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HomeMy WebLinkAboutSPRING HILLS ESTATES #1 BLK 1 LT 9Onsite File j � 4f%w ��,`"`""',,a MUNICIPALITY OF ANCHORAGE• ,enc On-Site Water&Wastewater Program moo' �r �r PO Box 196650 4700 Elmore Road �• l Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 httpa/www.muni.org/onsite • 114-11 .„. __ I)cl>,u anent On-Site Wastewater Disposal System Permit Permit Number: OSP171193 Effective Date: 8/8/2017 Work Type: Septic Upgrade Expiration Date: 8/8/2018 Tax Code Number: 01505179000 Site Legal Address: SPRING HILLS ESTATES #1 BLK 1 LT 9 G:2436 Site Mailing Address: 4720 GOLDEN SPRING CIR, Anchorage Owner: ABOOD PATRICK C Lot Size in Sq Ft: 41089 Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 6 This permit is for the construction of: 0 Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: The contractor shall ensure that the burial rating of the STEP tank is suitable for the actual burial depth. Received By: Date: Issued By: 1C-Wtr.2/0_0•, tiTL 0 Date: 7 8 . C2 <06 '1 8 9 1p 77 4 JUL 17 2017 3 MUNICIPALITY OF ANCHORAG • Community Development Department \ // Phone: 907-343-7904 Development Services \ Fax: 907- 343-7997 On-Site Water & Wastewater Program Mayor Dan Sullivan On-Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 015-051-79 Property owner(s) PATRICK ABOOD Day phone 229-0492 Mailing address 4720 GOLDEN SPRING CIRCLE *ANCHORAGE, AK 99507 Site address 4720 GOLDEN SPRING CIRCLE *ANCHORAGE, AK 99507 Legal description (Sub'd, Block& Lot) SPRING HILL ESTATES #1; BLOCK 1, LOT 9 Legal description (Township, Section & Range) Lot Size Sq.Ft. Number of Bedrooms 6 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: ( l that apply) Initial ❑ Single Family (SF) Absorption Field ® (w/wo ADU) Septic Tank ® Upgrade Duplex(D) ❑ Renewal ❑ Holding Tank ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR: WELL TO SEPTIC TANK; PROPOSED DRAINFIELD TO ABANDONED DRAINFIELD; PERK PRE-SOAK; DRAINFIELD TO ACTIVE DRAINFIELD Distance: 50 FEET; 0 FEET; NO PRE-SOAK; 10 FEET I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: 669 Waiver Fees: (2 Date of Payment: 91 lQ `r* Date of Payment: 1-1,0111. Receipt Number: C3575t3Receipt Number: (05� y Permit No. QeP itci:J Waiver No. 05V` 4-( 13 (Rev. 01/11) Quanics GARNESS ENGINEERING GROUP, Ltd CIVIL&ENVIRONMENTAL ENGINEERS - I]ealer July 28T", 2017 Municipality of Anchorage Development Service Department On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic System Upgrade for Spring Hills Estates #1; Block 1, Lot 9 To whom it may concern: The existing 5 bedroom house is served by a private well and septic system. The property is currently served by a holding tank. The owner would like to get off of the holding tank and install a new septic system to serve the home. He also requested that we design the septic system to serve a six (6) bedroom residence. We are proposing to install a CAT II system consisting of a new 2500 gallon STEP tank (with a Quanics control panel), Quanics 1050 Aerocell Pod, and a bed type drainfield_ One testhole was excavated on the property and the drainfield is designed around its 30 foot radius. Comments regarding the design are summarized as follows: 1. SOILS: See the attached 2017 log which show the soil classifications, groundwater monitoring, and the percolation test results. It should be noted that Garness Engineering Soil log shows no groundwater encountered down to 16.5 feet. However, the 1984 Testhole #2 by Earl V. Ausman, P.E. shows groundwater at a depth of 6.5 feet below grade. Additionally, Earl V. Ausman, P.E. T.H.#1 and Leroy C. Reid T.H. shows no groundwater to a depth of 14 and 8.5 feet. Based upon this information as well as Garness Engineering groundwater monitoring, it seems reasonable to believe that the 1984 testhole was influenced by the failed drainfield or the groundwater drainage pattern has changed due to unknown factors. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There is a creek to the south of the proposed septic system. The creek location and 100' offset is shown on the design. 4. TOPOGRAPHY: As can be seen on the attached topography drawing, the average topography around the proposed drainfield is 0-5%. 