HomeMy WebLinkAboutRABBIT CREEK VIEW & HEIGHTS BLK 2H LT 9ARabbit Creek
View &Heights
Block 2H
Lot 9A
#020-551-08
Municipality of Anchorage
On -Site Water and Wastewater Program . (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP171031 PID Number: 020-551-08
Dwelling: 0 Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: 9 New ❑ Upgrade
Name:
Deas & Karlena Bode
16360 Diane Dr, Anchorage, AK 99516
Phone
Number of Bedrooms
250-4989
3
LEGAL DESCRIPTION
Subdivision
Block Lot
Rabbit Creek View & Heights
2H 9A
Township Range
Section
(SEPARATION DISTANCES
To Septic Absorption Holding Sewer
From
Tank Field Lift Station Tank Line
Well >100' >100' >100' NSA >25'
Surface water >100' >100' >100' N/A
Lot Line 1 >5' 1 >10' 1 >5' 1 N/A
Foundation 1 >5' 1 >10' 1 >5' 1 N/A
Curtain Drain 1 None I Noted
Remarks Owner installation
Installer
Deas Bode (Homeowner)
Inspector C. Johansen
3SORPTION FIELD
❑ Deep Trench 9 Shallow Trench ❑ Bed ❑ Mound
F1 Other
Soil Rating Total depth from original grade
2.0 GPD/SF 0 Ft.
Depth to pipe invert from original grade Gravel depth beneath pipe
+0.5 Ft. 0.5 Ft.
Fill added above original grade Gravel length
3.0 Ft. 45 Ft.
Gravel width Beds: Number of Lines Distance between lines
5 Ft. ---- ---- Ft.
Total absorption area Number of trenches Dist. between trenches
225 Fe 1 ---- Ft.
TANK ❑ Septic ❑ S.T.E.P. ❑ Holding 9 Other
Manufacturer Capacity
Orenco/Advantex CAT III 1500 Gal.
Material lNumber of compartments
NA Fiberglass
LIFT STATION
Manufacturer
Orenco
Pump on level at
i!i
Capacity
100 Gal.
mp off level at High water alarm at
48 in.l 42
Pump make and model
Orenco/PF2005
in. 54 in.
Electrical Inspections performed by
MOA
PIPE MATERIAL House to tank D3034 Tank to D 1785
drainfield
Drainfield D 1785 Co/MTD3034
BENCH MARK (Assumed elevation) 100 ft
Inspection i51 6/18/17 2nd 6/19/17 Location and description
dates:3'" 6/20/17 a" Bottom of lower window
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp
!Vol `
�Iktl
Conditional Approval: Date ���_. � • .
`49 M ......:#
/ . ...�--... :-: f
Be is in Schiller
CE 1252
Approved �Le �G(`� ��vic�X Date .3 (5 j c �l, FO •' ; h ` �"
i\
inspection rteport_u-i-iz.00c
il
RABOT CREEK SI H BLOCK 2H LOT 9A
PERMIT # OSP171031 PID # 020-551-08
I � ,'i� tom+ tom: ' f � - !�: � '�.' C �•' � �,
PERMIT # OSP171031
PID # 020-551-08
3:1 SLOPES
VEGETATED I -I
811150.1
100.4
103.4 FINISH GRADE
INSULATION
r)PAINFIFI n Pnrx
2' MOA -APPROVED FILTER SAND
98.4 GROUNDWATER 5/21/17
93.4
45'
PROFILE AS -BUILT
(NO SCALE)
E-
-3:1 SLOPES
VEGETATED
100.4 ORIGINAL GRADE I
�- 100.9
100.4
�,~ j 4� be-Veliopal. en se -i -es D�f;3i3 ' 4men�:
^p p�
.,� �'S iii -i a YF'J Q d �! t�W QSei%�Q F �7;'Q s"af 6�!
i
4700 Elmore Road = =
P.O. Qox 196650 Anchorage, AK 99507
Mark Begich s , E ; ,.
