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Home My WebLink AboutWOODHAVEN #3 LT 5Onsite File k� r w Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191036 PID Number: 015-282-50 Dwelling: ❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: OR New ❑ Upgrade Name SPINELL HOMES ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 3951 Marcelle Circle, ❑ Other Phone Number of Bedrooms Soil Rating depth from original grade 4 1.2 GPD/SF JTotal 6.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2.0 Ft. Gravel depth beneath pipe 4 Ft. Subdivision Block Lot WOODHAVEN #1; LOT 5 Fill added above original grade 1 + Ft. Gravel length 50 Ft. Township Range Section Gravel width 5.0 Ft. Beds: Number of Lines 0 Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 500 Ft2 1 .0 Ft. Well 50'+ 50'+ 50'+ 50'+ TANK X Septic [IS.T.E.P. F_1 Holding E]Other Manufacturer Capacity ANCH TANK, ADVANTEX 1500 Gal. Surface Water 100'+ 100'+50'+ Material Number of compartments Lot Line 10'+ 10'+ 5'+ NA FIBERGLASS 2.0 Foundation 101+ 101+ 101+ LIFT STATION Manufacturer Capacity Remarks ADVANTEX 1500 Gal. Alarm location PRE-SET Electrical installed by MOA PIPE MATERIAL House to tank 3034.Tank to 3034 drainfield Installer MIKE N ANDERSON, P.E. Drainfield 3034 CO/MT 3034 Inspector MIKE N ANDERSON, P.E. BENCH MARK (Assumed elevation) 108.1 ft Inspection 1s' OCT 14 OCT 15 Location and description dates:2nd GARAGE SLAB 3`d 4,h ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp o t 4 Conditional Approval: Date —17 ....... m 0 .... 0 O C m p@ O p 4 ° r. rJMICHAEL N. ANDEP,SON �,�� Septic System r' °ase CE 9459 �• Approved Date Note: this approval does not include well permit requirements. .� (Rev 05/02/18) Permit No. OSP191036 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: WOODHAVEN #3, LOT 5 PID No.: 015-282-50 MARK A 0T__ 206— TC01 B — — — — -- — — — — — — — — — —— TCO2 CO2 17_ 38 39 C05 3 702 / / \ \ MT2 11 35 41 / ( NEW 1500 GALLON FIBERGLASS AD I NTEX TANK AND POD I I l p I I / NEW/'kLL WITH 50' R DIUS /6-CQ5 CO3� 2 \ 1 �i SEPTIC AREA /I jC 2 TC01 \ l TH#2 �\\ \ 04 I _ i I � � BENCH, GARAGE SLAB / ASBUILT i o SCALE: 1"=50' I �COt TCO7 }r CO2 1F -0O3 TCO2 I I C04 C05 MT FIAT ® OF a., , OG ®.•.�� '® FINISH GRADE ®��' ••��-®J®®® ' •• •. — �RLTER FABRIC .0 ORG ® y ® "` 49 TH `• ®®I g 1.500 GALLON flBERGLASS TANK uva aa. 98 9 SM/CM ........ 9 a ....................... 0. _ MICHAEL N. ANDERSON; ':•OAF No. CE 9469 �® ® 40410 SEPTIC SECTION N.T.S. 88 _\' ®444 ESS` DRY, OCT 2019 ®®®®® 1- '7 ' 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20 - COMMENTS WAS GROUND WATER -� Gross Time ENCOUNTERED? Municipality of AnchorageI EE 7s EA' - Development Services Department f ° On -Site Water and Wastewater Section 3P o 7 E}3�" b` L 4700 Elmore St. P.O. Box 196650 Anchorage, r°°°°°°°° F' 0 PE Monitoring? AK 99519-6650 3 www.muni.org/onsite °p MICHAEL N. ANDERSON (907) 343-79041 CE-9469U*j 'r%� Soils Log - Percolation Test=°u Performed For: "?7 P 1C-1 Date Performed: Legal Description: XV6,VI -44 j L J Township, Range, Section: Slope Site Plan 1- '7 ' 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20 - COMMENTS WAS GROUND WATER Date Gross Time ENCOUNTERED? - /^ Net Drop s IF YES, AT WHAT DEPTH? L Depth to Water After 0 PE Monitoring? rH Date: '01r- I 'r%� Reading Date Gross Time Net Time Depth to Water Net Drop °% PEK(;ULATION