5. WAIVERS: We are requesting that your department issue a 50 foot variance from the proposed STEP tank, pump vault and trickling filter to the wells on Lots 8 & 9 of Block 1 in Spring Hill Estates #1 . We also requesting a variance 0 feet to the abandoned 3701 East Tudor Road,Suite 101 'Anchorage,Alaska 99507-1259 Phone: (907)337-6179 *Fax: (907)338-3246*Website: www.garnessengineering.coni Page 2 of 2 drainfield on lot 9. Additionally, a 4 hour presoak was not performed (see attached soil log). Justifications for granting these waivers are as follows: • Under the proposed code an Advanced Wastewater Treatment System may be installed up to 50 feet from an existing well. • The proposed tank will have a high water alarm and be remotely monitored. If the tank were to become surcharged, the service provider and homeowner would be notified and corrective action taken. • The area between the wells and the proposed septic tank is vegetated (see attached photo) • The area between the wells and proposed tank is visible, so if effluent were to overflow, it would be recognized by the homeowner and corrective action taken. • It appears that the basement of the house would flood before liquid (in a surcharged tank) could overflow onto the ground surface. • Water samples were pulled on 6/16/17 for Spring Hill Estates #1; Block 1, Lot 8 and nitrates were non-detectable. • The proposed tank will be 3/16" or 10 gauge steel rather than standard 12 gauge steel. • The effluent to the proposed drainfield will be CAT II and the drainfield has a 2 foot sand filter. Before the effluent reaches the abandoned drainfield, it will much greater quality in terms of BOD, TSS, and Fecal Coliform then that of conventional treatment. • The proposed code allows does not require a 4 hour pre-soak if the liquid level in the percolation hole drops more than 0.5" in the first 30 minute reading. • See attached drilling logs for Lots 8 and 9. They appear to be confined aquifers. We are unaware of any adverse impacts this installation or waivers would have on adjacent wells or septic systems. If you have any questions, please contact us at 337- 6179. Thank yon., for your assistance. ' lnc:rely, � r Je rey ness, P.E., M.S. Presid:nt 3701 East Tudor Road,Suite 101 *Anchorage.Alaska 99507-1259 Phone:(907) 337-6179* Fax: (907) 338-3246*Website:www. garnessengineering.com • SPRING HILL ESTATES#1; BLOCK 1,LOT 4 SPRING HILL ESTATES#1; BLOCK 1,LOT 3 �. N / -- 1(k) // / ,' SPRING HILL ESTATES#1; / // Q BLOCK 1,LOT 2 / / Q4 \ N. SCALE: / / vIl / // �� \ \ \ \ \ r'=too' I oo �sjol`S \ / / _GOLDEN SPRUNG ... CLE / I SPRING HILL ESTATES#1; -�- / I BLOCK 1,LOT 1 / \\ \ / SPRING HILL ESTATES#1; BLOCK 1,LOT6 — // '\ / 100'CREEK OFFSET �q WELL RADIUS I \ .\\�,�/ -:::•• \/\ 1,\--......2\,,,___ ...- \ y• • I, \ j 1 \ 1/ 4 1 I - 1 1 I I 100'WELL RADR S 1 / / SPRING HILL ESTATES#1; I I / \7c10.1. j / / BLOCK 1,LOT 7 \\ ; / {/ • \ \ / / / \ \ /\ • \ \\ /// SPRING HILL ESTATES#1; \� \� BLOCK 1,LOT 14A SPRING HILL ESTATES#1;,T_--_ BLOCK 1,LOT 8 ...---- SPRINGB ILLEK 1, TATES#1; S\�OT 10 v�fP 1G C----- SPRING HILL ESTATES#1; 7 SPRING HILL ESTATES#1; BLOCK 1,LOT 12A BLOCK 1,LOT 13 SPRING HILL ESTATES#1; BLOCK 1,LOT 11A 4•• � OFI4 •4 / ' '� 41,`P;•.,.•••••.••4 ••••4 111 ..� �a Oma • I /1 GARNESS ENGINEERING GROUP .Ltd IN �`.' 49 ►• ,,� �.* .: ••.,,. CIVIL&ENVIRONMENTAL ENGINEERS ._• , _,• 0 i 3701 E TUDOR ROAD.SUITE 101•ANCHORAGE,AK 99507'PHONE(907337-6179'FAX(907)138-3246'WEBSITE won+,gamessangineenng cam 0. ��� 10 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: PATRICK ABOOD (907) 229-0492 1 OF 3 1� I J ecy A. me - '' t • LEGAL DESCRIPTION: DRAWN BY: � � •�•'<c§-••� SPRING HILLS ESTATES S/D;#1; BLOCK 1, LOT 9 D.J.G. 111.;0••• •••.if•' tx, .0. TYPE SITE PLAN DATE: 7/12/2017 #AECC884,��liss11114, • / / 1 SIGN CRITERIA: 1 GEG, Ltd. HAS A 7 PAGE SPECIFICATION NUMBER GALLO S PER DAY (GPD)OF BEDROOMS: :900 /LETTER OBTAIN AERTAINS COPY OFOTHE THISDESIGN. \ 1 PERCOLATION RATE/S: 24 MIN/INCH CONTACT GEG. BY PROCEEDING FORWARD PROPOSED APPLICATION RATE: •2.0 WITH THIS INSTALLATION, THE ENGINEER, MINIMUM DRAINFIELD SQ.FT.: 450 FT' WELL DRILLER, CONTRACTOR AND I I SCAT II ADVANCED TREATMENT PROPERTY OWNER AGREE THl�7 THEY 100' WELL RADIUS HAVE READ THESE SPECIFICATIONS AND o AGREE TO ACCEPT THE TERMS AI4D DRAINFIELD DESIGN: CONDITIONS OUTUNED. MAXIMUM DEPTH OF EXCAVATION: 8 FEET / itk) i WIDTH: 12 FEET / / LENGTH: 37.5 FEET MOA APPROVED SAND FILTER: 2 FEET EFFECTIVE: 0.5 FEET SCALE' ACTUAL SQ.FT.: 450 FT' \\ PROPO , BED 1• — 40' \ / NOTE: THE CONTRACTOR 1 APPROXI`, LOCATI SHALL HAVE THE NORTH & of GEG THo / WEST LOT LINES, AND ALL WELL RADII FLAGGED BY A • APPROXIMATE LOCATION OF ___ ABANDONED DRAINFIELD PER REGISTERED LAND SURVEYOR \ WAIVER / M A RECORDS 10 / PRIOR TO CONSTRUCTION. REQUE \\C. \ ss. \I, o- G ��� EXISTING HOLDING ° I •,• CI R � TANK AND LIFT v MT ` STATION TO BE N / DECOMMISSIONED 0 FOOT WAVER I OM UPC ° : V O REQUEST C ° N o • .d 3 FEIiiiii %. 4 . a 11 6\ i VP: '• 100' CREEK SETBACK' DRIVEWAY ' if 1.2 PVC 4 PROPOSED 1050/k PROPOSED 24• DIAMETER / IA AEROCELL PO - ORENCO PUMP VAULT WITH \� ORENCO CONTROL PANEL _ V.SULATED RISER & UD. o N /N. \ / r(70411111.1P.- \ EXISTING FC� \ .-11 ilitt EXISTING/5 \ \ BEDROOM HOME \ LIM O. �/% \ PROPOSED 2500 — 1 I GALLON STEP TANKtk:\ 1111 .-" 1 CONTRACTOR MAY SUBSTITUTE QUANICS SYSTEM / / / \ WITH AN ADVANTEX 6 BEDROOM SYSTEM (3000 ;� / GALLON TANK WITH TWO AX-20 PODS) 100' ELL RADIUS I I ( 1 :Il R I I /, 1 I E.(,fsr / I ,i>� •' 4911' i,‘ •*• GARNESS ENGINEERING GROUP •� , Ltd i *•' • 4 �. • ... ........e....,,'•,�....