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HomeMy WebLinkAboutNEWBY LT 2BNewby Lot 2B #015-081-30 Municipality of Anchorage . Development Services Department Building Safety Division On-Site Water & Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW040192 PID Number: 015-081-30 Name: LARRY WALKER Wastewater System: ❑ New ■ Upgrade Address: cjGROVER DRIVE * ANCHORAGE, AK. 99507 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 346-2674 4 O Deep Trench O Shallow Trench assail O Mound ■ Other* LEGAL DESCRIPTION Soil Rating:*1 0 Total Depth from origingrace: 1.0 MAX GPD/Sq. Ft. Ft. Block: Lot: Subdivision: Depth to pipe bottom from original grade: Grovel depth beneath pipe: — 2B NEWBY SEE DWG. Ft. 0.52 Ft. Township: Range: Section: Fill added above original grade: Gravel length: — — — SEE DWG. Ft. 40 Ft. WELL: [I New [I Upgrade Gravel width: 15 Number of linea: 3 Distance between lines: 5 Ft. Ft. Claesifkation (Private, ABC): Total De Cased T.:(MRWK) Total absorption area: Pipe material: 600 D 3034/ F-810 Ft. Ft. so. Ft. X�S�\�1G Diller.. Data Drilled: Static Water Level; Installer. Data installed: A+ HOME SERVICES 7/19-.21/2004. Ft Eaah,g-Heigh!-Above-Ground:. __...- TANK GPM Ft. Ft. SEPARATION DISTANCES aseptic ❑Holding ■S.T.E.P. ❑Other To Septic Absorption Lift Holding Public/Private Manufacturer. Capacity in gallons: 1500 From Tank Field Station Tank Sewer Linea ANCHORAGE TANK/ORENCO SYSTEMS Well 100'+ 100'+ 100'+ — 25'+ Material: ***STEEL Number of compartments: 2 Surface Water 100'+ 100'+ 100'+ - - LIFT STATION Lot Line 5'+ 10'+ 5'+ — — Size in gallons: 1500/88 Manufacturer. ANCHORAGE TANK ORENCO SYSTEMS Pump on' level at' 'Pump off level at: Nigh water alarm at Foundation 5'+ 10'+ 5'+ — — TIMER 29 TIMER 29" 46"/40" Pump Moke & Madel: Electrical Inspections performed by: Curtain Drain NO KNOWN #20 OSI OS HHF M.O.A. Remarks: *THIS IS AN ADVANTEX TREATMENT SYSTEM BENCH MARK Location and Deeeription: **2' OF M.O.A. APPROVED SAND FILTER ADDED GARAGE BACK DOOR THRESHOLD ***3/16" POLY—COATED STEEL.(RATED FOR DEEP BURIAL). Assumed ElevaDon: 97.50 Ft. ENGINEER'S SEAL QQ� Inspections performed by: GEG, Ltd. Dates: 1st 7/19/2004 Qom: 0 4 .:...... ...........:... 2nd 7/20/2004 PD 3rd 7/21/2004 ness:' P of e O E-7953 oQ Opts Development Servi es Depart tApproval CoQ Reviewed by: Date: Qv' 0'O 4 04o 'rofessio'oo� and approved 00�00�00 (Rev. 12/01) PERMIT NUMBER: SW040192 \ I AS—BUILT DRAWING A B FCO 59.06 28.48 ST1 60.68 31.56 MH1 62.80 37.49 MH2 64.03. 41.27 MT1 111.26 126.92 MT2 119.35 140.51 M13 153.67 159.37 MT4 148.25 147.02 100' WELL RADIUS EXISTING DRAINFIELDS \ TO BE USED AS RESERVE SITE \ NEW 1500 GALLON�.- AOVANTEX W/ PUMP VAULT. — — INSTALL BALL VALVES INSIDE VAULT., PARCEL ID NUMBER: 015-081-30 \ I �I E NEW DRAINFIELD–\ - - - - MH1 1. MH2 ,MT4 NOTE: THE EXISTING SEPTIC TANK WAS COMPLETELY ABANDONED PER U.P.C. / �n SHED / x w i / rIm \ a.. A / I RADIUS \ / t00� WELL EXISTING WELL 1 I A I RAJ,' xy, VAI L: 7/29/2004 '`�! • O ;7S14p DRAWN BY: GAR NESS ENGINEERING GROUP, Lia: R.A.L. Q� oQ 0 SCALE ll o 50 . . CONSULTANTS & GENERAL CONTRACTORS 3701 E. TUDOR ROAD, SUITE 101 ` ANCHORAGE, AN 99507 • PHONE (907)337-6179' FAX (907)338-3246 Q it ; .. T • • .. • • .*. DO O Q PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ..... O LARRY WALKER 907 346-2674 2 OF 3.... '.•J ffr y Ga ess: 7953 ' k LEGAL DESCRIPTION: NEWBY SUBDIVISION; LOT 28, 4�4oC p�ofesso�oo� TYPE OF WORK: AS—BUILT OF SEPTIC SYSTEM UPGRADE DOpOOoopo PERMIT NUMBER: �........ p* 4 S°0 PARCEL ID NUMBER: SW040192 AS—BUILT –DRAWING 015-081-30 3 OF 3 �O effr y A. Gar C —7953 0� s TOP OF MANHOLE FINAL GRADE = 100.06 � TOP OF ADVANTEX POD = 100.16 = 101.20. TOP OF MANHOLE = 100.22 TOP OF TANK I I I. LU SIV I! 1I TOP 9F� TANK 9F TA Y INVERT OF PIPE1500 GALLON STEEL = 90.25 ADVANTEX ' TANK FINAL GRADE MT = 102.52-103.18 MT �._ /-2" INSULATION _... _.. _. r FILTER FABRIC TO DRAIN FIELD ORENCO PUMP VAULT -ORIGINAL GRADE ® HIGHEST POINT � = 98.84 2 OF M.O.A. ': APPROVED SAND FILTER 5' WIDE RELATIVE GROUNDWATER TOP OF SAND FILTER INVERT OF DISTRIBUTION LINE _ LEVEL ® 95.84 = 99.84 (AVG.) 100.36 (AVG.) THE DISTRIBUTION LINE ARE 1.25 INCH PVC WITH 1/8 BOTTOM OF BEDINCH HOLES SPACED 24 INCHES ON 7197.84 (AVG.) CENTER. (18 HOLES PER LATERAL/54 HOLES TOTAL. DATE: 7 GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS 3701 E. TUDOR ROAD, SUITE 101 - ANCHORAGE, AK 99504 • PHONE (907)337-6179 - FAX (907)338-3246 PREPARED FOR: PHONE NUMBER: LARRY WALKER (907) 346-2674 LEGAL DESCRIPTION: NEWBY SUBIDIVISION; LOT 2B TYPE OF WORK: PROFILE AS—BUILT DRAWING OF SEPTIC SYSTEM UPGR I BY: R.A.L. �........ p* 4 S°0 N.T.S. �........ .. ............... NUMBER: 3 OF 3 �O effr y A. Gar C —7953 0� s ess.- �mG GROVER DRIVE O 155.63' --------------------- 3snOH ONLLSIX3 L0,M! 4 9,� wl t: n 1.0 OX LX -X- N00'06'18"W 155.38 LOT 1 0 O 00 rn uj D z(n D 00 O Ul) LO b) 00 z z 0-0 W x IO0z m Xff [01 z m< z Z= 0 z t < 0 2 U<0w 0 0 0 -:5 opo dog Pot.0 0 V-S.S (YO° COtlY OCr m0.0 -L .go LF < EE M° y m 820-0 Fzu" .0 Z 0 0 to NQ dU U3� raw 0 Ew -0 ., 3 Z,' 0 �vo c 00 0 0 W -0 Z 0 U) 5: CL M (n C-4 3: WaM 0 < Z C14 0� C9 W co '0 z C.D W I X �'t LL, Z� cc 1 2 a 0 C'4 M LO a (L V 04 1 ,0 .=, OM LO 9< ro o of -#Z,00 =3 . CY, 0 z F= uz U) no < f� UT �< U) LLJ Z M LLF 31 0 U F- U) C) qk 1 t < 0 m C*4 F- 0 —j N00'06'18"W 155.38 LOT 1 0 O 00 rn uj D z(n D 00 O Ul) LO b) 00 z z 0-0 W x IO0z m Xff [01 z m< z Z= 0 z t < 0 2 U<0w 0 0 0 -:5 opo dog Pot.0 0 V-S.S (YO° COtlY OCr m0.0 -L .go LF < EE M° y m 820-0 Fzu" .0 Z 0 0 to NQ dU U3� raw 0 Ew -0 ., 3 Z,' 0 �vo c 00 0 0 W -0 Z 0 U) 5: CL M (n C-4 3: WaM 0 < Z C14 0� C9 W co '0 z C.D W I X �'t LL, Z� cc 1 2 a 0 C'4 M LO a (L V 04 1 ,0 .=, OM LO 9< ro o of -#Z,00 =3 . CY, 0 z F= uz U) no < f� UT �< U) LLJ Z M LLF 31 0 U F- U) C) qk 1 t < 0 MUNICIPALITY OF ANCHORAGE 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 PERMIT Upgrade Permit Number: SW040192 Legal Description: FEWRrtT- Design Engineer: 0855 Garness Engineering Group, LTD Owner Name: Larry Walker Owner Address: 9680 Grover Drive Anchorage , AK 99507- ` j1,1jDq 12 5D -q1)'q1Dq I� Date Issued: Jun 15, 2004 Expiration Date: Jun 15, 2005 ParcelID: 015-081-30 Site Address: 009660 GROVER DR Lot Size: 59090 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: ❑✓ Disposal Field ❑✓ 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 closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: 4Z_151_0 �Z Date: (v [5 0 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. _ ��� !�� 1 - -�> O Permit Number Property owner(s) _ LARRY WALKER Mailing address (1) 9680 GROVER DRIVE Day phone * ANCHORAGE AK 346-2674 Mailing address (2) Zip Code 99507 Legal description (Lot, Block & Sub'd.) LOT 2B. NEWBY SUBDIVISION Legal description (Section, Township & Range) N/A Lot Size Acres q.Ft. Number of Bedrooms 4 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ 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. GARNESS ENGINEERING GROUP, Ltd. (Signatufe of IsFepeFty owner or autheFiped agent) Permit Fees:__! r4 �® V Date of Payment: Vl I Receipt Number: Waiver Date of Payment: Receipt Number: UARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS May 26, 2004 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Proposed Septic Upgrade for Newby Subdivision; Lot 2B, To whom it may concern: The proposed 4 bedroom house is served by a private well and septic system. The existing septic system is in a state of failure and must be upgraded prior to the sale of the house. We are proposing to install a 1500 gallon steel Advantex septic tank, and a bed type drainfield. One test hole was excavated on the property. The drainfield will be designed around the 30 foot radius of this test hole. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that an application rate of 1.0 gallons/day/ft should be used. 2. TRENCH DESIGN: a. Percolation Rate: 60 minutes/inch b. Allowable Application Rate: 2.0 gallons/day/ ft2 c. Proposed Application Rate: 1.0 gallons/day/ft' d. Number of Bedrooms: 4 e. Design Flow: 600 gallons per day f. Minimum Absorption Area: 600 ft' g. Total Depth: 1.0 feet (maximum) h. Effective Depth: 0.5 feet i. Width: 15 feet k. Proposed Length: 40 feet long 1. Effective absorption area = 600 ft' Note: The distribution line is to be 1.25 inch pvc with 1/8 inch holes spaced 24 inches on center. (18 holes per lateral/54 holes total) 3701 E. Tudor Road, Suite 101 *Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: gamessengineering.com 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPHY: As can be seen on the attached topography site plan, the area around the proposed drainfield is relatively flat. In short, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. .E., M.S. NOTE: A site plan drawing, a design drawing, one soil log, and 7 page construction specification letter which are all part ofthe design package for this septic system. 3701 E. Tudor Road, Suite 101 *Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: gamessengineering.com MELD VL�If^� �(U C2 LOT 2, BLOCK 5, 11 it THAYERMOORE S/D " i'o CcsN S"1'TLu G^p�uN I DATE: 5/25/2004 OF _ DRAWN BY: GARNESS ENGINEERING GROUP, Ltd. C.J.G• c .tim -----m .w;n CONSULTANTS & GENBRAL CONTRACTORS a SCALE: r 4 T •.� °�/ GA ....:. .... ii 3701 E. TUDOR ROAD, SUITE 101 •ANCHORAGE. AK' 99507 `PHONE (907)337-6179 • FAX (907)338-3246 l" -- 100' .... .. ......... it �n PREPARED FOR(.