HomeMy WebLinkAboutSHANGRI-LA ESTATES EAST BLK 3 LT 5Onsite File
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Municipality of Anchorage
On-Site Water and Wastewater Program • (907) 343-7904 Page- 1 of
ON-SITE WASTEWATER INSPECTION REPORT FEB 0 1 2018
Permit Number:
OSP171082 PID Number: 020-043-66
Dwelling: 0 Single Family (SF) ❑ Duplex(D) ❑ Multiple (SF and/or D) Project: ❑■ New ❑ Upgrade
Name: ABSORPTION FIELD
Crown Pointe Inc.
Address ❑ Deep Trench ❑■ Shallow Trench ❑ Bed ❑ Mound
PO Box 112313 Anchorage AK 99511 ❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
(907) 346-1506 5 5.0 GPD/SF 7.8 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 3.8 Ft.4.0 Ft.
Shangri-La Estates East 3 5 Fill added above original grade Gravel length
Township Range Section 0.9 Ft. 15.0 Ft.
Gravel width Beds:Number of Lines Distance between lines
SEPARATION DISTANCES 5.0 Ft. Ft.
To
Septic i Absorption Holding Sewer Total absorption area Number of trenches Dist.between trenches
From
Tank Field Lift Station Tank Line 150 Ft2 1 Ft.
Well >100' >100' >100' N/A >25' TANK ❑Septic ❑� S.T.E.P. 0 Holding 0 Other
Manufacturer Capacity
' >100' N/A Anchorage Tank 2500 Gal.
Surface Water >100' >100 , Material Number of compartments
Lot Line >5' >10' >5' N/ANA Steel 2
Foundation >5' >10' >5' N/A LIFT STATION Capacity
Manufacturer
Curtain Drain None Noted Orenco/Anchorage Tank 2500 Gal.
c ' (t I Pump on level at Pump off level at High water alarm at
Remarks
48 in. 42 in. 54 in.
Pump make and model Electrical Inspections performed by
Orenco/PF2005 MOA
PIPE MATERIAL House to tank D3034Tank to D3034
drainfield
Installer Drainfield D3034 CO/MT
Sanders & Sanders D3034
Inspector J. Millette BENCH MARK (Assumed elevation) 100 ft
Inspection 1$' 12/11/17 2"0 12/11/17 Location and description
dates:
3'" 4m Bottom of front door jam under deck.
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp"...�`��N\
It
Conditional Approval: Date At,Q:•• •...A:
.'1%4A
�: 49 TMI .1
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•••�00 Benjam' - ille , f
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Approve.
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Inspection Report_9-1-12.doc
SHANGRI-LA ESTATES EAST BLOCK 3 LOT 5
PERMIT # OSP171082 PID # 020-043-66
0
U
ON
= — —
LL
2
_
/-102
— — AX-20 POD AND
MANHOLES
/-96.0 s
96.7
95.8
95.4 2500 GAL
2
STEP TANK
4 /
90.7
100.0 FINISH GRADE O
OU 2 /- 99.1 ORIGINAL GRADE U
95.3' ~ — — 95.3
DRAINFIELD ROCK
91.3 15, 91.3—1 l
85.1
NO GROUNDWATER 10/25/17
I
..Z :• •
49 TM f ••*�//
• Benja n Schiller
PROFILE AS-BUILT r���; CE 12592
S.••• Feb 06.20!
(NO SCALE) �I\OPROFESSI0 ��
SHANGRI-LA ESTATES EAST, BLOCK 3 LOT 5
PERMIT # OSP171082 PID # 020-043-66
/
/ /
/ ��
P /--10' T. &\E. E5MT. \ 50'FROM EPHEMERAL CHANNEL
\�P� / \ \
r
"p
LOT 4
IFpy f \ 15'x 5'x 4'EFFECTIVE DEPTH VACANT
yFigy� ABSORPTION TRENCH
// cfY�ti�F� ADVANTEX TREATMENT SYSTEM WI
/ • 1 2500-GAL TANK AND 2x AX20 PODS
1.
