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HomeMy WebLinkAboutBIRCHWOOD LOOP LT 2girchwood Loop #051 243 16 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201152 PID Number: 051-243-16 Dwelling: ❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ®❑ New ❑ Upgrade Name Jason & Ryan Mathias ABSORPTION FIELD ❑ Deep Trench R Wide Trench ❑ Bed E] Mound Site Address NHN S. Birchwood Loop Road ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 2.0 GPD/SFI 8.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 4.0 Ft. Gravel depth beneath pipe 4.0 Ft. Subdivision Block Lot Birchwood Loop 2 Fill added above original grade 0 Ft. Gravel length 30 Ft. Township Range Section Gravel width 5.0 FL Beds: Number of Lines NA Distance between lines NA Ft. SEPARATION DISTANCES To Septic Absorption Lift Station I Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 300 Ftz 1 NA Ft. Well 88,2 95.1 NA NA 25'+ TANK pp Septic [:1S.T.E.P. E] Holding 171 Other Manufacturer Orenco Capacity 1500 Gal, Surface water 100'+ 1001+ NA I NA Material Number of compartments Lot Line 51+ 10'+ NA NA i NA Fiberglass 2 Foundation 10'+ 10'+ NA I NA LIFT STATION Manufacturer Capacity I Remarks Gal. Alarm location Electrical installed by Installer PIPE MATERIAL House to tank 3034 Tank to drainfield 3034 Groundbreakers Drainfield 3034 CO/MT 3034 Inspector Pannone Engineering BENCH MARK (Assumed elevation) 194.0 It Inspection 1st 7/13/2020 ectio 7/14/2020 Location and description 3rd 2nd 0' Bottom of house trim at point A ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date OFF co - St2veri •R. Ponriorie �� �, . CE 814 ° o- Septic System � Approved ��'�;'� 5 Date o? � a ,Ftcd�,� $� • rr. Note: this approval does not include well permit requirements. � - (n O C)-- 2 D �:' D�7ACn'D—iZ --1 "2ju "00 I AX coCD D N N .. a��m mnz m o m pO�O� Trim x (mit < z i� A�(no� �zz - o y C) z r Ul y z � :E 0 N N O m = U m -• -' 41 WO _ W �n0O in z :E :E D z m m* � A m o z O r� + Cm D r 9 (n to �(AD -n0< O —1 Z 5 Nm Z O 11 rn --1 (14— 0o(n �:' D�7ACn'D—iZ --1 "2ju "00 AX 0 A n�Go N N .. r AOFTI 0 N D> C) n A N N N N = U -' -• -' 41 WO N t�rna)vcncn8 D p Orn O CAO � n D m Cn 0 Ul rn (n to �(AD -n0< O Z O rn N W Ut a -? P O (f) tD O -P Ut m J ci P N co W rn O W J n - N --1 (14— 0o(n �:' D�7ACn'D—iZ --1 "2ju "00 AX 0 A n�Go A (n .. r AOFTI 0 N D> ;aO n A 0 N� Z D x = U O O m 41 WO �0 W00 W P 0NNp.. D p Orn O CAO � n Zu m Cn 0 Ul rn (n to �(AD -n0< O Z O rn m X Q �I 0 O (f) rn 0 1 � z I II A \\ \\ b', \ m \ r A m rio I 1 \ \ \ czit 0 -Ti I 1 \ CV) 1 I n A nx � I I 1 \ o K (— I OJ r O W D I \ ` (TI m Dor I rn O rn z m n rn UI i m �� Z O A Q D I I A o cA -+ FTI Z 1 m I I 1 n I \ O\0 m0 A \ 0 3 Ac Ax F, A / \ pZ� \ =00o \ \ \ \ \\ >Xx z� \ \ \ \ \ -q Z- \ \ ZOZ \ \ \ 1 I I E r- I\> I I I E I E w IE e 1 0 " I I I 1 A m x T \ \\ I 0 (A 41 <lO� I E \ I I I 0 m8Z E� \ I / r 0 E/ E //E D�p IGn / � - / E E/ E '-oD >I z / E I / / I m a E / It It I /\ / zl E / E E E / aa� 0 NOTES: P%LNNONE ENG SVC, LLC C.I. 1088)""" t, REVISIONS DATE RECORD DRAWING PHONE 9087)X745-82 0 FAX (907 XD 745-8201 _ ��P�� F ACAS's. I i 2£C�t�( SCA E4/2021 BIRCHWOOD LOOP L2 1" = so' S.. _.. .... . ..... P.LD. No SITE: NHN S BIRCHWOOD LOOP RD ..- .. .. 051-243-16 DRAWN MJL JASON &RYAN MATHIAS %,'. Stevan t. Ponnone= PERMIT No. cE-etas _ OSP201152 PO BOX 110818 4 SHEET SITE PLAN ���,,,;°:'��` 2 of 2 ANCHORAGE, AK 99511 atton Water Well., Inc. 1190 N. Wasilla-Fishhook Road Wasilla, Aft 99654 (907)376-2041 Name: Mathias Address: PO Box 110818 City: Anchorage State: AK Zip Code: 99511 Well Site: Birchwood Loop Lot/Block: L2 Additional: Well Depth: 204 ft From: To: Formation: 0 9 silt/gravel Below Ground: 202 ft. 9 22 soft grey rock Above Ground: 2 ft. 22 26 coal Gal/Min: 2 26 117 sandstone 117 126 coarse broken sandstone Static Level: 8 ft 126 148 shale/sandstone streaks 148 186 shale Casing: 45ft. of 6 in. x .25 in. steel 186 204 sandstone Liner Pipe: 160 