Building'Safety Division
On-Site Water & Wastewater Program
4700 Bragaw Street
P O Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite J /,¢/',,,~./)~""
(907) 343-7904
CERTIFICATE
FOR A
O¥5'W ~2-,5' I
Parcel I.D.-,~,,~'=~-~'~'*~ 05
1. GENERAL INFORMATION
OF ON-SITE SYSTEMS APPROVAL
SINGL~"'FAHILY DWELLING
COSA# (m~,(,~ / ~ ,,/
Expiration Date: ,/
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
U.S.S. 504-2; LOT 84- A&B
228 JEWEL MINE ROAD * GIRDWOOD~ AK * 99587
DAVID & BREANNA HARDIN ~ Day phone
228 ,JEWEL MINE ROAD * GIRDWOOD, AK * 99587
Day phone
754-7297
ERIN EKER W/ DYNAMIC GIRDWOOD Day phone 785-~495
P.O. BOX 50 * GIRDWOOD, AK * 99587
Unlessotherwise ~queste~ COSA willbeheldbyDSD ~rpick~.
2. NUMBER OFBEDROOMS: 2
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well · ~ Individual On-site ·
Individual Water Storage [] ~ Individual Holding tank []
Community Class Well E~. community on-site []
Public Water System [] Public Sewer []
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On-Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems
Approval are valid for 90 days from the date ofissue for properties served by a private or ClasS C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As ceRified by my seal affixed hereto and as of the validation date shown below, f 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 afl applicable Municipal
and State codes, ordinances, and regulations in effect at the time of instaflation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd.
Address 5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Phone 337-6179
Date
Engineer's Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the'system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right Whatsoever.
DSD SIGNATURE
~ Approved for, ~-- bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the fllowing stipulations:
Attachments: COSA Checklist
Septic System Advisory
Well Flow Advisory .
Nitrate Advisory
(Rev. 11/05)
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report'
Other
Original Certificate Date:
M'Unicipality of Anchorage
Development Se ices Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www. muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Legal Description:
U.S.S. 3042; LOT 84 A&B
WELL DATA
Well type PRIVATE
If A, B, or C provide PWSID# N/A
CHECKLIST
Parcel ID:
Well Log (Y/N)
YES
Date corn pleted 6/20/2002
Total depth ,320 ft.
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Cased to
FROM WELL LOG
6/20/2002
15
Sanitary seal (Y/N) YES
320 ff.
Colifor~ colonies/100 mi.
Arsenic:t__ .IL.
SEPTIC/HOLDING TANK DATA
25
.ft.
g.p.m.
Wires properly protected (Y/N)
Casing height (above ground)
AT INSPECTION
6/25/2010
26 ft.
5.61 g.p.m.
YES
24+ in.
I./L.
Date of sample: 6/25/2010
Other baCteria~l~~coIonies/lO0 mi.
Collected by: GEG Ltd.
Tank TYpe/Material
Tank size 1500 gal.
Foundation cleanout (Y/N) YES
Date of pumping -
ABSORPTION FIELD DATA
ADVANTEX/STEEL
Number of Compartments 2
Depression over tank (Y/N) NO
Pumper
I'BELOW EXISTING (~RADEI
Date installed
Cleanouts (Y/N)
High water alarm (Y/N)
Absorption rate >=
Date installed 7/15-16/2002 Soil rating ~r ft2/bdrm) 2.0
Length 20 ft. Width 10 ft.
Total depth '2.9-3.2ft. Eft. absorption area 200 ft2 Monitoring tube YES
Date of adequacy test 6/25/2010 Results (Pass/Fail) PASS
Fluid depth in absorption field before test 'DRY in. Water added 380 gal.
Elapsed Time: - min. Final fluid depth DRY in.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN
7/15-16/2002
YES
YES
System type BED
Gravel below pipe 0.58 .ft.
Depression over field NO
For 2 bedrooms
New depth DRY in.
300+ g.p.d.
If yes, give date -
D. LIFT STATION
G=
Date installed 7/15/2002
TIMER/
"Pump on" level at 32 in.
