HomeMy WebLinkAboutPOTTER HIGHLANDS PH 2 BLK 3 LT 1 Municipality, of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP17127(0 PID Number: 020-281-72 Dwelling: 0 Single Family (SF) ['with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑■ New ❑ Upgrade Name RICHARD NEUMAN ABSORPTION FIELD Site Address ❑ Deep Trench ■❑Wide Trench ❑ Bed ❑ Mound ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 1 4.0 GPD/SF 5.5" Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 4 j 5—',5- Ft. OA ,' 0 Ft. POTTER HIGHLANDS PH 2 BLK 3 LT 1 Fill added above original grade Gravel length Township Range Section 1.0+ (IS ' Ft. 30 Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 5.0 Ft. Ft. To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 150 Ft2 1.0 Ft. Well 100411001+ 100'+ 50'+ TANK ❑Septic I] S.T.E.P. ❑Holding ❑Other Manufacturer Capacity Surface Water 1001+ 1 00'+ 1 00'+ ADVANTEX 1500 Gal.Material Number of compartments Lot Line 10'+ 10'+ 10'+ NA FIBERGLASS 2 Foundation 101+ 10'+ 10'+ LIFT STATION Manufacturer Capacity Remarks ADVANTEX BASIN 150 Gal. Alarm location Electrica staled by 4 4. EXTERIOR PANEL 4LIcti rit gATtk% PIPE MATERIAL House to tank 3034Tank to 3034 Installer drainfield MIKE N ANDERSON, P.E. Drainfield 3034 CO/MT 3034 Inspector MIKE N ANDERSON, P.E. BENCH MARK (Assumed elevation) 100 ft Inspdates: 151 1012-'6 2" Location and description 3rd 4th CORNER OF THE SIDING ON-SITE WATER AND WASTEWATER SECTION APPROVAL _` .:9eec ft,ktmp Conditional Approval: Date ;141.*'� '• t d / *.4 9TH :/% •• IT !, .0 pni-4_ f r yo•• MICHAEL N. ANDERSON :�r Septic System r oI �r�'•• CE- 469 •,`moi Approved ����h awe/ 7611 Date 1/(1/11 tI�•74e •. . . .•Ns 1 r • ' • .. f�k n� • �� ..16,16‘..a.1.70.-.... PRUj �Q;:� -� Note: this approval does not include well permit requirements. (Rev 05/02/18) Permit No. OSP171276 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: POTTER HIGHLANDS PH 2 BLK 3 LT 1 PID No.: 020-281-72 t \ MARK A - iC \ / \ / CO1 31 I \ / CO2 45 19 i \ / TCO1 50 18 I N i' TCO2 60 20 I N z A MT1 35 h6 �' ` NT2 158 120 ::: ———_ r / / i 1 SEPTIC \ J/,/ PUMf BASIN \ 1 11 ,�—�- a_ /./ \ TCO2 r / 1 1 // 1 T CO2 \ MT1 \~ \\ NEW 1500 GALLON ADVANTE / POD 1 \ / ' \ V / ' 4W�CO1 � \ , MT27 '042 // BEN�H Ate' / \ -'N / // 1 / - /\ - \ V // 1 \\ ' II \ \ 1 I ‘ DRIVEWAY 1 /1 I \ rl I I // I \ SELL { I I + 1 I I Il1 1 / 11 1 \ /' II \ \ ASBUILT f 1 \ \ / \ SCALE: 1"=50' / 1 , \ / I Ecol coz rco+ un N,z r xt ♦♦♦♦...,,,, 1 i :7,i- `,� TCO2 M 1 r 9AS'I , CO ♦♦•-\* OF.............. 2 1.3 .444- � u (IMO( r lYF[ �.0 ORG l ... ♦•I _ 1GIER rA9R1O : 49 TH * r;� �� / 1 95s 9140 91 ,.500 O S TA �•oa aa we r'a wo GM /��� • • rBCRCAA55 TANK G2 9 � % 4z� �� MICHAEL N. ANDERSON: ' No 9469 o • SEPTIC SECTION 1r5= •�♦• •• "-i '' '..., Ip N.T.S. DRY MAY 2018 4 CSS\��4♦ 4I�IIi11♦♦♦ Municipality of Anchorage „,, . E�k' SES Development Services Department C . 4,.... •"V On-Site Water and Wastewater Section / Itri 49TH !''a • ;r 4 i i -',,e 4700 Elmore St. /G�:,, % n •` P.O.Box 196650 Anchorage,AK 99519-6650 �.i. Jam_ www.muni.orq/onsite Ors• • MICHAEL N. ANDERSON ;�' ,° (907)343-7904 �... ``.---...-----./ i ..,..:;.,;•• C -9469 ..‘: .1-,),w, et ‘.1-;`..?:•- "1 r ��” Soils Log - Percolation Test IVO ' •••' _ -'� ofES=ko." Performed For: �r 1 �N.