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HomeMy WebLinkAboutCINERAMA TERRACE BLK 1 LT 1Onsite File rionerama errac� • it tKev u5/uln u) Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191412 PID Number: 020-521-01 Dwelling: X Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: X New ❑ Upgrade Name Alex Hall ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed X Mound Site Address 15610 Kings Way Anchorage, AK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 907-244-3269 4 2 GPD/SF +5.33 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade +2.5 Ft. Gravel depth beneath pipe .5 Ft. Subdivision Block Lot Cinerama Terrace 1 1 Fill added above original grade 5.33 Ft. Gravel length 20 Ft. Township Range Section Gravel width 15 Ft. Beds: Number of Lines 3 Distance between lines 5 Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer. Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 300 Ft2 Ft. Well >50' >50' >50' N/A >25 TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Orenco/Advantex Capacity 1,500 Gal.Material Surface Water >50' >50' >50' N/A Fiberglass Number of compartments 2 Lot Line >5' >10' >5' N/A NA Foundation >10' > 1 0' >10' NIA LIFT STATIONManufacturer Anchorage Tank Capacity 100 Gal. Remarks Alarm location Electrical installed by Inside closet at front entrance Frontier Electric PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 Installer Red Dog Masonry Drainfield D3034 CO/MT D3034 Inspector J. Millette BENCH MARK (Assumed elevation) 100 ft Inspection 15' 3/23/20 3/24/20 Location and description at 2�a Top of foundation Near FCO 3'd 4°i ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp e*.�� OF q�� iso Conditional Approval: Date .•�P,.•••" . S e Ar ♦s `.�. 49th � /................................................ 0 f♦♦ E. ANDER50N J Septic System .MICHAEL Iv ,•' ��-AW ®i TF'••.,, ♦ �� No. CE-4381FD Approve Date �- S'ZO 7/15/20 ,.•� <`��` ♦y Note: this approval does not include well permit requirements. �1�%flu'a -�a�i�••s tKev u5/uln u) PERMIT # OSP191412 -- -�- \ \ WET�AIVDS r �` AL ERNA \ ) BOUI�IDARY SI 1 I i \11TOE dF FILL Z61PI 70' LON x 15'NVIDE x . E FECTIE DEPT BSORP ON BED r L 1 // I / TH10 1,400 GALLO� FAPDVA TE 2 TH TANK x/AX-A FILTE PO�AN / r PIUMP VAUL' \�OUVEDRdOM\HOU�`�` . WELL w/50 DIUS -4 -A' CRM NT. ES T - 10' T&E EAOEMENT i ENGINEERING PID # 020-521-01 INT E r311 r I �� ❑ ® I iH \3' SECTION LINE EASEMENT T4 MT T1 : : II 1 �0' T& EASEMENT MT 20' PLEBLIC USE EASEMENT II �� PV H2 II I CO 1 3 I i �Q A B :AM �cl IwWmAl � 0 100 200 FEET 1"=100' FCO 6.5 31.0 MH1 14.1 32.95 SV1 24.0 37.9 PV 27.25 41.75 MT1 149.8 159.9 MT2 153.6 166.3 MT3 164.55 176.0 MT4 62.45T171.6 LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEAN PV - PUMP VAULT MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE CINERAMA TERRACE i , BLOCK 1 LOT 1 OSP1 91412 PID # 1 1 104.12 ORIGINAL GRADE 75 X106.62 106.12 - 104.12 - 99.54 GROUNDWATER 104.12 9/16/19 96.12 106.12 TYPE II GRAVEL' 104.12 20' 98.2 (NO SCALE) .'• • 49th MICHAEL E. ANDERSON N O. CE -4381 r •'0 6/25120 �o••� Permit Number: #SW 191412 Date of Issue: 9-27-19 Parcel Identification Number: 02052101000 Date Started: 11-5-19 Date Completed: 11-5-19 Is well located at approved permit location? x Yes ❑ No Legal Description: Cinerama Terrace Block 1 Lot 1 Property Owner Name & Address: Colony Builders 9420 Vanguard Unit A Anchorage, Alaska 99507 Borehole Data: Depth (ft) Soil Type, Thickness & Water Strata From To stick-up gravel fill organics & silt gravelly silt water sand & gravel 0 2 4 11 2 4 11 45 Method of Drilling x air rotary ❑ cable tool Casing type: steel Wall Thickness: .250 inches Diameter: 6 inches Depth: feet Liner Type: Diameter: inches Depth: feet Casing stickuta above ground: 2 feet 45 48 Static water level (from ground level): —0feet Pumping level: 45 feet after 2 hours pumping 40 gpm Recovery Rate: 40 gpm Method of Testing: air li Well Intake Opening Type: x Open End ❑ Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet Grout Type Bentonite -cement Volume: 120 gallons Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? x Yes ❑ No Method of Disinfection: chlorine tablets Comments: Well was pressure grouted from surface to 30 feet to offset artesian effect from surfacing around casing. Well Driller: Alpine Drilling & Enterprises PO Box 110496 Anchorage AK 99511 O o 'u o rn FOrn o cn U)-u o (A (A o Nj rnm m 6 Z 9 W � -D'i I nim toto v_ 40 CA A v00 o �z ;a0-0< u�nom -4 o �om� � ornm .. rn o=� p 0 z m n� m =4 o m CDNrTl n MM--omam m� o m M cvK�rrrn N � m vvo Hm� v Cl) . ommom Z oo— z<na o -o vN 0cv0(j)n 0vn m z= c�oamzv� mo�zoo� v V1 � -0 Z mm my m c N 0 KING'S WAY DRIVE N - W O O v -I rn rn P� o n !Tn z C: m K rrn co tD W w tom L4 U2 OD iA • ►- . nom x'"yL"r MUNICIPALITY OF ANCHORAGE ,rent On-Site Water&Wastewater Program moo 3 • S, PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 �' n • htt /1www,muni.or lonsite ( p 9 4'CMoanbf elm rtment On-Site Water & Wastewater System Permit Permit Number: OSP191412 Effective Date: 9/27/2019 Work Type: WellSeptic Initial Expiration Date: 9/26/2020 Tax Code Number: 02052101000 Site Legal Address: CINERAMA TERRACE BLK 1 LT 1 G:3241 Site Mailing Address: 8949 Cinerama CIR,Anchorage Owner: COLONY BUILDERS INC Lot Size in Sq Ft: 128106 Design Engineer: FORGE ENGINEERING Total Bedrooms: 4 This permit is