• CIVIL&ENVIRONMENTAL ENGINEERS , r 3701 C.TUDOR ROAD,SUITE 101 •ANCHORAGE.AK 99607•PHONE(907) 337-6179•FAX( ' 336-3246•WEBSITE:Imo nwrin•corn :411.". �. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: j • •�, r y A. Garness . �0 PATRICK ABOOD (907)229-0492 2 OF 3 •06 . CE 795 LEGAL DESCRIPTION: DRAWN BY: .� •' SPRING HILL ESTATES #1; BLOCK 1, LOT 9 D.J.G. .j 1- 141,44..k.fi TYPE OF WORK: DATE: ♦+44" iTLR'ESS':4 SEPTIC SYSTEM DESIGN UPGRADE 7/17/2017 AECC884-�IIuss*� J I STANDARD TANK CONFI25GURATION TANK NOTES: QUAN 1 CS AEROCELL CAT. I 1 • GEG RECOMMENDS ALL PIPE PENTRATIONS!JOINTS AND RISER CONNECTION ASSOCIATED WITH A TANK THAT WILL BE SUBMERGED DIAMETER LENGTH 206'64" IN GROUNDWATER BE ENCASED IN BENTONITE CHIPS. TOTAL SHELL 3/16' • IF GROUNDWATER IS ENCOUNTERED, THE CONTRACTOR SHALL QUANICS AEROCELL SYSTEM COMPARTMENT A 13T CONTACT THE ENGINEER TO EVALUATE IF THE EXISTING SOIL COVER 0 COMPARTMENTS 69" CATEGORY II CONFIGURATION °O INLET INVERT 57" IS ADEQUATE TO RESIST BUOYANCY FORCES OR IF ADDITIONAL HIGH WATER ALARM 34"(52") BALLASTING WILL BE NECESSARY TO OVERCOME BUOYANCY FORCES. m ON/OFF E FLOAT 24"(42") (5 TO 6 BEDROOM SYSTEMS) O- ... ON/OFF FLOAT 24"(42"1 r--- NOTE: NOTE:FLOAT LEVELS ARE FROM BOTTOM OF PUMP(BI IS FROM BOTTOM OF TANK. QUANICS CUSTOM CONTROL cr o m Q) W O COMPONENTS SUPPLY NOTE: = PANEL WITH SENSAPHONE w EE v m co N AND ACTUATOR CONTROLS o 1 z o 2U_ m 2 1.THE TANK, RISER EXTENSION, AND ADAPTER RING ARE SUPPLIED Q Q w N z 0 . r BY ANCHORAGE TANK. CEEM a a. Oz(V W co a rN. 2.THE INSULATED RISER.LID,PUMP, FLOATS,INTERNAL PIPING, cr = < a a GROMMETS,CONTROL PANEL, AND AEROCELL UNIT ARE SUPPLIED L. a a 0 0 BY GARNESS ENGINEERING,THE ALASKA STATEWIDE DISTRIBUTOR v, FOR QUANICS INC. at 3.ALL OTHER EXTERNAL COMPONENTS SUCH AS PIPING,FITTINGS, QUANICS AEROCELL1050 TREATMENT MODULE N"", WIRING, INSULATION, ETC., SHALL BE SUPPLIED BY THE CONTRACTOR. WITH INTERNAL DIVIDER WALL AND CLEANOUTS in 4"BY 4'WIDE RIGID Moi ELECTRICAL WIRE/S(SUPPLIED BY CONTRACTOR) INSULATION CENTERED SEE INSTALLATION MANUAL FOR SPECIFICATIONS OVER PIPE `� 4"BY 4'WIDE RIGID4"VISUAL PORT �/ 8 24" INSULATED LID .I rl 4"CLEANOUT INSULATION CENTERED g * € SIM/TECH OVER PIPES 70/ �T PRESSURE FILTER W 4 v. „./ Um 4 r • .•. _ e :i ::: x �� 24"RISER-TOP 4 FEET "Tr' ,�� :� W Z INSULATED WITH 2 INCHES 2"DISCHARGE LINE ISI E URETHANE WITH TOPCOAT 1 IW Za 1- 0U :';:::•:•1: 2X4 BUSHING Oe O 2 (SUPPLIED BY GARNESS) — %///////////////. PVC CONDUIT FOR ELECTRICAL ' ■ •:.;///////� -a LLJ 1- .� ~ Z Y } CONNECTIONS(FLOATS& PUMP) ��I��I� ', �111�� r 01 4 U U �a (y9, J TO PUMP VAULT_ , JN m U / ' j; U .7. /i rJW 'k 2 2"OF INSULATION OVER TANK %///////////////////////i 2"DISCHARGE LINE U w IS RECOMMENDED ON ALL ( �1�� + f) H Q INSTALLATION REGARDLESS ( ❑ I �J DRAINFIELD.SEE APPROVED '� : < OF BURIAL DEPTH " 1.25"SUPPLY LINE ENGINEERED DESIGN DRAWING/So U Q WEEP HOLE W LL U J U- V / A' / • 2"RECIRCULATION LINE Z ; oJ 0 i RISER EXTENSION AND ADAPTER RING & aO oY SUPPLIED BY ANCHORAGE TANK 8 �Z L- 0 HIGH WATER FLOAT w o a o 0 (OU as TIMER OVERRIDE FLOAT w ›- <9 _ NOTE:ALL PIPING FROM S.T.E.P TANK TO AEROCELL r **vast ii i 1,444,44 FIRST COMPARTMENT= 1667 GALLONS ( LOW LEVEL CUTOFF FLOAT(ON/OFF) MODULE SHALL BE PLACED ON SUITABLE BEDDING .4 ff OF ,4 (WORKING VOLUME) �/ MATERIAL THAT IS MECHANICALLY COMPACTED. 4,4\\>,......4 _ G +4 2ND COMPARTMENT=833 GALLONS ALL LINES SHALL BE GRADED SO THAT THEY WILL • 71 DRAIN AFTER EACH PUMP CYCLE AND WILL NOT = .jam •.`•.' ♦♦ 2500 GALLON S T.E.P.TANK 6f. s SUPPLIED BY ANCHORAGE TANK RETAIN ANY STANDING WATER. s 491 H i‘ •; RATED FOR BURIAL DEPTH • • ENCOUNTERED IN FIELD NOTE:ALL PRESSURIZED PIPES ARE TO BE GOULDS PE51 M FROM ALASKA PUMP OR -. ` + SCHEDULE 40 PVC UNLESS NOTED OTHERWISE. 0 0 BAFFLE(SEALED) WELDED I • EQUIVALENT(SUPPLIED BY GARNESS ENG.) Jeffrey A. Garness AROUND ENTIRE PERIMETER 1r • �n CE 7953 PUMP PLATFORM ♦♦4•• ••mac . +• ROFESS\C 4 LICENSE ,II\1�t,i�� LICENSE lirli' II'IPIPPPIP"-' ' i_ .1 ills: irf ,"-t- s• c. ''`. . vio i t a 4t GARNESS ENGINEERING GROUP, Ltd �; -• 4:.�.- - • 3701 E.TUDOR ROAD,SUITE 101'ANI I,,.CC E.AKIL 99507•& ENVINE R9071 33/4179'FA%ONMENTAL RONMENTAL11�EN GEASPEERS e � ;w� ,, w SOIL LOG - PERCOLATION TEST I.s�0 • r`y A. ess �a 1.'J, ... CEf 795 ,� jr LEGAL DESCRIPTION: SPRING HILL ESTATES#1; BLOCK 1, LOT 9 I. .4, 0.,R""//a1, i. ,<rI PERFORMED FOR: PATRICK ABOOD DATE: 6/21/2017 w4 tWOFESS\ 4� DEPTH #AECC884 Alt.. 4111. (feet) _ TEST HOLE #1 __= ORG/LOAM 1 — zz • ^•+ SOIL CLASSIFICATIONS SITE PLAN 2 -- .r ` ■ ..I.,.., '!,0GW " ORG 3 ■ • 11111 191 GM CL 4 I . 76W,;%; G C f OL Q�,PP MH ` • SP J CH LO' 5 • • RifilIC SM �i OH (Q 6 — ` •■ � < l't! SC G,z` 7 • DEPTH TO ` • GROUNDWATER DA l E �CiP N • 8 • ` DRY 6/21/2017 • ■ DRY 7/10/2017 SCALE. • 0 1" -100' ■ • • 10 — - • • • DATE READING CLOCK NET TIME WATER LEVEL NET DROP 11 — ■ • TIME (MINUTES) READING (INCHES) • • 6/22/2017 1 2:45 6" 12 — - it • 2 3:15 30 4.75" 1.25' • • 13 — 3 3:15 6" ` 4 3:45 30 4.75" 1.25' • • 14 — • 5 3:45 6" • ■ • 6 4:15 30 4.75' 1.25" 15 — II • 7 4:15 6" - • • . 