��7~ �,�t,or �/ ! towafi ✓, Date Performed: otv 7-/f 70( Legal Description: A arf /-. 1 h ci yI d, t, NA 21fownship,Range, Section: I VCS 3 Slope Site Plan Depth ^1.. / 2 (Feet) /7` 1- -- 2- -2- C'12 c. 14-c .p(©►7 , 3- 4- C Pop 5- 6- t�7- � 8- LjG n L WAS GROUND WATER �D 9- `��� ENCOUNTERED? S - 10- IF YES.AT WHAT DEPTH? L Depth to Water After P 11- Monitoring? 0f ki E 12- Date: 3 S6 13- 14----- ____ ^ Reading Date Gross Time Net Time Depth to Water Net Drop 15- ,V74 r • e 0,1,7 LJ It,1,7 It 16- G Ir 5.,./ 18- tj./ , a ••,, /, rt 19- (O 20- PERCOLATION RATE 2j (minutes/inch) PERC HOLE DIAMETER ID I( TEST RUN BETWEEN oaf FT AND 141 FT COMMENTS PERFORMED BY: NI /AA I CERTIFY THAT THIS TEST A PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Certified Drilling Log DOC CO dba BILL & COLE 110► ULLIVAN WATER WELLS le- P.O. Box 670269, Chugiak,AK 99567 688-2759 OWNER OF LAND: Richard &Julia Neumann ADDRESS: Bore Hole Data LEGAL DESCRIPTION Potter Highlands Ph 2 B3 11. Depth DATE: 3-26-18 From To PERMIT OSP171276 DATE OF ISSUE: 10/24/17 0 2 Casing Stickup NUMBER: _ TAX IDENTIFICATION 02028172000 2 4 Overburden NUMBER Is well located at approved permit location: NYes FINo 4 24 Tight Silty Sand &Gravel Method of Drilling: Nair rotary Ucable tool 24 31 Silty Sand & Gravel Depth of Well: 360' 31 42 Hardpan Casing Type: Steel Wall thickness .250 inches 42 164 Bedrock Diameter: 6 inches, depth 44 feet 164 219 Bedrock Gray Liner type Static Water Level: 50 feet 219 262 Bedrock Green Hard Recovery Rate 3 ® gpm _ gph 262 315 Bedrock Gray w/Quartz Method of Testing Air 315 360 Bedrock Gray Well Intake Opening Type: n open end open hole ElScreened Start feet Stopped 0 Perforations Start feet Stopped Grout Type: Bentonite Volume: 150 lbs Depth:from 2 feet,to 42 feet Well Disinfected Upon Completion: ®yes ❑ no Method of Disinfection: Chlorine 50 PPM Comments: WATER QUALITY TESTING Cdlform 11�e CoI/100mL Nitrates yt( mg&L Arsenic ug/I Drillers Name: Cole Sullivan ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservation. DOC CO dba lbiLi(I0iN WATERWELLS P.O. Box 670269,Chugiak,AK 99567 688-2759 www.sullivanwaterwells.com Pump Installation Log Well Drilling Permit Number: SW OSP171276 Date of Issue 10-24-17 Parcel Identification Number: 02028172000 Legal Description Property Owner Name & Address Potter Highlands Ph 2 B3 11 Richard &Julia Neumann Pump Installation Date: 9-25-18 Pump Intake Depth Below Top of Well Casing: 350 feet Pump manufacturer's Name: F&W Pump Model: 4F07G10301 Pump Size: 1 hp Pitless Adapter Burial Depth: 10 feet Pitless Adapter Installer: Mike Anderson—Anderson Engineering Disinfected Upon Completion? ® yes ❑ no Method of Disinfection: Chlorine 50 PPM Comments: Pitless Manufacturer: Martinson Pump Installers Name: Sullivan Water Wells Attention:The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Eo PLAT NO. 2015-10 t• iPOTTER HIGHLANDS, PHASE 2 1iJ LOT 1 , BLOCK 3 P I '°' 1.509 ACRES I 0 o I Z S Soo 4- -k`.24 S9, \ c2 • a •80, \ • 4) 1 010/ o,, 4.„, Iiiiir /A' o \ PJ V, \ \ \n v, \ I 6,o W \ ! ! S. n \ 5, 0 / / \ ,0 TSfT et CKfi,r / II n /c? .o \ 1 trj t0 \ 1I W CC \ III 35' \ 1 ( > \ 11 ^° W \ II J it \ II a \ II \ AGREEMENT TO 1 1 PROVIDE ACCESS \ (2017-007870-0) \ i I \ II II \ b II o vi II to SII cc 6:1. •:06 01, I 01. %n ui • Js0. ,).21 I I �O • 6, ii 0 1 1 ” = 50, „. ?0. / s;:r 1,i, c. OC op e-O <c‘' •\ Py G VD N J 60. 