RATE X) (minutes/inch) PERC HOLE DIAMETER (41_ TEST RUN BETWEEN Z— FT AND �_ FT PERFORMED BY: I�/CI�(✓I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 1/ 1 q _ Certified Drilling Log manDOC CO dba SILL Sc COLE ®�►LI WELL PO. Box 670269, Chugiak, AK 99567 688-2759 OWNER OF LAND: Spinell Homes ADDRESS: Bore Hole Data Depth From To LEGAL DESCRIPTION Woodhaven #3 Lot 5 DATE: 4-2-19 0 2 Casing Stickup PERMIT NUMBER: OSP191036 DATE OF ISSUE: 3-14-19 TAX IDENTIFICATION NUMBER 01528250000 Is well located at approved permit location: ®Yes ❑No Method of Drilling: ®air rotary ❑cable tool Depth of Well: 125' Casing Type: Steel wall thickness.250 inches Diameter: 6 inches, depth 125 feet Liner type Static Water Level: 52 feet Recovery Rate 8 ® gpm ❑ gph Method of Testing Air Well Intake Opening Type: ® open end ❑open hole ❑ Screened Start feet Stopped ❑ Perforations Start feet Stopped Grout Type: Bentonite Volume: 50 lbs Depth: from 2 feet, to 42 feet Well Disinfected Upon Completion: ®yes ❑ no Method of Disinfection: Chlorine 50 PPM Comments: 2 4 Overburden 4 21 Silty Sand & Gravel w/ Clay 21 27 Tight Sand & Gravel 27 81 Hardpan 81 88 Tight Sand & Gravel 88 121 Tight Sand & Gravel w/ Clay 121 125 Sand & Gravel Water E, c. i i i u E1181 11c; Ug/L 10 31 l 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. Well Drilling Permit Number: SW OSP191036 Date of Issue 3-14-19 Parcel Identification Number: 01528250000 Legal Description Woodhaven #3 Lot 5 Pump Installation Date: 4-5-19 Pump Intake Depth Below Top of Well Casing: 110 Pump manufacturer's Name: F&W Pump Model: 4F07P05301S Pump Size: 1/2 Pitless Adapter Burial Depth: 10 Pitless Adapter Installer: Pomraning Excavation Disinfected Upon Completion? ® yes ❑ no Method of Disinfection: Chlorine 50 PPM Comments: Pitless Manufacturer: Martinson 11 Pump Installers Name: Sullivan Water Wells Property Owner Name & Address Spinell Homes feet hp feet Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. S 804804, I L I HEREBY CERTIFY THAT I HAVE SURVEYED THE -T PROPERTYAS-BU DEPICTED .a r THAT NO GASTALOI LANOr ENCROACHMENTSr f LLC RESPONSIBILITYSURVEYING, JEFF A. r DETERMINE 000 E. DOWLING RD., SUITE 81,COVENANTS OR RESTRICTIONS WHrr NOT kNCHORAGE, 99507 APPEAR ON O'r r SUBDIVISION PHONE UNDER • CIRCUMSTANCES SHOULD ANY DATA 3RIr DATE HEREONUSED FOR CONSTRUCTION OR r 10/3/2019 '� ESTABLISHING BOUNDARY OR FENCE LINES. H_.. „ . ANCHORAGEr......RECORDING DISTRICT, M i O NOTE: NO CORNERS DATE WHS5 I '3i po tT V W �ti OF AL �P•'® ®°®,`ref T� `:..49TH .........:.. .. No Jff 2 e ery A. Gostaidi : o •O 'o LS -6091 ��AW sP 'o, 10/3/2019 �J 0 Po' °••.000000 a°' pr0fe5510n01 \-pn FA vias%* BUILDING i 20° DRAINAGE ESMT. —15° GAS & SLOPE ESMT. ""T, MUNICIPALITY OF ANCHORAGE ' v- -- " — ..- 1'r n 1. On-Site Water &Wastewater Program ° sr; PO Box 196650 4700 Elmore Road ` '�. ... 1 Anchorage,Alaska 99519-6650 Phone:(907)343 7904 Fax:(907)343-7997r i,' " httpa/www.muni.org/onsite .i i o i '> l) artmcnt 4NCH0"P('- On-Site Water & Wastewater System Permit Permit Number: OSP191036 Effective Date: 3/14/2019 Work Type: WellSeptic Initial Expiration Date: 3/13/2020 Tax Code Number: 01528250000 Site Legal Address: WOODHAVEN #3 LT 5 G:2735 Site Mailing Address: 11740 ELMORE RD, Anchorage Owner: SPINELL HOMES INC Lot Size in Sq Ft: 43214 Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Total Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field EI Septic Tank ❑ Holding Tank 0 Privy E I Private Well 0 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 i, 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: Date: / (,�Issued By: jDate: 7' MUNICIPALITY OF ANCHORAGE Development Services Department \ Phone: 907-343-7904 On-Site Water & Wastewater Section ` Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 015-282-50 Property owner(s) SpinelI Homes Day phone Mailing address Site address Legal description (Sub'd., Block & Lot) WOODHAVEN #3 LT 5 Legal description (Township, Range & Section) Lot Size 43,214 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field Initial 0 Single Family (SF) Li (w/wo ADU) Septic Tank ❑ Upgra•- 6 7 8 ( Duplex Du D ❑ p ) Holding Tank ❑ Re ..!' I\ !j , _ . Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ® a FEB 1 2019 a Water Storage ❑ ti 40 h� THIS APPLICATION INCLUDES A WAIVER - "eia} OR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. OA— (Signature of property owner or authorized agent) Permit/Rush Fees: 49.0//9 9 r Waiver Fees: Date of Payment: '$020 cL Date of Payment: Receipt Number: ' IU 963 Receipt Number: Permit No. 03P19 1036 Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc • March. 12,2019 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: New Septic&well Permit Legal: WOODHAVEN #3 LT 5(revised) To Whom it may concern: This is a request for a septic/well permit on the above referenced lot. The test hole was done by Anderson Engineering(no relation)and showed Silty Sands,see attached and water at 11 feet. A new test hole will be done prior to installation to verify the soils. The plat requires an Advantex type system therefore we have designed around this requirement. The perc rate was 24 minutes therefore we are proposing to use an application rate of 1.2 gallon per square foot per day which is conservative. The perc location doesn't cover the leach field completely but the neighboring test hole has the same soils, see attached soils log. The maximum water table on both lots is 9 feet which is 3 feet below the bottom of our new system. If a external pump basin is required it will be installed per this design. The slopes are shown on the site plan and the system will be installed parallel to the slopes. A detention basin has been added to the site which is required by the subdivision agreement. The bottom of the basin is covered with rock to allow infiltration of any water to prevent any open water within 50 feet of the septic system. The footing drain note has been shown on the 50 scale site plan with no outfall due to freezing. 1 This permit \\ill not impact any of the neighboring lots due to the size and good soils. Sincerely TOL Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 I DESIGN CRITERIA: I MOUND OVER (TH#1) b -- GRADE 4 BDRM X 150 = 600 GPD SOILS = 600/1.2 = 500 GPD IFILTER FABRIC 500 GA/5 = 50' 2ORG -2.0 m''' ''' ^(�PIPE SM SEWER ROCK (1)TRENCH 6.0' DEEP -6.0 4.0' EFFECTIVE 5.0'WIDE I_5° I 50' LONG 17 TEST HOLE#6 DATA,WATER AT 11,MAY 2013 SEPTIC FIELD SECTION I 1 I 1 , III '1— - - - - - - - - --_ - - - - - - - - _ III -E KLATT ROAD- — - I / / • H - 1 III I WELL \1 II I I , II t\ J SEPTIC I I PROPOSED •• i\ ' WELL PROPOSED ON-LOT / '-_, I DETENTION BASIN PROPERTY LINE - �� ' I II I -- — Jl� _ - / SEPTIC, \ . — - - - — �- - - -\- -1r. — — � ;III 1 I I 1 I .1 /,�$ PTIC � / i 1 I t t •WELL i 1 t I III PROPOSED HOUSE I t \ / I \ \ / / \ 1 / - e / r-'-. \ \ / / \\ / \ \ / / _I.,'� / I --iQ III 1 J I WELL t1 �- -_ ---1�Q 1 II t 1 I / `� 01 - \ / III .