BOTTOM OF TANK/
Datum BOTTOM OF PUMP VAULT
*SEE ATTACHED INSPECTION
Size in gallons 1500/'43.5
TIMER,,/
'"Pump off" level at 22 in.
Cycles tested *
REPORT: I TANK/PuMP VAULT I
Manhole/Access (Y/N) YES/YES
High water alarm level at 46/36
Meets alarm & circuit requirements? YES
in.
SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+'
Absorption field on lot 100'+
Public sewer main N/A
Sewer/septic service line 25'+
Animal containment areas 50'+
On adjacent lots 100'+
On adjacent lots 100'+
'Public sewer manhole/cleanout
Holding tank N/A
Manure/animal excrete storage areas
N/A
100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line *4'
Water main N/A Water service line 10'+
Wells on adjacent lots 100'+
Absorption field.
Surface water
5'+
100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line *7' .Building foundation. 10'+
Water service line 10'+ Surface water 100'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
Water main N/A
Driveway, parking/vehicle storage 10'+
COMMENTS
*APPROVED PER EXISTING WAIVER #WR020025.
ENGINEER'S CERTIFICATION
I certify that i~have determined through fieldinspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this
date:
Engineer!s Printed Name' JEFFREY A. GARNESS
Date
COSA Fee $ ('~
Date of Payment
Receipt Number
Waiver Fee $
Date of Payment
Receipt Number,
(Rev. 11/05)
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
Arsenic Advisory
Certificate of On-Site Systems Approval # 101106
A Certificate of On-Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block , Lot
84 A&B of USS Survey 3042 Subdivision. This inspection revealed an
arsenic concentration of 192 micrograms per liter (ug/L) for the property's
well water sample. The Environmental Protection Agency (EPA) has
established a maximum contaminant level (MCL) of 10.0 ug/L for public
drinking water systems. While private wells are not subject to this
regulation, EPA standards are based on existing health information and can
therefore be used to gauge the relative quality of water from private wells.
Information on arsenic is available from the On-Site Water and Wastewater
Program website (www.muni.org/onsite) or at 343-7904.
This advisory must be attached to all copies of the subject Certificate of On-
Site Systems Approval.
SGS ReL# 1103064001
Client Name Garness Engineering Group, Ltd Printed Date/Time 06/30/2010 13:53
Project Name/# USS 3042,L84A BB Collected Date/Time 06/25/2010 11:40
Client Sample ID USS 3042,L84A BB Received Date/Time 06/25/2010 12:57
Matrix Drinking Water Technical Director Stephen C. Ede
Sample Remarks:
Allowable Prep Analysis
Parameter Results LOQ Units Method Container ID Limits Date Date Init
Metals by ICP/MS
Arsenic 192 * 5.00 ug/L EP200.8 C (<10) 06/27/10 06/29/10 KDC
Waters Department
TotalNitrate;Nitrite-N ND 0.100 mgFL SM20 4500NO3-F B (<10) 06/28/10 AYC
Microbiology Laboratory
E. Coli
Total Coliform
Negative 1 100mL SM20 9223B A 06/25/10 DLC
Negative 1 100mL SM20 9223B A 06/25/10 DLC
14,4 27'~ ~
-'-" III I IIIII / I/ B! III [] · II IIII ~ (
a · · · lllll I I ! · · · [] · ",,~
· nm,l lib · II · IIIII I lB I m
:lva ® Field Maintenance Report AnchorageTank & Welding, lng
Annual Inspection 907-272-3543
David Hardin j Mi,ke Blakeslee
Site ~dd~ Contact Phone
228 Jewel Mine Road, Girdwood AK 99587 (907) 783-1099
AX-100091 SW020169 12fl 0/2008
Retrieve O&M Info
Dally flow ......
Re~ln= r~tlo
Timer settings-.