ft. Screened: N/A Perforated: N/A Grouted: Yes Depth: to 42' WATER QUALITY TESTING d1brm 5 � C0Il400ML FeNc Develop. Method: Air ates O� 3/L Ass �� 4 Use of Well: Residential 428120 Drilling Method: Rotary Misc: Other: chlorinated to 50ppm The well was pumped 5' off the bottom with 100% draw down for 2 hours and recovered at 2 . Date Drilled: 6.22.20 Driller: Ben Mattson Development Services Department Building Safety Division Aj,� � On -Site Water & Wastewater Program ©� '< ` 4700 Elmore Road P.O. Box 196650 Mark Begich Anchorage, AK 99507 s Mayor www.muni.org/onsite (907) 343-7904 Pump Installation Well Drilling Permit Number: SW OSP Date of Issue: Parcel Identification Number: Legal Description Birchwood Loop Lot 2 Property Owner Name & Address: Mathias Homes PO Box 110818 Anchorage, AK 99511 Pump Installation Date: 11/23/2020 Pump Intake Depth Below Top of Well Casing: 165 feet Pump Manufacturer's Nacne: MEYERS Pump Model: 3NFL72-8-P4-02 Pump Size 3/4 lip Pitless Adapter Burial Depth: 13 feet Pitless Adapter Manufacturer's Name: Campbell Pitless Adapter Installer: unknown Well Disinfected Upon Completion? [,-/] Yes ❑ No Method of Disinfection: Sterilene Comments: Pump Installer Name: Wheaton Water Well, Inc. 1190 N. Wasilla-Fishhook Road Wasilla, AK 99654 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. I 8 s Ve t o I s Manholes House Detail Scale 1" =- 20' R -1 - Legal Description: Asbuilt Legend: Set Rebar with Cap 0 AL. Monument BFound YPC 0 irchwood Lool-% Subd Monument F Well 0 Lot 2 Septic QS Survey Certification: I hereby certify that a Mortgagee's Grove[ Inspection was performed on the described property. Notes: It is the owner's responsibility to determine the Overhang existence of any easements, covenants, or restriction which Wood Deck are not on the recorded subdivision plot. Concrete I Checked by. CB Drawn by: BH Scale 1 80' Grid NW0954 Job 2013-39 Field Book: 137 Plot 2018-46 Date: 7/1/2020 Fire Turnaround with 150' length 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://wwvv.muni.org/onsite On -Site Water & Wastewater System Permit Permit Number: OSP201152 Work Type: WellSeptic Initial Tax Code Number: 05124316000 Site Legal Address: BIRCHWOOD LOOP LT 2 G:0954 Site Mailing Address: Owner: MATHIAS JASON 50% & Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: `, 11�cnr �4 A '81 A r n V I�eparrn7enr 6/9/2020 6/9/2021 93544 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy LTJ 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 By: Issued By: Date: / Date: (A 112 MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWERfWELL PERMIT APPLICATION Parcel I.D. 051-243-16 Property owner(s) Jason & Ryan Mathias Day phone Mailing address PO Box 110818 Anchorage, AK 99511 Site address NHN S. Birchwood Loop Rd Legal description (Sub'd., Block & Lot) Birchwood Loop L2 Legal description (Township, Range & Section) Lot Size 93,544 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial 0 Single Family (SF) (w/wo ADU) Septic Tank RX Upgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal ❑ 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. (Signature of property owner or authorized agent) Permit/Rush Fees: 126 / (g 15' Waiver Fees: Date of Payment: Date of Payment: Receipt Number: 65 (0 Receipt Number: Permit No. (35 P26110J - Waiver No. Permit App_-'-:. .-.,:c COVID-1 9 25% DISCOUNT APPLIED Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201152, Rebecca Carroll, 06/09/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201152, Rebecca Carroll, 06/09/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201152, Rebecca Carroll, 06/09/20 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this Day of of 24,d , by and between �/✓� /1�j , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as located at (legal description) LG f ,�, A;"ujo,,,S /. oz� 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 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 shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). V.JIV\ 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. P- Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page I of 3 VOwner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. 