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WAGERS LT 24A
Wagers Lot 24A #015-141-53 Municipality of Anchorage Development Services Department y y: Building Safety Division On-Site Water and Wastewater Program. 4700 S. Bragaw St. P.O. Box 196650 Andwrage, AK 99519-6650 Page' Of 4 www.d.anchorage.ek.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SWD40420 PID Number. 015-141-53 Ne.: Fais Lena Wastewater System: ❑ New El Upgrade Anm...: 11000 Our Road ABSORPTION FIELD wne. aa.aaa.: 4 gOr.FraxnOswkavrn.m ❑e.a ❑Cram ❑Oew LEGAL DESCRIPTION � ` 2.0 raro.w GFD0ir 4.0 ,. 6l LK Suedrepn: — 24A Wagers S/D WVA b FM eoaan can a" Veale' Gr EarelOMWel P"; 2.0 Ft. 2.0 F Ta.wip. Rn W: 6icoan: GY Lsig : 0.8 Ft. 42.0 F , Well: ❑New ❑ Upgrade c.. eaac 5.0 wnvarw De ;; wea aea Fr. 1 _ FL cw.d rnn (Finer. A s. Ck Tcar DOM: Cana V. T" akragm nea: Fq INwW: Private 305.0 FI. 305.0 n 300 Fp ASTM D 30341PVC DrrNr: Dir Diwa. Sux WerrLM. kwrrr. Dir krW�a. Alpine Drilling & Enterprises 7/11/05 1 283.0 FL Arck Mountain Development 8/22/2005 YeK 10,0 Fant S t st NIA Cera rwya w Gr . TANK GPI F1.1 2.0 n SEPARATION DISTANCES psep6o ❑Holding ❑S.T.E.P. ❑+ Other: TO Septic Absorption Lilt Holding lublwPovate atl1ef tr Fran Tank Field Station Tank Sewer Una Anchorage Tank &Welding 1 1500 Gr. w« 123 187 136 N/A 119 Steel " ^ `a °.` . a: sar r.w.« 100+ 100+ 100+ N/A LIFT STATION Laity 34 1.81 34 N/A100 Gal Anchorage Tank & Welding Faagakon 15 18 14 N/A 'Pane W K FwrD all' kM1 eL ,.,� w.w,.wn eL 3i- n 22 w 36 h C~ Dred WA N/A N/A N/A Pump r.x. a Lwar OS120 t:""d kipakar Pvranwa ley. MOA R«nr.e. 1 foot lot line waiver requested. BENCH MARK lauken.na D.ap4m. Garage slab r .ter, 100.00 FL Engineer's Stamp C F Inspections performed by: Cindy W. Ellis, P.E. Dates: 1" 9/13/05 , 49TH '?* 2"° 9/14105 t Development Servi es Departt proval �`:, Reviewed and approved by: Date: — 1„=1 C dY W. Ellis'/ CE -10577 i .................. xKx+u — —IVUTILITY EASEMENT - --- —t— -------- Property fine is \ Lot 9 109.910 the west well radius Approximate location HOUSE BR of water line �� 4 1500 gal I FCO Steel AdvanTex \ ' Lot 24A. 100' / o well radius. POD/ PV Lot 248 I / 1-1 well radius Tg3 Taw \ Reserve drainrield a is of ID 01 A B C FCO 15.3 45.6 STI 26.6 48.8 Mil 32.9 42.7 PV36.7 37.3 MT 55.8 61.2 AS -BUILT T114 1 101.1 49.0 79.5 Wagers 5/D, Lot 24A Record Drawing of Septic Upgrade Fais Lena Watkins Engineering, Inc �; OF q t �4a o 4 .............r9 5��0 •• y C� Parcel ID: 015-141-53 p s 49 TH9 . Permit Number: SW040420 ""' "'.""' ..... �...... C 0; �Ql%... p Cindy W. Ellis, P.E.P.O. Box 110443 00; •. ea+p� wO5 GOp•.,• December 5, 2005 Anchorage, Alaska 99511-0443 ., ,', 000 Scale 1 Inch - 30 ft Phone: (907) 349-1851, Fax (907) 349-1934 ��00000Vo ;y FCO NOTE: RELATIVE DEPTH OF TEST HOLE = 90.07 NO WATER FINAL GRADE S 99.10 ADVANTEX MAN - AX -20 POD HOLE STEEL ADVANTEX TANK 1500 GALLON N.T.S. FINAL GRADE = 104.89 .1.25"0 PIPE FILTER FABRIC + INSULATION SEWER ROCK 42.0' TRENCH N.T.S. MT1C01 NOTE: ORIGINAL GRADE _ 103.70 -104.07 AS -BUILT Wagers S/D Lot 24A Record Drawing Septic Upgrade �00000 �o OF ACF pp4 of ��........•••..•q UO Fais Lena Parcel ID 015-141-53 Watkins Engineering, Inc. 9 9• o��? ' `raj 00 o°;?" 49TH ' Permit No. SW040420 0 ....:.......................... D (y� �... p s 6W. ECUS �0� E - 10577 Cindy W. Ellis, P.E. P.O. Box 110443 : O��ppoo6000�d"vuo November 30, 2005Anchorage, NoScale -x 07) 349-1851, Fa Phone: ( (907) 349-1934 Watkins Engineering, Inc P.0 Box 110443, Anchorage, AK 99511 (907)349-1851 cwellis@gcLnet December 5, 2005 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: Wagers SID, Lot 24A Permit No. SW040420 Reserve Drainfield Site To Whom It May Concern: During construction of the house on the subject lot, the placement of the driveway eliminated the reserve drainfield site. Thus, a new test hole was dug to prove up a new reserve site. This change was verbally approved during construction. Following are the results of the test hole. This property is served by an AdvanTex advanced septic system. Test hole #4 was dug to a total depth of 18 ft on August 23, 2005. There was no groundwater influx when the hole was dug or after 7 days of monitoring. A percolation test conducted between 6.5 ft and 7.0 ft resulted in a rate of 15 minutes per inch. The soil log is attached. Design calculations for the reserve site are as follows: 4 Bedrooms x 150 GPD/BR = System Type: Application rate: 600 GPD / 5.0 gpd/ff = Maximum Depth: Effective Depth: Length Required: 600 GPD AdvanTex w/deep trench 5.0 gpd/ ft 120 ft' required 12 ft 5 f 12 ft If you need further information, please call me at 349-1851. Sincerely, Cindy