� PHONE NUMBER: PAGE NUMBER: LARRY WALKER 346-2674 1 OF 4 V!....:. ... .' """' """"" o�g am ss;' LEGAL DESCRIPTION: G, NEWBY SUBDIVISION; LOT 28 E 795 TYPE OF WORK: 1�1y1je,ea Pio fessiono._-A'�' SITE PLAN FOR PROPOSED SEPTIC SYSTEM UPGRADE +. LOT 1, BLOCK 2, 1 NETTLETON ACRES S/D #3 t LOT 1, BLOCK 1, NETTLETON ACRES S/D #3 I -•-- _..-........___....� / LOT 2A, (:SEPTIC / NEWSY S/D#1 / ARI 100' WELL RA IU I I 1100' WELL RADIUS I 1 Imo_ APPROXIMATE WELL LOCATION EXISTING I (� 1A NETTLETON S/D #1 1\ EPTIC SYSTEM \\ I CSEPTIC AREA # LOT 1, / RPTEIIC NEWBY S/0 \ LOT 18, I NETTLETON S/D #1 pyAD1U5 1\ / I ,DO I i .......... EXISTING PROPOSED SEPTIC SYSTEM UPGRADE 4 BEDROOM I 4� (SEE DESIGN PAGE 2 OF 4) HOUSE 1 GQ• \ I / LOT 2, BLOCK 1, THAYERMOORE S/D BEPTIC lig/ I ARE NEWBY SD/#L ____... ---------------- MELD VL�If^� �(U C2 LOT 2, BLOCK 5, 11 it THAYERMOORE S/D " i'o CcsN S"1'TLu G^p�uN I DATE: 5/25/2004 OF _ DRAWN BY: GARNESS ENGINEERING GROUP, Ltd. C.J.G• c .tim -----m .w;n CONSULTANTS & GENBRAL CONTRACTORS a SCALE: r 4 T •.� °�/ GA ....:. .... ii 3701 E. TUDOR ROAD, SUITE 101 •ANCHORAGE. AK' 99507 `PHONE (907)337-6179 • FAX (907)338-3246 l" -- 100' .... .. ......... it �n PREPARED FOR(.� PHONE NUMBER: PAGE NUMBER: LARRY WALKER 346-2674 1 OF 4 V!....:. ... .' """' """"" o�g am ss;' LEGAL DESCRIPTION: G, NEWBY SUBDIVISION; LOT 28 E 795 TYPE OF WORK: 1�1y1je,ea Pio fessiono._-A'�' SITE PLAN FOR PROPOSED SEPTIC SYSTEM UPGRADE +. � I C 100' WELL RADIUS EXISTING DRAINFIELD TO BE / 1 USED AS A RESERVE SITE PROPOSED DRAINFIELD. EXCAVATE A BED.\ I / THAT IS 1 FOOT DEEP MAXIMUM BY 15 INSTALL DOUBLE FEET WIDE BY 40 FEET LONG. ADD 2 FEET /C/LEANOUTS I / OF M.O.A. APPROVED SAND FILTER THEN ADD 0.5 FEET OF CLEAN, WASHED SEWER \ INSTALL FLOW DIV ERTER I/ DRAINROCK. THE DISTRIBUTION LINE IS TO / BE 1.25 INCH PVC WITH 1/8 INCH HOLES EXISTING SEPTIC TANK SPACED 24 INCHES ON CENTER (18 TO BE COMPLETELY / I / HOLES PER LATERAL/54 HOLES TOTAL.) \ ABANDONED / 4"PVD - - TH#1 � I �zgw I EXISTING / / PROPOSED ORENCO SHED 28,+/_ < PUMP VAULT / •' --;;,,,.-,._„ PROPOSED 1500 GALLON STEEL FOINSTALL UNDATION WELL RADIUS \ ADVANTEX TREATMENT TANK 100' I / CLEANOUT EXISTING WELL 130'+/- 77-- ---' NOTE: CONTRACTOR SHALL VERIFY ALL A low SEPERATION DISTANCES TO NEIGHBORING WELLS. \ \ I < DATE: o'6ppp 5/25/2004 0 4 DRAWN 8Y: p 4 v 0 GARNESS ENGINEERING GROUP, Ltd, C.J.G. vo :..4 smnn;cnconx CONSULTANTS & GENERAL CONTRACTORS SCALE' = �.. .... .......0 3701E TUDOR ROAD, SUITE 101 'ANCHORAGE. AK 99507 `PHONE (907)33] 6179 •FAX (907)338-324650' ......... .. . D PREPARED FOR: PHONE NUMBER: PAGE NUMBER: LARRY WALKER (907) 346-2674 2 OF 4... e A Ga e .• 00 .rQ LEGAL DESCRIPTION: Jef NEWBY SUBDIVISION; LOT 213, TYPE OF WORK: 444Pred pra........ 1� DESIGN DRAWING FOR PROPOSED SEPTIC UPGRADE ��4ppfe s 00\ INLET 6" JIM CAP —(TYP.2)� FINAL GRADE - 6" PVC PUMP—OUT (TYP.2) --,, 1500 GALLON STEEL ADVANTEX TANK -ADVANTEX 30 INCH AX20 POD INSULATED RISER -7 GARNESS ENGINEERING GROUP, Ltd. SCAT *=' CONSULTANTS & GENERAL CONTRACTORS 5701.E. TUDOR ROAD, SUITE 101 - ANCHORAGE, AK 99507' PHONE (907)337-6179 • FAX (907)338-3246 PREPARED FOR: PHONE NUMBER: PAGE LARRY WALKER (907) 346-2674 LEGAL DESCRIPTION: NEWBY SUBDIVISION; LOT 2B, TYPE OF WORK: PROFILE DRAWING OF PROPOSED 1500 GALLON ADVANTEX _�Iliil�ll : • ��gIsr,g1'i �N__o0 VAULT EFFLUENT PUMP Is C.J.G. p 4 N.T.S. ....... ... .— . ............. NUMBER: 3 OF 4 ff A. ess:' �Q 9. C —7953 ,},�' o �4 4e � ........ • •' �4cA\�O TANK 4 �� rofess!OT o OOppo� INSTALL BRACING AND STAKING THE DISTRIBUTION LINE IS TO BE 1.25 INCH PVC CENTER 1/8INCH THOLES PER LATERAL/54 HOLES TOTAL.) ----------- --------------------7 I I I FROM ORENCO I PUMP VAULT I -------------------- 40 FEET LONG V DEEP MAXIMUA 0.5 FEET OF Cl WASHED SEWI DRAINROCK GARNESS ENGINEERING GRC}i CONSULTANTS & GENERAL CONTRACTORS 3701 E. TUDOR ROAD, SUITE 101 - ANCHORAGE AK 99507 ` PHONE (907)337-6179 • F, PREPARED FOR: PHONE NUMBER, LARRY WALKER (907) 3, LEGAL DESCRIPTION: NEWBY SUBDIVISION; LOT 213, TYPE OF WORK: DETAIL DRAWING OF PROPOSED DRAINFIELD GRADE LATION .TER FABRIC STALL BRACING AND STAKING HE DISTRIBUTION LINE IS TO BE 1.25 INCH PVC w/ 1/8 INCH HOLES SPACED 24 INCHES ON CENTER (18 HOLES PER LATERAL/54 HOLES TOTAL.) 4 ..... eff C —7953 .•.• cA�G 4�n0, pro f essio�°� �� DATE: 5/25/2004 DRAWN BY: F, Ltd. c.J.c. SCALE: (907)338-3246 N.T.S. PAGE NUMBER: 5-2674 4 OF 4 4 ..... eff C —7953 .•.