9 Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. �" ` Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. QA Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. 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 constriction, 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 AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By:(signature) (print name) STATE OF ALASKA Date: 6 9 Lzo ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this 2021, by NQ My Y PUBLIC FOR ALASKA expires: MUNICIPALITY: C�fdtC By: l(signature) A_& ec6i dl -r -o / (print name) t' day of aDw- p , Date: Title: (rev. 05/18/2018) Page 3 of 3 MMR 7i 11azural Gas Company September 5, 2018 Subject: Letter of Non -Objection: Septic Lots 2, 3, and 4, Birchwood loop Subdivision To whom it may concern: ENSTAR Natur•aI Gas Company A DIVISION OF SEMCO ENERGY Engineering Departnent, Right of Way Section 401 E. International Airport Road P. d. Box 190288 Anchorage, Alaska 99519-0288 (907)277-5551 FAX (907) 3334-7798 ENSTAR Natural Gas Company has no objection to the proposed septic system, which will cross a portion of the ten foot wide natural gas easement, within Lots 2, 3, and 4, Birchwood Loop Subdivision, as described in "Note 12" of Plat No. 2018-46, located within the Anchorage Recording District, Third Judicial District, State of Alaska. Acceptance and use of this letter of non -objection by yourself,, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: Landowner/Contractor working near ENSTAR gas facilities shall contact the Alaska Digline, Inc., (907) 278-3121 or 811 for line locating two (2) business days prior to any related excavation. This service is free of charge. 6 ENSTAR will be held harmless, now and forever for any damages or injury to any person or property as a result of this encroachment. 4 Any ENSTAR facility damaged or destroyed, as a result of this encroachment will be repaired at no cost to ENSTAR. a Any costs incurred by ENSTAR for special construction necessitated by this encroachment will be borne by the land owner. • All applicable safety code regulations will be observed and maintained. d This Ietter of non -objection will in no way preclude ENSTAR from full use and enjoyment of its rights within any portion of its right-of-way. Sincerely, Cassie Acres Right of Way and Compliance Technician ENSTAR Natural Gas Company 0���D N�0B��0���.Q 8~�~�7 ���� ANCHORAGE @��N��d»gU����~����B� � ��0— 6��Q`�������Q�u������ Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fa--: 907-343-7097 Certificate of On -Site Systems Approval Parcel I.D. 051-243-1K 1. GENERAL INFORMATION Como����cm|��mic�Birchwood '[chVVOOd(OOD|2 . �� ~_ - — Location (site address) N-tr-K S Expiration Date: _ jcA_ne_ A'[ChVVOOHLoop Road Current property mmner(s) Jason & RV8D [Naih'@S Day phone Mailing address Real estate agent Day phone 2. TYPE (]FDWELLING: �] Single Family kx/vvoA[}U\ �] Duplex Multiple Dwellings (Single Family and/or Duplex) � 2. NUK8BEROFBEDF�OOK0S: ` 4. TYPE OFWATER SUPPLY: TYPE OFWASTEWATER DISPOSAL: Private Well El Private Septic Fx_l Water Storage || Holding Tank D Community Well U Community El Public Water System Fl Public GGvver El Waiver request for: Distance' COSA to be released to the engineer, unless otherwise requested by the engineer. C[)SA Fee75 Waiver Fee $ Date of Payment Date ofPayment Receipt Number Receipt Number COSA# OSC211003 VVaivar# 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. 6. DSD/ SIGNATURE l System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Date OF ACgkk� � "'Fp�••. ..