1� J 60, O BUILDING DETAIL AS — BU IL T I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO GASTALDI LAND ENCROACHMENTS EXIST EXCEPT AS INDICATED. �� X111 -44 SURVEYING. LLC SCALE: 1"=20' OF q •, IT IS THE RESPONSIBILITY OF THE OWNER TO 44 . JEFF A. GASTALDI, R.L.S. ♦ ' �..•••••.. DETERMINE THE EXISTENCE OF ANY EASEMENTS •,` .• '` •:S,� .. 2000 E. DOWLING RO., SUITE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT ).149TH %\ .S 0 ANCHORAGE, ALASKA 99507 APPEAR ON THE RECORDED SUBDIVISION PLAT. :�.* * 0 PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA •• 1/. f : GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR • % ,, • Jeffery A. Gostold : • w. LS-6091 sIN SW3638 3/12/2019 ESTABLISHING BOUNDARY OR FENCE LINES. ,, .•.•3/12/2019 ..•�s.- :ANCHORAGE RECORDING DISTRICT, ALASKA ••. i);• F.B. JOB NO. ♦� �� 18/04 PHS213 NOTE : NO CORNERS SET THIS DATE :ri'c PAL r_0 MUNICIPALITY OF ANCHORAGE On-Site Water&Wastewater Program �o ;, r ,5,:. \,, PO Box 196650 4700 Elmore Road ,. ; ; Anchorage,Alaska 99519-6650 Phone: (907)343-7904 Fax: (907)343-7997 - httpalwww.muni.orglonsite )Cpar t111Cl)t 4hcHORP•GE On-Site Water & Wastewater System Permit Permit Number: OSP171276 Effective Date: 10/24/2017 Work Type: WellSeptic Initial Expiration Date: 10/24/2018 Tax Code Number: 02028172000 Site Legal Address: POTTER HIGHLANDS PH 2 BLK 3 LT 1 G:3638 Site Mailing Address: Owner: NEUMANN JULIA V Lot Size in Sq Ft: 65740 Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Total Bedrooms: 4 This permit is for the construction of: 0 Disposal Field El Septic Tank ❑ Holding Tank 0 Privy El 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: The Engineer needs to do an additional test hole prior to the construction of the septic field. Construction may proceed at your own risk before the 7 day water monitoring is complete. Please submit stamped and signed results with the As-built Inspection Report. If the results require a design change, construction of the system will stop pending On-Site review and approval. Received By: /714- Date: !Vi?if! I ,)- Issued By: / a`� „ - Date: /O/�LI[ 7 • MUNICIPALITY OF ANCHORAGE Community Development Department `; Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On-Site Water& Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 020-281-72 Property owner(s) RICHARD NEUMANN Day phone Mailing address Site address Legal description (Sub'd., Block & Lot) POTTER HIGHLANDS PH #2, BLK 3, LOT 1 Legal description (Township, Range & Section) Lot Size 65740 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑X Initial Single Family (SF) (w/wo ADU) Septic Tank 0 Upgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑X Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER tiLJE FOR: Distaipce: I certify that the above information is correct. I further certir at this is in accorda a with applicable Municipal Codes. 68L95 '1 (Signature of property owner or authorized agent) Permit/Rush Fees: ?Z7 Waiver Fees: Date of Payment: 60,240 Date of Payment: Receipt Number: 0 t o3 ('a- Receipt Number: Permit No. ean4274 Waiver No. Permit App_.