\
Y .` (ice TH1 • 2C0 TH-DHI CONSULTING
�p '. v MT��`�,_ MH1 *,d'SV1
P1- CO `�• DEC FCO
LOT 2 \ C — — . ' LOT 5
1
\ \ /
VACANT
Five Bedroom N m co
` HomeI \ w w
t \ \ 1.5 a3
A B C \ \\ \ i •
FCO 21.6 9.0 ‘ / \ \ M
SV1 24.9 12.0 / \ \ _ 1 .
MH 11.4 28.5 \ / \ \
2C0 15.0 27.6 \ / \
CO1 47.4 36.0 \
CO2 60.0 44.1
MT1 59.1 43.8 1 .
t
--\ ---\ \ /
NOTE: \WELL f \ /
`"` Surrounding Lots are Vacant. N I \ /
�.`� \\u, LOT 9 Surface Water is Within 100' of An \ f \ /
Amor °F' :gsiy VACANT Part of the Proposed,Septic System.' / \ L?T 6
4,v •• �)0 9 OI \ \ / \ /VACANT
011'149 TH /\ •*? \ /
1 / LEGEND I
rryrrir.ii.;,--. / MT-MONITORING TUBE
. Benjailler ' FCO-FOUNDATION CLEANOUT
I��9Fc-.• C .•.4 .69 0 50 100 TH TEST HOLE
1 s.•., J 25,zoi��.••F .r = = FEET
4i\\;R.0.4SS--O`� 1"=50' CO-CLEANOUT
ANN,. ,...."4,--- MH-MANHOLE
Alpine Drilling & Enterpris-ds
Well Log
Permit Number: #SW 171082 Date of Issue: 5-17-17 Parcel Identification Number: 02004366000
Date Started: 8-6-17 Date Completed: 8-7-17 Is well located at approved permit location?x Yes ❑ No
Legal Description: Shangri-La East Block 3 Lot 5
Property Owner Name& Address: Crown Pointe
PO Box 112313
Anchorage, Alaska 99511
Borehole Data: Depth (ft) Method of Drilling x air rotary ❑ cable tool
Soil Type,Thickness&Water Strata From To Casing type: steel
stick-up 0 2 Wall Thickness: .250 inches
Diameter: 6 inches Depth: 130 feet
gravelly silt 2 50
Liner Type:
silt 50 54 Diameter: inches Depth: feet
silty gravel wet 54 67 Casing stickup above ground: 2 feet
gravelly silt 67 95 Static water level(from ground level): 25 feet
silt 95 107 Pumping level: 130 feet after
2 hours pumping 30 gpm
gravelly silt wet 107 127 Recovery Rate: 30 gpm
water sand&gravel 127 130 Method of Testing: air lift
Well Intake Opening Type:
x Open End ❑ Open Hole
❑ Screened Start feet Stopped feet
❑ Perforations Start feet Stopped feet
Grout Type: bentonite granules Volume: 2
Depth: Start 0 feet Stopped ?feet
Pump: Intake Depth feet
Pump size hp Brand Name
Well Disinfected Upon Completion? x Yes❑ No
WATER UALITY TESTING Method e:Disinfection: chlorine tablets
Coliform ��.e q CoVIOOmL Comments:
Titrates 1• ?3 mglL
.arsenic N D Well Driller: Alpine Drilling&Enterprises
PO Box 110496
Anchorage AK 99511
Development Services Department
' •
Building Safety Division
On-Site Water & Wastewater Program r Q
ti ~ 4700 Elmore Road = oX
P.O. Box 196650 t+Li l t c
S A ETY
Mark Begich Anchorage, AK 99507
Mayor www.muni.oro/onsite
(907)343-7904
Pump Installation Log
Well Drilling Permit Number: SW 171082 Date of Issue:5/17/2017
Parcel Identification Number:02004366000
IILegal Description I Property Owner Name&Address: �I
Bock 3,Lot 5 Shangri-La East Crown Pointe
P.O.Box 112313
Anchorage,AK 99511-2313
Pump Installation Date:1/6/2018
Pump Intake Depth Below Top of Well Casing: 121 feet
Pump Manufacturer's Name: Goulds
Pump Model:10SHO7
Pump Size 3/4 hp
Pitless Adapter Burial Depth: N/A feet
Pitless Adapter Manufacturer's Name:NIA
Pitless Adapter Installer: N/A
Well Disinfected Upon Completion? ✓l Yes No
Method of Disinfection:7'000k
Comments: Please save,needed for COSA
Pump Installer Name: Aarow Pump&Well Service,LLC
P.O.Box 110496
Anchorage,AK 99511-0496
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
MUNICIPALITY OF ANCHORAGE _�����\\\\
DEVELOPMENT SERVICES DEPARTMENT ��Q •'S,f-,l,
4700 ELMORE ROAD ANCHORAGE, AK 99519-6650 * ••••, . TM ,4,-- *fly
SOILS LOG AND PERCOLATION TEST / • J.