Perform Field SamplingfObsewations
j NTU ['IS ~ N"ru,) J pM (6-9) DO ~-~1
Odor ~ ~ple
~plcal ~ Mus~ ~E~hy ~ Moldy
Ol~ .Ira m. ~ ,7~ Yea ~No
C~ek ~m~l Panel
Audible and vi~u~ ala~s ~OK
Dl~ ~ne ~lem~ only} ~y~ ~ No
Inspe~Cle~ ~mp System
In~ Clean
RieerlLId ..................... ~
Measure Sludge/Scum
Sludge Scum
1 st Compamnent Curmit~,* ?,/ Pmvlou~ I Current Previous
2nd Compartment Currant Previous Currant Previous
v'
Inspect/Cleero Advan?ex Filter
O~10~ ~[ Non. nj [] Pungent
Blomat: ~ ~ NormalE~ Exoe$$1ve
Bddgl~ondt~g: ~ No~lnor ~ ~oeeglVe
Iflsp~Olean Dlecha~e Pump S~tem
Inspe~
RIBsr/L~ ~
· pliee Box ~
Inepe~Sa~l~e ~r S~tem Cam~onen~
Inap~ Clean
Dl~nf~tian Equipment ~ ~
Ob~erYatfona
In,poor Clean
Floa~s
Pump
Dispersal Lsterala,-'Odflces [] ~ ,
Additiohal Services Rendered ', .
, ~Cleaned te~lle sheets? [] Replaced LIV Items?
[] ReplaeedtUned other Items? ·"
Parts Used." W .. Wan'amy, B. EIIIleble ((' ~ppn~priate selection) W B Item Number Description
[] Other?
Final/Safety Inspec, tion
~ RSV relns~allecl r~ LJds bo~ed ~n
~Manl~ld moanerS; flush ~lv~ ~l~ed ~on~l ~nel ma~lv~
Summaw~ommendatlons
Fax completed form to 1-BGG-384-7404
~2'~~:'::// /
LOT 84E
..............
............
~. ........... ~' . ....... . . ....
...... , ........~ ~
~~~ ,~ ~,~ .~ ~ ~ ...................
LOT B4-A
WASTEWATER TREATMENT SYSTEM MAINTENANCE AND
REPAIR AGREEMENT
MEMORANDUM OF UNDERSTANDING
BETWEEN MUNICIPALITY OF ANCHORAGE
THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this
~,~ Day of"~ C.~ of 20t 0., by and between~) tt[-t ~' ~-~-I~
herein the "OWNER," and the Municipality of Anchorage, herein the
"MUNICIPALITY." In consideration of the mutual covenants contained herein, the
parties to this Memorandum of Understanding agree as follows:
1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality
grants permission to Owner to utilize and operate an Advanced Wastewater
Treatment System (AWWTS), described as A ~ Ye( ,,v 4- e~ ~ located
at ~k) ~> $ ~D~r ue ~ '~-'~ O~ ~ L ~ qJ~ ~ 8 c/,~Anchorage, Alaska.
2. Definitions.
A. Alteration. Any change to the design or function of an AWWTS that
Includes the installation or removal of any parts, components or pieces not
included in the original construction permit and design. Prior to
performing any alterations to an AWWTS the owner must obtain a
Wastewater Disposal System Construction Permit from the Municipality
pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65.
B. Certificate of On-Site Systems Approval. An approval by the
Municipality of existing water and wastewater disposal systems given at
the time of property sale and title transfer in accordance with AMC 15.65.
These approvals certify that the systems are adequate for the homes that
they support and meet the codes that were in place at the time of system
construction.
C. Damage. Any man-made or natural change in a system that would inhibit
the system from performing as designed.
D. Maintenance and Repair. The scheduled and as needed replacement of
existing parts, components and pieces of an AWWTS that were included in
the original design which would allow the AWWTS to continue to
perform as designed.
E. Permit (Construction) An On-Site Wastewater Disposal System
Construction Permit as defined by AMC 15.65.
F. Permit (Operating) An Advanced Wastewater Treatment System
Operating Permit. An annual permit, issued by the Municipality, that
allows the Owner to operate an AWWTS, upon meeting all the
requirements of this agreement, the conditions of Operating Permit, the
requirements of the On-Site Wastewater System Construction Permit and
3. Fee. (~)
($ C.) .00), payable on or before the issuance of the operating permit and annually
thereafter. The annual fee is due on or before the anniversary date of the approval by the
Municipality of installed system.