W. Ellis, P.E. President V{G Municipality of Anchorage Development Services Department Building Safety Division y,. On -Site Water and Wastewater Program 4700 South Brag" SL P.O. Box 196650 Anchorage. AK 99519-6650 www.muni.org/onsite (907) 3437904 Soils Log - Percolation Test Performed For. Fais Lena 16Y W. Ellis CE -10577 performed: August 23, 2005 Legal Description: Wagers SID. Lot 24A Township, Range, Section: Sbpe Depth I I I I I GP oryaklic s 11- 12- 13- 14- 15- 16- 17- 18- 13.6 19- POFI 20. WAS GROUND WATER Date Gross Time ENCOUNTERED? NO Net Drop 1 8-24-05 8 IF YES, AT WHAT DEPTH? — L Depth to Water After 0 Monitoring? DRY e Date: 9-7-05 12:30.1:00 Site Plan Reading Date Gross Time Net Time Depth to Water Net Drop 1 8-24-05 11:28.11:58 30 min 6.3.5 2.5 2 11:59.12:29 30 6.3.75 2.25 3 12:30.1:00 30 6-4.0 2.0 4 1:01-1:31 30 6-3.75 2.25 PERCOLATION RATE 15 ( r) PERC HOLE DIAMETER s TESTRUNSETWEEN e.5 FT AND 7.0 FT COMMENTS _Presoak prow totest PERFORMED BY: Rocky Trainor/Cindy Ellis ) kfl L:!>' CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELI S IN EFFECT ON THIS DATE. DATE: q -g.05 ALPINE DRILLING & ENTERPRISES Permit Number: #SW040420 Date of Issue: 10-8-04 Date Started: 4-10-05 Date Completed: 7-11-05 Legal Description: Wagers Lot 24A Property Owner Name & Address: Fais Lena 1100 Our Road Anchoraqe. Alaska Parcel Identification Number: 015-141-53 Is well located at approved permit location? ® Yes ❑ No 99516 Borehole Data: Soil Type, Thickness & Water Strata Depth (ft) From To Method of Drilling ®air rotary ❑cable tool Casing type: steel stick-up 0 2 Wall Thickness:.250 inches silt 2 6 Diameter: 5"& 6" inches Depth: 2005_ feet gravelly silt 6 172 Liner Type: Boulder gravelly silt silt gravelly silt 172 181 219 238 181 219 238 290 Diameter: inches Depth: feet Casing stickup above ground: 2 feet Static water level (from ground level): 283 feet Pumping level: 305 feet after 2 hoursum in 10 P P S—SPm water sand & gravel 290 305 Recovery Rate: 10 gpm Method of Testing: airlift Well Intake Opening Type: ® Open End ❑ Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet Grout Type: bentonite granules Volume: I bg Depth: Start 0 feet Stopped? feet Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? ® Yes ❑ No Method of Disinfection: Chlorine tablets Comments: 6"casing to 172' S"casingjrom 150 to 305' Well Driller: Alpine Drilling & Enterprises PO Box 110496 Anchorage, AK 99511 Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the propertv Sep 24 05 01:57p Jason Wood LVS k.LkA.:INIL: INC 907 27Z 4S.9O j From +19079309507 wed A.w 31 05:25:27 2005 907-561-1561 p.1 03/01/OS 01108pm P. 001 Page 1 of 1 INSPECTION REPORT MUNICIPALITY OF ANCHORAGE. BUILDING SAFETY DIVISION 4700 SOUTH BRAGAW I INSPECTION INFORMATION &HELP: 373-7962 INSPECTION; VOICE 341-0300 INSPECTION. FAX (907)244-7777 www.murd.org/BSD/4e�pocfioro.clm NAME: OWAYNE PERMIT 0: 04-1306 COMPANY: EUS ELECTRIC INSPECT DATE: 6131/2006 I PHONE #: 272-4591 PHONE #: PHONE #: 'fff ADDRESS: t I OW OUR RD LOT 24A SUBDIVISION: WAGERS GRID t. 3W2536 COMMENTS or DIRECTIONS AM CALL 64 FOR ONSITE MTG SEPTIC LIFT STATION TYPE OF INSPECTION: Olhor Eloctrieal COMMENTS: (FOR INSPECTOR USE ONLY) Ir . �1_>✓ �:-4—KI CAI I_ ) 1 vr`! i-vfzL_- L 1 i `:STA t 101\1 CO/t'1 r N 15• r �i r,107" Ar�J f -F L E_ i rc P C -4-t_ r—I FJft 1 1-4 Jr i -1 PRINTED NAME 01, w /11%l. I.- �� 1: G DATE- � — ! 1 i ) MUNICIPALITY OFANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519.6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Permit Number: SWO40420 Legal Description: WAGERS SUBDIVISION LOT 24A Date Issued: Oct 08, 2004 Expiration Date: Oct 08, 2005 Parcel ID: 015-141-53 Design Engineer: 0844 Watkins Engineering, Inc Site Address: 11000 OUR ROAD Owner Name: FAIS LENA Lot Size: 47196 SO. FT. Owner Address: 11000 OUR ROAD Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE, AK 99516 - This permit is for the construction of: ❑✓ Disposal Field ❑Q Septic Tank ❑ Holding Tank ❑ Privy Private Well ❑ Water Storage All construction must 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 engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and dosed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date, /D—ll-o4 Issued By:Date: Municipality of Anchorage -. Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 015.141-53 Permit Number SW Property owner(s) Fais Lena Day phone 764-1310 Mailing address (1) SITE: 11000 Our Road Mailing address (2) Anchorage, AK Zip Code 99516 Legal description (Lot, Block & Sub'd.) Wagers S/D. Lot 24A Legal description (Section, Township & Range) Lot Size 47,196 /Sq.Ft. Number of Bedrooms 4 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well Q Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub 0 Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. R (Signature ofiroperty owner or authorized agent) Permit Fees: Waiver Fees: Date of Payment: 0 y Date of Payment: Receipt Number: Receipt Number: (Rev. 12100) Watkins Engineering, Inc. RO Box 110443, Anchorage, AK 99511 (907)349-1851 cwellis@gci.net October 2, 2004 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: Wagers SID, Lot 24A Well and Septic Permit Application To Whom It May Concern: Attached please find the application and supporting documentation to construct a private well and septic system to support a proposed 4 bedroom house on the subject lot. An AdvanTex advanced wastewater treatment system is proposed. A site plan is attached identifying the adjacent properties' well and septic system locations. The well for the subject lot is proposed in the western portion of the lot, due to soil quality in the west which would not support a septic system. The well will be placed greater than 100 ft from any adjacent property's septic system. All of the adjacent lots are currently developed, and this well placement should not adversely affect their future septic system requirements. The proposed septic system is located on the eastern portion of the lot, around test hole #3, dug on September 25, 2004. No water was encountered when the hole was dug or after 7 days of monitoring. The test hole was dug to a total depth of 14.0 ft and encountered silt with some sand and gravel. No impermeable soils were encountered. Two percolation tests were run: 1) from 1.5 to 2.0 ft, with a rate of 9 minutes per inch, and 2) from 4.5 to 5.0 ft, with a rate of 24 minutes per inch. The soil log is attached. A shallow trench is proposed, with 2 ft of effective depth, from 2 ft to 4 ft. Thus, it will be installed in both soil types. The application rate is based upon the less permeable layer. Following are the details of the design. Welland Septic Permit Application for Wagers SM, Lot 24A Watkins Engineering, Inc.; October 2004; page 2 Proposed Soil Absorption System: 4 Bedrooms x 150 GPD/BR = Application rate: 600 GPD / 2.0 gpd/ft' = System Type: Maximum Depth: Effective Depth: Reduction Factor: Length Required = 600 GPD 2.0 gpd/fe 300 sq. ft required shallow trench 4.0 ft 2.0 ft 0.70 300 sq. ft / 5 ft x 0.70 = 42 ft There are no surface waters or private wells within 100 ft of the proposed septic system, and there are no slope concerns. An alternate site is identified for a replacement drainfield. The owner will execute the required maintenance agreement prior to 'approval of the permit. am not aware of any adverse effect that this upgrade would have on any adjacent properties' water and wastewater treatment needs. Thank you for consideration of this permit application. If you have any questions or need further information, please call me at 349-1851 or 360-3389 (cell). Yours truly, A/,)64�1 CindyUW. Ellis, P.E. President Municipality of Anchorage Development Services Department Building Safety Division yam. On -Site Water and Wastewater Program 4700 South Bragaw Sl. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343.7904 Soils Log - Percolation Test Performed For: Fais Lena Date Performed: 9-25-04 Legal Description: Wagers SID, Lot 24A Township, Range, Section: Slope TN Deplh &r( h _ tfG 1 2- Date Dryan )cs /.5 reddish loam 5111 3 Net Drop 3.0 4- rdy S Silt 5- SM w/gradd- 1:49 4.0 1.75 7- 3 riq Siff. & IYi L WA r1lad A)Fp 144a- 9 q Frrywcable 10- 30 2.5 11- 15- 16- 17- 18 - COMMENTS 4 hr presoak prior to test. WAS GROUND WATER ENCOUNTERED? NO s IF YES, AT WHAT DEPTH? — L O Depth to Water Agar P Monitoring? None E Dare: 10-2-04 Reading Date Gross Time Net Time Depth to Water Net Drop 1 9-25-04 1:19 0 6 - 2 1:49 30 1.75 4.25 3 2:19 30 2.5 3.5 q 2:49 30 2.5 3.5 PERCOLATION RATE 9 (n+nuNrGvlq rcn,, nv�c �.,.,,.� •"� TEST RUN BETWEEN 15 FT AND 2.0 FT PERFORMED BY: Cindy W. Ellis. P.E. I WWII tv Ztl CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELI -S IN EFFECT ON THIS DATE. DATE:10-7-49 Municipality of Anchorage Development Services Department Building Safety Division yd On -Site Water and Wastewater Program 4700 South Brag" St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Soils Log - Percolation Test Performed For: Fais Lena Performed: Legal Description: Wagers S/D, Lot 24A Township, Range, Section: I Depth Lo w1"er.8en�k 1- 2- Date pre�Q/1 iC5 1.5 rLdd(sh I04YVL 5Y11 3- Net Drop $r0 P`rG 4- th sand 3; It 6 - w/ 9raticQ6- 661 30 4.25 1.75 3 graH 8- mL. VIt 9- w/6mod . 