• cA�G 4�n0, pro f essio�°� �� GARNESS ENGIN ,+ CONSULTANTS & IJVIL LUV — rLfCL.VLAllVll IGJII LEGAL DESCRIPTION: NEWSY SUBDIVISION; LOT 2B, PERFORMED FOR: LARRY WALKER DATE: 5/8/2004 DEPTH - ,.,; ORGANICS (feet) — TEST HOLE #71] 1 I � 2 4 5 6 ( i SEEPS_® 3' ML/GM INORGANIC SILTS AND VERY FINE SANDS & GRAVEL MIXTURES SOIL CLASSIFICATIONS 5/11/2004 ORG CL OL MH CH OH GW GM GC SW SP SM SC — 30 6" 5 1/2' — 1/2' 3 4 5 3:45 4:15 4:15 — 30 — 6" _ 5 1 2' 6" — 1/2' — ,®° • °e• 4 6 ' ' ' 30 5 1/2' 7- 8- 10- 11 81011 12- 13- 14- 5— B.O.H. 213145B.O.H. 17- 18— ML 718 ML INORGANIC SILTS & VERY FINE SANDS DEPTH TO GROUNDWATER DATE SEEPS_® 3' 5/8/2004 *DRY TO 16.0' 5/16/2004 5/11/2004 1 2 T �* A'ff y . ar ess.- F 7953 q �O��frofesslot\° i A J 1"=100' DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 5/11/2004 1 2 3:15 3:45 — 30 6" 5 1/2' — 1/2' 3 4 5 3:45 4:15 4:15 — 30 — 6" _ 5 1 2' 6" — 1/2' — 6 4:45 30 5 1/2' ____1/2' A4- 19� PERCOLATION RATE 60 (MINJIN& PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 2.0 FT. AND 2.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: 0 YES ❑ NO SOILS LOGGED BY: CARLA SMITH >= PERCOLATION TEST PERFORMED BY: NICK HEITSTUMAN COMMENTS: *WATER IN BENCH ® 3.0' PERFORMED BY GEG, Ltd. 1, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS KRF MED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 0 LOT 1, BLOCK , NETTLETON ACRES /D #3 LOT 1, BLOCK 1, (t�` \ NETTLETON 3 \! LOT 2A, CSEPTIC NEWBY S/D#1 ARS 10 ' WELL RADIUS 0 i 100' WE RADIUS APPROXIMATE ISTING ITI 1 NETTlETO S/D j)1 WELL LOCATION EP SYS SYSTEM 0 CSEPTIC ARS 71{ CSEPTIC AREA LOT 1, NEWBY S/0 - . _ - .... LOT 1 , NETTLETON S/D 1 , RADIUS 0 W L EXISTING PROPOSED SEPTIC SYSTEM UPGRADE 4 BEDROOM (SEE DESIGN PAGE 2 OF 4) HOUSE T 2, BL K 1 HAYERMO E S S TIC E BY SD/#1 LOT BLO 5, RM00 S/ i A 5 25 004 0 �F �� o D G. �40 • p T '•.� O ; 3701 E. TUDOR ROAD)ITE• ANCHO GE AN 99507 ` PHONE ( 7)337-6179 ` FAX (907)338-3246 EPAGENUM O OQ PREPARED F P NE NUMBER: LAKY WALKER 46-2674 F 4 g, s y C 7953 ev ° AL DESCRIPTION: NEWSY IVISION• TYPE WORK: SITE PLAN R PROPOSED S GRADE o0 L-21-2004 07:58P FROM:A+ HOME SERVICES, IN 907-868-6770 TO:3383246 P:1/1 WREN CORREMONS AREMIDE0 PLEASE CALL FOR MSPECTTON DO NOT RF PE TMS NOTICE Ai JUL-21-2004 WED 07:44PM ID:A+ HOML SEkU1�,ES, Trak- PAGE:1 :ns W Pepe t of 1 INSPEG * N REPORT MUNICIPALTI'Y OF ANCIIORA= : - BUILDING SAFETY DIVISION 4790 SE)UrH HRAGAW StOWT, ANC UORAGE, ALASKA INSPFM. O1W: Voice— (907) 34'3-8300F _ ,' 07J 2/9.7777 INFORMii770N. (907J 3I3.7962 NAW. �G� [ %l PER,NIfNEWDER: ADDRESS, /� DA lam: / IV LOT.- 6 BiOCK.t5 VISION.- fiv' COMMEN79: i)n TYPE OF#z: u3: INSPEC770N. J [ -_.. 'Le 1 1] Nonowm np6cieo obo ncd. © De not cas. I to roiwpwtcd. C�' 6➢W°`�d Conaotion ee omw a a p m cd bcla ❑ W,11 M• nil6'd mvpootion GC.U. 6pprorad (wma:mte bolvw). CUMMBNTS: / SG Rainspwtion7 EE � sJt� 4 -AL-l 4L - �!Gi G✓LSI ,t 5 i. 1 PUPEC7OR: .. , , DATE: .• _, G�'• WREN CORREMONS AREMIDE0 PLEASE CALL FOR MSPECTTON DO NOT RF PE TMS NOTICE Ai JUL-21-2004 WED 07:44PM ID:A+ HOML SEkU1�,ES, Trak- PAGE:1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 87.5 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT - ----® NAME v PHONE .W L. 0�vJC'U\Ce 72� 5-6 1 01 S rI ❑ UPGRADE MAILING ADDRESS _`4-IO4 Ile.\ Place 1thC(\ot�:t �(�s'k�. �drl�'v LEGAL DESCRIPTION If NCw b� LaA— r-L-nf23 LOCATION NO. OF BEDROOMS q mer Well Absorption area DISTANCE TOM 18 2-G Dwelling ,V/Y(5� PERMIT NO. �y V 5��` �— Uy Z Manufacturer Material No, of compartments Liq. capacity in gallons Inside length Width Liquid depth IZ-SD IF HOMEMADE: Well Dwelling PERMIT NO. ®� z DISTANCE TO: z h Manufacturer Material Liquid capacity in gallons �Q WellFoundation I Ll `{ % Nearest lot line -�� PERMIT NO �1 � ` w 3: DISTANCE TO: 1� J a 2No. of lines Langth of each line -2,y Total loped) of lines Trench widths 3 '�' Distance bet eer) nes �� 2 w F _� - 20, _ inches I_ CL Top of rile to finish grade Material beneath rile ��y Total effective absojption area C3 iRehes i w Length Width Depth PERMIT NO. Q b Type of crib Crib diameter Crib depth Total effective absorption area o. w Ln N Well Building foundation Nearest lot line DISTANCE TO: _ Class Depth Driller Distance to lot line PERMIT NO. r w Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO: OTHER PIPE MATERIALS CtVV Iry �L S 0 1 L TEST RATI NG INSTALLER REMARKS IA.T fe-leet Olt C) 1+ :L 4 V. .l fi E r APPROVED - DATE LEGAL C/ f `y`�_�7 TI �2c TIL N 72-013 (Rev. 3/78) PERMIT NO: DATE ISSUED: APPLICANT: ADDRESS: 1-11-1 INK X ILT 1: NovWJ L_��W - 1:11"" 01; INK M 1 -1 tit M wmo M KIS", DEPARTMENT CY lEAI-TH AND ENVIRONMENTAL F lTECTION 825 L STREET, ANCHORAGE, AK 995o� 264~4720 1Z I KAI 10 1: -V FEE Ell FEE tAh FEE 16�. ���....... �FEE: ���" V, 850342 06/21/85 CQNTACT PHON�: LAWRENCE D. WALKER 4101 ALLEN PLACE ��CHORAGE� AK 00508 561-0459 LEGAL DESCRIP: SUBDIVISION: NEW�Y