8 4:45 30 4.75' 1.25' 16 r r 4 t1 oI[. 1; 18 — 19 — PERCOLATION RATE 24 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES TEST RUN BETWEEN 4 FT. AND 5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES U NO SOILS LOGGED BY: DAVID GARNESS PERCOLATION TEST PERFORMED BY: ERIK WIDGER. COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH. PERFORMED BY GEG, Ltd. I,JEFFREY A. GARNESS,CERTIFY THAT THIS WAS PEIiFOR ED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 1//Aril ! } PPIPIPPPIPP- ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND Pk ALuk. 1 THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this Day of A.1.4...E. - of 20197-by and between Pe., fir;C,,kk 0,o Cli herein the "OWNER,"and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as ciu located at(legal description). ( In J- f Es4-- # I l: ) Lel 2. Definitions. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On-Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code (hereinafter, "AMC") 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On-Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations, Installation and Removal of Additional Equipment. Prior to performing any alterations to an AWWTS, the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement,the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense,to pay for any and all: (I)repair(s), (2) maintenance, (3) adjustment(s),(4)replacement costs, and(5) inspection costs. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AWWTS. C. Upon request by the Municipality,the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor,the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. H. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed with, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement, the only authorized representatives of the parties are: + a. Owner: Pa Gk ,A 6600 b. Municipality: Director, Community Development or designated authority C. Any attempt to amend, modify,or change this contract by either an unauthorized representative or unauthorized means shall be void. 1111111 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the aintenance and Repair Agreement. OWNER: / By: / �-- a/ (signature) Date: ` 7 /2 (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT T^ The regoin instrument was acknow edged before me this' day of�� ._S 4-3 20l, by rukrccic. uoc \\,PI I ``` NOTARY LIC FOR ALASKA O •''' % My Commission expires:1- / alp-o )-1 ' A� ��TAgy * * = '/, F OF•PLP . MUNICIPALITY: By: 7 LLL CC4 eVrzeb (signature) Date: 0/2oi 7 pebQec,k arro (/ (print name) Title: Municipality of Anchorage page ? of .~ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Name: ~/~ ~tewater System: d New ~ Upgrade Address: ABSORPTION FIELD LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: Subdivision: ~ [ ~B/~ Ft. Ft. SEPARATION DISTANCES ~ s~.tio ~Ho~i.~ ~ S.T.~.~. To Sepbc Absorption LiSt Holding Public/PrNate Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~. ~ Material: Number of Compartments: Surface Lot Size in gallons; I Manufacturer: "Pump on" level al: I"Pump O~f' level at: I High water alarm Pump Make & Model Electrical Inspections performed by: Curtain Remarks: BENCH MARK Location and Description: /00 fl, Inspections performed by: Dates: 1st Department of Health and Human Services approval ~ ../'% ....... 72-013 IRev 9/91) MOA 25 polarcon;ult alaska, Inc, 1503 West 33rd Avenue · Suite 310 ANCHORAGE, ALASKA 99503 (907) 258-2420 Fax (907) 258-2419 polarconsult alaska, inc. 1503 West 33rd Avenue · Suite 310 ANCHORAGE, ALASKA 99503 (907) 258-2420 Fax (907) 258-2419 CHECKED aY SCALE OF -~ PAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920261 DESIGN ENGINEER:POLARCONSULT OWNER NAME:FDIC OWNER ADDRESS:P. O. BOX 196639 ANCHORAGE, ALASKA 99519 DATE ISSUED: 9/02/92 EXPIRATION DATE: PARCEL ID:01505179 LEGAL DESCRIPTION: SPRING HILLS ESTATES #1 BLK 1 LT 9 LOT SIZE: 41089 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: HOLDING TANK SYSTEM 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 FOLLOWING SPECIAL PROVISIONS. 1 OF 9/02/93 SPECIAL PROVISIONS: 1. PROVIDE CLEANOUT BETWEEN TANK AND LIFT STATION WHICH ALLOWS CLEANINg]IN BOTH/D~CTIONS. 