for the construction of'. Q Disposal Field 0 Septic Tank 0 Holding Tank ❑ Privy Q 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 • • Received By: I9I ``I/Mi Date: Issued By: ,(, Date: :hp pv.:et .S Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http://www.muni.orq/Onsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV191084 COSA#: Permit#: OSP191412 PID#: 020-521-01 Legal Description: Cinerama Terrace Blk 1 Lt 1 Engineer: Forge engineering Your request for a waiver of the code requirement that for an ERS system, the laboratory analysis of the soils demonstrates the classification to be USCS GP, GW, SP or SW. Soils were determined to be SM. This waiver approval applies to the 2019 permitted primary and alternate fields only. Waiver is Granted: X Waiver is not Granted: Date: ' Approved by: 1)-e, Name of Revie **** VARIANCE/WAIVER REVIEW **** EPL NS MUNICIPALITY OF ANCHORAGE • Community Development Departments 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. 020-521-01 Property owner(s) Alex Hall Day phone 244-3269 Mailing address 15610 Kings Way Drive Anchorage, AK 99516 Site address NHN Kings Way Drive Anchorage, AK Legal description (Sub'd., Block & Lot) Cinerama Terrace, Block 1, Lot 1 Legal description (Township, Range & Section) Lot Size 128,106 Sq. Ft. Number of Bedrooms Four (4) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field [ Initial 0 Single Family (SF) EK (w/wo ADU) Septic Tank [ Upgrade ❑ Duplex (D) ❑ Holding Tank _ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well N 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. 1v1/,, ,L,(2,. a(C)t, -t9-.----‘ (Signature of property owner or authorized agent) Permit/Rush Fees: 6 ow Waiver Waiver Fees: 2-1 Date of Payment: ' I110P4 Date of Payment: q/Z7/°/ Receipt Number: cc docib Receipt Number: Q v7S 0 Permit No. O5PI Rl(J/' Waiver No. O, V I a 820 0 Li Permit App_.:-: ::_...c.: PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) September 25, 2019 MOA Development Services Dept, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Cinerama Terrace, Block 1, Lot 1 – NHN Kings Way Drive Septic System Design Dear On-Site Services Engineer: The owner of the above lot intends to build a 4-bedroom home on the property. We are submitting this permit application for the construction of a new well and septic system to serve the home. The attached site plan identifies the location of the home and the proposed well, septic location and alternate site. No conflicts exist between this proposed system and any other well or septic system on this lot or adjacent lots. The ground surface on the slopes to west at less than 10% grades. There are no slopes greater than 25% within 50 feet downslope of either the primary or alternate site. Ground surface contours are shown on the site plan indicating the grade and direction of flow. Stormwater drainage will not impact this septic system. The new bed will be constructed parallel to the slope as much as possible. The absorption trench will be constructed utilizing engineered receiving soils (ERS) in conformance with Section 15.65.210D3c and the attached design documents. The absorption bed will be utilized in association with an Advantex Treatment System with an AX-20 pod and pump vault. The system will be 50’ from the well on this and adjacent lots. The percolation rate for the accepting soils was estimated based on the silt content of the material found at that location. The silt content was determined to be 22% with 52.7% sand and 25.3% gravel. This resulted in a USCS Classification of SM or silty sand. Past experience has shown this material to absorb water at between 15 and 30 minutes per inch and often faster depending on in situ density. Municipal Code requires soils be GW or SW for utilization with ERS. We are requesting a waiver to the code to allow the use of SM soils. As mitigation we are using an application rate of 2 gallons per day/per square foot in lieu of the 3 gallons per day/square foot dictated by the assumed percolation rate. Groundwater monitoring indicates the water level will be at the surface during certain periods of the year. The absorption bed has been designed to compensate for groundwater levels at the surface. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191412, Deb Wockenfuss, 09/27/19 Please refer to the attached test hole logs, soils lab analysis, plan and profile sheets for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Michael E. Anderson, PE 9/25/19 130513001300200100 0 FEET 1"=100' 20' LONG x 15' WIDE x .5' EFFECTIVE DEPTH ABSORPTION BED NOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT PV - PUMP VAULT MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND FCO CINERAMA TERRACE SUB, BLOCK 1 LOT 1 9/17/19 10' T&E EASEMENT 3' SECTION LINE EASEMENT 10' T&E EASEMENT 20' PUBLIC USE EASEMENT 10' T&E EASEMENT CINERAMA CI RCLE KING'S WAY DRIVE50' CREEK MAINT. ESMT 1,500 GALLON FAP ADVANTEX TANK x AX-20 FILTER POD AND PUMP VAULT FOUR BEDROOM HOUSE PROPOSED WELL w/50' RADIUS ALTERNATE SITE MH MH PV MTMT MT MT TOE OF FILL SLOPE TH3 TH4 TH1 TH2 NOTE: WELL MUST BE A MINIMUM OF 25' FROM THE STREAM. WETLANDS BOUNDARY Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191412, Deb Wockenfuss, 09/27/19 CINERAMA TERRACE, BLOCK 1, LOT 1 DESIGN FACTORS: SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW PERK RATE: 15-30 MIN/IN APPLICATION RATE: 2 GPD/SF SHALLOW BED ABSORPTION SYSTEM 1,500 GALLON ADVANTEX TREATMENT TANK w/AX-20 POD AND PUMP VAULT TYPICAL RAISED BED SECTION (NO SCALE) NOTES: 1. GRADE AREA AROUND BED TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER BED AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY BOTTOM OF BED: 2' ABOVE GRADE FLOW LINE ELEVATION: 2.5' ABOVE GRADE TOP OF BED: 5' ABOVE GRADE 9/25/19 2" Insulation & 2' Cover (Min.) 2.5' 5.0' 2.5' Drainfield Rock.5' 3 1 1" PVC.5' Type IIA Classified Fill Silty Sand - SM 3 1 5.0' 10 - 3/16" Diameter Holes per Lateral Exact Limits of Excavation to be Determined in the Field by the Engineer. Maximum Excavation 6.0' Below Existing Ground MOA Approved Coarse Sand 6.0' 2.0' Original Ground Original Ground @ 3' OC 4" TOPSOIL & REVEGETATE REMOVE EXISTING PEAT AND ORGANIC MATERIAL TO IN SITU SANDY SILT. PLACE 6' OF TYPE IIA CLASSIFIED FILL WITH 2' OF MOA APPROVED SAND ATOP THE TYPE IIA FILL. CONSTRUCT ABSORPTION BED ATOP THE SAND LAYER. 4 BEDROOMS * 150 GPD.BDRM 600 GPD/2 GPD/SF/15' WIDTH = 20' LENGTH (REQUIRED) 20' LONG (SPECIFIED) Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191412, Deb Wockenfuss, 09/27/19 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE 1 SLOPE SLOPE SITE PLAN See Site Plan DATE READING GROSS TIME (minutes) NET TIME (minutes) DEPTH to WATER NET DROP TEST HOLE PRESOAKED PRIOR TO TESTING: PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) CINERAMA TERRACE B1 L1 4/10/19 J. Millette DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH OF WATER AFTER MONITORING: IF YES @ WHAT DEPTH? NO - 0 10 6 1 2 020-521-01 BILL TAYLOR 1:11 4/10 1 2 3 4 5 6 30 30 30 4 7 4 16 3 4 16 4 7 3 4 7 3 1:41 1:42 2:12 2:13 2:43 1' OB CLAY W/ COBBLES 9/16/19 Professional Engineers Stamp: 9/17/19 PEAT BOH TEST PERFORMED IN PEAT LAYER. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191412, Deb Wockenfuss, 09/27/19 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE 2 SLOPE SLOPE SITE PLAN See Site Plan DATE READING GROSS TIME(minutes)NET TIME(minutes) DEPTH toWATER NET DROP TEST HOLE PRESOAKED PRIOR TO TESTING: PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) CINERAMA TERRACE B1 L1 4/10/19 J. Millette DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING: IF YES @ WHAT DEPTH? NO - 0 480 6 1 2 020-521-01 BILL TAYLOR 1:38 4/10 1 2 3 4 5 6 30 30 30 3 4 16 4 12 16 3 4 16 0 2 16 2:08 2:09 2:39 2:40 3:10 1' OB CLAY W/ COBBLES 9/16/19 Professional Engineers Stamp: 9/17/19 PEAT BOH 3 4 16 3 4 16 3 6 16 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE 3 SLOPE SLOPE SITE PLAN See Site Plan DATE READING GROSS TIME (minutes) NET TIME (minutes) DEPTH to WATER NET DROP TEST HOLE PRESOAKED PRIOR TO TESTING: PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) CINERAMA TERRACE B1 L1 9/9/19 J. Millette DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING: IF YES @ WHAT DEPTH? Yes 4.5' 0' 020-521-01 BILL TAYLOR SILTY SAND SM 9/16/19 Professional Engineers Stamp: 9/17/19 PEAT BOH ORGANIC SILTY SAND UNABLE TO PERFORM PERCOLATION TEST DUE TO GROUNDWATER. SEE LABORATORY GRADATION. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191412, Deb Wockenfuss, 09/27/19 DEPTH (feet) PROJECT No.: TEST HOLE 4 SLOPE SLOPE SITE PLAN See Site Plan DATE READING GROSS TIME (minutes) NET TIME (minutes) DEPTH to WATER NET DROP TEST HOLE PRESOAKED PRIOR TO TESTING: PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) CINERAMA TERRACE B1 L1 9/9/19 J. Millette DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING: IF YES @ WHAT DEPTH? Yes 4.5' 0' 020-521-01 BILL TAYLOR SILTY SAND SM 9/16/19 Professional Engineers Stamp: 9/17/19 PEAT BOH LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 ORGANIC SILTY SAND SILTY SAND IDENTICAL TO TEST HOLE NO. 3. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191412, Deb Wockenfuss, 09/27/19 PROJECT CLIENT:% GRAVEL 25.3 USCS SM PROJECT NAME:% SAND 52.7 USACOE FC N/A PROJECT NO.:% SILT/CLAY 22.0 % PASS. 0.02 mm N/A SAMPLE LOC.:% MOIST. CONTENT 8.7 % PASS. 0.002 mm N/A NUMBER/ DEPTH:UNIFORMITY COEFFICIENT (Cu) DESCRIPTION:COEFFICIENT OF GRADATION (Cc) DATE RECEIVED:ASTM D1557 (uncorrected) N/A TESTED BY:ASTM D4718 (corrected) N/A REVIEWED BY:OPTIMUM MOIST. CONTENT. (corrected) N/A SIEVE SIEVE TOTAL % SPECIFICATION SIZE (mm) SIZE (U.S.) PASSING (% PASSING) 152.40 6" 76.20 3" 38.10 1.5" 100 19.00 3/4" 92 12.70 1/2" 86 9.50 3/8" 83 4.75 #4 75 2.00 #10 65 0.85 #20 55 0.43 #40 46 0.25 #60 39 0.15 #100 32 0.075 #200 22.0 ELAPSED DIAMETER TIME (MIN) (mm) 0 0.5 1 2 4 8 15 30 60 250 1440 HYDRAULIC COND. (ASTM D2434) DEGRADATION (ATM T-313) PLASTICITY INDEX ASTM 4318 PASSING The testing services reported herein have been performed to recognized industry standards, unless otherwise noted. No other warranty is made. Should engineering interpretation or opinion be required, NGE-TFT will provide upon written request. 11301 Olive Lane ∙ Anchorage, Alaska 99515 ∙ Phone: 907-344-5934 ∙ Fax: 907-344-5993 ∙ www.nge-tft.com N/A N/A UNKNOWN UNKNOWN Forge Engineering HYDROMETER RESULT N/A SIEVE ANALYSIS RESULT Cinerama Terrace 5248-19 Block 1 Lot 1 19-S-1 Silty sand w/ gravel 9/11/2019 EA RJPC TOTAL % 115 120 125 130 135 140 145 0 2 4 6 8 10 12 14 16DRY DENSITY (pcf) MOISTURE CONTENT (%) MOISTURE -DENSITY RELATIONSHIP ASTM D1557 SILT or CLAY COBBLES GRAVEL Coarse Fine SAND Coarse Medium Fine 0 10 20 30 40 50 60 70 80 90 100 0.0010.01 0.11 10 100 FINER BY MASS (%)GRAIN SIZE (mm) PARTICLE SIZE ANALYSIS ASTM D422 / C136 #200#40 #10 1.5 1/2 3 6 3/4 #4 #20 #60 #100 3/8 U.S. SIEVE OPENING IN INCHES U.S. SIEVE NUMBERS HYDROMETER Test Hole #3 - Sample taken at 6' to 7' below the surface. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191412, Deb Wockenfuss, 09/27/19 nrs o. 0 (14 „ OPINION OF COMPLIANCE �`�` on��e ANCHORAGE GENERAL PERMIT 93-10-M4/11-M4/12-M4 File Number: POA-2019-00570, Little Rabbit Creek [GP 93-10-M4 Residential Fill] Municipal Reference Number: Little Rabbit Creek 19-A Permittee (LANDOWNER): Colony Builders, Bill Taylor Expiration Date: October 31, 2020 Project Location: Lot 1 , Block 1, Cinerama Terrace Subdivision, Kings Way at Cinerama Circle Intersection, Anchorage Anchorage Wetland Management Plan Map #: 108 Wetland Unit #: 83 Wetlands Fill Amounts: -4,050 sq. ft/0.09 acre; -300 cyds gravel Work Description: Excavation and backfill for septic systems (main & back-up) and connection line to new home All work will be performed in accordance with the attached plans submitted with application dated: September 24, 2019 The permittee will perform work in waters of the U.S. (wetlands) in accordance with the terms and conditions of the Anchorage General Permit, as specified below: Anchorage General Permit Conditions: GENERAL CONDITIONS OF THESE GENERAL PERMITS All activities identified and authorized by these GPs shall be consistent with the special conditions listed above, as well as the general conditions listed below.The Corps can also add site-specific special conditions to a GP verification, as applicable. Obtain GP verification prior to activity: No work shall be done under these GPs without first obtaining an Opinion of Compliance (OC)from the MOA Planning Division or General Permit Verification from the Corps. A copy of the Municipal building permit application and grade/fill permit application or Land Use permit application must be included with the GP application. Compensatory mitigation, if required, must be acquired before proceeding with authorized jurisdictional activities. Wetland area confirmed by 2017 field visits. Time limit: Verification under these GPs is valid until October 31,2020, unless the GPs are modified, reissued or revoked. It is incumbent upon the applicant to remain informed of Cinerama Terrace 1 POA-2019-00570; Little Rabbit Creek 19-A • changes to the GPs. Mitigation:The activity must be designed and constructed to avoid and minimize adverse effects, both temporary and permanent,to waters of the U.S.to the maximum extent practicable at the project site. Mitigation in all its forms (avoiding, minimizing, rectifying, reducing, or compensating for resource losses) will be required to the extent necessary to ensure that the adverse effects to the aquatic environment are minimal. Compensatory mitigation will be required for all wetland losses greater than 0.1-acre unless the District Commander determines in writing that either some other form of mitigation would be more environmentally appropriate or the adverse effects of the proposed activity are minimal and provides a project specific waiver of this requirement.The applicant may seek this determination by written request to the Corps.The Corps'determination on compensatory mitigation will be returned, in writing,to the MOA Planning Division for inclusion into the OC. If applicable, compensatory mitigation must be completed prior to conducting work authorized under these GPs. Compensatory mitigation projects provided to offset losses of aquatic resources must comply with the applicable provisions of 33 CFR 332. NO MITIGATION REQUIRED—fill is less than the mitigation cut-off Setback:Where there are wetlands along or around a stream or water body,the project shall include and maintain a non-disturbance setback, measured horizontally from the ordinary high water mark,as specified in Attachment A. Applicants shall contact the MOA Planning Division or Corps to obtain or confirm delineation of the setback.The setback extends only as far as the outer edge of the adjacent wetland boundary. Setbacks greater than 25 feet wide do not extend into non-wetlands. NO additional SETBACKS Buffer:The project shall include and maintain a non-disturbance buffer area,as specified in Attachment A.Applicants shall contact the MOA Planning Division or Corps to obtain or confirm delineation of the buffer. NA Delineation of project boundary: Project boundaries shall be staked,flagged or otherwise clearly delineated prior to the commencement of the authorized activity to prevent inadvertent encroachment of adjacent wetlands. Staff verified wetland boundary Endangered Species:Activities authorized under these GPs must not adversely affect a federally listed threatened or endangered species or destroy or adversely modify its designated critical habitat. Historic properties: No cultural resources shall be adversely affected by activities authorized by these GPs. If the permittee discovers any previously undiscovered archeological, paleontological, or historic resource,while conducting activities authorized by these GPs,the DC must be immediately notified by calling (800)478-2712.The Corps will notify the Alaska State Historic Preservation Office