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HomeMy WebLinkAboutKARD LT 2Kard Lot 2 #0! §- ! 63-46  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 Page 1 of On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number:. SW020466 PID Number:. · 015--163--46 Name: BILL ECKHARDT Wastewater System: [] New [] Upgrade Address: 11361 HIDEAWAY TRAIL ANCHORAGE AK, 99511 ABSORPTION FIELD Phone: No, of Bedroomm: (907) 786-2755 *5 I-1 Deep Trench n Shallow Trench rlBed rlMound IIS-WID£ Total ~ from Or.nd grade: LEGAL DESCRIPTION ~' "~': 3.0 -.o/~, ~ 5 Block: L~t: Subdlvleion: Death t~ pil~ bott~ fn~ mlg~nal gm6e: G.r,~ ~1 ben. th I~: - 2 KARD 3 r~ 2 Township: Range: Section: RIi added ~ edg~al gn~e: - - - SEE DWG r~ 35 WELL: [] New [] Upgrade 5 n. 1 Claeea'mat~m (P~,~3te. A.B,C): ~ Cae~I To: Tetal ebeeq~n area: P~pe material: ~ ~ ~ 250 s~. r~ D 3034/ F-810 ~ A+ HOME SERVICES 8/2003 ~ i&~M I pum~ ~ At: Ft. ICe,rig He,bt N~we ~round~. TANK SEPARATION DISTANCES = S,.t~a=Holding E] S.T.E.P. ,Other T~'"',.,~TM Septic Absorption Uft HoldSng F~4~e/Pdwte U~n~actamc. Tank Field Station Tank S.*~ U.,* ANCH TANK 2000 ,rom--.... Well 100'+ 100'+ 100'+ - 25'+ STEEL 2 Sa.ac. Wot., lOO'. lOO'+ lOO'+ - - LIFT STATION S~ze In gel~: I Lot Une 5'+ 10'+ 5'+ -- - 2000/82IANCHORAGE TANK/ORENCO SYSTEMS 'l~ump eh' ~ et: 'Pump eft' ~ at: ~ wet~ alarm et: Foundation 5'+ 10'+ 5'+ -- - TIMER/25" TIMER/14" 46"/39" Curtain Drain N(~NE KNOW~ lump ~ · lax~: a.e~l In.~-uo~ I,*~on~s I~. M0DFI 30 1/2HP M.O.A. Remarks: BENCH MARK ~ end OLD SEPTIC TANK WAS ABANDONED PER U.P.C. TOP OF PORCH RAILINO POST '3 BEDROOM HOUSE. SEPTIC SIZED FOR 5 BEDROOMS EXISTING CUTBANK LOCATED 35' EAST OF *"""~"'~h,~'' i"100.00 DRAINFIELD REQUIRES NO WAIVER BECAUSE SLOPE FROM 2' ELEVATION ~='¥v ..... .~"< ~ ABOVE DRAINFIELD TO TOP OF CUTBANK IS LESS THAN 25, ~_~....~ ,~ ~ ..~!~, Inspections performed by:. AKWWC, INC. Dates: 3rd2ndlSt 1/6/20031/8/20031/6/2003 ~,' '~'" ')::j~f; ............... ,~ *~'*~ i~'~'~i ~.i.: ' ' '~,:" Development S ;rvices Department Approval 'O~e~"~. '~l~'[.'._", ...... "~;~ R v ewed and approved by: JF I PERMIT NUMBER: swo2o,6. AS- BUILT DRAWING P,~C~.o 015-163-46 I \\ , EXISTING I \ I ^ . ~ I % ~1 ' 42.0 21.4 · ~:'r~ ';~. ,.~"";: ~ · 'v'." .' '. ..... ~. ~ · . ' ~ .''.'.* '. -~;'"~'"' ' , I I' ~ MH2 ~.7 ~.2 -- ,'~.,,', ,' . .~ ." ."~: ,".~'-'. -'.... ~I~NO Iu~t"'.':'..-'~:.'"':: '- ' '-":"..--~/ m - ,.~ ~., j. ,Q.. : .., .. : .',., ,.~ ~//~~~ ~ ~N ST~P T~K W~ ~ J I ~0 '' · A PUMP VAULT ~ REOUIR~ NO W~ BEMUSE ~// / ~OD J I --~----~ / -- I I I ' ' I / ~~ s~ I / I 1/8/2003 ~C~ .~./~ ~ ~, ~V~_ ~.. :':.~..~ ~ ALASKA WATER & WASTEWATER B.s.G. CONSULTANTS, INC., SCALE: 6~01 OEBAR~ ROAD. SUITE ~'~1 · ANCHOI~AGE. AK qq$o& * PHONE (q07)~37-617~ * FAX {'qOT)338-~&6 1 I~ ~ 40I PREPARED FOR: PHONE NUMBER: PAGE NUMBER: BILL ECKHARDT (907) 546-2700 2 OF 3 LEGAL DEF:~CRIPTION: KARD SUBDIVISION; LOT 2 TYPE OF' WORK: AS-BUILT OF SEPTIC SYSTEM UPGRADE (ADVANTEX SYSTEM) A B C ST1 42.0 21.4 -- POD 47.6 27.0 - MH1 55.6 55.2 - MH2 58.7 58.2 - MT1 - 58.0 ~8.5 UT2 -- 88.9 60.3 P~.~ ~u.B~: AS BUILT DRAWING P~C~,O ~u.~: SW020466 ~ 015-163-46 /,-'-*TOP / 95.90 (AVG.) ...... TOP OF ADVANTD( AX-20 POD / TOP OF MANHOLE IGI'<AD~_ OVl~J< lANK ~ ' ' :.' ORENCO PUMP VAULT :,; '; T'rO TRENCH - 91.,35 ~ /-RELATIVE ELEVATION OF Bo'rroM OF TEST ~ /HOLE .= 82.,35 (GROUNDWATER O 84..85) PREPANED ['OR: PHONE NUMBER: PAGE NUMBER: ~I~-- KARD SUBDIVISION; LOT 2 AS-BUILT 0~ SEPTIC SYSTEM UPGRADE (ADVANTEX SYSTEM:) '~%%~ R~h%FAX AM EDS. ELECTRIC 1/18/2003 5:31 PAOE 1/1 RiBhtFAX Inspection Report Iqunicipsllty of Anchorage, Building 8aha. ty Division 4700 eouth' BraDaw P.O1 INSPECTION: VOICE 343-8300 Name Legal Subdivision Comments or Directions INSPECTION: FAX (907)249-7777 INFO: 343-8211 ED'S EL~CTRTC 11361 HIDEAWAY TR LT2 KARD Pm'mit 02-9755 PhonJ 272-4591 Ihspectlon Date 1/17/2002 AM .AM CALLTO HEET Inspection Retm I:lectrlcal Z'.'~. /*- .: 1~ .'~ ,. Reln~ectlon N ~0 NONCOMPLIANCE OBSERVED'~".;' [] CORRECTION5 ESSENTIAL AS EXPLAINED BELOW WILL RE-EXAMINE AT NEXT n [] INSPECTION DO NOT CONCEAL UNTIL REINSPECTION · COHMENT-~: (for Inspector use only) ' 4. "" / ';// · ~:. <.' ' i ~,' 4 ' ~/v; /4' ,'/ MUNICIPALITY OF ANCHORA GE Development Se/vices Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Nov 20, 2002 Expiration Date: Nov 20, 2003 Permit Number: SW020466 Legal Description: KARD LT 2 Design Engineer: 0041 AK Water & Wastewater Consultan' Owner Name: Bill Eckhardt Owner Address: 11361 Hideaway Trail ANCHORAGE, AK 99511-2167 Parcel ID: 015-163-46 Site Address: 011361 HIDEAWAY TR Lot Size: 49362 SQ. FT. Total Bedrooms: 5 Permit Bedrooms: 5 This permit is for the construction of: [] Disposal Field [] Septic Tank [--] Holding Tank [] Privy [] Private Well [] Water Storage Ail 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: 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) 343-7904 Parcel I.D. ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING 01~-16~-46 Permit Number Property owner(s) Mailing address (1) Mailing address (2) I~ILL ECKHARDT 11561 HID~WAY TRAIL ANCH. AK. Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) Lot Size /~:~,_~'2~;;2- Acre~ THIS APPLICATION IS FOR: Sewer Only ~ Sewer and Well Sewer Upgrade [] THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool KARD ~./D: LOT 2: Number of Bedrooms Day phone 786-2755 Zip Code 99507 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. ALASKA WATER &: WASTEWATER CONSULTANTSr INC. Permit Fees:.~ ~"~00°- Date of Payment:' DI ~ ID~"" Receipt Number: ~'I~5'~ b Waiver Fees; Date of Payment: Receipt Number:. ALASIG WATER & WASTEWATER CONSULTANTS, INC. - October 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 Proposed Well and Septic System for Lot 2; Kard Subdivision; ADVANTEXTM TREATMENT SYSTEM To whom it may concern: 1. GENERAL: The existing 3 bedroom home is served by a private well and septic. The property owners are adding a new addition to their home and require a septic rated for 5 bedrooms. Three test holes were excavated on the property. We are proposing to design the drainfield around the 30 foot radius of TH#3. Due to the limited area around TH#3 for a primary and reserve site, we are proposing to use an Advantex treatment system and 5-wide pressurized type drainfield. 2. SOILS: See the attached logs, which shows the soil classifications, groundwater monitoring, and the pemolation test results. 3. DRAINFIELD APPLICATION RATE: The intent is to install an Advantex Treatment System that will allow the use of a 5-wide drainfield in the area around the 30 foot radius of the TH#3. A percolation test was performed in TH#3 between the depth of 4.0 to 4.5 feet and the rate was <1 minute/inch. The insitu sandy soils will act as a sand filter. The Advantex system has received class II approval, so the allowable application rate is 4.0 GPD/FT2. We are going to conservatively assume an application rate of 3.0 GPD/FT2. 4. TRENCII DESIGN: a. Percolation Rate: <1 minutes/inch b. Proposed Application Rate: 3.0 gallons/day/fi c. Number of Bedrooms: 5 d. Design Flow: 750 gallons per day e. Minimum Absorption Area: 250 fl: f. Total Depth: 5.0 feet (max.) g. Effective Depth: 2.0 feet 6901 Debarr Road, Suite 2B ~ Anchorage, AK 99504 ~ Ph: (907)337-6179 - Fax: (907)338-3246 h. Width: 5 feet i. Reduction Factor: 0.70  Minimum Length: 35 feet long · Effective absorption area: 250 fi2 Note: the distribution line is to be 1.25 Sch. 40 PVC with ¼ inch diameter holes spaced 13 inches on center (30 holes total). 5. 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 MeNutt. 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 in the area of the proposed drainfield is a 10%- 15% slope running approximately east to west. In short, there are no slope concerns. 8. 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 tdjacent wells, or septic systems. If you have any questions, please call us at 337-6179.~ ~.E Sincerely, NOTE: Attached is a site platt dra,ving, a design drawing, att Advantex detail, a trench detail, a topography draw#tg, three soil logs, and a 7 page construction speciftcation letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B ~ Anchorage, AK 99504 ~ ?h: (907)337-6179 ~ Fax: (907)338-3246 I I ~ I I I I I ~ON S/D; I I LONGVIEW S/D; ~ LOT 2 I I LOT 4 I I I WORLD TOP ACRES S/D; I I I LOT 4 ~ I I I I I APPROXIMATE I \ I I ! i I \\ I / LARSON S/D I ~ ~ ~ 11300 SNOWUNE DR. LOT lA J C"~'~L-1:~BC I"~'~.~")1 (SEE DESIN, PAGE 2 Or 4) I t I I CASSL-rrA S/D , J KARVIEW S/D; \\ / I LOT 1 I ALASKA WATER & WASTEWATER , ,, CONSULTANTS, INC. , 1" ~t/..~..: KARD SUBDIVISION; LOT 2 '(/~,. '1.1j .." ,~_~ff IYPE OF WORK: ~ ",, I \ NOTE: THE CONTRACTOR SHALL HAVE THE 100 FEET WELL RADIUS AND THE SOUTH LOT LINE FLAGGED BY A REGISTERED LAND ~. I SURVEYOR PRIOR TO CONSTRUCTION. I NOTE: THE P~OPOSE~ SEPTIC S¥STE~ ~S L '~ I \\ I ~g2°-' """~ · -""-' ~1 x ~~.~:.'i:'. ~ ~ -/ , · ::'r" ...~!. o..;;..-: J.';,:,' ;'. '~'-.: ';../; ..-,,' I [',,, \. / i · ~" :.':' :." ' ' :'.; ':': ~- : "',": : :': ' ~X~S~N~'~'"'¢ '---' ' '~ / ..... I' " '"'" """" "~" ""* ' '" "" ~ ~ "" ~ --.. AB, AN N PER U.P C. ~ I ~ t /-"'.. ~'<~'//I;'~' ~ COM~,~,~-¥ ~..~oo.a~ ' I ~ .... ~ %~, 1, I ~' '"'"'.-- ~ ~ ~ '""" ..... J ~PROPOSKD ~000 CALLON $.T.K. Po T~NK ....... .W ~ ~ ~-2o ~ Poo ~o ^ ~uMP ~ r.u~.----Z." V^UL~ (Sa: Drr~:L. P~[ 3 Or 4). '\X /' r ...... \ - X-/ ............. · ~ %~ / 5 FEET Da:P BY 5 FEET WiDE BY 55 FEET LONG. ADD I. %! UNE IS TO BE 1.25 SCH 40 PVC WiTH 1/4 INCH HOLES \ I /~ sP~Ca~ ~o ~.c.~s o. C~r~R (3o .OLDS ~OT~.). I /' ~-,~--~'~ ~"~ \ I I I I /"%0 ,o0. ,~,, I *MEASUREMENTS ARE FOR MOA PURPOSES~,r ~ ALASKA WATER t% WASTEWATER sc~:., ?"