4. Term. The term of this Memorandum of Understanding shall be for the life of the
AWWTS.
all relevant provisions of AMC 15.65
Owner shall pay to Municipality an annual fee of
rm begins on the date of approv'aI by the Municipality of the installed system and
shall continue while the AWWTS system is in use or operational or until the property is
sold or title is transferred by owner a~d a new certificate of On-Site approval is issued to
the new owner or transferee of the property.
5. Alte..ra..t..io~s, Installation and Removal of Additional Equ..ipment. Owner agrees
not to make any alterations, removal of parts or additi°ns to the AWWTS without a
Construction Permit from the Municipality.
6. Maintenance and Rel~airs.
A. Throughout the term of this Memorandum of Understanding, the Owner shall
maintain AWWTS in good repair. In addition, it shall be the responsibility of the
Owner during the term of this Memorandum of Understanding, and any extensions or
renewals thereof, at the 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.
Further, Owner agrees to comply will all applicable ordinance, laws, regulations,
rules and orders for the AWWTS.
B. Owner agrees to provide the Municipality a written schedule of routine
maintenance and repairs which have been performed on the system pursuant to the
terms and conditions contained in the Owner's AWWTS Operating Permit. This
schedule shall be submitted to the Municipality annually upon the renewal of the
permit. The schedule of maintenance and repair contained in the Owner's AWWTS
Operating Permit is: -/r'C~ 'i c..~, /~'
C. Owner acknowledges that the fine schedule for failing to maintain and repair an
AWWTS are codified in AMC 14.60.
Owner agrees that only maintenance, repair personnel certified by the
Municipality will inspect and make any necessary maintenance, repairs or permitted
alterations to the system.
E. Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS upon 24 hours written notice.
F. Owner agrees that any sale or transfer of title of the property will not occur
without a new Certificate of On-Site Systems Approval.
G. Owner agrees that the relevant provisions of the standard specification guidebook
for AWWTS is the governing professional guidelines for the construction,
maintenance and repair of the Owner's AWWTS.
7. Nonwaiver. The failure of either party at any time to enforce a provision of this
Memorandum of Understanding shall in no way constitute a waiver of the provisions,
nor in any way effect the validity of the Memorandum of Understanding or any part
hereof, or the right of such party thereafter to enforce each and every provision
hereof.
8. Amendment.
A. This Memorandum of Understanding shall only be amended, modified or changed
by a writing, executed by authorized representatives of the parties, with the same
formality of this Memorandum of Understanding was executed and such writing shall
be attached to this Memorandum of Understanding as an amendment.
B. For the purposes of any amendment modification, or change to the terms and
conditions of this contract, the only authorized representatives of the parties are:
Anchorage: Purchasing Officer
C. Any attempt to amend, modify, or change this contract by either an
unauthorized representative or unauthorized means shall be void.
9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of
Understanding shall be brought in the Superior Court for the Third Judicial District of the
State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and
obligations of the parties under this 1Memorandum of Understanding.
10. Severabilitv. Any provisions of this Memorandum of Understanding decreed
invalid by a court of competent jurisdiction shall not invalidate the remaining provisions
of the Memorandum of Understanding.
OWNER:
Title:
Date: ~ "'g) C) '-' (- O Date:
STATE OF ALASKA
THIRD JUDICIAL DISTRICT
MUN,!CIPALITY:
The foregoing instru_.ment was acknowledged before me this ~:ED day
20 IL?by ~"bO--t~ ,,de."P~c.~-t4'x-c-e'r&~
NOTARY PUBLIC FOR ALASI(A
My Commission expires:
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) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 075-152-51
1. GENERAL INFORMATION
HAA# O ~ O.~.~ '7
Expiration Date: I - ~ '~" O /3/-
Complete legal description U.S.S.
Location (site address or directions)
Current Property owner(s)
Mailing address P.O.
Lending agency
Mailing address
Real Estate Agent
Mailing address
304.2 LOT 84.A , ... ....
P.O. BOX 63 * GIRDWOOD~ AK * 99587
NATHAN WORKS ~ Day phone 783-1027
BOX '63 * GIRDWOOD~ AK * 99587
Day phone
Day phone
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4-
3. TYPE OF WATER SUPPLY:
Individual Well I
Individual Water Storage [~
Community Class Well r-~
Public Water System O
TYPE OF WASTEWATER DISPOSAL:
Individual On-site I
Individual Holding tank ['1
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 samples. (Certificates may be reissued for a period of up to one year with valid
· water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water
system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's
work.