-. c: r" Sept 21, 2017 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: New septic and well permit Legal: POTTER HIGHLANDS PH 2 BLK 3 LT 1 To Whom it may concern: a cod_ ,, frot-G. Red •l This is a request for an well and septic permit on the above referenced lot. The plat requiresAtle-Arfrmtrt system therefore that is what we have designed. The perc was done by the subdivision developer and is less than 5 minutes per inch. The contours have been shown on the 50 scale lot and the system is located in a flat spot in the front of the house. The system is designed to be in a small basin with zero slope in the area of the proposed installation,see the drawing. No slopes or cut banks exist within 50 feet of the this site due the site being in the bottom of a small basin. This new system will not impact any of the neighboring properties due to the lot layout. Please call me i i \Ou have any questions. Sincerely/AA_ Mike Anderson, P.E. 4661 Natrona Ave. Anch, Ak 99516 DESIGN CRITERIA: MOUND OVER (TH#1) o I GRADE 4 BDRM X 150 = 600 GPD ,DEll ORG SOILS = 600/4.0 = 150 GPD { WI, FILTER FABRIC 150 GA/5 = 30' GP'GM 2,a-;�o `�_ 1.25"0 PIPE 0 6"SEWER ROCK -4(1) TRENCH I s.o 24"FILTER SAND 4.0' DEEP 0.5' EFFECTIVE 5.0' WIDE 30' LONG 9 SEPTIC FIELD SECTION POTTER HIGHTLANDS PHASE 2 BLOCK 3.LOT 4 i POTTER HIGHTLANDS PHASE 2J BLOCK 2.LOT 7 POTTER HIGHTLANDS PHASE 2 W VACAf.JI' / - BLOCK 3.LOT 3 \��- Ii WELL I ��� PROPOSED I PO TFR HIGHTLAN 3S PHASE 2 O< VACANT HOUSE \ BLOCK 3.}OT2 Q POTTER HIGHTLANDS PHASE 2 Q ;1. �I PROPOSED BLOCK 2.LOT8 Ai DRAINAGE FIELD tir13 , 11 . 7 ' ins A CI / W t POTTER HIGHTLANDS PHASE 2 L(1 (` t - l BLOCK 2.LOT 9 VAC NT I '--a I A i �/ PROPOSED WELL 100'RADIUS PROPERTY LINE POTTER HIGHTLANDS PHASE 2 VIEWPOINT SOUTH BLOCK 2.LOT 10 TRACT Al VACANT VACANT Septic Design Prepared for +_IoisaaaMi,f RICHARD NEUMANN •.• c OF ,q4! !.4. , . �;:.. POTTER HIGHLANDS PHASE 2, BLOCK 3, LOT 1 - •�i� Anchorage, Alaska : 49 TH •:. ia,41/61/c‘ • Michael N. Anderson, P.E. DATE: 10/19/2017 0I ' :MICHAEL N. ANDERSON; ! No. CE 9469 4601 NATRONA AVE DRAWN: DJR •j� sur / .;... ANCHORAGE, ALASKA 99516 (907) 345-3377/FAX: (907) 345-1391 SCALE: 1"=200' ��+',` �S;+aAvie aa� i ,, \ / \ //' 1 \ / N.\ I ..` - i i i _ ice^ It. 1 ,1 ___ -�s. I I �Fa r `` 1 I 1 • j 1 1 / ( ADVANTEX AX20 CAT III NITRATE \-^ , 1POTTER HIGHTLAN PHASE 2 ///'' REDUCING SYSTEM W/PUMP BASIN �� BLOCK 3.I T 2 // PROPOSED / \\\\\ 1 RESERVE FIELD • ' (/f \\\ o z; - - . NI J4/.# • i r,1 r70/ 1/' yl Itj Q I ' 1 1 j N l 1 I 1 1 • I I I // 1 LJ t1 1 PROPERTY LINE , \� NEW TEST HOLE �% , REQUIRED PRIOR ,_ ,iJ I INSTALLATION OF _ L THE SYSTEMc<>1/11': I fJ / 1 _ l i/, ESTIMATED LOCATION OF SUBD.TEST // J HOLE. SEE TH 922 FROM LOUIS BUTERA // P.E. // f / \ rr N\ r \ / / 1 r 1 I I • 1 r/ A ' r�, 11� I ',z I \ j I 1 �� .___16 I I f(--q a I I O I '1 PROPOSED WELL C7 r -; I 100'RADIUS I 1 ' rr � N1 � cn O I1 ,-- wir s� 1 3; to \ \\ / . \ / T \ ' POTTER HIGHTLAN S PHASE 2 1 I // BLOCK 3.L T1 / 1 /// i Septic Design Prepared for ...ovisilisigi 4, RICHARD NEUMANN w�t,, . OF q��+,-+ . � POTTER HIGHLANDS PHASE 2, BLOCK 3, LOT 1 - i� ''.. .i : '7%1 49 TH : Anchorage, Alaska • . ,�/j(J�Q�/— �� *- • • �`! Y •I. Michael N. Anderson, P.E. DATE: 10/19/2017 •�� :.MICHAEL N. ANDERSDN;'a - #1��'. No. CE 9469 a 4601 NATRONA AVE DRAWN: DJR • /' �, ANCHORAGE,ALASKA 99516 .