Mayor }rrnv.MYa or /-Tisite
(907) 3-r-.3-7904
Well Log
Permit Number: OSP171031 Date of Issue: 5/30/17
Date Started: 6/5/17 Date Completed: 6/5/17 Is well located at approved permit location? Lj Yes [J No
Legal Description: Rabbit crk view & hghts blk2H Iot9A
Property Owner Name & Address: Bode Deas M
4910 Chuck Dr Unit A
Anchorage, AK 99516
Borehole Data: Depth (ft)
Soil Type, Thickness & Water Strata From To
stickup _
�0
2
—
overburden --�—=2
4
sandy gravel
4
16
boulder
16
18
dry gravel
18
23
silty gravel
23
27
sandy gravel
27
36
damp gravel
wet gravel
gravel w/ H2O
36
38
42
38
42
56
vv ater -.,,ampie xesuits:
Arsenic:
Nitrates:
Total Coliform Bacteria:
Other Bacteria:
-IL u&L 3I16I\ b
—t4- mg/L Sc4q
�__ coloniesl100mL
Vie- col/100mL
Method of Drilling LJ air rotary L j cable tool
Casing type: steel
Wall Thickness: .250 inches
Diameter_ ._ 6 . inches Depth: _56 _ feet
Liner Type: __
Diameter: inches Depth: feet
Casing stickup above ground: 2 feet
Static water level (from ground level): 25 feet
Pumping level:_ feet after
hours pumping gpm
Recovery Rate: 15 gpm
Method of Testing: airlift
Well Intake Opening Type:
M Open End 1=1 Open Hole
❑ Screened Start feet Stopped feet
R Perforations Start feet Stopped feet
r vauiuc.�l
20' Start _ 0 feet Stopped _ 20 feet
Pump: Intake .Depth feet
Pump size hp Brand Name
Well Disinfected Upon Completion? (1 Yes (1 No
Method of Disinfection;_ chlorine tablets
Comments:
Well Driller_ Hefty Drilling, Inc.
3540 Akula Dr.
Anchorage, AK 99516
Attention: The well dril ler shall provide a well log to DSD within 30 days of completion.
Developmers,11- Services Department
Building Safety Division
On—Site Water Wasteviater Programrt
4700 Eirnore Road
P.0, Box 196650
4i E T Y
Mark Begich Anchorage, AK 99507 S A E T Y
Mayor
(907) 343-7904
Pump Installation Log
Well Drilling Permit zap mbercw-D�f 171 D -2S Date of Issue: 5—' —1 —7
Parcel Identification Number: �
Legal Description Property Owner Name & Address: Wt;lr UK vie&,, � R5tic
q A
Pump Installation Date:
Pump Intake Depth Below Top of Well Casing: 0 feet
Pump Manufacturer's Name:
Pump Model: I ID 5 qG (2-7 — 200
Pump Size "I by
Pitless Adapter Burial Depth: J() feet
Pitless Adapter Manufacturer's Name: C -90f 6e /I R—/0
V
Pitless Adapter Installer:
Well Disinfected Upon Completion?Yes F, No
Method of Disinfection: ' * 0
LA loriq�
Comments:
Pump Installer Name:
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
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
hftp://www.muni.org/onsite
On -Site Water & Wastewater System Permit
Permit Number: OSP171031
Work Type: WellSeptic Initial
Effective Date:
Expiration Date:
Tax Code Number: 02055108000
Site Legal Address: RABBIT CREEK VIEW & HEIGHTS BLK 2H LT 9A G:3340
Site Mailing Address: 16360 Diane DR, Anchorage
Owner: BODE IDEAS M
Design Engineer: ANDERSON ENGINEERING
This permit is for the construction of:
Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy
mcnt S,
�a
c �
e �
r,
epartmm" t
5/30/2017
6ficl3'W181[:3
Lot Size in Sq Ft: 20498
Total Bedrooms:
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
Received B3
Issued By:
Date:
Date: JC 30 /7
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907
Development Services Division Fax: 907
On -Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 020-551-08-000
Property owner(s) Bode, Deas & Karlena
Mailing address 17015 Jacqueline Circle
Site address
Day phone 250-4989
1 8 9
/ -'
MAR 2 0 1017
Legal description (Sub'd., Block & Lot) Rabbit Creek View & Heights, BI 2H Lt 9A
Legal description (Township, Range & Section)
Lot Size 20,498 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑X
Initial ❑X
Single Family (SF)
❑X
(w/wo ADU)
Septic Tank
❑x
Upgrade ❑
Duplex (D)
❑
Holding Tank
❑
Renewal 1_71
Multiple Dwellings
❑
Privy
❑
(SF and/or D)
Private Well
❑X
Water Storage
❑
THIS APPLICATION INCLUDES
A VARIANCE / WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
Permit/Rush Fees:
Date of Payment: _
Receipt Number: _
Permit No.