` `-- /' I \LL /'tII \`� \j\NNAMED STREE I \\ II ` -' PROPOSED / I • 011 iL I DRAINAGE FIELD 1 j1 • t1 I t\ I II w • I /t I 1 w� - I • / \ • / •• 2 I r �` _ I 1 III cII I \ t - - - - - - - - I„ '' A LL \t II 1 1 II PROPOSED WELL 100' III /x `.�_`y�'/ // .••• RADIUS-TYPICAL 1 II \` ___�-C /1 \ t II I I I I • I I t I II 1 \ I/ I I \ • II ' 11I - - I / II 1 .dionwI Septic Design Prepared for ..4�`1111SIRitI,, SPINELL HOMES INC ••�PE OF q�,�S�•i• WOODHAVEN #3, LOT 5 Anchorage, Alaska :• 49TH /\ ♦% Michael N. Anderson, P.E. DATE: 2/15/2019 ♦♦';MICHAEL N. ANDERSON;! ♦ cE 69 4601 NATRONA AVE DRAWN: DJR ♦♦%No.••.:�030q•.•••'. : ANCHORAGE,ALASKA 99516 �• (907) 727-8864/FAX: (907)345-1391 SCALE: 1"=200' ��1 ;' i4 ' I i S'I T12N R3W,SECTION 21 / N2NW4NE4SE4,PARCEL 58 I --`— VERIFICATION NEED PRIOR TO PLACEMENT OF THE WELL OF �s NEIGHBORING WELLS AND SEPTIC ,' `,SYSTEMS. / • I I J L _ - - - - 7— \ rT7 �' `\ / \ \ I �i' PROPOSED WELL \\ \ PROPERTY LINE I I 100'RADIUS \ t j WELL It II I i \ I ® PROPOSED ADVANTEX � 4"DIAMETER DRAIN TILE PIPE TEST HOLE#6 FROM SUBD. It SEPTIC TANK, POD AND PUMP I AROUND FOUNDATION AGREEMENT BY \ BASIN IF REQUIRED COVERED W/PEA GRAVEL ANDERSON ENGINEERING \ / iAND FILTER FABRIC TYP.NO \ \ / / �,`/' OUTFALL TO PREVENT \\ �� / /i FREEZING. --7 f I C• I I ��vv MT TCO 0 PI�QPOSED / '� / S • \ \ 1 •• / H USE / / t• \ \•\ / / / � /\• • ; i \ \ , `\ `\ i / / / SEPTIC AREA \' • ` \ \ _ / \\\ \\\\\ ��\`IV. `'S - Wv.DryAVEN 31 Ste' \ I •... \ ------ LOT 5. 1 I \ I \ \ / r' = -- PROPERTY LINE /'. I , wz V I / QU! // of / $/ `� 3'CONTOURS . Q,6 WOODHAVENp3 / Ri /. LOT 4 / \ . 1$- / / . � / •/ `\ PROPOSED ON-LOT . \ DETENTION BASIN,26'X 26' WITH 10X'10'BOTTOM s COVERED W/3-6"STONE. NO W®L • OPEN WATER ALLOWED. PCAN� AND SEED.SLOPE S AT 4:1 TOPSOIL . VSPILLWAY LINED WOODHAVEN#3 WITH 1"TO 3"STONE.SEE TRACT A SUBD.ADD#3 SHEET C7,BY ANDERSON ENGINEERING \ \ I \, Septic Design Prepared for ii"11sii .•'.7E OF 4 4k4. SPINELL HOMES INC 44x G ,..••................qS.. '�' .♦♦ WOODHAVEN #3, LOT 5 • ) .• 49 TH I, •; , ♦j Anchorage, Alaska • • - • Michael N. Anderson, P.E. DATE: 2/15/2019 ,♦♦v.- •;MICHAEL N. ANDERSON: ♦ � No. 0 9 69 • � 4601 NATRONA AVE DRAWN: DJR ♦1♦ •. z, it(.11••••• •••< ANCHORAGE,ALASKA 99516 4,� 4• (907) 727-8864/FAX: (907) 345-1391 SCALE: 1"=50' 4441 �SS;. i. MUNICIPALITY OF ANCHORAGE 44 1 DEVELOPMENT SERVICES DEPARTMENT �P•• (�;, •.. '111 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 'ZJAS' C").'.* •1 49th >� 0 SOILS LOG - PERCOLATION TEST ;�y .. .. T a MICHAEL E. ANDERSON;j WOODHAVEN SUBDIVISION NO. 3 •V�f.. No. CE-4381 LEGAL DESCRIPTION: • �` '•.. �'• PERFORMED FOR: SPINFLL HOMES 11ESS� 4. DATE: 1/17/13 PROJECT No.: ,•��"`•�� PARCEL ID#: TECHNICIAN: A. HARALA Professional Engineers Stamp: DEPTH TEST HOLE No. 5 (feet) SLOPE SITE PLAN I � OB/OG 1 3 SILTY SAND SEE SITE PLAN 4 • WITH VARYING SILT G 5 6 SM 7 K WAS GROUND WATER.ENCOUNTERED? No 9 IF YES[a)WHAT DEPTH? DEPTH TO WATER AFTER MONITORING: 1 1 O DATE OF MONITORIN : 5/15/13 5/15/1 `/' 11 1 DEPTH TO 1 DATE :FADING GROSS TI E NITUT s) WATER N(INCHDESOP (INCHES) 13 III' TEST HOLE PRESOAKED PRIOR TO TESTING: 