•j-''/Y1. ar'''*� �%�• (907) 345-33771 FAX: (907) 345-1391 SCALE: 1"=50' hi SS 44 "•t Municipality of Anchorage E. ri.d•n a^.•a•..r•a it DEPARTMENT QF HEALTH & HUMAN SERVICES 7.� .^ a e'.'1vlleewe •ores.••••'• 1'. 825 "L" Street, Anchorage, Alaska 99502-0650 4 : =s' `,•. 'P,a LOOS A..8utera ;D e SOILS LOG — PERCOLATION TEST t.:` a %E4s7 6 ' e • ERFORMED FOR: AZ.D77— (re_,f-r---Y_ ZG`. .,rT'7 L.L.C. DATE PERFORMED: ---i` ,:ro,c'-?Y EGAL DESCRIPTION: -Til 6.2'7 - Township, Range, Section: ' SLOPE SITE PLAN12- 017 I//— 7S• 4V 'sti�OtirJ 2 -1.....?? .'..t. I .-At [t , 4C • ,,4d77-GA-,-Cw.' „ 4d77- I . •�✓%;” 5.aio.' c '-iz Ad 514-T- 5 . f�. • L� z,•••••,2.,./ ( . 7 1L3; ! # �: I 9 r 1 I F A WAS GROUND WATER t0 ,/;3=..4.4.:1/2F",-.S) ENCOUNTERED' /t./[) . 11 L IF YES, AT WHAT D I i • I DEPTH' p , - 12 E Depth to Water Atter 13 - Monitoring? Cry Date:/D-22.99 14 - Reading Dare Gross Net Depth t0 Net TimeTimt Water /� Drops � v'rri 15 - P xt.z. _ / /0-i5-49 I/,.5 — 9'-'7//c..•' — 16 - 7 //: iv : is, . 7.1.56c 5'-c7" d"/,,,-° ,. //:/° . 30 — 4'_ ' — 17 - .4 ', J/"/.. :ow 44, -c._. ..5'-c, lo' 5 r, Il: 1.7 : r 6 — , -f/'' " — 18 - 6 /I "r7 : we (90. ---r- -5'-o'' �o_ 19 20 - -. PERCOLATION RATED•45 minutes/inch) PERC HOLE DIAMETER " TEST RUN BETWEEN d FT AND S FT OMMENTS 2,i Foe /3L--,2 Syri c" FId.TE�P .r. -go/2T ~a n,rc•p.b7U ERFORMED BY: FPCS 1 ' CERTIFY THAT THIS TEST WAS PERFORMED IN 2CCRDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE. 7� -'7Y f r O 9s,, I g...---- Municipality of Anchorage , t,a••v. / ,...r..:... DEPARTMENT OF HEALTH & HUMAN SERVICES a• — 825"L' Street, Anchorage.Alaska 99502-0650 `�� • <•r.............` ' 0 SOILS LOG — PERCOLATION TEST ,t.,*,,,,.,:% LouCE4735isA.8utera .....<,,.:,,44„:,14„ ',, " ERFORMED4 IN_FOR: /�^Tier G2t-F7G T�eT Lc, ,,2,� L.L.C, DATE PERFORMED' 14''.4)1,1' rri EGAL DESCRIPTION: ---77/ '9-I Township, Range, Section: I ¢ I SLOPE , SITE PLAN 1 �'-7,1 ��' I 2 - • I' b I I N 1 I3 . .5--.- -- 4 - •�c.1-7. 1 5 - (.. I I , 6 I 1 7 - 0 • .• I 8 _ , . /5,�- c,�'+, I tall 9 - c ✓ canis..-5 I I 10 • WAS GROUND WATER ' 0 ENCOUNTER E07 , 1 1 - S I }1 IF YES,AT WHAT L P I • i---" DEPTH? p 12 - E Neth to Wale(Auer 13 - 1.- Monitoring? �°4I Datt 1/-3-99 14 -• `� Reading DateGross Net Depth to Net ,E , Time Time Water Drop I 15 P, x1,.�:- _ _ / /D•i5-49 /x•29:55 _ G'-[." 16 - 2 /6;39.•55 /o.._+..✓ ea. '`?1/ice' 28/,x' 3 /1..4/.•00 — h'-[a" 17 - 4 r /l..Si:co /U,a,v (--1'-/,..•. 2 44.-'' 5 /i-,52!25 -- G -C., — 18 - 6 j•7 Z:2-5 'O,4'. / -1 /iv' 2 s/41 i 19 - I 20 - PERCOLATION RATE _l_r.2 (mrnutes,mch) PERC HOLE DIAMETER (-, p TEST RUN BETWEEN FT AND '7 FT IOMMENTS 1� =CC. TR(NLN -9/t re'n, ERFORMED BY. C s ,C r.G I -J CERTIFY THAT THIS TEST WAS PERFORMED IN CCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS LATE. DATE. /4:- -F'"515 ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND -T;(4 'U U e(A.r-( ►-3,J THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this 10 Day of ocroF3r12 of 2417 , by and between .7:5;Li 4 \ . 7.4_14.,1-11,40 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 AV:NAUTEA ,& 20 located at (legal description). p,T 1, t.oc -pa r-rK 414-14 Laiuv ?MSE- 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/instal ler and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. I. Owner agrees to provide and maintain a telephone connection to the AWWTS as required by the AWWTS approval. 