10- Al,f,ears 11- potable. COMMENTS 4 M presoak prim to test. WAS GROUND WATER ENCOUNTERED? NO S IF YES, AT WHAT DEPTH? — L O Depth to Water Aller P Monitoring? None E Date: 10-2.04 G' Site Plan Reading Date Gross Time Net Time Depth to Water Net Drop 1 9-25-04 1:17 0 6 - 2 1:47 30 4.25 1.75 3 2:17 30 4.75 1.25 4 2:47 30 4.75 1.25 PERCOLATION RATE 24 (mnuteMncnl vtnc "ULM uoaac rcn TESTRUNBETWEEN 4 FT AND 4.5 FT PERFORMED BY: Cindy W. Ellis, P.E. I PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL CERTIFY THAT THIS TEST WAS IN EFFECT ON THIS DATE. DATE: O'Z,V7 septic T12N R3W Sec 22 rea S2 S2 Lot 9 septic T12N R3W Sec 22 rea Lot 10B Proposed WELL TH#2 TH#1 0 NOTE: Test Holes A, B. and C were logged by Michael E. Anderson, P.E. Test Holes #1, 2, and 3 were logged by 2 `t B Cindy W. Ellis, P.E. septic rea septic rea T12N R3W Sec 22 E2 Lot 23 Existing.�'� WELL Existing WELL Proposed PTHH03� cuse 0 Existing WELL 0 L� o Y. Existing WELL Ik 4 P 9 T12N R3W Sec 22 S 180' Lot 8 Existing WELL 0 Existing WELL 0 septic \ rea T12N R3W Sec 22 N 284' Lot 25 T12N R3W Sec 22 S 396' Lot 25 �r�tJ OF ' Wagers S/D, Lot 24A Proposed Septic system - site Plan Watkins Engineering, Inc .• ,� �fp.,y, ; �� . R,� Fais Lena *CO 49 TH Parcel ID: 015-141-53 Cindy W. Ellis, P.E. P.O. Box 110443 Anchorage, AK 99511-0443 °" W.. . . y..I 10577 �. •.•�o October 2, 2004 Phone: (907) 349-1851 Fax (907) 349-1934 �' : :0 o.= ••• 4,os ooc> L Scale 1' - 100' ' . Property Line -- SF9'S8'S5"E 10 ft utility easement - — — — -t — — — — — — — — — — — — — — — d / \ \ 2 / \ Q. / \ Lot 9 well / \ 100 ft radius i West portion of lot is not shown. t - Driveway 30 ft test hole I radius I Proposed 4 BR House / I FCO 1.25" PVC pip w/ TH#3025" holes 24" C Lot 24A i 1500 gal o MT proposed well fiberglass o Prima Drainfield 100 ft radius AdvanTex tank MT __ -10 ft minimum / Pum Reserve Site / vault / Lot 24Bwell P / 100 ft radius Property Line DESIGN DETAILS 4 BR, 600 GPD AdvanTex 2.0 gpd/ft2 Requires 300 ft2 Shallow Trench 2 ft effective, from 2 ft -4 ft RF = 0.70 42 ft long S89'57'50" Notes: 1. Drainfield must be insulated with 2" rigid foam. 2. Fiberglass tank to be bedded in pea gravel. Wagers Se Lot 24A Proposed Septic System Watkins Engineering, Inc `�F A�As�I.. Fais Lena y • 49 TH j- y ;. ParcelID:015-141-53 ,.. CI Y W. ELLIS 4 � - 10577 Cindy W. Ellis, P.E. P.O. Box 110443 October 2, 2004 Anchorage, Alaska 99511-0443:'• �' '' /4.• 2.0.E Scale 1 Inch 30 ft Phone: (907) 349-1851, Fax: (907) 349 1934 «. • MUNICIPALITY OF ANCHORAGE Development Services Department ,\ j Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On-Site Systems Approval C. Parcel I.D. 015-141-53 Expiration Date: Q- ` 1. GENERAL INFORMATION Complete legal description WAGERS LT 24A Location (site address) 11000 OUR RD, ANCH AK Current property owner(s) ROCKEY, SCOTT Day phone gilt-.Z? 5 2-- Mailing address SAME Real estate agent D. 0 ,0t6e7 1111-Sit 2. TYPE OF DWELLING: Q� M ❑ Single Family (w/wo ADU) MAY c 111 Duplex . 2 2019 ❑ Multiple Dwellings (Single Family and/or Duplex) N 4 68L91 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic CI 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 $ 5540'r A'1 % v- Waiver Fee $ Date of Payment 6 Lail C:K klitd Date of Payment Receipt Number 23-J1q5g Receipt Number COSA# osC 11 I I e Waiver# • 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On-Site staff may visit the site to verify the information submitted. Name of Firm MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 5-24-19 r • 49TH ' '..47 >/ 6. DSD IGNATURE Wt„..., System #1 Approved for 4 bedrooms yo MICHAEL N. AnDERSCN ; System #2 Approved for bedrooms J�• 9 ,,, 1i 19F•.c,• �!••... ,., Disapproved �t%PeaFESS10y4�-y Conditional approval for bedrooms, with the following stipulations����'~� \(kk vTYtOFf r���i(. ?G do% ON SITE WATER AND �,r ...,la 'T WASTEWATER oz O PROGRAM r,;.: J1)))),» C By: l,-- l Original Certificate Date: c�-1 r1 7 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: WAGERS LT 24A Parcel ID: 015-141-53 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system A. WELL DATA • Well log is filed with Onsite (or attached) Well production at time of test 5.0+ gpm Date drilled 7-11-05 Water storage tank volume 0 gallons Total depth 305 ft Well disinfected for coliform test? ❑ Yes 0 No Cased to 305 ft ❑■ Coliform bacteria is Negative ❑■ Sanitary seal is functioning correctly Nitrate 1.92 mg/L ❑ Nitrate less than MRL (ND) ❑■ Wires are properly protected Arsenic ug/L ❑� Arsenic less than MRL (ND) Casing height(above ground) 24+ in. Collected by MNA Date of flow test for COSA 5-1-19 Date of Sample 5-1-19 Static water level at beginning of test 285 ft. Comments B. TANK DATA C. LIFT STATION Age of tank(s) 