SECTION: 14 TOWNSHIP: 121\1 LOT SIZE: 49000 (SQ.FT" OR ACHES) MAX BEDROOMS: 4 L8T: 2B QLQCK: 0 RANGE: 3W Listed below are the options available to you in designing ymur septic t Ch oInt.ion that ycn.tr site" ..... ���������..... ... ������ T='4 1'."11 0:::;;i:! W-`4][IN DEPTH TO PIPE BOTTOM (FT 6,0 5"0 GRAVEL DEPTH (FT") 0"5 3,0 TOTAL DEPTH (FT`)13 6.5 E.3 GRAVEL WIDTH (F -T. ) 30"0 15.0 GRAVEL LENGTH (1:::'I El 9 58.0 166"0 ** GRAVEL VOLUME (CU.YDS,) 64"5 109^6 TANK SIZE (GALS) 1,�50^0 ** 1,250,0 ** SOIL RATING (SQ"FT"/BR> 290 362 ** GRAVEL LEN8TH > 75 FT. 1: 1-11,-E RUNS (NOT EXCEEDING 75 FT" EACH) ** TANK MUST HAVE AT LUAST m ENTS certi[y that: f,ami1iar with the requirements for on-site sewepg wDd wells aAs seA' �orth by the Munir:ipa1ity bf' Anchorage (MOA) and the State of' Alaska" 2, I will install the system in accordance with all MOA codes and PegVlations, and in compliance with the design criteria of' this permit. 3. I will adhere toa1l MOA and State of Alaska requirements �or the set back distances f'rom any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby .1ot" 4" I that this p8rmit is valid for at maximum of 4 L-,)edrooms �.And any will require an additional permit" IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOABUILDING CODIES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AT -BUIL -TE; WILL NOT BE APPROVED WITHOUT AN ��LECTRICAL INSPECTION REPORT; AND (3> THE ELECTRICAL WORK MUST BE DONF: BY A LICENSED ELECTRICIAN" SIGNE.DDATE: � . _70 �Z~~ ApPLICANT: LAWRE r— ISSUED BY DATE: �// z�) --e ld�� AAA— /�/�'/~~~ / K SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: L. (z :J 1%-Y'/ (/��,E ��l�i DATE PERFORMED: (e I 1411 11 CJ LEGAL DESCRIPTION: Li)fzf_3)._.1 w � �-G�. C I -w—1 1piot EMTSLOPE SITE PLAN Fi� _ _ PfF/V 5V 2-I�IIII f 11111( — 3-11111I 4-1 1111, j SILT`( n -N SAND 6 - Cotii, �4� , ��2�( �(I�TY L�,�UI✓L- t, 7 9 _ 01 M, LA6I t-ff ,2b�,'� ( LI , a C-, A U�%(�. WT TV It FR 10 10 GROUND WATER S 11 ENCOUNTERED? LO 4` P 12- E p IF YES, AT WHAT 11 DEPTH? 13-i lt, p F 14 15 16 17 18 19 20 Sru Corw3in v '.° CC•528.' `='moi, ����°• �` y PERCOLATION RATE �-�, �a (minutes/inch) TEST RUN BETWEEN _LLQ FT AND FT Reading Date Gross Time Net Time Depth to Water Net Drop (0 f to:zl� U 0. v9 0 10.155 10 0, &q d. ()q 10 0. to& 610t, _14!5 /0"% to 0. &4- 0, 0+ //-105 v 0.6,s- 5' 11: 1a- to D&4- 0.0+ %� COMMENTS /f1�3!1Lii�fd'w71_��11laJ►��7i�A1/I►u.�f'J��1IJI�IL"��L��/ti.� ii/.!: �1 �1u1u� -5 V _ 60476M 1 L a. f A 69AUED, PERFORMEDJ DATE: 72-008 (6/79) < C3) __j co Eo- t� < 0 C4 cn Baa (1) 5T. yo V,> CD 0 0 0 0 0 0 0 F4 [L. IL4 0 0 W, rA as ce w w Grl w w w 0 �P_ 5T. yo V,> CD 0 0 0 0 0 0 0 F4 [L. IL4 0 0 W, rA as ce w w Grl w w w 0 �P_ 0 �P_ ePLANS MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water& Wastewater Section - Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-081-30 1. GENERAL INFORMATION Complete legal description Location (site address) Expiration Date: 12— — LO ^/ Newby, Lot 2B 9660 Grover Drive Anchorage, AK 99516 Current property owner(s) Aleutian Housing Authority Day phone (907) 563-2146 Mailing address 520 E 32nd Ave. Anchorage, AK 99503 Real estate agent 2. TYPE OF DWELLING: E Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well F Private Septic Z 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 $ 5-574) Waiver Fee $ Date of Payment g/21l19 Date of Payment Receipt Number Q° 57151 Receipt Number COSA # ®sC M I YU Y 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 siteto verify the information submitted. Name of Firm Forge Engineering Phone 907-522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 8/27/19 6. DSD SIGNATURE _X_ System #1 Approved for 4 bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: 111) ,m" Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory C Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Newby, Lot 2B If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 5/26/85 Total depth 100 ft Cased to 100 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) '24 in. Date of flow test for COSA 8/26/19 Static water level at beginning of test 61 ft. Comments B. TANK DATA Age of tank(s) 15 years Tank type/material Advantex/FAP Measured operating fluid level in septic tank NIA ❑ Standpipes/foundation cleanout per record drawing Date of pumping See maintenance report. D. ABSORPTION FIELD DATA Shallow Bed Which system tested (date installed) 7/21/04 ON ALL standpipes present per record drawing Total measured depth from grade 3 ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced N/A gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 015-081-30 Structure served by this system Well production at time of