~'"':" ,, GONSULTANT$.ING., ' = ~0' ~ :I"7 .... :"~" PR~ FOR: PHONE NUMBS: PAGE NUMBER: . ~ ~ ........... BILL ECKHARDT 546-2700 2 OF 4 KARD SUBDIVISION; LOT 2 q~."-.. / .."~ DESIGN OF SEPTIC SYSTEM UPGRADE (ADVANTEX SYSTEM) AdvanTex Treatment System ~ I"°~; ,,M CRO,,.~ ,0~ THE .~ ,.su~,=o, TO .E P.E. HAS THE INSTA! trO OVER THE SILPiiC TANK ac 4' AX Series - Mode 1 a (~ ~v,~x ~u,~ .r~ON. o. ~ S.D~S ~cm UN.*R THE N)VANTEX FILTER. THIS WlU. ALLOW One (1) 40x96 Pod o.~,..,...--- for ,,*~ .~,TTO TOTH~ ~SC~ .~R FROM ,~ov~TANK .." FROM TANK TO FILTER INLET~ (~ ~ - I LET (~ ~ PUMP VAULT ~DRNNF1ELD 0 POD /~ _~ ~1~_ SEWER INLETE~E]~I ~ -~ / : ~ ORENCO I I IIIII - '~ IIIII I /~VAU[T r ~ I ti [-- .OREN¢O .... CONSULTANTS, INC., ....... Gq01 DESARR ROAD. SUITE 2e ' ANCHORAGE. AK OgS0z. * PHONE (~07)3~,7..617g · FAX (q07)558-3Z~.6 N,T.S, ....... .ILL ECKHA.DI (907) 7~-2755 5 OF 4 KARD SUBDIVISION; LOT 2 ~E or WORK: DETAIL DRAWINO OF ADVANTEX TREATMENT SYSTEM THE DISTRIBUTION UNE IS TO BE 1.25 INCH SCH 40 PVC PiPE WITH {' HOLE~ SPACED EVlD~ 10 INCHIrC: ON CENTER (50 HOLES TOTAL) HOLES SHALL FACE DOWN. ~ MT I ............................... I PUMP VAULT I I [ I MT RNAL RIOINALf GRADE INSULA'RON--~ 2 OF ' 5 FL~f WIDE , 11/15/2002 ~R~EDBILL FoR:ECKHARDT PHONE .UMeER:786_2755 PACE:4NUUaER:oF 4 '"'J~4~ (907) KARD SUBDIVISION; LOT 2 ~,"~,. i, .... '" .~,~ -- ~, · ,, CONSULTANTS, IN,C,., ..... ....; ................... ISOIL LOG - P[RCO~TION TE~TI ~" ORGANICS 4-- :GC OL l 7-- GROUNDWATER DATE , 11-- DATE READING CLOCK NEI TIHE WAIER LEVEL NEI DROP TIHE (HINUIES) READING (INCHES) 12_ 9/18/2002 I 5:36 - 6- _ 2 5:46 10 15 -- 5 5:52 - 6- _ 4 4:02 10 4 1/a' I 7/8" 14 ~ 5 4:05 - 6- _ 9 4:27 - 6- _ PERCOLATION RATE 5.7 (HIN./INCH) PREC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 2.0 FT. AND 2.5 FT. 20 ~ A FOUR HOUR PRESOAK WAS PERFORHED: ~ YES ~ NO SOILS LOGGED BY:. SU~N OSW~T PERCOLATION TEST PERFORHED BY: MA~ FISHER COHHENTS:. PERFORMED BY AK~C, INC. I, JE~ A. GARNESS, CER~ T~T ~IS W~ P~RFORUED IN ACCORD~CE WITH ALL STATE AND MUNICIPAL GUIDELINES IN E~ECT ON THIS DATE: t~ I t~/o~ DEPTH TO DATE GROUNDWATER 4.5 9/13/2002 4.3 9/18/2002 1.2 !0/26/02 _~u_~sI~ ]sa & ~XS'i~-~.~a:'~ii''' /.~--~'"' ''/- PERFORMED FOR: BIm ECK~DT DA~: 9/13/2002 ~h~'".. EP~ ,..t) ~///j NEST HOLE SOIL C~SSIFICATION$ ~ ~w :~ o~G i , ORGANICS ~ GP ML j  SP CH :~: ~-~ ......... ., --- ' SM ~ SC / ' ~lm~,,,,,,=' ~ ~ ..~ .... .~,~ ~. ,, , 7~/T/;; DEPTHTO ' ~_ ~'~ ....... ~ J "' 5.0 9/13/2002 ............... ~ .............. ~--~L ................ D~ .... 4.5 9/18/2002 j~C ~// 3.75 10/22/02 , / ~o 3.o lO/2S/o2 ~ t I 11 DATE READING CLOCK NEI TIHE WATER LEVEL NEI DROP TIHE (HINUTES) READING (INCHES) ~/18 /2002 I 3:34 - 6- - 2 4:04 30 3 4:06 - 6-. - 4 4:36 30 4" 2' 5 4:37 - 6- - 6 5:07 30 4" 2" PERCOLATION RATE 15 (HIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 3.0 FT. AND 3.5 FT. A FO~ HOUR PRESOAK WAS PERFORHED: I YES ~ NO SOILS LOGGED BY: SU~N OSW~T PERCOLATION TEST PERFORHED BY: ~ FISHER COHHENTS: PERFORMED BY AK~C, INC. I, JE~ ~ GARNESS, CERTI~ T~T THIS W~S ~ERFORMED IN ACCORD~CE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: l, DEPTH TO GROUNDWATER DATE 5.0 9/13/2002 4.5 9/18/2002 3.75 10/22/02 3.0 10/26/02 CONSULTANTS, INC. ITEST HOLE tt"l TOP4 FEET W~ LOOSE GM/SM MORE SM/S~LT WrrH DEPTH SOILS LOGGED BY: COMMENTS: SOIL CLASSIFICATIONS GP ML GM CL GC OL SW NH SP CH SM OH SC DEPTH TO GROUNDWATER DATE DRY 11/8/2002 1~.5' 11/12/02 iI.~~ 1~/15/o2 DATE READING PERCOLATION RATE TEST RUN BETWEEN CLOCK NET TIME WATER LEVELI NET DROP TIME (MINUTES) READING I (INCHES) <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 4.0 FT. AND 4.5 FT. A FOUR HOUR PRESOAK WAS PERFORMED: I-lYES I NO JODY MAUS PERCOLATION TEST PERFORMED BY: JODY MAUS PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WA~; PI~RFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: S~nt By: Alaska Water and Wastewater Con; 907 338 3248; 0ct-1-02 1:33PM; Page Municipality of Anchorage ~~. Development Services Department Bailding Safety Division On-Site Water and Wastcwatcr Program 4700 Brag. aw Strtet P.O. Box 196650 3mchoragc. AK 99:519-6650 www.cl.anchoragc.ak.u$ 0O7) ]43.79O4 PROPERTY OWNER AGREEMENT FOR THE MAINTENANCE OF AN ON-SITE WASTEWATER DISPOSAL SYSTEM This agreement, dated ~)c~r~o, ~, ~0&Z-, is made between the Municipality of Anchorage Development Services Department (hSD) and thc property owner(s) of: This agreement is made for the purpose of malntalning an on-site wastcwatcr disposal system on the subject property. The property owners agree to the following: Submit to the Municipality 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, and that any deficiencies have been repaired and that thc system is functioning as designed. r ~ - - (5ignatmc) (Signature) (Printed Name) (Printed Name) Thc Foregoiag Inslxument was acknowledged ~fore me by xJ' (Ih'am B. TY. hOX '[' on this I dayof With my han d seal. Notary P. ublic (Signature) (Notary's printed name) My Commission Expires "i NAME MAILING ADDRESS EGAL DESCRIPYION LOCATION ~ I I Well ~ ~ Absorption area / DISTANCE TO: / I ~ I / P ~ / Manufacture~ ~ ~' ~Liq. capacity in gallons/ ............ Inside length MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAl. PROTECTION ENVIRONMEN'I'Af_ ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OF~ WELL INSPECTION REPORT PHONE tiwellh/g NO' OLBEDR~MS No. of compartments(.w.~j Liquid deptb Liquid capacity in gallons Founclation PERMIT NO, Distance between lines Total [enoth offlines Material beneath tile tA,~ I DISTANCETO: ]Well Ma ture,' DISTANCE TO: I No. of lines~-- / Length of eact; line Top of tile to finisb Eength W~dtb ~ ~ Crib diameter ~ ~ Well DISTANfiE ED ; IClass Deptb DISTANCE TO: Buildin9 foundation Material r~st Iot lin widtb incbes Depth Total effective absorption area PERMIT NO. Crib deptb Total effective absorption area Building foundation Nearest lot line Driller Distance to Jot line PERMIT NO, Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS TEST RATING ~NSTA L LER//,~ REMARKS APPROVED DATE LEGAL l FI F:' F::' L I C F! N T L, 0 C F! "F I 0 N L.E:GF!L ;L::2,::I.O KEI'.,I'T'L'T' CT. L. O'T' :51 Z E TYF'E OF:' SOIL.. I:IBS;OI:ii:I':"T'iOI'.,I '.:!;'T'STE:H :I::5: 'TRENCH HI::I::':: :[ HUH I'~L.tl'"l[ii:El:;;: OF: E:E:[:,I::~:C.::)HSE; =: 3 SOIl_ F:FYFIhlG ,::S~::! FT,..'EJR:: .... :L25 THE RE(;!L.I:I: F':IED S :[ Z:E OF: THEE ::.50:1: L FIB'.:~;OF:F:'T I ON Sh"S't"EI"'I I S: THE L. ENEi'f'Fi [> :1: t"!E:N:~; :[ Obi I S THE L.E:NGTH < ]: I'.,1 FEET ::, OF:' THEE TI:;:Ei'..,ICH OR DRFI I NFI EL..[::,. 'T'HE [:,Ei:::'TH OF FI 'T'REF,IL:.:H OR PIT ]:S THE [:,IL-";]"Ftt'.,ICE BETHli.:.EI'.,t THE: SLff;~:F'FICE OF' THE GF::OLIN[:, RN[:, "1"1-.t[~:: E,'OTTOr'I OF THE IEXCfl'v'FFI"IOI'.,I ,:::[t'.,t F'EET>. 'T'HERE ]:5; NO %E:T I.,.I :I: [:,]"H F'OF: 'TRENCHES. THE GRFr,,,'E'L. [:,EI':'TFi IS:; THE H]:NIHLIH C, EPTH OF GRFI',/EL BETHEEN T.kfE EHJTI:::'FiLI... F'IF'E i::11'-,1[:, TFIIZ BEFFI'O?I OF' THE E:XCFI'v'F:i'FI 01'.,I ,:: :1: N F'EET>. PERH :[ T FIF:'r::'L :1: CF:IhI'f' HFI!{; THE F:ESFu3N'.:!; I [ii~ I L :[ TY TO i' hlFORH TH I S [:,EF'RRTHENT [:,I_IF;;: :[ I",IG THE: I i",IS-;'FF:ILLI::IT :[ 0t",1 I NSF'EC. T Z OI'.,tS OF' F:It'.,P.r' FIE:LES FI[:,JI::ICEi'.,FI' "I"O 'I"H ]: '."~; F'RCd::'EI:;it"FY I::llql::, THE I'.,IIJHE',E::I:;: OF' RESII::,ENCE~; T'HF:I'F T'HE HE:L.L. 1.4IL. L SEF.':',,,'E:. Eq:IC:I<F: :[ L.L.. Z i",IG OF' FINY [:'EF'FIF.':'I"HI!:.::I",I'T' H 1[ I.._L E',E SUE',J'EC:T "1"0 PF.".OSEC:UT ]101'.,!. I"tt I'.,I l HLIH F.:, I S'TF~NCE E:[:::]"P.!IEEN Iq I,.IEI....L. F:II',I[:, FII'.,!Y OI'.,F.-S I TE SE:F.IF:IGE [:, I :._'SF'OS. iRL. SYS'I"EH I ::tJ;;:lO I::'EE"I' FOR Ft F'RI'v'F::I'I'E FIEL. L OR :LDO TO ;;2:00 FEET FROH Fi F'I...IE,'LIC I,.IEL. L E:,EF:'E!'.,I[:,:[N(:~i LIF'Ot'.,I THE "FYF'E OF I::'UBL:[C 1.4EL. I. .... H]:I'.,I]:HLIH I:::,I:~;TFINC:[~:: I:::'F:OH F:] PR :[ 'v'FFI"E I.,.IEL. L. TO FI PRI',,,'FITE: SEI.,.IEF:: L. INE iS 25 I:::'EET i::11'.,1[:, TO I:::1 COHHLtN]:T'Y SEI.,.tER LINE :['5 7'5 f:EET. OTH[i:F: I';;:[ii:~:::!l...I :[ REHEI'.,ITS HRY FIF'PL.Y. '.:':';PEC I F' I CRT 101'.,t'.'3; FIN[::, C::O.NS]"Fi:UE:T t ON E:, :[ FIGI:~:Flt"IS'; FIF:E f'¥v'l::l Z L. FIE.3L..E TO I hI'_:;Ui:~'.E F'ROF'EF;~t :1: I",IS]"FIL.LFIT:!: O1'.,I. I C:E:F~:'I"]: F"T' THF:I'T :l.: I Fill F'Fli"IIL:[Ftl;:.: .b. IITH "FHE: REQIJ:[I::~:EHEI'.,I'I"S.; F'CIF,~'. CII'.,I-...:~!;ITE ':_-",E,[,IER:!i; Ri'.,I[.', HELLS I:::]S:, '..'~;E]" F'OR]"H B'T' THE HI...li",l I C: I F'I::II.... :1: 'f'Y OF' Fti",ICHE~RF:IC~i[:::. ;':ii:: I H ZL..L INS'T'FIL. L. THE: S,Y'-STEH :I:?',1 !::~CCOR[:'F!I",ICE !-,.IITH THE COI:::'ES. 3: Z I..IN[::'EF.:~;TFII",I[:' ]"HFFT THE ON'""S]:TE ':_':;EIDER SY'..E;T[-:H HI:::IY F.'.EQUII:;':E EI",!L. FIRGEHENT :[t:::' THE RE:S:!:E:,E'I'.4CE I':S REHI::~[::,E:LED I:::Ll...IE:,Ji.:: i"IORE TF.IFII'.,t ]: E~E[:,F..:CIOHS. S t GNE[:,: FtF'F'L I C:l: E:R ! FII",! D. I",INE':::I:::'Y :[ '.'i?L':; U IE [::' . ..................................... "," 4. 0 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: ~/~'~ ¢'} ~.~\ ~--4~-¢rt)l ~J.,~, DATE PERFORMED: LEGAL DESCRIPTION: ~.