14 I 1:15 1.375" ' 1:45 30 2.00" .625" 15 3 1:46 1.50" 16-- • BOH @ 16.5 1• 2:16 30 2.125" .62.5 17— 2:17 1.25" 18— 6 2:47 30 1.875" .625" 19 PERCOLATION RATE: 48 (MIN/INCH) PERC.HOLE DIA. 8" (INCHES) TEST RUN BETWEEN—FT. and 5 FT. COMMENTS: 1 EST HOLE F'RE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 3/12/13 MUNICIPALITY OF ANCHORAGE •��1� DEVELOPMENT SERVICES DEPARTMENT • 1 L4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 d"�. L 1♦ • 49th �� ♦♦ SOILS LOG - PERCOLATION TEST ;7 , MICHAEL E. ANDERSON;'i„ ♦c : No. CE- 381 . LEGAL DESCRIPTION: WOODHAVEN SUBDIVISION No. 3 ♦♦♦.r„ ,.4—Z .•• .: PERFORMED FOR: SPINELL HOMES h♦f'ROFESSI�•••- DATE: 1/18/13 PROJECT No.: "Immus� PARCEL ID#: TECHNICIAN: A. MARACA Professional EngineersStamp. DEPTH TEST HOLE No. 6 (feet) SLOPE SITE PLAN 0 j�/ OB/OG 2 3 SILTY SAND 4 WITH VARYING SILT SEC SIT 1: F(AN 5 7 Y 6 SM 7 TRACE COBBLES 8 • WAS GROUND WATER ENCOUNTERED? tl: C) IF YES(tij WHA"1'own!? • DEPTH TO WATER AFTER MONITORING: li 10 DATE OF MONITORIN : t)fl/Li 5/15/It. II' 11 DATE READING GROSS TIME NET TIME WATER° NET DROP 12— (MINUTES) (MINUTES) (INCHES) (INCIiFs) 13 718 TEST HOLE PRESOAKED PRIOR TO TESTING: 14 - DAMP I 9:02 2.50° 15 2 9:32 30 3.75" 1.25' • - 3 9:33 2.25" 16 . . t, 10:03 30 3.50" 1.25° 17 BOH @ 17.0' 5 10:04 2.375' 18 6 10:34 30 3.625" 1.25" 19 PERCOLATION RATE: 24 (MIN/INCH) PERC. HOLE DIA. 8" (INCHES) TEST RUN BETWEEN-FT. and 5 FT. I COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGINEERING. 1,MICHAEL E.ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 3/12/13 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 /91K Day of ic,0411.y of 20 /9 , by and between Paved ,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 Afa/vrr..Ac r located at(legal description) s..f6gt.f/iJ/Art. / 440 f .� 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) pu! 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. 4' 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). PM) 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. fit) Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 • p ) Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. o«/ Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Did Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. n.✓ Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. pi.) 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. De/ 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: c_orV (signature) Date: L/i 3) s 1:›4& 4.14 .1`..< (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) The foregom instrument was acknowledged before me this/9 day of Fey eui , 20/7, by "D/1///) k/rti7F/EL, \\1��1/4kuuc(t((o(r'i ( >(1/(// - NOTARY PUBL FOR ALA KA `S 0pTARY •• My Commission expires: oma-/tel PUMA MUNICIPALITY: By: " I (signature) Date: 3/ .1),b (,C .ke,, ,5 (print name) Title: (rev. 05/18/2018) Page 3 of 3 MUNICIPALITY OF NCHORAGJE .. 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. 015-282-50 Expiration Date: V�_ b 1 3 0 2 0 1. GENERAL INFORMATION Complete legal description WOODHAVEN #3 LT 5 Location (site address) ANCH AK /�/'u„ tc.