/ Ben' in Schiller
rlie'te•• E 12592 •:C�//
LEGAL DESCRIPTION: SHANGRI-LA ESTATES LT5 BLK3 ll FgFpp••••''P���
PERFORMED FOR: SANDERS 8 SANDERS l\txx ESS '
DATE: 10-10-2017 PROJECT No.: ProfessionalEngineeaScamp:
PARCEL IMP 020-043-66 TECHNICIAN: J. MILLETTE
DEPTH TEST HOLE 1
(feet)
1 11. :4 : SLOPE SITE PLAN
2 (M ':V
`.i:,1iirs,
.l3 ASS!•?u.z::
4 +i'?ii
%k;e
+!ti+. :riy:;iii
5 . ,,,,.
:;:•�1:... SEE SITE PLAN
41
7 hF .T 7•}yy..
i +.. :k SANDY GRAVEL
8 s;=c4cju'•lr WITH SOME SILT
9 i`.; i .
-
g`�, k' WAS GROUND WATER ENCOI NTERED? No
10 ,-::!.24.4.4" — S
e; 1,4.4! y IF YES @ WHAT DEPTH?
Cr;µ,Vi�!,y.
«,�:..��.,,,," DEPTH OF WATER AFTER MONITORING: NONE
,� `1' DATE OF MONITORING: 10/25
12- -P11 r 4;;:
.4:;,.,:^,ti ;, DEPTH To
%:ks e ? DATE READING GROSS TIME NET TIME WATER NET DROP
13 �•1:ti Ol (MINUTES) (MINUTES) (INCHES) (INCHES)
I �,:r•:.4 w;
sr,''''''.i
14 '''` "" ' ` 10/24 TEST HOLE PRESOAKED PRIOR TO TESTING:
15 10/25 1 2:26 0
2 2:36 10 2 3/16 2 3/16
16
17 9 3:10 0
18 10 3:20 10 21/2 21/2
19 II 3:21 0
20 12 3:31 10 21/2 21/2
PERCOLATION RATE: 4 (MIN/INCH) PERC.HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN: 3.5 FT. and 4.5 FT.
COMMENTS:
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Water & Wastewater System Permit
Permit Number: OSP171082
Work Type: WellSeptic Initial
Effective Date:
Expiration Date:
Tax Code Number: 02004366000
Site Legal Address: SHANGRI-LA ESTATES EAST BLK 3 LT 5 G:3239
Site Mailing Address: 16041 MOUNTAIN AIR DR, Anchorage
Owner: ANCHORAGE DEVELOPMENT &
Design Engineer: ANDERSON ENGINEERING
This permit is for the construction of:
Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy
�1»cnt
o�
r
t)epartInent
5/17/2017
5/17/2018
Lot Size in Sq Ft: 46579
Total Bedrooms: 5
Q Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions: A test hole is to be completed prior to construction of the septic field to demonstrate
Jseparation to impermeable barrier and groundwater and to confirm percolation rate. Location of test hole shall
be as shown on permitted site plan. Construction may proceed at your own risk before the 7 -day groundwater
monitoring is complete. If the results require a design change, construction of the system shall stop pending On-
site review and approval of a change order. Please submit stamped and signed results of the test hole with the
Inspection Report/Record Drawings.