Permit App__- :L. -c:
_rb-T_ Waiver Fees: 61
Date of Payment: SfZz/Z7
41' 02,11) i3-7 (44 Receipt Number: G 2121✓' Z
O,SP/71 b3) Waiver No. 0 5 I7/0 3 u
OK <�Pe owner -1v Gv I*r (�S5
YL
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (F
May 24, 2017
Municipality of Anchorage
Development Services Dept- On -Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: Rabbit Creek View & Heights Sub, Block 2H Lot 9A
Septic system design and permit application
Dear On -Site Services Engineer:
The owner of the above lot intends to build a 3 -bedroom home on the property, so we are
submitting this permit application for the construction of a new well and septic system. The
attached site plan identifies the location of the home as well as the proposed well, septic location
and alternate site. No conflicts exist between this proposed system and any wells, whether on this
lot or adjacent lots. Drainage arrows are shown on the site plan showing the direction of flow.
The drainage pattern in general will not be changed by the construction.
There was a test hole placed on the lot back in 2013; however, there are inconsistencies in the
dates and perk calculations. The hole indicates very silty sand with some gravel, and n
groundwater or bedrock was found down to 10'. Adjacent lots show water to be at 2' to 3' below
grade after monitoring, with slightly better percolation rates.
We dug a new test hole and placed a monitoring tube in it. We also performed two new perk tests
on the site. We found similar results to the neighboring property, with perk rates between 30-60
min/in., and groundwater at 2' below grade. We are proposing to place a new 1500 -gallon septic
tank w/ an Advantex System on the lot. An application rate of 2.0 gpd/sf was used in the design
of the absorption system. The trench will be a 5' wide, shallow trench (6" effective), 45' long.
The elevation of the distribution line will be 2.5' above the existing surface, for a 4' separation
from bottom of rock to groundwater. Soil will be mounded 2' above the trench and sloped at 3:1
to the existing grade. A minimum of 2" of insulation and 2' of fill will be placed over the
absorption trench and 4' over the septic tank.
The ground surface on the lot slopes toward the road an average of 6-8%. There are no slopes of
25% or greater within 50' downslope of the bed. The new bed will be constructed parallel to the
slope as much as possible. There will be 10' separation between the proposed and alternate sites.
There will be a minimum of 100' separation from all wells and surface water, and more than 5'
separation from the septic tank.
If the system is constructed as designed, it will have no adverse impact:
• On the wells in the area or those to be constructed in the future.
• On existing septic systems in the area or those to be constructed in the future.
• On reserve space, either surface or subsurface, on any lots located in the area.
• On drainage patterns in the area. The current drainage pattern will be maintained.
Sincerely,
Benjamin Schiller, PE m `' 7HP k.s
n� ..........
:1g J Scliller c W
pJ.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
May 22, 2017
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Rabbit Creek View & Heights, Block 2H Lot 9A
Engineered receiving soils waiver
Dear On -Site Services Engineer:
The owner of the above lot is building a home with a new septic system and well on this lot. Due
to the high groundwater, a mounded system will be necessary to achieve the required separation
distance from groundwater.
The test hole data shows peat for the first two feet, and gravelly silt under that. The seasonal high
groundwater has been measured at 2', right at the top of the in-situ soils. Current code requires 2'
of in-situ receiving soils above the seasonal high groundwater levels.
We are asking for a waiver to allow 2' of classified fill (either Type II soils or well -graded sand)
to be used in this case. The peat will be removed from under the trench, minimum of 2' of
classified fill placed, then 2' of sand, and then the filter rock. Thus, the 4' separation to
groundwater will be met.
There are no adverse consequences to this proposal. The classified fill is better quality than the
in-situ soils, and this waiver will allow for the required separation to groundwater.
Thank you for considering this request.