test 6.5 gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑ Nc ❑ Coliform bacteria is Negative Nitrate 6.59 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Forge Engineering Date of Sample 8/23/19 C. LIFT STATION ❑ Required maintenance completed Age of lift station 15 years Lift station material PVC Comments: Pump vault for Advantex FAP Adequacy test date 8/26/19 Results R/ Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 813 gal New depth 0 in Elapsed time 60 min Final fluid depth 0 in Absorption rate '600 gpd Any rejuvenation treatment (past 12 months) No If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) ❑v Yes Septic Tank/Lift Station on Lot > 100' ft Surface Water > 100' Community Sewer Manhole/Cleanout > 100' Property Line > 5'v0 Q Yes if No ft ❑✓ Yes if No ft Neighboring Tank > 100' 0✓ Yes if No ft Private Sewer/Septic Line > 25' F✓ Yes if No ft Absorption Field on Lot > 100' P-1 Yes if No ft Holding Tank > 100' F/ Yes if No ft Neighboring Absorption Fields > 100' Yes if No ft Water Service Line > 10' Animal Containment > 50' 0 Yes if No ft F� Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' E] Yes if No ft Fv Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑v Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5'v0 Yes Yes if No ft Wells on Adjacent Lots: „✓0 Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100'✓Q Yes if No ft Water Main > 10' 21 Yes if No ft Community Wells > 200'✓Q Yes if No ft Water Service Line > 10' Fv 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' Q✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ✓Q Yes if No ft Wells on Adjacent Lots: Water Main > 10' „✓0 Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' F-71 Yes if No ft Community Wells > 200' p✓ Yes if No ft Surface Water > 100' ✓Q Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION 46�T OF I certify that l have determined through field inspections and review ���'�p *..,..,..,;..,c� of Municipal records that the above systems are in conformance with e p•e " MOA COSA guidelines in effect on this date. # ; 4«« � 9th_ MICHAEL E. ANDERSON d z 'S No. CE -4381 �� eeee 8!27/19 COSA Checklist yellow sheet th—FESS �OFISS�®+'� Nitrate Advisory Certificate of On -Site Systems Approval # OSC191404 Subdivision: Newby Lot 2B R r a A water sample revealed a nitrate concentration of 6.59 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. WINa.MEN INz +z ,tis" `.,5`r "�.;. #k',�R.e.'""'','':°2s''"..,w"'zg?''a?��r`2"'"�n',,',„�,` 6aC1'��n�lo�ra�`�e�A�a"�s��665��*��nr�nv From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. s '` s 4 wa` � � ing �dtlress; U BC�it 15 550 * Anc in a &-1- i 1650 `...%'����.i�,.z.:a MtiNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREENMEN`I', herein the "AGREEMENT" made and entered into as of this Day of of 20 i ' by and between herein the "OI�jNER," and the 14unicipatity 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 folloxvs: I . Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (.AWWTS), described as Advantex Waste Water Treatment System located at (legal description) Newby Lot 2B 2. Maintenance. Repairs and Alterations. (Owner is required to read, understand and initial each section) n i Tluouiahout the term of this Agreement. the Owner shall enter into a service agreement with an AWWTS service and maintenance pro<<ider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). %7> C 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. Y� Owner acknowledges that regular maintenance of an AWII-TS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05118;2018) Page 1 of 3 ;:?�� Owlier aclaiowIedges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. Owner aclaiowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. lkt Owner agrees to grant the Municipality reasonable access to test and inspect the AI WTS. The Municipality will give at least 24-hour notice. 1D i Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. j t� 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. j4 Owner agrees to maintain remote Mnitorinb of the AWWTS as required by the AW'«'TS approval. �. 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. `ontivaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void.. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18!2018) Page 2 of 3 OWNER: By:jQ �/�<c ��=� � —` (signature) Date: 9 (print naive) STATE OF ALASKA ) ss. THIRD JT.IDTCTAI, DISTRICT ) The foregoing instrument was acknowledged before me this _T":d' ay of 20LL_, by \SSA f?oI NOTARY PUBLIC FOR ALASKA = 'h My Conunission expires: {„-2-6 2..2 ^� ;' N�QTgR� MUNICIPALITY: By: signature) Date: (print name) Title: A�gLIG .tip; �+ psi ofi ALP .