2. OBTAIN ELECTRiCaL IN~CTION/ ON ALARMS IN LIFT STATION DATE: polarconsult alaska, inc. ENGINEERS · SURVEYORS · ENERGY CONSULTANTS DH~-IS, Environmental Services, On-site Services P.O. Box 196650 Anchorage, Alaska 99519 September 16, 1992 Attn: Re: Susan Oswalt Design and Construction Approval for On-site Sewer System at 4720 Golden Springs Circle, Anchorage. Lot 9, Block 1, Spring Hills S/D Dear Susan: In accordance with our recent phone conversations, this letter is to conf'nma that the above named site is unsuitable for the construction of an on-site septic system. As this is the case, we request your approval of the installation of a 2000 gallon holding tank with alarm.. Our proposed location for this tank is shown on the attached diagram. Thank you for the extra effort that you and the department have made to help us resolve this situation. If you have any questions, please give me a call. cc: Robin Stout, FDIC Account Officer RF?r: VED SEP 1 6 1992 Mu~,~,pahty o~ Aachorage Dept, Health & Human Services 1503 WEST 33RD AVENUE · SUITE 310 · ANCHORAGE, ALASKA 99503 PHONE (907) 258-2420 · TELEFAX (907) 258-2419 polarconsult alaska, inc. 1503'West 33rd Avenue · Suite 310 ANCHORAGE, ALASKA 99503 (907) 258-2420 Fax (907) 258-2419 'JOB SHEET NO. OF. CHECKED BY DATE sc^~ PAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT 3ER:SW920261 DESIGN ~EER:POLARCONSULT OWNER NAME OWNER ADDRE~ :P. O. BOX 196639NG CIR ANCHORAGE, ALASKA 99519 DATE ISSUED: 9/02/92 EXPIRATION DATE: PARCEL ID: .79 LEGAL SPRING HILLS ESTATES #1 BLK 1 LT 9 LOT SIZE: 41089 FT.) NUMBER OF BEDROOMS: THIS PERMIT: 4 THIS PERMIT IS FOR TH] DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST CONTRUCTION OF: IN 1. THE ATTACHED APPROVED ,ESIGN. 2. ALL REQUIREMENTS iED IN 15,55 AND 15.65 AND .TATE REGULATIONS (18AAC72) 3. THE FOLLOWING SPECIAL NS. ~IPAL 'TERS SPECIAL PROVISIONS: 1. REMOVE PIPING AND INSTALL SAND AND 2. PROVIDE FILL AND IN 3. TOTAL DEPTH MAY NOT EXCEED 2.5 4. VERIFY INTEGRITY OF EXISTING SYSTEM CONSTRUCTION; REPLACE IF RECEIVED BY: EXISTING TRENCHES; INSTALLING BED. STHOLES. TANK DURING .SARY. DATE: ISSUED BY: 1 OF 9/02/93 1 polarconsult alaska, inc. ENGINEERS ' SURVEYORS · ENERGY CONSULTANTS DHHS, Environmental Services, On-site Services P.O. Box 196650 Anchorage, Alaska 99519 August 14, 1992 Attn: Re: Permit Review Officer Design and Construction Approval for On-site Sewer System at 4720 Golden Springs Circle, Anchorage. Lot 9, Block 1, Spring H/lis S/D Dear Sir or Madam: Please accept the following design for review and permitting. The permitted existing system on the above property has failed due to a high groundwater table. Your department became involved with this property upon being informed that the previous owners were pumping the effluent from the leach field into the nearby drainage ditch. In an effort to resolve this situation, the new owners have retained us to monitor the groundwater levels at the property and design a workable system given the site conditions. Due to the high groundwater level, we propose to build a bed system. It will be necessary to place the bed over the existing trench system because of the limited space for system installation. Discussions with Dan Roth indicate that this approach is acceptable provided that native soils be used to fill the portions of the trench system below the bed. These soils will extend to a depth two feet below the bed and should be compacted to 90%. The purpose of this is to eliminate the flow of effluent to the groundwater via the existing trench. A percolation test will be conducted to verify that the permeability of the compacted soil is less than that of the undisturbed soils but satisfacto~ for the proposed bed design. If this is not the case, the department will be informed of the new conditions and will be asked to approve the appropriate modificadons. 1503 WEST 33RD AVENUE · SUITE 310 · ANCHORAGE, ALASKA 99503 PHONE (907) 258-2420 · TELEFAX (907) 258-2419 polarconsUit Cfiven the difficulties that the site offers for development of an On-site system, we hope that the department can offer some flexibility in leu of the limited area available for system installation and the undesirable alternative of installing a holding tank. If you have any questions, please give me a call. David Ausman, CE cc: Robin Stout, FDIC Account Officer Attachments: On-site Sewer/Well Permit Application Site Plan, Sheet 1 of 4 System Design Calculations and Section, Sheet 2 of 4 Percolation Test, Sheet 3 of 4 Percolation Test, Sheet 4 of 4 polarconsult alaska, inc. 1503'West 33rd Avenue · Suite 3].0 ANCHORAGE, ALASKA 99503 (907) 258-2420 Fax (907) 255-2419 SHEET NO CALCULATED CHECKED BY SCA~E OF DATE '~T--- DATE polarconsult alaska, Inc. 1503 West 33rd Avenue · Suite 310 ANCHORAGE, ALASKA 99503 (907) 258-2420 Fax (907) 258-2419 PERFORMED FOR: LEGAL DESCRIPTION: I 2 3 4 § 6 7 8 9- 10- 11 Municipality of Anchorage 825 "L' Street, Anchorage, Alaska 99502-0650 TE T SOILS LOG -- PERCOLATION S · Township, R.ng~, SLOP~ SITE PLAN 13- 14- 15- 16- 17- 18 19- 20- WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT ~) DEPTH? P Depth to Water After Monitoring;' ~- ~' Date: Gross Net Depth to Net Reading Date Time Time Water Drop '/ ' 5--'1~ /,- z) o -- ~ -- .' Z I: lc) /o ;q'. (~'~, PERCOLATION RATE ~-'~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~/ FT AND ~' FT COMMENTS PERFORMED BY: ~']~Z~,'~[b ~Lb/-~M.~d,"~ i~"'~ .... ~.4~, ~--.CERTIFY THAT THIS TEST WAS PERFORMED IN ACOOROA.CEW,THALLSTATEA..M..,C, ^LG"'D L'"ES'NEEFEOTO"TH'$OAT ' .