``0v�LUW,11 i
Of A4
Sincerely,
IV
IV
.. . � .V
Benjamin Schiller, P.E. � .Blit'•!►': I=�%�
0
Qb � �N+�: �: r 55•j7=�"�
RABBIT CREEK VIEW & HEIGHTS, BK 2H LT 9A
DESIGN FACTORS:
Peak flow: 450 GPD (3 bedroom)
Perk rate: 48 min/in
Application rate: 2 GPD/SF (Cat III System)
SYSTEM REQUIREMENTS:
450 GPD / 2 GPD/SF / 5' wide ' 1.0 reduction = 45 LF of trench
5 -Wide Trench
1500 -gallon septic tank
Category III Advantex System
THEREFORE: Construct a trench 5'x 45' x 0.5' effective depth. Flow line elevation in the
trenches will be 2.5' above original ground surface. Provide 2' of MOA -approved sand below
drainfield rock. Remove all peat and organics and provide sand or Type II classified fill down to
in-situ soils. Provide insulation and 2' cover over absorption trenches and 4' cover over septic
tank.
6" TOPSOIL t" PVC
REVEGATE MOUND
10 x 1-16" DIAMETER HOLES
2" INSULATION AND 2' COVER
V DRAINFIELD ROCK T
6" BELOW LATERAL i
2.0
SIDE SLOPES @ 1.0
J�
EXISTING GRADE MOA -APPROVED
a; J
2.0j COARSE SAND
2.5
T REMOVE ALL PEAT AND
TYPE II CLASSIFIED FILL OR 5.0 ORGANICS
MOA -APPROVED COARSE SAND
IN-SITU SOILS
5' TRENCH SECTION
(NO SCALE)
NOTES:
GRADE AREA OVER BED TO DRAIN AWAY
MINIMUM 6' SEPARATION FROM BEDROCK
MINIMUM 4' SEPARATION FROM BOTTOM OF BED TO GROUNDWATER
MINIMUM 100' SEPARATION FROM WELLS OR SURFACE WATER
AV
AV
■ 49th
NJAYN SCHILLER
No. CE -12592
fROFESSt �
G
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 ELMORE ROAD ANCHORAGE, AK 99519-6650
SOILS LOG AND PERCOLATION TEST
LEGAL DESCRIPTION: RABBIT CREEK VIEW & HEIGHTS, 82H L9A
PERFORMED FOR: DEAS BODE
DATE: 5/11/2017 PROJECT No.:
PARCEL ID#: TECHNICIAN: B. SCHILLER
DEPTH Test Hole THI
(feet)
I ORGANICS/PEAT
2
3 BROWN SILTY GRAVEL
4
6 GREY CLAY WITH GRAVEL
7
8
9
II
I
15
16
17
18
19
COMMENTS:
WAS GROUNDWATER ENCOUNTERED?YES
IF YES @WHAT DEPTH -0
DEPTH OF WATER AFTER MONITORING: 2.0
DATE OF MONITORING: 5/21/17
SITE PLAN
SEE SITE PLAN
DATE
READING
GROSS TIMEFNETTIME
TES)
WgTER
(INCHES)
NET DRO(MINUTES)
(INCHES)
TEST HOLE PRESOAKED PRIOR TO TESTING:
PERCOLATION RATE;_(MIN/INCH) PERC. HOLE DIA_INCHES)
TEST RUN BETWEEN: FT. and FT.
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 ELMORE ROAD ANCHORAGE, AK 99519-6650
SOILS LOG AND PERCOLATION TEST
LEGAL DESCRIPTION: RABBIT CREEK VIEW & HEIGHTS, B2H 1-9A
PERFORMED FOR: IDEAS BODE
DATE: 5/22/2017 PROJECT No.:
PARCEL IDn: TECHNICIAN: B. SCHILLER
DEPTH
(feel)
I-
2
3
4
6
7
8
9
10-
11-
12-
13-
14-
15-
16 -
IT
18-
19.
COMMENTS:
Perk Test P 1
SLOPE
WAS GROUND WATER ENCOUNTERED?
IF YES @a WHAT DEPTHS
DEPTH OF WATER AFTER MONITORING:
DATE OF MONITORING:
SITE PLAN
SEE SITE PLAN
DATE
READING
GROSS TIM
(MINUTES)
NET TIME
(MINUTES)
DEPTH To
WATER
(INCHES)
NET DROP
(INCHES)
TEST HOLE PRESOAKED PRIOR TO TESTING:
5/22
1
4:10
3.25"
2
4:40
30
4.63"
1.38"
3
4:45
1.75"
4
5:15
30
2.63"
.88"
5
5:20
1.50"
6
5:50
30
2.38
.88"
PERCOLATION RATE: 34.1(MINQNCH) PERC. HOLE DIA. 6)" (INCHES)
TEST RUN BETWEEN: 2.0 FT. and 3.0 FT.