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: Vit a. Owner: Zuet V t J6 hrl►.1 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. OWNER: By: �� C �--� (signature) Date: /0-/17- 24t 7 L('1 • • (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this 18' day of Oc1t 20 , by -Z kJ.c., If (UQ�r►'n — .4111111111 - ;001.16,e4ti osk ARY ��C OR AL: 01My C �s�i- sion expires: /1.90J Z 32Q 1? ••••...... MUNICIPALITY: By: Date: 0047 Deb Lu'&kif.101_rfA 5 (print name) Title: ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND �J(c.�.l q �J, CE(A-04 til THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this 10 Day of emic3re. of 2017 , by and between Z3j LA \J . tie-It %1/41 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 Ar"/A-turrF,c Ay, 20 located at(legal description). �o T 1, t-OC , 170-r-wiz 4-ft i41 laiNc6 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. I. Owner agrees to provide and maintain a telephone connection to the AWWTS as required by the AWWTS approval. 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: <JI.LU tt , IN;O-L ud4ht 4.) 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. OWNER: By: 1 " �� C (signature) Date: /0-/8' 20t7 t,t q ' E(4M4,Jp,) (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this l& day of Out 20 f , by w l cr v N ew M or nY1 ` / ARY 1:rs'C OR AL: " IP 704.10,1e4;poi OTARY My C00Mon expires: (V D J 2 5+ZO 1 PIBLt . 40,141.0In* MUNICIPALITY: By: b-ele(), 1 (signature) Date: /0 A 7 Deb 4) kengtt 5 (print name) Title: MUNICIPALITY OF ANCHORAGE 1.--r Development Services Department `'�'_;.7 J Phone: 907-343-7904 _ On-Site Water & Wastewater Section Y Fax: 907-343-7997 Certificate of On-Site Systems Approval Parcel I.D. 020-281-72 Expiration Date: c}1Z /1/ 2O1,' 1. GENERAL INFORMATION Complete legal description POTTER HIGHLANDS PH 2 BLK 3 LT 1 Location (site address) Current property owner(s) RICHARD N EU MAN N Day phone Mailing address Real estate agent s Day phone 2. TYPE OF DWELLING: ^�9 t11 /2 AM IllSingle Family (w/wo ADU) <o AKv E Duplex 40N .4 .. `. .. r1V N ❑ Multiple Dwellings (Single Family and/or Duplex) c' % w P 3. NUMBER OF BEDROOMS: 4 �0' irt.• H. 01 AT 0 4. TYPE OF WATER SUPPLY: TYPE OF WA ' ATER DISPOSAL: Private Well E Private Septic 0 Water Storage ❑ Holding Tank E Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: MDate: I-) // COSA to be released to the engineer,unless otherwise requested by the engineer. O COSA Fee $ 120 6 Waiver Fee $ Date of Payment i i5 A Date of Payment Receipt Number 2 3 S g5(o Receipt Number COSA# V SCl// OqZ 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. I acknowledge that On-Site staff may visit the site to verify the information submitted. Name of Firm MIKE ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE. ANCH AK Engineer's Printed Name MIKE ANDERSON, P.E. Date P>� ••0000••• { l �\ py�• 0 � • i • 6. DSD SIGNATURE O O00 1•�0 0 .0• e..o• .• :r e. `Pv .. System #1 Approved for V bedrooms ' •e V .eoe ............. 11 ••MICHAEL N. ANDERSON System #2 Approved for bedrooms tC �••• /969 ff Disapproved �a,fp ..(? ...