C�o -it 1 ( I I � G j 1 i� : Re- � o caA-, c�r c�� -
Received By: V
Issued By:
Date:
Date: 5/Z 7 7
MUNICIPALITY OF AN .- ,! ' AGE
f F�
Community Development Department , ••ne: 907-343-7904
Development Services Division `{ 0 2� — ax: 907-343-7997
On-Site Water& Wastewater Program a MP
4\
ON-SITE SEWER/WELL PERMIT " '_ � I
M. 6
Parcel I.D. 020-043-66
Property owner(s) Crown Pointe, Inc. Day phone 229-1886
Mailing address P.O. Box 112313 Anchorage, AK 99511
Site address NHN Mountain Air Drive Anchorage, AK 99516
Legal description (Sub'd., Block& Lot) Shangri-La Estates East, Block 3, Lot 5
Legal description (Township, Range & Section)
Lot Size 46,579 Sq. Ft. Number of Bedrooms Five (5)
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(®all that apply)
Absorption Field ❑X Initial Single Family (SF) EI
(w/wo ADU)
Septic Tank ❑X Upgrade ❑ Duplex (D) ❑
Holding Tank ❑ Renewal ❑
Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑X
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE 1 WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Si ature • roperty owner or authorized agent)
Permit/Rush Fees: S q fa-i6 = —/$y Waiver Fees:
Date of Payment: e- 11°1/1 `"ma- Date of Payment:
Receipt Number: o33S. Receipt Number:
Permit No. ()G P I i los-2 Waiver No.
Permit App__-.• : c;
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
May 9, 2017
Municipality of Anchorage
Development Services Department
On-Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 5, Block 3, Shangri La Estates East Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 5, Block 3, Shangri La Estates East Subdivision intends to construct a
new five-bedroom home on the lot. We are therefore requesting a permit be issued for
the construction of a new well and septic system to accommodate the home. The
attached Site Plan and backup documentation identify the location and configuration of
the proposed well and septic system along with the alternate site. None of the lots
surrounding this lot are developed and no conflicts are found between the proposed
well and septic system and those on neighboring lots. Drainage arrows developed from
the ground surface contours are shown on the site plan indicating the grade and
direction of flow on the lot. The drainage pattern will not be changed as a result of this
project.
A test hole placed on the lot during the subdivision phase indicates poorly graded
gravel with sand (GP) in the zone specified for the absorption trench. The percolation
rate of the soil was determined to be 7 minutes per inch. No groundwater was found
during the placement of the test hole. A new test hole will be placed prior to
construction at the location shown on the plan to verify the subsurface soil conditions. If
conditions exist other than those utilized in the attached design a change order will be
initiated with a new design reflecting conditions encountered. An application rate of 5.0
gallons per day per square foot was used in the design of the absorption system. We
are proposing to place a new 2,500-gallon Advantex Treatment Tank with gravity flow to
a 15' long by 5' wide by 4' effective depth absorption trench to treat and dispose of the
effluent generated in the house. The elevation of the distribution line in the absorption
trench will be 4' below the surface and the total depth will be 8'. A minimum of 3' of fill
or 2" of insulation and 2' of fill will be placed over the absorption trench and 4' over the
septic tank.
Lot 5, Block 3, Shangri La Estates East Subdivision
May 9, 2017
Page Two
The ground surface on the lot in the area of the septic system slope to the northwest at
a grade of about 10-15%. The new trench will be constructed parallel with the contours
of the slope as much as possible in conformance with Municipal requirements. The
new septic system will be constructed a minimum of 100' from all wells and any surface
water and 10' the proposed and existing water services in the area.
If the system is constructed in accordance with our design the following statements
apply:
1. The system, if constructed as designed, will have no adverse impact on the wells
in the area or those to be constructed in the future.
2. The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
3. The system, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
4. The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current,sr ihage pattern will be maintained.
••' OF :44 °y
Sincerely, »'x.:•'.... .. sa.
•
�.. ( •�
Benjamin Schiller, P.E.
• • - jai 1 Uhlief
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SHANGRI LA ESTATES EAST SUBDIVISION
LOT 5, BLOCK 3
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Five Bedroom Home 5' Wide Trench System
Perc. Rate: 6-15 Min./Inch 2,500 Gallon Advantex Treatment Tank
Application Rate: 5 GPD/SF 4' Drainfield Rock
5 Bedrooms * 150 GPD/Bedroom = 750 SF Absorption Area
750 SF/5 GPD/SF/5 SF/LF (Width)*,5 (Red. Factor) = 15.0 LF Trench Length
THEREFORE: Furnish and Install a Five Bedroom Advantex Treatment System with a 2,500
Gallon Steel Tank with 2 AX20 Filter Pods. Construct a 15' Long x 5' Wide x 4' Effective Depth
Absorption Trench at the Location Shown. Distribution Line to be Placed at 4' Below the
Ground Surface. Total Depth of Trench to be 8'. Maintain 100' Separation From All Private
Wells and any Surface Water in the Area. Place a Minimum of 4' of Cover Over the Treatment
Tank and 3' of Cover Over the Absorption Trench.