14 years ❑■ Required maintenance completed Tank type/material STEEL Age of lift station 14 years Measured operating fluid level in septic tank ""A°"' Lift station material BASIN ❑■ Standpipes/foundation cleanout per record drawing Comments: PUMP BASIN FROM ANCH TANK Date of pumping ADVANTEX INSTALLED 2005 D. ABSORPTION FIELD DATA Which system tested (date installed) 5-1-19 Adequacy test date 5-1-19 ❑■ ALL standpipes present per record drawing Results ❑✓ Pass For 4 bedrooms Total measured depth from grade 4 ft (max) Fluid depth prior to test 8 in Measured depth to pipe invert from grade 2.0 ft(min) Water added 600+ gal ❑ N/A—pressurized field New depth 20 in ❑■ Monitor tubes go to bottom of effective. If not, state Elapsed time 1440 min depth into effective ❑� Code-required soil cover over field Final fluid depth 8 in Absorption rate 600+ gpd ❑ System presoaked UN (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot> 100' Community Sewer Manhole/Cleanout > 100' p Yes if No ft p Yes if No ft Neighboring Tank> 100' 0 Yes if No ft Private Sewer/Septic Line >25' E Yes if No ft Absorption Field on Lot> 100' 0 Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' Animal Containment> 50' 0 Yes if No ft —ElYes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ICI Yes if No ft L Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water> 100' 0 Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ✓0 Yes if No ft Private Wells > 100' ✓0 Yes if No ft Water Main > 10' ✓❑ Yes if No ft Community Wells> 200' p Yes if No ft 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' 0 Yes if No ft If absorption field is under driveway comment below r Property Line > 10' ® Yes if No 1C ft Wells on Adjacent Lots: Water Main > 10' Cl Yes if No ft Private Wells> 100' ❑✓ Yes if No ft Water Service Line> 10' ✓0 Yes if No ft Community Wells> 200' Cl Yes if No ft Surface Water> 100' p Yes if No ft F. ENGINEER'S COMMENTS f- I f P -c4P 1-A. c. w 0IV 4 if o to C4 G. ENGINEER'S CERTIFICATION _ OF A/ �i 1 certify that/have determined through field inspections and review •%°41.• 4 •'• d of Municipal records that the above systems are in conformance with j Ir •49TH '1 •y• * // MOA COSA guidelines in effect on this date. fetio•••' ' ! >+ IA rte"�MICHAEL N. ANDERSON : / CE-946 COSA Checklist yellow sheet ltN.cx o`tM`4 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT,herein the"AGREEMENT" made and ?Lis entered into as of this 2S Day of `Ylci c of 207,,by and between ' usS't , 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 ,A A # located at(legal description) 2<-` ALo 1 <-` ✓;s 0� 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. 5-( 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). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, • repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the 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. TZOwner 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. 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 construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the 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: -dry (.3y '0/, By: ��� L (signature) Date: ,dry hdmr ` t% r (print name) STATE OF ALASKA ) )ss. THIRD JUDICIAL DISTRICT ) The foregoin_ instrument was acknowledged before me this2-6day of fro, , 20n, by •. i s - -" • Al 44 AtA NOTARY"'UBLIC FOR ALAIKA� z : pTAR .. My Com 1 ssion expires: � ! ( F • N --- Y•• J°UBtAG Ei Expires MUNICIPALITY: By: (signature) Date: (print name) Title: • (rev. 05/18/2018) Page 3 of 3 04/17/2019 05:00 8686770 APLUS PAGE 08 338 175 pm11■ 00011 00010 00 p 0 1$ 80 t10i011 5 — 5111 11 0H 0 I I ■ I NO etre! r•si ■■ ON 011 NONNI I 0 000 UN mu ;I:, A cIvaI 1 x Field Maintenance Report AnchorageTank Annual Inspection 907-2723543 Property°valor/Trvckinp f Operator Scott&Mindy Rockey Larry Betts -^ S1ta Addrosa CoMatt Pftono 11000 Our Road, Anchorage AK 99516 (907)349.0800 __ AX Site IP if County ID It Pod s Fi1U aPJL a Date or tact In.rcotton AX-105660 SW040420 204772 RTU105274 08/01/2018 Retrieve o&M Info Measure Sludge/Scum Daily flaw Sludge _ Scum — tet Compartment Current Previous Current 1 Previous R©Ciro ratio \\ _— Trmorsettings: 2nd Compartment Current Previous Current Previous inspect/Clean AdvanTex Filter Inspect Clean Odor. VNormel E Pungent Lateratg/Orificee Z • v Perform Field Sampling/observations Z _ Biomet: Normal E Excessive Pod Bottom 1 NTU(t5±NTOs) p1-I(69) DO(2-8) 8rldginp/Ponding: NoneMilnor ❑Excessive Intake Vent V J21 6 - 7 3 Inspect/Cleon Discharge Pump System Inspect Imppect Clean Odor of Sampio Ricer/Lid 0 Floats AL1 ) 'typical Musty El Earthy ❑Moldy S Splice Box V Pump ;2' Non-typical ZSulfide ❑Cabbage ❑Decay • Oily film in PVU ❑Yea r�LJ yJ No Float cordo Foam In tank ❑Yes No Inspect/Service Other System Components Inspect Clean Inrpect Clean Check Control Panel Dtsinfectlon Equipment JJ g. Dispersal Later ls/Orltices 7 +r1 Recirc Amps Discharge Amps Observations Y 1 0.9 I 0 - b Additional Services Rendered ❑Cleaned textile sheets? ❑Repin ed UV iters:? Audible and visual alarms ZOK ❑ReplacedNsed other Items? Dial tone(telemetry only) ❑Yes IZINo Ports Used:W=Warranty,B=Billable{✓appropriate selection) Inspect/Clean Pump System W B nom Number Description Inspect Clean ---' Rtser/Lld V splice Box ,CZ – Float Cords floats la RI Final/Safety Inspection Pump [A RSV reinstalled ,\ V lids bolted on Biotut a Filter 121 ( Manifold reconnected;flush valves closed ;j Control panel ronct vated Blotube Pump Vault Jf`�'-' Summery/Recommendatlons cu Recirculating Splitter Valve.... Z v� ❑System performing;no further action needed ❑Tank needs pumping j ' ❑Call tor service Cottle? Comments Q.e.,Yt 14Qo _ 1` `.Q n e- - �i/C) Nell �'1�t P►�' Jr -- Sign xturc f� Pato /C7 __.. /� Fax completed form to 1-840-384-7404 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onshe (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015.141.53 1. GENERAL INFORMATION COSA # ', 0'000 Expiration Date: or Complete legal description WagersLot 24A Location (site address) 11000 Our Rd, Anchorage, AK 99516 Current Property owner(s) Fals Lena Day phone 764-1310 Mailing address 3801 Centerpoint Dr. Suite 200, Anchorage,'AK 99503 Lending agency Residential Mortgage Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ✓❑ Individual On-site 0 Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of Onsite Systems Approval (COSA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Onsite Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work. 4. 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 Onsite 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. Name of Finn Walklns Engineering, Inc. Phone 349.1851 Address PO Box 110443, Anchorage, AK 99511.0443 Engineer's Printed Name Cindy W. Elils Date 5. DSD SIGNATURE ✓ Approved for 4__ bedrooms. Disapproved. Conditional approval for bedrooms, with the following 49` ICO W. Ellis CE -inn Y�� OFF AN, ON-SITE COSA Checklist X Arsenic Advisory Septic System Advisory Well Flow Advisory Nitrate Advisory Maintenance Agreements Supplemental Engineer's Report Other By:_ ����� Original Certificate Date: I-?— "o co (RN IM) 05/03/2006 12:22 3491934 WATKINS ENGR PAGE 01 SCS Ref.# 1062024001 Client Name WsairtsEugiHCtt Project Name/# Wagers Lot 24A Client Sample M Wagers Lot 24A Matrix Drinking Water M= 0 Sample Remark3: All D■t"Mimes are Alaaka Standard Time Printed Date/timeOS 16:16 Collected Dahlrmne 4/1512006 :10 Received Dat&Mme 830 Technical Director Stephen G Ede Paraneree Allo. V. Prep Analysis Results PQL Vnits Mettmd Caatainum limits Data Date ink x_ ate:a bopartm ret Nitmto-N 0.931 0.100 Microbiology Labosate Tool Coliform 69 o Coli mg/L EPA 3532 B (r10) 04/26106 ALR coVl00mL 3M20 9222B A (<-1) 04/25/06 TLF /J-eC 2tt"hwe Municipality of Anchorage • -�1 Development Services Department Building Safety Division . On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 015-141-53 1. GENERAL INFORMATION Complete legal description Wagers Lot 24A 41;;i4l0� HAA # !AD 0005 Expiration Date: 14-4—o6, Location (site address or directions) 11000 Our Rd, Anchorage, AK 99516 Current Property owner(s) Fais Lena Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Day phone 764-1310 3801 Centerpoint Dr., Suite 200, Anchorage, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone. TYPE OF WASTEWATER DISPOSAL: Individual On-site ❑Q Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions In the professional engineer's work. 4. 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 Health Authority 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-sfte 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. Name of Firm Watkins Engineering, Inc. Phone 349-1851 Address P.O. Box 110443, Anchorage, AK 99511-0443 Engineer's Printed Name Cindy W. Ellis Date 5. DSD SIGNATURE Approved for Disapproved. X Conditional approval for bedrooms. 4 bedrooms, with the following stipulations: Maintainence agreement to be signed by buyer before unconditional approval Is issued. Additional Comments Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By:. i %� Original Certificate Date: "/ " ts.+. 