•' Conditional approval for bedrooms, with the following stipulatt`'§. Lirr ��R~ • • ON a 1\N- .10_ o \IJP�E APs z \t‘t\S 0 d ct \C<4'. �in4AAp'nr(SC." BY 6h-24,1 ICA/u•i d Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Appr.val (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 COSA Checklist Legal Description: POTTER HIGHLANDS PH 2 BLK 3 LT 1 Parcel ID: 020-281-72 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) Well production at time of test 3 gpm Date drilled 3-26-18 Water storage tank volume 0 gallons Total depth 360 ft Well disinfected for coliform test? ❑ Yes ❑ No Cased to 42 ft © Coliform bacteria is Negative ❑l Sanitary seal is functioning correctly Nitrate mg/L CI Nitrate less than MRL (ND) ElWires are properly protected Arsenic_ ug/L El Arsenic less than MRL (ND) Casing height(above ground) 24 in. Collected by MNA Date of flow test for COSA NEW Date of Sample 3.27-19 Static water level at beginning of test 50 ft. the/ 04/Vie Comments ,%r`'t" B. TANK DATA C. LIFT STATION Age of tank(s) 2018 years ❑ Required maintenance completed Tank type/material FIBERGLASS Age of lift station NEW years Measured operating fluid level in septic tank NEW Lift station material F.G. II Standpipes/foundation cleanout per record drawing Comments: Advantex Date of pumping NEW t' 1f" D. ABSORPTION FIELD DATA SW SOL Ott" Which system tested (date installed) 10-12-1 Adequacy test date new ❑ ALL standpipes present per record drawing Results Pass For 4 bedrooms Total measured depth from grade 5,S ft(max) Fluid depth prior to test new in Measured depth to pipe invert from grade ft(min) Water added gal El N/A-pressurized field New depth in Monitor tubes go to bottom of effective. If not, state Elapsed time min depth into effective ❑■ Code-required soil cover over field Final fluid depth in ❑ System presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) date of test) Gallons introduced new gallons If yes, enter date Comments/Deficiencies: 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' Community Sewer Manhole/Cleanout > 100' 0 Yes if No ft ❑✓ Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' ❑✓ Yes if No ft Absorption Field on Lot> 100' 0 Yes if No ft Holding Tank > 100' 0✓ Yes if No ft Neighboring Absorption Fields > 100' Animal Containment> 50' 0 Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0 Yes if No ft []Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water> 100' 0 Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ..L./.1 Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' 0 Yes if No ft 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' 0✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ✓0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft 'Private Wells > 100' CI Yes if No ft Water Service Line > 10' 0 Yes if No ft Community Wells >200' 0 Yes if No ft Surface Water> 100' 0 Yes if No ft F. ENGINEER'S COMMENTS ` `��`a�aC G. ENGINEER'S CERTIFICATION �"*:. Gf 9..OFq..•C••�@ k�, I certify that 1 have determined through field inspections and review r h'• '•"p d of Municipal records that the above systems are in conformance with *: 4 9?H •• �i d, � MOA COSA guidelines in effect on this date. �•' � •• s el-';`• MICHAEL'N. ANU[.RSON : ms's�. • �++ �i . CE �``4�69 . �. I14/te..111: r'Tii••••�;!.4.: COSA Checklist yellow sheet il��������~