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 ELMORE ROAD ANCHORAGE, AK 99519-6650
SOILS LOG AND PERCOLATION TEST
LEGAL DESCRIPTION: RABBIT CREEK VIEW d HEIGHTS, B21-1 L9A
PERFORMED FOR: IDEAS BODE
DATE: 5/22/2017 PROJECT No:
PARCEL ID#: TECHNICIAN: B. SCHILLER
DEPTH Perk Test P2
(feet)
1
2
3
4
6
7
8
9
10
11
12
13
14
15
16
17
18
19
COMMENTS:
SLOPE
WAS GROUND WATER ENCOUNTERED?
IF YES @WHAT DEPTHI ,S
DEPTH OF WATER AFTER MONITORING: IEPU�
DATE OF MONITORING:
Benj in Schiller • •'
C 12592 •� i
.' wra.mn `' i
SITE PLAN
SEE SITE PLAN
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH TO
WATER (IN
CHES)
NET DRO
(INCHES)
TEST HOLE PRESOAKED PRIOR TO TESTING:
5/22
1
4:10
2.00"
2
4:40
30
2.38"
0.38"
3
4:45
2.38"
4
5:15
30
3.00"
0.62
5
5:20
1.13"
6
5:50
30
1.75'
0.62
PERCOLATION RATE: 48•4(MINIINCH) PERC. HOLE DIA. 6" (INCHES)
TEST RUN BETWEEN: 2.0 FT. and 3.0 FT.
SOILS LOG - PERCOLATION TEST
TEST HOLE 1
RRR���wwww
1
SLOPE /
6:35
OR
CLASS 'C' WETLANDS
n
yy
2
x
3
/
8.82
4
TH-1
5
SM/ SERV SITU
•�
6.30
6 GM SAND W/ SOME
x
LOT 9A
GRAVEL
GRAVEL
IN
6.62
7
s
6
I
II{
6.30
9
a
10
I�
/NI,
BOH
11
J
�
/
12
� -0 '41
13
WAS GROUND WATER
SLOPE
14
ENCOUNTERED?—N
15
IF YES, AT WHAT TH
1e
DEPTH? x
17
DEPTH TO WATER AFTER
MONITORING? -XX-
1s
DATE: XOOf120XX
WATER
DATE PERFORMED: 4115113
READING DALE TME
MET TYE LEVEL IEf DROP
READING
PEROLATION RATE 77 (minlinch) PERC HOLE DIAMETER 6 kxtms
TEST RUN BETWEEN 3 FT AND 4 FF
COMMENTS: Test hole excavated by BEEKS CONTRACTING. Prec hole was
presoaked.
Test run for one hour. Last 3 readings reported
PERFORMED BY: Steven R.
Pannone, P.E. 1 CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON�THE OF THIS TEST.
"°�S'
/�DATE
PANNONE ENG SVC, LLA.
P.O. BOX 102954 ANCHORAGE, AK 99510
���` 14
. �oF.ACas1�'
Dale
4„7„3
PHONE (907) 272-8218 FAX (907) 272-8211
THy�jl/
�..... .. ....
J
Scale
P.I.D. NO
RABBIT CREEK NEW & HEIGHTS, BLOCK 2H, LOT 9A _
020-551-08
CHARLES PRESTON
DIANNE DRIVE
}
LtWven ."OD none
IIl CE 8149 .G+i/
lk��wais5a��
PERMIT NO.
OSPXXXxxX
sneer
SOILS LOG
ANCHORAGE, AK 99516
\
1 OF 1
1
0822f12
6:35
—
8.30
—
x
6:05
30 MIN
8.82
0.39
s
8O6
—
6.30
—
4
6:35
30 MIN
6.62
024
s
6:35
6.30
--
a
7:05
30 MIN
6.79
0.23
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
On -Site Water & Wastewater Program Fax: 907-343-7997
Septic System Owner -installer Agreement
A real estate property owner (Owner) may install their own septic system.
The department may issue an approval for a homeowner to perform work on a conventional
(not AW A/TS) on-site wastewater disposal system to serve that individual's owner -occupied,
single-family or duplex home if the homeowner satisfies and agrees to the following
requirements.