-~ 'F Z /~ ~.f"- O,~ 1 2 3 -~4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS WAS GROUND WATER S ENCOUNTERED? C-/~, ~ ~) DEPTH? "-~ PERFORMED BY: SLOPE SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT 72-oo8 (6/79) Certificate of On -Site Systems Approval Parcel I.D. 015-163-46 Expiration Date: Z 3 Legal description KARD LT 2 Site address 11361 Hideaway Trail Anchorage Current property owner(s) Bruce Kuzyk X The On-site system(s) is/are approved for 5 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 2/7/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory X Arsenic Advisory Other COSA Approval_June 2022 Mumnp ury OF ° HC HOR OE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-163-46 Complete legal description Kard Lot 2 Location (site address) 11361 Hideaway Trail, Anchorage, AK Current property owner(s) Bruce Kuzyk Day phone 2. ON-SITE SYSTEMS SIZED FOR 5 BEDROOMS 3. TYPE OF WATER SUPPLY: 0 Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: © Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 20 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ® AWWTS ❑ Bed ❑ Deep Trench ® Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ Waiver Fee $ Date of Payment 2 Date of Payment COSA # OSC *2 3 1 OV Waiver # COSA Application—June 2022 Septic Tank Advisory Certificate of On -Site Systems Approval # OSC231021 Subdivision: Kard Block: , Lot: 2 The septic tank for this property is 20 years old. The average life for a steel septic tank is 20 years. Typical replacement costs range from $7,000 to $11,000. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like. Mailing Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org `� 1/25/23 2.71 20 20 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 of 2023 , by and between herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Advantex AX20 located at (legal description) Kard Lot 2-11361 Hideaway Trail, Anchorage 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) C.,'SLJ 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. Ci 5,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). 0%,J 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. &5,J 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. c%S `J Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. (, Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. G,3 W Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. Qi51'J 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. L'S IJ 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 OV*rNE, By: STATE OF ALASKA THIRD JUDICIAL DISTRICT (signature) Date: .(print name) ) ss. MUNICIPALITY: By: (signature) CoA -11-13 r0 (, v --.5 r;/vp (print name) Date: Title: (rev. 05/18/2018) Page 3 of 3 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 5 A F E T Y Certificate of On -Site Systems Approval Parcel I.D. 015-163-46 Expiration Date: 1. GENERAL INFORMATION: Complete legal description KARD; LOT 2 Location (site address) 11361 Hideaway Trail *Anchorage 99511 Current Property owner(s) Bill Eckhardt Day phone 227-2755 Mailing address Real Estate Agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 5 4. TYPE OF VVATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ y 12. 50 CO U10 Date of Payment Receipt Number COSA # 05C2_015012 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: L 0[� In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and 000apOp�� industry practices. The reported results describe the condition of the system/s on the date/s of the o�F t. Q evaluation. Separation distances were measured to readily identifiable features. Hidden defects or O "'� •`� �Q encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and ;�Q �9 TN,�j� .Y� workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and;""'"/i�r�'i� are outside the control of GEG. Satisfactory test results do not guarantee future performance of the ;1 l system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of i/I the well or septic system. GEG makes no representation whether an alternative well or septic system /O 1, '.eF,t� Gayness: can be installed on the property in the event either of the current systems fail to perform adequately in Q 9•!';, CE=' 7953 �r ••' �„G the future. The content of this report is for the sole benefit of the person/party that retained GEG to �4 srf L^�• p perform the evaluation. Reliance upon the information provided in this report by any other person or 04P ed p0 �� i F°o party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. D—f-1GNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms \QP5TYfOF(rr��/���� Disapproved `J Conditional approval for bedrooms, with the foltbvrig s I �xf dR Anir, r. Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist4—C Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other 121 Legal Description: KARD; LOT 2 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 1981(?) Total depth `"81.3 ft Cased to UNKNOWN ft ® Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 10/9/20 Parcel ID: 015-163-46 Structure served by this system 1 Well production at time of test 4.8+ gpm Water storage tank volume **1500 gallons Well disinfected for coliform test? ❑ Yes WE No El Coliform bacteria is Negative Nitrate o4, 15 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ®Arsenic less than MRL (ND) Collected by GEG, LTD. Date of Sample 10/8/20 Static water level at beginning of test 61.4 ft. Comments 'PER GEG INSPECTION ON 8/9/20 "AGRICULTURAL