Natural
Backfill
3'6"
Geotextile Fabric
6" 4" Perforated
PVC (Holes Down)
Drainfield Rock
4'
5'
I I
TYPICAL 5' WIDE TRENCH SECTION ..••-••����,
(NO SCALE) .4e-\ 4♦1
4c..);• `911
NOTE: Grade Area Over Trench to Drain Away. :.;;L; *II
Minimum 6' Separation From Bedrock. . = .. '9th .
•Minimum 4' Separation From Groundwater. •
Minimum 100' Separation From Private Wells in the Area. 0j(4, BE SCHILLER 0�
Minimum 100' Separation From Surface Water or Streams.//.%�; _`��
No. CE.12592
1j +.6'°•"• " / to i
1 +i,OFESS1 4
DEPTH
(feet)
1
2
3
4
1
1
1
1
1
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 ELMORE ROAD ANCHORAGE, AK 99519-6650
SOILS LOG AND PERCOLATION TEST
LEGAL DESCRIPTION: SHANGRI-LA ESTATES LT5 BLK3
PERFORMED FOR: SANDERS & SANDERS
DATE: 10-10-2017 PROJECT No.:
PARCEL ID#: 020-043-66 TECHNICIAN: J. M ILLETTE
TEST HOLE 1
IAw
COMMENTS:
SANDY GRAVEL
WITH SOME SILT
SLOPE
WAS GROUND WATER ENCOUNTERED? NO
IF YES @ WHAT DEPTH? - L
DEPTH OF WATER AFTER MONITORING: NONE 0
DATE OF MONITORING: 10/25 P i
E
SITE PLAN
SEE SITE PLAN
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH To
WATER
(INCHES)
NET DROP
(INCHES)
10/24
TEST HOLE PRESOAKED PRIOR TO TESTING:
10/25
1
2:26
0
2
2:36
10
2 3/16
2 3/16
9
3:10
0
10
3:20
10
2 1/2
2 1/2
11
3:21
0
12
3:31
10
2 1/2
2 1/2
PERCOLATION RATE: 4 (MIN/INCH) PERC. HOLE DIA. -6!--(INCHES)
TEST RUN BETWEEN: 3.5 FT. and 4.5 FT.
W.0.# 05716 ++i.. \
DHI CONSULTING ENGINEERS .' c., OFA \
800 E. DIMOND BLVD. SUITE 3-545 ai Q� '"••' 4Sf
ANCHORAGE, ALASKA 99515 \,' ( '••./ �,
SOILS LOG-PERCOLATION TEST s a i 9TH j� p*;
II TEST HOLE LOG L5B3 0• ,:••• ••••. •••• •••••
•
0.• . ... ....••
DENNIS •
I. DEE H•` L
PERFORMED FOR: ANCHORAGE DEVELOP. 8C CONST. DATE PERFORMED: 2/01/Q6 �4 (E, .• CE 5807•.'<45`-'4,4.• ` �
LEGAL DESCRIPTION: LOT 5, BLOCK 3 SHANGRA—LA EAST SUBD. +�41 profe c .•
ii it
la
Dote:__ __
"'alp" FROZEN ORGANIC MAT/ROOTS -
SLOPE -
SITE PLAN
"', —
Art
2 s � .L
r°`. .../'-_- REDDISH BROWN, GRAVELLY
'!' SAND WITH SILT P
4 -:. - - -
5 -.. D - G`�.r
6 ° .. . ..