The property owner and excavation equipment operator may perform work on no more than
one owner installed project in a 12 -month period.
As owner of (legal description) j.oi- I A/ OkA z H 1&bki Gff k I agree the
following items are true and accurate.
1. My experience Inst Ilin septic systems is as follows.
�6 s 4 94-, MOA
2. The name of the excavation equipment operator is. 19&c4s ( �
There will not be compensation for installation services rendered.
I will be actively involved with the septic system installation at all times.
The name of the inspecting engineer is 13p�r 5c4Jte_r �
6. 1 agree to discuss the following items with the inspecting engineer:
a. Permit design criteria and specifications.
b. Inspection requirements set forth in AMC 15.65.150.
C. 2 -hour minimum advance notice given to the On-site Water & Wastewater
Program for all required municipal inspections.
7. 1 agree any changes I make to the items listed above will require a new approval before
performing work.
8. 1 agree to have the project -specific On-site Wastewater Disposal System Permit available
at the construction site for the duration of all related work.
Owner's printed name: f0&l zJe
Owner's signature
Septic System Owner Installer Agreement_Feb2015.doc
Date: 5- 2 2- 1 -:T
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section �" Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 020-551-08
1. GENERAL INFORMATION
Expiration Date:
Complete legal description Rabbit Creek View & Heights, Block 2H, Lot 9A
Location (site address)
16360 Diane Drive Anchorage. AK
Current property owner(s) Deas Bode Day phone (907) 250-4989
Mailing address 16360 Diane Drive, Anchorage, AK 99516
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:
3
e
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
Q
Private Septic
FE
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community ,
❑
Public Water System
❑
Public Sewer
❑
Waiver request for: Distance:
Received by: Date:
COSA to be released to the engineer, unless othemise requested by the engineer.
COSA Fee $ �J 5� ` '-(� o� •S�
Date of Payment 6
Receipt Number q(_1 D
COSA# QSc as a52
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
I
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the
on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater
disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in
effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm Forge Civil Engineering Phone 522-7773
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E.
6. DSD SIGNATURE
System #1 Approved for _a_ bedrooms
System #2 Approved for bedrooms
Disapproved
Date 5/11/2020
t'
Conditional approval for bedrooms, with the following stipulations:
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By:1:;:�_J6L Original Certificate Date: �1 ®Z0
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 Checklist blue sheet
Legal Description: Rabbit Creek View & Heights, Block 2H, Lot 9A Parcel ID: 020-551-08
If more than 1 septic system on lot: COSA Checklist # of Structure served by this system
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled 6/5/17
Total depth 56 ft
Cased to 56 ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) '24 in.
Date of flow test for COSA 6/1/20
Static water level at beginning of test 24.9 ft.
Comments
B. TANK DATA
Age of tank(s) 3 years
Tank type/material Advantex/FAP
Measured operating fluid level in septic tank N/A
❑ Standpipes/foundation cleanout per record drawing
Date of pumping See Maintenance Log.
D. ABSORPTION FIELD DATA 5' Wide Shallow Trench
Which system tested (date installed) 6/20/17
❑ ALL standpipes present per record drawing
Total measured depth from grade 3 ft (max)
Measured depth to pipe invert from grade ft (min)
❑ N/A — pressurized field
❑ Monitor tubes go to bottom of effective. If not, state
depth into effective
❑ Code -required soil cover over field
❑ System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced N/A gallons
Comments/Deficiencies:
COSA Checklist yellow sheet
Well production at time of test 2.2 gpm
Water storage tank volume 0 gallons
Well disinfected for coliform test? ❑ Yes ❑ No
OR Coliform bacteria is Negative
Nitrate mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ❑ Arsenic less than MRL (ND)
Collected by FORGE ENGINEERING
Date of Sample 6/1/20
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments: See Maintenance Log.