STORAGE FOR GREENHOUSE NOT PLUMBED TO HOME (PER OWNER) B. TANK DATA Age of tank(s) 17 years Tank type/material STEEUSTEP Measured operating fluid level in septic tank 111A"11 ® Standpipes/foundation cleanout per record drawing Date of pumping SEE ATTACHED MAINTENANCE D. ABSORPTION FIELD DATA TRENCH Which system tested (date installed) 1/8/03 ' ® ALL standpipes present per record drawing Total measured depth from grade 4.91 ft (max) C. LIFT STATION ® Required maintenance completed Age of lift station 17 years Lift station material STEEL Comments: SEE ATTACHED MAINTENANCE ADVANTEX SYSTEM Adequacy test date 10/9/20 Results F. / -]Pass For 5 bedrooms Fluid depth prior to test 0 in Measured depth to pipe Invert from grade ft (min) Water added 896 gal ® N/A — pressurized field �I New depth 3 in Q Monitor tubes go to bottom of effective. If not, state Elapsed time 120 min depth into effective L❑ Code -required soil cover over field Final fluid depth 0 in nE System presoaked Absorption rate 750+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NONE date of test) Gallons introduced '`1123 gallons If yes, enter date N/A Comments/Deficiencies: *PRE-SOAK PERFORMED ON 10/8/20. SEE ATTACHED EMAIL FROM OWNER REGARDING FREEZING COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' [Q *50'+ Community Sewer Manhole/Cleanout > 100' ❑ Yes if No ft ❑✓ Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No *50'+ ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' ❑ Yes if No *50+ ft Water Main > 10' Animal Containment > 50' ❑/ Yes if No ft ❑✓ Yes if No ft ❑✓ Yes if No ft Water Service Line > 10' ❑✓ Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway comment below Community Sewer Main > 75' 7 Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' [Q Yes if No ft Surface Water > 100' ❑ Yes if No *50'+ ft Property Line > 5' Q Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No ft Private Wells > 100' ❑ Yes if No *50+ ft Water Main > 10' 0 Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ❑✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ✓❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓❑ Yes if No ft Private Wells > 100' ❑ Yes if No *50 + ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' R Yes if No ft Surface Water > 100' ❑ Yes if No *50'+ ft F. ENGINEER'S COMMENTS *CAT III AWWTS - FIVE BEDROOM APPROVAL IN 2003 WITH A SINGLE AX -20 POD. G. ENGINEER'S CERTIFICATION I certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet l; �: ,,...........r....... Jeff` e Gorne`ss.- 9, � �r?�E-79-53-y -f •'� Q�� Professior°© #AECC884 L, OD _ � J c c3 O-co7 N C O (n CL Z = m m •- > w Q coo pap!ntpgnsul _ -a � �•o�c (0UQ °co In •�I- Z5 p u Om0)j 'O n nO"O ?' O No 0 0 "yC. C'C ON Q 7' vl C U QO: .- Oc C N C "0 o6 i-- O N N N't,9 � M„6 � �90000S r 2 - M _ a ° N o U)o W N O (Q . N u) •y X J E- a C O U r`. U O��' N 3 °N- Qc m�`�m of E N C E O. E>' JQ ` O -O F N --------ivaWaseB A�!I!�fl �O W O C� ¢ C C 7 c C O p U G L ° Q N Z C)O m u O QUcv 3 m° E° N c s-a Of c =off d a> U UF Q)U•-r >-o NU- >° a c l O QO a�aci°c@3� W o1 o z s UJ m� o ¢ N'5° 3 L) N .q c o o c3 ° m a r-�mc> �w° ro2N f-S pc o j :5 ° n`-°oo°c �o c as N 1 J 2' N C N N j d N E U ((0 ° .Q L U T -C U C O N N O C r Co O O Q) O (— C ( O m O C 0.0 0 O N Q 'C O- U O O Y LL U Sa,C C C +N QmroN O C CmpQOQ O O°UUm -0 �•O 'C 00- N 0 2a0c-ommi0'a o tU Q E cc m w i >0 0), m o W N QNm• O O O O W C N 'O N O •p N p U N @ Gl oosz as �rr� ��, ° • bis i� �,� ° C)i N 0)°CY)• O r N m ♦ U N oo.00 �aC. °. Q9•� Lc-0 °'�c°� _ = I00 J. o�.. e�ro mm p LO v' a> e0 441 - O c W c m V• e"V... o N •O .D C E LOLO o I m O •Oy{ I o (� • y �F•�� p N C OG) S ca E ° �a - C C z511 0 cn �® N Q _ �mE = 0 0-8 5L _0 F O J I u o 0 o 3 N 6 0.2ri - i2 V c°om Ci I o G Q) �c C r� -�m 9 9LZ a p 'S m d� �02`-°m H soap a w .p o f m U N15 u s ° N l W SG f rn m c c } V O CL fn N w O N 6- 3L r U + -v N N �' O m O ='olSN CO U} C� titer 0 v N Q 77�— � -- }— N N m N ro c — -- O !l J L O N m m N d U Y — = N L6 v9 G 3..00 O.00N ,- .N p - b a =� O ei v co m o b- — 3 n o IMI I AVAAV3 (]f H o o W w W LoOfT�- li p=zz �- wZQLD IL W �: -� 0,ozr�- U wCOofcn o f!i wwcn Qw nem o,o=Qa-J QZ WF-0..Z) MUNICIPALITY OF ANCHORAGE OEPARTMENT 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 ~ -5'(., ~ HAA # 1. GENERAL INFORMATION Complete legal description Lot 2; Kard Subdivision Location (site address or directions) 11361 Hideaway Tr~l Anchorage, AK property owner Mailing address, Lending agency Mailing address Jim & Elizabeth Berqman P.O. Box I12167 Anchorage., Day phone 346-2287 AK 99511~7167 Day phone Agent Robert Arms/ R~max Properties Address 2600 Cordova Street Anchorage, AK Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 ~ TYPE OF WATER SUPPLY: Individual well X×X Community well Public water NOTE: Day phone 244-6138 99.503 If community well system, provide written confirmation from State ADEC,at,test- lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: XXX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72~)25 (Rev. 1/91) Front MOA #21 sl. uewwoo leUO!l!PpV :suo!