^TE: 72-008 (Rev. 4~85) PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES LEGAL DESCRIPTION: 3 4 5 6 7 8 9 10 11 13- 14 15 16 17 18 19- 20- WAS GROUND WATER ENCOUNTERED? /'Vx¢;:~' IF YES, AT WHAT DEPTH? Deplh to Water After , ~, _/ M0nitorieg7 /v'o/,~'~ Date:. Township, Range, Section: '77Z~ ~ SLOPE SITE PLAN S L O E Gross Net Depth to Net Reading Date Time Time Water, Drop PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND ~ FT COMMENTS PERFORMED BY: Z~/c~M/~2 ///.~,~.~/~,~' . I ?:~', CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL G UIDELINESIN EFFECT ON THIS CATE. DATE:' SEP 0~ ~9~ 16:30 POL~RCONSULT 35? polarconsult alaska, inc. ENGINEERS · SURVEYORS · ENERGY CONSULTANTS DHHS, Environmental Services, On-site Services P.O. Box 196650 Anchorag¢,Al~ka 99519 Attn: Re: Susan Oswalt Design mM Construction Approval for On-site Sewor System at 4720 Golden Springs Circle, Anchorage. Lot 9, Block I, Spring Hills S/D September 1, 1992 seolAJe8 UeLunH p q;leeH 'ldo0 e§eaoqouv ;o Al! ed.omnyq 866[ £ d35 Dear Susan: In accordance with our recent phone conversations, this letter is to confirm that Polarconsult has monitored the groundwater level on the above referenced site in the months of March, April, and May. Our findings show that the groundwater reached a maximum of 6.5 feet below the surrounding grade. If you have any questions, please give me a call. David Ausman, CE cc: Robin Stout, FDIC Account Officer -Fo ~ /zot~.o~o~-D /37 a~/~-,,o,~a_ 1503 WEST 33RD AVENUE · SUITE 310 * ANCHORAGE, ALASKA 98503 PHONE (907) 258-2420 · TELEFAX (907) 258-24~9 polarconsult alaska, inc. ENGINEERS · SURVEYORS · ENERGY CONSULTANTS DHHS, Environmental Services, On-site Services P.O. Box 196650 Anchorage, Alaska 99519 Attn: Re: Susan Oswalt Design and Construction Approval for On-site Sewer System at 4720 Golden Springs Circle, Anchorage. Lot 9, Block 1, Spring Hills S/D .J~ [ September 1, 1992 RECEIVED BEP 8 1992 Municipality of Anchorage Dept. Health & Human Services Dear Susan: In accordance with our recent phone conversations, this letter is to confirm that Polarconsult has monitored the groundwater level on the above referenced site in the months of March, April, and May. Our findings show that the groundwater reached a maximum of 6.5 feet below the surrounding grade. If you have any questions, please give me a call. David Ausman, CE cc: Robin Stout, FDIC Account Officer 1503 WEST 33RD AVENUE · SUITE 310 · ANCHORAGE, ALASKA 99503 PHONE (907) 258-2420 · TELEFAX (907) 258-2419 i MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ,[~LN EW /V~ AIM ~0~ 8-4'Z- ~ ~2o ? E] UPGRADE MAILING ADDRESS' I'We,I /~ --1 I Absor~tionare~ Dwelling ~ ~0 ~ PERM NO, ~ DISTANCE TO: 21 I iKt  Manufacturer Material No. of compa~ents Liq. capacity in ~allons Inside Jength Width Liquid depth ~, ~ O~ IF HOME'DE: ' ~ Well Dwelling PERMIT NO. O Z ~ Manufacturer Material Liquid capacity in gallons No, of lines ~ Lent of each line Total length of Ii es Trench wid~ ~ Distance between lines ~ ~ Top of tile to finish grade ;1 Material beneath tile __, Total effective abso~on area Length Width Depth PERMIT NO, ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Clas~ ~ · Depth Driller Distance to lot line PERMIT NO, OTHER REMARKS 72-013 fRev. 3/78) / / PERMIT NO: DATF ISSUED: APPLICANT: 'ADDRESS: CONTACT PHONIE: ~ EJI lh,~ ]E I_.. ]lC F" ~b IL... ~ -~" '"'~ E) E=' ,~.~,~ I, .. E~. ,I ~ ~[..} I, .,. ~,.-a ,,~J IE_ DEF'ARTMENT OF HEALTH AND EI,VIRO ....... NTAL PRO1-ECTION. .~:.~ L STREET, ANCHORAGE~ AK 99501 264-'4720 10/05/84 MAIN CORPGRAT ION 4155 TIJDOR CENTRE ANCHORAGE, Al'.'.: 99508 562-4907 LEGAL DF. SCRIP: SUBDIVISION: SPRING HILLS ~1 LGT: 9 ,_,LOC~ .... ~ SECTION: :1.5 TOWNSHIP: 12h! RANGE: 3W LGT SIZE: 41089 (~(;..FT. OR ACRES) MAX BEDROGMS: 3 Lieted below al-e the op{ions available to yau :i.n designlnq yot.u- septic system. Choose ±.he option that best ¢its DEF']]'-I 'TO PIPE BGTTGM (FT.) 4.0 4,, 0 ~. 0 GRAVEL DEPTH (F'T.) 6.0 0.5 3.5 TOTAL DEF'TH (FT.) 10~0 4.5 7,.5 GRAVEL WIDTH (FT. ~ 2.5 27.0 5.0 GRAVEL LENG]]-I (FT.) 108.0 ~. 54.0 140.0 ~-.~ GRAVEl._ VOLUME (CU.YDS.) 65,,0 54,,0 103.8 TANK SIZE (GALS) 1,000.0 .~. 1,000.0 ~..~ 1~000.0 m.~ SOIl_ RATING (SO.FT. /BR) 431 324 43:[ · ~..x- GRAVE[. L£NGTH > 75 FT. REQUIRES MULTIPLE RUNS (NO)' EXCEEDENG 75 FT. EACH) ~'~ TANK MUST' HAVE A'T' LEAST TWO COMPARTMENTS cer't i ~'y that: I am familiar' with the r'equipements for' on-site !_~eweps and wells as set eot'th by the Municipality of AnchoPage (MOA) and the State oi' Alaska. I will install the ~ys'[:.em in ac:coPdance~ witl- ail MGA codes and r, egulations, and in comp]ianc:e with the design cpite~'ia o¢ this pepmit. 3. I will. adhepe to ~].] MOA ~nd State o~ Alaska -'e~ui~'ements ¢o~* Che set back distances Ir'om any existing wel],~ ~.~astewater' disposal system of public 4. I understand tha'L 'Lhis per'mlt is valid Cot a maximum (]{ 3 []8dpoo~s and any en].argemen'~, will require an additional per'~'llt. , ~'."