STATEMENT OF INSPECTION BY ENGINEER
As certified by my se'al affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the Health Authorfty 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 ALASKA WATER & WASTEWATER CONSULTANTS. INC. Phone
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Date
337- 6179
Engineer's Comments:
In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
· there are no hidden defects or encroachments. AKWWC, Inc. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
X Conditionalapprovalfor 4 bedrooms, withthefllowing stipulations:
At the time of title transfer the new property·owner shall sign th~ attached
Maintenance Agreement which shall be returned to this office before an
unconditional approval is issued.
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
Manitenance Agreements
· Supplemental Engineer's Reort
Other
(Rev. 12/01)
Original Cedificate Date:
/o -.?..;5
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) 343-7904
Legal Description:
WELL DATA
Well type PRNATE
HEALTH AUTHORITY APPROVAL
U.S.SURVEY ,3042 LOT 84A &: 84B
If A, B, or C provide PWSID# N/A,
Date completed
Total depth 320
Date of test
Static water level
Well production 25
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mi.
Arsenio: N/A mg./L.
SEPTIC/HOLDING TANK DATA
6/20/2002 Sanitary seal (Y/N) YES.
fl. Cased to 320 .ft.
FROM WELL LOG
6/20/2002
15
.ft.
g.p.m.
Nitrate 0.1 mgJL.
10/ 4./2oo3
Date of sample: 9/24./2003
Tank Type/Material ADVANTEX/FIBERGLASS
Tank size 1500 gal. Number of Compartments
Foundation cleanout (Y/N) YES
Date of pumping 9/50/2003
ABSORPTION FIELD DATA
Date installed 7/15-16/2002Soil rating ~r ff~/bdrm)
Length 20 ft. Width 10
2
Depression over tank (Y/N) NO
Pumper
pI~ELOW I~XISTINO GRADEI
5
ff.
CHECKLIST
Parcel ID:
075-132-51
Well Log (Y/N)
Wlres properly protected (Y/N)
Casing height (above ground)
AT INSPECTION
g.p.m.
YES
YES
18"+ in.
Other bacteria 0 colonies/100 mi.
Collected by: AKWWCt INC.
Date installed 7/15/2002
Cleanouts (Y/N) YES
High water alarm (Y/N)
McDONALD'S PUMPING
System type BED
Gravel below pipe 0.58
Total depth '3.0+ ft. Eft. absorption area 200. ft2 Monitoring tube YES Depression over field NO
Date of adequacy test Results (Pass/Fail)
~Nowdepth in
ratest
Fluid depth in absorption field before test in. u Water ad .
· enation treatment (past 12 mo.) (YIN & type) ' NONE ...... KNOWN If yes, give date -
D. LIFT STATION
Date installed 7/15/02 Size in gallons 1500
"Pump on" level at TIMER in. "Pump off" level atTIMERin.
Datum BOTrOM OF' TANK Cycles tested 2+
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
FJ
Septic tank/lift station on lot 100°+
Absorption field on lot 100'-I-
Public sewer main N//A
Sewer/septic service line 25'+
Manhole/Access (Y/N) YES
High water alarm level at 46
Meets alarm & circuit requirements?,
YES
in.
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout
Holding tank 75'-I-
N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'-I-
Water main N/A
Wells on adjacent lots 100°+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line *7'+ Building foundation 10°+
Water service line 10'+ Surface water
Property line *4'+
Water service line 10'+
Curtain drain
COMMENTS *WAIVERS
NONE KNOWN Wells on adjacent lots
GRANTED ON ORIGINAL INSTALLATION
G. ENGINEER'S CERTIFICATION
Absorption field 5'+
Surface water 100'+
100'+
100'+
Water main N/A
Driveway, parking/vehicle storage 10'+
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.