of what has been have found.The Corps or the appropriate federal land manager will initiate the Federal and State coordination required to determine if the remains warrant a recovery effort or if the site is eligible for listing in the National Register of Historic Places. Inspection:The applicant shall allow the DE or their authorized representative(s)and/or a representative from the MOA Planning Division to inspect authorized work at any time deemed necessary to assure that on-going and completed work is in compliance with the terms and conditions of these GPs. Cinerama Terrace 2 POA-2019-00570; Little Rabbit Creek 19-A Transfer of General Permit: If the applicant sells or wishes to transfers the property associated with the authorized activity,the applicant must obtain the signature of the new property owner or lessee in the appropriate space on the verification/OC and submit a copy of that page to the MOA Planning Division and/or Corps,along with appropriate documentation of the transaction.All information must be submitted within 30 days of the property transfer to validate the transfer of the GP authorization to the new party. Modification by other authorization: If the work proposed under these GPs is subsequently modified by any other Federal, State, or local governmental authorization,a modification of the GPs, MOA Planning Division's Opinion of Compliance,and any verification by the Corps to perform activities under these GPs may need to be obtained. Use of multiple general permits, including Nationwide Permits:The use of more than one GP or Nationwide Permit(NWP)for a single and complete project is prohibited,except when the acreage loss of waters of the United States authorized by the GPs and/or NWPs does not exceed the loss of more than one acre of wetlands. Project site restrictions and design criteria: 1. For residential developments,the aggregate total loss of waters of the United States authorized by GP-1993-10-M4 shall not exceed one acre. For residential subdivisions,the aggregate total loss of waters of United States authorized by this GP cannot exceed one acre.This includes any loss of waters of the United States associated with development of individual subdivision lots. 2. Erosion Control: Prior to the initiation of any fill discharge authorized in accordance with GP- 1993-10-M4,the Permittee shall install erosion control measures along the perimeter of all work areas to prevent the displacement or erosion of fill material outside the authorized work areas. The erosion control measures shall remain in place and be maintained until all authorized work is completed and the work areas are stabilized. Immediately after completion of the final grading of the land surface, all slopes, land surfaces, and filled areas shall be stabilized using sod, degradable mats, barriers, or a combination of similar stabilizing materials to prevent erosion. 3. Fill Material: Only clean fill material shal I be used for this project.The fill material shall be free from items such as trash, debris, automotive parts, asphalt, construction materials, concrete blocks with exposed reinforcement bars, and soils contaminated with any toxic substance, in toxic amounts in accordance with Section 307 of the Clean Water Act. 4 Within 60 days of completion of the work authorized by this permit,the Permittee shall complete EITHER the attached"Self-Certification Statement of Compliance"form (Attachment D),Q$the attached"As-Built Certification by Professional Engineer"form (Attachment E),and submit it to the Corps. These are further described below. Self-Certification Statement of Compliance: In the event that the completed work deviates in any manner from the authorized work,the Permittee shall describe the deviations between the work authorized by this permit and the work as constructed on the"Self-Certification Statement of Compliance"form. The description of any deviations on the"Self-Certification Statement of Compliance"form does not constitute approval of any deviations by the Corps. As-Built Certification: Within 60 days of completion of the work authorized by this permit,the Permittee shall submit as-built drawings of the authorized work and a completed"As-Built Certification by Professional Engineer"form to the Corps.The as- built drawings shall be signed and sealed by a registered professional engineer and include the following: a. A plan view drawing of the location of the authorized work footprint, as shown on Cinerama Terrace 3 POA-2019-00570; Little Rabbit Creek 19-A • the permit drawings,with transparent overlay of the work as constructed in the same scale as the permit drawings on 81-inch by 11-inch sheets or PDF. The plan view drawing should show all "earth disturbance," including wetland impacts and water management structures. b. A list of any deviations between the work authorized by this permit and the work as constructed. In the event that the completed work deviates, in any manner,from the authorized work,describe on the attached"As-Built Certification by Professional Engineer" form the deviations between the work authorized by this permit and the work as constructed. Clearly indicate on the as-built drawings any deviations that have been listed. Please note that the depiction and/or description of any deviations on the drawings and/or"As-Built Certification by Professional Engineer"form does not constitute approval of any deviations by the Corps. c. Include the Department of the Army permit number on all sheets submitted. Project-specific conditions: 1. Time Limit. GP authorization of this project expires on: October 31,2020. If you need more time to complete the authorized activity,submit a request for extension under these GPs to the Municipal Planning Department prior to the expiration date. You may not continue work beyond the expiration date until receiving notification to that effect from the Municipal Planning Department or the Corps Regulatory Branch. Note: Permitee should allow at least one month for processing of extension requests. 