•'-L - lit It (rev. 05/18/2018) Page 3 of 3 04/11/2019 10:10 5688677E APLUS 339622F a 1111 11 swo III I ROM Rose% r-110id maintenance Annual Inspootion I'Twe Yp,. ar/rraeking f� Steve tic oawn Harris site Addrlas 9660 Grover Drive, Anchorage AK 99507 Fed N A% ottn iD M county Ip SW040192 203058 AX -103847 _y-�-�- Measure sludgelScum Sludge 1 It Compartment Ctnrent _ 2nd Compartment Currant PACE E1 Anchorage,Tank. 907-272--354'3, _. (�parntor 1� pungent Larry Buts E%ceasive Blomat: Brldging�onding: None/Minor ContactPhoeb linspeet/Clean Discharge pump (907) 248-7728 inspect patoor Laet Invpo,alon EtTtJ aNL 1,TU103410 03!0+;!201 Retrieve O&M Info Dalty flow-- FlecirC ratio.— Timer settings: Perform Field Sampiln910bseTV2,tIons NTU (15 NTUa) pH (9-9) Do (2-6) Odor of $ample r-7 Typical Musty L Earthy Moldy Non-typicalr� 7 Sulfide C]cabbage ❑ Decay pity film in PW F� Yes 5"' No roast in tank Dy" 2 No Check COntvOl Panel Recire Amp- Discharge Amps t_f `r Audible and visual alarms OOK ,{ Dial tone (telemetry only) jlYes No Inspect/Clean pump System Inspect Clean Riser/Lid ..................... $plica Sox ................... I FloatCards ................... Floats..... ....: . KZ Pump ............. ..... .. Z B-lotube"• Filter .... _ ....... .. . Biotub? Pump VAUtt .... • , - .. • . Roarcutating Splitter Valve...... . Comments (� Signature Inspinct/Clean AdvanTex Filter Scum �� Current Pnwioua E Previous Cum3nt Imlpect CIC:rn Normal 1� pungent Odor: Normal E%ceasive Blomat: Brldging�onding: None/Minor [i C9ssive linspeet/Clean Discharge pump system inspect Riser/Lid splice Bax Float cords tnspect/Serutce O#kter System Components Inspect Clem Dlainfection EQuiprnent V1/0 Diap LateralsrOnflcaa; i �,e Pod Bottom L,J� iGfi Intake vent 7 7-1 trtspeat Gkon Floats rr pump Inspect Gean eraalLateraworifice5 Observations Additional Services Rendered Replaced uv Ite-nM? {�] Cleaned textile shaets? Replaced/Used other items? parfis Used: W = Warranty, B = wu(nbie (✓ appropriate selection) Final/Safety Inspection i RSV reinstalled / Llda bolted on Manifold mconnectod: flush valves lased � control panel r iact(vated Summa ry/Recommendations n System performing: no further action needed ❑ lank needs Pumping El call for service ❑Other? ���_�. Rata Fax completed form to 1.866-884-7404 I or. O NO co 3AI�lCI �3AOc\JO FA I C14 co O 00 to oi rrl X—X—X 00 ( xe o0 x U) C: -4 M 24.2 V) z 3&0 24.0 EXIS-nNG HOUSE rn 37.2 24,2 0, 02 24.8 0 ------------------ - -------------- 3,,g L,90.O0S C4 3AI�lCI �3AOc\JO FA I C14 co l' Municipality of Anchorage ' Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL w FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-081-30 HAA# (—) �T 0 3_ 1. GENERAL INFORMATION Expiration Date: Complete legal description NEWBY SUBDIVISION: LOT2B 6 Location (site address or directions) 96910 GROVER DRIVE * ANCHORAGE AK. 99507 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address LARRY WALKER Day phone 346-26-74 NEWBY SUBDIVISION; LOT 3B Day phone ED SHELTON w/ PRUDENTIAL VISTA REAL ESTATE Day phone 562-6464 4241 "B" STREET * 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 ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 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 samples. (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. 1 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 Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may Fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Phone 337-6179 Date e o 5 Disapproved. Conditional approval for T bedrooms, with the flowing stipulations: the attached maintenance agreement which shall be returned to this `V� ♦♦ G ON-SITE •♦ office before an unconditional approval is issued. WATERAND WASTEWATER pRnrpAM � O Attachments: �/ ManitenanceA Agreements JJJ�� •• g0 HAA Checklist g J� OIENTSEN� ` Septic System Advisory Supplemental Engineer's Reort Well Flow Advisory Other Original Certificate Date:�� (Rev. 12101) Developm On -Site of Ancnorage p rvices,Department-` Mill4r afety Division Nastewater AKt99519 Program iiorae 6650 . ofi'or ge ak us _,._. ell,lo"g'(Y/N) —U ierly protected (Y/N) YES 24+ YM in. fight (above grounj (q"' _.,. VAC IEW KQ$Uits.�(rassirau� • - , , -, �.. W. A`;a Y v 3rr vt"a e ore_ es ' T New dep#Ft -,.ate: in. Psorpt�on�ate _p.d.wy, sf1Emil&type)rj Cf yes, "givedate „.. ., d to Size in gallons 1500/88 Manhole/Access (Y/N) YES TIMER/ 46"/40" "Pump off' level at 29 in. High water alarm level at in. Cycles tested' NEW Meets alarm & circuit requirements? YES ' ilding foundation 10"+ Water x. xs ".�r.3ata'aR. fear,-m*SL k1.: '.7,, termmed through field`lnspecfions and icords that the above systems are in )A HAA guidelines in effect on this date w a . •^.;. ,ns°t� a w+'" 4 of arn ss.: Q ame JEFFIA.'