Engineer's Printed?me
Date J o/Z ~/0 ,t'
JEFFREY A. GARNESS
HAA Fee $
Date of Payment
Receipt Number
(Rev. 12/01)
Waiver Fee $
Date of Payment
Receipt Number
10-- 5--03~ 1:44PM; ;907 5615301 # 2/ 3
GS l~ef.#
~ilent Name
'roject Name/#
'.llent Sample ID
latrix
1036236001
AK Water & Wastcwatcr Consultants Inc.
USS 3042; Lot s 84A and 84B
USS 3042; Lots 84A and 84B
Drinking Water
All Dates/Times are Alaska Standard Time
Printed Date/Time 10/02/2003 14:15
Collected Date/Time : 09/24/2003 15:30
Received Date/Time 09/25/2003_ 14:15
ample Remarks:
Allowable Prep Analysis
~rameter Qualifi~'rs Results PQL Units Method Container ID Limits Date Date Init
'aters Department
Ni~=-N
0.100 U 0.100 mg]L EPA 300.0 B (<:10) 09/25/03 JIB
.'~ crobiology Laboratory
Total Coliform
12 OB, No Colt col/100mL SMI8 9222B A (<=l) 09/25/03 KC
10--16--03;18;23 ;CT and E AWWC ;5615301 # 2/ 2
· . : .. --..-.-- ..~---~..~ .-- ~--T.~ .........
... '.'...:."'"..:" ':': '" ".RUSH ' :.."
...z. .......' ' '"'"'
· CT&E Envjronniental Set, ices' linc. :.:' '.: .. · ." .-'- ..
.Lab.oratory: D!vi. si0n ·
' .. · · ".' 200 W.' Potter Drive
]:)finki~ Watcr'A'na]y'sis :Report'~or'Tota! Co]i£orm. Bacteria Anchorpge; AK 99518-1605
· · · ' ' Tel: (907).562-2343. · ' .'
.. ~2~.$T. RU..CTION. S..O~..P3~.EEE~ZD.E.B.~FORE COI. J..E~G $AM.P~ Fa~: .!907) 561-5301 "
· o ~T~UCWA~Jm
IV[U~ BE COMPLETED BY WATER. SUPPLIER.
Year
Treated Wate~
Untreat~ Water'
Time Collected
'Collect~l .By.-
SAMPLE DATE: J'~J'~ '
: Mon~
· SAIVIPLE TYPE:. '
~, . Routine
· m Repent'Sample (for'routi.qe sample
O *Spec!al ]'urpose
Commcnt~:
TO BE COMPLE-I-~,D BY .LABORATORY
Analysis shbws this Water SAMPLE to be:
Satisfactory
0 .Unsad.sfactory
0 Sample over 30 hours'old, results amy.
o · Sample too'l~g in'transit; sample should
not be ovcr,~r~ours old et exnminntion.
to in ,~cate rcliaMc'results..Flcasc send
. ......:
Time ~eceiv'ed Z ..... "' "
· Analytical. ]VIethod: ' ~ Membran'c Fiber o MMO-MU~
D~: ~ 'Timc: ' "
Client· notified of U~iatisfactory results:
[] · ·
· Phoned '..SPb .ke with ~
BACTERIOLOGICAL.WATER ANALYSIS '.RECORD
E~ ce//
Col0nles/l~0 mi
. co~ .nm~.
Coliform/lO0 mi .
Time J'~'~ hfs .
MMo-MUG R~sult: Total C~ltfonn '
Membrane Filter:. 'Dirut C~unt . ~'
Verification: LTB BGB
Fecal Coliform'Confirmation
Final M~'mbrane Fllt*J'
Reporte~i ]~y Date
Faxed
TNTC- r~ Nm. er~ Yv'C~ .
",'. ~,~SGB Membe~ofthe'$GSGro.p{Soci6t~lG,n,ralede~urve|!iance) · '.
;907 5615301
CT&E Environmental Services Inc.
200 W. Potter Drive
AnchOrage, AK 99518'-1605
Telepho. ne: (907) 562-2343
Facsimile: (907) 561-5301' · .-
# 1/
dnking Water' g n a:lysls Report .for. Total .ColiformiBac. t.~ .ria
I~ ': Treated Wate~'
~'- ~1~ :.: I~.ntreated.Water .