Adequacy test date 6/1/20
Results ❑✓ Pass For 3 bedrooms
Fluid depth prior to test 0 in
Water added 475 gal
New depth 0 in
Elapsed time 30 min
Final fluid depth 0 in
Absorption rate >450 gpd
Any rejuvenation treatment (past 12 months)
If yes, enter date
None
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
Yes
Community Sewer Manhole/Cleanout > 100'
Q Yes
if No
ft
✓, Yes
if No
Neighboring Tank > 100' 0 Yes
if No
ft
Private Sewer/Septic Line > 25' E] Yes
if No
Absorption Field on Lot > 100' 0 Yes
if No
ft
Holding Tank > 100' F,71 Yes
if No
Neighboring Absorption Fields > 100'
Yes
if No
Animal Containment > 50' Q Yes
if No
Fv� Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' Q Yes
if No
ft
E Yes
if No
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'✓® Yes if No ft Surface Water > 100'
ft
ft
ft
ft
ft
Q✓ Yes if No ft
Property Line > 5'
Q
Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
F/�
Yes
if No
ft
Private Wells > 100' ❑✓ Yes if No
Water Main > 10'✓Q
F/�
Yes
if No
ft
Community Wells > 200' 0✓ Yes if No
Water Service Line > 10'
0✓
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' E✓ Yes if No ft If absorption field is under driveway comment below
Property Line > 10'
Q✓
Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'
✓l
Yes
if No
ft
Private Wells > 100' a Yes if No
Water Service Line > 10'
F/�
Yes
if No
ft
Community Wells > 200' Q Yes if No
Surface Water > 100'
0
Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
l 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
01 '1474
-� 49th �•���
s. ...... .........: ... •. ....�
0
6 ..........................................'.....0
MICHAEL E. ANDERSON
No. CE -4381
6/15/20
ft
ft
ft
ft
_s°
LOT 13A
df
�L
RAP
.50
P—:
n
N
LOT 11A N
0
z
z
NOTE: '
Dimensions are measured to the wood trim.
I hereby certify that an accurate survey of the following described
property:
RABBIT CREEK VIEW AND HEIGHTS (2004-91)
LOT 9A, BLOCK 2H
:9 f} was made on August 25. 2018 and that the improvement:
i Fr 49TH :#� situated thereon are within the property lines and do not overlap or
0•, .encroach on the property lying adjacent thereto, that no
improvements on the property Y in I adjacent thereto encroach on
F. Lee Knrn6¢lnikoffi9 1
I �? the premises in question and that there are no roadways,
�{ No. 3143-S..-* transmission lines or other visible easements on said property except
?Z�a� as indicated hereon. Ecsements other than those shown on the
{k,i 4 record plat may not appear on this drawing.
cJAnchorage Alaska, this 29th day of August 2018,
M13NIC:IPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE ANIS REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR. AGREEMENT, herein the "AGREEMENT" made and
en — r
entered into as of this Day of EA of 20'.Z, by and between
herein the "017v ER," 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 Wasteivater Treatment Systems. The Municipality, grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWVFS),
described as Advantex Waste Water Treatment System
located at (legal description)
Rabbit Creek View & Heights B2H i_9A
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
Throughout the term- of this Agreement, the Owner shall enter into a service agreement
FAV 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.
It shal l be the responsibility of the Ovrrrer during the term of this Agreement to pay.for all
1IW repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the systern, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Pagel of 3
Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
t Owner acknowledges that the fine for 4 failing to maintain and repair an AWWTS may be
assessed in accordance vtjith 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.
Owner agrees that any sale or transfer of title of the propeity willnot occur without a new
Certificate of On -Site Systems Approval,
Owner agrees that the AWWTS installation and maintenance requirements .as provided
by the AVWTS vendor/installer and approved by the Municipality are the governing
t guidelines for the construction; maintenance and repair of the Owner's AWWTS.
Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term_ The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, ;or upon transfer of title, and shall continue
while the A�VWTS is operational or until title is transferred.
4. \ onwaiyer. 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 lv.,aw. 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
OWNER,
B ��y
(signature) C (aitue) Date. I
Gi Y Q�c.t--2, (print name) M e k-, 5S, -
STATE
S c
STATE OF ALASKA
) ss.
THIRD JUDICIAL DISTPJCT )
The foregoi a instru�m�ent was acknowledged b fore me this � day of
1
PAZ&
OTARY PUBLIC FOR AL-A-SkA
7 rf+ e
My Commission empires:
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s� rn � �
O�
A -�
IgUNICI 4 `_tt �SICA
PALITj'• •�.���.
(signature) Date: l0 C7
(print name) Title.
(rev. 05/18/2018) Page 3 .of 3
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