0110x) Municipality of Anchorage US Development Services Department Building Safety Division OnSRe Water R Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orgtonsite (907)943-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Wagers Lot 24A Parcel ID: 015141-53 A. WELL DATA Wen type Pr+ Date completed 'n"" Total depth 305 R. Date of test Static water level If A, B, or C provide PWSID #= Well Log (YIN) Yes Sanitary seal (YIN) Yes Wires properly protected (Y/N) Yes Cased to 305 R. Casing height (above ground) 24 In. FROM WELL LOO July 11, 2005 283 R, Well production 10 g,p,m, WATER SAMPLE RESULTS: l v l o/b$ Couto= o colonies/100 ml. Nitrate 0,741 rng.A. Arsenic: NA mg.A. Date of sample:12!15 05 B. SEPTICIHOLDING TANK DATA Tank TypwM terlal AdvanTez steel Tank size 15M gal. Number of Compartments 2 AT INSPECTION NA NA in NA g.p.m. Other bacteria 0 oolon"I00 ml. Collected by: Rocky Trainor Date installed 522-05 Cleanouts (YM) Yes Foundation deanout (YM) Yes Depression over tank (YIN) No High water alar (Y/N) Yes Date of pumping N/A New Pumper C. ABSORPTION FIELD DATA Date knotted B-22-05 Soil rating (g•p•d.At2 or fe/bdr) 2_0 System type Shallow Trench Length 42 R Wider 5 R. Gravel below pipe 2 R. Total depth 4 R ER. absorption ansa 3t><! t2 Monitoring tube es Depression over Reid No Date of adequacy test WA New Results (Pass/Fail) For 4 bedrooms Fluid depth In absorption field before test _ in. Water added_ gal. New depth_ in. Elapsed Time: _ min. Final fluid depth _ in. AnY rejuvenation treatment (past 12 mo.) (Y/N & type) Absorption rate >= g.p.d. If yes, give date D. UFT STATION Date installed 8-22-M "Pump on" level at 32 in. E. SEPARATION DISTANCES Size in gallon 100 -Pump oR' level at In. Cycles tested NA - no SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankHlft station on lot 123.0' Absorption field on lot 187.0' Public sewer main 100'+ Sewer /septic service line 119.0' Manhole/Access (YIN) Y High water alarm level at 38 In. Movie alarm 8 circuit requlrewnente? Yes On adjacent kds 100'+ On adjacent kits 100'+ Public sewer manhole/cleanout 100+ Holding tank WA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 15.T Property line 34.5' Absorption field 54.5' Water main 100'+ Water service line 35'* Surface water 100'+ Wells on adjacent lob 1104 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 1.8' Building foundation 18.4 Water main 100'* Water Service line W+ Surface water 100'+ CMver . parlkrrg/veNde skxage 1.0' Curtain drain N/A Wells on adjacent lots 115'+ F. COMMENTS TH#4 dug on 8/23/05 to prove up reserve drainfield site. G. ENGINEER'S CERTIFICATION I cer fy that I have detemuned through Held krspecd= and review of Municipal records that Hie above systems are In t C)-.'* conformance **h MOA HAA guidelines M effect on this date. :} Y W. EIIIB CE -loan Engineer's Printed Name Cindy W. Ellis Date HAA Fee E ill .r�0 Waiver Fee i Ct> 1Q1 k' M , Date of Payment / Date of Payment ial Receipt Number , cj f A \A rYi Receipt Number. (Rev. 12/01) .'//s' co -1 �,fi6J..L 79-272- j— q. 0 6 Watkins Engineering, Inc P.0 Box 110443, Anchorage, AK 99511 (907)349-1851 cwellis@gcLnet December 5, 2005 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: Wagers SID, Lot 24A Permit No. SW040420 Lot Line Waiver Request To Whom It May Concern: We respectfully request a waiver on the subject property for the distance of 1 ft from the soil absorption system to the east lot line. Approval of this waiver will not adversely affect water or wastewater treatment needs for any adjacent properties. Verbal permission was received during construction. If you need further information, please call me at 349-1851. Sincerely, i1 Cindy W. Ellis, P.E. President Municipality of Anchorage Development Services Department • +r Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.anchoragc.ak.us (907)343-7904 Waiver Review Worksheet WR#: 060001 PID#: 015141-53 HAM 060005 Permit#: 040420 Date Received: 12130/05 Legal Description: Wagers Lot 24A Engineer. Watkins Engineering Applicant: Fais Lena Waiver Requested: I foot separation distance absorption field to property line, Criteria: Geology Points: A. Water Table S. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: _.... mann.neem.................................................manage... a....a. Waiver Is Granted: t "I" Waiver Is not Granted: List Conditions or Reasons for above: Date: I— U— o 5 gamma ... .ammammnmman. Rec#: 12-30-05 Amount: $430.00 Date Paid: 12-30-05 Municipality Of Anchorage C r� r 4 ,y M).1Ars NNi(4i0•\nchorn,a,Ahidm!Y.1719-MR) dcphnnc( M7S�Ki)I 1nz(M)i)731afiNN1 47M 11nigmw Street •,\nchorngc, Alaska 9!6507 (11a yor Dlnrk 13cgich ImwnumLorg Building; Safely llhision 1/4/2006 Watkins Engineering P.O. Box 110443 , Anchorage, Alaska 99511-0443 Subject: Waiver Request for Wagers Lot 24A Waiver Request #WR060001 Parcel ID #015-141-53 HAA#060005 or Permit # 040420 Dear Engineer, Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 1.