•
• D
7 - BROWN/GRAY SANDY GRAVEL,
D. '•• ROCK TO 4", OCCA. _ i
8 _' •- -_ BOULDER TO 14" WAS GROUND WATER S -- 1 -
-a •
'• D• GP ENCOUNTERED ? NO L -
0 g ` IF YES, AT WHAT O
10 D DEPTH ? P
_ E
• DEPTH OF WATER
• 1 AFTER MONITORING ? 15.6' * DATE: APRIL 20, 2006
11 1
•'° . RPT IC DAM CROSS DIK NEI TONE1 i�IrAI�ERa NET DROP PERC.RAIE
1 ' •• I 2/1/06 2: � 30 MIN. 12' 9 3/6" 3.20
i 60 06-
• • 2 2/1/06433:., 30 MIN. 12' a 13/16' 3.40
13 'A t'73 2/1/0607:00' 30 MN. 6- 4 1/4' 7.06
4:08:00-
D • 4 2/1/06 4:36:00 30 MIN. 6' 4 3/16' 7.16
• 2/1/06 4°39:06-
5 30 MIN. 6' 4 1/4" 7.06
14 - ." - s;o9:66
16 • B.O.H. -
17 PERCOLATION RATE: 7.1 (MINUTES/INCH.) PERCHOLE DIAMETER: 6"
TEST RUN BETWEEN: 4.0 FT. AND 4.5 _FT.
COMMENTS: THIS TEST HOLE INFORMATION IS PROVIDED TO COMPLY WITH THE SUBDIVISION APPROVAL PROCESS AS
OUTLINED IN AMC 15.6.180.B.1. ANY USE OF THIS DATA FOR ANY OTHER PURPOSE, INCLUDING THE
DESIGN OF AN INDIVIDUAL SEPTIC SYSTEM IS STRICTLY PROHIBITED, WITHOUT THE WRITTEN CONSENT
OF THE ENGINEER OF RECORD.
ALL SOILS WERE PRE-SOAKED PRIOR TO STARTING THE PERCOLATION TEST.
0 * NO WATER TABLE FOUND MAY 13, 2011.
PERFORMED BY: DHI CONSULTING ENGINEERS. I DEE HIGH CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 2/07/06 716CSSLD
AND -CROWN POINTE HOMES
THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this
7TH Day of
NOVEMBER
of 20 17, by and betweenCROWN POINTE HOME
herein the "OWNER," and the Municipality of Anchorage, herein the
"MUNICIPALITY." In consideration of the mutual covenants contained herein, the
parties to this Maintenance and Repair Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. Municipality grants permission to
Owner to utilize and operate an Advanced Wastewater Treatment System
(AWWTS), described as
ADVANTEX WASTE WATER TREATMENT SYSTEM
located at (legal description).
SHANGRI-LA ESTATES EAST BLOCK 3 LOT 5
2. Definitions.
Alteration. Any change to the design or function of an AWWTS that
includes the installation or removal of any parts, components or pieces not
included in the original construction permit and design.
Certificate of On -Site Systems Approval (COSA). An approval by the
Municipality of existing water and wastewater disposal systems given at
the time of property sale and title transfer in accordance with Anchorage
Municipal Code (hereinafter, "AMC") 15.65. These approvals certify that
the systems are adequate for the homes that they support and meet the
codes that were in place at the time of system construction.
Damage. Any man-made or natural change in a system that would inhibit
the system from performing as designed.
Maintenance and Repair. The scheduled and as needed replacement of
existing parts, components and pieces of an AWWTS that were included
in the original design which would allow the AWWTS to continue to
perform as designed.
Permit. An On -Site Wastewater Disposal Permit as required by AMC
15.65 to construct and operate an AWWTS.
3. Term. The term of this Maintenance and Repair Agreement shall begin on the
date of approval by the Municipality to operate the installed system or issuance of a
COSA, and shall continue while the AWWTS is in use or is operational or until the
property is sold or title is transferred by the owner and a new COSA is issued to the
new owner or transferee of the property.
4. Alterations, Installation and Removal of Additional Equipment. Prior to
performing any alterations to an AWWTS, the owner agrees to obtain an On-site
Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65.
5. Maintenance and Repairs.
A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall
maintain their AWWTS in a satisfactory condition capable of producing treated
septic effluent in accordance with the equipment's approval for operation in the
Municipality. The owner shall enter into a service agreement with an AWWTS
service and maintenance provider approved by the municipality and the
manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it
shall be the responsibility of the Owner during the term of this Maintenance and
Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay
for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement
costs, and (5) inspection costs.
B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules
and orders for the AWWTS.
C. Upon request by the Municipality, the owner agrees to provide the Municipality a
written schedule of routine maintenance and repairs which have been performed
on the system. When a record of maintenance is documented and maintained by
the system vendor, the owner agrees to allow the Municipality access to this
information.