~elnd?,s BU!MOIIO¢ eq~. 4~,!M 'SWOOJpeq ~Ot leAo~dde leUO!~!puo3 · sLuooJp@q -~ ~.~L/, I 'pa^o~ddes!ci Jot pe^o~ddv '-~ ~l~nl~fNglS SHHO '9 ~uN~IPALITY OF ANCHORAG~ ENVIRONMENTAL ,~F. RVICE$ DI Municipality of Anchorage ~U~ DEPARTMENT OF HEALTH & HUMAN SERVICES - Environmental Services Division 825 L Street, Room 502 * Anchorage, Alaska 99501 * (907) Health Authority Approval Checklist Legal Description:/~ 7~'.2, / A. WELL DATA Well type ./~z-~,.4 Log present (Y/J:¢')~ ~ o Total depth ~.0" Sanitary seal (d~N) Y'~,~-'.-~' If A, B, or C, attach ADEC letter. ADEC water system number Date completed /¢/ ¢"/ c- Cased to /?1 O' "/- Casing height (above ground) Wires properly protected CC/N) FROM WELL LOG AT INSPECTION Date of test ~/"/-'~'"~,'-' ~-'-','~ '~ ~'/~ ~ ~-~' Static water level Well production g.p.m. WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate I. '~/ Other bacteria ~"~'/? -,~-~'6 Collected by: .-~ ,-'C/i//2 ,¢ ,z~.;~j~z..4.~'/r-~/~"~-~-z,)~'~ B. SEPTIC/HOLDING TANK DATA Date installed ~/7~/ Tank size/-'¢O¢ ¢;4/- Number of Compartments ~ CleanoutsC¢)N) Y/~'% Foundation cleanout Date of Pumping ~;4;~ C. ABSORiSTION FIELD DATA Depression (Y~N'¢ ..-z./ Pumper ~ ¢,.~o High water alarm (Yfl~' /z/o Date installed ~-~/'7.¢~'/ ' Soil rating (g.p.d./fFc~ff~ /2.,~-"" Systemtype ~Z¢*-~'~,'¢ Lengih" ~/Z / Width/-/',c.-e',~'~'~--'-'¢ Gravel thickness below pipe /7/ '~ ''/Total depth c>,,/ Effectivb ~bsorption area ~ 7¥ (%~¢C)Monitoring Tube present ~/N) Y~:'~' Depression over field (Y/~¢,~ ,'~'¢ Date of adequacy test '~"/~ ~ ~,2~ Results ~s~ss~,Fail) ,/'~/}-~.~ For ~ bedrooms Fluid depth in absorption field before test (in.); ~' ~' Immediately after z/7¢' gal. water added (in.): Fluid depth ~ / (ins) Minutes later: ~'~,2 Absorption rate = ~'~,"'-¢2 ,-/~ .g.p.d. Peroxide treatment (past 12 months) (Y/~~'v'°/cZ~ ,Z'~~' 0¢¢~.,t/ If yes, give date 72-026 (Rev. 3/96)* ~(96/~ 'Aebl) 9~0-~/- U!'eJp u[e~,JnO j a~,li~M eoepn$ eu!l ApedoJd :O/lOq NO Q-I'::IIH NOIJ.d~IOS~3V IAlObtJ 'qONV/SICI NOI/¥bIVd=lS slOI lUeOe[p~ uo SlleM .~/, ~/eBeu!eJp/JeieM eoepns' ~ ¢.~/ eu!l eo!AJas/u!eLU JeleM 'Ple!J uo!ldJosqv _/ / ._? eull ~lJedoJcl ¢/ ~ uo!~Pun°-I :OL.LO'I NO NNV~ 9NIQ-IO~ I~O~=1S3ONYLSIa NOI2VMVdBS ~le leAel ,jjo dLund,, S~]ONVISIO NOI.LYI=IYd="S ']] ,, h 6 ~l.e leAei ,,uo dLUnd,, ~"..~7/'( SUOlle6 u! ez!s '0 CT&E Environmental Services Inc, Laboratory Division ~~,~,~.~r~r~-~r~j,,~,a~J~me-~rmm~'~'~m 200 w. Potier Drive Aachorage, AK 9951 8-1605 Tel: (907) 562-2343 Fox: (907) 561-§301 CT&E Ref.# 963079,963079002 Client Sample 1D Lot 2 Ka[o Matrix Ddnldng Water FWSID 0 Sample R~mark~: Collected Date 07/17/96 Technical Director: Stephen C, Ede Released By ~ ~'. ~ Paramoter Resu[t~ qC PQL Qu~L Nitrate-N Total coliform Unit~ Method 1.40 0.100 mg/L EPA 353.2 col/100mL SM1B 9222B Allowable Prep Analyaig Init Limits Date pete 07/19/96 EMB 07/19/96 lAV U - undetected LT · Less than GT - GreeteP than D - Secondary Dilution J · Below the cat(bration range I~~ Member of tho 8GB Group (Soci6t6 G6n6rele de. Surveillance) ENVIRONMENTAL FACILITIES IN ALASKA, CALIFORNIA, FLORIDA, ILLINOIS. MARYLAND, MICHIGAN. MISSOURI. NEW JERSEY. OHIO, WEST VIRGINIA CT,&,.: E~vironmental Services Inc. '-"5--~'~ L~bO.~orY ~ivi~on ~ ..mkm= Water. ._lysis ? . RE.4.D L"'$TR&'CTIO.V$ 0.V p~vEP, SE SIDE SgFOR~ CO~LECTI.VO $.43[P£E TO 3E COM?¢ETE,D B\' $.<,". ~ LE DATF,: 5[onlh ~ Repeat Sompl~ (for ~ou~ine sample wilh (~b rcf. no. ~ · J07~ Z~ 0 Special PurpoSe 5Ab'~Cg LOCATION Da.,,' Yc'a¢ 0 Teeatcd \V~ter Time Collected Collected . Analytical .Method ~--~"'"'.',(~mbrz~e Fillet g .'4MO-.MUC, SOo;.< '- BACTEP, IOLOGICAL WATER ~'q.-%LYSIS P,.ECOP,.D Coliform Confirmation BGB E, C 0 L I F[K'O,t.. Colil'o rm!tOg mi Time [ S'-C~'-2 hfs F~xcd bfONICIPALITY OF ANCHORAG% DIVISION OF ENVIRONMENTAL HEALTH DEPARq~ENT OF HEALTH AND ENVIRONb~NTAL PROTECTION APPLICATION FOR I~ALTH AUTHORITY APPROVAL CERTIFICATE 1o General Information Application Date (a) Legal Description (include lot, block,~ subdiyisio~n s.ectio~ t~gwns~ip~ range) Location (address or directions) ~ ~ ~___//. z_./~~-/ . ~r~ ~ ..................... (b) Applicants Nam~_~/~.~L~.~_ _Telephone_-- Home Business Applicants ~dress buyer ~ ; Other ~ (explain); (d) Lending Institution Telephone Address (f) Mail the HAA to the following address: 2o ~ of Residence Single-Family~ Number of Bedrooms Multi=Family~ Other (describe) 3o Water ~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status° Sewage Di~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] .Engineerin~ Firm Providi~n I~ec_tio_n_s._Testp, File Search~ Data 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 infoz~ation 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 regula- tions in effect on the date of this inspection. Name of Firm__~7~ ~ ~F ~ ~z ~f ~,~f ~ DHEP Approval Approved for ~)~;g~:L ~ bedrooms Approved ~ ,.