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Jeffrey W. Poet Engineering Technician On -Site Water & Wastewater Program ColJImunity, Security, Prosperity wqi PWSID 0 Sample Remarks: 3532 - Sample initially run without passing QCS, rerun past hold time with passing QCS to verify results. Parameter PQL Units Method Allowable Prep Containcr ID Limits Date SCS Ref.N 1057540001 All Data?imes are Alaski Standard Time Client Name Watkins Engineering Printed Date/time 11/302005 16:18 Project Name/N Wagers SD Lot 24A Collected Date fime 11/092005 14:50 Client Sample ID Wagers SD Lot 24A Received Date fime 11/102005 9:49 Matrix Drinking Water Technical Director Stephen C. Ede PWSID 0 Sample Remarks: 3532 - Sample initially run without passing QCS, rerun past hold time with passing QCS to verify results. Parameter PQL Units Method Allowable Prep Containcr ID Limits Date Analysis Date Init Nitratc-N 0.747 0.100 mg/L EPA 353.2 B (<-lj) 11/10/05 AZS _Microbiology Laboratory_ I I � Total Coliform 178 OB. No Coli coVl00mL SM209222D A (<-I)I 11/10/05 TLF 0411, I yt eb -t (-( - f u to I Sfi$— SGS/CT&E ENVIRONMENTAL SERVICES Drinking' Water Analysis Report for Total Coliform Bacteria . READ INSTRUCTIONS ON REVERSE WE BEFORE COLLECTNo &mwM MUST BE COMPLETED BY WATER SUPPLIER ❑ Kwx wATER aYarEm we' ($'PRIVATE WATER iYa1O1 $..mR.nr. a S«wr.ob. r Irl •... M15.2" Thr Y./ i. D.� Dcc 1 S 2005 a.. m. r.. E3 a.M RrweN SAMPLE TYPE: 200 W. POTTER DRIVE - ANCHORAGE. ALASK119951S Tat 507-582-2343 Fax 907-5813301 0 Routh*- 0 Treated Water 2 0 AAS -npm 13 Repeat Sernple . . 0 Ur&,041w wow y (refer to lab no. t �1^ r 0 Speolai Purpose Tnnpary M W K Larne as Cokclor TO BE COMPLETED BY LABORATORY SemWe RaeeMnB• . Temp: gym' MsdwcL- Received Sr. ❑ 5in * ow 3o hou. oit ❑ RUSH SAMPLE R.ai. may be u..1.tle Pham #-' .............................................................................................................................................. BecterloloDkel Water .,-u..�. e.W.. F067:1 MYO•YUO �/A) REaUITa: � FBKToa Coalmt 7 Ar -allow 7lf E. COt Flbr MMo-MUO (P/A) MEMBRANE FLTER RESULTS: Dber Coot. vwoseac 6.ri1 b CYi Rwrrd ❑ Famed ❑ cmarnoam. .� rsmw war 6(—satisfactory '17 Unsatiafac6ty — Reported By: / Date/Tk m: /�-�/ 9 /. /J -",T0 o � ror vA Rias.Yre.01VWK Crann.bw�,a�txrc7afNnrnausw.r..wena c,�..., ».m..�. FOrm S FW -0063 12/17M °.VOIV •Y1ML RYGR :� afR•GT RJt .Abq C1eMt RLM e11RtAq R1eM1 9 30' S B9� S8.3S"E 2 99.85' /-0' a r/L, rjm - Y h 4,Y WEa 4 J 24°- 01 E1YsriN ' vause � '; p In ,', •.'T M ° 0 28_8 T'1 O C/li✓r � GO .04 O ,O ..Q . Mf d h 24 B SURVEY CERnFICAIION Prepared by PLOT PLAN .,�mllgm►,arp,J, �o-��........ Robert E. Johns, Jr & Assoc. Yr M eww M YeOY I,wq, ay .y{ 1 ""�"° "° ""'°" """'"' L•w AUH .� ,•• •.• • .• �j _ __ . Professional Land Surveyors . •war.• w w n. w, �"^ •ww•..•n .w �s i�'Aw •�.� .•• ♦♦ 1700 BRINK OR. ANCHORAGE, +iww.�i•i Iw:iri` t• ♦ ALASKA 9950+ Seale: ,1 11 0 501. Rea Lot S.F. Ree Plot File No. FOUNDATION AS -BUILT '.••• t 49 h •..` • ••� r •wtl'r °^ l y 'a «er )/ Date Su rveYOd: 102 r 5— O J Drawn DY REJ CRecRea by. Ar•.ir, w, eA. 01 aw ew +-.�•.•�...•..+—.•...� ww .• » ww.•w.�w aow w•a aew wA..r --t ROBERT OHMS• ••�• ..I • -i' ♦ :. ,.; '' 'i Dote D'am: — —OS wm: 2636 w.o. , ° 121,-, 5363 FINAL smucnlRE As-euttr L R+w1 c AwA a. •wa•Y •nelr W11 '♦ . - : - + ♦. pan C•.,,.: i _.._ i. - _- ••,.•'..9pO AP Legal Deaar'rylian: a'�"-r..'«ww,.".a-e' e'•u.� ,�f� p�oh$.bnd °����• LOT 24A :.�..�.C.�......ww.r � Wagers Subdivision ❑ LOT SURVEY SURVEY TYPE ❑ FOUNDA11011 AS -BUILT SYMBOLS ❑ rwAL sTRuCI11RE As-Bu1LT • SET RE3AR r= W DRAINAGE ASPHALT ❑ PLOT PLAN ... AS -MAT ... LOT SURY ... TOPOGRAPHY O FOUND REBAR O�>..... WOOD FENCE: .:... CONCR_'TE a_ U . H •gree An - tr r � y ASSUMED ELEV. ��,.�„ MFTAL FFNCE n PLOT PLANS t LOT SURVEYS NOTE: D DECK IT IS THE RESPONSIBIUTY OF THE BUILDER OR OWNER. PRIOR TO CONSTRUCTION. TO VERIFY PROPOSED BUILDING GRADE RELATIVE I ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE TO FINISHED GRACE AND UMUTY CONNECTIONS AND TO DETERMINE SHOWN. FENCES. WELLS. SEPTIC CLEANOUTS, SIDEwAl1G5, DRIVEWAYS. ETC.. ARE SHOWN IN THEIR APPROXIMATE LOCATION. THE EXISTENCE OF ANY EASEMENTS. COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED ONLY. SNOW MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. SURDIVISION PI AT ALL DBTANnF�S A4' P1c o0 1,mif" UNDER NO CIRCUMSTANCES SHOULD AN AS -BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL UAB!UTY ONLY FOR THE COST OF LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE. THE SURVEY.