2. Setback Where there are wetlands along or around a stream or waterbody,the project shall include and maintain a non-disturbance setback, measured horizontally from the ordinary high water mark.The setback extends only as far as the outer edge of the adjacent wetland boundary. Setbacks greater than 25 feet wide do not extend into non-wetlands. For previously unplatted residential subdivisions,the setback area shall be tracted-out, rather than being included in individual lots. 65'from streams that are neither anadromous nor headwaters, as defined above; and, 3. Other Approvals Required Before Starting Work. You must not disturb wetlands for this project until you have obtained all applicable Municipal and State approvals required for the work. These approvals may include,but are not limited to: Municipality of Anchorage: ® Land Use Permit ❑ Clearing Permit ❑ Grading& Fill Permit El Building Permit ❑ Right-of-Way Permit ❑ Flood Hazard Permit ❑ Utility Agreement(s) ❑ Rezoning Approval ❑ Preliminary Plat Approval ❑ Subdivision Agreement ❑ Stormwater Treatment Plan ❑ Parks Right-of-Entry Permit ❑ Wastewater Disposal ❑ Urban Design Commission ❑ Geotechnical Commission Alaska Department of Environmental Conservation: ❑ Stormwater Treatment Plan ❑ Wastewater Disposal ❑ Soil Remediation Plan Cinerama Terrace 4 POA-2019-00570; Little Rabbit Creek 19-A If any of these—or other—approvals result in a change to the attached plans,you must provide a description of the change and a revised plan(s)to either Municipal Planning Department Staff or the Corps Regulatory Branch,and may not proceed with the project until the change is authorized. 4. Offset Unavoidable Impacts. To offset the unavoidable adverse impacts of the project to the aquatic environment,the permitee: ❑ Mitigation not required;fill less than 0.1 acres.Area covered under mitigation from original,but now expired GP. 5. Limits on Work Area. You must not conduct any of the following activities in wetlands or waterbodies beyond the approved project footprint(or in any other avoidance area identified above) during either construction or operation of the project/facility: > Discharge of fill material (even temporarily), including stockpiles;or, > Excavation and sidecasting/backfilling;or, > Mechanized land clearing; or, • Operation, parking/storage or servicing of equipment. 6. Construction Runoff. You must employ runoff control measures necessary to preclude or minimize both erosion and the transport of sediment, pollutants,and solid waste beyond the approved project footprint. These measures shall include, but are not limited to: ❑ Phasing of Site Preparation (to minimize the extent of exposed soil); • Silt Fence; Place at outer edge of new fill and wetland edge ❑ Reroute Offsite Runoff around Disturbed Soils (e.g.,dike/ditch) ❑ Mulching(e.g.,wood chips,straw,grass clippings,gravel); ❑ Matting(e.g.,jute,straw,coir); ❑ Sheeting for Stockpiles,Temporarily Exposed Slopes(e.g., plastic,geotextile fabric); ❑ Check Dams in Ditches/Drainageways(e.g., hay bales,sand bags,gravel berms); ❑ Surface Roughening(to slow runoff down slope); ❑ Terracing of Slopes; ❑ Sediment Trap(s); . ❑ : Temporary Sediment Basin; ❑ Storm Drain Inlet Protection (e.g., hay bales,sand bags, and gravel berm) ❑ Outlet Filtering/Stabilization for Construction Dewatering; ❑ Revegetation of Fills and Disturbed Soils—basic,regrade and seeding ❑ Onsite petroleum spill/leak response equipment and supplies.and provision for their proper disposal 7. Contaminated Soil. If contaminated soils are discovered during construction,you must immediately cease all work in the vicinity of the contamination,contact the Alaska Department of Environmental Conservation for instructions, and defer any further activity until you receive ADEC approval to continue. 8. Endangered Species. The activity must not jeopardize the continued existence of a threatened or endangered species, as identified under the Endangered Species Act, nor endanger the critical habitat of such species. Cinerama Terrace 5 POA-2019-00570; Little Rabbit Creek 19-A Special Conditions, as required by the Watershed Management Services (WMS) of the Municipality of Anchorage: Minor backfill at wetland outer edge only. Site verified by On-Site Services for percolation. Special Conditions, as required by the Planning Division of the Municipality of Anchorage: No special conditions beyond silt fence are required by the MOA Planning Division. Special Conditions, as required by the Corps of Engineers: This project did not reach the threshold of a General Permit Agency Coordination (GPAC); therefore, the Corps did not comment on this application. Your signature below, as permittee, confirms that you accept and agree to comply with the terms and conditions of Anchorage General Permit 93-10-M4 as supplemented in this document. /.