- ,~ ~ __/~ ,~ ~.Z .' ~.,~, :. ' 7'~-' "v ,'~' 7~'~'~''' ' ' 5'~ ....... -~ ..... : ....... Disapprovedy Co~i~ion~"~ Temns of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY ~N INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA° THE DHEP DOES ~{IS AS A COURTESY TO PURC~iSERS OF HOBOS AND THEIR IgNDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED, THE MUNICIPALITY OF ~CHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 UNIC; AUn, Or Ae - DEPT, OF HEALTH MUNICIPALITY OF ANCHORAGE (MOA)ENVIRONM~NI'AL PRO'rE63'IO~ HEALTH AUTHORITY APPROVAL (HAA) MA~ ~ 0 ~9~5 CHECKLIST- FEBRUARY 1984 264-4720 ~ F C F I Legal Description: ~ ~ 'f' ~ ~ V~u', WELL DATA Well Classification _/¢~/ w, ~.... Well Log Present (Y/N) , Total Depth L~/~ ¢' Cased to 4/`0 ~'~ Static Water Level Casing 14eight Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: If A, B, C, D.E.C. Approved (Y/N) /'~./~ Date Completed ,/~"¢' / Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) " .,.v' Depression Around Wellhead (Y/N) ~ To Septic/Holding Tank on Lot /¢¢ To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results -~"~'~ Comments ; On Adjoining Lots /&~ ~' /o~ ¢~ ; On Adjoining Lots /~ ~'- To Nearest Public Sewer To Nearest Sewer Service Line on Lot ;Date B. SEPTIC/HOLDING 'TANK DATA Date Installed /9 ~/ Size /¢~>~ ¢i~/ No, of Compartments "~ Standpipes (Y/N) ,/I/ Air-tight Caps (Y/N) 7 Foundation Cleanout (Y/N) Depression over Tank (Y/N) ~ Date Last Pumped Pumping/Maintenance Contract on File (Y/N) /1//4 ; for Holding Tank High-Water Alarm (Y/N) zV Separation Distances from Septic/Holding Tank: To Water-Supply Well /¢o d-- To Property Line / 0 + To Water Main/Service Line __/¢¢ ~ Course /[/,¢ '~ ~L Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field ,.5" · ,¢/4- To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 72 026(11/84) ~ jo Z: e6ed (-'"XL"')* ¢~ )b $ :lUnOLUV .~ -' 0~-' ~ ~',-- luauJ~d Jo Oleq SlUeLULUO0 (N/A) sapoo leOp$Oel:3 NOI/'¢/S .L-ll-I 'Q --g ~ ~,/1/ (luasoad ,t!) Nueqlno oJ. ..f. ¢~ s)o-I 8u!u!ofpv uo ~ uo LUO~S,~9 pouopueqv Jo 8u!ls!X=l o± _¢ ~/ ou!q ~podoJd oJ. S~UOLULUOO eeJv a6eJOlC:d elo!qaA JO 'eeJv 6upi~ed ',~eMOA!JO O± asJnoo eSeu!eJC] JOfelAl Jo/e)iel/puod/uJeaJ1S oI ? ~ ~, uo!l~puno-I 8U!Pl!n~] afl. _¢ e~/ IleNt ,(Iddns-Jele~ o/ :Plan uo!ld~osqv LUO~ @OUelS!O uo!le~edes 1SOl ,%enbepv lse-I jO sllnseb] (N/A) pla!J Ja^o uo!ssoJdac] eeJV uo!ldJosqv jo lao-I oaenbs I ~/ pellelSUl oleC] eleJ1S uo!~dJosqv u! 6u!le[J silos Y.LYQ (3"1:11:1 NOIldI:IOSaV '0 ' D A .ir~-'~ ~(~'E i V E D I NSPECTI ON APPOI NTM ENTS -~'~ M E TIME TIME DATE DATE DATE INSPECTOR : INSPECTOR INSPECTOR ¢ y. LOl, . MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE  DEPARTMENT OF HEALTH & ENVl RONMENTAL PROTECTION DEPT. OF 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ,%C rEC'HON ENVIRONMENTAL SANITATION DIVISION [J[~ ~ Telephone 264-4720 REOUEST FOR APPROVAL OF INDIVIDUAL WATER AND sEWEI~E~I~'~IVS~ D I DIRECTIONS: Complete all parts on page 1,1ncompleterequestsw not be processed Please allow ten 10 days for processing. 1 PROPERTY OWNER ~ I PHONE r~A I [~I'N G ADDRESS .... . PR~PERTY RESIDENT (Iffdifferent from above) ~r /' PHONE 2, BUYER PHONE MAILING ADDRESS 3, LENDINGINSTI'rUTION I PHONE MAILING ADDRESS 4. REAL~TOR/AGENT///~/~ [ PHONE MAI LING ADDRESS 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE ~;;]-~'~'1 N G L E FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One [] Four [] Two [] Five J~;]~'"~h r ee [] Six [] Other 7, WATER SUPPLY [~"~iNDIVI DUAL* [] COMMUNITY [] PUBLIC UTILITY 8, SEWAGE DISPOSAL SYSTEM [~'"'1 N DI VI DUAL/ON-SITE** [] PUBLIC UTILITY * ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date,~give well depth(attachlogifavailable.) ~)(~/~.C, i ~'),~OJ/ ~/~0~ /'~'~'/o¢ / YEAR ON-SITE SYSTEM WAS INSTALLED, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1, TYPE OF RESIDI:NCE NUMBER OF BEDROOMS [] SINGLE FAMILY [~] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBEI~ 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY -- DATE DRILLED [] PUBLIC UTILITY Connection Verified. LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []iNDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY ~1 Connection Verified INSTALLER []Septic Tank or E]Holding Tank Size: / O~-20 If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL ~ /) 4. DISTANCES Septic/Holding Tank IAbsorption Area Sewer Line I Nearest Lot Line WELL TO: I Absorption Area to nearest Lot Line 5, COMMENTS [~P'PROVED FOR -~3 BEDROOMS [~] CONDITIONAL APPROVAL. (letter must accompany certificate) [] DISAPPROVED DATE BY 72-010 (Rev. 6/79) A¥/~¥':1(I I H