D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS
may be assessed in accordance with AMC 14.60 for improper discharge.
E. Owner agrees that only maintenance and repair personnel approved by the
Municipality will inspect and make any necessary maintenance, repairs or
permitted alterations to the system.
F. Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS upon 24 hours written notice.
G. Owner agrees that any sale or transfer of title of the property will not occur
without a new Certificate of On -Site Systems Approval.
H. Owner agrees that the AWWTS installation and maintenance requirements as
provided by the AWWTS vendor/installer and approved by the Municipality are
the governing guidelines for the construction, maintenance and repair of the
Owner's AWWTS.
6. Nonwaiver. The failure of either party at any time to enforce a provision of this
Maintenance and Repair Agreement shall in no way constitute a waiver of the
provisions, nor in any way affect the validity of the Maintenance and Repair
Agreement or any part hereof, or the right of such party thereafter to enforce each and
every provision hereof.
7. Amendment.
A. This Maintenance and Repair Agreement shall only be amended, modified or
changed by a writing, executed by authorized representatives of the parties, with
the same formality that this Maintenance and Repair Agreement was executed
with, and such writing shall be attached to this Maintenance and Repair
Agreement as an amendment.
B. For the purposes of any amendment modification or change to the terms and
conditions of this agreement, the only authorized representatives of the parties
are:
a. Owner: CROWN POINTE HOMES
b. Municipality: Director, Community Development or designated authority
C. Any attempt to amend, modify, or change this contract by either an unauthorized
representative or unauthorized means shall be void.
8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance
and Repair Agreement shall be brought in the Superior Court for the Third Judicial
District of the State of Alaska at Anchorage. The laws of the State of Alaska shall
govern the rights and obligations of the parties under this Maintenance and Repair
Agreement.
9. Severability. Any provisions of this Maintenance and Repair Agreement decreed
invalid by a court of competent jurisdiction shall not invalidate the remaining
provisions of the Maintenance and Repair Agreement.
QWNER-
B (signature) Date: %% v
(print name)
STATE OF ALASKA
THIRD JUDICIAL DISTRICT
The foregoing instrument A
20/ 7 , by /,y C
i
ss.
ledged before me this day of I ,
NOTARY PUBLIC FOR AL�SKA
My Commission expires: ," l✓
MUNICIPALITY:
By:_ :UAP d (Ixt& (signature)
IRB be c a A &rry (I (print name)
Date: 1 2 18/00 17
Title:
'1{
STATE OF ALASKA }0
OFFICIAL SEAL }4
Notary Public }4
�{ =
Patrlchl E. Huling }4
_
My commissiop expires }4
MUNICIPALITY:
By:_ :UAP d (Ixt& (signature)
IRB be c a A &rry (I (print name)
Date: 1 2 18/00 17
Title:
• 8c,
•
1 9 �Q i GE BV
;!c-
Munic al of nc r erf ',
V
On-Site Water and Wastewater Progr � , p* i
l 1 ,Ll�
< . i
(907) 343-7904 SAFETY
FL-d U 1 'LM
Certificate of On-Site Systems As; oval w
Parcel I.D. 020-043-66 Expiration ib I' -6 8 4 -��
---'6—1
1. GENERAL INFORMATION
Complete legal description Shangri-La Estates East B3 L5
Location (site address) 16041 Mountain Air Dr.
Current Property owner(s) Crown Pointe Inc. Day phone (907) 346-1506
Mailing address PO Box 112313 Anchorage AK 99511
Real Estate Agent Day phone
2. TYPE OF DWELLING:
O Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 5
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well 0 Individual 0
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
Received by: V / /)/2(2) Date: vfig
COSA to be released to the engineer,unless otherwise requested by the engineer.
COSA Fee $ $ ilt•tig Waiver Fee $
Date of Payment 2/i ji7 Date of Payment
Receipt Number 0R6/9gf Receipt Number
COSA# Of%a ro3? Waiver#
.,- f 0)04.7 ,,: . .
5. STATEMENT OF INSPECTION*BY, NfIE`'7 A ,�'�
•
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 Forge Engineering Phone (907)522-7773
Address PO Box 240773 Anchorage, AK 99524
Engineer's Printed Name Benjamin Schiller, PE Date 2/5/18
iA.* . • TM �i� *?