(3946_SIGN Owner DATE •9 1\_ lol PRINT Owner DATE Opinion of Compliance The signature below confirms the Municipality of Anchorage's opinion that the project described above meets the terms and conditions of Anchorage General Permit 93-10-M3. Agg SIGN Thede To ish, Senior Planner DATE P(e 7 o:h c(pq_ig PRINT Thede Tobish, Senior Planner DATE Cinerama Terrace 6 POA-2019-00570; Little Rabbit Creek 19-A When the work authorized by the Anchorage General Permit is still in existence at the time the property is transferred the terms and conditions of the permit will continue to be binding on the new owner(s) of the property. To validate the transfer of the permit and the associated liabilities associated with compliance with its terms and conditions have the transferee sign and date below. (TRANSFEREE) (DATE) Attachments: Final Project Plans(sheets , dated 9/9/19 ) Cinerama Terrace 7 POA-2019-00570; Little Rabbit Creek 19-A CINERAMA TERRACE SUB, BLOCK 1 LOT 1 1 / iI / -------'1 '(1) /1 j\) ) 1 \ s \ ) i ' i ` — -- :' I11 I :1 ____\ \ \ (1 1 fl' \) \ \\ E DS AL RNA E r ( \ I 1 BO R SI • :n sll . 1 I ,_ �J ) Tut OF LLL SLOPE ` "! - . \3'SECTION LINE EASEMENT ) I ) )I• •� )0'T& EASEMENT 2 ' ONG x 5'WIDE .5' J 0'PBLIC USE EASEMENT EFFE�TIVE DE-TH �i_ ) ' I / ‘ ABSORPTION =ED 1Yt'`a , ) / i I ) I • THb �I I �I 1,500 GLLOIY FAP VAN EX TH2 I \ TANK x A-20 FILTER POD ND . tit (_ ( I I 1 ! 1 I PI.JMP V ULTI \ 1 _ _, 11 k , { _ , k \ k o \ \ \ \ \ \ Warn I\¼ \ \ 1 \\ \\ \f OU BEDRdOM-10U• • ) o Pi \\ \ \\PI�OPO • ' WELL - - l \ NOTE: // \ \ .\ w/50" •DIUS .Ys W L-1 UST BOA MINIMUM 0 \ \ • - L 1 Z / i / (!5 FROM NE STREAM, \ l — - - I I I I r_ , -' / �-- -s0'CRL'�KM NT.E T r / , \ 4 Il ( ► / / / ''‘ / VI ) > \ /// i\ 10'T&E EAOEMENJ / — _) i SeEj / /� // \\\ / � /, „ / r /.... ,J WI Ci ) / / J I2 // / / � � '- / d ( / / / ,/ / id !GE NOTE: • •0�®,-t asia48� NO SLOPES>25%WITHIN 50'OR SURFACE WATER WITHIN 100'OF THE LEGEND \"- AL'9. 0o PROPOSED SEPTIC SYSTEM CO-CLEANOUT x`99 a 49th i, X0004, 2C0-DOUBLE CLEANOUT 0 ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS FCC-FOUNDATION CLEANOUT o y;-,_A- 11 _1 PROPERTY ARE SHOWN.NO CONFLICTS WITH WELLS OR SEPTIC -PUMP VAULT 6 -MICHAEL EE ANDERSON SYSTEMS. 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'..',14:13:;,,i;f0'..iii'...›.74r‘ii;'Y' '4' 'to .• 1.."E5,;if ••.i.•=1,ii-- -,•,;.4 k„s, • .1 ‘4•,.. •511, ,.,•-•,2-- , ..- w... ,.4- ,..,.. ji,•• it, it ' : rf.r..-=r-mvisisciii,,, .s..,'i .• p.• , . .. :•,.,-;.•••••f' •••-..! .P-, ....... • . •. , •.• ..v.,', .....2,6,,4 . P"..A . r; P.'1,..;,,o_ f - • f••••,ve.i ' P ..i-77-'jrz7,-'-7----•P'.2:-.`,ii',!,'•- ' •••,,it ht'Ir.. :.....,. .• ...4.•..•.. ,.... . I ... . .. ,,,_ .., „ _„_,,,,,__ ., , _ V(r'l ii Ai 9/23/2019 http://moanw.mans.arceis.com/aonsNiew/index.html?annid=3efDdec8lfcf4837bf9b45af5f4264bc MUNICIPALITY OF ANCHORAGEjQj5*1V �. z'Q Development Services Department _ Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 020-521-01 Expiration Date: 17-2 OCA 1. GENERAL INFORMATION Complete legal description Cinerama Terrace, Block 1, Lot 1 Location (site address) 15750 King's Way Drive Anchorage, AK Current property owner(s) Colony Builders, Inc Day phone (907) 244-3269 Mailing address 9420 Vanguard Drive Anchorage, AK 99503 Real estate agent Day phone 2. TYPE OF DWELLING: ❑ Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic ❑° Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ QO cc)VID-19 Date of Payment Receipt Number 3) �} Waiver Fee $ Date of Payment Receipt Number COSA # 03C-2-01'32-3 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 Forge Civil Engineering Phone (907) 522-7773 Address 1399 W 34th Anchorage, AK, Suite 101, 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 7/14/2020 49th ®� 6. DSD SIGNATURE i...... """"""' s l✓L'1�i 0 .......... .............. ..................:.� i System #1 Approved for bedrooms ®,�n? MICHAEL E. ANDERSON .'tu' System #2 Approved for bedrooms ®®®�s�'�.., No • CE -4381 '.,._`"AV 7/14/20 Disapproved°®4♦44VIpROFESS\��s�®o sr®®.®®eo Conditional approval for bedrooms, with the following stipulations: WATER ANU �v WAST �•�,; nhA JJ i 0^ ! 1 nrininal (-imrFifirata data --7— 1-7_z&2_a The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Cinerama Terrace, Block 1, Lot 1 If more than 1 septic system on lot: COSA Checklist # A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 9/27/19 Total depth 48 ft Cased to 48 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) '24 in. Date of flow test for COSA 9/27/19 of Parcel ID: 020-521-01 Structure served by this system Well production at time of test 40 gpm Water storage tank volume None gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 7.36 mg/L ❑ Nitrate less than MRL (ND) Arsenic ** ug/L ❑ Arsenic less than MRL (ND) Collected by Forge Engineering Date of Sample 7/1/&7/8/20 Static water level at beginning of test 0 ft. Comments No pump in well. Well is artesian and a jet pump was installed inside dwelling. "Awaiting Arsenic Results. See surrounding well results. B. TANK DATA Age of tank(s) <1 years Tank type/material FAP/Fiberglass Measured operating