¢ o",- '-' ~ IS ~.O\LF'. ...... BY MOA BUILDING IF A .... F ..,A]].OI~, INSTALLED IN AN AREA n ~ '-',~:r~ * ' -c' THEN (1) AN ELECTRISAL F:'ERMI AND 1,,I~.FE,.TJ. OI4 MUSI- BE L,B,,-,.,.NLD, ,~) A ........ ;.,L.]-S WILL NOT BE APPROVED WITHOUT AN .... E_,T,,,.C,L INSF'ECTION I;:E;F'ORT; AND (3) THE: WGRI.. IdLk.~T B~ ~'ONE B~ ¢.t ~.ICEt,L.,ED ELEGTRICAL " ' ¢: ' ~= ' = " - '' '=: - ~'=''' T AFF t_IL,~NT. MAIN CORF'ORP¢I'ION 'MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 89501 264-4720 SOILS LOG - PERCOLATION TEST ~SOILS LOG LE ALDESDRIPTION:__L 2 5 t 5 6 7 8 9 10 11 WAS GROUND WATER ENCOUNTERED? SL~OPE *~ SITE PLAN I+ E IF YES, AT WHAT DEPTH? 12 13 14 15 16 17 18 20- ~ ~1/~"~ , ~7 (minute~/inch) PERCOLATION RATE TESTRUN BETWEEN ff FTAND ~ FT Reading Date Time Time Water Drop ~.~;~o ~o: ~5 ,5~ , o~ t.~zo ~o; 55 · ~6 ~ ~:o5 ~o~,~ ,5o ,o6 3 h: ~ 3 10 ~ ~z° ~;~5 ,57 PERFORMED BY: ~}t~ t4~,~ CERTIFIED BY; 72-008 (6/79) 84-308 rvl-w DRILLING, Inc. f-"], P.O. Box 10-378 ',' 10300 O~d Seward Highway (907) 349-8535 ANCHORAGE, ALASKA 99511 DRILLING LOG Well Owner lv~IN, DOUG/PP~4IERE CONSTRUCTION Use of Wel~ Location (address of: Township, Range, Section, if known; or distance main road- Lot 9 Block 1 Spring Hills Estates Addition ~'jl - Anchorage Size of casing. 6" Depth of Hole Static water level 141 ft. ~ Screen ( ); Perforated ( 161 feet Cased to l~eet (below) land surface. Finish of well (check one) ). open end x ); Describe screen or perforation-l~ne Well pumping test at 20 gallons per ' of drawdown from static level. Date of completions_October 30~ 1984 (minute) for 1 hours with__ 100% WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness Casing stickup ft. 0 TO 2 2 TO 3 3 TO 6 6 TOt 10 10 TO 29 29 TO 55 55 TO_ 63 63 TO 125 125 TO 151 151 TO 1~ TO- .TO. TO Organics Silty_ gravel Gravel - wet Silty. hardpan Silty. gravel _Silty. sand _Silty. hardpan Grave].] y b~rdp, an ~xnV~ C~,Li&~u Contractor ~C~f/eate No'$. 814 & 973 TO 1--CUSTOMER ALASKA nulRonm nTAL COI]TROL ~nclineerinq ~ (!nuironmenlal Studies $~I~UIC~$~I~? o~ DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION 1200 LUest 33rd Aucnue. Suite B.Anchoreqe. Aloska 99503e[907) 561-50~0 'JAN 1 4 ig85 TO DATE MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Oi'~--[:?,~i?~ HAA# ~/~%~':I - '~ ~,,~',q~l Location (address or directions) (b) Property owner F Mailing Address (c) Lending Institution Mailing Address Telephone: (home) . Business Telephone (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or check here r-i, if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single-Family ~. Number of bedrooms 3. WATER SUPPLY Individual Well ~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site [] Public [] Community [] Holding Tank ~. Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 IRev. 7/88) Page 1 of 2 ~ ,to ~ abgd ')pOM s,Jeau!bua leUO!SSejoJd eql u! sue!ss!we Jo sJOJJa Jo~ elq!guodseJ leu s! gbgJoqouv Jo ,~l!lgd!o! un!Al eq/'panes! s! alea!JRJao e eJoteq e~gp @z,qgue Jo suoqoadsu! lonpuoa leu op SHHO jo sgeXoldtu3 'slUaLUgJ!flbaJ elels pue leJepej u!glJgo/~ls!),ga o~, Jap JO u! suoRn),!lsu! bu!~uel j!eql pug se~uoq Io sJesgqoJnd el ~sglJnoa g se s!ql seep SHHQ eqJ. 'eHSglV to alelS eql u! peJe~sibaJ Jaau~bua iguo!ssaloJd ~uapuadepu! ug ~q a^oqe B qdgJbeJgd u! ua^lb suo!~e~uesaJdeJ eq1 uodn/~lUO peseq paleo!jpeo igAoJddv ~lpoqlnv qlleaH senss] (SHHQ) seo!^Jes UeLUnH pue qllgeH to lueLulJedea ebeJoqouv Io ~!ledio!un~ eq.L leUOR!puoo ¢ leAoJdd'¢ leUO!~lpuoo 1o SL,UJa.J. peAoJddes!a ~ pe^oJddv /~q SLUOOJpeq~ JOt peAoJddv 'IVAOI=Id,4V SHHa '9 IgaS s,Jaeu!eu3 'uo!loedgu! s!q~ to e~gp eq~ uo Joa~l@ u! suo!lelneeJ pue 'seoueu!pJo 'sepoo ele~S pug led!a!unR IIg ql!M eoUe!ldLUoo u! s! uJe~s/~s lesods!p JeleMalSeM Jo/pug ~lddns Je~eM eHs-uo eqi 'uo!loedsu! pug uoRg[~!~saAu! ,~uJ LUOJt pue Sal!t ebgJOqOuv 1o ,~!lgd!o!unw eql LUOJ~ peu!elqo UO!JeLUJOIU! eq~ uo paseq jgql/gpe^ Jeq~Jnj I 'u!aJeq peleo!pu! eJn~anJis lo ed,~l pue suJooJpaq Io Jeq~unu aqi Jot e~gnbape puc IgUOl~ounj 'eJgs s! uJels/,s lesods!p JaleMelSgM Jo/pug ,~lddns JeleM e~!s-uo eq~ ~eql BMOqS leAoJddv ~l!Joqln¥ qlleeH s!qi to uo!leb!~seAu! ,~LU leLJ~,~Jpa^ I 'MOlaq UMOqS e~ep uo!jep!lg^ eql Io se pug oleJeq pax!j~e leas,~uJ ,~q pe!jRjeo sv NOIJ. V~IEIO..-INI ONV v.Lva 'HOidV=lS ':i"114 'B.L$3J. 'SNOI.LO=IdSNI 9NIOIAOMd INEIIJ IDNIM':I3NIIDN=~ 'g Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LO?P, ~.~,<'_y.. ); ."SP~Z~4-. ~AiL~.%'~lParcel I.D, A. WELL DATA Well type /~///,4 ','-E Log present (~N) Total depth /~' / Sanitary seal ~_)N) If A, B, or C, attach ADEC letter. Date completed ADEC water system number /~/3o/,9,4 Driller Cased to /4¢/. I ~ Casing height Wires properly protected (~/N) FROM WELL LOG Date of test /a/~O/64 Static water level /"~1 / Well flow ~O Pump level ~,v/< ~o~ k/ g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot /oo ~-- Absorption field on lot Public sewer main Public sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank /vo.