6. DSD SIGNATUREfil. .. r
•• • p .
System #1 Approved for bedrooms 0° • Benia chiller
System#2 Approved for bedrooms �j{'��... ca/S 592 .' • �• /
Disapproved "''itlF::$5 G"4
Conditional approval for bedrooms, with the following stipulations:
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By: ��A/ Original Certificate Date: -� �— �1
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet S c
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system
Certificate of On-Site Systems Approval Checklist
Legal Description: Shangri-La Estates East B3 L5 Parcel ID: 020-043-66
A. WELL DATA
Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y
Date completed 8/7/1 7 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y
Total depth 1 30 ft. Cased to 1 30 ft. Casing height(above ground) 24 in.
FROM WELL LOG AT INSPECTION
8/7/17 New
Date of test
Static water level 25 ft. ft.
Well production 30 m.
9-p. g.p.m.
WATER SAMPLE RESULTS:
Coliform ND colonies/100 mL Nitrate 1 .73 mg/L
Arsenic ND ug/L Date of sample: 1/23/18 Collected by: Forge Eng
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material
STEP/Steel/Ad v,,,-4,/ Date installed 12/11/17
Tank size 2500 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) Y
Date of pumping New Const Pumper
C. ABSORPTION FIELD DATA
Date installed 12/11/17 Soil rating5-Wide
(g.p.d./ft2 or ft2/bdrm) 5.0 GPD/SF System type
Length 15 ft. Width 5.0 ft. Gravel below pipe 4 0 ft.
Total depth 8.7 ft. Eff. absorption area 150 ft2 Monitoring tube Y Depression over field N
Date of adequacy test New Const ResultsPass/Fail
( ) For bedrooms
Fluid depth in absorption field before test in. Water added gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d_
Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date
D. LIFT STATION
Date installed 12/11/17 Size in gallons 2500 Manhole/Access (Y/N) Y
"Pump on" level at 48 in. "Pump off' level at 42 in. High water alarm level at 54 in.
Datum Bottom Cycles tested New Meets alarm&circuit requirements? Y
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot >100 On adjacent lots 100
> >100'
Absorption field on lot 100 On adjacent lots
Public sewer main >75' Public sewer manhole/cleanout >100'
>25' >75'
Sewer/septic service line 25 Holding tank
Animal containment areas >50' Manure/animal excrete storage areas >100'
SEPTIC/HOLDING TANK ON LOT TO:
>5'
Building foundation >5' Property line >5' Absorption field 5
Water main >10' Water service line >10' Surface water >100'
Wells on adjacent lots >100
ABSORPTION FIELD ON LOT TO:
Property line >10 Building foundation >10' Water main >10'
>50' > '
Water Service line >10' 1
Surface water Driveway, parking/vehicle storage
Curtain drain None Noted Wells on adjacent lots >100'
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and A:1kt.. *4-review of Municipal records that the above systems are in *•49m .•*�i
conformance with MOA COSA guidelines in effect on this date. , •• •
Benjamin Schiller, PE / . • ,...,
Engineer's Printed Name /r•• .. Ben;• ••'
0,4
Eery, in Schiller •�
Date
2/5/18 f CE 12592 ,'`-
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BUILDING DETAIL
SCALE: 1"=20'
AS -BU I L T
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
GASTALD! LANA PROPERTY DEPICTED ABOVE AND THAT NO ,s1�B®1
SURVEYING, LLC ENCROACHMENTS EXIST EXCEPT AS INDICATED. 41 OF *t
JEFF A. GASTALDI, LC IT IS THE RESPONSIBIIJTY OF THE OWNER TO ��R �'•°"•••A<4�..
2000 E. A.DGASTWUNG RD., SUITES DETERMINE THE EXISTENCE OF ANY EASEMENTS, '•. 0
COVENANTS OR RESTRICTIONS WHICH DO NOT if . 49TH '1,17* ;
ANCHORAGE, ALASKA 99507 APPEAR ON THE RECORDED SUBDIVISION PLAT. !•j
PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA •
GRIP -_- I DATE HEREON BE USED FOR CONSTRUCTION OR FOR 0 o effE.,-6091 told •°4o it