fluid level in septic tank New ❑ Standpipes/foundation cleanout per record drawing Date of pumping System installed 3/24/20. D. ABSORPTION FIELD DATA Elevated Mound System Which system tested (date installed) 3/24/20 ❑ ALL standpipes present per record drawing Total measured depth from grade 5.33 ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced NA gallons Comments/Deficiencies: COSA Checklist yellow sheet C. LIFT STATION ❑ Required maintenance completed Age of lift station 'f1 years Lift station material PVC Comments: This is a pump vault designed to pump treated effluent up to the drain field. Adequacy test date New Construction 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' ❑✓ >50 Community Sewer Manhole/Cleanout > 100' Yes if No ft Q Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' Fv-� Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No >50 ft Holding Tank > 100' F/� Yes if No ft Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' []✓ Yes if No ft F✓ Yes if No ft if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' E] Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' M✓ Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5' ❑✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' Q Yes if No ft Community Wells > 200' ✓� Yes if No ft Water Service Line > 10' F1 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' ED 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' Yes if No ft Water Service Line > 10' F1 Yes if No ft Community Wells > 200' 0✓ Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION OF 14 k ho 1 certify that l have determined through field inspections and review '� AA.° •.,.', of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date., 49th ' u ......uu..uuuuanu..........r, MICHAEL E. ANDERSONAV No CE -4381 Aw p7/15/20 .•.°° cc�� COSA Checklist yellow sheet � ��� ..... .......�4 411, ROFESS\a`_ + M NICTI'ALITY OF ANCHORAGE ADVANCED W ASTI;WA"r?ER 'I'1IEATJ'%ITr.N'r SYSTEM iM;AINTI,NANCE AND REPAIR AGREE.NIENT THIS MAINTENANCE AND REPAIR AGREl,MENT, herein the "AGREEMENT" made and entered into as of this, 14 Day of July of 20 20 , by and between Andera S. Davis . herein the "OWN'ER," and the Municipality of Anchorage, herein the "IMUNICIPALITIY". in accordance with Aitchorao e Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants coi'itained herein, the patties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Svstenis. The :!-::lunicipality grants permission to the Owner to utilize and operate an Advanced W'astc ater Treatment System (AWWTS), described as Advantex Waste Water Treatment System located at (legal description) Cinerama Terrace Block 1 Lot 1 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) AD Throughout the term of this Atigreement. the Owner shall enter into a service agreement Nvith an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisi'aetoiy condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. AD It shall be the responsibility of the Owner during the terns of this Agreement to pay for all repair(s), maizitenaue, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). AD 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. AD OWRUr ackuUWled.GtS that regular maintenance of an AW'WTS reduces the potential failure of the s}stern, which could include smage backup and costly .repairs or drainfield replacement. (.rev. 05/1.8/2018) Pagel oC3 AD O,,veer acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. AD Owner acluiowledge.5 that the fine for failing to maintain and repair an A-WWTS may be assessed in accordance. with AMC 14.60.030. AD Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. 1 -'he Municipality will give ,it lea t 2=1 -hour notice. AD Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. AD Owner agrees that the AWWTS installation and maintenance requirements as provided by the .A� W'I'S vendor installer and approved by the .A/huiicipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. AD Owner agrees to maintain remote monitorinf, of the ANVWTS 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 systen-r, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Aonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a Avaiver 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. S. 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 vivid, 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shrill. 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. Severabilify. Any provisions of this Agreerncrrt decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions oP the Agreement. (rev. 05118/2018) Pace 2 of 3 OWNER: By: Andera S. Davis (print name.) STATE OF A.LA,SKA ) ) SS. THIRD JUDICIAL DISTRICT ) Datc: July 14, 2020 The foregoing instrument was acknowledged before me. this leday qj;++n yyj� I _ T .+ 20'LO, by /� yl �l' iy �. � (Ali � `j ���,, ���� Sol! 113 NOTARY PUBLIC FOR ALASKA � � ' Oil My Commission expires:/!SI ZoLf l 'f t Irk MUNJUPALITY: (signature) Date: (print name) Title: (rev. 05/18/201,8) Pagc 3 of 3 'Nitrate Advisory Certificate of On -Site Systems Approval # OSC 201323 Subdivision: Cinerama Terrace, Block: 1, Lot: 1 A water sample revealed a nitrate concentration of 6.75 milligrams per liter (mg/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. �= � Ma�lmg Address P O Box 196650 *Anchorage Alaska�99519 6650 *www mi�rn org '