~=- WATER SAMPLE RESULTS: Coliform ~ Nitrate Date of sample: ,"//.~'/~Z Collected by: Other bacteria ~'"~u/d ~u~ ~_~ B. SEPTIC/HOLDING TANK DATA Date installed /////,¢xl/~/~? Tank size /¢'~o ¢"AL/Zo°° (o&~-C0 m par t men ts Cleanouts (Y/N) Y / ¥ Foundation cleanout (Y/N) YE'S Depression (Y/N) High water alarm (Y/N) YE'% Alarm tested (Y/N) Date of pumping ~J F-.~tc,.,,,,4 ~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot IOO .¥ .On adjacent lots To property line 'S.r~ Surface water/drainage 72-026 (Rev. 3/91)Front MOA21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot /O(~ -¢- / On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed ///~ ~A/OT //d' ~.~_ Soil rating System type Length Widt'h~'% Gravel thickness __Total depth Total absorption area ~ Cleanouts present (Y/N) Depression Over field (Y/N) Date of adequacy test Results (pass/fail) ~ for Peroxide treatment (past 12 months) (Y/N) ~'~ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: ~ Well on lot__ __ _On adjacent lots 'P~erty line To building foundation __ To existing or aband~ syst~ lot On adjacent~ lots Cutbank Water main/service I%' Sa rface water Driveway, parking/vehicle stOrage area ~._..~ Curtain drain bedrooms E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA Engineer's Name ~//~ ~/' "~ ~ //~/-/5'''~''/~'~/L/ Date ¢2..~/~ HAA Fee $ l ¢~ 0 o Date of Payment J J' ~/-1L- c~ Receipt Number c~/7~L J' ¢ Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Beck MOA 21 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date t'~--¢'~ ~'- GENERAL INFORMATION (a) Legal Description (include lot, block, .s..ubdiv~si,on, s,e~ township,..[a~ge) t4;t I I /_ 7 [:;I //2 J Location (,a. ddress or directions) (b) Applicant Name )'~-~'~ J~Telepnone: Home Applicant Address ~ Business (c) Applicant is [check one): Lending Institution []; Owner/builder'~L; Buyer []: Other [] (explain); (d) ',Lending Institution Address Telephone (e) Real Estate Company and Agent Address Teleohone (f) Mail the HAA to the following aadress: TYPE OF RESIDENCE Single-Family'~ Multi-Family[] Number of Bedrooms -~ Other WATER SUPPLY ' ' individual Well/~ Community [] Public [] Note: if com munJty well system, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite,~] Public [] Community [] Holding Tank [] ,., Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11/84) Page 1 .of 2 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verity 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 in corn pliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this ~.P~.< Name of Firm . Oat -12- Engineer's Seal DHEP APPROVAL,*' ~. ~, //~ I . Approved,or"Z bedroome by Approved Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 WELL DATA Well Classification MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 · MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION P 9 lg85 Legal Descri ption:,--~/9~,'~l f'.J~/')/1' ~ '"1 ~. ~ ~"/~,,~/ If A, B, C, D.E.C. Approved (Y/N) Well Log Present(~N) Cate Completed ~' '~ ~_'~('/' Yield '~-~ ~-~-~PJ~ / TotalDepth_~___ ,~k~Casedto /~.'~, / Depth of Grouting Jt'~r Static Water Level IL'I Pump Set At Casing Height Above Ground Electrical Wiring in Conduit Sanitary Seal on Casing CN) Depression Around Wellhead (Y,~ Separation Distances from Well: To Septic/Holding Tank on Lot ~./~¢',~_ ~' ; On Adjoining Lots To Nearest Edge of Absorption Field on'Lot /,"~¢)'~' .... On Adioining Lots __/~-2.¢~ To Nearest Public Sewer Line _~ To Nearest Public Sewer Cleanout/Manhole ___/~¢/~/-'~'.. To Nearest Sewer Service Line on Lot Water Sample Collected by ~)t'¢ ~',~',~',~',~',~',~7~ ~,'~'N ;Date wetersamp,eTest.eeu,ts Comments 8. SEPTIC/HOLDING TANK DATA Date Installed Size Standpipes CN) Air-tight Caps ~N) Depression over Tank (YI~ Pu mping/Maintenance Contract on File (Y/~.~J~/'/'~/' Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well _ //--")¢ To Property Line iVrl- To Water Main/Service Line Course No. of Compartments Foundation Clean out~xl) Date Last Pumped ;for ~V]~ Temporary Holding Tank Permit (Y/N) ~,/~"'~ __ To Building Foundation /[/ To Disposal Field /~ / To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed )1- i- (0a ~{ Width of Field /"/ ~ Square Feet of Absorption Area Depression over Field (Y~.~ Results of Last Adequacy Test Separation Distance from Absorption_F,~eld: To Water-Supply Well To Building Foundation Lot ~ Type of System Design Length of Field / / ~' -- Depth of Field /? /%// Gravel Bed Thickness ~ / Standpipes Present, N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots ~,J ~'q- To Water Main/Service Line .~.~ TO Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course To Driveway. Parking Area. or Vehicle Storage Area Comments D. LIFT STATION Tested for Electrical Codes (Y/N) acy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I bav~ ch. cckled, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. 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