`GARNESS �Q @ 79 mpO 656 f �o • " • F,�°jd© 4 P,o fesslonogo Date of Payment Ar V\ Receipt Number 05-27-04 03:35PM FROM-CT&E ESI, SGS ENV SERVICES _SG SGS Ref.# 1042855001 Client Name Garness Engineering Group, Ltd. Project Name/# Newby S/D, Lot 20 Client Sample ID Newby S/D, Lot 2B Matrix Drinking Water Sample Remarks: Parameter Results PQL Waters Department Nitrate -N 3.37 0.100 Microbiology Laboratory Total Coliform 0 9075615301 T-540 P.02/03 F-286 All Dates/Times are Alaska Standard Time Printed Date/Time 05/27/2004 8:46 Collected Date/Time 05/242004 13:20 Received Date/Time 0524/2004 14:30 Technical Director Stephegt. Ede Allowable Prep Analysis Units Method Coutaiaer ID Limits Date DateInd mg/L EPA 300.0 B (<=10) 0524/04 JJB col/100mL SM189222B A (<=1) 0524/04 DKC b 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 /a / 8215— 7� 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, 7 lV t3 1 �(�;� n1 (address or directions) Business a/ _ (b) Applicant Name lI-� I��%��� Telephone: Home (V �a �•_ AA.L.:nn — (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder V Buyer Other C] (explain); (d) Lending Institution = W s_6 Telephone A !lfl.r.cc (e) Real Estate Company and Agent Address -- —_ — TIn nhi.nn (f) Mail the HAA to the following address: �1■�1l�iL 2. TYPE OF RESIDE CE Single -Family Multi -Family L7 Other Number of Bedrooms &--- 3. WATER SUPPLY Individual Well Community 17 Public Cl Note: If community well system, mustQiave vtritten confirmation from the State Department of Environmental Conservationo1',%.,Ni'' w` attesting to the legality and status. \ 1 t 4. SEWAGE La#SPOSAL Onsite [ Public L7 Community Cl Holding Tank El Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025(11/84) 5. ENGINEERING FIRM PROVIDhvG INSPECTIONS, TESTS, FILE SEARCH, DHrA 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 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. /- Name of Firm �✓��/�����2,� ��, �� ©� �1Telephone�- Address-/-��—J''ccJ/�- Date xo - 6. DHEP APPRL Approved for7--C)Co/_ bedroc Approved -_—._lam._-- Disa Terms of Conditional Approval fj a C -v `.wry W j o r•..- � c resin 0. CE -5283 "' 9 0FE5SI0 ditional Engineer's Seal Date 1 0 > ( — 2 — - -- 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 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 J_ -- Legal Description: A. WELL DATA 1 14-3(A-) Well Classification �J _ If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) — Date ComPleted lu �z`f -- J —Yieldj%��i•IlD i Total Depth t) Cased to ��0 Depth of Grouting Static Water Level _ o' Pump Set At Casing Height Above Ground Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) Separation Distances from Well: 1 To Septic/Holding Tank on Lot fl On Adjoining Lots To Nearest Edge of Absorption Field o Lot 14-'tL ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/ManholeTo - _ Nearest Sewer Service Line on Lot / Water Sample Collected t1 faNw W01 -66 --re- ; Date 00_ to & e 17-, Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed5'Size 50 No. of Compartments Standpipes (Y/N) —y Air -tight Caps (Y/N) T Foundation Cleanout (Y/N) Depression over Tank (Y/N) IN4 / Date Last Pumped Pumping/Maintenance Contract on File (Y/N) _ AJ ; for N Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well —��� To Building Foundation —� To Property Line 3 To Disposal Field To Water Main/Service Line 6J To Stream, Pond, Lake, or Major Drainage Course Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Type of System Design Date Installed 7 —gs-9� Length of Field Width of Field . Depth of Field' Gravel Bed Thickness Square Feet of Absorption Area 15'69 5r Standpipes Present (Y/N) Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well —14-4-1 Date of Last Adequacy Test To Property Line (57-/ To Building Foundation�_Fd To Existing or Abandoned System on Lot -/'�1,.� On Adjoining Lots To Water Main/Service Line AIIA- T Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course — To Driveway, Parking Area, or Vehicle Storage Area 77-0 —l"' Comments — D. LIFT STATION Date Install Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes — Dimensions Manhole/Access (Y/N) "Pum e a] Vent(Y/N) g Cycles during Adequacy Test. Meets MOA ** Check Pe itted Bedr om Rating Against HAA Request ** I certify th the e verified-, or conformed to all MOA/and HAA guidelines in effect on the date of this inspection. Signed //� Date l Company MOA No. Receipt No. G r' Date of Payment i ti• c c ¢ ` ' " rLngineer's Seal Amount: .1.0-� pit �— (............. a, n n = Brim 1. Corwin � + ;'No. CE -5253 0 Page 2 of 2 72-026 (11/84) -