•••cit'\ Conditional approval for bedrooms, with the following stipulations: tttt(ttt Orr 01V -S/ VVtjE A rj WAS nID m= PRO GF;q �o _. `K _Z1 ti I By: \��J �a9U•�A Original Certificate Date:_-; The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist Legal Description: Birchwood Loop L2 Parcel ID:^� If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) 1 / Date drilled 6-22-2020 Total depth 204 ft Cased to 45 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA New Static water level at beginning of test 8 ft. Comments New well, no well flow test performed B. TANK DATA Age of tank(s) 72020 years Tank type/material Measured operating fluid level in septic tank new ❑ Standpipes/foundation cleanout per record drawing Date of pumping New tank D. ABSORPTION FIELD DATA Wide Trench Which system tested (date installed) 7/13'2020 ❑ ALL standpipes present per record drawing Total measured depth from grade 8 ft (max) Measured depth to pipe invert from grade 4 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective On Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: New Absorption Field, no adequacy test performed COSA Checklist yellow sheet Well production at time of test 2 gpm Water storage tank volume na gallons Well disinfected for coliform test? ❑✓ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate .38 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Pannone Engineering Date of Sample 12/29/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date Results ❑ Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date 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' 88.2* Yes Community Sewer Manhole/Cleanout > 100' Yes if No ft M Yes if No Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' ❑✓ Yes if No > Absorption Field on Lot 100' p _ Yes 95. if No 1*ft ft Holding Tank > 100' �✓ Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' [�✓_ Yes if No F71 Yes if No ft if No ft F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main ? 75' Yes if No ft 0 Yes if No ft ft ft ft 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' M Yes if No ft Property Line > 5' ✓0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' El Yes if No ft Private Wells > 100' Q Yes if No ft Water Main > 10' M Yes if No ft Community Wells > 200' Q Yes if No ft Water Service Line > 10' M Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10' Q Yes if No ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100' Yes if No Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' Q✓ Yes if No Surface Water > 100'✓Q Yes if No ft F. ENGINEER'S COMMENTS *This septic system uses an advantex tank. G. ENGINEER'S CERTIFICATION ��tF A(�sk� P I certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with 4T MOA COSA guidelines in effect on this date. .i 0....... ......... Steven R. Pannone COSA Checklist yellow sheet ft ft MtiNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this ��Day of�� 1� of 20 2.- 1, by and between erein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described asEj located at (legal description) gvc A \jJ C-) al L � L, 2- 2. Maintenance, Repairs and Alterations. Owner is required to read,. understand and initial each section) ;it" //hroughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). A�;eAOwner 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. Aye, P-/wner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. "Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Pa,,A�"wner 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 property will not occur without a new Certificate of On-Site Systems Approval. A"wner 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. A'ly*Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: .� f By: ' (signature) (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknow 20 by A Ali r NOTARY '?UBLIC FOR ALA My Commission expires: Date: /"I FeO 7-c)2, bre me this 1 day of 14AREN GRAY Lary Public to of Alaska MY commfssfcn Expires Nov 6, 2024 MUNICIPALITY: l By: D. (signature) (print name) Date: Title: (rev. 0/18/2018) Page 3 of 3