((c, Pcr Current property owner(s) SPINELL HOMES Day phone Mailing address Real estate agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: Private Well 0 Water Storage ❑ Community Well ❑ Public Water System ❑ Waiver request for: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer Day phone TYPE OF S Private e ti Holding Community Public Sewei Date: COSA Fee $ -7 + 145 ---°rs Waiver Fee $ Date of Payment "114 —\O\ C1IlaDate of Payment Receipt Number Z41gga 3 Receipt Number COSA # Waiver # L,(z tG 6 78 9 �O t TEWP",DIS R SAL: C 0 a z Distance: 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 N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 11-8-19 r o WASTEWATER o J < VT SERv�G By f1"�, Original Certificate 1 i 13 1 I g to Date: l 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 r Gci d S 4a � to n b 0 • ,.,� a 6. DSD SIGNATURE 4QTH `» System #1 Approved for 4 bedrooms System #2 Approved for t bedrooms per`F'Icti"� N. `'"D`'`'c CL 4469 r Disapproved Conditional approval for bedrooms, with the following stipulat r o WASTEWATER o J < VT SERv�G By f1"�, Original Certificate 1 i 13 1 I g to Date: l 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: WOODHAVEN #3 LT 5 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 4/2/19 Total depth 125 ft Cased to 125 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 24°+ in. Date of flow test for COSA NEW Static water level at beginning of test 52 ft. Comments NEW WELL AND WATER SYSTEM B. TANK DATA Age of tank(s) 2019 years Tank type/material ADVAN Measured operating fluid level in septic tank NEW ❑ Standpipes/foundation cleanout per record drawing Date of pumping NEW ADVANTEX SYSTEM D. ABSORPTION FIELD DATA NEW SYSTEM Which system tested (date installed) NEW ❑ ALL standpipes present per record drawing c� i Total measured depth from grade 00 D ft (max) t 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 0 gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 015-282-50 Structure served by this system Well production at time of test 5+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ Nc ❑ Coliform bacteria is Negative Nitrate 2.96 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by MNA Date of Sample 10-31-19 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date NEW Results Q✓ Pass For 4 bedrooms Fluid depth prior to test 0 in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) UN 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'Community 0✓ 50 + Sewer Manhole/Cleanout > 100' f7 Yes if No ft Q Yes if No Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' F-/� Yes if No Absorption Field on Lot > 100' ❑ Yes if No 50'+ ft Holding Tank > 100' F/� Yes if No Neighboring Absorption Fields > 100' Yes if No. Water Main > 10' Animal Containment > 50' Q Yes if No [-71 Yes if No ft Q✓ Yes if No. Water Service Line > 10' Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' [D Yes if No ft P/1 Yes if No 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' Yes if No. Property Line > 5' 0✓ Yes if No ft Wells on Adjacent Lots: M✓ Absorption Field > 5' 0✓ Yes if No ft Private Wells > 100' Yes if No. Water Main > 10' ft Yes if No ft Community Wells > 200' Q✓ Yes if No. Water Service Line > 10' Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 20 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' Water Service Line > 10' M✓ Yes if No ft Community Wells > 200' Surface Water > 100'✓Q 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 ft ft ft ft ft ft ft ft E✓ Yes if No ft ❑✓ Yes if No ft A' •9TH y • jb p •se o . % ,° ay o • • • . • • o ° ,ys MICHAEL N. ANDLR5CN t I �C `v. • 0 6 • 6 �,. °ate