200 W. Potter Drive
Anchp.mge, AK 9~}518-1605
Tel: (907) 562.2343' ' .
Analy:~ shows this .W.a~ S. ~VlI'Ltl to ~
· Ratisfaetory
Unsafi~facto~ : ..
Sampl*.ov=r ~'0 hou~' o!~ ~I~ ~y
~ ~,~abl, .... · .
not ~,o~0~ ~ld'~t ei~a~n '
~ ~'reli~I~l~. Pl~e ~d .
.a~.~I6 ~a ~ de~v~.~ .
I6l~ .'
tbw ...
Mcmbmc Filt~
.
' ~I.
.Time .l~eeeived
AnalytiC.al Method:
1036494'-~t~- R~-ult*
· . . · ncli Fbks
Date2 Tim~: :
JuIi
· CIien't no'iff.ed of?nsatisf~ctor,2 .resulis.:.
b'pbke with
SA.MPL,~ DATE:'
SAMPLE TYPE:
Ro~ti .ne
El Witl~ 'lab
Ti~e Collected
· 'Colle~teit J3y.
Comments:
[]
Faxe. d
.ri'
H~ld For confirmation
10- 5--03; 1:44PM; ;907 5615301 # 3/ 3
CT&E ·Environmental Services lnc;
" 200 W: Potter D;'ive
dnking Water Analysis Report for Total Coliform Bacteria .^nchm.e, ^K sss~.~os
· Tel: (907) 562-2343
,READ:X~$.~IIC. TIO, N$ OJY...'RE~V,f~E $,~, ~..I[!7FOJ~F COLLECTIN~.$AMI',J,,E Fax: .(90, ,7}.561-5301
"' '~i~E COMPLETED BY WATER SUPPLIER ' '" T~ BE CQM2PLI~T£D BYL.ABORA. T6RY
K 2PRIVATE WATER SYSTEM .........
WATER & WASTEWA?--ER
phone
~ity
ALASKA WATER ,Er WASTEWATER
5701 g. Tudor Road, Suite 101
Anchorage, alas~ra
Analysis shows this .Water SAMPLE to be:
Satisfactory
[] Unsati.sfactory ..
13 SampIe.ov~r 3'0 hour~ old, results may
be unreliable ·
th. Sar~l~ tooJ~?g i~.transit; sample should
not be?w~;~g.~..o .uzs 0Id'at c~xamination
~o indicat6 reliable mits. Please s~d
.aew..s' .amp.16 via spem..'al delivery.maiL
Date'Ree'eiVed
Time Received ' lq~.~
A.n alysl"s Began _
Analytical Method: ~ Membrane Filter
· 1V~O~MUG
City
S~VIPLE DATE: '
Month
SAMPLE TYPE: ~
[] Ro~,.ti~e .'
[] R;l~it gampl; (for r.u~e safl/ple
wltli.lab re£-i~o: . ' , '"
13 Special Purpose
.SA1VI~LE,LQCATI O,N
· Day Year
[] Treated War. er
J;L Untreated .Water
· Ti.me Collected
1036236
Sent to A.D,E.C.
30 ml.
Result* Analyst
· An'ch Fbks Jun []
Fax.e.d
Date: Time:
Client noiiiled of Unsa.tl.ffact~r~,' re_~u.li~:
Spoke with
Time:
Phbned
Date:
Faxed
MI~O-MUG Result: Total Ci~liform
Membrane Filter: Direct Count
· Verification: LTB
Fecal Coliform Confirmation
Final Membrane Filter Results
'Reported By ~
B~CTERIOLOGICAL ~ATER ANALYSIS RE¢0RD
E. Col~ .-
r, GB · COLIFIRM
TJVTC- ~'~o Numtrmtz To Count
OB - Other B~t~ria
Comments:
Member of the S GS Grou. p {Soci6,6 G6n6rale de Surveitl'ahce)
09Z1312~02 1~:86 90?2767804 ~ E JOr-I~ PA(~' 82
LOT 83
. LOT
~: Jo ~ ~6ed
ZEO 1.£8L(106) :# xe-!
poo,~pJ!§)le :l,u oJ-.!
COOE 'Zt